Chapter 12: Preservation and Perishing of the Spirit Qì from Complete Compendium of Zhang Jingyue

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Translated by Allen Tsaur, edited by Michael Brown

November, 2020

The Canon(1) states, “Those who grasp the spirit will prosper, those who lose the spirit will perish.”(2)  Well said! This is the meaning of the spirit, which is the root of life and death; one must not fail to inspect it.(3) 


From the perspective of pulse, it is indispensable for the pulse to have a presence of spirit. The Method of Pulse states, “When force is present within the pulse, it is the presence of spirit.”(4) For what is meant by “force”, it is not speaking about being strong and robust; rather, it is about the force of central harmony.(5)

 

Generally speaking, it is a [pulse that is] forceful but without losing its harmony and moderation; it is a [pulse that is] soft but without losing its force. It is only then that there is the presence of spirit within the pulse. 


If [a pulse] is deficient, such as the forceless [quality] of being faint, weak, deserting and expiring; or if [a pulse] is excessive, such as the forceful [quality] of being string-like, strong, and true visceral;(6) these two [pulses] are both absent of spirit, which is a dangerous sign.


From the perspective of physical signs, when there is vivid brightness in the eyes, a clear and resonant voice, lack of disturbance in spirit and thoughts, no whittling of the flesh, normal respiration and no desertion in defecation and urination, for such a person, even if the pulse may be questionable, there is no need for concern, as the person has a presence of spirit in the physical form.

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When there are dull and confounded eyes, emaciated and weak form, decaying physical body, abnormal rapid panting and incessant diarrhea; or possibly the loss of the major muscles all over the body, picking at bedclothes,(7) incoherent speech without the presence of evil, vision of ghosts in the vacant space without the presence of disease; or suffering from distension and fullness when neither supplementing nor draining [method] can be carried out, suffering from [aversion to] cold and heat [effusion] when neither warming nor cooling [medicinals] can be utilised; or sudden fulminant disease that results in deep confounding, vexation, agitation, clouded [spirit] and inability to recognise people; or sudden collapse with eyes shut, open mouth, limp hands and enuresis; for such a person, even if the pulse may be absent of unfavorable indicators, the person will die without a doubt, as there is no longer the presence of spirit in the physical form.


Furthermore, from the perspective of treatment methods, for the medicinals and food to enter the stomach and prevail over evils, one must depend on the stomach qì to distribute the medicinal effects; it is only then that one can be warmed, induced to vomit and precipitated, in order to expel the evil. When one is overcome by the evil qì, if the stomach qì is exhausted, then even with the administration of a medicinal decoction, the stomach qì will not be able to distribute it; as a result, even if one has the divine elixir, what can one hope to achieve?


Thus, there are those who fail to cool down after consuming cold [medicinals], those who fail to warm up after consuming hot [medicinals], those whose exterior has no response after [attempting to] promote sweating, those whose interior has no response after [attempting to] move the stagnation, those whose vacuity cannot tolerate supplementation, those whose repletion cannot be attacked, those who cannot swallow medicinals or food, and those who vomit upon ingesting [medicinals or food]. For this lack of response after being called and this lack of movement after being dispatched(8), this is due to the complete exhaustion of the visceral qì and original spirit; thus, there is nothing left that can be employed. Regardless of the pulse and signs, these people will die without any doubt.


Although the [discussion regarding] the presence of spirit in the pulse and [physical] signs appears to conclude here, there are still those with critical pulse [indicators] and mild signs, whom one knows can survive; and there are those with mild pulse [indicators] and critical signs, whom one knows will certainly die. For [these people], one considers the signs but disregards the pulse. [Nonetheless], there are also those with critical signs and mild pulse [indicators], whom one knows can survive; and there are those with mild signs and critical pulse [indicators], whom one knows will certainly die. For [these people], one considers the pulse but disregards the signs.


Between choices, at the moment of doubt, there is naturally a sense of profundity and ingenuity. Verily so! Such is the difficulty of explaining the spirit! For those who can understand the urgent and non-urgent [signs] of the spirit, they are certainly the divine ones among physicians.

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  1. i.e. The Yellow Emperor’s Inner Canon. 

  2. Sùwèn Chapter 13.

  3. The title of this chapter and this very line are reminiscent of the beginning line of Sūnzǐ’s Art of War (c. 5th century BCE), “兵者,國之大事,死生之地,存亡之道,不可不察也。War, it is the great matter of the state, the situation of life and death, and the path to preservation or to perishing, one must not fail to inspect it.”

  4. Though we cannot find a work bearing this title, we have located this quote in Táo Jié’ān’s傷寒六書 Six Books of Cold Damage (1445 CE) and 古今醫鑒Mirror of Medicine Ancient and Modern (1576 CE) published by the Imperial Academy of Medicine.

  5. This most likely refers to the stomach qì, as Zhāng Jǐngyuè often mentions about the “central harmony” of the stomach qì. The two are often brought up together throughout his writings.

  6. 真臟脈 True visceral pulse” is defined by the Practical Dictionary of Chinese Medicine as “A pulse indicating that the true qì of one or more of five viscera is bad and exposed; observed in critical stages of disease when the pulse is bereft of stomach [qì], spirit and root.” Refer to Sùwèn Chapter 19, “玉機真藏論 Discourse on the Jade Mechanism and the True [Qì of the] Zàng-Viscera.”

  7. From Shānghán Lùn, lines 111 and 212. The Practical Dictionary defines “尋衣摸牀 picking at bedclothes” as  “an aimless plucking at bedclothes observed in an extreme stage of disease. It occurs notably in extreme yángmíng heat with heat effusion and clouded spirit.”

  8. This is an idiom that depicts the lack of response when an order is given to the subordinates. It is here describing the lack of response when a treatment is carried out.
     

Allen Tsaur

Allen Tsaur lives and practices Chinese Medicine in Maryland, USA. He is the editor for Explanations of Channels and Points (Vol. 1) and translator for the upcoming Complete Compendium of Zhang Jingyue (Vol. 1-3).

Michael Brown

Michael Brown is a scholar-physician living in Brisbane. He practises Chinese medicine, with an emphasis on classical aspects. He is the translator of Explanations of Channels and Points (Vol. 1). He is the editor for the upcoming Complete Compendium of Zhang Jingyue (Vol. 1-3).