Library

It is heard that spirit and mind (Jingshen) belong to the domain of Heaven, while bones and skeletons (Guhai) belong to the domain of Earth. That which belongs to Heaven is clear and diffuse; that which belongs to Earth is turbid and condensed. Therefore, Yang transforms into Qi (vital energy), and Yin forms into structure. Spirit and mind are Yang, while bones and skeletons are Yin.

Furthermore, bones are the mansion of marrow (Sui), and marrow fills the bones. The manifestation of bone health is observed in the ears, and its governing organ is the Kidney (Shen). The method of diagnosing bones is as follows: when vigorous, it manifests as strong and rigid sinews and bones; when declining, it manifests as a stooped and hunched appearance. If bones are damaged, it manifests as bone萎 (Guwei - bone atrophy/weakness), making it impossible to rise from bed. If bones are extremely depleted, it manifests as loose teeth, making it impossible to stand for long periods. If seen in Bi syndrome (Obstruction syndrome), it manifests as heavy bones difficult to lift; if seen in other diseases, it manifests as limbs extended but unable to flex. If walking involves trembling and shaking, and standing cannot be maintained for long, one knows that the bones are about to become exhausted. If hair lacks luster and moisture, and muscles do not adhere closely to the bones, one knows that the bones have perished first. Regarding the bones of the head, back, waist, and knees, gaining strength leads to life, losing strength leads to death. These are all the external manifestations of bones.

If observing bones allows one to know the disease, as stated in the *Ling Shu* (Spiritual Pivot): The zygomatic bone (Quan gu) is the root of the skeletal system. A large zygoma indicates large bones; a small zygoma indicates small bones. If the body is full but the zygoma does not protrude, the bones are small, and those with small bones will die young. However, if the body is full and the zygoma protrudes, the bones are large, and those with large bones should live long. The *Qian Jin Fang* states: Infants born with an incompletely formed occipital bone (Zhen gu) will die after learning to speak; those with an incompletely formed sacral/coccygeal bone (Kao gu) will die after learning to sit upright; those with incompletely formed palmar bones (Zhang gu) will die after learning to crawl; those with incompletely formed calcaneal bones (Zhong gu) will die after learning to walk; those with incompletely formed patellar bones (Bin gu) will die after learning to stand. Those with four cranial defects preventing normal formation, or those whose entire bodies are soft as if lacking bones, will not enjoy longevity. This is also what is meant by "gaining strength leads to life, losing strength leads to death."

As for the classics stating that the five colors appear in their respective regions, if the bone in the corresponding region is depressed, illness is inevitable. If the color overlaps or attacks the region (Chengxi - pathological interaction of colors), even severe illness may not be fatal. Thus, if the bone region is not depressed, illness can be avoided. If the bone region is depressed and the color shows signs of Chengxi, severe illness becomes critical. This is another method of combining Qi, color, and bone regions for observation. Additionally, great bones being withered and great muscles collapsing are considered death omens, because the Spleen and Kidney qi are severed internally, and flesh and bone dissipate externally. Withering means the skin adheres to the bones; depression of bones means the flesh has completely wasted away.

Regarding innate endowment, bones and skeletons vary. As mentioned in the *Ben Cang* chapter: Red complexion with fine texture indicates a small Heart; coarse texture indicates a large Heart; [missing character] indicates a high Heart; [missing character] small and short/elevated indicates a low Heart; [missing character] long indicates a firm Heart; [missing character] weak/small and thin indicates a fragile Heart; [missing character] straight down without elevation indicates an upright Heart; [missing character] leaning to one side indicates a tilted Heart. White complexion with fine texture indicates a small Lung; coarse texture indicates a large Lung; large shoulders, reversed chest, and depressed throat indicate a high Lung; closed armpits and spread ribs indicate a low Lung; preference for thick shoulders and back indicates a firm Lung; thin shoulders and back indicate a fragile Lung; thick back and chest indicate an upright Lung; slanted and sparse ribs indicate a tilted Lung. Blue/Green complexion with fine texture indicates a small Liver; coarse texture indicates a large Liver; broad chest and reversed ribs indicate a high Liver; closed ribs and rabbit-like protruding ribs indicate a low Liver; good development of chest and ribs indicates a firm Liver; weak chest and ribs indicate a fragile Liver; harmonious relationship between chest and abdomen indicates an upright Liver; slanted and elevated rib bones indicate a tilted Liver. These are the general rules of bones and skeletons. As for the size and quantity of bones, referring to the *Gu Du* (Bone Dimensions) chapter and *Xi Yuan Lu* (Washing Away Wrongful Records) allows one to grasp the essentials. However, this is not urgent for diagnosticians, so it is not recorded in detail.