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The *Ling Shu: Jue Qi Pian* states: Humans possess Jing (Essence), Qi, Jin (Thin Fluids), Ye (Thick Fluids), Blood, and Mai (Vessels). When Jing is depleted, deafness occurs; when Qi is depleted, vision becomes unclear; when Jin is depleted, the Cou Li (skin pores) open, leading to profuse sweating; when Ye is depleted, joint flexion and extension become difficult, complexion becomes dull, brain marrow diminishes, legs feel weak, and tinnitus frequently occurs; when Blood is depleted, the complexion turns pale, dry and lusterless, and the pulse feels empty. These are their respective signs.

Jing belongs to Yin and can transform into Qi, while Qi belongs to Yang and can generate Jing; this represents the mutual root of Yin and Yang and their mutual generation. Water vaporized by Yang Qi becomes Jin and circulates on the exterior, while water condensed becomes Ye and circulates in the interior. The Middle Jiao receives Qi from food and drink, extracts juices, and transforms them into red Blood. Red is the color of Fire, and Blood is the substance of Water; this is formed by the union of Yin and Yang, thus circulating throughout the body, reaching everywhere in the interior and exterior, meridians, muscles, and Zang-Fu organs. Jing is stored in the Zang organs, Jin moistens the skin, Ye nourishes the sinews and bones, and Blood fills the Mai. These four substances must rely on the transformation, production, and circulation of Yang Qi to be distributed throughout the interior and exterior. Therefore, Qi is the commander of these five substances, yet each has its distinct function. Consequently, when they are depleted, they present different clinical manifestations. Complexion and luster are the splendor of Blood; thus, when Blood is depleted, the complexion is pale and lusterless. The Mai relies on Blood for fullness and on Qi for pulsation; without Blood, although the Mai may beat, it is hollow inside.

In the *Su Wen: Ju Tong Lun*, the Emperor said: "I know that all diseases arise from Qi disorders. Anger causes Qi to rise upward; joy causes Qi to slacken; grief causes Qi to dissipate; fear causes Qi to sink downward; cold causes Qi to contract; heat causes Qi to leak out; shock causes Qi to become chaotic; overexertion causes Qi to be exhausted; and contemplation causes Qi to knot together. Since these nine Qi changes differ, what diseases do they produce?" Qibo replied: "Anger causes Qi to rebel; in severe cases, it leads to vomiting blood and undigested diarrhea, hence Qi rises upward. Joy causes Qi to harmonize and the will to be accessible, allowing Ying and Wei Qi to flow freely, hence Qi slackens. Grief causes the Heart vessel to contract and lung lobes to elevate, blocking the Upper Jiao, preventing Ying and Wei Qi from dispersing, and trapping heat in the center, hence Qi dissipates. Fear causes Essence to retreat; retreatment closes the Upper Jiao; closure causes Qi to return; returning Qi causes distension in the Lower Jiao, hence Qi fails to move. Cold closes the Cou Li, obstructing Qi movement, hence Qi contracts. Heat opens the Cou Li, allowing Ying and Wei Qi to flow, resulting in profuse sweating, hence Qi leaks out. Shock leaves the Heart without support, the Shen (Spirit) without a refuge, and thoughts without stability, hence Qi becomes chaotic. Overexertion causes panting and sweating, with both internal and external Qi escaping outward, hence Qi is exhausted. Contemplation fixes the mind on one object and the Shen on one place, causing Zheng Qi (Upright Qi) to remain stagnant and not move, hence Qi knots together."

This passage discusses how the Nine Qi cause disease. Only Cold and Heat encompass external pathogens, presenting symptoms related to Cou Li and Ying-Wei Qi. The other seven Qi changes stem from internal emotional injuries. Generally, where the Heart directs, Qi follows. Emotions arise from the Heart, and Qi changes with the Heart, leading to injury and disease. Therefore, anger causes Liver Qi to rebel; since the Liver stores Blood, Blood ascends with Qi, causing hematemesis. As the Liver governs free flow, Wood pathogen invading Earth (Spleen/Stomach) causes food indigestion and undigested diarrhea. Joy primarily concerns the Heart, and grief primarily concerns the Lung, so Qi slackening and dissipation differ accordingly. Fear primarily concerns the Kidney; since the Kidney stores Essence, Essence retreats. Retreat implies leakage, as mentioned earlier regarding uncontrollable seminal emission due to fear. Shock agitates the Heart and injures the Liver; since the Heart stores Shen and the Liver stores Hun (Ethereal Soul), the Shen and Hun become unsettled, causing Qi chaos. Overexertion causes internal and external Qi to float and rush outward, leading to exhaustion. The Spleen governs contemplation, but if the Shen fixates on one point, Qi stagnates and knots. Although diseases of the Seven Emotions belong to various Zang organs, they are all governed by the Heart. The Heart is the sovereign official; the body's Qi and Blood are directed by the Heart. Thus, a calm Heart means calm Qi and Blood; emotional agitation injures and exhausts Qi and Blood. Therefore, for diseases caused by the Seven Emotions, one must first regulate the Heart/Mind; otherwise, medication will be ineffective. This chapter should be studied in conjunction with the preceding *Ling Shu: Ben Shen Pian* to thoroughly explore its meaning.