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*Lingshu: Shou Yao Gang Rou Chapter*

Huangdi asked Bogao: I have heard that human forms vary in laxity and tension, qi varies in abundance and decline, bones vary in size, muscles vary in firmness and fragility, and skin varies in thickness. How can one determine longevity or premature death based on these characteristics? (This seeks to predict longevity or premature death based on an individual's physical constitution and qi dynamics.)

Bogao replied: When form and qi are mutually balanced, there is longevity; when they are not balanced, there is premature death. ("Ren" means equivalent or balanced. Form houses qi, and qi fills form. With a certain form, there should be corresponding qi; with a certain qi, there should be corresponding form. Therefore, those whose interior and exterior are harmonious live long, while those where one aspect is strong and the other weak, failing to balance each other, die young.) When skin and muscle are mutually supportive, there is longevity; when they are not, there is premature death. (Muscle lies inside the skin, and skin is the exterior of muscle. Firm muscle and tight skin constitute mutual support; fragile muscle and loose skin constitute lack of mutual support. Those with mutual support retain qi effectively and thus live long; those without it lose qi easily and thus die young.) When blood, qi, and meridians surpass the form, there is longevity; when they do not surpass the form, there is premature death. (Blood, qi, and meridians are the internal root; the form is the external branch. When the root surpasses the branches, there is longevity; when the branches surpass the root, there is premature death.)

Huangdi asked: What is meant by the laxity and tension of form?

Bogao answered: When the form is full but the skin is lax, there is longevity; when the form is full but the skin is tense, there is premature death. (When the form is full and the skin is relaxed, the qi and pulses are leisurely, indicating longevity. When the form is full but the skin is tight, the qi and pulses are hurried and constrained, indicating premature death.) When the form is full and the pulse is firm and large, it is favorable; when the form is full but the pulse is small and weak, it indicates qi decline, which is dangerous. (A full form with a large pulse indicates consistency between interior and exterior, hence "favorable." A full form with a weak pulse indicates external excess and internal deficiency, hence "dangerous.") If the form is full but the cheekbones do not protrude, the bones are small; small bones indicate premature death. (In the human body, bone is the ruler, and flesh is the minister. When the ruler prevails over the minister, it is favorable; when the minister prevails over the ruler, it is adverse. The cheekbone is the root of the bone structure. Thus, if the form is full but the cheekbones do not protrude, the bones must be small. Small bones with abundant flesh represent the minister prevailing over the ruler, indicating premature death.) When the form is full, and the large muscles (buttocks) are firm with distinct separations, the flesh is firm, indicating longevity; when the form is full, but the large muscles lack distinct separations and are not firm, the flesh is fragile, indicating premature death. ("Large muscle" refers to the buttock muscles. "Gu" refers to areas where tendons and muscles cluster, being firm and dense. "With separation" means clear fascial lines within the muscle. This passage states that although the form is full, longevity or premature death must be judged by the firmness or fragility of the flesh. The reason for focusing on the large muscles is that they are the representatives of all muscles. Therefore, anyone whose form is full but whose buttocks are emaciated is unlikely to enjoy fortune and longevity. "Gu" is pronounced like "Yun". "Tun" is pronounced like "Tun".) These are the natural laws of life, used to establish form, determine qi, and observe longevity or premature death. One must understand how to establish form and determine qi before facing patients to decide life and death.

Huangdi said: I have heard about longevity and premature death, but I have no method to measure it. ("Duo" is pronounced with the entering tone, meaning to measure.)

Bogao replied: If the facial bone structure (wall base) is low and does not match the width of the facial flesh (ground), death will occur before thirty years of age; if illness is added due to negligence, death will occur before twenty years of age. ("Wall base" refers to the bones around the face. "Ground" refers to the flesh of the face. When the wall base does not reach the ground, it indicates declining bones and excessive flesh, leading to short life. If illness is contracted due to carelessness, death comes even faster, hence before twenty. According to the *Se Colors Chapter*: Ming Tang refers to the nose, Que refers to the area between the eyebrows, Ting refers to the forehead, Fan refers to the sides of the cheeks, and Bi refers to the ear gates. These areas should be square and broad, visible from ten steps away; such individuals live long, reaching at least a hundred years. See detailed discussion in *Pulse and Color Category*, Part 32.)

Huangdi asked: How do the mutual superiority and inferiority of form and qi determine longevity or premature death?

Bogao answered: In healthy individuals, if qi surpasses form, there is longevity. (Human life and death depend on qi; when qi is superior, spirit is complete. Thus, healthy individuals with qi surpassing form are long-lived. Even if the exterior appears full, if the middle qi is insufficient, they are not destined for longevity.) In diseased individuals, if the form and flesh are depleted but qi still surpasses form, death occurs; if form surpasses qi, the condition is critical. (If disease leads to depletion of form and flesh, even if qi temporarily surpasses form, death is inevitable. Qi belongs to Yang, and form belongs to Yin. Yin complements Yang, and form houses qi. If Yin depletes, Yang has no attachment; if form depletes, qi cannot remain alone, hence death is unavoidable. Alternatively, if form and flesh are not yet depleted but primal qi is exhausted, although form may appear to surpass qi, this represents Yin exceeding Yang, and the disease is critical. Note: The main theme of this chapter discusses innate endowment. As discussed in the *Wu Chang Zheng Da Lun* regarding longevity based on the high and low of Yin and Yang, geographical factors also play a role, which must also be understood. See detailed discussion in *Qi Movement Category*, Part 16.)