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*Huangdi Neijing Lingshu: Chapter on the Abnormalities of Wei Qi*

The Yellow Emperor asked Bo Gao, "How can one distinguish between people in terms of fatness and thinness, size, cold and heat, as well as old age, prime, youth, and childhood? (By 'cold and heat,' it refers to the innate constitution being either Yin or Yang.)"

Bo Gao replied, "Those above fifty years of age are considered 'old' (Lao), those above twenty are 'prime' (Zhuang), those above eighteen are 'young' (Shao), and those above six are 'small/children' (Xiao)."

The Yellow Emperor asked, "How does one assess their fatness and thinness?"

Bo Gao said, "People can be categorized into three types: 'Fei' (Fat/Lipid), 'Gao' (Piaf/Adipose), and 'Rou' (Muscle/Flesh). ('Fei' here refers to what is later described as 'Zhi'.)"

The Yellow Emperor asked, "How are these distinguished?"

Bo Gao said, "If the muscles are firm and the skin full, it is 'Fei' (Zhi). If the muscles are not firm and the skin is lax, it is 'Gao'. If the skin and flesh are tightly adhered and inseparable, it is 'Rou'. ('Rou' refers to the accumulation of muscle tissue. This passage describes the differences among tall and sturdy individuals regarding these three types: 'Zhi' is tight and full, hence described later as having firm muscles and a smaller body; 'Gao' is moist and large, hence described later as having soft muscles with hanging abdominal fat; 'Rou' is characterized by solid adherence between skin and flesh with correspondence from top to bottom, hence described later as having a body that appears voluminous.)"

The Yellow Emperor asked, "What about the cold and heat conditions of the body?"

Bo Gao said, "In 'Gao' types, the muscles are soft and moist; if the skin texture is coarse, the body feels cold; if fine, the body feels hot. In 'Zhi' types, the muscles are firm; if the skin texture is fine, the body feels hot; if coarse, the body feels cold. ('Nao' means soft and moist. For Gao types, muscles are soft; for Zhi types, muscles are firm. Regarding temperature, those with coarse textures feel cold, and those with fine textures feel hot. Nao sounds like 'nao'.)"

The Yellow Emperor asked, "What about their fatness, thinness, and size?"

Bo Gao said, "'Gao' types have abundant Qi, with lax and relaxed skin, thus allowing the abdomen to hang down with fat. 'Rou' types have bodies that appear large and voluminous. 'Zhi' types have compact and smaller bodies. ('Zong' means loose and relaxed. 'Yu' means fatty adipose tissue. Since Gao types have hanging abdominal fat while Zhi types are compact, Gao is fatter than Zhi. Rou involves solid connection of skin and flesh, distinct from Zhi and Gao. Zong is pronounced with a falling tone; Yu sounds like 'yu'.)"

The Yellow Emperor asked, "What is the difference in the quantity of Qi and Blood among these three?"

Bo Gao said, "'Gao' types have abundant Qi; those with abundant Qi tend to be hot and can tolerate cold. 'Rou' types have abundant Blood, which fills the form, resulting in a balanced temperament. 'Zhi' types have clear/thin Blood and smooth but scanty Qi, thus they cannot grow large. This distinguishes them from the general population. (Gao types have abundant Qi; Qi belongs to Yang, so their constitution is hot and they tolerate cold. Rou types have abundant Blood; Blood nourishes the form, so the form is filled and the temperament is balanced. Zhi types have thin Blood and scanty smooth Qi, so they cannot become large. Although these three types are all obese and distinct from ordinary people, the Qi and Blood of Zhi types seem inferior to those of Gao and Rou types. My commentary notes: It is commonly believed that fat, fair-skinned people often have Qi deficiency, whereas this text states Gao types have abundant Qi, which seems contradictory. However, based on my observations, lean, dark-skinned people also suffer from Qi deficiency no less than fat, fair-skinned ones; therefore, one should not adhere rigidly to fixed notions.)"

The Yellow Emperor asked, "What characterizes the general population?"

Bo Gao said, "In the general population, the proportions of skin, flesh, lipid, and adipose tissue do not exceed normal limits, nor do Blood and Qi become excessive. Thus, their bodies are neither too small nor too large, but proportionate to themselves. This is called the 'general population' (Zhongren). (By 'general population,' it refers to the majority of ordinary people outside the previous three categories. Their skin, flesh, lipid, adipose tissue, Blood, and Qi each maintain their own characteristics, neither adding up excessively nor lacking, so their body sizes are appropriately proportional.)"

The Yellow Emperor said, "Excellent. How should they be treated?"

Bo Gao said, "One must first distinguish these three body types, clarify the amount of Blood and the clarity/turbidity of Qi, and then regulate them. Treatment will not deviate from standard principles. (Once the three body types are identified and the state of Qi and Blood is understood, whether to tonify or drain can be determined without violating standard therapeutic principles.)"

Therefore, 'Gao-ren' (people of the Gao type) have hanging abdominal fat; 'Rou-ren' (people of the Rou type) appear large both above and below; 'Zhi-ren' (people of the Zhi type) may have fat but cannot appear large. (This reiterates the details previously mentioned.)