The Five Taxations 五勞 Part I

It’s a snow day here in northern New Jersey so I thought I’d spend some time writing about a topic from the Neijing. In the last week or so I’ve been reading for myself the Xuan Ming Wu Qi (Wide Promulgation of the Five Qi, Su Wen 23). One of the concepts at the end of the chapter is “Five Taxations” (五勞), a list of 5 damages caused by overuse or overexertion. Like the rest of the chapter, the Five Taxations closely track Five Phase theory, although a deeper look at these five simple lines makes us ponder interesting theory and complex interrelationships in the body.

The first of the Five Taxations reads, “To observe over a long time harms the blood” (久視傷血). Here the character for observe (shì 視) means to look at, or to watch. It also means vision. In classical Daoist literature it is part of the compound term Nèi Shì (內視) – “Inward Vision,” the practice of internal visualization of body gods or viscera as a meditative practice. What do we use to observe something, or to look at something? The sense organ that looks is the eyes. In Five Phase theory the eyes are the orifice of the Liver and Wood Phase.

Yet, Wang Bing in his commentary says that the first taxation of observing for a long time is the taxation that damages the Heart viscera…

In the Neijing the Heart viscera is associated with the tongue, or sometimes the ears (for example in the Jin Gui Zhen Yan Lun, SW4). The Liver is associated with the eyes, and the Liver also stores blood. Yet, the Yin Yang Ying Xiang Da Lun (SW5) tells us that the Heart generates the blood (心生血). It would seem that Liver and Heart both have a close relationship with blood. So what is the relationship between Liver and Heart?

In terms of Five Phase theory, Wood-Liver is the mother of Fire-Heart. When one of the phases is vacuous the treatment strategy is to supplement the mother (from Nanjing 69: 虛者補其母). Use of the eyes is overtaxing to the Liver and can damage the Liver’s ability to store blood. When the Liver is vacuous it fails to generate Fire-Heart, and leads to vacuity of the Heart. This is even more so when people do the common overuse of looking at screens in the evening before bed, which we clearly know upsets sleep. When sleep is disturbed and we fail to go adequately into the storage phase of the daily cycle, the Yin-blood (rooted both in the Liver and the Heart) cannot be secured or generated. Eventually then both Liver and Heart are harmed.

In Tung’s acupuncture the main Dao Ma group for Liver vacuity and for chronic eye problems is the Upper Three Yellows (Shang San Huang, 上三黃). This point group also has an ability to supplement and nourish the blood. It shouldn’t be a surprise then that in Tung’s original writing he said that the points in this group are associated with the Liver, Kidney and Heart channels. In many ways they mimic the channel connections of San Yin Jiao SP-6, the meeting of the leg Taiyin, Jueyin and Shaoyin. Kidney-Water is the mother of Liver-Wood, and the viscera that stores the Jing-essence, a substance essential to the material production of blood. Liver stores blood, and Heart generates blood. Acupuncture treatment for vacuity detriment of the blood then can include points like the Upper Three Yellows, or the application of moxa at points such as San Yin Jiao SP-6.

But perhaps there is another deeper meaning of, “To observe over a long time harms the blood.” Other definitions for observe (shì 視) are to treat as, to take to be. Also, to look for but not see. When we ‘look but cannot see’ or cannot find, this in many ways describes yearning or desire. Or when we ‘treat as’ or ‘take to be,’ this can be a description of attachment. Both Daoism and Buddhism warn about this subtle form of suffering. The Shang Gu Tian Zhen Lun (SW1) says that, “quiet peacefulness, absolute emptiness, the true Qi follows these states” (恬惔虛无,真氣從之). Zhang Zhicong explains that ‘emptiness’ in this passage means not being confused by items and desires. The same chapter tells us that constant desires damage the Heart. Thus, observing for a long time, or in other words, looking for and desiring for a long time, clearly damages the blood (the material basis of the Shen-Spirit) and by extension the Heart.

What about treating this? Certainly some acupuncture can calm and nourish the Heart. In Tung’s acupuncture we have points such as Zhen Jing 1010.03 (鎮靜穴) or Huo Ying 66.03 (火硬穴), or Dao Ma groups such as the Leg Three Penetrations (Zu San Tong, 足三通). However, the first chapter of the Su Wen tells us the main treatment for this type of Heart detriment when is says, “When essence and spirit are guarded internally, where could a disease come from?” (精神內守,病安從來) Essence is Kidney and Yin, Spirit is Heart and Yang. This line is a reference to contemplative or meditative practices such as Neigong, Zuo Chan, or Japanese practices such as Naikan, practices that all function to revert attention of Heart-mind to the interior rather than to the exterior world around us. While acupuncture and Chinese herbal medicines can be good adjuncts for damage to Heart, the best treatments are those taken from the schools of meditation, or in modern times practices that would for example fall under the heading of Qigong. This is why in Chinese it is said, “Disease of the heart has never been treated with medicine” (心病從來無藥醫), or “Diseases of the heart must be treated in the heart [i.e., not with acupuncture, herbs or drugs]” (心病還用心藥醫).

Note: Neijing translations are from the Unschuld and Tessnow translation (University of California Press, 2011).