Here’s repost part four!
When I originally started the Five Taxations series at this point a long time ago, I never got to finishing all five, only getting to the third installment. So, now it’s time for part four! For those who are new subscribers or who missed the last posts, the Five Taxations (五勞) are a list of five damages caused by overuse or overexertion that are found in the Xuan Ming Wu Qi (Wide Promulgation of the Five Qi, Su Wen 23). The first was taxation that involved the Heart, and the second the Lung, and the thirst the Spleen. As is typical with the Neijing the five track along the Five Phases and thus the Five Viscera.
The fourth of the taxations reads, “standing for a long time damages the bones” (久立傷骨), and according to Wang Bing this is taxation that affects the Kidneys. We have little other commentary in modern versions of the Neijing aside from this. For example, my copy of a Translation and Explanation of the Neijing Suwen by the Shanghai Scientific and Technical Publishers simply adds this comment: 过度的站立，可以伤骨 (“being on one’s feet too much can injure the bones”). Not really much of an explanation – just a translation into modern Chinese with not much else to offer readers. This leaves us to ponder this short but interesting line.
Medically we know that standing, especially for longer periods of time, puts increased pressure on the spine and lower extremities (in particular the knees). If people are overweight, this is even more of a potential problem. Prolonged standing thus can cause muscular tension and strain, wear on joints from joint compression, low back pain, foot pain and inflammation, and a host of other issues (click here or here to read more).
But, in terms of Chinese medicine, we need to think more deeply about the symbolic meaning that may be present in the original line from the Su Wen. When I read this line, I first am reminded of the phrase “spring engenders, summer flourishes, autumn harvest and winter stores” (春生，夏長，秋收，冬藏). This association of the four seasons with a specific movement is recorded in several locations in the Neijing, and the idea likely comes out of even earlier literature. For example, in the Yin Shu (引書; Book of Pulling), one of the earliest texts we have from the Dao Yin 導引 traditions, it says, “in spring generate, in summer flourish, in autumn harvest and in winter store – this is the Way of Peng Zu” (春產，夏長，秋收，冬藏，此彭祖之道也). Perhaps sometime soon I can write a blog post about Peng Zu and the deeper meaning in this line! But the important point for now is that these lines are almost identical. This association of the seasons, and thus the five phases, were shared by numerous authors in the formative period of our medicine.
For winter then, we have to ask ourselves what is the meaning of “store.” Storage means a time of quietude, and a time of moving inwards. In the symbolism of the Twelve Branches, the utmost of storage is Zi 子. This branch represents the time of midnight, and in the course of the year represents the 12th solar month and the time of the Winter Solstice, in Chinese literally the zenith of Winter (冬至). The definition of “store” from the Shuo Wen Jie Zi is “to hide or to conceal” (藏：匿也). Hiding or concealing something is the image of hibernation, or the image of a person going into the most private part of their house – their bedroom. The movement of Winter and storage in my opinion is sleep, as this is the closest humans get to hibernation. For example, in Tung’s acupuncture we place heavy emphasis on having patients move while getting acupuncture. However, when I have patients that have Kidney vacuity patterns I often find letting them sleep while getting acupunctured is best. Why? Because sleeping is the actual movement of Winter, and therefore the Kidney. If we want to help those patients rebuild Kidney, we need to let them sleep and help them rebuild normal sleeping patterns.
Even though prolonged standing is a type of stillness, it is not the same stillness that sleeping or hibernating are. Prolonged standing without any movement can create significant stiffness. This idea reminds me of another important quote, this time from the eighth chapter of the Su Wen. “The Kidneys are the official functioning as operator with force” (腎者，作強之官). This word force (qiáng 強) deserves special attention. On one hand it represents the healthy state of the Kidney and the bones. The bony structure is that which gives the body the scaffolding that holds it up. The spine, as a symbol and extension of the Kidney and bone, needs to be strong and upright, which is why the first point on the Du Mai is called “long and strong” (長強穴). On the other hand, however, this same word represents the diseased state of the Kidney and the bones. An alternate pronunciation of the character 強 is jiàng, and when read this way means stiff or unyielding. This is exactly the diseased state of the Kidney! Cold is the evil associated with Water and thus Kidney, and cold is nothing more than the symbol for a pathological state of being still, stuck and unmoving.
Now we can see that prolonged standing, a stiff sort of stillness, can damage the bones and the Kidney. Taken together with the previous taxation related to the flesh and the Spleen it is a powerful reminder that we must balance rest and activity, but maintain flexibility at the same time. For example, in my lineage of Taijiquan standing post (站樁) is an important practice. In standing post exercises we adopt a specific standing posture and hold it as a type of standing meditation for a period of time. In my own practice I’ll typically stand in that one position for 20-30 minutes without moving. But, standing by itself is never enough. That practice must be balanced by some sort of moving practice. Just as Yin and Yang are intimately linked, so too must be movement and stillness.
For this blog post I’m not going to offer any specific acupuncture points or protocols. My best suggestion is that we encourage patients to engage in a movement practice that simultaneously encourages flexibility and relaxation, such as Qigong, Taijiquan, Baguazhang, or anything else similar. And then I’ll offer everyone my secret formula for strengthening the Kidneys – go to sleep!
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