The Huangdi Neijing (Yellow Emperor’s Inner Canon) contains numerous references to ‘spirits’ that are said to reside within the body. The term ‘shen-zhi’ means ‘spirit-mind’ and telescopes the five spirits (shen, hun, po, yi, zhi) of early Chinese medical theorising. Shen-zhi theory explains the principles for understanding Chinese medicine’s perspective on human consciousness. The theory describes how each of the wu shen (five spirits) govern certain aspects of mentality and are closely related to sensory faculties, body tissues, visceral systems, and physiological substances according to the wu xing (five phase) framework of correspondence and relationship. Spirit activities thereby provide the human organism with its distinctive array of mental and sensory abilities including intelligence, insight, focused attention and memory. Shen-zhi theory is derived from key sections of the Neijing that define the nature of the wu shen, their physiological activities and relationships. When these resources and relationships are disrupted a variety of common or more serious disorders may result. We discuss some of these, and a number of specific disorders that have a particular connection with the five spirits and shen-zhi theory. Broadly speaking, they are ‘mind’ or ‘mental’ disorders. Analysis of their signs and symptoms illustrates the theory and clarifies its diagnostic relevance for modern clinicians.