Will Yang Qi Deficiency Make You Sick? Does Leaving Sweat on Your Skin Really Cause Acne? — Doctor Ni Haixia on the Sheng Qi Tong Tian Lun of the Huang Di Nei Jing

Patient search terms: what are the symptoms of yang qi deficiency / what is yang qi in Chinese medicine / why do I get acne when I sweat / should I wipe sweat off right away / how to feel the pulse / how to tell deficiency from excess on the pulse / why do bedridden stroke patients get bedsores / sudden blindness with eyes that check out fine / having a stroke right after losing your temper / sweating that will not stop

Corresponding medical names: the Sheng Qi Tong Tian Lun · yang qi · yin-yang pulse diagnosis · the lungs and large intestine are interior-exterior paired · injury from cold, heat, dampness and qi · jian jue (collapse from overwork) · pian ku (one-sided withering) · ying wei (nutritive and defensive) qi and blood · bedsores

Opening: continuing from the last lecture, the yin and yang of pulse diagnosis

The previous lecture finished the growth cycles of the human body. This one opens with Doctor Ni Haixia tying up one loose end — the yin and yang of pulse diagnosis — before entering the third chapter of the Huang Di Nei Jing, the Sheng Qi Tong Tian Lun.

💬 Note from Doctor Ni Haixia: The pulse can also reveal the balance point of yin and yang. The cun pulse is yang — the position of the heart and lungs (the upper jiao); the chi pulse is yin (the lower jiao); the guan pulse is the spleen and stomach, which belong to earth and can receive the five grains. In pulse diagnosis you feel the yin and yang in one touch — the yang pulse is gone, the yin pulse is gone, now you know how to feel for them.

The phenomenon of yin and yang separating:

💬 Note from Doctor Ni Haixia: When the yin pulse is too abundant, the excess yin pushes the yang outward — yang scatters outward and moves upward. Originally it was only nine fen; now it goes more than one cun upward — when it exceeds that, it is called the overflowing pulse (yi mai, too full, spilling over), because the abundant yin is pushing the yang out. When the chi pulse runs more than one cun downward, it is called the inverted pulse (fu mai). The overflowing pulse going up and the inverted pulse going down are both repulsion phenomena in which yin and yang are separated and the normal order is reversed — the two become divided.

Vital qi connects with heaven: human life communicates with the qi of heaven

With pulse diagnosis complete, Doctor Ni Haixia moves to the main subject — the third chapter, Sheng Qi Tong Tian Lun.

💬 Note from Doctor Ni Haixia: The root of human life is yin and yang. The Chinese of old spoke of the “six harmonies” (liu he) — heaven and earth, up and down, left and right, the four directions. All the five organs, six bowels and meridians communicate with the qi of heaven. The concept of Chinese medicine is very simple: human beings and nature are connected, so we must accord with nature. Western medicine does not care about any of this — it only looks at blood test reports. Chinese medicine insists that we must be connected with the natural world — the pathogenic qi that injures people is what decides who lives long and who dies young.

Why it is called “vital qi connects with heaven” — Doctor Ni Haixia explains through the Du Mai (Governor Vessel):

💬 Note from Doctor Ni Haixia: The Du Mai runs down the back along the spine, all the way down to Mingmen (GV4, the Gate of Life). Between Mingmen and Guanyuan (CV4) imagine a line (passing through the small intestine and the kidneys), and from there it turns back and exits along the Ren Mai (Conception Vessel) — whether through the nose or the mouth, it exits through the Ren Mai. So the body’s complete circulation (zhou tian) is this: when you inhale, draw the breath down into the lower abdomen; when you exhale, it comes out from there — which is why the lower abdomen is always vibrating. When heavenly yang enters, it produces heat inside the body (Westerners call it oxygen). The kidney is the root of the prenatal endowment because it communicates with the qi of heaven. Western medicine only thinks of the lungs doing the breathing; it never considers the whole process of descending — so Western medicine only treats the lungs and cannot cure lung disease. You only know the lungs, and you do not manage the other organs.

Yang qi is like the sun in the sky: when yang qi declines, the person’s lifespan is shortened

💬 Note from Doctor Ni Haixia: Yang qi is like the sun in the sky. If yang qi declines, the person’s lifespan is shortened. Heaven should be brightened by the sun — yang qi is what guards the exterior, so the classic says: “Yang qi is to the person as heaven is to the sun; if it loses its proper place, the lifespan is shortened and this shortening is not obvious” (yang qi zhe ruo tian yu ri, shi qi suo ze zhe shou er bu zhang).

Where yang qi comes from — explained starting from the lungs and the large intestine:

💬 Note from Doctor Ni Haixia: At the navel (Shenque, CV8), the front-mu point of the small intestine is Guanyuan (CV4) — passing this barrier, the qi enters the small intestine. The small intestine is full of fire, and the fire of the small intestine comes from the heart — the heart and the small intestine communicate with each other. The heart fire can sink down to the small intestine because the lungs manage it: the lungs act like a bellows, pushing the heat down into the small intestine. The small intestine is extremely hot; the food residue and the fluids enter the large intestine, and when the water meets fire it vaporizes and boils — when you exhale, that is steam. This water then returns from the large intestine back to the lungs — this is where the qi inside the lungs comes from. The lungs govern the skin and body hair, so the fluids inside the skin all over the body come from the lungs; the qi inside the lungs comes from the large intestine; and the water in the fluids of the large intestine comes from the water in food.

The water you drink and the water in food are not the same:

💬 Note from Doctor Ni Haixia: The human body is extremely precise. The moment you drink water, it reaches the stomach and is digested and vaporized — because the stomach sits between the small intestine and the heart and is very hot. But the water in food (vegetables, meat and rice all contain water — without water you could not bite them down) is mixed into the food, so it does not vaporize as quickly; it must be digested in the small intestine and absorbed in the large intestine — so the water in food returns from the large intestine to the lungs, and the yang qi then goes to the surface and guards the exterior.

The four ways yang qi is injured: cold, heat, dampness and qi

The Sheng Qi Tong Tian Lun describes four ways yang qi can be injured, and Doctor Ni Haixia takes them one by one:

💬 Note from Doctor Ni Haixia: In the normal state, yang guards the exterior. The first thing that injures yang is cold (yin yu han) — when the fire of the small intestine is not warm enough, yang qi does not go to the surface and does not guard the exterior; “life becomes startled and the spirit qi floats” (qi ju ru jing, shen qi nai fu), because when yang qi cannot secure the exterior, the spirit qi becomes very restless. The second thing that injures yang is summer heat (yin yu shu, too hot) — the fluids are injured, sweating with panting, and the fluids inside the lungs are insufficient. What appears is a pure heat syndrome, with the disease in the yang ming — the yang ming is the large intestine and the stomach. When the fluids are lost, the stomach and large intestine manifest pure heat. At that point, clear out the dried retained food, and the fluids will return by themselves. This is exactly how Zhang Zhongjing understood the treatment of yang ming syndrome.

The third injury to yang is dampness (yin yu shi):

💬 Note from Doctor Ni Haixia: When dampness is extremely abundant it injures yang qi — yang gathers at the meeting of all the yang, which is the head, so the head feels as if wearing a hat, as if something is bound around it. The patient will come and tell you: “What is wrong with me? It feels like something is tied around my head with a rope.” That is yang qi injured by dampness. Remove the dampness, and the yang qi returns. When dampness injures the sinews, the large sinews shorten and the muscles atrophy — the large sinews are long, and many fine collateral vessels (sun luo) stay inside the muscles; the muscles then wither away.

The fourth injury to yang is from qi (yin yu qi):

💬 Note from Doctor Ni Haixia: Injury to qi produces swelling. The pulse has pulse qi; when qi is injured, the form changes and swells. So when you see a person’s form change and suddenly become bloated — you know his qi has been injured. Some people have the form injured first and then the qi: you bump into something, a lump appears and it hurts, and only a little later it swells — pain first, then swelling — that is the form injured first. Other people swell all over with no impact at all — that is yang qi not moving; we should open the heart yang, let the yang qi disperse, and vaporize the water.

Excessive toil makes yang qi stretch and collapse: work yourself past your limit and you faint

💬 Note from Doctor Ni Haixia: Yang qi itself moves very fast; it never stays in one place — it circulates continuously without interruption. When you overwork, yang qi is consumed too much, and the yang qi that accumulates in the body has no kinetic energy. A cycle is circular; if one segment is injured, the front and the back can no longer connect, and it stagnates — this produces jian jue: fainting, no sweating, and the eyes cannot see.

All five sense organs depend on yang qi:

💬 Note from Doctor Ni Haixia: Our ears can hear, our mouth can taste, our nose can smell, our eyes can see clearly — all of this exists because yang is inside providing the action. When yang is injured and yang qi does not move — the ears cannot hear: we know the kidneys govern the ears, so we tonify the kidney yang. When the eyes suddenly go blind in an instant (not the aging kind like cataracts), and the eye exams all come back fine — yang qi is blocked off inside. Let the yang qi return, and the vision returns.

Great anger severs the form and qi: lose your temper, and you can have a stroke on the spot

💬 Note from Doctor Ni Haixia: Getting angry requires a great deal of energy. At that moment the yang qi rushes upward, all the way up into the head and face — the eyes turn red, the whole face turns red, and at that point fainting can occur. Many people, the moment they lose their temper, have a stroke on the spot, or have a heart attack on the spot. So do not get angry.

When yang qi is insufficient, the sinews are injured:

💬 Note from Doctor Ni Haixia: When yang qi is insufficient, the meridians are injured and the sinews and bones can no longer be controlled — the hands tremble, you cannot control them; you tell them to obey and they will not listen. What is able to command and move the body is the “spirit” (shen), not the “form” (xing) — the hand you see is the form; if you cannot move it, the yang has a problem.

Sweat running on one side (han chu pian ju) leads to one-sided withering (pian ku):

💬 Note from Doctor Ni Haixia: When yang qi is damaged, sweat keeps flowing out and the muscles atrophy. Look at people with muscle-wasting disease — the muscles have all atrophied, and the sweat keeps flowing and will not easily stop — that is the manifestation of yang qi failing to secure the exterior.

Bonus: if you do not wipe your sweat dry, you get skin disease

To close the lecture, Doctor Ni Haixia turns to a very everyday topic — sweat and skin disease:

💬 Note from Doctor Ni Haixia: “Nai sheng cuo fei” — cuo is what we call oil. When you sweat, a lot of oil is left on the skin. Where does the oil come from? It comes from sweat meeting dampness. For example, outside it is drizzling and you are running and sweating; the sweat comes into contact with the dampness outside, and this dampness together with the sweat stays on the surface of the skin, and after a period of time it produces oil. Western medicine talks about filterable viruses and such — but you must remember: when sweat comes out, wipe it dry immediately with a towel. Bring a towel when you exercise; wipe the sweat off right away, do not let it stay on the skin for too long.

When sweat meets cold:

💬 Note from Doctor Ni Haixia: When sweat meets cold qi, the skin produces red rashes and blisters, like pimples, that form pus. For example, some people grow very big pimples on the buttocks — because they sit in one place for a very long time, and the sitting area sweats a lot and stays damp. So sit for an hour, then stand up and walk around — do not sit for too long.

Essence nourishes the spirit when yang qi is refined; softness nourishes the sinews when yang qi is gentle

💬 Note from Doctor Ni Haixia: At night people practice the Yi Jin Jing (Sinew-Transformation Classic) — but the Shaolin monks all recite the Yi Jin Jing in the early morning; no one recites it at night. When yang qi is trained until it is pure essence, then there is spirit; when yang qi is very gentle and soft, the sinews are soft and will not cramp. When yang qi should open but does not open, should close but does not close, cold qi takes advantage of the yang deficiency and enters the body — nai sheng da lou — the person bends over and becomes hunched. When yang qi does not guard, the pathogenic qi transmits into the organs — excessive joy, excessive anger, excessive worry, excessive grief, excessive fear — all of these are managed by the internal organs; when the organ qi is injured, the damage is there.

Distinguishing deficiency from excess on the pulse: the metaphor of the scallion

💬 Note from Doctor Ni Haixia: When you feel the pulse, you must feel its blood — the thick thing inside the vessel is the blood; outside the vessel is the qi — you feel its kinetic energy, its strength, its elasticity. Softness means the yang qi is smooth and yin and yang are in harmony; hardness is not acceptable. How do you distinguish deficiency from excess inside? It is like the three-star scallion sold at the market — the leaf of the scallion is hollow, empty in the middle; the white part of the scallion is solid in the middle. Where you touch the leaf part is deficiency; where you touch the white part is excess — deficiency and excess are thus distinguished. If you cannot feel the difference, grab a scallion, close your eyes and feel the leaf and the white part. If you still cannot tell them apart, there is no help for you — the human pulse is exactly like that.

Bedsores: when yang qi does not move, yin accumulates

💬 Note from Doctor Ni Haixia: Pus and purulent lumps produced inside the muscles — for example, bedsores. A stroke patient lies there for two weeks and no one turns him over — this happens all the time in hospitals. The person lies face up the whole time, and after two weeks a huge sore grows on his back, so big that it can be opened like a door, rotten inside — why? Yang qi does not move. Because he lies there and the yang qi does not move, the yin accumulates in that place; when it accumulates long enough, it absorbs a lot of pus-forming matter, and disease develops.

Compiled from Doctor Ni Haixia’s third lecture of the Ren Ji series on the Huang Di Nei Jing, presented by Doctor Luo Dalun.