Why Does a Winter Chill Become a Spring Warm Disease? Is Wind Really the Beginning of All Illness? — Doctor Ni Haixia on the Sheng Qi Tong Tian Lun of the Huang Di Nei Jing, Part Two

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Corresponding medical names: the Sheng Qi Tong Tian Lun · shen, hun and po · wind is the beginning of all disease · the daily circulation of yang qi · yin ping yang mi (yin calm, yang dense) · the five flavors injuring the five organs · injured by cold in winter, warm disease in spring · the five colors and the five organs · regional diet and stones

Opening: the shen (spirit) governs the hun and the po

This lecture continues the Sheng Qi Tong Tian Lun. Doctor Ni Haixia begins with the theory of shen, hun and po — the key to understanding the mental and spiritual activity of the human body.

💬 Note from Doctor Ni Haixia: The hun (ethereal soul) and the po (corporeal soul) are actually all governed by the shen (spirit). The heart manages the shen, the hun and the po. What is the po? It is the sweat hidden inside the lungs — when you should be sweating, do you sweat? Sweating during the daytime (po han) is normal; but if you sweat during the day when you should not, the lungs already have a problem — the po is no longer holding firm.

The yin and yang of the shu points and the mu points:

💬 Note from Doctor Ni Haixia: All the shu points on the back — the Bladder Meridian’s shu points (Feishu BL13, Xinshu BL15, Jueyinshu BL14, Ganshu BL18, Danshu BL19, Pishu BL20, Weishu BL21, Shenshu BL23) — are where yang qi travels; the mu points on the front of the body are where yin qi travels. Yin and yang are always interconnected and mutually checking.

Wind is the beginning of all disease: why does a person tremble?

💬 Note from Doctor Ni Haixia: When yang qi cannot move, wind syndrome develops. Wind arises because yang wants to disperse outward but the pores are blocked, so yang qi cannot move — wind is movement. You see a person shaking, shaking, shaking — that is wind. Something that should not move — why does it move? That is the symptom of wind. Chinese medicine uses a single word for it, and that is why we have herbs that dispel wind — this helps us choose our medicines later on.

Wind is the source of all illness:

💬 Note from Doctor Ni Haixia: Chinese medicine holds that wind is the beginning of all disease (feng wei bai bing zhi shi). In the whole framework of the Shang Han Lun and the Jin Gui Yao Lue, wind is everything — all disease comes from being injured by wind. But turn it around: when we treat an internal or latent disease, and toward the end of treatment wind signs appear — for example the pulse becomes floating, reaching the surface of the skin — that means the disease is retreating and gradually fully healing. So wind is both the beginning of disease and the end of disease.

How can a person avoid getting sick?

💬 Note from Doctor Ni Haixia: When a person is tranquil, keeps the mind calm and peaceful, the flesh and the interstices (cou li, the space between skin and muscle) can close and defend themselves — even if the seasons change, nothing can harm you. This is how you move with the seasons.

When yang qi does not move, things accumulate

💬 Note from Doctor Ni Haixia: Everything in our body — growing, nurturing, storing; what should be released, released; what should be expelled, expelled; what should be stored, stored — depends on yang qi. When a person’s yang qi is upright, all the turbid things are expelled and all the good nourishment is stored — that is a normal person. When yang qi cannot move, everything, good or bad, accumulates — because yang is a moving force; without kinetic energy pushing it, the body accumulates many things.

Food kept in the body too long turns into poison:

💬 Note from Doctor Ni Haixia: According to Chinese medicine, food runs a 24-hour cycle and should leave the body. But when yang qi is blocked, it cannot leave — it stretches to 36 hours, 48 hours, 72 hours, or even a whole week without a bowel movement. Within 24 hours, food is nutrition, a good thing; kept inside the body too long, it becomes poison. So the five organs and six bowels must discharge, and having a normal bowel movement every day — that is all yang moving. When yang does not move and things accumulate inside, tumors and pathological changes arise this way. Yin accumulates because yang does not move — so moving yang is very important: let yang qi travel and yin will not accumulate. This is the rule of diagnosis and the rule of treatment alike; when something is blocked (ge zhe dang xie), drain it promptly — when the body is obstructed, quickly purge it out.

A day in the life of yang qi: rising at dawn, peaking at noon, yin at its extreme at midnight

💬 Note from Doctor Ni Haixia: The 24-hour changes of yang qi — at dawn (ping dan) yang qi begins to rise; at noon yang qi is at its strongest; and at high noon, at the same time, yin begins to be born — because yin and yang are one and the same, yang at its extreme gives birth to yin. When the sun sets toward the western hills, yang qi declines; at midnight yin reaches its limit; and when yin reaches its extreme, yang begins to rise again. The Daoists of old expressed this as the taiji giving birth to the two forms, and the two forms giving birth to the four images. When you read the Nei Jing you must read it with diagrams, and you must read history (the Twenty-Four Histories, the Records of the Grand Historian, the Strategies of the Warring States, the Spring and Autumn Annals and Zuo’s Commentary) — do not read only Chinese medicine books stiffly; read widely, and your thinking will be flexible.

Yin unable to overcome yang: a wife who can no longer manage her husband

💬 Note from Doctor Ni Haixia: Yin and yang are balanced. Yin unable to overcome yang means yin can no longer control or hold yang — to use a husband-and-wife analogy, the wife can no longer manage her husband. Conversely, when yang does not weary the qi, yin obtains the true qi of the five organs — the husband’s way of doing things makes the wife feel secure and happy, so the true qi of the five organs is secure. Thus the sages keep yin and yang in harmony, the sinews and vessels joined, the marrow and bones firm, and qi and blood flowing freely. The true way of preserving life is to keep yin and yang balanced — you can compare it to the relationship between husband and wife, or between one person and another; the organs and bowels must always be in harmony with one another. When they are not harmonious, the physician’s job is to find which part is out of coordination.

Seeing the zang organ through the fu organ:

💬 Note from Doctor Ni Haixia: The liver wood and the large intestine should check each other — checking means not interfering with each other, coexisting peacefully and cooperating. The liver stands on the right; when liver wood and the large intestine are not in harmony, there is constipation. If the constipation is worst between 3 and 5 a.m. (the yin hour, when the Lung Meridian is in command), it relates to the lungs. When you see a symptom, you may be seeing a fu-organ symptom — but the fu and the zang are connected, yin and yang are connected — so through the fu you can see what is happening inside. The essence of Chinese medicine is standing outside and seeing what is hidden inside.

The way to preserve yourself:

💬 Note from Doctor Ni Haixia: The main way to take care of yourself is this: as soon as you are slightly abnormal, do everything you can to make it normal again — whether with medicine or anything else, pull it back to normal first; then keep your mood good and do not lose your temper casually.

The pathogens of the four seasons: injured by cold in winter, warm disease in spring

This is the endlessly debated passage of the Sheng Qi Tong Tian Lun, and Doctor Ni Haixia explains it with unusual clarity:

💬 Note from Doctor Ni Haixia: Injured by wind in spring, injured by summer heat in summer, injured by dampness in autumn (developing into wei jue, limpness and inversion) — and this last line, “injured by cold in winter, warm disease in spring,” is the source of a thousand years of controversy. What is the definition of warm disease? You must be injured by cold in winter for warm disease to appear in spring. In other words, warm disease does not exist on its own — it always arises from a winter chill.

The most common case is children:

💬 Note from Doctor Ni Haixia: Children do not care about you — they go out to play, run around in winter, work up a sweat, and then the weather is very cold after the sweating — injured by cold in winter. When spring comes, it flares up; the warm-disease school looks at it, calls it warm disease, and prescribes cold-cool detoxifying herbs. But this is wrong! On the surface it looks like a heat pattern, but the reason is that there is cold inside. “The south has no shang han” is also wrong — shang han has nothing to do with where you live. Taiwan’s winters are still very cold. There is another kind of cold that issues from within, and most of it comes from unclean diet — eating spoiled food, drinking alcohol — the cold of alcohol injures the ability to ward off cold. These diseases that look warm and febrile on the surface are actually cold patterns; if you prescribe cold-cool herbs, the fever resolves on the spot, but two or three days later it comes back — the root is not removed, because the inside has not been cleared. So if you can treat shang han, you are fine — anyone who understands the Shang Han Lun will not make mistakes.

Forcing a heavy lift relies on the kidneys

💬 Note from Doctor Ni Haixia: Eating too full and then running — the meridian qi is not strong enough, and you easily develop hemorrhoids. Drinking too much makes qi rebel (da yin ze qi ni) — people who drink regularly have shortness of breath, shallower breathing. And lifting something too heavy for you, forcing it up — when we exert force to lift something, we rely on the kidneys: on the back there is Dazhu (BL11, the meeting point of the bones), and on the feet there are Chengshan (BL57) and Juegu (GB39). Chengshan means “able to carry a mountain,” because on the shoulder there is the Dazhu meeting point of the bones. Lifting a heavy object uses the strength of the bones, not the strength of the muscles — the whole effort falls on the kidneys. If you force the lift, the kidney qi is injured.

Yin ping yang mi: yang must be strong enough to be “dense”

💬 Note from Doctor Ni Haixia: If the two are not in harmony, it is like a year with no autumn, like a winter with no summer. How strong must yang be to qualify? Yang must be strong enough to be dense — to hold yin and not let it leak away. That is its required strength. Some people have very strong yang but not dense enough — yin still gets depleted. Yin calm and yang dense, the spirit is whole (yin ping yang mi, jing shen nai zhi). Yin and yang check each other within me: when yin is injured it affects yang; when yang is injured, yin disperses and is lost. When yin and yang separate — yin goes its way, yang goes its way, the two are not connected, they are divorced — this is a very dangerous state. The person develops chills and fevers (the disease of alternating heat and cold); in Chinese medicine this is called ying yu lou feng — when the body is exposed to wind, harm comes with the change of seasons; such disease is external in origin.

The five flavors injure the five organs: what you eat is what injures you

💬 Note from Doctor Ni Haixia: The qi of the seasons injures the five organs, and what gives rise to it is the five flavors. Too much sour (wei guo yu suan) — the liver qi becomes excessive and the spleen qi is exhausted: sour in excess increases liver qi too much, wood overcomes earth, and the spleen is injured. Too much salty (wei guo yu xian) — the great bones labor: a heavy taste injures the kidneys (the kidneys govern the bones), and qi labor can injure the skeleton in the short term. Too much sweet (wei guo yu gan, sweetness too heating) injures the kidneys — and when the kidneys are injured you see black color.

The five colors and the five organs:

💬 Note from Doctor Ni Haixia: The five organs — liver, heart, spleen, lungs, kidneys — pair with their original colors: green, red, yellow, white, black. Green is stored in the liver, red in the heart, yellow in the spleen, white in the lungs, black in the kidneys. When the kidneys are affected, the black nourishment can no longer be retained and it shows outward — the complexion you see is black. A sickly black is different from a Black person’s skin: in America you see the most Black people everywhere, black and glossy — none of them are sick. But sitting by the roadside eating in Taipei, I look at our Taiwanese compatriots with faces so black — their kidneys have a problem. Go sit in a dialysis center: a whole row of them are black, because kidney function is damaged. The black of disease has no luster — it is like charcoal. A healthy Black person’s skin shines with blackness; do not tell him he is sick. Black people’s teeth are especially long, especially hard, and their bones especially strong and large — different from white people and yellow people. We have our brains.

The five flavors of the diet must be harmonized:

💬 Note from Doctor Ni Haixia: Too much bitter makes the spleen moist; too much pungent, too much fishy-smelling, none of it is good. When you eat, the flavors must be harmonized — not too spicy, too salty, too sour, too bitter, too sweet. Everyday food should be relatively bland; when using medicine (when a person is sick) the flavor is thick and heavy — bitter herbs are for treating disease; who could stand them cooked into everyday dishes? If I can harmonize these five flavors, no pathological change will arise in the body.

Bonus: eat sour to prevent gallstones, eat qing salt to prevent kidney stones

💬 Note from Doctor Ni Haixia: On the southeast coast of mainland China people love sour food — Jiangsu-Zhejiang dishes put in a lot of vinegar, rice vinegar; some people drink two bottles of vinegar a day. Because they eat too much sour — sour is the liver — these southeast coastal people carry it in themselves: the people without gallstones are exactly the ones who eat a lot of sour; the sourness keeps the liver clean. Conversely, those who do not eat sour, who do not eat vinegar, grow gallstones. People around Qinghai Lake cannot get sea salt; they eat the qing salt (cyan salt) of inland lakes. The weather is very cold and they like heavy flavors — they eat a lot of salt — and of the people living along the Qinghai coast who eat inland salt, not one has kidney stones. Do not want gallstones? Eat sour. Do not want kidney stones? Eat qing salt — sea salt cannot prevent kidney stones either.

What to take away: wind is the movement of blocked yang qi — trembling and shaking are wind, and wind is both where disease begins and where disease ends. When yang qi moves, waste is expelled and nourishment stored; when it stalls, food held past 24 hours turns to poison and accumulates into tumors — so moving yang is the rule of both diagnosis and treatment. Yin accumulates because yang does not move, and from the fu you can see the zang. Warm disease never exists alone: it always grows out of a winter chill, most often in a child who sweated and caught cold — treat the shang han underneath, and the fever will not return. Keep yin and yang balanced like a good marriage; when anything is slightly off, pull it back to normal and keep your temper. And for the stones: sour food keeps the liver clean, and qing salt protects the kidneys.

Based on Doctor Ni Haixia’s Ren Ji (Human Records) Huang Di Nei Jing lecture series (Lecture Four)