Green Face Means Liver Disease, Black Face Means Kidney Disease? — Doctor Ni Haixia on the Five Organs Paired with the Five Colors from the Huang Di Nei Jing

Patient search terms: why is my face green / what disease makes my face turn black / does a pale face mean poor health / why does my mouth taste sweet all the time / is eating chicken good for cramps / what is the connection between the root of the tongue and the spleen / does drinking lemon water nourish the liver / does eating salt cause swelling / what do the kidneys have to do with urine and stool / what does it mean when my hair suddenly stops being oily

Corresponding medical names: the Jin Gui Zhen Yan Lun · five-color diagnosis · the five organs paired with the five colors and five flavors · the five organs responding to the four seasons · the five-element restraint cycle as checks and balances · the He Tu and Luo Shu · the Yin Yang Ying Xiang Da Lun

Opening: this lecture teaches you to see the disease

The previous lecture covered the five organs responding to the four seasons. This one goes further — the five colors: green, red, yellow, white and black, all of which come from the Huang Di Nei Jing. Doctor Ni Haixia says that every theory of Chinese medicine has its source right here:

💬 Note from Doctor Ni Haixia: These five things — green, red, yellow, white and black — all come from the Huang Di Nei Jing. All the theories of Chinese medicine come from the Huang Di Nei Jing; it is the earliest source. If you just say, "green is green, red is red, yellow is yellow, white is white, black is black," nobody understands what you are talking about. But today a person comes to see you with a green face — liver disease. You know it at a glance, just from looking.

When the face changes color, the disease is written on it

Five-color diagnosis comes down to three sentences: green and black mean pain; yellow and red mean heat; white means cold.

💬 Note from Doctor Ni Haixia: A person’s face is green, and he is in great pain — green and black mean pain; yellow and red mean heat; white means cold. After you begin treating him, a week or two later — ah, the color has turned red. That is moving along the generating direction; it means the patient is almost well and your direction is right. When the direction is right, do not change it — keep using the same medicine! But if he came to you green and you treated him into black — then you were wrong, and it is your fault.

For judging the direction of treatment, Doctor Ni gives an easy rule to remember:

💬 Note from Doctor Ni Haixia: If a person comes to you with a black face — kidney disease — and you treat him until his face turns green, wonderful! It is only if his face turns white that I am afraid. Think with this idea, and once you have it, you don’t need to memorize anything — everything connects at once. So you must know what normal is, and then you know what abnormal is.

The vegetable market hides a whole materia medica

The five colors are not only used on the face — the vegetable market is full of learning:

💬 Note from Doctor Ni Haixia: Go to the vegetable market and look — all the green vegetables enter the liver. A leaf that is green on the blade and white on the stem is something between green and white. Cucumbers are yellow, mushrooms are black, tomatoes are red, and so on. Among all the fruits and vegetables, those with light flavors all enter the qi level. The qi level and the blood level are different — qi moves water; water-qi and the san jiao all belong to qi. Blood is what has a thick, heavy flavor; things with a heavy flavor enter the blood level. Meat all has a heavy flavor, and Chinese medicine is the same — the flavors of Chinese herbs are very heavy.

How did Chinese herbs come to be known? You don’t need to imitate Shen Nong tasting every herb:

💬 Note from Doctor Ni Haixia: We can know how herbs were discovered — you don’t have to grab one and taste it, that’s too tiring, and what if you bite into poison? You can tell from its form, color, qi and flavor. The hardest to understand is the image and number (xiang shu). This time, when we go through the Shen Nong Ben Cao Jing (Shen Nong’s Classic of the Materia Medica), I will try to explain as much of it as possible.

The generating and restraining cycles: “restraint” is not destruction, it is balance

Start with the simplest judgment: generating is auspicious — it means all is well; if it is going against the flow, it is ominous. Put the two side by side, and you have a direction for treating disease.

In the season that is in command, you must see the color that belongs to it:

💬 Note from Doctor Ni Haixia: The east is green. The proper green matches spring — in spring, if a person’s face carries a little green, that is a good sign. In spring, if you see white, that is not good. What about the generating relationship? For example, seeing red in spring — since the colors generate each other, although it is not ideal, it is still harmless. And the restraining colors — in Chinese medicine, this "restraint" (ke) is not the same as in the eight-character fortune telling. In fortune telling, ke means it is taken away; that is not the meaning here. Ke means checks and balances.

What does “checks and balances” mean? The five organs live by it:

💬 Note from Doctor Ni Haixia: Take the liver for example — should not metal (the lungs) restrain wood (the liver)? It must balance it. If today metal fails to balance it, the liver develops problems. The five organs restrain each other; only when their forces are even can they survive in harmony. When they are uneven, problems arise — and that unevenness is the cause of disease. Restoring the evenness is the method and the rule of treatment. This is the discipline of our body.

The liver: why do you eat chicken when you have a cramp?

The five-organ correspondences start with the liver — the liver’s color is green, and its domestic animal is the chicken:

💬 Note from Doctor Ni Haixia: The liver governs the sinews. In other words, when you have a cramp, eat chicken! Apart from the head and neck, which grow and cramp up (joking), chickens don’t cramp anywhere else — because the chicken is a wood animal. The liver opens into the eyes. Why into the eyes? Because the liver channel directly connects to the back of the eyes. The liver stores the ethereal soul (hun); when it falls ill, the person is easily frightened — a person who startles easily has a problem in the liver.

The liver’s flavor is sour. Doctor Ni says the market already told you:

💬 Note from Doctor Ni Haixia: Go to the market and look — the lemon, green on the outside, and when you cut it open it is very sour inside. Isn’t that plainly telling you "I am the liver"? Do you still need a lab test? We don’t need tests. Chinese medicine doesn’t send herbs off for chemical analysis — what good is it to test the water and find it’s H₂O? Chinese medicine has ji liu shui (rushing water): water taken beneath a waterfall, whose nature is to rush downward. When we treat rheumatic arthritis, we cook the herbs in rushing water, and the medicine rushes straight down to the feet.

Along the way, a bonus: an ancient emergency method for food poisoning:

💬 Note from Doctor Ni Haixia: When the stomach and intestines are upset from bad food, we go to the river and draw water, and to the well and draw water. The river water that sees the sun is yang water; the well water is yin water. Mix the yin and yang water together and drink it — then all the undigested food and the poisoned stuff comes up and out. Because even a normal person will vomit from drinking both kinds of water — it is an emetic, for emergencies. Think about it: China is an agricultural society, five thousand years old. When someone’s stomach went bad, what were they to do? You have to save a life! It is certainly better than letting spoiled food rot in the belly, isn’t it? So there are many methods. A student of Chinese medicine must adapt quickly — with no equipment at all, when something happens, you can turn whatever is around you into a weapon. Western medicine has to bring the whole hospital with it; Chinese medicine only needs two hands. It’s fun in exams too: the examination room has everything prepared, but we Chinese doctors rely on these two hands and on five thousand years of experience — not on equipment.

The sour flavor enters the liver. How should you eat it?

💬 Note from Doctor Ni Haixia: When you find sour things entering the liver, does it tonify it or moisten it? It moistens it, and at the same time drains it and disperses it. So when we have nothing to do, we slice a lemon — with the peel, because the peel is green — put it in water, rub it a little so the essence comes out, and drink it. It’s not sour at all; it’s maintenance! We have never heard of anyone dying from drinking lemon water, right? You can take care of yourself anytime, anywhere.

The liver’s grain is wheat — and through “dispersing the liver,” Doctor Ni explains the temperament of wood:

💬 Note from Doctor Ni Haixia: Wheat is the liver’s grain. When we disperse the liver — the liver is like a tree. When a tree grows too luxuriantly, too densely, you must cut away the dead branches. If you don’t, won’t the tree die? Suffocated! At that point the liver must be dispersed. What disperses the liver is sour things. By sour I mean natural sourness — the sour that your body produces naturally when you eat. That is what is very good for the liver.

The He Tu and Luo Shu: why is the liver’s number eight?

The liver’s number is eight. Here Doctor Ni connects the Yi Jing (Book of Changes) with the Nei Jing:

💬 Note from Doctor Ni Haixia: The Yi Jing and the Nei Jing are connected in a certain way — we need to talk about the He Tu and the Luo Shu. What does the He Tu say? Heaven gives birth to water in number one, and Earth completes it in number six; Earth gives birth to fire in number two, and Heaven completes it in number seven; Heaven gives birth to wood in number three, and Earth completes it in number eight; Earth gives birth to metal in number four, and Heaven completes it in number nine; Heaven gives birth to earth in number five, and Earth completes it in number ten. Every number has its meaning and its five-element nature — take ba jiao (star anise): eight, isn’t that wood? Done. We have many things named by numbers: wu xiang (five spices), ba jiao (star anise), san qi… many Chinese herbs will use these numbers later. When you see a number, you immediately know which five-element nature it belongs to, and you know how to use that herb.

Why is the liver’s number eight? Because wood is “born by Heaven in three and completed by Earth in eight”:

💬 Note from Doctor Ni Haixia: Why do we speak of Heaven and Earth? It is because there is this Heaven, this Earth, and this number that wood comes into being. Eight is the extreme yin number — yin is the even numbers two, four, six, eight; the odd numbers one, three, five, seven, nine — so nine is the extreme yang number and eight is the extreme yin number. At the extreme of yin, the deepest organ of the human body is the liver. The liver governs the sinews — the sinews of the whole body. Think of it this way: wood bends and straightens; in nature, whatever has this image of bending and straightening is the sinew, and all of it belongs to the liver.

The liver’s fruit is the plum:

💬 Note from Doctor Ni Haixia: The liver’s fruit is the plum (the plum that fruits in spring). So we use many plums in treating the liver — for example, li gen bai pi (the white bark of the plum tree root); and for the liver there is also yu li ren (plum seed). All of these are plums, because the plum is the liver’s fruit, the liver’s grain-family thing. The liver’s smell is rank (sao) — take wild animals that eat grass and vegetation; go smell one, that is the rank smell, because it comes from the rankness produced by grass and trees.

The heart: red rice, mutton, bitter flavor, and one special channel

The south is red, and it connects into the heart. Two special points in this passage:

💬 Note from Doctor Ni Haixia: The south is red, connecting into the heart, opening into the ear. Why does it say opening into the ear? Actually the kidneys open into the ear — here, “opening into the ear” means that the qi of heaven enters the heart through the ear. When the heart is ill it affects the five organs, because all five organs contain blood. The heart’s flavor is bitter; the heart belongs to fire, and everything that has been cooked through is bitter. Its domestic animal is the sheep — eating mutton has a nourishing power for the heart. Its grain is shu, which is red millet, red rice. Above it corresponds to ying huo — our planet Mars. When the heart has a problem, the disease shows in the pulse and the blood vessels. Its sound is the zhi sound — the zhi sound is very soft and drawn out long, produced with the tongue pressed against the teeth. Its smell is scorched — everything that has been cooked is scorched, a burned smell. The heart’s number is seven. Why? Between heaven and earth, from the fire-image in the sky down to becoming the human form on earth, it is the number seven.

The spleen: a sweet taste in the mouth is the spleen crying for help

The center is yellow, connecting into the spleen, opening into the mouth, with disease at the root of the tongue. What does “disease at the root of the tongue” mean?

💬 Note from Doctor Ni Haixia: The spleen opens into the mouth, and the disease is at the root of the tongue — how to explain it? The fluids in our mouth: because the spleen’s qi opens into the mouth. When you stick your tongue out far, the root of the tongue is the spleen — the heart opens into the tongue, so the tongue is the heart, but its root is the spleen, because fire generates earth. That is the root of the tongue.

The spleen’s flavor is sweet. The sweet flavor is supposed to stay “hidden”:

💬 Note from Doctor Ni Haixia: In clinical practice a patient comes to you and says, "It’s strange — why is my mouth always sweet? I constantly have a sweet taste in it?" — that is the spleen. I said earlier that everything with a thick flavor belongs to yin. This yin should by nature be stored. In learning Chinese medicine you must always remember what normal is — sour, bitter, sweet, pungent, salty: on the liver side is sour, the heart is bitter, the spleen is sweet. In a normal person the sweet flavor should be inside the spleen. The spleen of Chinese medicine includes the pancreas of Western medicine, and the sweet flavor should be hidden inside it. Why do we call the five organs zang? Zang means to store — zang is to hide. So the sweet flavor should be stored in the spleen and never come out. Now that it is showing itself, it means the spleen has a problem.

Why does the yin come out? Doctor Ni explains the rule of yin and yang:

💬 Note from Doctor Ni Haixia: Every organ has yang inside controlling it. If yang wraps it up, the yin hides inside and never comes out — so yin and yang are balanced. If yang becomes deficient, the yin goes outward. The spleen’s domestic animal is the cow — beef itself enters the earth flavor. Its grain is ji, which is millet — when we eat millet porridge, that millet is ji. Above it corresponds to the planet Saturn. The disease shows in the flesh, because it is earth — Chinese medicine compares the person with heaven and earth: heaven above, earth below; on top of the earth are rocks and lots of soil; the soil is the flesh of the earth; flesh is soil. The spleen is earth — the spleen-earth is the flesh of the earth. Its sound is the gong sound; the gong sound is like a cow mooing — in The Butterfly Lovers there is a big silly ox, and the sound that ox makes is the gong sound. Its smell is fragrant — that is why roasted meat smells so good. The spleen’s number is five.

The lungs: only a bright glossy white is good — and hair losing its oil is a big deal

The west is white, connecting into the lungs, opening into the nose, with disease in the back. In the lungs passage, the diagnostic teaching is the most interesting:

💬 Note from Doctor Ni Haixia: The lungs’ disease is in the back. Its flavor is pungent; its domestic animal is the horse — but you can’t eat horse meat; horse, beef, mutton and chicken are all fine, but horse you won’t find. Its grain is rice — among the five grains, rice enters the lungs: white enters the lungs, so ordinary rice is good for the lungs. The lungs govern the skin and body hair — all the skin and pores of the whole body are managed by the lungs. In a normal person you see two kinds of white: one is a sallow pale, like dried bone, a colorless white; the other is a white that is bright and glossy — you are walking down the street and a girl’s skin is very white and pretty, bright white — that has spirit! Having spirit means having qi. Without spirit means qi is gone — when you can see brightness on the face, that is spirit.

There is also a secret trick for reading “qi” — look at the hair:

💬 Note from Doctor Ni Haixia: When you read qi, look at the hair. You sleep at night and in the morning your hair is oily; or you need to wash your hair by the end of the day — the oil in the hair is a person’s qi. When the qi is about to leave, suddenly a week earlier, the hair stands up, completely dry, no oil at all — the qi is already gone, the spirit has already departed. We can see it immediately. The lungs’ sound is the shang sound — the sound of the mouth opening wide and calling out. Its number is nine — Heaven gives birth to metal in number four, and Heaven completes it in number nine. Its smell is fishy — fish belong to the lungs; the fishy smell of fish.

The kidneys: even the stool is governed by the kidneys

The north is black, connecting into the kidneys, opening into the two lower orifices. Doctor Ni says that the statement “the kidneys govern urine and stool” first came from the Huang Di Nei Jing:

💬 Note from Doctor Ni Haixia: The kidneys govern urine and stool. When I see patients it is often very simple — sometimes a patient calls on the phone, and you cannot see him. How do you know whether it is kidney yang deficiency or kidney yin deficiency? We have two kinds of formulas: Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) and Gui Fu Ba Wei Wan (Cinnamon and Aconite Eight-Ingredient Pill). How is the stool? If there is diarrhea (xia li), it is the Ba Wei (the Cinnamon and Aconite Eight-Ingredient Pill) — that’s the whole answer, very fast. Why? Because his yang is insufficient! Yang insufficient, diarrhea, several times a day, keeps on pouring — yin and yang are separated immediately. Because the kidneys govern urine and stool, problems with urine and stool are not only about urine — common thinking only brings up urine, but actually the stool is also constantly governed by the kidneys. Some people with severe kidney disease cannot pass stool at all, and cannot pass urine either; at that point the whole (face) turns black, because toxins are depositing inside and cannot be eliminated. Later we have a special master formula for that.

The kidney’s flavor is salty. The salty flavor enters the kidneys, and there is great learning here:

💬 Note from Doctor Ni Haixia: The kidneys’ disease is in the joints — in the crevices between the joints. Everything salty enters the kidneys. But when the Huang Di Nei Jing was written, it did not anticipate artificial salt — the salty flavor refers to inland salt and sea salt; those are the best salts. Now the salt has been replaced, with artificial salt and so on — none of that is very good. When Chinese medicine treats liver disease we tell the patient to eat a little sour — but not a huge amount of sour; anything excessive is bad, and the sour must be natural sour, not formulated fruit acid. When treating kidney disease, give the patient a little salt — because the salty flavor enters the kidneys; when the salty flavor enters the kidneys it can guide our medicines into the kidneys (as a channel-guiding herb), so the kidneys need salt. But now Western medicine says "you cannot eat salt" — why? Because it is using refined salt — that salt tastes salty, but its nature is wrong.

Why is artificial salt bad? Doctor Ni explains the principle of “addiction”:

💬 Note from Doctor Ni Haixia: If you eat artificially made salt, you retain water, and the more you eat the more water accumulates. Artificial things are made finer and finer; because they are too fine, the body absorbs them strongly, draws them deep into the body, and then your body develops an addiction to them. Look at Westerners eating steak — if you have lived in America you know: children sprinkle a little salt, by middle age they sprinkle a lot, and old men just pile the whole slab on — more and more. Why? Because of the salt — they eat until both feet swell with edema. But if you eat real sea salt, you don’t sprinkle more and more, you don’t become addicted — who sits around eating salt by itself? But artificially refined things won’t do — they are addictive. Why? The particles are too small, they penetrate too deep into the body, and that produces the desire to eat them.

The kidney’s domestic animal is zhi, the black pig; its grain is the bean — every bean that comes out looks just like a kidney; the kidney’s disease is in the joint crevices; the kidney’s fruit is nuts, such as chestnuts — the roasted chestnuts we eat are the kidney’s fruit.

The fruits of the five organs: plums, apricots, dates, pears and chestnuts

Doctor Ni finally gathers all the things of heaven and earth into the five organs:

💬 Note from Doctor Ni Haixia: The liver’s fruit is the plum; the heart’s fruit is the apricot — the apricot of apricot kernel; the spleen’s fruit is the date — the red date, which is why we often use red dates; the lungs’ fruit is the pear — the water pear; the kidney’s fruit is nuts, such as chestnuts. In this way we take all things between heaven and earth, with their five colors and five flavors, and gather them into the five organs of our body.

Closing: one who is good at the pulse — a single look, and the disease is finished

💬 Note from Doctor Ni Haixia: "One who is good at the pulse observes the five organs and six bowels, the going against and the following, the yin-yang, the exterior-interior, the male-female relationship; he stores it in his heart and mind, unites his mind with the essence — if it is not the right person, do not teach; if it is not the true teaching, do not transmit; this is called attaining the Way." So in the past, Chinese medicine was not taught to just anyone, and you had to be sure that what you taught was correct — do not teach wrongly. This passage looks like something fixed, but in actual clinical practice it is extremely useful — you know at a glance. For example, in winter a face that is a little dark (in winter the kidney is black; the north is a little dark), and suddenly two red eye rings appear — heart disease, the diagnosis is finished! Isn’t it fast? You don’t need to think, you don’t need to feel the pulse — one look and the heart disease is done. By the time you have finished studying the Shen Nong Ben Cao Jing, the Shang Han Lun and the Jin Gui Yao Lue, when your eyes finish looking, the prescription is finished — he can go home. But the patient thinks you don’t know him yet, right? So you still have to sit with him and patiently listen to him talk, and after all that talking, (the prescription) is still the same formula. That is why my temper is a bit short.

Preview: the Yin Yang Ying Xiang Da Lun — to treat disease, seek the root

At the end of this lecture, turn to page 31 and enter a new chapter:

💬 Note from Doctor Ni Haixia: We come to the Yin Yang Ying Xiang Da Lun (The Great Discourse on the Correspondence and Manifestation of Yin and Yang). This chapter deals with xiang ying (correspondence and manifestation) — it is not easy to understand; it is a very deep chapter on yin and yang. Chinese medicine must understand yin and yang; without it you cannot treat disease. The Yellow Emperor said: Yin and yang are the way of heaven and earth, the discipline of all things, the parents of change, the root of life and death, the abode of spirit illumination. To treat disease, one must seek the root. Accumulated yang forms heaven; accumulated yin forms earth.

Based on Doctor Ni Haixia’s Ren Ji · Huang Di Nei Jing lecture series (Lecture Six)