Drinking Water Makes You Gain Weight, and You Can Never Get Thin? — Doctor Ni Haixia on Clear Yang and Turbid Yin, and True Cold with False Heat, from the Huang Di Nei Jing
Patient search terms: drinking water makes me gain weight and I can’t get thin / huge appetite but I never gain weight / do cold hands and feet mean my body is weak / why do I keep having diarrhea / my stomach is bloated and nothing I eat digests / does a black face mean serious illness / how can I tell if I’m taking the wrong medicine / is sweat the same thing as rain
Corresponding medical names: the Yin Yang Ying Xiang Da Lun · clear yang and turbid yin · the ascent and descent of yin and yang · extreme cold generating heat / extreme heat generating cold · true cold with false heat · the reversal of yin and yang · qi and flavor as yin and yang · vigorous fire and gentle fire · qi transformation of the heart, small intestine and bladder
Opening: the whole Huang Di Nei Jing is about one thing
Doctor Ni Haixia says that the Huang Di Nei Jing, from beginning to end, keeps coming back to two words: yin and yang. How do you understand it? He uses the example of boiling water:
💬 Note from Doctor Ni Haixia: You are boiling water, and the water is dirty, right? You want to drink clean water, so you bring it to a rolling boil! The moment it boils, the steam rushes upward — clear yang rises. So clear yang above, turbid yin below is the normal state of a healthy person.
With that picture in mind, the human body becomes easy to understand: everything above the diaphragm is the lungs, which belong to the region of clear yang. The diaphragm’s original job is to separate the clear from the turbid — turbid qi can rise no higher than this line. Below it is where turbid yin belongs.
💬 Note from Doctor Ni Haixia: If one day a patient has it backwards — yin above, yang below — that is a diseased state. From now on you will see many different kinds of disease states. Make your foundation strong. No matter how disease changes, or if one day you meet an illness you have never seen before, one that even doctors cannot identify, you can still solve it — because your principles are the same. The world is full of strange people, and it is full of strange diseases.
The rules of yin and yang: yang gives birth and yin grows; yang kills and yin stores
What is the normal state? Doctor Ni lists a string of passages straight from the Nei Jing:
💬 Note from Doctor Ni Haixia: Accumulated yang forms heaven; accumulated yin forms earth. Yin is still, yang is restless; yang gives birth and yin grows; yang kills and yin stores — this is the interactive relationship between yin and yang. Yang transforms qi, yin shapes form — this is yin and yang keeping each other in balance. If one becomes unbalanced, the other is immediately affected. That is all there is to it.
Once the balance of yin and yang is broken, illness follows — extreme cold can generate heat, and extreme heat can generate cold.
💬 Note from Doctor Ni Haixia: Cold qi generates turbidity; hot qi generates clarity. And the reverse? When clear qi sinks below, it produces sun xie — that is, you get diarrhea, loose stools with undigested food; when turbid qi rises above, it produces chen zhang — your belly feels bloated and full. This is the reversal of yin and yang (yin yang fan zuo), the disease going against its proper order. This is how illness happens.
The extremities: where yin and yang meet
Yin and yang are not an abstract theory floating in the air — you can see them and touch them on the body. Doctor Ni has his students look at their own hands and feet:
💬 Note from Doctor Ni Haixia: The heart is up above, and the farthest point from the chest cavity is the heel. The heel, and the extremities of the limbs, are the meeting points of the yin and yang channels — the jing-well points of both the yin and yang channels, aren’t they all at the very tips of the limbs? The yang channels run along the surface, on the yang side; the yin channels all run on the inner side. When a yang channel reaches its end, it turns into yin; and when yin reaches its extreme, it gives birth to yang. When the yin channel has gone as far as it can go and can go no further, it turns back and generates yang.
Human beings are the same as nature: when cold reaches its extreme, it generates heat. In summer you stand in Taipei, sweltering — but go upward, into the high sky, and it is freezing cold! Extreme heat generates cold. And in reverse, when cold reaches its extreme, it also generates heat.
A nearly 400-pound patient: the more cold medicine, the fatter — one dose of hot medicine, and he slimmed down to the end
Theory done, Doctor Ni drops a clinical story — and he says the reason he is telling this is that when it really comes time to act, some people actually dare to do this:
💬 Note from Doctor Ni Haixia: The general rule in Chinese medicine has always been: see a heat disease, use cold medicine; see a cold disease, use hot medicine. That is normal — anybody can do that. But some people with heat disease, when you apply cold medicine, the more cold medicine you apply, the hotter they get — because their heat has reached its extreme. At that point you must act boldly and give hot medicine. For example, if a person is already burning hot and sweating without stopping, would you still give him hot medicine? No — but one dose down, and he turns into a cold pattern.
Who was the patient? A super-obese man in Doctor Ni’s American clinic:
💬 Note from Doctor Ni Haixia: He was close to 400 pounds. The water he drank was all ice — a huge pile of ice cubes — and his appetite was always strong; no matter how he ate, he could never lose weight. So first we gave him gypsum (shi gao) — eight liang, ten liang, a whole jin. The more we gave, the bigger his appetite grew. The fire was raging, so I hit him with one dose of raw aconite (sheng fu zi)! The next day he called: “Why am I so cold?” It was summer — everyone else was sitting in the air conditioning, and he alone was huddled in a thick black jacket in the air-conditioned room, freezing! He couldn’t take it!
The turning point of this case is a living textbook of Chinese medicine’s “extreme cold generates heat, extreme heat generates cold”:
💬 Note from Doctor Ni Haixia: He was suffering from aversion to cold (e han) — heat that has reached its extreme gives birth to cold. Chinese medicine has this principle, written out clearly, but many Chinese doctors don’t dare to use it — they’re terrified! Originally the goal was to make him lose weight; he was that fat, and we kept giving him cold, cooling herbs — the fatter he got, the hungrier he became. He even asked us, “Did you prescribe the wrong medicine?” — foreigners don’t understand! The moment he took the raw aconite, he told me, “You got it right — I’m so cold.” From then on his appetite shrank, and he got thinner and thinner. Cold people tend to be lean at heart, hot people tend to be heavy at heart — and as it turned out, he was cold on the inside and fat on the outside. Look at that: true cold with false heat!
Tumors and cancers are all cold: heat moves, only cold accumulates
Following “cold qi generates turbidity,” Doctor Ni makes a point that is very important — and one of the boldest things he says:
💬 Note from Doctor Ni Haixia: If cold qi lingers too long, it produces turbidity. If there is cold inside the human body, things accumulate. All tumors and cancers are cold. Look at water: if you don’t boil it, it just sits there and doesn’t move; the moment you bring it to a boil, the water starts circulating. So heat has kinetic energy — it moves, it doesn’t pile up in one place. Only cold accumulates.
This directly decides how you treat serious disease — get the direction wrong, and it can kill:
💬 Note from Doctor Ni Haixia: Today you see a critically ill patient, a tumor or cancer, and you hammer him with cold, cooling herbs — the patient dies very fast. After all, he was already cold to begin with. The more cold herbs you give, the bigger the tumor grows, and the face goes from green to black to white — and then he is gone. When we treat, the face starts out white, then turns black, then green, then red — done, he can go home! Completely different! You see, a few words cover everything — Chinese medicine’s self-diagnosis lives right here.
Tears are clear, stool is turbid: clear yang exits through the upper orifices
When clear yang and turbid yin are applied to the body, you can see them everywhere:
💬 Note from Doctor Ni Haixia: Clear yang exits through the upper orifices; turbid yin exits through the lower orifices. Everything that comes out of the upper orifices is clear — have you ever seen turbid tears? Very rarely; when you cry, what comes out is clear water. Turbid yin exits through the lower orifices — urine and stool come out turbid, very smelly, right? Clear yang spreads through the interstices (cou li); turbid yin travels through the five organs. Clear yang fills the four limbs; turbid yin returns to the six bowels.
Yin and yang can be re-divided at any level:
💬 Note from Doctor Ni Haixia: The four limbs are yang; the body is yin. Divided by organs: the digestive system is yang, and the five solid organs are yin. Water is yin, fire is yang; yang is qi, yin is flavor — you smell grilled meat, “wow, that smells good” — that is qi; you pick it up and eat it, “the taste is wonderful” — that is flavor. Flavor returns to form; form returns to qi; qi returns to essence; essence returns to transformation.
Even eating follows the rules of yin and yang:
💬 Note from Doctor Ni Haixia: Vegetables and meat — when you eat vegetables, you are eating qi. Vegetables are light in flavor; they belong to qi. Meat is thick in flavor; it belongs to flavor. A person’s spirit should eat light-flavored things; if you want to build the body, to train it strong, you eat thick-flavored things. Look at Japanese sumo wrestlers eating their hotpot — the flavor is very thick, and they eat a huge amount — because they want the form, the bulk!
The properties of the materia medica are all hidden on this page
Doctor Ni points out specifically: the properties of herbs in the Shen Nong Ben Cao Jing (Shen Nong’s Classic of the Materia Medica) first came out of this very chapter — the last line of page 33:
💬 Note from Doctor Ni Haixia: Qi and flavor — from now on, when we introduce medicinal herbs, we will talk about qi, flavor, form and color, with form, color, qi and flavor as the main thread. Yin flavor exits through the lower orifices; yang qi exits through the upper orifices. Thick flavor is yin; thin flavor is the yang within yin. Thick qi is yang; thin qi is the yin within yang. Thin qi disperses and releases — the herbs that induce sweating and release the exterior have relatively thin qi; thick qi generates heat.
💬 Note from Doctor Ni Haixia: From now on, when we introduce which herb has thick qi, which has thin qi, which has thick flavor, which has thin flavor — the materia medica makes its choices precisely on this basis. This is how herbs are selected.
Vigorous fire weakens qi, gentle fire strengthens it: why Western medicine can’t fool Chinese medicine
Fire is the heat in the human body:
💬 Note from Doctor Ni Haixia: If a person has a lot of fire, he runs hot; a person who is too hot will injure his qi — heat injures qi, cold injures blood. But this only happens after living in one environment for years and years: you run into a sauna (san wen nuan) and bake for twenty minutes — no harm to your qi. Being a cook year in and year out, standing by the fire every day — that injures qi. A butcher going in and out of the freezer every day — one or two days is nothing, but year after year, that becomes a problem.
The human body is extremely precise, which is exactly what Western medicine exploits:
💬 Note from Doctor Ni Haixia: The human body is very precise — it never develops problems all at once. This gives Western medicine its opening: the doses are tiny, they enter gradually, you can’t feel them, and they fool a great many people. But they cannot fool Chinese medicine! It’s simple — because we know what a normal person is. Today, before I take the medicine my hands and feet are warm; the more I take it, the colder my hands and feet get — that means I’m taking the wrong medicine! I used to sleep wonderfully; after taking the medicine I can’t sleep well — you know it immediately.
Vigorous fire and gentle fire — how you eat matters:
💬 Note from Doctor Ni Haixia: Vigorous fire weakens qi; gentle fire strengthens qi (zhuang huo zhi qi shuai, shao huo zhi qi zhuang) — if you ordinarily run hot, a strong, hot constitution, eat lighter food; if your qi is on the thin side, you can eat food with a thicker flavor. That is the great principle.
Heart fire descends to the small intestine; the bladder’s water is qi-transformed and enters the liver
Using “qi,” Doctor Ni connects the five organs into one complete cycle:
💬 Note from Doctor Ni Haixia: The heart — yang within yang — is fire, very hot. The lungs — yin within yang: the chest is yang, and what is inside it is yin; the lungs are modeled on heaven (fa xiang tian), like the canopy of the sky. After the heart fire produces heat — because the heavenly yang above is very cold — it sends the heat downward into the small intestine. The bladder’s water and the small intestine’s fire sit right next to each other. Once the water is qi-transformed, the bladder’s water enters the liver — the water goes back and generates wood. Water goes into the liver to clean it — to clean anything you need water, right? After the cleaning, the residue comes out from the large intestine. This is a phenomenon of yang being born at the extreme of yin (yin ji sheng yang) — and yang is qi.
Along the way, yesterday’s exterior-interior relationship gets a review:
💬 Note from Doctor Ni Haixia: Yesterday we introduced that the large intestine’s fluids and food travel upward from the large intestine, and the large intestine returns to the lungs — that is why the lungs and the large intestine are interior-exterior paired (biao li).
Closing: pungent and sweet disperse and release — yang; sour and bitter surge and drain — yin
The lecture ends with the great yin-yang method of using herbs — which is also the opening principle of the Shen Nong Ben Cao Jing:
💬 Note from Doctor Ni Haixia: Pungent and sweet disperse and release — that is yang; sour and bitter surge and drain — that is yin. Pungent and sweet flavors put together generate yang; sour and bitter herbs surge and drain as yin. The yin-yang action of a medicine is decided by its qi and flavor. Yin and yang should be balanced — when yin is excessive and overabundant, yang becomes ill.
💬 Note from Doctor Ni Haixia: Pungent, sweet things — even insects won’t eat them. Spicy things they also avoid. But if you eat only bitter and sour things, you will be injured — yin is too abundant! If you go the other way, skipping sour and bitter and eating only spicy and sweet, you will also be injured. So when yin prevails, yang becomes ill; when yang prevails, yin becomes ill (yin sheng ze yang bing, yang sheng ze yin bing). This lecture ends here — let’s take a break.
Based on Doctor Ni Haixia’s Ren Ji · Huang Di Nei Jing lecture series (Lecture Seven)