Why Is My Left Ear Sharper Than My Right, and My Left Hand Weaker Than My Right? Doctor Ni Haixia on Left and Right Yin-Yang, and the Great Method of Treatment, from the Huang Di Nei Jing

Patient search terms: my left ear hears better than my right / my left hand is not as strong as my right / my hands and feet feel clumsy when I concentrate on work / runny nose and drooling / how to treat a cold just as it starts / I can feel my pulse with the lightest touch / treat the left for disease on the right / coughing yellow phlegm / when the liver is ill, treat the spleen first / how is liver cancer treated? / treatment must wait for the right timing / no appetite and no bowel movement / taking tonic herbs

Corresponding medical names: the Yin Yang Ying Xiang Da Lun · heaven insufficient in the northwest / earth not full in the southeast · left-right yin and yang · the correspondence of man with heaven and earth · the six channels are rivers / the intestines and stomach are the sea · the nine orifices are the places where water pours in · the best physician treats the skin and hair · the floating pulse and disease of the skin and hair · disease entering the five organs is half dead and half alive · the superior physician cures nine out of ten · the evil qi of heaven / the cold and heat of food and drink / the dampness of the earth · drawing yang from yin / treating the left for the right · opposing needling (ju ci) · inspection, listening, inquiry and palpation · floating and slippery are yang pulses, deep and choppy are yin pulses · the superior physician treats disease before it arises · Nan Jing (Classic of Difficult Issues), Difficulty Seventy-Five: draining the south and tonifying the north · treating the liver during the spleen’s reigning time · when the form is insufficient, warm it with qi / when the essence is insufficient, supplement it with flavor · the sweating and vomiting methods

Opening: heaven is insufficient in the northwest — and your left and right sides are not the same

In the previous lecture Doctor Ni Haixia finished explaining “heaven is insufficient in the northwest.” In this lecture he pushes the argument forward — the deficiencies and surpluses of heaven and earth are written directly into the human body:

💬 Note from Doctor Ni Haixia: The northwest is yin. This makes the right ear less sensitive than the left. Because the right side is yin and the left side is yang — yang is on this side, and yang means acuity, dynamism, energy, so the yang of the left is stronger. In hearing, the left ear is better than the right. And “earth is not full in the southeast”? The southeast is flat terrain, with many lakes and rivers; earth is not full in the southeast, so it is not complete. Corresponding to the person: ordinarily, the left hand is not as strong as the right hand. Of course, some people are right-handed, so there are exceptions.

The emperor asks: why are people divided into left and right?

The Yellow Emperor asks Qi Bo: why are people divided into left and right in this way? Qi Bo’s answer proceeds in layers:

💬 Note from Doctor Ni Haixia: The east is yang; yang gathers its essence above — when disease is above, the upper part is bright and the lower part is deficient, so the ears and eyes are sharp, while the hands and feet are clumsy. When you are concentrating intently on doing something or reading a book, your hands and feet are not nimble, because your essence and qi are up above. Conversely, the west is yin; yin gathers its essence below — when disease is below, the lower part is full and the upper part is deficient. So when the hands and feet are strong, the ears and eyes become dull. When we are affected by evil qi, generally speaking, the weaker places are the first to be invaded by the pathogen. So above, the right side tends to fall ill more easily; below, in the lower body, it is the left side that is more easily attacked by the pathogen — yin and yang cannot both be complete. They cannot both be complete.

A True Person sitting beneath the Bodhi tree: what does a person live on?

On page 45, the Nei Jing brings man and heaven and earth together — the worthy person “above matches heaven to nourish the head, below images the earth to nourish the feet, and in the middle follows human affairs to nourish the five organs.” Doctor Ni uses the “True Person” as an example:

💬 Note from Doctor Ni Haixia: The so-called True Person — for instance, we introduced this before — he sits in India, like a person sitting beneath a Bodhi tree. Look at the tree he sits under: the branches grow out like this, the roots spread out like a board, and he sits in the middle, leaning against it, sitting cross-legged there. Have you ever seen a tree eat? No. It simply sits there — just like a tree: the qi of the earth nourishes it, and the qi of heaven can also nourish it. This is an act of “eating qi” (shi qi); he only needs to imagine himself as a tree, and he does not expend much energy, so he does not need to eat. As for us humans, we live and are nourished by the qi between heaven and earth. The qi of heaven communicates with the lungs — the qi of heaven above is connected with our lungs; the qi of the earth communicates with the throat (ai) — ai is our throat, the region of the larynx; wind qi communicates with the liver, thunder qi with the heart, grain qi with the spleen, rain qi with the kidneys. The six channels are rivers, and the intestines and stomach are the sea.

The nine orifices: places where water pours in — when full, they overflow

Setting the human body side by side with the natural world, even the openings and passages have their rules:

💬 Note from Doctor Ni Haixia: The nine orifices — we humans have nine orifices: two ears, two eyes, two nostrils — that is six, plus the mouth makes seven, so there are seven orifices above; and the places for urine and stool together make nine. These are the places where water pours in, so where water pours in, when it is full, it overflows — that is why we often have a runny nose and drooling; sometimes when you sleep very deeply at night you drool, right? And urine and stool — when full, they overflow.

Man is born of the qi of heaven and earth, and even sweat has its name:

💬 Note from Doctor Ni Haixia: Man takes the yin and yang of heaven and earth as his own yin and yang; the yang of sweat is named after the rain of heaven and earth — the rain that falls between heaven and earth is in fact the sweat on our bodies. The yang of qi is like the swift wind of heaven and earth; violent qi is like thunder, and rebellious qi is like yang. These are all the relations between man and heaven and earth.

Page 46: now comes the real application

Doctor Ni reminds us: everything said before about yin and yang you only need to understand; the real application lies in this chapter:

💬 Note from Doctor Ni Haixia: In the Huang Di Nei Jing, for all of medicine, the Yellow Emperor has already laid down the definition: if your method of treatment does not follow the discipline of heaven and does not use the principles of the earth — heaven has the cycle of the seasons, with wind, cold, summer heat, dampness, dryness and heat; the earth has the five flavors, sour, bitter, sweet, pungent and salty — if you do not follow this method, disaster comes. Our pharmaceutical industry today does not follow this. Of all the synthetic drugs they produce, the overwhelming majority are sour in taste — aspirin, all of them are sour. What does sour do? It injures the liver. So you must absolutely follow the method of heaven and earth.

The best physician treats the skin and hair: the moment illness begins, one touch tells you

The onset of evil wind is as swift as wind and rain. The best physician treats the disease in the skin and hair from the very beginning. Doctor Ni walks everyone through a chain of reasoning:

💬 Note from Doctor Ni Haixia: The skin and hair are the lungs. The lungs sit at the top of the body — this is the heart, this is the lungs; everything above is yang. As for the pulse on our wrist, at the wrist joint, taiyuan (LU9) is here — above it is cun, in the middle guan, below is chi. Above is the yang pulse, below is the yin pulse. So we already know: skin and hair, lungs, yang — the reasoning has been completed on this side.

Once the reasoning is done, the way of palpating the pulse changes accordingly. When the disease is in the skin and hair it is very simple — your hand is this skin, this is the muscle; the doctor’s finger does not press down onto the skin at all, it only touches the skin. Touch the skin lightly and you feel the pulse — the disease is in the skin and hair! That is how it comes about. So if you are very familiar with the Huang Di Nei Jing, the moment you feel the pulse you know the disease is in the skin and hair — in the exterior, so we define it: at the most superficial place.

Needling the skin and hair: just scrape lightly

When the disease is in the skin and hair, how does acupuncture handle it? Doctor Ni’s answer will surprise many people:

💬 Note from Doctor Ni Haixia: You do not actually need to insert the needle. Take the needle and scrape it across the skin and hair — and he breaks into a great sweat, frightened out of his wits! Because treating the skin and hair does not require a deep needle; do not overdo it. The method is exactly right and not a hair more — this stroke cuts the clothes but not the skin; that is the true master. You only need to scrape the needle across the skin and the sweat comes out. Especially with children — a scare and the sweat appears; do not really insert it. You can do it on the Lung channel, or on waiguan (SJ5), or on hegu (LI4) — a gentle scrape with the needle and he sweats, because the disease is in the skin and hair.

From skin and hair to the five organs: half dead, half alive

Disease does not stop at the skin and hair:

💬 Note from Doctor Ni Haixia: If the disease is in the muscles, we treat the muscles — the needle goes into the muscles; if it is on the channels, we needle the channels; next we treat the six organs, and after that the five organs. When the disease passes from the exterior and the muscles to the middle, and reaches the five organs, according to the Huang Di Nei Jing it is half dead and half alive — if you save him, the odds are fifty-fifty. When disease has entered the liver, heart, spleen, lungs or kidneys, it is half dead and half alive. But this is only a lenient standard: the superior physician must achieve nine out of ten — find a way to make it at least eighty percent, not half dead and half alive. Half dead and half alive — that is not good enough, not up to standard!

Three kinds of evil qi, injuring three levels

How does disease get in? Doctor Ni divides the sources into three layers:

💬 Note from Doctor Ni Haixia: The evil qi of heaven harms the five organs — this refers to epidemic diseases; the evil qi of heaven harms the five organs. The cold and heat of food and drink harm the six organs — when we take in food and drink, eat spoiled beef, drink unclean water, eat unclean food, it harms our six organs: the gallbladder, small intestine, stomach, large intestine and bladder. As for the dampness of the earth — if dampness injures you, it harms our skin, flesh, sinews and vessels. So the evil qi of heaven (things that exist in the natural world) gives us epidemic diseases and can harm the five organs; dampness harms our skin, flesh, muscles and bones.

Treat the left for disease on the right, treat the right for disease on the left: the skilled needler’s method of symmetry

For diseases at different depths, needling carries great learning:

💬 Note from Doctor Ni Haixia: The skilled needler draws yang from yin and yin from yang, treats the left for disease of the right and the right for disease of the left — with what I know I know the other, with the exterior I know the interior. Left disease, treat the right; right disease, treat the left — right? Once you have studied acupuncture you know this is called opposing needling (ju ci), the symmetrical method. In the Huang Di Nei Jing the great acupuncture masters teach just this. But after the Cultural Revolution on the mainland, the barefoot doctors — pain on the left, needle the left; pain on the right, needle the right; wherever it hurts, needle it there. Ever since Sun Simiao invented the a shi point — “Ah, is it right here?” “Yes, yes, yes” — right here — once the a shi point was developed, nobody needed to study anymore: just use the a shi point. That is wrong! Treat the left for disease on the right, the right for the left — that is drawing yin from yang and yang from yin.

Inspection, listening, inquiry and palpation: first separate yin from yang

This passage is about diagnosis. Doctor Ni says, “Too little and too much are both bad; the right measure is exactly right”:

💬 Note from Doctor Ni Haixia: The skilled diagnostician observes the complexion and palpates the pulse, and first separates yin from yang — we first look at his yin and yang; we can tell from his complexion too. First separate yin and yang, then look at clear and turbid, and know which place it is. For example: the lungs are where clear yang resides. Now someone spits phlegm — turbid phlegm, yellow turbid phlegm — we know the disease is in the lungs: the lungs are normally clear, now they are turbid, so the disease is in the lungs. And if you palpate the pulse, the moment you feel the Lung pulse floating up, on the surface of the skin, right? You know it is a problem of the lungs.

💬 Note from Doctor Ni Haixia: Inspection, listening, inquiry and palpation (wang wen wen qie) — every Chinese medicine practitioner must master them: the panting and breathing, listening to the voice, listening with the ears, looking with the eyes — these are the diagnostic methods of Chinese medicine. Then we can judge where the disease is in this person. Observe the balance and regulation (quan heng gui ju) and treat what governs the disease; measure the cun and chi, observe floating and sinking, slippery and choppy, and treat where the disease is born. When your hand touches the pulse and you feel a yang pulse — floating, slippery — that is a yang pulse; when you feel a yin pulse — deep, choppy, with little strength; deep sometimes cannot be felt, it seems present and seems absent — that is a yin pulse picture.

When yin and yang are out of balance, the pulse speaks:

💬 Note from Doctor Ni Haixia: If you feel the cun pulse, the yang pulse — teacher, the yang pulse is very deep — then your yang is insufficient; if you feel the yin pulse and the yin pulse has become floating and large — then yin is too full. Yin and yang must be balanced, must check each other; too much will not do, and too little will not do.

Doctor Ni also explains the origin of the name “cun” (inch): why is it called cun here? In fact, from here to the thenar eminence is also a cun; the true pulse is only nine fen, less than one cun. Coming down from this guan, one cun of distance is the normal range of the pulse — more than one cun means excess; when it is excessive, the person is on the road to death.

The superior physician treats disease before it arises: when the liver is ill, treat the spleen first

Now we come to the passage Doctor Ni is most proud of — the superior physician treats disease before it arises:

💬 Note from Doctor Ni Haixia: When the liver is ill, we must first treat the spleen. Because we know that when the liver falls ill it will transmit to the spleen, so we first go treat the spleen — this is what is called the superior physician treating disease before it arises. The Nan Jing (Classic of Difficult Issues), Difficulty Seventy-Seven, says this.

Why treat the spleen first? Because what you are guarding against is “transmission and change” — once the liver is ill, the next step is the spleen.

Draining the south and tonifying the north: Doctor Ni’s great method for liver cancer

Now for the main event. The Nan Jing, Difficulty Seventy-Five — Doctor Ni says, “This passage is excellent; if you can understand it, you can treat very serious diseases”:

💬 Note from Doctor Ni Haixia: The east is excess, the west is deficient. The east is wood, the west is metal — is this what is meant by “each taking its own position”? The original text says “metal does not control wood” (jin bu zhi mu) — in fact the character “not” (bu) can be deleted; this one character has harmed and killed a great many people. Truly, when one organ is out of balance, you use the organ that overcomes it to level it. For example, when the liver wood has a problem, metal overcomes wood, so you use metal to level wood — “metal controls wood.” But the problem is: when the liver wood is too full, metal is deficient — when the liver has a problem, the liver is very excess, in severe disease, because metal is very deficient, metal cannot control wood, and at this time the liver wood keeps getting more severe, more and more excess. If we tonify earth — when the liver has a problem, you tonify the spleen earth. Tonifying earth has only one benefit: earth generates metal. But no matter how much earth generates metal, because the liver is too excess, the strength is absolutely not enough. So Difficulty Seventy-Five raises the method: drain the south and tonify the north (xie nan bu bei)!

Why drain the south and tonify the north? Doctor Ni lays out the full reasoning of the five phases:

💬 Note from Doctor Ni Haixia: The north is water, the south is fire. Among the five phases, water overcomes fire. If you drain the fire — drain the south, the moment you drain the fire, the liver will naturally go to rescue the fire — wood generates fire, so give it a little more wood, and the liver will turn from excess to deficiency; by this it becomes deficient. And when the water comes forward — water overcomes fire. The liver is already very large, at its most severe, its greatest moment; at this time you go tonify the kidney water — will it make it even larger? No. Why? Because it has already reached its limit. At this time the mother can make the child deficient (mu neng ling zi xu): the liver wood will throw itself into the fire; when the liver wood enters the fire and keeps burning, the liver becomes a deficiency pattern. As for metal and water, water is the child of metal — the child can make the mother full (zi neng ling mu shi): with one move of tonifying water, the liver wood is dissolved and removed, metal becomes vigorous, and when metal is vigorous it goes to control wood. So we tonify water to drain fire. When you drain the fire, the water comes over and extinguishes the fire, the fire becomes very small, and the liver wood can naturally accept it — this is the principle of mutual checking.

Doctor Ni finally reveals the point: this one move, two gains! Because of the five phases — we have the liver; the heart has heart fire problems, earth has its problems, metal has its problems, water has its problems — the treatment is the same. So Difficulty Seventy-Five raises draining the south and tonifying the north. When draining the south and tonifying the north appears, this sentence changes the cause in “the mother can make the child deficient” — the treatment rule: the mother can make the child deficient, the child can make the mother full. When we tonify the water, it is one move, two gains! So if someone comes in now with liver disease, the liver is hugely swollen — if you only tonify the earth and treat the spleen, even if the spleen becomes very small, your treatment of the spleen has limits, and the liver disease is still there; there is only one benefit: earth generates metal, but metal is very weak because the liver is too strong — can this cure the disease? Very difficult. That is why Difficulty Seventy-Five raises draining the south and tonifying the north — when you encounter east excess and west deficiency, draining the south and tonifying the north means this. The reason for draining the south and tonifying the north is the hope that metal can control wood. This concept of the five phases rises up and slowly builds itself in you.

Here Doctor Ni lays down a sentence of great weight:

💬 Note from Doctor Ni Haixia: This is why I can cure liver cancer! The reason is raised right here, in this later passage.

When disease first begins, a single needling can cure it: the timing of treatment

Page 47 speaks of timing:

💬 Note from Doctor Ni Haixia: No excess, and the whole regulation is not lost. Therefore it is said: when disease first begins, a single needling can cure it — at the very beginning we can treat it. When the disease is at its peak, we must wait for it to decline; we must not contend with the disease! Wait for it to decline, wait for the timing. When the timing arrives, strike hard; after the disease force declines, pursue it swiftly.

Why does the prescription keep changing? Because the disease is changing:

💬 Note from Doctor Ni Haixia: Treating disease is like waging war: when the disease is in great battle, when the disease force is strong and flourishing, at that time we guard his primordial qi; when we have guarded the primordial qi and the disease force has weakened, then we go pursue it. That is why our prescriptions are constantly changing.

The best window for treating liver disease: the two weeks when the spleen is at its peak

Timing is not empty talk — Doctor Ni gives a concrete example:

💬 Note from Doctor Ni Haixia: For example, we use the reigning time of earth to treat liver disease. The east is excess, exactly at the transition of summer and autumn — the end of summer, the beginning of autumn, at the junction, the week before and the week after — this is the reigning time of the spleen (pi wang shi). At this time the spleen qi is at its most vigorous; when it is at its peak, do not touch it — heaven and earth are speaking of the spleen being at its peak; when you strike at this time, you need not worry about the spleen, the spleen will not be injured. These two weeks, it is as if a window has opened — the timing for treatment has arrived! Strike very hard and clear it all out in one sweep.

What if the timing has not arrived? Doctor Ni shares his clinical experience: when the reigning time is not open, when it has not entered the reigning time, we use a procedure: when we see the disease force is very severe, we stop. “Very severe” means the disease is serious, no appetite, urine and stool both blocked — then we find a way to give him medicine to open the appetite and move the bowels, and do not touch the disease. Wait until the timing arrives, then begin to strike. When striking, if you must attack, attack all at once; do not attack too much. This is the problem we face in clinical practice — page 47 talks on and on, and this is what it is talking about.

Light illness is dispersed and sweated out; severe illness is reduced and guarded

Disease may be light or heavy, and the treatment divides accordingly:

💬 Note from Doctor Ni Haixia: The light is raised and scattered (qing er yang zhi) — for the clear and light, we have the method of raising and dispersing, such as releasing the exterior and inducing sweat; the heavy is reduced (zhong er jian zhi) — when the disease is severe, we use the way of reducing and guarding. So treating disease is like waging war: when the disease is in great battle, when the disease force is strong and flourishing, at that time we guard his primordial qi.

When the form is insufficient, warm it with qi; when the essence is insufficient, supplement it with flavor

The tonifying methods also have two roads:

💬 Note from Doctor Ni Haixia: When the form is insufficient, warm it with qi (xing bu zu zhe, wen zhi yi qi) — so we have appetite-opening herbs and warming herbs; when the essence is insufficient, supplement it with flavor (jing bu zu zhe, bu zhi yi wei) — so we use warming medicines; moxibustion is also a kind of warming; for tonics, we use medicines of thick flavor to supplement, because the essence is insufficient — the essence and qi are insufficient. Of course we must see in which place the essence is insufficient, and nourish it there.

Disease in the high places: the sweating and vomiting methods — the common and the miraculous

Disease in different places calls for different treatments:

💬 Note from Doctor Ni Haixia: When the disease is in a high place — near the throat, in the upper burner — we use the sweating method and the vomiting method. Two ways: one is that what you prescribe is itself an emetic; the moment the medicine is taken, vomiting follows. You say, teacher, that is amazing — but you would also vomit from drinking soapy water, right? Many things can make you vomit. This is one way — this is the “common” (xing). What is called the “miraculous” (shen)? When your prescription is exactly right, and the disease is present in the upper, middle and lower parts at once — when it is exactly right, what should be vomited above is vomited, what should leave below leaves, the vomiting above and the diarrhea below come together, and it is over! That is the miraculous!

Closing: treating disease is like waging war — timing decides victory

This lecture ran from the difference between the left and right ears all the way to draining the south and tonifying the north and striking the evil at the spleen’s reigning time. Doctor Ni finally gathers the thread: the principles of the yin and yang of heaven and earth must ultimately land on “how to treat.” Disease in the skin and hair — a scrape or two and it is done; disease that has entered the five organs is half dead and half alive; east excess and west deficiency — drain the south and tonify the north, one move, two gains. Understand the correspondence between man and heaven and earth, and treatment has its aim.

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