Why Is My Face Green, Black, or Pale? Doctor Luo Dalun Presents Doctor Ni Haixia’s Seventeenth Lecture on the Huang Di Nei Jing — Reading Illness From the Five Colors of the Face, the Five Viscera Blocks (Fei Bi, Gan Bi, Jue Shan, Shen Bi), Moxa on Guanyuan (CV4) for a Cold Womb, and Why the Pulse at the Wrist Tells You About All Five Viscera

Patient search terms: face turning green / face turning black / pale face / sallow yellow face / dull complexion with no luster / how to read a bad complexion / pale lips / lung problems and wheezing / panting with every breath / what does a bad liver look like? / cold belly / cold womb and can’t get pregnant / cold pain in the lower abdomen / moxa on Guanyuan / moxa on Zhongji / constipation / no stool or urine for two or three days / swollen feet in a man / swollen head in a woman / hydrocephalus / what can pulse diagnosis detect? / qi kou pulse / Chinese medical inspection of the face

Corresponding medical names: Su Wen · Wu Zang Sheng Cheng Pian (On the Generation of the Five Viscera, chapter ten) · five-color diagnosis (wu se zhen bing) · morbid color (bing se) · the five colored nutrients · the five viscera receiving nutrients · the white pulse arriving with panting and deficiency (bai mai zhi zhi chuan er xu) · the lung block (fei bi) · forcing sex while drunk (zui er shi nei) · the lung governs purifying and descending (su jiang) · upper deficiency and lower excess (shang xu xia shi) · the green pulse arriving long and snapping left and right (qing mai zhi zhi chang er zuo you dan) · the liver block (gan bi) · accumulation below the heart (xin xia) with flank fullness · xin xia means the stomach · Xie Xin Tang (Draining the Heart Decoction: Ban Xia / Gan Cao / Sheng Jiang / San Huang) · long pulse and short pulse · proportional body-inch (tong shen cun) · the yellow pulse arriving large and empty (huang mai zhi zhi da er xu) · jue shan (reversal hernia) · sweating into the wind (han chu dang feng) · cold womb infertility in women · moxibustion on Guanyuan (CV4) and Zhongji (CV3) · the black pulse arriving hard and large above (hei mai zhi zhi shang jian er da) · the kidney block (shen bi) · bathing in cold water and lying down to sleep · tai yang governs opening, yang ming governs closing, shao yang governs the pivot · a yellow face with green/red/white/black eyes is never fatal · stomach qi (wei qi) · in fu disease the appetite returns at noon, in zang disease at midnight (fu bing ri zhong er hui, zang bing ye ban er hui) · omen complexion (zai se) · solar terms · cold never lasts more than five days, heat never more than five · Su Wen · Wu Zang Bie Lun (On the Separate Discourses of the Five Viscera, chapter eleven) · the extraordinary organs (qi heng zhi fu: brain, marrow, bone, vessels, gallbladder, uterus) · store without draining (cang er bu xie) · hydrocephalus · a swollen head in a man versus a woman, swollen feet — yin and yang reversed · the organs of transformation and transport (chuan hua zhi fu: stomach, large intestine, small intestine, triple burner, bladder) · drain without storing (xie er bu cang) · receiving the turbid qi of the five viscera · the po men (the anus) serves the five viscera · the lung and large intestine are paired · the valveless vessel between the liver and large intestine · metal conquers wood (jin ke mu) · treat the large intestine whenever treating the liver · full but cannot be replete, replete but cannot be full (man er bu neng shi, shi er bu neng man) · the qi kou alone governs the five viscera (qi kou du wei wu zang zhu) · the stomach, the sea of grain and water · the Lung channel of Hand Taiyin · earth generates metal (tu sheng jin) · the five qi enter the nose and are stored in the heart and lung · when the heart or lung is ill, the nose is blocked · in every disease examine the lower passages (fan zhi bing bi cha qi xia) · those who cling to ghosts and spirits cannot be spoken to of the highest virtue

Opening: look at the face first — the five colors hide the secrets of the five viscera

The last lecture finished the generation of the five viscera and the injuries of the five flavors. This one continues onward, and Doctor Ni opens with a master rule — what a normal person’s complexion should look like:

💬 Note from Doctor Ni: In a normal person, on the outside you only see a little sheen, and that is all normal. When your internal organs have a problem, the color becomes very strong — that is what is called the morbid color (bing se). So you see, a little red on the face is fine, but too red — the heart has a problem; too white will not do either — white must shine with a bright light, a deathly white like dried bone will not do.

The reasoning is simple: color is the outward manifestation of visceral qi. The cleaner and more lustrous the color, the fuller the visceral qi; the stronger and more lusterless the color, the more the visceral qi is failing.

Why do the nutrients of the five viscera end up on your face?

Many people do not understand: what does the state of my face have to do with my internal organs? Doctor Ni explains the mechanism underneath:

💬 Note from Doctor Ni: After we eat, the food goes into the belly, and in the small intestine it is separated into nutrients of five colors — green, red, yellow, white and black. These five nutrients are each received by one of the five viscera. When one of your organs has a problem — the white nutrient that should enter the lung cannot get in, but the nutrient is still there, and the lung will not accept it, so it has no choice but to float up onto the face. The face is where stomach qi (wei qi) is located, so you can see the lung’s original color.

So the face is the window through which the five viscera “return the goods” — whichever organ refuses to accept its color, that color floats up onto the face for you to see. This is the deepest confidence behind Chinese medical inspection.

White face and panting: the lung block — forcing sex while drunk

Next Doctor Ni walks through the classic text color by color. First, white:

💬 Note from Doctor Ni: “White — when the pulse arrives, panting and deficient, upper deficiency and lower excess, qi accumulated in the chest, panting and deficient — this is called the lung block (fei bi).” How do you get this disease? After getting drunk, forcing yourself to have sex — zui er shi nei, that causes it. Why does a bad lung make you pant? Because a normal lung governs purifying and descending (su jiang) — after the nutrients inside the lung are used up, they go into the kidney to generate water; essence generates water, that is normal purifying and descending. When it cannot descend, it stops in the upper burner and creates panting: the qi that should go down cannot get down, and with every inhalation you pant, every breath in and you pant.

So the lung block is “upper deficiency and lower excess”: above, lung qi is stalled and turns into panting; below, the nutrients that should be received cannot be received.

How do you measure a long pulse or a short pulse? With the body-inch — the standard is one cun nine fen above the guan

Before the liver block, Doctor Ni teaches how to judge “long pulse” and “short pulse” — because the liver block’s pulse is a long pulse:

💬 Note from Doctor Ni: When we speak of long and short pulses, you need a concept: this is our hand, this is the guan, this is the cun, this is the chi. From the guan upward count nine fen, and from the guan downward a little bit more — that is one cun. So the normal pulse length is one cun and nine fen. Now if it is too long, that is a long pulse; if a person’s pulse is too short, that is a short pulse. Without this standard, how could you judge it? This cun is the proportional body-inch (tong shen cun) — anyone who has studied acupuncture knows the body-inch.

Green face with a long pulse snapping left and right: the liver block — the root is below the heart, which is the stomach

Now the green color:

💬 Note from Doctor Ni: “Green — when the pulse arrives, long and snapping left and right.” The face is turning green, and the pulse pattern is extremely long. Snapping left and right means there is accumulated qi below the heart (xin xia) — and the place below the heart is the stomach. Chest qi suffering fullness — this is called the liver block (gan bi), acquired from cold-damp. It causes low back pain, icy feet, and headache.

Here Doctor Ni stops specially to correct a thousand-year-old misunderstanding — where exactly is “xin xia,” below the heart?

💬 Note from Doctor Ni: From the Huang Di Nei Jing to the Shang Han Lun and the Jin Gui Yao Lue, every time you see “xin xia” — xin xia means the stomach! If you bring it down to the position of the stomach and then read the Shang Han Lun and the Jin Gui Yao Lue, everything becomes simple. Look: for xin xia pi (a stuffy lump below the heart) we have the Xie Xin Tang formulas — Ban Xia Xie Xin Tang, Gan Cao Xie Xin Tang, Sheng Jiang Xie Xin Tang, San Huang Xie Xin Tang, a whole pile of Xie Xin Tang — what is xin xia? It is the stomach. Back then I do not know why they wrote “below the heart” — it misled people into not understanding.

One sentence lights up the whole picture: all the “Draining the Heart” decoctions treat stomach disease.

Yellow face with a large, empty pulse: qi accumulated in the spleen, cold in the belly

Now the yellow color:

💬 Note from Doctor Ni: “Yellow — when the pulse arrives, large and empty.” The normal spleen pulse is a slow, relaxed pulse (huan); it should be slow. But now the pulse is large — and it is an empty pulse: it feels big, but has no strength. This means qi accumulated in the abdomen. Yellow governs the spleen and stomach, and governs the lower abdomen — it means something is blocked in the belly, with cold qi inside the belly. A normal belly should be warm; now there is cold in it, so of course there will be pain — this is called jue shan (reversal hernia). Why must we distinguish cold from heat? Because some Chinese herbs are cold-dispelling drugs and some are heat-dispelling drugs — you must know what the normal state inside is, and only then do you know how to choose, when to use cold herbs and when to use hot herbs.

A woman with a cold belly cannot conceive: moxa on Guanyuan (CV4) and Zhongji (CV3) solves it

On this yellow-pulse passage, the classic adds one line — “the same applies to women” — girls get the same disease, and the consequence is worse:

💬 Note from Doctor Ni: “The same applies to women, acquired by sweating into the wind.” If a girl’s abdomen is cold, besides stomach and intestinal pain, when the abdomen is too cold she will not become pregnant, will not conceive. Modern medicine uses artificial insemination — you keep doing it artificially, but no matter what you do, the cold is still cold inside; the cold has not changed. So they go through all that pain, spend all that money, and still fail. In Chinese medicine it is simple — warm it up and she becomes pregnant!

So how do you warm it up? Doctor Ni says the methods are many:

💬 Note from Doctor Ni: There are many ways to warm it — we spoke of acupuncture earlier, no herbs needed, acupuncture works too — moxa Guanyuan (CV4), moxa Zhongji (CV3), moxa until it is warm and it is done. So one simple word, cold, and the problem is solved. Because it is so simple, there is no way to charge a high price; Western medicine has lots of equipment and can charge however much it likes. So no matter what we Chinese medicine doctors do, we cannot make big money — it is too cheap.

Sweating into the wind: why you must not sit in a draft when you sweat

The cause written on this yellow-pulse passage is “sweating into the wind” (han chu dang feng) — the last four characters of page 84 of the classic. Doctor Ni says this is the thing we must avoid most:

💬 Note from Doctor Ni: Remember: tai yang governs opening — when you sweat, the pores open, that is tai yang’s job; yang ming governs closing; and what lets the closing happen smoothly is shao yang, which is like a door bolt. When you are sweating continuously and the wind keeps blowing in, the wind pathogen easily enters the body. At first it stays in the channels; if it never heals, only then does it slowly move from the channels into the internal organs.

The pores are open and the bolt is not shot — the wind comes in. So after exercising and sweating, do not rush into a draft.

Black face, pulse floating up: the kidney block — acquired by bathing in cold water and going to sleep

The last color, black:

💬 Note from Doctor Ni: “Black — when the pulse arrives” — the face is a dark color, and when you feel the pulse it is hard and large above, with qi accumulated in the lower abdomen — this is called the kidney block (shen bi). The normal kidney pulse is deep (chen); now the pulse floats up, meaning there is something wrong in the body. Bi means numbness — bi from wind, cold and damp; there is blockage, qi and blood do not flow smoothly, that is bi. “Acquired by bathing in clear water and lying down” — you wash in cold water, then lie down to sleep — that is how you get it.

Doctor Ni adds one note: this is only a rough look; the deepest, clearest explanation comes later in the Bi Lun (Treatise on Blockage), where it is discussed most fully.

A yellow face never dies: stomach qi is the last line of defense

Having covered the five colors and the five blocks, Doctor Ni turns to a life-saving line — the classic says “a yellow face with green eyes, a yellow face with red eyes, a yellow face with white eyes, a yellow face with black eyes — none of these die”:

💬 Note from Doctor Ni: Why? Because the qi and color of our face are governed by the stomach. A little yellow on the face — not a dark yellow, but basically yellow, look around the eyes, around the eye bags. The natural complexion is yellow, stomach qi is there — no matter how the rest changes, the person will not die; the disease will be very shallow. Basically the idea of this passage is: when stomach qi is sufficient, the patient has no fatal danger.

So the first thing Chinese medicine does in treating disease is check the stomach qi:

💬 Note from Doctor Ni: When I treat a patient, however severe the disease, I first check whether the stomach is there. If there is stomach qi, the person will certainly live — no question; if there is no stomach qi, it is very serious. Of course we will not let him die — I keep telling you, when it is very dangerous, be careful.

Hungry at noon or hungry at midnight? Watch which moment the stomach qi returns

Stomach qi decides not only life and death, but also when you “come back.” Doctor Ni shares the clinical secret of judging prognosis:

💬 Note from Doctor Ni: After I give a prescription, if the disease is on the surface, in yang, in a fu organ — the gallbladder, small intestine, stomach, large intestine, bladder — or a cold with fever, the patient comes back at noon. In broad daylight when the sun is at its peak, that is yang; at this time the stomach qi recovers — it means he is hungry and eats. If it is a zang disease — liver, heart, spleen, lung, kidney — the general internal medicine diseases, the patient comes back in the middle of the night, around 2 a.m., when the function of the internal organs returns. So when we treat liver disease or lung disease, we watch that moment — if he is hungry in the middle of the night, he has come back. If you have treated for a long time and the stomach qi still has not returned at midnight, then the method was wrong or the medicine was not strong enough — hurry and review.

Waking in the afternoon or waking at midnight, hungry or not hungry — both are the “receipt” of the stomach qi.

A free bonus skill: the omen complexion — check the mirror before boarding a plane

In this lecture Doctor Ni also teaches a special skill of “reading life and death from the face” — the omen complexion (zai se). Note that the omen complexion and the morbid color are not the same thing:

💬 Note from Doctor Ni: Someone accompanies a patient in; the patient sits there panting, and the one accompanying him is his son — the son’s face is green, but he eats, drinks, and moves his bowels and urine all perfectly normally, and he is not your patient. This man is about to meet a great disaster! People die in two ways: one is dying of illness, the other is dying by accident. Before death, you will see the omen complexion. The omen complexion is simple — the same wrong complexion, but eating, drinking, and elimination are all completely normal, and you can find nothing wrong; that complexion is the omen complexion. When the omen complexion appears, you count by solar terms — one solar term is two weeks. For example, if you see it on the day of the spring equinox, then something will happen within two weeks; if you see it in the middle of a term, then within one week. So two weeks is a probabilistic number — generally sometimes it happens in one week, or five days.

And how does Doctor Ni himself use it?

💬 Note from Doctor Ni: So every time I board a plane, I look first — you cannot see yourself, and when you look in the mirror you always favor yourself a little, not fair enough. If everyone’s complexion looks good, no problem, I can board. If I see a wrong complexion — I would rather die than go out; taking the next flight is no problem, life matters more. So first, inspect.

Along with it, a piece of everyday health knowledge: in the climate, “cold never lasts more than five days, heat never more than five days” is the norm — on the sixth day it should warm up again. If it stays cold for over ten days, this place is not fit for people to live; it is bad for the body — hurry and run away.

Entering the Wu Zang Bie Lun: brain, marrow, bone, vessels, gallbladder, uterus — the extraordinary organs

With the five-color diagnosis done, Doctor Ni opens a new chapter — the Wu Zang Bie Lun (On the Separate Discourses of the Five Viscera), chapter eleven, page 87. The Yellow Emperor asks Qi Bo: I hear the various masters — some take the brain and marrow as zang organs, some take the stomach and intestines as zang organs, some take them as fu organs; who is right? Qi Bo first unifies the definitions:

💬 Note from Doctor Ni: Qi Bo says: the brain, marrow, bone, vessels, gallbladder and uterus — these six are born of earthly qi, all stored in yin and modeled on the earth, so they store without draining, and are named the extraordinary organs (qi heng zhi fu). This is not merely giving a definition — we know they are born of earthly qi, they are yin, and storing without draining is their normal state. Inside this is contained our diagnosis, and contained our treatment methods.

The extraordinary organs “store without draining” — when they go wrong, it is “what should be stored is not stored”:

💬 Note from Doctor Ni: If they grow without storing, or do not store, there is a problem. For example, if something grows inside the head — a tumor — then it no longer stores; the nutrients cannot be delivered in, and it turns into hydrocephalus, something growing inside. Originally the brain should be storing; now something grows inside and it does not store — so it bleeds. Many people have accidents — a car crash hits the head; after the hit the head swells up — there is stagnant blood inside. Is stagnant blood not an excess condition? There is fluid accumulation inside.

Men and women are reversed: a swollen head and swollen feet carry completely different dangers

Next Doctor Ni teaches a great clinical law — men and women are exactly opposite in yin and yang:

💬 Note from Doctor Ni: If a woman hits her head and it swells up, it is extremely, extremely dangerous; if a man hits his head and it swells, he does not easily die — he can be saved. But women — swollen feet: for a woman, swollen feet are fine, a swollen head is not; for a man, a swollen head does not matter, but swollen feet do — reversed! You see many wives with swollen feet; ask them how long the swelling has lasted — forty years of swelling, and they still live fine. For a man, swollen feet will not do — once the feet swell up, it is dangerous; some do not live six months.

So in the clinic, when you see hydrocephalus or a head injury — if it is a man, it is easy to treat; if it is a woman, be careful.

The organs of transformation and transport: stomach, large intestine, small intestine, triple burner, bladder — drain without storing

After the extraordinary organs, there is another class — the organs of transformation and transport:

💬 Note from Doctor Ni: The stomach, large intestine, small intestine, triple burner and bladder — these five are born of heavenly qi; their qi faces heaven, so they drain without storing. This is the digestive system — it discharges and does not hoard. If you do not drain — that is constipation. A person who has not urinated for two days — frightening, very dangerous; constipation, not going to the toilet for a week — that is also no small matter. Because this kind of fu should drain without storing; now it is stored inside, and either one can be fatal. “These receive the turbid qi of the five viscera, and are named the organs of transformation and transport — they cannot be retained for long”: after our food is digested, the turbid qi of the viscera and bowels as well all accumulate in the stomach and intestines, and the intestines expel it. So what is in the stomach and intestines is not only food residue — things from inside the five viscera also come out through the stool.

The secret passage between the liver and the large intestine: one vessel without valves

Speaking of draining the turbid qi of the five viscera through the gut, Doctor Ni reveals a physiological structure that makes you clap your hands in admiration — between the liver and the large intestine there is a unique blood vessel:

💬 Note from Doctor Ni: The lung and the large intestine are interior-exterior paired: the large intestine is yang, a fu organ; the lung is yin, the interior. Between them is the diaphragm — above the diaphragm is the lung, below it is the liver. When the lung has dirty things inside — water, phlegm — when we attack downward (gong xia), it enters the large intestine and is drained out through the fu system. The liver? The liver’s metabolic waste enters the gallbladder, is discharged to the duodenum, to the small intestine to help digestion. And below the liver, a vessel also connects to the large intestine — in the whole body, this is the only vessel without valves. All our other vessels have valves — the blood goes past and is not allowed to come back; it can only go forward. But this one has no valves. So when you inhale, lung qi descends, metal conquers wood (jin ke mu), pressing the blood in the liver through this vessel into the large intestine. The large intestine receives this blood and gains strength — the hand receives blood and can grasp, the foot receives blood and can walk, and the large intestine, receiving the liver’s blood, has the strength to push out stool!

This one vessel explains “the liver and the large intestine communicate with each other” in complete clarity. So Chinese medicine, in treating liver disease, always treats the large intestine:

💬 Note from Doctor Ni: The turbid things inside the liver — we can use the large intestine to clear them out. So Chinese medicine, treating liver disease, will certainly treat the large intestine — if the large intestine is not treated, the turbid things in the liver are not metabolized out, and this turbid stuff keeps running toward the heart. The liver is the clearer — it must guarantee the heart a very good quality of blood, an appropriate amount of blood; that is “clear.” If the blood is overabundant, very dirty, and goes down in large quantity, the heart cannot bear it and will have problems.

The po men (the anus — the gate of the po) serves the five viscera, and grain and water may not be stored long — so in treating zang diseases, we often drain through the stool, clearing out the accumulations inside the viscera.

Full but not replete, replete but not full: the fundamental difference between zang and fu

Finally, Qi Bo gives the most refined definition of the zang and fu organs:

💬 Note from Doctor Ni: The zang organs are where essence and qi are stored — full but cannot be replete; the fu organs are where turbid things reside — replete but cannot be full. What is “full”? What is “replete”? When you feel the pulse, if you feel a full pulse — it is like water rushing through a water pipe, very full — that is a lot of water; the same water pipe put into a freezer, hard as a board — that is replete. So the zang can be full but cannot be replete, because the zang stores essence and qi; the essence is perfect and complete, no filtering needed, stored without draining — stored inside it will not spoil. The fu: dirty things can make it replete, but it cannot be full — it must be discharged at all times; the new must replace the old and be expelled. Brought down to eating, it is the two characters “replacement”: when grain and water enter the mouth and reach the stomach and intestines, they stop in the stomach — the stomach is replete and the intestines empty; after chewing, the food reaches the small intestine — now the intestines are replete and the stomach empty. This is the relationship of the fu: replete but not full, full but not replete.

Closing: the qi kou alone governs the five viscera — why does one pulse at the wrist tell you about all five viscera and six fu?

On page 89, the Yellow Emperor asks again: why does the qi kou alone govern the five viscera? How can the pulse on our hand measure the five viscera? Qi Bo’s answer is the foundation of pulse diagnosis:

💬 Note from Doctor Ni: Qi Bo says: the stomach is the sea of grain and water, the great source of the six fu. The five flavors enter the mouth and are stored in the stomach, to nourish the qi of the five viscera — qi speaks of yang, the stomach speaks of yin; the five flavors are sour, bitter, sweet, pungent and salty. The five flavors enter the mouth and are stored in the stomach to nourish the five viscera — the visceral qi of the five viscera comes from here. “The qi kou is also tai yin” — the pulse on the hand, when you practice acupuncture, does it not belong to the Lung channel of Hand Taiyin? The Lung channel of Hand Taiyin is metal; the spleen and stomach are earth; earth generates metal (tu sheng jin) — the essence of the spleen and stomach is upon the lung, and appears on the lung’s qi pulse. So the lung’s qi pulse can represent the five viscera — the qi and flavors of the five viscera and six fu all come out of the stomach and are seen at the qi kou. So from the pulse on the hand alone, we can diagnose the rise and fall of the qi pulses of the five viscera and six fu. And the nose: the five qi enter the nose and are stored in the heart and lung — when the heart or lung is ill, the nose is blocked. From this you know: the lung governs the nose; when the nose has a problem, it is in the lung.

The last sentence is the master procedure of seeing patients in Chinese medicine, and the closing of this lecture:

💬 Note from Doctor Ni: Qi Bo says: in every disease, first examine the lower passages — look at the state of his stool and urine; then look at the state of his pulse; then carefully observe the patient’s emotions — if the patient is easily angered, or his spirit is fearful, very worried, very anxious — at this point you can find where his disease lies. If the patient clings to ghosts and spirits, you cannot speak to him of the highest virtue — to such a patient, no amount of medical reasoning will do any good.

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