One Flick of the Ankle Tells You Whether Someone Can Still Be Saved — Doctor Luo Dalun Presents Doctor Ni Haixia’s Thirtieth Lecture on the Huang Di Nei Jing: The Three Sections and Nine Indicators, Nine Pulses Across the Whole Body That Decide Life and Death

Patient search terms: how to tell whether a disease is easy or hard to treat / why does the pulse not match the body / is it dangerous to have diarrhea until you collapse / what disease makes the eyes sink in / can you feel a pulse beside the ear / how does Chinese medicine see deafness and tinnitus / what does it mean when you flick someone’s ankle and there is no response / why do dying people’s eyes roll upward / when is a water-swelling patient most dangerous / is morning sickness in pregnancy a disease

Corresponding medical names: Su Wen · Yu Ji Zhen Zang Lun (On the True Organ Pulses and the Jade Engine, the nineteenth chapter) — closing of prognosis by pulse · Su Wen · San Bu Jiu Hou Lun (On the Three Sections and Nine Indicators, the twentieth chapter) · the pulse of stomach qi (four to five beats per breath) · form and qi out of accord · the complexion withers without luster · the pulse replete and hard · the pulse running against the four seasons (lung pulse in spring / kidney pulse in summer / heart pulse in autumn / spleen pulse in winter) · pulse and symptoms matching (heat syndrome with quiet pulse / loss of blood with large pulse / diarrhea with large pulse — all hard) · the five excesses and five deficiencies (full pulse / hot skin / abdominal distension with blocked bowels / dim vision; thin pulse / cold skin / scant qi / incontinence of stool and urine / inability to take food) · if gruel and congee enter the stomach the deficient survive · if the body sweats and the bowels move the excessive survive · the three sections and nine indicators (upper heaven — Xuan Li (GB6) and Qu Bin (GB7); upper earth — Ren Ying (ST9); upper man — the artery before the ear; middle heaven — Jing Qu (LU8); middle earth — He Gu (LI4); middle man — Shen Men (HT7); lower heaven — Tai Chong (LR3); lower earth — Tai Xi (KI3); lower man — Ji Men (SP11) and Chong Yang (ST42)) · the nine indicators must be even · one alone large / racing / hot / cold / sunken — all disease · sunken eye sockets are all death (the eye sockets are governed by the stomach) · the ankle-flick test (five cun above the ankle / Xuan Zhong three cun / Yang Fu four cun) · exhaustion of the foot tai yang channel qi — the feet cannot bend, at death the eyes turn upward (dai yan) · winter yin and summer yang (pure yin pulses die at midnight / pure yang pulses die at noon / cold-heat disease dies at dawn / wind disease of the liver dies at dusk / water swelling dies at midnight / the spleen pulse now fast now slow dies at chen, xu, chou and wei hours) · when form and flesh have already fallen away, the nine indicators harmonious or not, still death · when the seven signs of illness appear yet the nine indicators all follow, the person does not die · false diseases are not diseases (wind qi / exterior syndromes / menstruation / pregnancy vomiting)

Opening: continuing from the last lecture — first learn how to tell easy from hard

At the start of this lecture, Doctor Ni is still finishing off the tail of the Yu Ji Zhen Zang Lun. The previous lecture taught that once a true organ pulse appears you begin counting the days. This lecture first sorts out for you the pulses that are “easy to treat” and “hard to treat” — something you use every single day in the clinic:

💬 Note from Doctor Ni: A pulse that is very soft, four to five beats to one breath — that is stomach qi! Any pulse that still has stomach qi is easy to treat. But if it is xing qi xiang shi — the form has been lost: whether the person is too fat (so fat that it is really edema) or too thin, the form is injured, and on top of that the qi is gone — breathing is very short. The chest is the place where all the yang gathers; we judge whether a person’s yang qi is sufficient by watching how he pants and coughs.

When the complexion is lost and the pulse turns replete, it becomes hard to treat

After form and qi, look at the complexion and the pulse:

💬 Note from Doctor Ni: If the complexion is se yao bu ze — the color is eaten up, without luster — then it is comparatively hard to treat. Hard to treat does not mean untreatable — many places say “untreatable,” and that really means untreatable; hard to treat means it can still be treated, only with difficulty. Mai shi yi jian wei zhi yi shen — when the pulse is too replete, too hard and strong, and moreover the pulse runs against the four seasons, that is untreatable. Bi cha qi nan, ming gao zhi: when you feel the patient’s pulse and this is the heart — summer, right? — yet you feel a winter pulse, this is a pulse of mutual conquest. You must tell the patient clearly: “Your heart is in trouble,” and you must tell the family. What is meant by running against the four seasons: in spring getting a lung pulse, in summer getting a kidney pulse, in autumn getting a heart pulse, in winter getting a spleen pulse — these are all xuan jue, deep and hanging-suspended pulses; this is running against the four seasons.

Do not memorize pulse names — remembering “the pulse without stomach qi” is enough

Pulses change in a thousand ways. Doctor Ni teaches a lazy but effective shortcut:

💬 Note from Doctor Ni: You do not need to memorize hong (flooding), xian (wiry), huan (relaxed), fu (floating), chen (deep) — do not memorize them. You only need to remember: a pulse without stomach qi — for instance too wiry, too rough, a very rough pulse, very small and very weak, and moreover not following the four seasons — is a serious disease, running against the four seasons. Also: in spring and summer the pulse should naturally float, in summer the pulse is larger, yet in spring and summer the pulse turns deep instead; in autumn and winter the pulse should be comparatively deep, yet it turns floating and large instead — these too are pulses running against the four seasons.

Pulse and symptoms must match — heat syndrome with a quiet pulse, diarrhea with a large pulse: both dangerous

There is another most troublesome situation: the person and the pulse do not agree. Doctor Ni runs through several examples in a row:

💬 Note from Doctor Ni: The patient has all heat symptoms — with heat the body should be moving, very agitated, excited, tense. But suddenly the patient becomes very still, and the pulse is also very still — thin and slow. The body shows heat symptoms yet the pulse is quiet; a person who has lost blood shows a large pulse — this person’s blood is gone; when you feel the pulse it should be deficient, like a balloon with no air, it should be soft and deflated — yet the pulse is large. A person has diarrhea, twenty or thirty times a day; the pulse should be very thin and weak — yet the pulse is large. This is pulse and symptoms not agreeing; none of these are easy to treat. Bing zai zhong, mai shi jian; bing zai wai, mai bu shi jian — jie nan zhi. Generally speaking, when the disease is inside, the pulse is comparatively relaxed; when the disease is outside, the pulse is comparatively firm. Yet when the disease is outside and the pulse is not firm, this is pulse and symptoms not agreeing — all hard to treat. So to sum it up: when pulse and symptoms match — a deficient person gets a deficient pulse, a replete person gets a replete pulse; for example constipation, you feel a large pulse — that is very easy to treat. Diarrhea with a large pulse — that is hard to treat.

New disease or old disease — know it from the complexion

💬 Note from Doctor Ni: On color and pulse: when the color is lost but the pulse is still there, it can still be treated, only with a little difficulty; when both color and pulse are gone, that is ominous. In a new disease, the complexion must still be there; in a person with a chronic disease, the complexion has already run away upward. So when the complexion is gone, it must be a chronic disease; in a new disease the complexion is still there — this is how you distinguish a new disease from an old one.

Five excesses and five deficiencies: five kinds of deadly “excess,” five kinds of deadly “deficiency”

On page 169, the Yellow Emperor asks: we use deficiency and excess to decide life and death — explain this in detail. Qi Bo answers: wu shi si, wu xu yi si — five excesses mean death, and five deficiencies also mean death:

💬 Note from Doctor Ni: What are the five excesses? First, mai sheng — the pulse is extremely large, growing larger and larger, never stopping. Second, pi re — when you touch the body it is scalding hot. Third, fu zhang — the belly is distended, and both stool and urine are blocked. Fourth, men mao — the vision is blurred and unclear. These are the five excesses. The five deficiencies? First, mai xi — the pulse is thin. Second, pi han — when you touch the skin it is ice cold. Third, qi shao — the inhale is very small, the exhale very short. Fourth, the person stops speaking — we call it loss of voice. Fifth, xie li qian hou — incontinence of both stool and urine, and on top of that food cannot get in. Think about it: both stool and urine are running out of control, so the person should be taking food in to replace it — yet the food still cannot get in. These are the five deficiencies. We are always asking about appetite and about stool and urine. A patient calls on the phone and says in a loud voice: “Doctor, I keep having diarrhea, what do I do?” — no problem there; his middle qi is sufficient. If he says in a very weak voice: “I keep having diarrhea…” — isn’t that dangerous? So you have to listen carefully; see enough cases and you will learn it. The five excesses and the five deficiencies are all dangerous conditions.

The deficient can still live — when gruel and congee enter the stomach, the deficient survive

The Yellow Emperor asks: but some people still live — why? Qi Bo says:

💬 Note from Doctor Ni: Jiang zhou ru wei, xie zhu zhi, ze xu zhe huo — you have a deficiency syndrome, but if the most easily digested things — thin congee, rice, noodles — can enter the stomach, and the moment you eat something the diarrhea stops — you live! Originally the person was having diarrhea even without eating — when eating makes the diarrhea stop, there is hope.

The way of life for the excess syndrome lies in “sweat” and “stool”:

💬 Note from Doctor Ni: Shen han de hou li, ze shi zhe huo. In the five excesses the pores are closed and the sweat cannot come out — if we induce sweating, once the sweat breaks, the patient’s spirit recovers quickly; and when both stool and urine pass freely — originally both were blocked, but after the sweating both move — the excess patient survives. This is the condition; there is a chance of survival.

Chapter 20 appears: the San Bu Jiu Hou Lun — nine pulses across the whole body, corresponding to heaven, earth and man

On page 172 we enter the twentieth chapter of the Huang Di Nei Jing, the San Bu Jiu Hou Lun (On the Three Sections and Nine Indicators). The Yellow Emperor says he has heard Qi Bo’s nine needles and treasures them so much he dare not leak them abroad, and wants to store them away — note the blood oath: he tells Qi Bo, I am absolutely single-minded and sincere in learning from you, and I will never dare to leak this carelessly — this is not to be learned by just anyone:

💬 Note from Doctor Ni: The Yellow Emperor asks about the ultimate numbers of heaven and earth — human physiology must match the principles of heaven and earth. Above, it must correspond to the sun, moon and stars; below, to the changes of the four seasons of spring, summer, autumn and winter, and to the changes of yin and yang and the five elements. Qi Bo says: the ultimate numbers of heaven and earth begin at one and end at nine. One is heaven, two is earth, three is man; taking these three three times, three times three makes nine. So man has three sections, and each section has three indicators, used to decide life and death.

Why nine pulse positions? Because heaven and earth are divided into nine fields:

💬 Note from Doctor Ni: Heaven and earth have directions — east, southeast, south, southwest, west, northwest, north, northeast — and man stands in the middle; between heaven and earth there are nine directions, so we humans have nine places where the pulse is felt, also divided into nine indicators.

The upper three indicators: forehead, throat, and beside the ear

On page 177, Doctor Ni points out the nine pulse positions one by one. First the head — the upper section also has heaven, earth and man:

💬 Note from Doctor Ni: The upper heaven is at the two temporal arteries — the positions of Xuan Li (GB6) and Qu Bin (GB7) on the gallbladder channel, near the inner corner of the temple there is an artery; this is where the shao yang channel qi emerges. The upper earth is at the Ren Ying (ST9) pulse — on both sides of the throat; this is where the stomach qi and stomach pulse travel. The upper man is in front of the ear — feel in front of the ear and there is a pulse moving; that is the shao yang pulse, the pulse qi of the San Jiao. So on the head there are three pulses: one of the gallbladder channel, one of the stomach channel, and one of the San Jiao — the San Jiao pulse is beside the ear.

The middle three indicators: Jing Qu, Shen Men, He Gu

The middle of the body also divides into heaven, earth and man:

💬 Note from Doctor Ni: The middle heaven is at the Jing Qu (LU8) point of the lung channel — where lung qi resides. The middle earth is at the He Gu (LI4) point — where the pulse qi of the hand yang ming large intestine channel resides. The middle man is at the Shen Men (HT7) point of the hand shao yin heart channel. Man is divided into the three sections of upper, middle and lower; the upper section has three indicators, the middle section has three, and the lower section has three.

The lower three indicators: Tai Chong, Tai Xi, Ji Men — and Chong Yang

The lower three indicators are on the feet, where the spleen, stomach, liver and kidney all gather:

💬 Note from Doctor Ni: The lower three indicators — Tai Chong (LR3) of the liver channel, Tai Xi (KI3) of the kidney channel, the Ji Men (SP11) point of the spleen channel, and also the Chong Yang (ST42) point of the stomach channel. When we generally check stomach qi, we check Chong Yang — the place of the stomach pulse, on the instep. So the upper three indicators: the heaven indicator checks the qi of the head and corners, the earth indicator checks the qi of the mouth and teeth, the man indicator checks the qi of the ears and eyes; the middle indicators check the lung, the heart, and the middle qi — matching the positions of the three powers of heaven, earth and man.

The pulse before the ear: at one touch you know whether deafness and tinnitus can be treated

Doctor Ni is especially interested in “the upper man indicator checks the ears and eyes,” because he uses it in the clinic all the time:

💬 Note from Doctor Ni: The man indicator is beside the ear, and there we can know the qi of the ears and eyes. Strangely: if we have deafness and tinnitus — deaf day after day — this pulse disappears altogether — because there is no pulse qi left. If the pulse is large, that is an excess condition; if the pulse is very small, that is a deficiency condition — either way, the deafness can be treated. You can feel the pulse right there and know — these are our acupuncture points: Er Men (SJ21), Ting Gong (SI19), Ting Hui (GB2). You do not need to open the mouth to feel it; just stroke lightly like this and you can feel the pulse moving — the pulse moving means there is qi.

The pulse of mania races — after medicine and needling you should see it slow down

💬 Note from Doctor Ni: At the qi of the head and corners we can feel the brain. Generally its pulse is also four to five beats per breath. If it beats very fast, it means you are very agitated inside — the artery in a manic episode beats very fast. You give him medicine — whether it is Kong Xian Dan (a purging formula for phlegm) or whatever — or you needle him, or moxa the yang qiao channel, moxa Zhao Hai (KI6), or needle Bai Hui (GV20) — that pulse will grow smaller and slower, and when it returns to five beats per breath, it means he is well.

What are the three sections and nine indicators for? — Regulating qi and blood, without asking the disease

The Yellow Emperor asks: now that we know these three sections and nine indicators, what is their purpose? Doctor Ni says Qi Bo’s answer is the pivot of the whole chapter:

💬 Note from Doctor Ni: You must look at whether he is fat or thin, and regulate the deficiency and excess of his qi and blood — excess, drain it; deficiency, tonify it. Bi xian qu qi xue mai, er hou tiao zhi — wu wen qi bing, yi ping wei qi. In a case like this we do not need to ask what disease is inside; just even out his blood and pulse. See which side has stagnant blood and let it out; see the deficiency and excess, and at the pulse positions of the three sections and nine indicators, regulate directly along the channels.

Bonus: how to drain excess and tonify deficiency along the channels — Nei Ting, Yang Fu, Xia Xi, bloodletting

Doctor Ni demonstrates on the spot how to needle using the three sections and nine indicators — his clinical technique:

💬 Note from Doctor Ni: For example, we know this is the San Jiao channel, this is the stomach channel — if the Ren Ying (ST9) pulse is very large, you know the stomach is replete; excess means drain it, and you will needle Nei Ting (ST44). At Qu Bin, it is the place of Xuan Zhong (the suspended bell, GB39) — the pulse qi of the gallbladder channel; for an excess condition you needle Yang Fu (GB38), for a deficiency condition you needle Xia Xi (GB43), to regulate its pulse qi. Along the channel, seeing the stomach channel — Ren Ying pulse large — follow the stomach channel down to the foot: Zu San Li (ST36), Shang Ju Xu (ST37), Xia Ju Xu (ST39), Feng Long (ST40), Jie Xi (ST41); where you see blue veins and stagnant vessels, let the blood out. Let the stagnant blood out and let the qi and pulse run smoothly — you do not need to regulate the internal organs inside, do not need to ask about his disease; once the pulse qi runs smoothly, the disease of the internal organs heals by itself.

The three head indicators have one more special skill — they check the internal organs. Doctor Ni adds a very important sentence:

💬 Note from Doctor Ni: The three pulses on the head govern our organs. So when the five organs are failing, the complexion on the face turns very fierce — why? Because the pulse qi is gone. The yang ming channel qi reaches the face; when all the pulse qi of the head is gone, the complexion turns fierce.

Death sign one: once the eye sockets sink, stomach qi is gone

How do you use the three sections and nine indicators to decide life and death? On page 178, Qi Bo lists a string of death signs. Doctor Ni explains the most important one first:

💬 Note from Doctor Ni: Anyone whose eye sockets have sunk inward is a death sign — because stomach qi is gone! The whole eye socket is governed by the stomach. Also: xing sheng mai xi — the form is tall and strong and sturdy, yet the pulse is thin and small — form and pulse do not agree, qi is too little to sustain breathing — dangerous; a thin, withered person whose pulse is instead very large — with much qi in the chest — these are all pulse and symptoms not agreeing. Whenever we speak of the chest, remember it is the place of yang. When the outer form and your qi and pulse are the same, mutually generating, that is a good sign; when they are not the same, not coordinated, there is disease.

Death sign two: the nine indicators must be even — one alone large, racing, hot or cold — all disease

💬 Note from Doctor Ni: The pulses of the three sections and nine indicators must be even; being the same is the correct pulse. If one pulse is too large, or too small, uneven — there is disease. For example, feel the Ren Ying (ST9) pulse and at the same time feel the San Jiao collateral pulse beside the ear — if their speed is the same, that is good; if the San Jiao pulse is faster and the Ren Ying pulse slower, or fast and slow unevenly, there is disease. So du da ze bing, du ji ze bing — among the nine pulses, if only one pulse is large, or one pulse beats very fast, or one pulse is alone hot, or one pulse is alone cold, or one pulse alone sinks down — all are disease.

Upper, lower, left and right not matching — that is also a death sign:

💬 Note from Doctor Ni: Shang xia zuo you xiang shi, bu ke shu zhe — some places fast, some places slow; you feel the Ren Ying pulse fast, the shao yang pulse slow, the San Jiao pulse fast — you cannot find any rule, not harmonious — that too is death. You feel for a long while and say, “Teacher, there is no rule” — right, that itself is a death sign, because it is not coordinated anymore. Also, the pulses of the middle section — the lung channel, heart channel, and the He Gu (LI4) point of the large intestine channel — fast one moment and slow the next: a death sign. If the middle pulse is dai and gou — dai means constantly changing, and when a fast-slow pulse suddenly turns hook-shaped, the disease is all in the collaterals.

The three sets of nine indicators must echo one another. Doctor Ni teaches a method of checking stomach qi at both ends:

💬 Note from Doctor Ni: Feel the Chong Yang (ST42) pulse — Chong Yang is on the foot — and at the same time feel the Tai Chong (LR3) pulse; both are stomach pulses, one at the head and one at the tail. Feeling these two, can you know how the stomach channel’s qi is? If this one is very large and that one has no pulse — the yang qi has run upward, and inside the yin there is yin excess, such as stomach cancer; the yang qi is cut off. So checking the pulse at head and tail, you can know whether the qi and pulse of the whole channel are smooth; in a normal person the head and tail should move at the same speed; if there is fast and slow, the disease is on the channel.

The most remarkable diagnostic method in the whole chapter: flick the ankle — one flick tells you whether someone can still be saved

In this lecture Doctor Ni teaches a diagnostic hand technique from the Nei Jing on the spot, saying he “uses it all the time”:

💬 Note from Doctor Ni: Yi zuo shou zu shang, shang qu huai wu cun an zhi; you shou zu dang huai er tan zhi. Ying guo wu cun yi shang, ru ru ran zhe bu bing — if you flick and the impulse transmits past five cun, this person has no disease. Zhong shou hun hun ran zhe bing; zhong shou xu xu ran zhe bing; tan zhi bu ying ze si. When we go to see a patient — grab the foot first! This is the Nei Jing’s diagnostic method: at the little toe — the little toe of the foot — five cun above the lateral malleolus — we know three cun is Jue Gu (Xuan Zhong, GB39), four cun is Yang Fu (GB38), and the fifth cun is here. Press the knee with your hand, flick with this finger, and the impulse comes through immediately — past this point, all normal people. You flick here and feel nothing? Try it — you have to grab the whole skin with your hand, and flick — bang! The force is great; the power of the qi and pulse is great. You flick and he has no response — then move forward — the qi stops here with no response, he is almost dead; still no response here — he is gone. This is how you diagnose health and critical illness. What is meant by “no response to the flick”: your hand is here, this hand flicks the lateral malleolus — one flick and there is no response. No response at four cun, and it is still hard? I flick again — your face changes color, and the heart leaps up again — done! You know what I mean, right? That is what it means. For you normal people, flick twice and there is generally an immediate response — very competitive — you can try it.

Why can this not be told casually to the patient? Doctor Ni adds:

💬 Note from Doctor Ni: Right, you cannot tell — we have already said that heretics must not be taught. You cannot tell the patient because the patient would be scared to death first.

Exhaustion of the foot tai yang channel qi: the feet cannot bend and the eyes turn upward — the end is near

After the ankle-flick, the original text suddenly jumps to a passage on the exhaustion of the foot tai yang channel qi. Doctor Ni pokes fun at the bamboo-slip editing of the Nei Jing:

💬 Note from Doctor Ni: This passage suddenly jumps out; before this it did not discuss any of the others — why the tai yang? Speaking of tai yang, should not the shao yang and yang ming also be discussed? No, suddenly this passage appears — that is the Huang Di Nei Jing for you; the bamboo slips were turned to the back and then back to the front; there is no way to manage the data of Chinese medicine. The best way is not to move it, keep it as it is — moving it only makes it messier. But the content itself is very practical: when the foot tai yang channel qi is about to expire, the feet cannot bend or stretch — because the channel qi goes all the way to the feet; below is the pulse, above it reaches Jing Ming (BL1). Many ladies say: “I cannot bend my foot; the foot arches up” — done for; they cannot press it to the ground or walk — this is the tai yang channel qi about to expire. Si bi dai yan — at death the eyes must turn upward: when the eyes turn up a little, the end is near; when the whole eyes roll all the way up, it is over. When a person dies the eyes all roll upward. So we Chinese doctors can occasionally moonlight as forensic examiners — no problem.

Winter yin and summer yang: which pulse, and at what time death

On page 180, the Yellow Emperor asks “dong yin xia yang nai he” — for the nine indicators, how do you determine the time of death by winter and summer? Doctor Ni runs through a whole timetable in one breath:

💬 Note from Doctor Ni: When the pulses of the nine indicators — including the Ren Ying pulse, the forehead pulse, the hand pulses — all appear deep and thin and hanging-suspended, thin and small — these are pure yin pulses, pure cold pulses. Yin pulses govern winter; generally speaking, death comes at midnight (the zi hour), when yin is at its height. If the pulses are sheng zao chuan shu — surging, restless, panting and rapid — pure heat, dry heat pulses — they govern summer; summer is the daytime, and death comes at noon (ri zhong). So: cold-heat disease — cold one moment, hot the next — is between midnight and noon, and death comes at dawn (ping dan). Heat-in-the-middle, heat disease, damp-heat disease — death at noon. Disease from wind — illness caught because of wind; wind is a liver disease; the liver — death at dusk (ri xi). Disease of water — the water-swelling patient — dies at midnight. If the pulse is now fast now slow, this is the spleen’s pulse, and death comes at chen, xu, chou and wei — these four hours are the time when the spleen opens, the four seasons within a day; at this time death comes.

As long as form and flesh remain, even a serious disease can be saved — the seven signs appear, yet if the nine indicators all follow, the person does not die

Near the end, Qi Bo speaks of two crucial “not-dying” conditions:

💬 Note from Doctor Ni: If the patient’s xing rou yi tuo — the body has wasted away, the flesh is gone, skin and bone — even if the pulses of the three sections and nine indicators are harmonious, even if harmonious, still death. Conversely: if the form and flesh are not gone and yin and yang are both still there — even in a serious disease, but not skin and bone, the form and flesh not lost — then if the nine indicators’ pulses are still smooth, the person does not die. So form and flesh are very important! If a person’s form is injured and the spirit is injured, there is no hope. Qi zhen sui jian, jiu hou jie cong zhe bu si — some disease pulses appear on the outside, but as long as the nine indicators all follow, the person does not die.

Closing: some “diseases” are actually not diseases — pregnancy nausea should not be mistaken for a shao yang syndrome

Finally, Doctor Ni teaches one lesson: some false diseases must not be treated as diseases:

💬 Note from Doctor Ni: Suo yan bu si zhe — if you catch a disease of wind qi, some exterior syndromes, or when a woman’s menstruation comes — this kind of disease is “a disease that is not a disease.” For example, this girl is perfectly fine, then suddenly she starts feeling nauseous every day — you look at her: shao yang syndrome? Nausea! Actually she is pregnant — she is an expectant mother. A normal person is normal, but some symptoms will appear; you cannot treat them as a disease.

This lecture carries an enormous amount of information: first the closing of the Yu Ji Zhen Zang Lun — a pulse with stomach qi is easy to treat, a pulse running against the four seasons is hard, pulse and symptoms must match to be treatable, and the life-and-death gate of the five excesses and five deficiencies; then the San Bu Jiu Hou Lun — the numbers of heaven and earth reduce to nine, the head, body and feet each have three indicators totaling nine pulses, checking the head and corners, the ears and eyes, the mouth and teeth, and the lung, heart, spleen, stomach, liver and kidney; the nine indicators must be even to be the correct pulse — one alone large, racing, hot or cold are all disease; when the eye sockets sink, stomach qi is gone; when the ankle-flick draws no response, the day of death has come; winter yin and summer yang — the hour can be calculated; and finally the reminder: as long as form and flesh are not lost and the nine indicators all follow, even a serious disease still has a road to life.

To string this lecture into one sentence: when treating, first distinguish whether stomach qi is present and whether pulse and symptoms agree, then use the three sections and nine indicators to even out the qi and pulse of the whole body — once the pulse qi runs smoothly, the diseases of the internal organs heal by themselves; and to judge life and death, look at the eye sockets, flick the ankle, and see whether the nine indicators are even.

Compiled from Doctor Ni Haixia’s Ren Ji · Huang Di Nei Jing lecture series (Lecture 30)