Hiccups That Won’t Stop, Getting Sick After a Fright, and Sweating From Different Places — What Do They Mean? Doctor Luo Dalun Presents Doctor Ni Haixia’s Thirty-First Lecture on the Huang Di Nei Jing: The Jing Mai Bie Lun (On the Separate Discourses on the Channels) — Emotions, Sweat, and Where Blood and Qi Come From

Patient search terms: hiccups that won’t stop — what disease is this / your face no longer produces oil and the skin is dry and rough — what does it mean / I keep getting sick after a fright / are timid people more likely to fall ill / does the place where you sweat mean something different / breaking out in a cold sweat after a fright / sweating while carrying something heavy and walking / sweating right after a meal / how does the water you drink become body fluid / what does the spleen have to do with edema

Corresponding medical names: Su Wen · Yu Ji Zhen Zang Lun (On the True Organ Pulses and the Jade Engine, the nineteenth chapter) — closing: loss of both complexion and pulse · hiccup death sign (exhaustion of stomach and spleen qi) · ask about the former and present disease first · slow pulse means disease / a pulse that does not come and go means death · withered dry skin means death · the sign of yang exhaustion (the face no longer oils + the skin is dry and rough) · channel disease is treated on the channel · bloodletting the grandchild collaterals (sun luo) · blood disease is treated on the channels · the mao ci (hair-needling) method for disease at the extraordinary vessels (jing-well bloodletting of the twelve channels + pricking the green veins) · when the tai yang pulse is exhausted the eyes roll upward · Su Wen · Jing Mai Bie Lun (On the Separate Discourses on the Channels, the twenty-first chapter): for every person, fright, fear, anger, labor, movement and stillness can all alter the body · breathing hard at night comes from the kidney (the overflow harms the lung) · breathlessness from falling and fright comes from the liver (wood conquers earth) · breathlessness from shock and fear comes from the lung · breathlessness from drowning or a sudden fall comes from the kidney and bone · the brave let their qi move and it resolves; the timid let it settle in and it becomes disease · bones, flesh and skin can reveal a person’s disposition · the five places of sweating (sweat from the stomach after a full meal / sweat from the heart after a fright that seizes the essence / sweat from the kidney when carrying heavy loads and walking far / sweat from the liver when running in fear / sweat from the spleen when tumbling and laboring) · the gallbladder is the official of the middle and correct · disease arises from overuse · food qi enters the stomach and disperses essence to the liver, moistening the sinews · turbid qi returns to the heart · the lung faces the hundred vessels and sends essence to the skin and hair · hair and vessels unite their essence and move qi to the organs · qi returns to the balance · drink enters the stomach and the essence wanders and overflows, sent up to the spleen · the spleen qi disperses essence and returns it to the lung · regulating the waterways, sending down to the bladder · the water essence spreads in all directions and the five channels run together · the spleen (earth) governs water

Opening: continuing from the last lecture — two life-and-death signals

At the very start of this lecture, Doctor Ni is still wrapping up the Yu Ji Zhen Zang Lun. The previous lecture had just finished discussing complexion and pulse — and now comes the heaviest sentence of all:

💬 Note from Doctor Ni: When both the complexion and the pulse change — when both are damaged, both lost — that is death. And before death, everyone develops this… the character is pronounced “e” — e ni, hiccups. When a person’s organ qi is gone, when the stomach qi of the spleen and stomach has vanished, he hiccups. The way he hiccups: “hic, hic, hic” — unceasing, non-stop, hiccup after hiccup — that is a death sign.

Four steps of examination: first ask the whole story, then feel the pulse and look at the channels

So how do you actually examine a patient? Doctor Ni lays out the order of practice — this is the clinical rule:

💬 Note from Doctor Ni: When we examine and diagnose a patient, we must ask him: how did it start in the beginning? What is the disease like now? You have to take both the former disease and the later disease into account, and only then feel his pulse, look at the floating and sinking of his channels, and examine the up-and-down order and the pattern. If the pulse is normal, there is no disease; a slow pulse means there is disease; a pulse that does not come and go means death; skin that is withered and dry means death. All these diagnostic rules are written out at length — use them as they come.

There is one extra detail here that Doctor Ni specifically reminds you about — touching the skin:

💬 Note from Doctor Ni: The most important thing is the skin. Our skin secretes a little oil — especially the face. The face is the meeting place of yang (yang zhi hui) — yang qi rushes upward, so oil on the face is normal. The day you stop producing oil, or you touch the skin and it feels dry and rough — when those two go together, it is a death sign. The yang qi is about to expire.

How to treat? Disease of the channel is treated on the channel; disease of the collateral is treated by bloodletting

After life and death, treatment. Earlier we covered “in the three sections and nine indicators, winter is yin and summer is yang” — so how do you treat such diseases? Qi Bo gives four levels:

💬 Note from Doctor Ni: Jing bing zhe zhi qi jing — when the disease is in the twelve channels, we treat it on the channels. If it is a collateral disease (luo bing), a weakness disease, then we treat the sun luo — the grandchild collaterals — and let blood. We have the channels (jing), then the collaterals (luo), then the grandchild collaterals (sun luo); the sun luo are the finest. If the patient has a blood disease (xue bing) — a painful one — we treat the channels and collaterals. What is a blood disease? A disturbance of blood circulation — mostly from external injury, falls or knocks. For this we treat the channels and collaterals so the qi of the channels flows smoothly, and he recovers.

Not in the channel, not in the collateral, not in the grandchild collateral — enter the mao ci (hair-needling) method

Next, this “mao ci” is very interesting. It is the special method for diseases where you cannot find which channel the problem is on:

💬 Note from Doctor Ni: Qi bing zhe zai qi xie — the disease stops at the extraordinary vessels (qi xie). Qi xie zhi mai ze miao ci — when the evil qi stops in the extraordinary vessels, you use miao ci (opposite needling). In miao ci, you needle deeply at the jing-well points of the twelve channels and let out a little blood. That is the first technique. After that, on the limbs and hands and feet — especially on the feet and legs, where green veins appear most — wherever you see a green vein, prick it and let out a little blood. That needling method is miao ci.

Doctor Ni even gives a live example, to show how much these patients make you scratch your head:

💬 Note from Doctor Ni: The use of the miao ci method is for disease on the surface, but not on a channel. We can see the stomach channel and bladder channel easily — if it’s excess, we needle Nei Ting (ST44); if deficiency, we needle Jie Xi (ST41), and we’re done. Then a patient shows up and says: it’s not the stomach channel, not the gallbladder channel, not the spleen channel either. Isn’t that just asking for trouble, making trouble for you? You see, the disease has broken out not on a channel — not on the channel, not on the collateral, not on the grandchild collateral. It just sits there, penetrating — what do you do? This is what miao ci is for.

A disease unchanged for ten years — still treat it by the regular method

There is also a kind of “strange disease” — and Doctor Ni teaches you not to panic:

💬 Note from Doctor Ni: This person is thin, and the disease does not move, does not shift — the same disease stays in the same place. You ask him how long: ten years, just like this, never changing, always parked there. Even though his body is wasting away, we still treat it by the regular method. Shang shi xia xu, qie er cong zhi — that means: follow along the channel and feel it, feel for the tender point, and when you find the tender point, knead and rub it, or insert the needle. This is how acupuncture was done in ancient times. Suo qi jie luo mai zhe — at the places that are knotted, painful, tender — we may prick them and let out blood. Generally, these are diseases on the channels.

When the tai yang pulse is exhausted, the eyes roll upward

Here is another trick for judging life and death:

💬 Note from Doctor Ni: Tai yang mai bu zu — when the tai yang pulse is insufficient, the eyes roll upward. Just now we said “thin” is a person whose body is insufficient; but now the tai yang pulse is insufficient — the eyes roll up, and once they have rolled all the way up, you cannot see [the pupils] at all. When the eyes turn up, the tai yang pulse is already exhausted. These methods are all for judging life and death.

Doctor Ni’s small lament: the loss of the true text is a great pity

At this point, the original text suddenly produces a line — “insert the needle five cun above the fingers and the outer ankle” — and Doctor Ni immediately pokes fun at it:

💬 Note from Doctor Ni: This — nobody knows where it came from. It has nothing to do with what comes before or after — very troublesome. If one day, say, a traveler on the mainland found a complete copy of the Huang Di Nei Jing somewhere, or found the lost portions — that would be extraordinary! It is a matter of fate. Do we still have zhen ren (true persons), sheng ren (sages), xian ren (worthy persons)? A true person might still be alive, running around out there. That is why I go into the mountains whenever I have time, to look around. A zhen ren is not afraid of heat or cold — on a bitterly cold day he runs around naked and doesn’t mind; he is in tune with the seasons, and he doesn’t eat. Naked? In America we call it naked — in Taiwan, what do they call it? Liu niao — “walking the bird”! As for these lost treasures — I think it is almost impossible that they were all destroyed. They must be somewhere — maybe in someone’s tomb, or somewhere else, hard to say. Thousands of years old — what a pity, what a great pity.

Transition: Chapter 21, the Jing Mai Bie Lun — is boldness written on the pulse?

After the lament, we enter today’s main topic — the twenty-first chapter of the Huang Di Nei Jing, the Jing Mai Bie Lun (On the Separate Discourses on the Channels):

💬 Note from Doctor Ni: This chapter is different from the ones before. This chapter is about a person’s emotions — about how, in daily life, a person moves or stays still, is brave or timid. A person with great courage, a person with very little courage — does the pulse change? Can it cause disease? Does it affect the pulse? Of course it does. Qi Bo says: for every person — jing (fright), kong (fear), hui (anger — this character is pronounced “hui,” it means getting angry), lao (labor), dong jing (movement and stillness) — all can alter the body. So a person should not be frightened, should not be fearful, should not get angry, should not move or rest randomly and excessively. Too much change is not good.

Where does breathlessness come from? Night walking, falling in fright, shock, and drowning — each hurts a different organ

The Jing Mai Bie Lun opens by talking about “chuan” (breathlessness, panting) — the same panting, but the source is different in each of the five organs and six bowels. Doctor Ni translates tactfully, but the meaning is quite plain:

💬 Note from Doctor Ni: Ye xing ze chuan chu yu shen — panting at night comes from the kidney. I was a little tactful in my translation: sexual intercourse is also a nighttime activity. And thieves — they are night-walkers, night is when they work; at night they are very tense, very nervous about stealing. That panting comes from the kidney, and the overflow harms the lung (yin qi bing fei). Suo zhui kong — falling from a height, or being terrified, scared, frightened — the breathlessness that results comes from the liver. If the liver is injured, it will harm the spleen, because wood conquers earth (mu ke tu). If sometimes a person is shocked and afraid — constantly fearful, a window rattles and he gasps — that breathlessness comes from the lung; the lung qi is injured. Once the lung qi leaves, once the spirit leaves, the lung will hurt the heart — because the heart can be blocked by qi; when you leave, the lung becomes deficient, and fire comes to conquer it. This harms the heart qi. Some people are drowned, or fall and collapse in an instant — that breathlessness comes from the kidney and the bone.

The brave: qi moves and it’s over; the timid: it settles in and becomes disease — the story of the burglar

The same fright — why does one person come through fine while another falls ill from that day on? The whole answer is in this one sentence: “yong zhe qi xing ze yi, qie zhe zhe er wei bing.” Doctor Ni illustrates it with a very everyday example:

💬 Note from Doctor Ni: Whether it is fright or an accident — falling into water, falling from a height, suddenly collapsing — the text goes on to say: yong zhe qi xing ze yi — the brave one’s qi moves and he resolves it himself. So you have to be bold! Be bold, don’t be afraid — what is there to be afraid of? Qie zhe — people who are timid by nature — zhe er wei bing, it settles in and they become sick. For example, there is a man who was perfectly healthy; one day a burglar breaks into his house, and from that day on he is sick — that is a coward. Another man has a burglar break in and chases after him, and comes back perfectly fine — that man has a big courage. That is why I always tell people: be happy, be fearless, don’t be afraid. We doctors — patients don’t dare provoke me, because what if they get sick? They still need me! So you have to use [the medicine] — don’t be afraid.

Feel the bones, flesh and skin — and you will know whether this person is bold

Can you feel boldness? Doctor Ni says you can:

💬 Note from Doctor Ni: When you see a patient, you must always assess whether this person is bold or timid. Gu rou pi fu neng zhi qi qing, yi wei zhen fa — bones, flesh and skin can reveal the person’s condition; this is a diagnostic method. Generally speaking, bold people have sturdy bones and muscles, and their skin is firm. Timid people are more fragile — their bones and flesh are softer, the flesh softer.

Where you sweat matters: sweat from the stomach, the heart, the kidney, the liver, the spleen

Here comes the most practical part of this chapter. The same sweat — where it comes from, under what circumstances — points to a completely different organ. Doctor Ni sorts it out clearly:

💬 Note from Doctor Ni: After a person eats and is full, sweat comes from the stomach — when we eat, we sweat, and that sweat comes from the stomach; when the food enters the intestine, sweat comes from the small intestine. When a person is frightened, shocked, loses his essence — the cold sweat that comes out after a fright, that cold sweat comes from the heart. So the same sweat — it heats differently, and the cause is different. Chi zhong yuan xing — carrying heavy loads and walking. In olden times these were the woodcutters, hauling things — that sweat comes from the kidney. Because you are bearing weight. Why can you carry heavy loads and walk? Our shoulders have Da Zhu (BL11) — the meeting of the bones (gu hui da zhu); the feet have Jue Gu (Xuan Zhong, GB39) — the meeting of the marrow (sui hui jue gu); and on the back of the calf there is Cheng Shan (BL57). These points handle it, so you can carry heavy loads and walk — because the kidney governs the bones (shen zhu gu). Ji zou kong ju — someone wants to kill you, you are running, and worried — the sweat that comes out then comes from the liver. Yao ti lao ku — entertainers, dancers, singers; laborers hoeing and planting in the fields; Beijing opera performers tumbling their bodies excessively — that sweat comes from the spleen.

Why are some people fearless? The gallbladder is the “official of the middle and correct”

Sweat done, Doctor Ni circles back to the gallbladder — it turns out the whole discussion of sweat was building the stage for this sentence:

💬 Note from Doctor Ni: This is where we can mention: why is the gallbladder called “dan wei zhong zheng zhi guan” — the official of the middle and correct? The gallbladder must be large. When your gallbladder qi is vigorous, you are fearless (wu ju). So to make a person fearless, wen dan — warm the gallbladder. Fix the gallbladder up a little, and he will be less afraid.

Disease arises from overuse — even your knees, which you use every day, need rest

Next comes another famous line from the Jing Mai Bie Lun — “sheng bing qi yu guo yong” (disease arises from overuse):

💬 Note from Doctor Ni: Chun qiu dong xia, si shi yin yang — in spring, summer, autumn, winter, in the yin and yang of the four seasons, disease arises. Why does disease arise right here? Ji yu guo yong — because you used it too much. But then, if you don’t use it at all, that is also bad. For example, the two knees — you need them to walk, right? If you run on them every day, using them too much, disease will arise. So for the long road, we must use [our body], but we must not overuse it.

How does the food you eat become blood and qi? (The journey of food qi entering the stomach)

On page 185 we reach the classic passage of this chapter — how the subtle essence of food and drink travels through the body. Doctor Ni first explains the road of “food”:

💬 Note from Doctor Ni: Shi qi ru wei, san jing yu gan, yin qi yu jin — here I change “jing” (essence) to “jin” (sinews), because the liver governs the sinews. Shi qi ru xiao chang, zhuo qi gui xin — the turbid qi is blood; blood is the dark-colored thing. When you eat, the food enters the small intestine; inside the small intestine the food transforms into dark-colored blood, which returns to the heart; at that point the heart-blood takes care of the blood vessels throughout the whole body. Mai qi liu jing, jing qi gui yu fei — the qi of the vessels flows through the channels, the channel qi returns to the lung; fei chao bai mai, shu jing yu pi mao — the lung faces the hundred vessels and sends essence to the skin and hair. Mao mai he jing, xing qi yu fu — the hair and the vessels unite their essence and move qi to the organs; fu jing shen ming, liu yu si zang — the essence and spirit of the organs, flowing to the four organs; qi gui yu quan heng, quan heng yi ping — the qi returns to the balance, and the balance is level.

Afraid you might be dizzy by now, Doctor Ni explains it again in the simplest words:

💬 Note from Doctor Ni: Let me introduce it in a simple way: in us, qi and blood support each other. Blood comes from the food that enters the small intestine, is digested and becomes blood, and enters the heart. Qi also comes from drinking water and from the essence of ordinary food — what enters the lungs is qi, what enters the heart is blood. Because of this, our bodies are full of blood vessels everywhere, and the blood vessels reach every place in the body. The lung is like the canopy (hua gai) over the skin and hair; we use qi to wrap the whole body. So the heart (blood) and the lung (qi) — the two are yang, above. We can use the heart and lungs, use the ancestral yang (zong yang), to decide and determine a person’s life and death.

How does the water you drink become body fluid? (The journey of drink entering the stomach)

Last is the road of “drink” — this is one of the most quoted passages in the whole Huang Di Nei Jing, and one Doctor Ni tells most vividly:

💬 Note from Doctor Ni: Yin ru yu wei, you yi jing qi, shang shu yu pi — the drink enters the stomach, and the stomach lets the essence wander and overflow, sending it up to the spleen. So as I said before: food goes to the small intestine; drinking water goes into the stomach and up to the spleen. Pi qi san jing — the spleen qi disperses the essence. The spleen is earth, so it sends the essence up to the lung — earth generates metal (tu sheng jin). At this point the spleen, tong tiao shui dao — regulating the waterways — sends it down to the bladder; shui jing si bu, wu jing bing xing — the water essence spreads in all four directions and the five channels run together. So this is the normal course. The spleen is earth, yet it governs water, manages water. You should not only think of “managing” — think of it like the water conservancy bureau managing the rivers: as long as the spleen is there, there will be no edema.

Closing: once you understand the routes of food and water, you will not get far into disease

This lecture began with “death signs” and closes with “where blood and qi come from” — which makes exactly one complete picture:

💬 Note from Doctor Ni: You see how finely Chinese medicine can divide things. Western medicine — sweat is just sweat, it’s all water; what’s so great, what’s the difference? We are different: sweat from the stomach, from the heart, from the kidney, from the liver, from the spleen — the sweat that flows from different actions comes from different places. What you eat becomes blood and becomes qi; what you drink becomes body fluid and travels the water route — crystal clear. Once you understand these routes, you can see at a glance where the disease is.

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