Liver Disease Gets Better in Summer and Worse in Autumn — Does the Day You Take Medicine Really Matter? And Why Would a Heart Patient Take a Cold Shower? Doctor Luo Dalun Presents Doctor Ni Haixia’s Thirty-Second Lecture on the Huang Di Nei Jing: The Zang Qi Fa Shi Lun (On the Qi of the Organs and the Laws of the Seasons) — the Time Codes of the Five Organs and Treatment by the Five Flavors

Patient search terms: when does liver disease get better, when does it get worse / why can’t liver patients face the wind / do you really have to pick the right day to treat disease / is winter dangerous for heart disease / can a heart patient take a cold shower / why can’t heart patients eat food that is too hot / what are sour, bitter and acrid medicines each used for / why use salty medicines for tumors / what is the san jiao (Triple Burner) / which organ do you treat for edema / how do you treat sleeping too much, sleepwalking and seminal emission

Corresponding medical names: Su Wen · Jing Mai Bie Lun (On the Separate Discourses on the Channels, the twenty-first chapter) — closing: the diaphragm divides clear from turbid · the san jiao (Triple Burner) is the official of the waterways (jue du zhi guan) · the spleen governs the water routes · tai yang cang du zhi (counterflow cold, deficient breath and rebellious qi / yin insufficient, yang in excess / drain the shu points below) · yang ming cang du zhi (double yang joined, pure yang / drain yang and tonify yin / Xiangu ST43) · shao yang mai du zhi (qi runs backward / sudden swelling of the yang qiao vessel / Linqi GB41) · the transmission rule (stops at yang ming / only from half-interior half-exterior can evil enter the interior) · the three yin and three yang (tai yin the third yin / jue yin the second yin / shao yin the first yin) · yi yang du xiao shao yang jue (one yang crying alone is shao yang reversal) · yi yin du xiao shao yin jue (counterflow cold / yang disease above / the four pulses contending / qi returning to the kidney) · jue yin cold entering the heart; Su Wen · Zang Qi Fa Shi Lun (On the Qi of the Organs and the Laws of the Seasons, the twenty-second chapter): disease follows the four seasons · it heals in the generating season and turns severe in the conquering season · liver patients must not face the wind · recovery on bing-ding, aggravation on geng-xin, holding on ren-gui, starting on jia-yi · clears at dawn, worsens at dusk, quiet at midnight · the likes and dislikes of the five organs and the tonic-draining of the five flavors (the liver hates urgency — eat sweet to slow it / the heart hates slackness — eat sour to gather it / the spleen hates dampness — eat bitter to dry it / the lung hates rebellious qi — eat bitter to drain it / the kidney hates dryness — eat acrid to moisten it) · saltiness can soften hardness · sour and bitter drain and purge and are yin; acrid and sweet disperse and release and are yang · heart disease heals in chang xia (long summer) and on the wu-ji earth days · avoid hot food and warm clothing · extreme heat generates cold, extreme cold generates heat · jin shi (metal and stone drugs) versus ben cao (herbal medicines)

Opening: continuing from the last lecture — how does the water you drink become body fluid?

In this lecture Doctor Ni is still moving through the Jing Mai Bie Lun, and he first clears up the tail end left from the previous talk — that mouthful of water, once you swallow it, what road does it actually take?

💬 Note from Doctor Ni: Yin ru yu wei, you yi jing qi, shang shu yu pi; pi qi san jing, shang gui yu fei; tong tiao shui dao, xia shu pang guang — the drink enters the stomach, the essence wanders and overflows upward to the spleen; the spleen qi disperses the essence, sending it up to the lung; the waterways are regulated and it descends to the bladder. The most important thing here is that word "tiao" — regulate. In the middle we have the diaphragm — this partition. I keep telling you: this is where Chinese medicine says the clear and the turbid are divided.

The diaphragm: the watershed of the whole body

Do not underestimate this one membrane, Doctor Ni says — it is the watershed of the whole body:

💬 Note from Doctor Ni: The clear qi rises into the lung, and the turbid qi comes down. The turbid matter from the grains we eat all goes out below — through the stool and urine; the clear qi rises into the lung. That is why the sweat we shed is clear — you never sweat out your stool. That is the function of the diaphragm.

What is the san jiao (Triple Burner)? The oil net you use to fry things in the kitchen!

For water to travel through the whole body, it depends on the san jiao. This time Doctor Ni’s comparison is wonderfully everyday:

💬 Note from Doctor Ni: The san jiao is the official of the waterways (jue du zhi guan) — it governs water. The san jiao is born from the spleen — the spleen has a lot of fatty, oily material on it, so after the san jiao grows out of the spleen it extends between the organs of the whole body, and between the organs and the intestines this oily web connects everything. Think of frying food: you wrap the food in an oil net and drop it in — that net is the san jiao. It has oil in it, so it can drain water, and water runs through it very fast — if you spill oil on the floor, water slides right across it. That is what makes it easy to transport fluids.

The water fluid is thus delivered to the bladder and spread over the whole body — "shui jing si bu, wu jing bing xing" (the water essence spreads in all four directions and the five channels run together) — and only then is a person normal. And the organ in charge of all this is the spleen:

💬 Note from Doctor Ni: Our spleen governs the waterways. Remember: whenever a water problem appears, treat it with the methods for the spleen. When water moves through the body, it should be warm qi — it should not be cold water. If it is cold water, we must find a way to transform that cold water into qi or expel it — that is our method of treating water. The Jin Gui Yao Lue (Essentials from the Golden Cabinet) is full of excellent formulas for draining water.

The six channels arriving alone: the tai yang channel arrives alone, hands and feet turn cold

Next comes disease of the six channels, and the first is tai yang:

💬 Note from Doctor Ni: Tai yang cang du zhi — when the qi of the tai yang channel inside the body travels alone, it makes the patient’s hands and feet ice cold — "jue" means counterflow cold of the hands and feet; and the breathing is short and hasty, the qi rebellious. This condition is yin insufficient and yang in excess. The tai yang is a yang channel, its yang qi is extremely vigorous, and yang qi is light — it should travel out to the four limbs. When the yang is too vigorous it dominates and travels alone, running up to the head, so the four limbs are comparatively cold instead. When both exterior and interior should be drained, take its shu points below — the shu points of the bladder channel, in the region of Tonggu (BL66).

The yang ming channel arrives alone: two yangs colliding

After tai yang comes yang ming:

💬 Note from Doctor Ni: Yang ming cang du zhi is a severe disease of yang — two yangs joined together as one, pure yang ming. At this point we drain yang and tonify yin — because the yang is very exuberant, we must drain the yang and at the same time supplement a little yin. Take the shu point of the yang ming channel: Xiangu (ST43).

The shao yang pulse arrives alone: qi runs backward, the qiao vessel swells

💬 Note from Doctor Ni: Shao yang mai du zhi is exhausted qi — the qi runs in reverse, and the qiao vessel swells suddenly ahead of it (qiao qian cu da); take its shu point below. Because the yang qiao vessel runs together with the gallbladder channel, when the qi of the shao yang channel goes wrong, the qi runs backward and makes the whole yang qiao vessel swell. The shu point of the gallbladder channel is Linqi (GB41).

The transmission rule: why does evil stop at yang ming, and why can it still run inward from shao yang?

Here Doctor Ni conveniently re-sorts the transmission logic from the previous lecture:

💬 Note from Doctor Ni: When tai yang disease transmits, there are two possibilities: one is into shao yang, the other is into yang ming. If it enters yang ming, it stops there and goes no further, because yang ming is pure yang. If it enters shao yang — the half-interior half-exterior — then there is still a chance it lingers on the surface; only then can the evil qi slip into the interior and run to the organs. This is the basic concept. So the shu points on our channels are for treating organ qi that is too exuberant, yang qi that is too exuberant — in all such cases you can take the shu points. Shao yang is one yang, yang ming is two yangs, tai yang is three yangs.

The account of the three yin: tai yin, jue yin, shao yin

After the yang, the yin. The tai yin pulse is the pulse of the third yin, and the spleen and stomach are paired as exterior and interior:

💬 Note from Doctor Ni: Tai yin cang bo — when the tai yin organ pulses, the qi of the five organs and five pulses is scanty and the stomach qi is not level; this is the pulse of the third yin — three yins knotted together make yin. Because the spleen and stomach are paired as exterior and interior, tai yin speaks directly of the spleen, and we treat it through its shu points as well; when the yin is very exuberant, we tonify yang and drain yin — use the hand technique to tonify yang and drain yin.

When it reaches shao yin, the original text has a couple of typographical errors, and Doctor Ni catches them on the spot and corrects them:

💬 Note from Doctor Ni: Yi yang du xiao, shao yang jue ye — one yang crying out alone is shao yang reversal; yi yin du xiao, shao yin jue ye — one yin crying out alone is shao yin exhaustion: counterflow cold, yang disease above, the four pulses contending, qi returning to the kidney; treat the yin channels, drain yang and tonify yin. The text here has errors, so let us correct them: the third yin is tai yin, the second yin is jue yin, and the first yin is shao yin.

Cold entering the heart: the patient tells you a very cold sentence

Finally jue yin. This passage is especially vivid — Doctor Ni makes "cold qi lingering and stirring" sound like he is hearing the patient speak:

💬 Note from Doctor Ni: Jue qi liu bo — when cold qi stops inside the body, in the jue yin channel — the liver is the mother, and when the mother is deficient, the cold qi enters the heart. The patient will tell you: very cold — a stream of cold air entering my heart.

The code of the five flavors (1): the liver hates urgency — when urgent, eat sweet to slow it

With the six channels finished, we enter the real feast of this lecture — the Zang Qi Fa Shi Lun (On the Qi of the Organs and the Laws of the Seasons). First, the correspondence between the five organs and the five flavors, and the very first flavor is that character "huan" — slow:

💬 Note from Doctor Ni: Gan ku ji, ji shi gan yi huan zhi — the liver hates urgency; when urgent, eat sweet to slow it. People with liver disease are the most prone to urgency, and that word "slow" is used marvelously. Anything that is urgent, slow it — and to slow it you use sweet-flavored medicines. Teacher, so sugar will do? No — sugar is not a medicine. When we speak of the flavor of medicines, we mean ben cao — the flavors of the herbs in the materia medica.

Here Doctor Ni also explains the difference between "jin shi" (metal and stone drugs) and "ben cao" (herbal medicines):

💬 Note from Doctor Ni: We explained at the very beginning that there are metal and stone drugs — the five-colored meteorites, stalactites, gold, sulfur — all metal and stone. The Daoists refined metal and stone into elixirs, believing that gold never decays, so eating gold makes your body as indestructible as vajra. As for herbal medicines, wood and grass last a hundred years without decaying, so we eat the herbs. The metal and stone drugs are stronger — their flavors are stronger.

The code of the five flavors (2): sour governs gathering — sleepwalking, insomnia and seminal emission all rely on it

The second flavor is sour:

💬 Note from Doctor Ni: The heart governs the hand shao yin heart channel and the hand tai yang small intestine channel, and the bing-ding days belong to fire. Xin ku huan — the heart dislikes slackness; the heart too slow — what do we do? Ji shi suan yi shou zhi — when urgent, eat sour to gather it. Later, when we study the materia medica, all sour medicines are gathering medicines. Some people sleepwalk at night — we need to gather them, and we use sour medicines to gather. Dreaming too much at night, the spirit not settling — or when a person sleeps, water should return to the liver, and because the water has not returned to the liver it causes insomnia — all of these are treated with sour astringents. Seminal emission, a trickling drip that will not stop — that too is gathering. Sour-flavored medicines all govern gathering — some are even more sour than a lemon.

The code of the five flavors (3): bitter dries, bitter drains

The third flavor is bitter, and it takes care of two organs, the spleen and the lung:

💬 Note from Doctor Ni: The spleen governs chang xia (long summer), the foot tai yin and foot yang ming channels govern it, and its days are the wu-ji days. The spleen dislikes dampness — when dampness is too exuberant it presses on the spleen, and at that point ku yi zao zhi: when too damp, use bitter-flavored medicines to dry it — just as when the air is very damp you put out a little desiccant. The lung governs autumn, the hand tai yin and hand yang ming channels govern it, and its days are the geng-xin days. What the lung can least stand is qi rebelling upward — lung qi should descend, that is normal; when the qi runs in reverse, ji shi ku yi xie zhi: eat bitter to drain it. Bitter-flavored medicines can dry and can drain qi, making the qi sink down.

The code of the five flavors (4): the kidney hates dryness — eat acrid to moisten it, plus saltiness can soften hardness

The fourth flavor is acrid, and it governs the kidney. Doctor Ni also throws in a bonus gift ahead of schedule — saltiness can soften hardness:

💬 Note from Doctor Ni: The kidney governs winter, the foot shao yin and foot tai yang channels govern it, and its days are the ren-gui days. The kidney dislikes dryness, because the kidney is the water organ. Too dry — what do we do? Ji shi xin yi run zhi — eat acrid to moisten it. He did not mention this later, so I will tell you ahead of time: of all the salty-flavored Chinese medicines, xian neng ruan jian — saltiness can soften hardness — "jian" is the jian of hard. All tumors and hard masses — saltiness can soften hardness and dissolve them. My tumor patients always ask me: Doctor, why is your medicine so salty? I say: I did not give you any salt — the flavor of the medicine itself is salty.

Yin medicines and yang medicines: sour and bitter drain and purge and are yin; acrid and sweet disperse and release and are yang

Beyond the five flavors there is the great division of yin and yang — one sentence that ties together everything you have learned before:

💬 Note from Doctor Ni: You learned earlier — xin gan fa san wei yang, suan ku yong xie wei yin: acrid and sweet disperse and release and are yang; sour and bitter drain and purge and are yin. Put sour and bitter medicines together and you have a yin medicine, draining and purging — this generates yin. Acrid and sweet joined together can generate yang. Slowly I am leading you into the territory of Chinese herbal medicine.

The centerpiece: disease follows the four seasons — heal in the generating season, turn severe in the conquering season

Next comes the part Doctor Ni says he uses all the time:

💬 Note from Doctor Ni: This passage is about how disease follows the changes of the four seasons: it heals in the generating season and turns severe in the conquering season. This is very important — it is what I use all the time. If a person is diseased in the liver, he recovers in summer — the generating season. If he is not better by summer, in autumn it turns severe — why? Metal conquers wood. If he survives autumn, chi yu dong — it holds in winter: in winter the disease does not extend, it just stops there. Qi yu chun — it starts again in spring.

The taboo of liver disease: never face the wind!

Here Doctor Ni tells a "cruel" joke, and in the same breath points out the most important taboo of liver disease:

💬 Note from Doctor Ni: Liver disease starts in spring, so a liver patient absolutely must not face the wind. If your enemy has liver disease, take an electric fan and blow it on him — no, you cannot do that, he does not understand; you even invite him to your home and blow the fan on him — he will die very fast. When treating liver disease, the patient should be exposed to as little wind as possible: he cannot go for walks by the sea, taking his girlfriend for a walk is no good — the wind blowing on him is bad; he should settle quietly indoors.

Reading the calendar: recovery on the bing-ding days, aggravation on the geng-xin days, holding on the ren-gui days

Disease not only follows the seasons — it also follows the days. In this passage Doctor Ni teaches you to read the almanac:

💬 Note from Doctor Ni: Gan bing zhe yu zai bing-ding — bing-ding are the fire days, the same idea as summer, so the patient recovers on the bing and ding days. If bing-ding do not resolve it, jia yu geng-xin — the geng-xin metal days clash with the liver, and the disease worsens on the geng days. If he survives the geng-xin days, chi yu ren-gui — the ren-gui water days are holding days: no change, the condition is comparatively stable. So if you are a novice doctor and you meet liver disease on the ren-gui holding days, you have time to think and to treat him carefully — this patient will not die; he is holding steady, and you have two days to think.

When does it turn bad again?

💬 Note from Doctor Ni: Qi yu jia-yi — back to the jia-yi days: the disease starts again with the month, because the disease qi is there. If you begin treating liver disease in winter, after spring passes you tell him: start taking your medicine now, and by summer you should be well.

The twelve hours of a day: clears at dawn, worsens at dusk, quiet at midnight

Beyond the seasons and the days, there is also a pattern within a single day. Doctor Ni spells out the practical value of this passage plainly:

💬 Note from Doctor Ni: Gan bing zhe ping dan hui — the liver patient clears in the early morning; that is when you see it most clearly. Why? Ping dan is the yin-mao hours, and yin-mao is wood; liver disease starts in wood. By afternoon, xia bu — it worsens: dusk is metal — is that not the fiercest time? If he does not die then, it holds. At midnight, ye ban jing — midnight is water, and water holds. So within one day you can reason it out with wood, fire, earth, metal and water. In those four or five evening hours the condition holds steady, and you can think about how to handle him; the next morning, at first light, run and feel his pulse — that is the most accurate time.

Doctor Ni also tells a story about a "father-in-law," which conveniently leads into the rule of how Chinese medicine is transmitted:

💬 Note from Doctor Ni: There is no way around it — the patient is alone, and for his sake you feel his pulse, you want to save him — maybe he is your father-in-law or someone close. You must tell him: be careful at this time, do not face the wind, do not be out in the breeze. But even if you tell him, it does not help — disease is disease. So when you are a doctor, the medical arts must not be passed on casually. Western medicine can be passed on freely — that is fine, because they do not understand. Chinese medicine cannot. What if I teach a very bad student, and he covets his father-in-law’s money, or blows a fan on his own enemies — then the father-in-law is out of luck. That is why the classics say: fei ren wu chuan — do not transmit to unworthy people. Chinese medicine can predict not only when a person will die, but also when his disease will be cured — and this is only the elementary level.

A diagnostic gem: when the complexion turns from green to black, you do not even need to feel the pulse

Next comes a clinical golden sentence. Doctor Ni says it is one that clicks the moment you see it in practice:

💬 Note from Doctor Ni: In the course of treating liver disease, the patient calls you: my face used to be green, and now it has turned black — handle it immediately! If it turns red-green, if it turns red — you do not even need to feel the pulse; you know from hearing it. You look at the Huang Di Nei Jing and think it is chaotic — but once I explain a few cases in real practice, it all unlocks for you.

Heart disease: heals in chang xia (long summer), most dangerous in winter — avoid hot food and warm clothing

With the liver finished, the heart. Doctor Ni first settles the question of "chang xia" (long summer) that people have argued over for thousands of years:

💬 Note from Doctor Ni: Bing zai xin — disease in the heart heals in chang xia. Within the twelve hours and the four seasons, chang xia is the time of the season change. The four seasons resolve themselves at the moment the seasons hand over to each other — otherwise, spring, summer, autumn, winter — where would chang xia squeeze in? It cannot squeeze in anywhere. So stop arguing, everyone: chang xia is the season change — this has been argued for thousands of years. If chang xia does not cure it — because fire meets earth, generating — the best days are in chang xia. If it is not better by chang xia, winter makes it worse — water conquers fire. If he survives the winter, spring holds — neither better nor worse, it just stops there. Then in summer the whole cycle starts again. Heart patients must avoid hot food and warm clothing — better not to eat things too hot, eat cooler food, wear fewer clothes, keep yourself a little cool.

A cold shower to treat heart disease: extreme heat generates cold, extreme cold generates heat

"Avoid hot food and warm clothing" sounds counterintuitive, so Doctor Ni demonstrates the principle on the spot — and drops that famous "cold shower" line:

💬 Note from Doctor Ni: Your teacher here is very cool — I am determined to make it work. Every morning when I get up, winter or summer, I shower with cold water, and I have no heart disease. Why? The power of nature is the greatest — we humans must comply with the qi between heaven and earth. The heart is extremely hot; extreme heat generates cold, and extreme cold generates heat. When your heart has a problem, use external cold to stimulate it, and the heart will be forcibly pulled back into line. An enlarged heart generally has no cure — we use the surface method: wear fewer clothes, stay a little cold. He will not catch a cold — heart patients do not catch colds. If you dress him in more clothes he will catch a cold instead, and the heart will stop; dress him less — no cold, no cardiac arrest.

Bonus: eat a big lunch in winter and the heart function comes back

Last, an everyday-care tip for the families of heart patients — Doctor Ni says this single action alone already improves heart disease a great deal:

💬 Note from Doctor Ni: In winter your appetite opens wide — keep eating at noon. The wu (noon) hour opens the heart, and the heart function comes back. With this one action alone, the heart disease is already much better. Xin bing zhe yu zai wu-ji — the wu-ji days are earth, and it heals on the earth days. So you must know this earthly-branch chart, and fuse the weather of heaven together with it — look how deep it goes.

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