Always Hiccuping, Always Yawning, Talking to Yourself? Which Organ Is Signaling Trouble? And Does Unexplained Pain at Huantiao (GB30) Point to Bone Cancer? Doctor Luo Dalun Presents Doctor Ni Haixia’s Thirty-Fourth Lecture on the Huang Di Nei Jing: The Xuan Ming Wu Qi Pian (Clarifying the Five Qi, Part Two) — the Alarm Signals of the Five Zang and Six Fu, the Five Flavor Taboos, and the Five Kinds of Overwork

Patient search terms: constant hiccuping, which organ is it / always yawning and sneezing / talking to myself and repeating words / can’t pass urine / bed-wetting at night / dry eyes with no tears / sudden unexplained Huantiao pain / can’t bend or straighten the foot / varicose veins, which department / sitting too long, sore bottom, hemorrhoids / leg pain from standing too long / what is sleepwalking / voice suddenly lost / anger and bad temper, is the liver bad / how Chinese medicine says to quit spicy food

Corresponding medical names: Su Wen · Xuan Ming Wu Qi Pian (Clarifying the Five Qi, the twenty-third chapter), second half: the five qi illnesses (heart = belching / lung = cough / liver = talking to oneself / spleen = swallowing / kidney = yawning and sneezing) · the six fu qi illnesses (stomach qi rebellion = hiccups / large and small intestines = diarrhea / Triple Burner = water / bladder blocked = long (retention), not holding = yi niao (incontinence) / gallbladder = anger) · the five essences merging (merge into the heart = joy / into the lung = grief / into the liver = worry / into the kidney = fear) · what the five organs dislike (heart dislikes heat / lung dislikes cold / liver dislikes wind / spleen dislikes damp / kidney dislikes dryness) · the fluids of the five organs (heart = sweat / lung = nasal discharge / liver = tears / spleen = saliva / kidney = spittle; tongue diagnosis: coating = lung / body = heart / root = spleen / Jinjin EX-HN12 and Yuye EX-HN13 under the tongue = kidney / sinews = liver) · the five flavor taboos (qi disease: little acrid / blood disease: little salty / bone disease: little bitter / flesh disease: little sweet / sinew disease: little sour) · where the five diseases arise (yin arises in the bone / yang in the blood / yin in the flesh / yang in winter / yin in summer) · the five evils in confusion (evil into yang = mania / into yin = bi / striking yang = dian ji head disease / striking yin = loss of voice / yang entering yin = stillness / yin emerging into yang = anger) · what the five evils show (spring gets autumn pulse, metal conquers wood / summer gets winter pulse, water conquers fire / long summer gets spring pulse, wood conquers earth / autumn gets summer pulse, fire conquers metal / yin emerging into yang = death, incurable) · what the five organs store (heart stores spirit / lung stores po / liver stores hun / spleen stores yi / kidney stores zhi) · what the five organs govern (heart governs the vessels / lung the skin / liver the sinews / spleen the flesh / kidney the bone) · the five kinds of overwork (prolonged gazing injures blood / lying injures qi / sitting injures flesh / standing injures bone / walking injures sinews) · the five pulse images (liver wiry / heart hooked / spleen dai / lung hairy / kidney stony); Xue Qi Xing Zhi Lun (On Blood, Qi, Form and Will, the twenty-fourth chapter), opening: the earliest source of six-channel differentiation · the qi-blood ratios of the twelve channels (Taiyang much blood little qi / Shaoyang little blood much qi / Yangming much qi and much blood) · the three sections and nine indicators (Renying ST9 / Taixi KI3 / Shenmen HT7 / Chongyang ST42 / Taichong LR3; the foot Taiyang has no qi pulse, hence absent) · Tang Rongchuan’s Xue Zheng Lun: remove blood stasis first · in excess drain the child, in deficiency tonify the mother · the proportional inch (tong shen cun) · xing le zhi ku, disease born in the vessels, treat with moxa and needles / xing le zhi le, disease born in the flesh, treat with needle and stone (bian shi, the heated stone ironed over the skin)

Opening: the body talks — learn to understand its “alarm sounds”

In this lecture Doctor Ni Haixia hands over the most practical set of “listen-to-the-sound-and-name-the-disease” mnemonics in the Huang Di Nei Jing — whichever of the five organs and six fu is failing, the body sends out its own signal. Learn this, and the moment a patient opens his mouth, you know which organ is sick.

💬 Note from Doctor Ni: When the qi of the five organs is diseased, the patient makes sounds — the heart gives yi, which is belching and burping; the lung gives cough, which everyone knows; the liver gives yu, talking to oneself or repeating the same words; the spleen gives tun, the patient keeps making swallowing movements; the kidney gives qian and ti — yawning and sneezing are both kidney qi going wrong.

The six fu alarms: hiccups, diarrhea, being unable to urinate, and anger

After the five organs come the six fu, and each fu has its own “dedicated alarm”:

💬 Note from Doctor Ni: When stomach qi rebels upward, the patient hiccups (yue). When the large and small intestines’ qi goes wrong, there is xia li — diarrhea. The Triple Burner is the waterway, the path along which qi travels — our organ qi and fu qi are able to meet and hand over precisely through the Triple Burner system; inside the Triple Burner is all steam and hot vapor, so when qi goes wrong, there will be a condition of accumulated water. When the bladder is blocked it is long — blocked up and unable to pass, there may be a stone, a rock stuck inside; when it cannot hold, it is yi niao — the urine cannot be controlled, and that is a deficiency pattern, a cold pattern. When gallbladder qi goes wrong, the patient flies into a rage. And when a person is terrified, you can see it in the eyes — the eyes stare wide.

The five essences merging: when one organ is deficient, the other four come and “bully” it

Next comes a concept that is central to Chinese medicine — why, when one organ is deficient, the whole body falls ill with it?

💬 Note from Doctor Ni: Wu jing suo bing — the five essences merging — means that if one of your five organs (wood, fire, earth, metal, water — liver, heart, spleen, lung, kidney) is deficient in qi, the other organs will move their disease into it — because normally they survive in a balanced state; the moment one organ’s qi weakens, the others converge on it. Merge into the heart, and there is joy (heart qi deficient, the four organs’ disease reaches the heart); merge into the lung, grief; merge into the liver, worry; merge into the kidney, fear — for example, when kidney qi is deficient, the other four organs all concentrate on the kidney, and what is produced is a symptom of fear. So when you see one symptom, you know which organ’s qi is deficient, and you treat that organ.

What the five organs dislike: the heart fears heat, the lung fears cold — know their “temperaments” to nourish them

Each of the five organs has something it hates. Doctor Ni says that the character wu (恶) alone tells you it means dislike:

💬 Note from Doctor Ni: The heart dislikes heat — conversely, it likes cold. So when the heart has a problem, if you warm it, cover it with blankets, roast it with fire, you accelerate the damage to the heart; you should keep it on the cooler side. The lung dislikes cold and likes heat. The liver dislikes wind — heat conquers wind, so on a hot day when you feel there is not a breath of wind, that is heat overpowering wind. The spleen dislikes damp — the spleen is itself a damp organ, it manages all the fluids inside the muscles of the whole body; too much damp is bad, and dryness conquers damp. The kidney dislikes dryness — the kidney itself has a great deal of fluid, and excessive dryness injures the kidney.

So Doctor Ni reminds us: if you arrive at a place and find the climate bone-dry, you know it will injure the kidney; and a place where the wind is strong enough to knock a man over (such as a mountain pass in Yunnan), standing there injures the liver (the wind injures the liver).

The fluids of the five organs: sweat, nasal discharge, tears, saliva and spittle — each has its own source

The fluids our bodies discharge can represent the five organs. The most important item is “sweat”:

💬 Note from Doctor Ni: The heart makes sweat. Generally speaking, sweat comes from the heart — that is why we speak of “sweat herbs”: the exterior-releasing herbs, once swallowed, make you sweat, and most of them enter the heart. But there is one kind of sweat that does not come from the heart: when you sweat from terror — someone is behind you trying to kill you and you run — that sweat comes from the kidney. The lung makes ti (nasal discharge), and the liver makes tears — if your eyes are dry and there are no tears at all, treat the liver; the spleen makes xian (saliva), and the kidney makes tuo (spittle).

Bonus: a map of the human body on the tongue

Speaking of saliva and spittle, Doctor Ni casually draws the entire tongue-diagnosis map:

💬 Note from Doctor Ni: Under the tongue, on the left and right, there is one point on each side — Jinjin and Yuye. Both of these belong to the kidney channel. The coating on the surface of the tongue is called the lung; the tongue itself is the heart; the root of the tongue is the spleen; and the sinews inside the tongue are the liver. In any organ, in any tissue, the five organs generate an evenly balanced structure. The heart governs the tongue — when the heart has a problem the person cannot speak; the tongue flips and turns, and we know something is wrong.

The five flavor taboos: qi disease — little acrid; blood disease — little salty; bone disease — little bitter; flesh disease — little sweet; sinew disease — little sour

Treatment has its prohibitions, and so does the choice of food and medicine. Doctor Ni goes through the Nei Jing’s “five prohibitions” one by one — this section is the most practical of all:

💬 Note from Doctor Ni: In qi disease, do not eat much acrid. The heart governs dispersing, and the function of acrid flavor is to disperse. If your qi is already diseased — already dispersing — and you eat more acrid things (acrid herbs, a spicy beef noodle bowl, lots of garlic), you make the qi run away even faster. So in treating qi disease — whether its symptoms are emphysema or bronchitis — eat less spicy food. When blood is injured (an accident, an internal injury with blood stasis, or anemia), do not eat too much salty — salt goes to the blood. In bone disease, do not eat much bitter — bitter goes to the bone; bitter flavor injures the bone. In flesh disease, do not eat much sweet — too much sweet injures the flesh: either you become too fat, or too thin, your flesh wasting away. In sinew disease, do not eat much sour — sour goes to the sinews.

“Wu ling duo shi” — “do not let it be eaten much” — means you may eat it, just not a lot. It does not mean never eat it.

Why sudden unexplained Huantiao pain should make you worry about bone disease

On the subject of “bone disease: little bitter,” Doctor Ni throws out a diagnostic shortcut that is extremely useful in the clinic:

💬 Note from Doctor Ni: In the beginning of any bone disease — every disease has a place where it begins — there must be Huantiao pain. Because Huantiao is where the bone begins. When the bone is diseased — take bone cancer: in the cases we see clinically, bone cancer patients all start with pain at Huantiao. So if you suddenly have unexplained Huantiao pain, your bone is diseased.

As for the bitter flavor, Doctor Ni adds a distinction: the bitterness of vegetables is a light flavor; light flavors all enter the qi aspect, not the blood aspect; only the genuinely bitter herbs of Chinese medicine enter the blood — “if you don’t believe me, I’ll hand you a bitter herb and guarantee even a mute will cry out loud.”

Where the five diseases arise: look at where the illness starts and you know whether it is yin or yang

Chinese medicine must understand yin and yang. Doctor Ni explains it as “layer upon layer of handover”:

💬 Note from Doctor Ni: Bone is yin, the blood vessels are yang, muscle is yin, the skin surface is yang — layer after layer of yin and yang receiving each other and supporting each other. Yin disease arises in the bone, yang disease arises in the blood (blood patterns are all yang disease), and yin disease arises in the flesh. Yang disease arises in winter — the definition of winter is that yang should be hidden; disease in winter means yang did not hide but ran out, so it belongs to yang disease. In summer yang is outside and yin is inside, so disease in summer comes from within — it is yin disease. Looking at the surface manifestation of an illness, you can know whether it is yin or yang. Remember one sentence: yang must be hidden, and yang is not afraid of excess — we have many herbs that strengthen yang, and yang is not afraid of being plentiful; but yang must be hidden, and how to make it hide is something we will teach later.

The five evils in confusion: mania, numbness, head disease, loss of voice — four kinds of chaos

When the five evils enter in confusion, each has its own symptoms. This section also contains an important anatomical point — why the head is the “chief of the six yang”:

💬 Note from Doctor Ni: Evil entering yang gives mania — yang is by nature excited; when evil enters on top of yang, the person goes mad. The head is the chief of the six yang, because the kidney channel only reaches the neck; none of the great sinews land on the head — look, there are no kidney-channel points on our face, so the head is the chief of the six yang. Evil entering yin gives bi — numbness appears on the body; yang is always movement, yin is always stillness — numb and unable to move is yin disease. When it strikes yang it is dian ji — yang is hyperactive, and yang qi at the head plus the disease evil gives head disease. When it strikes yin it is yin (瘖) — the voice suddenly disappears.

Bonus: raw Ban Xia and the mother-in-law kitchen story

On “striking yin gives yin (voice loss),” Doctor Ni tells a story that makes everyone laugh — it turns out a master of Chinese medicine can even control who gets silenced:

💬 Note from Doctor Ni: When we talk about herbs later, this is very funny — there is a “mother-in-law herb.” You live with your mother-in-law, and she nags and nags, very noisy, right? So while cooking, put a little raw ban xia (Pinellia) into the dish — and her talking stops. That herb itself causes the voice to go hoarse. Many people, because raw ban xia silences the voice, call it a poison and dare not take it — but use fresh ginger to resolve the toxicity of ban xia. Two weeks later, before you leave your mother-in-law, add plenty of ginger to the cooking — hey, her voice comes right back. So if you know how to use it, you can control a great many things — but do not transmit this to unworthy people.

Wang, Wen, Wen, Qie: pulse-taking only “confirms” the diagnosis — it is not everything

After the five evils in confusion, Doctor Ni stresses the proper order of diagnosis — this passage is a cold splash of water on the “pulse-taking is everything” crowd:

💬 Note from Doctor Ni: The standard four examinations of Chinese medicine are wang (inspection), wen (listening and smelling), wen (asking), and qie (pulse-taking). Once we have done inspection, listening and asking, pulse-taking at the end is only to confirm whether the earlier diagnosis was wrong. If you only know how to feel a pulse and do not even look at the patient’s bearing — the hand comes in through a little hole, you feel the pulse and tell them all about themselves — many people think this is brilliance, and the patient says, “he knows everything about me,” yet in fact not one disease is cured; the prescription runs to seventy or eighty herbs, even ninety herbs, and still nothing is cured.

What the five evils show: feeling an autumn pulse in spring — that is a death pattern

What does “yin emerging into yang” mean? Explained through the pulse, it becomes clear at once:

💬 Note from Doctor Ni: Spring is wood, and if you get an autumn pulse, that is metal conquering wood. Summer getting a winter pulse is water conquering fire. Long summer getting a spring pulse is wood conquering earth. Autumn getting a summer pulse is fire conquering metal. When this kind of conquering pulse appears, it is yin emerging into yang — the disease cannot be treated; there is no way to cure it. Why does a person fly into a rage at the very end, on the last of the yin channels? Because the liver qi has collapsed, and the disease qi of all five organs converges on the liver — what bursts out is anger. That is the final moment.

Doctor Ni adds a deeply felt remark: people are pitiable — born crying loudly, and before they go they must rage once more. And when the physician meets a case of “death, incurable,” what is he to do?

💬 Note from Doctor Ni: You know it is incurable, but you cannot tell him it is incurable — you must still try every way to save him. It has to be done while he still believes in us. Qi Bo said it: the sign of not believing in the doctor — “bing bu xu zhi zhe, bing bi bu zhi” (a disease the patient refuses to have treated will not be treated). There is no way around that. Even if it is your own family member, if he cannot be saved, he cannot be saved.

What the five organs store: spirit, po, hun, yi, zhi — when they run out, that is disease

In the normal state these five things are stored inside the organs (zang means to store — full but not solid). When they run out, we know where the disease comes from:

💬 Note from Doctor Ni: The heart stores spirit (shen). When spirit is not kept, the mind is confused and the emotions unstable — all of that is spirit not being kept. The liver stores the hun (the ethereal soul) — the hun governs the night; when a person lies down, the blood returns to the liver, and the hun hides inside the blood, so it should return to the liver; if at night the liver fails to keep it and the hun runs out, there will be sleepwalking. The lung stores the po (the corporeal soul) — po governs stillness; if a person is so restless he runs here and there, his po is not being kept. The spleen stores yi — being single-minded in what you do. The kidney stores zhi — besides memory, also our aspirations and ambition.

What the five organs govern: why treat varicose veins through the heart?

“Zhu” (govern) means the disease is treated from here:

💬 Note from Doctor Ni: The heart governs the vessels — when the blood vessels have a problem, for example varicose veins, we treat the heart. The lung governs the skin. The liver governs the sinews — if a person tells you his foot cannot bend or stretch, this is a tight, critical clue: the channels are diseased, treat the liver, done — that fast, before the pulse has even been felt. The spleen governs the flesh — muscle problems are treated through the spleen. The kidney governs the bone — bone problems are treated through the kidney.

The five kinds of overwork: prolonged gazing injures blood, lying injures qi, sitting injures flesh, standing injures bone, walking injures sinews

This section is all about the daily roots of modern people’s illnesses, and Doctor Ni explains it very down to earth:

💬 Note from Doctor Ni: Prolonged gazing injures the blood — you sit in an internet cafe every day drinking coffee and playing video games for three days and three nights: that is prolonged gazing injuring the blood. In the past we became myopic from reading by bad light; now you have computers, and staring at the screen makes the eyes myopic. Prolonged lying injures the qi — seen the other way: a person who cannot lie (cannot lie flat) has a lung problem, a qi problem, so the lung governs qi. Prolonged sitting injures the flesh — sitting too long does not only injure the flesh, it also grows hemorrhoids; taxi drivers have a lot of hemorrhoids, it is an occupational disease, so get up and walk around. Prolonged standing injures the bone — you stand at the counter eight hours a day; Chinese medicine holds that prolonged standing injures the bone, not the blood (it is prolonged gazing that injures the blood), so varicose veins from long standing have nothing to do with it; the first place bone injury shows is Huantiao (GB30) pain. Prolonged walking injures the sinews.

Why should a woman give birth in a squat?

On prolonged sitting, Doctor Ni takes the opportunity to criticize the modern delivery room’s “lie on your back,” and this passage is wonderful:

💬 Note from Doctor Ni: Western medicine has you lying on your back to give birth — that is wrong. A normal person should squat to give birth — because our liver channel runs to the big toe; on the big toe two channels converge (the liver channel and the spleen channel), one governing muscle and one governing sinews; the second toe carries the Yangming channel, rich in qi and rich in blood, so the power of the squat is the greatest — you should give birth squatting. In China, women always squatted, with the midwife receiving below. You should also squat to use the toilet — do not sit on the toilet seat. The toilet seat is of course comfortable technology, but it does not match the human body. Our body was truly designed for the squat — look at how we do horse stance (zhan ma bu), always a squat; that is how it should be.

The five pulse images: wiry, hooked, dai, hairy, stony

To close the Xuan Ming Wu Qi Pian, the five pulse images are simple — the liver pulse is wiry (xuan), the heart pulse hooked (gou, full), the spleen pulse dai (intermittent), the lung pulse hairy (mao), the kidney pulse stony (shi). All familiar things.

Opening the next chapter: Xue Qi Xing Zhi Lun — the earliest source of six-channel differentiation

With the Xuan Ming Wu Qi Pian finished, Doctor Ni turns a new leaf in the Xue Qi Xing Zhi Lun and states its thesis outright:

💬 Note from Doctor Ni: The Xue Qi Xing Zhi Lun — the earliest appearance of six-channel differentiation (liu jing bian zheng) in the Huang Di Nei Jing is right here. So when we read the Huang Di Nei Jing, you must be strong in acupuncture — otherwise you will not know what I am talking about. That is exactly why we taught acupuncture first.

The qi-blood ratios of the twelve channels: why is the foot Taiyang absent from the three sections and nine indicators?

The Xue Qi Xing Zhi Lun opens with the “constants of a person” — the qi-blood ratios of the twelve channels. This passage explains one of the deepest principles of Chinese pulse diagnosis:

💬 Note from Doctor Ni: The Taiyang channel has much blood and little qi; the Shaoyang channel little blood and much qi; the Yangming channel much qi and much blood — of the three yang channels, only Shaoyang and Yangming have much qi. That is why, in the three sections and nine indicators (san bu jiu hou), the points taken are on the gallbladder channel (Shaoyang) and the stomach channel (Yangming) — Renying (ST9) is where the Yangming channel’s pulse qi lies. The Taiyang channel itself has much blood and little qi; on the foot Taiyang channel no qi pulse can be found, which is why the three sections and nine indicators leave out the foot Taiyang. As for the three yin channels: the Shaoyin channel has much qi, and the Taiyin channel has much qi — so on Shaoyin you can feel Taixi (KI3) and Shenmen (HT7) (the pregnant woman’s pulse, the heart pulse); Taiyin is the lung channel’s qi pulse, and the cun-guan-chi pulse talks about the Taiyin pulse. On the foot, the Jueyin channel is the limit of yin, the place where yang turns back, so there is the Taichong (LR3) pulse. The great principle of the three sections and nine indicators: when feeling pulse qi, you must confirm that upper and lower agree — if the upper pulse is very small and the lower very large, or the upper very large and the lower very small, both are wrong.

Treat blood stasis first: Tang Rongchuan’s Xue Zheng Lun

Next comes the clinical law Doctor Ni has used all his life — “remove the blood first”:

💬 Note from Doctor Ni: In treating disease through the hand and foot yin-yang channels, you must first remove blood stasis — I recommend that you all read Tang Rongchuan; I was greatly influenced by him. He was a Jing Fang master and wrote a book called Xue Zheng Lun (Treatise on Blood Patterns). When we treat disease we first remove blood; blood stasis must be cleared. There are many ways to remove it — acupuncture has covered this, and the results are immediate.

In excess, drain the child; in deficiency, tonify the mother

This is the centuries-old quarrel between acupuncturists and prescribers, and Doctor Ni settles it in one sentence:

💬 Note from Doctor Ni: When treating the channels: if an excess pattern appears, needle the child point of that channel (in excess, drain the child); if a deficiency pattern appears, tonify the mother point (in deficiency, tonify the mother). It is when the qi of the five organs themselves is diseased that the mother-drain, child-tonify, mother-point, child-point rule applies — in excess drain the child, in deficiency tonify the mother — do not misunderstand this. When a person is sick, it is the twelve channels, the eight extraordinary vessels, the five organs and six fu — if the twelve channels are sick, the fu are sick, and the zang are sick too, then the person dies.

Measuring points: why you cannot measure acupoints with a straw

On measurement, Doctor Ni incidentally corrects a clumsy method in the old books:

💬 Note from Doctor Ni: There is a passage we no longer use — take the depression between two bones, put a straw between them, fold it back and forth to measure. In the old days that was possible. But how do you measure a woman? Everyone is different, and there is an upper and a lower difference — however you measure it, you will be wrong. So do not measure that way; follow our acupuncture method of locating points — the proportional inch (tong shen cun) and the bone-length method — that is always correct.

Closing: the Song hexagram — “form at ease, will bitter” turns out to mean this

In the final short passage, Doctor Ni uses the Yi Jing (Book of Changes) to explain “xue qi xing zhi,” and it is fascinating:

💬 Note from Doctor Ni: Xing (form) le (at ease), zhi (will) ku (bitter) — the “Song” (litigation) hexagram: outside are three yang lines (Qian) joined together, very firm and strong; inside is Kan, water, very dangerous. When a person is headed for lawsuits and disputes, beforehand he appears to say “it wasn’t me who stole it,” righteous and confident — outside very firm, inside very hollow and guilty — that is xing le zhi ku. The disease is born in the vessels, and it is treated with moxa or needles, either will do. If xing le zhi le — outside and inside both too hot, excessive — the disease is born in the flesh, and it is treated with needle and stone. The earliest needle was stone (bian shi) — not a stone stuck into the body, but a stone heated until very hot and ironed over the skin with rubbing; do not heat it so hot that it burns — warm is fine, and even without fire, you can warm the stone in your hand for a while and use it that way.

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