Sweating for No Reason, a Voice That Suddenly Changes, a Face Turning Black — Are These Signs of Serious Illness? Can’t Eat and Diarrhea, or No Stool and No Urine — Can the Person Still Be Saved? Doctor Luo Dalun Presents Doctor Ni Haixia’s Thirty-Fifth Lecture on the Huang Di Nei Jing: The Bao Ming Quan Xing Pian (Preserving Life and Completing Form) and the Ba Zheng Shen Ming Lun (The Eight Directions and the Spirit of Brightness) — Seeing Illness at Its Very Beginning, the Five Deficiencies and Five Excesses, Dao Yin Guidance Technique, and the Right Moment to Insert the Needle

Patient search terms: sweating for no reason and it will not stop / my voice suddenly changed, went hoarse / my face has turned dark, even black / hiccuping all the time / I cannot eat and I have diarrhea at the same time / no bowel movement and no urine at all / severe constipation that will not pass / shoulder pain — where should I needle? / when is the best time to get acupuncture? / liver disease and a green-black face / what is the dao yin (guidance) technique in Chinese medicine? / is sweating a lot a sign of deficiency?

Corresponding medical names: Su Wen · Xue Qi Xing Zhi Pian (On Blood, Qi, Form and Will, the twenty-fourth chapter), closing section: xing ku zhi ku (body and mind both bitter) — disease born in the throat and voice, treated with bai yao (a hundred medicines) · xing shuo jing kong (body repeatedly frightened) — channels blocked, disease born as numbness (bu ren), treated with massage and lao yao (wine-boiled medicine) · blood-rich and blood-poor channels (Yangming rich in qi and blood / Taiyang rich in blood, poor in qi — bleed the blood, never let out the qi) · men zhen (sealing needle); Su Wen · Bao Ming Quan Xing Pian (Preserving Life and Completing Form, the twenty-fifth chapter): seeing the beginning of illness (the salt-water cup / sweating for no reason = qi leaking / the voice changing tone / the zither string with its rough note before snapping / pruning the tree) · yue (hiccuping) · wei qi jue (stomach qi exhausted: sweating that will not stop plus a failing voice — no medicine can save) · the liver patient’s changing complexion (green → dark yellow → black: qi running against the current, death) · the five methods of needling (governing the spirit / knowing how to nourish life / knowing true medicines / sizing the stone needle / knowing the diagnosis of organs, blood and qi) · the lost chapters of the Huang Di Nei Jing after chapter 65 (supplied in the Song-dynasty edition) · fan ci zhi zhen, bi xian zhi shen (in needling, the truth is to govern the spirit first) · wu xu wu jin, wu shi wu yuan (keep away from the five deficiencies, do not stay away from the five excesses; from the Yu Ji Zhen Zang Lun: rice gruel saves the five deficiencies, the sweating method saves the five excesses) · still as a virgin, quick as a startled hare (the moment for needling) · dao yin (guidance technique: draw from yin to yang and yang to yin; xu zhe xu qi shi — in deficiency needle until the qi returns; shi zhe xu qi xu — in excess needle until the qi empties; yuan jin ruo yi — near and far are one; shou ru wo hu, shen wu ying yu zhong wu — hold the needle as if gripping a tiger, the spirit paying no attention to anything); Su Wen · Ba Zheng Shen Ming Lun (The Eight Directions and the Spirit of Brightness, the twenty-sixth chapter): fa tian ze di, he yi tian guang (model on heaven and earth, match the heavenly light) · when the moon is born, do not drain; when the moon is full, do not tonify · cang xu (hidden deficiency) / chong shi (surging excess) / luan jing (chaotic channels) · never drain a deficiency, never tonify an excess (pain that refuses to be touched = excess; dull aching pain = deficiency) · the nine-palace diagram: proper winds and improper winds (tian ji, the taboo of heaven’s seasons) · first know the Zhen Jing (the classic of needling): combine the sun’s cold and warmth, the moon’s waxing and waning, and the four seasons’ floating and sinking to see where disease first stirs (ru shen fang fu — as if a spirit showed it to you)

Opening: first, close the account from the last lecture

The last lecture ended with the “xing le zhi ku and xing le zhi le” of the Xue Qi Xing Zhi Pian. In this lecture Doctor Ni Haixia first finishes the last two “diseases of form and will,” then opens two major new chapters — the Bao Ming Quan Xing Pian and the Ba Zheng Shen Ming Lun. Both chapters are about the same thing: how to see a disease before it has even surfaced, and when the needle should go in.

Xing ku zhi ku: why do refugees and hunted men have problems with their voice and throat?

First, “xing ku zhi ku” — body bitter and mind bitter. Doctor Ni Haixia says that when a person suffers in both body and heart, the disease lands in the throat:

💬 Note from Doctor Ni: Outside is water, inside is also water — a double danger sitting there — and in this situation the throat develops problems. So if a person lives in fear, then flees as a refugee, or is being hunted by the authorities — bitter indeed, with nothing at all — people like this have problems with the voice and the throat. Zhi zhi yi bai yao — treat it with “a hundred medicines.” There is no single medicine actually named “bai yao” (a hundred medicines); it means all kinds of medicines, many of them.

Xing shuo jing kong: when fright blocks the channels, the body goes numb — use massage and lao yao (wine-boiled medicine)

The second pattern is more common — people who are constantly frightened become numb:

💬 Note from Doctor Ni: Xing shuo jing kong — the body repeatedly frightened — the channels and collaterals do not pass, and the disease is born as bu ren — numbness. Treat it with massage and lao yao. If someone is often affected this way, besides massaging the points, use wine to boil the medicines, to decoct the herbs in wine. Boiling herbs in wine drives the medicinal power deeper and makes it happen faster and stronger. This is the five forms — the diseases generated by the five forms (of body and will).

Blood-rich channels may be bled; blood-poor channels must never have their “qi let out”

This passage is the basic skill of every acupuncturist, and Doctor Ni explains it in detail:

💬 Note from Doctor Ni: On a blood-rich channel you may let blood out, that is fine; on a blood-poor channel, try not to bleed it. The Yangming channel itself is rich in both qi and blood, so letting out blood or qi is all the same to it; the Taiyang channel is rich in blood and poor in qi — we may let blood out, but we absolutely must not let qi out. What is called “letting qi out” we do with a men zhen (sealing needle) — after you pull the needle out, wait a moment, then press; pressing after a pause lets the qi escape; pressing immediately seals the hole and does not let the qi leak. When you insert a needle, think of the pinhole as a balloon — we are careful even about a single needle hole. If we are that careful about a needle tip, what about Western medicine — one knife cut and it is done, right? That is the end of it.

Page 212: Bao Ming Quan Xing Pian — wait until the disease surfaces and it is already too late

Turning to page 212, the Bao Ming Quan Xing Pian (Preserving Life and Completing Form) — this chapter is about how to sustain life, care for the body, and see illness at its beginning. The Yellow Emperor opens with a question that strikes straight at the heart:

💬 Note from Doctor Ni: Between heaven and earth, all people are born between heaven and earth — receiving qi at birth, growing, storing. But sometimes, when an illness begins, you cannot see it at all; it only develops slowly inside the body. In that situation, by the time the person knows he is sick it is too late — treatment can no longer catch it, and the patient dies. This almost sounds like a criticism of Western medicine. The people who wrote the Nei Jing must have known that thousands of years later Western medicine would appear — everyone waits until the disease has already grown before treating it, and by then it is too late.

Seeing the beginning of illness: a cup of salt water tells you the body has already sounded the alarm

Qi Bo’s answer is the “inspect, listen, and ask” of Chinese medicine:

💬 Note from Doctor Ni: We take a cup of salt water and set it down. After a while you see the salty moisture clinging to the outside of the cup. What does it mean? When a person has a pathological change, you can already see that something has changed. For example, you lie there and sweat for no reason (night sweats), or you sit there and the sweat keeps coming, pouring without stopping — that is qi leaking out. There is sickness inside; that is why the qi leaks. The voice is the same — when there is illness, the voice changes. One day you hear my voice differently — the teacher is sick, and the voice has changed. When the string of a zither is about to break, you hear a rough, impure note — so zither players know best. A person is the same: when there is a little illness inside, it can already be heard in the voice.

A tree with branches too dense will die — a person also needs “pruning”

Qi Bo also uses a tree as a metaphor — Doctor Ni says this is for us to examine ourselves:

💬 Note from Doctor Ni: If the branches of a tree grow too densely, the tree will die, so the tree must be pruned — look at flower arranging, you always trim the branches, letting them breathe oxygen. A person’s four limbs are like branches growing out of the trunk — they should look very moist and glossy, and the head and face should be bright and fresh. Actually the body provides many symptoms, but only a good physician can see them — the moment the body has a pathological change, symptoms appear immediately.

One layer deeper: hiccuping

When the illness is shallow, the symptoms are on the surface; when it goes deeper, the symptoms change:

💬 Note from Doctor Ni: When the disease is deeper, qi shen ji yue — yue is hiccuping. If the sweating will not stop and the voice is ruined as well — that is bad. Stomach qi is exhausted — du yao wu zhi (no poison medicine can treat it), fan zheng wu qu (no method can recover it) — at this point the patient can no longer be saved. If you then give him medicine or use acupuncture, you only wound the spleen flesh and wound the blood — wounding it more severely — and there is no way to treat it.

Liver disease, the face turning from green to black: qi running against the current — a death sign

Doctor Ni gives a clinical example, teaching everyone to watch “the changing complexion”:

💬 Note from Doctor Ni: Take a person with liver disease. In liver disease the face is originally green, with a dark yellow inside — wood conquers earth — a dark yellow, a very dark yellow. You treat him, and at the end black appears — that is qi running against the current (ni qi ni xing). In the final stage of liver disease the whole face turns black, even the inside of the mouth is black — the qi is running backwards. So this one cannot be cured either.

The emperor’s troubled heart: the people say I am not a good man — what do I do?

Facing a dying patient, even the physician’s own heart begins to waver:

💬 Note from Doctor Ni: The Yellow Emperor said: when I meet a case that is very dangerous, my heart becomes disturbed — I watch the illness grow worse and worse, and the people say I am not a good man. What can I do? Qi Bo’s answer — in reality, what he says is: the changes are many, and it is not easy to truly understand them. So in the way we needle, first there is zhi shen (governing the spirit), second knowing how to nourish life, third knowing true medicines (du yao), and also sizing the stone needle (bian shi), and knowing the diagnosis of the organs, blood and qi.

Needling is not only “tonify deficiency, drain excess”

People today, when needling, mostly know only tonification and draining — Doctor Ni says that is far from enough:

💬 Note from Doctor Ni: The needling methods of today are all xu ze xie zhi, man ze xie zhi, xu ze shi zhi — drain deficiency, drain fullness, fill deficiency — everyone knows these. But if you model on heaven and earth (fa tian ze di) and move in response (sui ying er dong), that is “the Dao has no ghosts and spirits; it comes alone and goes alone” (dao wu gui shen, du lai du wang). When we insert the needle, it is not simply tonify deficiency and drain excess — we must also govern the spirit, know how to nourish life, and know the true medicines. Governing the spirit is something an ordinary acupuncturist cannot understand.

The lost chapters of the Huang Di Nei Jing: after chapter 65 there is nothing

At this point Doctor Ni inserts a precious piece of textual history:

💬 Note from Doctor Ni: The Huang Di Nei Jing truly lost a great deal. After chapter 65, chapter 66 is missing, and the whole stretch up to chapter 74 is gone. This time I copied the original text and placed it inside the Huang Di Nei Jing — this text comes from the Song-dynasty edition. Generally we do not consider it part of the Huang Di Nei Jing, because it is too complex — it talks about the twenty-eight celestial stars (tian gang) of the sky, and its language does not connect with the earlier text of the Nei Jing. So many scholars believe that because the original text of the Nei Jing was lost, this was supplied to fill the gap. I do not think it is right either, but I still put it in the book for you. The years are too long; we have lost a great deal, and we must rely on later generations — you can supply more in the future, perhaps more than I can.

Governing the spirit and nourishing life can even avert disaster? — But teaching the common people to nourish the spirit is hard

How miraculous is zhi shen (governing the spirit)? Doctor Ni says that once you master it, even car accidents avoid you:

💬 Note from Doctor Ni: Zhi shen yang sheng — governing the spirit and nourishing life — and it also lets you avoid disaster: even car accidents dodge you. I will teach you a set of methods, and we will put it in — see how miraculous it is, and it can nourish life too. But generally, teaching the common people how to nourish and settle their spirit, so they do not get sick, is very difficult — you tell them, and they go home thinking it made sense at that moment; then they see their son locked up in prison, taking drugs, and in a fit of anger it is all gone. So this is very hard. But we have methods — methods to bring them back, to turn them around.

Fan ci zhi zhen, bi xian zhi shen: in needling, the truth is to govern the spirit first

The first requirement of inserting a needle is “spirit”:

💬 Note from Doctor Ni: The Yellow Emperor asked: what is the true principle of needling? Qi Bo said: fan ci zhi zhen, bi xian zhi shen — in all needling, the truth is to govern the spirit first; when the five organs are settled and the nine indicators are prepared, then the needle may be kept (wu zang yi ding, jiu hou yi bei, hou nai cun zhen). When we practice acupuncture, we always have the patient lie down calm and still, not moving, relaxed, and only then do we insert the needle — if the patient is wriggling around, how can you needle? This includes the physician himself — the one inserting the needle must also be calm and even-tempered, the spirit must be present.

Wu xu wu jin, wu shi wu yuan: keep away from the five deficiencies, but do not walk away from the five excesses

Page 217 discusses the “five deficiencies and five excesses.” Doctor Ni asks everyone to turn back to page 170, the Yu Ji Zhen Zang Lun:

💬 Note from Doctor Ni: A person has deficiency and excess — wu xu wu jin (keep away from the five deficiencies), wu shi wu yuan (do not stay away from the five excesses). According to the Yu Ji Zhen Zang Lun, in the five deficiencies and five excesses the person is dead or nearly dead, is he not? You might say: it looks hopeless, so stay away and let him die? We must not do that either. In the five deficiencies — for example, a person cannot get food down and is having diarrhea at the same time. If we give him rice gruel and it goes down, and the diarrhea stops, the deficient person is saved and brought back.

The five excesses: both stool and urine blocked — the only rescue is the sweating method

The five excesses are even more dangerous, but Doctor Ni makes it crystal clear with a “straw principle”:

💬 Note from Doctor Ni: In the five excesses, the person also cannot eat, and stool and urine have both stopped. The only method is the sweating method — like putting a straw into water: press your finger over the top and lift the straw, and the water stays in; the only way to let the water out is to release it. So once you break a sweat and the stool and urine come out, there is rescue. If he sweats and still is not saved — well, either way he was dying, so you try.

Still as a virgin, quick as a startled hare — the moment for needling, missed and gone

Next comes the “opportune moment” for needling, and Doctor Ni uses shoulder pain as an example:

💬 Note from Doctor Ni: When inserting the needle, be still as a virgin, quick as a startled hare (jing ru chu nv, dong ru tuo tu) — I must grasp the moment: the moment the qi arrives, we insert at once. Example for you: a patient comes in today with left shoulder pain, on the Large Intestine channel, not yet moved to another channel. We say: today we will needle you — this is the moment. You say: no matter, we are too busy today, go home and come back in two days — in two days, other channels begin to open. As soon as you see the patient begin to hurt, and you know the needle can do the job, start right away. Some people come in when two channels or three channels already hurt — you can only do your best: the moment you see the pain begin, strike. When needling, the technique must be accurate, the points accurate, the moment grasped — grasp it well, and this is what deficiency-excess tonification-draining means.

The dao yin (guidance) technique: drawing from yin to yang, from yang to yin

Page 218 discusses the dao yin technique — Doctor Ni says this is the skill of the master needle-worker:

💬 Note from Doctor Ni: The good needler is good at dao yin (guidance). Dao yin means drawing from yin to yang and from yang to yin. In this passage Qi Bo says: ci xu zhe xu qi shi — if it is a deficiency, needle until it reaches fullness, until the channel qi returns; ci shi zhe xu qi xu — in excess, you find a way to needle so that the channel qi empties; when the channel qi arrives, guard it and do not let it slip away (zheng shou wu shi). The depth is decided by you; near and far are one (yuan jin ruo yi).

How is it done concretely? One needle at the nearby point, one at the distant point, both hands working together:

💬 Note from Doctor Ni: For example, a person now has shoulder pain. You look at the Large Intestine channel and ask: it has hurt for three days. You insert at Erjian LI2, and it is done. Retain the needle for 20 minutes — ah, there is still a little left — then thread through at that point (the tender point). You only need to remember open-close: the joints are all places of opening and closing, and everything that opens and closes belongs to the Shaoyang. The disease sits here; the open-close is disturbed; it is stuck here. We insert one needle above, one hand twisting the needle at the Jianyu LI15 tender point, the other hand draining on the yang channel. This is yuan jin ruo yi — near and far are one.

How do you practice dao yin? With a single devoted heart — the patient can feel your qi

Dao yin is not a hand technique; it is a skill of “heart and spirit”:

💬 Note from Doctor Ni: Shou ru wo hu, shen wu ying yu zhong wu — hold the needle as if gripping a tiger, the spirit paying no attention to anything around: people call you from outside and you hear nothing; your wife calls you “you old ghost” and you do not answer her, hearing nothing, still placing the needle. Doing dao yin well is simple — it is not the patient, it is you: you must be single-hearted and single-minded, and the dao yin comes out. When your mind concentrates, the moment of touch is like yin and yang meeting — the needle has a sensation, as if yin and yang have made contact, like being charged with electricity. When you are single-hearted and single-minded, the patient feels your qi arriving in his body. What we call “qi treating disease” — the skin is qi, because the skin is governed by the lung. The needle is a gold needle; only when your hand grasps it does it conduct electricity, does it conduct qi — so if you needle while wearing surgical rubber gloves, it does not conduct. On Erjian LI2, to drain, the twirling method is better — because scraping the skin there (“playing the pipa”) hurts very much. Of course, if the patient is your enemy, then by all means scrape his skin; if it is your family or your wife, you had better twirl. One hand working the point, one hand doing even tonification-draining — left and right are symmetrical places — when you do it this way, the patient will tell you his sensation: the qi moves and keeps moving, travels along and connects to this side — “connected, connected” — and you withdraw. So when doing dao yin, both needles start, and both move together.

The Ba Zheng Shen Ming Lun: model on heaven and earth, match the heavenly light

The next chapter, the Ba Zheng Shen Ming Lun (The Eight Directions and the Spirit of Brightness), discusses the laws of acupuncture — coordinating with the yin and yang of heaven and earth, the sun and moon and stars:

💬 Note from Doctor Ni: Using acupuncture must always follow a law; you cannot needle carelessly — fa tian ze di, he yi tian guang: model on heaven and earth, match the heavenly light, coordinate with the yin and yang of heaven and earth, with the sun, moon and stars. What is the principle? When the qi is excessive, when the qi is very full — that is not the moment to treat. For example, now we are about to needle; the lung qi is very full, the disease qi is very strong — then the upright qi must be deficient. You know the lung qi is strong; you drain it, and you cannot drain it away — instead you drain away the upright qi. So we find the moment — wait until the qi has declined, until the upright qi has returned, and then you insert the needle.

When the moon is born, do not drain; when the moon is full, do not tonify

Page 220 discusses the relationship between the phases of the moon and blood and qi — a very refined section of the Nei Jing:

💬 Note from Doctor Ni: When the moon is full, the blood and qi are very full and the muscles are firm (yue man xue qi shi, ji rou jian); when the moon is empty, the muscles shrink, the channels are empty, the defensive qi departs, and the form dwells alone (yue kong ji rou jian, jing luo xu, wei qi qu, xing du ju). So regulate blood and qi according to the season of heaven: when heaven is cold and the ground frozen, we do not needle, because it is too cold; when heaven is warm there is no problem — needle freely, warm weather is the best time to needle. Yue sheng wu xie — when the moon is just born, the qi has just begun to move; at this time you must not drain it, you may tonify. At the full moon, because the qi is full, tonification is forbidden (yue man wu bu). And if the timing is not right for needling, a prescription (medicine) will do instead.

Cang xu, chong shi, luan jing: tonify wrongly or drain wrongly, and the disease qi runs wild

This passage has three terms — cang xu (hidden deficiency), chong shi (surging excess), and luan jing (chaotic channels) — and Doctor Ni takes them apart one by one:

💬 Note from Doctor Ni: What is cang xu (hidden deficiency)? When the moon has just risen and the qi has just begun to move, and you drain it — when the qi has not yet been protected it must not be drained; doing so is called cang xu. When you know a person has deficiency, you need not use draining — it will make him doubly deficient. Then at the full moon, when the blood and qi are already surging, you tonify — that creates blood stasis, and the disease qi goes deeper, the excess goes deeper. Example: constipation, right? When it is already tightly packed, and you tonify it — it becomes even more packed, it cannot come out — that is chong shi (surging excess). And draining at the empty moon — that is luan jing (chaotic channels). Inserting needles at the wrong time always makes the essential qi more chaotic.

Never drain a deficiency, never tonify an excess — pain that refuses touch is excess, dull pain is deficiency

The great principle of pattern discrimination, in Doctor Ni’s plainest words:

💬 Note from Doctor Ni: The true principle: when you meet a deficiency, do not drain; when you meet an excess, do not tonify. How do you tell deficiency from excess? Deficiency is no strength; excess shows yang hyperactivity, or stool that will not come out, urine that will not come out, or something growing — all of these are excess. The pain produced by excess refuses to be touched — it hurts terribly, that is excess; a dull, aching pain is deficiency. The patient tells me “it hurts, and it is also sore, more sore than pain” — that is more deficiency than excess, so tonify first, then drain. The main point is: do not tonify randomly, do not drain randomly; once you are certain, then act. Tonify wrongly and this is the result — yin and yang cross each other (yin yang xiang cuo): when you should tonify you do not, when you should drain you do not — if the channels become chaotic, the disease qi changes and runs wild inside, going deeper, or stopping and not advancing.

The nine-palace diagram: the wind that comes with the season is proper wind; an “improper wind” blowing the wrong way enters the organs directly

On page 221, Doctor Ni begins to draw the nine-palace diagram — the relationship between the winds of heaven and earth and illness:

💬 Note from Doctor Ni: Heaven and earth have the east wind, south wind, southeast wind, southwest wind, west wind, northwest wind, north wind, northeast wind. The winds that come according to the four seasons — spring, summer, autumn, winter — these are zheng feng, the proper winds; they are normal and cause no trouble. But suddenly, at the junction of spring and summer, a northwest wind or northeast wind blows — an improper wind — and at this time people fall ill. When the direction of the wind changes, contrary winds and storm winds produce illness in people: if the wind blows against the normal order and enters the body, it goes straight into the organs. So the physician must know from the very beginning that the disease will be deep. For example, on an ordinary hot summer day, what you get is heat stroke — no big deal; but when a typhoon is blowing, what you get is different — the disease will be deeper. At that moment, quickly clear the disease out — that is the beginning of treatment, and this is the superior physician (shang gong). This is called tian ji — the taboo of heaven’s seasons and nodes — and you must pay attention to it.

Closing: first know the Zhen Jing — whoever practices Chinese medicine must first understand acupuncture

In the final short passage, the Yellow Emperor asks how to emulate the needling of the ancients, and Qi Bo’s answer is a sentence the whole book repeats:

💬 Note from Doctor Ni: To emulate the ancients, you must first know the Zhen Jing — the classic of needling. We must first understand acupuncture; anyone who practices Chinese medicine must first understand acupuncture. We must know four things: the cold and warmth of the sun (the daytime sun), the waxing and waning of the moon, and the floating and sinking of the four seasons (spring, summer, autumn, winter) — combine these four and regulate with them (can he er diao zhi), and at this point we can detect where the disease first begins to move. And the result — ru shen fang fu: as if a spirit showed it to you — not the smallest change escapes your eyes.

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