Baby Fever — How Do You Tell Good from Bad? Bloody Diarrhea — Cold or Heat? Diabetes That Leaves You Always Hungry — Can It Still Be Treated? Doctor Luo Dalun Presents Doctor Ni Haixia’s Thirty-Eighth Lecture on the Huang Di Nei Jing: The Tong Ping Xu Shi Lun (Part 2) — Infant Pulse and the Harmony of Color and Pulse; Life-and-Death Pulses in Diarrhea; Deficiency and Excess in Epilepsy; Xiaoke (Diabetes) and the Binding of the Three Yang; Abscesses, Suppuration and the Ah Shi Points; Da Zhu (BL11) the Meeting Point of Bones; Acupuncture for Cholera and Mania; Illnesses of Rich Food and of Sudden Grief; Wind-Cold-Dampness; the Opening of the Tai Yin Yang Ming Lun

Patient search terms: baby fever what to do / baby fever with green face / bloody diarrhea cold or heat / dysentery with pus and blood / can epilepsy be cured / diabetes always thirsty always hungry / boil with pus what to do / what is an Ah Shi point / gallstones kidney stones needle where it hurts / rheumatoid arthritis swollen joints / sudden collapse and hemiplegia / how to lose a big belly

Corresponding medical names: Su Wen · Tong Ping Xu Shi Lun (Chapter 28) closing: infant pulse and pattern (wiry thin pulse, harmony of color and pulse, wheezing with raised shoulders, one-finger pulse taking) · life-and-death pulses in diarrhea (fever death / cold life; white foam — sinking lives, floating dies; pus and blood — wiry cut off dies, slippery large lives; stomach qi lives, true-organ pulse fixes the day of death) · epilepsy (yang excess above; broad large slippery needs no treatment; small rapid means tumor; deficiency treatable, excess dies) · xiaoke and the binding of the three yang (full large pulse treatable, wiry small means yang exhausted) · abscess needling (cold around hot center / ruptured gallbladder peritonitis / appendicitis / Lung channel Xia Bai LU4, Chi Ze LU5, Kong Zui LU6, Lie Que LU7 and Stomach channel Ah Shi points / needles above elbow and above knee / armpit abscess on Foot-Shaoyang and Hand-Shaoyin / Da Zhu BL11 Meeting of Bones guards pus from entering bone / sudden abscess with cramping tendons at navel shu points / sudden lower abdominal fullness at Hand-Taiyang Luo point three cun from the spine with round-sharp needle / abdominal fullness from water on Kidney channel, from stool on Large Intestine channel) · living use of extraordinary points (Dong Jingchang’s Dong-style points / Liver channel tender spots / one cun below Yang Ling Quan GB34 for gallstones / around Tai Xi KI3 for kidney stones) · cholera on Foot-Yangming · acupuncture for mania (five points below Chi Ze / five Taiyang points / Tong Li HT5 Luo point / three needles five cun above the ankle) · the three xiao and the disease of rich food (hemiplegia, wilting and reversal, qi fullness) · the disease of sudden grief (blockage above and below) · wind-cold-damp joint bi · long illness with qi counterflow suddenly turns to jaundice or mania · Su Wen · Tai Yin Yang Ming Lun (Chapter 29) opening (Tai Yin and Yang Ming interior-exterior / yang qi governs exterior, yin qi governs interior / yang receives external evil into the six fu, yin receives internal injury into the five zang / Yang Ming sees heat only, never cold / channel heat Bai Hu Tang, fu heat Cheng Qi Tang / six fu blockage affects the zang / headache treated at Zhong Wan CV12 / Spleen governs the abdomen, weight loss starts with diet)

Opening: whole-body edema with icy feet — the heart itself grows cold — time to act

This lecture continues from the edema patient of the previous one: the swelling is enormous, the whole body is waterlogged, and when Doctor Ni asks about his feet, they are ice cold — even the heart feels cold.

💬 Note from Doctor Ni: The feet are ice cold — the heart itself has grown cold. This is very dangerous. When the heart has gone cold you cannot delay — you must act. We have very good medicines that can bring him back.

One sentence decides life and death — that is the confidence of a classical formula physician. After the patient is saved, Doctor Ni turns the page and begins pediatrics.

A nursing baby runs a fever — the pulse speaks of good or bad fortune first

The Yellow Emperor asks: a child still nursing from the breast is called a ru zi (infant). When such a child falls ill with fever, how do we judge? Qi Bo’s answer begins with the pulse: this child’s pulse ought to be full and large, but instead it has become thin and wiry.

💬 Note from Doctor Ni: This is what we call pulse and pattern agreeing (mai zheng he). The child has a fever, and the pulse beats large and full — that is pulse and pattern agreeing. Whenever pulse and pattern agree, the case is easy to treat. A ruddy face, a fever, and a fine strong pulse on the wrist — all of these are easy to treat. The reverse — a green face, a full large pulse, and fever — is hard to treat, because color and pulse do not agree. When color and pulse do not agree, something is wrong, so use observation. Qi Bo also says: warm hands and feet mean life — you can simply touch the child’s hands and feet to know.

Fever with wheezing, breathing with the shoulders raised — the lung qi is sealed shut

If a nursing infant is struck by wind and fever, gasps, and raises the shoulders to breathe — Doctor Ni points out this is the “raised shoulders” sign he often mentions; you will see it later in practice. Because the lung qi is sealed shut, the child can only pull in a full breath by shrugging the shoulders — that is called raised-shoulder breathing (chuan ming jian xi).

💬 Note from Doctor Ni: If the pulse is slow and large — slow but large, with a good gentle speed — that is fine. If the pulse is too rapid, it is still a death sign — there is no stomach qi. One detail: when feeling a child’s pulse you do not use three fingers — a child’s wrist is tiny; one finger pressed down is enough to feel it. So we like pulses that are slow and gentle, and we do not like rapid ones.

Bloody diarrhea: fever is dangerous, cold actually means hope

The Yellow Emperor asks again: what if there is diarrhea (xia li) and the stool contains blood? Qi Bo says: fever means death, cold means life. Many people cannot understand: when someone is bleeding from the bowels, why should we be afraid of heat?

💬 Note from Doctor Ni: Think it through with your mind. A person with diarrhea and blood — the body must be cold, right? If he tells you his body is hot, is that not a counter-pattern? It means yang qi is about to expire. Fever means death; cold means life. When a person is losing blood, he should naturally be cold — cold is the normal accompanying phenomenon.

White foam diarrhea and pus-and-blood diarrhea — each has its own pulse rule

Even with the same diarrhea, different discharges follow different pulse rules:

💬 Note from Doctor Ni: If the diarrhea discharges white foam, cold is at its height. With white foam, a sinking pulse means life and a floating pulse means death. Diarrhea with pus and blood is different from diarrhea with white foam — white foam means the yin has collapsed, and when yin is deficient the pulse sinks; conversely, if a yin-deficient person shows a floating pulse — and a floating pulse is a yang pulse — that is bad. For pus-and-blood diarrhea: a wiry pulse cut off means death; slippery and large means life — a slippery pulse shows qi and blood are still in good shape, so the pus and blood are not fatal. Also: diarrhea without body heat and without the pulse hanging cut off — this kind of dysentery can still be saved. In all diarrhea, stomach qi means life — slippery and large is the stomach pulse, stomach qi present, so life; wiry and rough — the pulse is wiry but rough, without strength, stalled and not moving forward — these are death patterns, and we can fix the day of death by the true-organ pulse.

The epileptic child: pulse large and slippery — do not rush to treat

Now, how do we read dian ji (epilepsy, this kind of brain disorder)? This is important:

💬 Note from Doctor Ni: If the pulse is broad, large and slippery, do not treat it — it will heal by itself in a while. If the pulse is small and rapid, it is death, untreatable. When we have dian ji, it happens because yang is hyperactive above — the pulse is very broad and large, the yang pulse is extremely broad and large. If it turns small and rapid, that is generally a death sign — it means a tumor is growing inside. How do we read deficiency and excess in brain disorders? Qi Bo says: whatever is deficient can be treated; excess means death. Deficiency means there is nothing there; excess means something has grown — solid, substantial, something real growing inside.

Xiao ke — diabetes: the three yang are bound, and the heat is unbearable

The Yellow Emperor asks about the deficiency and excess of xiao ke (diabetes). Doctor Ni explains: xiao ke is “the binding of the three yang” — a yang-bound pattern of pure heat.

💬 Note from Doctor Ni: The diabetic drinks water, but drinking cannot stop the thirst. He eats well, but eating cannot stop the hunger — he is always hungry, always eating. This illness, because yang is bound, is extremely hot. For the prognosis, look at the pulse: if the pulse is full and large, illness and pulse agree, and however long the disease has lasted it can be treated. If the pulse is wiry and small, a long illness cannot be treated — once it turns wiry and small, yang is already exhausted. But if the pulse is still large, it is xiao ke, and we can still treat it and cure it.

There are standards for treatment: by form, by bone, by pulse, by sinew

The Yellow Emperor asks: in our methods of treatment, some take the outward form as the standard, some the bone, some the pulse, some the sinew — how do we know which standard applies? This passage discusses the needling methods for abscesses (yong ju) and acute sudden-onset conditions.

💬 Note from Doctor Ni: In winter, our yang qi enters the interior and the outer skin is sealed shut — the weather is cold, so we use more herbs and less acupuncture. Why does the text mention this? Because where an abscess has suppurated, it is the exception — there we still use acupuncture.

How to feel out a suppurating abscess? Cold around, hot in the center

When an abscess has suppurated deep inside, how does the hand know? Doctor Ni gives the most practical palpation trick — whenever pus is forming anywhere:

💬 Note from Doctor Ni: Take a limb, for example. You touch the skin — the arm is cold all around, and the middle of the area is hot. Then we know that underneath, pus has formed. The same happens on the belly — say the gallbladder ruptures and bile flows to that area, producing peritonitis; or the appendix (the head of the large intestine) is inflamed, swollen huge, and bursts. After it bursts, the patch of skin you touch is extremely hot, while all around it is cold. One touch of the hand tells you — all around it is icy, the middle is hot.

Why press for tender points on the Lung channel? Because the lung governs skin and body hair

Suppuration can still be treated with acupuncture. Doctor Ni says: needle the Hand-Taiyin channel (the Lung channel) at the “pang san” (three places), and also search on the yang channel (the Yangming channel).

💬 Note from Doctor Ni: Why do we look for the Lung channel when there is suppuration under the skin? Because the lung governs the skin and body hair — from the lung you can investigate what is underneath. We press along the Lung channel: Xia Bai (LU4), Chi Ze (LU5), Kong Zui (LU6), Lie Que (LU7), about one cun in, and needle the tender point — this is called Ah Shi. You press, “Ah, yes, yes, yes, yes” — you see, it hurts a lot — that tells you to needle there. This point has no fixed location; it may be two cun below, one cun below, not on a regular channel point — you simply needle the tender spot. The Stomach channel is the same. This “Ah Shi” name comes down from Sun Simiao of the Tang dynasty: he described the form of the Ah Shi point. Much of modern acupuncture uses fixed point selection along the channels: my shoulder hurts, so I needle Jian Yu (LI15) — but that is the “form,” not the “spirit.” The true Ah Shi is the point where the patient cries “Ah! Yes, yes, yes, yes” when you press — needle wherever it hurts.

Above the elbow, above the knee: the great rule for needling suppuration

There is a general principle for needling abscesses: the hand does not go past the elbow, the foot does not go past the knee.

💬 Note from Doctor Ni: Find two points on the Yangming channel and three on the Lung channel — this is the treatment pattern that comes out of the Huang Di Nei Jing. And it must be: hand not past the elbow, foot not past the knee. You cannot say, the inflammation is inside — gallbladder or intestinal inflammation, peritonitis from a rupture — and go looking at the chest; it will not be there. It is always below the knee. Armpit abscess (ye yong) is great heat, and the armpit is a Shaoyang area: needle Foot-Shaoyang; if the heat does not stop, add the Hand-Shaoyin Heart channel, needling three more times (three points) — because it lies on the Heart channel, the place where blood gathers. On Shaoyang too, everything is below the knee.

The Yellow Emperor asks: how do we know the measure (du)? This “measure” means finding the tender point.

💬 Note from Doctor Ni: There is no fixed location — because the abscess inside is not fixed; you simply search along the channel. The Hand-Shaoyin Heart channel has three points, and the Hand-Taiyin channel works as well.

Da Zhu (BL11), the Meeting of Bones: guarding against pus reaching the bone

For ordinary abscesses and any suppurating sore, treatment can be done on the Lung channel. But Doctor Ni adds a special warning about one crucial point — Da Zhu (BL11), the Meeting of Bones:

💬 Note from Doctor Ni: The meeting of the great bones is Da Zhu (BL11), the Meeting of Bones; we can find three points there. Why do we look at the Meeting of Bones? Because when an abscess suppurates, if the pus moves toward the skin surface and toward the extremities, that is an urgent (good) sign; if the abscess sinks into the bone, or travels inward toward the body, that is a bad sign. So we search beside Da Zhu (BL11) to prevent the suppuration from reaching and infecting the bone.

Sudden abscess and sudden fullness of the lower abdomen — each has its own point selection

Sudden abscess with cramping tendons (bao yong jin ruan) — sudden onset, very painful, cold sweat pouring without end, and bladder qi insufficiency — urination very difficult, unable to pass water: treat at the shu points beside the navel.

Sudden fullness of the lower abdomen (shao fu bao man)? Take the Luo-connecting point position of the Hand-Taiyang Small Intestine channel (Zhi Zheng SI7), three cun from the spine, using a round-sharp needle.

💬 Note from Doctor Ni: When the belly suddenly fills, why do we take the shu points of the Shaoyin (Kidney channel)? Because when the abdomen is full and distended, it may be constipation, or it may be water accumulated inside — you cannot be sure; always select the points according to the pattern.

Bonus: Dong Jingchang could not read — where did his extraordinary points come from?

Doctor Ni uses this passage to teach a great principle and to introduce a legendary figure — Dong Jingchang (Dong’s extraordinary points):

💬 Note from Doctor Ni: We have an acupuncturist named Dong Jingchang who specialized in extraordinary points. Of the books in his library of Chinese medicine, he understood none — he recognized only one character, “one,” which looks like a carrying pole. Yet he had a vast number of extraordinary points, because they came down through his family. He himself was illiterate; when his father taught him, he simply grabbed his arm and needled like this, needled like that — and then he came to Taiwan. That is where his Dong-style extraordinary points came from. How do you find extraordinary points? Take liver disease as an example: the Liver channel runs along the inner thigh, right? Press along the Liver channel and you will press onto a point in the middle — that plus the points before and after makes exactly three points. So in clinical practice, when we treat cirrhosis, liver cancer or liver disease, we press for tender points on the Liver channel — that is the origin of extraordinary points.

Gallstones and kidney stones — needle wherever it hurts

Points are often chosen according to the time and the place. Yuan-Luo treatment, Shu-Mu treatment, the five gates and ten changes — these are fixed principles; in the clinic you must use them flexibly:

💬 Note from Doctor Ni: Take gallstones — we know the sinews meet at Yang Ling Quan (GB34), and the extraordinary point for gallstones is one cun below Yang Ling Quan. But the book’s “one cun below” is only approximate: the gallbladder sits somewhere inside, and the stone may be here or there, which shifts the point up or down. So you press above and below, find the tender spot, and needle there. The most obvious one is kidney stones — around Tai Xi (KI3): on the inner ankle here, coming up from Tai Xi (KI3), imagine a kidney sitting there in your mind, and press with your finger — the finger is quite big, so use a blunt round chopstick instead (not a sharp one; a sharp one hurts everywhere you press). There is a tender spot here, a tender spot there. Because the kidney is three-dimensional like this, and the stones are here and there, they cannot all happen to sit in the same place — so you needle according to the tender spots. This works for any disease.

So whenever you see abdominal fullness (a distended belly): if the patient may have water, search the Kidney channel; if it may be stool, search the Large Intestine channel, or the Stomach channel.

Cholera and mania — acupuncture can treat them too

The “cholera” of the classics — it appears in the Huang Di Nei Jing — means vomiting and diarrhea together.

💬 Note from Doctor Ni: If it is a pain condition, we know to search around the stomach and spleen area, along the Yangming channel. Is there a technique for needling mania and psychosis? There is! Acupuncture can treat mental illness and epilepsy too: the Hand-Taiyin has five points — below the elbow, below Chi Ze (LU5), find five points; the Taiyang (Small Intestine) channel also has five, like Yang Gu (SI5); the Luo-connecting point of the Hand-Shaoyin Heart channel — Tong Li (HT5) is the Luo point — press beside it and needle the tender spot. Five cun above the ankle, needle three consecutive times. Just remember the channels, and press continuously along them for tender points. Epilepsy and psychosis — acupuncture can help treat all of them. There are no fixed points; it is decided entirely by the tender spots the patient feels on his own body.

The rich eat too well, the worried think too much — illnesses arising from within

On page 251, Qi Bo discusses treating the three xiao illness (xiao dan): sudden collapse, hemiplegia, wilting and reversal, qi fullness rushing contrary — these are all “the disease of rich food” (gao liang zhi ji):

💬 Note from Doctor Ni: These are all the fat and the precious — rich people, gao liang (rich food). Because they eat too well, the evil lives inside, and the moment it erupts it becomes disease. Then there is “blockage and closure, nothing passing above or below” — food and drink cannot enter, or the stool cannot come out — this is the disease of sudden grief (bao you zhi bing): worry in the heart. People of a temperament that likes to toil and worry all get this kind of illness.

Also sudden cold reversal — the four limbs icy, sudden deafness, stuffy nose, blocked urination — these are all illnesses arising from within. Everything in this passage is internally arising — the rich who eat too well, or the worried, all fall ill from within.

Closing: wind-cold-damp, and “illnesses that never erupt in an instant”

Finally Qi Bo speaks of the “cold-wind-damp” disease: swollen painful joints of the hands and feet, difficulty walking — all are cold-wind-damp.

💬 Note from Doctor Ni: Why does the text say cold-wind-damp here? Because later, when we prescribe, we will use medicines: this herb dispels cold, this herb dispels wind, this herb dispels damp — mix the wind-dispelling, cold-dispelling and damp-dispelling together, and that is the treatment. So you must learn to identify wind-cold-damp. Generally, swollen joints and rheumatoid arthritis are wind-cold-damp. The original text says “cold-wind-damp,” which does not roll off the tongue, so I say wind-cold-damp — does it make any difference? Disperse wind, dispel cold, drain damp — done. Do not be so fussy.

And one more definition to close:

💬 Note from Doctor Ni: Things like the whole body turning yellow, a sudden burst of pain, a sudden epileptic fit, sudden madness — running wild like a madman, no longer human — these all come from long, chronic illness with qi counterflow, qi not flowing smoothly, running contrary again and again before they are produced. They never erupt in an instant.

Preview of the next lecture: Tai Yin and Yang Ming — both interior-exterior, why do the illnesses differ?

Closing this lecture, Doctor Ni mentions that “the five zang — liver, heart, spleen, lung, kidney — when the five zang are not level among themselves,” and smoothly turns to the twenty-ninth chapter, the Tai Yin Yang Ming Lun:

💬 Note from Doctor Ni: Tai Yin and Yang Ming are interior-exterior — the Foot-Taiyin Spleen channel and the Foot-Yangming Stomach channel are interior-exterior, right? When the Spleen and Stomach channels are ill, the two are equally interior-exterior, so why do the illnesses differ? Of course they differ — one is interior, one is exterior. Qi Bo says the yin and yang are different: some come from within, some from without, so the symptoms naturally differ. This chapter is also the source of six-channel pattern differentiation — Zhang Zhongjing’s Shang Han Lun (Treatise on Cold Damage) divided the six channels in great detail, with all the treatments and all the formulas; he studied this from the Huang Di Nei Jing.

Doctor Ni also explains the characteristic of Yangming disease first: the Yangming pattern sees only heat, never cold — a pure Yangming pattern.

💬 Note from Doctor Ni: Yangming means the fu (the definition of Yangming: one is channel heat, one is fu heat). Yangming patterns are all heat-without-cold — you see heat signs only, never cold signs. Why is Yangming a “two-yang” disease? Two yang joined together make Yangming. The two — channel heat and fu heat — show different symptoms: both have high fever and thirst; fu heat is the large intestine and stomach, so think of constipation — that is why we later have formulas like Cheng Qi Tang (Order the Qi Decoction). Channel heat: the patient runs a fever, also high fever, and we sometimes use Bai Hu — Bai Hu Tang (White Tiger Decoction) treats channel heat. When Zhang Zhongjing prescribed, he separated the two.

Yang qi is the qi of heaven and governs the exterior; yin qi is the qi of earth and governs the interior. The nature of yang is fullness; the nature of yin is emptiness. When thieves of wind and deficiency-evil attack, yang qi receives them first (external disease — yang receives first, governs the exterior); when food and drink are immoderate and living irregular (meals not on time, overeating and starvation, sleeping by day and staying up all night), yin receives them — the internal organs fall ill.

💬 Note from Doctor Ni: When yang receives, it enters the six fu — external wind and cold coming in will injure the six fu. When yin receives, it enters the five zang — food and drink entering the stomach, eating badly, bingeing, eating without restraint, enters the zang. Entering the six fu produces heat, loss of appetite, restless sleep, and above, wheezing and gasping; entering the five zang produces fullness and blockage, and below, undigested diarrhea (sun xie), and after a long time, intestinal dysentery (chang pi).

Speaking of irregular living, Doctor Ni gives his own youth as an example: sleeping by day, staying up all night reading martial-arts novels until dawn — Jin Yong’s Demi-Gods and Semi-Devils — that is exactly the reversal (yin receiving).

Doctor Ni also reveals the most practical clinical point in this passage — treating the zang often through the fu:

💬 Note from Doctor Ni: The zang and the fu communicate through the San Jiao (Triple Burner); they support each other. So when a zang is not level, it must come from a fu being blocked — when the six fu are stopped up and not passing, the fu problem affects the zang. That is why in treating the zang we often treat the fu. Reading the Huang Di Nei Jing up to now, you should have one basic concept: a person who keeps bowel movements and urination free at all times, with an even appetite — not eating too much — free bowel movements and the ability to sleep — when his fu have no disease, he has no zang disease. Some people have constipation for thirty years and nothing happens — but the fu disease never passes, and sooner or later it will affect the zang. Thirty years is not long — some people are constipated their whole lives, seventy years, sixty years.

Headache, tinnitus, and the nine orifices not functioning — all are born of the stomach and intestines — so headache is often treated at Zhong Wan (CV12) on the Stomach channel:

💬 Note from Doctor Ni: Why? Because stomach qi rises — stomach qi reaches only as high as the eyes, and then keeps rushing up to the head. That is why we needle Zhong Wan (CV12) for headache.

The Taiyin Spleen governs the lower abdomen — governs the belly. When food and drink enter and the Spleen is injured, the belly distends. Doctor Ni takes the opportunity to speak plainly about weight loss:

💬 Note from Doctor Ni: Many ladies say, “Help me lose weight.” I say, “You are not fat.” She says, “No, it is my belly that is fat” — the Spleen governs the abdomen, and the first thing food and drink enter is the belly. I can help you lose weight, but first, from today, no more afternoon tea — ladies love afternoon tea, sitting around gossiping, and the belly grows from sitting; of course you must start changing there. Eat less dry food, no sweets, less fish; eat more light, plain food. Then we remove the dampness — if it is a heat pattern, remove damp and heat together; if there is constipation, add a formula to open the bowels; that is how the prescription comes about. But if you do not change your environment, I cure you and you go back to sitting there every afternoon eating until nine at night, and the belly grows big again — that is useless.

Compiled from Doctor Ni Haixia’s Ren Ji (Human Records) lecture series on the Huang Di Nei Jing (Lecture 38), presented by Doctor Luo Dalun