Fever With Sweating That Won’t Break? Read the Face and You’ll Know Which Organ Is Inflamed: Doctor Luo Dalun Presents Doctor Ni Haixia’s Forty-First Lecture on the Huang Di Nei Jing — the Ci Re Pian (Needling Heat) Concluded: Five Face Maps of the Organs, Treating Disease Before It Starts, Cold Water Before Needling, Well-Point Bloodletting, Heat Shifting Up the Vertebrae; and the Ping Re Bing Lun (Assessing Heat Disease): Three Death Signs of Yin-Yang Interlocking, the Root of the Warm-Disease School’s Fear of Sweating, Sweat Born from Grain, the Boatman’s Tale, Wind Reversal, Labor Wind, and the Five Organs’ Fluids

Patient search words: fever with sweating that won’t break / fever that doesn’t come down after sweating / sweating then feeling cold after a fever / catching wind after sweating from work / coughing after sweating from labor / dry mouth at night — is it the kidneys / does MSG hurt the kidneys / reading the face to see where the fire is / red on the face — which organ is hot / drooling after a stroke / drooling in sleep / sweating a lot — what does it mean / fever with headache and a stiff neck / how to break a fever fast / is inflammation the same as getting angry-fire

Corresponding topics (medical terms): Su Wen · Ci Re Pian (chapter 32), continued: spleen heat disease (abdominal fullness and pain in both cheeks; when heat contends, low-back pain that cannot bend or straighten; spleen governs the lower abdomen; worse on jia-yi wood days, great sweating on wu-ji earth days) · the exhaustion of yang (the extremities grow cold first — the extremities are where yin and yang meet) · moxa and needling Sanyinjiao SP6 and Zusanli ST36 (no need to distinguish reinforcing from reducing) · lung heat disease (sudden chills with the body hair standing on end — the lung governs the skin and body hair; wind is yang; yellow tongue coating — the coating belongs to the lung; when heat contends: panting, coughing, pain circling the chest and back along the Yang Wei vessel, inability to take a deep breath, unbearable headache, sweating — the pores open and yang heat escapes; worse on bing-ding fire days, great sweating on geng-xin metal days, death on bing-ding days if qi rebels; needle hand tai yin and hand yang ming, blood like a soybean — bleeding the Jing-well points for heat; Jing-well governs fullness below the heart, Ying-spring governs body heat; green veins on the extremities can all be bled, the heat retreats at once) · kidney heat disease (low-back pain, shin soreness — the shinbone like an ox’s back; the kidney governs saliva — the mouth is always parched; MSG hurts the kidneys; when heat contends: neck pain, icy shins — the Bladder and Kidney channels are interior-exterior; heat under the foot — the sole should be warm and the dorsum cool; severe on earth days; sweat breaks on the day that conquers) · the five-organ heat face maps (liver heat: left cheek red first; heart heat: center of the forehead red first — water and fire oppose, the Ji Ji and Wei Ji hexagrams, fire qi rushes upward; spleen heat: nose red first; lung heat: right cheek red first; kidney heat: chin red first; a red spot above the inner corner of the eye is hemorrhoids, not heart heat) · treating before disease (the superior doctor treats disease before it begins — needle at the first sight of color; if needled wrongly, three cycles; if reversed again, death) · the great rule of heat disease (drink cold water in large amounts before needling; wear thin clothing; stay in cool places; stop when the body becomes cool) · locating the channel by region (chest and rib pain: needle foot shao yang, reinforce foot tai yin; arm pain: hand yang ming and hand tai yin; vertex headache: tai yang; shin pain: foot yang ming; heavy body, bone pain, deafness and drowsiness: foot shao yin — heaviness belongs to tai yin; severe cases: the fifty-nine acupoints of the Shui Re Xue Lun, Water-Heat Acupoint Discussion, chapter 61) · tai yang pulse and color (a bright, vivid, glossy color on the cheekbone is heat disease; rong wei jiao — before the blood meets; if it is still purely yang heat, sweat it and wait for the hour; if the jue yin pulse contends, death within three days) · heat disease in blood and qi (below the third vertebra: chest heat; fourth: diaphragm heat; fifth: liver heat; sixth: spleen heat; seventh: kidney heat; the nutritive qi resides at the sacrum — because tai yang connects with the Governor Vessel and heat naturally rises, all the Back-Shu points shift upward; press along the Governor Vessel, needle beside the tender points, stop when the needle touches bone; when dispersing heat, pull the needle out without pressing the hole) · cheek diagnosis (color rising from below the cheek against the cheekbone: a great mass — a hard lump in the belly, uterine tumors; color at the lower jaw cart, Jiache ST6: abdominal fullness; color above the cheek: the diaphragm region) · heat is inflammation (myocarditis, hepatitis, nephritis, pneumonia, pancreatitis, splenitis); Su Wen · Ping Re Bing Lun (chapter 33): a warm-disease patient sweats but the fever returns, the pulse races without weakening from sweat, raving and unable to eat — yin-yang interlocking, and death · the warm-disease school dares not use sweating drugs (lian qiao and jin yin hua, mild supporting formulas) · sweat is born from grain and grain from essence (the essence of the five grains) · the pathogen retreats and the essence prevails (able to eat, no return of fever) · the three death signs (fever returns after sweating; racing, agitated pulse; raving and unable to eat — seeing three deaths and not one life, though seemingly recovered, death is certain; if the disease lingers, the lifespan topples at once) · the prerequisite of the sweating method (as long as the fluids remain, sweating can resolve; first replenish fluids with large amounts of cold water or a pear — the pear is the fruit of the lungs) · the boatman’s tale (sweating all day in yang ming dry heat, then the cold river wind at night; Ma Huang Tang and Gui Zhi Tang patterns — replenish fluids first) · wind reversal, feng jue (sweating with the body still hot is wind; sweating with unrelieved vexation and fullness is reversal — ju yang governs qi, shao yin and tai yang are interior-exterior, the kidney channel fluids rise upward, the lower limbs are icy cold; the Shang Han Lun already has the formula) · labor wind, lao feng (its method lies below the lungs, that is, the kidneys; the head is stiff and the vision dim; spitting like nasal discharge — water overflowing back into the lung channel; aversion to wind with shivering; labor sweat caught by wind; lovemaking under cold air-conditioning is also labor wind) · the five organs’ transformed fluids (the liver transforms into tears, the heart into sweat, the spleen into drool, the lungs into nasal discharge, the kidneys into saliva — Xuan Ming Wu Qi Pian, chapter 23; stroke patients drool)

Opening: we haven’t finished with fever — read the face and you’ll know which organ is on fire

Last lecture opened the liver heat disease, heart heat disease and spleen heat disease. In this lecture Doctor Ni Haixia finishes the Ci Re Pian (Needling Heat) — the heat diseases of the five organs, told apart at a glance from a single face — and then walks straight into the chapter the warm-disease school has feared most for a thousand years, the Ping Re Bing Lun (Assessing Heat Disease).

💬 Note from Doctor Ni: This section is about the blood and qi of heat disease. Often this heat, put simply, is inflammation — today’s myocarditis, hepatitis, nephritis, pneumonia, and pancreatitis and splenitis. When heat disease sits in the five organs, each has its own face color and its own treatment.

Spleen heat disease, wrapped up: a bloated belly and low-back pain that pulls — why?

First, the tail end of spleen heat disease from last lecture. When the spleen has heat, the abdomen is full and both cheeks (the sides of the face) hurt. When the heat contends, there is low-back pain that cannot bend or straighten — you cannot bend over.

💬 Note from Doctor Ni: Why does spleen heat cause low-back pain? Very simple: the spleen governs the navel region, and the lower abdomen is all governed by the spleen. When your spleen dampness is very heavy, the dampness below is heavy; when the heat goes too deep, the belly drags downward, and at that time the patient has low-back pain — pain from being pulled.

Spleen heat disease also has its days: on jia-yi days — the wood days, and wood conquers earth — the spleen illness is at its worst; on wu-ji days — the earth days, of the same element as the spleen — the organ’s own qi comes to help, and there is a great sweating that resolves it.

💬 Note from Doctor Ni: Speaking of rebellious qi, why do we talk about cold hands and feet? Because what we call death is always the exhaustion of yang. When yang is about to end, the extremities — especially the feet — begin to cool first. The extremities are where yin and yang meet. When yang begins to end, the feet start cold, and the cold moves from the extremities inward toward the body. Cold spreading from the extremities toward the trunk — that is the exhaustion of yang.

So how do you needle? You needle the points of foot tai yin and foot yang ming (the Spleen and Stomach channels). Doctor Ni frankly confesses his own habit:

💬 Note from Doctor Ni: You can choose the points. Teacher, I personally love needling Sanyinjiao SP6, and I also love needling Zusanli ST36 — Zusanli ST36 and Sanyinjiao SP6, either works. Because these points don’t really distinguish reinforcing from reducing; both can be used.

Lung heat disease: the body hair stands on end, the tongue coating turns yellow, panting and coughing so you can’t take a deep breath

Next, lung heat disease. At the very beginning, the patient feels “sa xi ran” — a sudden chill passes over them, the fine body hair stands up, and the skin feels a little cold first.

💬 Note from Doctor Ni: Why? The lung governs the skin and body hair, so the hairs stand to attention, and the patient hates wind and cold — the wind blowing on them is unbearable. Remember, everyone: when Chinese medicine says “wind,” the first character that should jump into your head is “yang” — wind is yang. The lung sits in the upper burner; the heart and lungs, the chest, are the yang place. So when the skin and body hair feel wind evil, they hate wind and cold, and dislike the wind blowing.

Then the tongue turns yellow — the coating becomes yellow:

💬 Note from Doctor Ni: I said before: the tongue coating governs the lung. When the lung is hot, the coating turns yellow. When heat contends: panting and coughing, with pain circling the chest — from the chest it goes around to the back. This is where our Yang Wei (Yang Linking) vessel passes. If the patient has no headache and the pain just travels along the chest, with no lung heat, then it is Yang Wei vessel pain — treat it from the Yang Wei vessel and it goes away; but if the patient does have lung heat, it can also cause Yang Wei vessel pain.

When lung heat flares up, the patient cannot take a deep breath (bu de tai xi), and the headache is severe — when yang is damaged, qi keeps rushing upward, and the head hurts very badly; there is also sweating — the lung governs the skin and body hair, so when the lung is hot the pores open, sweat pours out, and yang heat keeps leaving the body, which is why the patient can feel the cold outside.

💬 Note from Doctor Ni: Lung heat disease is severe on bing-ding days (fire days), and on geng-xin days (metal days) there is great sweating; if the qi rebels, death comes on bing-ding days. At this time we can needle hand tai yin and hand yang ming, letting out blood like a soybean, and it stops at once — if we want to let blood, the overwhelming majority is done at the Jing-well points. Remember, everyone: in all heat patterns, the Jing-well point governs fullness below the heart, and the Ying-spring point governs body heat! You can strengthen the Ying-spring points — very useful. You can also look at the extremities — wherever green veins bulge on the channels, wherever stagnant blood bulges, you can bleed all of them, and the heat retreats the moment you let blood.

Kidney heat disease: low-back pain, sore shins, drinking water without end — and a warning about MSG

Page 273: when the kidney has heat — it looks like nephritis, acute kidney inflammation. The opening symptoms: low-back pain and shin soreness — “xing” (hang) is the region of the shin, the tibia.

💬 Note from Doctor Ni: In the old days this “xing” character meant an ox’s back. If you’ve never touched an ox, just look at a picture, or feel an ox’s back — the tibia region feels exactly like an ox’s back. Kidney heat gives sore shins, extreme thirst, and constant drinking. The kidney governs saliva — when the kidney has a problem, the mouth is always parched and dry. The patient tells you: “Strange — every night I wake up with a very dry mouth.” In the old days we took one look and knew it was the kidney: the fluids were gone, the saliva was gone.

Then Doctor Ni turns aside and adds a big warning for modern people:

💬 Note from Doctor Ni: Not now! You have to think: did you eat out at noon — ate MSG. Once MSG goes down, your whole mouth dries up. So MSG hurts the kidneys. So don’t eat MSG — you can feed it to your enemies, but don’t eat it yourself!

When kidney heat contends, there is neck pain — because tai yang (the Bladder channel) and the Kidney channel are interior-exterior channels, and you can see the shin region of the foot is icy cold; there is also a classic sign: heat under the foot.

💬 Note from Doctor Ni: What is “heat under the foot”? A normal foot should be warm on the sole and cool on the dorsum. If both the sole and the dorsum heat up, that’s not right — too hot. Kidney heat becomes severe on earth days (wu-ji days). The last paragraph says: when it is time to sweat, on the day that conquers it, the sweat comes out in great amounts — on the day that conquers, there will be a sweating phenomenon.

One face, five organs: left cheek the liver, forehead center the heart, nose the spleen, right cheek the lung, chin the kidney

Page 274: Doctor Ni maps the five organs (liver, heart, spleen, lung, kidney — wood, fire, earth, metal, water) onto the face, revealing the great secret of inspection diagnosis:

💬 Note from Doctor Ni: When the liver has heat, the left cheek shows red first; when the heart has heat, the forehead — the very center — shows red first. This is opposite to water and fire. Just as in the I Ching, the Ji Ji (Already Fording) and Wei Ji (Not Yet Fording) hexagrams — water and fire are opposed; fire qi rushes upward, making the very center of the forehead red.

Then spleen, lung and kidney line up in order:

💬 Note from Doctor Ni: Spleen heat — the nose reddens first; heat is red, after all; lung heat — the right cheek reddens first; kidney heat disease — the yi, the chin, reddens. If you always see a red patch on the chin, that’s the kidney. It is exactly reversed from the left and right cheeks.

He also throws in a differential diagnosis so you don’t call every red mark heart heat:

💬 Note from Doctor Ni: If the very center is fine and only the area above the inner corner of the eye, just above zhan zhu, is red — that’s hemorrhoids! Don’t say, “Ah teacher, this is heart heat.” Only red in the exact center is that. Those of us who practice a lot of inspection diagnosis see it at a glance.

The disease hasn’t broken out yet — the face tells you first: this is treating disease before it begins

The meaning of seeing the color on the face is to get one step ahead:

💬 Note from Doctor Ni: The disease hasn’t started yet; you see the face color and know he is about to have a heat disease — treat it first! This is treating disease before it begins. So when you see the color, the disease hasn’t broken out, hasn’t inflamed yet — needle right away, and it won’t break out. This is the superior doctor treating disease before it manifests; inspection diagnosis can see it.

Whichever region the heat disease shows in, you needle that region, and it resolves by the appointed time (the day that conquers); if you needle wrongly (ci zhi fan zhe), it takes three cycles to get well; if the reversed treatment is severe, the person dies.

The great rule for treating heat disease: drink cold water first, dress thin, stay in a cool place

Whatever the heat disease, Doctor Ni gives a universal treatment protocol:

💬 Note from Doctor Ni: In treating all heat diseases, before we insert the needle we let the patient drink cold water — drink large amounts; after drinking, insert the needle. Then the clothing should be thinner, not too warm; and the place they stay should be cooler, not too warm — this is the way to treat heat disease. Stop when the body becomes cool.

Which channel is the heat disease coming from? Look at the region — and the fifty-nine points

The next passage covers the fifty-nine acupoints of heat disease; the Huang Di Nei Jing’s sixty-first chapter, the Shui Re Xue Lun (Water-Heat Acupoint Discussion), is devoted to the fifty-nine points, and Doctor Ni will introduce them in that chapter.

💬 Note from Doctor Ni: If the heat disease starts in the chest and ribs, we needle foot shao yang and reinforce foot tai yin — chest and rib pain is the liver and gallbladder region, you think of it at once; if the pain starts in the arm, that’s hand yang ming and hand tai yin; heat disease with vertex headache — the vertex is tai yang; if it starts with shin pain, the foot yang ming stomach channel runs along the shin, needle foot yang ming; heat disease that first makes the body heavy, with bone pain, deafness and drowsiness (hao ming, wanting to sleep), needle foot shao yin — heaviness of the body belongs to tai yin, you can work on tai yin, but the bone pain, deafness and dim vision that follow are shao yin signs, so you can needle foot shao yin. In severe disease, use the fifty-nine points.

Doctor Ni reassures everyone: if you can’t remember, no matter — just remember the Ci Re Pian, and turn back to it next time you treat heat. Chinese medicine has too much to memorize; memorizing it all is not easy.

Tai yang pulse and color: a thick, bright color means heat disease; if the jue yin pulse contends — death within three days

Page 276: how reading the tai yang pulse and color tells you heat disease.

💬 Note from Doctor Ni: On the tai yang pulse, if the cheekbone region has a very thick, vivid, glossy color — this is all heat disease; heat disease shows on the face. This is “rong wei jiao” — the blood hasn’t yet crossed over, it is purely yang heat. At this time “jin qie de han, dai shi er yi” — now let it sweat, and wait for the hour: every heat disease at the exterior is resolved by sweating; tai yang channel diseases are all resolved by sweating. But if the jue yin pulse contends — normally the tai yang pulse is yang, the cun pulse should float a bit, the upper body should float; now it contends and meets the jue yin pulse — death within no more than three days!

If the heat disease connects internally to the kidney — the tai yang and shao yang pulse colors contend, because the Bladder and Kidney channels are interior-exterior, and it flows into the kidney. All of this is on the channels.

Heat disease in blood and qi: from the third to the seventh vertebra, everything has run upward!

This passage is important — the blood and qi locations of heat disease:

💬 Note from Doctor Ni: Below the third vertebra governs chest heat; below the fourth, diaphragm heat; below the fifth, liver heat; below the sixth, spleen heat; below the seventh, kidney heat. This blood (rong) resides at the sacrum, around the tailbone. Teacher, didn’t you say before that the lung is at the third vertebra, the fourth is Jue Yin Shu, the fifth is Heart Shu, the sixth is Du Shu, the seventh is Ge Shu? The liver is at the ninth vertebra — now it has run to the fifth; the spleen is at the eleventh — now it runs to the sixth; the kidney was at the fourteenth — now it runs to the seventh. Why?

Doctor Ni asks his own question, and answers it himself:

💬 Note from Doctor Ni: Because when tai yang is affected, the illness is on the back — the tai yang channel on the back connects with the Governor Vessel. When it enters the Governor Vessel, once the heat flares up, the nature of heat is to rush upward! That’s why you can see color on the head and face. On the Governor Vessel, the qi that was originally below — the Bladder and Kidney qi below — all rises. So you cannot take the points by the original vertebra numbers; it rises, and you shift everything upward — that’s the meaning.

The blood and qi location of heat disease does more than help diagnosis — you can needle by it:

💬 Note from Doctor Ni: If you press along the back — if you don’t remember, no matter — press along the Governor Vessel for tender points; you can needle on both sides of the Governor Vessel, and let blood above and below the point; you can also needle the Governor Vessel itself directly. Don’t try so hard to reach the bone — that’s too troublesome. You just needle until you touch the bone, and that’s enough. Remember: when dispersing heat, when you remove the needle don’t press the hole — don’t cover the hole with your hand, just pull the needle straight out, and let a little qi escape; that’s better.

Reading the cheek to judge what’s in the belly: color rising upward is a hard lump; at the jaw cart, a bloated belly

One last inspection secret — the color of the cheek region:

💬 Note from Doctor Ni: Color below the cheek rising against the cheekbone is “da jia” — a great mass: there is something growing in the belly. Here is the cheekbone position, here the cheek position. If the color rises from the cheek upward — red rising upward — there is a hard lump in the abdomen; uterine tumors and the like can all show a hard lump in the belly. If this needling point is at the lower jaw cart (the Jiache ST6 point), that’s abdominal fullness — a bloated, distended belly; if you see red above the upper cheek, that is the diaphragm region — chest-diaphragm heat lies in that stretch. That’s what you see from the front; from the back, it’s what we just discussed, from the third to the seventh vertebra — chest, diaphragm, liver, spleen, kidney. Remember it this way: three chest, four diaphragm, five liver, six spleen, seven kidney.

Assessing Heat Disease opens: the sweat came out — why has the fever come back?

With the Needling Heat chapter finished, we enter chapter 33, the Ping Re Bing Lun (Assessing Heat Disease). The Yellow Emperor asks Qi Bo a question that would make the later warm-disease school tremble:

💬 Note from Doctor Ni: The Emperor asks Qi Bo: “There is a patient with warm disease who sweats, yet the fever immediately returns, and the pulse is racing and agitated, not weakened by the sweat; he raves and cannot eat.” What does this mean? Ordinarily when we meet a heat pattern, we release the exterior — once the sweat comes out, the heat resolves and it’s done. Not this time: after releasing, the patient is more agitated; not only does the pulse not retreat, the fever burns a little higher, the pulse beats faster, the patient is more restless — the illness does not get better from the sweating, it gets worse, and it even causes raving and inability to eat. This is damage to the fluids throughout! This disease is called “yin-yang interlocking — and when yin and yang interlock, it is death.”

Doctor Ni points out the effect this one passage had on the history of Chinese medicine:

💬 Note from Doctor Ni: It is precisely because of this passage that warm disease could not take sweating drugs — those who took sweating drugs died. So the warm-disease school — read the Huang Di Nei Jing and you’ll understand: for thousands of years, when it came to the warm-disease school, they were afraid, most afraid, that the patient’s treatment window would slip away. When the nourishing-yin formula goes down, you dare not open a sweating formula, and the patient sinks deeper. But if your pattern identification is accurate, how could you miss? To this day I have never had an accident with a sweating formula — no raving, no cramping of the hands and feet, nothing like that.

Qi Bo defines it: where does sweat come from? — Grain! And grain is born from essence!

Page 279: this is where the southern school (the warm-disease school) doctors read this and dare not use sweating drugs — they cannot induce sweat. Qi Bo begins to define:

💬 Note from Doctor Ni: The reason a person sweats is that it all is born from grain — the source of sweat is grain qi; and grain is born from essence — the essence of heaven and earth produces the five grains. Now when the pathogenic evil contends between the bones and flesh and the patient sweats — the evil qi is on the surface of the four limbs, on the surface of the body, not yet in the organs — this is the phenomenon of the pathogen retreating and the essence prevailing: the disease is about to retreat and the essence is about to recover. So the source of sweating is this: while the disease is still between bone and channel, of course you resolve it by sweating, because the evil has not yet entered the organs.

The key is how to judge victory or defeat after the sweat:

💬 Note from Doctor Ni: If the essence prevails, the patient should be able to eat and the fever should not return — when the body’s essence qi returns, there should be no more fever; a return of fever means the pathogen prevails. If after the sweating resolves the fever hasn’t broken but has grown worse — sweat is essence qi; now the sweat comes out and the fever immediately returns: that is the pathogen prevailing. And if the patient cannot eat, the essence receives no replenishment (jing wu bi), and there is no way. If this disease lingers in the body, the lifespan will be affected — the life span can topple at once!

That is why the Re Lun says specially: when the sweat comes out and the pulse is still surging and agitated, death. Now the pulse and the sweat do not match, which means the sweating cannot drive the disease out — and the death is obvious.

💬 Note from Doctor Ni: Raving is loss of will (shi zhi), and loss of will is death — all death signs. Here three death signs are given: first, after sweating, the fever returns; second, the pulse is extremely agitated, fast and urgent; third, raving and unable to eat. When you resolve by sweating and the patient shows these three signs, it means yin-yang interlocking — the body’s normal essence qi cannot overcome the pathogenic evil. Now we see three deaths and not one life: though seemingly recovered, death is certain!

Why was the warm-disease school so afraid? — Because they dared not sweat

It was precisely because of these three death signs that the southern school doctors stopped sweating:

💬 Note from Doctor Ni: They began using what? Lian qiao (Forsythia) and jin yin hua (honeysuckle) — very mild medicines; the supporting formulas appeared — because they dared not resolve by heavy sweating. Here accumulates a great principle: as long as the fluids (jin ye) remain, everything can be resolved by sweating! In our acupuncture we say it very clearly: when we are going to use the needle to treat heat, we tell the patient: drink large amounts of cold water.

The tale of travel by boat and carriage: sweat drained dry, then the cold wind at night

Doctor Ni gives a case of the great principle applied with flexibility:

💬 Note from Doctor Ni: In the old days Chinese people traveled by boat and carriage — really by boat. In summer on the boat, you rowed the oars by day; on the Yellow River, on the Yangtze, the weather was very hot, and you sweated a great deal rowing — at that time there is yang ming dry heat. At night, the old boats were like this: the guests slept inside, and the boatman slept beside them. At night on the river, on the water, there is cold wind — because it’s water — cold wind. By day you sweated heavily; at night that cold wind blew on you — injury from cold. The result: look at him — closed and dry, parched mouth; the fluids inside are all gone. Look again at his exterior cold — he’s freezing. You think to yourself: hmm, this is Ma Huang Tang (Ephedra Decoction), or I want to use Gui Zhi Tang (Cinnamon Twig Decoction) — but if I sweat him, his fluids are gone — isn’t that dangerous?

How to break the deadlock? Doctor Ni gives a clever clinical aid:

💬 Note from Doctor Ni: Then give him large amounts of cold water to drink, or let him eat water pears — the pear is the fruit of the lungs, after all! Because when our sweat comes out, it goes from the lung to the surface of the skin. You can’t say, “Teacher, this person’s fluids are exhausted, but he needs to sweat” — the moment you see exhausted fluids you freeze up, and that’s trouble. And without experience, afraid that sweating will kill, you just don’t do it. There are many methods: before you give the patient the sweating formula, first replenish his fluids a little — all of it works. The dosage in our formulas is all very skillful.

Wind reversal: still hot after sweating, still vexed and full — the Shang Han Lun already has the formula

Page 281: a more detailed pattern: a disease with body heat, sweating, and vexation and fullness — and the vexation and fullness are not resolved by the sweat. Why?

💬 Note from Doctor Ni: This vexation and fullness — for example in the foot jue yin liver channel, many conditions have this vexation and fullness. Sweating with the body still hot is wind — after the sweat flows out this is wind evil; sweating with the vexation and fullness unrelieved is reversal — the disease is called wind reversal (feng jue). Generally a heat disease resolves with sweat; if it hasn’t resolved after sweating and the body is still hot, only wind keeps the heat going — wind-heat.

The mechanism of wind reversal is still the interior-exterior channels:

💬 Note from Doctor Ni: Ju yang governs qi — tai yang receives qi at the exterior; the upright qi in the muscles, in the nape and back region, receives qi first and receives the evil first. Because shao yin and tai yang are interior-exterior — the Bladder channel and the Kidney channel are interior-exterior. Once you get heat, the kidney channel’s fluids rise and follow it, causing the lower limbs to become icy cold, counterflow cold. Meeting this disease where tai yang and shao yin are simultaneously affected, you can needle both the interior and exterior, and also boil a little decoction for him to drink.

Then Doctor Ni tosses out a relaxed, big conclusion:

💬 Note from Doctor Ni: Everyone, don’t worry — when we lecture the Shang Han Lun, this is the wind-heat formula — Zhang Zhongjing has already prescribed it for you; you people have it easy. If you studied before the Han dynasty, it was exhausting; after the Han dynasty, it’s simple — he already solved the great majority of it, and the small part he didn’t solve, I filled it in. It wasn’t that he didn’t solve it — it must be that his disciples were careless: every time they carried the master’s bamboo slips out the door, they forgot the threshold, stumbled, and — smack! — the slips scattered; afraid the master would scold them, they scooped them up and laid them out any old way. So I recapture it and put it back — it must be exactly that!

Labor wind: a full sweat from work, then the wind blows — “the method lies below the lungs”

What is labor wind? Wind caught after labor.

💬 Note from Doctor Ni: Workers have it a lot — woodcutters, boatmen at the oars, all get labor wind; construction workers have this phenomenon too. Labor wind’s method lies below the lungs (lao feng fa zai fei xia) — what is below the lungs? The kidneys! Metal engenders water; below the lung is the kidney. This disease makes a person qiang shang ming shi — the head and neck are stiff and the eyes cannot see clearly; tuo chu ruo ti — spitting like nasal discharge: saliva — the kidney governs saliva, and saliva should come out of the mouth; now it comes out of the nose, like nasal mucus — it is the water overflowing back into the lung channel. Aversion to wind with trembling cold — this is labor wind.

People with labor wind all catch it while doing labor, in the middle of sweating. And there is an unexpected source:

💬 Note from Doctor Ni: Also, lovemaking is labor — you work very hard. After lovemaking, the air conditioner is on, the wind blows — labor wind! This character is simple. Let’s rest a moment, and next class we continue with this labor wind.

Closing: the five organs transform fluids — tears, sweat, drool, nasal discharge, saliva, each to its own organ

Before finishing labor wind, Doctor Ni brings out the five organs’ transformed fluids from the Xuan Ming Wu Qi Pian (chapter 23):

💬 Note from Doctor Ni: The liver — it flows tears; tears are the fluid of the liver. The heart — it sweats; sweat is the fluid of the heart. The spleen — xian, drool. The lung — ti, the water of sneezing and nasal discharge. The kidney — tuo, saliva. So sometimes a patient drools — for example after a stroke, the saliva runs downward; sometimes when you sleep very deeply, you also drool.

Compiled from Doctor Ni Haixia’s Ren Ji (Human Records) lecture series on the Huang Di Nei Jing (Lecture 41), presented by Doctor Luo Dalun.