Coughing Is Not Only About the Lungs? Doctor Luo Dalun Presents Doctor Ni Haixia’s Forty-Fifth Lecture on the Huang Di Nei Jing: the Qi Jue Lun (Qi Reversal Treatise, Chapter 37) — Cold and Heat Moving House Between the Five Zang and Six Fu, Kidney Cold Entering the Liver, Liver Cold Entering the Heart, Lung Wasting, Welling Water, the Extinguished Fire of the Small Intestine, Thick Nasal Mucus from the Brain; and the Ke Lun (Cough Treatise, Chapter 38) — All Five Zang and Six Fu Can Make You Cough, the Five-Zang Coughs, the Sea of Qi, and Sun Simiao Expelling Worms

Patient search words: cough / cough with wheezing / coughing blood / cough with chest pain / throat feeling blocked / cough with pain in both flanks / cough with shoulder and back pain / cough with low-back pain / coughing until the food comes up / coughing up bile / nosebleeds / drinking too much water / urine blocked and unable to pass / bloated belly with gurgling water / thick mucus running from the nose / eating yet never gaining weight / erosion of the mouth / alternating chills and fever / the shakes / attacks every other day / acupuncture and bloodletting / qi reversal / cold and heat transmitting between the five zang

Corresponding topics (medical terms): Su Wen · Ci Nue Lun (Needling Malaria Treatise, chapter 36) — concluding notes (malaria with body aches needled at Zhiyin BL67, the bladder Jing-Well point; yin-channel Jing-Well points are not bled, needled every other day; malaria without thirst every other day — foot tai yang; malaria with thirst every other day — foot shao yang; warm malaria that cannot sweat — deferred to the Shui Re Xue Lun, chapter 61) · Su Wen · Qi Jue Lun (Qi Reversal Treatise, chapter 37): qi reversal is qi going against its course to the extreme; cold and heat move between the five zang and six fu · the cold routes (kidney cold enters liver — yong zhong, abscesses and swelling with shortness of breath; spleen cold enters liver — abscesses and tendon twitching; liver cold enters heart — kuang ge zhong, mania with inability to eat; heart cold enters lungs — fei xiao, lung wasting, drink one bowl urinate two, untreatable; lung cold enters kidneys — yong shui, welling water, water lodging in the large intestine) · mu ling zi xu (mother makes the child deficient) is used only when the child is actually full (liver excess is disease, liver deficiency is not; tonifying the kidney does not empty a healthy liver) · bu nan xie bei (tonify the south, drain the north) · the heat routes (spleen heat enters liver — jing nü, nosebleeds with fright; liver heat enters heart — death, adding fuel to fire; heart heat enters lungs — ge xiao, wasting with thirst; lung heat enters kidneys — rou jing, soft spasms; kidney heat enters spleen — earth defeated by water, stomach qi lost, untreatable; bao heat enters bladder — lin/retention, the small intestine fire gone out, urine blocked, essence-blood or womb blood entering the bladder causing blood in the urine; bladder heat enters small intestine — ge chang bu bian, blocked intestines with mouth erosion; small intestine heat enters large intestine — fu jia, a hidden mass or tumor; large intestine heat enters stomach — shan shi er shou / shi yi, eating well yet thin; stomach heat enters gallbladder — shi yi; gallbladder heat enters brain — bi yuan, nasal well with thick mucus, nü mie foul blood, mu ming dim vision) · the small intestine fire and bladder vaporization (Guanyuan CV4 is the Front-Mu point of the small intestine) · ji yin sheng yang, yang ji sheng yin — the extreme of yin gives birth to yang and vice versa; yin and yang, exterior and interior, support each other (cold instep, warm sole) · Su Wen · Ke Lun (Cough Treatise, chapter 38): all five zang and six fu can make a person cough · the skin and body hair are the lining of the lungs; cold enters from the surface channels or from cold food through the stomach · the five zang each fall ill in their own season (liver, heart, spleen, lungs, kidneys correspond to spring, summer, long summer, autumn, winter); out-of-season cough is transmitted from another zang · the five-zang coughs (lung cough — wheezing with blood; heart cough — throat blockage, swollen throat; liver cough — flank pain, unable to turn; spleen cough — flank pain drawing to shoulder and back; kidney cough — low-back pain drawing the back, much sputum) · the throat is the sea of qi (one of the four seas) · the six-fu coughs (stomach cough — vomiting; gallbladder cough — vomiting bile; intestinal worms emerging; Sun Simiao expelling worms)

Opening: a few malaria needles were left unfinished last time — here they are

Last lecture’s Ci Nue Lun (Needling Malaria Treatise) covered the needling methods for the six-channel malarias and the five-zang malarias. At the start of this lecture, Qi Bo finishes the last methods: when the patient still has alternating chills and fever with general body aches — small aches, not severe pain — where do you put the needle?

💬 Note from Doctor Ni: Malaria with body aches is needled at Zhiyin BL67, the Jing-Well point of the bladder channel. Zhiyin — the Jing-Well points of all the yin channels are not bled; supervise it once, meaning needle every other day. In treating malaria by letting blood at the Jing-Well points, we do not bleed the Jing-Well points of the yin channels; most of the bleeding is done on the yang channels. Yongquan KI1, for example, we would not bleed either, because it is a yin channel.

💬 Note from Doctor Ni: The following lines are all rules of needling malaria: malaria that returns every other day without thirst is needled on the foot tai yang channel; with thirst and every-other-day attacks, it is the shao yang. As for warm malaria (wen nue) where the patient cannot sweat — we leave that until we reach chapter sixty-one of the Huang Di Nei Jing, the Shui Re Xue Lun (Water-Heat Acupoints Treatise), which has fifty-nine points; we will explain it in great detail then.

Next, the Qi Jue Lun: qi reversed to the extreme — the five zang and six fu start "moving house"

With the malaria finished, we enter chapter thirty-seven of the Huang Di Nei Jing — the Qi Jue Lun (Qi Reversal Treatise). Doctor Ni Haixia first takes the two characters "qi" and "jue" apart and explains them clearly.

💬 Note from Doctor Ni: What is qi? Qi all returns to yang. What is yang? Yang is what you cannot see, but its movement — the heat you feel, the vitality, the spirit — that is all yang. When you look at me, my eyes are bright and spirited; that yang, that spirit — it is not the person. What you see is the form; the life force within it is yang. Yin is everything you can see and touch. If there is yin alone without yang, there is no life at all — look at a person who has died, lying there: that is yin, without yang. It is because we have qi in our bodies that we have this life force. Qi jue — jue means reaching the top, the extreme; qi reversed to its extreme is called jue.

Where does the importance of this chapter lie? Doctor Ni says the Yellow Emperor asks how cold and heat move and transfer between the five zang and six fu — the first passage describes the movement of cold, the second passage describes the movement of heat. How does cold move house? Cold from the kidneys moves to the liver, cold from the liver moves to the heart, cold in the heart does not enter the spleen but moves to the lungs, cold in the lungs turns back to the kidneys; cold in the spleen moves into the liver.

The cold routes (one): kidney cold enters the liver — abscesses inside, and shortness of breath

In the first passage, Qi Bo says "kidney cold moves to the liver — abscesses and swelling, with shortness of breath." Doctor Ni Haixia especially reminds us that this passage has a great deal to do with treating liver disease.

💬 Note from Doctor Ni: When cold inside the kidneys enters the liver, the liver develops abscesses and swelling, and the patient becomes short of breath — breathing very shallowly. That is kidney cold moving to the liver, so the liver becomes very cold. When we warm the kidneys and tonify them, the cold in the kidneys is removed, and the liver no longer receives cold or harm — this is what we discussed earlier: bu nan xie bei, tonify the south and drain the north.

Speaking of tonifying the kidney, Doctor Ni is afraid students will misunderstand "mu ling zi xu" (the mother makes the child deficient), so he stops and clarifies it at length:

💬 Note from Doctor Ni: Mu ling zi xu — I want to use this principle. But it does not mean that because the mother makes the child deficient, we must tonify the kidney and make the liver deficient — that is only when the liver is actually full that we tonify the kidney. Liver deficiency is not a disease; liver excess is the disease. Only when the liver is very full, very solid inside, do we find a way to make it deficient. If your liver is ordinarily healthy, with nothing accumulated inside, why would you make it deficient? When the liver is not full, tonifying the kidney will not make the liver deficient, because there is no disease. In Chinese medicine we treat by seeking balance — when the liver has no accumulation, no piled-up material, and you tonify the kidney, the liver should be fine; it will not become deficient. So "mu ling zi xu" is only used when the child is actually full — only then do we use the mother to make the child deficient, and that is all. When the child has no disease, tonifying the kidney has no effect at all; the liver will not become deficient.

The cold routes (two): spleen cold enters the liver and tendons twitch; liver cold enters the heart and a person goes mad

Next, the moves are described one by one: cold from the spleen enters the liver — the liver swells and the tendons twitch; cold from the liver enters the heart — the person goes mad.

💬 Note from Doctor Ni: Spleen cold moves to the liver — when cold from the spleen enters the liver, it is yong zhong jin luan: the liver also swells up, causing the tendons to twitch. If cold inside the liver moves into the heart, it is kuang ge zhong — the patient becomes manic, deranged, his spirit lost; ge zhong means the food and drink cannot go down anymore, nothing can be taken in.

💬 Note from Doctor Ni: Heart cold moves to the lungs — if there is a cold condition in the heart, it will pass into the lungs, and the yang inside the lungs will be consumed and lost, because it is too cold, producing fei xiao (lung wasting). What is lung wasting? Fluids can no longer enter the lungs — inside it is all cold. You drink one bowl of water and urinate two bowls — this means the lung function is completely gone. Untreatable, death.

The cold routes (three): lung cold enters the kidneys — a distended belly that is not hard, like carrying a water bag when you walk

The last cold route: lung cold moves to the kidneys, called "yong shui" (welling water).

💬 Note from Doctor Ni: Yong shui — press the belly and it is not firm: the belly is distended inside, but not hard, because the water qi lodges in the large intestine. When a person walks very fast, the belly seems to hold a water bag — you hear gurgling, gurgling water sounds, but it is soft and flabby, not hard. That is cold from the lungs moving to the kidneys.

Why go to the trouble of distinguishing this cold? Doctor Ni points out the clinical key — the choice of medicinals is different, so you must clarify where the disease sits:

💬 Note from Doctor Ni: Why do we need to know it is cold? Because the medicinal choices differ — warming the lungs, warming the kidneys, warming the liver, strengthening the heart — each uses different herbs. So we must differentiate the pattern, and choose the herbs after differentiating. When cold is moving, there is a very simple rule: the moment you feel the pulse, a cold pulse is thin and small. In a normal person, the cun (inch) position is yang and the chi (foot) position is yin; now if you feel the cun pulse thin and small, that is yin cold — that is heart cold. Cure heart cold quickly; if you do not, it will enter the lungs.

The heat routes (one): spleen heat enters the liver and the nose bleeds; liver heat enters the heart — a fatal case

The second passage: the movement of heat. When heat moves house, it is often more ferocious than cold.

💬 Note from Doctor Ni: When heat from the spleen moves to the liver, it causes jing nü — nosebleeds, and the patient is easily startled. If heat from the liver runs into the heart, it is a fatal case. The heart itself is hot; adding fuel to fire, the heart will die. Heart heat moving to the lungs is often ge xiao — in wasting-thirst (xiao ke), when the diaphragm is too hot, it produces wasting-thirst with heavy drinking — the person drinks a great deal of water. Lung heat moving to the kidneys is rou jing — soft spasms, limp and without strength.

Why does a zang organ, which by nature is cold, still transmit heat? Doctor Ni explains: the zang organs are cold by nature, but they contain yang inside, so the cold never becomes extreme; what is described here is the cold of extreme cold causing disease. When it is too hot, yin is insufficient and therefore heat arises — and heat moves. The two most ferocious routes are liver heat entering the heart (adding fuel to fire) and kidney heat entering the spleen:

💬 Note from Doctor Ni: Kidney heat moves to the spleen — originally spleen earth overcomes water and can manage water; "overcome" means suppress, assist, restrain, so that it does not go too far. Now water turns around and insults earth. When earth becomes too hot it is lost — earth is stomach qi; once it is lost, the spleen becomes deficient. The spleen governs the lower abdomen; this belly region is managed by the spleen. Once injured by excessive heat, there is immediate diarrhea, and with the diarrhea the stomach qi is gone — these are all death, not to be treated. As for heat — when you feel the pulse and it beats very fast, very rapid, that is heat.

The heat routes (two): the small intestine’s fire goes out — urine blocks up, and blood runs into the bladder

The most vivid passage is "bao heat moves to the bladder." To understand it, you must first understand the fire of the small intestine and the vaporization of the bladder.

💬 Note from Doctor Ni: In the middle is the small intestine; in front is the bladder. In a normal person, the small intestine’s fire is normal and water vaporizes upward. This bao — in a man the bao is where essence is produced, a flat region; in a woman the bao is the uterus and ovaries. Normally the small intestine and the bladder work together — the small intestine’s heat comes from the bladder… Now the heat of the bao enters the bladder instead of the small intestine, which means the small intestine’s temperature is insufficient. The small intestine’s fire is gone; the water inside cannot vaporize — in a normal person, when water vaporizes, the bladder expands like a hot-air balloon, and the urine sits at the top of the bladder because there is hot vapor, there is propulsive force, and only then can urine be squeezed out. Now the small intestine’s fire is gone, and the heat and cold inside the bladder are sealed in; the urine cannot be passed, because there is no heat to propel it.

💬 Note from Doctor Ni: What is called bao heat — the bao palace is originally a place of blood: in a man it is essence-blood here; after it comes out and is steamed hot by the small intestine, it turns white and is discharged into the testicles to become semen. A woman’s uterus is originally blood. If cold is extreme, the blood in the uterus, or the essence-blood of a man, will all enter the bladder — when you urinate you see blood in it. That is the reason.

If the bladder is too cold, there is a whole chain of reactions: bladder heat moves to the small intestine, called "ge chang bu bian" (blocked intestines, difficult stool) —

💬 Note from Doctor Ni: When the small intestine’s temperature is insufficient, too cold, the heat inside the intestines is gone, peristalsis slows down, and the patient feels as if fingers are pulling at the intestines — you want to pass stool but cannot. The qi inside the intestines, the qi of the stool, cannot get out, so it rises upward, producing erosion of the mouth.

The heat routes (three): a hard mass in the large intestine, "can’t gain weight" in the stomach, thick mucus in the forehead

The heat keeps moving: heat from the small intestine enters the large intestine — and something grows there.

💬 Note from Doctor Ni: Normally the small intestine is here and the large intestine above; the small intestine is fire and the large intestine is metal — metal on top, fire burning below; that is the normal person. Now the small intestine has turned cold and the heat enters the large intestine. This character is read "fu" — as in fu, hidden, lurking — and it causes hard masses and tumors to grow inside, called fu jia, lurking shallowly within.

💬 Note from Doctor Ni: The large intestine’s heat does not stay in the large intestine; it runs into the stomach and becomes shan shi er shou — eat well yet remain thin: however much you eat, the person stays skinny; it is called shi yi. Stomach heat moving to the gallbladder is also called shi yi. Gallbladder heat moving to the brain is called bi yuan (nasal well) — inside the nose, at the bridge of the nose (bi e), the mucus is extremely thick and runs without stopping; in worse cases there is also nü mie — mie means foul blood — the nose discharges a great deal of dark, dirty blood; and mu ming — the eyes are dizzy and dim, unable to see clearly. These are all phenomena of heat in transmission.

What is the Qi Jue chapter really about? — Qi going against its course; clinically you only need to grasp cold and heat

Having listed so many routes of transmission, Doctor Ni finally sums up the purpose of the chapter so clearly — don’t be frightened by the lines; clinically grasp just two things.

💬 Note from Doctor Ni: The Qi Jue chapter says that normal qi should travel like the channel of a clear river; now the qi travels against its course, and as it travels there is cold and there is heat, and you will see these situations. When you actually differentiate patterns, do not worry — the Huang Di Nei Jing sets out all the physiology and the pathology of Chinese medicine’s anatomy. Clinically, when we differentiate, we only need to know whether it is cold or heat inside, and we can act. Distinguishing the cold and heat of the five zang is very simple! The book lets you know the mechanism, lets you know the pathogen sits here, and if it is not treated, where it will transmit — you can predict what will happen. Its main purpose is to tell you the phenomena of transmission, so that in differentiating and treating you can seize the moment. Disease transmits exactly according to these routes, so you can treat at the very beginning of disease: for example, spleen heat moves to the liver, and the moment the liver enters the heart it is death — knowing this heat, hurry and treat, lest danger occur. You can know this disease will be dangerous, that one will not. The principle is simple — heat enters the heart; the heart is originally hot, adding fuel to fire, the heart beats very fast and is gone in a moment. This is a predictive medicine and a medicine of transmission.

Before the Cough Treatise: the small intestine’s fire, Guanyuan, and why the instep is cold but the sole is warm

Before the next lecture begins chapter thirty-eight, the Ke Lun (Cough Treatise), Doctor Ni finishes the last passage of the Qi Jue Lun — the root is still the fire of the small intestine.

💬 Note from Doctor Ni: The small intestine is fire; normally the small intestine is hot inside — that is the normal state. The heart and the small intestine are exterior-interior to each other; the heart is the monarch organ, and the small intestine governs the circulation of heat in the entire lower burner. So the Front-Mu point of the small intestine — Guanyuan CV4 — can treat many diseases. The small intestine sits in the middle, wrapped outside by many yin things: the urine in the bladder, the food in the large intestine, the water in the kidneys. In the lower burner, it is because the small intestine’s fire sits in the middle that the normal state exists. The extreme of yin gives birth to yang, the extreme of yang gives birth to yin — the yang channels of the foot run over the instep; it is where yang first rises, yet when you touch it, it is ice cold. Why? Because yin and yang are exterior-interior to each other: the sole (where the yin channels run under the foot) is instead warm — yang lives inside yin. That is the normal mutual support of yin and yang, exterior and interior. The day the small intestine’s fire suddenly disappears, heat will run everywhere, scattered and disordered — the whole Qi Jue Lun, traced to its root, is talking about exactly this.

All five zang and six fu can make you cough? — It is not only the lungs

We now enter chapter thirty-eight of the Huang Di Nei Jing — the Ke Lun (Cough Treatise), devoted to coughing. Most people think: isn’t coughing simply a matter of the lungs? The moment Qi Bo opens his mouth, he overturns that.

💬 Note from Doctor Ni: The Emperor asks — coughing seems to be all about the lungs, right? Qi Bo says, no, no — all five zang and six fu can make a person cough, not only the lungs! So to look at a cough and treat only the lungs is wrong; there are very many different kinds of cough with very different symptoms. The skin and body hair are the lining of the lungs; the lungs govern the skin and body hair. In a lung cough, the skin and hair receive the qi first, and then this pathogen slowly follows the channels into the lungs — that is a true lung cough. Cold enters in one of two ways: one is cold from the surface coming in along the channels to cause the cough; the other is that you eat cold food, and the cold qi, the coldness, follows the vessels into the lungs, creating lung cold, which also produces cough.

To read this passage, Doctor Ni says you must first establish the concept of the "normal state":

💬 Note from Doctor Ni: When you read the Huang Di Nei Jing you must understand what the normal state is. Heart fire and lung metal — metal and fire mutually overcome each other; "overcome" means mutual restraint. In the balanced state, the heart is hot and the lungs are cold; only then is cold and heat balanced. If it is too hot — the lungs too hot — the heart is originally hot, and heat plus heat is excess; if it is too cold, it produces lung cold. As for how cold comes in: one way is feeling wind-cold on the surface of the skin and following the channels into the lungs; the other is eating cold things. So we usually eat hot food; eating cold things can also create lung cold. Of course there are hot coughs, but the heat on the surface is all born from cold; each person’s constitution is different — on the surface they are all cold, but inside some are cold and some are hot, different.

The five zang each fall ill in their own season — coughs that come by the calendar, and coughs that come from the organs

Qi Bo then teaches a great method of differentiation: coughs have two origins — those contracted according to the season, and those transmitted from the organs.

💬 Note from Doctor Ni: The five zang each fall ill in their own season — liver, heart, spleen, lungs, kidneys; we match them to spring, summer, long summer, autumn, winter, and they fall ill according to the season. In spring it is a liver cough, in summer a heart cough, in autumn a lung cough, in winter a kidney cough. If you see a kidney cough break out in summer, then it is not a disease caused by the change of seasons but one transmitted from the organs — fei qi shi, ge chuan yi yu: not in its own season, each transmits to it from elsewhere. Human beings merge with heaven and earth; the five zang, each in its season, feel cold and fall ill: minor cases just cough, severe cases have diarrhea and even pain. In autumn the lungs receive the pathogen first, in spring the liver, in summer the heart, in long summer (the tai yin spleen) the spleen first, in winter the kidneys receive it. Remember: a cough that does not follow the seasons is transmitted from the organs.

How to tell the five-zang coughs (one): lung cough wheezes and coughs blood; heart cough feels something stuck in the throat

So how do you tell which zang a cough belongs to? Qi Bo says you can tell from the symptoms.

💬 Note from Doctor Ni: The lung cough’s symptoms: cough with wheezing, and sound when moving — the lungs are on top, the lungs image the canopy of heaven, and the lung fluid opens and closes inside like a pair of bellows, so the cough has sound, and it wheezes; in severe cases it coughs out blood — for example, coughing very forcefully can rupture a bronchus. That is the severe one. The heart cough is different: together with the cough the heart aches, and the throat feels as if something is stuck in it; in severe cases the throat swells and there is blockage — that is the syndrome of a heart cough.

💬 Note from Doctor Ni: The liver cough — pain under both flanks; the liver lives in the flank region, under both sides of the chest and ribs; in severe cases you cannot turn the body — turn, and both flanks become distended and full. That is the liver cough.

Speaking of the throat, Doctor Ni takes the opportunity to explain the "sea of qi":

💬 Note from Doctor Ni: At the position of our throat — a person has four seas: the brain is the sea of marrow (we will describe it in detail later), and the throat is the sea of qi. The twelve channels are like water; rivers all return to the sea, finally returning to the sea — this neck region is the sea of qi. So in general, when qi is diseased, it affects the throat.

How to tell the five-zang coughs (two): spleen cough pains the shoulder and back; kidney cough pains the low back — and the Huang Di Nei Jing’s "left-right riddle"

For the spleen cough and the kidney cough, one pains the flank, the other the back.

💬 Note from Doctor Ni: The spleen cough’s symptoms: pain under the right flank, drawing into the shoulder and back; you also cannot turn, and when the body moves the cough grows worse. The spleen governs the lower abdomen; the spleen sits below the flank. When the Huang Di Nei Jing says the right flank, it uses the patient as the reference — I am the patient; for me it is the left flank, and the spleen is in the left flank; for the doctor looking at the patient, it is the right side. So there is often a left-right distinction, and some physicians in the past wrote it differently. Many medical scholars have studied the Huang Di Nei Jing; some concluded — is it a dialogue between two people? It is not that simple — it is many physicians, slowly recording it, using the form of a dialogue between two people to pass this medicine down; in fact it is the crystallization of many minds. Whatever it is, just do not misunderstand the Huang Di Nei Jing; do not go chasing after what happened in ancient times. What matters most now is how to apply it. In practice, the doctor sees the right side and the patient’s is the left.

💬 Note from Doctor Ni: The kidney cough — with each cough the low back draws the back into pain; in severe cases each cough brings out a great deal of phlegm and fluids. This is only the simple introduction; later it will be divided more finely.

The six-fu coughs: coughing until the food comes up, coughing up bile — only a long cough moves to the fu

After the five-zang coughs, the Yellow Emperor asks: what about the six-fu coughs? Qi Bo’s answer hides an iron rule — the cough is first received by the zang; only after coughing a long time does it move to the fu.

💬 Note from Doctor Ni: The cough is one of the five zang coughing for a long time before it moves to the fu. The organs receive it first; after coughing a long time without being cured, it moves up to the fu. For example, pi ke bu yi — the spleen coughs for a long time, and then the stomach receives it — the stomach cough’s presentation: cough with vomiting. You often hear: my son coughs terribly, coughs until he throws up his meal — that is a long cough; a heart cough would not do that. Only a long cough moves to the fu; that is the definition the Huang Di Nei Jing gives. In severe coughs there may also be intestinal worms coming out — the stomach has them too. In the past, China was an agricultural society; there was no concept of parasites, people grabbed food and ate it directly, so parasites were common in society, very widespread in the agricultural environment. That is why in the old medical books, so many medicinals are for expelling worms — Sun Simiao easily caught worms.

💬 Note from Doctor Ni: Gan ke bu yi, dan shou zhi — when the liver coughs for a long time, the gallbladder receives it; the gallbladder is a fu, and at that point a single cough vomits out bile. So you hear patients say: I coughed my gall bladder out — that is a liver-gallbladder cough, because the liver cough went unhealed for a long time and transferred to the gallbladder.

Closing: the Qi Jue Lun is a "book of prophecy," the Ke Lun is a "map of the organs"

This lecture carries a great deal: the Qi Jue Lun teaches us how pathogens move house and how to predict danger; the Ke Lun teaches us to treat cough by distinguishing the organs. Doctor Ni says at the end that there is no need to memorize these lines by rote — clinically, grasp cold and heat, grasp the five-zang differentiation, and when you look back, everything connects.

💬 Note from Doctor Ni: Next time we will discuss chapter thirty-eight, the Ke Lun (Cough Treatise), devoted to coughing. That is today’s introduction — the Qi Jue Lun, in simple terms, is about qi traveling against its course, not following the normal path. Once you know the phenomena of transmission, you can seize the moment in differentiation and treatment. Clinically, when we examine the pattern, we know whether it is cold or heat inside, and we act — truly, there is nothing to fear.

Based on Doctor Ni Haixia’s Ren Ji (Human Records) Huang Di Nei Jing lecture series (Lecture 45)