Hands and Feet Ice-Cold, Legs Cold as Ice Below the Knees, Suddenly Fainting and Losing Consciousness? — Doctor Ni Haixia’s Fifty-Third Lecture on the Huang Di Nei Jing: the Jue Lun (Reversal Treatise, Part 1)

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Corresponding topics (medical terms): Su Wen · Jue Lun (Reversal Treatise, chapter 45), part 1 — jue means reversal: when yang qi fades below, han jue (cold reversal) arises; when yin qi fades below, re jue (heat reversal) arises; the normal state of yin and yang — yang descends and yin ascends: the foot-yangming stomach channel (descending to Lidui ST45), the foot-taiyang bladder channel (descending to Zhiyin BL67) and the foot-shaoyang gallbladder channel all travel from the head down to the feet, while the foot-shaoyin kidney channel (rising from Yongquan KI1 to Rangu KI2), the foot-taiyin spleen channel and the foot-jueyin liver channel all travel up from the feet; lone yin cannot grow, solitary yang cannot live; the origin of heat reversal — yang qi rises from the surface of the five toes while the yin channels gather beneath the foot and collect at the center of the sole; the cold of cold reversal — yin qi arises within the five toes, gathers below the knee and collects above the knee, and must climb from the five toes up to the knee; it is cold generated from within, not cold from outside; qi jie (qi street, Qichong ST30) lies above and the yangming qi guards it, so the cold stops at the knee; when channel qi is pressed down, yang qi fades day by day and yin qi stands alone, the hands and feet turn cold; the cause of heat reversal — wine enters the stomach, the collaterals fill and the channels empty; the qi of wine is fierce and sharp and enters the collaterals first (boiling certain medicines in wine carries them to the extremities — the origin of Zhang Zhongjing’s wine-boiled formulas); the spleen moves the fluids for the stomach; when yin qi is deficient, yang enters; when wine qi and grain qi clash, heat prevails in the middle; when kidney qi fades, yang stands alone, yin is injured, hence the hot hands and feet; dark red urine is the sign of internal heat; jue can distend the abdomen — when yin qi prevails above, the lower becomes deficient, and deficient below means abdominal distension; jue can make a person suddenly unconscious — when yang qi is thrown into disorder above, the person loses awareness; to treat wei take only the yangming — the acupuncture method: supplement each ying-spring point and unblock its shu-stream point, regulate deficiency and excess, harmonize counterflow and smooth flow, and let sinews, vessels, flesh and bones each receive what their season gives, and the disease ends; the belt vessel circles the waist — the three points Dai Mai GB26, Wushu GB27 and Weidao GB28; the yang of the governing vessel descends from Ming Men (GV4) through the san jiao to Guanyuan (CV4); the mansion of the zong jin; the belt vessel and leucorrhea (bai dai); the salt-field worker case — sun-scorched lung fluid, heavy loads injuring kidney essence, feet in water injured by damp (the Wei Lun conclusion — to treat wei take only the yangming; the zong jin and the meeting of the belt, governing and penetrating vessels)

Opening: last time we said “wei is atrophy” — this time Doctor Ni first closes the book on “treating wei”

The last lecture finished the causes, the looking diagnosis, and the treatment of the Wei Lun (Atrophy Treatise). Now Doctor Ni first lands the sentence “to treat wei, take only the yangming” on the actual channels — he explains the whole territory of the zong jin (the gathering sinews), the belt vessel, the governing vessel and the penetrating vessel — and then, with a turn of the topic, opens a brand-new chapter: the Jue Lun (Reversal Treatise).

First, look at the channel chart. Doctor Ni points at the chart and explains: the yangming channel and the penetrating vessel (chong mai) join at qi jie (qi street), and they also meet the governing vessel (du mai) behind. The belt vessel (dai mai), seen from the side, circles the waist — the navel is here, and the belt vessel wraps from Ming Men in the back around to the front, with roughly three points — Dai Mai (GB26), Wushu (GB27) and Weidao (GB28) — all covered in earlier lectures.

💬 Note from Doctor Ni: The belt vessel falls on the yin side, so women have leucorrhea — the bai dai (white vaginal discharge) we talk about, the “belt below,” exists because of the belt vessel. The yang of the governing vessel descends from Ming Men all the way down, passes through the san jiao, and lands at Guanyuan (CV4). So this whole region is the mansion of the zong jin — all the gathering sinews converge here. The zong jin is present at every joint, and it all gathers in this place.

Why is the Yangming the “boss”? — the mansion of the zong jin, with the yangming at its head

Doctor Ni then clarifies how these channels relate: the governing vessel, the penetrating vessel, the belt vessel, and the foot-yangming — with the foot-yangming at the head — because the yangming’s greatest qi pathway is right here.

💬 Note from Doctor Ni: When the yangming qi becomes deficient, it affects the zong jin — because the zong jin reaches every joint in the body. Some people have weak blood vessels, some have weak muscles, some have atrophied sinews — sinew atrophy — it is all governed by the zong jin. That is why treating wei takes only the yangming: because the yangming channel reaches everywhere, and this place is governed by the yangming.

The Yellow Emperor asks: after all this talk, how is wei actually treated? Bo Qi’s answer is one sentence — use acupuncture.

💬 Note from Doctor Ni: Treating wei is simple — acupuncture. “Supplement each ying-spring point and unblock its shu-stream point, regulate deficiency and excess, harmonize the counterflow and the smooth flow, and let sinews, vessels, flesh and bones each receive what their season gives, and the disease ends.” It means: when we needle, we know whether it is sinew wei (the liver is spring; sinews are governed by the liver), or flesh wei, or vessel wei, and we needle according to the four seasons and regulate its deficiency and excess — supplement its ying-spring point, unblock its shu-stream point. The shu-stream points of the five zang and six fu lie on the back, and all of them can be worked with acupuncture.

Bonus case: the salt-field worker — sun-scorched, load-carrying, water-soaked: atrophy comes from three roads

How are the herbs chosen? Once you know the disease is in the yangming channel, there are herbs that enter the yangming and herbs that clear heat. Doctor Ni gives a very vivid example — the worker who dries sea salt:

💬 Note from Doctor Ni: Take salt-field work, for instance. When they dry sea salt, their feet stand in the water. When the salt is dry, they carry the salt out — walking a very long way, very hard work. When they come to see you, the money from selling the salt is not even enough to pay the consultation fee — they work very hard, so we try our best to help them — this is why everyone should buy sea salt, not the artificial kind. Why does he get wei? Sea salt can only be dried in a place with strong, blazing sun; outside, his body is being steamed and scorched — the lung’s fluids run short, he sweats heavily; inside, he carries heavy loads — carrying heavy loads uses the strength of the kidneys, so the kidney fluids are injured too, the kidney becomes hot, and therefore wei develops; and below, his feet stand in water, so he is also injured by damp. How to treat it? See the heat, know where the heat is, replenish the fluids and clear the heat; see that the lung is too hot, and replenish the lung’s fluids.

How do you replenish fluids? Doctor Ni says you can eat fruit — water pear replenishes fluids. And he has noticed something very interesting: Heaven’s arrangement.

💬 Note from Doctor Ni: Strangely enough, the fruit in season in summer grows right there locally — Budai is famous for drying sea salt, and the fruit grown around Budai is precisely the kind that replenishes fluids; the fruit that can really cure him is right beside him. Heaven is playful: you are drying sea salt — look at what fruit is in season, and that is Heaven’s compensation. Hami melons grow in Hami — how hot it is there, by the Flaming Mountains, the inside is so hot — and yet a Hami melon grows there. If you only drink water, the fluids get dirty and you dehydrate; but if you eat a Hami melon, its water is dense and substantial, concentrated inside the fruit, and that water, entering the body through the fruit, gets stored. Drinking plain water is useless — this is common sense.

💬 Note from Doctor Ni: Clinically, when we treat wei, the results are good — it will definitely heal — but it takes time, because you have to make up for everything the patient has squandered, and that is tiring.

Next chapter: the Jue Lun — “jue” means reversal, the disease that turns the body upside down

The Wei Lun finished, Doctor Ni enters chapter 45: the Jue Lun of the foot-jueyin liver channel. He first takes the character “jue” apart:

💬 Note from Doctor Ni: The real meaning of jue is reversal. We use this character for the foot-jueyin liver channel — “jue” also means extreme, reaching the peak, reaching the very bottom. The foot-jueyin liver channel guards the organ hidden deepest inside the body — the liver. Jue means the limit.

The Yellow Emperor asks: jue syndrome has cold and heat — why? Some people get heat reversal, some get cold reversal. To understand this, first understand the definition of yin and yang — what the normal state looks like.

First understand the normal state: yang qi descends, yin qi ascends

Doctor Ni draws out the “normal state” of yin-yang circulation in the body: the diaphragm, the navel, and the lower abdomen — above is yang, below is yin.

💬 Note from Doctor Ni: Yin ascends, yang descends. The yang of the upper body, coming in from the grains in the stomach, enters the stomach channel and travels all the way to the toes — the stomach channel reaches the second toe, coming all the way down to the foot; so yang qi always descends. Does the bladder channel not run from the head all the way down the back to the Zhiyin point (BL67) on the foot? The gallbladder channel also runs from the head to the foot, and the stomach channel runs from the head downward. The gallbladder is here, the stomach here, the bladder at the very bottom — the fu organs sit below, yet their channels run from above downward — yang qi always descends. Yin qi ascends: the kidney channel goes from Yongquan (KI1) to Rangu (KI2), climbing all the way up; the spleen channel and the liver channel both travel upward from the feet. That is the normal state.

Yang qi fades below, then cold; yin qi fades below, then heat — lone yin cannot grow, solitary yang cannot live

Now turn to the pathology. Doctor Ni keeps repeating one sentence: the human body has no empty space.

💬 Note from Doctor Ni: When the yang qi of the lower jiao fades, yin qi moves in to fill its place — sometimes you see one thing on the surface, but inside it is actually the reverse. When yang qi fades below, there will be cold, because yin has no temperature — it is icy cold. When yin qi fades below, yang qi is too strong and keeps pouring downward, the yin is not enough — then it overheats, and goes toward heat. Yin and yang must always balance each other — lone yin cannot grow, solitary yang cannot live. If you have solitary yang without yin, the person is gone; if you have lone yin without yang, the person is gone too. So whether it is heat reversal or cold reversal, it is all about balancing yin and yang: when you see a person with yin deficiency, yin qi fading, what you see is heat; when yang qi fades, what you see is cold.

Why does heat reversal start from the soles? — yang qi rises from the surface of the five toes, yin channels gather at the center of the foot

The Yellow Emperor asks: why does heat reversal always begin from the feet? Bo Qi’s definition is one every acupuncture student knows well:

💬 Note from Doctor Ni: Bo Qi says, yang qi rises from the surface of the five toes — the surface of the foot; the yin channels come from beneath the foot and gather at the center of the sole — the sole’s center is where Yongquan (KI1) sits. So when yang qi prevails, the soles of the feet are hot. In a normal person — let me tell you all: above is yang, and within the yang there must be yin. Feel the back of your hand — the back of the hand is cool; the palm is warm. Compare the palm and the back of the hand: in a normal person the back of the hand should be cool and the palm should be warm. That is the boundary limit of yin and yang meeting.

One touch tells you cold or heat: the extremities are the most sensitive “thermometer”

Then Doctor Ni teaches a clinical specialty — diagnosis by touching the hand:

💬 Note from Doctor Ni: When the pattern changes between cold and heat, you just touch: if the heat goes from the palm all the way to the back of the hand — heat normally belongs at the limit (the palm); if the heat overflows and runs to the back of the hand, that person is hot. Some people, the moment you touch them, the cold runs from the fingertips all the way to the back of the hand — the whole hand is ice — by definition the cold should only reach this far (the fingertip limit); when the whole hand is ice all the way down, that is yin prevailing. And there are others: the front (fingers) is ice-cold while the palm is warm — that is yet another distinction. Today a patient comes to see you; you write the prescription; originally the whole palm was ice; after a few days of medicine he comes back and you touch — the palm is warm now, the fingers are still ice-cold — keep him on it. If after taking the medicine it gets colder — it was cold to here, now it climbs higher, colder — then something is wrong.

💬 Note from Doctor Ni: This is our standard — the standard of yin and yang. The extremities of the human body are the most sensitive. In a single check you know whether the patient is cured — the instant you touch, you know. That is why in my clinic practice it is simple: the patient reaches out a hand, I look and touch the head — and the consultation is done — before the patient has even spoken, before he has told me anything, I have already finished the diagnosis. If the patients all knew what kind of doctor we are, I tell you, I could see sixty patients in an hour, prescriptions all written — but the patients do not know that, so you have to sit there patiently and listen. Once you know the Huang Di Nei Jing thoroughly, diagnosis is fast, very fast.

Han Jue (cold reversal): why does the cold stop at the knee? — Qi Jie blocks the way

Page 379. The Yellow Emperor asks: in cold reversal, the cold must climb from the five toes up to the knee — why does it go from the five toes to the knee? Bo Qi says:

💬 Note from Doctor Ni: Yin qi arises within the five toes, gathers below the knee and collects above the knee. So when yin qi is too strong, from the foot up to the knee, that whole stretch is ice-cold. And this cold does not come from outside — it is not that you put your foot in ice water; it is generated from within. So why does it stop at the knee and cannot climb higher? Because qi jie (qi street) lies above; the yangming qi blocks it a little, so the cold stops at the knee.

An infuriating case: breast cancer metastasized to the lung, Shi Zao Tang — phlegm and water must leave together

Speaking of qi jie, Doctor Ni tells a clinical case — and the more he tells it, the angrier he gets:

💬 Note from Doctor Ni: There was a patient with breast cancer that had metastasized to the lung. The lung was accumulating a great deal of water; she could not lie flat — the moment she lay down, she panted. We wrote the prescription and recognized the Shi Zao Tang (Ten Jujubes Decoction) pattern. When Shi Zao Tang goes down — look at this lung: the lung is the canopy (hua gai). When there is water in the lung, normally the lung is filled with qi. If today you spit a wad of phlegm into water, does the phlegm not float on the surface? Whose phlegm ever sinks? Even thick yellow phlegm still floats on the water. So there is phlegm on top of the water, the phlegm rides on top. If the water is not removed, with time it breeds phlegm, the phlegm floats up, and the water keeps accumulating. When Shi Zao Tang goes down, it must remove the phlegm and the water together — not just the water. If the phlegm is stuck on top, the patient vomits — vomiting and diarrhea are the normal response.

The patient took the medicine to the pharmacy, and the pharmacy staff said: this medicine is too fierce, you cannot use it. So the patient took it upon herself to halve the dose — and the result?

💬 Note from Doctor Ni: After halving it, the water was expelled — huge bowel movements — she could lie flat and sleep. But the phlegm was not removed, and she still coughed. Then the patient came and told me: since she fell ill she had never lain flat; now she could lie flat and sleep, but the cough was still inside. And she asked me, puzzled: why are my mother’s feet cold from the knees down? Isn’t that infuriating! If you had driven out the lung qi, the yang qi would recover, the stomach yang below, and the yang channels would open. Then we could take the prescription and replenish the stomach’s fluids, restore the yang channels; when the stomach qi recovers, the feet warm all the way up, and the disease is cured. But she did not dare; she halved it; the feet were still cold to the knee, because the stomach qi only reached qi jie — qi jie blocked the way.

Qi Jie is an inborn force — the medicine must break through it; the pitiable always have something detestable

Why does the cold stop at the knee? Doctor Ni explains: qi jie blocking the way is an inborn force of the human body, something everyone is born with.

💬 Note from Doctor Ni: If the medicine’s force arrives and breaks through, it removes the phlegm and water from the lung and drives out the cancer cells of the breast cancer and the lung — these things that have accumulated inside — all together, and in a week she is well. But the patient’s ignorance makes it much more troublesome! This patient was half cured — she said the chest pain was completely gone — it could all have healed together, but instead it made far more trouble. So do not take matters into your own hands. I always say: when you see a pitiable person, there is bound to be something detestable about them.

What happened to the patient afterward? Doctor Ni continues:

💬 Note from Doctor Ni: He begged and begged — help me, cure my mother, my mother is dying — he begged for a long time. Fine, we cure his mother, and still he does not obey. It comes from exactly this — now you know why it turned out this way? Why are the feet cold to the knee? Your mother’s stomach qi is still there; she is not going to die that fast. Qi jie — clinically it is just like this, you can see it very clearly.

How to use “poison” medicines? — one dose clears it all, then regulate the stomach qi; there may be no second chance

Using this case, Doctor Ni explains the use of “poison” medicines — a great principle in the classical formulas:

💬 Note from Doctor Ni: When we use a poison medicine, that medicine cannot be taken every day — if you take it twice a day every day, the person dies. But should it be used? Yes — why? One dose removes it all. Once it has cleared everything in a single go, you begin regulating the stomach qi, and the person comes back, is saved. There may be no second chance — so what do you do? Of course you gamble boldly. But nowadays nobody knows how to use these medicines, very few people use them; you will all know how, and will all use them in the future — for certain special patterns, the moment we see the pattern we can use it.

Page 380: in spring and summer yang qi is more and yin qi less; autumn and winter call for restraint — running in winter is worse than staying home with your wife

The Yellow Emperor asks again about cold reversal, and Bo Qi answers: the genitals are where the zong jin gathers, the meeting of the taiyin and yangming.

💬 Note from Doctor Ni: In spring and summer yang qi is more and yin qi less — that is the yang of Heaven. In autumn and winter yin qi prevails and yang qi fades — that is the normal state. In autumn and winter yang fades and the keynote is restraint; you should follow Heaven. So if you love exercise and sexual activity, spring and summer are the better times; in autumn and winter restrain yourself a little, behave, be a good child. If you want a pregnancy, summer is the time. How does a doctor know how hard a couple works? Just look at when the children are born — common sense, one glance and it is done. So a doctor must have common sense.

And what happens if you squander in autumn and winter? Doctor Ni says it bluntly — winter squandering is not only about sex, it is also about running:

💬 Note from Doctor Ni: Some people keep squandering in winter — “I am fine, my body is great” — all autumn and winter they drain their essence. Squandering is not only sex, it is also running: early in the morning, the weather is freezing cold — how do you run in that? If you run alone, fine — but why drag your wife along to run? That is not good. Later, when we lecture on astronomy, I will give you an example. You have squandered a great deal of essence — compared to that, it is better to stay home with your wife. Because below is originally yang — it should be guarded and stored; but you spent it, the yang becomes deficient — where yang lives, once yang is deficient, yin prevails. Yin and yang are exactly like this — they never stick tightly together; when yang is gone, yin comes out.

Doctor Ni uses the image of a quarreling married couple to explain this “tug-of-war” of yin and yang:

💬 Note from Doctor Ni: It is like a married couple: when you get married, your wife signs a contract with you — when I quarrel with you, you may run, but you cannot leave the bounds of the home; you may hide, but leave the home and the yang is cut off and yin prevails; at least you can lose your temper and that is the end of it — that is good coordination, staying in bounds. And we should also stop here, not go beyond — run outside the bounds, and yang fades while yin rises; come back home and everything in the house is smashed to pieces. If you do not run out but dodge around inside the house, that is fine — she will not smash things. So people should still get married — marriage is good: the couple has a tug-of-war; otherwise things go too far.

The hands and feet turn cold — yang qi fades day by day, yin qi stands alone

Back to the classic text. Bo Qi closes the mechanism of cold reversal: the channel qi is pressed down, the pathogen rises from below, qi stagnates in the middle, yang qi fades and can no longer moisten the channels, yang fades day by day, yin qi stands alone — and the hands and feet turn cold.

💬 Note from Doctor Ni: That is why I often ask people about cold hands and feet — because they are the origin of yin and yang. In cold reversal the hands and feet immediately turn ice-cold. Some people have heat reversal — heat too strong, running to the hands and feet, all hot — that is not right. It must be exactly right — at the fingertips, beside the toes — this is the Chinese-medicine definition. Now you all understand — everything I write on my website, where does it come from? All from the Huang Di Nei Jing — the detailed explanations are found right in these places. So when our feet are cold, when the cold climbs to here (the knee), to qi jie, it all stops. That is why sometimes in edema the knee swells but above the knee there is no swelling — that is still fine; in that condition the stomach qi is still there, you see? This helps us differentiate patterns.

The modern version of han jue: every Western drug injures the zong jin — of all things that must “drop,” the one certain drop is impotence

Here Doctor Ni pulls the Jue Lun into the modern world — why are so many people’s hands and feet cold nowadays?

💬 Note from Doctor Ni: The cold reversal discussed here is not only the ancient way the disease ran. In modern times, we strongly disapprove of Western drugs — because when Western drugs go down, they kill the yang of the lower jiao. If you do not believe me, take one antibiotic — swallow it — and within twenty-four hours you will see. Look at clinical practice now: many people take blood-pressure drugs, blood-sugar drugs, cholesterol drugs, triglyceride drugs — whatever it is that “lowers” something, after taking it, the thing that should be high is still high; but there is one thing that will certainly drop — impotence, it certainly withers. So why are aphrodisiacs so popular? In the past these drugs were despicable — Americans did not yet know we have aphrodisiacs; our own Chinese considered it an insult to Chinese medicine — “Chinese medicine only knows how to strengthen yang and tonify the kidneys, nothing else.” Then the foreigners started selling Viagra; foreigners may sell it, we Chinese may not — we Chinese are very lousy. Go on, keep taking it, and die of heart disease.

💬 Note from Doctor Ni: Viagra is very bad, because you do not know how to make the gathering of the zong jin rise. We understand that the zong jin, the belt vessel, the governing vessel, the penetrating vessel and the yangming channel all converge in one place — add a little liver channel into it, and the zong jin returns, and the yang rises. You say many Chinese reject Chinese medicine — let me tell you, actually the foreigners do not reject Chinese medicine; the foreigners are dying to have it — because they all hate their own medicine. So all Western drugs injure the zong jin; once the zong jin is injured, cold reversal — the hands and feet are all ice-cold. So if you date a girlfriend and she has ice-cold hands and feet, you cannot casually say such things — because when she was little, no one knows she was hit with antibiotics, took Western drugs, or was vaccinated, leaving her hands and feet cold — it is not winter essence-squandering; do not misunderstand her.

💬 Note from Doctor Ni: In ancient times it was like this, so this is one source — if you squander your essence in winter, it is the same as taking antibiotics every day. You say, “No, I rarely do — I meditate every day, no sex in winter, I never touch women” — then taking Western drugs every day is even faster, even worse. I would rather be with a woman than take those drugs — those drugs are truly bad.

Page 381: how does heat reversal arise? — wine enters the stomach, the collaterals fill and the channels empty

Cold reversal finished, the Yellow Emperor asks how heat reversal happens. Bo Qi’s answer begins with one word: wine.

💬 Note from Doctor Ni: Wine enters the stomach, the collaterals fill and the channels empty. Because the qi of wine is very fierce, very sharp and quick — the moment it goes down it reaches the hands and feet, it immediately enters the collaterals, very fast, because it disperses. And many of our Chinese medicines need dispersing — we want to carry the medicine to the collaterals, to the extremities — at that point we add a little wine and boil it in, using the fierceness of the wine qi to deliver the medicine straight to the extremities. Later, when you all read the Shang Han Lun (Treatise on Cold Damage), whenever Zhang Zhongjing says to boil with wine or add a little wine, there is always a reason — from right here you can trace the clues.

Why does wine brew heat reversal? Because drinking is never just drinking:

💬 Note from Doctor Ni: The spleen moves the fluids for the stomach. When yin qi is deficient, yang enters — when the spleen yin is insufficient, yang follows in; yang was already the stomach’s nature, yang added to yang, the stomach loses harmony, and at this point the fluids fail. The main cause? The wine we drink is never drunk alone — you always eat a lot of good food with it: rich, fatty food, barbecue, piles of meat, and wine on top. These two things arrive in the stomach together, steaming in the middle, heat on heat. So when we drink, let us just drink — sip a little, eat a bit, but do not eat too full. The disease lives in “feast and wine” — drinking too much makes digestion impossible; the stomach cannot digest, the channel qi fails, and instead the limbs cannot be nourished and replenished.

Heat reversal is accumulated day by day — feast and wine, forced intercourse, dark red urine

So how does a person come to have heat reversal?

💬 Note from Doctor Ni: A person with heat reversal must have built it up over years — not one or two days. One or two days is nothing; indulging yourself occasionally is nothing. Bo Qi says it must be accumulated day by day over a year: getting drunk every day, eating to the full, then forcing intercourse, performing the sexual act — the hot qi of the wine gathers in the spleen and cannot disperse; the wine qi and the grain qi (food) clash together; heat prevails in the middle, making the middle jiao too hot. At that point heat pervades the whole body — internal heat. When we have internal heat, the urine is red, dark red. So we often ask the patient: what color is your urine? Dark red, red. For example, in liver disease, hepatitis, the urine immediately turns the color of tea — very fast — internal heat. Why does a teacher know it is internal heat? Of course he must know — knowing, we prescribe cooling medicine for him. Chinese medicine says heat, Western medicine says inflammation; we have cold-cooling herbs — the Northern classical school also uses cold-cooling herbs. Of course we use cooling herbs — it is not that we only use warm herbs.

💬 Note from Doctor Ni: The qi of wine is itself strong and fierce; the kidney qi fades and yang stands alone — when the stomach’s middle jiao is too hot, the heat runs to the four limbs; the inside becomes too hot, the body overheats, and it injures yin; when yin is injured, yang stands alone — and that creates heat reversal. That is the source of heat reversal. So eating must be simple, and drink less wine.

Page 382: jue can also distend the belly and make a person suddenly not recognize anyone

In the last section, the Yellow Emperor asks: jue sometimes makes a person’s abdomen distend, and sometimes makes a person suddenly collapse and not recognize people — why?

💬 Note from Doctor Ni: When a person’s abdomen is distended — the belly swollen — it is yin qi prevailing above — when yin qi prevails above, the lower becomes deficient, and deficient below means abdominal distension. Originally the lower part is yin; now the yin has run up above. Our body is like this: at the midpoint of the diaphragm, above is yang and below is yin. Suddenly not recognizing people — not even close relatives — that is yang qi too strong — yang qi thrown into disorder; the disorder makes a person lose his mental clarity, not recognition; sometimes half a day, sometimes a day, and only then does he gradually recover. This is “jue” — reversal.

Doctor Ni closes: jue is reversal — turning the body’s normal ascending and descending of yin and yang upside down — cold reversal chills to the knee, heat reversal heats the hands and feet, and in the severe cases the belly distends and the person suddenly loses consciousness. To know whether your own body is cold or hot, you need no instruments — one touch of the hands and feet tells you everything.

What to take away

1. Jue means reversal. The Jue Lun is about the body’s yin-yang circulation being turned upside down: yang qi fades below and cold reversal arises, yin qi fades below and heat reversal arises. Lone yin cannot grow and solitary yang cannot live — yin and yang must balance.
2. The extremities are the most sensitive thermometer. Back of the hand cool with palm warm is the normal boundary. Touch the hand: heat running to the back of the hand means heat; ice from the fingertips to the wrist means yin prevailing; palm warming while fingers stay cold means the medicine is working. One touch tells you whether the patient is getting better.
3. Cold reversal stops at the knee because qi jie (qi street, Qichong ST30) blocks it — the cold is generated from within, and the yangming guards the road above. If the medicine is strong enough to break through qi jie, the stomach qi recovers and the feet warm to the toes — which is why the breast-cancer case failed: halving the fierce dose of Shi Zao Tang (Ten Jujubes Decoction) let the water go but left the phlegm, and the feet stayed cold to the knee. One dose clears it all, then regulate the stomach qi — there may be no second chance.
4. Autumn and winter are for restraint. Sexual activity and even winter morning running squander essence; yang fades day by day and yin stands alone, and the hands and feet turn cold. If you want a pregnancy, summer is the time.
5. The modern cold reversal: Western drugs injure the zong jin. Blood-pressure, blood-sugar, cholesterol and triglyceride drugs may lower nothing else — but impotence is the one certain drop. Viagra does not know that the zong jin gathers with the belt, governing, penetrating and yangming channels plus a touch of the liver channel. Antibiotics and vaccines in childhood can leave hands and feet cold for life — the same damage as squandering essence in winter.
6. Heat reversal comes from wine. Wine qi is fierce and enters the collaterals first (which is why Zhang Zhongjing boiled some formulas in wine, to carry the medicine to the extremities). Feast and wine, heat on heat, day after day — wine qi and grain qi clash, heat prevails in the middle, yin is injured, and the hands and feet burn. Dark red urine is the sign of internal heat — hepatitis turns urine the color of tea. Eat simply, drink little.
7. Jue can distend the abdomen or steal consciousness — yin prevailing above empties the lower and swells the belly; yang qi in disorder above makes a person suddenly not recognize anyone, recovering gradually after half a day or a day.
8. Bonus from the Wei Lun conclusion: to treat wei, take only the yangming, with acupuncture — supplement each ying-spring point and unblock its shu-stream point. The zong jin’s mansion is where the belt, governing and penetrating vessels meet the yangming around the lower abdomen (Dai Mai GB26, Wushu GB27, Weidao GB28; Ming Men GV4 to Guanyuan CV4); a woman’s leucorrhea ties to the belt vessel. And the salt-field worker’s atrophy — sun-scorched lung fluid, heavy loads injuring kidney essence, feet in water injured by damp — is treated by clearing heat and replenishing fluids, with seasonal fruit as Heaven’s own compensation.

Compiled from Doctor Ni Haixia’s Ren Ji (Human Records) lecture series on the Huang Di Nei Jing (Lecture 53)