Suddenly Fainting, Face Swollen and Head Heavy So You Cannot Walk, Deafness, Passing Whatever You Eat Undigested, Urinary and Bowel Blockage — What to Do? — Doctor Ni Haixia on the Huang Di Nei Jing, Lecture 54: the Jue Lun (Reversal Treatise, Part 2) — the Jue of the Six Channels and the Counterflow Reversals of the Six Channels
Patient search words: suddenly fainting / fainting and losing consciousness / suddenly not recognizing people / syncope / swollen face / heavy head / heavy head and light feet / unable to walk / deafness / tinnitus / buzzing in the ears / flank pain / chest and flank fullness / distended ribs / bloated belly / abdominal distension / no appetite / vomiting right after eating / constipation / unable to pass stool / passing whatever you eat undigested / undigested food in the stool / urinary blockage / unable to urinate / cramps / calf cramps / lower back pain / ice-cold hands and feet / urinary and bowel blockage / nosebleed / vomiting blood / coughing blood / cough / stiff joints / joint pain / sore throat / throat blockage / unable to swallow / tonsillitis / thyroid / weak pulse / thin pulse / stomach pain / gastritis / Chinese medicine for jue syndrome / counterflow reversal of the six channels
Corresponding topics (medical terms): Su Wen · Jue Lun (Reversal Treatise, chapter 45), part 2 — the jue of the six channels and the counterflow reversals of the six channels. When yin prevails above, the lower becomes deficient — the cun kou pulse grows large, and a deficient lower abdomen distends; when yang qi is thrown into disorder, the person suddenly loses consciousness (when the pathogenic qi enters from the side, if the spirit departs, life is at risk). The jue of the six channels: taiyang jue — swollen head and heavy head, feet unable to walk, and on attack sudden vertigo, blurred vision and collapse (the bladder channel qi descends from the head; reversed, it brings vertigo and collapse); yangming jue — manic running and shouting, abdominal distension so one cannot lie down, red face and heat, seeing and speaking wildly (the yangming stomach and large-intestine yang qi turns back upward; when the lower intestine is blocked, marshy gas rushes up — climbing high and singing); shaoyang jue — sudden deafness, swollen and hot cheeks, flank pain (fullness and distension of both flanks belong to shaoyang — chest-flank fullness); taiyin jue — abdominal distension with difficult bowel movements, no desire for food, vomiting right after eating, unable to lie down (the spleen enlarged with accumulated damp; when the spleen yang is insufficient, build up the spleen yang and the appetite opens); shaoyin jue — dry mouth (saliva originates from the kidneys), difficult urination, abdominal distension and heart pain; jueyin jue — swelling and pain of the lower abdomen, abdominal distension, difficult urination, liking to lie with knees bent, retracted genitals, and inner heat of the shank (the inner tibia is traversed by the liver, spleen and kidney channels). The treatment principle: drain when replete, supplement when vacuous, and when neither replete nor vacuous, take the channel’s own points. The counterflow reversals of the six channels: taiyin — severe cramping of the shank with pain drawing up into the heart and abdomen, treat the primarily diseased organ (the spleen governs the lower abdomen; the lower abdomen is the small intestine, so treat the spleen together with the small intestine — the lady who wants to lose weight with a belly full of spleen damp); shaoyin — distension, vomiting, and discharging clear undigested food (the stomach is the official of the kidney; before kidney failure there is violent vomiting; treat the kidney together with the stomach); jueyin — cramping, lower back pain, distension, blockage of the front (urination and defecation) and delirium (to treat the liver you must clear the large intestine — metal controls wood; keep the stool free and the liver heals itself; smoking injures the liver, but never forget that constipation is even worse for it; treat early, while the disorder is still slight); all three yin in counterflow — ice-cold hands and feet, no urination or defecation, death in three days (the one-strike power of the classical formulas; gamble boldly — Zhang Zhongjing already opened the road); taiyang — stiff collapse, vomiting blood and frequent nosebleed (the lung is the upper source of water; lung water enters the kidney and bladder through two distillations: the finest essence enters the marrow to nourish the brain, the turbid water is distilled again into the liver; treat the lung for bladder problems and vice versa); shaoyang — the joints (hinges) fail to move (shaoyang is the pivot; the lower back belongs to the san jiao and Ming Men GV4), intestinal abscess is incurable, and fright means death (before death, the spirit departs); yangming — wheezing cough, body heat, easy fright, nosebleed and vomiting blood (the stomach holds much blood — the blood spurts out, attacks at midnight, easy to treat); hand-taiyin — distension with cough and vomiting of froth (the lung is like a bellows pressing qi downward; normal qigong sinks qi to the dantian — rising qi is evil kung fu); hand-shaoyin — heart pain drawing to the throat with body heat (the heart is yang within yang; the last flare before the fire dies is the terminal rally — difficult to treat); hand-taiyang — deafness with tears flowing, the neck unable to turn, the lower back unable to bend (the small-intestine, gallbladder and san-jiao channels meet in front of the ear; exterior tinnitus buzzes without pressure while kidney-deficiency tinnitus has deep pressure — treat the small intestine together with the spleen); hand-yangming and shaoyang — throat blockage (the throat is the sea of qi and danzhong CV17 is the gathering of qi; all throat disease is qi blockage; qi-moving herbs push the qi; understand the design of the classical formulas and you can innovate). Su Wen · Bing Neng Lun (Treatise on the Manifestations of Disease, chapter 46, part 1) — wei wan yong (carbuncle of the stomach duct): palpate the right guan (stomach) pulse; the length of the pulse — cun nine fen, chi one cun; longer is a long pulse, shorter a short pulse; the left guan: the outside is the liver, near the sinew the gallbladder; the right guan: cun is yang, chi is yin; the qi of the pulse is outside (governing qi) and the blood is inside — outside examines the spleen, inside the stomach (yin and yang reversed: the stomach is yang, the spleen is yin); the normal stomach pulse is relaxed yet forceful (four to five beats per respiration cycle — a moistening strength, not a large force); when abscess pus is present, the pulse sinks and becomes fine.
Opening: the jue lecture is not finished — from upper-lower yin-yang, to the six channels
The last lecture explained cold reversal (han jue) and heat reversal (re jue) thoroughly: when yin prevails above, the lower part becomes deficient — and when you feel the pulse at that point, the cun kou pulse turns very large, so you know the upper is replete. When the upper is replete, the lower is deficient, and a deficient lower abdomen distends.
Doctor Ni Haixia then lifts out the most dangerous situation: if the yang qi above is doubled — the yang qi of the lower burner rises again.
💬 Note from Doctor Ni: The yang qi of the lower burner comes from our Ming Men (GV4) and from our small intestine — the lower part is very hot; yang qi added to yang qi travels upward, aggravating the upper; the pathogenic qi reverses — when the pathogenic qi reverses, the yang qi is thrown into disorder, and when the yang qi is thrown into disorder, the person no longer recognizes anyone. Why is it called pathogenic qi? Because our yang qi entering the head follows a definite direction; when the pathogenic qi enters from the side and throws a person’s qi into disorder, the person collapses.
He says that ordinary fainting without consciousness — when people come to on their own — is generally easy to treat; but there is one kind — after losing consciousness, the spirit (shen) departs, and that person’s life is gone — that is extremely dangerous.
💬 Note from Doctor Ni: Page 383. What we just covered is the theory of jue of the upper and lower, yin and yang. The Yellow Emperor now asks: I want to see the jue symptoms of the six channels. By the six channels I mean taiyang, shaoyang, yangming, taiyin, shaoyin and jueyin — not the twelve channels individually. And Qi Bo answers.
Taiyang jue: swollen face, heavy head, feet unable to walk — the bladder channel qi runs backward
Qi Bo speaks of taiyang (the great yang) jue first: the face swells, the head feels heavy, and the feet cannot walk. When it attacks, the person becomes dizzy and falls — the eyes dim, and the person collapses.
💬 Note from Doctor Ni: Those of you who have studied acupuncture know: the bladder channel runs from the back all the way to the front, and drops into the eyes — so when it attacks, the eyes go dim and dizzy. The bladder channel runs down the back and down to the feet, so the feet cannot walk — because the yang qi is in counterflow. When we covered acupuncture we explained: the qi of the bladder channel normally flows from the head downward; now it runs backward, and the person experiences vertigo, dimmed vision, collapse, and feet that cannot walk.
Yangming jue: a belly full of gas, climbing high and singing — the marsh gas of the large intestine turns back
Yangming jue: manic running and shouting, abdominal distension so one cannot lie down, red face and heat, seeing and speaking wildly.
💬 Note from Doctor Ni: The essence qi of the yangming channel normally bears down — Touwei ST8, Xiaguan ST7, Jiache ST6, all the way down the body, right? Now the yangming turns back upward. The yangming here includes both the large-intestine channel and the stomach channel. Most of the time, the reason the yang qi turns back is that something blocks the road below — the stomach qi handles food, so when the large intestine below is blocked, the marsh gas turns back up. Originally this marsh gas can only reach the chest and diaphragm — the diaphragm separates it. Now the marsh gas rises: abdominal distension so you cannot lie down, manic running, climbing high and singing — that is exactly this.
Shaoyang jue: deafness, distended and painful flanks — remember, fullness of both flanks is shaoyang
Shaoyang jue: deafness, tinnitus, swollen cheeks, hot ears, flank pain.
💬 Note from Doctor Ni: The shaoyang channels include hand-shaoyang and foot-shaoyang (the gallbladder channel). They too can cause deafness, tinnitus, swollen cheeks, hot ears and flank pain. From now on, whenever a patient tells you: my chest and flanks here feel full and distended, painful — shaoyang is settled! The Shang Han Lun explains it in detail: this bilateral flank pain, chest-flank fullness, fullness of both flanks, is the shaoyang location. And “the shank cannot be used” — the shank is the tibia: between the foot-yangming sinew and the spleen channel, the place where the bone protrudes when you press down — that is the tibia. It affects walking, making it somewhat unsteady.
Taiyin jue: bloated belly, vomiting right after eating — the spleen fears dampness most
Taiyin jue: abdominal distension, difficult bowel movements, no desire for food, vomiting right after eating, unable to lie down comfortably.
💬 Note from Doctor Ni: Taiyin includes the hand-taiyin lung channel and the foot-taiyin spleen channel. The spleen governs the lower abdomen — the spleen manages the inside of the belly. When the spleen has problems: poor appetite, distended abdomen, stools not smooth, vomiting right after eating — because the spleen is enlarged, accumulating a lot of damp, so it is hard to lie down. Often a person has a poor appetite, and Western medicine lists many reasons — pay no attention to them. When you examine and find abdominal distension and poor stools, you know: the spleen fears being too damp; the spleen yang is insufficient because yin is too abundant. Prescribe herbs that build up the spleen yang, and once the spleen and stomach are strengthened, the appetite opens.
Shaoyin jue: dry mouth — the saliva in your mouth is managed by the kidneys
Shaoyin jue: dry mouth, abdominal distension when urinating, heart pain.
💬 Note from Doctor Ni: The shaoyin kidney channel and the hand-shaoyin heart channel both belong to shaoyin, because they are extremely close. In shaoyin jue with dry mouth — the fluid under your tongue, the saliva in your mouth, originates from the kidneys. Now the essence fluid is weak, the channel qi runs perversely, causing dry mouth; when urinating, abdominal distension and heart pain.
Jueyin jue: swelling and pain of the lower abdomen, liking to sleep with knees bent
Jueyin jue: the foot-jueyin liver channel and the hand-jueyin pericardium channel — swelling and pain of the lower abdomen, abdominal distension, difficult urination, liking to lie with knees bent, retracted genitals, and inner heat of the shank.
💬 Note from Doctor Ni: When the kidney channel has problems, the knees like to bend when sleeping, and the genitals retract and swell. The inner heat of the shank — inside the tibia run the lung (spleen) sinew, the kidney channel and the liver channel; the inner side of the shank is also the kidney channel location. This is disease on the liver channel. The treatment principle: drain when replete, supplement when vacuous, and when neither replete nor vacuous, take the channel’s own points — knowing it is on the liver channel, supplement when vacuous, drain when replete, and in ordinary cases take the channel’s own points. This is a great governing principle of treatment.
Now the more serious level: jue ni — from “jue” to “ni,” the disease deepens
Doctor Ni Haixia turns the topic: just now we only discussed “jue” — a slight reversal. Now we discuss “jue ni” (counterflow reversal) — this is more serious. When it is serious, what do you do? — Treat the primarily diseased organ.
💬 Note from Doctor Ni: “Treating the primarily diseased organ” means treating the organ that is mainly sick — knowing its location, seeing the symptoms, you know which channel the disease is on, and you treat that channel.
Taiyin counterflow: calf tight as a cramp, pain drawing to the lower abdomen — treating the spleen always means treating the small intestine too
Taiyin counterflow: severe cramping of the shank (the tibia tight, like a cramp), pain drawing into the heart and abdomen (pain reaching the abdomen).
💬 Note from Doctor Ni: As soon as you see heart pain drawing to the lower abdomen, you know it is the spleen channel — disease arising in the lower abdomen belongs to taiyin, so treat taiyin, and taiyin is the spleen. Here is something amusing: the spleen governs the lower abdomen — and is the lower abdomen the small intestine? So when Chinese medicine treats the spleen, it often treats the small intestine at the same time — because the small intestine is the official of receiving and transforming, located in the lower abdomen. Where there is much damp, many ladies and young women say, “I want to lose weight” — you look at her, she is not fat at all; lose weight for what? She says her belly is big — it does not look big because the girdle and belt hold it in. Women want a perfectly flat belly, and her lower abdomen is entirely spleen damp. We must treat her spleen and simultaneously treat the small intestine — treating the spleen always reaches the small intestine as well. That is treating the primarily diseased organ.
Shaoyin counterflow: passing whatever you eat — before the kidneys fail, there is always violent vomiting first
Shaoyin counterflow: distension, vomiting, and discharging clear food — the stool comes out as qing gu (clear grain): you eat spinach and pass spinach; eat water spinach and pass water spinach.
💬 Note from Doctor Ni: When shaoyin is in counterflow, the reversal is more severe. Why vomiting? Because the stomach is the official of the kidney — I explained before: when the kidneys have problems, you begin to see stomach symptoms — vomiting. Before the kidneys fail, the patient always has extreme dizziness and violent vomiting, bringing up a great deal of fluid. Let me remind you of the reason once more: the kidney is here, and the kidney governs water — now there is too much water: the kidney is not eliminating it, the stomach cannot bear it, it all pushes up into the stomach, so of course the person vomits. There is a limit; once the limit is exceeded and the stomach begins to vomit, we have already reached the middle burner, and the kidney function is nearly gone. At first the water starts below and swells up to the feet; when the body reaches its limit, the function is gone. So we also treat the primarily diseased organ — when treating the kidney, we often treat the stomach as well.
Jueyin counterflow: to treat liver disease, you must simultaneously open the large intestine — metal controls wood, open the stool and the liver heals itself
Jueyin counterflow: cramping, lower back pain, distension, blockage of the front (urination and defecation blocked), delirium — treat the primarily diseased organ.
💬 Note from Doctor Ni: In liver disease, how do we treat the primarily diseased organ? To treat liver disease you must at the same time clear the large intestine — treating the liver alone will not cure it; you must free the large intestine. So in treating liver disease, you must always keep the patient’s stool moving well; if urination and defecation are blocked and stuck, it is already too late. A good physician does not wait until the patient reaches the end stage — from the very first encounter with liver disease we prevent: we are already freeing the stool. As long as you maintain the balance of metal controlling wood — while treating the liver, always soothing the liver, always clearing the large intestine, always keeping the stool moving — the liver disease naturally gets better. Because metal goes to control wood: with metal controlling it, the poor liver has a lung above pressing on it and a large intestine below pressing on it — the liver is like the father, the lungs like the mother, and the child below; two metals pressing on it, so the liver wood behaves very, very well in the middle — that is the normal state. The day disease arises and problems appear, it is too late for either of these two to act. So when the lungs are injured, the liver is affected — correct: Western medicine says smoking is bad for the liver, and Chinese medicine agrees; but you must also clear the large intestine — you forgot to say “constipation is bad for the liver”! So we always keep the stool moving; when the stool is bad, free it quickly, and while the body still has only a slight disorder, a small change, treat it at once — that is treating the primarily diseased organ.
All three yin in counterflow: ice-cold hands and feet, no urination or defecation — death in three days, so gamble boldly
The blockage of the front is not only about urination — both urination and defecation are blocked; the patient is delirious and clouded. If all three yin are in counterflow, with ice-cold hands and feet and no urination or defecation, death comes in three days.
💬 Note from Doctor Ni: Saying “death in three days” means that if these symptoms are discovered and left untreated, observing the patient, he dies in three days. We physicians do not behave that way — we have life-saving methods; we bring him back with one strike, let him gamble boldly, right? Why do we study the classical formulas (jing fang)? Because among all the pharmacopoeias of Chinese medicine, only the classical formulas have very great power — one strike and it hits. If you say, let me think it over, let us attack gently — his disease can kill him urgently; it kills urgently, and a gentle attack is too slow. We cannot afford it, so I train you: sometimes you will face only one chance — when you take that one chance, what you deliver must be heavy; the delivery must be heavy, and the tools inside must be excellent — error is not permitted. Zhang Zhongjing already opened the road and laid the formulas there; it is truly a pity that people do not use them. You will understand when we reach the Shang Han Lun.
Doctor Ni also jokes: you cannot keep reading the Huang Di Nei Jing and seeing “death in three days” and want to watch whether he really dies in three days — you cannot experiment with a human life.
💬 Note from Doctor Ni: Western medicine reports death very accurately — if they say you will live one year, you live one year; fifty-three days, fifty-three days, because their death records are very detailed and never wrong. But after we bring a patient back — Western medicine said he had only one month; we saved him, and a year later he still goes back to the hospital every year for checkups. The patient does not know any better — that is normal; he goes every year for the physical because of the medical insurance. The doctor inside sees him, thinks he has seen a ghost, is startled, and even touches the patient to check whether he is still alive or whether his eyes deceived him. We often startle Western doctors, which is why the doctors over there respect Chinese medicine very much: “Whose medicine are you taking?” — great respect; they never attack us. Even a princess wants to live, right?
Taiyang counterflow: stiff collapse, vomiting blood, nosebleed — when the bladder has problems, treat the lung
Taiyang counterflow: stiff collapse (fainting), vomiting blood, frequent nosebleed — treat the primarily diseased organ. Taiyang is the channel qi of the three yang; when it attacks, it is very strong — the patient collapses, vomits blood, and bleeds from the nose.
💬 Note from Doctor Ni: Take the bladder as the example. In the normal state, in physiological anatomy: the lung faces heaven; rain falls from heaven and runs into the kidneys, and the kidneys accumulate it; after accumulation, the kidneys transport it to the bladder. Before transport, there is the first distillation — here at Ming Men (GV4) there is also the fire of the small intestine; when it distills, the finest essence of the kidney — like the first distillation of fermented wine — is the best Maotai; what comes next is er guo tou (second-grade liquor). This fine essence enters the bones and marrow, to supplement our marrow and nourish our brain; the turbid essence says “I do not want you” — it is thrown into the bladder, and after entering the bladder, a second evaporation takes place: behind the bladder is the small intestine, which burns it once more; this “second-grade liquor” enters the liver — water generates wood — washing the liver once again, and the turbid water is then discharged. This is the normal state. So the water of the lung and the water of the bladder are related — “treat the primarily diseased organ” here means: when the bladder has problems, treat the lung; when the lung has problems, you can treat the bladder. That is why some people, as soon as they cough, urinate.
Shaoyang counterflow: the joints fail, intestinal abscess incurable, fright means death — when the spirit is about to leave is the most dangerous moment
Shaoyang counterflow: the joints (hinges) fail — the ribs are distended, and the joints have problems.
💬 Note from Doctor Ni: Why do we speak of the joints? Remember: shaoyang — shaoyang is the pivot, like a door that can open and close. Everywhere on your body that bends: the eyelids blinking, the mouth opening and moving — all are related to shaoyang; everything that bends this way and that, opening and closing like a door, is governed by shaoyang. The lower back that cannot bend — that too. The san jiao governs the lower back, and the lower back is at Ming Men (GV4). When intestinal abscess (chang yong) develops it is incurable — an intestinal abscess is peritonitis, or a ruptured gallbladder — that kind is incurable; but the Yellow Emperor says incurable, and we still treat it — do I have a method? I have a method. You cannot watch a dying person and say “cannot be treated.”
Fright means death — Doctor Ni Haixia states the basic concept of Chinese medicine: when disease is very deep and threatens life, before death, the spirit departs.
💬 Note from Doctor Ni: Look at this person — his spirit was very good before; but in a major illness, a severe illness, one or two days before the end, the spirit leaves. Once the spirit leaves, a small stir frightens him enormously — this is the spirit about to go. So when you see “fright” and death, it is because the spirit can no longer be stored.
Yangming counterflow: wheezing cough, body heat, blood spurting out — blood from the stomach, attacking at midnight, easy to treat
Yangming counterflow: yang qi surging upward — wheezing cough, body heat, easy fright, nosebleed and vomiting blood — nosebleed and also vomiting blood.
💬 Note from Doctor Ni: Yangming includes the stomach and the large intestine. When something grows in the stomach, stomach cancer vomiting blood, there will be vomiting of blood — counterflow is a very severe symptom. Coughing blood and vomiting blood are different: if it is a cough from the lungs, phlegm and blood are connected; blood from the stomach is not like that — it is vomited, the blood spurts out — because the stomach has much yang qi and much blood; wow, it comes up and covers the whole bed. This kind of disease always attacks at midnight, and what comes up is all blood. It is very easy to treat, very easy.
Hand-taiyin counterflow: distension with cough, vomiting froth — the lung is like a bellows, the qi must be pressed downward
Hand-taiyin counterflow: distension with cough, vomiting froth — think of hand-taiyin and you think of the lung channel.
💬 Note from Doctor Ni: When the essence qi of the lung channel runs backward, there is distension with cough. Normally the lung qi expands — why do we speak of opening and closing? The purpose of opening and closing is to move downward: the lung is like a bellows, pressing the upright qi downward. In Daoist meditation practice we try to make the qi descend — have you ever practiced a martial art where the qi rises? That is evil kung fu! Normal martial arts all sink the qi to the dantian. Now the lung qi is reversed: distension with cough; vomiting froth — because the lung holds much fluid, and that fluid should sink; now it comes out. Running backward, treat the primarily diseased organ — when we treat lung disease, we also treat the bladder and the lower burner, by the same principle.
Hand-shaoyin counterflow: heart pain drawing to the throat, body heat — the last flare before the fire dies is the terminal rally
Hand-shaoyin counterflow: heart pain, drawing to the throat, body heat — this one is very special.
💬 Note from Doctor Ni: When the heart has problems, it is yang within yang — the heart is like fire, and the heart is extremely hot, yang within yang. The lung is yang with yin within. When the heart has problems, the yang is too hot, the yang qi rises, it concentrates — yang exhaustion: when yang qi is about to be used up, it is like a candle burning in fire; when it is nearly burned out, “bang” — one very bright flare, and then it is gone. The heart is the same: bang, it rushes up into the throat — this is about to die; truly nothing can be done.
Hand-taiyang counterflow: deafness, tears flowing, lower back unable to bend — treat the small intestine, and the spleen too
Hand-taiyang (small-intestine channel) counterflow: deafness, tears flowing, the neck unable to turn, the lower back unable to bend.
💬 Note from Doctor Ni: When a patient has deafness, many conditions cause deafness: the hand-taiyang small-intestine channel can, the gallbladder channel can — because in front of the ear, the small-intestine channel, the gallbladder channel and the san-jiao channel all meet here. Exterior wind-cold on the yang channels causes tinnitus; and the kidney opens at the ears — internal hearing is managed by the kidneys, and kidney deficiency also causes tinnitus. These two are somewhat different: kidney-deficiency tinnitus is deeper — because it comes from the internal organs, the interior is vacuous, and you feel great pressure, great external pressure; if the tinnitus is an exterior pattern, it buzzes — you hear it buzzing, with no pressure, not the great pressure of kidney deficiency. Treat the primarily diseased organ: treating small-intestine problems also means treating the spleen, because the spleen and the small intestine are connected.
Throat blockage (hou bi): unable to swallow — the throat is the sea of qi; every throat disease is treated with qi-moving herbs
Hand-yangming and shaoyang counterflow: throat blockage (hou bi) — problems swallowing — also treat the primarily diseased organ. Here Doctor Ni Haixia stops and explains the whole matter of “throat disease”:
💬 Note from Doctor Ni: This is a person’s chin, the neck and throat. When you study acupuncture, the place between the two breasts is called danzhong (CV17) — qi gathers at danzhong; it is the gathering of qi, and qi disease is treated here. The nature of qi is to rise; when it rises, it comes up this way, passing through the kidney channel position and moving upward — so the throat area, this whole region, is where qi collects — it is the sea of qi; the sea of qi is at the throat. So when we treat throat disease — I do not care whether it is the tonsils or the thyroid — as long as the disease occurs in the middle of the throat, it is qi blockage. So we have certain herbs — you will learn qi-moving herbs later — these herbs can push the qi, making it run faster. I want you to know the location, then you will know how to design the prescription and will not make mistakes.
Doctor Ni then shares his attitude toward learning Chinese medicine — do not memorize formulas:
💬 Note from Doctor Ni: I do not approve of memorizing prescriptions. What I approve of is: from the very beginning you know the prescription — the prescription is naturally formed in your heart. Only then can you become a master; otherwise you will forever be “Zhang Zhongjing number two” and can never surpass him. Your generation will encounter many special things in the future, things our past medicine may never have reached — that is where you break through. So you must be confident, know why every ancient formula was designed the way it was, and then you can seek the new and change; at the same time, understanding these things is how you know how to write a prescription, how to weigh the light and heavy — the dosage of the prescription. That is what I want you to understand.
Page 386: opening the Bing Neng Lun — “bing neng” means the state of disease
Huang Di Nei Jing page 386, chapter 46, the Bing Neng Lun (Treatise on the Manifestations of Disease).
💬 Note from Doctor Ni: This chapter discusses the pathological state — the state of disease. Earlier, from the first chapter on, it spoke of great principles, heaven and earth — that part is rather dull; gradually, gradually it becomes connected to your body, and then you can feel what it is analyzing.
The first question of the chapter: wei wan yong — yong means suppuration. How to diagnose it? Teacher, how do you know the place in his stomach is suppurating?
💬 Note from Doctor Ni: Qi Bo says it is simple — palpate the stomach pulse. Where is the stomach pulse? At the right guan position. The left hand cun-guan-chi: the cun kou is above the guan, nine fen; from below the guan down to the bottom is one cun — this is the standard length of the pulse; longer than this is a long pulse, shorter than this is a short pulse. On the left guan in this region, the outside of the pulse is the liver pulse, with a sinew in the middle, and near the sinew is the gallbladder — you can feel the gallbladder. On the right guan, above the guan is the cun, also nine fen; starting from the nine fen, one cun below, this is the chi pulse. The guan and cun are yang; the chi is yin — this is exactly the position Qi Bo speaks of.
The qi of the pulse is outside, the blood is inside — yin and yang are exactly reversed
Where is the qi of the pulse? Doctor Ni Haixia breaks the key point of pulse diagnosis:
💬 Note from Doctor Ni: When you feel the pulse, what you touch on the outside of the pulse is where the pulse qi resides; the inside of the pulse is where the blood resides — so we separate qi and blood. This pulse is here; when we detect from the outside, we speak of the spleen; when we detect from the inside, we speak of the stomach — yin and yang are exactly reversed. In the Chinese medical view, yin and yang advance side by side, so feeling the outside is reversed — in fact the stomach is yang and the spleen is yin.
The normal stomach pulse: relaxed yet forceful — four to five beats per respiration
So what does the normal stomach pulse look like?
💬 Note from Doctor Ni: The normal stomach pulse is relaxed yet forceful. “Relaxed” alone is not enough — it must also be forceful. The meaning of “relaxed”: four to five beats — four to five beats per respiration of the physician, the patient’s pulse beating four to five times — this is the most standard speed. And it must be “forceful” — that force is a moistening strength, not a large force; you can feel its strength. If there is abscess pus, you will feel the pulse become sinking and fine — originally relaxed yet forceful, now the pulse becomes very sinking and very fine. This sinking means the pulse moves downward — because the spleen and stomach qi is no longer moving.
Compiled from Doctor Ni Haixia’s Ren Ji (Human Records) lecture series on the Huang Di Nei Jing (Lecture 54), presented by Doctor Luo Dalun