Cannot Lie Down and Sleep, Mind Always Dwells on Your Illness, a Pus-Filled Lump on Your Neck, Suddenly Going Mad and Running Wild — What to Do? — Doctor Ni Haixia on the Huang Di Nei Jing, Lecture 55: the Bing Neng Lun (Treatise on the Manifestations of Disease, Part 1)

Patient search words: cannot lie down and sleep / insomnia / tossing and turning all night / mind always dwelling on illness / random anxious thoughts / anxiety about being sick / cannot lie flat / qi rushing upward the moment I lie down / lower back pain / kidney-deficiency back pain / pus-filled lump on the neck / swollen neck / suppurating lymph nodes / carbuncle / suddenly going mad / manic running and shouting / climbing high and singing / hitting and cursing people / mania / too much stomach acid / heartburn / cardia / stomach pain / stomach abscess / sinking pulse / tight pulse / floating pulse / yang vacuity / sheng tie luo (iron filings) / ji shi bai (white chicken droppings) / Chinese medicine for mania / Chinese medicine for carbuncles

Corresponding topics (medical terms): Su Wen · Bing Neng Lun (Treatise on the Manifestations of Disease, chapter 46), part 1, closing the Mai Yao Jing Wei Lun (Treatise on the Essentials of Pulse Examination). Pulse diagnosis: the spleen-stomach pulse lies within the muscle — press and you find it; pressing further to the bone is the sinking pulse. The renying pulse (ST9, the stomach pulse) larger than the cun kou pulse means stomach qi reversing upward with heat gathering at the stomach opening; most stomach disease is at the lower opening of the stomach (the upper mouth of the small intestine); when too much acid reverses up and burns the cardia, it becomes a stomach abscess (wei wan yong). The guan position should normally feel relaxed yet forceful (the earth pulse); feeling sinking and fine (a water pulse) means accumulation and blockage in the stomach — earth and water overcome each other, and the stomach qi that should descend no longer descends. Lying down restlessly: when an organ is injured, and the essence has a place to lodge, one is at ease; a person cannot suspend his illness (the mind dwells on the disease, anxious and restless); excess lung qi makes the pulse large, and a large pulse means one cannot lie flat (lying on the back, the qi rushes upward). The pulse responds to the four seasons: sinking belongs to winter and the kidney, floating to autumn and the lung, wiry to the liver, surging to the heart, relaxed to the spleen; tight means something solid inside (cold, stones, accumulation); the right hand governs qi, the left hand governs blood; the upper burner of heart and lung meets heaven qi, the lower burner meets earth qi. In winter a sinking, tight pulse on the right is the norm; a floating, slow (autumn, vacuous) pulse on the left is yang vacuity, disease in the kidney, presenting as lower back pain; the chi pulse rising up and crossing the guan position is the kidney family’s repletion pattern, with qi reversing and the pulse becoming large (kidney stones, tumors). The shaoyin pulse threads the kidney and links the lung, reaching upward to the throat and the Jinjin (EX-HN12) and Yuye (EX-HN13) points under the tongue (the kidney channel runs beside the Governor Vessel). Neck carbuncle: the neck is the sea of qi — when qi is excessive, blood gathers, and after long stagnation the stagnant blood suppurates; when pus is present, lance it with a stone needle (bian shi) or treat it with acupuncture (a red swelling with a white head, or a lump that feels hot while the surrounding skin is cold, indicates pus); once the pus is drained the qi is released and the disease resolves. Never lance it when there is no pus. Madness and rage: born of yang — a person whose yang qi is suddenly broken and hard to resolve is prone to rage; double yang (yang with no yin to control it) means mania; yangming qi reversing causes manic running, climbing high and singing (yangming qi is normally abundant and descends, giving the feet more strength than the hands; when it reverses, the enormous force rushes upward and causes movement); the reversal of taiyang and shaoyang does not move the body. Treatment: deprive him of food and it resolves (food enters the yin and grows qi in the yang; the qi of yangming originates from grain and water); if it persists, give sheng tie luo as a drink — sheng tie luo (the iron dust knocked off a blacksmith’s anvil by striking, not the oxidized iron from a pharmacy) powerfully sends qi downward and settles the spirit; with the appended story of ji shi bai (white chicken droppings) and self-collected medicinal materials.

Opening: continuing from last time — how to feel the stomach pulse precisely

Last lecture discussed the stomach abscess (wei wan yong) and cutting the right guan position for the stomach pulse. This time Doctor Ni Haixia continues: how exactly do you feel the stomach pulse?

💬 Note from Doctor Ni: The stomach pulse lies in the middle of the muscle. Look — this is skin, this is muscle, and inside is the bone. Because the stomach governs the muscles, you will definitely feel the pulse in the muscle layer. Press down a little and feel it — that is the spleen-stomach pulse; press further down and you reach the bone edge — that is the sinking pulse.

He gestures at the blackboard as he speaks: press down, and the pulse sinks — a pulse sinking all the way to the bone is called “sinking.”

The renying pulse large — heat stops above the stomach and will not move

Pulse diagnosis is not done on one hand alone. Doctor Ni Haixia teaches a comparison method:

💬 Note from Doctor Ni: With one hand feel the cun kou pulse, with the other feel the renying pulse (ST9). The renying pulse is the stomach pulse; when it is much larger than the cun pulse, this is a heat pulse. Renying is the stomach pulse — the stomach qi reverses, and heat stops at the upper part of the stomach without moving. Most people fall ill in the lower part of the stomach — here the text says “the upper opening of the stomach,” but in fact it is talking about the upper mouth of the small intestine, below the stomach.

The stomach has two openings: the cardia above and the pylorus below. Most stomach disease occurs below; when it occurs above, it is because too much acid has reversed up and burned the cardia.

💬 Note from Doctor Ni: After it is burned, it can suppurate. How do we see this? The guan position is where it shows. A sinking pulse is generally a water pulse, the kidney pulse; you were supposed to feel an earth pulse (the spleen and stomach), and now you feel a water pulse — earth and water overcome each other. And the renying pulse is very large, so we know: there is something accumulated inside, accumulated in the stomach. This is Qi Bo’s explanation.

Why? — stomach qi can only descend; it cannot turn back

Why does this happen? Doctor Ni Haixia explains the principle thoroughly:

💬 Note from Doctor Ni: In a normal person the qi inside the stomach descends — not only does the stomach qi descend, the contents of the stomach can only go downward and never turn back. When it descends, the stomach qi is relaxed yet forceful; now you feel it very sinking and very fine — that means it is blocked.

Stomach qi descending, relaxed yet forceful — that is the normal state; feeling sinking and fine means something is stuck inside.

Lying down restlessly, tossing and turning — when an organ is injured, and the essence has a place to lodge, one is at ease

The Yellow Emperor asks again: some people lie down to sleep but their hearts are not at peace; they toss and turn all night and cannot sleep. Why?

💬 Note from Doctor Ni: Qi Bo answers: when an organ is injured, and the essence has a place to lodge, one is at ease — so a person cannot suspend his illness. The meaning is: once you fall ill, every day your mind keeps thinking about your illness — that is called “not being able to suspend the illness.” So I often tell patients: stop thinking about it! You have come to me; I will resolve it for you.

From this sentence Doctor Ni launches into a long digression — Chinese medicine is more humane than Western medicine:

💬 Note from Doctor Ni: Why? Because even when we know what disease you have, we still say: don’t think about it, I will treat you and make you well; go back to work and take care of your family. Western medicine is not like that: you see cancer — stomach cancer — you don’t need to go to work tomorrow, we will perform emergency surgery right now, remove the stomach, connect your esophagus to your intestine, and after that do half a year of chemotherapy. He says all this very casually, as if reading from a textbook; the patient’s face turns pale — he had stomach cancer, and now he is scared to death before anything has been done. The patient is thinking: what about my wife? What about my children? My children have not grown up yet, one is still in elementary school! So Western medicine has not even started, and the patient is already frightened to death.

💬 Note from Doctor Ni: And then he tells you how long you have to live — if you don’t see a Chinese doctor, I guarantee you will die right on schedule; that is what they are most accurate at, very accurate. When the patient dies, he does not blame Western medicine — he says “I died of stomach cancer” — but in fact he was scared to death and treated to death, right? So I say Chinese medicine is more humane than Western medicine.

Excess lung qi: cannot lie flat — a large pulse cannot lie down

The Yellow Emperor asks again: some people cannot lie down (they cannot lie flat, cannot lie still). What to do?

💬 Note from Doctor Ni: This is the lung. At the very top of the body, when the lung qi is excessive, it makes the pulse large so one cannot lie down — because when you lie on your back, the qi rushes upward, the person wakes up and cannot stay lying. This is excess lung qi.

Page 388: right pulse sinking and tight, left pulse floating and slow — what disease is this?

There is a patient with qi vacuity and fatigue — feel his pulse: the right hand is sinking and tight, the left hand is floating and slow. What disease is this?

Before answering, Doctor Ni Haixia teaches a master concept of pulse study — use common sense, do not memorize:

💬 Note from Doctor Ni: Everyone looks at the pulse and finds it extremely complicated. I am now gradually gathering it up for you, giving you a simple basic concept, and then it becomes your common sense — you do not need to memorize all those channel pulses and pulse treatises. Go read the Southern school books, or the Tai Su, or the Twenty-Eight Pulses of Pinghu — read for half a day and you will only be more confused. No need! Once you have finished the Huang Di Nei Jing, the Shen Nong Ben Cao Jing, acupuncture, and the Shang Han Lun and Jin Gui Yao Lue, then go back and read the other books — truly a waste of words, useless. I am doing everything I can to guide you onto the right road.

What does sinking mean? Think with common sense:

💬 Note from Doctor Ni: In winter, everything is stored away — that is sinking. Sinking belongs to winter, to what is below; the kidney is also sinking. That is your first basic concept. What about floating? We covered “wiry, surging, floating, sinking” earlier: wiry is the liver, surging is the heart, relaxed is the spleen, floating is the lung, sinking is the kidney. Floating is autumn, is the lung. What is tight? Tight means there is something solid inside — something has grown there, or kidney stones, or cold — all of these feel like a tight pulse. When you feel the pulse, it feels taut, like a rope pulled tight: when you catch cold in winter, the cold arrives, the skin surface contracts, and when you feel the pulse it is not only floating but also tight. So sinking down below and very tight is “sinking and tight.”

What does the right hand govern, and what does the left hand govern?

💬 Note from Doctor Ni: A person’s right hand governs heaven qi, governs the person’s qi; the left hand governs the person’s blood and vessels. Hold this concept: the place where our internal organs meet heaven qi is at the upper burner of heart and lung, exchanging with heaven qi; below, they exchange with earth qi and blood qi. So the right governs qi and the left governs blood.

Feeling an autumn pulse in winter — disease in the kidney, presenting as lower back pain

With these basic concepts in hand, return to that patient: in winter, the right hand feels sinking and tight — in winter it should naturally be sinking and tight, that is fact, that is the norm; the right hand has no problem. The left hand?

💬 Note from Doctor Ni: In winter, the left pulse should also be sinking; but now the left pulse is floating and slow — you are feeling an autumn pulse. Floating at the skin surface is the exterior, is yang; below it is yin. If the pulse floats on the surface and also appears vacuous, very weak and lacking strength, that speaks of yang vacuity. So the left pulse floating and slow means the left hand has a problem — the right hand is fine, the left hand is not.

In winter you should feel a winter pulse; now the left hand feels an autumn pulse — the disease is in the kidney.

💬 Note from Doctor Ni: Originally it should be a kidney pulse, but we feel a lung pulse (an autumn pulse), so we know the disease is in the kidney. What about lower back pain? Look at this arm: this is the wrist crease, this is the bone, and cun, guan, chi are divided like this. In a normal person this pulse has the cun part a little higher and the chi part a little lower, so what you feel is — the bone below, the pulse like this, that is the normal pulse. If this pulse rises up, stands up, surges upward — the lower-burner pulse crossing the middle burner and rushing past the guan position — that represents lower back pain, the kidney family’s repletion pattern. When there is repletion, the qi reverses, because the kidney is here; when there is something solid inside — whether kidney stones or a tumor — the pulse hardens and reverses backward, the pulse becomes very large — that is the stone pulse crossing the guan position.

Qi Bo’s words make the point: the shaoyin pulse threads the kidney and links the lung; now feeling a lung pulse, the kidney is diseased — hence the kidney is the disease of lower back pain — most lower back pain is related to the kidney.

The pathway of the kidney pulse: from the kidney to the lung, to the throat, to under the tongue

Doctor Ni Haixia closes the discussion of the kidney channel’s course:

💬 Note from Doctor Ni: The kidney pulse goes directly to the lung, passes through the lung, reaches our throat, and then to the underside of our tongue — Jinjin (EX-HN12) and Yuye (EX-HN13). Jinjin and Yuye are where fluids and blood are generated. So the kidney pulse reaches the throat, all the way to under the tongue; the kidney channel runs on both sides of the Governor Vessel. Now we feel a lung pulse — the kidney should feel a kidney pulse, but we feel a lung pulse instead, meaning the qi has reversed upward, and we know the kidney has a problem.

Page 389: a pus-filled lump on the neck — lance only when there is pus; do not touch it without pus

The Yellow Emperor asks: some people fall ill with a carbuncle and pus lump growing inside the neck — whether you lance it with a stone needle (bian shi) or treat it with acupuncture, they recover. Why? Qi Bo says: yes, exactly.

💬 Note from Doctor Ni: For this kind of suppuration beside the throat, use a relatively thick needle, a hot needle, and pierce directly into the carbuncle to break it open; a stone needle (bian shi) is a very fine stone — in ancient times, before metallurgy, they used a long thin stone to scrape it. If the head of the carbuncle breaks, pierce it and let the pus drain out. Remember this principle: when there is pus inside, then you may lance it; when there is no pus inside, do not lance it!

Why? The neck is the sea of qi — the place where qi gathers. When qi is excessive, blood gathers there:

💬 Note from Doctor Ni: When qi is too abundant, blood collects here. The blood gathers together; if it cannot disperse, the stagnant blood blocks the spot and suppurates. After it suppurates, you remove the pus, and at the same time the qi is released — and the disease gets better. But when it has not suppurated, do not touch it.

How do you know whether there is pus inside? Two methods:

💬 Note from Doctor Ni: One — look at the surface of the skin: red, with a white head (a pus head) on top, then you drain it. The other — feel it with your hand: if there is a lump here, and the skin all around it is cold while the lump itself is hot, then it has suppurated inside — when there is pus, you will certainly feel the heat; you can sense the steaming heat.

Page 391: suddenly going mad — yang without yin to control it

The Yellow Emperor asks: some people develop mania, madness and rage. Where does this disease come from?

💬 Note from Doctor Ni: Mania, rage, fury — all are born of yang. Why does yang make a person manic? A person with normal yang qi has good spirits, abundant vitality, concentrated spirit. Then why does it make people manic? Because of double yang — yang with no yin to control it becomes mania. This is only one reason, not the whole reason: “when the yang qi is suddenly broken and hard to resolve, the person is prone to rage” — sudden events, major setbacks, many things one cannot decide, all make a person furious. For example, you are sitting here fine, and suddenly the police call you and say your son is in prison for drug dealing — in a fury, you might go mad.

💬 Note from Doctor Ni: This we can change: Chinese medicine does not only heal the diseases of the body; it can change a person’s entire way of thinking — a rebellious son, I will turn him into a filial son for you to see; we have methods.

Yangming heat, manic running, climbing high and singing — Doctor Ni Haixia tells a story:

💬 Note from Doctor Ni: Look — yangming dryness-heat, manic running and shouting, climbing high and singing; the stool is blocked, and once it is cleared out, he is better. There was a patient who every day at dusk (five to seven in the evening, the you hour) would go mad, run wild, climb high and sing. The doctor cured him — before he was cured, every day at dusk he would run wild; after the channel qi passed and the next solar term eased things, he went out on a date. When a normal person behaves abnormally, it is abnormal; when an abnormal person behaves abnormally, it is also abnormal — however you look at it, it is not normal. A doctor can cure the mental illness of manic running and climbing high and singing, but we still do not have a “homosexuality decoction” — after the disease is cured, he goes on a date with another man, and you are still furious, right? Everything has a solution; I can dissolve it all for you.

The exhaustion of the three yang channels: yangming moves, taiyang and shaoyang do not

How do you distinguish the jue (exhaustion) of the three yang channels?

💬 Note from Doctor Ni: Very simple — you need to know the fatal signs of shaoyang, taiyang and yangming. If yangming qi reverses, it will certainly move (agitate and thrash about); with taiyang and shaoyang, the heart does not move — this is how we read a person’s movement and stillness. When yangming qi is depleted it moves; earlier we also mentioned that wind moves; if yangming qi jue is added on top, then it moves very violently.

Why does yangming move?

💬 Note from Doctor Ni: The yangming qi descends very vigorously; as it goes down, our feet become very strong, so the strength of the feet is greater than the strength of the hands. Now the yangming qi reverses, and the surging force comes up — of course it cannot withstand such a huge force rushing upward, so it moves, thrashes about — this gives rise to “movement diseases.”

Treatment one: deprive him of food — the qi of yangming comes from food; cut off the source

The emperor asks: then how do you treat him?

💬 Note from Doctor Ni: No treatment needed! Stop him from eating — just do not let him eat. The yangming qi is reversing; if you do not let him eat, then nothing inside receives qi, the source is cut off — because the qi of yangming comes from food. Once the source is gone, he gradually and obediently goes back to normal. So when a doctor’s diagnosis is strong, Western medicine cannot deceive you.

Doctor Ni Haixia then drops a bombshell:

💬 Note from Doctor Ni: That is why I say AIDS does not kill people — yangming qi reversing is a small problem; even without treating the poison, it will get better. But they need to make money, so they insist on treating it as a terrible disease. It is like a dry towel — they squeeze every possible drop of water out of it and force you to death.

The principle is in the original text of the classic: food enters the yin, and qi grows in the yang — food goes down and enters the blood aspect (yin); the rich, heavy flavors in food nourish yin, and the clear, light parts generate clear yang qi that rises. Cut off the food, and both yin and yang are blocked — and it resolves — because you know it is yangming, and yangming is the movement pattern.

Treatment two: Sheng Tie Luo Yin — the iron dust that flies off when a blacksmith strikes, the first calmer of the spirit

If he is still moving? Then give him sheng tie luo (iron filings) as a drink.

💬 Note from Doctor Ni: Sheng tie luo sends qi downward urgently — when yang qi rushes upward, you can take sheng tie luo. For treating mania and madness and calming the spirit, sheng tie luo is extremely strong — truly very strong. How do you obtain sheng tie luo? You have to find a blacksmith in the south — the master who forges hoes and sickles. When the red-hot iron is struck, the iron ash and filings that fly off and fall to the ground — that is sheng tie luo.

💬 Note from Doctor Ni: So it is best to collect it yourself. What the pharmacy sells is iron that has rusted away, oxidized into iron oxide and then crushed — that is not sheng tie luo; it is completely useless! It must be the residue knocked off by striking iron and falling to the ground — only that is sheng tie luo. That is why I do not dare to buy ji nei jin (chicken gizzard lining), and I do not dare to buy sheng tie luo — I have to find them myself.

Bonus: while traveling on outings, collect ji shi bai on the side

Doctor Ni Haixia closes with the finer points of gathering medicinal materials:

💬 Note from Doctor Ni: Some special medicines are best prepared yourself. So from now on, when you travel and go on outings, when you have nothing to do, collect a little chicken droppings — the white part, ji shi bai. If you see an old blacksmith, ask the boss for a little iron dust and bring it home — it will not spoil anyway. Only what I collect myself do I dare use; what comes from the pharmacy I cannot trust — I am afraid the patient will not receive medicine but a fake.

💬 Note from Doctor Ni: Now there is avian flu; if it is avian flu season, and I bring chicken droppings from mainland China — think about it, would customs let me in? They would throw it into the sea. I would not go collect it in China; here in America many people raise chickens, raising and butchering them for food themselves. The chickens run around the yard, very well behaved, and come back by themselves at night; they peck at scraps on the ground — those droppings we can pick up.

Closing: this lecture closed the pulse teachings and opened the Bing Neng Lun

In this lecture Doctor Ni Haixia finished gathering the common-sense concepts of pulse diagnosis (sinking and floating, tight, left-right qi and blood, the pulse responding to the four seasons, the chi pulse crossing the guan meaning lower back pain), and opened the door of the Bing Neng Lun — the lancing principle for neck carbuncles, madness born of yang, depriving the patient of food, and sheng tie luo. Next lecture, we continue deeper into the Bing Neng Lun.

Compiled from Doctor Ni Haixia’s Ren Ji (Human Records) lecture series on the Huang Di Nei Jing (Lecture 55), presented by Doctor Luo Dalun