Epilepsy From Birth? Whole-Body Swelling With No Appetite? A Hard Lump That Never Moves? — Doctor Ni Haixia on the Da Qi Lun (The Great Oddities, Part One) of the Huang Di Nei Jing

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Corresponding medical names: the Su Wen chapters Qi Bing Lun (Discourse on Strange Diseases), conclusion, and Da Qi Lun (The Great Oddities), Chapter Forty-Eight, part one · qi ru ge (qi like a partition) — the yang of the chest and the qi of the neck cut off from each other, yin and yang separating, mostly death · wu you yu er bu zu (five excesses and two deficiencies) — the body hot as charcoal, chest and diaphragm separated, the Renying pulse racing with panting, urine gone, the lung pulse thin — the picture before heart and lung failure, seen constantly in intensive care units · tai bing dian ji (fetal epilepsy) — the mother frightened during pregnancy, qi rushing upward, essence and yang qi lodging together; not hereditary; day seizures moxa Shen Mai (BL62), night seizures moxa Zhao Hai (KI6), treating the upper from below · shen feng (kidney wind) — whole-body swelling, pulse large and tight, no pain, no emaciation, unable to eat; the stomach is the kidney’s gate; if kidney wind is untreated, water conquers fire and the heart qi withers — death · man zheng (fullness syndromes) — fullness of liver, kidney and lung all being excess appearing as swelling; lung fullness is emphysema (the lung opens and will not close); liver fullness causes startle on lying down and blocks urination (wood conquers earth; drain water by strengthening the spleen); kidney fullness fills the lower body with cold water and easily causes one-sided hemiplegia; water at the diaphragm makes the head spin like a shaken balance fulcrum · the heart pulse full and large, or the liver pulse small and urgent — xian chi jin luan (seizures, cramping and sinew spasm); the liver governs the sinews · a liver pulse racing like a startled flock with a history of fright — liver and kidney channels both diseased; if the pulse suddenly turns small, the illness is passing and cures itself · the standard of health: eat, drink and eliminate well, warm hands and feet, cool head and face, warm soles and palms · fu gu mai (coffin-bone pulse) — kidney, liver and heart pulses small, urgent and not drumming are jia (hard masses); pressed against the bone, thin, small and racing, meaning a tumor inside; named by Zhang Zhongjing · liver and kidney sinking together are shi shui (stone water); floating together are feng shui (wind water); both deficient together is death; both small and taut predicts fright · shan qi (hernia) — the sickness radical over ‘mountain’, pain fixed and immovable, always from cold; kidney pulse large, urgent and deep, or liver pulse large, urgent and deep, both indicate hernia · the normal pulse: relaxed yet forceful like a vigorous scallion — relaxed represents stomach qi; spring taut, summer surging, autumn feathery, winter deep; the wrist bone below is Guan, before Guan is Cun (Taiyuan LU9), after Guan is Chi (Lieque LU7); one cun nine fen sets the length · eight-principle differentiation: yin and yang, interior and exterior, deficiency and excess, cold and heat; the pulse large, urgent and deep means blockage inside (kidney stones, kidney tumors); the three yang urgent indicate jia, the three yin urgent indicate hernia, the two yin urgent indicate epilepsy and reversal, the two yang urgent indicate fright; the heart pulse bounding, slippery and urgent is heart hernia; the lung pulse deep and bounding is lung hernia; the spleen pulse drumming outward governs intestinal afflux (cures itself after a long time)

Opening: the neck and the chest — as if they were about to separate

Doctor Ni Haixia opens this lecture by picking up the thread from the previous one, where the text spoke of “the neck and chest as if partitioned” (jing ying ru ge) — as if something stood between the neck and the chest.

💬 Note from Doctor Ni Haixia: Didn’t I just talk about the neck? That is the partition of qi. The chest is yang — the chest is yang, and the qi of the neck as if separated means the neck and the chest seem about to split apart, as if the neck had been chopped through, with a partition standing between them.

In a healthy body, the yang of the chest and the qi of the neck communicate freely — normal yang and cold qi mingle with each other, which is why we can turn our necks freely. But when yang qi and cold qi suddenly separate, that is danger.

💬 Note from Doctor Ni Haixia: Yang and sweating qi (yin qi) are not the same thing, but they are very close, supporting each other. Yet the road of qi splits apart, and then the whole qi rushes upward — yang qi by nature wants to descend; that is the normal state. When the whole qi goes upward, it means yin and yang are about to separate. So when we see the symptoms of separation, yin and yang divided, most of them are death sentences. Every time I see this pulse, my hand goes weak — yin and yang separated.

The Yellow Emperor asks again: some people have a racing and surging taiyin pulse — the taiyin pulse is the seat of stomach qi (the Guan pulse of the right hand) — the stomach qi is very strong and dry-hot, the panting leaves the strength to spare; yet the pulse is thin as described, showing insufficiency. What disease is this?

💬 Note from Doctor Ni Haixia: Qi Bo says this disease is in the taiyin, and its pulse lies in the kidney — the disease is named “jue si bu zhi” (certain death, no treatment). This is an excess pattern. Remember, when you judge excess versus deficiency — we will come to “excess and insufficiency” in a moment — keep it in your mind.

What is “five excesses and two deficiencies”? — and why it is a death sentence

The Yellow Emperor asks: is this “certain death” pattern what we mean by “five excesses and two deficiencies”? And what exactly are the five excesses and two deficiencies?

💬 Note from Doctor Ni Haixia: Qi Bo says: the so-called “five excesses” means the qi of five diseases is in excess — the evil qi of five diseases overflows; the “two deficiencies” means the disease qi is deficient. Outwardly there are the five excesses, inwardly the two deficiencies, and the body is neither superficially nor interiorly — that is the clear mark of death. Let me translate it for you, following the book: the whole body hot as charcoal, the chest and diaphragm separated, the Renying pulse racing and panting — these are all phenomena of yang qi reversing upward; and then urine is gone, and the lung pulse is thin as described — because the lung pulse is the place of the chest-yang pulse, this is yang about to expire, yin and yang both separating. When we see these two conditions — evil qi and upright qi both insufficient — these are death sentences.

Doctor Ni adds a comparison from Western medicine:

💬 Note from Doctor Ni Haixia: From the Western medical point of view, this is the scene you see right before the heart and lungs fail, before death. If you work in an intensive care unit, you will see a lot of it — you will see a great deal of it.

Epilepsy from birth — a fetal disease, not heredity

The Yellow Emperor then asks a question that makes the heart sink: some people are born with dian ji (epilepsy). What disease is this? Why does it strike from the moment of birth?

💬 Note from Doctor Ni Haixia: Qi Bo says this indeed exists — this is “tai bing” (fetal disease). It is not heredity; it has nothing to do with genetics. Western medicine cannot figure it out, so when they cannot find the cause, they say it is hereditary or allergic — allergy is a nervous complaint! We often say to our wives and girlfriends, “don’t be so allergic” — yes, that is a nervous complaint. And heredity — when they cannot find anything they call it hereditary, that is how they talk.

What is the real cause? Qi Bo states it clearly —

💬 Note from Doctor Ni Haixia: It is because when the fetus was inside the mother’s belly, the mother was frightened. Once she was frightened, the qi rushed upward and would not come down; the yang qi was startled, and the essence qi and yang qi lodged together. When the child was born, it would develop epilepsy.

How to treat epilepsy? — day seizures moxa Shen Mai, night seizures moxa Zhao Hai

Fortunately, acupuncture long ago supplied the treatment. Doctor Ni introduced it in his acupuncture classes:

💬 Note from Doctor Ni Haixia: That is why we use moxa. Day seizures, moxa Shen Mai (BL62); night seizures, moxa Zhao Hai (KI6) — seizures that occur in the daytime, moxa Shen Mai; seizures at night, moxa Zhao Hai. This is what we call “treating the upper disease from below” — the upper disease treated at the lower point.

Swollen all over, a large tight pulse, and no appetite — kidney wind

Next comes a more common patient: the whole body is swollen, with a great deal of water accumulated inside; feel his pulse and it is large and tight (the normal pulse should be relaxed yet forceful); the body is not painful, not emaciated, nothing has changed — it feels like water inside; the only trouble is he cannot eat — the appetite is gone.

💬 Note from Doctor Ni Haixia: Qi Bo says this disease is called “shen feng” (kidney wind). When the kidney has wind, the body feels the water moving poorly. When the kidney itself truly fails — when there is kidney fluid buildup — it is no longer kidney wind. Then the pulse would show kidney yang insufficiency, so the water accumulates. Kidney wind with inability to eat — you see, Qi Bo always connects it to the stomach: the stomach is the kidney’s gate. When the kidney has wind, the gate will not open, the patient cannot eat, and the function of distributing essence is easily affected.

If kidney wind goes untreated, the heart withers — water conquers fire

What happens if kidney wind is left to drag on? Doctor Ni explains the whole chain clearly:

💬 Note from Doctor Ni Haixia: If the patient keeps being frightened and no one treats him, in the end the heart will wither. Because the heart is fire and the kidney is water — fire and water; one is water, one is fire, and in the normal state they conquer each other: water conquers fire. If the kidney disease never heals, the water grows deeper and deeper, cannot be metabolized out, and the water qi injures the fire, so the heart qi withers. The normal kidney pulse should be deep and rather thin; now it is large and tight — the reverse of what it should be.

What exactly does the kidney govern? — by the time the patient finishes talking, the prescription is already written

Doctor Ni says that the Huang Di Nei Jing chapters seem scattered, one by one; but when you gather them together, the full function of the kidney emerges:

💬 Note from Doctor Ni Haixia: The kidney governs the bones, controls the hair, the hearing of the ears, and urination and defecation; the kidney is the gate of the stomach, and the kidney channel governs standing on the bones. So accumulate everything you know — someone comes and tells you: my memory is not so good (the kidney governs memory), and I cannot eat, and when I stand too long I get tired and have to sit down, and my lower back hurts (the kidney governs the waist) — he is telling you right there! Before he even finishes, you have already seen it, haven’t you?

💬 Note from Doctor Ni Haixia: In Taiwan and in America alike, Western medicine has patients who do not understand — as the patient talks, the patient has already told you what is wrong. We see it very clearly, and by the time he finishes, the prescription is already written. He says, “Doctor, you don’t ask me anything!” — you just told me everything; I know it all; you told me and I have already seen the prescription — no need to even feel the pulse. Of course no need, you told me everything. So if you make the four examinations too simple, the patient does not believe you, and even thinks you are a bad, inferior doctor.

So Doctor Ni performs a little scene of “the art of the consultation” —

💬 Note from Doctor Ni Haixia: So sometimes you still have to put on a (thoughtful) show. Listen carefully; when he has finished, he asks, “Doctor, what is wrong with me?” — it is exactly what you just told me; you told me everything. When you see ten patients a day as a doctor, every one is different: some are indecisive, so you chat with them about this and that; some talk a long time and are very eloquent. I often ask an eighty-year-old lady: how are your bowels? “When I got married sixty years ago, my bowels were fine” — just tell me about yesterday! She cannot; she tells a long story. When the old lady finishes, I say all right, then I will do acupuncture for this — “No, I’m afraid of needles” — then herbal decoction — “the decoction is too bitter, I won’t drink it” — then pills — “I can’t swallow pills” — then powder — “the powder tastes bad too” — then what do you want me to do? “I don’t know.” So I chat with her for an hour, lose my patience, and charge you! Patients are indecisive; you meet all kinds of people. Later, when you come and follow me in the clinic, it is very funny.

The Da Qi Lun opens: fullness of the liver, kidney and lung — all fullness patterns appear as swelling

Turning to page four hundred and six, Doctor Ni enters Chapter Forty-Eight of the Huang Di Nei Jing — the Da Qi Lun (The Great Oddities). He says this chapter is a good one, a little harder to explain. It opens by defining “excess”:

💬 Note from Doctor Ni Haixia: Fullness of the liver, fullness of the kidney, and fullness of the lung are all excess — whenever a fullness pattern appears in the liver, kidney or lung, swelling appears. Lung fullness: panting with both flanks (both hypochondria) distended — this describes what modern medicine calls “emphysema”: the lung opens but cannot contract. The lung is supposed to open, contract, open, contract; here it opens and only opens, never closes — that is lung fullness. Both flanks swell; the chest and flanks are extremely distended.

Liver fullness and kidney fullness — why one keeps you awake, the other paralyzes half the body

💬 Note from Doctor Ni Haixia: In liver fullness, both flanks are distended, the heart pulse is full and large, and lying down brings fright — people with liver problems are often easily startled; and urination is blocked, affecting the passage of urine. Why? Because wood conquers earth — wood conquers earth, and earth is the spleen, and the spleen governs the water of the whole body. So when we drain water, we often include herbs to strengthen the spleen, to push the water out. When the liver is severely swollen, filled and truly enlarged, the patient cannot sleep properly and cannot pass urine. These three organs are by nature yin viscera — the gallbladder, small intestine, stomach and bladder are yang — when yin viscera show excess patterns, we call it “yin excess” (yin shi).

What about kidney fullness? This is the most direct kind of edema:

💬 Note from Doctor Ni Haixia: In kidney fullness, from the feet up to the lower abdomen, the whole lower body is filled with water; urination and defecation are disturbed, and one side becomes hemiplegic. Why does water cause hemiplegia? Water in its normal state in the body is vaporized — it is steam. So when you exhale, warm air comes from your mouth; the body should not accumulate water. The water below is water — cold water. Cold water pools below, accumulating from the feet up to the abdomen, and the whole lower half swells. Cold water sloshes, and when water sloshes, it causes one side to become paralyzed, one side without strength.

When water rises to the diaphragm, the person spins — the image of a swaying balance

Doctor Ni then gives a particularly vivid image — why water rising to the “diaphragm” (ge) makes the head spin:

💬 Note from Doctor Ni Haixia: Say this is the middle — from the navel this is the boundary. Some people have water rising to the diaphragm — the diaphragm is the place where yin and yang meet, and normally water is steam. But if water is sitting here, you should think: here is a person who is dizzy, dizzy as can be. Go to a courthouse and look — whether the courts of the world are fair is another matter, but the emblem must look good: the balance, standing for fairness. Put that balance on a person, all the way up to the middle diaphragm — our diaphragm happens to be at the dividing place; the diaphragm is the central fulcrum of the balance. When this water sloshes, this (balance) sloshes, and vertigo is produced. Western medicine does not know — inner-ear imbalance; middle-ear inflammation, inner-ear inflammation, antibiotics taken for half a day and the water still sloshes! From the first day, they give you five days of antibiotics — five days and it cannot be sustained — then the hands and feet turn cold; and if you happen to forget to take it before meals, the stomach is hurt too. So antibiotics are food for the enemy!

💬 Note from Doctor Ni Haixia: When you see a patient, once you know the cause, one sentence is enough. If this water rises from the lower burner, the person becomes hemiplegic; if the water is here (the middle diaphragm), the head spins. Later I will tell you where the water is and what the person is like — you see it very clearly; the moment you see the symptom, the herbs and the prescription come out. I want to train you to be like that — to respond instantly.

Heart pulse full and large, liver pulse small and urgent — seizures, cramping and sinew spasm

The text then speaks of pulses and diseases: “the heart pulse full and large — xian chi jin luan (seizures, cramping and sinew spasm); the liver pulse small and urgent — also xian chi jin luan.” Doctor Ni first teaches the characters:

💬 Note from Doctor Ni Haixia: This character is read xian — above it is the same part as in the word for epilepsy (dian) — the bone radical side is read xian — also meaning epilepsy; the second character is chi — according to the Cihai dictionary, it means the channels and collaterals drawing taut in response, stretched very tight — that is chi; jin luan — spasm, cramping — everyone knows that. The heart pulse full and large can produce this symptom; below, the liver pulse small and urgent also produces xian chi jin luan — these two are easily misunderstood; this is the old text. I will not touch the original; I will slightly revise it here and correct it: the heart pulse full and large speaks of the Cun position — does not the heart govern the Cun pulse? On the left hand, Cun, Guan, Chi — the Cun position is the place of the heart pulse. The heart pulse extremely surging is what we call full and large.

What are the symptoms of a full and large heart pulse? Doctor Ni lists them one by one:

💬 Note from Doctor Ni Haixia: The symptoms of a full and large heart pulse: palpitations — the heart feels panicky, as if hanging to one side; bu mei — unable to sleep at night, insomnia; short qi — the breathing becomes short; and cold hands and feet. Normally the heart pulse beats fast — everyone should know that the liver generates the heart, wood generates fire; when the liver has a problem, it affects the heart. So when you see liver disease, that heart pulse races, producing excessive palpitations — this kind of palpitation is caused by the liver; it is the liver pulse small and urgent that produces xian chi jin luan — that makes sense, because the liver pulse itself governs the sinews. That is how the original text goes; I cannot change it, but I will change it here for myself — go back and check it.

A liver pulse racing like a startled flock, with a history of fright — why one person startles so easily

What is “wu bao” (racing like a startled flock)? Doctor Ni breaks down the character again:

💬 Note from Doctor Ni Haixia: The character wu means running wildly — in the old days when a horse got loose and the whole herd charged forward, running wild, we call it wu. The liver pulse wu bao means the pulse races wildly, and the patient has a history of being frightened. What causes liver and kidney disease? It is the liver plus the kidney — the liver channel and the kidney channel both fall ill at the same time; when these two diseases combine, you see the phenomenon of fright. So when a person startles easily, startles at everything, many things are wrong inside that one viscus — a single viscus alone would not do it; only when two viscera are combined does it appear.

And does this frightening pulse need treatment?

💬 Note from Doctor Ni Haixia: With the heart pulse full and large, the liver pulse racing like a startled flock, and a history of fright — this kind of patient, if the pulse is not treated, will get better on his own — you feel his pulse and the problem looks very serious; but the original pulse, which was urgent and large, suddenly turns very small, meaning the illness period is passing. Then if you do not treat it, it will heal itself — there is no need to treat it at all.

What is health? — eat, drink and eliminate well, warm hands and feet

Doctor Ni says that if you look only at the pulse, it is hard to differentiate syndromes — so when examining a patient you need a baseline:

💬 Note from Doctor Ni Haixia: This disease needs no treatment — it is simple. We have certain symptoms of health: you must be able to eat, drink and eliminate; hands and feet warm — that is all. If he has problems with urination and defecation, or cannot sleep, then there is other differentiation. So when you see a patient who sleeps well, eats normally, passes stool well, has good spirits, warm hands and feet, and a cool head and face — normal people have a cool head and face; only the soles and palms are warm — this person has no major problem. Even if you meet a pulse like this (strange) today, it is not a major problem.

A thin racing pulse right at the bone — the coffin-bone pulse, a hard lump in the belly

Next comes a very practical passage of the Da Qi Lun — “kidney pulse small and urgent, liver pulse small and urgent, heart pulse small and urgent, none drumming — all are jia”:

💬 Note from Doctor Ni Haixia: The kidney pulse small and urgent — the kidney pulse is normally deep and thin; now it becomes very small and very urgent. Everyone, this is how we feel for lumps. Later Zhang Zhongjing defined this passage as the “coffin-bone pulse” (fu gu mai): small and urgent — you feel at the position of the liver pulse or the position of the kidney pulse, small and urgent; the heart pulse small and urgent and not drumming up — this is called jia — this jia means a hard lump growing in the belly. Why is it called “coffin-bone”? Because when you press right next to the bone, your fingertip lies against the bone, and you feel it thin and small, racing fast — that means a tumor is growing inside. You can feel it — when you feel a tumor on that side, you know at once: this is the coffin-bone pulse.

Liver and kidney disease together: stone water, wind water, death — how to tell them apart

💬 Note from Doctor Ni Haixia: If the liver and kidney sink together — the liver and kidney combined sinking — it becomes “stone water” (shi shui, dead water); this is hard to treat. If the liver qi is cold and the kidney qi floats, both floating at the surface, it is “wind water” (feng shui). Stone water is hard to treat; wind water is very easy — later we will introduce the “water chapter” and how to treat wind water. This wind water has nothing to do with the feng shui of houses and astronomy and geography — this is water obtained through wind. If they are both deficient together — the liver and kidney both deficient at the same time — that is a death pattern; if both are small and taut, then fright is predicted — that one is still nothing serious.

Hernia: the sickness radical over a “mountain”

Turning to page four hundred and seven, the whole passage concerns a very important disease — hernia (shan qi). Doctor Ni first breaks down the character:

💬 Note from Doctor Ni Haixia: Look at this character — it is not only our (disease): the character shan — inside a sickness radical there is a mountain. The patient comes and tells you: my belly hurts, hurting over here, this lump; does it move around? Sometimes it runs here and there — no, it is steady as a mountain, sitting there very fixed. This kind of shan is ceaseless pain, a deep pain fixed in one part, immovable — we define it as shan — hernia. Generally hernia comes from cold; only cold produces this shan.

Before reading pulses, first remember what a “normal pulse” is

Before entering this chapter, Doctor Ni repeatedly emphasizes one idea — only when you know the normal pulse can you read the Nei Jing:

💬 Note from Doctor Ni Haixia: When we speak of pulses, keep an idea in your mind: what is a normal pulse? The movement of the normal pulse, the spirit of the pulse, must carry a hint of relaxation in the middle — relaxed, and it must itself be forceful — relaxed yet forceful. This force is not speed; rather you feel its vitality is strong — like touching a scallion: the difference between a vigorous scallion and a withered one; the vigorous one is the forceful one — relaxed, but forceful. What does this “relaxed” represent? Stomach qi. All five viscera and six bowels receive qi from the stomach — that is the normal pulse.

He also teaches the seasons and positions together:

💬 Note from Doctor Ni Haixia: Spring taut, summer surging, autumn feathery, winter deep — in winter, we should feel the pulse rather deep. The positions of Cun, Guan and Chi: at the wrist joint, below the wrist bone is Guan (the bowed position); before Guan is Cun — that is the position of Taiyuan (LU9); after Guan is Chi — the position of Lieque (LU7). Measured from Guan, this is nine fen and this is one cun; anything longer than one cun and nine fen is a long pulse, anything shorter is a short pulse. The Cun pulse sits a little higher, closer to the skin; the Chi pulse lies deeper.

The eight-principle differentiation: yin and yang, interior and exterior, deficiency and excess, cold and heat

What does a pulse large, urgent and deep represent? Here Doctor Ni lays out the skeleton of Chinese-medicine differentiation:

💬 Note from Doctor Ni Haixia: The kidney pulse is by nature deep; it should be relaxed yet forceful, thinner in winter; now it becomes large and urgent while still deep. In Chinese medicine, whenever you feel a deep pulse, think: deep means interior, floating means exterior. Our differentiation is called the “eight-principle differentiation”: first, disease must be divided into yin and yang; second, know interior and exterior; third, know deficiency and excess; fourth, know cold and heat. Chinese medicine relies on these eight characters, plus the matching of yin-yang and the five elements, and the prescription comes out by addition and subtraction. So the formula looks simple; in reality it is very complex. And when you have become very complex, after a period of time you return to simple again — that is how Chinese medicine is.

💬 Note from Doctor Ni Haixia: So if the pulse is large, urgent and deep, it means something is blocked inside. We often feel kidney stones, or a kidney tumor — where there is a knot, we feel this kind of pulse. This chapter deals specifically with hernia: the character shan is the sickness radical over a mountain — stagnant and immovable, hard and stuck in that place; generally it is cold; only cold produces a hernia.

The pulses of hernia: kidney pulse large, urgent and deep; liver pulse large, urgent and deep

💬 Note from Doctor Ni Haixia: So if you feel the kidney pulse large, urgent and deep, or the liver pulse large, urgent and deep, both are hernia. The heart pulse and lung pulse are at the Cun position above — Cun is yang, Chi is yin; the heart and lung are naturally rather floating, the liver and kidney rather deep behind them. The three yang urgent indicate jia — a hard lump growing in the belly; the three yin urgent indicate hernia; the two yin urgent speak of the jueyin, indicating xian jue (epilepsy and reversal); the two yang are the yangming, and yangming urgent is a phenomenon of fright. The spleen pulse drumming outward — this character gu is read pì, meaning floating in dust — floating and drumming outward.

At this point the lecture draws to a close — the next lecture will finish explaining these strange pulses and disease names of the Da Qi Lun.

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