Kidney Deficiency — Yang Deficiency or Yin Deficiency? Cold Hands or Hot Feet? Can You Still See or Not? — Doctor Ni Haixia on the Mai Jie Pian (Resolving the Pulse, Part Two) of the Huang Di Nei Jing

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Corresponding topics (medical terms): the Su Wen chapter Mai Jie Pian (Resolving the Pulse, Chapter Forty-Nine), continued — the master mechanism of the six-channel patterns. Dian ji (mania/seizure disorder) = lower empty and upper excess, yang exhausted above with yin below; stiff neck and arched back belong to Taiyang (the Governing Vessel and Bladder channel gather the yang of the body), tinnitus mostly to Shaoyang; treating mania: the disease is in the head, so treat below — Kong Xian Dan (Pill to Control Phlegm) clears the phlegm (phlegm blocking the yang path is like a crowd piling into a wall). ‘Entering the center causes loss of voice’ (yin): yang should travel outside; trapped in the middle, the voice dies. ‘Interior depletion with reversal becomes yin pai’ (pai = waste): kidney deficiency, the Shaoyin channel unable to arrive, the voice abandoned. The yang/yin deficiency reference table: yang deficiency — headache reaching the teeth, upper excess with lower emptiness, common after heavy vomiting, vomiting blood or bloody stool, ice-cold hands and feet, inability to see (the kidney governs the pupil), frequent urination (the kidney governs the two excretions), two or three stools in the afternoon — treat with Gui Fu Ba Wei Wan (Cinnamon and Aconite Eight-Ingredient Pill); yin deficiency — visions of five colors (gold, black, yellow), tinnitus slowly turning deaf, warm hands and feet. Shaoyang heart-flank pain (chest-rib fullness): the source of the Shang Han Lun six-channel diagnosis; the six channels take turns ruling by the solar terms (twelve channels matching twelve months, one ‘king’ per solar term); in the ninth month yang is exhausted and yin flourishes, hence heart-flank pain; ‘cannot turn over’ = yin stores things, and stored things do not move, the disease entering from outside in (Taiyang → channel → collateral → fu → zang); ‘leaping’ (yue) = vomiting and nausea, so Shaoyang chest-rib fullness always carries nausea. Yangming ‘shivering as if sprinkled with cold water’ = a pure heat pattern (the fifth month, flourishing yang holding yin); pure heat feels the outer cold, not cold inside; Yangming receiving heat: heat rises, yin fails to return and accumulates below, causing swollen shins; thigh swelling rising to panting becomes water — yin descends then rises again, the pathogen lodging between organs. The master plan of water disease: water comes from the kidney and is carried by the lung (kidney the root, middle diaphragm the soil, lung the leaf); cold water causes disease, warm water does not; the water in the san jiao is hot; patterns differ by where the water stops (ribs / below the lung / diaphragm / inside the intestines / outside the intestines / skin surface) with different formulas; the lung governs the skin and body hair, and skin is moist only when water returns to its place. Chest pain with short breath = water is yin qi, yin in the center; the exact center (the great artery between heart and small intestine) is the seat of yang; the heart moves heat to the small intestine, the small intestine to the bladder; the lung metal wraps the heart fire to sink the heat; heart yang reversing upward causes pain, lung fluid insufficiency causes shortness of breath. Severe reversal = yin and yang clashing, water and fire clashing, hence sudden startling (aversion to people and fire, startling at the sound of wood); ‘wanting to shut the door and hide alone’ = yang exhausted and yin flourishing, liking darkness and solitude — prescribe yang-strengthening medicine; ‘wanting to climb high and sing, tearing off clothes and running’ = yang hyperactivity with confused spirit. ‘The pathogen lodging in the tertiary collaterals causes headache, nasal congestion and belly swelling’ = Yangming uniting above, its tertiary collaterals in Taiyin; nosebleeds under fourteen are normal (a child with fever and a nosebleed avoids high fever, because heat finds an outlet — do not stuff cotton in), nosebleeds after fourteen are pathological; children’s yang is vigorous, and the harm of vaccines and antibiotics to city children (free-range chickens vs. caged chickens). Taiyin disease with bloating = abdominal distension; Taiyin is the meeting of the three yin; in the eleventh lunar month (zi month) all things store their qi in the center; the spleen’s yin should hide in the belly, and disease makes it fail to hide, so the belly swells. ‘Rising to the heart makes belching’ = yin flourishing rises into Yangming, whose collateral connects to the heart; the heart and stomach are connected: a real case of a patient with a huge appetite, whole-body heat, drinking ice water, and sleeping without blankets — Yangming heat, so they opened gypsum and White Tiger Decoction, and the more they gave, the hotter and hungrier he got — because the interior was actually cold (true cold with false heat); processed aconite and dried ginger went in, the appetite shrank on the spot and the hands and feet warmed; when the heart is sick the appetite opens by instinct (the self-rescue reflex — cats and dogs eat grass when ill), and when the formula matches, the appetite falls fast.

Opening: mania — all the yang is up above, all the yin has run below

Last lecture finished the Taiyang channel patterns. This one, Doctor Ni Haixia digs straight into the next topic — the manic disorder (dian ji):

💬 Note from Doctor Ni Haixia: Lower empty, upper excess — this is called mania (dian kuang). Generally speaking, in both dian and kuang, the yang qi is above and the yin qi below. In a normal person, yang qi should descend and yin qi should rise — yin and yang exchange. That is why our head and face are cool — feel it carefully: the temperature of your head and face is the same as the rest of your body, and in every season, no matter how cold, your face is always exposed, because the yang is here.

So why does a person go mad the moment the yang qi is disordered?

💬 Note from Doctor Ni Haixia: Yang must contain yin inside it, and only then does a person feel comfortable. If everything above is yang with no yin at all, and the yin below cannot rise — with nothing to check it — the face flushes bright red, the yang rises, and above there is no yin. Once the yang is disordered, the spirit follows and gets disordered too, and mania erupts.

Stiff neck and arched back, tinnitus — the disease is in Taiyang, in Shaoyang

Doctor Ni first teaches how to read the “facing the wall” posture of a manic patient (stiff neck and arched back, opisthotonos):

💬 Note from Doctor Ni Haixia: If the disease is in the neck and back, bending backward, that is simple — it is the Governing Vessel and the Bladder channel. The Governing Vessel, as we learned in acupuncture, is the meeting of all the yang; the Bladder channel is the meeting of the three yang, so all the yang of the back lives in the back. If only the neck is stiff, the disease must be in Taiyang. If the whole body arches backward like a drawn bow, it could be epilepsy or meningitis — that is a Governing Vessel problem.

And tinnitus? Rising yang can also cause tinnitus, but Doctor Ni gives a general rule:

💬 Note from Doctor Ni Haixia: Generally when we speak of tinnitus, most of it is Shaoyang tinnitus.

The secret of treating mania: the disease is in the head, treat below — clear the phlegm first

For the treatment of mania, Doctor Ni teaches a very important principle — the disease is in the head, so we treat below:

💬 Note from Doctor Ni Haixia: Our method of treating mania: the disease is in the head, we treat below. On the one hand, why do we often use phlegm-clearing herbs? Like Kong Xian Dan — many medicines clear the phlegm, and we draw the phlegm out. Why do manic patients all have phlegm? It is because of the yang being above — the phlegm blocks the way, the yang is sucked up and cannot come back down. Yang comes up from the back, up the Governing Vessel and Taiyang, and it should go down the front; but the front is blocked by phlegm, the yang behind keeps coming up, and the front is blocked again. It is like a line of thirty or fifty people — the ones in front hit the wall, and the ones behind keep banging, bang bang bang, into them — it cannot stop, because the ones behind keep coming. So once we remove the phlegm and remove the blockage, the yang can flow freely, and the mania stops.

Entering the center causes loss of voice: yang outside is normal; trapped in the middle, you go mute

Next: “entering the center causes loss of voice” (ru zhong wei yin):

💬 Note from Doctor Ni Haixia: The so-called ‘entering the center causes loss of voice’ — yang flourishing has already declined. Yang qi comes up, and the head and face are mostly qi. If the yang qi enters the center and does not travel outside, the voice is gone. Our kidneys are below; kidney qi travels upward, falls into the heart, falls into the lungs, and finally reaches the tongue to make sound — that is the ‘center.’ If the yang qi is in the middle and cannot get out, blocked in the center, it causes yin (loss of voice). Yang deficiency should be outside — yang outside is normal; stopped in the middle, that is a state of yang deficiency.

There is also “interior depletion with reversal, becoming yin pai”:

💬 Note from Doctor Ni Haixia: The character pai is pronounced ‘pai’ — it means discarded, waste, cast off. This is kidney deficiency — when the Shaoyin channel cannot arrive, that is reversal. If a person’s qi is insufficient, the kidney qi cannot rise, and the voice is gone. This passage speaks of voice loss from kidney deficiency — the Shaoyin channel qi cannot arrive, so the voice is abandoned.

The two great schools of kidney deficiency: yang deficiency or yin deficiency? — first ask about cold or hot hands and feet

Next comes the centerpiece of this lecture: how to tell yang deficiency from yin deficiency in kidney weakness? Doctor Ni says, we will gradually introduce yin deficiency and yang deficiency, but first here is a simple way to separate them:

💬 Note from Doctor Ni Haixia: If it is yang deficiency of the kidney, there will also be headache — but this headache goes all the way to the teeth, it is very strong, and the headache enters the bone. Why? We speak of the cause of yang deficiency: yang is above, yin is below — this is called upper excess with lower emptiness. Yang is not where it should be; yang has run up, yin is below, so below is yang-deficient. When does yang deficiency occur? Most of the time after heavy vomiting, vomiting blood, or blood in the stool — patients with bleeding bowel movements will all have yang deficiency. The most standard symptom of yang deficiency is ice-cold hands and feet.

Yang deficiency also makes you unable to see, and loses control of urination:

💬 Note from Doctor Ni Haixia: The eyes — excuse me, the kidney governs the pupil, right? So the eyes can see. Now when yang is deficient, you cannot see — completely cannot see. In yang deficiency, yang is above and yin below; with no yang to control it, yin runs out — the kidney governs the two excretions, so urination becomes frequent, urinary frequency you cannot control — these are all yang deficiency phenomena. That is why in yang deficiency we use Zhang Zhongjing’s Gui Fu Ba Wei Wan.

A student asks: Teacher, how do you know whether it is yang deficiency or yin deficiency? Doctor Ni gives the distinguishing points:

💬 Note from Doctor Ni Haixia: There are several symptoms. First: in yang deficiency, your eyes cannot see — you cannot see anything at all; in yin deficiency, you see five colors — today gold, tomorrow black, yellow — your eyes go all blurry, that is yin deficiency. We will go into detail on this later. Also, doesn’t the kidney govern the ear and open into the ear? So a yin-deficient person starts with tinnitus — there is a sound in the ear, but they can still hear people talking; later they go deaf and cannot hear anything at all. Also, in yin deficiency the hands and feet are still warm; in yang deficiency the palms are ice-cold.

A one-line formula: the kidney governs the two excretions — count the bowel movements

In a busy clinic, what if you cannot remember all that? Doctor Ni teaches a quick judgment method — look at urination and stool:

💬 Note from Doctor Ni Haixia: Clinically, because the kidney governs the large and small excretions, sometimes you really cannot remember, right? Very simple: in yang deficiency — one stool in the morning, fine; but unexpectedly, in the afternoon, for no reason, one or two, two or three come out. Yang deficiency — the bowel cannot be controlled; the kidney manages the two excretions. In yin deficiency, once a day, and that is the whole story. That is how simple the differentiation is! Because you often get them confused — if you get it perfectly clear at the start, everything follows naturally and normally. Chinese medicine is a rather structural thing; you gradually realize it through experience.

Shaoyang heart-flank pain: Zhang Zhongjing’s entire six-channel diagnosis comes from the Nei Jing

Turning to page 1413, the Shaoyang section. Doctor Ni points out specially: the Shang Han Lun is entirely based on this:

💬 Note from Doctor Ni Haixia: When you read this, actually Zhang Zhongjing’s entire Shang Han Lun is based on all of this. So when we later teach the Shang Han Lun, the six-channel diagnosis — Taiyang, Shaoyang, Yangming — you see the teacher has it all right here; this is what Zhang Zhongjing was reading. ‘Heart-flank pain’ means the Shaoyang is flourishing — what we call chest-rib fullness (xiong xie ku man), fullness on one side of the chest and ribs. So a person comes in and says, strange, my chest feels distended on this side — Shaoyang, case closed, very fast. And the alternating chills and fever, Zhang Zhongjing simplified that later.

Why do the six channels take turns ruling by the solar terms? Doctor Ni teaches a concept of “twelve months on rotation”:

💬 Note from Doctor Ni Haixia: When Shaoyang flourishes, in ordinary people — although the six channels are Taiyang, Shaoyang, Yangming, Taiyin, Shaoyin and Jueyin, they are equal; no channel should conquer or decline relative to another. These channels move according to the solar terms: who prevails in spring, who in summer — following the solar terms, everyone takes a turn — like the management of our apartment building, every twelve months, one month each person takes a turn. Our body’s twelve channels likewise, starting from Taiyang, complete one circuit in twelve months, then cycle again. So every solar term has a ‘king,’ and that king prevailing is correct — this basic concept you must have — this is the Huang Di Nei Jing.

Then he explains “in the ninth month yang is exhausted and yin flourishes, hence heart-flank pain”:

💬 Note from Doctor Ni Haixia: If the heart spirit flourishes in summer, that is normal. But in the ninth month yang is exhausted and yin flourishes — the ninth month is autumn; autumn should belong to the lung. Now the heart qi is flourishing and the pulse is very strong, and this causes heart-flank pain, oppression in the chest and ribs. The so-called ‘cannot turn over’ — yin qi stores things, and stored things do not move, so you cannot turn over. That is what Qibo means: when the disease first strikes, it is in Taiyang — at the beginning it is the Taiyang receiving the disease, like a stiff neck and back. If Taiyang does not heal, the disease runs deeper into the body. So when the body receives disease, it is always the surface that receives it first; if the surface illness is not cured, it runs into the channels; from the channels to the collaterals; if the collaterals have no defensive qi (no one defending), it runs into the fu organs — the gallbladder, small intestine, stomach, large intestine, bladder — and the person’s digestive system becomes very poor; with stomach qi very weak, the disease enters the zang organs — the liver, spleen, lung, kidney. The Chinese medical concept is: disease comes in from outside. If it enters Taiyang and is not cured, it enters Shaoyang — and Shaoyang is the chest-rib fullness.

When the disease is in Shaoyang, why can’t you turn over?

The four characters “cannot turn over” (bu ke fan ce) — Doctor Ni explains them vividly:

💬 Note from Doctor Ni Haixia: When the disease is in Shaoyang, we know it is in the middle of the two sides — the ribs, the chest-flank area. In this location, if you meet Shaoyang in summer, no problem; now you meet autumn — in autumn, by rights, metal qi is in control there, metal governs killing and gathering in, yet the disease qi is still there. The disease is inside; in autumn it enters yin, and yin should flourish, but you have disease inside, pressing the disease qi down — stored things do not move. So it cannot rotate, because there is disease qi inside — the moment you move, it hurts — the disease is stuck in there.

‘Leaping’ (yue): chest-rib fullness always carries nausea

“Flourishing, then leaping” — what does this character yue mean? Doctor Ni says many people cannot find it in the dictionary:

💬 Note from Doctor Ni Haixia: The so-called ‘flourishing, then leaping’ — in the ninth month all things decline, the grass and trees shed and fall; by rights it should be ‘falling’ — when the trees kill and gather, the leaves fall down. But if qi leaves yang and enters yin, qi flourishes and yang grows downward below — hence ‘leaping,’ because you have disease qi here; by rights qi going down is gathering. Here ‘leaping’ does not mean a person jumping up — it means something coming out — vomiting, boing, jumping out. So now you know: in a Shaoyang pattern, with chest-rib fullness, there must always be what? Nausea. From now on, when you see nausea, that is what ‘leaping’ means. Those three deer characters together read cu — it means running very fast — even if you search the whole ocean of dictionaries over the Huang Di Nei Jing, you still will not know what it says; you only understand it when it is explained this way.

Yangming ‘shivering as if sprinkled with cold water’: a pure heat pattern, not true cold!

Arriving at Yangming, Doctor Ni especially warns about an easily misjudged pattern — “shivering as if sprinkled with cold water” (sa sa zhen han):

💬 Note from Doctor Ni Haixia: The so-called ‘shivering as if sprinkled with cold water’ — Yangming itself is noon — it is the hottest time, the fifth month, flourishing yang holding yin; yang flourishes and yin qi is added to it. By rights yang qi is pure heat, right? But in that solar term, the fifth month is yang containing yin; at this time yin is added on the outside, so you feel a fine aversion to cold — but actually inside it is a pure heat pattern! Because you are pure heat, you feel the cold of heaven and earth. Because your body is abnormally pure heat, you shiver and feel cold. So the fine aversion to cold in a Yangming pattern does not mean every Yangming pattern has a fine aversion to cold. From beginning to end, Qibo says the Yangming pattern is pure heat — no cold pattern at all. It is precisely because of the pure heat that you feel the cold in the air. A normal person does not feel it; a patient whose body is very hot feels it as comparatively cool. So a fine aversion to cold does not mean the patient has cold inside.

So where is the Yangming channel?

💬 Note from Doctor Ni Haixia: The so-called ‘swollen shins with the bones failing to hold’ — this is the fifth month, flourishing yang holding yin. The Yangming channel is Zusanli ST36, Shangjuxu ST37, Xiajuxu ST39, Fenglong ST40, running all the way down — this shin-bone region — inside it is a pure heat pattern. Yang declines in the fifth month, yin qi rises to contend with yang, hence swollen shins and the bones failing to hold. The Yangming channel’s course: Touwei ST8, Xiaguan ST7, Jiache ST6, Chengqi ST1, Sibai ST2, Juliao ST3, Dicang ST4, Daying ST5, all the way down, down the leg, passing the breast, all the way to Zusanli ST36 — its essence qi travels from above downward. Now Yangming receives heat. What is the nature of heat? Rising — hot qi rises. Once it rises, the yang below goes up, and yin rises; by rights yin qi should turn back and return into the body, relying on yang qi descending — this is the concept of yin-yang balance. Now yang goes upward, so below, of course, yin does not turn back; yin accumulates below — accumulating in the lower part of the body, it causes swollen shins.

Thigh swelling rising to panting becomes water: yin descends, then rises again

Next, edema:

💬 Note from Doctor Ni Haixia: The so-called ‘rising to panting becomes water’ — yin qi descends then rises again; rising, the pathogen lodges between the organs, hence water. When your Yangming qi reverses, this water stops below. By rights, this water is the body’s hot vapor; now without that temperature, without yang coming down, the water stays too long and turns into cold water. Cold water returns into the body — it will not stay in the channels; if it runs between the organs, it creates water.

Where does water come from? — the kidney is the root, the spleen is the soil, the lung is the leaf

Doctor Ni draws a “map of water”:

💬 Note from Doctor Ni Haixia: Water comes from the kidney and is carried by the lung. For example, the kidneys are like two beans — this is the root. The root sprouts and reaches up to the soil — the soil is the middle diaphragm; in the middle diaphragm you have the liver, the stomach; reaching the top, it starts to grow a trunk and leaves — the leaves are our lungs. So water comes from the kidney and is carried by the lung — that is the concept. Today that water may stop below the lung — it is cold water; only cold water causes disease, warm water does not. Among the five zang and six fu, we have the san jiao system; the water in the san jiao is very hot and very fast; if this water is cold, it stops between the organs.

Where the water stops, how to judge it and how to prescribe? Doctor Ni previews a complete system:

💬 Note from Doctor Ni Haixia: When we introduce treating disease, for water we look at: which symptoms mean water is in the ribs, which mean water is below the lung, which mean water is in the diaphragm, which mean water is inside the intestines, which mean water is outside the intestines — and so on; the prescriptions are all different, one by one; which symptoms mean water is on the skin surface — all of it can be seen clearly. You must know how normal water should travel: the lung is the leaf, water is carried by the lung, the lung governs the skin and body hair, so the skin should feel moist and well-nourished when touched. You say, then cosmetics are useless, let me go home and drink more water? If your body is not well, drinking water turns into edema, and your skin gets drier and worse. You have to regulate from inside the body, let the water return to its place — and only then will your skin be good.

Chest pain with short breath: yin qi has run into the very center

“Water is yin qi; yin qi in the center, hence chest pain with short breath” — Doctor Ni first explains the exact center of the body:

💬 Note from Doctor Ni Haixia: The exact center of the human body is the seat of yang; yin qi must not be there. This center is the great artery between the heart and the small intestine. Chinese medicine says the heart moves heat to the small intestine, and the small intestine moves heat to the bladder. This artery does not merely carry blood downward — Western medicine only knows blood goes down, led to the lower limbs; in fact this vessel carries the heat generated by the heart’s beating down to the feet too. So the heat of our upper body is managed by the heart, and the heat of the lower body by the small intestine; this keeps our four limbs warm, so in winter you can walk barefoot on snow — that is the normal state. We humans should be able to run in the snow like a bear.

Why does the heart fire descend instead of burning upward? It relies on the lung metal:

💬 Note from Doctor Ni Haixia: When we divide up the body, look at only this: the heart is fire, the small intestine is also fire, and in the middle is heat — this is the exact center of the human body. And this heat always sinks; it does not rise — the reason it sinks is that the lung metal is above, and the pericardium wraps it; the combined function of these two moves the heart heat downward, into the small intestine. So water is yin qi, yin qi in the center, hence chest pain with short breath: because the heart yang cannot come down, and when heart yang reverses upward it produces pain, a dull pain; when it reverses upward the lung is affected, and the lung’s fluids run short — just like a car radiator running out of water, steaming constantly — that gives shortness of breath, deficiency of qi.

Severe reversal: afraid of people, afraid of fire, startled by the sound of wood

“Severe reversal — aversion to people and fire; hearing the sound of wood, one startles with fright”:

💬 Note from Doctor Ni Haixia: Yang qi and yin qi clashing, water and fire clashing — hence sudden startling. Yin qi and yang qi support each other; they must absolutely not clash — when they clash a person has fainting episodes, abnormal reactions. Reversal (jue) is actually ‘rebellion’ — rebellion is abnormal phenomena, that is another way to put it. Seeing people is hateful, fire is hateful too; hearing the sound of wood — knock — the heart is startled inside; this is the clashing.

Liking to hide in a room, or tearing off clothes and running — two extremes

“Wanting to shut the door and windows and stay alone” — a person hiding away:

💬 Note from Doctor Ni Haixia: A person who stays alone, likes the dark — all of it is insufficient yang — yang exhausted and yin flourishing, that is why they like to hide alone in a room. You go to a friend’s house, and your friend tells you: strange, as soon as I get home I don’t want to see anyone, I just go into the room, shut the door and hide. That is yang deficiency (yang exhausted, yin flourishing) — give him some yang-strengthening medicine and it is done.

The reverse — “when the disease arrives, wanting to climb high and sing, tearing off clothes and running”:

💬 Note from Doctor Ni Haixia: Here it comes again — yin and yang contend again, and externally they unite with yang; yang is hyperactive in the extreme, the spirit is already confused, and the upper body is scorching hot. Because of the scorching heat he tears off all his clothes — the spirit is already confused, unconscious, not knowing what to do; he is hot, so tearing off his clothes is natural, and then he runs off without them.

Nosebleeds under fourteen are normal; nosebleeds in adults are the disease

“The pathogen lodging in the tertiary collaterals causes headache, nasal congestion and belly swelling” — Yangming unites above, and above, its tertiary collaterals are in Taiyin. From here Doctor Ni teaches a very practical piece of daily knowledge:

💬 Note from Doctor Ni Haixia: We have a concept: for a woman, at two times seven, fourteen years old, the tian gui (heavenly essence) arrives — women are ruled by blood. Precisely because of this, for children under fourteen, nosebleeds — you catch a cold and run a fever, and the child has a nosebleed — this is normal. So we say: children who get nosebleeds do not run high fevers. Why? Because when he catches a cold with fever, his body’s resistance is very strong; yang qi goes out to fight the surface cold, and in the fight he has a nosebleed — the heat has a place to disperse, and once it disperses, there is no high fever. So children under fourteen frequently having nosebleeds is normal — do not stuff cotton up there; no need! Nosebleeds in adults over fourteen are the disease. That is the standard definition. Why? Because a child’s yang is extremely vigorous.

City children versus country children — Doctor Ni makes a comparison with free-range chickens:

💬 Note from Doctor Ni Haixia: If you give this child — like a shepherd’s child, year round, never a vaccine, never an antibiotic — the child runs in the fields, this child is very healthy, nothing happens to him, he just has nosebleeds. Then you live in the city — this is the caged chicken: free-range chickens all have nosebleeds; that caged chicken, you raise it inside, every cold an antibiotic goes down, then at holidays you give the three-in-one vaccine — after that he does not have nosebleeds anymore, but he has colds all the time — that kind of body gets worse and worse the more you poke it.

Taiyin disease with bloating: the spleen’s yin is no longer hidden in the belly

Page 415, Taiyin. The previous passage “its tertiary collaterals are in Taiyin” was not explained; here it is treated specially:

💬 Note from Doctor Ni Haixia: The so-called ‘disease with bloating’ is abdominal distension — the belly, lower belly, lower abdominal distension. Because Taiyin is the meeting of the three yin. Every year, the eleventh and twelfth months: the eleventh month is the zi month, the twelfth the chou month, the first month is zheng yin month — that is how it is counted. In the eleventh lunar month, the zi month, the qi of all things is stored within; the qi of heaven and earth is stored within. This yin qi — the spleen is one of the three yin — should be inside the belly; now there is disease, so the belly swells up. ‘Stored’ — it means the yin is no longer hiding inside.

Rising to the heart makes belching: the heart and stomach are connected — a patient who got hotter and hotter

“Rising to the heart makes belching: yin flourishes and rises into Yangming, and the Yangming collateral connects to the heart” — Doctor Ni says the heart and the stomach are connected, and then tells a real case he treated himself, which is absolutely brilliant:

💬 Note from Doctor Ni Haixia: Let me give you an example. This patient had a huge appetite — a huge appetite, and when we looked at him, whole-body heat and fat, mouth thirsty, drinking ice water, eating a great deal, a belly full of heat, no blanket at night, still hot with the electric fan on — Yangming heat! We prescribed gypsum formulas, lots of White Tiger Decoction, kept pouring it in, heavier and heavier — and the more he drank, the hotter he got. Not only did the thirst not lessen, the appetite did not decrease — it actually grew and he got hotter. Hey, you find it strange: I prescribed cold, cooling medicine, prescribed by the book — it should cool him down, right? No, on the contrary, hotter. This means the interior is cold!

So what to do? Go against the grain — prescribe hot medicine:

💬 Note from Doctor Ni Haixia: If the interior is cold, we must prescribe hot medicine. At this point we prescribe very strong hot herbs — like processed aconite (pao fu zi) and dried ginger (gan jiang); if you give strongly heating medicine, the moment it goes down, the stomach warms up, and instead the appetite shrinks on the spot, and the hands and feet become warm — because the spleen governs the four limbs. What does this prove? The heart and the stomach are connected. When you have a stomach problem, it is a heart problem — how do I explain it? I will explain: it is because the heart has a problem that the body naturally produces a reflex — it goes looking for something to repair the heart, to heal my own heart. It is like cats and dogs — when sick, they do not eat meat; they run outside and eat grass. That is animal instinct. We humans also have mother nature — but because of civilization, this instinct is lost. We go looking for food; eating is right, but the object we seek is wrong, and the more we eat the fatter we get — the more we eat, the more wrong it is. The cat and dog are smarter than us; they just find roadside grass and eat it.

Finally he states the essence of the heart-stomach connection:

💬 Note from Doctor Ni Haixia: So when we prescribe a formula exactly right, the moment it reaches the stomach, the body senses it: ah, this is the food I was looking for! At that point the appetite drops precipitously. So using hot medicine to make people lose weight — that can be done too. Ordinary people cannot do it; they cannot even imagine it. So when the heart has a problem, the appetite opens up — because it wants to save itself, it wants to heal itself.

What to take away

This lecture runs from mania and loss of voice to yang and yin deficiency, then threads down the Shaoyang, Yangming and Taiyin sections, stringing together the six-channel mechanism of the Mai Jie Pian: the yang that should descend descends, the yang that should hide hides, the yin that should turn back turns back, the water that should return to its post returns to its post — when yin and yang never leave their proper places, the person does not get sick; when they leave their places, mania, chest-rib fullness, swollen shins, bloated belly and lost voice pop up one after another.

💬 Note from Doctor Ni Haixia: So remember one concept, everyone: in the normal state, yang qi descends and yin qi rises, the head and face are cool and the hands and feet warm; yang is outside and yin in the middle, with mutual restraint; water comes from the kidney and is carried by the lung, what should be hot is hot, what should return to its place returns. Once you remember this normal state, all diseases are departures from the normal — at a glance you can see which channel is sick and how to treat it.

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