Lower Back Pain, Coughing, Blurry Eyes, and Flying Off the Handle — Is Your Yang Qi Sending Out an Alarm? — Doctor Ni Haixia on the Mai Jie Pian Wrap-Up and the Three Great Needling Chapters of the Huang Di Nei Jing

Patient search terms: lower back pain / back pain / lumbar pain / sore lower back / kidney-deficiency back pain / lumbar disc herniation / sprained back / coughing / panting / shortness of breath / can’t catch your breath / dry heaving / blurry eyes / dim vision / can’t see clearly / fading eyesight / declining vision / bad temper / quick to anger / easily angered / irritability / timid / fearful / afraid / feeling like someone is about to grab me / nauseated by the smell of cooking / aversion to food smells / no appetite / dark complexion / dull complexion / coughing blood / vomiting blood / nosebleeds / cerebral hemorrhage / ruptured blood vessels / arteriosclerosis / uterine fibroids / growth in the uterus / gynecological tumors / ovarian cysts / cervical cancer / Pap smear / cold hands and feet / cold feet / hot feet / cold hands with hot feet / diabetes / xiao ke / high blood sugar / blood sugar medication / insulin / acupuncture / needling / needle depth / acupuncture contraindications / wrong needling / plum-blossom needle / wen nue / going upstream / Huang Di Nei Jing

Corresponding topics (medical terms): the Su Wen chapters Mai Jie Pian (Resolving the Pulse, Chapter Forty-Nine) wrap-up, Ci Yao Lun (Essentials of Needling, Chapter Fifty), Ci Qi Lun (Evenness in Needling, Chapter Fifty-One), and Ci Jin Lun (Prohibitions of Needling, Chapter Fifty-Two). The heart and stomach are connected: the Yangming channel connects to the heart, so to treat the heart first open the stomach. Lower back pain: sprain (external injury) versus Shaoyin pain (kidney yang deficiency); Shaoyin is the kidney, October is the time of lowest yang, the kidney equals winter — kidney yang deficiency can bring back pain in any season. Vomiting, coughing and qi rushing upward: yang floats up with nothing to lean on, and the upper burner vomits, coughs and pants. Reading the eyes for yin and yang: yang deficiency cannot see (the kidney governs the pupil), yin deficiency sees five colors (green, red, yellow, white, black answering to the five zang). Prone to anger: kidney yang cannot come out, the liver qi that should have been governed is not (the kidney is the mother of the liver); extreme anger makes the sinews cramp and the feet spasm; fear is yin-yang imbalance. Aversion to food smells: stomach qi insufficiency. Coughing blood: the yang vessels are injured, the pulse fills and blood comes out the nose; the vessels carry yang so the blood moves, and when yang is deficient the vessel breaks — arterial rupture and cerebral hemorrhage are both yang deficiency. Yin jue (yin reversal): a woman’s lower abdomen swells; when the lower jiao is warm no tumors grow, when cold, blood stasis accumulates and fibers wrap the clots into tumors; critique of the Pap smear (if early detection worked, no woman would die of cervical cancer); orphan yin cannot grow and lone yang cannot last; the egg is yin essence; the warmth of the uterus and ovaries comes from the small intestine, and a warm small intestine grows nothing; gui zhi plus bai shao (cold hands with hot feet double the peony, hot hands with cold feet double the cinnamon twig) is the classic introduction to prescribing by hand and foot temperature. Xiao ke (diabetes): head and face cool with hot feet is normal during food-controlled high blood sugar; Western blood sugar drugs and insulin turn the feet cold — Western drugs make yin and yang clash, Chinese medicine repairs both to pair them up; the health standard (warm feet) instantly tests whether a medicine is right or wrong (the hot pot versus arsenic metaphor). Ci Yao Lun: acupuncture predates the Nei Jing (bian shi, stone needles, six thousand years ago); disease has floating and sinking, needling has shallow and deep, each reaches its own principle, never beyond the path; skin, flesh, sinews, bones and marrow each have their own destination; both excess and insufficiency harm (wrong depth is a great thief that harms the five zang and breeds serious illness); spring and summer shallow, autumn and winter deep, with the yin-pattern exception; the four seasons answer to the five zang; doctors cannot treat their own family; the seven layers of disease (fine hairs and interstices, skin, flesh, vessels, sinews, bones, marrow); the lung governs the skin and body hair, wounding the skin stirs the lung and brings wen nue in autumn; su means going upstream; han li means the downy hairs standing on end; wounding the flesh stirs the spleen — seventy-two days later, in the four-seasons month (long summer), heart and abdominal fullness with loss of appetite; wounding the vessels stirs the heart, which governs the blood vessels, disease in summer; wounding the sinews stirs the liver, in spring heat disease with slack sinews; the plum-blossom needle. Ci Qi Lun: needling the bone without wounding the sinew, the sinew without wounding the flesh, the flesh without wounding the vessels, the vessels without wounding the skin — insufficiency and excess. Ci Jin Lun: the zang organs have vital points that must be examined (the liver is born on the left, the lung stored on the right); needling the heart kills in one day, the liver in five (its movement is speech), the kidney in six (sneezing), the lung in three (coughing), the spleen in ten (swallowing), the gallbladder in one and a half days (nausea); ancient needles as thick as knives, the modern fine needle need not be feared; Feishu BL13 and Xinshu BL15 must be needled obliquely, the Governing Vessel straight; needling the great vessels with unceasing bleeding kills; the face — Jingming BL1, Sibai ST2, Juliao ST3, Quanliao SI18 — has arteries, be careful (the tension-bleeding story); entering the brain at naohu kills instantly, Baihui GV20 is needled obliquely; needling under the tongue too deeply with unceasing bleeding causes yin (loss of voice).

Opening: finishing the Mai Jie Pian, then diving into the three needling chapters

Last lecture worked through the disease mechanisms of the six channels with great gusto. This time, Doctor Ni Haixia first sweeps up the final passage of the Mai Jie Pian, then turns the page — straight into the three hardest-core acupuncture chapters of the Huang Di Nei Jing: Ci Yao Lun, Ci Qi Lun, and Ci Jin Lun.

💬 Note from Doctor Ni Haixia: The whole of this chapter (Mai Jie Pian) talks about mixing the person together with nature — you can compare a person to nature. From the Mai Jie Pian you can see: it does not say you only get lower back pain when winter arrives — it is describing that the kidney is winter.

The heart and stomach are connected: to treat the heart, first open the stomach

The opening passage says “yin flourishes and rises into Yangming, and the Yangming collateral connects to the heart”:

💬 Note from Doctor Ni Haixia: Because the spleen and stomach are interior-exterior paired. When yin comes up and reaches Yangming, and the Yangming connects to the heart, it produces these symptoms. So when we treat the heart and the patient’s stomach is bad, we prescribe a stomach medicine. Ah, once his stomach gets better, the heart follows — this is the reason. In fact the heart was never the problem.

Doctor Ni adds a solar-term explanation:

💬 Note from Doctor Ni Haixia: By the twelfth month, yin qi declines and yang slowly rises. When yang rises and becomes fuller, stomach yang no longer travels upward. And if the turbid yin is expelled and the spleen dampness is expelled, it goes out with the stool and the gas. The main point of this passage: the spleen governs the lower abdomen and the spleen governs dampness. When heat comes, the heat pushes the dampness out through the stool and out through the farts; but if cold-damp is stuck inside, it is not easy to push out, and it drives the heat of the stomach upward in reverse, causing disease to develop in the heart.

Lower back pain: one is a sprain, one is kidney yang deficiency — it hurts even in May and June

Next comes the “lower back pain” topic. Doctor Ni slices lower back pain cleanly into two kinds:

💬 Note from Doctor Ni Haixia: Generally we have two kinds of lower back pain: one is when you sprain it, an injury; the other is when you did not sprain it and the lumbar spine starts to hurt by itself — this is the Shaoyin pain. Shaoyin is the kidney. In the tenth month, the yang qi of the myriad things is all wounded, hence lower back pain. The kidney has kidney yang inside; in the tenth month yang qi is at its lowest, and only in the eleventh month does yang rise again. This is the solar-term relationship causing insufficiency of yang in heaven and earth — and in the body, insufficiency of kidney yang — which produces lower back pain.

But Doctor Ni is careful to say: this passage is not saying you only get back pain in November —

💬 Note from Doctor Ni Haixia: This is talking about the whole person mixed together with nature. It is describing that the kidney is winter. When yin qi and yang qi decline to the extreme, the kidney begins to hurt, the lumbar spine begins to hurt — so the kidney’s back pain is like the tenth month of heaven and earth. That is why we often meet lower back pain in May and June too — as long as your kidney yang is insufficient, your back will begin to hurt.

Vomiting, coughing, qi rushing upward: yang floats up with no yin to lean on

“So-called vomiting, coughing and qi rushing upward: yin qi below, yang qi above.” Doctor Ni puts his finger on it:

💬 Note from Doctor Ni Haixia: All the yang qi floats up with nothing to attach to. Yang must sink — I just told you yang must hide, heat must go downward. When yang qi floats up with no yin to lean on and nothing to attach to, so you get vomiting, coughing and qi rushing upward. Yang is reversed, and it creates vomiting, coughing and panting in the upper burner, unable to catch your breath.

The great lesson of the eyes: yang deficiency cannot see, yin deficiency sees five colors

Next, “unable to stand or sit long, eyes dim and see nothing” — Doctor Ni makes a joke first: do not read this as “pervert plus pervert” (the original text “se se” being misread as “se lang,” the slang for pervert).

💬 Note from Doctor Ni Haixia: No! It just means the eyes cannot see things. I just told you all: when your eyes cannot see clearly, cannot see things, that is yang deficiency; when you can see, but everything is blurry and flowery, that is yin deficiency. The flowery look is because there is yang, and with yang you can see yang in all its different colors — because color exists. The five zang — liver, heart, spleen, lung, kidney — you see green, red, yellow, white, black; you can see the five colors, right? In yin deficiency, yang is inside, so you see the five colors; in yang deficiency, you see nothing. Seeing depends on yang; when yang is deficient, you cannot see anything at all. So from this you can tell: this person has kidney yang deficiency, that one kidney yin deficiency — and you will never write the wrong prescription again.

Prone to anger and fear: both are a loss of yin-yang balance

“Low qi and prone to anger: yang qi is not governed” — Doctor Ni explains this one vividly:

💬 Note from Doctor Ni Haixia: Yang qi cannot come out, the liver qi that should have been governed is not governed, and the patient becomes prone to anger. Because the kidney is the mother of the liver, and the yang inside the kidney must assist the liver. Now the kidney yang cannot come out, and the liver says: you should give it to me — but it does not get it, because it has become empty, so the patient is prone to anger. When a person’s emotions are very steady, it is when yin and yang are in harmony that they are steady. When liver yang is insufficient, something stirs up inside, and the patient shows anger. Conversely, when yin comes out, he has no strength to get angry either. Then the liver, which governs the sinews, begins to cramp and the feet spasm — the yin signs appear.

Fear works the same way:

💬 Note from Doctor Ni Haixia: Some people act as if someone is about to seize them. In autumn qi, the myriad things are not yet settled, yin qi is little and yang qi enters, yin and yang clash — not fear. So any fear, any emotion whatsoever, is caused by the loss of yin-yang balance — that is it in simple terms.

Aversion to the smell of food: the food is not spoiled, the stomach qi is short

A patient smells cooking and wants to throw up — is the food rotten? Doctor Ni says the opposite:

💬 Note from Doctor Ni Haixia: It is not that the food has gone bad — it is freshly cooked food. We smell it and it is fragrant; he smells it and feels awful, wants to vomit. This is what it says here: when the stomach has no qi, when stomach qi is insufficient, no matter how fragrant someone’s cooking smells, he still finds it unbearable.

Coughing blood and the blood vessels: when the yang inside the vessel is gone, the vessel breaks

“So-called coughing: the yang vessels are injured. Yang qi is not yet full above, and the pulse fills; when full, blood is coughed out and appears at the nose.” The lung and autumn both belong to metal — from here Doctor Ni reveals the great secret of the blood vessels:

💬 Note from Doctor Ni Haixia: The lung is full of fluids; the fluids are the yin of the lung. The lung’s motive power, its ability to expand and contract, is the yang of the lung. When you cough violently, the yang is coughed out continuously; the lung is normally open, and each cough contracts it, and the yang gets wounded. We all have blood vessels; the reason blood can travel inside the vessels is that there is a vessel wall outside, and inside the vessel wall there is yang, and it is the yang that holds the blood in control. If there is no yang inside the vessel, the blood vessel ruptures.

And what exactly is the yang inside the vessel? Doctor Ni offers a wonderful analogy:

💬 Note from Doctor Ni Haixia: Besides its motive power, the main thing is that there is water inside the vessel. Like a water hose with water in it — you keep using it. One day the hose is empty, left out in the sun; the surface moisture dries out, and when you bend the hose it cracks — why? Because the yang is gone. So we must have yang. Like arterial rupture, cerebral hemorrhage — vessels that should not break but do break — it is all yang deficiency, all yang deficiency!

Yin jue: why women grow tumors in the lower abdomen — cold, not heat

“So-called tui shan (hernia) and a woman’s swollen lower abdomen: it is reversal. The third month is yin, mao, chen; the chen month is the third month, yin qi within yang.” Doctor Ni turns this passage into a lesson in gynecological prevention:

💬 Note from Doctor Ni Haixia: Take the third month as the qi of heaven and earth. For a woman — any girl — the normal belly should be warm: the dantian, the lower abdomen, should be warm here. You think it is cold — cold means cold is inside, and cold inside causes tumors, hard lumps, fibroids. Many ladies tell me: the doctor says I must get a Pap smear, early detection — that is all his talk. If early detection really worked, then in fact no woman should die of cervical cancer, right? Chinese medicine does not need it! We simply keep the ladies’ lower jiao warm at all times, keep the uterus warm — no tumor will accumulate in there.

Why does cold accumulate into tumors? Doctor Ni explains the pathology thoroughly:

💬 Note from Doctor Ni Haixia: Why do you accumulate? Because there is stasis accumulated inside. One is cold inside, and blood clots stopped inside. When you are too cold, the blood clots stay too long, and outside a fiber wraps it, wraps it into a lump — and it becomes a tumor. That is why when they pull a tumor out and slice it open, sometimes you can see hair, even teeth inside — that is an egg that came out without being fertilized; another kind is just blood clots inside. All of these belong to yin. The woman’s egg is yin and the man’s semen is yang — orphan yin cannot grow, lone yang cannot last. With yin inside, the body naturally produces a membrane to wrap it — the body does not accept it, I cannot digest you, you are not food, and my uterus is not a stomach, so it wraps you up. That is why Western medicine sees a tumor, and when they cut it open there are stasis blood clots inside, or unfertilized eggs, and some people see hair.

So how do you know whether it is cold inside? Doctor Ni says you do not need a thermometer:

💬 Note from Doctor Ni Haixia: Cold feet — that settles it, right? The toes are the qi extremity, and the small intestine’s qi governs the temperature of the feet. The uterus and ovaries should be attached to the small intestine and should be warm. The warmth of the uterus and ovaries comes from the small intestine; when the small intestine’s temperature is sufficient, nothing grows inside the uterus and ovaries.

Hand and foot temperature can even directly guide the prescription — Doctor Ni leaks the classic-formula method in advance:

💬 Note from Doctor Ni Haixia: The heart governs the hands. It is fun when I teach the Shang Han Lun: the heart — gui zhi (cinnamon twig) governs the hands, the arms (yang); ice-cold feet are bai shao’s (white peony’s) business, bai shao governs venous return — then you can use it. Teacher, his hands are hotter and feet colder: double the bai shao. Teacher, his hands are colder and feet hotter: double the gui zhi. Gui Zhi Jia Bai Shao (Cinnamon Twig plus White Peony Decoction) — very fast. Once you understand this, when I teach the Jin Gui, you will get it in an instant.

Xiao ke (diabetes): the more Western medicine you take, the colder your feet

Right after comes a thought-provoking topic — xiao ke, diabetes:

💬 Note from Doctor Ni Haixia: Xiao ke we covered last session — the diabetes patient. When his blood sugar starts running very high and he controls it with food, up above you touch his head and face and body, still cold, and his feet are hot. From the day he starts taking blood sugar drugs or injecting insulin, his feet begin to turn cold. So Western medicine is trying by every means to make his yin and yang clash; Chinese medicine repairs everything, makes yin and yang pair up — foreigners invented these drugs without any concept of yin and yang, so the more Western medicine you take, the colder your feet get.

This is why Doctor Ni keeps repeating the “health standard”:

💬 Note from Doctor Ni Haixia: Why do we define a standard of health? This standard has always existed — it is in the Huang Di Nei Jing. Why does Western medicine have its health standard? Because Western drugs take ten or twenty years for the side effects to show, very hard to verify; I say no need — you know the next day, you know the same day. When you have a health standard, the more you take a medicine and the stronger your health standard becomes, that medicine is right for you; and if yesterday your feet were hot and today they are cold, it is wrong. Follow this principle and you can instantly tell which one is good for you and which is not.

Doctor Ni also gives a homely example: you come back from a trip, cold and hungry, and at home a hot pot warms you from head to toe — that means the food your wife prepared is excellent; but if she had put poison in it, the moment you ate it your hands and feet would go cold — that is poisoning.

💬 Note from Doctor Ni Haixia: Good — of course we have antidotes; a man who knows his bencao (the Bencao Gangmu, Compendium of Materia Medica) well cannot be poisoned by anyone. So when there is poison, we must know how it poisons — because the herbs are right here, and I can tell you how to make a poison out of them, so it is passed only to the upright, it cannot be passed on. Our tempers are good, but we never harm people — never harm people.

Ci Yao Lun: disease in the skin, needle the skin; disease in the bone, needle to the edge of the bone

With the Mai Jie Pian finished, page 419 opens Ci Yao Lun — the Yellow Emperor asks: where are the essentials of your needling method? Doctor Ni first tells a bit of history:

💬 Note from Doctor Ni Haixia: Look — is the Nei Jing not like this together with acupuncture? If we truly compare acupuncture with the Nei Jing, acupuncture is older than the Huang Di Nei Jing. Going back to the source of Chinese medicine, there is evidence from over six thousand years ago; the earliest (needle instrument) was bian shi (stone needles) — the eastern islands, where stones were born like needles, very long, slender. Acupuncture came before religion. So acupuncture predates the Yellow Emperor.

Then Qibo answers: “Disease has floating and sinking; needling has shallow and deep; each reaches its own principle; never beyond the path.”

💬 Note from Doctor Ni Haixia: The principle Qibo grasps: neither exceed nor fall short. When we know the disease is at the surface, our needle should be shallow; if it is very superficial, the pathogen on the skin, just scrape the needle over the skin — do not insert it, no need for deep needling. If we know the disease is inside the flesh, insert the needle into the flesh; if it is in the sinew, we insert beside the sinew; if in the bone, we insert to the edge of the bone. If the disease is clearly in the flesh and you sink the needle all the way to the bone — that is excess. Disease in the sinew and you insert to the bone — excess too. Disease in the skin and you insert to the flesh — excess as well.

Depth also relates to the seasons — but with one exception:

💬 Note from Doctor Ni Haixia: In spring and summer yang qi is stronger, the needle goes shallower; in autumn and winter yin qi is stronger and yang qi declines, so we needle a little deeper — all calculated by the solar terms. But sometimes we cannot go by spring, summer, autumn, winter: the patient’s disease arises in summer, yet it is a yin pattern — we must insert deeper. So the Huang Di Nei Jing only tells you the normal state. A person is born between heaven and earth, so we must honor the four seasons: spring is the liver, summer is the heart, long summer is the spleen, autumn is the lung, winter is the kidney. When you enter the zang organs, do not mind the outside first — if you see a heart disease in the kidney season, you still needle it the way you would in summer. The solar terms outside only tell you when he will recover and when he will hold steady, so you know there is a breathing space. The human body is extremely precise; when something happens it does not go down immediately, there is always a period.

Doctor Ni also touches on the eternal problem of “doctors cannot treat themselves”:

💬 Note from Doctor Ni Haixia: As a doctor, you cannot treat your own family. Why? Because the heart flutters, cannot settle, cannot judge accurately. Treating others is fine, because there is a layer in between; treating your own people, no. So I cannot treat my wife. People drive two thousand li to come have me needle them, but to needle my own wife — no. She can write her own prescription. Anyway it is not serious. But close relatives are very hard to treat, really impossible. That is why the telephone is also good — there is a layer; over the phone you can hear very clearly; when you see the person, you get more confused.

Next comes the general rule of needling — if the depth is wrong, the consequences are serious:

💬 Note from Doctor Ni Haixia: That is excess and insufficiency. If your depth is wrong, it becomes a great thief. Should be deep and you needle shallow — the disease is not removed in time and is bound to run inside; disease is shallow and you needle too deep — you wound the upright qi, the disease outside is not removed and runs inside. So depth must be grasped precisely. For example, a person’s skin is itchy with a rash — you needle very shallow; his knee hurts, the bone hurts — needle to the edge of the bone, passing beside the bone; you cannot go deeper, deeper would pierce through. Above, needle to the bone edge — how could that not heal? When depth is not grasped, on the contrary it harms the internal organs, and the five zang will later develop serious illness — this is the reason.

The disease has seven layers, each reaching its own destination:

💬 Note from Doctor Ni Haixia: Qibo says there is disease in the fine hairs and interstices, in the skin, in the flesh, in the vessels, in the channels, in the bone, in the marrow — all different. So needling the fine hairs and interstices, never wound the skin; disease in the fine hairs — must you insert even when scraping over the skin? If you wound the skin, the internal organs stir the lung, because the lung governs the skin and body hair. When the lung is stirred, in autumn there is wen nue — wen nue is when coughing begins in autumn.

Here he inserts a little philology note:

💬 Note from Doctor Ni Haixia: The character su is pronounced “su,” like shu in “shu kou” (rinse the mouth). In our language it means river water flowing backward, water going against the current is called su. So when we usually say “shuo xi er shang,” actually that character is wrong — it should be “su xi er shang” (going upstream along the stream). Now speaking of su — han li: han is reversal, the downy hairs of the skin all stand on end. The downy hairs normally lie downward; when you look at the direction of the downy hairs, you can tell the lung is normal this way. When the downy hairs suddenly stand at attention, that is the meaning of the skin pores and downy hairs standing up.

Doctor Ni then works “needling the skin without wounding the flesh” all the way down, each zang answering to its layer:

💬 Note from Doctor Ni Haixia: Disease on the skin — we needle very shallow. If you wound the flesh, the internal organs all wound the spleen — the spleen is stirred, and seventy-two days later, in the four-seasons month (long summer), there will be heart and abdominal fullness and dislike of food. If it is a flesh disease, we must not wound the blood vessels — if wounded, summer brings trouble, because the heart governs the blood vessels. When you truly understand that the spleen governs the flesh, the lung governs the skin and body hair, the kidney governs the bone, the liver governs the sinews, and the heart governs the blood vessels, you know why you must memorize this — everything else follows the same pattern. For example, disease in the flesh and you insert very deep, down beside the great sinew, wounding the sinew — nothing happens at the time, but the disease extends, the internal organ harmed is the liver, and when the liver is wounded, in spring you get heat disease and the sinews develop problems.

The plum-blossom needle is the practical application of “needling the skin”:

💬 Note from Doctor Ni Haixia: I taught this once — the plum-blossom needle. When a whole patch of skin is red rash and itching, we tap directly on the skin to let blood — that is on the skin. The plum-blossom needle head is very short, very fine, very shallow; even if you hit harder, it is still that depth, right? Hitting a person is the same. So the force matters — this way the patient will not suspect you have a grudge against him and needled him especially deep. The needle is the same depth; it will not go deeper.

Ci Qi Lun: insufficiency and excess

Page 421, Ci Qi Lun — right after Ci Yao Lun, it defines needle depth precisely:

💬 Note from Doctor Ni Haixia: “Needling the bone without wounding the sinew: the needle reaches the sinew and stops, not reaching the bone. Needling the sinew without wounding the flesh: stop at the flesh, not reaching the sinew. Needling the flesh without wounding the vessels: stop at the vessels, not reaching the flesh” — this is insufficiency. The second passage is excess: needling the bone, the needle must reach the bone; needling the sinew must reach the sinew; needling the skin reaches the skin; needling the flesh reaches the flesh. Needling the bone and you stop beside the sinew before reaching the bone — the bone lies beneath the sinew — that is already excess. Disease in the skin, insert into the skin without wounding the flesh; wounding the flesh is already too heavy — you went too far, beyond a certain degree it is excess. One is insufficiency, one is excess — the simplest principle is the same as before: disease on the skin, needle the skin; disease in the flesh, needle the flesh; disease in the sinew, needle the sinew.

Ci Jin Lun: needle the wrong place, hit the heart, die in one day

Page 423, Ci Jin Lun — the prohibitions of needling. The Yellow Emperor asks about needling taboos, and Qibo answers: “The zang organs have vital points; they must be examined”:

💬 Note from Doctor Ni Haixia: The liver is born on the left, the lung is stored on the right… in short: when needling, you must not hit the internal organs, absolutely must not hit the internal organs — hitting them wounds them. If your needle strikes the heart, death in one day; strike the liver, death in five days, its movement is speech — talking without stopping; strike the kidney, death in six days, you will see the patient begin to sneeze; strike the lung, death in three days, coughing; strike the spleen, death in ten days, its movement is swallowing — you see him swallowing constantly, and you know the needle hit the spleen; strike the gallbladder, death in one and a half days, nausea. These were the prohibitions of acupuncture in the past.

But Doctor Ni immediately reassures everyone — those were the ancient needles, not today’s:

💬 Note from Doctor Ni Haixia: With your needle today, even if we really hit a problem, Western emergency medicine and all that — you cannot do anything about it anyway, but actually you will not hit a problem. Unless our needles of old were that thick — see? That thick. How could they not cause trouble?

Doctor Ni then goes through several modern clinical pointers one by one:

💬 Note from Doctor Ni Haixia: Some points — when you needle Feishu BL13, Xinshu BL15 on the back from behind — if you study medicine, when you insert the needle, if it is not oblique but straight in, it can hit the lung. Do you know how deep it is? Say I needle the spine — the Governing Vessel: we insert on the Governing Vessel, above and below, even that deep — how could the needle possibly reach the lung? But beside it, it is shallow; when it is shallow, if you insert straight down, it can hit the lung, pierce through the lung. So you may needle the Governing Vessel straight, but beside it — for anyone over fourteen, oblique needling is best, not straight; straight can hit. I would rather you go a little shallow than too deep. Do not say: Teacher, watch me show off, I am good — and drive the needle straight down and cause trouble.

💬 Note from Doctor Ni Haixia: If you strike the great vessels of the abdomen and the blood will not stop flowing, you die — you struck a big blood vessel. Our old needles were that thick, stabbing in like a knife; blood hits a big vessel, bleeding unceasing, and you die. Today’s needle is that fine — even if you hit it, you hit an artery, you press it, after a while a lump rises and it stops. Not like before.

The face is a real danger zone, and Doctor Ni names the points one by one:

💬 Note from Doctor Ni Haixia: If you strike the arteries of the face, carelessness can easily cause blindness. So the eye points — Jingming BL1, Sibai ST2, Juliao ST3, and Quanliao SI18 — they all have arteries here, small vessels inside. Careful, careful. Will you go blind? When we needle and there is bleeding — how can you drop sesame seeds when eating a sesame cake? There is always a patient who tenses up, and with the pull, blood comes out inside the eye, a black patch under the eye the next day, like he was punched. Will he go blind? No, because our needle is very fine.

He even tells a real “filming accident”:

💬 Note from Doctor Ni Haixia: We needle every Monday, Wednesday, Friday and Saturday; the first three times before that there was no problem, never any bleeding. That day I said I want to film (clinical video), and I explained to him first — I said I will film first, I need your consent, and he said no problem. When he heard I was going to film, I took the eyelid and pulled it tight — he began to tense up, and that day it bled; the next day he came with a black patch on the eye. See? You were that tense. The patients I ask to film for me are all very familiar — look how tense he was. It only bled that day because we were filming; before, when we never filmed, there was never any bleeding, right? Because it bled that day — tension. That is the evidence. So from now on, when we film clinical sessions, I will keep talking, all the way to retirement, and the tapes will gradually be attached. Some patients needle just fine, because you can see it directly when you insert; but for the consultation and inspection it is harder. I only film with familiar patients who are easy to talk to — and every time we film, the patient changes: he starts talking and I feel it is very tiring — how is this different from usual, like being a movie star.

The head prohibition — naohu (the brain door) — needle it wrong and you die on the spot:

💬 Note from Doctor Ni Haixia: If it is the head — naohu, entering the brain — so when you needle the head, it must be at the fontanelle center. For example, when I talk about Baihui GV20: you insert obliquely downward from five fen above, right? If the patient is lying face down, you can insert from back to front, front or back both fine — but never straight in! On the head, if you insist on finding an empty space in the brain and drive straight into the skull, you die on the spot. Never.

And the last item: “Needling under the tongue too deeply, with bleeding that will not stop, causes yin (loss of voice)”:

💬 Note from Doctor Ni Haixia: Too deep, bleeding will not stop, the voice goes hoarse — it is like when we usually stick out the tongue: you tell him to, and the brave one finishes it right there; the timid one pulls it back in, gone. Then you… there is nothing you can do.

Wrap-up: the whole art of needling lives in one word — the measure

From the lower back pain, blurry eyes, quick temper and aversion to food smells of the Mai Jie Pian, to the cold-feet, hot-feet test in xiao ke, to the “never beyond the path” of Ci Yao, Ci Qi and Ci Jin — this lecture really taught only one character: du, the measure.

💬 Note from Doctor Ni Haixia: Disease in the skin, needle the skin; disease in the flesh, needle the flesh; disease in the sinew, needle the sinew; disease in the bone, needle to the edge of the bone — never beyond the path; neither exceed nor fall short. Grasp the depth precisely and the disease leaves quickly; miss the depth and it becomes a great thief, harming the five zang and breeding serious illness. That is the whole secret of needling.

What to take away

This lecture closed out the Mai Jie Pian with the heart-stomach connection, the two kinds of lower back pain, the eye test for yin and yang deficiency, anger and fear as lost balance, the yang inside the blood vessels, the cold that grows tumors, and the diabetes feet — then crossed over into the three great needling chapters. Underneath it all, one thread runs through everything: yang must sink, yang must hide, the lower abdomen must be warm, the vessels must hold yang, and the needle must hit exactly its own depth — not too much, not too little. When every thing stays in its place, the person stays well; the moment anything leaves its place — the back aches, the eyes blur, the temper flares, the vessel breaks, the tumor grows, the needle goes one layer too deep — the alarm goes off. The cure is always the same: put it back.

💬 Note from Doctor Ni Haixia: Remember one concept: the normal state is yang qi descending and yin qi rising, the head and face cool and the hands and feet warm; the vessel holds yang so the blood stays inside; the lower abdomen is warm so nothing grows; and the needle goes neither too deep nor too shallow — that is the measure. Once you know the normal state, every disease is a departure from the normal — you see at a glance where it has left its place and how to bring it home.

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