Heart Pain That Pulls to the Back, Back Pain That Pulls to the Heart? Four Needles Cure It — Doctor Ni Haixia on the Jing Luo Lun and the Qi Xue Lun of the Huang Di Nei Jing

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Corresponding topics (medical terms): the Su Wen chapters Jing Luo Lun (Channels and Collaterals, Chapter Fifty-Seven), closing, and Qi Xue Lun (Qi Acupoints, Chapter Fifty-Eight), opening. Five-color diagnosis of the collaterals: the yang collaterals change color with the four seasons — much cold congeals the blood and turns it blue-black, much heat moistens it and turns it yellow-red, and all five colors appearing together is called cold-heat; the yin collaterals answer to their parent channel and never change, only the yang collaterals change. The cinnabar palm (dull dark red palm) is a sign of liver disease. The 365 qi points answer to one year. The heart-back needle method: the back is yang and the chest yin; when yin and yang do not meet, heart pain draws to the back and back pain draws to the heart; needle Tiantu CV22 (the sea of qi) + the upper ji Zhongwan CV12 + the lower ji Guanyuan CV4 (the mu point of the small intestine, whose qi vessels reach the ming men) + the tenth vertebra (the meeting of the san jiao qi vessels); the Conception Vessel and Governor Vessel thread yin and yang through — one treatment works at once. Total count of qi points: the zang shu fifty points (each of the five zang organs has five points, left and right) and the fu shu seventy-two points (each of the six fu organs has six points, left and right), all major points of the twelve channels; the Conception Vessel rhyme ‘ren mai san ba qi hui yin, qu gu zhong ji guan yuan rui…’ Sun collaterals: also 365 meetings answering to one year; the qi of the vessels overflows with abnormal pathogens and opens ying and wei; when qi is exhausted the blood stops (qi jie xue zhu) — outwardly fever, inwardly shortness of qi; ji xie wu dai, jian er xie zhi, wu wen suo hui — wherever you see a blockage, bleed it — a feverish child is bled at Shangyang LI1 and the fever retreats; needling a baby must be fast and patient, never lose your temper. Xi valleys: the great meetings of the flesh are gu (valleys), the small meetings are xi (streams) — Hegu LI4, Yanggu SI5, Houxi SI3, Jiexi ST41 and Yangxi LI5 are all named after valleys and streams; the wei qi, sweat and blood meet at the junctions of the muscles; when evil is exuberant, qi and blood congest, heat rots the flesh into pus, the pus enters the marrow and lodges in the bone joints, and everything fails; heat lodged in the xi valleys rots the flesh into pus, while cold lodged in the xi valleys (ying and wei no longer dwelling there) withers the muscles and cramps the sinews; wind, cold and damp together form bone bi, whose external sign is numbness; cold congealed in the xi valleys swells the joints like rheumatoid arthritis. Treatment: when cold first arises use moxa; when there is slight pain use moxa and needling; for bone bi use the short needling method — the needle goes to the side of the bone and rubs up and down against it. The Yellow Emperor is enlightened and his doubts dispelled, and he stores the words in a golden cabinet. Zhen Jiu Da Cheng: Yang Jizhou compiled the rhapsodies and odes of the various schools (the Jade Dragon Rhapsody, the Ode to Elucidating Mysteries and others) into one book; the ancients passed techniques from father to son and never to outsiders, so Yang Jizhou bought them at high prices when rich and stole them as a thief when poor; Doctor Ni synthesized all the schools, which is why his acupuncture teaching is so concise. Next lecture: Gu Kong Lun (Bone Emptiness).

Opening: Why do the colors of the collaterals keep changing?

The last lecture ended with the pages of the Jing Luo Lun (Channels and Collaterals), Chapter Fifty-Seven, just opened — the channels have fixed colors, the collaterals have no fixed color and change. This lecture, Doctor Ni Haixia continues: so how exactly do the colors of the collaterals change?

💬 Note from Doctor Ni Haixia: The skin is yellow — it is yellow. But the yang channels (their collaterals) have no fixed color — the yang collaterals change back and forth, following the four seasons. When cold predominates, the blood congeals and thickens (ning qi); when it congeals, the color turns blue-black. When heat predominates, it becomes moist and glossy (nao ze); when it is moist, the color turns yellow-red. These are all normal colors — this is called having no disease. When all five colors appear together, that is called cold-heat.

All five colors together mean cold-heat; the cinnabar palm means liver disease

Where do you look to see “all five colors together”? Doctor Ni says you can see them on the face and around the hands and feet:

💬 Note from Doctor Ni Haixia: All five colors together — you can see it on your face, and you can see it around the hands and feet. It is hard for you to imagine now, but when you actually go into clinical practice, that face really does turn waxy yellow — when you lift the hand it really is yellow tinged with black. And when you hold up the hand and people say, “A cinnabar palm, wonderful!” — the whole hand dull dark red — cinnabar palm? That is liver disease! Things like that — you really do see these colors.

Having finished with the colors, Doctor Ni states the principle:

💬 Note from Doctor Ni Haixia: So this is a color that the collaterals change — the principle of the channels and collaterals. So now you all know: the yin channels and yin collaterals never change; only the collaterals of the yang channels and yang collaterals change.

The Yellow Emperor asks about qi and blood: 365 points, 365 days in a year

Then the lecture turns to the Qi Xue Lun (Qi Acupoints), Chapter Fifty-Eight, page 447. The Yellow Emperor asks about qi and blood — and Doctor Ni first gives a compliment:

💬 Note from Doctor Ni Haixia: This Qi Bo is remarkable. The Yellow Emperor said “qi and blood” — a person has qi and blood, 365 points, right? The moment he asks, Qi Bo hurries to answer — the Yellow Emperor asked well, asked brilliantly.

When the Yellow Emperor asks this kind of question, Qi Bo’s answer is very clever:

💬 Note from Doctor Ni Haixia: Qi Bo said, asking this kind of question — “the sage is easy to speak with, the fine horse is easy to drive.” Right? The sage — I am not saying you all have to be sages, but how do you tell a gentleman from a petty man? A person of great wisdom, you communicate with him simply — you explain once and he listens. A mind that is dull and foolish, like a stubborn rock, you knock and it will not wake, you scold it and it still will not wake — it dies without knowing why: it died of stupidity.

💬 Note from Doctor Ni Haixia: A good horse is easy to drive. A person of high intelligence can weigh and choose — so everyone must learn to weigh and choose. That person runs off to believe in Western anatomy and pharmacology — you say, why do you believe him? “I just believe him.” Do you understand it? “I don’t.” What did you graduate in? It has nothing to do with the medicine — and yet he believes him. Then why do you believe him without understanding? “Ah, he’s scientific.” Then what is science? He cannot even tell you what science is — anyway, everyone is in there, so if everyone goes, I go. Oh! This is a wild horse! You don’t know how to drive it, you can’t teach it, it’s exhausting.

Bonus: a mother-in-law choosing a daughter-in-law looks at the back view

Speaking of “looking only at the front door and never the back,” Doctor Ni tosses in an old joke:

💬 Note from Doctor Ni Haixia: So I said to him: look, everyone is over there — that is the front door; I’ll take you to see the back door. This person looked at the front door and never the back door, right? Even a mother-in-law choosing a daughter-in-law looks at the front and the back — the front looks fine, then look at the back as she walks away: big hips will bear children, small hips won’t do (good childbearing) — in the old days it had to be this way, the way of the mother-in-law is to look at the back. I’ll take you to the back of the hospital — it scared him to death.

A rule of treatment: heart pain draws to the back, back pain draws to the heart

Qi Bo’s first answer was remarkable; his second is even more so — in one short passage, everything is said. Doctor Ni notes that before that, the text first sets out a rule of treatment — and his own needling method comes from right here in the Huang Di Nei Jing:

💬 Note from Doctor Ni Haixia: Qi Bo said: the back and the heart pull at each other — that is yin and yang not meeting. The back is yang, the chest is yin. If yin and yang do not meet, heart pain draws to the back, and back pain draws to the heart. See, he points to Tiantu and the tenth vertebra, and the upper ji. Qi Bo’s upper ji is the stomach duct — that is the Zhongwan point. The lower ji is Guanyuan. So we needle Tiantu, Zhongwan, Guanyuan, and after needling the front, needle the tenth vertebra on the back — following Qi Bo, it treats specifically heart pain drawing to the back and back pain drawing to the heart. And indeed one treatment, one session, and it is cured — the effect is very good.

What happens if you miss a needle? Doctor Ni shares a little clinical experience:

💬 Note from Doctor Ni Haixia: If you needle Tiantu, Zhongwan and Guanyuan, but skip the tenth vertebra — after the needles, his chest no longer hurts, but the back still hurts, and he says, “It’s just this one spot.” Look — the tenth vertebra! That is quite something. Why? Because the qi vessels of the san jiao meet right there. So when you test someone to the end (how to finish it) — just give him that one needle.

The four needles explained: Tiantu is the sea of qi, Guanyuan reaches the ming men fire

Why exactly these four points? Doctor Ni takes them apart one by one — and this whole set of reasoning is the soul of acupuncture:

💬 Note from Doctor Ni Haixia: The back and chest are bound to yin and yang — because the back is yang and the chest is yin; when yin and yang do not meet, disease makes the front and back hurt together. Chest and rib pain so you cannot lie down, upper qi and shortness of breath with one-sided pain, the vessel qi (not flowing smoothly) — for this we have the collaterals: the chest collaterals run all the way up to Tiantu, slant to the shoulder, and below cross to the tenth vertebra. This sentence explains why we needle here: we have many collaterals in the body; in fact the qi vessels of these three places thread through — the three in front are the Conception Vessel, the one behind is the Governor Vessel; they have always threaded yin and yang through each other, so it travels from within.

💬 Note from Doctor Ni Haixia: Second, our Guanyuan point is the mu point of the small intestine. Guanyuan itself — its qi vessels drop straight to the ming men. The ming men is the place of the san jiao and the ming men fire, so the Guanyuan point works very well. Third, our Tiantu — our qi meeting is Danzhong; above Danzhong the qi always gathers into a sea. The brain is the sea of marrow; it can no longer hold qi, so the sea of qi is here at the neck. Apart from the brain as the sea of marrow, there is one more above — so the neck is the sea of qi. So I needle Tiantu to let the qi pass through — it is the sea of qi, Tiantu governs it. In the middle is the stomach duct (Zhongwan), letting the stomach qi descend — in this way yang qi rises and yin qi descends. Because the stomach is yang qi: once you needle it, yang qi comes up. Tiantu is needled downward to let qi go down and yin qi sink. At that moment, the phenomenon of heart pain drawing to the back and back pain drawing to the heart disappears.

💬 Note from Doctor Ni Haixia: If you read the Huang Di Nei Jing up to here, this is exactly this needling method — the Huang Di Nei Jing puts out several (treatment principles) here, right? Now you have learned them: how we use moxa, how we needle, and how cuttlefish bone is made into medicine (the bone of the cuttlefish), and later there are treatments for insomnia… after that it starts to talk about these things.

Fifty zang shu points and seventy-two fu shu points: Qi Bo dismisses the Yellow Emperor in a few words

Before the needling method, Qi Bo first finishes the three great statements on qi and blood — all the points on the whole body are called qi points:

💬 Note from Doctor Ni Haixia: These 365 qi points — they are all our Guanyuan, Taichong LR3, Yinbai SP1, Yuji LU10… all of them are qi points. In front of them the text adds the treatment points (moxibustion and needling) — the zang shu fifty points and the fu shu seventy-two points; all those points put together are the major points of the twelve channels. We will not go through them in detail here — you can go home and count them slowly yourselves.

What if you cannot count them? Doctor Ni laughs at himself:

💬 Note from Doctor Ni Haixia: If I were to explain (it), Qi Bo would be very impressive — he’s lazy, you see. If the Yellow Emperor asked me, I could not answer like that — I would start reciting from memory, and the Yellow Emperor would listen to me recite: “The Conception Vessel: thirty-eight points starting at Huiyin; Qugu, Zhongji, Guanyuan sharp…” reciting until I was dead tired. Qi Bo is formidable — with a few words he dismisses the Yellow Emperor. And after being dismissed, the Yellow Emperor admires him to death, hides it away, stores it in the golden cabinet. We studied and studied, moved a bench around and did not even finish one bench — Qi Bo is a genius, you have to concede.

Sun collaterals and xi valleys: the great meetings of the flesh are valleys, the small meetings are streams

Page 451: the Yellow Emperor says — now I know the origin of the qi points — in fact he knows even less, truly stopped (at the qi points), right? I wish to ask about the sun collaterals and xi valleys — do they have a correspondence too?

💬 Note from Doctor Ni Haixia: Yes, they do. The sun collaterals also have 365 meetings, also answering to one year. The qi of the vessels comes to nourish and overflow with abnormal pathogens, opening ying and wei — the ying and wei (qi) surges (through), the wei easily scatters (dissipates); when qi is insufficient, the blood stops (qi jie xue zhu) — outwardly fever arises, inwardly shortness of qi — this is what happens when the blood stops. Ji xie wu dai, jian er xie zhi, wu wen suo hui — its meaning is: wherever you see a blockage — for example, in fever the (collateral) vessels are blocked — bleed it.

Where there is stasis, let blood: a feverish child’s fever retreats with a drop of blood at Shangyang

“Jian er xie zhi, wu wen suo hui” — Doctor Ni brings it down to clinical practice; the most classic example is bringing down a child’s fever:

💬 Note from Doctor Ni Haixia: Real acupuncture, we do it very shallowly, not very deep — for very shallow disease, like a child with a fever, we let a tiny bit of blood at Shangyang LI1 and the fever retreats. So often a child comes in — you see a little baby, he understands nothing; when you go to needle him, he turns his head this way and that, making trouble for you, because he does not want it, right? And you have no way (to explain) — the child was just born, how do you talk to him? Never mind (whether he understands), let the blood — the fever retreats long before. So there are many ways (to bring down a fever) — but you must not lose your temper, saying “hold still” (by force)? That little baby stares at you with those big eyes — what do you do? Oh, to be a good doctor you cannot be too rough. And so Qi Bo answered.

The xi valley theory: Hegu, Houxi, Jiexi — secrets hidden in their very names

Qi Bo’s answer is one of the great secrets of acupuncture point names:

💬 Note from Doctor Ni Haixia: The great meetings of the flesh are gu (valleys); the small meetings of the flesh are xi (streams). So in our acupuncture, Hegu LI4, Yanggu SI5 — many points are named with “gu” (valley). Where the flesh meets in small places — Houxi SI3, Jiexi ST41, Yangxi LI5… these are the small meeting places — dividing between flesh and flesh; between the flesh is where the xi valleys meet, describing how the wei qi, sweat and blood all meet at the junctions of the muscles, and where they meet they join into the great (valleys). If evil is very exuberant, it makes the qi congest and the blood congest — qi and blood become blocked and congested within. Then heat rots the flesh: if heat stays and does not leave, the muscles cannot (bear) so much heat and will rot; when ying and wei cannot move, it will surely become pus — it suppurates. If that pus is not eliminated, it slowly seeps into the marrow — on the outside it breaks (through the skin) into the great muscles, on the inside it reaches the marrow, and lodging between the bone joints it will surely fail (decay).

Heat lodged in the xi valleys brings pus and rotten flesh — and what about cold evil? Doctor Ni finishes the other side:

💬 Note from Doctor Ni Haixia: Now this is the cold pattern — if cold qi lodges between these xi valleys, ying and wei originally gather in the xi valleys, but now cold qi stays there, and it causes a person’s muscles to wither and the sinews to cramp and pull. Then yang qi cannot arise (is insufficient), cannot produce heat — because of bone bi, the joints are very stiff, cold congealed within. Bone bi is always wind, cold and damp joined together, and its external sign is numbness (bu ren) — because great cold stays between the xi valleys. Earlier was heat; now this is cold.

Cold lodged in the xi valleys becomes bone bi: joints swell like rheumatoid arthritis

The xi valleys also have 365 points, also answering to one year:

💬 Note from Doctor Ni Haixia: All the xi valleys — for example the ones you know, Hegu, Houxi… these small (stream) valleys — what it means is: the whole body has 365 joints, and in the middle of every joint there are xi valleys. So if cold stays in the middle of the xi valleys, it becomes bone bi — it swells up, the joint becomes very large: rheumatoid arthritis! It also answers to one year.

And how do you treat bone bi? Doctor Ni gives the specific needling method:

💬 Note from Doctor Ni Haixia: When this kind of disease first arises, when the cold qi first starts — we use moxa. When it just begins to hurt a little, use moxa and a little needling, and you can get rid of it. For example, our short needling (duan ci) is for needling bone bi — the short needling method: rub beside the bone (rub up and down along the bone).

The Yellow Emperor is won over: his ignorance dispelled, the words stored in a golden cabinet

Page 453: the Yellow Emperor greatly respects Qi Bo — Doctor Ni’s commentary is vivid:

💬 Note from Doctor Ni Haixia: Actually Qi Bo spoke truly well — the Yellow Emperor’s ignorance is dispelled and his doubts resolved (fa meng jie huo), and he constantly stores it in a golden cabinet (chang zhu zhi jin gui). This Qi Bo is formidable: with a few words he dismisses the Yellow Emperor, making him admire him to death, and he hides it away, storing it in the golden cabinet. In fact, no matter how many qi points are spoken of, if you want to know how to treat disease, you still have to look at the Zhen Jiu Da Cheng.

Bonus: Why does acupuncture teaching use only the Zhen Jiu Da Cheng?

At this point Doctor Ni answers a question everyone asks — why, in his acupuncture teaching, does he use only this one book, the Zhen Jiu Da Cheng (Great Compendium of Acupuncture and Moxibustion)?

💬 Note from Doctor Ni Haixia: When we teach acupuncture, why do we use only the Zhen Jiu Da Cheng? Because of the Zhen Jiu Da Cheng — this Yang Jizhou was remarkable. In the old days the Chinese were like this: I keep it, pass it to my son, not to outsiders — and so, generation after generation, as long as the family holds this skill, you never have to teach anyone and you never run out of a living. That was his thinking. But Yang Jizhou was formidable: he got hold of the special skills of every school (no matter which). He was not a very rich man — the great households with money, he bought from them at high prices; apart from that, he was a thief — he stole the skills. There was no other way; when he ran into that situation, how else could he do it? So look at each of his chapters — the Jade Dragon Rhapsody, the Ode to Elucidating Mysteries — the parts before and after are not connected, suddenly they are just put together. Yang Jizhou strung them together, gathered the masters of every school, and compiled them into one book.

💬 Note from Doctor Ni Haixia: When it reached our hands, we synthesized them in order and resolved them. So you see, when we teach acupuncture it becomes very simple — otherwise, if you just read it like this, how could you memorize it? You could not, because there was no principle in it. Now that you understand the principle in the Huang Di Nei Jing, when you read the Huang Di Nei Jing again, everything is very clear.

Closing: the next lecture is the Gu Kong Lun

This chapter is introduced up to here. Doctor Ni previews the arrangement ahead:

💬 Note from Doctor Ni Haixia: We will introduce this chapter up to here. Next, the second half of the Qi Xue Lun — we will not discuss it. It has drifted away from (the main thread of) the Huang Di Nei Jing; if you look at those translations, there is no meaning in them, nothing about treating disease. So next time we will skip over it and continue with the Gu Kong Lun (Bone Emptiness).

Compiled from Doctor Ni Haixia’s Ren Ji (Human Records) lecture series on the Huang Di Nei Jing (Lecture 63), presented by Doctor Luo Dalun.