Vomiting Blood at Midnight and Bleeding That Won’t Stop? Chinese Medicine Says There Is No Method for Stopping Blood — Doctor Ni Haixia on the Discourse on the Five Faults of Physicians, from the Huang Di Nei Jing

Patient search terms: vomiting blood / bleeding that won’t stop / blood in the stool / weak four limbs / can’t sleep at night / insomnia / doctor misdiagnosis / how Chinese medicine takes a history / brain tumor / treatment requires knowing the cause of illness / Huang Di Nei Jing

Corresponding medical names: the Su Wen · Shi Cong Rong Lun (Discourse on Calm Diagnosis), closing section (the mechanism of spleen disease with wheezing, cough, blood and diarrhea; there is no method for stopping blood; vomiting blood at the chou hour; lung damage always showing as nosebleed or vomiting) + the Su Wen · Shu Wu Guo Lun (Discourse on the Five Faults of Physicians), Chapter 77 (not asking about rank and wealth, not asking about diet and daily life, not comparing and inferring, not asking about desires, not asking how the illness began and ended) + the opening of the Su Wen · Zheng Si Shi Lun (Discourse on the Four Losses), Chapter 78 (spirit not focused, not knowing the contrary and compliant movements of yin and yang, leaving one’s teacher unfinished, recklessly practicing miscellaneous arts).

Opening: the case from the last lecture — “misdiagnosed as lung damage” — this lecture explains the answer completely

In the last lecture we spoke of a person with slack, powerless four limbs, wheezing and coughing, and blood in the stool. Ordinary doctors diagnosed lung damage — but Doctor Ni said it was spleen disease. Right at the opening of this lecture, the Yellow Emperor explains — why the spleen?

💬 Note from Doctor Ni Haixia: This disease is on the yangming. The hand yangming governs yangming — it is yang fire, two fires joined together; the foot taiyin spleen is the three yin. Fire cannot overcome water, and when the water is too great, the pulse becomes chaotic and loses its regularity — so the four limbs cannot be controlled, they are weak — this is the spleen channel qi failing to move. As for the wheezing and coughing, that is a water disease.

Blood in the stool: the pulse is urgent, the blood has nowhere to go, so it runs out

So what is going on with blood in the stool (xue xie, blood discharge)? The original text says: “xue xie zhe, mai ji xue wu suo xing ye” — when the pulse is urgent, the blood has nowhere to go, and this produces blood discharge. At this point Doctor Ni sets out a great principle of Chinese medicine — there is no method for stopping blood (xue wu zhi fa):

💬 Note from Doctor Ni Haixia: Chinese medicine has a concept called “no method for stopping blood.” When the blood vessels rupture and the blood runs outward, Western medicine gives hemostatic agents to stop the bleeding. The Chinese medical view is: when your yang is very sufficient, the blood will not run wildly, the blood will not leak out. So when we restore yin and yang, the blood stops naturally. But if you simply stop the bleeding without bringing yin and yang back into balance — the congealed blood is still inside, it creates blockage and can’t get out. Even if you manage to stop the bleeding, the patient still has congealed blood inside, and that congealed blood is like a hidden bomb — it slowly, slowly expands, because yin and yang are not balanced — and one day it bursts open!

So when Chinese medicine treats a blood disorder, it speaks of restoring yin and yang — not merely pressing the blood down. Doctor Ni promises that in the lectures ahead we will meet a great many blood disorders, and he will teach how to handle them, how to use the methods, how to stop the bleeding, and how to bring the patient back — all in good time.

A bonus real-life scene: in the depth of night, the whole bed is covered in blood

Right after this, Doctor Ni describes a real scene of vomiting blood in the middle of the night — frightening just to hear:

💬 Note from Doctor Ni Haixia: Sometimes when a patient’s stomach illness comes on, in the depth of night — boom! — he vomits blood. Because the chou hour is the time when stomach-earth illness begins — when the chou hour arrives, the whole bed is covered in blood, it really scares people to death! If you don’t understand, you rush him to the hospital, they press the stomach and stop the bleeding — and that actually makes it harder to treat. But once the chou hour passes, he won’t vomit blood anymore — the blood stops by itself. Why? Because the chou hour is earth — the stomach-earth is when the illness begins.

What does lung damage look like? Nosebleed or vomiting — and it must be distinguished from spleen disease

Since Lei Gong’s question was “why the spleen,” the Yellow Emperor takes the opportunity to also make clear what lung damage looks like — the essence of the spleen, its finest substance, cannot circulate because of yang qi failure; but what about a person whose lung qi is truly injured?

💬 Note from Doctor Ni Haixia: Because earth generates metal, when the lung is injured it causes the spleen qi to fail to hold its post, the stomach qi to become unclear, the channel qi to be unable to serve, the true organs to break and fail, the channels and vessels to be severed at the side, and the five organs to leak and discharge — then it is “bu nü ze ou”: either the nose bleeds, or he vomits blood. When the lung is injured, it always affects its related child organ and mother organ. But the spleen and the lung do not implicate each other like that — we cannot mix the two together.

So the correct attitude in diagnosis is to “ming yin bi lei, cong rong zhi zhi” — to cite comparisons clearly, to know it through calm inference. This is the law diagnosis must follow — never panic. Doctor Ni adds one more observation:

💬 Note from Doctor Ni Haixia: Always make comparisons. The rat I talked about is exactly to give you a comparison — a rat is not a person, a person is not a rat. What a rat can eat, if you feed it to a person, you get the opposite result. Take those antidepressant drugs: you take them with the aim of preventing suicide, and after taking them for a while, you leap happily off a tall building to your death. If you could take a photo of him mid-air, you’d see he’s still smiling — this is the way of demons!

New chapter, the Discourse on the Five Faults of Physicians: the medical art has its laws, and doctors have five mistakes they must not make

Having finished the Discourse on Calm Diagnosis, Doctor Ni turns to page 545 and begins Chapter 77, the Shu Wu Guo Lun — the Discourse on the Five Faults of Physicians. Our medical art certainly has its laws that people can follow; if a physician errs, the errors can simply be grouped into five faults.

💬 Note from Doctor Ni Haixia: What does “no fault” mean? Which five faults do you commit? This is what the medical classic lays out — the five faults, one by one.

First fault: not asking about rank and wealth — the origin of tuo ying and tuo jing

The first fault: when diagnosing, you must ask “chang gui hou jian” — were you once rich and are now poor, or once poor and now rich? This question is hard for patients to answer — “I come to see a doctor and you ask me whether I have money — none of your business!” But what is the purpose?

💬 Note from Doctor Ni Haixia: The purpose is to learn about illnesses caused by emotion. So in Chinese medicine, besides looking at the patient’s complexion — green, red, yellow, white, black — you should also learn a bit of physiognomy: whether he was poor first and rich later, or rich first and poor later — one glance tells you. Physiognomy can be included in Chinese medicine; books like the Shen Xiang Tie Guan Dao (Iron Blade Gate of Divine Physiognomy) are worth studying. Foreigners are the opposite of Easterners — see enough of them and you naturally know; if you really can’t tell, just ask. When one goes from noble to lowly, the disease is born from within. Formerly well-off, now not — we say it’s easy to go from frugality to extravagance, hard from extravagance to frugality. If a person was rich before and now has nothing, it creates tuo ying — the blood becomes insufficient; if he held high office and now has lost it, it is tuo jing — the yang qi and metal qi of the five organs are lost. The qi of the five organs should keep circulating and revolving, never stopping; when they clump together, illness arises.

What if you can’t get the answer by asking directly? Approach it sideways — learn from what the people around him say, from his past experiences. This is very helpful to the doctor. That is the first fault.

Second fault: not asking about diet and daily life — violent anger wounds yin, violent joy wounds yang

The second fault: in taking a history, you must ask about his diet and his dwelling. Some people are generally fine, then in an instant very happy, in an instant very miserable — people whose joy and anger are unstable all wound their essence qi.

💬 Note from Doctor Ni Haixia: People given to violent anger wound yin; people given to violent joy wound yang — this is the definition we set down ourselves. This causes qi to rebel and rise; the blood vessels become very full, but because the qi is surging upward, the outer form is injured. That is the second fault.

Third fault: deciding everything from the pulse alone? Not acceptable

The third fault: you must compare and classify, infer calmly — not doing so is a fault. The original text speaks of “shan wei mai zhe,” those skilled at pulse diagnosis:

💬 Note from Doctor Ni Haixia: Some people look at nothing else — no inspection, no listening, no questioning — “I just know how to feel the pulse, I can tell you everything from the pulse alone” — this is not acceptable! A doctor must never judge many things about a person from the pulse alone. The person sits in front of you; many things in his past you cannot learn from the pulse. You absolutely may not make a diagnosis from the pulse alone — that is the third fault. That is why we have the inspection, listening and questioning before the pulse — first inspect, listen and ask, then feel the pulse.

Fourth fault: a person with too much ambition does not live long

The fourth fault: “bi wen gui jian feng jun bai shang, ji yu hou wang” — you must ask about rank, nobility, downfall and ruin, even of princes and kings — this concerns a person’s desires and ambition:

💬 Note from Doctor Ni Haixia: If his ambition is enormous — “I want to be emperor, I want to be president, I don’t want to be deputy, I want to be the chief!” — violent joy, violent sorrow, violent anger all originate right there — crying, making scenes, threatening suicide. A person with this kind of spiritual injury will not have a long life.

When faced with such a patient with spiritual and emotional problems, the doctor must use many methods to correct him. Doctor Ni offers a “hard first, soft later” tactic:

💬 Note from Doctor Ni Haixia: Nobody listens to kind words — you say Chinese medicine is good, you should believe in Chinese medicine, Western medicine is bad — who listens to you? There’s no time for a long persuasive speech. So speak hard first: scolding works. A hard word lands, frightens him half to death — he runs out — and he’s saved. Life and death hang in an instant. Afterwards, slowly change his mental state. Say you have 100 US dollars and you envy someone with a million — let me tell you, the hamburger a million dollars buys is the same as the hamburger 100 dollars buys — you’re not going to buy a solid-gold hamburger and eat yourself to death. Why fuss over a million versus a hundred? It’s all the same. Be happy, that’s all. Desire set too high drains the spirit and the essence.

Fifth fault: not asking how the illness began and ended — neck pain has three treatments

The fifth fault: when treating illness, know the beginning and know the end — that is, understand the cause and the whole chain of events. Doctor Ni gives a perfect example: neck pain.

💬 Note from Doctor Ni Haixia: You often ask the patient: how did your neck pain come about? “I was in a car accident, the car hit me from behind and injured me, and there was some shock” — that’s one kind. Another person’s neck hurts — he went to bed fine, woke up in the morning with a stiff neck — that’s a wry neck, a crick, another kind. And another person has severe neck pain and dizziness — he caught a cold, it wasn’t there before, it appeared in the last few days — yet another kind. The same symptom — neck pain — with different causes, naturally requires different treatments. So of course you must ask.

The same with abdominal pain — when did the pain start? Is it continuous or intermittent? If it’s continuous, we know there is something inside — is it a tumor, or is it stool stuck there? Then you ask about constipation. You must ask about the cause, the origin, the before and after of the disease. If someone comes with a stomachache and you ask how many girlfriends he has — isn’t that talking nonsense, as clumsy as Lei Gong?

Western medicine pronounces “54 days”: very accurate, and that itself is a fault

Doctor Ni continues: some people were once rich and are now poor — worry wounds the lung, producing rough skin. If the doctor neither knows nor asks the cause of the illness, and without asking anything tells him “you will die at such-and-such a time” — that too is a fault.

💬 Note from Doctor Ni Haixia: You go to the Western hospital for a checkup, they see a brain tumor — “54 days!” Very impressive, very accurate — he never miscalculates. But this is also a fault! How the disease came about, he has no idea. From the day you hear those words to the day you die, those 54 days are a purgatory on earth: at first you cling to life, then you think, let me just die early, even a few more days of living are agony. People who commit these five faults are those whose art is not mastered and whose human affairs are not understood. Look at Western doctors seeing 120 patients in an hour — 30 seconds per person. He doesn’t ask whether you used to be an official, whether you used to be rich — he writes a prescription and out you go. Then next time he sees you: “You have 30 more days!” “Your tumor won’t survive a year!” — done speaking. All of this is fault. Why do some women get breast cancer and others not? Heredity, allergies — they explain it at length, and actually none of it is right — because they fundamentally don’t know how the disease came about.

The brain tumor patient’s story: how to tell whether the medicine is working

Practicing in America, Doctor Ni tells a real brain tumor case — after the patient’s surgery, the tumor grew even bigger in three months, and the right side was completely paralyzed; the Western doctors said surgery was impossible now, chemotherapy couldn’t be done, they would have to cauterize; and after that, “you won’t live more than 3 months.”

💬 Note from Doctor Ni Haixia: Since you won’t live more than 3 months anyway, why stay in the hospital? In three months, shouldn’t you go out for a walk? You came from Pennsylvania — go travel and enjoy yourself! I could see he had given up hope, despaired. So I analyzed for him how the tumor came about: “Your tumor is getting bigger and bigger, and your right side is getting weaker and weaker — you told me this yourself. So when you take my medicine, if after a while your right side gets even weaker, that means the tumor is still growing and the medicine isn’t working — then stop taking it. If the medicine doesn’t work and you keep taking it anyway, how stupid is that? But if after taking the medicine for a while the right side gets better and better, while the left side — which was always normal — plus your spirit and strength all recover, that means you are in the process of healing. So you don’t need to go get X-rays for nothing — in our local hospital, six nurses worked in one room with the X-ray chamber right next door behind the wall; five of those six nurses got cancer — that’s the radiation! If you find life too dull, move a bed next to the X-ray chamber and sleep there — I guarantee you’ll get cancer. How do you know whether you’re cured? You’ll know yourself — eating, drinking, excreting, sleeping all normal; head cool, feet warm, all normal — very simple!”

💬 Note from Doctor Ni Haixia: So as doctors, we must know the true cause of the disease. The biggest problem today is: how the disease came about, nobody knows — they just tell everyone how old you’ll be when you die, what time you’ll die. The Way of treating disease is to cure it so it never recurs: if you understand the full chain of events, then basically cure it, the disease won’t come back; if you treat it without understanding the chain of events — first, the condition won’t improve; second, even if you happen to guess right and cure the same illness, it will recur. So we absolutely must understand the cause of the disease.

The Discourse on the Four Losses: Lei Gong memorized all the books — why does he still fail?

Page 552 — Chapter 78 of the Huang Di Nei Jing, the Zheng Si Shi Lun, the Discourse on the Four Losses. In this chapter Lei Gong has learned his lesson and doesn’t ask. Actually, he first asks: I have read many books, I’ve read them all, memorized them all, done everything — yet I still fail when treating patients. Why?

💬 Note from Doctor Ni Haixia: The Yellow Emperor said: your age is too young, your wisdom has not yet reached the stage where you can distinguish right from wrong. I often tell everyone that I prefer students who are a bit “naughty.” When you are fighting a disease, the patient is merely a battlefield — this is the Way of life and death. As Sunzi said: the Way of life and death — spare no means whatsoever! That’s why Zhuge Liang produced so many stratagems — many of them actually harmed people, but there was no choice — because it was a matter of life and death, so you have to be a little crooked. That “crooked” doesn’t mean truly harming anyone. Don’t be rigid and one-track; your mind must be alive — just be able to distinguish clearly.

The first loss: spirit not focused, not knowing the contrary and compliant movements of yin and yang — the story of not sleeping at night

The Yellow Emperor says: the twelve channels, the collaterals, 365 of them — ordinary physicians all follow these, you understand medicine, yet you cannot achieve perfection — why? Because your spirit is not focused; you cannot concentrate on treating the disease; you press and manage without attending to it, inside and outside lose touch with each other — so doubts constantly arise, and diagnosis cannot discern the contrary and compliant movements of yin and yang. Doctor Ni brings this to life with an example of insomnia:

💬 Note from Doctor Ni Haixia: A person comes and tells you: “Doctor, I can’t sleep at night.” Just look at him with your eyes — at night, when one should sleep, yin flourishes and yang declines; by day, yang flourishes and yin declines. Now this person, at the time when he should sleep, doesn’t sleep — isn’t he carrying the daytime’s yang-flourishing, yin-declining state into the night? Yin and yang separate out immediately! Then you look at his deficiency and excess, exterior and interior, cold and heat. So you must know the contrary and compliant movements of yin and yang. You meet someone who sleeps by day and is full of energy at night — his environment caused it: abroad there are many 24-hour stores, police stations run three shifts around the clock; people on the night shift sleep by day this week, then switch back next week — yin and yang keep being shuffled back and forth. In the prime of life it doesn’t matter. But you must always tell yourself: if you’re assigned the night shift, tell yourself “great, wonderful!” — you must be cheerful. Whether you do it or not, you have to do it — why suffer? Your work has already made your yin and yang irregular; you must keep your mood calm and open. Working the night shift is actually the best — you can read, watch DVDs, most enjoyable! Whatever you do, don’t ruin your emotions.

The second loss: leaving one’s teacher unfinished and recklessly practicing miscellaneous arts

The second loss concerns the lineage of medical study:

💬 Note from Doctor Ni Haixia: Shou shi bu zu — you found a teacher, and ran away before finishing your studies; wang zuo za shu — recklessly practicing miscellaneous arts, with no proper understanding of principle either. The result: your theory is not well learned — that is your second fault in treating disease.

Look at the age first: you don’t ask a 7-year-old about her periods, nor a 65-year-old

The Discourse on the Four Losses says: “sheng ren zhi zhi bing ye, bi zhi tian di yin yang, si shi jing ji, wu zang liu fu, ci xiong biao li, ci jiu bian shi, du yao suo zhu, cong rong ren shi, yi ming jing dao” — when the sage treats disease, he must know heaven and earth, yin and yang, the order of the four seasons, the five organs and six bowels, male and female, exterior and interior, the needling, moxibustion, stone needles, and the actions of toxic medicinals; and calmly attend to human affairs, to clarify the Way of the channels. Rich and poor, noble and lowly — each has a different constitution and principle. Treating disease always follows laws — it is absolutely never a matter of one simple gesture. At the same time, you must ask the age:

💬 Note from Doctor Ni Haixia: Ask whether this person is an old man or a young man. A seven-year-old girl tells you her shoulder hurts and she’s constipated — you ask her how her periods are? She’s only seven, for heaven’s sake! A sixty-five-year-old — you ask her how her periods are? She’s sixty-five! So keep your eyes sharp — when we see a patient ordinarily, the first thing is to see how old he is, look at the age first.

Then Doctor Ni speaks of the most difficult kind of patient — the timid one:

💬 Note from Doctor Ni Haixia: Timid people are the hardest to treat — why? They scare themselves to death, suspicious of everything, this is wrong, that is wrong. Originally just one illness — say qi stagnation or a stomach disorder — it turns into a gallbladder disorder, indecision — and then we have to treat their gallbladder as well. The gallbladder is the upright and just official, from which decision and judgment come. He has no upright-and-just official, he doesn’t dare, and he’s frightened — very troublesome. So treating physiological illness is simple; treating psychological illness is exhausting! With a psychological case I tell him: “Keep going like this, very good — I guarantee you’ll die. And what will the medical record say when you die? Scared to death!” Then think — what can be done? Only he can resolve it himself.

And a piece of hard-won experience — as a doctor, never give patients your phone number:

💬 Note from Doctor Ni Haixia: Otherwise you’re done for — he calls you every hour, you won’t sleep the whole night — some callers are different patients, sometimes the same one. Because he’s sick and can’t sleep at night, so he calls you; just hearing your voice calms him — and you get no sleep at all. After a week, I guarantee you’ll look like a panda, with dark, terrible coloring. The Huang Di Nei Jing didn’t write this — but we really experience it: a doctor must nourish his own spirit well before he can be composed; when a person is exhausted, he can’t be composed even if he wants to, because he’s irritated.

Closing: the valuable things from this lecture

This lecture carries an enormous amount of information: in treating disease, first ask five things — rank and wealth, diet and daily life, calm comparison, desires and ambitions, and the full chain of the illness. Western doctors are very accurate at pronouncing death dates — but “not knowing how the disease came about” is itself a fault. The Way of treating disease: qi within is the treasure (qi nei wei bao):

💬 Note from Doctor Ni Haixia: The Way of treating disease — qi within is the treasure. We must find ways to keep qi stored inside the body. The moment qi leaks, you must pay attention immediately: what is qi leakage? You can’t see it, but you can see it — sweat pouring without stopping is qi leakage. A person constantly losing something is qi leaking! Qi within is the treasure — qi absolutely must not run outward, like a balloon. That is why we do not advocate surgery — with surgery, the qi scatters; qi must be hidden inside. If a person’s qi cannot hold within, it will certainly be found in the exterior or the interior. Also — the “data” spoken of here is not the data of modern Western lab reports; don’t misunderstand. “Teacher, you’re talking about CT scans here?” No, no — that’s far off the mark.

Qi leakage is not only heavy sweating: when the yin and yang qi lose their exchange, along the back’s Bladder channel there are many Shu points — the Heart Shu, Lung Shu, Liver Shu, Gallbladder Shu, Spleen Shu, Stomach Shu, San Jiao Shu — those Shu points are where the organs are rebalanced. When the organs are out of balance, all organ diseases arise — that is why we have the Front-Mu and Back-Shu treatment: the Mu points in front, the Shu points in back — this way many symptoms of excess heat or excess cold can be dispersed at the very beginning of the illness.

💬 Note from Doctor Ni Haixia: The central point of the Discourse on the Five Faults: absolutely do not commit the mistakes a doctor should not commit — the patient is innocent. The doctor must clearly understand the full chain of the illness — understand the chain, basically cure it, and the disease won’t recur; treat without understanding the chain — first, the condition won’t improve; second, even if you guess right and cure the same illness, it will recur, and the patient will come back again — so we absolutely must understand the cause of the disease.

From blood has no method of stopping to the five faults of physicians to the four losses, Doctor Ni’s treasures in this lecture: bleeding is a sign of imbalanced yin and yang, so stop it by restoring yin and yang — never merely press the blood down, or the congealed blood stays inside like a hidden bomb; when a patient vomits blood at the depth of night, that is the chou hour (1–3 am), the hour when stomach-earth illness begins, and once the hour passes the bleeding stops by itself. A doctor must ask five things — was the patient once rich and now poor (the origin of tuo ying and tuo jing), diet and daily life (violent anger wounds yin, violent joy wounds yang), compare and infer calmly instead of judging everything from the pulse, the patient’s desires and ambitions, and the full chain of the illness — the same neck pain has three different causes and three treatments. Western medicine can pronounce “54 days” with terrifying accuracy, but never knowing how the disease came about is itself a fault. And in treating disease, qi within is the treasure: profuse sweating that won’t stop is qi leakage, surgery scatters the qi, and the Shu points on the back (Heart Shu BL15, Lung Shu BL13, Liver Shu BL18, Gallbladder Shu BL19, Spleen Shu BL20, Stomach Shu BL21, San Jiao Shu BL22) together with the Front-Mu points rebalance the organs and disperse excess heat and cold at the very onset of illness.

Compiled from Doctor Ni Haixia’s Ren Ji (Human Records) lecture series on the Huang Di Nei Jing (Lecture 71), presented by Doctor Luo Dalun.