Waking at 1–3 AM, Dreaming Too Much, Icy Cold Below the Knees? What Your Body Is Telling You — Doctor Ni Haixia on the Discourse on Classifying Yin and Yang and the Discourse on Fullness and Decline, from the Huang Di Nei Jing

Patient search terms: waking at 1–3 am / waking at 3 am / dreaming too much / always having nightmares / icy cold below the knees / cold feet / fullness and pain in the chest and ribs / alternating chills and fever / liver disease and constipation / how Chinese medicine makes a diagnosis / inspection, listening, questioning and pulse-taking / Huang Di Nei Jing

Corresponding medical names: the closing of the Su Wen · Zheng Si Shi Lun (Discourse on the Four Losses), Chapter 78 (the third loss: not asking about rank, wealth, dwelling, boldness or timidity; the fourth loss: not asking about the cause of the illness — grief, irregular diet, daily routine, poisons — and rushing straight to the pulse) + the Su Wen · Yin Yang Lei Lun (Discourse on Classifying Yin and Yang), Chapter 79 (the three yang as warp, the second yang as woof, the one yang as the wandering part — the beginning and end of the five organs; the twelve-channel monthly cycle; waking at night and the channel hours; distinguishing the three yang pulses at the cun, guan and chi positions; freeing the bowels in liver disease; the diseases of yin and yang joining) + the Su Wen · Fang Sheng Shuai Lun (Discourse on Fullness and Decline), Chapter 80 (yang from the left, yin from the right; qi rising without descending and cold reversal to the knees; the dreams of deficiency in the five organs; the ten measures of diagnosis).

Opening: last time we said “doctors can fail” — this time the remaining faults are finished

In the last lecture we reached the Zheng Si Shi Lun — the Discourse on the Four Losses — the ways in which a doctor can fail when treating illness. At the very opening of this lecture, Doctor Ni Haixia finishes the last two losses — and as he speaks, he even says of himself: “And then there’s one more — this is the one I hate the most.”

💬 Note from Doctor Ni Haixia: The third one: you are not suited — you have not asked him, have not understood the rank and wealth of his dwelling, whether he sits on thick cushions or thin, whether his body is warm or cold; you don’t know what diet suits him, and you cannot distinguish whether this patient’s nature is bold or timid — then you will have a place where you fail. All of these are our failures — the doctor loses his hold.

The fourth? Doctor Ni’s voice even changed — this is the one he hates most:

💬 Note from Doctor Ni Haixia: Number four: you don’t ask the cause of his illness — grief and worry, loss of regulation in food and drink, the direction of his daily life is not right, or he is fond of poisons, or takes drugs, or ate unclean food. You don’t ask him any of this first, you just go “ba-la-ha” and feel the pulse right there, then tell him what’s going on and how severe he is — you talk for ages, ten thousand words turned into a motto! This is the fourth place where you fail.

Inspection, listening, questioning, pulse-taking: feeling the pulse is merely “skill” — a skilled craftsman cannot cure disease

At this point Doctor Ni lays out the home arts of Chinese medical diagnosis in outline — inspection, listening, questioning, pulse-taking; each of the four words carries its own weight, and the order is deliberate:

💬 Note from Doctor Ni Haixia: You must all understand — Chinese medicine is inspection, listening, questioning and pulse-taking. One who knows by looking is called a spirit; one who knows by listening is called a sage; one who knows by asking is called a craftsman; feeling the pulse is called skill — the way of the pulse is the way of the skilled craftsman, and a skilled craftsman cannot cure disease! Some of us just feel the pulse and tell you all sorts of things about your body over a 24-hour period, and this doctor is very impressive — he knows it all before I’ve even asked! Then when he writes the prescription, one dose comes out with eighty or ninety herbs — shotgun pellets! Anything in the Ben Cao Gang Mu that can treat a cough, he throws it all in together, and not one ingredient hits the mark. Our prescriptions are absolutely never written according to the Ben Cao Gang Mu! These are the four places where we fail — none of you should ever make this mistake.

A doctor must often ask himself: was it I who was wrong?

Now the reverse case — you asked very thoroughly, you knew his rank and wealth, you knew his mood, your pattern differentiation was right, the prescription went in — and there was no effect. What then? Doctor Ni gives out the self-check formula: the first thing to consider is the diagnosis; or the prescription; and also — is your herb correct? Is the medicine correct? All of these must be considered. When you discover an error, correct it quickly — it doesn’t matter at all; you can even tell the patient frankly, the patient will absolutely not blame you, you should tell him plainly.

No sooner had he said this than he told a true story from his own experience — “the pharmacy mixed the medicine wrong.” Anyone who studies the Ten-Jujube Decoction must remember this story.

A bonus real case: the Ten-Jujube Decoction produced neither vomiting nor diarrhea — the problem was the red dates

Doctor Ni had an old friend, an old patient, who had the Ten-Jujube Decoction pattern — the chest cavity was terribly uncomfortable, he couldn’t lie down; lying down, he felt miserable.

💬 Note from Doctor Ni Haixia: Simple — I gave him the Ten-Jujube Decoction. He took it in the morning, and at noon he called me: “I’ve neither vomited nor purged!” What kind of strange illness is this? I thought, I can’t be wrong. Then I said: “Well, do you feel uncomfortable?” “What? Not at all!” I gave him a second dose; he took it, and it was the same. I still had my doubts, so I went to the pharmacy and asked: “How did you mix this Ten-Jujube Decoction?” The pharmacy said: “We followed the proportions you wrote, and added the red dates in.” He had made the red dates the largest proportion — all the others were one part, or half a part, and the red dates he made one whole part! So I mixed it myself, grabbed it and mixed it myself, all raw, and the red dates set apart on the side — one dose cured him! He took it in the morning, vomited and purged, and after the vomiting stopped, he was fine at noon — that evening he went out to play baseball.

The pharmacy put in too many red dates, and the power of the yuan hua (Genkwa Flower), gan sui (Kansui Root) and da ji (Peking Euphorbia Root) was pressed down by the dates — so the formula didn’t work. Doctor Ni sighed: pattern differentiation is important, but so is preparing the medicine — pharmacies can also make mistakes; when you find it, correct it quickly, and the patient will absolutely not blame you.

New chapter, the Discourse on Classifying Yin and Yang: the examination in early spring — Lei Gong answered wrong

Having finished the four losses, Doctor Ni turns to a new chapter — the Yin Yang Lei Lun, the Discourse on Classifying Yin and Yang, Chapter 79. The chapter opens with an “examination”: in early spring, the Yellow Emperor sits there and asks Lei Gong: within yin and yang, in the way of the channels and vessels, among the five organs — which organ is the most noble?

Lei Gong looks up outside — spring, after all, and he has recited his lessons until they roll off the tongue:

💬 Note from Doctor Ni Haixia: In spring, jia-yi is the green in the center, governing the liver, so Lei Gong recited it very fluently — for these 72 days, within these three months, this pulse governs the season, so he thought this organ was the most noble. The Emperor scolded him on the spot: “That liver of yours is actually the most lowly!”

Why is the liver the most lowly? Because the Yellow Emperor’s answer is a different set — look at the channels, not at any single organ:

💬 Note from Doctor Ni Haixia: What did the Yellow Emperor say? The three yang is the warp — the three yang means the sun (taiyang), the circulation of essence qi; the second yang is the yangming; the shaoyang is the wandering part — this one yang is the shaoyang, and this is the beginning and end of the five organs. The three yin is the exterior — the three yin means the taiyin as the exterior; the second yin is the interior; the one yin reaching its extreme is the jueyin. What he is describing is that we human beings have yin and yang running in parallel — the body is not a circle, but it has a beginning and an end.

The twelve channels correspond to the twelve months: beginning with the Lung channel at the yin hour — the circulation must never stop

Why say the liver is most lowly, and the channels are most important? Doctor Ni takes this passage apart and chews it thoroughly — because the human body is a circulation system; it is not that any single organ alone calls the shots:

💬 Note from Doctor Ni Haixia: In a year there are twelve months, and we take the first month of the lunar calendar (the yin month) as the start. The twelve channels of the human body, mapped onto the twelve months: when we begin, the first hour is the hand taiyin Lung channel — so we count from the Lung channel beginning at the yin hour, and over the twelve months of the year we come back around — the person has a heavenly cycle that circulates without stopping. The circulation of the channels is the most important thing — not which organ. The five organs are all important, but the circulation of the channels absolutely must never stop. Wherever it stops, that organ falls ill.

What use is this idea? Used, it’s miraculous — predicting illness, even inferring which organ is sick:

💬 Note from Doctor Ni Haixia: If you want to predict a person’s illness: this man has gotten up at 1 to 3 am every night for two years — we know the Liver channel is sick, because the chou hour (1–3 am) is when the Liver channel is on duty. If the Liver channel is sick and you don’t treat it in time, it will enter the organ, and entering the organ it becomes liver disease. But before it enters the organ it is a channel disease — when the channel is sick, it’s simple: needle his Ying-Spring point! My teacher Xu Jimin told me the Ying-Spring point; the classics say the Ying-Spring point; in clinical practice I do both, and both work.

A bonus joke before prescribing: let me reset you

Channel diseases, Doctor Ni treats with a bit of “high-tech” flavor — he often jokes with patients, calling acupuncture a reset:

💬 Note from Doctor Ni Haixia: You know “reset” — your digital watch, right? I’ll reset you. Every time a patient comes to me: “Ah, you forgot to reset me!” He used to get up at 3 to 5 am (the yin hour, when the Lung channel is on duty) — and after one treatment, he changed to getting up at 5 to 7 am. What do you do if you wake at 5 to 7? Hey, that’s normal! That’s the Large Intestine channel’s time — the first thing in the morning you take a big bowel movement — that’s the best!

Waking at some hour of the night, and which channel is on duty at that hour — this is the living application of the channel circulation. So Doctor Ni keeps stressing: the circulation of the channels is the most important thing — not which organ.

Feeling the three yang at the cun, guan and chi: the sun pulse floats, the yangming is short, a string-tight shaoyang that expires means death

Next the Yellow Emperor explains the three yang pulses in detail — how do you feel the diseases of these three yang channels on the hand? Doctor Ni takes it sentence by sentence:

💬 Note from Doctor Ni Haixia: The three yang is the sun (taiyang) as the warp — the sun pulse reaches the hand taiyin; the sun’s pulse enters the hand taiyin, that is, it enters the cun position. If the patient’s pulse is floating and not sinking, this is an exterior pathogen — the foot taiyang Bladder channel is sick, the disease is at the exterior, and you will feel a floating pulse at the cun, guan and chi — the floating pulse means there is a pathogen at the exterior. The second yang is the yangming — the yangming pulse should originally be floating, large and short — what is “short”? This is the cun pulse; this is our arm area, and this is the guan position. We feel below this high bone and call it guan; the cun is at the wrist joint side, it is 9 fen — the pulse length is 9 fen; behind it, to the chi region, it is one cun — so the whole pulse shape adds up to one cun nine fen. If the pulse is a little shorter than this, we call it a short pulse. The yangming pulse floating and short — this is the correct pulse. But now it is string-tight and sinking, not drumming — in this heat disease, the pulse should be floating and short, and now it has sunk — the disease has run to the inside, and at that point it is dangerous!

The one yang shaoyang? The shaoyang pulse enters the hand taiyin Lung channel, and the pulse qi connects directly to the Renying pulse at the neck. If the pulse is string-tight and exhausted, this is shaoyang disease — solitary yin, and death. Doctor Ni especially tells everyone: for this passage you don’t need to feel the Renying pulse:

💬 Note from Doctor Ni Haixia: What this describes is that the shaoyang has only one yang left; when that single yang is about to expire, the pulse is very fragile and will immediately enter the yin organs. If you feel the shaoyang pulse — for example, shaoyang pattern: alternating chills and fever, the patient sometimes nauseated, with fullness and discomfort in the chest and ribs, because the shaoyang is here — in the region of the chest and ribs. You feel his pulse; the Liver and Gallbladder pulses should be relatively thin and string-tight — this is the normal state. If it becomes very floating, very large, very fierce — that is truly a genuine-organ pulse (zhen zang mai) — because after yang comes the entry into yin; once the yin pulse appears, solitary yin means lone yin, and when there is no yang, it is a death pattern.

Taiyin is the source of qi and blood: the moderate pulse is best — hook, overflowing and inverted pulses are all ominous

After the three yang, the three yin. The three yin is taiyin — Doctor Ni gives it a very high appraisal:

💬 Note from Doctor Ni Haixia: The three yin is the taiyin — the master of the six yin — this is the source of qi and blood; taiyin is very important. The normal taiyin pulse is moderate — floating and moderate, the pulse in the middle, moderate and forceful. If it is a diseased pulse, it sinks very deep — because something has already gone wrong; whenever the pulse sinks, it has entered the internal organs; if the pulse floats, it is at the exterior and departs through the exterior.

The second yin is shaoyin, whose qi returns to the bladder; the one yin reaching its extreme is jueyin. The jueyin pulse is the pulse of the liver — the normal liver pulse sits a little string-tight at the liver position, moderate and forceful — because there is stomach qi; moderation is having stomach qi. If a hook pulse (gou mai) appears, that is a genuine-organ pulse, and whenever it appears it brings death. Doctor Ni also teaches how to read the “slant” between the cun and chi pulses — in a normal person the cun and chi pulses must have a certain slant: the cun pulse is closer to the surface of the skin, and the chi pulse is a bit lower. If this pulse rises up and exceeds this standard place, we call it an overflowing pulse (yi mai); if it sweeps up from above the pulse and presses back down, that is the inverted pulse (fu mai) — both belong to the genuine-organ pulses, the pulse measure again large and long. Sometimes the six pulses feel yin, sometimes yang, interweaving with each other; when they can communicate with the five organs and harmonize with yin and yang, treat the primary first, treat the secondary afterward. But this pulse keeps circulating — it moves according to the solar terms, according to spring, summer, autumn and winter. This is the normal person; a normal person should be like this; if he does not follow this direction, it is a diseased pulse.

Three yang as father, second yang as guard, one yang as discipline: the “family relations” of liver, gallbladder, intestine and lung

On the next page, the Yellow Emperor compares the relations of the five organs with a family — this talk of “father, mother, male and female,” Doctor Ni makes especially vivid:

💬 Note from Doctor Ni Haixia: The three yang is the father — the sun (taiyang) is like a father; the second yang is the guard — the yangming is defense; the one yang is the discipline — the shaoyang is the pivot, he manages the discipline of yin and yang, they must maintain each other, support each other, and absolutely must not lose one another. The three yin is the mother, the second yin is the female, the one yin is the sole envoy.

How does this family cooperate? Here comes the key point — in treating liver disease you must always free the bowels:

💬 Note from Doctor Ni Haixia: Second yang plus one yin — the yangming governs the disease — the yangming is the second yang joined; the second yang is always greater than the one yin, so the yin cannot overcome the two yang. So you should not treat his liver disease (the one yin is jueyin, the liver) — you treat his large intestine (the second yang is yangming, the large intestine)! So I always say: in treating liver disease, you must free the bowels — that is the basic move. If you free his bowels, his liver disease will not advance, will not worsen. So a patient with liver disease fears constipation most of all — fears the bowels not being open!

The worst is “not even knowing you caught a cold”: getting vaccinated is not knowing you caught a cold

Next comes three yang plus one yin — three yang (taiyang) diseased, still carrying one yin (jueyin) — how could yin overcome three yang? Doctor Ni uses this to push out an important principle:

💬 Note from Doctor Ni Haixia: For example, this person has a bit of a liver problem. Logically, if you have a problem in your internal organs, you shouldn’t catch colds — if the internal organ problem is severe, it goes from the exterior toward the interior, and you simply have no ability to guard the exterior. And yet he still gets a taiyang pattern? So if a person has a taiyang pattern — “I’ve caught a cold now, I’ve got the Ge Gen Tang pattern, such-and-such a pattern” — when the exterior pattern is present, it means the yang qi is sufficient — only then do you have an exterior pattern! The worst is not even knowing you caught a cold. When you get vaccinated, that is not knowing you caught a cold.

These words are worth pondering: having an exterior pattern means the body still has the capacity to hold the disease at the surface; when it reaches the point where not even a cold erupts — that is when the yang qi has declined so far it can no longer guard the exterior.

Second yin opposing second yang: disease in the kidney — Zhang Zhongjing already organized it for you

Second yin (shaoyin) and second yang (yangming) joined together — that is opposition. Two yin and two yang advancing side by side, the two intersecting — then disease of the internal organs appears. Doctor Ni notes that the Yellow Emperor says “disease in the lung, the shaoyin pulse sinks” — here there is a little controversy — actually when shaoyin appears it is the heart channel (shaoyin Heart channel, shaoyin Kidney channel). In this passage he also gives everyone a reassurance: the Huang Di Nei Jing says a great deal, and if you can’t remember it clinically, don’t worry — because later, when you study the Shang Han Lun and the Jin Gui Yao Lue, Zhang Zhongjing has organized it for you — Doctor Ni suspects Zhang Zhongjing saw chapters sixty-six through seventy-four and organized them in great detail, so after you’ve studied the Shang Han Lun and the Jin Gui, you will never be confused here.

Water conquers fire: second yin plus one yang — disease emerges from the kidney, cold qi enters the heart

Second yin plus one yang — shaoyin plus shaoyang, two diseases together — the disease will emerge from the kidney:

💬 Note from Doctor Ni Haixia: Then the cold qi will enter the heart — because water conquers fire — entering the heart, so there will be blockage without passage, the four limbs separated. When the kidney also has problems, urination and defecation will be affected. So there is blockage without passage, the four limbs separated. When the kidney also has problems, urination and defecation will be affected.

One yin plus one yang — jueyin plus shaoyang — on the pulse it pauses from time to time, without force, stopping often: this is the yin qi and cold qi about to run into the heart; the disease is in dryness of the throat and in the spleen. Doctor Ni exposes the clinical meaning of this passage: for example, when the heart and kidney have problems at the same time, it looks like the heart and kidney are sick, but actually we treat the spleen, and both sides get better! Jueyin is the liver; shaoyang is the Gallbladder channel and the San Jiao channel. When this problem appears, the passage says the disease is in the spleen — in treating the liver we treat wood, and we must treat earth, because wood conquers earth. So when the liver has a problem, we attend to the spleen, and the problem disappears; the liver’s own problem heals by itself — so the real disease is in the spleen.

Second yang plus third yin: yin and yang in opposition — a floating pulse means blood masses, a sinking pulse means pus

Second yang (yangming) and third yin (taiyin) both present — the yin is strong, and the second yang is also strong; yin does not overcome yang, and yang qi also cannot stop the yin: yin and yang oppose each other — you can’t control me and I can’t control you — this is yin and yang both expiring. It shows on the pulse:

💬 Note from Doctor Ni Haixia: If the pulse that appears is floating, because the yin and yang oppose each other, their strength about equal, not assisting but fighting each other — it produces blood masses (xue jia) — that is, lumps growing in the belly. If the pulse sinks, it means pus is forming inside, pus forming at the bone. These are not good signs. When yin and yang are both strong — below, they join yin and yang; above, they join the brilliant; below, they join the obscure — one can determine the period of death or survival.

Clinical living application: blurred vision plus poor appetite — treat the earth first

After this long stretch of theory, Doctor Ni changes course: clinically it is actually very simple, not as hard as the book. The patient will tell you the answer himself:

💬 Note from Doctor Ni Haixia: The patient tells you: “I can’t sleep at night, my appetite is poor, I’m tired and weary, my urine is yellow, and my eyes are blurred when I look at things.” While you listen to him — this person’s liver has a problem, because the liver opens into the eyes; then you hear his appetite is also poor — wood conquers earth (the spleen), so the appetite becomes poor, the person becomes tired and weary — then you just treat the earth, and you’ve already found the method! But this is at the beginning of the disease — when you really reach a serious internal illness, simply attending to the earth is not enough. At the onset of illness, when the essence qi of the twelve channels has gone a little wrong and the organs have a little problem, it affects the essence qi — at this moment of striking, we only need to secure one organ.

Disease in the last three months of winter: pulse and symptoms matching means safety, opposing means the greatest danger

The next passage is about winter disease. Winter governs storage — originally the time of storage, and now it does not store but brings out yang patterns — such diseases are all very dangerous. Falling ill in winter, the pulse should be the winter pulse (sinking); if pulse and symptoms match, there is no problem. But if in winter you see a yang pattern — winter should not have yang patterns — this is pulse and symptoms not matching. Doctor Ni gives a living example, and the candle metaphor is a classic:

💬 Note from Doctor Ni Haixia: For example, there is a patient who vomits blood and passes blood — this person has lost blood, right? Logically this person should be very tired, pale, exhausted — when you lose blood the body feels cold, and the pulse should become very small — losing blood means deficiency. But you feel the pulse and it is very large and very rapid, and the patient says: “I’m not afraid of cold, I’m afraid of heat!” That’s it — this is a contrary pattern, pulse and symptoms opposing each other. Why? Because the yang is about to leave the body; when the yang floats outward, the patient shows heat signs — it’s like the very last bit of a burning candle: a little oil remains, and in an instant the candle flame becomes very large! In that stretch of time what you see is a yang pattern. So when a Chinese doctor sees a patient who is deficient, feels a deficient pulse everywhere, and all is deficiency — this is called pulse and symptoms agreeing, and it’s fine; when pulse and symptoms do not agree, it is always a critical pattern.

The relation of solar terms to disease, Doctor Ni conveniently summarizes into a table: when the solar terms overcome each other, excess patterns arise and the disease flares up; in solar terms that generate each other, the disease will heal — the time for liver disease to get better is summer; spring and summer are the seasons when the liver’s qi is generated, and it will get better; liver disease flares and starts in spring; in the seasons that overcome each other it is fatal, the most dangerous. The disease of the three months of spring, with yin and yang both expired, kills people in autumn — all spoken of before.

New chapter, the Discourse on Fullness and Decline: yang from the left, yin from the right — how the qi travels

Page 565 — entering the Fang Sheng Shuai Lun, the Discourse on Fullness and Decline, Chapter 80. Lei Gong asks: how does the qi of our body operate? What is contrary qi, what is compliant qi? The Yellow Emperor’s answer, Doctor Ni makes especially vivid:

💬 Note from Doctor Ni Haixia: Yang from the left, yin from the right — the yang qi uniformly travels from the left side of the body toward the right; the yin qi travels from the right toward the left. In old people the yang qi descends from above; in young people the yang qi ascends from below. So you see children after they are born, before age fourteen — watch them carefully — they all have fetal breathing (tai xi): the belly breathes. After fourteen, it naturally changes to chest breathing. So the older a person is, the higher his breathing rate; the younger, the lower — the normal person should be a fetal breather. That is why many people in Daoism and Buddhism sit in meditation using abdominal breathing — breathing with the belly — returning to the fetal-breathing stage. But as people age, the qi declines more and more and runs upward — the old person’s qi goes from above downward, the young person’s from below upward. So now that we are older, when we sit in meditation we hope the qi will go from below upward, not from above downward — this is the principle. In spring and summer, returning to yang is life; in autumn and winter, returning to yin is rest. In spring and summer the yang qi gradually flourishes and the yin qi diminishes, so when you see a yang pattern it is a good sign, and seeing a yin pattern is not good; in autumn and winter the yin qi flourishes and the yang qi is weaker, so the appearance of a yin pattern actually becomes life.

Qi rises but does not descend: icy cold below the knees — the yang is still up above, it hasn’t come down

When qi is in excess, illness arises; when qi is insufficient, illness also arises. This section Doctor Ni speaks of “one rising without descending” (qi rising but not coming down) — clinically extremely common:

💬 Note from Doctor Ni Haixia: The yang qi travels upward. Logically, yang qi going up will come down, and yin qi going up will come down — yin and yang are always alternating. When a yang goes up and does not come down, and the yin below stops below — this is the phenomenon of yin and yang being separated — cold reversal reaches the knees: the feet are cold, cold from the toes up to the knees. The knee is the yang pass (yang guan), the gate where yin and yang meet. When the yang comes up, below it becomes cold, cold reaching the knees. So the answer to the question patients often ask is right here — patients often ask: “My mother takes the medicine and everything is fine, but there’s one strange thing now — from the knees down to the toes it’s icy cold!” That means the yang is still above and has not come down. If it is a young person with qi in excess, autumn and winter are fine — the young person’s qi goes from below upward, and now the qi is above and cannot come down; in old people the qi goes from above downward, so when an old person gets cold feet in autumn and winter — the yang is above, and below is cold qi — he will not be harmed. Qi rises but does not descend — the yang qi rushes up and must come down, circulating forever, never stopping. If it only goes up and does not come down, it makes the upper part hyperactive — at that time there is headache and vertex disease — these are not good signs.

Dreaming too much means qi is insufficient: diagnosing which of the five organs is deficient from dreams

The next passage Doctor Ni himself says is “great fun, very interesting” — deficient qi (shao qi) makes people dream a lot:

💬 Note from Doctor Ni Haixia: When a person’s qi is insufficient, it makes him dream a great deal — he starts dreaming randomly about anything, and in severe cases the person will even become unconscious. So as long as a person dreams a lot — I always say: why are you always dreaming? People with insufficient qi dream a lot; people with severely deficient qi fall into unconsciousness. Then how do you know which qi is deficient? You can find it from the dreams — when the Lung qi is deficient, the person dreams of white objects, everything white, seeing a stretch of snow outside; seeing people beheaded and bloody — because the lung belongs to metal, governing slaughter and killing, holding a blade and cutting, seeing blood. If it happens to be autumn and you dream these very dreams, meeting autumn — then it is meeting warfare: the solar terms of heaven and earth connect with your lung, with the lung qi of your body — metal governs warfare, metal is fighting. When the Kidney qi is deficient? Kidney qi deficiency makes a person constantly dream of boats and ships, often the boat capsizing and drowning people. If you dream it ordinarily it’s nothing; but if in winter you still dream of a boat turning over and dead people, then you have met its season. If there is fear and timidity, often seeing houses that are dark and tense — all these dreams represent Kidney qi deficiency.

The Liver qi deficiency and Spleen qi deficiency each have their own dreams:

💬 Note from Doctor Ni Haixia: When the Liver qi is deficient, he often sees mushrooms and fresh grass; if it meets spring, he dreams of hiding under a tree, not daring to run out. Heart qi deficiency, Lung and Spleen qi deficiency all have these symptoms. What is called “not meeting its season” — for example, the Spleen qi governs long summer (chang xia); if you dream of long summer, you dream of building a house (raising walls and covering a roof). If you dream it not in the long-summer solar term, it doesn’t count, because the season does not match. This is the correspondence between the four seasons of heaven and earth — spring, summer, autumn and winter — and the qi of our organs — the deficiency of the five organs’ qi.

Having finished the dreams of the five organs’ deficiency, Doctor Ni points out the key: the organs are yin organs — whenever you say organ (zang), it is yin; the bowels (fu) are yang. So when the organ qi is deficient, the yang qi is certainly in surplus and the yin qi insufficient: so when we say this person’s organ is deficient, it means yang in surplus, yin qi insufficient. We regulate this — it can be regulated on the channels — regulate his yin and yang. In the later Ci Fa Lun (Discourse on Needling Methods), there are the methods for regulating his yin and yang.

The ten measures of diagnosis: pulse measure, organ measure, flesh measure, sinew measure, Shu-point measure

Page 568 — about the standards of diagnosis. The methods of diagnosis have ten standards; “measure” (du) is the way of measuring a person:

💬 Note from Doctor Ni Haixia: Is there the pulse measure, the organ measure, the flesh measure, the sinew measure, the Shu-point measure? When you take these five measures and divide each into yin and yang, that is ten measures. When yin and yang qi expire, when the yin qi and yang qi decline, a person’s external symptoms reveal it. Looking from the pulse measure — the pulse moves without regularity: when the two qi, yin and yang, have all vanished, are about to end, about to expire, the pulse becomes irregular, sometimes large, sometimes small. So what is the point of diagnosis? The way of diagnosis has no fixed method — you must adapt to the time and the place. Grasp the principle: you watch a person’s spirit — if the spirit is poor, the strength insufficient, without force — is the yang not deficient? Then yin speaks of the form, the outward appearance — if the body shape is swollen, the feet swollen, then the yin has a problem. Look at it this way — the whole of Chinese medicine is about yin and yang.

Closing: yin and yang interweave — yang qi arrives first, yin qi arrives after

The last page, 569, speaks of the general principle of the diagnostic way. Doctor Ni passes over it in a few words — but the weight in the words is great:

💬 Note from Doctor Ni Haixia: When the qi of heaven expires, treat the yin deficiency; when the qi of earth is insufficient, yin and yang must intersect. When yin and yang interweave, the yang qi arrives first and the yin qi arrives after — this is the diagnostic way of the sage, needling after yin, before yang. This has been spoken of at length; we have it later — no matter what you study, however you study it, you must get yin and yang clear!

Compiled from Doctor Ni Haixia’s Ren Ji (Human Records) lecture series on the Huang Di Nei Jing (Lecture 72), presented by Doctor Luo Dalun.