A Pulse You Can Barely Feel, Collapsing Suddenly in the Daytime, Cold Soles and Cool Insteps? What Your Body Is Telling You — Doctor Ni Haixia on Unraveling the Subtleties and the Needling Methods, from the Huang Di Nei Jing

Patient search terms: a pulse you can barely feel / suddenly collapsing in the daytime / suddenly dozing off during the day / waking up for no reason in the middle of the night / crying without tears / fake crying / cold soles and cool insteps / cold hands and feet / a bloated belly / prematurely gray hair / poor memory / Beginning of Spring health care / using acupuncture to prevent illness / heat above and cold below / a dry tongue / the last chapter of the Huang Di Nei Jing

Corresponding medical names: the Su Wen · Jie Jing Wei Lun (Discourse on Unraveling the Subtleties), Chapter 81 — the last chapter of the Huang Di Nei Jing proper (the essences of water and fire, spirit and will; distinguishing real tears from fake crying; ‘when the will is grieved, the lament rushes at the yin’; qi transformation with fire below and water above; cold feet and water settling in the lower jiao) + the Su Wen · Ci Fa Lun (Discourse on Needling Methods), Chapter 72 — a recovered lost chapter of the Su Wen (the strange signs of a blocked channel cycle in the ascending and descending of yin and yang; the five-stagnation needling methods — well, spring, stream, river and sea points matched to spring, summer, long summer, autumn and winter; needling the left side first, then the right; draining excess as preventive medicine; using the five-element control cycle to drain the excess of the five organs).

Opening: after more than seventy lectures, it still comes back to two words — yin and yang

By the seventy-third installment of the Huang Di Nei Jing, Doctor Ni Haixia opens by first tying a bow on everything taught in the previous lectures. And what he says it comes down to is still those two words.

💬 Note from Doctor Ni Haixia: The most important thing is to look at yin and yang. On the pulse: the cun pulse is yang, the chi pulse is yin. In the normal state, yang is a little higher, yin a little lower. Reverse it, and yin flourishes while yang declines; if everything runs to the outside, yang is too exuberant and yin is vacuous; if everything runs to the inside, yang is vacuous and yin flourishes. The floating and sinking of the pulse distinguish yin and yang; the cun and chi positions distinguish yin and yang; the patient’s symptoms also distinguish yin and yang. Talk as long as you like — it is still yin and yang. When we hold the diagnostic way, everything we speak of is yin and yang.

Two sentences of death: a pulse you can barely feel — most dangerous in summer

Next, Doctor Ni reads two lines of the Nei Jing text — every word of them a formula for judging life and death: “If the body is weak and the qi is weak, death. If the body and qi are full but the pulse qi is insufficient, death. If the pulse is full and the body and qi are insufficient…” He reads and explains at the same time: when a person’s qi is deficient and yang is deficient, and the body (the xing, the form — which is yin) is also weak, so that both yin and yang are deficient — that is a death pattern. And there is another, more sinister one: the person looks perfectly normal, but the moment you take the pulse, the pulse qi is insufficient — this too is a death pattern.

💬 Note from Doctor Ni Haixia: I have met exactly this! The man looked wonderful, spoke in a loud voice, full of vigorous spirit. By rights his pulse should have been fairly full and strong — but it was slow — the so-called “four beats to one breath,” and it should have been even stronger than that. And yet — I could hardly find the pulse! I felt and felt, and only after a long time managed to find a thin thread of it inside. Then I looked — and it was summer. Oh — this is very dangerous, because the pulse qi is insufficient.

So how exactly do you feel pulse qi? Doctor Ni teaches the hand gesture: in a person’s blood vessels, the blood is in the middle, and the qi is outside, around the vessel. Press your finger on the pulse and push it to one side — then see whether it pushes your fingertip back. If it rebounds, the qi is sufficient. If it simply follows your finger and has no strength to come back, the qi is not enough.

💬 Note from Doctor Ni Haixia: Blood is inside the vessel; qi is outside the vessel. When you feel the pulse and push it from this side, or push your fingertip over from this side, watch its qi — the pulse will push your fingertip back. If the qi is vigorous, the pulse you push over comes back along with it; if it has no strength to return, then the qi is not enough. So pulse qi is very important.

When pulse and symptoms agree, one dose cures; when they disagree, it is hard — but not hopeless

Having finished pulse qi, Doctor Ni sets out the master rule of diagnosis: every direction in diagnosis must be a case of pulse and symptoms agreeing.

💬 Note from Doctor Ni Haixia: What we call pulse and symptoms agreeing is very easy to treat, very fast. For example, you feel the patient’s cun pulse and it is floating — floating indicates the exterior — and the patient says: “Oh, I have a headache and a stiff neck” — excellent! One dose and it’s cured! He drinks one dose of medicine, and in two or three hours he is better. On the other hand, when pulse and symptoms do not agree, this is hard to treat — it is only harder to treat, it is not untreatable! You must not say “death” and then refuse to treat him. And even when we foresee the time of death, we do not tell him he is going to die.

He gives two extreme examples: a man whose pulse is very strong and robust, yet who lies in bed sleeping all day long — pulse and symptoms disagree. And the reverse: a man whose pulse is very fine, very small, yet who manages to sleep eighteen of the twenty-four hours — pulse and symptoms agree, and one dose cures him. Speaking of formulas, he naturally brings up the predecessor he has talked about all his life:

💬 Note from Doctor Ni Haixia: Doctor Zhang Zhongjing was extremely remarkable! He not only understood the disease — he had already written the formulas down for you, and the formulas are extremely simple, just a few herbs — that is why they are classical formulas, what we call jing fang. They are all in the book; please just read the book.

Into the main text: the Jie Jing Wei Lun — the last chapter of the Huang Di Nei Jing

Changing the subject, Doctor Ni announces: beginning at page 573, this chapter is the very last chapter of the Huang Di Nei Jing — the Jie Jing Wei Lun, the Discourse on Unraveling the Subtleties — followed by the Ci Fa Lun, the Discourse on Needling Methods. This chapter records a conversation between the Yellow Emperor and Lei Gong — Lei Gong being the disciple who is constantly scolded.

Lei Gong’s question is a strange one: he wants to ask how a physician should consider the whole of medical technique, the patient’s circumstances, and everything happening around him — a very large question. Yet he himself shrinks it down:

💬 Note from Doctor Ni Haixia: Lei Gong narrowed it down and asked: “When a person cries but no tears come out” — there is a person crying, but there are no tears — this is plainly fake crying! Look at the scene: the person crying has no tears at all — that is absolutely a cat weeping over a dead mouse, absolutely up to no good! And if the crying does not bring out the qi — but if it does come out, there is also nasal mucus coming along — what is going on?

The Yellow Emperor’s answer is also interesting: you ask this kind of question — tears and mucus are basically of no use in treatment, of little help in truly curing disease — but he still patiently explains it to him.

The essences of water and fire: real tears and fake tears, seen at a glance

Of the explanation, Doctor Ni exclaims repeatedly, “It is so well said, I don’t know what words to use to describe it” — this is the doctrine of the essences of water and fire:

💬 Note from Doctor Ni Haixia: The essence of fire is spirit (shen); the essence of water is will (zhi). When fire is pure, with no impurity at all, that is a person’s spirit. When water is pure, with no impurity at all, that is a person’s will. So when I resolve to become president, when I resolve to become something — that is the essence of water. If the water is pure essence and contains no impurity, a person’s ambition is very large. When the fire contains no impurity, the spirit is able to hold; the moment impurity enters, the spirit no longer holds, and the will no longer rises.

Water and fire are meant to respond to each other, not to clash. When spirit and will are both grieved, tears and mucus come at the same time — so when a person cries from real grief, once he starts crying, both tears and nasal mucus pour out. And fake crying? Doctor Ni offers an observation from real life: go to a funeral parlor and look — these are hired mourners! They are specially brought in to weep for the filial son; they represent the son, and they cry very sorrowfully — you hear them wailing, but look at them: no tears at all! This kind of crying has no tears. When a normal person cries, what you see is tears and mucus together.

Fire below, water above: the truth of qi transformation in the body

Next Doctor Ni explains a question many people cannot work out — why, when the heart is above and the kidney is below, do we still say fire is below and water is above? He takes it apart layer by layer:

💬 Note from Doctor Ni Haixia: In the normal state, fire is below and water is above — only then do water and fire unite. The kidney is below, the heart is above; by rights the fire should burn up above and the water should be below, and they should never meet — right? In fact, because the lung is the mother of the kidney, the lung holds a great deal of water up above; this water enters the lung, enters the kidney; the small intestine holds a great deal of fire, and the large intestine surrounds the small intestine, so this water also turns back into the lung. The fire of the small intestine is below; the kidney water is here; and the fire of the small intestine comes from the heart fire. So in the true human body, fire is below and water is above, and only then do we have qi transformation — when qi transforms, and you exhale from the mouth, warm breath goes out, doesn’t it? Has anyone ever seen a person spray water out of his mouth when he exhales?

When water and fire respond to each other and spirit and will are both grieved, tears and mucus come together. The lines that follow, Doctor Ni reads with unusual solemnity — “When the will is grieved, the lament rushes at the yin; when the lament rushes at the yin, the will leaves the eyes; when the will leaves, spirit no longer guards the essence…”

💬 Note from Doctor Ni Haixia: When you are deeply wounded, deeply sorrowful, the whole body shakes — “rushing at the yin, the will leaves the eyes”: the yin channels surge upward to the head and eyes; “the will leaves, spirit no longer guards the heart” — the spirit goes (to the eyes), the qi goes out — because the will has left the kidney and the spirit has left the heart. When a person truly suffers a very wounding, very painful blow, the spirit and the will leave.

The secret of the feet: the soles should be warm, the insteps cool

This installment also carries a very practical health tip — the temperature of the feet. Doctor Ni keeps saying “the feet must be warm,” but where it is warm and where it is cool is a matter of great precision:

💬 Note from Doctor Ni Haixia: The feet must be warm — but the warmth is in the soles, and the insteps must be cool. The yang channels run along the instep, and yin channels come to assist them there, so within the yang there is a bit of yin — the instep carries the yang channels, but it feels cool. The sole is where the yin channels lie, and yang comes to help them, so the sole is warm — this is the normal state. If both the sole and the instep are hot, that is also wrong. And if both are cold, icy cold, that is even worse — then the water stops below, accumulates below; yin is diseased below, and the lower jiao is overfull of cold. Once we know the cold of the lower jiao is flourishing, we prescribe medicines that enter the yin and drive out cold; once we know the water is below, we prescribe water-draining medicines to push it out.

Wrapping up: the Jie Jing Wei Lun is about the finest details

Having finished the whole Jie Jing Wei Lun, Doctor Ni gives his overall assessment: this chapter — the last chapter of the Huang Di Nei Jing — is about the finest details: the eyes, the nasal mucus, things like that. If you do not know them, it will not affect your ability to treat disease. But then he immediately adds a heartfelt remark that pulls the topic away from the book and onto himself:

💬 Note from Doctor Ni Haixia: In my whole life, the two doctors who influenced me most were Doctor Tang Rongchuan and Doctor Cao Yingfu — I was greatly influenced by these two! As for Doctor Zheng Qin’an’s books — someone gave them to me, and I have not even finished reading them; you see, the influence was not great. The true classical-formula masters — go read what they wrote; they really wrote well!

Bonus: the story of Doctor Tang Rongchuan — studied Western medicine abroad, returned as an orthodox classicist

Speaking of Doctor Tang Rongchuan, Doctor Ni tells a remarkable story:

💬 Note from Doctor Ni Haixia: Doctor Tang Rongchuan lived at the time of the Boxer Indemnity, when the Qing court sent a group of very clever people abroad to study. Tang Rongchuan went abroad, studied Western medicine, and came back — and discovered that Chinese medicine was right. He began to study Chinese medicine — and from beginning to end, he did it in the orthodox Chinese way: he studied the Shang Han Lun, the Huang Di Nei Jing, and the Shen Nong Ben Cao Jing.

At this point Doctor Ni cannot resist turning aside to share his view of the split between the schools of Chinese medicine today — a position he repeats throughout the whole lecture series:

💬 Note from Doctor Ni Haixia: If you truly understand the Huang Di Nei Jing from the start, how could you become a Warm Disease (wen bing) doctor? From beginning to end, the Huang Di Nei Jing teaches six-channel pattern differentiation; it mentions qi and blood, nutritive and defensive — but always in connection with the six channels. There are two possibilities for the Warm Disease school outside today: first, its members have simply never read the Huang Di Nei Jing — if you merely finish reading the Huang Di Nei Jing, you are a Cold Damage (shang han) doctor, how could you turn into Warm Disease? Second, they cannot understand it — taiyang, shaoyang, yangming; they cannot follow Doctor Zhang Zhongjing’s six-channel differentiation. The Cold Damage school has existed since ancient times; as for why it was later covered over by the Warm Disease school, there were many transformations of the tradition in between. I hope the Cold Damage versus Warm Disease dispute ends in our generation! Stop arguing — everyone should use the Shang Han Lun and the Jin Gui Yao Lue.

So is the classical formula tradition flawless? Doctor Ni does not think so — he is both clear-headed and generous:

💬 Note from Doctor Ni Haixia: Although the classical formulas are classical, unavoidably they have places that are insufficient — no one is a sage; everyone, including Doctor Zhang Zhongjing, has insufficiencies, and in the future you will have insufficiencies too. When you have insufficiencies, you already have the fundamental spirit, and as long as you keep walking on this road, the road is right — then you can consult many of the secondary masters and miscellaneous theories beside you, and the central spirit will not be lost. Doctor Zhang Zhongjing’s writings, read from beginning to end, all look like variations of Gui Zhi Tang (Cinnamon Twig Decoction) — but in fact they harmonize yin and yang; his rule comes entirely from the Huang Di Nei Jing.

A new chapter: the Ci Fa Lun — a recovered lost chapter

Having finished the Jie Jing Wei Lun, Doctor Ni opens the Ci Fa Lun appended after it, and first gives a word of warning:

💬 Note from Doctor Ni Haixia: This chapter is a chapter of the Su Wen — chapter 72. Looking back, the original chapters 66 to 74 were temporarily lost, and this one was recovered. Speaking for myself, the other chapters I do not explain — I show you the original text, and you can read it yourselves and see why I do not explain: because to this day everyone doubts they are not the original chapters. But this chapter is worth our discussion: it is very lifelike, and its effects are good — we use it, I use it.

The chapter opens with a question from the Yellow Emperor: yin ascends and yang descends, yang ascends and yin descends — the heavenly cycle, never resting — that is the normal person. Once the ascending and descending of yin and yang lose control, the interchange of qi and blood changes, and a person can die suddenly — so how do we prevent it, how do we save the lives of the people? Qi Bo first speaks a very grand passage (Doctor Ni laughs, “first he pats the horse’s rear end”), but the real point comes after — the needling techniques.

When a channel is blocked, the body shows these “strange signs”

Qi Bo explains: the qi and blood of the channels circulate in the order of “the Lung at the yin hour, the Large Intestine at the mao hour, the Stomach at the chen hour, the Spleen at the si hour, the Heart at the wu hour, the Small Intestine at the wei hour…” — the cycle continues; when the flow reaches a place where it is obstructed, the patient shows anomalous signs.

💬 Note from Doctor Ni Haixia: For example, in the daytime, when he should not be sleeping, he suddenly falls asleep; or suddenly, with the onset of an illness, he collapses in the daytime — and when that hour has passed, he wakes up by himself. Or at night he is sleeping soundly and suddenly wakes up, for no known reason, and then lies staring at the ceiling with wide eyes — and when the hour passes, he falls back asleep. All of these are signs in a person that the channel is obstructed. How do we regulate it? And we regulate it with acupuncture — this is exactly in line with the meaning of the Huang Di Nei Jing.

Why emphasize acupuncture? Doctor Ni points out a fact most people have never noticed:

💬 Note from Doctor Ni Haixia: In the Huang Di Nei Jing, the overwhelming majority — 98, 99 percent — is about needling technique. With great difficulty a few formulas come out — for example, Sheng Tie Luo Yin (Raw Iron Filings Drink), Ji Shi Li (Chicken Droppings Wine), or the Four Cuttlefish-Bone One-Sedge Pill (Si Wu Zei Gu Yi Lu Ru Wan) for withered blood, adding some madder… Most of the rest is needling technique. This chapter is about needling — how to regulate these signs with needling technique.

Wood stagnation: why do trees die when they grow too dense? Why must metal control wood?

Qi Bo begins with the liver wood. Doctor Ni uses a tree as a metaphor: if a tree grows too dense, the tree will die — we often see vines climb up a tree and wrap it entirely; after a while the tree dies. Why? Because it cannot breathe.

💬 Note from Doctor Ni Haixia: Wood must not be too dense; wood must be thinned! That is why we have metal to control wood — metal is the axe. When the wood is too dense, you beat it, chop it, let it open up. So there must always be something to govern it; if nothing governs it, the liver qi will run wild.

When liver qi is bound up, how do you make it grow and scatter the oppressed qi? Qi Bo’s answer is surprising — you must wait for the time, wait for the solar terms:

💬 Note from Doctor Ni Haixia: When the illness has just begun, when it is not yet severe, and we discover the liver qi is bound, we must wait for the right moment. After the Winter Solstice, at Minor Cold and Major Cold, water is generating wood — in winter the weather is too cold, the liver wood has not yet grown; if you act now, it is not the moment. You must wait until the liver qi has risen, and then act! So to remove the symptoms of liver qi binding with acupuncture, wait until the Beginning of Spring to begin — at the Beginning of Spring, the liver wood is in its own qi; the spring solar terms belong to the liver by nature. When the liver qi rises, we needle the well point of the Liver channel, Da Dun LR1.

At this point Doctor Ni lowers his voice and hands out a health secret you get “for free”:

💬 Note from Doctor Ni Haixia: From this you can all learn — every year, whether you are sick or not, when the Beginning of Spring arrives, needle Da Dun LR1 and let two drops of blood. I am teaching you secretly — I guarantee you will not be sick!

Fire, earth, metal, water stagnation: well, spring, stream, river and sea points matched to spring, summer, long summer, autumn and winter

After wood comes fire. The heart qi is bound, the fire qi is too great and is trapped inside with no way out — what to do? Wait until after the Spring Equinox, around the Qingming festival, and take the spring point of the Pericardium channel — Lao Gong PC8 — which scatters the heart fire. And the spleen earth? When dampness is flourishing and the whole belly is bloated — wait until the Beginning of Summer, when the seasons turn, and needle the stream point of the Spleen channel, Tai Bai SP3.

💬 Note from Doctor Ni Haixia: The well point, spring point, stream point, river point and sea point match the five organs and match spring, summer, autumn and winter — in spring and summer we take the well and spring points, in autumn and winter the river and sea points, and in long summer the stream points; this can relax the organ qi. Every person has organ qi; when it is oppressed, the cause of the oppression is mostly the emotions — sometimes I fly into a rage; sometimes I am too delighted, I see something (so funny) and laugh until I roll on the ground, laughing with too much joy; sometimes I am too grieved, sometimes too terrified — all of these can do it. When the lung qi is suppressed and cannot grow? Then needle the river point of the Lung channel, Jing Qu LU8. In winter, if the kidney qi is inhibited — the kidney qi should rise upward, enter the Governor Vessel, enter the bone marrow, enter the brain; only then can we have wisdom, have memory, can the ears hear things and the hair stay black. If the kidney qi does not rise and is obstructed, in winter needle the sea point of the Kidney channel — Yin Gu KI10.

Why needle the left side first? This chapter “may be genuine”

Having finished the five-stagnation needling methods, Doctor Ni stops to explain a detail — the needling is always done on the left side first, then the right. Why?

💬 Note from Doctor Ni Haixia: Did the Yellow Emperor not say earlier — human qi moves from left to right, and blood moves from right to left. It is precisely because the content of this chapter agrees with the earlier Huang Di Nei Jing that I suspect this chapter may be genuine — it should be genuine, and so I have placed it here. Clinically we also use it, because it agrees with the great law of acupuncture; it was not invented by anyone. As for the other several chapters (the recovered chapters), go read them — they are very strange; I will not comment. Your own things are all fine.

What if it goes too far? — “preventive medicine” in the needling method

The Yellow Emperor then asks: what you have just taught me is the treatment for organ qi that fails to grow (the deficiency side); but what if it grows too much, in excess — how do we prevent that? Qi Bo’s answer Doctor Ni calls “preventive medicine”:

💬 Note from Doctor Ni Haixia: Once we understand how to make it grow, in the same way we can know how to drain — when the organ qi is too abundant, we drain it. Of this kind of disease qi, the deficiency (bu ji) side is mostly vacuity; the excess (guo) side is repletion — there is a problem: something grows inside the organ, and that is trouble. When it is excessive, use the draining method — and we can all prevent it in advance — this is preventive medicine.

Why does liver qi become excessive? Doctor Ni gives a very modern analogy:

💬 Note from Doctor Ni Haixia: The liver is the provider — the liver provides blood to the heart. Now it provides the blood, but the heart will not accept it: “I won’t take it!” Then your goods are overstocked — and still not accepted — the liver qi becomes excessive. Do you remember we said “the child can make the mother full”? The liver wood generates fire; fire is the child. When the heart will not accept, the mother becomes full, and at this time the liver becomes excessive. When it is excessive, we must let it scatter; it cannot be left sitting inside, or it will create danger. To make the liver’s qi scatter, we use metal to control wood — when we discover the liver qi is excessive, with signs like liver yin repletion or stones inside, we can needle the well point of the Lung channel, Shao Shang LU11, and also needle its sea point, Chi Ze LU5. Once the channel qi is drained, the liver qi scatters — the bound liver qi can be scattered from here; this is the governing law of acupuncture treatment.

Heat above and cold below? Water controls fire — draining without retaining the needle

The heart problem is the liveliest. The heart fire wants to descend, but the spleen earth does not receive it; the fire descends but does not enter, and the heart fire rebels upward — the upper jiao is scorched and dry, and even the tongue dries out. Doctor Ni says: when the heart fire is too hot, the heart pulse is certainly very large; you must scatter the heart fire — fire is controlled by water:

💬 Note from Doctor Ni Haixia: The yang organ of water is the Bladder channel; the yin organ is the Kidney channel. Needle the well point of the yin organ (Yong Quan KI1), and needle the sea point of the Bladder channel (Wei Zhong BL40) — in this way the excessive heart fire of the upper jiao can descend. So we often see a patient whose upper jiao is too hot — we know the heart fire cannot come down, and the lower jiao is cold — this patient has heat above and cold below (shang re xia han)! Acupuncture can do the controlling and draining, right at this place. You must take the yin channel of the organ that controls it — for the heart, we take water to control fire: find the well point of the Kidney channel and the sea point of the yang channel — these two points can drain the heart fire down. For this kind of heat-draining technique, when the channel qi is in excess, the draining methods never retain the needle — insert the needle and then withdraw it (raise the needle), letting the qi drain out; that is enough.

The spleen’s damp-heat and the lung’s metal qi: wood controls earth, fire controls metal

When the spleen earth qi is stagnant and the lung channel does not receive it — earth should generate metal, but metal does not receive, so the damp-heat of the middle jiao becomes excessive. Wood controls earth, so you act on the Liver channel: needle the Liver channel well point Da Dun LR1, then the Gallbladder channel sea point Yang Ling Quan GB34 — these two points can drain the excessive damp-heat of the middle jiao. The lung metal should generate water, but water does not receive, so the metal qi becomes excessive — fire controls metal:

💬 Note from Doctor Ni Haixia: Needle the well point of the Pericardium channel, Zhong Chong PC9, and then the sea point of the San Jiao channel, Tian Jing TE10 — this lets the excessive metal qi finally dissolve. You all know — if the essence of the lung cannot be purified and descended to the kidney…

Closing: with this, the main text of the Huang Di Nei Jing comes to an end

At this point the lecture draws to a close — and this is also the last lecture of the main text of the Huang Di Nei Jing: from the first chapter, the Shang Gu Tian Zhen Lun (Discourse on the True Qi of High Antiquity), all the way to the eighty-first chapter, the Jie Jing Wei Lun, plus the recovered lost chapter Ci Fa Lun. Doctor Ni says that 98 to 99 percent of the Huang Di Nei Jing teaches needling, and inside the needling techniques is hidden the great pattern of “spring, summer, autumn and winter, and the generating and controlling cycles of the five elements”: for wood stagnation needle Da Dun LR1, for fire stagnation Lao Gong PC8, for earth stagnation Tai Bai SP3, for metal stagnation Jing Qu LU8, for water stagnation Yin Gu KI10; and for excess, use metal to control wood, water to control fire, wood to control earth, fire to control metal — draining the excessive organ qi away. And the root of all these treatments is planted in the great cycle of yin and yang ascending and descending, qi and blood circulating — after more than seventy installments, it still comes back to those two words: yin and yang.

What to take away

Pulse qi is real and testable: blood is inside the vessel and qi is outside it — push the pulse with your finger; if it pushes back, the qi is sufficient. A person who looks full of vigor yet has a pulse you can barely find — especially in summer — is a dangerous sign, not a healthy one.
Pulse and symptoms should agree: floating cun pulse with headache and stiff neck — one dose, better in hours. When they disagree, the case is hard but never hopeless; and a doctor who foresees death does not announce it to the patient.
Real tears come with mucus; fake tears come alone: the essence of fire is spirit and the essence of water is will; when both are grieved, tears and mucus pour together — which is how you can tell a genuine cry from a hired mourner’s performance.
The normal body is fire below and water above: heart fire descends to the small intestine, lung water descends to the kidney, large-intestine water returns to the lung — only then is there qi transformation, and only then does a warm breath come out when you exhale.
Check your feet: warm soles with cool insteps are the normal state; both hot or both icy cold are out of balance — icy cold means water has settled below and the lower jiao is cold, so drive out cold and drain water.
Strange sleep signs are channel messages: falling asleep or collapsing in the daytime and waking when the hour passes, or waking at the same hour every night, means the channel cycle is blocked — acupuncture is the Huang Di Nei Jing’s own remedy.
The five stagnations follow the seasons: wood stagnation needle Da Dun LR1 at the Beginning of Spring (Doctor Ni’s private tip: bleed it every year and stay healthy); fire stagnation Lao Gong PC8; earth stagnation Tai Bai SP3; metal stagnation Jing Qu LU8; water stagnation Yin Gu KI10 — well, spring, stream, river and sea points matched to spring, summer, long summer, autumn and winter, because stagnated organ qi is almost always made by the emotions.
Excess is drained in advance: use the controlling cycle — metal controls wood, water controls fire, wood controls earth, fire controls metal — and draining methods never retain the needle.

Compiled from Doctor Ni Haixia’s Ren Ji (Human Records) lecture series on the Huang Di Nei Jing (Lecture 73), presented by Doctor Luo Dalun.