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[Background Information]
Book: Shanghan Zhengzhi Zhunsheng (Standard Rules for the Diagnosis and Treatment of Cold Damage)
Author: Wang Kentang
Dynasty: Ming
Chapter: Jie Xiong (Chest Binding)
Category: Shanghan (Cold Damage)

If there is a sensation of fullness and obstruction in the epigastrium (heart below), which feels hard upon palpation and is painful, it is called Jie Xiong (Chest Binding). If it feels hard upon palpation but is not painful, it is called Pi Qi (Stagnant Qi). The Classics state: When a disease originates from Yang (manifesting as fever and aversion to cold), if purgatives are incorrectly applied, heat enters internally, resulting in Jie Xiong. When a disease originates from Yin (manifesting as no fever but only aversion to cold), if purgatives are incorrectly applied, it results in Pi (Stagnation). The reason Jie Xiong forms is that purgation was performed too early. Originally, the exterior syndrome should have been resolved through sweating, but instead, purgation was used, damaging the healthy Qi inside. Consequently, the excess heat from the exterior entered the interior due to this deficiency, binding at the epigastrium to form Jie Xiong. When the Yin aspect of the interior has already been affected by pathogenic heat, this is termed originating from Yin. Alternatively, if there is only slight fever and the interior excess syndrome is not fully established, yet the patient cannot tolerate drastic purgation but receives it anyway, the slight internal heat may be cleared, but the exterior pathogenic heat then enters the interior. Even if Jie Xiong does not form, Pi will result. Xiao Xie Xiong (Minor Chest Binding) is milder than Da Xie Xiong (Major Chest Binding) but more severe than Pi. This difference depends on the magnitude of the mis-treatment, not because Pi is considered a cold syndrome. The Classics say, "Only chest binding without significant fever indicates cold-excess Jie Xiong," but this is actually not true cold; it merely indicates mild heat. Regarding Zang Jie (Organ Binding), the Classics state that when heat binds in the Zang organs, the disease is deep and difficult to treat. However, using cooling agents can also lead to recovery. Regarding Yang Jie, heat binds in the Fu organs, making the condition mild and superficial. Additionally, retained fluid (Liu Yin) that fails to resolve can cause head sweating, deep and submerged pulse, and accumulation of fluid binding near the bones, forming water-binding Jie Xiong. There are also cases of Jie Xiong and Pi that do not arise from incorrect purgation, but rather from failure to purge when indicated, or from incorrect sweating. The Classics state: "When heat has entered the interior and remains unattacked for a long time, it leads to solidity; this is called 'three deaths and one life,' referring to the failure to purge." After sweating, if heat qi transmits to the heart below causing Pi, it is due to failed sweating. Jie Xiong certainly requires purgation, but if the pulse is floating and large, purgation must not be used; doing so leads to death, because the exterior pathogen has not completely resolved and the disease has not fully solidified. Furthermore, if all symptoms of Jie Xiong are present and accompanied by irritability (Fan Zao), it is also incurable. Medicines drive out pathogens only after the Stomach Qi distributes their power, allowing them to use warming, sweating, vomiting, or purging methods to expel evil. If pathogenic factors are strong and Stomach Qi is exhausted, treatment is impossible.

In Taiyang Disease (Disease of the Taiyang Channel), the pulse is floating, moving, and rapid. Floating indicates wind, rapid indicates heat, moving indicates pain, and rapid also indicates deficiency. Headache, fever, slight night sweats (sweating during sleep), and aversion to cold indicate that the exterior syndrome is unresolved. If the physician incorrectly applies purgation, the moving and rapid pulses change to slow. There is resistance and pain in the diaphragm, emptiness in the stomach, external pathogens disturb the diaphragm due to emptiness, leading to shortness of breath, irritability, and inner restlessness (Ao Nao). Yang Qi sinks internally, causing hardness in the epigastrium, forming Jie Xiong. The main formula is Da Xie Xiong Tang (Major Chest Binding Decoction). (Cheng Wuji notes: Moving and rapid are Yang pulses; the pathogen should be sought at the exterior. Sweating during sleep is called night sweats; if the pathogen is in the half-exterior half-interior, there is no aversion to cold. Here, headache, fever, slight night sweats, and aversion to cold indicate unresolved exterior syndrome, requiring sweating. Incorrect purgation damages Stomach Qi, allowing exterior pathogens to sink. Pathogens in the interior manifest as Yin pulses. The sinking of Yang Qi causes the moving/rapid pulse to become slow, while the floating pulse remains unchanged because the pathogen binds in the upper Jiao chest, preventing the pulse from sinking. 'Ke Qi' refers to external pathogens entering the interior due to empty Stomach Qi and binding in the chest-diaphragm. Resistance and pain in the diaphragm indicate Ke Qi disturbing the diaphragm. *Jin Gui Yao Lue* states: Shortness of breath with inability to breathe fully indicates excess. Shortness of breath, irritability, and inner restlessness are caused by pathogenic heat excess. Sinking Yang Qi blocks Qi flow, congesting the epigastrium into hardness and pain, forming Jie Xiong. Da Xie Xiong Tang is used to purge the binding heat. Danbo Yuanjian cautiously notes: In Taiyang disease at the exterior, if not resolved, attacking the interior is deficient. Moreover, the pulses are floating, moving, and rapid. Now, after incorrect purgation, they become slow, and it is stated that the stomach is empty, with shortness of breath and irritability, indicating severe deficiency. If Yang Qi sinks and the epigastrium becomes hard, can we rapidly attack? Is Da Xie Xiong weaker than Chengqi Tang? Since purgation has already been used, it should not be repeated; how can we not fear deficiency? Earlier it was said that floating-large pulses in Jie Xiong contraindicate purgation, leading to death; and that complete Jie Xiong with irritability is fatal. Now, with floating pulse and irritability, is Da Xie Xiong Tang truly applicable? If Yang disease excess is incorrectly purged, leading to empty stomach, Ke Qi disturbing the diaphragm, and inner restlessness, Zhizi Chi Tang should be used to vomit pathogens from the chest. Especially since Taiyang disease failing to purge clearly shows deficiency.)

After six or seven days of Shanghan, if there is Jie Xiong Heat Excess, with a deep and tight pulse, pain in the epigastrium, and hardness like stone upon palpation, the main formula is Da Xie Xiong Tang. (Zhang Yinan notes: The previous text explained that originating from Yang and incorrect purgation leads to heat entering and forming Jie Xiong, so repetition is unnecessary. The previous text only explained the cause; here, the pulses and syndromes of Jie Xiong are elaborated. Cheng Wuji incorrectly interprets the mention of "six or seven days" instead of "after purgation" as transmission of interior excess heat. Zhang Yinan notes: The Classics say Jie Xiong forms because purgation was too early. Here, mentioning "six or seven days" and "Heat Excess Jie Xiong" without mentioning purgation implies Jie Xiong can occur without early purgation. Early purgation causing Jie Xiong is the norm; Heat Excess Jie Xiong is a variation. Heat transmitting to the interior to form Jie Xiong is a gap in standard rules, so Zhang Zhongjing described the syndrome to attach the formula. This shows the ancients' meticulous care. Similarly, the next chapter mentions water binding in the chest-hypochondrium with only head sweating, treated with Da Xie Xiong Tang, which is outside standard rules, so the syndrome is listed to clarify the principle. It may also be that the person was originally deficient, or had undergone vomiting/purgation weakening interior Qi, allowing external pathogens to enter naturally, forming Jie Xiong. Although the cause differs, the treatment principle is the same.)

After ten-plus days of Shanghan, if heat binds in the interior and there is alternating chills and fever, the main formula is Da Chai Hu Tang. If there is only Jie Xiong without significant fever, this is water binding in the chest-hypochondrium, with only slight head sweating; the main formula is Da Xie Xiong Tang. (Cheng Wuji notes: After ten-plus days, heat binding in the interior is a purgation indication. Alternating chills and fever indicate struggle between healthy Qi and pathogens, not fully consolidated, so Da Chai Hu Tang is used. Only Jie Xiong without significant fever is not heat binding, but residual water binding in the chest-hypochondrium, called Water Jie Xiong. Generalized sweating indicates water dispersing externally, leading to recovery. Only slight head sweating with no other sweating indicates water retention and stagnation, so Da Xie Xiong Tang is used to drain water. *Huo Ren Shu* says: For Water Jie Xiong, use Xiao Ban Xia Jia Fu Ling Tang or Xiao Chai Hu Tang removing Zao and adding Mu Li.)

In Taiyang disease, after heavy sweating and subsequent purgation, if there is constipation for five to six days, dry tongue with thirst, slight tidal fever in the late afternoon (Shen hour), hardness and fullness from the epigastrium to the lower abdomen that is painful and intolerable to touch, the main formula is Da Xie Xiong Tang. (See Tidal Fever section for details.)

Da Xie Xiong Tang Formula
Da Huang (6 liang, peeled) Mang Xiao (1 sheng) Gan Sui (1 qian, powdered)
Take the above three herbs, add 6 sheng of water, first decoct Da Huang until 2 sheng remain, remove dregs, add Mang Xiao, boil for 1-2 boils, add Gan Sui powder, and take 1 sheng warm. Stop subsequent doses once loose stools occur.

Jie Xiong occurs because pathogens are in the chest, located at the high part of the body. Should emesis be used? The term "binding" refers to Yang Qi receiving energy in the chest; pathogens bind with Yang Qi, becoming indistinguishable, blocking Qi flow, causing congestion, hardness, and pain in the epigastrium. This is a firm binding of pathogen and healthy Qi in the chest, distinct from deficiency vexation or diaphragmatic excess, requiring purgation. Low diseases are lifted; high diseases are sunk to restore balance. Jie Xiong is a high pathogen, so sinking therapy is used, hence "Xie Xiong Tang" (Sinking Chest Decoction). Breaking the binding requires bitter-cold herbs reaching directly, so Gan Sui is the sovereign herb. *Nei Jing* states: Salty flavors induce vomiting and purging, belonging to Yin. Also: Salty softens hardness. Hard Qi is softened by salty; heat excess is eliminated by cold. Thus, Mang Xiao (salty-cold) is the minister herb, sweeping away pathogens and restoring balance, acting as the general. Da Huang (bitter-cold) is the envoy herb for clearing heat. This is a potent purgative. Among purgatives, it is swift. Shanghan complications are severe in Jie Xiong; only this can clear it. Large dose, small frequency, to rapidly decompose the binding.

Danbo Yuanjian cautiously notes: The Classics mention "empty stomach," "shortness of breath and irritability," and "floating pulse"; this decoction must not be used lightly.

Xiao Xie Xiong (Minor Chest Binding) disease is located exactly in the epigastrium; pain occurs only upon palpation, with a floating-slippery pulse. The main formula is Xiao Xie Xiong Tang. (The previous text mentioned hardness/fullness and pain intolerable to touch, implying pain without palpation. Here, pain only upon palpation indicates it arises after touching. The previous text mentioned pain extending to the lower abdomen, covering the whole abdomen. Here, location is strictly the epigastrium, so the lower abdomen is not hard/painful. Heat is milder than before, hence "Minor." )

Xiao Xie Xiong Tang Formula
Ban Xia (washed in hot water, 0.5 sheng) Huang Lian (1 liang) Gua Lou Shi (one large fruit)
Take the above three herbs, add 6 sheng of water, first decoct Gua Lou until 3 sheng remain, remove dregs, add other herbs, decoct until 2 sheng remain, remove dregs, divide into three warm doses. (If one dose is ineffective, take a small amount again; resolving yellow phlegm brings relief. Bitter drains heat, acrid disperses binding. Huang Lian and Gua Lou Shi are bitter-cold to drain heat; Ban Xia is acrid to disperse binding.)

If the disease is in the Yang channel, it should be resolved by sweating. Instead, cold water is poured or splashed, suppressing heat so it cannot escape, increasing irritability, causing gooseflesh on the skin. The patient desires to drink but feels no thirst; administer Wen Sha San. If ineffective, give Wu Ling San. For Cold-Excess Jie Xiong without heat signs, San Wu Xiao Xie Xiong Tang or Bai San may be administered.

Bai San Formula
Jie Geng Bei Mu (each 3 fen) Ba Dou (1 fen, peeled, heart removed, roasted black, ground to paste)
Grind the above three into powder, mix with Ba Dou, pound in a mortar, and mix with rice water (Bai Yin). Strong patients take half a qian; weak patients reduce the dose. Pathogens above the diaphragm cause vomiting; below, diarrhea. If no diarrhea, drink a cup of hot porridge; if diarrhea persists, drink a cup of cold porridge. If sweating occurs followed by abdominal pain, add Shao Yao (1 liang) and follow the method. For Upper Heat-Excess Jie Xiong and Cold-Excess Jie Xiong, *Huo Ren Shu* suggests using Xie Xiong Tang regardless of cold/heat; if ineffective, use Zhi Shi Li Zhong Wan, which acts swiftly. For Jie Xiong with neck stiffness resembling Rou Jing (Soft Spasm), purgation harmonizes; use Da Xie Xiong Wan.

Da Xie Xiong Wan Formula
Da Huang (0.5 jin) Ting Li (roasted) Mang Xiao Xing Ren (peeled, tips removed, roasted black, each 0.5 sheng)
Sieve two powders, mix with Xing Ren and Mang Xiao, grind to paste. Take a pill size of a bullet. Separately grind Gan Sui (1 qian bi), mix with 2 he of white honey and 2 sheng of water. Decoct until 1 sheng remains, take warm in one dose. Bowels move overnight. If not, repeat. Effectiveness is marked by bowel movement. Follow medication taboos. Haizang says: Da Xie Xiong Tang is for Taiyang root disease; Da Xie Xiong Wan is for Yangming; Xiao Xie Xiong Tang is for Shaoyang. Da Xie Xiong treats Heat Excess; Da Xie Xiong Wan treats panting; Xiao Xie Xiong treats Pi. (Da Huang and Mang Xiao are bitter-salty to drain heat; Ting Li and Xing Ren are bitter-sweet to drain fullness; Gan Sui reaches directly; white honey moistens and lubricates; all drain excess matter.)

If the epigastrium is full and painful like Jie Xiong, accompanied by neck stiffness, headache, and dizziness, puncture Da Zhui and Gan Shu. If after sweating/purgation there is neck stiffness, headache, fever, and dysuria, use Gui Zhi Qu Gui Jia Fu Ling Zhu Yu Tang (see Neck Stiffness section for formula and discussion).

In Taiyang disease, after two or three days, if the patient cannot lie down but wants to rise, the epigastrium is bound, and the pulse is weak, this indicates pre-existing cold. Incorrect purgation follows. If diarrhea stops, Jie Xiong will form; if it continues, and purgation is repeated after four days, it becomes Xie Re Li (Collateral Heat Diarrhea).

In Taiyang disease, if the pulse is floating after purgation, Jie Xiong will definitely form.

In concurrent Taiyang and Shaoyang disease, incorrect purgation leads to Jie Xiong, epigastric hardness, incessant diarrhea, inability to swallow fluids, and irritability. If all Jie Xiong symptoms are present with irritability, it is fatal. Floating-large pulses in Jie Xiong contraindicate purgation; purgation leads to death. (Zhang Yinan notes: Using medicine is like using troops; advance when possible, retreat when difficult. Cun pulse overflowing and Guan pulse deep indicate Jie Xiong suitable for purgation. Now, with floating-large pulse, although the chest is bound, exterior pathogens are still abundant and not fully solidified. Immediate purgation severely damages interior Qi, allowing external pathogens to gather, leading to death. Zhang Zhongjing warns against this. If the pulse cannot be attacked, observe changes and wait for solidity. For example, Minor Jie Xiong has floating-slippery pulse and pain on palpation, indicating shallow binding; do not purge, only clear epigastric heat with Xiao Xie Xiong Tang. Some ask: If Jie Xiong has exterior signs, is Da Xie Xiong far off? I say: Jie Xiong has no exterior signs, or only slight fever/tidal fever, as stated by Zhang Zhongjing. Other than these, there are no exterior signs, and pathogens are not solidified, so it is not Jie Xiong. The Classics say: After six-seven days of Shanghan, if exterior signs exist (fever, aversion to cold, limb pain, slight vomiting, sub-costal binding), and exterior signs persist, use Chai Hu Jia Gui Zhi Tang. Also, after six-seven days, if sweating and purgation were done, with slight chest-hypochondrial binding, dysuria, thirst, no vomiting, only head sweating, alternating chills/fever, and irritability, this is unresolved; use Chai Hu Gui Zhi Gan Jiang Tang. These cases have exterior signs, so Chai Hu formulas harmonize. Without exterior signs, only chest/abdominal solidity and pain constitute Jie Xiong.)

Appendix
*Huo Ren Shu*: If incorrect purgation initially does not form Jie Xiong, frequently administer Li Zhong Tang to resolve it naturally, preventing Jie Xiong, as Li Zhong Tang treats the Middle Jiao. This insight came later. If stool worsens with Jue syndrome, combine with Si Ni Tang. If Stomach harmonizes but Shanghan persists, wait for sufficient days for purgation, then use Chengqi Tang, as previous purgation was inappropriate.

Western Jin Cui Gongyun said: For severe Shanghan Jie Xiong with high epigastric distension and intolerance to touch, if Da Xie Xiong Tang fails, it is due to post-purgation deficiency/reversal, where Qi is disordered and toxins attack upward, binding in the chest. Use Zhi Shi Li Zhong Wan to regulate Qi first, then treat other diseases. It works miraculously.

Zhi Shi Li Zhong Wan Formula
Zhi Shi (16 pieces, bran-fried) Fu Ling Ren Shen Bai Zhu Gan Jiang (roasted) Gan Cao (honey-fried, each 2 liang)
Grind into powder, make pills with honey the size of chicken egg yolk. Take one pill dissolved in hot water. Continue 2-3 doses. If chest opens and thirst occurs, add Gua Lou Gen (1 liang). If spontaneous sweating, add Mu Li (2 liang). If excessive diarrhea, add as well.

*Huo Ren Shu* Modified Li Zhong Wan: Wang Chaofeng said: If Da/Xiao Xie Xiong Tang/Wan fail, use this.
Ren Shen Bai Zhu Gua Lou Mu Li (calcined) Gan Cao (honey-fried, each 2 liang) Gan Jiang (white-roasted, 0.5 liang) Zhi Shi (bran-fried, 24 pieces) Huang Qin (remove rotten parts, 1 liang)
Grind into powder, make pills the size of bullets. Decoct one pill in one bowl of water. If unresolved, repeat. Within 5-6 pills, the chest opens. The speed is miraculous. Add Gua Lou Gen for thirst, Mu Li for sweating.

*Huo Ren Shu*: Water binding in the chest-hypochondrium is also called Jie Xiong. Symptoms include slight head sweating and absence of significant heat. Use Xiao Ban Xia Jia Fu Ling Tang or Xiao Chai Hu Tang removing Zao and adding Mu Li.

Sun Simiao: Yu Bodao suddenly had slight fever, epigastric fullness, and head sweating that could not resolve. Doctors treated it as Warm Disease with exterior-releasing drugs, or food stagnation in the diaphragm, all failing. Sun Simiao used Ban Xia Fu Ling Tang, and he recovered. Asked why, Sun said: Head sweating and epigastric fullness are not dampness, but water binding in the chest-hypochondrium. Once water leaves, the disease resolves. Dampness causing epigastric fullness would cause generalized sweating. Food stagnation would not cause head sweating. If it were exterior, there would be no body ache or aversion to cold. Thus, water binding in the chest-hypochondrium always presents with head sweating.

Xiao Ban Xia Jia Fu Ling Tang (see Vomiting section)

Chuan Jie San: For severe excess and fullness, with high chest/epigastrium and blocked Qi, it is binding.
Chan Su She Xiang Qing Fen Ba Dou (grind separately slightly)
Grind finely, make pills with milk the size of millet seeds. Take 2 pills with ginger water, frequently.

*Ben Cao*: Women with Shanghan having Blood Binding in the chest-diaphragm experience pain upon rubbing that is intolerable.

Hai Ge San
Hai Ge Hua Shi Gan Cao (honey-fried, each 2 liang) Mang Xiao (0.5 liang)
Grind into powder. Take 2 qian mixed with egg white.

If the Small Intestine is open, chest-diaphragm blood disperses. If Dan Zhong blood gathers, Small Intestine is blocked. Blocked Small Intestine prevents Dan Zhong blood circulation; use this formula. If urine contains blood dispersed over several passages, Gui Zhi Hong Hua Tang to sweat is better. *Huo Ren Shu* doubts this is Zhang Zhongjing's formula but keeps it for its logic.

Dai Shi: Treat Heat-Excess Jie Xiong per Zhang Zhongjing. Cold-Excess Jie Xiong involves pain without irritability, caused by post-purgation deficiency/cold binding; use Li Zhong Tang plus Zhi Shi (0.5 qian) and Fu Ling (1 qian), or Zhi Shi Li Zhong Tang. Water Jie Xiong without significant heat and slight head sweating uses Xiao Ban Xia Fu Ling Tang. Blood Jie Xiong, intolerable to touch, with desire to rinse mouth but not swallow, forgetfulness/manic behavior, black stool, and free urination, uses Xi Jiao Di Huang Tang.

Tao Shi: Common doctors see chest fullness and prescribe Jie Geng Tang, calling it Jie Xiong, following Zhu Fengyi. Frequent use creates true Jie Xiong. Unknowingly, Jie Xiong forms from early purgation. Without purgation, it is not Jie Xiong but exterior pathogens transmitting to the chest, not entering Fu organs. Though full, it is still exterior, belonging to Shaoyang (half-exterior/half-interior). Use Xiao Chai Hu Tang plus Zhi Qiao. If ineffective, combine with Xiao Xie Xiong Tang for immediate relief. If formed by early purgation, use Xie Xiong Tang/Wan, treating gently according to depth. Do not be too harsh. The Upper Jiao is the clear pathway, highest part; excessive purgation damages Yuan Qi. Thus, Xie Xiong Tang/Wan should be used gently. Reading Zhang Zhongjing's *Shanghan Lun* Jie Xiong section: "Originating from Yang, incorrect purgation leads to heat entering and Jie Xiong; originating from Yin, incorrect purgation leads to Pi. Reason: purgation too early." Cheng Wuji notes: "Fever/aversion to cold = Yang; no fever/aversion to cold = Yin." Repeated reading raises doubts. No fever/aversion to cold is direct invasion of Yin channels (true cold), not transmission from Yang. Incorrect purgation would be fatal or critical; how could Xie Xin Tang (mixed cold/hot) cure it? It seems lighter than Jie Xiong? Perhaps this discusses Ying/Wei and Yin/Yang. Wind is Yang; Yang pathogens injure Wei, causing headache/fever/slight sweating/aversion to cold; use Gui Zhi Tang. Incorrect purgation damages Stomach Qi, causing chest binding. Classics say: "Floating-large pulse in Jie Xiong contraindicates purgation; complete Jie Xiong with irritability is fatal." Wei originates from Upper Jiao; injury to clear pathway is serious. Thus, use harsh Xie Xiong Tang to purge. Cold is Yin; Yin pathogens injure Ying, use Ma Huang to release exterior. Incorrect purgation causes Pi; use Xie Xin Tang. Ying originates from Middle Jiao; Huang Lian clears Pi, pathogens go below diaphragm, not harming clear pathway, so it is lighter than Jie Xiong. Direct Yin cold cured by Xie Xin Tang is unheard of. Also: Deep-solid-strong pulse indicates Jie Xiong; urgently use Da Xie Xiong Tang plus Zhi/Jie to purge.

Moxibustion for Jie Xiong
Ba Dou (14 pieces) Huang Lian (7 cun, peeled)
Grind fine, mix with saliva into paste, fill navel. Moxa above. Abdominal sounds indicate cure. Number of cones varies until cured. Wipe immediately with warm wet cloth to prevent sores.

*Zhai Xuan*: For Shanghan Jie Xiong, massage left side of sternum below the painful point. Puncture Zhi Gou (left) with hair needle (2 cun). Then pierce Jian Shi (left), named Shuang Que. Then pierc Xing Jian (left, 6 cun). Twist needle during patient's 5 inhales, outward twist 3 exhales, inward twist 5 inhales, long exhale, remove needle. Left-side Jie Xiong resolves immediately. Right side follows same method. Breathe slowly, hold needle, remove at correct time for cure.

*Yun Qi Zi*: Shanghan Jie Xiong Pi.
Chest binding: Yong Quan, Tai Xi, Zhong Chong, Tai Ling.
Heart binding: Yin Bai, Tai Bai, Shao Chong, Shen Men.
Stomach binding: Shao Shang, Tai Bai, Da Dun, Tai Chong, plus upper/lower wrist draining.

*Tong Xuan Zhi Yao*: Jie Xiong with jaundice: Yong Quan.

*Zhai Xuan*: Blood Jie Xiong, red face, severe dryness, dry mouth/thirst, unbearable chest pain.
Qi Men, Tai Ling, Guan Yuan (Pregnant women must not puncture Guan Yuan; if fetus dies, mother and child die. Be cautious.)

*Ji Yan*: Shanghan chest-diaphragm pain: Qi Men, Tai Ling.

*Huo Ren Shu*: Recent times treat Jie Xiong with gold needles, Liu Huang, and Yang Qi Shi. If Cold-Excess Jie Xiong heals, Heat-Excess Jie Xiong is fatal.