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When pathogenic factors invade the Lung, symptoms include pain in the skin, aversion to cold with fever (Han Re), upward rushing of Qi, panting, sweating, and coughing that pulls on the shoulders and back. Treatment should involve needling points in the anterior chest region (Ying Zhong Wai, referring to points like Yunmen and Zhongfu) and near the five Zang Shu points beside the third thoracic vertebra on the back. Press quickly with the hand until the patient feels relief, then needle.

Additionally, select points in the Clavicular Fossa (Que Pen) to vent the pathogen.

When pathogenic factors invade the Liver, symptoms include pain in both hypochondriac regions, internal cold, stagnation of evil blood within, frequent pulling sensations in the joints, and occasional swelling of the feet. Treatment involves selecting Xingjian (LR2) to guide Qi from the hypochondrium, tonifying Zusanli (ST36) to warm the Stomach middle, selecting blood vessels to disperse evil blood, and selecting blue veins behind the ear to remove joint pulling sensations.

When pathogenic factors invade the Spleen and Stomach, symptoms include muscle pain. If Yang Qi is excessive and Yin Qi deficient, there is heat in the middle jiao and frequent hunger; if Yang Qi is deficient and Yin Qi excessive, there is cold in the middle jiao with borborygmus and abdominal pain. Whether both Yin and Yang are excessive or both are deficient, resulting in alternating cold and heat, all can be regulated via Zusanli (ST36).

When pathogenic factors invade the Kidney, symptoms include bone pain, Yin Bi (Bi syndrome affecting Yin channels). Yin Bi is characterized by tenderness that cannot be pinpointed by pressure, abdominal distension, lower back pain, difficulty defecating, pain in the shoulders, back, neck, and nape, and occasional dizziness. Treatment involves selecting Yongquan (KI1) and Kunlun (BL60). Observe for blood stasis; if present, drain it completely.

When pathogenic factors invade the Heart, symptoms include heart pain, a tendency toward sadness, and occasional dizziness leading to fainting. Regulate their Shu points based on excess or deficiency patterns. (The text notes that these five items follow a direct structure, typical of the classic, but possess subtle variations that give vitality to the text.)

In Skin Cold-Heat disease, the patient cannot lie flat on the mat, hair becomes dry and brittle, the nose dries up, and the skin is dry without sweat ("La" refers to dry skin). Treatment involves selecting the Luo-connecting points of the Three Yang meridians and tonifying the Hand Taiyin Lung meridian.

In Muscle Cold-Heat disease, there is muscle pain, dry/brittle hair, dry lips, and dry skin without sweat. Treatment involves selecting points below on the Three Yang meridians to remove blood stasis, and tonifying the Foot Taiyin Spleen meridian to induce sweating.

In Bone Cold-Heat disease, the patient finds no comfort in any position, with continuous profuse sweating. If the teeth are not yet dry/cracked, select the Luo-connecting points of the Shaoyin meridian in the inner thigh. If the teeth are already dry/cracked, it is a fatal condition untreatable. Gujue (Bone Jue) presents similarly.

Bi syndrome affecting bones causes limited joint movement with pain, profuse sweating, and vexation. Treatment involves tonifying the Jing-river points of the Three Yin meridians.

If the body has suffered injury, excessive blood loss, wind-cold invasion, or falls/trauma, leading to flaccidity and inability to control the limbs, this is called Body Languor (Ti Duo). Treatment involves selecting the San Jie Jiao point below the umbilicus. The San Jie Jiao is the intersection of the Foot Yangming Stomach and Foot Taiyin Spleen meridians, located three cun below the umbilicus at Guanyuan (CV4).

Jue Bi (Jue Bi Syndrome) involves Jue Qi rising to the abdomen. Treatment involves selecting the Luo-connecting points of Yin and Yang meridians, treating the primary affected area by draining Yang and tonifying Yin.

The arterial pulse on the side of the neck is Renying (ST9). Renying belongs to the Foot Yangming Stomach meridian, located anterior to the sternocleidomastoid muscle ("Ying Jin"). Posterior to the Ying Jin is the Hand Yangming Large Intestine meridian, named Futu (LI18). The next pulse is the Foot Shaoyang Gallbladder meridian, named Tianyou (TB16). The next is the Foot Taiyang Bladder meridian, named Tianzhu (BL10). The axillary artery is the Arm Taiyin Lung meridian, named Tianfu (LU3).

Headache due to rebellious Qi (Ying should be Ni), chest fullness, and dyspnea: select Renying (ST9).
Sudden aphonia and Qi obstruction: bleed Futu (LI18) and the base of the tongue.
Sudden deafness, mental clouding, and unclear vision/hearing: select Tianyou (TB16).
Sudden spasms, epilepsy, dizziness, and inability of the legs to support the body: select Tianzhu (BL10).
Dan heat syndrome with internal rebellious Qi, where Liver and Lung Qi clash causing bleeding from nose and mouth: select Tianfu (LU3). These constitute the Five Regions of Tianyou. (This section transitions from Cold-Heat to Gujue, then discusses Gu Bi, Ti Duo, and Jue Bi. Though seemingly unrelated, there is a subtle continuity. Read subsequent chapters with this understanding of structural flow.)

The Foot Yangming meridian has a branch entering the teeth, named Daying (ST5). For lower tooth decay/pain, select points on the arm. If accompanied by aversion to cold, use tonification; if not, use sedation.

The Foot Taiyang meridian has a branch entering the teeth, named Jiaosun (SI18). For upper tooth decay/pain, select points between the nose and cheekbone. At onset, if the pulse is full/excessive, use sedation; if deficient, use tonification. Alternatively, select points outside the nostrils.

The Foot Yangming meridian has branches flanking the nose into the face, named Xuanlu (GB21 - *Note: Text says Xuanlu but describes GB21 location/function often associated with other points, strictly translating text*), belonging to the mouth, opposite the entrance, connecting to the root of the eye. Treat areas of excess. Reduce excess, tonify deficiency; reversing this worsens the condition.

The Foot Taiyang meridian has a branch passing through the neck into the brain, directly connecting to the root of the eye, named Yanxi (Eye System). For severe head and eye pain, select points between the two tendons in the neck, penetrating into the brain, distinguishing between Yin Qiao and Yang Qiao meridians. Yin and Yang intersect; Yang enters Yin, Yin exits Yang, intersecting at the outer canthus. Excess Yang leads to open eyes; excess Yin leads to closed eyes. (This section covers tooth and eye pain related to Yangming and Taiyang, ending with the influence of Qiao meridians on vision.)

For Reversible Heat Jue (Re Jue), select Foot Taiyin and Foot Shaoyang meridians, retaining the needles. For Reversible Cold Jue (Han Jue), select Foot Yangming and Foot Shaoyin meridians in the foot, retaining the needles.

Tongue deviation with drooling and vexation: select Foot Shaoyin.
Shivering, chattering teeth, inability to sweat, abdominal distension, and vexation: select Hand Taiyin.
To treat deficiency, needle in the direction the Qi departs; to treat excess, needle in the direction the Qi arrives.

In Spring, select Luo-connecting points; in Summer, select Fen Cou (interstices); in Autumn, select Qikou (Radial artery); in Winter, select Jing-Well and Shu-Stream points. These four seasonal methods correspond to their respective times. Luo points treat the skin; Fen Cou treats muscles; Qikou treats sinews/tendons; Jing-Shu points treat bones and the Five Zang organs. (This concludes the discussion on Re Jue and Han Jue with a structured summary.)

There are five critical parts of the body: Futu (Vast Rabbit) is one; the calf (Fei) is two; the back is three; the Shu points of the Five Zang are four; the neck is five. Carbuncles and sores occurring in these five parts are fatal.

Diseases starting in the arms: first select Hand Yangming and Hand Taiyin to induce sweating.
Diseases starting in the head: first select Neck Taiyang to induce sweating.
Diseases starting in the lower legs: first select Foot Yangming to induce sweating.
Arm Taiyin and Foot Yangming can induce sweating. Therefore, if sweating induced by Yin meridians is excessive, stop/supplement via Yang meridians; if sweating induced by Yang meridians is excessive, stop/supplement via Yin meridians.

In needling, if harm strikes the vital area and the needle is not removed immediately, essence will leak. If the needle is removed before striking the vital area, pathogenic Qi may accumulate. Essence leakage worsens the disease; accumulated Qi generates carbuncles and sores. (This section discusses carbuncle treatment. "Inducing sweat" refers to the principle "sweat them, and the sore heals." The discussion on Yin-Yang regulation of sweating is profound, analogous to the differentiation between Guizhi Tang and Shengmai San in herbal medicine.)

From here onwards, the four chapters and miscellaneous disease chapters are narrative texts. One must appreciate the beauty of their structured and free-flowing, interrupted and continuous, intricate changes. Although items seem unrelated, they naturally avoid fragmentation. This is due to the flow, reversal, and interaction of the writing style, generating vitality throughout the lines.