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Pain is circumferential, and there is palpitation with a sense of insecurity. ("Dandan" refers to a state of mental fatigue and lack of vitality, indicating a condition of yin deficiency and qi depletion.) The condition worsens on Wu-Ji days (Earth days), and profuse sweating occurs on Ren-Gui days (Water days); if qi rebels upward, death ensues. (Wu-Ji corresponds to Earth, which overcomes Water, i.e., suppresses the Kidney; Ren-Gui corresponds to Water, when the Kidney qi is dominant.) Treatment involves needling the Foot-Shaoyin and Foot-Taiyang meridians. (This treats the Water organ and its interior-exterior relationship.) For all conditions involving sweating, recovery occurs on the day when the pathogenic factor is overcome by the host qi. (The day of qi dominance is the day of overcoming. When qi is strong, it defeats the pathogen, leading to sweating and cure.) In Liver Heat disease, redness appears first on the left cheek. (The following discusses the colors corresponding to the five zang organs on the face. The Liver belongs to Wood and corresponds to the East, so in Liver heat, redness should appear first on the left cheek.) In Heart Heat disease, redness appears first on the forehead. (The Heart belongs to Fire and corresponds to the South. "Yan" refers to the forehead, also called "Ting".) In Spleen Heat disease, redness appears first on the nose. (The Spleen belongs to Earth and corresponds to the Center, so redness appears first on the nose.) In Lung Heat disease, redness appears first on the right cheek. (The Lung belongs to Metal and corresponds to the West, so redness appears first on the right cheek.) In Kidney Heat disease, redness appears first on the chin. (The Kidney belongs to Water and corresponds to the North, so redness appears first on both cheeks/jawline.) Even if the disease has not yet manifested clinically, if redness is seen in the corresponding areas, one should needle and apply medication targeting that organ in advance; this is called "treating the disease before it arises." (Although symptoms are absent, the appearance of redness in the five facial zones indicates an early sign of disease. One should identify the affected organ and treat it preemptively, preventing the disease before it occurs.) If a heat disease originates from a specific facial zone, it will resolve on the corresponding day. (The following discusses treatment methods for various heat diseases. Originating from a specific zone and resolving on the corresponding day means, for example, if Liver color appears first on the left cheek, it will resolve via sweating on Jia-Yi days. The same applies to other organs.) If needling is performed contrary to principles, three cycles are required for recovery, and the same applies to medication. ("Fan" refers to draining deficiency and tonifying excess. Treating the condition inversely causes worsening and delayed recovery. "Three cycles" means waiting for three occurrences of the overcoming days until resolution.) Severe violation of treatment principles leads to death. (One error requires waiting three cycles; how can a second error not lead to death?) All treatments for heat disease involve having the patient drink cold water to restrain the heat, wearing cool clothing, residing in cool places, and continuing until the body feels cool. (Drinking cold water before needling aims to guide yin qi from the interior to the exterior, allowing heat to dissipate outward. Thus, cool clothing and residence are used to avoid warmth and seek coolness. Medication methods should follow this principle.) If heat disease begins with chest and hypochondriac pain and restlessness of the hands and feet, needle the Foot-Shaoyang meridian and tonify the Foot-Taiyin meridian. (The Foot-Shaoyang meridian descends through the chest and follows the hypochondrium, causing chest and hypochondriac pain. The Spleen governs the four limbs; if Wood overacts on Earth, wind pathogens cause limb disorders, leading to restlessness. Due to Wood excess and Earth deficiency, one should drain the excess of the Foot-Shaoyang and tonify the deficiency of the Foot-Taiyin. For chest and hypochondriac pain, Qiuxu (GB40) is the primary point. To tonify the Foot-Taiyin, select points from the Jing-Well and Ying-Spring categories.) For severe cases, use the Fifty-Nine Points Needling method. (The details of the Fifty-Nine Points are discussed elsewhere.) If heat disease begins with arm and hand pain, needle the Hand-Yangming and Hand-Taiyin meridians until sweating stops. (For arm pain, Lieque (LU7) is indicated. Lieque is the Luo-Connecting point of the Hand-Taiyin Lung meridian. To induce sweating, Shangyang (LI1) is indicated. Shangyang is the Jing-Well point of the Hand-Yangming Large Intestine meridian.) If heat disease begins with head pain, needle the Foot-Taiyang meridian at the nape until sweating stops. (Tianzhu (BL10) is indicated.) If heat disease begins with leg and shin pain, needle the Foot-Yangming meridian until sweating stops. (To stop sweating in the Foot-Yangming meridian, needle Neiting (ST44) and Xangu (ST43).) If heat disease begins with heavy body, bone pain, deafness, and a desire to close the eyes and sleep, needle the Foot-Shaoyin meridian; for severe cases, use the Fifty-Nine Points Needling method. (The Kidney governs bones and opens into the ears. Heat pathogens occupying these areas cause heaviness, bone pain, and deafness. Heat damaging true yin leads to mental fatigue and a desire to sleep. Zhang Zhongjing stated: "The characteristic of Shaoyin disease... is merely wanting to sleep." The meaning is consistent here. For needling the Foot-Shaoyin, there is no single primary point; one should tonify or drain the Ying-Spring points. If the condition is severe, use the Fifty-Nine Points Needling method.) If heat disease begins with dizziness, fever, and chest/hypochondriac fullness, needle the Foot-Shaoyin and Foot-Shaoyang meridians. ("Xuan" refers to spinning dizziness; the brain is filled with marrow. "Mao" refers to visual blurriness; the pupil contains essence. Both are governed by the Kidney. Additionally, the Foot-Shaoyang meridian starts at the outer canthus and follows the hypochondrium, causing these symptoms. Therefore, needle the Foot-Shaoyin and Foot-Shaoyang meridians, specifically the Jing-Well and Ying-Spring points.) When the pulse color of the Taiyang meridian manifests on the cheekbones, it indicates heat disease. (The following discusses the fatal prognosis of simultaneous involvement of exterior and interior meridians. "Rong" means manifestation. The Taiyang meridian starts at the inner canthus, and its sinews connect to the eye area; thus, in Taiyang heat disease, redness manifests on the cheekbones. This indicates that Ying and Wei qi have not yet interpenetrated.) If it is said that sweating can be achieved now, recovery will occur after waiting for the appropriate time. (The character "Rong" here differs from the previous section; it refers to Ying and Wei qi. "Rong" and "Ying" were used interchangeably in ancient texts. "Rong not interpenetrated" means the pathogen is still in the Wei level and has not entered the Ying level, so the disease is shallow. Thus, "if sweating can be achieved now," one can "wait for the time." For example, Liver disease resolves on Jia-Yi days, Heart on Bing-Ding, Spleen on Wu-Ji, Lung on Geng-Xin, and Kidney on Ren-Gui.) If the pulse of the Jueyin meridian appears simultaneously, death occurs within three days. (There are two meanings of pulse: regarding the Cun-Kou pulse, Taiyang is floating, and Jueyin is wiry and fine; regarding meridian symptoms, Taiyang presents with headache, stiff neck, and back stiffness, while Jueyin presents with irritability, fullness, and retraction of the genitals. If Taiyang heat disease and Jueyin symptoms/pulse appear simultaneously, both yin and yang are diseased, and death occurs within three days. Why? This refers to "Liang Gan" (simultaneous contraction of exterior and interior meridians). In Liang Gan from cold, on day one, Taiyang and Shaoyin are both diseased; on day two, Yangming and Taiyin are both diseased; on day three, Shaoyang and Jueyin are both diseased. The sequence of six-meridian heat disease starts with Taiyang and ends with Jueyin. If the beginning and end appear simultaneously, all six meridians are involved in Liang Gan, hence death within three days.) If heat disease internally connects to the Kidney and shows the pulse color of the Shaoyang meridian. (This continues the discussion on Liang Gan. The previous text described Taiyang heat with Jueyin signs; this describes Kidney heat with Shaoyang signs, both being Liang Gan. Since Taiyang and Shaoyin are interior-exterior pairs, and Shaoyang and Jueyin are interior-exterior pairs, seeing Jueyin signs in Taiyang disease implies Shaoyin involvement; seeing Shaoyang signs in Kidney disease implies Jueyin involvement, as detailed below.) When the pulse color of the Shaoyang meridian manifests on the front of the cheek, it indicates heat disease. (The Foot-Shaoyang meridian descends past Jiache; thus, in its heat disease, redness manifests on the front of the cheek.) If Ying and Wei qi have not yet interpenetrated, and it is said that sweating can be achieved now, recovery will occur after waiting for the appropriate time. (Meaning is the same as above.) If the pulse of the Shaoyin meridian appears simultaneously, death occurs within three days. (Shaoyang pulse is wiry; Shaoyin pulse is deep and faint. Shaoyang symptoms include chest/hypochondriac pain and deafness; Shaoyin symptoms include dry mouth, tongue, and thirst. If Shaoyang heat disease and Shaoyin signs/pulse appear simultaneously, death occurs within three days due to complete transmission of Liang Gan. As mentioned earlier, Taiyang-Jueyin simultaneous appearance represents the start of exterior transmission and the end of interior transmission (from start to end). Here, Shaoyang-Shaoyin simultaneous appearance represents the end of exterior transmission and the start of interior transmission (from end to start). Mentioning start and end covers all six meridians, so there is no need to mention Yangming-Taiyin simultaneous appearance.) Acupoints for heat qi: The space below the third vertebra treats chest heat; the space below the fourth vertebra treats diaphragm heat; the space below the fifth vertebra treats Liver heat; the space below the sixth vertebra treats Spleen heat; the space below the seventh vertebra treats Kidney heat; yin qi gathers at the coccyx. (This summarizes the Back-Shu points for treating heat in the five zang organs. "Zhui" refers to vertebral segments. "Rong" refers to yin qi. "Wei" refers to the coccyx, specifically Changqiang (GV1) of the Du meridian. The points beside the Zang Shu points are: below the third vertebra side is Pohu (BL42); below the fourth is Gaohuang (BL43); below the fifth is Shentang (BL44); below the sixth is [missing character]; below the seventh is Ge Guan (BL18). Since yang pathogens are drained from above, yin must be tonified from below, hence "yin qi gathers at the coccyx." These descriptions of Zang Shu points do not fully align with later acupuncture standards; the text is preserved for reference. Understanding the general principle is sufficient; strict adherence to later acupuncture classifications is not required.) The depression in the center of the third vertebra from the neck is Dazhui (GV14). (This is the general method for locating spinal points. The "three vertebrae from the neck" refers to the cervical vertebrae, not the thoracic spine. The depression below the third cervical vertebra is the first segment, named Dazhui. Counting downwards from here allows identification of subsequent vertebrae.) A large mass (Jia) extends from the chin towards the cheekbones; abdominal fullness is indicated by changes toward the mandible; hypochondriac pain is indicated behind the cheekbones; upper diaphragm disease is indicated on the upper cheeks. (This uses facial coloration to diagnose abdominal diseases.)