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Head Swelling. It is caused by the internal retention of wind-warmth pathogenic factors and the congestion and obstruction of heat-toxin. If it occurs on both cheeks, it is called mumps (epidemic parotitis); if it occurs on the head and face, it is called "Big Head Plague" (an epidemic disease characterized by swelling and redness of the head and face). Internal treatment is primarily based on Puji Xiaodu Yin (General Benefit Decoction for Disinfection) with Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), and Lianqiao (Forsythiae Fructus) removed.

Massage techniques: Fen Yin-Yang (Two Hundred Repetitions), Tui Sanguan (Pushing the Three Gates) (Two Hundred Repetitions), Tui Liufu (Retreating the Six Palaces) (One Hundred Repetitions), Tui Pitui (Pushing the Earth of the Spleen) (One Hundred Repetitions), Rou Liang Taiyang (Rubbing the Two Temples) (Fifty Repetitions), Yun Bagua (Moving the Eight Trigrams) (Twenty Repetitions), Rou Neilaogong (Rubbing Inner Laogong) (Thirty Repetitions). Apply Hanfa (Sweating Method) and Tuifa (Vomiting Method) first. For all pushing techniques, use Congtang (Green Onion Decoction) as a medium, combined with Qingli Fa (Clearing Interior Method) (see Vol. 2, p. 37) and Jiefan Fa (Relieving Irritation Method) (see Vol. 2, p. 38).

Note: Head swelling belongs to warm-toxin epidemic pathogens. Epidemic qi is mostly dry-heat toxic pestilence; there has never been an example of using acrid-warm ascending and dispersing methods. All herbs such as Chaihu (Bupleuri Radix), Gegen (Puerariae Lobatae Radix), and other wind-drying acrid-hot substances must not be used. To resolve exterior pathogens, use Congbai (Allii Fistulosi Bulbus), Douchi (Sojae Semen Preparatum), Lianqiao (Forsythiae Fructus), Bohe (Menthae Haplocalycis Herba), etc. To clear interior heat-toxins, use Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Huashi (Talcum), Zhizi (Gardeniae Fructus), etc. To purge downward, use Mangxiao (Natrii Sulfas), Dahuang (Rhei Radix et Rhizoma), etc. Moreover, epidemic qi is a turbid pathogen that steams and generates heat-phlegm, clouding the Pericardium, leading to coma and delirious speech. It is appropriate to use aromatic methods to diffuse and expel, and clear blood collaterals to prevent blockage. Use Shuiniujiao (Rhinocerotis Cornu - *note: usually substituted with Shuiniu Jiaojiao in modern practice*), Gegen (Puerariae Lobatae Radix), Yujin (Curcumae Radix), Peilan (Agastaches Herba), Jinyinhua (Lonicerae Japonicae Flos), etc. For irritability, thirst, and excessive sweating, use Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), etc. For rash and sore throat, use Shuiniujiao (Rhinocerotis Cornu), Niubangzi (Arctii Fructus), Shengdihuang (Rehmanniae Radix), etc. In the presence of seasonal epidemic qi, detoxification should be prioritized. Big Head Plague involves damp-heat damaging the vertex, causing swelling as large as a bucket. Without rapid treatment, eight or nine out of ten will die; how can it be cured merely by massage? (Ti Li Zi)

Abdominal pain includes cold pain, heat pain, food stagnation pain, qi disharmony pain, spleen deficiency pain, liver wood overacting on spleen pain, and ascariasis pain. These must not fail to be distinguished.

Cold pain is due to qi stagnation and yang decline, presenting with pale complexion, cold breath, green-colored stool, and clear, profuse urine. The onset of pain is slow and gradual, lingering continuously. During pain, the patient prefers pressure from hot hands, which slightly alleviates the pain, and the abdomen feels cold to the touch. Internal treatment is primarily based on Xiangsha Lizhong Tang (Aucklandia and Amomum Decoction for Regulating the Middle) with Baizhu (Atractylodis Macrocephalae Rhizoma) removed.

Massage techniques: Fen Yin (Dividing Yin) (One Hundred Repetitions, heavy force), Fen Yang (Dividing Yang) (Two Hundred Repetitions, light force), Tui Sanguan (Pushing the Three Gates) (Two Hundred Repetitions), Tui Liufu (Retreating the Six Palaces) (Fifty Repetitions), push left and right from the chest and abdomen (Two Hundred Repetitions), Rou Duqi (Rubbing the Umbilicus) (Two Hundred Repetitions), Tui Bu Pitui (Tonifying Pushing the Earth of the Spleen) (One Hundred Repetitions), Tianmen Ru Hukou (Heaven's Gate Entering Tiger's Mouth) (Twenty Repetitions), Qia Rou Yiwofeng (Pinching and Rubbing Yiwofeng) (Fifty Repetitions). For all pushing techniques, use Congjiangshui (Green Onion and Ginger Water), combined with Dingtong Fa (Calming Pain Method) (see Vol. 2, p. 44). Moxibustion at Shenque (CV 8) and Qihai (CV 6) points, seven moxa cones each (see Vol. 2, p. 26).

Heat pain presents with red face, hot breath, red lips, irritability, thirst, constipation, dark urine, intermittent pain, sudden and severe onset, normal abdominal shape without swelling or fullness, no resonance upon percussion, and increased pain upon pressure from hot hands, with the abdomen feeling hot like burning fire. This is true heat. Internal treatment focuses on clearing heat and purging fire.

Massage techniques: Fen Yin (Dividing Yin) (Two Hundred Repetitions), Fen Yang (Dividing Yang) (One Hundred Repetitions), Tui Sanguan (Pushing the Three Gates) (Fifty Repetitions), Tui Liufu (Retreating the Six Palaces) (One Hundred Repetitions), Shuidi Lao Mingyue (Fishing for the Bright Moon from the Bottom of the Water) (One Hundred Repetitions), Qing Tianheshui (Clearing the Heavenly River Water) (Thirty-Six Repetitions), Fen Fu Yin-Yang (Dividing Abdominal Yin-Yang) (Two Hundred Repetitions), Rou Duqi (Rubbing the Umbilicus) (One Hundred Repetitions), Tui Pitui (Pushing the Earth of the Spleen) (One Hundred Repetitions). Combine with Qingli Fa (Clearing Interior Method) (see Vol. 2, p. 37).

Food stagnation pain is caused by irregular diet and indigestible accumulation, resulting in immediate pain after eating, swollen eyelids, foul-smelling diarrhea, abdominal fullness, drum-like resonance upon percussion, yellowish complexion, sour belching, pain relief after defecation, and loss of appetite. Internal treatment is primarily based on Xiangsha Pingwei San (Aucklandia and Amomum Powder for Leveling the Stomach).

Massage techniques: Fen Yin-Yang (Dividing Yin-Yang) (Two Hundred Repetitions), Tui Sanguan (Pushing the Three Gates) (One Hundred Repetitions), Tui Liufu (Retreating the Six Palaces) (One Hundred Repetitions), Tui Pitui (Pushing the Earth of the Spleen) (One Hundred Repetitions), Tianmen Ru Hukou (Heaven's Gate Entering Tiger's Mouth) (One Hundred Repetitions), Fen Fu Yin-Yang (Dividing Abdominal Yin-Yang) (Two Hundred Repetitions), Rou Qi (Rubbing the Umbilicus) (Two Hundred Repetitions). For all pushing techniques, use Congshui (Green Onion Water) or Xiangsheshui (Musk Water), combined with Moxibustion at Shenque (CV 8) and Qihai (CV 6) points, seven cones each (see Vol. 2, p. 26), Yi Fa (Ironing Method) (see Vol. 2, p. 45), and Dingtong Fa (Calming Pain Method) (see Vol. 2, p. 44).

Qi disharmony pain occurs in newborns when the umbilical bandage is too tight. As the infant grows, if the bandage is not loosened, the qi flow between upper and lower parts becomes obstructed.

Massage techniques: Fen Yin-Yang (Dividing Yin-Yang) (Two Hundred Repetitions), Tui Sanguan (Pushing the Three Gates) (One Hundred Repetitions), Tui Liufu (Retreating the Six Palaces) (One Hundred Repetitions), Tui Pitui (Pushing the Earth of the Spleen) (One Hundred Repetitions), Fen Fu Yin-Yang (Dividing Abdominal Yin-Yang) (Two Hundred Repetitions), Rou Qi (Rubbing the Umbilicus) (Two Hundred Repetitions), Yun Tu Ru Shui (Moving Earth into Water) (Thirty-Six Repetitions), Rou Qi (Rubbing the Umbilicus) (Two Hundred Repetitions), Yun Tu Ru Shui (Moving Earth into Water) (Thirty-Six Repetitions), Yun Bagua (Moving the Eight Trigrams) (Thirty-Six Repetitions). For all pushing techniques, use Congtang (Green Onion Decoction), combined with Moxibustion at Shenque (CV 8) point, three cones (see Vol. 2, p. 26). Also treat Qi Lun (Umbilical Rim), Qihai (CV 6), and Xinwo (Heart Well) points (see Vol. 2, p. 30).

Spleen deficiency pain presents with sallow complexion, scanty white stool, indicating internal deficiency-cold. Internal treatment is primarily based on Xiangsha Liujun Tang (Aucklandia and Amomum Six Gentlemen Decoction).

Massage techniques: Fen Yin-Yang (Dividing Yin-Yang) (One Hundred Repetitions), Tui Sanguan (Pushing the Three Gates) (One Hundred Repetitions), Tui Liufu (Retreating the Six Palaces) (One Hundred Repetitions), Tui Bu Pitui (Tonifying Pushing the Earth of the Spleen) (Three Hundred Repetitions), Yun Shui Ru Tu (Moving Water into Earth) (One Hundred Repetitions), Fen Fu Yin-Yang (Dividing Abdominal Yin-Yang) (Two Hundred Repetitions), Rou Qi (Rubbing the Umbilicus) (One Hundred Repetitions). For all pushing techniques, use Congtang (Green Onion Decoction), combined with Moxibustion at Shenque (CV 8) and Qihai (CV 6) points, three cones each (see Vol. 2, p. 26).

Liver wood overacting on spleen pain occurs when liver wood suppresses spleen earth, and liver qi has no outlet, attacking the deficient spleen to cause pain. Symptoms include pale lips, bland taste, occasional bluish complexion, pain radiating from the abdomen to both hypochondria, pain cessation upon heavy pressure, and recurrence upon lifting the hand. Internal treatment is primarily based on Sijun Zi Tang (Four Gentlemen Decoction) plus Chaihu (Bupleuri Radix) and Shaoyao (Paeoniae Radix).

Massage techniques: Fen Yin-Yang (Dividing Yin-Yang) (One Hundred Repetitions), Tui Sanguan (Pushing the Three Gates) (One Hundred Repetitions), Tui Liufu (Retreating the Six Palaces) (One Hundred Repetitions), Tui Bu Pitui (Tonifying Pushing the Earth of the Spleen) (Two Hundred Repetitions), Tianhe Ru Hukou (Heavenly River Entering Tiger's Mouth) (Two Hundred Repetitions), Rou Qi (Rubbing the Umbilicus) (Two Hundred Repetitions), Fen Fu Yin-Yang (Dividing Abdominal Yin-Yang) (Two Hundred Repetitions), Yun Shui Ru Tu (Moving Water into Earth) (One Hundred Repetitions), Yun Bagua Kan Zhong (Moving Eight Trigrams with Heavy Pressure on Kan) (One Hundred Repetitions), Tui Dachang (Pushing Large Intestine) (Sixty Repetitions), Yun Wu Jing (Moving Five Meridians) (One Hundred Repetitions). For all pushing techniques, use Congjiangtang (Green Onion and Ginger Decoction).

Ascariasis pain presents with vomiting of green fluid, prolonged unceasing pain, stopping intermittently after one or two hours, or recurring after half a day, yellowish complexion, pale lips, possible red spots, and fluctuating pulse (alternating large and small). These are its signs. Internal treatment is primarily based on Lizhong Anhui San (Regulate Middle Calm Ascariasis Powder) or Wumei Wan (Mume Pill) with modifications.

Massage techniques: Fen Yin-Yang (Dividing Yin-Yang) (One Hundred Repetitions), Tui Sanguan (Pushing the Three Gates) (One Hundred Repetitions), Tui Liufu (Retreating the Six Palaces) (One Hundred Repetitions), Tui Pitui (Pushing the Earth of the Spleen) (One Hundred Repetitions), Rou Duqi (Rubbing the Umbilicus) (One Hundred Repetitions). For all pushing techniques, use Congjiang Xiangsheshui (Green Onion, Ginger, and Musk Water). Combine with Moxibustion at Shenque (CV 8) and Qihai (CV 6) points, five cones each (see Vol. 2, p. 26).

Shijunzi (Quinine Seed/Carissa Carandas Linn. fruit - *Note: Traditionally Canarium album seed or similar antiparasitic seed, often Quisqualis indica*) shelled and roasted/fired for feeding, or eat about ten grains; if pain recurs shortly, eat more until pain stops. Kuanlgenpi (Meliae Cortex) one tael, decocted in water to make a concentrated liquid, taken orally, worms will be expelled. However, adjust dosage for weak constitutions.

Note: Regarding abdominal pain, cold pathogenic factors are common, while heat pathogenic factors are rare, because cold easily obstructs yang qi. Qi stagnation is common, while blood stagnation is rare. Treating qi stagnation should not disturb blood; treating blood stagnation must involve moving qi. Ancient sages stated "pain implies obstruction, freedom from pain implies free flow." Therefore, the general principle for treating pain is warming and dispersing with acrid-pungent substances to promote circulation. The key lies in initially using methods to unblock the fu organs, and for chronic cases, using methods to unblock the collaterals. Treatment should be tailored according to deficiency and excess conditions. (Ti Li Zi)