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In the *Ci Fa Lun* (Treatise on Needling Methods), the Yellow Emperor asked: I have heard that when the five plagues arrive, they all infect each other, regardless of age, and the symptoms are similar. If no treatment is provided, how can one avoid mutual infection? Qibo replied: Those who do not get infected are those whose Zheng Qi (Upright Qi/Vital Energy) is preserved within, so that Xie Qi (Evil/Pathogenic Factors) cannot invade. Avoid the toxic vapors; these vapors enter through the nose (Tian Ping, meaning nose. Laozi referred to it as the gate of the mysterious female. Toxic vapors enter via the nose and can be expelled by sneezing). To prevent them from taking hold, let the Qi return to its source, exiting through the brain, thus preventing interference by pathogenic factors. For Qi to exit through the brain, one must first visualize the heart like the sun. Before entering a plague chamber, one should first visualize green Qi emanating from the Liver, moving left to the East, transforming into forests and trees. Next, visualize white Qi emanating from the Lung, moving right to the West, transforming into weapons and armor. Next, visualize red Qi emanating from the Heart, moving south to the upper region, transforming into bright flames. Next, visualize black Qi emanating from the Kidney, moving north to the lower region, transforming into water. Next, visualize yellow Qi emanating from the Spleen, remaining in the center, transforming into earth. After completing the visualization of the Five Qi protecting the body, visualize the head shining brightly like the Big Dipper, and only then may one enter the plague chamber.

In the *Yangming Mai Jie Pian* (Chapter on Explaining the Yangming Meridian), the Yellow Emperor asked: When the disease is severe, the patient discards clothes and runs, climbs high places and sings, or goes without food for several days, climbing over walls and roofs. These places are beyond their usual capabilities, yet the disease enables them to do so. What is the reason? Qibo replied: The four limbs are the root of all Yang meridians. When Yang is excessive, the four limbs become solid and strong, enabling one to climb high. The Yellow Emperor asked: Why discard clothes and run? Qibo said: Heat is excessive in the body, hence discarding clothes and running. The Yellow Emperor asked: Why talk nonsense, curse, and sing without regard for intimacy or distance? Qibo said: Excessive Yang causes people to talk nonsense, curse, disregard relationships, and lose appetite. Due to loss of appetite, they walk aimlessly. (This refers to stomach diseases caused by excessive pathogenic factors. Excess pathogens lead to heat excess, heat excess leads to Yang excess, and thus these three conditions arise.)

In the *Re Lun* (Treatise on Heat), the Yellow Emperor asked: After a heat disease has healed, why do residual symptoms sometimes occur? Qibo replied: All residual symptoms occur because the patient forces themselves to eat while the heat is still intense. In such cases, although the disease has subsided, heat remains hidden. The Qi of food grains clashes with this residual heat, and the two heats combine, causing residual symptoms. The Yellow Emperor asked: How to treat residual symptoms? Qibo replied: Observe deficiency and excess, regulate reversal and normalcy, and the disease will surely heal. The Yellow Emperor asked: What should be forbidden during a heat disease? Qibo replied: When a heat disease slightly improves, eating meat causes relapse, and overeating causes residual symptoms. This is the prohibition. (This explains that residuals result from forced eating, providing both treatment methods and prohibitions. "Residual" means the disease seems cured but pathogenic factors remain. "Prohibition" means forbidding actions before residuals occur. Meat is hot in nature and hard to digest, especially to be avoided.)

In the *Ping Re Bing Lun* (Treatise on Evaluating Heat Diseases), the Yellow Emperor asked: There is a person suffering from a warm disease who sweats and immediately fever returns, with a rapid and restless pulse that does not subside with sweating. They speak deliriously and cannot eat. What is this disease called? Qibo replied: This disease is called Yin-Yang Jiao (Intersection of Yin and Yang), where Yin and Yang Qi are mixed and indistinguishable. "Jiao" implies death. The Yellow Emperor requested an explanation. Qibo said: Human sweating originates from grain, which generates Jing (Essence). Now, if pathogens struggle in the flesh and bones and sweat results, it means pathogens are retreating and Jing is victorious. Victory of Jing should allow eating and prevent recurrent fever. Recurrent fever indicates pathogenic dominance. Sweat represents Jing/Essence. Sweating followed by immediate fever indicates pathogenic excess. Inability to eat means Jing lacks support (Essence cannot facilitate digestion). If the disease lingers, life is imperiled. Furthermore, heat diseases state: sweating followed by a still restless and vigorous pulse indicates death. Here, the pulse does not correspond to the sweat (pulse is rapid/restless and does not subside with sweat), indicating the body cannot overcome the disease; death is evident. Delirious speech indicates loss of Zhi (Will/Spirit); loss of Will leads to death. Seeing three signs of death (fever with inability to eat, rapid/vigorous pulse, delirium) and no sign of life, even if temporary improvement occurs, death is inevitable.

The *Ling Shu* (Spiritual Pivot) *Re Bing Pian* states: If a heat patient sweats but the pulse remains restless, accompanied by asthma and recurrent fever, do not needle; severe asthma indicates death. It also states: If a heat patient sweats but the pulse remains vigorous, this is the extreme of Yin pulses, indicating death.

The *Ci Re Pian* (Treatise on Needling Heat) states: In Liver Heat Disease, urination turns yellow first, abdominal pain occurs, and the patient lies down often (the Liver meridian circles the genitalia and ascends to the lower abdomen, causing these symptoms), along with body heat. During Zheng-Zheng (struggle between righteous and pathogenic Qi), delirium and惊骇 (fright) occur, along with hypochondriac fullness and pain, restlessness of hands and feet, and inability to sleep peacefully (the Liver meridian ascends from the lower abdomen, passes through the diaphragm, spreads over the hypochondrium, follows the throat behind, and connects to the tongue root, causing these symptoms. Liver disease manifests as fright. Disharmony of the Stomach leads to restless sleep; Wood overacting on Earth causes inability to rest). Symptoms worsen on Geng-Xin days (Metal overcomes Wood) and improve significantly on Jia-Yi days (when the Liver meridian Qi is prosperous). If Qi rebels, death occurs on Geng-Xin days (due to severe Qi rebellion. The preceding sentences summarize severity and death occurring on days overcoming the organ; recovery with sweat occurs on days of the organ's prosperity. The following paragraphs follow this pattern). Needle the Foot Jueyin and Foot Shaoyang meridians. If Qi rebels, headache and dizziness occur, with pulse sensation pulling towards the head (the Liver meridian originates at the tongue root, follows the throat behind, emerges above the forehead, and meets the Du vessel at the vertex. Thus, rebellious Qi causes this. "Yuan Yuan" means undulating/unstable).

Song Feng stated: This specifically cites canonical principles regarding needling; further details on needling are omitted.

In Heart Heat Disease, the patient feels unhappy for several days (pathogens entering meridians disturb Shen [Spirit], causing unhappiness), followed by fever. During Zheng-Zheng, sudden heart pain occurs. There is vexation, frequent vomiting, headache, red face, and absence of sweat (the Heart meridian originates in the heart; its branch ascends alongside the pharynx. The Small Intestine meridian descends through the diaphragm to the stomach; its branch ascends the neck to the cheek and outer canthus, explaining these combined symptoms. The Heart governs sweat; in heat disease, sweat fails to emerge). Symptoms worsen on Ren-Gui days (overcoming) and improve significantly on Bing-Ding days (prosperous Qi). If Qi rebels, death occurs on Ren-Gui days. Needle the Hand Shaoyin and Hand Taiyang meridians.

In Spleen Heat Disease, there is initial heaviness of the head and cheek pain, mental vexation, bluish complexion around the mouth, and desire to vomit (the Stomach meridian starts at the nose, descends outside the nose, enters the upper teeth, curves around the lips, meets at Chengjiang, descends along the jawline to Daying, passes Guest Master, follows the hairline to the forehead. Hence initial head/cheek heaviness and bluish complexion. The Spleen meridian branch separates from the stomach, ascends the diaphragm to the heart; its main line ascends the diaphragm alongside the pharynx. Hence mental vexation and desire to vomit), along with body heat. During Zheng-Zheng, lower back pain prevents bending or stretching, abdominal fullness, diarrhea, and pain in both jaws (the Stomach meridian branch starts below the stomach, runs inside the abdomen to Qichong, descending to Bituan. Qichong is anterior to the waist, causing back pain. The Spleen meridian enters the abdomen, belongs to the Spleen and connects to the Stomach; its path from Chengjiang descends along the jawline to Daying and Chejia. Hence abdominal fullness, diarrhea, and jaw pain). Symptoms worsen on Jia-Yi days and improve significantly on Wu-Ji days. If Qi rebels, death occurs on Jia-Yi days. Needle the Foot Taiyin and Foot Yangming meridians.

In Lung Heat Disease, there is initial chills, goosebumps, aversion to wind and cold, and a yellow coating on the tongue (the Lung governs skin and hair; heat invading causes chills and goosebumps. The Lung meridian originates in the middle Jiao, connects to the Large Intestine, and loops around the stomach. Lung heat entering the stomach causes stomach heat to rise, resulting in a yellow tongue coating), along with body heat. During Zheng-Zheng, asthma and cough occur, pain radiates to the chest, epigastrium, and back, inability to take deep breaths, unbearable headache, sweating with chills (the Lung sits above the diaphragm, Qi governs the chest/epigastrium, changes manifest as cough; the back is the mansion of the chest, causing asthma/cough and pain. Lung collaterals meet in the ear; rising heat causes headache. Sweating with chills occurs). Symptoms worsen on Bing-Ding days and improve significantly on Geng-Xin days. If Qi rebels, death occurs on Bing-Ding days. Needle the Hand Taiyin and Hand Yangming meridians; bleed until bean-sized drops appear, and relief is immediate.

In Kidney Heat Disease, there is initial lower back pain (the Bladder meridian runs along the shoulder interior, alongside the spine to the waist; the waist is the mansion of the Kidney, hence pain). There is bitter thirst and frequent drinking (pain/soreness in the legs. The Kidney meridian follows behind the medial malleolus, ascends the medial leg, and emerges at the medial knee. Its main line ascends from the Kidney, pierces the Liver and Diaphragm, enters the Lung, follows the throat alongside the tongue root). Body heat ensues. During Zheng-Zheng, neck pain and stiffness occur, chills with soreness, heat in the soles of the feet, and reluctance to speak (the Bladder meridian exits the brain, branches down the neck. The Kidney meridian starts below the little toe,斜趋 (slants towards) the sole, emerges below Ran Gu, follows behind the medial malleolus, enters the heel, and ascends the medial leg. Its main line ascends from the Kidney, pierces the Liver and Diaphragm, enters the Lung, follows the throat alongside the tongue root, causing these symptoms). If Qi rebels, neck pain with dizziness and palpitations occur. Symptoms worsen on Wu-Ji days and improve significantly on Ren-Gui days. If Qi rebels, death occurs on Wu-Ji days. Needle the Foot Shaoyin and Foot Taiyang meridians. ("Yuan Yuan" means undulating; "Dan Dan" means meaningless/palpitations).

It is also stated: In Liver Heat Disease, the left cheek reddens first. In Heart Heat Disease, the face reddens first. In Spleen Heat Disease, the nose reddens first. In Lung Heat Disease, the right cheek reddens first. In Kidney Heat Disease, the chin reddens first. Even if the disease has not fully manifested, if redness is seen, needle it; this is called treating disease before it arises (matching facial areas to the Five Zang organs).

It is also stated: To treat various heat diseases, drink cold water, then needle. Wear cool clothing, reside in cool places, until the body is cool (heat recedes, body cools), then stop needling.

I once witnessed a child suffering from severe epidemic heat with deep pathogens, discarding clothes and running day and night without rest, moving hands and feet constantly, overturning vessels, and rummaging through items. Finding a jar of cool water, he bathed in it and drank it. After one day, as the heat receded and the body cooled, he recovered. Recorded by Song Feng.

Needling methods have their own specialized field. These excerpts are recorded because their implications relate to epidemics, not to teach needling techniques.

In the *Re Lun*, the Yellow Emperor asked: Current heat diseases are all of the Shang Han (Cold Damage) type. Some recover, some die; deaths usually occur within six or seven days, recoveries after ten days. Why? Qibo replied: Ju Yang (Great Solar/Taiyang) is the chief of all Yang meridians (the leader of the Six Yang meridians, commanding all Yang). Its vessel connects to Fengfu, making it the master of Yang Qi. When humans are injured by Cold, they develop heat diseases; even if heat is severe, it is not fatal. However, those suffering from Liang Gan Yu Han (simultaneous contraction of Cold by two meridians) will inevitably die. On the first day, Ju Yang is affected (Ju Yang is Taiyang), causing headache, stiff neck, and rigid spine. On the second day, Yangming is affected; Yangming governs flesh, its vessel runs alongside the nose and connects to the eyes, causing body heat, eye pain, dry nose, and insomnia. On the third day, Shaoyang is affected; Shaoyang governs the Gallbladder, its vessel runs along the flanks and connects to the ears, causing hypochondriac pain and deafness. If the three Yang meridians and their collaterals are diseased but have not entered the Zang organs, sweating can cure it. On the fourth day, Taiyin is affected; Taiyin vessel runs through the stomach and connects to the throat, causing abdominal fullness and dry throat. On the fifth day, Shaoyin is affected; Shaoyin vessel pierces the Kidney, connects to the Lung, and ties to the tongue root, causing dry mouth, dry tongue, and thirst. On the sixth day, Jueyin is affected; Jueyin vessel runs along the genitalia and connects to the Liver, causing irritability, fullness, and retraction of the scrotum. When all Three Yin and Three Yang, Five Zang, and Six Fu organs are diseased, Ying and Wei Qi cease to circulate, and obstruction of the Five Zang leads to death. If less than three days have passed, sweating can cure it; if three days or more have passed, purgation can cure it.

Song Feng stated: This is the correct example of meridian transmission in the *Nei Jing* and *Shang Han Lun*. Although epidemics differ from Shang Han, the pathogen resides in the Mo Yuan (Membrane Source), at the junction of the meridians and Stomach, half-exterior and half-interior. The excessive heat Qi floats to a specific meridian, manifesting its symptoms. Specialists in epidemics must understand this. (Sweating and purgation should not be rigidly applied based on the three-day rule.)

The Classics state: Unseasonably warm weather in winter is called Dong Wen (Winter Warmth). The toxicity of Dong Wen is vastly different from Shang Han. Dong Wen has early and late stages, overlapping, with varying severity and treatments.

Song Feng stated: Winter warmth leads to illness in the following summer; few fall ill at the time.

The *Yin Yang Ying Xiang Da Lun* states: Injury by Cold in winter leads to Wen Bing (Warm Disease) in spring.

Song Feng stated: The *Yun Ji Qi Qian* cites this as "Injury by Sweat in Winter," which is profound. It suggests that excessive warmth in winter causes sweating, leading to Warm Disease the following year. My careful experience confirms this. Severe cold in winter results in no epidemics in spring because it conforms to seasonal norms. Moreover, how can Cold remain in the body for a year before causing disease?

The *Jin Gui Zhen Yan Lun* states: Jing (Essence) is the root of the body. Therefore, those who preserve Jing will not suffer from Warm Disease in spring.

Song Feng stated: Those who preserve Jing are free from all diseases, not just Warm Disease.

The *Lun Ji Zhen Chi Pian* states: If the skin of the chi position is very hot and the pulse is vigorous and restless, it is a Warm Disease. If the pulse is vigorous and slippery, the disease is about to exit (resolve).

Song Feng stated: "Exit" means the pathogen does not enter the interior but is about to dissipate.

Zhang Zhongjing's *Wen Bing Pian* states: Taiyang disease with fever, thirst, and aversion to cold absent is Wen Bing; after sweating, if the body becomes burning hot, it is named Feng Wen (Wind Warmth). In Feng Wen, the pulse is floating and vigorous on both Cun and Chi positions, spontaneous sweating occurs, the body feels heavy, there is excessive sleepiness, nasal breathing is snoring-like, and speech is difficult. (From post-sweating onwards, this describes the harm of excessive sweating.) If mistakenly treated with purgation, urination becomes difficult, eyes stare fixedly, and incontinence occurs. (Loss of Zang Qi fixation causes incontinence. These four lines describe the harm of mistaken purgation.) If treated with fire therapy, mild cases turn yellow; severe cases resemble epilepsy with convulsions. (Epilepsy sounds like a lamb bleating. Convulsions involve jerking. These four lines describe the harm of forcing sweat with fire.) If fumigated with fire, one mistake delays death, a second mistake accelerates it. (Exterior heat without cold makes sweating inappropriate. Interior heat without excess makes purgation inappropriate. Exterior and Interior heat together make fire therapy highly inappropriate. Mistaken sweating, purgation, or fire coercion are errors; one error may prolong life, a second error leads to immediate death of Yin.)

The Classics state: Spring should be warm but is severely cold; Summer should be hot but is severely cool; Autumn should be cool but is severely hot; Winter should be cold but is severely warm. This is having the Qi out of season, causing similar illnesses among young and old throughout the year; this is the Qi of Shi Xing (Seasonal Epidemic).

Liu Nanying stated: Illnesses caused by irregular four-season climates are called Shi Zheng (Seasonal Patterns), distinct from Shang Han, Wen, Shu, and Han Yi. Autumn rarely sees such illnesses.

The *Su Wen* states: Irregularities in the four seasons generate great epidemics.

The *Shang Han Lun* states: A洪数 (Vigorous-Rapid) Yang pulse and 实大 (Solid-Large) Yin pulse, encountering warmth, transform into Wen Du (Warm Toxicity). (Yang governs exterior, Yin governs interior; Vigorous-Rapid and Solid-Large are all heat. Two heats combine to form Warm Toxicity.)

It also states: The pulse of Warm Disease travels through the various meridians; knowing which meridian is activated is difficult. Treat according to the affected meridian. (Epidemic pathogens disperse through various meridians due to abnormal Qi, making it hard to identify the affected meridian. One must determine the meridian involved before treating.)

Heat diseases require a floating-vigorous pulse; a fine-small pulse wastes effort uselessly (Yang diseases should have Yang pulses. Fine-small are Yin pulses, indicating terminal cases, untreatable). After sweating, a quiet pulse indicates recovery; asthma-heat with a chaotic pulse indicates impending death. (Post-sweat, quiet pulse means survival; chaotic pulse means death.)

Song Feng stated: Heat diseases with fine-small pulses are generally considered untreatable, except in cases of Pulse Jue (Pulse Collapse), which is an exception.

Yang Du (Yang Toxin) causes limb agitation and vexation, red face with floral spots, delirium, seeing spirits/demons, frequent dysentery, and throat discomfort. Generalized sweating should indicate major recovery; if the mouth opens like a fish's gills, death is imminent. If medicine is available and administered, surviving seven days brings peace. (Yang patterns suit sweating; failure to sweat allows pathogens to enter Zang, causing critical symptoms. Internal transmission contraindicates sweating. Generalized sweating plus open-mouth breathing indicates death. Surviving seven days means passing the meridian stage, Yang heat retreats, and rescue is possible.)

Song Feng stated: The "seven days to peace" notion merely implies a chance of rescue, not cure. Do not adhere to it rigidly.

For heat diseases, before sweating, the pulse must be floating-vigorous; after sweating, the pulse should be quiet. If a scattered pulse appears, or if recovery occurs without sweating (called Gan Chai/Dry Recovery), full recovery cannot be guaranteed.

Epidemics, where everyone falls ill similarly, are also called Tian Xing Shi Yi (Heavenly Travel Seasonal Epidemic). Treatment methods include tonification, dispersion, and descent. For severe heat, drinking human urine (Tong Bian) is suitable.

Song Feng stated: Tonification applies to Si Sun (Four Damages) where direct treatment is contraindicated, and to the elderly, young, or inherently weak. Dispersion refers to clearing heat and resolving the exterior (Epidemics should not use warm dispersion). Descent involves expelling pathogens via stool and urine.

The pulse of epidemic patients is scattered and hard to name; classify by meridian based on pulse characteristics. If floating and large but weak upon pressure, combine tonification with exterior resolution according to timing.

Song Feng stated: Floating-large-weak is typically a deficient-pulse. How to identify it as an epidemic? It must be correlated with Wen Mai (Epidemic Pulse: Vigorous-Rapid-Floating) and Wen Zheng (Epidemic Symptoms) to be accurate. "Pulse characteristics" refers to symptoms, complexion, and voice.

The key to epidemic diseases lies in the two characters: Xu (Deficiency) and Shi (Excess). Excess is easy to treat; deficiency is difficult because Yuan Qi (Primal Qi) is fundamentally weak, making pathogen expulsion hard. Treating deficiency-with-excess without supporting and dispersing, but only attacking pathogens, leads to greater deficiency and inevitable death.

Song Feng stated: Deficiency and Excess apply to all three types of epidemics, including Wen, though Wen is mostly heat without cold.

Epidemics come without fixed direction, but their arrival has causes: human disorder, climatic deviation, corpse qi contamination, or toxic vapor transformation. Since symptoms vary, treatment cannot be uniform. Epidemics are mostly Fire-Heat Qi accumulating in houses (affecting families), villages (affecting townships), markets (affecting cities), or roads (affecting thousands of miles). Thus, despite varied symptoms, removing Fire-Heat Qi and adding mild pathogen-expelling and filth-removing herbs yields efficacy.

Treating epidemics with Qing Li (Clearing and Purging) involves multiple aspects: Clear Heat for Fire Excess, Move Qi for Qi Stagnation, Digest for Food Retention, Transform Phlegm for Severe Phlegm. Removing stagnation moves Qi and resolves exterior pathogens. However, this suits Excess patterns, not Deficiency. For Deficiency-with-Excess, mild clearing and resolving may be used.

Purgation for epidemics is indicated only for Yangming Excess in the Fu organs, with constipation and abdominal fullness, or in those with strong Yuan Qi and robust Stomach Qi. If stool is retained for days but the abdomen is not full, or if there is no blockage, or if the patient hasn't eaten for days but the umbilical/abdominal area is soft and unobstructed, there is no Yangming Excess. Do not blindly purge to drain Middle Qi. Among errors, purgation is most harmful; do not neglect this.

Zhou Hanguang stated: Combine this with discussions on urgent attack for acute conditions and pathogen expulsion. Adapt to circumstances and remain flexible.

Although ancient texts state that epidemics affect the Three Yang meridians more than the Three Yin, do not adhere to this rigidly.