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Mandibular pain; the condition worsens on Jia (Wood) and Yi (Wood) days, profuse sweating occurs on Wu (Earth) and Ji (Earth) days, and if Qi rebellion occurs, death ensues on Jia or Yi days. Acupuncture of Foot-Taiyin (Spleen) and Foot-Yangming (Stomach).

In Spleen disease, heaviness in the head is the initial symptom. The Spleen belongs to Wet Earth, its nature is heavy. The Classics state that when Dampness invades the human body, the head feels as if wrapped, thus in Spleen disease, heaviness in the head appears first. The cheek is the region of Shaoyang (Gallbladder). In the relationship between Earth and Wood, if one is defeated, the other prevails; thus, when Spleen Earth is diseased, Liver Wood pathology also manifests. Vexation in the heart occurs because the Spleen meridian connects to the Heart. Cyan complexion and desire to vomit are also signs of Liver Wood pathology. Lower back pain with inability to bend or extend: the lower back is the mansion of the Kidney. The Spleen controls water, while the Kidney is the deity governing water. When Spleen disease fails to control water, lower back pain results. Furthermore, when the Spleen is diseased, the Stomach cannot function independently. Yangming governs conjunction and binding, facilitating joint movement; thus, pain becomes severe enough to prevent bending or extending. Abdominal fullness and diarrhea are primary diseases of the Spleen meridian. Mandibular pain is also a manifestation of Liver Wood pathology.

13. In Lung Heat Disease, the patient first experiences shivering chills, erection of hair follicles, aversion to wind and cold, yellow coating on the tongue, and fever. During the struggle between Heat and Healthy Qi, asthma and cough occur, pain radiates to the chest, hypochondrium, and back, deep breathing is difficult, headache is unbearable, sweating occurs followed by chills. The condition worsens on Bing (Fire) and Ding (Fire) days, profuse sweating occurs on Geng (Metal) and Xin (Metal) days, and if Qi rebellion occurs, death ensues on Bing or Ding days. Acupuncture of Hand-Taiyin (Lung) and Hand-Yangming (Large Intestine), releasing blood drops the size of soybeans brings immediate relief.

In Lung disease, aversion to wind and cold appears first. The Lung governs Qi and the skin/hair. In Lung disease, Qi becomes congested and stagnant, failing to defend the skin and hair. A yellow tongue coating indicates that failure of Lung Qi transformation leads to the accumulation of Damp-Heat forming a yellow coating. (Note: In medical texts, "Tai" [moss] is often written as "Tai" [embryo/fetus]. Fetus refers to the sac of an embryo. Specifically because moss grows on the tongue, it uses the flesh radical. However, ancients borrowed characters frequently. Generally, Damp-Heat steaming produces moss, which may be yellow, white, cyan, or black, depending on the depth of disease and whether it is Cold, Heat, Dryness, or Dampness, similar to moss growing on the shaded side of stones in spring and summer. Therefore, in this treatise, the character for moss always uses the grass radical, not the flesh radical.) Asthma represents extreme Qi stagnation. Cough represents Fire overcoming Metal. The chest and hypochondrium are the mansions of the back, governed by Heaven's Qi. The Lung governs Heaven's Qi; extreme stagnation of Lung Qi causes pain radiating to the chest, hypochondrium, and back. "Radiating" implies unpredictability. Inability to take a deep breath signifies extreme Qi stagnation. Severe headache also signifies extreme congestion and stagnation of Heaven's Qi. Sweating followed by chills: pores open causing sweating; after sweating, Wei Qi (Defensive Qi) becomes deficient, causing aversion to cold; moreover, the Lung inherently dislikes cold.

14. In Kidney Heat Disease, lower back pain appears first, soreness in the popliteal fossa, bitter taste, thirst with frequent drinking, and fever. During the struggle between Heat and Healthy Qi, neck pain and stiffness occur, aversion to cold and soreness, heat in the soles of the feet, and reluctance to speak. If Qi rebels, neck pain occurs accompanied by dizziness and palpitations. The condition worsens on Wu (Earth) and Ji (Earth) days, profuse sweating occurs on Ren (Water) and Gui (Water) days. If Qi rebellion occurs, death ensues on Wu or Ji days. Acupuncture of Foot-Shaoyin (Kidney) and Foot-Taiyang (Bladder).

In Kidney disease, lower back pain appears first. The lower back is the mansion of the Kidney. Additionally, the Kidney meridian penetrates the spine and converges at Changqiang (GV1) of the Du Meridian. The popliteal fossa: the Kidney meridian enters the heel and ascends into the popliteal fossa; the Taiyang Bladder meridian also descends through the popliteal fossa. Soreness is caused by Heat scorching fluids. Bitter taste and thirst with frequent drinking: the Kidney governs the five fluids and dislikes dryness. In heat disease, fluids are damaged leading to dryness, hence the bitter taste, thirst, and drinking to seek relief. The neck: the Taiyang Bladder meridian enters the brain from the vertex and emerges to descend behind the neck. In Kidney disease progressing to the struggle of Heat, Zang disease becomes severe and transfers to Fu organs, causing neck pain and stiffness. Aversion to cold and soreness: soreness is explained above; aversion to cold is the manifestation of extreme Heat transforming into Cold; soreness is caused by Heat scorching fluids. Heat in the soles of the feet: the Kidney meridian runs from below the little toe, slanting towards Yongquan (KI1) in the sole of the foot; severe disease generates heat. Reluctance to speak: the Heart governs speech; in Kidney disease, Water overcomes Fire. "Yuan yuan dan dan" describes severe, helpless pain.

15. In Liver Heat Disease, redness appears first on the left cheek. In Heart Heat Disease, redness appears first on the center of the face. In Spleen Heat Disease, redness appears first on the nose. In Lung Heat Disease, redness appears first on the right cheek. In Kidney Heat Disease, redness appears first on the chin. Even if the disease has not yet fully manifested, if redness is seen, acupuncture should be applied. This is called treating disease before it arises.

This section states that before the Five Zang organs become diseased, they inevitably show preliminary signs in their corresponding regions, indicating early treatment to prevent worsening during the struggle of Heat and Healthy Qi.

16. From *Re Lun Pian* (Treatise on Heat): The Yellow Emperor asked: Heat disease has healed, but sometimes residual symptoms remain. Why? Qibo answered: All cases of residual symptoms occur because the patient eats strongly while Heat is still intense. Thus, residual symptoms arise. In such cases, the pathogenic factor has declined but Heat is still hidden. The Qi from food grains clashes with the residual Heat, and the two heats combine, causing residual symptoms. The Yellow Emperor asked: How to treat residual symptoms? Qibo answered: Observe deficiency and excess, regulate reversal and normalcy, and the disease can surely be cured. The Yellow Emperor asked: What should be prohibited in heat disease? Qibo answered: When heat disease slightly improves, eating meat causes recurrence, and overeating causes residual symptoms. These are the prohibitions.

This section discusses prohibitions in heat disease, the meaning being clear. Generally, pathogens attach to the body relying on substantial matter. During fever, eating must absolutely be avoided. After fever subsides, food intake must be minimal, akin to the military strategy of clearing fields and fortifying walls. Only after the Heat pathogen has completely retreated can large meals be consumed.

17. From *Ci Fa Lun* (Treatise on Needling Methods): The Yellow Emperor asked: I have heard that the arrival of the Five Plagues causes mutual infection, regardless of age, with similar symptoms. If no treatment is provided, how can one avoid transmission? Qibo answered: Those who do not get infected do so because Healthy Qi exists within, preventing pathogens from invading.

This speaks to the way to avoid plagues.

Note: Below this, there are further words about avoiding toxic vapors, such as visualizing green or white Qi, which resemble Zhu You (incantation) practices. These are likely later interpolations, so they are omitted. Ultimately, they do not exceed the principle of "Healthy Qi exists within, pathogens cannot invade." The meaning is complete; there is no need to confuse students.

18. From *Yu Ban Lun Yao*: "Those suffering from Warm Disease with extreme deficiency die."

Patients with Warm Disease who have extreme deficiency of Essence and Blood lack Yin to overcome the Warm-Heat, leading to death.

19. From *Ping Ren Qi Xiang Lun* (Treatise on Normal People's Pulse Images): "If a person's pulse beats three times per exhalation and three times per inhalation, and is rapid, with heat in the Chi position, it is Warm Disease. If the Chi position is not hot but the pulse is slippery, it is Wind Disease. If the pulse is choppy, it is Bi Syndrome."

Three beats per exhalation and three per inhalation constitute a pulse rate of six to seven beats per cycle, which is rapid. If the muscles at the Chi position are hot, it indicates Warm Disease. Generally, Warm Disease damages the fluids of the Metal (Lung) and Water (Kidney) organs. The Chi pulse belongs to the Kidney, and the Chi skin area relates to the Lung. Heat in this muscle area indicates Warm Disease. If not hot but the pulse is slippery, it is Wind Disease. Wind pathogens affect Yang Qi; Chi is Yin, hence not hot. If the pulse is rapid and choppy, there is excess Qi and insufficient Blood, resulting in Bi Syndrome.