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Danbo Yuanzhen's commentary: Body stiffness and convulsions are called "Jing" (Spasm), inability to open the jaw is called "Jin" (Lockjaw), and teeth grinding is called "Chi". These symptoms all belong to the category of "Jing disease" (Spasm). This occurs due to extreme heat generating wind, which severely damages Yin blood. Once spasm has manifested, it constitutes a death syndrome.

(Note: "Jing" is pronounced Jing; "Chi" has three pronunciations Chi, Ji, Xi; "Zong" is pronounced Zong.)

For any of the above nine conditions, acupuncture should not be used. Zhang Jingyue stated that acupuncture offers no benefit and may instead invite disaster.

Jie Mei noted: Wu Jutong said that this section sequentially describes the fatal signs of heat diseases, aiming to prohibit acupuncture, as performing it would inevitably lead to death. However, although acupuncture is indeed contraindicated, there are cases that can be cured through herbal medicine.

Generally speaking, acupuncture methods can drain pathogens and unblock meridians, being most rapid in opening the blockage caused by heat pathogens. Nourishing Yin to preserve body fluids, however, is a shortcoming of acupuncture but a strength of herbal decoctions.

Three acupoints on each side of the medial and lateral aspects of both hands: Zhang Jingyue stated that the medial and lateral aspects of the hands refer to Shaose (SI1) of the Taiyang bladder meridian, Guanchong (SJ1) of the Shaoyang triple energizer meridian, and Shangyang (LI1) of the Yangming large intestine meridian. The three Yin meridians are located on the medial aspect: Shaoshang (LU11) of the Taiyin lung meridian, Zhongchong (PC9) of the Jueyin pericardium meridian, and Shaochong (HT9) of the Shaoyin heart meridian. There are twelve acupoints in total on the left and right. "Ci" refers to puncture wounds; since puncture leaves scars, the count is based on these scarred points.

Between the five fingers (and similarly for the feet): Zhang Jingyue explained that "between the five fingers" generally refers to the five fingers of the hand. Each finger has one acupoint located behind the proximal interphalangeal joint. Referring to Section 15 earlier, which states "take from their [acupoints] and those between the lower fingers," this is precisely what is meant. Generally, the Shu-stream points of various meridians are located behind the proximal joints of the fingers. For example, in the hand meridians, Houxi (SI3) of the Taiyang meridian, Zhongzhu (SJ3) of the Shaoyang meridian, and Sanjian (LI3) of the Yangming meridian. Only for the Shaoyin meridian, the point located behind the proximal joint is Shaofu (HT8), the Ying-Spring point. Among the six hand meridians, only the Taiyin and Jueyin meridians have no acupoints behind the proximal joint. Thus, the four meridians on the left and right total eight acupoints. Regarding the foot meridians, their Shu-stream points are: Shugu (BL65) of the Taiyang meridian, Linqi (GB41) of the Shaoyang meridian, XianGu (ST43) of the Yangming meridian, and Taibai (SP3) of the Taiyin meridian, all located behind the proximal joints. The Shaoyin meridian does not run to the toes, and the Jueyin meridian also has no acupoints behind the proximal joint. The four meridians on the left and right total only eight acupoints. Hence, it is said that the feet are similar.

One cun into the hairline (total six acupoints): The *Jia Yi Jing* adds the character "ji" (boundary) after "fa" (hair). The annotation notes that *Ling Shu* lacks the character "fen" (divide). Ma Yun stated that "fen" here is read with the falling tone, meaning "three areas." If read with the level tone, there would be no acupoints in the divided sections. Zhang Jingyue stated that one cun into the hairline corresponds to the acupoint next to Shangxing (GV23) of the Du vessel. The adjacent acupoints are divided into three rows: Wuchu (BL3), Chengguang (BL3), and Tongtian (BL7) of the Foot-Taiyang bladder meridian. There are three on each side, totaling six acupoints.

Further into the hairline (total ten acupoints): Zhang Jingyue stated that "further into the hair" means moving backward from Shangxing (GV23). The five acupoints at the edge three cun away are approximately three cun from the midline, five on each side. These are Linqi (GB41), Mucuang (GB16), Zhengying (GB17), Chengling (GB18), and Naokong (GB19) of the Foot-Shaoyang gallbladder meridian. Two rows on the left and right, totaling ten acupoints.

Before and behind the ears (total six acupoints): The *Jia Yi Jing* annotates under "kou" (mouth) that *Ling Shu* reads "yi xia" (below). Zhang Jingyue stated that the acupoint before the ear is Tinghui (GB2), and behind the ear is Wanggu (GB12). Both are acupoints of the Foot-Shaoyang gallbladder meridian, two on each side. The acupoint below the mouth is Chengjiang (CV24) of the Ren vessel, one acupoint. The acupoint in the nape is Fengfu (GV16) of the Du vessel, one acupoint. Totaling six acupoints.

One acupoint at the vertex: Zhang Jingyue stated this is Baihui (GV20), an acupoint of the Du vessel.

One acupoint at the hairline: Zhang Jingyue stated that Shenjing (GV24) is at the anterior hairline, and Fengfu (GV16) is at the posterior hairline. Both belong to the Du vessel. Totaling two acupoints.

Note: This chapter records fifty-nine Shu points for heat diseases. The *Shui Re Xue Lun* (Treatise on Water and Heat Acupoints) also records fifty-nine Shu points for heat diseases. Examining the similarities and differences between the two chapters, only eighteen acupoints coincide: Baihui (GV20), Xinhui (GV22), Wuchu (BL3), Chengguang (BL3), Tongtian (BL7), Linqi (GB41), Mucuang (GB16), Zhengying (GB17), Chengling (GB18), and Naokong (GB19). The rest differ. However, the acupoints mentioned in this chapter are mostly on the limbs, likely addressing the root of draining heat. The acupoints in the *Shui Re Xue Lun* are mostly determined by the location of the pathogen, likely addressing the branch of draining heat. The principles naturally differ, yet both have their applications. Furthermore, *Ling Shu* was compiled earlier, and *Su Wen* later; the latter supplements the brevity of the former. Therefore, both are referred to as the fifty-nine Shu points for heat diseases, not as errors or contradictions. Summing up the counts from both chapters, plus the fourteen acupoints mentioned above such as Weishu (ST21) and Yongquan (KI1) which were originally not included in the fifty-nine, and subtracting the eighteen duplicate acupoints, we arrive at a total of one hundred and fourteen acupoints, all of which are Shu points for heat. None should be discarded. When using acupuncture to treat heat diseases, one should comprehensively understand the principles of both chapters and select acupoints according to appropriateness, thereby mastering the art of acupuncture for heat diseases.

Brief Case: The *Jia Yi Jing* records the fifty-nine Shu points from this chapter and the *Shui Re Xue Lun*, stating: Although the two texts differ, they are both important acupoints for draining heat. This aligns with Zhang Jingyue's view. Ma Yun stated: The fifty-nine acupoints elsewhere are for treating water diseases, while these are for treating heat diseases. Since the diseases differ, the acupoints differ accordingly. Cheng Wuji, in his commentary on the *Shanghan Lun*, conflated them, likely due to a failure to verify the locations of these acupoints. Examining the *Shui Re Xue Lun*, there are clearly fifty-seven Shu points for water and fifty-nine for heat. It is unclear why Ma Yun held this view. Cheng Wuji was not negligent in his research.

Chest fullness of Qi (until Qi descends then normal): In the Daozang edition, Yuan edition, Zhaozang edition, and Zhang edition, "jiu" (leek) is written as "xie" (scallion/garlic chive). "Liu" is written as "liu" (stay) in various editions and should be corrected. Ma Yun stated: The following seven sections discuss miscellaneous syndromes separately, unrelated to the preceding heat diseases. This specific section discusses acupuncture methods for Qi syndromes. When Qi is full in the chest causing panting (breathing is called Xi), for diseases located superiorly, treatment should target inferiorly. One should needle Yinbai (SP1) of the Foot-Taiyin spleen meridian, stopping when Qi descends and panting ceases. Zhang Jingyue stated: For internal cold, Qi arrives slowly, so prolonged retention of the needle is appropriate. For internal heat, Qi arrives quickly, so rapid removal of the needle is appropriate. Zhang Zhicong, commenting on the *Ben Shu* chapter, noted: In ancient times, the pulse was as thin as a leek leaf; nowadays, it is as thick as a rice grain.

Heart Hernia (until removing its blood collaterals): Zhang Jingyue stated: Heart hernia, as described in the *Mai Yao Jing Wei Lun*: If the heart pulse is felt to be urgent, the disease is named Heart Hernia, and there should be palpable masses in the lower abdomen. Taking the Foot-Taiyin spleen and Foot-Jueyin liver meridians, thoroughly pricking and removing their blood collaterals works because both meridians converge in the lower abdomen. Removing collateral blood dissipates the pathogen.

Throat Bi and Rolled Tongue (width of a leek leaf): The *Jia Yi Jing* reads "bi biao tong" (arm surface pain). The annotation states that *Ling Shu* and *Tai Su* read "bi nei lian tong" (inner arm pain). Ma Yun stated: The *Yin Yang Bie Lun* says: Constriction of one Yin and one Yang is called Throat Bi. Thus, Throat Bi clearly involves the Hand-Jueyin pericardium and Hand-Shaoyang triple energizer meridians. Symptoms include a rolled and shortened tongue, dry mouth, irritability, pain, pain in the inner arm, inability to raise the arm, and pain extending to the head. One should take the second finger from the little finger, i.e., the fourth finger. This belongs to the Hand-Shaoyang triple energizer meridian. The acupoint is at the tip of the second finger, named Guanchong (SJ1), located at a distance from the nail margin equivalent to the width of a leek leaf.

Red and Painful Eyes (until taking Yin Qiao): Zhang Jingyue stated: The Yin Qiao vessel connects to the inner canthus of the eye. Zhaohai (KI6) of the Foot-Shaoyin kidney meridian is where the Yin Qiao vessel originates. Therefore, one should needle this acupoint.

Wind Spasm (until taking Zusanli): Zhang Jingyue stated: Spasm refers to body rigidity. Body arching backwards refers to opisthotonos. This is a wind syndrome affecting the bladder meridian, so one should take acupoints from the Foot-Taiyang bladder meridian. Weizhong (BL40) and blood collaterals (superficial vessels) should all be pricked to bleed. If there is cold in the Middle Jiao, one should still take Zusanli (ST36) of the Foot-Yangming stomach meridian to warm and tonify Stomach Qi, thereby eliminating wind-cold.

Enuresis/Retention taking Yin Qiao (until bleeding): The *Jia Yi Jing* writes "Jing" (spasm) for "Long" (retention). Ma Yun stated: Bladder dysfunction leading to Long refers to urinary retention. The bladder and kidney are exterior-interior pairs. One should needle Zhaohai (KI6) of the kidney meridian, which is a point of the Yin Qiao vessel. Also, Dazhun (LR1) of the liver meridian, located on the outer side of the big toe among the hairs. And any blood collaterals in these two meridians should be taken to bleed. Li Dongyuan stated: The Kidney governs closure/storage, and the Liver governs dispersion/excretion; thus, selecting these two meridians is appropriate. Zhang Jingyue stated: The kidney and bladder are exterior-interior pairs, and the liver meridian runs through the lower abdomen, so these two meridians should be selected.

Men resembling Gu Poison (until seeing blood): The *Jia Yi Jing* writes "Zu" (obstruction). Ma Yun stated: "Ju", pronounced Qin Lv, also Zi Xian. The *Yu Pian* defines it as "proud/arrogant," but the meaning is obscure, suspected to be a typo for "Ju" (abscess). Men suffering from distension resemble poisoning by Gu poison; women suffering from stagnation resemble forming Ju diseases. Their bodies and spines feel as if muscles are separated, not connected, and they lose appetite. For diseases located superiorly, treatment targets inferiorly. One should first needle Yongquan (KI1) of the kidney meridian until blood appears. Then observe the dorsum of the foot (Fu) for prominent blood collaterals and bleed them all. This likely refers to the Foot-Yangming stomach meridian. Zhang Jingyue stated: "Ju" should be read as "Tai" (fetus). Like Gu (same as Ma Yun), like fetus, implying a condition that resembles pregnancy without actually being one. Zhang Zhicong stated: "Ju" should be read as "Zu" (obstruction). Women with Zu resemble menstrual obstruction. Men do not have menstrual obstruction, hence "resembling Gu." Brief Case: The *Yu Ji Zhen Zang Lun* states: Transmission from Spleen to Kidney results in a disease named Shan Jia (hernia and mass), with heat and pain in the lower abdomen and discharge of white fluid, also named Gu. Thus, "men resembling Gu" means resembling Shan Jia rather than actual Shan Jia. Reading "Ju" as "Zu" is correct. "Zu" refers to pregnancy obstruction syndrome, meaning symptoms like morning sickness but not actual morning sickness. This is a disease of the Kidney and Stomach meridians, hence needling Yongquan and the dorsum of the foot to induce bleeding.