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The exterior belongs to Yang. Diseases located in the Yin aspect are termed Bi syndrome (Obstruction Syndrome). Bi syndrome refers to pain. Therefore, painful conditions belong to Yin. When pressing with the hand, if no specific point of tenderness can be found, it indicates that stagnant Bi pathogenic factors are retained within. This passage explains the relationship between interior/exterior and Yin/Yang.

Commentary: The *Nan Jing* (Classic of Difficult Issues), Chapter 48, states: "Itching belongs to Deficiency; Pain belongs to Excess." This interpretation seems contradictory to the present text.

If a disease originates first from the Yin aspect, treatment should target the Yin aspect. Zhang Jingyue stated: This discusses Yin and Yang in terms of meridian locations. Whether a disease is in Yin or Yang, its onset has a sequence. The initial manifestation is the root of the disease, while the subsequent manifestation is the branch. Treatment must address the root first, which aligns with the earlier statement regarding "first puncturing the source from which the disease arises."

Heat Jue (Rebellious Qi) and Cold Jue. Ma Shi stated: The *Su Wen* (Basic Questions) explicitly contains the *Jue Lun* (Treatise on Jue), and this classic's *Han Re Bing Pian* (Chapter on Cold and Heat Diseases) also details methods for puncturing cold-heat Jue patterns.

Two Yin and One Yang... only puncture the Yang meridian once. Zhang Jingyue explained: The phrase "two punctures of Yin, one puncture of Yang" means tonifying the Yin meridians twice and draining the Yang meridians once. This causes Yin Qi to become abundant while Yang pathogens recede, thus treating Heat Jue. The situation of "Two Yang and One Yin" follows the same logic, thereby treating Cold Jue.

For chronic diseases... the principles of needling are complete. Zhang Jingyue stated: In long-standing diseases, the pathogenic factor must be deep. If needling is not deep enough, it cannot reach the latent disease; if retention time is not long enough, consolidated pathogens cannot be dispersed. If one session does not cure the disease, it is necessary to puncture again after an interval of days. If two sessions are insufficient, puncture again after another interval. Continue until the disease is eradicated. However, one must first examine whether the pathogen is in the Jing (Main) Meridians or the Luo (Connecting) Vessels. If in the Jing Meridians, puncture the meridian directly; if in the Luo Vessels, employ Miao Puncture (Contralateral Puncture) on the vessels. This is called harmonizing the left and right, and removing blood stasis. Zhang Zhicong stated: In chronic diseases, pathogens enter deeply. When pathogens contend with Zheng Qi (Upright Qi), Qi remains in the Yin aspect and emerges into the Yang aspect after a day. Thus, puncturing at intervals waits for the arrival of Qi to extract it.

Regarding all needling methods... gathered Qi can be distributed. The *Jia Yi Jing* notes that "Zao Jue" is alternatively written as "Ji Zi". Zhang Jingyue stated: When a patient has shortness of Qi, flesh and muscles have not yet wasted away, the pulse is rapid and restless, and the condition presents as agitation with Jue, this indicates internal Qi Deficiency and Excess pathogens in the meridians. One should employ Miao Puncture: treat the left side by selecting points on the right, and the right side by selecting points on the left. Since the puncture site is in the Luo Vessels, the effect is light and superficial, allowing scattered Essence-Qi to be gathered and aggregated pathogens to be dispersed. Commentary: Reading "Zao Jue" as "Zao Ji" (Agitation and Rapidness) is correct.

Dwell in deep quiet places... rest only when Qi arrives. Ma Shi stated: This instructs the practitioner to nourish their Shen (Spirit) beforehand to perform needling. Although the practitioner observes the patient's Shen and Qi, they must first cultivate their own Shen and Qi. Therefore, dwelling in quiet places, closing doors and windows, allows Hun, Po, Shen, Yi, Jing, and Qi to converge. With the mind focused on the needle, insert shallowly and retain, or slightly lift to float it, thereby shifting the patient's Shen. Wait until the True Qi has arrived before withdrawing the needle.

Men avoid interior [sex], Women avoid exterior [going out]... this is termed De Qi (Arrival of Qi). Zhang Jingyue stated: After needling, extreme caution is required. Men must abstain from sexual intercourse indoors; women must avoid going outdoors. Those avoiding going out must firmly refuse to leave; those avoiding intercourse must guard strictly. Then pathogens will depart, and Zheng Qi will recover. This is called De Qi. The pronunciation annotation in the *Dao Zang* edition states that the *Nan Jing* reads "Men avoid exterior, Women avoid interior." Commentary: The *Nan Jing*, Chapter 78, states "Men avoid exterior, Women avoid interior," referring to needling techniques, which differs from the meaning in this chapter.

Those who have traveled or returned. The *Jia Yi Jing* writes "Chu" as "Bu" (Walk/Step).

These twelve prohibitions. Commentary: Ma Shi and Zhang Jingyue included "Men avoid interior, Women avoid exterior" as part of the twelve prohibitions. However, since there are further prohibitions in later sections, this classification is likely incorrect. The *Jia Yi Jing* lacks the characters "twelve three," suggesting these are textual omissions from ancient scriptures.

Jie noted: The so-called twelve prohibitions include four related to the four seasons (wind, rain, darkness, brightness) causing stagnation and disharmony of human Qi and Blood. Being overly full leads to Qi Deficiency (5th prohibition). Newly being full leads to Qi Excess (6th prohibition). Intoxication leads to chaotic Qi (7th prohibition). Great anger leads to rebellious Qi (8th prohibition). Thirst leads to scant fluids (9th prohibition). Great labor leads to depleted Qi (10th prohibition). Great fright leads to scattered Qi (11th prohibition). The location of the Ren Shen (Human Spirit) where injury might harm Sheng Qi (Vitality) is the 12th prohibition. Regarding the location of Ren Shen: in Spring, it is in the left hypochondrium; in Autumn, in the right hypochondrium; in Winter, in the waist; in Summer, at the umbilicus. These four correspond to the times governed by Liver, Lung, Kidney, and Spleen, respectively, and thus require prohibition.

Yin Luo (Laxity and Weakness). The *Dao Zang* and *Jia Yi Jing* editions read "Yin Luo". Zhang Jingyue stated: Yin Luo means dissipation and scattering. (See *Su Wen Shi* commentary on *Gu Kong Lun* for details on Yin Luo).

Loss of the Spirit generated by the Five Flavors. Zhang Zhicong stated: The five flavors enter the mouth and are stored in the stomach and intestines. Their essence is stored to nourish the Five Qi. Harmonized Qi generates life processes; fluids form together, and Shen naturally arises. The way of needling values attaining Shen and arriving at Qi. Violating these prohibitions results in the loss of the Shen and Qi generated by the five flavors, which is termed Loss of Qi.

Severing the skin severs the sweat pores. The text below the Taiyang Meridian is identical to the *Zhen Yao Jing Zhong Lun* (Essential Diagnosis of Meridian Termination) in the *Su Wen*. Here, differences are highlighted without further explanation. The *Zhen Yao Jing Zhong Lun* lacks the words "severing skin," reading instead "severing sweat pores then they emerge."

Does not move. The *Zhen Yao Jing Zhong Lun* reads "Numbseness" (Bu Ren).