《灵枢·热病篇》曰∶热病三日，而气口静、人迎躁者，取之诸阳，五十九刺，以泻其热而出其汗，实
其阴以补其不足。身热甚，阴阳皆静者，勿刺也；其可刺者，急取之，不汗出则泄。所谓勿刺者，有死征也。
两手之脉名气口，主五脏之阴，颈旁动脉名人迎，主六腑之阳，义详十二经络篇。热病三日，气口静而人
迎躁者，阳热之邪盛于阳经也。盖人迎为阳明之脉，阳明行气于三阳，故当治诸阳经，以泻其热而出其汗，再
实其阴气，以补其不足。如身热甚，而气口、人迎之脉皆静者，脉证不合，本元气败，不能与邪争，故脉反静，
为死之征，不可妄治也。如其可以治者，急取之，若不汗出，则通腑以泄之可也。五十九刺者，经穴针法，
详针灸篇，不录。
热病七八日，脉口动喘而短者，急刺之，汗且自出，浅刺手大指间。
脉口即气口，又名寸口，动喘而短者，短为肺脉，邪入手太阴肺经，故刺手大指间肺经之井穴。脉口动喘，
其人迎亦必躁盛可知，热病七八日之久，故当急刺也。
热病七八日，脉微小，病者溲血，口中干，一日半而死，脉代者，一日死。
脉微小及代，皆邪热深陷而元气脱，故溲血口干，而死之速也。
热病已得汗出，而脉尚躁，喘且复热，勿刺肤，喘甚者死。
此即精却而邪胜者也，故死。
热病七八日，脉不躁，躁不散数，后三日中有汗。三日不汗，四日死。未曾汗出者，勿腠刺之。
热病七八日而脉不躁，邪气深沉之象，或躁而不散数，其元气尚未败，三日中或得汗解。如三日不汗，其
元气败而邪更深，四日必死矣，凡此等日久未曾汗出者，多是死证，勿妄治也。
The *Ling Shu: Re Bing Pian* (Spiritual Pivot: Chapter on Heat Diseases) states: After three days of suffering from a heat disease, if the Qi Kou (Radial Artery at the wrist, reflecting Yin of the Zang organs) pulse is calm while the Ying Yang (Carotid Artery at the neck, reflecting Yang of the Fu organs) pulse is restless, one should puncture the various Yang meridians and apply the "Fifty-Nine Acupoints Needling" technique to drain the heat and induce sweating, thereby solidifying the Yin to replenish deficiencies. If the body heat is severe but both the Yin-Yang (Qi Kou and Ying Yang) pulses are calm, do not needle; for cases that can be treated, urgent needling is required, and if sweating does not occur, purgation should be used. The instruction "do not needle" refers to the presence of death omens.
The Qi Kou pulse of both hands governs the Yin of the Five Zang organs, while the Ying Yang pulse in the neck governs the Yang of the Six Fu organs; detailed explanations are found in the chapter on the Twelve Meridians. In heat disease lasting three days, a calm Qi Kou and restless Ying Yang indicate that Yang-heat pathogenic factors are abundant in the Yang meridians. Since Ying Yang belongs to the Stomach Meridian of Foot-Yangming, which circulates Qi among the Three Yang meridians, treatment should focus on the various Yang meridians to drain heat and induce sweating, followed by nourishing Yin Qi to address insufficiency. If body heat is severe yet both Qi Kou and Ying Yang pulses are calm, this represents a mismatch between pulse and symptoms, indicating the collapse of primordial Yuan Qi, which fails to contend with pathogens, resulting in a paradoxically calm pulse—a sign of death—thus prohibiting reckless treatment. For treatable cases, urgent needling is necessary; if sweating fails to occur, clearing the bowels via purgation is appropriate. The "Fifty-Nine Needling" refers to specific acupoint techniques detailed in the acupuncture chapters and is not repeated here.
After seven or eight days of heat disease, if the Mai Kou (Pulse Gate, synonymous with Qi Kou/Cun Kou) shows rapid movement accompanied by panting and shortness of breath, urgent needling is indicated; sweat will likely emerge spontaneously, and shallow needling should be applied to the space between the thumb and index finger.
Mai Kou is another name for Qi Kou or Cun Kou. Rapid movement with panting and shortness of breath indicates a Short pulse characteristic of the Lung; this signifies that pathogens have entered the Hand-Taiyin Lung Meridian, hence needling the Jing-Well acupoint of the Lung meridian located between the thumb and index finger. Given that the Mai Kou is rapid and the Ying Yang pulse is undoubtedly also restless after seven or eight days of heat disease, urgent needling is warranted.
After seven or eight days of heat disease, if the pulse is minute and faint, the patient experiences hematuria (blood in urine) and dry mouth, death occurs within half a day; if the pulse presents as Dai (Intermittent Pulse), death occurs within one day.
Both minute/faint and Dai pulses indicate deep entrapment of pathogenic heat and depletion of Yuan Qi, leading to rapid death manifested by hematuria and dry mouth.
If, after sweating has occurred in heat disease, the pulse remains restless, accompanied by panting and recurrent fever, skin needling should be avoided; severe panting indicates death.
This condition reflects the retreat of essence and the dominance of pathogens, leading to death.
In heat disease lasting seven or eight days, if the pulse is not restless, or if it is restless but not scattered and rapid, sweat may appear within the following three days. If no sweat occurs after three days, death ensues on the fourth day. For patients who have never sweated, do not needle the Cou Li (skin pores).
A non-restless pulse after seven or eight days of heat disease suggests deep-seated pathogens; if the pulse is restless but not scattered/rapid, Yuan Qi remains intact, allowing for potential resolution through sweating within three days. However, if no sweat occurs after three days, Yuan Qi has collapsed while pathogens deepen, guaranteeing death on the fourth day. Generally, prolonged heat diseases without sweating are often fatal conditions, warranting against reckless treatment.