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In the early stage of heat disease, skin pain occurs first, accompanied by nasal obstruction and facial swelling. Treatment should target the skin level using the first type of needle (Mao Zhen / Hair Needle). If rashes form on the nose due to heat accumulation, and treatment at the lung meridian's skin level fails to dispel the pathogen, one must seek treatment from the heart meridian, as the heart belongs to Fire.

This indicates that heat pathogens are invading the Lung Meridian, hence the initial skin pain, nasal obstruction, and facial swelling; the pathogen floats upward, so treatment begins from the skin and hair. Among the nine needles, there are variations in shape and size; for shallow needling of the skin and hair, the first type of needle (Mao Zhen) should be used. "Ke" means pain; "Zhen" is synonymous with "Zhen" (Rash), referring to rashes formed on the nose due to heat accumulation. If the pathogen in the Lung Meridian is not expelled after treating the skin, the Heart Fire should be drained to rescue Lung Metal. The term "Suo" refers to guiding Qi with the needle; when Qi arrives, it is considered "Suo De" (obtained).

In the early stage of heat disease, the body feels rough and stiff, fever increases when leaning against something, irritability occurs, and the lips and throat become dry. Treatment should target the vessels using the first type of needle, combined with fifty-nine acupoints (points on the head and neck for clearing heat). If skin swelling, dry mouth, and cold sweating occur, and treatment at the Heart Meridian's vessel level fails to dispel the pathogen, one must seek treatment from the Kidney Meridian, as the Kidney belongs to Water.

This indicates that heat pathogens are invading the Heart Meridian. The initial body stiffness and increased fever upon leaning are due to stagnant heat consuming body fluids, causing dry and rough skin, making the body feel as if leaning against a hot object, leading to irritability and dryness of the lips and throat. The Heart governs blood vessels, so treatment should focus on the vessels; if the pathogen persists after treating the vessels, Kidney Water should be nourished to assist the Heart, which is described as "if cooling does not work, it is because there is no water." By strengthening the source of Water to control Yang hyperactivity, the heat will naturally subside. If after treatment, skin swelling, dry mouth, cold body, and sweating occur, it indicates that Wei Yang (Defensive Yang) is deficient, causing coldness, skin swelling, and sweating. Excessive sweating damages fluids, causing dry mouth; thus, a method of clearing deficiency and tonifying should be used.

Heat disease presents with dry throat, excessive thirst, susceptibility to fright, and inability to rise from bed. Treatment should target the muscle layer using the sixth type of needle (Da Zhen / Large Needle), combined with fifty-nine acupoints. If bluish discoloration appears around the eyes, and treatment at the Spleen Meridian's muscle level fails to dispel the pathogen, one must seek treatment from the Liver Meridian, as the Liver belongs to Wood.

This indicates that heat pathogens have damaged the Spleen, preventing fluids from ascending, causing dry throat and excessive thirst; Spleen disease allows Liver Wood to overact, causing fright and bluish discoloration around the eyes; inability to rise from bed occurs because the Spleen governs muscles, and Spleen injury leads to heaviness of the body. If treating the Spleen fails to expel the pathogen, Liver Fire must be drained to relieve the Spleen's stagnation.

Heat disease presents with a bluish complexion, headache, and restlessness of the hands and feet. Treatment should target the intertendinous spaces using the fourth type of needle (Feng Zhen / Sharp Needle), applied at Si Ni points. If tendon tension and watery eyes occur, and treatment at the Liver Meridian's tendon level fails to cure, one must seek treatment from the Lung Meridian, as the Lung belongs to Metal.

This indicates that heat pathogens have damaged the Liver, causing a bluish complexion; the Liver Meridian ascends to the vertex and enters the brain, causing headache; pathogen invasion of the Jueyin Meridian causes restlessness of the extremities, progressing to cold limbs (Si Ni); tendon damage causes tension; the Liver opens into the eyes, and leakage of Liver fluids causes tears like water immersion. If treating the Liver via the tendons fails to resolve the condition, the Lung should be treated, utilizing the principle of Metal controlling Wood.