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One: Differentiate Yin and Yang by needling the hands and feet. If bright red blood spurts out, life will be prolonged. If only a little yellowish-white fluid appears, danger of death is imminent within days or hours. Two: From below the ears to the neck and cheeks, even if scraping with hemp fibers causes slight redness, use an eyebrow knife to incise the affected area. Profuse bleeding is not ominous. Three: Needling the small green veins under the tongue; if bright red blood flows, the condition is mild. If black and putrid strands appear, it indicates death. Clear phlegm from heat accumulation in the chest. Four: The four severe conditions are called Xuan Yong (Hanging Abscess), Chong Wa (Heavy Swelling), Chan Hou (Entangling Throat), and Suo Feng (Locking Wind). Heat, wind, and phlegm accumulate in the chest and diaphragm; San Huang Tang (Three Yellows Decoction) promotes downward flow and natural unblocking. Five: Internal deficiency allows evil fire to ascend; to disperse it, needling is required. Use Shaoshang (LU-11), Quchi (LI-11), and Jiache (ST-6) acupoints, distinguishing male left and female right clearly. Six: Use Zhuifeng San (Wind-Chasing Powder) to extract phlegm. If phlegm is like clear water and not abundant, continuously blowing this secret formula widens the chest obstruction. Take Liangge Zhuifeng (Cool the Diaphragm and Chase Wind) early. Seven: Needling can proceed from head to tail. Strictly avoid upward movement from the middle root. Profuse fresh bleeding is not far-reaching concern; black and scanty bleeding does not promise longevity. Eight: To know deeply how to cut lesions with a knife, first blow anesthetic onto the affected area. Hook the mouth open in the middle. Apply the knife method continuously without hesitation. Nine: Using a branding iron to remove roots. Burn charcoal and tung oil together. Wait until red hot before carefully branding. Continuously apply the secret medicine for peace. Ten: Moxibustion methods focus on Fengchi (GB-20). Five moxa cones are originally very suitable. Add several cones to Jiache (ST-6). After moxibustion at Shaoshang (LU-11), follow with Quchi (LI-11).

Whenever the throat has no disease, its color is pale red and white, neither high nor swollen. Once there is an affected area, it must be purple and swollen. The method to test the disease: whether it is an abscess (Yong), obstruction (Bi), or tonsillar swelling (E), if not recognized accurately, only blow the base [secret powder] on the external swollen area, then use knife and needle, followed by blowing the secret powder. There is no case without efficacy. If not swollen but only externally painful, it is due to excessive wind-heat. First, appropriate to vent and drain; later, use clearing and transforming methods. If it is Hou Bi (Throat Obstruction), no need for knife and needle. Blow the base secret powder, take San Huang Tang (Three Yellows Decoction) for three to four doses, and it will heal itself.

First: Di Ding (Stem Carbuncle) is in the throat, the master of the person. Do not use knife, needle, or branding iron. Never violate this rule; violation leads to certain death.
Second: Chong Wa (Heavy Swelling) starts swelling from above up to the tongue. Excessive wind-heat. Early treatment can save life; late treatment makes decoctions difficult to ingest.
Third: Xuan Ding (Hanging Carbuncle) is the same as Di Ding. Swelling rises and hangs down, hanging and blocking the throat. Knife and needle are difficult to apply.
Fourth: Accumulated heat-toxin causes various large and small sores in the throat, called Zhenzhu Du (Pearl Poison). Dry mouth with thick phlegm. Painful when bitter or spicy, or just painful. Difficulty in swallowing and breathing. Blow the base secret powder, puncture to bleed, and take Xueshi Tang (Scholar's Decoction).
Fifth: Method of needling. First press down the tongue. Place the needle near the lifted tongue root, gently lift and withdraw. Do not be slow. Fear that the patient lowering their head to spit phlegm and blood may cause mishaps. Pierce from afar. Must guard against Di Ding (Stem Carbuncle).
Sixth: Branding iron. Made of patterned silver into a tea spoon shape. Wrap the outside of the branding iron with aged mugwort (Ai Ye, Artemisia argyi), then wrap with cotton. Dip in tung oil. Burn over a lamp flame until smokeless. Place on the lamp. Use a ring to prop open the mouth. Have someone hold steady. Press the tongue root firmly. Have someone scrape the branding iron clean. View the true affected area. Brand once continuously, then withdraw. Do not be slow. Fear injuring Di Ding (Stem Carbuncle). After branding, immediately blow secret medicine to resolve heat-toxin. Another branding method: Burn charcoal red-hot, add dried mugwort. Place the branding iron on the mugwort to burn red-hot. Treat according to the previous method. Must have clear eyes and quick hands.
Seventh: Viewing patients at night requires a lamp. Have someone stand behind the doctor's head to illuminate. Only then can the throat be seen. Or if the throat is small and the disease is lower, it cannot be seen clearly. Do not use knife and needle. Only blow Zhuifeng Benmi (Wind-Chasing Base Secret) several times. Wait until dawn to view again.
Eighth: Avoid knife and needle on cloudy days. Fear unclear viewing or injuring healthy flesh. Wait for clear weather, borrow sunlight to assist vision, then can view and treat.
Ninth: Needling Shaoshang (LU-11) acupoint. If the disease is indeed critical, then needle this point. It is located at the corner tip of the thumb, about one leek leaf width away.
Tenth: If external neck swelling is severe, then use water-based medicine to roll down the phlegm. If not severely swollen, using it is inappropriate.
Eleventh: Teeth clenched shut. Do not immediately use a ring to prop the mouth. First blow Tongguan San (Pass-Through Powder) into the nose. Wait until the mouth opens slightly. Insert a thin small wooden chip to pry open. Blow Zhuifeng San (Wind-Chasing Powder) to remove phlegm. When the mouth opens slightly more, insert the flat ring slowly. Gently prop open. Have someone hold steady. Press the tongue into the ring. Carefully observe what syndrome it is, then can use medicine.
Twelfth: Using a knife to cut. Must let the patient lie supine. Then have someone support the head. Press the tongue. Cut finely bit by bit. Do not injure healthy flesh.
Thirteenth: Conditions such as Yong (Abscess), E (Tonsils), Gan (Ulcers), and Ding (Carbuncles). Red halo is treatable; black color means certain death.
Fourteenth: Gan Chuang (Ulcerous Sores) rotting deep. No need for knife and needle. Only blow the base secret powder several times. If much rotten flesh, tie a small brush with hair. Decoct Huanglian (Coptidis Rhizoma) and Huangqin (Scutellariae Radix) in water, remove dregs. Dip the brush in water, brush away all rotten flesh. Rinse mouth several times with this water. Blow secret powder for pain relief. Otherwise, medicinal qi cannot enter.
Fifteenth: Gan Chuang (Ulcerous Sores) rotting through to the external neck. Use fumigation medicine. Make the fumigation medicine into a wick, insert into a bamboo tube. The tube opening is as large as the sore. One end covers the sore, the other end fumes. Smoke rushes into the bamboo tube, gradually penetrating to the sore. Seven applications as the limit. Hold Gancao Tang (Licorice Decoction) in the mouth to detoxify. Fear poison entering internally causing other syndromes. After fumigation, avoid stimulating foods.
Sixteenth: Red face. Eyes looking upward. Untreatable.
Seventeenth: Head lowered. No spirit. Untreatable.
Eighteenth: Smell like burnt coal. Untreatable.
Nineteenth: Little air entering the nose, much air exiting. Untreatable.
Twentieth: Severe swelling below the neck. Mix medicine with honey to apply. Keep moist with water often. Do not let the medicine dry.