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(From *Ling Shu: Ci Jie Zhen Xie Pian*)

Please allow me to expound on the theory of "Jie Jie" (Untying Knots), which should correspond with Heaven and Earth, and align with the Four Seasons. Since humans can participate in and accord with the Way of Heaven and Earth, one is qualified to discuss the untying of knots. ("Jie Lun" refers to the discourse on untying knots. Humans and Heaven and Earth are mutually responsive; only by understanding this principle can one speak of untying knots.) Where there are subterranean springs beneath, reeds and rushes grow above; this is how one knows the abundance or scarcity of form and Qi. ("Jian Ru" refers to hidden springs. If there are hidden springs below, reeds and rushes grow above; this internal-external correspondence is a matter of natural law. The relationship between the exterior and interior of the human body allows us to observe excess and deficiency, just as it is here. "Jian" is pronounced with the level tone; "Ru" sounds like "ru".) Yin and Yang correspond to Cold and Heat. When it is hot, moisture evaporates into rain and rises upward; the roots have less juice, and the Qi of humanity floats outward. The skin becomes relaxed, the cou li (pores) open, blood and Qi diminish, sweat pours out profusely, and the skin becomes moist and lustrous. (When summer heat steams the earth's Qi into rain, the Qi gathers above, so the Qi of grass and trees also gathers in the branches and leaves, leaving the roots with less juice. Regarding human Qi, when it is hot, Yang floats to the surface, so blood and Qi are depleted and sweat pours out. However, heat facilitates movement, so acupuncture is suitable. "Nao" sounds like "gai", meaning moist; "Nao" is cut at "nai bao", meaning glossy.) When it is cold, the ground freezes and water turns to ice. Human Qi remains within. The skin is tight, the cou li are closed, sweat does not come out, blood and Qi are strong, and the flesh is firm and stiff. At such times, even those skilled in swimming cannot traverse ice, and those skilled in digging cannot pierce frozen earth. Similarly, those skilled in acupuncture cannot treat Si Jue (Four Reversals/Cold Extremities); if the blood vessels are coagulated and hard, pulsating without flow, they cannot be immediately softened. Therefore, those skilled in navigation must wait for the sky to warm, ice to melt, and frost to thaw before water can flow and earth can be penetrated; the meridians of the human body are the same. (When cold, the earth's Qi is solid and condensed, and human Qi is knotted, making meridians difficult to navigate. Even those skilled in acupuncture cannot treat limb reversal, so one must wait for warmth, melting ice, and the circulation of Yang Qi before human Qi flows freely, allowing acupuncture to be used.) To treat Jue Ni (Reversal of Qi), one must first use moxibustion or warming techniques to harmonize the meridians. Warm the palms and axillae, elbows and feet, neck and spine to regulate them. Once the fire Qi has circulated, the blood vessels will flow. Then, observe the condition: if the pulse is moist and lustrous, puncture to calm it; if it is hard and tight, break and disperse it. Stop when the Qi descends. This is what is meant by "Untying Knots." (This is the method for treating Jue Ni. If the weather is not yet warm but one insists on using needles, one must borrow Fire Qi to warm and harmonize the meridians. All areas between the palms, axillae, elbows, feet, neck, and spine are intersections of large joints and valleys, so they should be warmed. Thus, Fire Qi passes and blood vessels flow. Then observe the diseased pulse: if moist and lustrous, Wei Qi is floating, so it can be punctured to calm it. If hard and tight, Evil Qi is excessive, so it should be broken and dispersed. Once Jue Ni is removed and Zong Qi descends, the needle can be stopped. A "Knot" is where Evil gathers; puncturing away the Evil is called "Untying the Knot.") The essence of acupuncture lies in regulating Qi. Qi accumulates in the Stomach, facilitating the circulation of Ying Qi (Nutrient Qi) and Wei Qi (Defensive Qi), each following its own path. Zong Qi (Pectoral Qi) remains in the Sea of Qi; the portion that goes downward injects into the Qi Street, and the portion that goes upward travels to the Xi Dao (Respiratory Pathway). (All who use acupuncture must focus on regulating Qi. Humans receive Qi from grain, so Qi accumulates in the Stomach. However, Qi has three meanings: Ying Qi, Wei Qi, and Zong Qi. The clear part is Ying Qi, which circulates within the vessels; the turbid part is Wei Qi, which circulates outside the vessels, hence they follow different paths. Zong Qi is Great Qi. Great Qi resides in the Upper and Lower Qi Seas. The lower portion accumulates in the Dantian, injects into the Qi Street of the Foot-Yangming Meridian, and descends to the foot; the upper portion accumulates in the Chest, exits via the Xi Dao, and governs respiration. These three types of Qi are all referred to as Qi, and one should seek their respective affiliations to regulate them. Note: Regarding the meaning of "Qi Street," as stated in the *Wei Qi* chapter: "One who understands the Qi Streets of the Six Fu Organs can understand tying and untying knots at the gates." Refer to this section and see the Twelve Meridians category for details.) Therefore, if Jue occurs in the feet, Zong Qi fails to descend, and blood in the vessels coagulates and stagnates. Without Fire regulation, it cannot be treated with needles. ("Jue" means reversal, referring to Yin-Cold Qi. If Jue Ni is in the feet, the Yang pathway is blocked, so Zong Qi does not descend and blood vessels stagnate. Without warming with Fire, needling is impossible.) Those who use acupuncture must first examine the excess or deficiency of the meridians. Palpate, trace, press, and flick the points. Observe where the response and movement occur, then select points to drain the Qi downward. (To examine excess and deficiency, verification relies on Qi. Therefore, one must trace and flick to observe Qi responding to touch. Whether weak or strong, excess and deficiency become known. Then apply methods to select points, and Qi will naturally descend.) When the Six Meridians are harmonious, it is called disease-free. Even if illness occurs, it will resolve itself. (When meridians are harmonious, even if illness occurs, it is mild and will inevitably self-resolve.) If one meridian exhibits excess above and deficiency below with blockage, there must be an overfull transverse collateral compressing the main meridian, causing obstruction. Observe and drain it; this is called "Untying Knots." (The main meridian normally flows continuously. If a transverse collateral is overfull and presses on the main meridian, obstruction occurs. Observing and draining it harmonizes the meridian, which is also called "Untying Knots.") For Cold Above and Heat Below, first puncture the Foot-Taiyang Bladder Meridian points in the neck region, retaining the needle for a long time. After needling, moxa/warm the neck and shoulder blades until heat is generated. Stop when the upper and lower heats merge. This is called "Pushing Upward." (Cold above and heat below indicates Deficiency of Yang above and Excess below. One should first puncture points such as Dazhu and Tianzhu of the Foot-Taiyang Bladder Meridian in the neck, retain the needle for a long time to tonify, and simultaneously warm the neck and shoulders to await Qi arrival. When upper heat merges with lower heat, stop the needle. This is pushing the lower Qi to ascend.) For Heat Above and Cold Below, observe the deficient and sunken meridians in the lower body and select points. Stop when the Qi descends. This is called "Drawing Downward." (Heat above and cold below indicates Excess of Yang above and Deficiency below. Therefore, observe the deficient and sunken meridians below, select points to tonify, ensuring Yang Qi descends before stopping. This is "Drawing Downward." Note: These two sections discuss upper/lower cold/heat, which differs from the previous section regarding "one meridian with excess above/deficiency below due to transverse collaterals." That case involves physical obstruction; this case involves root-and-branch excess/deficiency. The syndromes differ and should not be confused.) For generalized severe heat, mania, hallucinations (seeing/hearing things that aren't there), and delirious speech, examine the Foot-Yangming Stomach Meridian and major collaterals. Tonify deficiency; drain blood excess. With the patient supine, position yourself at the head. Use four fingers of both hands to clamp and press the carotid artery. Hold firmly for a long time, curl the fingers, and push downwards to the Quepen point, then repeat as before. Stop when the heat dissipates. This is called "Pushing and Scattering." (The preceding text discusses different treatments for upper/lower cold/heat; this section addresses generalized severe heat, requiring treatment of the Foot-Yangming Meridian. The Yangming Meridian is rich in Qi and Blood, serving as the Sea of the Five Zang and Six Fu Organs. Thus, by examining whether the pathology is in the meridian or collateral, or in excess/deficiency, and selecting points accordingly, generalized heat can be eliminated. Furthermore, with the patient supine, the practitioner sits at the head, using the index and middle fingers (four fingers total) to clamp the carotid artery at Renying and Daying points. Press firmly from top to bottom, hold, curl fingers, and push down to Quepen, then repeat. Wait for heat to dissipate. Since the Three Yang Meridians converge at the head, one can exclusively select Renying to push and scatter the heat. "Juan" is synonymous with "Quan" [fist].)