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(From *Suwen: Qixue Lun*, *Chang Cijie Lun*, *Tongping Xushi Lun*; *Lingshu: Rebing Pian*, *Zabing Pian*, *Sishi Qi Pian*, *Jiuzhen Shier Yuan Pian*)

Pain in the back and heart that pulls each other should be treated by needling Tianchu (CV22), Zhongshu (DU10, located at the level of the 10th thoracic vertebra), and Shangji (Zhongwan, CV12).
(From *Suwen: Qixue Lun*. Tianchu is an acupoint of the Ren Mai. Zhongshu at the 10th thoracic vertebra belongs to the Du Mai. This point is not recorded in most texts; only in the commentary of Wang Bing on *Suwen: Qifu Lun* under the section of points where Qi of the Du Mai emerges does it state: "Zhongshu is between the segments of the 10th vertebra." This coincides with the text here and can be confirmed without doubt. Shangji refers to Zhongwan as mentioned below.) Shangji refers to Zhongwan (CV12). Xiaji refers to Guanyuan (CV4). (Zhongwan is the Front-Mu point of the Stomach, generated by the Qi of the Hand-Taiyang, Hand-Shaoyang, and Foot-Yangming meridians, and is a meeting point of the Ren Mai; Guanyuan is the Front-Mu point of the Small Intestine, a meeting point of the Foot-Sanyin and Ren Mai meridians, hence called Shangji and Xiaji.) Thus, the pathological connection of Yin and Yang on the left and right between the back and chest is as follows: the symptoms include pain and astringency in the front and back, pain in the chest and hypochondrium causing dyspnea and inability to lie down, shortness of breath with unilateral pain, full and protruding pulses slanting out from the Kaibone region, connecting the chest and hypochondrium, supporting the Heart and piercing through the Diaphragm, ascending to the shoulder adding Tianchu, and slanting down to the shoulder intersecting below the 10th vertebra. (This elaborates on the previous statement that pain pulling between the back and heart is entirely due to diseases of the Ren and Du meridians. Since Ren is anterior and Du is posterior, Back is Yang and Abdomen is Yin, thus causing symptoms like pain and astringency in the front and back. The pulse slanting out from the Kaibone below connects the chest and hypochondrium above, supports the Heart and pierces the Diaphragm, ascends to the shoulder adding Tianchu, and slants down to the shoulder intersecting below the 10th vertebra; therefore, one should needle Tianchu, Zhongshu, Zhongwan, and Guanyuan.)

For accumulations in the lower abdomen, needle the skin area downwards stopping at the lower abdomen.
(From *Suwen: Chang Cijie Lun*. The character "HT" is absent in rhyme books. Quan Yuanqi's version reads "Sui" (Marrow), but this is not logically sound. The New Correction states it should be "Pi" (Skin), considering "HT" a typo, which is reasonable. The explanation says "refers to bone ends." Here, "below the skin" likely refers to Zhangmen (LR13) and Qimen (LR14) of the Foot-Jueyin Liver Meridian, both located at the ends of the floating ribs. "Stopping at the lower abdomen" refers to Tianshu (ST25) and Guilai (ST29) of the Foot-Yangming Stomach Meridian, Fushhe (SP15) and Chongmen (SP12) of the Foot-Taiyin Spleen Meridian, Qixue (KI14) and Siman (KI15) of the Foot-Shaoyin Kidney Meridian, all of which treat Ben Tun (fleeing pig) and accumulations. [Sound: Kuo].) Needle the spaces between the fourth vertebrae on both sides of the spine. (These are Jueyin Shu (BL18) of the Foot-Taiyang Bladder Meridian, where the Qi of the Hand-Jueyin Pericardium Meridian reaches. According to *Suwen: Maiyao Jingwei Lun*: "The Heart is a Yang organ, and the Small Intestine is its envoy, therefore there should be tangible signs in the lower abdomen." Thus, Jueyin Shu undoubtedly treats lower abdominal diseases.) Needle the areas beside the two Iliac bones and between the costal margins, guiding the Qi in the abdomen so that heat descends and the disease resolves. (The lumbar bone is called Iliac. The areas beside the two Iliacs refer to the positions beside the lumbar bones. The space between the costal margins is Jingmen (GB25), acupoints of the Foot-Shaoyang Gallbladder Meridian. Dao means to guide. Guiding the heat in the abdomen downward into the lower abdomen will cure the disease. Iliac sounds like Ge, or Qiu Ya.)

For diseases in the lower abdomen involving abdominal pain and inability to urinate or defecate, the disease is named Shan (Hernia), caused by cold. Needle the lower abdomen, the space between the thighs, and the space between the lumbar condyles. Needle frequently until warmth is felt and the disease resolves. (Abdominal pain in the lower abdomen with obstruction of urine and stool is Shan disease, caused by cold pathogen. Needling the lower abdomen removes cold from the Liver and Kidney. Needling the space between the thighs removes pathogens from the Yangming and Taiyin meridians. Needling the lumbar condyle area: any large flat bone in the posterior or lateral waist is called a condyle bone. The posterior part is where the Foot-Taiyang meridian travels. The lateral part is where the Foot-Shaoyang meridian travels. Although these meridians do not primarily govern cold Shan, observe the location of the pathogen, select multiple points, and needle until the lower abdomen feels warm, then the disease resolves. Condyle sounds like Ku Wa. Jiong sounds like Ju Yong, meaning heat.)

For fullness in the chest with wheezing, take the end of the Great Toe of the Foot-Taiyin meridian, at a distance from the nail edge like the width of a leek leaf.
(From *Lingshu: Rebing Pian*. The end of the great toe is Yinbai (SP1). Xie sounds like Xie, resembling a leek but without bulbs.) In cold conditions, retain the needle for a long time; in heat conditions, remove it quickly. Stop when the Qi descends. (Internal cold causes slow Qi arrival, so prolonged retention is suitable. Internal heat causes fast Qi arrival, so quick removal is suitable. Wait until the Qi descends and wheezing stops before removing the needle.)

For sudden severe pain of Xin Shan (Heart Hernia), take the Foot-Taiyin and Foot-Jueyin meridians, and thoroughly needle to drain their blood collaterals. (Xin Shan, as stated in *Suwen: Maiyao Jingwei Lun*: "If the Heart pulse is rapid and urgent, the disease is named Xin Shan, and there should be tangible signs in the lower abdomen." Taking the Foot-Taiyin and Foot-Jueyin meridians and thoroughly draining the blood collaterals works because these two meridians converge in the lower abdomen; draining collateral blood disperses the pathogen.)

For internal heat with wheezing, take the Foot-Shaoyin meridian and the blood collaterals at Weizhong.
(From *Lingshu: Zabing Pian*. Internal heat with wheezing indicates heat in the Middle and Upper Jiao. Taking the Foot-Shaoyin strengthens Water to control Fire. The blood collaterals at Weizhong refer to Weizhong (BL40) of the Foot-Taiyang Bladder Meridian, which can clear fire.)

For lower abdominal distension and enlargement extending upwards to the stomach and heart, accompanied by chills and fever, and difficulty urinating, take the Foot-Jueyin meridian. (Xi Xi describes a chilly sensation. The Liver meridian reaches the lower abdomen and flanks the stomach; its branch diverges from the Liver, pierces the Diaphragm, thus causing such symptoms. One should needle the Foot-Jueyin meridian. Xi sounds like Xi.)

For abdominal distension, constipation, abdominal enlargement extending upwards to the chest and throat, and loud wheezing, take the Foot-Shaoyin meridian. (The Kidney opens into the two orifices; its meridian ascends from the Kidney, passes through the Liver and Diaphragm into the Lung, and follows the throat, thus causing such symptoms. One should needle the Foot-Shaoyin meridian. He He describes rapid breathing. Yi sounds like Yi.)

For abdominal distension, indigestion, rumbling abdomen, and inability to defecate, take the Foot-Taiyin meridian. (When the Spleen loses its function, food cannot be transformed, leading to abdominal distension and rumbling, Qi stagnation in the middle, and irregular bowel movements. One should needle the Foot-Taiyin meridian.)

For rebellious Qi ascending, needle the depressions in the Ying (chest) and the arteries in the lower chest. (The depression in the Ying is Wuyi (ST15) of the Foot-Yangming Stomach Meridian. The artery in the lower chest is Zhongfu (LU1) of the Hand-Taiyin Lung Meridian. What is in the center is called Chest; the sides of the Chest are called Lower Chest.)

For abdominal pain, needle the arteries on the left and right of the umbilicus. Press after needling; pain stops immediately. If not, needle Qiejie (Qichong); press after needling; pain stops immediately. (The arteries on the left and right of the umbilicus include Hanyu (KI13) of the Foot-Shaoyin Kidney Meridian and Tianshu (ST25) of the Foot-Yangming Stomach Meridian, both treating abdominal pain. Qiejie refers to Qichong (ST30) of the Foot-Yangming Stomach Meridian.)

For intestinal obstruction, take Zusanli (ST36). Use reducing method for excess, tonifying method for deficiency.
(From *Lingshu: Sishi Qi Pian*. Obstruction of the Small Intestine implies inability to transform substances; obstruction of the Large Intestine implies inability to transmit waste. Both belong to the Stomach, so one should take Zusanli (ST36) of the Foot-Yangming Stomach Meridian. Reduce if pathogenic Qi is excess; tonify if Healthy Qi is deficient.)

For frequent abdominal rumbling, Qi rushing up to the chest, wheezing preventing standing for long periods, with pathogen in the Large Intestine, needle the Yuan source of Hu (Belly Oil), Jubian Shanglian (Shangjuxu ST37), and Zusanli (ST36). (*Lingshu: Jiuzhen Shier Yuan Pian* states: "The Yuan source of Hu originates from Bo Yang," which is Xiaguhai (CV6) of the Ren Mai. Jubian Shanglian and Zusanli are acupoints of the Foot-Yangming Stomach Meridian. According to *Lingshu: Benshu*: "The Large Intestine belongs to Shanglian." Since the pathogen is in the Large Intestine, needle Jubian Shanglian; if the pathogen were in the Small Intestine as in the following text, one would take Jubian Xialian (Xiajuxu ST39).)

For lower abdominal pain pulling to the testicles, connecting to the lumbar spine, and Qi rushing up to the Heart, where the pathogen is in the Small Intestine, connecting the testicular ligaments, belonging to the spine, penetrating the Liver and Lungs, and linking to the Heart system. Excess Qi causes reversal and upward rush to the stomach and intestines, steaming the Liver, spreading to the Hu membrane, and knotting at the umbilicus. (Kong means pulling. Gao refers to the testicles. The Small Intestine connects to the lower abdomen; if pathogen is excessive, reversal rushes upward from below to the Heart and Lungs, steams the Liver and Stomach, pulls the lumbar spine, and extends to the Hu membrane, umbilicus, and testicular ligaments. See Disease Category 67 for the meaning of Hu. Gao sounds like Gao.) Therefore, take the Yuan source of Hu to disperse it, needle the Taiyin to tonify it, take the Jueyin to descend it, take Jubian Xialian to eliminate it, and regulate according to the meridians passed. (Taking the Yuan source of Hu disperses knots in the umbilical and abdominal regions. Needling Taiyin tonifies Lung deficiency. Taking Jueyin descends Liver excess. Taking Jubian Xialian targets the Small Intestine. Regulating according to passed meridians means observing the pathogen's location to regulate.)

For frequent vomiting with bitter taste, frequent sighing, feeling empty and fearful in the Heart as if being pursued, where the pathogen is in the Gallbladder and rebellion is in the Stomach, bile leakage causes bitterness, and Stomach Qi rebellion causes vomiting of bitter fluid, hence called Ou Dan (Vomiting Gallbladder). (Describes a feeling of emptiness. Pathogen in Gallbladder and rebellion in Stomach is Wood overacting on Earth. Bile leakage causes bitterness; Stomach Qi rebellion causes vomiting, hence vomiting bitter fluid is called Ou Dan.) Take Zusanli (ST36) to descend rebellious Stomach Qi, then needle the blood collaterals of the Shaoyang to close Gallbladder rebellion, and subsequently regulate deficiency and excess to eliminate the pathogen. (Zusanli is a Foot-Yangming Stomach Meridian point, capable of descending Stomach Qi. Needling Foot-Shaoyang blood collaterals calms Wood, preventing bile leakage, thus closing Gallbladder rebellion. However, one must regulate deficiency and excess, whether tonifying or reducing, to eliminate the pathogen.)

For inability to eat, blockage in the diaphragm, where the pathogen is in the Wei Wan (Stomach Epigastrium), if in Shangwan (CV13), needle to suppress and direct downward; if in Xiawan (CV10), scatter and remove it. (Shangwan and Xiawan are Ren Mai points, also known as Wei Wan. Suppressing and directing downward means needling Shangwan to reduce high-standing food Qi. Scattering and removing means warming Xiawan to dissipate stagnant cold. This applies to both acupuncture and herbs.)

For lower abdominal swelling and pain with inability to urinate, where the pathogen is in the constraint of the Sanjiao, take the Da Luo (Great Collateral) of the Taiyang, observing collaterals connected with small collaterals of the Jueyin containing blood stasis; if swelling extends to the epigastrium, take Zusanli (ST36). (Pathogen in Sanjiao constraint: Sanjiao exits downward at Weiyang (BL39), joins the Zheng channel of the Foot-Taiyang, enters and links to the Bladder, constraining the Lower Jiao. The Da Luo of Taiyang is Feiyang (BL58). Also observe its branch collaterals and small collaterals of the Jueyin with blood stasis and remove them, as the Foot-Jueyin meridian also reaches the lower abdomen. If lower abdominal swelling and pain extend to the epigastrium, take Zusanli (ST36) of the Foot-Yangming Stomach Meridian.)

For Sundry diarrhea (Sun Xie) with undigested food, tonify the upper point of Sanyin, tonify Yinlingquan (SP9), retaining the needle for a long time until heat is felt. (The upper point of Sanyin refers to Sanyinjiao (SP6), the meeting point of the Spleen, Liver, and Kidney meridians. Yinlingquan is a Foot-Taiyin Spleen Meridian point. Tonifying and retaining the needle allows Yang Qi to arrive and heat to circulate; once heat circulates, diarrhea stops.)

For distension, take the Three Yang meridians; for Sundry diarrhea, take the Three Yin meridians.
(From *Lingshu: Jiuzhen Shier Yuan Pian*). Distension refers to abdominal distension. Sun Xie refers to undigested food in stool. For distension, take the Three Yang meridiors of the foot, i.e., Stomach, Gallbladder, and Bladder meridians. For Sun Xie, take the Three Yin meridians of the foot, i.e., Spleen, Liver, and Kidney meridians. Sun sounds like Sun.)

For sudden abdominal fullness that does not yield to pressure, take the Luo-Connecting point of the Taiyang meridian, which is the Mu-Alarm point of the Stomach.
(From *Suwen: Tongping Xushi Lun*. The Taiyang Luo point refers to the Luo point of the Hand-Taiyang Small Intestine Meridian, which is Zhongwan (CV12), the Mu-Alarm point of the Stomach. Zhongwan is generated by the Qi of the Hand-Taiyang, Hand-Shaoyang, and Foot-Yangming meridians, hence called Taiyang Luo. Mu sounds like Mu.) Shao Yin Shu (Kidney Shu BL23), located three cun five fen lateral to the spine, use a Yuanli needle. (Shao Yin Shu is Kidney Shu (BL23). The Kidney is the gate of the Stomach, so it should also be taken. It is a Foot-Taiyang Bladder Meridian point, one inch five fen lateral to each side of the spine, totaling three cun, and five fen lateral. Use the sixth type, Yuanli needle.)

For Huo Luan (Cholera-like syndrome), needle five fen lateral to the Shu points. (Pathogen in the Middle Jiao causes both vomiting and diarrhea, chaotic Zang-Fu Qi and spirit, hence called Huo Luan. Shu pang refers to the area five fen lateral to Shao Yin Shu mentioned above, which is Zhishi (BL52). Needle five fen on each side.) Foot-Yangming and the three points above laterally. (Foot-Yangming refers to Weishu (BL21). The points above laterally are Yishe (BL49), outside Pishu (BL20). Needle three fen on each.)