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(Suwen: Changci Jie Lun, Gukong Lun; Ling shu: Hanre Bing Pian, Rebing Pian, Juebing Pian, Zabing Pian, Zhongshi Pian)

Expert acupuncturists may not necessarily require pulse diagnosis; they can rely on the patient's description of symptoms. (Suwen: Changci Jie Lun. Those skilled in acupuncture need not wait for pulse diagnosis; by listening to the patient's account, their needle insertions will be accurate. This statement praises those who have mastered the divine skill of acupuncture and does not imply that all practitioners should completely disregard diagnosis. However, later generations of physicians, lacking both acupuncture proficiency and diagnostic skills, inevitably make errors in tonifying deficiency and reducing excess. Therefore, the Jiuzhen Shier Yuan chapter states: "Before using needles, one must first diagnose the pulse, observe the severity and ease of the Qi condition, and only then proceed with treatment." The meaning is clear.)

For headache located in the head, deep insertion of the needle is required. ("Cang zhen zhi" implies inserting the needle deeply into the interior.) Insert until reaching the bone; once the disease is resolved, ensure there is no damage to the muscle, bone, or skin above, as the skin merely serves as the pathway for needle entry. (Headaches indicate a deep pathological location, so needling to the bone level resolves the disease. Although reaching the bone might seem to risk damaging superficial tissues, the instruction means avoiding reckless tonification or reduction that would erroneously damage the Qi of the skin, muscle, and bone layers; the skin and muscle are simply utilized as the access route for the needle.)

The pulsating artery on the lateral neck is Renying (ST 9). Renying belongs to the Foot-Yangming Stomach Meridian and is located anterior to the Yingjin (neck tendon). (Lingshu: Hanre Bing Pian. The midline of the neck corresponds to the Ren Mai (Conception Vessel). The two pulsating arteries refer to the Renying point of the Foot-Yangming Stomach Meridian. The Shuowen Jiezi defines "Ying" as the neck tendon; thus, the tendons on the side of the neck are called Yingjin.) Posterior to the Yingjin lies the Hand-Yangming Large Intestine Meridian, named Futu (SI 16). (Located in the third row of the neck.) The next vessel posteriorly is the Foot-Shaoyang Gallbladder Meridian, named Tianyou (TE 16). (Located in the sixth row of the neck; it belongs to the Hand-Shaoyang Sanjiao Meridian. The character "Foot" is likely an error. "You" is pronounced yǒu.) The subsequent vessel is the Foot-Taiyang Bladder Meridian, named Tianzhu (BL 10). (Located in the seventh row of the neck.) The arterial pulse in the axilla belongs to the Arm-Taiyin Lung Meridian, named Tianfu (LU 3). ("Arm-Taiyin" refers to the Hand-Taiyin Lung Meridian. These five points are detailed in the Benshu chapter, see Meridians Category 10, and are used to treat the conditions described below.) For headache caused by rebellious Yang Qi, accompanied by chest fullness and dyspnea, select Renying (ST 9). ("Ying" means rebellious. When pathogenic Yang Qi rebels within the Yang meridians causing headache and chest fullness, Renying should be selected.) For sudden aphonia and stiff throat/tongue, select Futu (SI 16) and bleed the base of the tongue. ("Yin" denotes hoarseness or inability to speak. "Qi ying" refers to stiffness of the throat and tongue. One should select Futu of the Hand-Yangming Large Intestine Meridian and bleed the root of the tongue. Conditions described as "sudden" (bao) result from acute Qi rebellion rather than chronic disease, so these points are indicated to treat the branch/symptoms. "Yin" is pronounced yīn; "ying" is synonymous with "geng".) For sudden deafness, mental clouding, and unclear vision/hearing, select Tianyou (TE 16). (When meridian Qi is obstructed causing sudden impairment of vision and hearing, Tianyou should be selected as described above.) For sudden spasms, epilepsy, vertigo, and lower limb weakness unable to support the body, select Tianzhu (BL 10). ("Luan" refers to spasms; "xian" refers to epilepsy; "xuan" refers to vertigo. When these three conditions present with lower limb weakness, Tianzhu should be selected as described above. "Xian" is pronounced xián.) For sudden heat disease with internal Qi rebellion, where Liver and Lung Qi clash causing hemorrhage from the nose and mouth, select Tianfu (LU 3). ("Dan" refers to heat disease. Sudden internal heat rebellion causes Liver and Lung Qi to clash, leading to blood溢 (overflow/hemorrhage) from the mouth and nose; Tianfu should be selected as described above. "Dan" is pronounced dān, also read as qùshēng.) These five points constitute the "Tianyou Five Regions." (This summarizes the aforementioned five points as the Tianyou Five Regions, with Tianyou at the center governing the anterior, posterior, superior, and inferior areas.)

The Hand-Yangming Large Intestine Meridian has a branch entering and distributing throughout the teeth, emerging at Daying (ST 5). For mandibular tooth decay/pain, select this point. If the arm feels aversion to cold, apply tonification; if not, apply reduction. (The Hand-Yangming Large Intestine Meridian has branches entering the teeth. Its pathway emerges at Daying of the Foot-Yangming Stomach Meridian. For mandibular toothache, Daying should be selected, along with Shangyang (LI 1), Erjian (LI 2), and Sanjian (LI 3), which all treat toothache. However, aversion to cold in the arm indicates deficiency, warranting tonification; absence of aversion to cold indicates excess, warranting reduction. "Quan" refers to the cheekbone; "qu" refers to dental caries/decay.)

The Foot-Taiyang Bladder Meridian has a branch entering and distributing throughout the teeth, emerging at Jiaosun (SJ 7). For maxillary tooth decay/pain, select this point. It is located between the nose and the cheekbone. During the acute phase of the disease, if the pulse is vigorous, apply reduction; if deficient, apply tonification. (The Foot-Taiyang Bladder Meridian also has branches entering the teeth, emerging from Jiaosun of the Hand-Shaoyang Sanjiao Meridian. For maxillary toothache, this point should be selected. Additionally, points such as Dicang (ST 4) and Juliao (ST 3) between the nose and cheekbone, belonging to the Foot-Yangming Stomach Meridian which enters the upper teeth, also treat toothache. Treatment must be guided by observing pulse excess or deficiency during the acute phase.) Alternatively, select points outside the nose (such as Heliao (LI 18) and Yingxiang (LI 20) of the Hand-Yangming Large Intestine Meridian).

The Foot-Yangming Stomach Meridian has a branch flanking the nose and entering the face, associated with Xuanlu (GB 6). It connects to the mouth and ascends to the root of the eye. Select points showing pathology, reduce excess, and tonify deficiency. If treated incorrectly, the condition will worsen. (The character "qi" should likely be "shen" [severe]. The Foot-Yangming Stomach Meridian has a branch flanking the nose into the face, originating from Xuanlu of the Foot-Shaoyang Gallbladder Meridian. Its descending branch connects to the mouth, and its ascending branch enters the root of the eye. Pathology in either the eye or mouth can be treated. However, one must assess excess or deficiency to apply tonification or reduction; reversing this approach will exacerbate the disease.)

The Foot-Taiyang Bladder Meridian has a pathway passing through the nape into the brain, directly connecting to the root of the eye, known as the Eye System (Yanxi). For severe headache and eye pain, select this point, located between the two tendons in the nape. (The Foot-Taiyang Bladder Meridian passes through the nape into the brain via Yuzhen (BL 9), located between the two tendons in the nape; this point should be selected for headache and eye pain.) Upon entering the brain, the meridian diverges to connect with the Yin Qiao and Yang Qiao vessels. Yin and Yang intersect; Yang enters Yin, and Yin exits Yang, meeting at the inner canthus. When Yang Qi is excessive, the eyes open wide; when Yin Qi is excessive, the eyes close. (The Taiyang meridian enters the brain from the nape and diverges to the Yin and Yang Qiao vessels, intersecting at Jingming (BL 1) in the inner canthus. Excess Yang Qiao Qi prevents Yin from nourishing, causing the eyes to remain open and unable to close. Excess Yin Qiao Qi prevents Yang from nourishing, causing the eyes to remain closed and unable to open. Note: The Maidu chapter states the Qiao vessels belong to the inner canthus and merge with Taiyang. The Rebing chapter states: "Redness and pain in the eyes starting from the inner canthus should be treated by the Yin Qiao." Thus, "outer canthus" (ruixie) in this text is likely a textual error for "inner canthus" (neixie). See Meridians Category 28. "Qiao" has multiple pronunciations: qiāo, jiǎo, qiáo, jiǎo, and jí nüè. "Chen" is pronounced chēn; "ming" is pronounced míng, also read as qùshēng.)

For upper jiao Qi rebellion with audible sounds, treat the center of the throat, specifically the Tantu (RN 22) point located in the suprasternal fossa. (Suwen: Gukong Lun. This refers to rapid breathing with audible stridor in the throat. The center of the throat corresponds to Tantu (RN 22) of the Ren Mai, located between the clavicles.) For disease Qi rushing up to the throat, treat the Jian point, which is located alongside the jaw. (When Qi stagnation rushes up to the throat, treat Daying (ST 5) of the Foot-Yangming Stomach Meridian, which runs alongside the jaw. The Yangming meridian gradually ascends from here to the face, hence "Jian" refers to the area alongside the jaw.)

Stiff neck (Shizhen) is treated in the transverse bone region of the shoulder. (Stiff neck results from wind invading the neck, causing pain and limited mobility preventing comfortable resting on a pillow. Needling should be performed in the transverse bone region of the shoulder, likely referring to Jianwaiyu (SI 15) of the Hand-Taiyang Small Intestine Meridian on the posterior shoulder bone. Alternatively, Jianjing (GB 21) of the Foot-Shaoyang Gallbladder Meridian may be used for neck pain. If Wang Bing suggests Quepen (ST 12), its meridian runs anteriorly and is unlikely to be effective for stiff neck.) Have the patient extend their arms parallel to the elbows to measure the spine, then moxa the corresponding point on the Du Mai, which is Yangguan (DU 13). ("Zhe" means pain like breaking; "Yu" should be "You," meaning to draw/pull. Instruct the patient to extend their arms to align with the elbow ends to locate the spinal level for moxibustion, likely Yangguan (DU 13) of the Du Mai.)

For throat obstruction with aphonia, rolled tongue, dry mouth, irritability, heart pain, and pain along the medial aspect of the arm extending to the head, select the point on the nail bed of the fourth finger (ring finger), approximately one grain of wheat width from the corner. (Lingshu: Rebing Pian. The tip of the fourth finger corresponds to Guanchong (TE 1) of the Hand-Shaoyang Sanjiao Meridian.)

For redness and pain in the eyes starting from the inner canthus, select the Yin Qiao vessel. (The Yin Qiao vessel belongs to the inner canthus; Zhaohai (KI 6) of the Foot-Shaoyin Kidney Meridian is the source of the Yin Qiao, so this point should be needled.)

For deafness and inability to hear, select Tinggong (SI 19) in the ear. (Lingshu: Juebing Pian. "Ear middle" refers to Tinggong (SI 19) of the Hand-Taiyang Small Intestine Meridian.)

For tinnitus, select the arterial pulse anterior to the ear, Ermen (TE 2). (Ermen is located at the arterial pulse anterior to the ear, belonging to the Hand-Shaoyang Sanjiao Meridian.)

If ear pain precludes needling due to pus or dry cerumen (earwax) in the ear canal causing hearing loss, do not needle. (Cerumen is earwax. If there is pus or dry cerumen causing pain or hearing loss, needling is contraindicated; removal of the pus and wax will allow the ear to heal naturally. "Ding" is pronounced dīng; "ning" is pronounced níng, also read as qùshēng.)

For deafness, select the junction of the nail and flesh on the fourth finger (Guanchong TE 1), first treating the Hand meridian, then the Foot meridian (Quanguan GB 44). (The point on the nail of the fourth finger is Guanchong (TE 1) of the Hand-Shaoyang Sanjiao Meridian. Treating the Foot meridian subsequently refers to Quanguan (GB 44) of the Foot-Shaoyang Gallbladder Meridian, also located on the fourth toe/finger digit.)

For tinnitus, select Zhongchong (PC 9) on the nail of the middle finger. Treat the right side for left-sided tinnitus, and the left side for right-sided tinnitus. First treat the Hand meridian, then the Foot meridian. (Zhongchong is on the nail of the middle finger, belonging to the Hand-Jueyin Pericardium Meridian. Cross-needling applies: left tinnitus treated on the right, right tinnitus on the left.)

For deafness without pain, select the Foot-Shaoyang Gallbladder Meridian; for deafness with pain, select the Hand-Yangming Large Intestine Meridian. (Lingshu: Zabing Pian. The Foot-Shaoyang Gallbladder Meridian descends behind the ear, branches into the ear, and emerges anterior to the ear. The collateral of the Hand-Yangming Large Intestine Meridian enters the ear. Differentiate based on presence or absence of pain to apply tonification or reduction.)

For dry throat and mouth feeling hot like glue, select the Foot-Shaoyin Kidney Meridian. (The Foot-Shaoyin Kidney Meridian follows the throat and connects to the root of the tongue. Dry throat and sticky heat in the mouth indicate Yin deficiency; therefore, tonification is required. "Yi" is pronounced yì.)

For throat obstruction with inability to speak, select the Foot-Yangming Stomach Meridian; if speech is possible, select the Hand-Yangming Large Intestine Meridian. (Both Hand and Foot Yangming meridians follow the throat. Ability to speak indicates mild condition, treat upper points; inability to speak indicates severe condition, reduce lower points.)

For toothache not aggravated by cold drinks, select the Foot-Yangming Stomach Meridian; for toothache aggravated by cold drinks, select the Hand-Yangming Large Intestine Meridian. (Both meridians enter the teeth. The Stomach Meridian often involves excess heat, so avoid cold drinks indicates excess, requiring reduction of Foot-Yangming. The Large Intestine Meridian often involves deficiency cold, so aversion to cold drinks indicates deficiency, requiring tonification of Hand-Yangming. This relates to the previous section on Hand-Yangming and should be cross-referenced. "Chuo" is pronounced chuò.)

For persistent epistaxis (nu) and dark stagnant blood flow, select the Foot-Taiyang Bladder Meridian; for coagulated blood (yu), select the Hand-Taiyang Small Intestine Meridian. If bleeding persists, needle Wan'gu (SI 4); if still persisting, bleed Weizhong (BL 40). (Nosebleed is called nu; dark purple-black coagulated blood is called yu. Flowing blood indicates significant loss, treated by Foot-Taiyang. Coagulated blood indicates less loss, treated by Hand-Taiyang. Wan'gu under the wrist is SI 4. Bleeding Weizhong refers to BL 40. "Nu" is pronounced nǜ; "yu" is pronounced yū.)

For cheek pain, bleed the abundant collaterals of the Hand-Yangming Large Intestine Meridian and the temples (han). (The temples are the two solar regions on either side of the hairline. The collateral of the Hand-Yangming Large Intestine Meridian enters the ear and merges with the Zong vessels, exiting between the temples. Bleed the prominent collaterals in the temple region. "Han" is pronounced kǎn, also hǎi gǎn.)

For jaw pain, needle the curved arterial pulse of the Foot-Yangming Stomach Meridian (Jiache ST 6). Bleeding stops the pain immediately; if not, press Renying (ST 9) and lightly needle the meridian for immediate relief. (The Foot-Yangming Stomach Meridian follows the cheekbone up to the ear anteriorly, passes through Chengman (ST 7), follows the hairline to the forehead. For jaw pain, needle Jiache (ST 6), so named because it curves around the jaw. Bleeding provides immediate relief; otherwise, press Renying and lightly needle the meridian for immediate relief.)

For neck pain limiting flexion and extension, needle the Foot-Taiyang Bladder Meridian; for neck pain limiting turning the head, needle the Hand-Taiyang Small Intestine Meridian. (Inability to flex/extend indicates pain in the posterior neck, treated by Foot-Taiyang. Inability to turn the head indicates pain on the lateral neck, treated by Hand-Taiyang.)

For double tongue (chong she), use a Bi needle to puncture the tongue pillar. (Lingshu: Zhongshi Pian. A small tongue growing beneath the main tongue is called double tongue. The tongue pillar refers to the tendon-like structure under the tongue. Use the fifth type of needle, the Bi needle, to puncture it. "Pi" is pronounced pī.)