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[Naohu (GV17)] Direct needling into the brain leads to immediate death.

[Sublingual Veins] Needling the middle vein under the tongue; if bleeding is excessive and does not stop, it causes aphonia (Supplementary note: The Spleen meridian connects to the root of the tongue and spreads under the tongue, flanking the pharynx. If blood flows excessively without stopping, the Spleen Qi cannot transport and nourish the tongue, thus causing aphonia and inability to speak).

[Bu Luo under the Foot] Needling the dispersed collaterals under the foot; if blood does not flow out, it causes swelling (Supplementary note: Bu Luo is located in the hollow space anterior to the medial malleolus and under the foot, where the dispersed collaterals are situated, corresponding to the area of Ran Gu (KI2)).

[Weizhong (BL40)] Needling the large vessel at Weizhong (BL40) causes the person to collapse, with a complexion as if the color has drained away (Supplementary note: Causing the person to fall prostrate and the facial color to appear blanched).

[Qijie (ST30)] Needling the large vessel at Qijie (ST30); if blood does not flow out, it causes swelling shaped like a crouching rat (Supplementary note: Internal accumulation forms swelling resembling a crouching rat. The Qijie region contains the Gallbladder and Stomach meridians. The acupoint is located below the abdomen, flanking both sides of the umbilicus, four cun apart. Shupu (ST29) is one cun above Qijie, where the arterial pulse is palpable).

[Intervertebral Space] Needling between the vertebrae; if the spinal marrow is injured, it causes kyphosis (Supplementary note: Louyu refers to the curling and bending of the body).

[Above the Breast] Needling above the breast; if the breast tissue itself is punctured, it causes swelling and root erosion (Supplementary note: Puncturing the breast results in severe swelling with pus formation inside, eroding the skin from the root).

[Quepen (LI12)] Needling Quepen (LI12); if inserted too deeply causing internal depression and leakage of Lung Qi, it induces asthma, cough, and rebellious Qi (Supplementary note: Among the Zang organs, the Lung is the canopy. Quepen is the pathway for Lung Qi. The Lung stores Qi and governs respiration; rebellious Qi causes cough. Deep needling into Quepen causes internal depression and external leakage of Lung Qi, resulting in asthma, cough, and rebellious Qi).

[Contraindications] Do not needle when the patient is severely intoxicated, as this disrupts Qi dynamics; do not needle when the patient is extremely angry, as this causes Qi rebellion; do not needle individuals who are exhausted; do not needle individuals who have just eaten a full meal (Supplementary note: Qi is abundant, and needling may cause leakage). Do not needle individuals who are starving (Supplementary note: Qi is deficient). Do not needle individuals who are extremely thirsty (Supplementary note: Blood vessels are dry). Do not needle individuals who have been greatly startled (Supplementary note: The Spirit is scattered, and Qi dynamics are unregulated. The *Ling Shu* states: Do not needle after sexual intercourse; do not engage in intercourse after needling; do not needle after anger; do not become angry after needling; do not needle after exhaustion; do not exert yourself after needling; do not needle after overeating; do not eat heavily after needling; do not needle when starving; do not remain hungry after needling; do not needle when extremely thirsty; do not remain thirsty after needling; after great fear or shock, wait until Qi is stabilized before needling).

[Middle Vessel of the Inner Thigh] Needling the large vessel in the inner thigh (Supplementary note: The Spleen meridian); if bleeding does not stop, it is fatal.

[Keyuzhuren (Shangguan, GB19)] Needling Keyuzhuren (modern name: Shangguan, GB19, intersection of Foot Shaoyang, Foot Yangming, and three other meridians); if inserted too deeply into the vessel, it causes internal leakage and deafness (Supplementary note: Keyuzhuren is now known as Shangguan (GB19), where the Foot Shaoyang and Foot Yangming meridians intersect. "Xian Mai" refers to needling too deeply).

[Knee Patella] Needling the knee patella region; if fluid leaks out, it causes limping.

[Hand Taiyin Meridian] Needling the Hand Taiyin (Lung) meridian; if excessive bleeding occurs, death follows immediately.

[Foot Shaoyin Meridian] Needling the Foot Shaoyin (Kidney) meridian; if bleeding occurs in a state of double deficiency, it causes tongue stiffness and difficulty in speech.

[Yongzhong (Chest Center)] Needling the center of the chest; if inserted too deeply injuring the Lung, it causes asthmatic rebellion and orthopnea (difficulty breathing while lying flat).

[Zhouzhong (Elbow Center)] Needling Zhouzhong (Supplementary note: Refers to Chi Ze (LU5) at the elbow flexure); if inserted too deeply into the vessel, evil Qi accumulates there, causing inability to flex or extend the arm.

[Three Cun Below Inner Thigh] Needling three cun below the inner thigh (Supplementary note: This is the collateral of the Kidney. It originates from below the Kidney, exits at Qijie, and ascends along the inner thigh; its ascending branch exits from the Bao Zhong. Thus, needling this deep vessel causes enuresis).

[Axilla and Hypochondrium] Needling the axilla and hypochondriac region; if inserted too deeply, it causes cough (Supplementary note: The axilla is where the Lung meridian resides. The direct path of the Heart meridian goes from the Heart system up to the axilla. Needling deeply here agitates both the Heart and Lung, causing cough).

[Lower Abdomen] Needling the lower abdomen (below the umbilicus) involving the Bladder; if urine leaks out, it causes lower abdominal fullness.

[Intestines] Needling the intestines; if inserted too deeply, it causes swelling.

[Above the Orbit] Needling the vessel within the bone above the orbit; it causes fistula or blindness (Supplementary note: "Bone" refers to the orbital bone. The vessel within the orbital bone is the connection to the eye, belonging to the Liver meridian).

[Joints] Needling the joints; if synovial fluid leaks out, it causes inability to flex and extend (Supplementary note: All tendons attach to the joints. Fluid refers to moistening fluids; if they leak out, the fascia dries, preventing movement. From *Jin Gui Yi Shu*).

The Yellow Emperor asked: You mentioned ten types of excess and deficiency syndromes arising from the Five Zang organs and their five pulses. However, all twelve meridians can generate disease. Why do you speak only of the Five Zang? The twelve meridians all have diseases, and diseases at the 365 acupuncture points inevitably affect the meridians. Since meridian diseases all have excess and deficiency, how should they be integrated?

Qi Bo answered: The Five Zang organs originally have a exterior-interior relationship with the Six Fu organs. Collaterals and joints each generate excess and deficiency. Wherever the disease is located, regulate it according to its site (Supplementary note: Regulate by following the Qi dynamics of the meridians and joints on the left and right).

If the disease is in the vessels, regulate the Blood (Supplementary note: Vessels are the residence of Blood. Excess vessels indicate excess Blood, deficient vessels indicate deficient Blood. Thus, treat the vessels by regulating the Blood).

If the disease is in the Blood, regulate the Collaterals (Supplementary note: When Blood is diseased, the collateral vessels change easily, so regulate them via the collaterals. I believe "change" means altering their normal state).

If the disease is in Qi, regulate the Wei Qi (Supplementary note: Wei Qi governs Qi; therefore, regulate Wei Qi when Qi is diseased).

If the disease is in the flesh, regulate the muscle intervals (Supplementary note: Observe cold and heat to select points).

If the disease is in the sinews, regulate the sinews (Supplementary note: Needle or moxa based on the tension or laxity of the sinews).

If the disease is in the bones, regulate the bones (Observe severity to regulate).

For tendon spasms, use burning needles and rapid stimulation on the affected area and below (Supplementary note: This is the method for regulating sinews. For tense sinews, burn the needle and apply rapid stimulation).

For bone diseases, use cauterizing needles and herbal hot compresses (Supplementary note: This is the method for regulating bones. Cauterizing needles refer to fire needles).

When the pain location is unknown, treat the two Qiao vessels (Supplementary note: The two Qiao vessels refer to the Yin and Yang Qiao meridians. Yin Qiao emerges from Zha Hai (KI6), and Yang Qiao emerges from Shen Mai (BL62)).

If the body has pain but the Nine Pulses show no abnormality, use Miao Ci (Supplementary note: Miao Ci involves needling collateral vessels; pain on the left is treated by needling the right, and vice versa).

If pain is on the left but the pulse on the right is abnormal, use Ju Ci (Supplementary note: Ju Ci involves needling the main meridians; pain on the left is treated by needling the right, and vice versa).

One must carefully observe the Nine Pulses, and the principles of needling will be complete (From *Tiao Jing Lun*).

The Yellow Emperor asked: When true Qi and evil Qi combine, causing pulsation without rising, how should it be examined?

Qi Bo answered: Carefully palpate and examine the fullness or emptiness of the Three Regions and Nine Pulses to regulate them (Supplementary note: Regulation means reducing excess and tonifying deficiency. If neither excess nor deficiency is present, take from the affected meridian).

Observe whether the left and right, upper and lower are discordant (Supplementary note: Discordance refers to mismatched climatic conditions) and whether they diminish each other. Examine which Zang organ is diseased and time the treatment accordingly (Supplementary note: "Time" means if Qi is in the Yin, wait for the Qi to enter the Yin portion to needle; if Qi is in the Yang, wait for the Qi to enter the Yang portion to needle. This is called "meeting the time." The classic states: At the first stroke of the water clock, Human Qi is in the Taiyang meridian; at the fourth stroke, it is in the Yin portion. As strokes accumulate, Qi moves continuously in a cycle. Thus, examine the diseased Zang and time the Qi to needle appropriately).

Not knowing the Three Regions and Nine Pulses prevents distinguishing Yin and Yang and separating Heaven and Earth. Earth is used to observe terrestrial Qi, Heaven to observe celestial Qi, and Humanity to observe human Qi. Regulate the Middle Palace to define the Three Regions (I interpret "regulate" as measuring; measure the position of the Middle Palace to define upper and lower).

Therefore, it is said: If needling ignores the locations of the Three Regions, Nine Pulses, and disease pulses, even if an excessive pathogen arrives, a skilled physician cannot prevent its harm.

Attacking those without fault is called great confusion. Reversing the great meridians, the True Qi cannot be restored. Mistaking excess for deficiency, and evil for truth, using needles without principle becomes a thief of Qi, depriving the person of healthy Qi, causing Ying and Wei to scatter, True Qi to be lost, and evil to remain alone inside. This cuts short life and brings premature disaster. This is due to ignorance of the Three Regions and Nine Pulses, hence longevity cannot be achieved.

My commentary: The term "Three Regions" refers to the Upper, Middle, and Lower regions of the body. The internal tunnels of the *Nei Jing* pass through these, so observing survival or demise depends entirely on them. Each region has three pulses:
Upper Region Heaven: Arteries on both foreheads, lateral to the forehead, palpable upon pressing; this is where the Foot Shaoyang Qi travels.
Upper Region Earth: Arteries on both cheeks, lateral to the nostrils, palpable upon pressing, near the Juliao (ST3) area; this is where the Foot Yangming Qi travels.
Upper Region Man: Artery in front of the ear, in the depression anterior to the ear; palpable upon pressing; this is where the Shaoyang Qi travels.
Middle Region Heaven: Hand Taiyin vessel, at the radial pulse (Cunkou), Jingqu (LU8) point, palpable upon pressing.
Middle Region Earth: Hand Yangming vessel, at Hegu (LI4), palpable upon pressing.
Middle Region Man: Hand Shaoyang vessel, at Shenmen (HT7), palpable upon pressing.
Lower Region Heaven: Foot Jueyin vessel, one and a half cun below the ramus of the mandible, at Wuli (LR2), taken while supine, palpable upon pressing. In women, take Taichong (LR3), two cun distal to the metatarsophalangeal joint of the big toe.
Lower Region Earth: Foot Shaoyin vessel, at Taixi (KI3), palpable upon pressing.
Lower Region Man: Foot Taiyin vessel, above Yuji (SP2), between the tendons, directly below Wuli (LR2) towards Jimen (SP11); obtainable by heavy pressure with thin clothing.
To observe Stomach Qi, take the Chongyang (ST42) artery on the dorsum of the foot, palpable upon pressing. (From *Li He Zhen Xie Lun*)