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(From *Zhenjiu Juying*)

Li Dongyuan said: The *Huangdi Zhenjing* (Yellow Emperor's Classic of Acupuncture) records: For those suffering from stomach disease, there is pain in the epigastrium corresponding to the heart, radiating upward to both hypochondriac regions, with obstruction in the diaphragm and pharynx, and difficulty in swallowing food. One should select Zusanli (ST36) and apply tonification.

When Spleen and Stomach deficiency leads to dampness transforming into flaccidity syndrome (Wei syndrome), with profuse sweating and impaired appetite, puncture Zusanli (ST36) and Qichong (ST30) with a three-edged needle to bleed. If sweating does not cease, bleed at Shanglian (ST34), located three cun below Zusanli (ST36). Alcohol is prohibited, and damp wheat noodles are contraindicated.

Li Dongyuan said: The *Huangdi Zhenjing* states: For conditions rising from below, guide them downward to eliminate them. For insufficiency of Qi in the Upper Jiao, push and elevate it. The "Qi of the Upper Jiao" refers to the Qi of the Heart and Lungs in the Upper Jiao. Yang diseases affecting Yin require drawing from Yin to reach Yang, expelling pathogenic factors from the Couli (interstices) and skin/hair layer. It also states: Where previous pain existed, one should first treat that area. This involves using Miao-cicada needling (Miu Ci) to drain stagnation in the meridians, as blood coagulation prevents flow; thus, remove the stasis first, then treat other diseases.

Li Dongyuan said: When Stomach Qi sinks, the Qi of the Five Zang organs becomes chaotic, and their pathological manifestations appear alternately. The Yellow Emperor asked: Is there a method for needling when Qi is chaotic in the five Zang? Qibo replied: There is a way for it to come, and a way for it to go; understanding this way thoroughly is the treasure of the body. The Yellow Emperor said: I wish to hear this method! Qibo said: When Qi is chaotic in the Heart, select the Shu-stream points of the Hand Shaoyin Heart Meridian and Hand Jueyin Pericardium Meridian: Shenmen (HT7) and Daling (PC7). Maintain Jing (Spirit) and guide Qi to restore its original position.

When Qi is chaotic in the Lung, select the Ying-Spring and Shu-stream points of the Hand Taiyin Lung Meridian: Yuji (LU10) and Taiyuan (LU9). For cases developing into flaccidity syndrome, guide damp-heat out through the Yang pathways to prevent Damp Earth from overacting on Kidney Water; the relevant point is Taixi (KI3).

When Qi is chaotic in the intestines and stomach, select points on the Foot Taiyin Spleen Meridian and Foot Yangming Stomach Meridian. If descent fails, select Zusanli (ST36), Zhangmen (LR13), and Zhongwan (CV12). For deficiency of the Foot Taiyin Spleen Meridian, guide Qi within the Mu-alarm points. There is a theory that Back-Shu points of Fu organs treat Fu organ diseases. For Stomach deficiency causing insufficient nourishment to the Foot Taiyin Spleen, guide Qi within the Mu-alarm point of the Foot Yangming Stomach Meridian. For example, in cases of Qi reversal causing Huoluan (cholera-like vomiting and diarrhea), select Zusanli (ST36); stop when Qi descends, or continue treatment if it does not.

When Qi is chaotic in the head, select Tianzhu (BL10) and Dazhu (BL11). For insufficiency, select the Ying-Spring and Shu-stream points of the Foot Taiyang Bladder Meridian: Tonggu (BL65) and Shugu (BL64). First select Tianzhu (BL10) and Dazhu (BL11), applying neither tonification nor sedation, merely to guide Qi. Select points on the Foot Taiyang Bladder Meridian, applying neither tonification nor sedation, and deeply needle Tonggu (BL65) and Shugu (BL64) (Ding Fire and Ji Earth points) to guide away the pathogen.

When Qi is chaotic in the arms, treat via foot points. First address the blood vessels, then select the Ying-Spring and Shu-stream points of the Hand and Foot Yangming Meridians: Erjian (LI2) and Sanjian (LI3), needled deeply; Neiting (ST44) and Xianggu (ST43), needled deeply. Observe the collateral vessels in the feet and arms and treat all visible ones. Subsequently treat flaccidity and cold limbs, applying neither tonification nor sedation. Draw from Yin deeply, guiding Qi upward. "Upward" implies dispersal and elimination. These conditions involve excess Yin Fire and insufficiency of Yang Qi, with Ying Blood hiding in the earth (Yin). One must draw from Yin to reach Yang, first raising Yang Qi from the Yin level, then draining Yin Fire. This is the method of guiding Qi and harmonizing Jing.

The Yellow Emperor asked: How are tonification and sedation performed? The answer was: Slow insertion and slow withdrawal is called guiding Qi. Tonification and sedation without fixed form are called harmonizing Jing. This is not about excess or insufficiency, but about the counterflow of chaotic Qi. The Yellow Emperor said: Truly profound is this Dao, truly clear is this question. Please inscribe it on the Jade Tablet, naming it "Treating Chaos."

Li Dongyuan said: Treat Yang diseases by addressing Yin, and Yin diseases by addressing Yang. The *Treatise on Yin-Yang Correspondences* states: Examine Yin and Yang to distinguish soft and hard; treat Yang diseases by addressing Yin, and Yin diseases by addressing Yang. Stabilize the blood vessels, each remaining in its domain. For excess blood, lancing is appropriate; for Qi deficiency, guiding and leading (Daoyin) is appropriate. "Yin disease in Yang" refers to external Wind-Cold pathogens entering from outside and invading the Back-Shu points of Fu and Zang organs. Humans contracting external pathogens have two scenarios. Pathogens entering Yang flow into the meridians; such diseases start with external Cold and end with external Heat. Thus, treating Wind-Cold pathogens involves treating the Shu points of respective Zang organs, not just Wind-Cold itself. The Six Evils (Wind, Cold, Summerheat, Dampness, Dryness, Fire) are received by the Five Zang, affecting sinews, bones, blood, and vessels, each having corresponding Back-Zang Shu points on the back to eliminate them. Regarding Cold Damage, one school follows Zhang Zhongjing; regarding contraction of the Eight Winds, there is a discussion on Wind. For Summerheat, treat Xiaochangshu (BL28) on the back; for Dampness, treat Weishu (BL21); for Dryness, treat Dachangshu (BL25). These are all excess conditions caused by external Six Evils, treated by draining the Back-Fu Shu points. If the disease persists and transforms, becoming either deficient or excess, treatment varies according to transformation, focusing only on the Back-Fu Shu points.

There is also Upper Heat and Lower Cold. The classic states: For Yin disease in Yang, one should draw from Yang to guide Yin, first removing blood from the collaterals and channels. If Fire within Yin is excessive and rises to Heaven, causing the Six Yang to remain full and ascend, first remove blood from the collaterals of the Five Zang, guiding it downward. When Heavenly Qi descends, the Lower Cold condition naturally resolves. Do not solely drain the Six Yang meridians. This condition features Yang hyperactivity fueled by Yin Fire pathogens; only remove Yin Fire and the pathogens in the collaterals/channels. Do not err. "Yang disease in Yin" means drawing from Yin to guide Yang; this involves Cold and Heat from food and drink harming the Six Fu organs. Furthermore, irregular diet and physical exertion allow Yin Fire to invade Kun Earth (Spleen/Stomach), preventing Grain Qi, Ying Qi, Clear Qi, Stomach Qi, and Yuan Qi from ascending to nourish the Yang Qi of the Six Fu organs. This results in the prior exhaustion of the Five Yang Qi externally. The exterior corresponds to Heaven; sinking into Kun Earth Yin Fire, these conditions originate from emotional injuries (Joy, Anger, Sorrow, Worry, Fear) damaging the Five Zang, followed by Stomach Qi stagnation due to exertion and dietary irregularities, injuring Yuan Qi. One should select Zusanli (ST36), the He-Sea point of the Stomach, to push and elevate, extending Yuan Qi; hence, "drawing from Yin to guide Yang." If Yuan Qi is severely deficient, treat the Mu-alarm points of the Fu organs on the abdomen. If transmission reaches the Five Zang, causing obstruction of the Nine Orifices, treat the abdominal Mu-alarm points of the respective Zang organs based on the specific orifice pathology. Hence, "Five Zang imbalance arises from the blockage of Yuan Qi in the Six Fu organs." It is also stated: "Five Zang disharmony and obstruction of the Nine Orifices result from Yang insufficiency and Yin excess," meaning Yang cannot overcome Yin. All treatments of abdominal Mu-alarm points address Yuan Qi insufficiency by drawing from Yin to guide Yang; do not err. Incorrectly tonifying Shu points at the four extremities, or incorrectly sedating Ying-Spring points at the four extremities, especially incorrect sedation, leads to severe errors. According to Qibo, one should only select points on "Heaven" (the back). "Heaven" refers to the Back-Shu points of the Five Zang and Six Fu organs. To sedate where sedation is inappropriate—how could life be preserved? Reflecting on this chills the bone. For Six Evil pathogens, Upper Heat/Lower Cold, and diseases of sinews, bones, skin, flesh, blood, and vessels, erroneously selecting the He-Sea point of the Stomach or abdominal Mu-alarm points will surely endanger life. As Qibo said, how can inferior practitioners fail to be cautious!

Li Dongyuan said: Regarding the decline and flourishing of Sanjiao (Triple Burner) Yuan Qi. The *Huangdi Zhenjing* states: Insufficiency of Upper Qi causes brain fullness to decrease, bitter ringing in the ears, tilting of the head, and dimming of vision. Insufficiency of Middle Qi causes changes in urination and defecation, and painful constipation in the intestines. Insufficiency of Lower Qi leads to flaccidity, cold limbs, and mental oppression; tonify Kunlun (BL60) below the outer ankle...

Li Dongyuan said: A wealthy man suffered from foul odor in the anterior yin region and abdominal discomfort due to consecutive days of drinking alcohol, seeking treatment from his master. The master said: The anterior yin is the pathway of the Foot Jueyin Liver Meridian, circulating through the genitalia and emerging at the penis. Odors are governed by the Heart; dispersed into the five directions, they become the five odors. Entering the Liver, it becomes fishy/sour (Sao). This is one aspect. One should sedate Xingjian (LR2) on the Liver Meridian to treat the root; subsequently, sedate Shaochong (HT9) on the Heart Meridian to treat the branch.