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In ancient times, moxa cones were large, so a washing method was used. The method involves decocting red-skin scallions and mint in water, and using the warm solution to wash around the moxibustion sore for about one shi (two hours). This aims to expel wind pathogens from the sore and ensure the smooth flow of qi and blood in the meridians, leading to natural recovery. After the moxibustion fire subsides and the scab falls off, washing with a decoction of tender bark from peach branches grown in the southeast can protect the sore from wind pathogens; if the sore turns black and ulcerates, adding coriander (Hu Su) to the decoction is effective; if the pain is unbearable, adding Coptis Rhizome (Huang Lian) to the decoction yields miraculous results.

After moxibustion, one should not drink tea immediately, as it may dissipate the warming qi of the moxa; nor should one eat immediately, as it may obstruct the flow of meridian qi. One should rest for one or two shi, then enter a room to lie quietly, distancing oneself from worldly affairs and sexual desires, maintaining a calm mind and steady breath, and keeping all matters relaxed. It is especially taboo to be extremely angry, overexerted, starving, overly full, overheated, or chilled. Raw and cold fruits and vegetables should also be avoided. Diet should consist of bland, stomach-nourishing foods to promote the free flow of qi and blood, allowing the heat of the moxa to drive out pathogenic qi. Consuming overly strong, pungent, or toxic foods, or indulging in alcohol, can generate phlegm and turbidity, blocking pathogenic qi. Fresh fish, chicken, and mutton, although they can stimulate fire, are only suitable for use during initial moxibustion treatments; they should not be consumed after half a month. Nowadays, most people do not know how to cultivate tranquility, so what benefit is there in moxibustion? Thus, some suffer harm due to moxibustion, which is the reason why some merely blame the ineffectiveness of moxa. Why is this?

(Master Yang's Cases)
In the year Yimao, I arrived at Tengkeshan in Jianning. A mother suffered from an inability to raise her arm, aversion to cold in the back, and bodily fatigue. Even in midsummer, she preferred wearing cotton-padded jackets. Various physicians treated her as a deficiency-cold syndrome. Upon palpating her pulse, which was deep and slippery, I diagnosed Phlegm-Dampness obstructing the meridians. I needled Feishu (BL13), Quchi (LI11), and Zusanli (ST36). On that day, she felt lighter, could raise her arm, no longer feared cold, and stopped wearing the jacket. Later, I prescribed herbs to resolve dampness and transform phlegm. She has remained healthy since, with no recurrence of diseases. If treated as deficiency-cold, tonification would only cause more phlegm condensation. How important caution is!

In the spring of the year Wuwu, Lu Xiaoshan, an official at the Court of State Ceremonial, had a tubercle in his arm, the size of a persimmon, neither red nor painful. Physicians claimed it was a swelling toxin. I said: "This is a Phlegm-Nodule condensed outside the fascia between skin and muscle, not curable by herbs alone." I then needled Quchi (LI11) on the hand, applying the Six Yin number technique (reduction), and moxibusted fourteen cones to unblock meridian qi. Within a few days, it flattened and healed. If treated as a swelling toxin using formulas to support the interior and expel pus, wouldn't this damage the pure qi of the spleen and stomach?

In the summer of the year Jisi, the wife of Li Jian'an, a selection official, suffered from postpartum Blood-Jue syndrome. Her legs suddenly swelled to the size of her thighs, a critical condition. Colleagues Xu and He invited me to treat her. Her pulse was hollow (Kou) with interruptions. This indicated incomplete expulsion of lochia postpartum, compounded by wind-pathogen invasion. The conflict between yin-yang pathogens and righteous qi caused Jue, unconsciousness, and lower body swelling/pain. Although critical, needling the Three Yin meridians of the foot would ensure safety. As predicted, she revived within the time it takes to eat a meal, and the swelling and pain vanished instantly.

In the autumn of the Guiyou year, Elder Li Yihe, Minister of Justice, suffered from bilateral leg pain for over ten years, unresponsive to various medicines. The Chancellor recommended me. His pulse was slippery and floating, indicating Wind-Dampness invading the sinews and bones. Medicine alone cannot cure this; needling is required. I needled Fengshi (GB31) and Yinshi (ST32). (Note: Text implies successful treatment leading to his promotion to Minister of Works.)

In the summer of the Jiawu year, Xiong Keshan, Vice Director, suffered from dysentery accompanied by continuous hematemesis, fever, cough, and severe pain from a mass around the navel, with a critical pulse nearing extinction. Physicians declared it incurable. Wei Yuetan, a Director in the Ministry of Works and my friend, summoned me. Although the pulse was critical, his chest was still warm. There was a mass around the navel raised like a fist. Since needling was contraindicated that day, I urgently needled Qihai (CV6) and moxibusted fifty cones. He revived, the mass dissipated, and pain ceased. Subsequently, treating the dysentery cured it; treating the cough and hematemesis through sequential regulation led to recovery. When he asked about the rationale later, I explained: "Disease has root and branch; treatment has urgency and slackness. If we adhere strictly to taboos and did not needle Qihai, how would the mass disperse? Once dispersed, qi flows freely, pain stops, and pulse recovers. This is the meaning of 'treat the branch in emergencies.' Although your body recovered, avoid anger after meals to preserve the root; otherwise, righteous qi will be disrupted, liver qi will flourish, and spleen earth will be overcome, leading to relapse."

In the summer of the Xinwei year, Wang Nianyi of the Ministry of Justice suffered from a throat disorder, feeling a lump moving up and down. This disease lies in the lung and diaphragm, uncurable by herbs alone. Xu Donggao recommended me to needle. I selected Danzhong (CV17) and Qihai (CV6), plus Zusanli (ST36) below, and moxibusted dozens of cones, slowly regulating until recovery. Donggao was a renowned physician with high talent and broad knowledge. Just as Li Dongyuan treated women with Cold Damage where heat entered the Blood Chamber, requiring needling to heal, specifically needling Qimen (LR14), Donggao's intent mirrors Dongyuan's. Their virtues are comparable. Contrast this with today's jealous individuals. However, jealousy is not new. I once visited Ci Zhou, passing Fudao in Tangyin, where the tomb of Master Bian Que lies. I dismounted and bowed. Asked why, I was told: "Bian Que was from Hejian. His acupuncture skills were unparalleled. He was assassinated by Li Xi, the Medical Commissioner of Qin, beside the road, hence the name Fudao (Hidden Road). It is truly lamentable, recorded in history."

In the Wuchen year, the son of Yang Houshan, a Censor, suffered from Gan disease (childhood malnutrition/parasitism). Despite daily medication, he grew thinner. Zheng Xiangxi invited me. I said: "The child is emaciated. Although it is Gan disease, there is an accumulation mass in the abdomen attached to the spleen and stomach. Treating only the Gan disease without addressing the mass is seeking the tip but ignoring the root. We must first needle and moxa Zhangmen (LR13) to dissipate the mass, then sequentially regulate the spleen and stomach. This is like removing villains so the gentleman may govern." Following this, needling the mass, moxa Zhangmen, and using Toad Pill (Chanshu Wan) resulted in gradual strengthening and complete recovery.

In the Renshen year, the eldest grandson of Chancellor Chen of Sichuan had a protrusion on his chest, an unusual ailment. People said medicine couldn't cure it. Qian Chengweng recommended me. I said: "This is Phlegm condensed in the Lung Meridian, unable to disperse. Over time it rises higher. We must early needle Shufu (BL10) and Danzhong (CV17). Then select a day to needle, apply the Six Yin number, and moxa five cones, followed by plaster application. Phlegm will exit and flatten." The father, a Compiler, was very pleased.

In the Xinwei year, the second wife of Wang Huiquan, Military Selection Official, suffered a critical, strange illness. She hadn't eaten for half a month and kept her eyes closed for a long time. The six pulses were faint, almost non-existent. This illness requires needling to revive. Colleagues urged immediate needling but worried about offending spiritual taboos. Waiting for an auspicious day might lead to death. Reluctantly, I needled Neiguan (PC6) bilaterally. Her eyes opened immediately, and she could consume rice water. Slowly regulated with milk, she recovered. Colleagues asked the diagnosis. I explained: "Heaven and Earth Qi are stable in normalcy and diseased in change. Humans inherit this Qi. Five Movements invade externally; Seven Emotions battle internally. Sages cherish Qi like treasure; fools waste it, harming Taihe Qi. Hence Huangdi and Qibo stated all pains arise from Qi, and hundred diseases arise from Qi, leading to discussions on nine orifices. Zhang Hezi also detailed this. Qi is one, but manifests as nine due to triggers: Anger, Joy, Sorrow, Fear, Cold, Heat, Startle, Thought, Labor. Severe Anger causes Qi to rise, leading to hematemesis and undigested diarrhea (Sunxie). Joy harmonizes Qi, spreads will, and balances Ying-Wei, slowing Qi. Sorrow tightens the Heart Tie, lifts Lung leaves, blocks Upper Jiao, prevents Ying-Wei dispersion, traps heat, and consumes Qi. Fear gathers spirit, closes Upper Jiao, causes Qi reversal and Lower Jiao distension, stopping Qi flow. Cold closes pores, stops Qi, contracting Qi. Heat opens pores, allows Ying-Wei flow, causes profuse sweating, leaking Qi. Startle leaves heart unsupported, spirit unanchored, thoughts unsettled, chaotic Qi. Labor causes panting and sweating, internal and external leakage, depleting Qi. Thought fixes mind and spirit, stagnating Zheng Qi, causing Qi knotting."

"I further examined the pathological changes. Anger causes: hematemesis, Sunxie, Jian Jue, Bo Jue, Yang Jue, chest fullness/pain, food regurgitation, panting/thirst/irritability, Fei Qi (mass under left hypochondrium), sudden blindness/deafness, flaccid sinews, and external carbuncles. Joy causes: incessant laughter, dry hair, flesh disorders, unrestrained Yang Qi, and mania. Sorrow causes: Yin retraction, sinew spasm, muscle Bi, vessel flaccidity, male seminal weakness, female metrorrhagia, sour nose/acrid cheeks, blurred vision, shortness of breath, weeping, arm numbness. Fear causes: ruptured popliteal space/muscle wasting, bone ache/flaccidity/cold limbs, sudden watery diarrhea, hot face/tight skin, impotence, jaw dropping from fear. Startle causes: tidal salivation, eye twitching, epilepsy, unconscious collapse, and chronic flaccidity/Bi. Labor causes: dysphagia, panting, hemoptysis, lumbar pain/bone flaccidity, lung rales, high bone destruction, impotence, spitting blood, closing eyes, deafness, male low sperm/female amenorrhea, severe decay. Thought causes: insomnia, lethargy, dizziness, epigastric fullness, Triple Burner blockage, throat obstruction, gallbladder heat/bitter vomiting, sinew flaccidity, white discharge, loss of appetite. Cold causes: clear/cold fluids, green-white dysentery. Heat causes: panting/vomiting acid, sudden violent diarrhea/tenesmus."

"Consulting the *Neijing*, treatments use the principle of Five Elements overcoming each other. Anger injures Liver (Wood); Qi gathers in Liver, injuring Spleen (Earth). Excess Wood harms Liver. Joy injures Heart (Fire); Qi gathers in Heart, injuring Lung (Metal). Excess Fire harms Heart. Sorrow injures Lung (Metal); Qi gathers in Lung, injuring Liver (Wood). Excess Metal harms Lung. Fear injures Kidney (Water); Qi gathers in Kidney, injuring Heart (Fire). Excess Water harms Kidney. Thought injures Spleen (Earth); Qi gathers in Spleen, injuring Kidney (Water). Excess Earth harms Spleen. Cold injures Form (Yin); Cold defeats Heat, harming Yang. Excess Cold harms Yin. Heat injures Qi (Yang); Heat defeats Cold, harming Yin. Excess Heat harms Yang. These counteract each other: Sorrow treats Anger (using sad words); Joy treats Sorrow (using playful words); Fear treats Joy (using threats of death); Anger treats Thought (using insulting words); Thought treats Fear (using distracting worries). These methods require cunning to alter perception. Those without talent cannot use them. Heat treats Cold; Cold treats Heat; Rest treats Labor; Habituation treats Startle. *Jing* says: 'Startle is treated by leveling.' Startle comes from suddenness; habituation removes fear. Danyu treated a woman whose husband traveled for three years; she stopped eating, lay facing the bed, suffering from Thought-knotting. Medicine failed; Joy resolved it. Provoking anger broke the knot (Wood overcomes Earth), restoring appetite. Zhang Hezi treated a woman sleeping poorly due to thought by provoking anger; she slept soundly that night. Only Labor-depletion and Fear-exhaustion are hard to treat. Xie Gong treated a grieving widow by having relatives cheer her up and using depression-resolving herbs. Zhuang Gong treated excessive Joy-Labor causing aphonia by inducing fear, curing it. Joyful people rarely get sick because their vessels are harmonious. *Jing* says: 'Fear overcomes Joy,' revealing the secret. These cases are in *Neijing*; why do practitioners ignore them? Note this for practice."

"In the Jisi year, the beloved son of Minister Wang Xi had swollen, painful nodules on the neck, unresponsive to medicine. I said: "Neck diseases correspond to specific Yuan, Luo, Jing, Shu, and Hui points of the meridians. Needling the Yuan point cures it." Indeed, needling cured it, followed by moxa, preventing recurrence. The neck is a place of transverse muscles and meridian convergence; nodules here are ill omens. Without investigating the root and treating with moxa/needling, spread is inevitable. Patients beware."

"In the winter of the Wuyin year, the eldest grandson of Chancellor Zhang suffered from dysentery for half a year, unresponsive to medicine. The Chancellor asked if acupuncture could help, citing his own past success with Zhongwan (CV12) and Zhangmen (LR13) for similar issues. I replied: "Long-term dysentery alters the physique. Wait for slight Qi recovery, then select a day for acupuncture." Huacen Zi insisted on immediate treatment. I needled Zhongwan and Zhangmen, and he could eat immediately."

"In the summer of Dingchou year, Madam Zhang, wife of Zhang Shaoquan of the Imperial Guard, suffered from Epilepsy for over twenty years, unresponsive to dozens of doctors. Her pulse indicated disease in the meridians, causing limb traction, visual obscurity, and convulsions/shouting when affecting the Heart. I selected Jiawei (CV15) and Zhongwan (CV12) to regulate Spleen/Stomach; Jianyu (LI15) and Quchi (LI11) to regulate meridians and disperse Phlegm-Qi, promoting circulation. She stabilized the next day, then took phlegm-resolving and spleen-tonifying herbs."

"In the Wuchen year, Li Sulu, a government observer in the Ministry of Personnel, had a痞 (Pi - stuffiness/mass) near the stomach, shaped like an inverted cup, with emaciation, unresponsive to medicine. I said: "Internal masses cannot be removed by herbs alone; acupuncture and moxibustion are needed." Using a coiled needle technique and moxa Shicang (SP15) and Zhongwan (CV12), it healed. Li asked about the difference between Pi, Pi (癖 - hidden accumulation), Ji (积 - fixed mass), Ju (聚 - mobile mass), and Jia (瘕 - shifting mass). I explained: "Pi means obstruction (like the Hexagram Pi in I Ching), internal softness/external hardness, blockage. Long-term Pi becomes distension. Pi (癖) refers to hidden, mysterious accumulations. Ji (积) is trace-like, formed by Phlegm-Blood, long-standing. Ju (聚) is thread-like, based on Yuan Qi, gathering/scattering irregularly. Lei (疰) is evidence/refinement, becoming concentrated over time. Jia (瘕) is false/provisional, borrowing Qi-Blood to form, lasting long. Generally, Pi and Pi are chest/diaphragm signs; Ji and Ju are abdominal diseases of Upper/Middle Jiao, common in men. Lei and Jia appear below the navel (Lower Jiao), common in women. Abdominal masses in both sexes are serious. Early treatment is crucial. If waiting until distension and drum-tight abdomen occurs, even Bian Que reborn cannot save. Beware!" Li agreed deeply."

"In the Wuchen year, the brother of Wang Jin'an from the Ministry of Revenue suffered from Heart-Epilepsy for years. Xu Tangweng summoned me. I applied the Eight Methods of Opening/Closing, needling Zhaohai (KI6) and Lieque (LU7), and moxa Xinshu (BL15). Waiting for Qi arrival, I applied Generation/Destruction numbers, and he recovered. Treatment requires distinguishing the Five Types of Epilepsy, detailed earlier in this volume."

"In the Renshen year, Xia Meiyuan, a County Magistrate, stayed at Emei Nunnery and contracted Cold Damage. Colleagues noted fine, weak pulses (Yin pulse in Yang disease). *Jing* states: Yin pulse in Yang channel suggests death; Yang pulse in Yin channel suggests life. Living nearby during evaluation, I felt pity for his remote lodging and frugal governance. I gave modified Chai Hu formula with slight effect, but pulse didn't match symptoms. Exhausting my thoughts, I changed herbs and needled Neiguan (PC6). Pulses turned Yang. Sequential decoctions cured him. He later promoted to Department Director."

"In the Renxu year, Xu Jing'an from the Ministry of Personnel, staying at Lingji Palace, suffered severe lower back pain. Colleague Dong Longshan recommended me. Pulse: Chi position deep, rapid, forceful. Male Chi pulse should be deep/solid, but rapid/forceful indicates Damp-Heat excess. Physicians treating it as deficiency were wrong. He feared needles, so I used finger acupressure on Shenshu (BL23) with tonification/reduction, reducing pain slightly. Given empty-stomach damp-draining/Qi-moving herbs, he settled. He asked why add draining herbs after finger therapy. I said: "Needles forcefully remove disease. Your fear necessitated finger therapy, which only temporarily reduces pain, not curing the root. For full cure, Shenshu needling is needed. Since not done, draining herbs are necessary. As ancients said: 'Waist is the mansion of Kidneys, major joint of the body.' Deep-rapid pulses indicate Damp-Heat stagnation, requiring draining, not tonifying. Moderns confuse deficiency/excess, misusing tonics, causing chronic pain. Most prefer tonifying over attacking. Removing pathogenic Damp generates new Blood; isn't attack containing tonification?"

"In the Renshen year, Yu Shaodong, a Herald, suffered from Ge Qi (Diaphragmatic Qi stagnation), emaciated, unresponsive to medicine. Pulse: deep, choppy. I selected Danzhong (CV17) to harmonize the diaphragm, and Qihai (CV6) to nourish the source, filling Yuan Qi and strengthening pulse. Selecting a day, I needled upper points (Six Yin number) and lower points (Nine Yang number), moxa seven cones each. Fully recovered. Now Prefect of Yangzhou. In Gengchen year, visiting Yangzhou, I saw his restored physique..."

"In the summer of Renshen year, Wang Shuweng, Minister of Revenue, suffered from intense Phlegm-Fire, unable to extend arms. Seeing his strong physique, I diagnosed Wet-Phlegm flowing into meridians..."