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Yellow Emperor asked: Heat diseases all belong to the category of cold damage. Some recover, some die; those who die do so within six or seven days, and those who recover do so after ten or more days. What is the reason for this? Qibo replied: The Taiyang (Greater Yang) channel is the leader of all Yang channels. Its vessels connect to the Fengfu (GV16) acupoint, thus it governs the Qi of all Yang channels. When humans are injured by cold pathogens, they develop heat diseases. Even if the heat is severe, death will not occur; however, if two channels are simultaneously affected by cold (Lianggan), death is inevitable. On the first day of cold damage, the Taiyang channel is affected. Thus, headache, neck stiffness, and back/spine rigidity occur. (The character "back" is absent in *Suwen*.) On the second day, the Yangming (Bright Yang) channel is affected. Yangming governs the flesh; its vessels run alongside the nose and connect to the eyes, causing chest/hypochondriac pain and deafness. If the three Yang channels (*Suwen* adds "vessels and channels" after "three Yang") are diseased but have not yet entered the Fu organs (*Suwen* reads Zang organs), they can be cured by sweating. On the fourth day, the Taiyin (Greater Yin) channel is affected. The Taiyin vessels distribute in the stomach and connect to the throat, causing abdominal fullness and dry throat. On the fifth day, the Shaoyin (Lesser Yin) channel is affected; its vessels pass through the Kidney, connect to the Lung, and tie to the root of the tongue, causing dry mouth, dry tongue, and thirst. On the sixth day, the Jueyin (Terminal Yin) channel is affected; its vessels circulate around the genitalia and connect to the Liver, causing irritability, abdominal fullness, and retraction of the scrotum. If the three Yin and three Yang channels, as well as the five Zang and six Fu organs, are all diseased, with Ying and Wei Qi failing to circulate and the five Zang organs blocked, death ensues. In cases not involving simultaneous infection of two channels, on the seventh day, the Taiyang disease declines, and headache lessens. On the eighth day, Yangming disease declines, and body heat subsides slightly. On the ninth day, Shaoyang disease declines, and hearing improves slightly. On the tenth day, Taiyin disease declines, abdominal distension resolves, appetite returns. On the eleventh day, Shaoyin disease declines, thirst stops (*Suwen* adds "no feeling of fullness" after "thirst stops"), and tongue dryness ceases. On the twelve days, Jueyin disease declines, the scrotum relaxes, lower abdominal tension subsides, and the pathogenic Qi descends, leading to daily recovery. Treatment involves unblocking the respective organ vessels, allowing the disease to decline daily. For diseases lasting less than three days, sweating can cure them; for those lasting three days or more, purging/draining can cure them. Question: Why does residual heat sometimes remain after a heat disease has healed? Answer: Residual heat occurs when food is consumed forcibly while heat is intense. In such cases, although the pathogen has declined, heat remains hidden. The Qi from food grains struggles against this residual heat, combining to form lingering heat. Treatment requires assessing deficiency and excess, regulating reversal and smoothness, which can lead to immediate recovery. Eating meat when heat is slightly better causes recurrence; overeating causes residual heat. These are contraindications. In cases of simultaneous infection of two channels: On the first day, Taiyang and Shaoyin are both diseased, causing headache, dry mouth, and irritability/fullness. On the second day, Yangming and Taiyin are both diseased, causing abdominal fullness, body heat, anorexia, and delirium. On the third day, Shaoyang and Jueyin are both diseased, causing deafness, scrotal retraction, and cold limbs. If water and grain cannot enter and consciousness is lost, death occurs within six days.

Question: If the five Zang organs are damaged, the six Fu organs are blocked, and Ying and Wei Qi do not circulate, why does death occur three days later? Answer: Yangming is the head of the twelve regular channels, possessing abundant Blood and Qi. Loss of consciousness persists until its Qi is exhausted after three days, leading to death.

In Liver Heat Disease, urine turns yellow first, accompanied by abdominal pain, excessive lying down, and body heat. When heat contends with healthy Qi, there is maniacal speech and惊骇 (fright). Chest and hypochondriac fullness/pain, restlessness of hands and feet, and inability to lie peacefully occur. Condition worsens on Geng/Xin days; profuse sweating on Jia/Yi days indicates recovery. If Qi rebels, death occurs on Geng/Xin days. Treat by needling Foot Jueyin (Liver) and Foot Shaoyang (Gallbladder). If Qi rebels, severe headache occurs (*Suwen* reads "Yuan"), caused by vessel Qi rushing upward.

In Heart Heat Disease, unhappiness precedes fever by several days. When heat contends, there is heart vexation, oppression, frequent vomiting, headache, red face, and absence of sweat. Condition worsens on Ren/Gui days; profuse sweating on Bing/Ding days indicates recovery. If Qi rebels, death occurs on Ren/Gui days. Treat by needling Hand Shaoyin (Heart) and Hand Taiyang (Small Intestine).

In Spleen Heat Disease, heavy head and cheek pain precede, followed by heart vexation (*Suwen* adds "greenish face" after "heart vexation"), desire to vomit, and body heat. When heat contends, lower back pain prevents bending/straightening, abdominal fullness with diarrhea, and bilateral mandible (*one version reads forehead*) pain occur. Condition worsens on Jia/Yi days; profuse sweating on Wu/Ji days indicates recovery. If Qi rebels, death occurs on Jia/Yi days. Treat by needling Foot Taiyin (Spleen) and Foot Yangming (Stomach).

In Lung Heat Disease, initial chilliness, hair standing on end, aversion to wind/cold, yellow tongue coating, and body heat occur. When heat contends, panting and coughing occur, pain radiates to chest/epigastrium/back, difficulty taking deep breaths, mild headache (*Suwen* reads "Kan"), sweating with chills. Condition worsens on Bing/Ding days; profuse sweating on Geng/Xin days indicates recovery. If Qi rebels, death occurs on Bing/Ding days. Treat by needling Hand Taiyin (Lung) and Hand Yangming (Large Intestine); bleed until blood droplets appear for immediate recovery.

In Kidney Heat Disease, initial lower back soreness/aching, bitter thirst with frequent drinking, and body heat occur. When heat contends, neck pain and stiffness, aversion to cold with soreness, hot soles, and reluctance to speak occur. If Qi rebels, dizzy neck pain occurs (*Suwen* adds "Dan Dan" after "Yuan Ran"). Condition worsens on Wu/Ji days; profuse sweating on Ren/Gui days indicates recovery. If Qi rebels, death occurs on Wu/Ji days. Treat by needling Foot Shaoyin (Kidney) and Foot Taiyang (Bladder). For heat diseases requiring sweating, sweating is most pronounced on their controlling days.

In Liver Heat Disease, the left cheek reddens first. In Heart Heat Disease, the chin/face reddens first. In Spleen Heat Disease, the nose reddens first. In Lung Heat Disease, the right cheek reddens first. In Kidney Heat Disease, the jaw/chin reddens first. If color changes appear before disease onset, needle them; this is called "treating undiseased." Heat diseases arising from specific facial regions resolve by their designated time; contrary needling extends recovery to three cycles; repeated contrary treatment leads to death. All heat disease treatments involve drinking cold water first, then needling, wearing cool clothes, staying in cool places, until the body cools. Severe cases use the 59-needle method. For heat disease with initial chest/hypochondriac pain/fullness and hand/foot restlessness, needle Foot Shaoyang, tonify Foot Taiyin; severe cases use 59 needles. For heat disease with initial heaviness, bone pain, deafness, and desire to close eyes, needle Foot Shaoyin; severe cases use 59 needles. For heat disease with initial dizziness/fainting and fever, chest/hypochondriac fullness, needle Foot Shaoyin and Foot Shaoyang. Sun channel color reflecting on cheekbones indicates heat disease. If color is not yet perished (*Suwen* reads "not intersected"), saying "if sweat is obtained now, it will heal with time." If appearing simultaneously with Jueyin channel, death occurs within three days, as heat Qi connects internally to the Kidney. Shaoyang channel color reflecting on the front of the cheek indicates heat disease. If color is not yet perished, saying "if sweat is obtained now, it will heal with time." If appearing simultaneously with Hand Shaoyin channel, death occurs within three days. Heat disease acupoints: space below the 3rd thoracic vertebra governs chest heat; below 4th governs stomach heat; below 5th governs liver heat; below 6th governs spleen heat; below 7th governs kidney heat. Color reflects on the cheekbone area. The depression below the 3rd cervical vertebra in the neck is the reference point. Large masses under the jaw opposite the cheekbone; abdominal fullness below the dental arcade; hypochondriac pain behind the cheekbone. Upper cheek corresponds to above the diaphragm.

Cold injury in winter leads to Warm Diseases in spring. Summerheat injury in summer leads to Malaria in autumn.

All cold damage transforming into warmth: those occurring before the Summer Solstice are Warm Diseases; those after are Summerheat Diseases. Summerheat should exit with sweat; do not stop sweating. The so-called Xuanfu refers to sweat pores.

Question: The *Jingmai* chapter mentions the "Removing Clothes" technique, needling all odd acupoints of Yang channels without fixed locations. I wish to hear the details. Answer: This is excess Yang and deficient Yin. Deficient Yin causes internal heat; excess Yang causes external heat. Two heats contend, feeling hotter than holding charcoal. Clothes feel too hot to touch, bed feels too hot to lie on. Pores are closed with no sweat, tongue is scorched, lips are withered (*Huangdi Gu Zhen Jing* reads "Gao La"), throat is dry, and thirst exists. Take Tianfu (LU3) and Dazhu (BL11) three times each; needle Zhonglshu (BL44) to remove heat; tonify Hand/Foot Taiyin to induce sweat. Heat removal and sweating occur faster than removing clothes.

*Nan Jing* Chapter 81 states: Yang deficiency and Yin excess, sweating cures, purging kills; Yang excess and Yin deficiency, sweating kills, purging cures. (This contradicts the classic text and reverses the logic; it should not be used.)

Question: Why do some people have hot limbs that feel like moxibustion or fire when exposed to wind/cold? Answer: This person has deficient Yin and excess Yang. Hot limbs indicate Yang. Two Yangs combine, while Yin is scanty; little water cannot extinguish strong fire, leaving Yang to dominate alone. Dominant Yang cannot grow/nourish, only stagnate. Thus, exposure to wind/cold feels like burning, leading to muscle wasting.

Question: Why does the body feel neither constantly warm nor constantly hot, yet present with vexation and fullness? Answer: Scanty Yin and victorious Yang cause heat, vexation, and fullness.

Question: Foot Taiyin (Spleen) and Foot Yangming (Stomach) are exterior-interior pairs and both relate to the Spleen/Stomach meridians. Why do their diseases differ? Answer: Yin and Yang occupy different positions, alternating between excess and deficiency, reversal and smoothness. Some originate internally, some externally. Different origins yield different disease names. Yang represents Heaven Qi, governing the exterior; Yin represents Earth Qi, governing the interior. Yang pathways are solid/excess; Yin pathways are hollow/deficient. Thus, invading wind-pathogens affect Yang first, entering Fu organs; irregular diet/lifestyle affects Yin first, entering Zang organs. Entering six Fu organs causes body heat, insomnia, and upper respiratory distress/wheezing; entering five Zang organs causes abdominal fullness/blockage and lower diarrhea (undigested food), progressing to intestinal dysentery over time. The throat governs Heaven Qi; the pharynx governs Earth Qi. Thus, Yang channels receive Wind pathogens; Yin channels receive Damp pathogens. Yin Qi ascends from the foot to the head, then descends along the arm to the fingertips. Yang Qi ascends from the hand to the head, then descends to the foot. Therefore, Yang diseases ascend to the extreme then descend; Yin diseases descend to the extreme then ascend. Thus, Wind injury affects the upper part first; Damp injury affects the lower part first.