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Huangdi asked, saying: When the Foot-Yangming meridian is diseased, the patient dislikes people and fire, startles at the sound of wood, desires to close doors and windows alone to stay indoors. I wish to hear the reason for this.

Qibo replied: The Yangming is the stomach meridian; the stomach belongs to Earth. The reason for startling at the sound of wood is that Earth fears Wood (in the Five Elements theory, Wood overcomes Earth). Yangming governs the muscles; its blood and qi are abundant. When pathogenic factors invade, heat arises; when heat is severe, the patient dislikes fire. If Yangming qi rebels, it causes panting and chest oppression; oppression leads to disliking people. When Yin and Yang contend, Yang is exhausted and Yin becomes excessive, thus the desire to close doors and windows and stay alone. (Note: This description of Yin and Yang contention originates from the "Mai Jie" chapter of *Su Wen*, moved here by Wang Shuhe.)

Huangdi asked: Some survive with panting, while some die with panting. Why?

Qibo answered: If the rebellion connects to the Zang organs, death ensues; if it connects only to the meridians, survival is possible.

Huangdi asked: In severe cases, patients discard clothes and run, climb high places and sing, or go several days without eating, crossing walls and roofs. These actions are beyond their usual capabilities, yet they can perform them when ill. What is the reason?

Qibo answered: This is because Yin and Yang contend, and Yang expands outwardly into the Yang aspect (These eight characters also appear in the "Mai Jie" chapter of *Su Wen*). When pathogens are excessive, the four limbs become solid and strong, enabling climbing and singing. Heat is rampant in the body, hence discarding clothes and running. Yang is excessive, leading to delirious speech and cursing regardless of kinship. Severe heat pervades the body, causing manic talk, hallucinations, and auditory/visual disturbances. Treatment involves examining the Foot-Yangming meridian and its large collaterals for acupuncture. Deficiency patterns are supplemented; excess patterns are drained.

The patient should be made to lie supine. With hands placed before the head, use four fingers of both hands to press the carotid artery for a prolonged period. Then, curl the fingers and push downwards and cutively until the Quepen area (ST12), then move upwards as before. Continue until the heat dissipates. This is referred to as "pushing and dispersing."

For body heat, manic running, delirium, and seeing ghosts, Shenzhu (DU12) is indicated.

For mania, delirious speech, irritability, aversion to fire, and frequent cursing, Juque (CV14) is indicated.

For febrile diseases with no sweat, epistaxis, dizziness, frequent collapse with edema, cold calves, inability to sleep, chills, aversion to people and wooden sounds, throat obstruction, toothache, aversion to wind, nasal congestion, and frequent fright, Lidui (ST45) is indicated.

For coldness and oppression of the hands and feet, maintain pressure on the acupoint for a long time. For rebellious heat (another version reads coldness), calf pain, abdominal distension, skin pain, frequent stretching and yawning, aversion to people and wooden sounds, chills, pain radiating from the throat externally, febrile disease with no sweat, lower toothache, aversion to cold with acute eyes, panting with chest fullness and chills, lockjaw with facial deviation, and loss of appetite, Neiting (ST44) is indicated.

For manic singing, delirious speech, anger, aversion to people and fire, and cursing, Zusanli (ST36) is indicated.