Library

Individuals with strong bones, weak sinews, loose muscles, and thick skin can tolerate pain; the same applies to the pain from acupuncture and moxibustion. Those with a dark complexion and well-formed bones can tolerate fire therapy (moxibustion). Those with firm muscles and thin skin cannot tolerate the pain of needles and stones (acupuncture), nor can they tolerate fire therapy.

The Yellow Emperor said: I have heard that there are five adverse conditions in acupuncture, where the disease contradicts the pulse. In heat diseases, if the pulse is quiet, this is the first adverse condition. If the pulse becomes rapid and restless after sweating, this is the second adverse condition. In diarrhea, if the pulse is surging and large, this is the third adverse condition. If spleen pathology causes immobility, muscle wasting, body heat, and an absent pulse on one side, this is the fourth adverse condition. If excessive sexual activity leads to emaciation, body heat, pale and lifeless complexion, followed by bloody stool that is heavy and difficult to pass, this is the fifth adverse condition. If alternating chills and fever lead to emaciation and a firm, bounding pulse, this is also an adverse condition.

The first puncture expels pathogenic factors from the Yang aspect; the second puncture expels pathogenic factors from the Yin aspect; the third puncture brings about the arrival of Gu Qi (Grain Qi/Healthy Qi). Stop needling when Gu Qi arrives. The arrival of Gu Qi means that after tonification, the healthy Qi is solidified, and after sedation, the pathogenic factor is depleted; thus, it is known that Gu Qi has arrived.

In Liver Heat Disease, urination turns yellow first, accompanied by abdominal pain, lethargy, and body heat. When heat struggles with healthy Qi, there may be delirium and fright, distension and pain in the hypochondrium, restlessness of the hands and feet, and inability to lie down peacefully. Symptoms worsen on Geng-Xin days, and profuse sweating on Jia-Yi days indicates recovery. If Qi rebels, death occurs on Geng-Xin days. Treatment involves puncturing the Foot-Jueyin (Liver) and Foot-Shaoyang (Gallbladder) meridians. If the rebellion ascends, it causes dizzy headaches due to pulse qi rushing to the head.

In Heart Heat Disease, there is initial dissatisfaction, followed by fever after several days. When heat struggles with healthy Qi, sudden heart pain, irritability, frequent vomiting, headache, red face, and absence of sweat occur. Symptoms worsen on Ren-Gui days, and profuse sweating on Bing-Ding days indicates recovery. If Qi rebels, death occurs on Ren-Gui days. Treatment involves puncturing the Hand-Shaoyin (Heart) and Hand-Taiyang (Small Intestine) meridians.

In Spleen Heat Disease, there is initial heaviness of the head, cheek pain, mental distress, bluish complexion, desire to vomit, and body heat. When heat struggles with healthy Qi, severe lower back pain preventing flexion and extension, abdominal fullness, diarrhea, and pain in both mandibles occur. Symptoms worsen on Jia-Yi days, and profuse sweating on Wu-Ji days indicates recovery. If Qi rebels, death occurs on Jia-Yi days. Treatment involves puncturing the Foot-Taiyin (Spleen) and Foot-Yangming (Stomach) meridians.

In Lung Heat Disease, there is initial aversion to wind, bristling of hair, fear of cold and wind, yellow tongue coating, and body heat. When heat struggles with healthy Qi, wheezing and coughing, pain radiating to the chest, epigastrium, and back, difficulty taking deep breaths, unbearable headache, and sweating followed by chills occur. Symptoms worsen on Bing-Ding days, and profuse sweating on Wu-Ji days indicates recovery. If Qi rebels, death occurs on Jia-Ding days. Treatment involves puncturing the Hand-Taiyin (Lung) and Hand-Yangming (Large Intestine) meridians and releasing blood (like the size of a soybean) for immediate relief.

In Kidney Heat Disease, there is initial lower back pain and soreness, bitter thirst with frequent drinking, and body heat. When heat struggles with healthy Qi, stiff and painful neck, chills with soreness, heat in the soles of the feet, and reluctance to speak occur. If the rebellion ascends, it causes dizzy neck pain and palpitations. Symptoms worsen on Wu-Ji days, and profuse sweating on Ren-Gui days indicates recovery. If Qi rebels, death occurs on Wu-Ji days. Treatment involves puncturing the Foot-Shaoyin (Kidney) and Foot-Taiyang (Bladder) meridians. For all cases requiring sweating, sweating will occur profusely on the day corresponding to the element that overcomes the diseased organ.

In Liver Heat Disease, redness appears first on the left cheek; in Heart Heat Disease, on the forehead; in Spleen Heat Disease, on the nose tip; in Lung Heat Disease, on the right cheek; in Kidney Heat Disease, on the chin. Even if the disease has not fully manifested, puncturing these areas upon seeing redness is called "treating the disease before it arises." Heat diseases originating from specific regions resolve by their designated time. If treated incorrectly, resolution takes three cycles; repeated mismanagement leads to death. All cases requiring sweating will exhibit profuse sweating on the overcoming day.

All treatments for heat diseases involve giving the patient cold water to drink, followed by needling. The patient must wear cool clothing and reside in a cool place until the body temperature cools.

For heat diseases starting with chest/hypochondriac pain and hand/foot restlessness, puncture the Foot-Shaoyang (Gallbladder) meridian and tonify the Foot-Taiyin (Spleen) meridian. Severe cases require the 59-point method. For heat diseases starting with arm pain, puncture the Hand-Yangming (Large Intestine) and Hand-Taiyin (Lung) meridians until sweat appears. For heat diseases starting with head symptoms, puncture the Neck Taiyang (Bladder) meridian until sweat appears. For heat diseases starting with leg/calf symptoms, puncture the Foot-Yangming (Stomach) meridian until sweat appears. For heat diseases starting with body heaviness, bone pain, deafness, and preference for silence, puncture the Foot-Shaoyin (Kidney) meridian; severe cases require the 59-point method. For heat diseases starting with dizziness, vertigo, and fever with chest/hypochondriac fullness, puncture the Foot-Shaoyin (Kidney) and Foot-Shaoyang (Gallbladder) meridians.

If the Taiyang pulse color manifests on the zygomatic bone, it indicates heat disease. If Ying Qi (Nutritive Qi) has not yet intersected, sweating will occur today, and waiting for the appropriate time leads to recovery. If it competes with the Jueyin pulse signs, death will occur within three days. If heat disease internally connects to the Kidney and shows Shaoyang pulse colors, or if Shaoyang pulse colors appear on the front of the cheeks indicating heat disease, and Ying Qi has not yet intersected, sweating will occur today, and waiting leads to recovery. If it competes with the Shaoyin pulse signs, death will occur within three days.

Acupoints for treating heat diseases: The space below the 3rd thoracic vertebra governs chest heat; below the 4th, diaphragmatic heat; below the 5th, liver heat; below the 6th, spleen heat; below the 7th, kidney heat. Ying Qi flows here. The depression at the 3rd cervical vertebra in the neck is a key point. Below the chin against the zygoma indicates Da Jia (large accumulation); down to the jaw indicates abdominal fullness; behind the zygoma indicates hypochondriac pain; above the cheek corresponds to the area above the diaphragm. Five rows of five points on the head are used to vent rebellious heat from all Yang meridians. Dazhu, Yingchu, Shufu, Quepen, and Back-Shu points (eight points) vent chest heat. Qichong, Zusanli, Shangjuxu, and Xiajuxu (eight points) vent stomach heat. Yunmen, Kugu, Weizhong, and Suikong (eight points) vent limb heat. The five points beside each of the Five Zang Back-Shu points (ten points total) vent heat from the Five Zang and Six Fu organs.

There are nine types of heat disease that should not be needled:
1. No sweat, red zygomatic bones, and hiccups indicate death.
2. Diarrhea with abdominal fullness, especially if severe, indicates death.
3. Clouded vision with persistent heat indicates death.
4. Infantile heat with abdominal fullness indicates death.
5. No sweat with vomiting or bleeding indicates death.
6. Ulcerated tongue base with persistent heat indicates death.
7. Coughing with epistaxis, no sweat, or sweat failing to reach the feet indicates death.
8. Marrow heat indicates death.
9. Heat with spasms indicates death. Symptoms include opisthotonos, convulsions, clenched teeth, and retracted gums. None of these nine conditions should be needled.