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Guiku (Ghost Cry) acupoint: Bind the two thumbs together. Place a moxa cone on the seam between them and moxibustion. Ignite the fire at the four fleshy areas behind the nail corners of both thumbs. If one area is not ignited, it will be ineffective.

According to records, Zhu Danxi treated a woman who had long-term anger and consumed alcohol. She suffered from epilepsy (seizure disorder), with eyes rolling upward, waving hands and kicking legs, tendons pulling causing throat sounds, salivation, and unconsciousness during episodes, accompanied by abdominal distension and pain. This was due to Liver Qi invading and causing pain. Alcohol's nature is active, moving up, down, in, and out; entering the interior causes pain, while exiting triggers epilepsy. Danxi used many medicines such as Bamboo Sap (Zhuli), Ginger Juice (Jiangzhi), and Ginseng-Atractylodes Paste (Shenzhu Gao). The epilepsy and pain alternated incessantly. During pain episodes, he moxibusted Dacun (LR1), Xingjian (LR2), and Zhongwan (CV12). Between episodes, he administered Stone Gypsum (Shigao) mixed with Bamboo Sap using a decoction of Tangerine Peel (Chenpi), White Peony Root (Shaoyao), Licorice Root (Gancao), and Szechuan Lovage Rhizome (Chuanxiong). After numerous treatments, he also moxibussed Taichong (LR3), Ran Gu (KI2), Juque (CV14), and the flesh around the big toenail. The patient even exhibited behavior like being possessed by ghosts, angrily scolding shamans. Danxi said, "Evil pathogens enter when deficiency exists; this may be true." He prescribed the previous medicines, assisted by Schizonepeta (Jingjie) and Bamboo Sap to prevent phlegm, and again moxibussed the Guiku acupoints. The remaining symptoms were regulated and she recovered.

The *Bencao* states: Horse bit iron is non-toxic. Rihua Zi says: Old iron ingots are good. Or they can be made into needles for medical use.

Wu's commentary: The *Bencao* mentions that soft iron (shu tie) is actually wrought iron, which is toxic. Therefore, horse bit iron is used because it is non-toxic. Since horses belong to Wu (noon) and the Fire element, and Fire overcomes Metal, it resolves the toxicity of iron. Thus, it is used to make needles. Ancient texts refer to "Gold Needles" (Jin Zhen) to indicate preciousness. Furthermore, "Metal" is a general term encompassing copper, iron, gold, and silver.

Wei Shi's book states: Aconite Root (Wutou) and Croton Seed (Badou) each 1 liang, Realgar (Liuhuang) and Ephedra Herb (Mahuang) each 5 qian, and 10 Momordica Charantia Seeds (Mubiezi). Place these herbs along with a sour plum (Wumei) into a ceramic vessel. Wash with soap pod water, then boil in dog meat for one day. Remove and polish clean with tile dust until straight. Coat with pine nut oil; keeping it close to human body heat is ideal.

Wu's commentary: Boiling needles is not the intent of the *Suwen*. However, following this method to boil needles today helps resolve iron toxicity, which is beneficial and harmless.

The Classics state: To prepare the needle, fill a cup with sesame oil. Use a rush wick as thick as a thumb. Gather the lamp flame to burn the needle. Frequently dip the needle in sesame oil while burning it until it glows red-hot. The physician uses it immediately to avoid heating their hand. As soon as the needle feels red-hot, the physician removes it. First, place the needle on the acupoint to let it cool naturally and dry, then insert it; this is also excellent. This is similar to acupuncture and moxibustion techniques. Mark the point with ink to ensure accuracy during insertion. If the acupoint is off, there will be no effect. Fire needling is difficult and requires the heart of a butcher and the decisiveness of an executioner. Press the acupoint firmly with the left hand first, then insert the needle. Avoid inserting too deeply, as this damages meridians and collaterals. Avoid inserting too shallowly, as this fails to treat the disease. Find the middle ground. Do not perform needling after heavy drunkenness; improper depth is harmful. Before fire needling, comfort the patient to prevent fright. Compared to moxibustion, moxibustion involves direct burning, causing prolonged pain. Fire needling looks intimidating but is quick; the needle is removed immediately after one insertion, so pain is short-lived. Moxibustion requires multiple cones (zhuang), causing longer pain. Fire needling involves only one insertion; repeating it causes excessive pain. After fire needling, remove the needle quickly. Immediately press the puncture site with the left hand to stop pain; otherwise, pain intensifies. Before inserting, press the acupoint to ensure it is centered. Observe carefully with your eyes before inserting. The person burning the needle must focus; looking away may result in a cold needle that fails to treat or penetrate. Needling can be performed on most parts of the body, but the face is contraindicated. In late summer, blood and qi flow heavily to the lower limbs. Be extremely cautious about using fire needling on the inner legs and feet, as it may cause ulceration, abscesses, and persistent pain. For example, Hong Kong Foot (foot odor/athlete's foot or gouty arthritis, here referring to damp-heat bi syndrome) often occurs in summer, with blood, qi, and dampness accumulating in the feet. Misusing fire needling worsens swelling and pain, making walking impossible. In summer, if Hong Kong Foot occurs and medicine is ineffective, moxibustion is unavoidable. Apply only three cones per acupoint to curb the disease progression. Even annual moxibustion is tolerable, and ulcers/abscesses heal easily. Fire needling is suitable for breaking open carbuncles and back boils where pus is internal but the skin has no head. Press the soft, non-hard swelling to drain pus. For large swellings, mark the head, tail, and center. Insert three needles to break open and drain pus. Insert one needle into the swelling without pressing; instead, press from both sides with fingers to guide pus out. If swollen with much pus, stand aside during needling to avoid splashing. Sun Simiao said: After fire needling, repeat treatment every other day. After treatment, large amounts of pus discharge, leading to rapid efficacy. Fire needling is very suitable for masses and accumulations. It is not a universal cure, but very effective. On the mass, keep the needle in place slowly withdrawing, rotating it to expel turbid stagnation. One night after fire needling, fever and aversion to wind/chill occur; this indicates the pathogen is being addressed (Zhong Bing) and is harmless. Fire needling also moves Qi. It relies solely on fire power, avoiding harms of tonification/reduction or excess/deficiency manipulation, except for the risk of deep insertion. Other aspects are safe. Regular acupuncture (Qi Zhen) varies in depth and technique (tonification/reduction), requiring careful timing of Qi and pathogen difficulty. Mistakes can harm deficient patients by reducing them or fail to benefit excess patients. Modern makers of fire needles use horse bit iron, which is a pleasing choice. The key is long exposure to fire; well-heated, non-crystallized iron is best. Using waste fire chopsticks from a furnace is ideal. New fire needles must be burned continuously with sesame oil lamp fire for one day and night before use. Fire needling is especially effective for paralysis because it opens acupoints widely, not sealing the gate, allowing Wind Pathogens to exit. Fine regular needles close the pore immediately upon withdrawal, trapping Wind. Moxibustion is like locking the door to chase thieves; if closed, pathogens have no exit. For Wind-Damp-Cold stuck in meridians, fire needling is suitable to vent pathogens externally via fire power, surpassing regular acupuncture. For breaking hard carbuncles, tumors, and nodules, the intense heat of fire needles is useful. Sichese monks often use heated needles (Wei Zhen), thicker than shoe needles or standard fire needles, heated by fire, corresponding to the Large Needle (Da Zhen) of the Nine Needles. Larger than regular needles, it treats Wind Pathogens trapped in bones and sinews, second only to fire needles. Sun said: The Three Needles refer to Feng Zhen (Pricking Needle), Pi Zhen (Sword Needle), and Huo Zhen (Fire Needle). Fire needle is equivalent to Wei Zhen.

Wu's commentary: Burning needles were commonly used before Zhang Zhongjing, causing disasters, hence frequently mentioned in *Shanghan Lun*. Examples include: burning needles cause fright; inducing sweat via burning needles leads to cold affecting the needle site, forming knots and triggering Running Piglet syndrome (Ben Tun); adding burning needles causes chest irritability. Today, some use it conveniently to discharge pus from carbuncles.