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The abdomen suddenly becomes distended, and pressing it does not relieve the fullness. One should puncture the Luo-connecting vessel of the Foot-Taiyang channel, which is the Front-Mu point of the Stomach, Zhongwan (CV 12). (Note: The Luo-connecting vessel of the Hand-Taiyang channel actually refers to Zhongwan on the Ren Mai, because Zhongwan is where the Hand-Taiyang, Hand-Shaoyang, and Foot-Yangming channels originate, hence it is called "the Taiyang Luo-vessel, the Mu-point of the Stomach".) Then take Shenshu (BL 23), located three cun lateral to the spine, and another five cun outward. (Note: Also take the Shenshu points on both sides of the spine, spanning three cun in total width, each five cun from the midline.) Use a Yuanli needle. For Huoluan (cholera-like syndrome with vomiting and diarrhea), puncture Zhishi (BL 52), located five cun lateral to Shenshu, five times at each point. Then puncture the Foot-Yangming channel and the points three cun lateral to the upper back. (Note: Also pierce Yishe (BL 48), located lateral to Weishu (BL 21) and Pishu (BL 20), three times at each point.) To treat epilepsy and惊厥 (convulsions), puncture the Five Channels (referring to lower limb meridians as detailed below). Puncture the Hand-Taiyin Lung channel, five times on each side. Puncture Jingqu (LU 8). Puncture the Daiyang channel (referring to the Hand-Taiyang Small Intestine channel), Yanggu (SI 5), five times at each point. Puncture Lingdao (HT 4), located one finger-breadth beside the Luo-connecting point Tongli (HT 5) of the Hand-Shaoyin Heart channel, once at each point. Puncture the Foot-Yangming channel once. (This also refers to the Jing-river point Jiexi (ST 41).) Puncture three needles at five cun above the medial malleolus; this is the Luo-connecting point Guangming (GB 37) of the Foot-Shaoyang Gallbladder channel, puncture three times at each point.

In Liver Heat disease, urination turns yellow first, accompanied by abdominal pain, excessive sleepiness, and body heat. When pathogenic heat contends with healthy qi, there may be delirious speech and惊悸 (palpitations/fright), distension and pain in the hypochondrium, restlessness of the hands and feet, and inability to lie down peacefully. The condition worsens on Geng-Xin days (Metal days), and profuse sweating occurs on Jia-Yi days (Wood days), leading to recovery. If Qi rebels (reverses flow), death occurs on Geng-Xin days. (Geng-Xin belong to Metal, which overacts on Liver Wood; Jia-Yi belong to Wood, when Liver Qi is prosperous. Rebellion indicates pathogenic excess overcoming the organ's qi.) Puncture the Foot-Jueyin Liver channel and the Foot-Shaoyang Gallbladder channel. (Shaoyang is the exterior counterpart of Jueyin, so both should be punctured.) If Qi rebels, dizziness and vertigo occur, with pulse tension pulling towards the head.

In Heart Heat disease, there is initially a sense of unhappiness, followed by fever after several days. When heat contends with healthy qi, sudden heart pain, vexation, irritability, frequent vomiting, headache, flushed face, and anhidrosis occur. The condition worsens on Ren-Gui days (Water days), and profuse sweating occurs on Bing-Ding days (Fire days), leading to recovery. If Qi rebels, death occurs on Ren-Gui days. (Ren-Gui belong to Water, which overacts on Heart Fire; Bing-Ding belong to Fire, when Heart Qi is prosperous.) Puncture the Hand-Shaoyin Heart channel and the Hand-Taiyang Small Intestine channel. (Taiyang is the exterior counterpart of Shaoyin, so both should be punctured.)

In Spleen Heat disease, there is initially heaviness of the head, cheek pain, mental vexation, bluish complexion, desire to vomit, and body heat. When heat contends with healthy qi, lower back pain occurs, making flexion and extension difficult, along with abdominal fullness, diarrhea, and pain in both mandibles. The condition worsens on Jia-Yi days (Wood days), and profuse sweating occurs on Wu-Ji days (Earth days), leading to recovery. If Qi rebels, death occurs on Jia-Yi days. (Jia-Yi belong to Wood, which overacts on Spleen Earth; Wu-Ji belong to Earth, when Spleen Qi is prosperous.) Puncture the Foot-Taiyin Spleen channel and the Foot-Yangming Stomach channel. (Yangming is the exterior counterpart of Taiyin, so both should be punctured.)

In Lung Heat disease, there is initially chills, piloerection (goosebumps), aversion to wind and cold, yellow tongue coating, and body heat. When heat contends with healthy qi, wheezing and coughing occur, pain radiating to the chest, epigastrium, and back, inability to take deep breaths, unbearable headache, sweating followed by coldness. The condition worsens on Bing-Ding days (Fire days), and profuse sweating occurs on Geng-Xin days (Metal days), leading to recovery. If Qi rebels, death occurs on Bing-Ding days. (Bing-Ding belong to Fire, which overacts on Lung Metal; Geng-Xin belong to Metal, when Lung Qi is prosperous.) Puncture the Hand-Taiyin Lung channel and the Hand-Yangming Large Intestine channel. (Lung and Large Intestine channels.) Bleed until the amount resembles a bean size, and symptoms will stop immediately. (Select areas where the collateral vessels are abundant.)

In Kidney Heat disease, there is initially lower back pain, soreness and weakness in the legs, bitter taste, thirst with frequent drinking, and body heat. When heat contends with healthy qi, stiff and painful neck, aversion to cold with soreness, hot soles, and reluctance to speak occur. If Qi rebels, there is stiff and painful neck with dizziness, and a listless spirit. The condition worsens on Wu-Ji days (Earth days), and profuse sweating occurs on Ren-Gui days (Water days), leading to recovery. If Qi rebels, death occurs on Wu-Ji days. (Wu-Ji belong to Earth, which overacts on Kidney Water; Ren-Gui belong to Water, when Kidney Qi is prosperous.) Puncture the Foot-Shaoyin Kidney channel and the Foot-Taiyang Bladder channel. (Kidney and Bladder channels.)

In Liver Heat disease, the left cheek becomes red first. In Heart Heat disease, the forehead becomes red first. In Spleen Heat disease, the nose becomes red first. In Lung Heat disease, the right cheek becomes red first. In Kidney Heat disease, the chin becomes red first. Even if the disease has not yet manifested, if redness is seen in these areas, one should puncture them. This is called "treating disease before it arises." (Redness appearing in the five facial zones corresponding to organs is a precursor of disease; one should identify the affected organ and treat it preemptively.) For Heat diseases originating from specific regions, recovery occurs when the corresponding prosperous day arrives. (For example, Liver disease recovers on Jia-Yi days, when Wood Qi is prosperous.) If the acupuncture method is reversed (incorrectly tonifying deficiency or reducing excess), recovery takes three cycles (three days). If one errs again (double rebellion), death results. (One error requires waiting for three cycles; a second error deepens the pathogen and depletes Zheng Qi further, leading to death.) All treatments for Heat diseases involve having the patient drink cold water before puncturing. The patient must wear light clothing and reside in cool places until the body feels cool. (The aim is to allow Yin Qi to reach the exterior from within, allowing Heat to dissipate externally.)

For Heat diseases starting with chest/hypochondriac pain and restlessness of hands/feet, puncture the Foot-Shaoyang Gallbladder channel and tonify the Foot-Taiyin Spleen channel. (Chronic hypochondriac pain is primarily treated with Qiuxu (GB 40). Tonifying Foot-Taiyin involves selecting Jing-Well and Ying-Spring points.) For severe cases, use the "Fifty-Nine Acupoints" needling method. (See *Ling Shu: Re Bing* chapter.) For Heat diseases starting with arm pain, puncture the Hand-Yangming Large Intestine and Hand-Taiyin Lung channels until sweating stops. (Points such as Shangyang (LI 1) and Lieque (LU 7).) For Heat diseases starting with head/neck pain, puncture the Foot-Taiyang Bladder channel at the nape (Tianzhu BL 10) until sweating stops. For Heat diseases starting with leg/calf pain, puncture the Foot-Yangming Stomach channel until sweating stops. (Foot-Yangming can induce sweating; puncture Neiting (ST 44) and Xangu (ST 43).) For Heat diseases starting with body heaviness, bone pain, deafness, and a preference for closing eyes, puncture the Foot-Shaoyin Kidney channel. For severe cases, use the "Fifty-Nine Acupoints" method. (Puncturing Foot-Shaoyin: according to the text, there is no single primary point; select Jing-Well and Ying-Spring points. If severe, use the Fifty-Nine Acupoints method.) For Heat diseases starting with dizziness, vertigo, fever, and chest/hypochondriac fullness, puncture the Foot-Shaoyin Kidney and Foot-Shaoyang Gallbladder channels. (Dizziness refers to spinning sensation; vertigo refers to visual obscurity. Bone nourishes the brain; eye pupils reflect bone essence, both governed by Kidney. Additionally, Foot-Shaoyang starts at the outer canthus and runs through the hypochondrium, relevant to these symptoms; thus, points should be selected from both channels.) These are also acupoints for Heat diseases. The interspace below the third thoracic vertebra (Pohu BL 42) treats chest heat; below the fourth (Gaohuang BL 43) treats diaphragm heat; below the fifth (Shentang BL 44) treats Liver heat; below the sixth (Yixi BL 45) treats Spleen heat; below the seventh (Geguan BL 46) treats Kidney heat. The Ying-Spring points are located at the tailbone. (This summarizes treating Heat in Zang organs via Back-Shu points. Only puncturing the upper seven segments treats Yang pathogens. Vertebrae refer to spinal joints. Ying refers to Yin Qi. Tailbone. Treating Yang pathogens in the upper region; puncturing the lower seven vertebrae would damage Yin Qi, hence the warning: Ying Qi is at the tailbone, do not puncture recklessly.) The depression below the third cervical vertebra in the neck is Dazhui (GV 14). (Method for locating vertebrae: locate the depression below the third cervical vertebra named Dazhui; counting downwards sequentially allows identification of other vertebral levels.)