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Upon observing the patient, there was continuous vomiting and retching, accompanied by loud breathing and coarse voice, saliva flowing from the corners of the mouth, distended blue veins at the temples on both sides of the forehead, a facial expression resembling anger, fixed gaze, sweating like beads, involuntary urination, a pale tongue with little coating, and a red complexion.

According to the midsummer season and the red complexion, one should expect a "Hong pulse" (a normal summer pulse characterized by being vigorous at the beginning and weak at the end). However, upon palpation, the radial artery pulses at the Cun Kou (Radial Pulse Position) on both left and right sides were nearly absent; only slight pulse waves were faintly perceptible at the Guan (Middle) and Chi (Cunaminal) positions. The carotid artery pulses at the Ren Ying (Carotid Pulse Position) on both left and right sides exhibited a magnificent image reaching four times the normal strength. The pulse images at the Cun and Guan positions were particularly strong, while the Chi position was comparatively weaker.

Based on the pulse diagnosis, this practitioner believes that the patient's Three Yin Meridians (Foot-Taiyin Spleen Meridian, Foot-Shaoyin Kidney Meridian, Foot-Jueyin Liver Meridian) are on the verge of exhaustion but have deviated and escaped due to the "overstepping" of the Foot-Yangming Stomach Meridian. Although the meridian qi of the Foot-Yangming Stomach Meridian is observed to be excessively vigorous and unstoppable, it should not be treated by draining excess. Instead, urgent measures must be taken to rescue the functional movement of the Foot-Three Yin Meridians to retrieve the Yang Qi about to perish and secure the escaping essence. Therefore, tonification needle techniques were urgently applied to select Yinlingquan (SP9) and Sanyinjiao (SP6) on both sides. Due to the lack of moxa sticks, incense smoke was quickly ignited to deliver warm needle therapy. Simultaneously, the Neiting (ST44) acupoints on both feet were pressed with fingers to guide the meridian qi of the Yang aspect downward and into the Yin meridians. Following the principle of guiding Yang to assist Yin, after 20 minutes of treatment, the patient's symptoms improved significantly, with more than half of the illness receding. The patient could hold my hand to express gratitude. Re-examination of the pulse at the Cun Kou showed slightly increased pulse waves at the Guan and Chi positions, but no pulse remained at the Cun positions. Although the strength of the Ren Ying pulses had decreased, they remained magnificently filling the finger.

After stopping treatment and observing for 20 minutes, the patient's symptoms relapsed as before. Re-palpation of the Yin and Yang arteries revealed the original pulse images again.

This practitioner pondered the root cause of the Three Yin Meridians' inability to function normally and their internal exhaustion, which was mainly caused by the counter-movement where the Foot-Yangming Stomach Meridian reversed and escaped upward. A second treatment was decided upon, employing intense fire moxibustion to forcefully redirect the Yangming Stomach Meridian qi into the Taiyin Spleen Meridian. Still adhering to the principle of guiding Yang to assist Yin to strengthen the Spleen Meridian (selecting points on Yin meridians), and lacking moxa sticks, cotton cloth was wrapped into strips approximately 1 cm thick, dipped in sesame oil, and burned for moxibustion. Right Yinlingquan was moxibusted first, followed by left Yinlingquan, repeated three times. Finally, Taicang (Zhongwan, CV12) was moxibusted twice. After intense stimulation using direct moxibustion for about 10 minutes, the illness was cured. Re-examination of the pulse showed that the Cun, Guan, and Chi positions at both pulse ports emerged; the magnified pulse images at both Ren Ying positions also normalized. Subsequent follow-up visits confirmed the illness did not recur, although the moxibustion sores became inflamed and took over a month to heal. Reflection: This condition was encountered for the first time in clinical practice; it onset abruptly and was critical, representing an acute case of "Da Jue" (Great Syncope) and sudden collapse. The *Su Wen, Tiao Jing Lun* states: "When blood and Qi move together upwards, it is called Da Jue. In syncope, there is sudden death; if Qi returns, life is preserved; if it does not return, death occurs." According to this syndrome, intense fire moxibustion should have been used from the start to "forcefully reverse the Qi mechanism to restore syncope." Thus, the warm needle tonification method initially adopted was superfluous treatment.

If this practitioner had not understood the flexible mechanism of Yin/Yang and Positive/Negative movements of the "Twelve Meridians," correct point selection on the Foot-Taiyin Spleen Meridian to save this critical condition would have been impossible. Without confirming the decline or excess of Yin/Yang pulse images at the "Mai Kou" (Radial Pulse) and "Ren Ying" (Carotid Pulse), rescuing this critical condition would also have been difficult. Because the patient's external symptoms—such as red complexion, coarse breath, saliva discharge, and vomiting—all belong to the syndrome of "Stomach Qi rebelling upward." If one mistakenly identifies this as Stomach Qi rebelling upward and incorrectly selects Zusanli (ST36) to descend rebellion and harmonize the Stomach, the patient would surely die as the weak internal Three Yin meridian qi "completely cuts off outwardly" upon obtaining Deqi (needle sensation). This would violate the prohibition: "When the Qi of the Five Zang organs is exhausted internally, but the practitioner instead reinforces the exterior." Therefore, treating critical conditions of sudden Yin/Yang collapse is like a train about to derail; at the moment of life and death judgment, the acupuncture and moxibustion practitioner must apply transformation and correction treatments according to the principles of positive/negative movements of Yin/Yang meridians to achieve immediate results.

Supplementary reflection: The above case was my first treatment of "Da Jue" sudden collapse, lacking experience. Thus, using warm needle therapy to select Sanyinjiao (SP6) the first time was incorrect point selection. At that time, I believed that since the Yin pulses at both pulse ports were nearing extinction, warm needling Sanyinjiao would supplement the meridian qi of the Three Yin Meridians. Later, I realized that the Sanyinjiao acupoint is below the horizontal line of the Fenglong (ST40) divergent branch of the Foot-Yangming Stomach Meridian, making it an incorrect selection. Proper selection should be Spleen Meridian Shu points above the horizontal line of the Fenglong divergent branch, such as Diji (SP8), Yinlingquan (SP9), and Xuehai (SP10). The second treatment using "direct fire moxibustion" did not use Sanyinjiao, only selecting Yinlingquan and Zhongwan, resulting in a cure. For such acute emergencies of "Da Jue" sudden collapse, without rescue, the patient will inevitably die; however, through treatment, if the Qi of the Excessive Meridian is not redirected to the Deficient Meridian, death is also inevitable. Therefore, saving such cases of "Da Jue" sudden collapse requires determining treatment methods based on the excess/decline phenomena of Yin/Yang pulse images at the Mai Kou and Ren Ying.

(II) Case Two

Qian XX, Male, 38 years old, residing at Taizi Po. Consulted on September 4, 1985. The patient reported experiencing hernia pain and swelling of both testicles starting August 18, 1985. Treatment with Chinese and Western medicine for half a month was ineffective. During treatment, the doctor also used moxibustion on Dadun (LR1) acupoint, which was also ineffective. Furthermore, the swelling of both testicles increased, and pain intensified.

Pulse examination: The Cun position of the Mai Kou (Radial Pulse) on both left and right sides exclusively showed a tight and choppy pulse image, while the Guan and Chi positions showed relaxed arterial pulses. The Chi position of the Ren Ying (Carotid Pulse) on both left and right sides exclusively showed a tight and choppy pulse image, while the Guan and Cun positions showed relaxed arterial pulses. Previous experience: Using moxibustion on Dadun (LR1) for hernia disease is indeed very effective. Based on this practitioner's observation of pulse images after curing multiple hernia cases via Dadun moxibustion, the Chi position of the Mai Kou arterial pulse is mostly tight/choppy, tight/slow, or purple/small/thin. Currently, the Guan and Chi positions of the Mai Kou arterial pulses on both sides show no tightness, proving that the lower end of the Foot-Jueyin Liver Meridian has no cold stagnation. Only the tightness/choppiness at both Cun positions proves that the upper end of the Foot-Jueyin Liver Meridian is constrained by cold. The tightness/choppiness at the two Chi positions of the Ren Ying arterial pulse proves that the lower end of the Foot-Shaoyang Gallbladder Meridian is obstructed by cold stagnation. It was decided to use moxibustion combined with acupuncture for regulation.

Moxibustion was applied to Diwuhui (GB29) and Qiaoyin (GB44) (bilateral), three moxa cones each. Next, Yutang (CV19) was moxibusted three cones, and Danzhong (CV17) one cone. Then, Yuji (LU10) (bilateral) was needled using tonification technique, retaining the needles for 15 minutes. After resting for 10 minutes post-needling, the left and right Yin/Yang pulse images were re-examined; the tight/choppy pulse images at the Cun position of the Mai Kou and the Chi position of the Ren Ying transformed into relaxation. Second consultation on September 6, 1985. After the previous day's acupuncture and moxibustion treatment, the patient's testicular pain and swelling reduced by more than half. Palpation of the left and right Yin/Yang pulse images showed significant improvement in the tight/choppy pulse images at the Cun positions of both Mai Kou and the Chi positions of both Ren Ying, though slight tightness/choppiness remained. Adhering to the previous method of acupuncture and moxibustion regulation resulted in a cure with no recurrence.

Reflection: This case involved the Foot-Jueyin and Foot-Shaoyang meridians. Why was the Yuji (LU10) acupoint of the Lung Meridian needled? Because the branch of the Foot-Jueyin Liver Meridian connects upwards to the Lung Meridian. The *Ling Shu, Jing Mai* states: "Its branch separates from the Liver, pierces the diaphragm, and flows into the Lung." Therefore, selecting the Hand-Taiyin Lung Meridian's Yuji (LU10) acupoint guides Liver Qi to connect with the Lung Meridian, ensuring unobstructed flow of Liver Meridian Qi. This is analogous to using pungent-flavor herbs to soothe the Liver, because pungent herbs enter the Lung and can consequently flow through the Liver. Confirming the syndrome via pulse and applying treatment according to reason yielded rapid results.

(III) Case Three

Dong XX. Male. 28 years old. Carving worker from Zhejiang Province. Consulted on July 15, 1983.

Symptoms: Pain, swelling, and heaviness in the right testicle; inability to extend the waist, with pain radiating to the lower abdomen upon extension; thin white tongue coating and pale-red tongue body. The patient underwent Western medicine treatment for four days after onset with no effect.

Pulse examination: The Yin/Yang arterial pulses at the Cun, Guan, and Chi positions of the left Mai Kou and left Ren Ying showed equal entry/existence and ascending/descending movements, with pulse waves showing double width and a tight image. The arterial pulse at the right Mai Kou: the Cun position was floating and tight, while the Guan and Chi positions were abnormally "tight and small." The Ren Ying pulses at the Cun, Guan, and Chi positions on the right side were deep and tight.

Historical medical experts discuss "hernia pathogenic factors" mostly in the Liver Meridian. Since the Foot-Jueyin Meridian: "follows the inner thigh, enters the pubic hair region, passes through the genitalia, and reaches the lower abdomen." Currently, the Yin and Yang arterial pulses all show tight images; a tight pulse indicates cold. According to the exclusive appearance of the "tight and small" pulse image at the Chi position of the right Mai Kou, the diagnosis is that the Foot-Jueyin Meridian is afflicted by cold invasion.

Treatment with moxa stick moxibustion was employed. First, Xingjian (LR2) and Dadun (LR1) on the right side were moxibusted for 10 minutes. Next, Limen (SJ2) and Guanchong (SJ1) on the right side were moxibusted for 2 minutes. The distance between the moxa fire and the skin surface could be near or far, adjusted until the patient felt comfortable warmth. After warm moxibustion, immediate pulse re-examination revealed that the "tight and small" pulse image at the Chi position of the right Mai Kou had loosened compared to before.

Following the above moxibustion method once daily, after three days of treatment, the patient's right testicular pain and swelling gradually decreased day by day. The tight pulse images of the left and right Yin/Yang also transformed into relaxed images day by day. Finally, after taking one dose of the Chinese herbal medicine formula Tongjing Sanhan Xingqi Lishi (Meridian-Unblocking Cold-Dispersing Qi-Moving Dampness-Draining), the treatment concluded successfully. Prescription: Tufuling (Smilax Glabra Rhizome) 20g, Zhi Chuanwu (Aconitum Carmichaelii Radix Preparata) 5g, Xuanhu (Corydalis Rhizoma), Wuyao (Lindera Root), Qingpi (Citrus Reticulata Pericarpium Viride), Chuan Niuxi (Achyranthes Bidentatae Radix), Chao Juhe (Citrus Aurantium Fructus Immaturus Preparatus), Chuanlianzi (Evodiae Fructus), each 10g, Guizhi (Cinnamon Twig) 9g, Bai Fuling (Poria) 15g. One week later follow-up, the patient reported complete recovery.

(IV) Case Four

Zhao XX, Female, 57 years old, mountain pilgrim. Night consultation on July 7, 1992.

Symptoms: After sleeping at the Daoxie Hostel, the patient suddenly experienced unbearable abdominal pain, chest discomfort, followed by vomiting and diarrhea.

Pulse examination: The arterial pulses at the Guan and Cun positions of the Mai Kou (Radial Pulse) on both left and right sides were distinct in their coming and going, but the two Chi positions were choppy and lacked pulse; the Ren Ying (Carotid Pulse) on the right side showed a large Chi position and small Cun position, while the Ren Ying on the left side showed a large Cun position and small Chi position. This indicates abnormal movement of Yin/Yang Qi mechanisms disordering the intestines and stomach, thus manifesting the above pulse and symptom complex.

Acupuncture treatment was performed by selecting points from the Foot-Taiyin Spleen Meridian and Foot-Yangming Stomach Meridian: Gongsun (SP4) on both left and right, Tianshu (ST25) on both left and right; Ren Ying (ST9) on the right side, Zusanli (ST36) on the left side. Needles were retained for a total of 25 minutes, after which all symptoms disappeared. After resting for 10 minutes, the Yin/Yang arterial pulses were re-examined; the pulse images at the Cun, Guan, and Chi positions of both Mai Kou and both Ren Ying showed balanced opposing movements. Follow-up the next day, the patient stated that symptoms improved after acupuncture, with only one episode of diarrhea before recovery.

(V) Case Five

Wei XX. Male. 12 years old. Residing in Xinxiang City, Henan Province. Consulted on August 16, 1995.

Symptoms: Left-sided facial paralysis, mouth deviated to the right, incomplete closure of the left eye with tearing, inability to move the tongue flexibly during eating and drinking. Local treatment for over three months yielded poor results, leading to seeking medical care at the Wudang Taoist Clinic.

Pulse examination: The arterial pulses at the three positions of the Mai Kou on both left and right sides were peaceful in their coming and going; the Ren Ying pulse on the right side was also harmonious. Uniquely, the arterial pulse at the Cun position of the left Ren Ying was large, firm, and powerful, appearing three times stronger. The classics state: "Those who examine the location of deficiency and excess can determine the height and depth of the disease." This proves that both the disease and pulse image manifest in the upper left side.

Acupuncture was immediately employed to dispel pathogenic factors, supplemented by oral administration of "Qianzheng San" (Straightening Powder). Acupuncture was performed on Sibai (ST2), Yingxiang (LI20), Dicang (ST4), and Jiache (ST6) on the left side of the face. Upon obtaining Deqi, the sedation technique was applied, and needles were withdrawn. Immediately upon withdrawal, five to seven taps were made on the needle hole with the middle finger to allow one drop of blood to flow out; alternatively, fingers could squeeze the needle hole to release one drop of blood. If the blood appeared dark purple/black, two or three drops could be released to drain pathogenic factors. Acupuncture was performed once daily. After five sessions of sedation technique regulation, most symptoms were basically eliminated, with only slight deviation remaining externally. Re-examination of the arterial pulse at the Cun position of the left Ren Ying showed that the large and firm pulse image had disappeared and tended toward balance.

The classics say: "Those who know the hardness and softness of deficiency and excess know where tonification and sedation lie." Now, based on the firm pulse image at the Cun position of the left Ren Ying, treating the left facial acupoints with sedation technique yielded very rapid results. This illustrates the ancient sages' correct understanding and application of the Yin/Yang meridians at the Mai Kou and Ren Ying.

Two months later, the patient's father came to inform that about seven days after returning home, the facial deviation had returned to normal.

(VI) Case Six

Cui XX, Male, 18 years old, Taoist disciple. Initial consultation on September 20, 1984. Symptoms: Sequelae left after suffering from jaundice hepatitis four years ago. For over four years, frequently experienced heart heat and irritability, fullness under the left hypochondrium, occasional abdominal pain, excessive sweating, thirst preferring hot drinks, deep red tongue body with slightly yellow coating, normal bowel movements, and yellow urine. Multiple treatments were ineffective, prompting a request for my treatment. Yin/Yang pulse examination: Slippery and rapid, both presenting arterial phenomena of one times intensity. Uniquely, the Chi position of the left Mai Kou was slippery, rapid, and powerful; the Chi position of the right Ren Ying was slippery, rapid, and powerful. It was determined that the Liver Meridian on the left contained accumulated heat, and the Gallbladder Meridian on the right had residual heat. Sedation technique regulation was adopted. First, Taichong (LR3) on the left side was selected; then, Yanglingquan (GB34) and Qiuxu (GB40) on the right side were selected. After resting for 10 minutes post-needling, the Yin/Yang arterial pulses were re-examined; the slippery, rapid, and powerful pulse images at the "Chi position" of the left Mai Kou and the "Chi position" of the right Ren Ying both decreased. Following the above sedation needle technique regulation five times, the patient felt all symptoms were completely removed. Re-examination of the Mai Kou and Ren Ying pulses on both left and right sides showed that the pulse waves at the four Yin/Yang locations were peaceful in their coming and going.

Reflections on Treating Disease with Acupuncture and Moxibustion

In my many years of clinical practice using acupuncture and moxibustion, I must base the tonification and sedation of acupuncture treatment on the excess and decline phenomena of Yin/Yang pulse images. Therefore, the part of the pulse image that is exclusively excessive is where the Excess Pathogen lies; the part that is exclusively declined is where the Deficiency lies.

Treating Excess Pathogens requires the sedation needle technique. After regulation, resting for a short period (about 10 minutes), one should re-examine the "vigorous and firm pulse wave." If there is a decrease, it indicates efficacy. The classics state: "Sedation benefits the deficient; if the deficient person's pulse remains large as before but not firm..." If the pulse still resembles the "vigorous and firm pulse wave" before needle regulation, it indicates no efficacy. If the pathogenic factor is too severe, and although the pulse image shows reduction upon immediate re-examination after needle regulation, if the pulse and symptoms revert to the previous state the next day, it is still considered effective, due to the severity of the pathogen. Persistently executing sedation of excess regulation will inevitably cause the pathogen to recede. Therefore, treating Excess Pathogens requires continuing treatment until the symptoms and pulse no longer flare up and reach Yin/Yang harmony for a cure.

Treating Deficiency areas: Tonification needle technique should be applied. After regulation, one should re-examine the "deficient pulse wave." If there is an enhancement, it indicates efficacy. The classics state: "Speaking of tonification, there must be a sense of acquisition..." If after regulation the "deficient pulse wave" remains unchanged, it indicates no efficacy. If a certain Yin or Yang meridian Qi is extremely deficient, and although the pulse image shows enhancement upon immediate re-examination after regulation, if the pulse and symptoms remain deficient as before the next day, it is still considered effective, due to the extreme deficiency of that meridian. Persistently executing tonification of deficiency regulation will inevitably restore health. Therefore, treating deficiency areas requires continuing treatment until the pulse and symptoms no longer deteriorate and become sufficient for a cure. Thus, using acupuncture and moxibustion to treat deficiency and excess diseases has no fixed rule, but rather aims for cure as the standard.

Using acupuncture and moxibustion to regulate "deficient meridians" also requires clear differentiation: whether Yin meridian deficiency leads to Yang meridian excess, or Yang meridian deficiency leads to Yin meridian excess. Only then can acupuncture and moxibustion be used to tonify deficiency and sedate excess to harmonize Yin/Yang meridians. During needle therapy, one should follow ancient teachings: first tonify the "deficient meridian," then sedate the "excessive meridian" to harmonize it. If the Yin and Yang pulse images of the patient both decline evenly, needle treatment should not be adopted. The classics state: "When Yin and Yang form and Qi are both insufficient, do not use needles, but regulate with sweet medicines." Therefore, patients with dual deficiency of Yin and Yang meridian Qi should use "sweet-warm medicines" to supplement Yin/Yang Qi and Blood; forcibly applying needle treatment may easily lead to fainting from needles or adverse consequences.

(VII) Case Seven

Xiong XX, Male, 29 years old, residing at Hongzhuan Third Team, Gong'an County. Consulted on August 19, 1979. Symptoms: Illness began two days prior, with internal pain in the intercostal area below the right breast, worsening upon inhalation. Diet and bowel/bladder functions were normal.

Pulse examination: The arterial pulses at the right Mai Kou and right Ren Ying showed balanced ascending/descending and coming/going movements. The arterial pulse at the left Mai Kou was also relatively peaceful, with only the Cun position slightly showing a floating image. The pulse images at the Cun and Guan positions of the left Ren Ying were not particularly strong, but uniquely, the "Chi position was deep, large, and powerful." The classics state: "Differentiating from Yang allows knowing the location of disease." Therefore, in pulse diagnosis, any position exhibiting a unique pulse image is the site of disease. Currently, the patient's pain is located on the "right side," but the pathological pulse phenomenon is on the "left side." Following the guidance of ancient sages, the "Giant Puncture Method" (Ju Ci Fa) of "treating the right side by selecting the left" was used for regulation: Zusanli (ST36) on the left side was needled, employing the "Penetrating Heaven Cool" needle technique to sedate it. After needling, the patient's pain disappeared. Resting for about 10 minutes, the deep, large, and powerful pulse image of the "Chi position arterial pulse" at the left Ren Ying disappeared and transformed into harmony. Visiting the patient three days later, the illness had not recurred. This case had special pulse and symptom characteristics, cured by selecting only one acupoint, possessing certain clinical guiding significance. For this syndrome, without examining the Ren Ying pulse, it would be difficult to diagnose which meridian is diseased, let alone adopt the "Giant Puncture" treatment method. This demonstrates the importance of examining the Ren Ying pulse.

(VIII) Appendix: Summary of Acupuncture and Moxibustion Regulation

The above cases include some from many years ago when I first discovered the mechanism of the "Twelve Meridians," treating with local folk methods based on the principles of the "Twelve Meridians" under conditions lacking modern medical equipment. Other cases had short treatment courses. The treatment methods were concise and easy to remember, representing ordinary cases encountered in clinical practice. Because treatment regulated the patient's left/right, upper/lower, Yin/Yang deviations based on the positive/negative mechanisms of the Twelve Meridians, all achieved good effects.