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Reflection: Before I fully understood the principles of the Twelve Meridians (Twelve Main Channels), regarding the Jue-Ni syndromes (reversal syndromes) of each meridian, because the symptoms varied and I did not understand the differences between the Yin-Yang arterial pulses at the Cunkou (Radial Artery Pulse Position) and Yingyang (Carotid Artery Pulse Position), it was difficult to make accurate judgments and effective treatments for these syndromes. Later, after understanding the functional principle that Yin and Yang Qi mutually exchange at the "Bie-Xue" (Luo-Connecting Points separating meridians), and combining this with the diagnostic and therapeutic rules for Jue-Ni diseases as outlined in the *Neijing* (*Inner Canon*), I was able to achieve therapeutic effects on Jue-Ni syndromes.

There are many such syndromes; if the acupoints selected for treatment contradict the Yin-Yang mechanisms, medical accidents may easily occur. I hereby make my practical experience public.

Jue-Ni of the Foot-Yang meridians is mostly Cold-Jue (Cold Reversal); Jue-Ni of the Foot-Yin meridians is mostly Heat-Jue (Heat Reversal). The pulse manifestation of Heat-Jue shows floating and excessive pulses at the Cun position of both Cunkou arteries, while the Chi position is deficient. The pulse manifestation of Cold-Jue shows floating and excessive pulses at the Cun position of both Yingyang arteries, while the Chi position is deficient. Additionally, due to individual variations in pathology, differences in left/right and Yin/Yang pulse manifestations can appear. Regarding the theoretical guidance for treating Jue-Ni syndromes, one should follow the point selection principles for Foot-Yangming Meridian Jue-Ni described above: one should select points below the "Fenglong Bie-Xue" (Luo-Point of ST40) on the Foot-Yangming Meridian, avoiding points above "Fenglong". The most suitable points are "Neiting" (ST44) and "Xangu" (ST43). Because Neiting and Xangu are located lower than the horizontal line of the "Gongsun Bie-Xue" (Luo-Point of SP4) of the Foot-Taiyin Meridian, they can guide the descending of Foot-Yangming Qi to seal the "Gongsun Bie-Xue," thereby preventing excessive output of Foot-Taiyin Qi from "Gongsun" into the Foot-Yangming Meridian, and facilitating the input of Yangming Qi from "Fenglong" into the Foot-Taiyin Meridian. However, selecting a point on the Foot-Taiyin Meridian must be higher than the horizontal line of "Fenglong Bie-Xue," so as to guide Yangming Qi from "Fenglong" to input and supplement the ascending function of Zheng-Qi (Upright Qi) in the Foot-Taiyin Meridian. The Classic states: "In needling Cold-Jue, retaining the needle reverses it to heat." By adhering to the ancient sages' therapeutic principles, this patient's Foot-Yangming Jue-Ni syndrome characterized by coldness below the knees was cured after nine sessions of needle retention, transitioning from cold to warm.

If the syndrome involves severe Cold-Jue, moxibustion should also be employed. Chronic Jue-Ni headache leading to upper excess and blood stasis requires bloodletting to remove stasis before regulating Yin and Yang. Any pathogenesis of Jue-Ni presents with upper excess and upper deficiency. If Yin meridians reverse upward, their corresponding Yang meridians must sink downward; if Yang meridians reverse upward, their corresponding Yin meridians must sink downward. Whether Yang-Jue or Yin-Jue, all result from unbalanced ascending and descending movements caused by the excess or deficiency of Yin and Yang natures. The Classic states: "Yang is outside, the servant of Yin; Yin is inside, the guardian of Yang." The cause of Jue-Ni is the dysfunction of this external/internal "servant-guardian" relationship. Therefore, the movement functions of exterior/interior and Yin/Yang must be regulated back to the correct path for the Jue-Ni symptoms to be completely cured.

Eleven. Explaining the Contradiction of Jing-He Points in Hand-Taiyin and Hand-Yangming

Previous chapters repeatedly explained the forward and reverse running mechanisms of the "Twelve Meridians." Based on these Yin-Yang and forward-reverse mechanisms, the three contradictions proposed earlier regarding the operation of the "Twelve Meridians" can now be reasonably explained. When the Hand-Taiyin Meridian operates forward outwardly, its Qi flows to the "Jing-Well" point; when it operates reverse inwardly, its Qi flows to the "He-Sea" point. When the Hand-Yangming Meridian operates forward upwardly, its Qi flows to the "He-Sea" point; when it operates reverse downwardly, its Qi flows to the "Jing-Well" point.

The *Lingshu · Benshu Chapter* records: "Huangdi asked Qibo: 'In all needling methods, one must understand the endings and beginnings of the Twelve Meridians, where collateral vessels branch off, where the Five Shu points reside, which six Fu organs correspond, the entry and exit of the four seasons, where the Five Zang organs store Qi, the measurements of width and number, the depth and shape, and the high and low limits. I wish to hear your explanation.' Qibo replied: 'Let us speak of secondary matters. Lung Qi originates at Shaoshang; Shaoshang is on the medial side of the tip of the thumb, and is the Wood Jing-Well point. It flows to Yuji; Yuji is the thenar eminence, and is the Ying-Spring point. It pours into Taiyuan; Taiyuan is one cun behind the thenar eminence in a depression, and is the Shu-Stream point. It travels through Jingqu; Jingqu is at the Cunkou position, moving without staying, and is the Jing-River point. It enters Chize; Chize is the pulsating artery in the elbow, and is the He-Sea point...'" "Large Intestine connects with Hand-Yangming, originating at Shangyang; Shangyang is at the radial end of the index finger, and is the Metal Jing-Well point. It flows to Erjian, two joints proximal to this segment, and is the Ying-Spring point. It pours into Sanjian, distal to this segment, and is the Shu-Stream point. It passes Hegu; Hegu is between the metacarpal bones of the thumb and index finger, and is the Yuan-Source point. It travels through Yangxi; Yangxi is in the depression between the two tendons, and is the Jing-River point. It enters Quchi; Quchi is in the depression lateral to the olecranon process of the humerus, obtained by flexing the arm, and is the He-Sea point of Hand-Yangming..." In the opening discussion of the "Twelve Meridians" in the *Lingshu · Benshu Chapter*, the five Shu points (Jing, Ying, Shu, Jing, He) of the Five Zang organs and the six Shu points (Jing, Ying, Shu, Yuan, Jing, He) of the Six Fu organs are typically presented. The positions of the five points for Hand and Foot Three-Yin meridians and the six points for Hand and Foot Three-Yang meridians are detailed, but other body points are not discussed. This proves that the "Five Shu Points" of the Five Zang and "Six Shu Points" of the Six Fu are crucial for regulating Yin-Yang meridians and treating all diseases.

Since the Five Shu points of the Five Zang and Six Shu points of the Six Fu are all located below the elbows and knees, they are important sites for the exchange of Yin and Yang Qi. Based on my experience during "Fetal Breathing," the most obvious entering and exiting motor functions of the Three-Yin and Three-Yang meridians of the limbs are that the hands do not exceed the elbows, and the feet do not exceed the knees. Thus, I believe the key site for Yin-Yang Qi exchange lies in the limbs. Although exchanges also occur above the head and within the viscera, these are secondary to the limbs. Therefore, the Shu points below the elbows and knees of the limbs can treat excess or deficiency in the Five Zang, Six Fu, and various meridians, making them common points for treating hundreds of diseases.

The *Lingshu* often states in discussions of disease treatment: "Select Foot-Shaoyin; select Foot-Taiyang," etc. Thus, whenever it says "select a certain meridian" without specifying a point, it refers to points below the knees on the limbs. In the *Lingshu · Jiuzhen Shieryuan Chapter*, Huangdi said: "I wish to hear where the Five Zang and Six Fu originate." Qibo said: "The Five Zang have five Shu points, totaling twenty-five; the Six Fu have six Shu points, totaling thirty-six. There are twelve meridians and fifteen collaterals, totaling twenty-seven Qi pathways moving up and down. Where they emerge are Jing-Well points; where they flow are Ying-Spring points; where they pour are Shu-Stream points; where they travel are Jing-River points; where they enter are He-Sea points. The movement of the twenty-seven Qi all resides in the Five Shu points." This explains that treating all diseases of the Zang, Fu, Yin, and Yang meridians mainly utilizes the 122 points below the elbows and knees on the four limbs to regulate the Yin-Yang Qi mechanism of the Twelve Meridians. Hence, they are emphasized at the beginning of the *Lingshu*.

Twelve. Explaining the Gen-Jie (Root-Knot) Contradiction of Foot-Yin and Foot-Yang Meridians

When the Foot-Yin meridians operate forward upwardly, their Qi flows to the "Jie-Knot" point; when the Foot-Yang meridians operate reverse downwardly, their Qi flows to the "Gen-Root" point.

When the Foot-Yang meridians operate forward downwardly, their Qi flows to the "Gen-Root" point; when the Foot-Yang meridians operate reverse upwardly, their Qi flows to the "Jie-Knot" point. Thus, Foot-Yin and Foot-Yang meridians are continuously "rooted and knotted" with their interior-exterior paired Yin-Yang meridians. For example, if the Yang meridian is at the "Root," the corresponding Yin meridian is at the "Knot"; if the Yin meridian is at the "Root," the Yang meridian is at the "Knot."

When using acupuncture to treat diseases, one must first examine the prosperity and decline of the forward/reverse and root/knot functions in the upper/lower, left/right, interior/exterior, and Yin/Yang aspects, to effectively regulate the Yin-Yang "Twelve Meridians."

The *Lingshu · Genjie Chapter* states: "Strange pathogens leaving the meridians are countless. Without knowing the Root and Knot, the Five Zang and Six Fu will suffer broken hinges and failed pivots, doors opening and closing improperly, and great loss of Yin and Yang, which cannot be recovered. The mystery of the Nine Needles lies in the Beginning and End; thus, knowing the Beginning and End concludes the matter in one word. Not knowing the Beginning and End cuts off the way of needling." Based on this scripture, it is sufficient to explain that understanding the continuous mechanism of Root and Knot functions can save critical conditions involving broken hinges, failed pivots, and great loss of Yin and Yang in the Five Zang and Six Fu. Therefore, understanding the "Root and Knot" mechanism of the "Twelve Meridians" is extremely critical!

The essence of treating Root and Knot does not refer to fixed "Root-Knot" Shu points, but rather to the dynamic functions of ascending, descending, going, and returning of the Spirit-Qi of Yin and Yang in the left, right, upper, and lower regions.

A specific Yin-Yang meridian pathway in the human body is like a railway track; its Shu points are like train stations; its Qi is like the "train." Without the train running back and forth, the track and station serve no purpose. Thus, when a person dies, the pathways and points remain, but without the往来 (coming and going) of Yin-Yang Spirit-Qi, needling produces no sensation and has no effect. The *Lingshu · Zhazen Shieryuan Chapter* states: "What is called a 'node' is where Spirit-Qi travels and exits; it is not skin, flesh, sinew, or bone." This clearly expresses the emphasis on the "dynamic Spirit-Qi" traveling in and out within the body. Therefore, diseases caused by the imbalance of Root-Knot Qi are like a "train" unable to reach the terminal station or return to the starting station. Critical conditions described as "broken hinges, failed pivots, improper opening/closing, and great loss of Yin and Yang" are like a "train" about to derail and cause danger. Thus, practitioners of acupuncture and moxibustion must timely apply methods based on the forward/reverse Yin-Yang mechanisms of the "Twelve Meridians." A case study follows:

Patient Xiong XX, Female, 71 years old, from Gong'an County. Night consultation on March 25, 1979. The patient suddenly fell unconscious at night. After ineffective treatment by two doctors, she sought my help. Symptoms: Eyes tightly closed, slightly red complexion, inability to speak, rapid upper chest breathing, rattling phlegm sounds in the throat, warm hands and cold feet. Her hands could move, but her feet were paralyzed and immobile. Examination of the bilateral Cunkou and Yingyang arteries showed that both Yin and Yang sides exhibited large pulses at the Cun position and weak pulses at the Chi position, presenting a double-pulse image. Superficial palpation showed excess, while deep palpation showed deficiency. The pulses showed Yin and Yang floating and rising to the head (Dai-Yang), primarily due to emptiness of True Yin in the Lower Jiao failing to anchor Yang, leading to floating and impending collapse of Yin and Yang. The disease source is in the Kidney. Since the Foot-Shaoyin Kidney Meridian governs downward movement, and its pathway ascends to clasp the tongue base, these symptoms formed.

Based on the patient's ability to move her hands, stroke was excluded. The diagnosis was "Stroke-like Flaccidity Syndrome" caused by deficiency of the Lower Yuan in the Foot-Shaoyin Kidney Meridian, leading to Yin's inability to anchor Yang. The method should be to consolidate the root and nourish the Kidney, but no emergency medication was available. In urgency, I treated according to the Root-Knot mechanism of the Twelve Meridians. I placed a glass bottle filled with warm water under the Yongquan (KI1) points of the patient's feet to use thermal conduction to guide Foot-Shaoyin Kidney Qi to return to the "Root," while simultaneously pressing the Neiting (ST44) and Kunlun (BL60) points on both feet to guide Yang meridian Qi downward. After 30 minutes of heat transmission and massage guidance, the patient's feet turned warm, she could speak, breathing stabilized, and phlegm subsided, bringing peace. Thus, the Yin-Yang Root-Knot motor mechanism of the "Twelve Meridians" can serve as a guide for differential diagnosis and treatment of all diseases.

Thirteen. Utilizing the Twelve Meridians for Treatment Must Link to Yin-Yang Pulse Diagnosis

The *Lingshu · Jiuzhen Shieryuan Chapter* states: "Whenever one intends to use needles, one must first diagnose the pulse, observe the severity and ease of the Qi condition, and only then can treatment proceed." This indicates that before needling, the practitioner must first diagnose the pulse. Based on the deficiency/excess shown in the pulse and the severity of the illness, one can appropriately determine the treatment method. The *Lingshu · Zhongshi Chapter* says: "If the Yingyang pulse is three times excessive, drain Foot-Yangming and tonify Foot-Taiyin; two drains and one tonification, taken twice daily, must be verified by palpation. Release and take from above until Qi harmonizes and stops. If the Cunkou pulse is one time excessive, drain Foot-Jueyin and tonify Foot-Shaoyang; two tonifications and one drain, taken once daily, must be verified by palpation. Release and take from above until Qi harmonizes and stops." According to the scripture's discussion of "Yingyang pulse three times excessive," one should tonify Foot-Taiyin Spleen and drain Foot-Yangming Stomach. For "Cunkou pulse one time excessive," one should tonify Foot-Shaoyang Gallbladder and drain Foot-Jueyin Liver. This fully illustrates that deciding on specific meridians and points for treatment without first examining the prosperity/decline of Yin-Yang pulses does not conform to the methods of the ancient sages.

Through years of research, I have realized that when the human body falls ill, the movement of the "Twelve Meridians" changes. The Three-Yin and Three-Yang meridians of the hands and feet do not maintain a fixed state of prosperity or deficiency. Therefore, to reasonably and legally treat diseases of the Twelve Meridians, one must first examine the deficiency/excess of Yin-Yang pulses. Only then can one decide which meridian or point to treat based on the pulse wave phenomena. Furthermore, based on the prosperity/decline of Yin-Yang pulses, one can determine whether to apply tonification or sedation, adhering to the correct rule of combining diagnosis and treatment established by the ancient sages.

Reviewing later acupuncture texts, there is a lack of Yin-Yang pulse diagnosis. They focus only on "certain types of syndromes" with pre-determined "empirical points," advocating the "empirical effects" of each point, thus summarizing much experience for each point.

Although acupuncture books discuss pulse diagnosis, they mostly only describe the "Cunkou pulse" of both hands. Thus, in later "acupuncture books," pulse discussion only covers "Yin meridian" diagnostics, lacking "Yang meridian" diagnostics, resulting in an incomplete Yin-Yang diagnosis.

The *Lingshu · Jingmai Chapter* discusses the Lung Meridian of Hand-Taiyin: "In excess, Cunkou is three times larger than Yingyang; in deficiency, Cunkou is smaller than Yingyang." Similarly, for the Large Intestine Meridian of Hand-Yangming: "In excess, Yingyang is three times larger than Cunkou; in deficiency, Yingyang is smaller than Cunkou." This shows that the ancient sages diagnosed pulses by comparing Yin and Yang sides, determining the deficiency/excess of Yin-Yang Qi by size and prosperity/decline. Therefore, I adhere to the ancient sage's method of diagnosing the Yin-Yang arteries of "Cunkou and Yingyang," achieving high efficacy in diagnosis and treatment. I believe inheriting the sages' diagnostic method can reduce misdiagnosis.

Taking large and small pulses as examples: If the "Yingyang" Yang pulse is large and the "Cunkou" Yin pulse is small, it can be confirmed as "Excess of Yang Meridian energy, Deficiency of Yin Meridian energy." If the "Cunkou" Yin pulse is large and the "Yingyang" Yang pulse is small, it can be confirmed as "Excess of Yin Meridian energy, Deficiency of Yang Meridian energy." If both "Cunkou and Yingyang" show excessive pulses, it can only be diagnosed as "Excess of both Yin and Yang Qi," and one cannot determine which side wins or loses. Therefore, if the "large pulse" lacks the "small pulse" for comparison, it loses the basis for "contrast." What evidence is used to confirm it as a "large pulse"? Thus, if the "Yin pulse of Cunkou" lacks the "Yang pulse of Yingyang" for comparison, it loses the basis for "contrast." What evidence is used to confirm which of Yin and Yang is "excessive or deficient"? Therefore, there must be opposites to have a complete and unified dialectical method.

The Classic states: "In excess, sedate it; in deficiency, tonify it; in heat, treat quickly; in cold, retain the needle." It also states: "If Yin is excessive and Yang is deficient, first tonify Yang, then sedate Yin to harmonize; if Yin is deficient and Yang is excessive, first tonify Yin, then sedate Yang to harmonize." All these "principled treatments" rely on diagnosing "Cunkou and Yingyang" to weigh the prosperity/decline of the Three-Yin and Three-Yang Qi before confidently applying sequential tonification and sedation techniques. This is the proper diagnostic and therapeutic rule; otherwise, it abandons the correct rules of the ancient sages. Because applying tonification and sedation without basing it on the prosperity/decline of "Cunkou and Yingyang" pulses is blind application of tonification/sedation, losing the diagnosis of the "Yingyang pulse" is a great pity.

The *Lingshu* is the ancestral classic of acupuncture therapy, embodying the principle of unity between Heaven and Humanity. It truly aligns with the Great Void and corresponds to the human body, being an unparalleled "Chinese Treasure." If one adheres to ancient teachings for diagnosis and treatment, chronic illnesses can be cured, benefiting humanity with immeasurable merit.

Therefore, before studying, I bow respectfully with sincere reverence, hoping future colleagues do not underestimate this. If using acupuncture to treat diseases, one must restore the ancient sages' opposing Yin-Yang "Cunkou and Yingyang" diagnostic method. Thus, Yin-Yang pulse diagnosis must be combined with the principles of the "Twelve Meridians" to correctly apply differential diagnosis and treatment in clinical practice.

(I) Analysis of One-Time, Two-Time, and Three-Time Differences in Cunkou and Yingyang Pulses

Regarding the arterial manifestations of one-time, two-time, and three-time differences, these discuss the pulse wave differences in the "width/narrowness" of the positive/negative operation of Yin-Yang arteries. What is meant by a three-time pulse in the Taiyin and Yangming meridians of the hands and feet indicating disease, a two-time pulse in the Shaoyin and Taiyang meridians, and a one-time pulse in the Jueyin and Shaoyang meridians?

1. The pulse diagnosis site of the two Cunkou positions belongs to the pathway of the Hand-Taiyin Lung Meridian; the pulse diagnosis site of the two Yingyang positions belongs to the pathway of the Foot-Yangming Stomach Meridian.