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(When needling the Shu-stream points of the Hand-Yangming Large Intestine channel, such as Sanjian (LI 15), and if symptoms persist, needle the Duanduan point. Note: In "Needling Hand-Yangming," the *Jia Yi Jing* adds "Li Yi" (immediate relief). The *Su Wen* lacks the character "Zhe" in "Chi Zhong Xia." Regarding the annotation for the Duanduan point: consulting the *Jia Yi Jing*, there is no Duanduan point on the Hand-Yangming channel; rather, the Shousanli point is located two cun below Quchi, where pressing causes the flesh to rise at the end of the Dui meat. Thus, "Duanduan" likely refers to the Shousanli point.) When pathogenic factors invade the space between the five Zang organs, the disease manifests as pulling pain along the meridians, with pain that comes and goes intermittently. Observe the pathological pulse, apply Miao-cissation (Miao Ci) therapy, and at the Jing-well points on the fingernails and toenails, observe the vessels and bleed them. Needle once every other day; if one session is insufficient, proceed up to five sessions. (The pulses of the five Zang organs pull and cause pain; observing the location of the pathological pulses on the left or right allows for Miao-cissation. The area above the fingernails and toenails contains the Luo-connecting vessels of the Jing-well points of the twelve meridians, hence they are selected. This is also a method of treating Luo diseases by selecting Jing-well points. Note: In the *Su Wen*, the character "Mai" (pulse) is absent in "Bing Mai".) Miao-cissation is used to treat upper toothache. (For the Luo vessel of the Foot-Yangming Stomach channel, if the left side is diseased causing right-sided pain, or vice versa, one may needle the Luo vessel of the Foot-Yangming channel at the upper teeth. Note: In the *Su Wen*, "Ci" (needle) is written as "Yin" (lead).) For cold pain in the teeth and lips, observe the blood stasis in the vessels on the back of the hand and remove it. Needle one point on the nail of the middle toe of the Foot-Yangming channel, and one point each on the nails of the thumb and index finger of the Hand. Relief will be immediate. Treat the left side by needling the right, and the right side by needling the left. (The Hand-Yangming Large Intestine channel enters the lower teeth, emerges, crosses the mouth, and intersects at Renzhong. The Foot-Yangming Stomach channel enters the upper teeth, emerges, circles the lips, and intersects below at Chengjiang. Therefore, the blood vessels of the Hand-Yangming channel are selected to relieve tooth and lip pain. The nail of the middle toe of the foot is the Luo vessel of the Foot-Yangming channel, so it is also selected. The nails of the thumb and index finger of the hand are also Luo vessels of the Hand-Yangming channel, so they are also selected. One must observe whether the pathology is on the left or right and apply Miao-cissation. Note: In the *Jia Yi Jing*, "Tong" (pain) is absent in "Chi Chun Han Tong"; the annotation states, "The *Su Wen* has an extra 'Tong' character." In "Foot Yangming Shang," the *Jia Yi Jing* includes the character "Ci" (needle).) For swelling in the throat, inability to swallow saliva, and frequent desire to spit but inability to do so, apply Miao-cissation to bleed the vessels anterior to Ran Gu. Relief will be immediate. Needle the right side for left-sided symptoms, and the left side for right-sided symptoms. (The Foot-Shaoyin Kidney channel emerges from Ran Gu, ascends into the lung, follows the throat, and flanks the root of the tongue. Therefore, for swelling in the throat, the vessels anterior to Ran Gu are needled. Note: In the *Su Wen*, this section appears above "Pathogenic factors invading the Luo vessel of the Foot-Taiyin Spleen." Below "Tuo" (spit), the character "Miao" is missing. In the *Jia Yi Jing*, "Zuo Ci You, You Ci Zuo" uses "Qu" (take) instead of "Ci" (needle).) When pathogenic factors invade the Luo vessels of the Hand-Shaoyin, Foot-Shaoyin, Hand-Taiyin, Foot-Taiyin, and Foot-Yangming channels, these five Luo vessels all converge in the ear and ascend to connect with the left corner of the head. (The Hand-Shaoyin Heart, Foot-Shaoyin Kidney, Hand-Taiyin Lung, Foot-Taiyin Spleen, and Foot-Yangming Stomach channels: The Hand-Shaoyin Tongli point enters the heart, connects to the root of the tongue, and its Sun-branches enter the ear. The Foot-Shaoyin channel reaches the root of the tongue, and its skin-region Luo vessels enter the ear. The main divergent branch of the Hand-Taiyin channel, from the throat, also has Sun-branches entering the ear. The Foot-Taiyin channel connects to the root of the tongue below and spreads under the tongue, also having skin-region Luo vessels entering the ear. The Foot-Yangming channel ascends before the ear, passes anterior to the Guest Master point, and also has skin-region Luo vessels entering the ear. These five Luo vessels enter the ear, converge, and then ascend to connect with the left corner. The left corner represents Yang.) If all five Luo vessels are exhausted, it causes the body's pulses to move chaotically while the form remains insensible. The condition resembles Shi Jue (corpse-like fainting/coma), (These five Luo vessels serve as the framework of the body. When their Qi is severed, the various pulses move chaotically, and the form loses consciousness. It resembles the state of death in Shi Jue but is not true Shi Jue. Note: In the *Su Wen* and *Jia Yi Jing*, "Qi Zhuang Ruo Shi Jue" is written as "Qi Zhuang Ruo Shi, Huo Yue Shi Jue" [Its appearance is like a corpse, or some say corpse-fainting].) Needle the inner side of the big toe of the foot, one leaf-width below the nail edge. This is needling Yinbai (SP 1) of the Foot-Taiyin Spleen channel. Note: In the *Su Wen* and *Jia Yi Jing*, "Jia Xia" is written as "Zhao Jia Shang" [Above the nail].) Subsequently, needle the sole of the foot, (This is needling Yongquan (KI 1) of the Foot-Shaoyin Kidney channel.) Subsequently, needle one point on the nail of the middle toe of the foot, (This is needling Lidui (ST 45) of the Foot-Yangming Stomach channel. Note: In the *Su Wen* and *Jia Yi Jing*, the character "Zhao" [nail] appears after "Zhong Zhi" [middle toe].) Subsequently, needle the inner side of the thumb of the hand, one leaf-width from the edge, (This is needling Shaoshang (LU 11) of the Hand-Taiyin Lung channel. Note: In the *Su Wen*, "Zhi Nei" is written as "Ce Nei" [Inner side].) Subsequently, needle one point each at the end of the Dui bone of the Hand-Shaoyin channel. Relief will be immediate, (This is needling Shenmen (HT 7) of the Hand-Shaoyin Heart channel. The previous five needleings all targeted Jing-acupoints to regulate Luo diseases. Note: Above this section, the *Su Wen* has the phrase "Hou Ci Xin Shou Zhu" [Subsequently needle the Pericardium of the Hand]. Wang Bing annotated this as Zhongchong (PC 9). The New Correction states that the *Jia Yi Jing* does not needle the Hand-Yuejin Pericardium, and these five Luo vessels do not involve the Hand-Yuejin. Wang's adherence to Wang Bing's annotation is incorrect.) If symptoms do not cease, use a bamboo tube to blow into both ears. Shave a square cun of hair at the left corner of the head, burn it, and administer it with a cup of fine wine. If the patient cannot drink, force-feed it. Symptoms will stop immediately. ("Ti" [shave/remove], pronounced Chi Li fan, means to remove. The ear is the convergence point of the five Luo vessels. The left corner is the connection point of the five Luo vessels. Note: In the *Jia Yi Jing*, "Er" [ear] has the character "Zhong" [middle]. "Ti" is written as "Ti" [scrape/remove]. In the *Su Wen*, "Zhu Tong" [bamboo tube] is written as "Zhu Guan" [bamboo pipe], and "Fang Cun" is written as "Fang Yi Cun" [one square cun].) In general, the principles of needling require first observing the meridians, palpating and following their flow, examining their excess or deficiency, and regulating them. For those not regulated, apply Jing-cissation (Jing Ci), (Not regulated implies local excess or deficiency. Where there is local excess or deficiency, one can regulate the Qi via Jing-acupoints. Note: In the *Su Wen*, "Shun" [follow] is written as "Cong" [obey]; in the *Jia Yi Jing*, as "Xun" [trace].) If there is pain but no disease in the meridian itself, apply Miao-cissation, (Palpating along the meridian reveals no disease, yet pain persists; this indicates the pathology is elsewhere, hence needling the opposite side for left-sided pain, etc., is called Miao-cissation.) and further observe the skin regions for blood stasis in the vessels, removing all such stasis. This is the principle of Miao-cissation. (In Miao-cissation, the pathogenic blood in the skin-region Luo vessels is all removed, which is called the method of Miao-cissation. "Shu" [number/principle] means method. Note: In the *Jia Yi Jing*, "Yin" [therefore] is written as "Mu" [eye]. In the *Su Wen*, below "Yin Shi" [therefore observe], the character "Qi" [its] appears; the *Jia Yi Jing* agrees.)