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期门二穴。图经云。在不容旁。一寸五分。上直乳。第二肋端。肝之募也。足厥阴。太阴。阴维之会可刺。入四分。
不可灸。凡针期门。必泻勿补。活人书云。可肥人二寸。瘦人寸半。又云。凡妇人病。法当针期门。不可行子午法。恐
缠藏膜。引气上。但下针。令病患吸五吸。停针良久。徐徐出针。此是平泻法也。庞安时又云。刺期门法。须得脉弦或
浮紧。刺之必愈宜针入一寸。
琥按上图经云。不容在幽门旁。一寸五分。幽门又在巨阙旁五分。巨阙在臆前蔽骨下。一寸五分。盖巨阙。系腹
部中行。期门系腹部第四行穴也。细量左右上下分寸。其穴自明。活人书云。穴在乳直下。肋骨近腹处是也。则是第二
肋。当从下数起。恰在软肋之两端是穴。刺法。肥人一寸。瘦人半寸不肥不瘦。中而取之。
伤寒发热。啬啬恶寒。大渴。欲饮水。其腹必满。自汗出。小便利。其病欲解。此肝乘肺也。名曰横刺期门。（自汗
出云云至病欲解三句。当在刺期门三字之下。伤寒发热。啬啬恶寒者。此太阳之风邪。尚未除也。然肺主皮毛。邪在手
太阴肺经亦然。大渴欲饮水者。成注引玉函云。作大渴欲饮酢浆。是知肝气胜也。肝来乘肺。肺受邪热。则渴欲饮水。
饮水既多。其腹必满。肺属金。金本制木。而反受木乘。其事不直。故曰横法。宜刺期门。以泻肝经之盛气。成注云。
肝肺气平。水散而津液得通。外作自汗出。内为小便利而解也。或问此条病。既云发热。啬啬恶寒。又云。大渴欲饮水。
焉知非太阳阳明证。余答云。若果系阳明胃热。大渴欲饮。则热能消水。未必腹满。热邪既传阳明。虽太阳经中之邪。
或不尽除。又未必啬啬恶寒。故成注云。大渴欲饮水。为肝气胜也。）
以上太阳可刺病二条（自原论中第三卷。太阳治法中集入于此）
妇人中风。发热恶寒经水适来。得之七八日。热除而脉迟。身凉胸胁下满。如结胸状谵语者。此为热入血室也。当
刺期门。随其实而泻之。（发热恶寒者。表未解也。本系妇人中风。风热甚。迫血妄行。故经水适来。正当七八日。为邪
将传里之时。邪气乘虚而入于血室。热除脉迟身凉者。成注云。邪气内陷而表证罢也。胁下满。如结胸状。谵语者。条
辩云。血室为营血停留之所。经脉集会之处。即冲脉。所谓血海是也。其脉起于气街。并少阴之经。夹脐上行。至胸中
而散。故热入而病作。其证则如是也。法当刺期门者。以期门为肝之募。肝主血。血热则瘀热入血室。而瘀积必归于肝。
故随其经之实。而用刺法以泻之也。成注反云。审看何经气实。更随其实而泻之。殊出不解。愚按此条病。仲景虽出太
阳治法之下。实则少阳之邪。传入厥阴。血分实热。故作谵语等证。仲景恐医人。认为阳明府实证。轻用三承气汤以伐
胃气。故特出一刺期门法以疗之。愚又按仲景云。如结胸状。必病患胁下满。虽如结胸。及按之必不痛。故知其非胃实。
且也。胁下虽痛。而痛不在胸。此其邪。止在肝胆之分。仲景当日。特用刺法。何其神哉。）
以上太阳可刺病一条（自原论中第四卷太阳治法下集入于此）
阳明病。下血谵语者。此为热入血室。但头汗出者。刺期门。随其实而泻之。 然汗出。则愈。（按此条。当亦是妇
人病。邪热郁于阳明之经。阳明多气多血。邪热甚。则迫血从下而行。血下。则经脉空虚。热得乘虚而入其室。亦作谵
语。后条辩云。血室虽冲脉所属。而心君实血室之主。室被热扰。其主必昏故也。但头汗出者。血下夺。则无汗。热上
扰。则汗蒸也。刺期门。以泻经中之实。则邪热得除。而津液回复。遂 然汗出而解矣。或问此条病。仲景不言是妇人。
所以尚论诸家。直指为男子。今吾子偏以妇人论之。何也。余答云。血室虽不分男女皆有。而热入血室之证。则惟妇人
始有之。余于前第七卷少阳篇后。言之已明。况仲景于太阳篇中。一则曰妇人中风云云。经水适来。此为热入血室。再
则曰妇人中风云云。经水适断。此为热入血室。三则曰妇人伤寒。云云。经水适来。此为热入血室。则是热入血室。明
系妇人之证。至此。实不待言而可知矣。且也。此条言下血。当是经水及期。而交错妄行。以故血室有亏。而邪热得以
乘之。故成热入血室之证。考之灵枢海论云。冲脉为十二经之海。注云。此即血海也。冲脉起于胞中。其前行者。并足
少阴之经。挟脐上行。至胸中而散。又考素问天真论云。女子二七而天癸至。任脉通。太冲脉盛。月事以时下。夫少阴
也。任也。冲也。其经脉皆行于腹。故其血必由前阴而下。斯血室有亏。邪热方得而入。则是仲景云。下血。乃经水交
错妄行。又不问而自明矣。此其理。非读书明理之君子。其孰能知之。）
以上阳明可刺病一条（自原论中第五卷阳明治法集入于此）太阳与少阳并病。头项强痛。或眩冒。时如结胸心下痞
硬者。当刺大椎第一间。肺俞。肝俞。慎不可发汗。发汗则谵语。脉弦。五六日。谵语不止。当刺期门（间去声。太少
并病者。本太阳之表邪不衰。并入少阳而交病。故谓之并病。并者。犹秦并六国。并则其势大矣。太阳之脉。络头下项。
故头项强痛。少阳之脉。循胸络胁。故如结胸。心下痞硬。二阳之脉。皆起于目而行于头。故目眩而头冒也。当刺大椎
第一间者。谓当刺大椎一穴。在第一椎之间。为背部中行穴。乃手足三阳督脉之会。先刺之。以泻太少并病之邪。不已。
更刺两肺俞。盖肺主气。尚论篇云。刺肺俞以通其气。斯膀胱之气化行。而邪自不留。复刺肝俞。以泻少阳之邪。以肝
与胆两经相合。为表里也。慎不可发汗者。以太阳之邪。既并少阳。则发汗在所当禁。倘误发其汗。则胃中津液干。木
邪乘之。必发谵语而脉弦。至五六日。邪当解而谵语不止。成注云。此为少阳邪热甚也。刺期门以泻肝胆之气。或问此
条病于发汗后。谵语不止。又见心下痞硬。何以不用下药。余答云。仲景云。时如结胸。则是心下虽痞硬。必按之不痛。
非真结胸。且也。心下痞硬。而脉又见弦。乃肝木旺而乘胃土。少阳经证。居多虽欲下之。敢轻下邪。）
期门穴图
期门穴共有两穴。《图经》记载：位于不容穴旁开一寸五分处，向上正对乳头，在第二肋骨端。这是肝的募穴，是足厥阴肝经、足太阴脾经与阴维脉的交会穴。可以针刺，进针深度为四分。不可艾灸。凡是针刺期门穴，必须用泻法，不能用补法。《活人书》说：对于肥胖的人可刺入二寸，瘦的人刺入一寸半。又说：凡是治疗妇女疾病，应当针刺期门穴，不可使用子午捣臼等手法，恐怕会缠绕脏腑膜络，引气上逆。只是下针后，让病人吸气五次，留针很久，然后慢慢出针。这就是平泻法。庞安时又说：针刺期门穴的方法，必须诊得脉象弦或浮紧，针刺后必定痊愈，适宜进针一寸。
琥珀按：上图经记载，不容穴在幽门穴旁开一寸五分，幽门穴又在巨阙穴旁开五分，巨阙穴在前胸正中线上，鸠尾骨（蔽骨）下缘一寸五分处。巨阙属于腹部正中线穴位，期门属于腹部第四侧线穴位。仔细衡量左右上下的分寸，穴位自然明了。《活人书》说：穴位在乳头直下，肋骨靠近腹部的地方。那就是第二肋，应当从下往上数起，恰好就在软肋的两端，此处就是穴位。针刺方法：肥胖的人刺入一寸，瘦的人刺入半寸，不胖不瘦的人取中间深度。
伤寒发热，啬啬恶寒（怕冷），大渴，想喝水，腹部必然胀满，自汗出，小便通畅，病情将要解除。这是肝气乘袭肺脏，名叫“横”证，宜刺期门穴。（关于“自汗出……病情欲解”这三句，应当放在“刺期门”三字之下。“伤寒发热，啬啬恶寒”，这是太阳风邪尚未清除的表现。然而肺主皮毛，邪气在手太阴肺经也是如此。“大渴欲饮水”，成无己注引用《玉函经》说，作“大渴欲饮醋浆”，由此可知是肝气旺盛。肝气来乘袭肺，肺受邪热，所以口渴想喝水。喝水多了，腹部必然胀满。肺属金，金本来克制木，反而受到木的乘袭，这种情况不正常，所以叫“横”法，适宜刺期门，以泻肝经的盛气。成无己注说：肝肺气机平和，水液散行而津液得以通调，外表现为自汗出，内表现为小便利，从而病愈。有人问：这条条文既说发热、啬啬恶寒，又说大渴欲饮水，怎么知道不是太阳阳明合病？我回答说：如果确实是阳明胃热，大渴欲饮，那么热能消水，未必会出现腹满。热邪既然传入阳明，虽然太阳经中的邪气或许没有完全清除，但也未必会有啬啬恶寒的症状。所以成无己注说：“大渴欲饮水”，是因为肝气胜。）
以上两条是太阳病可刺的病例（从原论第三卷太阳治法中收集于此）
妇人中风，发热恶寒，月经适来，患病七八天，热退脉迟，身凉，胸胁下满闷，像结胸的样子，并有谵语，这是热入血室，应当刺期门穴，随其实证而用泻法。（发热恶寒，说明表证未解。本属妇人中风，风热甚盛，迫血妄行，所以月经适来。正当七八天，是邪气将要传里的时期，邪气乘虚进入血室。热退、脉迟、身凉，成无己注说：邪气内陷而表证罢除。胁下满闷，像结胸的样子，谵语，条辩说：血室是营血停留的地方，经脉集会之处，即冲脉，所谓血海。其脉起于气街，伴少阴经上行，夹脐上行，至胸中而散。所以热邪进入而发病，症状就是这样。法当刺期门，因为期门是肝的募穴，肝主血，血热则瘀热进入血室，而瘀积必然归于肝，所以顺着肝经的实证，用刺法来泻之。成无己注反而说：审看哪条经气实，更随其实而泻之，实在令人不解。我认为这条病，仲景虽然列在太阳治法之下，实际上是少阳邪气传入厥阴，血分实热，所以出现谵语等症状。仲景恐怕医生误认为是阳明腑实证，轻率使用三承气汤来攻伐胃气，所以特别提出刺期门的方法来治疗它。我又认为仲景说“如结胸状”，一定是患者胁下满闷，虽然像结胸，但按压时一定不痛，所以知道不是胃实。况且，胁下即使疼痛，痛也不在胸部，这说明邪气只在肝胆之分。仲景当时特意用刺法，真是神妙啊！）
以上一条是太阳病可刺的病例（从原论第四卷太阳治法下收集于此）
阳明病，下血谵语，这是热入血室，只有头部出汗，刺期门穴，随其实证而用泻法，濈然汗出，则病愈。（按此条，应当也是妇人病。邪热郁结于阳明经，阳明多气多血，邪热炽盛，则迫血下行，血下行，则经脉空虚，热邪乘虚进入血室，也出现谵语。后文条辩说：血室虽属冲脉，但心君实为血室之主，血室被热邪扰乱，君主必昏昧。只有头部出汗，是因为血下行耗夺，故无汗；热邪上扰，故头汗蒸出。刺期门，以泻经络中的实证，则邪热得以清除，津液回复，遂濈然汗出而病解。有人问：这条病，仲景没说是不是妇人，所以尚论诸家直接指为男子，现在您偏偏按妇人论述，为什么？我回答说：血室虽然男女都有，但热入血室的证候，只有妇人始有。我在前第七卷少阳篇后已经讲得很明白。况且仲景在太阳篇中，一次说“妇人中风……经水适来，此为热入血室”，二次说“妇人中风……经水适断，此为热入血室”，三次说“妇人伤寒……经水适来，此为热入血室”。那么热入血室，明显是妇人的证候，到了这里，实在是不言自明。况且，此条说下血，应当是经期交错妄行，因此血室亏损，邪热得以乘虚而入，故形成热入血室之证。考《灵枢·海论》说：冲脉为十二经之海，注解说：这就是血海。冲脉起于胞中，前行者伴足少阴经，夹脐上行，至胸中而散。又考《素问·上古天真论》说：女子二七（14岁）天癸至，任脉通，太冲脉盛，月事按时而下。少阴、任脉、冲脉，其经脉都行于腹部，所以血液必从前阴而下。这样血室亏损，邪热才能进入。那么仲景说的“下血”，乃是经期交错妄行，不问自明。这个道理，如果不是读书明理的君子，谁能知道呢？）
以上一条是阳明病可刺的病例（从原论第五卷阳明治法中收集于此）
太阳与少阳并病，头项强痛，有时眩晕冒昧，有时像结胸，心下痞硬，应当刺大椎第一间、肺俞、肝俞，千万不要发汗。发汗则谵语，脉弦。五六天后，谵语不止，应当刺期门。（“间”读去声。太少并病，本是太阳表邪不衰，并入少阳而共同发病，所以叫并病。“并”就像秦兼并六国，并则势力大了。太阳脉，络头下项，所以头项强痛。少阳脉，循胸络胁，所以像结胸，心下痞硬。二阳之脉，皆起于目而行于头，所以目眩而头冒。当刺大椎第一间，意思是应当刺大椎一穴，在第一椎之间，为背部正中线穴位，乃手足三阳督脉之会。先刺它，以泻太少并病之邪。如果不愈，再刺两肺俞。盖肺主气，《尚论篇》说：刺肺俞以通其气，这样膀胱的气化运行，邪气自然不留。再刺肝俞，以泻少阳之邪，因为肝与胆两经相合，互为表里。慎不可发汗，是因为太阳之邪既并少阳，则发汗在所当禁。倘若误发其汗，则胃中津液干燥，木邪乘之，必发谵语而脉弦。到五六天，邪气应当解除而谵语不止，成无己注说：这是因为少阳邪热很盛。刺期门以泻肝胆之气。有人问：这条病在发汗后，谵语不止，又见心下痞硬，为什么不用下药？我回答说：仲景说“时如结胸”，则是心下虽然痞硬，但按压一定不痛，不是真正的结胸。况且，心下痞硬，而脉又见弦，乃肝木旺而乘胃土，多为少阳经证。虽然想用下法，岂敢轻下呢？）
Diagram of Qimen (LR14)
There are two Qimen (Liver Front-Mu Point, LR14) acupoints. The *Tu Jing* (Illustrated Classic) records: Located 1.5 cun lateral to Burong (ST19), directly above the nipple, at the end of the second rib. It is the Front-Mu point of the Liver and an intersection of the Foot-Jueyin Liver Meridian, Foot-Taiyin Spleen Meridian, and Yin-Wei Vessel. It can be needled to a depth of 0.4 cun. Moxibustion is contraindicated. Whenever needling Qimen, one must use the reducing method, not the reinforcing method. The *Huo Ren Shu* (Book that Revives People) states: For obese individuals, needle 2 cun; for thin individuals, needle 1.5 cun. It further states: Whenever treating women's diseases, one should needle Qimen. One must not use the Zi-Wu manipulation (Zi-Wu Dao Jiu technique), lest it entangle the organ membranes and draw Qi upward. Simply insert the needle, instruct the patient to inhale five times, retain the needle for a considerable period, and then slowly withdraw it. This is the gentle reducing method. Pang Anshi further stated: The method for needling Qimen requires the pulse to be wiry or floating-tight. After needling, recovery is certain; insertion to a depth of 1 cun is appropriate.
Hu Po notes: As recorded in the Tu Jing above, Burong (ST19) is located 1.5 cun lateral to Youmen (CV14), and Youmen is located 0.5 cun lateral to Juque (CV14). Juque is located on the anterior midline, 1.5 cun below the xiphoid process. Juque belongs to the abdominal midline, while Qimen belongs to the fourth lateral line of the abdomen. By carefully measuring the distances left, right, up, and down, the location of the acupoint becomes clear. The *Huo Ren Shu* states: The acupoint is directly below the nipple, where the ribs approach the abdomen. That is the second rib, counted from below upwards, exactly at both ends of the costal margin, which is the acupoint. Needling methods: Insert 1 cun for obese individuals, 0.5 cun for thin individuals, and take the middle depth for those of average build.
In Shanghan (Cold Damage), there is fever, aversion to cold with shivering, severe thirst, desire to drink water, abdominal fullness, spontaneous sweating, and free urination, indicating the disease is about to resolve. This is Liver Qi invading the Lungs, named "Heng" (Horizontal) syndrome. It is suitable to needle Qimen. (The three sentences regarding "spontaneous sweating... disease about to resolve" should follow the words "needle Qimen". "Shanghan fever, aversion to cold with shivering" indicates that the Wind pathogen of the Taiyang channel has not yet been eliminated. However, the Lung governs the skin and hair; thus, pathogens affecting the Hand-Taiyin Lung Meridian present similarly. "Severe thirst, desire to drink water": Cheng Wuji's commentary cites the *Yu Han Jing*, stating it as "severe thirst, desire to drink vinegar," from which we know this is due to excess Liver Qi. Liver Qi invading the Lung causes the Lung to suffer from pathogenic heat, leading to thirst and desire to drink. Excessive drinking leads to abdominal fullness. The Lung belongs to Metal, which normally controls Wood, but here it is invaded by Wood, an abnormal situation, hence called the "Heng" method. It is suitable to needle Qimen to reduce the excess Qi of the Liver Meridian. Cheng Wuji's commentary states: When Liver and Lung Qi are balanced, fluids disperse and body fluids circulate freely, manifesting externally as spontaneous sweating and internally as free urination, leading to resolution. Someone asked: This clause mentions fever and aversion to cold with shivering, as well as severe thirst and desire to drink water. How do we know it is not a Taiyang-Yangming combined pattern? I answered: If it were indeed Yangming Stomach heat causing severe thirst and desire to drink, the heat would consume fluids, and abdominal fullness might not occur. If the pathogenic heat had transmitted to Yangming, although some Taiyang pathogens might remain, aversion to cold with shivering would likely not persist. Thus, Cheng Wuji noted that "severe thirst, desire to drink water" is due to excess Liver Qi.)
The above two clauses concern treatable cases in Taiyang disease (Collected from Chapter 3, Treatment Methods of Taiyang, in the original treatise).
A woman with Fengzhong (Wind Strike) presents with fever and aversion to cold. Her menstruation happens to begin. After seven or eight days, the fever subsides, the pulse becomes slow, the body feels cool, there is fullness in the chest and hypochondrium resembling Jie Xiong (Chest Binding), and she experiences delirium. This is Re Ru Xue Shi (Heat Entering the Blood Chamber). One should needle Qimen and apply the reducing method according to the excess condition. (Fever and aversion to cold indicate the exterior syndrome is unresolved. Originally, this was Fengzhong in a woman. With intense wind-heat forcing blood to move recklessly, menstruation begins. At seven or eight days, it is the time when pathogens are about to transmit inward. Pathogens enter the Blood Chamber through deficiency. Fever subsiding, pulse slowing, and body cooling: Cheng Wuji's commentary states that pathogens have sunk inward and exterior symptoms have ceased. Fullness in the hypochondrium resembling Jie Xiong and delirium: The Tiao Bian commentary states that the Blood Chamber is where Ying-Blood accumulates and meridians converge, i.e., the Chong Mai (Penetrating Vessel), also known as the Sea of Blood. Its vessel originates at Qichuang, runs alongside the Shaoyin Meridian, ascends flanking the umbilicus, and disperses in the chest. Thus, heat entering causes these symptoms. The method dictates needling Qimen because Qimen is the Front-Mu point of the Liver, and the Liver governs Blood. Heat in the blood leads to stasis-heat entering the Blood Chamber, and stasis inevitably returns to the Liver. Therefore, following the excess of the meridian, one uses needling to reduce it. Cheng Wuji's commentary instead says: Examine which meridian has excess Qi and reduce it accordingly, which is truly incomprehensible. I believe this case, although listed under Taiyang treatment methods by Zhang Zhongjing, actually involves Shaoyang pathogens transmitting to Jueyin, causing excess heat in the blood level, resulting in delirium etc. Zhang Zhongjing feared physicians might mistake this for Yangming Fu-organ excess and lightly use the Three Chengqi Decoctions to attack Stomach Qi, so he specifically presented the method of needling Qimen for treatment. Furthermore, Zhang Zhongjing said "resembling Jie Xiong," implying hypochondriac fullness. Although it resembles Jie Xiong, pressing it will not cause pain, indicating it is not Stomach excess. Moreover, even if there is hypochondriac pain, it is not in the chest, showing the pathogen is confined to the Liver and Gallbladder regions. Zhang Zhongjing's use of needling at that time was truly miraculous.)
The above one clause concerns a treatable case in Taiyang disease (Collected from Chapter 4, Treatment Methods of Taiyang, in the original treatise).
In Yangming disease, bleeding from the lower orifices accompanied by delirium indicates Heat Entering the Blood Chamber. There is sweating only on the head. Needle Qimen and apply the reducing method according to the excess condition. Profuse sweating follows, and the disease resolves. (Note: This clause likely also refers to a woman's disease. Pathogenic heat stagnates in the Yangming Meridian. Yangming has abundant Qi and Blood. Intense pathogenic heat forces blood downward. As blood flows out, the meridians become empty, allowing heat to enter the chamber vacuously, also causing delirium. The later Tiao Bian commentary states: Although the Blood Chamber belongs to the Chong Mai, the Heart Sovereign is the master of the Blood Chamber. When the chamber is disturbed by heat, the master becomes confused. Sweating only on the head occurs because blood loss depletes sweat sources, while heat disturbing upward causes head sweating. Needling Qimen reduces excess in the meridian, clearing pathogenic heat and restoring body fluids, leading to profuse sweating and resolution. Someone asked: In this clause, Zhang Zhongjing does not specify if it is a woman, so various commentators directly identify it as a man. Why do you insist on interpreting it as a woman's disease? I answered: Although the Blood Chamber exists in both men and women, the syndrome of Heat Entering the Blood Chamber occurs only in women. I explained this clearly after the Shaoyang chapter in Volume 7. Moreover, in the Taiyang chapter, Zhang Zhongjing states once: "Woman with Fengzhong... menstruation just began, this is Heat Entering the Blood Chamber"; twice: "Woman with Fengzhong... menstruation just stopped, this is Heat Entering the Blood Chamber"; and thrice: "Woman with Shanghan... menstruation just began, this is Heat Entering the Blood Chamber." Thus, Heat Entering the Blood Chamber is clearly a woman's syndrome, which is self-evident here. Furthermore, this clause mentions lower bleeding, which implies irregular menstrual flow. Consequently, the Blood Chamber is deficient, allowing pathogenic heat to invade, forming the Heat Entering the Blood Chamber syndrome. Consulting the *Ling Shu - Hai Lun*: "The Chong Mai is the Sea of the Twelve Meridians." The commentary adds: "This is the Sea of Blood." The Chong Mai originates in the uterus, runs forward alongside the Foot-Shaoyin Meridian, ascends flanking the umbilicus, and disperses in the chest. Also consulting the *Su Wen - Tian Zhen Lun*: "At age fourteen (two sevens), a woman's Tian Gui arrives, the Ren Mai becomes patent, the Tai Chong Mai flourishes, and menstruation occurs regularly." The Shaoyin, Ren, and Chong meridians all run through the abdomen, so blood must exit via the anterior yin. Thus, when the Blood Chamber is deficient, pathogenic heat can enter. Therefore, Zhang Zhongjing's mention of "lower bleeding" refers to irregular menstrual flow, which is self-evident. This principle can only be understood by scholars who study books and comprehend principles.)
The above one clause concerns a treatable case in Yangming disease (Collected from Chapter 5, Treatment Methods of Yangming, in the original treatise).
When Taiyang and Shaoyang Bingbing (Combined Disease) occur, there is stiffness and pain in the head and neck, occasional dizziness and vertigo, sometimes resembling Jie Xiong with epigastric hardness. One should needle Dazhui (GV14) at the first interspace, Feishu (BL13), and Ganshu (BL18). Do not induce sweating. Inducing sweating will cause delirium and a wiry pulse. After five or six days, if delirium persists, one should needle Qimen. ("Jian" is pronounced with the departing tone). In Combined Disease of Taiyang and Shaoyang, the Taiyang exterior pathogen remains strong and merges with Shaoyang, causing simultaneous illness, hence "Combined Disease." "Combined" is like Qin annexing the six states; combining increases power. The Taiyang meridian connects the head and neck, causing stiffness and pain in the head and neck. The Shaoyang meridian traverses the chest and hypochondrium, causing symptoms resembling Jie Xiong and epigastric hardness. Both Yang meridians originate from the eyes and travel to the head, causing dizziness and vertigo. "Needle Dazhui at the first interspace" means needling the single acupoint Dazhui, located between the first thoracic vertebrae, on the posterior midline, an intersection of the Hand and Foot Triple Yang meridians and the Du Mai. Needle it first to drain the pathogens of the Combined Disease. If ineffective, needle both Feishu points. Since the Lung governs Qi, the *Shang Lun Pian* states: Needling Feishu unblocks Qi, allowing Bladder Qi transformation to function, so pathogens do not linger. Then needle Ganshu to drain Shaoyang pathogens, as the Liver and Gallbladder meridians are interior-exterior pairs. Do not induce sweating because, once Taiyang pathogens merge with Shaoyang, inducing sweating is prohibited. If mistakenly induced, Stomach fluids dry up, Wood pathogens invade, causing delirium and a wiry pulse. By day five or six, pathogens should resolve, but if delirium persists, Cheng Wuji's commentary states: This is due to intense Shaoyang pathogenic heat. Needle Qimen to drain Liver and Gallbladder Qi. Someone asked: After inducing sweating in this case, delirium persists, and epigastric hardness is seen. Why not use purgatives? I answered: Zhang Zhongjing said "sometimes resembling Jie Xiong," meaning although the epigastrium is hard, pressing it causes no pain, so it is not true Jie Xiong. Moreover, epigastric hardness with a wiry pulse indicates Liver Wood overacting on Stomach Earth, mostly representing Shaoyang meridian syndromes. Although one might wish to purge, how could one lightly use purgation?)