Heat Disease

Hemiplegia: The body is immobile on one side with pain, but speech remains unchanged and consciousness is not confused. The disease is located between the muscles and the interstices. Treatment with a large needle, supplementing what is deficient and draining what is excessive, can lead to recovery.

Paralysis: There is no pain in the body, but the limbs are slack and cannot be controlled. If consciousness is not severely confused and speech can still be faintly understood, it is treatable. If it becomes severe to the point of inability to speak, it is incurable. When pathogenic factors first invade the yang aspect and then enter the yin aspect, first needle the yang aspect, then needle the yin aspect, using a shallow needling technique.

On the third day of heat disease, if the qi-kou pulse is calm but the ren-ying pulse is agitated, needle the various yang channels using the fifty-nine needling method to drain the heat pathogen, induce sweating, and replenish the yin aspect to supplement deficiencies. If the body is severely hot but both yin and yang pulses are calm, do not needle. For those that can be needled, quickly select points; if sweating does not occur, the heat pathogen should be drained outward. What is meant by not needling is the presence of signs of death. On the seventh or eighth day of heat disease, if the mai-kou pulse throbs with rapid, short breathing, quickly needle; sweat will naturally emerge. Shallowly needle between the thumb and index finger. On the seventh or eighth day of heat disease, if the pulse is minute, the patient has hematuria, and the mouth is dry, death occurs within one and a half days. If a dai pulse appears, death occurs within one day. When heat disease has already produced sweat but the pulse remains agitated, with panting and recurrence of fever, do not needle the skin; severe panting leads to death. On the seventh or eighth day of heat disease, if the pulse is not agitated, or is agitated but not scattered or rapid, sweating will occur within three days. If sweating does not occur within three days, death occurs on the fourth day. If sweating has not yet occurred, do not needle the interstices.

In heat disease, the first sign is skin pain, nasal congestion, and facial fullness. Needle the skin using the first needle (chan needle), selecting fifty-nine points. If small papules appear in the nose, treat at the skin region of the lung; if ineffective, seek treatment from fire, which corresponds to the heart. In heat disease, the first sign is bodily sluggishness, leaning and feeling hot, restlessness with bending and stretching, and dry lips. Treat by needling the skin using the first needle (chan needle), at the fifty-nine points. If the skin is distended, the mouth is dry, and there is cold sweating, treat at the vessel region of the heart; if ineffective, seek treatment from water, which corresponds to the kidney. In heat disease, dry mouth with excessive drinking, easy fright, and inability to rise from bed. Needle the skin and muscles using the sixth needle (yuanli needle), at the fifty-nine points. If the corners of the eyes are cyanotic, treat at the flesh region of the spleen; if ineffective, seek treatment from wood, which corresponds to the liver. In heat disease, the complexion is cyanotic, there is headache, and the hands and feet are restless. Needle between the sinews using the fourth needle (feng needle), at points where the limbs are cold. If the sinews are weak and limp, with eyes weeping, treat at the sinew region of the liver; if ineffective, seek treatment from metal, which corresponds to the lung. In heat disease, there are frequent convulsions, twitching, and mania. Needle the blood vessels using the fourth needle (feng needle), quickly draining what is excessive. If there is epilepsy with hair loss, treat at the blood region of the heart; if ineffective, seek treatment from water, which corresponds to the kidney. In heat disease, the body is heavy, the bones and joints ache, there is deafness, and a preference for closing the eyes. Needle the bones using the fourth needle (feng needle), at the fifty-nine points, needling the bones. If the patient cannot eat, grinds the teeth, and the ears are cyanotic, treat at the bone region of the kidney; if ineffective, seek treatment from earth, which corresponds to the spleen.

In heat disease, if the patient does not know the location of pain, is deaf, cannot control the limbs, has a dry mouth, severe yang heat, and slight cold signs in the yin aspect, the heat is in the bone marrow; it is fatal and untreatable. In heat disease, with headache, twitching in the temporal region and eyes, pulse pain, and easy nosebleeds, this is jue-heat disease. Use the third needle (di needle) to needle, adjusting according to deficiency and excess, and treat cold-heat hemorrhoids. In heat disease, the body is heavy and the intestines are hot. Use the fourth needle (feng needle) to needle the back shu points and the points between the toes, seeking qi in the luo vessels of the stomach channel. In heat disease, there is spasmodic pain on both sides of the navel, and fullness in the chest and ribs. Needle Yongquan and Yinlingquan using the fourth needle (feng needle), and needle inside the throat. In heat disease, if sweating occurs and the pulse is favorable for inducing more sweat, needle Yuji, Taiyuan, Dadu, and Taibai. Using drainage removes the heat pathogen; using supplementation induces sweating. If sweating is excessive, needle the transverse vessel above the inner ankle to stop sweating.

In heat disease, if sweating has already occurred but the pulse remains agitated and large, this indicates the yin pulse has reached its extreme; death will follow. If the pulse becomes calm after sweating, the patient can survive. In heat disease, if the pulse remains large and agitated without sweating, this indicates the yang pulse has reached its extreme; death will follow. If the pulse is large and agitated but becomes calm after sweating, the patient can survive.

There are nine conditions in heat disease where needling is contraindicated: First: no sweating, red cheekbones, and hiccups—death. Second: diarrhea with severe abdominal distension—death. Third: blurred vision and unremitting fever—death. Fourth: fever with abdominal distension in the elderly and infants—death. Fifth: no sweating, vomiting, and bloody stools—death. Sixth: ulceration of the root of the tongue with unremitting fever—death. Seventh: cough with nosebleed, no sweating, or sweating that does not reach the feet—death. Eighth: bone marrow heat—death. Ninth: fever with tetany—death. The manifestations of tetany are arching of the back, convulsions, clenched jaw, and grinding teeth. In these nine cases, needling is contraindicated.

The so-called fifty-nine needling points are: three points on each of the inner and outer sides of both hands, totaling twelve. One point between each finger, totaling eight, and the same for the feet. On the head, one cun within the hairline, three fen lateral, three points on each side, totaling six. Three cun within the hairline, five points on each side, totaling ten. One point each in front of and behind the ear, one below the mouth, and one at the nape, totaling six. One point at the crown of the head, one at Conghui, one at the hairline, one at Lianquan, two at Fengchi, and two at Tianzhu.

For fullness in the chest and shortness of breath, needle the tip of the big toe of the foot taiyin channel, at a distance from the nail as wide as a leek leaf. For cold conditions, retain the needle; for heat conditions, withdraw quickly. Stop when qi descends. For sudden pain from cardiac hernia, needle the foot taiyin and foot jueyin channels, draining all blood from the congested luo vessels. For throat bi with curled tongue, dry mouth, restlessness, heart pain, and pain on the inner side of the arm unable to lift to the head, needle below the nail of the ring finger, at a distance from the fingertip as wide as a leek leaf. For red, painful eyes starting from the inner canthus, needle the yin qiao vessel. For wind tetany with the body arching backward, first needle the foot taiyang channel, the popliteal fossa, and the blood luo vessels to drain blood. If there is internal cold, needle Zusanli. For urinary retention, needle the yin qiao vessel and the three hairs on the big toe, and drain blood from the blood luo vessels. For men as if suffering from gu disease and women as if suffering from nu disease, with the body and lower back feeling as if they will fall apart and no desire to eat, first needle Yongquan to drain blood, then observe the dorsal vessels of the foot; if they are engorged, drain blood from them all.