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Lingshu: Chapter 21 – Cold and Heat Diseases

Plain-Language Interpretation of Lingshu · Chapter 21: Cold and Heat Diseases

Overall Paraphrase

⚠️ The following content is an academic interpretation of a Chinese medicine classic. The acupuncture, acupoint, and disease-pattern discussions are provided for scholarly study only and do not constitute any treatment advice.

Cold–Heat Diseases of the Skin, Flesh, and Bone

Cold–heat disease of the skin: When pathogenic qi resides in the skin and body hair, the body feels hot and the patient cannot lie down upon the mat. The body hair is withered, the nose is dry with no moisture, and there is no sweating. The ancient method of treatment was to select the collateral points of the three yang channels* and supplement the Hand Great Yin Lung Channel 🌿.
Cold–heat disease of the flesh: When pathogenic qi resides in the flesh, there is muscle pain, withered body hair, a dry nose, and also no sweating. The treatment is to select the lower collateral vessels of the three yang channels of the foot, remove stagnant blood, and then supplement the Foot Great Yang Channel to promote sweating 💨.
Cold–heat disease of the bone: When pathogenic qi resides in the bone, the patient is agitated and restless, with incessant sweating. If the teeth are not yet withered, one may select the collateral of the Foot Lesser Yin Channel on the inner aspect of the thigh; if the teeth are already withered, it indicates decline and depletion of essential qi, and the ancients considered the prognosis poor. Bone reversal (gu jue) is similar to this condition.
Bone Bi (bone impediment): Joints are difficult to move and painful, with sweating and restlessness. One may select the transport points of the three yin channels for supplementation.
Lethargic body (ti duo): When the body is injured with excessive bleeding and is then affected by wind–cold, or after falling from a height, resulting in the four limbs being lax, limp, and unable to move with strength—this is called "lethargic body." One may select the three bindings (san jie jiao) below the navel, i.e., the Guan Yuan point three cun below the navel.

Reversal–Bi and the Five Regions of Tian You

Reversal–Bi (jue bi): The qi of counterflow surges upward to the abdomen. For treatment, select the collaterals of the yin and yang channels. Observe which channel is chiefly affected; for this, drain the yang channels and supplement the yin channels.
The pulsating artery on the side of the neck is the Ren Ying point, which belongs to the Foot Yang Brilliance Channel, located in front of and beside the major sinew beside the larynx. Behind the major sinew is the Fu Tu point, belonging to the Hand Yang Brilliance Channel. Further back is the Tian You point. In the original text, the channel attribution at this point is a transmission error; according to the commonly received edition, it should belong to the Hand Lesser Yang Channel. Further back still is the Tian Zhu point, belonging to the Foot Great Yang Channel. The pulsating artery in the armpit is the Tian Fu point, belonging to the Hand Great Yin Channel.
When yang heat reverses upward and causes headache, chest oppression, and impeded breathing, select Ren Ying. For sudden loss of voice with qi blockage at the throat, select Fu Tu and let blood from the base of the tongue. For sudden deafness with clouding of qi and unclear vision, select Tian You. For sudden cramping, dizziness, and feet unable to support the body, select Tian Zhu. For sudden heat disease with internal counterflow, when the qi of the liver and lungs clash, causing hemorrhage from the mouth and nose, select Tian Fu. These are the Five Regions of Tian You.

Face and Tooth-Related Points and the Heel (Qiao) Vessels

The Yang Brilliance Channel has a branch that enters the cheek and spreads through the teeth. The corresponding point is called Da Ying, which is selected for caries of the lower teeth. If there is aversion to cold, use supplementation; if there is no aversion to cold, use drainage.
The Great Yang Channel has a branch that enters the vertex and spreads through the teeth. The corresponding point is called Jiao Sun, which is selected for caries of the upper teeth and is located at the nose and the front of the neck. The channel attribution at this point in the original text is also a transmission error; in the commonly received edition, Jiao Sun belongs to the Hand Lesser Yang Channel.
At the height of the acute condition, the local vessel is full. When the vessel is full, use drainage; when the vessel is deficient, use supplementation. Another tradition says to select the point on the outer side of the nose.
The Foot Yang Brilliance Channel has a branch that flanks the nose and enters the face. This is called **Xuan Lu, which connects to the mouth and internally connects with the eye system. Examine the abnormality at this site and select it accordingly. In excess conditions, drain the surplus; in deficiency conditions, supplement the insufficiency. Using the opposite approach will aggravate the condition.
The Foot Great Yang Channel has a branch that travels from the nape into the brain and directly connects with the root of the eye, and is called the eye system. For pain in the head and eyes, select the site between the two sinews at the nape; only after entering the brain do the channel branches diverge.
The Yin Heel Vessel and the Yang Heel Vessel intersect, with yang entering yin and yin emerging from yang, meeting at the outer canthus of the eye. When yang qi is predominant, the eyes open; when yin qi is predominant, the eyes close.

Reversal Patterns, Four-Season Needling Methods, and Harmful Needling Practices

Heat reversal (re jue) : Select the Foot Great Yin Channel and Foot Lesser Yang Channel with retained needles. Cold reversal (han jue) : Select points on the foot of the Foot Yang Brilliance Channel and Foot Lesser Yin Channel with retained needles.
When the tongue is flaccid and loose, saliva drips from the mouth, and the chest and heart are oppressed and agitated: select the Foot Lesser Yin Channel. For shivering with aversion to cold, chattering teeth, absence of sweating, and abdominal fullness with restlessness: select the Hand Great Yin Channel.
When needling deficiency conditions, follow the direction of qi movement for supplementation. When needling excess conditions, meet the qi coming toward the needle for drainage.
In spring, select mostly the collaterals; in summer, select mostly the flesh spaces and striae (cou li) ; in autumn, select mostly the qi opening (qi kou) ; in winter, select mostly the channel transport points (jing shu) . Each of the four seasons has needling standards appropriate to its prevailing qi. The collaterals govern the skin, the striae and intermuscular spaces govern the flesh, the qi opening governs sinews and vessels, and the channel transport points govern the marrow and the five viscera.
There are five important regions of the body: first, the Fu Tu point (at the upper-anterior thigh); second, the calf (fei) body (back); fourth, the back-shu points of the five viscera; and fifth, the nape region. The ancients considered that if carbuncle or deep abscess arises in any of these five regions, the prognosis is poor.
When a disease first arises from the arm and hand, first select points from the Hand Yang Brilliance Channel and Hand Great Yang Channel to promote sweating for the nape to promote sweating. When a disease first arises from the lower leg and foot, first select the greater yang channel at the sacral hip to enable sweating. If the disease arises at a counter pattern, Qi disease affecting generalized Yang, then implement mental counter-treatment avoiding "dark fire above.
Therefore, when after needling the yin channels there is excess sweating, one may needle the Fu s to Stop the sweat. Blood-likewise w the skin: For effects of that in. 二指 practice

Therefore, if after needling the yin channels, sweating is excessive, one may needle the yang channels to stop the sweating. If after needling the yang channels, sweating is excessive, one may needle the yin channels to stop the sweating in order it. are counter patterns.

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🧠 Deeper Understanding

Core Principles 💡

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