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Huangdi Neijing · The Yellow Emperor’s Inner Canon
Lingshu 22 · Dian and Kuang Disorders
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The corner of the eye opening outward toward the face is the pointed canthus. The inner corner near the nose is the inner canthus. Above is called outer canthus and below inner canthus.
At the beginning of dian illness there is first unhappiness, heavy headache and an upturned gaze; marked redness accompanies the height of the attack, followed by vexation of the heart. Observe the forehead and address Hand Taiyang, Yangming and Taiyin, stopping when the blood changes. When an initial dian attack pulls the mouth and brings crying, shouting, panting and palpitations, observe Hand Yangming and Taiyang. If the left side is rigid, attack the right; if the right is rigid, attack the left. Stop when the blood changes. When the initial attack first brings backward rigidity and then spinal pain, observe Foot Taiyang, Yangming and Taiyin and Hand Taiyang; stop when the blood changes.
Dian and kuang are the source’s historical disorder categories, not exact modern diagnoses. The upper/lower canthus wording is retained alongside the preceding outer/inner distinction.
In treating dian illness, remain continually with the patient and observe which places should be addressed. When an attack comes, inspect for disordered sites and drain them. Put the blood in a gourd vessel. The text says that when another attack occurs, the blood alone moves. If it does not move, it prescribes twenty moxibustion cones at Qionggu, explaining Qionggu as the yan bone.
The source uses an anomalous flame-related graph in this bone name; it is not converted into a modern anatomical landmark. The moving blood is the historical text’s claim.
In bone dian, the cheeks, teeth, transporting sites and divisions of flesh are all full while the bone stands out; sweat and vexed oppression occur. Much vomiting of froth and qi leaking downward are declared beyond treatment.
In sinew dian the body is fatigued, with severe contraction and tension. Needle the Dazhu vessel of the great channel at the nape. Much vomiting of froth and qi leaking downward are declared beyond treatment.
In vessel dian there is sudden collapse, and the vessels of all four limbs swell and become slack. When the vessels are full, needle them all to draw blood. When not full, apply moxibustion to Taiyang beside the nape, to the belt vessel at the waist at the stated spacing of three cun, and to the root transporting sites in the divisions of flesh. Much vomiting of froth and qi leaking downward are declared beyond treatment. The text declares a dian attack resembling kuang fatal and beyond treatment.
The compressed description of the bones and the waist spacing is retained without supplying missing anatomical details.
Kuang first arises with sadness, frequent forgetting, distressing anger and ready fear, attributed to anxiety and hunger. Address Hand Taiyin and Yangming until the blood changes, and also Foot Taiyin and Yangming.
At an initial attack, the patient sleeps little and feels no hunger, considers himself exceptionally worthy, clever and noble, and curses without rest day and night. Address Hand Yangming, Taiyang and Taiyin, and Shaoyin beneath the tongue. Inspect them: address all that are abundant and leave those that are not.
Wild speech, fright, frequent laughter, fondness for singing and music and ceaseless aimless activity are attributed to great fear. Address Hand Yangming, Taiyang and Taiyin. Seeing unreal things, hearing unreal sounds and frequent singing are attributed to scant qi. Address Hand Taiyang, Taiyin and Yangming, Foot Taiyin and both sides of the head at the cheeks.
Eating much, frequently seeing ghosts and spirits and laughing without outward expression are attributed to a great joy. Address Foot Taiyin, Taiyang and Yangming, then Hand Taiyin, Taiyang and Yangming. In newly arising kuang not yet responding in this way, first address the moving vessels at left and right Ququan and draw blood from abundant sites. It should cease after a short time. If it does not, address it according to the method and apply twenty moxibustion cones at the named yan-bone region.
The bone name at the close has the same anomalous flame-related graph as the preceding record. No modern location is supplied.
Wind counterflow brings sudden swelling of the four limbs, a slack, weary body and sighing with intermittent cold. Hunger causes vexation, and fullness brings frequent changes. Address the exterior and interior of Hand Taiyin and the Foot Shaoyin and Yangming channels. For cold in the flesh address the spring sites; for cold in bone address the well and channel sites.
Reversal counterflow brings sudden cold feet, a chest seeming about to split and intestines seeming cut with a knife, with vexation and inability to eat. Both large and small pulses are rough. For warmth address Foot Shaoyin; for cold address Foot Yangming. If cold, supplement; if warm, drain.
For reversal counterflow with abdominal distension, rumbling intestines and chest fullness preventing breathing, address the two spaces below the chest that move against the hand during coughing, together with the back transporting sites. The appropriate site is one where pressure promptly gives relief.
For internal closure and inability to urinate, needle Foot Shaoyin, Taiyang and above the yan-bone region with a long needle. For rising counterflow, address Taiyin, Yangming and Jueyin; if severe, address the moving channel sites of Shaoyin and Yangming.
Scant qi brings a weary, slack body, gasping speech, aching bones, bodily heaviness and lassitude preventing movement: supplement Foot Shaoyin. For short qi, short disconnected breaths and exhaustion of qi on movement, supplement Foot Shaoyin and remove blood from networks.
The source’s warm/cold treatment sequence is retained as written, without reversing or harmonizing its channel assignments.
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