Lingshu · Withdrawal and Mania

The text

The canthus that opens outward on the face is the sharp canthus. That inward, near the nose, is the inner canthus. The upper is the outer canthus; the lower is the inner canthus. When withdrawal first arises, there is first unhappiness, a heavy aching head; the gaze lifts the eyes; the red is extreme and then peaks; afterward the heart is vexed. Watch for it on the forehead; take hand taiyang, yangming, and taiyin; stop when the blood changes. When withdrawal first acts, pulling the mouth, crying out, panting and palpitating: watch hand yangming and taiyang. If the left is strong, attack the right; if the right is strong, attack the left; stop when the blood changes. When withdrawal first acts, first there is backward rigidity, and thus pain in the spine. Watch foot taiyang, yangming, taiyin, and hand taiyang; stop when the blood changes. To treat withdrawal, dwell with the person always; watch the places that should be taken. When the illness arrives, look at what has transgression and drain it; place the blood in a gourd-pot; when the episode comes, that blood alone will move. If it does not move, moxa the exhausted bone twenty cones. The exhausted bone is the tail-bone. Bone withdrawal: the cheeks, the teeth, all the shu and the divided flesh are full, and the bones sit; sweat goes out, vexation and oppression; much vomiting of froth; qi discharges downward — do not treat. Sinew withdrawal: the body is weary, contracted, tight and large. Needle the great-shuttle vessel of the great channel of the nape. Much vomiting of froth, qi discharging downward — do not treat. Vessel withdrawal: sudden falling; the vessels of the four limbs all swell and slacken. If the vessels are full, needle them all and let blood; if not full, moxa taiyang flanking the nape, moxa the belt vessel at the waist three cun apart, and the various divided-flesh root shu. Much vomiting of froth, qi discharging downward — do not treat. Withdrawal whose episodes issue like mania: death, and there is no treating it. When mania first arises, there is first grief at oneself; one is apt to forget, bitter anger, apt to fear — this is got from worry and hunger. Treat by taking hand taiyin and yangming; stop when the blood changes; and take foot taiyin and yangming. When mania first issues: little sleep, no hunger; one takes oneself for high and worthy, takes oneself for discerning and wise, takes oneself for honored and noble; one is apt to curse and revile, day and night without rest. Treat by taking hand yangming, taiyang, taiyin, below the tongue, and shaoyin. Look at what is abundant and take it all; what is not abundant, let it go. Wild speech, fright, apt to laugh, fond of song and music, walking wildly without rest — this is got from great fear. Treat by taking hand yangming, taiyang, and taiyin. Mania, the eyes seeing wildly, the ears hearing wildly, apt to sing — this is born of little qi. Treat by taking hand taiyang, taiyin, yangming, foot taiyin, and the two cheeks of the head. The manic eat much, are apt to see ghosts and spirits, apt to laugh without it issuing without — this is got from a great joy. Treat by taking foot taiyin, taiyang, yangming; afterward take hand taiyin, taiyang, yangming. Mania newly issued, not yet like this: first take the arterial vessels left and right of the crooked spring, and where it is abundant let blood be seen; in a short while it ends. If it does not end, take it by the method; moxa the tail-bone twenty cones. Wind-reversal, sudden swelling of the four limbs, the body dripping, sighing with cold at times; when hungry, vexed; when full, apt to change. Take the outer and inner of hand taiyin, and the channels of foot shaoyin and yangming. If the flesh is clear-cold, take the brooks; if the bones are clear-cold, take the wells and the channels. Reversal as illness: the feet suddenly clear-cold; the chest as if about to split; the intestines as if a knife were cutting them; vexed and unable to eat; the vessels, large and small, all rough. If warm, take foot shaoyin; if clear-cold, take foot yangming. If clear-cold, fill; if warm, drain. Reversal, the abdomen swollen and full, the intestines sounding, the chest full, unable to breathe: take below the chest at the two flanks; those that cough and move the hand, and the back shu; what feels immediate ease when pressed with the hand — that is it. Inward closure, unable to pass urine: needle foot shaoyin and taiyang and above the tail-bone with a long needle. If qi reverses, take taiyin, yangming, jueyin; if severe, take the channels of shaoyin and yangming that move. Little qi, the body dripping, speech drawn in with the breath, the bones sore, the body heavy, slack and unable to move: fill foot shaoyin. Short breath, the breath short and not joining, movement making qi fail: fill foot shaoyin, and remove the blood collaterals.

The line

When withdrawal first arises, there is first unhappiness, a heavy aching head; the gaze lifts the eyes; the red is extreme and then peaks; afterward the heart is vexed. Watch for it on the forehead; take hand taiyang, yangming, and taiyin; stop when the blood changes.

The note

When it first arises, there is first unhappiness. Withdrawal and mania are yin and yang run to two extremes. Seeing "first unhappiness" matters more than seeing the later grand name.