Engorging the vessel
This aims to expose the vessel so it can be easily bled. Different methods are adopted at different sites. For the vertex, scalp and the occipital parts, a bandage is applied around the occiput and the eyebrows, while a small rod ,be used to strangulate from the nape. For bloodletting from the dental, eye care, ear and nose vessels, bandaging at the root of the neck above the clavicle is applied.

The thread is tightened in the front part of the neck. For the tongue vessel, retract the tongue to expose the vessels underneath, using a bamboo or wood clamp wrapped in cloth to clamp the tongue. For bloodletting from the arm, use a slender thread and tie it just below the goat-tail muscle (deltoid); for that of the forearm, tie it at a site three fingers breadth above the cubital fossa; for the hand vessels, tie it above the wrist. For bloodletting at the two major vessels, tie it at a site four-finger breadth above the knee; for bloodletting below the two major vessels, tie it just above the ankle, the same applying to the foot. To let out blood in the abdominal region, tie at the level of the 10th vertebra around the body and use a small rod to strangulate on the left side when operating on the right side, and vice versa. For bloodletting from the male genitalia, tie at the root of the scrotum around the thigh and strangulate with a rod above the
hip bone.

The skinat the site of bloodletting must be rendered smooth without wrinkles or folding. When the vessels are engorged and congested, gently massage the site so as to relax the local part and minimize pain sensation.

Cutting
The site for cutting should be smooth and even. The operator uses the left fingers to stretch the skin so as to fix the vessels and to exposethe engorged vessels. For large vessels, the incision should be in the direction of the vessel, while for the small ones, an oblique direction with an angle should be adopted.
For minute .vessels, it should be cut right-angled. The size of incision should be similar to the caliber of the vessel so as to facilitate the running out of impaired blood and qi. When the vessel is near a bone, use a lancet so that the vessel can be cut open and the required amount of blood allowed to flow out.
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