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When performing needle manipulation, tonification and reduction (Bu-Xie) must distinguish between cold and heat. To treat cold conditions, use tonification; to treat heat conditions, use reduction. When twisting the needle handle, rotating the thumb outward (forward) constitutes reduction; rotating the thumb inward (backward) constitutes tonification. For reducing the left meridians, rotate the thumb forward; for reducing the right meridians, pull the thumb backward. For tonifying the left meridians, rub the thumb forward; for tonifying the right meridians, pull the thumb downward. Why are there two types of tonification and reduction? This is because the Qi of the meridians circulates on both sides of the body. Tonification and reduction also require understanding "Ying-Sui" (Following and Opposing): following the meridian direction is tonification, opposing the meridian direction is reduction. Ancients distinguished tonification and reduction by left and right, while modern practitioners distinguish them by gender. However, the meridian generation in men and women is identical, circulating day and night without pause. The Yang meridians of the hands ascend to the head, while the Yin meridians descend from the fingers toward the torso; the Yang meridians of the feet descend from the head to the feet, while the Yin meridians ascend from the feet to the abdomen. "Sui" (Following) means advancing the needle tip along the meridian's direction; "Ying" (Opposing) means advancing the needle tip against the meridian's direction to seize the pathogenic factor. There is also a method of determining tonification and reduction through respiration: reduce during inhalation, tonify during exhalation. This is truly wondrous. For tonification, withdraw the needle during the patient's exhalation and insert it during inhalation. One must know the "San Fei" (Three Flights) technique: after Qi arrives, withdraw the needle, insert during inhalation, withdraw rapidly once, and quickly press the acupoint. For reduction, insert the needle during the patient's inhalation and withdraw it during exhalation. One must know that Qi and Blood permeate the whole body; after Qi arrives, withdraw the needle during exhalation, withdraw slowly three times, open the needle hole, and press. This secret was revealed by Zisang Jun. I now transmit it to you, whose mind is as clear as snow. This is the profound mystery within tonification and reduction; do not easily reveal it to others.

Human Qi and Blood never cease their movement, circulating dynamically with respiration. During exhalation, Qi moves three cun; during inhalation, it also moves three cun. In one breath cycle, Qi moves six cun. After 270 pulse beats, the pulse Qi travels 60 zhang and 2 chi. Accumulating these calculations, the Qi and Blood complete one circuit around the body. Tonification and reduction are distinct, allowing one to discern slippery or choppy pulses. How many breaths occur in one shichen (two hours)? 1,125 breaths. The pulse Qi travels 67 zhang and 5 chi. After four circuits around the body, some time remains. Let me explain the remainder: in 45 breaths, Qi moves 2 zhang and 7 chi. How many breaths constitute a full day-night cycle? 13,500 breaths. The pulse Qi travels 810 zhang. Completing 500 circuits, the circulation of Qi and Blood around the body finishes. This is the Song of Qi and Blood describing a healthy person. A slow pulse indicates cold, a rapid pulse indicates heat; they cannot be treated alike.

Heaven generates Water with One, Earth completes it with Six. Earth generates Fire with Two, Heaven completes it with Seven. Heaven generates Wood with Three, Earth completes it with Eight. Earth generates Metal with Four, Heaven completes it with Nine. Heaven generates Earth with Five, Earth completes it with Ten. What diagram is this? It is the numerical generation of the Five Elements. One, three, five, seven, nine are odd numbers, belonging to Heaven. Two, four, six, eight, ten are even numbers, belonging to Earth. How can the numbers one through ten generate the Five Elements? It is said that since the separation of Heaven and Earth, Water appeared first, generated by Heaven One and Earth Six. Just as parents have children, the firstborn ranks first, hence "One and Six." The second batch of children ranks second, hence "Two and Seven generate Fire," and so on. The term "Sheng" (Generate) is like the father initiating creation; the term "Cheng" (Complete) is like the mother nurturing gestation.