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Acupuncture treatment for shoulder pain involves three methods:
The first method selects the Hand-Yangming Meridian. The classic states: Diseases generated by the Large Intestine Hand-Yangming Meridian include pain in the anterior shoulder. Treatment should be based on observing excess or deficiency, heat or cold, and sinking conditions.
The second method selects the Hand-Taiyang Meridian. The classic states: Abnormal movements of the Small Intestine Hand-Taiyang Meridian cause symptoms where the shoulder feels as if being pulled out or broken. Treatment should be based on observing excess or deficiency, heat or cold, and sinking conditions.
The third method targets the sinews (Jing-Jin). The classic states: Pathology of the Hand-Taiyang Sinew causes pain winding around the scapula and radiating to the neck, accompanied by tinnitus and pain in the ears. If both the Hand-Yangming and Foot-Taiyang Sinews are affected, leading to an inability to raise the shoulder, these conditions are treated with *Fanzhen Jiesi* (burning needle rapid puncture), using the improvement of symptoms as the endpoint and the painful area as the acupoint location.
[From *Dongfang*] Shoulder immobility, arm unable to lift: Select Jianliao (Shou Sanli) [Note: Text says 肩, likely Jianliao SJ14 or similar contextually, but literal is 'Shoulder'. Given depth 2.5 cun, likely Jianyu LI15 or Jianliao SJ14. Text says "肩", usually refers to Jianyu LI15 in this context of depth]. Depth 2.5 cun. Select Jugu (LI1), depth 0.5 cun. Select Qinglingyuan (SI11), depth 1 cun. Select Guanchong (SJ1), depth 0.5 cun.
[From *Yuji*] Swelling at the shoulder tip: Select Jianyu (LI15), depth 2.5 cun, use reducing method, nine inhalations. Select Wangu (SI4), depth 0.7 cun, reduce first then tonify. Pain in both scapulae: Select Jianjing (GB21), depth 2.5 cun, do not retain needle for long. Select Zhigou (SJ6).
[From *Jia Yi*] Stiffness in shoulder/back preventing looking back, governed by Qishe (ST11). Heat in the center of the shoulder, pain in fingers and arms, governed by Jianliao (SJ14). Pain in shoulder and elbow joints difficult to flex and extend, arm unable to lift, heavy and urgent wrist, governed by Quchi (LI11). Soreness and heaviness in shoulder and elbow joints, arm pain unable to flex and extend, governed by Zhouluo (LI9 - Note: Text says 肘, likely Zhouluo or similar). Inability to self-lift shoulder due to pain, no sweat, headache, governed by Yangchi (TE4). Heaviness in shoulder, arm pain unable to lift, governed by Tianzong (SI11). Peri-scaphular bi-syndrome, governed by Qu Yuan (BL38). Pain in the center of the scapula with cold extending to the elbow, governed by Jianwaishu (BL14). Closure and urgency in shoulder/upper arm, cold limbs and aversion to cold, governed by Pohu (BL42). Shoulder pain unable to lift, governed by Tiannao (SI10? Text says 天, likely Tiannao or Tianzhu) and Bingfeng (SI12). Heaviness in shoulder, inability to lift, arm pain, governed by Jianliao (SJ14). Inability to lift shoulder, difficulty dressing, governed by Qinglingyuan (SI11). Shoulder pain unable to lift, radiating to Quepen and Yunmen, governed by these points.

[From *Suwen*] The Yellow Emperor asked: I have heard that skin has its divisions, meridians have their pathways, sinews have their knots and networks, and bones have their measurements. The diseases they generate differ. I wish to know how to distinguish their divisions, left and right, upper and lower, yin and yang locations, and the beginning and end of diseases. Qibo replied: To understand the skin divisions, one should record according to the meridian pathways; this applies to all meridians. The yang qi of the Yangming meridian is called Haifei. Following the same principle above and below, observe floating collaterals in the region; these are all Yangming collaterals. If the color is mostly blue/green, there is pain; mostly black, there is bi-syndrome; yellow/red, there is heat; mostly white, there is cold. If all five colors appear, it indicates mixed cold and heat. When collaterals are full, pathogens enter the main meridians. Yang governs the exterior, Yin governs the interior. The yang qi of the Shaoyang meridian is called Shuchi. Following the same principle, observe floating collaterals; these are all Shaoyang collaterals. When collaterals are full, pathogens enter the meridians. Thus, pathogens in yang primarily move inward, and those in yin primarily move outward to seep into the interior; this applies to all meridians. The yang qi of the Taiyang meridian is called Guanshu. Following the same principle, observe floating collaterals; these are all Taiyang collaterals. When collaterals are full, pathogens enter the meridians. The yin qi of the Shaoyin meridian is called Shuru. Following the same principle, observe floating collaterals; these are all Shaoyin collaterals. When collaterals are full, pathogens enter the meridians. Upon entering the meridians, pathogens from the yang aspect inject into the meridians; exiting, they inject from the yin aspect internally into the bones. The yin qi of the Heart Master is called Haijian. Following the same principle, observe floating collaterals; these are all Heart Master collaterals. When collaterals are full, pathogens enter the meridians. The yin qi of the Taiyin meridian is called Guanxie. Following the same principle, observe floating collaterals; these are all Taiyin collaterals. When collaterals are full, pathogens enter the meridians. All twelve meridian-collateral systems are the cutaneous regions of the skin. Therefore, the onset of all diseases begins in the skin and hair. When pathogens attack, the interstices (Couli) open, allowing entry into the collaterals. If they remain, they transmit to the meridians; if they remain further, they transmit to the fu organs, accumulating in the intestines and stomach. When pathogens initially enter the skin, lanugo rises and interstices open. When they enter the collaterals, collaterals become full and color changes occur. When they invade the meridians, deficiency leads to sinking. When they linger between sinews and bones, excessive cold causes sinew spasms and bone pain; excessive heat causes sinew flaccidity and bone wasting, muscle emaciation, skin cracking, and hair failure. The Emperor said: Regarding the twelve divisions of the skin you mentioned, what are the diseases they generate? Qibo said: Skin is the domain of the vessels. When pathogens lodge in the skin, interstices open, allowing entry into collaterals. When collaterals are full, they inject into meridians; when meridians are full, they lodge in the zang-fu organs. Thus, skin has divisions; failing to distinguish them leads to serious disease. The Emperor said: Excellent. (From *Pi Bu Lun*)
Skin belongs to the Lung. The classic states: The Lung harmonizes with the skin, and its flourishing manifestation is in the hair. It also states: The Lung governs the skin and hair. In the viscera, it is the Lung; in the body structures, it is the skin and hair.
Withered and broken lanugo and dry nails indicate the exhaustion of the Hand-Taiyin Meridian. The classic states: The Hand-Taiyin Meridian circulates qi to nourish the skin and hair. If qi fails to nourish, the skin and hair become scorched/dry; if skin and hair become dry, body fluids depart. When skin qi is exhausted and fluids depart, nails become dry and lanugo breaks. Broken lanugo signifies the death of the hair qi first.