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The application of the Nine Needles has its specific indications. Their lengths and sizes have their respective applications. For treating heat syndromes, use the Chan Needle (Cian Zhen, a needle with a sharp tip for superficial pricking to drain heat). When the disease is in the skin, select the Chan Needle; however, do not use it if the skin at the affected area is pale. For treating cold syndromes, use the Hao Needle (Hao Zhen, the finest needle used for retaining needles to regulate Qi). In cases of Bi syndrome where the Qi flows freely but the pathogenic factor persists, use the Hao Needle. The characteristic of the Hao Needle is to wait quietly, insert slowly, retain slightly for a long time to nourish, thereby treating painful Bi syndrome. For treating excess syndromes, use the Feng Needle (Feng Zhen, a triangular needle used for bloodletting). The function of the Feng Needle is to disperse chronic diseases. For treating deficiency syndromes, use the Yuanli Needle (Yuanli Zhen, a needle that is thicker yet sharp, used for urgently draining sudden pathogens). The function of the Yuanli Needle is to treat sudden Qi rebellion; in cases of Bi syndrome with sudden onset, use the Yuanli Needle. For treating carbuncles and sores, use the Pi Needle (Pi Zhen, a blade-like needle used for incision and drainage). The function of the Pi Needle is to drain large amounts of pus; when Jing, Ying, or Shu points develop large abscesses, use the Pi Needle and Di Needle (Di Zhen, a blunt needle used for pressing acupoints without penetrating the skin) to drain and reduce Yang Qi. The function of the Yuan Needle (Yuan Zhen, a round-tipped needle) is to rub between muscle divisions without damaging muscles, thereby draining pathogenic Qi from the interstices. The function of the Di Needle is primarily to press the vessels without sinking deep, guiding Qi to prevent pathogens from sinking into the disease site. When the disease is in the vessels and Qi is deficient, requiring tonification, use the Di Needle. The Chang Needle (Chang Zhen, a long needle) can treat distant Bi syndromes; for deep-seated diseases, use the Chang Needle. The Fire Needle (Huo Zhen) drains fluid accumulation in joints; for edema that cannot cross joints, use the Fire Needle. Using small needles to treat large diseases yields little effect due to their small capacity; using large needles to treat small diseases causes much harm. Therefore, for conditions already formed into pus and blood, only Bian Stones (Bian Shi, stone knives for surgical incisions) and Pi Needles are suitable.

The Yellow Emperor said: I have heard that the method of needling is to drain excess and tonify deficiency. Qibo replied: The origin of all diseases involves both excess and deficiency, thus tonification and reduction must be applied. Draining deficiency and tonifying excess causes the Spirit (Shen) to leave its residence, leading to the invasion of pathogens and loss of righteousness; the True Qi becomes unstable, which is the failure of incompetent physicians, resulting in premature death. Tonifying deficiency and draining excess allows the Spirit to return to its residence and fills the emptiness for a long time; this is called a skilled artisan.

In general, when using needles, following the direction of Qi constitutes draining, while opposing the direction of Qi constitutes guiding (tonifying). Treat deficiency by making it solid (tonify), treat fullness by draining it, remove stagnant and old blood, and reduce pathogens when they prevail. Slow withdrawal and rapid pressing tonifies; rapid withdrawal and slow pressing reduces. Discussing excess and deficiency feels like something there or not there; observing sequence feels like existing or perishing; implementing tonification and reduction feels like gaining or losing. The key to excess and deficiency lies in the Nine Needles, which are most excellent. The timing of tonification and reduction relies on the needle. For draining, one must hold and insert the needle, release blood, push away Yang to obtain needle sensation, allowing pathogenic Qi to be excreted; pressing and drawing out the needle creates internal warmth, preventing blood dispersion and Qi escape. For tonifying, follow the Qi; the intent is like forgetting, moving lightly, pressing gently, stopping like a mosquito bite, lingering like a circle, departing like a broken thread, causing Left to belong to Right, so Qi stops. The external gate closes, Middle Qi becomes solid, no blood remains, and pathogens are destroyed. If Qi does not arrive after needling, do not count the number of times; if Qi arrives, stop and do not needle again.

There are five aspects of needling suspended for the world: Common people share excess food but do not know how to nourish themselves. First is Governing Spirit (Zhi Shen); Second is knowing how to nourish the body (原文缺失第二，据上下文推断); Third is knowing toxic drugs; Fourth is making Bian stones; Fifth is diagnosing the Qi and Blood of the Five Viscera. Once these five methods are established, each has its priority. In modern times, practitioners simply tonify deficiency and drain excess, which is common knowledge among artisans. However, regarding emulating Heaven and Earth, moving in response, harmonizing like an echo, following like a shadow—the Dao has no ghosts or gods, coming and going alone. The Yellow Emperor said: I wish to hear about this Dao. Qibo said: The essence of needling requires first governing the Spirit. Once the state of the Five Viscera is determined and the Nine Pulses are prepared, then consider the needle. When major pulses show no abnormality and ominous signs are unheard, when internal and external match, and form is not prioritized, one can study the flow of Qi before applying it to the patient. There are deficiency and excess in humans; avoid close contact with Five Deficiencies and do not stay far from Five Excesses. When the moment for insertion arrives, it allows no room for eyelashes to blink. Move hands with focus, keep the needle bright and even, calm your mind to observe principles, watch for changes in adaptation. This is called "Ming Ming" (obscure/subtle), unknown in form. See it dark, see it high, follow its flight, knowing not who it is. Lie still like a crossbow, rise like releasing a trigger.

Tonifying deficiency requires making it solid; reducing excess requires making it empty. Once Meridian Qi arrives, guard it carefully and do not lose it. Depth depends on intention; near and far are equal. Be like facing an abyss, hold the hand like grasping a tiger, let the Spirit not be distracted by other things. Do not insert unless the principle is upright; must rectify the Spirit. The essence of the small needle is easy to state but hard to enter. Incompetent doctors guard form; superior doctors guard Spirit. Spirit! Spirit! The guest (pathogen) is at the door. Before seeing the disease, how can one know its origin? The subtlety of needling lies in speed. Incompetent doctors guard joints; superior doctors guard the mechanism (Ji). The movement of the mechanism does not leave the void (acupoint). The Qi in the void is pure, quiet, and subtle. Its arrival cannot be met (tonified if excessive); its departure cannot be chased (reduced if deficient). One who knows the Dao of the mechanism cannot err by a hair's breadth; one who does not know, though struck, will not react. Knowing the coming and going, seize the opportunity. Incompetent doctors are ignorant; how wonderful! Only skilled artisans possess this. Going is reverse; coming is smooth. Knowing reverse and smooth, proceed correctly without doubt. Opposing and seizing makes it empty; chasing and assisting makes it solid. Opposing and following, harmonize with intent, and the Dao of needling is complete.

In general, when using needles: tonify deficiency, drain excess, remove stagnation, and reduce pathogens. The *Da Yao* states: The way of holding the needle values firmness. Point straight and pierce directly, do not deviate left or right; let the Spirit be in the finest detail. Focus on the patient, examine the blood vessels, and needle without danger. At the time of needling, focus on the Xuan Yang (eyes) and the Two Wei (spirit residences). Keep the Spirit attached, knowing life and death. Blood vessels lie horizontally; look to see clarity, feel to see hardness.

Tonifying deficiency makes the needle feel hot; Qi becoming solid brings heat. Draining excess makes the needle feel cold. Removing stagnation expels bad blood. Reducing pathogens means not pressing after withdrawing the needle. Slow withdrawal and rapid pressing tonifies; rapid withdrawal and slow pressing reduces. Discussing excess and deficiency refers to the amount of cold/warm Qi. "Like something there or not there" refers to the unknowable speed. Observing sequence refers to knowing the order of disease. Implementing tonification and reduction requires artisans not to lose the method. "Like gaining or losing" refers to deviating from the method. The Nine Needles are best for excess/deficiency because each is suitable for specific conditions. The timing of tonification/reduction matches the opening and closing of Qi. The names of the Nine Needles differ in shape because each needle exhausts its appropriate tonification/reduction function. To reduce excess, retain the needle until Yin Qi arrives, then remove. To tonify deficiency, retain until Yang Qi arrives and the needle feels hot, then remove. Guarding Qi once arrived means not changing tactics. Depth depends on knowing interior/exterior. Near/far equality means waiting for Qi equally at different depths. Facing an abyss means not being negligent. Grasping a tiger means wanting strength. Spirit not distracted means calming the mind to observe the patient, not looking left or right. Upright insertion means being端正 (correct/upright). Rectifying Spirit means having courage and caution, controlling the Spirit with eyes to facilitate Qi flow.

"Saying easily" means easy to speak. "Hard to enter" means hard to grasp by others. Guarding form means sticking to needling techniques. Guarding Spirit means monitoring the surplus or deficit of Blood and Qi in humans, determining what to tonify or reduce. "Spirit Guest" means the meeting of Righteous Qi and Pathogenic Qi. Spirit is Righteous Qi; Guest is Pathogenic Qi. "At the door" means pathogens enter/exit along the path of Righteous Qi. "Not seeing the disease" means first knowing which meridian suffers from pathogenic or righteous imbalance. "How to know the origin" means knowing which meridian is diseased and where to needle. The subtlety of needling lies in slowness and speed. Guarding joints means focusing on limbs without knowing the往来 (coming and going) of Blood/Qi and Zheng/Xie. Guarding the mechanism means guarding Qi. The movement of Qi stays within the void, indicating the deficiency/excess of Qi and the speed of needling. The pure and subtle Qi in the void means obtaining Qi and guarding it closely. Arrival cannot be met (do not tonify if Qi is excessive); departure cannot be chased (do not reduce if Qi is deficient). Cannot err by a hair means Qi is easily lost. Striking without reaction means not understanding tonification/reduction intent; Blood/Qi is exhausted and Qi does not descend. Knowing coming/going means knowing the reversal/smoothness and surplus/deficiency of Qi. Seizing the period means knowing the time to take Qi. Ignorance means not knowing the subtleties of Qi. Wonderfulness belongs only to artisans who fully understand the needle's intent. "Going is reverse" means Qi is deficient and small; small is reverse. "Coming is smooth" means Qi is balanced; balanced is smooth. Knowing reverse/smooth means knowing where to needle. Opposing and seizing is draining; chasing and assisting is tonifying. "Tonify deficiency" means the Pulse Gate is deficient and should be tonified. "Drain excess" means the Pulse Gate is full and should be drained. "Remove stagnation" means removing from blood vessels. "Reduce pathogens" means draining excess in all meridians. "Slow in/fast out" means inserting slowly and withdrawing quickly (Note: Text says "Xu Nei Ji Chu" for Shih, usually Xu Chu Ji An is Shih/Tonify. Text here seems to describe specific manipulations or contains variations. Translating literally: Insert slowly, withdraw quickly). "Fast in/slow out" means inserting quickly and withdrawing slowly. "Excess/Deficiency, like something there/not there" means Excess has Qi, Deficiency lacks Qi. "Sequence, like existing/perishing" refers to the order of tonification/reduction based on Qi status. "Gaining/Losing" means Tonification feels like gaining; Reduction feels like losing. Thus, skilled artisans know where Qi resides, guard its gates, understand regulating Qi, locations of tonification/reduction, speed intentions, and selection points.

To drain, use circular motions: press and rotate, then Qi flows. Withdraw quickly, retain slowly, so pathogenic Qi exits; extend and oppose, shake the hole large, so Qi exits rapidly. To tonify, use square methods: pull skin outward to align with the gate, pull left pivot, push right skin, rotate slightly and push slowly. Must be upright and calm. Firm heart without relaxation, want to retain Qi slightly and withdraw quickly, push skin, cover the external gate, so Spirit Qi remains. The essence of needling never forgets the Spirit. "Draining uses Square" implies Qi is flourishing, Moon is full, Day is warm, Body is stable. Insert during inhalation, wait for inhalation to rotate, wait for exhalation to slowly draw out. Thus, "Draining/Tonifying uses Circle". Circle means movement; movement means shifting. Puncture must hit the Ying (Spring) point, then withdraw during inhalation. Thus, Circle and Square are not needles. To drain excess, insert when Qi is strong. Needle and Qi enter together, opening the gate like a door; Needle and Qi exit together, sparing Essence Qi, allowing Pathogenic Qi to descend. External gate not closed, letting disease out; shake large the path, like clearing the road, this is Great Drainage. Press and withdraw, great Qi yields. Hold needle, do not place down, stabilize intent. Wait for exhalation to insert; when Qi exits, do not insert. Needle space sealed, Essence cannot exit. When full, withdraw quickly; Qi enters, needle exits, heat does not dissipate, close the gate, Pathogenic Qi disperses, Essence Qi is preserved. Moving Qi according to time, keeping near Qi, attracting far Qi, this is Chasing.

Inhale to insert, do not let Qi rebel; stay quiet and retain long, do not let Evil spread. Inhale to rotate, aim for Qi arrival; exhale to draw needle, exit when breath ends. Great Qi all exits, hence called Drainage. Palpate and stroke, press and scatter, push and press, flick to engorge, claw to descend, connect and take. Pull external gate to close Spirit. Exhale completely to insert, stay quiet and retain long, aim for Qi arrival. Wait like a noble person, ignoring dusk; when Qi arrives, protect appropriately. Inhale to withdraw, Qi cannot exit, each stays in place, push and close gate, let Spirit Qi remain, Great Qi stays, hence called Tonification. Tonification/Reduction without loss, unity with Heaven and Earth, Qi arrives, guard carefully. Depth in intention, near/far equal, face abyss, hold tiger, Spirit undistracted. Holding needle: upright, calm, know deficiency/excess, direction/speed. Left hand holds bone, right hand guides, do not tangle with flesh. Drainage requires upright insertion; Tonification requires closing skin. Assist needle to guide Qi, allow Evil to disperse, True Qi to reside.

Yellow Emperor asked: How to handle open skin and pores? Qibo replied: Follow the muscle divisions, separate skin with left hand, insert slightly and slowly upright, ensure Spirit does not scatter, allow Evil Qi to depart. Know where Qi is, first find the path, sparse and loose, penetrate slightly deeper and retain, thus entering slowly. High heat above, push down; upper issues, draw away. View prior pain, often treat first. External cold, retain and tonify; internal entry, drain via He-Sea points. Upper Qi deficiency, push and raise; Lower Qi deficiency, accumulate and follow. Cold entering middle, push and circulate.

Excess is Qi entering; Deficiency is Qi exiting. Qi excess is Heat; Qi deficiency is Cold. Entering Excess: Open needle hole with left hand. Entering Deficiency: Open needle hole with right hand.

Form/Qi deficiency, Disease Qi excess: Pathogen prevails, urgently drain. Form/Qi excess, Disease Qi deficiency: Urgently tonify. Form/Qi deficiency, Disease Qi deficiency: Both Yin and Yang are deficient. Do not needle; needling causes double deficiency, leading to exhaustion of Yin/Yang, Blood/Qi, emptiness of Five Viscera, withered sinews/bones/marrow. Old die, strong do not recover. Form/Qi excess, Disease Qi excess: Both Yin and Yang are excess. Urgently drain pathogens, regulate deficiency/excess. Thus: Drain excess, tonify deficiency.

Needling without knowing reverse/smooth causes True/Pathogenic collision. Tonifying fullness causes Yin/Yang overflow, intestinal/gastric distension, liver/lung internal pressure, mixed Yin/Yang. Reducing deficiency causes meridian emptiness, Blood/Qi枯竭, intestinal deviation, thin skin, burnt hair/pores, giving death date.

All needling aims to regulate Qi. Qi accumulates in Stomach, connects Ying/Wei, follows paths, Zong Qi stays in Sea. Lower goes through Qichong; straight goes to Respiration Path. Jue in feet, Zong Qi does not descend, Lung blood coagulates/stagnates. Without Fire regulation, cannot treat. Scattered Qi can be gathered; Taken Qi can be distributed. Dwell quietly, monitor Spirit, close doors/windows,不散魂魄 (do not scatter soul/spirit), focus on one Spirit, divide Essence/Qi, ignore voices, gather Essence. Unify Spirit, focus on needle, shallow retention, slight floating, shift Spirit, rest when Qi arrives. Men internalize, Women externalize, firmly reject exit, carefully guard entry, this is Obtaining Qi. If Qi does not arrive, ignore count. If Qi arrives, stop, do not needle again. Needles have specific suitability, different shapes, each serves its purpose. Key to needling: Qi arrival brings effect. Effect is certain, like wind blowing clouds, clear as seeing blue sky. Dao of needling is complete.

User of needles must first examine meridian deficiency/excess, palpate, stroke, press, flick, observe reaction, then select and lower. Six Meridians regulated means no disease. Even if diseased, self-healing. One meridian upper excess/lower deficiency/blockage: likely collateral overgrowth on main meridian, causing blockage. Observe and drain, this is Untying Knots. Upper cold/lower heat: First needle Neck Taiyang, retain long. After needling, moxa neck/shoulders, let heat descend and merge, then stop. This is Pushing Up. Upper heat/lower cold: Observe pulse deficiency/sinking in meridian, needle, until Qi descends, then stop. This is Pulling Down. Generalized high heat, mania, hallucinations: Observe Foot Yangming and large collaterals, needle. Deficiency tonify, Blood excess drain. Patient lying down, head forward, use four fingers of both hands to clamp/press head artery, hold long, tiredly press/push down to Quepen, stop as before, heat gone then stop. This is Pushing and Dispersion.

Yellow Emperor asked: I heard "Drain excess, tonify deficiency." What is excess? What is deficiency? Qibo: Excess has five, deficiency has five. What do you ask? Emperor: Tell me all. Qibo: Shen has excess/deficiency; Qi has excess/deficiency; Blood has excess/deficiency; Form has excess/deficiency; Zhi has excess/deficiency. These ten have unequal Qi. Emperor: Humans have Essence/Qi/Jin/Ye, four limbs/nine orifices, five viscera/sixteen parts, 365 joints, generating hundred diseases. Hundred diseases have excess/deficiency. Why five excess/five deficiency? Qibo: All born from Five Viscera. Heart stores Shen; Lung stores Qi; Liver stores Blood; Spleen stores Flesh; Kidney stores Zhi. This forms shape. Zhi/Yi internally connects marrow to form shape. Pathways of Five Viscera/Six Fu organs emerge from Jing Sui (Meridian tunnels) to move Blood/Qi. Blood/Qi disharmony generates hundred diseases. Therefore, guard the Jing Sui.

Emperor: Shen excess/deficiency? Qibo: Shen excess laughs incessantly; Shen deficiency grieves. Blood/Qi not merged, Five Viscera stable, Evil guests form, shivering starts at hair follicles, not yet entered Jing Luo. Called Shen's Micro. Emperor: Tonification/Reduction? Qibo: Shen excess, drain small collateral blood, bleed, do not deeply repel, do not hit major meridians, Shen Qi balances. Shen deficiency, view deficient collaterals, press to gather, needle to benefit, do not bleed, do not leak Qi, unblock meridian, Shen Qi balances. Emperor: Needle Micro? Qibo: Massage without releasing, place needle without repelling, transfer Qi to deficiency. Qi excess causes panting/cough; Upper Qi deficiency causes clear breathing/shortness of breath. Blood/Qi not merged, Five Viscera stable. Skin micro-disease, called White Qi Micro Leakage. Emperor: Tonification/Reduction? Qibo: Qi excess, drain meridian tunnels, do not injure meridian, do not bleed, do not leak Qi. Deficiency, tonify meridian tunnels, do not leak Qi. Emperor: Needle Micro? Qibo: Massage without releasing, withdraw needle and look, say "I will go deep," adapt to person, Spirit changes, Essence hides, Evil scatters, rests nowhere, Qi leaks pores, True Qi obtains. Emperor: Good. Blood excess/deficiency? Qibo: Blood excess anger; deficiency fear. Blood/Qi not merged, Five Viscera stable. Sun collaterals water overflow, meridian retains blood. Emperor: Tonification/Reduction? Qibo: Blood excess, drain vigorous meridian, bleed. Deficiency, view deficient meridian, needle pulse center, retain long, observe. Pulse large, withdraw quickly, do not bleed. Emperor: Needle retained blood? Qibo: View blood collaterals, prick to bleed, do not let bad blood enter meridian to form disease. Emperor: Good. Form excess/deficiency? Qibo: Form excess abdominal distension, difficult urination/defecation; deficiency limbs useless. Blood/Qi not merged, Five Viscera stable. Muscle twitching, called Micro Wind. Emperor: Tonification/Reduction? Qibo: Form excess, drain Yang meridians; deficiency, tonify Yang collaterals. Emperor: Needle Micro? Qibo: Select between muscles, do not hit meridians, do not injure collaterals, Wei Qi recovers, Evil Qi vanishes.