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The *Shen Ying Jing* (Divine Response Classic) states: On the left side of the human body, advancing the needle forward with the thumb of the right hand constitutes tonification (Bu), while retracting it backward constitutes sedation (Xie). On the right side, retracting the needle backward with the thumb of the right hand constitutes tonification, while advancing it forward constitutes sedation.

"Advancing" refers to situations where Qi has not yet arrived (De Qi). For men, one acts externally; for women, internally. There are specific principles of advancement and retraction corresponding to the four seasons.
"Retracting" is used for tonification and sedation. When preparing to withdraw the needle, first retract it slightly (about the size of a bean), then retain the needle for a moment before withdrawal.
"Moving" refers to lifting and thrusting the needle up and down if Qi does not circulate.
"Shaking" involves shaking the needle body before withdrawal when performing sedation.
"Tapping" involves lightly tapping the needle handle with the fingernail during tonification to accelerate the flow of Qi. This method is not used for sedation.
"Closing" involves pressing and closing the acupoint with the hand upon needle withdrawal during tonification.
"Pinching" refers to using the thumbnail to pinch up and down along the meridian if Qi feels stagnant after insertion, thereby restoring smooth circulation.
"Tracing" involves tracing up and down along the meridian with the hand after insertion at specific points to facilitate the flow of Qi and Blood. As the classics state: pushing promotes movement, drawing stops it.
"Cutting" involves pressing around the acupoint with the thumbnail before insertion to disperse Qi and Blood, preventing injury to Ying and Wei upon needle entry.
"Pressing" involves holding the needle steady with the hand so it neither advances nor retreats, resembling the sensation of pulse diagnosis.
"Marking" involves using fingers to apply force and position the needle accurately.
"Rotating" involves gently rotating the needle within the acupoint, particularly when needling the abdomen.
"Twisting" involves twisting the needle with fingers until the patient feels warmth. The needle is oriented outward; do not twist too tightly. For cold conditions, the needle is oriented inward, twisting according to previous methods.
"Manipulating" involves twisting the needle with fingers, keeping in mind that left corresponds to external and right to internal.

(Miu implies disorder or crossing.)

The Yellow Emperor said: I have heard of Miu Ci (Counter-Needling) but do not understand its meaning. Qibo said: When pathogenic factors lodge in the skin and hair, they enter the Sun Luo (fine collateral vessels). If they remain there without being expelled, they cause blockage. Unable to enter the main meridians, they overflow into the large collaterals, generating strange diseases. When pathogens lodge in the large collaterals, they shift from left to right and right to left, interacting with the meridians above and below, and distributing to the four extremities. Their location is variable, and they do not enter the meridian shu points; this is called Miu Ci.

The Yellow Emperor said: I wish to learn about Miu Ci. How does one treat the left by needling the right, and the right by needling the left? How does it differ from Ju Ci (Giant Needling)? Qibo replied: In collateral diseases, the pain is located differently from the main meridians, hence the name Miu Ci.

If pathogenic factors lodge in the collateral of Foot-Shaoyin (Kidney Meridian), causing sudden heart pain, acute distension, and fullness in the chest and hypochondrium (without accumulation), bleed the area anterior to Rangu (KI2). Recovery occurs in the time it takes to eat a meal. If ineffective, needle the opposite side. New onset cases resolve within five days.

If pathogenic factors lodge in the collateral of Hand-Shaoyang (Sanjiao Meridian), causing throat obstruction, tongue retraction, dry mouth, irritability, pain on the lateral aspect of the arm, and inability to raise the hand to the head, needle the nail edges of the middle and index fingers, approximately the width of a leek leaf from the tip, one moxa cone per point. Strong individuals recover immediately; older individuals recover shortly. Needle the opposite side. New onset cases resolve within a few days.

If pathogenic factors lodge in the collateral of Foot-Jueyin (Liver Meridian), causing sudden hernia and severe pain, needle the junction of the nail and flesh on the big toe, one moxa cone per point. Men recover immediately; women recover shortly. Needle the opposite side.

If pathogenic factors lodge in the collateral of Foot-Taiyang (Bladder Meridian), causing headache, neck, and shoulder pain, needle the junction of the nail and flesh on the big toe, one moxa cone per point. Recovery is immediate. If ineffective, needle three cun below the lateral malleolus, needle the opposite side. Recovery occurs in the time it takes to eat a meal.

If pathogenic factors lodge in the collateral of Hand-Yangming (Large Intestine Meridian), causing chest fullness, wheezing, and heat in the chest, needle the nail edges of the thumb and index finger, approximately the width of a leek leaf from the tip, one moxa cone per point. Needle the opposite side. Recovery occurs in the time it takes to eat a meal.

If pathogenic factors lodge between the arm and palm, causing immobility, needle behind the ankle. Press with the finger first; needle where pain is elicited. The number of moxa cones should correspond to the waxing moon: one cone on day 1, two on day 2, fifteen on day 15, and fourteen on day 16.

If pathogenic factors lodge in the Foot-Yangqiao Vessel, causing eye pain starting from the inner canthus, needle half a cun below the lateral malleolus, two moxa cones per point. Needle the opposite side. Recovery occurs in the time it takes to walk ten li.

If trauma causes blood stasis retention in the abdomen, leading to distension and constipation/inability to urinate, first administer purgatives. This indicates injury to the Jueyin vessel above and Shaoyin collateral below, causing rib pain, dyspnea, cough, and sweating. Needle the junction of the nail and flesh on the little and second toes, one moxa cone per point. Dyspnea resolves immediately, sweating stops immediately. Cough resolves within a day with warm clothing and diet. Needle the opposite side. If ineffective, repeat.

If pathogenic factors lodge in the collateral of Foot-Shaoyin (Kidney Meridian), causing sore throat preventing meat consumption, unprovoked anger, and Qi rushing upward toward the贲 (Bifen/Gastroesophageal junction), needle the central vessel under the foot three times. Recovery is immediate with six applications. Needle the opposite side.

If pathogenic factors lodge in the collateral of Foot-Taiyin (Spleen Meridian), causing lower back pain radiating to the lower abdomen and flanks, preventing supine breathing, needle the gap of the sacrum, above the two iliac bones, which is Yaoshu (BL23). The number of applications follows the lunar cycle. Recovery is immediate upon needle withdrawal. Needle the opposite side.

If pathogenic factors lodge in the collateral of Foot-Taiyang (Bladder Meridian), causing spasms and stiffness in the back with radiating rib pain, count vertebrae from the neck, press rapidly along both sides of the spine. Where tenderness is felt laterally, needle three times. Recovery is immediate.

If pathogenic factors lodge in the collateral of Foot-Shaoyang (Gallbladder Meridian), causing pain in the pivot (Huantiao GB30) preventing thigh movement, needle Huantiao with a filiform needle. Retain the needle longer for cold conditions. The number of applications follows the lunar cycle. Recovery is immediate. For general meridian treatment, if the traversed meridian is not diseased, use Miu Ci. For deafness, needle Hand-Yangming; if ineffective, needle the channel emerging before the ear. For toothache, needle Hand-Yangming; if ineffective, needle the Lung channel entering the teeth. Recovery is immediate.

If pathogenic factors lodge between the five zang organs, causing lung-related pain that comes and goes, examine the condition and use Miu Ci. Observe the vessels at the nail beds of hands and feet and bleed them. Needle every other day. If one session is insufficient, five sessions suffice.

For Miu transmission causing upper tooth pain with cold lips and teeth, observe blood vessels on the dorsum of the hand and bleed them. One moxa cone on the big toe of Foot-Yangming, one on the thumb and index finger of Hand-Yangming. Recovery is immediate. Needle the opposite side.

If pathogenic factors lodge in the collaterals of Hand-Foot Shaoyin, Taiyin, and Foot-Yangming, these five collaterals converge in the ear and ascend to the left corner of the head. If all five are exhausted, the patient exhibits pulsation throughout the body but lacks consciousness, resembling a corpse, known as Shijue (Corpse Faint). Needle the medial side of the big toe nail bed (width of a leek leaf from tip), then Yongquan (KI1), then the middle toe nail bed, one cone each. Then needle the medial side of the thumb nail bed, then the Pericardium channel and the radial styloid process of the Shaoyin channel, one cone each. Recovery is immediate. If ineffective, blow air into both ears with a bamboo tube. Burn one square cun of hair from the left temple, mix with a cup of fine wine, and administer. If the patient cannot drink, force-feed. Recovery is immediate.

For pain where the meridian itself is not painful, use Miu Ci. Observe the skin regions for blood vessels and bleed them all. This is the methodology of Miu Ci. If the body shows disease symptoms but the nine pulses are normal, use Miu Ci.