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[Qizhuma Moxibustion Method]
To treat all types of carbuncles and sores (Yong Ju), malignant ulcers, and back carbuncles. The measurement method is: for males, use the left hand; for females, use the right hand. Starting from the transverse crease in the middle of the wrist, use a thin bamboo strip to measure up to the point where the flesh at the base of the thumb ends, excluding the fingernail, then cut it off. Next, use another thin bamboo strip to measure a length equal to one "cun" (body-inch) based on the previous measurement. Have the patient remove upper and lower garments. Place a large bamboo pole horizontally across two supports, held up by two people, ensuring the patient's feet are about five cun above the ground. Two other people should hold the sides steady to prevent shaking. Then, place the previously cut long bamboo strip vertically against the bamboo pole, starting from the tailbone along the spine upwards, until the end of the strip. Mark this point with ink; this is not the moxibustion point. Next, take the bamboo strip measuring one "cun", measure two cuns, fold it in half, align the center with the ink mark, and extend one cun to each side. This is the actual moxibustion point (three moxa cones can be applied).

Commentary: This point is located between Zhongyang (DU12) on the Governor Vessel (Du Mai) of the spine and the two points of Jinshu, inside the second line of the Foot-Taiyang Bladder Channel on the back, specifically within Ge Shu (BL17) and Ganshu (BL18). It is not a standard acupoint. I suspect this is a transmission error by later generations, mistaking three cuns for two cuns. How could acupuncture and moxibustion be used without following the meridians and acupoints? Therefore, doubt remains. Users should examine this carefully.

[Discussion on Moxibustion vs. Decoctions]
Question: In the *Neijing* (Classic of Internal Medicine), methods for treating diseases mention decoctions and fermented wines very rarely. Only one or two methods of taking medicine are recorded, while moxibustion accounts for four or five, and clear needle methods account for eighteen or nineteen out of twenty.

Why did herbal prescriptions become prevalent later, while acupuncture and moxibustion were barely preserved? Answer: The *Neijing* is an ancient text. People in ancient times understood the Dao. They worked without becoming exhausted and rested without becoming indulgent. Their food was not rich or fresh enough to damage their internal organs; their clothing was not heavy or hot enough to harm their exterior. Their daily life was regular, they avoided cold and heat appropriately, maintained a tranquil and empty mind, and kept their spirit inward. How could disease arise? Even if pathogenic winds and empty evils invaded, they could not penetrate deeply but only gathered at the skin level, causing stagnation and Qi depression. Using needles to unblock stagnation and dissipate depression would cure the disease immediately, why wait for decoctions? In today's world, morality has declined. People treat wine as water and recklessness as normal, indulging desires to exhaust essence, worrying excessively to scatter true Qi, failing to maintain fullness, failing to control the spirit, seeking only mental pleasure, going against the joy of life, lacking regular routines, and ignoring cold and heat. Thus, diseases mostly arise internally, and external pathogens easily invade. The classics state: Needles treat external conditions; decoctions treat internal conditions. Since the disease belongs to the interior, how can it be cured without the cleansing power of decoctions? This is why after He Huan, herbal prescriptions became prevalent and acupuncture/moxibustion rare. It is truly because the world is not like antiquity, and people are not as they were. Diseases have depths, and treatments have external and internal focuses. It is not that acupuncture suits the past but not the present, nor that decoctions suit the present but not the past. The classics say: In ancient times, decoctions were made but not taken; in mid-antiquity, taking them ensured complete success; in today's world, one must use potent drugs to attack the interior and needles to treat the exterior. Even if the form is ruined and blood exhausted, efficacy cannot be established—this is what is meant.

[Regarding Jing-Luo Disease]
Question: Are there differences in treating Jing (Meridian) disease and Luo (Collateral) disease? The classics say: When evil qi resides in the body, it first stays in the hair and skin. If it does not leave, it enters the Sun Luo (Fine Collaterals); if it still does not leave, it enters the Luo vessels; if it still does not leave, it enters the Jing meridians. Internally connecting to the Five Zang organs and spreading to the Six Fu organs, both Yin and Yang are affected, and the Five Zang organs are injured. This is the sequence of evil entering from the skin and reaching the Five Zang organs. In such cases, treat the Jing meridians. Now, if evil resides in the skin, enters the Sun Luo, stays without leaving, becomes blocked, cannot enter the Jing, overflows into the Da Luo (Great Collaterals), and produces strange diseases. When evil resides in the Da Luo, it flows from left to right and right to left, interacting with the Jing meridians above and below, distributing to the four extremities. Its Qi has no fixed location and does not enter the Jing acupoints, hence it is called Miao Ci (Contralateral Puncture).

[Regarding Acupuncture for Qi vs. Blood Levels]
Question: Diseases exist in the Qi level and the Blood level. Do acupuncture practitioners distinguish between Qi and Blood? Answer: Practitioners must know about diseases in the Qi and Blood levels. Diseases in the Qi level move unpredictably; diseases in the Blood level are fixed and immovable. Taking masses as an example: those moving up or down in the abdomen, appearing or disappearing, belong to the Qi level; those fixed in the hypochondrium, under the heart, or around the navel, growing gradually, belong to the Blood level. Taking wind diseases as an example: those moving from left hand to right hand, or left foot to right foot, changing frequently, belong to the Qi level; those staying fixed in the left foot or right hand, adhering without moving, belong to the Blood level. All diseases follow this pattern. Know that for Qi-level diseases, if the pathology is above, select points below; if below, select points above. If on the left, select on the right; if on the right, select on the left. For Blood-level diseases, select points corresponding to the location of the blood and the disease. If you drain Qi when treating Blood disease, or drain Blood when treating Qi disease, this is punishing the innocent; who bears the blame?

[Regarding Morning/Evening Acupuncture for Men and Women]
Question: The fu texts state that men's Qi is high in the morning and low in the evening, while women's Qi is low in the morning and high in the evening. Forenoon is morning, afternoon is evening. Above the waist is upper, below the waist is lower. For men, morning acupuncture causes Qi to ascend; evening acupuncture causes Qi to descend. For women, morning acupuncture causes Qi to descend; evening acupuncture causes Qi to ascend. Is there basis for this? The classics say: Ying (Nutrient) Qi circulates in the Lungs, completing 50 cycles through the body day and night. At dawn, it meets Wei (Defensive) Qi at the Hand-Taiyin Lung Meridian. Wei Qi circulates outside the vessels, traveling through Yang 25 times during the day and Yin 25 times at night, meeting Ying Qi at the Hand-Taiyin Lung Meridian at dawn. Thus, Wei Qi circulation distinguishes only day and night, not upper and lower. The meridians, collaterals, Qi, and Blood flow in men and women are not different. The morning/evening distinction in the fu texts seems baseless and cannot serve as a principle!

[Regarding Prohibition of Moxibustion near Eyes]
Question: Jingming (BL1), Yingxiang (LI20), Chengqi (ST1), and Sizhukong (SJ23) are prohibited for moxibustion. Why? Answer: These four points are near the eyes, and the eyes fear fire, so moxibustion is prohibited. By analogy, Jingming (BL1) can be moxibusted; Wang Bing's commentary is erroneous.

[Regarding Ying-Sui Tonification and Sedation]
Question: "Ying er duo zhi" (Meeting and draining) and "Sui er ji zhi" (Following and assisting) refer to tonification and sedation. What is their meaning? Answer: "Ying" means encountering the Qi as it arrives. For example, at Yin hour, Qi flows into the Lung; at Mao hour, Qi flows into the Large Intestine. At these times, Lung and Large Intestine Qi are abundant, so we apply the draining method. "Sui" means following the Qi as it departs. For example, at Mao hour, Qi leaves the Lung for the Large Intestine; at Chen hour, Qi leaves the Large Intestine for the Stomach. At these times, Lung and Large Intestine Qi are deficient, so we apply the assisting (tonifying) method. Apply this logic to others.

[Regarding Depth of Insertion and Retention Time]
Question: Regarding the rules for inserting needles to certain depths and retaining them for specific breath counts. Answer: I believe one should not be so rigidly bound by this. Muscles vary in thickness, and diseases resolve at different speeds. Where muscles are thick, deep insertion is possible; where thin, shallow insertion is appropriate. If the disease resolves quickly, withdraw the needle promptly; if the disease lingers, retain the needle longer. Hence it is said: To puncture deficiency, make it solid; to puncture excess, make it empty.

[Regarding Sun Simiao's "Closing the Door to Drive Out Thieves"]
Question: Sun Simiao described moxibustion as "closing the door to drive out thieves." What do you think? Answer: In fire-draining methods, blowing rapidly on the fire expels both fire energy and pathogenic energy. This is the fire-draining method of the *Neijing*; how is it closing the door? As for Qi, although the needle is small, needling unnecessarily drains Qi like a river bursting its banks; one must not ignore it because it is small. Sun's remark specifically refers to fire needles. Generally, statements may have flaws, hence it is said that making statements is difficult.

[Regarding Ren Shen and Kao Shen]
Question: Ren Shen (Person Spirit) travels the body according to age; Kao Shen (Buttock Spirit) sits upon the person daily. If a person dies, do these spirits die with them? Or do they leave the body, drift in heaven and earth, and lose their anchor? Or do they attach to another person? If they attach to another, everyone already has their own spirit. If no one to attach to, the spirit scatters. Since it is called "spirit," it is mysterious and unpredictable; why seek attachment to humans? The Heart is the Sovereign Official, from which Ming (Spirit) emerges. Why not command this spirit to keep the body safe from acupuncture injury? Answer: Talk of Ren Shen and Kao Shen comes from later fortune-tellers; it is not in the *Suwen* or *Nanjing*. Why trust it?

[Regarding Timing and Efficacy]
Question: The twelve meridians and acupoints have specific times of flow and abundance/deficiency. Timely tonification and sedation are correct. However, for diseases in various meridians, timely treatment can also cure. This is because the disease attaches to the meridian, which has its own excess or deficiency; tonifying deficiency and draining excess naturally hits the target. Some diseases are cured with one needle, others require several, due to newness/oldness and depth/shallowness. New and shallow diseases can be cured with one needle; deep and stubborn ones require repeated needling, just as medicines work: some cure in one or two doses, others in forty or fifty. If one needle fails to reduce the disease, stopping treatment will never yield results.

[How Small Needles Tonify and Drain]
Question: Needles are tiny; how can they drain excess and tonify deficiency? Answer: Consider a balloon. Without air, it collapses and is useless; blowing air in makes it full and firm—this is tonifying deficiency. Removing the blockage allows air to escape, collapsing it again—this is draining excess.

[Discrepancies in Acupoint Lists]
Question: Books like *Tongren* and *Qianjin* list many empty points, while *Shisi Jing Jingluo Fahui* lists fewer. Points like Fengshi (GB31), Duyu (BL12), Jinjin, and Yuye are in the former but not the latter. Why? Answer: *Shisi Jing Jingluo Fahui* relies on the *Suwen: Gu Kong Pian* and Wang Bing's annotations. *Tongren* and *Qianjin* are compilations, not the orthodox classics of Huangdi and Qibo.

[Regarding "Neither Excess Nor Deficiency, Treat the Meridian"]
Question: The classics say: Tonify deficiency, drain excess, and for neither excess nor deficiency, treat the meridian. What does this mean? The classics say: Tonify the Mother of deficiency; the Mother can make the Child solid. Drain the Child of excess; the Child can make the Mother empty. For Liver disease, tonify Ququan (LR8), the He-Sea point of Jueyin, for deficiency; drain Xingjian (LR2), the Ying-Spring point of Jueyin, for excess. "Neither excess nor deficiency, treat the meridian" means the primary meridian is diseased itself, not invaded by other pathogens. One should treat the meridian directly, e.g., using Jing-well points for chest fullness. Primary meridian disease arises from internal factors, such as worry injuring the Heart or forceful immersion in water injuring the Kidney. "Neither excess nor deficiency" means the Zang organs do not overact upon each other, hence "treat the meridian itself."

[Regarding Secrecy in Needle Techniques]
Question: Modern doctors cover their hands with sleeves when needling, performing techniques secretly, claiming mystery and fearing theft. What is this technique? Answer: The fourteen methods in *Jinzhen Fu* and techniques like Green Dragon Tail Wagging are comprehensive. Seeking further mystery outside these is unbelievable. Such behavior is merely deceitful trickery to deceive people. Even if skillful, divine protection and efficacy will likely fail. Why value it?

[Regarding Attitude During Needling]
Question: Some doctors insert needles carelessly, chatting or drinking, twisting the needle occasionally, then returning to banquets before withdrawing. Can this really cure disease? Answer: The classics say: The truth of needling requires governing the Shen (Spirit) first. Also: Hands busy, needles bright and even, mind quiet observing changes. Also: Like facing an abyss, hand like holding a tiger, spirit not distracted by worldly things. Also: Like awaiting a noble, forgetting the passing of days. Are these respectful or negligent? Also: Gain and loss relate to Qi arriving solid/firm (gain) or weak/empty (loss). Also: "Seeing like entering, seeing like exiting" means pressing the point with the left hand, waiting for Qi arrival before inserting, and withdrawing when Qi is exhausted. Such careless behavior is done by vulgar artisans; nothing is more disrespectful!

[Regarding Needling Only Draining, Not Tonifying]
Question: Needling is purely draining, not tonifying. It guides Qi and treats excess diseases, so few use it. Is it unused because it doesn't tonify, or because people have weak constitution, or excessive depletion, or poor skill? The classics say: For Yang deficiency, warm with Qi; for Essence deficiency, tonify with flavor. Needles are made from Bian stones; they have no Qi or flavor. They break skin and flesh, opening pores, allowing Qi to escape. How can this be tonification? The classics say: If Qi, Blood, Yin, and Yang are all deficient, do not use needles; harmonize with sweet herbs. Also: If Form-Qi and Disease-Qi are both deficient, this is total Yin-Yang deficiency; do not needle, or you will severely deplete Qi, leading to death in the elderly and failure to recover in the strong. Such statements imply needling only drains, never tonifies.