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It is stated that acupuncture has nine variations (Jiu Bian) and twelve segments/methods (Shi Er Jie). The "nine variations" are as follows: First, Shu Ci (Acupuncture at Shu points), which refers to needling the Ying-Spring and Shu points of various meridians and the Back-Shu points of the Zang organs. Second, Yuan Dao Ci (Distal Acupuncture), which refers to treating diseases located in the upper part by selecting points in the lower part, specifically needling the Back-Shu points of the Fu organs. Third, Jing Ci (Meridian Acupuncture), which refers to needling the collaterals and meridian divisions where large meridians are knotted or obstructed. Fourth, Luo Ci (Collateral Acupuncture), which refers to pricking the blood vessels of small collateral networks. Fifth, Fen Ci (Compartment Acupuncture), which refers to needling between the muscle compartments. Sixth, Da Xie Ci (Major Draining Acupuncture), which refers to using a Pi needle (a flat surgical knife-like needle) to puncture large abscesses. Seventh, Mao Ci (Hair Acupuncture), which refers to superficial needling of the skin to treat floating Bi syndrome (obstruction syndrome). Eighth, Ju Ci (Great Crossing Acupuncture), which refers to cross-needling, i.e., treating the left side by needling the right and vice versa. Ninth, Cui Ci (Cauterizing Acupuncture), which refers to heating the needle until red before insertion to treat Bi syndrome.

The "twelve segments" are as follows: First, Ou Ci (Paired Acupuncture), placing hands directly over the heart or back opposite the pain site, inserting one needle anteriorly and one posteriorly to treat Heart Bi; this involves paracentesis. Second, Bao Ci (Reporting Acupuncture), used for pain with no fixed location that migrates up and down; the needle is inserted vertically without withdrawal, while the left hand presses along the moving pain site, then the needle is withdrawn and re-inserted. Third, Hui Ci (Expanding Acupuncture), involving vertical insertion with lateral manipulation to relax tense sinews anteriorly and posteriorly, used to treat Sinew Bi. Fourth, Qi Ci (Aligned Acupuncture), consisting of one vertical needle and two oblique needles, used for shallow but deep-penetrating cold pathogens; also known as San Ci (Three Needles), used for Bi syndrome with shallow but deep-seated pathogens. Fifth, Yang Ci (Dispersing Acupuncture), involving one central needle and four surrounding superficial needles, used for extensive cold pathogens. Sixth, Zhi Zhen Ci (Direct Needle Acupuncture), pulling the skin taut before needling, used for superficial cold pathogens. Seventh, Shu Ci (Shu Acupuncture - distinct from the first variation), involving direct insertion and withdrawal with sparse needling and deep penetration, used for conditions with excess Qi and heat. Eighth, Duan Ci (Short Acupuncture), used for Bone Bi, involving slight rocking and deep insertion to reach the bone, followed by rubbing against the bone. Ninth, Fu Ci (Floating Acupuncture), inserting obliquely and superficially, used for muscle tension accompanied by cold. Tenth, Yin Ci (Yin Acupuncture), needling both sides simultaneously, used for Cold Jue (cold extremities), selecting the Shaoyin points behind the ankle. Eleventh, Bang Zhen Ci (Paralleling Needle Acupuncture), one vertical and one oblique needle, used for chronic, lingering Bi syndrome. Twelfth, Zan Ci (Assisting Acupuncture), involving direct insertion and withdrawal with frequent, shallow pricking to induce bleeding, used to treat carbuncles and swelling.

For pulses located deeply and not visible, insert the needle slightly and retain it for a long time to draw out the Qi of the empty vessel; do not needle superficial pulses; instead, press to occlude the pulse before needling, ensuring no essence escapes, only expelling the pathogenic Qi. Regarding the concept that "after three insertions, Gu Qi (Grain Qi) emerges": the first shallow insertion penetrates the epidermis to expel Yang pathogens; the second insertion goes slightly deeper, penetrating the epidermis to the muscle layer but not yet entering the muscle intervals; once inside the muscle intervals, Gu Qi emerges. Thus, the acupuncture method states: begin with shallow needling to drive out pathogenic Qi and attract healthy Blood and Qi; proceed with deeper needling to address Yin pathogens; finally, needle extremely deeply to mobilize Gu Qi. Beyond these three stages, there are five additional needling methods corresponding to the Five Zang organs. First, Ban Ci (Half Acupuncture), shallow insertion and rapid withdrawal without injuring the muscle, resembling plucking hair, to obtain Qi from the skin level; this corresponds to the Lung. Second, Bao Wen Ci (Leopard Pattern Acupuncture), needling around left, right, front, and back, aiming at the vessels to drain blood from the meridians; this corresponds to the Heart. Third, Guan Ci (Gate Acupuncture), vertical insertion at the tendons on either side to treat Sinew Bi, taking care not to cause bleeding; this corresponds to the Liver, also known as Yuan Ci or Qi Ci. Fourth, He Gu Ci (Union Valley Acupuncture), inserting in a chicken-foot pattern into the muscle compartments to treat Muscle Bi; this corresponds to the Spleen. Fifth, Shu Ci (Shu Acupuncture), direct insertion and withdrawal, deep penetration to the bone, to treat Bone Bi; this corresponds to the Kidney.

Having distinguished these needling methods, one must conform to the Four Seasons. Spring, Summer, Autumn, and Winter each have specific indications. In Spring, Qi resides in the meridians; it is appropriate to select collaterals and muscle compartments, described as "Spring needling disperses Shu points and tissue planes, stopping when blood appears." In Summer, Qi resides in the Sun-Luo (Plexus Collaterals); it is appropriate to select full meridians and interstices, described as "Summer needling collaterals and Shu points, stopping when blood appears." In Autumn, Qi resides in the skin; it is appropriate to select Meridian Shu points, described as "Autumn needling the skin, following the grain until spiritual transformation occurs." In Winter, Qi resides in the marrow; it is appropriate to select Jing-Well and Ying-Spring points, described as "Winter needling Shu apertures within the tissue planes." For Late Summer, Qi resides in the muscles, and needling depth varies accordingly. Additionally, the principle of "Spring needling Jing-Well, Summer needling Ying-Spring, Late Summer needling Shu, Autumn needling Jing, and Winter needling He" reflects the correspondence between seasons and acupoints. The Jing-Well point of Yin meridians belongs to Wood, and the Jing-Well point of Yang meridians belongs to Metal, distributing the Five Phases across the four seasons appropriately. If one needles without adhering to these positional rules, it will invite disease. By carefully examining these principles before applying needling, one can achieve appropriateness and avoid error.