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When performing acupuncture, the needle should be warmed in the mouth. First, use the left hand to palpate and press the Ying (Nutrient) point area where the needle is to be inserted. Flick the area with a finger to distend the meridians, press down with the fingernail for positioning, then palpate and stroke along the meridian to unblock and regulate Qi. When the patient coughs once following their condition, insert the needle with the right hand. In spring and summer, perform twenty-four breaths; in autumn and winter, perform thirty-six breaths. Withdraw slowly and insert slowly. When Qi arrives, it feels like a pulsating artery. For tonification: push the needle into the body following the direction of the meridian flow. Close the needle hole with the left hand, withdraw the needle slowly, and press it quickly. For sedation: withdraw the needle against the direction of the meridian flow. Open the needle hole with the left hand, withdraw the needle quickly, and press it slowly. Following the flow to assist is called tonification; opposing the flow to deprive excess is called sedation. To treat excess syndromes and make them deficient, retain the needle until Yin Qi becomes abundant before removing it. To treat deficiency syndromes and make them solid, remove the needle when Yang Qi becomes abundant and heat is felt under the needle. For diseases of the twelve meridians: sedate if excess, tonify if deficient; puncture quickly without retention for heat syndromes; retain for cold syndromes; moxa for sinking conditions; and select points from the affected meridian for neither excess nor deficient conditions.

The four limbs are the branches and trunks of the body, with Qi connected to the Zang and Fu organs. Their flesh and skin are shallow, so moxibustion should not be excessive; one must follow the standard number of moxa cones according to the meridian. For other diseases, this principle applies. However, for Hong Kong foot (Gouty Arthritis/Jiaqi), this rule does not apply strictly; since it is caused by wind-toxin, moxibustion should be copious. If one strictly follows the standard meridian counts, the disease will be difficult to cure quickly. The *Xiao Pin Fang* discusses eight types of wood fires for moxibustion, and the *Ming Tang Jing* discusses moxibustion tonification and sedation methods; following these theories yields correct results. Among the eight wood fires: pine wood fire makes healing difficult; cypress wood fire causes excessive discharge from sores; orange wood fire damages the skin; mulberry wood fire causes muscle withering; date wood fire causes emaciation; bamboo wood fire damages tendons; too many cones cause tendon flaccidity; bitternut tree wood fire causes sinking into collaterals and ulceration; elm wood fire damages bones; too many cones cause bone withering. None of these eight wood fires should be used. One should use fire from a Yang Sui (bronze mirror), or secondarily from a grinding stone (Dun Shi). On cloudy days, use locust wood fire. The Yang Sui involves holding a bronze mirror towards the sun with mugwort underneath to catch the flame. Dun Shi is hard like jade; striking it against bloomery iron produces sparks, which are caught on rotten elm wood to ignite mugwort. This is the Xiongnu fire method, still used by people in the north today. Regarding moxibustion tonification and sedation, the *Jia Yi Jing* states: for tonification, do not blow on the fire; let it extinguish naturally. For sedation, blow rapidly on the fire to hasten the burning of the mugwort cone until it extinguishes. Blowing rapidly to extinguish is sedation; letting it extinguish naturally is tonification. The *Duan Ju Fang* adds: Huang Di said, moxibustion should not exceed three fen, which is called following the acupoint. This means the base of the moxa cone should be three fen wide. If less than this, it will not penetrate the acupoint, fail to reach the meridian, prevent Qi flow, and cannot eliminate disease. In Jiangnan and Lingnan, where cold Qi is scarce, two fen is the standard; for small mirrors, do not reduce below one and a half fen. Reduce dosage for infants. Generally, moxa sores must suppurate and break open for the disease to exit; if the sore does not break, the disease remains. The *Jia Yi Jing* states: if moxibustion fails to produce a sore, apply hot compresses using old shoe soles; the sore will appear within three days. This is worth understanding. Su Gong, skilled in treating this disease, was famous in the capital and renowned in lower regions. He wrote volumes on Hong Kong foot formulas, serving as a guide. His discussion on moxibustion was not rigid. He stated: "Toxic vapors are like thieves; why must they exit through the main gate? Moxibustion is required on the abdomen, back, hands, and feet." I argue that moxing the abdomen attacked by wind-toxin is inviting the thief into the house; how can one expect the thief to leave? This must be known carefully and not treated lightly. Moxibustion on fingers for stiffness is permissible. If a patient has a heat syndrome, upon feeling Qi arrival at the disease site, withdraw the needle two or three fen. Have the patient inhale through the mouth and exhale through the nose. Count according to the generative numbers of the meridian. When Yin Qi becomes abundant under the needle, remove it according to the previous method. If a patient has a cold syndrome, upon feeling Qi arrival, advance the needle two or three fen. Have the patient inhale through the nose and exhale through the mouth. Count according to the generative numbers of the meridian. When Yang Qi becomes abundant under the needle, remove it according to the previous method. For example, in tonifying cold: first have the patient cough once to enter the interstices. Then have the patient blow air once, insert the needle while blowing, to a depth of six or seven fen. Gradually advance to the Kidney and Liver areas. Retain the needle for a long time. Withdraw slightly (one bean's width), twirl the needle, and ask if the patient feels heat. Then advance to three or four fen, reaching the Heart and Lung areas. Have the patient inhale while inserting, twirl to direct Qi downward to the disease site, then twirl outward to direct Qi upward, passing one or two cun beyond the needled point. Inhale while twirling outward to withdraw, and quickly press the acupoint with the hand. This is tonification. For post-illness heat, how to treat with cold methods? To induce coolness, first puncture the Yang aspect. After obtaining Qi, push inward to the Yin aspect. Have the patient draw Earth Qi in and release Heaven Qi out. Carefully count the generative breaths until complete; the patient will feel cool. For aversion to cold, how to treat with heat methods? To induce warmth, first puncture the Yin aspect. After obtaining Qi, slowly withdraw to the Yang aspect. Have the patient draw Heaven Qi in and release Earth Qi out. Carefully count the generative breaths until complete; the patient will feel warm.