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In ancient times, there was the system of Bian stones (Bian Shi, 砭石 - stone knives for surgical incision), and in the *Neijing* (Inner Canon), there are distinctions among the Nine Needles (Jiu Zhen, 九针 - nine types of acupuncture needles). Although their forms differ, the intent to eliminate disease is the same. Moreover, in the specialty of sores and ulcers (Chuang Yang, 疮疡), the use of needles is highly valued. When using them, although one must measure the depth of ulceration, it is even more important to follow the thickness of the flesh. If the skin is thin and the needle insertion is deep, it will instead damage healthy tissue and exacerbate ulceration. If the flesh is thick and the needle insertion is shallow, pus and toxins will not be discharged, increasing pain instead. Those who use needles must be extremely cautious. As for Gujiju (Attaching-Bone Abscess, 附骨疽), Qi-toxin flowing deposits, and conditions that persist without resolving where flesh ulcerates but does not hurt, it is appropriate to use Fan Zhen (Fired Needle, 燔针 - a red-hot needle) to open them. For treating throat ailments, a Three-Edge Needle (San Leng Zhen, 三棱针) should be used. For Danliu (Erysipema-like Tumors, 丹瘤) and carbuncle toxins with surrounding redness and burning pain, Bian stones should be used to bleed, thereby draining the toxin; severe cases will become mild, and mild cases will resolve. For instance, the wife of Mr. Hong suffered from an abdominal carbuncle with distension, fullness, and fainting due to pus accumulation; she revived immediately after being needled (Wu Zhen, 卧针 - flat/oblique insertion) to drain the pus. Another patient suffered from scrotal carbuncle with ripened pus and swelling, causing difficulty in urination and nearly fatal condition; urgent needling led to massive drainage of pus and fluid, restoration of Qi flow, and recovery. Generally, the method of using needles involves attacking against the pathogen to deprive it (Ying Er Duo Zhi, 迎而夺之) and following the pathogen to extract it (Shun Er Qu Zhi, 顺而取之). This refers to the principle of "treating before the abscess fully matures," which is exactly this meaning. Today's patients fear needles and refuse treatment, while doctors, complying with patients' wishes, do not needle. Consequently, pus forms but cannot rupture, or if it ruptures, the damage is already deep. Ultimately, eight or nine out of ten die prematurely, which is truly lamentable. See *Waike Xinfa* (New Methods in Surgery).

The Classic states: When the weather is warm and sunny, human blood flows freely and abundantly, and Wei Qi (Defensive Qi, 卫气) floats on the surface; thus, blood is easily released, and Qi moves readily. When the weather is cold and cloudy, human blood becomes congealed and sluggish, and Wei Qi sinks inward. Therefore, one must adjust the blood vessels according to the seasons. Hence, whenever encountering cold weather, frozen water, or times when Yin Qi is stagnant, and one intends to perform acupuncture, one should first keep the patient warm with clothing or coverings, or use heated mugwort leaves, or hot water for washing hands and warming clothes, to moxa-warm or heat the area first. It is essential to ensure the blood vessels are warm before needling; then, as blood releases and Qi moves, the illness will be cured immediately. If blood is cold and pulses are sluggish, and needles are used hastily, the pathogenic toxins will not be drained, only healthy tissue will be injured, and the illness will worsen.

Lizhai (Xue Ji) stated: For those with deficient Yuan Qi (Original Qi, 元气), it is necessary to tonify the Spleen and Stomach, and knife-and-needle procedures are strictly prohibited. If used recklessly, damaging flesh and blood, Yang will dissipate along with Yin, accelerating danger.

Xue Ji noted: There was a butcher named Tu Shouqing in Siming. Suddenly, his front teeth felt as if struck, with unbearable pain. The pulse was surging (Hong, 洪) and wiry (Xian, 弦). I said, the combination of wiry and surging pulses indicates that sores and toxins are about to erupt. I first prescribed Qingwei San (Stomach-Clearing Powder, 清胃散) plus Bai Zhi (Angelicae Dahuricae Radix, 白芷), Yin Hua (Honeysuckle Flower, 银花), and Lian Qiao (Forsythiae Fructus, 连翘) for one dose, and the pain stopped immediately. By evening, a sore erupted on the nose, with dark, swollen, and painful face. Using the previous prescription plus Xi Jiao (Rhinoceros Horn, 犀角), the swelling spread to both temples, foul breath emanated, the pulse became more surging, and there was aversion to cold with internal heat. This indicated blazing toxin and blood stasis, beyond the power of medicine alone. I bled the affected area multiple times with Bian stones, releasing purple blood, and administered detoxifying medicines with Xi Jiao. The next day, swelling and pain were even worse. I again bled the affected area and the upper lip, and pricked the red vessels inside the mouth, draining toxic blood each time. After administering the previous medicine for several doses, he recovered.