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The exquisite method for rescuing [patients from] disease lies in acupuncture.

How can people today cure diseases without relying on the efficacy of medical treatment to劫 (rescue/overcome) illness? Nothing is more exquisite than needle therapy. Thus, the *Classic* states: "One who is bound by ghosts and spirits cannot be spoken to regarding the highest virtue; one who dislikes needles and stones cannot be spoken to regarding supreme skill." This is precisely what is meant.

Observe the seasons and years in accordance with the Heavenly Dao.

The human body has twelve meridians and three hundred and sixty joints, corresponding to the twelve months and three hundred and sixty days of a year. "Seasons and years" refer to the normal qi of the four seasons: warmth in spring, heat in summer, coolness in autumn, and cold in winter. If spring should be warm but turns cold, summer should be hot but turns cool, autumn should be cool but turns hot, and winter should be cold but turns warm, then one will encounter situations such as: "Winter injury by cold leads to warm diseases in spring; spring injury by wind leads to undigested diarrhea in summer; summer injury by summer-heat leads to malaria in autumn; autumn injury by dampness leads to upward reversal and coughing." Qibo said: "In all methods of needling, one must wait for the moon, sun, stars, and the normal qi of the four seasons to arrive. Only when the qi is settled should one needle." Therefore, when the weather is warm and the sun is bright, human blood flows smoothly, and Wei Qi (Defensive Qi) floats on the surface; thus, blood is easily drained, and qi moves easily. When the weather is cold and the sky is overcast, human blood becomes stagnant, and Wei Qi sinks. When the moon begins to wax, blood and qi begin to refine, and Wei Qi begins to circulate. When the moon is full, blood and qi are substantial, and muscles grow. When the moon wanes, muscles diminish, meridians become empty, Wei Qi departs, and the form stands alone. Hence, one must regulate blood and qi according to the heavenly timing. Do not needle when it is cold; do not allow stagnation when it is warm; do not use draining methods when the moon is waxing; do not use tonifying methods when the moon is full; do not treat when the moon is waning. This is called regulating according to heavenly timing. If one drains when the moon is waxing, this causes visceral deficiency. If one tonifies when the moon is full, qi overflows, and collateral vessels retain blood, named as disorder of excess and deficiency. If one treats when the moon is waning, this disrupts the meridians, confuses yin and yang, fails to distinguish true pathogenic factors from false ones, allowing evil to sink and remain, causing external weakness and internal chaos, so that licentious pathogens arise. It is also said: Heaven has Five Movements (Metal, Water, Wood, Fire, Earth); Earth has Six Qi (Wind, Cold, Summer-heat, Dampness, Dryness). Students must observe these principles.

Determine the patient's form and qi within your mind.

The *Classic* states: "In all cases of using needles, one must first measure the fatness or thinness of the form to regulate the emptiness or fullness of qi. Fullness requires draining; emptiness requires tonifying. One must first remove blood stasis before regulating qi. Regardless of whether the disease is stable, regulation is required. Carefully observe form and qi; they must be understood in the heart." If the form is robust but the pulse is fine, and there is shortness of breath insufficient for respiration, this is critical. If the form is emaciated but the pulse is large, and there is excessive qi in the chest, this is fatal. If form and qi are harmonious, life prevails; if they are discordant, death ensues. Therefore, if the complexion and pulse are incompatible, avoid needling. Beware, beware!

In spring and summer, for thin individuals, needle shallowly; in autumn and winter, for fat individuals, needle deeply.

The *Classic* states: "Diseases have depth and superficiality; needling has shallowness and profundity. Each must reach its proper level without exceeding the pathway. Exceeding it causes internal injury; falling short causes external obstruction. Obstruction allows pathogens to enter. Improper depth becomes a great thief, injuring the five zang internally and giving rise to major diseases later." Thus, it is said: Spring diseases are in the hair follicles and interstices; summer diseases are in the skin. Therefore, in spring and summer, people's Yang qi is light and floating, muscles are thin, and the four qi are not yet abundant; shallow needling is appropriate. Autumn diseases are in the muscles; winter diseases are in the sinews and bones. In autumn and winter, Yang qi is stored, muscles are thick, and blood and qi are abundant; deep needling is appropriate. It is also said: Spring needling targets the Twelve Jing-Well points; Summer, the Twelve Ying-Spring points; Late Summer, the Twelve Shu-Stream points; Autumn, the Twelve Jing-River points; Winter, the Twelve Luo-Connecting points. These correspond to Wood, Fire, Earth, Metal, and Water, following the principles of the Zi Wu Liu Zhu (Midnight-Noon Ebb-Flow) theory.

Meridians and Yin-Yang cannot be exhausted; one must encounter and respect contraindications.

The Classics record the Twelve Meridians: Hand Taiyin Lung, Hand Shaoyin Heart, Hand Jueyin Pericardium, Hand Taiyang Small Intestine, Hand Shaoyang Sanjiao, Hand Yangming Large Intestine; Foot Taiyin Spleen, Foot Shaoyin Kidney, Foot Jueyin Liver, Foot Taiyang Bladder, Foot Shaoyang Gallbladder, Foot Yangming Stomach. There are Fifteen Collateral Vessels: Lung collateral Lieque, Heart tongli, Pericardium Neiguan, Small Intestine Zhizheng, Sanjiao Waiguan, Large Intestine Pianli, Spleen Gongson, Kidney Dazhong, Liver Ligou, Bladder Feiyang, Gallbladder Guangming, Stomach Fenglong, Yin Qiao Zhaohai, Yang Qiao Shenmai, Great Collateral of Spleen Dabao, Du Mai Changqiang, Ren Mai Pingyi.

Yin and Yang are the Yin and Yang of Heaven. From dawn to noon is Heaven's Yang, Yang within Yang; from noon to dusk is Heaven's Yang, Yin within Yang; from nightfall to rooster crow is Heaven's Yin, Yin within Yin; from rooster crow to dawn is Heaven's Yin, Yang within Yin. Humans correspond to this. Speaking of human Yin and Yang, exterior is Yang, interior is Yin; speaking of body Yin and Yang, back is Yang, abdomen is Yin; hands and feet are divided by red and white flesh boundaries; speaking of Zang-Fu Yin and Yang, Five Zang are Yin, Six Fu are Yang. Therefore, spring and summer diseases are mostly in Yang, autumn and winter diseases are mostly in Yin. One must view their locations and apply needles and stones accordingly. Furthermore, the back is Yang: Yang within Yang is Heart, Yang within Yin is Lung; the abdomen is Yin: Yin within Yin is Kidney, Yin within Yang is Liver, Ultimate Yin within Yin is Spleen. These are all mutual correspondences of Yin-Yang, interior-exterior, male-female. Thus, one must correspond to Heavenly Yin-Yang. If students do not understand the principles of meridian Yin-Yang ascending-descending and left-right differences, such as treating Yangming by attacking Jueyin, or Taiyang by harmonizing Taiyin, the pathogenic factor will not be removed, and the original qi will suffer, resulting in labor without merit. Violating contraindications, how can one proceed rashly?

Having discussed the emptiness and fullness of Zang and Fu, one must seek answers in the meridians.

Zang includes Heart, Liver, Spleen, Lung, Kidney; Fu includes Gallbladder, Stomach, Large Intestine, Small Intestine, Sanjiao, Bladder. Emptiness manifests as itching and numbness; fullness manifests as swelling and pain. Zang reside inside, meridians travel outside. Emptiness requires tonifying the Mother; fullness requires draining the Child. For example, Heart emptiness tonifies Liver Wood; Heart fullness drains Spleen Earth. Moreover, the same meridian has Mother-Child relationships: Heart emptiness tonifies Shaohai point; Heart fullness drains Shaofu point. All meridians follow this, adhering to the principle of Mutual Generation of the Five Elements.

Tracing the origin, it starts at the Middle Jiao, where water descends initially, beginning with the Taiyin meridian and ending with the Jueyin meridian. Points emerge from Yunmen and end at Qimen.

This describes human Qi and Pulse traveling through the Twelve Meridians, completing one cycle around the body. Excluding Ren and Du, there are three hundred and ninety-three points. In one day and night, there are one hundred Ke (time units), distributed among the Twelve Shi (two-hour periods). Each Shi has eight Ke and two Fen; each Ke has sixty Fen, totaling five hundred Fen per Shi. At Yin hour, Taiyin Lung meridian arises from the Middle Jiao, emerging from Zhongfu at Yunmen, starting at Shaoshang. At Mao hour, Yangming Large Intestine meridian goes from Shangyang to Yingxiang. At Chen hour, Yangming Stomach meridian goes from Touwei to Lidui. At Si hour, Taiyin Spleen meridian goes from Yinbai to Dabao. At Wu hour, Shaoyin Heart meridian goes from Jiquan to Shaochong. At Wei hour, Taiyang Small Intestine meridian goes from Shaoze to Tinggong. At Shen hour, Taiyang Bladder meridian goes from Jingming to Zhiyin. At You hour, Shaoyin Kidney meridian goes from Yongquan to Shufu. At Xu hour, Pericardium meridian goes from Tianchi to Zhongchong. At Hai hour, Shaoyang Sanjiao meridian goes from Guanchong to Heliao. At Zi hour, Shaoyang Gallbladder meridian goes from Tongziliao to Qiaoyin. at Chou hour, Jueyin Liver meridian goes from Dadun to Qimen, concluding the cycle.

The Twelve Regular Meridians have Extraordinary Collaterals, traveling through over three hundred branches.

The Twelve Meridians are the regular meridians of the Three Yin and Three Yang of the Hands and Feet. The Collaterals, besides the Fifteen Major Collaterals, include Hengluo, Siluo, and Sunluo, whose numbers are incalculable, traveling through the pulses of over three hundred branches.

Upright, side-lying, supine, and prone positions involve over six hundred acupoints for Qi circulation.

This refers to meridians being upright, oblique, supine, or prone, with Qi and Blood circulating around the body. Ying Qi travels within the vessels (over three hundred points); Wei Qi travels outside the vessels (over three hundred points).

Hand and Foot Three Yang meridians: Hands go to the Head, Head goes to the Feet. Hand and Foot Three Yin meridians: Feet go to the Abdomen, Chest goes to the Hands.

This describes the mechanism of Yin ascending, Yang descending, and Qi-Blood entering and exiting, which is no different for men and women.

To recognize Ying and Suai techniques, one must understand Reversal and Following.

Ying and Suai require knowing the flow of Ying and Wei and the coming and going of meridians. Clarify the Yin-Yang meridians' reversal and following to select them. "Ying" means the needle head faces the source against the flow (Reversal); "Sui" means the needle head follows the flow (Following). Thus, Reversal is Draining (Ying); Following is Tonifying (Sui). If one knows Ying and Sui, Qi will harmonize, and the method of harmonizing Qi will be unobstructed. The principles of Yin-Yang ascending-descending, upper-lower source-flow, and coming-going reversal/following will be clear.

Moreover, the abundance and scarcity of Yin-Yang Qi and Blood are most important. Jueyin and Taiyang have little Qi and much Blood; Taiyin and Shaoyin have little Blood and much Qi; Shaoyang has much Qi and little Blood; Yangming has abundant Qi and abundant Blood. This discusses the differences in Qi and Blood abundance among the Three Yin and Three Yang. One must remember this when selecting points; it is crucial.

First, detail the suitability of abundance and scarcity; second, observe the seasonal Qi.

This means the practitioner must first understand the abundance and scarcity of Qi and Blood mentioned above, and secondly observe the arrival of the needle Qi.

Light, slippery, slow, and delayed indicate Qi has not arrived; heavy, choppy, tight, and firm indicate Qi has arrived.

Light, floating, slippery, empty, slow, and delayed—after inserting the needle, these three conditions indicate True Qi has not arrived. Heavy, choppy, stagnant, tight, and firm—after inserting the needle, these three conditions indicate Righteous Qi has arrived.

Once Qi arrives, gauge Cold and Heat to determine retention time.

"Retention" means keeping the needle; "Rapid" means quick withdrawal. This states that once Righteous Qi arrives, one must examine Cold and Heat to apply treatment. Thus, the *Classic* says: "For Heat, wait for Cold sensation; retain the needle until Yin Qi is abundant, then exhale and withdraw slowly without pressing the hole. For Cold, wait for Heat sensation; when Yang Qi is abundant and the needle feels hot, inhale and withdraw quickly, pressing the hole immediately."

If Qi has not arrived, guide it based on Emptiness and Fullness.

This refers to the non-arrival of Needle Qi. The *Classic* says: "For Emptiness, push inward and advance/rub to tonify Qi; for Fullness, stroke, press, flick, and tense to draw out Qi."

The sensation of Qi arriving is like a fish swallowing bait, rising and sinking; the sensation of Qi not arriving is like sitting quietly in a deep, secluded hall.

Once Qi arrives, the needle feels tight and choppy, like a fish on a hook, moving up and down, stirring the Qi. If Qi does not arrive, the needle feels light and slippery, like sitting in a quiet room, silent and hearing nothing.

Fast Qi arrival brings fast results; slow Qi arrival brings difficult-to-treat outcomes.

This means if Qi arrives quickly after insertion, the disease cures quickly and effects are rapid. If Qi arrives slowly, the disease is hard to heal, with risks of untreatability. Thus, the Ode states: "Fast Qi, fast effect; slow Qi, slow effect." If Qi does not arrive after waiting, death is certain.

Observing the Nine Needles, the Filiform Needle is the finest, corresponding to the Seven Stars for various points, governing treatment.

In ancient times, the Yellow Emperor created the Nine Needles, corresponding to Heaven and Earth, Yin-Yang, and Four Seasons. Their names and shapes differ. 1. Chan Needle (Lancet): Corresponds to Heaven, 1.6 cun long, sharp tip, for draining Yang Qi. 2. Yuan Needle (Round): Corresponds to Earth, 1.6 cun long, egg-shaped, rubbed between muscles without damaging them, to drain muscle Qi. 3. Di Needle (Probe): Corresponds to Man, 3.5 cun long, blunt tip like millet, presses meridians without penetrating to gather Qi. 4. Feng Needle (Three-edged): Corresponds to Four Seasons, 1.6 cun long, three edges, for chronic diseases. 5. Pi Needle (Broadsword): Corresponds to Five Tones, 4 cun long, 0.25 cun wide, sword-like tip, for draining large abscesses. 6. Yuanli Needle (Sharp/Round): Corresponds to Six Laws, 1.6 cun long, slightly thicker in the middle, sharp and round, for acute conditions. 7. Hao Needle (Filiform): Corresponds to Seven Stars, 3.6 cun long, mosquito-bite-like tip, gentle insertion, prolonged retention, for pain and bi-syndrome. 8. Chang Needle (Long): Corresponds to Eight Winds, 7 cun long, sharp and thin, for distant bi-syndrome. 9. Da Needle (Large): Corresponds to Nine Fields, 4 cun long, slightly rounded tip, for draining joint fluid. These are the Nine Needles. The filiform needle is the most refined, corresponding to the Seven Stars, suitable for the three hundred and sixty points.

Its form is Metal, possessing the way to dispel Evil and support Righteousness.

"Form" refers to the needle. Needles were originally made of metal (or stone in antiquity). "Juan" means to eliminate. When Evil Qi is strong, the needle eliminates it; "Fu" means to assist. When Righteous Qi is weak, the needle assists it.

Lengths vary like Water, having the mechanism to resolve doubts and open stagnation.

This compares needle lengths to water levels. Human Qi and Blood stagnation is like blocked water. Blocked water is diverted to lakes and seas; blocked Qi and Blood are circulated through meridians by needles. Thus, the needle corresponds to Water.

Needling posture resembles Wood, either oblique or upright.

Wood grows obliquely or uprightly; needling varies similarly. For Yang meridians, insert obliquely to avoid Wei Qi; for Yin divisions, insert uprightly to avoid Ying Qi. Thus, the needle corresponds to Wood.

Holding the needle in the mouth adds Yang and tonifies emaciation.

"Holding in mouth" warms the needle. "Lei" means emaciation. Before inserting, warm the needle in the mouth to connect Ying and Wei, advancing one's own Yang Qi to tonify the patient's weakness. Thus, the needle corresponds to Fire.

Stroking and closing the aperture resembles Earth.

"Stroking" guides Qi and Blood with hand movements; "Closing" presses the acupoint after needling to seal it. Thus, the needle corresponds to Earth.

Fullness corresponds to the Five Elements and can be known.

The Five Elements are Metal, Wood, Water, Fire, Earth. This concludes that the needle's correspondence to the Five Elements is evident.

Yet, an inch and six fen contains profound principles.

Although the needle is only 1.6 cun long, it skillfully manipulates divine mechanisms, containing Water and Fire, reversing Yin and Yang, with profound principles.

Though fine as a hair, it penetrates many branches.

"The shaft" is fine as a hair, yet it penetrates the pathways of Qi and Blood in numerous meridians.

It can balance Cold and Heat of the Five Zang and regulate Emptiness and Fullness of the Six Fu.

"Balance" means to treat; "Regulate" means to adjust. The needle treats Zang-Fu disorders: warming Cold, clearing Heat, tonifying Emptiness, draining Fullness.

For spasms and blockages, expel the Eight Evils.

"Spasms" are tendon contractions; "Blockages" are Qi-Blood stagnation; "Eight Evils" refer to the Eight Wind pathogens. For spasms and blockages, one must disperse the Eight Wind evils.

For Cold, Heat, Pain, and Bi, open the Four Gates to stop them.

"Cold" is trembling chills; "Heat" is tidal fever; "Pain" is painful obstruction; "Bi" is numbness. "Four Gates" refer to the Twelve Source Points originating from the Four Gates: Taichong and Hegu.

In all needling, ensure the Spirit gathers before insertion; after insertion, ensure the Spirit settles and Qi follows. If the Spirit does not gather, do not needle. If the Spirit settles, proceed.

When needling, ensure the patient's Spirit is focused before insertion. After insertion, ensure the patient's Spirit stabilizes before manipulating Qi. If the Spirit is not gathered, the needle will feel light and slippery, painless like inserting into tofu; do not proceed, as this indicates impending death. If Qi arrives, the needle feels tight; proceed with methods to examine Emptiness/Fullness.

At the fixed point, prioritize Qi and Blood.

When preparing to needle, prioritize the abundance/scarcity of Yin-Yang Qi and Blood (see above).

At the starting point, recognize Water and Wood as the foundation.

Tonify the Mother to supplement deficiency; drain the Child to balance excess. This emphasizes the Mother-Child relationship. Mentioning Water and Wood implies omitting Earth, Metal, and Fire for brevity.

Heaven, Earth, and Man: Yongquan, Xuanji, and Baihui.

Baihui (Head) corresponds to Heaven; Xuanji (Chest) corresponds to Man; Yongquan (Foot sole) corresponds to Earth. This is the Three Realms.

Upper, Middle, Lower Parts: Dabao, Tianshu, and Diji.

Dabao (Under breast) is Upper; Tianshu (Beside navel) is Middle; Diji (Leg) is Lower. This is the Three Parts.

Yang Qiao, Yang Wei, and Du Mai govern shoulder, back, waist, leg exterior diseases.

Yang Qiao starts at heel, ascends outer ankle to Fengchi; Yang Wei maintains Yang convergence (e.g., Stomach meeting point); Du Mai starts at lower extremity, ascends spine, passes brain, enters nose to Yinjiao. These three extraordinary meridians are Yang, treating exterior shoulder/back/waist/leg diseases.

Yin Qiao, Yin Wei, Ren, Chong, and Dai Mai address interior heart, abdomen, flank, rib diseases.

Yin Qiao starts at heel, ascends inner ankle to throat, intersects Chong; Yin Wei maintains Yin convergence (e.g., Spleen intersecting Liver); Ren Mai starts below Zhongji, ascends abdomen to throat; Chong Mai starts at Qichong, runs alongside Stomach meridian up chest; Dai Mai starts at hypochondrium, encircles body like a belt. These five extraordinary meridians are Yin, treating interior heart/abdomen/flank diseases.

Er Ling, Er Qiao, Er Jiao: Successively connecting the Five Bodies.

Er Ling: Yinlingquan, Yanglingquan; Er Qiao: Yin Qiao, Yang Qiao; Er Jiao: Yin Jiao, Yang Jiao. "Connect" means succession. "Five Bodies" refers to physical structures. These six points connect sequentially in hands, feet, and head.

Liang Jian, Liang Shang, Liang Jing: Arranged along two arm branches.

Liang Jian: Erjian, Sanjian; Liang Shang: Shaoshang, Shangyang; Liang Jing: Tianjing, Jianjing. These six points are arranged along the two arm branches.

Regarding point location methods, there are measurements. First judge mentally, then observe flesh distribution.

To measure points, use the "Same-Body Cun": flex thumb and middle finger to form a ring; the distance between the creases is one Cun. Adjust for size. First identify the disease and meridian; then measure the patient's thinness/thickness, bone structure, and hairline to locate points accurately.

Some points are found by extending/flexing; others by lying straight or sitting upright.

Extending/Flexing: e.g., Huantiao requires extending the lower leg and flexing the upper. Straight/Upright: Lying flat, sitting upright, or standing naturally, e.g., Chengjiang under the lip.

In Yang regions, beside sinews/bone depressions are true points; in Yin regions, corresponding arterial pulses indicate true points.

Yang regions (e.g., Hegu, Zusanli, Yanglingquan): Locate in the depression beside the bone. Yin regions (e.g., Qimen, Wuli, Taichong): Locate where the arterial pulse responds to touch.

Selecting one point from five ensures accuracy; selecting one meridian from three corrects the diagnosis.

Choosing one precise point from five candidates ensures accuracy. Selecting one meridian among three helps verify the diagnosis.

Head and Shoulder: Differentiate Du and Ren meridians easily.

Head and shoulder points are numerous. By assessing size and fatness, and noting Du (Back/Midline) and Ren (Front/Midline) paths, location is easy.

Clarify Root and Branch, discuss depth of needling.

Root and Branch have multiple meanings: Six Meridians, Heaven/Earth Yin/Yang, Disease progression.
Six Meridians Roots/Branches:
Taiyang: Root at heel, Branch at eye.
Shaoyang: Root at Qiaoyin, Branch at ear.
Yangming: Root at Lidui, Branch at Renying/Jaw.
Taiyin: Root at Zhongfeng, Branch at Back Shu/Tongue base.
Shaoyin: Root at Inner Ankle, Branch at Back Shu/Sublingual veins.
Jueyin: Root at Xingjian, Branch at Back Shu.
Hand Taiyang: Root at Outer Ankle, Branch at Mingmen +1 cun.
Hand Shaoyang: Root at Finger web, Branch at Ear posterosuperior angle.
Hand Yangming: Root at Elbow, Branch at Forehead.
Hand Taiyin: Root at Cun Kou, Branch at Axillary artery.
Hand Shaoyin: Root at Sharp Bone end, Branch at Back Shu.
Hand Jueyin: Root at Wrist crease, Branch at Under tendon.

The *Classic* states: "Disease has Root/Branch; needling has Reversal/Following and Depth."
Principles:
1. Treat Branch for Branch symptoms; Root for Root symptoms.
2. Treat Root for Branch origin; Branch for Root origin.
3. Specific rules:
- Prioritize Root generally.
- Exceptions (Treat Branch first): Fullness of middle jiao (regardless of cause); Diarrhea followed by other diseases (Treat Root/Diarrhea first); Fullness followed by irritability (Treat Root/Fullness first).
- Urinary/Bowel issues: Obstruction treated as Branch; Normal function treated as Root.
- Excess diseases: Treat Root first, then Branch.
- Deficiency diseases: Treat Branch first, then Root.
- Time-based: Onset date is Root; Transmission is Branch.
Depth: Yang meridians need shallow needling (avoid damaging Wei); Yin meridians need deep needling (avoid damaging Ying).

To stop pain and move stiffness, select intersecting and crossing pathways.