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This passage discusses the method of acupuncture that possesses the efficacy of stopping pain and shifting discomfort. One must first move the needle to the left and rotate it counter-clockwise to obtain the number "nine" (a yang number), then move it to the right and rotate it clockwise to obtain the number "six" (a yin number). This is the way of yin-yang interpenetration. Meridians also have interpenetration; for example, Lieque (LU7) of the Taiyin Lung meridian connects to the pathway of the Yangming Large Intestine meridian, and Fenglong (ST40) of the Yangming Stomach meridian branches off to the pathway of the Shaoyang Gallbladder meridian. This is what is meant.

Have you not heard that for Zang-Fu diseases, one should seek acupoints such as "Men Hai Shu Mu"? "Shu" refers to the Back-Shu points of the five Zang and six Fu organs. "Men Hai" refers to points like Zhangmen (LR13) and Qihai (CV6). The Shu points are located in the two rows on the back. "Mu" refers to the Front-Mu points: Zhongfu (LU1) for the Lung, Juxue (CV14) for the Heart, Zhongwan (CV12) for the Stomach, Qimen (LR14) for the Liver, Riyue (GB24) for the Gallbladder, Zhangmen (LR13) for the Spleen, Jingmen (GB25) for the Kidney, Tianshu (ST25) for the Large Intestine, and Guanyuan (CV4) for the Small Intestine. Only the Sanjiao, Pericardium, and Bladder lack Front-Mu points. This states that when any of the five Zang or six Fu organs are diseased, one must puncture these Men, Hai, Shu, and Mu points, which is most subtle.

When meridians and collaterals are stagnant, one should seek the principles of Yuan (Source) points, Bie (Divergent) collaterals, and Hui (Meeting) points. "Yuan" refers to the Source points of the twelve meridians. "Bie" refers to the divergent collaterals of the Yang meridians. "Jiao" refers to the intersecting points of the Yin meridians. "Hui" refers to the Eight Hui points. The Twelve Source points are: Qiuxu (GB40) for the Gallbladder, Taichong (LR3) for the Liver, Wangu (SI4) for the Small Intestine, Shenmen (HT7) for the Heart, Chongyang (ST42) for the Stomach, Taibai (SP3) for the Spleen, Hegu (LI4) for the Large Intestine, Taiyuan (LU9) for the Lung, Jinggu (BL64) for the Bladder, Taixi (KI3) for the Kidney, Yangchi (TE4) for the Sanjiao, and Daling (PC7) for the Pericardium. The Eight Hui points are: Geshu (BL17) for Blood, Danzhong (CV17) for Qi, Taiyuan (LU9) for Vessels, Yanglingquan (GB34) for Tendons, Dazhu (BL11) for Bone, Jiexi (GB41) for Marrow, Zhangmen (LR13) for Zang organs, and Zhongwan (CV12) for Fu organs. This states that when qi and blood in the meridians are condensed and blocked, one must puncture these Yuan, Bie, and Hui points.

Further investigating the Four Roots and Three Knots, and puncturing according to the Root-Branch theory ensures recovery. "Roots and Knots" refer to the roots and knots of the twelve meridians. The *Ling Shu* states: The Taiyin meridian roots at Yinbai (SP1) and knots at Ticang (ST8); the Shaoyin meridian roots at Yongquan (KI1) and knots at Lianquan (CV23); the Jueyin meridian roots at Dadun (LR1) and knots at Yutang (CV19); the Taiyang meridian roots at Zhiyin (BL66) and knots at the Eye; the Yangming meridian roots at Lidui (ST45) and knots at the Jaw; the Shaoyang meridian roots at Qiaoyin (GB44) and knots at the Ear. The Hand-Taiyang meridian roots at Shaoze (SI1) and knots at Tianchuang (SI16) and Zhengzheng (SI7); the Hand-Shaoyang meridian roots at Guanchong (TE1) and knots at Tianyou (TE10) and Waiguan (TE5); the Hand-Yangming meridian roots at Shangyang (LI1) and knots at Futu (LI18) and Pianli (LI6). The lower text for the Hand-Taiyin meridians is not forcibly annotated. It is also said that the "Four Roots" refer to the ear root, nose root, breast root, and foot root; the "Three Knots" refer to the chest knot, limb knot, and bowel knot. This states that if one can thoroughly understand the principle of roots and knots and puncture according to the aforementioned root-branch methods, diseases will surely be cured.

However, using the Eight Methods and Five Gates, distinguishing between Master and Guest points, ensures efficacy. "Eight Methods" refers to the Eight Extraordinary Vessels. Gongsun (SP4) connects to the Chong Mai, treating the stomach, chest, and heart; Neiguan (PC6) connects to the Yin Wei Mai; Linqi (GB41) connects to the Dai Mai, treating the gallbladder meridian, Dai Mai, Yang Wei Mai, and outer canthus; Waiguan (TE5) connects to the Yang Wei Mai, treating Houxi (SI3), Du Mai, and the neck; Shenmai (BL62) connects to the Yang Qiao Mai; Lieque (LU7) connects to the Ren Mai, treating the lung system; Zhaohai (KI6) connects to the Yin Qiao Mai, treating the diaphragm and throat. These five pairings (Five Gates) are based on heaven-earth correspondence divided into five elements: Jia combines with Ji, Yi with Geng, Bing with Xin, Ding with Ren, Wu with Gui. The Master-Guest relationship is: Gongsun is Master, Neiguan is Guest; Linqi is Master, Waiguan is Guest; Houxi is Master, Shenmai is Guest; Lieque is Master, Zhaohai is Guest. This states that if using the Eight Methods, one must deduce the time using the Five Gates to select points, prioritizing the Master then the Guest, ensuring efficacy. Details are recorded later.

The Eight Extraordinary Vessels always connect to the Eight Hui points, serving as the guiding principle. "Eight Vessels" refers to the Eight Extraordinary Vessels, noted above. "Eight Hui" refers to the eight meeting points of qi, blood, vessels, tendons, bone, marrow, zang, and fu, also noted above. "Guiding Principle" is like the main rope of a net. This states that the starting and ending points of the Eight Extraordinary Vessels connecting to the Eight Hui points serve as the guideline for all meridians in the body.

The Twelve Meridians and Twelve Source points are a pivotal hub. The Twelve Meridians, Fifteen Collaterals, and Twelve Source points are noted above. This states that the Twelve Source points are the pivot of entry and exit for the Twelve Meridians.

The method of selecting sixty-six acupoints in one day reveals profound subtleties. The "sixty-six acupoints" refer to the Jing-River, Ying-Spring, Shu-Stream, Yuan-Source, Jing-Stream, and He-Sea points in the Zi Wu Liu Zhu (Midnight-Noon Ebb-Flow) system. On Yang days, thirty-six points are used for Fu organs; on Yin days, thirty points are used for Zang organs, totaling sixty-six points, fully detailed in the Zi Wu Liu Zhu chart later. This states that meridians circulate through the body once a day, passing through the twelve meridian points. At this time, utilizing one point within the flow reveals profound principles.

At any given hour, selecting the Source points of the Twelve Meridians allows one to know the essential subtleties. The Source points of the Twelve Meridians are noted above. This states that within an hour, one should examine which meridian is dominant on that day. At that time, puncturing the Source point of that specific meridian reveals the mystery of the flow method.

Originally, tonification and reduction methods depend not on respiration but on finger manipulation. This states that tonification and reduction rely on manual techniques rather than just breathing. Techniques include fourteen types: Xun (Rubbing), Men (Gate), Ti (Lifting), An (Pressing), Tan (Plucking), Nian (Twirling), Cuo (Rubbing like twisting thread), Pan (Coiling), Tui (Pushing), Na (Inserting), Yao Dong (Shaking), Zhao (Scratching), Qie (Cutting/Pressing), Jin (Advancing), Chu (Retreating), and She (Collecting). The rules are as stated; skill depends on flexible application, detailed in the *Golden Needle Ode*.

Rapid efficacy requires crossing meridians correctly and recognizing the affected meridian. Crossing meridians follows the pairing: Large Intestine and Lung as transmitting organs; Heart and Small Intestine as receiving organs; Spleen and Stomach as digestive organs; Liver and Gallbladder as pure and clear positions; Bladder and Kidney interacting via yin-yang and exterior-interior relations. The "Affected Meridian" is the meridian suffering from disease; for example, heart disease requires puncturing Small Intestine points. If one recognizes the disease of the affected meridian and understands the principle of crossing meridians, acupuncture efficacy will be rapid.

Crossing Meridian Miu Ci involves taking points on the opposite side. Miu Ci involves puncturing collaterals; pain on the right is treated by puncturing the left, and vice versa. This is the principle of Crossing Meridian Miu Ci.

Reducing collaterals and needling far away: Head ailments are treated by needling foot points. The three Yang meridians descend from the head to the feet, so head ailments are treated by selecting foot points.

Ju Ci and Miu Ci differ. Ju Ci involves puncturing meridians; if pain is on the left but the right pulse is diseased, Ju Ci is applied (left pain punctured on right, right pain on left), targeting the meridian. Miu Ci involves puncturing collaterals; if there is bodily pain but no pulse abnormality, Miu Ci is applied (right pain punctured on left, left pain on right), targeting the collateral. The classic states that excess on the left causes disease on the right, and vice versa. If right pain persists but the left pulse becomes diseased, Ju Ci must be used to target the meridian, not the collateral. Thus, collateral diseases involve meridians crossing each other, hence called Miu Ci. These methods are similar but differ in targeting the meridian versus the collateral.

Micro-needling and subtle needling are interconnected. Micro-needling refers to the skill of insertion; subtle needling refers to the subtlety of the technique. They are connected.

Observing sections reveals the deficiency and excess of meridians. When inserting the needle into flesh, one advances in three levels (Heaven, Human, Earth) and must observe the arrival of De Qi to easily discern internal and external deficiency and excess. Also, observing the three positions of the pulse reveals which meridians are deficient or excessive.

Observing floating and sunken pulses distinguishes cold and heat in Zang-Fu organs. After needling, observing the speed of the needle's sensation determines the cold or heat of the Zang-Fu organs.

First, ensure the needle is bright and check for damage; then keep it in the mouth to warm it. Before needling, ensure the needle is shiny and undamaged. Then place it in the mouth to warm it, allowing it to meet the Ying and Wei without causing shock.

Do not look away; hold the hand like grasping a tiger; do not let the mind wander; treat it like awaiting a noble person. This warns acupuncturists to focus sincerely and respect the procedure. Do not look elsewhere, as holding a tiger prevents injury; do not let the mind wander, as awaiting a noble person prevents disrespect. The classic states: In needling, observe the section, do not let the mind wander, hold the hand like capturing a tiger, await like a noble person, pay attention until dusk, and do not lose the correct position. This is what is meant.

The left hand presses heavily and frequently to disperse qi; the right hand inserts lightly and slowly to avoid pain. Before needling, use the left thumb nail to press the acupoint to disperse qi. Insert the needle gently and slowly with the right hand; this avoids pain.

Fasting causes fear and dizziness when standing or lying sideways. Fasting means before eating. One should not needle a hungry person, as their qi and blood are unstable, causing fear or dizziness whether standing or lying sideways.

Close the eyes and press hard; sit or lie flat to avoid fainting. Before needling, instruct the patient not to look at the needling site. Press the acupoint firmly with the nail. Sit or lie flat to avoid fainting.

Understand the Ten Heavenly Stems and Ten Changes to know the opening and closing of acupoints. The Ten Heavenly Stems are Jia, Yi, Bing, Ding, Wu, Ji, Geng, Xin, Ren, Gui. The Ten Changes refer to daily variations, detailed in the Ling Gui Ba Fa. Points open at the appropriate time and close at the inappropriate time. Understanding this reveals the gain and loss of acupoints.

Explain the Five Elements and Five Zang, observing the prosperity and decline of days and times. Five Elements and Five Zang are noted above. This states that if a disease occurs during a time supported by the Five Elements, it prospers; if controlled, it declines. For heart disease, Jia/Yi times support it, while Ren/Gui times control it. Others follow this pattern.

Lie still like a drawn bow; respond swiftly like releasing a trigger. This describes the swift efficacy of acupuncture, like hitting a target.

Yinjiao and Yangbie stop blood dizziness; Yin Qiao and Yin Wei expel the placenta. There are two Yinjiao points: one below the umbilicus and one above the medial malleolus (Sanyinjiao). These two points stop postpartum blood dizziness. Zhaohai and Neiguan expel the placenta.

Bi syndrome, Jue syndrome, and hemiplegia are treated with Ying-Sui to reconnect meridians. Bi and Jue refer to cold paralysis of limbs; hemiplegia refers to stroke-induced paralysis. Treating these requires connecting qi and meridians, using Ying-Sui methods to ensure blood flow and meridian continuity.

Leukorrhea, metrorrhagia, and flooding are treated with warming and tonifying to restore qi and blood. These are women's diseases. Warming needle therapy is used to tonify and harmonize Ying and Wei.

Remain still and retain the needle for a long time. After needling, one must remain still and retain the needle.

For certainty, use Zhaohai to treat throat blockage; for accuracy, use Dazhong to treat mental dullness. Zhaohai and other points are recorded in measurement methods, so they are not repeated.

Generally, pain indicates excess requiring reduction; itching and numbness indicate deficiency requiring tonification. Pain is often due to heat and requires reducing with cooling; itching and numbness are often due to cold and require tonifying with warming.

Heavy body and joint pain are treated with Shu points; epigastric fullness is treated with Jing-Well points. Shu points are the Shu-Stream points of the twelve meridians; Jing-Well points are the Jing-Well points.

Heart distension and throat pain are cured by needling Taichong; spleen cold and stomach pain are relieved by reducing Gongsun; chest fullness and abdominal pain are treated by puncturing Neiguan; flank pain is treated by needling Feihu. Taichong and others are listed later. Feihu is Tongmen or Zhigou.

Tendon spasms and bone pain are treated by tonifying Hunmen; body heat and chronic cough are treated by reducing Pohu; head wind pain is treated by puncturing Shenmai and Jinmen; eye itching and pain are treated by reducing Guangming and Diwu; reducing Yin stops night sweats; treating pediatric bone steaming involves puncturing Pianli; promoting urination treats adult ascites; stroke is treated by needling Huantiao; deficiency is treated by selecting Tianshu. Diwu refers to Diwu Hui.

Before noon, specifically Chen and Si hours, the Moon grows, and warmth should be applied quickly. During these hours, the lunar influence is growing, so depletion should be avoided, and warming methods used. Between Wei and Shen hours, the Moon wanes, and cooling should be applied quickly. This compares the monthly lunar cycle to the daily cycle. The moon grows from day 1 to 15 and wanes from 16 to 30. Morning is growth; afternoon is decline.

Rubbing, patting, plucking, and retaining: Xun involves rubbing around the needle to promote qi flow. Men involves closing the point after withdrawal to prevent qi leakage. Tan-Nu involves lightly plucking to tonify deficiency. Liu-Xi-Mu involves retaining the needle and inhaling to tonify the Mother point until warmth is felt.

Nail pressing, quick extension, and calling: Nail pressing involves cutting the skin before insertion. Extension involves lifting the needle slightly. Shi-Xu-Zi involves reducing the Son point by withdrawing quickly after feeling cold.

Moving, retreating, emptying, and resting: Dong-Tui involves shaking the needle upon withdrawal. Kong-Xie involves pausing after withdrawal. Ying-Duo involves opposing the needle to reduce the Son point (e.g., reducing Spleen/Stomach for Heart disease).

Pushing, inserting, twirling, and following: Tui-Nei-Jin involves pushing the needle in. Cuo involves twirling slowly. Sui-Ji involves following the needle's direction to tonify the Mother point (e.g., tonifying Liver/Gallbladder for Heart disease).

Caution: Do not needle critical cases with unfavorable complexion and pulse. Caution is advised. For critical conditions, observe complexion and pulse; if contradictory, do not needle, as it may cause harm.

Avoid needling in extreme cold, heat, wind, rain, hunger, fullness, drunkenness, and fatigue. Extreme conditions are strictly contraindicated for needling.

Do not tonify on the Full Moon day, reduce on the New Moon day, reduce on the Half-Moon days, or tonify on the New Moon. Full Moon (15th), New Moon (30th/1st), and Half Moons (7th/8th, 22nd/23rd) are unsuitable for specific tonification/reduction methods. Acute emergencies are exceptions.

Refine your mind and master the methods; do not let moxibustion ruin the skin. Moxibustion requires careful study of points and methods to avoid violating taboos and damaging skin.

Correct the principle and seek the origin; strive to insert needles accurately. Needling requires understanding the principles and disease origins to ensure accurate placement.

Avoid forty-nine moxibustion contraindications and twenty-two needle contraindications. There are 45 moxibustion contraindicated points plus four Jing-Well points on limbs, totaling 49. There are 22 needle contraindicated points excluding Six Fu Back-Shu points. These are recorded previously.

Furthermore, Li pierced Juxue to revive an elderly patient; Yuancie pierced Weizhong to revive the Crown Prince; Zhen Quan pierced Quchi for arm pain; Hua Tuo pierced Huantiao and ZuSanLi for walking; Wang Zuan pierced Jiaoshu to expel spirits; Liver Shu and Mingmen restored sight to the blind; Shaoyang and Jiaobie restored hearing to the deaf. These examples illustrate the immediate efficacy of past masters to encourage students. However, as time passes since the sages, this art declines. Some abandon it when unsuccessful; others violate taboos due to ignorance. I humbly record these words to enlighten beginners, not to show experts. Master Dou was humble despite his wisdom. Those who boast of minor knowledge should be ashamed.