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Observing the swift methods of acupuncture, they are most wondrous; one must master tonification and sedation to rescue patients from critical peril. First, distinguish the upper and lower aspects of the disease; second, determine the high and low points of the acupoints. When there is a disease in the head, take points on the feet; when there is a disease on the left, take points on the right. For men, Qi (vital energy) is higher in the morning and lower in the evening; treatment must understand this principle. For women, Qi is lower in the morning and higher in the evening; treatment must recognize this timing. Before noon is morning, belonging to Yang; after noon is evening, belonging to Yin. The upper and lower distribution of Qi for men and women is divided by the waist. The Hand-Yang meridians go from hand to head and head to foot; the Hand-Yin meridians go from chest to hand; the Foot-Yang meridians go from head to foot and foot to abdomen; the Foot-Yin meridians go from foot to abdomen and chest to hand. Yin ascends, Yang descends; this is the mechanism of entry and exit. Opposing this flow constitutes sedation (Xie), while following it constitutes tonification (Bu). In spring and summer, needling should be shallow, especially for thin individuals; in autumn and winter, needling should be deep, especially for fat individuals. One must also observe the thickness or thinness of Yuan Qi (Source Qi) to decide the depth of needling, which is particularly appropriate.

Tracing back the methods of tonification and sedation, their subtlety lies in respiration and finger manipulation. For men, the tonification method involves advancing the needle forward with the thumb turning left during exhalation; withdrawing backward with the thumb turning right during inhalation constitutes sedation. Lifting the needle generates heat; inserting the needle generates cold. For women, the tonification method involves withdrawing the needle backward with the thumb turning right during inhalation; advancing forward with the thumb turning left during exhalation constitutes sedation. Inserting the needle generates heat; lifting the needle generates cold. Left and right directions differ, as do the chest and back. The above applies to before noon; after noon, it is reversed. Therefore, pressing and cutting with the fingernail is the method for inserting the needle; shaking and withdrawing is the method for removing the needle; moving and advancing is the method for urging Qi; circling and grasping is the method for guiding Qi. Twisting the needle removes disease; flicking the needle tonifies deficiency. For abdominal and visceral points, rotate to locate; palpate to confirm the point. Pressing heavily for a bean-sized area is called "An" (Press); lifting lightly for a bean-sized area is called "Ti" (Lift). These fourteen methods are prepared in the essentials of needling. Tonification: one withdrawal and three flights, and True Qi returns naturally. Sedation: one flight and three withdrawals, and Evil Qi avoids naturally. Tonify insufficiency; sedate excess. Excess manifests as swelling and pain; insufficiency manifests as itching and numbness.

It is said that excess presents as swelling and pain; insufficiency presents as itching and numbness. Regarding reality and insufficiency, under the needle, one knows if the patient is noble or humble, alive or dead. Noble pulses are crisp and soft; humble pulses are hard. Living pulses are choppy; dead pulses are empty. If Qi arrives but does not reach, death is certain.

Furthermore, the method of inserting the needle requires first pressing heavily with the fingernail, then having the patient cough once, and inserting the needle with the cough, which is wonderful.

For tonification, at the beginning of exhalation, insert into the skin and flesh, called "Tian Cai" (Heavenly Talent); pause slightly, advance into the muscle, called "Ren Cai" (Human Talent); pause again, advance to between tendon and bone, called "Di Cai" (Earthly Talent). This is the deepest point; perform tonification here. Pause for a long time, then withdraw to the "Ren" level, wait for Qi to sink and tighten, invert the needle towards the disease, advance and retreat, flying through meridians and moving Qi—all contained within. For sedation, at the beginning of inhalation, insert to Tian level, pause, advance straight to Di level, obtain Qi, and perform sedation. Pause for a long time, then withdraw to Ren level, wait for Qi to sink and tighten, invert the needle towards the disease, same method as before. If fainting occurs due to Shen Qi (Spirit Qi) deficiency, use tonification, wipe the mouth and nose with a sleeve until Qi returns, give hot soup, and rest briefly.

As for regulating Qi, after inserting to Di level, withdraw to Ren level. To move Qi upward, twist the needle to the right; to move Qi downward, twist to the left. To tonify, exhale first then inhale; to sedate, inhale first then exhale. If Qi does not arrive, circle with hand, cut with nail, shake needle, advance, twist, rub, and flick until Qi arrives. Use Long Hu Sheng Teng (Dragon and Tiger Ascending and Soaring) method: press front to make Qi go back, press back to make Qi come forward, guide Qi to the painful area. As for gathering Qi, hold needle straight, insert, then push down to gather Qi so it does not return. If joints are blocked and Qi cannot pass, use Long Hu Gui Feng Tong Jing Jie Qi Da Fa (Great Method of Dragon, Tiger, Turtle, Phoenix to Unblock Meridians and Connect Qi) to drive and transport it, still combining circling, grasping, and cutting—nothing will fail. This is the wonder of Tong Xian.

Moreover, regarding removing the needle: if the disease trend recedes and needle Qi loosens slightly, good; if disease remains, needle Qi is like a root, immovable and unturnable, because Evil Qi is sucking the needle. This means True Qi has not arrived; do not remove. If removed, disease recurs; re-tonify and sedate, wait for harmony, only remove when slightly loose. Shake slightly upon removal and pause. For tonification, remove during inhalation, quickly close the acupoint. For sedation, remove during exhalation, slowly, leave acupoint open. To ensure closure, inhale afterwards. Thus, inserting the needle should be slow; too fast injures Blood. Removing the needle should be slow; too fast injures Qi. The above twisting essentials are complete here.

Examining the eight methods of treating disease: 1. Shao Shan Huo (Fire Mountain Burning): treats stubborn numbness and cold bi. Shallow then deep, use Nine Yang numbers, three advances and three withdrawals, slow lift, firm press, heat arrives, close tightly, insert needle, standard for removing cold. 2. Tou Tian Liang (Cooling Heaven from Below): treats muscular heat and bone-steaming fever. Deep then shallow, use Six Yin numbers, three exits and three entries, firm lift, slow press, slowly raise needle, reliable for reducing heat. Fine twisting removes disease accurately. 3. Yang Zhong Zhi Yang (Yang within Yang): chills first, heat later, shallow to deep, using Nine-Six method, tonify first then sedate. 4. Yin Zhong Zhi Yang (Yang within Yin): heat first, chills later, deep to shallow, using Six-Nine method, sedate first then tonify. Shallow method uses shallow technique, deep method uses deep technique; do not mix and confuse. 5. Zi Wu Dao Jiu (Pestle Grinding at Rat and Horse hours): treats water distension and diaphragmatic qi. After setting the point, regulate Qi evenly, move needle up and down, nine inserts, six exits, rotate left and right a thousand times, naturally balanced. 6. Jin Qi Zhi Jue (Secret of Advancing Qi): treats pain in waist, back, elbows, knees, and wandering pain throughout body. Insert 9 fen, perform nine tonifications, lie flat, inhale five to seven times, wait for Qi to ascend. Also Long Hu Jiao Zhan (Dragon and Tiger Battle): twist left nine times, right six times; this is also a stopping-pain needle. 7. Liu Qi Zhi Jue (Secret of Retaining Qi): treats masses and fixed lumps. Insert 7 fen, use pure Yang, then insert straight, when Qi arrives, deepen, lift needle, pause again. 8. Chou Tian Zhi Fa (Method of Drawing and Adding): treats paralysis, sores, and leprosy. Take essential points, let Nine Yang obtain Qi, lift and press to search, major essence is circulating Qi, hold needle straight, insert, push down, restore Yang and reverse Yin, subtle under fingers, active in mind. If one response fails, repeat.

Regarding passing through passes and joints, urging Qi to fly through meridians and move Qi, there are four methods: 1. Qing Long Bai Wei (Green Dragon Wags Tail): like steering a boat rudder, no advance or retreat, one left one right, slowly拨动 (拨动 means to move/adjust). 2. Bai Hu Yao Tou (White Tiger Shakes Head): like shaking a bell, retreat square advance circle, combined with left-right shaking and vibrating. 3. Cang Ying Tan Xue (Fly Probes Hole): like entering soil, one retreat three advances, drill and pick four directions. 4. Chi Feng Ying Yuan (Red Phoenix Welcomes Source): spreading wings. Insert to Di, lift to Tian, wait for needle to shake naturally, re-enter its origin, fly around up/down/left/right. Disease above, retreat during inhalation; disease below, advance during exhalation.

For chronic hemiplegia, the method of connecting meridians and Qi has fixed breath counts and cun measurements. Hand-Foot Yang meridians: up [implied count], down 14, crossing meridians 4 cun. Hand-Foot Yin meridians: up 7, down 12, crossing meridians 5 cun. Rely on shaking, insertion/extraction, and respiration same method, driving and circulating Qi, flowing instantly, connecting up and down. Can make cold warm and heat cool, stop pain and reduce distension. Like opening a canal to release water, immediate effect seen, how can critical illness not rise? Although diseases have three causes, all stem from Qi and Blood; needles divide into eight methods, not departing from Yin and Yang. Meridians circulate day and night, respiration comes and goes without ceasing. Harmony means health; otherwise, disease arises. Like countries, places, mountains, seas, fields, rivers, and valleys: when seasons and wind/rain are balanced, waterways are smooth, people are safe, goods abundant. If one region suffers uneven wind/rain, droughts or floods cause waterways to surge or dry up, disasters follow. Human Qi and Blood suffer, evil is dispelled, righteousness supported. Thus, medicine is the most wondrous.

Alas! Xuanyuan and Qibo are ancient, Lu and Bian are dead; this path is profound, not exhausted in one word. This text is detailed; understanding comes from long practice. It is not common talk of the world, nor lack of skill by mediocre streams. Those who obtain it are like passing imperial exams, joyful in heart; those who use it are like archers hitting the target, progressing to the eye. Narrated from the learning passed down by sages, practitioners aspiring to this, if they can thoroughly penetrate the profound subtleties and exhaust their essence and wonder, then those in the world lying in bed, destined to meet, will encounter needle arrival and disease removal, healing accordingly.