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I have heard that ancient physicians could discern the changes of heaven and time, understand the flow of qi and fortune, master the subtleties of the Four Diagnostic Methods (inspection, auscultation/olfaction, inquiry, palpation), be familiar with the standard and variant patterns of the meridians, and perceive pathological mechanisms as clearly as seeing through a wall. Their medical skills were indeed divine. Therefore, since the transmission of the *Ling Shu* (Spiritual Pivot) and *Su Wen* (Basic Questions), although these texts contain theoretical discussions but lack specific prescriptions, they primarily aim to demonstrate the great principles of meridians to people, urging them to comprehend with their minds and realize with their spirits. Only in the treatment of acupuncture and moxibustion are the explanations necessarily detailed, because acupuncture and moxibustion rely on fixed acupoints, necessitating the clear differentiation of meridians and the indication of the Five Shu Points (Jing-Well, Ying-Spring, Shu-Stream, Jing-River, He-Sea), so that later practitioners may select points according to the meridians. From this, we can know how meticulous the ancient sages were in their thinking and how rigorous their establishment of laws!

The origin of acupuncture and moxibustion is long-standing; the *Ling Shu* serves as the ancestor of these disciplines. Since then, famous physicians emerged one after another, nearly reaching a hundred schools, such as Bian Que, Cang Gong, Zhang Ji (Zhang Zhongjing), Hua Tuo, as well as the virtuous scholars Li Dongyuan, Liu Wansu, and Zhu Danxi from the Jin-Yuan period. All these individuals were most renowned and each had writings that elucidated the classic meanings of the ancient sages. From the Qin and Han dynasties down to the Ming Dynasty, there were inheritors generation after generation. In the Ming Dynasty, Zhang Huiqing (Zhang Jiebin) collected the essential points of various schools and wrote the *Lei Jing* (Classified Classic), making the study of acupuncture and moxibustion even more prominent, yet there remained incomplete aspects. It was only in our dynasty that the compilation of the *Yi Zong Jin Jian* (Golden Mirror of Medicine) became the general repository for the medical field, like all waters returning to their source. Its statements on acupuncture and moxibustion carefully examine the proportions of acupoints without error; truly, it stands outstanding for millennia. Unfortunately, few medical practitioners learn it; among those treating with needles, not one or two out of a hundred do so; among those treating with moxa, not two or three out of ten do so. Yet, treatments using decoctions (herbal medicine) are everywhere. Is it that herbal medicine is easy while acupuncture and moxibustion are difficult? No. Human beings are born receiving the qi of heaven and earth, possessing meridians and zang-fu organs within. When disease strikes, whether in the meridians or collaterals, entering the fu-zang or zang-organs, one must wait for someone who understands meridians and zang-fu to remove the disease. Could it be that those using herbal medicine can abandon meridians and zang-fu to treat differently? I know such a principle does not exist. Then why are there many treating with acupuncture/moxibustion and few practicing herbal medicine? [Note: The original text actually says "why are there many treating [with acupuncture/moxibustion] and few practicing [the other]" - wait, re-reading original: "然则何为治此者多而习彼者寡". Context implies "Why are there many doing [acupuncture/moxibustion?] and few doing [herbs?]". Actually, looking at the next sentence "盖以汤液之治易于藏拙... 若夫针灸之治... 人之不乐为此而乐为彼者", it implies people prefer herbs (easy to hide flaws) over acupuncture (hard, obvious errors). So "治此" refers to Acupuncture/Moxibustion? Or Herbs? Let's look closer: "惟汤液之治比比皆然" (Herb treatments are everywhere). "岂为汤液易而针灸难欤... 非也". "然则何为治此者多而习彼者寡". If herbs are everywhere, then "many" = herbs, "few" = acupuncture. But the text says "人之不乐为此而乐为彼者" (People do not like to do 'this' but like to do 'that'). Usually, 'this' refers to the subject just mentioned or the harder task. Let's trace: "治针者百无一二... 汤液... 比比皆然". So Few=Acupuncture, Many=Herbs. "为何治此(Many/Herbs?)多而习彼(Few/Acupuncture?)寡". The explanation follows: "盖以汤液之治易于藏拙... 若夫针灸之治... 人之不乐为此(Acupuncture)而乐为彼(Herbs)". So "此" in "治此者多" likely refers to Herbs (Tangye) and "彼" to Acupuncture. Wait, the prompt text says "然则何为治此者多而习彼者寡". If "此" is Herbs, then it matches "比比皆然". The reasoning "汤液... 易于藏拙" supports that Herbs are the "many". So "此" = Herbs, "彼" = Acupuncture. However, the book is about Acupuncture/Moxibustion ("神灸经纶"). The author might be lamenting that few do acupuncture. Let's stick to the literal translation: "Why is it that those treating with [Herbs] are many, while those practicing [Acupuncture/Moxibustion] are few?"

Actually, let's re-read carefully: "惟汤液之治比比皆然... 然则何为治此者多而习彼者寡". "此" usually points forward or backward. Given the context of "Moxibustion" being the focus, he might be saying "Why are there few doing THIS (Moxibustion/Acupuncture) and many doing THAT (Herbs)?". But grammatically "治此" often refers to the topic at hand. If the topic is Acupuncture, and he says "治此者多", it contradicts "百无一二". So "此" must refer to Herbs (Tangye) which were just described as "比比皆然". And "彼" refers to Acupuncture. The explanation "汤液... 易于藏拙" confirms Herbs are the preferred/easy path. So: Why are Herb-treatments many and Acupuncture-practice few? Because Herb-treatment hides deficiencies easily... whereas Acupuncture requires knowing meridians... and its effects are obvious/gentle vs harsh? No, "其用刚" (its use is firm/harsh/direct). People don't like doing Acupuncture ("为此") but like doing Herbs ("为彼").

However, the final conclusion is "独是用针之要先重手法... 是编置针言灸...". The author advocates for Acupuncture/Moxibustion.

Let's translate based on: Many = Herbs, Few = Acupuncture/Moxibustion.

Translation adjustment: "Then why is it that those treating with herbal decoctions are many, while those practicing acupuncture and moxibustion are few? This is because herbal treatment allows one to easily conceal inadequacies; its application is gentle, and its efficacy can be gradual..."

Back to English:

The history of acupuncture and moxibustion is long; the *Ling Shu* is the ancestor of these arts. Since then, famous physicians emerged, numbering nearly a hundred schools, such as Bian Que, Cang Gong, Zhang Ji, Hua Tuo, and the virtuous scholars Li Dongyuan, Liu Wansu, and Zhu Danxi. All were highly renowned and each authored works expounding the classics of the ancient sages. From the Qin and Han dynasties to the Ming, there were inheritors in every generation. In the Ming, Zhang Huiqing (Zhang Jiebin) compiled the essentials of various schools into the *Lei Jing*, making the study of acupuncture and moxibustion increasingly clear, though still incomplete. Only in our dynasty was the *Yi Zong Jin Jian* (Golden Mirror of Medicine) compiled, serving as the comprehensive repository of medicine, like rivers flowing to the sea. Its discussions on acupuncture and moxibustion accurately determine point locations and measurements, truly outstanding for millennia. Regrettably, few medical practitioners learn it; among those treating with needles, not one or two out of a hundred do so; among those treating with moxa, not two or three out of ten do so. Yet, treatments using herbal decoctions are ubiquitous. Is it that herbal medicine is easy while acupuncture and moxibustion are difficult? No. Humans are born receiving the qi of heaven and earth, possessing meridians and zang-fu organs internally. When disease occurs, whether in meridians or collaterals, entering fu or zang organs, one must rely on those who understand meridians and zang-fu to cure the disease. Can those using herbal medicine abandon meridians and zang-fu to treat differently? I know this is impossible. Then why are there many treating with herbal medicine and few practicing acupuncture and moxibustion? This is because herbal treatment makes it easier to conceal one's shortcomings; its application is gentle, and results can be slow. Even those who merely memorize herbal formulas and materia medica can gain fame as physicians. In contrast, acupuncture and moxibustion treatment requires understanding meridians and acupoints to begin; otherwise, one has no starting point. Moreover, its application is direct/firm, and success or failure is easily seen. Thus, people are unwilling to practice this (acupuncture/moxibustion) but prefer that (herbal medicine). They do not realize that although acupuncture/moxibustion and herbal medicine differ in application, the essence of being a physician is the same.

However, the priority in needle therapy is to emphasize manual technique. If the technique is not harmonious, one cannot speak of acupuncture and moxibustion. Needle therapy and moxibustion are equally important, but the key lies in selecting accurate points. Once the correct point is identified, life can be revived from death. Therefore, the ancients discussed them together but used them separately, aiming solely to hit the disease. This book places needle therapy first and discusses moxibustion second, not because needle therapy is difficult and moxibustion is easy, but because needle techniques are hard to convey by words, whereas moxibustion point locations can still be understood through measurement. If one can study diligently, learning needle therapy through moxibustion, and understanding the Dao through needle therapy, inheriting the source of the ancient sages and supplementing what herbal medicine lacks, would the efficacy not be significant? Thus, I ordered my grandson Yunlu to draft and compile this work as a family treasure.

This was written in the first year of Xianfeng, in the year Xin Hai, during the mid-autumn month, by Wu Yiding, styled Yanchen, of Gushao.