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(From "Ling Shu: Shou Yao Gang Rou Pian")

Huangdi asked: I have heard that there are three variations in acupuncture. What are these three variations? Bogao replied: There is needling of the Ying (Nutrient) level, needling of the Wei (Defensive) level, and needling for Cold Bi syndrome lingering in the meridians. (Needling the Ying level involves treating its Yin aspect; needling the Wei level involves treating its Yang aspect; needling Cold Bi involves warming the meridians. Since these three needling methods differ, they are called the three variations.)

Huangdi asked: How exactly are these three variations performed? Bogao replied: Needling the Ying level causes bleeding; needling the Wei level releases Qi; needling Cold Bi causes heat to enter internally. (The "Tiao Jing Lun" also states: Extract blood from the Ying, extract Qi from the Wei. The meaning of causing heat to enter internally is explained below.)

Huangdi asked: What are the manifestations of diseases caused by disturbances in Ying, Wei, and Cold Bi? Bogao replied: When the Ying level is diseased, there are aversion to cold with fever, shortness of breath, and blood moving erratically up and down. (Ying governs blood and belongs to Yin Qi. When disease is in the Yin aspect, Yang overcomes it, resulting in alternating chills and fever. Yin disease leads to Yin deficiency; Yin deficiency leads to lack of Qi, resulting in shortness of breath. Pathogens in the blood cause erratic movement of blood up and down. Therefore, when needling the Ying level, one should treat the blood aspect.)

When the Wei level is diseased, there is Qi pain that comes and goes intermittently, chest oppression with sighing, and abdominal borborygmi sounding like galloping horses, due to Wind-Cold pathogens lodging in the stomach and intestines. (Wei Qi belongs to Yang and is the fierce and slippery Qi derived from food and drink. Disease in the Yang aspect results in Qi pain. As Qi has no fixed form, the pain comes and goes. Fu refers to depression and anger; Xi refers to deep sighing; Benxiang refers to abdominal sounds resembling running horses. These are all disorders of the Qi aspect. Wind-Cold attacks externally and lodges between the stomach and intestines. Because the Six Fu organs belong to the exterior, Yang pathogens tend to attach to them, so the disease arises from Wei Qi. Fu is pronounced fú; Xi is pronounced xì.)

Cold Bi disease manifests as pathogens lingering without departing, causing intermittent pain and skin numbness (loss of sensation). (When Cold Bi lingers for a long time, blood vessels do not flow smoothly, leading to stagnation and pain, or the skin loses sensitivity to pain and itch, manifesting as numbness.)

Huangdi asked: How does one cause heat to enter internally when needling Cold Bi? Bogao replied: For commoners, use fire moxibustion/cauterization; for nobles, use herbal compresses. (Causing heat to enter internally means warming the meridians. Commoners have turbid and sluggish Qi and Blood, so they should undergo cauterization, such as the Lei Huo Zhen (Thunder Fire Needle) or moxa-garlic steaming used in later times. Fan is pronounced cuán, meaning to scorch.)

Huangdi asked: How is the herbal compress prepared? Bogao replied: Take twenty sheng of pure wine, one sheng of Shu pepper, one jin of dried ginger, and one jin of Gui Xin (Cinnamon Heart). These four ingredients should be chewed or crushed into bean-sized pieces and soaked in the wine. Add one jin of cotton wadding and four zhang of fine white cloth, and put them together into the wine. Place the container in a furnace burning dry horse manure, cover and seal it with salt mud to prevent leakage. After five days and nights, take out the cloth and cotton wadding, sun-dry them, and then soak them again in the wine until all the juice is absorbed. Each soaking must last a full day before drying. Finally, mix the dregs with the cotton wadding, wrap them in multiple layers of cloth to make "Fu Jin" (double-layered cloths), each six or seven chi long, making six or seven such cloths. Then, heat the cloths using raw mulberry charcoal and apply them to the acupoints needled for Cold Bi, allowing the heat to penetrate to the site of the disease. When the cloth cools, reheat it and continue applying for thirty repetitions. Wipe the sweat from the body with the cloth, also for thirty repetitions. (Ju refers to chewing herbs finely in ancient times; later generations used knives but retained the term. Zi means soaking. Placing in horse manure fire refers to simmering over burning dry horse manure, commonly used in the northwest. Tu refers to sealing with salt mud. Xun refers to ten days. Fu Jin refers to double-layered cloths acting like pockets to hold the cotton and dregs. Zi refers to dregs. Raw mulberry charcoal is used because mulberry wood benefits joints and dispels Wind-Cold-Damp Bi pains. Nobles have clear and smooth Qi and Blood, so for them, only herbal compresses are needed before and after needling to unblock the meridians, induce sweating, and eliminate Cold Bi. Nei is synonymous with Na. Shi is synonymous with Shi. Fan is pronounced fán. Yun is pronounced wèi; Zi is pronounced zǐ. Fu is pronounced fù.)

After needling, walk inside a sealed room and avoid exposure to wind. Apply the compress every time after needling. In this way, the disease will be cured. This is what is meant by causing heat to enter internally. (Walking inside a sealed room after needling aims to promote Qi and Blood circulation while carefully avoiding Wind-Cold. All these methods constitute the technique of causing heat to enter internally.)