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(From *Ling Shu: Zhong Shi Pian*)

In all acupuncture methods, one must observe the patient's physical form and vital energy (Zheng Qi). If the flesh and muscles have not yet wasted away, but there is a deficiency of Qi and the pulse is restless, accompanied by restlessness and cold extremities (Jue Ni), Miao Ci (Mirroring Acupuncture, where left-sided ailments are treated on the right and vice versa) must be employed. This can gather scattered Qi and distribute accumulated [pathogenic] Qi. (When there is a deficiency of Qi while the flesh and muscles remain intact, with a restless pulse and symptoms of restlessness and Jue Ni, it indicates internal deficiency of healthy Qi and excess of pathogenic factors in the meridians. One should employ Miao Ci, treating the left side by needling the right, and the right side by needling the left. The puncture targets the collaterals, employing light and shallow techniques, so that scattered essence and Qi can be gathered, and accumulated pathogenic Qi can be dispersed.)

One should reside in a quiet place, focus the spirit, close the doors and windows to prevent the soul from scattering, concentrate entirely on the spirit, avoid hearing human voices to gather the essence, ensure the spirit is unified, and direct the intention toward the needle. (This means that when performing this acupuncture, one must be clear and quiet, gather concentration and spirit, observe minute details carefully, and direct the intention to the needle, thereby ensuring accuracy amidst ambiguities of deficiency and excess.)

Insert the needle shallowly and retain it; manipulate it slightly and superficially to shift the patient's spirit; cease manipulation once the De Qi sensation arrives. (The principle of acupuncture lies in regulating Qi. The aforementioned "deficiency of Qi" refers to the deficiency of Qi itself. For conditions characterized by Qi deficiency and pathogenic excess, when using acupuncture, it is appropriate to insert shallowly and retain the needle, emphasizing a slow and gentle approach. Slight superficial manipulation avoids damaging the interior. The goal is merely to gently shift the patient's spirit. One stops manipulating only after the true Qi has arrived.)

For men, guard against the inward leakage of essence; for women, guard against the outward dispersion of essence. Firmly reject its exit and carefully preserve its containment; this is called "De Qi" (arrival of Qi). (After needling, extreme caution is required. Men must avoid sexual intercourse to prevent internal depletion, and women must avoid activities causing external dispersion. By firmly preventing outward loss and carefully guarding against inward depletion, pathogenic factors will be eliminated, and healthy Qi will recover. This state is termed "De Qi".)

Prohibitions regarding acupuncture: Do not needle those who have recently engaged in sexual intercourse; do not allow sexual intercourse immediately after needling. Do not needle those who are already drunk; do not drink alcohol immediately after needling. Do not needle those who are newly angry; do not become angry immediately after needling. Do not needle those who are newly fatigued; do not exert oneself immediately after needling. Do not needle those who are fully fed; do not eat excessively immediately after needling. Do not needle those who are hungry; do not remain hungry immediately after needling. For those experiencing sudden fright or great fear, wait until their Qi is stabilized before needling. For patients arriving by carriage, let them lie down and rest for about the time it takes to eat a meal before needling. For patients arriving on foot, let them sit and rest for about the time it takes to walk ten li before needling. (Including the instruction on guarding essence for men and women, these constitute the Twelve Prohibitions.)

If these Twelve Prohibitions are violated, the pulse becomes chaotic and Qi scatters, Ying and Wei Qi reverse, and Jing Qi flows out of order. If needling is performed under such conditions, Yang diseases enter Yin, and Yin diseases emerge as Yang, causing pathogenic factors to regenerate. Incompetent physicians who fail to observe these rules commit "attacking the body," leading to physical dissipation, consumption of brain marrow, failure to transform fluids and essences, and loss of the five flavors. This is called "Shi Qi" (loss of Qi). "Yin Yi" refers to dissipation and lack of restraint. Ignoring these prohibitions and needling recklessly leads to chaos of Yin and Yang and exhaustion of true Qi, which is termed "Shi Qi." ("Yi" is pronounced like "Yi" meaning leisure/escape.)