Library

Chenguang (Chéngguāng), Yamen (Yāmén), Fengfu (Fēngfǔ), Tianzhu (Tiānzhù), Suliao (Sùliáo), Linqi (Línqì), Jingming (Jīngmíng), Cuanzhu (Cuánzhú), Yingxiang (Yíngxiāng), Heliao (Héliáo), Sizhukong (Sīzhúkōng), Baihuan (Báihuán), Quanliao (Quánliáo), Touwei (Tóuwéi), (below) missing. Jizhong (Jīzhōng), Jianzhen (Jiānzhēn), Xinshu (Xīnshù), Tianzhiyou (Tiānzhīyǒu), Renying (Rényíng), Ruzhong (Rúzhōng), Zhourong (Zhōuróng), Tianfu (Tiānfǔ), Zhongchong (Zhòngchōng), Yangguan (Yángguān), Yangchi (Yángchí), Yinbai (Yǐnbái), Lougu (Lòugǔ), Diwuhui (Dìwǔhuì), Yinlingquan (Yīnlíngquán), Tiaokou (Tiáokǒu), Dubi (Dúbí), Yinshi (Yínshì), Furu (Fútù), Biguan (Bìguān), Weizhong (Wěizhōng), Yinmen (Yīnmén), Shenmai (Shēnmài), Chengfu (Chéngfú). (Total forty-five acupoints.)

The *Neijing* (Yellow Emperor's Inner Canon) states: Where the pulse is visible, there lies the pathogenic factor. A deep pulse indicates that the pathogen is within; a floating pulse indicates that the pathogen is at the exterior. Physicians of the world only understand the theory of pulses but fail to grasp the contraindications of symptoms. If exterior cold syndrome manifests with sweating, frequent curling up of the body, shivering and coldness, absence of thirst, desire for thick clothing, aversion to cold, cold limbs, and dry skin, the pulse will necessarily be deep, fine, and slow. If one or two of these symptoms are present, moxibustion is suitable because yang qi has sunk. If the body is hot and averse to heat, occasionally restless, or if the face is red or yellow, the throat and mouth are dry, the tongue coating is yellow and red, thirst occurs frequently accompanied by sore throat, this indicates heat at the exterior. If one or two of these symptoms are present, moxibustion must not be used. The pulse will necessarily be floating and rapid, or merely rapid; in either case, moxibustion is contraindicated, as harm will arise immediately. If there is anosmia, runny nose, itchy eyelids, yawning or sneezing, and aversion to cold, the pulse will be deep, indicating correspondence between pulse and symptoms. Or, if the pulse is wiry and tight upon light palpation, this indicates yin pathogen suppressing yang qi; even if the face is red, moxibustion is suitable, and one should not forbid it solely based on facial redness. (Liu Chun)

The Fifty-Nine Needle Points refer to the five rows of points on the head, used to overcome and clear heat from all yang meridians. Dazhu (Dàzhù), Yingchuang (Yīngchuāng), Quepen (Quēpén), Beishu (Bèishū) — these eight points, are used to drain heat from the chest. Qichong (Qìchōng), Zusanli (Zúsānlǐ), Shangjuxu (Shàngjǔxū), Xiajuxu (Xiàjǔxū) — these eight points, are used to drain heat from the stomach. Yunmen (Yúnmén), Bigu (Bīgǔ), Weizhong (Wěizhōng), Suikong (Suǐkōng) — these eight points, are used to drain heat from the four limbs.

Eight Methods of Needling
The so-called Eight Methods of Needling are: first,迎着 and following (Yingsui); second, rotating the needle; third, manipulation of fingers; fourth, rotation of the needle head; fifth, distinguishing deficiency and excess; sixth, differentiating yin and yang; seventh, lifting and thrusting; eighth, coordinating with respiration. Tonification, reduction, benefit, loss, deficiency, and excess are contained within these eight methods.

Five Gates of Needling: Master and Guest
The Five Gates of Needling refer to the Jing-Well, Ying-Spring, Jing-River, and He-Sea points. In spring, puncture Jing-Well points; in summer, Ying-Spring points; in autumn, Jing-River points; in winter, He-Sea points; in the last month of each season, puncture Shu-Stream points, due to the existence of five gates. This applies equally to each month and each day. The Tai Sui of the year represents the guest and corresponds to pathogenic factors; the Earthly Branch of the year represents the host and corresponds to healthy qi. Those who understand this principle achieve efficacy without fail.

Fixed Needling Resembles Wood
Needling can be bent or slanted, straight or upright. Thus, the fixed number of needles symbolizes the curving and straightening nature of wood.

Mouth Storage Compared to Fire
When using needles, first hold the needle in the mouth to warm it, thereby regulating Ying and Wei qi. Since fire tends to flare upward, this facilitates the ascending, descending, rotating, and lateral movement of qi before it descends.

Yan Shi of Changshan stated: Warming the needle in the mouth not only makes insertion smoother and less painful but also borrows one's own harmonious qi, avoiding conflict of temperature with the patient's Ying and Wei qi, allowing them to follow together. If the needle is not warmed beforehand, it conflicts with blood and qi, causing cold and heat to struggle, leading to many cases of ulcer formation.

Moxibustion and Needling Divided by Morning/Afternoon and Mao/Hou, Li/Zuo, You/Nan
"Mao Hou" refers to the Mao, Chen, and Si hours. This is the "Old Yang" within yang, suitable for moxibustion and needling to treat various deficiency-cold syndromes. "Li Zuo You Nan" refers to the Wu, Wei, and Shen hours. This is the "Young Yin" within yang, suitable for moxibustion and needling to treat various irritability syndromes. For labor heat resembling double steaming requiring drainage, moxibustion combined with blowing can be used. During moxibustion, a virgin girl blows for male patients, and a boy blows for female patients; through blowing and exhaling ("he"), a cooling sensation is generated. Blowing and exhaling constitute the draining method of moxibustion.

Method of Connecting Qi and Unblocking Meridians
To treat hemiplegia and chronic disorders of Ying and Wei qi, which often recur after apparent recovery, the initial cause is usually disconnected qi leading to blocked meridian flow. Although there may be temporary relief, the exogenous pathogen overcomes true qi, and the disease remains unresolved. In such cases, one should connect qi from above and guide it downward. The number of breaths and the length of meridians have fixed numbers. The established rule is: Hand Three Yang meridians require nine breaths to traverse four cun; Hand Three Yin meridians require seven breaths to traverse five cun; Foot Three Yang meridians require fourteen breaths to traverse four cun; Foot Three Yin meridians require twelve breaths to traverse five cun. For severe cases, double these numbers; inhalation follows the same count. This is the method of connecting qi and unblocking meridians regarding respiration length. (Yan Guangming)

Moxibustion Divided by Yin/Yang, Upper/Lower, and Quantity
Generally, moxibustion should proceed from yang to yin, starting from the head and face moving leftward and downward, then from the head moving rightward and downward, prioritizing upper then lower. The *Mingtang* states: Moxa the upper first, then the lower; moxa the fewer applications first, then the more; all should be carefully considered. (Wang Zhizhong, courtesy name Shuquan)

Needling and Moxibustion Require Medicine
The *Qianjin Fang* states: For diseases requiring needling, use needles for tonification and drainage. For those unsuitable for needling, apply moxibustion directly. However, the general principle of moxibustion allows the same acupoints as needling without contraindication; thus, applying plain needles (Baizhen) or warming needles before moxibustion is the practice of a good physician. The condition known as "Hongjiao" (foot qi/podagra) is most suitable for combined needling and moxibustion. To needle without moxa, or moxa without needling, is not the practice of a good physician. To use only acupuncture/moxa without medicine, or only medicine without acupuncture/moxa, is also not the practice of a good physician. It is regrettable that few in rural areas understand needling. Therefore, students must master both needling and moxibustion, including warming and plain needles. Knowing both needling and medicine constitutes a good physician; this highlights the interdependence of acupuncture, moxibustion, and pharmacology. Today, some know only needling but not moxibustion, or vice versa, or rely solely on medicine while ignoring acupuncture and moxibustion; all commit the error warned against by Sun Simiao. Modern so-called physicians know only of medicine and never inquire about acupuncture and moxibustion. When informed, they claim: "That is surgery; excellence lies in specialization, not eclecticism." Or they say: "Wealthy families may not consent to acupuncture and moxibustion." These are excuses to cover their faults. I therefore detail the words of *Qianjin Fang* to instruct others.

Avoiding Human Spirits Theory
The *Qianjin Fang* states: Before performing acupuncture and moxibustion, one must know the auspicious and inauspicious years and the location of Human Spirits (Renshen), ensuring no conflict with taboos. Men avoid "Chu" days, women avoid "Po" days; men avoid Wu days, women avoid Ji days. There are Day Spirit taboos, monthly taboos, twelve-hour taboos, seasonal Human Spirits, and twelve-part Human Spirits, as well as Blood Branch and Blood Taboo categories. Physicians who do not know these taboos may encounter difficulties when treating patients during periods of misfortune or when the patient's qi is weak. Enlightened masters, however, are not bound by these rules. In cases of sudden acute illness, these methods are not restricted. Xu Xi also stated: If the disease is sudden and violent, urgent moxibustion is appropriate, without restriction. Only one hour per day is taboo.
It is further stated: Carbuncles, furuncles, throat bi, and external shock are especially urgent. When preparing decoctions, one should not avoid inauspicious days; treatment should begin immediately upon feeling ill. It is also said: If a person suddenly contracts wind or seasonal pathogens, suffering from any distress, immediate moxibustion is required; delaying makes cure difficult. This argument is sound. In emergencies, life hangs in the balance; waiting for an auspicious day means death. Thus, one should not be rigidly bound by taboos. However, for preventive treatment before disease manifests, selecting days of Heavenly Virtue or Monthly Virtue for medication and acupuncture/moxibustion is acceptable.

On Moxibustion
Moxibustion involves tonification and drainage and should not be discussed lightly. Generally, it is suitable for deep, knotted, and cold syndromes. When yin-cold and dampness stagnate in the blood vessels, decoctions and hot compresses cannot cure alone. At such times, only moxa can burn away the pathogen. Does fire not circulate yang qi and expel yin pathogens, achieving effects faster than herbs and minerals? Whether old or young, strong or weak, the method of burning varies. Some receive hundreds of moxa cones, while others receive only three, five, seven, or nine; all must be performed with careful deliberation. Applying moxibustion to yang syndromes is a major violation. Therefore, in discussions of Cold Damage, it is stated that a fine-rapid pulse, post-sweating floating pulse, and intense heat are three conditions where moxibustion is contraindicated. Only Shaoyin syndromes characterized by aversion to cold, vomiting/diarrhea, deficient pulse, or cold limbs associated with pulse characteristics are suitable for moxibustion. Understanding this thoroughly allows one to apply it universally, preventing reckless moxibustion. Thus: forcing moxibustion when unnecessary introduces fire pathogen into the abdomen, disturbs the five zang organs, and worsens irritability. Withholding moxibustion when necessary causes cold coagulation to harden over time, with qi rushing to the heart and nowhere dissipating; one must take warning!

On Needling
For spasms and bi-syndromes, micro-needles are suitable. For those physically comfortable but mentally distressed, with disease arising in the vessels, moxibustion and needling are treatments. Understanding the Nine Needles clarifies meridian tonification and drainage. Different needling for Ying and Wei distinguishes blood and qi deficiency/excess. Different needling for Jing-Well and Ying-Spring distinguishes the mother-child relationship of the Five Elements. Different needling for Mu and Shu points distinguishes back-abdominal yin-yang. Different needling for spring/summer distinguishes the depth of human qi. Generally, tonifying deficiency and draining excess without exceeding limits restores balance; this is the essence of needling. However, for shallow diseases, needling leads to immediate cure, as stated: "At the onset, needling suffices." For numbness, pain, and swelling caused by bi, moxibustion and needling remove them. For diseases transmitting to multiple meridians requiring upper and lower needling, such as treating malaria with heat or severe cases using the Fifty-Nine Needles, specific protocols apply. The term "Ci" (puncture) implies striking; while beneficial, harm lies within. Huangdi stated that those who are calm, skilled, and prudent may perform acupuncture and moxa. Zhang Ji stated that needles can kill the living but cannot revive the dead; thus, their use requires utmost caution. Moreover, the Nine Needles differ in form and indication; the Twelve Methods vary in weight and application. One must understand celestial bodies, seasons, solar terms, terrestrial climate, water levels, body constitution, and qi/blood status. Then, through respiration, tonification/drainage, entering/following, and intention, one acts freely. Is it merely knowing Mu-Shu locations, skin/muscle/tendon/bone, hunger/fullness, and labor/rest? Thus: observing subtle changes prevents danger. (Note: While reading this chapter, I heard that the daughter-in-law of Magistrate Chen Han, granddaughter of Guan Qin Chu, traveled to Yue for treatment by Mr. Chen. After needle insertion, bleeding did not stop, and she died shortly after. This confirms the truth of Zhongjing's words.)

On Bian Stones
Ancient needle techniques spread throughout the world. Bian stones were made in various sizes according to the disease. Using stone instead of needles, they are called Zhen Stone, Bian Stone, or Chan Stone; essentially, they are the same. To break hard accumulations and pierce swollen heat, Bian stones are used for lancing. Because pathogenic factors are violent, micro-needles cannot reach. Furthermore, for conditions with abundant qi and blood, counterflow in muscles, and accumulated carbuncles, only Bian stones can lance them; this is what is meant by "blood excess should be lanced." For those physically and mentally content with internal diseases, Bian stones are the treatment. People in the East often suffer from carbuncles and ulcers, treated suitably with Bian stones. Thus, Bian stones originated here. Bian Que said: For diseases in the blood vessels, use Bian stones. Therefore, all swellings are suitable for incision at the transverse crease below the little toe. Left swelling is cut on the left, right on the right; slight bleeding leads to recovery. This applies to furuncles, carbuncles, erysipelas, phagedenic gangrene, dystrophic nails, Qi-pain swelling, etc., all requiring bloodletting via urgent Bian stone application. Generally, Bian stone usage employs draining methods. In winter, when human qi is closed, medicine is preferred over needles/stones. "Few needles/stones" does not refer to carbuncles. Carbuncles cannot wait; delay allows toxin to attack internally, rotting bones and tendons, piercing viscera. For stone furuncles, avoid brick/rubble. For knife-cut furuncles, avoid iron knives. Such cases are treated with medicine. The *Suwen* states: Neck carbuncles cured by stone or by acupuncture/moxibustion demonstrate treating the same disease differently. For carbuncles with weak qi, needling to open and remove is suitable; for those with abundant qi and pooled blood, stone lancing to drain is suitable. Thus, Bian stones and Nine Needles each have advantages. Skilled practitioners of blood vessel changes and carbuncles assess severity to determine treatment. (All from *Shengji Zonglu*, from Wang Zhizhong onwards.)