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The method of rubbing the needle to drain Qi is most wondrous. When Qi arrives and the needle feels entangled, do not move it hastily. It is like slowly rotating a thread while twisting. If done too quickly, the flesh will tightly wrap around the needle head.

Rubbing the needle refers to using rubbing and twisting motions during insertion and withdrawal to urge Qi to arrive at the site, thereby draining pathogenic factors. If one feels tightness under the needle, do not shift the needle immediately; instead, apply the draining method. Gently rotate the needle as if twisting a thread.

If rotated too tightly, the flesh will inevitably wrap around the needle head, causing pathogenic Qi to stagnate and become difficult to eliminate.

The finger technique for twisting the needle differs from rubbing. Although both are performed with the hand, they yield two different effects. By shifting internally and externally, and moving up and down, one can assist healthy Qi and drive away pathogenic factors, causing the disease to lighten naturally.

When twisting the needle, although the general hand position is similar, the finger techniques differ, resulting in two distinct functions. To treat the upper body, twist outward with the thumb; outward twisting directs Qi upward. To treat the lower body, twist inward with the thumb; inward twisting directs Qi downward. Inward twisting constitutes tonification, while outward twisting constitutes drainage. If the meridian flows downward, turning the needle head against the flow is called "Ying" (meeting/draining); if the meridian flows upward, moving the needle head with the flow is called "Sui" (following/tonifying). When the finger technique is appropriate, healthy Qi recovers naturally, and pathogenic factors retreat.

Retaining the needle requires waiting for the floating and sinking, entering and exiting of Qi; lingering slowly allows Ying and Wei Qi to disperse freely. The subtle mechanism lies entirely in the fingers.

Retaining the needle means withdrawing to the Heaven level (superficial) upon extraction and inserting to the Earth level (deep) upon insertion, keeping the needle between the skin and muscle. One must linger slowly until Ying and Wei Qi disperse before extracting. If extraction is too hasty, blood may follow the needle out, damaging Ying and Wei Qi. The subtlety lies entirely in the control of the fingers.

Shaking the needle involves six shakes in each of the three levels (Heaven, Human, Earth), arranged sequentially by the fingertips, opening the acupoint widely without obstruction, so that pathogenic factors retreat and the disease heals itself.

Shaking the needle refers to shaking two to three times in each of the three levels during extraction when applying drainage, with no more than six shakes per level. Using the fingers to twist the needle as if shaking a person's head opens the acupoint widely without blockage, allowing pathogenic factors to retreat and the disease to heal.

Do not rush when extracting the needle. Closing the gate and preserving Shen requires precision and detail. Seek the sensation where the needle is neither heavy nor tight, grasping the needle handle. This secret must be kept in a brocade bag.

After acupuncture is completed, extracting the needle requires precision and care; one must not be rash or hurried. To extract, wait until the sensation under the needle is relaxed, neither heavy nor tight, feeling light, smooth, and quick. Then, use the right thumb to hold the needle handle, and press the acupoint and surrounding skin with the left thumb to close the acupoint gate and preserve internal Shen before extracting. This prevents bleeding. This is the crucial secret of acupuncturists and should be kept in a brocade bag.