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This chapter is the origin of acupuncture methods in the *Neijing* (Inner Canon). Although the needles used have evolved differently from ancient to modern times, the subtlety and profundity of the acupuncture techniques described therein cannot be transcended by any generation.

Acupuncturists who do not study this chapter are like those who count their ancestors' deeds but forget their own origins; they do not know how to apply the needle.

The Yellow Emperor asked Qibo: "I nurture the people and collect taxes from them. I pity their insufficient livelihoods and the fact that some fall ill. I wish for them not to suffer from toxic medicines or use bian stones (stone scalpels), but instead use fine needles to unblock their meridians, regulate their qi and blood, and ensure the proper circulation of Ying (Nutritive) and Wei (Defensive) qi at the intersections of their flow. I want these methods to be passed down to future generations. They must be clearly defined with laws, ensuring they endure forever without extinction or interruption, are easy to use and remember, and serve as a framework. Differentiate the chapters, distinguish the interior and exterior, establish beginnings and endings. Give each needle a distinct shape, and first establish the *Classic of Needles*. I wish to hear the details."

Qibo replied: "Please allow me to deduce and arrange them in order, establishing a systematic framework, starting from one and ending with nine. Please permit me to explain the principles. The essence of the small needle is easy to state but difficult to master. Crude practitioners adhere only to physical forms, while superior practitioners observe Shen (Spirit/Mind). Shen is profound; when a guest pathogen enters the gate, before one can discern the disease, how can one know its origin? The subtlety of needling lies in speed and slowness. Crude practitioners guard only the joints, while superior practitioners guard the mechanism (Ji) of qi movement. This movement does not depart from the acupoint (Kong). The mechanism within the acupoint is clear, quiet, and subtle. When it arrives, it should not be met/aggressively treated; when it departs, it should not be pursued. One who understands the way of the mechanism will not err by even a hair's breadth; one who does not understand will find no response even if struck. Knowing the coming and going, one must seize the timing. Crude practitioners are dim-witted about this; only skilled artisans possess this妙 (wonder). Departing qi is Ni (Rebellious/Counter-flow); arriving qi is Shun (Smooth/Compliant). Clearly knowing the compliant and rebellious flows, one proceeds without hesitation. Meeting and draining [the pathogen] prevents deficiency; following and assisting [the healthy qi] prevents emptiness. Meeting and following, harmonizing with intention—thus the Way of the Needle is complete.

In general, when using needles: tonify deficiency to make it solid; drain excess to empty it; remove stasis and old accumulation; weaken excessive pathogenic factors. The general principle states: Slow insertion and rapid withdrawal constitutes Tonification (Shi); rapid insertion and slow withdrawal constitutes Drainage (Xu). Discussing excess and deficiency, there is a sense of presence and absence; observing the sequence of treatment, there is a sense of retention and loss. Judging deficiency and excess feels like gaining and then losing.

The key to regulating deficiency and excess lies in the Nine Needles, which are most excellent. The timing of tonification and drainage is achieved through the needle. Regarding Drainage: Hold the needle firmly, insert it, release the blood/qi, push away the Yang aspect to receive the needle, allowing pathogenic qi to vent. Press and guide the needle inward; this is called 'internal warming,' preventing blood from scattering and qi from escaping. Regarding Tonification: Follow the qi; your intention should seem absent. Move and press gently, like the stop of a mosquito or horsefly, lingering and returning. Withdraw the needle swiftly like a breaking bowstring. Coordinate left and right hands so that qi stops, the external gate closes, and internal qi becomes solid. Ensure no blood remains; urgently apply the method of eradication. The principle of holding the needle is firmness and stability. Point straight and pierce directly; do not deviate left or right. Focus your spirit on the finest details (autumn hair), direct your attention to the patient, examine the blood vessels carefully, and you will avoid danger. During needling, focus on the suspended Yang (consciousness/spirit) and the two Weis (Defensive Qi). Keep your spirit attached and do not leave, thereby knowing whether the disease will survive or perish. Blood vessels lie horizontally under the skin; visually they appear clear and distinct; upon palpation, they feel firm.

The names of the Nine Needles differ in shape:
1. Chan Needle (Chan Zhen): 1.6 cun long. Head is large, tip is sharp; used to drain Yang qi.
2. Yuan Needle (Yuan Zhen): 1.6 cun long. Needle body is egg-shaped; used for rubbing between muscle intervals without damaging muscles, to drain subcutaneous qi.
3. Di Needle (Di Zhen): 3.5 cun long. Tip is sharp like millet grains; used for pressing vessels without penetrating deeply, to gather qi.
4. Feng Needle (Feng Zhen): 1.6 cun long. Three-edged blade; used to treat chronic diseases.
5. Pi Needle (Pi Zhen): 4 cun long, 0.25 cun wide. Tip resembles a sword edge; used to drain large amounts of pus.
6. Yuanli Needle (Yuanli Zhen): 1.6 cun long. Size like a cattle tail hair, round yet sharp, slightly thicker in the middle; used to treat sudden qi stagnation.
7. Hao Needle (Hao Zhen / Filiform Needle): 3.6 cun long. Tip like a mosquito proboscis; insert quietly and slowly, retain briefly to nourish; used to treat painful obstruction (Bi syndrome).
8. Chang Needle (Chang Zhen): 7 cun long. Sharp and thin body; used to treat deep-seated Bi syndrome.
9. Da Needle (Da Zhen): 4 cun long. Tip like a rod, slightly rounded edge; used to drain water-dampness from joints.
Thus, the Nine Needles are complete.

When qi resides in the meridians, pathogenic qi is in the upper part, turbid qi in the middle, and clear qi in the lower part. Therefore, needling superficial veins expels pathogenic qi; needling middle veins expels turbid qi. If needling is too deep, pathogenic qi sinks back, and the disease worsens. Thus it is said: Skin, flesh, sinews, and vessels each have their specific locations; diseases each have their appropriate treatments. Shapes differ, and one must follow what is suitable. Do not tonify excess or drain deficiency. Depleting the insufficient and adding to the surplus is called severe disease, and the condition will worsen. Depriving the five pulses leads to death; depriving the three pulses leads to disability; depriving Yin leads to death; depriving Yang leads to mania. These are the harms of needling.

If qi does not arrive after needling, do not limit the number of attempts. If qi arrives, remove the needle and do not repeat. Each needle has its specific suitability and shape, performing its unique function. The essence of needling is that efficacy occurs when qi arrives. The confirmation of efficacy is like wind blowing away clouds, revealing the blue sky clearly. Thus, the Way of Needling is complete.

The Yellow Emperor said: "I wish to hear where the qi of the Five Zang and Six Fu organs emerges."
Qibo said: "Each of the Five Zang organs has five Shu points, totaling twenty-five. Each of the Six Fu organs has six Shu points, totaling thirty-six. There are twelve primary meridians and fifteen Luo (Connecting) vessels, totaling twenty-seven qi pathways moving up and down. Points where qi emerges are Jing-Well points; where it flows are Ying-Spring points; where it pours is Shu-Stream points; where it travels is Jing-River points; where it enters is He-Sea points. The movement of these twenty-seven qi pathways all pass through the Shu points of the Five Zang organs. At the intersections of joints, there are 365 Hui (Meeting) points. One who knows the essentials summarizes it in one word; one who does not knows endless dispersion. The term 'Jie' (Node/Joint) refers to the place where Shen Qi circulates and exits/enters, not merely skin, flesh, bone, or tendon. Observe the complexion and eyes to know if Shen is scattered or restored. Unify the form and listen to movements to know if evil or righteousness prevails. Push with the right hand, hold and control with the left. Remove the needle when qi arrives.

Before using needles, one must first diagnose the pulse and assess the severity and ease of the qi condition before treating. If the internal qi of the Five Zang organs is exhausted, but the practitioner tonifies the exterior, this is called 'Double Exhaustion' (Zhong Jie), which leads to death with quietness. The practitioner wrongly selected axillary and chest points. If the external qi (Wei Qi) of the Five Zang organs is exhausted, but the practitioner tonifies the interior, this is called 'Reverse Cold' (Ni Jue), which leads to death with restlessness. The practitioner wrongly selected the four extremities. The harm of needling: if one hits the target but does not stop, essence leaks; if one hits the target and stops immediately, qi stagnates. Essence leakage causes the disease to worsen and leads to death; qi stagnation causes carbuncles and ulcers.

The Five Zang correspond to the Six Fu. The Six Fu have twelve Yuan-Source points. These twelve Yuan points emerge from the 'Four Gates' (areas below the elbows and knees) and govern the Five Zang. When the Five Zang are diseased, one should select the twelve Yuan points. These points are where the Five Zang receive the qi and flavors of the 365 joint nodes. Disease in the Five Zang manifests at the twelve Yuan points. Knowing the Yuan points and observing their responses allows one to know the damage to the Five Zang.
- Shaoyin of Yang is Lung; its Yuan point is Taiyuan (LU9), bilateral.
- Taiyang of Yang is Heart; its Yuan point is Daling (PC6 - *Note: Text says Daling, traditionally Shenmen HT7 is Heart Yuan, Daling is Pericardium*), bilateral.
- Shaoyang of Yin is Liver; its Yuan point is Taichong (LR3), bilateral.
- Zhiyin of Yin is Spleen; its Yuan point is Taibai (SP3), bilateral.
- Taiyin of Yin is Kidney; its Yuan point is Taixi (KI3), bilateral.
- The Yuan point of Gao (Fat/Marrow) is Jiwei (CV15), unilateral.
- The Yuan point of Huang (Membrane/Dan Tian) is Boyang (Navel area), unilateral.

These twelve Yuan points govern diseases of the Five Zang and Six Fu. For distension, select Yang meridians; for undigested food diarrhea (Sun Xie), select Yin meridians.

Diseases of the Five Zang are like a thorn in the body, dirt on cloth, a knot, or a blockage. Even if long-standing, a thorn can be pulled out; dirt can be washed clean; a knot can be untied; a blockage can be cleared. Those who say long-term diseases cannot be treated are incorrect. A skilled acupuncturist treats disease like pulling a thorn, washing dirt, untying knots, or clearing blockages. Even long-standing diseases can be cured. Those claiming incurability simply lack the technique.

For heat syndromes, needle quickly, like dipping a hand in hot water. For cold syndromes, needle slowly, like a person reluctant to walk. For Yin disorders with Yang heat, select Zusanli (ST36). Insert correctly without hesitation; stop when qi descends; if it does not descend, restart. For high-positioned diseases located internally, select Yinlingquan (SP9). For high-positioned diseases located externally, select Yanglingquan (GB34)."