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Treat the root. If other diseases occur first and then fullness in the middle (chest/abdominal distension) develops, treat the root; one must regulate the qi first, and then treat other diseases. If a disease occurs first and then fullness in the middle develops, treat the branch (symptom/fullness); if fullness in the middle occurs first and then vexation of the heart develops, treat the root. For difficulty in urination and defecation, treat the branch; for free urination and defecation, treat the root. If other diseases arise due to difficulty in urination and defecation, treat the root. When pathogenic factors are excessive and surplus, treat the root first and the branch later; when deficiency is present, treat the branch first and the root later. It is also said: the initial onset of disease is the root, and the transmission/spread of disease is the branch.

Regarding the depth of needling: Needling Yang meridians requires targeting the Ying-Spring points; the needle must be inserted shallowly with the patient lying down, without damaging the Wei-Qi. Needling Yin regions to reach the Wei-Qi requires deep insertion, without damaging the Ying-Blood. This refers to the principles of Yin-Yang, Root/Branch, and depth of needling.

To stop pain and move discomfort, select meridians that intersect and connect.

This section discusses the method of using needles, which has the effect of stopping pain and moving discomfort. One must first rotate the needle to the left and turn it counter-clockwise until the number nine (Yang number) is reached, then rotate to the right and turn clockwise until the number six (Yin number) is reached. For example, the Luo-Connecting point Feiyang (BL58) of the Foot-Taiyang Bladder Meridian connects to the Foot-Taiyin Spleen Meridian; this is such a case.

Have you not heard that for Zang-Fu diseases, one should seek points such as "Men" (Gate), "Hai" (Sea), "Shu" (Transporting), and "Mu" (Alarm) points?

"Men Hai" refers to points like Zhangmen (LR13) and Qihai (CV6). "Shu" refers to the Back-Shu points of the Five Zang and Six Fu organs, all located in the two lines on the back. "Mu" refers to the Front-Mu points of the Zang-Fu organs. For instance, Fei Mu is Zhongfu (LU1), Xin Mu is Juque (CV14), Gan Mu is Qimen (LR14), Dan Mu is Riyue (GB24), Pi Mu is Zhangmen (LR13), Wei Mu is Zhongwan (CV12), Dachang Mu is Tianshu (ST25), Xiaochang Mu is Guanyuan (CV4). Only the Sanjiao and Pericardium do not have separate Mu points. This states that for diseases of the Five Zang and Six Fu organs, one must select these Men, Hai, Shu, and Mu points for needling, which is most subtle and effective.

For stagnation in the meridians, seek the methods of Yuan-Source, Bie-Luo, Jiao-Hui (intersecting/converging) points.

"Yuan" refers to the Yuan-Source points of the Twelve Meridians. "Bie" refers to the Bie-Luo (separating/collateral) points of Yang meridians. "Jiao" refers to the intersecting points of Yin meridians. "Hui" refers to the Eight Hui (Meeting) points. The Twelve Yuan-Source points are: Dan Yuan Qiuxu (GB40), Gan Yuan Taichong (LR3), Shen Yuan Taixi (KI3), Sanjiao Yuan Yangchi (TE4), Baoluo (Pericardium) Yuan Daling (PC7). The Eight Hui points are: Blood Hui Geshu (BL17), Qi Hui Tanzhong (CV17), Mai Hui Taiyuan (LU9), Jin Hui Yanglingquan (GB34), Gu Hui Dazhu (BL11), Sui Hui Juegu (GB39), Zang Hui Zhangmen (LR13), Fu Hui Zhongwan (CV12). This states that for condensation and blockage of Qi and Blood in the meridians, one must select these Yuan, Bie, Jiao, and Hui points for needling.

Further explore the Four Roots and Three Knots, and according to the Root/Branch principles, there will be no cure that fails.

"Root and Knot" refers to the Root-Knot theory of the Twelve Meridians. The *Ling Shu* states: The Foot-Taiyin Spleen Meridian roots at Yinbai (SP1) and knots at Tai Cang (Zhongwan CV12). The Foot-Shaoyin Kidney Meridian roots at Yongquan (KI1) and knots at Lianquan (CV23). The Foot-Yangming Stomach Meridian roots at Lidui (ST45) and knots at Touwei (ST8). The Foot-Taiyang Bladder Meridian roots at Zhiyin (BL67) and knots at Jingming (BL1). The Foot-Shaoyang Gallbladder Meridian roots at Qiaoyin (GB44) and knots at Tinggong (SI19). The Hand-Taiyang Small Intestine Meridian roots at Shaoze (SI1) and knots at Tianchuang (SI16) and Zhengzheng (SI7). The Hand-Shaoyang Sanjiao Meridian roots at Guanchong (TE1) and knots at Tianyou (TE16) and Waiguan (TE5). The Hand-Yangming Large Intestine Meridian roots at Shangyang (LI1) and knots at Futu (LI18) and Pianli (LI6). The Root-Knot of the Hand-Yin meridians is not recorded in the text, so I dare not force an annotation. Furthermore, the "Four Roots" refer to the roots of the ears, nose, breasts, and feet. The "Three Knots" refer to the knots of the chest, abdomen, and bowels/bladder. This states that by understanding the principle of Roots and Knots and needling according to the aforementioned Root/Branch methods, diseases can be cured.

Merely use the Eight Methods and Five Gates, distinguish Master and Guest, and there will be no needling that is ineffective.

"Eight Methods" refers to the Eight Extraordinary Vessels. Gongsun (SP4) connects to the Chong Mai, treating stomach, chest, and heart issues; Neiguan (PC6) connects to the Yin Wei Mai, treating lower chest, heart, and stomach issues; Linqi (GB41) connects to the Dai Mai and Gallbladder meridian; Waiguan (TE5) connects to the Yang Wei Mai and lateral eye corner. Combined, they form five categories. This is based on the combination of Heavenly Stems: Jia combines with Ji, Yi with Geng, Bing with Xin, Ding with Ren, Wu with Gui. "Master and Guest" refers to using Gongsun as the Master point and Neiguan as the Guest point; needle the Master first, then the Guest, and efficacy is assured. Detailed records follow.

The Eight Extraordinary Vessels always connect to the Eight Hui points, serving as the general guidelines.

"The Eight Vessels" are the Eight Extraordinary Vessels, noted above. "Eight Hui" are the meeting points of Qi, Blood, Mai, Jin, Gu, Sui, Zang, and Fu, also noted above. "Ji Gang" refers to the main rope of a net. This states that the start and end of the Eight Extraordinary Vessels, connecting to the Eight Hui points, serve as the general guidelines of the body's meridians.

The Twelve Meridians correspond to the Twelve Yuan-Source points, forming a key pivot.

The Twelve Meridians, Fifteen Collaterals, and Twelve Yuan-Source points are noted above. This states that the Twelve Yuan-Source points are the pivots of the entry and exit of the Twelve Meridian pathways.

The method of selecting sixty-six points in one day reveals the subtleties.

"The sixty-six points" refer to the Jing-River, Ying-Spring, Shu-Stream, Yuan-Source, Jing-River, and He-Sea points in the Zi Wu Liu Zhu (Midnight-Noon Ebb-Flow) system. Yang stems nourish the Fu organs with thirty-six points, Yin stems nourish the Zang organs with thirty points, totaling sixty-six points, all recorded in the subsequent Liu Zhu text. Using one point reveals the subtle principles.

Selecting the Yuan-Source points of the Twelve Meridians in one hour reveals the essence.

The Twelve Meridian Yuan-Source points are noted above. This states that within an hour, one should examine which meridian is dominant on that day and time, and needle the Yuan-Source point of that meridian for that day; thus, the mystery of the Liu Zhu method becomes known.

As for tonification and sedation methods, they lie not in respiration but in finger techniques.

This states that tonification and sedation depend not only on respiration but on finger manipulation. There are fourteen techniques: Xun (rubbing), Men (covering), Ti (lifting), An (pressing), Tan (plucking), Nian (twirling), Cuo (friction), Pan (rolling), Tui (pushing), Na (inserting), Yao Dong (shaking), Zhao Qie (nail pressing), Jin (advancing), Chu (withdrawing), She (releasing). The rules are as stated; skill depends on flexible application, detailed in the *Jin Zhen Fu*.

Rapid efficacy requires recognizing the intersection of meridians and the primary meridian.

"Jiao Zheng" refers to the correct intersection of meridians, e.g., Large Intestine and Lung are interior-exterior transmitting organs; Heart and Small Intestine are interior-exterior receiving organs; Spleen and Stomach are interior-exterior digestive organs; Liver and Gallbladder are interior-exterior pure organs. When needling, one may combine points from both meridians. Others follow this pattern. It means recognizing the disease of the primary meridian and understanding the principle of intersecting meridians ensures rapid efficacy.

Intersecting Meridian Miao Needling: Disease on the left, take points on the right.

"Miao Ci" (Miao Needling) involves needling collateral vessels. Pain on the right treated by needling the left, pain on the left treated by needling the right; this is the principle of Intersecting Meridian Miao Needling.

Sedate collaterals and distant needling: Head disease, needle foot points.

The Three Yang meridians descend from head to foot; thus, for head disease, one must select foot points for needling.

Ju Ci differs from Miao Ci.

"Ju Ci" (Ju Needling) involves needling the main meridians. If pain is on the left but the pulse on the right is abnormal, use Ju Needling: left pain needle right, right pain needle left, targeting the main meridian. Miao Ci targets collaterals. Left excess causes right disease, right excess causes left disease. Sometimes pathology shifts; right pain persists while left pulse becomes diseased. In such cases, use Ju Needling, targeting the main meridian, not the collateral. Thus, collateral disease intersects with main meridians, hence "Miao" (intersecting). These two methods are similar, differing only in whether they target the main meridian or the collateral.

Micro-needling and subtle needling are interconnected.

"Micro-needling" refers to the skill of needling; "subtle needling" refers to the subtlety of the technique. They are interconnected.

Observing sections reveals the deficiency and excess of meridians.

It means inserting the needle into flesh layers, advancing through Heaven, Human, and Earth levels, and observing De Qi; thus, internal and external deficiency/excess can be known. Also, examining the three positions of the pulse reveals which meridians are deficient or excess.

Observing floating/sinking differentiates cold/heat of Zang-Fu.

It means after inserting the needle, observing the speed/slowness of the needle sensation determines the cold/heat of the Zang-Fu.

First, ensure the needle is bright and check for damage; second, keep it in the mouth to warm it.

It means before needling, ensure the needle is shiny and undamaged, then keep it in the mouth to warm it, aligning with Ying-Wei Qi, avoiding shock.

Eyes do not look outward, hands hold like a tiger, mind has no distractions, await like a noble guest.

This warns practitioners to focus sincerely and respect the procedure. Eyes should not wander, hands steady like holding a tiger to avoid injury, mind free of distraction, attentive as if awaiting a noble guest.

Left hand presses heavily and rubs often to disperse Qi; right hand inserts lightly and slowly to avoid pain.

It means before needling, use the left thumb nail to press the acupoint to disperse Qi, then insert the needle gently and slowly with the right hand, which prevents pain.

Fasting induces fear and timidity; standing or lying sideways causes dizziness.

"Fasting" refers to before eating. This states not to needle hungry people, as their Qi and Blood are unsettled, causing fear or timidity; standing or lying sideways may cause dizziness.

Close eyes, sink spirit, press firmly; sit or lie flat to avoid fainting.

It means before needling, instruct the patient not to look at the needling site. Press the acupoint firmly with nails, sit or lie flat, to avoid fainting.

Deduce the Ten Stems and Ten Changes to know the opening and closing of acupoints.

"Ten Stems" are Jia, Yi, Bing, Ding, Wu, Ji, Geng, Xin, Ren, Gui. "Ten Changes" refer to daily temporal variations. Recorded in the *Ling Gui Ba Fa*.

Thus, timely opening and untimely closing determine the gain and loss of acupoints.

Discuss the Five Elements and Five Zang, observe the waxing and waning of days and times.

Five Elements and Five Zang are noted above. This states that depending on the day and time, receiving generation leads to prosperity, receiving restriction leads to decline. For Heart disease, Jia/Yi days/times generate/prosper; Ren/Gui days/times restrict/decline. Others follow this.

Lie like a drawn crossbow, respond like releasing a trigger.

This describes the swift efficacy of needling, like hitting the target upon release.

Needling Yin Jiao and Yang Bie settles blood vertigo; Needling Yin Qiao and Yang Wei delivers the placenta.

"Yin Jiao" has two points: one below the umbilicus, one above the medial malleolus named Sanyinjiao (SP6). These two points settle postpartum blood vertigo. Also, Zhaohai (KI6) and Neiguan (PC6) deliver the placenta.

Bi syndrome, Jue cold, hemiplegia: Use Ying-Sui to reconnect meridians.

"Bi Jue" refers to cold paralysis of limbs. "Pian Ku" refers to hemiplegia from stroke. Treating these requires connecting Qi and meridians, using Ying-Sui methods to unblock blood flow and reconnect meridians.

Lou bleeding, Beng hemorrhage, Dai discharge: Warm tonification restores Qi and Blood.

"Lou Beng Dai" refers to women's diseases. Treat with warm needling to tonify, harmonizing Ying-Wei and restoring foundation.

Stay quietly and retain long, pause the needle to await arrival.

It means after inserting the needle, remain quiet and retain it for a long time.

Accuracy requires Zhaohai for throat obstruction; certainty uses Dazhong for mental dullness.

Zhaohai etc. are recorded in measurement methods, so not repeated.

Generally, pain and excess require sedation; itching and numbness and deficiency require tonification.

Pain indicates heat, sedate to cool; itching/numbness indicates cold, tonify to warm.

Heavy body and joint pain: Shu points govern; Chest fullness and bloating: Jing points govern.

"Shu" refers to Shu-Stream points of the Twelve Meridians. "Jing" refers to Jing-Well points.

Heart distension and throat pain: Needle Taichung to remove; Cold spleen and stomach pain: Sedate Gongsun to cure. Chest fullness and abdominal pain: Needle Neiguan; Hypochondriac and rib pain: Needle Feihu.

Taichung etc. are in subsequent diagrams. Feihu is Zhangmen (LR13). Alternatively, it refers to Zhigou (TE6), found by flying hand from Tiger Mouth to middle finger tip.

Tendon spasms and bone pain: Tonify Hunmen; Body heat and劳 cough: Sedate Pohu. Head wind and headache: Needle Shenmai and Jinmen; Itchy/painful eyes: Sedate Guangming at Diwu.

From then, morning Mao hours, Taiyin generates and warms quickly; Li left You south, moon dies and cools quickly.

This compares monthly cycles to daily ones. Morning Mao hours refer to Chen/Si times. At this time, Taiyin moon grows, so avoid sedation, use warming. Monthly cycle compared to daily: Moon grows 1 unit/day to 15th, shrinks to 30th. Before Full Moon is growth, after is death. Before noon is growth, after is death.

Xun, Men, Tan, Nu; Retain inhale Mother for firmness/length.

"Xun": Rub up/down after needling to move Qi/Blood. "Men": Cover acupoint after withdrawal to seal Qi. "Nail extension/lifting": Fast exhale Child for shortness. Nail pressing and lifting; fast exhale Child after cold sensation arrives, withdraw quickly, exhale short.

Move/withdraw, empty/rest, meet/grab right for sedation/cooling.

"Move/withdraw": Shake needle while withdrawing. If Qi doesn't move, lift/extend. "Empty/rest": Release hand and pause. "Meet": Needle against flow. "Grab": Sedate Child. E.g., Heart disease sedates Spleen/Stomach (Child). This is the sedation method.

Push/insert, advance/rub, follow/nourish left for tonification/warming.

"Push/insert": Push needle in. "Rub": Rotate slowly like twisting thread, not too tight. "Follow": Follow needle direction. "Nourish": Nourish Mother. E.g., Heart disease tonifies Liver/Gallbladder (Mother). This is the tonification method.

Be cautious! Generally, critical diseases with unfavorable complexion/pulse should not be needled.

"Cautious" means warning. Critical diseases require observing complexion and pulse; if contradictory, do not needle. Fear of futile effort and blame.

Avoid extreme cold, wind, rain, hunger, fullness, drunkenness, fatigue.

Do not needle in extreme cold, heat, wind, rain, hunger, fullness, drunkenness, or fatigue. Great taboo.

Full moon day no tonification, last day no sedation, half-moon no grabbing, new moon no nourishing.

"Full moon" 15th day. "Last day" 30th day. "Half-moon" upper/lower. Upper 7th/8th, Lower 22nd/23rd. Here?

Refine mind and exhaust methods, do not burn skin with moxibustion.

Moxibustion: Encourage practitioners to study acupoints carefully, avoid errors, prevent skin damage from taboos.

Correct principle and seek origin, strive to needle without losing position.

Needling: Encourage learners to understand needling principles, observe disease origin, avoid misplacement.

Avoid moxa points and harmonize limbs, total forty-nine; Avoid needle points and exclude Six Shu, total twenty-two.

Forty-five forbidden moxa points plus four limb Jing points total forty-nine. Twenty-two forbidden needle points excluding Six Fu Shu points, recorded above.

I also heard: Emperor Gaozhang was ill, Li Shi needled Juque and revived him; Crown Prince died suddenly from Jue, Yue Ren needled Weihui and woke him. Jianjing, Zuan needle intersecting Shu, spirits expelled immediately. Take Ganshu and Mingmen, let blind man see autumn hair tip. Shaoyang and Jiaobie, let deaf man hear summer mosquito sound.

Citing ancestors' immediate effects to encourage sincere study.

Since ancient sages are far, this Dao declines. Some give up learning when confused, some violate taboos due to lack of skill. I am humble and shallow, hard to grasp profound words. The Great Dao is deep, few attain it. I casually speak these words, not showing them to the wise, hoping to enlighten beginners.

Ancestors sigh at ancient sages and declining Dao. Principles are deep, hard to reach perfection. Conclude with humility. Ah, Dou Tai...