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II: Whenever pain occurs during needling, it is merely due to the practitioner's rough technique. One should use the left hand to support the middle of the needle shaft and perform tonification or sedation with the right hand calmly. If pain persists, do not withdraw the needle; instruct the patient to take a deep breath in, and while they inhale, twirl the needle to make it flexible and lift it slightly (about the height of a grain of rice), at which point the pain will cease. If lifting it causes pain again, lift it further; if pain recurs upon further lifting, one must re-insert the needle deeper, and the pain will stop.

III: In cases of broken needles, insert another needle beside the original acupoint and extract the broken piece using a tonifying method, or use magnetite (Ci Shi) to attract the needle out, or apply medicinal paste to the area.

Alas! The art of the Divine Needle originated in ancient times; even in the era of Qibo, it was lamented that its transmission had been lost, let alone in later generations. Fortunately, we rely on the two masters, Dou Hanqing and Xu Feng, who were able to investigate the intent behind the surviving texts, enabling future students to gain insight and grasp the essentials. These are summarized into four sections, offered tentatively for beginners to open the gate of learning and for emergency rescue purposes, awaiting the judgment of wise scholars from all directions (The section on tonification and sedation, along with the section on acupoints for miscellaneous diseases, can be found in Volume III; the section on songs for the fourteen meridian points, in Volumes VI and VII; the section on essential acupoints for treating diseases, in Volume VII).

The section on tonification and sedation was transmitted by the descendants of Ouyang from Luling, differing from the methods used by contemporary practitioners. However, examining the *Suwen* (Basic Questions), it does not speak of "needle technique" but rather "the Way of Needling," implying that needling should follow the pathway of qi and blood circulation. It also states: "In all needling, one must distinguish yin and yang." Further consulting the *Nanjing Illustrated Commentary* and the words of Master Xu: left and right differ, and chest and back are distinct; only then can one understand their origins. Generally speaking, the left side belongs to Yang, governing ascending, exhalation, exiting, lifting, morning hours, and the back of men; the right side belongs to Yin, governing descending, inhalation, entering, inserting, afternoon hours, and the abdomen of men. Therefore, women are the reverse of this because women belong to Yin and men to Yang. Women have Yin on the back and Yang on the abdomen, while men have Yang on the back and Yin on the abdomen. This is the subtle wonder of heaven, earth, male, and female yin and yang, occurring naturally thus.

The commentary on Shenshu (BL23) in the *Suwen* states: Use a round-bladed needle (Yuanli Zhen). Before needling, recite: "Five Emperors' supreme truth, Six Jia's mysterious spirit, Qi aligns with Supreme Yin, hundred evils close the pores." Recite three times. First, insert to a depth of 2 cun, retain for six respiratory cycles, then advance the needle to 3 cun. When qi arrives, slowly withdraw the needle and press the site with your hand. Instruct the patient to swallow three times to settle the spirit and soul. The commentary on Pishu (BL20) states: Before needling, recite: "The Emperor supports the heavenly form, protecting life to become spiritual." Recite three times. Insert to 3 cun, retain for seven respiratory cycles, and when qi arrives, quickly withdraw the needle.

Note: These incantations are not the intent of the *Suwen*; they are merely used by needle workers to focus their mind entirely on the needle.

The *Bacui Ji* (Collection of Extracts) states: For sedation, first use the left hand to palpate and locate the acupoint. Place the needle on the point with the right hand. Instruct the patient to cough once, then twirl the needle into the subcutaneous tissue. Instruct the patient to inhale deeply, advancing the needle to 6 fen. When a heavy and obstructive sensation is felt, retreat to 3 fen. When the heavy sensation is felt again, retreat the needle by about one bean's width. Turn the palm upward and rotate the needle head towards the diseased area. Palpate along the meridians to the disease site, return the hand to guide the needle, leading the qi directly past the needle by three inches. Withdraw the needle slowly during exhalation, without closing the acupoint. This is called sedation.

For tonification, first use the left hand to palpate and locate the acupoint. Place the needle on the point with the right hand. Instruct the patient to cough once, then twirl the needle into the subcutaneous tissue. Instruct the patient to exhale, inserting the needle to 8 fen. When a heavy and tight sensation is felt, retreat by 1 fen. When the tightness increases, turn the palm upward and rotate the needle head towards the diseased area. Follow the previous method to palpate the disease site. When qi arrives, the illness is cured. Withdraw the needle during inhalation and quickly press the acupoint. This is called tonification.

The *Mingtang* commentary states: Regarding cold-heat tonification and sedation, for example, to treat cold deficiency with tonification: First, have the patient cough once to enter the subcutaneous tissue. Then, have the patient blow out air once. As they exhale, insert the needle to 6–7 fen, gradually advancing to the regions of the Kidney and Liver. Retain the needle slowly for a long time, then retreat it by about one bean's width. Twirl the needle and ask the patient if they feel heat. Then, advance the needle to 3–4 fen, reaching the regions of the Heart and Lung. Have the patient inhale, first twisting the needle inward to direct qi down to the disease site, then twisting outward to direct qi up, passing one to two inches beyond the needled acupoint. Withdraw the needle while inhaling and twisting outward, and quickly press the acupoint with the hand. This is tonification.

If treating a heat disease with cold methods, how should it be done? To induce a cooling sensation, first insert into the Yang layer. Wait for qi arrival, then push the needle inward to the Yin layer. Then, instruct the patient to allow Earth Qi to enter and Heaven Qi to exit. Carefully count the respiratory cycles according to the numbers of generation and completion. The patient will spontaneously feel cool.

If treating aversion to cold with heat methods, how should it be done? To induce a warming sensation, first insert into the Yin layer. Wait for qi arrival, then slowly draw the needle up to the Yang layer. Then, instruct the patient to allow Heaven Qi to enter and Earth Qi to exit. Carefully count the respiratory cycles according to the numbers of generation and completion. The patient will spontaneously feel warm.

Respiration Tonification and Sedation

The *Suwen* commentary states: According to the principles of the meridians, one must first tonify the true qi before sedating the pathogenic factors. Why? Because tonification involves inserting the needle during exhalation and retaining it quietly for a long time. Sedation involves inserting the needle during inhalation and retaining it quietly for a long time. However, exhalation is followed by inhalation, and inhalation does not include exhalation. Since the timing of insertion is similar and the principle of long retention is identical, the meaning of "tonifying first" is clearly evident. The *Bacui Ji* states: Exhalation should not exceed three times, inhalation should not exceed five times. The *Mingtang* states: When performing tonification, wait for qi to reach the disease site, then use the numbers of generation and completion. Instruct the patient to inhale through the nose and exhale through the mouth; internal heat will naturally arise. When performing sedation, lead qi to the disease site, then use the numbers of generation and completion. Instruct the patient to exhale through the nose and inhale through the mouth while pressing the affected zang-fu organ area; internal coolness will naturally arise.

Eight Methods of the Divine Needle

Keep the mind free from distraction, as if awaiting a distinguished guest; the mind is the Shen (Spirit). The practitioner's mind, the patient's mind, and the needle move up and down together. First, consider whether the needle is damaged. Second, hold the needle tip in the mouth to warm it. Third, massage the afflicted acupoint with the left hand as if grasping a tiger. Fourth, twirl the needle with the right hand as if holding a blade without weight. This is the first method of needling.

Twisting nine times with the left hand and six times with the right hand is the second method to stop pain.

Advancing the needle while the patient coughs is the third method of insertion.

When the needle feels heavy and stagnant for a long time, wait until there is no distension internally and qi does not move. Apply the previous methods. If the qi surrounds the needle but does not descend, it indicates excess. Twist left to sedate the excess. If it does not dissipate, instruct the patient to exhale three times, and the practitioner should grasp the needle with the hand to dissipate it. If there is no stagnation or distension upon insertion, it indicates qi deficiency. Instruct the patient to inhale, and twist right to tonify the deficiency. This is the fourth method of tonification and sedation.

The sedation method includes "Phoenix Spreading Wings": Use the right thumb and index finger to twirl the needle head, resembling a flying motion, twisting once and releasing once. This is the fifth method of sedation.

The tonification method includes "Hungry Horse Shaking Bell": Use the right thumb and index finger to twirl the needle head, resembling a weak horse. Slowly advancing makes the effect longer; retreating makes it shorter. This is the sixth method of tonification.

If the patient experiences fainting from needling, cover them with a sleeve and give hot soup to wake them. This is the seventh method of tonification.

If the needle reaches a deep level and cannot be advanced or withdrawn, and wrinkles appear around the skin where the needle resembles it has grown into the flesh, this indicates extreme qi excess, resembling flies swarming and biting. Using the right index finger, move forward three times and backward once around the wrinkled skin near the needle. This is the eighth method of sedation. When withdrawing the needle, immediately press the acupoint; this is the essential secret of tonification.