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Or obtain the point through extension and flexion, or by keeping the body level and stable.
"Extension and flexion," such as when selecting the Huantiao (GB30) acupoint, requires extending the lower limb and flexing the upper limb to locate it accurately.
"Level and stable" refers to selecting points while lying supine, sitting upright, or standing straight, with the body naturally at rest, such as the Chengjiang (CV24) located in the depression below the lower lip.

On the lateral sides of muscles and bones along the Yang channels, the true point is found in the depression; between the Yin channels, the true point corresponds to a palpable arterial pulse.
The "Yang parts" refer to the Yang channels, such as Hegu (LI4), Zusanli (ST36), and Yanglingquan (GB34); the true point must be sought in the depression beside the bone where the finger sinks.
The "Yin divisions" refer to the Yin channels, such as points on the palm, sole, and abdomen; the true point is confirmed only when there is a corresponding arterial pulse between the muscles and bones.

When selecting one point from five, it must be positioned precisely; when selecting one channel from three, its correctness must be verified.
This discusses the method of point selection: among five candidate points, choosing one accurately ensures precision. When using a specific channel, one must verify its correctness relative to adjacent channels.

The head and shoulder regions require detailed differentiation, while the Du (Governing Vessel) and Ren (Conception Vessel) are easier to define.
The head and shoulders contain numerous points; the practitioner must carefully distinguish them based on the patient's size and build. The Du and Ren vessels run vertically along the midline of the back and abdomen, respectively, with standard measurements, making them easier to locate.

Understand the principles of Root (Ben) and Branch (Biao) to discuss the depth of needling in different channels;
"Root and Branch" encompasses multiple meanings: the Root and Branch of the Six Channels, of Heaven and Earth/Yin and Yang, and of disease transmission. In terms of the human body, the exterior is Branch, the interior is Root; Yang is Branch, Yin is Root; Fu organs (Yang) are Branch, Zang organs (Yin) are Root; internal Zang and Fu organs are Root, external meridians are Branch.
For the Six Channels: The Root of the Foot-Taiyang Bladder Channel is 5 cun above the heel, and its Branch is in the eyes; the Root of the Foot-Shaoyang Gallbladder Channel is at Qiaoyin (GB44), and its Branch is in the ear, etc. Furthermore, Zang/Fu organs, Qi/Blood, and meridians each have their own Root and Branch.
Regarding disease: The initial pathology is Root, and subsequent progression is Branch. Generally, treat the Root first, then the Branch, and other symptoms will resolve. For example, if a mild illness precedes a severe one, treat the mild illness first. However, if there is abdominal fullness (Zhongman), regardless of Root/Branch, treat the fullness urgently. If abdominal fullness is accompanied by difficulty in urination or defecation, prioritize relieving these obstructions to address the urgency. Except for these three cases, always treat the Root with caution.
Pathogenic factors arriving from the preceding element constitute Excess (Shi) patterns ("Child causes Mother to be Excess"); those arriving from the following element constitute Deficiency (Xu) patterns ("Mother causes Child to be Deficient"). Treatment: Tonify the Mother for Deficiency, Drain the Child for Excess. For instance, if the Liver receives pathogenic Fire from the Heart (preceding element), it is an Excess pattern; drain the Fire. Since the Five Elements exist within all twelve channels, one should address the Fire at its source in Wood (Liver). Thus, the *Treatise on Root and Branch* states: "Root then Branch: Treat the Root first, then the Branch." If the Liver suffers from Fire pathogen, drain the Ying-Spring Fire point, Xingjian (LR2), on the Liver Channel. Pharmacologically, use Liver-channel guiding herbs as assistants and Heart-draining herbs as sovereigns. This treats Excess patterns.
Conversely, if the Liver receives pathogenic Water from the Kidney (following element), it is a Deficiency pattern; tonify the Mother. The *Treatise on Root and Branch* states: "Branch then Root: Treat the Branch first, then the Root." If Liver Wood suffers from Water pathogen, first tonify Wood at Yongquan (KI1) on the Kidney Channel (treating the Branch/manifestation), then drain Water at Ququan (LR8) on the Liver Channel (treating the Root/cause). Although this appears to treat the Branch first, philosophically it addresses the Root. Pharmacologically, use Kidney-channel guiding herbs as assistants and Liver-tonifying herbs as sovereigns.
The day of onset is Root; the day of transmission is Branch.

To stop pain and shift discomfort, select points along intersecting and crossing pathways.
This describes needle techniques that alleviate pain. Rotate the needle left nine times (Yang number), then right six times (Yin number), following the principle of Yin-Yang intersection. Meridians also intersect; for example, Lieque (LU7) of the Hand-Taiyin Lung Channel intersects with the Yangming pathway; Fenglong (ST40) of the Foot-Yangming Stomach Channel runs along the Taiyin pathway.

Have you not heard that for Zang-Fu diseases, one seeks the subtle efficacy of Men (Gate), Hai (Sea), Shu (Transport), and Mu (Alarm) points?
Men and Hai points include Zhangmen (LR13) and Qihai (CV6). Shu points refer to the Back-Shu points of the Zang and Fu organs, located in two rows on the back. Mu points include: Fei (Lung) Zhongfu (LU1), Xin (Heart) Juque (CV14), Gan (Liver) Qimen (LR14), Pi (Spleen) Zhangmen (LR13), Shen (Kidney) Jingmen (GB25), Wei (Stomach) Zhongwan (CV12), Dan (Gallbladder) Riyue (GB24), Dachang (Large Intestine) Tianshu (ST25), Xiaochang (Small Intestine) Guanyuan (CV4), Sanjiao (San Jiao) Shimen (CV5), Pangguang (Bladder) Zhongji (CV3). This means for Zang-Fu diseases, one must select these Gate, Sea, Transport, and Alarm points.

For stagnant meridians and collaterals, seek the principles of Yuan (Source), Bie (Divergent), Jiao (Intersection), and Hui (Meeting) points.
Yuan points are the Source points of the twelve channels. Bie refers to Yang Divergent vessels. Jiao refers to Yin Intersection points. Hui refers to the Eight Hui-Meeting points.
The Twelve Yuan Points: Dan (Gallbladder) Qiuxu (GB40), Gan (Liver) Taichong (LR3), Xiaochang (Small Intestine) Wangu (SI4), Xin (Heart) Shenmen (HT7), Wei (Stomach) Chongyang (ST42), Pi (Spleen) Taibai (SP3), Dachang (Large Intestine) Hegu (LI4), Fei (Lung) Taiyuan (LU9), Pangguang (Bladder) Jinggu (BL64), Shen (Kidney) Taixi (KI3), Sanjiao (San Jiao) Yangchi (TE4), Xinbao (Pericardium) Daling (PC7).
The Eight Hui-Meeting Points: Blood Ge-shu (BL17), Qi Tanzhong (CV17), Pulse Taiyuan (LU9), Sinew Yanglingquan (GB34), Bone Dashu (BL11), Marrow Yangxi (GB39), Zang Zhangmen (LR13), Fu Zhongwan (CV12).
This means for stagnation of Qi and Blood in meridians, one must needle these Yuan, Bie, Jiao, and Hui points.

Further investigate the Four Roots and Three Knots; needling according to Root and Branch ensures recovery.
Roots and Knots refer to the Root-Knot theory of the twelve channels. The *Ling Shu* states: Taiyin roots at Yinbai (SP1) and knots at Taicang; Shaoyin roots at Yongquan (KI1) and knots at Lianquan (CV23); Jueyin roots at Dazhun (LR14) and knots at Yutang (CV19); Taiyang roots at Zhiyin (BL67) and knots at the eyes; Yangming roots at Lidui (ST45) and knots at the jaw/ears; Shaoyang roots at Qiaoyin (GB44) and knots at the ears; Hand-Taiyang roots at Shaoze (SI1) and knots at Tianchuang (SI16)/Zhizheng (SI7); Hand-Shaoyang roots at Guanchong (TE1) and knots at Tianyou (TE16)/Waiguan (TE5); Hand-Yangming roots at Shangyang (LI1) and knots at Futu (LI18)/Pianli (LI6). The Hand-Taiyin channels are not recorded here.
Also: The Four Roots are the Ear Root, Nose Root, Breast Root, and Foot Root. The Three Knots are the Chest Knot, Limb Knot, and Bowel Knot.

Simply apply the Eight Methods and Five Gates, distinguishing Master and Guest, and needling will be effective.
The Eight Needle Methods: 1. Ying-Sui (Following/Rebelling), 2. Rotation, 3. Finger manipulation, 4. Insertion, 5. Deficiency/Excess, 6. Tremor, 7. Lift/Thrust, 8. Respiration.
The Body's Eight Methods refer to the Eight Extraordinary Vessels, summarized as "Gongsun, Chong Vessel, Stomach, Heart, Chest."
The Five Gates refer to the pairing of Heavenly Stems into five categories (Ji-Jia, Yi-Geng, etc.).
Master and Guest refer to Gongsun as Master and Neiguan as Guest.
Alternatively, Jing-River-Stream-Source-He-Well points form the Five Gates, with Pathogenic Qi as Guest and Healthy Qi as Master. Using the Eight Methods requires calculating the time via the Five Gates, prioritizing Master then Guest, ensuring efficacy.

The Eight Extraordinary Vessels connect to the Eight Hui-Meeting points, forming the main綱 (Gang); the Twelve Channels and Twelve Yuan points are the pivot (Shuyao).
The Eight Extraordinary Vessels are Du, Ren, Chong, Dai, Yinwei, Yangwei, Yinqiao, and Yangqiao. The Eight Hui-Meeting points (as listed above) connect the start and end of these vessels, serving as the main framework of the body, like the cord of a net.
The Twelve Channels, Fifteen Collaterals, and Twelve Yuan points were noted earlier. The "Pivot" refers to the hub of the gate, indicating the entry and exit of Qi through the Yuan points.

One-day selection of sixty-six points reveals profound subtleties;
The sixty-six points refer to the Jing-River-Stream-Source-He-Well points of the Zi Wu Liu Zhu (Midnight-Noon Ebb-Flow) system. Yang days nourish Fu organs (36 points); Yin days nourish Zang organs (30 points), totaling sixty-six points, detailed in the Zi Wu Liu Zhu diagrams. This implies that as meridians circulate daily, selecting the active point at that moment reveals profound principles.

Selecting the Yuan points of the twelve channels at specific hours reveals essential mysteries.
The Twelve Yuan points were noted above. At any given hour, determine which channel is dominant and needle its Yuan point to understand the mysteries of flow and distribution.

As for tonification and reduction methods, they rely not on respiration but on finger technique;
Tonification and reduction depend on manual skills rather than just breathing. There are fourteen techniques: Xun (Rubbing), Men (Closing), Ti (Lifting), An (Pressing), Tan (Plucking), Nian (Twirling), Cuo (Friction), Pan (Rolling), Tui (Pushing), Nei (Inserting), Yao Dong (Shaking), Zhua Qie (Nail Pressing), Jin (Advancing), Tui (Retreating), Chu (Withdrawal), She (Collecting). Skill varies by individual; see the *Golden Needles Ode*.

Rapid efficacy requires understanding intersecting channels and recognizing the primary channel.
Intersecting channels refer to paired Zang-Fu relationships: Large Intestine/Lung, Small Intestine/Heart, Spleen/Stomach, Liver/Gallbladder, Bladder/Kidney, linked by Yin-Yang and Interior-Exterior. The "Primary Channel" is the diseased channel; e.g., Heart disease requires treating Small Intestine points as well. Recognizing both the primary channel and intersecting principles ensures rapid results. Hence: "Better to miss the point than the channel; better to miss the time than the Qi."

Cross-meridian Miao needling: Disease on the left, treat the right side;
Miao needling targets the collaterals. Pain on the right treated on the left, and vice versa, follows the logic of cross-meridian interaction.

Drain collaterals and needle distally: Head disease, needle the feet.
Yang channels descend from head to foot; thus, head diseases are treated by needling foot points.

Ju needling differs from Miao needling.
Ju needling targets the main meridians. Left pain with right meridian pathology requires Ju needling (left pain, needle right; right pain, needle left), affecting the meridian. Miao needling targets collaterals. Body pain without pulse abnormality requires Miao needling (right pain, needle left; left pain, needle right), affecting the collateral. The difference lies in targeting meridians vs. collaterals.

Micro-needling and exquisite needling are interconnected.
Micro-needling refers to technical skill; exquisite needling refers to the artistry of treatment. They are mutually supportive.

Observe the sectors to know the deficiency and excess of meridians.
Insert the needle in three depths (Heaven, Human, Earth) and observe Deqi to determine interior/exterior deficiency or excess. Alternatively, pulse diagnosis at three positions reveals meridian status.

Observe floating/sinking to differentiate cold and heat of Zang organs.
After insertion, the speed and quality of the needle sensation indicate Zang organ cold or heat.

First, ensure the needle is bright and undamaged; second, warm it in the mouth.
Before needling, inspect the needle for damage. Warm it in the mouth to match body temperature and prevent shock to the Ying and Wei Qi.

Eyes do not look away; hands hold firm like grasping a tiger; mind has no distractions; behave as if awaiting a noble guest.
This admonishes practitioners to focus sincerely and respect the procedure. Keep eyes fixed on the site, hands steady, and mind free of distraction, treating the patient with utmost care.

Left hand presses heavily and frequently to disperse Qi; right hand inserts lightly and slowly to avoid pain.
Before insertion, press the point with the left thumb nail to disperse local Qi. Insert gently with the right hand to minimize pain.

Fasting patients may feel fearful; standing or lying sideways may cause dizziness.
Do not needle hungry patients, as their Qi and Blood are unstable, leading to fear or dizziness if they stand or lie awkwardly.

Close eyes, sink spirit, press firmly; sit or lie flat to avoid fainting.
Instruct the patient to close their eyes and not watch the needle. Press firmly with nails. Proper positioning prevents syncope.

Study the Ten Stems and Ten Changes to know the opening and closing of acupoints;
The Ten Stems are Jia, Yi, Bing, Ding, Wu, Ji, Geng, Xin, Ren, Gui. The Ten Changes refer to daily variations. These are detailed in the *Spirit Turtle Eight Methods*; timely points are "Open," untimely points are "Closed."

Discuss the Five Elements and Five Zang organs, observing the waxing and waning of days and hours.
Based on previous notes: Diseases benefit from generating elements (Waxing) and suffer from controlling elements (Waning). e.g., Heart disease benefits from Jia/Yi days/hours and suffers from Ren/Gui days/hours.

Lie still like a drawn crossbow; strike swiftly like releasing a trigger.
Needling should be precise and swift, like shooting an arrow to hit the target.

Yinjiao and Yangbie calm blood vertigo; Yinqiao and Yangwei expel the placenta.
Yinjiao refers to either the point 1 cun below the umbilicus or Sanyinjiao (SP6) on the inner ankle; both calm postpartum blood vertigo. Zhaohai (KI6) and Waiguan (TE5) help expel the placenta.

Bi syndrome, cold limbs, and hemiplegia: Ying-Sui methods restore meridian continuity.
Bi syndrome involves cold/numbness; hemiplegia involves stroke paralysis. Treat by connecting Qi and meridians using Ying-Sui techniques to promote circulation.

Metrorrhagia, leukorrhea: Warm tonification restores Qi and Blood.
These gynecological disorders require warm moxibustion or needling to harmonize Ying and Wei and restore vitality.

Retain the needle quietly for a long time, waiting for the effect.
After insertion, retain the needle calmly to allow the therapeutic effect to manifest.

Accurately, select Zhaohai to treat throat obstruction; definitively, use Dazhong to treat mental dullness. Generally, pain indicates Excess (drain); itching/numbness indicates Deficiency (tonify).
Pain suggests Heat/Excess, requiring draining to cool. Itching/numbness suggests Cold/Deficiency, requiring tonifying to warm.

Body heaviness and joint pain are treated by Shu points; subcostal fullness is treated by Jing-Well points.
Shu points treat body/joint issues; Jing-Well points treat chest/abdominal fullness.

Chest distension and sore throat: Needle Taichong (LR3) for relief. Spleen cold and stomach pain: Drain Gongsun (SP4) for immediate cure. Chest fullness and abdominal pain: Needle Neiguan (PC6). Flank and rib pain: Needle Feihu (Zhi-gou/Sanjiao TE6).
Feihu is another name for Zhi-gou (TE6), located at the tip of the middle finger when flying the hand from the web space.

Sinew spasms and bone pain: Tonify Hunmen (BL47). Body heat and劳嗽 (consumptive cough): Drain Pohu (BL42). Head wind and headache: Needle Shenmai (BL62) and Jinmen (BL63). Eye itching and pain: Drain Guangming (GB37) and Diwu (Diwu Hui, GB12). Drain Yinxi (HT6) to stop night sweats and treat pediatric bone-steaming fever. Needle Pianli (LI6) to promote urination and treat adult ascites. Stroke: Needle Huantiao (GB30). Deficiency: Select Tianshu (ST25).
Diwu refers to Diwu Hui (GB12).

Therefore, before noon (Chen/Si hours), when the Moon grows, warm quickly; after sunset (Wei/Shen hours), when the Moon wanes, cool rapidly.
This compares monthly lunar phases to daily cycles. Morning (Chen/Si) corresponds to Moon growth; avoid draining, use warming. Afternoon (Wei/Shen) corresponds to Moon waning; avoid tonifying, use cooling. As stated in classics: The Moon grows from new moon to full moon (1st-15th) and wanes from full to new (16th-30th). Morning is growth; afternoon is waning.

Rub, close, pluck; retain inhalation to tonify Mother (firm and long);
Xun (rubbing) moves Qi; Men (closing) seals the point after withdrawal. Tan (plucking) tonifies deficiency. Retain inhalation tonifies the Mother; wait for warmth, then retain deeply.

Nail press, lift, thrust; quick exhalation to drain Child (short and rapid).
Nail press guides insertion. Lift/thrust manipulates Qi. Quick exhalation drains the Child; wait for coolness, then withdraw swiftly.

Move and retreat, pause; rebelling drainage (right rotation) brings coolness; push and insert, friction; following nourishment (left rotation) brings warmth.
Moving/retreating adjusts Qi flow. Pausing allows settling. Rebelling (counter-direction) drains the Child (e.g., drain Spleen for Heart disease). Pushing/friction inserts and rotates slowly. Following nourishes the Mother (e.g., tonify Liver for Heart disease). For Heat: Guide Qi to lesion, slightly lift/rotate right to induce cold. For Cold: Guide Qi to lesion, slowly insert/rotate left to induce heat.

Be cautious! Do not needle critical illnesses with discordant complexion and pulse;
Caution is advised. If complexion and pulse contradict the disease severity, avoid needling to prevent failure or harm.

Avoid needling in extreme cold, heat, wind, rain, hunger, fullness, drunkenness, and fatigue.
Never needle during extreme weather conditions or states of hunger, satiety, intoxication, or exhaustion.

Do not tonify on the Full Moon (Wang), drain on the New Moon (Hui); do not drain on the Half Moon (Xian), nor tonify on the New Moon (Shuo);
Full Moon (15th), New Moon (30th), Half Moon (7th/8th or 22nd/23rd), New Moon (1st). Avoid needling on these days unless for emergencies.

Refine your mind and master the methods; do not let moxibustion burn the skin;
Regarding moxibustion: Study acupoints carefully to avoid burns and contraindications.

Correct the principles and seek the origin; avoid missing the point location with needles.
Regarding needling: Understand the theory and disease origin to ensure accurate point placement.

Avoid forty-nine points for moxibustion (including four-limb Jing-Well points); avoid twenty-two points for needling (excluding Six-Fu Shu points).
Forty-five points are forbidden for moxibustion, plus four Jing-Well points on limbs = 49. Twenty-two points are forbidden for needling, excluding the Shu points of the Six Fu organs.

Furthermore, it is said that Emperor Gaozu was cured of his illness by Li Shi needling Juque (CV14); Yu Qian revived the Crown Prince from syncope by needling Weizhong (BL40) and Huizong (?). Zhen Quan relieved arm pain by needling Jianjing (GB21) and Quchi (LI11); Hua Tuo restored walking by needling Xu zhong (GB39) and Huantiao (GB30). Qiu Fu treated lumbar issues by needling Yaoshu (BL23)...