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(Methods for Broken Needles)
One method is to use a lodestone (magnet) to attract the broken needle from within the muscle, and the needle will be extracted.
One method is to grind ivory shavings into fine powder, mix with water to form a paste, apply it, and the needle will be extracted.
One method is to use axle grease made into a paste, spread on paper the size of a coin, change three to five times daily, and the needle will emerge.
One method is to take three or five crow or magpie feathers, roast them until charred, grind into powder, mix with good vinegar to form a paste, apply it, cover with paper one or two times, and the needle will naturally come out.
One method is to crush candle wax (from December candles), apply it, and the needle will be extracted.
One method is to grind sulfur finely, mix and apply, secure with a paper flower patch; when itching is felt, the needle will emerge.
One method is to crush two apricot kernels, mix with fresh animal fat, apply to the needle wound, and the needle will self-extract. If meridians are injured and pus/blood does not stop, use Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Rougui (Cinnamomi Cortex), Muxiang (Aucklandiae Radix), Ruxiang (Olibanum), Chenxiang (Aquilariae Lignum), separately ground with mung bean flour paste to make pills. Take fifty pills each time, administered with warm water.

The Yellow Emperor said: I have heard that in acupuncture, excess conditions are treated by reducing (Xie), and deficiency conditions by tonifying (Bu). Qibo said: The onset of all diseases involves either deficiency or excess, thus tonification and reduction methods are applied. Reducing deficiency and tonifying excess causes the Shen (Spirit) to leave its chamber, inviting pathogenic factors and losing righteous Qi, making the true condition indeterminate; this ruin is caused by incompetent practitioners but blamed on fate. Tonifying deficiency and reducing excess allows the Shen to return to its chamber and fills the emptiness over time; this is called a skilled artisan.

In using needles, one follows the flow to assist (tonify), opposes the flow to drain (reduce), tonifies deficiency to make it solid, reduces fullness to drain it, removes stagnation and old blood, and reduces pathogenic excess. Slow insertion and rapid withdrawal constitutes tonification; rapid insertion and slow withdrawal constitutes reduction. Discussing excess and deficiency feels like something there and then gone. Observing sequence and priority feels like presence and absence. Addressing deficiency and excess feels like gaining and losing. The key to deficiency and excess lies in the Nine Needles. The timing of tonification and reduction is achieved through the needle. Reduction is termed "opposing"; one must hold and insert the needle, release and withdraw it, push away the Yang aspect to obtain needle sensation, allowing pathogenic Qi to vent. Pressing and guiding the needle out is called "internal warming," preventing blood dispersion and Qi escape. Tonification is termed "following"; follow the Qi as if it were nothing. Movements resemble walking or pressing, like a mosquito bite lingering, staying then returning, withdrawing like a snapping bowstring, coordinating Left (Yin) and Right (Yang) so Qi stops naturally. The external gate closes, internal Qi becomes solid, no blood remains, and the needle is quickly removed to purge the pathogen.

If Qi does not arrive after needling, do not limit the number of manipulations. If Qi arrives, remove the needle and do not re-needle.

There are five principles of acupuncture suspended for the world: 1. Regulating the Shen (Spirit); 2. Knowing how to nourish the body; 3. Knowing medicinal drugs; 4. Determining the size of bian stones (lithic tools); 5. Diagnosing Zang-Fu organs and Qi-Blood. When these five laws are established, each has its priority. In modern times, practitioners simply tonify deficiency and reduce excess, which is common knowledge among artisans. However, following Heaven and Earth, responding spontaneously, harmonizing like an echo, following like a shadow—the Dao has no ghosts or gods, coming and going alone. The Yellow Emperor asked: I wish to hear this Dao. Qibo replied: The truth of needling requires first regulating the Shen. Once the Five Zang organs are stabilized and the Three Pulses (Jiu Hou) are prepared, then consider the needle. Do not see abnormal pulses, do not hear ominous signs; internal and external must correspond, not prioritizing form. Play with the coming and going of Qi before applying to the patient. Regarding deficiency and excess, avoid treating severe deficiency (Wu Xu) closely and severe excess (Wu Shi) distantly. When the moment to needle arrives, hesitate not. Hand movements should be focused, needles bright and even. Calmly observe the meaning, watch for changes in adaptation; this is the unseen realm, unknown in form. See Qi gathering like crows, seeing Qi abundant like grain; follow its flight, knowing not who it is. Lie still like a drawn crossbow, rise like releasing a trigger.

Tonifying deficiency requires making it solid; reducing excess requires making it empty. Once Jing Qi arrives, guard it carefully without loss. Depth is determined by intent; proximal and distal sensations are uniform. Be like facing an abyss; hand like holding a tiger. Let Shen not be distracted by worldly objects. Insert the needle straight without deviation; must rectify the Shen.

The essence of small needles is easy to state but hard to master. Incompetent doctors guard form; superior doctors guard Shen. Shen is subtle; the guest (pathogen) meets at the gate. Before seeing the disease, how can one know its origin? The subtlety of needling lies in speed. Incompetent doctors guard joints; superior doctors guard the mechanism (Ji). The movement of the mechanism does not leave the void (acupoint). The mechanism in the void is pure and subtle. Its arrival cannot be met with tonification; its departure cannot be chased with reduction. One knowledgeable in the Dao of Ji does not err by a hair's breadth. One ignorant of Ji knocks but receives no response. Knowing the coming and going, seize the opportunity. Incompetent doctors are dark to this. Wonderful indeed, only artisans possess this. Departing Qi is Ni (Rebellious/Reverse); arriving Qi is Shun (Smooth/Favorable). Knowing Ni and Shun, proceed correctly without doubt. Opposing and draining—how can it not become deficient? Following and assisting—how can it not become solid? Opposing and following, harmonizing with intent, completes the Dao of needling.

In using needles: tonify deficiency, reduce fullness, remove stagnation, reduce pathogenic excess. Generally: holding the needle firmly is solid; point straight, do not deviate left or right. Focus spirit on the finest details, attend to the patient. Examine blood vessels; needling will be safe. During needling, focus on Xuan Yang (eyes) and Liang Wei (ears). Keep Shen attached, know if the disease survives. Blood vessels lie horizontally; they appear clear upon viewing and firm upon palpation.

Tonifying deficiency makes the needle feel hot; Qi becoming solid generates heat. Reducing fullness makes the needle feel cold. Removing stagnation expels evil blood. Reducing pathogenic excess means not pressing the needle hole upon withdrawal. Slow withdrawal and rapid pressing constitutes tonification (Xu Er Ji Ze Shi). Rapid withdrawal and slow pressing constitutes reduction (Ji Er Xu Ze Xu). Discussing excess and deficiency refers to observing the abundance or scarcity of Qi and Blood. "Something there and then gone" refers to the unpredictability of speed. Observing sequence and priority refers to knowing the order of the disease. "Presence and absence" refers to the intermittent nature of the pulse. Addressing deficiency and excess means the artisan must not lose the method. "Gaining and losing" refers to deviating from the method. The Nine Needles are best for deficiency/excess because each suits specific indications. The timing of tonification/reduction aligns with the opening and closing of Qi. The different shapes of the Nine Needles allow them to exhaust their respective tonifying/reducing functions. To reduce excess, retain the needle until Yin Qi arrives abundantly, then remove. To tonify deficiency, wait until Yang Qi arrives abundantly and the needle feels hot, then remove. Guarding Qi once arrived means not changing techniques. Depth depends on knowing interior/exterior pathology. Uniformity of distance implies equal waiting for Qi at different depths. "Facing an abyss" means not being negligent. "Holding a tiger" implies strength. "Shen not distracted" means quiet observation of the patient, no looking around. "Straight insertion" implies uprightness. "Rectifying Shen" means observing the patient to control one's own Shen, facilitating Qi flow.

"Easy to state" means easy to speak of. "Hard to enter" means hard to grasp by others. "Guarding form" means adhering to technique. "Guarding Shen" means monitoring the surplus or deficit of Qi and Blood for tonification/reduction. "Shen Guest" is the meeting of Righteous and Pathogenic Qi. Shen is Righteous Qi; Guest is Pathogenic Qi. "At the gate" means the pathogen enters/exits via the Righteous Qi. "Not seeing the disease" means knowing which meridian is affected by pathogen or righteousness. "Knowing the origin" means knowing the disease location and selection points. "Subtlety in speed" refers to slow/fast manipulation. "Guarding joints" means focusing on limbs without knowing Qi/Blood dynamics. "Guarding the mechanism" means guarding Qi. "Mechanism in the void" means understanding Qi's deficiency/excess and manipulating speed accordingly. "Pure and subtle" means securing Qi once obtained. "Cannot meet arrival" means Qi is excessive, do not tonify. "Cannot chase departure" means Qi is deficient, do not reduce. "Not erring by a hair" means Qi is easily lost. "Knocking yields no response" means ignorance of tonification/reduction intent. "Qi exhausted but not descending." "Knowing coming and going" means knowing Qi's direction and strength. "Seizing the period" means knowing the optimal time to needle. "Incompetent darkness" means ignorance of Qi's subtlety. "Artisan's wonder" means complete understanding of needle intent. "Departing is Reverse" means Qi is weak and small. "Arriving is Smooth" means Form and Qi are balanced. "Knowing Reverse/Smooth" means knowing point selection. "Opposing drains" is reduction. "Following assists" is tonification. "Tonifying deficiency" means tonifying when the Qi Kou (Radial artery) is deficient. "Reducing fullness" means reducing when Qi Kou is excessive. "Removing stagnation" means clearing blood vessels. "Reducing pathogenic excess" means draining all meridians with excess. "Slow in, fast out" is tonification. "Fast in, slow out" is reduction. "Excess is Qi, Deficiency is No Qi." "Sequence and priority" refers to the order of tonification/reduction based on Qi status. "Gaining/Losing" describes the feeling of tonification (as if gaining) and reduction (as if losing).

Therefore, artisans know where Qi resides, guard the gates, understand adjustment and tonification/reduction locations, speed, and point selection. Reduction uses "Round" (Yuan): press and rotate, Qi flows, withdraw rapidly and slowly, pathogen exits, extend and oppose, enlarge the aperture, Qi exits swiftly. Tonification uses "Square" (Fang): pull skin externally to align with the gate, draw the pivot left, push skin right, rotate slightly and push slowly, keep upright and calm, firm heart without relaxation, retain Qi slightly, then withdraw Qi rapidly, push skin to close the gate, Shen Qi remains. The essence of needling: Reduction uses Fang because Qi is flourishing, moon is full, day is warm, body is stable, and inhaling to insert; wait for inhalation to rotate, exhalation to withdraw slowly. Thus "Reduction uses Fang." Tonification uses Yuan because Yuan means movement; movement means shifting. Puncture Ying (Nutrient) points, exhale to withdraw. Thus Yuan and Fang refer to methods, not needles.

Reducing excess: Insert when Qi is excessive. Needle and Qi enter together, opening the gate like a door. Needle and Qi exit together, preserving Essence Qi, expelling pathogen. External gate remains open to drain excess. Enlarge the path like a road. This is Great Reduction. Press to withdraw, major Qi exits. Hold needle steady, fix intent. Wait for exhalation to insert, Qi out/Needle in. Close needle hole, Essence cannot escape. When full, withdraw rapidly, Qi in/Needle out. Heat cannot return, gate closed, pathogen disperses, Essence preserved. Move with Qi timing, near Qi not lost, far Qi arrives. This is Pursuing Inhalation to Insert, preventing Qi conflict. Retain quietly, prevent pathogen spread. Rotate on inhalation until Qi arrives. Guide out on exhalation, remove completely when breath ends. Major Qi exits. This is named Reduction. Palpate and rub, press and scatter, push and press, flick and tense, nail down, penetrate and extract. Pull external gate to close Shen. Insert on end of exhalation, retain quietly until Qi arrives. Wait like a valued guest, ignoring time. Once Qi arrives, protect appropriately. Withdraw on inhalation, Qi cannot exit. Each stays in place. Push and close gate, let Shen Qi remain, Major Qi stay. Thus tonification/reduction is not lost, harmonizing with Heaven and Earth. Guard Qi once arrived, depth by intent, uniform sensation, face abyss, hold tiger, Shen undistracted.

Holding the needle: upright and calm. Know deficiency/excess first, then apply speed. Left hand holds bone, right hand guides, avoid wrapping flesh. Reduction requires upright insertion; Tonification requires closing skin, assisting needle to guide Qi, preventing pathogen invasion, preserving True Qi.

Yellow Emperor asked: How to open skin and interstices? Qibo replied: Follow the muscle layers, separate skin with left hand, insert slightly and slowly upright. Ensure Shen does not scatter, know pathogen location, find the Dao first, prick sparsely and lightly, deepen slightly to retain, thus entering slowly. High heat above: push downward. From top to bottom: guide and remove. Treat prior pain points first. External cold: retain and tonify. Internal entry: drain from He-Sea points. Upper Qi deficiency: push and raise. Lower Qi deficiency: accumulate and follow. Cold entering middle: push and circulate.

Excess is Qi entering. Deficiency is Qi exiting. Qi excess is heat. Qi deficiency is cold. Entering excess: open needle hole with left hand. Entering deficiency: close needle hole with right hand.

Form/Qi deficiency, Disease Qi excess: Pathogen is strong, urgently reduce. Form/Qi excess, Disease Qi deficiency: Both Yin and Yang are deficient, do not needle. Needling causes double deficiency, exhausting Yin/Yang, depleting Blood/Qi, emptying Five Zang, drying sinews/marrow/bones. Elderly perish, strong do not recover. Form/Qi excess, Disease Qi excess: Both Yin and Yang are excessive, urgently drain pathogen, adjust deficiency/excess. Thus: excess reduce, deficiency tonify. If needling ignores reverse/smooth, True/Pathogenic clash, tonifying fullness causes Yin/Yang overflow, gut/bladder distension, Liver/Lung internal pressure, Yin/Yang confusion. Reducing deficiency causes meridian emptiness, Blood/Qi exhaustion, gut/bladder collapse, thin skin, burnt hair/follicles. Know the time of death.

All needling aims to regulate Qi. Qi accumulates in Stomach, connects Ying/Wei, follows its paths, Zong Qi stays in Sea (Chest). Downward flows to Qichong. Straight flows to Respiration Path. Jue in feet: Zong Qi does not descend, blood in vessels coagulates/stagnates. Without fire regulation, Qi cannot disperse. Qi can be gathered, Qi can be distributed. Dwell quietly, observe Shen's coming/going. Close doors/windows, Hun/Po do not scatter. Focus on one Shen, divide Jing/Essence. Do not hear human voices. Gather Essence, unify Shen, focus mind on needle. Shallow retention, slight floating, shift Shen, rest when Qi arrives. Male retain internally, Female retain externally. Firmly reject outward, carefully guard inward. This is obtaining Qi.

If Qi does not arrive, ignore number. If Qi arrives, remove and do not re-needle. Needles have specific suitability, different shapes, serving their purpose. This is the essence of needling. Qi arrival brings effect. Proof of effect: like wind blowing clouds away, clearly seeing blue sky. The Dao of needling is complete.

Practitioners must first examine meridian deficiency/excess, palpate and rub, press and flick, observe reactive areas, then select and needle. Six Meridians harmonious means no disease; if diseased, it resolves itself. If one meridian has upper excess/lower deficiency with blockage, there must be transverse collaterals overflowing onto main meridians causing blockage. View and reduce this. This is untying knots. Upper cold/lower heat: needle Neck Taiyang, retain long. After needling, moxa/warm neck and scapula until heat merges downward, then stop. This is pushing upward. Upper heat/lower cold: view deficient/collapsed meridians, needle until Qi descends, then stop. This is pulling downward. Generalized high heat, mania, hallucinations, delirium: view Foot Yangming and large collaterals. Tonify deficiency, reduce blood excess. Patient lying supine, position head forward. Press carotid arteries with four fingers of both hands, hold long, roll and press, move down to Supraclavicular fossa, stop as before. Stop when heat dissipates. This is pushing and dispersing.

Yellow Emperor asked: Excess reduce, deficiency tonify. What is excess? What is deficiency? Qibo: Five types of excess, five types of deficiency. What do you ask? Emperor: Tell me all. Qibo: Shen has excess/deficiency, Qi has excess/deficiency, Blood has excess/deficiency, Form has excess/deficiency, Zhi (Will) has excess/deficiency. These ten differ in Qi. Emperor: Humans have Jing/Essence/Jin/Fluids, four limbs/nine orifices, five Zang/sixteen parts, 365 joints, generating hundred diseases, all having deficiency/excess. Why five excess/five deficiency? Qibo: All originate from Five Zang. Heart stores Shen, Lung stores Qi, Liver stores Blood, Spleen stores Flesh, Kidney stores Zhi, forming the body. Intent connects to marrow, forming Five Zang. Paths of Five Zang emerge from Jing-Tunnels, circulating Qi/Blood. Qi/Blood disharmony generates hundred diseases. Thus guard Jing-Tunnels. Emperor: Shen excess/deficiency? Qibo: Shen excess laughs incessantly; Shen deficiency weeps. Qi/Blood not combined, Zang stable, pathogen in form, chills start at hairs, not yet in meridians. Called Shen's subtlety. Emperor: Tonification/Reduction? Qibo: Shen excess: bleed small collaterals, do not pierce deep, avoid main meridians, Shen Qi balances. Shen deficiency: view deficient collaterals, press to gather, needle to facilitate, do not bleed, do not leak Qi, open meridians, Shen Qi balances. Emperor: Subtle needling? Qibo: Massage without releasing, needle without deep piercing, transfer Qi to deficiency, Shen Qi recovers. Emperor: Qi excess/deficiency? Qibo: Qi excess: panting, coughing, rebellious Qi. Qi deficiency: smooth breathing but shortness of breath. Qi/Blood not combined, Zang stable, slight skin disease, called White Qi slight leakage. Emperor: Tonification/Reduction? Qibo: Qi excess: drain Jing-Tunnels, do not injure meridian, do not bleed, do not leak Qi. Qi deficiency: tonify Jing-Tunnels, do not leak Qi. Emperor: Subtle needling? Qibo: Massage without releasing. Remove needle, say: "I will deepen." Patient reacts, Jing/Essence subside, pathogen scatters, Qi leaks from pores, True Qi obtains harmony. Emperor: Blood excess/deficiency? Qibo: Blood excess: anger. Blood deficiency: fear. Qi/Blood not combined, Zang stable, Sun-collaterals overflow, blood stasis in main meridians. Emperor: Tonification/Reduction? Qibo: Blood excess: drain vigorous meridians, bleed. Blood deficiency: tonify deficient meridians, insert into vessel, retain long, observe, withdraw quickly when pulse is large, do not bleed. Emperor: Stasis needling? Qibo: View blood collaterals, bleed, prevent evil blood entering meridians to cause disease. Emperor: Form excess/deficiency? Qibo: Form excess: abdominal fullness, difficult urination/defecation. Form deficiency: limbs unusable. Qi/Blood not combined, Zang stable, muscle twitching, called Mild Wind. Emperor: Tonification/Reduction? Qibo: Form excess: drain Yang meridians. Form deficiency: tonify Yang collaterals. Emperor: Subtle needling? Qibo: Select between muscles, avoid meridians/collaterals, Wei Qi recovers, pathogen vanishes. Emperor: Zhi excess/deficiency? Qibo: Zhi excess: abdominal fullness, undigested stool diarrhea. Zhi deficiency: reversal cold. Qi/Blood not combined, Zang stable, joint movement. Emperor: Tonification/Reduction? Qibo: Zhi excess: bleed anterior to Ran Gu. Zhi deficiency: tonify Fuliu. Emperor: Uncombined needling? Qibo: Select points, avoid meridians, pathogen immediately becomes deficient.

Clear Qi slippery: rapid drainage exhausts Qi easily. Turbid Qi stagnant: rapid drainage opens meridians.