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(The depth of needle insertion should also be consistent with the intention mentioned later to insert deeply to draw out Yin Qi.) Inserting the needle three fen allows one to understand the qi of the four seasons, five elements, and the reverse and smooth flow of the five zang organs and six fu organs (this is also consistent with the intention of inserting extremely deeply at the end to obtain Gu Qi [Grain Qi], which is the root). The *Xuanzhu Miyu* states: Inserting into the skin three fen corresponds to the regions of the Heart and Lung, where Yang Qi circulates. Inserting five fen corresponds to the regions of the Kidney and Liver, where Yin Qi circulates (symbolizing the numerical values of "Three Heavens and Two Earths"). This explanation can be considered detailed and clear. Later sages' writings introduced the theory of accumulating from one fen to ten fen, making this method even more detailed and precise. Generally, although breadth and simplicity differ, the underlying principles are identical, mutually illuminating each other.

Q: What is the principle of Yin and Yang exchanging positions?
A: This refers to the mutual invasion of Yin and Yang. Because Yang enters the Yin aspect, and Yin exits to the Yang aspect, they exchange places, resulting in disease. Tracing the origin, it may be due to a deficiency of Ying Qi [Nutrient Qi] causing Wei Qi [Defensive Qi] to attack inward; or due to a deficiency of Wei Qi causing Ying Qi to overflow outward. Thus, Blood and Qi fail to maintain their proper positions. Where Qi gathers, there is Excess; where Qi scatters, there is Deficiency. Excess manifests as pain, while Deficiency manifests as itching. Pain belongs to Yin; if pain persists despite pressure, it also belongs to Yin, and the treatment method requires deep needling. Itching belongs to Yang, requiring superficial needling. Diseases located above belong to Yang, those below belong to Yin. If a disease originates in the Yin aspect, treat the Yin first, then the Yang. If it originates in the Yang aspect, treat the Yang first, then the Yin.

Q: What is the cause of reversal and opposition?
A: This refers to Wei Qi being unable to follow its normal pathway, a condition named Jue [Reversal]. Since the diseases differ, the needling methods must be distinguished. The classics state: When treating Re Heat Jue, retaining the needle may conversely induce Cold. When treating Re Cold Jue, retaining the needle may conversely induce Heat. This is caused by rebellious Qi. Therefore, for Re Heat Jue, it is appropriate to needle the Yin meridians three times and the Yang meridians once. For Re Cold Jue, needle the Yang meridians three times and the Yin meridians once. However, for patients with chronic illness, where pathogenic factors have penetrated deeply, deep insertion and prolonged retention are necessary, with sessions repeated every other day. One must first regulate the left and right sides and remove blood stasis.

Q: What are the treatments for Deficiency/Excess and Cold/Heat?
A: First, examine the Renying [Carotid Artery point] and Qikou [Radial Pulse point] to determine the excess or deficiency of Yin and Yang, thereby examining the upper and lower meridians. Follow the cold and heat in specific regions, palpate the changes in the Nine Pulses, press the moving meridians, and observe the color and shape of the blood vessels. If there is no abnormality, it is the same as normal; if there is, it differs. Rapid pulses require swift manipulation; large pulses require reduced force; stillness is desired when strength is lacking. For Qi excess in the upper body, guide it downward. For Qi deficiency in the upper body, push and elevate it. The classics say: For stagnant Qi that does not arrive, meet and reduce it. For deficient Qi, accumulate and follow it. For severe Heat in the upper body, push and direct it downward. For Heat stopping from below, guide and disperse it. For severe Cold on the exterior, retain and tonify. For pathogens entering the interior, follow and drain. For Cold above and Heat below, push and direct upward. For Heat above and Cold below, guide and direct downward. For competing Cold and Heat, guide and circulate them. For stagnated and old blood clots, needle to remove them.

Q: Tonification takes Qi from Wei, and Reduction places Qi in Ying.
A: Wei Qi is floating Qi, primarily governing the exterior. Ying Qi is Essence Qi, primarily governing the interior. Thus, the classics state: Ying is the essence of food and drink; Blood and Qi harmonize within the Five Zang, are distributed throughout the Six Fu, and then enter the vessels, circulating up and down, penetrating the Five Zang, and connecting the Six Fu. Wei is the vigorous Qi of food and drink; it is fierce, rapid, and slippery, unable to enter the vessels. Thus, it circulates among the skin and muscles, steams the Huangmo [Triple Burner membrane], and disperses in the chest and abdomen. Rebellious Qi causes disease; compliant Qi leads to recovery. In this way, Ying and Wei are the masters of the interior and exterior, are they not significant! How can one not seek their tonification and reduction methods?

Q: Needling Yang parts involves lying the needle horizontally; needling Yin parts involves pressing to scatter Yang Qi before insertion.
A: Needling Yang parts follows their superficial nature, associated with the Heart and Lung regions. Needling Yin parts follows their deep nature, associated with the Kidney and Liver regions. To perform Yang needling, insert the needle shallowly and horizontally, stroke and massage to relax, flick the finger to promote Qi abundance, then rotate the needle so the Qi spreads naturally, because Yang parts are active. To perform Yin needling, first press and claw to scatter Yang Qi, then insert the needle deeply. Upon obtaining Deqi [Needling Sensation], extend and lift to ensure the Qi flows smoothly, because Yin parts are static.

Q: Knowing the Qi of Ying and Sui allows for regulation.
A: The method of Ying [Meeting/Anticipating] and Sui [Following] is established based on internal/external, upper/lower, and distant pathways. Therefore, one must understand the entry and exit of Ying and Wei, and the coming and going of meridians up and down to practice it. Ying and Wei are Yin and Yang. The classics state: Yang receives Qi from the four extremities; Yin receives Qi from the Five Zang. Thus, reduction involves deep insertion followed by shallow withdrawal, drawing Qi out from the interior. Tonification involves shallow insertion followed by deep advancement, pushing Qi in from the exterior. This advances and retreats the needle according to Yin/Yang and interior/exterior. Regarding meridians as channels of circulation: Hand-Yang meridians go from hand to head; Hand-Yin from chest to hand; Foot-Yang from head to foot; Foot-Yin from foot to abdomen. Therefore, for Hand-Yang reduction, the needle tip faces outward, meeting and reducing against the flow; for tonification, the tip faces inward, following and chasing the flow. The rest follow this pattern. This is advancing and retreating the needle according to the direction of Qi and Blood flow. Generally, Ying and Wei refer to the entry and exit of internal/external Qi. Meridians refer to the coming and going of upper/lower Qi. Needle according to the local direction (forward or backward). Hence, it is called Ying Sui.

Q: Does the timing of tonification and reduction correspond to the opening and closing of Qi?
A: This method applies not only to the Ten Heavenly Stem points. Whenever the needle enters the skin, during the phase of Yang Qi expansion, it is called Kai [Open]. When the needle reaches the muscle layer, during the phase of Yin Qi consolidation, it is called He [Close]. However, within Open is Close, and within Close is Open. The mechanism of one Open and one Close never leaves the acupoint. Interchangeably pausing the needle, observe the Qi to determine tonification or reduction. Thus, the *Qianjin Fang* states: Exterior Wei is Yang part, Interior Ying is Yin part.

Q: "At the time of needling, one must focus on Xuan Yang and Liang Wei, keeping the spirit attached, knowing whether the disease survives or perishes."
A: Xuan Yang refers to the Qi facing the needle between the interstices. Liang Wei refers to the Qi of inhalation and exhalation in Ying and Sui. "Keeping the spirit attached, knowing survival" refers to using the left hand for diagnosis to determine tonification or reduction. This is ancient legislation, containing many subtleties in its wording.

Q: "Leave space equivalent to a bean for the needle."
This method is specifically designed for Ying and Sui. When Qi arrives at the needle, one must first withdraw slightly, leaving a space like a bean, wait for Qi to arrive, then meet or follow it. The classics state: Do not lose the nearby Qi, so that distant Qi may come.

Q: "There are great and small needlings."
A: There is Ping Bu Ping Xie [Balanced Tonification and Reduction], used when Yin and Yang are imbalanced to restore balance. Lowering Yang is tonification; raising Yin is reduction. It suffices when internal and external Qi are harmonized. There is Da Bu Da Xie [Great Tonification and Great Reduction], used when both Yin and Yang show excess and deficiency. Insert the needle into the Heaven and Earth layers, applying both tonification and reduction, ensuring internal and external Jing Qi connect and upper and lower aspects meet, so that excessive Qi declines. This is called: Tiao Yin Huan Yang [Regulating Yin and Changing Yang], also known as: Jie Qi Tong Jing [Connecting Qi and Unblocking Meridians], or Cong Ben Yin Mo [Leading from Root to Tip]. Carefully follow the pathway to administer treatment, moving slowly forward and backward to dispel pathogens. The meaning is essentially the same.

Q: "The acupoint is located at the bone."
A: Initially, insert the needle into the interstices. Upon reaching the acupoint, advance the needle during inhalation to gain deep understanding. Otherwise, Qi will resist the needle, preventing insertion. Furthermore, for obese people with internal deficiency, tonify first, then reduce; for thin people with internal excess, reduce first, then tonify.

Q: "Appropriate tonification and reduction."
A: For diseases localized in one area, affecting interior and exterior, use Zi Wu Liu Zhu [Midnight-Noon Ebb-Flow] method for tonification and reduction, involving rotating the needle left and right. For diseases in the Three Yin and Three Yang, use the Liu Zhu method for tonification and reduction, involving Ying-Shu points combined with respiratory admission and expulsion. These two are different. However, techniques like flicking, clawing, lifting, and pressing are the same; the key is to understand the state of Qi and Blood.

Q: "Ying Duo Sui Ji [Meeting/Reducing and Following/Nourishing] are indeed said to be tonification and reduction, what is their meaning?"
A: Ying [Meeting] is anticipating the arrival of Qi. For example, at Yin hour, Qi flows to the Lung; at Mao hour, Qi flows to the Large Intestine. At these times, Lung and Large Intestine Qi are abundant, so we reduce it. Sui [Following] is following the departure of Qi. For example, at Mao hour, Qi leaves the Large Intestine; at Chen hour, Qi leaves for the Stomach, Lung, and Large Intestine. At these times, the area is relatively deficient, so we nourish/tonify it. The rest follow this pattern.

Q: "How many fen deep to insert, how many breaths to retain?"
A: One should not be so rigid. Muscles vary in depth, and disease resolution varies in speed. In thick muscle areas, deep insertion is possible; in thin areas, shallow insertion is suitable. If the disease resolves quickly, withdraw the needle promptly; if the disease is stagnant, prolonged retention is appropriate.

Q: "What if tonification and reduction do not involve Jing, Ying, Shu, Jing, He points?"
A: For example, Mingmen and Tongziliao treat eye pain; Tinggong, Sizhukong, and Tinghui treat deafness; Yingxiang treats nasal issues; Dicang treats mouth issues; Fengchi and Touwei treat head and neck issues. Ancients also had cases not bound by Jing-Ying-Shu-Jing-He points. This is generally because the disease is in the upper body, so points in the upper body are selected.

Q: "Regarding meridian point ebb-flow and timed tonification/reduction, if current diseases affect various meridians, can timed treatment cure them?"
A: Disease attaching to a meridian implies that meridian has its own deficiency or excess. Tonifying deficiency and reducing excess naturally hits the target. Some diseases are cured with one needle; others require several. Diseases vary in newness, chronicity, and depth. New and superficial diseases can be cured with one needle; deep and chronic diseases require multiple sessions. Danxi and Dongyuan had cases cured with one prescription, and others with dozens. Modern practitioners often stop after one unsuccessful needle session. Moreover, diseases rarely originate from just one meridian; their onset often involves concurrent influences of the Six Qi and differences in root and branch. One needle might cure the branch but not the root; focusing solely on the root might leave the branch active. Multiple needles are required to eradicate the disease's adjacency.

Q: "How can such a tiny needle effect tonification and reduction?"
A: Consider a balloon. Without air, it is limp and cannot withstand kicking. Blowing air into the hole makes it full and firm; this is the meaning of tonifying deficiency. Blocking the hole allows air to escape, returning it to a limp state; this is the meaning of reducing excess.

Q: "In the *Neijing*, treatments relied less on decoctions and more on acupuncture/moxibustion. Why?"
A: The *Neijing* is an ancient text. Ancient people were not exhausted by labor nor idle to the point of lethargy; their diet was not rich or fatty, damaging the interior; their clothing did not trap heat, damaging the exterior. Their daily life was regulated, avoiding extreme cold and heat. They were tranquil and empty, guarding their Spirit internally. How could disease arise? Even with evil winds and empty pathogens, they could not penetrate deeply, merely causing stagnation and depression in the skin and meridians. Using needles to move Qi and moxa to dissipate depression would resolve the disease. Why wait for decoctions? In today's world, morality declines. People treat wine as water, make irregularity their norm, indulge desires to exhaust Essence, worry excessively to scatter True Qi. They do not know how to maintain fullness or control the Spirit, seeking only pleasure, overindulging in leisure. Their routines are unregulated, ignoring seasonal changes. Thus, diseases arise internally, and external pathogens easily invade. The classics say: Needles treat the exterior; decoctions treat the interior. If the disease is internal, only decoctions can assist. After He Huan, pharmaceuticals became prevalent, and acupuncture/moxa were used concurrently. This is partly due to the decline of the age and human nature compared to the past, but also due to imprecision in needle techniques and failure to transmit the secret formulas correctly. It is not that ancients used more acupuncture/moxa and moderns use less, nor that decoctions suit modern times but not ancient ones. Students should investigate this carefully.

Q: "What are the essential secrets of the Eight Methods and Ebb-Flow?"
A: There are many mantras, too numerous to record fully. I will now summarize the most important ones:
Ancient true mantras passed down, the Eight Methods originally use only eight points. Inhaling generates odd numbers, transforming Heat to Cold; exhaling generates even numbers, transforming Cold to Heat. Exhale first then inhale for true tonification; inhale first then exhale for swift reduction. Slow insertion and rapid withdrawal is reduction for Cold; rapid insertion and slow withdrawal is tonification for Heat. Tight lifting and slow pressing feels like icy cold; slow lifting and tight pressing feels like fire heat. Yang Qi runs outside the vessels; Yin Blood runs inside. For deficiency, the mechanism is slow insertion; for excess, the theory is rapid withdrawal. Following and nourishing the Mother element; meeting and reducing the Child element. Simply distinguishing between Meeting/Reducing and Following/Nourishing, correctly reducing excess and tonifying deficiency without error. Heaven Layer: Skin and Muscle; Human Layer; Earth Layer: Sinew and Bone, divided into three sections. Wei Qi moves counter-clockwise; Ying Qi turns clockwise. Summer requires shallow insertion, Winter deep; distinguish by fat and thinness. Do not damage tendons and fascia; seek with intent. When manipulating the needle, distinguish bone joints. Advancing the thumb to the left tonifies deficiency; retreating the thumb to the right reduces excess. Firmness indicates success; softness indicates failure. Firmness and softness determine floating and sinking. Firm is success; soft is failure. Reduction uses square movements; tonification uses circular movements, allowing natural connection of Ying and Wei. Right-side reduction: inhale first, withdraw needle, exhale. Left-side tonification: exhale first, withdraw needle, inhale. Do not treat this method as ordinary. Flick, promote, stroke, massage, finger press, and palpate. Separate sinews, move bones, come from depressions, yet reveal all mechanisms. Travelers on the road wish to proclaim it; rushing waters and windy forests cease not. Grateful for the grace of the Three Emperors for ten thousand generations, elucidating the true oral teachings of the Needle Classics.