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Yellow Emperor asked, saying: I have heard of Miao Ci (Mysterious Pricking), but do not understand its meaning. What is Miao Ci?
Qibo replied: When pathogenic factors invade the skin and hair, they enter the Sun Luo (Collaterals of the Skin) and remain there without departing. This causes blockage and obstruction, preventing them from entering the Meridians. Instead, they overflow into the Da Luo (Large Collaterals), giving rise to strange diseases (The Large Collaterals refer to the fifteen major collaterals). When pathogenic factors invade the Large Collaterals, they flow from the left to the right, and from the right to the left. They interact with the meridians above and below, on the left and right, and distribute to the four extremities. Their Qi has no fixed location and does not enter the Shu points of the meridians. This method of needling is called Miao Ci (The four extremities refer to the arms and legs).

The Emperor said: I wish to hear about Miao Ci, specifically taking the left to treat the right and the right to treat the left. How should this be done? How does it differ from Ju Ci (Giant Pricking)?
Qibo said: When pathogenic factors invade the meridians, excess on the left causes disease on the right, and excess on the right causes disease on the left. There are also cases where the condition shifts and moves (meaning the disease changes and migrates). If pain on the left persists while the pulse on the right shows signs of disease first, in such cases, one must use Ju Ci. One must needle the meridian itself, not the collateral vessels. Therefore, when a collateral vessel is diseased, its pain is located differently from the meridian's pathway; thus, it is called Miao Ci.

The Emperor said: I wish to know how to perform Miao Ci and what the principles for selecting points are.
Qibo replied: When pathogenic factors invade the collateral of the Foot Shaoyin (Kidney) meridian, it causes sudden heart pain, acute abdominal distension, and fullness/supporting sensation in the chest and hypochondrium. If there is no accumulation, needle the point anterior to Ran Gu (Rangu, KI2) until bleeding occurs. Recovery takes approximately the time it takes to eat a meal. If not recovered, take the left to treat the right, and the right to treat the left. For newly onset diseases, the pathogenic factor will depart after five days.

When pathogenic factors invade the collateral of the Hand Shaoyang (Sanjiao) meridian, it causes throat obstruction (Hou Bi), tongue retraction, dry mouth, and vexation. It also causes pain along the lateral aspect of the arm and inability to raise the hand to the head. Needle the point on the nail corner of the fourth finger (ring finger), at a distance from the tip like the width of a leek leaf, one needle each side (Guanchong, SJ1, bleed). In vigorous individuals, recovery is immediate; in elderly individuals, it takes a short while. Take the left to treat the right, and the right to treat the left. Newly onset diseases resolve within a few days.

When pathogenic factors invade the collateral of the Foot Jueyin (Liver) meridian, it causes sudden hernia and acute pain. Needle the point where the nail meets the flesh on the big toe, one needle each side (Dadun, LR1, needle both feet, hence "one each"). In men, recovery is immediate; in women, it takes a short while. Take the left to treat the right, and the right to treat the left.

When pathogenic factors invade the collateral of the Foot Taiyang (Bladder) meridian, it causes pain in the head, neck, and shoulder. Needle the point where the nail meets the flesh on the little toe, one needle each side, immediately effective (Zhiyin, BL64, or on the lateral side of the little toe). If not effective, needle three cun below the lateral malleolus, take the left to treat the right, and the right to treat the left. Recovery takes approximately the time it takes to eat a meal (Jinmen, BL63).

When pathogenic factors invade the collateral of the Hand Yangming (Large Intestine) meridian, it causes fullness of Qi in the chest, wheezing with a supporting sensation, and heat in the chest. Needle the point on the nail corner of the index finger, at a distance from the tip like the width of a leek leaf, one needle each side. Take the left to treat the right, and the right to treat the left. Recovery takes approximately the time it takes to eat a meal (Shangyang, LI1, or on the medial side of the index finger).

When pathogenic factors invade the area between the arm and palm, causing inability to flex, needle the posterior aspect of the ankle (the ankle joint of the hand). First, press with the finger to locate the painful spot, then needle. Determine the number of needles based on the waxing and waning of the moon. On the first day of the waxing moon, one needle; on the second day, two needles; on the fifteenth day, fifteen needles; on the sixteenth day, fourteen needles. (Before the middle of the month is considered waxing/sheng; after the middle of the month is considered waning/si).

When pathogenic factors invade the Foot Yangqiao Mai (Yang Heel Vessel), it causes eye pain starting from the inner canthus. Needle two needles each side below the lateral malleolus, half cun down. Left needle right, right needle left. Recovery takes approximately the time it takes to walk ten li.

If a person suffers a fall, leaving evil blood inside, causing abdominal fullness and distension, and inability to pass urine or stool, first administer purgative medicines. This injury damages the Jueyin meridian above and the Shaoyin collateral below. Needle the blood vessels anterior to Ran Gu below the medial malleolus until bleeding occurs. Also needle the arterial pulse on the dorsum of the foot (Chongyang, ST42). If not effective, needle one point each side on the pubic hair (Dadun, LR1). See blood, and recovery is immediate. Left needle right, right needle left. For symptoms of sadness, fright, and unhappiness, needle according to the method above.

When pathogenic factors invade the collateral of the Hand Yangming (Large Intestine) meridian, it causes deafness and intermittent inability to hear sounds. Needle the point on the nail corner of the index finger, at a distance from the tip like the width of a leek leaf, one needle each side. Hearing returns immediately (Shangyang, LI1). If not effective, needle the point where the nail meets the flesh on the middle finger. Hearing returns immediately (Zhongchong, PC9). If hearing loss is constant, do not needle (because the collateral Qi is exhausted). For wind sensation in the ear, needle in the same manner. Left needle right, right needle left.

For all types of Bi syndrome that move around with no fixed location, needle the painful areas between the muscle layers. Determine the number of needles based on the waxing and waning of the moon. The practitioner should adjust the number according to the flourishing and declining state of Qi. Needling beyond the appropriate number depletes Qi; needling fewer than the appropriate number fails to drain the pathogen. Left needle right, right needle left. Stop when the disease is cured. If not cured, repeat according to the method. On the first day of the waxing moon, one needle; on the second day, two needles; gradually increase. On the fifteenth day, fifteen needles; on the sixteenth day, fourteen needles; gradually decrease.

When pathogenic factors invade the collateral of the Foot Yangming (Stomach) meridian, it causes nasal congestion, epistaxis, and coldness in the upper teeth. Needle the point where the nail meets the flesh on the second toe, one needle each side. Left needle right, right needle left (Lidui, ST45).

When pathogenic factors invade the collateral of the Foot Shaoyang (Gallbladder) meridian, it causes hypochondriac pain with difficulty breathing, coughing, and sweating. Needle the point where the nail meets the flesh on the fourth toe, one needle each side (Qiaoyin, GB44). Difficulty breathing resolves immediately; sweating stops immediately. For coughing, keep warm, dress warmly, and eat warm food; recovery occurs within one day. Left needle right, right needle left. The disease resolves immediately. If not cured, repeat according to the method.

When pathogenic factors invade the collateral of the Foot Shaoyin (Kidney) meridian, it causes sore throat, inability to swallow food, unprovoked irritability, and Qi rushing upward to Fen Shang (Fen refers to the rising of Qi; or refers to the diaphragm, meaning Qi rushes above the diaphragm). Needle the vessel in the center of the sole of the foot (Yongquan, KI1), three needles each side, totaling six needles. Recovery is immediate. Left needle right, right needle left. If there is swelling in the throat, inability to swallow saliva, or inability to expectorate saliva, needle the point anterior to Ran Gu until bleeding occurs. Recovery is immediate. Left needle right, right needle left.

When pathogenic factors invade the collateral of the Foot Taiyin (Spleen) meridian, it causes lower back pain radiating to the lower abdomen and hypochondrium, with inability to extend the body or breathe deeply. Needle the gap in the lumbosacral region, above the two muscles (Shen), which is Yaoshu (BL23). Determine the number of needles based on the waxing and waning of the moon. Recovery is immediate upon withdrawing the needle. Left needle right, right needle left. (Some say Yaoshu has no left-right distinction; it may be Xia Liao, BL32).

When pathogenic factors invade the collateral of the Foot Taiyang (Bladder) meridian, it causes spasms and stiffness of the back, radiating to the hypochondrium with pain. Start needling from the neck, counting the vertebrae alongside the spine. Press firmly to find the tender spot, then needle three points beside it. Recovery is immediate.

When pathogenic factors invade the collateral of the Foot Shaoyang (Gallbladder) meridian, it causes pain in the pivot area (hip joint) and inability to lift the thigh. Needle Huantiao (GB30) with a filiform needle. For cold patterns, retain the needle for a long time. Determine the number of needles based on the waxing and waning of the moon. Recovery is immediate.

To treat various meridians by needling: if the meridian traversed is not diseased, use Miao Ci. For deafness, needle the Hand Yangming meridian. If not effective, needle the point where the meridian emerges before the ear (Tinghui, GB2). For dental caries/pain, needle the Hand Yangming meridian. If not effective, needle the vessel entering the teeth. Recovery is immediate (Yinjiao, DU28).

When pathogenic factors invade the interior of the five zang organs, the disease involves pulling pain in the meridians, coming and going intermittently. Observe the disease and apply Miao Ci at the nail corners of the hands and feet (needle each Jing-Well point, left take right, right take left). Observe the meridians and release blood. Needle every other day. If one session is not effective, five sessions will cure it. If Miao transmission causes pulling pain in the upper teeth and cold pain in the lips, observe the blood vessels on the dorsum of the hand and remove the blood. Needle one point on the nail of the second toe of the Foot Yangming meridian (Lidui, ST45), and one point each on the nail of the thumb and index finger of the Hand (Shangyang, LI1). Recovery is immediate. Left take right, right take left.

When pathogenic factors invade the collaterals of the Hand and Foot Shaoyin, Hand and Foot Taiyin, and Foot Yangming meridians, these five collaterals all converge in the ear and ascend to connect with the left frontal horn. If all five collaterals are exhausted, it causes movement of all pulses in the body while the form remains unconscious, resembling a corpse. This is sometimes called Shi Jue (Corpse Faint). Needle the point on the medial side of the big toe nail, at a distance from the tip like the width of a leek leaf (Yinbai, SP1). Then needle the center of the foot (Yongquan, KI1). Then needle one point each on the nail of the middle toe (Lidui, ST45). Then needle Shaoshang (LU11), Zhongchong (PC9), and Shenmen (HT7), one point each. Recovery is immediate. If not effective, blow air into both ears using a bamboo tube. Cut a square inch of hair from the left frontal horn, burn it to ash, and drink it with a cup of fine wine. Recovery is immediate.

The general principle of needling is to first observe the meridians, palpate and follow their course, examine their deficiency and excess, and regulate them. If regulation fails, use Jing Ci (Meridian Pricking). If there is pain but the meridian itself is not diseased, use Miao Ci. Simultaneously observe the skin regions for blood vessels (luo vessels) and treat all visible ones. This is the principle of Miao Ci.