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When acupuncture is performed, if the area that was initially painful becomes painless, or if an initially painless area becomes painful, the needle should be withdrawn. This refers to withdrawing the needle when the sensation changes from tight to loose, or from loose to tight.

Upon withdrawing the needle, one should immediately press the acupoint with the fleshy part of the finger to prevent the leakage of Qi and avoid bleeding. Subsequently, covering the acupoint with earth and massaging it repeatedly is advisable. If there is excessive bleeding, massaging will stop it; this is a hemostatic method. Instructing the patient to massage the area occasionally can permanently prevent future complications.

Currently, people practice acupuncture less and use more medication because they fear syncope during acupuncture (Yun Zhen). They fail to realize that patients who experience syncope often achieve therapeutic effects, whereas improper medication use makes it difficult to preserve life. Comparing needles and drugs, acupuncture is easier while drug therapy is harder; why not learn acupuncture? Details regarding syncope are provided later.

Syncope occurs due to deficiency of Shen Qi (Spiritual Energy). Ancient texts state: "Do not needle when complexion and pulse are discordant," and one must avoid windy, rainy, snowy, or cloudy days, as well as treating individuals who are drunk, exhausted, engaged in sexual activity, startled, hungry, or mourning. Previously, [text missing] was treated first; now, pressing the notch above the upper lip (Shuigou/GV26) with a fingernail wakes the patient quickly, which is faster than before. However, those who experience syncope invariably achieve significant therapeutic effects because their Blood and Qi become harmonious. As the saying goes, "Needles do not harm people," referring to this phenomenon.

Mr. Li from Nanfang's method for treating syncope is: Do not withdraw the needle immediately upon syncope; instead, insert another needle nearby, cover the patient's mouth and nose with a sleeve to help restore Qi, give hot water to drink, and the patient will wake up. After some time, resuming acupuncture is appropriate. For severe cases, needle the depression between the tendons on the lateral aspect of the forearm (referred to as Xiamadu), named "Xingxing" (Waking Up Acupoint). Alternatively, needling Zusanli (ST36) will wake the patient, and the illness will surely heal; withdrawing the needle at this moment would harm the person.

The *Nan Jing* (Classic of Difficult Issues), Chapter 61, states: "The classics say that knowing through observation is called 'Divine' (Shen), knowing through listening/smelling is called 'Sage' (Sheng), knowing through inquiry is called 'Skilled' (Gong), and knowing through palpation is called 'Clever' (Qiao). What does this mean?" Knowing through observation involves seeing the five colors to identify the disease.

The *Su Wen* (Basic Questions), Chapter on the Generation of the Five Zang Organs, says: Complexions appearing green like dead grass, yellow like the fruit of the wild orange, black like charcoal, red like clotted blood, or white like dry bones indicate death. Complexions appearing green like kingfisher feathers, red like chicken combs, yellow like crab bellies, white like pig fat, or black like crow feathers indicate survival.

Knowing through listening involves distinguishing diseases by the five tones. Chen from Siming said: The Zang organs have sounds, manifested as tones. The liver tone is shouting, the heart tone is laughing, the spleen tone is singing, the lung tone is weeping, and the kidney tone is groaning. Normalcy implies health; alteration implies disease. Hearing a specific tone reveals the disease in the corresponding meridian.

Knowing through inquiry involves asking about preferences for the five flavors to determine the origin and location of the disease. ("Desired" refers to foods that are craved or excessively consumed.)

Knowing through palpation involves examining the Cun Kou (radial artery) pulse, observing its excess or deficiency, to identify the affected Zang-Fu organ. Wang's Praise of Pulse Diagnosis states: There are three positions of the pulse. As the clepsydra (water clock) turns, after two units of time, the pulse completes one circulation of the body and returns to the Cun Kou, where excess and deficiency become visible.

The classics state: Knowing from external signs is called 'Sage'; knowing from internal mechanisms is called 'Divine.' This is what is meant.

Regarding the serious determination of disease names, detailed consultation of subsequent texts shows that masters agree on identifying symptoms and selecting acupoints without contradiction. Under each disease name, the text lists which acupoints to use, whether to apply one, two, three, or five needles, the depth (in fen), or the number of moxa cones (zhuang). It specifies whether to use tonification or sedation, Ying-Sui techniques, half-tonification half-sedation, to flexibly regulate meridians. It may involve Fei Jing Zou Qi (Flying Meridian and Moving Qi) methods to guide Blood and Qi. It may involve long retention or rapid withdrawal. Techniques include lifting and thrusting, bleeding or non-bleeding, all contained within the aforementioned manual techniques. These have been used successfully many times.

Where only acupoints are mentioned without specifying acupuncture or moxibustion, it implies needle insertion. Where moxibustion is mentioned but not needles, needle insertion is prohibited. Where needles are mentioned but not moxibustion, moxibustion is prohibited. Measurements of three or five fen refer to needle insertion depth. Mentions of three or five zhuang refer to the number of moxa cones.

The *Ling Shu* (Spiritual Pivot), Chapter on Miscellaneous Diseases, states: Diseases of the upper body are treated by selecting the Hand-Yangming Large Intestine Meridian; diseases of the middle body by the Foot-Taiyin Spleen Meridian; and diseases of the lower body by the Foot-Jueyin Liver Meridian. One or two acupoints can be selected for treatment.