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Huangdi asked: How were the Nine Needles generated? Qibo replied: The Nine Needles embody the numerical principles of Heaven and Earth. The numbers of Heaven and Earth begin with one and end with nine.

Therefore, one corresponds to Heaven, two to Earth, three to Humanity, four to the Four Seasons, five to the Five Tones, six to the Six Pitch-pipes (Lü), seven to the Seven Stars, eight to the Eight Winds, and nine to the Nine Provinces. Huangdi asked: How do needles correspond to the number nine? Qibo said: One is Heaven; Heaven belongs to Yang. Among the Zang organs, the Lung corresponds to Heaven. The Lung is the canopy of the Zang and Fu organs. The skin is the exterior correspondence of the Lung and represents the Yang Qi of the human body. Therefore, the Chan Needle (Chan Zhen, a needle with a large head and sharp tip) was created for its treatment. The Chan Needle takes its form from cloth (or towel). Half an inch is removed from the tip, leaving it sharp. Its total length is one cun and six fen. The head is broad while the tip is sharp, preventing deep insertion so that Yang Qi can be released. It primarily treats heat conditions in the head and body. Thus, when pathogenic factors are located in the skin at variable positions, the Chan Needle should be used at the affected site. If the complexion is pale, do not needle.

Two corresponds to Earth; Earth belongs to Earth element. In the human body, flesh corresponds to Earth. Therefore, the Yuan Needle (Yuan Zhen, a cylindrical needle with an oval tip) was created for its treatment. The Yuan Needle takes its form from cotton wool. The shaft is cylindrical, and the tip is rounded like an eggshell. Its total length is one cun and six fen. It is used to drain Qi from between the muscles without damaging the muscle tissue, thereby exhausting the pathogenic factors. Thus, when disease is located between the muscles, the Yuan Needle is used.

Three corresponds to Humanity. Human life depends on the blood vessels. Therefore, the Di Needle (Di Zhen, a needle with a blunt, millet-grain-like tip) was created for its treatment. The Di Needle takes its form from millet grains. The shaft is thick, and the tip is rounded like a millet grain. Its total length is three cun and five fen. It is used to press upon the vessels without sinking into them, thereby guiding healthy Qi and allowing pathogenic factors to exit alone. Thus, when disease is in the vessels accompanied by Qi deficiency, tonification should be performed using the Di Needle at the Jing-Well, Ying-Spring, and Shu-Stream acupoints.

Four corresponds to Time. When humans are exposed to wind from the Eight Correct Directions according to the Four Seasons, pathogenic factors may lodge in the meridians, causing chronic diseases. Therefore, the Feng Needle (Feng Zhen, a triangular needle with three edges) was created for its treatment. For fixed pathogenic factors residing in the Zang organs, the Feng Needle is used. Draining is performed at the Jing-Well, Ying-Spring, and Shu-Stream acupoints, following the principle of adapting to the Four Seasons.

Five corresponds to Tone. Tones distinguish winter from summer, separated by the Zi and Wu hours. Yin and Yang differ, cold and heat contend, and these two energies clash, merging to form abscesses. Therefore, the Pi Needle (Pi Zhen, a needle shaped like a sword blade) was created for its treatment. The Pi Needle takes its form from a sword. The tip resembles a sword edge, is half a fen wide, and four cun long. It is used to incise and drain large amounts of pus and blood. Thus, for conditions involving large abscesses or blood stasis, the Pi Needle is used.

Six corresponds to Fluids (referring to the Six Pitch-pipes regulating Yin-Yang and the Four Seasons to align with the Twelve Meridians). When deficient pathogens invade the meridians causing sudden bi-syndrome, the Yuanli Needle (Yuanli Zhen, a needle that is round yet sharp with a slightly thicker middle section) was created for its treatment. The Yuanli Needle takes its form from fine hair. The shaft is both round and sharp, slightly thicker in the middle. Its total length is one cun and six fen. It is used to treat abscesses and sudden bi-syndrome. Alternatively, it is described as having a tip like fine hair, a slightly larger end, and a thinner shaft, allowing for deep insertion. Thus, for sudden onset of bi-Qi, the Yuanli Needle is used.

Seven corresponds to Stars. Stars correspond to the seven orifices of the human body. When pathogens lodge in the meridians and reside in the collaterals, they cause painful bi-syndrome. Therefore, the Hao Needle (Hao Zhen, a fine, long needle) was created for its treatment. The Hao Needle takes its form from fine hair. Its total length is one cun and six fen. The tip is like the proboscis of a mosquito or horsefly. Insertion should be quiet and slow, and retention should be prolonged. This aids healthy Qi, allowing true Qi and pathogenic factors to exit together. After withdrawal, nourishment is provided. It primarily treats painful bi-syndrome in the collaterals. Thus, for bi-Qi requiring tonification before expulsion, the Hao Needle is used.

Eight corresponds to Wind. Wind corresponds to the eight joints of the thighs and arms. Deficient wind from the Eight Correct Directions injures the body, lodging deeply in the bone gaps, waist, spine, and interstices, causing deep bi-syndrome. Therefore, the Chang Needle (Chang Zhen, a long needle) was created for its treatment. The Chang Needle takes its form from shoe soles (Qi). It is seven cun long, with a thin shaft and a sharp tip, enabling the removal of deep pathogens and distant bi-syndrome. Thus, for diseases located internally or deeply, the Chang Needle is used.

Nine corresponds to the Provinces. The Provinces correspond to the bone joints. Deficient wind injures the body, lodging between the bones and skin. Excessive pathogens overflow throughout the body, resembling wind-water edema, but cannot pass through the major joints. Therefore, the Da Needle (Da Zhen, a large needle) was created for its treatment. The Da Needle takes its form from the Feng Needle (or Fan Needle). Its tip is slightly rounded, and it is four cun long. It is used to drain excessive Qi accumulating inside and outside the joints, preventing blockage. Thus, for edema that cannot pass through the joints, the Da Needle is used.

In all needling, the use of official standard needles is most excellent. The suitability of the Nine Needles lies in their specific functions. Their lengths and sizes have specific applications. Without mastering their usage, diseases cannot be resolved. If a superficial disease is treated with deep needling, healthy flesh is injured internally, leading to skin abscesses. If a deep disease is treated with shallow needling, pathogenic Qi is not drained, potentially turning into a large abscess. If a minor disease is treated with a large needle, excessive draining of Qi will cause harm after the illness. If a major disease is treated with a small needle, the excessive pathogenic Qi is not drained, leading to subsequent deterioration. Having discussed these errors, we now explain their proper applications.

There are nine types of needling methods corresponding to the Nine Changes. First is Shu-Stimulation (Shu Ci). Shu-Stimulation involves needling the Ying-Spring, Shu-Stream, and Zhu-Stream acupoints of various meridians. Second is Dao-Stimulation (Dao Ci). Dao-Stimulation treats upper-body diseases by selecting lower-body points, specifically needling the Fu-organ acupoints. Third is Jing-Stimulation (Jing Ci). Jing-Stimulation involves needling the knotted collaterals and divisions of the major meridians. Fourth is Luo-Stimulation (Luo Ci). Luo-Stimulation involves needling the blood vessels of the minor collaterals. Fifth is Fen-Stimulation (Fen Ci). Fen-Stimulation involves needling between the muscles. Sixth is Da-Xie-Stimulation (Da Xie Ci, also Tai Ci). Da-Xie-Stimulation uses the Pi Needle to drain large abscesses. Seventh is Mao-Stimulation (Mao Ci). Mao-Stimulation involves needling superficial bi-syndrome on the skin surface. Eighth is Ju-Stimulation (Ju Ci). Ju-Stimulation involves treating the left side by needling the right, and vice versa. Ninth is Cui-Stimulation (Cui Ci). Cui-Stimulation involves burning the needle to expel bi-Qi.

There are twelve categories of needling techniques corresponding to the Twelve Meridians. First is Ou-Stimulation (Ou Ci). Ou-Stimulation involves pressing the chest or back directly against the pain site, inserting one needle anteriorly and one posteriorly to treat Heart Bi, using oblique insertion. Second is Bao-Stimulation (Bao Ci). Bao-Stimulation treats wandering pain that moves up and down. The needle is inserted and withdrawn immediately. With the left hand pressing the pain site, the needle is re-inserted. Third is Hui-Stimulation (Hui Ci). Hui-Stimulation involves vertical insertion near the tendon, lifting the needle, and moving the tendons forward and backward to relieve tension, treating Sinew Bi. Fourth is Qi-Stimulation (Qi Ci). Qi-Stimulation involves one vertical insertion and two oblique insertions to treat shallow accumulation of cold and heat. Also called Can-Stimulation (Can Ci), it treats shallow bi-Qi. Fifth is Yang-Stimulation (Yang Ci). Yang-Stimulation involves one central insertion and four surrounding superficial insertions to treat widespread cold and heat. Sixth is Zhi-Zhen-Stimulation (Zhi Zhen Ci). Zhi-Zhen-Stimulation involves pulling the skin taut before inserting to treat superficial cold. Seventh is Shu-Stimulation (Shu Ci). Shu-Stimulation involves direct insertion and withdrawal, sparse needling, and deep penetration to treat excess Qi with heat. Eighth is Duan-Stimulation (Duan Ci). Duan-Stimulation treats Bone Bi by slightly rocking the needle while deepening it until it reaches the bone, rubbing the bone up and down. Ninth is Fu-Stimulation (Fu Ci). Fu-Stimulation involves oblique insertion and superficial placement to treat muscle tension with cold. Tenth is Yin-Stimulation (Yin Ci). Yin-Stimulation involves simultaneous bilateral needling to treat Cold Jue and internal cold, selecting the Shaoyin points behind the ankle. Eleventh is Bang-Stimulation (Bang Ci). Bang-Stimulation involves one vertical insertion and one oblique insertion to treat chronic, lingering bi-syndrome. Twelfth is Zan-Stimulation (Zan Ci). Zan-Stimulation involves direct insertion and withdrawal, frequent shallow needling to bleed, treating abscesses.

For deep-seated vessels not visible to the eye, insert the needle slightly and retain it for a long time to empty the vessel Qi. Do not needle superficial vessel Qi. Press to occlude the vessel before needling to prevent leakage of essence, ensuring only pathogenic Qi is expelled. The saying "three insertions yield Gu Qi" means: first, shallow insertion penetrates the skin to expel Yang pathogens; second, slight deepening penetrates the skin to reach the muscle but stops before the muscle layers to expel Yin pathogens; third, deep insertion reaches the muscle layers, at which point Gu Qi emerges. Thus, the needling method states: start with shallow needling to drive out Yang Qi; proceed to deeper needling to draw out Yin Qi; finally, needle extremely deeply to bring forth Gu Qi. This is the principle. (This text explains the concept of three insertions and Gu Qi from the *Lingshu: Zhong Shi* chapter.) Therefore, a practitioner who does not understand the influence of annual cycles, the waxing and waning of Qi, and the origins of deficiency and excess cannot be considered a skilled artisan.

There are five types of needling corresponding to the Five Zang organs. First is Ban-Stimulation (Ban Ci). Ban-Stimulation involves shallow insertion and rapid withdrawal without injuring the muscle, resembling plucking hair, to affect the Qi of the skin. This corresponds to the Lung. Second is Bao-Wen-Stimulation (Bao Wen Ci). Bao-Wen-Stimulation involves needling around the center, targeting the blood vessels, to remove blood from the meridians. This corresponds to the Heart. Third is Guan-Stimulation (Guan Ci). Guan-Stimulation involves vertical insertion at the junctions of tendons on both sides to treat Sinew Bi, being careful not to bleed. This corresponds to the Liver. Fourth is He-Gu-Stimulation (He Gu Ci), also known as Yuan Ci or Qi Ci. He-Gu-Stimulation involves inserting needles in a chicken-foot pattern among the muscle layers to treat Muscle Bi. This corresponds to the Spleen. Fifth is Shu-Stimulation (Shu Ci). Shu-Stimulation involves direct insertion and withdrawal, deep penetration to the bone, to treat Bone Bi. This corresponds to the Kidney.

Huangdi asked: What are the Five Pathogens in needling? Qibo replied: Diseases include those holding abscesses, those with excess pathogens, those with deficient pathogens, those with heat, and those with cold. These are the Five Pathogens. To treat abscesses (using the Pi Needle), do not attack when the pathogen is at its peak. Change habits and nature; if pus does not form, change the approach. Move away from the original location. Only when the pathogen is unsettled will it dissipate. For any Yin-Yang meridian encountering an abscess, select its Shu-Stream point and apply draining. To treat Excess pathogens, use the Feng Needle and drain moderately. Deplete the excess to restore deficiency. Needle the pathogen in the muscle tissue. Once no pathogen is visible, return to the normal pathway and needle between the Yang muscle layers. To treat Deficient pathogens, use the Yuan Needle and greatly tonify the deficiency to avoid harm. Observe the location and meet the pathogen at its boundary. Ensure thoroughness regardless of distance, preventing external spread. Invade and treat, and the condition will improve. Needle between the muscle layers. To treat Heat pathogens, use the Di Needle. Coolness spreads, traveling far and returning no more, curing the disease. Open the pathways and doors, allowing pathogens to exit so the disease ceases. To treat Cold pathogens, use the Hao Needle to warm. Enter slowly and withdraw quickly to gather Shen (Spirit). Close the portals, prevent Qi dispersion, harmonize deficiency and excess, and preserve True Qi.