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The principles of acupuncture are fully contained within the theory of "Zhongshi" (Beginning and End). By clearly understanding Zhongshi, with the Five Zang organs as the guideline, the attributes of Yin and Yang are determined. Yin meridians primarily govern the Five Zang organs, while Yang meridians primarily govern the Six Fu organs. Yang Qi is received in the four limbs, and Yin Qi is received in the Five Zang organs. Therefore, for the reducing method (Xie), one needles against the direction of the Qi flow (Ying); for the reinforcing method (Bu), one needles with the direction of the Qi flow (Sui). Knowing Ying and Sui allows the Qi to be harmonized. The method to harmonize Qi must involve a thorough understanding of Yin and Yang. The Five Zang organs belong to Yin, and the Six Fu organs belong to Yang. Respectfully following the Way of Heaven, I will now explain Zhongshi. Zhongshi refers to using the meridians as the guideline; by holding and palpating the Maikou (Radial artery at the wrist) and Yingyang (Carotid artery at the neck), one can determine whether Yin and Yang are in excess or deficiency, and assess whether the body is balanced or imbalanced, thus completing the knowledge of the Heavenly Way.

A "Pingren" (healthy person) is one who is not diseased. A healthy person's Maikou and Yingyang pulses correspond to the four seasons, move up and down in coordination, and arrive simultaneously. The pulses of the six meridians do not show knotting or restlessness. The proximal and distal pulse positions meet in harmony, and the cold and warm energies each maintain their proper functions. The form, flesh, blood, and Qi must be mutually proportional; this is called a Pingren. In cases of Shaqi (deficiency of Qi), both the Maikou and Yingyang pulses are weak and do not correspond to the Cun and Chi positions. Such a condition indicates a deficiency of both Yin and Yang. If one reinforces Yang in this state, Yin fluids will be exhausted; if one reduces Yin, Yang Qi will escape. For such conditions, sweet and mild herbs may be used, but potent medicinal preparations should not be administered. Moxibustion is also contraindicated. If the condition does not improve and reduction methods are applied, the Qi of the Five Zang organs will deteriorate.

If the Yingyang pulse is one-fold stronger than normal, the disease is in the Foot-Shaoyang Gallbladder Meridian; if it is one-fold stronger and restless, the disease is in the Hand-Shaoyang Sanjiao Meridian. If the Yingyang pulse is two-fold stronger, the disease is in the Foot-Taiyang Bladder Meridian; if two-fold stronger and restless, it is in the Hand-Taiyang Small Intestine Meridian. If three-fold stronger, the disease is in the Foot-Yangming Stomach Meridian; if three-fold stronger and restless, it is in the Hand-Yangming Large Intestine Meridian. If the Yingyang pulse is four-fold stronger, large, and rapid, it is named "Yiyang" (Overflowing Yang), which constitutes the syndrome of "Waige" (External Grid).

If the Maikou pulse is one-fold stronger, the disease is in the Foot-Jueyin Liver Meridian; if one-fold stronger and restless, it is in the Hand-Jueyin Pericardium Meridian. If two-fold stronger, the disease is in the Foot-Shaoyin Kidney Meridian; if two-fold stronger and restless, it is in the Hand-Shaoyin Heart Meridian. If three-fold stronger, the disease is in the Foot-Taiyin Spleen Meridian; if three-fold stronger and restless, it is in the Hand-Taiyin Lung Meridian. If the Maikou pulse is four-fold stronger, large, and rapid, it is named "Yiyin" (Overflowing Yin). Yiyin constitutes the syndrome of "Neiguan" (Internal Closure); if there is no unblocking, death occurs and is untreatable.

If both the Yingyang and Taiyin Maikou pulses are more than four-fold stronger, it is named "Guan Ge" (Grid and Lock). Patients with Guan Ge have a short life expectancy.

For an Yingyang pulse one-fold stronger, reduce the Foot-Shaoyang Gallbladder Meridian and reinforce the Foot-Jueyin Liver Meridian. Use a ratio of two reductions to one reinforcement, needle once daily, always palpate to verify, and regulate the Qi gently until the upper Qi is harmonized, then stop. For an Yingyang pulse two-fold stronger, reduce the Foot-Taiyang Bladder Meridian and reinforce the Foot-Shaoyin Kidney Meridian. Use a ratio of two reductions to one reinforcement, needle every two days, always palpate to verify, and regulate the Qi gently until the upper Qi is harmonized, then stop. For an Yingyang pulse three-fold stronger, reduce the Foot-Yangming Stomach Meridian and reinforce the Foot-Taiyin Spleen Meridian. Use a ratio of two reductions to one reinforcement, needle once daily, always palpate to verify, and regulate the Qi gently until the upper Qi is harmonized, then stop.

For a Maikou pulse one-fold stronger, reduce the Foot-Jueyin Liver Meridian and reinforce the Foot-Shaoyang Gallbladder Meridian. Use a ratio of two reinforcements to one reduction, needle once daily, always palpate to verify, and stop when the Qi is harmonized, regulating gently. For a Maikou pulse two-fold stronger, reduce the Foot-Shaoyin Kidney Meridian and reinforce the Foot-Taiyang Bladder Meridian. Use a ratio of two reductions to one reinforcement, needle every two days, always palpate to verify, and stop when the Qi is harmonized, regulating gently. For a Maikou pulse three-fold stronger, reduce the Foot-Taiyin Spleen Meridian and reinforce the Foot-Yangming Stomach Meridian. Use a ratio of two reinforcements to one reduction, needle twice daily, always palpate to verify, and stop when the Qi is harmonized, regulating gently. The reason for twice-daily needling here is that the Taiyin meridian governs the Stomach, which is rich in grain essence, allowing for more frequent treatment.

If both Yingyang and Maikou pulses are more than four-fold stronger (three-fold in *Ling Shu*), it is named "Yin Yang Ju Yi" (Both Yin and Yang Overflowing). In such cases, if not opened and drained, the blood vessels will become blocked, Qi will fail to circulate, and pathogenic factors will flow and diffuse excessively. The voice may become louder, and hearing and vision may seem sharper (false signs); conversely, if blood and Qi do not circulate properly, these symptoms will not occur.

The sign of "Qi arrival with efficacy" is: after reduction, the pathogen becomes weaker; the pulse may appear large as before but loses its firmness. If the pulse remains large and becomes even firmer, although the patient feels comfortable, the disease has not been eliminated. After reinforcement, the righteous Qi becomes fuller; the pulse may appear large as before but becomes firmer. If the pulse remains large but not firm, although the patient feels comfortable, the disease has not been eliminated. Thus, reinforcement makes the righteous Qi solid, and reduction makes the pathogen weak. Even if the disease does not diminish immediately with needling, the pathological trend will certainly decline. One must first understand the diseases generated by the twelve meridians before transmitting the principles of Zhongshi. Therefore, Yin and Yang should not shift into each other, and deficiency and excess should not replace each other; treatment should target the affected meridians.

Regarding the "Three Needlings" technique to reach "Guqi" (Grain Qi/Good Qi): When pathogenic factors combine abnormally, Yin and Yang shift positions, and the order of reversal and adherence is inverted, with floating and sinking occurring in different places, and the four seasons failing to align, causing pathogenic stagnation, needles are required to remove them. The first needling expels Yang pathogens; the second expels Yin pathogens; the third brings Guqi, at which point needling stops. The arrival of Guqi is indicated by the pulse becoming full after reinforcement and empty after reduction. Only when the pathogen is removed while Yin and Yang are not yet fully harmonized can recovery be anticipated. Thus, reinforcement solidifies, and reduction empties; even if symptoms do not vanish instantly, the disease will surely recede. (This text appears to interpret the third paragraph of the previous section.)

When Yang is excessive and Yin is deficient, reinforce Yin first, then reduce Yang to harmonize. When Yin is excessive and Yang is deficient, reinforce Yang first, then reduce Yin to harmonize.

There are three meridians pulsating between the big toes; their deficiency or excess must be carefully examined. Reducing a deficiency is called "Chongxu" (Double Deficiency), which worsens the disease. When needling these points, press with fingers: if the pulse is strong and rapid, reduce; if weak and slow, reinforce. Doing the opposite worsens the disease. These three pulsations (or overlaps) at the big toe refer to the Yangming above, Jueyin in the middle, and Shaoyin below.

Pain in the chest (Yingzhong) requires needling Yingzhong points; pain in the back requires back-Shu points; weakness in the shoulders requires treating the upper region. For Chongshe (double tongue), use a Pi needle on the tongue pillar. Inability to extend the hand indicates a disorder in the sinews; inability to flex indicates a disorder in the bones. Treat bones by focusing on the bone, and sinews by focusing on the sinew.

For reinforcement: if one side is excess, needle deeply, press the acupoint sparsely to exhaust the pathogen. If one side is deficiency, needle superficially to nourish the meridian, press the acupoint quickly to prevent pathogen entry. Pathogenic Qi arrives tight and rapid; Guqi arrives slow and harmonious. For excess pulses, needle deeply to drain Qi; for deficiency pulses, needle superficially to prevent leakage of essence, nourishing the meridian and expelling only the pathogen.

For various pains, needle deeply, as pain pulses are generally excess. Diseases above the waist are governed by the Hand-Taiyin and Hand-Yangming meridians; diseases below the waist are governed by the Foot-Taiyin and Foot-Yangming meridains. Treat lower diseases by selecting upper points; treat upper diseases by selecting lower points; treat head diseases by selecting foot points; treat waist diseases by selecting sacral points. Disease originating in the head causes heaviness in the head; in the hand, heaviness in the arm; in the foot, heaviness in the foot. To treat disease, first needle the site where the disease originated.

Spring Qi resides in the hair follicles; Summer Qi in the skin; Autumn Qi in the muscle layers; Winter Qi in the sinews and bones. When needling diseases of these seasons, use the seasonal depth as the standard. For fat individuals, use autumn/winter depth standards; for thin individuals, use spring/summer depth standards. Pain upon needling indicates Yin pathology; pain that cannot be located by pressure also indicates Yin, requiring deep needling. Itching indicates Yang pathology, requiring shallow needling. Upper diseases are Yang; lower diseases are Yin. If disease originates in Yin, treat Yin first, then Yang; if in Yang, treat Yang first, then Yin. For chronic diseases where pathogens have penetrated deeply, needle deeply and retain for a long time, needling every other day. First, regulate the left and right sides, remove stagnant blood, and the principles of needling are complete.

In all needling methods, observe the Xing (form) and Qi. If Xing and Qi are not depleted, but Qi is short and the pulse is restless (Jue/Ji), use Miu Ci (Lateral Needling). This gathers scattered Qi and distributes accumulated Qi. The practitioner should dwell in quiet places, focus the spirit, close doors and windows, keep Hun and Po intact, concentrate on one deity, monitor the distribution of Jing Qi, ignore external sounds, collect Jing Qi, unify the spirit, and direct the mind to the needle. Needle shallowly and retain, move slightly and float, to shift the spirit (Yi Shen), and rest when Qi arrives. Whether male or female, internal or external, resist expulsion firmly, guard carefully against invasion; this is called "De Qi" (Arrival of Qi).