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When treating pain with acupuncture, if the needle feels tight upon insertion, apply three tonifying manipulations. If Qi and Blood circulation is obstructed during needle retention, perform three additional tonifying manipulations and three flicks to induce tremors; after three blood-tonifying actions, the attacking pain will naturally subside.

Rubbing and quickly lifting the needle generates heat; extending the needle body while slowly lifting and inwardly grasping promotes Qi movement. Pressing the handle while slowly extending and lifting feels cold as ice, whereas rubbing like fire generates precise heat. For men, insert the needle one *fen*; for women, lift the needle two *fen* and stop. Although cold-heat responses in men and women seem standardized, the key to depth and manipulation lies in the practitioner's clear understanding.

Exhale while blowing (directing intent); if Qi is fierce and urgent, utilize respiration techniques. If Qi rises fiercely, blow three times; if Qi sinks fiercely, exhale three times. Utilizing respiration on the right side is a true profound secret. Allow Qi to move slowly up and down through three exhalations and three inhalations to perceive its direction; those who master this can become excellent physicians.

When it is difficult to regulate the ascending and descending of Qi or to raise Yang, rubbing and tonifying may lack a fixed method. Combine rubbing, grasping, scraping, and trembling manipulations; frequent regulation will harmonize the Qi, and the illness will naturally settle.

For abdominal distension in both men and women, select Shaoyin meridian points. At midnight (Zi hour), puncture Yongquan (KI1). Bilaterally, pause breathing until Qi fully gathers, then use raising Yin, trembling, and pressing methods.

The abdominal area spans approximately 3 chi 5 cun. Frequently use circling and following manipulations to draw Qi forth. For obese individuals, insert the needle to the full depth of three *cun*; for thin individuals, insert half a *cun* slightly. Obese men require three *cun* depth; thin women require one *cun*, observing excess or deficiency. These depth standards are set, but this method must be adapted for different body constitutions.

While pressing the "pan" (needle base/stability), have the patient exhale. Rub heavily dozens of times, then lift and support the needle. Use trembling, lifting, and grasping to circulate Qi up and down, eliminating pathogenic factors.

Upper points raise Yin, lower points raise Yang. Continuously lift and double-grasp to balance the middle Qi. Add circling, grasping, and lifting; stimulating two points to raise Yang may produce sound. To achieve seven sounds, grasp seven times. Extend, lift, and press downward several times, then stop. If the sounding method is exhausted, use rubbing to harmonize before withdrawing the needle.

Continuously lift the upper point to stabilize the "pan"; the lower point raises Yang in the center. The upper point continuously stabilizes and grasps the lower; the lower point raises Yang with audible resonance. To achieve forty-nine (7x7) resonant lifts and grasps, urgently press and rub frequently. For women, once the "pan" resonance is settled, rub to balance the dual heat.

If abdominal Qi is deficient, circle fourteen times. If Qi still does not arrive despite further circling, withdraw the needle halfway and then completely; if the patient's Qi is exhausted, it is difficult to treat.

If abdominal Qi is excessive, use seven circlings. Extend and lift until the skin rises visibly. Utilize upper and lower "pan" manipulations to move Qi. Withdraw the needle calmly according to the physician's treatment method.