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The manipulation of fingers relies entirely on skillful dexterity; one must understand the lightness and heaviness, as well as the elevation and depression. When elevating, one often adds a following rotation; when depressing, force must not be lacking. Lightly manipulating the fingers performs a slight tonification, while heavy manipulation requires tight rotation to perform sedation. This is the subtle method of finger manipulation; whoever masters it becomes a good physician.

Such tonification and sedation are centered on the needle head, relying entirely on the control of the golden needle in hand. Heavy insertion may injure tendons and bones, while light insertion may fail to dispel the pathogen. One must distinguish the degree of tonification and sedation, preventing the needle head from wandering randomly. This is the profound method of needle manipulation; students must carefully memorize it in their hearts.

Tonification and sedation should be understood through their principles, with every detail adhering to standards. Rotating left three times achieves tonification; rotating right three times ensures no loss in sedation. Following the method of "three," three movements and three rotations naturally achieve the result. "Three times three equals nine" is based on numerical formulas; this miraculous needle method is called "Zhiwei" (Subtle Finger).

One must carefully consider tonification and sedation for deficiency and excess; tonifying deficiency and sedating excess is the superior approach. When sedating an excess condition, recovery should occur; adding a deficiency-tonifying technique at that time causes no harm. Do not assume that deficiency only requires sedation followed by tonification, nor claim that sedation alone is best for excess. If one understands the measure of tonification and sedation, one's medical reputation will be praised forever.

Elevation and depression for tonification and sedation require utmost attention, with deficiency/excess and light/heavy sensations conveyed through the fingertips. For deficiency, tonification requires a light hand; for excess, sedation requires a heavy hand. Elevation and depression rise with the hand, and up-and-down elevation/depression utilize the divine needle. If one understands the measure of tonification and sedation, this subtle method surpasses gold.

Since ancient times, tonification and sedation have been based on Yin and Yang theory, with Qi and Blood changes detailed according to days. When encountering Yang days, Qi flourishes; when encountering Yin days, Blood thrives. Yang meridians and Yang fu-organs follow Yang rotation; Yin collaterals, Yin fu-organs, and Yin zang-organs transmit via Yin. This is the method of Yin-Yang tonification and sedation; those who understand it are virtuous and excellent.

One must know the method of Ying-Sui (Following and Opposing) tonification and sedation. Moving against the flow is considered Shun (following), pushing against the hand is Ni (opposing). To tonify, rotate with the hand; to sedate, use opposing following after needling. One must know the depth and shallowness of insertion. Wang Zuan's *Zhen Yao* relied on this method, and Akufu used divine mechanisms to treat spirits.

Liu-Zhu (Flowing and Pouring) needle techniques are light and difficult to master; respiration coordination is handled temporarily by the practitioner. At initial insertion, rotate clockwise; during inhalation, correct with counter-clockwise movement.

Pushing, pressing, advancing, and rubbing constitute tonification; retreating, moving, lifting, and drawing meridians constitute sedation. Slow pressing and rapid lifting feel like cold ice water; rapid pressing and slow lifting feel like fire and heat. Shallow-to-deep insertion generates warming heat (tonification); deep-to-shallow insertion generates cooling sensation (sedation). If one masters advancement and retreat in tonification and sedation, the clinical efficacy of the physician will be supreme.