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Needle (a type of acupuncture needle)
Flat half cun, one inch six fen in length. Its head is large and the tip is sharp. It is suitable for conditions where heat pathogenic factors are located in the head and body.

Round Needle (Yuan Zhen, a type of acupuncture needle)
Its body is round, and the tip is shaped like an egg. It is one inch six fen in length. It is suitable for regulating qi in areas with full flesh.

Di Needle (Di Zhen, a type of acupuncture needle)
The tip is as sharp as millet grains. It is three inches five fen in length. It is suitable for cases where pulse qi is deficient and scanty.

Sharp Needle (Feng Zhen, a type of acupuncture needle)
It has three edges. It is one inch six fen in length. It is used to drain heat and induce bleeding. It is suitable for expelling stubborn diseases.

Sword Needle (Pi Zhen, a type of acupuncture needle)
Also known as Pi Zhen. The end is like the edge of a sword. It is two inches and a half wide and four inches long. It is used to lance carbuncles and abscesses to discharge pus and blood.

Round-Sharp Needle (Yuan Li Zhen, a type of acupuncture needle)
The tip is like a filiform needle, both round and sharp. The middle part is slightly larger. It is one inch six fen in length. It is used to harmonize Yin and Yang and eliminate acute Bi syndrome (obstruction syndrome).

Filiform Needle (Hao Zhen, a type of acupuncture needle)
Modeled after the tip of a hair, resembling the proboscis of a mosquito or horsefly. It is three inches six fen in length. It is used to regulate the meridians and eliminate diseases.

Long Needle (Chang Zhen, a type of acupuncture needle)
The tip is sharp. It is seven inches long. It is suitable for deep-seated Bi syndrome located between bone fissures and spinal joints.

Moxibustion Needle / Fire Needle (Fan Zhen, a type of acupuncture needle)
Also known as Huo Zhen (Fire Needle). It is four inches long. It is suitable for wind pathogens combined with deficiency pathogens located between bone fissures and the skin.

Nanjing (Classic of Difficult Issues), Chapter 78 states: Acupuncture involves tonification and sedation methods. What does this mean? The answer is that the methods of tonification and sedation do not necessarily require coordinating breathing with needle insertion and withdrawal.
Master Ji said: Inserting the needle at the end of exhalation and withdrawing it during inhalation constitutes tonification. Inserting the needle during inhalation and withdrawing it at the end of exhalation constitutes sedation. This refers to the timing of tonification and sedation, which is not merely about breathing during needle manipulation.
However, those who understand acupuncture rely on the left hand, while those who do not understand acupuncture rely on the right hand.
Master Ji said: "Relying on the left hand" means using the left hand to regulate the right side, performing tonification or sedation at the Ying-Spring and Shu-Acupoints based on excess or deficiency. Those who do not understand acupuncture rely on the right hand, focusing solely on the needle without knowing how to use the left hand to regulate the right side.
When needling, first press the Ying-Spring or Shu-Acupoint to be needled with the left hand, flick it to make it protrude, and press down with the fingernail. When the arrival of Qi is felt, resembling the pulsation of an artery, insert the needle smoothly along the direction. Upon obtaining Deqi (needle sensation), push the needle deeper; this is called tonification. Shake and withdraw the needle slightly; this is called sedation. If Deqi is not obtained, adjust depth according to gender: shallow for men (Wei-Qi level) and deep for women (Ying-Qi level). Failure to obtain Deqi indicates ten deaths and untreatable conditions.

Master Hua said: "Flick and make it protrude" – "Nu" is pronounced as "Nu" (anger/swell); "Press down with nails" involves slightly heavier pressing. Both aim to elicit the arrival of Qi. When Qi arrives under the fingers, resembling arterial pulsation, proceed to insert the needle while the Qi is present. "Shun" (smooth/follow) implies following or taking advantage of the moment. Wait for Qi to arrive; when Qi arrives, the needle feels active; this is Deqi. Pushing the needle in is tonification; shaking and withdrawing is sedation. This is the secret method of Yue Ren (Bian Que), not relying on breathing for insertion/withdrawal, which is natural. If Qi does not arrive after waiting, for men, needle shallowly to await Wei-Qi; for women, needle deeply to await Ying-Qi. If still no Deqi, the disease is incurable. The term "Qi" appears twice with different meanings: the first "Qi" (resembling arterial pulsation before needling) refers to the Qi sensed by the left hand prior to insertion; the second "Qi" (obtaining or not obtaining Deqi) refers to the Qi sensed under the needle after insertion. These are two distinct phases. Zhou Zhongli stated that for sensing Qi, the left hand should press slightly harder; if unsuccessful, press lightly for men at the Wei-Qi level and heavily for women at the Ying-Qi level. This ignores the distinction between pre-insertion and post-insertion phases and violates the principle of waiting for Qi, making tonification/sedation basis unclear.

Nanjing, Chapter 69 states: The classic says treat deficiency with tonification, excess with sedation, and neither with direct meridian selection. What does this mean? The answer is: Tonify the Mother point for deficiency, sedate the Child point for excess. Generally, tonify first, then sedate. For neither excess nor deficiency, select points from the affected meridian directly. This indicates the meridian is diseased itself, not invaded by external pathogens. Hence, "select from the meridian."
Master Hua said: Ling Shu (Spiritual Pivot), Chapter 10 records: For all twelve meridians, excess requires sedation, deficiency requires tonification, and neither requires direct meridian selection. Deficiency tonifies the Mother, excess sedates the Child. The Child can make the Mother full; the Mother can make the Child empty. For example, Liver deficiency tonifies the He-Sea point of Jueyin, Ququan. Liver excess sedates the Ying-Spring point of Jueyin, Xingjian. Tonifying first then sedating aligns with the later chapter's principle: if Yang is deficient and Yin is excessive, tonify Yang first, then sedate Yin. If this logic is misunderstood, it may be a textual error or interpolation. "Neither excess nor deficiency, select from the meridian" refers to Nanjing Chapter 49: Worry and thought injure the Heart; cold exposure and cold drinks injure the Lungs; anger and qi rebellion injure the Liver; diet and overwork injure the Spleen; sitting long in dampness or strenuous water entry injure the Kidneys. These are self-injuries of the regular meridians. Master Yang said: "Neither excess nor deficiency" means no mutual overacting among organs, hence "select its own meridian."

Nanjing, Chapter 76 states: What are tonification and sedation? When tonifying, where is Qi taken from? When sedating, where is Qi placed? The answer is: When tonifying, take Qi from the Wei (Defensive) layer; when sedating, place Qi in the Ying (Nutritive) layer. If Yang is deficient and Yin is excessive, tonify Yang first, then sedate Yin. If Yin is deficient and Yang is excessive, tonify Yin first, then sedate Yang. The key is the free flow of Ying and Wei Qi.
Master Hua said: Ling Shu, Chapter 52 states: Floating Qi that does not follow the meridians is Wei-Qi; Essence Qi flowing within the meridians is Ying-Qi. Tonification takes the floating Wei-Qi to fill deficiency; sedation places Qi in the Ying layer and discards it ("Zhi" means discard). Since diseases vary in excess/deficiency, the methods of tonification/sedation also vary. Thus, if Yang is deficient and Yin excessive, tonify Yang then sedate Yin to harmonize; if Yin deficient and Yang excessive, tonify Yin then sedate Yang to harmonize. This ensures natural circulation of Ying and Wei Qi.

Nanjing, Chapter 75 states: The classic says East is Excess, West is Deficiency; Sedate South, Tonify North. What does this mean? The answer is: Metal, Wood, Water, Fire, Earth should balance each other. East is Wood, West is Metal. If Wood is excessive, Metal should control it; if Fire is excessive, Water should control it; if Earth is excessive, Wood should control it; if Metal is excessive, Fire should control it; if Water is excessive, Earth should control it. East corresponds to Liver (Excess); West corresponds to Lung (Deficiency). Sedate South (Fire), Tonify North (Water). South is Fire, the Child of Wood. North is Water, the Mother of Wood. Water controls Fire. The Child can make the Mother full; the Mother can make the Child empty. Therefore, sedating Fire and tonifying Water aims to allow Metal to control Wood. The classic says: "If you cannot treat the deficiency, why ask about the rest?" This is what it means.
Master Hua said: "Metal cannot control Wood" – the character "Bu" (not) is likely an interpolation. East Excess, West Deficiency, Sedate South, Tonify North reflects the desire of Wood, Metal, Fire, Water to balance. The desire for Wood, Fire, Earth, Metal, Water to be full represents the greed for dominance in the Five Elements. Their mutual balancing uses the controlling cycle to restrain greed. The classic says: If one Zang is unbalanced, the element that controls it balances it. East is Liver, West is Lung. If East is Excess, West must be Deficient. If West were not deficient, how could East be excessively excess? Tonification or sedation aims to suppress the extreme and aid the deficient, following the path of moderation. Water controls Fire. Sedating South (Fire) steals the Child's Qi, forcing it to consume the Mother's excess. Tonifying North (Water) benefits the Child's Qi, preventing it from consuming the Mother. This reduces excess and aids suppression. Metal can then control Wood, eliminating imbalance in East and West. Yue Ren's intent is that since East is overly excess and West is deficient, sedating Fire suppresses Wood, and tonifying Water assists Metal, allowing Metal to balance Wood. Saying "Metal cannot control Wood" creates logical contradictions. If Liver Wood is not excessive and Lung Metal is not deficient, sedating Fire and tonifying Water would constitute "tonifying excess and sedating deficiency," which is wrong. Nanjing Chapter 81 clarifies this. Cai Shifeng of Jiufeng stated that cultivating the elements through mutual control to relieve excess shares the same intent. The concluding sentence, "If you cannot treat the deficiency, why ask about the rest," warns against those who know the constant but not the variable. The main point is Liver Excess and Lung Deficiency, treated by sedating Fire and tonifying Water.
Question: Since "Child makes Mother full, Mother makes Child empty," shouldn't we sedate Fire and tonify Earth? Because if the Child is sufficient, it doesn't consume the Mother's Qi; if the Mother is deficient, it cannot nourish the Child. Sedating Fire steals Child Qi to consume Mother's excess; tonifying Central Earth benefits Mother Qi to nourish the Child. Why sedate Fire and tonify Water?
Answer: This is Yue Ren's brilliance, achieving two goals at once. Sedating Fire achieves two things: stealing Wood's Qi and removing Fire's restriction on Metal. Tonifying Water achieves two things: benefiting Metal's Qi and restraining Fire's brightness. Tonifying Earth only benefits Metal, which is insufficient for dual purposes. Hence, tonify Water instead of Earth.
Question: "Mother makes Child full, Child makes Mother empty" is the Way of Five Elements. Why does Yue Ren say "Child makes Mother full, Mother makes Child empty"?
Answer: There are different theories. "Mother makes Child full, Child makes Mother empty" refers to the generation cycle. "Child makes Mother full, Mother makes Child empty" refers to acupuncture manipulation (giving/taking), which differs from biological generation.
Master Chen Siming of Siming said: Zhang Zhongjing stated that Wood overacting on Metal is called "Heng" (Horizontal). Nei Jing states: When Qi is excessive, it controls what it normally controls and insults what it normally fears. Wood Excess and Metal Deficiency represent Wood insulting Metal (insulting the unconquerable). Normally, Metal controls Wood. But if Wood is strong and horizontal, Metal's control leads to conflict, harming both. Metal needs Earth for support, but Earth is controlled by Wood at this time. Thus, Water is chosen as Metal's Child and Wood's Mother. Sedating Fire and tonifying Water allows Water to control Fire. Fire becomes weak and draws Qi from Wood, reducing Wood. Tonifying Water (Wood's Mother) makes the Child empty (Mother makes Child empty via reduction of Wood). Once Wood is balanced, Metal is no longer insulted and recovers. Water (Metal's Child) makes the Mother full (Child makes Mother full). "Metal cannot control Wood" means not directly using Metal to control Wood, but indirectly via sedating Fire and tonifying Water to naturally balance Wood and Metal. Chen's theory has merit but is constrained by the word "not," leading to forced explanations. Deleting "not" is simpler. See Nanjing Chapter 81 for confirmation.
Wang Andao said: I always sigh at Yue Ren's grasp of the Classic's intent and lament later generations' loss of it. Ancients said: Do not read commentaries first. Read the text repeatedly to find your own understanding, then compare with commentaries. Otherwise, preconceived ideas block new insights. I admire this advice. Nanjing Chapter 75 is comprehensive and pure, a model for eternity. Later debates are unreliable. Treating excess by sedating, deficiency by tonifying is standard. Sedating the Child for excess, tonifying the Mother for deficiency is also standard. Everyone knows treating Liver Excess/Lung Deficiency by sedating Heart (Fire) instead of Liver. But tonifying Kidney (Water) instead of Spleen (Earth) is unknown to most, known only to Yue Ren.
Common sense: Heart Fire Excess causes Liver Wood Excess (Child makes Mother full). Spleen Earth Deficiency causes Lung Metal Deficiency (Mother makes Child empty). Heart Fire is autonomous; Spleen Deficiency is caused by Liver controlling Earth. Standard treatment: Sedate Heart, Tonify Spleen to balance Liver and Lung.
Yue Ren disagrees. "Child makes Mother full": Child is Fire, Mother is Wood (same as common sense). "Mother makes Child empty": Mother is Water, Child is Wood (differs from common sense). "Water is Mother of Wood." "Child makes Mother full" explains etiology. "Mother makes Child empty" explains treatment. Intent: Fire (Child) helps Wood (Mother) become excessive and pathological. Treatment: Tonify Water, Sedate Fire.
Why Tonify Water? Water is Mother of Wood. Tonifying Water's deficiency enables it to control Fire. As Fire recedes, Wood recedes. This is "Mother makes Child empty" (suppressing excess to create emptiness/reduction). Note: This "empty" differs from "Essence and Qi depletion causes deficiency." Here, it means suppressing excess to induce reduction.
If this logic applied to Spleen/Lung, why not Tonify Spleen? In Five Elements, fear comes from being controlled. Fire is strong, Water is weak. Fire fears nothing. Without fear, Fire grows unchecked. Only by nourishing Water can it be overcome. "Water controls Fire" is Yue Ren's key insight. Although both sedating Fire and tonifying Water are mentioned, the key is tonifying Water. Later practitioners who only sedate Fire without tonifying Water, or claim "sedating Fire is tonifying Water," deviate significantly from Yue Ren and the Classic. If tonifying Water were unnecessary, the Classic wouldn't mention "Tonify North," nor would Yue Ren. Even if Water is not deficient but Fire is violently excessive, tonifying Water might seem optional. However, if Fire excess stems from initial Water deficiency, failing to tonify Water is fatal. Medicines may temporarily suppress Fire, but it returns after medication ends, becoming chronic. Bitter-cold herbs suppress Yang and support Yin but only clear Fire pathogen; they do not nourish the True Yin of the North (Kidney). To nourish True Yin, Rehmannia and Phellodendron are essential.
Liver Excess has two causes: 1. Heart assists Liver. 2. Lung fails to control Liver.
Lung Deficiency has two causes: 1. Heart controls Lung. 2. Spleen, controlled by Liver, fails to generate Lung.
By tonifying Water and sedating Fire: Fire recedes, Wood weakens. Metal is no longer controlled by Wood and can control Wood (East not Excess). Metal Qi balances, Earth is no longer controlled by Wood and generates Metal (West not Deficient).
If we followed "Tonify Mother for Deficiency," Lung Deficiency would require Tonifying Spleen. But Liver Qi is strong and deeply controls Earth. Daily Spleen tonification cannot counter strong Liver. Even if Earth generates Metal, Metal is controlled by Fire, resulting in net loss. Hence, Tonify Water, not Earth.
Doubt: Tonifying Water might generate Wood, worsening Wood Excess. Some prefer sedating Fire only.
Refutation: Wood is already excessive; it doesn't need generation. Water deficiency is severe; even heavy tonification struggles to restore original Qi, let alone generate Wood. If Water could generate Wood, it would control Fire.
Another doubt: Tonifying Water prevents it from consuming the Mother (Metal). If Water doesn't consume Metal, Metal Qi returns.
Refutation: Fire controls Metal, Earth fails to generate Metal. Metal is extremely deficient and cannot sustain itself. Even if Water wanted to "consume" (support) Metal, there is nothing to consume. If Metal deficiency were due to Water consuming it, that would be illogical. Even if Water doesn't consume Metal, Metal may not recover.
The phrase "Metal cannot control Wood" contains an extra "Not." Sedating Fire and tonifying Water aims to allow Metal to control Wood. Delete "Not."
"Cannot treat deficiency, why ask about rest": "Deficiency" refers to Lung Deficiency. Sedating Fire and tonifying Water allows Metal to control Wood, effectively treating the deficiency. Not tonifying Earth or Metal, but using this indirect method, is clever. If one cannot understand this method and treat this deficiency, they are incompetent. Hence, "why ask about the rest."
The earlier discussion on mutual balancing of Five Elements is self-evident and thus omitted. Yue Ren is a near-sage. I bow to his argument but correct erroneous interpretations.
(Note: Master Hua learned acupuncture from Gao Dongyang of Dongping, so he annotated tonification/sedation using acupuncture principles. Perhaps Master Wang was unfamiliar with acupuncture and discussed it via herbal medicine, clarifying the principles. However, the Classic's intent applies to both acupuncture and herbal medicine.)

Nanjing, Chapter 72 states: The classic says knowing the Qi of Ying and Sui (Meeting and Following) allows regulation. The method of regulating Qi must lie in Yin and Yang. What does this mean? The answer is: Ying and Sui refer to knowing the circulation of Ying and Wei Qi and the flow of meridians. Following their direction (with or against) constitutes Ying and Sui.
Master Hua said: Ying and Sui methods are paths of tonification and sedation. Ying (Meeting) is meeting and draining (sedating); Sui (Following) is following and assisting (tonifying). One must know Ying/Wei circulation and meridian flow. Understanding this allows assessing disease reversal/adherence and applying appropriate sedation/tonification.
Master Chen Siming said: Ying (Meeting) targets Qi as it approaches but is not yet strong, using sedation. Sui (Following) targets Qi as it passes but is not yet depleted, using tonification.
My analysis: Ying and Sui have two types: Excess/Deficiency Ying/Sui, and Mother/Child Ying/Sui. Chen's view refers to Excess/Deficiency. Nanjing Chapter 79 refers to Mother/Child.
Regulating Qi lies in Yin and Yang. Knowing interior/exterior and table/depth, regulate according to Yin/Yang. Hence, "Regulating Qi lies in Yin and Yang."
Master Hua said: "Zai" means observe. Interior is Yin, Exterior is Yang; Table is Yang, Depth is Yin. Observe whether the disease is in Yin or Yang and regulate accordingly.
Master Yang said: Regulating Qi lies in Yin/Yang. If Yin Deficient/Yang Excessive, tonify Yin/sedate Yang. If Yin Deficient/Yin Excessive, tonify Yang/sedate Yin. Or Yang merging into Yin, Yin merging into Yang, or both Yin/Yang deficient/excessive. Regulate based on presentation.
Master Xie said: Men are Exterior/Yang, Women are Interior/Yin; Table is Yang, Depth is Yin. Regulating Yin/Yang Qi includes drawing Yin from Yang, Yang from Yin, treating Yin diseases via Yang, Yang diseases via Yin, etc.

Nanjing, Chapter 79 states: The classic says Ying (Meeting) and draining results in emptiness. Sui (Following) and assisting results in fullness. Emptiness and Fullness feel like gaining or losing.