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The Yellow Emperor said: I wish to hear whether there are specific rules for needling people of different skin colors (black and white), body constitutions (fat and thin), and sizes (small and tall). Qibo replied: If a person is in their prime, robust in physique, with abundant Qi and Blood, and firm and tough skin, and has been affected by pathogenic factors, needling such individuals requires deep insertion and retention of the needle. This applies to fat people. Such individuals typically have broad shoulders and axillae, thin flesh on the neck, thick skin, and dark complexion; their lips are full and protruding. Their blood is dark and turbid, and their Qi flow is sluggish and slow. In terms of temperament, they are greedy and pleasure-seeking. When needling them, one should insert deeply, retain the needle, and increase the number of needles or repetitions.

Thin people have thin skin, lackluster complexion, lean muscles, thin lips, and speak lightly. Their Qi and Blood are clear and pure, but they are prone to Qi depletion and Blood damage. When needling them, one should insert shallowly and withdraw quickly. When needling fat people, follow the depth principles of autumn and winter; when needling thin people, follow the depth principles of spring and summer.

How should normal people be needled? Observe their skin color (white or black) and adjust accordingly. Those who are upright and dignified have harmonious Qi and Blood; when needling them, do not deviate from the standard rules.

The Yellow Emperor said: Regarding kings and nobles, who are masters of Qi and Blood, with soft and fragile bodies and weak muscles, yet whose Qi and Blood are fierce and slippery, how should the depth, speed, and quantity of needling be determined? Qibo replied: One cannot treat those who consume rich foods (gao liang) and those who eat coarse grains (huo shu) in the same way! If the Qi is slippery, withdraw the needle quickly; if the Qi is sluggish, withdraw it slowly. If the Qi is fierce, use small needles and insert shallowly; if the Qi is sluggish, use large needles and insert deeply. Deep insertion requires retention, while shallow insertion requires quick withdrawal. Based on this observation: commoners should be needled deeply with retention, whereas nobles should be needled gently and slowly. This is all due to their fierce and slippery Qi and Blood. For cold bi syndrome with internal heat, needling commoners involves fire therapy (moxibustion/fire needle), while needling nobles involves herbal compress therapy.

The Yellow Emperor said: How should vigorous men with solid bones be needled? Qibo replied: Vigorous men have solid bones, relaxed muscles, and strong joints. If such a person is heavy-set, their Qi is sluggish and blood is turbid; needling requires deep insertion, retention, and an increased number of needles. If they are agile and strong, their Qi is slippery and blood is clear; needling requires shallow insertion and quick withdrawal.

How should infants be needled? Infants have fragile flesh, little blood, and weak Qi. Use fine needles (hao zhen), insert shallowly, and withdraw quickly. Treatment can be performed twice a day.

When the pulse is excess, insert deeply to drain the pathogenic factor (note: original text says "zhen qi", contextually implies draining excess); when the pulse is deficiency, insert shallowly to prevent the loss of essential Qi, thereby nourishing the vessels and expelling only the pathogenic factor. Needling Yin disorders requires deep insertion and retention; needling Yang disorders requires shallow insertion and quick withdrawal. Do not needle superficial pulses directly; press the pulse first before needling to avoid losing essence and to expel only the pathogen. For pulses located deeply and invisibly, do not press; insert slightly and retain the needle for a long time to guide the vessel Qi.