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The Seventy-Seventh Difficulty of the *Nan Jing* states: The medical classics say, "Superior physicians (Shang Gong) treat disease before it arises; average physicians (Zhong Gong) treat disease after it has arisen." What does this mean? The answer is: Treating disease before it arises means that upon observing a liver disease, one knows that the liver pathology will transmit to the spleen. Therefore, one first strengthens the Spleen Qi (vital energy of the Spleen) so that it is not susceptible to pathogenic factors from the Liver. This is called treating disease before it arises. Average physicians treating disease after it has arisen observe a liver disease but do not understand the principle of transmission between Zang organs; they focus solely on treating the Liver. This is called treating disease after it has arisen.

Master Hua Shou stated: Observing a liver disease and first strengthening the Spleen to prevent pathogens from entering constitutes treating disease before it arises, which characterizes a Superior Physician. Observing a liver disease and focusing solely on treating the Liver constitutes treating disease after it has arisen, which characterizes an Average Physician. Chapter 55 of the *Ling Shu* (Spiritual Pivot) states: "Superior physicians needle where disease has not yet generated; next best is to needle where disease has not yet become excessive; next best is to needle where disease has already declined. Inferior physicians needle when pathogens are just invading, or when the patient's constitution is still robust, or when the disease pattern contradicts the pulse." Thus it is said: When disease is in its exuberant phase, do not dare to attack recklessly and cause damage; wait for its decline, and success will be great. Hence, superior physicians treat disease before it arises and do not treat disease after it has fully manifested; this is what is meant.

The Yellow Emperor asked: "When physicians treat diseases, why is it that the same disease is treated with different methods?" Qibo replied: "This is caused by the influence of local geographical and climatic conditions. The Eastern region is where heaven and earth begin to generate Yang Qi. It is a land of fish and salt, near the sea and waters. Its people eat fish and crave salty flavors, being content with their location and food. Fish consumption tends to cause heat accumulation in the interior; excessive salt consumption depletes Blood. Consequently, the people have dark skin and loose tissue texture, and their diseases are mostly carbuncles and ulcers (yang). Treatment is suitable with Bian stones (lithic therapy). Thus, Bian stone therapy originated from the East. The Southern region is where heaven and earth nurture and grow with abundant vitality. The terrain is low, the water and soil are weak, and mist and dew gather there. Its people favor sour flavors and fermented foods. Their people have dense skin texture and reddish complexion, and their diseases are mainly spasms and Bi syndrome (obstruction syndrome). Treatment is suitable with fine needles (Wei Zhen). Thus, the Nine Needles also originated from the South. When the body is at ease but the mind suffers, disease arises internally; treatment employs needles and stones."

The Yellow Emperor asked: "Are there specific lengths for the needles?" Qibo answered: "The first is the Chan Needle (Chan Zhen), modeled after the pin used for headgear. It has a large head and sharp tip. Removing half an inch from the tip leaves a sharp point extending one cun and six fen. The second is the Yuan Needle (Round Needle), modeled after the quilting needle. Its shaft is cylindrical and its tip is ovoid. The needle body resembles an egg shape with a rounded end, one cun and six fen long. The third is the Di Needle (Di Zhen), modeled after the sharp tip of millet grains, three cun and half a cun long. The fourth is the Feng Needle (Sharp Needle), modeled after the quilting needle. Its shaft is cylindrical, its tip is sharp, and its blade has three edges, one cun and six fen long. The fifth is the Pi Needle (Pi Zhen), modeled after the edge of a sword. The end is like a sword blade, two cun and half a cun wide, four cun long. The sixth is the Yuanli Needle (Round-Sharp Needle), modeled after cattle tail hair. The needle is thick like cattle tail hair, both round and sharp, with a slightly larger end and a slightly smaller shaft, or described as having a slightly larger middle section, one cun and six fen long. The seventh is the Hao Needle (Hair Needle), modeled after body hair. The tip is sharp like the proboscis of a mosquito or horsefly, one cun and six fen long. The eighth is the Chang Needle (Long Needle), modeled after the Qi needle. It is sharp and thin, seven cun long. The ninth is the Da Needle (Large Needle), modeled after the Feng Needle. The tip is straight like a rod, and the edge is slightly rounded. These constitute the forms of the Nine Needles. These are the lengths of the Nine Needles."