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The constant physiological norms of humans are as follows: The Taiyang (Greater Yang) channel typically has abundant blood and deficient qi, the Shaoyang (Lesser Yang) channel typically has deficient blood and abundant qi, the Yangming (Yang Brightness) channel typically has abundant qi and abundant blood, the Shaoyin (Lesser Yin) channel typically has deficient blood and abundant qi, the Jueyin (Terminal Yin) channel typically has abundant blood and deficient qi, and the Taiyin (Greater Yin) channel typically has abundant qi and deficient blood. These are the natural constants. Regarding the Yangming channel, which has abundant qi and blood, needling may cause both blood and qi to be discharged; for the Taiyang channel, which has abundant blood and deficient qi, needling should discharge blood but avoid discharging qi; for the Shaoyang channel, which has abundant qi and deficient blood, needling should discharge qi but avoid discharging blood; for the Taiyin channel, which has abundant qi and deficient blood, needling should discharge blood but avoid discharging qi; for the Jueyin channel, which has abundant blood and deficient qi, needling should discharge blood but avoid discharging qi; and for the Shaoyin channel, which has abundant qi and deficient blood, needling should discharge qi but avoid discharging blood.

The Foot-Yangming Stomach Channel is the sea of the five zang organs and six fu organs; its vessels are large, blood is abundant, and qi is vigorous with strong heat. When needling this area, if not inserted deeply enough, the qi will not disperse; if not retained long enough, the pathogenic factor will not be drained. For the Foot-Yangming channel, the insertion depth is six fen, with retention for ten breaths. For the Foot-Taiyang Bladder Channel, the depth is five fen, retained for seven breaths. For the Foot-Shaoyang Gallbladder Channel, the depth is four fen, retained for five breaths. For the Foot-Shaoyin Kidney Channel, the depth is three fen, retained for four breaths. For the Foot-Taiyin Spleen Channel, the depth is two fen, retained for three breaths. For the Foot-Jueyin Liver Channel, the depth is one fen, retained for two breaths. For the hand yin and yang channels, the pathway for receiving qi is proximate, and the arrival of qi is rapid; therefore, the maximum insertion depth should not exceed two fen, and the maximum retention time should not exceed one breath. If these limits are exceeded, it will lead to qi depletion.

The Yellow Emperor said: I have heard that in needling techniques, excess conditions are treated by draining (Xie), and deficiency conditions are treated by reinforcing (Bu). Qibo replied: The onset of all diseases involves either excess or deficiency, thus necessitating the application of reinforcing and draining methods. Draining deficiency and reinforcing excess causes the Shen (Spirit) to leave its chamber, inviting pathogens and causing loss of righteousness; the true qi becomes unstable, leading to ruin by incompetent practitioners, termed premature death. Conversely, reinforcing deficiency and draining excess allows the Shen to return to its chamber and permanently fills the void, characterizing a skilled artisan. In using needles, one should drain by following the flow of qi, guide by opposing the flow, treat deficiency with reality (reinforcement), treat fullness with drainage, remove stagnation and old blood, and reduce excess pathogens. Slow insertion and quick withdrawal reinforce (Shi); quick insertion and slow withdrawal drain (Xu). Discussing excess and deficiency appears as if present and absent. Observing sequence and priority seems like existence and non-existence. Managing deficiency and excess feels like gaining and losing. The key to deficiency and excess lies in the Nine Needles, which are most excellent; the timing of reinforcement and drainage is achieved through the needle. To drain, one must hold and insert the needle, release and withdraw it, push aside the skin to admit the needle, allowing pathogenic qi to escape, then press and draw out the needle, creating internal warmth so that blood does not scatter and qi does not escape. To reinforce, one follows the qi; the intention is as if nonexistent, moving or pressing lightly, like a mosquito or horsefly landing, lingering yet distant, withdrawing quickly like a snapping bowstring, coordinating left and right, stopping the qi naturally, closing the external gate, and filling the central qi. One must ensure no residual blood remains; if present, it must be purged. If qi does not arrive after needling, do not count the number of inserts; if qi arrives, stop and do not re-needle. There are five principles of needling disseminated under heaven, yet few understand them: first, regulating the Shen; second, knowing how to nourish the body; third, understanding toxic drugs; fourth, sizing calami (stone needles); fifth, diagnosing the qi and blood of the five zang organs. With these five methods established, each has its precedence. In modern times, practitioners mistakenly reinforce deficiency and drain excess, a common error among artisans. However, those who follow the laws of heaven and earth, responding dynamically, harmonize like echoes and follow like shadows. The Dao operates without ghosts or gods, coming and going alone. The Yellow Emperor asked to hear this Dao. Qibo replied: The essence of needling requires first regulating the Shen. Once the five zang organs are stabilized and the nine pulses are prepared, one focuses on the needle, ignoring chaotic pulses and sounds. External and internal factors must align; do not rely solely on physical form. Understand the movement of qi before applying treatment. Recognize deficiency and excess; avoid treating severe deficiency (Five Deficiencies) and severe excess (Five Excesses). When the moment for needling arrives, act swiftly. Handle the needle with focus, keeping it bright and even. Observe silently, watching for adaptation. This state is called "Mingming" (obscure/subtle). Its form is unseen, yet one sees it gathering ("Wuwu") and abundant ("Jiji"), flying yet unidentifiable. It hides like a drawn crossbow and rises like a released trigger. Treating deficiency requires achieving fullness; treating excess requires achieving emptiness. Once Jing Qi (Meridian Qi) arrives, guard it carefully without loss. Depth and distance are determined by intent, remaining consistent. Approach with caution like standing at an abyss; handle the needle firmly like holding a tiger; keep the Shen focused, undistracted by external objects. Do not insert obliquely; correct the Shen. The essentials of small needles are easy to describe but hard to master. Incompetent practitioners focus on form; superior practitioners focus on Shen. Shen is subtle; the pathogen resides at the gate. Before seeing the disease, how can one know its origin? The subtlety of needling lies in speed and slowness. Incompetent practitioners guard joints; superior practitioners guard the Qi mechanism. The movement of the mechanism stays within the acupoint (Kong). The Qi within the acupoint is pure, clear, and subtle. When Qi is abundant, do not reinforce (meet it); when Qi is deficient, do not drain (chase it). Those who understand the Dao of Qi do not miss by a hair's breadth; those who do not understand fail to elicit a response even when prompted. Knowing the direction of Qi allows one to time the intervention correctly; incompetence is characterized by ignorance. Marvelous indeed, only skilled artisans possess this knowledge. "Going" represents reversal (Ni); "Coming" represents smoothness (Shun). Knowing reversal and smoothness allows precise action without deviation. Opposing and seizing drains; chasing and assisting reinforces. Following and opposing, harmonized by intent, completes the Dao of needling. Generally, treat deficiency by reinforcing, fullness by draining, stagnation by removing, and excess pathogens by reducing. The general principle states: Slow insertion and quick withdrawal reinforce; quick insertion and slow withdrawal drain. Discussing excess and deficiency appears as if present and absent. Observing sequence and priority seems like existence and non-existence. Managing deficiency and excess feels like gaining and losing. The key to deficiency and excess lies in the Nine Needles, which are most excellent because each is suitable for specific conditions. The timing of reinforcement and drainage corresponds with the opening and closing of Qi. The Nine Needles differ in shape because they target different aspects of supplementation and drainage. To treat excess requiring reduction, retain the needle until Yin Qi arrives abundantly, then remove it. To treat deficiency requiring reinforcement, retain the needle until Yang Qi arrives abundantly and the needle feels warm, then remove it. Once Jing Qi arrives, guard it carefully without changing technique. Depth depends on knowing the interior/exterior location; consistency in depth reflects equal observation. Approaching with caution like standing at an abyss prevents falling; handling firmly like holding a tiger ensures strength; keeping Shen undistracted means focusing quietly on the patient. Inserting correctly requires uprightness; correcting the Shen involves observing the patient's eyes to control their spirit and facilitate Qi flow. "Easy to describe" refers to simple speech; "hard to enter" refers to difficulty in application. Incompetent practitioners guard form (technique); superior practitioners guard Shen (vitality/Qi-Blood balance). "Shen Ke" refers to the meeting of righteous and pathogenic Qi. Shen is righteous Qi; Ke is pathogenic Qi. "At the gate" means the pathogen enters/exits along the path of righteous Qi. Before observing the disease, one must first know which meridian is affected. Knowing the origin means knowing where to select points. The subtlety of needling lies in speed/slowness. Incompetent practitioners guard limbs, unaware of Qi-Blood dynamics; superior practitioners guard Qi. The mechanism's movement relies on the acupoint, indicating Qi deficiency/excess and determining needle speed. The acupoint's purity and subtlety require careful guarding of Qi once obtained. "Cannot meet abundance" means do not reinforce when Qi is excessive; "cannot chase deficiency" means do not drain when Qi is deficient. "Not missing by a hair" emphasizes the fragility of Qi; "prompting without response" indicates ignorance of reinforcement/drainage intentions, where Qi-Blood is exhausted and Qi fails to descend. Knowing Qi's direction allows timing the intervention. Incompetence is ignorance of Qi's subtleties. Skill lies in mastering needle intent. "Going/Ni" implies deficient/small Qi; "Coming/Shun" implies balanced/smooth Qi. Knowing reversal and smoothness guides point selection. Opposing drains; chasing reinforces. "Reinforce deficiency" means tonifying a deficient pulse; "Drain fullness" means reducing a full pulse. "Remove stagnation" means clearing blood vessels; "Reduce excess pathogens" means draining all meridians with excess. "Slow in/quick out" reinforces; "Quick in/slow out" drains. "Excess has Qi, deficiency lacks Qi." "Observing sequence" refers to the order of Qi deficiency/excess and treatment. "Gaining/Losing" describes the sensation of successful reinforcement (feeling gained) versus drainage (feeling lost). Thus, skilled practitioners locate Qi, guard the gate, regulate Qi, and determine reinforcement/drainage sites. For draining, use round movements: press and rotate to move Qi, withdraw quickly and slowly to expel pathogens, extend and oppose, enlarge the aperture, and allow rapid Qi exit. For reinforcing, use square movements: pull skin to align with the gate, guide with left hand, push with right, rotate slightly and push slowly, maintaining uprightness and stillness. Keep the mind free from distraction, retain Qi slightly, withdraw quickly, push skin to close the gate, preserving Shen Qi. The essence of needling is never forgetting the Shen. Draining uses "Fang" (Square) when Qi is abundant, moon is full, day is warm, body is stable, and during inhalation: insert during inhalation, rotate during inhalation, withdraw slowly during exhalation. Reinforcing uses "Yuan" (Round/Moving): penetration reaches Ying (Nutrient) level, withdrawing during inhalation. "Round" and "Square" refer to techniques, not needle shapes. To drain excess: insert when Qi is abundant, entering with Qi to open the gate like a door, exiting with Qi to preserve essence and expel pathogens without closing the external gate, enlarging the path for major drainage. Press upon withdrawal to subdue strong Qi. Hold and place the needle calmly. Insert during exhalation (Qi out, needle in), sealing the needle space so essence cannot escape. Withdraw quickly while Qi enters, closing the gate to prevent heat loss, dispersing pathogens and preserving essence. Timing movement with Qi brings nearby Qi and attracts distant Qi, termed "Chasing." Insert during inhalation to avoid Qi conflict. Retain quietly to prevent pathogen spread. Rotate during inhalation until Qi arrives. Withdraw during exhalation, emptying large amounts of Qi, termed "Draining." Palpate, rub, press, tap, and scratch to open the gate and close the Shen. Insert at end of exhalation, retain until Qi arrives, guarding like waiting for a noble. When Qi arrives, protect it appropriately. Withdraw during inhalation to trap Qi, closing the gate to store Shen Qi, termed "Reinforcing." Adhering to reinforcement/drainage aligns with Heaven and Earth. Guard Jing Qi once arrived; maintain depth/distance consistency; approach cautiously; handle firmly; keep Shen focused. Hold the needle upright and calm; determine deficiency/excess before acting. Left hand holds, right hand guides; avoid flesh resistance. Drain with uprightness; reinforce by closing skin. Rotate to guide Qi, expelling pathogens and securing true Qi. The Yellow Emperor asked about separating skin and opening pores. Qibo replied: Separate skin along muscle intervals, insert slightly and slowly uprightly, ensuring Shen remains undisturbed so pathogens depart. Knowing Qi location, find the method first. Needle sparsely and deeply for retention, allowing slow entry. For upper heat, push downward; for upper heat, draw away. Treat painful areas first. For exterior cold, retain and reinforce; for interior cold, drain via He-Sea points. For insufficient upper Qi, push and raise; for insufficient lower Qi, accumulate and follow; for cold in interior, push and circulate. Excess involves Qi entering; deficiency involves Qi leaving. Excess is hot; deficiency is cold. For entering excess, open the needle hole with the left hand; for entering deficiency, close the needle hole with the right hand. If Form-Qi is deficient but Pathogenic-Qi is excess, it is pathogenic victory; urgently drain. If Form-Qi is excess but Pathogenic-Qi is deficient, urgently reinforce. If both Form-Qi and Pathogenic-Qi are deficient, both Yin and Yang are depleted; do not needle, as this causes double deficiency, exhausting Yin/Yang, Blood/Qi, emptying five zang organs, drying sinews/marrow/bone, leading to death in the elderly and irreversibility in the strong. If both Form-Qi and Pathogenic-Qi are excess, both Yin and Yang are surplus; urgently drain pathogens and regulate deficiency/excess. Thus, "excess is drained, deficiency is reinforced." If one needles without knowing reversal/smoothness, true and pathogenic Qi clash. Reinforcing excess causes Yin/Yang to overflow, intestines/stomach to distend, liver/lungs to compress, and Yin/Yang to disorder. Draining deficiency causes meridians to empty, Blood/Qi to枯竭, intestines/stomach to collapse, skin to thin, hair/pores to wither, and death to ensue. All needling aims to regulate Qi. Qi accumulates in the stomach to nourish Ying and Wei, traveling their respective paths. Zong Qi (Pectoral Qi) remains in the Sea (Chest); descending parts pass through Qichong; straight parts travel the respiratory tract. Thus, Jue (reversal/cold) in feet occurs when Zong Qi fails to descend, causing blood in vessels to flow endlessly. Without fire regulation, it cannot be treated. Scattered Qi can be gathered; aggregated Qi can be distributed. Dwelling quietly, observe Shen's movement. Close doors, gather Hun and Po, focus on one Shen, divide Jing Qi, ignore human voices, collect essence, unify Shen. Direct intent to the needle. Insert shallowly and retain; float slightly to shift Shen; rest when Qi arrives. For men, retain internally; for women, retain externally; firmly reject exit, guard against entry; this is obtaining Qi. If Qi does not arrive, ignore counts; if Qi arrives, stop and do not re-needle. Needles vary in suitability and shape, serving specific needs. The essence of needling is efficacy upon Qi arrival. Efficacy is confirmed like wind blowing clouds away, revealing blue sky. The Dao of needling is complete. Practitioners must first examine meridian deficiency/excess, palpate, rub, press, and tap. Observe reactions before selecting points. If six meridians are harmonious, there is no disease, or recovery occurs. If one meridian has upper excess/lower deficiency with blockage, likely due to transverse collaterals obstructing main meridians, visualize and drain to untie knots. For upper cold/lower heat, needle Neck-Taiyang, retain long, apply heat to neck/shoulders until heat descends, termed "Pushing Upward." For upper heat/lower cold, select deficient/depressed points, lower Qi, then stop, termed "Drawing Downward." For high fever with mania/hallucinations, examine Foot-Yangming and major collaterals; reinforce deficiency, drain blood excess. Have patient lie supine, press head arteries with four fingers, roll and push down to Quepen, repeat until heat subsides, termed "Pushing and Dispersing." The Yellow Emperor asked about excess/deficiency definitions. Qibo listed five excesses and five deficiencies arising from five zang organs: Heart stores Shen, Lungs store Qi, Liver stores Blood, Spleen stores Flesh, Kidneys store Zhi. These form the body and connect to marrow. Five zang pathways emerge from meridians to circulate Blood/Qi; disharmony causes disease. Therefore, guard the meridians. For Shen excess, laughter is unceasing; for Shen deficiency, sadness prevails. If Blood/Qi are not mixed and zang organs are stable, pathogen affects form superficially (Haomaotao), termed "Subtle Shen Disease." To treat Shen excess, drain small collaterals' blood without deep pressure or damaging major meridians. For Shen deficiency, view deficient collaterals, press to gather Qi, needle to benefit without bleeding or leaking Qi, unblocking meridians to restore Shen. For subtle Shen disease, massage without releasing, needle without pushing, transferring Qi to deficiency to restore Shen. For Qi excess, panting/coughing/upward Qi; for Qi deficiency, clear breathing but shortness of breath. Skin mildly affected, termed "White Qi Micro-Leak." To treat Qi excess, drain meridian tunnels without damaging meridians, bleeding, or leaking Qi. For Qi deficiency, reinforce meridian tunnels without leaking Qi. For subtle Qi disease, massage without releasing, withdraw needle and observe, pretending deep insertion to settle essence, scatter pathogens, leak Qi through pores, restoring True Qi. For Blood excess, anger; for Blood deficiency, fear. If Blood/Qi not mixed, sun-collaterals overflow, causing major vessel bleeding. To treat Blood excess, drain full meridians and bleed. For Blood deficiency, view deficient meridians, needle pulse, retain long, watch pulse enlarge, withdraw quickly without bleeding. For retained blood, view blood collaterals, needle to bleed, preventing evil blood from entering meridians. For Form excess, abdominal distension, difficult urination/defecation...