Library

The principle of acupuncture is to stop once the Qi is harmonized. Tonifying Yin and reducing Yang will enhance voice and improve hearing and vision. (Here, Yin and Yang refer to interior and exterior. The healthy Qi resides in the interior, so one should tonify Yin; pathogenic factors enter from the exterior, so one should reduce Yang. Once the Yang pathogen is eliminated and the true Qi recovers, the voice becomes resonant, and hearing and vision become sharp.) Doing the opposite leads to stagnation of Blood and Qi. The phrase "Qi arrival brings efficacy" means: after reduction therapy, although the pulse may remain large as before, it should no longer be firm. (The purpose of reduction is to induce deficiency. After reduction, even if the pulse size remains unchanged, if it becomes soft and not firm, this indicates efficacy.) If the pulse remains firm as before, although the patient claims the disease has gone, the pathogen has not actually been removed. (A pulse firm as before, despite the patient's claim of recovery, indicates that the pathogen remains.) After tonification therapy, the pulse should become more solid. The sign of solidity is a pulse that is large as before but becomes firmer. (Tonification aims for solidity, hence the pulse becomes firm.) If the pulse size remains unchanged and is not firm, although the patient feels comfortable, the disease has not been cured. (After tonification, if the pulse size is unchanged and not firm, although the patient reports feeling better, the pathogen persists. The term "large" in these sections generally refers to the fluctuation of the pulse body.) Therefore, tonification makes the pulse solid, and reduction makes it deficient. Even if pain does not disappear immediately with needling, it will inevitably diminish gradually. (If the pulse is firm after tonification and not firm after reduction, any existing pain, though not instantly cured by needling, will gradually subside.) One must first understand the diseases occurring in the twelve meridians before mastering the principles of *Zhongshi* (Ends and Beginnings). (One must treat the root of the disease to understand the meaning of ends and beginnings. *Zhongshi* refers to root and branch.) Thus, Yin and Yang do not shift into each other, and deficiency and excess do not compromise each other; points should be selected according to the affected meridian. (Yin or Yang remains distinct without interference. Deficiency and excess are independent and do not harm each other. In such cases where the origin is unclear, simply locate the affected meridian and needle it.)

Regarding all categories of needling, three insertions lead to the arrival of *Guqi* (Grain Qi, i.e., healthy Qi). (Meaning follows below.) When pathogenic factors mix abnormally, Yin and Yang positions reverse, inversion and順 (shun) contrast, and floating/sinking locations differ, causing four-season Qi imbalance and pathogenic retention. (These six sentences describe pathological changes. For all such conditions, needling using the three-insertion method can eliminate the diseases.) Thus, the first insertion expels Yang pathogens. (Initial insertion is superficial, thus expelling Yang-pathogens.) The second insertion expels Yin pathogens. (Second insertion is deeper, thus expelling Yin-pathogens.) The third insertion brings about *Guqi*. Stop needling when *Guqi* arrives. We know *Guqi* has arrived because tonification results in a solid pulse, and reduction results in a deficient pulse. (The third insertion monitors *Guqi*, which is Yuan Qi. "Stop" refers to withdrawing the needle. Generally, pathogenic Qi arrives tight and rapid, while *Guqi* arrives slow and harmonious. Only after pathogenic Qi leaves does *Guqi* arrive. Thus, after tonification, deficiency becomes solid; after reduction, solidity becomes soft. This indicates *Guqi* has arrived.) When only pathogenic Qi departs, and Yin and Yang are not yet harmonized, but the disease is known to be healing, we say: tonification leads to solidity, reduction leads to deficiency, and although pain may not cease immediately with needling, the disease will surely decline. (*Guqi* arrival indicates pathogenic departure. Although Yin-Yang meridian Qi is not instantly harmonized, the disease heals, hence the previous statement that tonification leads to solidity, reduction to deficiency, and disease decline.)

When Yin is excessive and Yang is deficient (manifested as a full Pulse at the Cun Kou), first tonify Yang, then reduce Yin to harmonize. When Yin is deficient and Yang is excessive (manifested as a full Pulse at the Ren Ying), first tonify Yin, then reduce Yang to harmonize. (Treating disease always requires prioritizing healthy Qi before treating pathogenic factors.)

Three meridians pulsate between the big toes. (These three meridians are: the Yangming Meridian from Dui to Chongyang, the Jueyin Meridian from Dadun to Taichong, and the Shaoyin Meridian from Yongquan upwards to Taixi. All three are located posterior to the big toe.) One must examine whether they are excess or deficiency. Reducing a deficiency constitutes double deficiency, worsening the disease. When needling here, press with fingers: if the pulse movement is solid and rapid, reduce rapidly; if weak and slow, tonify. Doing the opposite worsens the disease. Their pulsation locations: Yangming is superior (on the dorsum of the foot), Jueyin is medial (on the medial aspect of the dorsum), and Shaoyin is inferior (Yongquan originates at the sole of the foot).

(Note: "Tonify" here should be "Needle".) If one side is excess, needle deeply, avoid pressing the acupoint frequently, to exhaust the pathogenic Qi. (There are only two needling methods: tonification and reduction. One method, due to excess, involves deep needling without pressing the hole to expel pathogenic Qi; this is reduction.) If the other side is deficiency, needle shallowly to nourish the vessels, and press the acupoint quickly to prevent pathogenic entry. (One method, due to deficiency, involves shallow needling to nourish blood vessels and quick pressing to repel pathogens; this is tonification.) Pathogenic Qi arrives tight and rapid; *Guqi* arrives slow and harmonious. (Although this refers to needle sensation, pulse Qi arrival is similar.) For a solid pulse, needle deeply to drain Qi; for a deficient pulse, needle shallowly to prevent essence leakage, thereby nourishing the vessels and expelling only pathogenic Qi.

For needling various pain conditions: if there is swelling under the tongue, needle the tongue pillar (the tendon-like structure under the tongue) using a Bi Needle. If the hand is flexed but cannot extend, the disease is in the sinews; if extended but cannot flex, the disease is in the bones. Diseases originating in the head cause heaviness in the head; those in the hands cause arm heaviness; those in the feet cause foot heaviness. To treat disease, first needle the site of origin. Spring Qi is in the hair follicles, Summer Qi in the skin, Autumn Qi in the muscle layers, Winter Qi in the tendons and bones. (This describes how pathogens invade humans, varying in depth according to seasonal Qi.) When needling such diseases, adjust depth according to the season. Therefore, for obese individuals, use the depth appropriate for autumn/winter; for thin individuals, use the depth appropriate for spring/summer. Itching and pain belong to Yin. Pain without a fixed point upon palpation belongs to Yin and requires deep needling. Diseases in the upper body belong to Yang; diseases in the lower body belong to Yin. Itching belongs to Yang and requires shallow needling. (Pathogens on the surface emit Qi outward; flowing Qi causes itching.)

For heat jue syndrome, tonify Yin meridians twice and reduce Yang meridians once. For cold jue syndrome, tonify Yang meridians twice and reduce Yin meridians once. For chronic diseases where pathogens have penetrated deeply, needle deeply and retain for a long time, repeating every other day. First regulate the left and right Qi, puncture the collaterals to remove blood stasis, and the principles of needling are complete.

In general, observe the patient's form and Qi. If muscles are not wasted but Qi is scant and the pulse is restless, indicating restlessness and jue, employ Miao Needling to gather scattered Qi and disperse aggregated Qi. (Scant Qi with non-wasted muscles, restless pulse, and symptoms of restlessness/jue indicate internal deficiency and external meridian excess. Needling the collaterals lightly gathers scattered essence and disperses aggregated pathogens.)

Needle in a quiet place, monitor the spirit's movement, close doors and windows, keep the soul intact, focus entirely on the spirit, ignore external sounds to conserve essence, unify the spirit, and direct attention to the needle. (This emphasizes clarity and stillness, focusing attention on the needle to avoid errors in distinguishing deficiency/excess.) Needle shallowly and retain, manipulate slightly to float the needle, shifting the patient's spirit, and rest when Qi arrives. (For Qi deficiency and pathogenic heat, needling should be leisurely to shift the patient's spirit.) Men should guard the interior, women the exterior; firmly reject exit and carefully prevent entry of pathogens—this is called obtaining Qi. (After needling, caution is needed: men should avoid sexual activity, women should avoid going out. Preventing exit and preventing entry ensures pathogen expulsion and healthy Qi restoration, termed "obtaining Qi.")

Contraindications for needling: Do not needle after recent coitus; do not cohabit after needling. Do not needle when drunk; do not drink after needling. Do not needle when angry; do not get angry after needling. Do not needle when fatigued; do not exert after needling. Do not needle when full; do not eat after needling. Do not needle when hungry; do not eat after needling. Do not needle when thirsty; do not drink after needling. For those with great fright or fear, stabilize their Qi before needling. For those arriving by carriage, let them lie down and rest for the duration of a meal before needling. For those arriving on foot, let them sit and rest equivalent to walking ten li before needling. Violating these twelve prohibitions causes chaotic pulses and scattered Qi, disrupting Ying-Wei and meridian Qi order. Needling under these conditions allows Yang diseases to enter Yin and Yin diseases to emerge as Yang, regenerating pathogens. Unskilled physicians who fail to observe this harm the body. Excessive indulgence consumes brain marrow, impedes fluid transformation, and depletes the five flavors, resulting in loss of Qi.