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(Miu Ci, or Cross-Needling, refers to treating the left side for right-sided pathology and the right side for left-sided pathology, and treating the limbs for body pathology by crossing the stimulation at the site of disease. The reason for employing Miu Ci is that the pathogenic factor resides in the Luo-connecting vessels (Luo vessels) but not in the Jing-main vessels (Jing vessels).)

Generally, when a pathogenic factor invades the human body, it first lodges in the skin and hair (mao pi). If it remains there without being expelled, it enters the Sun-loops (Sun luo); if it remains in the Sun-loops without being expelled, it enters the Luo-connecting vessels; if it remains in the Luo-connecting vessels without being expelled, it enters the Jing-main vessels, connects internally with the Zang-organs (Zang organs), and scatters outside the intestines. When both Yin and Yang are affected by pathogens, the Zang-organs will be injured. This is the sequence of pathogens entering from the skin and hair and reaching the extreme depth of the Zang-organs. In such cases, one should treat the Jing-main vessels. (Miu Ci is not used here.) Now, if a pathogenic factor lodges in the skin and hair, enters the Sun-loops, and remains there without being expelled, causing blockage and obstruction so that it cannot enter the Jing-main vessels, instead overflowing into the large Luo-vessels, it generates strange diseases. When a pathogenic factor lodges in the large Luo-vessels, the evil on the left flows to the right, and the evil on the right flows to the left; up and down, left and right, it interferes with the Jing-main vessels and distributes to the four extremities. Its Qi has no fixed location and does not enter the Shu-points (Shu points) of the meridians; this is called Miu Ci. How does it differ from Ju Ci (Great Cross-Needling)? It is said: When a pathogenic factor lodges in the Jing-main vessels, excess on the left causes illness on the right, and excess on the right causes illness on the left; there are also cases of shifting symptoms, where pain on the left persists while the pulse on the right shows signs of disease first. In such cases, one must use Ju Ci, ensuring the needle strikes the Jing-main vessel, not the Luo-connecting vessel. (The phrase "right illness affecting right, left illness affecting left" refers to situations where right-sided illness manifests on the left, or left-sided illness manifests on the right.) Therefore, when Luo-vessels are diseased, the pain occurs at locations crossing the normal pathways of the Jing-main vessels, hence it is named Miu Ci. ("Miu chu" refers to locations differing/crossing from the regular pathways of the Jing-main vessels.)

When a pathogenic factor lodges in the Luo-connecting vessel of Foot-Shaoyin (Kidney Meridian), it causes sudden heart pain, acute distension, and fullness/supporting sensation in the chest and hypochondrium. If there is no accumulation, needle the point anterior to Ran Gu (Rangu, KI2) until slight bleeding occurs; recovery takes about the time of a meal. ("Shi qing" means the duration of one meal.) If not cured, apply left-to-right or right-to-left needling. (This is precisely Miu Ci; other cases follow this principle.) It may also cause throat pain, inability to swallow food, inexplicable irritability, and Qi rushing upward to Ben (the diaphragm/epigastrium). Needle Yongquan (Yongquan, KI1) upwards. (For throat pain in the center, needle three times on each side; for pain on one side, apply left-to-right or right-to-left cross-needling. Ben refers to the diaphragm.) For swelling in the middle of the throat, inability to swallow saliva, and frequent attempts to spit out saliva that cannot be expelled, needle Rangu until bleeding occurs; recovery is immediate. (The sentence "causing throat pain and inability to swallow food" was placed under the section on Foot-Shaoyang in older editions.)

When a pathogenic factor lodges in the Luo-connecting vessel of Hand-Shaoyang (Sanjiao Meridian), it causes throat obstruction (bi), tongue retraction, dry mouth, vexation, pain on the lateral aspect of the arm, and inability to raise the hand above the head. Needle Guanchong (Guanchong, TE1). When a pathogenic factor lodges in the Luo-connecting vessel of Foot-Jueyin (Liver Meridian), it causes sudden hernia and acute pain. Needle Dazhun (Dazhuncun, LR1). When a pathogenic factor lodges in the Luo-connecting vessel of Foot-Taiyang (Bladder Meridian), it causes pain in the head, neck, and shoulder. Needle Zhiyin (Zhiyin, BL67) for immediate relief. If not relieved, needle three cun below the lateral malleolus (Jinmen, BL63; Jinggu, BL64; Tonggu, BL65). It may also cause spasms, back tightness, and pain radiating to the hypochondrium. Needling begins from the neck, counting along the spine paravertebrally; press firmly, and needle where tenderness is felt upon pressing. (This method of needling based on tenderness rather than fixed acupoints is called Ying-tong points. The section on "causing spasms and back tightness" was placed under Foot-Taiyin in older editions.)

When a pathogenic factor lodges in the Luo-connecting vessel of Hand-Yangming (Large Intestine Meridian), it causes chest fullness, wheezing, supporting pain in the chest, and heat. Needle Shangyang (Shangyang, LI1). It may also cause deafness and intermittent hearing loss. Needle Shangyang for immediate hearing restoration. (The branch of Hand-Yangming enters the ear.) If not relieved, needle Guanchong (Guanchong, TE1). (Older texts suggested Zhongchong, PC8, on the middle finger nail bed because the Pericardium meridian emerges behind the ear and joins Shaoyang at Wanggu; Wu Shi corrected this to Xiaozhi Cizhi, suggesting Guanchong, TE1, because the Hand-Shaoyang Luo-vessel enters the ear from behind the ear.) Patients who occasionally hear sounds can still be treated; those who never hear sounds have exhausted Luo-Qi and should not be needled. For a sensation of wind in the ears (hearing wind-like sounds despite deafness), needle this point as well. (The section on "deafness" was placed under "falling from height" in older editions.)

When a pathogenic factor lodges between the arm and palm (Hand-Jueyin Pericardium Meridian), causing inability to flex the fingers, needle the posterior aspect of the ankle (Neiguan, PC6). Press with fingers first; needle only when pain is elicited. (This follows the principle of Ying-tong, ignoring fixed acupoint rules.) Determine the number of needle insertions based on the waxing and waning of the moon. When a pathogenic factor lodges in the Foot-Yangqiao Mai, it causes eye pain starting from the inner canthus. Needle Shenmai (Shenmai, BL62).

If a person falls from a height, leaving stagnant blood inside, causing abdominal fullness and inability to urinate or defecate, first administer purgatives to promote blood circulation and remove stasis. This involves injury to the Jueyin vessel above and the Shaoyin Luo-vessel below. Bleed the vessels anterior to Ran Gu (Shaoyin Luo-vessel) and the arterial pulse on the dorsum of the foot (Wang Shi and Wu Shi identify this as Chongyang, ST42, due to abdominal fullness; Zhang Shi identifies it as Taichong, LR3, the Shu-stream of Foot-Jueyin). If not relieved, needle Dazhun (LR1) until bleeding occurs for immediate relief.

For frequent sadness, fright, and unhappiness, use the needling methods described above. For Bi-syndrome characterized by wandering pain with no fixed location, painful in the muscle intervals, determine the number of needle insertions based on the lunar cycle. (This means adjusting the number of needles according to the abundance or deficiency of Qi.) Exceeding the appropriate number depletes Qi; falling short fails to expel pathogens. Treat left-side pathology by needling the right, and right-side pathology by needling the left. Stop when cured; if not, repeat the procedure. On the first day of the waxing moon, needle once; on the second day, twice, increasing gradually. On the fifteenth day, fifteen times; on the sixteenth day, fourteen times, decreasing gradually.

When a pathogenic factor lodges in the Luo-connecting vessel of Foot-Yangming (Stomach Meridian), it causes nasal congestion, epistaxis, and coldness in the upper teeth. Needle Lidui (Lidui, ST45). When a pathogenic factor lodges in the Luo-connecting vessel of Foot-Shaoyang (Gallbladder Meridian), it causes hypochondriac pain, dyspnea, cough, and sweating. Needle Qiaoyin (Qiaoyin, GB44). Dyspnea resolves immediately; sweating stops immediately. For cough, keep warm and adjust diet; recovery occurs within one day. If not relieved, repeat the procedure. It may also cause pain in the pivot area (hip/groin) and inability to lift the thigh. Needle Huantiao (Huantiao, GB30). For cold syndromes, retain the needle for a long time, determining the number of insertions based on the lunar cycle, leading to immediate relief. (The section on "pain in the pivot area" was placed under Foot-Taiyang in older editions.)

When a pathogenic factor lodges in the Luo-connecting vessel of Foot-Taiyin (Spleen Meridian), it causes lower back pain radiating to the lower abdomen and flanks, with inability to breathe deeply while lying supine. Needle the gap of the sacrum, above the two gluteal muscles, which is Yaoshu (Yaoshu, BL23). Determine the number of insertions based on the lunar cycle; relief is immediate upon needle withdrawal. (Wang's commentary identifies Yaoshu as the lower Liao points of Foot-Taiyang; Wu Shi removed "is Yaoshu" and identified it as Pishu. According to *Treatise on Lower Back Pain*, lower back pain radiating to the lower abdomen and flanks with inability to extend is treated at the intersection of the sacrum and the upper gluteal muscles. *Bone Empty Treatise* states lower back pain with twisting difficulty and testicular traction is treated at the Eight Liao points. Here, Yaoshu refers to Cishi, Zhongshi, and Xiashi of Foot-Taiyang. See *Treatise on Needling Lower Back Pain*.)

For areas traversed by the meridians that are not diseased, employ Miu Ci. (If the Jing-main vessels are not diseased, the pathogen is in the Luo-vessels, hence Miu Ci is indicated.)

For deafness, needle Hand-Yangming (Shangyang, Hegu, Yangxi, Pianli). If not relieved, needle the connecting vessel emerging before the ear (Tinghui, GB2). For dental caries (toothache), needle Hand-Yangming (points as above). If not relieved, needle the vessel entering the teeth for immediate relief. (Hand-Yangming enters the lower teeth, so Yinjiao, DU26, is indicated.)

When a pathogenic factor lodges in the Luo-vessels between the five Zang-organs, the symptom is pulling pain in the vessels, coming and going intermittently. Observe the pathology and apply Miu Ci on the fingernails and toenails. (Observe the affected area and needle the Jing-well points of the respective limbs using Miu Ci.) Observe the vessels and bleed them; needle every other day. If one session is ineffective, five sessions will cure it.

Mis-transmission leads to pulling pain in the upper teeth and cold pain in the teeth and lips. Observe the veins on the dorsum of the hand and eliminate blood stasis. (Foot-Yangming disease causes hot pain in teeth and lips; now lower tooth pain radiates to upper teeth, indicating Hand-Yangming disease. Thus, for cold pain in teeth and lips, remove blood stasis from the Hand-Yangming Luo-vessel.) Needle Zhongzhi (middle finger) nail bed (branch of Foot-Yangming, alternatively Lidui) and Dashuzhi Cizhi (index finger) nail bed (Shangyang, LI1), one insertion each, for immediate relief.

When a pathogenic factor lodges in the Luo-vessels of Hand-Shaoyin, Foot-Shaoyin, Hand-Taiyin, Foot-Taiyin, and Foot-Yangming, these five Luo-vessels converge in the ear and connect to the left corner of the head. If all five Luo-vessels are exhausted, the patient exhibits pulsation throughout the body but lacks consciousness, resembling a corpse; this is called Corpse-Jue (Shi Jue). Needle Yinbai, Yongquan, and Lidui, one insertion each. Then needle Shaoshang, Zhongchong, and Shenmen. If not relieved, blow air into both ears using a bamboo tube. Apply a square inch of hair from the left corner of the head, burn it to ash, and drink it mixed with a cup of fine wine. If unable to drink, force-feed; relief is immediate.

In general, the principles of needling require first observing the meridians, palpating and following their course, assessing excess and deficiency, and then regulating. For irregularities, use Jing-Ci (Main Needling) to strike the Jing-main vessels, not the Luo-vessels. For pain without Jing-main vessel pathology, use Miu Ci. (Body pain where the pathway of the corresponding Jing-main vessel is not diseased indicates Luo-vessel pathology, not Jing-main pathology.) Observe the skin regions for collateral blood vessels and drain them all. (To vent clustered pathogens in the Luo-vessels.) These are the rules of Miu Ci. (Shu refers to regulations or protocols.)