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(The meridians are the tunnels through which Qi and Blood flow.)
The Heart stores Shen (Spirit). The Lungs store Qi, the Liver stores Blood, the Spleen governs muscles, and the Kidneys store Zhi (Will). Each forms a specific physical manifestation. When Yi (Intent) and Zhi are smooth and harmonious, they connect internally with the Marrow to form the body structure.

Five Zang Organs.
The pathways of the Five Zang Organs all emerge from the meridian tunnels to circulate Qi and Blood. If Qi and Blood are disharmonious, various diseases arise and change. Therefore, one must guard the meridian tunnels. (The Zang organs are internal, while the meridian tunnels are external; the vessel channels are connected. Thus, by guarding the meridians and tunnels, diseases of the five Zang organs can be treated.)

Excess of Shen manifests as unceasing laughter; deficiency of Shen manifests as sadness. (When Yang is excessive, Shen is vigorous, leading to joy and laughter; when Yang is deficient, Yin cold takes advantage, leading to worry and sadness.)
If Qi and Blood have not yet aggregated (Zheng Qi has not yet contended with pathogenic factors), and the Five Zang organs are stable, but pathogens invade the形体 (body surface), causing chills starting from the hair follicles without entering the meridians, this is called "Wei Xiao Shen" (Subtle Disorder of Shen). (This refers to superficial, subtle pathogens on the exterior of the vessels, representing a slight disorder of Shen.)
In cases of Shen excess, drain the blood from the small collaterals (Xiao Luo), do not pierce deeply, and avoid damaging the main meridians, so that Shen Qi will return to balance. (Small collaterals refer to Sun Luo [branch collaterals]; Chi refers to needle insertion.)
In cases of Shen deficiency, observe the deficient collaterals, massage to guide Qi to them, then puncture to promote flow. Do not bleed, and do not dissipate Qi. By unblocking the meridians, Shen Qi will return to balance. (By massaging to guide Qi to the deficient collaterals, and then puncturing to promote flow, one tonifies deficiency and moves stagnation.)
For treating subtle pathogens, massage without releasing, insert the needle without deep thrusting, and shift Qi to the deficient areas so that Shen Qi recovers. (Subtle pathogens are on the exterior of the Heart Meridian; massage should continue to disperse external pathogens; inserting the needle without deep thrusting prevents damage to the interior.)

Excess of Qi manifests as wheezing, coughing, and rebellious Qi rising; deficiency of Qi manifests as free breathing but shortness of breath.
If Qi and Blood have not yet aggregated, and the Five Zang organs are stable, with only slight skin pathology, it is called "Bai Qi Wei Xie" (Slight Leakage of White Qi). (The Lungs govern the skin and their color is white; slight pathogens invading cause this name.)
In cases of Qi excess, drain the meridian tunnels without damaging the meridians themselves, without bleeding, and without dissipating Qi. (If this applies to excess, deficiency is understood similarly.)
In cases of Qi deficiency, tonify the meridian tunnels without dissipating Qi.
For treating subtle pathogens, massage without releasing. When withdrawing the needle, look at the patient and say, "I will insert it deeply." This induces a state of alertness where Jing Qi settles inward, pathogenic Qi scatters, finds no rest, and leaks out through the Cou Li (pores/skin spaces), allowing True Qi to recover. (First, massage to prevent stagnation in the meridian tunnels; second, verbally suggesting deep insertion induces mental focus and inward settling of Jing Qi. However, skilled practitioners may alter this verbal cue while actually using shallow needling. Thus, Jing Qi remains settled, pathogenic Qi scatters externally, and True Qi is restored.)

Excess of Blood manifests as anger; deficiency of Blood manifests as fear.
If Qi and Blood have not yet aggregated, and the Five Zang organs are stable, with overflow from the Sun Luo, there is stagnant blood in the main meridians. (This is pathogenic influence on the exterior of the Liver Meridian. Observing overflow in the Sun Luo indicates stagnant blood within the main meridians.)
In cases of Blood excess, drain the full meridians and release blood.
In cases of Blood deficiency, observe the deficient meridians, insert the needle into the vessel, retain it for a long time while observing, and withdraw quickly once the pulse becomes large. Do not allow blood to leak. (The method for tonifying deficiency involves retaining the needle to await Qi arrival; observing the pulse gradually enlarge indicates Qi has arrived, warranting quick withdrawal.)
To treat stagnant blood, observe the blood collaterals, puncture to release blood, ensuring evil blood does not enter the meridians to form disease.

Excess of Form (Xing) manifests as abdominal distension and difficulty in urination and defecation. (Spleen dampness prevails, causing Qi stagnation.)
Deficiency of Form manifests as inability to use the four limbs. (The Spleen governs the four limbs; deficiency leads to dysfunction.)
If Qi and Blood have not yet aggregated, and the Five Zang organs are stable, with twitching muscles, it is called "Wei Feng" (Gentle Wind). (Earth fears Wood/Wind; Wind causes movement. Twitching in the muscles like insects moving is thus called Gentle Wind.)
In cases of Form excess, drain the Yang meridians. (Puncture Jie Xi of the Foot-Yangming Stomach Meridian, as the Stomach is the Yang aspect of the Spleen.)
In cases of Form deficiency, tonify the Yang collaterals. (Puncture Feng Long of the Foot-Yangming Collateral.)
For treating subtle pathogens, select points between the muscle layers, avoiding the meridians and collaterals. Once Wei Qi recovers, the pathogenic Qi disperses. (Suo means to scatter.)

Excess of Zhi (Will) manifests as abdominal distension and undigested food diarrhea. (Water transforms into cold; cold qi resides in the abdomen.)
Deficiency of Zhi manifests as Jue (reversal/cold extremities). (Yin deficiency leads to Yang excess, causing reversal Qi to rush upward.)
If Qi and Blood have not yet aggregated, and the Five Zang organs are stable, there is movement in the bone joints. (Pathogens have not entered the Zang organs but press against the bones, causing pulsation in the joints.)
In cases of Zhi excess, bleed Ran Gu. (Blood here refers to inducing bleeding.)
In cases of Zhi deficiency, tonify Fu Liu. (Both are points on the Foot-Shaoyin Kidney Meridian.)
For treating non-aggregated states, select points where the pathogen resides, avoiding the main meridians, so the pathogenic Qi can be instantly vacated. (Selecting points at the pathogen's location avoids damaging the meridians, allowing the pathogen to depart naturally.)

Qi and Blood aggregating together. (Yin and Yang are disharmonious, merging with each other.)
Yin and Yang leaning/falling. (Qing means sinking or collapsing.)
Qi chaotic in the Wei (Defensive) level, Blood rebellious in the Jing (Main) vessels, Qi and Blood separated in residence, one excess and one deficient. (Qi and Blood fail to nourish each other.)
Blood aggregating in Yin. (This is Heavy Yin.)
Qi aggregating in Yang. (This is Heavy Yang)
Thus,惊狂 (Fright and Mania) occur. (Diseases of mania.)
Blood aggregating in Yang. (Exterior Cold)
Qi aggregating in Yin. (Interior Cold)
Thus, Jiong Zhong (Heat Stroke/Interior Heat) occurs. (Heat in the middle.)
Blood aggregating above, Qi aggregating below: Heart vexation, depression, and irritability. (Blood, being Yin, aggregates above the Diaphragm, suppressing the Heart with Yin pathogen, causing vexation; Qi, being Yang, aggregates below the Diaphragm, stirring Fire in the Liver, causing irritability.)
Blood aggregating below, Qi aggregating above: Confusion and forgetfulness. (Blood below prevents Yin Qi from ascending; Qi above prevents Yang Qi from descending. Yin and Yang separate, causing Shen chaos and forgetfulness.)

Qi and Blood prefer warmth and dislike cold. Cold causes stagnation and immobility; warmth causes dissipation and removal. (This explains the origin of Qi and Blood aggregation diseases.)
Therefore, where Qi aggregates, Blood is deficient; where Blood aggregates, Qi is deficient. (Referring to Qi aggregating in Yang and Blood aggregating in Yin.)
Presence constitutes Excess (Shi); absence constitutes Deficiency (Xu). Thus, Qi aggregation implies lack of Blood; Blood aggregation implies lack of Qi. Loss of connection between Blood and Qi results in Deficiency.
Luo (Collateral) and Sun Luo (Branch Collaterals) both transport to the Jing (Main) meridians. When Blood and Qi aggregate, it constitutes Excess.
If Blood and Qi both rush upward, it results in Da Jue (Great Reversal), leading to sudden death. (Death occurs without Yang.)
If Qi returns, life is preserved; if it does not return, death ensues.

Yin and Yang both have Shu (Transporting) and Hui (Meeting) points. (Acupoints include Shu and Hui points.)
Yang pours into Yin; when Yin is full, it extends outward. When Yin and Yang are balanced and even, they fill the形体 (body). If the Nine Pulses are uniform, the person is called Ping Ren (Healthy Person).
Pathogens arise either from Yin or from Yang. Those arising from Yang result from Wind, Rain, Cold, and Summer-heat. Those arising from Yin result from Diet, Lifestyle, and Emotional fluctuations (Joy, Anger, etc.).
Wind and Rain injure humans first by lodging in the Skin, transmitting to Sun Luo; when Sun Luo is full, it transmits to Luo Mai; when Luo Mai is full, it transports to the Da Jing (Main Meridians). Qi and Blood combine with pathogens and lodge between the Fen Sou (muscle intervals). The pulse becomes firm and large, hence termed Shi (Excess). In Excess conditions, the exterior is firm and full, cannot be pressed, and pressing causes pain.
Cold-Dampness injuring humans causes the skin to relax and not contract (muscles and skin are flaccid and loose). Muscles become tight and hard, Ying Blood becomes sluggish, and Wei Qi departs, hence termed Xu (Deficiency). In Xu conditions, speech is quiet and gait is weak (Nie refers to quiet speech; Pi refers to weak legs unable to walk). Qi is insufficient; pressing generates Qi to warm, bringing relief and absence of pain.
Yin generating Excess: Unregulated emotions cause Yin Qi to rebel upward. Upward rebellion causes lower deficiency; lower deficiency allows Yang Qi to rush in. Hence, it is termed Excess.
Yin generating Deficiency: Joy causes Qi to sink; Sadness causes Qi to dissipate. Dissipation leaves vessels empty. Combined with cold diet, cold Qi fills the area, causing Blood to stagnate and Qi to depart. Hence, it is termed Deficiency. (This describes internal injury causing Deficiency. Overeating causing stagnation is also internal injury, but represents Deficiency mixed with Excess.)

Yang Deficiency leads to Exterior Cold; Yin Deficiency leads to Interior Heat. Yang Excess leads to Exterior Heat; Yin Excess leads to Interior Cold. (Meaning follows below.)
Yang receives Qi from the Upper Jiao to warm the skin and muscle intervals. Now, if Cold is external, the Upper Jiao becomes blocked. Blockage of the Upper Jiao causes Cold to remain solely on the exterior, resulting in chills. (This clarifies Yang Deficiency leading to Exterior Cold.)
Labor and fatigue cause Yin Qi to decline and Grain Qi to be insufficient. The Upper Jiao fails to function, and the Lower Wan (stomach outlet) is blocked. Stomach Qi becomes hot, and hot Qi steams the chest, resulting in Interior Heat. (This clarifies Yin Deficiency generating Interior Heat.)
Blockage of the Upper Jiao leads to dense skin, closed Cou Li, and blocked Xuan Fu (pores). Wei Qi cannot vent, resulting in Exterior Heat. (The Qi of the Upper Jiao governs the Yang aspect. External Cold blocks the Upper Jiao, closing the muscle surface, causing Wei Qi to stagnate and generate Exterior Heat. This clarifies Yang Excess leading to Exterior Heat in external contraction syndromes.)
Rebellious Qi rises, Cold accumulates in the chest and does not dissipate. Lack of dissipation causes Warm Qi to depart, leaving Cold alone. Blood coagulates and stagnates, vessels become blocked. The pulse is large and choppy, indicating Middle Cold. (Jue Qi refers to Cold Reversal Qi. Cold remaining in the Middle Jiao causes Yang Qi to depart and meridians to stagnate. This clarifies Yin Excess generating Interior Cold in internal injury syndromes.)

When Yin and Yang merge, and Qi and Blood aggregate, forming disease patterns, how should one puncture?
To treat this, select the meridian tunnels, draw Blood from Ying (Nutrient) and Qi from Wei (Defensive). Utilize the patient's physique and adjust according to the Four Seasons, considering quantity and depth. (Needling must adapt to the patient's height, fat/thinness, and size. It must also follow the seasonal changes—cold, heat, warmth, coolness—and lunar phases. Depth varies by season: Spring points in neck/neck, Summer in chest/hypochondrium, Autumn in shoulders/back, Winter in waist/thighs.)
When Qi and Blood aggregate, forming disease, and Yin/Yang lean, how to tonify and sedate?
To sedate Excess: Insert the needle when Qi is abundant (during patient's inhalation). The needle enters with the Qi (preserving Shen and preventing disturbance of True Qi). Open the gate, like opening a door. Withdraw the needle with the Qi (during patient's exhalation). Jing Qi is not damaged, Pathogenic Qi descends. The outer gate remains open to expel the disease. Widen the channel, like clearing a road. This is major sedation. Press upon withdrawal to ensure the major pathogenic Qi is subdued, preserving True Qi.
How to tonify Deficiency? Hold the needle steady, focus intention. Insert during exhalation (Qi exits, needle enters). Seal the needle space tightly so Jing Qi cannot escape (when Qi arrives under the needle, True Qi gathers and does not scatter). When the sensation is full, withdraw quickly. As Qi enters, the needle exits. Heat (from the needle/Qi interaction) cannot return; seal the pore. Pathogenic Qi scatters, Jing Qi is preserved. (Heat refers to the warmth under the needle.) Move the needle to await the right timing. Do not lose nearby Qi, invite distant Qi. This is called "Chasing" (Pursuing and assisting, a tonification method).

The Five Zang organs have the Six Fu organs as their interior-exterior pairs. Meridians and branches/joints each generate Excess and Deficiency. Based on the disease location, regulate accordingly. (Zang and Fu are paired, forming twelve meridians. Meridians branch into 365 joints. Qi and pulses connect, integrating with the Five Zang. Variations in Excess/Deficiency determine disease location. Regulation methods follow below.)
Disease in the Pulse: Regulate Blood. (Vessels are the mansion of Blood.)
Disease in Blood: Regulate Collaterals. (When Blood is harmonious, Sun Luo fill first, then pour into Luo Mai. Thus, Blood diseases require regulating collaterals.)
Disease in Qi: Regulate Wei. (Wei governs Yang Qi.)
Disease in Flesh: Regulate Muscle Intervals. (Select points between muscle layers based on location.)
Disease in Tendons: Regulate Tendons using Burning Needles (Fan Zhen) and rapid stabbing below, and for spasms.
Disease in Bone: Regulate Bones using Quenching Needles (Cui Zhen) and Herbal Hot Compresses. (Burning needles involve heating the needle after insertion for warmth; Quenching needles involve heating the needle red-hot before insertion for stronger warming. Necessary for stubborn Cold-Toxins. Now called Fire Needle. Herbal compresses use pungent-hot herbs to disperse. Usage depends on disease depth and severity.)
Disease with unknown pain location: Use the Two Chong Mai (Penetrating Vessels) as primary points (for Damp-Bi, select Shen Mai of Foot-Taiyang).
Body pain with normal Nine Pulses: Use Miao Ci (Mysterious Puncture). (Disease is in collaterals, not meridians; puncture collaterals.)
Pain on the left with abnormal pulse on the right: Use Ju Ci (Major Puncture). (Puncture major meridians.)
Must carefully examine the Nine Pulses (Nine pulses of all meridians). The Way of Needling is complete.