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Treating deficiency with tonification means that heat is felt under the needle. Heat arises when Qi becomes full. Treating excess with sedation means that cold is felt under the needle. Cold arises when Qi becomes deficient. "Removing stagnation and old blood" refers to bleeding to eliminate evil blood. ("Wen" implies accumulation, and "Chen" implies long-standing; it means that if there is accumulated evil blood in the collaterals for a long time, it should be removed.) When pathogenic factors are excessive, use sedation: do not press the needle hole upon withdrawal. (Not pressing the needle hole allows the excess pathogenic factors in the meridians to dissipate.) "Slow withdrawal and rapid pressing constitutes tonification": withdraw the needle slowly and press it rapidly. (This prevents the leakage of meridian Qi, thereby achieving tonification.) "Rapid withdrawal and slow pressing constitutes sedation": withdraw the needle rapidly and press it slowly. (This allows the pathogenic factors to escape, thereby achieving sedation.) The statement "speaking of excess and deficiency" refers to the sensations of cold (deficiency) and warmth (excess), and the quantity of Qi. (Little Qi indicates deficiency; abundant Qi indicates excess.) "As if present but as if absent, swift and unknowable" refers to the sensation of Qi arrival being rapid and difficult to discern. (It describes the Qi arriving swiftly, making it hard to grasp.) "Observing what comes after and what comes before" refers to understanding the sequence and urgency of the disease. "Addressing deficiency and excess, the practitioner must not lose the method": do not deviate from the methods of tonifying deficiency and sedating excess. "If one feels as if having obtained or lost [the Qi], it is because one has departed from the method": failing to maintain control over the Qi arrival or departure indicates a deviation from the proper technique. The key to treating deficiency and excess lies in the nine needles, which are most excellent because each is suitable for specific indications. "The timing of tonification and sedation corresponds with the opening and closing of Qi": the timing of these techniques should align with the opening and closing of Qi. (When Qi arrives at the appropriate time, it is called "opening"; when it has passed or not yet arrived, it is called "closing". Furthermore, when Qi comes under the needle, it is "opening," allowing for迎 (Ying, meeting/attacking) to sedate; when Qi goes away under the needle, it is "closing," allowing for 随 (Sui, following/supporting) to tonify. These are all meanings of the harmony between the needle and the opening/closing of Qi. The above explains the text from the *Lingshu* chapter "Nine Needles and Twelve Origins.") The names of the nine needles differ, and their shapes vary, because they exhaustively cover the necessary tonification and sedation functions. For excess conditions requiring them to become deficient, retain the needle until Yin Qi arrives abundantly and cold is felt under the needle, then remove it. For deficiency conditions requiring them to become sufficient, wait until Yang Qi arrives abundantly and heat is felt under the needle, then remove it. "When meridian Qi has arrived, guard it carefully and do not lose it": do not alter the state of the acquired Qi. "Depth and shallowness depend on intention": one must know whether the disease is internal or external. "Distance and nearness are treated equally regarding depth": although acupoints on the limbs, chest, and back vary in distance, the depth required to obtain Qi is consistent. (For acupoints on the limbs, chest, and back, although their distances differ, the depth for obtaining Qi is the same.) "Like standing on the edge of an abyss": do not dare to be negligent or drop [the needle]. "Hand like holding a tiger": desire strength and stability. ("Zhuang" refers to holding the needle firmly and steadily.) "Spirit not engaged with many things": calm the mind and observe the patient without looking left or right. (The above explains the text from the *Suwen* chapter "Treasure Life and Complete Formulation.") "Meaningful insertion without deviation": desire to insert the needle upright and correct. "Must rectify the spirit": gaze at the patient's eyes to stabilize their spirit, facilitating the flow of Qi. (Upon inserting the needle, since the eyes are the orifices of the spirit, to rectify the patient's spirit, one must gaze at their eyes to control their mental focus, preventing distraction. Thus, Qi is directed by the spirit, and the vessel pathways become easy to navigate. This embodies the meaning of the text in "Nine Needles and Twelve Origins": "Straight insertion, no deviation left or right, spirit focused on the finest details, attention on the patient, observing the blood vessels, so that needling is without danger.")

Regarding Heaven One, Earth Two, Man Three, Four Seasons, Five Tones, Six Pitch-pipes, Seven Stars, Eight Winds, Nine Fields, the human body also corresponds to them. Because each needle has its specific suitability, they are called the Nine Needles. Human skin corresponds to Heaven. (Encompassing everything, this is the image of Heaven.) Human flesh corresponds to Earth. (Gentle and thick, this is the image of Earth.) Human meridians correspond to Man. (Nourishing internally and guarding externally, this is the image of Man residing in the intersection of Qi.) Human sinews correspond to the Seasons. (Length and size reflect the waxing and waning of the four seasons.) Human voice corresponds to the Five Tones. (Clarity, turbidity, length, and shortness generate the five tones.) Human Yin-Yang combined Qi corresponds to the Six Pitch-pipes. (Six Yin and Six Yang represent the Qi of Heaven and Earth, corresponding to the twelve pitch-pipes.) Human teeth, face, and eyes correspond to the Seven Stars. (Densely arranged, this is the image of stars.) Human inhalation and exhalation correspond to the Eight Winds. (Breathing in and out mirrors the wind.) Human nine orifices and 365 collaterals correspond to the Nine Fields. (The physical form encompasses the fields like the earth.) Therefore, the first needle treats the skin, the second the flesh, the third the meridians, the fourth the sinews, the fifth the bones, the sixth regulates Yin and Yang, the seventh benefits Jing (Essence), the eighth dispels wind, and the ninth opens the nine orifices and removes the 365 joint-related Qi issues. This is called having specific dominions. (Summarizing the above.) Human intent corresponds to the Eight Winds. (Human intent is changeable, just as the eight winds of heaven are unpredictable, hence they correspond.) Human Qi corresponds to Heaven. (Qi belongs to Yang and circulates ceaselessly, thus corresponding to Heaven.) Human hair, teeth, ears, eyes, and five sounds correspond to the Five Tones and Six Pitch-pipes. (The abundance of hair, the arrangement of teeth, the acuity of hearing, the clarity of vision, and the modulation of the five sounds are orderly and distinct, thus corresponding to the five tones and six pitch-pipes.) Human Yin-Yang meridians, blood, and Qi correspond to Earth. (The movement of Yin-Yang meridians, blood, and Qi within the flesh is like water flowing in the soil, thus corresponding to Earth. ○ From "Human intent corresponds to the Eight Winds" onwards, further clarifies the未尽 (unexpressed) meaning of the previous text.)