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("Chang Ci" means deep and long needling; "Jie Lun" refers to essential discussions.)

In acupuncture treatment, pulse diagnosis is not required; one should only listen to the patient's description. If the disease is in the head accompanied by headache, needle therapy should be applied. The needle should be inserted to the bone level, and stopped when the disease resolves. (For example, if the patient reports headache, needles are inserted into head acupoints, and insertion ceases once the headache subsides.) Do not damage the bones, muscles, or skin. The term "skin" here refers to the pathway of needle insertion. (One must not randomly lift, press, or shake the needle, so as not to damage the true qi of the bone, muscle, and skin layers.)

Adopt the "Yin Ci" (Yin Needling) technique, inserting needles at one central point and four surrounding points to treat cold-heat syndromes. (Wu Kun's commentary: Yin needling implies not shaking the needle. "Insert one, surround four" refers to inserting one needle at Baihui GV20, and one each anteriorly, posteriorly, laterally left, and laterally right. ○ The term "Yin Ci" here is suspected to be an error and should likely be "Yang Ci" (Yang Needling).) If the pathogenic factor is deeply concentrated in a specific Zang organ, needle the corresponding Back-Shu point of that organ. (When cold-heat pathogens penetrate deeply and concentrate in one Zang, seek its Root Zang Back-Shu point for needling.) When the pathogen presses close to the Zang organs, needle the Back-Shu points on the back. (The phrase "needle the Root Zang" refers to needling the back where the pathogen approaches the Zang, because the back is the location of Shu points.) Needling the Shu points near the Zang organs works because these points are where the Zang Qi converges. (Needling the Shu points approaching the Zang organs is effective because they are the gathering places of Zang Qi.) Stop needling when the cold and heat sensations in the abdomen disappear. (The cessation of needling is determined by the elimination of cold and heat symptoms.)

This relates to the essentials of needling: upon withdrawing the needle, induce slight bleeding. (This means that when needling the Back-Shu points of the Five Zang organs, excessive bleeding should be avoided; the key is to withdraw the needle with shallow insertion and allow only a small amount of blood to escape.)

To treat abscesses or necrotic tissue, puncture the necrotic area. Determine the depth and extent of needling based on the size and depth of the carbuncle. For large lesions, drain more blood; for small ones, insert deeply. The needle must be inserted steadily and upright, using this as the standard for stopping. ("Wei Gu" means taking this as the criterion; "Zhi" means there are no other special techniques, simply adhering to this standard.)

If the disease is located in the lower abdomen with accumulations, needle below the Qugu CV2 point. ("Qugu" sounds like 'kuo', referring to the bony end; here it refers to acupoints such as Zhangmen LR13 and Qimen LR14.) Needle until reaching the lower abdomen, then stop. (Such as Tianshu ST25 and Guilai ST29 of the Foot-Yangming Stomach Meridian; Fushe SP16 and Chongmen SP12 of the Foot-Taiyin Spleen Meridian; Qixue KI15 and Siman KI14 of the Foot-Shaoyin Kidney Meridian, all of which govern Ben Tun [fleeing pig] and accumulations.)

Needle the interspaces between the fourth vertebrae on both sides of the spine. (The Yuan source of the Hui (Triple Burner/Pericardium area) is below the navel, hence needling Gaohuang BL43.) Needle the two Ilia regions. ("Ili" sounds like 'ge', referring to Juliao GB29, located in the intercostal space of the hypochondrium, i.e., Jingmen GB25.) Guide the hot Qi descending from the abdomen; stop when symptoms resolve.

If the disease is in the lower abdomen with pain, and urination and defecation are obstructed, the disease is named Shan (Hernia), caused by cold. (Pain in the lower abdomen with obstruction of bowel and bladder movements is called Shan disease, resulting from cold pathogen invasion.) Needle the lower abdomen. (Aiming to eliminate cold from the Liver and Kidney meridians.) Needle between the two thighs. (Aiming to eliminate pathogens from the Yangming and Taiyin meridians.) Needle between the lumbar and acetabular bones. Select multiple points and needle them abundantly. Stop when the area feels thoroughly warm, and the disease will resolve. (Any large bony structures in the posterior or lateral waist are called Huo bones. Those posterior belong to the Foot-Taiyang Bladder Meridian; those lateral belong to the Foot-Shaoyang Gallbladder Meridian. These conditions are not merely cold Hernia; observe the location of the pathogen, select multiple points, and needle them until the lower abdomen becomes completely warm, at which point the disease resolves.)

If the disease affects the tendons, causing tendon spasms and joint pain with inability to walk, it is named Jin Bi (Tendinal Bi). Needle above the tendons, using this as the standard. Insert needles into the intermuscular spaces, avoiding the bone. Stop when the tendons feel warm, and the disease resolves.

If the disease affects the skin and muscles, causing widespread pain, it is named Ji Bi (Muscular Bi), caused by injury from cold and dampness. Needle the Da Fen (Major Intermuscular Spaces) and Xiao Fen (Minor Intermuscular Spaces). (Da Fen refers to spaces between large muscles; Xiao Fen refers to spaces between small muscles.) Use multiple needles and insert deeply, using local heat as the goal. Do not damage the sinews and bones. Damaging sinews and bones may lead to the development of abscesses or pathological changes. (If Qi sinks and fails to disperse, abscesses may develop and alter the normal state.) Stop when all intermuscular spaces feel warm, and the disease resolves.

If the disease affects the bones, causing heaviness, inability to lift limbs, and soreness/aching in the bone marrow due to cold invasion, it is named Gu Bi (Osseous Bi). Insert deeply but do not damage the vessels and muscles; use this as the standard. The pathway of insertion involves the Da Fen and Xiao Fen. (Referring to the depth and location of insertion.) Stop when the bones feel warm, and the disease resolves.

If the disease affects the Yang meridians, presenting with alternating chills and fever, and the intermuscular spaces also show alternating chills and fever, it is named Kuang (Mania). Needling should tonify the deficient pulses. Observe until the intermuscular spaces are thoroughly warm, then stop, and the disease resolves. (Needle the deficiency aspects of the various meridian pulses. Observe until the deficiency pulses and intermuscular spaces are thoroughly warm, ensuring Yang Qi circulates freely and does not congregate in one place to cause mania.)

At the initial onset of disease, if it occurs once a year, do not treat. If it occurs once a month, do not treat. If it occurs four or five times a month, it is named Dian Bing (Epilepsy/Mania). Needle the various intermuscular spaces and meridians. For cases without cold signs, regulate with needles. Stop when the disease resolves. (Dian Pu [falling seizure] disease refers to Xian [epilepsy]. Needling various spaces and meridians regulates their size, cold/heat, rapid/slow, and sinking characteristics.)

Suffering from Feng (Wind) disease with alternating chills and fever, and sweating with heat. (As cold recedes, only heat remains, causing sweating.) If this happens several times a day, first needle the textures of the various intermuscular spaces and collateral vessels. If sweating recurs with alternating chills and fever. (Recurrent sweating after initial sweating indicates excess pathogen.) Needle once every three days. The disease will resolve after one hundred days.

Suffering from Da Feng (Great Wind) disease with heavy joints and loss of eyebrows and beard, it is named Da Feng. Needle the muscles until sweating occurs, continuing for one hundred days. (Draining stagnant heat from the Wei [Defensive] level.) Needle the bone marrow until sweating occurs, continuing for one hundred days. (Draining stagnant heat from the Ying [Nutritive] level.) In total, two hundred days. When eyebrows and beard regrow, stop needling. (Stagnant heat is expelled, Yin Qi returns internally, hence profuse sweating and regrowth of eyebrows and beard occur.)