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(Jingying)
The application of reinforcing and reducing methods during needle manipulation produces cold or heat sensations, respectively. One must distinguish between the cold sensation produced by reducing and the heat sensation produced by reinforcing. Twisting the needle handle outward is the method for reducing; twisting the needle handle inward is the secret for reinforcing.
To reinforce points on the left side, one should push forward with the thumb. To reinforce points on the right side, pull backward with the thumb (the old text contains errors regarding reinforcing/reducing left/right).
To reduce points on the left side, rub forward with the index finger. To reduce points on the right side, pull upward with the thumb (the old text contains errors regarding reinforcing/reducing left/right).
Why are there two types of reinforcing and reducing? This is because meridian Qi emanates from both sides, and one must understand "Ying-Sui" (following and opposing) to apply reinforcing and reducing correctly (referring to the reverse and forward directions of meridian flow). Following the flow constitutes reinforcing; opposing the flow constitutes reducing.
Ancients distinguished reinforcing and reducing by left and right sides; moderns distinguish them by male and female. However, the meridians of men and women are generated in the same way, circulating day and night without pause.
The Yang meridians of the hands travel from the head down (Note: Textual anomaly, usually Hand-Yang goes from hand to head), while the Yin meridians travel from the chest to the fingertips. The Yang meridians of the feet travel from the head to the feet, and the Yin meridians travel from the feet up to gather in the abdomen.
"Sui" means the needle tip follows the direction of the meridian; "Ying" means the needle tip opposes the meridian to drain pathogenic factors.
There is also a method of determining reinforcing and reducing through respiration: reducing during inhalation and reinforcing during exhalation, which is truly remarkable.
For reinforcing, withdraw the needle during the patient's exhalation. Upon insertion, use circular rubbing techniques, applying the "Three Flights" method (Circular rubbing was formerly described as emitting a sound from the Dantian/Ancestral Qi in Daoist practices, which acupuncturists do not use, hence replaced by Three Flights; see below for details). When Qi arrives, withdraw the needle while the patient inhales, retreat quickly, and immediately press the acupoint.
For reducing, insert the needle during the patient's inhalation, extending and lifting to allow Qi to reach the whole body. When Qi arrives, withdraw the needle while the patient exhales, retreat slowly in three stages, and leave the acupoint open (do not press).
This secret comes from Zisang Jun. I now impart it to you, clearing my heart like snow. This is the ultimate principle of reinforcing and reducing; do not lightly reveal it to others.

(Shenying Jing)
Chen Honggang said: Once the acupoints are accurately selected, use the thumb of the left hand to press the point, and place the needle in the right hand upon the point. Ask the patient to cough once, and insert the needle to the appropriate depth following the cough. After needling several points, wait a moment. Hold the needle with the thumb and index finger of the right hand, gently shaking, advancing and retreating, and twisting the needle, resembling a trembling hand. This is called "Cui Qi" (Urging Qi). Perform this about five or six times until the Qi feels tight under the needle, then apply the reducing method.
If needling a point on the left side, hold the needle with the thumb and index finger of the right hand, thumb forward, index finger backward. Gently lift the needle head and rotate it to the left. If needling multiple points, follow this method for all. After rotating, still hold the needle with the right thumb and index finger, and rub continuously three times with the index finger; this is called "Fei" (Flying). Then gently lift the needle head and rotate to the left, withdrawing slightly by half a cun; this is called "Three Flights, One Retreat." Follow this method five or six times until the needle feels heavy and tight, indicating Qi has reached its peak. Lift the needle head gently and rotate left one or two more times.
If needling a point on the right side, hold the needle with the thumb and index finger of the left hand, thumb forward, index finger backward. Follow the previous method, rubbing continuously three times, then gently lift the needle head and rotate to the right. This is the reducing method for right-side points.
To withdraw the needle, ask the patient to cough once, and withdraw the needle following the cough. This constitutes the reducing method.
Generally, diseases arise from the gathering of pathogenic factors. Even if the patient is emaciated and weak, one should not exclusively use reinforcing methods. The Classics state: "Where pathogenic factors gather, Qi must be deficient." However, for conditions like red eyes, where it is clearly caused by pathogenic heat, one may exclusively use reducing methods. For other diseases, balanced reinforcing and reducing (Ping Bu Ping Xie) is suitable. One must reduce first, then reinforce; this is called draining pathogenic Qi first, then tonifying True Qi. This is the untransmitted secret of the ancestors.
If a person is ill, use the aforementioned techniques to urge and obtain Qi. After completing the reducing method, proceed with reinforcing. Ask the patient to take a deep breath in, and rotate the needle following the inhalation. If needling a left-side point, rotate the needle head to the right, holding the needle with the right thumb and index finger, index finger forward, thumb backward. Continue twisting the needle deeper by one or two fen to guide True Qi into the muscle layers. If needling a right-side point, rotate the needle head to the left, holding the needle with the left thumb and index finger, index finger forward, thumb backward. Continue twisting the needle deeper by one or two fen.
If needling multiple points, follow this method. After completion, wait a moment, and gently tap the needle head three times, repeating this three times. Still hold the needle with the left thumb and index finger, and rub continuously three times with the thumb; this is called "Fei." Advance the needle deeply by one or two fen, with the needle head pointing to the left; this is called "One Advance, Three Flights." Follow this method five or six times until the needle feels heavy and tight, or warm under the needle, indicating sufficient Qi. Ask the patient to take a deep breath in, and withdraw the needle following the inhalation, immediately pressing the acupoint with the hand.
(Note: Reinforcing and reducing are scattered across chapters such as Baoming Quancheng Lun, Bazheng Shenming Lun, Lihe Zhenxie Lun, and Zhenjie. There are also combined methods involving Liu Zhu and Ying Sui. The book Zhenjiu Dacheng mentions names like Shao Shan Huo, Tou Tian Liang, Qing Long Bai Hu, etc., which deviate from the original meaning of the Classics. ○ In the Neijing, "Zhen" is synonymous with "Ci." Common belief holds that leaving the needle in the acupoint for a long time is "Zhen," while inserting and removing immediately is "Ci," which is incorrect.)