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All Ying-Sui tonification and sedation methods: For the three Yang meridians of hand (Large Intestine, Small Intestine, San Jiao) and the three Yin meridians of hand (Lung, Pericardium, Heart), the Ying method is eight fen, and the Sui method is three fen. For the Hand Taiyin Lung Meridian, Hand Yangming Large Intestine Meridian, Hand Taiyang Small Intestine Collateral, and Foot Jueyin Liver Collateral, these two meridians and two collaterals have a Ying method of nine fen and a Sui method of four fen. For the Foot Yangming Stomach Meridian, Foot Taiyin Spleen Meridian, Foot Shaoyang Gallbladder Collateral, and Foot Shaoyin Kidney Collateral, these two meridians and two collaterals have a Ying method of one cun and a Sui method of five fen.

The Classic states: Stars and constellations are used to regulate the movements of the sun and moon; they constitute the Twenty-Eight Mansions and correspond to the water-clock measurements. From Fang Mansion to Bi Mansion, fourteen mansions, the flowing water indicates night. The *Ling Shu* states: When the water clock drops one unit, the vital Qi is in the Three Yang meridians; when it drops two units, the vital Qi is in the Yin compartments. It also states: As the sun traverses one mansion, the vital Qi circulates five hundred breaths within the body, completing fifty cycles around the body. One hundred units drop from the water clock as the sun traverses the twenty-eight mansions. Wang Ji comments: This is the normal degree to which human vital Qi responds to Heaven. In one exhalation, the pulse travels three cun; in one inhalation, the pulse travels three cun. Between exhalation and inhalation, the pulse travels six cun. This refers to a person without disease. If a person is ill, blood and Qi become stagnant, and meridians become obstructed, unable to follow their normal course. The Classic states: When the weather is warm and sunny, human blood flows smoothly, and Wei Qi (Defensive Qi) floats on the surface; when the weather is cloudy and cold, human blood coagulates and becomes sluggish, and Wei Qi sinks deep inside. This is human vital Qi deviating from its normal degree due to seasonal changes. Diseases accompanied by heat cause rapid breathing and fast pulse movement; diseases accompanied by cold cause slow breathing and slow pulse movement. This is human vital Qi deviating from its normal degree due to pathogenic factors. If one follows those methods, calculating how many breaths are needed to connect to a specific meridian and how many cun are covered, how can one possibly hit the exact target every time? Although the *Su Wen* and *Nan Jing* do not explicitly detail the method of connecting Qi and unblocking meridians, the initial establishment of acupuncture and moxibustion was undoubtedly based on this method. The Classic states: Diseases in the upper part belong to Yang; diseases in the lower part belong to Yin. If a disease originates in the Yin first, treat Yin before Yang; if it originates in Yang first, treat Yang before Yin. It also states: If there is pain in the body but no abnormality in the Nine Palpations, use Miao Needling (Mirrored Needling). Miao Needling involves needling the right side for left-sided pain and the left side for right-sided pain; this targets the collateral vessels. It also states: When pathogenic factors invade the meridians, excess on the left causes illness on the right, and excess on the right causes illness on the left. Or, if left-sided pain persists while the right pulse shows pathology, such cases require Ju Needling (Giant Needling). Ju Needling involves needling the right side for left-sided pain and the left side for right-sided pain; this targets the main meridians. When Qi sinks and pathogens move downward, take points from above along the meridian to draw the Qi upward. When Qi rebels and pathogens move upward, take points from below along the meridian to guide the Qi downward. If pathogens accumulate in the chest, treat from above by reducing Renying (ST 9), Tantu (CV 22), and points in the throat. If they accumulate in the abdomen, treat from below by reducing Zusanli (ST 36) and Qichong (ST 30). For severe cases, use Chicken-Foot Needling. Examine the pulse; if it is large and wiry, absent, or if the abdominal skin is extremely tense, do not needle. It also states: Examine Yin and Yang to distinguish softness and hardness. Treat Yin for Yang diseases, and treat Yang for Yin diseases. (This is the same as drawing Yin from Yang, drawing Yang from Yin, treating the right with the left, and treating the left with the right.) It also states: When using tonification, how should Qi be obtained? When using sedation, how should Qi be placed? The answer is: Floating Qi that does not follow the meridians is called Wei Qi... (Original text has gaps here, inferred context regarding Ying and Wei Qi). If Yin Qi is insufficient and Yang Qi is excessive, first tonify Yin then sedate Yang to harmonize them. In this way, Ying and Wei Qi will naturally flow freely. It also states: The acupuncturist must first examine the deficiency and excess of the meridians, palpate and trace them, flick and press them, observe the reactive moving areas, and only then select points to needle. If the Six Meridians are harmonious, it is called non-diseased; even if diseased, it will heal itself. If one meridian presents with upper excess and lower deficiency causing obstruction, there must be an overgrowth of transverse collaterals pressing on the main meridian, causing blockage. Observe and reduce this, which is called "Untying the Knot." For upper cold and lower heat, first needle the Taiyang meridians in the neck and retain the needle for a long time. After needling, apply heat to the neck and back until warm, allowing the heat to descend and merge with the lower part before stopping. This is called "Pushing Upward." For upper heat and lower cold, locate the deficient pulse sinking into the meridians and needle there; stop when the Qi descends. This is called "Drawing Downward." For generalized severe heat, delirium, hallucinations, and visual/auditory disturbances, examine the Foot Yangming Meridian and major collaterals to needle. Tonify deficiency, sedate blood excess. With the patient supine, position yourself at the head, use both hands' four fingers to clamp and press the carotid artery, hold firmly, curl and push downwards to the Jianjing/Dque area, then stop as before. Stop when the heat dissipates. This is called "Pushing and Dispersing." All these are essentially connecting Qi and unblocking meridians, merely using meridian length rather than breath count as the standard for waiting for Qi. The annotations in the *Zhi Wei Fu* explain this as akin to importing Confucianism into Buddhism or confusing jade with stone—how absurd!

Someone asks: Nowadays, doctors cover their hands with sleeves when needling, secretly performing techniques, claiming the methods are mysterious and not shown lightly, fearing others might steal them. What exactly are these methods?

I reply: The Fourteen Methods of the *Jin Zhen Fu*, along with techniques like Green Dragon Tail Swing, are comprehensive enough. Seeking mystery beyond these, I do not believe it. I consider it nonsense. While it may fool the masses, it is actually despised by the knowledgeable. Ancients feared their good skills would not reach others; now, people are so stingy. Even if the methods were mysterious, surely the spirits would not bless them, nor would they be effective. What is there to admire?

Someone asks: Now, doctors place needles in acupoints negligently, chatting or drinking wine. After half an hour, they twist the needle a few times, asking the patient to breathe a few times, then return to banquets to satisfy desires, finally removing the needle. Can this really cure diseases?

I reply: The Classic states: The essence of all needling lies first in regulating the Spirit. It also states: Manual work requires focus; needles should be bright and uniform. Calmly observe the meaning, watch for appropriate changes. It also states: Deficiency and excess are like gain and loss; excess and deficiency are like presence and absence. A solid and firm arrival of Qi indicates success (De Qi); a soft and empty sensation indicates failure. Success or failure depends on following or opposing the Qi's movement.

It also states: There is entering as seen, and exiting as seen. ("Ru" is read as "Er"). Entering means pressing the acupoint with the left hand, waiting for Qi arrival before inserting the needle. Exiting means waiting for the Qi to exhaust after insertion before withdrawing.

It also states: Upon Qi arrival, determine retention time based on cold or heat. Cold conditions require retention; heat conditions require quick withdrawal. Retention implies slowness; quick withdrawal implies speed. Tonification involves slow retention upon pressing; sedation involves quick lifting.

It also states: For needling Heat Jue syndrome, retention makes it colder; for Cold Jue syndrome, retention makes it hotter. For Heat Jue, needle Yin twice and Yang once; for Cold Jue... (Text gap, inferred proportion). People remain attentive because they fear missing the mark on deficiency/excess or mistiming cold/heat retention. I have compiled this to help future students correct current errors and habits.

Someone asks: Various acupuncture texts record needle depth in fen, retention in breaths, and moxa moxibustion in moxas. Do these come from the Classics?

I reply: They are not recorded in the Classics but likely derived later. The Classic states: Diseases have superficial and deep levels; needling has shallow and deep depths. Improper depth causes great harm. Over-penetration... (Text gap). Requiring specific breath counts for certain points is particularly illogical. The Classic states: To sedate excess, retain the needle until Yin Qi arrives and the needle feels cold, then remove it. Once Jing Qi arrives, guard it carefully. It also states: If Qi does not arrive after needling, ignore the number of attempts; if Qi arrives, remove the needle and do not repeat. Each needle has... (Text gap). It also states: Before Qi responds to the needle, it lies still like a drawn bowstring; when it responds, it rises swiftly like a triggered mechanism. However, Qi flow cannot be fixed by breath counts. It also states: Remain still and retain until Qi arrives; do not remove the needle just because many breaths have passed. This is ancient practice... (Text gap) removing the needle, merely breaking skin and damaging flesh, benefiting nothing. Thus: Harm of needling: If inserted correctly but not removed, Essence leaks; if inserted incorrectly and removed, Pathogenic Qi accumulates. Essence leakage worsens disease... (Text gap); accumulated Qi causes carbuncles and ulcers. Saying specific points require specific moxa amounts is also not ultimate truth. One should judge based on the acupoint, muscle thickness, and disease severity. Do not stick to rigid rules. The statement "needle X fen, moxa Y mozas" means: if needling is indicated for a point, insert X fen; if moxibustion is indicated, burn Y mozas. Needle without moxa, moxa without needle. Those who misunderstand may needle and moxa simultaneously, causing significant harm.

Someone asks: The Classic states the Foot Yangming Stomach Meridian is the Sea of Five Zang and Six Fu, with large pulses, abundant blood, vigorous Qi, and strong heat. Needling this meridian requires deep insertion to disperse... (Text gap). Taiyin needs three fen depth, retained for four breaths; Shaoyin needs two fen, three breaths; Jueyin needs one fen, two breaths. Hand Yin and Yang meridians receive Qi closely, and Qi comes quickly; maximum depth is two fen, retention one breath. Moxibustion follows similarly. Exceeding this causes bad fire, leading to dry bones and sluggish pulses; exceeding needling depth causes Qi depletion. This is ancient law. Given the previous chapter, is this chapter wrong too?

I reply: This discusses the general principle. Acupuncture methods have their own appropriateness and should not be rigidly bound. The Classic states: Pathogens in... (Text gap). Clear Qi is below... (Explaining clear/warm earth Qi enters humans starting from feet). Thus, needling deep muscles expels pathogens (take from above); needling middle muscles expels turbid Qi (take from Yangming junction); needling too deeply causes pathogens to sink deeper and worsen disease (superficial diseases should not be needled deeply, or pathogens enter deeper). It also states: Adjust for age, size, fat/thinness mentally. Also: Measurable standards apply only to those not emaciated and with robust Qi/Blood. How can emaciated individuals be measured for needling? Examine, palpate, press, and adjust based on cold/heat and excess/deficiency. This is true adaptation.

Someone asks: The *Jin Zhen Fu* states: All Yang meridians run outside the vessels; all Yang collaterals run inside the vessels; all Yin meridians run inside the vessels; all Yin collaterals run outside the vessels. Is this correct?

I reply: The Classic states: Twelve Jing Meridians run hidden between muscle layers, deep and unseen. Vessels that float and are visible are all Luo Collaterals. It also states: Countable ones are Jing Meridians; uncountable ones are Luo Collaterals. It also states: Luo Collaterals cannot pass through major joints; they must travel via unique paths and re-enter the skin. (*Shi Si Jing Fa Hui* interprets branch vessels running between muscles as collaterals, implying collaterals are also hidden, pass through joints, and count towards the total length of sixteen zhang two chi, which seems erroneous). The Classic states: Hundred diseases begin in skin and hair; pathogens enter, pores open, and enter collaterals (blood collaterals, not major collaterals). Remaining there, they transmit... (Text gap). It never mentions Yin/Yang distinctions here. Moreover, Ying Qi runs inside vessels, Wei Qi outside. Ying Qi flows day and night; Wei Qi moves through Yang during day and Yin at night, as stated in *Su Wen* and *Nan Jing*. Now saying Yang meridians are outside, Yang collaterals inside, Yin meridians inside, Yin collaterals outside lacks Classical basis.

Someone asks: The *Fu* states men's Qi is early in the upper, late in the lower; women's Qi is early in the lower, late in the upper. Forenoon is early, afternoon is late. From... (Text gap). Evening needling causes Qi to rise. Is there evidence for this?

I reply: The Classic states: Ying Qi circulates the body fifty times day and night, meeting Wei Qi at Hand Taiyin at dawn. Wei Qi circulates outside vessels, twenty-five times through Yang during day and Yin at night, meeting Ying Qi at Hand Taiyin at dawn. Wang Ji comments: Wei Qi movement distinguishes only day and night... (Text gap) how can this serve as a model for humans?

Someone asks: The *Fu* states tonification/sedation methods: Men use thumb forward-left rotation for tonification on exhalation, backward-right rotation for sedation on inhalation, lifting for heat, inserting... (Text gap). Reverse this in the afternoon. Is this correct?

I reply: The Classic states: Forty-five days after Winter Solstice, Yang Qi slightly rises, Yin Qi slightly falls; forty-five days after Summer Solstice, Yin Qi slightly rises, Yang Qi slightly falls. This discusses... (Text gap). Examining *Su Wen* and *Nan Jing*, male and female organ/meridian/acupoint/Qi circulation is identical day and night. The *Fu* claims morning/afternoon and male/female tonification/sedation reversals contradict the Classics severely. Thus: Not knowing Yin/Yang reversal principles is a treatment error. It also states: Sedating excess requires needle-cold sensation; tonifying deficiency requires needle-heat sensation. Heat/cold is judged by needle sensation, not by lifting/inserting for gender.

Someone asks: Needling left-side points: twisting right makes Qi rise, twisting left makes Qi fall. Right-side points reverse. For tonification, exhale then inhale; for sedation, inhale then exhale. Is this method valid?

I reply: Meridians surround the body without left/right or up/down distinction. Current practices differ thus, implying left meridians differ from right, up from... (Text gap) coming. Exhale-tonify, inhale-sedate is consistent since ancient times; I need not comment.

Someone asks: Danxi said acupuncture methods are purely sedation without tonification. What does this mean?

I reply: The Classic states: Yang insufficiency is warmed by Qi; Yin insufficiency is tonified by flavor. Needles are made of stone/bone, having neither Qi nor flavor, breaking skin... (Text gap) is correct. It also states: Sedation uses Square (Fang) form; tonification uses Round (Yuan) form. This means: When Qi is full, Moon is full, Day is warm, Body is stable, Insert needle on inhalation, rotate on next inhalation, withdraw slowly on exhalation. Hence: Sedation uses Square, moving Qi. Tonification uses Round; Round means movement; movement means shifting. Promote stagnant Qi, shift unrecovered pulses. Promoting/shifting sounds like sedation. And examining *Su Wen*... (Text gap). Removing old excess generates new. Emperor asked: How to tonify/sedate? Qibo answered: This attacks pathogens. Quickly withdraw to remove excess blood and restore True Qi, hence called tonification. Yu Shi said: Though acupuncture has tonification/sedation methods, I fear there is only sedation, no tonification. Sedation opposes and drains incoming Qi to write excess. Tonification follows and supports outgoing Qi to retain it,未必 able to tonify. Otherwise, why does *Nei Jing* say: Form and Qi insufficient, Disease Qi insufficient, both Yin and Yang deficient, do not needle. Needling exhausts Qi further; the elderly perish, the strong do not recover. Such words imply only sedation, no tonification.