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When the weather is warm and the sun is bright, human blood becomes thin and fluid, and Wei Qi (Defensive Qi) floats on the surface; therefore, blood is easily discharged, and Qi movement is smooth. When the weather is cold and the sky is overcast, human blood becomes coagulated and sluggish, and Wei Qi sinks within. When the moon begins to wax, Blood and Qi begin to become refined, and Wei Qi starts to circulate. When the moon is full, Blood and Qi are abundant, and muscles are firm. When the moon wanes and becomes empty, muscles diminish, meridians and collaterals become deficient, Wei Qi departs, and the form exists alone. Therefore, one must regulate Blood and Qi according to the changes in heavenly timing. Thus, when the weather is cold, do not apply acupuncture; when the weather is warm, avoid causing stagnation (or: do not interfere with natural flow); when the moon is waxing, do not use reducing methods; when the moon is full, do not use tonifying methods; when the moon is empty, do not treat. This is called regulating according to the proper time. If reducing methods are used during the waxing moon, it is said to further deficiency of the Zang organs. If tonifying methods are used during the full moon, Blood and Qi will overflow, and stagnant blood will remain in the collaterals; this is called "double excess." If treatment is performed during the empty moon, it is said to disrupt the meridians, causing Yin and Yang to be confused, true pathogenic factors and evil pathogens indistinguishable, leading to deep retention and external deficiency with internal chaos, allowing excessive pathogens to arise. (From *Neijing*)

One must first assess the patient's body fatness or emaciation to regulate the deficiency or excess of Qi. For excess patterns, apply reduction; for deficiency patterns, apply tonification. One must first remove blood stasis from the vessels before regulating, regardless of the disease, aiming for balance. (From *Neijing*) ○ To tonify deficiency: First, palpate and follow the meridian pathway, press and disperse, push and massage, flick to make the area protrude, grasp and press down, unblock to obtain Qi, draw outward to close the pores and calm the Shen (Spirit). Insert the needle at the end of expiration, retain it quietly for a long time until Deqi (arrival of Qi) is achieved. Upon obtaining Qi, guide the patient to inhale while withdrawing the needle, ensuring Qi does not escape, keeping it at the site, pushing and closing the needle hole so that Shen Qi remains and substantial Qi stays; this is called tonification. ○ To reduce excess: Insert the needle during inspiration, preventing Qi rebellion. Retain it quietly for a long time to prevent the spread of pathogens. Rotate the needle during inspiration until Deqi is achieved. Upon obtaining Qi, guide the patient to exhale while withdrawing the needle, removing it completely at the end of expiration so that substantial Qi exits; this is called reduction. (From *Neijing*) ○ A skilled acupuncturist relies on the left hand, while an unskilled one relies on the right hand. At the time of needling, first use the left hand to press and anchor the Ying-Shu point, flick to make it protrude, and grasp to press down. When Qi arrives, it feels like a pulsating artery. Needle along the direction of Qi arrival. After Deqi, push the needle deeper; this is tonification. Move and withdraw the needle; this is reduction. (From *Nanjing*) ○ Tonification: Follow the meridian direction to insert the needle. The left hand closes the needle hole upon withdrawal, exiting slowly and pressing quickly. Reduction: Oppose the meridian direction, move and withdraw the needle. The left hand closes the needle hole upon withdrawal, exiting quickly and pressing slowly. Following the trend to assist is tonification; opposing the trend to deprive is reduction. (From *Nanjing*) ○ Needling deficiency requires achieving fullness (warmth/sensation of Qi arrival); needling excess requires achieving emptiness (coolness/sensation of Qi departure). Explanation: Needling excess to achieve emptiness means waiting for Yin Qi to arrive at the needle tip, feeling cold, then removing the needle. Needling deficiency to achieve fullness means waiting for Yang Qi to arrive at the needle tip, feeling warm, then removing the needle. Note: The key is effectiveness through Deqi. (From *Neijing*) ○ Observing Qi has two types: one is Pathogenic Qi, the other is Grain Qi (Genuine Qi). Pathogenic Qi arrives tight and rapid; Grain Qi arrives slow and harmonious. Tight and rapid indicates tonification has not yet made it solid, or reduction has not yet made it empty. Slow and harmonious indicates tonification has easily made it solid, or reduction has easily made it empty. ○ For a solid pulse, needle deeply to drain Qi; for a deficient pulse, needle shallowly to prevent Essence-Qi from escaping and to nourish the meridians, expelling only the pathogenic Qi. (From *Lingshu*) ○ Heavy pressing with the left hand disperses Qi; light and slow insertion with the right hand prevents pain. (From *Zhenjiu Dacheng*)