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Chapter 80 states: The classic texts mention "seeing as entering, seeing as exiting." What does this mean?

The response is: By "seeing as entering," it refers to inserting the needle only when the practitioner's left hand perceives the arrival of Qi (vital energy). By "seeing as exiting," it refers to withdrawing the needle only after perceiving that the Qi has dissipated. This is what is meant by "seeing as entering" and "seeing as exiting."

This discussion concerns the insertion and withdrawal of needles, emphasizing that one must observe whether the Qi has arrived or dissipated before proceeding with insertion or withdrawal. When the classics say "seeing as entering, seeing as exiting," they mean that whenever one intends to puncture, one should first press the acupoint with the left hand, wait for the Qi within the point to arrive, and then insert the needle. After insertion, one waits until the Qi is exhausted before withdrawing the needle. This is not the method of Ying-Sui Bu-Xie (a tonification and sedation technique based on the direction of meridian flow and deficiency/excess conditions). Hua Shou (Hua Shi) stated: Below the phrase "so-called seeing as entering," the four characters "seeing as exiting" are likely missing. The character "Ru" (如) is read as "Er" (而, indicating sequence), as seen in the *Mencius* where "looking at the Way but not yet seeing it" uses "Er" pronounced as "Ru"; thus, they were used interchangeably.

Chapter 81 states: The classic texts say, "Do not reinforce excess nor deplete deficiency; do not damage what is insufficient nor benefit what is already abundant." Does this refer to the Cun Kou pulse, or does it refer to the inherent deficiency and excess of the disease itself? How should these tonifications and sedations be applied?

The response is: This refers to the disease itself, not the Cun Kou pulse. For example, if the Liver is in a state of Excess and the Lungs are in a state of Deficiency: The Liver corresponds to Wood, and the Lungs correspond to Metal. Metal and Wood should mutually regulate each other. One should understand how Metal regulates Wood. If the Lungs are in Excess and the Liver is in Deficiency, manifesting as slightness of Qi, and the practitioner uses acupuncture without tonifying the Liver but instead further reinforcing the Lungs, this is called "reinforcing excess and depleting deficiency," damaging the insufficient and benefiting the abundant. This causes harm through the actions of average physicians.

These words from the classic texts originate from *Ling Shu: Nine Needles and Twelve Origins*. The principle of treating diseases aims for balance: tonify deficiency, sedate excess, augment what is lacking, and reduce what is abundant. If an excess condition is suitable for sedation but is treated with tonification; if a deficiency condition is suitable for tonification but is treated with sedation; if what is lacking is damaged rather than augmented, and what is abundant is benefited rather than reduced—all these constitute misdiagnosis and mistreatment. Therefore, it is said: "Do not reinforce excess, do not deplete deficiency, do not damage the insufficient, do not benefit the abundant." However, regarding the terms deficiency and excess mentioned here, it is unclear whether they refer to the pulse or the disease symptoms. Hence the question: "Does this refer to the Cun Kou pulse, or does the disease itself have deficiency and excess? How should the principles of reduction and augmentation be applied in treatment?" Thus it asks, "What are the principles of reduction and augmentation?" But this does not refer to the deficiency and excess of the pulse, but rather the inherent deficiency and excess of the disease itself. Hence it says: "This refers to the disease, not the Cun Kou pulse."

If the Liver is in Excess and the Lungs are in Deficiency, Metal lacks the strength to regulate Wood. One should understand to sedate the South (Heart/Fire) and tonify the North (Kidney/Water), employing indirect treatments such as "separating two" or "separating three" (treating related organs indirectly). Only then can Metal and Wood achieve balance again. Conversely, if the Lungs are in Excess and the Liver is in Deficiency, one should suppress Metal and support Wood. Crude practitioners fail to grasp this; knowing not to tonify the Liver, they instead further reinforce the Lungs. In doing so, the Lungs become more excessive and the Liver more deficient. This not only shows ignorance of indirect treatment methods but also an inability to distinguish between deficiency and excess, resulting in damaging the insufficient and benefiting the abundant. This not only fails to cure the disease but harms the patient. Therefore, it is reiterated: "Reinforcing excess and depleting deficiency, damaging the insufficient and benefiting the abundant—this is the harm caused by average physicians." Although this chapter discusses acupuncture tonification and sedation, it essentially serves as the summary and guideline for the entire volume. Physicians must not make even the slightest error regarding deficiency and excess; if they do, the harm occurs as quickly as flipping a hand. Therefore, Bian Que (Yue Ren) did not hesitate to repeat his admonitions earnestly.

Someone asked: *Nan Jing* questions the meanings of *Nei Jing*, yet the matters worthy of questioning in *Nei Jing* are not limited to these. Why did Yue Ren specifically address up to Chapter 81? The answer is: Laozi stated, "The Dao produced One, One produced Two, Two produced Three, Three produced All Things." Multiplying nine by nine yields eighty-one chapters. Yang Xiong’s *Tai Xuan* divides one Yuan into three Fangs, leading to nine, which accumulates to eighty-one sections. *Su Wen: Discussion on Separating True and Evil* contains eighty-one chapters derived from the Huang Zhong pitch-pipe number. Ancient texts often use eighty-one as a numerical standard, originating from this concept. Although the language is concise, the principles are comprehensive, covering diagnostic methods, meridians, zang-fu imagery, pathological capabilities, acupoints, and needling techniques. Concepts such as pulses having roots, humans possessing Yuan Qi, males originating in Yin month, females in Shen month, wood being heavy/sinking, metal being light/floating, metal originating in Si, water originating in Shen, sedating South Fire, and tonifying North Water—these theories are not found in *Ling Shu* or *Su Wen* but serve to supplement the canonical texts. Diagnostic methods focusing solely on the Cun Kou divided into three positions are concise and easy to understand, serving as an enduring model. Examining the rhetorical questions, most citations of "the classics" come from *Su Wen* and *Ling Shu*, though some appear nowhere in these two works, likely extracted from ancient medical texts. Thus, *Nan Jing* stands in intimate relation to *Nei Jing* and should not be viewed separately. With deep study and exploration of its intent, although one may not fully penetrate the complexities of the five zang organs, one will have grasped more than half of the knowledge.

This concludes Volume Six, Chapters 69 to 81, discussing needling techniques.