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Huangdi asked Qibo, saying: "I nurture the myriad people, comfort the commoners, and collect their taxes. I pity them for not living out their natural lifespan and suffering from diseases. I wish to prevent them from being harmed by toxic medicines and avoid using bian stones (a type of stone medical tool). Instead, I intend to use fine needles to unblock the meridians, regulate qi and blood, and ensure that Ying and Wei Qi circulate normally at their intersections of reversal, smooth flow, entry, and exit, so that this method can be passed down to future generations. (Note: The methods for treating diseases vary across the five directions. Now, the Sage evaluates what is appropriate and combines them to achieve perfect results, hence the following discussion. 'Zi' refers to the Sage's love for the commoners, akin to loving one's own infant. Internal evil injuries lead to various diseases, preventing a full natural life. If treated with toxic medicines or bian stones, skin and internal organs may be damaged; whereas nine types of fine needles can unblock meridians and regulate qi, allowing transmission to descendants.)

One must clearly establish relevant laws and regulations, ensuring they endure without extinction, lasting long and being easy to use yet difficult to forget. (Note: Here, 'laws and regulations' refer to the principles of the *Classic of Acupuncture*.)

It should be established as a standard. (Note: It can serve as the standard for fine needle therapy.)

Chapters and sections should be distinguished. (Note: These can form the chapters and sections of fine needle treatment.)

Exterior and interior relationships should be differentiated. (Note: Take the Shu points of the Six Fu Organs as Exterior, and the Shu points of the Five Zang Organs as Interior.)

A beginning and an end should be established. (Note: The number of fine needles starts from one and ends with nine.)

Each needle should have a specific shape. First, establish the *Classic of Acupuncture*. I wish to hear the details. (Note: To apply the first five methods, each must have its specific form. To establish the foundation of these five needles, one must follow the principles of the *Classic of Acupuncture*. Therefore, let us first establish the *Classic of Acupuncture*, and I wish to hear the detailed description of the Dao of Needling.)

Qibo replied: "Please allow me to deduce them in order, establishing a framework starting from one and ending with nine. Let me explain the Dao." (Note: 'Ci zhi' refers to deducing the sequence of the Nine Needles and organizing the framework.)

The essence of the small needle is easy to state but difficult to master thoroughly. Crude practitioners focus only on physical forms, while skilled practitioners focus on Shen (Spirit/Energy). How profound! The pathogenic factor resides at the gate. Before observing the illness, one must know its source. The subtlety of needling lies in the speed—fast or slow. Crude practitioners guard only the joints of the limbs, while skilled practitioners grasp the movement of Qi. The movement of Qi does not depart from emptiness. The Qi in the void is clear, quiet, and subtle. When the pathogen comes, do not meet it head-on; when it goes, do not pursue it. Those who understand the Dao of Qi will not err by even a hair's breadth; those who do not understand will not even perceive the arrival of Qi. Knowing the coming and going of Qi requires timing. Crude practitioners are ignorant and obscure; only skilled practitioners possess this ability. The departing Qi is Ni (Reversal), the arriving Qi is Shun (Smoothness). Clearly knowing Reversal and Smoothness, proceed correctly without hesitation. Meeting and draining (Ying Er Duo Zhi) leads to deficiency; chasing and supplementing (Zhui Er Ji Zhi) leads to excess. (Note: However, the essentials of the Nine Needles below will be explained in the subsequent commentary.) Meeting and following, harmonized by intention, completes the Dao of Needling. (Note: Observe Reversal and Smoothness through Yin and Yang; implement Draining and Supplementing through Ying and Sui.)

In general, the principle of using needles is: For deficiency, use supplementation to make it solid; for excess, use draining to empty it; for stagnant blood and old accumulation, remove it; for prevailing pathogenic factors, weaken them. The summary states: Slow insertion and rapid withdrawal constitute Supplementation; rapid insertion and slow withdrawal constitute Draining. Speaking of Excess and Deficiency, it seems present yet absent; observing sequence, it seems lost yet existing. Treating Deficiency and Excess feels like gaining and losing. (Note: This means that by mentally regulating Supplementation and Draining, the Dao of Needling can be fully understood.)

The key to Excess and Deficiency lies in the Nine Needles, which are most excellent. The timing of Supplementation and Draining relies on the needle. (Note: Among therapies in the five directions, none is prior to acupuncture; thus, Supplementation and Draining are performed via needles.)

Draining: One must hold the needle upon insertion, release it upon withdrawal, shake it, push away the Yang aspect, withdraw rapidly, and allow the pathogenic Qi to escape. (Note: In all draining methods, insert the needle steadily, release it upon withdrawal, shake the needle body, push away Yang Qi, and withdraw the needle from the Yang layer so that disease Qi escapes. This is called Draining.)

Supplementation: Press the acupoint and guide the needle; this is called 'Internal Warmth'. Blood must not scatter, and Qi must not escape outward. (Note: Use your hand to press the needled area. After guiding the needle, warmth gathers internally. Hold the needle with your mind, preventing Ying Blood from scattering and closing the exterior gate to prevent Wei Qi from escaping. This is called Supplementation.)

Supplementation: Follow the Qi, acting as if forgetting. Move like walking or hesitating, like a mosquito or horsefly biting. (Note: Move the needle slightly with respiration. 'Xing' (walking) implies moving forward; 'Hui' (regret/hesitation) implies stopping. The needle is in the skin, moving slightly back and forth, like a mosquito landing, causing slight sensation in the skin.)

Like staying and returning. (The needle remains in the skin, seeming to stay, while the person seems to return. This describes the state of waiting for Qi.)

Withdraw the needle swiftly, like breaking a string. (After obtaining Qi, withdraw immediately. This supplements Yin... Upon obtaining Qi during supplementation, withdraw quickly, described as swift as a broken string.)

Let the left belong to the right, so the Qi stops. (Left hand presses the acupoint, right hand manipulates the needle; internal Qi is supplemented. Right hand withdraws, left hand seals the pore, ensuring Qi continues without interruption. 'Shu' connects to 'Xu' meaning continuity.)

Once the exterior gate is closed, the internal Qi becomes solid. ('Kong' [pore] is the exterior gate. After supplementation, leakage ceases, so internal Qi becomes solid.)

Do not leave blood; urgently remove it. (Supplementation retains Zheng Qi, not allowing pathogenic blood to remain. Stagnant pathogenic blood can be punctured away, hence 'urgently purge'.)

The way to hold the needle requires firmness to ensure solidity. (If holding the needle is not firm, Qi scatters and does not follow the needle.)

Point straight and pierce vertically; the needle must not deviate left or right. (To hit the disease, if the needle enters incorrectly off the acupoint, the disease will not heal.)

Focus your spirit on the tip of the finest hair. (Autumn Hao refers to the fine new hairs of a rabbit in autumn, sharp and minute. Focusing spirit on the needle tip to regulate Qi is why it says 'Spirit is at the Autumn Hao'.)

Attend to the patient. (Focus on the absence of pathogenic factors under the needle.)

Examine the blood vessels; puncture without danger. (Examine the excess and deficiency of the Twelve Meridians and collateral vessels; puncture without peril. 'Dai' means danger.)

At the time of needling, observe the Xuan Yang (nose) and Liang Heng (areas above the eyebrows). Keep your spirit focused, knowing whether the disease survives or perishes. (Since 'at the time of needling' refers to observing complexion first. 'Xuan Yang' is the nose, hanging below the 'Heng'. The nose is the Ming Tang, where the complexions of the Five Zang and Six Fu organs appear, including the areas above the eyebrows. Thus, the practitioner observes complexion to determine prognosis before needling.)

Where blood resides, collaterals lie horizontally. Visually, they appear full; palpating, they feel uniquely hard. (Blood vessels and collaterals. Collaterals lying horizontally within Shu points appear full upon viewing and hard upon palpation; these are horizontal collaterals.)

Qi resides in the meridians. Pathogenic Qi is in the upper part, turbid Qi in the middle, and clear Qi in the lower part. Therefore, needling deep veins expels pathogenic Qi; needling mid-level veins expels turbid Qi. Needling too deeply causes pathogenic Qi to sink further, worsening the disease. Thus, skin, flesh, sinews, and bones each have their proper locations, diseases have their specific containment, and needles have their specific suitability, all different. Each form serves its appropriate purpose. Do not tonify excess, do not drain deficiency. Do not harm without benefit. Having excess is called severe disease, worsening the condition. Puncturing the Five Pulses leads to death; puncturing the Three Pulses... Depriving Yin leads to death; depriving Yang leads to mania. The harm of needling reaches its peak here. ('Qu' sounds like 'fang fan', meaning timid. Low Qi causes timidity. 'Harm of needling' refers to the severe prohibitions mentioned earlier.)

If Qi does not arrive after needling, regardless of the number of manipulations, wait until Qi arrives, then stop; do not needle again. Each needle has its suitability, differing in form, serving its purpose. The essence of needling is that effectiveness follows the arrival of Qi. The sign of effectiveness is like wind blowing clouds away, revealing the blue sky. The Dao of Needling is complete. (If Qi does not arrive, supplementation and draining cannot occur. Thus, manipulate the needle to await Qi, regardless of count. Once Qi arrives and supplementation/draining is performed, withdraw the needle. The disease heals quickly, likened to bad winds blowing clouds to reveal the clear sky.)

Huangdi said: "I wish to hear about the origins of the Five Zang and Six Fu organs." Qibo said: "The Five Zang have five Shu points, totaling twenty-five. The Six Fu have six Shu points, totaling thirty-six. There are twelve Meridian Qi and fifteen Collateral Qi, totaling twenty-seven Qi moving up and down. Where they emerge are Jing (Well) points; where they trickle are Ying (Spring) points; where they pour are Shu (Stream/Transport) points; where they flow are Jing (River) points; where they enter are He (Sea) points. (All twenty-seven Qi movements have Five Shu points.)"

There are 365 junctions. Knowing the essence allows one to conclude with a single word; not knowing the essence leads to endless dispersion. The 'junctions' referred to are where Shen Qi travels, enters, and exits—not merely skin, flesh, sinew, or bone. Observe the complexion, examine the eyes, to know if Qi is scattered or restored. Unify the form, listen to movements, to know if it is pathogenic or healthy. The right hand pushes forward, the left hand supports and holds. Withdraw when Qi arrives. Generally, to use needles, one must first diagnose the pulse, assess the severity and ease of the Qi condition, and then treat the disease.

If the Qi of the Five Zang is exhausted internally, and the practitioner tonifies the exterior, this is called Double Exhaustion. Double Exhaustion leads to certain death, characterized by stillness. If the practitioner reverses this by taking the axillary and chest regions, it exacerbates the error. If the Qi of the Five Zang is exhausted externally, and the practitioner tonifies the interior, this is called Reverse Jue. Reverse Jue leads to certain death, characterized by restlessness. If the practitioner mistakenly treats the four extremities, it worsens the condition. (This emphasizes that needling must be preceded by diagnosis.)

The harms of needling: If the needle hits the target but is not withdrawn, Essence leaks; if it misses the target and is withdrawn, it causes Qi stagnation. Essence leakage worsens the disease... Qi stagnation generates carbuncles and ulcers. (Hitting the Essence instead of the disease causes leakage; missing the disease leaves residual Qi, forming carbuncles. Essence leakage worsens the disease...)