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Experts in acupuncture do not rely on pulse diagnosis but determine the condition by listening to the patient's description. (According to the *Needle Canon: True and Evil of Acupuncture* chapter, there are five levels of needling: one is "Shaking Dust" (clearing stagnation of superficial yang qi); two is "Opening Blindness" (eliminating obstruction in the head and eyes); three is "Removing Claws" (treating limb joint lesions); four is "Removing Clothes" (relieving systemic cold-heat disorders); five is "Resolving Confusion" (harmonizing yin and yang to clarify the condition). These are the general principles of needling, the ultimate technique, belonging to the realm of divine clarity. Thus it is said that "acupuncturists do not diagnose," meaning the subtlety of needling lies in its divine and clear understanding, knowing the location of the disease without waiting for pulse diagnosis. This chapter lacks dialogue but is called a "Treatise" because Bo Gao, following the previous chapter, supplemented the unfinished discussions of the *Acupuncture Sections* chapter, which were later recorded by others. Hence it is titled "Long Treatise on Acupuncture Sections." Master Yu states: The qi of all yang meridians gathers at the head, while the shu points of the three yin meridians are located on the back. If a patient complains of headache, the disease is known to be in the yang aspect, and points on the head are selected; if a patient complains of chills and fever, the disease is known to be in the yin aspect, and points on the back are selected. For abdominal masses, abdominal points are selected; for tendon spasms and pain, tendon areas are treated; for muscle pain, muscles are needled; for heavy and sore bones, the bone level is reached. These are methods of selecting needling sites according to the disease, knowing the location without examination. Thus it is said "acupuncturists do not diagnose but listen to the patient," referring to the inspection and inquiry methods beyond observation and palpation.)

If the disease is in the head and causes severe pain, the needle should be concealed and inserted deeply to the bone; the disease will resolve. Care must be taken not to damage the flesh or skin above. The skin is the pathway for the needle. (This is due to the great rebellion of yang qi, causing severe pain in the head. "Conceal" means hiding the needle body during deep insertion. Since the scalp is thin and easily reaches the bone, needling to the bone does not injure the bone; shallow needling avoids damaging the skin. The skin is the entry path; the needle must pass through it. Shallow needling injures the skin, deep needling injures the bone, and intermediate depth injures the muscle. This indicates that depth depends on intent, making head needling particularly difficult. Mastering the difficult makes the easy manageable. According to the first chapter of *Ling Shu: True and Evil of Acupuncture*, yang qi rebels greatly, filling the chest. Yang qi rises from the diaphragm, either filling the chest or rebelling upward to the vertex. This supplements the *Ling Shu*, and the principle applies to subsequent diseases.)

Use the "Yin Needling" method: insert one needle centrally and four needles obliquely around it to treat cold-heat disorders. If the disease is deep and localized in the zang organs, target the major zang organs by needling near the back shu points. Needling near the zang organs connects with the zang qi, resolving abdominal cold-heat. This aligns with the essential needling technique: withdraw the needle allowing slight bleeding. (This discusses treating cold-heat disorders using Yin Needling. The method involves one central and four surrounding needles. Deep and localized disease indicates involvement of the zang organs. Needling the major zang organs requires approaching the back shu points. Stimulating the shu points near the zang organs allows zang qi to interact with the needle, resolving abdominal cold-heat. This matches the technique in *Ling Shu: Official Needles*, which describes twelve needling techniques corresponding to the twelve meridians. The fifth is "Yang Needling" (one central, four surrounding, shallow) for widespread cold qi. The tenth is "Yin Needling" (symmetrical left-right needling) for cold reversal at the medial malleolus (Shaoyin meridian). Here, Yin Needling targets the Shaoyin shu point, using Yang Needling technique for cold-heat disorders, harmonizing conflicting cold and heat. Yang Junli notes this supplements the twelve techniques.)

To treat abscesses and ulcers, puncture the necrotic area, assessing size and depth. Large abscesses require shallow needling for abundant drainage; small ones require deeper needling. Insert the needle steadily, stopping once pus and blood are evacuated. (Necrosis refers to tissue decay forming pus and blood. Assess size to determine depth. Large abscesses have more pus/blood, suitable for shallow needling for easy drainage. Small abscesses have internalized toxins not yet ruptured, requiring deeper needling. Steady insertion prevents damage to healthy tissue. Stop when blood/pus is reached. *True and Evil of Acupuncture* suggests using a nine-edged needle for large abscesses and a round-sharp needle for small ones, differing slightly here.)

For masses in the lower abdomen, needle below the skin down to the lower abdomen. Needle between the fourth thoracic vertebrae on both sides of the spine, and between the iliac bones and costal margins. This guides heat qi downward to resolve the condition. ("HT" refers to thick muscle areas. Observe thick muscle regions below the lower abdomen for insertion. Abdominal masses manifest externally. Palpate the lower abdomen to locate the mass. The space between the fourth thoracic vertebrae corresponds to the Gaohuang acupoint. The origin of Huang (Epididymis/Bladder) qi is below the navel. The ilium is the hip bone; the area between the ilia and costal margins follows the Foot-Shaoyang Gallbladder Meridian. Lower abdominal masses involve Liver and Kidney pathology; thus, the Shaoyang meridian is used to guide heat out.)

For lower abdominal pain with inability to urinate or defecate, named "Hernia" (Shan), caused by cold. Needle between the lower abdomen and groin, and between the waist and ankle. Retain the needle until warmth is felt throughout. (Jiong means heat. This describes Jueyin Cold Hernia. The Liver governs free flow; rebellious Liver qi causes urinary/fecal retention. Cold hernia causes lower abdominal pain radiating upward. The groin and ankle-waist area follow the Jueyin Liver Meridian. Retain the needle until local warmth resolves the condition.)

For tendon diseases with spasms and joint pain preventing walking, named "Tendon Bi" (Obstruction). Needle the tendons, inserting into the intermuscular spaces, avoiding the bone. Stop when the tendon feels warm and symptoms resolve. (Tendons connect to joints; spasms cause immobility. "Bi" means obstruction and pain. "Gu" implies causality. Needling the tendon within the intermuscular space, avoiding bone, relaxes the tendon. Warmth indicates resolution.)

For skin and muscle diseases with generalized pain, named "Muscle Bi," caused by cold-dampness. Needle large and small intermuscular spaces, using multiple deep needles until warmth is achieved. Avoid damaging sinews and bones; injury may cause abscesses or complications. Stop when all intermuscular spaces feel warm. (Cold dominates causing painful Bi; dampness dominates causing fixed Bi. Intermuscular spaces contain 365 acupoint intersections. Deep needling targets these. Injury to sinews/bones mimics wind-cold changes, causing swelling. Warmth indicates Qi arrival and resolution.)

For bone diseases with heaviness, inability to lift limbs, and marrow soreness due to cold, named "Bone Bi." Deep needling is required, avoiding vessels and muscles. Follow the path through intermuscular spaces. Stop when bone warmth is felt. (The Kidney governs bones and cold water qi. Deep needling targets bone Qi via intermuscular pathways. Warmth indicates resolution.)

For diseases affecting Yang meridians with alternating cold and heat in meridians and intermuscular spaces, named "Mania" (Kuang). Reduce the pulse by needling; stop when intermuscular spaces feel hot. (Yang excess causes mania. Pathogens enter from skin/muscle to meridians. Yang pathogens in muscles enter Yang meridians, causing alternating cold/heat. Needling reduces Yang excess, allowing pathogens to exit via muscles. Heat indicates dispersion.)

If a disease starts with annual attacks, progresses to monthly, then frequent attacks (4-5 times/month), it is named "Dian Disease" (Epilepsy/Melancholia). Needle various intermuscular spaces and meridians. For cases without cold signs, regulate with needles. Stop when cured. (Chronic rebellion generates Dian disease. Progression from annual to frequent attacks requires needling abnormal areas in muscles and meridians. Yin excess causes Dian. Wait for external cold signs; if absent, regulate with needles. Lu Lianghou notes: wait for heat in cold conditions and vice versa, observing Yin-Yang shifts. This demonstrates subtle needling variations.)

For wind diseases with alternating cold and heat and sweating several times daily, first needle interstitial collaterals. If sweating persists with cold/heat, needle every three days until cure after 100 days. (Wind pathogens cause alternating cold/heat via pore opening/closing. Sweating indicates pathogen expulsion. Needling collaterals facilitates this. Persistent symptoms require spaced needling to expel pathogens via sweat.)

For severe wind disease ("Da Feng") with heavy joints and loss of eyebrows/beard, needle muscles until sweating occurs for 100 days, then needle marrow until sweating occurs for another 100 days. Total 200 days; stop when hair regrows. (Severe wind enters from muscles to marrow, causing joint heaviness and hair loss due to Chong/Ren vessel damage. Muscle needling induces sweat for 100 days; marrow needling for another 100 days. Hair regrowth signals cure. Wind in collaterals cures in 100 days; deep marrow involvement doubles the time. 100 days represents a major Qi cycle. Lu Lianghou warns against injuring marrow unnecessarily, noting that targeted treatment avoids harm despite deep toxicity.)