补法∶
左手掐穴，右手置针于穴上，令病患咳嗽一声，针入透于腠理，令病患吹气一口，随吹
分寸，待针头沉紧时，转针头以手循扪，觉气至，却回针头向下，觉针头沉紧，令病患吹气
一口，随吸出针乃闭其穴（谓一手急然孔是也。）虚羸气弱痒麻者补之。
泻法∶
左手掐穴，右手置针于穴上，令病患咳嗽一声，针入腠理，复令病患吸气一口，随吸气
至分寸，觉针沉紧，转针头向病所，觉气至病退，便转针头向下，以手循扪，觉针沉闷，令
病患吹气一口，随吹气一口，徐出其针不闭其穴，命之曰泻。丰肥坚硬疼痛者泻之。
素问泻必用方补必用员
夫泻必用方，以气方盛也，以月方满也，以日方温也，以身方定也，以息方吸而内针。
及复后其方吸而转针，及复后其方呼而徐引针，故曰泻。
夫补必用员，员者行也，行者移也。行谓行不宣之气，移谓移未复之脉。故刺必中其荣
，及复后吸而推针至血，故员与方非针也。余不知圣人之意，请后之明达之士详究焉。
春夏刺浅秋冬刺深
《内经》曰∶病有浮沉，刺有浅深，各正其理，无是其道。然春夏为阳，其气在外，人气亦
浮，凡刺者，故浅取之。秋冬为阴，其气在内，人气在脏，凡刺者，故当深取之。又言∶春夏
各致一阴，秋冬各致一阳。秋冬各致一阳者，谓春夏为阳，谓阴所养，故刺之各致一阴。秋
冬为阴，谓阳所养，故刺之各致一阳。春夏温必致一阴者，谓下针深刺至肾肝之部，得其气
针便出之，是
以引持之阴也。秋冬寒必致一阳者，谓下针浅刺至心肺之部，得气推而内之良久出针，是
推内之阳也。故《素问》曰∶春夏养阳，秋冬养阴也。
呼吸补泻
补泻者，言呼吸出内以为其法。然补之时，从卫取气也。取者，言其有也。《素问》曰∶必
先扪而循之，切而散之，推而按之，弹而弩之，爪而下之，通而取之。外别其门，以闭其神
呼尽内针，静以久留。以气至为故，如待贵宾，不知日暮，其气以至，适而自护。候吸引针
，气不得出，各在其处，推阖其门，令神气存，大气留止，故命曰补，是取其气而不令气大
出也。当泻之时，从荣置气也，置其气而不用也。故《素问》曰∶吸则内针，无令气忤，静
以久留，无令邪有。吸则转针，以得气为故，候呼引针，呼尽乃去，大气皆出，故命曰泻。
泻者，是置其气而不用也。若阳气不足，而阴血有余者，当先补其阳，而后泻其阴。阴血不
足而阳气有余者，当先补其阴，而后泻其阳。以此则阴阳调和，荣卫自然通行，此为针之要也。
寒热补泻
假令补冷，先令病患咳嗽一声，得入腠理。复令病患吹气一口，随吹下针，至六七分，
肾肝之部，停针。徐徐良久复退针一豆许，乃捻针，问病患觉热否？然后针至三四分，及心肺
之部，又令病患吸气内针，捻针，使气下行至病所。却外捻针，使气上行，直达所针穴一二
寸，乃吸而外捻针出，以手速按其穴，此为补。
夫病后热者，治之以寒也何如？须其寒者，先刺入肠之分，后得气推内至阴之分。复令病患
地气入而天气出，谨按生成之息数足，其病患自觉清凉矣。夫病恶寒者，治之以热也何如？
须其热者，先刺入阴之分，后得气徐引针，至阳之分，复令病患天气入而地气出，亦谨按生
成之息数足，其病患自觉知暖矣。
生成数法（生五加）
冷补之时，使气至病，更用生成之息数，令病患鼻中吸气出，自觉热矣。
当热泻之时，使气至病，更用生成之息数，令病患鼻中出气，口中吸气，按所病脏腑之
数，自觉清凉矣。
手指补泻
经云∶凡补泻，非必呼吸出内，而在乎手指何谓也。故动、摇、进、退、搓、盘、弹、
捻、循、扪、摄、按、爪、切者是也。今略备于后∶
动∶动者，如气不行，将针伸提而已。
退∶退者，为补泻欲出针时，各先退针一豆许，然后却留针，方可出之，此为退也。
搓∶搓者，凡令人觉热，向外针似搓线之貌，勿转太紧。治寒而里卧针，根据前转法，以为搓也。
进∶进者，凡不得气，男外女内者，及春夏秋冬各有进退之理，此之为进也。
盘∶盘者，为如针腹部，于穴内轻盘摇而已，为盘之也。
摇∶摇者，凡泻时，欲出针，必须动摇而出者是也。
弹∶弹者，凡补时，可用大指甲轻弹针，使气疾行也。如泻，不可用也。
捻∶捻者，以手捻针也。务要识乎左右也，左为外，右为内，慎记耳。
循∶循者，凡下针于属部分经络之处，用手上下循之，使气血往来而已是也。经云∶推之则行，引之则止。
扪∶扪者，凡补时，用手扪闭其穴是也。
摄∶摄者，下针如气涩滞，随经络上，用大指甲上下切其气血，自得通行也。
按∶按者，以手捻针无得进退，如按切之状是也。
爪∶爪者，凡下针用手指作力置针，有准也。
切∶切者，凡欲下针，必先用大指甲左右于穴切之，令气血宣散，然后下针，是不伤荣卫故也。
迎随补泻
经云∶东方实而西方虚，泻南方而补北方，何谓也？此实母泻子之法，非只刺一经而已
。假令肝木之病实，泻心火之子，补肾水之母，其肝经自得其平矣。五脏皆仿此而行之。
补法：
左手掐按穴位，右手将针置于穴上，让患者咳嗽一声，进针穿透至腠理（皮肤与肌肉之间的间隙），让患者吹气一口，随着吹气的动作进针一定深度，等到针下感觉沉紧时，转动针头并用手循扪（顺着经络方向抚摸按压）穴位，感觉到经气已至，然后将针头向下转，再次感觉针下沉紧，让患者吹气一口，随着吸气拔出针，随即闭合其穴位（即一只手迅速按住针孔）。对于身体虚弱、气血不足、出现瘙痒麻木症状的患者，采用补法。
泻法：
左手掐按穴位，右手将针置于穴上，让患者咳嗽一声，进针至腠理，再让患者吸气一口，随着吸气的动作进针一定深度，感觉针下沉紧，转动针头指向病所（病变部位），感觉到经气已至且病邪退去，便将针头向下转，用手循扪穴位，感觉针下沉闷，让患者吹气一口，随着吹气的动作缓慢拔出针，不闭合其穴位，这叫做泻法。对于身体肥胖、坚硬、疼痛的患者，采用泻法。
《素问》说：泻法必须用“方”，补法必须用“圆”。
所谓泻法必须用“方”，是因为此时正气正盛，月亮正满，日子正温暖，身体正安定，在患者吸气时进针。等到后来，在患者吸气时转针，在患者呼气时缓慢拔针，所以称为泻。
所谓补法必须用“圆”，“圆”代表运行，“行”代表移动。所谓“行”是指运行不通畅的气血，所谓“移”是指移动尚未恢复的脉气。所以针刺必须中其荣穴（指血脉深处），等到后来在吸气时将针推入至血分，所以“圆”与“方”并非指针的形状。我不明白圣人的本意，请后世明达之士详细探究吧。
春夏浅刺，秋冬深刺
《内经》说：疾病有浮在表、沉在里的区别，针刺就有浅有深，各自遵循其道理，没有固定的法则。然而春夏属阳，阳气在外，人气也浮于体表，凡针刺者，故应浅取之。秋冬属阴，阳气在内，人气在脏腑，凡针刺者，故应当深取之。又说：春夏各致一阴，秋冬各致一阳。所谓秋冬各致一阳，是说春夏为阳，但其中涵养着阴，所以针刺时要各致一阴。所谓春夏各致一阴，是说秋冬为阴，但其中涵养着阳，所以针刺时要各致一阳。春夏温热必致一阴的方法，是说下针深刺至肾肝的部位，得到经气后便出针，这是引导阴气的方法。秋冬寒冷必致一阳的方法，是说下针浅刺至心肺的部位，得气后推动针深入留置较长时间再出针，这是推内阳气的方法。所以《素问》说：春夏养阳，秋冬养阴。
呼吸补泻
补泻，是指利用呼吸进出作为方法。补的时候，是从卫分取气。所谓取，是指获取。《素问》说：必须先扪而循之，切而散之，推而按之，弹而弩之，爪而下之，通而取之。辨别其门户，以闭护神气。呼尽时进针，安静地长久留针。以气至为度，如同等待贵宾，不知日暮，待气至，适当自护。候吸气时拔针，使气不得外出，各在其处，推阖其门，令神气留存，大气留止，所以叫作补，这是取其气而不令气大量外泄。当泻的时候，是在荣分放置气，放置其气而不用它。所以《素问》说：吸气时进针，不让气逆乱，安静地长久留针，不让邪气停留。吸气时转针，以得气为度，候呼气时引针，呼尽乃去，大气皆出，所以叫作泻。泻，就是放置其气而不用它。如果阳气不足，而阴血有余，应当先补其阳，而后泻其阴。如果阴血不足而阳气有余，应当先补其阴，而后泻其阳。这样阴阳调和，营卫自然通行，这是针刺的要领。
寒热补泻
假如要补冷（治疗寒证），先让患者咳嗽一声，进针至腠理。再让患者吹气一口，随着吹气下针，至六七分深，到达肾肝的部位，停针。徐徐良久后退针约一豆许的距离，然后捻针，询问患者是否感觉热？然后再进针至三四分深，到达心肺的部位，又让患者吸气进针，捻针，使气下行至病所。然后向外捻针，使气上行，直达所针穴一二寸，然后吸气时向外捻针出针，用手迅速按压穴位，这叫作补。
大病之后发热，用寒凉的方法治疗怎么样？需要产生寒感时，先刺入肠的分部，后得气后推内至阴的分部。再让患者地气入而天气出，谨慎按照生成之息数足，患者自觉清凉了。如果病人怕冷，用温热的方法治疗怎么样？需要产生热感时，先刺入阴的分部，后得气后缓慢引针，至阳的分部，再让患者天气入而地气出，也谨慎按照生成之息数足，患者自觉暖和了。
生成数法（生五加）
补冷之时，使气至病所，再用生成之息数，让患者鼻中吸气出（注：此处原文可能有误或特指某种呼吸配合，通常理解为通过呼吸调节），自觉热了。
当热泻之时，使气至病所，再用生成之息数，让患者鼻中出气，口中吸气，按照所病脏腑之数，自觉清凉了。
手指补泻
经文说：凡补泻，不一定非要依靠呼吸进出，而在于手指的操作，这是什么意思呢？就是指动、摇、进、退、搓、盘、弹、捻、循、扪、摄、按、爪、切这些手法。现在简要备列如下：
动：动的手法，如气不行，只需将针伸提而已。
退：退的手法，为补泻欲出针时，各先退针一豆许，然后却留针，方可出之，这叫作退。
搓：搓的手法，凡是令人觉热，向外针似搓线之貌，勿转太紧。治寒而里卧针，根据前转法，以为搓也。
进：进的手法，凡是不得气，男外女内者，及春夏秋冬各有进退之理，这叫作进。
盘：盘的手法，如针腹部，于穴内轻盘摇而已，为盘之也。
摇：摇的手法，凡泻时，欲出针，必须动摇而出者是也。
弹：弹的手法，凡补时，可用大指甲轻弹针，使气疾行也。如泻，不可用也。
捻：捻的手法，以手捻针也。务要识乎左右也，左为外，右为内，慎记耳。
循：循的手法，凡下针于属部分经络之处，用手上下循之，使气血往来而已是也。经文说：推之则行，引之则止。
扪：扪的手法，凡补时，用手扪闭其穴是也。
摄：摄的手法，下针如气涩滞，随经络上，用大指甲上下切其气血，自得通行也。
按：按的手法，以手捻针无得进退，如按切之状是也。
爪：爪的手法，凡下针用手指作力置针，有准也。
切：切的手法，凡欲下针，必先用大指甲左右于穴切之，令气血宣散，然后下针，是不伤荣卫故也。
迎随补泻
经文说：东方实而西方虚，泻南方而补北方，这是什么意思呢？这是实母泻子之法，不只刺一经而已。假如肝木之病实，泻心火之子，补肾水之母，其肝经自得其平矣。五脏皆仿此而行之。
Tonification Method:
The left hand presses the acupoint, and the right hand places the needle on the point. Instruct the patient to cough once; insert the needle penetrating into the *Couli* (interstices between skin and muscle). Instruct the patient to exhale forcefully (blow air) once; advance the needle to a certain depth following the exhalation. When the needle feels heavy and tight, rotate the needle head and use the hand to follow and palpate (*Xun Men*) along the meridian. Once the arrival of *Qi* is felt, turn the needle head downward. When the needle again feels heavy and tight, instruct the patient to exhale forcefully once, then withdraw the needle following the inhalation, immediately closing the acupoint (i.e., rapidly pressing the needle hole with one hand). This method is used for patients with emaciation, weak Qi, and symptoms of itching or numbness.
Evacuation Method:
The left hand presses the acupoint, and the right hand places the needle on the point. Instruct the patient to cough once; insert the needle into the *Couli*. Then instruct the patient to inhale deeply; advance the needle to a certain depth following the inhalation. When the needle feels heavy and tight, rotate the needle head towards the diseased area. Once the arrival of *Qi* is felt and the pathogenic factor recedes, turn the needle head downward and use the hand to follow and palpate (*Xun Men*). When the needle feels heavy and dull, instruct the patient to exhale forcefully once, then slowly withdraw the needle without closing the acupoint. This is called Evacuation. This method is used for patients who are obese, have hard tissues, and experience pain.
The *Su Wen* states: "Evacuation must use 'Square'; Tonification must use 'Round'."
To say "Evacuation must use Square" means that at this time, the healthy Qi is flourishing, the moon is full, the day is warm, the body is stable, and the needle is inserted during the patient's inhalation. Later, when turning the needle, do so during inhalation; when withdrawing the needle, do so slowly during exhalation. Hence it is called Evacuation.
To say "Tonification must use Round," "Round" implies movement ("Xing"), and "Movement" implies shifting ("Yi"). "Movement" refers to circulating stagnant Qi and Blood; "Shifting" refers to restoring the pulse. Therefore, needling must penetrate to the *Rong* (Nutrient) level. Later, during inhalation, push the needle into the blood level. Thus, "Round" and "Square" do not refer to the shape of the needle. I do not understand the intent of the Sages; I leave it to future scholars to investigate in detail.
Shallow Needling in Spring and Summer, Deep Needling in Autumn and Winter
The *Nei Jing* states: Diseases may be superficial or deep; needling may be shallow or deep, each following its own principle, without a fixed rule. However, Spring and Summer belong to Yang, with Qi external; human Qi also floats outward. Therefore, in needling, one should generally take shallowly. Autumn and Winter belong to Yin, with Qi internal; human Qi resides in the Zang organs. Therefore, in needling, one should generally take deeply. It is also said: "In Spring and Summer, each elicit one Yin; in Autumn and Winter, each elicit one Yang."
What is meant by "eliciting one Yang in Autumn and Winter"? It means that although Spring and Summer are Yang, they nurture Yin; thus, needling should elicit one Yin. What is meant by "eliciting one Yin in Spring and Summer"? It means that although Autumn and Winter are Yin, they nurture Yang; thus, needling should elicit one Yang.
The method of eliciting one Yin in warm Spring and Summer involves inserting the needle deeply to the regions of the Kidney and Liver, obtaining *Qi*, and then withdrawing the needle. This guides Yin inward. The method of eliciting one Yang in cold Autumn and Winter involves inserting the needle shallowly to the regions of the Heart and Lung, obtaining *Qi*, pushing the needle deeper, retaining it for a long time, and then withdrawing. This pushes Yang inward. Thus, the *Su Wen* states: "Nourish Yang in Spring and Summer; nourish Yin in Autumn and Winter."
Respiratory Tonification and Evacuation
Tonification and Evacuation refer to methods based on respiratory inhalation and exhalation. During Tonification, Qi is taken from the *Wei* (Defensive) level. "Taking" implies acquiring. The *Su Wen* states: "First palpate and follow (*Xun*), cut and disperse, push and press, tap and stretch, mark with the fingernail, open the pathway, and acquire." Distinguish the gate to close the Spirit. Insert the needle at the end of exhalation, retain quietly for a long time. The goal is the arrival of *Qi*, like waiting for a distinguished guest, unaware of the passing day. When *Qi* arrives, protect it appropriately. Withdraw the needle during inhalation so that Qi does not escape, remaining in place. Close the gate, let the Spirit and Qi remain, and the Great Qi stay stopped. Hence it is called Tonification, taking Qi without allowing it to escape greatly.
During Evacuation, Qi is placed at the *Rong* (Nutrient) level, placing the Qi but not using it. The *Su Wen* states: "Insert the needle during inhalation, do not let Qi rebel; retain quietly for a long time, do not let evil accumulate. Turn the needle during inhalation until *Qi* arrives; draw the needle during exhalation, removing it completely at the end of exhalation. The Great Qi all exits. Hence it is called Evacuation." Evacuation means placing the Qi but not using it.
If Yang Qi is insufficient while Yin Blood is excessive, one should first Tonify Yang, then Evacuate Yin. If Yin Blood is insufficient while Yang Qi is excessive, one should first Tonify Yin, then Evacuate Yang. This harmonizes Yin and Yang, allowing Ying and Wei to circulate naturally. This is the essence of needling.
Cold-Heat Tonification and Evacuation
For example, to Tonify Cold (treat cold syndromes): First, have the patient cough once; insert the needle into the *Couli*. Then, have the patient exhale forcefully once; insert the needle following the exhalation to a depth of 6–7 fen, reaching the Kidney/Liver region. Retain the needle. Slowly withdraw it slightly (about the size of a bean), then twirl the needle, asking if the patient feels heat. Then re-insert to 3–4 fen, reaching the Heart/Lung region. Have the patient inhale to insert the needle, twirl to direct Qi downward to the disease site. Then twist outward to direct Qi upward, directly to 1–2 cun above the needled point. Finally, inhale while twisting outward to withdraw the needle, and quickly press the acupoint with the hand. This is Tonification.
For post-illness heat treated with cold methods: To induce a cooling sensation, first needle the Intestine region. After obtaining *Qi*, push deeper into the Yin region. Have the patient facilitate Earth Qi entering and Heaven Qi exiting. Carefully count the breaths according to the Generation-Number method. The patient will feel cool.
For aversion to cold treated with heat methods: To induce a warming sensation, first needle the Yin region. After obtaining *Qi*, slowly draw the needle to the Yang region. Have the patient facilitate Heaven Qi entering and Earth Qi exiting. Carefully count the breaths according to the Generation-Number method. The patient will feel warm.
Generation-Number Method (Sheng Wu Jia)
When Tonifying Cold, after directing Qi to the disease site, use the Generation-Number breaths. Have the patient inhale through the nose and exhale through the mouth (or vice versa depending on specific interpretation, text says "nose inhale out") to feel warmth.
When Evacuating Heat, after directing Qi to the disease site, use the Generation-Number breaths. Have the patient exhale through the nose and inhale through the mouth. Count according to the affected Zang-Fu organ numbers. The patient will feel cool.
Finger Manipulation for Tonification and Evacuation
The Classics state: Tonification and Evacuation do not necessarily rely on respiratory inhalation/exhalation, but depend on finger manipulation. What are these? They are: Move, Shake, Advance, Retreat, Rub, Plateau/Twirl, Tap, Twirl, Follow, Palpate/Close, Pinch, Press, Mark, and Cut. Briefly listed below:
Move: If Qi does not move, simply lift and lower the needle.
Retreat: When preparing to withdraw the needle for Tonification/Evacuation, first withdraw the needle slightly (bean-sized), then retain it before final withdrawal. This is Retreat.
Rub: To induce heat, rub the needle outward as if twisting thread, but not too tightly. For treating cold with internal needling, follow the previous turning method as rubbing.
Advance: If *Qi* has not arrived, or for gender-specific techniques (Male-External/Female-Internal), and considering seasonal advances/retreats, this is Advance.
Plateau/Twirl: For abdominal needling, gently rotate within the acupoint. This is Plateau.
Shake: For Evacuation, when withdrawing the needle, one must shake it while withdrawing.
Tap: For Tonification, lightly tap the needle with the thumbnail to accelerate Qi movement. Not used for Evacuation.
Twirl: Twisting the needle with fingers. Must distinguish left (External) and right (Internal). Remember carefully.
Follow: After inserting into the meridian region, use the hand to stroke up and down to promote Qi and Blood circulation. The Classic says: "Push to make it move, pull to stop it."
Palpate/Close: For Tonification, use the hand to cover/close the acupoint.
Pinch: If Qi is sluggish upon insertion, follow the meridian upward and pinch/cut the Qi and Blood with the thumbnail to restore flow.
Press: Hold the needle with fingers without advancing or retreating, resembling a pressing motion.
Mark: Use the finger to apply force when placing the needle to ensure accuracy.
Cut: Before needling, use the thumbnail to cut/pinch around the acupoint to disperse Qi and Blood, then insert. This prevents damaging Ying and Wei.
Following-Against Tonification and Evacuation
The Classics state: "East is Excess, West is Deficiency; Evacuate South, Tonify North." What does this mean? This is the method of tonifying the Mother and evacuating the Child, applicable beyond just one meridian. For example, if Liver Wood is Excess, evacuate the Child of Heart Fire, and tonify the Mother of Kidney Water. The Liver Meridian will naturally balance. All Five Zang organs follow this principle.