This disease presents with tendon spasms and bi-syndrome (painful obstruction syndrome) characterized by numbness and pain. The treatment is suitable for the use of micro-needles. For patients whose physical form is at ease but whose spirit is suffering, the pathology primarily resides in the meridians; the treatment employs moxibustion and acupuncture. One must clearly understand the application of the Nine Needles (Jiu Zhen) and the methods of tonification and sedation of the meridians. Therefore, the needling techniques for Ying-Qi (Nutritive Qi) and Wei-Qi (Defensive Qi) differ to distinguish the deficiency or excess of Blood and Qi. The needling of Jing-Well points (Jing Xue) and Ying-Spring points (Ying Xue) differs to distinguish the Mother and Child relationships within the Five Elements (Wu Xing). The needling of Mu-Alarm points (Mu Xue) and Shu-Transport points (Shu Xue) differs to distinguish Yin and Yang between the back and abdomen. The needling techniques for Spring/Summer and Autumn/Winter differ to distinguish the depth of human Qi. Generally, deficiency is treated with tonification and excess with sedation, avoiding injury from over-treatment or under-treatment, thereby assisting in restoring balance; this is the general principle of acupuncture therapy. However, there are cases where the pathological process has not yet penetrated deeply, allowing for immediate cure through needling. This refers to the principle that when a disease is in its initial stage, it can be cured by needling; or for Bi-syndrome causing numbness, pain, and swelling, it can be eliminated by moxibustion and needling. There are also cases where the disease has transmitted to various meridians, requiring simultaneous needling of both upper and lower parts. This refers to the "Fifty-Nine Points Needling" method used for treating heat diseases and malaria when the condition is severe.

However, the term "Ci" (puncture/needle) implies striking or piercing; while seemingly beneficial, harm may lie within. The Yellow Emperor stated that only those who are slow, calm, skilled in hand movements, and careful in mental deliberation should perform acupuncture and moxibustion. Zhang Ji (Zhang Zhongjing) said that needles can kill living people but cannot revive the dead; this emphasizes that the use of needles must be handled with extreme caution. Moreover, the nine types of needles have different shapes and indications; the twelve seasonal methods vary in application and weight. One must understand the celestial changes of the sun, moon, stars, and the Eight Correct Seasons (Ba Zheng); the terrestrial variations of cold, heat, dryness, and dampness affecting the fullness or emptiness of meridian waters; and the human differences in fat/thin, strong/weak, deficiency/excess, and flourishing/depletion. Only then can one perform respiratory tonification/sedation and following/following-away techniques, acting according to intent. This goes far beyond merely knowing the locations of Mu-points, the structure of skin, flesh, tendons, and bones, or the effects of hunger/fullness and labor/rest. Thus it is said: "To perceive the subtle signs of error and apply the needle accordingly ensures no danger."

In ancient times, acupuncture methods were widespread. Bian stones (Bian Shi, stone knives) were made in various sizes. They were used to replace needles according to the suitability of the condition. One type is called Needle Stone (Zhen Shi), another Bian Stone (Bian Shi), and another Jian Stone (Jian Shi); essentially, they are the same. For hard accumulations in flesh and for conditions involving redness, swelling, and heat, Bian stones are used to lacerate and drain. This is because pathogenic factors are violent and acute, rendering micro-needles ineffective. Furthermore, in cases of excessive Qi and Blood stagnating in muscle tissue, leading to abscesses and swellings, only Bian stones can penetrate and drain them. This corresponds to the principle: "When Blood is excessive, it should be drained." Additionally, for individuals whose physical form is at ease and spirit is joyful, but whose diseases arise in the flesh/muscles, treatment involves Bian stones. People in the Eastern regions often suffer from sores and ulcers; their treatment is suitable for Bian stones. The origin of Bian stones begins here. Bian Que stated: "For diseases in the blood vessels, treat with Bian stones." Therefore, for all types of swelling diseases, incision and drainage are suitable at the transverse crease below the little toe. If swelling is on the left, cut the left; if on the right, cut the right. Healing occurs when a small amount of blood is discharged. For conditions such as Ding-sores (hard boils), abscesses, erysipelas, Biao-j疽 (acute suppurative infections), Dai-zhi (paronychia), Gu-ben ju (deep-seated abscesses), and Qi-pain with flowing swelling, which require bloodletting, one should urgently puncture with a stone Bian. Generally, the method of using Bian stones is always sedation. In winter, when human Qi is closed and obstructed, medication is preferred over needles and stones. The phrase "few needles and stones" does not refer to abscesses and gangrene. Abscesses and gangrene cannot be delayed even for an instant; if treatment with needles and stones is postponed, toxic pathogens will attack internally, rotting muscles and bones and penetrating viscera. When treating Stone Ding-sores, one must avoid materials like gravel and bricks; when treating Knife/Ladle Ding-sores, one must avoid iron blades. Such cases can be treated with herbs. The *Su Wen* (Basic Questions) also states: "A person suffers from neck carbuncle; some are cured with stone therapy, others with acupuncture and moxibustion, and all recover. This is known as treating the same disease with different methods." For carbuncles and gangrene characterized by stagnant Qi, acupuncture opening and removal is suitable; for those with abundant Qi and pooled Blood, Bian stone sedation is suitable. Thus, the applications of Bian stones and the Nine Needles each have their advantages. Those skilled in treating blood vessel alterations and swelling diseases should assess the severity and formulate appropriate treatments.