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。
经云。凡补泻。非必呼吸出内。而在乎手指何谓也。故摇、动、进、退、搓、盘、弹、
捻、循、扪、摄、按、爪切是也。略备于后。
动 动者。如足不能行。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。必须动摇而出者也。
弹 弹者。凡用补时。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。务要识手左右也。左为外。右为内。慎记耳。
循 循者。凡下针于穴部分经络之处。用手上下循之。使气血往来而已。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穴。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。
在实施“冷补”手法时，使针感（气）到达病变部位，再运用生成之息数（呼吸计数），让患者用鼻子吸气、嘴巴呼气，患者会自觉发热。
在进行“热泻”手法时，使针感（气）到达病变部位，再运用生成之息数，让患者用鼻子呼气、嘴巴吸气，并根据所病脏腑对应的生成之数进行操作，患者会自觉清凉。
《内经》说：“凡是补法或泻法，不一定非要配合呼吸的进出，关键在于手指的操作。”这是什么意思呢？就是指摇、动、进、退、搓、盘、弹、捻、循、扪、摄、按、爪、切这些手法。以下略作介绍。
动：所谓“动”，是指如足部不能行走的情况，只需将针刺入后轻轻提插即可。
退：所谓“退”，是指在补法或泻法结束欲出针时，先将针退出少许（约豆大距离），然后再留针片刻，最后方可拔出。这就叫“退”。
搓：所谓“搓”，是指凡令患者感觉发热的手法，动作向外，形状如同搓线一般。注意不要转得太紧。治疗寒证时，若采用卧针（平刺）法，则依据前述的旋转方法来进行搓法。
进：所谓“进”，是指凡不得气时，根据男女不同（男外女内）以及春夏秋冬四季的不同规律进行进退操作，这就叫“进”。
盘：所谓“盘”，是指如针刺腹部穴位时，在穴内轻轻盘旋摇动而已，这就是“盘”法。
摇：所谓“摇”，是指凡使用泻法时，欲出针必须动摇针体然后拔出。
弹：所谓“弹”，是指凡使用补法时，可用大拇指指甲轻轻弹击针柄，使经气迅速运行。如果是泻法则不可用此法。
捻：所谓“捻”，是指用手捻转针体。务必分清手的左右方向。左手为外，右手为内，需谨慎记忆。
循：所谓“循”，是指凡下针于穴位所属经络部位时，用手沿经络上下循按，以使气血往来流通。《内经》说：“推之则行，引之则止。”
摄：所谓“摄”，是指下针后如果气机涩滞，随经络上行，用大拇指指甲上下切掐以调畅气血，自然得以通行。
按：所谓“按”，是指用手捻住针体，使其不得进退，状如按切的样子。
When performing the "Cold Tonification" technique, guide the needle sensation (Qi) to the diseased area. Then, utilize the generation and completion breath counts (respiratory counting), instructing the patient to inhale through the nose and exhale through the mouth; the patient will spontaneously feel warmth.
During the "Heat Sedation" technique, guide the needle sensation (Qi) to the diseased area. Again, utilize the generation and completion breath counts, instructing the patient to exhale through the nose and inhale through the mouth. Based on the generation numbers corresponding to the affected Zang-Fu organs, the patient will spontaneously feel coolness.
The Classics state: "Regarding tonification and sedation, it is not necessarily dependent on inhalation and exhalation, but rather lies in the manipulation of the fingers." What does this mean? It refers to the techniques of shaking, moving, advancing, retreating, rubbing, coiling, flicking, twisting, following, pressing, pinching, scratching, and cutting. These are briefly detailed below.
Moving: The term "Moving" refers to situations such as inability to walk with the feet, where one simply inserts the needle and performs gentle lifting and thrusting.
Retreating: The term "Retreating" refers to withdrawing the needle slightly (approximately the size of a bean) before removing it at the end of tonification or sedation procedures, followed by retaining the needle for a moment before final removal. This is called "Retreating."
Rubbing: The term "Rubbing" refers to a technique intended to induce heat in the patient. The motion is outward, resembling the action of rubbing thread. One must avoid turning too tightly. For treating cold conditions using horizontal needling (lying needle), the rubbing technique is performed according to the aforementioned rotational methods.
Advancing: The term "Advancing" refers to the manipulation used when Qi has not yet arrived. It involves adjusting advancement and retreat based on gender differences (external for males, internal for females) and the principles applicable to the four seasons. This constitutes "Advancing."
Coiling: The term "Coiling" refers to gently rotating and shaking the needle within the acupoint, particularly when needling the abdomen. This is known as "Coiling."
Shaking: The term "Shaking" refers to the requirement during sedation techniques to shake the needle before withdrawal.
Flicking: The term "Flicking" refers to using the thumbnail to gently tap the needle handle during tonification to accelerate the flow of Qi. This method should not be used for sedation.
Twisting: The term "Twisting" refers to rotating the needle with the hand. One must clearly distinguish between left and right hands. The left hand corresponds to external manipulation, and the right hand to internal manipulation; this requires careful memorization.
Following: The term "Following" refers to using the hand to stroke along the meridian pathways above and below the acupoint after insertion, facilitating the circulation of Qi and Blood. The Classics state: "Pushing causes movement; drawing causes cessation."
Pressing: The term "Pressing" refers to using the hand to press and close the acupoint during tonification techniques.
Pinching: The term "Pinching" refers to using the thumbnail to pinch up and down along the meridian if Qi stagnation occurs after insertion, allowing smooth passage of Qi and Blood.
Anchoring/Pressing (At): The term "At" (or Anchoring) refers to holding the needle firmly with the hand to prevent advancement or retreat, resembling a palpating or pressing motion.
Scratching: The term "Scratching" refers to using finger pressure to precisely locate the acupoint before needle insertion.
Cutting: The term "Cutting" refers to using the thumbnail to cut or press around the acupoint from both sides prior to needle insertion. This disperses Qi and Blood, ensuring that the Ying and Wei Qi are not injured upon needle entry.