补者，呼气初针，刺至皮内，号曰天才。少停进针，刺至肉内，号曰人才。又停进针，刺至筋骨之间，号
曰地才。得气补之，再停良久，退针人部，待气沉紧，倒针朝病，进退往来，飞经走气，尽在其中。泻者，吸
气针至天部，少停直至地部，得气泻之。再停良久，退针人部，待气沉紧，倒针朝病，施法同前。
少停者，三息也。再停者，五吸也。
病未退者，针下如根，推之不动，转之不移，此为邪气吸拔其针。未可出针，出则病复，再须补泻，停以
待之，直候病势已退，针下微松，如鱼吞饵之状，乃真气至也，方可出针豆许，搓而停之，补者吸之去疾，
急扪其穴，泻者呼之去徐，不闭其穴。
（以下各法，诸家之书不同。兹从实验后考订改正，其紧要异同之处，识者自能辨之）
一切
凡欲下针之时，用两手大指甲，于穴旁上下、左右四围，掐而动之，如刀切割之状，令血气宣散。次用
爪法，爪者掐也，用左手大指甲着力掐穴，右手持针，插穴有准，此下针之法也。
二摇
凡退针出穴时，必须摆撼而出之，所谓青龙摆尾者，即摇法也。故曰摇以行气，此出针法也。
三退
凡施补泻，出针豆许，补时出针，宜泻三吸，泻时出针，宜补三呼。再停少时，方可出针。又一泻法，
一飞三退，邪气自退。其法一插至地部，三提至天部，插针宜速，提针作三次出，
每一次停三吸，宜缓提时，亦宜吸气，故曰退以清气。飞者进也。
四动
凡下针时，如气不行，将针摇之，如摇铃之状。动而振之，每穴每次，须摇五息，一吹一摇，按针左
转，一吸一摇，提针右转，故曰动以运气。所谓白虎摇头者，亦用此法。又曰飞针引
气，以大指次指拈针来去上下也。
五进
下针后气不至，男左女右，转而进之，外转为左，内转为右。春夏秋冬，各有浅深。又有补法，一退
三飞，真气自归。其法一提至天部，三进入地部，提针宜速，进针三次，每停三息宜
缓，进时亦宜吹气。故曰进以助气。
六循
下针后气不至，用手上下循之。假如针手阳明合谷穴，气若
不至，以三指平直，将指面于针边，至曲池上下往来抚摩，使气血循经而来。故曰循以至气。
七摄
下针之时，气或涩滞，用大食中三指甲，于所属经分，来往摄之，使气血流行。故曰摄以行气。
八努
下针至地，复出人部，补泻务待气至。如欲上行，将大指次指拈住针头，不得转动，却用中指将针腰轻
轻按之，四五息久，如拨努机之状。按之在前，使气在后，按之在后，使气在前。气或行迟，两手各持其针，
仍行前法，谓之龙虎升腾，自然气血搬运。故曰努以上气。
一说∶用大指次指拈针，名曰飞针，引气至也。如气不至，令病患闭气一口，着力努之，外以飞针引之，则气至矣。
九搓
下针之后，将针或内或外，如搓线之状。勿转太紧，令人肥
肉缠针，难以进退。左转插之为热，右转提之为寒，各停五息久。故曰搓以使气。
按《内经》云∶针入而肉着者，热气因于针则针热，热则肉着于针，故坚焉。兹谓转紧缠针，与经不同。
十弹
补泻之时，如气不行，将针轻轻弹之，使气速行。用大指弹
之，象左补也；用次指弹之，象右泻也，每穴各弹七下。故曰弹以催气。
十一盘
如针腹部软肉去处，只用盘法，兼子午捣臼提按之诀。其盘法如循环之状，每次盘时，各须运转五次。左
盘按针为补，右盘提针为泻，故曰盘以和气。如针关元穴，先刺入二寸五分，退出一寸，只留一寸五分，在内
盘之。且如要取上焦之病，用针头迎向上，刺入二分，补之使气攻上。脐下之病，退出二分。
十二扪
补时出针，用手指掩闭其穴，无令气泄。故曰扪以养气。一说∶扪者因痛处未除，以手扪摩痛处，外以
飞针引之，除其痛也。
十三按
欲补之时，以手紧捻其针按之，如诊脉之状，毋得挪移再入。每次按之，令细细吹气五口。故曰，按以
添气，添助其气也。
十四提
欲泻之时，以手捻针，慢慢伸提豆许，无得转动再出。每次
提之，令细细吸气五口，其法提则气往。故曰，提以抽气。
补法：在患者呼气开始时进针，刺入皮内，称为“天才”。稍作停留后继续进针，刺入肌肉层，称为“人才”。再次停留后继续进针，刺入筋骨之间，称为“地才”。待得气（针下产生酸、麻、胀、重等感觉）后进行补法操作。再停留较长时间，将针退至人部（肌肉层），等待针下沉紧感出现，然后倒转针尖朝向病所，通过进退、往来等操作，以及飞经走气的手法，补法的精髓尽在其中。
泻法：在患者吸气时进针，直达天部（皮部），稍作停留后直至地部（筋骨间），待得气后进行泻法操作。再停留较长时间，将针退至人部，等待针下沉紧感出现，然后倒转针尖朝向病所，施术方法同前。
所谓“少停”，是指三次呼吸的时间；所谓“再停”，是指五次吸气的时间。
如果病邪未退，针下感觉像树根一样稳固，推之不动，转之不移，这是因为邪气吸拔着针体。此时不可出针，若出针则病情会复发，需要再次进行补泻操作，并停留等待，直到病势消退，针下感觉微微松动，如同鱼吞食鱼饵时的状态，这才是真气已至的表现，才可以将针退出少许，搓动针柄并停留片刻。补法时应在患者吸气时迅速出针，并立即按压闭合穴位；泻法时应在患者呼气时缓慢出针，不闭合穴位。
（以下各法，各家书籍记载不同。此处依据临床实验考证改正，其中紧要的异同之处，懂行的人自然能辨别。）
一、掐
凡是要下针的时候，用两手的大指甲，在穴位旁上下、左右四周围，掐按并移动，就像用刀切割一样，使血气宣散。接着使用爪法，爪就是掐的意思，用左手大指甲用力掐住穴位，右手持针，准确插入穴位，这是下针的方法。
二、摇
凡退针出穴时，必须摆动摇晃而出，所谓的“青龙摆尾”手法，就是摇法。所以说“摇以行气”，这是出针的方法。
三、退
凡是施行补泻，出针时先退出少许，补法时出针宜配合泻法节奏（三吸时间），泻法时出针宜配合补法节奏（三呼时间）。再停留片刻，方可完全出针。另一种泻法是“一飞三退”，邪气自然消退。其方法是插针一次至地部，提针三次至天部，插针宜快，提针分三次退出，每次停留三个吸气的时间，提针宜缓，提时也宜配合吸气，所以说“退以清气”。“飞”即进针之意。
四、动
凡下针时，如果气未至，将针摇动，像摇铃一样的状态。动而振之，每穴每次，须摇动五个呼吸的时间，一吹气一摇针，按针左转；一吸气一摇针，提针右转，所以说“动以运气”。所谓的“白虎摇头”手法，也使用此法。又说“飞针引气”，是用大拇指和食指捏住针柄来去上下捻动。
五、进
下针后气不至，男左女右，转而进之，外转为左，内转为右。春夏秋冬四季，针刺深浅各有不同。又有补法，“一退三飞”，真气自然回归。其方法是一提至天部，三进入地部，提针宜快，进针三次，每次停留三个呼吸的时间宜缓，进针时也宜配合吹气。所以说“进以助气”。
六、循
下针后气不至，用手上下循按。假如针刺手阳明大肠经的合谷穴，气若不至，用三指平直，将指面在针边，至曲池穴上下往来抚摩，使气血沿经脉而来。所以说“循以至气”。
七、摄
下针之时，气或涩滞，用食指和中指的指甲，在所属经络部位，来往摄按，使气血流行。所以说“摄以行气”。
八、努
下针至地部，复出至人部，补泻务必等待气至。如欲使气上行，用大拇指和食指捏住针头，不得转动，却用中指将针身轻轻按压，四五息之久，如同拨动弩机发射箭矢的状态。按在前面，使气向后方运行；按在后面，使气向前方运行。气若运行迟缓，两手各持其针，仍行前法，称为“龙虎升腾”，自然气血搬运。所以说“努以上气”。
一说：用大拇指和食指捻针，名为飞针，用以引气至。如气不至，令病患闭气一口，着力努之，外以飞针引之，则气至矣。
九、搓
下针之后，将针或向内或向外，像搓线一样的状态。不要转得太紧，以免令人肥肉缠住针体，难以进退。左转插针为热，右转提针为寒，各停留五个呼吸的时间。所以说“搓以使气”。
按《内经》说：针入而肉附着者，是因为热气因于针则针热，热则肉附着于针，所以坚硬。这里说的转紧缠针，与经典不同。
十、弹
补泻之时，如气不行，将针轻轻弹之，使气速行。用大拇指弹之，象左补也；用次指（无名指）弹之，象右泻也，每穴各弹七下。所以说“弹以催气”。
十一、盘
如针刺腹部软肉去处，只用盘法，兼用子午捣臼的提按诀。其盘法如循环之状，每次盘时，各须运转五次。左盘按针为补，右盘提针为泻，所以说“盘以和气”。如针关元穴，先刺入二寸五分，退出一寸，只留一寸五分，在内盘之。且如要取上焦之病，用针头迎向上，刺入二分，补之使气攻上。脐下之病，退出二分。
十二、扪
补时出针，用手指掩闭其穴，无令气泄。故曰扪以养气。一说：扪者因痛处未除，以手扪摩痛处，外以飞针引之，除其痛也。
十三、按
欲补之时，以手紧捻其针按之，如诊脉之状，毋得挪移再入。每次按之，令细细吹气五口。故曰，按以添气，添助其气也。
十四、提
欲泻之时，以手捻针，慢慢伸提豆许，无得转动再出。每次提之，令细细吸气五口，其法提则气往。故曰，提以抽气。
Tonification: Insert the needle at the beginning of the patient's exhalation, penetrating into the skin layer, termed "Heaven Talent" (Tiancai). After a brief pause, advance the needle into the muscle layer, termed "Human Talent" (Rencai). Following another pause, advance the needle into the space between sinews and bones, termed "Earth Talent" (Dicai). Upon obtaining Deqi (arrival of Qi, characterized by sensations such as soreness, numbness, distension, or heaviness), perform tonification. Pause for a considerable duration, withdraw the needle to the Human level (muscle layer), wait for the sensation of sinking and tightness at the needle tip, then invert the needle direction towards the disease site. Through techniques of advancing and withdrawing, and methods like "Flying through the Meridians and Moving Qi," the essence of tonification is contained.
Evacuation: Insert the needle during inhalation, reaching directly to the Heaven level (skin), pause briefly, then advance to the Earth level (sinews/bones). Upon obtaining Deqi, perform evacuation. Pause for a considerable duration, withdraw the needle to the Human level, wait for the sensation of sinking and tightness, then invert the needle direction towards the disease site. The method is the same as above.
"Short pause" refers to three breaths. "Longer pause" refers to five inhalations.
If the pathogenic factor has not receded, the needle feels rooted; it cannot be pushed or rotated. This indicates that the pathogen is grasping the needle. Do not withdraw the needle yet; doing so will cause the disease to recur. Perform tonification or evacuation again, and wait until the pathological momentum subsides and the needle feels slightly loose, resembling the sensation of a fish biting bait. This signifies the arrival of True Qi. Only then may the needle be withdrawn slightly. Rotate the needle handle and pause. For tonification, withdraw quickly during inhalation and immediately press the acupoint closed. For evacuation, withdraw slowly during exhalation without closing the acupoint.
(The following methods vary among different schools. These have been verified and corrected based on clinical practice. Those knowledgeable can discern the critical similarities and differences.)
1. Pinching (Qia): When preparing to insert the needle, use the thumbnails of both hands to pinch and move around the four sides (upper, lower, left, right) of the acupoint, similar to cutting with a knife, to disperse blood and Qi. Next, use the Clawing method (Zhua). "Clawing" means pinching. Use the thumbnail of the left hand to apply force to the acupoint, while the right hand holds the needle and inserts it accurately. This is the method of insertion.
2. Shaking (Yao): When withdrawing the needle, it must be shaken and swayed out. This is known as "Green Dragon Swinging its Tail," which is the Shaking method. Thus, "Shaking moves Qi." This is an extraction method.
3. Withdrawing (Tui): When performing tonification or evacuation, withdraw the needle slightly first. For tonification, the withdrawal rhythm should correspond to three exhalations; for evacuation, it should correspond to three inhalations. Pause briefly before fully withdrawing. Another evacuation method is "One Fly, Three Withdrawals," where pathogenic Qi naturally recedes. The technique involves inserting once to the Earth level and lifting/three times to the Heaven level. Insertion should be fast; lifting should be done in three stages, pausing for three inhalations each time. Lifting should be slow and coordinated with inhalation. Thus, "Withdrawing clears Qi." "Fly" refers to advancement.
4. Moving (Dong): If Qi does not arrive after insertion, shake the needle like a bell. Move and vibrate it; for each acupoint per session, shake for five breaths. One exhalation accompanies one shake while pressing the needle rotating left; one inhalation accompanies one shake while lifting the needle rotating right. Thus, "Moving circulates Qi." The "White Tiger Shaking its Head" method also uses this technique. Also called "Flying Needle Guiding Qi," using the thumb and index finger to manipulate the needle up and down.
5. Advancing (Jin): If Qi does not arrive after insertion, rotate according to gender (left for males, right for females) to advance. External rotation is left, internal rotation is right. Seasonal variations dictate depth. Another tonification method is "One Withdrawal, Three Flies," allowing True Qi to return naturally. The technique involves lifting once to the Heaven level and advancing three times to the Earth level. Lifting should be fast; advancing is done in three stages, pausing for three breaths each time. Advancing should be slow and coordinated with exhalation (blowing air). Thus, "Advancing assists Qi."
6. Stroking (Xun): If Qi does not arrive after insertion, stroke along the meridian above and below with the hand. For example, if needling Hegu (LI-4) of the Hand Yangming Large Intestine Meridian and Qi does not arrive, use three flat fingers to stroke from the needle side up to Quchi (LI-11), causing Qi and Blood to flow along the meridian. Thus, "Stroking brings Qi."
7. Pressing/Plucking (She): When inserting, if Qi is sluggish, use the thumbnails of the index and middle fingers to press and pluck along the relevant meridian segment to promote Qi and Blood circulation. Thus, "Pressing moves Qi."
8. Pushing/Straining (Nu): Insert to the Earth level, withdraw to the Human level, waiting for Qi arrival for tonification or evacuation. To direct Qi upward, hold the needle head with the thumb and index finger without rotating, then gently press the needle shaft with the middle finger for four to five breaths, resembling pulling a crossbow trigger. Pressing forward directs Qi backward; pressing backward directs Qi forward. If Qi movement is slow, hold the needle with both hands and repeat the previous method, called "Dragon and Tiger Ascending," naturally transporting Qi and Blood. Thus, "Pushing raises Qi."
Alternative view: Holding the needle with thumb and index finger is called "Flying Needle" to guide Qi. If Qi does not arrive, ask the patient to hold their breath for one moment and strain forcefully, while externally guiding with the Flying Needle, then Qi will arrive.
9. Rubbing (Cuo): After insertion, rotate the needle inward or outward like rubbing thread. Do not turn too tightly to avoid muscle fibers wrapping around the needle, hindering movement. Rotating left and inserting generates heat; rotating right and lifting generates cold. Pause for five breaths each. Thus, "Rubbing facilitates Qi."
According to *Neijing*: When flesh adheres to the needle upon insertion, it is because heat causes the needle to become hot, making the flesh adhere firmly. This description of tight rotation differs from the classic text.
10. Tapping (Tan): During tonification or evacuation, if Qi does not move, gently tap the needle to accelerate Qi flow. Tap with the thumb to symbolize left-side tonification; tap with the ring finger to symbolize right-side evacuation. Tap each acupoint seven times. Thus, "Tapping urges Qi."
11. Coiling/Panning (Pan): When needling soft flesh areas of the abdomen, use only the Panning method, combined with the lifting and pressing technique of "Ziwu Daojiu." The panning motion is circular; perform five rotations each time. Left pan with pressing is tonification; right pan with lifting is evacuation. Thus, "Panning harmonizes Qi." For Guanyuan (CV-4), insert 2.5 cun, withdraw 1 cun, leaving 1.5 cun inside, and pan within. To treat Upper Jiao diseases, angle the needle head upward, insert 2 fen, and tonify to drive Qi upward. For diseases below the umbilicus, withdraw 2 fen.
12. Covering (Men): When withdrawing after tonification, cover the acupoint with fingers to prevent Qi leakage. Thus, "Covering nourishes Qi." Alternative view: Covering refers to massaging the painful area with the hand to relieve pain, while externally using the Flying Needle to guide Qi.
13. Pressing (An): When tonifying, tightly grasp the needle with the hand and press it, similar to taking a pulse, without moving or reinserting. Each time pressing, exhale five gentle breaths. Thus, "Pressing adds Qi," augmenting the Qi.
14. Lifting (Ti): When evacuating, grasp the needle with the hand and slowly lift it slightly (about the size of a bean), without rotating or withdrawing further. Each time lifting, inhale five gentle breaths. The principle is that lifting draws Qi away. Thus, "Lifting extracts Qi."