气（亦与后刺深之，以致阴气意合）。针入三分，则知四时五行，五脏六腑逆顺之气（亦与最
后极深，以下谷气意合，乃根本也）。《玄珠密语》言∶入皮三分，心肺之部，阳气所行。
入皮五分，肾肝之部，阴气所行（取象三天两地之数）。此说可谓详明矣。及夫后贤所着，则
又有自一分，而累至于十分之说，此法益详且密矣。大抵博约不同，其理无异，互相发明，
问∶阴阳居易之理。
答曰∶此则阴阳相乘之意也。以其阳入阴分，阴出阳分，相易而居，成其病也。推原所
由，或因荣气衰少，而卫气内伐；或因卫气衰少，而荣气外溢。故令血气不守其位，一方气
聚，则为一方实，一方气散，则为一方虚。其实者为痛，其虚者为痒。痛者阴也，痛而以手
按之不得者，亦阴也，法当深刺之。痒则阳也，法当浅刺之。病在上者阳也，在下者阴也。
病先起于阴者，法当先治其阴，而后治其阳也。病先起于阳者，法当先治其阳，而后治其阴
问∶顺逆相反之由。
答曰∶此谓卫气独不得循于常道也，其名曰厥，为病不同，刺法当别。故经言∶刺热厥
者，若留针反为寒。刺寒厥者，若留针反为热。盖被逆气使然。由是言之，刺热厥者，宜三
刺阴，一刺阳。刺寒厥者，宜三刺阳，一刺阴。惟其久病之人，则邪气入深，却当深入而
久留，须间日而复刺之，必先调其左右，去其血脉。
问∶虚实寒热之治。
答曰∶先诊人迎气口，以知阴阳有余不足，以审上下经络，循其部分之寒热，切其九候
之变易，按其经络之所动，视其血脉之色状，无过则同，有过则异，脉急以行，脉大以弱，
则欲要静，筋力无劳。凡气有余于上者，导而下之。不足于上者，推而扬之。经云∶稽留不
到者，因而迎之。气不足者，积而从之。大热在上者，推而下之。从下止者，引而去之。大
寒在外者，留而补之。入于中者，从而泻之。上寒下热者，推而上之。上热下寒者，引而下
之。寒与热争者，导而行之。菀陈而血结者，刺而去之。
问∶补者从卫取气，泻者从荣置气。
卫气者，浮气也，专主于表。荣气者，精气也，专主于里。故经言∶荣者水谷之精也，
血气调和于五脏，洒陈于六腑，乃能入脉，循上下，贯五脏，络六腑也。卫者水谷之生也，
悍疾滑利，不能入脉，故循皮肤之中，分肉之间，熏于肓膜，散于胸腹，逆其气则病，从其
气则愈。如是则荣卫为中外之主，不亦大乎！安得不求其补泻焉。
问∶刺阳者卧针而刺之，刺阴者按令阳散乃内针。
答曰∶刺阳部者，从其浅也，系属心肺之分。刺阴部者，从其深也，系属肾肝之分。凡
欲行阳，浅卧下针，循而扪之，令舒缓，弹而努之，令气隆盛而后转针，其气自张布矣，以
阳部主动故也。凡欲行阴，必先按爪，令阳气散，直深内针，得气则伸提之，其气自调畅矣
，以阴部主静故也。
问∶能知迎随之气，可令调之。
答曰∶迎随之法，因其中外上下、病道遥远而设也。是故当知荣卫内外之出入，经脉上
下之往来，乃可行之。夫荣卫者阴阳也，经言∶阳受气于四末，阴受气于五脏。故泻者先深
而后浅，从内引持而出之。补者先浅而后深，从外推内而入之。乃是因其阴阳内外而进退针
耳。至于经脉为流行之道，手三阳经，从手上头；手三阴经，从胸至手；足三阳经，从头下
足；足三阴经，从足入腹。故手三阳泻者，针芒望外，逆而迎之；补者针芒望内，顺而追之
，余皆仿此。乃是因其气血往来，而顺逆行针也。大率言荣卫者，是内外之气出入。言经脉
者，是上下之气往来。各随所在顺逆而为刺也。故曰迎随耳。
问∶补泻之时，与气开阖相应否？
答曰∶此法非止推于十干之穴，但凡针入皮肤间，当阳气舒发之分谓之开。针至肉分间
，当阴气封固之分谓之阖。然开中有阖，阖中有开，一开一阖之机，不离孔中，交互停针，
察其气以为补泻。故《千金》言∶卫外为阳部，荣内为阴部。
问∶方刺之时，必在悬阳，及与两卫，神属勿去，知病存亡。
答曰∶悬阳，谓当腠理间朝针
之气也。两卫，谓迎随呼吸出入之气也。神属勿去，知病存亡，谓左手占候，以为补泻也。
此古人立法，言多妙处。
问∶容针空豆许。
此法正为迎随而设也。是以气至针下，必先提退空歇，容豆许，候气至然后迎之
、随之。经言∶近气不失，远气乃来。
问∶刺有大小。
答曰∶有平补平泻，谓其阴阳不平而后平也。阳下之曰补，阴上之曰泻。但得内外之气
调则已。有大补大泻，惟其阴阳俱有盛衰，内针于天地部内，俱补俱泻，必使经气内外相通
，上下相接，盛气乃衰，此名∶调阴换阳，一名∶接气通经，一名∶从本引末。审按其道以
予之，徐往徐来以去之，其实一义也。
问∶穴在骨所。
答曰∶初下针入腠理，得穴之时，随吸内针，乃可深知之。不然，气与针忤，不能进。
又凡肥人内虚，要先补后泻；瘦人内实，要先泻后补。
问∶补泻得宜。
答曰∶凡病在一方，中外相袭，用子午法补泻，左右转针是也。病在三阴三阳，用流注
法补泻，荥俞呼吸出纳是也。二者不同。至于弹爪提按之类，无不同者，要明气血何如耳。
问∶迎夺随济，固言补泻，其义何如？
答曰∶迎者，迎其气之方来，如寅时气来注于肺，卯时气来注于大肠，此时肺大肠气方
盛，而夺泻之也。随者，随其气之方去，如卯时气去注大肠，辰时气去注于胃肺与大肠，此
时正虚，而济补之也。余仿此。
问∶针入几分，留几呼？
答曰∶不如是之相拘。盖肌肉有浅深，病去有迟速，若肌肉浓实处，则可深；浅薄处，
则宜浅。病去则速出针，病滞则久留针为可耳。
问∶补泻有不在井荥俞经合者多如何？
答曰∶如晴明、瞳子 治目疼，听宫、丝竹空、听会治耳聋，迎香治鼻，地仓治口
，风池、头维治头项，古人亦有不系井荥俞经合者如此。盖以其病在上，取之上也。
问∶经穴流注，按时补泻，今病有各经络，按时能去病否？
答曰∶病着于经，其经自有虚实耳。补虚泻实，亦自中病也。病有一针而愈，有数针始
愈。盖病有新痼浅深，而新浅者，一针可愈，若深痼者，必屡针可除。丹溪、东垣有一剂愈
者，有至数十剂而愈者，今人用一针不愈，则不再针矣。且病非独出于一经一络者，其发必
有六气之兼感，标本之差殊，或一针以愈其标，而本未尽除；或独取其本，而标复尚作，必
数针方绝其病之邻也。
问∶针形至微何能补泻？
答曰∶如气球然，方其未有气也，则恹塌不堪蹴踢，及从窍吹之，则气满起胖，此虚则
补之之义也。去其窍之所塞，则气从窍出，复恹塌矣，此实则泻之之义也。
问∶《内经》治病，汤药少而针灸多，何也？
答曰∶《内经》，上古书也。上古之人，劳不至倦，逸不至流，食不肥鲜，以戕其内，
衣不蕴热，以伤其外，起居有节，寒暑知避，恬澹虚无，精神内守，病安从生？虽有贼风虚
邪，莫能深入，不过凑于皮肤，经滞气郁而已。以针行气，以灸散郁，则病随已，何待于汤
液耶？当今之世，道德日衰，以酒为浆，以妄为常，纵欲以竭其精，多虑以散其真，不知持
满，不解御神，务快其心，过于逸乐，起居无节，寒暑不避，故病多从内生，外邪亦易中也
。经曰∶针刺治其外，汤液治其内，病既属内，非汤液又不能济也。此和缓以后，方药盛行
，而针灸兼用，固由世不古，若人非昔比，亦业针法之不精，传授之不得其诀耳。非古用针
灸之多，今用针灸之少，亦非汤液之宜于今，而不宜于古耶。学人当究心焉。
问∶八法流注之要诀何如？
答曰∶口诀固多，未能悉录，今先撮其最要者而言之∶
上古流传真口诀，八法原行只八穴。口吸生数热变寒，口呼成数寒变热。先呼后吸补自
真，先吸后呼泻自捷。徐进疾退曰泻寒，疾进徐退曰补热。紧提慢按似冰寒，慢提紧按如火
热。脉外阳行是卫气，脉内阴行是荣血。虚者徐而进之机，实者疾而退之说。补其母者随而
济，泻其子者迎夺挈。但分迎夺与济随，实泻虚补不妄说。天部皮肤肌肉人，地部筋骨分三
截。卫气逆行荣顺转，夏浅冬深肥瘦别。毋伤筋膜用意求，行针犹当辨骨节。拇指前进左补
虚，拇指后退右泻实。牢濡得失定浮沉，牢者为得濡为失。泻用方而补为圆，自然荣卫相交
接。右泻先吸退针呼，左补先呼出针吸。莫将此法作寻常，弹努循扪指按切。分筋离骨陷中
来，却将机关都漏泄。行人载道欲宣扬，湍水风林没休歇。感谢三皇万世恩，阐尽针经真口
（针刺深度也应当与后文提到的深刺以引致阴气的意图相吻合）。针刺入三分，就能知晓四时五行、五脏六腑逆顺之气（这也与最后极深刺以获取谷气之意相合，这是根本所在）。《玄珠密语》中说：入皮三分，是心肺所在的部位，为阳气运行的区域。入皮五分，是肾肝所在的部位，为阴气运行的区域（取象于“三天两地”的数理）。这种说法可以说是详尽明白了。到了后世贤者所著述的内容中，又有从一分累加到十分的说法，这种方法更加详细严密了。大体上博学与简约不同，但其中的道理没有差异，可以互相阐明。
问：阴阳居易的道理是什么？
答：这就是阴阳相互乘袭的意思。因为阳进入阴分，阴出于阳分，相互交换位置，从而形成疾病。推究其根源，可能是因为营气衰少，导致卫气向内攻伐；或者因为卫气衰少，导致营气向外溢出。所以使得血气不能守住其正常位置，一方气聚，就形成一方的实证；一方气散，就形成一方的虚证。其实证表现为疼痛，其虚证表现为瘙痒。痛属于阴，如果痛而用手按压却找不到痛点，也属于阴，治疗方法应当深刺。痒属于阳，治疗方法应当浅刺。病在上部的属于阳，在下部的属于阴。病先从阴分起发的，治疗方法应当先治其阴，而后治其阳。病先从阳分起发的，治疗方法应当先治其阳，而后治其阴。
问：顺逆相反的缘由是什么？
答：这指的是卫气独自不能循行于常道，这种病症名叫厥，由于病情不同，针刺方法应当区别对待。所以经书说：针刺治疗热厥，如果留针反而会导致寒症。针刺治疗寒厥，如果留针反而会导致热症。这是因为被逆乱之气所影响。由此而言，针刺治疗热厥，适宜三刺阴经，一刺阳经。针刺治疗寒厥，适宜三刺阳经，一刺阴经。只有对于久病的人，邪气深入，才应当深刺并长时间留针，需要隔日再次针刺，并且必须先调理左右两侧，去除血脉中的瘀滞。
问：虚实寒热的治疗方法是什么？
答：先诊察人迎穴和气口脉，以了解阴阳的有余和不足，以此审察上下经络，循着各部分的寒热情况，切按九候脉象的变化，按其经络的搏动情况，观察其血脉的颜色和形态，如果没有异常则与普通情况相同，如果有异常则有所不同。脉急则快速行针，脉大则减弱力度，想要安静则需静养，筋力不可过度劳累。凡是气有余于上部的，引导使其下行。上部气不足的，推动使其上扬。经书说：气机稽留不行的，顺势迎而夺之。气不足的，积聚而随之补之。大热在上部的，推引使其下行。热气从下停止的，引导使其散去。大寒在体表的，留针以温补之。邪气入于体内的，顺势泻之。上寒下热的，推引使其上行。上热下寒的，引导使其下行。寒与热相争的，导引而行使其流通。瘀血陈积且结块的，针刺以去除之。
问：补法是从卫分取气，泻法是从营分置气。
答：卫气是浮行之气，专门主管体表。营气是精微之气，专门主管体内。所以经书说：营是水谷的精微，血气在五脏调和，洒布于六腑，才能进入脉管，循行上下，贯穿五脏，联络六腑。卫是水谷的悍气，剽疾滑利，不能进入脉管，所以循行于皮肤之中，肌肉之间，熏蒸于肓膜，散布于胸腹，逆其气则生病，顺其气则痊愈。像这样，营卫作为内外的主宰，不是很重大吗！怎能不探求其补泻的方法呢。
问：刺阳部要卧针斜刺，刺阴部要先按压使阳气分散再进针。
答：刺阳部，是因为其位置较浅，系属于心肺的分野。刺阴部，是因为其位置较深，系属于肾肝的分野。凡是要施行阳部针刺，浅卧进针，循按抚摸，令其舒缓，弹指努气，令气隆盛后再转针，其气自然张布，这是因为阳部主动的缘故。凡是要施行阴部针刺，必须先按爪，令阳气分散，直接深进针，得气后伸提，其气自然调畅，这是因为阴部主静的缘故。
问：能知道迎随的气机，就可以使之调和。
答：迎随的方法，是根据其中外上下、病道遥远而设立的。因此应当知道营卫内外的出入，经脉上下的往来，才可以施行。夫营卫就是阴阳，经书说：阳受气于四肢末端，阴受气于五脏。所以泻法是先深后浅，从内引出持出。补法是先浅后深，从外推入内。这是根据其阴阳内外而进退针具罢了。至于经脉是气血流行的通道，手三阳经，从手上头；手三阴经，从胸至手；足三阳经，从头下足；足三阴经，从足入腹。所以手三阳经泻法，针尖朝外，逆其气而迎夺之；补法针尖朝内，顺其气而追随之，其余都仿照此例。这是根据其气血往来，而顺逆行针。大体上说营卫，是指内外之气的出入。说经脉，是指上下之气的往来。各自随着所在部位的顺逆进行针刺。所以叫作迎随。
问：补泻的时机，是否与气的开阖相应？
答：这种方法不仅适用于十天干的穴位，但凡针刺入皮肤间，当阳气舒发的时候称为开。针至肉分间，当阴气封固的时候称为阖。然而开中有阖，阖中有开，一开一阖的机理，不离孔穴之中，交互停针，观察其气机来进行补泻。所以《千金方》说：卫外为阳部，营内为阴部。
问：方刺之时，必在悬阳，及与两卫，神属勿去，知病存亡。
答：悬阳，指的是当腠理间朝向针具的气机。两卫，指的是迎随呼吸出入的气机。神属勿去，知病存亡，指的是左手占候，用来决定补泻。这是古人立法，言语中多有妙处。
问：容针空豆许。
这种方法正是为迎随而设立的。所以当气至针下，必须先提退空歇，留出豆大的空间，候气至然后迎之、随之。经书说：近处的气不失，远处的气乃来。
问：刺有大小。
答：有平补平泻，说的是阴阳不平然后使之平复。阳下行为补，阴上行为泻。只要内外之气调和即可。有大补大泻，只有当阴阳都有盛衰时，将针插入天地部内，俱补俱泻，必须使经气内外相通，上下相接，盛气乃衰，这叫作：调阴换阳，一名：接气通经，一名：从本引末。审慎地按照其道给予治疗，徐往徐来以去除病邪，其实义理是一样的。
问：穴在骨所。
答：初下针入腠理，得穴之时，随着吸气进针，才可以深知穴位。不然，气与针相抵触，不能进针。又凡是肥人内部虚弱，要先补后泻；瘦人内部充实，要先泻后补。
问：补泻得宜。
答：凡是病在一方的，中外相袭，用子午流注法补泻，即左右转针。病在三阴三阳，用流注法补泻，即荥俞穴配合呼吸出纳。两者不同。至于弹指、爪切、提按之类，没有不同的，关键在于明白气血的情况。
问：迎夺随济，固然说是补泻，其意义如何？
答：迎，是迎其气之方来，如寅时气来注于肺，卯时气来注于大肠，此时肺大肠气正盛，而夺泻之。随，是随其气之方去，如卯时气去注大肠，辰时气去注于胃肺与大肠，此时正气正虚，而济补之。其余仿照此例。
问：针入几分，留几呼？
答：不必如此拘泥。因为肌肉有浅深，病去有迟速，如果肌肉浓实处，则可以深刺；浅薄处，则宜浅刺。病去则快速出针，病滞则久留针为宜。
问：补泻有不在井荥俞经合者多如何？
答：如晴明、瞳子髎治疗目疼，听宫、丝竹空、听会治疗耳聋，迎香治疗鼻病，地仓治疗口病，风池、头维治疗头项病，古人也有不隶属于井荥俞经合的情况如此。大概是因为病在上部，取之上部的穴位。
问：经穴流注，按时补泻，今病有各经络，按时能去病否？
答：病着于经，其经自有虚实。补虚泻实，也自然中病。病有一针而愈的，有数针始愈的。大概病有新久浅深之分，新浅者，一针可愈，若深痼者，必屡针可除。丹溪、东垣有一剂愈的，有至数十剂而愈的，今人用一针不愈，就不再针刺了。况且病并非独出于一经一络，其发作必有六气之兼感，标本之差殊，或一针以愈其标，而本未尽除；或独取其本，而标复尚作，必须数针方能绝其病之邻也。
问：针形至微何能补泻？
答：如同气球一样，当其没有气时，则萎靡塌陷不堪蹴踢，及从窍吹之，则气满起胖，这就是虚则补之的意义。去掉窍的堵塞，则气从窍出，复萎靡塌陷，这就是实则泻之的意义。
问：《内经》治病，汤药少而针灸多，为什么？
答：《内经》，是上古的书。上古之人，劳不至倦，逸不至流，食不肥鲜，以戕害其内，衣不蕴热，以伤害其外，起居有节，寒暑知避，恬澹虚无，精神内守，病从哪里生？虽然有贼风虚邪，也不能深入，不过是凑于皮肤，经滞气郁而已。用针行气，用灸散郁，则病随即已，何待于汤液呢？当今之世，道德日衰，以酒为浆，以妄为常，纵欲以竭其精，多虑以散其真，不知持满，不解御神，务快其心，过于逸乐，起居无节，寒暑不避，故病多从内生，外邪亦易中也。经说：针刺治其外，汤液治其内，病既属内，非汤液又不能济助。这是和缓以后，方药盛行，而针灸兼用，固然由世道不古，若人非昔比，也是业针法之不精，传授之不得其诀耳。不是古用针灸之多，今用针灸之少，也不是汤液宜于今，而不宜于古耶。学人应当用心探究。
问：八法流注的要诀如何？
答：口诀固然多，未能全部记录，现在先撮取其最重要的来说：
上古流传真口诀，八法原行只八穴。口吸生数热变寒，口呼成数寒变热。先呼后吸补自真，先吸后呼泻自捷。徐进疾退曰泻寒，疾进徐退曰补热。紧提慢按似冰寒，慢提紧按如火热。脉外阳行是卫气，脉内阴行是荣血。虚者徐而进之机，实者疾而退之说。补其母者随而济，泻其子者迎夺挈。但分迎夺与济随，实泻虚补不妄说。天部皮肤肌肉人，地部筋骨分三截。卫气逆行荣顺转，夏浅冬深肥瘦别。毋伤筋膜用意求，行针犹当辨骨节。拇指前进左补虚，拇指后退右泻实。牢濡得失定浮沉，牢者为得濡为失。泻用方而补为圆，自然荣卫交接收。右泻先吸退针呼，左补先呼出针吸。莫将此法作寻常，弹努循扪指按切。分筋离骨陷中来，却将机关都漏泄。行人载道欲宣扬，湍水风林没休歇。感谢三皇万世恩，阐尽针经真口
(The depth of needle insertion should also be consistent with the intention mentioned later to insert deeply to draw out Yin Qi.) Inserting the needle three fen allows one to understand the qi of the four seasons, five elements, and the reverse and smooth flow of the five zang organs and six fu organs (this is also consistent with the intention of inserting extremely deeply at the end to obtain Gu Qi [Grain Qi], which is the root). The *Xuanzhu Miyu* states: Inserting into the skin three fen corresponds to the regions of the Heart and Lung, where Yang Qi circulates. Inserting five fen corresponds to the regions of the Kidney and Liver, where Yin Qi circulates (symbolizing the numerical values of "Three Heavens and Two Earths"). This explanation can be considered detailed and clear. Later sages' writings introduced the theory of accumulating from one fen to ten fen, making this method even more detailed and precise. Generally, although breadth and simplicity differ, the underlying principles are identical, mutually illuminating each other.
Q: What is the principle of Yin and Yang exchanging positions?
A: This refers to the mutual invasion of Yin and Yang. Because Yang enters the Yin aspect, and Yin exits to the Yang aspect, they exchange places, resulting in disease. Tracing the origin, it may be due to a deficiency of Ying Qi [Nutrient Qi] causing Wei Qi [Defensive Qi] to attack inward; or due to a deficiency of Wei Qi causing Ying Qi to overflow outward. Thus, Blood and Qi fail to maintain their proper positions. Where Qi gathers, there is Excess; where Qi scatters, there is Deficiency. Excess manifests as pain, while Deficiency manifests as itching. Pain belongs to Yin; if pain persists despite pressure, it also belongs to Yin, and the treatment method requires deep needling. Itching belongs to Yang, requiring superficial needling. Diseases located above belong to Yang, those below belong to Yin. If a disease originates in the Yin aspect, treat the Yin first, then the Yang. If it originates in the Yang aspect, treat the Yang first, then the Yin.
Q: What is the cause of reversal and opposition?
A: This refers to Wei Qi being unable to follow its normal pathway, a condition named Jue [Reversal]. Since the diseases differ, the needling methods must be distinguished. The classics state: When treating Re Heat Jue, retaining the needle may conversely induce Cold. When treating Re Cold Jue, retaining the needle may conversely induce Heat. This is caused by rebellious Qi. Therefore, for Re Heat Jue, it is appropriate to needle the Yin meridians three times and the Yang meridians once. For Re Cold Jue, needle the Yang meridians three times and the Yin meridians once. However, for patients with chronic illness, where pathogenic factors have penetrated deeply, deep insertion and prolonged retention are necessary, with sessions repeated every other day. One must first regulate the left and right sides and remove blood stasis.
Q: What are the treatments for Deficiency/Excess and Cold/Heat?
A: First, examine the Renying [Carotid Artery point] and Qikou [Radial Pulse point] to determine the excess or deficiency of Yin and Yang, thereby examining the upper and lower meridians. Follow the cold and heat in specific regions, palpate the changes in the Nine Pulses, press the moving meridians, and observe the color and shape of the blood vessels. If there is no abnormality, it is the same as normal; if there is, it differs. Rapid pulses require swift manipulation; large pulses require reduced force; stillness is desired when strength is lacking. For Qi excess in the upper body, guide it downward. For Qi deficiency in the upper body, push and elevate it. The classics say: For stagnant Qi that does not arrive, meet and reduce it. For deficient Qi, accumulate and follow it. For severe Heat in the upper body, push and direct it downward. For Heat stopping from below, guide and disperse it. For severe Cold on the exterior, retain and tonify. For pathogens entering the interior, follow and drain. For Cold above and Heat below, push and direct upward. For Heat above and Cold below, guide and direct downward. For competing Cold and Heat, guide and circulate them. For stagnated and old blood clots, needle to remove them.
Q: Tonification takes Qi from Wei, and Reduction places Qi in Ying.
A: Wei Qi is floating Qi, primarily governing the exterior. Ying Qi is Essence Qi, primarily governing the interior. Thus, the classics state: Ying is the essence of food and drink; Blood and Qi harmonize within the Five Zang, are distributed throughout the Six Fu, and then enter the vessels, circulating up and down, penetrating the Five Zang, and connecting the Six Fu. Wei is the vigorous Qi of food and drink; it is fierce, rapid, and slippery, unable to enter the vessels. Thus, it circulates among the skin and muscles, steams the Huangmo [Triple Burner membrane], and disperses in the chest and abdomen. Rebellious Qi causes disease; compliant Qi leads to recovery. In this way, Ying and Wei are the masters of the interior and exterior, are they not significant! How can one not seek their tonification and reduction methods?
Q: Needling Yang parts involves lying the needle horizontally; needling Yin parts involves pressing to scatter Yang Qi before insertion.
A: Needling Yang parts follows their superficial nature, associated with the Heart and Lung regions. Needling Yin parts follows their deep nature, associated with the Kidney and Liver regions. To perform Yang needling, insert the needle shallowly and horizontally, stroke and massage to relax, flick the finger to promote Qi abundance, then rotate the needle so the Qi spreads naturally, because Yang parts are active. To perform Yin needling, first press and claw to scatter Yang Qi, then insert the needle deeply. Upon obtaining Deqi [Needling Sensation], extend and lift to ensure the Qi flows smoothly, because Yin parts are static.
Q: Knowing the Qi of Ying and Sui allows for regulation.
A: The method of Ying [Meeting/Anticipating] and Sui [Following] is established based on internal/external, upper/lower, and distant pathways. Therefore, one must understand the entry and exit of Ying and Wei, and the coming and going of meridians up and down to practice it. Ying and Wei are Yin and Yang. The classics state: Yang receives Qi from the four extremities; Yin receives Qi from the Five Zang. Thus, reduction involves deep insertion followed by shallow withdrawal, drawing Qi out from the interior. Tonification involves shallow insertion followed by deep advancement, pushing Qi in from the exterior. This advances and retreats the needle according to Yin/Yang and interior/exterior. Regarding meridians as channels of circulation: Hand-Yang meridians go from hand to head; Hand-Yin from chest to hand; Foot-Yang from head to foot; Foot-Yin from foot to abdomen. Therefore, for Hand-Yang reduction, the needle tip faces outward, meeting and reducing against the flow; for tonification, the tip faces inward, following and chasing the flow. The rest follow this pattern. This is advancing and retreating the needle according to the direction of Qi and Blood flow. Generally, Ying and Wei refer to the entry and exit of internal/external Qi. Meridians refer to the coming and going of upper/lower Qi. Needle according to the local direction (forward or backward). Hence, it is called Ying Sui.
Q: Does the timing of tonification and reduction correspond to the opening and closing of Qi?
A: This method applies not only to the Ten Heavenly Stem points. Whenever the needle enters the skin, during the phase of Yang Qi expansion, it is called Kai [Open]. When the needle reaches the muscle layer, during the phase of Yin Qi consolidation, it is called He [Close]. However, within Open is Close, and within Close is Open. The mechanism of one Open and one Close never leaves the acupoint. Interchangeably pausing the needle, observe the Qi to determine tonification or reduction. Thus, the *Qianjin Fang* states: Exterior Wei is Yang part, Interior Ying is Yin part.
Q: "At the time of needling, one must focus on Xuan Yang and Liang Wei, keeping the spirit attached, knowing whether the disease survives or perishes."
A: Xuan Yang refers to the Qi facing the needle between the interstices. Liang Wei refers to the Qi of inhalation and exhalation in Ying and Sui. "Keeping the spirit attached, knowing survival" refers to using the left hand for diagnosis to determine tonification or reduction. This is ancient legislation, containing many subtleties in its wording.
Q: "Leave space equivalent to a bean for the needle."
This method is specifically designed for Ying and Sui. When Qi arrives at the needle, one must first withdraw slightly, leaving a space like a bean, wait for Qi to arrive, then meet or follow it. The classics state: Do not lose the nearby Qi, so that distant Qi may come.
Q: "There are great and small needlings."
A: There is Ping Bu Ping Xie [Balanced Tonification and Reduction], used when Yin and Yang are imbalanced to restore balance. Lowering Yang is tonification; raising Yin is reduction. It suffices when internal and external Qi are harmonized. There is Da Bu Da Xie [Great Tonification and Great Reduction], used when both Yin and Yang show excess and deficiency. Insert the needle into the Heaven and Earth layers, applying both tonification and reduction, ensuring internal and external Jing Qi connect and upper and lower aspects meet, so that excessive Qi declines. This is called: Tiao Yin Huan Yang [Regulating Yin and Changing Yang], also known as: Jie Qi Tong Jing [Connecting Qi and Unblocking Meridians], or Cong Ben Yin Mo [Leading from Root to Tip]. Carefully follow the pathway to administer treatment, moving slowly forward and backward to dispel pathogens. The meaning is essentially the same.
Q: "The acupoint is located at the bone."
A: Initially, insert the needle into the interstices. Upon reaching the acupoint, advance the needle during inhalation to gain deep understanding. Otherwise, Qi will resist the needle, preventing insertion. Furthermore, for obese people with internal deficiency, tonify first, then reduce; for thin people with internal excess, reduce first, then tonify.
Q: "Appropriate tonification and reduction."
A: For diseases localized in one area, affecting interior and exterior, use Zi Wu Liu Zhu [Midnight-Noon Ebb-Flow] method for tonification and reduction, involving rotating the needle left and right. For diseases in the Three Yin and Three Yang, use the Liu Zhu method for tonification and reduction, involving Ying-Shu points combined with respiratory admission and expulsion. These two are different. However, techniques like flicking, clawing, lifting, and pressing are the same; the key is to understand the state of Qi and Blood.
Q: "Ying Duo Sui Ji [Meeting/Reducing and Following/Nourishing] are indeed said to be tonification and reduction, what is their meaning?"
A: Ying [Meeting] is anticipating the arrival of Qi. For example, at Yin hour, Qi flows to the Lung; at Mao hour, Qi flows to the Large Intestine. At these times, Lung and Large Intestine Qi are abundant, so we reduce it. Sui [Following] is following the departure of Qi. For example, at Mao hour, Qi leaves the Large Intestine; at Chen hour, Qi leaves for the Stomach, Lung, and Large Intestine. At these times, the area is relatively deficient, so we nourish/tonify it. The rest follow this pattern.
Q: "How many fen deep to insert, how many breaths to retain?"
A: One should not be so rigid. Muscles vary in depth, and disease resolution varies in speed. In thick muscle areas, deep insertion is possible; in thin areas, shallow insertion is suitable. If the disease resolves quickly, withdraw the needle promptly; if the disease is stagnant, prolonged retention is appropriate.
Q: "What if tonification and reduction do not involve Jing, Ying, Shu, Jing, He points?"
A: For example, Mingmen and Tongziliao treat eye pain; Tinggong, Sizhukong, and Tinghui treat deafness; Yingxiang treats nasal issues; Dicang treats mouth issues; Fengchi and Touwei treat head and neck issues. Ancients also had cases not bound by Jing-Ying-Shu-Jing-He points. This is generally because the disease is in the upper body, so points in the upper body are selected.
Q: "Regarding meridian point ebb-flow and timed tonification/reduction, if current diseases affect various meridians, can timed treatment cure them?"
A: Disease attaching to a meridian implies that meridian has its own deficiency or excess. Tonifying deficiency and reducing excess naturally hits the target. Some diseases are cured with one needle; others require several. Diseases vary in newness, chronicity, and depth. New and superficial diseases can be cured with one needle; deep and chronic diseases require multiple sessions. Danxi and Dongyuan had cases cured with one prescription, and others with dozens. Modern practitioners often stop after one unsuccessful needle session. Moreover, diseases rarely originate from just one meridian; their onset often involves concurrent influences of the Six Qi and differences in root and branch. One needle might cure the branch but not the root; focusing solely on the root might leave the branch active. Multiple needles are required to eradicate the disease's adjacency.
Q: "How can such a tiny needle effect tonification and reduction?"
A: Consider a balloon. Without air, it is limp and cannot withstand kicking. Blowing air into the hole makes it full and firm; this is the meaning of tonifying deficiency. Blocking the hole allows air to escape, returning it to a limp state; this is the meaning of reducing excess.
Q: "In the *Neijing*, treatments relied less on decoctions and more on acupuncture/moxibustion. Why?"
A: The *Neijing* is an ancient text. Ancient people were not exhausted by labor nor idle to the point of lethargy; their diet was not rich or fatty, damaging the interior; their clothing did not trap heat, damaging the exterior. Their daily life was regulated, avoiding extreme cold and heat. They were tranquil and empty, guarding their Spirit internally. How could disease arise? Even with evil winds and empty pathogens, they could not penetrate deeply, merely causing stagnation and depression in the skin and meridians. Using needles to move Qi and moxa to dissipate depression would resolve the disease. Why wait for decoctions? In today's world, morality declines. People treat wine as water, make irregularity their norm, indulge desires to exhaust Essence, worry excessively to scatter True Qi. They do not know how to maintain fullness or control the Spirit, seeking only pleasure, overindulging in leisure. Their routines are unregulated, ignoring seasonal changes. Thus, diseases arise internally, and external pathogens easily invade. The classics say: Needles treat the exterior; decoctions treat the interior. If the disease is internal, only decoctions can assist. After He Huan, pharmaceuticals became prevalent, and acupuncture/moxa were used concurrently. This is partly due to the decline of the age and human nature compared to the past, but also due to imprecision in needle techniques and failure to transmit the secret formulas correctly. It is not that ancients used more acupuncture/moxa and moderns use less, nor that decoctions suit modern times but not ancient ones. Students should investigate this carefully.
Q: "What are the essential secrets of the Eight Methods and Ebb-Flow?"
A: There are many mantras, too numerous to record fully. I will now summarize the most important ones:
Ancient true mantras passed down, the Eight Methods originally use only eight points. Inhaling generates odd numbers, transforming Heat to Cold; exhaling generates even numbers, transforming Cold to Heat. Exhale first then inhale for true tonification; inhale first then exhale for swift reduction. Slow insertion and rapid withdrawal is reduction for Cold; rapid insertion and slow withdrawal is tonification for Heat. Tight lifting and slow pressing feels like icy cold; slow lifting and tight pressing feels like fire heat. Yang Qi runs outside the vessels; Yin Blood runs inside. For deficiency, the mechanism is slow insertion; for excess, the theory is rapid withdrawal. Following and nourishing the Mother element; meeting and reducing the Child element. Simply distinguishing between Meeting/Reducing and Following/Nourishing, correctly reducing excess and tonifying deficiency without error. Heaven Layer: Skin and Muscle; Human Layer; Earth Layer: Sinew and Bone, divided into three sections. Wei Qi moves counter-clockwise; Ying Qi turns clockwise. Summer requires shallow insertion, Winter deep; distinguish by fat and thinness. Do not damage tendons and fascia; seek with intent. When manipulating the needle, distinguish bone joints. Advancing the thumb to the left tonifies deficiency; retreating the thumb to the right reduces excess. Firmness indicates success; softness indicates failure. Firmness and softness determine floating and sinking. Firm is success; soft is failure. Reduction uses square movements; tonification uses circular movements, allowing natural connection of Ying and Wei. Right-side reduction: inhale first, withdraw needle, exhale. Left-side tonification: exhale first, withdraw needle, inhale. Do not treat this method as ordinary. Flick, promote, stroke, massage, finger press, and palpate. Separate sinews, move bones, come from depressions, yet reveal all mechanisms. Travelers on the road wish to proclaim it; rushing waters and windy forests cease not. Grateful for the grace of the Three Emperors for ten thousand generations, elucidating the true oral teachings of the Needle Classics.