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Huangdi asked Qibo, saying: I govern the people, nourish the populace, and collect taxes. I grieve that they are not self-sufficient and suffer from diseases. I wish to avoid using poisonous drugs and stone needles, but to use fine needles to unblock their meridians, regulate their blood and qi, and nourish their Nishun convergence and divergence. I want to establish a method that can be passed down to future generations, clearly defined and enduring, easy to use and hard to forget, forming a systematic framework. Differentiate its chapters, distinguish its exterior and interior, and compile it into Zhongshi. Let each have its form, first establish the Classic of Acupuncture, and I wish to hear about its principles.

Qibo replied: I will explain it systematically, establishing a framework, starting from one and ending at nine. Let me explain its principles. The essence of small needles is easy to describe but difficult to master. The superficial practitioner focuses on form, while the superior practitioner focuses on spirit. The spirit, ah, the spirit, resides at the gate; without seeing the disease, how can one know its origin? The subtlety of needling lies in speed and slowness. The superficial practitioner focuses on the joints, while the superior practitioner focuses on the mechanism. The movement of the mechanism does not stray from its cavity. The mechanism within the cavity is clear, quiet, and subtle; its arrival cannot be anticipated, its departure cannot be pursued. Those who understand the mechanism cannot be delayed by a hair; those who do not understand the mechanism, even if urged, will not act. Knowing its coming and going, one must meet it at the right time. The superficial practitioner is in the dark. How wonderful! Only the superior practitioner possesses this ⁽¹⁾. What goes is contrary, what comes is favorable. Clearly understanding Nishun, one proceeds without doubt ⁽²⁾. To oppose and seize it, how can it not be deficient? To follow and supplement it, how can it not be excessive? To meet it and follow it, harmonizing it with intention, completes the way of acupuncture.

In general, when using needles, deficiency should be supplemented, excess should be drained, stagnation should be removed, and pathogenic factors should be reduced. The main principle is: "Slow and then fast is supplementation; fast and then slow is drainage." Speaking of supplementation and drainage, it is as if it exists and as if it does not; observe what comes after and what comes before, as if it remains and as if it vanishes; for deficiency and excess, it is as if gained and as if lost. The key to deficiency and excess lies in the nine needles, which are most marvelous. When supplementing and draining, use the needles accordingly.

Draining requires holding and inserting, releasing and withdrawing, expelling yang and obtaining the needle, pathogenic qi is drained. Press and withdraw the needle, this is called internal warming; blood does not scatter, qi does not escape. Supplementation follows, following the intention, as if forgetting, as if moving, as if pressing, like a mosquito stopping, as if lingering, as if returning ⁽³⁾, departing like a snapped string, connecting left to right, the qi thus stops, the external gate is closed, middle qi becomes substantial, there must be no retained blood, quickly remove and eliminate it ⁽⁴⁾. The principle of holding the needle is that firmness is precious ⁽⁵⁾, insert perpendicularly, do not move the needle left or right, the spirit is in the finest detail, focus on the patient, carefully observe the blood vessels, and needle without error. When needling, focus on the suspended yang ⁽⁶⁾, and the two guards, the spirit remains without departing, knowing the existence or absence of disease. The blood vessels are located transversely at the acupoints, observe them clearly ⁽⁷⁾, palpate them firmly.

The names of the nine needles are different in form.

• The first is the arrow needle, one inch six fen long.
• The second is the round needle, one inch six fen long.
• The third is the blunt needle, three and a half inches long.
• The fourth is the sharp needle, one inch six fen long.
• The fifth is the sword needle, four inches long, two and a half fen wide.
• The sixth is the round-sharp needle, one inch six fen long.
• The seventh is the filiform needle, three inches six fen long ⁽⁸⁾.
• The eighth is the long needle, seven inches long.
• The ninth is the large needle, four inches long.

• The arrow needle has a large head and a sharp tip, used to drain yang qi.
• The round needle is shaped like an egg, used to rub between the tissues without injuring the muscles, to drain the tissue qi.
• The blunt needle has a tip like a foxtail millet, used to press the vessels without penetrating, to guide the qi.
• The sharp needle has three edges, used to treat chronic diseases.
• The needle of beryllium has a tip like a sword's edge, used to extract large abscesses.
• The round-sharp needle is as large as a yak's tail hair, both round and sharp, with a slightly larger middle part, used to extract violent qi.
• The filiform needle is as sharp as a mosquito's proboscis, inserted gently and slowly, retained for a long time to nourish, used to treat agonizing arthralgia.
• The long needle has a sharp edge and a thin body, used to treat distant bi syndromes.
• The large needle is as sharp as a stick, with a slightly round tip, used to drain water from the joints.

The nine needles are now fully described.

When qi is in the vessels, pathogenic qi is above, turbid qi is in the middle, and clearing qi is below. Thus, needling the sunken vessels expels pathogenic qi, needling the middle vessels expels turbid qi, and needling too deeply causes pathogenic qi to sink further, worsening the illness. ⁽⁹⁾Therefore, it is said: the skin, flesh, sinews, and vessels each have their specific locations, and illnesses ⁽¹⁰⁾Each has its appropriate treatment, each has a different form, and each is suited to its specific treatment. Neither excess nor deficiency ⁽¹¹⁾Reducing what is already deficient and reinforcing what is already excessive leads to severe illness, worsening the condition. Needling the five vessels leads to death, needling the three vessels leads to debilitation, and depleting yin leads to death ⁽¹²⁾Depleting yang leads to mania. The harms of needling are now fully described.

⁽¹³⁾If qi does not arrive after needling, do not ask how many times; if qi arrives, then withdraw the needle and do not needle again. Each needle has its appropriate use, each has a different form, and each is suited to its specific purpose. The key to needling is that when qi arrives, there is ⁽¹⁴⁾effectiveness. The effectiveness is as certain as the wind dispersing clouds, as clear as seeing the blue sky. The principles of needling are now fully described.

Huangdi said: I wish to hear about the locations where the five zang and six fu organs emerge. Qibo said: The five zang organs have five shu points, totaling twenty-five shu points. The six fu organs have six shu points, totaling thirty-six shu points. There are twelve meridians and fifteen collateral vessels, making twenty-seven pathways that circulate above and below. The well points are where qi emerges, the spring points are where qi flows, the stream points are where qi gathers, the river points are where qi moves, and the sea points are where qi enters. The circulation of the twenty-seven pathways is all within the five shu points. The intersections of the joints are the three hundred and sixty-five meeting points. Those who understand the essentials can summarize it in one sentence; those who do not understand will be lost in endless details. The so-called joints are where the spirit qi circulates and enters and exits, not the skin, flesh, sinews, or bones. Observe the complexion, examine the eyes, and know the dispersion and recovery; unify the form, listen to the movements, and know the pathogenic and righteous qi. The right hand pushes, the left hand holds and controls, and when qi arrives, withdraw the needle.

In general, before using needles, one must first diagnose the pulse, observe the severity of the qi, and then treat accordingly. If the qi of the five zang organs is already exhausted internally, and the needler reinforces the exterior, this is called double exhaustion, which leads to death, and the death will be quiet. The one who treats it will reverse the qi and take from the armpit and chest. If the qi of the five zang organs is already exhausted externally, and the needler reinforces the interior, this is called counterflow collapse, which leads to death, and the death will be agitated. The one who treats it will take from the four extremities. If the harm of needling is not removed after hitting the target, essence will leak; if the harm is removed after hitting the target, qi will be induced. Leaking essence worsens the illness and causes debilitation; inducing qi leads to abscesses and ulcers.

The five zang organs have six fu organs, and the six fu organs have twelve source points. The twelve source points emerge from the four joints, and the four joints govern the five zang organs. When the five zang organs are diseased, the twelve source points should be needled. The twelve source points are where the five zang organs receive the three hundred and sixty-five seasonal qi. When the five zang organs are diseased, they should manifest in the twelve source points. Each of the twelve source points has its specific emergence. By understanding their origins and observing their manifestations, one can know the harm to the five zang organs.

• The shaoyin within yang is the lung, and its source emerges from Taiyuan (LU9), two Taiyuan points.
• The Taiyang within yang is the heart, and its source emerges from Daling (PC7), two Daling points.
• The shaoyang within yin is the liver, and its source emerges from Taichong (LR3), two Taichong points.
• The Zhiyin within yin is the spleen, and its source emerges from Taibai (SP3), two Taibai points.
• The taiyin within yin is the kidney, and its source emerges from Taixi, two Taixi points.
• The source of fat emerges from Jiuwei (CV15), one Jiuwei point.
• The source of the blind is located at the neck and abdomen , the neck and abdomen being one.

All these twelve source points are used to treat diseases of the five zang and six fu organs. For distension, select the three yang; for lienteric diarrhea, select the three yin.

The diseases of the five viscera are like thorns, like stains, like knots, like blockages. Although the thorns have been there for a long time, they can still be pulled out. Although the stains have been there for a long time, they can still be cleansed. Although the knots have been there for a long time, they can still be untied. Although the blockages have been there for a long time, they can still be cleared. Some say that long-standing diseases cannot be treated, but this is not true. Those who are skilled in using needles treat diseases like pulling out thorns, like cleansing stains, like untying knots, like clearing blockages. Even if the disease has been there for a long time, it can still be cured. Those who say it cannot be treated have not mastered the technique.

To treat heat, it is like probing hot water with your hand; to treat cold, it is like a person unwilling to move. For those with yin and yang diseases, treat them at Xia Ling San Li , proceed without hesitation, stop when the qi descends, and start again if it does not descend. For diseases high and internal, treat them at Yin Ling Quan ; for diseases high and external, treat them at Yang Ling Quan .

bubble_chart Note

1. Jiayi Jing "superior" is written as "工" in the text.
2. These two sentences also appear in Zhizhenyao Da Lun. Zhang Zhi-cong's version mistakenly writes "問" as "間".
3. Jiayi Jing "妄" is written as "忘", "還" is written as "環".
4. Some believe these two sentences do not belong to the tonifying method, and there may be missing text above.
5. Jiayi Jing "precious" is written as "實".
6. Jiayi Jing "必" is written as "心", "懸" is written as "衡".
7. Jiayi Jing "取" is added before "血", "澄" is written as "滿".
8. Jiuzhen Lun writes "one inch six fen".
9. Jiayi Jing states, "If pathogenic qi sinks further, the illness worsens."
10. Jiayi Jing adds, "each have their specific dwellings."
11. Jiayi Jing states, "Neither reinforcing excess nor reducing deficiency."
12. Jiayi Jing states, "depleting yin leads to collapse."
13. Jiayi Jing adds, "In general."
14. Jiayi Jing omits "there is."