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Chapter 7 of 81
黄帝内经·灵枢
Overall Paraphrase
Several characters in the original text were corrupted during transmission, such as "利" (benefit) for "刺" (needle), "操针" for "镵针", "少明" for "少阴", and "镇针" for "铍针." The following is a paraphrase based on the standard edition of the Miraculous Pivot · Official Needling.
The key to all needling lies in the proper use of the Nine Needles. The Nine Needles (nine ancient types of needling instruments) each have their appropriate targets and functions, with varying lengths and sizes for different applications. If used incorrectly, pathogens cannot be eliminated. When disease is superficial but needling is too deep, it will damage healthy muscle and may cause skin abscesses; when disease is deep but needling is too shallow, the pathogenic qi cannot be expelled externally and may instead form large suppurations. When disease is minor but a large needle is used, righteous qi will be drained excessively, inevitably causing harm; when disease is major but a small needle is used, pathogens cannot be fully expelled, also leading to failure. Needling that loses its standards—erroneously draining heavily where heavy drainage is inappropriate, or failing to use light needling where light needling is indicated—these faults have already been discussed; the specific methods of needling follow below.
For disease that wanders without fixed location on the skin, use the chan needle (a needle shaped like an arrowhead for superficial skin needling) to needle at the site of the disease. If the skin appears pale or white rather than red, do not needle. For disease located in the intermuscular spaces (between muscle striations), use the yuan needle (a needle with a cylindrical body for massaging the intermuscular spaces) to treat the affected area. For disease involving bi-obstruction in the channels and collaterals, use the feng needle (a triangular needle for bloodletting from the collaterals). For disease in the blood vessels where qi is deficient and supplementation is needed, use the di needle (a needle with a blunt, round tip for pressing on channels and vessels) at points such as the Jing-Well, Ying-Spring, and Shu-Transport points of the extremities. For disease where a large abscess has formed, use the pi needle (a sword-shaped needle for draining pus). For sudden onset of arthralgia (bi) due to cold, use the yuan-li needle (round-bodied with a sharp point, for acute bi pain). For prolonged, unrelieved bi pain, use the hao needle (fine and long, for retaining the needle and regulating qi). For disease located deep in the interior, use the chang needle (relatively long, for deep needling). For edema causing joint obstruction and dysfunction, use the da needle (relatively thick and large, for edema affecting the joints). For disease fixed in the five viscera and not moving, use the feng needle with reducing technique at Jing-Well, Ying-Spring, Shu-Transport and other points, selecting points according to the four seasons. In all, there are nine needling methods, corresponding to nine types of variations.
The first is called Shu Needling (Transport needling): Needling the Ying-Spring and Shu-Transport points of the various channels and the Back-Shu points of the five viscera.
The second is called Yuandao Needling (Distal needling): For disease in the upper body, select points on the lower body; specifically, needling the Shu-Transport points of the six bowels (fu organs).
The third is called Jing Needling (Channel needling): Needling the accumulations or diverging collaterals located between the major channels.
The fourth is called Luo Needling (Collateral needling): Needling the blood vessels of the fine collaterals.
The fifth is called Fen Needling (Intermuscular needling): Needling between the muscular striations.</br>
The sixth is called Daxie Needling (Major draining needling): Using the pi needle to lance abscesses and drain pus.
The seventh is called Mao Needling (Superficial/Skin needling): Shallow needling of the skin to treat superficial bi.</br>
The eighth is called Ju Needling (Opposing needling): For disease on the left, needle the right; for disease on the right, needle the left</br>
The ninth is called Cui Needling (Fire needling): Heating the needle red-hot before needling to treat bi syndrome.🔥
There are twelve sections of needling, corresponding to the twelve channels.
The first is called Ou Needling (Paired needling): Place one hand anteriorly over the chest and one posteriorly over the back, directly opposite the pain site. Needle one point anteriorly and one posteriorly to treat cardiac bi. When needling this condition, insert the needle obliquely; never perpendicularly, which could injure the internal organs.
The second is called Bao Needling (Repeated needling): For treating pain that moves without fixation, moving upward and downward. Insert the needle directly without immediate withdrawal, use the left hand to search and press for the disease site, then withdraw and re- needle repeatedly.
The third is called Hui Needling (Enlarging/Relaxing needling): Insert the needle directly beside the sinews, lifting and thrusting anteriorly and posteriorly to relax tension in the sinews; treats sinew bi.
The fourth is called Qi Needling (Uniform/Lined-up needling): Insert one needle directly in the center and one needle on each flank. Treatment for cold that has lodged relatively deeply but has a limited range. Also called three needling; for treating bi that is small in scope but deep.
The fifth is called Yang Needling (Spreading needling): Insert one needle centrally and four needles around it, all with shallow insertion. Treats cold qi with a relatively broad distribution.
The sixth is called Zhizhen Needling (Direct needling): Pinch up the skin before inserting the needle. Treats cold qi located in the superficial layers.
The seventh is called Shu Needling (Transport needling): Straight insertion and straight withdrawal, with fewer needle insertions but deeper needling. Treats conditions of exuberant qi with heat.
The eighth is called Duan Needling (Short needling): For needling bone bi, gently shake the needle while inserting deeply until reaching the bone region, then move the needle body up and down with a grinding motion.
The ninth is called Fu Needling (Superficial needling): Insert obliquely from the side and keep the insertion superficial. Treats muscular tension (spasm) accompanied by cold.
The tenth is called Yin Needling (Yin needling): Needle both left and right sides bilaterally. Treats cold reversal (jue). For cold reversal, needle the Shaoyin channel points behind the ankle.
The eleventh is called Pangzhen Needling (Lateral/Double needling): Insert one needle directly and one Needle adjacent/obliquely. Treats stubborn bi that has lingered for a long time.
The twelfth is called Zan Needling (Praising/Repeated shallow needling): Straight insertion and withdrawn straight out, needling multiple times shallowly to cause bleeding. Treats abscesses and swellings.
When the channels are deeply hidden and difficult to see, gently insert the needle and retain it for a long time to guide the vessel qi within the points. For superficially located vessels, do not needle hastily; first press to block the vessel then insert, ensuring no essential qi leaks out, only expelling the pathogenic qi yet allowing evil qi to depart.
The so-called "Three-Step" needling can elicit Grain Qi (the normal nourishing qi transformed from water and grain): The first step is shallow insertion through the skin, to release pathogens from the yang aspect. Next, slightly deeper, penetrating past the skin into the muscle, but not yet entering the intermuscular spaces, to release pathogens from the yin aspect. Finally, insert deeply into the intermuscular space itself; Grain Qi will then arrive. Therefore, the Needling Method states: Initially needle shallowly, in order to expel pathogens and activate blood qi; subsequently needle deeper to expel deep pathogens; ultimately needle deep, reaching the deep layers to guide Grain Qi. This describes exactly the principle at work.
Therefore, a practitioner who uses needles, if unaware of the annual cycle of qi (celestial influences), the ebb and flow of qi, and the causes of vacuity and repletion, cannot be called a skilled healer.
There are five types of needling for this section, corresponding to the five viscera.
The first is called Ban Needling (Half needling): Shallow insertion with rapid withdrawal, not injuring the muscles, like plucking/shaving a hair. Extracts skin qi. Responds to the Lung.
The second is called Baowen Needling (Leopard Spot needling): Needling the blood vessels anteriorly, posteriorly, left, and right to extract blood from the channels and luo. Responds to the Heart.
The third is called Guan Needling (Joint/Barrier Needling): Inserting directly left and right at the extremities/ends of the sinews/governing connections. Treats sinew bi. Take care not to cause bleeding. / Needle the major sinew along the four extremities. Responds to the Liver. Also called Yuan Needling or Qi Needling.
The fourth is called Hegu Needling (Combined Valley Needling): Inserting left and right in a shape like a chicken's claw/claw-shaped spread into the intermuscular spaces. Treats muscle bi. Responds to the Spleen.
The fifth is called Shu Needling (Transport needling): Direct insertion and direct withdrawal, deep down to the bone. Treats bone bi. Responds to the Kidney.
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The above represents an ancient textual classification of needling techniques. It is provided for theoretical study and understanding of principles only, and does not constitute a recommendation for modern practice or clinical application.
The core of this chapter is "using each instrument/or technique according to its appropriate application": instruments/tools, depth, and stimulation intensity must match the disease location, nature, and depth. The classifications of the Nine Needles, Nine Techniques, Twelve Sectional techniques, and Five Techniques reflect the ancient physicians' subtle considerations/precise observation of disease levels and constitution.
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