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General Principles

In all needling: where there is deficiency, make it full; where there is fullness, drain it; where there is accumulation, remove it; where the pathogen prevails, reduce it.

The four opening instructions of the Ling Shu, giving one action for each of the four situations a practitioner meets. Deficiency is filled by tonification, fullness is drained by reduction, chronic stasis is removed, and acute pathogen is reduced.

Ling Shu, Chapter 1
The essential of needling is that qi arrives and the treatment takes effect — as surely as wind disperses clouds, leaving the sky clear.

Deqi is not a preliminary to treatment; it is the criterion of it. The simile of wind clearing the sky describes both the speed and the completeness expected when qi has properly arrived.

Ling Shu, Chapter 1
The essentials of the small needle are easy to state and hard to master. The ordinary practitioner attends to form; the superior one attends to spirit.

A distinction drawn throughout the classics: technique can be taught, but the capacity to read the patient and adjust in the moment cannot. Form means the point, the depth and the manipulation; spirit means the state of the person being treated.

Ling Shu, Chapter 1
The subtlety of needling lies in speed and slowness. The ordinary practitioner guards the gate; the superior one guards the mechanism. The movement of the mechanism never departs from the hollow.

Timing rather than force is what distinguishes the skilled practitioner. The hollow is the point itself, where the mechanism of qi is accessible.

Ling Shu, Chapter 1
For the essentials of deficiency and excess, the nine needles are the most subtle; at the moment for tonification or reduction, the needle accomplishes it.

The closing statement of the opening chapter, returning to the instrument itself. The nine needles are not nine tools for nine diseases but one principle expressed in nine forms.

Ling Shu, Chapter 1

Tonification and Reduction

Slow insertion and rapid withdrawal makes full; rapid insertion and slow withdrawal makes empty.

One of the six single methods. The timing of insertion and withdrawal, rather than the manipulation in between, is what determines the direction of the effect.

Ling Shu, Chapter 1
To reduce, meet the qi; to tonify, follow it. Know meeting and following, and qi can be harmonised.

The origin of all directional methods. The needle is directed against the flow of channel qi to reduce and with it to tonify, and the phrase ying sui became the name of the whole family of techniques.

Ling Shu, Chapter 9
Insert on inhalation so that qi is not opposed; retain quietly so that the pathogen cannot spread; rotate on inhalation until qi arrives; withdraw on exhalation, and when the exhalation ends, remove the needle.

The most complete classical description of respiratory tonification and reduction. Every step is timed to the breath, and the passage assumes that the movement of qi in the patient follows the movement of air.

Su Wen, Chapter 27
To make the deficient full is to produce heat beneath the needle, for when qi is replete there is heat. To drain the full is to produce cold beneath the needle, for when qi is depleted there is cold.

The classical criterion for a successful technique. The practitioner judges the result by the temperature felt around the needle rather than by the manipulation performed.

Su Wen, Chapter 54
Slow and rapid making full means withdrawing the needle slowly and pressing the point quickly. Rapid and slow making empty means withdrawing quickly and pressing slowly.

A commentary that resolves an ambiguity in the earlier formula. The open or closed state of the point after withdrawal is what completes the effect: pressing closes it and retains qi, leaving it open allows qi to escape.

Su Wen, Chapter 54
One who understands needling trusts the left hand; one who does not trusts the right.

A remark that reverses the usual emphasis. The pressing hand locates the point, fixes the tissue and, in this account, performs much of the work that the needling hand is credited with.

Nan Jing, Chapter 78
Burning Mountain Fire treats stubborn numbness and cold bi: shallow first, then deep, using the nine yang numbers with three advances and three retreats, lifting slowly and pressing firmly; when heat arrives, press the needle in and close.

The classic compound tonifying technique. The odd numbers are yang, and the three-stage advance with a single withdrawal is what generates the sensation of heat.

Jin Zhen Fu (Xu Feng)
Penetrating Heaven Cool treats heat in the flesh and steaming bone: deep first, then shallow, using the six yin numbers with three exits and three entries, lifting firmly and pressing slowly; raise the needle gently.

The mirror image of Burning Mountain Fire, using even numbers and the reverse movement. The two techniques together are the standard illustration of how compound methods are built from single ones.

Jin Zhen Fu (Xu Feng)

Meridians and Points

The meridians determine life and death, manage the hundred diseases and regulate deficiency and excess; they must not be allowed to become blocked.

The single sentence on which the whole of acupuncture rests. It states the function of the channels in physiological terms and makes obstruction the fundamental pathology.

Ling Shu, Chapter 10
At the beginning of human life, essence is formed first; when essence is complete, the brain and marrow arise. Bone is the frame, vessels are the dwelling, sinew is the strength, flesh is the wall; when the skin is firm, the hair grows.

A compressed account of embryology and anatomy. Each tissue is given a function rather than a structure, and the passage is the classical starting point for the correspondence between the body and the channels.

Ling Shu, Chapter 10
Lung qi emerges at Shaoshang, at the inner side of the tip of the thumb, as the well point of wood; it slips to Yuji as spring; pours to Taiyuan as stream; moves at Jingqu as river; and enters at Chize as sea.

The template for the five shu points of every channel. The five names are hydraulic metaphors for the movement of qi from the extremity inward, and the phase assigned to the well point differs by channel.

Ling Shu, Chapter 2
The taiyang channel roots at Zhiyin and knots at the gate of life; the gate of life is the eye.

The root-and-knot model in one line: treatment is taken at the distal root, and the effect is felt at the knot. Identifying the eye as the gate of life is particular to this passage.

Ling Shu, Chapter 5
The three yang channels of hand and foot: those of the hand run to the head, those of the head to the foot. The three yin: those of the foot run to the abdomen, those of the chest to the hand.

The directional rules in four lines. They determine where a disorder travels and which distant point will reach it, which is why they are learned before any point is memorised.

Biao You Fu (Dou Mo)

Moxibustion

What the needle does not accomplish is what moxibustion is suited to.

The most quoted sentence in the literature on choosing between the two techniques. It establishes moxibustion as complementary to needling rather than as a substitute, and it is the classical warrant for treating cold and deficiency with moxa.

Ling Shu, Chapter 73
Where upper qi is insufficient, push and lift it; where lower qi is insufficient, gather and follow it; where both yin and yang are deficient, fire is the appropriate treatment.

A graded set of instructions in which moxibustion appears as the remedy of last resort, reserved for the case in which both aspects are depleted. The passage is often cited to show that moxa was regarded as the stronger intervention.

Ling Shu, Chapter 73

Channel Disorders

Use a heated needle and thrust rapidly; take the number of repetitions from the response, and treat the painful place as the point.

The classical basis of fire needling and of ashi points. It prescribes the technique, the endpoint and the location of treatment in a single sentence, and it is unusual among classical instructions in being entirely operational.

Ling Shu, Chapter 13
When the pathogen lodges in the channels, excess on the left produces disease on the right and excess on the right produces disease on the left. The pain of collateral disease lies elsewhere than the channel, which is why it is called contralateral needling.

The theoretical basis of treating the unaffected side. Miu ci applies when the disorder is in the collaterals; ju ci applies the same principle when it lies deeper in the channels.

Su Wen, Chapter 63

Constitution and Sensation

In a person of doubled yang, the spirit is easily stirred and the qi moves readily.

The Ling Shu explains variable responses to needling by constitutional type. The strong reactor needs fewer needles and gentler manipulation; the slow reactor may need repeated sessions before qi arrives.

Ling Shu, Chapter 67

Origins of Moxibustion

The north is the region where heaven and earth close and store. Its land is high, its people live in the open and eat milk; cold produces fullness, and the appropriate treatment is moxibustion. Thus moxibustion too comes from the north.

The classical account of the geographical origin of moxibustion. It explains the technique by climate and diet rather than by doctrine, and it is the source of the saying that moxa came from the north.

Su Wen, Chapter 12
The south is the region that heaven and earth nourish and grow, where yang is abundant. Its illnesses are contracture and bi, treated with fine needles. Thus the nine needles too come from the south.

Read with the preceding entry, this passage establishes that needling and moxibustion arose in different regions and were not originally one system — a point of considerable importance for the history of the discipline.

Su Wen, Chapter 12
For all illnesses of this kind, cauterise the taiyin channel of the arm.

The formula repeated throughout the earliest channel text. There are no points and no needles — only channels and burning, which is the strongest evidence that moxibustion came first.

Mawangdui Silk Texts, Cauterisation Classic

Deqi

Retain the needle quietly and at length, waiting for qi to arrive as one awaits an honoured guest, unaware that evening has come.

The classical attitude to waiting. The image insists that the practitioner neither hurry the arrival nor abandon the point, and it is the source of the practice of retaining the needle for as long as it takes.

Su Wen, Chapter 27
When the left hand perceives that qi has arrived, insert the needle; when, after insertion, qi has been exhausted, withdraw it.

Timing inside a single treatment. Neither insertion nor withdrawal is to be hurried, and the arrival of qi rather than the act of insertion is what constitutes the treatment.

Nan Jing, Chapter 80
When qi has arrived, it is like a fish swallowing bait, sinking and rising; when qi has not arrived, it is like a deserted hall, deep and still.

The best-known description of what the needling hand feels. The comparison is deliberately tactile: the sensation is a movement under the fingers, not a report from the patient.

Biao You Fu (Dou Mo)

Needling Safety

The viscera have vital places that must be examined; to follow them brings blessing, to oppose them brings blame.

The opening of the chapter on contraindications. The warning is anatomical: certain points lie over organs, and the depth of insertion at those points is a matter of consequence.

Su Wen, Chapter 52
Do not needle when greatly intoxicated — it disorders qi. Do not needle in great anger — it rebels qi. Do not needle the greatly exhausted, the newly fed, the very hungry, the very thirsty, or the badly frightened.

Seven states in which needling is deferred. Each corresponds to a recognisable increase in the risk of fainting or of an adverse reaction, which is why the list has survived so long unchanged.

Su Wen, Chapter 52
In all needling of the chest and abdomen, the five viscera must be avoided.

Nine characters that constitute the earliest explicit rule of needling safety. It is the classical statement of what modern practice calls anatomical contraindication.

Su Wen, Chapter 16

Seasonal Needling

In spring qi is in the channels; in summer in the fine collaterals; in late summer in the muscles; in autumn in the skin; in winter in the bone and marrow.

The seasonal distribution of qi, from which the depth of needling is derived. Spring and summer require shallow insertion, autumn and winter deeper, and the wrong depth is held to injure the organ corresponding to the season.

Su Wen, Chapter 64
In spring and summer needle shallowly; in autumn and winter needle deeply.

The seasonal rule reduced to a single line. It condenses the much longer arguments of the Su Wen into a form that can be recalled at the bedside.

Biao You Fu (Dou Mo)

Five Shu Points

The well points govern fullness beneath the heart; the spring points govern heat in the body; the stream points govern heaviness of the limbs and joint pain; the river points govern cough, dyspnoea, chills and fever; the sea points govern counterflow qi and diarrhoea.

The most compact statement of the therapeutic sphere of each category of shu point, and the basis of most later teaching. Later commentators qualify it, but as a mnemonic it has never been superseded.

Nan Jing, Chapter 68
In deficiency tonify the mother; in excess reduce the son. Tonify first, then reduce.

The rule governing five-phase point selection. It may be applied within a single channel or across channels, and the two applications do not always agree — a disagreement later authors argued over at length.

Nan Jing, Chapter 69

Rhymes and Odes

Of all means of rescue, the needle is the most subtle. Observe the seasons in the way of heaven; settle form and qi within your own mind.

The opening of Dou Mo’s celebrated rhapsody. It sets the two poles of practice: attention outward to the season and the patient, and attention inward to the practitioner’s own state.

Biao You Fu (Dou Mo)
For the abdomen, retain at Zusanli; for the back and loins, seek Weizhong; for the head and neck, use Lieque; for the face and mouth, Hegu.

Twenty characters covering four regions of the body with four distal points. It is both a mnemonic and a demonstration of the logic of distant point selection.

Song of the Four Command Points
Zusanli and Neiting, Quchi joining Hegu, Weizhong paired with Chengshan, Taichong and Kunlun, Huantiao and Yanglingquan, Tongli and Lieque. Where points pair, use them together; where they alternate, use them in turn.

Twelve points said to cover the disorders of the whole body. The closing instruction on pairing and alternating is the practical key to using a small repertoire well.

Twelve Celestial Star Points (Ma Danyang)

Needle, Moxa and Medicine

To needle without moxibustion, or to use moxibustion without needling, is not the mark of a good physician; and to use these without medication, or medication without them, is likewise not the mark of a good physician.

Sun Simiao insists on the unity of the three therapeutic methods. The sentence is regularly quoted against the assumption that acupuncture and herbal medicine were separate traditions.

Qian Jin Yao Fang (Sun Simiao)

Moxibustion Technique

In moxibustion, treat yang before yin: begin at the head, move down the left, then down the right — above before below.

The classical order of treatment. The sequence is not arbitrary: it follows the direction in which qi is held to move, and reversing it is said to produce stagnation.

Qian Jin Yao Fang, Moxibustion Methods

History

The method of needling has since antiquity been considered profound, and people today cannot fathom it. The classic says: the needle can kill a living person, but cannot raise the dead.

Wang Tao’s reason for recording moxibustion and omitting needling. His caution is worth remembering: the needle is the more powerful and the more dangerous of the two instruments.

Wai Tai Mi Yao (Wang Tao)

Moxa Material

Mugwort leaf is slightly bitter and very acrid when fresh, slightly acrid and very bitter when cured; warm when fresh, hot when cured — pure yang. It can draw the true fire of the sun and restore yang on the verge of collapse.

Li Shizhen’s account of why mugwort rather than another herb became the material of moxibustion, and why aged leaf is preferred to fresh.

Ben Cao Gang Mu (Li Shizhen)

Moxibustion in Heat

In deficiency, moxibustion uses fire to support original yang; in excess, it disperses the pathogen with fire; in cold, it restores warmth; in heat, it draws the depressed heat outward, fire following the nature of dryness.

A four-part justification for using moxa in heat patterns, the point of contention in the classical literature. The argument turns on whether the heat is depressed and therefore movable.

Yi Xue Ru Men

Moxa Sore

When moxibustion produces a sore that suppurates, the illness is cured; if no sore forms, the illness will not heal.

The rationale for scarring moxibustion, stated as a clinical rule. Modern practice has largely abandoned deliberate scarring, but the observation that response correlates with reaction still informs dosage.

Zhen Jiu Zi Sheng Jing (Wang Zhizhong)