Why patients respond to needling differently, and what slow responders require.
Ling Shu (灵枢)General Principles of Needling
ENGLISH TRANSLATION
The English is translated from the Chinese vernacular. The original text and its pinyin sit beneath each sentence in smaller type; hide them whenever you prefer to read the translation alone.
In a person of doubled yang, the spirit is easily stirred and qi easily goes ahead.
People’s qi and blood differ in form. In some the spirit stirs and qi moves ahead of the needle; in some qi meets the needle at once; in some qi arrives alone after the needle is out; in some response comes only after several insertions; in some qi rebels on withdrawal; in some repeated needling makes the illness worse.
These six differ in form; I would hear the method for each.
ORIGINAL凡此六者，各不同形，愿闻其方。
fán cǐ liù zhě，gè bù tóng xíng，yuàn wén qí fāng。
—— 《灵枢·行针》
Xing Zhen is a short but revealing chapter about individual variation. It observes that some patients respond to the first needle while others need several sessions before qi arrives, and it explains the difference in terms of constitutional type and the depth at which qi travels.
For contemporary practice its value is twofold. It justifies expecting a variable response rather than a uniform one, and it gives classical authority to the practice of retaining or repeating needles in slow responders instead of concluding that the treatment has failed.
ANNOTATION
Person of doubled yang (重阳之人): one whose yang qi is excessive; the spirit is easily stirred, so the needle sensation arrives quickly.
Qi goes before the needle (气先针行): before the needle enters, channel qi has already responded.
COMMENTARY
Though brief, this chapter is an ancient forerunner of individualised treatment. It explains the common clinical picture of strong deqi at a first visit and dulled response after many sessions. It also reminds us that the strength of needle sensation is not the only measure of efficacy, and that “soreness, numbness, distension and heaviness” should not be chased for their own sake.