Nan Jing, Chapter 78: Techniques of Tonification and Reduction
The pressing hand matters as much as the needling hand; the mechanics of tonification and reduction.
Nan Jing (难经)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.
Question: Needling has tonification and reduction; what does this mean?
ORIGINAL曰：针有补泻，何谓也？
yuē：zhēn yǒu bǔ xiè，hé wèi yě？
Answer: The methods of tonification and reduction do not necessarily depend on inserting and withdrawing with the breath. One who understands needling trusts the left hand; one who does not trusts the right.
At the moment of needling, first press with the left hand on the spring or transport point to be needled, flick it so the qi swells, pinch and insert; when qi comes with the feel of a pulsing artery, insert the needle following it.
When qi is obtained, push the needle inward: this is tonification. Move it and draw it out: this is reduction.
ORIGINAL得气，推而内之，是谓补；动而伸之，是谓泻。
dé qì，tuī ér nèi zhī，shì wèi bǔ；dòng ér shēn zhī，shì wèi xiè。
If qi is not obtained, then for men needle superficially to await the defensive qi and for women deeply to await the nutritive; if qi still does not come, it is said to be a case of certain death, beyond treatment.
ORIGINAL不得气，乃与男外女内；不得气，是谓十死不治也。
bù dé qì，nǎi yǔ nán wài nǚ nèi；bù dé qì，shì wèi shí sǐ bù zhì yě。
—— 《难经·七十八难》
The seventy-eighth difficulty opens with a remark that reverses the usual emphasis: the one who understands the needle trusts the left hand. The pressing hand locates the point, fixes the tissue and, in this account, does much of the work of tonification and reduction.
It then describes the mechanics of insertion and withdrawal, the direction of the manipulation and the timing of each step. The chapter is short, but it is one of the few classical texts that describes technique as a physical procedure rather than as a principle, and it remains directly usable.
ANNOTATION
Trust the left (信其左): 信 is to rely on and value — to value the role of the pressing left hand.
Press and suppress (厌按): 厌 is pronounced yā, the same as 压, to press.
Men outside, women inside (男外女内): men needled shallowly to await defensive qi, women deeply to await nutritive qi.
COMMENTARY
“Trust the left” is among the most neglected lines in needle technique. Students today rush to insert, leaving the left hand merely resting on the skin. Yet palpating the point, tracing the channel, probing the knot and summoning qi all belong to the left hand. If the left is dull, the right may be deft and still fail.