Can Needling Cure Stroke, Stomach Pain, or Tumors? First Sort Out Deficiency and Excess, Cold and Heat — Doctor Ni Haixia on the Chang Ci Jie Lun and the Zhen Jie Pian of the Huang Di Nei Jing

Patient search terms: acupuncture / needling / blood-letting / tongue blood-letting / wooden tongue / stroke / stroke speech problems / slurred speech / unclear speech / stomach pain / stomach ache / Zusanli / aversion to cold / chills / whole-body fever / fever / stubborn fever / anemia / blood deficiency / blue veins on the arm / varicose veins / venous tumor / blood stasis / bruising from a fall / internal injury / tumor / hard lump / lump in the belly / mass in the lower abdomen / fibroid / paralysis / hemiplegia / acupuncture contraindications / needled the wrong spot / needle shock / the nine needles / plum-blossom needle / blood-letting needle / Gaohuang point / Pi Gen point / Mingmen / Dazhui / Weizhong / dao yin / hunchback / Chang Ci Jie Lun / Zhen Jie Pian / Huang Di Nei Jing

Corresponding topics (medical terms): the Su Wen chapters Chang Ci Jie Lun (Long Needling Principles, Chapter Fifty-Five) plus Zhen Jie Pian (Explaining the Needle, Chapter Fifty-Four), together with the deficiency-excess discrimination of the Zhi Zhi Lun (Treating Intentions, Chapter Fifty-Three). Wooden tongue: blood-letting of the veins under the tongue (fine 32-gauge filiform needle, two or three shallow pricks on each side, letting a little blood; letting too much causes loss of voice). Qi jie (qi street): not a single point but a region — the whole Yangming course on the front of the thigh (Futu ST32 to Dubi ST35 to Zusanli ST36), lying inside the sinews as well; when stomach qi arrives, cold stops at the knee; stabbing the artery of qi jie makes the groin (inguinal region) and inner thigh swell. Needling prohibitions: the drunk, the angry, the overworked, the full, the starving, the frightened, and the thin qi-deficient patient are all forbidden; Ruzhong ST17 is forbidden (swelling that will not resolve); Quepen ST12 must not be needled deeply (injures the lung, causing collapse); the ancient unsterilized needle hitting the bone marrow causes inflammation and a bent, hunchbacked body. Zhi Zhi Lun (Chapter Fifty-Three): qi full with a full body, qi deficient with a deficient body, much grain with much qi, little grain with little qi, full pulse with full blood, deficient pulse with deficient blood are the norm; the reverse is disease; qi deficiency with a hot body comes from summer-heat injury, qi fullness with a cold body from cold damage; much grain with little qi means blood loss; little food with much qi means evil in the stomach and lung; small pulse with much blood means heat within (wine and fish); big pulse with little blood means wind in the pulse; full pulse is heat, deficient pulse is cold; when withdrawing: for excess the right hand opens the needle hole (drain without pressing), for deficiency the left hand closes the hole (tonify by pressing). Blood-deficiency inspection: bluish-black dull face, weak speech, blue veins standing out on the arm. Zhen Jie Pian: needling deficiency makes it full — the needle turns hot; fullness is drained — the needle turns cold; Zusanli ST36, the ben point of the stomach channel, treats both deficiency and excess (excess cools under the needle, cold warms under the needle); wan chen ze chu zhi — let blood from the blood networks, mostly in the lower half of the body (blood stasis in the upper body is mostly internal injury); cold and heat that come and go like a wandering ghost cannot be treated in haste; the nine needles each have their use (today’s filiform needle, blood-letting needle, and plum-blossom needle; in the cold north blood is let at the extremities in winter, in the hot south the points chosen differ — because of the time and place); retaining the needle to await qi (in excess retain until the yin qi arrives in force — the needle turns cold; in deficiency retain until the yang qi arrives — the needle turns hot); the needling mind (depth and shallowness lie in the intention, as if facing an abyss, hands like grasping a tiger, the spirit not occupied by ten thousand things); dao yin (both hands twisting together) for severe paralysis; needling a mass (lump in the lower abdomen) — pass to the top of the mass without entering it, combine with dao yin and internal herbs; the nine needles answer to heaven, earth and the four seasons (the skin answers to heaven).

Opening: finishing the tongue blood-letting technique

Last lecture covered the chapter on needling prohibitions. This time Doctor Ni Haixia does not hurry into a new chapter — he first wraps up one practical technique: tongue blood-letting.

💬 Note from Doctor Ni Haixia: Take a glove, take some cotton and hold the tongue out with it. When you let blood, use a fine needle. Our 32-gauge filiform needle — prick two or three spots on the vein, a few on each side, left and right — this is tongue blood-letting. For wooden tongue, for people who cannot speak clearly — when they have had a stroke and their speech is not fluent, it works very well. But be careful, do not let the patient bite it, do not let your hand get bitten.

💬 Note from Doctor Ni Haixia: Second, after you pull the tongue out, do not let too much blood. Use the fine needle, not a thick one — the kind of needle used for routine blood tests, going in that big, that is going too far. Let a little blood out and that is enough. Going too far is no good — it causes the voice to fail.

Doctor Ni sums up the point of this passage in one sentence: never let too much blood, and never stab the artery.

💬 Note from Doctor Ni Haixia: If the blood of the collateral vessels under the foot keeps coming out and will not stop, the foot swells. If it is the big central vessel — at Weizhong — and you pierce the artery, the person loses color. Because the great blood vessel is there, it is the blood of the middle vessel of qi jie. This qi jie, we introduced it last class — the true qi jie is not a single point, it is a region.

Qi jie is not a point: the whole front of the thigh is qi jie

Here Doctor Ni stops specially to make qi jie clear — this is where beginners in acupuncture most easily get it wrong:

💬 Note from Doctor Ni Haixia: Looking from the front, the knee is here, this is the right leg. Does the Yangming channel not come down along this line? Futu, down to Dubi, then to Zusanli — everything above that is qi jie. In fact qi jie is inside the sinews too. So when you look at the thigh from the side, this is also qi jie — because all these positions are qi jie. The stomach qi of qi jie can reach here, so when cold qi comes, the feet are ice cold, ice, ice — and it stops at the knee.

💬 Note from Doctor Ni Haixia: The vessels inside qi jie — if you stab into the middle of it, there are many arteries there, and if you stab into an artery, the rat-knee region (the groin), the inner part of the leg, will swell up.

And what if the needle goes too deep and hits the bone? Doctor Ni tells a story of the old needle masters:

💬 Note from Doctor Ni Haixia: If the spine gets water — no. If the needle goes very deep and reaches the bone marrow — this does not happen now, but it did before. In the old days needles were not sterilized. Our old masters — the needle was knocked on you, right? Then put back in the pocket and off they went, pulled out and left, and the next patient came. If that needle hit the bone, that was serious — it went into the bone marrow, it inflamed, and the person became bent, hunchbacked (lou). Also, Ruzhong must never be needled — it causes problems, swelling, inflammation that will not resolve; and needling Quepen into the lung causes collapse inward. These are simple common sense for anyone learning acupuncture.

Eight kinds of people who must not be needled: drunk, angry, overworked, full, starving, frightened, deficient

The needle is not for just anyone. Doctor Ni lists the forbidden patients in one breath:

💬 Note from Doctor Ni Haixia: The dead drunk — people who are drunk cannot be needled. People who are furious, angry, are not treated. The overworked, the exhausted, are not needled. People who have just eaten their fill, the greatly full, are not needled. The greatly starving are not needled. People who have had a great fright are not needled either. And what we said before: if the person is too thin — thin in form, greatly deficient, not a drop of yuan qi (original qi) left — then do not needle, we prescribe herbs. This person is already deficient, the disease qi is deep; if you force the needle in, you will push the upright qi out while the disease qi stays inside.

How to needle cold and heat: cold skin needled at the third vertebra, hot bones needled at the kidney shu

The Chang Ci Jie Lun opens with a general principle: “the needler does not diagnose, he listens to what the patient says” — Doctor Ni will return to that later. Then it teaches the needling of cold and heat: “yin ci, one needle in, four places around it. Treats cold and heat.” Doctor Ni translates it into plain words:

💬 Note from Doctor Ni Haixia: In this situation, we put one needle in and add four more around it — one above, one below, one left, one right. This one needle goes into the point, and above, below, left and right we add one needle each — it is specifically for cold and heat. What does aversion to cold mean? Teacher, I am afraid of the cold now. You ask him: where does this cold come from — from the inside, or from the cold of the skin on the outside? The skin is colder; the patient will know.

💬 Note from Doctor Ni Haixia: If the skin is colder — the lung governs the skin and body hair, skin and hair join with the lung — so you go to the lung: is the third vertebra not the third vertebra? Feishu (lung shu) is at the third vertebra. Put a needle in, one above, below, left and right, one cun each way — then the cold disperses. And if it is heat? You ask him: where does this heat come from? “It seeps out from inside my bones.” Right — the kidney governs bone. The patient knows this very clearly, and he will tell you. So there is no fixed point, but always beside the general point, adding one needle above, below, left and right.

Then “shen zhuan zhe ci da zang” — when the disease is deep, which layer do you needle?

💬 Note from Doctor Ni Haixia: If the disease condition is very deep, we must go down beside the bone — this is the principle of needling. And if the disease is in an organ — on the back we have shu points for all the internal organs: Xinshu BL15, Feishu BL13, Ganshu BL18, Pishu BL20, Shenshu BL23 — we have shu for all of them; the small intestine, stomach, large intestine, bladder, of course all have them (Weishu BL21, Pangguangshu BL28, and so on). If the disease comes out from inside an organ, we know it is organ disease, so we needle the shu point on the back — stomach disease, needle Weishu; kidney disease, needle Shenshu; san jiao disease, needle the san jiao shu, and so on. When you needle the shu points of the organs, the cold and heat in the abdomen naturally stop by themselves.

Organ disease needled at the back shu with blood-letting: the bladder channel has little qi and much blood

Blood-letting at the back shu is the great method for organ disease, and Doctor Ni explains the key point thoroughly:

💬 Note from Doctor Ni Haixia: In acupuncture, the Huang Di Nei Jing emphasizes again and again that the bladder channel is the channel with little qi and much blood. So when you treat organ disease — and what we are talking about now is entirely acupuncture, including treating asthma, treating lung and stomach cancer, treating kidney cancer — it is the same, we do not manage the disease inside. When you specifically treat organ disease, you needle the shu points — the shu points on the back — and you may let blood, prick the skin and let a little blood out. When you let blood, it must always be while the patient still has upright qi. If the patient’s yuan qi (original qi) is greatly deficient, and you let more, it will become more deficient and the evil will go deeper. So when you know the patient can still fight the disease, you let the blood out, and the disease evil retreats and goes outward.

Suppurating abscesses and boils: thick needle, rock the hole wide, suck it out with the cupping jar

In the Chang Ci Jie Lun, “for rotten swellings, needle the rotten place” — when an abscess has suppurated, Doctor Ni goes into unusual detail:

💬 Note from Doctor Ni Haixia: When there is an abscess with pus inside, we needle directly on the boil, matching the size and depth of the boil. The boil is deep, you needle deep; the boil is shallow, you needle shallow. How do you know the depth? Very simple — pinch it up, feel it, and you know how deep. Sometimes the needle goes into a hollow — the needle is empty, meaning it is rotten inside, suppurated — so you keep going down until you touch the bottom, then stop.

💬 Note from Doctor Ni Haixia: When we needle a boil we generally use a thick needle — a 32-gauge fine needle is useless, like brushing your teeth, like picking your teeth, it cannot reach it. Take a thicker needle, rock the hole wider, and let the pus come out. If the pus still will not come, suck it out with a cupping jar. Whenever there is pus — as long as the skin has an opening and there is pus — drain it all. You do not need to worry about deficiency or excess, yin or yang, exterior or interior. Why? Because once it has suppurated, the disease is inside; you pull the pus out, and recovery is much faster.

Lumps in the lower abdomen: needle to the top of the mass, back needling at the fourth intervertebral space

Next, “disease in the lower abdomen with accumulation” — the needling of hard lumps in the belly:

💬 Note from Doctor Ni Haixia: When the disease is in the lower abdomen with a lump, a hard mass — underneath is spleen (fat) bluntness, meaning fat — so you pierce straight through the fat and go down until the lower abdomen, meaning you needle to the top of the hard mass. You will see this in the clinic: when a woman has a hard lump in her belly, you can feel it, a big hard lump; some women feel nothing standing up, but the moment they lie down you can feel it. So we needle while the belly is lying down. When you feel the hard lump, you can needle straight to the top of the lump — do not pierce through, do not needle into the lump; needle to the top of it. At least retain the needle (for a while). After needling, that is the front with the needle retained; on the back you may needle beside the spine (jia ji), both sides, at the fourth intervertebral space — counting from the first vertebra of the Governing Vessel, Dazhui, the fourth vertebra onward, two needles on each side; and also needle Gaohuang; then needle the two Liao points and the intercostal spaces beside the floating ribs. This guides the qi in the abdomen — the heat goes down, drains down and out, and it is resolved.

Following “accumulation in the lower abdomen,” Doctor Ni recalls an extraordinary point — Pi Gen:

💬 Note from Doctor Ni Haixia: Do you remember, when I taught the extraordinary points: this is the patient’s back, the fourteenth vertebra is our Mingmen. One segment above Mingmen, three and a half cun lateral — this place has a special name, Pi Gen (the root of the lump). In the acupuncture view, all external disease is bai bing feng zhi shi — all disease begins with wind: it comes in from outside the body; if the skin surface is not resolved, it runs from the sunluo (minute collaterals) to the main channel; if the main channel is not resolved, it runs into the organs. That is how disease gets deeper and deeper — bai bing feng zhi shi.

The Zhi Zhi Lun: how to tell deficiency from excess — qi full with a full body is the normal person

Turning to page 427, the Yellow Emperor asks how to discriminate deficiency and excess, and Qibo answers — Doctor Ni says this chapter is called the Zhi Zhi Lun (in the transcript it appears as “chi zi run”):

💬 Note from Doctor Ni Haixia: Qi full and body full, qi deficient and body deficient — this is the normal person. If you are built solid and strong, your qi is full; thin and thin — that person we just spoke of has no qi, qi deficient and the form deficient — this is the norm. The reverse is disease. People who eat with a good appetite have flourishing qi; people with no appetite have deficient qi. Full pulse with full blood, deficient pulse with deficient blood — how do you know whether the blood is full or deficient? Feel the pulse: a full pulse means the blood is full, a deficient pulse means the blood is deficient — you can see it from the pulse. The reverse is the diseased state.

The Yellow Emperor asks again: how is it reversed? Qibo unpacks it layer by layer:

💬 Note from Doctor Ni Haixia: A qi-deficient person should have a cold body — qi is yang, right? He should be very afraid of cold. But now a qi-deficient person develops heat — this is the reverse, this is disease. Much grain and meat with little qi — eating a lot of food but the yuan qi is still insufficient, the speech still without strength — this kind is all disease. Cannot eat but the qi is much — this person is panting without stop, cannot eat anything, and the qi is much — this is also the reverse. A flourishing pulse with little blood — the pulse is very big, yet the person is blood-deficient.

And what are the disease names for these reversals? Doctor Ni points them out according to the text of the Zhi Zhi Lun:

💬 Note from Doctor Ni Haixia: A person with flourishing qi should not fear cold — a strong man who wears a short-sleeved shirt in winter like Rambo, yet he is afraid of cold, wears many layers and is still cold — qi full and body cold, comes from cold damage (shang han). Qi deficient with heat, comes from summer-heat injury (shang shu): a person with no yuan qi, no strength, yet his whole body runs hot — already hot, plus the summer heat of the blazing sun day after day, heat on heat — he has been injured by summer heat. Much grain with little qi comes from blood loss somewhere — you eat a lot but the essence still does not return, there must be blood loss, bleeding somewhere. Little food with much qi — evil is in the stomach and lung.

The pulse also has its sayings:

💬 Note from Doctor Ni Haixia: Small pulse with much blood — heat within from drinking; you may be a drinker, this type, and eating fish also heats the center. Big pulse with little blood — wind in the pulse, and food and water cannot enter. With anyone’s pulse, a big pulse, a floating pulse, is a wind pulse. A full pulse is certainly heat, and a deficient pulse is certainly cold — so cold and heat are deficiency and excess. Patients who always feel hot have qi fullness; patients who always feel cold have qi deficiency — that is the simple meaning.

Taking the pulse is only confirmation: discard the pulse and follow the signs, as Zhang Zhongjing did

Borrowing the opening line of the Chang Ci Jie Lun — “the needler does not diagnose, he listens to what the patient says” — Doctor Ni explains the true mind of Chinese diagnosis:

💬 Note from Doctor Ni Haixia: This begins the principles of acupuncture — the needler does not diagnose, he listens to what the patient says. A true Chinese doctor takes the pulse only to confirm the judgment from looking, listening and asking. Our looking, listening and asking is already sufficient. If the pulse gives a different answer from what looking, listening and asking have told us, we discard the pulse and follow the signs (she mai cong zheng). Zhang Zhongjing did exactly this in every case. So you must pay attention to what the patient says.

What does a blood-deficient person look like? Doctor Ni teaches a “stolen look” of inspection diagnosis:

💬 Note from Doctor Ni Haixia: The symptoms of blood deficiency: the face looks bluish, more black, more dull; the speech is weak, without strength. When the arm is raised, the blue veins standing out on this side of the arm — that is all anemia. So when I take the pulse, I steal a look at people’s arms — a bad doctor steals a look at whether the woman is pretty. You say “look over there,” and the pulse is forgotten; the arm plainly shows anemia all the time.

💬 Note from Doctor Ni Haixia: Regardless of beauty or ugliness, when we see a patient people often say “when you look at me, what do you think of me?” I say eyes are eyes, nose is nose — that is how we look. Some people think you are playing along with them; I say, of course I will grow — do I look like an idiot? People are happy when you flatter them — everyone likes to be praised, the patient is happy with you: “Ah, this doctor is good, he has confidence,” right? I still praise my patients — often very ugly ones, and I still say “you are beautiful” — and they are delighted: no one ever said I was beautiful, this doctor says I am beautiful, look, this Chinese blind man. We should still say the good things.

The Zhen Jie Pian: the cold and heat under the needle are the deficiency and excess

Around page 429 we enter the Zhen Jie Pian (Explaining the Needle), Chapter Fifty-Four. The Yellow Emperor asks about the way of the nine needles, the way of deficiency and excess of the nine needles. Qibo answers: “needling deficiency makes it full — the needle turns hot; fullness is drained — the needle turns cold.” Doctor Ni says clinically you see this very clearly:

💬 Note from Doctor Ni Haixia: What we call cold and heat, deficiency and excess — clinically, when you put the needle in, you see it very clearly. For example, a person with stomach pain: it hurts now, very uncomfortable. Forget about deficiency or excess — lie down and needle Zusanli. Zusanli is the ben point, master of blood, the ben point of the stomach channel — it treats deficiency and excess alike. When you put the needle in and level-tonify level-drain, if the patient’s stomach is excess, after a moment the needle will turn cold — it will cool, meaning the qi has scattered; if it is cold, you needle until it slowly warms up, meaning the heat qi has returned and the cold is gone. The patient feels it this way. So when you tonify and drain on one point, and that point is itself a ben point — the case where it treats both deficiency and excess regardless — is the most obvious.

💬 Note from Doctor Ni Haixia: A deficient person is cold inside, right? After you needle down, the needle warms up — that represents “needling deficiency makes it full.” So qi full is heat; when a deficient patient is needled and turns cold, that is because of deficiency — you must wait until it turns hot before withdrawing the needle.

Wan chen ze chu zhi: blood stasis lives on the feet

“Wan chen ze chu zhi” — when there is stasis on the channels, let it out. Doctor Ni teaches an extremely handy rule:

💬 Note from Doctor Ni Haixia: Wan chen ze chu zhi speaks of the blood networks, blood stasis on the channels and vessels — at that point we let the stasis blood out. On the body, especially the feet — not much on the hands, most of it is on the feet. The upper body is yang, the lower body is yin; when you have blood stasis — blood is yin — so stasis mostly stops in the lower body. Blood stasis in the upper body is mostly internal injury — a bump, a hit, a pull, or bleeding in the head. In the overwhelming majority of cases, stasis on the channels is in the lower body. That is why varicose veins all grow on the legs — has anyone seen varicose veins on the hands and none on the feet? So far no one has; they all grow on the feet — because the feet are yin, the lower body is yin.

There is a fine point about pressing the needle hole after blood-letting, and Doctor Ni explains it in detail:

💬 Note from Doctor Ni Haixia: In excess, when you let blood, do not press it — let the blood come out as much as it will. In deficiency, when we withdraw the needle, press it as much as possible, do not let the qi escape. Entering excess, the right hand opens the needle hole; entering deficiency, the left hand closes the needle hole — if the person is deficient, when we withdraw the needle we press the hole right away, do not let the qi out; he is already qi-deficient. With a qi-full person, when we withdraw the needle do not press — let the qi leak out a little, and he is better.

Cold and heat that come and go like a wandering ghost: do not treat in haste

Qibo explains deficiency and excess to the Yellow Emperor, still using cold and heat:

💬 Note from Doctor Ni Haixia: Speaking of excess and deficiency: it is the amount of cold and warm qi. Heat is excess, cold is deficiency. And when this cold and heat is ruo wu ruo you — sometimes very shallow, coming and going like a ghost — it cannot be treated in haste. Of the essentials of deficiency and excess, the nine needles are the most wonderful. What the Yellow Emperor’s classic books spoke of in the past were the nine needles; what hangs on our wall are the nine needles; but the needles we use today are all filiform needles, fine needles — thick needles are rarely used. The ancients differed from modern people: the ancients used their bodies a lot, their muscles were solid — a fine needle was useless, like hitting an iron wall and iron arms. Modern people are very, very thin — one poke and it goes in. The needles of old were that thick — only then could they get in.

For the practical use of the nine needles, Doctor Ni teaches a wisdom of “according to the time and the place”:

💬 Note from Doctor Ni Haixia: The nine needles are used in many places for blood-letting. In winter, when the ground outside is frozen, and the disease breaks out in the north — you strip the clothes off to needle, and the patient already has disease, plus cold on top — so we let some blood at the extremities, and that gets rid of it. The south is hot, the climate is hot, so the points we select are also different. So on the mainland, according to the time and the place, there is this kind of choice. What is used most today is our old filiform needle — very fine, only differing in length — plus the blood-letting needle, and the plum-blossom needle — blood-letting on the skin, used for disease on the skin.

Retain the needle until it turns hot under the needle: the technique for needling excess and deficiency

On page 430, Doctor Ni explains retaining the needle to await qi — the most hands-on passage on tonification and draining:

💬 Note from Doctor Ni Haixia: To make the four-season disease become deficient, you must retain the needle. Retain until the yin qi arrives in force, then withdraw — in excess, after the needle is in, leave it inside, wait until the yin qi comes. How do I know? The needle turns cold underneath — the spot by the lamp is cold — then you pull the needle out. If needling deficiency, you must wait until the yang qi arrives in force — how do you know the yang qi has come? The needle becomes very hot underneath. If it does not heat up, twist it, twist the needle a little, and then say to the patient: “I am waiting for the needle to warm up, then I will lift the needle for you.” After a while he will tell you the needle is very hot.

💬 Note from Doctor Ni Haixia: In fact patients are afraid of needles, and will not tell you about the heat, so you keep twisting. This cold and heat — you let him feel it, let the cold come… The qi arriving is very simple — it is not only the patient, the doctor included: the doctor’s mind must arrive.

On page 431, Doctor Ni recites the needling mind of the Zhen Jie Pian, character by character:

💬 Note from Doctor Ni Haixia: Depth and shallowness lie in the intention (shen qian zai zhi) — the person who handles the needle: under the needle there is much danger, and the mind must be clear: you must know whether the disease is inside or outside. Far and near as one, deep and shallow as one. Waiting is like facing an abyss (ru lin shen yuan) — do not dare to fall, do not dare to stop. Hands like grasping a tiger (shou ru wo hu), wishing it strong. The spirit is not occupied by ten thousand things (shen wu ying yu zhong wu) — still the intention, observe the patient, do not look left and right — focus your whole spirit on the patient. So when we guide the qi, hands like grasping a tiger.

Dao yin: both hands twisting together, for severe paralysis

Speaking of “hands like grasping a tiger,” Doctor Ni takes the opportunity to demonstrate the true dao yin (guiding) technique — his rarely used specialty:

💬 Note from Doctor Ni Haixia: For example, if the patient has pain on the bladder channel, the most common method we use is single needling — single needling means if the right side hurts, we needle one point on the left; for Weizhong deficiency we needle Weizhong; one sinew connects, and one sinew can be cured. If you truly do dao yin, how do you do it? It hurts here. One needle down — the painful place is very shallow; channel pain is never deep — you insert a one-cun needle halfway, needle the top there, then put another needle in Weizhong, and guide — hands like grasping a tiger, far and near as one. When you hold both needles in both hands, it is like plugging a plug in — very strong. You normally do not use it; I rarely use it, only for severe cases — severe cases are paralysis. Next time I will make a video for you to watch.

💬 Note from Doctor Ni Haixia: After you get both needles in, when you twist, the movement is the same, simultaneous — when you twist this way, you twist this way, the same direction. This is called dao yin. It comes in one go, extremely fast. But if you are over there watching TV, watching the news — terrorists hitting the Twin Towers, and you are watching intently — there is not a bit of qi. The spirit must arrive — this is dao yin. If I use it three times in a day, I am done for and go home to sleep — I never nap, but I would go nap anyway. Doing real dao yin, you may only be able to treat a few people a day, and already you cannot take any more.

How does dao yin cooperate when needling a mass (tumor)? Doctor Ni gives an advance preview of what will come later:

💬 Note from Doctor Ni Haixia: We will introduce it later — when needling a mass: when there is a lump in the belly, a hard mass, a tumor, the needle goes through the muscle and fat to the tumor — but not into the tumor. This needle on this side, the next needle below it — you must guide, twist simultaneously, and the mass scatters very fast. Of course, add some internal herbs. Acupuncture can achieve dao yin — it is done with both hands together.

💬 Note from Doctor Ni Haixia: With many people you cannot do it, so for single needling we simply use the filiform needle and let the patient settle down. So after we finish needling, we turn the light off and let the patient be quiet — let him say nothing. When the patient’s spirit arrives, the qi comes. So when we retain the needle inside, the patient recovers by himself; I can also help him. The needle and the family must be kept separate — you can be shen wu ying yu zhong wu (spirit unmoved by ten thousand things), right? But if your wife calls you and you pretend not to hear, you are in trouble — I tell you, it is better to keep those two things separate.

The nine needles answer to heaven and earth: closing on “the skin answers to heaven”

At the very end of this lecture, a line suddenly pops out — “as for the so-called Sanli, it is three cun below the knee.” Doctor Ni glances at it and says:

💬 Note from Doctor Ni Haixia: I do not know where this ran out from — it has nothing to do with this chapter. Landscape (ignore it).

The true closing is here — the Yellow Emperor asks how the nine needles answer to the yin and yang of heaven, earth and the four seasons:

💬 Note from Doctor Ni Haixia: The Yellow Emperor asks: the nine needles answer to the yin and yang of heaven, earth and the four seasons — I wish to hear the method, please transmit it to later generations. Qibo then begins to explain our nine needles — these nine needles are the nine hanging on the wall. First: the human skin answers to heaven, and the first needle answers to heaven. The person answers to heaven and earth: the five tones form the human voice, the six pitches form the harmony of yin and yang — when yin and yang join together, the phenomenon of harmony is produced, so music truly can heal disease; the eight winds are the coming and going of qi; and the nine orifices — two nostrils, two ear holes, one mouth — that makes five above, plus the places for urine and stool — nine in all. Because heaven and earth have nine places, we have nine kinds of needles, to answer to the nine orifices of our body.

Closing: the whole secret of needling is in four characters — deficiency, excess, cold, heat

From tongue blood-letting to qi jie, from the eight kinds of forbidden patients to the discrimination of deficiency and excess, from the cold and heat under the needle to two-hand dao yin — this lecture actually explains the two things about acupuncture: when you may needle, and how to needle effectively.

💬 Note from Doctor Ni Haixia: Cold and heat are deficiency and excess; deficiency and excess are cold and heat — patients who always feel hot have qi fullness, patients who always feel cold have qi deficiency. In excess, withdraw the needle without pressing the hole — let the qi out; in deficiency, press the hole — do not let the qi escape. Retain the needle until it turns hot under the needle before lifting it; in dao yin, hands like grasping a tiger and the spirit unmoved by ten thousand things. Of the essentials of deficiency and excess, the nine needles are the most wonderful — the whole principle of needling, said plainly, is these four characters.

Compiled from Doctor Ni Haixia’s Ren Ji (Human Records) lecture series on the Huang Di Nei Jing (Lecture 61)