Chinese Medicine
Vol. 3  No. 1 (2012) , Article ID: 18050 , 7 pages DOI:10.4236/cm.2012.31004

Acupuncture and Needle-Stimulation, Differences in Concepts and Methods

Lei Li1*, To Yau1, Chuen Heung Yau2

1School of Chinese Medicine, The University of Hong Kong, Hong Kong, China

2School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China

Email: *

Received November 28, 2011; revised January 11, 2012; accepted January 22, 2012

Keywords: Traditional Acupuncture (TA) Therapy; Needle-Stimulation; Qi


Based on related elaboration of the Yellow Emperor’s Canon of Medicine, this article analyzed and summarized the clinical meaning, application principles and the basic operating methods of Traditional Acupuncture (TA), and demonstrated that the TA is completely different to modern needle stimulation. TA has a specific application background, direct-viewing thinking mode and clear operational connotation. The key of operation in TA is how to grasp and control Qi, which typically reflect the unique image of the Chinese civilization with intuitive perceptual characteristics of thinking. In contrast, modern needle-stimulation uses needles as a stimulus, to activate a series of physical and functional reactions in a body. There have great differences between the two. It was indicated that correctly understanding with the basic principle and specific meaning of TA is very important in acupuncture clinical and research works.

1. Introduction

Traditional Acupuncture (TA) therapy has a different definition from Needle-Stimulation. If one does not recognize the different context and application principles between the two, then all clinical practices and research will take the wrong track.

The Yellow Emperor’s Canon of Medicine is an ancient classic for Traditional Chinese Medicine as well as for the Traditional Acupuncture. Acupuncture therapy was employed in the Yellow Emperor’s Canon of Medicine to illustrate medical theories, therapeutic principles and methods. Therefore, this classic has laid the groundwork for related fields, and subsequent opinions in acupunctures from general physicians were merely adding to it through for example, simplifying and clarifying the Meridian and Collateral principles, creating new puncturing methods, to compare medicine with the functions of acupoints and to combine the Chronotherapy with acupuncture, etc. Clearly, the Yellow Emperor’s Canon of Medicine has played a leading and significant role in the history of acupuncture.

This article analyzed and summarized discussions in the Yellow Emperor’s Canon of Medicine as the evidence to conclude the clinical meaning, application background, therapeutic principles and operational methods of TA therapy. It is hoped that the clarification of the differences between TA therapy and the modern needle-stimulation will provide a dependable reference for today’s clinical practices and research in acupuncture.

2. Definition of Disease in the Yellow Emperor’s Canon of Medicine

The Yellow Emperor’s Canon of Medicine believes that Qi is the basis for this world, which is the fundamental element to form everything on earth. Heaven and Earth, Yin and Yang are harmonized together for the birth of everything in this world.

The Plain Conversation: Discussion on the Most Important and Abstruse Theory mentions: “The Qi unified between heaven and earth has developed the Six Sections to allow the growth of everything.”

The Plain Conversation: Major Discussion on the Law of Motions and Changes in Nature mentions: “In heaven, Qi exists; on earth, Xing (body) is completed, the coreactions between Xing and Qi generate everything.”

Human, situating between heaven and earth has become the same creature of Qi.

The Plain Conversation: Discussion on Preserving Health and Protecting Life mentions: “Man is born on earth, relies on heaven, receives the integrated Qi between heaven and earth, and then comes into his existence.”

The Plain Conversation: Discussion on Preserving Health and Protecting Life also mentions: “Man lives with the Qi in heaven and earth, sustains according to the principles of four seasons.”

Qi is an essential element to construct the human body. Yin and Yang exist in heaven and earth, as well as inside the human body. All originate from the contrary alignment and interactions between the Qi of Yin and Yang. The Qi of a human is in continuous change, and all physical changes are simply manifestations of the Qi-Activity. Thus, the activities and changes of Qi are the physical activities of a human being.

The Spiritual Pivot: Channels and Collaterals mentions: “Life begins with Jing (essence) firstly created, then brain and marrow formed; bone taken as the trunk, channel as the pathway, tendon as the network, and flesh as the wall; when skin firms, hairs grow, food enters into the stomach; when channels are unobstructed, blood and Qi start to flow.”

The Spiritual Pivot: Life Span mentions: “When blood and Qi are balanced, Ying (Nutrient-Qi) and Wei (Defensive-Qi) are smoothed, Five Zang-organs are built, Shen (spirit) joins with heart, and both ethereal and corporeal souls are in place, human is then born.”

The Spiritual Pivot: Length of Channels mentions: “Qi flows and never stops, as the current of rivers, as the orbits of Sun and Moon. Thus Yin channels nourish the Zangorgans while Yang channels flourish the Fu-organs, as a wheel, turning with no break; it is like a circle no indication of beginning and end.”

The Yellow Emperor’s Canon of Medicine considers the physical function and the antivirus capability as Zheng-Qi (Healthy-Qi), and takes all pathogenic factors as Xie-Qi (Evil-Qi). The definition of Zheng-Qi points towards the normal Qi-Activity, which is up and down, in and out of a body, and the disorder of Qi is considered as a major reason for all happenings of diseases.

The Plain Conversation: Discussion on Acupuncture Methods mentions: “When Zheng-Qi is stored inside, Xie cannot interfere.”

The Plain Conversation: Comments on Febrile Diseases mentions: “When Xie-Qi (Evil-Qi) can intrude, indicates the Qi (Healthy-Qi) is deficient.”

The Plain Conversation: Discussion on Pain mentions: “I understand that all the diseases are raised from Qi: Qi up flows under infuriation, slacks when overjoyed, exhausts in sorrow, sinks in fear, stagnates in coldness, leaks in heat, disorders when frightened, consumes in overtiredness, and clots in contemplations.”

Thus the terminology of “disease” is identified as the abnormal travels of Qi, which is a basic concept in the Yellow Emperor’s Canon of Medicine.

3. Fundamental Therapeutic Principles in the Yellow Emperor’s Canon of Medicine

A treatment of a disease is to emphasize on rebuilding the disordered Qi, and revive to its balance and harmonization.

The Spiritual Pivot: Discussion on the Five Sections in Needling and Comments on the Geniune-Qi and Pathogenic Factors mentions: “The purpose of implementing needles is to manipulate Qi.”

The Spiritual Pivot: Beginning and End mentions: “All puncturing methods are finalized with manipulating the Qi.”

The Spiritual Pivot: Beginning and End also mentions: “Thus, reduction method is to puncture against, while reinforcement method is to puncture along the flows of Channel-Qi. Know when to reinforce, when to reduce, Qi can be harmonized. For harmonizing Qi, one must first understand Yin and Yang.”

The Spiritual Pivot: Nine Needles and Twelve Yuan Points mentions: “General rules for whoever practices needles: to reinforce the Xu (deficiency), to reduce the Man (repletion), to remove the stagnation, to diminish the predominant Xie. The Outline said, ‘slow insertion and quick lifting was reinforcement, quick insertion and slow lifting was reduction.’ Thus, Shi and Xu are representing the presence and absence of Qi. Decide treatments according to its approaching and receding. Obtain or diminish it based upon Xu and Shi.”

The Spiritual Pivot: Application of Needles mentions: “Thus, for whoever practices acupuncture unawares about the annual occurrence, the come and go of Qi, the increasing and diminishing of Xu (deficiency) and Shi (excess), can never be a doctor.”

The Plain Conversation: Discussion on the Theory of Yin and Yang and the Corresponding Relationships among All the Things in Nature mentions: “Thus, the professional acupuncturist can lead Yin to Yang, lead Yang to Yin; use right points cures the diseases on left sides, use left points cures the diseases on right sides; from my normal status to your abnormal condition, from exterior to interior, to understand the rationale of being excessive and deficient; find disease from a tiny sign, eliminate any fatal growth.”

The Spiritual Pivot: Inheritance of Knowledge Accumulated in History mentions: “No matter what types of theory of puncturing, must start with the channel; recognize its circulation routine, identify its length and volume of blood; the interior side of it cures Five Zang-organs, the exterior side of it treats Six Fu-organs; exam the diversifycation of Wei-Qi (Defensive-Qi) who acts as motherhood for all the diseases; balance Xu and Shi to stop their syndromes; let out blood from the collateral when needed, syndrome will be cleared with blood removed.”

The Plain Conversation: Discussion on Collateral Needling Therapy mentions: “For whatever techniques used in puncturing, one must first to examine the channels, press through to feel, manipulate with differentiations between Xu and Shi.”

The Spiritual Pivot: Discussion on Distension mentions: “The technique of acupuncture is to identify the conditions between abnormality and normality. When reduce the Xu (deficiency) and reinforce the Shi (excess), Shen (spirit) will be banished out of a body; Xie-Qi (Evil-Qi) will be intensified while Zheng-Qi (Healthy-Qi) is lost; mistakes made by this unskillful doctor will turn to premature death. Reinforce Xu and reduce Shi will help to center the Shen in place; for one who knows how to fill in emptiness, who is considered as a good doctor.”

Manipulation of Qi, is the basic therapeutic principle in the Yellow Emperor’s Canon of Medicine, and the acupuncture therapy is indeed a major operation method used in this book for manipulating Qi.

4. Acupuncture Principles and Methods in the Yellow Emperor’s Canon of Medicine

The Yellow Emperor’s Canon of Medicine has explicated various operation principles and methods for acupuncture therapies.

4.1. Restoring Shen (Spirit)

Shen does not only imply mind, consciousness and thinking activities, but also a sign of normal status of the up and down, in and out of Qi moving in a body, so that it is a totality of all living activates. Therefore, “Restoring Shen” does not only require a full attention of mind and heart from the doctors, but patients are also requested to be focusing and stay in peace. And most important, doctors must understand the aim of acupuncture therapies that is the proper manipulation of Qi.

Restoring Shen Qi to maintain the balance of the body, this is what is significant for “Restoring Shen” and “Obtaining Shen”.

The Spiritual Pivot: Basic State of Spirit mentions: “All puncturing methods have to deal with Shen.”

The Spiritual Pivot: Qualifications of Acupuncturists mentions: “The key of acupuncture is not to forget about Shen.”

The Spiritual Pivot: Nine Needles and Twelve Yuan Points mentions: “The ordinary one sticks to Xing (body), while the excellent one governs the Shen (spirit).”

The Spiritual Pivot: Explanation of the Small Needles explains: “ ‘The ordinary one sticks to Xing’ is about the method to use needles. ‘The excellent one governs the Shen’ is about puncturing with guarding the excess and deficiency of blood and Qi, and apply reinforcement and reduction methods accordingly.”

The Spiritual Pivot: Nine needles and Twelve Yuan Points also mentions: “The way of holding needles, as firm as holding the treasures. Insert straightly without deviations. Pay full attentions on even tinny changes from the patient. Exam closely on blood vessels, avoid dangers in punctureing. On top of these, inspect the eyes and complexion of the patient. Capture the Shen, so as to find out the progression of a disease.”

The Spiritual Pivot: Beginning and Ending mentions: “Stay isolated in a quiet place, observe closely the mental state. Shut inside a room to calm the body, then soul will not scatter. Focus the mind, then Jing (essence) and Qi will not detach. Hear no noise, as to store up Jing. Unify the Shen to center onto the needles. Insert shallowly and retain, rotate lightly and wait; to direct the Shen from the patient, finish up when Qi is adjusted.”

The Plain Conversation: Discussion on Preserving Health and Protecting Life mentions: “The reality of puncturing, Shen must be cured as the first priority. With understanding of Five Zang-organs, considering the Nine Divisions (pulse states), then treat with needles. Check if the pulses have reflected real problems of the disease, inspect if any potential danger is neglected; treat both the external (body) and internal (Shen), not to prioritize only Xing (body). Then, it is able to puncture, and to manipulate the arrival and departure of Qi.”

The Plain Conversation: Discussion on Preserving Health and Protecting Life also mentions: “The depth of puncturing is decided by treatment purposes, select distal or proximal points correspondingly. Apply needles as approaching to a deep abyss, and as holding the wand of power. Focus the mind with no distraction from other matters.”

4.2. Acquiring Qi

The purpose of acupuncture therapy is the “Manipulation of Qi”; in logic, “Acquiring Qi” must occur before Qi can be manipulated. Therefore, “Acquiring Qi” is the requisite factor before the “Manipulation of Qi”.

“Acquiring Qi” means a congregation of Qi from patients’ acupoints during acupuncture. Prior to the usage of reinforcement or reduction methods, Qi must first be acquired, wait for the “Arrival of Qi”, then the acupuncturist is able to apply different operation methods: to expel the Xie-Qi (Evil-Qi/pathogen), or to receive and retain the spirit and Zheng-Qi (Healthy-Qi). Thus, “Acquiring Qi” is the key in the Acupuncture therapy.

According to the discussion in the Yellow Emperor’s Canon of Medicine, acupuncture can only be effective when Qi is acquired. “Acquiring Qi” does not only mean to confirm the characteristic of Qi before operation, choosing a proper treatment on reinforcing the deficiency and reducing the excess, to help reviving Healthy-Qi and dispersing Evil-Qi, it also means to uphold and maintain the Qi which has been balanced after treatment, to secure Healthy-Qi while expelling Evil-Qi.

The Spiritual Pivot: Nine Needles and Twelve Yuan Points mentions: “Puncturing with waiting for Qi to come, wait with no limit of time. When Qi arrives and being adjusted, withdraw and not to puncture again. Different needles are in their specific strengths, different in shapes, and various in functions. The aim of puncturing: Qi arrives as effective. A sign of the effectiveness is similar as wind blows away heavy clouds to restore a clear blue sky. That is the way of puncturing.”

The Spiritual Pivot: Nine Needles and Twelve Yuan Points also mentions: “The ordinary one sticks to Guan (acupoint), the excellent one focuses on Ji (Qi). The movement of Ji is never out of the hollow (channel). Ji acts lightly and quietly inside the hollow. It should not be confronted when approaching toward, and not to be chased when receding away.”

The Spiritual Pivot: Nine Needles and Twelve Yuan Points also mentions: “Exam one’s complexion, inspect one’s visual changes, as to learn the dispersion and restoration of Qi. Observe one’s Xing (body), listen to one’s movements, as to identify Xie-Qi (Evil-Qi) and Zheng-Qi (Healthy-Qi). Insert with right hand while assisted with the left; when Qi arrives and has been adjusted, withdraw.”

The Plain Conversation: Discussion on Preserving Health and Protecting Life mentions: “Hand moves consistently in harmony, the needle goes in and out evenly in clarity. Watch and feel quietly the changes of Qi. Its changes can only be felt underneath, not in the appearance. Qi comes like a bird’s singing, and flying swiftly without leaving its shadow. The retention of needles is like a fully hauled bow, while the arrival of Qi is like shooting an arrow.”

The Spiritual Pivot: Beginning and End mentions: “Thus, the first puncture is to let out Yang-Xie (Yang Pathogen), the second one is to discharge Yin-Xie (Yin Pathogen) and the third one is to lead in Gu-Qi (Food-Qi); end it when Gu-Qi is restored. The meaning of the arrival of Gu-Qi implies: Zheng-Qi (Healthy-Qi) has been restored, Xie-Qi (Evil-Qi) has been removed, and then Gu-Qi can come.”

The Spiritual Pivot: Beginning and End also mentions: “Xie-Qi arrives with feeling tight and swift underneath, Gu-Qi arrives with feeling smooth and peaceful underneath.”

The Spiritual Pivot: Beginning and End also mentions: “In puncturing, lead in Men (Yang) and let out Women (Yin); prevent firmly the leakage of Yang-Qi, and protect closely against the entry of Yin-Xie; that is called acquiring Qi.”

The Spiritual Pivot: Circulation of Wei-Qi (DefensiveQi) mentions: “Healing with the arrival of Qi, diseases can be cured in an expected timing; if missing the right time of Qi flows, none of the diseases can be cured. Thus it is said, ‘puncturing the Shi (excess) syndrome, punctured against the flow, puncturing the Xu (deficiency) syndrome, punctured along the flow.’ This explains that the presence and absence of waiting for Qi is essential to treat the Xu and Shi. And that puncturing with the arrival of Qi is called the right timing.”

The Spiritual Pivot: Climatic Changes in the Four Seasons mentions: “Qi in four seasons are located differently; the way of acupuncture and moxibution is to acquire Qi.”

4.3. Reinforcement and Reduction

Qi has both the characteristics of deficiency and excess, hence both the reinforcement and reduction treatments are essential.

In the Yellow Emperor’s Canon of Medicine, Qi travelling within the channels is an objective substance with a perceptive and minimal existence. To implement the reinforcement and reduction methods in acupuncture, one must first be aware of the existence of the Channel-Qi of an acupoint, then feeling the changes of Qi-Activity to further learn about the excessive and the deficient syndromes of Qi, so as to operate with using both reinforcement and reduction methods.

All discussions with regard to reinforcement and reduction methods in acupuncture in the Yellow Emperor’s Canon of Medicine stem directly from perceptions in the ancient Chinese about blood and Qi in the channels based on their straightforward intuitive understanding. Medical experts in ancient times combined their knowledge in experiences in Qi-Gong, stone needling, acupuncture and moxibustion etc, together with their observations of channel transmissions. Gradually these different concepts come together into a coherent structure. When the channel concept and the acupoint theory are integrated, acupoints become critical locations for the flows of Qi and blood, as well as when implementing methods for reinforcement and reductions on the Qi.

As blood has a form, it is visible, and requires no special manipulating methods. Therefore, the reinforcement and reduction methods in acupuncture are mainly concerned with Qi. The straightforward interpretations in the Yellow Emperor’s Canon of Medicine about Qi and the Qi-Activity in channels have helped to characterize a direct image visualization for the reinforcement and reduction operational methods.

The Spiritual Pivot: Nine Needles and Twelve Yuan Points mentions: “Regressing from the flow of Qi means Ni, progressing towards the flow of Qi means Shun; with well understanding of Ni and Shun, there will be no problem to puncture. If seize with applying Ni, how can an evil spirit not be weaken? If chase along with enhancement, how can the healthy Qi not be strengthened? Regress or progress it, use spiritual will to harmonize it. That is the way of puncturing.”

The Spiritual Pivot: Nine Needles and Twelve Yuan Points also mentions: “Reduction means firmly insert and loosely lift up, leave open the puncturing hole. Puncturing to discharge Yang, so the Xie-Qi (Evil-Qi) can be dispersed. If withdraw needles with pressing the puncturing hole, this will cause to ‘internal stagnation’, when blood cannot be dissipated and Qi (Xie-Qi) cannot be dispersed.”

The Spiritual Pivot: Nine Needles and Twelve Yuan Points also mentions: “Reinforcement is to follow casually along the channels. Lightly adjusting and pressing, as if a mosquito is biting. Loosely retain, while lift up as if shooting out an arrow. Using right hand to withdraw while left hand to assist to press, Qi stays. With shutting the door (puncturing hole), Zhong-Qi (Center-Qi) is secured.”

The Spiritual Pivot: Beginning and Ending mentions: “Reinforcing the Shi (excess), puncturing deeply, not to press the puncturing hole at withdrawal so as to release Xie-Qi (Evil-Qi); reducing the Xu (deficiency), puncturing shallowly to nourish the channel, press quickly at withdrawal so as to prevent the invasion of Xie-Qi. …When the pulse is strong, puncture deeply, to disperse Xie-Qi; when the pulse is weak, puncture shallowly, to prevent leakage of the Jing-Qi (Essence-Qi), to help flourishing the channel to releasing the Xie-Qi.”

The Plain Conversation: Discussion on the Separation and Combination of Zheng-Qi and Xie-Qi mentions: “Diagnose through a careful examination of the Three-region and Nine-division. When diagnosis is confirmed, an immediate action should be taken against further progresssions. The patient is to inhale when inserting needles to prevent a reverse flow of Qi. Retain quietly for waiting the Qi comes, so as to stop the spreading of Xie. Rotating needles while patient is inhaling to acquire Qi. Withdrawing needles while patient is exhaling, withdraw at the end of the breath. When the major Xie-Qi is drawn out, it is called ‘reduction’.”

The Plain Conversation: Discussion on the Separation and Combination of Zheng-Qi and Xie-Qi also mentions: “Firstly, touch to feel through, press to disperse, then push and press, flick to dilate. Finally, nail the point and insert, when the Channel-Qi is smoothened; withdraw when Qi is acquired, withdraw with an immediate press to keep the Shen (spirit); exhale fully while needle is inserting, retain quietly and wait long enough until Qi arrives. It is like welcoming an honorable guest with taking no note of time. When Qi arrives, maintained properly. Patient inhales while needle is withdrawn, Qi will be kept in place. Push and press to close the puncturing hole, then Shen-Qi can be restored. Da-Qi (Zheng-Qi) is preserved, and that is called ‘reinforcement’.”

The Plain Conversation: Discussion on the Regulation of channels mentions: “To reduce Shi (excess), insert needles when Qi is firmed. Needle and Qi are entering together, seems to open the door, as to facilitate the room. Needle and Qi are coming out together; Jing-Qi (EssenceQi) is intact, while Xie-Qi (Evil-Qi) is discharged. The door remains unclosed, to let out of disease. Shake open the road (puncturing hole), as to benefit the pathway, and that is called Da-xie (numerous reduction). Must push hard while withdrawing, to expel the Da-Qi (Xie-Qi).”

The Plain Conversation: Discussion on the Regulation of channels also mentions: “Not to rush when inserting a needle, first to calm the mind. To insert with waiting inhalation from the patient, withdraw when the patient exhales. To achieve the fullness underneath the needle, Jing (essence) has no way out. When the Qi is secured, quickly withdraw while the patient breathes in, heat (Yang) will not be retreated. Shut the door (puncturing hole), then Xie-Qi is dissipated and Jing-Qi is preserved. Waiting is required in Qi manipulations, the obtained Qi will not be lost while more Qi are coming in from the far, and that is called chasing (reinforcement).”

The Plain Conversation: Discussion on Preserving Health and Protecting Life mentions: “Puncturing the Xu, reinforcement must be used; puncturing the Shi, reduction must be applied. When the Channel-Qi is gained, keep cautiously not to loose.”

The Plain Conversation: Discussion on the Fundamentals of Acupuncture mentions: “Thus, Shi means Qi (XieQi) enters; Xu means Qi (Zheng-Qi) leaves. When Qi is Shi, it is hot; when Qi is Xu, it is cold. To reduce Shi, the puncturing hole will stay opened with the left hand; to reinforce the Xu, the puncturing hole will be shut with the left hand.”

The Spiritual Pivot: Carbuncles and Gangrene mentions: “Judge the pulse, treat Shi with reduction, reduce means to decrease it, retain shortly so that Xie-Qi (EvilQi) will be minimized; retain long enough to receive Zheng-Qi (Healthy-Qi), heal Xu with reinforcement, reinforce means to increase it. When blood and Qi have been adjusted, Xing (body) and Qi will maintain.”

4.4. Manipulation of Qi

In the broad interpretation, all discussion about reinforceing and reducing acupuncture methods in the Yellow Emperor’s Canon of Medicine are actually principles on the “Manipulation of Qi”, and all puncturing methods are indeed methods to manipulate Qi. Employing acupuncture to regulate Qi-Activity: to conduct the Qi, or to disperse the pathogen, or to reinstall the Healthy-Qi, or to reduce the excess, or to reinforce the deficiency, all these are aimed to restore the balance of Qi.

Acupuncture methods do not all belong to the methods of reinforcement and reduction. An actual inspection of the Qi-Activity from a patient at his or her acupoints has the same importance when deciding on the type of therapies that a doctor is to apply. “Manipulation of Qi”, as the major characteristic, has concluded all operation methods in acupuncture.

The Spiritual Pivot: Root and Knot mentions: “Thus it said, ‘the key of implementing needles was to understand how to manipulate Yin and Yang. When Yin and Yang were balanced, the Jing-Qi (Essence-Qi) would be replenished; when Xing (body) and Qi were integrated, Shen (spirit) would be concealed.’”

The Spiritual Pivot: Five Disorders mentions: “Slowly insert and withdraw, which is called directing Qi. Stay neutrally between reinforcement and reduction, which is called Tong-Jing (preservation of essence). This is not a way to treat sufficiency or insufficiency, but to cure the disorder of Qi.”

The Spiritual Pivot: Qualification of Acupuncturist mentions: “Thus, when implementing needles, a doctor must aware where the Qi is located, then secures the entrance (puncturing hole). Aware that manipulating Qi is about knowing when to reinforce or reduce, how to interpret slow or quick motion, what is the proper point to select.”

The Spiritual Pivot: Qualification of Acupuncturist also mentions: “The rule of puncturing is to know where Xing (body) and Qi are located, left or right, up or down, Yin or Yang, external or internal, the quantity of blood and Qi, the Channel-Qi flows, in and out the convergence; avoid over-treatment, know how to remove stagnation, recognize when to reinforce Xu and reduce Shi; aware the upper and lower gate for Qi movement; identify the Four Seas, and where they are located; observe the manifestations of coldness and heat, emaciation and fatigue, and where they goes; exam carefully to manipulate Qi; understand the pathways for channels; know fully where the left and right collaterals are converged; the battles between coldness and heat can be harmonized through adjustment; the familiarity between Xu and Shi can be dealt with differentiations; disorders between left and right can be treated by puncturing the opposite; aware the pessimistic and optimistic of a disease, so as to see if it is curable; capture the balance of Yin and Yang, so the recuperation is predictable; to exam the origination and end, know whether it is cold or heat, identify where the Xie (Evil-Qi) is located, one will never miss in million punctures; understand the properties of the Nine Needles, then the theory of acupuncture is completed.”

The Spiritual Pivot: Abnormal Changes of Wei-Qi (Defensive-Qi) mentions: “Changes of a disease can be float up or sink in, deep or shallow, with uncountable sum, and locate variously. Treat a mild disease, insert shallowly; to treat a serious one, insert deeply, less (needles) for the trivial one, and more (needles) for the serious one. Manipulating with following the change of Qi, one is called the excellent doctor.”

The Plain Conversation: Discussion on the Theory of Yin and Yang and the Corresponding Relationships among All the Things in Nature mentions: “Thus it said, ‘punctured at the beginning of a disease; when it was getting too serious, wait to puncture at its declining.’ Therefore, a mild one can be treated with dispersion therapy, a serious one should be healed with alleviation therapy, and weakness can be cured with nourishing therapy.”

The Spiritual Pivot: Discussion on Great Perplexity mentions: “First to exam the Zang-organs and Fu-organs, remove minor pathogenic factors, then manipulate the Qi: to reduce the Shi, to reinforce the Xu; diagnose must be given according to a prior recognition of the physical and mental comfort and sufferings.”

The Plain Conversation: Discussion on the Mysterious Influence of the Eight Directions on Acupuncture mentions: “To manipulate blood and Qi in accordance with climate changes. It is forbidden to puncture in cold weather, warm days are fine; no reduction when the moon is starting to rise, no reinforcement at full moon days, no acupuncture when the moon dims down. That is called ‘manipulating along timing’.”

The Yellow Emperor’s Canon of Medicine has established the operational principles and the fundamental connotations in the Traditional Acupuncture therapy. Undoubtedly, if one does not follow the gist of operational methods in acupuncture when conducting clinical practices and researches, such work is not being conducted in accordance with TA therapy.

5. Conclusions

The modern physiological concept on “stimulation” is different to the Traditional Acupuncture therapy (Table 1).

“Needle-stimulation” is the use of needles as a way to activate as range of different physical reactions, where stimulations from the needles are sensed by a body to arouse a series of reactions from body cells, tissues and organs, and thus cause to the changes of its internal conditions. Hence, needle-stimulation is merely a stimulating mode, which requires no serious participation from the doctor, and the physiological response towards “needle-stimulation” is its only emphasis and purpose.

Table 1. Differences between acupuncture and needle-stimulation.

On the other hand, Traditional Acupuncture therapy employs needles as a basic tool, which will be operated through a well-trained practitioner. Once the syndromes have been differentiated, the first thing when inserting a needle is to be able to feel the Qi-Activity underneath, then implement the corresponding therapies: reducing the Qi to let out of pathogens; or doing reinforcement to lead in healthy Qi to the therapeutic point; or manipulating Qi to balance the disordered Qi-Activity. Such concrete operational methods are the pillars of TA therapies.

Obviously, the connotation of acupuncture therapy is a classic illustration of Chinese culture, for its direct image visualization with intuitive logic. The Traditional Acupuncture therapy thus is different to “needle-stimulation”. Acupoints, meridians and collaterals have their designated meanings as the aggregation locations for and the pathways for the movements of Qi, and are not equivalent to the so called “stimulation points” or “stimulation lines”.

To be able to understand and manage properly what have been really taught in the Yellow Emperor’s Canon of Medicine has become the primary and the critical step to implement accurately on further clinical practices and research in acupuncture.


  1. “The Yellow Emperor’s Canon of Medicine: Plain Conversation (copied print),” People’s Health Publishing House, Beijing, 1956.
  2. “The Spiritual Pivot (copied print),” People’s Health Publishing House, Beijing, 1956.


*Corresponding author.