“Careful inspection of complexion and examination of visual changes [enable one] to know[whether Qi is] dispersed or restored. Close observation of the physical condition and differen¬tiation of voice [changes of the patient enable one] to know [the states of]pathogenic factors and Healthy - Qi. The right [hand is] responsible for pushing [the needle] while the left [hand] holds [the body of the needle] to assist [insertion of the needle] . [The needle is] withdrawn when Qi has arrived. Before applying acupuncture，[the doctors] must examine the pulse condition [to see whether the visceral] Qi is deficient or excessive. [Only when the state of the Visceral - Qi is made clear can] treatment be de¬cided. [When] Qi of the Five Zang - Organs is already exhausted inside, the use of acupuncture to reinforce [the Yang Channels in] the external [will make Yang more predominant and Yin more deficient, leading to exhaustion of the Visceral - Essence. Such a pathological change is] known as Chongjie (double exhaustion) which inevitably causes death. [The patient appears] quiet when dying. [This is due to the fact that] the doctors have violated [the principles o£ reinforcing and reducing] the Qi [of the Yin and Yang Channels] and selected [the Acupoints located below] the armpit and [over] the chest. [When] Qi of the Five Zang — Or¬gans is already exhausted externally，the use of acupuncture to reinforce [the Yin Channels in] the internal [will make Yang more deficient and Yin more predominant, leading to coldness of the four limbs. Such a pathological change is] known as Nijue (coldness of the limbs) which inevitably causes death. [The pa¬tient appears] restless when dying. [This is due to the fact that] the doctors have selected [the Acupoints located on] the four limbs. [If the needle has been inserted into] the affected part [but is not withdrawn, it will] lead to discharge of Jing (Essence - Qi); [if the needle has not been inserted into] the affected part [but is withdrawn，it will] lead to stagnation of Qi[l5]. Discharge of Jing (Essence - Qi) will worsen the disease and weaken the body while stagnation of Qi will cause carbuncle and sores [due to retention of pathogenic factors in the skin].