﹝Overview﹞
The needle-inserting method, also known as the needle-piercing method, needle-lowering method, and needle-inserting method, is the technique of inserting a needle into an acupoint. During acupuncture, the hand holding the needle is generally referred to as the "needling hand"; the hand pressing the local acupoint is called the "pressing hand." Since most doctors use their right hand to hold the needle and their left hand to assist, the so-called needling hand is usually the right hand, and the pressing hand is the left hand. Both hands must cooperate during needle insertion to achieve good results. Therefore, the Biao You Fu states: "The left hand presses heavily and repeatedly to disperse the qi; the right hand inserts gently and slowly, which is the reason for the absence of pain." This is the valuable experience of predecessors, highlighting the importance of cooperation between both hands during acupuncture.
﹝Operational Methods﹞
1. Single-handed needle insertion: Hold the needle with the thumb and index finger of the needling hand, place the tip of the middle finger close to the acupoint, and press the lower part of the needle shaft with the finger pad. When the thumb and index finger press down forcefully, the middle finger bends accordingly, inserting the needle perpendicularly to the required depth. This method is mostly used for shorter filiform needles.
2. Two-handed needle-inserting method: Both hands cooperate to insert the needle. There are mainly the following types:
(1) Nail-pressing needle insertion: Also known as fingernail-pressing needle insertion. Use the nail of the left thumb or index finger to press the acupoint, hold the needle with the right hand, place the needle tip close to the nail edge, and quickly insert it under the skin.
(2) Pinching needle-inserting method: Use the left thumb and index finger to pinch the lower part of the needle shaft, exposing the needle tip. Hold the needle handle with the right thumb and index finger, align the needle tip with the acupoint, and as it approaches the skin, both hands cooperate to quickly insert the needle under the skin to the required depth. This method is mostly used for inserting needles longer than 3 inches.(3) Skin spreading needle insertion: Extend the five fingers of the left hand flat, place the index and middle fingers apart on the acupoint, and insert the needle from between the left index and middle fingers. During needle manipulation, the index and middle fingers can hold the needle shaft to prevent bending. This method is suitable for deep insertion with long needles. For areas with loose or wrinkled skin, use the thumb and index finger to stretch the skin tightly on both sides to facilitate needle insertion. This method is mostly used for inserting needles in abdominal and facial acupoints.
(4) Pinching needle insertion: Use the right thumb and index finger to pinch the skin at the acupoint, and insert the needle from the upper part of the pinched area. This method is mainly suitable for areas with thin skin and flesh, especially for inserting needles in facial acupoints.
(5) Needle insertion with tube: Use a metal tube or a specialized needle inserter to replace the pressing hand. Select a filiform needle with a flat or tube handle, and use the right index finger to strike the needle handle, quickly inserting the needle tip into the acupoint, then remove the tube.
﹝Clinical Application﹞
From a clinical perspective, needle insertion only requires accurate placement, minimizing pain, and quickly obtaining qi. Different needle insertion methods should be reasonably selected based on the anatomical characteristics of the acupoint location and the different requirements for tonification and sedation. The most commonly used needle insertion methods in clinical practice are the rapid insertion method and the twisting insertion method:
1. Rapid insertion method: A quick needle-inserting method. The key is to tightly hold the needle shaft or tip and forcefully tap the needle into the acupoint.2. Twisting Insertion Method: This involves inserting the filiform needle into the acupoint while twisting it. Compared to perpendicular insertion, twisting insertion is mechanically easier to penetrate the skin, thus it also features faster needle insertion and less pain.
﹝Precautions﹞
1. When inserting the needle, strictly disinfect the skin around the patient's acupoint. When holding the needle body with fingers, wrap the needle body with an alcohol cotton ball.
2. Focus your mind when inserting the needle, concentrate fully, and coordinate both hands closely during the procedure.