[Overview]

Twisting manipulation, as seen in Zhenjing Zhinan: "Twisting is when the patient feels heat, lying outward with the needle as if twisting cotton, not turning too tightly, treating cold within, lying with the needle and turning forward, considered as twisting." Metal Needle Fu states: "Twisting to remove illness." This indicates that twisting manipulation is a method summarized by acupuncture and moxibustion practitioners from clinical experience, involving twisting the needle handle in one direction like twisting thread, to moderately entangle muscle fibers around the needle body, utilizing its pulling effect to stimulate meridian qi as an auxiliary needling technique.

[Operational Method]

When twisting, generally start from the transverse crease of the distal phalanx of the index finger, using the thumb to twist forward like twisting cotton thread to the tip of the index finger, until the needle feels tight and sunk, with a sensation of being entangled by muscles. Twisting from the transverse crease of the distal phalanx to the tip of the index finger is considered left, inward, and tonifying. Twisting from the tip of the index finger to the transverse crease of the distal phalanx is considered right, outward, and purging.

(Illustration)

[Clinical Application]

1. This method can ensure that qi reaches the needle and does not leave, promoting qi arrival at the affected area.

2. Twisting manipulation combined with leftward insertion can move qi and tonify yang; combined with rightward lifting, it can move blood and tonify yin.

[Precautions]

During operation, avoid excessive or too tight twisting, which can entangle muscles around the needle, cause needle stagnation, and prevent the removal of pathogenic qi.