Editing Acupuncture (section)

=== Needling technique ===

==== Insertion ====

The skin is sterilized and needles are inserted, frequently with a plastic guide tube. Needles may be manipulated in various ways, including spinning, flicking, or moving up and down relative to the skin. Since most pain is felt in the [[Epidermis|superficial layers of the skin]], a quick insertion of the needle is recommended.<ref name=Aung2007>[[#Aung2007|Aung & Chen]], 2007, pp. [https://books.google.com/books?id=I6NclaeDWjgC&pg=PA113 113–14].</ref> Often the needles are stimulated by hand in order to cause a dull, localized, aching sensation that is called ''de qi'', as well as "needle grasp," a tugging feeling felt by the acupuncturist and generated by a mechanical interaction between the needle and skin.<ref name=Berman2010/> Acupuncture can be painful.<ref>{{cite journal | vauthors = Loyeung BY, Cobbin DM | title = Investigating the effects of three needling parameters (manipulation, retention time, and insertion site) on needling sensation and pain profiles: a study of eight deep needling interventions | journal = Evidence-Based Complementary and Alternative Medicine | volume = 2013 | pages = 1–12 | year = 2013 | pmid = 24159337 | pmc = 3789497 | doi = 10.1155/2013/136763 | doi-access = free }}</ref> The acupuncturist's skill level may influence the painfulness of the needle insertion; a sufficiently skilled practitioner may be able to insert the needles without causing any pain.<ref name=Aung2007/>

==== ''{{Lang|zh-latn|De-qi}}'' sensation ====

{{Lang|zh-latn|De-qi}} ({{lang-zh|s=得气|p=dé qì}}; "arrival of qi") refers to a claimed sensation of numbness, distension, or electrical tingling at the needling site. If these sensations are not observed then inaccurate location of the [[acupoint]], improper depth of needle insertion, inadequate manual manipulation, are blamed. If {{Lang|zh-latn|de-qi}} is not immediately observed upon needle insertion, various manual manipulation techniques are often applied to promote it (such as "plucking", "shaking" or "trembling").<ref name="AungChen2007">{{cite book | first1 = Steven | last1 = Aung | first2 = William | last2 = Chen | name-list-style = vanc |title=Clinical Introduction to Medical Acupuncture|url=https://books.google.com/books?id=I6NclaeDWjgC|year=2007|publisher=Thieme|isbn=978-1588902214|page=116}}</ref>

Once ''{{Lang|zh-latn|de-qi}}'' is observed, techniques might be used which attempt to "influence" the ''{{Lang|zh-latn|de-qi}}''; for example, by certain manipulation the ''{{Lang|zh-latn|de-qi}}'' can allegedly be conducted from the needling site towards more distant sites of the body.<!---is this threading?---> Other techniques aim at "tonifying" ({{lang-zh|s=补|p=bǔ}}) or "sedating" ({{lang-zh|s=泄|p=xiè}}) ''qi''.<ref name="AungChen2007"/> The former techniques are used in [[Traditional Chinese medicine#Eight principles of diagnosis|deficiency]] patterns, the latter in excess patterns.<ref name="AungChen2007"/> ''De qi'' is more important in Chinese acupuncture, while Western and Japanese patients may not consider it a necessary part of the treatment.<ref name=Dummies/>