Objectives : The authors performed this study to further understand Saam acupuncture treatment in an aspect of the use of two patterns i.e. fixed- and transformed-pattern. Methods : The authors did documentary survey based on Do Hae Kyo Kam Sa Am Do In Chim Beop. 1. We investigated the frequency of the use of fixed- and transformed-pattern as well as the examples of use. 2. We surveyed related literatures and classified transformed-pattern. We did study on the principles of prescriptions of fixed- and transformed-pattern and researched the utilization. Results and Conclusions : 1. Fixed-pattern occupys 35.3% and transformed-pattern takes much more part. 2. Fixed-pattern is based on Nangyoung 69nan, and has the prescription of two enhancement and two inhibition by adaptation of Sangsaengsanggeuk(相生相剋) into self meridian and other meridian, and suggests the importance of the order of needling. 3. There are main points and assistant points in tonifying and suppressing of Fixed-pattern, accordingly, it has a system like Gunshinjwasa(君臣佐使). 4. Transformed-pattern is classified into following 3 types: first, the use of Nangyoung 75nan; second, the substitution of Junghuyl(井穴) with Hyunghyul(滎穴) or Haphyul(合穴) according to Nangyoung 73nan; third, the substitution of the same Osuhyul(五輸穴) in other meridians.