（《灵枢·九针十二原篇》《小针解篇》）
夫气之在脉也，邪气在上，浊气在中，清气在下。故针陷脉则邪气出，针中脉则浊气出，针大深则邪气反沉，病益
（《灵枢·九针十二原篇》。邪气在上者，贼风邪气也。浊气在中者，水谷之气也。清气在下者，寒湿之气也。陷脉
诸义，具如下文；但缺取清气在下之义，或有所失。）故曰皮肉筋脉各有所处，病各有所宜，各不同形，各以任其所宜。
（经络疾病各有所处，九针各不同形，故其任用亦各有所宜也。）无实无虚，损不足而益有余，是谓甚病，病益甚。（无
实者，无实实也。无虚者，无虚虚也。反而为之，不惟不治病，适所以增病。）取五脉者死，取三脉者 ，夺阴者死，
夺阳者狂，针害毕矣。（五脉三脉，义如下文。 音匡，衰残也。）
《小针解》曰∶夫气之在脉也、邪气在上者，言邪气之中人也高，故邪气在上也。（此释上文之义也。伤于风者，
上
先受之，故凡八风寒邪之中人，其气必高而在上。）浊气在中者，言水谷皆入于胃，其精气上注于肺，浊溜于肠胃，言
寒
温不适，饮食不节，而病生于肠胃，故命曰浊气在中也。（水谷入胃，其清者化气，上归于肺，是为精气。若寒温失宜，
饮食过度，不能运化，则必留滞肠胃之间而为病，此浊气在中也。）清气在下者，言清湿地气之中人也，必从足始，故
曰
清气在下也。（伤于湿者，下先受之，故凡清湿地气之中人，必在下而从足始。）针陷脉则邪气出者，取之上。（诸经孔
穴，
多在陷者之中，如刺禁论所谓刺缺盆中内陷之类是也。故凡欲去寒邪，须刺各经陷脉，则经气行而邪气出，乃所以取阳
邪之在上者。）针中脉则浊气出者，取之阳明合也。（阳明合穴，足三里也。刺之可以清肠胃，故能取浊气之在中者。）
针
大深则邪气反沉者，言浅浮之病，不欲深刺也，深则邪气从之入，故曰反沉也。（反沉，病益深也。）皮肉筋脉各有所处
者，言经络各有所主也。（皮肉筋脉，各有浅深，各有所主，以应四时之气也。）取五脉者死，言病在中，气不足，但用
针尽大泻其诸阴之脉也。（五脉者，五脏五输也。病在中，气不足，而复尽泻其诸阴之脉，故必死。）取三阳之脉者，唯
言尽泻三阳之气，令病患 然不复也。（手足各有三阳，六腑脉也，六腑有六输。若不知虚实而尽泻之，令人 然羸败，
形气不可复也。）夺阴者死，言取尺之五里，五往者也。（夺阴者死，夺脏气也。尺之五里，尺泽后之五里也，手阳明经
穴，禁刺者也。详见后六十一。）夺阳者狂，正言也。（正言，即如上文取三阳之谓。）
(From *Ling Shu: Nine Needles and Twelve Origins Chapter* and *Small Needle Explanation Chapter*)
Regarding the distribution of Qi in the meridians, pathogenic Qi (Xieqi) tends to be in the upper part, turbid Qi (Zhuoqi) in the middle, and clear Qi (Qingqi, here referring to cold-dampness) in the lower part. Therefore, needling the superficial sunken vessels expels pathogenic Qi; needling the middle vessels expels turbid Qi. If needling is too deep, pathogenic Qi that was superficial may sink deeper into the body, causing the disease to worsen.
(*Ling Shu: Nine Needles and Twelve Origins Chapter* states: "Pathogenic Qi in the upper part" refers to invasion by treacherous wind and pathogenic factors; "Turbid Qi in the middle" refers to the metabolic products of food and drink; "Clear Qi in the lower part" refers to cold-dampness. The meanings of these various terms are detailed in the following text; however, the original text lacks an explicit explanation for "Clear Qi in the lower part," which may be an omission.) Thus it is said that skin, flesh, sinews, and vessels each have their specific locations, diseases each have their appropriate treatments, forms differ, and one should act according to what is suitable for each.
(Meridian diseases have specific locations; the nine types of needles have different shapes, so their applications vary accordingly.) One must not commit the errors of "reinforcing excess" or "depleting deficiency." Doing so damages healthy Qi while benefiting pathogenic Qi, which is called severe mismanagement, leading to a worsening of the condition. ("No reinforcing excess" means do not use tonification for excess syndromes; "No depleting deficiency" means do not use sedation for deficiency syndromes. Acting contrary to this will not only fail to cure the disease but exacerbate it.) Incorrectly needling the five pulses [of the Zang organs] leads to death; incorrectly needling the three Yang pulses leads to debility; depleting Yin leads to death, and depleting Yang leads to mania. The harms of needling are thus complete. (The meanings of "five pulses" and "three pulses" are explained below. "Kuang" sounds like kuāng, meaning debilitated or decayed.)
The *Small Needle Explanation* states: Regarding "pathogenic Qi in the upper part," it means that when pathogenic factors invade the human body, they tend to affect high positions, hence pathogenic Qi is in the upper part. (This explains the previous statement. Those injured by wind are first affected at the top; therefore, whenever wind-cold-pathogenic factors invade, their location is necessarily high and superior.) Regarding "turbid Qi in the middle," it means that water and grain enter the Stomach, their essence ascends to the Lung, while turbidity lingers in the intestines and stomach. If there is improper regulation of cold and warmth, or irregular diet, disease arises in the intestines and stomach, hence it is called "turbid Qi in the middle." (After water and grain enter the Stomach, the clear portion transforms into Qi and returns to the Lung, which is the essence. If cold and warmth are imbalanced, or diet is excessive, leading to failure in transformation and transportation, stagnation occurs in the intestines and stomach, forming disease; this is turbid Qi in the middle.) Regarding "clear Qi in the lower part," it means that when cool and damp earthy Qi invades the human body, it necessarily starts from the feet, hence it is called "clear Qi in the lower part." (Those injured by dampness are first affected at the bottom; therefore, whenever cool and damp earthy Qi invades, it affects the lower part and starts from the feet.)
Needling the sunken vessels to expel pathogenic Qi involves selecting points in the upper region. (Acupoints of the various meridians are mostly located in depressions, such as mentioned in the *Forbidden Needling Theory* regarding "needling into the hollow of the Supraclavicular Fossa." Thus, to dispel Yang pathogenic factors located above, one must needle the sunken vessels of the respective meridians to promote Qi flow and expel pathogens.) Needling the middle vessels to expel turbid Qi involves selecting the He-Sea point of the Foot-Yangming Meridian. (The He-Sea point of Yangming is Zusanli [ST 36]. Needling it can clear the intestines and stomach, thereby expelling turbid Qi in the middle.) Needling too deeply causing pathogenic Qi to sink refers to the fact that for superficial diseases, deep needling is undesirable. Deep needling allows pathogenic Qi to follow the needle inward, hence it is called "sinking in reverse." ("Sinking in reverse" implies the disease becomes deeper.) That skin, flesh, sinews, and vessels each have their locations means that meridians each have their specific dominions. (Skin, flesh, sinews, and vessels have different depths and dominions, corresponding to the Qi of the four seasons.)
Incorrectly needling the five pulses leads to death, meaning that when disease is in the interior and Qi is deficient, using needles to heavily sedate all Yin meridian pulses causes death. ("Five pulses" refer to the Five Shu points of the Five Zang organs. When disease is in the interior and Qi is deficient, further sedating all Yin meridian pulses inevitably leads to death.) Incorrectly needling the three Yang pulses means completely sedating the Qi of the three Yang meridians, leaving the patient emaciated and exhausted. (There are three Yang meridians on the hands and feet, belonging to the Six Fu organs, which have six Shu points each. If one does not know the patterns of excess and deficiency and sedates them all, it causes extreme debility and ruin, making the form and Qi irrecoverable.)
Depleting Yin leads to death, referring to repeatedly needling the Wuli [LI 21] point behind Chize [LU 5]. ("Depleting Yin" means depleting Zang Qi. Wuli behind Chi Ze is a point on the Hand-Yangming Large Intestine Meridian that is forbidden to needle. See Volume 61 for details.) Depleting Yang leads to mania, which is a correct statement. ("Correct statement" refers to the scenario described above of needling the three Yang meridians and sedating their Qi.)