中胆
单布上刺。刺之不愈。复刺。刺跗上。中大脉。血出不止死。刺面。中溜脉。为盲。刺头。
中脑户。入脑立死。刺舌下中脉太过。血出不止为喑。刺足下布络中脉。血不出为肿。刺
中大脉。令人仆脱色。刺气街中脉。血不出。为肿鼠仆。刺脊间。中髓为伛。刺乳上。中乳
房。为肿根蚀。刺缺盆。中内陷。气泄令人喘咳逆。刺手鱼腹内陷为肿。无刺大醉。无刺大
怒。无刺大劳。无刺大渴。无刺大惊。无刺大饥人。无刺新饱人。刺阴股中大脉。血出不止
死。刺客主人内陷中脉。为聋。刺膝膑出液为跛。刺臂太阴脉。出血立死。刺足少阴脉。重
虚
遗溺。刺腋下胁间内陷。令人咳。刺少腹。中膀胱。溺出。令少腹满。刺 肠内陷。为肿。刺
眶上陷骨中脉。为盲。刺关节中液出。不得屈伸。又曰。无刺浑浑之脉。 之热。漉漉之汗。
如大风大雨。严寒盛暑。卑湿烦燥。便黑吐血。暴然失听。失明失意。失神失便溺。及七情五伤
。皆不可刺。乘车马远来。亦候血气定。然后刺之。机按。今医但问某病。便针某穴。求其如经
所言。不犯针禁。不夭人寿者。几
问曰。针刺失宜。亦能杀人否乎。
经曰。人之所受气者。谷也。谷之所注者。胃也。胃者。水谷气血之海也。海之所行云
气者。天下也。胃之所出气血者。经隧也。经隧者。五脏六腑之大络也。迎而夺之而已矣。迎之五里
。中道而止。五至而已。五往而藏之气尽矣。故五五二十五而竭其输矣。（气之息道。一呼
一吸为一至。故此云五里者。五至而已。过其数。藏气尽。更过其数。极其输矣。五往者。
五至已往。则六至七至也。）所谓夺其天气者也。非能绝其命而倾其寿乎。又曰。窥门而刺
之者。死于家中。入门而刺之。死于堂上。（机按。胃经固多气血。若写之太过。则夭寿矣
。夫以多气多血之经。尚戒写之太过。余经可轻写乎。）
或曰。针灸宜避天忌日。何也。
经曰。左足应立春。其日戊子己丑。左胁应春分。其日己卯。左手应立夏。其日戊辰己
巳。
立冬。其日戊戌己亥。腰尻下窍应冬至。其日壬子。六腑膈下三脏应四季中州。其日戊巳。
大禁太乙所在日。（即前所云）凡此九者。善候八正所在之处。所主左右上下。身有痈肿欲治
之。无以其所值之日溃治之。是谓天忌日也。又曰。春三月。人气在左。无刺左足之阳。夏
三月。人气在右。无刺右足之阳。秋三月。人气在右。无刺右足之阴。冬三月。人气在左。
无刺左足之阴。
或曰。刺荣无伤卫。刺卫无伤荣。何谓也。
曰。荣为阴。行于脉中。卫为阳。行于脉外。各有浅深。故针阳必卧针之。以阳气轻浮
。过
或曰。刺骨者。无伤筋。刺筋者。无伤肉。刺肉者。无伤脉。刺脉者。无伤皮。何谓也
曰。此谓刺浅。不至所当刺之处也。如病在骨。当刺至骨。但针至筋而去。则伤筋矣。
或曰。刺皮无伤肉。刺肉无伤筋。刺筋无伤骨。何谓也。
曰。此戒过分太深也。如病在皮中。针至皮中而止。无令深入伤肉也。
或曰。春夏刺浅。秋冬刺深。何谓也。
经曰。春气在毛。夏气在皮。秋气在分肉。冬气在筋骨。浅深之应也。是知春夏之气。
浮而
。欲其无不及也。经曰。必先岁气。无伐天和。此之谓也。
或曰。春夏各致一阴。秋冬各致一阳。何谓也。
难经曰。致。取也。春夏气温。必致一阴者。春夏养阳之义也。初下针则沉之至肾肝之
部。
之义也。初内针浅而浮之当心肺之部。候其得气。推针纳之达肾肝之分。所谓致一阳也。此
则古人特推其理。有如此耳。凡用针补写。自有所宜。初不必以是相拘也。
或曰。针家亦诊脉否。
经曰。凡将用针。必先诊脉。视气之剧易。乃可以治也。五脏之气。已绝于内。（言脉
口气
。重竭必死。其死也。无气以动故静。五脏之气。已绝于外。（言脉口气外绝不至）用针者。
反实其内。取其四末之输。有留针以致其阴气。阴气至。则阳气反入。入则逆。逆则死。其
死也。阴气有余故躁。故曰。上工平气。中工乱脉。下工绝气危生。（机按。此言工不诊脉
。妄行针刺。故不免于绝气危生。）
经曰。持其脉口人迎。以知阴阳有余不足。平与不平也。不病者。脉口人迎应四时也。
上下相应而俱往来也。六经之脉。不结动也。是谓平人。少气者。脉口人迎俱少而不称尺寸
也。如是者。则阴阳俱不足。补阳而阴竭。写阴则阳脱。如此亦弗灸。可将以甘药。不已者
。因而写之。则五脏气坏矣。又曰。寸口主中。人迎主外。两者相应。俱往俱来若引绳。大
小齐等。春夏人迎微大。秋冬寸口微大。如是者。命曰平人。人迎大一倍于寸口。病在足少
阳。一倍而躁。在手少阳。人迎二倍。病在足太阳。二倍而躁。在手太阳。人迎三倍。病在
足阳明。三倍而躁。在手阳明。（盛则为热。虚则为寒。紧则为痛痒。代则乍甚乍间。盛则
写之。虚则补之。紧痛则取之分肉。代则取血络。见饮药陷下则灸之。不盛不虚。以经取之
。名曰经刺。）人迎四倍者。且大且数。名曰溢阳。溢阳为外格。死不治。必审按其本末。
察其寒温。以验其脏腑之病。寸口大。平人迎一倍。病在足厥阴。一倍而躁。在手心主。寸
口二倍。病在足少阴。二倍而躁。在手少阴。寸口三倍。病在足太阴。三倍而躁。在手太阴
。（盛则胀满寒中食不化。虚则热中出糜少气溺色变。紧则痛痒。代则乍痛乍吐。盛则写之
。虚则补之。紧则先刺而移灸之。代则取血络而后调之。陷下则徒灸之。陷下者。血结于中
。中有着血。血寒。故宜灸之。不盛不虚。以经取之。）寸口四倍者。名曰内关。内关者。且
大且数。死不治。必审察其本末之寒温。以验脏腑之病也。人迎与太阴脉口俱四倍以上。命
曰关格。关格者。与之短期。人迎一盛。写足阳明。补足厥阴。二写一补。日一取之。人迎
二盛。写足太阳。补足太阴。二写一补。二日一取之。人迎三盛。写足阳明。补足太阴。二
写
少阴。补足太阳。二补一写。二日一取之。脉口三盛。写足太阴。补足阳明。二补一写。日二
取之。所以日二取之。太阴主胃。富于谷气。故可日二取之也。（以上补写。皆必切而验之。
疏取之。上气和乃止。）人迎与脉口俱盛三倍以上。命曰阴阳俱溢。如是者不开。则血脉闭塞
。气
察脉盛衰。以知病在何经。乃可随病以施针刺也。苟不诊视。则经脉之虚实。补写之多寡。
病症之死生。懵然皆无所知矣。于此而妄施针灸。宁免粗工之诮哉。故集见于此。俾后之
针士。必先以诊视为务也。）
经曰。脉之诸急者。多寒。缓者。多热。大者。多气。少者小者。血气皆少。滑者。阳
气盛
热。大者。微写其气。无出其血。滑者。疾发针而浅内之。以写阳气而去其热。涩者。必中
其脉。顺其逆。顺而久留之。必先按而循之。已发针。疾按其 。小者。阴阳形气俱不足。
勿取以针。而调以甘药也。
经曰。凡刺之属。一刺则阳邪出。再刺则阴邪出。三刺则谷气至而止。所谓谷气至者。
已补
。阴盛而阳虚。先补其阳。后写其阴而和之。阴虚而阳盛。先补其阴。后写其阳而和之。三
脉动于足大指之间。（三脉盛虚和也）必审其实虚。虚而写之。是谓重虚。重虚病益甚。凡
刺
来也。徐而和。脉实者。深刺之。以写其气。脉虚者。浅刺之。使精气无得出。以养其脉。
独出其邪气。久病者。邪气深入。深内而久留之。间日而复刺之。必先调其左右。去其血脉
。刺道毕矣。（机按。此节不惟详于刺法。而亦详于诊法。但诊则以指行间动脉也。脉实而
疾。则深刺以写。脉虚而徐。则浅刺以补。邪气脉来。紧而疾。谷气脉来。徐而和。学人于
此而察识之。则临病施针。庶免妄治之失矣。）
经曰。必先明知十二经络之本末。皮肤之寒热。脉之盛衰滑涩。其脉滑而盛者。病日进
。虚
办。飧泄。脉小。手足寒难已。手足温而易已。审其尺之缓急大小滑涩。肉之坚脆。而病形定
矣。（机按。今之针士。多不诊脉。未免有误刺害论焉。）
或曰。针家亦察色否。
经曰。视目之五色。以知五脏。决死生。视其血脉。察其色。以知其寒热痹。故目赤色
。病
多青多痛多黑为久痹。多赤多黑多青皆见者。寒热身痛。而色微黄。齿垢黄。爪甲上黄。黄
疸也。诊目痛。赤脉从上下者太阳病。从下上者阳明病。从外走内者少阳病。耳间青脉起者
。
亦十无一二也。故集次灵枢察色数条于此。后之学人。扩而充之。庶几如经所谓能合色脉。
可以万全者矣。）
或曰。经云五脏五俞。五五二十五俞。六腑六俞。六六三十六俞。经脉十二。络脉十五。
凡二十七气以上下。所出为井。所溜为荥。所注为俞。所行为经。所入为合。又云。五脏有六
腑。六腑有十二原者。何谓也。
曰。井譬如谷。井。泉源之所出也。经穴之气所生。则自井始。而溜荥注俞。过经入合。
（合
乙。阴木也。乙与庚合。故阳井属庚金。庚。阳金也。阴木柔。阳金刚。刚柔相配。夫妇之道
。则有父子之相生。是以肝木大敦阴井。木生阴荥行间火。火生阴俞太冲土。土生阴经中封
金。金生阴合曲泉水。心之少冲井木。少府荥火。神门俞土。灵道经金。少海合水。脾之隐
白井木。大都荥火。太白俞土。商丘经金。阴陵泉合水。 肺之少商井木。鱼际荥火。太渊
俞土。经渠经金。尺泽合水。 肾之涌泉井木。然谷荥火。太溪俞土。复溜经金。阴谷合水
。心包之中冲井木。劳宫荥火。大陵俞土。间使经金。曲泽合水。此阴经之穴。以次而相
生也。 胆之窍阴阳井。金生阳荥侠溪水。水生阳俞临泣木。木生阳经阳辅火。火生阳合阳
陵泉土。 小肠少泽井金。前谷荥水。后溪俞木。阳谷经土。小海合火。 胃之厉兑井金。
内庭荥水。陷谷俞木。解溪经火。三里合土。 大肠之商阳井金。二间荥水。三间俞木。阳
溪经火。曲池合土。 膀胱之至阴井金。通谷荥水。束骨俞木。昆仑经火。委中合土。 三
焦之关冲井金。液门荥水。中渚俞木。支沟经火。天井合土。此阳经之穴。以次而相生也。
六腑又有原者。经曰。以三焦行于诸阳。故又置一俞。而名曰原。五脏则以俞为原。 肺俞
太渊。心俞大陵。肝俞太冲。脾俞太白。肾俞太溪是也。 膀胱俞束骨。过于京骨为原。胆俞
临泣。过于丘墟为原。胃俞陷谷。过于冲阳为原。三焦俞中渚。过于阳池为原。小肠俞后溪
过于腕骨为原。大肠俞三间。过于合谷为原。盖五脏阴经。止以俞为原。六腑阳经。既有俞
。仍别有原也。脏之俞。腑之原。皆三焦之所行。气之所留止也。主治五脏六腑之有病也。
名之曰原。以脐下肾间动气。人之生命。十二经之根本。三焦则为原气之别使。主通行上中
下之三气。经历于脏腑也。故曰。下焦禀真元之气。即原气也。
经曰。五脏有六腑。六腑有十二原。十二原出于四关。（言井荥俞经合。手不过肘。足
不过膝。）四关主治五脏。五脏有疾。当取之十二原。十二原者。五脏之所以禀三百六十五
节气味也。（节之交。三百六十五会者。络脉之渗灌诸节者也。）五脏有疾。应出十二原。明知
其原。睹其应。而知五脏之害矣。
或曰。五脏募皆在阴。俞皆在阳。何谓也。
难经曰。阴病行阳。阳病行阴。故募在阴。俞在阳。募与俞。五脏孔穴之总名也。在腹
为阴
中府。心募巨阙。脾募章门。肝募期门。肾募京门。俞在背者。肺俞在背第三椎下。心俞在第
五椎下。肝俞在第九椎下。脾俞在十一椎下。肾俞在十四椎下。皆侠脊两旁各一寸五分。阴
病行阳。阳病行阴者。阴阳经络。气相交贯。脏腑腹背。气相通应。所以阴病有时而行阳。
阳病有时而行阴也。针法曰。从阳引阴。从阴引阳。
或曰。六腑各有俞。（背俞）风寒湿气中其俞。而饮食应之。循俞而入。各舍其腑也。针
治奈何。
经曰。五脏有俞。（井荥俞经合之俞）六腑有合。（六腑合穴）各有所发。各随其过。（经
脉所经过处）则病瘳矣。
或曰。灵枢难经以大陵为心之原。而又别以兑骨为少阴之原。诸家针灸书。并以大陵为
手厥阴心主之俞。以神门在掌后兑骨之端者。为心经所注之俞。似此不同者。何也。
灵枢七十一篇曰。少阴无俞。心不病乎。岐伯曰。其外经病而藏不病。故独取其经于掌
后兑
冲。溜于劳宫。注于大陵。行于行间。入于曲泽。手少阴也。（按中冲以下。并手心主经俞
。灵枢直指为手少阴。而手少阴经俞。不别载也。）素问缪刺篇曰。刺手心主少阴兑骨之端
。各一 。又气穴篇曰。藏俞五十穴。（王注）五脏俞惟有心包络井俞之穴。而亦无心经井俞
穴。又七十九难曰。假令心病。写手心主俞。补手心主井。详此前后各经文义。则知手少阴
Zhongdan (Middle Gallbladder), a point not in standard meridian maps but mentioned here, is needled singly from above. If the condition does not improve after needling, needle again. If the needle hits the major vessel on the dorsum of the foot and bleeding does not stop, death will ensue. Needling the face and damaging the Liumei (Slipping Vessel) leads to blindness. Needling the head and damaging the Naohu (Brain Door) point, allowing the needle to enter the brain, causes immediate death. Needling under the tongue and damaging the vessel with excessive bleeding leads to aphonia. Needling the network vessels on the sole of the foot; if blood does not come out, swelling occurs. Needling the major vessel in the thigh, if bleeding does not stop, causes the patient to collapse and lose color. Needling the Qichong (Qi Street) major vessel; if blood does not come out, swelling like a crouching rat occurs in the groin. Needling between the vertebrae and damaging the spinal marrow leads to kyphosis (hunchback). Needling above the breast and damaging the breast tissue leads to root abscesses and erosion. Needling the Quepen (Collarbone Hollow) point too deeply, causing qi leakage, leads to asthma, cough, and rebellious qi. Needling the Yuji (Fish Border) area of the hand too deeply leads to swelling.
Do not needle when the patient is heavily intoxicated, extremely angry, severely fatigued, excessively thirsty, greatly frightened, newly satiated, or just after a large meal. Needling the major vessel in the medial thigh with uncontrolled bleeding causes death. Needling the Chongyang (Guest Master) point on the dorsum of the foot too deeply damages the vessel and causes deafness. Needling the patellar region causing effusion of joint fluid leads to claudication (limping). Needling the Mai of the Hand Taiyin Lung Meridian with bleeding causes immediate death. Needling the Mai of the Foot Shaoyin Kidney Meridian in a case of deficiency exacerbates the deficiency, leading to enuresis. Needling the axillary and hypochondriac regions too deeply causes cough. Needling the lower abdomen and damaging the bladder causes urine leakage and abdominal fullness. Needling the intestines too deeply causes swelling. Needling the pulse in the supraorbital depression causes blindness. Needling the joints causing effusion of fluid leads to inability to flex and extend.
It is also said: Do not needle when the pulse is chaotic and rapid; do not needle during high fever with profuse sweating; do not needle during severe weather such as strong winds, heavy rain, extreme cold, or intense heat; do not needle when feeling烦躁 (restless/agitated) due to dampness; do not needle when there is melena (black stool) or hematemesis (vomiting blood); do not needle sudden deafness, blindness, mental confusion, or loss of bowel/bladder control; do not needle conditions caused by the Seven Emotions or Five Injuries. For patients who have traveled far by carriage or horse, wait until their qi and blood settle before needling. Wang Ji's commentary: Modern physicians often ask for a disease name and immediately needle a specific point, seeking only to follow scripture without violating contraindications or shortening life, which is difficult to achieve.
Someone asked: Can improper needling kill?
The Classic says: The qi received by humans comes from grain. Grain enters the Stomach. The Stomach is the sea of water and grain, qi and blood. Just as the sea produces clouds and qi like the world, the Stomach outputs qi and blood through the Jing-Tong (Meridian Collaterals). The Jing-Tong are the great collaterals of the Zang-Fu organs. "Ying Er Duo Zhi" (Meeting and seizing/venting) should be done carefully. If one meets and seizes at the Wuli point and stops midway, five insertions are sufficient. Five withdrawals deplete the organ's qi. Thus, twenty-five insertions exhaust the Shu points. (One breath cycle is one "Zhi". So "Wuli" refers to five insertions. Exceeding this number depletes organ qi; exceeding it further exhausts the Shu points. "Five withdrawals" means five insertions have passed, so the sixth and seventh are excessive.) This is called depriving the heavenly qi. Does it not cut off life and shorten longevity? It is also said: Puncturing from the crack of the door (superficially) kills at home; puncturing entering the door (deeply) kills in the hall. (Wang Ji's commentary: The Stomach Meridian has abundant qi and blood; excessive draining shortens life. If even this meridian warns against excessive draining, how much more so others?)
Someone asked: Why avoid Heavenly Taboo Days in acupuncture?
The Classic says: The left foot corresponds to Lichun (Start of Spring) on Wu Zi and Ji Chou days. The left hypochondrium corresponds to Chunfen (Spring Equinox) on Ji Mao day. The left hand corresponds to Lixia (Start of Summer) on Wu Chen and Ji Si days. The right foot corresponds to Lidong (Start of Winter) on Wu Xu and Ji Hai days. The waist, buttocks, and lower orifices correspond to Dongzhi (Winter Solstice) on Ren Zi day. The Six Fu Organs, diaphragm, and three lower Zang organs correspond to the central earth of the four seasons on Wu and Ji days. The Great Taboo days are those when Taiyi resides. These nine situations require observing the Eight Rectitudes (Equinoxes, Solstices, Starts of Seasons). If treating a carbuncle or swelling, do not rupture or treat it on the corresponding taboo day. This is called Heavenly Taboo Day. Also: In the first three months of Spring, human qi is in the left; do not needle the Yang meridians of the left foot. In Summer, qi is in the right; do not needle the Yang meridians of the right foot. In Autumn, qi is in the right; do not needle the Yin meridians of the right foot. In Winter, qi is in the left; do not needle the Yin meridians of the left foot.
Someone asked: What does "Needle Ying without injuring Wei, needle Wei without injuring Ying" mean?
Answer: Ying (Nutrient) is Yin, flowing within the vessels; Wei (Defensive) is Yang, flowing outside the vessels. They have different depths. Therefore, to needle Yang (Wei), one must use horizontal insertion (lying needle) because Yang qi is light and floating.
Someone asked: What does "When needling bone, do not injure tendon; when needling tendon, do not injure flesh; when needling flesh, do not injure vessel; when needling vessel, do not injure skin" mean?
Answer: This refers to superficial needling, ensuring one does not go deeper than the target. If the disease is in the bone, one should needle to the bone. If one needles only to the tendon and withdraws, the tendon is injured.
Someone asked: What does "When needling skin, do not injure flesh; when needling flesh, do not injure tendon; when needling tendon, do not injure bone" mean?
Answer: This warns against excessive depth. If the disease is in the skin, needle only to the skin level and do not penetrate deeply to injure the flesh.
Someone asked: Why needle shallowly in Spring and Summer, and deeply in Autumn and Winter?
The Classic says: Spring qi is in the hair/skin surface; Summer qi is in the skin; Autumn qi is in the muscle layers; Winter qi is in the tendons and bones. This is the correspondence of depth. Thus, Spring and Summer qi is floating and superficial, aiming to avoid insufficiency. The Classic says: "First know the annual qi, do not violate the harmony of Heaven." This is what it means.
Someone asked: What does "In Spring and Summer, each obtain one Yin; in Autumn and Winter, each obtain one Yang" mean?
Nan Jing says: "Zhi" means to obtain. Spring and Summer are warm; obtaining one Yin follows the principle of nourishing Yang in Spring and Summer. Initially insert the needle deeply to the Liver-Kidney level (deep/Yin). Autumn and Winter are cool; obtaining one Yang follows the principle of nourishing Yin in Autumn and Winter. Initially insert the needle shallowly to the Heart-Lung level (superficial/Yang). Wait for De Qi, then push the needle deeper to the Liver-Kidney level. This is "obtaining one Yang." This is the ancient reasoning. In practice, tonification and sedation have their own appropriateness; one need not be strictly bound by this theory.
Someone asked: Do acupuncturists also diagnose pulses?
The Classic says: Before using the needle, one must diagnose the pulse to assess the severity and ease of treatment. If the Qi of the Five Zang organs is exhausted internally (pulse qi is weak/failing), double depletion leads to death; the deceased is still because there is no qi to move. If the Qi of the Five Zang organs is exhausted externally (pulse qi fails to reach the surface), and the practitioner instead tonifies the interior by selecting Shu points on the extremities and retaining the needle to attract Yin Qi, the Yin Qi arrives, causing Yang Qi to re-enter. Re-entry causes rebellion, leading to death; the deceased is restless due to excess Yin. Thus: The superior physician harmonizes Qi; the average physician disrupts the pulse; the inferior physician cuts off Qi and endangers life. (Wang Ji's commentary: This criticizes physicians who needle without diagnosing the pulse, leading to fatal errors.)
The Classic says: Hold the Kou (Cun Kou/Radial) and Ying (Carotid) pulses to know Yin-Yang excess or deficiency. A healthy person's pulses correspond to the four seasons, moving up and down in harmony. The Twelve Meridian pulses do not knot or stagnate; this is a normal person. One with deficient Qi has both Kou and Ying pulses weak relative to the Cun-Cun measurement. Such cases have both Yin and Yang deficiency; tonifying Yang exhausts Yin, sedating Yang causes Yang collapse. Do not use moxibustion; use sweet medicines. If ineffective, sedating will damage the Five Zang Qi. Also: Cun Kou governs internal (Zang) diseases; Ying governs external (Fu/Meridian) diseases. They should correspond like a pulled rope, equal in size. In Spring/Summer, Ying is slightly larger; in Autumn/Winter, Cun Kou is slightly larger. This is normal. If Ying is 1x larger than Cun Kou, disease is in Foot Shaoyang; if rapid, Hand Shaoyang. 2x larger, Foot Taiyang; if rapid, Hand Taiyang. 3x larger, Foot Yangming; if rapid, Hand Yangming. (Excess is heat, deficiency is cold, tight is pain/itching, choppy is fluctuating severity. Excess sedate, deficiency tonify, tight pain needle fleshy areas, choppy needle blood collaterals, sunken moxa, neither excess nor deficiency needle the meridian itself [Jing Ci].) If Ying is 4x larger and rapid, it is called Yi Yang (Overflowing Yang) or Outer Ge, which is untreatable death. Examine the root and branch, cold and heat, to verify Zang-Fu disease. If Cun Kou is 1x larger than Ying, disease is in Foot Jueyin; if rapid, Hand Jueyin. 2x larger, Foot Shaoyin; if rapid, Hand Shaoyin. 3x larger, Foot Taiyin; if rapid, Hand Taiyin. (Excess causes bloating/cold indigestion, deficiency causes internal heat/mucus/shortness of breath/urine changes. Tight is pain/itching, choppy is alternating pain/vomiting. Excess sedate, deficiency tonify, tight needle then moxa, choppy needle blood collaterals then regulate, sunken moxa alone. Sunken means blood stasis/cold, hence moxa. Neither excess nor deficiency needle the meridian.) If Cun Kou is 4x larger, it is called Nei Guan (Internal Obstruction), untreatable death. If both Ying and Cun Kou are 4x larger, it is called Guan Ge (Obstruction and Rejection), indicating imminent death.
Treatment protocols: Ying 1x excess, sedate Foot Yangming, tonify Foot Jueyin (2 sedate, 1 tonify), daily. Ying 2x excess, sedate Foot Taiyang, tonify Foot Taiyin (2 sedate, 1 tonify), every two days. Ying 3x excess, sedate Foot Yangming, tonify Foot Taiyin (2 sedate, 1 tonify), every two days. Cun Kou 3x excess, sedate Foot Taiyin, tonify Foot Yangming (2 tonify, 1 sedate), twice daily. (Because Taiyin governs the Stomach and is rich in Gu Qi, it can be treated twice daily.) All tonification/sedation must be verified by pulse, applied gently, and stopped when Qi harmonizes. If both Ying and Cun Kou are 3x+ excess, it is Yin-Yang Overflow. Without venting, blood vessels close, Qi blocks.
Observing pulse strength/weakness identifies the affected meridian for needling. Without diagnosis, one cannot know meridian deficiency/excess, tonification/sedation dosage, or prognosis. Wanton needling invites criticism of incompetence. Thus, these texts are collected to urge future practitioners to prioritize diagnosis.
The Classic says: Urgent pulses indicate Cold; slow pulses indicate Heat; large pulses indicate Excess Qi; small pulses indicate Deficient Qi and Blood; slippery pulses indicate Excess Yang and Heat; large pulses, mildly sedate Qi, do not bleed; slippery pulses, quick withdrawal and shallow insertion to sedate Yang and clear Heat; choppy pulses, center the needle, follow the flow, retain long. Press and rub before needling; press the hole quickly after. Small pulses (deficient Yin/Yang/Form/Qi) should not be needled but regulated with sweet medicines.
The Classic says: In needling categories, one insertion expels Yang pathogens; two expel Yin pathogens; three bring Gu Qi (Grain Qi) to a stop. Bringing Gu Qi means tonification is complete. If Yin excess and Yang deficiency, tonify Yang first, then sedate Yin to harmonize. If Yin deficiency and Yang excess, tonify Yin first, then sedate Yang to harmonize. Three pulses move between the big toes. Examine excess/deficiency. Sedating deficiency is Double Deficiency, worsening the disease. Needling should be slow and harmonious. Excess pulses, deep needle to sedate Qi. Deficient pulses, shallow needle to preserve Essence Qi and nourish the meridian, expelling only pathogenic Qi. Chronic diseases, pathogens are deep; needle deeply and retain long, repeat every other day. First regulate left/right, remove blood stasis, then needling is complete. (Wang Ji's commentary: This details needling and diagnosis via interdigital arteries. Excess/rapid pulse = deep sedation; Deficient/slow pulse = shallow tonification. Pathogenic pulse = tight/rapid; Gu Qi pulse = slow/harmonious. Practitioners must observe this to avoid errors.)
The Classic says: Know the Twelve Meridians' origins/endings, skin temperature, and pulse characteristics. Slippery/excess pulses indicate advancing disease; deficient pulses are hard to treat. Sudden diarrhea with small pulse and cold limbs is hard to cure; warm limbs are easy. Examine the Chi (Radial Forearm) skin for tension, size, slipperiness, and muscle firmness to determine the disease form. (Wang Ji's commentary: Modern practitioners often skip pulse diagnosis, risking harm.)
Someone asked: Do acupuncturists inspect complexion?
The Classic says: Inspect the five colors of the eyes to know the Five Zang and judge life/death. Inspect blood vessels and color to know Cold/Heat/Bi. Red eyes indicate disease; blue/pain/black indicates chronic Bi. Mixed red/black/blue indicates alternating chills/fever and body pain. Slight yellow complexion, yellow tooth tartar, yellow nails indicates Jaundice. Eye pain: Red vessels descending from above = Taiyang disease; ascending from below = Yangming disease; moving inward = Shaoyang disease. Blue vessels in the ear indicate similar patterns. Collecting these Ling Shu observations helps future students combine color and pulse for perfect diagnosis.
Someone asked: The Classic says Five Zang have five Shu points (25 total), Six Fu have six Shu points (36 total), Twelve Meridians, Fifteen Luo, totaling 27 Qi pathways. Exiting well (Jing), slipping stream (Ying), pouring reservoir (Shu), flowing river (Jing), entering pool (He). Also, Five Zang have Six Fu, Six Fu have Twelve Yuan sources. What does this mean?
Answer: Jing (Well) is like a valley spring, the source of meridian Qi. Qi starts at Jing, flows to Ying, pours to Shu, passes through Jing (Stream), enters He (Sea).
(Yin Meridians generate in Wood/Jing, flow to Fire/Ying, pour to Earth/Shu, flow to Metal/Jing, enter Water/He. E.g., Liver Da Dun (Wood) -> Xing Jian (Fire) -> Tai Chong (Earth) -> Zhong Feng (Metal) -> Qu Quan (Water). Heart Shao Chong (Wood) -> Shao Fu (Fire) -> Shen Men (Earth) -> Ling Dao (Metal) -> Shao Hai (Water). Spleen Yin Bai (Wood) -> Da Du (Fire) -> Tai Bai (Earth) -> Shang Qiu (Metal) -> Yin Ling Quan (Water). Lung Shao Shang (Wood) -> Yu Ji (Fire) -> Tai Yuan (Earth) -> Jing Qu (Metal) -> Chi Ze (Water). Kidney Yong Quan (Wood) -> Ran Gu (Fire) -> Tai Xi (Earth) -> Fu Liu (Metal) -> Yin Gu (Water). Pericardium Zhong Chong (Wood) -> Lao Gong (Fire) -> Da Ling (Earth) -> Jian Shi (Metal) -> Qu Ze (Water).)
(Yang Meridians generate in Metal/Jing, flow to Water/Ying, pour to Wood/Shu, flow to Fire/Jing, enter Earth/He. E.g., Gallbladder Qiu Xu (Metal) -> Xia Xi (Water) -> Lin Qi (Wood) -> Yang Fu (Fire) -> Yang Ling Quan (Earth). Small Intestine Shao Ze (Metal) -> Qian Gu (Water) -> Hou Xi (Wood) -> Yang Gu (Earth) -> Xiao Hai (Fire). Stomach Li Dui (Metal) -> Nei Ting (Water) -> Xian Gu (Wood) -> Jie Xi (Fire) -> Zu San Li (Earth). Large Intestine Shang Yang (Metal) -> Er Jian (Water) -> San Jian (Wood) -> Yang Xi (Fire) -> Qu Chi (Earth). Bladder Zhi Yin (Metal) -> Tong Gu (Water) -> Shu Gu (Wood) -> Kun Lun (Fire) -> Wei Zhong (Earth). San Jiao Guan Chong (Metal) -> Ye Men (Water) -> Zhong Zhu (Wood) -> Zhi Gou (Fire) -> Tian Jing (Earth).)
Six Fu have Yuan sources because San Jiao travels through Yang meridians. Five Zang use Shu as Yuan. Lung Tai Yuan, Heart Da Ling, Liver Tai Chong, Spleen Tai Bai, Kidney Tai Xi. Bladder Shu Gu (Yuan Jing Gu), Gallbladder Lin Qi (Yuan Qiu Xu), Stomach Xian Gu (Yuan Chong Yang), San Jiao Zhong Zhu (Yuan Yang Chi), Small Intest Hou Xi (Yuan Wan Gu), Large Intest San Jian (Yuan He Gu). Yin meridians use Shu as Yuan; Yang meridians have separate Yuan. Zang Shu and Fu Yuan are where San Jiao Qi stops, treating Zang-Fu diseases. Yuan is named so because the Qi moving below the navel (Kidney) is the root of life and Twelve Meridians. San Jiao is the envoy of Yuan Qi, circulating Upper/Middle/Lower Qi through Zang-Fu. Lower Jiao provides True Yuan Qi, i.e., Yuan Qi.
The Classic says: Twelve Yuan originate from Si Guan (Elbows/Knees). Si Guan treats Five Zang. Zang diseases should take Twelve Yuan. Yuan points receive the flavor of 365 solar terms from the collaterals. Knowing Yuan reveals Zang pathology.
Someone asked: Zang Mu (Alarm) points are on Yin (Front), Shu (Transport) points on Yang (Back). Why?
Nan Jing says: Yin diseases travel to Yang, Yang diseases travel to Yin. Hence Mu on Yin, Shu on Yang. Mu points: Fei Zhong Fu, Xin Ju Que, Pi Zhang Men, Gan Qi Men, Shen Jing Men. Shu points: Fei Shu (T3), Xin Shu (T5), Gan Shu (T9), Pi Shu (T11), Shen Shu (T14), all 1.5 cun lateral to spine. Yin-Yang Qi intersects; Front-Back Qi connects. Yin diseases may manifest on Yang, Yang on Yin. Needle method: "From Yang draw Yin, from Yin draw Yang."
Someone asked: Six Fu have Back-Shu points. Wind/Cold/Damp invade Shu, diet responds, pathogens enter Shu and lodge in Fu. How to treat?
The Classic says: Five Zang have Shu (specifically the Shu-Stream point of the Five Shu series), Six Fu have He (Sea) points. Each has a manifestation site; treat according to the meridian pathway involved, and the disease will heal.
Someone asked: Ling Shu/Nan Jing say Da Ling is Heart Yuan, but also mention Dui Bone as Shaoyin Yuan. Other books say Da Ling is Pericardium Shu, Shen Men (at Dui Bone) is Heart Shu. Why the discrepancy?
Ling Shu Ch. 71: Shaoyin has no Shu? Does the Heart not get sick? Qibo: External meridian gets sick, internal Zang does not. So we only take the meridian at the Dui bone... Zhong Chong flows to Lao Gong, pours to Da Ling, flows through Jian Shi, enters Qu Ze. (Note: These are Pericardium points, but Ling Shu sometimes refers to them as Shaoyin. Shaoyin proper points are not separately listed.) Su Wen Miao Ci: Needle Pericardium/Shaoyin at Dui bone. Qi Xue: 50 Zang Shu points. Only Pericardium has Jing/Shu, no Heart Jing/Shu. Nan Jing 79: For Heart disease, sedate Pericardium Shu, tonify Pericardium Jing. Analyzing these texts, we know Hand Shaoyin...