平按∶此篇自所谓三刺至不可以为工也，见《灵枢》卷二第七《官针》篇，又见《甲乙经》
卷五第二。自凡刺之属三刺至谷至末，见《灵枢》卷二第九《终始》篇，又见《甲乙经》卷五第
五。
所谓三刺则谷气出者，先浅刺绝皮以出阳邪；（三刺者，阳邪刺，阴邪刺，谷道气刺也。阳
邪浮浅在皮，故一刺浅之，阳邪得出也。平按∶三刺下《甲乙》有之字。）再刺则阴邪出者，少
益深，绝皮致肌肉，未入分间也；（阴邪次深，在于肌肉，故再刺出之也。平按∶分下《灵枢》、
《甲乙》有肉字。）已入分肉之间，则谷气出。（谷气者，正气也。故后刺极深，以致正气也。
平按∶《甲乙》已入上有后刺深之四字）故《刺法》曰∶始刺浅之，以逐邪气而来血气；后刺深
之，以致阴气之邪；最后刺极深之，以下谷气。此之谓也。（逐邪气者，逐阳邪。来血气，引正
气也。下，谷气不下，引之令下也。平按∶以逐邪气《甲乙》作以逐阳邪之气，无而来血气四字。
以致阴气之邪《甲乙》作以致阴邪之气。）故用针者，不知年之所加，气之衰盛虚实之所起，不
可以为工也。（人之大忌，七岁以上，次第加九，至一百六，名曰年加也。不知年加气之衰盛虚
实为不知也。）
凡刺之属，三刺至谷，（三刺得于谷气也。平按∶《灵枢》、《甲乙》谷下有气字。）邪僻妄
合，（阴阳二邪，妄与正气相合。一也。）阴阳易居，（脏腑一气相乘，名曰易居。二也。平按∶
《甲乙》易居作移居。）逆顺相反，（营气逆肺，卫气顺脉，以为相反。三也。）沉浮异处，（春
脉或沉，冬脉或浮，故曰异处。四也。）四时不得，（谓四时脉不相顺。五也。平按∶《甲乙》不
得作不相得。）稽留淫 ，（言血气或有稽留壅遏，或有淫 过度。六也。）须针而去。（以此六
过，故须微针以去之也。）一刺则阳邪出，再刺则阴邪出，三刺则谷气至，谷气至
而止。所谓谷气至者，已补而实，已泻而虚，故以知谷气至也。（已补而实，已泻而虚，皆正气
至，故病愈也。平按∶《甲乙》一刺再刺下均无则字，谷气至三字不重。）邪气独去者，阴与阳
未能调，而病知愈也。（行补泻已，邪气已去，以阴阳未调，病虽不愈，后必愈矣。）故曰补则
实，泻则虚，痛虽不随针减，病必衰去矣。（引上经证也。平按∶痛《甲乙》作病，《灵枢》针
下无减字。）阴盛而阳虚，先补其阳，后泻其阴而和之；阴虚而阳盛，先补其阴，后泻其阳而和
之。（重实泻之为易，重虚补之为难，故先补后泻也。）三脉重足大趾之间，（三脉，足阳明、足
厥阴、足太阴三脉也。足太阴脉起足大趾端，循趾内侧白肉际，过核骨后，上内踝，不言大趾岐间。
此言重在大趾间者，从大趾端，循大趾内侧入大趾间，以过核骨而上也。足厥阴脉起大趾丛毛上，
入大趾间，重在太阴之上，上循足跗。足阳明支，别跗上，入大趾间，重在厥阴之上。平按∶重
《灵枢》、《甲乙》作动，《甲乙经》注云∶“一作重。”又注重字原抄均作重，袁刻易作动。）
必审其实虚，虚而泻之，是谓重虚，重虚病益甚。（必审大趾间三脉虚实，以手按之，先补虚者，
后泻实者。若不知三脉有实，泻其虚者，是谓重虚，重虚病益甚也。）凡刺此者，以指按之，脉
动而实且病者疾泻之，虚而徐者则补之，反此者病益甚。其重也，阳明在上，厥阴在中，太阴在
下。（三脉有动而实者，有徐而虚者，皆审调补泻也。平按∶而实且病者《灵枢》、《甲乙》病作
疾。《甲乙》疾泻之作则泻之。其重也《灵枢》、《甲乙》重作动，《甲乙》注云∶“一作重。”
太阴在下《灵枢》、《甲乙》作少阴在下。）膺输中膺，背输中背。（膺输在胸中，背输在背中
也。平按∶输《灵枢》、《甲乙》作 。）肩 虚者，取之上。（补肩 肩井等穴，曰取之上也。平
按∶ 《灵
枢》作膊，《甲乙》作髀。）重舌，刺舌柱以 针。（重舌，谓舌下重肉生也。舌柱，舌下柱。
以针刺去血也。平按∶ 《灵枢》、《甲乙》作铍。）手屈而不伸者，其病在筋，伸而不屈者，
其病在骨，在骨守骨，在筋守筋。（肾足少阴脉主骨，可守足少阴脉发会之穴，以行补泻。肝足
厥阴脉主筋，可守足厥阴脉发会之穴，以行补泻也。）补须一方实，深取之，希按其 ，以极出其
邪气；（量此补下脱一泻字。方，处也。欲行泻者，须其泻处是实，然后得为泻也。深取之者，
令其出气多也。希，迟也。按其 者，迟按针伤之处，使气泄也。平按∶希《灵枢》、《甲乙》
作稀。 袁刻误作病，注同。）一方虚，浅刺之，以养其脉，疾按其 ，无使邪气得入。（行于
补者，须补处是虚也。浅刺者，恶其泄气，所以不深也。以养其脉者，留针养其所取之经也。按
其者，按针伤之处，疾关其门，使邪气不入，正气不出也。）邪气来也坚而疾，谷气来也徐而
和。（针下得气坚疾者，邪气也；徐和者，谷气也。平按∶坚《灵枢》、《甲乙》作紧。）脉实者
深刺之，以泄其气；脉虚者浅刺之，使精气无得出，以养其脉，独出其邪气。（实者，邪气盛也。
虚者，正气少也。）刺诸痛者深刺之，诸痛者其脉皆实。（脉之实满为痛，故刺深也。平按∶《灵
枢》无深刺之诸痛者六字。）从腰以上者，手太阴、阳明皆主之；从腰以下者，足太阴、阳明皆
主之。（腰以上为天，肺主天气，故手太阴、手阳明主之也。腰以下为地，脾主地土，故足太阴、
足阳明主之也。平按∶《灵枢》从腰以上者上有故曰二字。《甲乙》两主之上无皆字。）病在上者
下取之，病在下者高取之，（手太阴下接手阳明，手阳明下接足阳明，足阳明下接足太阴，以其
上下相接，故手太阴、阳明之上有病，宜疗足太阴、阳明，故曰下取之；足太阴、阳明之下有病，
宜疗手太阴、阳明，故
曰高取之也。平按∶注故手太阴阳明下袁刻脱之上二字。）病在头者取之足，病在腰者取之 。
（足之三阴三阳之脉，从头至足，故病在头取之足也。足太阳脉循腰入 ，故病在腰以取 也。）病
生于头者头重，生于手者臂重，生于足者足重，治病者先刺其病所从生者。（头手足有病之处，
其候皆重，各审其病生所由，以行补泻也。）春气在豪毛，（人之豪毛中虚，故春之阳气在豪毛。
平按∶《灵枢》无豪字。）夏气在肤，（肤，肉上也，阳气在皮肉也。平按∶肤上《灵枢》、《甲
乙》有皮字。）秋气在分肉，（分肉，谓 肉分间也。）冬气在筋骨，（筋附骨上最深，故冬阳
气深在筋骨也。）刺此病者，各以其时为齐。故刺肥人者，以秋冬之齐；刺瘦人者，以春夏之齐。
（秋冬之齐者，刺至筋骨，言其深也。春夏之齐，刺在于皮肤，言其浅也。平按∶《甲乙》为齐
下无故字。）病痛者阴也，痛而以手按之不得者阴也，深刺之。（人之病痛，以手按之，得与□
□□□□□□病在深在□□□□平按∶《甲乙》病痛者作刺之痛者。）病在上者阳也，在下者阴也。
痒者阳也，浅刺之。（卫气行皮肤之中，壅遏作痒，故浅刺之也。平按∶《甲乙》“痒者阳也浅
刺之”七字在“病在上者”上。注卫气袁刻作冲气。）病先起于阴者，先治其阴，而后治其阳；
病先起于阳者，先治其阳，而后治其阴。（皆疗其本也。平按∶《灵枢》两起字下无于字。）刺
热厥者，留针反为寒；刺寒厥者，留针反为热。（留久者，则无热动针留之为寒，无寒静针留之
为热也。）刺热厥者，二阴一阳；刺寒厥者，二阳一阴。所谓二阴者，二刺阴也；一阳者，一刺阳
也。（皮为阳分也，肌肉为阴分也，刺热厥者，二度刺阴留，补其阴也，一度刺阳留，泻其阳也。
刺寒反之。平按∶自刺热厥者留针反为寒至一刺者阳也《甲乙·针道终
始》篇无此二段。）久病者邪气入深，刺久病者，深内而久留之，间日而复刺之，先调其左右，
去其血脉，刺道毕矣。（病久益深，物理之恒，故非深取久留，不可去之。邪气不能速出，故须间
日而取。取之气调左右，血络刺而去之，可谓尽刺之理者也。平按∶刺久病者《灵枢》、《甲乙》
作刺此病者。）凡刺之法，必察其形气，形肉未脱，少气而脉又躁，躁厥者，必为缪刺之，（以下
缪刺之法也。形肉未脱，察其形也。少气，察其气也。脉躁，察其脉也。有此三种所由，必须缪
刺大络，左刺右，右刺左也。）散气可收，聚气可希。（希，散也。缪刺之益，正气散而收聚，
邪气聚而可散也。平按∶希《灵枢》、《甲乙》作布，恐原抄传写之误。）深居静处，（为针调
气，凡有六种。深□□□□□□静。一也。）与神往来，（去妄心，随作动。二也。平按∶与《灵
枢》、《甲乙》作占。注随作二字袁刻缺，此本尚完。）闭户塞牖，魂魄不散，（去驰散，守魂
魄。三也。）专意一神，精气不分，（去异思，守精神。四也。平按∶不分《灵枢》、《甲乙》
作之分。）无闻人声，以收其精，（去异听，守精气。五也。）必一其神，令之在针，浅而留之，
微而浮之，以移其神，气至乃休。（休，平和也，平针下和气。六也。平按∶令之在针《灵枢》、
《甲乙》作令志在针。微而浮之下原抄缺半行，细玩残缺处，中间笔画甚重，应是大字经文，谨
根据《灵枢》、《甲乙》补入“以移其神，气至乃休”八字。）男内女外，坚巨勿出，谨守勿内，
是谓得气。（男者在家，故为内也。女者出家，故为外也。是男为内气，女为外气。针下得男内
气，坚巨勿令出也。得女外气，谨守勿令入内也。平按∶男内女外《灵枢》注云∶有作男外女内。
《甲乙》作男女内外。巨《灵枢》、《甲乙》作拒。）
Ping An: This section, from "so-called three punctures" to "cannot be considered a skilled practitioner," is found in *Ling Shu* (Spiritual Pivot), Volume 2, Chapter 7, "Official Needles" (*Guan Zhen*), and also in *Jia Yi Jing* (Classified Classic of Acupuncture and Moxibustion), Volume 5, Section 2. From "Among all types of needling, the three punctures reach the grain qi" to the end, it is found in *Ling Shu*, Volume 2, Chapter 9, "Ends and Beginnings" (*Zhong Shi*), and also in *Jia Yi Jing*, Volume 5, Section 5.
The so-called "three punctures causing grain qi to emerge" refers to first making a superficial puncture through the skin to expel Yang pathogenic factors; (The so-called three punctures include puncturing Yang pathogens, puncturing Yin pathogens, and puncturing the Grain Qi pathway. Yang pathogens are shallow and located in the skin layer, so the first puncture is superficial to expel them. Ping An: *Jia Yi Jing* has the character "zhi" after "three punctures".) The second puncture causes Yin pathogens to emerge, slightly deeper, penetrating the skin to the muscle layer but not entering between the muscle bundles; (Yin pathogens are deeper, located in the muscles, so the second puncture expels them. Ping An: *Ling Shu* and *Jia Yi Jing* have the character "rou" after "fen".) Once deeply entered into the space between muscle bundles, then grain qi emerges. (Grain qi is righteous qi. Therefore, the third puncture is extremely deep to draw forth righteous qi. Ping An: *Jia Yi Jing* has the four characters "hou ci shen zhi" before "yi ru".) Thus, the *Ci Fa* (Needling Method) states: Start with superficial needling to drive out pathogenic factors and attract blood and qi; subsequently needle deeply to draw out Yin-pathogenic factors; finally, needle extremely deeply to guide grain qi. This is what is meant. (Driving out pathogenic factors refers to driving out Yang pathogens. Attracting blood and qi refers to introducing righteous qi. "Xia" means guiding grain qi downward when it does not descend naturally. Ping An: In *Jia Yi Jing*, "yi zhu xie qi" is written as "yi zhu yang xie zhi qi", without the four characters "er lai xue qi". "Yi zhi yin qi zhi xie" in *Jia Yi Jing* is written as "yi zhi yin xie zhi qi".) Therefore, one who uses needles, if unaware of the climatic influences added each year and the origins of the flourishing, declining, excess, and deficiency of qi, cannot be considered a skilled practitioner. (The great taboo for humans is that from age seven onwards, nine is added sequentially until one hundred and six years old, called "Nian Jia" (Yearly Addition). Not knowing the flourishing and declining, excess and deficiency of qi due to yearly additions constitutes ignorance.)
Among all types of needling, the three punctures reaching grain qi, (Three punctures obtain grain qi. Ping An: *Ling Shu* and *Jia Yi Jing* have the character "qi" after "gu".) Pathogenic deviations combining randomly, (Yin and Yang pathogens randomly combine with righteous qi. This is one.) Yin and Yang exchanging positions, (Viscera and organs' qi mutually overacting is called exchanging positions. This is two. Ping An: *Jia Yi Jing* writes "yi ju" as "yi ju".) Reversal and順逆 being opposite, (Ying qi reverses in the Lungs, Wei qi flows smoothly in the vessels, considered opposite. This is three.) Floating and sinking in different places, (Spring pulse may be sunken, Winter pulse may be floating, hence called different places. This is four.) Four seasons not harmonizing, (Refers to four-season pulses not being mutually compliant. This is five. Ping An: *Jia Yi Jing* writes "bu de" as "bu xiang de".) Stagnation and excessive overflow, (Refers to blood and qi having stagnation and obstruction, or excessive overflow. This is six.) Must use fine needles to remove them. (Because of these six errors, fine needles are required to remove them.) The first puncture expels Yang pathogens, the second expels Yin pathogens, the third brings grain qi to arrival; once grain qi arrives, stop. The so-called "grain qi arriving" means that after tonification, there is fullness; after purgation, there is emptiness; thus we know grain qi has arrived. (Fullness after tonification, emptiness after purgation, both indicate righteous qi arrival, thus the disease heals. Ping An: In *Jia Yi Jing*, neither "first puncture" nor "second puncture" has the character "ze", and "gu qi zhi" is not repeated.) When only pathogenic factors are removed, Yin and Yang are not yet harmonized, yet the disease knows it will heal. (After performing tonification and purgation, pathogenic factors are gone; although Yin and Yang are unharmonized and the disease hasn't fully healed, it will certainly heal later.) It is said that tonification leads to fullness, purgation leads to emptiness; even if pain does not decrease immediately with needling, the disease will surely decline. (Citing the classic text as evidence. Ping An: In *Jia Yi Jing*, "tong" is written as "bing"; in *Ling Shu*, there is no character "jian" after "zhen xia".) If Yin is excess and Yang is deficiency, first tonify Yang, then purge Yin to harmonize; if Yin is deficiency and Yang is excess, first tonify Yin, then purge Yang to harmonize. (Purging double excess is easy; tonifying double deficiency is difficult, hence tonify first, then purge.) The three meridians are between the big toes of the foot, (The three meridians refer to the Foot-Yangming, Foot-Jueyin, and Foot-Taiyin meridians. The Foot-Taiyin meridian originates at the tip of the big toe, follows the medial white flesh margin of the toe, passes behind the metatarsal head, ascends to the medial malleolus, and does not speak of the cleft between the toes. Here, saying it focuses on the interdigital space means starting from the big toe tip, following the medial side into the interdigital space to pass behind the metatarsal head and ascend. The Foot-Jueyin meridian originates above the tufted hair of the big toe, enters the interdigital space, lies above the Taiyin, and ascends along the dorsum of the foot. The branch of the Foot-Yangming diverges from the dorsum, enters the interdigital space, and lies above the Jueyin. Ping An: "Zhong" in *Ling Shu* and *Jia Yi Jing* is written as "dong"; *Jia Yi Jing* commentary notes: "Another version reads 'zhong'." Additionally, the original manuscript writes "zhong" as "zhong", while Yuan edition changes it to "dong".) One must carefully examine their excess and deficiency; purging deficiency is called double deficiency, and double deficiency makes the disease more severe. (Must carefully examine the excess and deficiency of the three meridians between the big toes; press with hand, tonify the deficient first, then purge the excess. If unaware that the three meridians have excess, yet purge the deficient, this is called double deficiency, and double deficiency makes the disease more severe.) For needling these areas, press with fingers; if the pulse moves and is excess with disease, purge rapidly; if deficient and slow, tonify. Doing the opposite makes the disease worse. Regarding their depth/position, Yangming is uppermost, Jueyin is middle, Taiyin is lower. (The three meridians have those moving and excess, and those slow and deficient; all require careful examination and regulation of tonification and purgation. Ping An: "Er shi qie bing zhe" in *Ling Shu* and *Jia Yi Jing* writes "bing" as "ji". *Jia Yi Jing* writes "ji xie zhi" as "ze xie zhi". "Qi zhong ye" in *Ling Shu* and *Jia Yi Jing* writes "zhong" as "dong"; *Jia Yi Jing* commentary notes: "Another version reads 'zhong'." "Taiyin zai xia" in *Ling Shu* and *Jia Yi Jing* is written as "Shaoyin zai xia".) Ying acupoints correspond to the chest center, Back-Shu points correspond to the back center. (Ying acupoints are in the chest, Back-Shu points are in the back. Ping An: "Shu" in *Ling Shu* and *Jia Yi Jing* is written as "Shu".) For weakness in the shoulder/arm, select points above. (Tonifying points like Jianjing is called selecting points above. Ping An: "Bo" in *Ling Shu* is written as "Bo", in *Jia Yi Jing* as "Bi".) For double tongue, puncture the tongue pillar using a Pi needle. (Double tongue refers to the growth of redundant flesh under the tongue. Tongue pillar is the pillar under the tongue. Use needle to drain blood. Ping An: "Pi" in *Ling Shu* and *Jia Yi Jing* is written as "Pi".) For hands that can flex but not extend, the disease is in the sinews; for those that can extend but not flex, the disease is in the bones. For bone diseases, focus on the bones; for sinew diseases, focus on the sinews. (Kidney Foot-Shaoyin meridian governs bones; one can focus on the meeting point of the Foot-Shaoyin meridian to perform tonification and purgation. Liver Foot-Jueyin meridian governs sinews; one can focus on the meeting point of the Foot-Jueyin meridian to perform tonification and purgation.) Tonification requires one side to be excess; needle deeply, slowly press the aperture, to exhaustively expel pathogenic qi; (Here, below "tonification", the character "purgation" is missing. Fang means place. To perform purgation, the site must be excess, then it can be purged. Deep needling allows much qi to exit. Xi means slow. Pressing the aperture means pressing the needle wound slowly to let qi escape. Ping An: "Xi" in *Ling Shu* and *Jia Yi Jing* is written as "Xi". "Kong" in Yuan edition is mistakenly written as "Bing", same in commentary.) For one side that is deficient, needle superficially to nourish the vessels; quickly press the aperture to prevent pathogenic qi from entering. (For tonification, the site must be deficient. Superficial needling avoids qi leakage, hence not deep. Nourishing the vessel means retaining the needle to nourish the selected meridian. Pressing the aperture means pressing the needle wound quickly to close the gate, preventing pathogenic qi from entering and righteous qi from exiting.) When pathogenic qi arrives, it is firm and rapid; when grain qi arrives, it is slow and harmonious. (Firm and rapid sensation upon needling indicates pathogenic qi; slow and harmonious indicates grain qi. Ping An: "Jian" in *Ling Shu* and *Jia Yi Jing* is written as "Jin".) For excess pulse, needle deeply to drain its qi; for deficient pulse, needle superficially to prevent essence qi from escaping, to nourish the vessels, and solely expel pathogenic qi. (Excess means pathogenic qi is abundant. Deficiency means righteous qi is scarce.) For needling various pains, needle deeply; for various pains, the pulse is always excess. (Pulse fullness and excess cause pain, hence deep needling. Ping An: *Ling Shu* lacks the six characters "shen ci zhi zhu tong zhe".) For conditions above the waist, Hand-Taiyin and Hand-Yangming govern them; for conditions below the waist, Foot-Taiyin and Foot-Yangming govern them. (Above the waist is Heaven; Lung governs Heavenly qi, hence Hand-Taiyin and Hand-Yangming govern it. Below the waist is Earth; Spleen governs Earthly soil, hence Foot-Taiyin and Foot-Yangming govern it. Ping An: *Ling Shu* has "Gu Yue" before "Cong yao yi shang zhe". *Jia Yi Jing* lacks "Jie" before both "Zhu".) For diseases above, treat below; for diseases below, treat high. (Hand-Taiyin connects down to Hand-Yangming, Hand-Yangming connects down to Foot-Yangming, Foot-Yangming connects down to Foot-Taiyin; because they connect up and down, for diseases above Hand-Taiyin and Yangming, treat Foot-Taiyin and Yangming, hence called treating below; for diseases below Foot-Taiyin and Yangming, treat Hand-Taiyin and Yangming, hence called treating high. Ping An: Commentary "Gu Shou Taiyin Yangming xia" Yuan edition omits "Zhi Shang" two characters.) For diseases in the head, treat the feet; for diseases in the waist, treat the popliteal fossa. (The three Yin and three Yang meridians of the foot run from head to foot, hence for head diseases treat the feet. Foot-Taiyang meridian follows the waist into the popliteal fossa, hence for waist diseases treat the popliteal fossa.) Diseases originating in the head cause heaviness in the head; originating in the hands cause heaviness in the arms; originating in the feet cause heaviness in the feet. Treating physicians should first needle where the disease originates. (Wherever the head, hands, or feet have disease, the symptom is heaviness; examine the origin of the disease to perform tonification and purgation.) Spring qi is in the hair follicles, (Human hair follicles are hollow, hence Spring Yang qi is in the hair follicles. Ping An: *Ling Shu* lacks the character "Hao".) Summer qi is in the skin, (Skin is above the flesh; Yang qi is in the skin and flesh. Ping An: Above "Fu", *Ling Shu* and *Jia Yi Jing* have the character "Pi".) Autumn qi is in the muscle bundles, (Muscle bundles refer to the spaces between muscles.) Winter qi is in the sinews and bones, (Sinews attach to bones, deepest, hence Winter Yang qi is deep in sinews and bones.) For needling these diseases, use the season as the standard. Hence, for fat people, use the standard of Autumn/Winter; for thin people, use the standard of Spring/Summer. (Standard of Autumn/Winter means needling to sinews and bones, indicating depth. Standard of Spring/Summer means needling in the skin, indicating shallowness. Ping An: *Jia Yi Jing* lacks the character "Gu" after "Wei Qi".) Painful diseases are Yin; painful diseases where pressing with hand yields no relief are Yin; needle deeply. (Human painful diseases, pressing with hand... disease is deep in... Ping An: *Jia Yi Jing* writes "Bing tong zhe" as "Ci zhi tong zhe".) Diseases above are Yang; diseases below are Yin. Itching is Yang; needle superficially. (Wei qi circulates within the skin; obstruction causes itching, hence needle superficially. Ping An: In *Jia Yi Jing*, the seven characters "Yang zhe yang ye qian ci zhi" appear before "Bing zai shang zhe". Commentary "Wei qi" Yuan edition writes as "Chong qi".) For diseases starting in Yin, treat Yin first, then Yang; for diseases starting in Yang, treat Yang first, then Yin. (All treat the root. Ping An: *Ling Shu* lacks the character "Yu" after both "Qi" characters.) For needling Heat Jue, retain the needle to reverse into Cold; for needling Cold Jue, retain the needle to reverse into Heat. (Long retention: without heat, moving needle and retaining creates Cold; without cold, still needle and retaining creates Heat.) For needling Heat Jue, two Yin one Yang; for needling Cold Jue, two Yang one Yin. So-called two Yin means two punctures of Yin; one Yang means one puncture of Yang. (Skin is Yang division, muscle is Yin division. For needling Heat Jue, twice puncture Yin and retain to tonify Yin; once puncture Yang and retain to purge Yang. Reverse for Cold. Ping An: From "Ci re jue zhe liu zhen fan wei han" to "Yi ci zhe yang ye", these two paragraphs are absent in *Jia Yi Jing · Zhen Dao Zhong Shi* chapter.) For chronic diseases, pathogenic qi has entered deeply; for needling chronic diseases, insert deeply and retain long, puncture every other day, first regulate left and right, remove blood vessels, the way of needling is complete. (Disease becomes deeper with time, constant physical law, hence without deep insertion and long retention, it cannot be removed. Pathogenic qi cannot exit quickly, hence must puncture every other day. Upon obtaining qi, regulate left and right, puncture blood collaterals to remove them, this can be called exhausting the principles of needling. Ping An: "Ci jiu bing zhe" in *Ling Shu* and *Jia Yi Jing* is written as "Ci ci bing zhe".) All methods of needling must observe form and qi; if flesh is not wasted, qi is scanty and pulse is restless, restless Jue cases must undergo Miao needling, (Below is the method of Miao needling. Flesh not wasted, observe form. Scanty qi, observe qi. Restless pulse, observe pulse. Due to these three reasons, must Miao-needle large collaterals, needle left at right, right at left.) Dispersed qi can be gathered, gathered qi can be dispersed. (Xi means disperse. Benefit of Miao needling: righteous qi disperses and gathers, pathogenic qi gathers and can be dispersed. Ping An: "Xi" in *Ling Shu* and *Jia Yi Jing* is written as "Bu", likely an error in original manuscript transmission.) Dwell in deep quiet places, (To regulate qi with needles, there are six aspects. Deep... Quiet. One.) Communicate with spirit, (Eliminate deluded mind, follow movement. Two. Ping An: "Yu" in *Ling Shu* and *Jia Yi Jing* is written as "Zhan". Commentary "Sui zuo" two characters omitted in Yuan edition, this version is complete.) Close doors and block windows, do not let soul and spirit scatter, (Eliminate scattering, guard soul and spirit. Three.) Focus intention on one spirit, do not divide essence and qi, (Eliminate different thoughts, guard spirit and essence. Four. Ping An: "Bu fen" in *Ling Shu* and *Jia Yi Jing* is written as "Zhi fen".) Do not hear human voices, to gather essence, (Eliminate different hearing, guard essence and qi. Five.) Must unify spirit, let it reside in the needle, needle superficially and retain, move slightly and float, to shift spirit, rest when qi arrives. (Rest means peaceful/harmonious, smoothing qi under needle. Six. Ping An: "Ling zhi zai zhen" in *Ling Shu* and *Jia Yi Jing* is written as "Ling zhi zai zhen". Under "Wei er fu zhi", original manuscript lacks half a line; examining the残缺 part, strokes are heavy, should be major text scripture, respectfully supplemented based on *Ling Shu* and *Jia Yi Jing* with eight characters "Yi yi qi shen, qi zhi nai xiu".) Men internal, women external, firm and large do not exit, carefully guard do not enter, this is called obtaining qi. (Men stay home, hence internal. Women go out, hence external. Thus men represent internal qi, women external qi. Obtaining male internal qi under needle, firm and large do not let exit. Obtaining female external qi, carefully guard do not let enter. Ping An: "Nan nei nv wai" *Ling Shu* commentary notes: Some make "Nan wai nv nei". *Jia Yi Jing* writes "Nan nv nei wai". "Ju" in *Ling Shu* and *Jia Yi Jing* is written as "Ju".)