黄帝问于岐伯曰。余闻刺有五禁。何谓五禁。岐伯曰。禁其不可刺也。黄帝曰。余闻刺有五夺。岐伯
曰。无泻其不可夺者也。黄帝曰。余闻刺有五过。岐伯曰。补泻无过其度。黄帝曰。余闻刺有五逆。岐
伯曰。病与脉相逆。命曰五逆。黄帝曰。余闻刺有九宜。岐伯曰。明知九针之论。是谓九宜。
余伯荣曰。此承上章。复论刺有五禁。五夺。五过。五逆以为刺禁。令民勿犯者也。五过者。五脏
外合之皮脉肉筋骨。有邪正虚实。宜平调之。如补泻过度。是为五过。九宜者。九针之论。各有所宜。
神而明之。是为九宜。
黄帝曰。何为五禁。愿闻其不可刺之时。岐伯曰。甲乙日自乘。无刺头。无发 于耳内。丙丁日
自乘。无振埃于肩喉廉泉。戊己日自乘四季。无刺腹去爪通水。庚辛日自乘。无刺关节于股膝。壬癸
日自乘。无刺足胫。是谓五禁。
余氏曰。天之十干。始于甲乙。终于壬癸。故甲乙以应头。壬癸以应足。丙丁应身半以上。庚辛
应身半以下。配天之四时也。戊己属土。故乘于四季。夫甲为阳木。乙为阴木。自乘者。阴阳自合。
非化气也。发 振埃者。所以通气也。天之十干。化生地之五行。通气者。通五运之化气。此天干自
乘。故为取气之禁。
黄帝曰。何谓五夺。岐伯曰。形肉已夺。是一夺也。大夺血之后。是二夺也。大汗出之后。是三
夺也。大泄之后。是四夺也。新产及大血。是五夺也。此病不可泻。
余氏曰。形肉血气已虚脱者。虽有实邪。皆不可泻。
黄帝曰。何谓五逆。岐伯曰。热病脉静。汗已出。脉盛躁。是一逆也。病泄脉洪大。是二逆也。
着痹不移。 肉破。身热。脉偏绝。是三逆也。淫而夺形。身热。色夭然白。及后下血 。血 笃
重。是谓四逆也。寒热夺形。脉坚搏。是谓五逆也。
余氏曰。热病脉静者。阳病见阴脉也。汗已出。脉盛躁者。阳热之邪。不从汗解。阴液去而邪
反盛也。病泄者脉宜沉弱。反洪大者。阴泄于下。阳盛于上。阴阳上下之相离也。着痹不移。 肉破。
身热者。湿邪伤形。久而化热。
脉偏绝者。脾胃之气败也。淫者。酷虐之邪。夺形者。邪伤形也。如但热不寒之疟。气内藏于心。而
外淫于分肉之间。令人消铄脱肉。夫心主血而血脉荣于色。色夭然白。及后下 血笃重者。形气消
于外。血液脱于内。血液外内之离脱也。寒热夺形。脉坚搏者。寒热之邪盛。而正气伤也。此为五
逆。皆不可刺也。
Huangdi asked Qibo, "I have heard that there are five prohibitions in acupuncture. What are these five prohibitions?" Qibo replied, "They prohibit needling when it is inadvisable." Huangdi said, "I have heard of five 'depletions' (conditions where vital qi is severely exhausted) in needling." Qibo said, "Do not apply reducing methods to conditions where depletion should not occur." Huangdi said, "I have heard of five errors in needling." Qibo said, "The tonifying and reducing methods must not exceed the appropriate degree." Huangdi said, "I have heard of five reversals (critical syndromes where symptoms contradict the pulse) in needling." Qibo said, "When the disease presentation contradicts the pulse, it is called a reversal." Huangdi said, "I have heard of nine appropriatenesses in needling." Qibo said, "To clearly understand the theory of the Nine Needles is called the nine appropriatenesses."
Yu Borong stated: This passage follows the previous chapter, reiterating the five prohibitions, five depletions, five errors, and five reversals as contraindications for needling, to prevent people from violating them. The so-called five errors refer to the skin, vessels, muscles, tendons, and bones externally corresponding to the five Zang organs, which present different states of pathogenic factors, excess, deficiency, and reality. They should be harmoniously regulated. If tonification or reduction is excessive, it constitutes the five errors. The so-called nine appropriatenesses refer to the theories of the Nine Needles, each having its specific indications. To comprehend and elucidate them divinely constitutes the nine appropriatenesses.
Huangdi asked, "What are the five prohibitions? I wish to hear about the specific times when needling is inadvisable." Qibo replied, "On Jia and Yi days (when the Heavenly Stem combines with the Earthly Branch), do not needle the head, and do not induce sweating or moxa in the ears. On Bing and Ding days, do not use the 'Zhen'ai' method (a needling technique to clear pathogenic factors from the shoulders, throat, and Lianquan point). On Wu and Ji days (corresponding to the end of the four seasons), do not needle the abdomen to remove stagnation in the nail beds or to promote water metabolism. On Geng and Xin days, do not needle the joints of the thighs and knees. On Ren and Gui days, do not needle the lower legs and shins. These are called the five prohibitions."
Master Yu stated: The ten Heavenly Stems begin with Jia and Yi and end with Ren and Gui. Therefore, Jia and Yi correspond to the head, Ren and Gui to the feet, Bing and Ding to the upper half of the body, and Geng and Xin to the lower half of the body; this aligns with the four seasons of Heaven. Wu and Ji belong to Earth, hence they prevail at the end of the four seasons. Jia is Yang Wood, and Yi is Yin Wood. 'Self-multiplication' (Zicheng) refers to the self-combination of Yin and Yang, not the generation of transformational Qi. Methods like inducing sweating and Zhen'ai are used to unblock Qi. The ten Heavenly Stems generate the Five Phases of Earth; unblocking Qi is equivalent to unblocking the transformational Qi of the Five Movements. Because the Heavenly Stems undergo self-multiplication, these become prohibitions against extracting Qi.
Huangdi asked, "What are the five depletions?" Qibo replied, "When the form and flesh have already been depleted, this is the first depletion. After severe blood loss, this is the second depletion. After profuse sweating, this is the third depletion. After severe diarrhea, this is the fourth depletion. After recent childbirth and massive bleeding, this is the fifth depletion. In these conditions, reducing methods are contraindicated."
Master Yu stated: When the form, flesh, blood, and Qi are already deficient and depleted, even if there are excess pathogens, reducing methods must not be used.
Huangdi asked, "What are the five reversals?" Qibo replied, "In febrile diseases, if the pulse is quiet, this is the first reversal. If the pulse becomes rapid and restless after sweating, this is the second reversal. If diarrhea occurs but the pulse is surging and large, this is the third reversal. If fixed Bi syndrome (Bi syndrome dominated by Dampness) does not move, muscles ulcerate, the body is hot, and the pulse is absent on one side, this is the fourth reversal. If excessive sexual activity leads to emaciation, the body is hot, the complexion is dull and pale, followed by hematochezia with severe condition, this is the fifth reversal."
Master Yu stated: A quiet pulse in a febrile disease indicates a Yin pulse appearing in a Yang disease. A rapid and restless pulse after sweating indicates that Yang-Heat pathogens have not resolved through sweating; the Yin fluids are gone, and the pathogens are relatively stronger. In cases of diarrhea, the pulse should be deep and weak; if it is surging and large, it indicates Yin leaking below and Yang flourishing above, representing a separation of Yin and Yang between the upper and lower parts. Fixed Bi syndrome with muscle ulceration and fever indicates Dampness damaging the form and transforming into Heat over time. An absent pulse on one side indicates the failure of Spleen and Stomach Qi. 'Yin' here refers to cruel pathogens; 'depleting form' means pathogens damaging the physical structure. For example, in malaria characterized by heat without chills, Qi hides internally in the Heart and externally invades the intermuscular spaces, causing muscle wasting. The Heart governs Blood, and the vessels nourish the complexion. A dull, pale complexion followed by severe hematochezia indicates that Qi and Form are consumed externally while Blood is lost internally, representing a disconnection of Blood internally and externally. Cold and heat alternating leading to emaciation with a firm and bounding pulse indicate that Cold and Heat pathogens are strong while Zheng Qi (Upright Qi) is damaged. These are the five reversals, all of which are contraindications for needling.