或问云。刺热病。当用何针。余答云。当用 针。 （音低）针。锋针。员利针。此四者。为刺热病之针也。
灵枢热病篇云。热病。先肤痛窒鼻充面。取之皮。以第一。针五十九（云云。）热病。先身涩。倚而热。烦 干唇。
口嗌。取之脉。以第一。针五十九。（云云。）（第一针者即九针论所云 针也。）
\r 针之图\pt68a17.bmp\r
（其头大。其末锐。取法干巾针。去末寸半。渐锐之。长一寸六分。主热在头身用之。令无得深入而使阳气出。）
热病头痛颞 目HT 。脉痛。善衄。厥热病也。取之以第三针（云云。第三针者。即九针论所云。 针也。）
\r 针之图\pt68a18.bmp\r
其身大。其末圆。取法于黍粟之锐。长三寸半。主按脉取气。令邪气出。
热病面青。脑痛手足躁。取之筋间。以第四针（云云。）热病数惊 而狂。取之脉。以第四针（云云。）热病。身
重。骨痛。耳聋而好瞑取之骨。以第四针五十九（云云。）热病体重肠中热取之以第四针（云云）热病挟脐急痛。胸胁满
（云云。）取以第四针。（第四针者。即九针论所云锋针是也。）
\r锋针之图\pt68a19.bmp\r
（筒其身。锋其末。取法于絮。针长一寸六分。令可以泻热出血。九针十二原篇曰。刃三隅。以发痼疾。前五十九
刺中。取少商穴以三棱针刺之。微出血。即用此针也。）
热病嗌干多饮善惊卧不能起。取之肤肉。以第六针五十九（云云。第六针者。即九针论所云员利针也。）
\r圆利针图\pt68a20.bmp\r
尖如 。且圆且锐。微大其末。反小其身。取法于 针。长一寸六分。以取暴气。
（琥）按以上（云云。）乃热病用针之大略也。欲观全文须于内经中细考之。
有人问道：“治疗热病，应当使用什么样的针具？”我回答说：“应当使用镵针（音低）、锋针、圆利针。这四种针具，是用于治疗热病的针具。”
《灵枢·热病》篇说：“热病，起初皮肤疼痛，鼻塞面部浮肿。应取皮部，用第一类针具（即镵针）配合五十九穴刺法（详见下文）。热病，起初身体涩滞，倚靠发热，心烦口干，唇燥咽干。应取脉部，用第一类针具配合五十九穴刺法（详见下文）。（所谓第一类针具，就是《九针论》中所说的镵针。）”
[镵针图]
（其头部较大，末端尖锐。制作方法是取干巾针，去掉末端一寸半，逐渐磨尖。长度为一寸六分。主治头身部的热邪，使用时不得深入，以使阳气外泄。）
“热病出现头痛、颞部疼痛、目痛如脱出状，容易鼻出血。这是厥热病。应取第三类针具（详见下文）。（所谓第三类针具，就是《九针论》中所说的鍉针。）”
[鍉针图]
（其针身粗大，末端圆钝。制作方法是参照黍粟的尖端形状。长度为三寸半。主要用于按压脉道以引导正气，使邪气排出。）
“热病见面色发青，头脑疼痛，手足躁动不安。应取筋间，用第四类针具（详见下文）。热病频繁惊悸且发狂。应取脉部，用第四类针具（详见下文）。热病，身体沉重，骨节疼痛，耳聋且喜欢闭目。应取骨部，用第四类针具配合五十九穴刺法（详见下文）。热病身体困重，肠中发热。应取第四类针具（详见下文）。热病脐旁拘急疼痛，胸胁胀满（详见下文）。应取第四类针具。（所谓第四类针具，就是《九针论》中所说的锋针。）”
[锋针图]
（针身呈筒状，末端锋利。制作方法是参照棉絮的形状。针长一寸六分。用于泻热和放血。《九针十二原》篇说：‘刃有三棱，用以治疗顽固性疾病。’在五十九刺法中，取少商穴用三棱针刺之，微出血，就是使用这种针具。）
“热病咽喉干燥，多饮易惊，卧倒后不能起身。应取肤肉部，用第六类针具配合五十九穴刺法（详见下文）。（所谓第六类针具，就是《九针论》中所说的员利针。）”
[员利针图]
（针尖像箭簇一样，既圆又锐，末端稍大，针身相对较细。制作方法是参照针的形状。长度为一寸六分。用于祛除暴发性邪气。）
（琥按：以上所述，乃是热病用针的大致原则。若想观看全文细节，须在内经中仔细考证。）
A question was asked: "When treating heat diseases, what kind of needles should be used?" I answered: "One should use Chan needles (Chan Zhen, 镵针), Feng needles (Feng Zhen, 锋针), and Yuanli needles (Yuanli Zhen, 圆利针). These four types are the needles designated for treating heat diseases."
The chapter "Heat Diseases" in *Ling Shu* (Spiritual Pivot) states: "In heat diseases, if skin pain, nasal congestion, and facial swelling occur first, treat the skin level using the first type of needle (i.e., Chan needle) combined with the fifty-nine acupoint method (see below). If the body feels rough or stiff, fever leans towards one side, there is irritability, dry mouth, dry lips, and dry throat, treat the vessel level using the first type of needle combined with the fifty-nine acupoint method (see below). (The first type of needle refers to the Chan needle mentioned in *Jiu Zhen Lun* [Treatise on Nine Needles].)"
[Diagram of Chan Needle]
(The head is large, and the tip is sharp. It is made by taking a needle from a dry cloth, removing one and a half cun from the tip, and gradually sharpening it. The length is one cun and six fen. It is primarily used for heat in the head and body; it must not be inserted deeply, so that Yang Qi can exit.)
"If heat disease presents with headache, temporal pain, eye pain as if protruding, and frequent epistaxis, this is Jue heat disease. Treat it using the third type of needle (see below). (The third type of needle refers to the Di needle mentioned in *Jiu Zhen Lun*.)"
[Diagram of Di Needle]
(The needle body is thick, and the tip is round. It is shaped like the sharp point of millet grains. The length is three cun and five fen. It is mainly used to press upon the vessels to guide Qi and expel pathogenic factors.)
"If heat disease presents with a bluish complexion, headache, restlessness of the hands and feet, treat the sinew level using the fourth type of needle (see below). If heat disease involves frequent fright and mania, treat the vessel level using the fourth type of needle (see below). If heat disease presents with heavy body, bone pain, deafness, and a preference for closing the eyes, treat the bone level using the fourth type of needle combined with the fifty-nine acupoint method (see below). If heat disease involves heavy body and heat in the intestines, use the fourth type of needle (see below). If heat disease involves urgency and pain around the navel, and fullness in the chest and hypochondrium (see below), use the fourth type of needle. (The fourth type of needle refers to the Feng needle mentioned in *Jiu Zhen Lun*.)"
[Diagram of Feng Needle]
(The body is cylindrical, and the tip is sharp. It is modeled after cotton wool. The needle length is one cun and six fen. It is used to drain heat and induce bleeding. The chapter 'Nine Needles and Twelve Source Points' states: 'Blades with three edges are used to release stubborn diseases.' In the fifty-nine acupuncture points method, the Shaoshang acupoint is pricked with a triangular blade to cause slight bleeding; this is where this needle is used.)
"If heat disease presents with dry throat, excessive thirst, susceptibility to fright, and inability to rise from bed, treat the flesh level using the sixth type of needle combined with the fifty-nine acupoint method (see below). (The sixth type of needle refers to the Yuanli needle mentioned in *Jiu Zhen Lun*.)"
[Diagram of Yuanli Needle]
(The tip is sharp like an arrowhead, being both round and acute, with a slightly larger tip and a relatively thinner body. It is modeled after the shape of a needle. The length is one cun and six fen. It is used to dispel sudden pathogenic Qi.)
(Hu notes: The above describes the general principles of needle therapy for heat diseases. To view the full text details, one must carefully examine the *Nei Jing* [Inner Canon].)