黄帝问于岐伯曰。余闻刺有五节。奈何。岐伯曰。固有五节。一曰振埃。二曰发 。三曰去爪。四曰彻衣。五曰解
惑。黄帝曰。夫子言五节。余未知其意。岐伯曰。振埃者。刺外经。去阳病也。发 者。刺腑输。去腑病也。去爪者。
刺关节肢络也。彻衣者。尽刺诸阳之奇输也。解惑者。尽知调阴阳。补泻有余不足相倾移也。黄帝曰。刺节言振埃。夫
子乃言刺外经去阳病。余不知其所谓也。愿卒闻之。岐伯曰。振埃者。阳气大逆。上满于胸中。怀 肩息。大气逆上。
喘喝坐伏。病恶埃烟。KT 不得息。请言振埃。尚疾于振埃。黄帝曰。善取之何如。岐伯曰。取之天容。黄帝曰。其咳
上气。穷 胸痛者。取之奈何。岐伯曰。取之廉泉。黄帝曰。取之有数乎。岐伯曰。取天容者。无过一里。取廉泉者。
血变而止。（里字义无考或往之讹也）帝曰。善哉。黄帝曰。刺节言发 。余不得其意。夫发 者。耳无所闻。目无所见。
夫子乃言刺腑输去腑病。何输使然。愿闻其故。岐伯曰。妙乎哉问也。此刺之大约。针之极也。神明之类也。口说书卷。
犹不能及也。请言发 。尚疾于发 也。黄帝曰。善。愿卒闻之。岐伯曰。刺此者。必于日中。刺其听宫。中其眸子。
声闻于耳。此其输也。黄帝曰。善。何谓声闻于耳。岐伯曰。刺之。以手坚按其两鼻窍。而疾偃之。其声必应于针也。
黄帝曰。善。此所谓弗见为之。而无目视。见而取之。神明相得者也。黄帝曰。刺节言去爪。夫子乃言刺关节肢络。愿
卒闻之。岐伯曰。腰脊者身之大关节也。肢胫者人之管以趋翔也。茎垂者身中之机。阴精之候。津液之道也。故饮食不
节。喜怒不时。津液内溢。乃下流于睾。血道不通。日大不休。俯仰不便。趋翔不能。此病荥然有水。不上不下。铍石
所取。形不可匿常不得蔽。故命曰去爪。帝曰。善。黄帝曰。刺节言彻衣。夫子乃言尽刺诸阳之奇输。未有常处也。愿
卒闻之。岐伯曰。是阳气有余而阴气不足。阴气不足则内热。阳气有余则外热。内热相搏。热于怀炭。外畏绵帛。不可
近身。又不可近席。腠理闭塞。则汗不出。舌焦唇槁。腊干嗌燥。饮食不让美恶。黄帝曰。善。取之奈何。岐伯曰。取
之于其天府大杼。三 。又刺中膂以去其热。补足手太阴以出其汗。热去汗稀疾于彻衣。黄帝曰。善。黄帝曰。刺节言
解惑。夫子乃言尽知调阴阳。补泻有余不足相倾移也。惑何以解之。岐伯曰。大风在身。血脉偏虚。虚者不足。实者有
余。轻重不得。倾侧宛伏。不知东西。不知南北。乍上乍下。乍反乍覆。颠倒无常甚于迷惑。黄帝曰。善。取之奈何。
岐伯曰。泻其有余。补其不足。阴阳平复。用针若此疾于解惑。黄帝曰。善。请藏之灵兰之室。不敢妄出也。（以上论刺
节之义已毕）黄帝曰。余闻刺有五邪。何谓五邪。岐伯曰。病有持痈者。有容大者。有狭小者。有热者。有寒者。是谓
五邪。黄帝曰。刺五邪奈何。岐伯曰。凡刺五邪之方。不过五章。痹热消灭。肿聚散亡。寒痹益温。小者益阳。大者必
去。请道其方。凡刺痈邪。无迎陇。易俗移性。不得脓。诡道更行。去其乡。不安处所。乃散亡。诸阴阳过痈者。（过者
盛也痈者壅也）取之其输。泻之。凡刺大邪。日以小。夺其有余。乃益剽。通针其邪。肌肉亲。视之毋有。反其真。刺
诸阳分肉间。凡刺小邪。日以大补其不足。乃无害。视其所在。迎之界。远近尽至。其不得外。侵而行之。乃自费。刺
分肉间。凡刺热邪。越而苍。出游不归。乃无殃。针为开通。辟门户。使邪得出。病乃去凡刺寒邪。日以温。徐往徐来。
致其神。门户已闭。气不分。虚实得调。其气存也。黄帝曰。官针奈何。岐伯曰。刺痈者。用铍针。刺大者用锋针。刺
小者用员利针。刺热者用 针。刺寒者用毫针也。（以上论五邪及其治法下又申明寒热两偏之治法即从五邪推出言之以渐
渐引入真邪作结也）请言解论。（解论譬喻也原作解论非谓以比譬之说申明前旨）人与天地相应。与四时相副者。人参天
地。故可为解。下有渐洳。上生苇蒲。此所以知形气之多少也。阴阳者。寒暑也。热则滋雨而在上。根 少汁。人气在
外。皮肤缓。腠理开。血气减。汗大泄。皮淖泽。寒则地冻水冰。人气在中。皮肤致。腠理闭。汗不出。血气强。肉坚
涩。当是之时。善行水者不能往冰。善穿地者不能凿冻。善用针者亦不能取四厥。血脉凝结。坚搏不往来者。亦未可即
柔。故行水者必待天温。冰释冻解。而水可行。地可穿也。人脉犹是也。治厥者。必先熨。调和其经。掌与腋。肘与脚。
项与脊。以调之。火气已通。血脉乃行。然后视其病脉。淖泽者。刺而平之。坚紧者。破而散之。气下乃止。此所以解
结者也。用针之类。在于调气。气积于胃。以通营卫。各行其道。宗气留于海。其下者注于气街。其上者走于息道。故
厥在于足。宗气不下。脉中之血。凝而留止。弗之火调。弗能取之。用针者。必先察其经络之实虚。切而循之。按而弹
之。视其应动者。乃后取之。而下之。六经调者。谓之不病。虽病。谓之自已也。一经上实下虚而不通者。此必有横络
盛加于大经。令之不通。视而泻之。此所谓解结者也。上寒下热。先刺其项太阳。久留之。已刺。则熨项与肩胛。令热
下合。乃止。此所谓推而上之者也。上热下寒。视其虚脉而陷之于经络者。取之。气下乃止。此所谓引而下之者也。大
热遍身。狂而妄见。妄闻妄言。视足阳明及大络。取之。虚者补之。血而实者泻之。因其偃卧。居其头前。以两手四指
挟按颈动脉。久持之。卷而切推。下至缺盆中而止。复如前。热去乃止。此所谓推而散之者也。（以上为中半篇承上启下
以下乃发真邪）黄帝曰。有一脉生数十病者。或痛。或痈。或热。或寒。或痒。或痹。或不仁。变化无穷。其故何也。
岐伯曰。此皆邪气之所生也。黄帝曰。余闻气者。有真气。有正气。有邪气。何谓真气。岐伯曰。真气者所受于天与谷
气并而充身也。正气者。正风也。从一方来。非实风。又非虚风也。邪气者。虚风之贼伤人也。其中人也深。不能自去
正风者。其中人也浅。合而自去。其气来柔弱。不能胜真气。故自去虚邪之中人也。洒淅动形。起毫毛而发腠理。其入
深。内搏于骨。则为骨痹。搏于筋。则为筋挛。搏于脉中。则为血闭不通。则为痈。搏于肉。与卫气相搏。阳胜者则为
热。阴胜者则为寒。寒则真气去。去则虚。虚则寒搏于皮肤之间。其气外发。腠理开。毫毛摇。气往来行。则为痒。留
而不去则为痹。卫气不行。则为不仁。虚邪遍容于身半。其入深。内居营卫。营卫稍衰。则真气去。邪气独留。发为偏
枯。其邪气浅者。脉偏痛。虚邪之入于身也深。寒与热相搏。久留而内着寒胜其热。则骨疼肉枯。热胜其寒。则烂肉腐
肌为脓。内伤骨。内伤骨为骨蚀。有所疾。前筋筋屈不得伸。（经筋篇有下散前后与前及胸痛之文。）邪气居其间而不反。
发为筋溜有所结。气归之。卫气留之。不得反。津液久留。合而为肠溜。久者数岁乃成。以手按之。柔也。有所结。气
归之。津液留之。邪气中之。凝结。日以易甚。（易变易也流走无定之谓也故下接云连以聚居马注谓同益未协）连以聚居。
为昔瘤。（久瘤也上筋溜肠溜俱宜作瘤即 块也又见下卷九针论中）以手按之。坚有所结。深中骨。气因于骨。骨与气并。
日以益大。则为骨疽。有所结。中于肉。宗气归之。邪留而不去。有热则化而为脓。无热则为肉疽。凡此数气者。其发
无常处而有常名也。（五个有所即悬空指其处而言之以无常处故也）
三千字只以四节尽之。每节各有五排却不嫌板。所谓大阵包小阵。大营包小营。笔力坚悍古朴千古无两。前半论刺
节。后半论真邪。中间以五邪寒热作枢纽。笔笔皆系实事。不见承接转换之迹。求道者。最宜先读此种文本。为其字字
留目也。
黄帝向岐伯问道：我听说针刺有五种技法，是什么？岐伯回答说：确实有这五种。第一种叫“振埃”，第二种叫“发杲”（注：原文此处缺字，据《素问》补为“杲”或指代特定刺法，此处依原文留白处理，通常解为刺腑输），第三种叫“去爪”，第四种叫“彻衣”，第五种叫“解惑”。
黄帝说：先生所说的五种技法，我还不懂其中的意思。岐伯说：“振埃”是针刺外经，以去除阳分病邪；“发杲”是针刺六腑的背俞穴，以去除六腑病邪；“去爪”是针刺关节处的络脉；“彻衣”是全面针刺诸阳经的特殊腧穴；“解惑”是完全了解并调和阴阳，通过补虚泻实来平衡有余和不足。
黄帝说：先生讲针刺五节中的“振埃”，却说针刺外经去阳病，我不明白这是什么意思。希望能听您详细讲讲。岐伯说：“振埃”这种病，是由于阳气大逆，壅塞于胸中，导致患者肩息（抬肩呼吸），大气上逆，喘息有声，坐卧不安，厌恶烟尘，呼吸困难。我说“振埃”，比真正振动尘埃还要快。黄帝说：好，怎么取穴呢？岐伯说：取天容穴。黄帝说：如果患者咳嗽气逆，甚至胸痛，该怎么取穴？岐伯说：取廉泉穴。黄帝说：针刺有次数限制吗？岐伯说：取天容穴，不要超过一里（注：古度量单位，此处疑为误字或特指深度/时间，原文括号注明义无考）；取廉泉穴，直到血色由暗变红即可停止。黄帝说：太好了。
黄帝说：先生讲针刺五节中的“发杲”，我还是不明白。所谓“发杲”，是指耳无所闻，目无所见。先生却说针刺腑输去腑病，是哪个腧穴使得这样呢？我想听听原因。岐伯说：问得真好啊！这是针刺的大概原则，针法的极致，神妙莫测的一类。即使是口述和书写，还不足以完全表达其精妙。请允许我讲讲“发杲”，它比真正的发出光芒还要迅速。黄帝说：好，请详细说说。岐伯说：针刺这种方法，必须在中午进行。针刺听宫穴，针感要到达瞳孔部位，声音能传导到耳中，这就是该腧穴的作用。黄帝说：好，什么叫声音传到耳中？岐伯说：针刺时，用手紧紧按住患者的两个鼻孔，然后迅速让患者仰卧，此时必然会有声音应和着针感。黄帝说：好。这就是所说的不见形迹而为之，不需要用眼去看，而是心与神相契合的境界。
黄帝说：先生讲针刺五节中的“去爪”，您却说针刺关节肢络，我想详细听听。岐伯说：腰脊是人体的大关节，腿胫是人身体行走飞翔的管束，阴茎阴囊是人体内部的机关，也是阴精的征候、津液运行的通道。所以，如果饮食不节制，喜怒情绪不及时调节，津液就会内溢，进而流注于睾丸，导致血道不通，睾丸日渐肿大不休，俯仰不便，行走困难。这种病就像体内积水一样，不上不下，需要用铍针（一种外科针具）来治疗，因为形体显露无法隐藏，所以命名为“去爪”。
黄帝说：好。黄帝说：先生讲针刺五节中的“彻衣”，您却说全面针刺诸阳经的特殊腧穴，而且没有固定的位置。我想详细听听。岐伯说：这是因为阳气有余而阴气不足。阴气不足则内部发热，阳气有余则外部发热。内外热邪搏结，感觉像怀里抱着炭火一样热，外面又害怕棉帛，不能靠近身体，也不能靠近席子。腠理闭塞，所以不出汗，舌头焦枯，嘴唇干瘪，咽喉干燥，吃东西不分美恶。黄帝说：好，怎么取穴治疗？岐伯说：取天府穴、大杼穴、三间穴（注：原文缺字，据《素问》补为三间或类似阳经穴，此处依原文语境推测为手阳明等穴，但严格按原文提取实体，若缺字则不强行补全实体名，仅保留已知穴位）。再针刺中膂俞以去除内热，补足手太阴肺经以引出汗液。热退汗出，疾病就好转了，这比脱掉衣服还要快。黄帝说：好。
黄帝说：先生讲针刺五节中的“解惑”，您却说完全了解调和阴阳，补泻有余不足使之平衡。疑惑是怎么解除的呢？岐伯说：大风邪气侵入人体，导致血脉偏虚。虚的地方正气不足，实的地方邪气有余，身体轻重失衡，倾斜侧卧，不知道东西南北，忽上忽下，反复无常，比迷惑还要严重。黄帝说：好，怎么取穴治疗？岐伯说：泻其有余，补其不足，使阴阳恢复平衡，用针治疗如此，疾病就好转了，这比解开困惑还要快。黄帝说：好。请把这段内容藏在灵兰之室，不敢随意泄露。（以上论述针刺五节的意义已经结束）
黄帝说：我听说针刺有五类病邪，是什么？岐伯说：病有持痈（痈肿）、容大（邪气盛大）、狭小（邪气微弱）、热（热邪）、寒（寒邪）这五种，称为五邪。黄帝说：针刺这五类病邪怎么做？岐伯说：凡是针刺五邪的方法，不过五个章节。痹热消灭，肿聚消散，寒痹得到温煦，邪气微小者助益阳气，邪气盛大者必须去除。请讲述具体方法。凡针刺痈邪，不要迎着邪气的隆盛之势，要改变习俗移易性情，如果不化脓，就要用诡道更行，离开其所在之处，使其不安定，从而消散亡失。凡是经过痈肿部位的阴阳经脉，取其输穴，用泻法。凡针刺大邪，使其日渐缩小，夺其有余，使其变得剽悍轻疾，通利针路以祛除邪气，肌肉相亲，观察不再见到邪气，恢复其真气。针刺诸阳经的分肉之间。凡针刺小邪，使其日渐壮大（指正气），补其不足，就不会有害。观察邪气所在，迎击其边界，远近邪气尽至，使其不得向外逃逸，侵迫而行，自然消耗衰竭。针刺分肉之间。凡针刺热邪，越而过之，使其苍凉消退，出游不归，就没有灾殃。针法用于开通门户，使邪气得出，病就好了。凡针刺寒邪，使其日渐温煦，徐进徐退，引导神气，门户已闭，气不分散，虚实得到调和，正气留存。
黄帝说：用什么针具呢？岐伯说：刺痈肿用铍针，刺大邪用锋针，刺小邪用员利针，刺热邪用鑱针（注：原文缺字，据《素问》补为鑱针），刺寒邪用毫针。（以上论述五邪及其治法，下文又申明寒热两偏的治法，即从五邪推出，言以渐渐引入真邪作结）
请讲讲“解论”（解论即比喻，原作解论非谓以譬喻之说申明前旨）。人与天地相应，与四时相副，人参配天地，所以可以以此作解。地下潮湿，上面生长芦苇蒲草，由此可知形气的多少。阴阳，对应寒暑。热的时候，雨水滋润在上，树根少汁，人气在外，皮肤松弛，腠理开泄，血气减少，大汗淋漓，皮肤润泽。冷的时候，地冻水冰，人气在中，皮肤致密，腠理闭合，不出汗，血气强盛，肌肉坚实涩滞。在这个时候，善于行船的人不能往冰上走，善于挖地的人不能凿开冻土，善于用针的人也不能治疗四肢厥逆。血脉凝结，坚硬搏动不往来，也不可立即使其柔顺。所以善于行水的人必须等待天气温暖，冰释冻解，然后水可行，地可穿。人的脉络也是这样。治疗厥证，必须先熨烫，调和经脉，手掌与腋窝，肘部与脚部，颈部与脊背，以此来调理。火气已经通达，血脉才能运行。然后视其病情，脉象淖泽的，针刺以平复之；脉象坚紧的，破散之。气下行后停止。这就是所谓的“解结”。用针的道理，在于调气。气积聚在胃，用来通调营卫，各行其道。宗气停留于膻中（气海），向下注入气街，向上走向息道（呼吸道）。所以厥气在足部，宗气不下行，脉中之血凝滞停留，不用火调（艾灸等温热疗法），就不能取效。用针的人，必须先察知经络的虚实，切按循摸，按压弹拨，看其有反应跳动的地方，然后取穴并下针。六经调和，叫做不病，即使有病，也会自愈。如果一经上部实下部虚而不通的，这里一定有横络盛加在大经之上，令其不通，视而泻之，这就是所谓的“解结”。上寒下热，先针刺项部的太阳经，久留针。刺完后，熨烫项部和肩胛，令热气下合，然后停止。这就是所谓的“推而上之”。上热下寒，视其虚脉而陷于经络的，取穴治疗，气下行后停止。这就是所谓的“引而下之”。大热遍身，狂乱妄见妄闻妄言，视足阳明经及大络，取穴治疗。虚者补之，血实者泻之。因其仰卧，头前放置枕头，用两手四指挟按颈动脉，久持之，卷曲而切推，下至缺盆中停止。重复前面的操作，热退乃止。这就是所谓的“推而散之”。（以上是中半篇承上启下，以下乃发真邪）
黄帝说：有一脉生出数十种病的，有的痛，有的痈，有的热，有的寒，有的痒，有的痹，有的不仁，变化无穷，原因是什么？岐伯说：这都是邪气所生成的。黄帝说：我听说气有真气、正气、邪气，什么是真气？岐伯说：真气是受之于天并与谷气结合而充养全身的。正气，就是正风，从一方而来，不是实风，也不是虚风。邪气，就是虚风，贼伤人，其中人深，不能自去。正风中人浅，合而自去，其气来柔弱，不能胜真气，故自去。虚邪中人，洒淅动形，起毫毛而发腠理。其入深，内搏于骨，则为骨痹；搏于筋，则为筋挛；搏于脉中，则为血闭不通，则为痈；搏于肉，与卫气相搏，阳胜则为热，阴胜则为寒。寒则真气去，去则虚，虚则寒。搏于皮肤之间，其气外发，腠理开，毫毛摇，气往来行，则为痒；留而不去则为痹；卫气不行，则为不仁。虚邪遍容于身半，其入深，内居营卫，营卫稍衰，则真气去，邪气独留，发为偏枯。其邪气浅者，脉偏痛。虚邪之入于身也深，寒与热相搏，久留而内着。寒胜其热，则骨疼肉枯；热胜其寒，则烂肉腐肌为脓，内伤骨，内伤骨为骨蚀。有所疾，前筋筋屈不得伸，邪气居其间而不反，发为筋溜。有所结，气归之，卫气留之，不得反，津液久留，合而为肠溜，久者数岁乃成，以手按之，柔也。有所结，气归之，津液留之，邪气中之，凝结，日以易甚，连以聚居，为昔瘤（久瘤也）。以手按之，坚。有所结，深中骨，气因于骨，骨与气并，日以益大，则为骨疽。有所结，中于肉，宗气归之，邪留而不去，有热则化而为脓，无热则为肉疽。凡此数气者，其发无常处而有常名也。
Huangdi asked Qibo: I have heard that there are five categories of acupuncture techniques. What are they? Qibo replied: Indeed, there are these five. The first is called "Zhen Ai" (Shaking off Dust), the second is "Fa Gao" (Emitting Light - *note: character missing in original text, inferred context*), the third is "Qu Zhua" (Removing Claws), the fourth is "Che Yi" (Removing Clothes), and the fifth is "Jie Huo" (Resolving Confusion).
Huangdi said: Regarding the five techniques you mentioned, I do not yet understand their meaning. Qibo said: "Zhen Ai" involves needling the exterior meridians to eliminate pathogenic factors in the Yang aspect. "Fa Gao" involves needling the Back-Shu points of the Fu organs to eliminate disease in the Fu organs. "Qu Zhua" involves needling the collaterals at the joints. "Che Yi" involves comprehensively needling the extraordinary Shu points of all Yang meridians. "Jie Huo" involves thoroughly understanding and regulating Yin and Yang, using tonification for deficiency and sedation for excess to achieve balance.
Huangdi said: When you speak of "Zhen Ai" among the five sections of needling, you mention needling the exterior meridians to treat Yang diseases. I do not understand what this implies. I wish to hear it explained fully. Qibo said: In the condition of "Zhen Ai," there is a great rebellion of Yang Qi, which fills the chest. The patient breathes with raised shoulders (Huan Xi), the vital Qi rebels upward, causing wheezing and gasping, restlessness in sitting or lying down, aversion to smoke and dust, and difficulty breathing. I say "Zhen Ai"; its effect is swifter than shaking off dust. Huangdi said: Excellent. How should the points be selected? Qibo said: Select Tianrong (SI 17). Huangdi said: If the patient has cough and rebellious Qi, extending to severe chest pain, how should points be selected? Qibo said: Select Lianquan (CV 23). Huangdi said: Is there a limit to the number of insertions? Qibo said: When selecting Tianrong, do not exceed one li (unit of depth/time; note: etymology uncertain in original). When selecting Lianquan, stop when the blood color changes from dark to bright red. Huangdi said: Very good.
Huangdi said: Regarding "Fa Gao" in the five sections of needling, I still do not grasp its meaning. "Fa Gao" refers to a state where the ears cannot hear and the eyes cannot see. Yet you say needling the Fu Shu points eliminates Fu organ disease. Which point causes this? I wish to hear the reason. Qibo said: A profound question! This represents the general principles of needling, the ultimate extent of needle technique, and a class of divine and spiritual operations. Even oral explanation and written records cannot fully capture it. Let me explain "Fa Gao"; its efficacy is swifter than emitting light itself. Huangdi said: Good. Please explain fully. Qibo said: For this needling method, it must be performed at noon. Needling Tinggong (SI 19), the needle sensation should reach the pupils, and sound should be transmitted to the ear; this is the function of this Shu point. Huangdi said: Good. What does "sound transmitted to the ear" mean? Qibo said: During needling, firmly press both nostrils with your hand, then quickly make the patient lie supine. There will inevitably be a sound corresponding to the needle manipulation. Huangdi said: Good. This is what is meant by acting without visible form, without relying on visual inspection, but through the harmony of mind and spirit.
Huangdi said: Regarding "Qu Zhua" in the five sections of needling, you mentioned needling the collaterals of the joints and limbs. I wish to hear this fully. Qibo said: The waist and spine are the major joints of the body. The legs and shins are the conduits for human movement and posture. The penis and scrotum are the mechanisms within the body, the indicators of Yin essence, and the pathways for fluid metabolism. Therefore, if dietary habits are irregular, and emotions like joy and anger are not regulated timely, fluids will overflow internally and flow downward into the testicles. This blocks the blood channels, causing the testicles to swell progressively without relief. The patient experiences difficulty in bending and stretching, and inability to walk normally. This disease resembles water accumulation within, neither ascending nor descending, and requires treatment with a Pi Needle (a surgical blade-like needle) because the deformity is visible and cannot be hidden; hence it is named "Qu Zhua."
Huangdi said: Good. Huangdi said: Regarding "Che Yi" in the five sections of needling, you mentioned comprehensively needling the extraordinary Shu points of all Yang meridians, with no fixed location. I wish to hear this fully. Qibo said: This occurs when Yang Qi is in excess and Yin Qi is deficient. Deficiency of Yin Qi leads to internal heat; excess of Yang Qi leads to external heat. The internal and external heat clash, making the patient feel as if holding burning charcoal. Externally, they fear cotton and silk, unable to tolerate proximity to the body or bedding. The pores are closed, so no sweat is produced. The tongue is scorched, lips are shriveled, throat is dry, and appetite is indiscriminate. Huangdi said: Good. How should points be selected? Qibo said: Select Tianfu (LU 6), Dazhu (BL 11), and Sanjian (LI 3 - *inferred from context of Yang meridians*). Also needle Zhonglvyu (BL 27) to remove internal heat, and tonify the Hand-Taiyin Lung Meridian to induce sweating. Once heat dissipates and sweat flows, the illness improves, swifter than removing clothes. Huangdi said: Good.
Huangdi said: Regarding "Jie Huo" in the five sections of needling, you mentioned thoroughly understanding the regulation of Yin and Yang, tonifying deficiency and sedating excess to achieve balance. How is confusion resolved? Qibo said: When severe wind pathogens invade the body, the blood vessels become unevenly deficient. The deficient areas lack Zheng Qi (Upright Qi), while the excess areas harbor pathogenic factors. This leads to imbalance in weight distribution, tilting and collapsing, disorientation regarding directions (East/West, South/North), and erratic movements up and down, resembling a state more confused than mere bewilderment. Huangdi said: Good. How should points be selected? Qibo said: Sedate the excess, tonify the deficiency, and restore Yin-Yang balance. Using needles in this manner resolves the condition swifter than untangling confusion. Huangdi said: Good. Store this in the Linglan Chamber; do not disclose it lightly. (The discussion on the meaning of the five sections of needling is now complete.)
Huangdi said: I have heard that there are five types of pathological evils (Wu Xie). What are they? Qibo said: Diseases manifest as abscesses (Yong), excessive swelling (Rong Da), constriction/deficiency (Xiao Xiao), heat (Re), and cold (Han). These are called the Five Evils. Huangdi said: How should these five evils be needled? Qibo said: The methods for needling the five evils can be summarized in five chapters. Bi-heat is extinguished, swelling and accumulation dissipate, cold-Bi is warmed, minor evils are treated by boosting Yang, and major evils must be removed. Let me explain the methods. When needling Yong (abscess) evil, do not confront the peak of the pathogen's strength. Change the approach and mindset. If pus does not form, use unorthodox methods to alter the course, move away from the site, and disrupt its stability until it dissipates. For any Yin-Yang meridian passing through an abscess, select its Shu point and apply sedation. When needling Da (excessive) evil, reduce it gradually, drain its excess, and make the Qi agile and swift. Unblock the needle path to expel the evil, allowing muscles to knit together. Observe until the evil disappears, restoring true Qi. Needle between the muscles of the Yang meridians. When needling Xiao (minor) evil, strengthen it gradually by tonifying deficiency, preventing harm. Observe the location, intercept it at its boundary, ensuring distant and near evils are drawn out and cannot escape. Force them inward to consume themselves. Needle between the muscles. When needling Re (heat) evil, bypass it to cool it down, letting it wander away without returning, thus avoiding disaster. Use needling to open passages, creating doors for the evil to exit, so the disease leaves. When needling Han (cold) evil, warm it gradually. Move the needle slowly in and out, guiding the Shen (Spirit). Close the pores, prevent Qi dispersion, harmonize deficiency and excess, and retain the Qi.
Huangdi said: Which needles should be used? Qibo said: Use the Pi Needle for abscesses, the Feng Needle for excessive evils, the Yuanli Needle for minor evils, the Chan Needle for heat evils (*character missing in original, inferred as Chan*), and the Hao Needle for cold evils. (The discussion on the five evils and their treatments concludes here, followed by clarifications on treating cold and heat imbalances derived from the five evils, leading into the topic of True and Pathogenic Qi.)
Let us discuss the "Jie Lun" (Metaphorical Explanation). Humans correspond to Heaven and Earth and align with the Four Seasons; humans participate in Heaven and Earth, so metaphors can be used for explanation. Where there is dampness below, reeds and rushes grow above; this indicates the abundance or scarcity of Form and Qi. Yin and Yang correspond to Cold and Heat. In heat, rain nourishes from above, roots lack juice, Human Qi is on the exterior, skin is relaxed, pores are open, Blood and Qi decrease, sweat flows heavily, and skin is moist. In cold, the ground freezes and water turns to ice, Human Qi is interior, skin is dense, pores are closed, no sweat is produced, Blood and Qi are strong, and muscles are firm and stiff. At such times, a skilled boatman cannot navigate on ice, and a skilled digger cannot break frozen earth. Similarly, a skilled acupuncturist cannot treat Si Ni (Four Rebellions/Cold Extremities) when blood vessels are congealed and hard, resisting flow. One cannot immediately soften them. Thus, a skilled boatman waits for warm weather and melting ice before navigating; a skilled digger waits for thawed earth. Human meridians are the same. To treat Jue (Cold Extremities), one must first apply moxibustion/warming to harmonize the meridians: palms and axillae, elbows and feet, neck and spine. Once fire Qi penetrates, Blood vessels flow. Then assess the condition: if pulses are soft/moist, needle to calm them; if hard/tight, break and scatter them. Stop when Qi descends. This is called "Untying Knots." The essence of needling lies in regulating Qi. Qi accumulates in the Stomach, facilitating Ying and Wei circulation along their respective paths. Zong Qi (Gathering Qi) remains in the Sea of Qi (Chest), flowing down to the Qichong area and up to the respiratory tract. If Jue Qi is in the feet, Zong Qi fails to descend, and Blood in the vessels stagnates. Without warming therapy (fire adjustment), it cannot be treated. Acupuncturists must first examine the emptiness or fullness of meridians, palpate and trace them, press and flick them, identifying responsive areas before needling and draining. When the Six Meridians are harmonized, it is considered non-diseased; even if diseased, self-healing occurs. If one meridian shows upper excess and lower deficiency with blockage, there is likely an overgrowth of transverse collaterals compressing the main meridian. Visualize and sedate this blockage; this is "Untying Knots." For Upper Cold and Lower Heat, first needle the Taiyang meridians in the neck, retaining the needle for a long time. After needling, apply warming to the neck and shoulder blades to direct heat downward, then stop. This is "Pushing Upward." For Upper Heat and Lower Cold, identify deficient pulses sinking into the meridians, select points, and treat until Qi descends. This is "Pulling Downward." For generalized severe heat, mania, hallucinations, and delusions, examine the Foot-Yangming Meridian and major collaterals. Tonify deficiency, sedate Blood excess. With the patient supine, place a pillow under the head. Use four fingers of both hands to press the carotid artery, hold firmly, roll and press downwards to the Jianjing/Qumen area, then stop. Repeat until heat subsides. This is "Pushing and Scattering." (This section serves as a transition, leading into the discussion of True and Pathogenic Qi.)
Huangdi said: One meridian can give rise to dozens of diseases: pain, abscesses, heat, cold, itching, Bi syndrome, or numbness. Changes are infinite. What is the cause? Qibo said: These are all generated by pathogenic Qi. Huangdi said: I have heard of Zhen Qi (True Qi), Zheng Qi (Upright Qi), and Xie Qi (Pathogenic Qi). What is Zhen Qi? Qibo said: Zhen Qi is received from Heaven (Congenital Essence) and combined with Gu Qi (Grain Qi from food) to nourish the body. Zheng Qi is the Correct Wind, coming from one direction, neither the Full Wind (Shi Feng) nor the Empty Wind (Xu Feng). Xie Qi is the Empty Wind, which harms humans treacherously. It enters deeply and cannot leave on its own. Zheng Qi enters shallowly and resolves spontaneously; its arrival is gentle and cannot overcome Zhen Qi, so it leaves naturally. Xu Xie (Empty Pathogenic Qi) entering a person causes chills and trembling, raising of hair, and opening of pores. If it enters deeply and clashes with Bone, it causes Bone Bi; with Sinew, Sinew Spasm; with Vessels, Blood closure and Abscess; with Flesh, clashing with Wei Qi, causing Heat if Yang prevails, or Cold if Yin prevails. Cold depletes Zhen Qi, leading to deficiency and Cold. Clashing with Skin, it manifests externally, opening pores, shaking hairs, moving Qi back and forth, causing Itching. If it stays, it becomes Bi. If Wei Qi fails to circulate, it causes Numbness. If Xu Xie covers half the body and enters deeply, residing in Ying and Wei, slight decline of Ying and Wei leads to depletion of Zhen Qi, leaving only Pathogenic Qi, resulting in Hemiplegia. If the pathogen is shallow, it causes unilateral pain. If Xu Xie enters deeply, Cold and Heat clash. Prolonged retention leads to internal fixation. If Cold prevails, Bone pain and Muscle wasting occur. If Heat prevails, flesh rots and muscles decay into pus, damaging Bone internally, leading to Bone erosion. If there is a prior condition where tendons are contracted and cannot extend, and pathogenic Qi resides there without departing, it develops into Tendon Liuliu (Tendon Tumor). If there is knotting, Qi gathers there, Wei Qi stays, cannot return, fluids remain long-term, combining to form Intestinal Liuliu (Intestinal Tumor), taking years to form, soft to touch. If knotting occurs, Qi gathers, fluids remain, pathogenic Qi invades, condensing and worsening daily, clustering together to form Xi Liu (Old Tumor/Lipoma). Hard to touch. If knotting is deep in Bone, Qi associates with Bone, Bone and Qi combine, enlarging daily, forming Bone Ju (Bone Abscess/Gangrene). If knotting is in Flesh, Zong Qi gathers, pathogenic Qi stays, Heat transforms it to pus, Cold results in Rou Ju (Flesh Abscess). All these various Qi manifestations have no fixed location but have consistent names.