行针手法口诀多，撮要编为十二歌，取穴持温进指摄，退搓捻留摇拔合。
【注】十二字分次第手法歌诀，始自三衢杨继洲。后之诸家，口诀虽多，皆不免于繁
杂。今撮其要，仍编为十二歌诀，庶简明切当，便于后学。
一、取穴歌
取穴先将爪切深，须教毋外慕其心，令彼荣卫无伤碍，医者方堪入妙针。
【注】凡下针，用左手大指爪甲，重切所针之穴，令气血开，教病者心专于内，不要
外驰，然后下针，使针不伤荣卫，方堪入妙也。
二、持针歌
持针之士要心雄，手如握虎莫放松，欲识机关三部奥，须将此理再推穷。
【注】凡下针之士，须心小力雄，以右手
持针于穴上，势若握虎，不敢放松，着力旋插，直至应止之处，吸气三口，然后提针，徐
徐而用。凡机关三才奥理，欲识于心而行于针者，须将此再三推穷可也。
三、温针歌
温针之理最为良，口内温和审穴方，毋令冷热相争搏，荣卫宣通始安祥。
【注】凡下针，必先将所用之针，入于口中，使之温热，审定穴所，方可与刺。勿令
冷热相争，庶血气调和，而得安祥也。
四、进针歌
进针理法取关机，失经失穴最不宜，阳经取陷阴经脉，三思已定针之愈。
【注】凡下针，要病患神气定，息数匀，医者亦如之。关机最密，切勿太忙，须细审
经络穴所在何部分，不可轻施其针，失于经络穴所也。如在阳部，必取筋骨间陷下之处，
则不伤于筋骨；如在阴分 之内动脉相应间，则以爪重切经络，少待片时，方可进针，
而不伤于荣卫。又必三思已定，然后下针，病可愈矣。
五、指循歌
部分经络要指循，只为针头不紧沉，推则行之引则止，调和血气使来临。
【注】凡下针，若气不至，用指于所属部分经络之路，上下、左右推而行之，引而止
之，往来循之，使气血上下均匀，针下自然气至沉紧，得气即泻之意也。
六、摄法歌
摄法原因气滞经，大指爪甲切莫轻，以指摄针待气至，邪气流行针自轻。
【注】凡摄针者，因针下邪气滞涩不行也。随经络上下，用大指爪甲重切之，使正气流
行，则邪气不能滞涩，而针下自觉活动矣。
七、退针歌
退针手法理要知，三才诀内总玄机，一部六数三吸气，须臾疾病自然愈。
【注】凡退针，全在手法，三才之内，皆有要诀玄机，不可不知。如欲退针，必须缓
缓而出，自地部退至人部，再渐退至天部，俱用少阴之六数泻之，每一部六数，须要少停，
三部共行三六一十八数，令病患吸气三口，随吸随提，徐徐退至天部，其疾病自然除矣。
八、搓针歌
搓针泻气最为奇，气至针缠莫就移，浑如搓线攸攸转，急则缠针肉不离。
【注】搓针者，凡进、退、搓、捻，皆催其气至以泻邪气也。如觉针下气紧，切勿就
移，须用泻法，但微微动转，如搓线之状，若抟之太紧，必至肉缠针头，邪气滞涩，而不能除矣。
九、捻针歌
捻针指法不相同，一般在手两般功，内外转移行上下，助正伏邪疾自轻。
【注】凡捻针时，虽一般在手，而指法不同，故功有两般也。如欲治上，则大指向外
捻，外捻者令其气向上也；如欲治下，则大指向内捻，内捻者令其气至下也。内捻为之
补，外捻为之泻。如经络向下者，转针头逆之则为迎也；经络向上者，移针头顺之则为
随也。指法得宜，则正气自复，而邪气自退矣。
十、留针歌
留针取气候沉浮，出入徐徐必逗留，能令荣卫纵横散，巧妙玄机在指头。
【注】留针者，凡出针至于天部，入针至于地部，须在皮肤肌肉间徐徐容留，令荣卫
宣散方可出针入针。若出针太急，则血随针出，反伤荣卫，其巧妙玄机，全在指头也。
十一、摇针歌
摇针三部皆六摇，根据次推排在指梢，孔穴大开无窒碍，邪气退除病自消。
【注】摇针者，如出针三部欲泻之际，每一部摇二三摇，多者不过六摇而已。以指捻
针，如扶人头摇之之状，使孔穴开大，无有窒碍，庶邪气退除而病愈矣。
十二、拔针歌
拔针之时切勿忙，闭门存神要精详，不
沉不紧求针尾，此诀须当韫锦囊。
【注】凡针毕拔针，最要精详，不可轻率忙乱也。如欲出针，须待针下气缓，不沉不
紧，觉轻动滑快，方以右指捻住针尾，以左手大指按其针穴，及穴外之皮，令针穴门户
不开，神气内存，然后拔针，庶不致于出血。此针家要诀，须当韫于锦囊也。
行针手法的口诀有很多，我将其要点编成十二首歌诀。取穴、持针、温针、进指、摄针、退针、搓针、捻针、留针、摇针、拔针、合针（出针），这十二个步骤依次进行。
【注】这十二字分步手法歌诀，最早源自三衢人杨继洲。后来的各家医家，虽然口诀繁多，但都不免过于繁杂。现在我提取其要点，重新编为十二首歌诀，以便简明恰当，方便后学者学习。
一、取穴歌
取穴时要先用指甲深深掐切穴位，必须教导患者不要心神外驰，保持内心专注，使患者的营卫之气不受损伤，医者才能施展高妙的针刺技术。
【注】凡是下针，要用左手大拇指的指甲，用力掐切所针刺的穴位，使气血开放流通，教导病人将心思专注于体内，不要向外分散，然后下针，这样能使针不损伤营卫之气，才算是高明的针刺。
二、持针歌
持针的人要有雄健的心志，手握针具要像握着老虎一样不能放松，想要了解机关三部（天、人、地）的奥妙，必须反复推究其中的道理。
【注】凡是下针的人，必须心细力雄，用右手持针置于穴位上，态势如同握虎，不敢放松，着力旋转插入，直到应当停止的地方，吸气三口，然后提针，慢慢运用。凡是关于三才（天、人、地）的深奥道理，想要心里明白并在手上操作自如，必须反复推究才行。
三、温针歌
温针的原理最为良好，要在口中含暖针具并仔细审定穴位，不要让冷热之气相互争斗，只有营卫宣通顺畅，身体才能安宁祥和。
【注】凡是下针，必须先将所用的针放入口中，使其温热，审定好穴位，才可以进行刺入。不要让冷热之气相争，这样血气调和，就能得到安宁祥和的效果。
四、进针歌
进针的道理和方法在于把握关键时机，失经错穴是最不适宜的。阳经取穴应在筋骨间的凹陷处，阴经脉则需仔细斟酌，深思熟虑确定后下针，病可痊愈。
【注】凡是下针，要使病患神气安定，呼吸均匀，医者也要如此。关键时机最严密，切勿太匆忙，必须仔细审察经络穴位所在的部位，不可轻率施针，以免偏离经络穴位。如果在阳部，一定要选取筋骨间凹陷的地方，这样就不伤及筋骨；如果在阴分内的动脉相应处，就用指甲重切经络，稍待片刻，方可进针，这样就不会损伤营卫。又必须经过三次深思熟虑确定后，再下针，疾病就可以痊愈了。
五、指循歌
所属部分的经络要用手指循按，只是因为针头不够沉稳紧实，推动则引导气行，牵引则使气止，调和血气使其到来。
【注】凡是下针，如果气未至，用手指在所属部分经络的路径上，上下、左右推动引导它，牵引制止它，往来循按，使气血上下均匀，针下自然感到气至沉紧，这是得气后即行泻法的意思。
六、摄法歌
使用摄法的原因是气滞于经络，大拇指指甲切掐时不要轻率，用手指摄持针具等待气至，邪气流行通畅后针体自然感觉轻松。
【注】凡是使用摄针法，是因为针下邪气滞涩不行。顺着经络上下，用大拇指指甲重切，使正气流行，那么邪气就不能滞涩，针下自然觉得活动灵活了。
七、退针歌
退针的手法道理需要知晓，三才诀中总括着玄机，每一部行六次呼吸数，配合吸气，片刻之间疾病自然痊愈。
【注】凡是退针，全在于手法，在三才（天、人、地）之中，都有重要的诀要和玄机，不可不知。如果想要退针，必须缓缓而出，从地部退至人部，再逐渐退至天部，都使用少阴之六数（泻法次数）来操作，每一部六数，必须要稍作停顿，三部共行三十六（3×6=18? 原文为“三六一十八数”，此处依原文逻辑，通常指每部六息或六动，共十八动/息，或者原文意指三部各六，共十八）个数，令病患吸气三口，随着吸气随提，徐徐退至天部，其疾病自然消除了。
八、搓针歌
搓针泻气最为奇妙，气至针缠时不要随意移动，就像搓线一样悠悠转动，如果动作太急导致肉缠住针头，就会造成痛苦。
【注】搓针，凡是进、退、搓、捻，都是催促气至以泻除邪气。如果觉得针下气紧，千万不要随意移动，必须使用泻法，只是微微转动，像搓线的样子，如果揉搓得太紧，必然会导致肌肉缠绕针头，邪气滞涩，而不能除去了。
九、捻针歌
捻针的指法各不相同，一般都在手上操作，但有两种不同的功效，内外转移引导气机上下运行，扶助正气伏制邪气，疾病自然减轻。
【注】凡是捻针时，虽然一般都在手上操作，但指法不同，所以功效有两种。如果想要治疗上部，则大拇指向外捻，外捻是引导气向上；如果想要治疗下部，则大拇指向内捻，内捻是引导气向下。内捻称为补，外捻称为泻。如果经络走向向下，转针头逆着经络方向则为“迎”；如果经络走向向上，移针头顺着经络方向则为“随”。指法得当，则正气自然恢复，邪气自然消退。
十、留针歌
留针是为了候气机的沉浮，出入要徐徐从容，必须停留一段时间，能让营卫之气纵横散开，巧妙的玄机全在手指的运用上。
【注】留针，凡是出针至于天部，入针至于地部，必须在皮肤肌肉间徐徐容留，让营卫宣散之后方可出针入针。如果出针太急，则血液随针流出，反而损伤营卫，其巧妙的玄机，全在于手指的运用。
十一、摇针歌
摇针在天、人、地三部都要摇六次，按照次序排在手指梢端，使孔穴大开没有阻碍，邪气退除疾病自然消除。
【注】摇针，如出针时欲行泻法，每一部摇二三摇，多的不超过六摇而已。用手指捻针，如同扶着人头摇晃的样子，使孔穴开大，没有窒碍，这样邪气退除而病愈了。
十二、拔针歌
拔针的时候切勿匆忙，闭门存神要精细详细，等到针感不沉不紧，寻求针尾的感觉，这个诀要应当藏在锦囊中珍藏。
【注】凡是针毕拔针，最要精细详细，不可轻率忙乱。如果想要出针，必须等待针下气缓，不沉不紧，感觉轻动滑快，然后用右手指捻住针尾，用左手大拇指按住针穴及穴外的皮肤，令针穴门户不开，神气内存，然后拔针，这样才不会导致出血。这是针灸家的要诀，应当藏在锦囊中珍藏。
The oral formulas for needle manipulation techniques are numerous; I have compiled their essentials into twelve songs. The sequence involves: selecting the acupoint (Quexue), holding the needle (Chizhen), warming the needle (Wenzhen), inserting the finger/needle (Jinzhi), grasping/manipulating (She), withdrawing (Tui), rubbing (Cuo), twisting (Nian), retaining (Liuyzhen), shaking (Yao), and extracting (Bazhen).
[Note] These twelve-step manual technique rhymes originated from Yang Jizhou of Sanqu. Later practitioners, although producing many formulas, inevitably became overly complex. Now, extracting the essentials, I have recompiled them into twelve songs to be concise and appropriate, facilitating learning for future students.
One: Song on Selecting Acupoints
When selecting an acupoint, first press deeply with your fingernail. You must instruct the patient to keep their mind focused inward and not let it wander externally. This ensures that Ying and Wei (Nutritive and Defensive Qi) are not harmed, allowing the practitioner to perform exquisite acupuncture.
[Note] When inserting the needle, use the nail of the left thumb to press firmly on the target acupoint, opening the flow of Qi and Blood. Instruct the patient to focus their mind internally and avoid external distractions. Then insert the needle so as not to damage Ying and Wei Qi; this constitutes excellent technique.
Two: Song on Holding the Needle
The practitioner holding the needle must possess a bold spirit. The hand should grip the needle as if holding a tiger, never relaxing. To understand the profound secrets of the three levels (Heaven, Man, Earth), one must repeatedly ponder these principles.
[Note] Practitioners must be attentive yet forceful. Using the right hand, hold the needle over the acupoint with the firmness of holding a tiger, without relaxing. Apply force to rotate and insert until the appropriate depth is reached. Take three deep breaths, then lift the needle slightly and apply it slowly. To master the profound theory of the Three Realms (Sancai) in both mind and hand, one must repeatedly analyze these principles.
Three: Song on Warming the Needle
The principle of warming the needle is most beneficial. Warm the needle in the mouth and carefully examine the acupoint. Do not allow cold and heat to clash; only when Ying and Wei Qi circulate freely can peace and harmony be achieved.
[Note] Before insertion, place the needle in the mouth to warm it. After confirming the acupoint, proceed with needling. Avoid conflicting temperatures so that Qi and Blood harmonize, resulting in a peaceful state.
Four: Song on Inserting the Needle
The method of insertion relies on seizing the critical moment. Missing the meridian or the acupoint is highly inadvisable. For Yang meridians, select depressions between sinews and bones; for Yin meridians, deliberate carefully. Once decided after thorough thought, insert the needle, and the disease will heal.
[Note] During insertion, the patient’s Shen (Spirit) must be calm and breathing even; the practitioner must mirror this state. The timing is precise; do not rush. Carefully examine which part of the meridian and acupoint is involved. Do not needle lightly to avoid missing the target. If in a Yang region, choose depressions between sinews and bones to avoid injury. If in a Yin region corresponding to arterial movement, press firmly with the nail, wait briefly, then insert to protect Ying and Wei Qi. After careful consideration, insert the needle, and the illness will resolve.
Five: Song on Finger Circulation (Xun)
Use fingers to trace the relevant meridians and regions. This is because the needle tip may lack stability. Pushing guides the Qi forward, pulling stops it, harmonizing Blood and Qi to ensure its arrival.
[Note] If Qi does not arrive upon insertion, use fingers to push and guide along the meridian path above and below, left and right. This circulation makes Qi and Blood uniform. Naturally, the sensation of Qi arrival becomes heavy and tight under the needle, indicating Deqi, which implies subsequent sedation.
Six: Song on Grasping (She) Method
The Grasping method addresses Qi stagnation in the meridians. Do not lightly cut with the thumb nail. Grasp the needle with fingers and wait for Qi arrival; once Evil Qi flows freely, the needle will feel light.
[Note] The Grasping method is used when Qi is stagnant and sluggish under the needle. Press firmly with the thumb nail along the meridian to promote Zheng Qi (Upright Qi) flow, preventing Evil Qi stagnation, making the needle feel active and free under the fingers.
Seven: Song on Withdrawing the Needle
One must understand the principles of withdrawal. The secrets lie within the Three Levels (Sancai). Applying six counts per level and coordinating with inhalation leads to natural recovery.
[Note] Withdrawal depends entirely on technique. Secrets exist within the Three Levels. Withdraw slowly: from the Earth level to the Man level, then gradually to the Heaven level. Use the "six count" sedation method at each level, pausing slightly. Total eighteen counts across three levels. Coordinate with the patient taking three deep breaths, lifting slightly with each inhalation, withdrawing slowly to the Heaven level, thereby eliminating the disease.
Eight: Song on Rubbing (Cuo) the Needle
Rubbing the needle to sedate Qi is miraculous. When Qi arrives and the needle feels entangled, do not move it abruptly. Rotate gently like twisting thread. If done too hastily, flesh may wrap around the needle head.
[Note] Rubbing, along with insertion, withdrawal, and twisting, accelerates Qi arrival to sedate Evil Qi. If the needle feels tight under the skin, do not shift position. Use sedation by rotating slightly, like twisting thread. If twisted too tightly, flesh may bind the needle, causing stagnation and failing to expel Evil Qi.
Nine: Song on Twisting (Nian) the Needle
Twisting techniques vary, though performed with the same hand, yielding two different effects. Internal and external rotation directs Qi up or down, supporting Zheng Qi and subduing Evil Qi, alleviating disease.
[Note] Although twisting uses the hand, finger mechanics differ, creating two functions. To treat the upper body, twist outward with the thumb to direct Qi upward. To treat the lower body, twist inward to direct Qi downward. Inward twisting is Tonification (Bu); outward twisting is Sedation (Xie). If the meridian flows downward, rotating the needle head against the flow is "Meeting" (Ying). If the meridian flows upward, moving the needle head with the flow is "Following" (Sui). Proper technique restores Zheng Qi and repels Evil Qi.
Ten: Song on Retaining the Needle
Retain the needle to await the fluctuation of Qi. Entry and exit must be slow and deliberate. This allows Ying and Wei Qi to disperse freely. The subtle secret lies in finger dexterity.
[Note] Retention involves keeping the needle in the skin and muscle layers while transitioning between Heaven (superficial) and Earth (deep) levels. Allow Ying and Wei Qi to disperse before removing or adjusting. Rapid removal causes blood loss and damages Ying and Wei Qi. The subtlety lies in finger control.
Eleven: Song on Shaking the Needle
Shake the needle six times at each of the three levels, ordered sequentially at the fingertips. This opens the acupoint aperture without obstruction, allowing Evil Qi to retreat and the disease to vanish.
[Note] Shaking is used during withdrawal for sedation. Shake two or three times per level, up to six times maximum. Manipulate the needle with fingers as if shaking a person's head, enlarging the aperture to remove obstructions, thus expelling Evil Qi and curing the disease.
Twelve: Song on Extracting the Needle
Do not rush during extraction. Close the gate and preserve Shen (Spirit) with precision. Wait until the sensation is neither heavy nor tight, seeking the feeling at the needle tail. Keep this secret in a brocade bag.
[Note] Extraction requires meticulous care, avoiding haste. Wait until the Qi sensation subsides, becoming light, smooth, and non-tight. Hold the needle tail with the right hand and press the acupoint and surrounding skin with the left thumb to close the aperture and retain Shen Qi. Then extract the needle to prevent bleeding. This is a crucial secret of acupuncture, worthy of being preserved in a brocade bag.