《灵》、《素》两经，其详论脏腑经穴疾病等说，为针法言者，十之七八。为方药言者
，十
之二三。上古之重针法如此，然针道而方药易，病者亦乐于服药，而苦于针。所以后世方药
盛行，而针法不讲。今之为针者，其显然之失有十，而精微尚不与焉。两经所言，十二经之
出入起止，浅深左右，交错不齐；其穴随经上下，亦参差无定。今人只执同身寸，根据左右一
直竖量，并不根据经曲折，则经非经而穴非穴，此一失也。两经治病，云某病取某穴者固多，
其余则指经而不指穴。如《灵枢》终始篇云∶人迎一盛，泻足少阳，补足厥阴；厥病篇云∶
厥头痛，或取足阳明、太阴，或取手少阳、足少阴；耳聋取手阳明，嗌干取足少阴。皆不言
其穴，其中又有泻子补母等义。今则每病指定几穴，此二失也。两经论治，井、荥、输、经
、合最重。冬刺井，春刺荥，夏刺输，长夏刺经，秋刺合。凡只言某经，而不言某穴者，大
者皆指井荥五者为言。今则皆不讲矣，此三失也。补泻之法《内经》云∶吸侧内针，无令气忤
；静以久留，无令邪布。吸则转针，以得气为故；候呼引针，呼尽乃去，大气皆出为泻。呼
尽内针，静以久留，以气至为故；候吸引针，气不得出，各在其处，推阖其门，令神气存，
大气留止为补。又必迎其经气，疾内而徐出，不按其 为泻；随其经气，徐内而疾出，即按
其为补。其法多端。今则转针之时，以大指出为泻，搓入为补，此四失也。纳针之后，必
候其气。刺实者，阴气隆至乃去针；刺虚者，阳气隆至乃出针。气不至，无问其数，气至即
去之，勿复针。《难经》云∶先以左手压按所针之处，弹而努之，爪而下之。其气来如动脉
之状，顺而刺之。得气因推内之，是谓补。动而伸之，是谓泻。今则时时转动，俟针下宽转
，而后出针，不问气之至与不至，此五失也。凡针之深浅，随时不同。春气在毛，夏气在皮
肤，秋气在肌肉，冬气在筋骨，故春夏刺浅，秋冬制深，反此有害。今则不论四时，分寸各
有定数，此六失也。古之用针，凡疟疾、伤寒、寒热咳嗽，一切脏腑七窍等病，无所不治。
今则只治经脉形体痿痹屈伸等病而已，此七失也。古人刺法，取血甚多，《灵枢》血络论言
之最详。而头痛腰痛，尤必大泻其血，凡血络有邪者，必尽去之。若血射出而黑，必令变色
，见赤血而止，否则病不除而反有害。今人则偶尔见血，病者医者已惶恐失据，病何由除？
此八失也。《内经》刺法，有九变十二节。九变者，输刺、远道刺、经刺、络刺、分刺、大
写刺、毛刺、巨刺、淬刺。十二节者，偶刺、报刺、恢刺、齐刺、扬刺、直针刺、输刺、短
刺、浮刺、阴刺、傍刺、赞刺。以上二十一法，视病所宜，不可更易，一法不备，则一病不
愈。今则只直刺一法，此九失也。古之针制有九∶ 针、员针、 针、锋针、铍针、员利针
、毫针、长针、大针，亦随病所宜而用，一失其制，则病不应。今则大者如员针，小者如毫
针而已，岂能治痼疾暴气？此十失也。其大端之失已如引，而其成尤要者，更在神志专一，
手法精严。经云∶神在秋毫，属意病者，审视血脉，刺之无殆。又云∶经气已至，慎守勿失
，深浅在志，远近若一，如临深渊，手如握虎，神无营于众物。又云∶伏如横弩，起如发机
。其专精敏妙如此。今之医者，随手下针，漫不经意，即使针法如古，志不凝而机不达，犹
恐无效，况乎全与古法相背乎？其外更有先后之序，迎随之异，贵贱之殊，劳逸之分，肥瘦
之度，多少之数，更仆难穷。果能潜心体察，以合圣度，必有神功。其如人之畏难就易，尽
违古法，所以世之视针甚轻，而其术亦不甚行也。若灸之一法，则较之针所治之病，不过十
之一二。知针之理，则灸又易易耳。
《灵枢》和《素问》这两部经典中，详细论述脏腑、经络、穴位及疾病等内容，其中谈论针法的占十分之七八，谈论方药的仅占十分之二三。上古时代如此重视针法，然而针道相对于方药来说较为难学，患者也乐于服药而畏惧针刺。因此后世方药盛行，而针法不再被讲究。如今从事针灸的人，其明显的失误有十种，至于精微之处尚不在讨论之列。
两经中所述十二经脉的出入起止、深浅左右、交错不齐；穴位随经脉上下分布，也参差不齐没有定数。现在的人只执着于“同身寸”这一标准，根据左右身体直接竖直测量，并不依据经脉的曲折走向，导致经脉不成其为经脉，穴位也不成其为穴位，这是第一种失误。
两经在治疗疾病时，说某病取某穴的情况固然很多，其余情况则只指明经脉而不指定具体穴位。例如《灵枢·终始》篇说：“人迎脉大一倍于寸口，泻足少阳经，补足厥阴经”；《灵枢·厥病》篇说：“厥头痛，有的取足阳明经、足太阴经，有的取手少阳经、足少阴经”；耳聋取手阳明经，咽喉干燥取足少阴经。这些都不提及具体穴位，其中还蕴含着“泻子补母”等治疗原则。现在则是每病都指定几个固定穴位，这是第二种失误。
两经论及治疗时，井、荥、输、经、合五腧穴最为重要。冬季刺井穴，春季刺荥穴，夏季刺输穴，长夏刺经穴，秋季刺合穴。凡是只提某经而不提某穴的情况，大多是指井、荥、输、经、合这五个穴位而言。现在的人对此都不再讲究了，这是第三种失误。
关于补泻的方法，《内经》说：吸气时进针，不要使经气逆乱；安静地长时间留针，不要让邪气散布。吸气时转动针具，以得气为度；呼气时引针，呼尽时才拔针，大气（邪气）随之排出即为泻法。呼气尽时进针，安静地长时间留针，以得气为度；吸气时引针，使气不得外出，各守其处，推按闭合针孔，使神气留存，大气（正气）留止即为补法。又必须迎着经气方向，快速进针而缓慢出针，出针后不按闭针孔为泻法；顺着经气方向，缓慢进针而快速出针，出针后立即按压针孔为补法。其方法多种多样。现在的人转针时，以大指推出为泻，搓入为补，这是第四种失误。
纳针之后，必须等待经气到来。刺实证时，待阴气隆盛到达才去针；刺虚证时，待阳气隆盛到达才出针。如果气未至，不问次数多少，气至即去针，不要再重复针刺。《难经》说：先用左手压按所针之处，弹击使其充盈，用指甲切下定位。其气来如动脉搏动之状，顺势刺入。得气后向里推进针，这叫补法；向外提插摇动针，这叫泻法。现在的人则时时转动针体，等到针下感觉宽松舒适后才出针，不问气是否已至，这是第五种失误。
凡针刺的深浅，随季节不同而变化。春气在毫毛，夏气在皮肤，秋气在肌肉，冬气在筋骨，所以春夏刺浅，秋冬刺深，反之则有害。现在的人不论四季，分寸各有定数，这是第六种失误。
古时候使用针法，凡是疟疾、伤寒、寒热咳嗽，以及一切脏腑七窍等疾病，没有不能治疗的。现在则只治疗经脉形体痿痹、屈伸不利等疾病而已，这是第七种失误。
古人的刺法，放血量较多，《灵枢·血络论》对此论述最详。而头痛腰痛，尤其必须大量泻血，凡是血络中有邪气的，必须全部去除。如果射出的血是黑色的，必须等到血色变红，见到赤色血液才停止，否则病不除反而有害。现在的人偶尔见到出血，病人和医生就已经惶恐失措，病怎么能去除呢？这是第八种失误。
《内经》的刺法，有九变和十二节两种分类。“九变”指：输刺、远道刺、经刺、络刺、分刺、大写刺、毛刺、巨刺、淬刺。“十二节”指：偶刺、报刺、恢刺、齐刺、扬刺、直针刺、输刺、短刺、浮刺、阴刺、傍刺、赞刺。以上二十一种方法，视病情适宜而定，不可更改，一种方法不具备，则一种病无法痊愈。现在的人只用直刺这一种方法，这是第九种失误。
古代的针具有九种：镵针、员针、鍉针、锋针、铍针、员利针、毫针、长针、大针，也是随病情适宜而选用，一旦失去其制式，则病不应验。现在的人用的针，大的像员针，小的像毫针罢了，怎么能治疗顽固疾病和暴烈之气呢？这是第十种失误。
上述主要的大端失误已经如上所述，而其成败的关键更在于神志专一，手法精严。经文说：“精神要集中在细微之处，意念关注病人，审视血脉，针刺才不会危险。”又说：“经气已至，谨慎守护不要丢失，深浅在意念中把握，远近如同一般，如同面临深渊，手如握虎，精神不被众物扰乱。”又说：“潜伏时像横放的弩弓，发起时像触动扳机。”其专精敏妙达到如此程度。现在的医者，随手下针，漫不经心，即使针法符合古代规范，意志不凝聚且时机不达，尚且恐怕无效，何况完全与古法相违背呢？
此外还有先后次序的不同，迎随手法的差异，贵贱的区别，劳逸的区分，肥瘦的程度，次数的多少，更是难以穷尽。如果能潜心体察，以符合圣人的法度，必定会有神奇的功效。无奈人们畏难就易，完全违背古法，所以世人看待针刺非常轻视，其技术也不甚流行。至于灸法这一种方法，其所治的疾病，不过只有针法所治疾病的十分之一二。懂得针的道理，那么灸法也就更容易掌握了。
The *Ling Shu* (Spiritual Pivot) and *Su Wen* (Basic Questions), these two classics, contain detailed discussions on Zang-Fu organs, meridians, acupoints, and diseases. Among these, those discussing acupuncture methods account for seven or eight tenths, while those discussing herbal prescriptions account for only two or three tenths. In ancient times, acupuncture was valued so highly; however, the Dao of acupuncture is more difficult than herbal medicine, and patients are also more willing to take medicine but suffer from acupuncture. Therefore, in later generations, herbal prescriptions became prevalent, while acupuncture fell into disuse.
Those who practice acupuncture today have ten obvious errors, not to mention the subtleties. The two classics describe the entry and exit points, depth, left and right positions, and irregular intersections of the twelve meridians. The acupoints follow the meridians up and down, also unevenly distributed without fixed patterns. Today, people only adhere to the "body-cun" measurement method, measuring vertically along the left and right sides without following the curves of the meridians. This results in meridians no longer being true meridians and acupoints no longer being true acupoints. This is the first error.
In treating diseases, the two classics often specify which acupoint to use for a certain disease, but frequently refer only to the meridian without specifying the acupoint. For example, the *Zhong Shi* chapter of the *Ling Shu* states: "If the Ren Ying pulse is one-fold larger than the Cun Kou pulse, drain the Foot Shaoyang meridian and tonify the Jueyin meridian." The *Jue Bing* chapter states: "For Jue headache, sometimes select the Foot Yangming or Foot Taiyin meridians, sometimes the Hand Shaoyang or Foot Shaoyin meridians." For deafness, select the Hand Yangming meridian; for dry throat, select the Foot Shaoyin meridian. None of these mention specific acupoints, yet they imply principles such as draining the son and tonifying the mother. Today, each disease is assigned specific acupoints. This is the second error.
Regarding treatment, the Jing, Ying, Shu, Jing, and He (Five Shu) points are most important in the two classics. Winter involves puncturing Jing points, spring Ying points, summer Shu points, late summer Jing points, and autumn He points. Whenever a meridian is mentioned without a specific acupoint, it usually refers to these five Five Shu points. Today, this is no longer discussed. This is the third error.
Concerning tonification and drainage methods, the *Nei Jing* states: "Advance the needle during inhalation, do not let the Qi rebel; keep it still for a long time, do not allow evil to spread. Rotate the needle during inhalation until De Qi is achieved; withdraw the needle during exhalation, removing it only after exhalation is complete, allowing the major Qi (evil) to exit—this is drainage." Conversely, "Insert the needle at the end of exhalation, keep it still for a long time until De Qi is achieved; withdraw during inhalation so Qi does not escape, keeping it in place, pushing and closing the aperture so Shen Qi remains and major Qi (healthy Qi) stays—this is tonification." One must also face the direction of the meridian Qi: advance quickly and withdraw slowly without pressing the hole for drainage; advance slowly and withdraw quickly while pressing the hole for tonification. There are many such methods. Today, rotation is used with thumb pushing out for drainage and rubbing in for tonification. This is the fourth error.
After inserting the needle, one must wait for Qi arrival. For excess conditions, remove the needle when Yin Qi arrives abundantly; for deficiency conditions, remove the needle when Yang Qi arrives abundantly. If Qi has not arrived, regardless of the number of manipulations, once Qi arrives, remove the needle and do not re-puncture. The *Nan Jing* states: "First press the area with the left hand, flick it to make it turgid, and mark it with the fingernail. When the Qi feels like a pulsating artery, insert the needle smoothly. After achieving De Qi, push the needle inward—this is tonification. Move and extend the needle outward—this is drainage." Today, people constantly rotate the needle until it feels loose before withdrawing, ignoring whether Qi has arrived or not. This is the fifth error.
The depth of acupuncture varies with the seasons. Spring Qi is in the hair, summer Qi in the skin, autumn Qi in the muscles, and winter Qi in the sinews and bones. Thus, shallow needling is used in spring and summer, deep needling in autumn and winter; reversing this causes harm. Today, people ignore the four seasons and use fixed measurements for each case. This is the sixth error.
Ancient acupuncture could treat all diseases, including malaria, cold damage, chills and fever, cough, and all internal organ and seven orifice disorders. Today, it only treats meridian and形体 (form/structure) disorders such as flaccidity, numbness, and limited flexion and extension. This is the seventh error.
Ancient needling involved significant bloodletting, as detailed in the *Xue Luo Lun* chapter of the *Ling Shu*. For headaches and lower back pain, massive bloodletting was essential. Any collateral vessels containing evil must be completely drained. If the discharged blood is black, it must continue until the color changes to red; otherwise, the disease will not be cured and may even worsen. Today, if any blood appears, both patient and doctor become panicked and lose their composure. How can the disease be removed? This is the eighth error.
The *Nei Jing* describes nine variations (Jiu Bian) and twelve sections (Shi Er Jie) of needling. The Nine Variations are: Shu Ci (Transport Puncture), Yuan Dao Ci (Distant Path Puncture), Jing Ci (Meridian Puncture), Luo Ci (Collateral Puncture), Fen Ci (Muscle Separation Puncture), Da Xie Ci (Major Drainage Puncture), Mao Ci (Hair Surface Puncture), Ju Ci (Cross Puncture), and Cui Ci (Moxibustion Puncture). The Twelve Sections are: Ou Ci (Paired Puncture), Bao Ci (Reporting Puncture), Hui Ci (Recovery Puncture), Qi Ci (Cluster Puncture), Yang Ci (Spreading Puncture), Zhi Zhen Ci (Straight Needle Puncture), Shu Ci (Transport Puncture), Duan Ci (Short Puncture), Fu Ci (Floating Puncture), Yin Ci (Yin Puncture), Bang Ci (Side Puncture), and Zan Ci (Assistant Puncture). These twenty-one methods must be chosen according to the condition and cannot be altered; lacking even one method means one disease cannot be cured. Today, only straight insertion is used. This is the ninth error.
There were nine types of ancient needles: Chan Zhen (Pointed Needle), Yuan Zhen (Round Needle), Di Zhen (Pressing Needle), Feng Zhen (Sharp Needle), Pi Zhen (Saber Needle), Yuan Li Zhen (Round Sharp Needle), Hao Zhen (Filiform Needle), Chang Zhen (Long Needle), and Da Zhen (Large Needle). They were selected according to the condition; losing the correct type meant the disease would not respond. Today, the largest needles resemble Yuan Zhen, and the smallest resemble Hao Zhen. How can they treat chronic stubborn diseases or sudden aggressive pathogens? This is the tenth error.
The major errors have been outlined above. The key to success lies in mental focus and rigorous technique. The classics state: "Focus your spirit on the finest details, attend to the patient, observe the blood vessels, and there will be no danger in needling." It also says: "When Meridian Qi has arrived, guard it carefully and do not lose it. Depth depends on your intent; distance is uniform. Approach it as if standing by an abyss, hold the needle as if grasping a tiger, let your spirit not be distracted by other things." And again: "Be still like a drawn crossbow, move like releasing the trigger." Such is the specialization and skill required. Today's physicians insert needles casually and carelessly. Even if their technique mimics the ancients, without focused intent and timely execution, efficacy is doubtful, let alone when completely contrary to ancient methods.
Furthermore, there are sequences of priority, differences in Ying-Sui techniques, distinctions of value, divisions of labor and rest, degrees of fat and thinness, and numbers of treatments, which are too numerous to exhaust. If one could study them deeply to align with the sage's standards, miraculous results would surely follow. However, people prefer ease over difficulty and completely abandon ancient methods. Consequently, society views acupuncture lightly, and its art is not widely practiced. As for moxibustion, the diseases it treats amount to only one or two-tenths of those treated by acupuncture. Understanding the principles of acupuncture makes moxibustion easy to master.