治一切痈疽，恶疮、发背。量法以男左女右，臂腕中横纹起，用薄篾一条，量至大指
齐肉尽处，不量爪甲，截断；次用薄篾取前同身一寸，令患人脱去上下衣服，以大竹竿一条
跨定，两人随余扛起，足要离地五寸许，两旁更以两人扶定，毋令摇动不稳，却以前长篾贴定
竹扛，竖起，从尾 骨贴脊量至篾尽处，以墨点记之，此不是灸穴。却用后取同身寸篾，
取两寸平折，中合墨点，横量两头各一寸，方是灸穴（可灸三壮。）
按∶在督脉脊中至阳，筋束二穴中外，太阳行背二行膈俞、肝俞之内，非正当穴
也。疑必后人传讹，以三寸为二寸耳，岂有不按经络穴道而用针灸者乎？故不能无疑
也。用者审之。
或闷∶《内经》治病，汤液醪醴为甚少，所载服饵之法才一二，而灸者四五，其他则
明针法，无虑十八九。
厥后方药之说肆行，而针灸之法仅而获存者，何也？曰∶《内经》，上古书也。上古之
人，其知道乎，劳而不至倦，逸而不至流。食不肥鲜，以戕其内；衣不蕴热，以伤其
外。起居有常，寒暑知避，恬淡虚无，精神内守，病安从生？虽有贼风虚邪，莫能深入，
不过凑于皮肤，经滞气郁而已。以针行滞散郁则病随已，何待于汤液醪醴耶？当今之世，
道德以衰，以酒为浆、以妄为常，纵欲以竭其精，多虑以散其真，不知持满，不解御神，
务快其心，逆于生乐，起居无节，寒暑不避，故病多从内生，外邪亦易中也。经曰∶针刺
治其外，汤液治其内。病既属内，非藉汤液之荡涤，其能济乎？此和缓以后，方药
盛行，而针灸罕用者，实由世不古若，人非昔比，病有深浅，治有内外，非针灸宜于古而
不宜于今，非汤液宜于令而不宜于古也。经曰∶上古作汤液，为而弗服；中古之时，
服之万全；当今之世，必齐毒药攻其中，针灸治其外。虽形弊血尽而功不立，此之谓也。
或问∶经病络病，治有异乎？经曰∶邪之客于形也，必先舍于皮毛，留而不去，
入舍于孙络；留而不去，入舍于络脉；留而不去，入舍于经肺。内连五脏，散于肠胃，
阴阳俱感，五脏乃伤。此邪之从皮毛而入，极于五脏之次也。如此，则治其经焉。今邪客
于皮毛，入舍孙络，留而不去，闭塞不通，不得入于经，流溢于大络，而生奇病也。夫邪客
大络者，左注右，右注左，上下左右，与经相干，而布于四末，其气无常处，不入于经俞，
故曰缪刺。
或问∶病有在气分者，在血分者，不知针家亦分气与血否？曰∶气分血分之病，针
家亦所当知。病在气分，游行不定；病在血分，沉着不移。以积块言之，腹中或上或下，
或有或无者，是气分也；或在两胁。或在心下，或在脐上下左右，一定不移，以渐而长者，
是血分也。以病风言之，或左手移于右手，右足移于左足，移动不常者，气分也；或常在
左足，或偏在右手，着而不走者，血分也。凡病莫不皆然。须知在气分者，上有病，
下取之；下有病，上取之。在左取右，在右取左。在血分者，随其血之所在，应病取之。
苟或血病泻气，气病
泻血，是谓诛伐无过，咎将谁归？
或问∶赋言男子之气，早在上而晚在下；女子之气，早在下而晚上。午前为早，午
后为晚。从腰以上为上，从腰以下为下。男子早针，气乃上行；晚针，气乃下行。女
子早针，气乃下行；晚针，气乃上行。其说亦有据乎？经曰∶荣气行于肺中，周身五十
度，无分昼夜，至平旦与卫气会于手太阴。卫气行于脉外，昼行阳二十五度，夜行阴二
十五度，平旦与荣气会于手太阴，是则卫气之行，但分昼夜，未闻分上下也。男女脏腑
经络、气血往来，未尝不同也。今赋所言早晚，似涉无稽之说，安可以为涉哉！
或问∶睛明、迎香、承泣、丝竹空皆禁灸，何也？曰∶四穴近目，目畏火，故禁灸
也，以是推之，则知睛明可灸，王注误也。
或问∶迎而夺之，随而济之，此固言补泻也。其义何如？曰∶迎者，逢其气之方
来，如寅时气来注于肺，卯时气来注于大肠。此时肺、大肠气方盛，而夺泻之也。随者，
气之方去，如卯时气去注大肠，辰时气去注于胃。肺与大肠，此时气虚而补济之也。余仿此。
或问∶ 穴针入几分、留几呼之说。曰∶愚以为初不如是相拘。盖肌肉有浅深，病去
有迟速。若肌肉浓实处，则可深；浅薄处，则宜浅。病去则速出针，病滞则久留针为可
耳，故曰∶刺虚者，须其实；刺实者，须其虚也。
或问∶孙氏以灸为闭门赶贼，何如？曰∶夫以火泻者，疾吹其火，则火气与邪气去
矣。此《内经》火泻法也，又胡为而闭其门乎？至于气，针虽微，妄加无病，则气之泻若
河决下流，不可以其微而忽之也。孙氏之云，特归重于火针耳。要之言不能无弊，故曰
立言难。
或问∶人神随年岁巡历于人身，尻神逐日坐临于人。若人死，此神与之俱死乎？抑
出于人之身，飘流于天地间而失所根据乎？抑别求人而附之乎？若别欲根据人，则人人自有
神矣。无人可根据，神亦离散矣。既曰神，则灵变莫测者也，何必求人而附之乎？人之心
为君主之官，神明出焉，胡不驱此神使身安而不为针灸所犯乎？曰人神，曰尻神，后世术
家之言，《素》《难》未有也，何足信哉？
或问∶十二经络、 穴、各有流注，衰旺之时，按时补泻固是。今病在各经络
者，或按时亦能去病，盖病着于经，其经自有虚实，补虚泻实，亦自中病也。病有一
针而愈，有数针始愈，盖病有新故浅深。新且浅，一针可愈；若深痼者，必屡针可去，
如服药然，有一二剂病愈，有服至四五十剂而愈者。今用针一次而病不退，
则不复针，如之何其取效也？
或问∶针形至微，何以能泻有余，补不足？曰∶如气球然。方其未有气也，则 塌不
堪蹴踢，及从窍吹之，则气满起胖，此虚则补之之义也；去其窍之所塞，则气从窍
出，复 塌矣，此实则泻之之义也。
或问∶《铜人》、《千金》等书空穴多，《十四经发挥》所载空穴少，如风市、督
俞、金津、玉液等穴，彼有此无，不同何也？曰∶《十四经发挥》据《素问·骨空篇》论
及王注，若《铜人》、《千金》纂偏书，非黄岐正经也。
或问∶经言虚者补之，实者泻之，不实不虚，以经取之，何谓也？经曰∶虚者补
其母，母能令子实也；实者泻其子，子能令母虚也。假令肝病，虚则补厥阴之合曲
泉，实则泻厥阴之荥行间。不虚不实，以经取之者，是正经自病，不中他邪，当自取
其经，如井取心满之类。正经自病，所谓忧愁思虑则伤心，强力入水则伤肾是也。
不虚不实是诸脏不相乘，故云自取其经。
或问∶今医用针，动辄以袖覆手，暗行指法，谓其法之神秘，弗轻示人，惟恐盗取
其法者，不知果何法耶？曰∶《金针赋》十四法与夫青龙摆尾等法，可谓已尽之矣。舍
此而他求法之神秘，吾未之信也。今若此者，不过过为诡妄，以欺人耳。纵为至巧，殆
必神亦不佑，针亦不灵也，奚足尚哉！
或问∶有医置针于穴，略不加意，或谈笑，或饮酒，半晌之间，又将针捻几捻，令呼
几呼，仍复登筵以饮，然后起针，果能愈病否乎？曰∶经云∶凡刺之真，必先治神。又
云∶手动若务，针耀而匀，静意视义，观适之变。又云∶如临深渊，手如握虎，神无营于
众物。又云∶如待所贵，不知日暮。凡此数说，敬乎怠乎？又云∶
虚之与实，若得若失；实之与虚，若有若无。谓气来实牢者为得，濡虚者为失；气来实
牢濡虚，以随济迎夺而为得失也。又曰∶有见如人，有见如出。盖谓入者以左手
按穴，待气以至乃下针，候其气尽乃出针也。若此
者，俗工之事也，不敬孰甚哉！
或问∶用针浑是泻而无补，古今用之，所以导气，治之以有余之病也，令人鲜
用之。或知其无补而不用，抑元气禀赋之簿，而不用欤？或斫丧之多而用针无益欤？抑不
善用而不用欤？经曰∶阳不足者，温之以气；精不足者，补之以味。针乃砭石所制，
既无气无味，破皮损肉，发窍于身，气皆自窍出矣，何得为补？经曰∶
气血阴阳俱不足，勿取以针，和以甘药是也。又曰∶形气不足，病气不足，此阴阳皆不
足也，不可刺之，刺之重竭其气，老者绝灭，壮者不复矣。若此语者，皆是有泻而无补也。
【骑竹马灸法】
治疗各种痈疽、恶疮以及发背。取穴方法：男性取左手，女性取右手。从臂腕中间的横纹处开始，用一条薄篾（细竹片）量到大拇指根部肌肉结束的地方为止，不要量到指甲，然后截断；接着再用一条薄篾量取前一段长度作为“同身一寸”，让患者脱去上下衣物，找一根大竹竿横跨架好，由两个人抬起竹竿两端，使患者的脚离地约五寸左右，另外两人在两旁扶稳竹竿，确保不摇晃不稳当。然后用之前截断的那条长篾贴在竹竿上竖起，从尾骨沿着脊柱向上量，直到篾的尽头，用墨汁做个记号，这个位置不是灸穴。接着用刚才量取“同身一寸”的那条篾，量取两寸并平折，中间对准之前的墨点，向两头各延伸一寸，这才是真正的灸穴（可以灸三壮）。
按语：该穴位位于督脉脊中的至阳穴与筋束二穴之间，足太阳膀胱经背部第二行膈俞、肝俞穴的内侧，并非正当的穴位。我怀疑这是后人传抄错误，把三寸误作二寸罢了，哪有不按经络穴位而随意使用针灸的呢？因此对此不能不存疑。使用者请审慎考察。
【关于灸法与汤液的讨论】
有人问：《内经》中记载的治疗疾病的方法里，汤液醪醴（药酒）很少，所载的服药方法只有一两个，而灸法有四五个，其他则是明确的针法，大概占十八九成。
后来方药之说盛行，而针灸之法仅能勉强保存下来，为什么呢？回答说：《内经》是上古时期的书。上古的人，他们懂得大道吗？劳作而不至于疲倦，安逸而不至于放纵。食物不肥美鲜嫩，以免损伤内脏；衣服不厚重闷热，以免伤害体表。起居有规律，知道躲避寒暑，心境恬淡虚无，精神内守，病从哪里产生呢？即使有贼风虚邪侵袭，也不能深入体内，不过是聚集在皮肤表面，导致经络阻滞、气机郁结而已。用针刺来疏通阻滞、发散郁结，病随即就好了，何必等待汤液醪呢？当今之世，道德衰微，人们把酒当水喝，把妄动当作常态，纵欲以耗尽精气，多虑以散失真气，不知道保持精气充盈，不懂得驾驭精神，只求心意快乐，违背了养生的乐趣，起居没有节制，不知躲避寒暑，所以病多从内生，外邪也容易侵入。经文说：针刺治疗体表的病，汤液治疗体内的病。既然病属于内部，不借助汤液的荡涤作用，怎么能治愈呢？这是和缓之后，方药盛行，而针灸少用的原因，实在是因为世道不如古代，人也不比从前，病的深浅不同，治疗的内外侧重也不同，并不是针灸适宜于古而不适宜于今，也不是汤液适宜于今而不适宜于古。经文说：上古制作汤液，备着但不服用；中古时期，服用它万无一失；当今之世，必须用毒药攻治其内部，用针灸治疗其外部。即使形体败坏、血液枯竭，功效也无法建立，说的就是这个道理。
【关于经病与络病】
有人问：经病和络病，治疗方法有区别吗？经文说：邪气客居在人体，一定先停留在皮毛，停留不去，就进入孙络；停留不去，就进入络脉；停留不去，就进入经脉。向内连系五脏，散布于肠胃，阴阳都受到感应，五脏就会受伤。这就是邪气从皮毛进入，极至于五脏的顺序。像这样，就治疗其经脉。现在邪气客居在皮毛，进入孙络，停留不去，闭塞不通，不能进入经脉，流溢在大络中，而产生奇异的病症。邪气客居在大络的情况，左边的注入右边，右边的注入左边，上下左右，与经脉相互干扰，而布散于四肢末端，其气流没有固定的位置，不进入经穴，所以称为缪刺。
【关于气分与血分的针刺】
有人问：病有的在气分，有的在血分，不知针灸家是否也区分气与血？回答说：气分和血分的病，针灸家也是应当知道的。病在气分，游走不定；病在血分，沉着不移。以积块为例，腹中或上或下，或有或无的，是气分；如果在两胁，或者在心下，或者在脐部上下左右，固定不移，逐渐长大的，是血分。以风病为例，或者左手移到右手，右足移到左足，移动不固定的，是气分；或者常固定在左足，或者偏在右手，附着而不移动的，是血分。所有疾病没有不是这样的。要知道在气分的病，上面有病，取下部的穴位；下面有病，取上部的穴位。左边有病，取右边的穴位；右边有病，取左边的穴位。在血分的病，随着血所在的位置，对应病症选取穴位。如果血病却泻气，气病却泻血，这叫做诛伐无罪之人，过错归于谁呢？
【关于男女早晚针刺的气机运行】
有人问：赋文中说男子的气，早在上而晚在下；女子的气，早在下而晚上。午前为早，午后为晚。腰部以上为上，腰部以下为下。男子早时针刺，气会上行；晚时针刺，气会下行。女子早时针刺，气会下行；晚时针刺，气会上行。这种说法有依据吗？经文说：营气运行于肺中，周身循环五十度，不分昼夜，到平旦时与卫气会合于手太阴肺经。卫气运行于脉外，白天行于阳分二十五度，夜晚行于阴分二十五度，平旦时与营气会合于手太阴肺经。那么卫气的运行，只分昼夜，没听说分上下。男女的脏腑经络、气血往来，并没有不同。现在赋文所说的早晚，似乎涉及无稽之谈，怎么可以作为准则呢！
【关于眼周禁灸】
有人问：睛明、迎香、承泣、丝竹空这几个穴位都禁止艾灸，为什么呢？回答说：这四个穴位靠近眼睛，眼睛畏惧火，所以禁止艾灸。由此推断，睛明穴是可以灸的，王冰的注释是错误的。
【关于迎随补泻】
有人问：迎而夺之，随而济之，这固然说的是补泻。其中的含义是什么？回答说：迎，是逢接其气刚来的时候，比如寅时气来注于肺，卯时气来注于大肠。此时肺、大肠的气正旺盛，而采用夺法进行泻治。随，是跟随其气刚离去的时候，比如卯时气离去注于大肠，辰时气离去注于胃。肺与大肠，此时气虚而采用济法进行补益。其余仿照此理。
【关于针刺深浅与留针时间】
有人问：关于穴位针刺入几分、留针几呼的说法。回答说：我认为起初不必如此拘泥。因为肌肉有浅深，病去有快慢。如果肌肉厚实的地方，就可以深刺；浅薄的地方，就宜浅刺。病去则快速出针，病滞留则久留针即可。所以说：刺虚证，须使其实；刺实证，须使其虚。
【关于孙思邈“闭门赶贼”之说】
有人问：孙思邈认为灸法是“闭门赶贼”，怎么样？回答说：用火泻法，快速吹火，则火气与邪气一同离去。这是《内经》的火泻法，又怎么会是关闭门户呢？至于气，虽然针很微小，但若无病妄加针刺，气的泻出就像河水决堤向下流，不可以因为它微小而忽视它。孙氏的话，特别归重于火针而言。总之，言论难免有弊端，所以说立言很难。
【关于人神与尻神】
有人问：人神随着年岁巡历于人身，尻神每天坐临于人身上。如果人死了，这些神也随之死亡吗？还是出于人的身体，飘流于天地间而失去依托呢？还是另找人依附呢？如果另找人依附，则人人自有神了。如果没有人可以依附，神也就离散矣。既然叫神，就是灵变莫测的，何必求人来依附呢？人的心是君主之官，神明由此而出，为什么不驱遣这个神使身体安宁而不被针灸所犯呢？回答说：所谓人神、尻神，是后世术士的话，《素问》、《难经》中都没有，有什么可相信的呢？
【关于按时补泻与疗效】
有人问：十二经络、穴位，各有流注、盛衰的时间，按时补泻固然是对的。现在病在各经络的，有时按时也能去病，大概是因为病附着于经，其经自有虚实，补虚泻实，自然中也命中病症。病有一针而愈的，有数针才愈的，大概因为病有新旧、深浅。新且浅的病，一针可愈；如果是深重顽固的病，必须多次针刺才能去除，就像服药一样，有一两剂病愈的，有服到四五十剂才愈的。现在用针一次而病不退，就不再针刺，怎么能取得疗效呢？
【关于针形微小如何补泻】
有人问：针形极其微小，为什么能泻有余，补不足？回答说：就像气球一样。当它还没有气的时候，就塌陷不堪踢踏，等到从窍口吹气，它就气满鼓起，这就是虚则补之的意义；去掉窍口的堵塞，气从窍口流出，又塌陷了，这就是实则泻之的意义。
【关于穴位异同】
有人问：《铜人》、《千金》等书中空缺的穴位多，《十四经发挥》所载的空缺穴位少，如风市、督俞、金津、玉液等穴，那些书有而这本书没有，有什么不同呢？回答说：《十四经发挥》依据《素问·骨空篇》的论述及王冰的注释，而《铜人》、《千金》是编纂的杂书，不是黄帝岐伯的正经。
【关于不虚不实以经取之】
有人问：经文说虚者补之，实者泻之，不实不虚，以经取之，这是什么意思？经文说：虚者补其母，母能令子实；实者泻其子，子能令母虚。假如肝病，虚则补厥阴之合穴曲泉，实则泻厥阴之荥穴行间。不虚不实，以经取之，是指正经自病，不中他邪，应当自取其经，比如井穴治疗心满之类。正经自病，所谓忧愁思虑则伤心，强力入水则伤肾就是这样。不虚不实是指诸脏不相乘克，所以说自取其经。
【关于医者施针的神秘主义】
有人问：现在的医生用针，动不动就用袖子覆盖着手，暗中施行指法，说是手法神秘，不轻易示人，惟恐被人盗取其法，不知道到底是什么法呢？回答说：《金针赋》的十四法以及青龙摆尾等法，可以说已经穷尽了。舍此之外再寻求手法的神秘，我不相信。现在像这样的，不过是过分诡诈狂妄，用来欺骗人罢了。纵使技巧极高，大概神灵也不会保佑，针也不会灵验，有什么值得推崇的呢！
【关于施针时的态度】
有人问：有的医生把针放在穴位上，略微不加在意，或者谈笑，或者饮酒，半晌之间，又将针捻几捻，令患者呼几口气，然后又回到宴席上饮酒，然后起针，真的能治好病吗？回答说：经文说：凡刺的真谛，必先治神。又说：手动若务，针耀而匀，静意视义，观适之变。又说：如临深渊，手如握虎，神无营于众物。又说：如待所贵，不知日暮。所有这些说法，是恭敬还是怠慢呢？又说：虚与实，若得若失；实与虚，若有若无。谓气来实牢者为得，濡虚者为失；气来实牢濡虚，以随济迎夺而为得失也。又说：有见如人，有见如出。大概是指进针时用左手按压穴位，待气至乃下针，候其气尽乃出针。像这样的情况，是庸俗工匠做的事，不恭敬还有比这更严重的吗！
【关于用针只有泻而无补】
有人问：用针完全是泻而没有补，古今使用它，是用来导气，治疗有余的病，让人很少用它。有人知道它无补而不用，或者是元气禀赋薄弱而不用呢？或者是斫丧过多而用针无益呢？还是不会使用而不用呢？经文说：阳不足者，温之以气；精不足者，补之以味。针乃是砭石所制，既无气也无味，破皮损肉，在身体开窍，气都从窍口出去了，怎么能算补呢？经文说：气血阴阳俱不足，勿取以针，和以甘药是也。又说：形气不足，病气不足，此阴阳皆不足也，不可刺之，刺之重竭其气，老者绝灭，壮者不复矣。像这样的话，都是有泻而无补啊。
[Qizhuma Moxibustion Method]
To treat all types of carbuncles and sores (Yong Ju), malignant ulcers, and back carbuncles. The measurement method is: for males, use the left hand; for females, use the right hand. Starting from the transverse crease in the middle of the wrist, use a thin bamboo strip to measure up to the point where the flesh at the base of the thumb ends, excluding the fingernail, then cut it off. Next, use another thin bamboo strip to measure a length equal to one "cun" (body-inch) based on the previous measurement. Have the patient remove upper and lower garments. Place a large bamboo pole horizontally across two supports, held up by two people, ensuring the patient's feet are about five cun above the ground. Two other people should hold the sides steady to prevent shaking. Then, place the previously cut long bamboo strip vertically against the bamboo pole, starting from the tailbone along the spine upwards, until the end of the strip. Mark this point with ink; this is not the moxibustion point. Next, take the bamboo strip measuring one "cun", measure two cuns, fold it in half, align the center with the ink mark, and extend one cun to each side. This is the actual moxibustion point (three moxa cones can be applied).
Commentary: This point is located between Zhongyang (DU12) on the Governor Vessel (Du Mai) of the spine and the two points of Jinshu, inside the second line of the Foot-Taiyang Bladder Channel on the back, specifically within Ge Shu (BL17) and Ganshu (BL18). It is not a standard acupoint. I suspect this is a transmission error by later generations, mistaking three cuns for two cuns. How could acupuncture and moxibustion be used without following the meridians and acupoints? Therefore, doubt remains. Users should examine this carefully.
[Discussion on Moxibustion vs. Decoctions]
Question: In the *Neijing* (Classic of Internal Medicine), methods for treating diseases mention decoctions and fermented wines very rarely. Only one or two methods of taking medicine are recorded, while moxibustion accounts for four or five, and clear needle methods account for eighteen or nineteen out of twenty.
Why did herbal prescriptions become prevalent later, while acupuncture and moxibustion were barely preserved? Answer: The *Neijing* is an ancient text. People in ancient times understood the Dao. They worked without becoming exhausted and rested without becoming indulgent. Their food was not rich or fresh enough to damage their internal organs; their clothing was not heavy or hot enough to harm their exterior. Their daily life was regular, they avoided cold and heat appropriately, maintained a tranquil and empty mind, and kept their spirit inward. How could disease arise? Even if pathogenic winds and empty evils invaded, they could not penetrate deeply but only gathered at the skin level, causing stagnation and Qi depression. Using needles to unblock stagnation and dissipate depression would cure the disease immediately, why wait for decoctions? In today's world, morality has declined. People treat wine as water and recklessness as normal, indulging desires to exhaust essence, worrying excessively to scatter true Qi, failing to maintain fullness, failing to control the spirit, seeking only mental pleasure, going against the joy of life, lacking regular routines, and ignoring cold and heat. Thus, diseases mostly arise internally, and external pathogens easily invade. The classics state: Needles treat external conditions; decoctions treat internal conditions. Since the disease belongs to the interior, how can it be cured without the cleansing power of decoctions? This is why after He Huan, herbal prescriptions became prevalent and acupuncture/moxibustion rare. It is truly because the world is not like antiquity, and people are not as they were. Diseases have depths, and treatments have external and internal focuses. It is not that acupuncture suits the past but not the present, nor that decoctions suit the present but not the past. The classics say: In ancient times, decoctions were made but not taken; in mid-antiquity, taking them ensured complete success; in today's world, one must use potent drugs to attack the interior and needles to treat the exterior. Even if the form is ruined and blood exhausted, efficacy cannot be established—this is what is meant.
[Regarding Jing-Luo Disease]
Question: Are there differences in treating Jing (Meridian) disease and Luo (Collateral) disease? The classics say: When evil qi resides in the body, it first stays in the hair and skin. If it does not leave, it enters the Sun Luo (Fine Collaterals); if it still does not leave, it enters the Luo vessels; if it still does not leave, it enters the Jing meridians. Internally connecting to the Five Zang organs and spreading to the Six Fu organs, both Yin and Yang are affected, and the Five Zang organs are injured. This is the sequence of evil entering from the skin and reaching the Five Zang organs. In such cases, treat the Jing meridians. Now, if evil resides in the skin, enters the Sun Luo, stays without leaving, becomes blocked, cannot enter the Jing, overflows into the Da Luo (Great Collaterals), and produces strange diseases. When evil resides in the Da Luo, it flows from left to right and right to left, interacting with the Jing meridians above and below, distributing to the four extremities. Its Qi has no fixed location and does not enter the Jing acupoints, hence it is called Miao Ci (Contralateral Puncture).
[Regarding Acupuncture for Qi vs. Blood Levels]
Question: Diseases exist in the Qi level and the Blood level. Do acupuncture practitioners distinguish between Qi and Blood? Answer: Practitioners must know about diseases in the Qi and Blood levels. Diseases in the Qi level move unpredictably; diseases in the Blood level are fixed and immovable. Taking masses as an example: those moving up or down in the abdomen, appearing or disappearing, belong to the Qi level; those fixed in the hypochondrium, under the heart, or around the navel, growing gradually, belong to the Blood level. Taking wind diseases as an example: those moving from left hand to right hand, or left foot to right foot, changing frequently, belong to the Qi level; those staying fixed in the left foot or right hand, adhering without moving, belong to the Blood level. All diseases follow this pattern. Know that for Qi-level diseases, if the pathology is above, select points below; if below, select points above. If on the left, select on the right; if on the right, select on the left. For Blood-level diseases, select points corresponding to the location of the blood and the disease. If you drain Qi when treating Blood disease, or drain Blood when treating Qi disease, this is punishing the innocent; who bears the blame?
[Regarding Morning/Evening Acupuncture for Men and Women]
Question: The fu texts state that men's Qi is high in the morning and low in the evening, while women's Qi is low in the morning and high in the evening. Forenoon is morning, afternoon is evening. Above the waist is upper, below the waist is lower. For men, morning acupuncture causes Qi to ascend; evening acupuncture causes Qi to descend. For women, morning acupuncture causes Qi to descend; evening acupuncture causes Qi to ascend. Is there basis for this? The classics say: Ying (Nutrient) Qi circulates in the Lungs, completing 50 cycles through the body day and night. At dawn, it meets Wei (Defensive) Qi at the Hand-Taiyin Lung Meridian. Wei Qi circulates outside the vessels, traveling through Yang 25 times during the day and Yin 25 times at night, meeting Ying Qi at the Hand-Taiyin Lung Meridian at dawn. Thus, Wei Qi circulation distinguishes only day and night, not upper and lower. The meridians, collaterals, Qi, and Blood flow in men and women are not different. The morning/evening distinction in the fu texts seems baseless and cannot serve as a principle!
[Regarding Prohibition of Moxibustion near Eyes]
Question: Jingming (BL1), Yingxiang (LI20), Chengqi (ST1), and Sizhukong (SJ23) are prohibited for moxibustion. Why? Answer: These four points are near the eyes, and the eyes fear fire, so moxibustion is prohibited. By analogy, Jingming (BL1) can be moxibusted; Wang Bing's commentary is erroneous.
[Regarding Ying-Sui Tonification and Sedation]
Question: "Ying er duo zhi" (Meeting and draining) and "Sui er ji zhi" (Following and assisting) refer to tonification and sedation. What is their meaning? Answer: "Ying" means encountering the Qi as it arrives. For example, at Yin hour, Qi flows into the Lung; at Mao hour, Qi flows into the Large Intestine. At these times, Lung and Large Intestine Qi are abundant, so we apply the draining method. "Sui" means following the Qi as it departs. For example, at Mao hour, Qi leaves the Lung for the Large Intestine; at Chen hour, Qi leaves the Large Intestine for the Stomach. At these times, Lung and Large Intestine Qi are deficient, so we apply the assisting (tonifying) method. Apply this logic to others.
[Regarding Depth of Insertion and Retention Time]
Question: Regarding the rules for inserting needles to certain depths and retaining them for specific breath counts. Answer: I believe one should not be so rigidly bound by this. Muscles vary in thickness, and diseases resolve at different speeds. Where muscles are thick, deep insertion is possible; where thin, shallow insertion is appropriate. If the disease resolves quickly, withdraw the needle promptly; if the disease lingers, retain the needle longer. Hence it is said: To puncture deficiency, make it solid; to puncture excess, make it empty.
[Regarding Sun Simiao's "Closing the Door to Drive Out Thieves"]
Question: Sun Simiao described moxibustion as "closing the door to drive out thieves." What do you think? Answer: In fire-draining methods, blowing rapidly on the fire expels both fire energy and pathogenic energy. This is the fire-draining method of the *Neijing*; how is it closing the door? As for Qi, although the needle is small, needling unnecessarily drains Qi like a river bursting its banks; one must not ignore it because it is small. Sun's remark specifically refers to fire needles. Generally, statements may have flaws, hence it is said that making statements is difficult.
[Regarding Ren Shen and Kao Shen]
Question: Ren Shen (Person Spirit) travels the body according to age; Kao Shen (Buttock Spirit) sits upon the person daily. If a person dies, do these spirits die with them? Or do they leave the body, drift in heaven and earth, and lose their anchor? Or do they attach to another person? If they attach to another, everyone already has their own spirit. If no one to attach to, the spirit scatters. Since it is called "spirit," it is mysterious and unpredictable; why seek attachment to humans? The Heart is the Sovereign Official, from which Ming (Spirit) emerges. Why not command this spirit to keep the body safe from acupuncture injury? Answer: Talk of Ren Shen and Kao Shen comes from later fortune-tellers; it is not in the *Suwen* or *Nanjing*. Why trust it?
[Regarding Timing and Efficacy]
Question: The twelve meridians and acupoints have specific times of flow and abundance/deficiency. Timely tonification and sedation are correct. However, for diseases in various meridians, timely treatment can also cure. This is because the disease attaches to the meridian, which has its own excess or deficiency; tonifying deficiency and draining excess naturally hits the target. Some diseases are cured with one needle, others require several, due to newness/oldness and depth/shallowness. New and shallow diseases can be cured with one needle; deep and stubborn ones require repeated needling, just as medicines work: some cure in one or two doses, others in forty or fifty. If one needle fails to reduce the disease, stopping treatment will never yield results.
[How Small Needles Tonify and Drain]
Question: Needles are tiny; how can they drain excess and tonify deficiency? Answer: Consider a balloon. Without air, it collapses and is useless; blowing air in makes it full and firm—this is tonifying deficiency. Removing the blockage allows air to escape, collapsing it again—this is draining excess.
[Discrepancies in Acupoint Lists]
Question: Books like *Tongren* and *Qianjin* list many empty points, while *Shisi Jing Jingluo Fahui* lists fewer. Points like Fengshi (GB31), Duyu (BL12), Jinjin, and Yuye are in the former but not the latter. Why? Answer: *Shisi Jing Jingluo Fahui* relies on the *Suwen: Gu Kong Pian* and Wang Bing's annotations. *Tongren* and *Qianjin* are compilations, not the orthodox classics of Huangdi and Qibo.
[Regarding "Neither Excess Nor Deficiency, Treat the Meridian"]
Question: The classics say: Tonify deficiency, drain excess, and for neither excess nor deficiency, treat the meridian. What does this mean? The classics say: Tonify the Mother of deficiency; the Mother can make the Child solid. Drain the Child of excess; the Child can make the Mother empty. For Liver disease, tonify Ququan (LR8), the He-Sea point of Jueyin, for deficiency; drain Xingjian (LR2), the Ying-Spring point of Jueyin, for excess. "Neither excess nor deficiency, treat the meridian" means the primary meridian is diseased itself, not invaded by other pathogens. One should treat the meridian directly, e.g., using Jing-well points for chest fullness. Primary meridian disease arises from internal factors, such as worry injuring the Heart or forceful immersion in water injuring the Kidney. "Neither excess nor deficiency" means the Zang organs do not overact upon each other, hence "treat the meridian itself."
[Regarding Secrecy in Needle Techniques]
Question: Modern doctors cover their hands with sleeves when needling, performing techniques secretly, claiming mystery and fearing theft. What is this technique? Answer: The fourteen methods in *Jinzhen Fu* and techniques like Green Dragon Tail Wagging are comprehensive. Seeking further mystery outside these is unbelievable. Such behavior is merely deceitful trickery to deceive people. Even if skillful, divine protection and efficacy will likely fail. Why value it?
[Regarding Attitude During Needling]
Question: Some doctors insert needles carelessly, chatting or drinking, twisting the needle occasionally, then returning to banquets before withdrawing. Can this really cure disease? Answer: The classics say: The truth of needling requires governing the Shen (Spirit) first. Also: Hands busy, needles bright and even, mind quiet observing changes. Also: Like facing an abyss, hand like holding a tiger, spirit not distracted by worldly things. Also: Like awaiting a noble, forgetting the passing of days. Are these respectful or negligent? Also: Gain and loss relate to Qi arriving solid/firm (gain) or weak/empty (loss). Also: "Seeing like entering, seeing like exiting" means pressing the point with the left hand, waiting for Qi arrival before inserting, and withdrawing when Qi is exhausted. Such careless behavior is done by vulgar artisans; nothing is more disrespectful!
[Regarding Needling Only Draining, Not Tonifying]
Question: Needling is purely draining, not tonifying. It guides Qi and treats excess diseases, so few use it. Is it unused because it doesn't tonify, or because people have weak constitution, or excessive depletion, or poor skill? The classics say: For Yang deficiency, warm with Qi; for Essence deficiency, tonify with flavor. Needles are made from Bian stones; they have no Qi or flavor. They break skin and flesh, opening pores, allowing Qi to escape. How can this be tonification? The classics say: If Qi, Blood, Yin, and Yang are all deficient, do not use needles; harmonize with sweet herbs. Also: If Form-Qi and Disease-Qi are both deficient, this is total Yin-Yang deficiency; do not needle, or you will severely deplete Qi, leading to death in the elderly and failure to recover in the strong. Such statements imply needling only drains, never tonifies.