其病挛痹，其治宜微针，形乐志苦，病主于脉，治以灸刺，明九针之用，经络补泻之法
也。故营卫异刺，以分血气之虚实，井荥异刺，以分五行之子母，募俞异刺，以分背腹之阴
阳，春夏异刺，以分人气之浅深，大抵虚补实泻，无过不及之伤，以辅其平者，刺法之大要
也，然有病势未深，可刺而即愈者。所谓病之始起，可刺而已，或痹不仁肿痛，可灸刺而去
之是也。有病传诸经，必上下俱刺者。所谓刺热刺疟，病甚为五十九刺是也。然刺之为言，
同于击刺之刺，以为利也害在其中。黄帝谓徐而安静，手巧而心审谛者，可使行针艾。张机
谓针能杀生人，不能起死人，凡以用之不可不慎也，况九针异体，取病有殊，十二节异法，
用有轻重，必明日月星辰四时八正之在天，寒暑燥湿经水盈虚之在地，肥瘠壮弱虚实盛衰之
在人，然后呼吸补泻，出入迎随，惟意之从，岂特知募 部分、皮肉筋骸、饥饱劳逸而已哉
。故曰见微得过，用之不殆。
上古针法垂布于天下。制砭石有小大者。乃随病所宜，用石代针。一曰针石，二曰砭石
，三曰 石，其实一也。破坚决肉，砭射肿热者，则决之以砭石，良由邪气暴戾，则微针
不能及，况又病有气血盛实，逆于肉理，蓄结痈肿之类，非砭石则不能射之，此所谓血实宜
决之，又形乐志乐，病生于肉者，治之以砭石，东方之民，多病痈疡，其治宜砭石，砭石之
来，始自于此。扁鹊有云，病在血脉者，治以砭石。是故一切肿疾，悉宜镰割足小指下横文
间。肿在左则割左，在右则割右。血少出则瘥，以至疔肿、痈疡、丹毒、瘭疽代指、 病、
气痛流肿之类，皆须出血者，急以石砭之。大抵砭石之用，其法必泻。若在冬时，人气闭塞
，则用药而少针石。所谓少针石者，非痈疽之谓也。痈疽不得顷时回，苟缓于针石，则毒瓦斯
内攻，腐坏筋骨，穿通腑脏矣。治石疔疮，则忌瓦砾砖石之类，治刀镰疔疮，则忌铁刃伤割
。若是者，可以药治也。素问又曰∶人病颈痈，或石治之，或针灸治之，而皆已，此盖同病
异治也。夫痈疽之气息者，宜针开除去之，气盛血聚者，宜石而泻之，若然则砭石九针之用
，各有所利，善治血脉之变，痈肿之病者，当审轻重而制之。
这种病表现为筋脉拘挛、肢体麻木疼痛，治疗适宜使用微针。形体安逸但精神苦闷的患者，病变主要在于经脉，治疗采用灸法和针刺。必须明确九针的用途以及经络补泻的方法。因此，营气和卫气的刺法不同，以区分血与气的虚实；井穴和荥穴的刺法不同，以区分五行相生关系中的母穴和子穴；募穴和俞穴的刺法不同，以区分背部和腹部的阴阳属性；春夏两季的刺法不同，以区分人体气血在体内的深浅程度。大抵原则是虚证用补法，实证用泻法，避免过度或不足造成伤害，以此辅助恢复平衡，这是针刺疗法的大要。然而，有些病势尚未深入，可以针刺并立即痊愈的情况。这就是所谓疾病初起时，可以通过针刺治愈；或者对于痹症导致的麻木、疼痛、肿胀，可以通过灸法和针刺来消除它。也有病情传变至各条经脉，必须上下同时针刺的情况。这就是所谓治疗热病和疟疾时的“五十九刺”法，当病情严重时使用。
然而，“刺”这个字，如同击打穿刺的意思，看似有利，实则隐患其中。黄帝曾说，动作缓慢安静、手法灵巧且心思审慎细致的人，才可以施行针刺和艾灸。张机（张仲景）说，针刺能杀死活人，却不能救活死人，这都是因为使用针刺不可不谨慎啊。何况九种针具形状各异，取效于不同的病症；十二种季节气候对应的刺法不同，应用的轻重也有所区别。必须明了日月星辰运行及四季八正之气在天象上的变化，寒暑燥湿导致地中经水盈虚的变化，以及人体肥瘦、强弱、虚实、盛衰的差异，然后才能进行呼吸补泻、迎随等手法，随心所欲地运用。这岂止是了解募穴部位、皮肉筋骨结构以及饥饱劳逸那么简单呢？所以说，发现细微的过失征兆，使用针刺就不会有危险。
上古时期的针刺方法流传天下。制作的砭石有大小的区别。都是根据病情适宜之处，用石头代替针具。一种叫针石，一种叫砭石，还有一种叫瑊石，其实它们是同一种东西。对于坚硬积聚的肉块，以及砭射红肿热痛的症状，就用砭石切开排脓。这是因为邪气暴戾猛烈，微针无法触及，况且又有气血盛实，逆乱于肌肉纹理，蓄积结成痈肿之类的情况，不用砭石就不能将其破泄。这就是所谓“血实宜决之”。另外，形体安逸、精神快乐，但病生于肌肉层面的患者，治疗用砭石。东方地区的百姓，多患痈疡类疾病，治疗适宜用砭石，砭石的起源，开始于此。扁鹊曾说，病在血脉中的，用砭石治疗。所以一切肿胀疾病，都适宜在小指下方的横纹间进行镰割放血。肿在左边就割左边，在右边就割右边。血液流出少则病愈。至于疔疮、痈疡、丹毒、瘭疽、代指、附骨疽、气痛流注肿胀之类，凡是都需要出血的，急忙用石砭刺破。大抵砭石的使用，其法则必然是泻法。如果在冬季，人气闭塞，则用药而少用针石。所谓“少用针石”，并不是指痈疽这类病。痈疽不能片刻延误，如果迟缓于使用针石，那么毒瓦斯就会内攻，腐蚀筋骨，穿透脏腑。治疗石疔疮，则忌讳瓦砾砖石之类的东西；治疗刀镰疔疮，则忌讳铁刃伤割。如果是这种情况，可以用药物治疗。《素问》又说：人患颈痈，有的用石治好了，有的用针灸治好了，而且都痊愈了，这大概是同病异治的道理。那些气息壅滞的痈疽，适宜用针刺开除去；气盛血聚的，适宜用砭石泻之。既然这样，那么砭石和九针的使用，各有其优势，善于治疗血脉变化和痈肿疾病的医生，应当审察病情的轻重来制定治疗方案。
This disease presents with tendon spasms and bi-syndrome (painful obstruction syndrome) characterized by numbness and pain. The treatment is suitable for the use of micro-needles. For patients whose physical form is at ease but whose spirit is suffering, the pathology primarily resides in the meridians; the treatment employs moxibustion and acupuncture. One must clearly understand the application of the Nine Needles (Jiu Zhen) and the methods of tonification and sedation of the meridians. Therefore, the needling techniques for Ying-Qi (Nutritive Qi) and Wei-Qi (Defensive Qi) differ to distinguish the deficiency or excess of Blood and Qi. The needling of Jing-Well points (Jing Xue) and Ying-Spring points (Ying Xue) differs to distinguish the Mother and Child relationships within the Five Elements (Wu Xing). The needling of Mu-Alarm points (Mu Xue) and Shu-Transport points (Shu Xue) differs to distinguish Yin and Yang between the back and abdomen. The needling techniques for Spring/Summer and Autumn/Winter differ to distinguish the depth of human Qi. Generally, deficiency is treated with tonification and excess with sedation, avoiding injury from over-treatment or under-treatment, thereby assisting in restoring balance; this is the general principle of acupuncture therapy. However, there are cases where the pathological process has not yet penetrated deeply, allowing for immediate cure through needling. This refers to the principle that when a disease is in its initial stage, it can be cured by needling; or for Bi-syndrome causing numbness, pain, and swelling, it can be eliminated by moxibustion and needling. There are also cases where the disease has transmitted to various meridians, requiring simultaneous needling of both upper and lower parts. This refers to the "Fifty-Nine Points Needling" method used for treating heat diseases and malaria when the condition is severe.
However, the term "Ci" (puncture/needle) implies striking or piercing; while seemingly beneficial, harm may lie within. The Yellow Emperor stated that only those who are slow, calm, skilled in hand movements, and careful in mental deliberation should perform acupuncture and moxibustion. Zhang Ji (Zhang Zhongjing) said that needles can kill living people but cannot revive the dead; this emphasizes that the use of needles must be handled with extreme caution. Moreover, the nine types of needles have different shapes and indications; the twelve seasonal methods vary in application and weight. One must understand the celestial changes of the sun, moon, stars, and the Eight Correct Seasons (Ba Zheng); the terrestrial variations of cold, heat, dryness, and dampness affecting the fullness or emptiness of meridian waters; and the human differences in fat/thin, strong/weak, deficiency/excess, and flourishing/depletion. Only then can one perform respiratory tonification/sedation and following/following-away techniques, acting according to intent. This goes far beyond merely knowing the locations of Mu-points, the structure of skin, flesh, tendons, and bones, or the effects of hunger/fullness and labor/rest. Thus it is said: "To perceive the subtle signs of error and apply the needle accordingly ensures no danger."
In ancient times, acupuncture methods were widespread. Bian stones (Bian Shi, stone knives) were made in various sizes. They were used to replace needles according to the suitability of the condition. One type is called Needle Stone (Zhen Shi), another Bian Stone (Bian Shi), and another Jian Stone (Jian Shi); essentially, they are the same. For hard accumulations in flesh and for conditions involving redness, swelling, and heat, Bian stones are used to lacerate and drain. This is because pathogenic factors are violent and acute, rendering micro-needles ineffective. Furthermore, in cases of excessive Qi and Blood stagnating in muscle tissue, leading to abscesses and swellings, only Bian stones can penetrate and drain them. This corresponds to the principle: "When Blood is excessive, it should be drained." Additionally, for individuals whose physical form is at ease and spirit is joyful, but whose diseases arise in the flesh/muscles, treatment involves Bian stones. People in the Eastern regions often suffer from sores and ulcers; their treatment is suitable for Bian stones. The origin of Bian stones begins here. Bian Que stated: "For diseases in the blood vessels, treat with Bian stones." Therefore, for all types of swelling diseases, incision and drainage are suitable at the transverse crease below the little toe. If swelling is on the left, cut the left; if on the right, cut the right. Healing occurs when a small amount of blood is discharged. For conditions such as Ding-sores (hard boils), abscesses, erysipelas, Biao-j疽 (acute suppurative infections), Dai-zhi (paronychia), Gu-ben ju (deep-seated abscesses), and Qi-pain with flowing swelling, which require bloodletting, one should urgently puncture with a stone Bian. Generally, the method of using Bian stones is always sedation. In winter, when human Qi is closed and obstructed, medication is preferred over needles and stones. The phrase "few needles and stones" does not refer to abscesses and gangrene. Abscesses and gangrene cannot be delayed even for an instant; if treatment with needles and stones is postponed, toxic pathogens will attack internally, rotting muscles and bones and penetrating viscera. When treating Stone Ding-sores, one must avoid materials like gravel and bricks; when treating Knife/Ladle Ding-sores, one must avoid iron blades. Such cases can be treated with herbs. The *Su Wen* (Basic Questions) also states: "A person suffers from neck carbuncle; some are cured with stone therapy, others with acupuncture and moxibustion, and all recover. This is known as treating the same disease with different methods." For carbuncles and gangrene characterized by stagnant Qi, acupuncture opening and removal is suitable; for those with abundant Qi and pooled Blood, Bian stone sedation is suitable. Thus, the applications of Bian stones and the Nine Needles each have their advantages. Those skilled in treating blood vessel alterations and swelling diseases should assess the severity and formulate appropriate treatments.