内经云。知为针者信其左。不知为针者信其右。盖取穴的时。先以沸水洗净穴位。
医者亦必用沸水温针。洗手。消毒。再以左手大指甲切按其穴。成十字形。然后令病患咳
嗽一声。医者左手持穴。右手以大指中指持针。食指压针顶。无名指辅针。随咳刺入。
再令病患用口吸气。医者徐徐左右旋转进针。大约吸气三口。针透天部。吸气至六口。
针至人部。吸气九口。针到地部。如肌肉轻松。进针容易。吸气未至九口而针已到地部
者。少吸数口气亦可。如肌肉紧密。吸气九口而针未到地部者。再多吸气数口。总以针
至地部为止。再如针至肉膜。膜浓针受阻。则令病患口呼气将针轻提。再令病患吸气。
将针重下。透肉膜后。进针至易。针到地部时。令病患呼气一口。微提针如小豆许。即
停针候气。停针时。用大指甲括针柄向上括之之正例。如病在下而针穴在上者。则下括
针柄。如病在阳经背部而所针开穴为手阴经者。右手括针时。以左手指随其经脉之道。
按引气而导至肩 。令病者用鼻大呼气一口。乘呼气时将针外转一次。用大指甲将针柄
下括数次。乃停针候气。此即灵
枢经第一篇右主推之左持而御之（一）之义。
如病在阴经腹部而所取开穴在手阳经者。用右手大指甲将针柄上括。左手指随其经
脉之道。按引气而导至肘上。转折入 腋。令病患用口大吸气一口。针向内转一次。再
用大指将针柄下括二三下。乃停针候气。
《内经》说：懂得针刺原理的人信赖左手（辅助定位与导气），不懂针刺原理的人只信赖右手（持针操作）。大概是因为在准确取穴时，先用沸水洗净穴位。医者也必须用沸水温热针具并洗手，进行消毒。然后再用左手的大指甲切按穴位，形成十字形的标记。然后让病人咳嗽一声，医者左手固定穴位，右手用大拇指和中指持针，食指按压针顶，无名指辅助针身，随着咳嗽的声音将针刺入。再让病人用口吸气，医者慢慢地左右旋转进针。大约吸气三口，针透达天部；吸气至六口，针到达人部；吸气九口，针到达地部。如果肌肉松软，进针容易，吸气未到九口而针已到达地部的，少吸几口气也可以。如果肌肉紧密，吸气九口而针未到达地部的，再多吸几口气，总以针到达地部为停止标准。又如针扎到肉膜，膜厚针受阻，则让病人口呼气并将针轻轻提起，再让病人吸气，将针用力刺下，穿透肉膜后，进针就容易了。针到达地部时，让病人呼气一口，微微提起针如小豆大小，随即停针候气。停针时，用大指甲顺着针柄向上刮拭，这是正例。如果病在下部而针刺穴位在上部，则向下刮拭针柄。如果病在阳经背部而所选取的开穴在手阴经，右手刮拭针柄时，左手指顺着经脉的走向，按压引导气机传导至肩部，让病人用鼻子大口呼气一口，趁呼气时将针向外旋转一次，用大指甲将针柄向下刮拭数次，然后停针候气。这就是《灵枢经》第一篇“右主推之，左持而御之”的含义。如果病在阴经腹部而所选取的开穴在手阳经，用右手大指甲将针柄向上刮拭，左手指顺着经脉的走向，按压引导气机传导至肘上，转折进入腋下，让病人用口大口吸气一口，针向内旋转一次，再用大拇指将针柄向下刮拭二三下，然后停针候气。
The *Neijing* (Inner Canon) states: "He who understands acupuncture trusts his left hand; he who does not understand acupuncture trusts his right hand." This is because when accurately selecting acupoints, one first cleanses the acupoint with boiling water. The practitioner must also use boiling water to warm the needle and wash hands for disinfection. Then, using the nail of the left thumb, press and cut across the acupoint to form a cross-shaped mark. Next, instruct the patient to cough once. The practitioner fixes the acupoint with the left hand, holds the needle with the thumb and middle finger of the right hand, presses the needle tip with the index finger, and supports the needle shaft with the ring finger. Insert the needle following the cough. Instruct the patient to inhale through the mouth. The practitioner slowly rotates the needle left and right while advancing. After approximately three inhalations, the needle penetrates the Tian Bu (Heaven Layer); after six inhalations, it reaches Ren Bu (Human Layer); after nine inhalations, it arrives at Di Bu (Earth Layer). If the muscles are relaxed and insertion is easy, reaching the Earth Layer before nine inhalations is acceptable, requiring fewer breaths. If the muscles are tight and the Earth Layer is not reached after nine inhalations, continue with additional breaths until the needle reaches the Earth Layer. If the needle encounters resistance from the fascia (muscle membrane), instruct the patient to exhale through the mouth and gently withdraw the needle slightly. Then, instruct the patient to inhale and forcefully drive the needle down to penetrate the fascia, after which insertion becomes easier. Upon reaching the Earth Layer, instruct the patient to exhale once, slightly withdraw the needle by the size of a small bean, and then pause to await the arrival of Qi (Deqi). While pausing, scrape the needle handle upward with the thumbnail; this is the standard method. If the disease is in the lower part but the acupoint is in the upper part, scrape the needle handle downward. If the disease is in the Yang meridians of the back but the selected open acupoint is on a Yin meridian of the hand, while scraping the needle handle with the right hand, use the left fingers to follow the meridian pathway, pressing and guiding the Qi towards the shoulder. Instruct the patient to exhale deeply through the nose once. During exhalation, rotate the needle outward once, then scrape the needle handle downward several times with the thumbnail, and pause to await Qi. This embodies the principle from the first chapter of the *Ling Shu* (Spiritual Pivot): "The right hand pushes forward, the left hand holds and controls." If the disease is in the Yin meridians of the abdomen but the selected open acupoint is on a Yang meridian of the hand, use the thumbnail of the right hand to scrape the needle handle upward. Use the left fingers to follow the meridian pathway, pressing and guiding the Qi to above the elbow, turning into the axilla. Instruct the patient to inhale deeply through the mouth once, rotate the needle inward once, then scrape the needle handle downward two or three times with the thumb, and pause to await Qi.