（《灵枢·九针十二原篇》《小针解篇》）
夫气之在脉也，邪气在上，浊气在中，清气在下。故针陷脉则邪气出，针中脉则浊气出，针大深则邪气反沉，病益
（《灵枢·九针十二原篇》。邪气在上者，贼风邪气也。浊气在中者，水谷之气也。清气在下者，寒湿之气也。陷脉
诸义，具如下文；但缺取清气在下之义，或有所失。）故曰皮肉筋脉各有所处，病各有所宜，各不同形，各以任其所宜。
（经络疾病各有所处，九针各不同形，故其任用亦各有所宜也。）无实无虚，损不足而益有余，是谓甚病，病益甚。（无
实者，无实实也。无虚者，无虚虚也。反而为之，不惟不治病，适所以增病。）取五脉者死，取三脉者 ，夺阴者死，
夺阳者狂，针害毕矣。（五脉三脉，义如下文。 音匡，衰残也。）
《小针解》曰∶夫气之在脉也、邪气在上者，言邪气之中人也高，故邪气在上也。（此释上文之义也。伤于风者，
上
先受之，故凡八风寒邪之中人，其气必高而在上。）浊气在中者，言水谷皆入于胃，其精气上注于肺，浊溜于肠胃，言
寒
温不适，饮食不节，而病生于肠胃，故命曰浊气在中也。（水谷入胃，其清者化气，上归于肺，是为精气。若寒温失宜，
饮食过度，不能运化，则必留滞肠胃之间而为病，此浊气在中也。）清气在下者，言清湿地气之中人也，必从足始，故
曰
清气在下也。（伤于湿者，下先受之，故凡清湿地气之中人，必在下而从足始。）针陷脉则邪气出者，取之上。（诸经孔
穴，
多在陷者之中，如刺禁论所谓刺缺盆中内陷之类是也。故凡欲去寒邪，须刺各经陷脉，则经气行而邪气出，乃所以取阳
邪之在上者。）针中脉则浊气出者，取之阳明合也。（阳明合穴，足三里也。刺之可以清肠胃，故能取浊气之在中者。）
针
大深则邪气反沉者，言浅浮之病，不欲深刺也，深则邪气从之入，故曰反沉也。（反沉，病益深也。）皮肉筋脉各有所处
者，言经络各有所主也。（皮肉筋脉，各有浅深，各有所主，以应四时之气也。）取五脉者死，言病在中，气不足，但用
针尽大泻其诸阴之脉也。（五脉者，五脏五输也。病在中，气不足，而复尽泻其诸阴之脉，故必死。）取三阳之脉者，唯
言尽泻三阳之气，令病患 然不复也。（手足各有三阳，六腑脉也，六腑有六输。若不知虚实而尽泻之，令人 然羸败，
形气不可复也。）夺阴者死，言取尺之五里，五往者也。（夺阴者死，夺脏气也。尺之五里，尺泽后之五里也，手阳明经
穴，禁刺者也。详见后六十一。）夺阳者狂，正言也。（正言，即如上文取三阳之谓。）
（出自《灵枢·九针十二原篇》和《小针解篇》）
邪气在经脉中的分布规律是：邪气多在上部，浊气多在中部，清气（此处指寒湿之气）多在下部。因此，针刺浅表的陷脉可以排出邪气，针刺中部的经脉可以排出浊气；如果针刺过深，原本在表浅的邪气反而陷入体内深处，导致病情加重。
（《灵枢·九针十二原篇》指出：所谓“邪气在上”，是指贼风邪气侵袭人体；所谓“浊气在中”，是指水谷之气的代谢产物；所谓“清气在下”，是指寒湿之气。上述各种含义，在下文中有详细阐述；但原文缺少对“清气在下”这一义理的明确解释，可能是有所遗漏。）所以说，皮、肉、筋、脉各有其所在的部位，疾病各有其适宜的治疗原则，形态各不相同，应当根据各自适宜的法则进行处理。
（经络疾病各有其特定的发生部位，九种针具形状各异，因此它们的应用也各有适宜之处。）治疗时不可犯“实实虚虚”的错误（即实证用补法，虚证用泻法），若损伤正气而助长邪气，这被称为严重的误治，会使病情更加严重。（所谓“无实”，即不要对实证使用补法；所谓“无虚”，即不要对虚证使用泻法。如果反过来这样做，不仅不能治愈疾病，反而会增加病痛。）错误地刺取五脏的经脉会导致死亡，错误地刺取三阳经的经脉会导致身体衰残，耗夺阴气者死，耗夺阳气者发狂，针刺的危害至此穷尽。（“五脉”、“三脉”的含义见下文。“匡”音kuāng，意为衰残。）
《小针解》说：邪气在经脉中，所谓“邪气在上”，是说邪气侵犯人体位置较高，所以邪气位于上部。（这是对上文含义的解释。伤于风邪，头部先受邪，所以凡是风寒邪气侵犯人体，其病位必然在高处而在上部。）所谓“浊气在中”，是说饮食水谷都进入胃中，其中的精微之气向上输送到肺，而浑浊之气留滞于肠胃。如果寒温失调，饮食不节制，就会在肠胃产生疾病，所以称为“浊气在中”。（水谷进入胃后，清轻的部分化为精气，上归于肺，这就是精气。如果寒温失宜，饮食过度，导致运化功能失常，就会留滞在肠胃之间形成疾病，这就是浊气在中。）所谓“清气在下”，是说清冷潮湿的地气侵犯人体，必定从足部开始，所以称为“清气在下”。（伤于湿邪，下部先受邪，所以凡是清湿地气侵犯人体，必定在下部并从足部开始。）
针刺浅表的陷脉以排出邪气，是因为要选取上部的穴位。（各条经络的腧穴，大多位于肌肉凹陷之处，如《刺禁论》中所说的“刺缺盆中内陷”之类。所以凡是要祛除在上部的阳邪，必须针刺各经的陷脉，使经气运行而邪气排出。）针刺中部的经脉以排出浊气，是因为要选取足阳明胃经的合穴。（阳明合穴即足三里穴。针刺它可以清理肠胃，因此能排出在中部的浊气。）针刺过深导致邪气反而深陷，是说对于浅表浮浅的疾病，不希望进行深刺。如果深刺，邪气就会随之深入体内，所以称为“反沉”。（“反沉”意味着病情加深。）皮、肉、筋、脉各有其所在部位，是说经络各有其主治范围。（皮、肉、筋、脉深浅不同，各有其所主，以对应四时的气候特征。）
错误地刺取五脏经脉导致死亡，是说病在中焦，气机不足，却只用针具大量泻法刺激诸阴经的经脉。（“五脉”指五脏的五输穴。病在中焦且气不足，如果再全部泻诸阴经的经脉，所以必然致死。）错误地刺取三阳经脉，是说完全泻去三阳经的气血，使病人虚弱疲惫不堪。（手足各有三条阳经，属于六腑的经脉，六腑各有六个输穴。如果不知虚实而全部泻之，使人极度羸弱败坏，形体与元气无法恢复。）
耗夺阴气者死，是说多次针刺尺泽穴后的五里穴。（“夺阴”即耗夺脏气。尺之五里，即尺泽穴后方五里的穴位，属于手阳明大肠经，是禁刺的穴位。详见后文第六十一篇。）耗夺阳气者发狂，这是确切的说法。（“正言”即如上文所说的刺取三阳经并泻其气的情形。）
(From *Ling Shu: Nine Needles and Twelve Origins Chapter* and *Small Needle Explanation Chapter*)
Regarding the distribution of Qi in the meridians, pathogenic Qi (Xieqi) tends to be in the upper part, turbid Qi (Zhuoqi) in the middle, and clear Qi (Qingqi, here referring to cold-dampness) in the lower part. Therefore, needling the superficial sunken vessels expels pathogenic Qi; needling the middle vessels expels turbid Qi. If needling is too deep, pathogenic Qi that was superficial may sink deeper into the body, causing the disease to worsen.
(*Ling Shu: Nine Needles and Twelve Origins Chapter* states: "Pathogenic Qi in the upper part" refers to invasion by treacherous wind and pathogenic factors; "Turbid Qi in the middle" refers to the metabolic products of food and drink; "Clear Qi in the lower part" refers to cold-dampness. The meanings of these various terms are detailed in the following text; however, the original text lacks an explicit explanation for "Clear Qi in the lower part," which may be an omission.) Thus it is said that skin, flesh, sinews, and vessels each have their specific locations, diseases each have their appropriate treatments, forms differ, and one should act according to what is suitable for each.
(Meridian diseases have specific locations; the nine types of needles have different shapes, so their applications vary accordingly.) One must not commit the errors of "reinforcing excess" or "depleting deficiency." Doing so damages healthy Qi while benefiting pathogenic Qi, which is called severe mismanagement, leading to a worsening of the condition. ("No reinforcing excess" means do not use tonification for excess syndromes; "No depleting deficiency" means do not use sedation for deficiency syndromes. Acting contrary to this will not only fail to cure the disease but exacerbate it.) Incorrectly needling the five pulses [of the Zang organs] leads to death; incorrectly needling the three Yang pulses leads to debility; depleting Yin leads to death, and depleting Yang leads to mania. The harms of needling are thus complete. (The meanings of "five pulses" and "three pulses" are explained below. "Kuang" sounds like kuāng, meaning debilitated or decayed.)
The *Small Needle Explanation* states: Regarding "pathogenic Qi in the upper part," it means that when pathogenic factors invade the human body, they tend to affect high positions, hence pathogenic Qi is in the upper part. (This explains the previous statement. Those injured by wind are first affected at the top; therefore, whenever wind-cold-pathogenic factors invade, their location is necessarily high and superior.) Regarding "turbid Qi in the middle," it means that water and grain enter the Stomach, their essence ascends to the Lung, while turbidity lingers in the intestines and stomach. If there is improper regulation of cold and warmth, or irregular diet, disease arises in the intestines and stomach, hence it is called "turbid Qi in the middle." (After water and grain enter the Stomach, the clear portion transforms into Qi and returns to the Lung, which is the essence. If cold and warmth are imbalanced, or diet is excessive, leading to failure in transformation and transportation, stagnation occurs in the intestines and stomach, forming disease; this is turbid Qi in the middle.) Regarding "clear Qi in the lower part," it means that when cool and damp earthy Qi invades the human body, it necessarily starts from the feet, hence it is called "clear Qi in the lower part." (Those injured by dampness are first affected at the bottom; therefore, whenever cool and damp earthy Qi invades, it affects the lower part and starts from the feet.)
Needling the sunken vessels to expel pathogenic Qi involves selecting points in the upper region. (Acupoints of the various meridians are mostly located in depressions, such as mentioned in the *Forbidden Needling Theory* regarding "needling into the hollow of the Supraclavicular Fossa." Thus, to dispel Yang pathogenic factors located above, one must needle the sunken vessels of the respective meridians to promote Qi flow and expel pathogens.) Needling the middle vessels to expel turbid Qi involves selecting the He-Sea point of the Foot-Yangming Meridian. (The He-Sea point of Yangming is Zusanli [ST 36]. Needling it can clear the intestines and stomach, thereby expelling turbid Qi in the middle.) Needling too deeply causing pathogenic Qi to sink refers to the fact that for superficial diseases, deep needling is undesirable. Deep needling allows pathogenic Qi to follow the needle inward, hence it is called "sinking in reverse." ("Sinking in reverse" implies the disease becomes deeper.) That skin, flesh, sinews, and vessels each have their locations means that meridians each have their specific dominions. (Skin, flesh, sinews, and vessels have different depths and dominions, corresponding to the Qi of the four seasons.)
Incorrectly needling the five pulses leads to death, meaning that when disease is in the interior and Qi is deficient, using needles to heavily sedate all Yin meridian pulses causes death. ("Five pulses" refer to the Five Shu points of the Five Zang organs. When disease is in the interior and Qi is deficient, further sedating all Yin meridian pulses inevitably leads to death.) Incorrectly needling the three Yang pulses means completely sedating the Qi of the three Yang meridians, leaving the patient emaciated and exhausted. (There are three Yang meridians on the hands and feet, belonging to the Six Fu organs, which have six Shu points each. If one does not know the patterns of excess and deficiency and sedates them all, it causes extreme debility and ruin, making the form and Qi irrecoverable.)
Depleting Yin leads to death, referring to repeatedly needling the Wuli [LI 21] point behind Chize [LU 5]. ("Depleting Yin" means depleting Zang Qi. Wuli behind Chi Ze is a point on the Hand-Yangming Large Intestine Meridian that is forbidden to needle. See Volume 61 for details.) Depleting Yang leads to mania, which is a correct statement. ("Correct statement" refers to the scenario described above of needling the three Yang meridians and sedating their Qi.)