天一生水，地六成之。地二生火，天七成之。天三生木，地八成之。地四生金，天九成
之。天五生土，地十成之。
问∶经脉有奇经八脉。
《难经》云∶脉有奇经八脉者，不拘于十二经，何谓也？然，有阳维、有阴维、有阳跷
、有阴跷、有冲、有任、有督、有带之脉，凡此八脉，皆不拘于经，故曰∶奇经八脉也。经
有十二，络有十五，凡二十七，气相随上下，何独不拘于经也。然，圣人图设沟渠，通利水
道，以备不然，天雨降下，沟渠溢满，当此之时， 霈妄行，圣人不能复图也。此络脉
满溢，诸经不能复拘也。
问∶迎随之法。
经曰∶随而济之是为补，迎而夺之是为泻。夫行针者，当刺之时，用皮钱擦热针，复以
口温针热，先以左手爪，按其所刺荣俞之穴，弹而努之，爪而下之，扪而循之，通而取之，
令病患咳嗽一声，右手持针而刺之。春夏二十四息，先深后浅（其浅深之故，注《标幽赋》内
），秋冬三十六息，先浅后深，徐徐而入，气来如动脉之状，针下轻滑。未得气者，若鱼之
未吞钩，既吞得气，宜用补泻。补，随其经脉，推而按内之，停针一二时，稍久，凡起针，
左手闭针穴，徐出针而疾按之。泻，迎其经脉，提而动伸之，停针稍久，凡起针，左手开针
穴，疾出针而徐按之。补针左转，大指努出；泻针右转，大指收入。补者先呼后吸，泻者先
吸后呼。疼痛即泻，痒麻即补。
问∶补针之要法。
答曰∶补针之法，左手重切十字缝纹，右手持针于穴上，次令病患咳嗽一声，随咳进针
，长呼气一口，刺入皮三分。针手经络者，效春夏停二十四息。针足经络者，效秋冬停三十
六息。催气针沉，行九阳之数，捻九撅九，号曰天才。少停呼气二口，徐徐刺入肉三分，如
前息数足，又觉针沉紧，以生数行之，号曰人才。少停呼气三口，徐徐又插至筋骨之间三分
，又如前息数足，复觉针下沉涩，再以生数行之，号曰地才。再推进一豆，谓之按，为截、
为随也。此为极处，静以久留，却须退针至人部，又待气沉紧时，转针头向病所，自觉针下
热，虚羸痒麻，病势各散，针下微沉后，转针头向上，插进针一豆许，动而停之，吸之乃去
，徐入徐出，其穴急扪之。岐伯曰∶下针贵迟，太急伤血，出针贵缓，太急伤气，正谓针之
不伤于荣卫也。是则进退往来，飞经走气，尽于斯矣。
问∶泻针之要法。
凡泻针之法，左手重切十字纵纹三次，右手持针于穴上，次令病患咳嗽一声，随咳进针
，插入三分，刺入天部，少停直入地部，提退一豆，得气沉紧，搓拈不动，如前息数尽，行
六阴之数，捻六撅六，吸气三口回针，提出至人部，号曰地才。又待气至针沉，如前息数足
，以成数行之，吸气二口回针，提出至天部，号曰人才。又待气至针沉，如前息数足，以成
数行之，吸气回针，提出至皮间，号曰天才。退针一豆，谓之提，为担、为迎也。此为极处
，静以久留，仍推进人部，待针沉紧气至，转针头向病所，自觉针下冷，寒热痛痒，病势各
退，针下微松，提针一豆许，摇而停之，呼之乃去，疾入徐出，其穴不闭也。
问∶经络。
答曰∶经脉十二，络脉十五，外布一身，为血气之道路也。其源内根于肾，乃生命之本
也。根在内而布散于外，犹树木之有根本，若伤其根本，则枝叶亦病矣。苟邪气自外侵之，
伤其枝叶，则亦累其根本矣。或病发内生，则其势必然，故言五脏之道，皆出经隧，以行血
气，经为正经，络为支络，血气不和，百病乃生。但一经精气不足，便不和矣。故经曰∶邪
中于阳，则溜于经，自面与颈，则下阳明，自项与背，则下太阳，自颊与胁，则下少阳。邪
中于阴，则溜于腑，自四末臂 始，而入三阴，脏气实而不能容，故还之于腑。腑者，
谓胆、胃、膀胱、大小肠也，故刺各有其道焉。针下察其邪正虚实以补泻之，随其经脉荣卫
以迎随之，其道皆不有违也。凡中外之病，始自皮肤，血脉相传，内连腑脏，则四肢九窍，
壅塞不通，内因之病，令气盛衰，外连经络，则荣卫倾移，上下左右，虚实生矣。经云∶风
寒伤形，忧恐忿怒伤气，气伤脏，乃病脏，寒伤形，乃应形，风伤筋，乃应筋，此形气内外
外具阴阳∶筋骨为阴，皮肤为阳。内具阴阳∶五脏为阴，六腑为阳。
问∶子午补泻。
答曰∶此乃宣行荣卫之法也。故左转从子，能外行诸阳，右转从午，能内行诸阴，人身
则阳气受于四末，阴气受于五脏，亦外阳而内阴也。左转从外则象天，右转从内则象地，
中提从中则象人，一左一右一提，则能使阴阳内外之气，出入与上下相参往来，而荣卫自流
通矣。男子生于寅─寅，阳也，以阳为主，故左转顺阳为之补，右转逆阳为之泻。女子生
于申─申，阴也，以阴为主，故右转顺阴为之补，左转逆阴为之泻，此常法也。然病有阴阳
热之不同，则转针取用出入，当适其所宜。假令病热，则刺阳之经，以右为泻，以左为补；
病寒则刺阴之经，以右为补，左为泻。此盖用阴和阳，用阳和阴，通变之法也。大凡转针逆
顺之道，当明于斯。
子（合）穴∶尺盛补之，顺其入也。午（荥）穴∶寸盛泻之，顺其出也。
问∶针头补泻何如？
答曰∶此乃补泻之常法也。非呼吸而在手指，当刺之时，必先以左手压按其所针荥俞之
处，弹而努之，爪而下之，其气之来，如动脉之状，顺针而刺之，得气推而内之，是谓补。
动而伸之，是谓泻。夫实者气入也，虚者气出也。以阳生于外故入，阴生于内故出，此乃阴
阳水火出入之气所不同也，宜详察之。
此外有补针导气之法，所谓扪而循之者，是于所刺经络部分，上下循之，故令气血舒缓
，易得往来也。切而散之者，是用大指爪甲，左右于穴切之，腠理开舒，然后针也。推而按
之者，是用右指捻针按住，近气不失，则远气乃来也。弹而努之者，是用指甲弹针，令脉气
满，而得疾行至于病所也。爪而下之者，是用左手指爪连甲，按定针穴，乃使气散而
刺荣，使血散而刺卫，则置针各有准也。通而取之者，是持针进退，或转或停，以使血气往
来，远近相通，而后病可取也。外引其门以闭其神者，是先用左指收合针孔，乃放针，则经
气不泄也。故曰∶知为针者信其左。
问∶候气之法何如？
答曰∶用针之法，候气为先，须用左指，闭其穴门，心无内慕，如待贵人，伏如横弩，
起若发机；若气不至，或虽至如慢，然后转针取之。转针之法，令患人吸气，先左转针，不
至，左右一提也。更不至者，用男内女外之法，男即轻手按穴，谨守勿内；女即重手按穴，
坚拒勿出，所以然者，持针居内是阴部，持针居外是阳部，浅深不同，左手按穴，是要分明
。只以得气为度，如此而终不至者，不可治也。若针下气至，当察其邪正，分其虚实。经言
∶邪气来者紧而疾，谷气来者徐而和，但濡虚者即是虚，但牢实者即是实。此其诀也。
问∶呼吸之理。
答曰∶此乃调和阴阳法也。故经言∶呼者因阳出，吸者随阴入。虽此呼吸分阴阳，实由
一气而为体，其气内历于五脏，外随于三焦，周布一身，循环经络，流注孔穴，顺其形气之
方圆，然后为用不同耳。是故五脏之出入，以应四时。三焦之升降，而为荣卫。经脉之循环
，以合天度。然则呼吸出入，乃造化之枢纽，人身之关楗，针家所必用也。诸阳浅在经络，
诸阴深在脏腑，补泻皆取呼吸，出内其针。盖呼则出其气，吸则入其气。欲补之时，气出针
入，气入针出。欲泻之时，气入入针，气出出针。呼而不过三口，是外随三焦之阳。吸而不
过五口，是内迎五脏之阴。先呼而后吸者，为阳中之阴；先吸而后呼者，为阴中之阳，乃各
随其病气，阴阳寒热而用之，是为活法，不可误用也。
三阴之经∶先吸后呼。三阳之经∶先呼后吸。
问∶迎随之理何如？
答曰∶此乃针下予夺之机也。
第一要知荣卫之流行。所谓诸阳之经，行于脉外；诸阳之络，行于脉内；诸阴之经，行
于脉内；诸阴之络，行于脉外，各有浅深。立针以一分为荣，二分为卫，交互停针，以候其
气，见气方至，速便退针引之，即是迎。见气已过，然后进针追之，即是随。故《刺法》云
∶动退空歇，迎夺右而泻凉，推内进搓，随济左而补暖。
第二要知经脉之往来。所谓足之三阳，从头走足；足之三阴，从足走腹；手之三阴，从
胸走手；手之三阳，从手走头。得气以针头逆其经脉之所来，动而伸之即是迎。以针头顺其
经脉之所往，推而内之即是随。故经云∶实者，绝而止之；虚者，引而起之。
凡下针之法，先用左手，揣穴爪按，令血气开舒，乃可内针。若欲出血，勿以爪按。右
手持针于穴上，令患人咳嗽一声，拈之，一左一右，透入于腠理，此即是阳部奇分。《刺要
》云∶一分为荣。又云∶方刺之时，必在悬阳，然后用其呼吸，徐徐推之，至于肌肉，以及
分寸，此二者，即是阴部偶分。《刺要》又云∶二分为卫，方刺之时，必在悬阳，及与两卫
，神属勿去，知病存亡。却以左手按穴令定，象地而不动；右手持针，法天之运转。若得其
气，左手按穴可重五两以来，右手存意捻针，而行补泻。惟血脉在俞横居，视之独澄，切之
独坚，凡刺脉者，随其顺逆，不出血，则发针疾按之。凡刺浅深，惊针则止。凡行补泻谷气
问∶疾徐之理。
答曰∶此乃持针出入之法也。故经言∶刺虚实者，徐而疾则实，疾而徐则虚。然此经有
两解∶所谓徐而疾者，一作徐内而疾出；一作徐出针而疾按之。所谓疾而徐者，一作疾内而
徐出；一作疾出针而徐按之（两说皆通）。盖疾徐二字，一解作缓急之义，一解作久速之义，
若夫不虚不实，出针入针之法，则亦不疾不徐，配乎其中可也。
问∶补泻得宜。
答曰∶大略补泻无逾三法。
一则诊其脉之动静。假令脉急者，深内而久留之；脉缓者，浅内而疾发针；脉大者，微
出其气；脉滑者，疾发针而浅内之；脉涩者，必得其脉，随其逆顺久留之，必先按而循之，
已发针疾按其穴，勿出其血；脉小者，饮之以药。
二则随其病之寒热。假令恶寒者，先令得阳气入阴之分，次乃转针退到阳分，令患人鼻
吸口呼，谨按生成气息数足，阴气隆至，针下觉寒，其人自清凉矣。又有病道远者，必先使
气直到病所，寒即进针少许，热即退针少许，然后却用生成息数治之。
三则随其诊之虚实。假令形有肥有瘦，身有痛有麻痒，病作有盛有衰，穴下有牢有濡，
皆虚实之诊也。若在病所，用别法取之，转针向上气自上，转针向下气自下，转针向左气自
左，转针向右气自右，徐推其针气自往，微引其针气自来，所谓推之则前，引之则止，徐往
微来以除之，是皆欲攻其邪气而已矣。
问∶自取其经。
答曰∶刺虚刺实，当用迎随，补其母而泻其子，若不虚不实者，则当以经取，谓其正经
自得病，不中他邪，故自取其经也。其法右手存意持针，左手候其穴中之气，若气来至如动
脉状，乃内针，要续续而入，徐徐而撞，入荣至卫，至若得气如鲔鱼食钩，即是病之气也，
则随本经气血多少，酌量取之，略待少许，见气尽乃出针；如未尽，留针在门，然后出针。
经曰∶有见如入，有见如出，此之谓也。
问∶补者从卫取气，泻者从荣置气？
答曰∶十二经脉，皆以荣为根本，卫为枝叶，故欲治经脉，须调荣卫，欲调荣卫，须假
呼吸。经曰∶卫者阳也，荣者阴也。呼者阳也，吸者阴也。呼尽内针，静以久留，以气至为
故者，即是取气于卫。吸则内针，以得气为故者，即是置气于荣也。
问∶皮肉筋骨脉病。
答曰∶百病所起，皆始于荣卫，然后淫于皮肉筋脉，故经言∶是动脉者，气也。所生病
者，血也。先为是动，而后所生病也。由此推之，则知皮肉经脉，亦是后所生之病耳。是以
刺法中但举荣卫，盖取荣卫逆顺，则皮骨肉筋之治在其中矣。以此思之，至于部分有浅深之
不同，却要下针无过不及为妙也。
一曰皮肤，二曰肌肉，三曰筋骨。
问∶刺有久速。
答曰∶此乃量病轻重而行，轻者一补一泻足矣，重者至再至三也。假令得病气而补泻之
，其病未尽，仍复停针，候气再至，又行补泻。经言∶刺虚须其实，刺实须其虚也。
问∶诸家刺齐异同。
答曰∶《灵枢》所言∶始刺浅之，以逐邪气，而来血气（谓绝皮以出阳邪也）。后刺深之
，以致阴气之邪（谓阴邪出者少，益深绝皮，致肌肉未入分肉间也）。最后取刺极深之，以下
谷气（谓已入分肉之间，则谷气出矣），此其旨也。余读《难经》，常见针师丁德用所注，乃
言人之肌肉，皆有浓薄之处，但皮肤之上，为心肺之部，阳气所行；肌肉之下，为肝肾之部
，阴气所行也。是说所以发挥《灵枢》之旨，却甚详明。至于孙氏《千金方》所言∶针入一
天一生水，地六成之。地二生火，天七成之。天三生木，地八成之。地四生金，天九成之。天五生土，地十成之。
问：经脉中有奇经八脉。
《难经》说：脉有奇经八脉，不受十二正经的约束，这是什么意思呢？回答说：有阳维脉、阴维脉、阳跷脉、阴跷脉、冲脉、任脉、督脉、带脉，这八条脉，都不受正经的约束，所以叫作奇经八脉。正经有十二条，络脉有十五条，总共二十七条，气相随上下运行，为什么唯独它们不受正经约束呢？回答说：圣人规划设置沟渠，疏通水道，以备用处不备之时，天下雨降下，沟渠溢满，到了这个时候，雨水泛滥妄行，圣人也不能再重新规划了。这就像络脉满溢，诸条正经不能再约束它一样。
问：迎随补泻的方法。
经文说：顺着经脉走向施针并推按是补法，逆着经脉走向施针并提引是泻法。施行针刺的人，在进针时，先用皮钱擦热针具，再用口温加热针体，先用左手拇指指甲，按压所刺的荣穴或俞穴，弹击使穴位鼓起，用指甲切按，然后扪摸循按，疏通气血后取穴，让病人咳嗽一声，右手持针刺入。春夏季节行针二十四息，先深后浅（深浅的原因，参见《标幽赋》注），秋冬季节行针三十六息，先浅后深，慢慢进入，得气的感觉像动脉跳动一样，针下感觉轻滑。没有得气的，像鱼还没有吞钩；已经吞钩得气了，应当使用补泻法。补法，顺着经脉走向，推按将针纳入，停针一段时间，稍久一点，起针时，左手闭合针孔，慢慢出针并迅速按压。泻法，逆着经脉走向，提引摇动伸展针体，停针稍久，起针时，左手张开针孔，快速出针并慢慢按压。补针向左转，大拇指用力推出；泻针向右转，大拇指收回。补法先呼后吸，泻法先吸后呼。疼痛就用泻法，痒麻就用补法。
问：补针的要领。
回答说：补针的方法，左手重切十字缝纹，右手持针置于穴上，接着让病人咳嗽一声，随着咳嗽进针，长呼气一口，刺入皮肤三分。针刺手部经络的，效法春夏，停针二十四息。针刺足部经络的，效法秋冬，停针三十六息。催气针感沉紧，行九阳之数，捻针九次，撅针九次，称为天才。稍停，呼气两次，慢慢刺入肌肉三分，如前所述息数足，又觉得针感沉紧，以生数行之，称为人才。稍停，呼气三次，慢慢再插至筋骨之间三分，又如前所述息数足，复觉针下沉涩，再以生数行之，称为地才。再推进一豆的距离，称为按，为截、为随。这是极处，静留很久，然后退针至人部，又等待气感沉紧时，转动针头朝向病所，自觉针下发热，虚羸痒麻，病势各自消散，针下微沉后，转动针头向上，插进针一豆许，动而停之，吸气时去针，慢进慢出，其穴急扪之。岐伯说：下针贵在慢，太急伤血，出针贵在缓，太急伤气，正是说针不伤及营卫。这就是进退往来，飞经走气，尽在于此了。
问：泻针的要领。
凡是泻针的方法，左手重切十字纵纹三次，右手持针置于穴上，接着让病人咳嗽一声，随着咳嗽进针，插入三分，刺入天部，稍停直入地部，提退一豆，得气沉紧，搓拈不动，如前所述息数尽，行六阴之数，捻针六次，撅针六次，吸气三口回针，提出至人部，称为地才。又等待气至针沉，如前所述息数足，以成数行之，吸气两口回针，提出至天部，称为人才。又等待气至针沉，如前所述息数足，以成数行之，吸气回针，提出至皮间，称为天才。退针一豆，称为提，为担、为迎。这是极处，静留很久，仍推进人部，待针沉紧气至，转动针头朝向病所，自觉针下冷，寒热痛痒，病势各自消退，针下微松，提针一豆许，摇而停之，呼气时去针，快进慢出，其穴不闭。
问：经络。
回答说：经脉十二条，络脉十五条，外布一身，是气血运行的道路。其源头内根于肾，是生命的根本。根在内而布散于外，就像树木有根本，如果伤了根本，枝叶也会生病。如果邪气从外侵袭，伤了枝叶，也会连累根本。或者病发内生，那更是必然，所以说五脏的道路，都出于经隧，以运行气血，经是正经，络是支络，气血不和，百病乃生。只要一经精气不足，就不和了。所以经文说：邪中于阳，则流入经，从面与颈，则下阳明，从项与背，则下太阳，从颊与胁，则下少阳。邪中于阴，则流入腑，从四肢臂始，而入三阴，脏气实而不能容纳，所以还之于腑。腑，指胆、胃、膀胱、大小肠，所以刺各有其道。针下察其邪正虚实以补泻之，随其经脉营卫以迎随之，其道皆不违背。凡中外之病，始自皮肤，血脉相传，内连腑脏，则四肢九窍，壅塞不通，内因之病，令气盛衰，外连经络，则营卫倾移，上下左右，虚实生矣。经文说：风寒伤形，忧恐忿怒伤气，气伤脏，乃病脏，寒伤形，乃应形，风伤筋，乃应筋，此形气内外俱具阴阳：筋骨为阴，皮肤为阳。内具阴阳：五脏为阴，六腑为阳。
问：子午补泻。
回答说：这是宣行营卫的方法。所以左转从子，能外行诸阳，右转从午，能内行诸阴，人身则阳气受于四末，阴气受于五脏，也是外阳而内阴。左转从外则象天，右转从内则象地，中提从中则象人，一左一右一提，则能使阴阳内外之气，出入与上下相参往来，而营卫自流通矣。男子生于寅─寅，阳也，以阳为主，故左转顺阳为之补，右转逆阳为之泻。女子生于申─申，阴也，以阴为主，故右转顺阴为之补，左转逆阴为之泻，这是常法。然而病有阴阳热之不同，则转针取用出入，当适其所宜。假令病热，则刺阳之经，以右为泻，以左为补；病寒则刺阴之经，以右为补，左为泻。这是用阴和阳，用阳和阴，通变之法。大凡转针逆顺之道，应当明白于此。
子（合）穴：尺盛补之，顺其入也。午（荥）穴：寸盛泻之，顺其出也。
问：针头补泻如何？
回答说：这是补泻的常法。不在呼吸而在手指，当刺之时，必先以左手压按其所针荣俞之处，弹而努之，爪而下之，其气之来，如动脉之状，顺针而刺之，得气推而内之，是谓补。动而伸之，是谓泻。夫实者气入也，虚者气出也。以阳生于外故入，阴生于内故出，这是阴阳水火出入之气所不同，应当详察。
此外有补针导气之法，所谓扪而循之者，是在所刺经络部分，上下循之，所以令气血舒缓，易得往来也。切而散之者，是用大指爪甲，左右于穴切之，腠理开舒，然后针也。推而按之者，是用右指捻针按住，近气不失，则远气乃来也。弹而努之者，是用指甲弹针，令脉气满，而得疾行至于病所也。爪而下之者，是用左手指爪连甲，按定针穴，乃使气散而刺荣，使血散而刺卫，则置针各有准也。通而取之者，是持针进退，或转或停，以使血气往来，远近相通，而后病可取也。外引其门以闭其神者，是先用左指收合针孔，乃放针，则经气不泄也。所以说：知为针者信其左。
问：候气的方法如何？
回答说：用针之法，候气为先，须用左指，闭其穴门，心无内慕，如待贵人，伏如横弩，起若发机；若气不至，或虽至如慢，然后转针取之。转针之法，令患人吸气，先左转针，不至，左右一提也。更不至者，用男内女外之法，男即轻手按穴，谨守勿内；女即重手按穴，坚拒勿出，所以然者，持针居内是阴部，持针居外是阳部，浅深不同，左手按穴，是要分明。只以得气为度，如此而终不至者，不可治也。若针下气至，当察其邪正，分其虚实。经言：邪气来者紧而疾，谷气来者徐而和，但濡虚者即是虚，但牢实者即是实。这是诀要。
问：呼吸的道理。
回答说：这是调和阴阳的方法。所以经文说：呼者因阳出，吸者随阴入。虽然呼吸分阴阳，实则由一气而为体，其气内历于五脏，外随于三焦，周布一身，循环经络，流注孔穴，顺其形气之方圆，然后为用不同耳。因此五脏之出入，以应四时。三焦之升降，而为营卫。经脉之循环，以合天度。然而呼吸出入，乃造化之枢纽，人身之关楗，针家所必用也。诸阳浅在经络，诸阴深在脏腑，补泻皆取呼吸，出内其针。盖呼则出其气，吸则入其气。欲补之时，气出针入，气入针出。欲泻之时，气入入针，气出出针。呼而不过三口，是外随三焦之阳。吸而不过五口，是内迎五脏之阴。先呼而后吸者，为阳中之阴；先吸而后呼者，为阴中之阳，乃各随其病气，阴阳寒热而用之，是为活法，不可误用也。
三阴之经：先吸后呼。三阳之经：先呼后吸。
问：迎随的道理如何？
回答说：这是针下予夺的机理。
第一要知道营卫的流行。所谓诸阳之经，行于脉外；诸阳之络，行于脉内；诸阴之经，行于脉内；诸阴之络，行于脉外，各有浅深。立针以一分为荣，二分为卫，交互停针，以候其气，见气方至，速便退针引之，即是迎。见气已过，然后进针追之，即是随。所以《刺法》说：动退空歇，迎夺右而泻凉，推内进搓，随济左而补暖。
第二要知道经脉的往来。所谓足之三阳，从头走足；足之三阴，从足走腹；手之三阴，从胸走手；手之三阳，从手走头。得气以针头逆其经脉之所来，动而伸之即是迎。以针头顺其经脉之所往，推而内之即是随。所以经文说：实者，绝而止之；虚者，引而起之。
凡下针之法，先用左手，揣穴爪按，令血气开舒，乃可内针。若欲出血，勿以爪按。右手持针于穴上，令患人咳嗽一声，拈之，一左一右，透入于腠理，此即是阳部奇分。《刺要》说：一分为荣。又说：方刺之时，必在悬阳，然后用其呼吸，徐徐推之，至于肌肉，以及分寸，此二者，即是阴部偶分。《刺要》又说：二分为卫，方刺之时，必在悬阳，及与两卫，神属勿去，知病存亡。却以左手按穴令定，象地而不动；右手持针，法天之运转。若得其气，左手按穴可重五两以来，右手存意捻针，而行补泻。惟血脉在俞横居，视之独澄，切之独坚，凡刺脉者，随其顺逆，不出血，则发针疾按之。凡刺浅深，惊针则止。凡行补泻谷气
问：疾徐的道理。
回答说：这是持针出入的方法。所以经文说：刺虚实者，徐而疾则实，疾而徐则虚。然而此经有两解：所谓徐而疾者，一作徐内而疾出；一作徐出针而疾按之。所谓疾而徐者，一作疾内而徐出；一作疾出针而徐按之（两说皆通）。盖疾徐二字，一解作缓急之义，一解作久速之义，若夫不虚不实，出针入针之法，则亦不疾不徐，配乎其中可也。
问：补泻得宜。
回答说：大略补泻无逾三法。
一则诊其脉之动静。假令脉急者，深内而久留之；脉缓者，浅内而疾发针；脉大者，微出其气；脉滑者，疾发针而浅内之；脉涩者，必得其脉，随其逆顺久留之，必先按而循之，已发针疾按其穴，勿出其血；脉小者，饮之以药。
二则随其病之寒热。假令恶寒者，先令得阳气入阴之分，次乃转针退到阳分，令患人鼻吸口呼，谨按生成气息数足，阴气隆至，针下觉寒，其人自清凉矣。又有病道远者，必先使气直到病所，寒即进针少许，热即退针少许，然后却用生成息数治之。
三则随其诊之虚实。假令形有肥有瘦，身有痛有麻痒，病作有盛有衰，穴下有牢有濡，皆虚实之诊也。若在病所，用别法取之，转针向上气自上，转针向下气自下，转针向左气自左，转针向右气自右，徐推其针气自往，微引其针气自来，所谓推之则前，引之则止，徐往微来以除之，是皆欲攻其邪气而已矣。
问：自取其经。
回答说：刺虚刺实，当用迎随，补其母而泻其子，若不虚不实者，则当以经取，谓其正经自得病，不中他邪，故自取其经也。其法右手存意持针，左手候其穴中之气，若气来至如动脉状，乃内针，要续续而入，徐徐而撞，入荣至卫，至若得气如鲔鱼食钩，即是病之气也，则随本经气血多少，酌量取之，略待少许，见气尽乃出针；如未尽，留针在门，然后出针。
经文说：有见如入，有见如出，此之谓也。
问：补者从卫取气，泻者从荣置气？
回答说：十二经脉，皆以荣为根本，卫为枝叶，故欲治经脉，须调营卫，欲调营卫，须假呼吸。经文说：卫者阳也，荣者阴也。呼者阳也，吸者阴也。呼尽内针，静以久留，以气至为故者，即是取气于卫。吸则内针，以得气为故者，即是置气于荣也。
问：皮肉筋骨脉病。
回答说：百病所起，皆始于营卫，然后淫于皮肉筋脉，所以经文说：是动脉者，气也。所生病者，血也。先为是动，而后所生病也。由此推之，则知皮肉经脉，亦是后所生之病耳。是以刺法中但举营卫，盖取营卫逆顺，则皮骨肉筋之治在其中矣。以此思之，至于部分有浅深之不同，却要下针无过不及为妙也。
一曰皮肤，二曰肌肉，三曰筋骨。
问：刺有久速。
回答说：这是衡量病情轻重而行，轻者一补一泻足矣，重者至再至三也。假令得病气而补泻之，其病未尽，仍复停针，候气再至，又行补泻。经文说：刺虚须其实，刺实须其虚也。
问：诸家刺齐异同。
回答说：《灵枢》所言：始刺浅之，以逐邪气，而来血气（谓绝皮以出阳邪也）。后刺深之，以致阴气之邪（谓阴邪出者少，益深绝皮，致肌肉未入分肉间也）。最后取刺极深之，以下谷气（谓已入分肉之间，则谷气出矣），这是它的旨意。我读《难经》，常见针师丁德用所注，乃言人之肌肉，皆有浓薄之处，但皮肤之上，为心肺之部，阳气所行；肌肉之下，为肝肾之部，阴气所行也。是说所以发挥《灵枢》之旨，却甚详明。至于孙氏《千金方》所言：针入一
Heaven One generates Water, Earth Six completes it. Earth Two generates Fire, Heaven Seven completes it. Heaven Three generates Wood, Earth Eight completes it. Earth Four generates Metal, Heaven Nine completes it. Heaven Five generates Earth, Earth Ten completes it.
Question: There are the Eight Extraordinary Vessels among the meridians.
The Nan Jing (Classic of Difficult Issues) states: "There are the Eight Extraordinary Vessels among the pulses, which are not restricted to the Twelve Regular Meridians." What does this mean? The answer is: There are the Yang Linking Vessel (Yangwei Mai), Yin Linking Vessel (Yinwei Mai), Yang Heel Vessel (Yangqiao Mai), Yin Heel Vessel (Yinqiao Mai), Chong Vessel (Chong Mai), Ren Vessel (Ren Mai), Du Vessel (Du Mai), and Dai Vessel (Dai Mai). These eight vessels are all unrestricted by the regular meridians, hence they are called the Eight Extraordinary Vessels. There are twelve regular meridians and fifteen collaterals, totaling twenty-seven, with Qi following each other up and down. Why are these specifically unrestricted by the regular meridians? The answer is: The sages planned and dug canals to facilitate water flow, preparing for unforeseen circumstances. When rain falls from heaven and the canals overflow, at that time, the waters flood wildly, and even the sages cannot redraw the plans. This is like the collaterals becoming full and overflowing; the various regular meridians can no longer restrain them.
Question: The method of Following and Opposing (Yingsui).
The Classic states: "Following and assisting is tonification; opposing and draining is sedation." When performing acupuncture, one should first warm the needle with a leather pad, then further warm it with the mouth. Using the left hand's fingernail, press upon the Ying-Spring or Shu-Stream acupoint to be needled, flick it to make it bulge, cut into it with the nail, then palpate and stroke along the meridian to unblock and obtain the point. Ask the patient to cough once, then insert the needle with the right hand. In spring and summer, perform twenty-four breaths (Xi), inserting deeply first and shallowly later (the reason for depth variation is noted in the commentary of Biao You Fu); in autumn and winter, perform thirty-six breaths, inserting shallowly first and deeply later. Insert slowly until the arrival of Deqi feels like a pulsating artery, with the needle feeling light and smooth under the skin. If Deqi has not arrived, it is like a fish that has not yet swallowed the hook; once the fish has swallowed and Deqi is obtained, apply tonification or sedation. For tonification, follow the direction of the meridian, push and press the needle inward, leave it stationary for a period, slightly longer. To withdraw, close the acupoint with the left hand, withdraw the needle slowly, and press quickly. For sedation, oppose the direction of the meridian, lift and extend the needle, leave it stationary for a while. To withdraw, open the acupoint with the left hand, withdraw the needle quickly, and press slowly. For tonification needles, rotate left and thrust the thumb outward; for sedation needles, rotate right and retract the thumb. Tonification follows exhalation then inhalation; sedation follows inhalation then exhalation. Pain indicates the need for sedation; itching and numbness indicate the need for tonification.
Question: The essential method for tonification needles.
The answer is: For the method of tonification needles, use the left hand to firmly press the cross-grain lines of the acupoint. Hold the needle with the right hand above the point. Ask the patient to cough once, and advance the needle with the cough. Take a long exhalation and insert the needle three fen into the skin. For needling hand meridians, emulate spring and summer by pausing for twenty-four breaths. For foot meridians, emulate autumn and winter by pausing for thirty-six breaths. When promoting Qi, if the needle feels heavy and tight, perform the number of Nine Yang: twist nine times and jerk nine times, termed "Heavenly Talent" (Tian Cai). Pause briefly, exhale twice, and slowly insert another three fen into the muscle. When the breath count is sufficient and the needle feels heavy and tight again, perform the generating numbers, termed "Human Talent" (Ren Cai). Pause briefly, exhale three times, and slowly insert another three fen between the sinew and bone. When the breath count is sufficient and the needle feels heavy and slippery again, perform the generating numbers, termed "Earthly Talent" (Di Cai). Advance the needle by the distance of a bean, called "Pressing" (An), which is intercepting and following. This is the extreme depth. Leave it still for a long time, then withdraw the needle to the Human level (Ren Bu). Wait until the Qi feels heavy and tight again, turn the needle head towards the disease site. When the patient feels heat under the needle, and the deficiency, emaciation, itching, and numbness dissipate, and the pathogenic trend recedes, after the needle feels slightly heavy under the skin, turn the needle head upward, advance it by a bean's distance, move and pause it, and remove it during inhalation. Withdraw slowly and insert slowly, and quickly cover the acupoint. Qibo said: "Insertion of the needle should be slow; too fast injures Blood. Withdrawal should be slow; too fast injures Qi." This precisely means that the needle does not injure Ying and Wei. Thus, advancing and retreating, flying through meridians and moving Qi, are all contained herein.
Question: The essential method for sedation needles.
For the method of sedation needles, use the left hand to firmly press the longitudinal grain lines three times. Hold the needle with the right hand above the point. Ask the patient to cough once, and advance the needle with the cough. Insert three fen, reaching the Heaven level (Tian Bu). Pause briefly and insert straight to the Earth level (Di Bu). Retract the needle by a bean's distance. When Deqi feels heavy and tight,搓 (rub) and twist without movement. When the breath count is complete, perform the number of Six Yin: twist six times and jerk six times. Inhale three times to draw back the needle, withdrawing to the Human level (Ren Bu), termed "Earthly Talent" (Di Cai). Wait again until Qi arrives and the needle feels heavy. When the breath count is sufficient, perform the completing numbers. Inhale twice to draw back the needle, withdrawing to the Heaven level (Tian Bu), termed "Human Talent" (Ren Cai). Wait again until Qi arrives and the needle feels heavy. When the breath count is sufficient, perform the completing numbers. Inhale to draw back the needle, withdrawing to the skin layer, termed "Heavenly Talent" (Tian Cai). Retract the needle by a bean's distance, called "Lifting" (Ti), which is supporting and opposing. This is the extreme depth. Leave it still for a long time, then advance to the Human level. Wait until the needle feels heavy and tight and Qi arrives. Turn the needle head towards the disease site. When the patient feels cold under the needle, and cold, heat, pain, and itching recede, and the needle feels slightly loose, lift the needle by a bean's distance, shake and pause it, and remove it during exhalation. Insert quickly and withdraw slowly, leaving the acupoint open.
Question: Meridians and Collaterals.
The answer is: There are twelve meridians and fifteen collaterals, distributed over the whole body, serving as the pathways for Qi and Blood. Their source roots internally in the Kidney, which is the root of life. The root is internal but spreads externally, just as a tree has roots; if the roots are injured, the branches and leaves will also suffer. If pathogenic factors invade from outside and injure the branches and leaves, they will also affect the roots. If the disease originates internally, the situation is inevitable. Therefore, it is said that the pathways of the Zang organs all emerge from the meridians and collaterals to circulate Qi and Blood. The Jing are the regular meridians, and the Luo are the branch collaterals. When Qi and Blood are disharmonious, myriad diseases arise. If the Essence and Qi of one meridian are insufficient, disharmony occurs. Thus, the Classic states: "When pathogenic factors strike the Yang, they flow into the meridians. From the face and neck, they descend to the Yangming; from the nape and back, they descend to the Taiyang; from the cheeks and flanks, they descend to the Shaoyang." When pathogenic factors strike the Yin, they flow into the Fu organs. Starting from the four extremities and arms, they enter the Three Yin. Since the Zang Qi is solid and cannot accommodate them, they return to the Fu organs. Fu organs refer to the Gallbladder, Stomach, Bladder, Large Intestine, and Small Intestine. Therefore, needling has its specific pathways. Observe the pathogenic and healthy states, excess and deficiency under the needle to apply tonification and sedation. Follow the Ying and Wei of the meridians to apply Following and Opposing methods; these paths do not deviate. All internal and external diseases begin in the skin and blood vessels, transmit through the meridians, connect internally to the Zang and Fu organs, causing blockage in the four limbs and nine orifices. Internal causes lead to Qi excess or deficiency, connecting externally to the meridians, causing shifts in Ying and Wei, and generating excess and deficiency in the upper, lower, left, and right. The Classic says: "Wind and Cold injure the Form; Worry, Fear, Anger, and Resentment injure Qi. Qi injury affects the Zang, resulting in Zang disease. Cold injury affects the Form, resulting in Form disease. Wind injury affects the Sinews, resulting in Sinew disease." Thus, both Form and Qi possess Yin and Yang internally and externally: Bones and Sinews are Yin, Skin and Flesh are Yang. Internally: Zang organs are Yin, Fu organs are Yang.
Question: Zi-Wu Tonification and Sedation.
The answer is: This is a method to promote the circulation of Ying and Wei. Turning left follows Zi (Rat), enabling the circulation of Yang in the exterior; turning right follows Wu (Horse), enabling the circulation of Yin in the interior. In the human body, Yang Qi is received in the four extremities, and Yin Qi is received in the Zang organs; thus, it is Yang on the outside and Yin on the inside. Turning left from the outside resembles Heaven; turning right from the inside resembles Earth; lifting from the middle resembles Man. One left, one right, one lift, allows the Qi of Yin-Yang and interior-exterior to enter, exit, and interact with the upper and lower, so that Ying and Wei circulate freely. Men are born in Yin (Tiger)—Yin is Yang, governed by Yang. Therefore, turning left follows Yang for tonification, and turning right opposes Yang for sedation. Women are born in Shen (Monkey)—Shen is Yin, governed by Yin. Therefore, turning right follows Yin for tonification, and turning left opposes Yin for sedation. This is the standard method. However, diseases differ in Yin-Yang and Heat/Cold, so turning the needle, selecting points, and entering/exiting must be appropriate. For example, in Heat diseases, needle the Yang meridians, using right rotation for sedation and left for tonification; in Cold diseases, needle the Yin meridians, using right for tonification and left for sedation. This is using Yin to harmonize Yang, and Yang to harmonize Yin, a method of adaptation. Generally, the principles of reversing and following in needle rotation must be understood here.
Zi (He-Sea) Point: If the Chi pulse is full, tonify, following its entry. Wu (Ying-Spring) Point: If the Cun pulse is full, sedate, following its exit.
Question: How about needle-head tonification and sedation?
The answer is: This is the standard method of tonification and sedation. It lies not in respiration but in the fingers. At the time of needling, first press and hold the Ying-Spring or Shu-Stream point with the left hand, flick it to make it bulge, cut with the nail. When the Qi arrives, resembling a pulsating artery, insert the needle smoothly. Upon obtaining Deqi, push the needle inward; this is tonification. Move and extend the needle; this is sedation. Excess involves Qi entering; deficiency involves Qi exiting. Because Yang is generated externally, it enters; because Yin is generated internally, it exits. This is due to the different nature of Qi entering and exiting from Yin-Yang and Water-Fire. Careful observation is required.
Additionally, there is a method of guiding Qi for tonification needles. "Palpating and stroking" means stroking up and down along the needled meridian segment to soothe Qi and Blood, facilitating their movement. "Cutting and dispersing" means using the thumbnail to cut左右 (left and right) around the acupoint to open the interstices before needling. "Pushing and pressing" means twisting and holding the needle with the right finger so that nearby Qi is not lost, allowing distant Qi to arrive. "Flicking to make bulge" means flicking the needle with the fingernail to fill the vessel Qi, allowing it to travel swiftly to the disease site. "Cutting down with the nail" means using the left hand's nail to fix the acupoint, dispersing Qi to needle Ying, and dispersing Blood to needle Wei, ensuring precise placement. "Unblocking to obtain" means advancing, retreating, rotating, or pausing the needle to allow Qi and Blood to circulate and connect near and far, so the disease can be treated. "Externally closing the gate to calm the Spirit" means using the left finger to close the needle hole before withdrawing, preventing the leakage of Meridian Qi. Hence it is said: "One who knows needling trusts the left hand."
Question: How is the method of waiting for Qi?
The answer is: In needling, waiting for Qi is paramount. Use the left hand to close the acupoint gate. Keep the mind free from distraction, awaiting the Qi like a noble guest, lying in wait like a crossbow, and striking like releasing the trigger. If Qi does not arrive, or arrives slowly, then rotate the needle to elicit it. The method of rotating the needle: ask the patient to inhale, then rotate the needle left. If it does not arrive, lift and pull left and right. If it still does not arrive, use the method of "Male Inside, Female Outside": for males, lightly press the acupoint and guard it strictly without inserting; for females, press heavily and firmly reject without withdrawing. The reason is that holding the needle inside is Yin, holding it outside is Yang, and depths differ. Pressing with the left hand clarifies this. Only aim for obtaining Deqi. If it still does not arrive despite this, it is untreatable. If Qi arrives under the needle, observe whether it is pathogenic or healthy, and distinguish excess and deficiency. The Classic says: "Pathogenic Qi arrives tight and rapid; Grain Qi arrives slow and harmonious. If soft and deficient, it is deficiency; if firm and solid, it is excess." This is the secret.
Question: The principle of respiration.
The answer is: This is the method of harmonizing Yin and Yang. The Classic says: "Exhalation is due to Yang exiting; inhalation follows Yin entering." Although respiration divides Yin and Yang, it is actually one Qi as the substance. This Qi traverses the five Zang organs internally, follows the San Jiao externally, distributes throughout the body, circulates through meridians, and flows into acupoints. Depending on the square/circular nature of Form and Qi, its application differs. Thus, the entry and exit of the five Zang correspond to the four seasons. The ascending and descending of the San Jiao constitute Ying and Wei. The circulation of meridians conforms to heavenly measures. Therefore, respiration and entry/exit are the hub of creation and the key of the human body, essential for acupuncturists. Yang meridians are shallow in the meridians; Yin meridians are deep in the Zang organs. Tonification and sedation both utilize respiration for needle insertion and withdrawal. Exhalation releases Qi; inhalation admits Qi. For tonification, when Qi exits, insert the needle; when Qi enters, withdraw the needle. For sedation, when Qi enters, insert the needle; when Qi exits, withdraw the needle. Exhalation should not exceed three breaths, following the Yang of the San Jiao externally. Inhalation should not exceed five breaths, welcoming the Yin of the five Zang internally. Exhaling first then inhaling is Yin within Yang; inhaling first then exhaling is Yang within Yin. Apply these according to the pathogenic Qi, Yin-Yang, and Cold-Heat of the disease. This is the flexible method and must not be misused.
Three Yin Meridians: Inhale first, then exhale. Three Yang Meridians: Exhale first, then inhale.
Question: What is the principle of Following and Opposing?
The answer is: This is the mechanism of giving and taking under the needle.
First, know the circulation of Ying and Wei. The Yang meridians run outside the vessels; the Yang collaterals run inside the vessels; the Yin meridians run inside the vessels; the Yin collaterals run outside the vessels. Each has its depth. Establish the needle at one fen for Ying and two fen for Wei. Alternate pausing to await Qi. When Qi is just arriving, quickly withdraw and pull the needle; this is Opposing (Ying). When Qi has passed, then advance the needle to chase it; this is Following (Sui). Thus, the Ci Fa (Needling Method) states: "Move back and rest, oppose and drain with right rotation for cooling; push in and rub, follow and assist with left rotation for warming."
Second, know the direction of the meridians. The Three Yang of the Foot go from Head to Foot; the Three Yin of the Foot go from Foot to Abdomen; the Three Yin of the Hand go from Chest to Hand; the Three Yang of the Hand go from Hand to Head. Upon obtaining Deqi, oppose the direction of the meridian's origin with the needle head, move and extend it; this is Opposing. Follow the direction of the meridian's destination with the needle head, push and insert it; this is Following. Thus, the Classic states: "For excess, stop and cut off; for deficiency, guide and raise."
For all needling methods, first use the left hand to palpate the acupoint and press with nails to open and soothe Qi and Blood, then insert the needle. If bleeding is desired, do not press with nails. Hold the needle with the right hand above the acupoint. Ask the patient to cough once, flick the needle, alternating left and right, penetrating into the interstices. This is the odd division of the Yang level. The Ci Yao states: "One fen is Ying." It also states: "At the time of needling, focus on the suspended Yang, then use respiration, slowly pushing to the muscle and beyond. These two are the even division of the Yin level." The Ci Yao further states: "Two fen is Wei. At the time of needling, focus on the suspended Yang and the two Weis. Do not let your spirit wander; know the survival or death of the disease." Then fix the acupoint with the left hand, immovable like Earth; hold the needle with the right hand, moving like Heaven. If Qi is obtained, the left hand pressing the acupoint can weigh five liang or more. Concentrate with the right hand to twist the needle and perform tonification/sedation. Only when blood vessels lie horizontally at the Shu point, appearing clear and feeling hard upon palpation, should one needle the vessel. Follow its direction, avoid bleeding, and if the needle is withdrawn, press quickly. For shallow or deep needling, fear of the needle stops the procedure. For performing tonification/sedation and Grain Qi...
Question: The principle of Slow and Fast.
The answer is: This is the method of holding and inserting/withdrawing the needle. The Classic states: "For needling excess and deficiency, slow insertion and fast withdrawal results in Repletion (Shi); fast insertion and slow withdrawal results in Emptiness (Xu)." However, this Classic has two interpretations: "Slow insertion and fast withdrawal" means either slow insertion and fast withdrawal, or slow withdrawal and fast pressing. "Fast insertion and slow withdrawal" means either fast insertion and slow withdrawal, or fast withdrawal and slow pressing (both interpretations are valid). The terms "Fast" and "Slow" can mean either urgency/slowness or duration/shortness. For cases that are neither excess nor deficiency, the method of inserting and withdrawing the needle should be neither fast nor slow, balanced in the middle.
Question: Appropriateness of Tonification and Sedation.
The answer is: Broadly, tonification and sedation do not exceed three methods.
First, diagnose the movement and stillness of the pulse. If the pulse is tense, insert deeply and retain for a long time; if loose, insert shallowly and withdraw quickly; if large, slightly release Qi; if slippery, withdraw quickly and insert shallowly; if choppy, ensure you have the pulse, follow its direction, retain for a long time, first press and stroke, after withdrawing press the acupoint quickly, do not bleed; if small, administer medicine.
Second, follow the Cold and Heat of the disease. For chills, first allow Yang Qi to enter the Yin portion, then rotate the needle back to the Yang portion. Ask the patient to inhale through the nose and exhale through the mouth. Strictly adhere to the generating/completing breath counts. When Yin Qi arrives abundantly, the needle feels cold, and the patient feels cool. For diseases far away, first guide Qi directly to the disease site. For Cold, advance the needle slightly; for Heat, withdraw the needle slightly, then treat using the generating/completing breath counts.
Third, follow the Excess and Deficiency diagnosed. Fat and thin bodies, pain, numbness, and itching, fluctuating severity of disease, firm and soft sensations under the acupoint—all are diagnoses of excess and deficiency. At the disease site, use other methods to obtain Qi: turning the needle up makes Qi rise; down makes Qi descend; left makes Qi go left; right makes Qi go right. Slowly pushing the needle makes Qi go forward; slightly pulling the needle makes Qi come. As stated, "Pushing advances, pulling stops, slowly going and slightly coming eliminates it." All these aim to attack pathogenic Qi.
Question: Selecting the Self Meridian.
The answer is: For needling deficiency and excess, use Following and Opposing, tonify the Mother, and sedate the Child. If neither deficient nor excess, select the Self Meridian, meaning the regular meridian itself has contracted the disease without invasion from other pathogens, hence selecting its own meridian. The method: Concentrate with the right hand holding the needle, use the left hand to await Qi in the acupoint. If Qi arrives like a pulsating artery, insert the needle, entering continuously and slowly bumping, entering Ying and reaching Wei. When Deqi feels like a tuna swallowing a hook, this is the Qi of the disease. Then, according to the amount of Qi and Blood in the original meridian, measure and select. Wait briefly, and when Qi is exhausted, withdraw the needle. If not exhausted, retain the needle at the gate, then withdraw.
The Classic says: "Enter when seen, exit when seen," this is what is meant.
Question: Tonification takes Qi from Wei, Sedation places Qi in Ying?
The answer is: The twelve meridians all take Ying as the root and Wei as the branches. To treat meridians, one must regulate Ying and Wei. To regulate Ying and Wei, one must rely on respiration. The Classic states: "Wei is Yang, Ying is Yin. Exhalation is Yang, Inhalation is Yin." Withdrawing the needle completely, leaving it still for a long time until Qi arrives, is taking Qi from Wei. Inserting the needle during inhalation until Deqi is obtained, is placing Qi in Ying.
Question: Diseases of Skin, Flesh, Sinew, Bone, and Vessel.
The answer is: The origins of all diseases begin in Ying and Wei, then spread to skin, flesh, sinew, and vessels. Thus, the Classic states: "Is Dong (Moving) refers to Qi. Suo Sheng Bing (Diseases Produced) refers to Blood. First comes Is Dong, then comes Suo Sheng Bing." From this, we know that diseases of skin, flesh, and vessels are also later-produced diseases. Therefore, in needling methods, only Ying and Wei are mentioned, implying that by understanding the reversal and following of Ying and Wei, the treatment of skin, flesh, bone, and sinew is included. Considering this, although parts have different depths, the妙 (wonder) lies in needling without excess or deficiency.
One is Skin, two is Muscle, three is Sinew and Bone.
Question: Duration and Speed of Needling.
The answer is: This is performed according to the severity of the disease. For mild cases, one tonification and one sedation suffice; for severe cases, repeat two or three times. If after tonifying and sedating the pathogenic Qi, the disease is not fully resolved, retain the needle, await Qi to arrive again, and perform tonification/sedation again. The Classic states: "Needling deficiency requires achieving Repletion; needling excess requires achieving Emptiness."
Question: Similarities and Differences in Needling Depths Among Various Schools.
The answer is: The Ling Shu states: "First needle shallowly to expel pathogenic Qi and attract Blood and Qi (meaning piercing the skin to expel Yang pathogenic factors). Then needle deeply to attract Yin pathogenic Qi (meaning few Yin pathogenic factors exit; pierce deeper through the skin, reaching the muscle but not entering the space between muscles). Finally, needle extremely deeply to bring out Grain Qi (meaning having entered the space between muscles, Grain Qi emerges)." This is its purport. I read the Nan Jing and often see the commentary by Acupuncturist Ding Deyong, who states that human muscles have varying thicknesses. Above the skin is the region of Heart and Lung, where Yang Qi travels; below the muscle is the region of Liver and Kidney, where Yin Qi travels. This explanation elaborates on the purport of the Ling Shu and is very detailed. As for Sun Simiao's Qian Jin Fang stating: "Needle insertion one..."