黄帝问曰∶四时之气，各不同形，百病之起，皆有所生，灸刺之道，何者为宝？岐伯对
曰∶四时之气，各有所在，灸刺之道，气穴为宝。
故春刺络脉诸荥大经分肉之间，甚者深取之，间者浅取之。《素问》曰∶春刺散俞，
及与分理，血出而止。又曰∶春者木始治，肝气始生，肝气急，其风疾，经脉常深，萁气少
不能深入，故取络脉分肉之间。《九卷》云春刺荥者正同，于义为是。又曰∶春取络脉治
皮肤。又曰∶春取经与脉分肉之间。二者义亦略同。又曰∶春气在经脉。
夏取诸俞孙络肌肉皮肤之上。又曰∶春刺俞。二者正同，于义为是。长夏刺经。又曰
∶取盛经孙络，取分间，绝皮肤。又曰∶夏取分腠，治肌肉。义亦略同。《素问》曰∶夏刺
络俞，见血而止。又曰∶夏者火始治，心气始长，脉瘦气弱，阳气流（一作留）溢，血温于腠
，内至于经，故取盛经分腠，绝肤而病去者，邪居浅也。所谓盛经者，阳脉也。义亦略同。
又曰∶夏气在孙络，长夏气在肌肉。
秋刺诸合，余如春法。秋取经俞，邪气在府，取之于合。素问曰∶秋刺皮肤循理，
上下同法。又曰∶秋者金始治，肺将收杀，金将胜火，阳气在合，阴初胜，湿气及体，阴
气未盛，未能深入，故取俞以泻阴邪，取合以虚阳邪，阳气始衰，故取于合。是谓始秋之治
变也。又曰∶秋气在肤，腠闭者是也。《九卷》又曰∶秋取气口，治筋脉。于义不同。
冬取井诸俞之分，欲深而留之。又曰∶冬取井荥。《素问》曰∶冬取俞窍，及于分理，
甚者直下，间者散下。俞窍与诸俞之分，义亦略同。又曰∶冬者水始治，肾方闭，阳气
衰少，阴气坚盛，巨阳伏沉，阳脉乃去，取井以下阴逆，取荥以通气（一云以实阳气）。曰
冬取井荥，春不鼽衄。是谓末冬之治变也。又曰∶冬气在骨髓。又曰∶冬刺井，病在脏取之
井。二者正同，于义为是。又曰∶冬取经俞治骨髓五脏。五脏则同，经俞有疑。
春刺夏分，脉乱气微，入淫骨髓，病不得愈，令人不嗜食，又且少气。春刺秋分，筋挛
逆气，环为咳嗽，病不愈，令人时惊，又且笑（一作哭）。春刺冬分，邪气着脏，令人腹胀，
病不愈，又且欲言语。
夏刺春分，病不愈，令人解堕。夏刺秋分，病不愈，令人心中闷，无言，惕惕如人将
捕之。夏刺冬分，病不愈令人少气，时欲怒。
秋刺春分，病不愈，令人惕然，欲有所为，起而忘之。秋刺夏分，病不愈，令人益嗜卧
，又且善梦（谓立秋之后）。秋刺冬分，病不愈，令人凄凄时寒。
冬刺春分，病不愈，令人欲卧不能眠，眠而有见（谓十二月中旬以前）。冬刺夏分，病不
愈，令人气上，发为诸痹。冬刺秋分，病不愈，令人善渴。
足之阳者，阴中之少阳也。足之阴者，阴中之太阴也。手之阳者，阳中之太阳也。手之
阴者，阳中之少阴也。
正月、二月、三月，人气在左，无刺左足之阳。
四月、五月、六月，人气在右，无刺右足之阳。
七月、八月、九月，人气在右，无刺右足之阳。
十月、十一月、十二月，人气在左，无刺左足之阴。
刺法曰∶无刺 之热，无刺漉漉之汗，无刺浑浑（音魂）之脉，无刺病与脉
相逆者。上工刺其未生者也。其次刺其未成者也，其次刺其已衰者也。下工刺其方袭者，与
其形之盛者，与其病之与脉相逆者也。故曰方其盛也，勿敢毁伤。刺其已衰，事必大昌。
故曰上工治未病，不治已病。大寒无刺，大温无凝，月生无泻，月满无补，月郭空无治。
新内无刺，已刺勿内。大怒无刺，已刺勿怒。大劳无刺，已刺勿劳。大醉无刺，已刺勿醉。
大饱无刺，已刺勿饱。大饥无刺，已刺勿饥。已渴勿刺，已刺勿渴。乘车来者，卧而休之，
如食顷乃刺之。步行来者，坐而休之，如行十里顷乃刺之。大惊大怒，必定其气，乃刺之。
凡禁者，脉乱气散，逆其荣卫，经气不次，因而刺之，则阳病入于阴，阴病出为阳，则
邪复生，粗工不察，是谓伐形；身体淫泺，反消骨髓，津液不化，脱其五味，是谓失气也。
曰∶愿闻刺浅深之分？曰∶刺骨者无伤筋，刺筋者无伤肉，刺肉者无伤脉，刺脉者无
伤皮，刺皮者无伤肉，刺肉者无伤筋，刺筋者无伤骨。曰∶余不知所谓，愿闻
其详？曰∶刺骨无伤筋者，针至筋而去，不及骨也。刺筋无伤肉者，至肉而去，不及筋也。
刺肉无伤脉者，至脉而去，不及肉也。刺脉无伤皮者，至皮而去，不及脉也。刺皮无伤肉者
，病在皮中，针入皮无中肉也。刺肉无伤筋者，过肉中筋，刺筋无伤骨者，过筋中骨，此之
谓反也。
刺中心，一日死，其动为噫。刺中肺，三日死，其动为咳。刺中肝，五日死，其动为欠
（《素问》作语）。刺中脾，十五日（《素问》作十日，一作五日）死，其动为吞。刺中肾，三
日（《素问》作六日，一作七日）死，其动为嚏。刺中胆，一日半死，其动为呕。刺中膈，为
伤中，其病虽愈，不过一岁必死。刺跗上中大脉，血出不止死。刺阴股中大脉，血出不止死
。刺面中流脉，不幸为盲。刺客主人，内陷中脉，为漏为聋。刺头中脑户，入脑立死。刺膝
膑出液为跛。
刺舌下中脉太过，出血不止为喑。刺肾中太阴脉出血多，立死。刺足下布络
中脉，血不出为肿。刺足少阴脉，重虚出血。为舌难以言。刺 中大脉，令人仆脱色。刺
膺中
。
浮上中乳房，为肿，根蚀。刺腋下胁间内陷，令人咳。刺缺盆中内陷气泄，令人喘咳逆。
刺少腹中膀胱，溺出，令人少腹满。刺手鱼腹内陷，为肿，刺 肠内陷，为肿。刺眶上陷
骨中脉为漏为盲。刺关节中液出，不得屈伸。
黄帝问道：四季的气候，各自有不同的形态，各种疾病的发生，都有其产生的原因。在艾灸和针刺的治疗原则中，什么是最为重要的？岐伯回答说：四季的气候，各有其所在的部位，在艾灸和针刺的原则中，以气穴（经络上的穴位）最为重要。
所以春季针刺应选取络脉、各荥穴（五输穴之一，主身热）、大经以及分肉之间。病情严重的深刺，病情轻浅的浅刺。《素问》说：春季针刺散俞穴（散布的腧穴），以及分理（肌肉纹理），出血即止。又说：春季是木气开始主令的时候，肝气开始生发，肝气急迫，风气疾速，经脉位置较深，而春气尚少不能深入，所以取络脉和分肉之间进行针刺。《九卷》（即《灵枢》）说春季针刺荥穴也是同样的道理，这在义理上是正确的。又说：春季取络脉治疗皮肤表层的病证。又说：春季取经穴和脉分肉之间。这两种说法义理大致相同。又说：春季的气机在经脉。
夏季取各俞穴（五输穴之一，主体重节痛）及孙络（细小的络脉），在肌肉和皮肤之上进行针刺。又说：春季针刺俞穴。这两种说法完全相同，在义理上是正确的。（注：此处原文“春刺俞”疑为“夏刺俞”之误，但依原文直译）。长夏季节针刺经穴。又说：取盛经（气血旺盛的经脉）和孙络，取分间，穿透皮肤。又说：夏季取分腠（肌肉间隙），治疗肌肉层面的病证。这两种说法义理大致相同。《素问》说：夏季针刺络俞，见血即止。又说：夏季是火气开始主令的时候，心气开始生长，脉道瘦弱，气力微弱，阳气流行溢出，血液温热于腠理，内达于经脉，所以取盛经和分腠，穿透皮肤使病邪去除，是因为邪气居处浅表。所谓盛经，是指阳脉。这两种说法义理大致相同。又说：夏季的气机在孙络，长夏的气机在肌肉。
秋季针刺各合穴（五输穴之一，主逆气而泄），其余方法如同春季。秋季取经穴和俞穴，如果邪气在腑，就取合穴进行治疗。《素问》说：秋季针刺皮肤，顺着纹理，上下治疗方法相同。又说：秋季是金气开始主令的时候，肺气将要收敛肃杀，金气将胜过火气，阳气汇聚于合穴，阴气初胜湿气及于体表，阴气尚未强盛，不能深入，所以取俞穴以泻除阴邪，取合穴以虚除阳邪，因为阳气开始衰退，所以取合穴。这叫做初秋治疗的变通之法。又说：秋季的气机在皮肤，腠理闭合就是这种情况。《九卷》又说：秋季取气口（寸口脉），治疗筋脉。这与上述义理不同。
冬季取井穴（五输穴之首，主心下满）和各俞穴的分部，想要深刺并留针。又说：冬季取井穴和荥穴。《素问》说：冬季取俞窍（俞穴的孔窍），以及分理，病情严重的直下深刺，病情轻浅的分散下针。俞窍与各俞之分，义理大致相同。又说：冬季是水气开始主令的时候，肾气方始闭藏，阳气衰少，阴气坚盛，巨阳（太阳经）伏沉，阳脉乃去，取井穴以下降阴逆之气，取荥穴以通气（一说以充实阳气）。说：冬季取井穴和荥穴，到了春季就不会发生鼻衄（流鼻血）。这叫做末冬治疗的变通之法。又说：冬季的气机在骨髓。又说：冬季针刺井穴，病在脏就取井穴。这两种说法完全相同，在义理上是正确的。又说：冬季取经穴和俞穴治疗骨髓和五脏。对于五脏来说是一样的，但对于经穴和俞穴则存在疑问。
如果在春季针刺了属于夏季的部位，会导致脉象紊乱、气息微弱，邪气侵入骨髓，疾病不能痊愈，使人食欲不振，并且气短。如果在春季针刺了属于秋季的部位，会导致筋脉拘挛、气机上逆，环绕咽喉形成咳嗽，疾病不能痊愈，使人时常惊恐，并且发笑（一说为哭）。如果在春季针刺了属于冬季的部位，会导致邪气附着于脏，使人腹胀，疾病不能痊愈，并且想说话。
如果在夏季针刺了属于春季的部位，疾病不能痊愈，使人懈怠无力。如果在夏季针刺了属于秋季的部位，疾病不能痊愈，使人心中烦闷，不能言语，惊恐不安好像有人要抓捕他一样。如果在夏季针刺了属于冬季的部位，疾病不能痊愈，使人气短，时常想要发怒。
如果在秋季针刺了属于春季的部位，疾病不能痊愈，使人惊惕不安，想做事情，但站起来就忘记了。如果在秋季针刺了属于夏季的部位，疾病不能痊愈，使人更加嗜睡，并且多梦（指立秋之后）。如果在秋季针刺了属于冬季的部位，疾病不能痊愈，使人凄凄寒冷。
如果在冬季针刺了属于春季的部位，疾病不能痊愈，使人想躺卧却不能入睡，睡着后会有幻觉（指十二月中旬以前）。如果在冬季针刺了属于夏季的部位，疾病不能痊愈，使人气机上逆，引发各种痹证。如果在冬季针刺了属于秋季的部位，疾病不能痊愈，使人容易口渴。
足部的阳经，是阴中的少阳。足部的阴经，是阴中的太阴。手部的阳经，是阳中的太阳。手部的阴经，是阳中的少阴。
正月、二月、三月，人气在左侧，不要针刺左足的阳经。
四月、五月、六月，人气在右侧，不要针刺右足的阳经。
七月、八月、九月，人气在右侧，不要针刺右足的阳经。
十月、十一月、十二月，人气在左侧，不要针刺左足的阴经。
针刺法说：高热时不要针刺，大汗淋漓时不要针刺，脉象浑混乱浊时不要针刺，病情与脉象相逆时不要针刺。高明的医生在疾病尚未发生时进行预防性针刺。其次是在疾病尚未形成时进行针刺。再次是在疾病已经衰退时进行针刺。低劣的医生却在邪气正袭扰人体、正气正盛、或者病情与脉象相逆的时候进行针刺。所以说，当邪气正盛时，不敢随意毁伤正气。在邪气已衰时进行针刺，事情必定大吉大利。所以说高明的医生治疗未病，不治疗已病。大寒天气不要针刺，大温天气不要凝滞（指不要过度补益导致气机壅滞），月亮初生时不要用泻法，月亮圆满时不要用补法，月亮亏缺时不要治疗。刚行房事后不要针刺，已针刺后不要行房事。大怒时不要针刺，已针刺后不要发怒。极度疲劳时不要针刺，已针刺后不要劳累。大醉时不要针刺，已针刺后不要醉酒。吃得太饱时不要针刺，已针刺后不要吃饱。极度饥饿时不要针刺，已针刺后不要饥饿。极度口渴时不要针刺，已针刺后不要喝水。乘车来就诊的人，让他躺下休息，大约一顿饭的时间后再进行针刺。步行来就诊的人，让他坐下休息，大约行走十里路所需的时间后再进行针刺。受到大惊或大怒刺激的人，必须等其气机安定后再进行针刺。
凡是禁忌的情况，如果脉象紊乱、气息散乱，违背了营卫的运行规律，导致经气次序错乱，此时如果进行针刺，那么阳病就会传入阴分，阴病就会传出变为阳病，这样邪气就会重新滋生。粗疏的医生不加考察，这叫做损伤形体；身体淫泺（倦怠无力），反而消耗骨髓，津液不化，脱失五味之精，这叫做失气。
有人说：希望听听针刺深浅的区别？回答说：刺骨的时候不要伤及筋，刺筋的时候不要伤及肉，刺肉的时候不要伤及脉，刺脉的时候不要伤及皮，刺皮的时候不要伤及肉，刺肉的时候不要伤及筋，刺筋的时候不要伤及骨。有人说：我不明白其中的含义，希望听您详细说明？回答说：刺骨而不伤筋，意思是针到达筋部就停止，没有达到骨部。刺筋而不伤肉，意思是针到达肉部就停止，没有达到筋部。刺肉而不伤脉，意思是针到达脉部就停止，没有达到肉部。刺脉而不伤皮，意思是针到达皮部就停止，没有达到脉部。刺皮而不伤肉，意思是病在皮中，针进入皮下没有触及肉部。刺肉而不伤筋，意思是穿过肉部到达筋部。刺筋而不伤骨，意思是穿过筋部到达骨部。这些叫做反常的错误操作。
针刺中心脏，一天后会死亡，其表现为嗳气。刺中肺脏，三天后会死亡，其表现为咳嗽。刺中肝脏，五天后会死亡，其表现为呵欠（《素问》作言语错乱）。刺中脾脏，十五天后会死亡（《素问》作十天，一说五天），其表现为吞咽动作。刺中肾脏，三天后会死亡（《素问》作六天，一说七天），其表现为打喷嚏。刺中胆腑，一天半后会死亡，其表现为呕吐。刺中膈膜，造成中焦损伤，虽然病看似痊愈，但不过一年必死。刺足背上的大动脉，出血不止会死亡。刺大腿内侧的大动脉，出血不止会死亡。刺面部流动的血脉，不幸会导致失明。刺客主人穴（上关穴），如果针头内陷刺入脉络，会导致耳漏和耳聋。刺头部脑户穴，如果进针过深入脑，立即死亡。刺膝盖髌骨部位，如果流出液体，会导致跛行。
刺舌下血脉太过，出血不止会导致失音。刺肾经太阴脉出血过多，立即死亡。刺足底分布的络脉中的血脉，如果血不出会导致肿胀。刺足少阴脉，如果是双重虚弱又出血，会导致舌头僵硬难以说话。刺髀关穴（股动脉）中大脉，使人跌倒面色苍白。刺胸膺部（胸部）。
刺乳房上方浮露的血管，会导致肿胀，根部腐蚀。刺腋下胁间内陷，会导致咳嗽。刺缺盆穴（锁骨上窝）中内陷，导致气泄，使人喘咳气逆。刺小腹中膀胱，导致小便排出，使人小腹胀满。刺手鱼际穴内陷，会导致肿胀。刺大肠穴内陷，会导致肿胀。刺眼眶上陷骨中的血脉，会导致眼漏和失明。刺关节中，如果液体流出，会导致关节不能屈伸。
Huangdi asked, saying: The qi of the four seasons each has a different form. The onset of myriad diseases all arises from specific causes. In the methods of moxibustion and acupuncture, what is considered the most precious principle? Qibo replied, saying: The qi of the four seasons each resides in specific locations. In the methods of moxibustion and acupuncture, the Qi points (acupoints on the meridians) are considered the most precious.
Therefore, in spring, acupuncture should target the collateral vessels (Luo Mai), the Ying-Spring points (Ying-Xue, one of the Five Shu points governing heat), the major meridians, and the spaces between muscles. For severe cases, deep insertion is used; for mild cases, shallow insertion is used. *Su Wen* states: In spring, needle the San-Shu points (dispersed acupoints) and the muscle fissures, stopping when bleeding occurs. It also states: Spring is when Wood qi begins to govern. Liver qi begins to generate. Liver qi becomes urgent, and wind qi moves swiftly. The meridians are located deeply, while the spring qi is insufficient to penetrate deeply. Therefore, one should select the collateral vessels and the spaces between muscles. *Jiu Juan* (i.e., *Ling Shu*) states that needling Ying-Spring points in spring follows the same principle, which is correct in theory. It further states: In spring, treat the collateral vessels to address skin-level disorders. It also states: In spring, select Jing-River points and the spaces between muscles and veins. These two statements have roughly similar meanings. It also states: The qi of spring resides in the main meridians.
In summer, select the Shu-Stream points and Sun-Luo vessels (fine collateral vessels) for needling above the muscles and skin. It also states: In spring [Note: Text likely implies Summer based on context], needle the Shu points. These two statements are identical and correct in theory. During the late summer season, needle the Jing-Emergent points. It also states: Select the Sheng-Jing (abundant qi-blood meridians) and Sun-Luo vessels, target the interstices, and pierce through the skin. It also states: In summer, target the Fen-Cou (muscle intervals) to treat disorders at the muscle level. These two statements have roughly similar meanings. *Su Wen* states: In summer, needle the Luo-Shu points, stopping when bleeding occurs. It also states: Summer is when Fire qi begins to govern. Heart qi begins to grow. The pulse channels are slender, and qi strength is weak. Yang qi flows and overflows; blood warms the Cou-Li (pores and interstices) and penetrates inward to the meridians. Therefore, one selects the Sheng-Jing and Fen-Cou, piercing the skin to expel the pathogen, because the pathogen resides superficially. The so-called Sheng-Jing refers to the Yang meridians. These two statements have roughly similar meanings. It also states: The qi of summer resides in the Sun-Luo vessels, and the qi of late summer resides in the muscles.
In autumn, needle the He-Sea points (one of the Five Shu points governing rebellious qi). The remaining methods are similar to those in spring. In autumn, select Jing-River and Shu-Stream points. If the pathogen is in the Fu organs, select the He-Sea points for treatment. *Su Wen* states: In autumn, needle the skin following the grain patterns, applying the same method above and below. It also states: Autumn is when Metal qi begins to govern. Lung qi begins to gather and肃 (purify). Metal qi will overcome Fire qi. Yang qi gathers in the He-Sea points. Yin qi initially prevails, and dampness affects the body. Yin qi is not yet strong and cannot penetrate deeply. Therefore, select Shu-Stream points to drain Yin pathogens, and select He-Sea points to empty Yang pathogens, because Yang qi is beginning to decline. Thus, one selects the He-Sea points. This is called the variation in treatment for early autumn. It also states: The qi of autumn resides in the skin, characterized by closed Cou-Li. *Jiu Juan* also states: In autumn, select the Qi-Kou (Cunkou pulse) to treat tendons and vessels. This differs in meaning from the above.
In winter, select the Jing-Well points (the first of the Five Shu points governing fullness below the heart) and the divisions of various Shu points. One should insert deeply and retain the needle. It also states: In winter, select Jing-Well and Ying-Spring points. *Su Wen* states: In winter, select the apertures of Shu points and the muscle fissures. For severe cases, insert directly and deeply; for mild cases, insert dispersively. The meaning of Shu apertures and the divisions of Shu points is roughly the same. It also states: Winter is when Water qi begins to govern. Kidney qi begins to close and store. Yang qi is weak and declining, while Yin qi is firm and abundant. Ju-Yang (Taiyang Meridian) sinks and hides. Yang meridians depart. Select Jing-Well points to descend rebellious Yin qi, and select Ying-Spring points to unblock qi (or to tonify Yang qi, according to another reading). It says: Selecting Jing-Well and Ying-Spring points in winter prevents nasal epistaxis (nosebleeds) in spring. This is called the variation in treatment for late winter. It also states: The qi of winter resides in the bone marrow. It also states: In winter, needle Jing-Well points; if the disease is in the Zang organs, select the Jing-Well points. These two statements are identical and correct in theory. It also states: In winter, select Jing-River and Shu-Stream points to treat bone marrow and the five Zang organs. Regarding the Zang organs, they are consistent; however, there is doubt regarding Jing-River and Shu-Stream points.
If one needles the areas corresponding to summer during spring, the pulse will become chaotic and qi weak. Pathogens will invade the bone marrow, the disease will not heal, appetite will be lost, and qi will be deficient. If one needles the areas corresponding to autumn during spring, tendons will spasm and qi will rebel. Coughing will encircle the throat. The disease will not heal, causing frequent fright and laughter (or crying, according to another reading). If one needles the areas corresponding to winter during spring, pathogens will adhere to the Zang organs, causing abdominal distension. The disease will not heal, and the patient will desire to speak.
If one needles the areas corresponding to spring during summer, the disease will not heal, causing lethargy and flaccidity. If one needles the areas corresponding to autumn during summer, the disease will not heal, causing chest oppression, muteness, and a sense of terror as if being pursued. If one needles the areas corresponding to winter during summer, the disease will not heal, causing qi deficiency and frequent anger.
If one needles the areas corresponding to spring during autumn, the disease will not heal, causing anxiety and restlessness. The patient may wish to act but forget upon standing. If one needles the areas corresponding to summer during autumn, the disease will not heal, causing increased somnolence and vivid dreaming (referring to after Liqiu/Start of Autumn). If one needles the areas corresponding to winter during autumn, the disease will not heal, causing shivering and chills.
If one needles the areas corresponding to spring during winter, the disease will not heal, causing insomnia despite the desire to lie down, with visual hallucinations during sleep (referring to before mid-December). If one needles the areas corresponding to summer during winter, the disease will not heal, causing rebellious qi and manifesting as various Bi syndromes. If one needles the areas corresponding to autumn during winter, the disease will not heal, causing excessive thirst.
The Yang meridians of the foot are Shaoyang within Yin. The Yin meridians of the foot are Taiyin within Yin. The Yang meridians of the hand are Taiyang within Yang. The Yin meridians of the hand are Shaoyin within Yang.
In the first, second, and third months, human qi resides in the left side; do not needle the Yang meridians of the left foot.
In the fourth, fifth, and sixth months, human qi resides in the right side; do not needle the Yang meridians of the right foot.
In the seventh, eighth, and ninth months, human qi resides in the right side; do not needle the Yang meridians of the right foot.
In the tenth, eleventh, and twelfth months, human qi resides in the left side; do not needle the Yin meridians of the left foot.
The needling method states: Do not needle when there is high fever. Do not needle when sweating profusely. Do not needle when the pulse is chaotic and turbid. Do not needle when the disease presentation contradicts the pulse. Superior physicians needle before the disease arises. Next best is to needle before the disease forms. Next is to needle after the disease has declined. Inferior physicians needle when the pathogen is actively attacking, when the constitution is robust, or when the disease contradicts the pulse. Therefore, it is said: When the pathogen is vigorous, do not harm the healthy qi. Needle when the pathogen has declined, and success is assured. Therefore, it is said: Superior physicians treat disease before it arises, not after it has formed. Do not needle in extreme cold. Do not use tonification in extreme warmth. Do not use draining methods when the moon is waxing. Do not use tonifying methods when the moon is full. Do not treat when the moon is new (waning). Do not needle immediately after sexual intercourse. Do not engage in intercourse after needling. Do not needle when extremely angry. Do not become angry after needling. Do not needle when extremely fatigued. Do not exert yourself after needling. Do not needle when extremely drunk. Do not drink alcohol after needling. Do not needle when overly full. Do not eat heavily after needling. Do not needle when extremely hungry. Do not starve after needling. Do not needle when extremely thirsty. Do not drink excessively after needling. For patients arriving by carriage, let them lie down and rest for about the time it takes to eat a meal before needling. For patients arriving on foot, let them sit and rest for about the time it takes to walk ten li before needling. For patients suffering from sudden fright or anger, stabilize their qi before needling.
All contraindications involve chaotic pulses and scattered qi, violating the circulation of Ying and Wei, and disrupting the order of Jing qi. If needled under these conditions, Yang diseases enter Yin, and Yin diseases emerge as Yang, causing pathogens to regenerate. Unskilled physicians fail to observe this, which is termed damaging the form. The body becomes flaccid and exhausted, bone marrow is consumed, fluids fail to transform, and the essence of the five flavors is depleted. This is termed loss of qi.
Someone asked: I wish to hear about the distinctions in needling depth. The response was: When needling bone, do not injure the tendon. When needling tendon, do not injure the flesh. When needling flesh, do not injure the vessel. When needling vessel, do not injure the skin. When needling skin, do not injure the flesh. When needling flesh, do not injure the tendon. When needling tendon, do not injure the bone. Someone asked: I do not understand what you mean; please explain in detail. The response was: Needling bone without injuring tendon means the needle reaches the tendon and stops, not penetrating to the bone. Needling tendon without injuring flesh means the needle reaches the flesh and stops, not penetrating to the tendon. Needling flesh without injuring vessel means the needle reaches the vessel and stops, not penetrating to the flesh. Needling vessel without injuring skin means the needle reaches the skin and stops, not penetrating to the vessel. Needling skin without injuring flesh means the pathology is in the skin; the needle enters the skin without reaching the flesh. Needling flesh without injuring tendon means passing through the flesh to reach the tendon. Needling tendon without injuring bone means passing through the tendon to reach the bone. These are referred to as errors of reversal.
Needling the heart results in death within one day, manifested by belching. Needling the lung results in death within three days, manifested by coughing. Needling the liver results in death within five days, manifested by yawning (*Su Wen* records as speech disturbances). Needling the spleen results in death within fifteen days (*Su Wen* records as ten days, or alternatively five days), manifested by swallowing movements. Needling the kidney results in death within three days (*Su Wen* records as six days, or alternatively seven days), manifested by sneezing. Needling the gallbladder results in death within one and a half days, manifested by vomiting. Needling the diaphragm causes injury to the middle jiao; although the illness may seem to resolve, death will occur within one year. Needling the large artery on the dorsum of the foot with uncontrolled hemorrhage leads to death. Needling the large artery in the medial thigh with uncontrolled hemorrhage leads to death. Needling flowing vessels in the face may unfortunately cause blindness. Needling the Keymaster point (Shangguan, GB19) with deep penetration into the vessel causes ear leakage and deafness. Needling the Brain House point (Naohu, GV17) with excessive depth entering the brain causes immediate death. Needling the knee patella region with effusion leads to limping.
Excessive needling of the sublingual vessels causing uncontrolled hemorrhage leads to aphonia. Excessive bleeding from the Taiyin vessel of the kidney meridian leads to immediate death. Needling the vessels in the network of collaterals on the sole of the foot without bleeding causes swelling. Needling the Foot Shaoyin meridian in a state of double deficiency with bleeding leads to tongue stiffness and difficulty speaking. Needling the large artery in the thigh causes collapse and pallor. Needling the chest wall (Ying Zhong).
Needling floating vessels above the breast causes swelling with root erosion. Needling the axilla and intercostal space with deep penetration causes coughing. Needling the Clavicle Fossa (Quepen, LI15) with deep penetration causes qi leakage, leading to wheezing, coughing, and rebellious qi. Needling the bladder in the lower abdomen causes urination and lower abdominal fullness. Deep penetration into the Fish Center (Yuji, LU10) on the hand causes swelling. Deep penetration into the Large Intestine area causes swelling. Needling the vessel in the supraorbital depression causes eye leakage and blindness. Needling the joint with effusion leads to inability to flex or extend.