病浅针深，内伤良肉，皮肤为痈。病深针浅，病气不泻，反为大脓。病小针大，气泄太
甚，
疾反为害。病大针小，气不泄泻，亦复为败。失针之宜大者泻，小者不移。病有浮沉，刺有
浅深，各至其理，无过其道。过之则肉伤，不及则生外壅，壅则邪从之。浅深不得，反为大
贼内动五脏，后生大病。故曰∶病有在毫毛腠理者，有在肌肉者，有在脉者，有在筋者，有
在骨者，有在髓者。是故刺毫毛腠理无伤皮，皮伤则内动肺，肺动则秋病瘟疟，沂（音素）沂
然寒栗。刺皮无伤肉，肉伤则内动脾，脾动则七十二日四季之月病腹胀烦不嗜食。刺肉无伤
脉，脉伤则内动心，心动则夏病心痛。刺脉无伤筋，筋伤则内动肝，肝动则春病热而筋驰。
刺筋无伤骨，骨伤则内动肾，肾动则冬病胀腰痛。刺骨无伤髓，髓伤则消烁， 酸解亦，然
不去矣。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
脉无伤肉者，至脉而去不及肉也。刺脉无伤皮者，至皮而去，不及脉也。所谓刺皮无伤肉者
，病在皮中，针入皮中，无伤肉也。刺肉无伤筋者，过肉中筋也。刺筋无伤骨者，过筋中骨
也。此谓之久也。（久疑作失）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，针太深则邪气反沉病益。故曰皮肉筋脉，各有所宜，各不同形，
各以任其所宜。无实实，无虚虚，损不足而益有余，是谓病甚病益。其取五脉者死，取三脉
者，夺阴者死，夺阳者狂，针害华矣。
病位浅而针刺过深，会内伤好肉，导致皮肤发生痈肿。病位深而针刺过浅，病邪之气不能排出，反而酿成大脓。病情轻而针具过大，会导致正气泄泻太过，疾病反而加重为害。病情重而针具过小，正气不能泄泻，也会导致治疗失败。失于针刺的适宜原则，大的病证该用泻法而不泻，小的病证不改变针具大小（或指小病误用大针）。病有浮沉之分，针刺就有深浅之别，必须各达到其应有的理度，不要超过规定的限度。超过限度就会损伤肌肉，达不到限度则会在外部产生壅滞，壅滞则邪气乘虚而入。深浅不得当，反而成为巨大的祸害，内部扰动五脏，日后生出大病。所以说：病有的在毫毛腠理，有的在肌肉，有的在脉，有的在筋，有的在骨，有的在髓。因此，刺毫毛腠理时不要伤及皮层，皮层受伤则会内动肺脏，肺脏受动则在秋季发生温疟，瑟瑟然寒战。刺皮层时不要伤及肌肉，肌肉受伤则会内动脾脏，脾脏受动则在四季之月（每季最后十八天）发生腹胀、心烦、不想吃东西。刺肌肉时不要伤及血脉，血脉受伤则会内动心脏，心脏受动则在夏季发生心痛。刺血脉时不要伤及筋腱，筋腱受伤则会内动肝脏，肝脏受动则在春季发生热病且筋弛缓。刺筋腱时不要伤及骨骼，骨骼受伤则会内动肾脏，肾脏受动则在冬季发生腹胀腰痛。刺骨骼时不要伤及骨髓，骨髓受伤则身体消瘦枯槁，酸软懈怠，症状持续不去。所谓“刺骨无伤筋”，是指针到达筋部即止，不到达骨部。“刺筋无伤肉”，是指针到达肌肉即止，不到达筋部。“刺脉无伤肉”，是指针到达血脉即止，不到达肌肉。“刺脉无伤皮”，是指针到达皮部即止，不到达血脉。所谓“刺皮无伤肉”，是指病在皮中，针只进入皮中，不伤及肌肉。“刺肉无伤筋”，是指针经过肌肉中部到达筋部。“刺筋无伤骨”，是指针经过筋部到达骨部。这叫做“失”（此处原文作“久”，疑为“失”字之误，意指过失或不当）。
至于气在脉中的情况，邪气多在上部，浊气多在中部，清气多在下部。所以针刺陷谷等穴则邪气外出，针刺中脉则浊气外出，如果针刺太深，邪气反而陷入体内，病情加重。所以说皮、肉、筋、脉，各有适宜的针刺深度和部位，形状各不相同，应各自顺应其适宜的情况。不要实证用实法（使实证更实），不要虚证用虚法（使虚证更虚），损害不足的正气而增加有余的邪气，这叫做病势加重，病情恶化。取五脉（指过度泻夺五脏之气）者死，取三脉（指过度泻夺阴气）者死，夺阳气者发狂，针刺的危害真是巨大啊。
If the disease is superficial but the needle insertion is too deep, it will damage healthy flesh internally, leading to carbuncles on the skin. If the disease is deep but the needle insertion is too shallow, the pathogenic qi will not be discharged, instead resulting in large abscesses. If the pathology is minor but the needle is too large, the righteous qi will be excessively depleted, causing the illness to worsen and become harmful. If the pathology is major but the needle is too small, the righteous qi will not be discharged, also leading to treatment failure. Deviating from the appropriate principles of acupuncture—failing to apply reducing methods for major conditions or failing to adjust needle size for minor ones—results in error. Diseases vary in their depth (superficial vs. deep), and needle insertion must correspondingly vary in depth, reaching the proper level without exceeding the prescribed limits. Exceeding the limit damages muscle; falling short causes external stagnation, allowing pathogens to enter. Improper depth becomes a great disaster, internally disturbing the Zang organs and later generating severe diseases. Thus it is said: diseases may reside in the hair follicles and interstices, in muscles, in vessels, in sinews, in bones, or in marrow. Therefore, when needling the hair follicles and interstices, do not injure the skin; if the skin is injured, it internally disturbs the Lung, which manifests as warm malaria with chills in autumn. When needling the skin, do not injure the muscle; if the muscle is injured, it internally disturbs the Spleen, which manifests as abdominal distension, irritability, and anorexia during the last eighteen days of each season. When needling the muscle, do not injure the vessel; if the vessel is injured, it internally disturbs the Heart, which manifests as heart pain in summer. When needling the vessel, do not injure the sinew; if the sinew is injured, it internally disturbs the Liver, which manifests as heat syndromes with flaccid sinews in spring. When needling the sinew, do not injure the bone; if the bone is injured, it internally disturbs the Kidney, which manifests as abdominal distension and lower back pain in winter. When needling the bone, do not injure the marrow; if the marrow is injured, emaciation and wasting occur, accompanied by soreness and weakness that persist. "Needling the bone without injuring the sinew" means stopping at the sinew level without reaching the bone. "Needling the sinew without injuring the muscle" means stopping at the muscle level without reaching the sinew. "Needling the vessel without injuring the muscle" means stopping at the vessel level without reaching the muscle. "Needling the vessel without injuring the skin" means stopping at the skin level without reaching the vessel. "Needling the skin without injuring the muscle" refers to cases where the disease is in the skin; the needle enters only the skin, sparing the muscle. "Needling the muscle without injuring the sinew" implies passing through the muscle to reach the sinew. "Needling the sinew without injuring the bone" implies passing through the sinew to reach the bone. This is referred to as an error (the original text says "Jiu," suspected to be a typo for "Shi," meaning mistake).
Regarding the distribution of Qi within the vessels, pathogenic Qi tends to be in the upper part, turbid Qi in the middle, and clear Qi in the lower part. Therefore, needling points like Xian Gu expels pathogenic Qi, while needling the central vessels expels turbid Qi; however, if needling is too deep, pathogenic Qi sinks back into the body, worsening the condition. Thus, the skin, muscle, sinew, and vessel each have specific appropriate depths and forms, requiring adherence to their respective suitability. One must not tonify excess nor reduce deficiency; damaging insufficient righteous Qi while augmenting excessive pathogenic Qi leads to aggravated disease and worsening prognosis. Depriving the Five Vessels (excessive reduction of all five Zang organs) leads to death; depriving three vessels (excessive reduction of Yin) leads to death; depriving Yang leads to mania. The harm caused by improper acupuncture is indeed profound.