夫气之在脉也邪气在上。(贼风邪气之中人。高而在上。)浊气在中。(小针宁曰。水谷
于胃。其精气上注于肺。独溜于肠胃。若寒温不适。饮食不节。病生于肠胃之间。此浊气在
中也。)清气在下。(言清湿地气之中人。必在下而从足始。)故针陷脉。则邪气出。(诸经孔
穴多在陷者之中。故刺各经陷脉。则经气行而邪气出。乃所以针阳邪之在上者。)针中脉。
则浊气出。(小针解曰。取之阳明合也。足三里穴刺之。可以清肠胃之留滞。○此下缺清气
在下之义。或有所失。)针太深则邪气反沉。病益。(言浅病深刺之。则邪气从之入反沉。病
益深也。)故曰皮肉筋脉。各有所处。病各有所宜。(经络疾病各有所处)各不同形各以任其
所宜。(言九针各不同形。故其任用亦各有所宜也。)无实无虚。(无实实无虚虚也)损不足而
益有余。是为甚病。病益甚。(反而为之。适所以增病。)取五脉者死。(五脉。五脏五 也
。
也。若不知虚实而尽写之。令人羸败。 衰残也。)夺阴者死。(本输篇曰。尺脉动在五里。
五之禁也。言取尺之五里五往以夺之。则五脏之 气皆竭也。故曰夺阴者死。)夺阳者狂
。(如上文取三阳之谓)针害毕矣。
刺之而气不至。无问其数。(必以气至为度也。)刺之而气至。乃去之。勿复针。(气至
勿复
有所宜也。)刺之要气至而有效效之信。若风之吹云。明乎若见苍天。刺之道毕矣。(刺以气
为要以效为信。促其要则效。如风之吹云。邪气去。则正气见。故明乎若见苍天也。)
五脏五 。五五二十五 。六腑六 。六六三十六 。( 穴之总名。五 。即各经井
荥俞经合穴也。六腑复多一原穴。故各有六 。)经脉十二。络脉十五。凡二十七气以上下。(脏
有五。腑有六。而复有手厥阴心主一经。是为十二经。十二经各有络脉。如手太阴别络在列
缺之类。又有任脉之络曰屏翳督脉之络曰长强。脾之大络曰大包。共为十五络。总二十七气
以通周身上下也。)所出为井。所溜为荥。(急流曰溜。)所注为 。(注灌溉也。)所行为经
。所入为合。二十七气所行。皆在五 也。(按张景岳解井荥俞经合云。井如水源出井。其
气正深。北方水也。荥小水也。脉气尚微。东方春也。 。输运也。脉由此而输。彼其气方
盛。南方夏也。经者。脉气大行。正盛于此应长夏也。合者。脉气由此内行。归合于腑脏西
方金也。合于本输水热穴等篇之旨。余如六十五难曰。井主春。合主冬。项氏曰井象水之泉
荥象水之陂俞象水之窬。经象水之流合象水之归。与灵素经旨。不合。)节之交。三百六十
五会。(络脉之渗灌诸节者也。)所言节者。神气之所游行出入也。非皮肉筋骨也。(节者。
即神气之所游行出入。以穴 为言也。)
凡将用针。必先诊脉。视气之剧易。乃可以治也五脏之气。已绝于内。而用针者。反实
。是谓重竭。重竭必死。其死也静。(脏气已绝于内。阴虚也。反实其外。误益阳也。益阳
则愈损其阴是重竭也。阴竭必死死则静也)治之者。辄反其气。取腋与膺。(腋与膺皆脏脉所
出。气绝于内而复取之。则致气于外。而阴愈竭矣。)五脏之气已绝于外。而用针者。反实
其内。是谓逆厥。逆厥则必死。其死也躁。(脏气已绝于外阳虚也反实其内。误补阴也助阴
则阳气愈竭。故致四逆而厥逆厥必死死必躁也。)治之者。反取四末。(四末为诸阳之本。气
绝于外。而取其本。则阴气至而阳愈陷矣)
四关主治五脏。五脏有疾。当取之十二原。(四关者。即两肘两膝乃周身骨节之大关也
。故凡井荥俞原经合穴。皆手不过肘。足不过膝也。十二原者。本篇言肺原太渊。心原即心主俞
太陵。肝原太冲脾原太白。肾原太 左右各二穴。并膏之原鸠尾。肓之原脖 。共为十二原
穴。而脏腑表里之气。皆通于此。故可以治五脏之疾。及考六十六难。又有心原神门。胆原
丘墟。胃原冲阳三焦原阳池。膀胱原京骨大阳原合谷小肠原腕骨。合共肺心主肝脾肾之原总
为十二原。而膏之原肓之原。不在其中。)胀取三阳。(胃胆膀胱)飧泄取三阴。(脾。肝。肾
气在脉中运行，邪气多侵犯人体上部。（贼风邪气侵袭人体，位置高而在上。）浊气停滞在中焦。（《小针解》说：饮食水谷进入胃中，其精微之气向上灌注于肺，唯独糟粕留滞于肠胃。如果寒温失调，饮食不节，疾病就产生于肠胃之间，这就是浊气停留在中部。）清气（此处指湿浊阴邪）下沉在下部。（说的是清冷潮湿的地气侵袭人体，必然从下部开始，由足部发起。）所以针刺陷下的脉络，就能使在上部的邪气排出。（各条经脉的穴位多在凹陷之处，所以刺各经的陷脉，经气运行而邪气排出，这是为了针刺阳邪位于上部的方法。）针刺中部的脉络，就能使中部的浊气排出。（《小针解》说：取阳明经即可。针刺足三里穴，可以清除肠胃中的积滞。○下文缺失关于“清气在下”的解释，可能是有遗漏。）针刺过深，邪气反而陷入体内，病情加重。（意思是浅表部位的病却深刺，邪气随之深入反而沉伏，病情更加严重。）所以说皮、肉、筋、脉各有其适宜的部位，疾病各有其适宜的治法。（经络疾病各有其所在部位）九针形状各不相同，应根据具体情况选用适宜的针具。（意思是九针形状不同，所以其应用也各有适宜之处。）不要实证用补法，也不要虚证用泻法。（即不要实其实，不要虚其虚）损伤不足的正气而增加有余的邪气，这会导致严重的疾病，病情会更加恶化。（反过来治疗，恰恰增加了疾病。）取五脏之脉进行泻法会导致死亡。（五脉对应五脏。如果不知虚实而全部泻之，使人身体虚弱衰败。）耗夺阴气的人必死。（《本输》篇说：尺脉动应于五里穴，这是五里穴禁刺的原因。意思是反复针刺尺泽附近的五里穴以泻夺阴气，则五脏的阴气都会枯竭。所以说耗夺阴气的人必死。）耗夺阳气的人会发狂。（如上文所说取三阳经之气）针刺的危害至此讲完了。
针刺时若经气未至，不必拘泥于针刺的次数。（必须以经气到达为度。）针刺后经气已至，就停止针刺，不要再刺。（经气已至就不必再刺，因为已有适宜的治疗效果。）针刺的要领在于经气到达才有效，有效的征象，就像风吹散乌云一样，清晰得如同看见蓝天。针刺的道理至此讲完了。（针刺以经气到达为关键，以疗效为验证。抓住关键就有疗效，就像风吹云散，邪气去除，正气显现，所以清晰得如同看见蓝天。）
五脏各有五个腧穴，共二十五个腧穴。六腑各有六个腧穴，共三十六个腧穴。（腧穴的总称。五脏五腧，即各经的井、荥、俞、经、合穴。六腑多一个原穴，所以各有六个腧穴。）经脉十二条，络脉十五条，总共二十七条气脉上下通行。（脏有五个，腑有六个，再加上手厥阴心主一经，共为十二经脉。十二经脉各有络脉，如手太阴肺经的别络在列缺等。还有任脉的络脉叫屏翳，督脉的络脉叫长强，脾的大络叫大包，共为十五条络脉。总共二十七条气脉来贯通周身上下。）所出为井穴，所流为荥穴。（急流称为溜。）所注为输穴。（注即灌溉之意。）所行为经穴，所入为合穴。二十七条气脉的运行，都在这五腧穴之中。（按张景岳解释井、荥、俞、经、合：井像水源出自井中，其气正深，属北方水；荥是小水流，脉气尚微弱，属东方春；输即输送，脉气由此输送到彼，其气正盛，属南方夏；经即脉气大行，正旺盛于此，应长夏；合即脉气由此内行，归合于脏腑，属西方金。这与《本输》、《水热穴》等篇的宗旨相符。其他如《难经·六十五难》说：井主春，合主冬。项氏说：井象泉水，荥象池塘，俞象坑洞，经象水流，合象归海。这与《灵枢》、《素问》的宗旨不完全吻合。）关节交会之处，共有三百六十五个会穴。（是络脉渗灌各个关节的地方。）所说的节，是指神气游行出入的地方，不是指皮、肉、筋、骨。（节，就是神气游行出入之处，这里指腧穴而言。）
凡是要使用针刺，必须先诊察脉象，观察病气的轻重难易，然后才可以治疗。五脏的内气已经衰竭，如果用针者反而在外侧施以补法，这叫重竭。重竭必死，死时安静。（脏气已在内部衰竭，属于阴虚。反而在外侧充实，误补了阳气。补阳就会进一步损伤阴气，这是重竭。阴竭必死，死时表现为安静。）治疗的人，反而逆着病势，选取腋部和胸膺部。（腋部和胸膺都是脏脉发出的地方，内气已绝又去取这些部位，会使气聚于外，导致阴气更加枯竭。）五脏的外气已经衰竭，如果用针者反而在内侧施以补法，这叫逆厥。逆厥必死，死时躁动。（脏气已在外部衰竭，属于阳虚。反而在内侧充实，误补了阴气。助阴则阳气更加衰竭，导致四肢逆冷而厥逆。厥逆必死，死时表现为躁动。）治疗的人，反而选取四肢末端。（四肢末端是诸阳之本。外气已绝，却取其根本，则阴气至而阳气更加下陷。）
四关主治五脏疾病。五脏有病，应当取用十二原穴。（四关，即两肘和两膝，是周身骨节的大关。所以凡是井、荥、俞、原、经、合穴，手部不超过肘，足部不超过膝。十二原穴：本篇说肺的原穴是太渊，心的原穴即心包经的俞穴太陵，肝的原穴是太冲，脾的原穴是太白，肾的原穴是太溪，左右各二穴，加上膏之原鸠尾，肓之原脖胦，共为十二原穴。脏腑表里的经气都通于此，所以可以治疗五脏的疾病。另外考证《难经·六十六难》，又有心的原穴神门，胆的原穴丘墟，胃的原穴冲阳，三焦的原穴阳池，膀胱的原穴京骨，大肠的原穴合谷，小肠的原穴腕骨。合计肺、心包、肝、脾、肾的原穴总共为十二原，而膏之原和肓之原不在其中。）腹胀取三阳经。（胃、胆、膀胱）完谷不化的泄泻取三阴经。（脾、肝、肾）
When Qi circulates in the meridians, pathogenic factors tend to affect the upper part of the body. (Wind-cold pathogens invade the human body, affecting high and upper regions.) Turbid Qi stagnates in the middle. (The *Xiao Zhen Jie* [Explanation of the Small Needle] states: Food and drink enter the Stomach; their essence ascends to the Lung, while only the dregs remain in the intestines and stomach. If there is improper regulation of cold and heat, or irregular diet, disease arises between the intestines and stomach; this is what is meant by turbid Qi remaining in the middle.) Clear Qi (here referring to damp-turbid Yin pathogens) sinks to the lower part. (This refers to cold and damp earthy pathogens invading the body, necessarily starting from the lower part, beginning at the feet.) Therefore, needling the sunken vessels expels pathogenic factors from above. (Most acupoints of the twelve meridians are located in depressions; thus, needling the sunken vessels of each meridian promotes the flow of meridian Qi and expels pathogenic factors, which is the method for treating Yang pathogens located in the upper part.) Needling the middle vessels expels turbid Qi from the middle. (The *Xiao Zhen Jie* states: Treating the Yangming Meridian is sufficient. Needling the Zusanli [ST-32] acupoint can clear stagnation in the intestines and stomach. ○ The explanation for "Clear Qi in the lower part" is missing below, possibly due to loss of text.) If needled too deeply, pathogenic factors sink back into the interior, and the illness worsens. (This means that if a superficial disease is treated with deep needling, pathogenic factors follow the needle inward and sink deeper, causing the illness to become more severe.) Thus it is said that skin, flesh, sinews, and vessels each have their appropriate locations, and diseases each have their appropriate treatments. (Meridian and collateral diseases each have their specific locations.) The nine needles differ in shape, so their application should be chosen according to what is appropriate. (This means that because the nine needles have different shapes, their usage also has specific appropriateness.) Do not tonify excess, and do not drain deficiency. (i.e., do not reinforce excess and do not deplete deficiency.) Damaging what is insufficient and augmenting what is excessive leads to severe illness, making the condition even worse. (Treating in reverse merely aggravates the disease.) Draining the five pulses causes death. (The five pulses correspond to the five Zang organs. If one does not discern excess and deficiency and drains all of them, the person becomes emaciated and weak.) Depriving Yin Qi causes death. (The *Ben Shu* chapter states: The pulse at the Chi position moves at the Wuli [LI-24] acupoint; this is why Wuli is contraindicated. It means repeatedly draining the Wuli acupoint near the Chi position deprives the body of Yin Qi, leading to the exhaustion of Yin Qi in all five Zang organs. Hence, depriving Yin Qi causes death.) Depriving Yang Qi causes mania. (As mentioned above regarding taking Qi from the three Yang meridians.) The harms of needling are now concluded.
If upon needling the Qi has not arrived, do not limit the number of manipulations. (One must wait until the Qi arrives as the standard.) Once the Qi has arrived, remove the needle and do not needle again. (Once the Qi has arrived, no further needling is necessary, as the treatment has taken effect.) The essence of needling lies in the arrival of Qi for efficacy; the sign of efficacy is like wind blowing away clouds, clearly revealing the blue sky. The principles of needling are now complete. (Needling relies on the arrival of Qi as the key and efficacy as the proof. Grasping the key yields efficacy, just as wind blows away clouds; when pathogenic factors are removed, healthy Qi appears, thus clearly revealing the blue sky.)
Each of the five Zang organs has five Shu points, totaling twenty-five Shu points. Each of the six Fu organs has six Shu points, totaling thirty-six Shu points. (Shu points refer to the major acupoints. The five Shu points of the Zang organs are the Jing-Well, Ying-Spring, Shu-Stream, Jing-River, and He-Sea points of each meridian. The Fu organs have one additional Yuan-Source point, hence six points each.) There are twelve main meridians and fifteen collaterals, totaling twenty-seven Qi pathways circulating up and down. (There are five Zang and six Fu organs, plus the Hand-Jueyin Pericardium meridian, making twelve meridians. Each of the twelve meridians has a collateral; for example, the Luo-connecting vessel of the Hand-Taiyin Lung meridian is at Lieque [LU-7]. Additionally, the collateral of the Ren Mai is Pingyi, the collateral of the Du Mai is Changqiang [GV-1], and the great collateral of the Spleen is Dabao [SP-21], totaling fifteen collaterals. These twenty-seven Qi pathways connect the entire body up and down.) What emerges is the Jing-Well point; what flows is the Ying-Spring point. (Rapid flow is called Liu.) What pours is the Shu-Stream point. (Pouring implies irrigation.) What travels is the Jing-River point; what enters is the He-Sea point. The circulation of the twenty-seven Qi pathways all occurs within these five Shu points. (According to Zhang Jingyue's interpretation of Jing-Well, Ying-Spring, Shu-Stream, Jing-River, and He-Sea: Jing-Well is like water emerging from a well, its Qi deep, corresponding to Water in the North. Ying-Spring is small flowing water, with faint Qi, corresponding to Wood in the East. Shu-Stream means transport, where Qi is transported from here to there, its Qi flourishing, corresponding to Fire in the South. Jing-River means the Qi of the meridian flows largely, peaking here, corresponding to Earth in the late summer. He-Sea means Qi flows inward from here and merges with the Zang-Fu organs, corresponding to Metal in the West. This aligns with the principles in chapters such as *Ben Shu* and *Shui Re Xue*. Others, such as *Nan Jing* Chapter 65, state: Jing-Well governs Spring, He-Sea governs Winter. Mr. Xiang stated: Jing-Well resembles spring water, Ying-Spring resembles a pond, Shu-Stream resembles a pit, Jing-River resembles a stream, and He-Sea resembles the return of water. This does not fully align with the principles of *Ling Shu* and *Su Wen*.) Intersections of joints, numbering three hundred and sixty-five meetings. (These are where collaterals seep and irrigate various joints.) The term "joint" refers to the places where Shen-Qi (Spiritual Qi) travels and exits; it does not refer to skin, flesh, sinews, or bones. (A joint is where Spiritual Qi travels and exits; here, it refers to acupoints.)
Whenever using needles, one must first diagnose the pulse and observe the severity and ease of the Qi before proceeding with treatment. If the internal Qi of the five Zang organs is exhausted, but the practitioner instead tonifies the exterior, this is called double exhaustion (Chong Jie). Double exhaustion leads to death, and the deceased dies quietly. (Internal Zang Qi is exhausted, indicating Yin deficiency. Tonifying the exterior erroneously reinforces Yang. Reinforcing Yang further damages Yin, constituting double exhaustion. Exhaustion of Yin leads to death, characterized by quietness.) The practitioner, however, acts against the pathology, selecting the axilla and chest. (The axilla and chest are sites where Zang meridian Qi emerges. Taking these points when internal Qi is exhausted drives Qi outward, causing further depletion of Yin.) If the external Qi of the five Zang organs is exhausted, but the practitioner instead tonifies the interior, this is called inverted reversal (Ni Jue). Inverted reversal leads to death, and the deceased dies restlessly. (External Zang Qi is exhausted, indicating Yang deficiency. Tonifying the interior erroneously reinforces Yin. Reinforcing Yin further exhausts Yang, leading to cold limbs and reversal. Reversal leads to death, characterized by restlessness.) The practitioner, however, acts in reverse, selecting the four extremities. (The four extremities are the root of all Yang Qi. When external Qi is exhausted, taking the root allows Yin Qi to arrive and causes Yang Qi to sink further.)
The Four Passes (Si Guan) treat diseases of the five Zang organs. When the five Zang organs are diseased, one should select the Twelve Yuan-Source points. (The Four Passes refer to the two elbows and two knees, which are the major joints of the body. Therefore, all Jing-Well, Ying-Spring, Shu-Stream, Yuan-Source, Jing-River, and He-Sea points of the hands do not exceed the elbow, and those of the feet do not exceed the knee. The Twelve Yuan-Source points: This chapter states the Lung Yuan is Taiyuan [LU-9]; the Heart Yuan is the Shu-Stream of the Pericardium, Tailing [PC-7]; the Liver Yuan is Taichong [LR-3]; the Spleen Yuan is Taibai [SP-3]; the Kidney Yuan is Taixi [KI-3], two on each side. Together with the Yuan of the Gao [Gao Yuan] Jiugwei [CV-15] and the Yuan of the Huang [Huang Yuan] Bozhi [CV-17? Note: Text says 'Bo Ye' likely typo for Boren/Bozhong area or specifically Neck-Throat region, traditionally ST-9 or CV-22 depending on interpretation, but text says 'Neck Throat'], totaling twelve Yuan-Source points. The Qi of the Zang and Fu, interior and exterior, all connect here, allowing treatment of Zang organ diseases. Furthermore, consulting *Nan Jing* Chapter 66, there are also the Heart Yuan Shenmen [HT-7], Gallbladder Yuan Qiuxu [GB-40], Stomach Yuan Chongyang [ST-42], Sanjiao Yuan Yangchi [TE-4], Bladder Yuan Jinggu [BL-64], Large Intestine Yuan Hegu [LI-4], and Small Intestine Yuan Wanggu [SI-4]. Combined with the Yuan points of Lung, Pericardium, Liver, Spleen, and Kidney, there are twelve Yuan-Source points in total, excluding the Yuan of Gao and Huang.) For distension, select the three Yang meridians. (Stomach, Gallbladder, Bladder) For undigested food diarrhea (Sun Xie), select the three Yin meridians. (Spleen, Liver, Kidney)