病之生时。有喜怒不测饮食不节。阴气不足阳气有余营气不行。乃发为痈疽。阴阳不通
两热相搏乃化为脓夫痈疽之生。脓血之成也积微之所生也(由微而积)
以小治小者其功小。以大治大者多害。故其已成脓血者。其惟砭石铍锋之所取也。(言
治痈
脓。小针不适用。大针即可用砭与铍针锋针)诸病皆有逆顺腹胀身热脉大是一逆也(邪正盛。
)腹鸣而满四肢清(冷也)泄其脉大。是二逆也(此阴证得阳脉。)衄而不止。脉大是三逆也。(
亦阴证得阳脉)咳。且溲血。脱形。其脉小劲是四逆也(正气已衰。)咳。脱形。身热。(正衰
火盛。)脉小以疾(邪亦未衰)是谓五逆也如是者。不过十五日而死矣 其腹大胀四末清脱
形。泄甚是一逆也腹胀便血其脉大时绝是二逆也(以阴证得阳脉。时绝者死脉也)咳溲血形肉
脱。脉搏是三逆也(火盛水亏。)呕血胸满引背脉小而疾是四逆也(脉小带疾虚而火盛也)咳呕
腹
胀且飧泄(病已虚)其脉绝。是五逆也如是者。不过一时而死矣。工不察此者而刺之。是谓逆
治。
人之所受气者。谷也。谷之所注者。胃也胃者。水谷气血之海也海之所行云气者。天下
也胃
之所出气血者。经隧也经隧者。五脏六腑之大络也迎而夺之而已矣上下有数乎。(问手足经
也)迎之五里。中道而止五至而已。五往而脏之气尽矣。故五五二十五而竭其输矣此所谓夺
其天气者也(五里手阳明经穴。阴气之所在也若迎而夺之则脏气败绝。必致中道而止且一脏
之气。大约五至而已。针凡五往以夺之则一脏之气已尽。若夺至二十五至。则五脏之输气皆
竭此所谓夺其天真之气也。)
疾病发生之初，往往由于喜怒无常、饮食不节制。导致阴气不足而阳气有余，营气运行不畅，于是发为痈疽。阴阳之气不通畅，两股热邪相互搏结，从而化为脓液。痈疽的产生，以及脓血的形成，都是由微小病变逐渐积累而成的。（由微而积）
用细小的针具治疗严重的病症，疗效甚微；用粗大的针具治疗轻微的病症，反而会造成更多伤害。因此，对于已经形成脓血的痈疽，只有使用砭石或铍针（锋针的一种）才能处理。（意思是治疗痈脓，小针不适用，大针如砭石和铍针锋针即可使用）。各种疾病都有顺证和逆证的区别：腹部胀满、身体发热、脉象洪大，这是一逆（邪气与正气盛实）；肠鸣且腹部胀满，四肢厥冷，泄泻而脉象洪大，这是二逆（此为阴证却出现阳脉）；鼻出血不止，脉象洪大，这是三逆（也是阴证出现阳脉）；咳嗽，且小便带血，形体消瘦脱失，脉象细小而强劲，这是四逆（正气已经衰败）；咳嗽，形体消瘦脱失，身体发热，脉象细小且快速（邪气也未衰退），这称为五逆。出现这种情况的人，不超过十五天就会死亡。
腹部极度胀满，四肢厥冷，形体消瘦脱失，泄泻严重，这是一逆；腹部胀满，大便带血，脉象洪大且时有间歇，这是二逆（因阴证出现阳脉，时绝是死脉）；咳嗽，小便带血，肌肉消脱，脉搏坚劲有力，这是三逆（火盛水亏）；呕血，胸部胀满并牵引背部疼痛，脉象细小且快速，这是四逆（脉小表示虚，带疾表示虚而火盛）；咳嗽、呕吐、腹部胀满且完谷不化之泄泻（病势已虚），脉象断绝，这是五逆。出现这种情况的人，不超过一个时辰就会死亡。医生如果不明察这些情况而进行针刺，就叫做“逆治”。
人体所摄取的气，来源于食物；食物所注归的地方，是胃。胃是水谷精微和气血的海洋。海洋中运行的云气，对应于天下（指全身经络气血的运行如同天地云气流通）。胃所化生的气血，通过经隧输送。经隧，就是五脏六腑的大络。迎而夺之（逆经取穴泻法）的方法罢了。上下经脉有定数吗？（问的是手足经脉）。在迎香穴旁的五里穴施针，中途就要停止。针刺五次也就够了。如果针刺五次，一脏的气就会被泻尽。所以，如果连续针刺二十五次（五五二十五），五脏的输穴之气就会枯竭。这就是所谓的剥夺人的先天真气。（五里穴是手阳明大肠经的穴位，是阴气汇聚之处。如果迎而夺之，则脏气败绝，必然导致中途停止。而且一脏之气，大约针刺五次也就耗尽了。如果凡针刺五次以夺其气，则一脏之气已尽；若夺至二十五次，则五脏的输气皆竭。这就是所谓剥夺其天真之气。）
At the onset of disease, it often arises from uncontrolled emotions (excessive joy or anger) and irregular diet. This leads to a deficiency of Yin Qi and an excess of Yang Qi, with Ying Qi (Nutritive Qi) failing to circulate properly, thereby developing into carbuncles and sores (Yong Ju). When Yin and Yang channels are blocked, two sources of heat clash and transform into pus. The generation of carbuncles and sores, and the formation of pus and blood, all stem from the accumulation of minute pathological factors over time.
Using small needles to treat severe conditions yields little effect; using large needles to treat minor conditions causes more harm. Therefore, for carbuncles and sores that have already formed pus and blood, only bi stone (Bianshi) or pi needle (Pifeng Zhen, a type of lancet) should be used. (This implies that small needles are unsuitable for treating pus in carbuncles; larger needles like bi stones and pi needles are appropriate.)
All diseases present either favorable (Shun) or unfavorable (Ni) prognoses:
1. Abdominal distension, body fever, and a洪大 (Hongda, surging/large) pulse constitute the first unfavorable sign (indicating excess of both pathogenic and healthy Qi).
2. Borborygmus (intestinal rumbling), abdominal fullness, cold extremities, diarrhea, yet a洪大 pulse constitutes the second unfavorable sign (a Yin syndrome presenting with a Yang pulse).
3. Unstopping epistaxis (nosebleed) with a洪大 pulse constitutes the third unfavorable sign (also a Yin syndrome presenting with a Yang pulse).
4. Coughing, hematuria (blood in urine), emaciation (depletion of form), and a fine yet forceful pulse constitute the fourth unfavorable sign (indicating depletion of Healthy Qi).
5. Coughing, emaciation, body fever, and a fine and rapid pulse (where pathogenic factors are also not depleted) constitute the fifth unfavorable sign. Individuals presenting these signs will die within fifteen days.
Severe abdominal distension, cold extremities, emaciation, and severe diarrhea constitute the first unfavorable sign. Abdominal distension, bloody stool, a洪大 pulse with intermittent interruptions constitute the second unfavorable sign (a Yin syndrome with a Yang pulse; intermittent interruption indicates a death pulse). Coughing, hematuria, muscle wasting, and a firm pulse constitute the third unfavorable sign (Fire excess and Water deficiency). Hematemesis (vomiting blood), chest fullness radiating to the back, and a fine and rapid pulse constitute the fourth unfavorable sign (fine pulse indicates deficiency, rapidity indicates deficiency with Fire excess). Coughing, vomiting, abdominal distension, and undigested food in stool (Sun Xie, indicating deficiency) with an absent pulse constitute the fifth unfavorable sign. Individuals presenting these signs will die within one shichen (two hours). If physicians fail to discern these conditions and proceed with acupuncture, it is termed "contrary treatment" (Ni Zhi).
The Qi received by the human body comes from grain; grain is stored and processed in the Stomach. The Stomach is the sea of water and grain, and thus the source of Qi and Blood. The clouds and Qi circulating in this sea correspond to the heavens (the whole body); the Qi and Blood emerging from the Stomach travel through the Jing Sui (Meridian Collaterals). The Jing Sui are the great collaterals connecting the Five Zang and Six Fu organs. The method of "meeting and seizing" (Ying Er Duo Zhi, i.e., reducing method by needling against the flow of Qi) applies. Are there fixed numbers regarding the upper and lower meridians? (Referring to hand and foot meridians). Needling the Wuli point (LI 21) requires stopping midway. Only five insertions/strokes are permissible. Five withdrawals deplete the Qi of one Zang organ. Thus, twenty-five insertions (5x5) deplete the Shu points of all five Zang organs. This is described as depriving the person of their innate Heaven-sent Qi. (Wuli is an acupoint on the Hand-Yangming Large Intestine Meridian, where Yin Qi resides. If one meets and seizes it, Zang Qi fails and must stop midway. Generally, the Qi of one Zang is depleted after about five insertions. If one reduces Qi five times, the Qi of one Zang is exhausted; if reduced twenty-five times, the Shu Qi of all five Zang organs is depleted. This is what is meant by depriving one's Tianzhen Qi [Innocent/Natural Vital Qi]).