。经曰。病在上者。阳也。病在下者。阴也。痛者。阴也。以手按之不得者。阴也。深刺
之。痒者。阳也。浅刺之。病先起阴者。先治其阴。后治其阳。病先起阳者。先治其阳。后治
其阴。（病在上者。下取之。在下者。上取之。病在头者。取之足。在腰者。取之 。病生
于头者。头重。生于手者。臂重。生于足者。足重。治病者。先刺其病所从生者也。）
经曰。病始手臂者。先取手阳明、太阴而汗出。病始头首者。先取项太阳而汗出。病始
足胫者。先取足阳明而汗出。足太阴可汗出。足阳明可汗出。故取阴而汗出甚者。止之于阳。取
阳而汗出甚者。止之于阴。
或曰。经言病有虚邪。有实邪。有贼邪。有微邪。有正邪。何谓也。
经曰。从后来者。为虚邪。从前来者。为实邪。从所不胜来者。为贼邪。从所胜来者。
为微邪。自病者。为正邪。假令心病由中风得之。为虚邪。木在火后。生火为母也。饮食劳倦得
之。为实邪。土在火前。为子也。中湿得之。为贼邪。水克火也。伤寒得之。为微邪。火胜
金也。伤暑得之。为正邪。火自病也。
或曰。有正经自病。有五邪所伤。针治亦当别乎。
经曰。忧愁思虑。则伤心。形寒饮冷。则伤肺。恚怒气逆。上而不下。则伤肝。饮食劳
倦。则伤脾。久坐湿地。强力入水。则伤肾。此正经自病也。盖忧思喜怒。饮食动作之过。而致
然也。风喜伤肝。暑喜伤心。饮食劳倦喜伤脾。（劳倦亦自外至）寒喜伤肺。湿喜伤肾。此五
邪所伤也。盖邪由外至。所谓外伤也。凡阴阳脏腑。经络之气。虚实相等。正也。偏实偏虚
。失其正。则为邪矣。由偏实也。故内邪得而生。由偏虚也。故外邪得而入。机按。经言凡
病皆当辨别邪正内外虚实。然后施针补写。庶不致误。
或曰。经言虚者补之。实者写之。不虚不实。以经取之。何谓也。
经曰。虚者补其母。母能令子实也。实者写其子。子能令母虚也。假令肝病虚。则补厥阴
之合。曲泉。实则写厥阴之荥。行间。不虚不实。以经取之者。是正经自病。不中他邪。当自取
其经。如井主心下满之类。正经自病。所谓忧愁思虑则伤心。强力入水则伤肾之类是也。不虚
不实。是诸脏不相乘。故云自取其经（重解卷末）
或曰。经言无实实。无虚虚。损不足。益有余。何谓也。
经曰。此谓病有虚实也。假令肝木实。肺金虚。金木当更相平。当知金平木。假令肺实
而肝虚。微少气。用针不补其肝。而反重实其肺。所谓实其实。虚其虚。损不足。益有余也。
或曰。七情所伤之病。何以察识。亦可以刺否。
经曰。智者之养生也。必顺四时而适寒暑。和喜怒而安居处。节阴阳而调刚柔。如是则
邪僻不生。长生久视。故心怵惕思虑。则伤神。伤神则恐惧自失。脾忧愁而不解。则伤意。意伤
则乱。肝悲哀动中。则伤魂。魂伤则狂忘不精。肺喜乐无极。则伤魄。魄伤则狂。肾盛怒
而不止。则伤志。志伤则喜忘。恐惧而不解。则伤精。精伤则骨酸痿厥。是故五脏主藏精者
也。不可伤。伤则失守而阴虚。阴虚则无气。无气则死矣。故用针者。察观病患之态。以知
精神魂魄之存亡得失之意。五者以伤。针不可以治之也。
又曰。肝藏血。血舍魂。肝气虚则恐。实则怒。脾藏营。营舍意。脾气虚则四肢不用。
五脏不安。实则腹胀。泾溲不利。心藏脉。脉舍神。心气虚则悲。实则笑不休。肺藏气。气舍魄。肺气虚则鼻
塞不利。少气。实则喘喝。胸盈仰息。肾藏精。精舍志。肾气虚则厥。实则胀。五脏不安。
必审五脏之病形。以知其气之虚实而谨调之也。
又曰。肺心有邪。其气留于两肘。肝有邪
。其气留于两腋。脾有邪。其气留于两髀。肾有邪。其气留于两 。凡此八虚者。皆机关之
宝。真气之所过。血络之所游。邪气恶血固不得住留。住留则伤筋络骨节。机关不得屈伸。
故病挛也。
或曰。八正之候何如。
经曰。候此者。常以冬至之日。立于叶蛰之宫。其至也。天必应之以风雨者矣。风雨从
南方
为虚风。主伤人杀害。故圣人谨候虚风而避之。邪弗能害。）其以夜半至也。民皆卧而弗犯
。故其岁民少病。以昼至也。民皆懈惰而中之。故民多病。虚邪入客于骨而不发于外。至其
立春。阳气大发。腠理开。因立春之日。风从西方来者。民皆又中于虚风。此两邪相搏。经
气结代者矣。故诸逢其风而遇其雨者。命曰遇岁露焉。而岁之和而少贼风。则民少病而少
死。贼风邪气寒温不和。则民多病而死矣。
或曰。诸病逆顺。可得闻乎。
经曰。腹胀身热脉大。一逆也。腹鸣而满。四肢清泄脉大。二逆也。衄而不止脉大。三
逆也
日而死矣。腹大胀。四末清。脱形泄甚。一逆也。腹胀便血。脉大时绝。二逆也。咳溲血脱
形。脉
时而死矣。工不察此而刺之。是谓逆治。五夺者。形肉已夺。一也。大夺血之后。二也。大汗
出之后。三也。大泄之后。四也。新产及大血之后。五也。此皆不可写。热病脉静。汗已出
。脉盛躁。一逆也。病泄。脉洪大。二逆也。着痹不移。 肉破。身热。脉偏绝。三逆也。淫
而夺形。身热。色夭然白。及后下血 笃重。四逆也。寒热夺形。脉坚搏。五逆也。小儿病
。头毛皆逆上者。必死。
或曰。经言痹病有众痹。有周痹。何分别耶。
经曰。众痹者。此各在其处。更发更止。更居更起。以右应左。以左应右。非能周也。
刺此
左右。各当其所。痛从上下者。先刺其下以遏之。后刺其上以脱之。痛从下上者。先刺其上
以遏之。后刺其下以脱之。此内不在脏。而外未发于皮。独居分肉之间。真气不能周。故曰周
痹。
问曰。经言凡痹往来。行无常处者。在分肉间痛。刺之以月。死生为数。何也。
经曰。用针者。随气盛衰以为 数。针过其数。则曰脱气。不及日数。则气不写。左刺
右。
。二日二 。渐多之。十五日十五 。十六日十四 。渐少之。（如是刺之则无过数。无
不及矣。）
或曰。经言热病有五十九刺。可得闻欤。
经曰。热病三日。气口静。人迎躁者。取之诸阳。五十九刺。以写其热。而出其汗。实
其阴
是。头入发一寸旁三分各三。凡六 。更入发三寸。边五。凡十 。耳前后口下者各一。项
中一。凡六 。巅上一。囟会一。发际一。廉泉一。风池二。天柱二也。热病七日八日。脉
口动。喘而短（一作弦）者。急刺之。汗且自出。浅刺手大指间。热病汗且出。及脉顺可汗者
。取之鱼际、太渊、大都、太白。写之则热去。补之则汗出。汗出太甚。取之内踝上横脉以止
之。热病七八日。脉微小。病溲血。口中干。日半死。脉代者。一日死。热病已得汗。脉尚
躁。喘且复热者死。热病七八日。脉不躁。躁不散数。后三日中有汗。三日不汗。四日死。
热病脉尚盛
颇有寒者。热在髓。死不可治。又热病不可刺者有九。一曰。汗不出。大颧发赤。哕者死。
二曰。泄而腹满甚者死。三曰。目不明。热不已者死。四曰。老人婴儿。热而腹满者死。五
曰。汗不出。呕下血者死。六曰。舌本烂。热不已者死。七曰。咳而衄。汗不出。出不至足
者
或曰。刺热病亦有异乎。
或曰。寒热瘰 在颈腋者。何气使然。
经曰。此皆鼠 寒热之毒瓦斯。留于脉而不去也。鼠 之本。皆在于藏。其末上出于颈腋
之间。
其寒热。审按其道以予之。徐往徐来以去之。其小如麦者。一刺知。三刺已。若反其目视之
。其中有赤脉。上下贯瞳子。见一脉。一岁死。见一脉半。一岁半死。见二脉。二岁死。见
二脉半。二岁半死。见三脉。三岁死。见赤脉不下贯瞳子。可治也。
或曰。痈疽何以治之。
经曰。痈疽之生。脓血之成。积微之所生也。故圣人自治于未有形也。愚者遭其已成者
。脓
已成脓血者。其惟砭石铍锋之所取也。所谓多害者。观逆顺也。其白眼青。黑眼小。一逆。
内药而呕。二逆。腹痛渴甚。三逆。肩项不便。四逆。音嘶色脱。五逆。除此五者。顺矣。
或曰。水肿之病。宜刺乎。
经曰。经脉满则络脉溢。络脉溢则缪刺之。以调其络脉。使复其形而不肿。缪刺者。不
分隧
。脉微弱者。今亦往往而缪刺之。祸不旋踵。盖不审经言。脉络满溢。宜缪刺之理也。
或曰。人有肥瘦白黑小长。刺法同乎否乎。
经曰。年质壮大者。血气充盈。肤革坚固。因加以邪。刺此者。深而留之。婴儿者。其
肉脆
色
少。肉廉廉然。薄唇轻言。血清气滑。易脱于气。易损于血。刺此者。浅而疾之。壮士真骨
者。坚肉缓节。监监然。此人重则气涩血浊。刺此者。深而留之。多益其数。劲则气滑血清
。刺此者。浅而疾之。常人者。视其黑白。各为调之。其端正敦浓者。血气调和。刺此者。
无失常数也。
或曰。匹夫大人。刺法同乎。
经曰。气滑则出疾。气涩则出迟。气悍则针小而入浅。气浊则针大而入深。深则欲留。
浅则
。春气在毛。夏气在皮肤。秋气在分肉。冬气在筋骨。凡刺病者。各以其时为齐。故刺肥人
以秋冬之齐。刺瘦人以春夏之齐。
经曰。营之生病也。寒热少气。血上下行。卫之生病也。气痛时来时去。怫气贲响。风
寒客
者内热。刺布衣者以火淬之。刺大人以药熨之。以熨寒痹所刺之处。令热入至于病所。起步
内无见风。每刺必熨。如此病已。所谓内热也。
或曰。三虚三实者。何谓也。
经曰。三虚者。乘年之衰。逢月之虚。失时之和。因为贼风所伤。是谓三虚。故论不知
三
或曰。人身有四海。何也。
经曰。胃者水谷之海。其输上在气街。下至三里。冲脉者。为十二经之海。其输上在于
大杼
海。其输上在于其盖。下在风府。气海有余者。气满胸中。 息面赤。不足。则气少不足以
言。血海有余。则常想其身大。怫然不知其所病。不足。常想其身小。狭然不知其所病。水
谷之海有余。则腹满。不足。则饥不受谷食。髓海有余。则轻劲多力。自过其度。不足。则
脑转耳鸣。胫酸眩冒。目无所见。懈怠安卧。治此者。审守其输。而调其虚实。无犯其害。顺
者得复。逆者必败。
或曰。诸家言某穴主某病。其说亦可从乎。
曰。治病无定穴也。邪客于人。与正周流上下。或在气分。或在血分。无有定止。故喻
用针
守某穴主某病之说。执中无权。按谱施治。譬之狂潦泛溢。欲塞下流而获安者。亦偶然耳。
夫病变无穷。灸刺之法亦无穷。或在上。下取之。或在下。上取之。或正取之。或直取之。
审经与络。分血与气。病随经所在。穴随经而取。庶得随机应变之理。岂可执以某穴主某病
哉。或曰。此固然矣。但学人望洋无下手处。曰。譬犹匠者。教人以规矩。取方圆也。规矩
之法在师。方圆之法则在子弟。夫圣人之于针。非经络孔穴。无以教后学。后学非经络孔
穴
守神。粗守关。上守机。机之动。不离其空中。此之谓也。
或曰。八穴治病。多有效者。何如。
曰。人身正经十二。奇经有八。大络十五。小络三百余。皆所以行气血也。圣人取穴。
三百
不知。孔穴不可不认。不知经络。无以知血气往来。不知孔穴。无以知邪气所在。知而用
。用而的。病乃可安。今之用八穴者。络穴六。经穴二。余络余经。置而不用。速求巧捷。
遂悖圣经。又有六十六穴。拘于日时开阖。用之犹未周备。而况拘于八穴者乎。盖八穴病在
气分。则有可劫之功。若在血分。徒损元气。病何由安。正是血病而泻气也。邪在血分。则
直求病之所在。而取之可也。今人泥而不用。良可笑耶。
或曰。膻中、鸠尾、中庭。人亦有针之者。宁无禁乎。
曰。心为一身之主。至贵不可犯。膻中、鸠尾、巨阙。心之宫城也。心主虚怯。不能主
事。
狂者有之。用针之士。多于膻中、鸠尾、中庭针之。亦犹伊芳尹之于太甲。周公之于孺子。事
有差误。则将倾覆社稷。荼毒生灵。其害有不可胜言者矣。夫针三穴亦然。犯真心。死不可
救。必须自揣己才。果有如伊芳周之能。可以扶危持颠。方能保心于无危也。
或曰。针三阴交。主何病也。
曰。足之三阴。从足走腹。太阴脾经循内踝上直行。厥阴循内踝前交入太阴之后。少阴
肾经
非危疾急证。与三阴俱有干者。不可轻刺。脾肾气常不足。肝虽有余。亦是宿血之藏。误刺
则脱人元气。不可不慎。
或曰。伤寒刺期门穴者。何如。
曰。十二经始于手太阴之云门。以次而传。终于足厥阴之期门。期门者。肝之募也。伤
寒过经
胁下肥气。凡是木郁诸疾。莫不刺之。以其肝主病也。经云。穴直乳下两肋端。又曰。在不
容旁一寸五分。古人说得甚明。今人不解用也。
或曰。刺胸腹者。必避五脏。何谓也。
经曰。中心。一日死。中肝。五日死。中脾。十日死。中肾。六日死。中肺。三日死。
经文说：病位在上部的，属于阳证；病位在下部的，属于阴证。疼痛的，属于阴证；用手按压找不到痛处的，也属于阴证，应当深刺。发痒的，属于阳证，应当浅刺。疾病如果先从阴分发起，就先治疗阴分，后治疗阳分；疾病如果先从阳分发起，就先治疗阳分，后治疗阴分。（病位在上部的，取下部穴位治疗；病位在下部的，取上部穴位治疗。病在头部的，取足部穴位；病在腰部的，取背部穴位。病生于头部，感到头部沉重；病生于手部，感到手臂沉重；病生于足部，感到足部沉重。治病时，先针刺疾病发生的根源部位。）
经文说：疾病起始于手臂的，先取手阳明大肠经、手太阴肺经的穴位，使患者出汗；疾病起始于头首部的，先取足太阳膀胱经颈项部的穴位，使患者出汗；疾病起始于足小腿部的，先取足阳明胃经的穴位，使患者出汗。足太阴脾经、足阳明胃经也可以使患者出汗。所以，如果取阴经穴位导致出汗过多，就改取阳经穴位以止汗；如果取阳经穴位导致出汗过多，就改取阴经穴位以止汗。
有人问：经文说病有虚邪、实邪、贼邪、微邪、正邪五种，这是什么意思？
经文说：从母脏传来的病邪，称为虚邪；从子脏传来的病邪，称为实邪；从克我之脏传来的病邪，称为贼邪；从我克之脏传来的病邪，称为微邪；本脏自病的病邪，称为正邪。例如，心病由中风（肝木生心火）引起，因为木在火之后，木生火为母子关系，所以是虚邪；由饮食劳倦（脾土生心火）引起，因为土在火之前，土生火为母子关系，所以是实邪；由中湿（肾水克心火）引起，因为水克火，所以是贼邪；由伤寒（肺金被火克）引起，因为火胜金，所以是微邪；由伤暑（心火自病）引起，因为火自病，所以是正邪。
有人问：有本经自病的情况，也有五邪所伤的情况，针灸治疗是否也应该加以区别？
经文说：忧愁思虑，会损伤心脏；形体受寒或饮用冷物，会损伤肺脏；愤怒气逆，气向上冲而不能下行，会损伤肝脏；饮食不节和过度劳累，会损伤脾脏；久坐湿地或强力涉水，会损伤肾脏。这些都属于本经自病。大概是因为忧思喜怒、饮食动作的过失，从而导致这些结果。风邪容易损伤肝脏，暑邪容易损伤心脏，饮食劳倦容易损伤脾脏（劳倦虽然看似内伤，但也由外因引发），寒邪容易损伤肺脏，湿邪容易损伤肾脏。这些属于五邪所伤。大概是因为邪气从外部侵入，所谓的外伤。凡是阴阳脏腑、经络之气，虚实平衡协调的，就是正常状态；如果偏实或偏虚，失去了正常状态，就成为邪气了。由于偏实，所以内生之邪得以产生；由于偏虚，所以外来之邪得以侵入。汪机按语：经文说凡是疾病都应当辨别邪正的内外虚实，然后施行针刺的补泻手法，这样才不至于出错。
有人问：经文说“虚则补之，实则泻之，不虚不实，以经取之”，这是什么意思？
经文说：虚证要补其母经，因为母能令子实；实证要泻其子经，因为子能令母虚。例如肝病虚证，则补厥阴肝经的合穴曲泉；实证则泻厥阴肝经的荥穴行间。所谓“不虚不实，以经取之”，是指本经自病，没有受到其他脏腑邪气的传变，应当直接取本经穴位，如井穴主治心下满等症状。本经自病，就是指忧愁思虑伤心、强力入水伤肾等情况。所谓不虚不实，是因为五脏之间没有相乘的关系，所以说直接取本经穴位（这是对卷末内容的重解）。
有人问：经文说“无实实，无虚虚，损不足，益有余”，这是什么意思？
经文说：这是指疾病有虚实之分。例如肝木实证，肺金虚证，金木应当相互平衡。应当知道用金来平抑木。假如肺实而肝虚，出现气息微弱少气的症状，使用针刺时不补肝，反而加重对肺的泻法，这就叫做“实其实”（使实证更实）、“虚其虚”（使虚证更虚）、“损不足”（损害不足的正气）、“益有余”（增加有余的邪气）。
有人问：七情所伤的疾病，如何察识？也可以用针刺治疗吗？
经文说：明智的人养生，必须顺应四季变化以适应寒暑，调和喜怒以安居处所，节制阴阳以调刚柔。像这样，邪僻之病就不会产生，可以长寿。所以，心中惊惧思虑，会损伤神志；损伤神志就会恐惧且自我丧失控制能力；脾脏忧愁不解，会损伤意念；损伤意念就会思维混乱；肝脏悲哀动中，会损伤魂；损伤魂就会狂妄健忘且不精明；肺脏喜乐无极，会损伤魄；损伤魄就会狂妄；肾脏盛怒不止，会损伤志；损伤志就会喜忘；恐惧不解，会损伤精；损伤精就会骨骼酸软、痿弱厥冷。因此，五脏是藏精的器官，不可损伤。损伤了就会失守而导致阴虚，阴虚就没有气，没有气就会死亡。所以使用针刺的人，要观察病患的状态，以此知晓精神魂魄的存亡得失之意。如果这五者都已损伤，针刺就不能治疗了。
又说：肝藏血，血舍魂。肝气虚则恐惧，肝气实则易怒。脾藏营气，营气舍意。脾气虚则四肢不能运用，五脏不安宁；脾气实则腹胀，大小便不利。心藏脉，脉舍神。心气虚则悲伤，心气实则笑个不停。肺藏气，气舍魄。肺气虚则鼻塞不利，气短；肺气实则喘促有声，胸部胀满需仰面呼吸。肾藏精，精舍志。肾气虚则厥冷，肾气实则腹胀，五脏不安宁。必须审察五脏的病状表现，以了解其气的虚实，从而谨慎地调理。
又说：肺心有邪，其气留滞于两肘；肝有邪，其气留滞于两腋；脾有邪，其气留滞于两髀（大腿）；肾有邪，其气留滞于两腘（膝窝）。这八个部位（八虚）都是关节机关的宝物，是真气经过的地方，也是血络游行的地方。邪气和恶血本来不得在此停留，如果停留就会损伤筋络骨节，导致关节不能屈伸，所以发生痉挛病症。
有人问：八正（二十四节气中的二分二至及四立等关键节气）的脉候是怎样的？
经文说：观察这些情况，通常在冬至日，立于叶蛰之宫（北方坎位）。当冬至之气到来时，天必然以风雨相应。如果风雨从南方来，称为虚风，主伤人杀害。所以圣人谨慎观察虚风并避开它，邪气就不能伤害人。（如果在夜半时分到来，百姓都在睡觉而不触犯它，所以这一年百姓少病。如果在白天到来，百姓懈怠懒惰而触犯它，所以百姓多病。）虚邪侵入客居于骨中而不发散于体表，到了立春之日，阳气大发，腠理开泄，如果恰逢立春之日，风从西方来，百姓又中于虚风。这两种邪气相互搏结，导致经气结代不通。所以凡是遇到这种风雨天气的，名叫遇岁露。如果年份温和而少贼风，则百姓少病少死；如果贼风邪气与寒温不调和，则百姓多病而死。
有人问：各种疾病的逆证和顺证，可以讲给我听吗？
经文说：腹部胀大，身体发热，脉象盛大，这是一逆。肠鸣且腹部胀满，四肢清冷，腹泻，脉象盛大，这是二逆。鼻出血不止，脉象盛大，这是三逆，（病情危重，可能）当日死亡。腹部胀大，四肢清冷，形体脱瘦，腹泻严重，这是一逆。腹部胀大且便血，脉象盛大但时有中断，这是二逆。咳嗽且尿血，形体脱瘦，脉象（躁急或微弱），（病情危重，可能）当日死亡。医生如果不察知这些情况而进行针刺，这叫逆治。
所谓的“五夺”，是指：1. 形肉已极度消瘦；2. 大量失血之后；3. 大汗出之后；4. 剧烈腹泻之后；5. 新产妇产后及大量出血之后。这五种情况都不可用泻法。
热病脉象静缓，但汗出之后，脉象反而盛大躁急，这是一逆。患泄泻病，脉象洪大，这是二逆。着痹不移，肌肉破溃，身体发热，脉象偏绝，这是三逆。淫邪致病且形体消瘦，身体发热，面色枯白，后来又下血且病情笃重，这是四逆。寒热交替且形体消瘦，脉象坚搏，这是五逆。小儿患病，头毛全部逆上竖立，必定死亡。
经文说：众痹，各自位于身体的不同部位，交替发作，交替停止，交替转移，交替兴起，左边对应右边，右边对应左边，不能遍及全身。针刺这种病，左右各取对应的穴位。疼痛从上往下传的，先刺下部以遏制病势，后刺上部以解除病根；疼痛从下往上传的，先刺上部以遏制病势，后刺下部以解除病根。周痹，此病在内不在脏腑，在外未发于皮肤，独居分肉之间，真气不能周流全身，所以叫周痹。
问：经文说凡痹症往来行无常处，在分肉间疼痛，针刺以月亮的盈亏来计算次数，为什么呢？
经文说：使用针刺的人，随着气血的盛衰来确定针刺的次数。针刺超过规定的次数，会导致脱气；不及规定的天数，则邪气不能排出。左刺右，右刺左，第一天两次，第二天两次，逐渐增加。第十五天十五次，第十六天十四次，逐渐减少。（像这样针刺就不会超过限度，也不会不足。）
有人问：经文说热病有五十九个刺穴，可以讲给我听吗？
经文说：热病三天，寸口脉静，人迎脉躁动的，取诸阳经穴位，用五十九刺法，以泻其热，使其出汗，充实其阴。具体穴位是：头入发际一寸，旁开三分各三个，共六个；再深入发际三寸，边各五个，共十个；耳前后、口下各一个，项中一个，共六个；头顶上一个，囟会一个，发际一个，廉泉一个，风池两个，天柱两个。热病七天八天，脉口动，气喘而短（一作弦）的，急刺之，汗将会自然流出，浅刺手大指间（少商穴）。热病汗将要出来，以及脉象顺可发汗的，取鱼际、太渊、大都、太白穴。泻这些穴位则热退，补这些穴位则汗出。如果汗出太多，取内踝上的横脉（复溜穴附近）以止汗。热病七八天，脉微小，病见尿血，口中干燥，半天内死亡；脉代（间歇）的，一天内死亡。热病已经出汗，脉尚躁动，气喘且再次发热的，死亡。热病七八天，脉不躁动，躁动不散且数，后三天中有汗出的可活，三天不出汗，第四天死亡。热病脉尚盛大，伴有明显寒战的，热在骨髓，死亡不可治。另外，热病有九种不可刺的情况：一曰，汗不出，大颧发赤，呃逆的，死亡；二曰，泄泻且腹部胀满严重的，死亡；三曰，眼睛不明，热势不退的，死亡；四曰，老人婴儿，发热且腹部胀满的，死亡；五曰，汗不出，呕吐且下血的，死亡；六曰，舌根腐烂，热势不退的，死亡；七曰，咳嗽且鼻衄，汗不出，汗出不到足的，（死亡）。
有人问：针刺热病也有不同之处吗？
经文说：这都是鼠瘰寒热毒气，留滞在脉中不去。鼠瘰的根本在于脏腑，其末端向上出于颈腋之间。对于这种寒热病，仔细按其经脉循行给予治疗，徐进徐退以去除邪气。小的如麦粒大小的，刺一次见效，刺三次痊愈。如果反过来看眼睛，其中有赤脉上下贯穿瞳子，见一条赤脉，一年死；见一条半，一年半死；见两条，二年死；见两条半，二年半死；见三条，三年死。见赤脉但不向下贯穿瞳子的，可以治疗。
有人问：痈疽如何治疗？
经文说：痈疽的产生，脓血的形成，都是由细微积累而成的。所以圣人要在未成形时自治，愚者等到已成形后才遭遇祸害。脓血已成，只能用砭石、铍锋等外科手段处理。所谓多有害的情况，是观察逆证和顺证。白眼青黑眼小，是一逆；服药即呕吐，是二逆；腹痛口渴严重，是三逆；肩项不便，是四逆；声音嘶哑，面色脱失，是五逆。除了这五种，就是顺证。
有人问：水肿病适宜针刺吗？
经文说：经脉满溢则络脉溢出，络脉溢出则用缪刺法，以调理络脉，使其恢复形态而不肿胀。缪刺法，不分隧道（经脉），脉象微弱的，现在也往往用缪刺法，灾祸立刻降临。大概是不审察经文所说的脉络满溢宜用缪刺的道理。
有人问：人有肥瘦黑白高矮之分，针刺方法相同吗？
经文说：年壮体质强壮的人，血气充盈，皮肤坚固，再加上邪气侵袭，针刺这种人，要深刺并留针。婴儿，其肉脆嫩，颜色红润，嘴唇薄，说话轻，血清气滑，容易脱气，容易损血。针刺这种人，要浅刺并快出针。壮士真骨者，肌肉坚实，关节舒缓，体格厚重，这种人如果体重，则气涩血浊，针刺要深刺并留针，增加针刺次数；如果体格劲健，则气滑血清，针刺要浅刺并快出针。常人，要看其肤色黑白，分别调理。那些端正敦厚的人，血气调和，针刺不要违背常规法则。
有人问：平民和大人（贵族/地位高者），针刺方法相同吗？
经文说：气滑则出针快，气涩则出针慢。气悍则用小针浅刺，气浊则用大针深刺。深刺想要留针，浅刺想要快出。春气在毫毛，夏气在皮肤，秋气在分肉，冬气在筋骨。凡是针刺治病，都要根据时令作为标准。所以刺肥人用秋冬的标准，刺瘦人用春夏的标准。
经文说：营气生病，表现为寒热、气少、血上下运行异常。卫气生病，表现为气痛时来时去，郁勃之气奔响，风寒客于体内产生内热。针刺布衣（平民）用火淬法，针刺大人（贵族）用药熨法。用熨法熨烫寒痹针刺的部位，使热气进入病所。起步后不见风，每次针刺必熨，这样病就好了。所谓内热，就是这样治疗的。
经文说：三虚，是指乘年之衰（运气衰弱之年），逢月之虚（月亮亏缺之时），失时之和（季节气候不和），因而被贼风所伤。这叫三虚。所以论述不知道三虚...（原文此处似有缺漏，意指不知三虚则易受邪）。
经文说：胃是水谷之海，其输注穴上部在气街，下部至三里。冲脉是十二经之海，其输注穴上部在大杼，下部出于巨虚上下廉。膻中是气之海，其输注穴上部在柱骨之上下，前在人迎。脑是髓之海，其输注穴上部在盖（百会），下部在风府。气海有余，则胸中胀满，喘息面赤；不足，则气少不足以言。血海有余，则常觉得自己身体大，郁郁然不知病在哪里；不足，则常觉得自己身体小，狭然不知病在哪里。水谷之海有余，则腹满；不足，则饥饿但不能进食。髓海有余，则轻便有力，超过常态；不足，则头晕耳鸣，小腿酸软，眩晕冒昧，视物不清，懈怠嗜卧。治疗这些情况，要审察并守住其输注穴，调理其虚实，不犯禁忌。顺此原则就能恢复，违背则必败。
有人问：各家说某穴主某病，这种说法可以采纳吗？
回答说：治病没有固定的穴位。邪气客居人体，与正气周流上下，或在气分，或在血分，没有固定位置。所以比喻用针者若死守某穴主某病的说法，执中无权，按谱施治，就像洪水泛滥，想堵塞下游来获得安宁，也只是偶然罢了。病变无穷，灸刺之法也无穷。或在上取下，或在下取上，或正取，或直取。审察经与络，分清血与气，病随经所在，穴随经而取，这样才能得到随机应变的道理，岂可固执于某穴主某病呢？有人说：这固然正确，但学习者望洋兴叹，不知从何下手。回答说：譬如工匠，教人用规矩取方圆。规矩的方法在老师，方圆的结果在子弟。圣人对于针刺，如果没有经络孔穴，就无法教导后学；后学如果没有经络孔穴的知识，也无法掌握针刺。所以要守神，粗工守关窍，上工守时机。时机变动，不离空中（指气机变化），说的就是这个道理。
有人问：八穴治病，很多有效的，怎么样？
回答说：人身正经十二条，奇经八条，大络十五条，小络三百余条，都是用来运行气血的。圣人取穴，三百六十穴...（原文此处似有缺漏，意指穴位众多）。不知经络，无法知晓气血往来；不知孔穴，无法知晓邪气所在。知道了并使用得当，病才能安。现在使用八穴的人，只取络穴六个，经穴两个，其余络经置之不用，追求快捷，违背圣经。又有拘泥于六十六穴按时辰开阖使用的，尚且不够周备，何况拘泥于八穴的呢？大概八穴病在气分，则有劫夺之功；若在血分，徒然损伤元气，病怎么能好？这正是血病却泻气。邪在血分，就直接求病所在而取穴即可。现在的人拘泥而不使用，实在可笑。
回答说：心是一身之主，最尊贵不可侵犯。膻中、鸠尾、巨阙，是心的宫城。心主虚怯，不能主事，有的狂病患者会有这种情况。使用针刺的医生，多于膻中、鸠尾、中庭针刺。这就像伊尹之于太甲，周公之于孺子，事情如果有差错，将倾覆社稷，荼毒生灵，其危害不可胜言。针刺这三个穴位也是这样，触犯真心，死亡不可救。必须自己揣度自己的才能，果然有伊尹、周公那样的能力，能够扶危持颠，才能保心于无危。
有人问：针刺三阴交，主治什么病？
回答说：足三阴经，从足走腹。太阴脾经循内踝上直行，厥阴肝经循内踝前交叉进入太阴之后，少阴肾经...（原文此处似有缺漏，意指循行路线）。如果不是危疾急证，且三阴经都有涉及，不可轻刺。脾肾之气常不足，肝虽有余，也是宿血之藏。误刺则会脱人元气，不可不慎。
回答说：十二经始于手太阴肺经的云门，依次相传，终于足厥阴肝经的期门。期门是肝的募穴。伤寒过经（传入厥阴），胁下有肥气，凡是木郁诸疾，无不针刺此穴，因为肝主病。经文说：穴直乳下两肋端。又说：在不容穴旁一寸五分。古人说得非常明白，今人不理解使用。
有人问：针刺胸腹，必须避开五脏，这是什么意思？
The Classic states: Diseases located in the upper part of the body belong to Yang; diseases located in the lower part belong to Yin. Pain belongs to Yin; pain that cannot be localized by palpation also belongs to Yin, and requires deep needling. Itching belongs to Yang, and requires shallow needling. If a disease originates from the Yin aspect first, treat the Yin first, then the Yang; if it originates from the Yang aspect first, treat the Yang first, then the Yin. (For diseases in the upper part, take points from the lower part; for diseases in the lower part, take points from the upper part. For diseases in the head, take points on the feet; for diseases in the waist, take points on the back. Diseases originating in the head cause heaviness in the head; those originating in the hands cause heaviness in the arms; those originating in the feet cause heaviness in the feet. In treating diseases, first needle the site where the disease originated.)
The Classic states: For diseases starting in the arm, first needle the Hand-Yangming Large Intestine channel and the Hand-Taiyin Lung channel to induce sweating. For diseases starting in the head, first needle the Foot-Taiyang Bladder channel at the neck to induce sweating. For diseases starting in the lower leg, first needle the Foot-Yangming Stomach channel to induce sweating. The Foot-Taiyin Spleen channel and Foot-Yangming Stomach channel can also induce sweating. Therefore, if taking Yin channel points causes excessive sweating, stop it by taking Yang channel points; if taking Yang channel points causes excessive sweating, stop it by taking Yin channel points.
Someone asked: The Classic mentions five types of pathogenic factors: Xu-Xie (Deficiency Evil), Shi-Xie (Excess Evil), Zei-Xie (Thief Evil), Wei-Xie (Minor Evil), and Zheng-Xie (Correct Evil). What do these mean?
The Classic states: Pathogenic factors coming from the Mother organ are called Xu-Xie (Deficiency Evil); those coming from the Child organ are called Shi-Xie (Excess Evil); those coming from the organ that overcomes me are called Zei-Xie (Thief Evil); those coming from the organ that I overcome are called Wei-Xie (Minor Evil); and diseases arising from the organ itself are called Zheng-Xie (Correct Evil). For example, heart disease caused by wind-stroke (Liver Wood generates Heart Fire) is Xu-Xie, because Wood follows Fire, and Wood generating Fire represents the Mother-Child relationship. Disease caused by diet and fatigue (Spleen Earth generates Heart Fire) is Shi-Xie, because Earth precedes Fire, representing the Mother-Child relationship. Disease caused by dampness invasion (Kidney Water overcomes Heart Fire) is Zei-Xie, because Water overcomes Fire. Disease caused by cold injury (Lung Metal is overcome by Fire) is Wei-Xie, because Fire overcomes Metal. Disease caused by summerheat (Heart Fire self-disease) is Zheng-Xie, because Fire is self-diseased.
Someone asked: There are cases of self-disease of the regular channels and injuries from the Five Evils. Should acupuncture treatment distinguish between them?
The Classic states: Worry and overthinking damage the Heart; exposure to cold and consumption of cold drinks damage the Lungs; anger with counterflow Qi rising and not descending damages the Liver; improper diet and overfatigue damage the Spleen; sitting long in damp places or forcing entry into water damages the Kidneys. These are self-diseases of the regular channels. This is generally due to excesses in emotions, diet, and activity. Wind easily damages the Liver; Summerheat easily damages the Heart; diet and fatigue easily damage the Spleen (though fatigue seems internal, it is triggered externally); Cold easily damages the Lungs; Dampness easily damages the Kidneys. These are injuries from the Five Evils. Generally, pathogens come from outside, which is external injury. When Yin-Yang, Zang-Fu, and Meridian Qi are balanced in deficiency and excess, it is normal; deviation towards excess or deficiency, losing normalcy, becomes evil. Due to deviation towards excess, internal evils arise; due to deviation towards deficiency, external evils enter. Wang Ji's commentary: The Classic states that all diseases should be distinguished regarding the nature, origin (internal/external), and deficiency/excess of the pathogen before applying tonification or sedation needling, to avoid errors.
Someone asked: The Classic says "Tonify deficiency, sedate excess, and for neither deficient nor excess, take from the channel." What does this mean?
The Classic states: For deficiency, tonify its Mother channel, as the Mother can make the Child full. For excess, sedate its Child channel, as the Child can make the Mother empty. For example, in Liver deficiency, tonify the He-Sea point Ququan of the Jueyin Liver channel; in excess, sedate the Ying-Spring point Xingjian of the Jueyin Liver channel. "Neither deficient nor excess, take from the channel" refers to self-disease of the regular channel without transmission from other organs' pathogens. One should directly take points from the affected channel, such as Jing-Well points governing chest fullness. Self-disease of the regular channel refers to conditions like worry damaging the Heart or forceful water entry damaging the Kidneys. "Neither deficient nor excess" means there is no mutual overcoming among the Zang organs, hence "take from its own channel" (a re-explanation of the end of the volume).
Someone asked: The Classic says "Do not tonify excess, do not sedate deficiency, do not harm what is insufficient, and do not add to what is already excessive." What does this mean?
The Classic states: This refers to the deficiency and excess of diseases. For example, if Liver Wood is in excess and Lung Metal is deficient, Metal and Wood should balance each other. One should know to use Metal to level Wood. If Lung is in excess and Liver is deficient, presenting with shortness of breath, and the practitioner fails to tonify the Liver but instead further sedates the Lung, this is called "making excess more excess, making deficiency more deficient, harming the insufficient, and adding to the excessive."
Someone asked: How can diseases damaged by the Seven Emotions be identified? Can they be treated with acupuncture?
The Classic states: Wise people nourish life by following the four seasons to adapt to cold and heat, harmonizing joy and anger to live peacefully, regulating Yin and Yang to adjust hardness and softness. By doing so, deviant diseases will not arise, ensuring longevity. Thus, fear and overthinking damage Shen (Spirit); damaging Shen leads to fear and loss of self-control. Unresolved sorrow damages Yi (Intellect); damaging Yi leads to mental confusion. Sadness moving within damages Hun (Ethereal Soul); damaging Hun leads to madness, forgetfulness, and lack of clarity. Unrestrained joy damages Po (Corporeal Soul); damaging Po leads to madness. Uncontrolled rage damages Zhi (Willpower); damaging Zhi leads to forgetfulness. Unresolved fear damages Jing (Essence); damaging Jing leads to soreness and weakness of the bones and cold extremities. Therefore, the Five Zang organs store Jing and must not be damaged. Damage leads to loss of control and Yin deficiency; Yin deficiency leads to lack of Qi; lack of Qi leads to death. Thus, acupuncturists must observe the patient's state to know the survival or loss of Spirit, Ethereal Soul, Corporeal Soul, etc. If these five are damaged, acupuncture cannot cure them.
It is also said: The Liver stores Blood, and Blood houses Hun. Liver Qi deficiency causes fear; Liver Qi excess causes anger. The Spleen stores Ying (Nutritive) Qi, and Ying Qi houses Yi. Spleen Qi deficiency causes inability to use the limbs and disharmony of the Five Zang; Spleen Qi excess causes abdominal distension and difficult urination and defecation. The Heart stores Mai (Vessels), and Vessels house Shen. Heart Qi deficiency causes sadness; Heart Qi excess causes incessant laughter. The Lungs store Qi, and Qi houses Po. Lung Qi deficiency causes nasal congestion and difficulty breathing, shortness of breath; Lung Qi excess causes wheezing, chest fullness, and仰息 (breathing with raised chest). The Kidneys store Jing, and Jing houses Zhi. Kidney Qi deficiency causes cold extremities; Kidney Qi excess causes abdominal distension and disharmony of the Five Zang. One must carefully examine the manifestations of Zang diseases to know the deficiency or excess of their Qi and regulate them cautiously.
It is also said: When the Lungs and Heart have pathogens, their Qi remains in the two elbows; when the Liver has pathogens, their Qi remains in the two axillae; when the Spleen has pathogens, their Qi remains in the two thighs (Pi); when the Kidneys have pathogens, their Qi remains in the two popliteal fossae (Guo). These eight voids (Ba Xu) are treasures of the joints, passages of True Qi, and routes of blood collaterals. Pathogens and bad blood should not stay here; if they stay, they damage sinews, collaterals, and bone joints, causing joint stiffness and spasms.
Someone asked: What are the observations for the Eight Normals (key solar terms)?
The Classic states: To observe these, one usually stands in the Ye Zhe Palace (North Kan position) on the day of Winter Solstice. When the Qi arrives, Heaven responds with wind and rain. If wind and rain come from the South, it is called Xu Feng (Empty Wind), which harms and kills. Thus, sages carefully observe and avoid Empty Wind so pathogens cannot harm. (If it arrives at midnight, people are sleeping and not exposed, so few get sick that year. If it arrives during the day, people are lax and exposed, so many get sick.) Empty evil enters and lodges in the bones without manifesting externally. When Spring Equinox arrives, Yang Qi expands greatly, pores open, and if wind comes from the West on that day, people are again struck by Empty Wind. These two evils collide, knotting the Meridian Qi. Those who encounter this wind and rain are called encountering Year Dew. If the year is harmonious with few Thief Winds, people have few diseases and deaths; if Thief Wind and pathogens clash with cold and warmth, people suffer many diseases and deaths.
Someone asked: Can you explain the reverse and favorable signs of various diseases?
The Classic states: Abdominal distension, fever, and large pulse is one reverse sign. Bowel sounds, abdominal fullness, cold extremities, diarrhea, and large pulse is the second reverse sign. Unstopping epistaxis and large pulse is the third reverse sign (death may occur on the same day). Abdominal distension, cold extremities, emaciation, and severe diarrhea is one reverse sign. Abdominal distension with bloody stool, large pulse with intermittent beats is the second reverse sign. Coughing and hematuria with emaciation and specific pulse changes indicate death (may occur on the same day). A physician who needles without observing these is practicing reverse treatment.
The "Five Deprivations" are: 1. Emaciation of flesh and muscle; 2. After massive blood loss; 3. After profuse sweating; 4. After severe diarrhea; 5. After childbirth or massive bleeding. None of these should be sedated.
In heat diseases, if the pulse is quiet but becomes rapid and restless after sweating, it is one reverse sign. In diarrhea, if the pulse is洪大 (Surging-Large), it is the second reverse sign. In fixed Bi syndrome with immobility, muscle wasting, fever, and absent pulse on one side, it is the third reverse sign. In淫邪 (Licentious/Excessive pathology) with emaciation, fever, pale waxy complexion, followed by bloody stool and severe condition, it is the fourth reverse sign. In alternating cold and heat with emaciation and firm, gripping pulse, it is the fifth reverse sign. In children, if illness causes hair to stand on end, death is certain.
Someone asked: The Classic mentions Zhong Bi (Multifocal Bi) and Zhou Bi (Circulating Bi). What is the difference?
The Classic states: Zhong Bi occurs in various locations, alternating in onset and cessation, shifting positions, left corresponding to right, right to left, not circulating throughout the body. To needle this, take points on both sides corresponding to the pain. If pain travels from top to bottom, needle the lower part first to block it, then the upper part to release it. If pain travels from bottom to top, needle the upper part first to block it, then the lower part to release it. Zhou Bi is internal, not in the Zang, and external, not yet in the skin, residing alone between muscle layers, where True Qi cannot circulate fully, hence called Zhou Bi.
Question: The Classic says Bi syndrome moves without fixed location, causing pain between muscle layers, and needling frequency is based on the moon's phases. Why?
The Classic states: The acupuncturist adjusts the number of needles according to the rise and fall of Qi. Needling beyond the limit causes Qi depletion; falling short fails to expel Qi. Needle left-right, right-left. Day 1: two times; Day 2: two times; gradually increase. Day 15: fifteen times; Day 16: fourteen times; gradually decrease. (This ensures no excess or deficit.)
Someone asked: The Classic mentions fifty-nine points for heat diseases. Can you list them?
The Classic states: On the third day of heat disease, if the Cun Kou pulse is quiet and Ren Ying pulse is restless, take points from all Yang channels using the fifty-nine needling method to sedate heat and induce sweat, thereby filling Yin. The points are: Six points one cun inside the hairline, three on each side; ten points three cun inside the hairline, five on each side; one point each in front of and behind the ears, below the mouth, and in the middle of the neck (six total); one point on the vertex, one at Xinhui, one at the hairline, one at Lianquan, two at Fengchi, and two at Tianzhu. On days seven or eight, if the pulse port moves, with panting and shortness of breath (or string-like pulse), needle urgently to induce spontaneous sweat; shallowly needle the space between the big toe (Shangyang). For heat disease about to sweat or with favorable pulses for sweating, take Yuji, Taiyuan, Dadu, and Taibai. Sedating clears heat; tonifying induces sweat. If sweat is excessive, take the transverse vessel above the medial malleolus to stop it. On days seven or eight, if the pulse is minute, with hematuria and dry mouth, death occurs in half a day; if the pulse is intermittent (Dai), death occurs in one day. If heat disease has sweated but pulse remains restless with panting and recurrent fever, death ensues. If on days seven or eight the pulse is not restless, but restless and rapid without dispersing, sweat within three days indicates survival; no sweat by day four indicates death. If heat disease pulse remains full with significant chills, heat is in the marrow, death is incurable. There are nine contraindications for needling heat diseases: 1. No sweat, red cheeks, hiccups (death); 2. Diarrhea with severe abdominal fullness (death); 3. Blindness with unrelenting heat (death); 4. Elderly or infants with fever and abdominal fullness (death); 5. No sweat, vomiting, and bloody stool (death); 6. Ulcerated tongue base with unrelenting heat (death); 7. Coughing with epistaxis, no sweat, or sweat not reaching feet... (text cuts off).
Someone asked: Is needling for heat diseases different?
Someone asked: What causes cold-heat Luoli (scrofula) in the neck and axilla?
The Classic states: These are toxins from mouse Luoli cold-heat, lingering in the vessels. The root lies in the Zang, emerging at the neck and axilla. Treat by carefully following the meridians, entering slowly and withdrawing slowly. Small ones like wheat grains heal after one insertion, cured after three. If looking into the eyes reveals red vessels piercing the pupil, one vessel predicts death in one year; one and a half vessels, one and a half years; two vessels, two years; two and a half vessels, two and a half years; three vessels, three years. If red vessels do not pierce the pupil, it is treatable.
Someone asked: How to treat Yong Ju (carbuncles and ulcers)?
The Classic states: Carbuncles and ulcers arise from accumulation of the minute. Sages treat before form appears; fools suffer after formation. Once pus and blood form, only stone lancets and scalpels can treat. Observing reverse and favorable signs is crucial. Reverse signs: blue whites of eyes with small black pupils (one); vomiting after taking medicine (two); severe abdominal pain and thirst (three); stiff shoulder and neck (four); hoarse voice and loss of complexion (five). Beyond these, it is favorable.
Someone asked: Is acupuncture suitable for edema?
The Classic states: When Jing vessels are full, Luo vessels overflow; when Luo vessels overflow, use Miao Ci (lateral needling) to regulate Luo vessels and restore shape without swelling. Miao Ci does not distinguish meridians. Now, even with weak pulses, Miao Ci is often used, bringing immediate disaster. This is due to ignoring the Classic's principle that full and overflowing Luo vessels require Miao Ci.
Someone asked: Do fat, thin, white, dark, tall, and short people require the same needling methods?
The Classic states: Robust adults with full Qi and blood and tough skin, when attacked by pathogens, require deep needling with retention. Infants with fragile flesh, ruddy color, thin lips, light speech, clear and slippery Qi and blood, prone to Qi depletion and blood damage, require shallow and quick needling. Strong men with solid bones and muscles: if heavy, Qi is stagnant and blood turbid, requiring deep needling with retention and increased frequency; if agile, Qi is slippery and blood clear, requiring shallow and quick needling. Ordinary people: adjust according to skin color. Those upright and thick have harmonious Qi and blood; needle without deviating from standard rules.
Someone asked: Do commoners and nobles require the same needling methods?
The Classic states: Slippery Qi requires quick withdrawal; stagnant Qi requires slow withdrawal. Fierce Qi requires small needles and shallow insertion; turbid Qi requires large needles and deep insertion. Deep needling retains; shallow needling withdraws quickly. Spring Qi is in the hairs; Summer Qi in the skin; Autumn Qi in the muscle layers; Winter Qi in the sinews and bones. Needling must follow seasonal standards. Needle robust people with winter/autumn standards; thin people with spring/summer standards.
The Classic states: Ying disease presents with cold-heat, shortness of breath, and abnormal blood flow. Wei disease presents with migrating pain, turbulent Qi sounds, and internal heat from wind-cold. Needling commoners uses fire cautery; needling nobles uses herbal warming. Apply warming to the needled site of cold Bi to drive heat to the disease site. Avoid wind after needling. Warm every time needled until cured. This treats internal heat.
Someone asked: What are the Three Deficiencies and Three Excesses?
The Classic states: Three Deficiencies refer to being in a year of declining fortune, meeting a deficient moon phase, and losing seasonal harmony, thus injured by thief wind. This is called Three Deficiencies. (Text implies ignorance of Three Deficiencies leads to error.)
Someone asked: What are the Four Seas of the human body?
The Classic states: The Stomach is the Sea of Water and Grain, with Shu points at Qichuang and Zusanli. The Chong Mai is the Sea of Twelve Channels, with Shu points at Dazhu and Xiangu. The Danzhong is the Sea of Qi, with Shu points at the upper and lower vertebral column and Renying. The Brain is the Sea of Marrow, with Shu points at Baihui and Fengfu. Excess Qi Sea causes chest fullness, panting, and red face; deficiency causes shortness of breath. Excess Blood Sea makes one feel large and depressed; deficiency makes one feel small and constrained. Excess Water/Grain Sea causes abdominal fullness; deficiency causes hunger without desire to eat. Excess Marrow Sea causes lightness and strength beyond normal; deficiency causes dizziness, tinnitus, sore legs, blindness, lethargy, and desire to lie down. Treat by examining Shu points and regulating deficiency/excess without violating taboos. Following this restores health; opposing it leads to failure.
Someone asked: Various schools say specific points treat specific diseases. Is this acceptable?
Answer: There are no fixed points for curing diseases. Pathogens move with Zheng Qi, residing in Qi or Blood levels without fixed location. Clinging to "Point X treats Disease Y" is rigid and ineffective, like trying to stop a flood by blocking the downstream. Diseases change infinitely; needling methods must also be infinite. Take upper points for lower diseases, lower for upper, direct or indirect. Examine Jing and Luo, distinguish Blood and Qi, follow the meridian for the disease and the point. This allows flexibility. How can one cling to specific point-disease pairs? Some say learners don't know where to start. Answer: Like a carpenter teaching rules for squares and circles. The teacher holds the rules; the student produces the shapes. Sages use meridians and points to teach; students must learn them to understand Qi/Blood flow and pathogen location. Knowledge must be applied accurately. Coarse practitioners guard joints; superior practitioners guard the timing/movement of Qi. This is the essence.
Someone asked: Eight points often work well for diseases. What about this?
Answer: The body has twelve Regular Channels, eight Extraordinary Channels, fifteen Major Collaterals, and hundreds of minor collaterals, all moving Qi and Blood. Sages selected 360 points... (text implies complexity). Not knowing meridians prevents understanding Qi/Blood flow; not knowing points prevents locating pathogens. Knowledge must be applied correctly. Using only eight points (six Luo, two Jing) ignores others, seeking shortcuts against the Classics. Even restricting to 66 points based on time openings is incomplete, let alone eight points. Eight points work for Qi-level diseases but damage Yuan Qi in Blood-level diseases. This is sedating Qi for Blood disease. For pathogens in Blood, find the site and needle directly. Modern rigidity is laughable.
Someone asked: Are there contraindications for needling Tanzhong, Jiutui, and Zhongting?
Answer: The Heart is the master, precious and inviolable. Tanzhong, Jiutui, and Jueque are the palace walls of the Heart. If the Heart Master is weak, patients may become manic. Practitioners often needle these points, akin to ministers serving a young king; errors could topple the state. Needling these three risks touching the True Heart, leading to incurable death. One must assess skill; only those with abilities like Yi Yin or Duke of Zhou can safely support the critical and protect the Heart.
Someone asked: What diseases does Sanyinjiao treat?
Answer: The Foot Triple Yin channels ascend from foot to abdomen. The Taiyin Spleen channel goes straight up the medial malleolus; the Jueyin Liver channel crosses anterior to it and enters posterior to Taiyin; the Shaoyin Kidney channel... (text cuts off). Unless it is a critical emergency involving all three Yin channels, do not lightly needle. Spleen and Kidney Qi are often deficient; Liver stores old blood. Mistaken needling depletes Yuan Qi. Be cautious.
Someone asked: What about needling Qimen for Shanghan (Cold Damage)?
Answer: The twelve channels start at Yunmen of Hand-Taiyin and end at Qimen of Foot-Jueyin. Qimen is the Mu point of the Liver. In advanced Shanghan, with hypochondriac masses or Wood stagnation diseases, needle this point as the Liver governs the pathology. The Classic states the point is under the nipple at the rib end, or 1.5 cun lateral to Burong. Ancients explained this clearly; moderns fail to apply it.
Someone asked: Needling the chest and abdomen requires avoiding the Five Zang. What does this mean?
The Classic states: Piercing the Heart causes death in one day; piercing the Liver in five days; piercing the Spleen in ten days; piercing the Kidney in six days; piercing the Lung in three days.