平按∶此篇自皇帝曰持针纵舍奈何以上，袁刻及别抄本均缺。杨惺吾氏日本卷子抄本自篇目
刺法左一行上二字仍缺，第三字至第七字有“问岐伯曰余”五字，以下至注“半反冲也”上复缺，
计共缺六行，每行十八字，除去“问岐伯曰余五字”并问字上所空二格外，下共缺一百零一字，
应空一百零一格。自黄帝曰持针纵舍奈何至故拘挛，见《灵枢》卷十第七十一《邪客》篇，又见
《甲乙经》卷五第七。自黄帝问岐伯曰余闻针道于夫子至则经可通也，见《灵枢》卷六第三十八
《逆顺肥瘦》篇，又见《甲乙经》卷五第六。自黄帝问曰逆顺五体至末，见《灵枢》卷二第五
《根结》篇，《甲乙经》同上。
□□问岐伯曰余□□□□□□□□□□□□□□□□□□□□□□□□□□□□□
（□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□
□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□半反，冲也。谓冲皮也。）
黄帝曰∶持针纵舍奈何？岐伯对曰∶必先明知十二经之本末，（起处为本，出处为末。）肤之寒
热，（皮肤热即血气通，寒即脉气壅也。平按∶肤上《灵枢》、《甲乙》有皮字。）脉之盛衰滑
涩。其脉滑而盛者病日进，虚而细者久而持，（阳气盛而微热，谓之滑也。多血少气微寒，谓之
涩脉□□细微□□□□□平按∶而持《灵枢》、《甲乙》作以持。）大以涩者为痛痹，（多气少血
为大，多血少气为涩，故为痛痹也。）阴阳如一者瘤，难治其本末。（阴阳之脉不可辨，故如一
也。瘤，悬疣□类也。以不可辨，故本末难疗也。平按∶瘤《灵枢》、《甲乙》作病。其上《甲
乙》有察字。）上热者病尚在，其热以衰者，其病亦去矣。（头及皮肤热也。其头及皮肤热衰，
病必去。平按∶上热《灵枢》作尚热，《甲乙》作上下热。以衰《灵枢》、《甲乙》作已衰。注
去上袁刻脱必字。）因持其尺，察其肉之坚脆、小大、滑涩、寒温、燥湿也。（持尺皮肤，决死
生也。平按∶持上《灵枢》无因字。）因视目之五色，以知五脏而决死生。（五脏之精华，并归
于目，心□□□□□藏□□）视其血脉，察其五色，以知其寒热痛痹。（候色脉尺□□□□平按∶
《甲乙》无其字。注右方有候色脉尺四字，左方缺，应空四小格。）黄帝曰∶持针纵舍，余未得
其意也。（□□□□□□针纵舍故重问也。）岐伯曰∶持针之道，欲端以正，安以静，（持针
当穴，故端正。以志不乱，故安静也。）先知虚实，而行疾徐，（补泻所由也。）左指执骨，右
手修之，毋与肉果之，（□□坚固，故曰执骨之□手修□不可伤肉果也。果
音颗。平按∶《灵枢》、《甲乙》左指作左手，修之作循之，果下无之字。）泻欲端以正，补必闭
肤，（□□直入直出，故曰端正。□□□□□□□□□平按∶端下《甲乙》无以字。补袁刻误作
萌。注直入上原缺二字，上一字不可辨，下一字右方有欠字，平据经文拟作泻欲二字。）转针导
气，邪得淫 ，真气得居。（□□□□□□□□□□□□淫 泄出，令真气居而不散也。平按∶
邪得淫 《甲乙》作邪气不得淫 。）黄帝曰∶ 皮开腠理奈何？岐伯曰∶因其分肉，在别其肤，
（肤，皮也。以手按得分肉之穴，当穴皮上下针，故曰在别其肤也。平按∶在别《灵枢》、《甲乙》
作左别。）微内而徐端之，适神不散，邪气得去。黄帝曰∶善。（泻法虽以□□□□□□审详为
先，故曰微内而徐正之□□□□□□得□□□□酒调也。平按∶注虽以下原缺六字，上三字不可
考，下三字右方作必余余，平拟作“端正而必徐徐”六字。）
黄帝问岐伯曰∶人有八虚，各何以候？岐伯答曰∶以候五脏。（八虚者，两肘、两腋、两髀、
两。此之虚，故曰八虚。以其虚，故真邪二气留过，故为机关之室。真过则机关动利，邪留则
不得屈伸，故此八虚，候五脏之气也。平按∶各何以候袁刻作各以何候，曰上袁刻脱答字。）黄帝
曰∶候之奈何？岐伯曰∶肺心有邪，其气留于两肘；（两肘，肺脉手太阴、心脉手少阴二脉所行，
故肺心有邪，肘为候也。）肝有邪，其气留于两腋；（两腋胁下，肝气在中，肝有邪，腋为候也。）
脾有邪，其气留于两髀；（脾足太阴脉，循股内前廉入腹，故脾有邪，髀为候也。）肾有邪，其
气留于两 。（肾脉足少阴，出 内廉，故肾有邪， 为候也。）凡此八虚者，皆机关之室，真
气之所过，血络之所游，邪气恶血，因不得住留，留则伤筋络，骨节机关不得屈
伸，故 挛。（此八大节相属虚处，乃是□□之动□机关又□□□□□□□□□□机关之室。 ，
其俱反，曲脊背偃也。平按∶因不得住留《灵枢》作固不得住留。故 挛《灵枢》作故病挛也。）
黄帝问岐伯曰∶余闻针道于夫子，众多毕悉矣，夫子之应若失，而据未有坚然者，夫子之问
学熟乎？将审察于物而生乎？（据，根据也。坚，定也。言夫子所说九针之应，曲从物理而变，似
未有定为也。夫子所问所学，从谁得乎？□□□□□□□□□心手也。平按∶《灵枢》应上有道
字，而生乎作而心生之乎。）岐伯答曰∶圣人之为道者，上合于天，下合于地，中合于人事，必
有明法以起度数，法式检押，乃后可传焉。（□□□合理乃后传之，三合而为法度，故可传也。）
故匠人不能释尺寸而意短长，废绳墨而起水准也；工人不能置规而为圆，去矩而为方。（匠人□
尺寸之度非以意而为短长准□□□□不有私而□水□□为□巧也工□为□□置□□□□欲为□□
为弃矩而□妙此为大工也圣人之为教也法自然之至理以起法度□为而□称圣人也 平按∶注匠人
下原缺一字，谨拟作准。不有私上原缺四字，谨根据经文作绳墨之法四字。水字上原缺一字，水字下
原缺二字，为下原缺一字，谨根据经文作而起水准以为技巧也。工下原缺一字，为下原缺二字，置
下原缺四字，谨根据经文作工欲为员无置规而为能。无弃矩上原缺二字，而下原缺一字，谨根据经文
作欲为方亦无弃矩而为妙。法度下原缺一字，谨拟作之。称上原缺一字，谨拟作后。）知用此者，
固自然之物，易用之教，逆顺之常。（绳墨非他，亦自然之绳墨，因其自然，故其教用易，是故
违之则为逆，顺之得常也。平按∶固自然之物，据注固应作因。注违之袁刻作遵之。）黄帝曰∶愿
闻自然奈何？岐伯曰∶临深决水，不用功力而水可竭
也；循掘决冲而经可通。此言气之滑涩，血之清浊，行之逆顺。（夫自然者，非为自能与也，所
谓因气之滑涩，血之清浊，行之逆顺，通之如临深决水，取自然之便而水可竭，故曰自然也。平
按∶循掘，掘字原缺，《灵枢》、《甲乙》作掘，下经文亦作掘，袁刻作地恐误。决冲下《甲乙》
有罔顾坚密四字。此言，此字原缺，《灵枢》、《甲乙》作此，袁刻作于恐误。注夫自然者，袁
刻脱自字。）黄帝曰∶愿闻人之白黑肥瘦少长，各有数乎？（白黑，色异也。肥瘦，形异也。少
长，强弱异也。刺之浅深多为分不同，故曰有数也。平按∶注多下恐脱少字。）岐伯曰∶年质壮
大，血气充盈，肤革坚固，因加以邪，刺此者深而留之。（此为肥人。平按∶盈《甲乙》作盛。
注此为肥人《灵枢》、《甲乙》作经文。）广肩腋项，肉薄皮浓而黑色，唇临临然，其血黑而浊，
其气涩，其为人贪于取与，刺此者深而留之，多益其数。（此黑色人也。平按∶皮浓《灵枢》、
《甲乙》作浓皮。临临然下《甲乙》有者字。涩下《灵枢》、《甲乙》有以迟二字。取与《甲乙》
作取予。）黄帝曰∶刺瘦人奈何？岐伯曰∶刺瘦人者薄皮色少，肉廉廉然，薄唇轻言，其血清气
滑，易脱于气，易损于血，刺此者浅而疾之。（瘦人，谓夭□□皮也。平按∶注夭下原缺二字，
谨根据经文拟作色薄二字。袁刻夭作天，皮作人。）黄帝曰∶刺常人奈何？岐伯曰∶视其白黑，各
为调之，其端正长浓者，其血气和调，刺此者无失常数之。（常，谓平和不肥瘦人。刺之根据于深
浅常数，不深之不浅之也。平按∶长浓《灵枢》作敦浓，《甲乙》作纯浓。常数之《灵枢》作常数
也，《甲乙》作其常数。）黄帝曰∶刺壮士真骨者奈何？岐伯曰∶刺壮士真骨，坚肉纵节监监然，
此人重则气涩血浊，刺此者深而留之，多益
其数；（壮士，骨□坚大者也。平按∶纵节《灵枢》、《甲乙》作缓节。坚坚《甲乙》作验验，注∶
“一作监监。”注骨下原缺一字，谨拟作节。）劲则气滑血清，刺此浅而疾之。（劲，急也。）黄
帝曰∶刺婴儿奈何？岐伯曰∶婴儿者，其肉脆血少气弱，刺此者以豪针，浅刺而疾发针，日再可
也。（刺婴儿日再者，不得过多也。）黄帝曰∶临深决水奈何？岐伯曰∶血清气滑，疾泻之则气
竭焉。（自有血清气滑，刺之如临深决水，不可行也。若血浊气涩而形壮气盛，可取自然之便，
刺而泻之，如临深决水。平按∶气滑《灵枢》、《甲乙》作气浊。）黄帝曰∶循掘决冲奈何？岐
伯曰∶血浊气涩，疾泻之则经可通也。（循其血气，掘决其冲，泻而通之，使其平也。）
黄帝问曰∶逆顺五体，言人骨节之小大，肉之坚脆，皮之薄浓，血之清浊，气之滑涩，脉之
长短，血之多少，经络之数，余已知之矣，此皆布衣匹夫之士也。（平按∶逆顺五体《甲乙》作
逆顺五体经络之数，直接下文此皆布衣匹夫之士也，无言人骨节之小大及余已知之矣数句。）夫
王公大人血食之君，身体柔脆，肌肉 弱，血气 悍滑利，其刺之徐疾浅深多少，可得同乎？（平
按∶夫王公大人血食之君《甲乙》作血食者三字，注云∶“《九墟》作血食之君。”《灵枢》 弱
作软弱。）岐伯答曰∶夫膏粱菽藿之味，何可同也？气滑则出疾，气涩则针大而入深，深则欲留，
浅则欲疾。以此观之，刺布衣者深以留，刺大人者微以徐，此皆因气 悍滑利者也。（脉气五十
动有代者，顺也；不满五十动一代者，逆也。言大人食以膏粱，布衣□□□□□□□□故刺之深浅
去留之异也。平按∶气滑则出疾下《灵枢》
有“其气涩则出迟，气悍则针小而入浅”，《甲乙》同，惟气涩上无其字。注布衣二字下原缺八
字，袁刻补食以菽藿四字，仍与缺处未尽合，谨根据经文拟作“匹夫之士食以菽藿”八字。）黄帝
问曰∶形气之逆顺奈何？岐伯答曰∶形气不足，病气有余，是邪胜也，急泻之。（急泻邪气，补
形气也。）形气有余，病气不足，急补之。（急以正气补之，气实则病除也。）形气不足，病气
不足，此阴阳气俱不足也，不可刺之，刺之则重不足，重不足则阴阳俱竭，血气皆尽，五脏空虚，
筋骨髓枯，老者绝灭，壮者不复矣。（俱不足者，不可行刺，宜以汤药调也。）形气有余，病气
有余，此谓阴阳俱有余也，急泻其邪，调其实虚。故曰有余者泻之，不足者补之，此之谓也。（形
气为阳，病气为阴，□俱有余者，可以泻邪气以调形气使和也。平按∶注阴下原缺一字，右方剩
气字半角，谨拟作气，袁刻脱。）故曰刺不知逆顺，真邪相薄。满而补之，则阴阳四溢，肠胃充
郭，肝肺内 ，阴阳相错。（满而补之，阴阳之气，满于□□故曰四溢。肠胃气聚，所以胀而充
郭。肝肺俱满，故曰内 。叱邻反。阴阳俱盛，所以相错也。平按∶《甲乙》四溢作血气皆溢，内
作内胀。注满于下原缺二字，上一字不可考，下一字下半剩又字，谨拟作四肢二字。）虚而泻
之，则经脉空虚，血气竭枯，肠胃摄辟，皮肤薄着，毛腠夭焦，予之死期。（摄辟，肠胃无气也。
摄，纸辄反。平按∶竭枯《甲乙》作枯竭。摄《灵枢》作HT ，《甲乙》作慑。焦《灵枢》作 。）
故曰用针之要，在乎知调，调阴与阳，精气乃光，合形与气，使神内藏。（光，章盛貌。神内藏
者，五神守藏也。平按∶知调下原缺一字，《灵枢》作阴与阳调阴与阳七字，《甲乙》重调字，谨
根据《甲乙》拟作调。乃光《甲乙》作乃充。使神内藏，使字原缺，谨根据《灵
枢》、《甲乙》补作使，袁刻作五。）故曰上工平气，中工乱经，下工绝气危生，故下工不可不
慎也。（平气，致气和也。下工守形，不知□气，伤口□实，故不可不慎也。平按∶《甲乙》无
“故下工”三字。注气伤上原缺一字，谨根据经文拟作平。伤下原缺二字，谨拟作生损二字。）必审
其五脏变化之病，五脉之应，经络之实虚，皮之柔粗，而后取之。（五脉，五时之脉也。柔粗，
谓调尺之皮肤柔弱粗强也。平按∶审下《灵枢》无其字。《甲乙》审作察，变化上有之字，下无
之病二字，应上有相字，皮下有肤字。）
【校勘说明】：本篇从“黄帝曰：持针纵舍奈何”以上部分，袁刻本及别抄本均缺失。杨惺吾氏收藏的日本卷子抄本中，篇名“刺法”左侧第一行上二字仍缺，第三字至第七字有“问岐伯曰余”五字，以下直至注文“半反冲也”上方再次缺失，共计缺失六行，每行十八字，除去“问岐伯曰余”五字及问字上方的空格外，下方共缺一百零一字，应空一百零一格。从“黄帝曰：持针纵舍奈何”至“故拘挛”，见于《灵枢》卷十第七十一《邪客》篇，又见于《甲乙经》卷五第七。从“黄帝问岐伯曰：余闻针道于夫子”至“则经可通也”，见于《灵枢》卷六第三十八《逆顺肥瘦》篇，又见于《甲乙经》卷五第六。从“黄帝问曰：逆顺五体”至末尾，见于《灵枢》卷二第五《根结》篇，《甲乙经》同上。
（此处原文缺失）
（此处原文缺失）
（注：“半反”意为“冲”的音读，指冲击皮肤。）
黄帝说：持针时如何运用进针与出针（纵舍）的技巧？岐伯回答说：必须首先明确十二经脉的起止（起处为本，出处为末），皮肤的寒热状况（皮肤热表示血气通畅，寒表示脉气壅滞），以及脉搏的盛衰、滑涩情况。脉搏滑而盛的，病情正在发展；脉搏虚而细的，病程持久（阳气盛而有微热，称为滑脉；多血少气且微寒，称为涩脉）。脉搏大而涩的，属于痛痹（多气少血为大脉，多血少气为涩脉，所以是痛痹）。阴阳脉象无法分辨、看似一样的，是瘤病（阴阳之脉不可辨别，所以看起来一样。瘤，即悬疣之类。因为无法辨别，所以本源难治）。上部热的，病邪尚在；上部热势减退的，病也就好了（头及皮肤发热。头及皮肤热势减退，病必去）。因此要持按尺肤，观察肌肉的坚脆、大小、滑涩、寒温、燥湿情况（持按尺肤皮肤，以决断生死）。还要观察眼睛的五色，以此了解五脏情况并决断生死（五脏的精华都汇聚于目）。观察其血脉，察视五色，以此知道寒热痛痹的情况。
黄帝说：关于持针的纵舍技巧，我还没理解其中的意思。岐伯说：持针的原则，要端正、正直、安详、宁静（持针对准穴位，所以要端正；心志不乱，所以要安静）。先辨明虚实，然后施行疾徐手法（这是补泻的依据）。左手固定骨骼部位，右手操作针具，不要损伤肌肉（肌肉坚固，所以叫执骨；右手操作不可伤及肉果。果音同颗）。泻法要端正直入直出，补法必须闭合针孔（直入直出，所以叫端正……转针引导正气，使邪气淫散排出，让真气安居而不散失）。
黄帝说：如何使皮开腠理？岐伯说：顺着分肉的纹理，在区分开的皮肤处下针（皮肤即皮。用手按压找到分肉的穴位，在穴位上下针，所以叫在别其肤）。微微进针并缓慢端正地推进，使神气不散，邪气得以去除。黄帝说：好。
黄帝问岐伯说：人有八虚（八个虚处），各用来候诊什么？岐伯回答说：用来候诊五脏（八虚是指两肘、两腋、两髀、两腘。这些部位是虚处，所以叫八虚。因为这里是虚处，所以真气和邪气容易停留经过，因此是机关之室。真气经过则关节活动灵活，邪气停留则不能屈伸，所以这八虚可以候诊五脏之气）。黄帝说：怎么候诊？岐伯说：肺和心有邪气，其气停留在两肘（两肘是肺经手太阴、心经手少阴两条经脉所行的地方，所以肺心有邪，肘部可作为候诊依据）；肝有邪气，其气停留在两腋（两腋胁下，肝气在中，肝有邪，腋部可作为候诊依据）；脾有邪气，其气停留在两髀（脾足太阴脉，循行大腿内侧前缘进入腹部，所以脾有邪，髀部可作为候诊依据）；肾有邪气，其气停留在两腘（肾脉足少阴，出于腘内廉，所以肾有邪，腘部可作为候诊依据）。凡是这八虚，都是关节活动的关键部位，是真气经过的地方，也是血络游行的地方，邪气和恶血因此不能停留，如果停留就会损伤筋络，导致骨节机关不能屈伸，所以会出现拘挛（这八大关节相连的虚处，是机关活动的所在……腘，其俱反，指曲脊背偃。因邪气不得停留，所以生病挛急）。
黄帝问岐伯说：我从先生那里听闻针道，内容众多且详尽，但先生所说的九针的应用似乎没有固定的定论，这是先生的学问熟练呢？还是根据事物的变化而生发的？（据，根据。坚，定。意思是先生说到的九针应用，随物理变化而变化，似乎没有固定的定论。先生所问所学，是从谁那里得来的？）岐伯回答说：圣人之道，上合于天，下合于地，中合于人事，必须有明确的法则来确立度数、法式和规范，然后才可以传授。（合乎道理然后才传授，三合而为法度，所以可传。所以工匠不能放弃尺寸而去随意测量长短，废弃绳墨而起水准仪；工人不能放下圆规而画圆，去掉矩尺而画方。（工匠不凭心意随意决定长短，不靠私意使用水准仪来显示技巧；工人想画圆不放下圆规就不能成，想画方不抛弃矩尺就不能妙。圣人教化遵循自然至理以建立法度……知道运用这些的人，本来就是顺应自然之物，是易于应用的教导，违背就是逆，顺应就是常。）黄帝说：愿意听听什么是自然？岐伯说：面对深水开闸放水，不用费力水就可以流干；顺着挖掘之处决开堵塞，经络就可以通畅。这是说气的滑涩、血的清浊、运行的逆顺。（所谓自然，不是自己有能力，而是顺应气的滑涩、血的清浊、运行的逆顺，通畅如同面对深水开闸放水，取自然之便水即可流干，所以叫自然。）
黄帝说：愿意听听人的黑白肥瘦老少，针刺各有定数吗？（黑白指肤色不同，肥瘦指形体不同，老少指强弱不同。针刺的深浅多少因此不同，所以说有定数。）岐伯回答说：年壮质强的人，血气充盈，皮肤坚固，如果加上邪气，针刺这种人要深刺并留针（这是针对肥人）。肩膀宽、腋下宽、项部粗，肉薄皮厚且肤色黑，嘴唇丰厚，其血黑而浊，其气涩，为人贪于索取给予，针刺这种人要深刺并留针，增加针刺次数（这是针对黑色人）。
黄帝说：怎样针刺瘦人？岐伯说：针刺瘦人，他们皮薄色少，肌肉消瘦，嘴唇薄说话轻，其血清气滑，气易脱，血易损，针刺这种人要浅刺并快出针（瘦人，谓色薄皮……）。
黄帝说：怎样针刺常人？岐伯说：观察他们的黑白，分别进行调整，那些端正长厚的人，其血气和调，针刺这种人不要违背常规的常数（常，指平和不肥不瘦的人。针刺根据深浅常数，不深不浅）。
黄帝说：怎样针刺骨骼坚实的壮士？岐伯说：针刺骨骼坚实的壮士，他们肌肉坚实、关节舒缓，如果此人体格沉重，则气涩血浊，针刺要深刺并留针，增加针刺次数；如果体格劲急，则气滑血清，针刺要浅刺并快出针（劲，急也）。
黄帝说：怎样针刺婴儿？岐伯说：婴儿肌肉脆弱，血少气弱，针刺要用毫针，浅刺并快速出针，一天两次也可以（一天针刺两次，是因为不能过多）。
黄帝说：面对深水开闸放水是什么意思？岐伯说：血清气滑，快速泻之则气会竭尽（自有血清气滑，刺之如临深决水，不可行也。若血浊气涩而形壮气盛，可取自然之便，刺而泻之，如临深决水）。
黄帝说：顺着挖掘之处决开堵塞是什么意思？岐伯说：血浊气涩，快速泻之则经络可以通畅（顺着血气，挖掘决开堵塞，泻而通之，使其平和）。
黄帝问：逆顺五体，说的是人的骨节大小、肌肉坚脆、皮肤薄厚、血之清浊、气之滑涩、脉之长短、血之多少、经络之数，我已经知道了，这些都是平民百姓的情况。至于王公大人、食肉享受的君主，身体柔脆，肌肉软弱，血气悍滑利，他们的针刺疾徐、深浅、多少，可以相同吗？岐伯回答说：膏粱菽藿的味道，怎么能相同呢？气滑则出针快，气涩则针大而入深，入深则欲留针，入浅则欲快出。由此看来，刺平民百姓要深刺留针，刺王公大人要微刺徐行，这都是因为大人的气悍滑利。
黄帝问：形气和病气的逆顺怎么样？岐伯回答说：形气不足，病气有余，这是邪胜，急于泻之。形气有余，病气不足，急于补之。形气不足，病气不足，这是阴阳气都不足，不可针刺，针刺则会加重不足，重不足则阴阳俱竭，血气皆尽，五脏空虚，筋骨髓枯，老者绝灭，壮者也不能恢复（都不足的人，不可行刺，宜用汤药调理）。形气有余，病气有余，这叫阴阳俱有余，急于泻其邪气，调和其实虚。所以说有余的泻之，不足的补之，就是这个道理。
所以说针刺不知道逆顺，真邪相搏。实证而补之，则阴阳四溢，肠胃充塞，肝肺内胀，阴阳相错。虚证而泻之，则经脉空虚，血气枯竭，肠胃无气，皮肤薄着，毛腠焦枯，给予死期。
所以说用针的要领，在于知道调和，调和阴与阳，精气才能光明，结合形与气，使神内藏。所以说上工平气，中工乱经，下工绝气危生，所以下工不可不慎。必须审察五脏变化的疾病，五脉的对应，经络的虚实，皮肤的柔粗，然后取穴治疗。
[Annotation]: This section, from "The Yellow Emperor said: How to hold the needle and release it?" onwards, is missing in the Yuan edition and other manuscript copies. In the Japanese scroll copy collected by Yang Xingwu, the two characters above the first line of the chapter title "Ci Fa" (Needling Methods) are still missing. Characters three through seven read "Wen Qibo Yue Yu" (Asked Qibo saying, I...). From there until above the note "Ban fan chong ye" (Half reversed, means impacting skin), it is missing again. A total of six lines are missing, with eighteen characters per line. Excluding the five characters "Wen Qibo Yue Yu" and the two empty spaces above the character "Wen", a total of one hundred and one characters are missing below, corresponding to one hundred and one empty spaces. From "The Yellow Emperor said: How to hold the needle and release it?" to "thus causing spasms," this text appears in *Ling Shu* (Spiritual Pivot), Volume 10, Chapter 71, "Xie Ke" (Evil Guests), and also in *Jia Yi Jing* (Classified Classic of Acupuncture and Moxibustion), Volume 5, Chapter 7. From "The Yellow Emperor asked Qibo saying: I have heard the Dao of needling from the Master..." to "...then the meridians can be unblocked," it appears in *Ling Shu*, Volume 6, Chapter 38, "Ni Shun Fei Shou" (Reverse and Smooth, Fat and Thin), and also in *Jia Yi Jing*, Volume 5, Chapter 6. From "The Yellow Emperor asked: Reverse and Smooth Five Bodies..." to the end, it appears in *Ling Shu*, Volume 2, Chapter 5, "Gen Jie" (Roots and Knots), and *Jia Yi Jing* is the same.
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(Placeholder for missing text) Half reversed, means impacting skin. (Note: Refers to impacting the skin.)
The Yellow Emperor said: What are the principles of holding the needle and releasing it (manipulating insertion and withdrawal)? Qibo replied: One must first clearly understand the origins and endings of the twelve regular meridians, (the starting point is the origin, the ending point is the end.), the cold and heat of the skin, (Skin heat indicates that blood and qi are flowing freely; cold indicates that pulse qi is stagnant.), and the flourishing or declining, slippery or choppy nature of the pulses. If the pulse is slippery and vigorous, the disease is progressing daily; if it is deficient and thin, the disease persists for a long time, (Yang qi is abundant with slight heat, called slippery pulse. Abundant blood with little qi and slight cold is called choppy pulse... fine and thin... Ping An: In *Ling Shu* and *Jia Yi Jing*, "er chi" is written as "yi chi".) If the pulse is large and choppy, it indicates painful bi syndrome, (Abundant qi and little blood constitute a large pulse; abundant blood and little qi constitute a choppy pulse, hence painful bi syndrome.) If yin and yang pulses are indistinguishable, it indicates a tumor, which is difficult to treat at its root. (Yin and yang pulses cannot be distinguished, so they appear the same. Tumor refers to hanging warts and similar growths. Because they cannot be distinguished, the root is hard to treat. Ping An: In *Ling Shu* and *Jia Yi Jing*, "liu" (tumor) is written as "bing" (disease). *Jia Yi Jing* also has the character "cha" (observe) above it.) If the upper part is hot, the pathogen is still present; if the heat has already declined, the disease will also depart. (Heat in the head and skin. If heat in the head and skin declines, the disease must depart. Ping An: In *Ling Shu*, "shang re" (upper heat) is written as "shang re" (still hot); in *Jia Yi Jing*, it is written as "shang xia re" (upper and lower heat). "Yi shuai" is written as "yi shuai" (already declined) in *Ling Shu* and *Jia Yi Jing*. The note misses the character "bi" (must) after "qu" in the Yuan edition.) Therefore, hold and examine the chi skin (skin of the forearm), observing whether the flesh is firm or brittle, large or small, slippery or choppy, cold or warm, dry or damp. (Holding and pressing the chi skin allows one to determine life and death. Ping An: The character "yin" (therefore) is absent in *Ling Shu*.) Simultaneously, observe the five colors of the eyes to know the condition of the five zang organs and determine life and death. (The essence of the five zang organs all converges on the eyes...) Observe their blood vessels and examine the five colors to know about cold, heat, and painful bi syndrome. (Observe color, pulse, chi... Ping An: *Jia Yi Jing* lacks the character "qi". The note has four characters "hou se mai chi" on the right, missing on the left, should be four small spaces.)
The Yellow Emperor said: Regarding holding the needle and releasing it, I have not yet grasped its meaning. (...regarding needle manipulation, hence the repeated question.) Qibo said: The way of holding the needle requires uprightness and correctness, stability and tranquility. (Holding the needle at the acupoint requires uprightness. With an undisturbed mind, one achieves tranquility.) First know deficiency and excess, then practice rapid and slow techniques (this is the basis for tonification and sedation). The left hand fixes the bone, the right hand manipulates the needle, do not injure the flesh. (...firm, hence fixing the bone... hand manipulates... must not injure the flesh. Guo sounds like ke. Ping An: In *Ling Shu* and *Jia Yi Jing*, "zuo zhi" (left finger) is written as "zuo shou" (left hand), "xiu zhi" (repair it) is written as "xun zhi" (follow it), and there is no "zhi" after "guo".) For sedation, be upright and direct; for tonification, one must close the skin. (...direct entry and exit, hence upright. ... Ping An: In *Jia Yi Jing*, there is no "yi" after "duan". The Yuan edition mistakenly writes "meng" instead of "bu" (tonify). The note originally lacked two characters before "zhi ru"; the first is illegible, the second has a "qian" (lack) mark on the right; based on the text, I propose "xie yu" (sedation desires).) Rotate the needle to guide qi, allowing evil qi to disperse and exit, while true qi remains settled. (...evil qi disperses and exits, letting true qi remain without scattering. Ping An: In *Jia Yi Jing*, "xie de yin" is written as "xie qi bu de yin".)
The Yellow Emperor said: How to open the skin and cou li (pores)? Qibo said: Follow the muscle intervals, distinguish the skin layers. (Skin is pi. By pressing with the hand, locate the acupoint at the muscle interval; insert the needle above and below the skin at the acupoint, hence distinguishing the skin. Ping An: In *Ling Shu* and *Jia Yi Jing*, "zai bie" is written as "zuo bie".) Insert slightly and advance slowly and uprightly; ensure the shen (spirit/mind) does not scatter, and the evil qi can depart. The Yellow Emperor said: Excellent. (Although sedation prioritizes... careful examination, hence inserting slightly and advancing slowly and uprightly... ...de... wine regulation. Ping An: The note originally lacked six characters after "sui"; the top three are unexamined, the bottom three on the right read "bi yu yu"; I propose "duan zheng er bi xu xu" [upright and necessarily slowly] six characters.)
The Yellow Emperor asked Qibo: Humans have eight voids (ba xu); how are they used for diagnosis? Qibo answered: They are used to diagnose the five zang organs. (The eight voids are the two elbows, two axillae, two thighs (bi), and two popliteal fossae (guo). These areas are hollow, hence called eight voids. Because they are hollow, both true qi and evil qi pass through and may stay, making them chambers of the joints. When true qi passes, the joints move freely; when evil stays, flexion and extension are impaired. Thus, these eight voids diagnose the qi of the five zang organs. Ping An: The Yuan edition writes "ge he yi hou" as "ge yi he hou"; the Yuan edition omits the character "da" (answer) after "yue".)
The Yellow Emperor said: How to diagnose? Qibo said: If the lungs and heart have evil qi, its energy stays in the two elbows; (The two elbows are where the Lung meridian of Hand-Taiyin and Heart meridian of Hand-Shaoyin run; thus, for lung and heart evil, the elbows serve as diagnostic sites.) If the liver has evil qi, its energy stays in the two axillae; (The area under the two ribs is where liver qi resides; for liver evil, the axillae serve as diagnostic sites.) If the spleen has evil qi, its energy stays in the two thighs (bi); (The Spleen Foot-Taiyin meridian runs along the anterior medial aspect of the thigh into the abdomen; thus, for spleen evil, the thighs serve as diagnostic sites.) If the kidneys have evil qi, its energy stays in the two popliteal fossae (guo). (The Kidney Foot-Shaoyin meridian emerges from the medial aspect of the popliteal fossa; thus, for kidney evil, the popliteal fossae serve as diagnostic sites.) Generally, these eight voids are chambers of joint movement, places where true qi passes, and areas where blood collaterals roam. Evil qi and foul blood cannot stay here; if they stay, they damage the sinews and collaterals, causing the joints and mechanisms to lose flexibility, resulting in ... spasms. (These eight major joint connections are hollow places,乃是... of movement... chambers of joints are also... Chamber of joints. ... , its ju fan, bending the spine and back. Ping An: "Yin bu de zhu liu" in *Ling Shu* is written as "gu bu de zhu liu". "Gu ... luan" in *Ling Shu* is written as "gu bing luan".)
The Yellow Emperor asked Qibo: I have heard the Dao of needling from the Master, and it is numerous and complete. The applications of the nine needles you speak of seem to change according to physical principles, without apparent fixed rules. Is your learning memorized, or does it arise from examining things? (Ju, basis. Jian, fixed. Speaking of the application of the nine needles mentioned by the Master, it follows physical changes, seemingly without fixed definition. Who did the Master learn from? ... heart and hand. Ping An: In *Ling Shu*, "dao" is added after "ying"; "er sheng hu" is written as "er xin sheng zhi hu".)
Qibo answered: The Dao established by sages aligns above with Heaven, below with Earth, and in the middle with human affairs. There must be clear laws to establish measurements, models, and standards, only then can it be transmitted. (...reasonable then transmit, three alignments form law and measure, hence transmissible.) Therefore, a carpenter cannot abandon chi and cun (units of measurement) to guess length and width arbitrarily, nor discard the ink line and water level; a worker cannot discard the compass to draw circles or remove the square to draw squares. (Carpenter... measurement of chi and cun is not arbitrary... not private... water... for... skill. Worker... for... place... desire to make... discard square and... wonder. This is great work. Sage's teaching follows natural ultimate principles to establish laws... for... call sage. Ping An: Note originally lacked one character after "jiang ren"; proposed "zhun". Originally lacked four characters before "bu you si"; proposed "sheng mo zhi fa" based on text. Originally lacked one character before "shui", two after "shui", one after "wei"; proposed "er qi shui zhun yi wei ji qiao ye". Originally lacked one character after "gong", two after "wei", four after "zhi"; proposed "gong yu wei yuan wu zhi gui er wei neng". Originally lacked two characters before "wu qi ju", one after; proposed "yu wei fang yi wu qi ju er wei miao". Originally lacked one character after "fa du"; proposed "zhi". Originally lacked one character before "cheng"; proposed "hou".) Those who know how to use these are indeed using natural objects; this is an easy-to-use teaching, the constant of reverse and smooth. (The ink line is nothing else, but natural ink line; following nature, its teaching is easy to use; thus, violating it is reverse, following it is constant. Ping An: "Gu zi ran zhi wu", according to the note, "gu" should be "yin". The note writes "zun zhi" instead of "wei zhi" in the Yuan edition.)
The Yellow Emperor said: I wish to hear what is meant by nature? Qibo said: Facing deep water and breaking the dam, without effort, the water can be drained; following excavated channels and breaking blockages, the meridians can be unblocked. This speaks of the slipperiness or choppy nature of qi, the clarity or turbidity of blood, and the reverse or smooth flow. (So-called nature is not self-capable, but rather following the slipperiness or choppy nature of qi, the clarity or turbidity of blood, and the reverse or smooth flow, unblocking them is like facing deep water and breaking the dam, taking natural convenience so water drains, hence called nature. Ping An: "Xun jue", the character "jue" was originally missing; *Ling Shu* and *Jia Yi Jing* write "jue"; the subsequent text also writes "jue"; Yuan edition writes "di" likely erroneously. After "jue chong", *Jia Yi Jing* has "wang gu jian mi" four characters. "Ci yan", the character "ci" was originally missing; *Ling Shu* and *Jia Yi Jing* write "ci"; Yuan edition writes "yu" likely erroneously. In the note "fu zi ran zhe", the Yuan edition omits "zi".)
The Yellow Emperor said: I wish to hear if people of different complexions (white/black), body types (fat/thin), and ages (young/old) have specific numbers [for needling]? (White/black, different skin color. Fat/thin, different body shape. Young/old, different strength. The depth and frequency of needling differ, hence there are numbers. Ping An: The note likely omits the character "shao" after "duo".)
Qibo said: For those who are young and strong, with abundant blood and qi, and firm skin and flesh, if evil qi is added, needling such persons requires deep insertion and retention. (This refers to fat persons. Ping An: "Ying" is written as "sheng" in *Jia Yi Jing*. The note "ci wei fei ren" is written as main text in *Ling Shu* and *Jia Yi Jing*.)* Shoulders wide, axillae wide, neck thick, muscles thin, skin thick and black, lips full, blood dark and turbid, qi choppy, such people are greedy in giving and taking; needling such persons requires deep insertion and retention, increasing the number of sessions. (This refers to dark-skinned persons. Ping An: "Pi nong" in *Ling Shu* and *Jia Yi Jing* is written as "nong pi". After "lin lin ran", *Jia Yi Jing* has "zhe". After "se", *Ling Shu* and *Jia Yi Jing* have "yi chi" two characters. "Qu yu" in *Jia Yi Jing* is written as "qu yu".)
The Yellow Emperor said: How to needle thin persons? Qibo said: Needling thin persons, whose skin is thin, color pale, muscles lean, lips thin, speech light, blood clear and qi slippery, where qi easily dissipates and blood easily damaged, requires shallow insertion and quick withdrawal. (Thin person, refers to tian... skin. Ping An: Note originally lacked two characters after "tian"; proposed "se bo" based on text. Yuan edition writes "tian" as "tian" [sky], "pi" as "ren" [person].)
The Yellow Emperor said: How to needle ordinary persons? Qibo said: Observe their white or black complexion, adjust accordingly. For those who are upright, tall, and plump, their blood and qi are harmonious; needling such persons should not deviate from the standard constants. (Constant refers to normal, neither fat nor thin. Needling is based on depth constants, neither too deep nor too shallow. Ping An: "Chang nong" in *Ling Shu* is written as "dun nong"; in *Jia Yi Jing* as "chun nong". "Shu chang zhi" in *Ling Shu* is written as "shu chang ye"; in *Jia Yi Jing* as "qi shu chang".)
The Yellow Emperor said: How to needle strong men with solid bones? Qibo said: Needling strong men with solid bones, firm muscles, relaxed joints, and imposing demeanor: if heavy, qi is choppy and blood turbid, needle deeply and retain, increasing the number of sessions; (Strong man, bone... solid and large. Ping An: "Zong jie" in *Ling Shu* and *Jia Yi Jing* is written as "huan jie". "Jian jian" in *Jia Yi Jing* is written as "yan yan", note: "one version is jian jian". Note originally lacked one character after "gu"; proposed "jie".) If vigorous, qi is slippery and blood clear, needle shallowly and withdraw quickly. (Vigorous means urgent/tense.)
The Yellow Emperor said: How to needle infants? Qibo said: Infants have fragile flesh, little blood, and weak qi; needling them requires hair-thin needles, shallow insertion, and quick withdrawal, twice a day is acceptable. (Needling infants twice a day means not exceeding this amount.)
The Yellow Emperor said: What does "facing deep water and breaking the dam" mean? Qibo said: If blood is clear and qi slippery, rapid sedation will cause qi depletion. (For clear blood and slippery qi, needling is like facing deep water and breaking the dam, not feasible. If blood is turbid, qi is choppy, and the body is strong with abundant qi, one can take natural convenience, needle and sedate, like facing deep water and breaking the dam. Ping An: "Qi hua" in *Ling Shu* and *Jia Yi Jing* is written as "qi zhuo".)
The Yellow Emperor said: What does "following excavated channels and breaking blockages" mean? Qibo said: If blood is turbid and qi is choppy, rapid sedation will unblock the meridians. (Follow the blood and qi, excavate and break the blockage, sedate and unblock, bringing them to balance.)
The Yellow Emperor asked: Reverse and Smooth Five Bodies discusses bone size, muscle firmness, skin thickness, blood clarity/turbidity, qi slipperiness/choppy nature, pulse length, blood quantity, and meridian counts; I already know this, as these apply to commoners. (Ping An: "Ni shun wu ti" in *Jia Yi Jing* is written as "ni shun wu ti jing luo zhi shu", directly followed by "ci jie bu yi pi fu zhi shi ye", omitting "ren gu jie zhi xiao da" and "yu yi zhi zhi yi yi" phrases.) But for kings, dukes, and rulers who eat meat, whose bodies are soft and fragile, muscles weak, and qi fierce, slippery, and smooth, can their needling speed, depth, and quantity be the same? (Ping An: "Fu wang gong da ren xue shi zhi jun" in *Jia Yi Jing* is written as "xue shi zhe" three characters, note: "*Jiu Xu* writes 'xue shi zhi jun'." In *Ling Shu*, "ruo" is written as "ruan ruo".)
Qibo answered: Can the flavors of rich food and beans/grasses be the same? Qi slippery means needle withdrawal is fast; qi choppy means larger needles and deeper insertion, deep insertion requires retention, shallow insertion requires quick withdrawal. From this, we see: needling commoners requires deep insertion and retention; needling nobles requires light and slow manipulation. This is because the qi of nobles is fierce, slippery, and smooth. (Pulse with intermission every fifty beats is smooth; less than fifty beats with intermission is reverse. Nobles eat rich food, commoners... hence differences in depth and retention. Ping An: After "qi hua ze chu ji", *Ling Shu* has "qi qi se ze chu chi, qi han ze xiao er ru qian"; *Jia Yi Jing* is the same, except no "qi" before "qi se". Note originally lacked eight characters after "bu yi"; Yuan edition supplemented "shi yi shu huo" four characters, still not fully matching the gap; proposed "pi fu zhi shi shi yi shu huo" eight characters based on text.)
The Yellow Emperor asked: What is the reverse and smooth relationship between form and qi? Qibo answered: Form qi is deficient, disease qi is excessive; this is evil victory, urgently sedate. (Urgently sedate evil qi, tonify form qi.) Form qi is excessive, disease qi is deficient; urgently tonify. (Urgently tonify with true qi; when qi is excess, disease resolves.) Form qi is deficient, disease qi is deficient; this is deficiency of both yin and yang qi, do not needle. Needling will cause double deficiency; double deficiency leads to exhaustion of yin and yang, depletion of blood and qi, emptiness of five zang, withering of sinews, marrow, and bones; the elderly perish, the strong do not recover. (Both deficient, do not needle; suitable for decoction therapy.) Form qi is excessive, disease qi is excessive; this is excess of both yin and yang, urgently sedate the evil, regulate the excess and deficiency. Hence, excess is sedated, deficiency is tonified, this is what is meant. (Form qi is yang, disease qi is yin, ...both excess, can sedate evil qi to regulate form qi to harmony. Ping An: Note originally lacked one character after "yin"; half of "qi" remained on the right; proposed "qi"; Yuan edition omitted.)
Hence, if needling ignores reverse and smooth, true and evil clash. Tonifying excess causes yin and yang to overflow, intestines and stomach become distended, liver and lungs swell internally, yin and yang become confused. (Tonifying excess, yin and yang qi fill... hence overflow. Intestine and stomach qi gathers, hence distension. Liver and lungs both full, hence internal swelling. Chi lin fan. Yin and yang both prosperous, hence confusion. Ping An: In *Jia Yi Jing*, "si yi" is written as "xue qi jie yi", "nei" as "nei zhang". Note originally lacked two characters after "man yu"; first illegible, second half of "you" remains; proposed "si zhi" four characters.) Sedating deficiency causes meridians to empty, blood and qi to wither, intestines and stomach contract, skin becomes thin and adherent, hair and cou li become withered and scorched, giving a death date. (She bi, intestines and stomach lack qi. She, zhi zhe fan. Ping An: "Jie ku" in *Jia Yi Jing* is written as "ku jie". "She" in *Ling Shu* is written as "HT ", in *Jia Yi Jing* as "she". "Jiao" in *Ling Shu* is written as " ".)
Hence, the essence of needling lies in knowing regulation; regulating yin and yang, essence and qi become bright; combining form and qi, let shen be stored within. (Bright, means radiant. Shen stored within means five shen guard and store. Ping An: Note originally lacked one character after "zhi tiao"; *Ling Shu* writes "yin yu yang tiao yin yu yang" seven characters; *Jia Yi Jing* repeats "tiao"; proposed "tiao" based on *Jia Yi Jing*. "Nai guang" in *Jia Yi Jing* is written as "nai chong". "Shi shen nei cang", "shi" was originally missing; proposed "shi" based on *Ling Shu* and *Jia Yi Jing*; Yuan edition writes "wu".)
Hence, superior doctors harmonize qi, intermediate doctors disrupt meridians, inferior doctors cut off qi and endanger life; thus, inferior doctors must be cautious. (Harmonizing qi, achieving qi harmony. Inferior doctors focus on form, do not know... qi, wound... excess, hence must be cautious. Ping An: *Jia Yi Jing* lacks "gu xia gong" three characters. Note originally lacked one character after "qi shang"; proposed "ping" based on text. Originally lacked two characters after "shang"; proposed "sheng sun" two characters.) Must carefully examine diseases of five zang changes, responses of five pulses, excess and deficiency of meridians, and softness or roughness of skin, then select points. (Five pulses, pulses of five seasons. Softness/roughness, referring to adjusting chi skin softness or roughness. Ping An: Under "shen", *Ling Shu* lacks "qi". *Jia Yi Jing* writes "shen" as "cha", adds "zhi" before "bian hua", removes "zhi bing" after, adds "xiang" before "ying", adds "fu" after "pi".)