黄帝问于岐伯曰。余子万民。养百姓。而收其租税。余哀其不给而属有疾病。余欲勿使被毒药。
无用砭石。欲以微针通其经脉。调其血气。荣其逆顺。出入之会。令可传于后世。必明为之法。
令终而不灭。久而不绝。易用难忘。为之经纪。异其章。别其表里。为之终始。令各有形。先立针
经。愿闻其情。岐伯答曰。臣请推而次之。令有纲纪。始于一。终于九焉。
按、本纪。帝经土设井。立步制亩。艺五谷。养万民。而收其租税。设有疾病。则不能力田以
供余食矣。故帝欲立九针微针之法。传于后世。令终而不灭焉。毒药。所以攻疾也。砭石。所以泄
邪也。二者皆攻泻之法。微针。能通调血气者也。逆顺出入者。皮肤经脉之血气。有逆顺之行。有
出入之会。盖人秉天地之气所生。阴阳血气。参合天地之道。营运无息。少有留滞。则为疾病。故
帝以天地人之道而立九针。用九针之法。以顺人之阴阳血气。而合于天道焉。明其理则易用。持于
心则难忘。经、径。纪、维也。按、篇名九针。而帝曰微针。伯曰小针。是九针
之外。又立小针也。九针者。圣人起天地之数。始于一而终于九。九而九之。九九八十一以起黄
钟之数。用九针而合小针者。以阳数五。阴数五。五位相得而各有合。以应河图之数也。帝继伏羲
神农氏而作。即以两仪四象河图奇偶之数。用法于针。所以修身治国平天下。盖国以民为本也。
请言其道。小针之要。易陈而难入。粗守形。上守神。神乎神。客在门。未观其疾。恶知其原。
刺之微在迟速。粗守关。上守机。机之动不离其空。空中之机。清静而微。其来不可逢。其往不
可追。知机之道者。不可挂以发。不知机道。扣之不发。知其往来。要与之期。粗之暗乎。妙哉工
独有之。往者为逆。来者为顺。明知逆顺。正行无间。迎而夺之。恶得无虚。追而济之。恶得无
实。迎之随之。以意和之。针道毕矣。
易陈难入者。易言而难着于人也。粗守形者。守皮脉肉筋骨之刺。上守神者。守血气之虚实
而行补泻也。神乎神。甚赞其得神之妙。门者。正气出入之门。客在门者。邪循正气出入之所也。
未睹其何经之疾。恶知其受病之原。言当先察其邪之所在而取之也。迟速。用针出入之疾徐也。
粗守关者。守四肢之关节。上守机者。守其空而当刺之时。如发弩机之速也。不离其空者。乘空而
发也。夫邪正之气。各有盛衰之时。宜补宜泻。当静守其空中之微。不可差之毫发。如其气方来。
乃邪气正盛。邪气盛则正气大虚。不可乘其气来。即迎而补之。当避其邪气之来锐。其气已往。则
邪气已衰。而正气将复。不可乘其气往。追而泻之。恐伤其正气。在于方来方去之微。而发其机也。
离合真邪论曰。俟邪不审。大气已过。泻之则真气脱。脱则不复。邪气复至而病益蓄。
故曰。其往不可追。此之谓也。是以其来不可逢。其往不可追。静守于来往之间而补泻之。少差毫
发之间则
失矣。粗工不知机道。叩之不发。补泻失时。则血气尽伤。而邪气不下。知其往来者。知邪正之盛衰。
要与之可取之期而取之也。粗工之暗。而良工独知之。是故工之所以异也。若气往则邪正之气虚小。
而补泻之为逆。气来则形气邪气相平。而行补泻为顺。是以明知顺逆。正行无间。知往来所处之时
而取之也。迎而夺之者。泻也。故恶得无虚。追而济之者。补也。故恶得无实。迎之随之。以意和
之。针道毕矣。
凡用针者。虚则实之。满则泄之。宛陈则除之。邪胜则虚之。大要曰。徐而疾则实。疾而徐则
虚。言实与虚。若有若无。察后与先。若存若亡。为虚为实。若得若失。
所谓虚则实之者。气口虚而当补之也。满则泄之者。气口盛而当泻之也。宛陈则除之者。去脉
中之蓄血也。邪胜则虚之者。言诸经有盛者。皆泻其邪也。徐而疾则实者。徐内而疾出也。疾而
徐则虚者。疾内而徐出也。言实与虚。若有若无者。实者有气。虚者无气也。察后与先。若亡若
存者。言气之虚实。补泻之先后也。察其气之以下与常存也。为虚为实。若得若失者。言补者 然
若有得也。泻则恍然若有失也。此以上论小针之法。虚实之要。九针最妙。补泻之时。以针为之。
泻曰必持内之。放而出之。排阳得针。邪气得泄。按而引针。是谓内温。血不得散。气不得出也。
补曰随之。随之意。若妄之。若行若按。如蚊虻止。如留而还。去如弦绝。令左属右。其气故
止。外门已闭。中气乃实。必无留血。急取诛之。持针之道。坚者为宝。正指直刺。无针左右。神
在秋毫。嘱意病者。审视血脉。刺之无殆。方刺之时。必在悬阳。及与两卫。神属勿去。知病存亡。
血脉者。在 横居。视之独澄。切之独坚。九针之名。各不同形。一曰 针。长一寸六分。二曰员
针。长一寸六分。三曰 针。长三寸半。四曰锋针。长一寸六
分。五曰铍针。长四寸。广二分半。六曰圆利针。长一寸六分。七曰毫针。长三寸六分。八曰长针。
长七寸。九曰大针。长四寸。 针者。头大末锐。去泻阳气。员针者。形如卵形。揩摩分间。不得
伤肌肉。以泻分气。 针者。锋如黍粟之锐。主按脉勿陷。以致其气。锋针者。刃三隅以发锢疾。
铍针者。末如剑锋。以取大脓。圆利针者。大如 。且圆且锐。中身微大。以取暴气。毫针者。
尖如蚊虻喙。静以徐往。微以久留之。而养以取痛痹。长针者。锋利身薄。可以取远痹。大针者。
尖如挺。其锋微圆。以泻机关之水也。九针毕矣。
此节论九针之法。盖首篇统论小针及九针之道。是以前后论小针。而详释于小针解中。此节
论九针。故详释于九针论内。而小针解中不与也。虚实之要。九针最妙。为其各有所宜也。补泻之
时。以针为之者。与气开合相得也。排阳得针者。排针而得阳气也。得其正气。则邪气去矣。内温
者。针下热也。谓邪气去而正气不出也。此论泻邪而养其正也。随之者。追而济之也。之、往也。
若妄之者。虽追之而若无有所往。若行若按。如蚊虻止。如留而还也。去如弦绝者。疾出其针也。
令左手按 。右手出针。其正气故得止于内。而外门已闭。中气乃实矣。此补正运邪之法。故必
无留血。设有留血。急取而诛之。坚者。手如握虎也。正指直刺者。义无邪下。欲端以正也。神在
秋毫。审视病者。静志观病患。无左右视也。悬阳。心也。心藏神。方刺之时。得之于心。则神
属于病者。而知病之存亡矣。经云。取血于荣。取气于卫。卫气行阳行阴者也。故于两卫间以取
阴阳之气。卫气行篇曰。是故谨候气之所在而刺之。是谓逢时。在于三阳。必候其气在阳分而刺之。
病在于三阴。必候其气在阴分而刺之。 、经 也。刺节真邪篇曰。六经调者。谓之不病。一经上
实下虚而不通者。此必有横络盛加于大
经。令之不通。视而泻之。此所谓解结也。故有血络横在于经 者。当视之独清。切之独确而去
之也。九针者。
有九者之名。有九者之形。各随其所宜而用之。九针之论毕矣。
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。各有所处。病各有所宜。各不同形。各以任其所宜。无实无
虚。损不足而益有余。是谓甚病。病益甚。取五脉者死。取三脉者 。夺阴者死。夺阳者狂。针害
毕矣。
此复论小针刺邪之法。而并论其要害焉。风雨寒暑之中人也高。故邪气在上也。水谷入胃。其
精气上注于肺。浊溜于肠胃。寒温不适。饮食不节。病生于肠胃。故浊气在中也。清湿地气之中
人也。必从足始。故清气在下也。陷脉。额颅之脉。显陷于骨中。故针陷脉。则阳之表邪去矣。
中脉。足阳明之合。三里穴也。针太深则邪气反沉者。言浮浅之病。不欲深刺也。深则邪气从之入。
故曰反沉也。皮肉筋骨。各有所处者。言经络各有所主也。故病各有浅深之所宜。形有皮肉筋脉之
不同。各随任其所宜而刺之。无实实。无虚虚。若损不足而益有余。则病益甚矣。五脉。五脏诸阴
之脉也。如中气不足。则血脉之生原已虚。再大泻其诸阴之脉。是虚于中而脱于外也。三脉。三
阳之脉。 怯也。言尽泻三阳之气。令病患怯然不复也。夺阴者死。言取人之五里五往者也。玉版
篇曰。迎之五里。中道而止。五至而已。五往而脏之气尽矣。夺阳者狂。正言取之五里而或夺其阳也。
此论针之为害毕矣。张开之曰。取尺之五里。取皮肤阳分之气血也。而曰夺阴者。谓阳分之气血。
生于五脏之阴也。病在中气不足。而大泻诸阴之脉者死。谓诸阴之脉。生于中焦之阳明。阳生于阴。
而阴生于阳也。
刺之而气不至。无问其数。刺之而气至。乃去之。勿复针。针各有所宜。各不同形。各任其所为。
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。
此言刺之效。以得气为要也。上文言病各有所宜。此言针各有宜。而有大小长短之形不同。各
任其所宜而用之也。若风之吹云。明乎若见青天。邪散而正气光明也。
黄帝曰。愿闻五脏六腑所出之处。岐伯曰。五脏五输。五五二十五输。六腑六输。六六三十六输。
经脉十二。络脉十五。凡二十七气以上下。所出为井。所溜为荥。所注为输。所行为经。所入为合。
二十七气所行。皆在五输也。
此言用针者。当知脏腑经脉之血气生始出入。夫荣卫气血。皆生于胃腑水谷之精。荣行脉中。
卫行脉外。血行脉中。气行脉外。然脉内之血气。从络脉而渗灌于脉外。脉外之气血。从络脉而
溜注于脉中。外内出入相通也。五脏内合五行。故其输五。六腑外合六气。故其输六。盖六气生于
五行而有二火也。经脉十二。六脏六腑之经脉也。络脉十五。脏腑之十二大络及督脉之长强。任脉
之尾翳。脾之大包。凡二十七脉之血气。出入于上下手足之间。所出为井。所溜为荥。所注为输。
所行为经。所入为合。此二十七气之所行。皆在于五输。盖十二经脉之血气。本于五脏五行之所生。
而脉外皮肤之气血。出于五脏之大络。溜注于荥输。而与脉内之血气。相合于肘膝之间。此论脏腑
经脉之血气出入。节之交。三百六十五会。知其要者。一言而终。不知其要。流散无穷。所言节者。
神气之所游行出入也。非皮肉筋骨也。
此言刺节者。当知神气之所出入也。神气者。真气也。所受于天与谷气并而充身者也。故知其
要。一言而终。不知其要。流散无穷。此络脉之渗灌诸节。非皮肉筋骨也。
观其色。察其目。知其散复。一其形。听其动静。知其邪正。右主推之。左持而御之。气至而
去之。
此言上工观五色于目。知色之散复。即知病之散复矣。知其邪正者。知论虚邪与正邪之风也。
右主推之。左持而御之者。言持针而出入也。气至而去之者。言补泻气调而去之也。
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。而用针者反实其外。
是谓重竭。重竭必死。其死也静。治之者。辄反其气。取腋与膺。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。治之者反取四末。
此言用针者。必先诊脉。视五脏之气剧易。乃可以治也。所谓五脏之气已绝于内者。脉口气
内绝不至。反取其外之病处。与阳经之合。有留针以致阳气。阳气至则内重竭。重竭则死矣。无气
以动故静。此言五脏之阴。生于中焦之阳。故外致其阳。则内重竭矣。五脏之气已绝于外者。脉
口气外绝不至。反取其四末之输。有留针以致其阴气。阴气至则阳气反入。入则逆。逆则死矣。其
死也阴气有余故躁。此言阴内而阳外。阳气内入。则为逆矣。
刺之害。中而不去则精泄。害中而去则致气。精泄则病益甚而 。致气则生为痈疡。
此言取气之太过不及。而皆能为害也。夫气生于精。故刺之害。中病而不去其针。则过伤其气。
而致泄其生原。故病益甚而 。刺之害。中而即去其针。邪未尽而正气未复。则致气留聚而为痈疡。痈疽篇曰。
经脉流行不止。与天同度。与地合纪。天宿失度。日月薄蚀。地经失纪。水道流溢。血脉荣卫。周
流不休。气血不通。故为痈肿。盖荣卫气血。营运于外内上下之不息也。是以首篇与第八十一篇始终
论精气之生始出入。若阴阳不调。血气留滞。则为痈疡矣。
五脏有六腑。六腑有十二原。十二原出于四关。四关主治五脏。五脏有疾。当取之十二原。
十二原者。五脏之所以禀三百六十五节气味也。五脏有疾也。应出十二原。十二原各有所出。明
知其原。睹其应而知五脏之害矣。阳中之少阴。肺也。其原出于太渊。太渊二。阳中之太阳。心
也。其原出于大陵。大陵二。阴中之少阳。肝也。其原出于太冲。太冲二。阴中之至阴。脾也。其
黄帝向岐伯问道：我养育百姓，征收他们的租税。我怜悯他们生活不充裕且常有疾病，希望不要让他们遭受毒药的伤害，不使用砭石治疗，而是想用微针来疏通他们的经脉，调和血气，使气血在逆顺、出入的交会处运行通畅，让这种方法能够流传于后世。必须明确制定法则，使其永久存在而不灭绝，长久延续而不中断，易于使用且难以忘记，作为治疗的纲领。区分章节，辨别表里，确立始末，使每种针具都有特定的形态。首先建立《针经》，希望能了解其中的详情。
岐伯回答说：请让我按次序推演，使其有纲纪，从一数起，到九数结束。
按：本纪记载，黄帝治理天下，设立井田制度，划定步亩，种植五谷，养育万民并收取租税。如果百姓生了病，就不能尽力耕种来供给您的粮食了。所以黄帝想要创立九针和微针的方法，流传给后世，使其永久存在而不灭绝。毒药，是用来攻治病邪的；砭石，是用来泄除邪气的。这两者都属于攻泻的方法。微针，则能通调血气。所谓逆顺出入，是指皮肤和经脉中的血气，有逆行的也有顺行的，有出入的交会点。大概人秉承天地的精气而生，阴阳血气与天地之道相合，运行不息，稍有停滞，就会成为疾病。所以黄帝依据天、地、人的道理来创立九针，运用九针的方法来顺应人的阴阳血气，使之符合天道。明白了其中的道理就容易使用，记在心里就难以忘记。“经”意为路径，“纪”意为纲维。按：篇名虽为“九针”，但黄帝说“微针”，岐伯说“小针”，这是在九针之外，又确立了小针。九针，是圣人取法天地的数理，从一数开始，到九数结束。九乘以九，八十一以起黄钟之数。运用九针并结合小针，是因为阳数为五，阴数为五，五位相得而各有配合，以对应河图的数理。黄帝继伏羲、神农氏之后兴起，将两仪、四象、河图奇偶的数理应用于针刺，以此来修身、治国、平天下。大概国家是以百姓为根本的。
请允许我谈谈它的道理。小针的要领，容易陈述却难深入掌握。粗疏的医生只守形迹，高明的医生则守护神机。神妙啊神妙，客邪之气守在门户（正气出入之处）。尚未观察病情，怎么知道病因呢？针刺的精微之处在于速度的迟与快。粗疏的医生只守住四肢关节，高明的医生则守候气机。气机的变动不离空虚之处（穴位）。空虚之中的气机，清静而细微。它来的时候不可迎击（逢），它去的时候不可追击。懂得气机之道的人，差错不会超过一根头发丝；不懂气机之道的人，叩问也不会有反应。知道气机的往来，要把握恰当的时机进行干预。粗疏的医生对此昏暗不明，只有技艺高超的工匠独自掌握它。气去者为逆，气来者为顺。明知逆顺，正确操作没有间隙。迎着气盛而夺之，怎么会不虚呢？追着气衰而济之，怎么会不实呢？迎随结合，用意念调和，针刺的道理就完备了。
所谓“易陈难入”，是说容易说清楚却难让人领会。“粗守形”，是指只关注皮、脉、肉、筋、骨的刺法；“上守神”，是指根据血气的虚实来进行补泻。“神乎神”，是非常赞叹得到“神”的奥妙。“门”，是指正气出入的门户；“客在门”，是指邪气顺着正气出入的地方侵入。还没看出是哪条经脉的病，怎么能知道受病的根源呢？这是说要先察明邪气所在的位置再取穴治疗。“迟速”，指针刺进出时的快慢。“粗守关”，是指只守住四肢的关节；“上守机”，是指守候那个空虚之处以及应当针刺的时机，就像弩机发射那样迅速。“不离其空”，是指乘其空虚而发针。邪气和正气的盛衰各有其时，宜补宜泻，应当静守那空虚之处的微妙变化，不能差之毫厘。如果气刚要来，那是邪气正盛，邪气盛则正气大虚，不可乘着气来之时，即迎而补之（此处原文逻辑似有误，通常迎而夺之是泻，追而济之是补，下文解释中澄清了这一点，此处依原文翻译但需注意上下文）：应当避开邪气来的锐势。气已过去，则邪气已衰，而正气将要恢复，不可乘着气往之时，追而泻之，恐怕损伤正气。关键在于气方来方去的微妙时刻，发动气机。《离合真邪论》说：“等待邪气而不审慎，大气已过，泻之则真气脱，脱则不复，邪气复至而病益蓄。”所以说“其往不可追”，就是这个意思。因此“其来不可逢，其往不可追”。在气来气往之间静守而进行补泻，稍微差一点失误就错了。粗工不知道气机之道，叩问也不发作，补泻失时，就会使血气尽伤，而邪气不下。知道气机往来的，是知道邪正的盛衰，把握可以取气的时期而取气。粗工的昏暗，而良工独自知晓。这就是工匠之所以不同的原因。如果气往，则邪正之气虚小，此时补泻为逆；气来，则形气邪气相平，此时行补泻为顺。因此明知顺逆，正确操作没有间隙，知道气机往来的时间而取气。所谓“迎而夺之”，是泻法，所以怎么会不虚呢？“追而济之”，是补法，所以怎么会不实呢？“迎之随之，以意和之”，针刺的道理就完备了。
凡是使用针的，虚证就用补法使其充实，实证就用泻法使其泄出，瘀血陈旧者就清除它，邪气胜者就削弱它。大要说：慢进快出则为实（补），快进慢出则为虚（泻）。所说的实与虚，若有若无。观察先后，若存若亡。造成虚或实，若得若失。
所谓“虚则实之”，是指寸口脉虚而应当补益。“满则泄之”，是指寸口脉盛而应当泻除。“宛陈则除之”，是指去除脉中蓄积的瘀血。“邪胜则虚之”，是说各经有盛实的，都应当泻除其邪气。“徐而疾则实”，是指慢慢进针、快速出针。“疾而徐则虚”，是指快速进针、慢慢出针。所说的“实与虚，若有若无”，是说实证有气，虚证无气。“察后与先，若亡若存”，是说气之虚实，补泻的先后顺序。观察气之下陷与常存的状态。“为虚为实，若得若失”，是说补的时候，好像有所得；泻的时候，恍然好像有所失。以上论述了小针的方法，虚实的关键，九针最为奇妙。补泻的时机，依靠针具来实现。
泻法说：一定要持针插入，放开而出，推开阳气以取得针位，使邪气得泄，按压并引出针，这叫“内温”，血液不得散逸，气不得外出。补法说：跟随气机，跟随的意念，好像妄动一样。若行若按，像蚊虻叮咬停留，像留针后又返回。出针时像弓弦断裂那样迅速。令左手按住穴位，右手出针，正气得以止于内，外门已闭，中气乃实，必定没有留血。如果有留血，急取诛杀它。
持针的原则，坚固稳重最为宝贵。正指直刺，针身不左右歪斜，精神集中在秋毫之末，嘱咐病人，审视血脉，针刺就没有危险。针刺的时候，必须在“悬阳”（心）和“两卫”（卫气运行的部位）之间，精神专注不去，才能知病之存亡。血脉，横居皮下，看它特别清澈，摸它特别坚硬。
九针的名称，各不相同。一曰鑱针，长一寸六分。二曰员针，长一寸六分。三曰鍉针，长三寸半。四曰锋针，长一寸六分。五曰铍针，长四寸，宽二分半。六曰圆利针，长一寸六分。七曰毫针，长三寸六分。八曰长针，长七寸。九曰大针，长四寸。
鑱针，头大末端锐利，用于泻除阳气。员针，形状像卵形，揩摩分肉之间，不伤肌肉，以泻分肉间的邪气。鍉针，锋如黍粟般锐利，主要按压脉络而不陷入，以引导气机。锋针，刃有三个棱角，用来发散锢结之疾。铍针，末端像剑锋，用来切开排大脓。圆利针，大如牦牛毛，既圆又锐，中间略大，用来取暴发性邪气。毫针，尖如蚊虻嘴，静缓徐进，微久留针，用以养痛痹。长针，锋利身薄，可以取远部之痹。大针，尖如挺杖，锋微圆，用来泻关节积水。九针的功效完备了。
这一节论述九针的方法。大概首篇统论小针及九针之道，所以前后论小针，而在《小针解》中详细解释。这一节论九针，所以在《九针论》中详细解释，而不在《小针解》中。虚实的关键，九针最妙，因为它们各有所宜。补泻的时机，以针为之，是与气之开合相得的。所谓“排阳得针”，是推开针位以得阳气。得到正气，邪气就去除了。“内温”，是针下发热，意思是邪气去而正气不出。这是论泻邪而养正的方法。“随之”，是追而济之。“之”是往的意思。“若妄之”，虽然是追随，却好像没有前往。“若行若按，如蚊虻止，如留而还”，是描述进针的感觉。“去如弦绝”，是快速出针。令左手按穴，右手出针，正气得以止于内，外门已闭，中气乃实。这是补正运邪的方法，所以必定没有留血。假设有留血，急取诛杀它。“坚者”，手如握虎般稳固。“正指直刺”，义无邪下，欲端正正直。“神在秋毫”，审视病人，静心观察病患，不左右视。“悬阳”，指心。心藏神。针刺之时，心得之于心，则神属于病人，而知病之存亡。经文说：“取血于荣，取气于卫。”卫气行于阳分、阴分。所以在两卫之间取阴阳之气。《卫气行》篇说：“所以要谨慎等候气之所在而刺之，这叫逢时。”病在三阳，必候其气在阳分而刺之；病在三阴，必候其气在阴分而刺之。“络”是经脉的分支。《刺节真邪》篇说：“六经调和，叫作不病。一经上实下虚而不通的，这一定有横络盛加于大经，令其不通。视而泻之，这叫解结。”所以有血络横在于经络之间的，应当看它特别清澈，摸它特别坚实而去之。九针，有九种名称，有九种形状，各随其所宜而用之。九针的理论完备了。
气在脉中，邪气在上，浊气在中，清气在下。所以针刺陷脉（浅表之脉）则邪气出，针刺中脉（深层之脉）则浊气出。针刺太深则邪气反而下沉，病加重。所以说皮肉筋脉，各有所处，病各有所宜，各不同形，各以任其所宜。不要实证用实法，不要虚证用虚法，不要损不足而益有余，这叫“甚病”，病会加重。取五脉（五脏诸阴之脉）会死，取三脉（三阳之脉）会怯弱。夺阴者死，夺阳者狂。针刺的危害讲完了。
这一段再次论述小针刺邪的方法，并论述其要害。风雨寒暑中人，位置较高，所以邪气在上。水谷入胃，其精气上注于肺，浊溜于肠胃。寒温不适，饮食不节，病生于肠胃，所以浊气在中。清湿地气中人，必从足始，所以清气在下。陷脉，指额颅之脉，显陷于骨中，所以针陷脉，则阳之表邪去矣。中脉，指足阳明之合穴三里穴。针太深则邪气反沉，是说浮浅之病，不欲深刺。深则邪气从之入，故曰反沉。皮肉筋骨，各有所处，是说经络各有所主。故病各有浅深之所宜，形有皮肉筋脉之不同，各随任其所宜而刺。无实实，无虚虚，若损不足而益有余，则病益甚。五脉，是五脏诸阴之脉。如中气不足，则血脉的生原已虚，再大泻其诸阴之脉，是虚于中而脱于外。三脉，是三阳之脉，怯弱也。言尽泻三阳之气，令病患怯然不复。夺阴者死，是说取人之五里穴五次。《玉版》篇说：“迎之五里，中道而止。五至而已。五往而脏之气尽矣。”夺阳者狂，正言取之五里而或夺其阳也。这是论针刺的危害讲完了。张开之说：取尺泽的五里，取皮肤阳分之气血。而曰夺阴，是说阳分之气血，生于五脏之阴。病在中气不足，而大泻诸阴之脉者死。谓诸阴之脉，生于中焦之阳明，阳生于阴，而阴生于阳。
针刺而气不至，不问次数多少。针刺而气至，就离开，不再针刺。针各有所宜，各不同形，各任其所为。刺的要领，气至而有效。有效的验证，像风吹云散，明白地看见青天。刺道的要领完备了。
这一段说刺的效果，以得气为关键。上文说病各有所宜，此说针各有宜，而有大小长短之形不同，各任其所宜而用之。若风之吹云，明乎若见青天，是说邪散而正气光明。
黄帝说：愿闻五脏六腑所出的穴位。岐伯说：五脏有五输穴，五五二十五输。六腑有六输穴，六六三十六输。经脉十二，络脉十五。凡二十七气以上下。所出为井，所溜为荥，所注为输，所行为经，所入为合。二十七气所行，都在五输穴中。
这一段说用针者，当知脏腑经脉之血气生始出入。营卫气血，皆生于胃腑水谷之精。营行脉中，卫行脉外。血行脉中，气行脉外。然而脉内之血气，从络脉而渗灌于脉外；脉外之气血，从络脉而溜注于脉中。外内出入相通。五脏内合五行，故其输五。六腑外合六气，故其输六。盖六气生于五行而有二火。经脉十二，是六脏六腑之经脉。络脉十五，是脏腑之十二大络及督脉之长强、任脉之尾翳、脾之大包。凡二十七脉之血气，出入于上下手足之间。所出为井，所溜为荥，所注为输，所行为经，所入为合。此二十七气之所行，皆在于五输。盖十二经脉之血气，本于五脏五行之所生，而脉外皮肤之气血，出于五脏之大络，溜注于荥输，而与脉内之血气，相合于肘膝之间。此论脏腑经脉之血气出入。
节的交会，三百六十五会。知其要者，一言而终；不知其要，流散无穷。所言节者，是神气之所游行出入也，非皮肉筋骨也。
这一段说刺节者，当知神气之所出入。神气者，真气也，所受于天与谷气并而充身者也。故知其要，一言而终；不知其要，流散无穷。此络脉之渗灌诸节，非皮肉筋骨也。
观其色，察其目，知其散复。一其形，听其动静，知其邪正。右主推之，左持而御之。气至而去之。
这一段说上工观五色于目，知色之散复，即知病之散复矣。知其邪正者，知论虚邪与正邪之风也。右主推之，左持而御之者，言持针而出入也。气至而去之者，言补泻气调而去之也。
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，而用针者反实其外，是谓重竭。重竭必死，其死也静。治之者，辄反其气，取腋与膺。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。治之者反取四末。
这一段说用针者，必先诊脉。视五脏之气剧易，乃可以治也。所谓五脏之气已绝于内者，脉口气内绝不至。反取其外之病处，与阳经之合，有留针以致阳气。阳气至则内重竭，重竭则死矣。无气以动故静。此言五脏之阴，生于中焦之阳，故外致其阳，则内重竭矣。五脏之气已绝于外者，脉口气外绝不至。反取其四末之输，有留针以致其阴气。阴气至则阳气反入，入则逆，逆则死矣。其死也阴气有余故躁。此言阴内而阳外，阳气内入，则为逆矣。
刺之害，中而不去则精泄，害中而去则致气。精泄则病益甚而痟，致气则生为痈疡。
这一段说取气之太过不及，而皆能为害也。夫气生于精，故刺之害，中病而不去其针，则过伤其气，而致泄其生原，故病益甚而痟。刺之害，中而即去其针，邪未尽而正气未复，则致气留聚而为痈疡。《痈疽》篇说：“经脉流行不止，与天同度，与地合纪。天宿失度，日月薄蚀，地经失纪，水道流溢，血脉营卫，周流不休。气血不通，故为痈肿。”盖营卫气血，营运于外内上下之不息也。是以首篇与第八十一篇始终论精气之生始出入。若阴阳不调，血气留滞，则为痈疡矣。
五脏有六腑，六腑有十二原。十二原出于四关，四关主治五脏。五脏有疾，当取之十二原。
十二原者，五脏之所以禀三百六十五节气味也。五脏有疾也，应出十二原。十二原各有所出，明知其原，睹其应而知五脏之害矣。阳中之少阴，肺也。其原出于太渊，太渊二。阳中之太阳，心也。其原出于大陵，大陵二。阴中之少阳，肝也。其原出于太冲，太冲二。阴中之至阴，脾也。其原出于太白，太白二。
Huangdi asked Qibo: I nurture the people and raise the commoners, collecting their taxes. I pity them for their insufficient livelihood and frequent illnesses. I wish to avoid using toxic medicines and bi-shi (stone needles) on them. Instead, I desire to use fine needles to unblock their meridians, regulate their blood and qi, and ensure the smooth flow of Ying (Nutrient) Qi in its normal and reverse directions, as well as at the intersections of entry and exit. I want this method to be passed down to future generations. Therefore, clear laws must be established so that it remains eternal and unextinguished, lasting long without interruption, easy to use and hard to forget, serving as the framework for treatment. The chapters should be distinguished, the exterior and interior differentiated, and beginnings and endings defined, so that each needle has a specific form. First, let us establish the *Classic of Needles* (*Zhen Jing*). I wish to hear the details.
Qibo replied: Please allow me to deduce and arrange them in order, establishing a systematic framework, starting from one and ending with nine.
Note: In the historical records, the Yellow Emperor governed the world, established the well-field system, measured land by steps and mu, cultivated the five grains, nurtured the ten thousand people, and collected taxes. If the people fell ill, they could not work diligently in the fields to provide food for him. Thus, the Emperor wished to establish the methods of the Nine Needles and fine needles to pass them down to posterity, ensuring they remain eternal. Toxic medicines are used to attack diseases; bi-shi (stone needles) are used to drain pathogenic factors. Both belong to draining and purging methods. Fine needles can unblock and regulate blood and qi. "Reverse and normal" refers to the flow of blood and qi in the skin and meridians, which have reverse and normal directions; "entry and exit" refers to the intersection points. Humans are born inheriting the Qi of Heaven and Earth; Yin-Yang and blood/qi integrate with the Way of Heaven and Earth, operating ceaselessly. Any stagnation leads to disease. Therefore, the Emperor established the Nine Needles based on the principles of Heaven, Earth, and Humanity, using them to align with human Yin-Yang and blood/qi, harmonizing with the Heavenly Way. Understanding the principles makes it easy to use; keeping it in mind makes it unforgettable. "Jing" (Meridian/Classic) means path; "Ji" (System) means framework. Note: Although the chapter is titled "Nine Needles," Huangdi mentions "fine needles," and Qibo mentions "small needles." This indicates that besides the Nine Needles, small needles were also established. The Nine Needles originate from the Sage's understanding of Heaven and Earth numbers, starting from one and ending at nine. Nine times nine equals eighty-one, initiating the number of Huangzhong (the fundamental pitch pipe). Using the Nine Needles combined with small needles corresponds to the fact that Yang numbers sum to five and Yin numbers sum to five; these five positions interact and combine, corresponding to the numbers of Hetu (River Map). The Emperor succeeded Fuxi and Shennong, applying the numbers of Liangyi (Two Powers), Sixiang (Four Images), and Hetu to acupuncture, thereby cultivating oneself, governing the state, and bringing peace to the world. The nation is founded upon the people.
Let me explain its principles. The essence of the small needle is easy to state but difficult to master. Crude practitioners only guard the form; superior practitioners guard the Shen (Spirit/Mind). How divine! The guest (pathogen) is at the gate (the portal of Zheng Qi/Healthy Qi). Without observing the disease, how can one know its origin? The subtlety of needling lies in the speed (slow or fast). Crude practitioners only guard the joints (Guan); superior practitioners guard the Ji (Opportunity/Mechanism). The movement of Ji does not depart from the Kong (Empty space/Acupoint). The Ji within the Kong is quiet, pure, and subtle. When it arrives, it should not be met head-on (Feng); when it departs, it should not be chased. One who knows the Way of Ji cannot err by even a hair's breadth. One who does not know the Way of Ji will not respond even if struck. Knowing the coming and going, one must seize the appropriate timing. Crude practitioners are ignorant of this; only skilled artisans possess this knowledge. Departing Qi is Ni (Reverse); Arriving Qi is Shun (Normal). Clearly knowing Ni and Shun, one acts correctly without gap. Meeting and seizing (Ying Er Duo Zhi) leads to deficiency (Xu). Chasing and assisting (Zhui Er Ji Zhi) leads to excess (Shi). Following and accompanying (Ying Zhi Sui Zhi), harmonizing with intention—this completes the Dao of Needling.
"Easy to state, difficult to enter" means it is easy to speak about but hard to penetrate deeply. "Crude guards form" means guarding the needling of skin, vessels, flesh, sinews, and bones. "Superior guards Shen" means guarding the deficiency and excess of blood and qi to perform tonification and sedation. "How divine!" highly praises the wonder of obtaining Shen. "Gate" refers to the portal where Healthy Qi enters and exits. "Guest at the gate" means pathogens follow the pathways of Healthy Qi. Not yet seeing which meridian is diseased, how can one know the root cause? This implies one must first locate the pathogen before selecting acupoints. "Slow and Fast" refers to the speed of needle insertion and withdrawal. "Crude guards Guan" means guarding the joints of the four limbs. "Superior guards Ji" means guarding the Kong (acupoint) and the timing of needling, like the release of a crossbow trigger. "Not departing from Kong" means striking while the point is empty. Pathogenic and Healthy Qi have times of excess and deficiency. Tonification and sedation should be performed by quietly guarding the subtlety within the Kong, allowing no error of a hair's breadth. If Qi is just arriving, the pathogen is strong, and Healthy Qi is weak. One should not meet the arriving Qi with tonification (note: text context clarifies later that meeting is sedation/chasing is tonification, but here it discusses avoiding the peak of pathogen). One should avoid the sharpness of the arriving pathogen. If Qi has already departed, the pathogen is weak, and Healthy Qi is recovering. One should not chase the departing Qi with sedation, lest it damage Healthy Qi. The key lies in the subtle moment between arrival and departure to activate the Ji. *He Li Zhen Xie Lun* states: "If one waits for the pathogen without prudence, and the major Qi has passed, sedating will cause True Qi to collapse. Collapse means it cannot recover; the pathogen returns, and the disease worsens." Hence, "its departure cannot be chased." This is what is meant. Therefore, "its arrival cannot be met, its departure cannot be chased." Quietly guarding the interval between arrival and departure to perform tonification and sedation, any slight error leads to failure. Crude workers do not understand the Way of Ji; asking them yields no response. Mistiming tonification and sedation injures blood and qi completely, preventing the expulsion of pathogens. Those who know the coming and going understand the waxing and waning of pathogen and Healthy Qi, seizing the proper time for intervention. The ignorance of crude workers contrasts with the exclusive knowledge of skilled artisans. This is why artisans differ. If Qi departs, both pathogen and Healthy Qi are weak; tonification/sedation would be Ni (wrong direction). If Qi arrives, shape, Healthy Qi, and pathogen are balanced; tonification/sedation is Shun (correct direction). Thus, clearly knowing Ni and Shun, acting correctly without gap, and knowing the timing of Qi's movement allows for correct intervention. "Meeting and seizing" is Sedation; thus, how can it not result in Xu? "Chasing and assisting" is Tonification; thus, how can it not result in Shi? "Meeting and following, harmonizing with intention"—this completes the Dao of Needling.
In all cases of needling: For Deficiency, make it Solid (Tonify); for Fullness, Drain it (Sedate); for Stasis/Old Blood, Remove it; for Excess Pathogen, Empty it. The General Principle says: Slow insertion and quick withdrawal creates Solidity (Tonification); Quick insertion and slow withdrawal creates Emptiness (Sedation). Regarding Solid and Deficient states, they seem to exist and not exist. Observing sequence and priority, they seem to remain and vanish. Creating Deficiency or Solidity feels like gaining or losing.
"Making Deficiency Solid" refers to tonifying when the Cun Kou pulse is deficient. "Draining Fullness" refers to sedating when the Cun Kou pulse is full. "Removing Stasis/Old Blood" refers to eliminating accumulated blood in the vessels. "Emptying Excess Pathogen" means sedating any meridian with excess. "Slow insertion, quick withdrawal creates Solidity" means inserting slowly and withdrawing quickly. "Quick insertion, slow withdrawal creates Emptiness" means inserting quickly and withdrawing slowly. "Solid and Deficient, seeming to exist and not exist" means Solid states have Qi, Deficient states lack Qi. "Observing sequence and priority, seeming to remain and vanish" refers to the priority of tonification and sedation based on Qi's deficiency or excess, observing whether Qi sinks or remains constant. "Creating Deficiency or Solidity, feeling like gaining or losing" means after tonification, one feels as if having gained something; after sedation, one feels as if having lost something. The above discusses the methods of the small needle. The key to Deficiency and Excess lies in the Nine Needles. The timing of tonification and sedation relies on the needle.
For Sedation: Hold the needle firmly, insert it, release and withdraw it, push away the Yang Qi to position the needle, allowing the pathogen to escape. Press and guide the needle out; this is called "Nei Wen" (Internal Warmth), where blood does not scatter and Qi does not escape.
For Tonification: Follow the Qi. The intention of following is like acting recklessly. Move and press as if walking, like a mosquito stopping, like staying then returning. Withdraw the needle swiftly like a breaking bowstring. Let the left hand hold the area, the right hand withdraws the needle. The Healthy Qi stops inside, the external gate closes, and the central Qi becomes solid. There must be no retained blood. If there is retained blood, urgently remove it.
The principle of holding the needle is firmness. Point straight and pierce directly, without tilting left or right. Focus your spirit on the finest detail (autumn hair). Instruct the patient, examine the blood vessels carefully, and there will be no danger during needling. At the time of needling, focus on "Xuan Yang" (Heart/Shen) and "Liang Wei" (Wei Qi pathways). Keep your spirit attached and do not wander, so you may know if the disease persists or resolves. Blood vessels lie horizontally under the skin; they appear distinctly clear to the eye and feel distinctively firm to the touch.
The names of the Nine Needles differ in shape:
1. Chan Needle (Chan Zhen): 1 cun 6 fen long. Head large, tip sharp; used to drain Yang Qi.
2. Yuan Needle (Yuan Zhen): 1 cun 6 fen long. Egg-shaped; used for massage between muscles without injuring them, to drain subcutaneous Qi.
3. Di Needle (Di Zhen): 3 cun 5 fen long. Tip sharp like millet grain; used to press vessels without penetrating, to guide Qi.
4. Feng Needle (Feng Zhen): 1 cun 6 fen long. Triangular blade; used to release entrenched diseases.
5. Pi Needle (Pi Zhen): 4 cun long, 2.5 fen wide. Tip like a sword edge; used to drain large abscesses.
6. Yuanli Needle (Yuanli Zhen): 1 cun 6 fen long. Thick like a cowhair, round and sharp, slightly thicker in the middle; used for acute conditions.
7. Hao Needle (Hao Zhen): 3 cun 6 fen long. Tip like a mosquito proboscis; inserted gently and slowly, retained for a long time to treat pain-bi syndromes.
8. Chang Needle (Chang Zhen): 7 cun long. Sharp and thin body; used for deep-seated bi syndromes.
9. Da Needle (Da Zhen): 4 cun long. Tip like a rod, slightly rounded edge; used to drain fluid from joints.
The functions of the Nine Needles are complete.
This section discusses the methods of the Nine Needles. The first chapter generally discusses the Small Needle and the Dao of the Nine Needles; hence, the Small Needle is discussed before and explained in detail in *Xiao Zhen Jie*. This section discusses the Nine Needles, explained in detail in *Jiu Zhen Lun*, not in *Xiao Zhen Jie*. The key to Deficiency and Excess lies in the Nine Needles because each is suitable for specific conditions. Timing tonification and sedation with the needle aligns with the opening and closing of Qi. "Pushing away Yang to get the needle" means pushing aside to access Yang Qi; obtaining Healthy Qi expels the pathogen. "Nei Wen" means heat under the needle, indicating the pathogen leaves and Healthy Qi remains. This discusses draining pathogen and nourishing Healthy Qi. "Following" means chasing and assisting. "Zhi" means going. "Ruo Wang Zhi" means although chasing, it seems as if not going. "Ruoxing Ruoa, ru wenmeng zhi, ru liu er huan" describes the sensation. "Qu ru xian jue" means withdrawing the needle quickly. Left hand presses, right hand withdraws; Healthy Qi stays inside, external gate closes, central Qi becomes solid. This is the method of tonifying Healthy Qi and moving pathogen. Retained blood must be urgently removed. "Jian" means firm grip like holding a tiger. "Zheng zhi zhi ci" means piercing straight without deviation, aiming for uprightness. "Shen zai qiu hao" means observing the patient quietly without distraction. "Xuan Yang" refers to the Heart, which houses Shen. During needling, focusing the Heart's Shen on the patient allows one to know the disease's status. Classics say: "Take blood from Ying, take Qi from Wei." Wei Qi moves through Yang and Yin. Therefore, needling between the two Weis accesses Yin and Yang Qi. *Wei Qi Xing* states: "Carefully await the location of Qi to needle; this is called 'meeting the time'." For Taiyang diseases, wait for Qi in the Yang aspect; for Shaoyin diseases, wait for Qi in the Yin aspect. "Luo" refers to collaterals. *Ci Jie Zhen Xie Lun* states: "When six meridians are harmonious, there is no disease. If one meridian has upper excess and lower deficiency with blockage, there must be a transverse collateral obstructing the main meridian. Observe and sedate it; this is called 'untying the knot'." Thus, if blood collaterals obstruct the meridians, observe their clarity and firmness to remove them. The Nine Needles have nine names and forms, used according to suitability. The theory of the Nine Needles is complete.
Qi in the vessels: Pathogenic Qi is in the Upper, Turbid Qi is in the Middle, Clear Qi is in the Lower. Needling superficial vessels expels Pathogenic Qi; needling deeper vessels expels Turbid Qi. Needling too deeply causes Pathogenic Qi to sink further, worsening the disease. Thus, skin, flesh, sinews, and vessels each have their proper locations, and diseases have their proper treatments. They differ in form and require appropriate selection. Do not tonify Excess or sedate Deficiency; do not damage the insufficient to benefit the excessive. This is called "Severe Disease," leading to worsening. Needling the Five Vessels (Yin vessels of Zang organs) causes death. Needling the Three Vessels (Yang vessels) causes timidity. Depriving Yin causes death; depriving Yang causes mania. The harms of needling are now complete.
This re-discusses the method of expelling pathogen with the small needle and its critical points. Wind, rain, cold, and summer heat affect the high parts, so Pathogenic Qi is in the Upper. Food and water enter the stomach; essence ascends to the Lung, turbidity flows to the intestines and stomach. Improper temperature and diet cause disease in the middle jiao, so Turbid Qi is in the Middle. Damp ground and earthy qi affect humans starting from the feet, so Clear Qi is in the Lower. "Xian Mai" refers to forehead/cranial vessels sunken into bone; needling them expels superficial Yang pathogen. "Zhong Mai" refers to He-Sea points like Zusanli (ST36). Needling too deeply causes pathogen to sink, meaning shallow diseases should not be needled deeply. Skin, flesh, sinews, and bones correspond to specific meridians. Diseases have depths requiring specific needling. Do not create Excess in Excess or Deficiency in Deficiency. Damaging the insufficient to benefit the excessive worsens the disease. "Five Vessels" are the Yin vessels of the Zang organs. If Central Qi is deficient, the source of blood vessels is weak; heavily sedating Yin vessels causes internal collapse and external depletion. "Three Vessels" are the Yang vessels; sedating them completely causes timidity. "Depriving Yin causes death" refers to repeatedly needling Wuli (ST35) points. *Yu Ban* states: "Meeting Wuli, stop halfway. Five times suffices. Five withdrawals exhaust Zang Qi." "Depriving Yang causes mania" refers to depriving Yang by needling Wuli. Zhang Kai notes: Taking Wuli extracts Qi and Blood from the Yang aspect of the skin. It is called "depriving Yin" because Yang Qi/Blood originates from Zang Yin. Heavy sedation of Yin vessels in cases of Central Qi deficiency leads to death because Yin vessels originate from Yang Ming in the Middle Jiao; Yang is born from Yin, and Yin from Yang.
If Qi does not arrive after needling, continue regardless of count. If Qi arrives, remove the needle and do not repeat. Each needle has its suitability and form, performing its specific function. The essence of needling is that effect follows Qi arrival. The proof of effect is like wind blowing clouds away, revealing the blue sky. The Dao of Needling is complete.
This discusses the efficacy of needling, emphasizing Qi arrival. Previously, diseases had specific indications; now, needles have specific indications with varying sizes and lengths, used appropriately. Like wind clearing clouds, revealing the blue sky, it signifies the dispersion of pathogen and the brightness of Healthy Qi.
Huangdi said: I wish to hear the origins of the Shu points of the Five Zang and Six Fu organs. Qibo said: The Five Zang have five Shu points each, totaling twenty-five. The Six Fu have six Shu points each, totaling thirty-six. There are twelve Meridians and fifteen Collaterals. Twenty-seven Qi systems move up and down. Points where Qi emerges are Jing-Well points; where it flows are Ying-Spring points; where it pours is Shu-Stream points; where it travels is Jing-River points; where it enters is He-Sea points. The movement of the twenty-seven Qi systems all occurs at the Five Shu points.
This explains that practitioners must know the origin, entry, and exit of blood and Qi in Zang-Fu meridians. Ying and Wei Qi and Blood/Qi are generated from the essence of water and food in the Stomach. Ying moves in the vessels; Wei moves outside. Blood moves in; Qi moves outside. However, blood and Qi inside vessels seep into the outside via collaterals; Qi and Blood outside flow into the inside via collaterals. Interior and exterior connect. Five Zang correspond internally to the Five Elements, hence five Shu points. Six Fu correspond externally to the Six Qi, hence six Shu points. Six Qi arise from Five Elements plus the Two Fires. Twelve Meridians correspond to Six Zang and Six Fu. Fifteen Collaterals include twelve major collaterals of Zang-Fu, plus Changqiang (DU1), Wei Yi (REN12), and大包 (SP21). The blood and Qi of these twenty-seven vessels circulate between upper and lower extremities. Emerging = Jing-Well; Flowing = Ying-Spring; Pouring = Shu-Stream; Traveling = Jing-River; Entering = He-Sea. These movements occur at the Five Shu points. The blood and Qi of the twelve meridians originate from the Five Zang and Elements. Subcutaneous Qi comes from major collaterals of Zang, flows into Ying-Shu points, and merges with intra-vascular Qi at the elbows and knees. This discusses the circulation of blood and Qi in Zang-Fu meridians.
Intersections (Jie) number three hundred and sixty-five. One who knows the essence needs only one word to conclude; one who does not knows endless dispersion. The "Jie" refers to the places where Shen Qi (Spirit Qi) travels and enters/exits, not merely skin, flesh, sinew, or bone.
This explains that for needling intersections, one must know where Shen Qi enters and exits. Shen Qi is True Qi, derived from Heaven and Grain Qi, filling the body. Knowing the essence simplifies understanding; ignoring it leads to confusion. Collateral seepage nourishes these intersections, distinct from physical tissues.
Observe color, inspect eyes, know dispersion and recovery. Unify form, listen to movement, know pathogen and Healthy Qi. Right hand pushes the needle; left hand holds and guides. Remove the needle when Qi arrives.
This explains that superior physicians observe colors in the eyes to determine disease dispersion. Knowing pathogen vs. Healthy Qi distinguishes deficiency-pathogen from healthy-pathogen winds. Right hand pushes, left hand guides describes needle manipulation. Removing upon Qi arrival indicates completion of tonification/sedation and Qi regulation.
Before using needles, one must diagnose the pulse. Assess the severity and ease of Qi regulation before treating. If Qi of the Five Zang is exhausted internally, but the practitioner tonifies externally, this is called "Double Exhaustion" (Chong Jie), which is fatal, resulting in quiet death. Practitioners who do this reverse the Qi, needling the armpit and chest. If Qi of the Five Zang is exhausted externally, but the practitioner tonifies internally, this is called "Inverse Cold" (Ni Jue), which is fatal, resulting in restless death. Practitioners who do this wrongly needle the four extremities.
This emphasizes diagnosing the pulse to assess Zang Qi severity. "Qi exhausted internally" means the Cun Kou pulse lacks internal arrival. Tonifying external Yang points retains Yang Qi, causing internal exhaustion and death due to lack of movement (quiet). This reflects that Zang Yin is born from Middle Jiao Yang; external tonification depletes internal Yin. "Qi exhausted externally" means the Cun Kou pulse lacks external arrival. Tonifying internal Yin points retains Yin Qi, causing Yang to retreat inward, leading to inverse cold and death due to Yin excess (restless). This reflects Yin inside, Yang outside; inward retreat of Yang is inverse.
Harm of needling: If the needle is inserted correctly but not withdrawn, Essence leaks, worsening the disease into emaciation. If the needle is withdrawn prematurely after hitting the target, Qi accumulates, generating carbuncles and ulcers.
This warns against excessive or insufficient Qi extraction. Qi is born from Essence. Leaving the needle too long damages Qi and leaks the source, causing emaciation. Withdrawing too early leaves pathogen and fails to restore Healthy Qi, causing Qi stagnation and abscesses. *Yong Ju Pian* states: "Meridian flow is ceaseless... if Qi and Blood do not flow smoothly, carbuncles and swelling arise." Continuous circulation of Ying, Wei, Blood, and Qi prevents this. The first and eighty-first chapters discuss the origin and circulation of Essence and Qi. Disharmony of Yin-Yang and stagnation of Blood/Qi lead to abscesses.
The Five Zang have six Fu organs; the Six Fu have twelve Yuan-Source points. The twelve Yuan points emerge from the Four Passes (Si Guan), which govern the Five Zang. When the Five Zang are diseased, one should select the twelve Yuan points.
The twelve Yuan points are where the Five Zang receive the Qi and flavor of the three hundred and sixty-five intersections. When Zang organs are diseased, reactions appear at the Yuan points. Knowing the Yuan points and their responses reveals Zang harm.
- Shaoyin of Yang (Lung): Yuan point Taiyuan (LU9), bilateral.
- Taiyang of Yang (Heart): Yuan point Daling (PC6), bilateral. *(Note: Text says Daling for Heart, which is pericardium, but traditional texts often cite Shenmen (HT7) for Heart. Following source text strictly)*.
- Shaoyin of Yin (Liver): Yuan point Taichong (LR3), bilateral.
- Zhiyin of Yin (Spleen): Yuan point Taibai (SP3), bilateral.