黄帝问于岐伯曰。余闻刺有五禁。何谓五禁。岐伯曰。禁其不可刺也。黄帝曰。余闻刺有五夺。岐伯
曰。无泻其不可夺者也。黄帝曰。余闻刺有五过。岐伯曰。补泻无过其度。黄帝曰。余闻刺有五逆。岐
伯曰。病与脉相逆。命曰五逆。黄帝曰。余闻刺有九宜。岐伯曰。明知九针之论。是谓九宜。
余伯荣曰。此承上章。复论刺有五禁。五夺。五过。五逆以为刺禁。令民勿犯者也。五过者。五脏
外合之皮脉肉筋骨。有邪正虚实。宜平调之。如补泻过度。是为五过。九宜者。九针之论。各有所宜。
神而明之。是为九宜。
黄帝曰。何为五禁。愿闻其不可刺之时。岐伯曰。甲乙日自乘。无刺头。无发 于耳内。丙丁日
自乘。无振埃于肩喉廉泉。戊己日自乘四季。无刺腹去爪通水。庚辛日自乘。无刺关节于股膝。壬癸
日自乘。无刺足胫。是谓五禁。
余氏曰。天之十干。始于甲乙。终于壬癸。故甲乙以应头。壬癸以应足。丙丁应身半以上。庚辛
应身半以下。配天之四时也。戊己属土。故乘于四季。夫甲为阳木。乙为阴木。自乘者。阴阳自合。
非化气也。发 振埃者。所以通气也。天之十干。化生地之五行。通气者。通五运之化气。此天干自
乘。故为取气之禁。
黄帝曰。何谓五夺。岐伯曰。形肉已夺。是一夺也。大夺血之后。是二夺也。大汗出之后。是三
夺也。大泄之后。是四夺也。新产及大血。是五夺也。此病不可泻。
余氏曰。形肉血气已虚脱者。虽有实邪。皆不可泻。
黄帝曰。何谓五逆。岐伯曰。热病脉静。汗已出。脉盛躁。是一逆也。病泄脉洪大。是二逆也。
着痹不移。 肉破。身热。脉偏绝。是三逆也。淫而夺形。身热。色夭然白。及后下血 。血 笃
重。是谓四逆也。寒热夺形。脉坚搏。是谓五逆也。
余氏曰。热病脉静者。阳病见阴脉也。汗已出。脉盛躁者。阳热之邪。不从汗解。阴液去而邪
反盛也。病泄者脉宜沉弱。反洪大者。阴泄于下。阳盛于上。阴阳上下之相离也。着痹不移。 肉破。
身热者。湿邪伤形。久而化热。
脉偏绝者。脾胃之气败也。淫者。酷虐之邪。夺形者。邪伤形也。如但热不寒之疟。气内藏于心。而
外淫于分肉之间。令人消铄脱肉。夫心主血而血脉荣于色。色夭然白。及后下 血笃重者。形气消
于外。血液脱于内。血液外内之离脱也。寒热夺形。脉坚搏者。寒热之邪盛。而正气伤也。此为五
逆。皆不可刺也。
黄帝向岐伯问道：我听说针刺有五种禁忌，什么是这五种禁忌？岐伯回答说：禁止对不可针刺的情况进行针刺。黄帝说：我听说针刺有五种“夺”（指正气严重耗损的情况）。岐伯说：不要对不可耗夺的正气进行泻法治疗。黄帝说：我听说针刺有五种过失。岐伯说：补法和泻法不能超过适当的限度。黄帝说：我听说针刺有五种逆证（指病情与脉象相违背的危重证候）。岐伯说：病症表现与脉象相互违背，称为五逆。黄帝说：我听说针刺有九种适宜的原则。岐伯说：明确了解九针的理论，就称为九宜。
余伯荣说：这段文字承接上一章，再次论述针刺的五禁、五夺、五过、五逆，作为针刺的禁忌，使民众不要触犯。所谓五过，是指五脏在体表合应的皮、脉、肉、筋、骨，存在邪正虚实的不同情况，应当平和调治。如果补泻过度，就称为五过。所谓九宜，是指九针的理论，各有其适宜的适用范围，若能神妙地领悟并阐明它，就称为九宜。
黄帝问：什么是五禁？希望听听不可针刺的具体时日。岐伯说：甲日和乙日自乘（天干与地支相合），不可针刺头部，不可在耳内施灸或发汗；丙日和丁日自乘，不可使用“振埃”法（一种清除肩部、喉部及廉泉穴邪气的刺法）；戊日和己日自乘，对应四季之末，不可针刺腹部以去除爪甲部位的积滞或通利水道；庚日和辛日自乘，不可针刺大腿和膝盖的关节部位；壬日和癸日自乘，不可针刺小腿足胫部位。这就叫做五禁。
余氏说：天的十天干，始于甲乙，终于壬癸。所以甲乙对应头部，壬癸对应足部，丙丁对应身体上半部分，庚辛对应身体下半部分，这是配合天的四时变化。戊己属土，所以寄旺于四季之末。甲为阳木，乙为阴木，“自乘”是指阴阳自行结合，并非化生之气。发汗和振埃法，是用来通畅气机的。天的十干化生地之五行，通畅气机即是通畅五运的化气。因为天干自乘，所以成为取气的禁忌。
黄帝问：什么是五夺？岐伯说：形体肌肉已经极度消瘦，这是一夺；大量失血之后，是二夺；大汗出之后，是三夺；严重腹泻之后，是四夺；刚分娩后及大量出血，是五夺。这些情况都不可用泻法。
余氏说：形体、肌肉、血液、气机已经虚弱脱失的人，即使有实邪，也都不可用泻法。
黄帝问：什么是五逆？岐伯说：热病患者脉象反而沉静，是第一种逆证；出汗后脉象反而盛大躁动，是第二种逆证；病泄泻而脉象洪大，是第三种逆证；着痹（湿邪偏盛的痹证）固定不移，肌肉溃破，身体发热，脉象一侧断绝，是第四种逆证；因淫欲过度导致形体消瘦，身体发热，面色枯槁苍白，随后出现便血且病情沉重，是第五种逆证。
余氏说：热病脉象沉静的，是阳病见到阴脉。出汗后脉象盛大躁动的，说明阳热之邪没有随汗解去，阴液已去而邪气反而强盛。患泄病的患者脉象应当沉弱，反而洪大的，说明阴气泄于下，阳气盛于上，这是阴阳上下分离的表现。着痹固定不移，肌肉溃破，身体发热的，是湿邪损伤形体，日久化热。脉象一侧断绝的，是脾胃之气败坏。淫，指酷虐的邪气；夺形，指邪气损伤形体。例如但热不寒的疟疾，气内藏于心，外淫于分肉之间，使人肌肉消减脱落。心主血，血脉荣华显现于面色，面色枯槁苍白，随后便血且病情沉重的，是形气消耗于外，血液脱失于内，这是血液内外离脱的表现。寒热交作导致形体消瘦，脉象坚劲搏指，是寒热邪气强盛而正气受损。这就是五逆，都不可针刺。
Huangdi asked Qibo, "I have heard that there are five prohibitions in acupuncture. What are these five prohibitions?" Qibo replied, "They prohibit needling when it is inadvisable." Huangdi said, "I have heard of five 'depletions' (conditions where vital qi is severely exhausted) in needling." Qibo said, "Do not apply reducing methods to conditions where depletion should not occur." Huangdi said, "I have heard of five errors in needling." Qibo said, "The tonifying and reducing methods must not exceed the appropriate degree." Huangdi said, "I have heard of five reversals (critical syndromes where symptoms contradict the pulse) in needling." Qibo said, "When the disease presentation contradicts the pulse, it is called a reversal." Huangdi said, "I have heard of nine appropriatenesses in needling." Qibo said, "To clearly understand the theory of the Nine Needles is called the nine appropriatenesses."
Yu Borong stated: This passage follows the previous chapter, reiterating the five prohibitions, five depletions, five errors, and five reversals as contraindications for needling, to prevent people from violating them. The so-called five errors refer to the skin, vessels, muscles, tendons, and bones externally corresponding to the five Zang organs, which present different states of pathogenic factors, excess, deficiency, and reality. They should be harmoniously regulated. If tonification or reduction is excessive, it constitutes the five errors. The so-called nine appropriatenesses refer to the theories of the Nine Needles, each having its specific indications. To comprehend and elucidate them divinely constitutes the nine appropriatenesses.
Huangdi asked, "What are the five prohibitions? I wish to hear about the specific times when needling is inadvisable." Qibo replied, "On Jia and Yi days (when the Heavenly Stem combines with the Earthly Branch), do not needle the head, and do not induce sweating or moxa in the ears. On Bing and Ding days, do not use the 'Zhen'ai' method (a needling technique to clear pathogenic factors from the shoulders, throat, and Lianquan point). On Wu and Ji days (corresponding to the end of the four seasons), do not needle the abdomen to remove stagnation in the nail beds or to promote water metabolism. On Geng and Xin days, do not needle the joints of the thighs and knees. On Ren and Gui days, do not needle the lower legs and shins. These are called the five prohibitions."
Master Yu stated: The ten Heavenly Stems begin with Jia and Yi and end with Ren and Gui. Therefore, Jia and Yi correspond to the head, Ren and Gui to the feet, Bing and Ding to the upper half of the body, and Geng and Xin to the lower half of the body; this aligns with the four seasons of Heaven. Wu and Ji belong to Earth, hence they prevail at the end of the four seasons. Jia is Yang Wood, and Yi is Yin Wood. 'Self-multiplication' (Zicheng) refers to the self-combination of Yin and Yang, not the generation of transformational Qi. Methods like inducing sweating and Zhen'ai are used to unblock Qi. The ten Heavenly Stems generate the Five Phases of Earth; unblocking Qi is equivalent to unblocking the transformational Qi of the Five Movements. Because the Heavenly Stems undergo self-multiplication, these become prohibitions against extracting Qi.
Huangdi asked, "What are the five depletions?" Qibo replied, "When the form and flesh have already been depleted, this is the first depletion. After severe blood loss, this is the second depletion. After profuse sweating, this is the third depletion. After severe diarrhea, this is the fourth depletion. After recent childbirth and massive bleeding, this is the fifth depletion. In these conditions, reducing methods are contraindicated."
Master Yu stated: When the form, flesh, blood, and Qi are already deficient and depleted, even if there are excess pathogens, reducing methods must not be used.
Huangdi asked, "What are the five reversals?" Qibo replied, "In febrile diseases, if the pulse is quiet, this is the first reversal. If the pulse becomes rapid and restless after sweating, this is the second reversal. If diarrhea occurs but the pulse is surging and large, this is the third reversal. If fixed Bi syndrome (Bi syndrome dominated by Dampness) does not move, muscles ulcerate, the body is hot, and the pulse is absent on one side, this is the fourth reversal. If excessive sexual activity leads to emaciation, the body is hot, the complexion is dull and pale, followed by hematochezia with severe condition, this is the fifth reversal."
Master Yu stated: A quiet pulse in a febrile disease indicates a Yin pulse appearing in a Yang disease. A rapid and restless pulse after sweating indicates that Yang-Heat pathogens have not resolved through sweating; the Yin fluids are gone, and the pathogens are relatively stronger. In cases of diarrhea, the pulse should be deep and weak; if it is surging and large, it indicates Yin leaking below and Yang flourishing above, representing a separation of Yin and Yang between the upper and lower parts. Fixed Bi syndrome with muscle ulceration and fever indicates Dampness damaging the form and transforming into Heat over time. An absent pulse on one side indicates the failure of Spleen and Stomach Qi. 'Yin' here refers to cruel pathogens; 'depleting form' means pathogens damaging the physical structure. For example, in malaria characterized by heat without chills, Qi hides internally in the Heart and externally invades the intermuscular spaces, causing muscle wasting. The Heart governs Blood, and the vessels nourish the complexion. A dull, pale complexion followed by severe hematochezia indicates that Qi and Form are consumed externally while Blood is lost internally, representing a disconnection of Blood internally and externally. Cold and heat alternating leading to emaciation with a firm and bounding pulse indicate that Cold and Heat pathogens are strong while Zheng Qi (Upright Qi) is damaged. These are the five reversals, all of which are contraindications for needling.