所谓易陈者。易言也。难入者。难着于人也。粗守形者。守刺法也。上守神者。守人之血气有
余不足。可补泻也。神客者。正邪共会也。神者。正气也。客者。邪气也。在门者。邪循正气之
所出入也。未睹其疾者。先知邪正何经之疾也。恶知其原者。先知何经之病所取之处也。刺之微
在数迟者。徐疾之意也。粗守关者。守四肢而不知血气正邪之往来也。上守机者。知守气也。机之
动不离其空中者。知气之虚实。用针之徐疾也。空中之机。清静以微者。针以得气。密意守气勿
失也。其来不可逢者。气盛不可补也。其往不可追者。气虚不可泻也。不可挂以发者。言气易失也。
扣之不发者。言不知补泻之意也。血气已尽而气不下也。知其往来者。知气之逆顺盛虚也。要与
之期者。知气之可取之时也。粗之暗者。冥冥不知气之微密也。妙哉工独有之者。尽知针意也。
往者为逆者。言气之虚而小。小者逆也。来者为顺者。言形气之平。平者顺也。明知逆顺。正行无
间者。言知所取之处也。迎而夺之者。泻也。追而济之者。补也。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。去血脉也。邪胜则虚之者。言诸经有
盛者。皆泻其邪也。徐而疾则实者。言徐内而疾出也。疾而徐则虚者。言疾内而徐出也。言实与虚。
若有若无者。言实者有气。虚者无气也。察后与先。若存若亡者。言气之虚实。补泻之先后也。
察其气之已下与常存也。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。夫气
之在脉也。邪气在上者。言邪气之中人也高。故邪气在上也。浊气在中者。言水谷皆入于胃。其精
气上注于肺。浊溜于肠胃。言寒温不适。饮食不节。而病生于肠胃。故命曰浊气在中也。清气在下
者。言清湿地气之中人也。必从足始。故曰清气在下也。针陷脉则邪气出者。取之上。针中脉则
邪气出者。取之阳明合也。针太深则邪气反沉者。言浅浮之病。不欲深刺也。深则邪气从之入。
故曰反沉也。皮肉筋脉。各有所处者。言经络各有所主也。取五脉者死。言病在中气不足。但用
针尽大泻其诸阴之脉也。取三阳之脉者。唯言尽泻三阳之气。令病患 然不复也。夺阴者死。言
取尺之五里五往者也。夺阳者狂。正言也。睹其色。察其目。知其散复。一其形。听其动静
者。言上工知相五色于目。有知调尺寸小大缓急滑涩以言所病也。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。气出而去之者。言补泻气调而去之也。调
气在于终始一者。持心也。节之交三百六十五会者。络脉之渗灌诸节者也。所谓五脏之气。已绝于
内者。脉口气内绝不至。及取其外之病处。与阳经之合。有留针以致阳气。阳气至则内重竭。重
竭则死矣。其死也无气以动故静。所谓五脏之气。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。所
以察其目者。五脏使五色循明。循明则声章。声章者。则言声与平生异也。（ 音弼）
张开之曰。此解小针之义。而九针之论不与焉。 、满也。恍、惚也。所以察其目者。承上
文而言也。目色者。五脏之血色。声章者。五脏之气也。五色循明则声章者。血气之相应也。言声
与平生异者。散败之声也。盖言五脏之气已绝于内。不宜重取之阳。五脏之气已绝于外。不宜再
取之阴。阴阳外内相资。宜藏而不宜尽章着于外也。
所谓“易陈”，意思是容易陈述。“难入”的意思是难以被普通人理解。
粗工（技术低劣的医生）只拘泥于形体表象，指的是他们只固守针刺的手法；上工（高明的医生）则注重观察神气，指的是他们关注人体血气的有余或不足，从而决定采用补法或泻法。
“神客”是指正气与邪气共同交会于体内。“神”指正气，“客”指邪气。“在门”是指邪气顺着正气出入的途径进入。
“未睹其疾”是指在尚未明确病症之前，先要判断邪气和正气病变所在的经络。“恶知其原”是指要知道疾病的根源，必须先明确哪条经络患病以及应当选取的治疗部位。
针刺的精微之处在于行针速度的快慢（徐迟），这体现了补泻时徐疾的用意。
粗工只拘守四肢关节（关），却不知道血气中正邪的往来变化；上工则善于把握气机变化的关键（机），懂得守气。气机变动不离空虚之处（空中），这是指通过感知气的虚实来决定用针的徐疾。
“空中之机，清静以微”，意思是当针刺得气后，医者需精神专注、意念严密地守气，不可使其流失。
“其来不可逢”，意思是当邪气正盛时，不可使用补法。“其往不可追”，意思是当正气已虚时，不可使用泻法。
“不可挂以发”，意思是气机极易丧失，稍有不慎就会出错。
“扣之不发”，意思是如果不知补泻的要领，就像敲击钟磬却不发声一样，无法调动气机。此时血气已尽而气机不能下行。
“知其往来”，是指了解气机的逆顺和盛虚状态。
“要与之期”，是指掌握可以施治的气机时机。
粗工昏暗不明，是因为他们在冥冥之中不了解气机细微隐秘的变化。
技艺高超的工匠独有所悟，是因为他们完全通晓针刺的奥妙。
“往者为逆”，是说气机虚弱且微弱，微弱即为逆证。“来者为顺”，是说形气平和，平和即为顺证。
“明知逆顺，正行无间”，是指知道正确的取穴和治疗原则，执行起来就没有差错。
所谓“虚则实之”，是指脉口处气虚，应当用补法使其充实。
“满则泄之”，是指脉口处气盛，应当用泻法使其消退。
“宛陈则除之”，是指去除瘀阻的血脉。
“邪胜则虚之”，是指各经有邪气亢盛的情况，都应当泻去其邪气。
“徐而疾则实”，是指缓慢进针、快速出针，可使正气充实。
“疾而徐则虚”，是指快速进针、缓慢出针，可使邪气衰减。
言及“实”与“虚”，有时似有似无，这是因为实证中有气感，虚证中无气感。
“察后与先，若存若亡”，是指根据气机的虚实，确定补泻操作的先后顺序，操作时感觉若有若无。
还要考察气机是否已经下行或依然留存。
表现为“为虚为实，若得若失”，意思是施行补法后，患者感觉好像得到了什么（舒适充实）；施行泻法后，患者感觉好像失去了什么（轻松解脱）。
关于气在经脉中的分布：邪气侵犯上部，是说邪气伤人往往从高处开始，所以病位在上。
浊气停留在中部，是说水谷饮食都进入胃中，其中的精微之气向上输送到肺，而浑浊之气留滞于肠胃。如果寒温失调、饮食不节，疾病就会生于肠胃，所以称为浊气在中。
清气滞留于下部，是说清冷潮湿的地气伤人，必然从足部开始，所以称为清气在下。
针刺陷脉（浅表脉络）使邪气排出，是在上部取穴治疗。
针刺中脉（较深脉络）使邪气排出，是在阳明经合穴取穴治疗。
如果针刺过深导致邪气反而内陷，是说浅表的浮邪，不希望深刺；如果深刺，邪气就会随之深入，所以称为反沉。
皮、肉、筋、脉各有其所属部位，是说经络各自主管相应的组织。
如果误取五脉（五脏之脉）进行强泻，会导致死亡，这是因为病在中焦气不足，却只用针大幅泻诸阴之脉。
如果误取三阳之脉进行强泻，只会说完全泻去了三阳之气，使病人疲惫不堪、精神萎靡。
夺伤阴气会导致死亡，是指反复取尺泽穴附近的五里穴（五往）所致。
夺伤阳气会导致狂乱，这是确切的说法。
观察患者的面色，审视其眼神，可以知道神气的离散与恢复。统一观察其形体，倾听其动静，这是说高明的医生能通过眼睛观察五色变化，并懂得调节寸口脉的大小、缓急、滑涩来判断病情。
了解邪正关系，是指辨别虚邪（外感六淫）与正邪（内伤七情等）之风。
右手主推针具，左手扶持控制，是指持针进出时的手法。
气机调畅后离去，是指补泻得当、气机调和后停止操作。
周身三百六十五个节之交会点，是络脉渗灌气血的地方。
所谓“五脏之气，已绝于内”，是指寸口脉的内侧脉搏微弱不至。如果此时反而去取外部的病处，或者取阳经的合穴，并留针以激发阳气，那么阳气到来时，内部的阴气就会再次枯竭，双重枯竭就会导致死亡。这种死亡是因为没有气机运动，所以表现为安静。
所谓“五脏之气，已绝于外”，是指寸口脉的外侧脉搏微弱不至。如果反而去取四肢末端的腧穴，并留针以激发阴气，那么阴气到来时，阳气反而会内陷入逆乱，逆乱就会导致死亡。这种死亡是因为阴气有余，所以表现为躁动。
之所以要观察眼睛，是因为五脏精气使五色显现清明，清明则声音彰显。声音彰显，是指说话的声音与平时不同。（“章”音弼，同“彰”）。
张开之解释说：这段文字解释了《小针》篇的含义，而没有涉及九针的理论。“惽”意为昏昧，“恍”意为恍惚。之所以观察眼睛，是承接上文而言的。目色反映的是五脏的血色，声音彰显反映的是五脏的气机。五色清明则声音彰显，这是血气相互对应的表现。所谓“声音与平生异”，是指神气散败的声音。大概意思是说，五脏之气已绝于内的，不宜再过度索取阳气；五脏之气已绝于外的，不宜再过度索取阴气。阴阳内外相互资生，宜于潜藏而不宜完全显露于外。
The term "Yi Chen" (Easy to State) means that the principles are easy to articulate. The term "Nan Ru" (Difficult to Enter) means that they are difficult for ordinary people to comprehend.
A crude practitioner (Cù Gōng, a physician with inferior skills) only adheres to physical forms; this refers to their rigid adherence to needling techniques. An superior practitioner (Shàng Gōng, a highly skilled physician) observes Shen (Spirit/Mind); this refers to their attention to the excess or deficiency of Blood and Qi in the human body, thereby determining whether to apply tonification or sedation.
"Shen Ke" (Spirit Guest) refers to the convergence of Zheng Qi (Upright Qi/Healthy Energy) and Xie Qi (Evil Qi/Pathogenic Factor). "Shen" denotes Zheng Qi, while "Ke" denotes Xie Qi. "Zai Men" (At the Door) indicates that Xie Qi enters along the pathways where Zheng Qi exits and enters.
"Wei Du Qi Ji" (Not yet perceiving the disease) implies that before clearly identifying the pathology, one must first determine which meridians are affected by Zheng Qi and Xie Qi. "E Zhi Qi Yuan" (How to know its origin) implies that to understand the root of the disease, one must first identify which meridian is diseased and select the appropriate treatment points.
The subtlety of needling lies in the speed (Xu Chi), reflecting the intention of Xu (slow) and Ji (fast) manipulation for tonification and sedation.
Crude practitioners only guard the joints (Guan) of the limbs, unaware of the fluctuation of Zheng and Xie Qi within the blood vessels. Superior practitioners guard the Ji (Mechanism/Opportunity), understanding how to secure the Qi. The movement of the Ji does not depart from the Kong Zhong (Empty Space/Void within the tissue); this refers to knowing the emptiness or fullness of the Qi and applying slow or fast needle manipulation accordingly.
"The Ji in the Empty Space is clear, quiet, and subtle." This means that once De Qi (Arrival of Qi/Acquired Sensation) is achieved, the practitioner must maintain mental clarity and closely guard the Qi so as not to lose it.
"Its arrival cannot be met (with tonification)." This means when Qi is excessive, tonification should not be used. "Its departure cannot be pursued (with sedation)." This means when Qi is deficient, sedation should not be used.
"It cannot hang by a hair." This signifies that Qi is easily lost; even a slight error can lead to mistakes.
"Striking but not sounding." This means if one does not understand the intent of tonification and sedation, it is like striking an instrument without producing sound, failing to mobilize the Qi. At this point, Blood and Qi are exhausted, and Qi fails to descend.
"To know its coming and going" refers to understanding the direction (Ni/Shun) and strength (Sheng/Xu) of the Qi.
"To set a time with it" refers to knowing the opportune moment to treat based on the Qi's state.
Crude practitioners are obscure because they unknowingly fail to perceive the subtle and secret changes of Qi.
The skillful artisan possesses unique insight because they fully understand the art of needling.
"Wang Zhe Wei Ni" (Going away is Ni/Reverse) describes a state where Qi is deficient and weak; weakness constitutes a Reverse pattern. "Lai Zhe Wei Shun" (Coming is Shun/Smooth) describes a state where Form and Qi are balanced; balance constitutes a Smooth pattern.
"To clearly know Reverse and Smooth, and act correctly without interval" means knowing the correct points to select and executing them without error.
"Ying Er Duo Zhi" (Meeting and seizing) is Sedation (Xie Fa). "Zhui Er Ji Zhi" (Chasing and assisting) is Tonification (Bu Fa).
"As for 'Deficiency requires Repletion' (Xu Ze Shi Zhi)," it means when the Qi Kou (Pulse at the radial artery) is deficient, it should be tonified.
"As for 'Fullness requires Draining' (Man Ze Xie Zhi)," it means when the Qi Kou is excessive, it should be sedated.
"As for 'Removing Stasis and Oldness' (Wan Chen Ze Chu Zhi)," it refers to removing stagnant blood from the vessels.
"As for 'Excess Evil requires Emptiness' (Xie Sheng Ze Xu Zhi)," it means that if any meridian has excessive evil, one should sedate the evil.
"Slow insertion and fast withdrawal result in Repletion (Xu Er Ji Ze Shi)." This means slowly inserting the needle and quickly withdrawing it tonifies the Qi.
"Fast insertion and slow withdrawal result in Emptiness (Ji Er Xu Ze Xu)." This means quickly inserting the needle and slowly withdrawing it sedates the Qi.
Speaking of "Repletion" and "Emptiness," appearing as if present or absent: this means that in Repletion patterns, there is a sensation of Qi; in Emptiness patterns, there is no sensation of Qi.
"Observing sequence and priority, as if present or absent" refers to determining the order of tonification and sedation based on the emptiness or fullness of Qi, performing the manipulation with a subtle, almost imperceptible feel. One must also observe whether the Qi has descended or remains constant.
"Being empty or full, as if gained or lost": When tonifying, the patient feels as if they have gained something (comfort/fullness); when sedating, the patient feels as if they have lost something (relief/lightness).
Regarding Qi in the meridians: "Evil Qi affecting the Upper" means that pathogenic factors often attack the body from high points, hence the disease location is upper.
"Turbid Qi remaining in the Middle" means that food and drink enter the Stomach; their essence ascends to the Lung, while turbid residues remain in the intestines and stomach. If there is disharmony in cold/warmth or irregular diet, disease arises in the intestines and stomach, thus termed Turbid Qi in the Middle.
"Clear Qi stagnating in the Lower" means that cold and damp earthy pathogens attack the body, necessarily starting from the feet; thus, it is termed Clear Qi in the Lower.
Needling the Xian Mai (Sunken/Depressed Collaterals) to expel evil involves selecting points in the upper body. Needling the Zhong Mai (Middle/Deep Meridians) to expel evil involves selecting points on the Yangming He-Sea acupoints.
If deep needling causes the evil to sink further, it means that superficial floating diseases should not be treated with deep needling; deep needling allows the evil to follow the needle inward, hence termed "reverse sinking."
Skin, flesh, tendons, and vessels each have their specific locations, meaning that different meridians govern specific tissues.
Taking the Five Pulse groups (referring to the Yin meridians associated with the Five Zang organs) excessively leads to death. This occurs when internal Qi is insufficient, yet one uses strong sedation on all Yin meridians. Taking the Three Yang pulses excessively results only in draining all San Yang Qi, leaving the patient exhausted and listless.
Depriving the Yin leads to death; this refers to repeatedly taking Wu Li (ST36) near the Chi area. Depriving the Yang leads to mania; this is a definitive statement.
Observing the complexion and inspecting the eyes allows one to know the dispersion and recovery of Shen. Unifying observation of the form and listening to movements means that a superior doctor knows to correlate the five colors observed in the eyes with the pulse characteristics (size, speed, tension, smoothness) at Cun Kou to diagnose the disease. Knowing the nature of evil and upright qi means distinguishing between Xu Xie (Deficient Evil/External Pathogens) and Zheng Xie (Upright Evil/Internal Factors).
Pushing the needle forward with the right hand while holding and controlling with the left hand refers to the manipulation of needle insertion and withdrawal. Expelling the Qi after it has moved refers to stopping the operation once the Qi is regulated through tonification or sedation. Regulating Qi depends on maintaining a consistent mindset (Zhong Shi Yi Zhe, Chi Xin Ye).
The 365 junctions of the body are the sites where collaterals seep and irrigate Qi.
As for "The Qi of the Five Zang is already exhausted internally," this refers to the inner pulse at Qi Kou being faint or absent. If one then treats external symptoms or selects He-Sea points of Yang meridians and retains the needle to attract Yang Qi, the arrival of Yang Qi will cause further depletion of internal Yin, leading to double depletion and death. Such death is characterized by stillness due to the lack of Qi movement.
As for "The Qi of the Five Zang is already exhausted externally," this refers to the outer pulse at Qi Kou being faint or absent. If one mistakenly treats the extremities (Si Mo) and retains the needle to attract Yin Qi, the arrival of Yin Qi will cause Yang Qi to retreat and reverse, leading to reversal and death. Such death is characterized by restlessness due to excess Yin Qi.
Therefore, observing the eyes is crucial because the Five Zang make the five colors bright and clear; clarity leads to distinct voice. A distinct voice indicates that the speech differs from the person's normal state. (Zhang, "Zhang", sounds like "Bi", meaning manifest/clear).
Zhang Kaizhi explains: This passage interprets the meaning of "Small Needle" but does not involve the theory of the Nine Needles. "Hun" means confused/dark; "Huang" means vague/uncertain. The reason for observing the eyes follows the previous text. Eye color reflects the blood aspect of the Five Zang, while vocal clarity reflects the Qi aspect of the Five Zang. The correspondence of clear colors and clear voice demonstrates the interaction of Blood and Qi. Speaking of "voice differing from normal" refers to the voice of scattered and ruined Qi. In summary, when the Qi of the Five Zang is exhausted internally, one should not over-tonify Yang; when exhausted externally, one should not over-tonify Yin. Yin and Yang, internal and external, support each other and should be stored rather than fully exposed externally.