黄帝问曰。愿闻刺要。岐伯对曰。病有浮沉。刺有浅深。各至其理。无过其道。（刺要者。刺之要法也。理者。皮肤
肌肉之纹理。道者。血气循行之道路也。盖脉肉筋骨之间。各有浅深之理路。随病之浮沉而取之。无使其过与不及也。）
过之则内伤。不及则生外壅。壅则邪从之。（刺过其道。则内动五脏。不及其理。则妄伤其外而生壅。壅则血气不行。而
邪气从之矣。）浅深不得。反为大贼。内动五脏。后生大病。（不得其浅深之法。反为大害矣。皮伤则内动肺。肉伤则内
动脾。后生温疟腹胀。心痛之大病矣。）故曰。病有在毫毛腠理者。有在皮肤者。有在肌肉者。有在脉者。有在筋者。有
在骨者。有在髓者。（此论形层之有次第。而针刺之有浅深也。夫皮肉筋骨。内合五脏。肾主之骨。而有髓之深。肺主之
皮。而有毛之浅。是针刺之道。由极浅而至于深也。腠理者。皮肤肌肉之纹理。从大小分肉。而至于肌理皮毛之间。皆
三焦通会元真之处。毫毛腠理者。鬼门元府也。谓气之理路。内通于脏腑。外出于毫毛。虽极浅而可以致气者也。卢良
侯曰。刺毫毛腠理无伤皮者。即诊要篇之所谓以布 着之。乃从单布上刺是也。）是故刺毫毛腠理无伤皮。皮伤则内动
肺。肺动则秋病温疟。 然寒栗。（ 音素。刺毫毛腠理。刺之极浅者也。肺主秋收之令。秋时阳气下降。阴气外出。
妄动其肺。则收令化薄。阴阳之气。反相得于外。而为温疟矣。逆流而上曰 。 然者。气上逆而寒栗也。动谓动其
脏气也。）刺皮无伤肉。肉伤则内动脾。脾动则七十二日。四季之月。病腹胀。烦不嗜食。（肉为脾之合。脾土寄王于四
季月。各一十八日。共为七十二日。妄动其脾。则脾伤而不能运转水谷。是以所主之日。病胀烦而不嗜食也。）刺肉无伤
脉。脉伤则内动心。心动则夏病心痛。（脉在肉中。肉有分理。不知其道。则伤脉矣。脉乃心之合。心主夏令。故至夏病
心痛。）刺脉无伤筋。筋伤则内动肝。肝动则春病热而筋弛。（筋深于脉。刺过其道则伤筋。筋乃肝之合。肝主春令。故
动肝则肝气虚而春病热。筋伤则弛纵矣。）刺筋无伤骨。骨伤则内动肾。肾动则冬病胀。腰痛。（筋生于骨。骨深于筋矣。
骨为肾之合。而主冬令。动肾气则所藏者少。故当病虚胀而腰痛。腰乃肾之府也。夫五脏主藏者也。经云。有故无殒。
无故而动之。则虚其所藏之气。故至其所主之时则病矣。）刺骨无伤髓。髓伤则销铄 酸。体解 然不去矣。（髓者骨之
充。刺骨太过则伤髓。髓伤则销铄而 酸也。解 、懈惰也。灵枢经云。脑为髓之海。髓海不足。则脑转耳鸣。 酸眩
冒。目无所见。懈怠安卧。卢良侯曰。骨穴多在节之交。节交会处有髓道。故刺太过。则伤髓矣。按针刺之要。首忌
太过。故曰。各至其理。无过其道。而此篇先论其太过焉。）
黄帝问道：我想听听关于针刺要领的知识。岐伯回答说：疾病有在表在里的区别，针刺就有浅刺和深刺的不同。必须根据病位的深浅来确定针刺的深度，不要超过应有的限度。（所谓“刺要”，就是针刺的关键法则。“理”，是指皮肤和肌肉的纹理；“道”，是指气血运行的道路。因为脉、肉、筋、骨之间，各有其深浅的路径，应根据病邪的浮沉（表里）来选取相应的深度，使其既不过深也不欠浅。）
如果针刺过深，就会损伤内脏；如果针刺过浅，则会在体表产生壅滞。一旦产生壅滞，邪气就会乘虚而入。（针刺超过了应有的深度，就会内动五脏之气；针刺未达到应有的深度，就会妄伤体表并产生壅滞。发生壅滞后，气血运行不畅，邪气便会随之侵入。）
如果深浅掌握不当，反而会成为巨大的祸害，内动五脏之气，随后引发严重的疾病。（如果不掌握深浅的法度，反而会造成大害。例如，伤及皮部会内动肺脏，伤及肌部会内动脾脏，随后可能引发温疟、腹胀、心痛等严重疾病。）
所以说，疾病有的位于毫毛腠理，有的在皮肤，有的在肌肉，有的在脉，有的在筋，有的在骨，有的在髓。（这是在论述人体形层的层次次序，以及针刺深度的相应变化。皮、肉、筋、骨内部与五脏相合，肾主骨而有髓，位置最深；肺主皮毛，位置最浅。因此，针刺之道是从极浅到极深的过程。腠理是皮肤肌肉间的纹理，从大的分肉间隙到小的肌理皮毛之间，都是三焦汇聚元气真气的地方。毫毛腠理被称为“鬼门”或“元府”，是说气的通路，内通脏腑，外出于毫毛，虽然位置极浅，但可以通过这里调治气机。卢良侯说：针刺毫毛腠理时不要伤及皮部，这就是《诊要经终论》中说的用布覆盖皮肤后，隔着布进行针刺的方法。）
因此，针刺毫毛腠理时不可伤及皮部。如果伤及皮部，就会内动肺气。肺气被扰动，到了秋季就会患温疟，出现忽冷忽热的症状。（“淅然”音同“素”。针刺毫毛腠理是极浅的刺法。肺主秋天的收敛之令。秋季阳气下降，阴气外出。如果妄动肺气，就会导致收敛之力变弱，阴阳之气反而出现在体表，从而形成温疟。逆流而上称为“淅”，“淅然寒栗”是指气机上逆导致的恶寒战栗。“动”是指扰动脏气。）
针刺皮部时不可伤及肌肉。如果伤及肌肉，就会内动脾气。脾气被扰动，在七十二天（即四季末各十八天，共七十二天）的时候，会出现腹胀、心烦、不想吃东西的症状。（肌肉是脾所主的组织。脾土寄旺于四季的最后一个月，每季十八天，共七十二天。如果妄动脾气，会导致脾受伤而不能运化水谷。因此在它所主的时间段内，会出现胀满、烦闷且食欲不振的症状。）
针刺肌肉时不可伤及血脉。如果伤及血脉，就会内动心气。心气被扰动，到了夏季就会患心痛。（脉位于肌肉之中，肌肉有纹理结构。如果不了解其中的道理，就会伤及血脉。脉是心的合应，心主夏令，所以到了夏季会患心痛。）
针刺血脉时不可伤及筋腱。如果伤及筋腱，就会内动肝气。肝气被扰动，到了春季就会患热病且筋腱松弛。（筋位于脉的深层，针刺超过限度就会伤及筋。筋是肝的合应，肝主春令，所以扰动肝气会导致肝气虚弱而在春季患热病，筋受伤则会弛缓无力。）
针刺筋腱时不可伤及骨骼。如果伤及骨骼，就会内动肾气。肾气被扰动，到了冬季就会患腹胀和腰痛。（筋生于骨，骨比筋更深。骨是肾的合应，主冬令。扰动肾气会导致肾所藏的精气减少，所以在冬季会患虚性腹胀和腰痛。腰是肾的府邸。五脏是贮藏精气的器官。经文说：如果有病邪存在，用药就不会造成伤害；如果没有病邪而妄动精气，就会使所藏之气虚弱，所以在其所主的时间段就会发病。）
针刺骨骼时不可伤及骨髓。如果伤及骨髓，身体就会消瘦枯槁、酸软无力，肢体懈怠困倦无法摆脱。（髓是由骨充养而成的。针刺骨骼太过就会伤及骨髓。骨髓受伤就会消瘦枯槁并感到酸软。“解㑊”意为懈怠懒惰。《灵枢经》说：脑为髓之海。如果髓海不足，就会出现头晕耳鸣、酸软眩晕、视物不清、懈怠嗜睡等症状。卢良侯说：治疗骨骼的穴位多在关节交会处，关节交会处有髓道，所以如果针刺太过，就会伤及骨髓。按针刺的要领，首先忌讳太过，所以说“各至其理，无过其道”，而本篇先论述了针刺太过的危害。）
Huangdi asked, saying: I wish to hear about the essential principles of acupuncture. Qibo replied: Diseases manifest at different depths, ranging from superficial to deep; accordingly, acupuncture needling should be performed at varying depths, from shallow to deep. One must reach the appropriate anatomical level according to the pathology, without exceeding the proper boundary. (The "essential principles of acupuncture" refer to the key methods of needling. "Li" refers to the texture of the skin and muscles; "Dao" refers to the pathways through which Qi and Blood circulate. Between the vessels, muscles, sinews, and bones, there are distinct levels of depth. One should select the appropriate depth based on whether the pathogenic factor is superficial or deep, ensuring that the needling is neither excessive nor insufficient.)
If the needling is too deep, it will cause internal injury; if it is too shallow, it will generate external stagnation. Once stagnation occurs, the pathogenic factors will invade. (Needling beyond the proper depth will disturb the Five Zang Organs internally; failing to reach the required depth will recklessly damage the exterior and cause stagnation. Stagnation impedes the flow of Qi and Blood, allowing pathogenic factors to enter.)
If the depth is not correctly determined, it may instead become a great disaster, disturbing the Five Zang Organs internally and subsequently giving rise to severe diseases. (Failing to master the principles of depth causes significant harm. For instance, damaging the skin layer disturbs the Lung internally, and damaging the muscle layer disturbs the Spleen internally, which may later lead to severe conditions such as warm malaria, abdominal distension, and heart pain.)
Therefore, it is said that diseases may reside in the hair follicles and interstices, in the skin, in the muscles, in the vessels, in the sinews, in the bones, or in the marrow. (This discusses the hierarchical structure of the body's tissues and the corresponding depths for needling. The skin, muscles, sinews, and bones correspond internally to the Five Zang Organs. The Kidneys govern the bones and contain the marrow, representing the deepest level; the Lungs govern the skin and hair, representing the most superficial level. Thus, the way of needling proceeds from the extreme superficiality to depth. The interstices are the textures between the skin and muscles. From the large fleshy spaces to the fine textures between the muscles and hair, these are all areas where the San Jiao converges and distributes Yuan Zhen Qi. The hair follicles and interstices are referred to as the "Ghost Gates" or "Yuan Fu," indicating that the pathways of Qi connect internally with the Zang Organs and emerge externally through the hair. Although extremely superficial, they can be used to regulate Qi. Lu Lianghou stated: When needling the hair follicles and interstices, one must not injure the skin. This corresponds to what is mentioned in the *Zhen Yao* chapter: covering the area with cloth and needling through the single layer of cloth.)
Therefore, when needling the hair follicles and interstices, do not injure the skin. If the skin is injured, it will disturb the Lung Qi. If Lung Qi is disturbed, warm malaria with chills will occur in autumn. ("Xiran" [shu] refers to the sensation of shivering. Needling the hair follicles and interstices is the shallowest form of needling. The Lung governs the descending and collecting function of autumn. In autumn, Yang Qi descends and Yin Qi moves outward. Recklessly disturbing the Lung weakens this collecting function, causing Yin and Yang Qi to remain on the exterior, resulting in warm malaria. Upward counterflow is called "Xi"; "Xiran hanli" refers to the aversion to cold and trembling caused by rebellious Qi. "Dong" means to disturb the Qi of the Zang.")
When needling the skin, do not injure the muscles. If the muscles are injured, it will disturb the Spleen Qi. If Spleen Qi is disturbed, during the seventy-two days (eighteen days at the end of each of the four seasons, totaling seventy-two days), symptoms such as abdominal distension, vexation, and loss of appetite will appear. (Muscles are the tissue associated with the Spleen. Earth of the Spleen reigns during the last eighteen days of each season, totaling seventy-two days. Recklessly disturbing the Spleen damages its ability to transform and transport food and fluids. Therefore, during the periods it governs, symptoms of distension, vexation, and anorexia occur.)
When needling the muscles, do not injure the vessels. If the vessels are injured, it will disturb the Heart Qi. If Heart Qi is disturbed, heart pain will occur in summer. (Vessels lie within the muscles, which have their own textures. Ignorance of the correct method leads to vessel injury. Vessels are the correspondence of the Heart, and the Heart governs the summer season; thus, heart pain manifests in summer.)
When needling the vessels, do not injure the sinews. If the sinews are injured, it will disturb the Liver Qi. If Liver Qi is disturbed, heat syndromes and flaccidity of the sinews will occur in spring. (Sinews are deeper than the vessels. Excessive needling depth injures the sinews. Sinews are the correspondence of the Liver, and the Liver governs the spring season. Disturbing the Liver depletes Liver Qi, leading to heat syndromes in spring. Injury to the sinews results in flaccidity.)
When needling the sinews, do not injure the bones. If the bones are injured, it will disturb the Kidney Qi. If Kidney Qi is disturbed, abdominal distension and lower back pain will occur in winter. (Sinews arise from the bones, and bones are deeper than sinews. Bones are the correspondence of the Kidneys and govern the winter season. Disturbing Kidney Qi reduces the stored essence. Consequently, deficiency-type abdominal distension and lower back pain occur. The lower back is the mansion of the Kidneys. The Five Zang Organs store essence. The classics state: If there is a pathological excess, treatment will not cause harm; but if there is no excess and one recklessly disturbs the Qi, the stored essence becomes deficient, leading to disease during the season governed by that organ.)
When needling the bones, do not injure the marrow. If the marrow is injured, the body will emaciate and feel sore and weak, with limbs feeling heavy and lethargic, unable to shake off the fatigue. (Marrow fills the bones. Excessive needling into the bones injures the marrow. Marrow injury leads to emaciation and soreness. "Jie Xie" refers to lethargy and lassitude. The *Ling Shu* states: The brain is the sea of marrow. If the sea of marrow is insufficient, dizziness, tinnitus, soreness, vertigo, blindness, and lethargy with a desire to lie down occur. Lu Lianghou stated: Acupoints for treating bone disorders are mostly located at joint intersections, where marrow channels exist. Therefore, excessive needling injures the marrow. Regarding the essentials of needling, the primary prohibition is against being too excessive. Hence, it is said, "Reach the appropriate level, do not exceed the proper boundary." This chapter first discusses the dangers of excessive needling.)