刺家不诊。听病者言。（按针经刺节真邪篇曰。刺有五节。一曰振埃。二曰发朦。三曰去爪。四曰彻衣。五曰解惑。
此刺之大约。针之极也。神明之类也。故曰刺家不诊。谓用针之妙。神而明之。不待诊而后知之也。按此篇无问答之辞。
而曰论者。乃伯承上章。复补论刺节篇之未尽。而后人记之也。故曰长刺节论。玉师曰。诸阳之气在头。三阴之俞在背。
病者言头痛。则知病在阳而取之头。病者言发寒热。则知病在阴而取之背。至如腹有积而取之腹。筋挛痛而取之筋。肌
肉痛而刺其肌。骨重酸而刺及骨。皆随病取刺之法。不待诊视而后知病之所在。故曰刺家不诊听病者。言此望切之外。
闻问之法也。）在头。头疾痛。为藏针之。刺至骨。病已。上无伤骨肉及皮。皮者道也。（此阳气大逆。故疾痛在头也。
藏、隐也。谓隐针而藏刺之也。盖头之皮肉最薄。易至于骨。故刺至骨而无伤骨。浅之而又无伤皮。盖皮者。针之道路
也。针必由皮而进。浅则伤之。深则伤骨。在浅深之间则伤肉。此言浅深在意。而头刺之更难也。能难其所难。则易其
所易矣。按灵枢刺节真邪篇。首章言阳气大逆。上满于胸中。盖阳气从胸膈而上升。或逆满于胸中。或上逆于巅顶。故
曰补灵枢之未尽。而以下诸病。大义相同。）阴刺入一。旁四处。治寒热。深专者。刺大脏。迫脏刺背。背俞也。刺之迫
脏。脏会。腹中寒热去而止。与刺之要。发针而浅出血。（此论刺寒热之法也。治寒热者。阴刺之。阴刺之法。正入一。
旁入四。若深而专者。此病在脏。当取大脏以治之。刺大脏者。当迫于脏而刺背。盖脏俞之在背也。刺其俞而迫于脏。
则脏气与针会。而腹中之寒热去矣。与刺之要同法。发针而浅出其血焉。按灵枢官针篇曰。凡刺有十二节。以应十二经。
五曰扬刺。扬刺者。正内一。旁内四。而浮之。以治寒气之博大者也。十曰阴刺。阴刺者。左右率刺之。以治寒厥。中
寒厥。足踝后少阴也。今此篇以阴刺而取少阴之俞。用扬刺之法以治寒热之病。所谓寒与热争。能合而调之。又一法也。
扬君立曰。此亦补十二节之未尽。）治腐肿者。刺腐上视痈小大深浅刺。刺大者多血。小者深之。必端内针。为故止。（腐
肿者。谓肿中肉腐。故为脓血者。刺其腐上当视其痈肿之大小而浅深之。腐肿之大者。多脓血。浅刺之而脓血易出也。
小者。毒内陷。而尚未外溃。故当深之。必端内针。以取脓血。盖恐有坏良肉。为此故当端内其针。刺至血处而止。又
按刺节真邪篇曰。刺大者用锋针。刺小者用圆利针。与此论亦少有别。）病在少腹有积。刺皮HT 以下。至少腹而止。
刺侠脊两旁四椎间。刺两髂 季胁肋间。导腹中气热下已。（骼音格 音醪。此论刺少腹积之法也。HT 作盾。肌浓也。
谓下至少腹间。视皮之肌浓处。即下针取之。盖腹内有积。则外见于皮间。故循于少腹之上下。至少腹而止。是其处也。
挟脊两旁四椎间。乃膏肓穴处。肓之原在脐下也。髂为腰骨。两髂 季胁肋间。乃足少阳经脉之所循。盖少腹之积。邪
在肝肾。故取少阳之经。导积热从针下而出也。）病在少腹。腹痛不得大小便。病名曰疝。得之寒。刺少腹两股间。刺腰
踝骨间。刺而多之。尽炅病已。（炅炯同。此厥阴寒疝之为病也。肝主疏泄。肝气逆。故不得大小便也。此为寒疝。故少
腹痛而上连于腹也。少腹两股及腰踝骨间。为厥阴肝脉之所循。刺而多留之。俟其尽热而病自已。）病在筋。筋挛节痛。
不可以行。名曰筋痹。刺筋上为故。刺分肉间。不可中骨也。病起筋炅。病已止。（此论刺筋痹之法也。诸筋皆属于节。
故筋挛节痛。病在筋者。屈而不伸。故不可行也。名曰筋痹。痹者闭也。痛也。故者因也。为因于筋。故当刺在筋。筋
在分肉间。而生于骨。故当从分肉内针。而不可中骨也。筋舒而病起。筋热而病已。即当止其针。）病在肌肤。肌肤尽痛。
名曰肌痹。伤于寒湿。刺大分小分。多发针而深之。以热为故。无伤筋骨。伤筋骨。痈发若变。诸分尽热。病已止。（此
论刺肌痹之法也。邪痹于肌。是以肌肉尽痛。此因伤于寒湿。盖寒胜为痛痹。湿胜为着痹也。宜刺大小分肉之间。分肉
之间。有三百六十五穴会。故当多发针而深取之。盖溪骨属骨。故当深之。而又无伤于筋骨也。伤筋骨者。则痈发而若
有所变矣。候其气至。而诸分肉尽热。则病已而可以止针矣。按脉要精微篇。帝曰。诸痈肿筋挛骨痛。此皆安生。岐伯
曰。此寒气之肿。八风之变也。如刺伤筋骨。而筋骨肿痛。有若风寒之变。故曰痈发若变。）病在骨。骨重不可举。骨髓
酸痛。寒气至。名曰骨痹。深者刺。无伤脉肉为故。其道大分小分。骨热病已止。（此论刺骨痹之法也。骨重难举。骨髓
酸痛。而寒气至者。肾主骨而寒水主气也。病在骨。故当深刺之。以候骨气。为因其针道。在于大小分肉之间。故当从
其道。而无伤脉肉也。候骨气至而针下热。病即已而可止其针。）病在诸阳脉。且寒且热。诸分且寒且热。名曰狂。刺之
虚脉。视分尽热。病已止。（夫邪并于阳则狂。邪之中人。始于皮肤肌肉。留而不去。则入于经脉。在肌腠之阳邪。而入
于阳脉。所谓重阳则狂矣。血气相乘。是以在阳脉。分肉之间。俱且寒且热也。当先刺其脉。使在脉阳实之邪已虚。而
复出于肌肉。视其分肉尽热。是邪从肌肉而外散矣。）病初发。岁一发。不治。月一发。不治。月四五发。名曰癫病。刺
诸分诸脉。其无寒者。以针调之。病已止。（此论刺癫疾之法也。朱永年曰。癫疾。久逆之所生也。故有病初发而岁一发
者。不亟治之。则月一发矣。又不治之。则一月四五发矣。当取诸分肉诸脉之有过者而刺之。夫重阴则癫。故当候其寒
气外至。其无寒者。以针调之。卢良侯曰。寒者须其热。热者须其寒。候邪正阴阳之变易也。病在阳者候其热。病在热
者候其寒。取邪气之外出也。此用针机变之妙。不可不知。）病风且寒且热。炅汗出。一日数过。先刺诸分理络脉。汗出。
且寒且热。三日一刺。百日而已。（风之伤人也。或为寒热。腠理开则洒然寒。闭则热而闷。故且寒且热也。如热时汗出。
一日数遍者。先刺诸分理络脉。如汗出而且寒且热。是寒热之邪。将与汗共并而出。故当三日一刺。至百日而病已矣。
盖病而汗出者。因邪气相搏而汗出也。刺而汗出者。取汗而邪出也。）病大风。骨节重。堕眉隋。名曰大风。刺肌肉为故。
汗出百日。刺骨髓。汗出百日。凡二百日。须眉生而止针。（大风、厉风也。从肌肉而直伤于骨髓。故骨节重。在肌肉而
伤冲任之血气。故须眉堕也。因邪从肌肉而入。故当先刺肌肉。取汗出而至百日。复刺骨髓。取汗出而亦至百日。凡二
百日。俟须眉生而止针。夫风之在分理络脉而为寒热病者。百日而已。大风而深入骨髓者倍已。盖百日者。气数之大周
也。卢良侯曰。刺骨无伤髓。今厉毒入深而刺髓。百日不致销铄。所谓有故无殒。在知病外内之不惑也。此与风论之厉
疡因证。少有差别。）
刺法专家不依赖诊脉，而是通过听取病人的陈述来判断病情。（按《针经·刺节真邪篇》记载：针刺有五种境界。一是“振埃”，即清除体表阳气的壅滞；二是“发朦”，即消除头目部的蒙蔽症状；三是“去爪”，即治疗四肢关节的病变；四是“彻衣”，即解除全身性的寒热病症；五是“解惑”，即调和阴阳，使病情明朗化。这是针刺的大致原则，是针法的极致，属于神明般的技艺。所以说“刺家不诊”，意思是运用针法的妙处在于神而明之，不需要等待诊脉就能知道病情的所在。按此篇没有问答的辞句，却称为“论”，是因为伯高承接上一章的内容，又补充论述了《刺节》篇未尽之意，而后人将其记录下来。所以称为《长刺节论》。玉师说：诸阳之气汇聚于头部，三阴经的俞穴位于背部。病人诉说头痛，就知道病在阳分，取头部的穴位治疗；病人诉说恶寒发热，就知道病在阴分，取背部的穴位治疗。至于腹部有积块就取腹部的穴位，筋脉拘挛疼痛就取筋部的穴位，肌肉疼痛就刺肌肉，骨骼沉重酸痛就刺及骨骼。这都是根据病情选取针刺部位的方法，不需要诊视就能知道病在哪里。所以说“刺家不诊听病者言”，这是在望诊和切诊之外的闻诊和问诊方法。）
如果在头部，头部疾病疼痛，应隐藏针体进行深刺，刺至骨部，病就好了。上部不要损伤骨肉和皮肤。皮肤是进针的道路。（这是因为阳气大逆，所以头部出现剧烈疼痛。“藏”意为隐蔽，指隐蔽针体进行深刺。因为头部的皮肉最薄，容易刺到骨头，所以刺至骨而不伤骨；浅刺则不伤皮。因为皮肤是针进入的道路，针必须经过皮肤进入，浅了会伤皮，深了会伤骨，在深浅之间则会伤肉。这说明深浅取决于意念的控制，头部的针刺更难掌握。能攻克难点，就容易处理简单的问题了。按《灵枢·刺节真邪篇》首章提到阳气大逆，上满于胸中。阳气从胸膈上升，或逆满于胸中，或上逆于头顶。所以说这是补充《灵枢》未尽之意，以下各病的道理大致相同。）
采用“阴刺”法，直入一针，旁边刺四针，用来治疗寒热症。如果病位深且专一在脏，就刺大脏（指五脏），逼近脏腑进行背部针刺，即刺背部的俞穴。针刺逼近脏腑，与脏气相会合，腹中的寒热去除即可停止。这与针刺的要领一致，出针时让少量出血。（这是论述治疗寒热症的方法。治疗寒热，用阴刺法。阴刺的方法是正中间刺一针，旁边刺四针。如果病位深且专一，说明病在脏，应当取大脏来治疗。刺大脏时，应当逼近脏腑而在背部针刺。因为脏的俞穴在背部，刺其俞穴而逼近脏腑，那么脏气就会与针感相会合，腹中的寒热就去除了。这与针刺的要领方法相同，出针时让其少量出血。按《灵枢·官针篇》说：凡针刺有十二种技法，以对应十二经脉。第五种叫“扬刺”。扬刺法是正中刺一针，旁边刺四针，且浅刺，用来治疗寒气博大弥漫的病证。第十种叫“阴刺”。阴刺法是左右对称地针刺，用来治疗寒厥证，中寒厥证是在足踝后方的少阴经。现在这篇以阴刺法取少阴的俞穴，用扬刺的方法来治疗寒热病，所谓寒热相争，能够调和它，这是另一种方法。扬君立说：这也是补充十二节未尽之处。）
治疗痈肿腐烂，刺破腐烂处，观察痈肿的大小来决定深浅。刺大的多出血，刺小的要深刺。必须端正地进针，以取出脓血为度。（腐肿是指肿胀处肌肉腐烂，形成脓血。刺其腐烂处应当观察痈肿的大小来决定深浅。腐肿大的，脓血多，浅刺而脓血容易排出。小的，毒邪内陷，尚未向外溃破，所以应当深刺。必须端正地进针，以取出脓血为目的。恐怕损伤好肉，因此应当端正地进针，刺至血处就停止。又按《刺节真邪篇》说：刺大的用锋针，刺小的用圆利针，与此处的论述略有不同。）
病在少腹且有积块，针刺皮肤以下，至少腹而止。针刺脊柱两旁第四椎间隙，针刺两侧髂骨与季胁肋间，引导腹中的热气下行而病愈。（骼音格，音醪。这是论述刺少腹积块的方法。“HT”作“盾”，指肌肉丰厚处。谓下至少腹之间，观察皮肤肌肉丰厚的地方，就在那里下针取之。因为腹内有积块，外部会在皮间显现，所以沿着少腹上下，至少腹为止，就是那个部位。挟脊两旁第四椎间，是膏肓穴的位置。肓的原气在脐下。髂是腰骨，两髂与季胁肋间，是足少阳经脉循行的部位。因为少腹的积块，邪气在肝肾，所以取少阳经，引导积热从针下排出。）
病在少腹，腹痛且大小便不通，病名叫做疝，由受寒引起。针刺少腹两侧大腿根部，针刺腰踝骨间，多留针，直到患处感到温热病就好。（炅同炯，意为热。这是厥阴寒疝的病证。肝主疏泄，肝气逆乱，所以大小便不通。这是寒疝，所以少腹痛并向上连及腹部。少腹两侧大腿及腰踝骨间，是厥阴肝脉循行的部位。针刺并多留针，等到患处完全变热，病自然痊愈。）
病在筋，筋脉拘挛关节疼痛，不能行走，病名叫筋痹。针刺筋的部位作为标准，刺在分肉之间，不可刺中骨头。病起于筋热，病好了就停针。（这是论述刺筋痹的方法。所有的筋都连接于关节，所以筋挛节痛。病在筋的人，屈伸不利，所以不能行走。名叫筋痹，痹就是闭塞、疼痛的意思。“故”通“因”，因为是筋的病，所以应当刺在筋上。筋在分肉之间生长于骨，所以应当从分肉内进针，而不可刺中骨头。筋舒展开且病起于筋热，病好了就应当停止针刺。）
病在肌肤，肌肤全部疼痛，病名叫肌痹，是由于寒湿所伤。针刺大分肉和小分肉，多放针并深刺，以局部发热为标准。不要损伤筋骨，如果损伤筋骨，会发生痈肿或变证。等到各个分肉都感到热，病好了就停针。（这是论述刺肌痹的方法。邪气痹阻于肌，所以肌肉全部疼痛。这是由于伤了寒湿。寒胜则为痛痹，湿胜则为着痹。适宜刺大小分肉之间。分肉之间有三百六十五个穴会，所以应当多放针并深取。因为溪谷属骨，所以应当深刺，而又不能损伤筋骨。如果损伤筋骨，就会发生痈肿或有其他变证。等候气至，各个分肉都感到热，病就好了就可以停针。按《脉要精微篇》，黄帝问：各种痈肿、筋挛、骨痛，是怎么产生的？岐伯说：这是寒气引起的肿胀，是八风变化的结果。如果针刺伤了筋骨，导致筋骨肿痛，就像风寒的变化一样，所以说痈发若变。）
病在骨，骨骼沉重不可抬起，骨髓酸痛，寒气侵袭，病名叫骨痹。深刺，不要损伤脉和肉作为标准。其道经过大分肉和小分肉。感到骨热病就好就停针。（这是论述刺骨痹的方法。骨骼沉重难举，骨髓酸痛，寒气侵袭，肾主骨而寒水主气。病在骨，所以应当深刺以候骨气。因为针道在于大小分肉之间，所以应当顺着这个路径，而不损伤脉肉。等候骨气至而针下热，病就好了就可以停针。）
病在诸阳脉，且寒且热，各个分肉也且寒且热，病名叫狂。针刺使其脉虚，观察分肉全部发热，病好就停针。（邪气并入阳分则发狂。邪气侵入人体，始于皮肤肌肉，停留不去，则进入经脉。在肌腠的阳邪，进入阳脉，所谓重阳则狂。血气相互搏乘，所以在阳脉和分肉之间，都且寒且热。应当先刺其脉，使脉中阳实的邪气已虚，然后复出到肌肉。观察其分肉全部发热，是邪气从肌肉向外消散了。）
病初发时一年发作一次，不治疗，一个月发作一次，还不治疗，一个月发作四五次，病名叫癫病。针刺各个分肉和诸脉，其中没有寒象的，用针调理，病好就停针。（这是论述刺癫疾的方法。朱永年说：癫疾是由久逆之气产生的。所以有病初发而一年发作一次的，不紧急治疗，就会一个月发作一次。又不治疗，就会一月发作四五次。应当取各个分肉和诸脉中有异常的而刺之。重阴则癫，所以应当等候寒气外至。其中没有寒气的，用针调理。卢良侯说：寒者须待其热，热者须待其寒，等候邪正阴阳的变化。病在阳的等候其热，病在热的等候其寒，以取邪气之外出。这是用针机变的妙处，不可不知道。）
患风病且寒且热，发热时出汗，一天多次发作。先刺各个分理络脉，汗出后，且寒且热，三天刺一次，一百天病愈。（风邪伤人，有的表现为寒热。腠理开则洒然恶寒，闭则热而闷，所以且寒且热。如发热时出汗，一天数次，先刺各个分理络脉。如汗出而且寒且热，是寒热之邪，将与汗一起并出。所以应当三天刺一次，到一百天病就好了。因为病而汗出，是因邪气相搏而汗出。针刺而汗出，是取汗而邪出。）
患大风病，骨节沉重，眉毛脱落，病名叫大风。刺肌肉作为标准，出汗一百天。刺骨髓，出汗一百天。总共二百天，等到胡须眉毛长出来就停针。（大风，即厉风。邪气从肌肉直接伤及骨髓，所以骨节沉重。在肌肉而伤及冲任的血气，所以须眉脱落。因为邪从肌肉而入，所以应当先刺肌肉，取汗出而至一百天，再刺骨髓，取汗出也至一百天。共二百天，等到须眉生出来就停针。风邪在分理络脉而为寒热病的，一百天就好。大风深入骨髓的，时间加倍。因为一百天是气数的大周期。卢良侯说：刺骨不要伤髓，现在厉毒入深而刺髓，一百天不会导致销铄，所谓有故无殒，在于知晓病内外而不迷惑。这与《风论》中的厉疡因证，稍有差别。）
Experts in acupuncture do not rely on pulse diagnosis but determine the condition by listening to the patient's description. (According to the *Needle Canon: True and Evil of Acupuncture* chapter, there are five levels of needling: one is "Shaking Dust" (clearing stagnation of superficial yang qi); two is "Opening Blindness" (eliminating obstruction in the head and eyes); three is "Removing Claws" (treating limb joint lesions); four is "Removing Clothes" (relieving systemic cold-heat disorders); five is "Resolving Confusion" (harmonizing yin and yang to clarify the condition). These are the general principles of needling, the ultimate technique, belonging to the realm of divine clarity. Thus it is said that "acupuncturists do not diagnose," meaning the subtlety of needling lies in its divine and clear understanding, knowing the location of the disease without waiting for pulse diagnosis. This chapter lacks dialogue but is called a "Treatise" because Bo Gao, following the previous chapter, supplemented the unfinished discussions of the *Acupuncture Sections* chapter, which were later recorded by others. Hence it is titled "Long Treatise on Acupuncture Sections." Master Yu states: The qi of all yang meridians gathers at the head, while the shu points of the three yin meridians are located on the back. If a patient complains of headache, the disease is known to be in the yang aspect, and points on the head are selected; if a patient complains of chills and fever, the disease is known to be in the yin aspect, and points on the back are selected. For abdominal masses, abdominal points are selected; for tendon spasms and pain, tendon areas are treated; for muscle pain, muscles are needled; for heavy and sore bones, the bone level is reached. These are methods of selecting needling sites according to the disease, knowing the location without examination. Thus it is said "acupuncturists do not diagnose but listen to the patient," referring to the inspection and inquiry methods beyond observation and palpation.)
If the disease is in the head and causes severe pain, the needle should be concealed and inserted deeply to the bone; the disease will resolve. Care must be taken not to damage the flesh or skin above. The skin is the pathway for the needle. (This is due to the great rebellion of yang qi, causing severe pain in the head. "Conceal" means hiding the needle body during deep insertion. Since the scalp is thin and easily reaches the bone, needling to the bone does not injure the bone; shallow needling avoids damaging the skin. The skin is the entry path; the needle must pass through it. Shallow needling injures the skin, deep needling injures the bone, and intermediate depth injures the muscle. This indicates that depth depends on intent, making head needling particularly difficult. Mastering the difficult makes the easy manageable. According to the first chapter of *Ling Shu: True and Evil of Acupuncture*, yang qi rebels greatly, filling the chest. Yang qi rises from the diaphragm, either filling the chest or rebelling upward to the vertex. This supplements the *Ling Shu*, and the principle applies to subsequent diseases.)
Use the "Yin Needling" method: insert one needle centrally and four needles obliquely around it to treat cold-heat disorders. If the disease is deep and localized in the zang organs, target the major zang organs by needling near the back shu points. Needling near the zang organs connects with the zang qi, resolving abdominal cold-heat. This aligns with the essential needling technique: withdraw the needle allowing slight bleeding. (This discusses treating cold-heat disorders using Yin Needling. The method involves one central and four surrounding needles. Deep and localized disease indicates involvement of the zang organs. Needling the major zang organs requires approaching the back shu points. Stimulating the shu points near the zang organs allows zang qi to interact with the needle, resolving abdominal cold-heat. This matches the technique in *Ling Shu: Official Needles*, which describes twelve needling techniques corresponding to the twelve meridians. The fifth is "Yang Needling" (one central, four surrounding, shallow) for widespread cold qi. The tenth is "Yin Needling" (symmetrical left-right needling) for cold reversal at the medial malleolus (Shaoyin meridian). Here, Yin Needling targets the Shaoyin shu point, using Yang Needling technique for cold-heat disorders, harmonizing conflicting cold and heat. Yang Junli notes this supplements the twelve techniques.)
To treat abscesses and ulcers, puncture the necrotic area, assessing size and depth. Large abscesses require shallow needling for abundant drainage; small ones require deeper needling. Insert the needle steadily, stopping once pus and blood are evacuated. (Necrosis refers to tissue decay forming pus and blood. Assess size to determine depth. Large abscesses have more pus/blood, suitable for shallow needling for easy drainage. Small abscesses have internalized toxins not yet ruptured, requiring deeper needling. Steady insertion prevents damage to healthy tissue. Stop when blood/pus is reached. *True and Evil of Acupuncture* suggests using a nine-edged needle for large abscesses and a round-sharp needle for small ones, differing slightly here.)
For masses in the lower abdomen, needle below the skin down to the lower abdomen. Needle between the fourth thoracic vertebrae on both sides of the spine, and between the iliac bones and costal margins. This guides heat qi downward to resolve the condition. ("HT" refers to thick muscle areas. Observe thick muscle regions below the lower abdomen for insertion. Abdominal masses manifest externally. Palpate the lower abdomen to locate the mass. The space between the fourth thoracic vertebrae corresponds to the Gaohuang acupoint. The origin of Huang (Epididymis/Bladder) qi is below the navel. The ilium is the hip bone; the area between the ilia and costal margins follows the Foot-Shaoyang Gallbladder Meridian. Lower abdominal masses involve Liver and Kidney pathology; thus, the Shaoyang meridian is used to guide heat out.)
For lower abdominal pain with inability to urinate or defecate, named "Hernia" (Shan), caused by cold. Needle between the lower abdomen and groin, and between the waist and ankle. Retain the needle until warmth is felt throughout. (Jiong means heat. This describes Jueyin Cold Hernia. The Liver governs free flow; rebellious Liver qi causes urinary/fecal retention. Cold hernia causes lower abdominal pain radiating upward. The groin and ankle-waist area follow the Jueyin Liver Meridian. Retain the needle until local warmth resolves the condition.)
For tendon diseases with spasms and joint pain preventing walking, named "Tendon Bi" (Obstruction). Needle the tendons, inserting into the intermuscular spaces, avoiding the bone. Stop when the tendon feels warm and symptoms resolve. (Tendons connect to joints; spasms cause immobility. "Bi" means obstruction and pain. "Gu" implies causality. Needling the tendon within the intermuscular space, avoiding bone, relaxes the tendon. Warmth indicates resolution.)
For skin and muscle diseases with generalized pain, named "Muscle Bi," caused by cold-dampness. Needle large and small intermuscular spaces, using multiple deep needles until warmth is achieved. Avoid damaging sinews and bones; injury may cause abscesses or complications. Stop when all intermuscular spaces feel warm. (Cold dominates causing painful Bi; dampness dominates causing fixed Bi. Intermuscular spaces contain 365 acupoint intersections. Deep needling targets these. Injury to sinews/bones mimics wind-cold changes, causing swelling. Warmth indicates Qi arrival and resolution.)
For bone diseases with heaviness, inability to lift limbs, and marrow soreness due to cold, named "Bone Bi." Deep needling is required, avoiding vessels and muscles. Follow the path through intermuscular spaces. Stop when bone warmth is felt. (The Kidney governs bones and cold water qi. Deep needling targets bone Qi via intermuscular pathways. Warmth indicates resolution.)
For diseases affecting Yang meridians with alternating cold and heat in meridians and intermuscular spaces, named "Mania" (Kuang). Reduce the pulse by needling; stop when intermuscular spaces feel hot. (Yang excess causes mania. Pathogens enter from skin/muscle to meridians. Yang pathogens in muscles enter Yang meridians, causing alternating cold/heat. Needling reduces Yang excess, allowing pathogens to exit via muscles. Heat indicates dispersion.)
If a disease starts with annual attacks, progresses to monthly, then frequent attacks (4-5 times/month), it is named "Dian Disease" (Epilepsy/Melancholia). Needle various intermuscular spaces and meridians. For cases without cold signs, regulate with needles. Stop when cured. (Chronic rebellion generates Dian disease. Progression from annual to frequent attacks requires needling abnormal areas in muscles and meridians. Yin excess causes Dian. Wait for external cold signs; if absent, regulate with needles. Lu Lianghou notes: wait for heat in cold conditions and vice versa, observing Yin-Yang shifts. This demonstrates subtle needling variations.)
For wind diseases with alternating cold and heat and sweating several times daily, first needle interstitial collaterals. If sweating persists with cold/heat, needle every three days until cure after 100 days. (Wind pathogens cause alternating cold/heat via pore opening/closing. Sweating indicates pathogen expulsion. Needling collaterals facilitates this. Persistent symptoms require spaced needling to expel pathogens via sweat.)
For severe wind disease ("Da Feng") with heavy joints and loss of eyebrows/beard, needle muscles until sweating occurs for 100 days, then needle marrow until sweating occurs for another 100 days. Total 200 days; stop when hair regrows. (Severe wind enters from muscles to marrow, causing joint heaviness and hair loss due to Chong/Ren vessel damage. Muscle needling induces sweat for 100 days; marrow needling for another 100 days. Hair regrowth signals cure. Wind in collaterals cures in 100 days; deep marrow involvement doubles the time. 100 days represents a major Qi cycle. Lu Lianghou warns against injuring marrow unnecessarily, noting that targeted treatment avoids harm despite deep toxicity.)