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。过之则内伤,不及则生外
壅,壅则邪从之。浅深不得,反为大贼,内动五脏,后生大病。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。是故刺毫毛腠理无伤皮,皮伤则内动肺,肺动则秋病
温疟,溯溯然寒栗。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。刺肉无伤脉,脉伤则内动心,心动则夏病心痛。刺脉无伤筋,筋伤则内动肝,肝动则春病热而筋弛。
刺筋无伤骨,骨伤则内动肾,肾动则冬病胀腰痛。刺骨无伤髓,髓伤则销铄 ,体解 然不去矣。
黄帝问曰∶愿闻刺浅深之分。岐伯对曰∶刺骨者无伤筋,刺筋者无伤肉,刺肉者无伤脉,刺脉者无伤皮,
刺皮者无伤肉,刺肉者无伤筋,刺筋者无伤骨。帝曰∶余未知其所谓,愿闻其解。岐伯曰∶刺骨无伤
筋者,针至筋而去,不及骨也。刺筋无伤肉者,至肉而去,不及筋也。刺肉无伤脉者,至脉而去,不及肉也。
刺脉无伤皮者,至皮而去,不及脉也。所谓刺皮无伤肉者,病在皮中,针入皮中,无伤肉也。刺肉无伤筋
者,过肉中筋也。刺筋无伤骨者,过筋中骨也。此之谓反也。
黄帝问曰∶愿闻禁数。岐伯对曰;脏有要害,不可不察,肝生于左,肺藏于右,心部于表,肾治于里,脾
为之使,胃为之市。膈肓之上,中有父
母,七节之旁,中有小心,从之有福,逆之有咎。刺中心,一日死,其动为噫。刺中肝,五日死,其动为
语。刺中肾,六日死,其动为嚏。刺中肺,三日死,其动为咳。刺中脾,十日死,其动为吞。刺中胆,一
日半死,其动为呕。刺跗上中大脉,血出不止死。
刺面中溜脉,不幸为盲。刺头中脑户,入脑立死。刺舌下中脉太过,血出不止为喑。刺足下布络中脉,血
不出为肿。刺 中大脉,令人仆脱色。刺气街中脉,血不出,为肿鼠仆。刺脊间中髓,为伛。刺乳上,中乳房,
为肿根蚀。刺缺盆中内陷,气泄,
令人喘咳逆。刺手鱼腹内陷,为肿。无刺大醉,令人气乱。无刺大怒,令人气逆。无刺大劳人,无刺新饱人,
无刺大饥人,无刺大渴人,无刺大惊人。刺阴股中大脉,血出不止死。刺客主人内陷中脉,为内漏为聋。刺膝
髌出液,为跛。刺臂太阴
脉,出血多立死。刺足少阴脉,重虚出血,为舌难以言。刺膺中陷中肺,为喘逆仰息。刺肘中内陷,气
归之,为不屈伸。刺阴股下三寸内陷,令人遗溺。刺掖下胁间内陷,令人咳。刺少腹中膀胱溺出,令人少腹满。刺 肠
内陷,为肿。刺匡上陷骨中脉,
为漏为盲。刺关节中液出,不得屈伸。
黄帝问道:我想听听针刺的要领。岐伯回答说:疾病有表浅和深重的区别,针刺也有浅刺和深刺的不同,必须根据病位的深浅来决定针刺的深度,不要超过应有的限度。如果针刺过深,就会损伤内脏;如果针刺过浅,则不能祛除病邪,反而会使邪气在体表壅滞,邪气壅滞就会进一步深入体内。针刺深浅不当,反而会变成极大的祸害,导致内脏受损,随后引发严重的疾病。所以说:疾病有的在毫毛腠理(皮肤纹理及汗孔),有的在皮肤,有的在肌肉,有的在脉管,有的在筋腱,有的在骨骼,有的在骨髓。因此,刺毫毛腠理时不要伤及皮肤,若伤了皮肤,就会内动肺脏,肺气受损则在秋季容易患温疟病,表现为瑟瑟发抖、畏寒战栗。刺皮肤时不要伤及肌肉,若伤了肌肉,就会内动脾脏,脾气受损则在四季末各十八天(共七十二日)的时段里,容易发生腹胀、心烦、不想吃东西的病。刺肌肉时不要伤及脉管,若伤了脉管,就会内动心脏,心气受损则在夏季容易患心痛病。刺脉管时不要伤及筋腱,若伤了筋腱,就会内动肝脏,肝气受损则在春季容易患热病且筋脉弛缓无力。刺筋腱时不要伤及骨骼,若伤了骨骼,就会内动肾脏,肾气受损则在冬季容易患腹胀和腰痛病。刺骨骼时不要伤及骨髓,若伤了骨髓,就会导致身体消瘦枯槁,肢体懈怠无力,久久不能恢复。
黄帝问道:我想听听针刺深浅的具体区分。岐伯回答说:刺骨的时候不要伤及筋,刺筋的时候不要伤及肉,刺肉的时候不要伤及脉,刺脉的时候不要伤及皮,刺皮的时候不要伤及肉,刺肉的时候不要伤及筋,刺筋的时候不要伤及骨。黄帝说:我不明白您的意思,希望您能解释一下。岐伯说:所谓“刺骨无伤筋”,是指针到达筋部就停止,不再深入去刺骨。所谓“刺筋无伤肉”,是指针到达肉部就停止,不再深入去刺筋。所谓“刺肉无伤脉”,是指针到达脉部就停止,不再深入去刺肉。所谓“刺脉无伤皮”,是指针到达皮部就停止,不再深入去刺脉。至于所说的“刺皮无伤肉”,是指病邪在皮中,针只刺入皮中,不伤及肌肉。所谓“刺肉无伤筋”,是指针穿过肌肉到达筋部。所谓“刺筋无伤骨”,是指针穿过筋部到达骨部。这些情况与前面所说的正好相反,所以称为“反”。
黄帝问道:我想听听针刺的禁忌有哪些。岐伯回答说:五脏都有要害部位,不可不仔细考察。肝气生于左侧,肺气藏于右侧,心气布散于体表,肾气治理于体内,脾脏作为转输枢纽,胃腑作为容纳水谷的市场。膈肓之上,中有父母(指心肺),脊柱第七节旁边,中有小心(指心包或命门)。顺应这些规律就有福,违背这些规律就会招致灾祸。针刺中心脏,一天后死亡,其症状表现为嗳气。刺中肝脏,五天后死亡,其症状表现为多言乱语。刺中肾脏,六天后死亡,其症状表现为打喷嚏。刺中肺脏,三天后死亡,其症状表现为咳嗽。刺中脾脏,十天后死亡,其症状表现为吞咽动作异常。刺中胆腑,一天半后死亡,其症状表现为呕吐。刺足背上方大脉,出血不止会死亡。刺面部溜脉,不幸会导致失明。刺头部脑户穴,针入脑部立即死亡。刺舌下脉太过,出血不止会导致失音。刺足底分布的络脉中的血管,血不出会导致肿胀。刺髀关穴处的大脉,使人跌倒面色苍白。刺气街穴处的大脉,血不出会导致腹股沟部肿胀如鼠仆状。刺脊间髓海,会导致驼背。刺乳上部位,误中乳房,会导致根部溃烂肿痛。刺缺盆穴处向内陷,导致气泄,使人气喘咳嗽气逆。刺手鱼腹部向内陷,会导致肿胀。不要在大醉时针刺,会使人气机紊乱。不要在大怒时针刺,会使人气机上逆。不要在极度疲劳时针刺,不要在刚吃饱时针刺,不要在极度饥饿时针刺,不要在极度口渴时针刺,不要在受到大惊吓时针刺。刺大腿内侧大脉,出血不止会死亡。刺客主人穴向内陷误中脉,会导致内部漏泄和耳聋。刺膝盖髌骨处使关节液流出,会导致腿脚跛行。刺手太阴肺经之脉,出血过多会立即死亡。刺足少阴肾经之脉,在虚证基础上再出血,会导致舌头僵硬难以说话。刺胸膺部向内陷误中肺,会导致气喘逆向上仰呼吸。刺肘窝处向内陷,气归聚于此,会导致手臂不能屈伸。刺大腿下部三寸处向内陷,会导致遗尿。刺腋下胁间向内陷,会导致咳嗽。刺小腹正中膀胱处,尿液流出,会导致小腹胀满。刺肠部向内陷,会导致肿胀。刺眼眶上陷骨中的脉,会导致瘘管和失明。刺关节中使液体流出,会导致关节不能屈伸。
Huangdi asked, "I wish to hear about the essentials of acupuncture." Qibo replied, "Diseases present at different depths, and needling has shallow and deep techniques. One must reach the appropriate level of pathology without exceeding the proper limit. If one needles too deeply, internal organs will be injured; if too shallow, external stagnation will occur, allowing pathogenic factors to penetrate further. Improper depth can become a major disaster, disturbing the five zang organs internally and subsequently causing severe diseases. Therefore, it is said that diseases may reside in the hair follicles and interstices (coulǐ), skin, muscles, vessels, sinews, bones, or marrow. Thus, when needling the hair follicles and interstices, do not injure the skin; if the skin is injured, the Lung (Fei) will be disturbed internally, leading to warm malaria (wēn nüè) with chills in autumn. When needling the skin, do not injure the muscle; if the muscle is injured, the Spleen (Pí) will be disturbed internally, leading to abdominal distension, irritability, and anorexia during the last eighteen days of each season (totaling seventy-two days). When needling the muscle, do not injure the vessel; if the vessel is injured, the Heart (Xīn) will be disturbed internally, leading to heart pain in summer. When needling the vessel, do not injure the sinew; if the sinew is injured, the Liver (Gān) will be disturbed internally, leading to heat syndromes and flaccid sinews in spring. When needling the sinew, do not injure the bone; if the bone is injured, the Kidney (Shèn) will be disturbed internally, leading to abdominal distension and lower back pain in winter. When needling the bone, do not injure the marrow; if the marrow is injured, the body will emaciate and waste away, with limbs feeling weak and unable to recover."
Huangdi asked, "I wish to hear about the distinctions in the depth of needling." Qibo replied, "When needling the bone, do not injure the sinew; when needling the sinew, do not injure the flesh; when needling the flesh, do not injure the vessel; when needling the vessel, do not injure the skin; when needling the skin, do not injure the flesh; when needling the flesh, do not injure the sinew; when needling the sinew, do not injure the bone." The Emperor said, "I do not understand what you mean; I wish to hear your explanation." Qibo said, "To 'needle the bone without injuring the sinew' means the needle reaches the sinew and stops, not going deeper to the bone. To 'needle the sinew without injuring the flesh' means the needle reaches the flesh and stops, not going deeper to the sinew. To 'needle the flesh without injuring the vessel' means the needle reaches the vessel and stops, not going deeper to the flesh. To 'needle the vessel without injuring the skin' means the needle reaches the skin and stops, not going deeper to the vessel. What is meant by 'needling the skin without injuring the flesh' is that when the disease is in the skin, the needle enters only the skin, not injuring the flesh. What is meant by 'needling the flesh without injuring the sinew' is passing through the flesh to reach the sinew. What is meant by 'needling the sinew without injuring the bone' is passing through the sinew to reach the bone. These are called 'reversals' (fǎn)."
Huangdi asked, "I wish to hear about the number of contraindications for needling." Qibo replied, "The five zang organs have critical points that must be carefully observed. The Liver (Gān) generates on the left, the Lung (Fèi) stores on the right, the Heart (Xīn) distributes on the exterior, the Kidney (Shèn) governs the interior, the Spleen (Pí) acts as the transporter, and the Stomach (Wèi) acts as the market. Above the diaphragm and huang (huáng), there are the Father and Mother (referring to the Heart and Lung); beside the seventh vertebra from the bottom, there is the 'Small Heart' (xiǎo xīn, referring to the Pericardium or Mingmen). Following these rules brings fortune; violating them brings disaster. Needling the Heart directly causes death in one day, with symptoms of belching (yì). Needling the Liver directly causes death in five days, with symptoms of excessive talking (yǔ). Needling the Kidney directly causes death in six days, with symptoms of sneezing (tì). Needling the Lung directly causes death in three days, with symptoms of coughing (ké). Needling the Spleen directly causes death in ten days, with symptoms of swallowing abnormalities (tūn). Needling the Gallbladder (Dǎn) directly causes death in one and a half days, with symptoms of vomiting (ǒu). Needling the large vessel on the dorsum of the foot with unceasing bleeding causes death. Needling the flowing vessels in the face, unfortunately, causes blindness. Needling the Naohu (B16) point on the head, entering the brain, causes immediate death. Excessive needling of the sublingual vessels with unceasing bleeding causes aphonia (yīn). Needling the collateral vessels under the foot where blood does not flow out causes swelling. Needling the large vessel in the thigh region causes collapse and pallor. Needling the vessel at the Qichong (ST30) point where blood does not flow out causes swelling in the inguinal region resembling a crouching rat. Needling the marrow between the vertebrae causes kyphosis (yǔ). Needling above the breast, hitting the mammary gland, causes root erosion and swelling. Needling into the Quepen (LI12) point inwardly causes qi leakage, leading to asthma, cough, and rebellious qi. Needling into the Yuji (LU10) area on the hand fish-moon inwardly causes swelling. Do not needle someone who is heavily intoxicated, as this disturbs qi. Do not needle someone who is extremely angry, as this causes qi to rebel. Do not needle someone who is extremely fatigued, newly full after eating, extremely hungry, extremely thirsty, or greatly startled. Needling the large vessel in the inner thigh with unceasing bleeding causes death. Needling into the Zuchunren (ST32) point inwardly hitting the vessel causes internal leakage and deafness. Releasing fluid from the knee patella causes limping. Needling the Taiyin vessel of the arm with excessive bleeding causes immediate death. Needling the Shaoyin vessel of the foot, causing bleeding in a condition of deficiency, leads to a stiff tongue and difficulty speaking. Needling into the Yingzhong (chest) area hitting the lung causes asthmatic rebellion and仰息 (breathing with the head thrown back). Needling into the elbow pit inwardly causes qi to gather there, resulting in inability to flex or extend the arm. Needling three inches below the inner thigh inwardly causes enuresis. Needling into the axillary and hypochondriac region inwardly causes cough. Needling the bladder in the lower abdomen, causing urine to leak, leads to lower abdominal fullness. Needling into the intestines inwardly causes swelling. Needling the pulse in the sunken bone above the orbital cavity causes fistula and blindness. Releasing fluid from joints results in inability to flex or extend.