凡刺之要。官针最妙。九针之宜各有所为。长短大小各有所施也。不得其用病。弗能移疾浅针。深内伤良肉。皮肤
为痈。病深针浅。病气不泻。支为大脓。病小针大。气泻太甚。疾必为害。病大针小。气不泻泄。亦复为败。失针之宜。
大者泻。小者不移。已言其过。请言其所施。（以上总括大意以下分叙其事）病在皮肤。无常处者。取以 针于病所。肤
白。勿取。病在分肉间。取以员针于病所。病在经络痼痹者。取以锋针。病在脉。气少。当补之者。取之 针于井荥分
输。病为大脓者。取以铍针。病痹气暴发者。取以员利针。病痹气痛而不去者。取以毫针。病在中者。取以长针。病水
肿不能通关节者。取以大针。病在五脏固居者。取以锋针。泻于井荥分输。取以四时。（此节分叙各病所宜用之法）凡刺
有九。以应九变。（以原作日误古字相近）一曰输刺。输刺者。刺诸经荥输脏 也。二曰远道刺。远道刺者。病在上。取
之下。刺腑 也。三曰经刺。经刺者。刺大经之结络经分也。四曰络刺。络刺者。刺小络之血脉也。五曰分刺。分刺者。
刺分肉之间也。六曰大泻刺。大泻刺者。刺大脓以铍针也。七曰毛刺。毛刺者。刺浮痹皮肤也。八曰巨刺。巨刺者。左
取右。右取左。九曰 刺。 刺者。刺燔针。则取痹也。（此节分叙各法所主治之病）凡刺有十二节以应十二经。一曰偶
刺。偶刺者。以手直心若背。直痛所。一刺前。一刺后。以治心痹。刺此者。傍针之也。二曰报刺。报刺者。刺痛无常
处也。上下行者。（四字是诠释痛无常处也经文每多如此）直内。无拔针。以左手随病所按之。乃出针。复刺之也。三曰
恢刺。恢刺。直刺傍之。举之。前后恢筋急。以治筋痹也。四曰齐刺。齐刺者。直入一。旁入二。以治寒气小深者。或
曰三刺。三刺者。治痹气小深者也。五曰扬刺。（长刺节论作阴刺甲乙经作阳刺）扬刺者。正内一。旁内四。而浮之。以
治寒气之博大者也。六曰直针刺。直针刺者。引皮乃刺之。以治寒气之浅者也。七曰输刺。输刺者。直入直出。稀发针
而深之。以治气盛而热者也。八曰短刺。短刺者。刺骨痹。稍摇而深之。致针骨所。以上下摩骨也。九曰浮刺。浮刺者。
旁入而浮之。以治肌急而寒者也。十曰阴刺。阴刺者。左右牵刺之。以治寒厥。中寒厥。足踝后。少阴也（言阴刺以治
寒厥为中寒也足踝后少阴是申言寒厥专刺踝后太溪也）十一曰旁针刺。旁针刺者直刺旁刺各一。以治留痹久居者也。十
二曰赞刺。赞刺者直入直出。数发针而浅之出血。是谓治痈肿也。（此节叙刺法之外应十二经并用针之手法也）脉之所居
深不见者。刺之微内。针而久留之。以致其空脉气也。脉浅者勿刺。按绝其脉。乃刺之。无令精出。独出其邪气耳。所
谓三刺则谷气出者。先浅刺。绝皮以出。阳邪再刺。则阴邪出者。少益深绝皮。致肌肉未入分肉间也。已入分肉之间。
则谷气出。故刺法曰。始刺浅之。以逐邪气而来。血气后刺深之。以致阴气之邪。最后刺极深之。以下谷气此之谓也。
故用针者。不知年之所加。气之盛衰。虚实之所起。不可以为工也。（此节叙刺法浅深之宜是统释五脏十二节浅深手法之
大义也不作通篇之退出而作中间之枢纽是篇法之变幻）凡刺有五。以应五脏。一曰半刺。半刺者。浅内而疾发针。无针
伤肉。如拔毛状。取皮气。此肺之应也。二曰豹文刺。豹文刺者。前后左右针之。中脉为故。以取经络之血者。此心之
应也。三曰关刺。关刺者。直刺左右尽筋上。（谓直刺又左右之其深尽筋上也）以取筋痹。慎无出血。此肝之应也。或曰
渊刺。一曰岂刺。四曰合谷刺。合谷刺者。左右鸡足。针于分肉之间。以取肌痹。此脾之应也。五曰输刺。输刺者。直
入直出。深内之至骨。以取骨痹。此肾之应也。（此节叙刺法之内应五脏并用针之手法也）
平铺直叙条理井然。首节从反面浑写大意笼罩全篇。次节叙九针功用。为下文安根。下三节畅发用针手法。夹叙夹
议不必互相照顾而自成文理。此篇叙用针之手法也。重刺字不重针字。故第四节特详浅深之义。
凡针刺的要领，九针最为精妙。九种针具的适宜用途各有不同，长短大小也各有其适用的病证。如果不了解各种针具的正确用法，就无法移易疾病。病位浅而用针过深，会损伤健康的肌肉，导致皮肤发生痈肿；病位深而用针过浅，病邪之气无法排出，会导致肢体肿胀并化为大脓包。病情轻而用针过大，会导致正气泻泄太过，必然造成危害；病情重而用针过小，病气无法排出，同样会导致治疗失败。失当使用针具，要么使实证更虚，要么使实证无法消除。以上已说明过失之处，现在请阐述正确的施用方法。（以上总括大意，以下分叙具体事项）
病在皮肤且位置不固定的，用鍉针（钝头针）在病所施治。如果皮肤颜色发白，不要使用此法。病在分肉之间的，用圆针在病所施治。病在经络且为顽固性痹证的，用锋针施治。病在脉中，表现为气血不足应当补益的，取井穴、荥穴、输穴进行施治。病情严重形成大脓包的，用铍针施治。痹气突然发作的，用员利针施治。痹气疼痛且久留不去的，用毫针施治。病位在体内的，用长针施治。患有水肿且关节不通畅的，用大针施治。病在五脏且固定不移的，用锋针施治，并在井、荥、输穴施以泻法，同时根据四季时令选取穴位。（此节分叙各病所宜用的方法）
凡针刺有九种方法，以对应九种变化。第一种叫输刺。输刺，是针刺诸经的荥穴和输穴以及脏腑背俞穴。第二种叫远道刺。远道刺，是病在上部，取下部穴位，针刺六腑的募穴或下合穴。第三种是经刺。经刺，是针刺大经脉的结聚之络脉及经分之间。第四种是络刺。络刺，是针刺小络脉中的血脉。第五种是分刺。分刺，是针刺分肉之间。第六种是大泻刺。大泻刺，是用铍针刺破大脓包。第七种是毛刺。毛刺，是针刺浮于皮肤的痹证。第八种是巨刺。巨刺，是左病取右，右病取左。第九种是燔针刺。燔针刺，是针刺火针，用以治疗痹证。（此节分叙各法所主治的病证）
凡针刺有十二种节度，以对应十二经脉。第一种叫偶刺。偶刺，用手按住心口和背部，正对疼痛处，前刺一针，后刺一针，用来治疗心痹。刺这种病时，要傍着针刺。第二种叫报刺。报刺，是刺痛位置不固定的，疼痛上下走行的。（这四个字是对“痛无常处”的解释，经文常有此类情况）直插入针，不拔出，用左手随着病痛所在部位按压，然后出针，再重新针刺。第三种叫恢刺。恢刺，直刺旁边，提插针具，前后活动以舒缓筋急，用来治疗筋痹。第四种叫齐刺。齐刺，直入一针，旁入两针，用来治疗寒气较小且病位较深的病症。有人说这是三刺。三刺，也是治疗寒气较小且病位较深的痹气。第五种叫扬刺。（《灵枢·官针》篇作阴刺，《甲乙经》作阳刺）扬刺，正中刺入一针，四周刺入四针，且浅刺，用来治疗寒气博大广泛的病症。第六种叫直针刺。直针刺，牵引皮肤然后进针，用来治疗寒气浅表的病症。第七种叫输刺。输刺，直入直出，少出针而深刺，用来治疗气盛而有热症的病症。第八种叫短刺。短刺，是针刺骨痹，稍微摇动针身并深入，直达骨骼，上下摩擦骨骼。第九种叫浮刺。浮刺，从旁侧进针而浅刺，用来治疗肌肉拘急且有寒症的病症。第十种叫阴刺。阴刺，左右交叉针刺，用来治疗寒厥。所谓中寒厥，是在足踝后方，属于少阴经。（这里说阴刺治疗寒厥是指中寒厥，足踝后少阴经是申述寒厥专门针刺太溪穴）。第十一种叫旁针刺。旁针刺，直刺一针，旁刺一针，用来治疗留滞日久、固定不移的痹证。第十二种叫赞刺。赞刺，直入直出，多次快速出针并浅刺出血，这就是治疗痈肿的方法。（此节叙述刺法之外应十二经脉，并用针的手法）
脉道所在位置深而不显露的，微进针并长时间留针，以引导空虚的脉气。脉道浅显的不要直接刺，应先按压阻断其脉气，然后再刺，不要让精气外泄，只排出邪气罢了。所谓的“三刺”使得谷气出来的过程是：先浅刺，穿透表皮以排出阳邪；再刺，则阴邪排出；稍微加深，穿透表皮，到达肌肉但未进入分肉之间；一旦进入分肉之间，谷气就出来了。所以刺法说：开始浅刺，是为了驱逐邪气并使血气来复；后来深刺，是为了引出阴分之邪；最后极深刺，是为了引导谷气。说的就是这个道理。所以用针的人，如果不了解每年岁运加临的情况，不知道气的盛衰虚实起因，就不能成为好医生。（此节叙述刺法深浅的适宜原则，是统释五脏十二节深浅手法的大义，不是通篇的退出而是作为中间的枢纽，体现了篇章手法的变幻）
凡针刺有五种方法，以对应五脏。第一种叫半刺。半刺，浅进针并迅速出针，不伤及肌肉，像拔毛一样，取皮部之气，这是肺的对应。第二种叫豹文刺。豹文刺，在前、后、左、右多个方向针刺，以刺中血脉为原则，用来取得经络中的瘀血，这是心的对应。第三种叫关刺。关刺，直刺左右肌腱的尽头处。（意思是直刺又向左右扩展，深度尽达肌腱）用来治疗筋痹，务必小心不要出血，这是肝的对应。有人说这叫渊刺，也叫岂刺。第四种叫合谷刺。合谷刺，呈鸡足状左右斜刺，针于分肉之间，用来治疗肌痹，这是脾的对应。第五种叫输刺。输刺，直入直出，深刺至骨，用来治疗骨痹，这是肾的对应。（此节叙述刺法之内应五脏，并用针的手法）
文章平铺直叙，条理井然。第一节从反面概括大意，笼罩全篇。第二节叙述九针的功用，为下文奠定基础。下面三节详尽阐述用针手法，夹叙夹议，不必互相照顾而自成文理。本篇叙述用针的手法，重在“刺”字而非“针”字，所以第四节特别详细地阐述了深浅的意义。
The essence of acupuncture lies in the proper use of the nine needles, which are most exquisite. Each of the nine types of needles has its specific indications, and their lengths and sizes have distinct applications. Failure to utilize them correctly renders them ineffective in treating diseases. If a superficial disease is treated with deep needling, healthy muscle tissue will be damaged, leading to skin abscesses; if a deep-seated disease is treated with shallow needling, pathogenic qi cannot be expelled, resulting in limb swelling and the formation of large pus-filled boils. Using a needle that is too large for a mild condition causes excessive leakage of healthy qi, inevitably causing harm; using a needle that is too small for a severe condition fails to expel pathogenic qi, also leading to treatment failure. Improper use of needles either exacerbates deficiency or fails to eliminate excess. The aforementioned points cover the errors; now let us discuss the correct applications. (The above summarizes the general principles, while the following details specific cases.)
For diseases located in the skin with no fixed position, employ the Di Needle (a blunt-tipped needle) at the affected site. However, if the skin appears white, this method should not be used. For diseases located between the muscles, employ the Yuan Needle (round-headed needle) at the affected site. For stubborn Bi syndrome (obstruction syndrome) involving the meridians, employ the Feng Needle (tri-edged needle). For diseases affecting the vessels where qi and blood are deficient and tonification is required, treat using the Jing-Well, Ying-Spring, and Shu-Stream acupoints. For conditions forming large abscesses, employ the Pi Needle (sword-like needle). For sudden onset of Bi syndrome, employ the Yuanli Needle (fine and sharp needle). For persistent pain due to Bi syndrome, employ the Hao Needle (filiform needle). For diseases located internally, employ the Chang Needle (long needle). For edema accompanied by joint obstruction, employ the Da Needle (large needle). For diseases fixed within the Zang organs, employ the Feng Needle, applying reducing methods at the Jing-Well, Ying-Spring, and Shu-Stream acupoints, selecting points according to the four seasons. (This section details the appropriate methods for various diseases.)
There are nine categories of needling techniques, corresponding to nine variations. The first is called Shu Ci (Needling Shu Points). Shu Ci involves needling the Ying-Spring and Shu-Stream acupoints of the twelve meridians as well as the Back-Shu points of the Zang organs. The second is called Yuan Dao Ci (Distal Needling). Yuan Dao Ci refers to treating upper body diseases by selecting lower body acupoints, specifically targeting the Front-Mu points or Lower He-Sea points of the Fu organs. The third is called Jing Ci (Meridian Needling). Jing Ci involves needling the knotted collateral vessels and areas between muscle compartments along major meridians. The fourth is called Luo Ci (Collateral Needling). Luo Ci involves puncturing the blood vessels in minor collaterals. The fifth is called Fen Ci (Compartment Needling). Fen Ci involves needling the spaces between muscle bundles. The sixth is called Da Xie Ci (Major Reducing Needling). Da Xie Ci involves draining large abscesses using the Pi Needle. The seventh is called Mao Ci (Hair Needling). Mao Ci involves superficial needling for floating Bi syndrome affecting the skin. The eighth is called Ju Ci (Great Cross Needling). Ju Ci involves treating the left side for right-sided diseases and vice versa. The ninth is called Fan Zhen Ci (Burning Needle Needling). Fan Zhen Ci involves using fire needles to treat Bi syndrome. (This section details the diseases treated by each method.)
There are twelve sections of needling techniques, corresponding to the twelve meridians. The first is called Ou Ci (Paired Needling). Ou Ci involves pressing the chest and back directly over the painful area, inserting one needle anteriorly and one posteriorly to treat Heart Bi syndrome. When performing this technique, insert the needle obliquely. The second is called Bao Ci (Reporting Needling). Bao Ci is used when pain moves unpredictably up and down. Insert the needle vertically without withdrawing it, press the affected area with the left hand, withdraw the needle, and re-insert it. The third is called Hui Ci (Expanding Needling). Hui Ci involves vertical insertion adjacent to the tendon, lifting and manipulating the needle anteriorly and posteriorly to relieve tendon tension, treating Tendon Bi syndrome. The fourth is called Qi Ci (Three-Needle Method). Qi Ci involves one central vertical insertion and two lateral insertions, treating cold pathogens that are shallow but deeply seated. Some call this San Ci (Three Needlings), which also treats cold-induced Bi syndrome with shallow depth but deep pathology. The fifth is called Yang Ci (Spreading Needling). (In *Ling Shu: Guan Zhen*, it is referred to as Yin Ci; in *Jia Yi Jing*, as Yang Ci). Yang Ci involves one central insertion and four surrounding insertions, all shallow, treating widespread cold pathogens. The sixth is called Zhi Zhen Ci (Direct Needle Insertion). Zhi Zhen Ci involves pulling the skin taut before insertion, treating superficial cold pathogens. The seventh is called Shu Ci (Shu Point Needling). Shu Ci involves direct insertion and withdrawal with sparse needle placement and deep penetration, treating conditions characterized by excess qi and heat. The eighth is called Duan Ci (Short Needle Insertion). Duan Ci is used for Bone Bi syndrome; gently rocking the needle while inserting it deeply until it reaches the bone, rubbing against the bone surface. The ninth is called Fu Ci (Floating Needling). Fu Ci involves oblique insertion with shallow penetration, treating muscle stiffness caused by cold. The tenth is called Yin Ci (Yin Needling). Yin Ci involves cross-needling on both sides to treat Cold Jue syndrome. Specifically, "Zhong Han Jue" refers to cold Jue, where needling targets the Shaoyin meridian behind the medial malleolus (specifically Taixi, KI3). The eleventh is called Pang Zhen Ci (Oblique and Direct Needling). Pang Zhen Ci involves one direct insertion and one oblique insertion to treat chronic, stationary Bi syndrome. The twelfth is called Zan Ci (Assisting Needling). Zan Ci involves direct insertion and withdrawal with multiple rapid pricks at a shallow depth to induce bleeding, treating carbuncles and swellings. (This section describes external correspondences to the twelve meridians and manipulative techniques.)
When the vessel is located deeply and is not visible, insert the needle slightly and retain it for a long time to guide the empty vessel qi. If the vessel is superficial, do not needle directly; instead, compress the vessel to stop flow, then needle, ensuring vital essence does not leak out, only expelling pathogenic qi. The process of "San Ci" (Three Stages of Needling) to elicit Gu Qi (Grain Qi) is as follows: First, needle superficially to penetrate the epidermis and expel Yang pathogens. Second, needle slightly deeper to expel Yin pathogens. Third, deepen further to reach the muscle layer but not yet the intermuscular space. Once the intermuscular space is reached, Gu Qi emerges. Thus, the needling principle states: Begin with shallow needling to drive out pathogens and attract healthy qi; proceed to deeper needling to draw out Yin pathogens; finally, needle extremely deeply to guide Gu Qi. This is the correct procedure. Therefore, an acupuncturist who does not understand the annual climatic influences, the fluctuations of qi, and the origins of deficiency and excess cannot be considered a skilled practitioner. (This section discusses the appropriateness of needling depth, summarizing the principles of the twelve techniques relative to the five Zang organs, serving as a pivotal transition rather than a conclusion.)
There are five categories of needling techniques, corresponding to the five Zang organs. The first is called Ban Ci (Half Needling). Ban Ci involves shallow insertion and rapid withdrawal without damaging muscle tissue, resembling plucking hair, to affect the skin qi. This corresponds to the Lung. The second is called Bao Wen Ci (Leopard Spot Needling). Bao Wen Ci involves multiple insertions around the front, back, left, and right, targeting blood vessels to remove stasis from the meridians. This corresponds to the Heart. The third is called Guan Ci (Joint/Tendon Needling). Guan Ci involves direct insertion at the extremities of tendons on both sides, treating Tendon Bi syndrome. Care must be taken to avoid bleeding. This corresponds to the Liver. It is also known as Yuan Ci or Qi Ci. The fourth is called He Gu Ci (Valley Convergence Needling). He Gu Ci involves a chicken-foot pattern of insertion into the intermuscular spaces, treating Muscle Bi syndrome. This corresponds to the Spleen. The fifth is called Shu Ci (Deep Shu Needling). Shu Ci involves direct insertion and withdrawal, penetrating deeply to the bone, treating Bone Bi syndrome. This corresponds to the Kidney. (This section describes internal correspondences to the five Zang organs and manipulative techniques.)
The text proceeds logically and systematically. The first section summarizes the general principles from a negative perspective, encompassing the entire chapter. The second section outlines the functions of the nine needles, laying the foundation for the subsequent content. The following three sections elaborate on needling techniques, combining narration and commentary to form a coherent structure without requiring explicit cross-referencing. This chapter focuses on needling techniques, emphasizing the action of "needling" (Ci) rather than the tool itself ("needle"). Therefore, the fourth section particularly elaborates on the significance of depth.