行针之士要辨沉浮脉明虚实针别浅深经脉络脉之别巨刺缪刺之分经络闭塞须用砭针疏导
脏腑寒温必明浅深补泻经气之正自有常数漏水百刻五十度周经络流注各应其时先脉诀病次穴蠲
左手掐穴右手置针刺荣无伤卫刺卫无伤荣气悍则针小而入浅气涩则针大而入深气滑出疾气涩
出迟深则欲涩浅则欲疾候其气至必辨于针徐而疾者实实而迟者虚虚则实之满则泄之宛陈则除
之邪胜则虚之刺虚者须其实刺实者须其虚经气已至慎守勿失谨守其法勿更变也贼邪新客未有
定处推之则前引之则至其来不可逢其往不可追损其有余补其不足先去血脉而后调之无问其病
以平为期若有若无若得若失五脏已定九候已 诊脉病明行针疾愈众脉不见众凶不闻外内相得
无以形先可玩往来乃施于人手动若务针耀而匀伏如横弩起若发机见其乌乌见其稷稷从见具飞
不知其谁静意是义观适之变是谓冥冥莫知其形如临深渊手如握虎如待所贵不知日暮其气已至
适而自护五虚勿近五实不远扪而循之切而散之推而接之弹而弩之爪而下之通而取之阴募在腹
阳俞在背脏病取原府病取合脏病腑募治腑病脏募治出入导气补泄同精善行水者不能注冰善穿
地者不能凿冻权衡以平气口成寸以决死生饮食入胃游溢精气上输于脾脾气散精上归于肺通调
水道下输膀胱食气入胃散精于肝淫气于筋食气入胃浊气归心淫精于肺五劳五痹九气七情六淫
六腑九窍九州四气三因伤风伤寒杂病奇病妇人小儿盛则泻之虚则补之不实不虚以经取之
行针的医师必须辨别沉浮脉象，明确虚实，根据经络和络脉的区别，区分巨刺与缪刺的不同。若经络闭塞，必须使用砭石进行疏导。
脏腑的寒热属性必须明了，针刺的深浅、补泻手法各有定数。人体经气在经络中流注，遵循漏水百刻（古代计时法）五十度循环的规律，各经脉的气血流注都对应特定的时辰。先依据《脉诀》判断病情，再选取穴位以祛除病邪。
左手掐按穴位，右手持针进针。刺营分时无伤及卫分，刺卫分时无伤及营分。若患者气机悍急，则选用小针浅刺；若气机涩滞，则选用大针深刺。若气机滑利，出针要快；若气机涩滞，出针要慢。等待经气到来时，必须仔细辨别：徐缓进针快速出针适用于实证，缓慢出针适用于虚证。虚证用补法使其充实，实证用泻法使其泄去，瘀血陈积则予以清除，邪气盛实则予以削弱。针刺虚证要使正气充实，针刺实证要使邪气消退。经气已至，务必谨慎守护，严守法则，不要随意更改。
对于新近入侵的贼邪之气，尚未有固定位置，推之则向前移动，引之则聚集而来。其来势不可迎而夺之，其离去不可追而补之。应损伤其有余的部分，补充其不足的部分。先去血脉中的瘀滞，然后调理整体，不论何种疾病，以平衡为最终目的。
感觉若有若无，似得气又似未得气。五脏状况已确定，三部九候脉诊已清晰，病情明确，行针后疾病可愈。当各种脉象不再显现异常，各种凶险征象不再出现，说明内外协调，不单纯依靠外形判断，可以观察气机的往来变化后再施治于人。
操作时要专注，针具光亮且均匀。下针时如横放的弩弓蓄势待发，起针时如发射箭矢般迅速。看到气至的迹象如同乌鸦群集，如同稷米堆积，从远处看像飞鸟一样，但不知具体是谁。静心体悟其中的义理，观察气机变化的微妙之处，这就是所谓的“冥冥”之境，难以察觉其形迹。
操作时要像面临深渊一样小心，手如握虎一般稳健，如等待猎物一般专注。贵在不知时间流逝，待经气已至，适当自我保护。五虚证不宜久留针，五实证不宜远离（指及时施治）。通过扪、循、切、散、推、接、弹、弩、爪、下等手法引导并取效。阴经的募穴在腹部，阳经的俞穴在背部。脏病取原穴，腑病取合穴；治脏病用腑的募穴，治腑病用脏的募穴。出入导气，补泻手法需精通。善于治水的人不能让冰注入水中，善于掘地的人不能在冻土上凿洞。权衡以平复气机，寸口脉象决定生死。
饮食进入胃中，游溢精气，向上输送到脾；脾气散布精微，向上归于肺；通调水道，向下输送到膀胱。食物入胃，精气散于肝，淫溢之气滋养筋脉；食物入胃，浊气归于心，精华之气输于肺。
五劳、五痹、九气、七情、六淫、六腑、九窍、九州、四气、三因，以及伤风、伤寒、杂病、奇病、妇人病、小儿病等，凡是实证则泻之，虚证则补之，不虚不实者则本经取之。
Practitioners of needle manipulation must differentiate between floating and sinking pulses, clarify deficiency and excess, distinguish between meridians and collaterals, and differentiate between Great Puncture (Juci) and Counter Puncture (Miaoci). If meridians are obstructed, Bian stones (stone needles) must be used for dredging.
The cold and heat conditions of the Zang-Fu organs must be clearly understood; the depth of insertion and the techniques of tonification and sedation follow fixed laws. The flow of Jing-Qi through the meridians follows a cycle of fifty rounds over one hundred water drops (an ancient timekeeping method), with each meridian's qi flow corresponding to specific times. First, diagnose based on the *Mai Jue* (Pulse Classic), then select acupoints to eliminate pathogenic factors.
With the left hand pressing the acupoint, the right hand inserts the needle. When puncturing the Ying (Nutrient) level, do not injure the Wei (Defensive) level; when puncturing the Wei level, do not injure the Ying level. If the Qi is vigorous and rapid, use a small needle and shallow insertion; if the Qi is stagnant and slow, use a large needle and deep insertion. If the Qi is smooth, withdraw the needle quickly; if the Qi is stagnant, withdraw slowly. When waiting for the arrival of Jing-Qi, one must carefully discern: slow insertion and quick withdrawal apply to Excess patterns; slow withdrawal applies to Deficiency patterns. Tonify Deficiency to make it solid; sedate Excess to drain it; remove stasis and old blood; weaken excessive pathogens. For Deficiency patterns, ensure the Qi becomes solid; for Excess patterns, ensure the Pathogen becomes deficient. Once Jing-Qi has arrived, guard it cautiously, adhere strictly to the method, and do not change it arbitrarily.
For newly invading "Thief-Pathogens" that have not yet settled in a fixed location, pushing them causes them to move forward, drawing them causes them to gather. Their approach should not be met with attack (sedation); their retreat should not be pursued with tonification. Damage what is in excess, supplement what is deficient. First remove blood stasis from the vessels, then regulate the whole body. Regardless of the disease, aim for balance.
The sensation may seem present yet absent, as if obtained yet lost. Once the condition of the Five Zang organs is determined and the Three Positions and Nine Pulses are clearly diagnosed, and the disease is understood, needle manipulation can lead to recovery. When abnormal pulse manifestations disappear and ominous signs cease, it indicates internal and external harmony. Do not rely solely on external appearance; observe the coming and going of Qi before treating the person.
Focus your mind; the needle should be bright and uniform. Insertion is like a drawn crossbow ready to fire; withdrawal is swift like an arrow leaving the bow. Seeing the arrival of Qi is like a flock of crows gathering or millet piling up; from afar it looks like flying birds, but you cannot see who they are. Contemplate the meaning quietly, observe the subtle changes of Qi. This is called the "Hidden Realm," where the form is unknown.
Be cautious as if standing at the edge of an abyss; hold the hand steady as if grasping a tiger; wait attentively as if awaiting prey. The virtue lies in losing track of time until the Qi arrives, then protect yourself appropriately. Do not leave patients with Five Deficiencies for long; do not delay treatment for Five Excesses. Use techniques such as palpating, rubbing, pressing, dispersing, pushing, connecting, flicking, tensing, clawing, and descending to guide and obtain the effect. Yin Mu points are on the abdomen; Yang Shu points are on the back. For Zang diseases, select Yuan-Source points; for Fu diseases, select He-Sea points. To treat Zang diseases, use the Mu points of the corresponding Fu organs; to treat Fu diseases, use the Mu points of the corresponding Zang organs. Guide Qi through entry and exit; master the essence of tonification and sedation. One skilled in managing water cannot pour ice into it; one skilled in digging earth cannot drill frozen ground. Balance the Qi using weights/measures; decide life and death by the Cun Kou pulse.
When food enters the Stomach, its refined essence floats up and is transported to the Spleen; the Spleen scatters the essence upward to the Lungs; the Lungs regulate the water passages, transporting it downward to the Bladder. Food entering the Stomach scatters essence to the Liver, nourishing the sinews with abundant Qi. Food entering the Stomach sends turbid Qi to the Heart, and refined essence to the Lungs.
Five Labors, Five Bi syndromes, Nine Qi variations, Seven Emotions, Six Exogenous Pathogens, Six Fu organs, Nine Orifices, Nine Provinces, Four Qi phases, Three Causes, Wind Strike, Cold Damage, Miscellaneous Diseases, Strange Diseases, Women's Diseases, and Children's Diseases: Excess patterns are drained; Deficiency patterns are tonified; patterns that are neither excess nor deficiency are treated by selecting points from the affected meridian itself.