〔《灵》〕五脏之气，已绝于内，而用针者反实其外，是谓重竭，重竭必死，其死也静。治之者，辄反其
气，取腋与膺。（针经云∶五脏之气已绝于内者，脉气口内绝。不知者反取其外之病处与阳经之合，有留针以致
阳气，阳气至则内重竭，重竭则死矣。其死也无气以动，故静。）五脏之气已绝于外，而用针者又实其内，是谓
逆厥，逆厥则必死，其死也躁。治之者，反取四末。（针解云∶五脏之气已绝于外者，脉气口外绝，不知者，反
取其四末之输，有留针以致其阴气，阴气至则阳气反入，入则逆，逆则死矣。阴气有余故躁。《难经》云∶
五脏脉绝于内者，肾肝气已绝于内也，而医反补其心肺，五脏脉绝于外者，心肺脉已绝于外也，而医反补其肾肝。
阳绝补阴，阴绝补阳，是谓实实虚虚，损不足益有余，如此死者，医杀之耳。）刺之害中而不去则精泄，害中
而去则致气。精泄则病益甚而 ，致气则生为痈疡。无实实虚虚，损不足而益有余，是谓甚病，病益甚。（《难经》
云∶假令肺实而肝虚，肝者木也，肺者金也，金木当更相平，当知金平木也，假令肺实，故知肝虚微少气，用
针不补其肝而反重实其肺，故曰实实虚虚，损不足而益有余，病中工所害也。）取五脉者死。（针解云∶言病
在中气不足，但用针尽大泻其诸阴之脉也。）取三阳之脉者 。（《针解》云∶言尽泻三阳之气，令病患惟然
不复也。）夺阴者死，（针解云∶言取尺之五里五往者也。）夺阳者狂，针害毕矣。（针解云∶夺阳者狂，正言也。）
〔《甲》〕问曰∶针能杀生人，岂不能起死人乎？对曰∶能杀生人，不能起死人者也。是人之所生，受气于谷，
谷之所注者胃也，胃者水谷之府，气血之海也。海之所行云雨者，天下也，胃之所出气血者，经隧也。经隧者，
五脏六腑之大络也，迎而夺之而已矣。迎之五里，中道而止，五至而已。五往而藏之，气尽矣，故五五二十五而
竭其输矣。此所谓夺其天气者也。故曰∶窥门而刺之者死于家中，入门而刺之者死于堂上。黄帝曰∶请传之后世，
以为刺禁。（经隧，《灵枢》作“经坠”。）
凡刺之补泻，无过其度，与脉逆者无刺。
〔《灵》〕凡刺之禁∶新内勿刺，新刺勿内，已刺勿醉，已醉勿刺，新怒勿刺，已怒勿刺，新劳勿刺，已
刺勿劳，已饱勿刺，已刺勿饱，已饥勿刺，已刺勿饥，已渴勿刺，已刺勿渴，大惊大恐，必定其气，乃刺之。
乘车来者卧而休之，如食顷，乃刺之。步行来者坐而休之，如行十里顷，乃刺之。
凡此十二禁者，其脉乱气散，逆其荣卫，经气不次，因而刺之，则阳病入于阴，阴病出于阳，邪气复生。
粗工不察，是谓伐身。形肉已夺，是一夺也。大夺血之后，是二夺也。大夺汗之后，是三夺也。大泄之后，是
四夺也。新产又大下血，是五夺也。此皆不可泻也。
〔《素》〕天温日明，则人血淖液而卫气浮，故血易泻气易行。天寒日阴，则人血凝泣而卫气沉。月始生
则血气始精，卫气始行。月廓满则血气实，肌肉坚。月廓空则肌肉减，经络虚，卫气去，形独居。是以因天时
而调血气也。是以天寒无刺，天温无疑，月生无泻，月满无补，月廓空无治，是谓得时而调之。因天之序，盛
虚之时，移光定位，正立而待之。故曰月生而泻，是谓脏虚。月满而补，血气扬溢，络有留血，命曰重实。
月廓空治，是谓乱经，阴阳相错，真邪不别，沉以留止，外虚内乱，淫邪乃起。（八正神明论）
刺阳明，出血气。刺太阳，出血恶气。刺少阳，出气恶血。刺太阴，出气恶血。刺少阴，出气恶血。刺厥
阴，出血恶气也。（血气形志篇）
〔《甲》〕神庭禁不可刺。上关禁不可深。（令人耳无闻。）颅囟刺不可多出血。左角刺不可久留。人迎刺过
深杀人。云门刺不可深。（使人逆息不能食。）缺盆刺不可过深。（使人逆气。）五里禁不可刺。（手阳明经穴。）
脐中禁不可刺。伏兔禁不可刺。（刺五分。）三阳络禁不可刺。复溜刺无多见血。承筋禁不可刺。然谷刺无
多见血。乳中禁不可刺。鸠尾禁不可刺。
〔《灵》〕刺上关者， 不能欠。刺下关者，欠不能 。刺犊鼻者，屈不能伸。刺两关者，伸不能屈。（本输篇）
〔《素》〕春气在经脉，夏气在孙络，长夏气在肌肉，秋气在皮肤，冬气在骨髓中。帝曰∶愿闻其故。岐伯
曰∶春者，天气始开，地气始泄，冻解冰释，水行经通，故人气在脉。夏者，经满气溢，入孙络受血，皮肤充
实。长夏者，经络皆盛，内溢肌中。秋者，天气始收，腠理闭塞，皮肤引急。冬者，盖藏，血气在中，内着骨
髓，通于五脏。是故邪气者，常随四时之气血而入客也。至其变化，不可为度。然必从其经气，辟除其邪，则
乱气不生。帝曰∶逆四时而生乱气，奈何？岐伯曰∶春刺络脉，血气外溢，令人少气。春刺肌肉，血气环逆，
令人上气。春刺筋骨，血气内着，令人腹胀。夏刺经脉，血气乃竭，令人解 。夏刺肌肉，血气内却，令人善
恐。夏刺筋骨，血气上逆，令人善怒。秋刺经脉，血气上逆，令人善忘。秋刺络脉，气不外行，令人卧不欲动。
秋刺筋骨，血气内散，令人寒栗。冬刺经脉，血气皆脱，令人目不明。冬刺络脉，内气外泄，留为大痹。冬刺
肌肉，阳气竭绝，令人善忘。凡此四时刺者，大逆之病不可不从也。反之则生乱气，相淫病焉。故刺不知四时
之经，病之所生，以从为逆，正气内乱，与精相搏，必审九候，正气不乱，精气不转。（四时刺逆从论）
春甲乙日自乘，无刺头，无发朦于耳内。夏丙丁日自乘，无振埃于肩喉廉泉。长夏戊己日自乘四季，无刺
腹去爪泻水。秋庚辛日自乘，无刺关节于股膝。冬壬癸日自乘，无刺足胫。是谓五禁。
〔《素》〕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。刺肉无伤筋，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 酸，体解 。然不去矣。（刺要论）
凡刺之道，必中气穴，无中肉节。中气穴则针游于巷，中肉节则皮肤痛。补泻反则病益笃。中筋则筋缓，邪
气不出，与真相搏，乱而不去，反还内着。用针不审，以顺为逆。刺中心，一日死，其动为噫。刺中肺，三
日死，其动为咳。刺中肝，五日死，其动为欠。（《素问》作“语”。）刺中脾，十五日死，（《素问》作“十”日。）
其动为吞。刺中肾，三日死，（《素问》作“六日”又云“七日”。）其动为嚏。刺中胆，一日半死，其动为呕。
刺中膈，为伤中，其病虽愈，过一岁必死。刺跗上，中大脉，血出不止死。刺阴股，中大脉，血出不止死。刺
面，中溜脉，不幸为盲。刺客主人，内陷中脉，为内漏，为聋。刺头，中脑户，入脑立死。刺膝髌，出液为
跛。刺舌下中脉太过，血出不止，为喑。刺臂太阴脉，出血多立死。刺足下布络中脉，血不出为肿。刺足少阴
脉，重虚出血，为舌难以言。刺 中大脉，令人仆，脱色。刺膺中，陷中肺，（《素》曰∶刺膺中陷中脉。）
为喘逆仰息。刺气冲中脉，血不出为肿鼠 。刺肘中内陷，气归之，为不屈伸。刺脊间中髓，为伛。刺
阴股下三寸内陷，令人遗溺。刺乳上，中乳房，为肿根蚀。刺腋下胁间内陷，令人咳。刺缺盆中内陷，气泄，
令人喘咳逆。刺少腹中膀胱，溺出，令人少腹满。刺手鱼腹内陷，为肿。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。（俱出刺禁篇）
【《灵枢》】五脏的内气，如果在内部已经衰竭，而用针的人反而在外部进行补益（使邪气充实），这叫做“重竭”。重竭必然导致死亡，死者表现为安静。治疗时，错误地反向操作，取腋部和胸膺部的穴位。（《针经》说：五脏内气已绝于内的，脉口处的脉气在内侧断绝。不懂医理的人反而去取外部的病处和阳经的合穴，留针以引致阳气，阳气到来则内部更加枯竭，内部枯竭就会死亡。死后没有气机活动，所以表现安静。）五脏的外气，如果在外部已经衰竭，而用针的人又在内部进行补益，这叫做“逆厥”。逆厥必然导致死亡，死者表现为躁动不安。治疗时，错误地反向操作，取四肢末端的穴位。（《针解》说：五脏外气已绝于外的，脉口处的脉气在外侧断绝。不懂医理的人反而去取四肢末端的输穴，留针以引致阴气，阴气到来则阳气反而陷入体内，陷入体内则气机逆乱，逆乱就会死亡。因为阴气有余所以躁动。《难经》说：五脏脉气绝于内的，是肾气和肝气在内部已经衰竭，而医生反而补益心肺；五脏脉气绝于外的，是心气和肺气在外部已经衰竭，而医生反而补益肾肝。阳绝却补阴，阴绝却补阳，这叫作“实实虚虚”，损害不足而增加有余，像这样的死亡，是医生杀死了病人。）针刺的危害在于：如果误中病所而不停止留针，就会导致精气泄漏；如果误中病所后过早拔针，会导致邪气滞留。精气泄漏则病情加重并出现消瘦，邪气滞留则会形成痈疡。不要实行“实实虚虚”的手法，不要损害不足而增加有余，这称为对重病患者的伤害，会使病情更加严重。（《难经》说：假如肺实而肝虚，肝属木，肺属金，金木应当互相制约平衡，应当知道是金来平抑木。假如肺实，因此知道肝气微弱少气，用针时不补益肝脏反而重重地泻肺，所以说这是“实实虚虚”，损害不足而增加有余，这是中等水平的医生造成的危害。）诊察五部脉象若见真脏脉现者死。（《针解》说：意思是病在中焦气不足，却用针完全大泻诸阴经的脉气。）诊察三阳经脉若见真脏脉现者亦死。（《针解》说：意思是完全泻夺了三阳之气，使病患昏沉不醒。）夺伤阴气者死，（《针解》说：意思是取尺泽穴的五里穴，连续刺五次。）夺伤阳气者狂，针刺的危害至此完备了。（《针解》说：夺伤阳气导致发狂，这是确切的说法。）
【《甲乙经》】问：针刺能杀死活人，难道不能救活死人吗？答：能杀死活人，但不能救活死人。人的生存，依赖从谷物中摄取的气，谷物注入的地方是胃。胃是水谷之海，也是气血之海。大海行云雨的地方是天下，胃所输出的气血通过经络隧道输送到全身。经络隧道，是连接五脏六腑的大络，迎而夺之即可。迎取五里穴，中途停止，刺五次就停止了。五次往复式针刺会藏匿并耗尽脏气，气就尽了，所以五五二十五次针刺就会竭尽输穴之气。这就是所谓的“夺其天气”。所以说：从门缝里刺入的，死在家中；进门直刺的，死在厅堂上。黄帝说：请传之后世，作为针刺禁忌。（“经隧”，《灵枢》中写作“经坠”。）
凡是针刺的补泻，不能超过限度，与脉象逆乱的不要针刺。
【《灵枢》】凡是针刺的禁忌：刚行房事不要针刺，刚针刺完不要行房事，刚针刺完不要醉酒，刚醉酒不要针刺，刚发怒不要针刺，刚发怒后不要针刺，刚劳累不要针刺，刚针刺完不要劳累，刚吃饱不要针刺，刚针刺完不要饱食，刚饥饿不要针刺，刚针刺完不要处于饥饿状态，刚口渴不要针刺，刚针刺完不要处于口渴状态。遇到大惊大恐的情况，必须等患者气机安定后再针刺。乘车来的患者，让其躺下休息，大约一顿饭的时间后，再针刺。步行来的患者，让其坐下休息，大约行走十里路所需的时间后，再针刺。
以上十二条禁忌，如果违反，会导致脉象紊乱、气机散乱，违背营卫规律，经气运行次序失常。在这种情况下针刺，会使阳病传入阴分，阴病传出阳分，邪气再次滋生。粗疏的医生不加考察，这叫做伐害身体。形体肌肉已经极度消瘦，这是一夺。大量失血之后，是二夺。大量出汗之后，是三夺。剧烈腹泻之后，是四夺。新产妇产后大量出血，是五夺。这些情况都不可使用泻法。
【《素问》】天气温暖日照充足时，人体血液滑润流畅，卫气浮越于表，所以血液容易泻出，气机容易运行。天气寒冷日照阴暗时，人体血液凝滞涩缓，卫气沉伏于里。月亮初生时，血气开始精纯，卫气开始运行。月亮圆满时，血气充实，肌肉坚实。月亮亏空时，肌肉减损，经络空虚，卫气离去，只有形体独存。因此要根据天时来调治血气。所以天寒时不针刺，天温时不必迟疑，月生时不泻，月圆时不补，月廓空时不进行常规治疗，这叫做顺应时机来调治。顺应天的秩序，根据盛衰的时节，观察日影位置的变化，端正站立等待适宜时机。所以说：月生时泻，会导致内脏虚弱。月圆时补，会导致血气洋溢，络脉中有留血，这叫做“重实”。月廓空时治疗，会导致经脉混乱，阴阳交错，真气与邪气不分，邪气沉伏停留，外表虚弱内部混乱，淫邪于是产生。（出自《八正神明论》）
刺阳明经，可出血和气。刺太阳经，可出血，忌恶气。刺少阳经，可出气，忌血。刺太阴经，可出气，忌血。刺少阴经，可出气，忌血。刺厥阴经，可出血，忌气。（出自《血气形志篇》）
【《甲乙经》】神庭穴禁止针刺。上关穴禁止深刺。（会导致耳聋听不见声音。）颅囟穴针刺不可多出血。左角穴针刺不可久留。人迎穴针刺过深会杀人。云门穴针刺不可深。（使人呼吸急促不能进食。）缺盆穴针刺不可过深。（使人气逆。）五里穴禁止针刺。（手阳明大肠经穴位。）脐中穴禁止针刺。伏兔穴禁止针刺。（可刺五分深。）三阳络穴禁止针刺。复溜穴针刺不要多见血。承筋穴禁止针刺。然谷穴针刺不要多见血。乳中穴禁止针刺。鸠尾穴禁止针刺。
【《灵枢》】刺上关穴，嘴巴不能闭合。刺下关穴，嘴巴不能张开。刺犊鼻穴，膝盖不能弯曲。刺双侧上关和下关穴，膝盖既不能伸展也不能弯曲。（出自《本输篇》）
【《素问》】春气在经脉，夏气在孙络，长夏气在肌肉，秋气在皮肤，冬气在骨髓中。黄帝说：我想听听其中的缘故。岐伯说：春季，天气开始开放，地气开始泄出，冻土解冻冰层融化，水流畅通经络通达，所以人气在脉中。夏季，经脉满溢，气进入孙络受血，皮肤充实。长夏季节，经络都旺盛，气血内溢至肌肉之中。秋季，天气开始收敛，腠理闭塞，皮肤紧缩。冬季，万物闭藏，血气在中，内着于骨髓，通达五脏。所以邪气，常常随着四季气血的变化而入客体内。至于邪气的变化，无法预测。然而必须顺从其经气，辟除邪气，那么乱气就不会产生。黄帝说：违背四时而产生乱气，怎么办？岐伯说：春季刺络脉，血气外溢，使人少气。春季刺肌肉，血气环逆，使人气逆上冲。春季刺筋骨，血气内着，使人腹胀。夏季刺经脉，血气乃竭，使人懈惰。夏季刺肌肉，血气内却，使人容易恐惧。夏季刺筋骨，血气上逆，使人容易愤怒。秋季刺经脉，血气上逆，使人容易健忘。秋季刺络脉，气不外行，使人卧倒不想动。秋季刺筋骨，血气内散，使人寒战。冬季刺经脉，血气皆脱，使人视力不明。冬季刺络脉，内气外泄，留滞成为大痹。冬季刺肌肉，阳气竭绝，使人容易健忘。以上四季针刺的错误做法，是大逆之病，不可不重视。反之则会产生乱气，相互混杂致病。所以针刺不知道四时的经脉规律，不了解疾病产生的原因，以顺为逆，正气内部混乱，与精气相搏结，必须审慎诊察九候脉象，使正气不乱，精气不转易。（出自《四时刺逆从论》）
春季甲乙日自乘（值日），禁止针刺头部，禁止对耳内进行发朦治疗。夏季丙丁日自乘，禁止对肩喉廉泉穴进行振埃治疗。长夏戊己日自乘四季之日，禁止针刺腹部去爪泻水疗法。秋季庚辛日自乘，禁止针刺大腿膝盖部位的关节。冬季壬癸日自乘，禁止针刺足胫部位。这叫做“五禁”。
【《素问》】黄帝问：我想听听针刺的要领。岐伯回答：疾病有浅深之分，针刺也有深浅之别，各到达其应有的层次，不要超过其道。超过了就会内伤脏腑，达不到就会造成外部壅塞，壅塞则邪气随之而入。深浅不得当，反而成为大害，内动五脏，后来生出大病。所以说：疾病有的在毫毛腠理，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。因此刺毫毛腠理不要伤及皮肤，伤皮则内动肺，肺动则在秋季患温疟，瑟瑟然寒战。刺皮肤不要伤及肌肉，伤肉则内动脾，脾动则在七十二日四季之交的月份，患腹胀，心烦不喜欢吃东西。刺肌肉不要伤及脉，伤脉则内动心，心动则在夏季患心痛。刺肌肉不要伤及筋，伤筋则内动肝，肝动则在春季患热病且筋弛缓。刺筋不要伤及骨，伤骨则内动肾，肾动则在冬季患胀病、腰痛。刺骨不要伤及髓，伤髓则身体消瘦酸软，肢体懈怠无力，久久不能恢复。（出自《刺要论》）
凡针刺之道，必须中准气穴，不要刺中肉节。中准气穴则针游走在巷陌间（指得气顺畅），刺中肉节则皮肤疼痛。补泻反了则病情加重。刺中筋则筋缓，邪气不出，与正气相搏，混乱而不除去，反而内着。用针不审慎，把顺当作逆。刺中心脏，一天后死，其表现为嗳气。刺中肺，三天后死，其表现为咳嗽。刺中肝，五天后死，其表现为呵欠。（《素问》作“言语错乱”。）刺中脾，十五天后死，（《素问》作“十天”。）其表现为吞咽动作。刺中肾，三天后死，（《素问》作“六天”又说“七天”。）其表现为打喷嚏。刺中胆，一天半后死，其表现为呕吐。刺中膈，为伤中，其病虽然痊愈，过了一年必死。刺足背上方，中中大脉，血流不止而死。刺大腿内侧，中中大脉，血流不止而死。刺面部，中溜脉，不幸会导致失明。刺客主人穴，针向内陷中脉，会导致内漏，导致耳聋。刺头部，中脑户穴，入脑立即死亡。刺膝盖髌骨，流出液体导致跛行。刺舌下中脉太过，血流不止，导致失音。刺臂太阴脉，出血多立即死亡。刺足底布络中的脉，血不出导致肿胀。刺足少阴脉，重虚出血，导致舌头难以说话。刺腘窝中大脉，令人跌倒，面色苍白。刺胸膺中，陷中肺，（《素问》说：刺胸膺中陷中脉。）导致喘逆仰面呼吸。刺气冲穴中脉，血不出导致腹股沟肿胀。刺肘中内陷，气归之，导致手臂不能屈伸。刺脊间中髓，导致驼背。刺大腿内侧下方三寸内陷，导致遗尿。刺乳房上方，中乳房，导致根部溃烂如虫蚀。刺腋下胁间内陷，导致咳嗽。刺缺盆中内陷，气泄，导致喘咳气逆。刺小腹中膀胱，尿液流出，导致小腹胀满。刺手鱼腹内陷，导致肿胀。刺肠道内陷，导致肿胀。刺眼眶上陷骨中的脉，导致瘘管或失明。刺关节中液出，导致不能屈伸。（均出自《刺禁篇》）
[Ling Shu] When the Qi of the Zang organs is exhausted internally, and the practitioner erroneously tonifies externally, this is called "Double Exhaustion" (Zhong Jie). Double Exhaustion leads to death, and the deceased appears quiet. The erroneous treatment involves taking points in the axilla and chest. (The Needle Classic states: When the Qi of the Zang organs is exhausted internally, the pulse at the Cun Kou position is absent internally. Those who do not understand this erroneously treat external disease sites and the He-Sea points of Yang meridians, retaining the needle to attract Yang Qi. When Yang Qi arrives, internal exhaustion becomes severe, leading to death. Since there is no Qi to move, the body remains quiet.) When the Qi of the Zang organs is exhausted externally, and the practitioner erroneously tonifies internally, this is called "Reverse Jue" (Ni Jue). Reverse Jue leads to death, and the deceased appears restless. The erroneous treatment involves taking points at the four extremities. (The Needle Explanation states: When the Qi of the Zang organs is exhausted externally, the pulse at the Cun Kou position is absent externally. Those who do not understand this erroneously take the Shu points of the four extremities, retaining the needle to attract Yin Qi. When Yin Qi arrives, Yang Qi enters inversely; entering inversely leads to reversal and death. Excess Yin causes restlessness. The Nan Jing states: When the pulses of the Zang organs are exhausted internally, it means the Qi of the Kidney and Liver is exhausted internally, yet the physician erroneously tonifies the Heart and Lung. When the pulses of the Zang organs are exhausted externally, it means the Qi of the Heart and Lung is exhausted externally, yet the physician erroneously tonifies the Kidney and Liver. Tonifying Yin when Yang is exhausted, and tonifying Yang when Yin is exhausted, is called "Solidifying the Excess and Emptying the Deficient," damaging what is insufficient and increasing what is already excessive. Such deaths are caused by the physician's killing action.) The harm of needling lies in: if one hits the pathological site but does not withdraw the needle, essence will leak; if one hits the pathological site and withdraws the needle prematurely, pathogenic Qi will remain. Essence leakage worsens the disease and causes emaciation; remaining pathogenic Qi generates carbuncles and ulcers. Do not practice "solidifying the excess and emptying the deficient," nor damage the insufficient to benefit the excessive; this is called harming a serious illness, making it worse. (The Nan Jing states: For example, if the Lung is Excess and the Liver is Deficient, the Liver is Wood, and the Lung is Metal. Metal and Wood should balance each other; one should know that Metal balances Wood. If the Lung is Excess, one knows the Liver Qi is slightly deficient and weak. Using needles, instead of tonifying the Liver, one heavily reduces the Lung. Thus it is said: "Solidifying the excess and emptying the deficient," damaging the insufficient and increasing the excessive—this is the harm caused by mediocre physicians.) Taking the five pulses [indicating true organ pulses] indicates death. (The Needle Explanation states: This refers to cases where Qi in the interior is deficient, yet the practitioner completely and heavily reduces the pulses of all Yin meridians.) Taking the three Yang pulses [indicating true organ pulses] also indicates death. (The Needle Explanation states: This refers to completely draining the Qi of the three Yang meridians, leaving the patient lethargic and unresponsive.) Depriving Yin leads to death, (The Needle Explanation states: This refers to taking the Wu Li point at Chi Ze, repeated five times.) Depriving Yang leads to mania; the harms of needling are thus complete. (The Needle Explanation states: Depriving Yang causing mania is an accurate statement.)
[Jia Yi Jing] Question: Can acupuncture kill living people? Can it not revive dead people? Answer: It can kill living people, but it cannot revive dead people. Human life derives Qi from grain. Grain enters the Stomach. The Stomach is the sea of water and grain, and the sea of Blood and Qi. Just as the sea produces clouds and rain for the world, the Stomach outputs Blood and Qi through the meridian tunnels. Meridian tunnels are the great collaterals connecting the Five Zang and Six Fu organs. One can drain them by meeting and reducing them. Meeting the Wu Li point and stopping midway, after five manipulations, the storage of Qi is exhausted. After five cycles of five manipulations, the Shu points are depleted. This is called "depriving the Heavenly Qi." Therefore, it is said: He who pierces through the door crack dies at home; he who enters the door and pierces deeply dies in the hall. Huang Di said: Pass this down to posterity as the prohibitions of needling. ("Meridian tunnels" is written as "Jing Zhui" in the Ling Shu.)
In all tonification and reduction of needling, do not exceed the proper degree. Do not needle when the pulse is contrary.
[Ling Shu] Prohibitions of needling: Do not needle immediately after intercourse; do not have intercourse immediately after needling. Do not needle when drunk; do not drink alcohol immediately after needling. Do not needle when angry; do not needle immediately after anger subsides. Do not needle when fatigued; do not exert yourself immediately after needling. Do not needle when full; do not eat until full immediately after needling. Do not needle when hungry; do not remain hungry immediately after needling. Do not needle when thirsty; do not remain thirsty immediately after needling. In cases of great fright or terror, stabilize the Qi before needling. For those arriving by carriage, let them lie down and rest for about the time it takes to eat a meal before needling. For those arriving on foot, let them sit and rest for about the time it takes to walk ten li before needling.
These twelve prohibitions, if violated, cause chaotic pulses and scattered Qi, reversing Ying and Wei, and disrupting the order of Jing Qi. Needling under these conditions causes Yang diseases to enter Yin, Yin diseases to emerge from Yang, and pathogenic Qi to regenerate. Unskilled practitioners fail to observe this, which is called destroying the body. Emaciation of form and flesh is the first depletion. Massive blood loss is the second depletion. Profuse sweating is the third depletion. Severe diarrhea is the fourth depletion. Postpartum hemorrhage is the fifth depletion. These conditions must not be treated with reduction methods.
[Su Wen] When the weather is warm and sunny, human blood is fluid and Wei Qi floats, so blood is easily drained and Qi moves easily. When the weather is cold and cloudy, human blood is coagulated and sluggish, and Wei Qi sinks. When the moon begins to wax, Blood and Qi begin to refine, and Wei Qi begins to circulate. When the moon is full, Blood and Qi are substantial, and muscles are firm. When the moon wanes, muscles diminish, meridians are empty, Wei Qi departs, and only the form remains. Therefore, adjust Blood and Qi according to the heavenly timing. Thus, do not needle when cold, do not hesitate when warm, do not reduce when the moon waxes, do not tonify when the moon is full, and do not treat routinely when the moon wanes. This is called adjusting according to the proper time. Following the order of Heaven, observing the times of abundance and deficiency, tracking the sun's shadow, standing upright and waiting. Thus, reducing when the moon waxes causes Zang deficiency. Tonifying when the moon is full causes Blood and Qi to overflow, leaving residual blood in collaterals, termed "Double Excess." Treating when the moon wanes causes disorder of meridians, confusion of Yin and Yang, indistinction between True Qi and Pathogen, stagnation of deep pathogens, external deficiency and internal chaos, allowing licentious pathogens to arise. (From Ba Zheng Shen Ming Lun)
Needle the Yangming Meridian to release Blood and Qi. Needle the Taiyang Meridian to release Blood, avoiding adverse Qi. Needle the Shaoyang Meridian to release Qi, avoiding Blood. Needle the Taiyin Meridian to release Qi, avoiding Blood. Needle the Shaoyin Meridian to release Qi, avoiding Blood. Needle the Jueyin Meridian to release Blood, avoiding Qi. (From Xue Qi Xing Zhi Pian)
[Jia Yi Jing] Shen Ting is prohibited for needling. Shang Guan is prohibited for deep needling (causes deafness). Cranial fontanelle needling should not cause excessive bleeding. Left Jiao needling should not be retained for long. Ren Ying needling too deeply kills. Yun Men needling should not be deep (causes dyspnea and inability to eat). Que Pen needling should not be too deep (causes Qi rebellion). Wu Li is prohibited for needling (Hand Yangming Large Intestine Meridian point). Shen Que (Umbilicus) is prohibited for needling. Fu Tu is prohibited for needling (can be needled 5 fen deep). San Yang Luo is prohibited for needling. Fu Liu needling should not cause visible bleeding. Cheng Jin is prohibited for needling. Ran Gu needling should not cause visible bleeding. Ru Zhong is prohibited for needling. Jiu Wei is prohibited for needling.
[Ling Shu] Needling Shang Guan prevents mouth closure. Needling Xia Guan prevents mouth opening. Needling Du Bi prevents knee flexion. Needling both Guan points prevents knee extension. (From Ben Shu Pian)
[Su Wen] Spring Qi resides in the Jing Mai, Summer Qi in the Sun Luo, Late Summer Qi in the Muscles, Autumn Qi in the Skin, and Winter Qi in the Bone Marrow. Huang Di asked: I wish to hear the reason. Qi Bo said: In Spring, Heavenly Qi opens, Earthly Qi exudes, ice melts, waters flow, and meridians connect, so Human Qi is in the vessels. In Summer, vessels are full, Qi overflows into Sun Luo to receive Blood, and skin is filled. In Late Summer, meridians and collaterals are prosperous, overflowing into muscles. In Autumn, Heavenly Qi gathers, pores close, and skin tightens. In Winter, things are hidden, Blood and Qi are inside, adhering to bone marrow and connecting to the Five Zang. Thus, pathogenic Qi often follows the seasonal changes of Blood and Qi to invade. Its variations are immeasurable. However, one must follow the Jing Qi, dispel the pathogen, and chaotic Qi will not arise. Huang Di asked: How to handle chaotic Qi arising from violating the Four Seasons? Qi Bo said: Needling collaterals in Spring causes Blood and Qi to overflow, leading to Qi deficiency. Needling muscles in Spring causes Blood and Qi to reverse, leading to upward Qi. Needling sinews and bones in Spring causes Blood and Qi to adhere internally, leading to abdominal distension. Needling vessels in Summer exhausts Blood and Qi, leading to flaccidity. Needling muscles in Summer causes Blood and Qi to retreat internally, leading to fear. Needling sinews and bones in Summer causes Blood and Qi to rise, leading to anger. Needling vessels in Autumn causes Blood and Qi to rise, leading to forgetfulness. Needling collaterals in Autumn prevents Qi from moving outward, leading to lethargy. Needling sinews and bones in Autumn scatters Blood and Qi internally, leading to chills. Needling vessels in Winter depletes Blood and Qi, leading to blurred vision. Needling collaterals in Winter leaks internal Qi outward, leading to major Bi syndrome. Needling muscles in Winter exhausts Yang Qi, leading to forgetfulness. All these errors in seasonal needling are major reversals. Violating them causes chaotic Qi and mixed diseases. Therefore, one must know the Jing of the Four Seasons and the origin of diseases. Acting against nature causes internal disorder of Zheng Qi, clashing with Jing Qi. One must carefully examine the Nine Pulses to ensure Zheng Qi is not chaotic and Jing Qi does not shift. (From Si Shi Ni Cong Lun)
On Jia and Yi days in Spring, avoid needling the head and auditory mending treatments. On Bing and Ding days in Summer, avoid dust-shaking treatments on Jian, Hou, and Lian Quan. On Wu and Ji days in Late Summer (Four Seasons days), avoid abdominal needling and claw-draining water methods. On Geng and Xin days in Autumn, avoid needling joints in the thighs and knees. On Ren and Gui days in Winter, avoid needling the lower legs. This is called the "Five Prohibitions."
[Su Wen] Huang Di asked: I wish to hear the essentials of needling. Qi Bo answered: Diseases have depth, and needling has shallowness. Each must reach its proper level without exceeding the Dao. Exceeding causes internal injury; falling short causes external obstruction, allowing pathogens to enter. Improper depth becomes a great disaster, disturbing the Five Zang internally and later causing serious illness. Thus: Diseases may be in the hair follicles and pores, skin, muscles, vessels, sinews, bones, or marrow. Therefore, needling hair follicles/pores must not injure the skin; injuring the skin disturbs the Lung internally, causing warm malaria with chills in Autumn. Needling skin must not injure muscles; injuring muscles disturbs the Spleen internally, causing abdominal distension, vexation, and anorexia during the transition months of the Four Seasons. Needling muscles must not injure vessels; injuring vessels disturbs the Heart internally, causing heart pain in Summer. Needling muscles must not injure sinews; injuring sinews disturbs the Liver internally, causing heat and flaccid sinews in Spring. Needling sinews must not injure bones; injuring bones disturbs the Kidney internally, causing distension and back pain in Winter. Needling bones must not injure marrow; injuring marrow causes emaciation and soreness, and limbs remain weak and unable to recover. (From Ci Yao Lun)
In all needling, one must hit the Qi Acupoint, not the flesh nodes. Hitting the Qi Acupoint allows the needle to roam freely; hitting flesh nodes causes skin pain. Reversing tonification and reduction worsens the disease. Hitting sinews causes flaccidity, preventing pathogen expulsion, leading to conflict with Zheng Qi and internal adherence. Inaccurate needling mistakes compliance for reversal. Needling the Heart causes death in one day, manifested as belching. Needling the Lung causes death in three days, manifested as coughing. Needling the Liver causes death in five days, manifested as yawning. (Su Wen says "speech disorders"). Needling the Spleen causes death in fifteen days, (Su Wen says "ten days"), manifested as swallowing movements. Needling the Kidney causes death in three days, (Su Wen says "six days" or "seven days"), manifested as sneezing. Needling the Gallbladder causes death in one and a half days, manifested as vomiting. Needling the Diaphragm causes internal injury; even if cured, death occurs within a year. Needling the dorsum of the foot, hitting a large vessel, causes death from uncontrollable bleeding. Needling the inner thigh, hitting a large vessel, causes death from uncontrollable bleeding. Needling the face, hitting a flowing vessel, unfortunately causes blindness. Needling the Master of the Guest point, sinking into the vessel, causes internal leakage and deafness. Needling the head, hitting the Brain House point, entering the brain, causes immediate death. Needling the knee patella, releasing fluid, causes limping. Needling the sublingual vessels excessively, with uncontrollable bleeding, causes aphonia. Needling the Hand Taiyin vessel, with excessive bleeding, causes immediate death. Needling the plantar network vessels, with no bleeding out, causes swelling. Needling the Foot Shaoyin vessel, causing heavy deficiency and bleeding, causes difficulty speaking. Needling the popliteal fossa large vessel, causes collapse and pallor. Needling the chest, sinking into the Lung, (Su Wen says: sinking into the vessel of the chest), causes dyspnea and orthopnea. Needling the Chong Men vessel, with no bleeding out, causes inguinal swelling. Needling the elbow, sinking inward, causes Qi to gather, resulting in inability to flex or extend. Needling the spinal interspace, hitting the marrow, causes kyphosis. Needling three cun below the inner thigh, sinking inward, causes enuresis. Needling above the breast, hitting the mammary gland, causes root-like ulceration. Needling the axillary hypochondrium, sinking inward, causes coughing. Needling the Que Pen, sinking inward, causes Qi leakage, leading to wheezing and coughing. Needling the lower abdomen, hitting the Bladder, causes urine leakage and abdominal fullness. Needling the fish of the hand, sinking inward, causes swelling. Needling the intestine, sinking inward, causes swelling. Needling the supraorbital depression, hitting the vessel, causes fistula or blindness. Needling the joint, releasing fluid, causes inability to flex or extend. (All from Ci Jin Pian)