伤寒有五者。指五病俱统于伤寒一门。而分其所苦之不同也。风为阳邪。寒为阴邪。故先列
中风，次列伤寒。寒者。皆冬月之正病也。湿温发于湿土之令居多。热病发于盛夏。温病即仲景伤寒
经中春温病也。乃见前之五邪。从本原来。非此之伤寒热病。故各立其法也。注家以疫症指此温病，非也。
中风之脉。阳浮而滑。阴濡而弱。（阴阳即尺寸脉下同）湿温之脉。阳濡而弱。阴小而急。伤寒
之脉。阴阳俱盛而紧涩。热病之脉。阴阳俱浮。浮之而滑。沉之散涩。温病之脉。行在诸经。不
知何经之动也。各随其经所在而取之。
此发明上文五病之脉。上四病之脉。本文自明。此独论温病之脉。行在诸经者。经言温脉必
行于诸阳。然不知在诸阳何经以动。动者。脉盛也。诸阳。三阳也。各随其经取之者。刺之也。
如仲景云。太阳病至七日以上。若欲作再经者。针足阳明。太阳病初服桂枝汤。反烦不解者。
先刺风池风府。即此义也。
伤寒有汗出而愈。下之而死者。有汗出而死。下之而愈者。何也。然。阳虚阴盛。汗出而愈
下之即死。阳盛阴虚。汗出而死。下之而愈。
阳虚者。邪实于表。而表之阳气虚也。阴虚者。邪实于里。而里之阴气虚也。此即邪实正虚也
。在表汗。在里下。此定法也。
寒热之病。候之如何也。然。皮寒热者。皮不可近席。毛发焦。鼻槁。不得汗。肌寒热者。皮肤
痛。唇舌齿槁。无汗。骨发寒热者。病无所安。汗注不休。齿本槁痛。
伤寒一门。最为关系。故首节先定其名。示后人不得紊乱。次节明风湿寒热温五证之脉。三
节言伤寒表里自有一定汗下之法。不可误行。此节明当汗当下之义。寒热病者。即伤寒中风之总
名也。皮寒热者。即仲景所谓太阳之表。风用桂枝汤。寒用麻黄汤。汗之而愈。肌寒热者。即仲景
所谓邪在半表半里。用小柴胡汤。和解而愈。骨发寒热者。里发寒热也。即仲景谓正阳阳明里症
。用承气汤下之而愈也。乃见先圣后圣。其揆一也。
中峰云。苟非明达仲景者。未能明达此义。
五十九难（误列四十二难）曰。人肠胃长短。受水谷多少。各几何。然。胃大一尺五寸。径五
寸。长二尺六寸。横屈受水谷三斗五升。其中当留谷二斗。水一斗五斗。小肠大二寸半。径八分
。分之小半。长三丈二尺。受谷二斗四升。水六升三合。合之大半。回肠。（回肠即大肠）大四寸
。径一寸半。长二丈一尺。受谷一斗。水七升半。广肠（广肠一名直肠）大八寸。径二寸半。长二尺八
寸。受谷九升三合。八分合之一。故肠胃凡长五丈八尺四寸。受水谷八斗七升六合。八分合之一。
此肠胃长短。受水谷之数也。
肝重二斤四两。左三叶。右四叶。凡七叶。主藏魂。
肝本两大叶。左三右四者。小叶也。
心重十二两。中有七孔三毛。盛精汁三合。主藏神。
脾重二斤三两。扁广三寸。长五寸。有散膏半斤。主裹血。温五脏。主藏意。
肺重三斤三两。六叶。两耳。凡八叶。主藏魄。
肾有两枚。重一斤二两。主藏志。
胆在肝之短叶间。重三两三铢。盛精汗三合。
胃重二斤十四两。（其长广容水谷之数与首节同故不录）
小肠重二斤十四两。左回叠积十六曲。（其广长容水谷之数与首节同故不录）
大肠重三斤十二两。当脐右回叠积十六曲。（其长广容水谷之数与首节同故不录）
膀胱重九两二铢。纵广九寸。盛溺九升九合。
口广二寸半。唇至齿。长九分。齿以后至会厌。深三寸半。大容五合。
舌重十两。长七寸。广二寸半。
咽门重十两。广二寸半。至胃长一尺六寸。
喉咙重十二两。广二寸。长一尺二寸。九节。
肛门重十二两。（其长广容水谷之数与首节同故不录。）
此章备细发明脏腑之形者。是发明内照之法也。其所以知之者。圣人之全知全能也。内经虽有
岐伯曰可剖而视之之句。此不过释疑问之意耳。
六十难（误列四十三难）曰。人不食饮七日而死者。何也。然。人胃中常存留谷二斗。水一斗
五升。故平人日再至圊。一行二升半。日行五升。七日五七三斗五升。而水谷尽矣。故平人不食
饮七日而死者。水谷津液俱尽。即死矣。
此与前章统结三卷始终之义。凡人所借以生者水谷也。能承运水谷者胃也。自首卷至此。俱发
明脉证无不以胃气为重。故曰四时之脉。胃气为本。百病死生。胃脉为本。前章首举胃而递及肛门
。此章复举胃存水谷。而及于水谷津液尽而死。余谓越人之着难经。真首尾相应。一气贯通。学
者读是经而不悟全文。究不能得其心传也。
六十一难曰。经言望而知之谓之神。闻而知之谓之圣。问而知之谓之工。切脉而知之谓之巧
。何谓也。然。望而知之者。望见其五色。以知其病。闻而知之者。闻其五音。以别其病。
问而知之者。问其所欲五味。以知其病所起所在。切脉而知者。诊其寸口。视其虚实。以知其病在
何脏腑也。
此章发明望闻问切四者之要。五色者。青黄赤白黑也。五音者。邪入肺为哭。入肝为呼。入
心为言。入脾为歌。入肾为呻。五味者。酸甘苦辛咸也。所起者。察其所欲五味中之何味。而知病起
何腑何脏也。所在者。知其病起何腑何脏。而又现传何腑何脏也。三者俱知。然后诊其寸口。再视其
虚实。则在腑在脏之病。无不明矣。
经言以外知之曰圣。以内知之曰神。此之谓也。
此章统包三卷全文之意而结也。外者。望其色。闻其声。病未见而知之也。内者。问其所欲
五味。切其脉而察其所病。知其虚实也。越人望后世医者。必臻此境。方合轩岐之道。否则未免
为粗工而已矣。
六十二难曰。脏井荥有五。腑独有六者。何谓也。然。腑者阳也。三焦行于诸阳。故置一输。名
曰原。所以腑有六者。亦与三焦共一气也。
井荥输经合。此五者。配五脏。井荥输原经合。此六者。配六腑。六腑多一原。所以脏五而
腑六也。所出为井。所溜为荥。所注为输。所行为经。所入为合。所过为原也。
六十三难曰。十变言五脏六腑荥合。皆以井为始者。何谓也。然。井者。东方春也。万物之始生
。诸 行喘息。 飞蠕动。当生之物。莫不以春生。故岁数始于春。月数始于甲。故以井为始也。
人身之穴。以井为始。井者。东方春也。万物之始生。如岁始于春者。东方木也。月始于甲者
亦应东方木也。
诸 蠕。皆入蛰之诸小虫也。得春气则能行。能喘息能飞能动矣。十变。古经名也。
六十四难曰。十变又言阴井木。阳井金。阴荥火。阳荥水。阴输土。阳输木。阴经金。阳经火。阴合水。阳合
土。阴阳皆不同。其意何也。然。是刚柔之事也。阴井乙木。阳井庚金。阳井庚。庚者。乙之刚也。
阴井乙。乙者。庚之柔也。乙为木。故言阴井木也。庚为金。故言阳井金也。余皆仿此。
此举古经十变言井荥输经合。俱以五行阴阳为配偶。但一阴一阳。俱有相克。是何意也。言
阳与阴配合。取刚柔之义耳。如阴井木。阳井金。是乙与庚合也。乙为阴木。合庚之阳金。故曰
庚乃乙之刚。乙乃庚之柔也。又如阴荥火。阳荥水。是丁与壬合也。丁为阴火。壬为阳水。阳输
木。阴输土。是甲与己合也。甲为阳木。己为阴土。阴经金。阳经火。是丙与辛合也。辛为阴金
。丙为阳火。阴合水。阳合土。是戊与癸合也。癸为阴水。戊为阳土也。如此配合。则刚柔相济。然
后气血流通而不息。乃见人身经穴脏腑。俱有五行配合。无时不交也。
中峰云。观此则二十三难庚之柔丙之柔之义益明矣。可见近来注家。不过逐章敷衍。未能通
体贯彻也。
六十五难曰。经言所出为井。所入为合。其法奈何。然。所出为井。井者。东方春也
。万物始生。故言
所出为井也。所入为合。合者北方冬也。阳气入藏。故言所入为合也。
此言井荥输经合。如春夏秋冬之周而复始。东南西北之循环无端。自井而生发。至合
而入脏。如天地一岁而有四时。一日亦有四时。人身随其气而营运。所以一呼一吸。阴阳无不周
遍也。
六十六难曰。经言肺之原。出于太渊。心之原。出于大陵。肝之原。出于太冲。脾之原。出
于太白。肾之原。出于太溪。少阴之原。出于兑骨。胆之原。出于丘墟。胃之原。出于冲阳。
三焦之原。出于阳池。膀胱之原。出于京骨。大肠之原。出于合谷。小肠之原。出
于腕骨。十二经皆以输为原者。何也。然。五脏输者。三焦之所行。气之所留止也。三焦
所行之输为原者。何也。然。脐下肾间动气者。人之生命也。十二经中之根本也。故名曰原。三
焦者。原气之别使也。主通行三气。经历于五脏六腑。原者三焦之尊号也。故所止辄为原。五
脏六腑之有病者。皆取其原也。
太渊在手掌后陷中。手太阴所注。此即脉之大会也。大陵。在掌后骨下横纹中两筋间陷中。
手厥阴所注。
太冲。在足大指本节后两寸。足厥阴所注。太白。在足大指后内侧横骨下。足太阴所注。太溪。
在足内踝后。
跟骨上动脉陷中。足少阴所注。兑骨。一名神门。在掌后锐骨端陷中。当小指后。手少阴所注。
丘墟。在足外踝下如前陷中。足少阳所过。冲阳。在足跗上五寸高骨间动脉。去陷谷二寸。足阳
明所过。仲景所谓趺阳
也。阳池。在手外腕上陷中。自本节后骨直对腕中。手少阳所过。京骨。在足小指外侧。本节后
大骨下。赤白肉际陷中。足太阳所过。合谷。一名虎口。在手大指次指歧骨陷中。手阳明所过。腕
骨。在手外侧腕前起骨下陷中。手太阳所过。三焦之原。在脐下肾间动气之所。人之生命。十二
经之根本。皆系乎此。三焦任此原气。分别致使通行上中下三气。经历于五脏六腑之输穴。因其
经历。故输亦可名原也。而所谓原者。岂非三焦尊重之号乎。五脏六腑之病。皆取十二经之原穴
。岂非三焦能统摄诸脏腑之一大腑乎。
六十七难曰。五脏募皆在阴。 皆在阳者。何谓也。然。阴病行阳。阳病行阴。故令募在阴
。在阳也。
此章发明募 所以在阴在阳之义。阴者。属于腹。募居于腹。阳者。属于背。 居于背。募
者。结募也。为经气之所聚。 者。输也。由此而输彼也。故募 为气血阴阳周行顿节之所。而
病邪亦无不从此而出入。如病在阴分。有 方可以行阳。病在阳分。有募方可以行阴。否则间隔
不通矣。故令募在阴。 在阳也。此义以疟证喻之。最为确切。凡疟必由外感暑湿之邪。内伤生
冷之气。其邪渐渍。隐于募原。邪气行阳则热。行阴则寒。邪入浅。则道近。故日作。邪入深
。则道远。故间日作。愈深则愈远。故有间二日三日者。此非阴病行阳。阳病行阴之明验乎。
五脏之募穴。肺募。中府穴。心募。巨阙穴。脾募。章门穴。肝募。期门穴。肾募。京门穴。
六十八难曰。五脏六腑。各有井荥输经合。皆何所主。然。经言所出为井。所流为荥。所注为输
。所行为经。所入为合。井主心下满。荥主身热。输主体重节痛。经主喘咳寒热。合主逆气而泄
此五脏六腑。井荥输经合所主病也。
自六十二难至此。俱发明井荥输原经合之穴。以下俱发明针刺之法也。纪氏曰。井者。若水
之源。水始出源流之尚微。故谓之荥。水上而注下。下复承而流之。故谓之输。水行经历而过。
故谓之经。经过于此。乃入于脏腑。与众经相会。故谓之合。素问曰。六经为川。肠胃为海也。
范曰。井法木以应肝。脾之位在心下。今邪在肝。肝侵脾。故心下满。今治之于井。不令木乘土
也。荥法火以应心。肺属金。外主皮毛。心火灼于肺金。故身热。谓邪在心也。故治之于荥。不
使火来乘金。则身热自愈矣。输法土以应脾。今邪在土。土必克水。水者肾也。肾主骨。故病则
节痛。邪在土。土自病则体重。故治之于输。经法金以应肺。今邪在肺。得寒则咳。得热则喘。
金必克木。木者肝。肝在志为怒。怒则气逆而作喘。故治之于经。合应水而主肾。肾气不足。伤
于冲脉。则气逆。肾开窍于二阴。气逆则不禁而下泄。故宜治合也。五脏六腑。各有井荥输经合
之穴。其原穴独在六腑。故六腑多一原穴。并列于后。
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六十九难曰。经言虚者补之。实者泻之。不虚不实。以经取之。何谓也。然。虚者补其母。
实者泻其子。当先补之。然后泻之。不实不虚。以经取之者。是正经自生病。不中他邪也。当自
取其经。故言
以经取之。
此章言针刺经穴补泻之大法。而亦可推之于用药也。子母以五行配脏腑而推之。先补之。
然后泻之者。 言欲泻其子而必先补其母也。可见古人必以固本为要。明矣
七十难曰。经言春夏刺浅。秋冬刺深者。何谓也。然。春夏者。阳气在上。人气亦在上。故当
浅取之。秋冬者。阳气在下。人气亦在下。故当深取之。
此言针法以得气为主。故气浅针亦浅。气深针亦深也。
伤寒包含五种病证，是指这五种疾病都归属于伤寒这一门类，但根据患者痛苦表现的不同而加以区分。风邪属于阳邪，寒邪属于阴邪，所以先列出中风，再列出伤寒。寒邪所致之病，都是冬季的正病。湿温病多发生于湿气当令之时。热病发生于盛夏季节。温病即张仲景《伤寒论》中的春温病。这是见到前述的五种邪气，从本源上来讲，并非此处的“伤寒”与“热病”，因此各自确立其治疗方法。注家将疫病指认为此处的温病，是不正确的。
中风的脉象，阳部（寸脉）浮滑，阴部（尺脉）濡弱。（阴阳即指尺寸脉，下文相同）湿温病的脉象，阳部濡弱，阴部细小而急。伤寒的脉象，阴阳两部皆盛大且紧涩。热病的脉象，阴阳两部皆浮，轻取则滑，重按则散涩。温病的脉象，运行于各条经脉之中，不知道是哪条经脉发生变动。应随其经脉所在之处进行诊察。
此处阐发上文五种病证的脉象。前四种病证的脉象，原文已自明。此处独论温病的脉象，说它“行在诸经”。经文说温脉必定行于诸阳经，然而不知道在诸阳经中的哪一条发生变动。“动”，指脉盛。诸阳，指三阳经。各随其经取之，指针刺治疗。如张仲景所说：太阳病至七日以上，若欲传变至下一经者，针刺足阳明经；太阳病初服桂枝汤后，反而烦闷不解者，先针刺风池、风府穴，即是这个意思。
伤寒有汗出而愈，误用下法而死的；也有汗出而死，误用下法而愈的。为什么呢？答曰：阳虚阴盛，汗出而愈，误用下法则死；阳盛阴虚，汗出而死，误用下法则愈。
阳虚，是指邪气实于体表，而体表的阳气虚弱。阴虚，是指邪气实于体内，而体内的阴气虚弱。这就是邪气实而正气虚。在表者用汗法，在里者用下法，这是确定的法则。
寒热病，如何诊察呢？答曰：皮寒热，皮肤不可贴近席子，毛发焦枯，鼻干，无汗。肌寒热，皮肤疼痛，唇舌齿干枯，无汗。骨寒热，病人无处安身，汗出不止，牙根干枯疼痛。
伤寒这一门类，最为关键，所以首节先确定其名目，示诫后人不得混乱。次节阐明风、湿、寒、热、温五证的脉象。第三节言伤寒表里自有确定的汗下之法，不可误行。此节阐明应当汗下之义。寒热病，即伤寒、中风的总名。皮寒热，即张仲景所谓太阳之表证，风邪用桂枝汤，寒邪用麻黄汤，发汗而愈。肌寒热，即张仲景所谓邪在半表半里，用小柴胡汤和解而愈。骨发寒热，是里证寒热，即张仲景所谓正阳阳明里证，用承气汤攻下而愈。可见先圣后圣，其道理是一致的。
第五十九难（误列为第四十二难）说：人的肠胃长短，受纳水谷多少，各是多少？答曰：胃大一尺五寸，径五寸，长二尺六寸，横屈可受水谷三斗五升。其中常留谷物二斗，水一斗五升。小肠大二寸半，径八分，分之小半（约五分），长三丈二尺，受谷物二斗四升，水六升三合又大半合。回肠（回肠即大肠）大四寸，径一寸半，长二丈一尺，受谷物一斗，水七升半。广肠（广肠一名直肠）大八寸，径二寸半，长二尺八寸，受谷物九升三合又八分之一合。所以肠胃总共长五丈八尺四寸，受水谷八斗七升六合又八分之一合。这是肠胃长短及受纳水谷的数量。
肝重二斤四两，左有三叶，右有四叶，共七叶，主藏魂。
肝本为两大叶，左三右四的是小叶。
心重十二两，中有七孔三毛，盛精汁三合，主藏神。
脾重二斤三两，扁广三寸，长五寸，有散膏半斤，主裹血，温养五脏，主藏意。
肺重三斤三两，有六叶两耳，共八叶，主藏魄。
肾有两枚，重一斤二两，主藏志。
胆在肝之短叶间，重三两三铢，盛精汁三合。
胃重二斤十四两。（其长广容水谷之数与首节同，故不录）
小肠重二斤十四两，左回叠积十六曲。（其广长容水谷之数与首节同，故不录）
大肠重三斤十二两，当脐右回叠积十六曲。（其长广容水谷之数与首节同，故不录）
膀胱重九两二铢，纵广九寸，盛溺九升九合。
口广二寸半，唇至齿长九分，齿以后至会厌深三寸半，大容五合。
舌重十两，长七寸，广二寸半。
咽门重十两，广二寸半，至胃长一尺六寸。
喉咙重十二两，广二寸，长一尺二寸，分九节。
肛门重十二两。（其长广容水谷之数与首节同，故不录）
此章详细阐发脏腑的形态，是阐发内照的方法。之所以能知道这些，是因为圣人的全知全能。《内经》虽有岐伯说可以剖开来看的句子，这不过是解释疑问的意思罢了。
第六十难（误列为第四十三难）说：人不饮食七天而死，为什么呢？答曰：人胃中常存留谷物二斗，水一斗五升。所以平人每天两次去厕所，一次排便二升半，一天排泄五升。七天就是五七三斗五升，水谷就排尽了。所以平人不饮食七天而死，是因为水谷津液都耗尽了，人就死了。
此章与前章统结三卷始终的意义。凡人所赖以生存的是水谷。能承运水谷的是胃。从首卷至此，都阐发脉证无不以胃气为重，所以说四时之脉，胃气为本；百病死生，胃脉为本。前章首举胃而递及肛门，此章复举胃存水谷，而及于水谷津液尽而死。我认为越人著《难经》，真可谓首尾相应，一气贯通。学者读这部经典而不悟全文，终究不能得其心传。
第六十一难说：经文说望而知之谓之神，闻而知之谓之圣，问而知之谓之工，切脉而知之谓之巧。这是什么意思？答曰：望而知之，是望见其五色，从而知道病情。闻而知之，是听其五音，从而辨别病情。问而知之，是问其所欲吃的五味，从而知道病起何处、位于何脏。切脉而知之，是诊察寸口，视其虚实，从而知道病在何脏腑。
此章阐发望闻问切四者的要领。五色，即青黄赤白黑。五音，邪入肺为哭，入肝为呼，入心为言，入脾为歌，入肾为呻。五味，即酸甘苦辛咸。所起者，观察其所欲五味中的哪一种，从而知道病起于何腑何脏。所在者，知道病起于何腑何脏，而又现传至何腑何脏。三者俱知，然后诊察寸口，再视其虚实，那么在腑在脏的病，就没有不明白的了。
经文说以外知之曰圣，以内知之曰神，说的就是这个意思。
此章统包三卷全文之意而作结。外者，望其色，闻其声，病未见而知之。内者，问其所欲五味，切其脉而察其所病，知其虚实。越人期望后世医者，必能达到此境界，才符合轩岐之道，否则未免沦为粗工而已。
第六十二难说：五脏井荥有五，六腑独有六者，是什么意思？答曰：腑属阳，三焦行于诸阳，所以设置一个原穴，名叫原。所以腑有六个，也是与三焦共一气。
井荥输经合，这五个，配五脏。井荥输原经合，这六个，配六腑。六腑多一个原穴，所以脏五而腑六。所出为井，所溜为荥，所注为输，所行为经，所入为合，所过为原。
第六十三难说：《十变》言五脏六腑荥合，皆以井为始，是什么意思？答曰：井，对应东方春，是万物始生。所有行走喘息、飞翔蠕动的生物，凡是生长的东西，没有不以春天出生的。所以岁数始于春，月数始于甲，所以以井为始。
人身穴位，以井为始。井，对应东方春，是万物始生。如岁始于春，因为东方属木。月始于甲，也对应东方木。
诸蠕，都是入蛰的各种小虫，得到春气就能行动，能喘息、能飞、能动了。《十变》，是古经名。
第六十四难说：《十变》又言阴井木，阳井金，阴荥火，阳荥水，阴输土，阳输木，阴经金，阳经火，阴合水，阳合土，阴阳皆不同，其意是什么？答曰：这是刚柔之事。阴井乙木，阳井庚金。阳井庚，庚是乙的刚；阴井乙，乙是庚的柔。乙为木，所以说阴井木。庚为金，所以说阳井金。其余都仿照此类。
此举古经《十变》言井荥输经合，俱以五行阴阳为配偶。但一阴一阳，俱有相克，是何意？是说阳与阴配合，取刚柔之义。如阴井木，阳井金，是乙与庚合。乙为阴木，合庚之阳金，所以说庚乃乙之刚，乙乃庚之柔。又如阴荥火，阳荥水，是丁与壬合。丁为阴火，壬为阳水。阳输木，阴输土，是甲与己合。甲为阳木，己为阴土。阴经金，阳经火，是丙与辛合。辛为阴金，丙为阳火。阴合水，阳合土，是戊与癸合。癸为阴水，戊为阳土。如此配合，则刚柔相济，然后气血流通不息，可见人身经穴脏腑，俱有五行配合，无时不交。
中峰云：观此则第二十三难庚之柔、丙之柔的意义更加明白了。可见近来注家，不过逐章敷衍，未能通体贯彻。
第六十五难说：经文说所出为井，所入为合，其法如何？答曰：所出为井，井对应东方春，万物始生，所以说所出为井。所入为合，合对应北方冬，阳气入藏，所以说所入为合。
此言井荥输经合，如春夏秋冬周而复始，东南西北循环无端。自井而生发，至合而入脏，如天地一岁而有四时，一日亦有四时。人身随其气而营运，所以一呼一吸，阴阳无不周遍。
第六十六难说：经文说肺之原出于太渊，心之原出于大陵，肝之原出于太冲，脾之原出于太白，肾之原出于太溪，少阴之原出于兑骨，胆之原出于丘墟，胃之原出于冲阳，三焦之原出于阳池，膀胱之原出于京骨，大肠之原出于合谷，小肠之原出于腕骨。十二经皆以输为原，为什么呢？答曰：五脏输穴，是三焦所行的部位，气停留的地方。三焦所行之输称为原，为什么呢？答曰：脐下肾间动气，是人的生命，十二经的根本，所以名叫原。三焦是原气的别使，主要通行三气，经历于五脏六腑。原是尊号，所以停留处辄为原。五脏六腑有病，都取其原穴。
太渊在手掌后陷中，手太阴所注，此即脉之大会。大陵在掌后骨下横纹中两筋间陷中，手厥阴所注。
太冲在足大指本节后两寸，足厥阴所注。太白在足大指后内侧横骨下，足太阴所注。太溪在足内踝后跟骨上动脉陷中，足少阴所注。兑骨，一名神门，在掌后锐骨端陷中，当小指后，手少阴所注。丘墟在足外踝下如前陷中，足少阳所过。冲阳在足跗上五寸高骨间动脉，去陷谷二寸，足阳明所过，张仲景所谓趺阳也。阳池在手外腕上陷中，自本节后骨直对腕中，手少阳所过。京骨在足小指外侧，本节后大骨下，赤白肉际陷中，足太阳所过。合谷，一名虎口，在手大指次指歧骨陷中，手阳明所过。腕骨在手外侧腕前起骨下陷中，手太阳所过。三焦之原，在脐下肾间动气之所，是人的生命，十二经的根本，皆系乎此。三焦任此原气，分别致使通行上中下三气，经历于五脏六腑之输穴，因其经历，故输亦可名原。而所谓原，岂非三焦尊重之号吗？五脏六腑之病，皆取十二经之原穴，岂非三焦能统摄诸脏腑之一大腑吗？
第六十七难说：五脏募皆在阴，腧皆在阳，是什么意思？答曰：阴病行阳，阳病行阴，所以令募在阴，腧在阳。
此章阐发募腧所以在阴在阳之义。阴者，属于腹，募居于腹。阳者，属于背，腧居于背。募，是结聚，为经气之所聚。腧，是输，由此而输彼。故募腧为气血阴阳周行顿节之所，而病邪亦无不从此出入。如病在阴分，有腧方可以行阳；病在阳分，有募方可以行阴，否则间隔不通矣。所以令募在阴，腧在阳。此义以疟证喻之，最为确切。凡疟必由外感暑湿之邪，内伤生冷之气，其邪渐渍，隐于募原。邪气行阳则热，行阴则寒。邪入浅，则道近，故日作。邪入深，则道远，故间日作。愈深则愈远，故有间二日三日者。此非阴病行阳，阳病行阴之明验乎？
五脏之募穴：肺募中府穴，心募巨阙穴，脾募章门穴，肝募期门穴，肾募京门穴。
第六十八难说：五脏六腑各有井荥输经合，皆何所主？答曰：经文说所出为井，所流为荥，所注为输，所行为经，所入为合。井主心下满，荥主身热，输主体重节痛，经主喘咳寒热，合主逆气而泄。此五脏六腑井荥输经合所主病也。
自第六十二难至此，都阐发井荥输原经合之穴，以下都阐发针刺之法。纪氏说：井，像水源，水始出源流尚微，故谓之荥。水上而注下，下复承而流之，故谓之输。水行经历而过，故谓之经。经过于此，乃入于脏腑，与众经相会，故谓之合。《素问》说：六经为川，肠胃为海。范氏说：井法木以应肝，脾之位在心下，今邪在肝，肝侵脾，故心下满。今治之于井，不令木乘土也。荥法火以应心，肺属金，外主皮毛，心火灼于肺金，故身热，谓邪在心也，故治之于荥，不使火来乘金，则身热自愈。输法土以应脾，今邪在土，土必克水，水者肾也，肾主骨，故病则节痛。邪在土，土自病则体重，故治之于输。经法金以应肺，今邪在肺，得寒则咳，得热则喘。金必克木，木者肝，肝在志为怒，怒则气逆而作喘，故治之于经。合应水而主肾，肾气不足，伤于冲脉，则气逆。肾开窍于二阴，气逆则不禁而下泄，故宜治合。五脏六腑各有井荥输经合之穴，其原穴独在六腑，故六腑多一原穴，并列于后。
第六十九难说：经文说虚者补之，实者泻之，不虚不实，以经取之，是什么意思？答曰：虚者补其母，实者泻其子。当先补之，然后泻之。不实不虚，以经取之，是正经自生病，不中他邪，当自取其经，故言以经取之。
此章言针刺经穴补泻之大法，而亦可推之于用药。子母以五行配脏腑而推之。先补之，然后泻之者，是说欲泻其子而必先补其母也。可见古人必以固本为要，明矣。
第七十难说：经文说春夏刺浅，秋冬刺深，是什么意思？答曰：春夏者，阳气在上，人气亦在上，故当浅取之。秋冬者，阳气在下，人气亦在下，故当深取之。
此言针法以得气为主，故气浅针亦浅，气深针亦深。
Shanghan (Cold Damage) encompasses five types of diseases, meaning these five illnesses are all categorized under the single heading of Shanghan, but are distinguished by their differing symptomatic manifestations. Wind is a Yang pathogen, and cold is a Yin pathogen; therefore, Zhongfeng (Wind Strike) is listed first, followed by Shanghan (Cold Damage). Cold-induced diseases are the proper illnesses of winter. Shiwen (Damp-Warmth) mostly occurs during the season when dampness prevails. Rebing (Heat Disease) occurs in midsummer. Wenbing (Warm Disease) refers to the Chunwen (Spring Warmth) disease found in Zhang Zhongjing's *Treatise on Cold Damage*. These represent the aforementioned five pathogens originating from their source, distinct from the specific "Shanghan" and "Rebing" mentioned here; thus, each has its own established treatment methods. Commentators who identify Yizheng (Epidemic Diseases) as this type of Wenbing are incorrect.
The pulse for Zhongfeng (Wind Strike) is floating and slippery at the Yang position (Cun/Inch) and soft and weak at the Yin position (Chi/Cubit). (Yin and Yang refer to Chi and Cun pulses respectively, same below). The pulse for Shiwen (Damp-Warmth) is soft and weak at the Yang position, and small and rapid at the Yin position. The pulse for Shanghan (Cold Damage) is both vigorous and tight/choppy at the Yin and Yang positions. The pulse for Rebing (Heat Disease) is floating at both Yin and Yang positions; superficial palpation reveals slipperiness, while deep palpation reveals dispersion and choppi-ness. The pulse for Wenbing (Warm Disease) travels through various meridians, making it unclear which specific meridian is affected. One should palpate according to the location of the affected meridian.
This section elucidates the pulses of the five diseases mentioned above. The pulses for the first four diseases are self-evident in the text; here, only the pulse for Wenbing (Warm Disease) is discussed, described as "traveling through various meridians." The classic states that the Wen pulse must travel through the Yang meridians, yet it is unknown which specific Yang meridian is affected. "Movement" indicates a full pulse. "Various Yang" refers to the Three Yang meridians. "Palpating according to each meridian" refers to acupuncture treatment. As Zhang Zhongjing stated: If Taiyang disease persists for seven days or more and is about to transmit to the next stage, needle the Foot-Yangming meridian; if Taiyang disease initially treated with Guizhi Tang (Cinnamon Twig Decoction) results in persistent irritability, first needle Fengchi (GB20) and Fengfu (GV16). This illustrates the principle.
In Shanghan (Cold Damage), there are cases where sweating leads to recovery but purgation leads to death, and cases where sweating leads to death but purgation leads to recovery. Why? Answer: In cases of Yang deficiency and Yin excess, sweating leads to recovery, but purgation causes death. In cases of Yang excess and Yin deficiency, sweating leads to death, but purgation leads to recovery.
Yang deficiency refers to pathogenic excess at the exterior with deficient exterior Yang Qi. Yin deficiency refers to pathogenic excess at the interior with deficient interior Yin Qi. This represents pathogenic excess and righteous deficiency. For exterior conditions, use diaphoresis (sweating); for interior conditions, use purgation. This is the fixed method.
How should Hanre Bing (Cold-Heat Disease) be observed? Answer: Pi Hanre (Skin Cold-Heat) involves skin sensitivity to bedding, scorched hair, dry nose, and anhidrosis. Ji Hanre (Muscle Cold-Heat) involves skin pain, dried lips/tongue/teeth, and anhidrosis. Gu Hanre (Bone Cold-Heat) involves restlessness, profuse continuous sweating, and dried/painful tooth roots.
The category of Shanghan (Cold Damage) is most critical; thus, the first section establishes its name to prevent confusion. The second section clarifies the pulses for Wind, Damp, Cold, Heat, and Warmth. The third section states that exterior and interior Shanghan have fixed methods for diaphoresis and purgation, which must not be misapplied. This section explains the rationale for when to use diaphoresis or purgation. Hanre Bing (Cold-Heat Disease) is the general term for Shanghan and Zhongfeng. Pi Hanre corresponds to Taiyang exterior syndrome in Zhang Zhongjing's work: Wind uses Guizhi Tang (Cinnamon Twig Decoction), Cold uses Mahuang Tang (Ephedra Decoction), cured by diaphoresis. Ji Hanre corresponds to half-exterior/half-interior syndrome: Xiao Chaihu Tang (Minor Bupleurum Decoction) is used for harmonization, leading to cure. Gu Hanre corresponds to interior cold-heat: Zhengyang Yangming interior syndrome uses Chengqi Tang (Order the Qi Decoction) for purgation, leading to cure. Thus, the ancient sages share the same principles.
Zhongfeng said: Only those who thoroughly understand Zhang Zhongjing can fully comprehend this meaning.
Difficulty 59 (misnumbered as Difficulty 42) asks: What are the lengths of the human intestines and stomach, and how much water and grain can they hold? Answer: The stomach is one chi five cun wide, five cun in diameter, and two chi six cun long, capable of holding three dou five sheng of water and grain after folding. It typically retains two dou of grain and one dou five sheng of water. The small intestine is two cun half wide, eight fen in diameter, and three zhang two chi long, holding two dou four sheng of grain and six sheng three he plus half a he. The Huichang (returning intestine, i.e., large intestine) is four cun wide, one cun half in diameter, and two zhang one chi long, holding one dou of grain and seven sheng half of water. The Guangchang (broad intestine, i.e., rectum) is eight cun wide, two cun half in diameter, and two chi eight cun long, holding nine sheng three he plus one-eighth of a he. Thus, the total length of the stomach and intestines is five zhang eight chi four cun, capable of holding eight dou seven sheng liu he plus one-eighth of a he. This details the dimensions and capacity of the stomach and intestines.
The liver weighs two jin four liang, has three lobes on the left and four on the right, totaling seven lobes, and houses the Hun (Ethereal Soul).
The liver originally consists of two major lobes; the left three and right four are smaller lobules.
The heart weighs twelve liang, contains seven apertures and three hairs, holds three he of essence juice, and houses the Shen (Spirit).
The spleen weighs two jin three liang, is three cun wide and five cun long, contains half a jin of dispersed paste, wraps blood, warms the five Zang organs, and houses the Yi (Intellect).
The lungs weigh three jin three liang, have six lobes and two ears, totaling eight lobes, and house the Po (Corporeal Soul).
There are two kidneys, weighing one jin two liang, housing the Zhi (Willpower).
The gallbladder lies between the short lobes of the liver, weighs three liang three zhu, and holds three he of essence juice.
The stomach weighs two jin fourteen liang. (Its dimensions and capacity are the same as stated earlier, so omitted.)
The small intestine weighs two jin fourteen liang, coiling sixteen times on the left. (Its dimensions and capacity are the same as stated earlier, so omitted.)
The large intestine weighs three jin twelve liang, coiling sixteen times to the right of the navel. (Its dimensions and capacity are the same as stated earlier, so omitted.)
The bladder weighs nine liang two zhu, is nine cun long and wide, and holds nine sheng nine he of urine.
The mouth is two cun half wide; from lip to teeth is nine fen; from teeth to epiglottis is three cun half deep, holding five he.
The tongue weighs ten liang, is seven cun long and two cun half wide.
The pharynx gate weighs ten liang, is two cun half wide, and extends one chi six cun to the stomach.
The larynx weighs twelve liang, is two cun wide, one chi two cun long, and divided into nine segments.
The anus weighs twelve liang. (Its dimensions and capacity are the same as stated earlier, so omitted.)
This chapter details the morphology of the Zang-Fu organs, illustrating the method of internal visualization. Such knowledge stems from the omniscience of the Sages. Although *Neijing* mentions Qibo stating that dissection allows observation, this merely serves to resolve doubts.
Difficulty 60 (misnumbered as Difficulty 43) asks: Why does a person die after seven days without food or drink? Answer: The stomach normally retains two dou of grain and one dou five sheng of water. A healthy person defecates twice daily, passing two sheng half each time, totaling five sheng per day. Over seven days, this amounts to three dou five sheng, exhausting the water and grain. Thus, a healthy person dies after seven days without intake because the water, grain, and Jin-Ye (Body Fluids) are completely exhausted.
This chapter concludes the overarching theme of the three volumes. All life depends on water and grain, transported by the Stomach. From the first volume to here, pulse and symptom analysis always prioritize Wei Qi (Stomach Qi). Hence, it is said: Four-season pulses rely on Wei Qi as the root; life and death from hundred diseases rely on the Stomach pulse. The previous chapter started with the Stomach and ended with the anus; this chapter starts with the Stomach retaining water/grain and ends with death due to exhaustion of fluids. I believe Yu Ren's *Nanjing* exhibits perfect coherence and continuity. Scholars who read this classic without grasping the whole cannot receive its true transmission.
Difficulty 61 states: The classic says seeing and knowing is called Divine, hearing and knowing is called Sage, asking and knowing is called Skilled, and pulse-taking and knowing is called Skillful. What does this mean? Answer: Seeing and knowing involves observing the Five Colors to diagnose illness. Hearing and knowing involves listening to the Five Tones to distinguish illness. Asking and knowing involves inquiring about cravings for the Five Flavors to determine the origin and location of the disease. Pulse-taking and knowing involves examining the Cunkou (Radial artery) to assess deficiency/excess and locate the diseased Zang-Fu.
This chapter elucidates the essentials of Inspection, Auscultation/Olfaction, Inquiry, and Palpation. The Five Colors are Green, Yellow, Red, White, Black. The Five Tones: Lung pathology manifests as crying, Liver as calling, Heart as speaking, Spleen as singing, Kidney as groaning. The Five Flavors are Sour, Sweet, Bitter, Pungent, Salty. Determining the origin involves identifying which flavor craving indicates which organ's disease. Determining the location involves tracing the transmission from the initial organ to others. Knowing these three aspects, then examining the Cunkou pulse for deficiency/excess, makes all Zang-Fu diseases clear.
The classic says knowing externally is Sage, knowing internally is Divine. This refers to the above.
This chapter summarizes the intent of the entire three-volume work. Externally, observing color and hearing sound allows diagnosis before symptoms appear. Internally, asking about flavor cravings and taking the pulse reveals deficiency/excess. Yu Ren hoped future physicians would reach this level to align with Xuanyuan and Qibo; otherwise, they remain crude practitioners.
Difficulty 62 asks: Why do the Five Zang have five Jing-River points, but the Six Fu have six? Answer: Fu organs belong to Yang, and Sanjiao (Triple Burner) circulates among the Yang meridians; thus, an Yuan (Source) point is added. The Fu organs share Qi with Sanjiao.
Jing, Ying, Shu, Jing, He correspond to the Five Zang. Jing, Ying, Shu, Yuan, Jing, He correspond to the Six Fu. The Fu have one extra Yuan point, hence Five Zang and Six Fu. Outflow is Jing, trickling is Ying, pouring is Shu, flowing is Jing, entering is He, passing through is Yuan.
Difficulty 63 asks: *Shibian* states that Jing and He points for Zang and Fu begin with Jing. Why? Answer: Jing corresponds to East and Spring, the beginning of all things. All moving, breathing, flying, and creeping creatures grow in spring. Thus, the year begins in Spring, months begin with Jia, so Jing points are first.
Human acupoints begin with Jing. Jing corresponds to East/Spring, the start of all things. Just as the year starts in Spring (East/Wood), months start with Jia (also East/Wood).
Creeping creatures hibernate and become active with Spring Qi, able to move, breathe, fly, and act. *Shibian* is an ancient classic title.
Difficulty 64 asks: *Shibian* also states Yin Jing is Wood, Yang Jing is Metal, Yin Ying is Fire, Yang Ying is Water, Yin Shu is Earth, Yang Shu is Wood, Yin Jing is Metal, Yang Jing is Fire, Yin He is Water, Yang He is Earth. Why are Yin and Yang different? Answer: This concerns Gang (Hard/Yang) and Rou (Soft/Yin). Yin Jing is Yi Wood, Yang Jing is Geng Metal. Geng is the Gang of Yi; Yi is the Rou of Geng. Yi is Wood, so Yin Jing is Wood. Geng is Metal, so Yang Jing is Metal. Others follow this pattern.
This cites *Shibian* pairing Jing, Ying, Shu, Jing, He with Five Elements and Yin-Yang. Although Yin and Yang mutually overcome, their combination takes the meaning of Gang-Rou complementarity. Yin Jing Wood (Yi) combines with Yang Jing Metal (Geng). Yi is Yin Wood, combining with Geng Yang Metal. Similarly, Yin Ying Fire (Ding) combines with Yang Ying Water (Ren); Yang Shu Wood (Jia) combines with Yin Shu Earth (Ji); Yin Jing Metal (Xin) combines with Yang Jing Fire (Bing); Yin He Water (Gui) combines with Yang He Earth (Wu). Such pairing ensures Gang-Rou balance, allowing uninterrupted Qi and Blood flow. Thus, meridians, acupoints, and Zang-Fu all possess Five Element interactions constantly.
Zhongfeng said: Observing this clarifies the meaning of Geng's Rou and Bing's Rou in Difficulty 23. Recent commentators merely elaborate chapter by chapter without grasping the holistic integration.
Difficulty 65 asks: The classic says outflow is Jing, inflow is He. What is the method? Answer: Outflow is Jing, corresponding to East/Spring, the beginning of all things. Inflow is He, corresponding to North/Winter, when Yang Qi enters storage.
Jing, Ying, Shu, Jing, He cycle like Spring, Summer, Autumn, Winter, or South, East, North, West. From Jing (generation) to He (entry into Zang), it mirrors the annual seasons and daily cycles. Human Qi circulates accordingly, ensuring Yin and Yang permeate every breath.
Difficulty 66 states: Lung Yuan is Taiyuan, Heart Yuan is Daling, Liver Yuan is Taichong, Spleen Yuan is Taibai, Kidney Yuan is Taixi, Shaoyin Yuan is Duigu, Gallbladder Yuan is Qiuxu, Stomach Yuan is Chongyang, Sanjiao Yuan is Yangchi, Bladder Yuan is Jinggu, Large Intestine Yuan is Hegu, Small Intestine Yuan is Wangu. Why do all Twelve Meridians use Shu as Yuan? Answer: The Shu points of the Five Zang are where Sanjiao travels and Qi accumulates. Why is the Shu traveled by Sanjiao called Yuan? Answer: The Moving Qi between the kidneys below the navel is human life and the root of the Twelve Meridians, hence named Yuan. Sanjiao is the special envoy of Yuan Qi, primarily circulating Three Qi through the Zang-Fu. Yuan is the honorific title of Sanjiao; thus, wherever it stops, it is Yuan. For diseases of the Zang-Fu, one selects their Yuan points.
Taiyuan is in the depression posterior to the palm, the pouring point of Hand-Taiyin, the meeting of pulses. Daling is in the depression between the two tendons at the transverse crease of the wrist, the pouring point of Hand-Jueyin.
Taichong is two cun posterior to the metatarsophalangeal joint of the great toe, the pouring point of Foot-Jueyin. Taibai is under the medial malleolus bone, the pouring point of Foot-Taiyin. Taixi is in the depression behind the medial malleolus over the arterial pulse, the pouring point of Foot-Shaoyin. Duigu, also known as Shenmen, is in the depression at the end of the sharp bone posterior to the wrist, opposite the little finger, the pouring point of Hand-Shaoyin. Qiuxu is in the depression anterior to the lateral malleolus, the passing point of Foot-Shaoyang. Chongyang is in the arterial pulse between the high bones five cun above the foot dorsum, two cun from Xiangu, the passing point of Foot-Yangming, also called Duyang in Zhang Zhongjing's work. Yangchi is in the depression on the dorsal wrist opposite the wrist joint, the passing point of Hand-Shaoyang. Jinggu is in the depression at the red-white flesh border below the large bone posterior to the fifth metatarsophalangeal joint, the passing point of Foot-Taiyang. Hegu, also known as Hukou, is in the depression between the first and second metacarpal bones, the passing point of Hand-Yangming. Wangu is in the depression anterior to the wrist bone on the lateral hand, the passing point of Hand-Taiyang. The Yuan of Sanjiao is located at the Moving Qi between the kidneys below the navel, the root of life and the Twelve Meridians. Sanjiao manages this Yuan Qi, distributing Upper, Middle, and Lower Qi to the Shu points of the Zang-Fu. Because it passes through, Shu can also be called Yuan. Is Yuan not the honored title of Sanjiao? Since diseases of Zang-Fu utilize the Yuan points of the Twelve Meridians, is Sanjiao not the great Fu organ governing all Zang-Fu?
Difficulty 67 asks: Why are the Mu points of the Five Zang all on the Yin (anterior) side, and Shu points on the Yang (posterior) side? Answer: Yin diseases manifest on Yang, and Yang diseases manifest on Yin; thus, Mu points are on Yin, and Shu points on Yang.
This chapter explains the rationale for Mu and Shu locations. Yin belongs to the abdomen, where Mu points reside. Yang belongs to the back, where Shu points reside. Mu means gathering, the convergence of Meridian Qi. Shu means transferring, transmitting from one to another. Mu and Shu are nodes for the circulation of Qi, Blood, Yin, and Yang, and pathogens enter/exit here. If disease is in Yin, Shu allows transmission to Yang; if in Yang, Mu allows transmission to Yin; otherwise, blockage occurs. Hence, Mu on Yin, Shu on Yang. This is best illustrated by Malaria. Malaria arises from external Summerheat-Dampness and internal Cold-Damage. Pathogens hide in the Mu-Yuan. Pathogen moving to Yang causes heat; moving to Yin causes chills. Shallow invasion leads to daily attacks; deep invasion leads to alternate-day attacks. Deeper invasion causes multi-day intervals. This proves Yin diseases affecting Yang and vice versa.
Mu points of the Five Zang: Lung-Mu Zhongfu, Heart-Mu Juque, Spleen-Mu Zhangmen, Liver-Mu Qimen, Kidney-Mu Jingmen.
Difficulty 68 asks: What do the Jing, Ying, Shu, Jing, He points of the Five Zang and Six Fu govern? Answer: The classic says outflow is Jing, trickling is Ying, pouring is Shu, flowing is Jing, entering is He. Jing governs chest fullness; Ying governs body heat; Shu governs heaviness and joint pain; Jing governs wheezing, coughing, and chills/fever; He governs rebellious Qi and diarrhea. These are the indications for the Jing, Ying, Shu, Jing, He points of the Zang-Fu.
From Difficulty 62 to here, the Jing, Ying, Shu, Yuan, Jing, He points are explained; subsequently, needling methods are detailed. Ji said: Jing is like a water source, initially slight, hence Ying. Water flows down and is承接, hence Shu. Water flows through, hence Jing. It enters the Zang-Fu and meets other meridians, hence He. *Suwen* says: Six Meridians are rivers, Intestines/Stomach are seas. Fan said: Jing corresponds to Wood/Liver. Spleen is located below the heart; Liver evil invades Spleen, causing chest fullness. Treating Jing prevents Wood from overcoming Earth. Ying corresponds to Fire/Heart. Lung is Metal, governing skin/hair; Heart Fire burns Lung Metal, causing fever. Treating Ying prevents Fire from overcoming Metal. Shu corresponds to Earth/Spleen. Earth evil overcomes Water/Kidney; Kidney governs bones, causing joint pain. Earth disease causes heaviness. Treating Shu addresses this. Jing corresponds to Metal/Lung. Lung cold causes cough, heat causes wheezing. Metal overcomes Wood/Liver; Liver emotion is anger, causing rebellious Qi and wheezing. Treating Jing addresses this. He corresponds to Water/Kidney. Kidney Qi deficiency injures Chong Mai, causing rebellious Qi. Kidney opens to two orifices; rebellious Qi causes diarrhea. Treating He addresses this. The Five Zang and Six Fu have Jing, Ying, Shu, Jing, He points; only Fu have Yuan points, listed separately.
Difficulty 69 states: The classic says tonify deficiency, sedate excess, and treat non-deficient/non-excess conditions via the Meridian. What does this mean? Answer: Tonify the Mother of deficiency, sedate the Child of excess. When treating excess, tonify first, then sedate. Non-deficient/non-excess conditions indicate the primary meridian is diseased without external pathogens; thus, treat the meridian itself.
This chapter outlines the major principles of tonification and sedation in acupuncture, applicable also to herbal medicine. Mother-Child relationships are deduced via Five Elements. Tonifying before sedating implies that to sedate the Child, one must first tonify the Mother. This shows the ancients prioritized securing the Root.
Difficulty 70 states: The classic says shallow needling in Spring/Summer, deep in Autumn/Winter. Why? Answer: In Spring/Summer, Yang Qi is superior, and human Qi is superior; thus, needle shallowly. In Autumn/Winter, Yang Qi is inferior, and human Qi is inferior; thus, needle deeply.
This emphasizes that needling depth depends on obtaining Deqi (Qi arrival); shallow Qi requires shallow needling, deep Qi requires deep needling.