凡将用针。必先诊脉。辨其虚实。五脏之气已绝内外者。针之即死。邪正俱虚。其
脉小。不可用针而应调以甘药。均详于上。其有邪正俱实。当用纯泻法、如邪实正虚。
当先泻而后补之。补泻反。则病益笃。男内女外。男外女内。亦详于前。其补泻有太过
不及者。亦能为害。例如邪气实而正气虚。邪气至针下。紧而急。谷气至针下。徐而
和。如医者针下不善分析。谷气已至而仍用泻针。则耗损精专之营（一）。营者水谷之
精气。此所谓刺之害中而不去则精泄。精泄则病益甚而 也。反言之。邪正俱实。邪气
未尽。谷气未至而针下紧急。当续用泻法。尽除其邪气。如指下针下不明。骤然出针。
则余邪蕴于中。或生痈疡。此所谓害中而去则致气。致气则生痈疡。用针者。不可不慎
也。此针害之概要。
灵枢经法时篇云。补泻反则病益笃。难经七十八难曰。男外女内。不得气。是谓十
死不一治。
十二禁针
（一）男外（一）失气。
（二）女内（一）失气。
（三）新内勿刺。已刺勿内。
（四）已醉勿刺。已刺勿醉。
（五）新怒勿刺。已刺勿怒。
（六）新劳勿刺。已剌勿劳。
（七）已饱勿刺。已刺勿饱。
（八）已饥勿刺。已刺勿饥。
（九）已渴勿刺。已刺勿渴。
（十）大惊大恐。必定其气乃刺之。
（十一）乘车来者。卧而休之。如食顷。乃刺之。
（十二）出行来者。坐而休之。如行十里顷。乃刺之。
忌灸者八穴（二）
少商 鱼际 经渠 劳宫 阳池 少海 委中 阴陵泉
歌曰 环周八穴灸无功。足下阴陵泉委中。鱼际经渠少商穴。阳池少海与劳宫。
妊妇忌针者二穴（三）
合谷 昆仑
歌曰 环周二穴慎施针。合谷昆仑可坠妊。妙手安胎亦有术。先从足下补三阴。
凡是准备使用针刺治疗，必须先诊察脉象，辨别病证的虚实。如果五脏之气在体内和体表都已衰竭，此时施针会导致死亡。若邪气与正气俱虚，脉象细小，不可使用针刺，而应当用甘味药物进行调理，这些内容在前面已有详细说明。如果有邪气与正气俱实的情况，应当采用纯泻法；如果是邪气实而正气虚，应当先泻后补。如果补法和泻法使用反了，病情就会加重。关于男子宜泻外（体表）女子宜补内（体内），以及男子宜补内女子宜泻外的原则，前面也已详述。如果补泻手法有过之或不及，也会造成危害。例如，邪气盛而正气虚，当邪气到达针下时，感觉紧而急；当谷气（正气）到达针下时，感觉徐缓而柔和。如果医生在针下不能善于分析，在谷气已经到达时仍然使用泻法，就会耗损精专的营气。营气是水谷化生的精气，这就是所说的“刺中要害却不去除病邪，就会导致精气泄脱；精气泄脱则病情更加严重”。反过来讲，如果邪正俱实，邪气未尽，谷气未至，而针下感觉紧急，应当继续使用泻法，彻底清除邪气。如果指下和针下的感觉不明确，就突然出针，那么余邪就会蕴结在体内，或者产生痈疡。这就是所说的“害中而去则致气，致气则生痈疡”。使用针刺的人，不可不谨慎啊。这是针刺危害的大概概要。
《灵枢·经法时篇》说：补泻反了，病情就会加重。《难经·七十八难》说：男子应泻外、女子应补内，如果不得气，就是十死一生，难以治愈。
十二种禁针情况：
（一）男子泻外（一）导致失气。
（二）女子补内（一）导致失气。
（三）刚行房事不要针刺，已针刺不要行房事。
（四）刚喝醉不要针刺，已针刺不要喝酒。
（五）刚发怒不要针刺，已针刺不要发怒。
（六）刚劳累不要针刺，已针刺不要劳累。
（七）刚吃饱不要针刺，已针刺不要吃饱。
（八）刚饥饿不要针刺，已针刺不要饥饿。
（九）刚口渴不要针刺，已针刺不要口渴。
（十）大惊大恐者，必须待其气血安定后再针刺。
（十一）乘车来就诊者，让其躺下休息片刻，约一顿饭的时间，然后再针刺。
（十二）步行来就诊者，让其坐下休息，约行走十里路所需的时间，然后再针刺。
忌灸的八个穴位：
少商、鱼际、经渠、劳宫、阳池、少海、委中、阴陵泉。
歌诀曰：环周八穴灸无功，足下阴陵泉委中。鱼际经渠少商穴，阳池少海与劳宫。
Whenever acupuncture is to be performed, the pulse must first be diagnosed to differentiate between deficiency and excess. If the Qi of the five Zang organs is exhausted both internally and externally, needling will result in death. When both pathogenic factors and healthy Qi are deficient, and the pulse is small, acupuncture should not be used; instead, sweet medicines should be employed for regulation, as detailed previously. In cases where both pathogenic factors and healthy Qi are excessive, a pure reducing method should be applied. If pathogenic factors are excessive while healthy Qi is deficient, reduction should precede tonification. Reversing the methods of tonification and reduction will exacerbate the disease. The principles regarding men being treated by reducing the exterior and tonifying the interior, and women by tonifying the interior and reducing the exterior, have also been detailed earlier. Improper application of tonification and reduction, whether excessive or insufficient, can also cause harm. For instance, when pathogenic factors are excessive and healthy Qi is deficient, the sensation at the needle tip when pathogenic factors arrive is tight and rapid, whereas when Gu Qi (Grain Qi, representing healthy Qi) arrives, it feels slow and mild. If the practitioner fails to analyze these sensations correctly and continues to use reducing techniques after Gu Qi has arrived, it will deplete the Ying Qi (Nutritive Qi), which is the refined essence derived from food and water. This is referred to as "hitting the target but failing to remove the pathogen leads to leakage of essence; leakage of essence causes the disease to worsen." Conversely, if both pathogenic factors and healthy Qi are excessive, and the pathogen has not yet been fully expelled while Gu Qi has not yet arrived, the needle sensation remains urgent. In such cases, reducing techniques should continue until the pathogen is completely eliminated. If the practitioner is unclear about the sensations under the finger and needle and withdraws the needle abruptly, residual pathogens may accumulate internally, potentially leading to carbuncles or sores. This is described as "harming the center and withdrawing leads to stagnation of Qi; stagnation of Qi generates carbuncles and sores." Practitioners must exercise extreme caution. This summarizes the general hazards of acupuncture.
The *Ling Shu: Jing Fa Shi Pian* states: "Reversing tonification and reduction exacerbates the disease." The *Nan Jing: Difficulty 78* states: "Men should reduce the exterior and women tonify the interior; failure to obtain De Qi indicates ten deaths for every one cure."
Twelve Prohibitions for Acupuncture:
(1) Reducing the exterior in men leads to loss of Qi.
(2) Tonifying the interior in women leads to loss of Qi.
(3) Do not needle immediately after sexual intercourse; do not engage in intercourse immediately after needling.
(4) Do not needle when intoxicated; do not drink alcohol immediately after needling.
(5) Do not needle when angry; do not become angry immediately after needling.
(6) Do not needle when fatigued; do not exert yourself immediately after needling.
(7) Do not needle when full; do not eat heavily immediately after needling.
(8) Do not needle when hungry; do not remain hungry immediately after needling.
(9) Do not needle when thirsty; do not remain thirsty immediately after needling.
(10) In cases of great fright or terror, wait until the Qi stabilizes before needling.
(11) For patients arriving by carriage, allow them to lie down and rest for approximately the time it takes to eat a meal before needling.
(12) For patients arriving on foot, allow them to sit and rest for approximately the time it takes to walk ten Li before needling.
Eight Acupoints Contraindicated for Moxibustion:
Shaoshang (LU-11), Yuji (LU-10), Jingqu (LU-8), Laogong (PC-8), Yangchi (TE-4), Shaohai (HT-3), Weizhong (BL-40), Yinlingquan (SP-9).
Rhyme:
Moxibustion on these eight acupoints around the circumference is ineffective;
Yinlingquan and Weizhong are located on the lower limbs.
Yuji, Jingqu, and Shaoshang points;
Yangchi, Shaohai, and Laogong.
Two Acupoints Contraindicated for Pregnant Women:
Hegu (LI-4), Kunlun (BL-60).
Rhyme:
Exercise caution with these two acupoints around the circumference;
Hegu and Kunlun may induce abortion.
Skilled practitioners also have methods to secure the fetus;
Begin by tonifying Sanyinjiao (SP-6) on the lower limbs.