马云。内有九针之名。又有十二原穴。故名篇。自篇内小针之要以下。岐伯尽解于第三篇小针解之内。
素问有针解篇。亦与此二篇小同。当合三篇而观之。其义无余蕴矣。旧本以第一篇为法天。第二篇为法地。三
篇法人。四篇法时。五篇法音。六篇法律。七篇法星。八篇法风。九篇法野。乃后人袭本经七十八篇九针论之
意而分注之。殊不知彼乃论针。而非论篇目也。甚为无理。简案本经多不下编字论字。乃所以为古书也。
余子万民 马云。按本纪、记帝经土设井。立步制。亩艺五谷。抚万民。则子万民。收租税信矣。
百姓 国语周语注。百姓、百官有世功者。又书尧典孔传。百姓百官。
租税 租税、田赋也。又凡赋取者曰税。史、食货志。食租衣税。
不给而属有疾病 给、相足也。属、附也。
微针 志云。按篇名九针。而帝曰微针。伯曰小针。是九针之外。又立小针也。简案、微针小
针。盖谓九针中之毫针。下文曰。尖如蚊虻喙。静以取往。微以久留之是也。
营其逆顺出入之会 志云。皮肤经脉之血气。有逆顺之行。有出入之会。简案、营。运也。
易用难忘 志云。明其理则易用。持于心则难忘。
经纪 志云。经、径。纪、维也。月令郑注。经纪。
谓天文进退度数。
为之终始 志云。九针者。圣人起天地之数。始于一而终于九。九而九之。九九八十一。以起黄
钟之数。
先立针经 张云。灵枢即名针经。义本诸此。
易陈而难入 张云。易陈者。常法易计也。难入者。精微难及也。志云。易言而难着于人也。
粗守形 上守神 马云。下工泥于形迹。徒守刺法。上工则守人之神。凡人之血气虚实。可补可
泻。一以其神为主。不但用此针法而已也。
神乎 神客在门 马云。所谓神者。人之正气也。神乎哉。此正气不可不守也。邪气之所感。有
时如客之往来有期。名之曰客。客在门者。邪客于各经之门户也。张云。神乎神。言正气盛衰。当辨于疑似也。
客在门。言邪之往来。当识其出入也。简案、小针解曰。神客者。正邪共会也。神者。正气也。客者。邪气也。
在门者。邪循正气之所出入也。据此。则神乎二字句。神客。谓神与客也。
刺之微 在速迟 马云。刺之微妙。在于速迟。速迟者。即用针有疾徐之意也。
粗守关 上守机 张云。粗守关。守四肢之关节也。上守机。察气至之动静也。
不离其空 马云。素问有骨空论。指各经之穴言。简案、据小针解。空下当有中字。
清静而微 张云。言察宜详慎也。
其来不可逢 其往不可追 志云。如其气方来。乃邪气正盛。邪气盛则正气大虚。不可乘其气
来。即迎而补之。当避其邪气之来。其锐气已往。则邪气已衰而正气将复。不可乘其气往。追而泻之。恐伤其
正气。在于方来方去之微而
发其机也。离合真邪论曰。俟邪不审。大气已过。泻之则真气脱。脱则不复。邪气复至。而病益蓄。故曰。其
往不可追。此之谓也。
不可挂以发 马云。知机之道者。唯此一气而已。犹不可挂一发以间之。志云。静守于来往之间而
补泻之。少差毫发之间。则失矣。
工独有之 甲乙任务上。
往者为逆 来者为顺 张云。往、气之去也。故为之逆。来、气之至也。故为之顺。
正行无问 志本问作间非。
逆而夺之 恶得无虚 追而济之 恶得无实 甲乙。逆、作迎。张云。逆其气至而夺之。泻其实也。
恶得无虚。随其气去而济之。补其虚也。恶得无实。故泻必因吸内针。补必因呼内针。此即迎来随去之义。高
武云。迎者逢其气之方来。如寅时气来注于肺。卯时气来注大肠。此时肺、大肠、气方盛而夺泻之也。随者随
其气之方去。如卯时气去注大肠。辰时气去注于胃、肺、与大肠。此时正虚而补济之也。余仿此。
大要 简案、盖古经篇名。
徐而疾则实 疾而徐则虚 张云。徐出针而疾按之为补。故虚者可实。疾出之而徐按之为泻。故实者
可虚。简案、张据素针解篇释之。与小针解之旨乖。
若有若无 马云。实者止于有气。虚者止于无气。气本无形。似在有无之间耳。
察后与先 张云。求病所急。而治分先后也。若存若亡。察气之行与不行。以为针之去留也。
若得若失 张云。欲虚而虚。欲实而实。是得法也。
粗工妄为。则失之矣。简案、小针解云。为虚与实。若得若失者。言补者 然若有得也。泻则恍然若有失也。
知张注失经旨矣。
补泻之时 针解篇曰。补泻之时者。与气开阖相合也。张云。当补当泻。用有其时。
泻曰 必持内之 放而出之 排阳得针 甲乙作迎之。迎之意。必持而内之。放而出之。排扬出针。
张云。凡用泻者。必持内之。谓因其气来。出之疾而按之徐也。故可排开阳道以泄邪气。简案、据下文补曰。
甲乙近是。
按而引针 是谓内温 简案、连下二句言补法。若病当用泻法。而反按而引针以补之。是谓内温。
引针谓退其针。温、蕴同。乃素问温血之温。谓血气蕴蓄于内。而不得散泄也。诸注并接下文补曰为释。恐误。
意若妄之 志云。之、往也。张云。妄、虚妄也。意若妄之。言意会于有无之间也。妄、甲乙作忘。
若行若按 若蚊虻止 张云。若行若按。言行其气。按其处也。若蚊虻止。言当轻巧无迹。而用
得其精也。
如留如还 去如弦绝 张云。留、留针也。还、出针也。去如弦绝。轻且捷也。故无损而能补。
还、甲乙作环。
令左属右 张云。右手出针。左手随而按扪之。是令左属右也。
必无留血 急取诛之 马云。如有留血。当急取以责之。但此补法。必无留血者。张云。凡取血
络者。不可使有留血。宜急取之也。志云。此补正运邪之法。故必无留血。设有留血。急取而诛之。简案、以
理推之。此间恐有遗脱。
坚者为宝 甲乙宝作实。王注素针解篇。手如握虎者。欲其壮也。云壮、谓持针坚定也。针经曰。
持针之道。坚者
为实。则其义也。新校正云。按甲乙经。实字作宝。乃与今本异。
正指直刺 简案、针解篇云。义无邪下者。欲端以正也。王注正指直刺。针无左右。
神在秋毫 张云。医之神见。在悉秋毫。必精必确。
属意病者 针解篇云。神无营于众物者。静志观病患。无左右视也。王注。目绝妄视。心专一务。
则用之必中。无或误也。
审视血脉 马云。审视其血脉之虚实而刺之。则无危殆矣。
必在悬阳 及与两卫 甲乙必作心。卫作衡。注云。一作冲。张云。悬、犹言举也。阳、神气也。凡
刺之时。必先举神气为主。故曰悬阳。两卫者。卫气在阳。肌表之卫也。脾气在阴。脏腑之卫也。二者皆神气
所居。不可伤犯。凡用针者。首宜顾此。故曰两卫。简案、马阳为扬。志以悬阳为心。并义难通。姑仍张注。
血脉者 甲乙。血上有取字是。
在 横居 视之独澄 切之独坚 甲乙。澄、作满。志云。 、经 也。刺节真邪篇曰。六经调者。
谓之不病。一经上实下虚而不通者。此必有横络盛大加于经。令之不通。视而泻之。此取谓解结也。故有血络
横在于经 者。当视之独清。切之独确。而去之也。张云。视之独澄者。必欲索其隐。切之独坚者。欲拔其本也。
针。 、锄衔切。犁铁也。说文。锐器也。史扁鹊传。 石注。 、石针也。
针。 、音时。又音低。镝也。箭镞也。
锋针。锋、王本作蜂非。
铍针。铍、音皮。说文。大针也。
毫针长三寸六分 九针论作一寸六分是。吴氏尊经集云。毫针又名小针。取用益多。犹布帛菽粟。
为日用之所急也。马云。此言九针之体。而及其所以为用也。大义见本经九针论。第七十八篇。故此不详解之。
今亦从此。
介按、考针类有九种。分述如后。
一曰 针。即今之箭头针也。此针长一寸六分。上去末寸半。下只留一分之锋。欲浅刺不令深入也。二曰
圆针。即絮针也。长一寸六分。取其筒其身而卵其锋者。身直如竹筒。末锋员如卵锐也。 三曰 针。长三寸
半。取法于黍粟之锐者。圆而微尖。利于用补者也。 四曰锋针。即今日之三棱针也。长一寸六分。是上去八
分。下留八分。取法于絮针刃三隅者。谓直壮而锐。可以泻热出血也。五曰铍针。长四寸。广二分半。取法于
剑锋。以其能开通也。 六曰圆利针。其形微大。其末反小。其身长一寸六分。取法于 者。以毛之强者曰 。
用其细健可稍深也。七曰毫针。长二寸六分。其尖如蚊虻喙者。取其微细徐缓也。八曰长针。长七寸。取法于綦
针。以能使深邪出远痹也。九曰大针。长四寸。尖形如挺。粗而且巨。其锋微圆。取法于锋针。可以泻通机关也。
如 前王莽传。师古注。毛之强曲者曰 。又后汉岑彭传。注 。长毛也。
以取暴气 甲乙云。痹气暴发者。取以圆利针。张云。暴气。痹气之暴发也。
静以取往 诸本取作徐。当改。
如挺 道藏本挺作 。简案、挺 同。杖也。
邪气在上 马云。邪气之中人也高。凡风寒暑雨之邪。
由上感之。故曰邪气在上也。 此以下。当参考小针解。
陷脉 张云。诸经孔穴。多在陷者之中。故凡欲去寒邪。须刺各经陷脉。则经气行而邪气出。乃所
以取阳邪之在上者。志云。陷脉、额颅之脉。显陷于骨中。故针陷脉。则阳气之表邪去矣。简案、张注为是。
中脉 小针解云。取之阳明合也。马云。阳明合。即足三里也。
病各有所宜 甲乙宜、作舍。是。
无实无虚 甲乙作无实宝虚虚是。
五脉 张云。五脉者。五脏五输也。志云。五脏诸阴之脉也。义具小针解。
三脉 据小针解。当三阳之脉。
马云 曲王切。不足也。张云。音匡。衰残也。志云。怯也。
夺阴者死 甲乙死、作厥。简案、与小针解之义不合。
若风之吹云 志云。邪散而正气光明也。
明乎若见苍天 甲乙作昭然于天。
经脉十二 络脉十五 凡二十七气 张云。脏有五。腑有六。而复有手厥阴心主一经。是为十二经。
十二经各有络脉。如手太阴别络在列缺之类是也。此外又有任脉之络曰屏翳。督脉之络曰长强。脾之大络曰大
包。共为十五络。十二十五。总二十七气。以通周身上下也。
所出为井 马云。其始所出之穴名为井穴。如水之所出。从山下之井始也。六十三难杨注云。凡脏
腑皆以井为始。井者谓谷井尔。非谓掘作之井。山谷之中。泉水初出之处。名之曰井。井者主出之义也。马云。
如肺经少商之类。水从此而流。则为荥穴。
所溜为荥 史云溜。按难经当作流。马云。如肺经鱼际之类。又从此而注。则为 穴。张云。急
流曰溜。小水曰荥。脉出于井而溜于荥。其气尚微也。简案、急流曰溜。未见所据。六十三难杨注云。泉水既
生。留停于近荥。迂未成大流。故名之曰荥。荥、小水之状也。此溜读为留也。然六十八难明言所流为荥。今
从史说。
所注为 马云。 者注此而输运之也。如肺经大渊之类。又从而经过之。则为经穴。张云。注、
灌注也。 、输运也。脉注于此而输于彼。其气渐盛也。
所行为经 张云。脉气大行。经营于此。其正盛也。六十三难杨注云。经者径也。亦经营之义也。
马云。如肺经经渠之类。又从而水有所会。则为合穴。
所入为合 张云。脉气至此。渐为收藏。而入合于内也。马云。如肺经尺泽之类。六十三难杨注云。
经行既达。合会于海。故名之曰合。合者会也。
知其要者 马云。凡节之所交。计三百六十五会。实经络渗灌诸节者也。此节者乃要之所在。张
云。其要则在乎五 而已。志云。血者神气也。二十七气。三百六十五会。总属血气之流行。故曰知其要者。
一言而终。简案、今从志注。
重竭 张云。脏气已绝于内。阴虚也。反实其外。误益阳也。益阳则愈损其阴。是重竭也。阴竭
必死。死则静也。
取腋与膺 张云。腋与膺。皆脏脉所出。气绝于内。而复取之。则致气于外。而阴愈竭矣。
逆厥 张云。脏气已绝于外。阳虚也。反实其内。误补阴也。助阴则阳气愈竭。故致四逆而厥逆。
厥必死。死必躁也。
反取四末 张云。四末为诸阳之本。气绝于外。而取其本。则阴气至而阳愈陷矣。
害中而去则致气 张云。害中而不去。去针太迟也。不中而去。去针太早也。均足为害。此节与
寒热病篇文同。但彼云不中而去。则致气者是。此云害中者误也。简案、害、当作不。张注为是。
痈疡 寒热病篇作痈疽。张云。不中而去。则病未除而气已致。故结聚而为痈疽。皆刺之害也。
十二原出于四关 张云。脏腑之气。表里相通。故五脏之表有六腑。六腑之外有十二原。十二原
出于四关。四关者。即两肘两膝。乃周身骨节之大关也。故凡井、荥、 、原、经、合、穴。皆手不过肘。足
不过膝。而此十二原者。故可以治五脏之疾。
马云：篇中既有“九针”之名，又有“十二原穴”，因此以该名称命名篇章。从本篇“小针之要”以下的内容开始，岐伯在第三篇《小针解》中全部进行了详细解答。
《素问》中有《针解》篇，与此两篇中的“小针”部分内容大致相同，应当将这三篇合在一起阅读，其中的义理就没有遗漏了。旧版刻本将第一篇解释为效法天，第二篇效法地，第三篇效法人，第四篇效法时，第五篇效法音，第六篇效法律，第七篇效法星，第八篇效法风，第九篇效法野。这是后人袭用本经第七十八篇《九针论》的意思而分别加注的，却不知道那是在论述针具，而不是在论述篇章标题，这非常没有道理。简案：本经大多不编排“字”或“论”的字样，这正是古书的特点。
余子万民：马云按语：根据《史记·五帝本纪》和《尚书·禹贡》，黄帝在土德兴盛时设立井田制度，确立步距，划分亩制，种植五谷，抚育万民，所以称为“子万民”（爱护百姓如子女），收取租税是确凿无疑的。
百姓：《国语·周语》注解说：“百姓”指世代有功绩的百官。又据《尚书·尧典》孔安国传：“百姓”即百官。
租税：租税即田赋。另外，凡是征收赋取的行为都叫税。《史记·平准书》（食货志）中有“食租衣税”的说法。
不给而属有疾病：“给”意为相互补充、满足；“属”意为附着、连接。
微针：《太素》记载：按篇名虽为“九针”，但黄帝称其为“微针”，岐伯称其为“小针”。这说明在九针之外，又设立了小针的概念。简案：“微针”和“小针”大概是指九针中的毫针。下文说：“尖如蚊虻喙，静以取往，微以久留之”，说的就是这种情况。
营其逆顺出入之会：《太素》记载：皮肤和经脉中的血气，运行有逆顺之分，有出入交会之处。简案：“营”意为运行。
易用难忘：《太素》记载：明白了其中的道理就容易运用，铭记在心中就不会忘记。
经纪：《太素》记载：“经”意为径路，“纪”意为纲维。《礼记·月令》郑玄注：“经纪”指天文运行的进退度数。
为之终始：《太素》记载：九针是圣人依据天地之数创立的，从一数开始，到九数结束。九乘以九，八十一，以此推演黄钟律管的数目。
易陈而难入：张景岳云：“易陈”指常规法则容易计算掌握；“难入”指精微之处难以达到。《太素》云：言语浅显易懂，但难以让人深刻领悟。
粗守形 上守神：马云：下工拘泥于形体表象，只死守刺法；上工则守护病人的神气。凡人的血气虚实，可以补也可以泻，一切以神气为主导，不仅仅局限于某种针法而已。
神乎 神客在门：马云：所谓“神”，指的是人体的正气。“神乎哉”，意思是正气不可不守护。邪气的侵袭，有时像客人一样往来有定期，所以称之为“客”。“客在门”，指邪气客居在各条经脉的门户处。张景岳云：“神乎神”，是说正气的盛衰应当在疑似之间加以辨别。“客在门”，是说邪气的往来，应当识别其出入。简案：《小针解》说：“神客者，正邪共会也。”神是正气，客是邪气。在门，指邪气顺着正气出入的路径而来。据此，“神乎”二字句意应为“神”与“客”。
刺之微 在速迟：马云：针刺的微妙之处，在于速度的快慢。速迟，即用针时有疾徐之意。
粗守关 上守机：张景岳云：“粗守关”，是守住四肢的关节；“上守机”，是观察气至的动静。
不离其空：马云：《素问》有《骨空论》，指各经的穴位而言。简案：据《小针解》，“空”字下应当有“中”字。
其来不可逢 其往不可追：《太素》记载：如果气方来，那是邪气正盛，邪气盛则正气大虚，不可乘其气来之际，即迎而补之，应当避开邪气之来势。当其锐气已去，则邪气已衰而正气将复，不可乘其气往之际，追而泻之，恐怕损伤正气。应当在气方来方去的微妙时刻，发动针机。《离合真邪论》说：“俟邪不审，大气已过，泻之则真气脱，脱则不复，邪气复至，而病益蓄。”所以说“其往不可追”，就是这个意思。
不可挂以发：马云：懂得把握时机之道的人，只关注这一股气罢了，就像不能挂住一根头发来间隔它一样（意指时机稍纵即逝）。《太素》云：在气往来之间静守进行补泻，稍微差之毫发，就会失误。
工独有之：《甲乙经》作“上独有之”。
往者为逆 来者为顺：张景岳云：往，指气之离去，所以称为逆；来，指气之到来，所以称为顺。
正行无问：《太素》本“问”作“间”，非。
逆而夺之 恶得无虚 追而济之 恶得无实：《甲乙经》：“逆”作“迎”。张景岳云：逆其气至而夺之，是泻其实，怎么能不虚呢？随其气去而济之，是补其虚，怎么能不实呢？所以泻必因吸气时进针，补必因呼气时进针。这就是“迎来随去”的意义。高武云：迎，是逢其气之方来，如寅时气来注于肺，卯时气来注大肠，此时肺、大肠之气正盛而夺泻之。随，是随其气之方去，如卯时气去注大肠，辰时气去注于胃、肺与大肠，此时正气正虚而补济之。其余仿此类推。
大要：简案：大概是古经的篇名。
徐而疾则实 疾而徐则虚：张景岳云：慢出针而快按压为补，所以虚者可变实；快出针而慢按压为泻，所以实者可变虚。简案：张景岳依据《素问·针解》篇解释，与《小针解》的宗旨相违背。
若有若无：马云：实证止于有气感，虚证止于无气感。气本来无形，似乎存在于有无之间。
察后与先：张景岳云：探求疾病的急缓，治疗分先后。若存若亡，观察气的运行与否，来决定针的去留。
若得若失：张景岳云：想要虚而变虚，想要实而变实，这就是得法。
粗工妄为，则失之矣：简案：《小针解》说：“为虚与实，若得若失者”，意思是补的时候恍然若有得，泻的时候恍然若有失。张景岳的注解偏离了经文主旨。
补泻之时：《针解》篇说：“补泻之时者，与气开阖相合也。”张景岳云：当补当泻，使用有其时机。
泻曰 必持内之 放而出之 排阳得针：《甲乙经》作“迎之”。迎之意，必持而内之，放而出之，排扬出针。张景岳云：凡是使用泻法，必持针而入，意为趁其气来，出针快而按压慢。所以可排开阳道以泄邪气。简案：据下文“补曰”，《甲乙经》的说法更接近。
按而引针 是谓内温：简案：连下两句讲补法。如果病应当用泻法，反而按而引针以补之，这叫“内温”。“引针”指退针，“温”通“蕴”，即《素问》中“温血”的温，指血气蕴蓄于内而不能散泄。诸家注释都接下文“补曰”来解释，恐怕有误。
意若妄之：《太素》云：“之”意为往。张景岳云：“妄”意为虚妄。“意若妄之”，意思是意念领会于有无之间。“妄”，《甲乙经》作“忘”。
若行若按 若蚊虻止：张景岳云：“若行若按”，指行其气，按其部位。“若蚊虻止”，指应当轻巧无痕迹，而用得精妙。
如留如还 去如弦绝：张景岳云：“留”，留针；“还”，出针。“去如弦绝”，轻且快。所以无损而能补。“还”，《甲乙经》作“环”。
令左属右：张景岳云：右手出针，左手随即按扪，这就是“令左属右”。
必无留血 急取诛之：马云：如果有留血，应当急取以责治。但这既然是补法，必然不会有留血。张景岳云：凡是取血络者，不可使有留血，宜急取之。《太素》云：这是补正运邪之法，所以必无留血。设有留血，急取而诛之。简案：以理推断，此处恐怕有文字脱漏。
坚者为宝：《甲乙经》“宝”作“实”。王冰注《素问·针解》篇：“手如握虎者”，欲其壮也。“壮”，谓持针坚定也。《针经》说：“持针之道，坚者为实”，则其义如此。新校正云：按《甲乙经》，“实”字作“宝”，乃与今本不同。
正指直刺：简案：《针解》篇云：“义无邪下者”，欲端以正也。王冰注：“正指直刺”，针无左右偏斜。
神在秋毫：张景岳云：医者的神见，在于详察秋毫，必须精微确切。
属意病者：《针解》篇云：“神无营于众物者”，静志观病患，无左右视也。王冰注：目绝妄视，心专一务，则用之必中，无或误也。
必在悬阳 及与两卫：《甲乙经》“必”作“心”，“卫”作“衡”。注云：一作“冲”。张景岳云：“悬”，犹言举也；“阳”，神气也。凡刺之时，必先举神气为主，故曰“悬阳”。“两卫”者，卫气在阳，为肌表之卫；脾气在阴，为脏腑之卫。二者皆神气所居，不可伤犯。凡用针者，首宜顾此，故曰“两卫”。简案：马云认为“阳”为“扬”，《太素》以“悬阳”为“心”，并义难通，姑且保留张景岳的注释。
血脉者：《甲乙经》“血”上有“取”字是对的。
在 横居 视之独澄 切之独坚：《甲乙经》“澄”作“满”。《太素》云：“ ”是经脉的意思。《刺节真邪》篇说：“六经调者，谓之不病。一经上实下虚而不通者，此必有横络盛大加于经，令之不通。视而泻之，此取谓解结也。”故有血络横在于经 者，当视之独清，切之独确，而去之也。张景岳云：“视之独澄者”，必欲索其隐；“切之独坚者”，欲拔其本也。 针，“ ”音锄衔切，犁铁也。《说文》：锐器也。《史记·扁鹊传》 石注：“ ”为石针。 针，“ ”音时，又音低，镝也，箭镞也。
锋针：锋，王本作“蜂”，非。
铍针：铍，音皮。《说文》：大针也。
毫针长三寸六分：《九针论》作一寸六分是对的。吴氏《尊经集》云：毫针又名小针，取用最多，犹如布帛菽粟，为日用之所急。马云：此言九针之体，及其所以为用的道理。大义见于本经第七十八篇《九针论》，故此不详解。今亦从此说。
介按：考针类有九种，分述如下：
一曰 针，即今之箭头针也。此针长一寸六分，上去末寸半，下只留一分之锋，欲浅刺不令深入也。二曰圆针，即絮针也，长一寸六分，取其筒其身而卵其锋者，身直如竹筒，末锋员如卵锐也。 三曰 针，长三寸半，取法于黍粟之锐者，圆而微尖，利于用补者也。 四曰锋针，即今日之三棱针也，长一寸六分，是上去八分，下留八分，取法于絮针刃三隅者，谓直壮而锐，可以泻热出血也。五曰铍针，长四寸，广二分半，取法于剑锋，以其能开通也。 六曰圆利针，其形微大，其末反小，其身长一寸六分，取法于 者，以毛之强者曰 ，用其细健可稍深也。七曰毫针，长二寸六分，其尖如蚊虻喙者，取其微细徐缓也。八曰长针，长七寸，取法于綦针，以能使深邪出远痹也。九曰大针，长四寸，尖形如挺，粗而且巨，其锋微圆，取法于锋针，可以泻通机关也。如 前王莽传，师古注：毛之强曲者曰 。又后汉岑彭传，注 ：长毛也。
以取暴气：《甲乙经》云：痹气暴发者，取以圆利针。张景岳云：暴气，痹气之暴发也。
静以取往：诸本“取”作“徐”，当改。
如挺：道藏本“挺”作 。简案：“挺 ”同，杖也。
邪气在上：马云：邪气之中人也高，凡风寒暑雨之邪，由上感之，故曰“邪气在上”也。此以下，当参考《小针解》。
陷脉：张景岳云：诸经孔穴，多在陷者之中，故凡欲去寒邪，须刺各经陷脉，则经气行而邪气出，乃所以取阳邪之在上者。《太素》云：陷脉，额颅之脉，显陷于骨中，故针陷脉，则阳气之表邪去矣。简案：张注为是。
中脉：《小针解》云：取之阳明合也。马云：阳明合，即足三里也。
病各有所宜：《甲乙经》“宜”作“舍”，是。
五脉：张景岳云：五脉者，五脏五输也。《太素》云：五脏诸阴之脉也。义具《小针解》。
三脉：据《小针解》，当为三阳之脉。
马云：曲王切，不足也。张景岳云：音匡，衰残也。《太素》云：怯也。
夺阴者死：《甲乙经》“死”作“厥”。简案：与《小针解》之义不合。
若风之吹云：《太素》云：邪散而正气光明也。
明乎若见苍天：《甲乙经》作“昭然于天”。
经脉十二 络脉十五 凡二十七气：张景岳云：脏有五，腑有六，而复有手厥阴心主一经，是为十二经。十二经各有络脉，如手太阴别络在列缺之类是也。此外又有任脉之络曰屏翳，督脉之络曰长强，脾之大络曰大包，共为十五络。十二十五，总二十七气，以通周身上下也。
所出为井：马云：其始所出之穴名为井穴，如水之所出，从山下之井始也。《难经·六十三难》杨玄操注云：凡脏腑皆以井为始，井者谓谷井尔，非谓掘作之井。山谷之中，泉水初出之处，名之曰井，井者主出之义也。马云：如肺经少商之类，水从此而流，则为荥穴。
所溜为荥：《史记》云溜。按《难经》当作流。马云：如肺经鱼际之类，又从此而注，则为 穴。张景岳云：急流曰溜，小水曰荥。脉出于井而溜于荥，其气尚微也。简案：“急流曰溜”，未见所据。《难经·六十三难》杨玄操注云：泉水既生，留停于近荥，迂未成大流，故名之曰荥。荥，小水之状也。此“溜”读为“留”也。然《难经·六十八难》明言“所流为荥”，今从史说。
所注为 ：马云： 者注此而输运之也。如肺经大渊之类，又从而经过之，则为经穴。张景岳云：注，灌注也； ，输运也。脉注于此而输于彼，其气渐盛也。
所行为经：张景岳云：脉气大行，经营于此，其正盛也。《难经·六十三难》杨玄操注云：经者径也，亦经营之义也。马云：如肺经经渠之类，又从而水有所会，则为合穴。
所入为合：张景岳云：脉气至此，渐为收藏，而入合于内也。马云：如肺经尺泽之类。《难经·六十三难》杨玄操注云：经行既达，合会于海，故名之曰合。合者，会也。
知其要者：马云：凡节之所交，计三百六十五会，实经络渗灌诸节者也。此节者乃要之所在。张景岳云：其要则在乎五 而已。《太素》云：血者神气也。二十七气，三百六十五会，总属血气之流行，故曰“知其要者，一言而终”。简案：今从《太素》注。
重竭：张景岳云：脏气已绝于内，阴虚也。反实其外，误益阳也。益阳则愈损其阴，是重竭也。阴竭必死，死则静也。
取腋与膺：张景岳云：腋与膺，皆脏脉所出。气绝于内，而复取之，则致气于外，而阴愈竭矣。
逆厥：张景岳云：脏气已绝于外，阳虚也。反实其内，误补阴也。助阴则阳气愈竭，故致四逆而厥逆。厥必死，死必躁也。
反取四末：张景岳云：四末为诸阳之本。气绝于外，而取其本，则阴气至而阳愈陷矣。
害中而去则致气：张景岳云：害中而不去，去针太迟也。不中而去，去针太早也。均足为害。此节与《寒热病》篇文同，但彼云“不中而去，则致气”者是，此云“害中”者误也。简案：“害”当作“不”，张注为是。
痈疡：《寒热病》篇作“痈疽”。张景岳云：不中而去，则病未除而气已致，故结聚而为痈疽，皆刺之害也。
十二原出于四关：张景岳云：脏腑之气，表里相通，故五脏之表有六腑，六腑之外有十二原。十二原出于四关，四关者，即两肘两膝，乃周身骨节之大关也。故凡井、荥、 、原、经、合穴，皆手不过肘，足不过膝，而此十二原者，故可以治五脏之疾。
Ma Yun: The chapter is named after the "Nine Needles" and the "Twelve Yuan (Source) Points". From the section on "The Essentials of Small Needles" onwards, Qibo explains everything in detail in Chapter 3, "Explanation of Small Needles".
The *Suwen* contains a chapter titled "Explanation of Needles", which is largely similar to the "Small Needle" sections of these two chapters. These three chapters should be read together to fully grasp their meaning without omission. Old editions interpreted Chapter 1 as emulating Heaven, Chapter 2 as emulating Earth, Chapter 3 as emulating Humanity, Chapter 4 as emulating Time, Chapter 5 as emulating Pitch-pipes, Chapter 6 as emulating Laws, Chapter 7 as emulating Stars, Chapter 8 as emulating Wind, and Chapter 9 as emulating Regions. This was a later annotation derived from the intent of Chapter 78, "Discussion on Nine Needles," mistakenly applying it to chapter titles rather than discussing the needles themselves, which is unreasonable. Note: The original text generally lacks specific chapter or section markers, which is characteristic of ancient texts.
Zi Wan Min (To cherish all people): Ma Yun comments: According to the *Records of the Grand Historian* and the *Book of Documents*, during the era of Yellow Emperor when Earth virtue flourished, well fields were established, measurements were standardized, five grains were cultivated, and the myriad people were nurtured. Thus, he was called "Zi Wan Min" (cherishing the people like children), and collecting taxes was indeed part of this governance.
Bai Xing (The hundred surnames/commoners): The commentary on *Guoyu* states that "Bai Xing" refers to the hundred officials with hereditary merits. Additionally, Kong Anguo's commentary on the *Book of Documents* equates "Bai Xing" with the hundred officials.
Zu Shui (Rent and Tax): Rent and tax refer to land tribute. Furthermore, any form of exaction is called tax. The *History of Han* mentions "living off rent and clothing off tax."
Bu Gei Er Shu You Ji Bing (Insufficient supply yet diseases attach): "Gei" means mutual sufficiency or support; "Shu" means attachment or connection.
Wei Zhen (Subtle Needle): Records indicate that although the chapter title is "Nine Needles," Huangdi calls them "Wei Zhen" and Qibo calls them "Xiao Zhen." This implies a distinction between the nine needles and small needles. Note: "Wei Zhen" and "Xiao Zhen" likely refer to the Filiform Needle among the nine needles. As stated later: "Sharp as a mosquito or horsefly proboscis, stillness to capture departure, subtlety for prolonged retention."
Ying Qi Ni Shun Chu Ru Zhi Hui (Circulate the intersections of reversal, smoothness, exit, and entry): Records state that blood and qi in the skin and meridians have directions of reversal and smoothness, and points of entry and exit intersection. Note: "Ying" means to circulate or manage.
Yi Yong Nan Wang (Easy to use, hard to forget): Records state that understanding the principles makes application easy, and keeping it in mind prevents forgetting.
Jing Ji (Meridians and Connections): Records state: "Jing" means path/direction, "Ji" means net/structure. Zheng Xuan's commentary on *Liji* defines "Jing Ji" as the degrees of celestial movement.
Wei Zhi Zhong Shi (Establishing its beginning and end): Records state: The Nine Needles were created by sages based on the numbers of Heaven and Earth, starting from one and ending at nine. Nine times nine equals eighty-one, initiating the number of the Huangzhong pitch-pipe.
Xian Li Zhen Jing (First establishing the Classic of Needles): Zhang Jiebin states: *Lingshu* is also named *Zhen Jing* (Classic of Needles), originating from this concept.
Yi Chen Er Nan Ru (Easy to express but hard to penetrate): Zhang Jiebin states: "Yi Chen" means common laws are easy to calculate; "Nan Ru" means subtle details are hard to reach. Records state: Words are easy to say but hard to deeply understand.
Coarse practitioners guard form; Superior practitioners guard spirit: Ma Yun states: Inferior practitioners are stuck on physical forms, merely guarding needling techniques. Superior practitioners guard the patient's Shen (Spirit). Whether tonifying or reducing blood and qi deficiency/excess depends primarily on Shen, not just mechanical needle methods.
Shen Hu (Oh, Spirit!) Shen Ke Zai Men (Spirit Guest resides at the gate): Ma Yun states: "Shen" refers to the body's Righteous Qi (Zheng Qi). "Shen Hu!" emphasizes that Righteous Qi must be guarded. Pathogenic Qi attacks periodically like a guest, hence called "Ke" (Guest). "Ke Zai Men" means pathogens reside at the gates of various meridians. Zhang Jiebin adds: "Shen Hu Shen" means distinguishing the fluctuation of Righteous Qi amidst ambiguity. "Ke Zai Men" means recognizing the entry and exit of pathogens. Note: *Xiao Zhen Jie* says: "Shen Ke" is the convergence of Righteous and Pathogenic Qi. Shen is Righteous Qi; Ke is Pathogenic Qi. "At the gate" means pathogens follow the pathways of Righteous Qi. Thus, "Shen Hu" refers to both Shen and Ke.
The subtlety of needling lies in speed and slowness: Ma Yun states: The subtlety of needling lies in the timing of speed and slowness (De Xu - rapid and slow manipulation).
Coarse practitioners guard joints; Superior practitioners guard the mechanism: Zhang Jiebin states: "Coarse guards joints" refers to guarding the joints of the limbs. "Superior guards mechanism" refers to observing the dynamics of Qi arrival.
Do not depart from the acupoint: Ma Yun cites *Suwen*'s "Bone Empty Acupoints" referring to meridian points. Note: According to *Xiao Zhen Jie*, there should be a character "Zhong" (Middle) after "Kong" (Empty/Acupoint).
Clear, quiet, and subtle: Zhang Jiebin states: This means observation must be detailed and cautious.
Its arrival cannot be met; Its departure cannot be pursued: Records state: If Qi is arriving, Pathogenic Qi is strong and Righteous Qi is weak. Do not meet the arriving Qi with tonification (which would be meeting the pathogen). Avoid the arrival of Pathogenic Qi. When its sharpness has passed, Pathogenic Qi is weak and Righteous Qi is recovering. Do not pursue departing Qi with reduction (which would chase away recovering Qi). Act at the subtle moment between arrival and departure. *He Li Zhen Xie Lun* warns: If one fails to examine the pathogen and the main Qi has passed, reducing will cause Righteous Qi to escape, leading to death and disease recurrence. Hence, "departure cannot be pursued."
Not even a hair's breadth can be missed: Ma Yun states: One who knows the way of seizing the opportunity focuses only on this Qi; even a hair's breadth cannot separate the timing. Records state: Guarding the balance between arrival and departure for tonification/reduction; a slight error leads to failure.
Only the skilled possess this: *Jia Yi Jing* reads "Superior only possesses this."
Departure is Reversal; Arrival is Smoothness: Zhang Jiebin states: Departure is Qi leaving, hence Reversal. Arrival is Qi coming, hence Smoothness.
Direct practice requires no questioning: *Tai Su* reads "Jian" (Interval) instead of "Wen" (Question), which is incorrect.
Reverse and seize it, how can it not be empty? Pursue and assist it, how can it not be full?: *Jia Yi Jing* reads "Ni" (Reverse) as "Ying" (Meet). Zhang Jiebin states: Meeting the arriving Qi to seize it reduces excess, making it empty. Following the departing Qi to assist it tonifies deficiency, making it full. Therefore, reduction uses inhalation for insertion, and tonification uses exhalation for insertion. This is the meaning of "Meeting arrival and following departure." Gao Wu explains: "Ying" meets Qi as it arrives (e.g., Lung Qi peaks at Yin hour); "Sui" follows Qi as it departs (e.g., Stomach Qi receives Qi as Large Intestine Qi leaves).
Da Yao (The Great Principle): Note: Likely an ancient chapter title.
Slow exit and fast press makes Full; Fast exit and slow press makes Empty: Zhang Jiebin states: Slow withdrawal with fast pressing is tonification (making Empty Full). Fast withdrawal with slow pressing is reduction (making Full Empty). Note: Zhang's interpretation based on *Suwen* contradicts *Xiao Zhen Jie*.
Seeming to exist, seeming not to exist: Ma Yun states: Excess stops at the sensation of Qi; Deficiency stops at the absence of Qi. Qi is formless, existing between presence and absence.
Observe posterior and anterior: Zhang Jiebin states: Determine the urgency of the disease and treat accordingly. Observe if Qi flows or stagnates to decide needle retention.
Seeming to gain, seeming to lose: Zhang Jiebin states: Achieving emptiness when desired is emptiness; achieving fullness when desired is fullness. This is correct method.
Crude practitioners act recklessly and fail: Note: *Xiao Zhen Jie* explains "Seeming to gain/lose": Tonification feels like gaining something; Reduction feels like losing something. Zhang's note deviates from the original intent.
Timing of tonification and reduction: *Needle Explanation* states: Timing aligns with the opening and closing of Qi. Zhang Jiebin states: There is a proper time for tonification and reduction.
Reduction says: Must hold and insert, release and withdraw, push away Yang to obtain the needle: *Jia Yi Jing* reads "Ying" (Meet). Meaning: Hold and insert, release and withdraw, pushing out Yang. Zhang Jiebin states: For reduction, hold and insert, withdrawing quickly and pressing slowly to open Yang channels and drain pathogens. Note: *Jia Yi Jing* is closer to the context of the following "Tonification says."
Press and draw needle, this is called Internal Warmth: Note: The following sentences describe tonification. If reduction is needed but one presses and draws the needle (tonification), it causes "Internal Warmth" (accumulation). "Drawing needle" means withdrawing. "Warm" is synonymous with "Yun" (accumulate), meaning Qi/Blood accumulates internally without dispersing. Previous annotations linking this to "Tonification says" are likely errors.
Mind seems delusional: Records state: "Zhi" means going. Zhang Jiebin states: "Wang" means delusional/virtual. "Yi Ruo Wang Zhi" means the mind grasps the space between existence and non-existence. *Jia Yi Jing* reads "Wang" as "Wang" (Forget).
Like moving, like pressing; Like a mosquito/biting fly stopping: Zhang Jiebin states: "Like moving/pressing" refers to manipulating Qi and pressing the site. "Like mosquito stopping" means using light, traceless precision.
Like staying, like returning; Leaving like a broken string: Zhang Jiebin states: "Stay" is retaining the needle; "Return" is withdrawing. "Leaving like a broken string" is light and swift, causing no damage while tonifying. *Jia Yi Jing* reads "Huan" (Return) as "Huan" (Circle).
Let Left belong to Right: Zhang Jiebin states: Right hand inserts the needle; Left hand follows to press/massage. This is "Left belonging to Right."
Must ensure no retained blood; Quickly take and punish it: Ma Yun states: If blood is retained, quickly remove it. However, since this is a tonification method, there should be no retained blood. Zhang Jiebin states: When taking blood from collaterals, do not allow retention; remove it quickly. Records state: This is a method of tonifying Righteous Qi and expelling Pathogens, so no blood should remain. If it does, remove it urgently. Note: Logic suggests textual loss here.
Firmness is precious: *Jia Yi Jing* reads "Bao" (Precious) as "Shi" (Solid). Wang Bing notes: "Hand like holding a tiger" implies strength/stability. *Zhen Jing* states: "The way of holding the needle is firmness as solidity." New Correction notes: *Jia Yi Jing* uses "Bao," differing from current texts.
Straight finger, direct puncture: Note: *Needle Explanation* says: "Meaning no deviation downward" implies uprightness. Wang Bing notes: Straight finger, direct puncture, needle has no left/right bias.
Spirit resides in the finest down: Zhang Jiebin states: The physician's spirit must observe the finest details with precision.
Focus attention on the patient: *Needle Explanation* states: "Spirit not distracted by many things" means quietly observing the patient without looking around. Wang Bing notes: Eyes avoid wandering, heart focuses solely, ensuring accuracy.
Carefully inspect the blood vessels: Ma Yun states: Inspect the deficiency/excess of blood vessels before needling to avoid danger.
Must focus on Suspended Yang and the Two Guards: *Jia Yi Jing* reads "Bi" (Must) as "Xin" (Heart), "Wei" (Guard) as "Heng" (Balance). Note: One version reads "Chong." Zhang Jiebin states: "Xuan" means raising; "Yang" means Spirit/Qi. During needling, prioritize raising Spirit/Qi ("Xuan Yang"). "Two Guards" refers to Wei Qi in Yang (muscle/surface defense) and Pi Qi in Yin (organ defense). Both house Spirit/Qi and must not be harmed. Ma Yun interprets "Yang" as "Yang" (Raise); *Tai Su* interprets "Xuan Yang" as "Heart," which is difficult to reconcile. Zhang's note is retained.
Blood vessels: *Jia Yi Jing* adds "Qu" (Take) before "Xue" (Blood), which is correct.
Located horizontally; Viewed alone clear; Palpated alone firm: *Jia Yi Jing* reads "Cheng" (Clear) as "Man" (Full). Records state: " " refers to meridians. *Ci Jie Zhen Xie* says: If six meridians are harmonious, there is no disease. If one meridian has upper excess and lower deficiency with blockage, there must be a transverse collateral adding pressure. Visualize and reduce it to untie the knot. Thus, transverse blood collaterals should appear clear upon viewing and firm upon palpation. Zhang Jiebin states: "Viewed clear" means seeking hidden issues; "Palpated firm" means extracting the root. Needle: Pronounced "Chu Xian Qie," a plow iron. *Shuowen*: Sharp tool. *History of Bian Que*: Stone needle. Needle: Pronounced "Shi" or "Di," an arrowhead.
Feng Zhen (Blade Needle): Feng, Wang edition reads "Feng" (Bee), incorrect.
Pi Zhen (Sword Needle): Pi, pronounced "Pi." *Shuowen*: Large needle.
Hao Zhen (Filiform Needle) length 3 cun 6 fen: *Jiu Zhen Lun* says 1 cun 6 fen is correct. Wu's *Zun Jing Ji* states: Hao Zhen is also Xiao Zhen, widely used like daily necessities. Ma Yun: This describes the form and function of the nine needles. The main ideas are in Chapter 78, so detailed explanation is omitted here.
Jie An: There are nine types of needles:
1. Needle: Arrowhead needle, 1.6 cun long, tip 0.1 cun, for shallow needling.
2. Round Needle: Sewing needle shape, 1.6 cun, cylindrical body, rounded tip, for massage.
3. Needle: 3.5 cun, sharp like millet, round and slightly pointed, for tonification.
4. Feng Zhen (Blade Needle): Triangular prism, 1.6 cun, for draining heat and blood.
5. Pi Zhen (Sword Needle): 4 cun long, 0.25 cun wide, sword-shaped, for opening/blockages.
6. Yuan Li Zhen (Round-Sharp Needle): Slightly large body, small tip, 1.6 cun, for deeper penetration.
7. Hao Zhen (Filiform Needle): 2.6 cun, sharp as mosquito proboscis, fine and slow.
8. Chang Zhen (Long Needle): 7 cun, for deep pathogens and distant bi-syndrome.
9. Da Zhen (Large Needle): 4 cun, thick, blunt tip, for draining joint blockages.
(Note on characters related to hair/quills).
To treat sudden Qi: *Jia Yi Jing* says: Use Yuan Li Zhen for sudden Bi-Qi onset. Zhang Jiebin: Sudden Qi is sudden Bi-Qi.
Stillness to capture departure: All editions read "Qu" (Take) as "Xu" (Slow); correction needed.
Like a staff: Daozang edition reads . Note: Same as staff.
Pathogenic Qi is above: Ma Yun: Pathogens attack from high places; wind, cold, summer-heat, rain enter from above. Refer to *Xiao Zhen Jie* below.
Xian Mai (Sunken Meridians): Zhang Jiebin: Acupoints are often in sunken areas. To dispel cold, needle sunken meridians to move Qi and expel Yang pathogens from above. Records: Sunken meridians refer to forehead/skull veins sinking into bone; needling expels exterior Yang pathogens. Zhang's note is correct.
Zhong Mai (Central Meridian): *Xiao Zhen Jie*: Take the He-Sea point of Yangming. Ma Yun: Yangming He-Sea is Zusanli (ST36).
Diseases each have their suitability: *Jia Yi Jing* reads "Yi" (Suitable) as "She" (Abode/Target), which is correct.
No excess, no deficiency: *Jia Yi Jing* reads "Wu Shi Bao Xu Xu" (No excess, treasure deficiency/tonify deficiency), which is correct.
Five Meridians: Zhang Jiebin: Five meridians refer to the Five Shu points of the Five Zang. Records: Yin meridians of the Five Zang. See *Xiao Zhen Jie*.
Three Meridians: Based on *Xiao Zhen Jie*, refers to Three Yang meridians.
Kuang (Weak/Deficient): Ma Yun: Pronounced "Qu Wang Qie," meaning insufficient. Zhang Jiebin: Pronounced "Kuang," meaning decay. Records: Timidity.
Depriving Yin leads to death: *Jia Yi Jing* reads "Si" (Death) as "Jue" (Cold extremities). Note: Contradicts *Xiao Zhen Jie*.
Like wind blowing clouds: Records: Pathogens scatter, Righteous Qi shines.
Clearly seeing blue sky: *Jia Yi Jing* reads "Zhao Ran Yu Tian" (Brightly like heaven).
Twelve Main Meridians, Fifteen Collaterals, Total Twenty-Seven Qi: Zhang Jiebin: Five Zang, Six Fu, plus Pericardium = Twelve Meridians. Each has collaterals (e.g., Lieque LU7). Plus Ren Mai (Pingyi), Du Mai (Changqiang), Spleen Major Luo (Dabao) = Fifteen Collaterals. Total twenty-seven Qi systems circulating the body.
Exiting as Jing (Well) Points: Ma Yun: The starting points are Well points, like water emerging from a mountain well. *Nan Jing* commentary: Wells are valley springs, not dug wells. Water flowing from Well becomes Ying (Stream) points (e.g., Shaoshang LU11).
Flowing as Ying (Stream) Points: *Shiji* uses "Liu" (Slip/Flow). *Nan Jing* should be "Liu" (Flow). Ma Yun: From Ying points, water flows to become Shu (Transport) points. Zhang Jiebin: Rapid flow is Liu, small water is Ying. Qi moves from Jing to Ying, still subtle. Note: "Rapid flow is Liu" lacks basis. *Nan Jing* commentary: Water stays near the source, not yet a large stream, hence Ying (small water). "Liu" reads as "Liu" (Stay). However, *Nan Jing 68* says "Suo Liu Wei Ying" (What flows is Ying). Follow *Shiji*.
Pouring as Shu (Transport) Points: Ma Yun: means pouring and transporting here. E.g., Taiyuan LU9. Passing through becomes Jing (River) points. Zhang Jiebin: Zhu (Pour) and (Transport). Qi pours here and transports there, becoming stronger.
Moving as Jing (River) Points: Zhang Jiebin: Qi moves greatly, managing here, peak strength. *Nan Jing* commentary: Jing means path or management. Ma Yun: E.g., Jingqu LU8. Water gathers, becoming He (Sea) points.
Entering as He (Sea) Points: Zhang Jiebin: Qi reaches here, gradually storing and entering internally. Ma Yun: E.g., Chize LU5. *Nan Jing* commentary: Qi reaches the sea, hence He (Confluence).
Knowing the essentials: Ma Yun: Intersections total 365, where meridians irrigate nodes. These nodes are essential. Zhang Jiebin: Essentials lie in the Five (likely Zang organs/Shu points). Records: Blood is Spirit/Qi. Twenty-seven Qi and 365 intersections belong to blood/qi circulation. Hence, "Knowing the essence, one word ends it." Follow Records' note.
Double Exhaustion: Zhang Jiebin: Zang Qi exhausted internally (Yin deficiency). Tonifying externally (Yang) worsens Yin depletion. Double exhaustion. Yin exhaustion leads to death, which is quiet.
Taking Axilla and Chest: Zhang Jiebin: Axilla and chest are exits of Zang meridians. If Qi is exhausted internally and one needles here, Qi goes outward, worsening Yin exhaustion.
Reversed Cold Extremities: Zhang Jiebin: Zang Qi exhausted externally (Yang deficiency). Tonifying internally (Yin) worsens Yang depletion, causing Si Ni (cold extremities) and Jue (collapse). Death is restless.
Counter-taking Four Ends: Zhang Jiebin: Four ends are roots of Yang. If Qi is exhausted externally and one takes the root, Yin arrives and Yang sinks further.
Harming middle and withdrawing causes Qi accumulation: Zhang Jiebin: Hitting the target but not withdrawing is too late. Missing the target and withdrawing is too early. Both cause harm. This matches *Han Re Bing* chapter, which says "Missing and withdrawing causes Qi accumulation." Here "Harming middle" is an error. Note: "Hai" (Harm) should be "Bu" (Not). Zhang's note is correct.
Abscesses/Ulcers: *Han Re Bing* reads "Yong Ju." Zhang Jiebin: Missing and withdrawing leaves disease unremoved but Qi accumulated, forming abscesses. Harm of needling.
Twelve Yuan Points originate from Four Passes: Zhang Jiebin: Zang-Fu Qi connects interior/exterior. Five Zang have six Fu outside; Six Fu have Twelve Yuan outside. Twelve Yuan originate from Four Passes (two elbows, two knees), major joint hubs. Thus, Jing, Ying, Shu, Yuan, Jing, He points never exceed elbows/knees. These Twelve Yuan can treat Five Zang diseases.