马云。九针十二原中。有小针之要。而此篇正以解其首篇。故名之曰小针解。素问又有针解篇。与此小同。
神客 张云。神、正也。客、邪也。邪正相干。故曰共会。
在门 张云。出入所由。故谓之门。
先知何经之病 张云。若不能先知。是为未睹其疾。又曰。恶知其原。
速迟 马本志。本作数迟。非。
守四肢 张云。手之两肘。足之两膝。谓之四关。
守气 张云。往来逆顺。至与不至。皆气之机也。
针以得气 张云。以、已同。
气易失地 张云。毫厘之差。即失其气之机也。
气不下也 张云。补泻不得其法。虽竭尽血气。而病气不应也。
小者逆也 张云。气去故脉虚而小。
平者顺也 张云。气来故脉平而和。
气口虚而当补之也 张云。此与针解篇。皆释九针十二原之义。但此以气口言虚实。彼以针下气至
言虚实。义虽若异。然互有发明。皆当察也。
徐而疾则（止）徐出也 张云。此二句释义。其用似反。当针解篇者为得。针解篇曰。徐而疾则
实者。徐出针而疾按之。疾而徐则虚者。疾出针而徐按之。
以下 张云。言已退也。
然 史云。 音必。满貌。张云。音弼。诗曰。威仪 。
然 史云。吁往切。狂貌。志云。 、惚也。简案、 、恍同。恍惚、又作 惚。不分明也。志
为是。（字典 然失意貌）
邪气之中人也高 张云。伤于风者。上先受之。故凡八风寒邪之中人。其气必高而在上。
浊气在中（止）在中也 张云。水谷入胃。其清者化气。上归于肺。是为精气。若寒温失宜。
饮食过度。不能运化。
则必留滞肠胃之间而为病。此浊气在中也。简案、溜、张读为留非也。所溜为荥。难经作流。知溜、流古通。
针陷脉 则邪气出者取之上 张云。诸经孔穴。多在陷者之中。如刺禁论所谓刺缺盆中内陷之类是也。
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。简案、志注十二原篇云。陷脉额
颅之脉。显陷于骨中。故针陷脉。则阳之表邪去矣。据此则取之上之上字。与下文阳明合对。殆为稳贴。但以
颅额之脉为陷脉者。未见所本。俟考。
针中脉 则邪气出 张本。邪、作浊。据十二原。作浊为是。
阳明合也 张云。足三里也。刺之可以清肠胃。故能取浊气之在中者。
夺阴者死（止）五往者也 张云。夺脏气也。尺之五里。尺泽后之五里也。手阳明经穴。禁刺者也。
正言也 张云。即如上文取三阳之谓。
尺寸小、大、缓、急、滑、涩 简案、邪气脏腑病形篇云。调其脉之缓、急、小、大、滑、涩。而
病变定矣。又论疾诊尺篇云。审其尺之缓、急、小、大、滑、涩。肉之坚、脆。而病形定矣。此云小、大、缓、
急、滑、涩、者。乃兼寸口之脉。与尺之皮肤而言也。
在于终始 张云。终始本经篇名。
持心也 张云。释前文观其形。听其动静。知其邪正者。皆主持于心也。
内绝 张云。脉口浮虚。按之则无。是谓内绝。不至脏气之虚也。
无气以动故静 张云。外者阳之分。阴气既虚。复留
针于外以致阳气。则阴愈虚而气竭于内。无气以动。故其死也静。
外绝 张云。脉口沉微。轻取则无。是谓外绝。不至阳之虚也。
阴气有余故躁 张云。阳气既虚。复留针四末以致阴气。则阳气愈竭。必病逆厥而死。阳并于阴。
则阴气有余。故其死也躁。
五色循明 马云。六节藏象论。岐伯曰。五气入鼻。藏于心肺。上使五色修明。音声能彰。则循
明当作修明。张云。五脏六腑之精气。皆上注于目。而为之精。故能使五色循明。盖色明于外者。由气盛于内。
故其声音亦必彰大。与平生异矣。简案、仍张注循明。不必改字。志云。声与平生异者。散败之声也。恐误。
马云说：在《九针十二原》篇中，有关于“小针”的要义，而本篇正是为了解释首篇的内容，所以命名为《小针解》。《素问》中也有《针解》篇，与此篇内容大致相同。
神客：张云说：“神”指正气，“客”指邪气。邪气与正气相互干扰，所以说它们“共会”。
先知何经之病：张云说：如果不能预先知道是哪条经脉患病，就是没有看清疾病（未睹其疾），又怎么能知道疾病的根源呢？
守四肢：张云说：手的两个肘关节、足的两个膝关节，称为“四关”。
守气：张云说：气的往来、逆顺，到达与否，都是气的机动的表现。
气易失地：张云说：毫厘之间的差错，就会失去对气机的把握。
气不下也：张云说：补泻不得法，虽然耗尽了血气，但病气不会消退。
气口虚而当补之也：张云说：这与《针解》篇一样，都是解释《九针十二原》的含义。只是本篇通过“气口”来论述虚实，彼篇通过“针下气至”来论述虚实。含义虽然看似不同，但互相发明，都应当考察。
徐而疾则（止）徐出也：张云说：这两句释义，其用法似乎相反，应当以《针解》篇的解释为准。《针解》篇说：“徐而疾则实者”，是指慢出针而快按压；“疾而徐则虚者”，是指快出针而慢按压。
以下：张云说：指已经退针。
然：史云：读音为“必”，形容饱满的样子。张云：读音为“弼”。《诗经》说：“威仪 然”。
然：史云：音“吁往切”，形容狂乱的样子。志云： 、惚同义。简案： 、恍同义。恍惚，又作 惚，意思是不分明。志注认为是正确的。（字典记载： 然，失意貌）
邪气之中人也高：张云说：伤于风邪的，上部先受邪。所以凡是八种风寒邪气中人，其气必然高位而在上。
浊气在中（止）在中也：张云说：水谷进入胃中，其中清的部分化为气，上行归于肺，这叫做精气。如果寒温失调，饮食过度，不能运化，就必定滞留于肠胃之间而成为疾病。这就是浊气在中。简案：“溜”字，张读为“留”是错误的。“所溜为荥”，《难经》作“流”，可知“溜”、“流”古字相通。
针陷脉 则邪气出者取之上：张云说：各经穴位，多在凹陷之处，如《刺禁论》所说的“刺缺盆中内陷”之类。所以凡是想要去除寒邪，必须针刺各经的陷脉，这样经气运行而邪气排出，这就是取在上部的阳邪。简案：志注《十二原》篇说：陷脉是额颅之脉，明显深陷于骨中。所以针刺陷脉，表层的阳邪就去除了。据此来看，“取之上”的“上”字，与下文阳明相对，大概很稳妥。但以额颅之脉为陷脉的，未见出处，等待考证。
针中脉 则邪气出：张本。邪，作浊。根据《十二原》，作“浊”是正确的。
阳明合也：张云说：即足三里穴。针刺它可以清理肠胃，所以能取在中部的浊气。
夺阴者死（止）五往者也：张云说：这是夺取脏气。尺之五里穴，在尺泽后方的五里穴。这是手阳明经的穴位，是禁止针刺的。
正言也：张云说：就像上文所说的取三阳的意思。
尺寸小、大、缓、急、滑、涩：简案：《邪气脏腑病形》篇说：调其脉的缓、急、小、大、滑、涩，病变就能确定了。又《论疾诊尺》篇说：审察尺肤的缓、急、小、大、滑、涩，以及肉的坚、脆，病形就能确定了。这里说小、大、缓、急、滑、涩，是兼指寸口的脉象和尺部的皮肤而言。
持心也：张云说：解释前文观察形体、听动静、知邪正的，都是由心主持的。
无气以动故静：张云说：外属阳分，阴气既虚，又在外部留针以导致阳气，那么阴更虚而气竭于内。没有气来推动，所以死亡时表现为静。
阴气有余故躁：张云说：阳气既虚，又在四肢末端留针以导致阴气，那么阳气更竭。必然病逆厥而死。阳并入阴，则阴气有余，所以死亡时表现为躁。
五色循明：马云说：《六节藏象论》中，岐伯说：五气入鼻，藏于心肺，上使五色修明，音声能彰。那么“循明”应当作“修明”。张云说：五脏六腑的精气，都上注于目，而为之精。所以能使五色循明。大概色明于外，是因为气盛于内，所以声音也必然彰大，与平时不同。简案：仍依张注解释“循明”，不必改字。志云：声与平生异者，是散败之声。恐怕错误。
Ma Yun states: In the chapter "Nine Needles and Twelve Source Points" (Jiuzhen Shier Yuan), there are essential principles regarding the "small needle" (Xiaozhen). This chapter serves to explain the content of the first chapter, hence it is named "Explanation of the Small Needle" (Xiaozhen Jie). The *Suwen* also contains a chapter titled "Explanation of Needling" (Zhenjie), which has similar content to this one.
Shen Ke (Spiritual Guest): Zhang Yun explains that "Shen" refers to righteous Qi (Zhengqi, healthy energy), while "Ke" refers to pathogenic factors (Xieqi, evil energy). When pathogenic factors interfere with righteous Qi, they are said to "converge" (gonghui).
In the Gate: Zhang Yun explains that the "gate" refers to the pathways through which Qi enters and exits.
To know in advance which meridian is diseased: Zhang Yun states that if one cannot predict which meridian is affected beforehand, it means one has not clearly perceived the disease (wei du qi ji) and how can one possibly know its origin?
Speed and Slowness: Ma Benzhi notes that the original text should read "Shu Chi" (frequent and slow), not "Su Chi".
Guarding the Four Limbs: Zhang Yun explains that the two elbows of the hands and the two knees of the feet are referred to as the "Four Passes" (Sigan).
Guarding Qi: Zhang Yun states that the movement, direction (reverse or smooth), and presence or absence of Qi are all manifestations of Qi's dynamics.
The needle obtains Qi: Zhang Yun explains that "yi" (以) is interchangeable with "yi" (已, already).
Qi is easily lost: Zhang Yun states that a discrepancy of even a hair's breadth results in losing control over the dynamics of Qi.
Qi does not descend: Zhang Yun explains that if tonification and sedation techniques are incorrect, even if blood and Qi are exhausted, the pathogenic Qi will not subside.
Small pulse indicates deviation: Zhang Yun states that when righteous Qi departs, the pulse becomes deficient and small.
Level pulse indicates compliance: Zhang Yun states that when righteous Qi returns, the pulse becomes level and harmonious.
When the Qi mouth (Qikou, radial artery area) is deficient, it should be tonified: Zhang Yun notes that this, like the "Zhenjie" chapter, interprets the meaning of "Nine Needles and Twelve Source Points." However, this chapter discusses deficiency and excess via the Qikou, whereas that chapter discusses them via the sensation of Qi arrival under the needle. Although the meanings appear different, they complement each other and both require examination.
Slow insertion and rapid withdrawal result in... (stop) Slow withdrawal: Zhang Yun states that the interpretation of these two sentences seems contradictory; the explanation in the "Zhenjie" chapter is correct. The "Zhenjie" chapter says: "For 'slow withdrawal and rapid pressing leads to fullness,' it means withdrawing the needle slowly and pressing quickly; for 'rapid withdrawal and slow pressing leads to emptiness,' it means withdrawing the needle rapidly and pressing slowly."
Below: Zhang Yun states this refers to having withdrawn the needle.
Ran (Sound: bi): Shi Yun states the pronunciation is "bi," describing a full appearance. Zhang Yun states the pronunciation is "bi." The *Book of Songs* says: "Majestic demeanor ran."
Ran (Sound: xu wang qie): Shi Yun states the pronunciation is "xu wang qie," describing a wild appearance. Zhi Yun states that "ran" and "hu" have similar meanings. Jian'an notes that "ran" and "huang" are synonymous. "Huanghu" (trance/unfocused) is also written as "ran hu," meaning indistinct. Zhi's annotation is considered correct. (Dictionaries describe "ran" as a look of disappointment).
Pathogenic factors attack humans from high positions: Zhang Yun states that those injured by wind pathogens are affected on the upper part first. Therefore, whenever the eight types of wind-cold pathogens attack humans, their influence is necessarily high and located above.
Turbid Qi remains in the middle (stop) Remains in the middle: Zhang Yun explains that when food and water enter the stomach, the clear portion transforms into Qi and ascends to the lungs, known as Essence Qi (Jingqi). If there is improper regulation of cold and heat, or excessive eating leading to failure in transportation and transformation, stagnation occurs in the intestines and stomach, causing disease. This is what is meant by Turbid Qi remaining in the middle. Jian'an notes that reading "liu" (flow/glance) as "liu" (stay/stagnate) by Zhang is incorrect. "Suo liu wei xing" (what flows becomes Ying-spring points) in the *Nanjing* uses "liu" (flow), indicating that "liu" and "liu" were interchangeable in ancient times.
Needling the sunken vessels to expel pathogenic factors requires targeting the upper areas: Zhang Yun states that acupoints of various meridians are mostly located in depressions, such as mentioned in the "Forbidden Acupuncture" chapter regarding needling into the depression of the clavicle fossa. Thus, to remove cold pathogens, one must needle the sunken vessels of each meridian so that meridian Qi circulates and pathogenic factors exit. This is how one targets Yang pathogens located above. Jian'an cites Zhi's note on the "Twelve Source Points" chapter: Sunken vessels refer to the forehead and skull vessels, which are deeply embedded in the bone. Therefore, needling sunken vessels removes superficial Yang pathogens. Based on this, the character "shang" (upper) in "target the upper" corresponds stably with the following mention of the Yangming meridian. However, identifying the forehead and skull vessels as sunken vessels lacks textual basis and awaits further verification.
Needling the central vessels to expel pathogenic factors: Zhang Ben suggests that "xie" (pathogen) should be written as "zhuo" (turbid). According to the "Twelve Source Points," writing it as "zhuo" is correct.
Yangming convergence: Zhang Yun states this refers to the Zusanli point. Needling it can clear the intestines and stomach, thus removing Turbid Qi located in the middle.
Depriving Yin leads to death (stop) Five visits: Zhang Yun states this refers to depriving Zang organ Qi. Wuli at the Chi position is the Wuli point behind Chize. It is an acupoint of the Hand Yangming Meridian and is forbidden to needle.
Correct statement: Zhang Yun states this refers to the aforementioned concept of targeting the Three Yang meridians.
Chi and Cun pulses: small, large, slow, urgent, slippery, choppy: Jian'an notes that the "Pathogenic Factors and Zang-Fu Disease Forms" chapter states: By regulating the pulse's slow, urgent, small, large, slippery, and choppy qualities, the pathology is determined. The "Discussing Diseases and Diagnosing the Chi Skin" chapter states: By examining the Chi skin's slow, urgent, small, large, slippery, and choppy qualities, along with the firmness or brittleness of the flesh, the disease form is determined. Here, mentioning small, large, slow, urgent, slippery, and choppy refers jointly to the pulse at the Cun Kou (radial artery) and the skin at the Chi position.
Located in Zhongshi: Zhang Yun states that "Zhongshi" is the title of another chapter in this classic.
Controlling the mind: Zhang Yun explains this interprets the preceding text: observing the form, listening to movements and sounds, and knowing the pathogenic and righteous factors are all governed by the mind (Xin).
Internal severance: Zhang Yun states that if the pulse at the Qi Kou is floating and deficient, disappearing upon pressure, it is called Internal Severance. This does not indicate Zang Qi deficiency.
No Qi to move, therefore stillness: Zhang Yun states that the exterior belongs to the Yang aspect. If Yin Qi is already deficient, and needles are retained in the exterior to deplete Yang Qi, then Yin becomes more deficient and Qi exhausts internally. With no Qi to drive movement, death manifests as stillness.
External severance: Zhang Yun states that if the pulse at the Qi Kou is sinking and minute, disappearing upon light touch, it is called External Severance. This does not indicate Yang deficiency.
Excess Yin Qi leads to restlessness: Zhang Yun states that if Yang Qi is already deficient, and needles are retained in the four limbs to deplete Yin Qi, then Yang Qi becomes more exhausted. This inevitably leads to pathological reversal, syncope, and death. Yang merges into Yin, resulting in excess Yin Qi; thus, death manifests as restlessness.
Five colors follow clarity: Ma Yun states that in the "Six Sections and Viscera Manifestations" chapter, Qibo says: The five Qi enter the nose, store in the Heart and Lungs, and cause the five colors to become refined and bright, and the voice to become prominent. Therefore, "xun ming" should likely be read as "xiu ming" (refined and bright). Zhang Yun states: The Essence Qi of the Five Zang and Six Fu organs all ascend to the eyes, forming the essence of vision. Thus, they enable the five colors to be clear. Generally, color brightness on the outside reflects Qi abundance inside; consequently, the voice also becomes prominent, differing from one's usual state. Jian'an maintains Zhang's annotation of "xun ming" without changing the character. Zhi Yun argues that a voice differing from normal indicates scattered and ruined Qi, which might be an error.