故善用针者,从阴引阳,从阳引阴,以右治左,以左治右,以我知彼,以表知里,以观过与不及之理,见微则过,
用之不殆。(见论治类八。)
是故刺法有全神养真之旨,亦法有修真之道,非治疾也。至真之要,在乎天玄,神守天息,复入本元,命曰归宗。(运
气四十三。)
黄帝曰∶刺其诸阴阳奈何?岐伯曰∶按其寸口人迎,以调阴阳。凝涩者,致气以温之,血和乃止。其结络者,脉结
血不行,决之乃行。故曰∶气有余于上者,导而下之;气不足于上者,推而休之;其稽留不至者,因而迎之;必明于经
隧,乃能持之。寒与热争者,导而行之;其宛陈血不结者,则而予之。必先明知二十五人,则血气之所在,左右上下,
刺约毕也。(藏象三十一。)
随日之长短,各以为纪而刺之。谨候其时,病可与期,失时反候者,百病不治。故曰∶刺实者,刺其来也;刺虚者,
刺其去也。此言气存亡之时,以候虚实而刺之。是谓逢时。在于三阳,必候其气在于阳而刺之;病在于三阴,必候其气
在阴分而刺之。(经络二十五。)
清者其气滑,浊者其气涩。故刺阴者,深而留之;刺阳者,浅而疾之;清浊相干者,以数调之。(藏象十九。)
病有标本,刺有逆从。凡刺之方,必别阴阳。故知逆与从,正行无问,知标本者,万举万当,不知标本,是谓妄行。
(标本四。)
刺急者,深内而久留之。刺缓者,浅内而疾发针,以去其热。刺大者,微泻其气,无出其血。刺滑者,疾发针而浅
内之,以泻其阳气而去其热。刺涩者,必中其脉,随其逆顺而久留之,必先按而循之,已发针,疾按其 ,无令其血出,
以和其脉。诸小者,阴阳形气俱不足,勿取以针,而调以甘药也。(脉色十九。)
凡刺之法,必先本于神。是故用针者,察观病患之态,以知精神魂魄之存亡得失之意,五者以伤,针不可以治之也。
(藏象九。)
病之起始也,可刺而已。(论治八。)
经病者治其经,孙络病者治其孙络血,血病身有痛者治其经络。其病者在奇邪,奇邪之脉则缪刺之。留瘦不移,节
而刺之。上实下虚,切而从之,索其结络脉,刺出其血,以见通之。(脉色二十五。)
五脏者,故得六腑与为表里,经络支节,各生虚实,其病所居,随而调之。病在脉,调之血;病在血,调之络;病
在气,调之卫;病在肉,调之分肉;病在筋,调之筋;病在骨,调之骨。燔针劫刺其下及与急者;病在骨, 针药熨;
病不知所痛,两跷为上;身形有痛,九候莫病,则缪刺之;痛在于左而右脉病者,巨刺之。必谨察其九候,针道备矣。(疾
病二十。)
夫实者,气入也。虚者,气出也。气实者,热也。气虚者,寒也。入实者,左手开针空也。入虚者,左手闭针空也。
(疾病二十一。)
泻实者气盛乃内针,针与气俱内,以开其门如利其户,针与气俱出,精气不伤,邪气乃下,外门不闭,以出其疾,
摇大其道如利其路,是谓大泻,必切而出,大气乃屈。帝曰∶补虚奈何?岐伯曰∶持针勿置,以定其意,候呼内针,气
出针入,针空四塞,精无从去,方实而疾出针,气入针出,热不得还,闭塞其门,邪气布散,精气乃得存,动气候时,
近气不失,远气乃来,是谓追之。(疾病二十。)
十二经病刺,盛则泻之,虚则补之,热则疾之,寒则留之,陷下则灸之,不盛不虚,以经取之。足少阴经病,灸则
强食生肉,缓带被发,大杖重履而步。(疾病十。)
有余有五,不足有五。有余泻之,不足补之。(疾病十八。)
无损不足者,身羸瘦,无用 石也。无益其有余者,腹中有形而泄之,泄之则精出而病独擅中,故曰疹成也。(疾病
六十二。)
血气有余,肌肉坚致,故可苦以针。(脉色三十一。)
有病肾风者,虚不当刺,不当刺而刺,后五日其气必至。(疾病三十一。)
其小而短者少气,甚者泻之则闷,闷甚则仆不得言,闷则急坐之也。(经络六。)
六经之厥,盛则泻之,虚则补之,不盛不虚,以经取之。(疾病三十五。)
气滑即出疾,气涩则出迟,气悍则针小而入浅,气涩则针大而入深,深则欲留,浅则欲疾。(针刺五十六。)
平治于权衡,去宛陈 。是以微动四极,温衣,缪刺其处,以复其形。开鬼门,洁净府,精以时服,五阳已布,疏
涤五脏,故精自生,形自盛,骨肉相保,巨气乃平。(论治十五。)
太阳脏独至,厥喘虚气逆,是阴不足、阳有余也,表里俱当泻,取之下俞。阳明脏独至,是阳气重并也,当泻阳补
阴,取之下俞。少阳脏独至,是厥气也,跷前卒大,取之下俞,少阳独至者,一阳之过也。太阴脏搏者,用心省真,五
脉气少,胃气不平,三阴也,宜治其下俞,补阳泻阴。一阳独啸,少阳厥也,阳并于上,四脉争张,气归于肾,宜治其
经络,泻阳补阴。一阴至,厥阴之治也,真虚 心,厥气留薄,发为白汗,调食和药,治在下俞。(脉色十五。)
足阳明,五脏六腑之海也,其脉大血多,气盛热壮,刺此者不深弗散,不留不泻也。足阳明,刺深六分,留十呼。
足太阳深五分,留七呼。足少阳深四分,留五呼。足太阴深三分,留四呼。足少阴深二分,留三呼。足厥阴深一分,留
二呼。手之阴阳,其受气之道近,其气之来疾,其刺深者皆无过二分,其留皆无过一呼。其少长大小肥瘦,以心撩之,
命曰法天之常。灸之亦然。灸而过此者得恶火,则骨枯脉涩;刺而过此者,则脱气。(经络三十三。)
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。(经络
二十。)
诸刺络脉者,必刺其结上,甚血者虽无结,急取之以泻其邪而出其血,留之发为痹也。(经络类六。)
孙络三百六十五穴会,亦以应一岁,以溢奇邪,以通荣卫,荣卫稽留,卫散荣溢,气竭血着,外为发热,内为少气,
疾泻无怠,以通荣卫,见而泻之,无问所会。溪谷三百六十五穴会,亦应一岁,其小痹淫溢,循脉往来,微针所及,与
法相同。(经络八。)
十五别络病刺。(经络五。)
十二原者,主治五脏六腑之有疾者也。(经络十五。)
病始手臂者,先取手阳明太阴而汗出;病始头首者,先取项太阳而汗出;病始足胫者,先取足阳明而汗出。臂太阴
可汗出,足阳明可汗出。故取阴而汗出甚者,止之于阳;取阳而汗出甚者,止之于阴。(针刺五十四。)
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。(经络十。)
刺胸腹者,必以布HT 着之,乃从单布上刺。(针刺十九。)
五脏热病死生刺法。(疾病四十四。)
脏腑之咳,治之奈何?岐伯曰∶治脏者治其俞,治腑者治其合,浮肿者治其经。(疾病五十二。)
夫痈气之息者,宜以针开除去之;夫气盛血聚者,宜石而泻之。(疾病八十八。)
诸经疟刺。(疾病五十。)
五脏背 ,灸之则可,刺之则不可。气盛则泻之,虚则补之。以火补者,毋吹其火,须自灭也。(经络十一。)
络满经虚,灸阴刺阳;经满络虚,刺阴灸阳。(疾病十六。)
紧则先刺而后灸之。陷下则徒灸之,陷下者,脉血结于中,中有着血,血寒,故宜灸之。(针刺二十九。)
针所不为,灸之所宜。阴阳皆虚,火自当之。经陷下者,火则当之,结络坚紧,火所治之。不知所苦,两跷之下,
男阴女阳,良工所禁。(针刺十。)
正月二月三月,人气在左,无刺左足之阳;四月五月六月,人气在右,无刺右足之阳。七月八月九月,人气在右,
无刺右足之阴;十月十一月十二月,人气在左,无刺左足之阴。(经络类三十四。)
大禁二十五,在天府下五寸。(经络七。)
无刺 之热,无刺浑浑之脉,无刺漉漉之汗,故为其病逆未可治也。先其时坚束其处,令邪气不得入,阴气不得
出,审候见之在孙络盛坚而血者皆取之。(疾病四十八。)
五逆,工不察此者而刺之,是谓逆治。(疾病类九十二。)
诸病以次相传,如是者,皆有死期,不可刺也;间一脏及二三四脏者,乃可刺也。(疾病九十四。)
诸经根结病刺。(经络三十。)
十二经筋痹刺。(疾病六十九。)
口问十二邪之刺。(疾病七十九。)
阴阳二十五人之刺。(藏象三十一。)
脏腑诸胀针治。(疾病五十六。)
周痹众痹之刺。(疾病六十八。)
升降不前,气交有变,即成暴郁,须穷刺法。(运气三十一。)
司天不迁正不退位之刺。(运气三十九。)
刚柔失守三年化疫之刺。(运气四十一。)
神失守位邪鬼外干之刺。(运气四十三。)
形气不足,病气不足,此阴阳气俱不足也,不可刺之。(针刺五十六。)
因此,善于使用针刺的人,从阴经引导阳气,从阳经引导阴气,通过治疗右侧来调理左侧,通过治疗左侧来调理右侧;以自身的感知去推知患者的状况,以表证的表现为依据来了解里证的情况,以此观察病情过度或不足的机理,见到细微的变化就能察觉病邪的过错,这样运用针刺就不会有危险。(参见《论治类》第八篇。)
所以,针刺的方法有着保全精神、涵养真气的宗旨,也是效法修真之道的体现,其目的不仅仅是治疗疾病。达到至真境界的关键,在于探究天道的玄妙,使精神守护于天息之中,回归本元,这叫做“归宗”。(参见《运气》第四十三篇。)
黄帝问道:针刺各个阴阳经脉应当如何处理?岐伯回答说:通过诊察寸口脉和人迎脉,来调节阴阳。如果脉象凝滞涩缓,就要用针引气以温通经脉,待血液调和后再停止针刺。如果有脉络结聚,导致血脉凝结不通,就要刺破结络使其通畅。所以说:气有余于上部的,要引导它向下运行;气不足于上部的,要推动并休止(指补益)它;对于气血稽留不行的,要顺势迎而取之。必须精通经络隧道的理论,才能掌握这些原则。寒热相争的,要疏导而行;对于瘀血停滞但未结成硬块的,要根据情况给予处理。必须先明确二十五种不同体质类型的人,了解他们血气所在的部位,左右上下分布的情况,针刺的要领就完备了。(参见《藏象》第三十一篇。)
根据白昼和黑夜的长短,分别制定纪时标准来进行针刺。谨慎地等候时机,疾病就可以预期治愈,如果失去时机反而违背了时令规律,各种疾病就无法治愈。所以说:针刺实证,要迎着邪气来的方向刺;针刺虚证,要顺着邪气离去的方向刺。这是说根据气的存亡时机,来候察虚实进行针刺。这叫做“逢时”。病在三阳经,必须等候气在阳分的时候再刺;病在三阴经,必须等候气在阴分的时候再刺。(参见《经络》第二十五篇。)
清气运行的气息滑利,浊气运行的气息涩滞。所以针刺阴经,要深刺并留针;针刺阳经,要浅刺并快速出针;清浊之气相互干扰的,用适当的次数来调节。(参见《藏象》第十九篇。)
疾病有标和本,针刺有逆法和顺法。凡是针刺的原则,必须辨别阴阳。所以知道逆与顺,正行无问,知道标本的,万举万当,不知道标本,这叫妄行。(参见《标本》第四篇。)
针刺急症,要深进针并长时间留针。针刺缓症,要浅进针并快速出针,以去除热邪。针刺大脉(实热),轻微泻其气,不要放出血液。针刺滑脉,快速出针并浅刺,以泻阳气而去热。针刺涩脉,必须中其脉,随着逆顺方向久留针,必须先按压循按,已出针后,迅速按住针孔,不让出血,以调和经脉。所有小脉(虚弱),阴阳形气都不足,不要用针刺,而要用甘味药物来调治。(参见《脉色》第十九篇。)
大凡针刺的方法,必须以神为本。所以使用针的人,要观察病患的状态,以此知晓精神魂魄的存亡得失之意,如果五脏精气受伤,针就不能治疗它。(参见《藏象》第九篇。)
疾病刚开始的时候,可以用针刺治愈。(参见《论治》第八篇。)
经脉发病的治疗其经穴,孙络发病的治疗其孙络出血,血病身体疼痛的治疗其经络。病邪在奇经异邪,奇邪的脉象则用缪刺法。形体消瘦且病位固定不移的,在腧节处针刺。上部实下部虚的,切按并从之,寻找结络脉,刺出其血,以见通畅。(参见《脉色》第二十五篇。)
五脏本来与六腑互为表里,经络支节各自产生虚实病变,病在哪里,就随其位置进行调治。病在脉,调治血;病在血,调治络;病在气,调治卫气;病在肉,调治分肉;病在筋,调治筋;病在骨,调治骨。用火针劫刺其下部及拘急之处;病在骨,用燔针药熨;病不知痛处,取两跷脉;身形有痛,九候脉象没有异常,就用缪刺法;痛在左边而右边脉象有病,就用巨刺法。必须仔细诊察九候脉象,针刺的道理就完备了。(参见《疾病》第二十篇。)
所谓实证,是气入内。所谓虚证,是气外出。气实的,表现为热。气虚的,表现为寒。进入实证,左手张开针孔。进入虚证,左手闭合针孔。(参见《疾病》第二十一篇。)
泻实的方法是:气盛时才进针,针与气一起进入,打开门户就像打开窗户一样,针与气一起退出,精气不伤,邪气乃下,外门不闭,以排出疾邪,摇大其道就像疏通道路一样,这叫做“大泻”,必须切按而出,大气乃屈。黄帝问:补虚怎么做?岐伯说:持针不要放置,以安定心意,等候呼气时进针,气出针入,针孔四周闭塞,精气无从出去,方实而快速出针,气入针出,热气不得返还,闭塞其门,邪气布散,精气乃得保存,动气候时,近气不失,远气乃来,这叫做“追之”。(参见《疾病》第二十篇。)
十二经病的针刺,盛则泻之,虚则补之,热则疾之,寒则留之,陷下则灸之,不盛不虚,以经取之。足少阴经病,灸后应强食生肉,放松腰带披散头发,拄着大杖穿着重鞋行走。(参见《疾病》第十篇。)
有余有五,不足有五。有余的泻之,不足的补之。(参见《疾病》第十八篇。)
不要损伤不足之人,身体羸瘦的,不要用砭石。不要增益有余之人,腹中有形而泄之,泄之则精出而病独擅中,所以叫疹成。(参见《疾病》第六十二篇。)
血气有余,肌肉坚致,所以可以用苦味的针法。(参见《脉色》第三十一篇。)
患有肾风病的人,正气虚不当刺,不当刺而刺,五天后邪气必至。(参见《疾病》第三十一篇。)
脉小而短的少气,严重的泻之则会胸闷,闷甚则仆倒不能说话,胸闷则紧急让其坐下。(参见《经络》第六篇。)
六经厥证,盛则泻之,虚则补之,不盛不虚,以经取之。(参见《疾病》第三十五篇。)
气滑即出针快,气涩则出针慢,气悍则针小而入浅,气涩则针大而入深,深则想留针,浅则想快出。(参见《针刺》第五十六篇。)
平治于权衡,去除宛陈。轻微活动四肢,穿暖衣服,缪刺其处,以恢复其形体。开鬼门(发汗),洁净府(利小便),精气按时服用,五阳已布,疏涤五脏,所以精气自生,形体自盛,骨肉相保,巨气乃平。(参见《论治》第十五篇。)
太阳脏独至,厥喘虚气逆,这是阴不足、阳有余,表里都应当泻,取下俞穴。阳明脏独至,是阳气重并,应当泻阳补阴,取下俞穴。少阳脏独至,是厥气,跷前卒大,取下俞穴,少阳独至者,是一阳之过。太阴脏搏者,用心省真,五脉气少,胃气不平,是三阴,宜治其下俞,补阳泻阴。一阳独啸,少阳厥也,阳并于上,四脉争张,气归于肾,宜治其经络,泻阳补阴。一阴至,厥阴之治也,真虚心,厥气留薄,发为白汗,调食和药,治在下俞。(参见《脉色》第十五篇。)
足阳明经,是五脏六腑之海,其脉大血多,气盛热壮,刺此者不深弗散,不留不泻也。足阳明,刺深六分,留十呼。足太阳深五分,留七呼。足少阳深四分,留五呼。足太阴深三分,留四呼。足少阴深二分,留三呼。足厥阴深一分,留二呼。手之阴阳,其受气之道近,其气之来疾,其刺深者皆无过二分,其留皆无过一呼。其少长大小肥瘦,以心撩之,命曰法天之常。灸之亦然。灸而过此者得恶火,则骨枯脉涩;刺而过此者,则脱气。(参见《经络》第三十三篇。)
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。(参见《经络》第二十篇。)
诸刺络脉者,必刺其结上,甚血者虽无结,急取之以泻其邪而出其血,留之发为痹也。(参见《经络类》第六篇。)
孙络三百六十五穴会,亦以应一岁,以溢奇邪,以通荣卫,荣卫稽留,卫散荣溢,气竭血着,外为发热,内为少气,疾泻无怠,以通荣卫,见而泻之,无问所会。溪谷三百六十五穴会,亦应一岁,其小痹淫溢,循脉往来,微针所及,与法相同。(参见《经络》第八篇。)
十二原穴,主治五脏六腑之有疾者也。(参见《经络》第十五篇。)
病始手臂者,先取手阳明太阴而汗出;病始头首者,先取项太阳而汗出;病始足胫者,先取足阳明而汗出。臂太阴可汗出,足阳明可汗出。故取阴而汗出甚者,止之于阳;取阳而汗出甚者,止之于阴。(参见《针刺》第五十四篇。)
刺上关者,口不能欠;刺下关者,欠不能口。刺犊鼻者,屈不能伸;刺两关者,伸不能屈。(参见《经络》第十篇。)
刺胸腹者,必以布HT 着之,乃从单布上刺。(参见《针刺》第十九篇。)
脏腑之咳,治之奈何?岐伯曰∶治脏者治其俞,治腑者治其合,浮肿者治其经。(参见《疾病》第五十二篇。)
夫痈气之息者,宜以针开除去之;夫气盛血聚者,宜石而泻之。(参见《疾病》第八十八篇。)
五脏背 ,灸之则可,刺之则不可。气盛则泻之,虚则补之。以火补者,毋吹其火,须自灭也。(参见《经络》第十一篇。)
络满经虚,灸阴刺阳;经满络虚,刺阴灸阳。(参见《疾病》第十六篇。)
紧则先刺而后灸之。陷下则徒灸之,陷下者,脉血结于中,中有着血,血寒,故宜灸之。(参见《针刺》第二十九篇。)
针所不为,灸之所宜。阴阳皆虚,火自当之。经陷下者,火则当之,结络坚紧,火所治之。不知所苦,两跷之下,男阴女阳,良工所禁。(参见《针刺》第十篇。)
正月二月三月,人气在左,无刺左足之阳;四月五月六月,人气在右,无刺右足之阳。七月八月九月,人气在右,无刺右足之阴;十月十一月十二月,人气在左,无刺左足之阴。(参见《经络类》第三十四篇。)
大禁二十五,在天府下五寸。(参见《经络》第七篇。)
无刺 之热,无刺浑浑之脉,无刺漉漉之汗,故为其病逆未可治也。先其时坚束其处,令邪气不得入,阴气不得出,审候见之在孙络盛坚而血者皆取之。(参见《疾病》第四十八篇。)
五逆,工不察此者而刺之,是谓逆治。(参见《疾病类》第九十二篇。)
诸病以次相传,如是者,皆有死期,不可刺也;间一脏及二三四脏者,乃可刺也。(参见《疾病》第九十四篇。)
口问十二邪之刺。(参见《疾病》第七十九篇。)
脏腑诸胀针治。(参见《疾病》第五十六篇。)
升降不前,气交有变,即成暴郁,须穷刺法。(参见《运气》第三十一篇。)
司天不迁正不退位之刺。(参见《运气》第三十九篇。)
神失守位邪鬼外干之刺。(参见《运气》第四十三篇。)
Therefore, those who are skilled in using acupuncture guide Yang from Yin and guide Yin from Yang; they treat the right side to regulate the left, and the left side to regulate the right. They use their own perception to understand the patient's condition, and use exterior manifestations to know interior pathology. By observing the principles of excess and deficiency, one can detect errors from subtle signs, and thus applying acupuncture will never lead to danger. (See *Lun Zhi Lei*, Chapter 8.)
Thus, the method of needling has the purport of preserving spirit and nurturing true Qi; it also follows the Way of cultivation, not merely treating diseases. The essence of reaching the Ultimate Truth lies in the mystery of Heaven. When spirit guards the Heavenly Breath and returns to the primal origin, it is called "Returning to the Source." (See *Yun Qi*, Chapter 43.)
The Yellow Emperor asked: How should one needle the various Yin and Yang meridians? Qibo replied: One regulates Yin and Yang by palpating the Cunkou (Radial artery) and Yingchang (Carotid artery) pulses. If the pulse is stagnant and choppy, one induces Qi to warm the channels, stopping only when the blood is harmonious. If there are knotted collaterals where blood does not flow due to knotting, one punctures them to restore flow. Thus it is said: For Qi that is excessive above, guide it downward; for Qi that is deficient above, push and nourish it; for Qi that stagnates and fails to arrive, follow its direction to welcome it. One must clearly understand the Jing-Tong (meridian pathways) to master these techniques. In cases of cold and heat contention, guide and promote flow; for stasis blood that is not firmly knotted, treat according to circumstances. One must first clearly understand the twenty-five types of constitutions to know the location of blood and Qi, their distribution in left/right and upper/lower, so that the principles of needling are complete. (See *Zang Xiang*, Chapter 31.)
According to the length of day and night, establish time standards for needling. Carefully await the appropriate time; if done correctly, the disease can be expected to heal. Losing the time or acting contrary to seasonal patterns means a hundred diseases cannot be treated. Thus it is said: To needle excess conditions, needle against the incoming Qi; to needle deficiency conditions, needle with the outgoing Qi. This refers to timing the presence or absence of Qi to observe deficiency and excess before needling. This is called "Meeting the Time." For diseases in the Three Yang meridians, one must wait until the Qi is in the Yang aspect before needling; for diseases in the Three Yin meridians, one must wait until the Qi is in the Yin aspect before needling. (See *Jing Luo*, Chapter 25.)
Clear Qi moves smoothly, while turbid Qi moves sluggishly. Therefore, when needling Yin meridians, insert deeply and retain the needle; when needling Yang meridians, insert shallowly and withdraw quickly. When clear and turbid Qi interfere with each other, adjust the number of manipulations accordingly. (See *Zang Xiang*, Chapter 19.)
Diseases have a Biao (Branch/Symptom) and Ben (Root/Cause); needling has Ni (Opposite/Reverse) and Cong (Following/Concordant). The principle of all needling is to distinguish Yin and Yang. Knowing Opposite and Concordant allows correct action without hesitation; knowing Root and Branch ensures success in every attempt. Not knowing Root and Branch is called reckless action. (See *Biao Ben*, Chapter 4.)
For urgent conditions, insert deeply and retain for a long time. For slack conditions, insert shallowly and withdraw quickly to remove heat. For large pulses (excess-heat), slightly drain Qi without releasing blood. For slippery pulses, withdraw quickly and insert shallowly to drain Yang Qi and remove heat. For choppy pulses, ensure penetration into the vessel, retain for a long time following the direction of flow, press and massage beforehand, and after withdrawing, quickly press the acupoint to prevent bleeding and harmonize the pulse. For small pulses (deficiency), where both Yin-Yang and Form-Qi are insufficient, do not use needles but regulate with sweet medicines. (See *Mai Se*, Chapter 19.)
All methods of needling must be based on Shen (Spirit). Therefore, the practitioner must observe the patient's state to know the existence or loss of Spirit, Hun, Po, Xin, and Yi. If these five are injured, needles cannot treat them. (See *Zang Xiang*, Chapter 9.)
At the beginning of a disease, it can be cured by needling. (See *Lun Zhi*, Chapter 8.)
Treat the Jing-Meridian for diseases of the Jing-Meridian; treat the Sun-Luo (Collaterals) for diseases of the Sun-Luo involving blood; treat the Jing-Luo for blood diseases accompanied by body pain. For diseases caused by strange pathogens affecting unusual vessels, use Miu-Ci (Misplaced Puncture). For chronic wasting conditions that do not move, puncture at the joints. For Upper Excess and Lower Deficiency, palpate and follow the flow, seek out knotted collaterals, puncture to release blood, thereby restoring circulation. (See *Mai Se*, Chapter 25.)
The Five Zang organs naturally have Six Fu organs as their interior-exterior pairs. Meridians and joints generate deficiency and excess independently. Treat according to the location of the disease. Disease in the Mai (Vessels): regulate Blood. Disease in Blood: regulate Collaterals. Disease in Qi: regulate Wei-Qi. Disease in Flesh: regulate Fen-Rou (Muscle intervals). Disease in Sinews: regulate Sinews. Disease in Bone: regulate Bone. Use burning needles (Cao-Zhen) to劫-stimulate the lower areas and sites of spasm. For bone diseases, use Cao-Zhen and medicinal hot compresses. For unknown pain locations, target the two Qiao vessels. For body pain with normal Jiuhou (Nine Palpations), use Miu-Ci. For pain on the left with pathological pulses on the right, use Ju-Ci (Great Puncture). One must carefully examine the Nine Palpations; then the Dao of Needling is complete. (See *Ji Bing*, Chapter 20.)
Excess is Qi entering; Deficiency is Qi exiting. Qi Excess manifests as Heat; Qi Deficiency manifests as Cold. For entering Excess, open the needle hole with the left hand. For entering Deficiency, close the needle hole with the left hand. (See *Ji Bing*, Chapter 21.)
To drain Excess: Insert the needle only when Qi is abundant. Insert the needle along with the incoming Qi, opening the gate like opening a door. Withdraw the needle along with the outgoing Qi. Essence is not damaged, Evil Qi descends. Keep the outer gate open to expel the pathogen. Shake the needle to widen the pathway, like clearing a road. This is called "Great Draining." Press firmly upon withdrawal to subdue the strong Qi. The Emperor asked: How to tonify Deficiency? Qibo replied: Hold the needle without placing it down, stabilize your intent. Wait for exhalation to insert the needle; as Qi exits, the needle enters. Seal the four sides of the needle hole so Essence cannot escape. When the area feels full, withdraw the needle quickly; as Qi enters, the needle exits. Heat cannot return. Close the gate tightly. Evil Qi disperses, Essence is preserved. Move with the climate and time. Near Qi is not lost, Distant Qi arrives. This is called "Pursuing [the Qi]." (See *Ji Bing*, Chapter 20.)
For diseases of the Twelve Meridians: Drain Excess, Tonify Deficiency, Treat Heat with rapid needling, Treat Cold with retention, Moxibustion for sinking/collapsed conditions, and treat via the Meridian itself for neither-excess-nor-deficiency conditions. For Foot-Shaoyin meridian diseases, after moxibustion, eat strongly to generate flesh, loosen belts, let hair down, and walk with a large staff and heavy shoes. (See *Ji Bing*, Chapter 10.)
There are five types of Excess and five types of Deficiency. Drain Excess, Tonify Deficiency. (See *Ji Bing*, Chapter 18.)
Do not harm those with Deficiency; if the body is emaciated, do not use Bian-Shi (Stone lancets). Do not benefit those with Excess; draining abdominal masses causes Essence to exit while the pathogen remains dominant internally, leading to the formation of rashes. (See *Ji Bing*, Chapter 62.)
If Blood and Qi are in excess and muscles are firm and dense, bitter-pungent needle techniques can be used. (See *Mai Se*, Chapter 31.)
For patients with Kidney-Feng (Wind-Dampness of the Kidney), who are deficient and should not be needled: if needled inappropriately, the pathogenic Qi will arrive in five days. (See *Ji Bing*, Chapter 31.)
For small and short pulses indicating Shortness of Qi: severe draining causes chest oppression. Severe oppression leads to collapse and inability to speak. In case of oppression, urgently have the patient sit down. (See *Jing Luo*, Chapter 6.)
For Jue syndromes of the Six Meridians: Drain Excess, Tonify Deficiency, treat via the Meridian for neither-excess-nor-deficiency. (See *Ji Bing*, Chapter 35.)
Smooth Qi requires quick withdrawal; Choppy Qi requires slow withdrawal. Bold/Han Qi requires small needles inserted shallowly; Choppy Qi requires large needles inserted deeply. Deep insertion implies retention; shallow insertion implies speed. (See *Zhen Ci*, Chapter 56.)
Balance through weighing scales. Remove accumulated stasis. Slightly move the four extremities, wear warm clothes, apply Miu-Ci to restore form. Open the Ghost Gate (sweat pores), Purify the Water House (bladder). Essence is consumed in time. The Five Yangs are distributed. Clear and wash the Five Zang. Thus Essence generates spontaneously, Form prospers, Bone and Flesh protect each other, and Great Qi becomes peaceful. (See *Lun Zhi*, Chapter 15.)
Taiyang Zang alone reaches extreme levels: Jue, wheezing, and reversed deficient Qi indicate Yin deficiency and Yang excess. Both Interior and Exterior require draining; select Lower Shu points. Yangming Zang alone reaches extreme levels: indicates heavy accumulation of Yang Qi. Drain Yang, Tonify Yin; select Lower Shu points. Shaoyang Zang alone reaches extreme levels: indicates Jue Qi. The Qiao vessels before suddenly enlarge; select Lower Shu points. Shaoyang alone reaching extreme is an error of One Yang. Taiyin Zang pulsing vigorously: examine sincerely. Five pulses lack Qi, Stomach Qi is uneven; this is Three Yin. Treat Lower Shu points, Tonify Yang, Drain Yin. One Yang whistles alone: Shaoyang Jue. Yang merges upward, Four pulses compete and expand, Qi returns to Kidney. Treat meridians, Drain Yang, Tonify Yin. One Yin arrives: Zhuiyin treatment. True deficiency of Heart, Jue Qi lingers thinly, causing white sweat. Regulate diet and medicine, treat Lower Shu points. (See *Mai Se*, Chapter 15.)
Foot-Yangming is the Sea of the Five Zang and Six Fu. Its vessels are large, blood abundant, Qi prosperous, heat strong. Needling this meridian requires depth to disperse, and retention to drain. Foot-Yangming: insert deep 6 fen, retain 10 breaths. Foot-Taiyang: deep 5 fen, retain 7 breaths. Foot-Shaoyang: deep 4 fen, retain 5 breaths. Foot-Taiyin: deep 3 fen, retain 4 breaths. Foot-Shaoyin: deep 2 fen, retain 3 breaths. Foot-Jueyin: deep 1 fen, retain 2 breaths. Hand Yin-Yang: pathways for receiving Qi are near, arrival of Qi is fast. Depth should not exceed 2 fen, retention should not exceed 1 breath. Adjust for age, size, fat/thin constitution mentally; this is called following the constant laws of Heaven. Moxibustion follows similar rules. Exceeding these limits in moxibustion causes evil fire, leading to dry bones and sluggish pulses. Exceeding these limits in needling causes depletion of Qi. (See *Jing Luo*, Chapter 33.)
Needle Yangming: release Blood and Qi. Needle Taiyang: release Blood, avoid releasing Qi (or release Qi avoiding Blood - context implies specific directional flow). Needle Shaoyang: release Qi, avoid releasing Blood. Needle Taiyin: release Qi, avoid releasing Blood. Needle Shaoyin: release Qi, avoid releasing Blood. Needle Jueyin: release Blood, avoid releasing Qi. (See *Jing Luo*, Chapter 20.)
For all collateral needling, must puncture at the site of knots. For severe blood stasis even without knots, urgently take to drain evil and release blood; retaining it causes Bi syndrome. (See *Jing Luo Lei*, Chapter 6.)
Sun-Luo (Fine Collaterals) meet at 365 acupoints, corresponding to one year, to overflow strange evils and circulate Ying-Wei. If Ying-Wei stagnate, Wei scatters and Ying overflows, Qi exhausts and Blood adheres. Exteriorly causes fever, interiorly causes shortness of Qi. Rapidly drain without delay to circulate Ying-Wei. See and drain, regardless of specific meeting points. Xi-Gu (Valleys) meet at 365 acupoints, corresponding to one year. For minor Bi overflowing along meridians, micro-needles suffice, following the same method. (See *Jing Luo*, Chapter 8.)
Fifteen Luo-Vessel diseases require needling. (See *Jing Luo*, Chapter 5.)
Twelve Yuan-Source points govern diseases of the Five Zang and Six Fu. (See *Jing Luo*, Chapter 15.)
Disease starting in arms/head: first needle Hand-Yangming and Hand-Taiyin to induce sweating. Disease starting in head/neck: first needle Neck-Taiyang to induce sweating. Disease starting in legs/shins: first needle Foot-Yangming to induce sweating. Arm-Taiyin can induce sweating; Foot-Yangming can induce sweating. Thus, if taking Yin points causes excessive sweating, stop at Yang points; if taking Yang points causes excessive sweating, stop at Yin points. (See *Zhen Ci*, Chapter 54.)
Needling Shangguan: mouth cannot gape. Needling Xiaguan: mouth cannot close. Needling Dubi: knee cannot bend. Needling both Guan points: knee cannot flex/extend freely. (See *Jing Luo*, Chapter 10.)
Needling Chest/Abdomen: must place cloth upon it, then needle through the single layer of cloth. (See *Zhen Ci*, Chapter 19.)
Five Zang Heat Death/Life Needling Methods. (See *Ji Bing*, Chapter 44.)
Cough of Zang/Fu organs: How to treat? Qibo said: Treat Zang diseases at their Shu points; treat Fu diseases at their He-Sea points; treat edema at their Jing-River points. (See *Ji Bing*, Chapter 52.)
For abscesses where Qi stagnates: open and remove with needles. For cases where Qi is excessive and Blood gathers: use stone lancets to drain. (See *Ji Bing*, Chapter 88.)
Malaria needling of various meridians. (See *Ji Bing*, Chapter 50.)
Five Zang Back-Shu points: Moxibustion is permissible, needling is not. Excess: drain. Deficiency: tonify. Fire tonification: do not blow the fire, let it extinguish naturally. (See *Jing Luo*, Chapter 11.)
Collateral Full, Meridian Empty: Moxa Yin, Needle Yang. Meridian Full, Collateral Empty: Needle Yin, Moxa Yang. (See *Ji Bing*, Chapter 16.)
Tight pulse: Needle first, then Moxa. Sinking/Collapsed: Only Moxa. Sinking indicates Blood-Knot in middle, congealed Blood, Cold Blood; thus Moxa is suitable. (See *Zhen Ci*, Chapter 29.)
Where needles fail, Moxa is suitable. Both Yin and Yang deficient: Fire handles it. Meridians sunk/collapsed: Fire handles it. Knotted collaterals hard/tight: Fire treats them. Unknown suffering: Lower part of Two Qiao vessels. Men: Yin side; Women: Yang side. Skilled physicians forbid needling here. (See *Zhen Ci*, Chapter 10.)
Jan-Feb-Mar: Qi is in Left. Do not needle Left Foot Yang. Apr-May-Jun: Qi is in Right. Do not needle Right Foot Yang. Jul-Aug-Sep: Qi is in Right. Do not needle Right Foot Yin. Oct-Nov-Dec: Qi is in Left. Do not needle Left Foot Yin. (See *Jing Luo Lei*, Chapter 34.)
Major Taboo 25: Located 5 cun below Tianfu. (See *Jing Luo*, Chapter 7.)
Do not needle high fever. Do not needle chaotic pulses. Do not needle dripping sweat. These are reverse diseases, not yet treatable. Before the time, bind the area firmly to prevent Evil entry and Yin exit. Observe carefully: if Sun-Luo are full, hard, and bloody, take them. (See *Ji Bing*, Chapter 48.)
Five Reversals: If practitioners do not examine these and needle, it is called Reverse Treatment. (See *Ji Bing Lei*, Chapter 92.)
Diseases transmitting sequentially: All have death dates, cannot be needled. Skipping one Zang or two-three-four Zangs: Can be needled. (See *Ji Bing*, Chapter 94.)
Gen-Jie (Root-Connection) diseases of various meridians require needling. (See *Jing Luo*, Chapter 30.)
Bi syndrome of Twelve Jing-Tendinomuscular meridians requires needling. (See *Ji Bing*, Chapter 69.)
Needling for Twelve Evils of Kou-Wen. (See *Ji Bing*, Chapter 79.)
Needling for Twenty-Five Yin-Yang Constitutions. (See *Zang Xiang*, Chapter 31.)
Needling treatment for various distensions of Zang/Fu. (See *Ji Bing*, Chapter 56.)
Needling for Zhou-Bi (General Bi) and Zhong-Bi (Clustered Bi). (See *Ji Bing*, Chapter 68.)
Ascending/Descending not proceeding, Qi intersection changes causing sudden depression: Must exhaust needling methods. (See *Yun Qi*, Chapter 31.)
Needling for Si-Tian failing to migrate properly or retreat position. (See *Yun Qi*, Chapter 39.)
Needling for Gang-Rou mismatch leading to epidemic transformation in three years. (See *Yun Qi*, Chapter 41.)
Needling for Shen losing position, allowing Evil/Ghosts to externally invade. (See *Yun Qi*, Chapter 43.)
Form-Qi insufficient, Disease-Qi insufficient: This is mutual insufficiency of Yin-Yang Qi. Cannot be needled. (See *Zhen Ci*, Chapter 56.)