（《素问·刺要论》全《刺齐论》全）
黄帝问曰∶愿闻刺要。
（《素问·刺要论》全）。）岐伯对曰∶病有浮沉，刺有浅深，各至其理，无过其道。（应浅不浅，应深不深，皆过其
道也。）过之则内伤，不及则生外壅，壅则邪从之。（过于深则伤气于内，失于浅则致气于外，故为壅肿而邪反从之。）
浅
深不得，反为大贼，内动五脏，后生大病。（贼，害也。动，伤动也。后生大病，详如下文。）故曰病有在毫毛腠理者，
有在皮肤者，有在肌肉者，有在脉者，有在筋者，有在骨者，有在髓者。（此详言内外之浅深，以见用针者当各有所取
也。）
是故刺毫毛腠理无伤皮，皮伤则内动肺，肺动则秋病温疟，溯溯然寒栗。（刺毫毛腠理者，最浅者也。皮则稍深矣，皮
为
肺之合，皮伤则内动于肺。肺应秋，故秋病温疟，溯溯然寒栗也。溯音素。）刺皮无伤肉，肉伤则内动脾，脾动则七十
二
日四季之月，病腹胀烦不嗜食。（皮在外，肉在内。肉为脾之合，肉伤则内动于脾。脾土寄王于四季之末各一十八日，
共
为七十二日，脾气既伤，不能运化，故于辰戌丑未之月，当病胀烦不嗜食也。）刺肉无伤脉，脉伤则内动心，心动则夏
病
心痛。（脉在肉中，为心之合，脉伤则内动于心。心王于夏，外气伤，故夏为心痛。）刺脉无伤筋，筋伤则内动肝，肝动
则春病热而筋弛。（脉非筋也，筋合肝而王于春，筋伤则肝气动，故于春阳发生之时，当病热证。热则筋缓，故为弛纵。
，弛同。）刺筋无伤骨，骨伤则内动肾，肾动则冬病胀腰痛。（筋在外，骨在内。骨合肾而王于冬，骨伤则内动于肾，
故至冬时为病胀，为腰痛，以化元受伤，而腰为肾之府也。）刺骨无伤髓，髓伤则销铄 酸，体解 然不去矣。（髓为骨
之充，精之属，最深者也。精髓受伤，故为干枯销铄 酸等病。解 者，懈怠困弱之名，阴之虚也。阴虚则气虚，气虚
则不能举动，是谓不去也。按∶海论所言髓海不足者，病多类此，详经络类三十二。铄，式灼切。 音杭。 音迹。）
黄帝问曰∶愿闻刺浅深之分。
（《素问·刺齐论》全）。岐伯对曰∶刺骨者无伤筋，刺筋者无伤肉，刺肉者无伤脉，刺脉者无伤皮；刺皮者无伤肉，
刺肉者无伤筋，刺筋者无伤骨。（前四句言宜深者勿浅，后三句言宜浅者勿深也。义如下文。）帝曰∶余未知其所谓，愿
闻其解。岐伯曰∶刺骨无伤筋者，针至筋而去，不及骨也。（病在骨者，直当刺骨，勿伤其筋；若针至筋分，索气而去，
不及于骨，则病不在肝，攻非其过，是伤筋也。）刺筋无伤肉者，至肉而去，不及筋也。（病在筋者，直当刺筋；若针至
肉分而去，不及于筋，则病不在脾，是伤肉也。）刺肉无伤脉者，至脉而去，不及肉也。（病在肉者，直宜刺肉；若刺至
脉分而去，不及于肉，则病不在心，是伤脉也。）刺脉无伤皮者，至皮而去，不及脉也。（病在脉者，直当刺脉；若针至
皮分而去，不及于脉，则病不在肺，是伤皮也。以上四节，言当深不深之为害也。）所谓刺皮无伤肉者，病在皮中，针入
皮中，无伤肉也。（刺皮过深而中肉者，伤其脾气。）刺肉无伤筋者，过肉中筋也。（刺肉过深而中筋者，伐其肝气。）刺
筋无伤骨者，过筋中骨也。此谓之反也。（刺筋过深而中骨者，伤其肾气。此上三节，言不当深而深者之害，是皆所谓反
也。）
（《素问·刺要论》和《刺齐论》全文）
岐伯回答说：疾病有在表在里的区别，针刺就有浅刺深刺的不同，必须各达到其应有的深度，不要超过或不及规定的范围。（应当浅刺而不浅刺，应当深刺而不深刺，都属于超过了限度。）如果过深就会内伤脏腑，过浅则会导致体表气机壅滞，气机壅滞则邪气容易乘虚而入。（针刺过于深入会损伤体内的正气，针刺过于浅表会使气机郁结于外，所以出现肿胀而邪气反而随之侵入。）深浅不得当，反而成为大的祸害，扰动五脏，日后引发严重的疾病。（“贼”是伤害的意思。“动”是伤动、扰乱的意思。“后生大病”，详细内容见下文。）所以说，病有的在毫毛腠理，有的在皮肤，有的在肌肉，有的在脉，有的在筋，有的在骨，有的在髓。（这里详细说明了内外病变的深浅层次，以表明施针者应当根据病情选择相应的针刺深度。）
因此，针刺毫毛腠理时不要伤及皮肤，皮肤受伤则会内动肺脏，肺脏受损则在秋季发生温疟病，表现为瑟瑟发抖、畏寒战栗。（针刺毫毛腠理是最浅的层次。皮肤稍深一些，皮肤与肺相合，皮肤受伤则内动肺脏。肺对应秋季，所以秋季易患温疟，出现瑟瑟然畏寒战栗的症状。“溯”音同“素”。）针刺皮肤时不要伤及肌肉，肌肉受伤则会内动脾脏，脾脏受损则在四季末各十八天共七十二天的月份里，出现腹胀、心烦、不想吃东西的症状。（皮肤在外，肌肉在内。肌肉与脾相合，肌肉受伤则内动脾脏。脾土寄旺于四季之末各十八天，共计七十二天，脾气既已受伤，不能运化水谷，所以在辰、戌、丑、未月，应当出现胀满、心烦、不欲饮食的症状。）针刺肌肉时不要伤及血脉，血脉受伤则会内动心脏，心脏受损则在夏季发生心痛病。（血脉在肌肉之中，与心相合，血脉受伤则内动心脏。心王于夏季，若外气受伤，故夏季易发心痛。）针刺血脉时不要伤及筋腱，筋腱受伤则会内动肝脏，肝脏受损则在春季发生热证且筋脉弛缓。（血脉并非筋腱，筋腱与肝相合并王于春季，筋腱受伤则肝气妄动，所以在春季阳气升发之时，应当发生热证。热盛则筋脉松弛，所以称为弛纵。“弛”字同义。）针刺筋腱时不要伤及骨骼，骨骼受伤则会内动肾脏，肾脏受损则在冬季发生腹胀和腰痛病。（筋腱在外，骨骼在内。骨骼与肾相合并王于冬季，骨骼受伤则内动肾脏，所以到了冬季会出现腹胀、腰痛的症状，这是因为元阳之气受伤，而腰为肾之府邸的缘故。）针刺骨骼时不要伤及骨髓，骨髓受伤则身体消瘦枯槁、酸软无力，肢体懈怠困弱无法起身活动。（骨髓是骨骼中的充养物，属于精的一类，位置最深。精髓受伤，所以出现干枯消瘦、酸软等病症。“解㑊”是形容懈怠困弱的名称，属于阴气虚弱。阴虚则气虚，气虚则不能举动，这就是所说的“不去”。按：《海论》中提到的髓海不足，病症大多类似于此，详见经络类第三十二节。“铄”读音为“式灼切”。“㑊”音同“杭”。“解”音同“迹”。）
（《素问·刺齐论》全文。）岐伯回答说：针刺骨骼时不要伤及筋腱，针刺筋腱时不要伤及肌肉，针刺肌肉时不要伤及血脉，针刺血脉时不要伤及皮肤；针刺皮肤时不要伤及肌肉，针刺肌肉时不要伤及筋腱，针刺筋腱时不要伤及骨骼。（前四句说的是应当深刺的不要浅刺，后三句说的是应当浅刺的不要深刺。含义如下文所述。）黄帝说：我不明白您说的意思，希望您给我解释一下。岐伯说：所谓“刺骨无伤筋”，是指针到达筋部就停止，没有达到骨骼。（病在骨的，应当直接刺骨，不要伤及其筋；如果针只到筋的分层就索取经气而退去，没有达到骨，那么病不在肝，攻伐的不是病灶所在，这就是伤了筋。）所谓“刺筋无伤肉”，是指针到达肌肉就停止，没有达到筋。（病在筋的，应当直接刺筋；如果针只到肌肉的分层就退去，没有达到筋，那么病不在脾，这就是伤了肉。）所谓“刺肉无伤脉”，是指针到达血脉就停止，没有达到肌肉。（病在肉的，应当直接刺肉；如果针刺到血脉的分层就退去，没有达到肌肉，那么病不在心，这就是伤了脉。）所谓“刺脉无伤皮”，是指针到达皮肤就停止，没有达到血脉。（病在脉的，应当直接刺脉；如果针只到皮肤的分层就退去，没有达到脉，那么病不在肺，这就是伤了皮。以上四节，讲的是应当深刺而没有深刺的危害。）所谓“刺皮无伤肉”，是指病在皮中，针进入皮中，不伤及肌肉。（针刺皮肤过深而伤及肌肉，会伤及脾气。）所谓“刺肉无伤筋”，是指针刺过肌肉伤及了筋。（针刺肌肉过深而伤及筋，会伐伤肝气。）所谓“刺筋无伤骨”，是指针刺过筋伤及了骨。这叫做反逆。（针刺筋过深而伤及骨，会伤及肾气。以上三节，讲的是不应当深刺而深刺的危害，这些都叫做“反”。）
(The full texts of *Suwen: Discourse on the Essentials of Needling* and *Discourse on the Levels of Needling*)
The Yellow Emperor asked, "I wish to hear about the essentials of needling."
Qibo replied, "Diseases manifest at different depths, superficial or deep; accordingly, needling must be performed at corresponding shallow or deep levels. Each treatment must reach its proper depth without exceeding the prescribed limits. (Failing to needle shallowly when required, or deeply when required, constitutes an excess beyond the limit.) If needling is too deep, it causes internal injury; if too shallow, it leads to external stagnation. Stagnation allows pathogenic factors to invade. (Needling too deeply damages the interior Qi, while needling too superficially causes Qi to stagnate externally, resulting in swelling and allowing pathogens to follow.) Improper depth becomes a great harm, disturbing the Five Zang organs and subsequently giving rise to severe diseases. ('Zei' means harm. 'Dong' means disturbance or injury. 'Subsequently giving rise to severe diseases' is detailed below.) Therefore, disease may reside in the hair follicles and interstices, in the skin, in the muscles, in the vessels, in the sinews, in the bones, or in the marrow. (This elaborates on the varying depths of internal and external lesions, indicating that practitioners must select appropriate needling depths based on the condition.)
Thus, when needling the hair follicles and interstices, do not injure the skin. Injury to the skin disturbs the Lung internally; disturbance of the Lung leads to warm malaria in autumn, characterized by shivering and chills. (Needling the hair follicles and interstices is the most superficial level. The skin is slightly deeper. The skin corresponds to the Lung; injury to the skin disturbs the Lung internally. The Lung corresponds to autumn, hence warm malaria occurs in autumn with shivering chills. 'Su' is pronounced 'su'.) When needling the skin, do not injure the flesh. Injury to the flesh disturbs the Spleen internally; disturbance of the Spleen leads to abdominal distension, irritability, and loss of appetite during the eighteen days at the end of each of the four seasons, totaling seventy-two days. (Skin is exterior, flesh is interior. Flesh corresponds to the Spleen; injury to the flesh disturbs the Spleen internally. Earth of the Spleen reigns for eighteen days at the end of each season, totaling seventy-two days. Once Spleen Qi is injured and cannot transform and transport, symptoms of distension, irritability, and aversion to food occur during the Chen, Xu, Chou, and Wei months.) When needling the flesh, do not injure the vessels. Injury to the vessels disturbs the Heart internally; disturbance of the Heart leads to heart pain in summer. (Vessels lie within the flesh and correspond to the Heart; injury to the vessels disturbs the Heart internally. The Heart reigns in summer; external qi injury leads to heart pain in summer.) When needling the vessels, do not injure the sinews. Injury to the sinews disturbs the Liver internally; disturbance of the Liver leads to heat syndromes and flaccid sinews in spring. (Vessels are not sinews. Sinews correspond to the Liver and reign in spring. Injury to sinews disturbs Liver Qi, leading to heat syndromes during the spring yang rising phase. Heat causes sinew relaxation, termed flaccidity. 'Chi' has the same meaning.) When needling the sinews, do not injure the bones. Injury to the bones disturbs the Kidney internally; disturbance of the Kidney leads to abdominal distension and lower back pain in winter. (Sinews are exterior, bones are interior. Bones correspond to the Kidney and reign in winter. Injury to bones disturbs the Kidney internally, leading to distension and lower back pain in winter, as the root Yuan Qi is injured and the waist is the mansion of the Kidney.) When needling the bones, do not injure the marrow. Injury to the marrow leads to emaciation, wasting, soreness, and a sense of bodily slackness and weakness, making movement difficult. (Marrows fill the bones and belong to the essence category, being the deepest level. Injury to essence and marrow leads to dryness, wasting, and soreness. 'Xie Xie' describes a state of slackness and weakness, indicative of Yin deficiency. Yin deficiency leads to Qi deficiency; Qi deficiency prevents movement, which is termed 'bu qu'. Note: As stated in *Hai Lun*, insufficiency of the Sea of Marrow presents with similar symptoms; see Meridian and Collateral Category 32. 'Shuo' is pronounced 'shi zhuo qie'. 'Xie' is pronounced 'hang'. 'Xie' is pronounced 'ji'.)
The Yellow Emperor asked, "I wish to hear about the specific distinctions in needling depth."
(The full text of *Suwen: Discourse on the Levels of Needling*.) Qibo replied, "When needling the bones, do not injure the sinews; when needling the sinews, do not injure the flesh; when needling the flesh, do not injure the vessels; when needling the vessels, do not injure the skin; when needling the skin, do not injure the flesh; when needling the flesh, do not injure the sinews; when needling the sinews, do not injure the bones. (The first four sentences advise against shallow needling when deep needling is indicated; the last three advise against deep needling when shallow needling is indicated. The meaning follows below.)"
The Emperor said, "I do not understand what you mean; I wish to hear your explanation."
Qibo said, "'Needling the bones without injuring the sinews' means the needle reaches the sinew layer and stops, failing to reach the bone. (For disease in the bone, one should needle directly into the bone without injuring the sinews; if the needle only reaches the sinew layer to extract Qi and then withdraws without reaching the bone, the disease is not in the Liver, and the attack is misplaced, thus injuring the sinews.)
"'Needling the sinews without injuring the flesh' means the needle reaches the flesh layer and stops, failing to reach the sinew. (For disease in the sinew, one should needle directly into the sinew; if the needle only reaches the flesh layer and withdraws without reaching the sinew, the disease is not in the Spleen, thus injuring the flesh.)
"'Needling the flesh without injuring the vessels' means the needle reaches the vessel layer and stops, failing to reach the flesh. (For disease in the flesh, one should needle directly into the flesh; if the needle only reaches the vessel layer and withdraws without reaching the flesh, the disease is not in the Heart, thus injuring the vessels.)
"'Needling the vessels without injuring the skin' means the needle reaches the skin layer and stops, failing to reach the vessel. (For disease in the vessel, one should needle directly into the vessel; if the needle only reaches the skin layer and withdraws without reaching the vessel, the disease is not in the Lung, thus injuring the skin. The above four sections describe the harm of failing to needle deeply when required.)
"'Needling the skin without injuring the flesh' refers to disease located in the skin; the needle enters the skin without injuring the flesh. (Needling the skin too deeply and hitting the flesh injures Spleen Qi.)
"'Needling the flesh without injuring the sinews' refers to over-penetrating the flesh to hit the sinew. (Needling the flesh too deeply and hitting the sinew attacks Liver Qi.)
"'Needling the sinews without injuring the bones' refers to over-penetrating the sinew to hit the bone. This is called 'reversal'. (Needling the sinew too deeply and hitting the bone injures Kidney Qi. The above three sections describe the harm of needling too deeply when not indicated, all of which are termed 'reversal'.)"