禁数 志云。数。几也。言所当禁刺之处有几也。高云。数。条目也。帝承上二篇之意。谓刺要刺齐。
其中必有所禁。故愿闻禁数。
要害 高云。言各所要。亦各有所害。当详察也。志云。五脏有紧要为害之处。要害二字。当知非
刺中五脏。（顾炎武日知录云。南越尉佗传。发兵守要害处。按汉书西南夷传注。师古曰。要害者。在我为要。于
敌为害也。此解未尽。要害。谓攻守必争之地。我可以害彼。彼可以害我。谓之害。人身亦有要害。素问。岐
伯对黄帝曰。脉有要害。后汉来歙传。中臣要害。）
肝生于左肺藏于右 高云。人身面南。左东右西。肝主春生之气。位居东方。故肝生于左。肺主秋收
之气。位居西方。故肺藏于右。
心部于表肾治于里 志云。部。分也。心为阳脏而主火。火性炎散。故心气分部于表。肾为阴脏而主
水。水性寒凝。故肾气主治于里。
脾为之使 高云。脾土王于四季。主营运水谷。以溉五脏。故为之使。志云。脾主为胃行其津液。以
灌四旁。故为之使。
胃为之市 志云。心为阳中之太阳。故部于表。肾为阴中之太阴。故治于里。盖以四脏之气。分左右
表里上下。脾胃居中。故为之市。
膈肓 吴云。膈。膈膜也。肓。膈上无肉空处也。志云。膈。膈膜也。内之膈肉。前连于胸之鸠尾。
旁连于腹胁。后连于脊之十一椎。肓者。即募原之属。其原出于脐下。名曰脖 。高云。肓。脐旁肓俞穴也。
简按吴注腹中论云。腔中无肉空隙之处。名曰肓。又注痹论云。肓。腔中空虚无肉之处也。张则袭其说云。肓
者。凡腔腹肉理之间。上下空隙之处。皆谓之肓。并因误读王注云布散于胸腹之中。空虚之处。熏其肓膜。王
意岂以肓为空虚之处乎。而张于本节。则全根据杨义。杨注原于说文。盖古来相传之说。宜无异论。志云。募原
之属。高云。肓俞。皆臆造已。当与举痛论及痹论参考。
小心 马云。心之下。有心包络。其形有黄脂裹心者。属手厥阴经。自五椎（心俞）之下而推之。则
包络当垂至第七节而止。盖心为君主。为大心。而包络为臣。为小心也。吴云。
脊共二十一节。此言七节。下部之第七节也。其旁乃两肾所系。左为肾。右为命门。命门者。相火也。相火代
心君行事。故曰小心。张同。昂云。旁者。两肾也。中者。命门也。按心者性之郛。肾者命之根。两肾中间。
一点真阳。乃生身之根蒂。义取命门。盖以此也。中有相火。能代心君行事。故曰小心。杨上善云云。吴亦主
其说。盖心君无为。吾人一日动作云为。皆命门之相火也。马注云云。若根据此解。旁字似无着落。志云。七节
之旁。膈俞之间也。小。微也。细也。中有小心者。谓心气之出于其间。极微极细。高同。简按甲乙。亦作志
心。王似指心包络。杨则为十四椎旁肾俞。而又云。得名为志者。心之神也。而阴阳类论。上空志心。王以为
小心。杨以为入肾志于心神之义。杨注彼此义异。未太明晰。且凡脊椎从上数而至下。未有从下数而云某椎者。
亦觉不允。背 篇。心俞。在五焦（当作椎。下同。）之间。膈俞。在七焦之间。而心包俞。经文无所考。
（铜人等。以心椎旁。为厥阴俞。）王马未为得矣。吴张虽主杨。然命门 见于难经。相火固是运气家之言。
并非本经之义。志高杜撰无论矣。窃疑云七节之旁。云上空。既非心包。又非肾。必有别所指也。举数说以俟考。
从之有福逆之有咎 马云。顺其所而不伤。则有福。逆其所而伤之。则有咎。所谓要害之当察者以此。
刺中肝五日死 马云。五日。疑作三日。乃木生数也。高同。
其动为语 张云。无故妄言也。简按宣明五气篇云。心为噫。肝为语。肾为嚏。肺为咳。脾为吞。
全本。甲乙。作欠。非。
刺中肺三日死 马云。三。疑为五。王注。释诊要经终篇。以为金生数四日毕。当至五日而死者。
是也。高同。
刺中胆一日半死 马云。胆为六腑之一。当别于五脏。故另为一节。一日半死。以其为生数之半也。
张云。凡十一脏者。皆取决于胆。是谓中正之官。奇恒之腑。伤之者。其危极速。呕出于胃。而胆证忌之。木
邪犯土。见则死矣。高云。邪气脏腑病形篇云。胆病者。呕宿汁。故其动为呕。呕。胆气虚也。
中大脉 马云。刺冲阳脉也。冲阳穴。为胃经之原。（伤寒论。以为趺阳之脉。）高云。胃足阳明之
脉。下足跗。其支者。别跗上。入足大指。交于足太阴。刺跗上。刺胃脉也。中大脉。中伤大指之经脉也。中
大脉。而血出不止。则太阴之脉。不能循大指而上。故死。简按大脉。盖谓冲脉之别。灵动输篇云。冲脉。并
少阴之经。下入内踝之后。入足下。其别者。斜入踝。出属跗上。入大指之间。注诸络。以温足胫。又逆顺肥
瘦篇云。其前者。伏行出跗属。下循跗。入大指间。渗诸络而温肌肉。其已如此。今刺而中伤之。则所以致死
也。中。去声。
溜脉 甲乙。溜。作流。马云。溜。流同。按本输篇云。溜于鱼际。则溜与流同。所谓溜脉者。凡脉
与目流通者。皆是也。又按大惑论云。五脏六腑之精。皆上注于目。而为之精。论疾诊尺篇云。赤脉从上下者。
太阳病。从下上者。阳明病。从外走内者。少阳病。此皆溜脉之义也。吴张义同。志云。溜脉者。脉之支别。
浮见于皮肤之间者也。高云。阴阳相过之脉也。简按志高注。未见所据。今从马义。
脑户 志云。督脉。从脑户而上。至于百会。囟会。乃头骨两分。内通于脑。若刺深。而误中于脑者。立死。
舌下 张云。舌下脉者。任脉之廉泉穴。足少阴之标也。中脉太过。血出不止。则伤肾。肾虚则无气。
故令人喑。按
忧恚无言篇曰。足之少阴。上系于舌。络于横骨。终于会厌。脉解篇曰。内夺而厥。则为喑俳。此肾虚也。然
则喑本于肾。无所疑矣。马云。王注以为脾脉者。无义。
刺足下布络中脉 马云。布络者。凡足之六经。皆有络脉也。误中其脉。而血又不出。则必邪不得
散。而为肿矣。王注止以为然谷之中者。凿之甚也。吴云。浮浅散见之络。中脉则过于深矣。简按中。王读如
字。非。
为肿 张云。若血不出。气必随针而壅。故为肿也。
刺 中大脉 马云。 中之下。有一中字。去声。张云。 。足太阳委中穴也。刺委中。而中其大
脉。伤阴气于阳经。故令人仆倒且脱色也。简按 下句。志高为浮 穴。非。
仆脱色 吴云。太阳为诸阳之会。故令如此。简按经脉篇云。甚者泻之则闷。闷甚则仆不得言。闷
则急坐之也。俱是后世所谓针晕也。详见于针灸聚英等。
刺气街中脉 王注。中。如字。诸家读为去声。今从之。
为肿鼠 甲乙。 。作 。千金作鼷。马云。 。当作鼷。刺气街者。血中其脉。而血又不出。
则血气并聚于中。故内结为肿在鼠鼷之中也。张同。吴云。 。仆也。刺之中脉。血不得出。则为肿。如鼠仆
焉。简按马注为是。但 不必改鼷。鼷。说文。小鼠也。 。玉篇。鼠名。巢源附骨疽候云。产妇女人。喜着
鼠HT 髂头 膝间。知是 HT 同义。即鼠鼷也。志高以为鼠鼷 参。非。
根蚀 熊音。蚀。音食。如蚕食叶。张云。乳房。乃胸中气血交凑之室。故刺乳上之穴。而误中乳
房。则气结不散。留而为肿。肿则必溃。且并乳根皆蚀。而难于愈也。简按根。
谓乳房之根。非乳根穴。吴云。生脓根而内蚀。非。（汉书西羌传。疽食浸淫。莫知所限。又后汉董卓传。溃
痈虽痛。胜于内食。）
刺缺盆中内陷 志云。缺盆在喉旁两横骨陷中。若缺盆然。故以为名。刺缺盆中者。刺手阳明大肠脉
也。手阳明之脉。下入缺盆。络肺。下属大肠。内陷气泄者。脉内陷。而气反泄于内也。针经曰。人之所生成
者。血脉也。故为之治针。必大其身。而圆其末。令可以按脉勿陷。以致其气。盖刺之要。气至而有效。若内
陷而气反下泄。则为咳喘之逆证矣。经云。气上冲胸。喘不能久立。病在大肠。盖大肠为肺之腑也。简按志仍
王注。缺盆中句。吴马张高。根据前例。以为中其内陷之脉。恐泥。高云。刺之过深。则为内陷。下俱仿此。
刺手鱼腹内陷 志云。鱼腹。在手大指下。如鱼腹之圆壮。手太阴之鱼际穴也。肺主气。而与大肠为
表里。脉内陷。则血不得散。气不得出。故为肿。以上论手足头项胸背。皆有要害之处。简按诸家鱼腹句。内陷
句。为是。
刺阴股中大脉 张云。阴股大脉。足太阴箕门血海之间。吴云。脾肾肝三脉。皆行于阴股。志云。阴
股。足少阴经脉所循之处。大脉。大络也。高云。厥阴之脉。起于足大指。循阴股而上。刺阴股中。伤大指之
经脉。故血出不止。简按诸说不一。吴似允当。
内漏 甲乙。无内字。吴云。内漏。脉气他泄而漏也。张云。脓生耳底。是为内漏。
刺膝髌出液 马云。犊鼻。在膝髌之下。则犊鼻两旁之上。为膝髌也。张云。髌。膝盖骨也。简按白
虎通云。髌。膝盖骨也。圣济总录云。髀枢下端。为膝盖骨者。左右共二。无势多液。志云。膝乃筋之会。液
者。所以灌精濡空窍者也。
刺膺中陷中肺 马云。次中字。去声。刺膺中之穴。如足阳明胃经气户库房屋翳膺窗。足少阴肾经俞
府或中之类。
乃误中云门中府。则肺气上泄。故为病喘息而逆。仰首而息也。简按此总言膺中诸穴。盖肺位于胸膺中。故误中
肺。则为云云证。不必中府云门二穴。
肘中 张云。手太阴之尺泽。厥阴之曲泽者。是也。
气归之 张云。气泄于此。则气归之。志云。内陷者。不能泻出其邪。而致气归于内也。气不得出。
则血不得散。故不能屈伸也。简按王注恶气。恐非。
刺阴股下三寸 马云。此言刺肝穴。而误使内陷者。当遗溺也。王注为肾经之络。今按肝经有阴包穴。
治遗溺。在膝上四寸。则正当股下三寸之处。肾经无穴。张云。阴股之脉。足三阴也。皆上聚于阴器。惟少阴
之在股间者。有经无穴。其在气冲下三寸者。足厥阴之五里也。主治肠中热满不得溺。若刺深内陷。令人遗溺
不禁。当是此穴。然厥阴之阴包。阳明之箕门。皆治遗溺。若刺之太深。则溺反不止矣。
腋下胁间 宋本。腋。作掖。马吴张并同。高本作腋。注云。腋。旧本讹掖。今改。手厥阴心包之脉。
循胸出胁。上抵腋下。刺腋下胁间。刺心包之脉也。刺之过深。中伤内陷。脉不循经。上迫于肺。故令人咳。
简按腋字。说文所无。作掖为正。腋下胁间。诸家仍王。言令人咳。则王注为是。
肠 马云。 肠。足鱼腹中承筋穴。俗云脚肚。吴云。 。足腹也。张云。足肚也。肉浓气深。
不易行散。故刺而内陷。则为肿。志云。俗名腿肚。
匡上陷骨中脉 马云。匡。目眶也。俗云眼眶。陷骨。谓匡骨也。脉。乃目之系也。中。去声。高
云。匡上。目眶之上。眉间也。陷骨。丝竹空穴。眉后陷骨也。简按匡。眶同。史记淮南王安传。涕满匡而横
流。是也。甲乙。丝竹空。在眉后陷者中。足少阳脉气所发。外台。一名目 。高注似是。
为漏为盲 张云。流泪不止。而为漏。视无所见。而为盲。诸家并同。
刺关节中液出 马云。中。平声。高云。关节。骨节交会之机关。淖液泽注于骨。骨属屈伸。若刺
关节中伤其液。致液出而不能淖泽注骨。故不得屈伸。此举刺之要害。皆为刺禁者如此。简按高。中。读为去
声。非。
禁数：志认为，“数”意为“几”，指应当禁止针刺的部位数量。高认为，“数”意为“条目”。黄帝承接前两篇的意思，认为针刺的要领和法度中，必然有所禁忌，因此希望听闻这些禁忌的具体条目。
要害：高认为，这是指各个部位的关键所在，同时也意味着如果误刺各有所害，应当详细考察。志认为，五脏有紧要且会造成危害的部位。“要害”二字，应当知道并非单指刺中五脏。（顾炎武在《日知录》中说，《南越尉佗传》记载：“发兵守要害处。”按《汉书·西南夷传》注，颜师古说：“要害者，在我为要，于敌为害也。”这个解释并不全面。要害，是指攻守必争之地，我可以伤害对方，对方也可以伤害我，这就叫害。人体也有要害，《素问》中岐伯对黄帝说：“脉有要害。”后汉《来歙传》记载：“中臣要害。”）
肝生于左，肺藏于右：高认为，人面朝南，左边是东，右边是西。肝主春生之气，位居东方，所以说肝生于左。肺主秋收之气，位居西方，所以说肺藏于右。
心部于表，肾治于里：志认为，“部”意为“分”。心为阳脏而主火，火性炎上发散，所以心气分部于体表。肾为阴脏而主水，水性寒凉凝滞，所以肾气主治于体内。
脾为之使：高认为，脾土旺于四季，主要营运水谷，以灌溉五脏，所以称它为“使”。志认为，脾主为胃运行津液，以灌输给四周，所以称它为“使”。
胃为之市：志认为，心为阳中之太阳，所以分部于表；肾为阴中之太阴，所以主治于里。大概因为四脏之气分左右、表里、上下，而脾胃居中，所以称胃为“市”。
膈肓：吴认为，“膈”是膈膜，“肓”是膈上无肉的空处。志认为，“膈”是膈膜。体内的膈肉，前连胸部的鸠尾穴，旁连腹胁，后连脊柱第十一椎。肓，即募原之类，其源出于脐下，名叫脖胦。高认为，“肓”是脐旁的肓俞穴。简按：吴氏在《腹中论》注中说：“腔中无肉空隙之处，名叫肓。”又在《痹论》注中说：“肓，腔中空虚无肉之处。”张氏沿袭此说，认为：“肓，凡是腔腹纹理之间，上下空隙之处，都叫做肓。”并因误读王氏注“布散于胸腹之中，空虚之处，熏其肓膜”，以为王意是将肓视为空虚之处。而张氏在本节则完全依据杨上善的解释。杨注源于《说文》，大概是古来相传的说法，应该没有异议。志认为是募原之类，高认为是肓俞，都是臆造，应当与《举痛论》及《痹论》参考对照。
小心：马认为，心之下有心包络，形状有黄脂包裹心脏，属于手厥阴经。从第五椎（心俞）之下推究，则包络应当垂至第七节为止。大概心为君主，为大心，而包络为臣，为小心。吴认为，脊椎共二十一节，这里说的七节，是下部的第七节。其旁乃是两肾所系，左为肾，右为命门。命门者，是相火。相火代心君行事，所以叫小心。张同。昂认为，旁者是两肾，中者是命门。按：心是性的廓宇，肾是命的根本。两肾中间的一点真阳，是生身的根蒂，义取命门，大概就是这个原因。中有相火，能代心君行事，所以叫小心。杨上善云云，吴也主张此说。大概心君无为，我们一天的动作行为，都是命门的相火。马注云云，如果根据这种解释，“旁”字似乎没有着落。志认为，七节之旁，是膈俞之间。“小”意为微、细。中有小心者，谓心气出于其间，极微极细。高同。简按：《甲乙经》也作“志心”。王冰似乎指心包络，杨上善则指第十四椎旁肾俞，又说：“得名为志者，心之神也。”而《阴阳类论》说：“上空志心。”王冰认为是小心，杨上善认为是入肾志于心神之义。杨注彼此义异，不太明晰。而且凡脊椎从上数至下，未有从下数而称某椎的，也觉得不公允。《背篇》说，心俞在五焦（当作椎，下同。）之间，膈俞在七焦之间，而心包俞，经文无所考证。（《铜人腧穴针灸图经》等，以心椎旁为厥阴俞。）王冰、马莳未为得当。吴崑、张景岳虽主杨上善之说，但命门见于《难经》，相火固然是运气家的言论，并非本经本义。志、高的杜撰且不论了。私下怀疑“七节之旁”、“上空”句，既然不是心包，又不是肾，必有别的所指。列举数说以等待考证。
从之有福，逆之有咎：马认为，顺其所而不伤，则有福；逆其所而伤之，则有咎。这就是所谓要害应当考察的原因。
刺中肝五日死：马认为，“五日”，疑作“三日”，乃木的生数。高同。
其动为语：张认为，无故妄言。简按：《宣明五气篇》说：“心为噫，肝为语，肾为嚏，肺为咳，脾为吞。”全本、《甲乙经》作“欠”，非。
刺中肺三日死：马认为，“三”，疑为“五”。王注在解释《诊要经终篇》时，认为金生数为四，毕当至五日而死，是对的。高同。
刺中胆一日半死：马认为，胆为六腑之一，应当别于五脏，所以另为一节。“一日半死”，因为其为生数的一半。张认为，凡十一脏皆取决于胆，这称为中正之官，奇恒之腑。损伤它，危险极速。呕出于胃，而胆证忌之。木邪犯土，见到就死。高认为，《邪气脏腑病形篇》说：“胆病者，呕宿汁。”所以其动作为呕。呕，是胆气虚。
中大脉：马认为，刺冲阳脉。冲阳穴，是胃经的原穴。（《伤寒论》认为是趺阳之脉。）高认为，足阳明胃脉，下行足跗，其支者，别跗上，入足大指，交于足太阴。刺跗上，是刺胃脉。中大脉，是中伤大指的经脉。中大脉，而血出不止，则太阴之脉，不能循大指而上，所以死。简按：大脉，大概谓冲脉之别。《灵枢·动输》说：“冲脉，并少阴之经，下入内踝之后，入足下。其别者，斜入踝，出属跗上，入大指之间，注诸络，以温足胫。”又《逆顺肥瘦篇》说：“其前者，伏行出跗属，下循跗，入大指间，渗诸络而温肌肉。”已经如此，现在刺而中伤之，所以致死。“中”读去声。
溜脉：《甲乙经》，“溜”作“流”。马认为，“溜”、“流”同。按《本输篇》说：“溜于鱼际。”则溜与流同。所谓溜脉者，凡是脉与目流通的，都是。又按《大惑论》说：“五脏六腑之精，皆上注于目，而为之精。”《论疾诊尺篇》说：“赤脉从上下者，太阳病。从下上者，阳明病。从外走内者，少阳病。”这都是溜脉的含义。吴、张义同。志认为，溜脉者，脉之支别，浮见于皮肤之间者也。高认为，阴阳相过之脉也。简按：志、高注未见所据，今从马义。
脑户：志认为，督脉，从脑户而上，至于百会、囟会，乃头骨两分，内通于脑。若刺深，而误中于脑者，立死。
舌下：张认为，舌下脉者，任脉之廉泉穴，足少阴之标。中脉太过，血出不止，则伤肾。肾虚则无气，故令人喑。按《忧恚无言篇》曰：“足之少阴，上系于舌，络于横骨，终于会厌。”《脉解篇》曰：“内夺而厥，则为喑俳。”此肾虚也。然则喑本于肾，无所疑矣。马认为，王注以为脾脉者，无义。
刺足下布络中脉：马认为，布络者，凡足之六经，皆有络脉也。误中其脉，而血又不出，则必邪不得散，而为肿矣。王注只以为然。谷之中者，凿之甚也。吴认为，浮浅散见之络，中脉则过于深矣。简按：“中”字，王读如字，非。
为肿：张认为，若血不出，气必随针而壅，故为肿也。
刺 中大脉：马认为， 中之下，有一中字，读去声。张认为， ，足太阳委中穴也。刺委中，而中其大脉，伤阴气于阳经，故令人仆倒且脱色也。简按： 下句，志、高认为是浮 穴，非。
仆脱色：吴认为，太阳为诸阳之会，故令如此。简按：《经脉篇》说：“甚者泻之则闷，闷甚则仆不得言。闷则急坐之也。”俱是后世所谓针晕也。详见于《针灸聚英》等。
刺气街中脉：王注，“中”如字。诸家读为去声，今从之。
为肿鼠 ：《甲乙经》，“ ”作“ ”。《千金方》作“鼷”。马认为，“ ”，当作“鼷”。刺气街者，血中其脉，而血又不出，则血气并聚于中，故内结为肿在鼠鼷之中也。张同。吴认为，“ ”，仆也。刺之中脉，血不得出，则为肿，如鼠仆焉。简按：马注为是。但“ ”不必改“鼷”。“鼷”，《说文》：小鼠也。“ ”，《玉篇》：鼠名。巢源《附骨疽候》云：“产妇女人，喜着鼠HT髂头膝间。”知是“HT”同义，即鼠鼷也。志、高以为是鼠鼷参，非。
根蚀：熊音，“蚀”，音食，如蚕食叶。张认为，乳房，乃胸中气血交凑之室。故刺乳上之穴，而误中乳房，则气结不散，留而为肿。肿则必溃，且并乳根皆蚀，而难于愈也。简按：“根”，谓乳房之根，非乳根穴。吴认为，生脓根而内蚀，非。（《汉书·西羌传》：“疽食浸淫，莫知所限。”又《后汉·董卓传》：“溃痈虽痛，胜于内食。”）
刺缺盆中内陷：志认为，缺盆在喉旁两横骨陷中，若缺盆然，故以为名。刺缺盆中者，刺手阳明大肠脉也。手阳明之脉，下入缺盆，络肺，下属大肠。内陷气泄者，脉内陷，而气反泄于内也。《针经》曰：“人之所生成者，血脉也。”故为之治针，必大其身，而圆其末，令可以按脉勿陷，以致其气。盖刺之要，气至而有效。若内陷而气反下泄，则为咳喘之逆证矣。经云：“气上冲胸，喘不能久立。”病在大肠，盖大肠为肺之腑也。简按：志仍王注。缺盆中句，吴、马、张、高根据前例，以为中其内陷之脉，恐泥。高认为，刺之过深，则为内陷，下俱仿此。
刺手鱼腹内陷：志认为，鱼腹，在手大指下，如鱼腹之圆壮，手太阴之鱼际穴也。肺主气，而与大肠为表里。脉内陷，则血不得散，气不得出，故为肿。以上论手足头项胸背，皆有要害之处。简按：诸家鱼腹句、内陷句，为是。
刺阴股中大脉：张认为，阴股大脉，足太阴箕门、血海之间。吴认为，脾、肾、肝三脉，皆行于阴股。志认为，阴股，足少阴经脉所循之处。大脉，大络也。高认为，厥阴之脉，起于足大指，循阴股而上。刺阴股中，伤大指之经脉，故血出不止。简按：诸说不一，吴似允当。
内漏：《甲乙经》无“内”字。吴认为，内漏，脉气他泄而漏也。张认为，脓生耳底，是为内漏。
刺膝髌出液：马认为，犊鼻，在膝髌之下，则犊鼻两旁之上，为膝髌也。张认为，髌，膝盖骨也。简按：《白虎通》云：“髌，膝盖骨也。”《圣济总录》云：“髀枢下端，为膝盖骨者，左右共二。”无势多液。志认为，膝乃筋之会，液者，所以灌精濡空窍者也。
刺膺中陷中肺：马认为，次“中”字，读去声。刺膺中之穴，如足阳明胃经气户、库房、屋翳、膺窗，足少阴肾经俞府或中之类。乃误中云门、中府，则肺气上泄，故为病喘息而逆，仰首而息也。简按：此总言膺中诸穴，盖肺位于胸膺中，故误中肺，则为云云证，不必中府、云门二穴。
气归之：张认为，气泄于此，则气归之。志认为，内陷者，不能泻出其邪，而致气归于内也。气不得出，则血不得散，故不能屈伸也。简按：王注“恶气”，恐非。
刺阴股下三寸：马认为，此言刺肝穴，而误使内陷者，当遗溺也。王注为肾经之络。今按肝经有阴包穴，治遗溺，在膝上四寸，则正当股下三寸之处。肾经无穴。张认为，阴股之脉，足三阴也，皆上聚于阴器。惟少阴之在股间者，有经无穴。其在气冲下三寸者，足厥阴之五里也。主治肠中热满不得溺。若刺深内陷，令人遗溺不禁，当是此穴。然厥阴之阴包，阳明之箕门，皆治遗溺。若刺之太深，则溺反不止矣。
腋下胁间：宋本，“腋”作“掖”。马、吴、张并同。高本作“腋”，注云：“腋，旧本讹掖，今改。”手厥阴心包之脉，循胸出胁，上抵腋下。刺腋下胁间，刺心包之脉也。刺之过深，中伤内陷，脉不循经，上迫于肺，故令人咳。简按：“腋”字，《说文》所无，作“掖”为正。腋下胁间，诸家仍王，言令人咳，则王注为是。
肠：马认为， 肠，足鱼腹中承筋穴，俗云脚肚。吴认为， ，足腹也。张认为，足肚也。肉浓气深，不易行散，故刺而内陷，则为肿。志认为，俗名腿肚。
匡上陷骨中脉：马认为，匡，目眶也，俗云眼眶。陷骨，谓匡骨也。脉，乃目之系也。“中”读去声。高认为，匡上，目眶之上，眉间也。陷骨，丝竹空穴，眉后陷骨也。简按：“匡”，“眶”同。《史记·淮南王安传》：“涕满匡而横流。”是也。《甲乙经》：丝竹空，在眉后陷者中，足少阳脉气所发。《外台秘要》一名目 。高注似是。
为漏为盲：张认为，流泪不止，而为漏。视无所见，而为盲。诸家并同。
刺关节中液出：马认为，“中”读平声。高认为，关节，骨节交会之机关。淖液泽注于骨，骨属屈伸。若刺关节中伤其液，致液出而不能淖泽注骨，故不得屈伸。此举刺之要害，皆为刺禁者如此。简按：高，“中”读为去声，非。
Number of Prohibitions: Zhi holds that "shu" (number) means "how many," referring to the quantity of locations where acupuncture is prohibited. Gao holds that "shu" means "items." The Yellow Emperor, following the meaning of the previous two chapters, considers that among the essentials and standards of acupuncture, there must be prohibitions; therefore, he wishes to hear about these specific items of prohibition.
Vital Points: Gao states that this refers to the critical points of each location, implying that accidental puncture at these points causes harm, and thus they should be examined in detail. Zhi states that the five zang organs have critical areas that cause harm. The term "vital points" (yaohai) should be understood not merely as puncturing the five zang organs. (Gu Yanwu, in *Rizhilu*, cites the *Records of the Nanyue Marquis Zhao Tuo*: "Dispatched troops to guard vital points." According to the commentary on the *Book of Han: Southwest Barbarians*, Yan Shigu said: "Vital points are 'critical' to us and 'harmful' to the enemy." This explanation is incomplete. A vital point refers to a place contested in attack and defense, where one can harm the other and vice versa. The human body also has vital points; in the *Suwen*, Qibo told the Yellow Emperor: "There are vital points in the pulses." In the Later Han *Bi Lai Xi Biography*, it is recorded: "Struck the minister's vital points.")
The Liver Arises on the Left, the Lung Stores on the Right: Gao explains that when a person faces south, the left is East and the right is West. The Liver governs the Qi of Spring generation and resides in the East; therefore, it is said that the Liver arises on the left. The Lung governs the Qi of Autumn harvest and resides in the West; therefore, it is said that the Lung stores on the right.
The Heart Distributes to the Exterior, the Kidney Governs the Interior: Zhi explains that "bu" (distribute) means "divide." The Heart is a Yang organ and governs Fire. Fire has the nature of flaming upward and dispersing; thus, Heart Qi distributes to the exterior. The Kidney is a Yin organ and governs Water. Water has the nature of coldness and coagulation; thus, Kidney Qi governs the interior.
The Spleen Acts as the Envoy: Gao states that Earth of the Spleen prospers during the four seasons, primarily transporting and transforming grain and water to irrigate the five zang organs; hence it is called the "envoy." Zhi states that the Spleen governs the transportation of fluids for the Stomach to irrigate the four directions; hence it is called the "envoy."
The Stomach Acts as the Market: Zhi states that the Heart is the Supreme Yang within Yang, so it distributes to the exterior; the Kidney is the Supreme Yin within Yin, so it governs the interior. Generally, because the Qi of the four zang organs divides into left/right, exterior/interior, and upper/lower, while the Spleen and Stomach reside in the center, the Stomach is called the "market."
Diaphragm and Huang: Wu states that "ge" (diaphragm) is the diaphragmatic membrane, and "huang" is the empty space above the diaphragm without flesh. Zhi states that "ge" is the diaphragmatic membrane. The internal diaphragmatic flesh connects anteriorly to the Jiuwei point on the chest, laterally to the abdomen and hypochondrium, and posteriorly to the eleventh thoracic vertebra on the spine. "Huang" belongs to the category of Mu Yuan (original source). Its origin is below the umbilicus, named Boyang. Gao states that "huang" refers to the Huangshu acupoint beside the umbilicus. Commentary: Wu’s note on the *Fuzhong Lun* says: "The empty space in the cavity without flesh is called huang." His note on the *Bilun* says: "Huang is the empty, fleshless space in the cavity." Zhang followed this view, stating: "Huang refers to any empty space between the textures of the abdominal cavity, up and down." He mistakenly interpreted Wang Bing’s note "dispersed in the chest and abdomen, in the empty spaces, fumigating its huang membrane" as Wang considering huang to be an empty space. However, Zhang based his interpretation in this section entirely on Yang Shangshan. Yang’s note derives from the *Shuowen Jiezi*, likely a traditional theory passed down, which should be uncontroversial. Zhi’s identification with Mu Yuan and Gao’s identification with Huangshu are conjectural and should be cross-referenced with the *Jutong Lun* and *Bilun*.
Xiao Xin (Small Heart): Ma states that below the Heart is the Pericardium, shaped like yellow fat wrapping the heart, belonging to the Hand Jueyin Meridian.推算 from the fifth vertebral level (Xinshu), the Pericardium hangs down to the seventh level. Since the Heart is the Monarch and constitutes the Great Heart, the Pericardium is the Minister and constitutes the Small Heart. Wu states that the spine has twenty-one segments; here, the "seven segments" refers to the lower seventh segment. Beside it are the two kidneys; the left is the Kidney, and the right is the Mingmen (Gate of Life). Mingmen is the Minister Fire. Minister Fire acts on behalf of the Heart Monarch, hence it is called "Small Heart." Zhang agrees. Ang states that the sides are the two kidneys, and the center is the Mingmen. The Heart is the enclosure of Nature, and the Kidney is the root of Life. The single true Yang fire between the two kidneys is the root of life generation; the concept takes the name Mingmen for this reason. Because Minister Fire resides within and acts on behalf of the Heart Monarch, it is called "Small Heart." Yang Shangshan’s views are cited, and Wu supports them. Essentially, the Heart Monarch is non-action-oriented; all our daily movements and actions are driven by the Mingmen’s Minister Fire. Ma’s notes suggest that if this interpretation is adopted, the character "pang" (side) seems unaccounted for. Zhi states that beside the seventh segment is the Ge Shu area. "Xiao" means minute or fine. "Having Xiao Xin within" refers to Heart Qi emerging from this area, extremely subtle and fine. Gao agrees. Commentary: The *Jiayingjing* also writes "Zhixin." Wang Bing likely referred to the Pericardium, while Yang Shangshan referred to the Shenshu beside the fourteenth thoracic vertebra, adding, "To be named Zhi is the Spirit of the Heart." In the *Yinyang Leilun*, it says "Empty above Zhixin." Wang Bing considered it "Xiao Xin," while Yang Shangshan interpreted it as Kidney Zhi entering the Heart Spirit. Yang’s notes are inconsistent and unclear. Moreover, counting spinal vertebrae always proceeds from top to bottom; counting from the bottom to call it a certain vertebra is unreasonable. The *Beipian* states Xinshu is between the fifth and sixth vertebrae, and Geshu is between the seventh and eighth. The Xinbaoshu is not documented in the classic texts (*Tongren Jing* etc. place Jueyinsyu beside the Heart vertebra). Wang Bing and Ma Shi were not entirely accurate. Although Wu Kun and Zhang Jingyue follow Yang Shangshan, Mingmen appears in the *Nanjing*, and Minister Fire is a concept of the Six Qi theory, not the original meaning of this classic. Zhi and Gao’s fabrications aside, I suspect that "beside the seventh segment" and "empty above" refer to something else, neither Pericardium nor Kidney. Several interpretations are listed for further study.
Following brings Blessings, Opposing Brings Blame: Ma states that following these principles without injury brings blessings, while opposing and injuring them brings blame. This is why the vital points must be examined.
Puncturing the Liver Causes Death in Five Days: Ma suggests "five days" might be a typo for "three days," as three is the generating number of Wood. Gao agrees.
Its Movement Manifests as Speech: Zhang states this refers to speaking nonsense without cause. Commentary: The *Xuanming Wuqi Pian* states: "The Heart manifests as belching, the Liver as speech, the Kidney as sneezing, the Lung as coughing, the Spleen as swallowing." The complete text and *Jiayingjing* write "yawn," which is incorrect.
Puncturing the Lung Causes Death in Three Days: Ma suggests "three" might be "five." Wang Bing, in his commentary on the *Zhenyao Jingzhong Pian*, argues that Metal’s generating number is four, and death occurs by the fifth day, which is correct. Gao agrees.
Puncturing the Gallbladder Causes Death in One and a Half Days: Ma states that the Gallbladder is one of the Fu organs and differs from the Zang organs, hence a separate section. "Death in one and a half days" is because one and a half is half of the generating number. Zhang states that all eleven organs depend on the Gallbladder, termed the Official of Justice and Extraordinary Fu Organ. Injury to it is rapidly fatal. Vomiting originates from the Stomach, but Gallbladder pathology contraindicates it. Wood pathogen attacking Earth leads to death. Gao cites the *Xieqi Zangfu Bingxing Pian*: "Gallbladder disease involves vomiting old bile." Thus, its movement manifests as vomiting. Vomiting indicates deficiency of Gallbladder Qi.
Puncturing the Da Mai (Great Pulse): Ma states this refers to puncturing the Chongyang pulse. Chongyang is the Yuan-Source point of the Stomach Meridian (considered the Duyang pulse in the *Shanghan Lun*). Gao states that the Foot-Yangming Stomach Meridian descends to the dorsum of the foot; its branch diverges above the dorsum, enters the big toe, and intersects with the Foot-Taiyin. Puncturing the dorsum punctures the Stomach Meridian. "Puncturing the Da Mai" means injuring the meridian of the big toe. If blood flows incessantly after puncturing the Da Mai, the Taiyin Meridian cannot ascend along the big toe, leading to death. Commentary: "Da Mai" likely refers to the branch of the Chong Mai. The *Lingshu: Dongshu* states: "The Chong Mai runs alongside the Shaoyin Meridian, descends behind the medial malleolus, enters the sole. Its branch obliquely enters the ankle, emerges on the dorsum, enters between the big toes, pours into the collaterals to warm the calves." The *Nishun Feishou Pian* states: "The anterior part runs hidden, emerges at the dorsum, follows the dorsum, enters between the big toes, seeps into collaterals to warm the muscles." Thus, injuring it causes death. "Zhong" is pronounced with the departing tone.
Liú Mài (Flowing Pulse): *Jiayingjing* writes "liu" as "liu" (flow). Ma states "liu" and "liu" are identical. The *Benshu Pian* states: "Flows into Yuji," confirming "liu" and "liu" are the same. The "Flowing Pulse" refers to any pulse connected to the eyes. The *Dahuo Lun* states: "The essence of the five zang and six fu organs all ascends to the eyes to form the visual spirit." The *Lunji Zhenshi Pian* states: "Red vessels moving from top to bottom indicate Taiyang disease; from bottom to top, Yangming disease; from outside inward, Shaoyang disease." These illustrate the concept of Flowing Pulses. Wu and Zhang agree. Zhi states that Flowing Pulses are branches of the pulses floating in the skin. Gao states they are pulses where Yin and Yang intersect. Commentary: Zhi and Gao lack evidence; Ma’s view is adopted.
Naohu: Zhi states that the Du Meridian ascends from Naohu to Baihui and Xinhui. These are splits in the skull bone, internally connecting to the brain. Deep puncture accidentally hitting the brain causes immediate death.
Under the Tongue: Zhang states that the pulse under the tongue is Lianquan, the Conception Vessel, and the marker of the Foot-Shaoyin Meridian. Excessive puncture causing incessant bleeding injures the Kidney. Kidney deficiency leads to lack of Qi, resulting in aphonia. The *Youhui Wuyan Pian* states: "Foot-Shaoyin connects to the tongue, links to the transverse bone, and ends at the epiglottis." The *Maiejie Pian* states: "Internal depletion and reversal result in aphonia and paralysis." This is Kidney deficiency. Thus, aphonia originates from the Kidney without doubt. Ma states that Wang Bing’s attribution to the Spleen pulse is meaningless.
Puncturing the Distributed Collaterals Under the Foot: Ma states that "distributed collaterals" refer to the collateral vessels of all six meridians of the foot. Accidental puncture without bleeding prevents pathogen dispersion, leading to swelling. Wang Bing only agreed with this. "Guo zhong zhe" implies excessive depth. Wu states that superficial, scattered collaterals, if punctured deeply, are too deep. Commentary: "Zhong" is read as written by Wang Bing, not incorrectly.
Causing Swelling: Zhang states that if blood does not exit, Qi will stagnate with the needle, causing swelling.
Puncturing [Weizhong] and Hitting the Large Pulse: Ma states there is a "zhong" character below [Weizhong], pronounced with the departing tone. Zhang identifies [ ] as Weizhong, the Foot-Taiyang point. Puncturing Weizhong and hitting the large pulse injures Yin Qi within a Yang meridian, causing collapse and loss of complexion. Commentary: Zhi and Gao identify the point as Fuxi, which is incorrect.
Collapse and Loss of Complexion: Wu states that Taiyang is the convergence of all Yang meridians, hence such symptoms. Commentary: The *Jingmai Pian* states: "Severe cases, if drained, cause dizziness; severe dizziness causes collapse and inability to speak. Dizziness requires sitting immediately." These are what later generations call needle syncope, detailed in *Zhenjiu Jiuying* etc.
Puncturing Qijie and Hitting the Pulse: Wang Bing reads "zhong" as written. Other schools read it with the departing tone; we follow Wang.
Swelling in Shuxi: *Jiayingjing* writes " " as " ". *Qianjin Fang* writes "xi". Ma states " " should be "xi". Puncturing Qijie hits the vessel; if blood does not exit, Qi and Blood gather internally, forming a swelling in the Shuxi (inguinal region). Zhang agrees. Wu interprets " " as "collapse," suggesting the swelling resembles a collapsed rat. Commentary: Ma’s note is correct. " " need not be changed to "xi". "Xi" means small mouse in *Shuowen*. " " is a type of mouse in *Yupian*. *Chunyuan*’s *Fugu Ju Hou* mentions women preferring to wear mice near the hip/knee, indicating "HT" is synonymous with Shuxi. Zhi and Gao’s identification with Shuxi Can is incorrect.
Root Erosion: Xiong pronounces "shi" as "food," like silkworms eating leaves. Zhang states the breast is a chamber where Qi and Blood of the chest converge. Puncturing points above the breast and accidentally hitting the breast tissue causes Qi stagnation and swelling. The swelling will ulcerate and erode the root of the breast, making healing difficult. Commentary: "Gen" refers to the root of the breast tissue, not the Rugen acupoint. Wu states it means pus forming roots and eroding internally, which is incorrect. (See *Book of Han: Western Qiang* and *Later Han: Dong Zhuo* for similar descriptions of erosion.)
Puncturing Quepen and Causing Internal Collapse: Zhi states Quepen is located in the depression between two horizontal bones beside the throat, resembling a basin, hence the name. Puncturing Quepen affects the Hand-Yangming Large Intestine Meridian. This meridian descends into Quepen, connects to the Lung, and belongs to the Large Intestine. Internal collapse with Qi leakage means the pulse collapses inward, and Qi leaks internally. The *Zhenjing* states: "What generates humans is blood and vessels." Therefore, needles must be thick and rounded at the tip to press the pulse without collapsing it, guiding the Qi. The essence of acupuncture is effectiveness upon Qi arrival. If internal collapse causes Qi to leak downward, it results in rebellious cough and asthma. The Classic states: "Qi rushes to the chest, asthma prevents standing for long." The disease is in the Large Intestine, which is the Fu organ of the Lung. Commentary: Zhi follows Wang Bing. Wu, Ma, Zhang, and Gao, following previous examples, interpret it as hitting the internally collapsed pulse, which may be rigid. Gao states that puncturing too deeply causes internal collapse, applying similarly below.
Puncturing the Fish Belly and Causing Internal Collapse: Zhi states the Fish Belly is below the thumb, round and strong like a fish belly, corresponding to the Yuji point of the Hand-Taiyin Meridian. The Lung governs Qi and is exterior-interior with the Large Intestine. Internal collapse prevents blood dispersion and Qi exit, causing swelling. The above discusses that the hands, feet, head, neck, chest, and back all have vital points. Commentary: The interpretations of "Fish Belly" and "Internal Collapse" by various scholars are correct.
Puncturing the Large Pulse in the Inner Thigh: Zhang identifies the large pulse in the inner thigh as between Jimen and Xuehai of the Foot-Taiyin. Wu states the Spleen, Kidney, and Liver meridians all run through the inner thigh. Zhi states the inner thigh is where the Foot-Shaoyin Meridian circulates. "Large pulse" refers to large collaterals. Gao states the Jueyin Meridian starts at the big toe, ascends through the inner thigh. Puncturing the inner thigh injures the meridian of the big toe, causing incessant bleeding. Commentary: Various theories differ; Wu’s seems appropriate.
Internal Leakage: *Jiayingjing* omits "nei". Wu states internal leakage is pulse Qi leaking elsewhere. Zhang states pus forming at the bottom of the ear is internal leakage.
Puncturing the Knee Patella Causes Fluid Exit: Ma states Dubi is below the patella; the area above both sides of Dubi is the patella. Zhang states "bin" is the kneecap. Commentary: *Baihu Tong* states "bin" is the kneecap. *Shengji Zonglu* states there are two kneecaps at the lower end of the thigh; fluid excess is unlikely. Zhi states the knee is the meeting of sinews; fluid nourishes the marrow and empties the orifices.
Puncturing the Chest and Collapsing into the Lung: Ma states the second "zhong" is pronounced with the departing tone. Puncturing points in the chest, such as Qihu, Kufang, Wuyi, Yingchuang of the Foot-Yangming Stomach Meridian, or Yufu, Zhongfu of the Foot-Shaoyin Kidney Meridian, may accidentally hit Yunmen or Zhongfu. This causes Lung Qi to leak upward, resulting in rebellious asthma and仰首 breathing (breathing with head tilted back). Commentary: This generally refers to all points in the chest. Since the Lung is located in the chest, accidental injury causes these symptoms; it does not specifically require hitting Yunmen or Zhongfu.
Elbow Center: Zhang identifies this as Chize of the Hand-Taiyin and Quze of the Hand-Jueyin.
Qi Returns Here: Zhang states that if Qi leaks here, it returns. Zhi states that internal collapse fails to drain pathogens, causing Qi to return inward. If Qi cannot exit, blood cannot disperse, preventing flexion and extension. Commentary: Wang Bing’s note on "evil qi" is likely incorrect.
Puncturing Three Cun Below the Inner Thigh: Ma states this refers to puncturing the Liver point; accidental internal collapse causes urinary incontinence. Wang Bing attributes it to the Kidney Meridian’s Luo vessel. Currently, the Liver Meridian has Yinbao, treating incontinence, located four cun above the knee, exactly three cun below the inner thigh. The Kidney Meridian has no point here. Zhang states the pulses of the Foot-Sanyin gather at the genitalia. Only the Shaoyin in the thigh has a meridian but no point. The point three cun below Qichong is Wuli of the Foot-Jueyin, treating intestinal heat and inability to urinate. Deep puncture causing internal collapse leads to incontinence, likely this point. However, Yinbao (Jueyin) and Jimen (Yangming) both treat incontinence. Too deep puncture might worsen incontinence.
Axilla and Hypochondrium: Song edition writes "ye" as "ye". Ma, Wu, and Zhang agree. Gao’s version uses "ye", noting correction from error. The Hand-Jueyin Pericardium Meridian circulates through the chest, exits the hypochondrium, and reaches the axilla. Puncturing the axilla and hypochondrium affects the Pericardium Meridian. Puncturing too deeply causes internal collapse; the pulse deviates from its course, pressing upward on the Lung, causing cough. Commentary: "Ye" is not in *Shuowen*; "ye" is correct. Following Wang Bing, causing cough validates his note.
Chengjin: Ma identifies Chengjin in the calf muscle, commonly called "calf belly." Wu and Zhang confirm. It has dense flesh and deep Qi, hard to disperse; internal collapse causes swelling. Zhi calls it "calf belly."
Above the Eye Socket, in the Depressed Bone, Hitting the Pulse: Ma states "kuang" is the eye socket. "Xian gu" is the orbital bone. "Mai" is the optic nerve connection. "Zhong" is pronounced with the departing tone. Gao states "kuang shang" is above the eye socket, between the eyebrows. "Xian gu" is Sizhukong, in the depression behind the eyebrow. Commentary: "Kuang" is identical to "kuang". *Shiji* cites "tears filling the kuang and flowing horizontally." *Jiayingjing* places Sizhukong in the depression behind the eyebrow, where Foot-Shaoyang Qi emerges. *Waitai* calls it "Mu ". Gao’s note is plausible.
Causing Leakage and Blindness: Zhang states incessant tearing is leakage; loss of vision is blindness. All scholars agree.
Puncturing the Joint Causes Fluid Exit: Ma reads "zhong" with the level tone. Gao states joints are the mechanisms of bone intersection. Moist fluid nourishes the bone, allowing flexion and extension. Puncturing the joint damages the fluid, preventing nourishment, thus restricting movement. This highlights the vital points of acupuncture, constituting the prohibitions. Commentary: Gao reading "zhong" with the departing tone is incorrect.