此篇乃前篇之注解，与《素问·针解篇》大同小异，皆古圣
针法之真传。恐后世以讹传讹，故特着此二篇，以防后世之贻误。凡习针法者，万不可不读。
所谓易陈者，易言也，难入者，难着于人也。粗守形者，守刺法也。上守神者，守人之血气有余不足，
可补泻也。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。未睹其疾
者，先知邪正何经之疾也。恶知其原者，先知何经之病所取之处也。刺之微在数迟者，徐疾之意也。粗守
关者，守四肢而不知血气正邪之往来也。上守机者，知守气也。机之动不离其空中者，知气之虚实，用针之徐
疾也。空中之机清净以微者，针以得气，密意守气勿失也。其来不可逢者，气盛不可补也。其往不可追者，气
虚不可泻也。不可挂以发者，言气易失也。扣之不发者，言不知补泻之意也，血气已尽而气不下也。
知其往来者，知气之逆顺盛虚也。要与之期者，知气之可取之时也。粗之暗者，冥冥不知气之微密也。妙哉！
工独有之者，尽知针意也。往者为逆者，言气之虚而小，小者逆也。来者为顺者，言形气之平，平者顺也。明
知逆顺，正行无问者，言知所取之处也。迎而夺之者，泻也。追而济之者，补也。所谓虚则实之者，
气口虚而当补之也。满则泄之者，气口盛而当泻之也。宛陈则除之者，去血脉也。邪胜则虚之者，言诸经有盛
者，皆泻其邪也。徐而疾则实者，言徐内而疾出也。疾而徐则虚者，言疾内而徐出也。言实与虚若有若无者，
言实者有气，虚者无气也。察后与先若亡若存者，言气之虚实，补泻之先后也，察其气之已下与常存
也。为虚与实若得若失者，言补者 然若有得也，泻则 然有失也。夫气之在脉也邪气在上者，言邪气之中人
也高，故邪气在上也。浊气在中者，言水谷皆入于胃，其精气上注于肺，浊溜于肠
胃，言寒温不适，饮食不节，而病生于肠胃，故命曰浊气在中也。清气在下者，言清湿地气之中人也，必从足
始，故曰清气在下也。针陷脉则邪气出者，取之上。针中脉则浊气出者，取之阳明合也。针太深则邪气反沉
者，言浅浮之病，不欲深刺也，深则邪气从之入，故曰反沉也。皮肉筋脉各有所处者，言经络各有所
主也。取五脉者死，言病在中，气不足，但用针尽大泻其诸阴之脉也。取三阳之脉者，唯言尽泻三阳之气，
令病 然不复也。夺阴者死，言取尺之五里五往者也。夺阳者狂，正言也。睹其色、察其目、知其散复、一
其形、听其动静者，言上工知相五色于目，有知调尺寸小大缓急滑涩，以言所病也。知其邪正者，知论
虚邪与正邪之风也。右主推之，左持而御之者，言持针而出入也。气至而去之者，言补泻气调而去之也。调气
在于终始一者，持心也。节之交三百六十五会者，络脉之渗灌诸节者也。所谓五脏之气已绝于内者，脉口气内
绝不至，反取其外之病处与阳经之合，有留针以致阳气，阳气至则内重竭，重竭则死矣，其死也无
气以动，故静。所谓五脏之气已绝于外者，脉口气外绝不至，反取其四末之输，有留针以致其阴气，阴气至
则阳气反入，入则逆，逆则死矣，其死也阴气有余，故躁。所以察其目者，
五脏使五色循明，循明则声章，声章者，则言声与平生异也。
本篇是对前一篇的注解，与《素问·针解篇》内容大体相同而细节略有差异，都是古代圣人在针刺疗法上的真正传承。担心后世以讹传讹，所以特意撰写这两篇，以防止后世产生误导。凡是学习针刺技法的人，万万不可不读。
所谓“易陈”，意思是容易陈述；“难入”，意思是难以被人领会和掌握。“粗守形”，是指只拘泥于固定的刺法形式。“上守神”，是指把握患者气血的有余或不足，从而决定使用补法或泻法。“神客”，是指正气与邪气相交会。“神”指正气，“客”指邪气。“在门”，是指邪气顺着正气出入的路径进入人体。“未睹其疾”，是指在诊断疾病之前，先要判断邪气和正气在哪条经络发生病变。“恶知其原”，是指先要知道哪条经络患病以及应该选取哪个穴位进行治疗。
针刺的精微之处在于进针速度的快慢（徐疾）。“粗守关”，是指只关注四肢关节部位，而不知道气血中正邪气的往来变化。“上守机”，是指懂得把握经气运行的时机。“机之动不离其空中”，是指知道经气的虚实，并据此决定用针的快慢。“空中之机清净以微”，是指针刺已经得气，需细心守候经气而不使其流失。
“其来不可逢”，是指当经气盛实的时候，不可使用补法。“其往不可追”，是指当经气虚弱的时候，不可使用泻法。“不可挂以发”，是说经气很容易流失。“扣之不发”，是说如果不懂得补泻的要领，即使血气已尽，经气也不会下行。
“知其往来”，是指了解经气的逆顺、盛衰和虚实。“要与之期”，是指知道可以施针的最佳时机。“粗之暗者”，是指庸医冥顽不灵，不知道经气细微的变化。“妙哉！工独有之”，是指高明的工匠独自掌握了这些奥妙，完全通晓针刺的意旨。
“往者为逆”，是说经气虚弱且脉象细小，细小即为逆证。“来者为顺”，是说形体与经气平和，平和即为顺证。“明知逆顺，正行无问”，是指知道该选取的治疗部位后，便径直施行，不再犹豫。
“迎而夺之”，是泻法；“追而济之”，是补法。所谓“虚则实之”，是指寸口脉虚弱时应当使用补法。“满则泄之”，是指寸口脉盛实时应当使用泻法。“宛陈则除之”，是指去除血脉中的瘀血。“邪胜则虚之”，是指各条经络如果有邪气亢盛的情况，都要通过泻法祛除邪气。
“徐而疾则实”，是指缓慢进针、快速出针，可使正气充实。“疾而徐则虚”，是指快速进针、缓慢出针，可使邪气衰减。“言实与虚若有若无”，是指实证时有经气感应，虚证时没有经气感应。“察后与先若亡若存”，是指根据经气的虚实，确定补泻的先后顺序，并观察经气是否已下行或依然存在。“为虚与实若得若失”，是指补法之后感觉好像有所获得，泻法之后感觉好像有所失去。
关于经气在经脉中的运行：邪气在上部的，是说邪气伤人位置较高，所以病位在上部。浊气在中部的，是说水谷饮食都进入胃中，其精微之气上注于肺，而浑浊之气留滞于肠胃，如果寒温失调、饮食不节，就会在肠胃产生疾病，所以称为浊气在中部。清气在下部的，是说清冷潮湿的地气伤人，必定从足部开始，所以称为清气在下部。
针刺陷脉（浅表脉络）使邪气排出，取穴在身体上部。针刺中脉使浊气排出，取阳明经的合穴。针刺过深导致邪气反而陷入体内，是说浅表的浮浅病症，不希望深刺，如果深刺，邪气就会随之深入，所以称为反沉。皮、肉、筋、脉各有其所属的部位，是说经络各自主管相应的组织。
误取五脏阴经的五里穴会导致死亡，是说病在中焦，气不足，如果只用针大肆泻诸阴经的脉气，就会致死。误取三阳经的脉气，是说如果将三阳经的气全部泻尽，病人就会萎靡不振，无法恢复。耗夺阴气会导致死亡，是指反复针刺尺泽穴附近的五里穴。耗夺阳气会导致狂乱，这是确切的说法。
观察病人的面色、眼睛，了解精气神的散失与恢复，统一观察其形体，倾听其动静，是说高明的医生能从眼睛的颜色辨别五脏状况，并懂得调节寸口脉的大小、缓急、滑涩等特征，以此判断病情。了解邪正关系，是指辨析虚邪贼风与正邪之风。
右手主要推动针具，左手扶持并控制针具，是说持针进出时的手法。经气到达后即可起针，是说补泻得当、经气调和后即可起针。调气的关键在于内心专注始终如一。全身三百六十五个节会之处，是络脉渗透灌注的地方。
所谓“五脏之气已绝于内”，是指寸口脉的内侧脉搏微弱甚至摸不到，此时如果反而去针刺外部的病处或阳经的合穴，并留针以引致阳气，阳气到来则内部阴气会更加枯竭，双重枯竭就会死亡，死时因为没有气机活动，所以表现为安静。
所谓“五脏之气已绝于外”，是指寸口脉的外侧脉搏微弱甚至摸不到，此时如果反而去针刺四肢末端的腧穴，并留针以引致阴气，阴气到来则阳气反而内陷，内陷则气机逆乱，逆乱就会死亡，死时因为阴气有余，所以表现为躁动。
之所以观察眼睛，是因为五脏使五色显现清明，清明则声音彰显，声音彰显，就说明患者的声音与平时不同。
This section serves as an annotation to the preceding section, differing only slightly in details from the *Suwen: Zhenjie Pian* (Plain Questions: Explanation of Needling). Both represent the true transmission of ancient sages regarding acupuncture techniques. Fearing that later generations might propagate errors, these two sections were specifically written to prevent future misunderstandings. Anyone studying acupuncture must read them without fail.
"Yi Chen" (Easy to state) means it is easy to describe verbally; "Nan Ru" (Difficult to enter) means it is difficult for others to comprehend and master. "Custody of Form by the Crude" refers to rigidly adhering to fixed needling forms. "Guarding Spirit by the Superior" refers to observing the patient's excess or deficiency of Blood and Qi to determine whether to apply tonification or sedation. "Shen Ke" (Spirit Guest) refers to the convergence of Righteous Qi and Pathogenic Qi. "Shen" denotes Righteous Qi, while "Ke" denotes Pathogenic Qi. "Zai Men" (At the Gate) indicates that pathogenic qi enters along the pathways where righteous qi exits and enters. "Wei Du Qi Ji" (Not yet seeing the disease) implies that before diagnosing the illness, one must first identify which meridian is affected by pathogenic or righteous qi. "E Zhi Qi Yuan" (How to know its origin) means knowing which meridian is diseased and selecting the appropriate acupoint for treatment.
The subtlety of needling lies in the speed of insertion and withdrawal (Xu Ji). "Custody of Joints by the Crude" refers to focusing only on the limbs and joints, unaware of the fluctuation of righteous and pathogenic qi within the blood vessels. "Guarding the Mechanism by the Superior" refers to understanding how to monitor the movement of Qi. The movement of the mechanism does not depart from the "void" (the space within the tissue), meaning one understands the deficiency or excess of Qi and adjusts the needling speed accordingly. The mechanism in the void is pure and subtle; once Qi De (arrival of Qi) is achieved, one must carefully guard the Qi so as not to lose it.
"When Qi comes, do not meet it with tonification": When Qi is excessive, tonification should not be applied. "When Qi goes, do not pursue it with sedation": When Qi is deficient, sedation should not be applied. "Do not let it slip by a hair": This emphasizes how easily Qi can be lost. "Striking but not releasing": This refers to the failure to understand the principles of tonification and sedation, resulting in the exhaustion of Blood and Qi without the downward movement of Qi.
"Knowing the coming and going" means understanding the direction, strength, and deficiency/excess of Qi. "Aiming for the right time" means knowing the optimal moment to needle. "Crude and obscure" describes practitioners who are ignorant of the subtle changes of Qi. "Wonderful! Only the skilled artisan possesses this": The skilled practitioner alone masters these mysteries and fully comprehends the intent of needling.
"Going is Ni (Reverse)" indicates that when Qi is deficient and the pulse is thin, it is considered a reverse condition. "Coming is Shun (Smooth)" indicates that when form and Qi are balanced, it is considered a smooth condition. "Clearly knowing reverse and smooth, proceeding correctly without hesitation" means knowing the correct points to select and proceeding directly.
"Meeting and seizing" refers to sedation. "Pursuing and assisting" refers to tonification. "Tonifying deficiency to make it solid" means applying tonification when the Cun Kou (radial artery at the wrist) pulse is weak. "Draining fullness to reduce it" means applying sedation when the Cun Kou pulse is strong. "Removing stagnation and old blood" refers to eliminating blood stasis. "Defeating pathogenic excess by reducing it" means that if any meridian exhibits excessive pathogenic factors, they should be drained.
"Slow insertion and rapid withdrawal makes solid" refers to slowly inserting the needle and rapidly withdrawing it to tonify. "Rapid insertion and slow withdrawal makes empty" refers to rapidly inserting the needle and slowly withdrawing it to sedate. "Speaking of solid and empty as if present or absent" means that in solid conditions, there is a sensation of Qi, whereas in empty conditions, there is no sensation of Qi. "Observing sequence and priority as if existing or perishing" refers to determining the order of tonification and sedation based on the deficiency or excess of Qi, and observing whether the Qi has descended or remains. "Treating empty and solid as if gaining or losing" means that after tonification, one feels as if something has been gained; after sedation, one feels as if something has been lost.
Regarding the location of Qi in the meridians: Pathogenic Qi in the upper part indicates that pathogens attack high positions in the body, hence the disease is located superiorly. Turbid Qi in the middle part refers to food and drink entering the Stomach; their essence ascends to the Lung, while turbid residues remain in the intestines and stomach. Improper temperature regulation and irregular diet cause diseases in the gastrointestinal tract, termed "Turbid Qi in the Middle." Clear Qi in the lower part refers to cold and damp earthy pathogens attacking from below, starting at the feet, hence termed "Clear Qi in the Lower."
Needling superficial collaterals expels pathogenic Qi, requiring selection of points in the upper body. Needling deeper meridians expels turbid Qi, requiring selection of He-Sea points of the Yangming Meridian. Needling too deeply causes pathogenic Qi to sink further; this warns against deep needling for superficial conditions, as deep needling may draw pathogens inward, causing them to sink. Skin, flesh, sinews, and vessels each have their specific locations, indicating that meridians govern corresponding tissues.
Taking the Wu Li (Five Miles) points of the Yin meridians leads to death; this warns that if Qi is insufficient due to internal pathology, excessively draining all Yin meridians will cause death. Taking the pulses of the Three Yang meridians excessively drains Yang Qi, leaving the patient lethargic and unable to recover. Depleting Yin Qi leads to death, specifically referring to repeatedly puncturing the Wu Li point near Chize. Depleting Yang Qi leads to mania, which is a correct statement.
Observing facial color, eyes, spirit dispersion/recovery, physical form, and auditory cues allows the superior physician to discern the Five Colors in the eyes and adjust the Cun Kou pulse characteristics (size, rate, tension, slippery/rough quality) to diagnose the disease. Understanding pathogenic vs. righteous factors involves distinguishing between false wind pathogens and normal wind influences.
The right hand primarily pushes the needle, while the left hand holds and controls it, describing the manipulation during insertion and withdrawal. Removing the needle upon the arrival of Qi means removing it once tonification or sedation has successfully regulated the Qi. Regulating Qi requires mental focus and consistency throughout the procedure. The 365 junctions of the body are sites where collateral vessels penetrate and irrigate various segments.
"Spirit of the Five Zang Organs already exhausted internally" refers to the absence of the inner pulse at the Cun Kou. If one mistakenly needles external disease sites or Yang meridian He-Sea points and retains the needle to attract Yang Qi, the arrival of Yang Qi will further deplete internal Yin, leading to double depletion and death. The deceased appears quiet because there is no Qi to move.
"Spirit of the Five Zang Organs already exhausted externally" refers to the absence of the outer pulse at the Cun Kou. If one mistakenly needles the extremities' Shu points and retains the needle to attract Yin Qi, the arrival of Yin Qi will cause Yang Qi to retreat inward, leading to reversal and death. The deceased appears restless due to excess Yin.
Observing the eyes is crucial because the Five Zang Organs manifest colors clearly through them. Clarity in color manifests in the voice. A change in voice compared to the person's usual state indicates pathological changes.