清气在阴。浊气在阳。营气顺脉卫气逆行。清浊相干乱于胸中。是谓大 。(清气属阳
在阴则乱浊气属阴而降在阳则乱营气阴性精专行常顺脉卫气阳性剽悍昼当行阳。夜当行阴若
卫气逆行则阴阳相犯乱于胸中而为 闷总由卫气之为乱耳。)故气乱于心。则烦心密嘿。俯
首静伏。取手少阴心主之 。(神门大陵)乱于肺。则俯仰喘喝。接手以呼。取手太阴荥足少
阴。(鱼际太 )乱于肠胃。则为霍乱。取足太阴阳明。(太白陷谷)不下者。取之三里(气
乱于内者上则在心肺下则在肠胃也。)乱于臂胫则为四厥。取之先去血脉。(臂足之有血络者
刺去其血。)后取其阳明少阳之荥 。(在臂取二间三间液门中渚。在足取内庭陷谷侠溪临泣
。)乱于头。则为厥逆。头重眩仆。取之天柱大杼。(足太阳经穴。)不知取足太阳荥输。(通
谷束骨○气乱于外者。下则在四肢上则在头也。)
徐入徐出。谓之导气。补泻无形。谓之同精(凡行针补泻皆贵和缓故当徐入徐出导气复
元而
已。然补者导其正气泻者导其邪气总在保其精气故曰补泻无形。谓之同精)是非有余不足也
。乱气之相逆也。(言此非为有余不足而设特以乱气相逆宜导治之如是耳。)
年质壮大。血气充盈。肤革坚固。因加以邪。刺之者。深而留之。此肥人也。(气血
正盛故与肥壮之人同其法)广肩腋项肉薄浓皮而黑色。唇临临然
。(
唇浓质浊之谓)其血黑以浊其气涩以迟。为人贪于取与刺此者。深而留之。多益其数也。(久
留针)瘦人者。皮薄色少肉廉廉然。(薄也)薄唇轻言。(肉瘦气少)其血清气滑。易脱于气。
易损于血。刺此者。浅而疾之 刺常人。视其白黑。各为调之。(白者同瘦人。黑者同肥人
当调其深浅之数也)端正敦浓者。其血气和调。(即常人之度)刺此者。无失常数也。(如经水
篇足阳明刺深六分。留十呼之类)
婴儿者。其肉脆。血少气弱。刺此者。以毫针浅刺而疾发针。日再可也。(若邪有未尽
少阴之脉独下行何也。夫冲脉者。五脏六腑之海也。五脏六腑皆禀焉。其上者。出于颃
颡。
于气街。循阴股内廉入 中。伏行 骨内。下至内踝之后属而别。其下者。并于少阴之经渗三
阴。(自少阴以渗及肝脾二经所以下行也。)其前者。伏行出跗属下。(足掌属也。)循跗入大
指间。渗诸络而温肌肉。(皆冲脉之气也。)故别络结。则跗上不动。不动则厥。厥则寒矣(
若冲脉之络因邪而结。则跗上之经不动而为厥寒矣。足三阴脉从足走腹。而独有足少阴肾
脉绕而下行者以冲脉与之并行故耳。)
清气本应属阳而居上，浊气本应属阴而降下。营气（运行于脉中、具有营养作用的气）沿经脉顺行，卫气（运行于脉外、具有防御作用的气）则逆行于体表。若清浊之气相互干扰，扰乱于胸中，这就称为“大悗”（指胸中烦闷窒塞的症状）。
因此，如果气机紊乱于心，就会出现心烦意乱、沉默不语、低头静伏的症状。治疗时取手少阴心经和手厥阴心包经的穴位（如神门、大陵穴）。如果气机紊乱于肺，就会出现呼吸急促、喘息有声、需俯仰呼吸并用手按胸部以助呼吸的症状。治疗时取手太阴肺经的荥穴（鱼际穴）和足少阴肾经的穴位（太溪穴）。如果气机紊乱于肠胃，就会发生霍乱（一种以剧烈吐泻为特征的疾病）。治疗时取足太阴脾经和足阳明胃经的穴位（太白穴、陷谷穴）。如果病情严重、气不下行者，取足三里穴。（气机紊乱在内，向上则影响心肺，向下则影响肠胃。）如果气机紊乱于手臂和小腿，就会出现四肢厥冷（手足逆冷）的症状。治疗时应先刺破瘀阻的血络放血，然后再取足阳明胃经和足少阳胆经的荥穴进行治疗。（在手臂取二间、三间、液门、中渚穴；在足部取内庭、陷谷、侠溪、足临泣穴。）如果气机紊乱于头部，就会出现厥逆（气血上冲导致的昏厥或眩晕）、头重脚轻、眩晕跌倒的症状。治疗时取天柱穴和大杼穴（均为足太阳膀胱经穴位）。如果效果不佳，再取足太阳膀胱经的荥穴和输穴（通谷穴、束骨穴）。（气机紊乱在外，向下则在四肢，向上则在头部。）
进针缓慢、出针缓慢，这叫做“导气”。补法和泻法如果不拘泥于形式，旨在调和精气，这叫做“同精”。（凡施行针刺补泻，都贵在平和舒缓，所以应当缓慢进针、缓慢出针，以引导气机恢复元气。然而，补法是引导正气，泻法是引导邪气，总归是为了保护精气，所以说补泻无形，称为同精。）这并不是因为正气有余或不足，而是由于气机逆乱所致。（意思是说，这种情况并非由虚实有余不足引起，特意用这种方法来疏导逆乱之气即可。）
对于身体壮实、气血充盈、皮肤坚固的人，如果又受到邪气侵袭，针刺时要深刺并留针。这是针对肥人的治法。（因为气血正盛，所以与肥壮之人的治法相同。）对于那些肩膀宽阔、腋下及颈部肌肉薄弱、皮肤厚密且颜色黑、嘴唇丰厚的人，他们的血液黑而浑浊，气机涩滞而运行迟缓。这类人贪于索取与给予（性格特征），针刺他们时，要深刺并长时间留针，增加针刺次数。（长时间留针。）
瘦人皮薄、面色苍白、肌肉消瘦、嘴唇薄、说话声音轻弱。他们的血液清稀、气机滑利，容易耗散正气，也容易损伤血液。针刺这类人时，要浅刺并快速出针。
针刺普通人，要根据其肤色黑白来调整。肤色白的人如同瘦人，肤色黑的人如同肥人，应当根据深浅和留针时间来调节。（肤色白者同瘦人，肤色黑者同肥人，当调其深浅之数也。）
形体端正、敦厚丰满的人，其血气和调。针刺这种人时，不要违背常规的针刺标准。（如《经水》篇中提到的足阳明胃经刺深六分、留针十呼等常规数据。）
婴儿肌肉娇脆，血量少，气力弱。针刺婴儿时，要用毫针浅刺并快速出针，每天可以针刺两次。（如果邪气未尽……）
足少阴肾经为什么独自下行呢？冲脉是五脏六腑气血汇聚的海源，五脏六腑都禀受于它。冲脉上行的一支，出于颃颡（鼻咽部），经过气街（腹股沟动脉搏动处），沿着大腿内侧下行，进入腘窝，伏行于骨骼之内，向下到达内踝后方，然后分支别行。其下行的一支，并入足少阴肾经，渗灌于足三阴经。（从足少阴肾经渗灌至足太阴脾经和足厥阴肝经，所以下行。）其前行的一支，伏行于足背下方，进入大脚趾之间，渗灌到各条络脉以温养肌肉。（这都是冲脉之气的作用。）所以，如果冲脉的别络结滞，足背上的经脉就会不动，经脉不动就会发生厥逆，厥逆就会导致寒冷。（如果冲脉的络脉因邪气而结滞，则足背上的经脉气血不通而为厥寒。足三阴脉都是从足走向腹部，唯独足少阴肾脉环绕下行，是因为冲脉与其并行的缘故。）
Clear Qi (Qing Qi) naturally belongs to Yang and resides superiorly, while Turbid Qi (Zhuo Qi) naturally belongs to Yin and descends. Ying Qi (Nutritive Qi, circulating within the vessels) follows the meridians in a順 (smooth/forward) direction, whereas Wei Qi (Defensive Qi, circulating outside the vessels) moves in a reverse direction on the exterior. If Clear and Turbid Qi interfere with each other and disrupt the chest, this is termed "Da Men" (severe chest oppression and stuffiness).
Therefore, if Qi disorder occurs in the Heart, it manifests as mental restlessness, muteness, bowing the head, and lying still. Treatment involves selecting points from the Hand Shaoyin Heart Meridian and Hand Jueyin Pericardium Meridian (e.g., Shenmen [HT7], Daling [PC7]). If Qi disorder occurs in the Lungs, it manifests as dyspnea, wheezing, difficulty breathing requiring leaning forward or backward, and using hands to assist respiration. Treatment involves selecting the Ying-Spring point of the Hand Taiyin Lung Meridian (Yuji [LU10]) and points from the Foot Shaoyin Kidney Meridian (Taixi [KI3]). If Qi disorder occurs in the Intestines and Stomach, it results in Huoluan (Cholera-like syndrome characterized by severe vomiting and diarrhea). Treatment involves selecting points from the Foot Taiyin Spleen Meridian and Foot Yangming Stomach Meridian (Taibai [SP3], XianGu [ST43]). If the condition is severe and Qi fails to descend, select Zusanli [ST36]. (Qi disorder internally: ascending affects Heart and Lungs; descending affects Intestines and Stomach.) If Qi disorder occurs in the arms and shins, it results in Si Jue (Four Coldness, i.e., cold extremities). Treatment should first involve pricking collateral vessels to release blood, followed by selecting Ying-Spring points of the Foot Yangming Stomach Meridian and Foot Shaoyang Gallbladder Meridian. (On the arm, select Erjian [LI2], Sanjian [LI3], Yemen [TE2], Zhongzhu [TE3]; on the foot, select Neiting [ST44], XianGu [ST43], Xiaxi [GB43], Zulinqi [GB41].) If Qi disorder occurs in the head, it results in Ni Ni (rebellious Qi leading to fainting or dizziness), heavy head, vertigo, and falling. Treatment involves selecting Tianzhu [BL10] and Dashu [BL11] (both Foot Taiyang Bladder Meridian points). If ineffective, select the Ying-Spring and Shu-Stream points of the Foot Taiyang Bladder Meridian (Tonggu [BL65], Shugu [BL64]). (Qi disorder externally: descending affects limbs; ascending affects the head.)
Slow insertion and slow withdrawal are called "Dao Qi" (Guiding Qi). Tonification and sedation without rigid form are called "Tong Jing" (Same Essence). (In acupuncture tonification and sedation, harmony and gentleness are paramount; thus, one should insert and withdraw slowly to guide Qi and restore Yuan Qi. However, tonification guides righteous Qi, while sedation guides pathogenic Qi; both aim to preserve Essence, hence "tonification and sedation have no fixed form," referred to as Tong Jing.) This is not due to Excess or Deficiency, but rather due to the rebellion of disordered Qi. (This indicates that the condition is not caused by Excess or Deficiency, but specifically requires guiding the rebellious Qi in this manner.)
For individuals who are physically robust, with abundant Qi and Blood, and firm skin, if they contract pathogens, needling should be deep and retain the needle. This is the method for fat people. (Since Qi and Blood are vigorous, the treatment aligns with that for robust/fat individuals.) For those with broad shoulders, thin axillary and neck muscles, thick dense black skin, and thick lips, their Blood is dark and turbid, and their Qi is sluggish and slow. Such individuals tend to be greedy in taking and giving. Needling them requires deep insertion, long retention, and increased frequency of treatment. (Long needle retention.)
Thin individuals have thin skin, pale complexion, emaciated muscles, thin lips, and soft speech. Their Blood is clear, and their Qi is slippery; they easily lose Qi and damage Blood. Needling them requires shallow insertion and rapid withdrawal.
For normal individuals, adjust based on skin color. Those with white skin are treated like thin individuals; those with black skin are treated like fat individuals. Adjust depth and retention time accordingly. (White skin corresponds to thin body type; black skin corresponds to fat body type; adjust depth and count.)
Individuals with upright, solid, and plump constitutions have harmonious Qi and Blood. Needling them should follow standard protocols. (Such as the standards mentioned in the *Jing Shui* chapter: e.g., Foot Yangming Stomach Meridian needled 6 fen deep, retained for 10 breaths.)
Infants have fragile flesh, little Blood, and weak Qi. Needling infants requires shallow insertion with a fine needle and rapid withdrawal. It may be performed twice daily. (If pathogens remain...)
Why does the Foot Shaoyin Kidney Meridian alone descend? The Chong Mai (Penetrating Vessel) is the sea of Qi and Blood for the Five Zang and Six Fu organs; all organs derive from it. Its ascending branch emerges from the Hangsang (nasopharynx), passes through the Qigie (inguinal region), runs along the medial aspect of the thigh, enters the popliteal fossa, travels deep within the bone, descends to behind the medial malleolus, and then branches off. Its descending branch merges with the Foot Shaoyin Meridian and permeates the Three Yin Meridians. (Permeating from Foot Shaoyin to Foot Taiyin Spleen and Foot Jueyin Liver Meridians, hence descending.) Its anterior branch travels beneath the dorsum of the foot, enters between the great toe, permeates various collaterals to warm the muscles. (All are functions of Chong Mai Qi.) Therefore, if the collateral branches of the Chong Mai become obstructed, the vessels on the dorsum of the foot will cease to move; lack of movement leads to Jue (cold extremities/fainting), which causes coldness. (If Chong Mai collaterals are obstructed by pathogens, blood flow in dorsal foot vessels stops, causing Jue and cold. While the Three Yin Meridians of the foot generally ascend toward the abdomen, the Foot Shaoyin Kidney Meridian descends uniquely because it runs parallel with the Chong Mai.)