凡刺之道。气调而止。补阴泻阳。音气益彰耳目聪明。(此阴阳以表里言。正气在中。
故当补阴。邪自外入。故当泻阳。阳邪去而真气复。故音气益彰。耳目聪明也。)反此者。血气
不行所谓气至而有效者。泻则益虚。虚者脉大如其故。而不坚也。(泻者欲其虚也。既泻之
后。虽其脉大如旧。但得和软不坚。即其效也。)坚如其故者。适虽言故。病未去也。(脉坚
如旧。虽言病去复旧。而病实未除也。)补则益实。实者脉大如其故。而益坚也。(补者欲其
实实则脉坚。)夫如其故而不坚者。适虽言快。病未去也。(既补之后。而脉之大小如旧。虽
言身体已快。病未除也。二节云大者。概指脉体进退而言也。)故补则实。泻则虚。痛虽不
随针病必衰去。(补则脉坚。泻则脉不坚者。若或有痛。虽未随针即愈。亦必以渐而去矣。)
必先通十二经脉之所生病。而后可得传于终始矣。(必治其病所从生。而后可得终始之义。
终始。即本末之谓。)故阴阳不相移。虚实不相倾。取之其经。(或阴或阳。无所改易。不相
移也。虚者自虚。实者自实。亦不相伤。此则无所从生。而各病其病但求其经而取之。)凡
刺之属。三刺至谷气。(义如下文)邪辟妄合。阴阳易居。逆顺相反沉浮异处。四时不得。稽
留淫 。(六句言病变也。凡此者。皆须用针。治以三刺之法。则诸病可去也。)故一刺则阳
邪出。(初刺之在于浅近。故可出阳分之邪。)再刺则阴邪出。(再刺之在于深远故可出阴分
之邪。)三刺则谷气至。谷气至而止。所为谷气至者。已补而实。已泻而虚。故以知谷气至
也。(三刺之在侯谷气。即元气也。止。出针也。盖邪气来也紧而疾。谷气来也。徐而和。
邪气去而后谷气至。故已补而实。则虚者坚已泻而虚。则坚者软是以知谷气之至也。)邪气
独去者。阴与阳未能调。而病知愈也。故曰补则实。泻则虚。痛虽不随针。病必衰去矣。(
谷气。至者。知邪气之去也。虽阴阳经气未见即调而病则已愈故上文曰补则实写则虚病必衰去。)
阴盛而阳虚。(脉口盛也。)先补其阳。后泻其阴而和之。阴虚而阳盛。(人迎盛也。)先补其
阴。后泻其阳而和之。(治病皆宜先顾正气。后治邪气) 三脉动于足大指之间。(三脉谓阳
明经属兑至冲阳。厥阴经大敦至太冲。少阴经自涌泉以上太 。三者皆在足大指之后也。)
必审其实虚。虚而泻之。是为重虚。重虚病益甚。凡刺此者。以指按之。脉动而实且疾者。
疾泻之。虚而徐者。则补之。反此者。病益甚。其动也。阳明在上。(在足跗上也。)厥阴在
内。(在足跗内也。)少阴在下。(涌泉穴起于足心在足跗下也)
补(当作刺)须一方实。深取之。稀按其 。以极出其邪气。(刺法惟二。则补泻而已。
一者因其方实。故深刺勿按其 。以出其邪气。此泻法也。)一方虚。浅刺之。以养其脉。疾按
其。无使邪气得入。(一者。因其方虚。故浅刺以养血脉。疾按其穴。以拒邪气此补法也
。)邪气来也紧而疾。谷气来也徐而和。(此虽言针下之气。然脉气之至亦如此。)脉实者。
深刺之。以泄其气。脉虚者。浅刺之。使精气无得出。以养其脉独出其邪气。刺诸痛者。其
上重舌。刺舌柱(舌下之筋如柱者。)以铍针也。手屈而不伸者。其病在筋。伸而不屈者。其病在骨。
病生于头者。头重。生于手者。臂重。生于足者。足重。治病者。先刺其病所从生者也。春
气在毛。夏气在皮肤。秋气在分肉。冬气在筋骨。(此言病气之中人。随时气而为浅深也。)
刺此病者。各以其时为齐。(同剂。针曰砭齐。)故刺肥人者以秋冬之齐。刺瘦人者。以春夏
之齐。痒痛者。阴也。痛而以手按之不得者。阴也。深刺之。病在上者。阳也。病在下者。
阴也。痒者。阳也。浅刺之。(邪之在表者。其气外发。或气往来行则流而为痒。)
刺热厥者。二阴一阳。(补阴经二次。泻阳经一次。)刺寒厥者。二阳一阴。(补阳经二次。
泻阴经一次。)久病者。邪气入深。刺此病者。深内而久留之。间日而复刺之。必先调其。
左右。去其血脉。刺道毕矣。凡刺之法必察其形气形肉未脱。少气而脉又躁。躁厥者。必为
缪刺之。散气可收。聚气可布。( 少气而形肉未脱。其脉躁急。其病躁而厥逆者。气虚于
内。邪实于经也。所刺在络。其用轻浅。则精气之散者可收。邪气之聚者可散也。)深居静
处。占神往来。闭户塞牖。魂魄不散专意一神。精气之分母闻人声。以收其精。必一其神。
令志在针。(言刺此者。必清必静。聚精会神。详察秋毫。令志在针。庶于虚实疑似之间无
误也。)浅而留之。微而浮之。以移其神。气至乃休。(言气虚邪热之病。用针宜从容以移其
神耳。)男内女外。坚拒勿出谨守勿内。是谓得气。(既刺之后。尤当戒慎男子忌内。女子忌
外。忌外者。坚拒勿出忌内者。谨守勿内。则其邪气必去。正气必复。是为得气。)凡刺之
禁
。新内勿刺。新刺勿内。已醉勿刺。已刺勿醉。新怒勿刺已刺勿怒。新劳勿刺。已刺勿劳。
已饱勿刺。已刺勿饱。已饥勿刺已刺勿饥已渴勿刺。已刺勿渴。大惊大恐。必定其气乃刺之
。乘车来者。卧而休之。如食顷乃刺之。步行来者坐而休之如行十里 乃刺之凡此十二禁者
其脉乱气散逆其营卫经气不次因而刺之。则阳病入于阴。阴病出为阳。则邪气复生。粗工勿
察。是为伐身。形体淫 。乃消脑髓。津液不化。脱其五味。是为失气也。
凡针刺的原则，在于使经气调和即可停止。补益阴分、泻除阳分，能使声音洪亮、耳目聪明。（这里的阴阳是指表里而言。正气居于体内，所以应当补阴；邪气从外侵入，所以应当泻阳。阳分之邪气去除而真气恢复，因此声音和听力视力都会变得敏锐清晰。）与此相反的做法，会导致血气运行不畅。所谓“气至而有效”，是指：用泻法后，脉象虽然依然盛大如旧，但不再坚实。（泻法的目的就是使其虚弱。泻法之后，即使脉象大小如旧，只要变得柔和不坚，就是有效的标志。）如果脉象依然坚实如旧，虽然患者说病好了，但实际上病邪并未去除。（脉象坚实如旧，虽然患者声称病去身安，但病邪实际上并未清除。）用补法后，脉象应该更加充实。充实的表现是脉象盛大如旧，并且变得更加坚实。（补法旨在使其充实，所以脉象会坚实。）如果脉象大小如旧且不坚实，虽然患者感觉身体舒适，但病邪并未去除。（补法之后，如果脉象大小如旧且不坚实，虽然患者自述身体已感轻松，但病邪仍未除去。这两节提到的“大”，泛指脉体的进退变化。）所以，补法使脉实，泻法使脉虚。疼痛即使没有随着针刺立即消失，也必然会逐渐减轻。（补法后脉象坚实，泻法后脉象不坚实。如果有疼痛，虽然不会随针即愈，但也一定会逐渐消退。）必须先通晓十二经脉所发生的病变，然后才能掌握《终始》篇的要义。（必须治疗疾病产生的根源，然后才能理解终始的含义。终始，就是本末的意思。）所以，阴阳不相移易，虚实不相倾夺，取穴应针对其所属的经脉。（或阴或阳，没有改变，互不干扰。虚者自虚，实者自实，互不损伤。这种情况是病无所从生，各自表现为各自的病症，只需寻找其所属的经脉进行针刺即可。）
凡是针刺的一类方法，经过三次针刺可以达到谷气（正气）。（含义见下文）邪气妄行混杂，阴阳位置颠倒，逆顺关系相反，浮沉部位各异，四时之气失调，导致邪气稽留浸淫。（这六句描述的是病变情况。凡是这些情况，都需要使用针刺，采用三刺的方法，各种疾病就可以去除。）所以，第一次针刺则阳分之邪外出。（初次针刺在浅层，所以可以排出阳分的邪气。）第二次针刺则阴分之邪外出。（再次针刺在深层，所以可以排出阴分的邪气。）第三次针刺则谷气到来。谷气到来就停止针刺。之所以知道谷气到来，是因为已经补过则脉实，已经泻过则脉虚，所以以此判断谷气已到。（第三次针刺是为了候察谷气，也就是元气。停止指起针。一般来说，邪气来时脉象紧而急，谷气来时脉象缓而柔和。邪气去而后谷气至，所以补后脉实，则原本虚的变得坚实；泻后脉虚，则原本坚实的变得柔软，以此知道谷气已至。）只有邪气单独离去，而阴阳尚未调和，但病势已知将愈。所以说，补则脉实，泻则脉虚，疼痛虽不随针即愈，但病势必然衰退。（谷气至，意味着知道邪气已去。虽然阴阳经气未见即时调和，但病已痊愈，所以上文说补则实、泻则虚、病必衰去。）
阴盛而阳虚。（表现为寸口脉盛。）先补其阳，后泻其阴以调和。阴虚而阳盛。（表现为人迎脉盛。）先补其阴，后泻其阳以调和。（治病都应当先顾护正气，后治疗邪气。）
足大指之间的三条经脉跳动。（这三条经脉指：阳明经属兑至冲阳，厥阴经自大敦至太冲，少阴经自涌泉以上至太溪。这三者都在足大趾之后。）必须审察其虚实。如果是虚证却用泻法，这就叫重虚。重虚会使病情更加严重。凡是针刺这里，用手指按压，如果脉动坚实且急促，就迅速泻之；如果脉动虚弱且缓慢，就补之。与此相反的做法，会使病情加重。这三条经脉的搏动位置：阳明经在上（在足背面上方），厥阴经在内（在足背内侧），少阴经在下（涌泉穴起于足心，在足底）。
补（此处应为“刺”字之误）须一方实证，深刺，不要频繁按压针孔，以彻底排出邪气。（针刺的方法只有两种，即补和泻。一种是因为邪气正盛，所以深刺并不按捺针孔，以排出邪气，这是泻法。）另一方为虚证，浅刺，以养护血脉，快速按压针孔，防止邪气进入。（一种是因正气正虚，所以浅刺以养护血脉，快速按压穴位，以拒绝邪气，这是补法。）邪气来时脉象紧而急，谷气来时脉象缓而和。（这里虽然说的是针下的气感，但脉气的到来也是如此。）脉实者，深刺以泄其气；脉虚者，浅刺以使精气不外泄，从而养护血脉，只排出邪气。
针刺各种疼痛病症，如果舌下肿胀，应刺舌柱（舌下像柱子一样的筋），使用铍针。手指弯曲不能伸直，病在筋；伸直不能弯曲，病在骨。病生于头部的，头部沉重；病生于手部的，手臂沉重；病生于足部的，足部沉重。治疗疾病，先针刺疾病产生的部位。春气在毫毛，夏气在皮肤，秋气在分肉，冬气在筋骨。（这说的是病邪中人，随着四季气候的变化而有深浅不同。）针刺这类疾病，要根据季节来确定针刺的深度（同剂，针称为砭齐）。所以，针刺肥人，要用秋冬的深度；针刺瘦人，要用春夏的深度。痒痛属于阴证。疼痛但用手按压找不到固定点的，属于阴证，要深刺。病在上部的，属于阳证；病在下部的，属于阴证。瘙痒属于阳证，要浅刺。（邪气在体表，其气向外发散，或者气往来流动变成流注而为痒。）
针刺热厥症，补阴经两次，泻阳经一次。针刺寒厥症，补阳经两次，泻阴经一次。久病患者，邪气深入，针刺这类疾病，要深进针并长时间留针，隔日再刺。必须先调理左右气血，刺破瘀阻的血脉，针刺的道理就完备了。
大凡针刺的方法，必须观察患者的形体和气色。如果形体肌肉未脱失，但气少且脉象躁动，出现躁厥症状的，必须用缪刺法，可以使散乱的气收敛，聚集的气布散。（气少而形体肌肉未脱失，脉象躁急，病表现为躁动和厥逆，这是内气虚而经络邪实。所刺的部位在络脉，作用轻浅，那么散乱的精气可以收敛，聚集的邪气可以消散。）
要在深静之处，占测神气的往来，关好门户堵塞窗户，使魂魄不散，专心一意于神灵，不分心于他人声音，以收摄精气，必须统一精神，使意念集中在针上。（说针刺这类病人，必须清静，聚精会神，详察细微，使意念集中在针上，这样在虚实疑似之间才不会出错。）浅刺并留针，轻微提插以浮动针感，以此来转移患者的注意力（移其神），待气至后再休息。（说气虚邪热的病，用针宜从容不迫以转移患者的神志罢了。）男子宜守内，女子宜守外，坚决拒邪勿出，谨守正气勿内，这就叫做得气。（针刺之后，尤其应当谨慎，男子忌讳房事，女子忌讳外出。忌讳外出的，要坚决拒绝邪气外出；忌讳房事的，要谨守正气勿内，这样邪气必去，正气必复，这就叫作得气。）
大凡针刺的禁忌：新近行房事者勿刺，新近针刺者勿行房事；已醉酒者勿刺，已针刺者勿饮酒；新近发怒者勿刺，已针刺者勿发怒；新近劳累者勿刺，已针刺者勿劳累；已吃饱者勿刺，已针刺者勿进食；已饥饿者勿刺，已针刺者勿进食；已口渴者勿刺，已针刺者勿饮水；大惊大恐者，必须安定其气然后再刺；乘车来者，让其躺下休息，约一顿饭的时间后再刺；步行来者，让其坐下休息，相当于行走十里路的路程后再刺。以上十二条禁忌，如果不遵守，会导致脉乱气散，营卫经气次序紊乱，因而针刺，则阳病入于阴，阴病出于阳，邪气再生。粗疏的医生不加考察，这是伤害身体。形体淫佚过度，就会消耗脑髓，津液不化，脱失五味之精，这就是所谓的失气。
The principle of acupuncture is to stop once the Qi is harmonized. Tonifying Yin and reducing Yang will enhance voice and improve hearing and vision. (Here, Yin and Yang refer to interior and exterior. The healthy Qi resides in the interior, so one should tonify Yin; pathogenic factors enter from the exterior, so one should reduce Yang. Once the Yang pathogen is eliminated and the true Qi recovers, the voice becomes resonant, and hearing and vision become sharp.) Doing the opposite leads to stagnation of Blood and Qi. The phrase "Qi arrival brings efficacy" means: after reduction therapy, although the pulse may remain large as before, it should no longer be firm. (The purpose of reduction is to induce deficiency. After reduction, even if the pulse size remains unchanged, if it becomes soft and not firm, this indicates efficacy.) If the pulse remains firm as before, although the patient claims the disease has gone, the pathogen has not actually been removed. (A pulse firm as before, despite the patient's claim of recovery, indicates that the pathogen remains.) After tonification therapy, the pulse should become more solid. The sign of solidity is a pulse that is large as before but becomes firmer. (Tonification aims for solidity, hence the pulse becomes firm.) If the pulse size remains unchanged and is not firm, although the patient feels comfortable, the disease has not been cured. (After tonification, if the pulse size is unchanged and not firm, although the patient reports feeling better, the pathogen persists. The term "large" in these sections generally refers to the fluctuation of the pulse body.) Therefore, tonification makes the pulse solid, and reduction makes it deficient. Even if pain does not disappear immediately with needling, it will inevitably diminish gradually. (If the pulse is firm after tonification and not firm after reduction, any existing pain, though not instantly cured by needling, will gradually subside.) One must first understand the diseases occurring in the twelve meridians before mastering the principles of *Zhongshi* (Ends and Beginnings). (One must treat the root of the disease to understand the meaning of ends and beginnings. *Zhongshi* refers to root and branch.) Thus, Yin and Yang do not shift into each other, and deficiency and excess do not compromise each other; points should be selected according to the affected meridian. (Yin or Yang remains distinct without interference. Deficiency and excess are independent and do not harm each other. In such cases where the origin is unclear, simply locate the affected meridian and needle it.)
Regarding all categories of needling, three insertions lead to the arrival of *Guqi* (Grain Qi, i.e., healthy Qi). (Meaning follows below.) When pathogenic factors mix abnormally, Yin and Yang positions reverse, inversion and順 (shun) contrast, and floating/sinking locations differ, causing four-season Qi imbalance and pathogenic retention. (These six sentences describe pathological changes. For all such conditions, needling using the three-insertion method can eliminate the diseases.) Thus, the first insertion expels Yang pathogens. (Initial insertion is superficial, thus expelling Yang-pathogens.) The second insertion expels Yin pathogens. (Second insertion is deeper, thus expelling Yin-pathogens.) The third insertion brings about *Guqi*. Stop needling when *Guqi* arrives. We know *Guqi* has arrived because tonification results in a solid pulse, and reduction results in a deficient pulse. (The third insertion monitors *Guqi*, which is Yuan Qi. "Stop" refers to withdrawing the needle. Generally, pathogenic Qi arrives tight and rapid, while *Guqi* arrives slow and harmonious. Only after pathogenic Qi leaves does *Guqi* arrive. Thus, after tonification, deficiency becomes solid; after reduction, solidity becomes soft. This indicates *Guqi* has arrived.) When only pathogenic Qi departs, and Yin and Yang are not yet harmonized, but the disease is known to be healing, we say: tonification leads to solidity, reduction leads to deficiency, and although pain may not cease immediately with needling, the disease will surely decline. (*Guqi* arrival indicates pathogenic departure. Although Yin-Yang meridian Qi is not instantly harmonized, the disease heals, hence the previous statement that tonification leads to solidity, reduction to deficiency, and disease decline.)
When Yin is excessive and Yang is deficient (manifested as a full Pulse at the Cun Kou), first tonify Yang, then reduce Yin to harmonize. When Yin is deficient and Yang is excessive (manifested as a full Pulse at the Ren Ying), first tonify Yin, then reduce Yang to harmonize. (Treating disease always requires prioritizing healthy Qi before treating pathogenic factors.)
Three meridians pulsate between the big toes. (These three meridians are: the Yangming Meridian from Dui to Chongyang, the Jueyin Meridian from Dadun to Taichong, and the Shaoyin Meridian from Yongquan upwards to Taixi. All three are located posterior to the big toe.) One must examine whether they are excess or deficiency. Reducing a deficiency constitutes double deficiency, worsening the disease. When needling here, press with fingers: if the pulse movement is solid and rapid, reduce rapidly; if weak and slow, tonify. Doing the opposite worsens the disease. Their pulsation locations: Yangming is superior (on the dorsum of the foot), Jueyin is medial (on the medial aspect of the dorsum), and Shaoyin is inferior (Yongquan originates at the sole of the foot).
(Note: "Tonify" here should be "Needle".) If one side is excess, needle deeply, avoid pressing the acupoint frequently, to exhaust the pathogenic Qi. (There are only two needling methods: tonification and reduction. One method, due to excess, involves deep needling without pressing the hole to expel pathogenic Qi; this is reduction.) If the other side is deficiency, needle shallowly to nourish the vessels, and press the acupoint quickly to prevent pathogenic entry. (One method, due to deficiency, involves shallow needling to nourish blood vessels and quick pressing to repel pathogens; this is tonification.) Pathogenic Qi arrives tight and rapid; *Guqi* arrives slow and harmonious. (Although this refers to needle sensation, pulse Qi arrival is similar.) For a solid pulse, needle deeply to drain Qi; for a deficient pulse, needle shallowly to prevent essence leakage, thereby nourishing the vessels and expelling only pathogenic Qi.
For needling various pain conditions: if there is swelling under the tongue, needle the tongue pillar (the tendon-like structure under the tongue) using a Bi Needle. If the hand is flexed but cannot extend, the disease is in the sinews; if extended but cannot flex, the disease is in the bones. Diseases originating in the head cause heaviness in the head; those in the hands cause arm heaviness; those in the feet cause foot heaviness. To treat disease, first needle the site of origin. Spring Qi is in the hair follicles, Summer Qi in the skin, Autumn Qi in the muscle layers, Winter Qi in the tendons and bones. (This describes how pathogens invade humans, varying in depth according to seasonal Qi.) When needling such diseases, adjust depth according to the season. Therefore, for obese individuals, use the depth appropriate for autumn/winter; for thin individuals, use the depth appropriate for spring/summer. Itching and pain belong to Yin. Pain without a fixed point upon palpation belongs to Yin and requires deep needling. Diseases in the upper body belong to Yang; diseases in the lower body belong to Yin. Itching belongs to Yang and requires shallow needling. (Pathogens on the surface emit Qi outward; flowing Qi causes itching.)
For heat jue syndrome, tonify Yin meridians twice and reduce Yang meridians once. For cold jue syndrome, tonify Yang meridians twice and reduce Yin meridians once. For chronic diseases where pathogens have penetrated deeply, needle deeply and retain for a long time, repeating every other day. First regulate the left and right Qi, puncture the collaterals to remove blood stasis, and the principles of needling are complete.
In general, observe the patient's form and Qi. If muscles are not wasted but Qi is scant and the pulse is restless, indicating restlessness and jue, employ Miao Needling to gather scattered Qi and disperse aggregated Qi. (Scant Qi with non-wasted muscles, restless pulse, and symptoms of restlessness/jue indicate internal deficiency and external meridian excess. Needling the collaterals lightly gathers scattered essence and disperses aggregated pathogens.)
Needle in a quiet place, monitor the spirit's movement, close doors and windows, keep the soul intact, focus entirely on the spirit, ignore external sounds to conserve essence, unify the spirit, and direct attention to the needle. (This emphasizes clarity and stillness, focusing attention on the needle to avoid errors in distinguishing deficiency/excess.) Needle shallowly and retain, manipulate slightly to float the needle, shifting the patient's spirit, and rest when Qi arrives. (For Qi deficiency and pathogenic heat, needling should be leisurely to shift the patient's spirit.) Men should guard the interior, women the exterior; firmly reject exit and carefully prevent entry of pathogens—this is called obtaining Qi. (After needling, caution is needed: men should avoid sexual activity, women should avoid going out. Preventing exit and preventing entry ensures pathogen expulsion and healthy Qi restoration, termed "obtaining Qi.")
Contraindications for needling: Do not needle after recent coitus; do not cohabit after needling. Do not needle when drunk; do not drink after needling. Do not needle when angry; do not get angry after needling. Do not needle when fatigued; do not exert after needling. Do not needle when full; do not eat after needling. Do not needle when hungry; do not eat after needling. Do not needle when thirsty; do not drink after needling. For those with great fright or fear, stabilize their Qi before needling. For those arriving by carriage, let them lie down and rest for the duration of a meal before needling. For those arriving on foot, let them sit and rest equivalent to walking ten li before needling. Violating these twelve prohibitions causes chaotic pulses and scattered Qi, disrupting Ying-Wei and meridian Qi order. Needling under these conditions allows Yang diseases to enter Yin and Yin diseases to emerge as Yang, regenerating pathogens. Unskilled physicians who fail to observe this harm the body. Excessive indulgence consumes brain marrow, impedes fluid transformation, and depletes the five flavors, resulting in loss of Qi.