(长刺。长于刺者也。节论犹要论也。)
刺家不诊。听病者言。在头头疾痛。为针之。刺至骨。病已止。(如言病在头而头疾痛
。则
为之针头。头痛已而后止其刺。)无伤骨肉及皮。皮者。道也。(无得妄为提按动摇。而伤骨
分肉分皮分之真气)阴刺入一傍四。处治寒热。(吴注阴刺者不摇动也。入一傍四。谓刺百会
一前后。两旁 又 各一也○阴刺疑误当是扬刺。)深专者。刺本藏(寒热之气深。而专于一
藏者求其本藏而刺之)迫藏刺背。背输也。(所为刺本藏者谓迫近其藏而刺背。背者。俞之所
在是也。)刺之迫藏。藏会。(刺俞之迫藏者。以其为藏气所会集也。)腹中寒热去而止。(以
寒
热去为期。)与刺之要。发针而浅出血(言凡与刺五脏俞者。不宜出血太多。要在发针浅而少
出其血也。)治腐肿者。刺腐上视痈小大深浅刺。刺大者多血。小者深之。必端内针为故止
。(为故。犹言为则。止。无他术之意。)病在少腹有积刺皮 以下。( 音括。骨端也。此
指章门期门穴。)至少腹而止(如足阳明之天枢归来。足太阴之府舍冲门。足少阴之气穴四满
。皆主奔豚积聚。)刺侠脊两旁四椎间(肓之原在脐下。故刺膏肓穴)刺两髂(音格) (居 穴
季胁肋间。(京门穴)导(引也)腹中气热下。已。病在少腹腹痛不得大小便。病名曰疝。得之
寒。(小腹间痛二便不行者为疝病。乃寒气之所致)刺少腹。(去肝肾。经之寒。)两股间。
(去阳明太阴之邪)刺腰髁骨间。刺而多之。尽炅病已。(凡腰中在后在侧之成片大骨皆曰髁
骨。在后者。足太阳之所行。在侧者。足少阳之所行。凡此诸病皆非寒疝但察邪之所在。多
取。其穴而刺之。俟其少腹尽热则病已矣)病在筋。筋挛节痛。不可以行。名曰筋痹。刺筋
上为故。刺分肉间。不可中骨也。筋炅病已止。病在肌肤。肌肤尽痛。名曰肌痹。伤于寒
湿。刺大分小分。(大肉之分。小肉之分。)多发针而深之。以热为故。无伤筋骨。伤筋骨。
痈发若变。(气沉而不散。则痈发而变其常)诸分尽热。病已。止。病在骨。骨重不可举骨髓
酸痛。寒气至。名曰骨痹。深者刺无伤。脉肉为故。其道大分小分。(刺入之道)骨热病已止
。
病在诸阳脉且寒且热。诸分且寒且热。名曰狂。刺之虚脉。视分尽热。病已。止(刺诸经之
脉之虚。视虚脉分间尽热则阳气流布不并于一而为狂矣。)病初发。岁一发不治。月一发不
治。月四五发。名曰癫病。刺诸分诸脉。其无寒者。以针调之。病已止。(癫仆之病。痫是
也。刺诸分诸脉者调其大小寒热迟疾陷下也)病风且寒且热。炅汗出。(寒去独热。而汗出也
。)一日数过。先刺诸分理络脉。汗出且寒且热。(既汗而复汗出者。邪盛也)三日一刺。百
日而已。病大风。骨节重。须眉堕。名曰大风。刺肌肉为故。汗出百日(泄卫中之怫热)刺骨
髓汗出百日。(泄营中之怫热)凡二百日。须眉生而止针。(怫热屏退。阴气内复。故多汗出
须眉生也。)
（“长刺”意为刺法深长，“节论”即要论。）
针刺治疗时不需诊脉，只需听取病人的陈述。如果病在头部且头痛，就用针治疗。进针要刺至骨部，病愈即止。（例如病人说头痛，就针刺头部穴位，待头痛缓解后便停止针刺。）不要损伤骨肉和皮肤。所谓“皮”，是指进针的通道。（不可随意提插摇动，以免损伤骨、肉、皮各层的真气。）
采用“阴刺”法，在一处旁开四处施治，以治疗寒热证。（吴崑注：阴刺是指不摇动针体。入一傍四，指在百会穴刺一针，其前、后、左、右各刺一针。○此处“阴刺”疑有误，应当是“扬刺”。）若病邪深聚于某脏，则针刺该本脏对应的背俞穴。（寒热之气深入并专聚于一脏者，需寻找其本脏的背俞穴进行针刺。）病邪迫近脏腑时，针刺背部腧穴。（所谓刺本脏，是指病邪迫近脏腑而针刺背部，因为背部是腧穴所在之处。）针刺迫近脏腑的腧穴，因为这些腧穴是脏腑经气汇聚之处。（针刺靠近脏腑的腧穴，是因为这里是脏腑之气汇聚的地方。）腹部中的寒热感消失即可停针。（以寒热症状消除为停止针刺的标准。）
这与针刺的要领有关，出针时应浅刺并少量出血。（意思是凡针刺五脏背俞穴时，不宜出血过多，关键在于出针时浅刺并只放出少量血液。）
治疗痈肿腐肉时，刺破腐肉部位。根据痈肿的大小和深浅决定刺法。大的多放血，小的深刺。必须端正地进针，以此为标准停止。（“为故”意为作为准则；“止”意为没有其他特殊技法，以此为准即可。）
病在少腹且有积块，针刺曲骨穴以下。（“曲骨”音括，指骨端，这里指章门、期门等穴位。）针刺至少腹部位即止。（如足阳明胃经的天枢、归来，足太阴脾经的府舍、冲门，足少阴肾经的气穴、四满，都主治奔豚积聚。）
针刺脊柱两旁第四椎间隙。（肓之原穴在脐下，所以针刺膏肓穴。）针刺两髂部。（“髂”音格，指居髎穴，位于季胁肋间，即京门穴。）引导腹中热气下行，症状缓解即止。
病在少腹，腹痛且大小便不通，病名叫做疝，由受寒引起。（小腹疼痛且二便不行称为疝病，这是寒气所致。）针刺少腹部位。（以去除肝肾经脉中的寒气为目的。）针刺两股之间。（以去除阳明、太阴经的邪气。）针刺腰髁骨间。多取穴位针刺，直到局部感到温热，病即痊愈。（凡是腰部在后或在侧的大片骨骼都叫髁骨。在后的属足太阳膀胱经所行，在侧的属足少阳胆经所行。凡此类病症都不是单纯的寒疝，只要察看病邪所在，多选取穴位针刺，等到少腹完全发热，病就好了。）
病在筋，筋脉拘挛，关节疼痛，不能行走，病名叫筋痹。针刺筋上，以此为标准。针刺分肉之间，不可刺中骨头。筋部感到温热，病即停止。（病在肌肤，全身肌肤都痛，病名叫肌痹，是伤于寒湿所致。针刺大分和小分。（大分指大肌肉之间，小分指小肌肉之间。）多下针并深刺，以局部发热为标准。不要损伤筋骨。如果损伤筋骨，会导致痈肿发生或病情变化。（气机沉滞不散，就会发生痈肿并改变常态。）各个分肉处都感到温热，病即痊愈，停止针刺。
病在骨，骨重沉重抬不起来，骨髓酸痛，寒气侵袭，病名叫骨痹。深刺但不要损伤脉络肌肉，以此为标准。进针的路径在大分和小分。（指进针的深度和位置。）骨部感到温热，病即痊愈，停止针刺。
病在诸阳脉，既怕冷又发热，各个分肉间也既怕冷又发热，病名叫狂。针刺时要泻虚脉，观察分肉间全部发热，病即痊愈，停止针刺。（针刺各经脉的虚处，观察虚脉和分肉间全部发热，则阳气流通不再偏聚于一处而发狂了。）
病初发时，一年发作一次的不治，一个月发作一次的不治。一个月发作四五次，病名叫癫病。针刺各个分肉和各条经脉。其中没有寒象的，用针调理即可，病愈停止。（癫仆的病，就是痫病。针刺各个分肉和经脉是为了调理其大小、寒热、迟疾、陷下等情况。）
患风病，既怕冷又发热，出汗发热。（寒气退去，只剩热邪，所以出汗。）一天多次发作。先针刺各个分肉的纹理和络脉。出汗后仍然又怕冷又发热。（已经出汗后又再次出汗，说明邪气盛。）每三天针刺一次，一百天即可痊愈。
患大风病，骨节沉重，眉毛胡须脱落，病名叫大风。针刺肌肉，以出汗为标准，持续一百天。（泄除卫分中的郁热。）针刺骨髓，以出汗为标准，持续一百天。（泄除营分中的郁热。）总共二百天，眉毛胡须长出，停止针刺。（郁热消退，阴气内复，所以多汗出且眉毛胡须再生。）
("Chang Ci" means deep and long needling; "Jie Lun" refers to essential discussions.)
In acupuncture treatment, pulse diagnosis is not required; one should only listen to the patient's description. If the disease is in the head accompanied by headache, needle therapy should be applied. The needle should be inserted to the bone level, and stopped when the disease resolves. (For example, if the patient reports headache, needles are inserted into head acupoints, and insertion ceases once the headache subsides.) Do not damage the bones, muscles, or skin. The term "skin" here refers to the pathway of needle insertion. (One must not randomly lift, press, or shake the needle, so as not to damage the true qi of the bone, muscle, and skin layers.)
Adopt the "Yin Ci" (Yin Needling) technique, inserting needles at one central point and four surrounding points to treat cold-heat syndromes. (Wu Kun's commentary: Yin needling implies not shaking the needle. "Insert one, surround four" refers to inserting one needle at Baihui GV20, and one each anteriorly, posteriorly, laterally left, and laterally right. ○ The term "Yin Ci" here is suspected to be an error and should likely be "Yang Ci" (Yang Needling).) If the pathogenic factor is deeply concentrated in a specific Zang organ, needle the corresponding Back-Shu point of that organ. (When cold-heat pathogens penetrate deeply and concentrate in one Zang, seek its Root Zang Back-Shu point for needling.) When the pathogen presses close to the Zang organs, needle the Back-Shu points on the back. (The phrase "needle the Root Zang" refers to needling the back where the pathogen approaches the Zang, because the back is the location of Shu points.) Needling the Shu points near the Zang organs works because these points are where the Zang Qi converges. (Needling the Shu points approaching the Zang organs is effective because they are the gathering places of Zang Qi.) Stop needling when the cold and heat sensations in the abdomen disappear. (The cessation of needling is determined by the elimination of cold and heat symptoms.)
This relates to the essentials of needling: upon withdrawing the needle, induce slight bleeding. (This means that when needling the Back-Shu points of the Five Zang organs, excessive bleeding should be avoided; the key is to withdraw the needle with shallow insertion and allow only a small amount of blood to escape.)
To treat abscesses or necrotic tissue, puncture the necrotic area. Determine the depth and extent of needling based on the size and depth of the carbuncle. For large lesions, drain more blood; for small ones, insert deeply. The needle must be inserted steadily and upright, using this as the standard for stopping. ("Wei Gu" means taking this as the criterion; "Zhi" means there are no other special techniques, simply adhering to this standard.)
If the disease is located in the lower abdomen with accumulations, needle below the Qugu CV2 point. ("Qugu" sounds like 'kuo', referring to the bony end; here it refers to acupoints such as Zhangmen LR13 and Qimen LR14.) Needle until reaching the lower abdomen, then stop. (Such as Tianshu ST25 and Guilai ST29 of the Foot-Yangming Stomach Meridian; Fushe SP16 and Chongmen SP12 of the Foot-Taiyin Spleen Meridian; Qixue KI15 and Siman KI14 of the Foot-Shaoyin Kidney Meridian, all of which govern Ben Tun [fleeing pig] and accumulations.)
Needle the interspaces between the fourth vertebrae on both sides of the spine. (The Yuan source of the Hui (Triple Burner/Pericardium area) is below the navel, hence needling Gaohuang BL43.) Needle the two Ilia regions. ("Ili" sounds like 'ge', referring to Juliao GB29, located in the intercostal space of the hypochondrium, i.e., Jingmen GB25.) Guide the hot Qi descending from the abdomen; stop when symptoms resolve.
If the disease is in the lower abdomen with pain, and urination and defecation are obstructed, the disease is named Shan (Hernia), caused by cold. (Pain in the lower abdomen with obstruction of bowel and bladder movements is called Shan disease, resulting from cold pathogen invasion.) Needle the lower abdomen. (Aiming to eliminate cold from the Liver and Kidney meridians.) Needle between the two thighs. (Aiming to eliminate pathogens from the Yangming and Taiyin meridians.) Needle between the lumbar and acetabular bones. Select multiple points and needle them abundantly. Stop when the area feels thoroughly warm, and the disease will resolve. (Any large bony structures in the posterior or lateral waist are called Huo bones. Those posterior belong to the Foot-Taiyang Bladder Meridian; those lateral belong to the Foot-Shaoyang Gallbladder Meridian. These conditions are not merely cold Hernia; observe the location of the pathogen, select multiple points, and needle them until the lower abdomen becomes completely warm, at which point the disease resolves.)
If the disease affects the tendons, causing tendon spasms and joint pain with inability to walk, it is named Jin Bi (Tendinal Bi). Needle above the tendons, using this as the standard. Insert needles into the intermuscular spaces, avoiding the bone. Stop when the tendons feel warm, and the disease resolves.
If the disease affects the skin and muscles, causing widespread pain, it is named Ji Bi (Muscular Bi), caused by injury from cold and dampness. Needle the Da Fen (Major Intermuscular Spaces) and Xiao Fen (Minor Intermuscular Spaces). (Da Fen refers to spaces between large muscles; Xiao Fen refers to spaces between small muscles.) Use multiple needles and insert deeply, using local heat as the goal. Do not damage the sinews and bones. Damaging sinews and bones may lead to the development of abscesses or pathological changes. (If Qi sinks and fails to disperse, abscesses may develop and alter the normal state.) Stop when all intermuscular spaces feel warm, and the disease resolves.
If the disease affects the bones, causing heaviness, inability to lift limbs, and soreness/aching in the bone marrow due to cold invasion, it is named Gu Bi (Osseous Bi). Insert deeply but do not damage the vessels and muscles; use this as the standard. The pathway of insertion involves the Da Fen and Xiao Fen. (Referring to the depth and location of insertion.) Stop when the bones feel warm, and the disease resolves.
If the disease affects the Yang meridians, presenting with alternating chills and fever, and the intermuscular spaces also show alternating chills and fever, it is named Kuang (Mania). Needling should tonify the deficient pulses. Observe until the intermuscular spaces are thoroughly warm, then stop, and the disease resolves. (Needle the deficiency aspects of the various meridian pulses. Observe until the deficiency pulses and intermuscular spaces are thoroughly warm, ensuring Yang Qi circulates freely and does not congregate in one place to cause mania.)
At the initial onset of disease, if it occurs once a year, do not treat. If it occurs once a month, do not treat. If it occurs four or five times a month, it is named Dian Bing (Epilepsy/Mania). Needle the various intermuscular spaces and meridians. For cases without cold signs, regulate with needles. Stop when the disease resolves. (Dian Pu [falling seizure] disease refers to Xian [epilepsy]. Needling various spaces and meridians regulates their size, cold/heat, rapid/slow, and sinking characteristics.)
Suffering from Feng (Wind) disease with alternating chills and fever, and sweating with heat. (As cold recedes, only heat remains, causing sweating.) If this happens several times a day, first needle the textures of the various intermuscular spaces and collateral vessels. If sweating recurs with alternating chills and fever. (Recurrent sweating after initial sweating indicates excess pathogen.) Needle once every three days. The disease will resolve after one hundred days.
Suffering from Da Feng (Great Wind) disease with heavy joints and loss of eyebrows and beard, it is named Da Feng. Needle the muscles until sweating occurs, continuing for one hundred days. (Draining stagnant heat from the Wei [Defensive] level.) Needle the bone marrow until sweating occurs, continuing for one hundred days. (Draining stagnant heat from the Ying [Nutritive] level.) In total, two hundred days. When eyebrows and beard regrow, stop needling. (Stagnant heat is expelled, Yin Qi returns internally, hence profuse sweating and regrowth of eyebrows and beard occur.)