也。阴井乙。乙（木）者庚（金）之柔（妇）也。乙为木。故言阴井木也。庚为金。故言阳井金也。余（荣俞经合四穴）
皆仿此。
按亦承上问。井既为诸穴之首。则其相配五行。亦当同。然今阴井为木。阳井为金。则名同而类异焉。且以井为木。
则所谓发生之意。固当其理。若以井为金。则其于为始之义。其理不通者何。答乃谓是刚柔之事。则五行十干。夫妇配
偶之义。而阳干属夫行。阴干。属妇行。表里二经。离而纵。则为相生。合而横。则为相制。实知圣人用针予夺之妙。
端在斯符焉。惜乎 近道污。而世乏其术。灵枢曰。五脏五俞。五五二十五俞。六腑六俞。六六三十六俞。阙手少阴者。
盖与厥阴同治也。与三十二篇。言肝肺乙甲。夫妇相配之义同矣。然彼直以脏腑言。此即以穴俞言。厥旨无异也。
（第六十五旧同）难曰。经言所出（始）为井。所入（终）为合。其（刺）法奈何。然。所出为井。井者东方春也。
万物之始生。故言所出为井也。所入为合。合者。北方冬也。阳气入藏。故言所入为合也。
按此篇虽以井合出入问之。其实则明五俞血气。各有浅深之量。井象谷井。而泉源所出。其血气至微。荣象水之陂。
而血气稍溜。俞象水之窦。而盈科湛澹。经象水之流。而奔波激浪。荡漾泱洋。合象水之海。而百川竞归。沸郁溟渤。
由是观之。凡刺井荣。则针贵轻浅。刺经合。则针贵重深。若夫俞者。在井合之中间。其血气无过不及之偏。则使夫冲
和之气。营运其经中。乃所谓三焦之气。而所以名原者。然本篇唯言春冬二时。阴阳升降。未曾及此者。聊示一义例耳。
(第六十六旧同)难曰。经（灵枢本输篇）言肺（经）之原（穴）出于太渊。（鱼际藏经以俞为原下仿之）心（经）之
原（穴）出于太陵。（手腕两筋间实手厥阴俞心病代主治之）肝（经）之原（穴）出于太冲。（足大指本节后）脾（经）
之原（穴）出于太白。（足大指核骨下）肾（经）之原（穴）出于太溪。（内踝后跟骨上）少阴（心经）之原（穴）出于
兑骨。（神门穴掌后锐骨端）胆（经）之原（穴）出于丘墟。（外踝前○腑经俞外有原下仿之）胃（经）之原（穴）出于
冲阳（足跗上）三焦（经）之原（穴）出于阳池。（手表腕中央）膀胱（经）之原（穴）出于京骨。（足小指本节后即京
骨下）大肠（经）之原（穴）出于合谷。（手大指食指两叉骨前）小肠（经）之原（穴）出于腕骨。（手小指腕侧起骨下）
按灵枢第一篇。并太渊太陵太白太冲太溪五俞。及鸠尾脖 。以为十二原。其第二篇连言五脏六腑。惟有十一原。
二篇俱代手少阴之原。以厥阴俞者。盖为诸邪在心。皆在心之包络。则知二经同治。故省一原耳。扁鹊乃从第二篇文。
加以少阴真心之俞。合为十二。盖灵枢第一篇。以穴数之。则为十二。以经俞数之。则五俞。其鸠尾脖 二穴。既系任
脉。以此备原穴数。亦古之一法。然非正经之原。故此难增入少阴出于兑骨一句。以明十二正经之原云。
十二经皆以俞为原者。（脏经俞为原腑经别有原是大概言之）何也。然。五脏俞（此俞字非藏经二十五俞之俞即俞原
之俞也可见以俞为原止藏经耳）者。三焦（气）之所（运）行。（原）气之所留止也。三焦所行之俞为原者。何也。（再
问）然。齐下肾间动气者。（先天真气）人之生命也。（资生之门）十二经之根本也。故名曰原。（即肾间动气）三焦者。
原气之别使也。（此一句最紧要）主通行三气。（宗营卫）经历于五脏六腑。原者三焦之尊号也。（本末一气）故所止辄为
原。五脏六腑之有病者。皆取其（十二经）原（穴）也。
此一节具言原穴为一身之至要。然十二经皆以俞为原之言。似未免后学之疑何者。六腑既已俞外有原。则未必以俞
为原。然其言如是者。盖阳经者从俞过为原。而其配五行。亦俞原俱木。则知二穴同治。虽然。六腑既已俞外有原。故
答辞独言五脏之俞。三焦之所行。而不言六腑者各别有原。夫三焦之所以尊者何。齐下肾间动气。人之性命。十二经之
根本也云云数语。一大关系。盖含蓄于肾间。则曰原气。曰动气。潜行默运于一身。则曰三焦。二气而一。一气而二者。
所谓原者。三焦之尊号也。且上焦如雾。中焦如沤。下焦如渎。故云通行三气。经历五脏六腑。所谓三气者。言宗营卫
也。由是观之。则三焦者。一身游行之气。而内从脏腑。外逮四肢百骸。无所不至焉。故曰五脏六腑之有病者。皆取十
二经诸原云。重按前篇三焦主治。取膻中齐旁齐下。此篇以手足原穴为三焦之主治。彼此各不同。一则以其气所位言。
一则以其气游行言。并行不相悖者也。肾间动气之说。详第三十篇。
（第六十七旧六十八）难曰。五脏（经）六腑（经）皆有井荣俞经合。皆何（病）所主（治）然。经（灵枢第一篇）
言所出为井。（木金）所流为荣。（火水）所注为俞。（土木）所行为经。（金火）所入为合。（水土）井（治在发生）主心
下满。（病）荣（治在散泄）主身热。（病）俞（治在和顺）主体重节痛。（病）经（治在收敛）主喘咳寒热。（病）合（治
在闭藏）主逆气而泄。（病）此五脏六腑。井荣俞经合。所主病也。
按五俞主治。岂止此数证。是举其要者。所谓井为东方木。则主阳气。开发其心下满。乃知各经邪郁。故发之。荣
为南方火。则主阳气。遍满其身热。乃知阳邪偏盛。故泄之。俞为中央土。则主无过不及。其体重节痛者。中气不和之
所致。故和之。经为西方金。则主阳气下降。其喘咳寒热者。是阳气失降。而阴气交争。故收之。合为北方水。则主阳
气闭藏。其逆气而泄者。是阳不归其根而下虚。故止之。凡诸井荣。皆属春夏。故行针之道。专主发泄。经合皆系秋冬。
则其施治。亦主收藏。俞原在其中间。共为三焦之所过。则使诸经气无过不及之差。此篇因前诸论。结以主治法。此下
诸篇。皆论针家补泻之法。
（第六十八旧七十三）难曰。诸（经）井（穴）者。肌肉浅薄。〔手足（血）指杪〕气（微）少不足使（为泻）也。
刺之奈何。然。诸（经）井（穴）者木也。荣（穴）者火也。火者木之子。（实者泻其子）当刺井（木）者。以荣（火）
泻之。故经言补者不可以为泻（法）泻者不可以为补（法）此之谓也。
按刺疟论曰。诸阴井莫出血。此篇因此以为刺井之戒。所谓诸井者。在手足指端爪甲角。其地至溢。而脉流亦涓涓
微派耳。故方其补之。则若无妨。方其为泻。固有所忌。故云气少不足使也。滑注以为不足使。为补泻。然此论专为刺
井者言之。则唯禁泻而未曾禁补。故本衣冠文物言刺井者。以荣泻之。惟示泻井。必以荣代之之法。若夫为补。岂所可忌哉。
第六十二至于此篇。并论井荣俞原经合。所以为治之义。
（第六十九旧六十七）难曰。五脏募（穴）皆在阴。（胸腹及胁）而俞（穴）在阳（背部足太阳）者。何谓也。然。
阴病行阳。（背）阳病行阴。（腹）故令募在阴。（身以前）俞在阳。（身以后）
按此因前篇井荣俞经合诸论。次及腹背募俞之义。募者结也。名阴穴。在腹者。俞者输也。名阳穴。在背者。夫经
之有募俞也。皆脏气所留止处。而俞与募又有差别。俞者属于背部。太阳经。其血气有积此输彼。募者在胸腹部。或属
本经。或属他经。血气逗留其处。内深连脏。故有病则阳病行阴。阴病行阳。率皆缘此取之。是针家从阳引阴。从阴引
阳之义也。灵枢以任脉之鸠尾脖 为膏与肓之原。则在腹部亦有原。所谓募者。盖募原之谓也。凡周身之气穴。总谓之
俞。此所谓俞者。止言背部五脏之俞耳。读者勿混同。
（第七十旧七十四）难曰。经（今经无所见）言春刺井。夏刺荣。季夏刺俞。秋刺经。冬刺合者。何谓也。然。春
刺井者。邪在肝。夏刺荣者。邪在心。季夏刺俞者。邪在脾。秋刺经者。邪在肺。冬刺合者。邪在肾。（以上五治当其时
取之）其肝心脾肺肾。而系于春夏秋冬者。何也。然。五脏一病。辄有五（邪）者。假令肝病。〔立（面）例〕色青者。
肝（病）也。（鼻）臊臭者。肝（病）也。（味）喜酸者。肝（病）也。（声）喜呼者。肝（病）也。（液）喜泣者。肝（病）
也。其病众多。（五邪相加）不可尽言也。四时（四脏）有数。（五病）而并系于春夏秋冬者也。针之要妙。在于秋毫。（旧
本有者也二字今削去）
按此承前篇。谓井荣俞经合。分为四时之治。凡五脏病当其时而发者。各视其所主之声色臭味液。从其脏之虚实。
而为之补泻也。所谓五脏。一病辄有五者。谓贼微虚实正五邪也。假令春病在肝。则尽见本脏之声色臭味液。乃知肝之
五邪也。若夫声臭味液糅至。则照鉴脉证。而顾夫贼微虚实。他邪相冒如何耳。余脏可以例推。或疑灵枢诸篇所言。冬
刺井者。与此篇异。何欤。盖审彼所言。皆谓先时资其化源之治也。如木以水为化源。火以木为化源之类。皆培其本。
而救病于未发者。扁鹊特举经之所遗阙。而论当时发病之治尔。夫五脏之病。以此察之。则虚实自明。而补泻之分。
然可知矣。故结之云。针之要妙。在秋毫者也。本篇旧出于第七十四。今详其辞。正与第六十八篇。义互相发。宜连读。
（第七十一旧七十）难曰。春夏刺浅。秋冬刺深者。何谓也。然。春夏者。阳气在（地）上。人气亦在上。（皮肤）
故当浅取之。秋冬者。阳气在（地）下。人气亦在下。（筋骨）故当深取之。（是随时为浅深）春夏各（经）致一阴（气）
秋冬各（经）致一阳（气）者。何谓也。然。春夏温（暑）必致一阴者。初下针深而（二字旧本脱今私补之）沉之。至
肾肝之部。（筋骨）得气（针下所得之气）引（伸）持之阴（营气）也。秋冬寒（凉）必致一阳（气）者。初内针浅而浮
之。至心肺之部。（皮脉）得气（针下所得之气）推内之阳（卫气）也。是谓春夏必致一阴。秋冬必致一阳。
按素问第六十四篇曰。春气在经脉。夏气在经络。长夏气在肌肉。秋气在皮肤。冬气在骨髓。又灵枢第九篇曰。春
气在毛。夏气在皮肤。秋气在分肉。冬气在筋骨。故刺肥人者。以秋冬之剂。刺瘦人者。以春夏之剂。此篇盖据是等说。
论刺有浅深之法。细味其旨。则春夏二字。微有浅深之分。若秋与冬。亦当然。乃知天时人气。升降浮沉。如合符节。
亦当知瘦人虽秋冬。犹用春夏之法。肥人虽春夏。更行秋冬之法。各随其宜。临机应变。允执厥中。是此篇之微意。不
可不察焉。后节又言春夏致阴。秋冬致阳。则似与前说左。而实不相乖。言方刺之初。先深下之。在筋骨之部。窥针下
所动之气。乃引浮之。留在浅处。而后行针久之。此所谓春夏致一阴之法。而其治专在浅处。盖春夏阳气升浮之时。故
人气亦提举。以从其道焉。其刺之初。先浅内之。在皮肤之分。针下得气。渐推下之。留在深处。而后行针灸之。此所
谓秋冬致一阳之法。而其治专在深处。盖秋冬阳气降沉之时。故人气亦重坠以从之耳。两初字勿轻看过。此盖下针初一
手法。而非谓至其经。犹且如是矣。读者察诸。
（第七十二旧七十一）难曰。经言刺荣（深取）无伤卫。（浅取）刺卫（出气）无伤荣。（出血）何谓也。然。针阳
（卫分邪气）者。卧针而刺之。刺阴（荣分邪气）者。先以左手摄按所针荣俞（诸穴）之处。（卫）气散乃内针。是谓刺
荣无伤卫。刺卫无伤荣也。
按灵枢曰。刺有三变。所谓刺荣卫。与寒痹留经是也。其言曰。刺营者出血。刺卫者出气。又素问曰。刺皮勿伤脉。
刺脉勿伤肉。刺肉勿伤筋。刺筋勿伤骨。刺骨勿伤筋。刺筋勿伤肉。刺肉勿伤脉。刺脉勿伤皮。由此文而推之。所谓无
伤者。言荣出血。卫出气也。伤者言荣出气。卫出血。盖刺荣者。有事于血。故以其左手摄按所针之俞。令卫气散而内
针。则浮气不乱。是刺荣无伤卫也。刺卫者。有事于气。故斜卧其针以行之。则无坠下之过。是刺卫无伤荣也。灵枢唯
以气血有浅深之分而言。此篇直谓行针之法。其实则彼是互相发明。
（第七十三旧七十六）难曰。何谓补泻。当补之时。何所取（致）气。当泻之时。何所置（弃）气。然。当补之时。
从卫（分）取气。当泻之时。从荣（分）置气。其阳（正）气不足。阴（邪）气有余。当先补其阳（穴）而后泻其阴（穴）
阴（正）气不足。阳（邪）气有余。当先补其阴（穴）而后泻其阳（穴）荣（血）卫（气）通行。此其要也。
按此篇专为补泻荣气。行于脉中者言之。凡补泻之法。前后诸篇所述。其义不一。各殊其归。集成以得之。则鼎湖
之蕴奥。渤海之要妙。当如得诸心。而运诸掌焉。所谓从卫取气者。浅留其针。得气因推下之。使其浮散之气。收入脉
中。是补之也。从荣置气者。深而留之。得气因引持之。使脉中之气。散置卫外。是泻之也。即与前篇所言。春夏致一
也。阴井穴对应天干乙，乙（属木）是庚（属金）的柔和之配（比喻为妻子）。乙五行属木，所以说阴经的井穴属木。庚五行属金，所以说阳经的井穴属金。其余的荣穴、俞穴、经穴、合穴这四个穴位也都依照这个规律类推。
按语：这也承接上面的问题。既然井穴是五腧穴之首，那么它们相配的五行属性也应该相同。然而现在阴经的井穴属木，阳经的井穴属金，这就导致名称相同而类别不同。况且以井穴属木来说，所谓万物发生的意思，确实符合道理；如果以井穴属金来说，那对于“开始”这一含义，其道理就不通了。回答说是刚柔的关系，也就是五行十天干夫妇配对的意义，阳干属于丈夫的行位，阴干属于妻子的行位。表里两经，分开纵向看，则是相生关系；合并横向看，则是相制关系。真正了解圣人用针补泻精妙之处的人，应当从这里去印证。可惜近世之道被污损，世间缺乏这种医术。《灵枢》说：五脏各有五个腧穴，五五共二十五个腧穴；六腑各有六个腧穴，六六共三十六个腧穴。唯独缺少手少阴心经的原穴，大概是因为它与手厥阴心包经共同治疗。这与第三十二篇所说的肝肺乙甲夫妇相配的意义是一样的。然而那篇文章直接谈论脏腑，这篇文章则从腧穴角度谈论，其主旨没有差异。（第六十五篇旧本相同）
问：经文说所出（起始）为井，所入（终止）为合，它们的刺法是怎样的？答：所出为井，井象征东方春季，是万物开始生长的地方，所以说所出为井。所入为合，合象征北方冬季，阳气潜入脏腑，所以说所入为合。
按语：这篇虽然通过井穴和合穴的出入来提问，其实是为了阐明五腧穴的血气，各有深浅的程度。井穴像山谷中的水井，泉水源头流出，那里的血气非常微弱；荣穴像水池，血气稍微流动；俞穴像水流的孔洞，水流充盈荡漾；经穴像水流，波涛汹涌，浩荡广阔；合穴像大海，百川竞相汇入，沸腾深邃。由此看来，凡是针刺井穴、荣穴，针法贵在轻浅；针刺经穴、合穴，针法贵在重深。至于俞穴，位于井穴和合穴的中间，其血气没有过与不及的偏颇，使得冲和之气在经脉中营运，这就是所谓的三焦之气，也是原穴命名的由来。然而本篇只提到了春冬两个季节的阴阳升降，未曾涉及这一点，只是略微展示一个义例罢了。（第六十六篇旧本相同）
问：《灵枢·本输》篇说肺经的原穴出于太渊穴（鱼际穴后方经脉中，以俞代原，以下仿照此例）；心经的原穴出于太陵穴（手腕两筋之间，实为手厥阴心包经的俞穴，心病由心包代主治）；肝经的原穴出于太冲穴（足大趾本节之后）；脾经的原穴出于太白穴（足大趾核骨下方）；肾经的原穴出于太溪穴（内踝后方跟骨上方）；少阴心经的原穴出于兑骨穴（神门穴，掌后锐骨端）；胆经的原穴出于丘墟穴（外踝前方○腑经在俞穴之外另有原穴，以下仿照此例）；胃经的原穴出于冲阳穴（足背上方）；三焦经的原穴出于阳池穴（手表腕中央）；膀胱经的原穴出于京骨穴（足小趾本节之后即京骨下方）；大肠经的原穴出于合谷穴（手大指食指两叉骨前）；小肠经的原穴出于腕骨穴（手小指腕侧起骨下方）。
按语：《灵枢》第一篇，将太渊、太陵、太白、太冲、太溪这五个腧穴，加上鸠尾穴、脖胦穴，合称为十二原。其第二篇连言五脏六腑，只有十一个原穴。两篇都用手厥阴心包经的俞穴代替手少阴心经的原穴，大概是因为各种邪气侵犯心脏，都是在心包络上体现，所以知道这两经共同治疗，因此省略了一个原穴。扁鹊于是依据第二篇的文字，加上少阴真心经的俞穴，合为十二个。大概《灵枢》第一篇是按穴位数量计算，则为十二个；按经脉腧穴数量计算，则是五个腧穴。那鸠尾、脖胦两个穴位，既属于任脉，用来凑足原穴的数量，也是古人的方法之一，但这并非正经的原穴。所以这篇《难经》增加了少阴心经原穴出于兑骨一句，以明确十二正经的原穴。
为什么说十二经脉都以俞穴作为原穴呢？（脏经以俞为原，腑经别有原穴，这是大概而言）为什么呢？答：五脏的俞穴（这里的“俞”字不是藏经二十五腧穴的“俞”，而是指俞原之“俞”，可见以俞为原仅止于脏经），是三焦之气所运行的，也是原气停留的地方。为什么三焦运行的俞穴被称为原穴呢？（再次提问）答：脐下肾间的动气，是先天真气，是人的生命根本，是十二经脉的根本，所以名叫原（即肾间动气）。三焦，是原气的别使（这一句最关键），主要通行三气（宗气、营气、卫气），经历于五脏六腑。原，是三焦的尊号（本末一气）。所以原气停留的地方就称为原。五脏六腑有病的，都取用十二经的原穴。
这一段详细说明了原穴是一身的关键所在。然而“十二经皆以俞为原”的说法，似乎难免让后学者产生疑惑。为什么呢？六腑既然在俞穴之外另有原穴，那么未必是以俞为原。但之所以这样说，大概是因为阳经从俞穴经过到达原穴，而且它们配合五行，俞穴和原穴都属木，所以知道这两个穴位共同治疗。虽然如此，六腑既然在俞穴之外另有原穴，所以回答辞中只谈论五脏的俞穴和三焦的运行，而没有谈论六腑各自有别的原因。三焦之所以尊贵，是因为脐下肾间动气，是人的性命，十二经脉的根本等话语，这是一个重大的关系。大概含蓄于肾间，叫做原气、动气；潜行默运于一身，叫做三焦。二气合一，一气分二，所谓的“原”，就是三焦的尊号。况且上焦如雾，中焦如沤，下焦如渎，所以说通行三气，经历五脏六腑。所谓的三气，指的是宗气、营气、卫气。由此看来，三焦是一身游走的气，内至脏腑，外达四肢百骸，无所不到。所以说五脏六腑有病的，都取用十二经的各原穴。重读前篇关于三焦主治的内容，取膻中、脐旁、脐下；本篇以手足原穴为三焦的主治，彼此各不相同。前者是从气所在的位置而言，后者是从气游行的角度而言，并行不悖。肾间动气的说法，详见第三十篇。（第六十七篇旧本为第六十八篇）
问：五脏经、六腑经都有井、荣、俞、经、合五腧穴，它们分别主治什么病呢？答：《灵枢·本输》篇说所出为井（阴经属木，阳经属金），所流为荣（阴经属火，阳经属水），所注为俞（阴经属土，阳经属木），所行为经（阴经属金，阳经属火），所入为合（阴经属水，阳经属土）。井穴（主治在发生）主心下满（病症）；荣穴（主治在散泄）主身热（病症）；俞穴（主治在和顺）主体重节痛（病症）；经穴（主治在收敛）主喘咳寒热（病症）；合穴（主治在闭藏）主逆气而泄（病症）。这就是五脏六腑井、荣、俞、经、合五腧穴所主治的病症。
按语：五腧穴的主治，难道只有这些证候吗？这是列举其主要者。所谓井穴属东方木，则主阳气开发，其心下满的病，可知是各经邪气郁结，所以用发汗法解除；荣穴属南方火，则主阳气遍满，其身热的病，可知是阳邪偏盛，所以用泄法清除；俞穴属中央土，则主无过不及，其体重节痛的病，是中气不和所致，所以用和法调和；经穴属西方金，则主阳气下降，其喘咳寒热的病，是阳气失降，阴气交争，所以用收法收敛；合穴属北方水，则主阳气闭藏，其逆气而泄的病，是阳不归根而下虚，所以用止法治愈。凡诸井穴、荣穴，都属春夏季节，所以行针之道，专门主发泄；经穴、合穴都系秋冬季节，那么施治也主收藏。俞穴、原穴在中间，共为三焦所经过，使得诸经之气没有过与不及的偏差。本篇因前面的诸论，总结主治法则，接下来的篇章，都论述针灸家的补泻之法。（第六十八篇旧本为第七十三篇）
问：诸经的井穴，肌肉浅薄，手足指尖末端，气微少，不足以进行泻法操作，该怎么刺呢？答：诸经的井穴属木，荣穴属火，火是木的子行（实证泻其子）。所以当刺井穴（木）时，用荣穴（火）来泻它。所以经文说补法不可以当作泻法，泻法不可以当作补法，说的就是这个意思。
按语：《刺疟论》说：诸阴经的井穴不要出血。本篇因此将其作为刺井穴的戒律。所谓诸井穴，在手足指端爪甲角处，那里的地界极窄，脉流也是涓涓细微。所以在补的时候，如果没有妨碍还可以；如果是泻法，固然有所忌讳，所以说气少不足以进行泻法操作。滑寿注解说“不足使”是指不适合做补泻。然而这篇论述专为刺井穴而言，那么只是禁止泻法而未曾禁止补法。所以本文主张刺井穴时，用荣穴来替代泻法，只是展示泻井穴必须用荣穴替代的方法。如果是补法，又有什么可忌讳的呢？第六十二篇至此，并论井、荣、俞、原、经、合，所以为治疗的义理。（第六十九篇旧本为第六十七篇）
问：五脏的募穴都在阴面（胸腹及胁部），而俞穴在阳面（背部足太阳膀胱经），这是什么意思呢？答：阴病行于阳（背部），阳病行于阴（腹部），所以令募穴在阴面（身体前面），俞穴在阳面（身体后面）。
按语：这是因为承接前篇关于井、荣、俞、经、合诸论，接着谈及腹背募俞的意义。募，意思是结聚，名为阴穴，位于腹部；俞，意思是输注，名为阳穴，位于背部。经脉中有募穴和俞穴，都是脏气停留的地方，而俞穴与募穴又有区别。俞穴属于背部足太阳膀胱经，那里的血气有积聚于此输注于彼的特点；募穴在胸腹部，或属于本经，或属于他经，血气逗留在那里，内深连接脏腑。所以有病时，阳病会反映到阴面，阴病会反映到阳面，通常都据此来选取穴位。这是针灸家“从阳引阴，从阴引阳”的意义。《灵枢》以任脉的鸠尾穴、脖胦穴作为膏肓的原，那么在腹部也有原穴，所谓的募穴，大概就是募原的意思。凡周身的气穴，总称为俞。这里所说的俞，只指背部五脏的俞穴。读者不要混淆。（第七十篇旧本为第七十四篇）
问：经文说春刺井，夏刺荣，季夏刺俞，秋刺经，冬刺合，这是什么意思呢？答：春刺井，是因为邪在肝；夏刺荣，是因为邪在心；季夏刺俞，是因为邪在脾；秋刺经，是因为邪在肺；冬刺合，是因为邪在肾。（以上五种治疗方法是在相应时节取穴）肝心脾肺肾，分别与春夏秋冬相联系，为什么呢？答：五脏每发生一种病，往往会有五种邪气侵袭。例如肝病，面色青的是肝病；闻到臊臭气味的是肝病；喜欢吃酸味的是肝病；喜欢呼喊的是肝病；喜欢流泪的是肝病。其病症众多（五邪相加），无法尽述。四时（对应四脏）有定数（五种病），并且都与春夏秋冬相联系。针刺的要妙，在于秋毫般细微之处。（旧本有“者也”二字，今删去）
按语：这是承接前篇，说井、荣、俞、经、合分为四时的治疗。凡五脏病在相应时节发作的，各自观察其所主的声、色、臭、味、液，根据其脏腑的虚实，进行补泻。所谓“五脏一病辄有五”，指的是贼邪、微邪、虚邪、实邪、正邪这五种邪气。例如春病在肝，如果见到本脏所有的声、色、臭、味、液，就知道是肝的五种邪气。如果声、臭、味、液混杂出现，就要对照脉证，顾及其中的贼、微、虚、实及其他邪气相互冒犯的情况。其他脏腑可以以此类推。有人怀疑《灵枢》诸篇所说“冬刺井”，与此篇不同，为什么呢？大概审察《灵枢》所言，都是谓先时资助其化源的治疗方法。如木以水为化源，火以木为化源之类，都是培补根本，而在疾病未发之前救治。扁鹊特意列举经文所遗漏缺失的部分，论述当时发病的治疗。通过这种方式考察五脏之病，那么虚实自然明了，补泻的区别也就知道了。所以总结说：针刺的要妙，在于秋毫般细微之处。本篇旧本出自第七十四篇，现在详察其文辞，正与第六十八篇意义互相发挥，宜连读。（第七十一篇旧本为第七十篇）
问：春夏刺浅，秋冬刺深，这是什么意思呢？答：春夏时节，阳气在地之上，人气也在上（皮肤表层），所以应当浅取；秋冬时节，阳气在地之下，人气也在下（筋骨深层），所以应当深取（这是随季节变化决定深浅）。春夏各经如何致一阴气，秋冬各经如何致一阳气，这是什么意思呢？答：春夏温热，必须致一阴气的方法是：初下针时深刺，沉取，到达肝肾部位（筋骨），得气（针下所得之气）后，引伸持守阴气（营气）。秋冬寒冷，必须致一阳气的方法是：初进针时浅刺，浮取，到达心肺部位（皮脉），得气（针下所得之气）后，推内阳气（卫气）。这就叫春夏必致一阴，秋冬必致一阳。
按语：《素问》第六十四篇说：春气在经脉，夏气在经络，长夏气在肌肉，秋气在皮肤，冬气在骨髓。又《灵枢》第九篇说：春气在毛，夏气在皮肤，秋气在分肉，冬气在筋骨。所以刺肥人，用秋冬的剂量（深度）；刺瘦人，用春夏的剂量（深度）。本篇大概是依据这些说法，论述针刺有深浅的方法。细细品味其旨意，那么“春夏”二字，略有深浅之分，若秋与冬，也当然如此。才知道天时与人气的升降浮沉，如同符节相合。但也应当知道瘦人虽在秋冬，仍用春夏的方法；肥人虽在春夏，更行秋冬的方法。各随其适宜，临机应变，执中守正，这是本篇的微意，不可不察。后节又言春夏致阴，秋冬致阳，则似乎与前说矛盾，而实际并不违背。意思是方刺之初，先深下针，在筋骨部位，窥视针下所动之气，乃引浮之，留在浅处，而后行针久之。这叫春夏致一阴之法，而其治疗专在浅处。盖春夏阳气升浮之时，故人气也提举，以顺从其道。其刺之初，先浅内针，在皮肤之分，针下得气，渐推下之，留在深处，而后行针灸之。这叫秋冬致一阳之法，而其治疗专在深处。盖秋冬阳气降沉之时，故人气也重坠以顺从之。两个“初”字勿轻易看过，这大概是下针初一手法，而非谓到了其经，还依然如此。读者请察知。（第七十二篇旧本为第七十一篇）
问：经文说刺荣（深取）无伤卫（浅取），刺卫（出气）无伤荣（出血），这是什么意思呢？答：针阳（卫分邪气）者，卧针而刺之；刺阴（荣分邪气）者，先以左手摄按所针荣俞（诸穴）之处，使卫气散开乃内针，这叫刺荣无伤卫，刺卫无伤荣。
按语：《灵枢》说：刺有三变，所谓刺荣卫，与寒痹留经是也。其言曰：刺营者出血，刺卫者出气。又《素问》说：刺皮勿伤脉，刺脉勿伤肉，刺肉勿伤筋，刺筋勿伤骨，刺骨勿伤筋，刺筋勿伤肉，刺肉勿伤脉，刺脉勿伤皮。由此文推之，所谓“无伤者”，是说荣出血，卫出气。“伤者”是说荣出气，卫出血。大概刺荣者，有事于血，所以用左手摄按所针之俞，令卫气散而内针，则浮气不乱，是刺荣无伤卫。刺卫者，有事于气，所以斜卧其针以行之，则无坠下之过，是刺卫无伤荣。《灵枢》唯以气血有浅深之分而言，本篇直谓行针之法，其实则是互相发明。（第七十三篇旧本为第七十六篇）
问：什么叫补泻？当补的时候，取什么气？当泻的时候，弃什么气？答：当补的时候，从卫分取气；当泻的时候，从荣分置气。正气不足，邪气有余，应当先补其阳（穴）而后泻其阴（穴）；邪气不足，正气有余，应当先补其阴（穴）而后泻其阳（穴）。荣卫通行，这是关键。
按语：此篇专为补泻荣气，行于脉中者而言。凡补泻之法，前后诸篇所述，其义不一，各殊其归。集成以得之，则鼎湖之蕴奥，渤海之要妙，当如得诸心，而运诸掌焉。所谓从卫取气者，浅留其针，得气因推下之，使其浮散之气，收入脉中，是补之也。从荣置气者，深而留之，得气因引持之，使脉中之气，散置卫外，是泻之也。即与前篇所言，春夏致一阴……
... The Yin Jing (Well) point corresponds to the Heavenly Stem Yi. Yi (Wood) is the soft counterpart of Geng (Metal), metaphorically representing the wife. Since Yi belongs to Wood, it is said that the Yin Jing points belong to Wood. Since Geng belongs to Metal, it is said that the Yang Jing points belong to Metal. The remaining four categories of points—Ying (Stream), Shu (Spring), Jing (River), and He (Sea)—follow this same principle for deduction.
Commentary: This also follows up on the previous question. Since the Jing (Well) point is the first of the Five Shu points, their corresponding Five Elements should theoretically be identical. However, currently, the Yin Jing point belongs to Wood, while the Yang Jing point belongs to Metal; thus, they share the same name but differ in category. Furthermore, regarding the Jing point as Wood, the meaning of "beginning and generation" indeed aligns with reason. But if the Jing point were considered Metal, its logic regarding the concept of "beginning" would be inconsistent. The answer attributes this to the relationship of rigidity and softness, which reflects the marital pairing meaning of the Five Elements and Ten Heavenly Stems: Yang stems belong to the husband's position, and Yin stems belong to the wife's position. When examining exterior-interior paired meridians longitudinally, they exhibit a generating relationship; when viewed horizontally, they exhibit a controlling relationship. Those who truly understand the subtlety of acupuncture tonification and sedation by the sages should verify this here. Alas, the true Dao has been tarnished in recent times, and this medical art is scarce in the world. *Ling Shu* states: Each of the Zang organs has five Shu points, totaling twenty-five (5x5); each of the Fu organs has six Shu points, totaling thirty-six (6x6). The only omission is the Yuan (Source) point of the Hand-Shaoyin Heart Meridian, likely because it shares treatment functions with the Hand-Jueyin Pericardium Meridian. This aligns with the meaning discussed in Chapter 32 regarding the marital pairing of Liver-Lung and Jia-Yi stems. However, that chapter discusses Zang-Fu directly, whereas this chapter discusses from the perspective of Shu points; their core principles are identical. (Chapter 65, Old Edition Same)
Question: The Classics state that what emerges (starts) is the Jing (Well), and what enters (ends) is the He (Sea). What is their needling method? Answer: What emerges is the Jing. Jing symbolizes the East and Spring, the time when all things begin to grow; hence, it is called "what emerges is Jing." What enters is the He. He symbolizes the North and Winter, when Yang Qi enters the Zang organs; hence, it is called "what enters is He."
Commentary: Although this chapter asks about the emergence and entry of Jing and He points, its true purpose is to clarify that the Blood and Qi of the Five Shu points have varying degrees of depth. The Jing point resembles a well in a valley, where the spring water originates; the Blood and Qi there are extremely minute. The Ying (Stream) point resembles a pond, where Blood and Qi flow slightly. The Shu (Spring) point resembles a water conduit, where water fills and ripples. The Jing (River) point resembles a flowing stream, with surging waves and vast expanses. The He (Sea) point resembles the ocean, where hundreds of rivers converge, boiling and deep. From this perspective, whenever needling Jing or Ying points, the technique should be light and shallow; when needling Jing (River) or He points, the technique should be heavy and deep. As for the Shu (Spring) point, located between Jing and He, its Blood and Qi are neither excessive nor deficient, allowing the harmonious Qi to circulate within the meridian. This is referred to as the San Jiao (Triple Burner) Qi, which is why these points are named Yuan (Source). However, this chapter only mentions the Yin-Yang ascent and descent of Spring and Winter, omitting this detail, merely to illustrate a principle. (Chapter 66, Old Edition Same)
Question: The *Ling Shu: Ben Shu* chapter states that the Yuan (Source) point of the Lung Meridian is at Taiyuan (Yuji posterior, using Shu as Yuan, following below); the Yuan point of the Heart Meridian is at Taoling (between two tendons at the wrist, actually the Shu point of Hand-Jueyin Pericardium, treating Heart disease by proxy); the Yuan point of the Liver Meridian is at Taichong (behind the base of the big toe); the Yuan point of the Spleen Meridian is at Taibai (below the medial cuneiform bone of the big toe); the Yuan point of the Kidney Meridian is at Taixi (posterior to the medial malleolus, above the calcaneus); the Yuan point of the Shaoyin (Heart) Meridian is at Duigu (Shenmen, at the end of the sharp bone behind the palm); the Yuan point of the Gallbladder Meridian is at Qiuxu (anterior to the lateral malleolus ○ Fu meridians have Yuan points outside the Shu points, following below); the Yuan point of the Stomach Meridian is at Chongyang (dorsum of the foot); the Yuan point of the San Jiao Meridian is at Yangchi (center of the dorsal wrist); the Yuan point of the Bladder Meridian is at Jinggu (behind the base of the little toe, i.e., below Jinggu); the Yuan point of the Large Intestine Meridian is at Hegu (anterior to the bifurcation of the thumb and index finger); the Yuan point of the Small Intestine Meridian is at Wangu (below the starting bone on the ulnar side of the hand).
Commentary: *Ling Shu* Chapter 1 lists Taiyuan, Taoling, Taibai, Taichong, and Taixi, along with Jiwei and Boyang, as the Twelve Yuan points. Chapter 2 mentions eleven Yuan points for the Five Zang and Six Fu organs. Both chapters use the Shu point of Hand-Jueyin Pericardium to substitute for the Yuan point of Hand-Shaoyin Heart. This is likely because pathogenic factors affecting the Heart manifest in the Pericardium, indicating that these two meridians share treatment functions, hence one Yuan point is omitted. Bian Que, relying on Chapter 2, added the Shu point of the True Heart (Shaoyin) to make twelve. *Ling Shu* Chapter 1 counts twelve based on the number of points; counting by meridian Shu points, there are five. The Jiwei and Boyang points belong to the Ren Mai (Conception Vessel) and are used to complete the count of Yuan points, an ancient method, though not the standard Yuan points of the regular meridians. Therefore, this *Nan Jing* adds "the Yuan point of Shaoyin emerges at Duigu" to clarify the Yuan points of the Twelve Regular Meridians.
Why do all Twelve Meridians use the Shu point as the Yuan point? (For Zang meridians, Shu serves as Yuan; for Fu meridians, there are separate Yuan points; this is a general statement.) Why? Answer: The Shu points of the Five Zang organs (here "Shu" refers to the Yuan-Shu connection, not the twenty-five Shu points of the Zang classics; thus, using Shu as Yuan applies only to Zang meridians) are where the Qi of the San Jiao (Triple Burner) travels and where the Yuan Qi remains. Why are the Shu points traveled by the San Jiao called Yuan? (Re-question) Answer: The moving Qi in the space between the kidneys below the umbilicus is the innate True Qi, the root of human life, and the foundation of the Twelve Meridians; hence it is called Yuan (i.e., Kidney Moving Qi). The San Jiao is the special envoy of the Yuan Qi (this sentence is crucial), primarily facilitating the circulation of Three Qi (Zong, Ying, Wei Qi), passing through the Five Zang and Six Fu organs. Yuan is the honorific title of the San Jiao (Root and branch are one Qi). Thus, wherever it stops, it is called Yuan. For diseases of the Five Zang and Six Fu, one selects the Yuan points of the Twelve Meridians.
This section fully explains that Yuan points are vital to the whole body. However, the statement "all Twelve Meridians use Shu as Yuan" may cause doubt among later students. Why? Since Fu organs have Yuan points distinct from their Shu points, they certainly do not simply use Shu as Yuan. The reason for such phrasing is likely that Yang meridians pass from Shu to Yuan, and in their Five Element correspondence, both Shu and Yuan belong to Wood, implying they share treatment functions. Nevertheless, since Fu organs have separate Yuan points, the answer only discusses the Shu points of Zang organs and the movement of San Jiao, omitting Fu organs' separate origins. Why is San Jiao honored? Because the Kidney Moving Qi below the umbilicus is human life and the foundation of the Twelve Meridians, etc. This is a major relationship. Contained within the Kidney space, it is called Yuan Qi or Moving Qi; circulating silently throughout the body, it is called San Jiao. Two Qi becoming one, one Qi becoming two: the so-called "Yuan" is the honorific title of San Jiao. Moreover, the Upper Jiao is like mist, the Middle Jiao like fermentation, and the Lower Jiao like a ditch; thus, it is said to circulate Three Qi and pass through Five Zang and Six Fu. The "Three Qi" refers to Zong, Ying, and Wei Qi. From this, we see that San Jiao is the wandering Qi of the body, reaching internally to Zang-Fu and externally to limbs and bones. Hence, for diseases of Five Zang and Six Fu, one takes the Yuan points of the Twelve Meridians. Re-reading the previous chapter on San Jiao treatment, points like Danzhong, beside the navel, and below the navel are used; this chapter uses hand and foot Yuan points for San Jiao treatment. They differ: one refers to the location of Qi, the other to the movement of Qi. They run parallel without contradiction. The theory of Kidney Moving Qi is detailed in Chapter 30. (Chapter 67, Old Edition 68)
Question: The Five Zang and Six Fu meridians all have Jing, Ying, Shu, Jing, and He points. What diseases do they treat? Answer: The *Ling Shu* states: What emerges is Jing (Wood for Yin, Metal for Yang); what flows is Ying (Fire for Yin, Water for Yang); what pours is Shu (Earth for Yin, Wood for Yang); what moves is Jing (Metal for Yin, Fire for Yang); what enters is He (Water for Yin, Earth for Yang). Jing (treatment focuses on generation) treats fullness below the heart; Ying (treatment focuses on dispersal) treats body heat; Shu (treatment focuses on harmony) treats heaviness of the body and joint pain; Jing (treatment focuses on gathering) treats wheezing, cough, cold, and fever; He (treatment focuses on closure) treats rebellious Qi and diarrhea. These are the diseases treated by the Jing, Ying, Shu, Jing, and He points of the Five Zang and Six Fu.
Commentary: Do the treatments of the Five Shu points cover only these symptoms? These are cited as the main ones. Jing belongs to East Wood, governing the opening of Yang Qi; fullness below the heart indicates stagnation of pathogens in various meridians, so it is treated by releasing. Ying belongs to South Fire, governing the spread of Yang Qi; body heat indicates excess Yang pathogens, so it is treated by draining. Shu belongs to Central Earth, governing balance; heaviness and joint pain result from disharmony of Middle Qi, so it is treated by harmonizing. Jing belongs to West Metal, governing the descent of Yang Qi; wheezing, cough, and chills/fever indicate failure of Yang descent and struggle with Yin Qi, so it is treated by gathering. He belongs to North Water, governing the storage of Yang Qi; rebellious Qi and diarrhea indicate Yang failing to root and lower deficiency, so it is treated by stopping. All Jing and Ying points relate to Spring and Summer, so needling focuses on release; Jing and He points relate to Autumn and Winter, so treatment focuses on storage. Shu and Yuan points lie in between, traversed by San Jiao, ensuring no excess or deficiency in meridian Qi. This chapter concludes the treatment methods based on previous discussions; subsequent chapters discuss tonification and sedation techniques. (Chapter 68, Old Edition 73)
Question: The Jing points of all meridians are in areas of thin muscle, at the tips of fingers and toes, where Qi is scant and insufficient for sedation. How should they be needled? Answer: The Jing points of all meridians belong to Wood; Ying points belong to Fire. Fire is the son of Wood (Excess conditions drain the son). Therefore, when needling a Jing point (Wood), one should use the Ying point (Fire) to drain it. Thus, the Classics say tonification cannot be used as sedation, and sedation cannot be used as tonification; this is what is meant.
Commentary: *Ci Nue Lun* states: Do not bleed the Jing points of Yin meridians. This chapter takes this as a warning for needling Jing points. The Jing points are located at the corners of the nails on the finger and toe tips, where the area is very narrow and the pulse flow is minute. Therefore, tonification is acceptable, but sedation is taboo, hence "Qi is scant and insufficient for operation." Hua Tuo's commentary suggests "insufficient" refers to unsuitability for tonification/sedation generally. However, this discussion specifically addresses needling Jing points, prohibiting only sedation, not tonification. Thus, the text advocates substituting the Ying point for draining the Jing point, showing the method of replacing Jing drainage with Ying. If tonifying, what is there to fear? Chapters 62 to this one discuss the therapeutic significance of Jing, Ying, Shu, Yuan, Jing, and He points. (Chapter 69, Old Edition 67)
Question: The Mu (Alarm) points of the Five Zang are all on the Yin side (chest, abdomen, flanks), while the Shu (Back-Shu) points are on the Yang side (back, Bladder Meridian). What does this mean? Answer: Yin diseases manifest on the Yang (back); Yang diseases manifest on the Yin (abdomen). Therefore, Mu points are on the Yin (front), and Shu points are on the Yang (back).
Commentary: This follows the previous discussion on Jing, Ying, Shu, Jing, He points, introducing the meaning of abdominal and back Mu-Shu points. Mu means accumulation/nodal, named Yin points, located on the abdomen; Shu means transport, named Yang points, located on the back. The meridians have Mu and Shu points, which are places where Zang Qi accumulates. There is a difference between Shu and Mu. Shu points belong to the Back Bladder Meridian, where Blood and Qi accumulate and transport; Mu points are on the chest and abdomen, belonging to either the same or other meridians, where Blood and Qi linger, deeply connecting to internal Zang organs. Thus, when diseased, Yang diseases travel to Yin, and Yin diseases travel to Yang, and points are selected accordingly. This is the principle of "drawing Yin from Yang, drawing Yang from Yin" in acupuncture. *Ling Shu* identifies Jiwei and Boyang of the Ren Mai as the origin of Gao and Huang, meaning there are Yuan points in the abdomen; the so-called Mu points refer to Mu-Yuan. All Qi points in the body are collectively called Shu. Here, "Shu" refers only to the Back Shu points of the Five Zang. Readers must not confuse them. (Chapter 70, Old Edition 74)
Question: The Classics say: Spring needs Jing, Summer needs Ying, Late Summer needs Shu, Autumn needs Jing, Winter needs He. What does this mean? Answer: Spring needs Jing because the pathogen is in the Liver; Summer needs Ying because the pathogen is in the Heart; Late Summer needs Shu because the pathogen is in the Spleen; Autumn needs Jing because the pathogen is in the Lungs; Winter needs He because the pathogen is in the Kidneys. (The above five treatments involve taking points according to the season.) Why are Liver, Heart, Spleen, Lung, and Kidney associated with Spring, Summer, Late Summer, Autumn, and Winter? Answer: When any of the Five Zang organs becomes diseased, five types of pathogens often attack. For example, in Liver disease: green complexion indicates Liver disease; smell of musk indicates Liver disease; craving for sour taste indicates Liver disease; tendency to shout indicates Liver disease; tendency to cry indicates Liver disease. The diseases are numerous (five pathogens combining), impossible to list completely. The Four Seasons (Four Zang) have fixed numbers (five diseases) and are linked to Spring, Summer, Autumn, and Winter. The essence of needling lies in the minuteness of autumn hair. (Old edition had "Ye Zhe", now deleted).
Commentary: This continues the previous chapter, stating that Jing, Ying, Shu, Jing, He correspond to seasonal treatments. For Five Zang diseases occurring in their respective seasons, observe the associated sound, color, odor, taste, and fluid, and apply tonification or sedation based on the organ's deficiency or excess. "One disease in Five Zang implies five pathogens" refers to the five types:賊 (Thief), 微 (Minor), 虚 (Deficiency), 实 (Excess), and 正 (Correct). For instance, if Spring disease affects the Liver, observing all sounds, colors, odors, tastes, and fluids of the Liver reveals the five pathogens of the Liver. If these mix, one must examine pulse and symptoms to distinguish thief, minor, deficiency, excess, and other interfering pathogens. Other organs can be deduced similarly. Some doubt that *Ling Shu* says "Winter needs Jing," differing from this chapter. Examining *Ling Shu*, those statements refer to preemptive treatment to nourish the source of transformation before disease onset (e.g., Wood uses Water as source, Fire uses Wood as source), cultivating the root to prevent illness. Bian Que specifically cites omissions in the Classics to discuss treatment for concurrent onset diseases. By examining Five Zang diseases this way, deficiency and excess become clear, and the distinction between tonification and sedation is known. Hence, it concludes: The essence of needling lies in the minuteness of autumn hair. This chapter was formerly Chapter 74; upon detailed examination, its meaning complements Chapter 68, so they should be read together. (Chapter 71, Old Edition 70)
Question: Spring and Summer require shallow needling; Autumn and Winter require deep needling. What does this mean? Answer: In Spring and Summer, Yang Qi is above ground, and human Qi is also above (skin), so one should needle shallowly. In Autumn and Winter, Yang Qi is below ground, and human Qi is also below (sinews and bones), so one should needle deeply (varying depth according to season). How should one "bring forth one Yin Qi" in each meridian during Spring and Summer, and "bring forth one Yang Qi" during Autumn and Winter? Answer: In warm/hot Spring and Summer, to bring forth one Yin Qi: initially insert the needle deeply and sink it to the Liver-Kidney region (sinews/bones), obtain Deqi (Qi felt under the needle), then draw and hold the Yin Qi (Ying Qi). In cold Autumn and Winter, to bring forth one Yang Qi: initially insert the needle shallowly and float it to the Heart-Lung region (skin/vessels), obtain Deqi, then push inward the Yang Qi (Wei Qi). This is called bringing forth one Yin in Spring/Summer and one Yang in Autumn/Winter.
Commentary: *Su Wen* Chapter 64 states: Spring Qi is in the Channels, Summer Qi in the Collaterals, Long Summer Qi in the Muscles, Autumn Qi in the Skin, Winter Qi in the Marrow. *Ling Shu* Chapter 9 states: Spring Qi is in the Hair, Summer Qi in the Skin, Autumn Qi in the Muscle Flesh, Winter Qi in the Sinews/Bones. Thus, needle fat people with Autumn/Winter dosage (depth); needle thin people with Spring/Summer dosage (depth). This chapter relies on these theories to discuss shallow vs. deep needling. Carefully considering the intent, "Spring/Summer" implies slight depth differences, and Autumn/Winter follow suit. One learns that heavenly timing and human Qi ascend/descend and float/sink like matching tally sticks. However, one must also know that thin people in Autumn/Winter still use Spring/Summer methods; fat people in Spring/Summer use Autumn/Winter methods. Adapt to circumstances, maintain balance—this is the subtle intent of this chapter, which must not be overlooked. The later section mentions bringing forth Yin in Spring/Summer and Yang in Autumn/Winter, which seems contradictory to the previous statement but is actually consistent. It means at the start of needling, first insert deeply into sinew/bone regions, observe the Qi movement, then draw it up to stay in the shallow layer, and proceed with needling. This is the method of bringing forth one Yin in Spring/Summer, focusing treatment in the shallow layer. Since Yang Qi ascends and floats in Spring/Summer, human Qi rises to follow. Conversely, initially insert shallowly into skin layers, obtain Deqi, then push down to stay in the deep layer, and proceed with needling. This is the method of bringing forth one Yang in Autumn/Winter, focusing treatment in the deep layer. Since Yang Qi descends and sinks in Autumn/Winter, human Qi weighs down to follow. Do not overlook the word "initially"; this is the first technique of insertion, not implying that once the meridian is reached, one continues thus. Readers should observe this. (Chapter 72, Old Edition 71)
Question: The Classics say: Needling Ying (deep) should not injure Wei (shallow); needling Wei (releasing Qi) should not injure Ying (bleeding). What does this mean? Answer: To needle Yang (Wei pathogenic Qi), insert the needle obliquely. To needle Yin (Ying pathogenic Qi), first press and massage the target Ying/Shu points with the left hand to disperse Wei Qi before inserting the needle. This is called "needling Ying without injuring Wei, needling Wei without injuring Ying."
Commentary: *Ling Shu* states: There are three variations in needling: needling Ying-Wei, and Bi syndrome in channels. It says: Needling Ying causes bleeding; needling Wei releases Qi. *Su Wen* states: Needling skin should not injure vessels; needling vessels should not injure flesh; needling flesh should not injure sinews; needling sinews should not injure bone; needling bone should not injure sinews; needling sinews should not injure flesh; needling flesh should not injure vessels; needling vessels should not injure skin. Inferring from this, "not injuring" means Ying bleeds, Wei releases Qi. "Injuring" means Ying releases Qi, Wei bleeds. Generally, needling Ying involves blood, so pressing the Shu point with the left hand disperses Wei Qi before insertion, preventing floating Qi from disturbing the process, thus "needling Ying without injuring Wei." Needling Wei involves Qi, so inserting the needle obliquely prevents downward over-penetration, thus "needling Wei without injuring Ying." *Ling Shu* speaks of shallow/deep distinctions of Qi and Blood; this chapter directly describes needling techniques. Essentially, they complement each other. (Chapter 73, Old Edition 76)
Question: What is tonification and sedation? When tonifying, what Qi is obtained? When sedating, what Qi is discarded? Answer: When tonifying, obtain Qi from the Wei level; when sedating, place/discard Qi from the Ying level. If Zheng Qi (Righteous Qi) is deficient and Xie Qi (Pathogenic Qi) is excessive, first tonify the Yang (point) then sedate the Yin (point). If Zheng Qi is deficient and Xie Qi is excessive [Note: Text says 'Yin Zheng deficient, Yang Xie excessive'], first tonify the Yin (point) then sedate the Yang (point). The smooth circulation of Ying and Wei is the key.
Commentary: This chapter specifically discusses tonifying and sedating Ying Qi circulating within the vessels. Various tonification and sedation methods described in previous chapters have different meanings and goals. Integrating them reveals the profound secrets of Dinghu and the subtleties of Bohai, making them clear as if held in the heart and operated in the palm. "Obtaining Qi from Wei" means retaining the needle shallowly, obtaining Deqi, then pushing it down to draw the floating, scattered Qi into the vessels—this is tonification. "Placing Qi from Ying" means inserting deeply and retaining, obtaining Deqi, then drawing and holding to scatter the Qi within the vessels to the exterior of the Wei—this is sedation. This corresponds to the previous discussion on bringing forth one Yin in Spring/Summer...