六十二难曰∶脏井、荥有五，腑独有六者，何谓也？（五，谓井、荥、输、经、合也。六，谓井、荥、输、原、经、
合也。其穴详《灵·本输篇》。）
然∶腑者，阳也。三焦行于诸阳，（诸阳经也。）故置一俞，一作 ）名曰原。（俞，穴也。
《灵·本输篇》以所过之穴为原，盖三焦所行者远，其气所流聚之处，五穴不足以尽之，故别置一穴，名曰原也。）所以
（一本无所以二字）腑有六者，亦与三焦共一气也。（共一气，谓亦行于诸阳，非谓其气皆出于三焦也。其详备见六十六
难中。）
六十三难曰∶《十变》言，五脏六腑荥合，皆以井为始者，何（一本有谓字）也？（凡经穴起止，其次第先井、次荥、
次输、次经、次合，故云以井为始。）
然∶井者，东方春也，（《灵·本输篇》以井属木，故于时配春也。）万物之始生。
诸KT 行喘息， 飞蠕动，（KT 、 、蠕，皆虫行之状；喘息，言有气以息，俱虫豸之属，一岁一生之物也。）当生之
物，莫不以春生。（此以生物之理，喻人之血气亦然也。）故岁数始于春，日数始于甲，（甲亦属木，言岁与日皆始于木，
故凡物尽然。）故以井为始也。
六十四难曰∶《十变》又言，阴井木，阳井金；阴荥火，阳荥水；阴俞（一作 ）土，阳俞木；阴经金，阳经火；阴
合水，阳合土。阴阳皆不同，其意何也？（脏属阴，故曰阴。腑属阳，故曰阳。阴井属木，次火、次土、次金、次水；
阳井属金，次水、次木、次火、次土，皆循五行相生之序也。）
然∶是刚柔之事也。（言此乃刚柔配合之道也。）阴井乙木，（乙为阴木。）阳井庚金，（庚为阳金。）阳井庚，庚者，
乙之刚也；阴井乙，乙者，庚之柔也。（阳金与阴木刚柔相合，为夫妇也。）乙为木，故言阴井木也；庚为金，故言阳井
金也。余皆仿此。（余，指荥、俞、经、合也。仿此，谓阴荥丁火、阳荥壬水，皆以此推之也。）
六十五难曰∶经言所出为井，所入为合，（详《灵·本输篇》，如肺出于少商为井，入于尺泽为合是也。）其法奈何？
然∶所出为井，井者，东方春也，（井属木，春为木令故也。）万物之（一本无之字）始生，故言所出为井也。所入
为合，
合者，北方冬也，（合属水，冬为水令故也。）阳气入藏，故言所入为合也。（此以时令之所属，配之经穴，以明出入二字
之义，亦与前六十三难义同。）
六十六难曰∶经言肺之原，出于太渊；（太渊，在手掌后陷中。）心之原，出于大陵；（大陵，在掌后骨下横文中两筋
间，此手厥阴之穴也。余皆本经穴。）肝之原，出于太冲；（太冲，在足大指本节后二寸陷中。）脾之原，出于太白；（太
白，在足大指后内侧白肉际陷中。）肾之原，出于太溪；（太溪，在足内踝后五分。）少阴之原，出于兑骨；（少阴，手少
阴也。兑骨，即神门穴，在掌后锐骨端陷中。）胆之原，出于丘墟；（丘墟，在足外踝下如前陷中。）胃之原，出于冲阳；
（冲阳，在足跗上，去内庭五寸高骨间动脉。）三焦之原，出于阳池；（阳池，在手表腕上陷者中。）膀胱之原，出于京骨；
（京骨，在足小指外侧、本节后大骨下白肉际陷中。）大肠之原，出于合谷；（合谷，在手大指次指歧骨间陷中。）小肠之
原，出于腕骨。（腕骨，在手外侧、腕前起骨下陷中。）
十二经皆以俞（一作 ）为原者，何也？
然∶五脏俞（一作 。下同。）者，三焦之所行，气之所留止也。（十二经皆营卫为之流行，三焦者营卫之所出，营
卫所留止之处，即三焦所留止之处也。）三焦所行之俞为原者，何也？（言何以三焦之所留即名为原也。）
然∶脐下肾间
动气者，人之生命也，十二经之根本也，故名曰原。（此即三十六难所云命门乃三焦之所本也。详三十六难中。）三焦者，
原气之别使也，（言根本原气分行诸经，故曰别使。）主通行三气，经历于五脏六腑。（三气，三焦有上、中、下三者之气
也。）原者，三焦之尊号也，（分言之则曰三焦，从其本而言之则曰原，故云尊号。）故所止辄为原。五脏六腑之有病者，
皆取其原也。（三焦为原气别使，则三焦气所在，即原气所在，故即以原名之，而病之深者，当取乎此也。《灵·九针十
二原篇》云∶“五脏有疾，当取之十二原。十二原者，五脏之所以禀三百六十五节气味也。”说最明晓。）
六十七难曰∶五脏募皆在阴，而俞（一作 。 下有一“皆”字。）在阳者，何谓也？（募，音暮。气所结聚处也。
俞，《史记·扁鹊传》作“输”，犹委输之义也。阴，腹也。肺募中府属本经，心主募巨阙属任脉，脾募章门属肝经，肝
募期门属本经，肾募京门属胆经，胃募中脘属任脉，大肠募天枢属胃经，小肠募关元属任脉，胆募日月属本经，膀胱募
中极属任脉，三焦募石门属任脉，诸穴皆在腹也。阳，背也。《素·气府论》∶“五脏之俞各五，六腑之俞各六”；《灵·背
输篇》云∶“肺俞在三焦之间，心俞在五焦之间，膈俞在七焦之间，肝俞在九焦之间，脾俞在十一焦之间，肾俞在十四焦
之间，皆侠脊相去三寸所”，焦即椎也。其心包俞在四椎下，大肠俞在十六椎下，小肠俞在十八椎下，胆俞在十椎下，胃
俞在十二椎下，三焦俞在十三椎下，膀胱俞在十九椎下，诸穴亦侠脊相去三寸，俱属足太阳脉，皆在背也）
然∶阴病行阳，阳病行阴。故令募在阴，俞（一作 。下同。）在阳也。（言阴经本皆在腹，而其俞则俱在背；阳经
本皆在背，而其募则皆在腹，盖以病气互相流传，由经络本互相通贯，故其气之结聚输转之处交相会也。）
六十八难曰∶五脏六腑，皆有井、荥、俞、经、合，皆何所主？（言此诸穴，刺之主治何病也。）
然∶经言所出为井，
所流为荥，所注为俞，所行为经，所入为合。（出，始发源也。流，渐盛能流动也。注，流所向注也。行，通达条贯也。
入，藏纳归宿也。五句本《灵·九针十二原篇》。经文流作“溜”，义同。）井主心下满，荥主身热，俞主体重节痛，经主
喘咳寒热，合主逆气而泄。（由六十四难五行所属推之，则心下满为肝木之病，身热为心火之病，体重节痛为脾土之病，
喘咳寒热为肺金之病，逆气而泄为肾水之病，然此亦论其一端耳。两经辨病取穴之法，实不如此，不可执一说而不知变
通也。）此五脏六腑井、荥、俞、经、合所主病也。
六十九难曰∶经言虚者补之，实者泻之，不实不虚，以经取之，何谓也？（虚，血气虚也。实，血气实也。补之，
行针用补法也。泻之，行针用泻法也。其说详《素·离合真邪论》等篇。以经取之，言循其本经所宜刺之穴也。）
然∶虚者补其母，实者泻其子，当先补之，然后泻之。（母，生我之经，如肝虚则补肾经也，母气实，则生之益力。
子，我生之经，如肝实则泻心经也，子气衰，则食其母益甚。详见下文七十五难。）不实不虚，（一本作不虚不实）以经
取之者，是正经自生病，不中他邪也，当自取其经，故言以经取之。（正经自病，如四十九难所云之类是也。自取其经，
即于本经取所当刺之穴，不必补母泻子也。）
七十难曰∶（一本有“经言”二字）春夏刺浅，秋冬刺深者，何谓也？（《灵·终始篇》云∶“春气在毛，夏气在皮肤，
秋气在分肉，冬气在筋骨，刺此病者，各以其时为齐。”两经虽互有异同，此其大较也。）
然∶春夏者，阳气在上，人气
亦在上，故当浅取之；秋冬者，阳气在下，人气亦在下，故当深取也。（阳气，谓天地之气。人气，谓营卫之气。上，谓
皮肉之上。下，谓筋骨之中。浅取、深取，必中其病之所在，则易已也。）春夏各致一阴，秋冬各致一阳者，何谓也？（致，
取也，谓用针以取其气也。）
然∶春夏温，必致一阴者，初下针，沉之至肾肝之部，得气，引持之阴也。（温，时令温也。
阳盛则阴不足，故取阴气以补阳也。沉之，谓深入其针至肾肝筋骨之位。引，谓引其气而出之至于阳之分也。）秋冬寒，
必致一阳者，初内针，浅而浮之至心肺之部，得气，推内之阳也。（寒，时令寒也。阴盛则阳不足，故取阳气以补阴也。
浮之，谓浅纳其针至心肺皮血之位。推，谓推其气而入之至于阴之分也。此即经文所谓“从阴引阳，从阳引阴”之义。）
是谓春夏必致一阴，秋冬必致一阳。
七十一难曰∶经言刺营无伤卫，刺卫无伤营，何谓也？（营主血在内，卫主气在外，营卫有病，各中其所，不得诛
伐无过也。此即《素·刺齐论》所云∶“刺骨无伤筋，刺筋无伤肉，刺肉无伤脉，刺脉无伤皮，刺皮无伤肉，刺肉无伤筋，
刺筋无伤骨”之义。）
然∶针阳者，卧针而刺之；（阳，卫也。卫在外，欲其浅，故侧卧其针，则针锋横达，不及营也。）
刺阴者，先以左手摄按所针荥俞之处，气散乃内针。（阴，营也。营在内，针必过卫而至营，然卫属气，可令得散，故摄
按之使卫气暂离其处，则针得直至营，而不犯卫也。）是谓刺营无伤卫，刺卫无伤营也。
七十二难曰∶经言能知迎随之气，可令调之；调气之方，必在阴阳，何谓也？（《灵·终始篇》云∶“阳受气于四末，
阴受气于五脏。故泻者迎之，补者随之，知迎知随，气可令和，和气之方，必通阴阳。”引经文本此。盖阳经主外，故从
四末始，阴经主内，故从五脏始。迎者，针锋迎其来处而夺之，故曰泻。随者，针锋随其去处而济之，故曰补。通阴阳
者，察其阴阳之虚实，不得误施补泻也。详见七十九难中。）
然∶所谓迎随者，知营卫之流行，经脉之往来也。随其逆顺
而取之，故曰迎随。（知往来逆顺，正经文所谓迎随之义，越人之所本也。诸家论说纷纷，皆属误解，盖经学之不讲久矣！）
调气之方，必在阴阳者，知其内外表里，随其阴阳而调之，故曰调气之方，必在阴阳。（阳主外、主表，阴主内、主里，
察其虚实而补之、泻之，令调和也。）
七十三难曰∶诸井者，肌肉浅薄，气少不足使也，刺之奈何？（诸井皆在手足指末上，故云肌肉浅薄。气藏于肌肉
之内，肌肉少，则气亦微。不足使，谓补泻不能相应也。）
然∶诸井者，木也；荥者，火也。火者，木之子，当刺井者，
以荥泻之。（此泻子之法也。如用补，则当补其合，可类推。然惟井穴为然，盖以其气少不足为补泻，泻子补母，则气自
应也。）
故经言（一作云）补者不可以为泻，泻者不可以为补，此之谓也。（言泻则当以子，补则当以母，不可误施。）
七十四难曰∶经言春刺井，夏刺荥，季夏刺俞，秋刺经，冬刺合者，何谓也？（五句经文无考）
然∶春刺井者，邪
在肝；夏刺荥者，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。（此亦以五脏所属为言也。井
与春皆属木，荥与夏皆属火，俞与秋皆属金，合与冬皆属水，故四时有病，则脏气亦与之相应，故刺法亦从时也。）
其肝、心、脾、肺、肾，而系于春、夏、秋、冬者，何也？
然∶五脏一病，辄有五也。（言有五者之证现于外也。）
假令肝病，色青者肝也，臊臭者肝也，喜酸者肝也，喜呼者肝也，喜泣者肝也。（说详四十九难中。此举邪之在肝者，以
例其余也。）其病众多，不可尽言也。（言五者之变，不可胜穷也。）四时有数，而并系于春、夏、秋、冬者也。（言病虽
万变，而四时实有定数，治之之法，总不出此，其道简约易行也。）针之要妙，在于秋毫者也。（此又推言用针之道，其
微妙之处，乃在秋毫之间，又非四时之所得而尽，学人又不可因易而忘难也。）
七十五难曰∶经言东方实，西方虚，泻南方，补北方，何谓也？（此即六十九难泻子之法。南方为东方之子，北方
为西方之子、东方之母。说详下文。）
然∶金、木、水、火、土，当更相平。（更相平，言金克木，木克土，循环相制，
不令一脏独盛而生病也。）东方木也，西方金也。木欲实，金当平之；火欲实，水当平之；土欲实，木当平之；金欲实，
火当平之；水欲实，土当平之。（此言五行本然之道也。）东方者肝也，则知肝实；西方者肺也，则知肺虚。泻南方火，
补北方水。南方火，火者，木之子也；（实则泻其子也。）北方水，水者，木之母也。水胜火，（木之母胜木之子也。）子
能令母实，母能令子虚，（木之子火，为木之母水所克，则火能益水之气，故曰子能令母实。水克火，能夺火之气，故曰
母能令子虚。）故泻火补水，欲令金不得平木也。（子能令母实，泻子则火势益衰，而水得以恣其克伐；母能令子虚，补
母则水势并旺，而火不敢留其有余，如此则火不能克金，而反仰食木之气以自给，使金气得伸，而木日就衰，则金自能
平木也。不字诸家俱以为衍文。
第六十二难说：五脏的井、荥穴各只有五个，而六腑独有六个，这是什么意思？（这里的“五”，指的是井、荥、输、经、合这五个穴位。所谓的“六”，指的是井、荥、输、原、经、合这六个穴位。这些穴位的详细情况参见《灵枢·本输篇》。）
回答说：六腑属于阳。三焦之气运行于所有阳经之中，（所谓诸阳经，即手足三阳经。）所以在六腑中增设一个穴位，又叫做“原穴”。（俞，就是穴的意思。《灵枢·本输篇》把经过的穴位作为原穴，大概是因为三焦所运行的路径遥远，其气流行汇聚的地方，仅靠五个穴位不足以完全表达，所以另外设置一个穴位，命名为原穴。）因此六腑有六个穴位，也是与三焦共同拥有同一股气的缘故。（所谓共一气，是指也运行于诸阳经，并非指它们的气都出自三焦。详细内容备见于第六十六难中。）
第六十三难说：《十变》中提到，五脏六腑的荥穴和合穴，都以井穴为起始，为什么呢？（一本中有“谓”字。）（凡是经脉穴位的起止，其次序先是井穴，其次是荥穴，再次是输穴，然后是经穴，最后是合穴，所以说以井穴为起始。）
回答说：井穴，对应东方春季，（《灵枢·本输篇》认为井穴属木，所以在时令上配属春季。）是万物开始生长的时节。
各种爬行、呼吸、飞翔、蠕动的生物，（KT、[虫+禹]、蠕，都是虫子爬行的形态；喘息，指有气息在呼吸，都属于虫豸一类，一年一生育的生物。）应当出生的事物，没有不随着春天而生的。（这是用生物生长的道理，来比喻人的血气也是如此。）所以岁数始于春季，日数始于甲日，（甲也属木，意思是年与日都始于木，所以凡物都是这样。）因此以井穴为起始。
第六十四难说：《十变》又说，阴经的井穴属木，阳经的井穴属金；阴经的荥穴属火，阳经的荥穴属水；阴经的输穴（一作“腧”）属土，阳经的输穴属木；阴经的经穴属金，阳经的经穴属火；阴经的合穴属水，阳经的合穴属土。阴阳的属性都不同，其中的含义是什么呢？（脏属于阴，所以叫阴。腑属于阳，所以叫阳。阴井属木，依次是火、土、金、水；阳井属金，依次是水、木、火、土，都遵循五行相生的顺序。）
回答说：这是刚柔配合的道理。（意思是这是刚柔相互配对的法则。）阴井是乙木，（乙为阴木。）阳井是庚金，（庚为阳金。）阳井庚，庚，是乙的刚强一面；阴井乙，乙，是庚的柔和一面。（阳金与阴木刚柔相合，如同夫妇关系。）乙为木，所以说阴井属木；庚为金，所以说阳井属金。其余类推。（余，指荥、输、经、合穴。仿此，是说阴荥丁火、阳荥壬水，都可以以此类推。）
第六十五难说：经文说“所出为井，所入为合”，（详见《灵枢·本输篇》，例如肺经出于少商穴作为井穴，入于尺泽穴作为合穴，就是这样。）其中的法则是怎样的？
回答说：所出为井，井穴，对应东方春季，（井穴属木，春季是木令当权的原因。）万物刚刚开始生长，所以说所出为井。所入为合，
合穴，对应北方冬季，（合穴属水，冬季是水令当权的原因。）阳气进入脏腑，所以说所入为合。（这是以时令的所属来配应经穴，以阐明“出入”二字的含义，也与前面第六十三难的含义相同。）
第六十六难说：经文说肺的原穴，出于太渊穴；（太渊穴，位于手掌后方的凹陷处。）心的原穴，出于大陵穴；（大陵穴，位于掌后骨下的横纹中两筋之间，这是手厥阴心包经的穴位。其余都依据本经穴位。）肝的原穴，出于太冲穴；（太冲穴，位于足大趾本节后方二寸的凹陷处。）脾的原穴，出于太白穴；（太白穴，位于足大趾后内侧白肉际的凹陷处。）肾的原穴，出于太溪穴；（太溪穴，位于足内踝后方五分处。）少阴经的原穴，出于兑骨穴；（少阴，指手少阴心经。兑骨，即神门穴，位于掌后锐骨端的凹陷处。）胆的原穴，出于丘墟穴；（丘墟穴，位于足外踝下方如前所述的凹陷处。）胃的原穴，出于冲阳穴；（冲阳穴，位于足背上，距离内庭穴五寸的高骨间动脉处。）三焦经的原穴，出于阳池穴；（阳池穴，位于手腕背侧的凹陷处。）膀胱经的原穴，出于京骨穴；（京骨穴，位于足小趾外侧、本节后方大骨下白肉际的凹陷处。）大肠经的原穴，出于合谷穴；（合谷穴，位于手大指与次指歧骨间的凹陷处。）小肠经的原穴，出于腕骨穴。（腕骨穴，位于手外侧、腕前起骨下的凹陷处。）
回答说：五脏的输穴，是三焦之气所运行的地方，也是气停留停止的地方。（十二经脉都由营卫之气流行运行，三焦是营卫之气发出的源头，营卫之气停留的地方，也就是三焦之气停留的地方。）三焦所运行的输穴之所以称为原穴，为什么呢？（意思是为什么三焦所停留的地方就命名为原穴呢？）
回答说：脐下肾间的动气，是人的生命根本，也是十二经脉的根本，所以名叫原穴。（这就是第三十六难所说的命门是三焦的本源。详见第三十六难中。）三焦，是原气的别使（分支使者），（意思是根本的原气分行到各条经脉，所以叫别使。）主要通行上、中、下三焦之气，经历五脏六腑。（三气，指三焦有上、中、下三种气。）原穴，是三焦的尊称，（分开说是三焦，从本源来说就是原，所以叫尊称。）所以气停留的地方就定为原穴。五脏六腑如果有病，都取用原穴。（三焦作为原气的别使，那么三焦气所在的地方，就是原气所在的地方，所以直接用原名来称呼它，而病情深重的，应当取用此处。《灵枢·九针十二原篇》说：“五脏有疾，应当取用十二原穴。十二原穴，是五脏禀受三百六十五节气味的地方。”这种说法最为明白晓畅。）
第六十七难说：五脏的募穴都在阴面（腹部），而俞穴（一作“腧”，下面有一个“皆”字）在阳面（背部），这是什么意思？（募，音暮。是气结聚的地方。俞，《史记·扁鹊传》写作“输”，犹如委输输送的意义。阴，指腹部。肺募中府穴属本经，心主募巨阙穴属任脉，脾募章门穴属肝经，肝募期门穴属本经，肾募京门穴属胆经，胃募中脘穴属任脉，大肠募天枢穴属胃经，小肠募关元穴属任脉，胆募日月穴属本经，膀胱募中极穴属任脉，三焦募石门穴属任脉，这些穴位都在腹部。阳，指背部。《素问·气府论》说：“五脏的俞穴各五个，六腑的俞穴各六个”；《灵枢·背俞篇》说：“肺俞在三椎之间，心俞在五椎之间，膈俞在七椎之间，肝俞在九椎之间，脾俞在十一椎之间，肾俞在十四椎之间，都在脊柱两旁相距三寸左右”，椎即脊椎骨。心包俞在四椎下，大肠俞在十六椎下，小肠俞在十八椎下，胆俞在十椎下，胃俞在十二椎下，三焦俞在十三椎下，膀胱俞在十九椎下，这些穴位也在脊柱两旁相距三寸，都属于足太阳膀胱经，都在背部。）
回答说：阴病行于阳，阳病行于阴。所以让募穴在阴，俞穴（一作“腧”，下同）在阳。（意思是阴经原本都在腹部，而其俞穴则在背部；阳经原本都在背部，而其募穴则都在腹部，大概是因为病气互相流传，由经络本来互相贯通，所以气结聚输转的地方交相会合。）
第六十八难说：五脏六腑，都有井、荥、俞、经、合穴，分别主治什么病症？（意思是这些穴位，针刺时主治什么病呢？）
所流为荥，所注为俞，所行为经，所入为合。（出，指始发源头。流，指逐渐盛大能流动。注，指流向灌注。行，指通达条贯。入，指藏纳归宿。这五句原本出自《灵枢·九针十二原篇》。经文中的“流”写作“溜”，意义相同。）井穴主治心下满闷，荥穴主治身体发热，俞穴主治身体沉重关节疼痛，经穴主治喘咳寒热，合穴主治气逆而泄泻。（根据第六十四难的五行归属来推断，则心下满是肝木的病，身热是心火的病，体重节痛是脾土的病，喘咳寒热是肺金的病，逆气而泄是肾水的病，但这只是论述其中一方面罢了。两条经脉辨别疾病选取穴位的方法，实际上并非如此，不能拘泥于一种说法而不知变通。）这就是五脏六腑井、荥、俞、经、合穴所主治的病症。
第六十九难说：经文说虚证用补法，实证用泻法，不虚不实，则取本经穴位治疗，这是什么意思？（虚，指血气虚弱。实，指血气盛实。补之，指行针时使用补法。泻之，指行针时使用泻法。这种说法详见《素问·离合真邪论》等篇章。以经取之，意思是沿着本经适宜针刺的穴位进行针刺。）
回答说：虚证补其母穴，实证泻其子穴，应当先补后泻。（母，指生我的经脉，如肝虚则补肾经，母气实，则生助的力量更强。子，指我生的经脉，如肝实则泻心经，子气衰，则消耗母气更甚。详见下文第七十五难。）不虚不实，（一本作“不虚不实”）以经取之，是指正经自己生病，没有受到其他邪气侵袭，应当直接取本经穴位，所以叫以经取之。（正经自病，如第四十九难所说的情形之类。自取其经，即在在本经取应当针刺的穴位，不必补母泻子。）
第七十难说：（一本有“经言”二字）春夏季节针刺要浅，秋冬季节针刺要深，这是什么意思？（《灵枢·终始篇》说：“春气在毫毛，夏气在皮肤，秋气在分肉，冬气在筋骨，刺这些病的人，各自以当时的时令为准。”两经虽然互有异同，但大体如此。）
也在上，所以应当浅取；秋冬季节，阳气在下，人气也在下，所以应当深取。（阳气，指天地之气。人气，指营卫之气。上，指皮肉之上。下，指筋骨之中。浅取、深取，必须中其病所在的位置，就容易痊愈了。）春夏各致一阴，秋冬各致一阳，是什么意思？（致，取的意思，指用针去获取气。）
回答说：春夏气温暖，必须致一阴，初下针时，深入至肾肝的部位，得气后，牵引持守以获取阴气。（温，指时令温暖。阳盛则阴不足，所以取阴气来补阳。沉之，指针深入至肾肝筋骨的位置。引，指引其气而出至于阳的部分。）秋冬气候寒冷，必须致一阳，初进针时，浅而浮提至心肺的部位，得气后，推进以获取阳气。（寒，指时令寒冷。阴盛则阳不足，所以取阳气来补阴。浮之，指针浅纳至心肺皮血的位置。推，指推其气而入至于阴的部分。这就是经文所说的“从阴引阳，从阳引阴”的含义。）这就叫春夏必致一阴，秋冬必致一阳。
第七十一难说：经文说刺营气不要伤及卫气，刺卫气不要伤及营气，这是什么意思？（营主血在内，卫主气在外，营卫有病，各自中其所受的病，不得诛伐无罪之人。这就是《素问·刺齐论》所说的“刺骨无伤筋，刺筋无伤肉，刺肉无伤脉，刺脉无伤皮，刺皮无伤肉，刺肉无伤筋，刺筋无伤骨”的含义。）
回答说：针刺阳分（卫），卧针斜刺；（阳，指卫气。卫气在外，希望刺得浅，所以侧卧针身，则针锋横向到达，不及营气。）
针刺阴分（营），先用左手摄按所针的荥穴、俞穴之处，待卫气散开后再进针。（阴，指营气。营气在内，针刺必须经过卫气到达营气，然而卫属气，可以让它散开，所以摄按使其卫气暂时离开该处，则针得以直达营气，而不触犯卫气。）这就叫刺营无伤卫，刺卫无伤营。
第七十二难说：经文说能知道迎随的气机，就可以调和；调气的方法，必定在于阴阳，这是什么意思？（《灵枢·终始篇》说：“阳受气于四肢末端，阴受气于五脏。所以泻者迎其气，补者随其气，知道迎随，气就可以平和，和气的方法，必须通晓阴阳。”引用经文原本出自这里。大概阳经主外，所以从四肢末端开始，阴经主内，所以从五脏开始。迎者，针锋迎着气来的方向而夺其邪，所以叫泻。随者，针锋跟着气去的方向而济其虚，所以叫补。通阴阳，是察其阴阳的虚实，不得误施补泻。详见第七十九难中。）
而取穴，所以叫迎随。（知道往来的逆顺，正是经文所说的迎随之义，是越人（秦越人/扁鹊）所依据的。各家论述纷纷，都属于误解，大概是经学不讲求很久了！）
调气的方法，必定在于阴阳，是知道内外表里，顺着其阴阳而调和它，所以叫调气的方法，必定在于阴阳。（阳主外、主表，阴主内、主里，察其虚实而补之、泻之，令其调和。）
第七十三难说：所有的井穴，肌肉浅薄，气少不足以施用（补泻），该怎么刺？（所有井穴都在手足指端，所以叫肌肉浅薄。气藏在肌肉之内，肌肉少，则气也微弱。不足使，指补泻不能相应。）
回答说：所有的井穴，属木；荥穴，属火。火，是木之子，当刺井穴时，
用荥穴来泻之。（这是泻子的方法。如果用补，则应当补其合穴，可以类推。然而只有井穴是这样，大概因为其气少不足以进行补泻，泻子补母，则气自然相应。）
所以经文说（一作云）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。（意思是泻则应当用子穴，补则应当用母穴，不可误施。）
第七十四难说：经文说春刺井，夏刺荥，季夏刺俞，秋刺经，冬刺合，这是什么意思？（这五句经文无法考证）
回答说：春刺井，是因为邪气在肝；夏刺荥，是因为邪气在心；季夏刺俞，是因为邪气在脾，秋刺经，是因为邪气在肺；冬刺合，是因为邪气在肾。（这也是以五脏的归属来说明。井与春都属木，荥与夏都属火，俞与秋都属金，合与冬都属水，所以四季有病，则脏气也与之相应，所以刺法也顺应时令。）
回答说：五脏一旦生病，就会出现五种表现。（意思是外表显现出五种证候。）
假如肝病，面色青的是肝，气味臊臭的是肝，喜欢酸味的是肝，喜欢呼喊的是肝，喜欢哭泣的是肝。（说法详见第四十九难中。这里列举邪气在肝的情况，用来举例其余脏腑。）病症众多，不可尽言。（意思是五种变化的情形，不可胜穷。）四季有定数，并且关联于春、夏、秋、冬。（意思是病虽万变，而四季实有定数，治疗的方法，总不出此，其道简约易行。）针刺的要妙，在于秋毫之间。（这又是推演用针的道理，其微妙之处，乃在秋毫之间，又不是四季所能完全涵盖的，学人又不可因为容易而忘记困难。）
第七十五难说：经文说东方实，西方虚，泻南方，补北方，这是什么意思？（这就是第六十九难中泻子的方法。南方为东方之子，北方为西方之子、东方之母。说法详见下文。）
回答说：金、木、水、火、土，应当互相平衡。（更相平，意思是金克木，木克土，循环相制，不让一脏独盛而生病。）东方属木，西方属金。木欲实，金应当平抑它；火欲实，水应当平抑它；土欲实，木应当平抑它；金欲实，火应当平抑它；水欲实，土应当平抑它。（这是说五行本然的道理。）东方是肝，则知肝实；西方是肺，则知肺虚。泻南方火，补北方水。南方火，火，是木之子；（实证泻其子）北方水，水，是木之母。水胜火，（木之母胜木之子也。）子能令母实，母能令子虚，（木之子火，被木之母水所克，则火能益水之气，所以叫子能令母实。水克火，能夺火之气，所以叫母能令子虚。）所以泻火补水，是想让金不能平抑木。（子能令母实，泻子则火势益衰，而水得以恣意克伐；母能令子虚，补母则水势并旺，而火不敢留其有余，如此则火不能克金，反而仰仗木之气来自给，使金气得伸张，而木日渐衰败，则金自然能平抑木也。不字，各家都认为是衍文。）
Chapter 62 states: The Jing-Well and Ying-Spring acupoints of the Zang organs are only five in number, yet the Fu organs have six uniquely. What is the meaning of this? (The "five" refers to the Jing-Well, Ying-Spring, Shu-Stream, Jing-River, and He-Sea points. The "six" refers to the Jing-Well, Ying-Spring, Shu-Stream, Yuan-Source, Jing-River, and He-Sea points. Details of these points can be found in *Ling Shu: Ben Shu*.)
The response is: The Fu organs belong to Yang. The San Jiao (Triple Burner) qi circulates through all Yang meridians. Therefore, an additional point is established in the Fu organs, also called the Yuan-Source point. (Shu means acupoint. In *Ling Shu: Ben Shu*, the passing-through points are considered Yuan points. This is likely because the San Jiao travels a long distance, and its qi gathers where the five points are insufficient to fully express it; thus, another point is separately designated as the Yuan point.) Hence, the Fu organs have six points because they share the same qi with the San Jiao. (Sharing the same qi means circulating through the Yang meridians, not that their qi originates solely from the San Jiao. Details are provided in Chapter 66.)
Chapter 63 states: *Shi Bian* says that for both Zang and Fu organs, the Ying-Spring and He-Sea points all begin with the Jing-Well point. Why? (In the sequence of acupoints along a meridian, they start with Jing-Well, followed by Ying-Spring, Shu-Stream, Jing-River, and finally He-Sea. Thus, it is said to begin with the Jing-Well point.)
The response is: The Jing-Well point corresponds to the East and Spring. (*Ling Shu: Ben Shu* associates Jing-Well with Wood, hence matching it with Spring in terms of seasons), which is when all things begin to grow.
All creatures that crawl, breathe, fly, or writhe—(KT, [insect+yu], and wriggling describe insect movements; breathing implies air exchange—all belong to insects and worms, creatures born annually)—must be born in accordance with Spring. (This uses the principle of biological growth to illustrate that human Qi and Blood behave similarly.) Therefore, the year begins with Spring, and the days begin with Jia. (Jia also belongs to Wood, indicating that years and days both start with Wood, so all things follow this pattern.) Thus, treatment begins with the Jing-Well point.
Chapter 64 states: *Shi Bian* further says that Yin Jing-Well points belong to Wood, while Yang Jing-Well points belong to Metal; Yin Ying-Spring points belong to Fire, while Yang Ying-Spring points belong to Water; Yin Shu-Stream points (also written as Shu) belong to Earth, while Yang Shu-Stream points belong to Wood; Yin Jing-River points belong to Metal, while Yang Jing-River points belong to Fire; Yin He-Sea points belong to Water, while Yang He-Sea points belong to Earth. The Yin and Yang attributes differ significantly. What is the intention behind this? (Zang organs are Yin, hence Yin. Fu organs are Yang, hence Yang. Yin Jing-Well is Wood, followed by Fire, Earth, Metal, Water. Yang Jing-Well is Metal, followed by Water, Wood, Fire, Earth. All follow the order of mutual generation in the Five Elements.)
The response is: This concerns the matter of Gang (Yang/Hard) and Rou (Yin/Soft). Yin Jing-Well is Yi Wood. (Yi is Yin Wood.) Yang Jing-Well is Geng Metal. (Geng is Yang Metal.) Yang Jing-Well is Geng; Geng is the Gang aspect of Yi. Yin Jing-Well is Yi; Yi is the Rou aspect of Geng. (Yang Metal and Yin Wood combine Gang and Rou, forming a husband-wife relationship.) Since Yi is Wood, it is said that Yin Jing-Well is Wood. Since Geng is Metal, it is said that Yang Jing-Well is Metal. The rest follow this analogy. (The "rest" refers to Ying-Spring, Shu-Stream, Jing-River, and He-Sea points. "Follow this analogy" means that Yin Ying-Spring Ding Fire and Yang Ying-Spring Ren Water are deduced in the same manner.)
Chapter 65 states: The classic text says, "What emerges is the Jing-Well, what enters is the He-Sea." (See *Ling Shu: Ben Shu* for details; for example, the Lung meridian emerges at Shaoshang as the Jing-Well and enters at Chize as the He-Sea.) What is the method behind this?
The response is: "What emerges is the Jing-Well." The Jing-Well point corresponds to the East and Spring. (Jing-Well belongs to Wood, and Spring is the season of Wood.) It is when all things begin to grow, hence "what emerges is the Jing-Well." "What enters is the He-Sea."
The He-Sea point corresponds to the North and Winter. (He-Sea belongs to Water, and Winter is the season of Water.) Yang Qi enters the Zang organs, hence "what enters is the He-Sea." (This matches seasonal attributes to acupoints to clarify the meaning of "emergence" and "entry," consistent with the meaning in Chapter 63.)
Chapter 66 states: The classic text says the Yuan-Source point of the Lung emerges at Taiyuan; (Taiyuan is located in the depression posterior to the wrist.) the Yuan-Source point of the Heart emerges at Daling; (Daling is located between the two tendons in the transverse crease distal to the wrist bone; this is an acupoint of the Pericardium Meridian of Hand-Jueyin. The others follow their respective meridians.) the Yuan-Source point of the Liver emerges at Taichong; (Taichong is located in the depression two cun proximal to the metatarsophalangeal joint of the great toe.) the Yuan-Source point of the Spleen emerges at Taibai; (Taibai is located in the depression at the medial border of the white flesh of the foot.) the Yuan-Source point of the Kidney emerges at Taixi; (Taixi is located five fen posterior to the medial malleolus.) the Yuan-Source point of the Shaoyin meridian emerges at Duigu; (Shaoyin refers to the Hand-Shaoyin Heart Meridian. Duigu is Shenmen acupoint, located in the depression at the end of the sharp bone of the wrist.) the Yuan-Source point of the Gallbladder emerges at Qiuxu; (Qiuxu is located in the depression below the lateral malleolus.) the Yuan-Source point of the Stomach emerges at Chongyang; (Chongyang is located on the dorsum of the foot, in the arterial pulse between the high bones, five cun distal to Neiting.) the Yuan-Source point of the San Jiao emerges at Yangchi; (Yangchi is located in the depression dorsal to the wrist.) the Yuan-Source point of the Bladder emerges at Jinggu; (Jinggu is located in the depression at the white flesh boundary under the large bone distal to the metatarsophalangeal joint of the little toe, on the lateral side.) the Yuan-Source point of the Large Intestine emerges at Hegu; (Hegu is located in the depression between the first and second metacarpal bones.) the Yuan-Source point of the Small Intestine emerges at Wangu. (Wangu is located in the depression anterior to the styloid process of the ulna on the lateral side of the hand.)
Why do all twelve meridians use the Shu-Stream point as the Yuan-Source point?
The response is: The Shu-Stream points of the Zang organs are where the Qi of the San Jiao travels and where Qi stays and stops. (Twelve meridians circulate Ying and Wei Qi. The San Jiao is the source of Ying and Wei Qi. Where Ying and Wei Qi stay is where San Jiao Qi stays.) Why are the Shu-Stream points traveled by the San Jiao called Yuan-Source points? (Why is the place where San Jiao stays named Yuan?)
The response is: The moving Qi in the kidney region below the navel is the root of human life and the foundation of the twelve meridians, hence it is named Yuan. (This refers to the Mingmen mentioned in Chapter 36 as the root of the San Jiao. See Chapter 36 for details.) The San Jiao is the special envoy of the Yuan Qi. (Meaning the fundamental Yuan Qi branches out to various meridians, hence "special envoy".) It primarily facilitates the circulation of the three Qi (Upper, Middle, and Lower San Jiao Qi) through the Zang and Fu organs. Yuan is the honorific title of the San Jiao. (When distinguished, it is called San Jiao; referring to its root, it is called Yuan, hence "honorific title.") Therefore, wherever Qi stops, it becomes the Yuan point. When Zang and Fu organs are diseased, one should select their Yuan points. (Since the San Jiao is the special envoy of Yuan Qi, wherever San Jiao Qi resides, Yuan Qi resides. Thus, it is named Yuan. For deep-seated diseases, one should treat here. *Ling Shu: Jiu Zhen Shi Er Yuan* states: "When Zang organs have disease, take the Twelve Yuan points. The Twelve Yuan points are where the Zang organs receive the essence and flavors of the three hundred and sixty-five Qi periods." This explanation is very clear.)
Chapter 67 states: The Mu points of the Zang organs are all on the Yin side (anterior/abdomen), while the Shu points (also written as Shu, with an additional "all" character below) are on the Yang side (posterior/back). What does this mean? (Mu sounds like "mu". It is where Qi gathers. Shu, written as "Shu" in *Records of the Grand Historian: Biography of Bian Que*, implies distribution/transmission. Yin refers to the abdomen. Fei Mu Zhongfu belongs to its own meridian; Xin Zhu Mu Jueque belongs to the Ren Mai; Pi Mu Zhangmen belongs to the Liver meridian; Gan Mu Qimen belongs to its own meridian; Shen Mu Jingmen belongs to the Gallbladder meridian; Wei Mu Zhongwan belongs to the Ren Mai; Da Chang Mu Tianshu belongs to the Stomach meridian; Xiao Chang Mu Guanyuan belongs to the Ren Mai; Dan Mu Riyue belongs to its own meridian; Pang Guang Mu Zhongji belongs to the Ren Mai; San Jiao Mu Shimens belongs to the Ren Mai. All these points are on the abdomen. Yang refers to the back. *Su Wen: Qi Fu Lun* says: "There are five Shu points for each Zang organ and six for each Fu organ." *Ling Shu: Bei Shu Pian* says: "Fei Shu is between the third and fourth vertebrae, Xin Shu between the fifth and sixth, Ge Shu between the seventh and eighth, Gan Shu between the ninth and tenth, Pi Shu between the eleventh and twelfth, Shen Shu between the fourteenth and fifteenth, all three cun lateral to the spine." Vertebrae are referred to as Jiao. Xin Bao Shu is below the fourth vertebra, Da Chang Shu below the sixteenth, Xiao Chang Shu below the eighteenth, Dan Shu below the tenth, Wei Shu below the twelfth, San Jiao Shu below the thirteenth, Pang Guang Shu below the nineteenth. These points are also three cun lateral to the spine, belonging to the Foot-Taiyang Bladder Meridian, all on the back.)
The response is: Yin diseases manifest on the Yang, and Yang diseases manifest on the Yin. Therefore, Mu points are placed on the Yin, and Shu points on the Yang. (This means Yin meridians originate on the abdomen, but their Shu points are on the back; Yang meridians originate on the back, but their Mu points are on the abdomen. This is because pathogenic Qi flows mutually, and meridians are interconnected, so places where Qi gathers and transforms intersect.)
Chapter 68 states: Zang and Fu organs all have Jing-Well, Ying-Spring, Shu-Stream, Jing-River, and He-Sea points. What do they each govern? (Asking what diseases these points treat upon needling.)
The response is: The classic text says what emerges is Jing-Well,
what flows is Ying-Spring, what pours into is Shu-Stream, what passes through is Jing-River, and what enters is He-Sea. (Emergence refers to the starting source. Flow refers to becoming abundant and mobile. Pouring into refers to the direction of flow. Passing through refers to thorough connection. Entering refers to storage and return. These five sentences originate from *Ling Shu: Jiu Zhen Shi Er Yuan*. In the classic text, "flow" is written as "liu", with the same meaning.) Jing-Well points govern fullness beneath the heart; Ying-Spring points govern body heat; Shu-Stream points govern heaviness of the body and joint pain; Jing-River points govern wheezing, coughing, and alternating chills and fever; He-Sea points govern rebellious Qi and diarrhea. (Inferring from the Five Element associations in Chapter 64, fullness beneath the heart is a Liver Wood disease, body heat is a Heart Fire disease, heaviness and joint pain are Spleen Earth diseases, wheezing/cough/chills-fever are Lung Metal diseases, and rebellious Qi/diarrhea are Kidney Water diseases. However, this discusses only one aspect. The methods for differentiating diseases and selecting points in the two classics are not limited to this; one must not adhere rigidly to one theory without flexibility.) These are the diseases governed by the Jing-Well, Ying-Spring, Shu-Stream, Jing-River, and He-Sea points of the Zang and Fu organs.
Chapter 69 states: The classic text says, "Tonify deficiency, sedate excess. If neither deficient nor excess, treat according to the meridian." What does this mean? (Deficiency refers to weak Qi and Blood. Excess refers to robust Qi and Blood. Tonifying involves using tonification needle techniques. Sedating involves using sedation needle techniques. This is detailed in *Su Wen: Li He Zhen Xie Lun* and other chapters. "Treat according to the meridian" means selecting appropriate acupoints along the affected meridian.)
The response is: Tonify the Mother point for deficiency, sedate the Child point for excess. One should tonify first, then sedate. (Mother refers to the meridian that generates me; e.g., if Liver is deficient, tonify the Kidney meridian. If Mother Qi is excess, generation is stronger. Child refers to the meridian I generate; e.g., if Liver is excess, sedate the Heart meridian. If Child Qi is weak, consumption of Mother Qi increases. See Chapter 75 below.) Neither deficient nor excess, (some versions read "neither deficient nor excess") treat according to the meridian means the primary meridian is sick itself, not invaded by external pathogens. One should take points from the meridian itself, hence "treat according to the meridian." (Primary meridian sickness, such as described in Chapter 49. Taking the meridian itself means selecting appropriate points on the original meridian, without needing to tonify Mother or sedate Child.)
Chapter 70 states: (Some versions have "The classic text says") Needling is shallow in Spring and Summer, and deep in Autumn and Winter. What does this mean? (*Ling Shu: Zhong Shi Pian* says: "Spring Qi is in the hairs, Summer Qi in the skin, Autumn Qi in the muscles/flesh, Winter Qi in the sinews and bones. To treat these diseases, align with the season." Although the two texts have differences, this is the general principle.)
The response is: In Spring and Summer, Yang Qi is superior, and Human Qi
is also superior, so one should needle superficially. In Autumn and Winter, Yang Qi is inferior, and Human Qi is also inferior, so one should needle deeply. (Yang Qi refers to Heaven and Earth Qi. Human Qi refers to Ying and Wei Qi. Superior refers to above the skin and flesh. Inferior refers to within the sinews and bones. Superficial and deep needling must hit the location of the disease to ensure recovery.) What does it mean to "attain one Yin in Spring and Summer, and one Yang in Autumn and Winter"? (Attain means to obtain, referring to using the needle to acquire Qi.)
The response is: Spring and Summer are warm. To attain one Yin, upon initial insertion, sink the needle to the level of the Kidney and Liver. Upon obtaining Deqi, draw and hold to acquire Yin Qi. (Warm refers to the warm season. When Yang is excess, Yin is insufficient, so Yin Qi is taken to supplement Yang. "Sink" means inserting the needle deeply to the Kidney/Liver sinew/bone level. "Draw" means drawing Qi out to the Yang portion.) Autumn and Winter are cold. To attain one Yang, upon initial insertion, float the needle superficially to the level of the Heart and Lungs. Upon obtaining Deqi, push inward to acquire Yang Qi. (Cold refers to the cold season. When Yin is excess, Yang is insufficient, so Yang Qi is taken to supplement Yin. "Float" means inserting the needle superficially to the Heart/Lung skin/blood level. "Push" means pushing Qi in to the Yin portion. This is the meaning of the classic text: "From Yin draw Yang, from Yang draw Yin.") This is called attaining one Yin in Spring and Summer, and one Yang in Autumn and Winter.
Chapter 71 states: The classic text says, "Needle Ying without injuring Wei, needle Wei without injuring Ying." What does this mean? (Ying governs Blood inside, Wei governs Qi outside. When Ying and Wei are diseased, they affect their respective locations; one must not punish the innocent. This aligns with *Su Wen: Ci Qi Lun*: "Needle bone without injuring sinew, sinew without injuring flesh, flesh without injuring vessels, vessels without injuring skin, skin without injuring flesh, flesh without injuring sinew, sinew without injuring bone.")
The response is: To needle Yang (Wei), lay the needle horizontally and insert. (Yang refers to Wei Qi. Wei is external; shallow needling is desired. By laying the needle horizontally, the tip reaches laterally, avoiding Ying.)
To needle Yin (Ying), first use the left hand to press and massage the Ying-Stream or Shu-Stream point. Once the Qi disperses, insert the needle. (Yin refers to Ying Qi. Ying is internal; the needle must pass through Wei to reach Ying. However, Wei belongs to Qi and can be dispersed. Pressing makes Wei Qi temporarily leave the area, allowing the needle to reach Ying directly without touching Wei.) This is called needling Ying without injuring Wei, and needling Wei without injuring Ying.
Chapter 72 states: The classic text says, "Knowing the Qi of Ying and Sui allows for regulation; the method of regulating Qi must lie in Yin and Yang." What does this mean? (*Ling Shu: Zhong Shi Pian* says: "Yang receives Qi from the extremities, Yin receives Qi from the Zang organs. Therefore, sedation follows Ying, tonification follows Sui. Knowing Ying and Sui, Qi can be harmonized. The method of harmonizing Qi must connect Yin and Yang." The citation originates here. Generally, Yang meridians govern the exterior, starting from extremities; Yin meridians govern the interior, starting from Zang organs. Ying means the needle tip meets the incoming Qi to drain it, hence sedation. Sui means the needle tip follows the outgoing Qi to support it, hence tonification. Connecting Yin and Yang means observing Yin/Yang deficiency/excess to avoid erroneous tonification/sedation. See Chapter 79.)
The response is: What is meant by Ying and Sui is knowing the circulation of Ying and Wei, and the flow of meridians. Following their counter-flow or順-flow to select points is called Ying and Sui. (Knowing the coming and going, counter and smooth flow is the true meaning of Ying and Sui in the classic text, which Yuèrén based his work on. Various interpretations are mistaken due to neglect of classical studies!)
The method of regulating Qi must lie in Yin and Yang means knowing the interior/exterior and surface/depth, and regulating according to Yin and Yang. Hence, the method of regulating Qi must lie in Yin and Yang. (Yang governs exterior/surface, Yin governs interior/depth. Observing deficiency/excess and applying tonification/sedation achieves harmony.)
Chapter 73 states: All Jing-Well points have thin muscle and little Qi, insufficient for manipulation. How should they be needled? (All Jing-Well points are at the tips of fingers/toes, hence thin muscle. Qi is stored in muscle; less muscle means weaker Qi. Insufficient for manipulation means tonification/sedation cannot be effectively applied.)
The response is: All Jing-Well points belong to Wood; Ying-Spring points belong to Fire. Fire is the Child of Wood. When needling a Jing-Well point,
sedate using the Ying-Spring point. (This is the method of sedating the Child. For tonification, one would tonify the He-Sea point, by analogy. This applies specifically to Jing-Well points because their Qi is too weak for direct tonification/sedation; sedating the Child and tonifying the Mother ensures Qi responds appropriately.)
Thus, the classic text says (or states) that tonification cannot be used as sedation, and sedation cannot be used as tonification. This is what is meant. (Meaning: for sedation, use the Child point; for tonification, use the Mother point. Do not misuse them.)
Chapter 74 states: The classic text says, "Spring needle Jing-Well, Summer needle Ying-Spring, Late Summer needle Shu-Stream, Autumn needle Jing-River, Winter needle He-Sea." What does this mean? (These five lines of the classic text cannot be verified.)
The response is: Spring needle Jing-Well because the pathogen is in the Liver; Summer needle Ying-Spring because the pathogen is in the Heart; Late Summer needle Shu-Stream because the pathogen is in the Spleen; Autumn needle Jing-River because the pathogen is in the Lung; Winter needle He-Sea because the pathogen is in the Kidney. (This is stated based on Zang organ associations. Jing-Well and Spring both belong to Wood; Ying-Spring and Summer both belong to Fire; Shu-Stream and Autumn both belong to Metal; He-Sea and Winter both belong to Water. Thus, when disease occurs in the four seasons, Zang Qi responds accordingly, so needling methods follow the season.)
Why are Liver, Heart, Spleen, Lung, and Kidney associated with Spring, Summer, Autumn, and Winter?
The response is: When a Zang organ is diseased, five manifestations appear. (Meaning five signs appear externally.)
For example, Liver disease: green color indicates Liver; musky odor indicates Liver; preference for sour taste indicates Liver; preference for shouting indicates Liver; preference for weeping indicates Liver. (Details in Chapter 49. This lists signs of Liver pathogen to exemplify the others.) Diseases are numerous and cannot be fully enumerated. (Meaning the variations of the five signs are endless.) The four seasons have fixed numbers and are linked to Spring, Summer, Autumn, and Winter. (Meaning although diseases vary infinitely, the four seasons have fixed patterns. Treatment methods do not exceed this; the way is simple and easy to practice.) The subtlety of needling lies in the finest details (autumn hair). (This further elaborates on the art of needling; its subtlety lies in minute details beyond just the seasons. Students must not forget difficulty because it seems easy.)
Chapter 75 states: The classic text says, "East is excess, West is deficiency. Sedate South, tonify North." What does this mean? (This is the method of sedating the Child from Chapter 69. South is the Child of East; North is the Child of West and Mother of East. Details below.)
The response is: Metal, Wood, Water, Fire, and Earth should balance each other. (Mutual balance means Metal controls Wood, Wood controls Earth, cycling to prevent any single Zang from becoming excessive and causing disease.) East is Wood, West is Metal. If Wood desires excess, Metal should balance it; if Fire desires excess, Water should balance it; if Earth desires excess, Wood should balance it; if Metal desires excess, Fire should balance it; if Water desires excess, Earth should balance it. (This describes the natural law of the Five Elements.) East is Liver, so Liver is excess; West is Lung, so Lung is deficiency. Sedate South Fire, tonify North Water. South Fire is the Child of Wood. (Sedate the Child when excess.) North Water is the Mother of Wood. Water overcomes Fire. (Mother overcomes Child.) The Child makes the Mother excess, and the Mother makes the Child deficient. (Fire, the Child of Wood, is controlled by Water, the Mother of Wood. Fire benefits Water's Qi, hence "Child makes Mother excess." Water controls Fire, depriving Fire of Qi, hence "Mother makes Child deficient.") Therefore, sedating Fire and tonifying Water aims to prevent Metal from balancing Wood. (If Child makes Mother excess, sedating the Child reduces Fire, allowing Water to dominate. If Mother makes Child deficient, tonifying the Mother strengthens Water, preventing Fire from retaining excess. Thus, Fire cannot control Metal, but instead relies on Wood for sustenance, allowing Metal Qi to expand and Wood to decline, so Metal naturally balances Wood. The character "not" is considered a superfluous character by most commentators.)