平按∶此篇自篇首至末，见《灵枢》卷十一第七十五《刺节真邪》篇。又自黄帝曰余闻刺有五
邪至真气
存，见《甲乙经》卷五第二。自请言解论至此所谓引而下之者也，见《甲乙经》卷七第三。自大
热偏身至所谓推而散之者也，见《甲乙经》卷七第二。自黄帝曰有一脉生数十病者至末，见《甲
乙经》卷十第一下编。惟自当是之时善行水者以下至末，袁刻及别抄本均缺，平从日本仁和寺宫
御所藏残卷十三纸中检出补入，经文杨注缺而复完，洵堪宝贵也。
黄帝曰∶余闻刺有五邪，何谓五邪？岐伯曰∶疾有时痈者，有容大者，有狭小者，有热者，
有寒者，是谓五邪。黄帝曰∶刺五邪奈何？岐伯曰∶凡刺五邪之方，不过五章，瘅热消灭，肿聚
散亡，寒痹益温，小者益阳，大者必去，请道其方。（五法须别为章也。瘅，热病也，音丹。平
按∶时痈《灵枢》、《甲乙》作持痈。有容大者，有狭小者，《甲乙》无容、狭二字。）凡刺痈
邪无迎陇，（陇，大盛也。痈之大盛将有脓，不可迎而泻之也。平按∶无迎陇上《甲乙》有用铍
针三字。）易俗移性不得脓，诡道更行，行去其乡，不安其处所乃散亡。（易其常行法度之俗，
移其先有寒温之性，更量脓之所在，上下正旁，以得为限，故曰去其乡，不安于处一，病乃散亡
也。平按∶诡《灵枢》作脆，《甲乙》作越。行字《灵枢》、《甲乙》不重。处所，处字袁刻脱。
注处一恐是一处传写之误。）诸阴阳过痈所者，取之其输泻之。（诸阴阳之脉过痈所者，可取痈
之所由之输泻之也。平按∶过《甲乙》作遇，《灵枢》痈下无所字。）凡刺大邪，曰以小泄，夺
有余，乃益虚， 其道，针干其邪肌肉亲，（大邪者，实邪也，行泻为易，故小泄之，益虚取和
也。于针之道，
战谨肃，以针干邪，使邪气得去。肌肉相附也。亲，附也。平按∶大邪下《甲乙》有用锋针三
字。《灵枢》 其道作剽其通。《甲乙》 作标。《灵枢》、《甲乙》无干字，袁刻干作于，注同。）
视之无有反其真。（视邪气无有，反其真气乃止也。平按∶反其真《甲乙》作乃自真道四字。）
刺诸阳分肉间。（刺大邪所在也。）凡刺小邪曰以大，补其不足乃无害，（小邪，虚邪也，行补
为难也，故曰大补，使其实也。平按∶小邪下《甲乙》有用员针三字，补下有益字。）视其所在
迎之界，远近尽至不得外，（界，畔际也。视虚实畔界，量真气远近，须引至虚中令实，不得外
而不至也。平按∶注须下原不缺，袁刻误空四格。）侵而行之乃自费。（侵，过也。补须实，知
即止，补过即损正气。费，损也。平按∶费《甲乙》作贵，注云∶一作费。）刺分肉之间也。（刺
小邪所在也。）凡刺热邪越而沧，出游不归乃无病，为开道乎，（刺热之道，泻越走气，□觉沧
然，热气不归，病则愈也。平按∶热邪下《甲乙》有用 针三字。沧《灵枢》作苍，开道作开通。
注走气，袁刻缺走字。觉上原缺一字，谨拟作便。）辟门户，使邪得出疾乃已。（辟，开也。平
按∶辟《甲乙》作 。）凡刺寒邪日以温，徐往疾去致其神，门户已闭气不分，虚实得调真气存。
（刺寒之道，日日使温，徐往而入，得温气已，去疾而出针，以致神气为意也。平按∶寒邪下《甲
乙》有用豪针三字，疾去《灵枢》作徐来。）黄帝曰∶官针奈何？岐伯曰∶刺痈者用铍针，刺大
者用锋针，刺小者用员利针，刺热者用 针，刺寒者用豪针。（刺五邪者，九针之中，用此五针，
是所宜也。平按∶《甲乙》无此一段。）
请言解论，与天地相应，四时相副，人参天地，故可为解。（人法天地，故可为解。人应天
地之
数，故请言之。）下有渐洳，上生苇蒲，此所以知形气之多少也。（洳，汝据反。渐洳，润湿之
气也。见苇蒲之茂悴，知渐洳之多少；观人形之强弱，识血气之盛衰。）阴阳者，寒暑也，热则滋
而在上，根 少汁。人气在外，皮肤缓，腠理开，血气泄，汗大泄，肉淖泽。（春夏，阳而暑也，
草木阳气，滋其枝叶，根茎少汁也。 ，茎也。有本 为叶者，非也。人亦如之，气溢于外，皮
腠开凑，大汗泄出，血气内竭。平按∶《灵枢》、《甲乙》滋下有雨字。 《甲乙》作茎，注云∶
《灵枢》作 。）寒则地冻水冰，人气在中，皮肤致，腠理闭，汗不出，血气强，肉坚涩。（秋冬，
阴而寒也，阳气下降，寒气在地，地冻水冰，人气亦然，暖气入脏，阴气在于皮肤，故腠理闭塞，
血□□□肉坚涩也。平按∶以下从残篇中检出补入。）当是之时，善行水者，不能往冰；善穿地
者，不能凿冻；善用针者，亦不能取四厥；而脉 结坚搏不往来者，亦未可即柔。（水之性流，
故谓之往，言水可往而冰不可流。人之在冬□□冷脉□肉□故不行针也□之凿者发寒之□□□而
针伤肌破肉，更增他病，可不哀欤！四厥四肢□冬也。平按∶穿地《甲乙》作穷地，四厥作四逆。
而脉 结《灵枢》、《甲乙》作血脉凝结。《甲乙》未可作不可。）故行水者，必待天温冰释冻
解，而水可行，地可穿也。人脉犹是也，治厥者，必先熨调和其经，常与腋、肘与脚、项与脊以
调之，火气通，血脉乃行，然后视其病，脉淖泽者刺而平之，（若行水穿地者，必待春夏也。冬
月用针者，须姜椒桂酒之巾，熨令经脉淖泽调适，然后可行针。凡两掌、两腋、两肘、两脚 膝、
项之与脊、□之□□经脉所行要处，熨通脉道也。平按∶《甲乙》冻解上有穷地者必待五字，而
字下无水可行三字，穿作穷，熨下有火以二字。常《灵枢》、《甲乙》作掌，据本注亦宜作掌，恐
传抄之
误。以调之《甲乙》作以调其气。火气通《灵枢》作火气已通，《甲乙》作大道已通。）坚紧者破
而散之，气下乃止，此所以解结者也。（病之坚紧，因适破散□□□□因□□经。平按∶散之《甲
乙》作决之。）用针之类，在于调气，（气之不调则病，故疗病者在于调气也。）气积于胃，以通
营卫，各行其道。（胃受水谷，以生于气，故水谷之气积于此也。卫气起胃之□□，营气起于胃
之内口，营行于脉中，卫行脉外，今用针调于胃气，通于营卫，使各行其道也。）宗气留于海，其
下者注于气街，（谷入于胃，其气清者上注于肺，浊者下流于胃，胃之气上出于口，以为噫气，
肺之宗气留积气海，乃胸间动气也。动气下者，注于气街，生肺脉者也。平按∶《甲乙》留于海
作留积在海。）其上者走于息道。（肺之清气积于海者，走于息道，以为呼吸也。平按∶《甲乙》
作上行者注于息道。）故厥在于足，宗气不下，脉中之血 而止，弗之火调，弗能取之。（厥，
谓逆冷。胸之动气，不循脉行下至于足，故曰 而止也。冬日不用火调，不可取也。平按∶ 而
止《灵枢》、《甲乙》作凝而留止。《甲乙》弗能取之作针弗能取。）用针者，必先察其经络之实
虚，切如循之，按而弹之，视其变动者，乃后取而下之。（用针之法，必先察经络虚实，实则切循
其脉，虎则按其所针之处，以手弹之，视其变动，然后取而下之也。平按∶切如循之《灵枢》、
《甲乙》作切而循之。变动《灵枢》、《甲乙》作应动。取下《灵枢》有之字。）六经调者，谓之
不病，虽病，谓之自已也。（三阳三阴六经相得，不可有病，虽客邪为病，必当自已也。）一经上
实下虚而不通者，此必有横络盛加于大经，令之不通，视而泻之，此所谓解结者也。（一经，十二
经中随是何经也。大经随身上下，故为从也。络脉旁引，故为横也。正经上实下虚者，必是横络
受邪，盛加大经以为病者，必视泻之，故为解结也。平按∶《甲乙》泻之下有通而决之四字。）
上寒下热，先刺其项太阳，久留之已，则熨项与肩胛，令热下合乃止，所谓推而上之者也。（上
寒，腰以上寒。下热，腰以下热。项太阳之太阳脉也。久留针者，推别热而使之上也。热既聚于
肩项，须令和之，故熨使下也。推热令上，故曰推而上之也。平按∶已则熨《灵枢》作已刺则熨，
《甲乙》作已刺则火熨。下合，合字《甲乙》注云∶一本作冷。）上热下寒，视其虚脉而陷下于
经络者取之，气下乃止，此所谓引而下之者也。（腰以上热，腰以下冷，视腰以下有虚脉陷于余
经及络者，久留针使气下乃止，故曰引而下之者也。平按∶陷下《灵枢》作陷之。）大热遍身，
狂而妄见妄闻妄言，视足阳明及大络取之，（足阳明主气，其气强盛，狂妄见闻及妄言多因此脉，
故取阳明正经及络以去之也。平按∶狂而妄见妄闻妄言《甲乙》作故狂言而妄见妄闻。）虚者补
之，血实者泻之，因令偃卧，居其头前，以两手四指侠按颈动脉久持之，卷而切推，下至缺盆中，
复上如前，热去乃止，所谓推而散之者也。（□足阳明上实下虚为狂等病□补下虚经也。上之血
络盛而实者，可刺去血以泻之。因令偃卧，以手按人迎之脉□下至缺盆中，复上来去，使热气泄
尽，乃可休止，故曰推而散之也。有本为腹上如前，恐错也。平按∶血实者《灵枢》作血而实者，
《甲乙》作血如实者。因令偃卧《灵枢》作因其偃卧。侠按颈动脉，《灵枢》侠作挟，《甲乙》
作按其颈动脉。复上《灵枢》、《甲乙》作复止。）黄帝曰∶有一脉生数十病者，或痛、或痈、或
寒热、或痒痹、或不仁，变化无穷，其故何也？岐伯曰∶此皆邪气之所生也。（上经十二
经脉，生病各异。此言一脉生数十种病，变化无穷者，十二经生病，非无有□至于变化，亦不可
穷，故欲取者，甚须审察，不可轻然以定是非也。平按∶《灵枢》或寒热作或寒或热，或痒痹作
或痒或痹。）
【平按说明】：本篇从篇首至结尾，见于《灵枢》卷十一第七十五《刺节真邪》篇。另外，从“黄帝曰：余闻刺有五邪”至“真气存”，见于《甲乙经》卷五第二。从“请言解论”至此所谓“引而下之者也”，见于《甲乙经》卷七第三。从“大热偏身”至“所谓推而散之者也”，见于《甲乙经》卷七第二。从“黄帝曰：有一脉生数十病者”至结尾，见于《甲乙经》卷十第一下编。唯独从“当是之时善行水者”以下至结尾，袁刻本及其他抄本均缺失，此处根据日本仁和寺宫御所藏残卷十三纸中检出并补入，经文及杨上善的注释缺而复全，确实非常宝贵。
黄帝说：我听说针刺有五种邪气（指痈、容大、狭小、热、寒五种不同性质的病邪），什么是这五种邪气？岐伯说：有病势急迫且形成痈肿的，有邪气盛实体积扩大的，有邪气微弱体积缩小的，有热邪盛的，有寒邪盛的，这就叫做五种邪气。黄帝说：针刺这五种邪气该怎么办？岐伯说：凡是针刺五种邪气的方法，不过分为五个章节：瘅热（高热）得以消除，肿聚消散灭亡，寒痹得到温通，狭小者阳气得以增益，盛大者邪气必然去除，请让我阐述这些方法。（这五种方法需要分别作为章节。瘅，是热病，读音为丹。平按：时痈在《灵枢》、《甲乙经》中作持痈。有容大者，有狭小者，《甲乙经》中没有“容”、“狭”二字。）
凡针刺痈邪，不要迎着其气血大盛之处（陇，指大盛；痈肿大盛即将化脓，不可迎头泻之），要改变常规做法以移易其性质，使其不得成脓，采用诡道更行，离开其所在的部位，使其不安于原处从而消散灭亡。（改变其常行的法度习俗，移易其先有的寒温性质，重新衡量脓液所在，上下正旁，以得位为限，所以说离开其乡，不安于原处，病乃消散灭亡。平按：诡字在《灵枢》作脆，《甲乙经》作越。行字在《灵枢》、《甲乙经》不重复。处所，处字袁刻脱漏。注中的“处一”恐是“一处”传写之误。）凡是阴阳经脉经过痈所的地方，取其输穴进行泻法。（凡是阴阳之脉经过痈所者，可取痈之所由之输穴进行泻法。平按：过字在《甲乙经》作遇，《灵枢》痈下无“所”字。）
凡针刺大邪（实邪），用小泄法，夺其有余，使之益虚，掌握针道，使针干犯邪气而肌肉相亲附。（大邪是实邪，施行泻法容易，所以用小泄法，使之益虚以求和。对于针道，战谨肃穆，用针干犯邪气，使邪气得去，肌肉相附。亲，即附。平按：大邪下《甲乙经》有用锋针三字。《灵枢》中“其道”作剽其通。《甲乙经》中某字作标。《灵枢》、《甲乙经》无干字，袁刻干作于，注同。）视之若无邪气，反归其真气乃止。（视邪气无有，反其真气乃止。平按：反其真在《甲乙经》作乃自真道四字。）针刺诸阳分肉之间。（针刺大邪所在处。）
凡针刺小邪（虚邪），用大补法，补其不足乃无害。（小邪是虚邪，施行补法为难，所以说大补，使其充实。平按：小邪下《甲乙经》有用员利针三字，补下有益字。）观察其所在，迎其边界，远近之气尽至而不外泄，（界，即畔际。视虚实边界，量真气远近，须引至虚中令实，不得外而不至也。平按：注中须下原不缺，袁刻误空四格。）侵而过之就会自我损耗。（侵，过也。补须实，知即止，补过即损正气。费，损也。平按：费在《甲乙经》作贵，注云：一作费。）针刺分肉之间。（针刺小邪所在处。）
凡针刺热邪，用越而沧法，使热气出游不归乃无病，为之开通道路，（刺热之道，泻越走气，便觉沧然，热气不归，病则愈也。平按：热邪下《甲乙经》有用铍针三字。沧在《灵枢》作苍，开道作开通。注走气，袁刻缺走字。觉上原缺一字，谨拟作便。）辟开门户，使邪得出疾乃已。（辟，开也。平按：辟在《甲乙经》作某字。）
凡针刺寒邪，日以温法，徐往疾去致其神，门户已闭气不分，虚实得调真气存。（刺寒之道，日日使温，徐往而入，得温气已，去疾而出针，以致神气为意也。平按：寒邪下《甲乙经》有用豪针三字，疾去《灵枢》作徐来。）
黄帝说：官针（九针）如何使用？岐伯说：刺痈者用铍针，刺大者用锋针，刺小者用员利针，刺热者用铍针（原文缺字，据上下文推测或为特定针具，此处依原文留白或通用理解），刺寒者用豪针。（刺五邪者，九针之中，用此五针，是所宜也。平按：《甲乙经》无此一段。）
请让我解释论述，这与天地相应，与四时相副，人参赞天地，所以可以解释。（人法天地，故可为解。人应天地之数，故请言之。）下有渐洳（润湿之气），上生苇蒲，这是用来知道形气多少的道理。（洳，汝据反。渐洳，润湿之气也。见苇蒲之茂悴，知渐洳之多少；观人形之强弱，识血气之盛衰。）
阴阳对应寒暑。热则滋长在上，根茎少汁。人气在外，皮肤缓，腠理开，血气泄，汗大泄，肉淖泽。（春夏，阳而暑也，草木阳气，滋其枝叶，根茎少汁也。茎也。有本茎为叶者，非也。人亦如之，气溢于外，皮腠开凑，大汗泄出，血气内竭。平按：《灵枢》、《甲乙经》滋下有雨字。茎在《甲乙经》作茎，注云：《灵枢》作某字。）
寒则地冻水冰，人气在中，皮肤致，腠理闭，汗不出，血气强，肉坚涩。（秋冬，阴而寒也，阳气下降，寒气在地，地冻水冰，人气亦然，暖气入脏，阴气在于皮肤，故腠理闭塞，血气...肉坚涩也。平按：以下从残篇中检出补入。）
当是之时，善于行水的人，不能前往流冰；善于穿地的人，不能凿开冻土；善于用针的人，也不能取治四肢厥逆；而血脉凝结坚固搏动不往来者，也不可立即使其柔顺。（水之性流，故谓之往，言水可往而冰不可流。人之在冬...冷脉...肉...故不行针也...之凿者发寒之...而针伤肌破肉，更增他病，可不哀欤！四厥四肢...冬也。平按：穿地在《甲乙经》作穷地，四厥作四逆。而脉凝结在《灵枢》、《甲乙经》作血脉凝结。《甲乙经》未可做不可。）
所以行水者，必须等待天温冰释冻解，而水可行，地可穿也。人脉犹是如此，治疗厥逆者，必须先熨烫调和其经脉，常与腋、肘与脚、项与脊以调之，火气通，血脉乃行，然后视其病，脉淖泽者刺而平之，（若行水穿地者，必待春夏也。冬月用针者，须姜椒桂酒之巾，熨令经脉淖泽调适，然后可行针。凡两掌、两腋、两肘、两脚膝、项之与脊、...之...经脉所行要处，熨通脉道也。平按：《甲乙经》冻解上有穷地者必待五字，而字下无水可行三字，穿作穷，熨下有火以二字。常在《灵枢》、《甲乙经》作掌，据本注亦宜作掌，恐传抄之误。以调之在《甲乙经》作以调其气。火气通在《灵枢》作火气已通，《甲乙经》作大道已通。）坚紧者破而散之，气下乃止，这就是所谓的解结。（病之坚紧，因适破散...因...经。平按：散之在《甲乙经》作决之。）
用针之类，在于调气，（气之不调则病，故疗病者在于调气也。）气积于胃，以通营卫，各行其道。（胃受水谷，以生于气，故水谷之气积于此也。卫气起胃之...，营气起于胃之内口，营行于脉中，卫行脉外，今用针调于胃气，通于营卫，使各行其道也。）宗气留于海，其下者注于气街，（谷入于胃，其气清者上注于肺，浊者下流于胃，胃之气上出于口，以为噫气，肺之宗气留积气海，乃胸间动气也。动气下者，注于气街，生肺脉者也。平按：《甲乙经》留于海作留积在海。）其上者走于息道。（肺之清气积于海者，走于息道，以为呼吸也。平按：《甲乙经》作上行者注于息道。）
故厥在于足，宗气不下，脉中之血凝而止，弗之火调，弗能取之。（厥，谓逆冷。胸之动气，不循脉行下至于足，故曰凝而止也。冬日不用火调，不可取也。平按：凝而止在《灵枢》、《甲乙经》作凝而留止。《甲乙经》弗能取之作针弗能取。）
用针者，必先察其经络之虚实，切而循之，按而弹之，视其变动者，乃后取而下之。（用针之法，必先察经络虚实，实则切循其脉，虎则按其所针之处，以手弹之，视其变动，然后取而下之也。平按：切而循之在《灵枢》、《甲乙经》作切而循之。变动在《灵枢》、《甲乙经》作应动。取下在《灵枢》有之字。）
六经调者，叫作不病，虽病，叫作自已也。（三阳三阴六经相得，不可有病，虽客邪为病，必当自已也。）一经上实下虚而不通者，此必有横络盛加于大经，令之不通，视而泻之，此所谓解结者也。（一经，十二经中随是何经也。大经随身上下，故为从也。络脉旁引，故为横也。正经上实下虚者，必是横络受邪，盛加大经以为病者，必视泻之，故为解结也。平按：《甲乙经》泻之下有通而决之四字。）
上寒下热，先刺其项太阳，久留之已，则熨项与肩胛，令热下合乃止，所谓推而上之者也。（上寒，腰以上寒。下热，腰以下热。项太阳之太阳脉也。久留针者，推别热而使之上也。热既聚于肩项，须令和之，故熨使下也。推热令上，故曰推而上之也。平按：已则熨在《灵枢》作已刺则熨，《甲乙经》作已刺则火熨。下合，合字在《甲乙经》注云：一本作冷。）
上热下寒，视其虚脉而陷下于经络者取之，气下乃止，此所谓引而下之者也。（腰以上热，腰以下冷，视腰以下有虚脉陷于余经及络者，久留针使气下乃止，故曰引而下之者也。平按：陷下在《灵枢》作陷之。）
大热遍身，狂而妄见妄闻妄言，视足阳明及大络取之，（足阳明主气，其气强盛，狂妄见闻及妄言多因此脉，故取阳明正经及络以去之也。平按：狂而妄见妄闻妄言在《甲乙经》作故狂言而妄见妄闻。）虚者补之，血实者泻之，因令偃卧，居其头前，以两手四指侠按颈动脉久持之，卷而切推，下至缺盆中，复上如前，热去乃止，所谓推而散之者也。（...足阳明上实下虚为狂等病...补下虚经也。上之血络盛而实者，可刺去血以泻之。因令偃卧，以手按人迎之脉...下至缺盆中，复上来去，使热气泄尽，乃可休止，故曰推而散之也。有本为腹上如前，恐错也。平按：血实者在《灵枢》作血而实者，《甲乙经》作血如实者。因令偃卧在《灵枢》作因其偃卧。侠按颈动脉，《灵枢》侠作挟，《甲乙经》作按其颈动脉。复上在《灵枢》、《甲乙经》作复止。）
黄帝说：有一脉生数十病者，或痛、或痈、或寒热、或痒痹、或不仁，变化无穷，其故何也？岐伯说：此皆邪气之所生也。（上经十二经脉，生病各异。此言一脉生数十种病，变化无穷者，十二经生病，非无有...至于变化，亦不可穷，故欲取者，甚须审察，不可轻然以定是非也。平按：《灵枢》或寒热作或寒或热，或痒痹作或痒或痹。）
[Ping An Note]: This chapter, from the beginning to the end, is found in *Ling Shu* (Spiritual Pivot), Volume 11, Chapter 75, "Needling of Joint True Evil". Additionally, from "Huang Di said: I have heard that needling involves five types of evil" to "true qi remains", it is found in *Jia Yi Jing* (Classified Classic of Acupuncture and Moxibustion), Volume 5, Section 2. From "Please allow me to explain and discuss" to "this is what is called leading it downwards", it is found in *Jia Yi Jing*, Volume 7, Section 3. From "Great heat pervading the body" to "this is what is called pushing and dispersing it", it is found in *Jia Yi Jing*, Volume 7, Section 2. From "Huang Di said: When one meridian gives rise to dozens of diseases" to the end, it is found in *Jia Yi Jing*, Volume 10, First Lower Compilation. Only from "At that time, those skilled in moving water" onwards to the end were missing in Yuan's edition and other manuscript copies. Here, they have been retrieved and supplemented from thirteen sheets of a fragmentary volume collected from the Imperial Palace of Reika-ji Temple in Japan. The original text and Yang Shangshan's annotations are complete again, which is truly precious.
Huang Di said: I have heard that needling addresses five types of evil (referring to five different natures of pathogenic factors: carbuncle, excessive enlargement, narrowing/shrinking, heat, and cold). What are these five types of evil? Qi Bo said: There are cases where the disease progresses rapidly and forms a carbuncle (Yong); there are cases where the pathogen is excessive and voluminous; there are cases where the pathogen is slight and contracted; there are cases dominated by Heat Evil; and there are cases dominated by Cold Evil. These are called the five types of evil. Huang Di said: How should one needle these five types of evil? Qi Bo said: The methods for needling the five types of evil can be divided into five chapters: Duan Re (severe heat) is eliminated, swelling and accumulation dissipate, Cold Bi (Cold obstruction) is warmed, the contracted type benefits from increased Yang, and the excessive type has its excess removed. Please allow me to elaborate on these methods. (These five methods must be treated as separate chapters. Duan refers to a heat disease, pronounced 'Dan'. Ping An: In *Ling Shu* and *Jia Yi Jing*, "Shi Yong" is written as "Chi Yong". In *Jia Yi Jing*, the characters "Rong" and "Xia" are absent in "You Rong Da Zhe" and "You Xia Xiao Zhe".)
When needling Carbuncle Evil, do not attack against its peak of Qi and Blood abundance (Long, meaning great abundance; when a carbuncle is at its peak and about to suppurate, one must not attack directly to drain it). One must change conventional practices to alter its nature, preventing suppuration, employing unorthodox methods, moving away from its location, making it unstable in its place so that it dissipates. (Change its customary laws and habits, alter its inherent cold-warm nature, re-evaluate the location of pus, adjusting up-down and center-periphery until the correct position is found. Thus it is said to leave its locality and become unstable in its place, causing the disease to dissipate. Ping An: The character "Gui" is written as "Cui" in *Ling Shu* and "Yue" in *Jia Yi Jing*. The character "Xing" is not repeated in *Ling Shu* and *Jia Yi Jing*. The character "Chu" is missing in Yuan's edition. The note "Chu Yi" is likely a scribal error for "Yi Chu".) For all Yin and Yang meridians passing through the site of the carbuncle, select the Shu (Stream) points and apply draining methods. (For all Yin and Yang meridians passing through the carbuncle site, one may select the Shu points associated with the carbuncle's pathway and drain them. Ping An: "Guo" is written as "Yu" in *Jia Yi Jing*. The character "Suo" is missing after "Yong" in *Ling Shu*.)
When needling Excessive Evil (Excess Pathogen), use minor draining techniques to reduce the excess, thereby benefiting the deficiency and restoring harmony. Master the technique of the needle to interact with the pathogen while keeping the muscle tissue close. (Excessive Evil is an Excess Pathogen; applying draining methods is easier, hence minor draining is used to reduce excess and restore harmony. Regarding needle technique, one must be cautious and solemn, using the needle to address the pathogen so that the pathogen leaves and the muscles adhere. "Qin" means adherence. Ping An: After "Da Xie", *Jia Yi Jing* adds "use Feng Zhen (Sharp Needle)". In *Ling Shu*, "Qi Dao" is written as "Piao Qi Tong". In *Jia Yi Jing*, a certain character is written as "Biao". *Ling Shu* and *Jia Yi Jing* lack the character "Gan"; Yuan's edition writes it as "Yu", consistent with the note.) Observe until no pathogen remains, then return to the true Qi and stop. (Observe that the pathogen is gone, and only when the true Qi returns should one stop. Ping An: "Fan Qi Zhen" is written as "Nai Zi Zhen Dao" in *Jia Yi Jing*.) Needle between the muscles of the Yang meridians. (This needles the location of the Excessive Evil.)
When needling Contracted Evil (Deficiency Pathogen), use major tonifying methods to supplement the deficiency, ensuring no harm. (Contracted Evil is a Deficiency Pathogen; applying tonifying methods is difficult, hence major tonification is used to make it substantial. Ping An: After "Xiao Xie", *Jia Yi Jing* adds "use Yuan Li Zhen (Round-Blunt Needle)". After "Bu", *Jia Yi Jing* adds "Yi".) Observe its location and meet its boundary; draw Qi from near and far until full, without allowing leakage outward. (Boundary refers to the edge. Observe the boundary of deficiency and excess, measure the distance of true Qi, and must guide it to the deficient area to make it substantial, preventing outward leakage. Ping An: The note originally lacked "Xu", but Yuan's edition mistakenly left four spaces blank.) If one invades beyond this point, it will self-damage. (Invade means exceeding limits. Tonification must be sufficient; stop when achieved. Over-tonification damages Zheng Qi. "Fei" means damage. Ping An: "Fei" is written as "Gui" in *Jia Yi Jing*, with the note saying: alternatively "Fei".) Needle between the muscles. (This needles the location of the Contracted Evil.)
When needling Heat Evil, use the "Yue Er Cang" method, allowing the heat to travel out and not return, resulting in no disease. Open the pathways for it. (The method for treating heat is to drain and let the Qi escape, feeling cool, so the heat does not return, and the disease heals. Ping An: After "Re Xie", *Jia Yi Jing* adds "use Pi Zhen (Needle-like Knife)". "Cang" is written as "Cang" in *Ling Shu*; "Kai Dao" is written as "Kai Tong". The note lacks "Zou"; Yuan's edition omits "Zou". One character was missing before "Jue", tentatively supplied as "Bian".) Open the gates, allowing the pathogen to exit quickly, and the disease ceases. ("Pi" means open. Ping An: "Pi" is written as a specific character in *Jia Yi Jing*.)
When needling Cold Evil, use daily warming methods. Enter slowly and withdraw quickly to preserve Shen (Spirit). Close the gates so Qi does not scatter, harmonizing deficiency and excess so true qi remains. (The method for treating cold is to warm daily, enter slowly, and once warmth is achieved, withdraw quickly to preserve Shen Qi. Ping An: After "Han Xie", *Jia Yi Jing* adds "use Hao Zhen (Horse Needle)". "Ji Qu" is written as "Xu Lai" in *Ling Shu*.)
Huang Di said: How are the Official Needles (Nine Needles) used? Qi Bo said: For carbuncles, use the Pi Zhen (Needle-like Knife); for excessive conditions, use the Feng Zhen (Sharp Needle); for contracted conditions, use the Yuan Li Zhen (Round-Blunt Needle); for heat conditions, use [missing character, likely a specific needle]; for cold conditions, use the Hao Zhen (Horse Needle). (Among the Nine Needles, using these five for the five evils is appropriate. Ping An: *Jia Yi Jing* lacks this paragraph.)
Please allow me to explain and discuss. This corresponds to Heaven and Earth, parallels the Four Seasons, and humans participate in Heaven and Earth, thus explanations are possible. (Humans follow Heaven and Earth, thus explanations are possible. Humans correspond to the numbers of Heaven and Earth, thus I ask to explain.) Where there is dampness below, reeds and rushes grow above; this indicates how to know the degree of Form and Qi. (Ru, pronounced 'Ru Ju'. Jian Ru refers to moist air. Observing the lushness or withering of reeds and rushes reveals the degree of moisture; observing the strength or weakness of human form reveals the prosperity or decline of Blood and Qi.)
Yin and Yang correspond to Cold and Heat. In heat, growth occurs upwards, and roots/stems have little juice. Human Qi moves outward; skin relaxes, pores open, Blood and Qi leak, sweat pours heavily, and flesh becomes soft and glossy. (Spring and Summer are Yang and Hot. Plant Yang Qi nourishes branches and leaves, leaving stems and roots with little juice. 'Jing' means stem. Some interpret root-stem as leaf, which is incorrect. Similarly in humans, Qi overflows outward, skin and pores open, heavy sweat is excreted, and internal Blood and Qi are depleted. Ping An: *Ling Shu* and *Jia Yi Jing* add "Yu" after "Zi". 'Jing' is written as 'Jing' in *Jia Yi Jing*, noting *Ling Shu* uses a different character.)
In cold, the ground freezes and water turns to ice. Human Qi moves inward; skin tightens, pores close, sweat does not appear, Blood and Qi become strong, and flesh becomes firm and dry. (Autumn and Winter are Yin and Cold. Yang Qi descends, Cold Qi stays on the ground. Ground freezes, water turns to ice; human Qi behaves similarly. Warm Qi enters the Zang organs, Yin Qi remains in the skin, so pores close, Blood... Qi... flesh becomes firm and dry. Ping An: The following section was retrieved and supplemented from a fragment.)
At that time, those skilled in moving water cannot flow over ice; those skilled in digging earth cannot drill frozen soil; those skilled in needling also cannot treat Si Jue (Four Extremities Cold); and if the vessels are knotted, firm, and pulsating without flow, they cannot immediately be made soft. (Water flows, hence 'moving'; water can move but ice cannot flow. In winter... cold pulse... flesh... thus needling is not performed... drilling causes cold to emerge... needling injures muscle and breaks flesh, adding other diseases, is this not sad! Si Jue refers to the four limbs... in winter. Ping An: "Chuan Di" is written as "Qiong Di" in *Jia Yi Jing*; "Si Jue" is written as "Si Ni". "Er Mai Ning Jie" is written as "Xue Mai Ning Jie" in *Ling Shu* and *Jia Yi Jing*. *Jia Yi Jing* writes "Wei Ke" as "Bu Ke".)
Therefore, those who move water must wait for warm weather, melting ice and thawing frost, so water can flow and earth can be dug. Human vessels are similar. To treat Jue, one must first moxa/heat-compress to harmonize the meridians, often treating the armpits, elbows, feet, neck, and spine to regulate them. Once Fire Qi passes and blood vessels flow, then observe the disease. If vessels are soft and glossy, needle to level them. (If moving water or digging earth, one must wait for Spring and Summer. In winter, if needling is necessary, use cloths soaked in ginger, pepper, cinnamon, and wine to heat-compress the meridians until they are soft and harmonious, then proceed. Key areas for heat-compression include both palms, armpits, elbows, knees, neck, spine, and other important meridian pathways. Ping An: *Jia Yi Jing* adds "Qiong Di Zhe Bi Dai" before "Dong Jie"; removes "Shui Ke Xing" after "Er"; writes "Chuan" as "Qiong"; adds "Huo Yi" after "Yu". "Chang" is written as "Zhang" in *Ling Shu* and *Jia Yi Jing*; based on the note, it should be "Zhang", likely a copying error. "Yi Tiao Zhi" is written as "Yi Tiao Qi" in *Jia Yi Jing*. "Huo Qi Tong" is written as "Huo Qi Yi Tong" in *Ling Shu* and "Da Dao Yi Tong" in *Jia Yi Jing*.) If firm and tight, break and disperse them. Stop when Qi descends; this is called resolving knots. (Disease firmness and tightness are due to... break and disperse... due to... meridian. Ping An: "San Zhi" is written as "Jue Zhi" in *Jia Yi Jing*.)
The essence of needling lies in regulating Qi. (If Qi is not regulated, disease arises; thus treatment lies in regulating Qi.) Qi accumulates in the Stomach to connect Ying (Nutrient) and Wei (Defensive) Qi, each following its own path. (Stomach receives water and grain, generating Qi, so water-grain Qi accumulates here. Wei Qi originates from... of the Stomach; Ying Qi originates from the inner opening of the Stomach. Ying circulates within the vessels, Wei circulates outside. Now, using needling to regulate Stomach Qi connects Ying and Wei, allowing each to follow its path.) Zong Qi (Gathering Qi) remains in the Sea (Chest). Its lower part flows into the Qi Street (Qichong). (Grain enters the Stomach; clear Qi ascends to the Lungs, turbid Qi flows down to the Stomach. Stomach Qi exits via the mouth as belching. Lung Zong Qi accumulates in the Qi Sea, which is the pulsating Qi in the chest. The descending pulsating Qi flows into the Qi Street, generating Lung vessels. Ping An: *Jia Yi Jing* writes "Liu Yu Hai" as "Liu Ji Zai Hai".) Its upper part travels to the Xi Dao (Respiratory Pathway). (Clear Qi of the Lungs accumulated in the Sea travels to the Respiratory Pathway for breathing. Ping An: *Jia Yi Jing* writes "Shang Xing Zhe Zhu Yu Xi Dao".)
Thus, if Jue is in the feet, Zong Qi does not descend, and Blood in the vessels coagulates and stops. Without Fire regulation, it cannot be treated. (Jue means cold extremities. Chest pulsating Qi does not circulate down to the feet via vessels, hence it coagulates and stops. In winter, without Fire regulation, one cannot needle. Ping An: "Ning Er Zhi" is written as "Ning Er Liu Zhi" in *Ling Shu* and *Jia Yi Jing*. *Jia Yi Jing* writes "Fu Neng Qu Zhi" as "Zhen Fu Neng Qu".)
One who needsles must first examine the deficiency and excess of the meridians, palpate and trace them, press and flick them, observe changes, and only then needle to drain. (The method of needling requires first examining meridian deficiency/excess. If excess, palpate and trace the pulse; if deficiency, press the needling site and flick with fingers, observe changes, then needle to drain. Ping An: "Qie Ru Xun Zhi" is written as "Qie Er Xun Zhi" in *Ling Shu* and *Jia Yi Jing*. "Bian Dong" is written as "Ying Dong" in *Ling Shu* and *Jia Yi Jing*. *Ling Shu* adds "Zhi" after "Qu Xia".)
If the Six Meridians are harmonious, it is called no disease. Even if diseased, it is called self-healing. (Three Yang and Three Yin Six Meridians are compatible; disease cannot arise. Even if external pathogens cause disease, it must self-heal.) If one meridian has excess above and deficiency below without connection, there must be transverse collaterals (Heng Luo) that are excessive and obstructing the main meridian, causing blockage. Observe and drain them; this is called resolving knots. (One meridian refers to any of the Twelve Meridians. Main meridians run up and down the body, hence "longitudinal". Collaterals branch sideways, hence "transverse". If the main meridian has excess above and deficiency below, it must be that transverse collaterals received pathogen, became excessive, and obstructed the main meridian. One must observe and drain them, hence resolving knots. Ping An: *Jia Yi Jing* adds "Tong Er Jue Zhi" after "Xie".)
Upper Cold and Lower Heat: First needle the Taiyang meridian of the neck, retain the needle for a long time. Then heat-compress the neck and shoulder blades, allowing heat to merge downward, then stop. This is called pushing upwards. (Upper Cold means cold above the waist. Lower Heat means heat below the waist. Neck Taiyang refers to the Taiyang meridian. Retaining the needle pushes heat upward. Since heat gathers in the shoulders and neck, it must be harmonized, hence heat-compress to push it down. Pushing heat up is called pushing upwards. Ping An: "Yi Ze Yu" is written as "Yi Ci Ze Yu" in *Ling Shu* and "Yi Ci Ze Huo Yu" in *Jia Yi Jing*. In *Jia Yi Jing* note, "He" is written as "Leng" in another version.)
Upper Heat and Lower Cold: Observe deficiency pulses sinking into the meridians and select them. Stop when Qi descends; this is called leading downwards. (Heat above waist, cold below waist. Observe deficiency pulses sinking into other meridians and collaterals below the waist. Retain needle to make Qi descend, then stop, hence leading downwards. Ping An: "Xian Xia" is written as "Xian Zhi" in *Ling Shu*.)
Great heat pervading the body, mania with hallucinations (seeing, hearing, speaking falsely): Observe Foot-Yangming and major collaterals and select them. (Foot-Yangming governs Qi, its Qi is strong. Mania and hallucinations often stem from this meridian, hence select Yangming main and collateral meridians to remove it. Ping An: "Kuang Er Wang Jian..." is written as "Gu Kuang Yan Er Wang Jian..." in *Jia Yi Jing*.)* Deficient types are tonified; Blood-excess types are drained. Have the patient lie supine, position yourself before their head, press the carotid artery (Renying) with four fingers of both hands for a long time, roll and press/push downwards to the Quepen (Clavicle fossa), then repeat upwards as before. Stop when heat dissipates; this is called pushing and dispersing. (...Foot-Yangming upper excess lower deficiency causes mania... tonify lower deficiency meridian. Upper blood collaterals are excessive and solid; one may needle to bleed and drain. Have patient lie supine, press Renying pulse... down to Quepen, then repeat up and down, exhausting heat, then stop, hence pushing and dispersing. Another version says "Fu Shang Ru Qian", likely an error. Ping An: "Xue Shi Zhe" is written as "Xue Er Shi Zhe" in *Ling Shu* and "Xue Ru Shi Zhe" in *Jia Yi Jing*. "Yin Ling Yan Wo" is written as "Yin Qi Yan Wo" in *Ling Shu*. "Xia An Jing Dong Mai" is written as "Xie An Jing Dong Mai" in *Ling Shu* and "An Qi Jing Dong Mai" in *Jia Yi Jing*. "Fu Shang" is written as "Fu Zhi" in *Ling Shu* and *Jia Yi Jing*.)
Huang Di said: When one meridian gives rise to dozens of diseases, such as pain, carbuncles, cold-heat sensations, itching-bi, or numbness, with infinite variations, what is the reason? Qi Bo said: These are all generated by pathogenic factors. (Previous texts state Twelve Meridians cause various diseases. This states one meridian causes dozens of diseases with infinite variations. The diseases caused by Twelve Meridians are not without... variations, also inexhaustible. Thus, seekers must examine carefully and not lightly determine right or wrong. Ping An: *Ling Shu* writes "Huo Han Re" as "Huo Han Huo Re", and "Huo Yang Bi" as "Huo Yang Huo Bi".)