（刺手阳明输三间等穴，不已，刺手阳明兑端穴。平按∶刺手阳明下《甲乙》有立已二字。《素问》
齿中下无者字。注兑端穴，查《甲乙经》手阳明无兑端穴，惟手三里穴在曲池下二寸，按之肉起
兑肉之端，兑端恐即手三里穴。）邪客于五脏之间，其病也，脉引而痛，时来时止，视其病脉，
缪刺之，于手足爪甲上，视其脉，出其血，间日一刺，一刺不已，五刺已。（五脏之脉，引而有
痛，视其左右病脉所在，可缪刺之。手足爪甲上，十二经脉井之络脉，故取之也。亦是取经井以
疗络病也。平按∶病脉，脉字《素问》无。）缪传刺上齿。（足阳明络，左病右痛，右
病左痛，可刺上齿足阳明络。平按∶《素问》刺作引。）齿唇寒痛，视其手背脉血者去之，足阳
明中指爪甲上一 ，手大指次指爪甲上各一 ，立已，左取右，右取左。（手阳明脉，入下齿中，
还出挟口交人中，足阳明脉，入上齿中，还出挟口环唇，下交承浆，故取手阳明血络，以去齿唇
痛也。足中趾爪甲上，足阳明络，故亦取之。手大指次指爪甲上，亦是手阳明络，故亦取之。皆视
其病左右，缪刺之。平按∶齿唇寒痛《甲乙》无痛字，注云∶“《素》多一痛字。”足阳明上《甲
乙》有刺字。）嗌中肿，不能内唾，时不能出唾者，缪刺然骨之前出血，立已，左刺右，右刺左。
（足少阴经，出然骨而上肺中，循喉咙，挟舌本，故嗌中肿，刺然骨前络脉也。平按∶《素问》此
节在邪客于足太阴之络之上，唾者下无缪字。《甲乙》左刺右右刺左，刺作取。）邪客于手足少阴
太阴足阳明络，此五络皆会于耳中，上络左角，（手少阴、足少阴、手太阴、足太阴、足阳明，
此五经脉，手少阴通里，入心中，系舌本，孙络至耳中。足少阴经至舌本，皮部络入耳也。手太
阴正别，从喉咙，亦孙络入耳中。足太阴经，连舌本下，散舌下，亦皮部络入耳中。足阳明经，上
耳前，过客主人前，亦皮部络入耳中。此之五络，入于耳中，相会通已，上络于左角。左角，阳也。）
五络俱竭，令人身脉皆动而形无知也，其状如尸厥，（此之五络，为身纲纪，故此脉绝，诸脉乱
动，形不知人，与尸厥死之相似，非尸厥也。平按∶其状若尸厥《素问》、《甲乙》作“其状若
尸，或曰尸厥”。）刺足大趾内侧甲下去端如韭叶，此刺足太阴隐白穴也。平按∶甲下《素问》、
《甲乙》作爪甲上。）后刺足心，（刺足少阴涌泉穴也。）后刺足中趾甲上各一 ，（刺足阳明
厉兑穴也。平按∶中趾下《素问》、《甲乙》有爪字。）后刺手大指之内去端如韭叶，（刺手太
阴少商穴也。平按∶之内《素问》作内侧。）后刺少阴兑骨之端各一 ，立已，（刺手少阴神门
穴也。此前五刺，皆中其经穴，以调络病。平按∶此节上《素问》有后刺手心主五字，王注谓中
冲穴，新校正谓《甲乙》不刺手心主，此五络亦不及手心主，王氏相随注之，非是。）不已，以
竹筒吹其两耳， 其左角之发方寸燔治，饮以美酒一杯，不能饮者灌之，立止。（ ，耻历反，
除也。耳中，五络会处也。左角，五络络处也。平按∶《甲乙》耳下有中字， 作剔。《素问》竹
筒作竹管，方寸作方一寸。）凡刺之数，必先视其经脉，切而顺之，审其虚实而调之，不调者经
刺之，（不调者，偏有虚实也。偏有虚实者，可从经穴调其气也。平按∶切而顺之，顺《素问》作
从，《甲乙》作循。）有痛而经不病者缪刺之，（循经候之不见有病，仍有痛者，此病有异处，故
左痛刺右等，名曰缪刺。）因视皮部有血络者尽取之，此缪刺之数也。（缪刺之处皮部络邪血，
皆刺去之，名曰缪刺之法。数，法也。平按∶因《甲乙》作目。《素问》因视下有其字，《甲乙》
同。）
（针刺手阳明大肠经的输穴三间等穴位，如果症状未缓解，则针刺兑端穴。按语：针刺手阳明下，《甲乙经》中有“立已”二字。《素问》中“齿中下”无“者”字。关于兑端穴的注释，查阅《甲乙经》，手阳明大肠经并无兑端穴，只有手三里穴位于曲池穴下二寸处，按压时肌肉隆起于兑肉之端，因此“兑端”恐怕指的就是手三里穴。）邪气侵犯五脏之间，病症表现为经脉牵引疼痛，痛感时来时止。观察病变的脉象，采用缪刺法治疗，在手足爪甲上的井穴处，观察其脉络，放出血液，每隔一日针刺一次，若一次针刺后症状未愈，可连续针刺五次。（五脏的脉象，牵引且伴有疼痛，观察左右病脉所在之处，可以采用缪刺法。手足爪甲上是十二经脉井穴的络脉，所以选取此处。这也是通过取经穴来治疗络病的方法。按语：“病脉”，《素问》中无“脉”字。）缪刺法用于治疗上齿疼痛。（足阳明胃经的络脉，左侧患病右侧疼痛，右侧患病左侧疼痛，可以针刺上齿部位的足阳明胃经络脉。按语：《素问》中“刺”作“引”。）牙齿和嘴唇寒冷疼痛，观察手背上有瘀血的脉络并予以清除，针刺足阳明胃经中指爪甲上一处，手大指与次指爪甲上各一处，症状立即缓解，左侧取右侧穴位，右侧取左侧穴位。（手阳明大肠经，进入下齿中，复出挟口交叉于人中的位置；足阳明胃经，进入上齿中，复出挟口环绕嘴唇，下方交会于承浆穴，因此取用手阳明大肠经的血络，以去除牙齿和嘴唇的疼痛。足中趾爪甲上是足阳明胃经的络脉，所以也选取此处。手大指与次指爪甲上，也是手阳明大肠经的络脉，所以也选取此处。都要观察病变在左还是在右，采用缪刺法。按语：《甲乙经》中“齿唇寒痛”无“痛”字，注释说：“《素问》多一个‘痛’字。”足阳明上，《甲乙经》有“刺”字。）咽喉中间肿胀，不能吞咽唾液，时常想吐出却吐不出来的，采用缪刺法针刺然骨之前的络脉出血，症状立即缓解，左侧针刺右侧，右侧针刺左侧。（足少阴肾经，出于然骨向上进入肺中，沿着喉咙，挟持舌根，所以咽喉中间肿胀，针刺然骨前的络脉。按语：《素问》这一节在“邪客于足太阴之络”之上，“唾者”下无“缪”字。《甲乙经》中“左刺右右刺左”，“刺”作“取”。）邪气侵犯手足少阴、太阴及足阳明的络脉，这五条络脉都交会于耳中，向上联络左角。（手少阴心经、足少阴肾经、手太阴肺经、足太阴脾经、足阳明胃经，这五条经脉，手少阴通里穴，进入心中，系连舌根，孙络进入耳中。足少阴肾经至舌根，皮部络脉进入耳中。手太阴肺经的正别支，从喉咙，也有孙络进入耳中。足太阴脾经，连接舌根下方，散布于舌下，也有皮部络脉进入耳中。足阳明胃经，上行至耳前，过客主人穴之前，也有皮部络脉进入耳中。这五条络脉，进入耳中，相互会通之后，向上联络于左角。左角，属阳。）这五条络脉全部衰竭，导致人身体的脉象都躁动而形体无知觉，其状态如同尸厥症，（这五条络脉，是身体的纲纪，所以这些脉气断绝，诸脉乱动，形体不知人，与尸厥死亡的状态相似，但并非真正的尸厥。按语：《素问》、《甲乙经》中“其状若尸厥”作“其状若尸，或曰尸厥”。）针刺足大趾内侧指甲下距离边缘如韭菜叶宽的地方，这是针刺足太阴脾经的隐白穴。按语：《素问》、《甲乙经》中“甲下”作“爪甲上”。）随后针刺足心，（这是针刺足少阴肾经的涌泉穴。）随后针刺足中趾爪甲上一处，（这是针刺足阳明胃经的厉兑穴。按语：《素问》、《甲乙经》中“中趾”下有“爪”字。）随后针刺手大指内侧距离边缘如韭菜叶宽的地方，（这是针刺手太阴肺经的少商穴。按语：《素问》中“之内”作“内侧”。）随后针刺手少阴心经兑骨之端各一处，症状立即缓解，（这是针刺手少阴心经的神门穴。此前五次针刺，都是针对经穴，以调理络病。按语：《素问》此节上有“后刺手心主”五字，王冰注认为是中冲穴，新校正认为《甲乙经》不刺手心主，这五络也不涉及手心主，王氏跟随王冰的注释，是不对的。）如果症状未缓解，用竹筒吹两耳，剃除左角方圆一寸处的头发，烧灼处理后，用一杯美酒送服，不能饮酒的人则灌服，症状立即停止。（“剃除”，耻历反，意为除去。耳中，是五络会合之处。左角，是五络联络之处。按语：《甲乙经》中“耳”下有“中”字，“剃除”作“剔”。《素问》中“竹筒”作“竹管”，“方寸”作“方一寸”。）凡是针刺的原则，必须先观察其经脉，切按并顺从其脉气，审察其虚实并进行调理，对于不调理的采用经刺法，（所谓不调理，是指偏盛偏虚。偏盛偏虚的，可以从经穴调理其气机。按语：《素问》中“顺”作“从”，《甲乙经》作“循”。）如果有疼痛但经脉没有病变的，采用缪刺法，（循着经候诊察不见有病，仍然有疼痛的，这是病位不同，所以左痛刺右等，称为缪刺。）进而观察皮部有瘀血络脉的，全部予以清除，这就是缪刺的原则。（缪刺之处，皮部的络邪血，全部刺去，称为缪刺之法。“数”，即法则。按语：《甲乙经》中“因”作“目”。《素问》中“因视”下有“其”字，《甲乙经》同。）
(When needling the Shu-stream points of the Hand-Yangming Large Intestine channel, such as Sanjian (LI 15), and if symptoms persist, needle the Duanduan point. Note: In "Needling Hand-Yangming," the *Jia Yi Jing* adds "Li Yi" (immediate relief). The *Su Wen* lacks the character "Zhe" in "Chi Zhong Xia." Regarding the annotation for the Duanduan point: consulting the *Jia Yi Jing*, there is no Duanduan point on the Hand-Yangming channel; rather, the Shousanli point is located two cun below Quchi, where pressing causes the flesh to rise at the end of the Dui meat. Thus, "Duanduan" likely refers to the Shousanli point.) When pathogenic factors invade the space between the five Zang organs, the disease manifests as pulling pain along the meridians, with pain that comes and goes intermittently. Observe the pathological pulse, apply Miao-cissation (Miao Ci) therapy, and at the Jing-well points on the fingernails and toenails, observe the vessels and bleed them. Needle once every other day; if one session is insufficient, proceed up to five sessions. (The pulses of the five Zang organs pull and cause pain; observing the location of the pathological pulses on the left or right allows for Miao-cissation. The area above the fingernails and toenails contains the Luo-connecting vessels of the Jing-well points of the twelve meridians, hence they are selected. This is also a method of treating Luo diseases by selecting Jing-well points. Note: In the *Su Wen*, the character "Mai" (pulse) is absent in "Bing Mai".) Miao-cissation is used to treat upper toothache. (For the Luo vessel of the Foot-Yangming Stomach channel, if the left side is diseased causing right-sided pain, or vice versa, one may needle the Luo vessel of the Foot-Yangming channel at the upper teeth. Note: In the *Su Wen*, "Ci" (needle) is written as "Yin" (lead).) For cold pain in the teeth and lips, observe the blood stasis in the vessels on the back of the hand and remove it. Needle one point on the nail of the middle toe of the Foot-Yangming channel, and one point each on the nails of the thumb and index finger of the Hand. Relief will be immediate. Treat the left side by needling the right, and the right side by needling the left. (The Hand-Yangming Large Intestine channel enters the lower teeth, emerges, crosses the mouth, and intersects at Renzhong. The Foot-Yangming Stomach channel enters the upper teeth, emerges, circles the lips, and intersects below at Chengjiang. Therefore, the blood vessels of the Hand-Yangming channel are selected to relieve tooth and lip pain. The nail of the middle toe of the foot is the Luo vessel of the Foot-Yangming channel, so it is also selected. The nails of the thumb and index finger of the hand are also Luo vessels of the Hand-Yangming channel, so they are also selected. One must observe whether the pathology is on the left or right and apply Miao-cissation. Note: In the *Jia Yi Jing*, "Tong" (pain) is absent in "Chi Chun Han Tong"; the annotation states, "The *Su Wen* has an extra 'Tong' character." In "Foot Yangming Shang," the *Jia Yi Jing* includes the character "Ci" (needle).) For swelling in the throat, inability to swallow saliva, and frequent desire to spit but inability to do so, apply Miao-cissation to bleed the vessels anterior to Ran Gu. Relief will be immediate. Needle the right side for left-sided symptoms, and the left side for right-sided symptoms. (The Foot-Shaoyin Kidney channel emerges from Ran Gu, ascends into the lung, follows the throat, and flanks the root of the tongue. Therefore, for swelling in the throat, the vessels anterior to Ran Gu are needled. Note: In the *Su Wen*, this section appears above "Pathogenic factors invading the Luo vessel of the Foot-Taiyin Spleen." Below "Tuo" (spit), the character "Miao" is missing. In the *Jia Yi Jing*, "Zuo Ci You, You Ci Zuo" uses "Qu" (take) instead of "Ci" (needle).) When pathogenic factors invade the Luo vessels of the Hand-Shaoyin, Foot-Shaoyin, Hand-Taiyin, Foot-Taiyin, and Foot-Yangming channels, these five Luo vessels all converge in the ear and ascend to connect with the left corner of the head. (The Hand-Shaoyin Heart, Foot-Shaoyin Kidney, Hand-Taiyin Lung, Foot-Taiyin Spleen, and Foot-Yangming Stomach channels: The Hand-Shaoyin Tongli point enters the heart, connects to the root of the tongue, and its Sun-branches enter the ear. The Foot-Shaoyin channel reaches the root of the tongue, and its skin-region Luo vessels enter the ear. The main divergent branch of the Hand-Taiyin channel, from the throat, also has Sun-branches entering the ear. The Foot-Taiyin channel connects to the root of the tongue below and spreads under the tongue, also having skin-region Luo vessels entering the ear. The Foot-Yangming channel ascends before the ear, passes anterior to the Guest Master point, and also has skin-region Luo vessels entering the ear. These five Luo vessels enter the ear, converge, and then ascend to connect with the left corner. The left corner represents Yang.) If all five Luo vessels are exhausted, it causes the body's pulses to move chaotically while the form remains insensible. The condition resembles Shi Jue (corpse-like fainting/coma), (These five Luo vessels serve as the framework of the body. When their Qi is severed, the various pulses move chaotically, and the form loses consciousness. It resembles the state of death in Shi Jue but is not true Shi Jue. Note: In the *Su Wen* and *Jia Yi Jing*, "Qi Zhuang Ruo Shi Jue" is written as "Qi Zhuang Ruo Shi, Huo Yue Shi Jue" [Its appearance is like a corpse, or some say corpse-fainting].) Needle the inner side of the big toe of the foot, one leaf-width below the nail edge. This is needling Yinbai (SP 1) of the Foot-Taiyin Spleen channel. Note: In the *Su Wen* and *Jia Yi Jing*, "Jia Xia" is written as "Zhao Jia Shang" [Above the nail].) Subsequently, needle the sole of the foot, (This is needling Yongquan (KI 1) of the Foot-Shaoyin Kidney channel.) Subsequently, needle one point on the nail of the middle toe of the foot, (This is needling Lidui (ST 45) of the Foot-Yangming Stomach channel. Note: In the *Su Wen* and *Jia Yi Jing*, the character "Zhao" [nail] appears after "Zhong Zhi" [middle toe].) Subsequently, needle the inner side of the thumb of the hand, one leaf-width from the edge, (This is needling Shaoshang (LU 11) of the Hand-Taiyin Lung channel. Note: In the *Su Wen*, "Zhi Nei" is written as "Ce Nei" [Inner side].) Subsequently, needle one point each at the end of the Dui bone of the Hand-Shaoyin channel. Relief will be immediate, (This is needling Shenmen (HT 7) of the Hand-Shaoyin Heart channel. The previous five needleings all targeted Jing-acupoints to regulate Luo diseases. Note: Above this section, the *Su Wen* has the phrase "Hou Ci Xin Shou Zhu" [Subsequently needle the Pericardium of the Hand]. Wang Bing annotated this as Zhongchong (PC 9). The New Correction states that the *Jia Yi Jing* does not needle the Hand-Yuejin Pericardium, and these five Luo vessels do not involve the Hand-Yuejin. Wang's adherence to Wang Bing's annotation is incorrect.) If symptoms do not cease, use a bamboo tube to blow into both ears. Shave a square cun of hair at the left corner of the head, burn it, and administer it with a cup of fine wine. If the patient cannot drink, force-feed it. Symptoms will stop immediately. ("Ti" [shave/remove], pronounced Chi Li fan, means to remove. The ear is the convergence point of the five Luo vessels. The left corner is the connection point of the five Luo vessels. Note: In the *Jia Yi Jing*, "Er" [ear] has the character "Zhong" [middle]. "Ti" is written as "Ti" [scrape/remove]. In the *Su Wen*, "Zhu Tong" [bamboo tube] is written as "Zhu Guan" [bamboo pipe], and "Fang Cun" is written as "Fang Yi Cun" [one square cun].) In general, the principles of needling require first observing the meridians, palpating and following their flow, examining their excess or deficiency, and regulating them. For those not regulated, apply Jing-cissation (Jing Ci), (Not regulated implies local excess or deficiency. Where there is local excess or deficiency, one can regulate the Qi via Jing-acupoints. Note: In the *Su Wen*, "Shun" [follow] is written as "Cong" [obey]; in the *Jia Yi Jing*, as "Xun" [trace].) If there is pain but no disease in the meridian itself, apply Miao-cissation, (Palpating along the meridian reveals no disease, yet pain persists; this indicates the pathology is elsewhere, hence needling the opposite side for left-sided pain, etc., is called Miao-cissation.) and further observe the skin regions for blood stasis in the vessels, removing all such stasis. This is the principle of Miao-cissation. (In Miao-cissation, the pathogenic blood in the skin-region Luo vessels is all removed, which is called the method of Miao-cissation. "Shu" [number/principle] means method. Note: In the *Jia Yi Jing*, "Yin" [therefore] is written as "Mu" [eye]. In the *Su Wen*, below "Yin Shi" [therefore observe], the character "Qi" [its] appears; the *Jia Yi Jing* agrees.)