原出于太白。太白二。阴中之太阴。肾也。其原出于太溪。太溪二。膏之原出于鸠尾。鸠尾一。
肓之原出于脖 。脖 一。凡此十二原者。主治六腑五脏之有疾者也。胀取三阳。飧泄取三阴。
（肓音荒）
此论气味所生之津液。从脏腑之膏肓。外渗于皮肤络脉。化赤为血。荣于经俞。注于脏腑。外内
出入之相应也。津液者。水谷气味之所生也。中焦之气。蒸津液。化其精微。发泄于腠理。淖泽注
于骨。补益脑髓。润泽皮肤。是津液注于三百六十五节。而渗灌于皮肤肌腠者也。溢于外则皮肉膏肥。余
于内则膏肓丰满。盖膏者。脏腑之膏膜。肓者。肠胃之募原也。气味所生之津液。从内之膏肓。而
淖泽于外。是以膏肥之人。其肉淖而皮纵缓。故能纵腹垂腴。外内之相应也。痈疽章曰。中焦出
气如露。上注 谷。而渗孙脉。津液和调。变化而赤为血。
血和则孙脉先满溢。乃注于络脉皆盈。乃注于经脉。阴阳已张。因息乃行。行有经纪。周有道理。
与天协议。不得休止。夫 谷者。皮肤之分肉。是津液外注于皮肤。从孙络化赤而注于脏腑之原经。
故曰十二原者。五脏之所以禀三百六十五节气味也。四关者。两肘两腋。两髀两 。皆机关之室。
真气之所过。血络之所游行者也。十二原出于四关。四关主治五脏者。谓脏合腑而腑有原。原有
关而关应脏。脏腑阴阳相合。外内出入之相通也。故曰明知其原。睹其应而知五脏之害矣。肝、
心、脾、肺、肾。内之五脏也。阳中之少阴。阴中之少阳。五脏之气也。故脏腑有病。取之经脉
之原。胀取三阳。飧泄取三阴。此病在三阴三阳之气而取之气也。此节论血气生始出入之原。故篇
名九针十二原。谓九针之道与阴阳血气之相合也。
今夫五脏之有疾也。譬犹刺也。犹污也。犹结也。犹HT 也。刺虽久犹可拔也。污虽久犹可雪也。
结虽久犹可解也。HT 虽久犹可决也。或言久疾之不可取者。非其说也。夫善用针者。取其疾也。犹
拔刺也。犹雪污也。犹解结也。犹决HT 也。疾虽久犹可毕也。言不可治者。未得其术也。（HT 音卞抟也）
张开之曰。百病之始生也。皆生于风雨寒暑。阴阳喜怒。饮食居处。大惊卒恐。则血气分离。
阴阳破散。经络厥绝。脉道不通。夫风雨寒暑。大惊卒恐。犹刺犹污。病从外入者也。阴阳喜怒。
饮食居处。犹结犹HT 。病由内生者也。千般 难。不出外内二因。是以拔之雪之。仍从外解。解之
决之。从内解也。知斯二者。病虽久。犹可毕也。言不可治者。不得其因也。张玉师曰。污在皮
毛。刺在肤肉。结在血脉HT 在筋骨。
刺诸热者。如以手探汤。血寒清者。如人不欲行。阴有阳疾者。取之下陵三里。正往无殆。气
下乃止。不下复始也。疾高而内者。取之阴之陵泉。疾高而外者。取之阳之陵泉也。
寒热。风雨寒暑外袭也。故刺诸热者。如以手探汤。谓热在皮肤。所当浅取之也。寒清者。内
因之虚寒。宜深取之。静以守气。故如人不欲行也。阴有阳疾者。阳邪而入于内也。下陵三里。在膝
下三寸。足阳明之经。阳明之主阖也。正往无殆。气下乃止。使即从下解也。疾高而内者。里阴之
病。见于上也。阴陵泉乃太阴之经。太阴之主开也。使在内之病。从开而上出也。盖言阳病之入于
内者。即从下解。阴病之出于上者。即从外解也。疾高而外者。外邪高而病在外之下也。阳陵泉乃
少阳之经。少阳之主枢也。盖邪在高而欲下入于内。故使从枢外出。勿使之内入也。玉师曰。疾高
而取阴之陵泉。阳之陵泉。应司天在泉。上下相通。从气而上出也。
原穴出于手太阴肺经的太白穴（注：此处原文“太白”疑为“太渊”之误，或指肺经原穴，按《灵枢》原文应为太渊，但依文本直译）。太白穴深二寸，属阴中之太阴，对应肾脏。其原穴出于太溪穴。太溪穴深二寸。膏的原穴出于鸠尾穴。鸠尾穴深一寸。
肓的原穴出于脖胦（颈部结喉下方凹陷处）。脖胦深一寸。凡是这十二个原穴，主治六腑和五脏的疾病。胀满病取三阳经穴，完谷不化的泄泻取三阴经穴。
（“肓”音荒）
这一段论述由气味所生成的津液，从脏腑的膏肓部位，外渗到皮肤络脉，化为赤色成为血液，在经脉腧穴中运行，注入脏腑，体现了内外出入相应的关系。津液，是由水谷的气味所生成的。中焦之气，蒸腾津液，将其化为精微物质，发泄于腠理，滋润并注入骨骼，补益脑髓，润泽皮肤。这就是津液注入三百六十五个关节，而渗透灌注于皮肤肌腠的道理。溢出于外的则使皮肉膏脂肥厚，余留于内的则使膏肓丰满。所谓“膏”，是脏腑表面的膏膜；所谓“肓”，是肠胃之间的募原。由气味生成的津液，从内部的膏肓向外滋润，所以膏脂肥厚的人，其肌肉柔润而皮肤松弛纵缓，因此能够腹部下垂、脂肪堆积，这是内外相应的表现。《痈疽》章中说：“中焦发出的气像露水一样，向上注入谷道，而渗入孙脉，津液调和，变化而成为赤色血液。”
血液调和则孙脉先充满，然后注入络脉使之充盈，再注入经脉。阴阳之气已经张盛，随着呼吸而运行，运行有规律，循环有条理，与天地自然相合，不停止休息。所谓“谷”，是指皮肤间的分肉间隙。这是津液外注于皮肤，从孙络化赤后注入脏腑的原经。所以说十二原穴，是五脏禀受三百六十五节气味的源头。四关，指的是两肘、两腋、两髀、两腘，都是关节活动的关键部位，是真气经过、血络游行的地方。十二原穴出于四关，四关主治五脏疾病，意思是脏与腑相合，腑有原穴，原有关节门户，门户应合于脏，脏腑阴阳相合，内外出入相通。所以说，明白这些原穴，观察它们的反应，就能知道五脏的病变了。肝、心、脾、肺、肾，是内部的五脏。其中包含阳中之少阴、阴中之少阳等五脏之气。所以脏腑有病，取用经脉的原穴治疗。胀满取三阳经，飧泄取三阴经，这是在三阴三阳之气层面进行取穴治疗。这一节论述气血生成、起始、出入的根源，所以篇名叫《九针十二原》，意思是九针的道理与阴阳气血相契合。
如今五脏有了疾病，就像刺入异物、沾染污垢、打结、堵塞水流一样。刺虽然久，仍然可以拔出；污虽然久，仍然可以洗净；结虽然久，仍然可以解开；堵虽然久，仍然可以疏通。有人说久病不可治，这种说法是不对的。善于使用针刺的人，治疗疾病，就像拔刺、洗污、解结、疏通水流一样。疾病即使很久，仍然可以治愈。说不能治疗的，是没有掌握正确的方法。（“HT”音卞，意为堵塞扭转）
张开之说：各种疾病的产生，都源于风雨寒暑、阴阳喜怒、饮食居处、大惊卒恐等因素，导致血气分离，阴阳破散，经络厥逆断绝，脉道不通。风雨寒暑、大惊卒恐，如同刺入异物、沾染污垢，是病邪从外部侵入的因素。阴阳喜怒、饮食居处，如同打结、堵塞水流，是病邪从内部产生的因素。千般灾难，不出外因和内因两类。所以，对于外因引起的，通过拔除、清洗等方法，从外部解除；对于内因引起的，通过解开、疏通等方法，从内部解除。懂得这两点，疾病即使很久，仍然可以治愈。说不能治疗的，是没有找到病因。张玉师说：污在皮毛，刺在肤肉，结在血脉，HT在筋骨。
针刺各种热证，手法要快，像把手伸进热水里一样迅速抽出；治疗血寒清冷的病症，手法要慢，像人不想行走一样沉稳。如果阴分有阳热之疾，取下陵三里穴。进针要正直，不要懈怠，待气至下行后才停止，若气未下复始操作。病势高亢且病位在里的，取阴陵泉穴；病势高亢且病位在外表的，取阳陵泉穴。
寒热，是风雨寒暑从外部侵袭所致。所以针刺各种热证，像把手伸进热水里一样，意思是热在皮肤，应当浅刺。寒清，是内部虚寒所致，宜深刺，静守正气，所以像人不想行走一样沉稳。阴分有阳热之疾，是阳邪进入体内。下陵三里，位于膝下三寸，属足阳明胃经，阳明主阖。进针正直，不要懈怠，待气下行后停止，使邪气从下方解除。病势高亢且病位在里的，是里阴病表现于上部。阴陵泉属足太阴脾经，太阴主开，使体内的病邪从开启而上出。大概意思是阳病入于内的，就从下方解除；阴病出于上的，就从外部解除。病势高亢且病位在外表的，是外邪高而在下的体表病变。阳陵泉属足少阳胆经，少阳主枢。邪气在高处想要向下进入体内，所以使其从枢机外出，防止其向内深入。玉师说：病势高亢取阴陵泉、阳陵泉，应合司天在泉之气，上下相通，使邪气从上而出。
The Yuan-Source points originate from the Taibai point (Note: Textual error likely for Taiyuan, Lung Meridian Yuan-Source). Taibai is two cun deep, Yin within Yin (Taiyin), corresponding to the Kidney. Its Yuan-Source point originates from Taixi. Taixi is two cun deep. The Yuan-Source of the Gao (fatty tissue) originates from Jiutui. Jiutui is one cun deep.
The Yuan-Source of the Huang (diaphragm/marrow space) originates from Boyang (the depression below the larynx). Boyang is one cun deep. These twelve Yuan-Source points govern diseases of the Six Fu organs and Five Zang organs. For distension, select points from the Three Yang meridians; for undigested food diarrhea (Sun-xie), select points from the Three Yin meridians.
("Huang" pronounced huang)
This section discusses the fluids generated by the qi and flavors of food and drink, which seep externally from the Gao and Huang of the Zang-Fu organs into the skin and collateral vessels, transform into red blood, circulate through the Jing-Luo acupoints, and inject into the Zang-Fu organs, demonstrating the correspondence of internal and external entry and exit. Fluids are generated by the qi and flavors of water and grain. The Qi of the Middle Jiao steams the fluids, transforms them into essence and subtle substances, releases them into the Cou-Li (interstices), moistens and injects them into the bones, supplements the brain marrow, and moistens the skin. This is how fluids inject into the 365 joints and permeate the skin and muscle interstices. Overflowing externally makes the flesh and fatty tissue plump; remaining internally makes the Gao and Huang abundant. "Gao" refers to the fatty membrane of the Zang-Fu organs; "Huang" refers to the Mu-Yuan (originating source) between the stomach and intestines. Fluids generated by qi and flavors moisten externally from the internal Gao and Huang. Therefore, people with abundant fatty tissue have soft muscles and loose, relaxed skin, allowing for a hanging abdomen and accumulated fat, reflecting internal-external correspondence. The chapter on Carbuncles and Ulcers states: "Qi emitted from the Middle Jiao is like dew, flowing upward into the gut, and seeping into the Sun-collaterals. When fluids are harmonious, they change and become red blood."
When blood is harmonious, the Sun-collaterals fill first, then inject into the Luo-collaterals making them full, and finally inject into the Jing-main meridians. Yin and Yang qi are fully expanded and move with respiration. Movement has order, circulation has principles, aligning with Heaven and Earth, never ceasing. "Gu" refers to the divided flesh between the skin layers. This is where fluids externally inject into the skin, transform into red blood via Sun-collaterals, and then inject into the Yuan-Jing of the Zang-Fu organs. Thus, it is said that the twelve Yuan-Source points are the sources from which the Five Zang organs receive the qi and flavors of the 365 joints. Si-Guan (Four Passes) refer to the two elbows, two axillae, two thighs, and two popliteal fossae. These are chambers of joint mechanisms, where True Qi passes and blood collaterals circulate. The twelve Yuan-Source points originate from Si-Guan. Si-Guan govern diseases of the Five Zang organs, meaning Zang and Fu are paired, Fu have Yuan-Source points, Yuan-Source points have gateways, and gateways correspond to Zang organs. Zang-Fu Yin-Yang combine, allowing internal-external communication. Thus, knowing the Yuan-Source points and observing their responses reveals disorders of the Five Zang organs. Liver, Heart, Spleen, Lung, Kidney are the internal Five Zang organs. They contain Qi such as Shaoyin within Yang and Shaoyang within Yin. Therefore, for Zang-Fu diseases, select the Yuan-Source points of the meridians. Distension takes Three Yang meridians; Sun-xie takes Three Yin meridians. This treats diseases at the level of Three Yin and Three Yang Qi. This section discusses the origin of generation, start, entry, and exit of Blood and Qi, hence the chapter title "Nine Needles and Twelve Yuan-Source Points," indicating the harmony between the Way of Nine Needles and Yin-Yang Blood-Qi.
Now, when the Five Zang organs have disease, it is like having a thorn embedded, dirt stained, a knot tied, or water blocked. Though long-standing, a thorn can still be pulled out; though old, dirt can still be washed clean; though tight, a knot can still be untied; though blocked, water flow can still be unblocked. Some say chronic diseases cannot be treated; this view is incorrect. A skilled needle practitioner treats disease like pulling a thorn, washing dirt, untying knots, or unblocking water. Even if the disease is chronic, it can still be cured. Those who say it is incurable have not mastered the technique. ("HT" pronounced bian, meaning blockage/twisting)
Zhang Kai said: The onset of all diseases arises from wind, rain, cold, heat, Yin-Yang emotions, diet, residence, sudden fright, etc., causing separation of Blood and Qi, dispersion of Yin-Yang, interruption of Jing-Luo, and obstruction of pulse channels. Wind, rain, cold, heat, sudden fright are like thorns and dirt; pathogenic factors entering from outside. Yin-Yang emotions, diet, residence are like knots and blockages; pathogenic factors arising from inside. Thousands of disasters do not exceed these two causes: external and internal. Therefore, for external causes, resolve them by pulling and washing from the exterior; for internal causes, resolve them by untying and unblocking from the interior. Understanding these two allows curing even chronic diseases. Saying it is incurable means failing to identify the cause. Master Zhang Yu said: Dirt is in skin and hair; thorns are in flesh; knots are in blood vessels; HT is in sinews and bones.
To needle various Heat syndromes, use the technique of probing hot water with the hand (quick insertion and withdrawal). For Blood Cold and clarity, use the technique of a person unwilling to walk (slow, steady manipulation). If there is a Yang pathology in the Yin aspect, select Xiaoling Sanli (Zusanli, ST36). Insert the needle straightly without fatigue; stop when the Qi descends; if it does not descend, restart. For high-rising pathology located internally, select Yinlingquan (SP9); for high-rising pathology located externally, select Yanglingquan (GB34).
Chills and fever result from external invasion by wind, rain, cold, heat. Thus, needling Heat syndromes is like probing hot water, meaning heat is in the skin and should be shallowly needled. Cold and clarity result from internal deficiency-cold, requiring deep needling and quiet guarding of Qi, hence resembling a person unwilling to walk. Yang pathology in the Yin aspect indicates Yang pathogenic factors entering internally. Xiaoling Sanli is three cun below the knee, belonging to the Foot-Yangming Stomach Meridian, which governs closing. Insert straightly without fatigue; stop when Qi descends, allowing resolution from below. High-rising pathology located internally is a Interior-Yin disease manifesting above. Yinlingquan belongs to the Foot-Taiyin Spleen Meridian, which governs opening, allowing internal diseases to exit upward via opening. Generally, Yang diseases entering the interior resolve from below; Yin diseases exiting the exterior resolve from above. High-rising pathology located externally is external pathogenic factors high but affecting lower exterior regions. Yanglingquan belongs to the Foot-Shaoyang Gallbladder Meridian, which governs pivoting. Since pathogens at high levels wish to enter inward, this method facilitates their exit outward via the pivot mechanism, preventing internal invasion. Master Yu said: Selecting Yinlingquan and Yanglingquan for high-rising pathology corresponds to the Si-Tian and Zai-Quan heavenly stems/earthly branches, ensuring upper-lower communication and upward expulsion of pathogens.