凡刺之要。官针最妙。九针之宜。各有所为。长短大小。各有所施也。不得其用。病弗能移。
疾浅针深。内伤良肉。皮肤为痈。病深针浅。病气不泻。支大为脓。病小针大。气泻太甚。疾必
为害。病大针小。气不泄泻。亦复为败。失针之宜。大者泻。小者不移。已言其过。请言其所施。
病在皮肤。无常处者。取以 针于病所。肤白勿取。病在分肉间。取以圆针于病所。病在经络痼
痹者。取以锋针。病在脉气少。当补之者。取之 针。于井荥分输。病为大脓者。取之
铍针。病痹气暴发者。取以圆利针。病痹气痛而不去者。取以毫针。病在中者。取以长针。病水肿
不能通关节者。取以大针。病在五脏固居者。取以锋针。泻于井荥分输。取以四时。
官、法也。九针之法。有大小长短之制。有浅深补泻之宜。有三五九十二刺之法。各有所施也。
如不得其用。病勿能移。而反为害焉。
凡刺有九。以应九变。一曰输刺。输刺者。刺诸经荥输脏输也。二曰远道刺。远道刺者。病在
上取之下。刺腑输也。三曰经刺。经刺者。刺大经之结络经分也。四曰络刺。络刺者。刺小络之血
脉也。五曰分刺。分刺者。刺分肉之间也。六曰大泻刺。大泻刺者。刺大脓以铍针也。七曰毛刺。
毛刺者。刺浮痹皮肤也。八曰巨刺。巨刺者。左取右。右取左。九曰 刺。 刺者。刺燔针则
取痹也。（输 俞互用 音萃燔音烦）
上节论针有九者之宜。此论刺有九者之变。一曰输刺。刺五脏之经输。所谓荥输治外经也。
远道刺者。病在上而取下之合穴。所谓合治六腑也。盖手足三阳之脉。其原皆在足。而上循于颈
项也。大经者。五脏六腑之大络也。邪客于皮毛。入舍于孙络。留而不去。闭结不通。则流溢于大
经之分。而生奇病。故刺大经之结络以通之。络刺者。见于皮肤之小络也。分刺者。分肉之间。溪
谷之会。亦有三百六十五穴会。邪在肌肉者取之。大泻刺者。泻大脓血也。毛刺者。邪闭于皮毛
之间。浮浅取之。所谓刺毫毛无伤皮。刺皮无伤肉也。巨刺者。邪客于十二经别。宜巨刺之。左取
右。右取左也。 刺者。燔针劫刺。以取筋痹也。（大经刺巨刺详素问缪刺论）
凡刺有十二节。以应十二经。一曰偶刺。偶刺者。以手直心若背。直痛所。一刺前。一刺后。
以治心痹。刺此者旁针
之也。二曰报刺。报刺者。刺痛无常处也。上下行者。直内。无拔针。以左手随病所按之。乃出
针复刺之也。三日恢刺。恢刺者。直刺傍之举之。前后恢筋急。以治筋痹也。四曰齐刺。齐刺者。
直入一。旁入二。以治寒气小深者。或曰三刺。三刺者。治痹气小深者也。五曰扬刺。扬刺者。正
内一。旁内四而浮之。以治寒气之博大者也。六曰直针刺。直针刺者。引皮乃刺之。以治寒气之
浅者也。七曰输刺。输刺者。直入直出。稀发针而深之。以治气盛而热者也。八曰短刺。短刺者。
刺骨痹稍摇而深之。致针骨所。以上下摩骨也。九曰浮刺。浮刺者。旁入而浮之。以治肌急而
寒者也。十曰阴刺。阴刺者。左右率刺之。以治寒厥。中寒厥。足踝后少阴也。十一曰旁针刺。
旁针刺者。直入旁刺各一。以治留痹久居者也。十二曰赞刺。赞刺者。直入直出。数发针而浅之
出血。是谓治痈肿也。
节、制也。言针有十二节制。以应十二经也。偶刺者。一刺胸。一刺背。前后阴阳之相偶也。
旁取之。恐中伤心气也。报刺者。刺痛无常处。出针而复刺。故曰报刺。恢、大之也。前后恢荡
其筋之急。以治筋痹也。齐刺者。中正以取之。故直入一以取中。旁入二以为佐。故又曰三刺。
治寒痹小深者也。扬刺者。从中而发扬于四旁也。直刺者。以亳针刺在皮毛。得气而直竖也。输
刺者。直入直出。如转输也。短刺者。用短针深入而至骨。所以便上下摩之而取骨痹也。浮刺者。
旁入而浮浅也。阴刺者。刺少阴之寒厥也。旁针刺者。直刺旁刺。治留痹之久居者也。赞、助也。
数发针而浅之出血。助痈肿之外散也。按十二刺中。独提少阴者。少阴主先天之阴阳水火。五运
六气之生原也。
脉之所居深不见者刺之。微纳针而久留之。以致其空脉气也。脉浅者勿刺。按绝其脉乃刺之。
无令精出。独出其邪气耳。
此言经脉内合五行之化运。外应六气之司天。用针者不可不知也。夫经脉内连脏腑。外合六
气。五脏内合五行。应五运之在中。命曰神机。而主出入。六气旋转于外。命曰气立。而主升降。
六气之司天在泉。应人之精水。随气而营运于肤表。故脉之所居。深不见者。内连五脏也。微纳
针而久留之。以致其空脉气者。致五脏之神气。营运于外也。脉浅者。见于皮肤之脉。外合于六气
也。精水随气行于肤表。故脉浅者勿刺。按绝其脉乃刺之。是使六气营运。而无令精出也。玉师曰。
致五脏之神机。非荣卫血气。故曰空脉气。
所谓三刺则谷气出者。先浅刺绝皮。以出阳邪。再刺则阴邪出者。少益深绝皮。致肌肉未入分
肉间也。已入分肉之间。则谷气出。故刺法曰。始刺浅之。以逐邪气。而来血气。后刺深之。以
致阴气之邪。最后刺极深之。以下谷气。此之谓也。故用针者。不知年之所加。气之盛衰。虚实
之所起。不可以为工也。
此申明三阴三阳之气。营运于皮表也。谷气者。通会于肌腠之元真。脾胃之所主也。故曰谷
气。阴邪阳邪者。谓邪在阴阳之气分也。少益深绝皮。致肌肉未入分肉间者。在皮肉相交之间。
仍在皮之绝处。未入于分肉也。盖言三阴三阳之气。营运于皮表。以应天之六气。故用针者。不知
年之所加。气之盛衰。虚实之所起。不可以为工也。年之所加者。六气之加临。气之盛衰者。五运
之气。有太过不及也。运有太少。气有盛衰。则人之虚实。所由起矣。
凡刺有五。以应五脏。一曰半刺。半刺者。浅纳而疾发针。无针伤肉。如拔毛状。以取皮气
。此肺之应也。二曰豹文刺。豹文刺者。左右前后针之。中脉为故。以取经络之血者。此心之应也。三
曰关刺。关刺者。直
刺左右尽筋上。以取筋痹。慎无出血。此肝之应也。或曰渊刺。一曰岂刺。四曰合谷刺。合谷刺
者。左右鸡足。针于分肉之间。以取肌痹。此脾之应也。五曰输刺。输刺者。直入直出。深纳之
至骨。以取骨痹。此肾之应也。
此言五脏之气。外合于皮脉、肉筋骨。五脏主中。故取之外合而应于五脏也。夫血者。神气也。
故五脏之神机。营运于血脉。以应五运之化。五脏之气。外合于皮肉筋骨。以应天之四时。玉师曰。
九宜九变。应地之九野九州。人之九脏九窍。十二节应十二月。三刺应三阴三阳。五刺应五行五时。
针道配天地人。而人合天地者也。
凡是针刺的要领，九针最为精妙。九针的适宜用法，各有其特定的作用。长短大小，各有其适用的部位。如果不掌握其用途，疾病就不能被治愈。
病位浅而针刺过深，会内伤好肉，导致皮肤发生痈肿；病位深而针刺过浅，病邪之气不能排出，会导致局部肿胀化脓。
病症轻而针具过大，会导致正气泻泄太过，必然对机体造成危害；病症重而针具过小，邪气不能泄出，同样会导致治疗失败。
失当的针刺，对于实证只能泻而不能消除病灶，对于虚证则不能移动病邪。以上已说明了过失，现在请说明其正确的施用方法。
病在皮肤，且没有固定部位的，用鍉针（钝头针）在病所施治。如果皮肤颜色发白，不要使用此法。
病在分肉之间的，用圆针在病所施治。
病在经络，属于顽固性痹证的，用锋针施治。
病在脉中，气血虚弱，应当补益的，用鍉针在井穴、荥穴、输穴施治。
病情严重形成大脓肿的，用铍针施治。
痹气突然发作的，用圆利针施治。
痹气疼痛且久留不去的，用毫针施治。
病位在体内的，用长针施治。
病在水肿，不能通利关节的，用大针施治。
病在五脏，固着不移的，用锋针施治，在井、荥、输穴进行泻法，并依据四季时令取穴。
“官”，是法则的意思。九针的法度，有大小长短的制度，有深浅补泻的适宜原则，有三五九十二种刺法，各有其适用之处。如果不掌握其用途，疾病不仅不能治愈，反而会造成危害。
凡是有九种刺法，以对应九种变化。第一种叫输刺。输刺，是刺各经的荥穴、输穴和脏的俞穴。第二种叫远道刺。远道刺，是病在上部取下部穴位，刺六腑的俞穴。第三种是经刺。经刺，是刺大经脉的结聚络脉和经分之间。第四种是络刺。络刺，是刺小络的血脉。第五种是分刺。分刺，是刺分肉之间。第六种是大泻刺。大泻刺，是用铍针刺破大脓肿。第七种是毛刺。毛刺，是刺浮于皮肤的痹证。第八种是巨刺。巨刺，是左病取右，右病取左。第九种是燔针劫刺。燔针劫刺，是用火针来治疗痹证。（注：“输”与“俞”通用，“燔”音烦）
上一节论述了九种针法的适宜之处，这一节论述了九种刺法的变通。第一种叫输刺，是刺五脏的经输穴，所谓“荥输治外经”。远道刺，是病在上部而取下部的合穴，所谓“合治六腑”。因为手足三阳经脉，其原气都在足部，而上行循行于颈项。大经，是指五脏六腑的大络。邪气客居在皮毛，进入孙络，停留不去，闭结不通，就会流溢到大经的分界处，产生奇病。所以刺大经的结络以疏通它。络刺，是见于皮肤的小络脉。分刺，是在分肉之间，溪谷交会之处，也有三百六十五个穴会，邪气在肌肉的就取这里治疗。大泻刺，是泻大脓血。毛刺，是邪气闭塞在皮毛之间，浅表取之，所谓“刺毫毛无伤皮，刺皮无伤肉”。巨刺，是邪气客居在十二经别，宜用巨刺法，左取右，右取左。燔针劫刺，是用火针劫刺，以治疗筋痹。（关于大经刺和巨刺详见《素问·缪刺论》）
凡是有十二种刺法，以对应十二经脉。第一种叫偶刺。偶刺，用手按住心前部和背部，正对疼痛部位，一刺前面，一刺后面，用来治疗心痹。刺这种病要旁开进针，以免损伤心气。第二种叫报刺。报刺，是刺痛没有固定部位的，疼痛上下走行的，直插入针不拔出，用左手随着病痛部位按压，然后出针再刺。第三种叫恢刺。恢刺，是直刺旁边提举针具，前后恢荡筋急，用来治疗筋痹。第四种叫齐刺。齐刺，是直入一针，旁入两针，用来治疗寒气小而深的病证。有人说叫三刺。三刺，也是治疗寒气小而深的病证。第五种叫扬刺。扬刺，是正中刺入一针，旁边刺入四针且浅刺，用来治疗寒气博大广泛的病证。第六种叫直针刺。直针刺，是牵引皮肤然后刺入，用来治疗寒气浅表的病证。第七种叫输刺。输刺，是直入直出，稀疏下针而且深刺，用来治疗气盛而热的病证。第八种叫短刺。短刺，是刺骨痹时稍微摇动针身并深入，使针到达骨骼，上下摩擦骨骼以取效。第九种叫浮刺。浮刺，是从旁边斜入而浅刺，用来治疗肌肉拘急而寒的病证。第十种叫阴刺。阴刺，是左右对称地刺，用来治疗寒厥证，中寒厥证，是在足踝后方的少阴经。第十一种叫旁针刺。旁针刺，是直刺一针，旁边再刺一针，用来治疗留滞日久不愈的痹证。第十二种叫赞刺。赞刺，是直入直出，多次快速下针且浅刺出血，这是治疗痈肿的方法。
“节”，是节制、制度的意思。说针法有十二种节制，以对应十二经脉。偶刺，是一刺胸，一刺背，是前后阴阳的相配。旁开进针，是怕中心脏之气。报刺，是刺痛无常处，出针后再刺，所以叫报刺。“恢”，是大的意思。前后恢荡其筋的拘急，以治疗筋痹。齐刺，是取中正之位，所以直入一针以取中，旁入两针作为辅助，所以又叫三刺，治疗寒痹小而深的病证。扬刺，是从中间发扬到四旁。直针刺，是用毫针刺在皮毛，得气后直竖针身。输刺，是直入直出，如转输一样。短刺，是用短针深入而至骨，以便上下摩擦以取骨痹。浮刺，是从旁边斜入而浅刺。阴刺，是刺少阴经的寒厥证。旁针刺，是直刺旁刺，治疗留痹久居的病证。“赞”，是辅助的意思。多次下针且浅刺出血，辅助痈肿向外消散。在十二刺中，唯独提到少阴，是因为少阴主管先天的阴阳水火，是五运六气的生原。
脉位深在不见的，刺它时要微微纳针并长久留针，以引导空脉之气。脉位浅显的不要直接刺，按压阻断其脉后再刺，不要让精气流出，只排出邪气而已。
这里讲的是经脉内合五行化运，外应六气司天。用针的人不可不知道。经脉内连脏腑，外合六气。五脏内合五行，应五运在中，名为神机，主出入。六气旋转于外，名为气立，主升降。六气司天在泉，应人的精水，随气营运于肤表。所以脉所在的位置，深在不见的，内连五脏。微微纳针并长久留针，以引导空脉之气，是致五脏的神气营运于外。脉浅显的，是见于皮肤的脉，外合六气。精水随气行于肤表，所以脉浅的不要刺。按压阻断其脉再刺，是使六气营运，而不让精气流出。玉师说：致五脏的神机，非靠营卫血气，所以说空脉气。
所谓三刺而谷气出的道理，是先浅刺切断表皮，以出阳邪；再刺则阴邪出，稍微加深切断表皮，达到肌肉但未进入分肉之间；已经入分肉之间，则谷气出。所以刺法说：开始浅刺，以驱逐邪气，而来血气；后刺深一些，以引致阴气之邪；最后刺极深，以下达谷气。说的就是这个道理。所以用针的人，不知道年份加临的气运，气的盛衰，虚实之所起，不可以成为好医生。
这里申明了三阴三阳之气，营运于皮表。谷气，是通会于肌腠的元真，由脾胃所主，所以叫谷气。阴邪阳邪，是说邪气在阴阳之气分。稍微加深切断表皮，达到肌肉但未进入分肉之间，是指在皮肉相交之间，仍在皮的绝处，未入于分肉。大概意思是说三阴三阳之气，营运于皮表，以应天之六气。所以用针的人，不知道年份加临的气运，气的盛衰，虚实之所起，不可以成为好医生。年份加临，指六气的加临。气的盛衰，指五运之气，有过剩和不足。运有太少，气有盛衰，那么人的虚实就由此产生了。
凡是有五种刺法，以对应五脏。第一种叫半刺。半刺，是浅纳针而疾速出针，不伤肉，像拔毛的样子，以取皮气，这是肺的对应。第二种叫豹文刺。豹文刺，是左右前后多针刺入，以中脉为度，以取经络之血，这是心的对应。第三种叫关刺。关刺，是直刺左右尽筋之上，以取筋痹，谨慎不要出血，这是肝的对应。有人说叫渊刺，也叫岂刺。第四种叫合谷刺。合谷刺，是像鸡足一样左右分刺，针于分肉之间，以取肌痹，这是脾的对应。第五种叫输刺。输刺，是直入直出，深纳至骨，以取骨痹，这是肾的对应。
这里讲五脏之气，外合于皮、脉、肉、筋、骨。五脏主中，所以取之外合而应于五脏。血，是神气所在。所以五脏的神机，营运于血脉，以应五运之化。五脏之气，外合于皮肉筋骨，以应天之四时。玉师说：九宜九变，应地之九野九州，人之九脏九窍。十二节刺应十二月。三刺应三阴三阳。五刺应五行五时。针道配合天地人，而人合于天地。
The essential principle of acupuncture lies in the optimal use of the Nine Needles. Each of the nine needles has specific indications and applications corresponding to their length and size. Failure to utilize them appropriately will prevent the resolution of disease.
If the pathology is superficial but the needle insertion is too deep, healthy tissue may be injured internally, potentially leading to skin abscesses (Yong). Conversely, if the pathology is deep but the needle insertion is too shallow, pathogenic Qi cannot be discharged, resulting in swelling and suppuration.
Using a large needle for a minor condition causes excessive dispersion of Healthy Qi, inevitably causing harm. Using a small needle for a major condition fails to discharge pathogenic factors, also leading to therapeutic failure.
Inappropriate needling results in an inability to drain excess or move deficiency. Having discussed these errors, we now proceed to describe the correct applications.
For diseases located in the skin without fixed sites, use the Di Needle (Di Zhen, blunt-pointed needle) at the affected area; avoid this method if the skin appears pale.
For diseases located between the muscle layers, use the Yuan Needle (Yuan Zhen, round-headed needle) at the affected area.
For diseases involving the meridians characterized by chronic Bi syndrome, use the Feng Needle (Feng Zhen, three-edged needle).
For conditions with deficient pulse Qi requiring tonification, use the Di Needle at the Jing-Well, Ying-Spring, and Shu-Stream points.
For severe cases forming large abscesses, use the Pi Needle (Pi Zhen, sword-shaped needle).
For acute onset of Bi syndrome, use the Yuanli Needle (Yuanli Zhen, fine and sharp needle).
For persistent Bi pain that does not resolve, use the Hao Needle (Hao Zhen, filiform needle).
For diseases located deeply within the body, use the Chang Needle (Chang Zhen, long needle).
For edema obstructing joint mobility, use the Da Needle (Da Zhen, large needle).
For diseases fixed within the Zang organs, use the Feng Needle to drain at the Jing-Well, Ying-Spring, and Shu-Stream points, selecting acupoints according to the four seasons.
"Guan" refers to standard methods. The methodology of the Nine Needles includes regulations on size and length, principles for depth and tonization/sedation, and techniques such as the Sanwu, Jiu, and Ershier Ci (35, 9, and 12-point punctures), each with specific applications. Misapplication leads to treatment failure and harm.
There are nine types of puncture techniques corresponding to nine variations:
1. **Shu Ci (Transport Puncture)**: Puncturing the Ying-Spring, Shu-Stream, and Back-Shu points of the meridians.
2. **Yuandao Ci (Distant Path Puncture)**: Treating upper body disorders by selecting lower body points, specifically the He-Sea points of the Fu organs.
3. **Jing Ci (Meridian Puncture)**: Puncturing collateral knots and divisions along major meridians.
4. **Luo Ci (Collateral Puncture)**: Puncturing small collateral blood vessels.
5. **Fen Ci (Muscle Separation Puncture)**: Puncturing between muscle layers.
6. **Da Xie Ci (Major Draining Puncture)**: Using the Pi Needle to drain large abscesses.
7. **Mao Ci (Hair Puncture)**: Superficial puncture for floating Bi syndrome in the skin.
8. **Ju Ci (Great Cross Puncture)**: Left-sided pathology treated by right-side needling, and vice versa.
9. **Fan Ci (Burning Needle Puncture)**: Using heated needles to treat Bi syndrome.
The previous section discussed the appropriateness of the nine needles; this section discusses the variations of the nine puncture techniques.
**Shu Ci**: Punctures the Shu points of the Five Zang organs, adhering to the principle "Ying-Spring and Shu points treat external meridians."
**Yuandao Ci**: Treats upper disorders by selecting He-Sea points below, adhering to "He-Sea points treat Six Fu organs." This is because the source Qi of the Hand and Foot Three Yang meridians originates in the foot and ascends to the neck and head.
**Jing Ci**: Addresses major collaterals where pathogens enter the skin and sun-collaterals, stagnate, and overflow into major meridians, causing unusual diseases. Puncturing these knots restores flow.
**Luo Ci**: Targets visible small collaterals on the skin surface.
**Fen Ci**: Targets the intersection of muscle fibers and valleys (acupoints), treating pathogens in the muscles.
**Da Xie Ci**: Drains large amounts of pus and blood.
**Mao Ci**: Superficial treatment for pathogens trapped in the skin, ensuring no injury to deeper tissues ("Puncture hair without injuring skin; puncture skin without injuring flesh").
**Ju Ci**: Treats pathogens in the Twelve Extraordinary Meridians via cross-limb needling.
**Fan Ci**: Uses fire needles to treat tendon Bi.
There are twelve categories of puncture techniques corresponding to the Twelve Primary Meridians:
1. **Ou Ci (Paired Puncture)**: Simultaneous anterior (chest) and posterior (back) needling opposite the pain site to treat Heart Bi, avoiding direct heart damage.
2. **Bao Ci (Reporting Puncture)**: For migrating pain without fixed location; insert needle, press surrounding area with left hand, withdraw, and re-insert.
3. **Hui Ci (Restoring Puncture)**: Vertical insertion with lateral manipulation to relax tight tendons in tendon Bi.
4. **Qi Ci (Uniform Puncture)**: One central vertical needle and two oblique needles for deep, localized cold Bi. Also called "San Ci" (Three Needles).
5. **Yang Ci (Spreading Puncture)**: One central needle and four surrounding superficial needles for extensive cold pathogens.
6. **Zhi Zhen Ci (Straight Needle Puncture)**: Pulling the skin taut before superficial puncture for shallow cold pathogens.
7. **Shu Ci (Transport Puncture - Variation)**: Deep, sparse needling with direct insertion and withdrawal for excess heat conditions.
8. **Duan Ci (Short Needle Puncture)**: Slightly shaking a short needle inserted deeply to the bone, rubbing against it to treat Bone Bi.
9. **Fu Ci (Floating Puncture)**: Oblique superficial insertion for muscle tension with cold.
10. **Yin Ci (Yin Puncture)**: Bilateral symmetrical needling for Cold-Jue syndrome, specifically targeting the Shaoyin meridian behind the ankle.
11. **Pang Zhen Ci (Side Needle Puncture)**: One vertical and one adjacent needle for chronic, stationary Bi syndrome.
12. **Zan Ci (Assisting Puncture)**: Rapid, shallow multiple pricks to bleed, treating carbuncles and swellings.
"Jie" refers to regulatory systems. Ou Ci pairs anterior (Yang) and posterior (Yin) points. Bao Ci repeats needling for migrating pain. Hui Ci expands and relaxes tendons. Qi Ci uses a central needle supported by two side needles for deep cold. Yang Ci spreads energy from center to periphery. Zhi Zhen Ci uses filiform needles vertically in the skin. Shu Ci mimics transport with direct deep insertion. Duan Ci uses short needles to reach bone for friction. Fu Ci is shallow and oblique. Yin Ci targets Shaoyin Cold-Jue. Pang Zhen Ci treats chronic Bi. Zan Ci assists the dispersal of swellings via bleeding. Among these, Shaoyin is highlighted as it governs先天 (Pre-heaven) Yin-Yang and Water-Fire, the origin of Wu Yun Liu Qi (Five Movements and Six Qi).
For deep, invisible pulses, insert the needle slightly and retain it for a long time to guide the empty pulse Qi. For superficial pulses, do not puncture directly; compress the vessel to stop flow before puncturing, allowing only pathogenic Qi to exit while preserving Essence.
This passage explains that meridians internally harmonize with the Five Elements and externally correspond to the Six Qi of Heaven. Meridians connect internally to Zang-Fu and externally to Six Qi. The Five Zang internally correspond to Five Elements (Wu Yun), named Shen Ji (Spirit Mechanism), governing ascent and descent. The Six Qi rotate externally, named Qi Li (Qi Establishment). The Six Qi of Heaven and Earth correspond to human Essence-Water, circulating on the body surface. Deep pulses connect to the Five Zang; retaining the needle brings Zang Shen Qi to the exterior. Superficial pulses correspond to external Six Qi; compressing prevents Essence loss while allowing Qi circulation. Master Yu states that guiding Zang Shen Ji relies not on Ying-Wei Blood-Qi, hence termed "Empty Pulse Qi."
The concept of "San Ci" (Three Stages of Puncture) yielding Gu Qi (Grain Qi):
1. Superficial puncture through the epidermis to expel Yang pathogens.
2. Slightly deeper puncture, reaching muscle but not the intermuscular space, to expel Yin pathogens.
3. Deep puncture into the intermuscular space to elicit Gu Qi.
Thus, initial shallow needling drives out pathogens and attracts Blood-Qi; deeper needling draws out Yin pathogens; deepest needling reaches Gu Qi. Practitioners must understand the annual climate influences (Nian Zhi Suo Jia), the waxing and waning of Qi (Qi Zhi Sheng Shuai), and the origins of deficiency and excess to be skilled physicians.
Gu Qi is the primordial truth integrated in muscle and tissue, governed by the Spleen and Stomach. Yin and Yang pathogens refer to imbalances in Qi levels. The progression of depth corresponds to the circulation of Three Yin and Three Yang Qi on the skin surface, mirroring the Six Qi of Heaven. Annual additions refer to the arrival of Six Qi; Qi waxing/waning refers to Wu Yun (excess/deficiency). These determine human deficiency/excess states.
There are five types of puncture techniques corresponding to the Five Zang:
1. **Ban Ci (Half Puncture)**: Superficial insertion and rapid withdrawal, resembling plucking hair, affecting skin Qi; corresponds to Lung.
2. **Bao Wen Ci (Leopard Pattern Puncture)**: Multiple punctures around the lesion intersecting vessels to release blood from meridians; corresponds to Heart.
3. **Guan Ci (Joint/Pivot Puncture)**: Vertical insertion at tendon attachments to treat Tendon Bi, avoiding bleeding; corresponds to Liver. Also known as Yuan Ci or Qi Ci.
4. **He Gu Ci (Valley Convergence Puncture)**: Chicken-foot shaped multi-directional needling between muscle layers to treat Muscle Bi; corresponds to Spleen.
5. **Shu Ci (Transport Puncture - Variation)**: Direct deep insertion to the bone to treat Bone Bi; corresponds to Kidney.
This section describes how Five Zang Qi externally correlates with Skin, Vessels, Flesh, Tendons, and Bone. Blood houses Shen Qi; Zang Shen Ji circulates in vessels corresponding to Wu Yun. Zang Qi externally correlates with tissues corresponding to Four Seasons. Master Yu notes: Nine Appropriatenesses/Variations correspond to Earth's Nine Regions/Nine Orifices; Twelve Categories correspond to Twelve Months; Three Stages correspond to Three Yin/Yang; Five Punctures correspond to Five Elements/Five Seasons. Acupuncture aligns with Heaven, Earth, and Humanity, wherein humans integrate with Heaven and Earth.