黄帝问曰。余闻缪刺。未得其意。何谓缪刺。（缪刺者。谓病在左而取之右。病在右而取之左。如纰缪也。）岐伯对
曰。夫邪之客于形也。必先舍于皮毛。留而不去。入舍于孙脉。留而不去。入舍于络脉。留而不去。入舍于经脉。内连
五脏。散于肠胃。阴阳俱感。五脏乃伤。此邪之从皮毛而入。极于五脏之次也。如此则治其经焉。（此先言邪气循序而入
于经者。则当治其经也。夫经脉为里。支而横者为络。络之别者为孙。络脉外见于皮部。经脉内连于脏腑。邪之始客于
形也。必先舍于皮毛。留而不去。则传入于孙络。盖从孙而络。络而经也。阴阳俱感者。谓皮毛气分为阳。经络血分为
阴。言五脏之血气。外充于形身。有阴而有阳也。夫十二经脉。三阴者属脏络腑。三阳者属腑络脏。而云内连五脏。散
于肠胃者。谓地之五行。以生人之五脏。三阴三阳之六气。亦由五行之所生。故凡论经脉。以五脏五行之气为主。而六
腑为其合也。极、至也。次、处也。此言邪入于经。而至于五脏之次者。不缪刺也。）今邪客于皮毛。入舍于孙络。留而
不去。闭塞不通。不得入于经。流溢于大络。而生奇病也。（此言邪入于大络者。当缪刺也。孙络者。孙脉也。孙络之脉
别经者。亦三百六十五脉。并注于大络。大络者。脏腑之经隧也。灵枢经曰。胃之所出血气者。经隧也。经隧者。五脏
六腑之大络也。闭塞不通者。络脉不通也。络脉闭塞。则皮肤孙络之邪。不得入于经而流溢于大络矣。奇病者。谓病气
在左而证见于右。病气在右而证见于左。盖大络乃经脉之别。阳走阴而阴走阳者也。按此论乃大络与皮肤孙络相通。胃
腑所出之气血。从胃络而注于脏腑之大络。从大络而先行皮肤。先充络脉。从络脉而复入于经。以养五脏气。此胃气之
所由出也。至于水谷所生之津液。以资养五脏之精者。由脾脏之转输也。是津液气血。皆由水谷之所生。胃腑之所出。
而各有其道。故曰孙络三百六十五穴会。以溢奇邪。以通荣卫。又曰。肉分之间。溪谷之会。以行荣卫。以会大气。大
气者。宗气也。是胃腑之宗气血气。有由经隧而先行于皮肤孙络之间。与荣卫交会者也。）夫邪客大络者。左注右。右注
左。上下左右。与经相干。而布于四末。其气无常处。不入于经俞。命曰缪刺。（左注右而右注左者。因大络之左右互交。
邪随络气而流注也。经、经隧也。言脏腑之大络。与胃之经隧相通。而布于四末。盖四肢乃为诸阳之本。阳明胃气之所
生也。其气无常处者。布于四末。而散于脉外。不入于经俞。故命曰缪刺。经脉篇曰。手太阴之别。并太阴之经直入掌
中。手少阴之别。循经入于心中。盖大络俱并经而行。故曰与经相干。）帝曰。愿闻缪刺。以左取右。以右取左。奈何。
其与巨刺。何以别之。（缪刺巨刺之病。皆左右相注。故问何以别之。）岐伯曰。邪客于经。左盛则右病。右盛则左病。
亦有移易者。左痛未已。而右脉先病。如此者。必巨刺之。必中其经。非络脉也。故络病者。其痛与经脉缪处。故命曰
缪刺。（此言邪客于经者。当巨刺也。巨、大也。谓当以长针取之。亦左取右而右取左也。夫大络之邪。由孙络之流注。
故可浅刺络脉。以取大络之气。如邪在经者。当巨刺以取之。必中其经。非络脉之比也。经谓十二经之别。即灵枢经别
篇之所谓足太阳之正。与足少阴之正为一合。足少阳之正。与足厥阴之正为二合。足阳明之正。与足太阴之正为三合。
手太阳之正。与手少阴之正为四合。手少阳之正。与手厥阴之正为五合。手阳明之正。与手太阴之正为六合是也。此亦
阴阳相贯。左右相交。是以左病则右盛。右病则左盛。亦有移易者。谓有病在阳经。而移入于阴经者。有病在阴经。而
移入于阳经者。故左病未已。而右脉先病。如此者。必巨刺之。必中其经。非络脉也。络脉者。大络也。故络病者。其
痛与经脉缪处。故命曰缪刺。按此节分别大络与经脉。各走其道。不相交通。然为病皆左注右而右注左。俱宜缪刺者也。
故以巨刺之法。少分别之。故曰络病者。其痛与经脉缪处。故命曰缪刺。再按灵枢经有经脉篇。论脏腑之十二经脉者也。
有经别篇。即巨刺之经也。有十五大络。即缪刺之络也。在十二经脉。则曰盛则泻之。虚则补之。热则疾之。寒则留之。
陷下则灸之。不盛不虚。以经取之。在十五大络。十二经别。未论其缪刺巨刺之法。故补论于诸刺篇之后。名曰缪刺论。
当知灵素二经。皆黄帝之典
坟。而素问多有补灵枢之未尽者。圣人救世之婆心也。愚谓血气之生始。经脉之贯通。乃医学之根本。学人当合参灵枢。
细心体会。不可以其刺而忽之。张兆璜曰。上古之法。首重针砭。次齐药食。故有讥丹溪为一代名流。不按针刺。针刺
之道。医者不可不知。）帝曰。愿闻缪刺奈何。取之何如。岐伯曰。邪客于足少阴之络。令人卒心痛。暴胀胸胁支满。
无积者。刺然骨之前出血。如食顷而已。不已左取右。右取左。病新发者。取五日已。（足少阴之络。名曰大钟。当踝后
绕跟。别走太阳。其别者。并经上走于心包下。外贯腰脊。故邪客之。令人卒心痛。暴胀。胸胁支满。无积者。无盛血
之结也。当刺然骨之前出血。如食顷而已。不已当缪取之。新病者。刺五日病已。）邪客于手少阳之络。令人喉痹。舌卷
口干。心烦。臂外廉痛。手不及头。刺手中指次指爪甲上。去端如韭叶。各一 。壮者立已。老者有顷已。左取右。右
取左。此新病。数日已。（手少阳之别。名曰外关。去腕二寸。外绕臂。注胸中。合心主。夫手少阳乃三焦相火主气。注
胸中而合。于心主包络。故邪客之。令人喉痹舌卷。口干心烦。脉循臂。故痛不能举也。当刺中指心包络之中冲。次指
手少阳之关冲。去爪甲如韭叶许。各一 。壮者之气盛。故立已。老者之气衰。故有顷。此言手少阳三焦之主气也。如
不已者。乃左注右而右注左。当缪刺之。此为新病。当数日已。盖言邪始客于皮毛孙络。而流溢于大络者。非久病也。
按灵枢经脉篇云。六经络。手阳明少阳之大络。起于五指间。上合肘中。饮酒者。卫气先行皮肤。先充络脉。络脉先盛。
故卫气已平。营气乃满。而经脉大盛。是胃气之行于经隧者。布于四末。行于皮肤。而诸井穴。乃经气之所出。故皆取
刺其井焉。）邪客于足厥阴之络。令人卒疝暴痛。刺足大指爪甲上与肉交者各一 。男子立已。女子有顷已。左取右。右
取左。（足厥阴之络。名曰蠡沟。去内踝五寸。别走少阳。其别者。经茎上睾。结于茎。故邪客之。令人卒疝暴痛。以其
络上睾丸而结于阴茎也。当取足大指之大敦。在爪甲上与肉相交之处。左右各一 。男子之血盛。故立已。女子之生。
不足于血。故有顷。此言厥阴肝经之主血也。如不已。再缪取之。）邪客于足太阳之络。令人头项肩痛。刺足小指爪甲
上与肉交者各一 。立已。不已刺外踝下三 。左取右。右取左。如食顷已。（足太阳之络。名曰飞扬。去踝七寸。别走
少阴。足太阳为诸阳主气。其气上升于头项。故邪客于络。而致头项肩痛也。当取足小指之至阴穴。左右各一 。如不
已。取外踝下之络脉三 。以缪刺之。）邪客于手阳明之络。令人气满胸中喘息。而支 胸中热。刺手大指次指爪甲上。
去端如韭叶。各一 。左取右。右取左。如食顷已。（手阳明之络。名曰偏历。去腕三寸。别入太阴。故邪客之。令人气
满胸中喘息。及支 胸热。盖手太阴主气。以司呼吸。而脉循于胸中也。故当取手大指之少商。次指之商阳。各一 。
左取右。右取左。如食顷。其病即已。）邪客于臂掌之间。不可得屈。刺其踝后。先以指按之。痛乃刺之。以月生死为数。
月生一日一 。二日二 。十五日十五 。十六日十四 。（臂掌之间。手厥阴之络也。厥阴之络。名曰内关。去腕二寸。
出于两筋之间。循经以上。系于心包络。故当刺其腕踝之后。循臂而上。按其痛处乃刺之。以月生死为数。盖手厥阴心
主主血脉。是谓得时而调之也。月晦初生曰朔。故一日为月生。）邪客于足阳跷之脉。令人目痛。从内 始。刺外踝之下
半寸所。各二 。左刺右。右刺左。如行十里顷而已。（此言阳跷之脉。亦左右互交。会于睛明。所当缪刺者也。阳跷者。
足太阳之别。起于足外踝下太阳之申脉穴。当踝后绕跟。以仆参为本。上外踝三寸。以跗阳为 。循股胁。上肩 。上
人迎。挟口吻。至目内 。会于足太阳之睛明穴。故邪客之。令人目痛。从内 始也。当刺外踝下之仆参申脉。左右各
二。如痛在左目者取之右。痛在右目者取之左。盖跷脉挟口吻。左右互交。而上于目内 也。按灵枢寒热篇曰。足太
阳有通项入于脑者。正属目本。名曰眼系。乃别阴跷阳跷。阴阳相交。阳入阴。阴入阳。交于目锐 。是阴跷阳跷。左
右交转于面。故病在上者。当缪取之下也。）人有所堕坠。恶血留内。腹中胀满。不得前后。先饮利药。此上伤厥阴之
脉。下伤少阴之络。刺足内踝之下。然谷之前。血脉出血。刺足跗上动脉。不已。刺三毛上各一 。见血立已。左刺右。
右刺左。善悲惊不乐。刺如右方。（此言堕伤者。亦当用缪刺之法也。恶血留内。则气脉不通。是以腹中满胀。肝主疏泄。
肾开窍于二阴。故不得前后也。先服利药。以去恶血。所谓先治其标也。夫堕坠者。有伤筋骨。筋即为肝。骨即为肾。
是以上伤厥阴之脉。下伤少阴之络。当刺足内踝下厥阴之中封。然谷前少阴之络脉。血脉出血。以调其经。再刺足跗上
阳明之动脉。以消腹胀。如不已。再刺三毛上肝经之大敦。盖堕坠者。伤筋骨与血。肝主筋而主血也。如悲惊不乐者。
亦刺如前法。盖堕伤血脉筋骨。伤五脏外合之有形。悲惊不乐。伤五脏内藏之神志。皆当以针调之。张兆璜曰。神有
余不足。志有余不足。皆调之于经。盖言用针之神妙。非则调之于有形也。）邪客于手阳明之络。令人耳聋时不闻音。刺
手大指次指爪甲上。去端如韭叶。各一 。立闻。不已。刺中指爪甲上与肉交者。立闻。其不时闻者。不可刺也。耳中
生风者。亦刺之如此数。左刺右。右刺左。（手阳明之络。其别者入耳。合于宗脉。故邪客之。令人耳聋。时不闻音。谓
有时闻而有时不闻也。盖邪客于络。络脉闭塞。则有时而不闻。脉气有时而通。则有时而闻矣。亦当取手太阴之少商。
手阳明之商阳。盖耳者。宗脉之所聚也。宗脉出于阳明。而合于手太阴。故刺之立闻。如不已。刺中指心主之中冲。盖
十二经脉。三百六十五络。皆上于面而走空窍。心主脉而开窍于耳也。其不时有闻者。乃内伤之聋证。非邪客于络。不
可刺也。耳中生风者。耳鸣之如风生也。此邪在于络。从外窍而欲出。故刺之亦如此数。）凡痹往来行无常处者。在分肉
间。痛而刺之。以月生死为数。用针者。随气盛衰。以为 数。针过其日数则脱气。不及日数则气不泻。左刺右。右刺
左。病已止。不已。复刺之如法。月生一日一 。二日二 。渐多之。十五日十五 。十六日十四 。渐少之。（此言邪
痹于肌腠之气分者。亦当以缪取也。凡痹往来行无常处者。邪随气转。谓之行痹。故当于分肉间。随其痛处而取之。夫
月始生。则血气始精。卫气始行。月郭满。则血气实。肌肉坚。月郭空。则肌肉减。经络虚。卫气去。形独居。是以邪
客于手厥阴心主之血分。客于肌腠分肉之卫分。皆当以月生死盈亏而加减之。）邪客于足阳明之经令人鼽衄。上齿寒。
刺足中指次指爪甲上。与肉交者各一 。左刺右。右刺左。（此言经脉之有互交者。亦当以缪取也。经、谓阳明之经脉也。
足阳明之脉。起于鼻交 中。上入齿中。环绕唇下。左右相交于承浆。故邪客阳明之经而令人鼽衄上齿寒者。亦当以缪
刺也。足阳明之脉。下入中指外间。其支者。别跗上。入大指间出其端。故当取中指间之内庭。大指次指间之厉兑。各
一。而缪刺之。此言脏腑之经脉。如左右互交而为病于相交之上者。亦当左取右而右取左也。）邪客于足少阳之络。令
人胁痛不得息。咳而汗出。刺足小指次指爪甲上。与肉交者各一 。不得息立已。汗出立止。咳者温衣饮食。一日已。
左刺右。右刺左。病立已。不已。复刺如法。（足少阳之络。名曰光明。去踝五寸。别走厥阴。下络足跗。一呼一吸曰息。
肺所司也。足少阳厥阴之脉。并循于胁。厥阴之脉。上主肺。循喉咙。邪客于少阳之络。令人胁痛不得息者。阳邪而走
于阴。络病而及于脉。盖阴阳经脉之相通也。足少阳所生病者汗出。上逆于肺则咳也。当刺足小指次指之窍阴穴。盖此
穴在四指五指之间。故各刺一 。其不得息。汗出立已。咳者。邪干肺也。故宜温衣。及温暖饮食。若形寒饮冷。是为
黄帝问道：我听说过缪刺，但还没理解它的含义。什么是缪刺？（缪刺，是指病在左侧而取右侧穴位，病在右侧而取左侧穴位，就像错乱一样。）岐伯回答说：邪气侵犯人体，一定先停留在皮毛。如果停留不去，就会进入孙脉；如果还停留不去，就会进入络脉；如果继续停留不去，就会进入经脉，向内连系五脏，散布于肠胃。阴阳都受到邪气侵袭，五脏就会受伤。这是邪气从皮毛侵入，进而到达五脏的次序。像这种情况，就应当治疗其经脉。（这里先说明邪气按照顺序传入经脉的情况，就应当治疗经脉。经脉是深部的主干，分支横出的叫络脉，络脉再分出的叫孙脉。络脉外显于皮部，经脉内连于脏腑。邪气刚开始侵犯人体时，一定先停留在皮毛，如果停留不去，就会传入孙络。大概是从孙脉传到络脉，再从络脉传到经脉。所谓“阴阳俱感”，是说皮毛的气分属阳，经络的血分属阴。意思是五脏的血气，向外充盈于形体身体，既有阴也有阳。十二经脉中，三阴经属于脏而络属腑，三阳经属于腑而络属脏。文中说“内连五脏，散于肠胃”，是指大地的五行化生人的五脏，三阴三阳的六气，也是由五行所产生。所以凡是论述经脉，都以五脏五行的气为主，而六腑作为配合它们的存在。“极”就是至，“次”就是处。这里说的是邪气进入经脉，进而到达五脏所在之处，这种情况下不采用缪刺法。）现在，邪气客居在皮毛，进入孙络，停留不去，导致闭塞不通，不能进入经脉，而是流溢到大络，从而产生奇异的病症。（这里说的是邪气进入大络的情况，应当采用缪刺法。孙络，就是孙脉。与经脉别行的孙络，也有三百六十五条，都注入大络。大络，是脏腑的经隧。《灵枢经》说：“胃所出血气的地方，就是经隧。”经隧，就是五脏六腑的大络。闭塞不通，是指络脉不通。络脉闭塞，那么皮肤孙络中的邪气，就不能进入经脉，而流溢到大络了。所谓的“奇病”，是指病气在左边而症状出现在右边，病气在右边而症状出现在左边。因为大络是经脉的别行部分，阳气走向阴经，阴气走向阳经。按此论述，大络与皮肤孙络相通，胃腑所出的气血，从胃络注入脏腑的大络，从大络先行于皮肤，先充盈络脉，再从络脉重新进入经脉，以滋养五脏之气。这就是胃气发出的途径。至于水谷所化生的津液，用来滋养五脏精气的，是由脾脏转输的。这样看来，津液和气血，都是由水谷生成，从胃腑发出，但各有其道。所以说孙络有三百六十五个穴会，用来溢出奇邪，通畅营卫。又说：“肉分之间，溪谷之会，用来运行营卫，汇聚大气。”大气，就是宗气。这说明胃腑的宗气和气血，有的通过经隧先行于皮肤孙络之间，与营卫交会。）邪气客居在大络，左边的注向右，右边的注向左，上下左右，与经脉相互干扰，并布散于四肢末端。它的气没有固定的位置，不进入经脉和腧穴，这就叫做缪刺。（左注右、右注左，是因为大络左右互相交错，邪气随着络脉之气流注。经，指经隧。意思是脏腑的大络，与胃的经隧相通，并布散于四肢末端。大概四肢是诸阳之本，是阳明胃气所生发的地方。它的气没有固定位置，是布散于四肢末端，散于脉外，不进入经脉腧穴，所以叫做缪刺。《经脉篇》说：“手太阴之别，并入太阴经直入掌中；手少阴之别，循经进入心中。”大概大络都是伴随经脉而行的，所以说“与经相干”。）黄帝说：我想听听缪刺的方法，为什么左边有病取右边的穴位，右边有病取左边的穴位？它与巨刺有什么区别？（缪刺和巨刺治疗的疾病，都是左右相互对应，所以问如何区别。）岐伯说：邪气客居在经脉，左边盛则右边发病，右边盛则左边发病，也有转移变化的情况，左边痛还没好，右边的脉先病了。像这种情况，必须用巨刺法。必须刺中经脉，而不是络脉。所以络脉生病，它的疼痛部位与经脉交错不同，所以叫做缪刺。（这里说的是邪气客居在经脉的情况，应当用巨刺法。巨，就是大。意思是用长针来取治，也是左病取右、右病取左。但是大络的邪气，由孙络流注而来，所以可以浅刺络脉，以取大络之气。如果邪气在经脉，应当用巨刺法来取治，必须刺中经脉，不像络脉那样浅刺。经，指十二经的别络，即《灵枢·经别》篇所说的足太阳之正与足少阴之正为一合，足少阳之正与足厥阴之正为二合，足阳明之正与足太阴之正为三合，手太阳之正与手少阴之正为四合，手少阳之正与手厥阴之正为五合，手阳明之正与手太阴之正为六合。这也是阴阳相互贯通，左右相互交错，所以左病则右盛，右病则左盛。也有转移变化的情况，是指有病在阳经而移入阴经的，有病在阴经而移入阳经的。所以左病未好，右脉先病，像这种情况，必须用巨刺法，必须刺中经脉，而不是络脉。络脉，指大络。所以络脉生病，它的疼痛部位与经脉交错不同，所以叫做缪刺。按此节分别了大络与经脉，各走其道，不相交通。然而致病都是左注右、右注左，都适宜用缪刺法。所以用巨刺法稍加区别。所以说络脉生病，其疼痛与经脉交错不同，故命曰缪刺。再按，《灵枢经》有《经脉篇》，论述脏腑的十二经脉；有《经别篇》，即巨刺所用的经；有十五大络，即缪刺所用的络。在十二经脉中，说盛则泻之，虚则补之，热则疾之，寒则留之，陷下则灸之，不盛不虚以经取之。在十五大络和十二经别中，没有论述缪刺和巨刺的方法，所以在各种刺法篇章之后补充论述，名叫《缪刺论》。应当知道《灵枢》和《素问》这两部经典，都是黄帝的典籍，而《素问》多有补充《灵枢》未尽之处的地方，这是圣人救世的一片苦心。我认为血气的生成起始，经脉的贯通，是医学的根本，学医的人应当合参《灵枢》，细心体会，不可以因为它只是针刺就忽视它。张兆璜说：上古的法度，首先重视针砭，其次才是齐备药食。所以有人讥讽丹溪先生是一代名流，却不按针刺之法行事。针刺之道，医者不可不知。）黄帝说：我想听听缪刺是怎么回事？取穴有什么讲究？岐伯说：邪气客居在足少阴肾经的络脉，使人突然心痛，突发腹胀，胸胁支撑胀满。如果没有瘀血积结的，针刺然骨之前的穴位出血，大约吃一顿饭的时间就好了。如果不好，左边取右边，右边取左边。新发的病，针刺五天就能痊愈。（足少阴的络脉，名叫大钟，位于踝后绕跟，别行走向太阳经。它的分支，伴随经脉上行走到心包下方，外贯腰脊。所以邪气客居于此，使人突然心痛，突发腹胀，胸胁支撑胀满。无积者，指没有盛血形成的结块。应当针刺然骨之前出血，大约吃一顿饭的时间就好。如果不好，应当采用缪刺法。新病，针刺五天病愈。）邪气客居在手少阳三焦经的络脉，使人喉痹，舌卷缩，口干，心烦，手臂外侧疼痛，手举不到头。针刺手中指和无名指指甲上，距离指尖如韭菜叶宽的地方，各刺一针。体质强壮的人立刻就好，年老体弱的人过了一会儿就好。左边取右边，右边取左边。这是新病，几天就能痊愈。（手少阳的别络，名叫外关，距离手腕二寸，向外绕行手臂，注入胸中，合于心主。手少阳是三焦相火主气，注入胸中合于心主包络，所以邪气客居于此，使人喉痹舌卷，口干心烦。脉循行于手臂，所以疼痛不能举起。应当针刺中指的心包络之中冲穴，无名指的手少阳之关冲穴，距离指甲如韭菜叶许，各刺一针。体质强壮的人气盛，所以立刻就好；年老体弱的人气衰，所以过了一会儿就好。这里讲的是手少阳三焦的主气。如果不好，那就是左注右、右注左，应当缪刺。这是新病，应当几天就好。大概说的是邪气刚开始客居在皮毛孙络，而流溢到大络的，不是久病。按《灵枢·经脉篇》说：“六经络，手阳明、手少阳的大络，起于五指间，向上合于肘中。”饮酒的人，卫气先行于皮肤，先充盈络脉，络脉先盛，所以卫气已平，营气乃满，而经脉大盛。这是胃气行于经隧，布散于四肢末端，行于皮肤，而诸井穴，是经气所出的地方，所以都取刺其井穴。）邪气客居在足厥阴肝经的络脉，使人突然疝气，突发剧痛。针刺足大指指甲上与肉交接的地方，各刺一针。男子立刻就好，女子过了一会儿就好。左边取右边，右边取左边。（足厥阴的络脉，名叫蠡沟，距离内踝五寸，别行走向少阳经。它的分支，沿阴茎上睾，结于茎。所以邪气客居于此，使人突然疝气，突发剧痛。因为它的络脉上连睾丸而结于阴茎。应当取足大指的大敦穴，在指甲上与肉相交之处，左右各刺一针。男子的血盛，所以立刻就好；女子因生育等原因血不足，所以过了一会儿就好。这里讲的是厥阴肝经主血。如果不好，再缪刺。）邪气客居在足太阳膀胱经的络脉，使人头项肩痛。针刺足小指指甲上与肉交接的地方，各刺一针，立刻就好。如果不好，针刺外踝下三寸处，左边取右边，右边取左边，大约吃一顿饭的时间就好。（足太阳的络脉，名叫飞扬，距离踝部七寸，别行走向少阴经。足太阳是诸阳主气，其气上升于头项，所以邪气客居在络脉，导致头项肩痛。应当取足小指的至阴穴，左右各一针。如果不好，取外踝下的络脉三寸处，以缪刺法针刺。）邪气客居在手阳明大肠经的络脉，使人气满胸中，喘息，胸部支撑发热。针刺手大指和食指指甲上，距离指尖如韭菜叶宽的地方，各刺一针。左边取右边，右边取左边，大约吃一顿饭的时间就好。（手阳明的络脉，名叫偏历，距离手腕三寸，别入太阴经。所以邪气客居于此，使人气满胸中喘息，以及胸部支撑发热。盖手太阴主气，司呼吸，而脉循行于胸中。所以应当取手大指的少商穴，食指的商阳穴，各一针，左边取右边，右边取左边，大约吃一顿饭的时间，病即好。）邪气客居在臂掌之间，不能屈伸。针刺其踝后，先用手指按压，感到疼痛后再针刺。以月亮的盈亏变化决定针刺的次数。月亮初生第一天刺一针，第二天刺两针，第十五天刺十五针，第十六天刺十四针。（臂掌之间，是手厥阴心包经的络脉。厥阴的络脉，名叫内关，距离手腕二寸，出于两筋之间，循经而上，系于心包络。所以应当刺腕踝之后，循臂而上，按压痛点再刺。以月亮的盈亏变化决定次数。盖手厥阴心主主血脉，这叫顺应时机来调治。月亮晦暗初生叫朔，所以第一天为月生。）邪气客居在足阳跷脉，使人目痛，从内眼角开始。针刺外踝下半寸处，各刺两针。左边刺右边，右边刺左边，大约行走十里路的时间就好。（这里说的是阳跷脉，也左右互相交错，会于睛明穴，应当缪刺。阳跷，是足太阳的别络，起于足外踝下太阳经的申脉穴，当踝后绕跟，以仆参为本穴，上外踝三寸，以跗阳为穴，循股胁，上肩，上人迎，挟口吻，至目内眦，会于足太阳的睛明穴。所以邪气客居于此，使人目痛，从内眼角开始。应当刺外踝下的仆参、申脉，左右各两针。如果痛在左眼取右，痛在右眼取左。盖跷脉挟口吻，左右交错，而上行至目内眦。按《灵枢·寒热篇》说：“足太阳有通项入于脑的，正属目本，名叫眼系。”乃别阴跷阳跷，阴阳相交，阳入阴，阴入阳，交于目锐眦。是阴跷阳跷，左右交转于面，所以病在上者，应当缪取下部。）人有所坠落，恶血留在体内，腹中胀满，大小便不通。先服用通利药物。这是上伤厥阴之脉，下伤少阴之络。针刺足内踝之下，然骨之前的血脉出血。针刺足背上的动脉，如果不好，针刺足大趾丛毛处各一针，见血立刻就好。左边刺右边，右边刺左边。如果伴有悲伤、惊恐、不乐的症状，针刺方法同上。（这里说的是坠伤者，也应当用缪刺法。恶血留在体内，则气脉不通，所以腹中满胀。肝主疏泄，肾开窍于二阴，所以大小便不通。先服利药，以去恶血，所谓先治其标。夫坠伤者，有伤筋骨，筋即为肝，骨即为肾，所以上伤厥阴之脉，下伤少阴之络。应当刺足内踝下厥阴经的中封穴，然谷前少阴经的络脉，使血脉出血，以调其经。再刺足背上阳明经的动脉，以消腹胀。如果不好，再刺足大趾丛毛处肝经的大敦穴。盖坠伤者，伤筋骨与血，肝主筋而主血。如果悲伤、惊恐、不乐，也刺如上法。盖坠伤血脉筋骨，伤五脏外合之有形；悲伤、惊恐、不乐，伤五脏内藏之神志，都应当以针调治。张兆璜说：神有余不足，志有余不足，都调之于经。意思是说用针的神妙，不仅仅是调治有形的东西。）邪气客居在手阳明大肠经的络脉，使人耳聋，有时听不见声音。针刺手大指和食指指甲上，距离指尖如韭菜叶宽的地方，各刺一针，立刻能听见。如果不好，针刺中指指甲上与肉交接的地方，立刻能听见。如果经常听不见的，不可针刺。耳中生风（耳鸣如风声）的，也如此针刺。左边刺右边，右边刺左边。（手阳明的络脉，其别络入耳，合于宗脉。所以邪气客居于此，使人耳聋，有时听不见声音。谓有时听得见有时听不见。盖邪客于络，络脉闭塞，则有时听不见；脉气有时通畅，则有时听得见。也应当取手太阴的少商穴，手阳明的商阳穴。盖耳是宗脉所聚之处，宗脉出于阳明，而合于手太阴，所以刺之立闻。如果不好，刺中指的心的中冲穴。盖十二经脉，三百六十五络，都上于面而走空窍。心主脉而开窍于耳。其不时有听的，乃是内伤的聋证，不是邪气客居在络脉，不可针刺。耳中生风，是耳鸣如风生。此邪在于络，从外窍而出，所以刺之也如此数。）凡是痹症往来游走，没有固定位置的，在分肉间，痛处针刺。以月亮的盈亏变化决定次数。用针的人，随气盛衰，决定针刺次数。针刺超过天数则耗气，不及天数则邪气不泻。左刺右，右刺左。病好了停止，不好，再按此法针刺。月亮初生第一天一针，第二天两针，逐渐增多。第十五天十五针，第十六天十四针，逐渐减少。（这里说的是邪气痹阻于肌腠气分的，也应当缪取。凡是痹症往来游走，没有固定位置的，邪随气转，称为行痹，所以应当在分肉间，随其痛处取治。月亮始生，则血气始精，卫气始行；月亮圆满，则血气实，肌肉坚；月亮亏空，则肌肉减，经络虚，卫气去，形独居。所以邪气客居在手厥阴心主的血分，客居在肌腠分肉的卫分，都应当以月亮的盈亏加减次数。）邪气客居在足阳明胃经，使人鼻塞流涕或鼻出血，上齿发冷。针刺足中指和次指指甲上，与肉交接的地方，各刺一针。左边取右边，右边取左边。（这里说的是经脉有互交的，也应当缪取。经，指阳明之经脉。足阳明之脉，起于鼻交頞中，上入齿中，环绕唇下，左右相交于承浆。所以邪客阳明之经而使人鼽衄、上齿寒的，也应当缪刺。足阳明之脉，下入中指外间，其支者，别跗上，入大指间出其端。所以应当取中指间之内庭穴，大指次指间的厉兑穴，各一针，而缪刺之。这里说的是脏腑的经脉，如左右互交而为病于相交之上的，也应当左取右而右取左。）邪气客居在足少阳胆经的络脉，使人胁痛不得呼吸，咳嗽而汗出。针刺足小指和次指指甲上，与肉交接的地方，各刺一针。不得呼吸立刻好，汗出立刻止。咳嗽者穿暖衣服，喝温暖饮食，一天就好。左边刺右边，右边刺左边，病立刻好。如果不好，再按此法针刺。（足少阳的络脉，名叫光明，距离踝五寸，别走厥阴，下络足跗。一呼一吸叫息，由肺所司。足少阳、厥阴之脉，并循于胁。厥阴之脉，上主肺，循喉咙。邪客于少阳之络，使人胁痛不得呼吸，是阳邪走于阴，络病及于脉，盖阴阳经脉相通。足少阳所生病者汗出，上逆于肺则咳。应当刺足小指次指的窍阴穴。盖此穴在第四指第五指之间，故各刺一针。其不得呼吸、汗出立刻好。咳嗽者，邪干肺也，故宜温衣及温暖饮食。若形寒饮冷，是为……）
Huangdi asked, saying: "I have heard of Miao Ci (Miao Puncture), but I do not yet understand its meaning. What is Miao Ci?" (Miao Ci refers to treating the right side when the disease is on the left, and treating the left side when the disease is on the right, akin to a cross-over or error.) Qibo replied: "When pathogenic factors invade the body, they first lodge in the skin and hair. If they remain and do not depart, they enter the Sun vessels (fine collateral branches). If they remain and do not depart, they enter the Luo vessels (collaterals). If they remain and do not depart, they enter the Jing vessels (main meridians), connecting internally to the Zang organs and scattering into the Fu organs and intestines/stomach. When both Yin and Yang are affected, the Zang organs are injured. This is the sequence by which pathogens enter from the skin and hair and reach the Zang organs. In such cases, one should treat the Jing vessels." (This first describes the scenario where pathogens enter the meridians sequentially; thus, one should treat the meridians. The Jing vessels are the deep trunks, while those branching horizontally are Luo vessels, and those branching further from the Luo are Sun vessels. Luo vessels manifest externally on the skin regions, while Jing vessels connect internally to the Zang-Fu organs. When pathogens first invade the body, they lodge in the skin and hair. If they remain, they transmit to the Sun collaterals. Generally, transmission goes from Sun to Luo, and from Luo to Jing. 'Both Yin and Yang affected' means the Qi aspect of the skin is Yang, and the Blood aspect of the meridians/collaterals is Yin. It implies that the Qi and Blood of the Zang organs fill the exterior body, possessing both Yin and Yang. Among the twelve Jing vessels, the three Yin belong to the Zang and connect to the Fu, while the three Yang belong to the Fu and connect to the Zang. The text says 'connecting internally to the Zang and scattering into the intestines/stomach,' referring to how the Five Elements of the earth generate the human Zang organs, and the Six Qi of the Three Yin and Three Yang also arise from the Five Elements. Therefore, discussions on Jing vessels focus primarily on the Qi of the Five Zang and Five Elements, with the six Fu organs serving as their counterparts. 'Ji' means ultimate/reaching, and 'Ci' means place/location. This states that when pathogens enter the Jing and reach the location of the Zang organs, Miao Ci is not used.)
"Now, if pathogens lodge in the skin and hair, enter the Sun collaterals, remain without departing, causing blockage and obstruction, preventing entry into the Jing vessels, and instead overflowing into the Da Luo vessels (major collaterals), strange diseases arise." (This describes the scenario where pathogens enter the Da Luo vessels, for which Miao Ci should be used. Sun collaterals are Sun vessels. The Sun vessels that branch off from the main channels number 365 and all pour into the Da Luo vessels. The Da Luo vessels are the major pathways of the Zang-Fu organs. The *Ling Shu* states: 'The places where the Stomach emits Qi and Blood are the Jing Sui (meridian tunnels). The Jing Sui are the great collaterals of the five Zang and six Fu organs.' Blockage and obstruction refer to blocked Luo vessels. When Luo vessels are blocked, pathogens in the skin and Sun collaterals cannot enter the Jing vessels and instead overflow into the Da Luo vessels. 'Strange diseases' refer to conditions where the pathogenic Qi is on the left but symptoms appear on the right, or vice versa. This is because the Da Luo vessels are branches of the Jing vessels, where Yang moves to Yin and Yin moves to Yang. According to this discussion, the Da Luo vessels communicate with the skin and Sun collaterals. The Qi and Blood emitted by the Stomach flow from the Stomach collaterals into the Da Luo vessels of the Zang-Fu, then proceed to the skin, first filling the Luo vessels, and then re-entering the Jing vessels to nourish the Qi of the five Zang organs. This is the pathway through which Stomach Qi emerges. As for the Jin Ye (body fluids) generated from food and water, which nourish the essence of the Zang organs, they are transported by the Spleen. Thus, Jin Ye and Qi/Blood are all generated from food and water, emitted by the Stomach, yet each has its own pathway. Hence it is said that the 365 Sun collaterals meet at acupoints to overflow strange pathogens and unblock Ying and Wei. It is also said: 'Between the muscles, in the convergence of the Xi Gu (valleys), Ying and Wei circulate, and the Da Qi (Great Qi) converges.' Da Qi is Zong Qi (Gathering Qi). Thus, the Zong Qi and Qi/Blood of the Stomach have pathways via the Jing Sui that proceed first between the skin and Sun collaterals, intersecting with Ying and Wei.)
"When pathogens lodge in the Da Luo vessels, Qi flows from left to right and from right to left, interacting with the Jing vessels above and below, and distributing to the four extremities. Its Qi has no fixed location and does not enter the Jing Shu points; this is called Miao Ci." (Left-to-right and right-to-left flow occurs because the Da Luo vessels intersect left and right, and pathogens follow the flow of Luo Qi. 'Jing' refers to the Jing Sui. It means the great collaterals of the Zang-Fu connect with the Jing Sui of the Stomach and distribute to the four extremities. The four limbs are the root of all Yang meridians and are generated by the Stomach Qi of Yangming. 'Qi has no fixed location' means it distributes to the extremities and scatters outside the vessels, not entering the Jing Shu points, hence named Miao Ci. The *Jing Mai* chapter states: 'The Luo vessel of Hand Taiyin joins the Taiyin Jing and enters the palm directly; the Luo vessel of Hand Shaoyin follows the Jing into the heart.' Generally, Da Luo vessels run alongside the Jing vessels, hence 'interacting with the Jing vessels.')
"The Emperor said: 'I wish to hear about Miao Ci. Why take the right for left-sided disease and the left for right-sided disease? How does it differ from Ju Ci (Ju Puncture)?'" (Both Miao Ci and Ju Ci involve cross-treatment of left and right, so the question asks for the distinction.)
"Qibo said: 'When pathogens lodge in the Jing vessels, excess on the left causes disease on the right, and excess on the right causes disease on the left. There are also cases of shifting. If pain on the left persists while the pulse on the right becomes diseased first, one must use Ju Ci. One must penetrate the Jing vessels, not the Luo vessels. Therefore, for Luo vessel diseases, the pain is located differently from the Jing vessels, hence it is called Miao Ci.'" (This explains that when pathogens lodge in the Jing vessels, Ju Ci should be used. 'Ju' means large/great, implying using long needles. It also involves taking the right for left and left for right. However, pathogens in the Da Luo vessels flow from the Sun collaterals, so shallow puncture of the Luo vessels can extract Da Luo Qi. If pathogens are in the Jing vessels, Ju Ci should be used to penetrate the Jing vessels, unlike the shallow puncture of Luo vessels. 'Jing' here refers to the divergent branches of the twelve meridians, as described in the *Ling Shu · Jing Bie* chapter: Foot Taiyang Zheng combines with Foot Shaoyin Zheng (1st combination); Foot Shaoyang Zheng combines with Foot Jueyin Zheng (2nd); Foot Yangming Zheng combines with Foot Taiyin Zheng (3rd); Hand Taiyang Zheng combines with Hand Shaoyin Zheng (4th); Hand Shaoyang Zheng combines with Hand Jueyin Zheng (5th); Hand Yangming Zheng combines with Hand Taiyin Zheng (6th). This represents the mutual connection of Yin and Yang and the intersection of left and right. Thus, left disease causes right excess, and right disease causes left excess. 'Shifting' refers to diseases moving from Yang meridians to Yin meridians, or from Yin to Yang. So if left disease persists and the right pulse becomes diseased first, Ju Ci must be used, penetrating the Jing vessels, not the Luo vessels. 'Luo vessels' refer to the Da Luo vessels. Thus, for Luo vessel diseases, the pain differs from the Jing vessels, hence called Miao Ci. Note that this section distinguishes Da Luo vessels and Jing vessels, which follow separate paths and do not communicate. However, pathology involves left-to-right and right-to-left flow, suitable for Miao Ci. Ju Ci is used to differentiate slightly. Hence, 'Luo vessel diseases have pain distinct from Jing vessels, hence called Miao Ci.' Furthermore, the *Ling Shu* has the *Jing Mai* chapter discussing the twelve Jing vessels of the Zang-Fu; the *Jing Bie* chapter, which relates to Ju Ci; and the fifteen Da Luo vessels, which relate to Miao Ci. For the twelve Jing vessels, the treatment principles are: excess is drained, deficiency is tonified, heat is treated quickly, cold is retained, sinking points are moxa-ed, and neither excess nor deficiency is treated via the Jing itself. For the fifteen Da Luo and twelve Jing Bie, Miao Ci and Ju Ci methods were not discussed, so they are supplemented after the chapters on various punctures, titled *Miao Ci Lun*. One should know that both *Ling Shu* and *Su Wen* are classics of Huangdi, and *Su Wen* often supplements what *Ling Shu* did not fully cover, reflecting the sage's compassionate desire to save the world. I believe the generation of Qi and Blood and the penetration of meridians are the foundation of medicine. Students should study *Ling Shu* together and reflect carefully; do not neglect it just because it concerns acupuncture. Zhang Zhaohuang said: 'In ancient times, acupuncture and bian stones were prioritized, followed by medicines and foods. Thus, some criticized Danxi as a famous scholar who did not follow acupuncture methods. Acupuncture is essential knowledge for physicians.')"
"The Emperor said: 'I wish to know how Miao Ci works and how to select points.' Qibo said: 'When pathogens lodge in the Luo vessel of Foot Shaoyin, sudden heart pain, acute distension, and fullness/support in the chest and hypochondrium occur. If there is no accumulation of blood stasis, bleed the point anterior to Ran Gu. Recovery takes about the time it takes to eat a meal. If not cured, take the right for left and left for right. For newly onset diseases, five days of treatment will cure it.'" (The Luo vessel of Foot Shaoyin is named Da Zhong, located behind the ankle, winding around the heel, and diverging to the Taiyang channel. Its branch ascends along the channel to below the pericardium and penetrates the waist and spine. Pathogens lodging here cause sudden heart pain, acute distension, and chest/hypochondriac fullness. 'No accumulation' means no blood stasis knot. Bleed the point anterior to Ran Gu; recovery takes about a meal time. If not cured, apply Miao Ci. New diseases resolve in five days.)
"When pathogens lodge in the Luo vessel of Hand Shaoyang, throat obstruction (Bi), curled tongue, dry mouth, vexation, pain on the lateral aspect of the arm, and inability to raise the hand to the head occur. Puncture the nail bed area of the middle finger and the ring finger, distance equal to the width of a leek leaf from the tip, one needle each. Strong individuals recover immediately; elderly individuals recover after a short while. Take right for left and left for right. This is a new disease, resolving in a few days." (The divergent vessel of Hand Shaoyang is named Waiguan, two cun distal to the wrist, winding around the arm externally, pouring into the chest, and combining with the Heart Master. Hand Shaoyang governs Sanjiao Ministerial Fire, pouring into the chest and combining with the Pericardium. Pathogens here cause throat Bi, curled tongue, dry mouth, and vexation. The pulse runs along the arm, causing pain and inability to lift. Puncture Zhongchong (Pericardium) on the middle finger and Guanchong (Shaoyang) on the ring finger, distance equal to a leek leaf from the nail, one needle each. Strong individuals have abundant Qi and recover immediately; elderly individuals have declining Qi and recover after a while. This discusses the governing Qi of Hand Shaoyang Sanjiao. If not cured, due to left-right flow, apply Miao Ci. This is a new disease, resolving in a few days. Generally, pathogens initially lodge in skin/Sun collaterals and overflow into Da Luo vessels; this is not a chronic disease. According to *Ling Shu · Jing Mai*: 'The great collaterals of Hand Yangming and Hand Shaoyang originate between the five fingers and ascend to combine at the elbows.' For drinkers, Wei Qi moves first in the skin, filling the Luo vessels first. Once Wei Qi is balanced, Ying Qi fills, and Jing vessels become prominent. This shows Stomach Qi traveling via Jing Sui, distributing to extremities and skin. The Jing-Well points are where Jing Qi emerges, so puncturing them is appropriate.)
"When pathogens lodge in the Luo vessel of Foot Jueyin, sudden hernia and acute pain occur. Puncture the junction of the nail and flesh on the big toe, one needle each. Men recover immediately; women recover after a short while. Take right for left and left for right." (The Luo vessel of Foot Jueyin is named Ligou, five cun above the medial malleolus, diverging to Shaoyang. Its branch ascends along the penis to the testicles, knotting at the shaft. Pathogens here cause sudden hernia and acute pain because the Luo vessel connects to the testicles and knots at the penis. Puncture Dazhun on the big toe, at the junction of nail and flesh, one needle each side. Men have abundant blood and recover immediately; women have insufficient blood due to childbirth/nature and recover after a while. This discusses the blood-governing nature of Jueyin Liver. If not cured, repeat Miao Ci.)
"When pathogens lodge in the Luo vessel of Foot Taiyang, head, neck, and shoulder pain occur. Puncture the junction of the nail and flesh on the little toe, one needle each, recovering immediately. If not cured, puncture three cun below the lateral malleolus. Take right for left and left for right. Recovery takes about a meal time." (The Luo vessel of Foot Taiyang is named Feiyang, seven cun above the ankle, diverging to Shaoyin. Foot Taiyang governs Yang Qi, ascending to the head and neck. Pathogens in the Luo vessel cause head/neck/shoulder pain. Puncture Zhiyin on the little toe, one needle each side. If not cured, puncture the Luo vessel three cun below the lateral malleolus using Miao Ci.)
"When pathogens lodge in the Luo vessel of Hand Yangming, chest fullness, wheezing, and heat supporting the chest occur. Puncture the nail bed area of the index and thumb fingers, distance equal to the width of a leek leaf from the tip, one needle each. Take right for left and left for right. Recovery takes about a meal time." (The Luo vessel of Hand Yangming is named Pianli, three cun above the wrist, diverging to Taiyin. Pathogens here cause chest fullness, wheezing, and chest heat. Hand Taiyin governs Qi and respiration, with pulses running through the chest. Puncture Shaoshang on the thumb and Shangyang on the index finger, one needle each, right-for-left/left-for-right. Recovery takes about a meal time.)
"When pathogens lodge between the arm and palm, causing inability to flex, puncture behind the ankle. Press with fingers until pain is felt, then puncture. Use the waxing and waning of the moon to determine the number of needles. On the first day of the waxing moon, one needle; second day, two needles; fifteenth day, fifteen needles; sixteenth day, fourteen needles." (The area between arm and palm is the Luo vessel of Hand Jueyin. The Jueyin Luo vessel is named Neiguan, two cun above the wrist, emerging between two tendons, ascending along the channel to the Pericardium. Puncture behind the wrist/ankle, ascending along the arm, pressing the painful spot before puncturing. Use lunar phases to adjust numbers. Hand Jueyin Heart Master governs blood vessels, adjusting according to timing. The new moon is called Shuo; the first day is considered 'moon birth'.)
"When pathogens lodge in the Foot Yangqiao vessel, eye pain starting from the inner canthus occurs. Puncture half a cun below the lateral malleolus, two needles each. Left puncture right, right puncture left. Recovery takes about the time to walk ten li." (Yangqiao vessel intersects left and right, meeting at Jingming, suitable for Miao Ci. Yangqiao is a branch of Foot Taiyang, originating at Shenmai below the lateral malleolus, winding around the heel, with Puban as the root, ascending three cun above the lateral malleolus to Shuyang, following the thigh/flank, up to the shoulder, Renying, crossing the mouth corner, to the inner canthus, meeting Foot Taiyang at Jingming. Pathogens here cause eye pain starting from the inner canthus. Puncture Puban and Shenmai below the lateral malleolus, two needles each. Pain in left eye treats right; pain in right eye treats left. Yangqiao crosses the mouth and intersects left/right, ascending to the inner canthus. *Ling Shu · Han Re* states: 'Foot Taiyang has passages entering the brain, belonging to the root of the eye, named Eye System.' Yin and Yang Qiao intersect, Yang enters Yin, Yin enters Yang, intersecting at the outer canthus. Yin/Yang Qiao rotate left/right on the face; thus, upper body diseases are treated by Miao Ci on the lower body.)
"If a person falls, causing blood stasis to remain internally, leading to abdominal distension and inability to urinate or defecate, first administer purgative herbs. This injures the Jueyin vessel above and the Shaoyin Luo vessel below. Puncture the blood vessels anterior to Ran Gu below the medial malleolus to bleed. Puncture the arterial pulse on the dorsum of the foot. If not cured, puncture the hair tuft on the big toe, one needle each, bleeding immediately cures. Left puncture right, right puncture left. For sadness, fright, and unhappiness, use the same method." (Fall injuries require Miao Ci. Internal blood stasis blocks Qi/blood vessels, causing abdominal distension. Liver governs free flow; Kidney opens to the two yin orifices, causing urinary/fecal retention. First use purgatives to remove stasis, treating the branch. Falls injure sinews and bones; sinews relate to Liver, bones to Kidney. Thus, upper injury to Jueyin vessel, lower injury to Shaoyin Luo. Puncture Zhongfeng (Jueyin) below medial malleolus and Shaoyin Luo anterior to Ran Gu, bleeding to regulate the channel. Then puncture Yangming artery on the foot dorsum to reduce distension. If not cured, puncture Dazhun (Liver) on the big toe hair tuft. Falls injure sinews, bones, and blood; Liver governs sinews and blood. Sadness/fright/unhappiness also treated similarly. Fall injuries damage有形 (physical) aspects of Zang-Fu; emotional disturbances damage Shen (spirit) within Zang-FU. Both require needle regulation. Zhang Zhaohuang said: 'Excess/deficiency of Shen and Zhi are regulated via the channels. Needle therapy is profound, regulating not just physical forms.')"
"When pathogens lodge in the Luo vessel of Hand Yangming, deafness and intermittent hearing loss occur. Puncture the nail bed area of the index and thumb fingers, distance equal to the width of a leek leaf from the tip, one needle each. Hearing returns immediately. If not cured, puncture the junction of nail and flesh on the middle finger. Hearing returns immediately. If hearing is consistently absent, do not puncture. Tinnitus (wind in ears) is treated similarly. Left puncture right, right puncture left." (Hand Yangming Luo vessel branch enters the ear, combining with Zong Mai. Pathogens here cause deafness and intermittent hearing. 'Intermittent' means sometimes hearing, sometimes not. Pathogens block Luo vessels, causing silence; when Qi flows, hearing returns. Puncture Shaoshang (Taiyin) and Shangyang (Yangming). The ear is the gathering place of Zong Mai, originating from Yangming and combining with Taiyin, so puncturing restores hearing immediately. If not cured, puncture Zhongchong (Heart Master). All twelve Jing vessels and 365 collaterals ascend to the face and open into orifices. Heart Master governs pulses and opens to the ear. Consistent deafness is internal injury, not external pathogens in Luo vessels, so do not puncture. Tinnitus is wind-like noise; pathogens in Luo vessels exit via external orifices, so puncture similarly.)
"For Bi syndrome wandering without fixed location, located between muscle layers, puncture the painful areas. Use lunar phases to determine needle count. Practitioners should adjust needle counts based on Qi excess/deficiency. Exceeding the daily number depletes Qi; falling short fails to drain pathogens. Left puncture right, right puncture left. Stop when cured; if not, repeat. Waxing moon: Day 1 one needle, Day 2 two needles, increasing gradually. Day 15 fifteen needles, Day 16 fourteen needles, decreasing gradually." (Pathogenic Bi in the Qi aspect of muscle/skin requires Miao Ci. Wandering Bi follows Qi movement. Puncture between muscles at painful spots. Moon waxing: Qi/Blood refine, Wei Qi moves. Moon full: Qi/Blood solid, muscles firm. Moon empty: Muscles thin, meridians deficient, Wei Qi departs. Pathogens in Hand Jueyin Heart Master blood aspect and muscle Wei aspect should be adjusted by lunar phases.)
"When pathogens lodge in the Jing vessel of Foot Yangming, nasal congestion/epistaxis and cold upper teeth occur. Puncture the junction of nail and flesh on the middle and second toes, one needle each. Left puncture right, right puncture left." (Meridians with intersections also use Miao Ci. 'Jing' refers to Yangming Jing vessel. Foot Yangming originates at the nose, enters the teeth, surrounds the lips, intersecting at Chengjiang. Pathogens in Yangming causing rhinitis/epistaxis and cold upper teeth require Miao Ci. Foot Yangming descends between middle toes; branch ascends dorsum, enters big toe. Puncture Neiting (middle toe) and Lidui (big toe/second toe junction), one needle each, applying Miao Ci. This shows Zang-Fu meridians intersecting left/right; diseases at intersection points are treated cross-wise.)
"When pathogens lodge in the Luo vessel of Foot Shaoyang,胁痛 (hypochondriac pain) preventing breathing, coughing with sweating occur. Puncture the junction of nail and flesh on the little and second toes, one needle each. Breathing difficulty resolves immediately; sweating stops immediately. For cough, wear warm clothes and drink warm liquids; resolves in one day. Left puncture right, right puncture left. Disease resolves immediately. If not, repeat. (The Luo vessel of Foot Shaoyang is named Guangming, five cun above the ankle, diverging to Jueyin, connecting to the foot dorsum. One breath is 'Xi', governed by the Lung. Foot Shaoyang and Jueyin pulses run along the hypochondrium. Jueyin pulse governs Lung and runs along the throat. Pathogens in Shaoyang Luo cause hypochondriac pain and breathing difficulty as Yang pathogens move to Yin, Luo disease affecting pulses, showing Yin-Yang connection. Shaoyang diseases cause sweating; rising to Lung causes cough. Puncture Xiaolin on the little/second toe junction. This point is between the fourth and fifth toes, so one needle each. Breathing/sweating resolve immediately. Cough indicates Lung invasion; warm clothing/diet is needed. Cold exposure/cold drinks worsen it...)"