《灵枢·官针》篇云∶刺有十二节。《刺节真邪》论云∶刺有五节。长，犹广也。长刺节者，即以
病之所在，而为刺之之节。如头痛、寒热、腐肿、积疝、痹病、狂癫诸风，皆以病之所在，而取刺
之，所以广五节十二节之刺，故曰长刺节。
刺家不诊，听病者言。
岐伯承上编针解，而广刺节之意。《九针十二原》论云∶凡将用针，必先诊脉。今曰刺家不诊，但
听病者言，是施刺之法，有凭脉者，有证书者，所以广刺法之未尽也。
在头，头疾痛，为藏针之。刺至骨，病已，上无伤骨肉，及皮。皮者，道也。
藏，如字。此刺头痛之法也。在头，病在头也。头疾痛，因病
在头，卒然而痛也。藏，犹深也。藏针，深刺也。为藏针之，故刺
至骨，其病始已。刺虽在骨，其上则无伤骨外之肉，以及于皮。刺法由皮至骨，乃行针之道。故曰∶皮
者道也。道，犹路也。
阳刺入一，旁四处，治寒热，深专者，刺大脏，迫脏刺背，背
俞也，刺之迫脏，脏会，腹中寒热去，而止与刺之，要发针而浅出血。
阳，旧本讹阴，今改。处，去声。此刺寒热之法也。《灵枢·官针》篇∶五曰阳刺，阳刺者，正内一，
旁内四。阳刺入一，即正内一也，旁四处，即旁内四也。此阳刺之法，乃治寒热之病，若寒热不
在阳分，深而且专。深专者，入于阴分，故刺大脏。申明大脏者，迫脏刺背。五脏之俞，皆在于背，是
背俞也。又申明刺之迫脏者，以脏俞在背，为脏之会。夫入一旁四，乃阳刺，而治阳分之寒热。
迫脏刺背，乃阴刺，而治腹中之寒热。故腹中寒热去，而止与刺之。止与刺者，中病即止之意。下凡言止者，
皆止与刺也。无论阳刺阴刺，大要发针之时，贵浅出其血，以通络脉也。
治腐肿者，刺腐上，视痈小大，深浅刺。刺大者多血，小者深之，必端内针，为故止。
内，音纳。此刺腐肿之法也。肉烂已腐，高硕曰肿，治腐肿者，治其内腐外肿也。内腐外肿，即
当刺其腐上，更视痈之小大，以为深浅之刺。刺大者，刺大痈也。多血，多脓血也。大痈多血，当浅刺之。
小者，小痈也。痈小未溃，毒瓦斯在内，当深刺之，其深刺也，必端以内针，为复其故，而止与刺之。
病在少腹有积，刺皮HT 以下至少腹而止，刺挟脊两旁四椎间，
刺两髂 ，季胁肋间，导腹中气，热下已。
HT ， 同，音突。髂，音驾。 ，音料，余篇同。此刺腹积之法也。 ，肥浓也。病在少腹有积，
刺其积上皮 之处。少腹有积，则少腹皮 ，故以下至少腹而止是其处也。挟脊两旁四椎间，
乃心包厥阴之俞。少腹有积，刺厥阴俞者，脉要精微论云∶病名心疝，少腹当有形，故刺也。腰骨曰髂。
两髂 ，两边腰骨之侧，居 穴也。季胁肋间，章门穴也。季胁肋，乃足厥阴肝脉之经。髂
，乃足少阳胆脉之经。少腹有积，合刺厥阴少阳者，乃导腹中之气，温热其下，则病可已。下，指少腹也。
病在少腹，腹痛，不得大小便，病名曰疝。得之寒，刺少腹两
股间，刺腰髁骨间，刺而多之，尽炅病已。
此刺寒疝之法也。病在少腹，少腹且痛，并不得大小便者，病名曰疝。得之于寒，当刺少腹两股间，冲
门穴也。刺腰髁骨间，乃背十三椎下外旁，盲门穴也。刺少腹两股间，所以治疝也。刺腰髁
骨间，所以治寒也，故当刺而多之。炅，犹热也。俟其尽热，则病可已。
病在筋，筋挛节痛，不可以行，名曰筋痹。刺筋上为故，刺分
肉间，不可中骨也，病起筋炅，病已止。
中，去声。此刺筋痹之法也。病在筋，则筋挛而骨节痛。筋挛节痛，则不可以行，病名曰筋痹。即当
刺其筋上，使之不挛，为复其故其刺筋上之法，当刺分肉间，不可中骨也。刺之得宜，则病起
筋热。病起筋热，则病已，病已，则止刺也。
病在肌肤，肌肤尽痛，名曰肌痹，伤于寒湿。刺大分小分，多发针而深之，
以热为故，无伤筋骨，伤筋骨，痈发若变，诸分尽热，病已止。
此刺肌痹之法也。病在肌肤，肌肤尽痛，则名曰肌痹。此因伤于寒湿而为痹也，当刺肌肉之大分小分。
大分，肉之大会；小分，肉之小会。分肉之间，三百六十五会、故当多发针而深刺之、以热
气之至，为复其故。虽曰深之，无伤筋骨，伤筋骨，则痈发而若变，其未变时，刺得其宜，使诸分肉尽热，
则病已而止针。
病在骨，骨重不可举，论髓酸痛，寒气至，名曰骨痹。深者，
刺无伤脉肉，为故，其道大分小分，骨热，病已止。
酸，作 。此刺骨痹之法也。病在骨，骨重不可举，兼骨髓 痛。寒气至骨，病名曰骨痹。痹在于骨，
当刺其骨，而刺之深者，其刺当无伤其脉肉。刺得其宜，则骨痹去，而为复其故。其道，骨
道也。无伤脉肉者，其骨道之气，亦从肉之大分小分而出也，在骨
刺骨，候其气至，骨热，则病已而止针。
病在诸阳脉，且寒且热，诸分，且寒且热，名曰狂。刺之虚脉，视分尽热，病已止。
此刺狂病之法也。病在诸阳脉，而且寒且热，则邪气乘于经脉矣。诸分而且寒且热，则邪气乘于
分肉矣。分肉之邪、经脉之邪，两相交并，病名曰狂。刺之虚脉，使邪不乘于经脉也。视分尽热，
视分肉之间，正气聚而尽热也，如是，则狂病已而止针。
病初发，岁一发。不治，月一发。不治，月四五发，名曰癫
病。刺诸分诸脉，其无寒者，以针调之，病已止。
此刺癫病之法也。病初发，癫病初发也。初发不治，则岁一发。岁发不治，则月一发。月发不治，
则月四五发，凡此病发，名曰癫病。当刺诸分诸脉。诸分，诸分肉也；诸脉，诸经脉也。其无
寒者，言无寒热，不同于狂病之且寒且热也。狂病为阳，癫病为阴，阳属有余，阴属不足，故当以针调
补之，使病已而止针。
病风，且寒且热，炅汗出，一日数过，先刺诸分理络脉，汗出，且寒且热，三日一刺，百日而已。
此刺风病之法也。病风，且寒且热，炅汗出。一日数过者，风为阳邪，其性鼓动，故寒热，炅汗出，
一日数至也。先刺诸分理络脉者，先其未发之时，刺分肉之腠理，经外之络脉也。汗出，刺出
其汗也。汗出而寒热不解，仍且寒且热，则当三日一刺，至百日，则天干十周，其病可已。
病大风，骨节重，须眉堕，名曰大风。刺肌肉为故，汗出百日，刺骨髓汗出百日，凡二百日，
须眉生，而止针。
此刺疠风之法也。大风、疠风也。风邪客于脉而不去、皮肤疡 、名曰疠风。故病大风，内
则骨节重，外则须眉堕，名曰大风。当刺其肌肉，使肌肉为复其故，刺肌肉。而汗出百日，去其风邪。
骨节之邪，犹未去也，故更刺骨髓，亦汗出百日，凡二百日，则天干二十周，须眉生，而止针。
此举头痛腐肿积疝痹病狂癫诸风，刺之有节，而为长刺节也。
《灵枢·官针》篇中说：针刺有十二种法度。《刺节真邪》篇中说：针刺有五种法度。“长”，就是广博的意思。“长刺节”的意思，就是根据疾病所在的部位，来确定针刺的法度。例如头痛、寒热、腐肿、积疝、痹病、狂癫等各种风病，都是根据疾病所在的部位来选取穴位进行针刺，以此来扩充和丰富那五种和十二种针刺法度的应用范围，所以称为“长刺节”。
从事针刺的医生如果不进行脉诊，而是听取病人的自述。
岐伯承接上文对针刺原理的解释，进一步阐发“长刺节”的含义。《九针十二原》篇中说：“凡是准备使用针刺治疗，必须先诊察脉象。”现在却说“从事针刺的医生不进行脉诊，只听取病人的陈述”，这说明施行针刺的方法，有的是依据脉象，有的是依据症状表现，以此来补充说明针刺方法中尚未详尽的部分。
如果病在头部，出现头部剧烈疼痛，采用深刺法（藏针）。针刺要到达骨部，病就好了，但上部不要损伤骨肉以及皮肤。皮肤，是行针的路径。
“藏”，按字面意思理解。这是治疗头痛的方法。“在头”，指病位在头部。“头疾痛”，因为病在头部，突然发生的疼痛。“藏”，通“脏”，意为深。“藏针”，即深刺。采用深刺法，所以要针刺到骨部，病才能痊愈。虽然针刺深入到了骨，但在上面的部分不能损伤骨头外面的肌肉以及皮肤。针刺的路径从皮肤进入直到骨部，这就是行针的道理。所以说：“皮肤是行针的路径。”“道”，就是路的意思。
阳刺法，直刺一针，旁刺四针，用于治疗寒热证。如果寒热之邪不在阳分，而是深入且专一于阴分，就针刺五脏的大俞穴。迫近脏腑进行针刺背部，即是背俞穴。针刺时迫近脏腑，是因为背俞穴是脏腑之气汇聚之处。腹部中的寒热去除后，就停止针刺。无论哪种刺法，关键在于出针时要浅刺出血，以疏通络脉。
“阳”，旧本误作“阴”，今改正。“处”，读去声。这是治疗寒热证的方法。《灵枢·官针》篇说：“第五种是阳刺。所谓阳刺，就是正中刺入一针，旁边刺入四针。”“阳刺入一”，就是正中刺入一针；“旁四处”，就是旁边刺入四针。这种阳刺法，是用来治疗阳分的寒热病。如果寒热不在阳分，而是深入且专一，深入专一意味着病入阴分，所以要针刺大脏（五脏的大俞穴）。这里解释什么是大脏，就是迫近脏腑刺背部。五脏的俞穴都在背部，这就是背俞穴。又解释为什么刺之能迫近脏腑，是因为脏俞在背部，是脏腑之气会合的地方。直刺一针旁刺四针，是阳刺，用来治疗阳分的寒热。迫近脏腑刺背部，是阴刺，用来治疗腹中的寒热。所以腹中的寒热去除后，就停止针刺。“止与刺者”，意思是中病即止。下文凡是说“止”的，都是指停止针刺。无论阳刺还是阴刺，大体上在出针的时候，贵在浅刺使其出血，以疏通络脉。
治疗腐肿（化脓性疮疡），针刺腐烂的部位，观察痈肿的大小，决定针刺的深浅。痈肿大的多刺出血，痈肿小的深刺。必须端正地进针，以达到预期效果为止。
“内”，音同“纳”。这是治疗腐肿的方法。肌肉腐烂叫“腐”，高起叫“肿”。治疗腐肿，就是治疗内部的腐烂和外部的肿胀。内部腐烂外部肿胀，就应该针刺腐烂的表面，再观察痈肿的大小，来决定针刺的深浅。刺大的，是指刺大的痈肿。多血，是指多脓血。大痈肿多脓血，应当浅刺。小的，是指小痈肿。痈肿小且未溃破，毒气在内，应当深刺。深刺时，必须端正地进针，以恢复其常态，达到治疗效果就停止针刺。
病在少腹且有积聚，针刺皮肤以下直到少腹的部位停止，针刺脊柱两旁第四椎间隙，针刺两侧髂骨与季胁肋之间的区域，以疏导腹中的气，热气下行则病愈。
“HT”，同“突”，音突。“髂”，音驾。“ ”，音料，其他篇章相同。这是治疗腹中积聚的方法。“ ”，指肥厚隆起。病在少腹有积聚，针刺积聚上方皮肤隆起之处。少腹有积聚，则少腹皮肤隆起，所以从下至少腹而止就是那个部位。脊柱两旁第四椎间隙，是心包经和厥阴经的俞穴。少腹有积聚，针刺厥阴俞，《脉要精微论》说：“病名心疝，少腹应当有形，所以要针刺。”腰骨叫髂。两髂骨之间隆起处，是居髎穴所在。季胁肋间，是章门穴。季胁肋，是足厥阴肝经的循行部位。髂骨侧，是足少阳胆经的循行部位。少腹有积聚，配合针刺厥阴经和少阳经，是为了疏导腹中的气，使下部温热，病就可以痊愈。“下”，指少腹。
病在少腹，腹痛，大小便不通，病名叫疝。这是由于受寒引起的，针刺少腹和大腿根部之间，针刺腰部和髋骨之间，多次针刺，直到局部感到温热，病就好了。
这是治疗寒疝的方法。病在少腹，少腹疼痛，并且大小便不通，病名叫疝。由于受寒引起，应当针刺少腹和大腿根部之间，即冲门穴。针刺腰部和髋骨之间，即第十三椎下外侧的盲门穴。针刺少腹和大腿根部之间，是为了治疗疝痛。针刺腰部和髋骨之间，是为了散寒，所以应当多次针刺。“炅”，就是热的意思。等到完全感到热，病就可以痊愈。
病在筋，筋脉拘挛，关节疼痛，不能行走，名叫筋痹。针刺筋的部位作为治疗目标，针刺分肉之间，不可刺中骨头。病起于筋部发热，病好了就停止针刺。
“中”，读去声。这是治疗筋痹的方法。病在筋，就会筋脉拘挛而骨节疼痛。筋脉拘挛关节疼痛，就不能行走，病名叫筋痹。就应当针刺筋的部位，使其不再拘挛，以恢复常态。针刺筋的方法，应当针刺分肉之间，不可刺中骨头。针刺得法，则病起于筋部发热。病起于筋部发热，说明病将愈，病好了，就停止针刺。
病在肌肤，全身肌肤都疼痛，名叫肌痹，是由于感受寒湿所致。针刺大分和小分，多放几针并深刺，以局部发热为有效标志，不要损伤筋骨。如果损伤了筋骨，会导致痈肿发生或病情变化。当各个分肉都感到热时，病就好了，停止针刺。
这是治疗肌痹的方法。病在肌肤，全身肌肤都疼痛，就叫肌痹。这是因为感受寒湿导致的痹症，应当针刺肌肉的大分和小分。大分，是大肌肉群的汇合处；小分，是小肌肉群的汇合处。分肉之间有三百六十五个穴位，所以应当多放针并深刺，以热气到来为恢复常态的标志。虽然说深刺，但不要损伤筋骨。如果损伤了筋骨，就会导致痈肿发生或病情变化。在未发生变化之前，针刺得法，使各分肉都感到热，病就好了，停止针刺。
病在骨，骨头沉重抬不起来，骨髓酸痛，寒气侵袭，名叫骨痹。深刺时，不要损伤脉和肉，以恢复常态为目标，路径经过大分和小分，骨头感到热，病好了就停止针刺。
“酸”，写作“ ”。这是治疗骨痹的方法。病在骨，骨头沉重抬不起来，兼有骨髓酸痛。寒气侵入骨部，病名叫骨痹。痹症在骨，应当刺骨，深刺时，不要损伤脉和肉。针刺得法，则骨痹去除，恢复常态。“其道”，指骨道。不损伤脉肉，是因为骨道的气，也从肉的大分和小分中透出。在骨部刺骨，等待气至，骨头感到热，病就好了，停止针刺。
病在诸阳脉，既怕冷又怕热，各个分肉也既怕冷又怕热，名叫狂病。针刺以泻实为主，观察各个分肉，直到全部发热，病好了就停止针刺。
这是治疗狂病的方法。病在诸阳脉，而且恶寒发热，说明邪气乘袭经脉。各个分肉也恶寒发热，说明邪气乘袭分肉。分肉的邪气和经脉的邪气相互交并，病名叫狂。针刺以泻实，使邪气不乘袭经脉。观察分肉全部发热，是观察分肉之间，正气聚集而全部发热，这样，狂病就好了，停止针刺。
病初发时，一年发作一次。不治疗，变成一个月发作一次。再不治疗，一个月发作四五次，名叫癫病。针刺各个分肉和各条经脉，对于没有寒热表现的，用针调理，病好了就停止针刺。
这是治疗癫病的方法。病初发，指癫病初发。初发不治疗，则一年发作一次。一年发作不治疗，则一个月发作一次。一个月发作不治疗，则一个月发作四五次，凡此病发，名叫癫病。应当针刺各个分肉和各条经脉。诸分，指各个分肉；诸脉，指各条经脉。其无寒者，是说没有寒热交替，不同于狂病的恶寒发热。狂病属阳，癫病属阴，阳属有余，阴属不足，所以应当用针调补，使病好了就停止针刺。
患风病，既怕冷又怕热，发热出汗，一天数次发作。先针刺各个分肉的腠理和络脉，汗出后，如果仍然恶寒发热，则三天针刺一次，一百天痊愈。
这是治疗风病的方法。患风病，恶寒发热，发热出汗。一天数次发作，是因为风为阳邪，其性鼓动，所以恶寒发热，发热出汗，一天数次。先针刺各个分肉的腠理和络脉，是在未发作之时，针刺分肉的腠理和经络之外的络脉。汗出，是刺出其汗。汗出后寒热不解，仍然恶寒发热，则应当三天针刺一次，到一百天，天干循环十周，病就可以痊愈。
患大风病（麻风），骨节沉重，胡须眉毛脱落，名叫大风。针刺肌肉作为治疗目标，出汗一百天；针刺骨髓，出汗一百天，总共二百天，胡须眉毛长出，停止针刺。
这是治疗疠风（麻风）的方法。大风，就是疠风。风邪客居在脉中不去，皮肤生疮疡，名叫疠风。所以患大风病，内部则骨节沉重，外部则胡须眉毛脱落，名叫大风。应当针刺肌肉，使肌肉恢复常态。针刺肌肉而出汗一百天，以祛除风邪。骨节的邪气，还没有去除，所以再针刺骨髓，也出汗一百天，总共二百天，天干循环二十周，胡须眉毛长出，停止针刺。
以上列举了头痛、腐肿、积疝、痹病、狂癫以及各种风病，针刺各有法度，所以称为“长刺节”。
*Ling Shu: Guan Zhen* (Spiritual Pivot: Official Needles) states: There are twelve categories of needling. *Ci Jie Zhen Xie* (Discourse on Needling Segments and True Evil) states: There are five categories of needling. "Chang" (Long/Extensive) means extensive or broad. "Chang Ci Jie" (Extensive Needling Categories) refers to determining the needling method based on the location of the disease. For example, headache, aversion to cold and fever, suppurative swelling, abdominal masses, bi-syndrome (painful obstruction), mania, epilepsy, and various wind diseases are all treated by selecting points based on the location of the disease. This serves to expand and enrich the application of the five and twelve needling categories, hence it is called "Chang Ci Jie".
Practitioners of needling may forgo pulse diagnosis and rely solely on the patient's self-reported symptoms.
Qi Bo, continuing the explanation of needling principles from the previous section, further elucidates the meaning of "Chang Ci Jie". The *Jiu Zhen Shi Er Yuan* (Nine Needles and Twelve Original Points) discourse states: "Whenever one intends to use needles, one must first diagnose the pulse." Now, stating that practitioners do not diagnose the pulse but only listen to the patient implies that needling methods can be guided either by pulse findings or by symptom presentation. This supplements the aspects of needling methods that were not fully detailed previously.
If the disease is in the head, manifesting as severe headache, employ deep needling (Cang Zhen). The needle should reach the bone; the disease will then resolve. However, the upper layers must not damage the muscle or skin above the bone. The skin is the pathway for the needle.
"Cang" retains its literal meaning. This describes the method for treating headache. "In the head" indicates the disease location is the head. "Severe headache" refers to sudden pain due to the disease being in the head. "Cang" here implies depth. "Cang Zhen" means deep needling. By employing deep needling, the needle must reach the bone for the disease to resolve. Although the needle reaches the bone, the tissue above (muscle outside the bone and skin) must not be damaged. The path of the needle from the skin to the bone constitutes the principle of needling. Hence, it is said: "The skin is the pathway." "Dao" (Pathway) means road or route.
Yang Ci (Yang Needling): Insert one needle centrally and four needles laterally. This treats aversion to cold and fever. If the cold-heat pattern is not in the Yang aspect but is deep and localized, needle the major Shu points of the Zang organs. To approach the Zang organs, needle the back Shu points. The back Shu points are located on the back. Needling these approaches the Zang organs because they are the convergence points of Zang Qi. Once the cold-heat in the abdomen is resolved, cease needling. Regardless of whether using Yang or Yin needling, the key point upon withdrawing the needle is to superficially induce bleeding to unblock the collaterals.
"Yang" was erroneously printed as "Yin" in old editions; corrected here. "Chu" is pronounced with the departing tone. This describes the method for treating cold-heat patterns. *Ling Shu: Guan Zhen* states: "The fifth is Yang Needling. Yang Needling involves inserting one needle centrally and four needles laterally." "Insert one centrally" corresponds to the central insertion; "four laterally" corresponds to the lateral insertions. This Yang Needling method treats cold-heat in the Yang aspect. If the cold-heat is not in the Yang aspect but is deep and specialized, it has entered the Yin aspect, so one needles the major Zang organs. Here, "major Zang organs" refers to approaching the Zang by needling the back. The Shu points of the five Zang organs are all on the back; these are the Back Shu points. It further explains that needling approaches the Zang because the Back Shu points are on the back and serve as the convergence of Zang Qi. One central and four lateral insertions constitute Yang Needling, treating cold-heat in the Yang aspect. Approaching the Zang by needling the back constitutes Yin Needling, treating cold-heat in the abdomen. Thus, once the cold-heat in the abdomen is gone, stop needling. "Stop needling" means to cease when the disease is addressed. Wherever "stop" appears below, it refers to ceasing needling. Whether Yang or Yin needling, generally, upon withdrawal, one should superficially induce bleeding to unblock the collaterals.
To treat suppurative swellings (Fu Zhong), needle the suppurating area. Observe the size of the abscess to determine the depth of needling. For large abscesses, which contain much pus and blood, needle superficially. For small abscesses, needle deeply. The needle must be inserted steadily, stopping when the desired effect is achieved.
"Na" (insert) is pronounced like "Na". This describes the method for treating suppurative swellings. Rotten flesh is "Fu"; elevated swelling is "Zhong". Treating Fu Zhong involves treating the internal rot and external swelling. When there is internal rot and external swelling, one should needle the surface of the rot. Then, observe the size of the abscess to decide the depth. Needling a large abscess involves superficial needling due to the abundance of pus and blood. A small abscess, if unruptured, contains toxic factors internally and requires deep needling. During deep needling, the needle must be inserted steadily, restoring normalcy, and stopping when the treatment goal is met.
For accumulations in the lower abdomen, needle from the skin downwards until reaching the lower abdomen. Needle the spaces between the fourth vertebrae on both sides of the spine. Needle the areas between the two iliac bones and the costal margin. This guides the Qi in the abdomen; when heat descends, the disease resolves.
"Tu" (protrude) is pronounced "Tu". "Qia" (iliac bone) is pronounced "Jia". "Liao" is pronounced "Liao", same as in other chapters. This describes the method for treating abdominal accumulations. "Liao" refers to thickening or protrusion. For accumulations in the lower abdomen, needle the protruding skin over the accumulation. Since there is an accumulation in the lower abdomen, the skin there protrudes; thus, needling from below to the lower abdomen targets this area. The space between the fourth vertebrae on both sides of the spine corresponds to the Shu points of the Pericardium and Jueyin meridians. For lower abdominal accumulations, needling the Jueyin Shu points is indicated. *Mai Yao Jing Wei Lun* states: "Disease named Xin Shan (Heart Hernia) presents with palpable form in the lower abdomen; therefore, needling is required." The lumbar bone is called Qia. The protrusions on both sides of the iliac bones correspond to the Juliao (Ju Liao) acupoint. The intercostal space at the costal margin corresponds to the Zhangmen (LR13) acupoint. The costal margin is the pathway of the Foot Jueyin Liver Meridian. The side of the iliac bone is the pathway of the Foot Shaoyang Gallbladder Meridian. For lower abdominal accumulations, combining needling of the Jueyin and Shaoyang meridians guides the Qi in the abdomen and warms the lower region, resolving the disease. "Lower" refers to the lower abdomen.
Disease in the lower abdomen, with abdominal pain and inability to urinate or defecate, is named Shan (Hernia). Caused by cold, needle the area between the lower abdomen and the thighs, and the area between the waist and the hip bone. Perform multiple needle insertions until local heat is felt, then the disease resolves.
This describes the method for treating Cold Shan. Disease in the lower abdomen, accompanied by pain and urinary/fecal retention, is named Shan. Caused by cold, one should needle the area between the lower abdomen and the thighs, which is the Chongmen (ST30) acupoint. Needle the area between the waist and the hip bone, which is the Mangmen (BL52) acupoint, located lateral to the spinous process of the 13th thoracic vertebra. Needling the area between the lower abdomen and the thighs treats the hernia. Needling the area between the waist and the hip bone dispels cold. Therefore, multiple insertions are used. "Jiong" means heat. Wait until full heat is perceived, and the disease will resolve.
Disease in the sinews, with sinew spasms and joint pain, preventing walking, is named Jin Bi (Sinew Bi). Needle the sinews as the target. Needle between the muscles, avoiding the bone. When the disease originates from heat in the sinews, cease needling once the disease resolves.
"Zhong" (hit/strike) is pronounced with the departing tone. This describes the method for treating Sinew Bi. Disease in the sinews causes spasms and joint pain. Spasms and joint pain prevent walking, hence the name Sinew Bi. One should needle the sinews to relieve spasms and restore normal function. The method for needling sinews is to needle between the muscles, avoiding the bone. Proper needling induces heat in the sinews. When heat arises in the sinews, the disease is resolving; once resolved, cease needling.
Disease in the skin and muscle, with widespread pain, is named Ji Bi (Muscle Bi), caused by injury from cold and dampness. Needle the major and minor divisions of the muscles. Use multiple needles and deep insertion. Local heat indicates efficacy. Do not injure the sinews or bones. Injury to sinews or bones may cause abscesses or complications. When all muscle divisions feel hot, the disease resolves, and cease needling.
This describes the method for treating Muscle Bi. Widespread pain in the skin and muscle is named Muscle Bi. Caused by cold and dampness, one should needle the major and minor muscle divisions. Major division refers to the convergence of large muscle groups; minor division refers to the convergence of small muscle groups. There are 365 meeting points between the muscles. Therefore, use multiple needles and deep insertion, considering the arrival of warm Qi as restoration of normalcy. Although deep needling is used, do not injure sinews or bones. Injury may lead to abscesses or changes in condition. Before such changes occur, proper needling should make all muscle divisions feel hot, resolving the disease, then cease needling.
Disease in the bones, with heavy bones that cannot be lifted, and soreness/pain in the marrow, with cold qi arriving, is named Gu Bi (Bone Bi). Deep needling should avoid injuring the vessels and muscles. Restore normalcy as the goal. The path follows the major and minor muscle divisions. When the bone feels hot, the disease resolves, and cease needling.
"Suan" (sore) is written as " ". This describes the method for treating Bone Bi. Disease in the bones causes heaviness and inability to lift them, accompanied by marrow soreness. Cold qi invading the bones is named Bone Bi. With Bi in the bones, one should needle the bones. In deep needling, avoid injuring vessels and muscles. Proper needling removes Bone Bi and restores normalcy. "Its Dao" refers to the bone pathway. Not injuring vessels and muscles means the Qi from the bone pathway also emerges through the major and minor muscle divisions. Needling the bone while waiting for Qi arrival, when the bone feels hot, the disease resolves, and cease needling.
Disease in the various Yang meridians, presenting with both aversion to cold and fever, and in all muscle divisions, also with both aversion to cold and fever, is named Kuang (Mania). Reduce the pulse (deplete excess). Observe the muscle divisions until they are all hot, then cease needling.
This describes the method for treating Mania. Disease in the Yang meridians with aversion to cold and fever indicates pathogenic factors attacking the meridians. Similar symptoms in the muscle divisions indicate pathogenic factors attacking the muscles. The interaction of pathogenic factors in the muscles and meridians results in Mania. Needling to reduce the pulse prevents pathogenic factors from attacking the meridians. Observing the muscle divisions becoming hot indicates the gathering of righteous Qi and heat. At this point, Mania resolves, and cease needling.
At the initial onset, the disease occurs once a year. If untreated, it occurs once a month. If still untreated, it occurs four or five times a month. This is named Dian Bing (Epilepsy/Melancholia). Needle the various muscle divisions and meridians. For cases without cold-heat alternation, regulate with needles. Cease needling when the disease resolves.
This describes the method for treating Dian Bing. Initial onset refers to the beginning of Dian Bing. If untreated at onset, it occurs annually. If annual attacks are untreated, it becomes monthly. If monthly attacks are untreated, it becomes frequent (4-5 times/month). All these manifestations are named Dian Bing. One should needle the various muscle divisions and meridians. "Various divisions" refers to muscle divisions; "various meridians" refers to the meridians. "Without cold" means absence of cold-heat alternation, differing from Mania. Mania belongs to Yang (excess); Dian Bing belongs to Yin (deficiency). Yang is associated with excess, Yin with deficiency. Therefore, one should tonify/regulate with needles, ceasing when the disease resolves.
Wind disease, presenting with aversion to cold and fever, and hot sweating occurring several times a day. First, needle the connective tissues and collateral vessels of the various muscle divisions. After sweating, if aversion to cold and fever persist, needle every three days. Cure within 100 days.
This describes the method for treating Wind Disease. Wind disease with aversion to cold, fever, and hot sweating occurring several times a day is due to Wind being a Yang pathogen with a stirring nature, causing alternating cold/heat and sweating. First, needle the connective tissues and extra-meridional collaterals of the muscle divisions before the attack occurs. Sweating is induced by needling. If sweating does not resolve the cold-heat pattern, needle every three days. After 100 days (ten cycles of the Heavenly Stems), the disease resolves.
Great Wind disease (Leprosy), with heavy joints and loss of eyebrows and beard, is named Da Feng (Great Wind). Needle the muscles as the target. Induce sweating for 100 days. Needle the bone marrow. Induce sweating for another 100 days. Total 200 days. Eyebrows and beard will regrow, then cease needling.
This describes the method for treating Li Feng (Leprosy/Great Wind). Great Wind is Leprosy. Wind pathogen lodging in the vessels and not leaving, causing skin ulcers, is named Li Feng. Thus, Great Wind disease presents internally with heavy joints and externally with loss of eyebrows and beard. One should needle the muscles to restore their normal state. Induce sweating for 100 days to expel the Wind pathogen. If the pathogen in the joints remains, needle the bone marrow and induce sweating for another 100 days. Total 200 days (twenty cycles of the Heavenly Stems). Eyebrows and beard will regrow, then cease needling.
This chapter lists needling methods for headache, suppurative swellings, abdominal masses, hernias, Bi-syndromes, mania, epilepsy, and various wind diseases, each having specific categories, hence titled "Chang Ci Jie" (Extensive Needling Categories).