二、原文、注释、语译及中译英 Original Text，Notes，Modern Chinese Translation，and English Translation

【原文】Original Text

所谓易陈者，易言也。难入者，难著于人也。粗守形者，守刺法也。上守神者，守人之血气有余不足可补泻也。神客者，正邪共会也。神者，正气也。客者，邪气也。在门者，邪循正气之所出入也。未睹其疾者，先知邪正何经之疾也，恶知其原者，先知何经之病，所取之处也。

刺之微在数迟者，徐疾之意也。粗守关者，守四肢而不知血气正邪之往来也；上守机者，知守气也。机之动不离其空中者，知气之虚实，用针之徐疾也。空中之机清净以微者，针以得气，密意守气勿失也。其来不可逢者，气盛不可补也。其往不可追者，气虚不可泻也。不可挂以发者，言气易失也。扣之不发者，言不知补泻之意也，血气已尽而气不下也。知其往来者，知气之逆顺盛虚也。要与之期者，知气之可取之时也。

粗之暗者，冥冥不知气之微密也。妙哉工独有之者，尽知针意也。往者为逆者，言气之虚而小，小者逆也。来者为顺者，言形气之平，平者顺也。明知逆顺，正行无问者，言知所取之处也。迎而夺之者，泻也。追而济之者，补也。

所谓虚则实之者，气口虚而当补之也。满则泄之者，气口盛而当泻之也。宛陈则除之者，去血脉也。邪胜则虚之者，言诸经有盛者，皆泻其邪也。徐而疾则实者，言徐内而疾出也。疾而徐则虚者，言疾内而徐出也。言实与虚，若有若无者，言实者有气，虚者无气也。察后与先，若亡若存者，言气之虚实，补泻之先后也，察其气之已下与尚存也。为虚与实，若得若失者，言补者佖然若有得也，泻则恍然若有失也。

夫气之在脉也，邪气在上者，言邪气之中人也高，故邪气在上也。浊气在中者，言水谷皆入于胃，其精气上注于肺，浊溜于肠胃，言寒温不适，饮食不节，而病生于肠胃，故命曰浊气在中也。清气在下者，言清湿地气之中人也，必从足始，故曰清气在下也，针陷脉则邪气出者，取之上。针中脉则浊气出者，取之阳明合也。针太深则邪气反沉者，言浅浮之病，不欲深刺也。深则邪气从之入，故曰反沉也。皮肉筋脉各有所处者，言经络各有所主也。

取五脉者死，言病在中，气不足，但用针尽大泻其诸阴之脉也。取三脉者恇，言尽泻三阳之气，令病人恇然不复也。夺阴者死，言取尺之五里，五往者也。夺阳者狂，正言也。睹其色，察其目，知其散复，一其形，听其动静者，言上工知相五色于目，有知调尺寸小大缓急滑涩，以言所病也。知其邪正者，知论虚邪与正邪之风也。

右主推之，左持而御之者，言持针而出入也。气至而去之者。言补泻气调而去之也。调气在于终始一者，持心也。节之交三百六十五会者，络脉之渗灌诸节者也。

所谓五脏之气，已绝于内者，脉口气内绝不至，反取其外之病处与阳经之合，有留针以致阳气，阳气至则内重竭，重竭则死矣，其死也，无气以动，故静。

所谓五脏之气，已绝于外者，脉口气外绝不至，反取其四末之输，有留针以致其阴气，阴气至则阳气反入，入则逆，逆则死矣。其死也，阴气有余，故躁。所以察其目者，五脏使五色循明。循明则声章，声章者，则言声与平生异也。

【注释】Notes

［1］难入者，难著于人也：著，是明白的意思。本句说针刺的精微之处是难于使人明白的。

［2］正邪共会：就是邪气与正气交争的意思。

［3］以：在此同“已”，已经。

［4］密意：密，蜜也，如蜜所涂，无不满也。蜜意者，言意之周，无所不至，示谨慎之意。

［5］血气已尽而气不下也：指补泻不得其法，虽耗尽血气而病气仍然不去。下，去的意思。

［6］冥冥：幽昧不明的意思。

［7］气口：即寸口的部位，又称脉n。

［8］宛陈：这里指恶血。

［9］泌然：泌，音“必”。泌然，满的意思。

［10］恍然：忽然的意思。

［11］五脉：指五脏六输穴而言。

［12］三脉：指六腑六输穴而言。

［13］渗灌：即灌输渗透之意。

［14］脉口气内绝不至：就是在脉口的部位出现浮而无根气的脉象，属髓竭、精伤等脏气内绝的现象。

［15］脉口气外绝不至：就是在脉口的部位出现沉微之脉，轻取如无，属五脏阳气衰竭的现象。

【语译】Modern Chinese Translation

所谓“易陈”，是指针刺的道理，谈起来较容易。“难入”，是难于使人十分明白之意。“粗守形”，是说医术平庸的医生只知机械地拘守刺法和在病的局部进行治疗。“上守神”，是指高明的医生能够灵活地根据患者气血虚实来运用补泻方法。“神客”，指正邪相争，“神”指正气，“客”指邪气。“在门”是说邪气入侵，循着正气运行出入的门户。“未睹其疾”，是说预先没有明确知道病在何经。“恶知其原”，是说不知病在何经，当然无法确定应取的穴位，哪里能够知道病因和治疗的原委。

“刺之微在数迟”的意思，是说针刺的精微奥妙之处，在于掌握针刺手法的快慢。“粗守关”指平庸的医生在针治时仅仅拘守四肢关节部位的一点穴位，而根本不知道辨别人体血气盛衰和邪正斗争的胜负进退等情况。“上守机”指高明的医生能够辨别人体血气盛衰，把握气机变化的规律。“机之动不离其空中”，是指气机变化都在腧穴中表现出来，了解了气机的虚实变化，就可以施用疾徐补泻的手法。“空中之机，清静以微”，是说气机的变化，在腧穴中的表现是微小的，必须审慎地观察静候，才可以抓住这变化的时机。“其来不可逢”，是说在邪气正盛的时候，不可用补法。“其往不可追”，是说邪气已去正气未复的时候，不可用泻法。“不可挂以发”，是说应该审慎地观察气机的往来变化，不可有毫发之差。“扣之不发”，是说不懂得气机的虚实变化，不知道抓住时机来掌握补泻方法的意义，这样，就会造成误补误泻，留邪伤正，以致血气竭尽了而邪气却没有被驱除。“知其往来”，是说要明了气机的逆顺盛衰。“要与之期”，是说能掌握气机变化的时机而及时用针。

“粗之暗”者，是说技术低劣的医生暗晦无知，不懂得气机变化的道理。“妙哉工独有之”，是说高明的医生，能够掌握气机的变化和运用针刺施行补泻的奥妙。“往者为逆”，是说气去正衰，脉虚而小，属逆证。“来者为顺”，是说正气尚充，形气阴阳平衡，这是顺证。“明知逆顺，正行无问”，是说知道了正气的盛衰，疾病的逆顺，而能够断然采取措施，正确选择针刺的腧穴。“迎而夺之”，是迎着经气循行的方向下针，这是泻法。“追而济之”，是随着经气循行的方向下针，这是补法。

所谓“虚则实之”，是气口血脉气虚的应当用补法，以充实正气。“满则泄之”，是气口脉盛的用泻法。“宛陈则除之”，是经脉有瘀血阻滞的应当排除之，用泻血法。“邪盛则虚之”，是说邪气盛的应当泻其邪。“徐而疾则实”是说慢进针快出针的为补法，“疾而徐则虚”，是说快进针慢出针的为泻法。“言实与虚，若有若无”，是说用补法后可使正气充实，用泻法后，可使邪气消失。“察后与先，若存若亡”，是说应该查清气机的虚实，以及病情的缓急，虚的用补法，实的用泻法，病急的先治，病缓的后治，同时，观察其经气的运行和滞留情况，来决定刺法。“为虚与实，若得若失”，是说施用补法要使患者感到正气充满而似有所得，施用泻法则要使患者马上感到轻松而若有所失。

“夫气之在脉也，邪气在上”，是说邪气侵入经脉后，虚邪贼风多伤人的上部，邪气侵犯的部位偏高，所以说邪气在上。“浊气在中”，是说水谷纳入后，皆入于胃中，水谷的精气上注于肺，水谷的浊气则流于胃肠，倘若饮食寒温不适，又多饮多食，不加节制，造成肠胃疾病，则浊气不能下行，所以说浊气在中。“清气在下”，是指清冷寒湿的邪气伤人，多从足部侵入，所以说清气在下。“针陷脉则邪气出”，是指风湿等邪气伤人上部，要取上部经脉的腧穴治疗。“针中脉则邪气出”，是指肠胃疾病造成浊气在中，应取手足阳明经的合穴治疗。“针太深，则邪气反沉”是说邪气轻浅的病，不宜深刺，刺得过深，则邪气会随针而内陷，所以说“反沉”。“皮肉筋脉，各有所处”，是说皮肉筋脉各个部位，都联署一定的经络，它们的发病，也可通过各经络来治疗。

“取五脉者死”，是说病在内脏而脏气不足的，反而用针尽力大泻五脏的腧穴，使五脏之气泻尽而成死证。“取三脉者恇”的意思，是说不辨虚实等具体情况，误用针尽力泻手足三阳六腑的俞穴，致三阳经气亏败，就会使病人形体衰弱虚怯，不易恢复。“夺阴者死”，是说脏阴之气，出于尺部的五里，针五里而泻至五次，则脏阴之气泻尽而成死症。“夺阳者狂”，是说泻尽了三阳正气，会使精神虚弱而成狂证。这些都是说针刺的禁忌。“睹其色，察其目，知其散复，一其形，听其动静”，这段话的意思，是说高明的医生能从目辨别五色，并且懂得结合脉象的大小、缓急、滑涩，全面观察，从而确切地诊知是哪里的病。“知其邪正”是说知道疾病是由于正风还是虚风所造成。

“右主推之，左持而御之”，是说针刺时要用右手推而进针，左手护持针身，以运用进针退针的手法。“气至而去之”，是说针得气后，即施用补法或泻法，达到气机平调后才去针。“调气在于终始一”，是说运针调气的时候要始终专心一意地进行。“节之交三百六十五会”，是说周身的三百六十五穴，为络脉将气血渗灌全身各部的通会之处。

所谓“五脏之气，已绝于内”，是说五脏的精气内虚，甚至近于竭绝，表现在气口的脉象就微弱无根，按之欲无。此病应补其阴精而不应取体表的病处与阳经的合穴，如果通过留针来补阳气，由于它的病机是阴气虚竭无以生阳，所以，愈补阳气则阴精愈衰，以致五脏精气重竭，竭而再竭则必死无疑，由于阴不生阳，无气以动，所以死时安静。所谓“五脏之气，已绝于外”，是说凡五脏气外绝的，而在脉口的脉象表现为沉微，轻取如无，是属于五脏之阳气衰竭的现象。这种病，宜用针补其阳气，如果在针治时，反而取用了四肢末梢部的腧穴，并用留针法以补益在内的阴气，致使阴气盛而阳气更虚，以致发生厥逆，厥逆甚则导致死亡。临死亡时，因阳并于阴，阴气有余，所以有烦躁的现象。察目的缘故，是因为五脏六腑的精气皆上注于目，精气旺盛于内，能使两目有神，面部五色明润，同时，由于精气内盛，则声音亦必洪亮，与平常不同，所以察目听声都是诊断上的依据。

【中译英】English Translation

The idea［that to use small needles to treat diseases］is“easy to describe”［means that the rules of needling are］easy to explain.［The idea that the skill of using small needles to treat diseases］is difficult to be mastered［means that it is］difficult to be applied to clinical treatment1.“Ordinary［doctors］just stick to the Xing”［means that ordinary doctors only］stick to the needling techniques.“Excellent［doctors］closely observe the Shen”［means that excellent doctors］use reinforcing and reducing［needling techniques］according to the Shi（Excess）or Xu（Deficiency）condition of blood and Qi.“Shen and Ke”refer to combat between Zheng（Healthy-Qi）and Xie（Evil-Qi）.“Shen”refers to Zhengqi（Healthy-Qi）and“Ke”refers to Xieqi（Evil-Qi）.“At the entrance”means that Xie（Evil-Qi）invades［the body］through the entranceof Zhengqi（Healthy-Qi）.“Without observing the disease”means ignorance of the location of the disease in advance.“Knowing nothing about the cause”［means that the doctor］does not know on which Channel the disease is located［and what Acupoints should be］selected.

［The idea that］“the key of acupuncture lies in the rapid and slow［manipulations of the needle］”［refers to the mastery of］slow and quick［needling techniques］.［The idea that］“ordinary［doctors］only stick to［the Acupoints located on］the joints［of the four limbs］”［means that the ordinary doctors］only pay attention to［the Acupoints on］the four limbs but do not know［how to differentiate］the conditions of blood，Qi，Zheng（Healthy-Qi）and Xie（Evil-Qi）.［The idea that］“excellent［doctors carefully］observe the changes［of Qi movement］”［means that the excellent doctors］know［how to follow the rules of］Qi movement.［The idea that］“the movement［of Qi］cannot deviate from the Acupoints”［means］to know the Xu（Deficiency）and Shi（Excess）［condition］of Qi as well as slow and rapid manipulation of the needles.［The idea that］“the movement［of Qi］inside the Acupoints is quiet and insensible”［means that］to obtain Qi in needling requires careful observation［of the changes］of Qi lest［the best time for needling］be lost.［The idea that］“when coming，it cannot be confronted”means reinforcing［techniques］cannot be used when Qi is predominant and［the idea that］“when receding，it cannot be chased”means that reducing［techniques］cannot be used when Qi is deficient.［The idea that those who］are aware of the changes［of Qi movement］make no errors［in applying the reinforcing and reducing techniques］emphasizes easiness of Qi to lose.［The idea that those who］are unaware of such changes act just as if holding the arrow without knowing when to shoot it describes ignorance of applying the reinforcing and reducing［techniques］.［Consequently，］blood and Qi have already exhausted，but Qi2remains unchanged.［The idea of］knowing［when it］comes and recedes means to know the adverse and due［movement as well as］the predominant and deficient［states of blood and Qi］.［The idea of understanding］the right time［of needling］means to know when it is proper to needle.

［The idea that］unskillful［doctors］are ignorant of［this mechanism］means that unskillful［doctors］do not know the mystery of Qi［movement］.［The idea that］only excellent［doctors］can understand this mystery［means that］excellent doctors can master the techniques of needling.［The idea that］receding［activity］means Ni（adverse）indicates that Qi is deficient and small［when it is receding because being］small means Ni（adverse）.［The idea that］the coming［activity］means Shun（due）indicates that Qi appears peaceful［when it comes because］peace means Shun（due）.［The idea that］understanding［the rules of］Ni and Shun［enables one to］practice［acupuncture］without any doubt emphasizes［the importance of］accurate location［of the Acupoints to be］selected.［The purpose of］needling in line with［the running direction of the Channel］is to reduce［Xieqi（Evil-Qi）］.［The purpose of］needling against［the running direction of the Channel］is to reinforce［Zhengqi（Healthy-Qi）］.

［The idea of using］reinforcing［techniques to deal with］Xu（Deficiency）means to use reinforcing［techniques when the pulse over］Qikou3appears weak.［The idea of using］reducing［techniques to deal with］Man（Excess）means to use reducing［techniques when the pulse over］Qikou is strong.［The idea of using］removing［techniques to deal with］stagnation［of Qi and blood］means to eliminate blood stagnation in the vessels.［The idea of using］attacking［techniques to deal with］predominance of Xie（Evil）means to eradicate Xie（Evil）［if it］is excessive in the Channels.［The idea that］slow［inserting］and quick［lifting the needle］means reinforcing，emphasizing slow insertion and quick withdrawal［of the needle］.［The idea that］quick［inserting］and slow［lifting the needle］means reducing，emphasizing quick insertion and slow withdrawal［of the needle］.［The so-called］Shi（Excess）means that there is［Qi beneath the needle］and［the so-called］Xu（Deficiency）means that there is no［Qi beneath the needle］，which indicates that there is［warming sensation beneath the needle when the reinforcing techniques are used］and that there is no［warming sensation beneath the needle when the reinforcing techniques are used］.［The saying that when inserting the needle，doctors should carefully］observe the coming and receding［fluctuation of Qi and blood to decide whether］to retain［the needle］or not indicates that the Xu（Deficiency）and Shi（Excess）state of Qi［decides when to use］the reducing［techniques and when to use］the reinforcing［techniques］.［In this way it can be easier］to differentiate whether the Qi still exists or not.［The idea that to use］the reinforcing［techniques］or the reducing［techniques］is［to achieve the goal of］obtaining［something］and losing［something］means that［the patient feels］to have obtained something［when］reinforcing［techniques have been used］and to have lost something［when］reducing［techniques have been used］.

［The idea that when］Qi has invaded the Channels，Xieqi（Evil-Qi）is in the upper means that Xieqi（Evil-Qi）usually attacks the upper part of the body.That is why［the part invaded by］Xieqi（Evil-Qi）is in the upper.［The idea that］Zhuoqi（Turbid-Qi）is in the middle means that water and food are all in the stomach［after being taken］，their nutrients are transported to the lung and the turbid［part］is kept in the intestine and stomach.Improper adaptation to the changes of weather and intemperance in eating may lead to disorders of intestines and stomach.That is why it is said that Zhuoqi（Turbid-Qi）is in the middle4.［The idea that］Qingqi（Lucid-Qi）is in the lower means the attack of cold and damp Diqi（Earth-Qi）on the body starts from the foot.That is why it is said that Qingqi（Lucid-Qi）is in the lower.［The idea that］needling［the Acupoints located in］the depressions eliminates Xieqi（Evil-Qi）means to needle［the Acupoints located on the Channels running in］the upper［part of the body］.［The idea that］needling the Zhongmai eliminates Zhuoqi（Turbid-Qi）means to needle the He-Sea［Acupoint］of the Yangming Channel.［The idea that to use］deep needling［to treat the disease that is superficial］leads to internal invasion of Xieqi（Evil-Qi）means that mild disease should not be［treated by］deep needling lest Xieqi（Evil-Qi）deepen［its invasion into the body］with the thrusting［of the needle］.That is why it is said that［deep needling may］worsen the disease.［The idea that］the locations of［the diseases in］the skin，muscles，sinews and vessels are different means that［the skin，muscles，sinews and vessels］are controlled respectively by Channels.

［The idea that wrongly］needling of Wumai causes death means disease［located in］the viscera with insufficiency of Qi［should be treated by needling the Acupoints located on］the Yin Channels5with drastic reducing techniques.［The idea that wrongly］needling of Sanmai leads to weakness［of Zhengqi（Healthy-Qi）］means wrongly use of drastic reducing techniques［to needle Acupoints on］the three Yang［Channels］makes the patient weak and unable to recover.［The idea that wrongly］needling of the Yin［Channel with］reducing［techniques］leads to death means［that needling］Wuli（LI13）which is［located on］the cubit［region］for five times［will exhaust visceral Qi］.［The idea that wrongly］needling of Yang［Channel with］reinforcing［techniques］leads to mania is the right expression6.［The idea that］inspecting the complexion and observing the eyes［of the patients enable the doctors］to know［whether Shenqi（Spirit-Qi）has been］dispersed or restored and［that observing］the physical［condition］and listening to the voice［of the patients can reveal the states of Xie（Evil-Qi）and Zheng（Healthy-Qi）］means that excellent doctors can make accurate diagnosis［by means of］differentiating the five colors from the eyes and synthesizing the small and large，slow and rapid as well as slippery and unsmooth［states of］pulse.［The idea of］knowing the states of Xic（Evil-Qi）and Zheng（Healthy-Qi）means to understand［whether the disease is caused by］Xuxie（Deficiency-Evil）and Zhengxie（Right-Evil）.

［The idea that］the right［hand］pushes［the needle into the Acupoint］and the left［hand］assists［the right hand to insert the needle］refers to the way to hold the needle and insert the needle.［The idea that when］Qi has arrived［the needle is］withdrawn means［that the needle］is withdrawn when Qi is regulated［by means of］reinforcing and reducing［techniques］.［The idea that］regulation of Qi must be done all the time7［means that Qi must be regulated］carefully.［The idea that］the convergences of joints are altogether three hundred and sixty-five8refer to［the Acupoints all over the body which are the places through which］the Collaterals［transport Qi and blood］to all parts of the body.

［The idea that］Qi of the Five Zang-Organs is already exhausted inside means that pulse over the wrist is indistinct［when pressed］.If the He-Sea［Acupoint］on the Yang Channel over the affected part is needled and the needle is retained for inducing Yangqi，it will further exhaust internal［visceral Essence］when Yangqi is invigorated Further exhaustion［of visceral Essence］will inevitably lead to death.［When the patient］is dying，there is no Qi to agitate，that is why［the patient appears］quiet.

［The idea that］Qi of the Five Zang-Organs is already exhausted externally means that pulse over the wrist is indistinct［when lightly pressed］.［If］the Acupoints on the four extremities are needled and the needles are retained to induce Yinqi，it will further weaken Yangqi when Yinqi becomes predominant，eventually leading to syncope which may cause death.［Since］Yinqi is excessive，that is why［the patient appears］restless.［The reason］to examine the eyes［is that the Essence of］the Five Zang-Organs［is transported to the eyes and makes］thecomplexion lustrous.［When the complexion appears］lustrous，the voice becomes sonorous.［If a person's voice becomes］sonorous，［that means it］is different from usual manifestation.

【注释】Notes

［1］The original Chinese characters for“difficult to be applied to clinical treatment”are Nan（难 difficult）Zhu（著describe or understand）Yu（于to）Ren（人people）.Another explanation about these four Chinese characters is“ it is difficult to make others understand.”

［2］Qi here refers to Xieqi（邪气Evil-Qi）.

［3］Qikou（气口）is another name for Cunkou（寸口）.

［4］Zhuoqi（浊气Turbid-Qi）in the middle means that Xieqi（Evil-Qi）of cold and dampness cannot move downwards.

［5］Yin Channels（阴脉）here refer to Acupoints of the Five Zang-Organs.

［6］The original Chinese characters for“is the right expression”are Zheng（正right or correct）and Yan（言 word or expression）.There are different explanations about these two Chinese characters.Zhang Jiebin（张介宾）said that“these two characters refer to the description of three Yang Channel mentioned above”.That is to say wrongly needling of the three Yang Channels leads to mania.According to Zhang Jiebin's（张介宾）explanation，Zheng（正 right or correct）Yan（言 word or expression）is a warning to doctors.Zhou Xuehai（周学海）said that Zheng（正）is the wrong form of Kuang（狂）and suspected that some of the characters in this sentence were lost.

［7］The original Chinese characters for this part are Tiao（调regulate）Qi（气）Zai（在in）Yu（于preposition indicating time or place）Zhong（终end）Shi（始begin）Yi（一one）which does not appear in the first chapter of Lingshu（《灵枢》）

［8］This part appears two paragraphs before in the first chapter of Lingshu（《灵枢》）.