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

【原文】Original Text

黄帝问于岐伯曰：余子万民，养百姓，而收其租税。余哀其不给，而属有疾病。余欲勿使被毒药，无用砭石，欲以微针通其经脉，调其血气，营其逆顺出入之会。令可传于后世，必明为之法，令终而不灭，久而不绝，易用难忘，为之经纪，异其篇章，别其表里，为之终始。令各有形，先立针经。愿闻其情。

岐伯答曰：臣请推而次之，令有纲纪，始于一，终于九焉。请言其道。小针之要，易陈而难入。粗守形，上守神。神乎，神客在门。未睹其疾，恶知其原？刺之微，在速迟。粗守关，上守机，机之动，不离其空。空中之机，清静而微。其来不可逢，其往不可追。知机之道者，不可挂以发。不知机道，叩之不发。知其往来，要与之期。粗之暗乎，妙哉工独有之。往者为逆，来者为顺，明知逆顺，正行无问。逆而夺之，恶得无虚？追而济之，恶得无实？迎之随之，以意和之，针道毕矣。

凡用针者，虚则实之，满则泄之，宛陈则除之，邪胜则虚之。《大要》曰：徐而疾则实，疾而徐则虚。言实与虚，若有若无，察后与先，若存若亡，为虚与实，若得若失。虚实之要，九针最妙，补泻之时，以针为之。泻曰必持内之，放而出之，排阳得针，邪气得泄。按而引针，是谓内温，血不得散，气不得出也。补曰随之，随之意若妄之。若行若按，如蚊虻止，如留如还，去如弦绝，令左属右，其气故止，外门已闭，中气乃实，必无留血，急取诛之。

持针之道，坚者为宝。正指直刺，无针左右。神在秋毫，属意病者。审视血脉，刺之无殆。方刺之时，必在悬阳，及与两衡。神属勿去，知病存亡。血脉者，在腧横居，视之独澄，切之独坚。

九针之名，各不同形。一曰镵针，长一寸六分；二曰员针，长一寸六分；三曰针，长三寸半；四曰锋针，长一寸六分；五曰铍针，长四寸，广二分半；六曰员利针，长一寸六分；七曰毫针，长三寸六分；八曰长针，长七寸；九曰大针，长四寸。镵针者，头大末锐，主泻阳气；员针者，针如卵形，揩摩分间，不得伤肌肉，以泻分气；针者，锋如黍粟之锐，主按脉勿陷，以致其气；锋针者，刃三隅，以发痼疾；铍针者，末如剑锋，以取大脓；员利针者，尖如氂，且员且锐，中身微大，以取暴气；毫针者，尖如蚊虻喙，静以徐往，微以久留，正气因之，真邪俱往，出针而养，以取痛痹；长针者，锋利身薄，可以取远痹；大针者，尖如梃，其锋微员，以泻机关之水也。九针毕矣。

夫气之在脉也，邪气在上，浊气在中，清气在下。故针陷脉则邪气出，针中脉则浊气出，针太深则邪气反沉，病益甚。故曰：皮肉筋脉，各有所处。病各有所宜，各不同形，各以任其所宜，无实实，无虚虚，损不足而益有余，是谓甚病。病益甚，取五脉者死，取三脉者恇；夺阴者死，夺阳者狂，针害毕矣。刺之而气不至，无问其数；刺之而气至，乃去之，勿复针。针各有所宜，各不同形，各任其所为。刺之要，气至而有效，效之信，若风之吹云，明乎若见苍天，刺之道毕矣。

黄帝曰：愿闻五脏六腑所出之处。岐伯曰：五脏五腧，五五二十五腧，六腑六腧，六六三十六腧。经脉十二，络脉十五，凡二十七气以上下，所出为井，所溜为荥，所注为腧，所行为经，所入为合，二十七气所行，皆在五腧也。节之交，三百六十五会，知其要者，一言而终，不知其要，流散无穷。所言节者，神气之所游行出入也。非皮肉筋骨也。睹其色，察其目，知其散复。一其形，听其动静，知其邪正。右主推之，左持而御之，气至而去之。

凡将用针，必先诊脉，视气之剧易，乃可以治也。五脏之气已绝于内，而用针者反实其外，是谓重竭，重竭必死，其死也静，治之者辄反其气，取腋与膺。五脏之气已绝于外，而用针者反实其内，是谓逆厥，逆厥则必死，其死也躁，治之者反取四末。刺之害中而不去，则精泄；害中而去，则致气。精泄则病益甚而恇，致气则生为痈疡。

五脏有六腑，六腑有十二原，十二原出于四关，四关主治五脏，五脏有疾，当取之十二原，十二原者，五脏之所以禀三百六十五节气味也。五脏有疾也，应出十二原，而原各有所出。明知其原，睹其应，而知五脏之害矣。

阳中之少阴，肺也，其原出于太渊，太渊二。阳中之太阳，心也，其原出于大陵，大陵二。阴中之少阳，肝也，其原出于太冲，太冲二。阴中之至阴，脾也，其原出于太白，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。盲之原，出于脖胦，脖胦一。凡此十二原者，主治五脏六腑之有疾者也。胀取三阳，飧泄取三阴。

今夫五脏之有疾也，譬犹刺也，犹污也，犹结也，犹闭也。刺虽久，犹可拔也；污虽久，犹可雪也；结虽久，犹可解也；闭虽久，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，犹决闭也。疾虽久，犹可毕也。言不可治者，未得其术也。

刺诸热者，如以手探汤；刺寒清者，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。

【注释】Notes

［1］黄帝：传说中的上古帝王，相传黄帝姓公孙，因生于轩辕之丘，故名轩辕，有熊国君少典之子，继神农而有天下。

［2］岐伯：相传为黄帝臣子，尊为天师。

［3］子：深切地抚爱，像爱自己的子女那样。

［4］百姓：这里指百官。

［5］砭石：古代用来刺治疾病的尖石，为金属针具的前身。

［6］经纪：条理、纲纪的意思，这里指条理清楚的理论体系。

［7］终始：指气血终而复始地运行于脏腑经脉阴阳表里的规律。

［8］易陈而难入：谈理论虽容易，在技术上达到精妙深入却难。

［9］粗守形：技术低劣的医生，只知拘守针法和发病部位来治疗。

［10］守神：高明的医生能辨别疾病的虚实，以调神为主，补泻运用自如。

［11］神客在门：神，指正气；客，指外邪入侵。正气循行径路，出入有门；外邪亦从此入，故曰“神客在门”。

［12］粗守关：关，指四肢关节。粗守关，指技术低劣的医生只知拘守着四肢关节治疗。

［13］上守机：机，指气的动静。上守机，谓上工等待着经气来往的动静，以施补虚泻实的针法。

［14］不离其空：空，指腧穴，《素问·骨空论》指各经之穴言。这里指气的来往，不离开经穴。

［15］其来不可逢：当其邪气正盛的时候，不可迎而补之。

［16］其往不可追：当邪气衰，正气未复之时，不可施用泻法。

［17］暗：暗昧不明。

［18］往者为逆，来者为顺：往，指气去；来，指气至。

［19］满则泄之：满实的病，应当用泄法。

［20］宛陈则除之：血气瘀滞日久，当排除之。宛，同“菀”e

［21］《大要》：古经篇名。

［22］徐而疾则实：是慢进针，快出针，针出急按针孔的刺法，为补法。

［23］疾而徐则虚：是快进针，慢出针，针出不闭针孔的刺法，为泄法。

［24］言实与虚，若有若无：针下有气的为实，针下无气的为虚。

［25］察后与先：分清疾病的缓急，而决定治疗的先后次序。

［26］若存若亡：根据气之虚实，而决定是否留针，及留针的久暂。若，有或义，若存若亡，犹言或去或留。

［27］若得若失：这是形容针刺补泻的效果，实证，泄而去之，使患者若有所失。虚证，补而实之，使患者若有所得。

［28］放而出之：即摇大针孔，使邪气得出之意。

［29］排阳得针：排阳有三解，一种认为，阳在这里指皮肤的浅表部位，排开浅表部位，使邪气随针外泄。另一种认为，阳，即表阳，排阳即排开表阳，以去邪气。第三种，排阳作推扬解。

［30］内温：气血蕴蓄于内的意思。

［31］若妄之：是随意而为之的意思。

［32］若行若按：行，指行针导气。按，指按压孔穴以下针，都要很轻巧。

［33］令左属右：右手出针，则令左手急按针孔。

［34］坚者为宝：指针刺时，持针一定要紧固有力。

［35］属意病者：指精神集中于病者。

［36］悬阳：一指心而言，一指目而言。

［37］两衡：眉上的部位称为衡。这里泛指眉间及面部。

［38］神属勿去：凝神静气注视患者神态变化，不要精神分散。

［39］视之独澄：看得很清楚。

［40］针：镵，锐也。因其针尖锐，故名镵针。镵

［41］针：，音“时”，又音“低”，镝也，箭镞也。因其针形似箭而得名。

［42］铍针：剑如刀装者称铍。

［43］氂：音“毛”，这里指长毛。

［44］蚊虻喙：指蚊子、虻虫的嘴。虻，亦吸血小飞虫。

［45］邪气在上：此处泛指风热阳邪侵犯上部而言。

［46］浊气在中：浊气，指饮食积滞之气。

［47］清气在下：清气，指清冷寒湿之气。

［48］针陷脉则邪气出：陷脉，指孔穴在筋骨陷中而言，针刺之以排除邪气。

［49］针中脉则浊气出：中脉，指中部阳明之合穴足三里。

［50］针太深则邪气反沉：应浅刺之病，针刺太深反而引邪深入。

［51］五脉：指五脏腧穴。

［52］取三脉者恇：三脉，指手足三阳脉。恇，音“匡”，衰弱、怯弱的意思。此言泻六腑经穴，必致形气虚弱。

［53］五脏六腑所出之处：指脏腑各自连属的经脉脉气所出之处。

［54］二十五腧：五脏者，心肝脾肺肾也。每脏有井荥输经合之五腧，则五五二十五腧也。

［55］六六三十六腧：六腑者，胆胃大肠小肠三焦膀胱也，每腑有井荥输原经合六腧，则六六三十六腧也。

［56］经脉十五：十二经及任、督二脉各有一络脉，加脾之大络大包，共十五络。

［57］所出为井：脉气由此而出，如井泉之发，其气正深也。

［58］所溜为荥：急流曰溜，小水曰荥，脉出于井而流于荥，其气尚微也。

［59］所注为腧：注，灌注也。腧，输运也。脉注于此而输于彼，其气渐盛也。

［60］所行为经：脉气大行，经营于此，其气正盛也。

［61］所入为合：形容其脉气汇合之处。

［62］节之交，三百六十五会：节，指关节肌肉等各部分而言。节之交，即人体关节等各部相交接之处，尤指其交接处的间隙，这些间隙共有365个，为经脉中的气血渗灌各部位的会合点。

［63］散复：谓气之耗散与复还。

［64］右主推之：指右手进针。

［65］左持而御之：指用左手护持针身。

［66］气至而去之：得气之后即起针。

［67］十二原“：原”即原穴。原穴是脏腑之气表里相通之处，本篇所论，是指五脏所属经脉的俞穴（左右各一，共10个）加鸠尾、气海。

［68］四关：即两肘两膝之关节。

［69］脖胦：胦，音“央”，指气海而言。

［70］污：即污染。

［71］闭：壅障的意思。

［72］雪：洗涤的意思。

［73］如以手探汤：形容针刺诸热时，针法宜轻而浅，如手探汤一样，一触即离开。

［74］如人不欲行：留针的意思。

［75］阴有阳疾者：指热在阴分。

［76］气下乃止：邪气退即止针。

［77］不下复始也：邪气不退，再继续针刺。

［78］疾高而内者：指病在上部而属于脏病者。

［79］疾高而外者：指上部有病而属腑者。

【语译】Modern Chinese Translation

黄帝问岐伯说：我爱护万民，亲养百官，并征收他们的租税。我哀怜老百姓生活不能自给，往往还发生疾病。我想不采用药物和砭石的治法，而用微针疏通经脉调和气血，调整经脉气血的顺逆出入，从而驱邪外出，以治疗他们的疾病，解除他们的痛苦。为了流传到后世去，必须明确提出针刺的大法。为使它长久存留，永不泯灭，容易使用而又便于记忆，就要使其条理分明，建立起眉目清楚的理论体系。进一步分出不同的篇章，区别开表里层次，确定人身气血周而复始地循环于脏腑经脉阴阳内外的规律。也要把各种针具的名称、形状、用途等交代清楚，为此，要首先创立一部针经。我想了解一下你的看法。

岐伯说：让我尽自己所知，从一至九，按次序谈吧！这样才能有纲纪之分，使得条理清楚，始终不乱。小针治病，谈起来比较容易，技术达到精妙的地步却较困难。粗劣的医生死守形迹，不知变化。高明的医生则能根据患者神气的盛衰，邪气的虚实，采用以调神为主的补泻手法。因为血气循行于经脉，出入有一定的门户，邪气从这些门户侵入人体，医生若不详细审察病情，怎么能了解病变发生的原因呢？至于针刺的巧妙，关键在于下针部位的适当和疾徐手法的正确运用，粗劣的医生死守着四肢关节的穴位治疗，而高明的医生却能观察经气的动静，洞达虚实的气机变化。经气循行离不开骨空，邪气是随着经气流动的，腧穴所表现的经气虚实变化是微小难见的，必须细心体察，邪气盛时，切不可用补法，以防留邪；邪气已去，正气衰时，切不可用泻法，以防伤正。懂得气机的虚实变化，就会正确运用补泻手法，不会有毫发之差；不懂得气机的虚实变化，就如箭在弦上，不知及时准确地射出去一样，当然不能达到治疗的目的，所以必须掌握气的往来逆顺盛衰之机，才能掌握针刺的正确时间，粗劣的医生对此昏昧无知，只有高明的医生才能体察它的妙处。所谓气的逆顺，气去的，经脉空疏为逆，气来的，经脉充实为顺，懂得逆顺之理，就可以大胆依法针刺。能够迎着经脉的循行方向进针，施用泻法，怎么会不使实邪得到宣泄呢？能够随着经脉的循行方向进针，施用补法，又怎么会不使正气由弱转强呢？因此，正确掌握迎随的补泻方法，再加以用心体察施用的时机，认真地调整病变的虚实，疾病自会解除。掌握了这些问题，针刺的道理，就可以完善具备了。

凡用针时，要根据病的虚实而用补泻手法。正气虚用补法，邪气实用泻法，气血郁结的用破除法，邪气盛的则用攻邪法。《大要》说：慢进针而快出针急按针孔的为补法，快进针而慢出针不按针孔的为泻法。针下有气的为实，针下无气的为虚。气本无形，似在于有无之间，要根据病的缓急及气的虚实以决定补泻的先后次序，根据气的行止，决定留针的久暂。如能掌握得法，就可以达到补虚泻实的目的，使患者感到补之若有所得，泻之若有所失。虚实补泻的要妙，以九针最为理想，补泻的功效，可以从针刺手法来解决。在用泻法时，很快持针刺入，得气后要慢慢地将针退出，退时摇大针孔，排出表阳，以驱除邪气。若当泻而误补，先按压俞穴，慢慢将针刺入，就会使血气内蕴而不外散，邪气亦不得外出。在运用补法时，应该随顺经脉循行的方向来下针，好像漫不经心地轻轻刺入，在行针导气，按穴下针时，就像蚊虫叮在皮肤上那种似有若无的感觉。出针时，要快捷利落，像箭离弓弦一样，右手出针，左手急按针孔，则经气因而留止，不至外散，这样中气就会充实，可以达到补虚的目的。如有皮下出血，不可任其瘀留，应及时除去。

持针有一定的法则，以紧握针柄为最重要，下针时，要对准腧穴，端正直刺，不可偏左偏右，要把精神集中到针尖，专心于患者，避开穴位上的血脉下针，这样就不会发生危险。进针时，要注意患者的两目及整个面部的神色变化，体察其神气的盛衰，不可稍有疏忽，从而测知疾病的好坏转归。如血脉横布在输穴周围，看起来显得很清楚，用手去按摸也会感到触手坚实，下针时就可避开血脉刺进腧穴。

九针的名称和形状各不相同。第一种叫做镵针，长一寸六分；第二种叫做员针，长一寸六分；第三种叫做针，长三寸五分；第四种叫做锋针，长一寸六分；第五种叫做铍针，长四寸，宽二寸半；第六种叫做员利针，长一寸六分；第七种叫做毫针，长三寸六分；第八种叫做长针，长七寸；第九种叫做大针，长四寸。它们的功用也随长度形状的不同而有所区别。镵针，针头大而针尖锐利，适于浅刺以泻肌表的阳热；员针，针形如卵，针尖圆钝，用以按摩分肉，既不至损伤肌肉，又能疏泄分肉之间的邪气；针，针尖像小米粒一样的微圆，主按摩经脉，流通气血，但不深陷皮肤之内，以匡正驱邪；锋针，三面有刃，锐而锋利，以治疗顽固的疾病；铍针，针尖像剑锋一样锐利，用来针刺痈疡以排脓；员利针，形状像长毛，圆而锐利，针身略粗，用以治疗急病；毫针，针尖细如蚊虫的嘴，可用来轻缓地刺入皮肉，轻微地提插，久留其针，正气因而得到充实，邪气消散，真气随之恢复，出针后很好地养息，以治疗痛痹之类的疾患；长针，针锋锐利，针身薄而长，可以治久痹；大针，粗大而头尖，其形如杖，其锋微圆，可用以泻去关节的积水。九针的情况大致就这些。

邪气侵犯经脉的部位各不相同，风热之邪多伤人体上部；饮食不节，寒温不适，浊气停于人体中部；清冷寒湿之邪，多伤人体下部。因此针刺的部位也不同，如刺筋骨陷中的各经腧穴，使经气流通，则风热之邪得以外出；刺阳明经合穴，可以调和肠胃，使浊气得出；病在浅层而针刺太深，能引邪入里，使病势加重。所以说：皮肉筋脉部位，病各不同，针刺深浅，也各不相同。九针的形状不同，各有其适应的病症，要根据病情适当选用，病有虚实，治疗时不可补实泻虚，如果虚症用了泻法，实症用了补法，不但不会减轻疾病，反而会增重病情，如精气虚的患者，误泻五脏腧穴，必至阴虚而死；阳气不足的患者，误泻三阳经的腧穴，必至正气虚怯而神志错乱。概括地说，误泻了阴经，耗竭了脏气，会死亡；误泻了阳经，耗损了阳气，就会使人发狂，这就是误用补泻的害处，应加注意。针刺时要等候经气到来，气未至时要耐心等待，若针下得气，就不要再继续用针。九针形状不一，用各有异，要根据病情选用，才能适合需要，针下气至，即为有效，疗效显著的，好像风吹云散，天气由阴暗变为晴朗一样，针刺的道理就是这样。

黄帝说：我想了解一下五脏六腑脉气所出之处的情况。岐伯说：五脏的各自经脉，分别有井、荥、腧、经、合五个腧穴，五五共二十五个腧穴，六腑各自的经脉，分别有井、荥、腧、原、经、合六个腧穴，六六共三十六个腧穴。这些腧穴，是脏腑气血循行出入的部位。人体脏腑共有十二经脉，每经各有一络，加脾之大络和任脉、督脉二络，共计十五络，十二经加十五络，这二十七脉之气上下循行出入于全身，都从井穴开始，故所出为井，如山谷间泉水初出；所溜为荥，像山泉的涓涓而行，其气尚微，未成大流；所注为腧，像水已汇贮而能转输运行，其气渐盛；所行为经，像水行成渠，脉气正盛；所入为合，像水已汇聚，经气入合于内。这二十七气的循行都出入于肘膝，流注于五腧，再从五腧内入于脏腑，昼夜循行不息，人体关节等部位的相交，共有三百六十五个会合处，这是神气游行出入和络脉渗灌诸节的地方，不是指皮肉筋骨说的。明确了这些道理的要妙，一两句话就能概括出来，否则就会散漫不经。观察患者面部气色的明暗和目光的清灵滞浊，可知气的消散和复还，从患者形态动静、声音变化，即可诊知邪正虚实。然后右手推而进针，并以左手护持针身，待其气至有针感时，即可出针。

凡用针之前，必先诊脉象，以观脏气的虚实，然后才可决定治法，如五脏之气已绝于内，是阴虚，气口脉必浮虚，按之则无，如用针反取阳经合穴，留针以致阳气，阳愈盛则阴愈虚，以致五脏精气竭绝，这叫“重竭”，重竭必死。阳虚则阳气无以生，无气以动故死时安静。这是因为脏气出于腋膺部的腧穴，脏气已虚于里，反而误泄其腧穴，导致脏气外脱，这是误治所致。如五脏之气已虚于外的患者，是阳虚，气口脉必沉微，轻取则无，治疗时若反取四肢腧穴，留针以补阴气，阴气盛则阳气内陷，引起四肢厥冷，这叫逆厥，逆厥亦必死，死时阴气有余，故烦躁不安，这是误针四肢末端而引起阳气竭绝所造成的。凡针刺一定要掌握好留针时间，针刺已中病的要害，应当立即出针，如中病而留针不去必致精气外泄，精气泄夺则病更加重而同时引起虚弱；假如没刺中病的要害而去针，就会使邪气留滞不散，停于肌肤而发生痈疡。

五脏六腑之气，表里相通，脏腑经络，内外相引，故五脏之表有六腑，六腑之外有十二原，十二原出于四关，四关原穴主治五脏的病变，故五脏有病，可以取十二原穴。因为五脏禀受水谷气味，精气注于三百六十五节、渗灌皮肤肌肉，营养全身，所以五脏的病变能反应到十二原，而十二原也各有所属的内脏，所以观察十二原的反应情况，就能知道五脏的病变。

心肺居膈上，膈上属阳位，肺属金，是阳部的阴脏，故为阳中之少阴，其原出于寸口太渊，左右共二穴。心属火，是阳部的阳脏，故为阳中之太阳，其原出于手厥阴心包络之大陵，左右共二穴。肝居膈下属木，是阴部的阳脏，为阴中之少阳，其原出于太冲，左右共二穴。脾居膈下，属土而象地，是阴部的阴脏，故为阴中之至阴，其原出于太白，左右共二穴。肾居最下属水，是阴部的阴脏，故为阴中之太阴，其原出于太溪，左右共二穴。膏的原穴，出于任脉之鸠尾。盲的原穴，出于脐下的气海。以上五脏之原各有二穴，加膏、盲两原穴，共计十二原穴，以通脏腑表里之气，所以能治五脏六腑的疾病。腹胀满的病，当取足之三阳经，飧泄食不化的病，当取足之三阴经，这是因于三阴三阳脏腑之气不合所致腹胀与泄泻的治疗原则。

人体五脏有病，就如身上扎了刺，美物被污染，绳子打了结，江河遭淤闭一样，刺扎得时间虽久，也是可以拔掉的，污垢沾染了多久，都是可以洗去的，绳结打了多久，总是能够解开的，江河即使久淤，一样是能够疏通的。有人认为得病的时间久了，就不能治愈，这种说法是不对的，精于用针的医生治疗疾病就像拔刺、洗掉污垢、解开绳结、疏通淤塞一样，病的时间虽然长久，照样能够治愈。说久病不能治，实际上是因为没有掌握相应的技术。

外感热病，邪在肌表，应当浅刺快刺，好像用手探触沸水，一触即起。阴寒凝滞的病，应当深刺留针，等候气至，好像行人在路上逗留，不愿走开那样。热在阴分的患者，要取阳明经的足三里穴，疾刺徐出不要懈怠，气至邪退即出针，如热仍不退，还可再刺。若脏病见于上部，当下取足太阴经的合穴阴陵泉，若病在上部而属于在外的腑症，当下取足少阳经的合穴阳陵泉。

【中译英】English Translation

Huangdi asked Qibo：“I love my people and provide for all the officials.But I also levy taxes on them.I feel sympathy for them［because they are］unable to support themselves and frequently attacked by diseases.I don't want to use drugs and stone needles to treat them.I am thinking of using the filiform needles to dredge their Channels，regulate their blood and Qi and adjust［the activities of］Ni（adverse），Shund（ue），Chugo（ing out）and Ru（coming into）.To pass it on to the latter generations，it is necessary to decide the principles［of acupuncture treatment］so that it can be kept forever and will never be lost.To make it easy to use and memorize，it is necessary to put it into good order and divide it into reasonable chapters［so as to］differentiate the internal from the external as well as to decide the starting and terminating［points of blood circulation and Qi flow］.In order to describe the shapes［of different kinds of needles］，the Canon of Acupuncture must be established first.［I'd］like to know［your ideas about］this issue.”

Qibo answered：“Please allow me to explain in order so as to define the principles［of acupuncture］，from one to nine.Please allow me to explain the rules.The principle of［using］small needles［to treat diseases］is easy to describe but difficult to be mastered.Ordinary［doctors］just stick to the Xing1while excellent［doctors］closely observe the Shen2.The so-called Shen［indicates that excellent doctors pay much attention to the struggle between Zhengqi（Healthy-Qi）and Xieqi（Evil-Qi）］at the entrance［of a certain Channel］.How［could a doctor］know the cause［of a disease if he］does not carefully analyze［the pathological changes of］the disease？The key of acupuncture lies in the proper location and the rapid and slow［manipulations of the needle］.Ordinary［doctors］only stick to［the Acupoints located on］the joints［of the four limbs］.［But］excellent［doctors carefully］observe the changes［of Qi movement］.The movement［of Qi］cannot deviate from the Acupoints.The movement［of Qi］inside the Acupoints is quiet and insensible.When coming，it cannot be confronted；when rece d ing，it cannot be chased3.［Those who］are aware of the changes［of Qi movement］make no errors［in applying the reinforcing and reducing techniques while those who］are unaware of such changes act just as if holding the arrow without knowing when to shoot it.Only［when one］knows［when it］comes and recedes［can he understand］the right time［of needling］.［Unskillful doctors］are ignorant of［this mechanism］.Only excellent［doctors］can understand this mystery.The receding［activity］means Ni（adverse）while the coming［activity］means Shund（ue）.［When one has］understood［the rules of］Ni and Shun，［he can］practice［acupuncture］without any doubt.To needle in line with［the running direction of the Channel］will certainly reduce Xieqi（Evil-Qi）while to needle against［the running direction of the Channel］will surely reinforce Zhengqi（Healthy-Qi）.［Whether to needle］along the running direction of the Channel or to needle against［the running direction of the Channel］requires careful consideration.This is a full explanation of acupuncture principle.

The general rule of acupuncture is［to use］reinforcing［techniques to deal with］Xu（Deficiency or Asthenia），［to use］reducing［techniques to deal with］Man（Excess or Sthenia），［to use］removing［techniques to deal with］stagnation［of Qi and blood］，［to use］attacking［techniques to deal with］predominance of Xie（Evil）.［The book entitled］Dayao（Essentials）says that slow［inserting］and quick［lifting the needle］meansreinforcing while quick［inserting］and slow［lifting the needle］means reducing.［The so-called］Shi（Excess or Sthenia）means that there is［Qi beneath the needle］and［the so-called］Xu（Deficiency or Asthenia）means that there is no［Qi beneath the needle］.［When inserting the need le，doctors should carefully］observe the coming and receding［fluctuation of Qi and blood to decide whether］to retain［the needle］or not.［The purpose of using］the reinforcing［techniques］or the reducing［techniques］is［to achieve the goal of］obtaining［something］and losing［something］.

The essentials of［strengthening］Xu（Deficiency or Asthenia）and［reducing］Shi（Excess or Sthenia）lie in［the application of］the Nine Needles.［The effects of］reinforcing and reducing can be achieved［by using proper］needling［techniques］.The reducing［needling is performed by］holding［the needle and immediately］inserting into［the selected Acupoint］，［then slowly］lifting［the needle out of the Acupoint and enlarging the needled hole for the purpose of］discharging Yang and eliminating Xieqi（Evil-Qi）.［If the needling is done by］pressing［the Acupoint］and slowly inserting［the needle］，it will lead to internal stagnation，making blood unable to dissipate and Qi difficult to disperse.The reinforcing［needling is performed by inserting the needle］in line with［the running direction the Channel］in a casual way.［When the needle is］pressed［into the Acupoint］，［it is felt just like］mosquito bite［on the skin］.［When the needle is］lifted［out of the Acupoint］，［it should be as quick as］a shot arrow.The left［hand withdraws the needle］and the right［hand presses the needled Acupoint］to prevent Qi from leaking.［Since］the needled Acupoint is closed，Zhongqi（Middle-Qi）is therefore enriched.There should be no blood stagnation.［If there is blood stagnation beneath the skin，it］must be removed immediately.The rule for holding the needle is like this：［The needle］must be held firmly and straightly，inserted directly［into the Acupoint］without any deviation.［When inserting the needle，the doctor should］concentrate his mind on the patient.［When inserting the needle，cares should be taken］to avoid the vessels.［When the vessels are avoided，］there will be no danger in needling.When inserting the needle，［the doctor should carefully observe］the eyes and complexion［of the patient］and inspect［the condition of］Shen（Spirit）［so as to］decide the prognosis of the disease.The blood vessels run around the Acupoints and are visible and sensible.

The Nine Needles are different in name and shape.The first one is called Chanzhens（agittate needle），1.6 Cun in length；the second one is called Yuanzhen（round-pointed needle），1.6 Cun in length；the third one is called Dizhen（arrow-shaped need le），3.5 Cun in length；the fourth one is called Fengzhens（harp needle），1.6 Cun in length；the fifth one is called Pizhens（word-shaped needle），4 Cun in length and 0.2 Cun in width；the sixth one is called Yuanlizhen（round-sharp needle），1.6 Cun in length；the seventh one is called Haozhen（filiform needle），3.6 Cun in length；the eighth one is called Changzhenlo（ng needle），7 Cun in length；and the ninth one is called Dazhenl（arge needle），4 Cun in length.The Chanzhen，marked by large head and sharp tip，can be used to reduce Yangqi；the Yuanzhen，ovoid-shaped，can be used to press muscular interstices to reduce Qi4without damaging the muscles；the Dizhen，as sharp as minute millet，can be used to press the Channels to promote the flow of Qi without penetrating into the skin；the Fengzhen，triple-bladed，can be used to treat obstinate disease；the Pizhen，as sharp as a sword，can be used to remove pus；the Yuanlizhen，like a piece of long hair which is round-sharp and thick in the middle part，can be used to treat acute disease；the Haozhen，as sharp as the mouth of a mosquito，can be used to treat pain and Bi-Syndrome by light insertion，mild thrust and lift and long retention［of the needle for the purpose of］invigorating［Zhengqi（Healthy-Qi）］；the Changzhen，sharp and thin，can be used to treat chronic Bi-Syndrome；the Dazhen，like a stick，slightly sharp and round，can be used to reduce retention of fluid in the joints.This is a general description of the Nine Needles.

When Qi5has invaded the Channels，Xieqi6（Evil-Qi）is in the upper，Zhuoqi7（Turbid-Qi）is in the middle and Qingqi8（Lucid-Qi）is in the lower.So needling［the Acupoints located in］the depressions eliminates Xieqi（Evil-Qi），needling the Zhongmai9eliminates Zhuoqi（Turbid-Qi）and deep needling［when the disease is superficial］leads to internal invasion of Xieqi（Evil-Qi）and worsening of the disease.That is why it is said that the locations of［the diseases in］the skin，muscles，sinews and vessels are different and［therefore the depth of］need ling is also different.［Since］the shapes［of the nine kinds of needles］are different，they should be used according to the condition［of the patients］.［Cares must be taken］not［to treat］Shi（Excess）［Syndrome with reinforcing needling techniques］and not［to treat］Xu（Deficiency）［Syndromewith reducing needling techniques］.［Violation of such a rule is known as］reducing insufficiency and reinforcing excess，［which will inevitably］worsens the disease.［When］the disease is worsened，［wrongly］needling of Wumai10causes death and［wrongly］needling of Sanmai11leads to weakness［of Zhengqi（Healthy-Qi）］.［Generally speaking，exhaustion of Visceral-Qi due to wrongly needling］of the Yin［Channel with］reducing［techniques］leads to death and damage of Yangqi［due to wrongly needling］of Yang［Channel with］reinforcing［techniques］leads to mania.These are the damages［caused by wrongly use of reinforcing and reducing techniques in］needling.

Needling［should be done when Qi has arrived.If］Qi has not arrived，［doctors must wait till it has arrived and］should not stick to the times［of using the needling techniques］.［When］Qi has arrived［after］needling，［the needles］must be withdrawn and［there is］no more needling.The needles are used to treat different diseases［because they］are different in shape.［Needles should be］selected according to their functions.The key point in needling is that the arrival of Qi ensures curative effect.The significant curative effect appears like wind blowing clouds that make the sky look bright.This is the general way of need ling.”

Huangdi said：“I'd like to know the places［where the Qi of］the Five Zang-Organs and Six Fu-Organs emerge.”

Qibo said：“［Each of］the Five Zang-Organs［has］five Acupoints［and altogether there are］twenty-five Acupoints12and［each of］the Six Fu-Organs［has］six Acupoints［and altogether there are］thirty-six Acupoints13.There are twelve Channels and fifteen Collaterals［through which these］twenty-seven kinds of Qi14［flow］upwards and downwards［in the body］.［The Acupoint where the Channel-Qi starts］to emerge is called Jing-Well，［the Acupoint where the Channel-Qi begins］to flow is called Ying-Spring，［the Acupoint where the Channel-Qi starts］to transport is called Shu-Stream，［the Acupoint where the Channel-Qi］runs is called Jing-River and［the Acupoint where the Channel-Qi begins］to enter is called He-Sea.The twenty-seven kinds of Qi all flow through the five Acupoints［of the Five Zang-Organs］.［Altogether there are］three hundred and sixty-five convergences of the joints.［Those who］understand these essentials［of Channels and Acupoints］can make it clear in one sentence while［those who are］ignorant of these essentials will make it confused.The so-calied joints are［the places where］Shenqi（Spirit-Qi）flows in and out，not just referring to skin，muscles，sinews and bones.

Careful inspe ction of complexion and examination of visual changes［enable one］to know［whether Qi is］dispersed or restored.Close observation of the physical condition and differentiation of voice［changes of the patient enable one］to know the states of pathogenic factors and Healthy-Qi.The right［hand is］responsible for pushing［the needle］while the left［hand］holds［the body of the needle］to assist［insertion of the needle］.［The needle is］withdrawn when Qi has arrived.

Before applying acupuncture，［the doctors］must examine the pulse condition［to see whether the visceral］Qi is deficient or excessive.［Only when the state of the Visceral-Qi is made clear can］treatment be decided.［When］Qi of the Five Zang-Organs is already exhausted inside，the use of acupuncture to reinforce［the Yang Channels in］the external［will make Yang more predominant and Yin more deficient，leading to exhaustion of the Visceral-Essence.Such a pathological change is］known as Chongjie（double exhaustion）which inevitably causes death.［The patient appears］quiet when dying.［This is due to the fact that］the doctors have violated［the principles of reinforcing and reducing］the Qi［of the Yin and Yang Channels］and selected［the Acupoints located below］the armpit and［over］the chest.［When］Qi of the Five Zang-Organs is already exhausted externally，the use of acupuncture to reinforce［the Yin Channels in］the internal［will make Yang more deficient and Yin more predominant，leading to coldness of the four limbs.Such a pathological change is］known as Nijue（coldness of the limbs）which inevitably causes death.［The patient appears］restless when dying.［This is due to the fact that］the doctors have selected［the Acupoints located on］the four limbs.［If the needle has been inserted into］the affected part［but is not withdrawn，it will］lead to discharge of Jing（Essence-Qi）；［if the needle has not been inserted into］the affected part［but is withdrawn，it will］lead to stagnation of Qi15.Discharge of Jing（Essence-Qi）will worsen the disease and weakens the body while stagnation of Qi will cause carbuncle and sores［due to retention of pathogenic factor in the skin］.

［Outside］the Five Zang-Organs there are Six Fu-Organs and［outside］the Six Fu-Organs there are twelve Yuan-Source［Acupoints which are all located］in the four joints16.［The Acupoints located in］the four joints［are used to］treat［the disorders of］the Five Zang-Organs.［So］the diseases of the Five Zang-Organs［can be treated by］needling the twelve Yuan-Primary［Acupoints］.The twelve Yuan-Source［Acupoints］show［how］the Five Zang-Organs receive［the nutrients of food and water］and［how Jingqi（Essence-Qi）is infused into］the three hundred and sixty- five joints.［That is why］the diseases of the Five Zang-Organs are manifested over the twelve Yuan-Primary［Acupoints which］show certain manifestations.Awareness of［the nature of］the twelve Yuan-Primary［Acupoints］and［careful］observation of the manifestations［over the twelve Yuan-Primary Acupoints enable the doctors］to know the pathological changes of the Five Zang-Organs.

The Shaoyin within Yang is the lung and its Yuan-Primary［Acupoint］is Taiyuan（LU9）on both sides；the Taiyang within Yang is the heart and its Yuan-Primary［Acupoint］is Daling（PC7）on both sides；the Shaoyang within Yin is the liver and its Yuan-Primary［Acupoint］is Taichong（LR3）on both sides；the Zhiyin within Yin is the spleen and its Yuan-Primary［Acupoint］is Taibai（Sp3）on both sides；the Taiyin within Yin is the kidney and its Yuan-Primary［Acupoint］is Taixi（KI3）on both sides.The Yuan-Primary［Acupoint］of the Gao is Jiuwei（GV15），and there is only one Jiuwei（GV15）.The Yuan-Primary［Acupoint］of Boyang is Qihai（CV6）and there is only one Qihai（CV6）.These twelve Yuan-Primary［Acupoints］are mainly used to treat the diseases of the Five Zang-Organs and the Six Fu-Organs.［Abdominal］distension［can be treated by］needling［the Acupoints on］the three Yang［Channels］and Sunxie（diarrhea with undigested food in it）［can be treated by］needling［the Acupoints on］the three Yin［Channels］.The diseases of the Five Zang-Organs are just like［the condition of］being thorned，being contaminated，being knotted and being stagnated.［It may be］thorned for a long time，［but the thorn］still can be removed；［it may be］contaminated for along time，［but it］still can be cleaned；［it may be］knotted for a long time，［but it］still can be undone；［it may be］stagnate d for a long time，［but it］still can be dredged.Some people may say that a prolonged disease is incurable.This is in fact not true.［Those who are］good at acupuncture treat diseases just like removing thorns，cleaning contamination，undoing knots and dredging stagnation.A disease may linger for a long time，it is still curable.［those who］regard lingering diseases as incurable are actually unskillful in doing Acupuncture.

［To treat］febrile diseases with Acupuncture is just like feel hot water with the hand17；［to treat］cold diseases with Acupuncture is just like people who are unwilling to leave18.［To treat］Yang disease in Yin19，Zusanli（ST36）should be selected.［The needle must be］inserted correctly without any deviation.［When］Qi20recedes，the needle is withdrawn；［if Qi］does not recede，［it can be need led］again.［If］the disease［is located in］the upper［part of the body and is related to］the internal（Zang-Organs），［it can be treated by］needling Yinlingquan（SP9）；［if］the disease［is located in］the upper［part of the body and is related to］the external（Fu-Organs），［it can be treated by］needling Yanglingquan（GB34）.”

【注释】Notes

［1］Xing（形），literally meaning shape，refers to the needling techniques and the location of disease.

［2］Shen（神），literally meaning Spirit，refers to the subtle changes of Qi and blood.

［3］The original Chinese characters for this sentence are Qi（其it）Lai（来come）Bu（不no）Ke（可can）Feng（逢meet or confront）Qi（其it）Wang（往recede or leave）Bu（不no）Ke（可can）Zhui（追chase）.There are different explanations about this sentence.One typical explanation is that“when Xieqi（邪气Evil-Qi）is predominant，reinforcing method cannot be used；when Xieqi（邪气Evil-Qi）has already dec lined，reducing method cannot be used.”Another common explanation is that“if the chance to treat the disease is lost，it cannot be obtained；if the chance has already lost，it impossible to be grasped again.”

［4］Qi（气）here refers to Xieqi（邪气Evil-Qi）or Xieqi（Evil-Qi）.

［5］Qi（气）here refers to Xieqi（邪气Evil-Qi）or Xieqi（Evil-Qi）.

［6］Xieqi（邪气Evil-Qi）here refers to pathogenic Wind-Heat which tends to attack the upper part of the body.

［7］Zhuoqi（浊气Turbid-Qi）here refers to retention of food.Improper adaptation to the changes of cold and warm weather and intemperance in eating may lead to retention of Zhuoqi（Turbid-Qi）in the intestines and stomach.That is why it is said that the Zhuoqi（Turbid-Qi）is in the middle.

［8］Qingqi（清气Lucid-Qi）here refers to coolness，coldness and dampness.Ma Shi（马莳）said：“When Diqi（地气Earth-Qi）of coolness and dampness attacks the human body，it must start from the feet.That iswhy it is said that Qingqi（Lucid-Qi）is in the lower.”

［9］Zhongmai（中脉）here refers to Zusanli（足三里ST36）which is the Lower He-Sea Acupoint of the Yangming Channel.It is said in Lingshushi（灵枢识）that“Explanation of Small Needle says that Zhongmai（中脉）refers to the Lower He-Sea Acupoint of the Yangming Channel.”Ma Shi（马莳）said“：Zhongmai（中脉）refers to the Lower He-Sea Acupoint of the Yangming Channel.”

［10］Wumai（五脉）refers to Shu-Stream Acupoints of the Five Zang-Organs.

［11］Sanmai（三脉）refers to the three Yang Channels of the hand and foot.

［12］Each Zang-Organ has five Acupoints，namely Jing-Well（井），Ying-Spring（荥），Shu-Stream（输），Jing-Rive（经）and He-Sea（合）.

［13］Each Fu-Organ has six Acupoints，namely Jing-Well（井），Ying-Spring（荥），Shu-Stream（输），Yuan-Primary（原），Jing-Rive（经）and HeSea（合）.

［14］Each of the twelve regular Channels has one Collateral.The Dumai（督脉Governor Vessel）hasa Collateral，the Renmai（任脉Conception Vessel）has a Collateral and the Spleen Channel still has a major Collateral.So altogether there are fifteen Collaterals.

［15］Qi（气）here refers to Xieqi（邪气Evil-Qi）or pathogenic factors.

［16］The four joints refer to the knees and the elbows.

［17］This sentence means that the needling techniques used to treat febrile diseases should be light and the needles should be inserted shallow.

［18］This sentence means that the needles must be retained in treating cold diseases.

［19］Yang disease in Yin means that there is heat in the Yin-Phase.

［20］Qi（气）here refers to Xieqi（邪气Evil-Qi）or pathogenic factors.