《黃帝素問靈樞集註》

The Yellow Emperor (legendary progenitor of Chinese civilization) consulted with Qibo (ancient master physician), saying: "In governing the people and collecting taxes, I witness their hardships and suffering from illness, which pains my heart. I wish to abandon harsh methods like poisonous drugs and stone lancets, instead using fine needles to regulate the meridians and harmonize Qi (vital energy) and blood circulation. May this method be transmitted to future generations with clear standards that will never be lost—easy to master and remember."

Qibo replied: "Allow me to systematically explain this acupuncture method. While its principles sound simple, true mastery is difficult. Ordinary physicians remain at the level of surface techniques, while skilled practitioners grasp the inner Shenji (divine mechanism). This 'divine mechanism' is like discerning the root of illness before symptoms manifest at the gate. The essence of needling lies in timing—common doctors rigidly follow point locations, whereas masters synchronize with Qi-blood movement."

"The patterns of Qi-blood flow are subtle and elusive—hard to seize when arriving, impossible to retain when departing. Those who understand this principle needle with perfect precision; those who don't are like drawing a bow without releasing the arrow. Only by comprehending the coming and going of Qi can one seize the optimal treatment moment. Common physicians remain confused, while true masters perceive these mysteries."

"Adverse Qi flow signifies disease; smooth circulation indicates health. Understanding this prevents treatment errors. Needling against pathogenic factors expels evil Qi, while following the current nourishes righteous Qi. The principles are: tonify deficiency, dredge stagnation, eliminate accumulations, and purge excess. The essential technique: slow insertion with quick withdrawal tonifies, while quick insertion with slow withdrawal drains."

"The transformations between Xu (deficiency) and Shi (excess) are subtle—demanding careful discernment. The nine types of needles each have specialized functions, and tonification/drainage techniques require particular attention. For drainage, insert deeply and shake the needle to enlarge the hole for expelling pathogens; for tonification, insert gently like a mosquito bite, then withdraw swiftly like a snapped bowstring—press the point with the left hand while the right swiftly removes the needle, thus preserving righteous Qi within."

This passage explains the essentials of acupuncture treatment and the characteristics of the nine types of needles. It first clarifies the key to needle insertion: once the needle tip enters the acupoint and the outer gate (skin surface) closes, the internal Qi will become substantial. At this point, the needle should be swiftly withdrawn to prevent blood stagnation.

The crucial technique in needle handling lies in steadiness—the needle must be inserted vertically without lateral swaying. Practitioners must concentrate fully while observing the patient, carefully examining the pathways of blood vessels to ensure safe needling. During treatment, focus should remain on the patient's facial complexion and both eyes (the "suspended yang" refers to facial Qi coloration, while the "two guardians" indicate the eyes). Maintaining mental concentration allows diagnosis through observing blood vessel distribution at specific acupoints (Shuxue).

The nine needle types are then detailed:

1. The chán needle: 1.6 cun long with a broad head and sharp tip, used for draining pathogenic Yang factors.

2. The round needle: with an oval-shaped shaft designed for massaging between muscle fibers without damaging tissue.

3. The dī needle: featuring a millet-grain-shaped blunt tip for pressing meridians to guide Qi.

4. The sharp needle: with triangular edges for treating stubborn illnesses.

5. The sword needle: 2.5 fen wide with a blade-like end for draining pus.

6. The round-sharp needle: slightly thicker shaft with acutely rounded tip for acute conditions.

7. The filiform needle: fine as a mosquito's proboscis, used for gentle, prolonged insertion to treat pain and numbness.

8. The long needle: with an elongated shaft for deep-seated bi syndromes.

9. The large needle: staff-shaped with slightly rounded tip for draining joint effusions.

Fundamental principles are then outlined: pathogenic Qi resides in the upper body, turbid Qi in the middle, and clear Qi below. Shallow insertion expels pathogens, moderate depth clears turbidity, while excessive depth may drive pathogens deeper, worsening conditions. Proper needle selection and techniques must match specific pathologies, with balanced supplementation and drainage. Incorrect needling brings severe consequences: mistaken insertion into visceral meridians proves fatal; damaging three meridians causes debility; exhausting Yin Qi leads to death; injuring Yang Qi induces mania.

A critical reminder: if no Qi sensation (needling response) occurs after insertion, repeated manipulation is permissible. However, upon obtaining Qi, immediate needle withdrawal is mandatory.

This scripture elucidates the key principles of acupuncture therapy and the distribution patterns of acupoints corresponding to the five zang and six fu organs.

The essence of acupuncture lies in obtaining Qi sensation (needle response), which produces effects as swiftly as clouds scattering before the wind. A true master of acupuncture discerns with immediate clarity, as if seeing through to a cloudless sky.

When the Yellow Emperor inquired about acupoint distribution for the five zang and six fu organs, Qibo replied: Each zang organ has five major acupoints (Jing-well, Ying-spring, Shu-stream, Jing-river, and He-sea), totaling twenty-five; each fu organ has six acupoints, making thirty-six in total. The human body contains twelve primary meridians and fifteen collaterals, forming twenty-seven Qi pathways circulating throughout. Acupoints are classified into five categories: Jing-well (where Qi and blood emerge), Ying-spring (where they flow), Shu-stream (where they pour), Jing-river (where they circulate), and He-sea (where they converge). The body contains 365 acupoint junctions—those who understand the essentials can explain them succinctly, while the uninitiated only create confusion.

Here, "jie" (acupoints) refers to gateways where Shen (spirit) and Qi come and go, not the physical tissues of skin, muscles, tendons or bones. Diagnosis requires observing the patient's complexion and eye expression to assess Qi-blood abundance or deficiency, while evaluating physical movements helps determine pathological conditions and distinguish pathogenic factors from healthy Qi. Insert needles with the right hand while supporting with the left, withdrawing upon obtaining Qi. Pulse diagnosis must precede needling to evaluate Qi-blood conditions.

Two grave treatment errors are specifically warned against: If the five zang's Jing (essence) is already deficient yet the exterior is reinforced, this causes "severe exhaustion" where the patient dies quietly; if surface Yang Qi is depleted yet the interior is supplemented, this causes "rebellious reversal" where the patient dies in agitation.

Improper needling yields two consequences: prolonged retention depletes Jing, while hasty withdrawal causes Qi stagnation. Depleted Jing worsens illness, while stagnant Qi may induce abscesses.

The five zang organs connect through six fu organs, which possess twelve Yuan-source points (key acupoints) located at limb joints that treat zang disorders. When zang organs are diseased, these manifest at Yuan-source points—for instance, the lung's Yuan point at Taiyuan (wrist) or the heart's at Daling (wrist). Observing Yuan-point changes reveals zang organ pathologies.

This passage primarily discusses the relationship between the body's meridian points and disease treatment. The source point (a key acupoint) of the Lesser Yang meridian (Gallbladder meridian) is Taichong (LV3), located in the depression behind the second toe. The source point of the Spleen meridian is Taibai (SP3), found on the inner side of the foot, while the Kidney meridian's source point is Taixi (KI3), situated behind the inner ankle. Other important points mentioned include Jiuwei (CV15) at the lower end of the sternum and Boyang (CV8) below the navel.

The text employs four metaphors to illustrate disease treatment principles: just as one extracts a splinter from flesh, washes away stains, unties knots, or clears blockages, even chronic illnesses can be cured with proper methods. Those who claim "chronic diseases cannot be treated" simply lack mastery of correct medical techniques.

Specific acupuncture principles are outlined: for heat syndromes, insert needles swiftly like testing hot water with a hand, while for cold syndromes, retain needles slowly. For disorders of Yin-Yang imbalance, one may select Zusanli (ST36) (located below and lateral to the knee) for treatment until pathogenic Qi dissipates. For upper-body diseases: Yin conditions target Yinlingquan (SP9) on the inner calf, while Yang conditions focus on Yanglingquan (GB34) on the outer calf.

Note: The "source points" mentioned refer to crucial acupoints at the extremities of the twelve main meridians that reflect and treat corresponding organ disorders. "Three Yang" denotes the Greater Yang (Taiyang), Lesser Yang (Shaoyang), and Yang Brightness (Yangming) meridians, while "Three Yin" refers to Greater Yin (Taiyin), Lesser Yin (Shaoyin), and Reverting Yin (Jueyin) meridians. Acupuncture techniques should be selected according to the nature of the condition.