灵枢经·官针 Proper Needling
凡刺之要，官针最妙。九针之宜，各有所为，长、短、大、小，各有所施也。不得其用，病弗能移。疾浅针深，内伤良肉，皮肤为痈；病深针浅，病气不写，支为大脓。病小针大，气写太甚，疾必为害；病大针小，气不泄写，亦复为败。失针之宜。大者写，小者不移。已言其过，请言其所施。
病在皮肤无常处者，取以鑱针于病所，肤白勿取。病在分肉间，取以圆针于病所。病在经络痼痹者，取以锋针。病在脉，气少，当补之者，取以鍉针于井荥分俞。病为大脓者，取以铍针。病痹气暴发者，取以圆利针。病痹气痛而不去者，取以毫针。病在中者，取以长针。病水肿不能通关节者，取以大针。病在五藏固居者，取以锋针，写于井荥分俞，取以四时。
凡刺有九，以应九变。一曰俞刺，俞刺者，刺诸经荥俞藏俞也；二曰远道刺，远道刺者，病在上，取之下，刺府俞也；三曰经刺，经刺者，刺大经之结络经分也；四曰络刺，络刺者，刺小络之血脉也；五曰分刺，分刺者，刺分肉之间也；六曰大写刺，大写刺者，刺大脓以铍针也；七曰毛刺，毛刺者，刺浮痹皮肤也；八曰巨刺，巨刺者，左取右，右取左；九曰焠刺，焠刺者，刺燔针则取痹也。
凡刺有十二节，以应十二经。一曰偶刺，偶刺者，以手直心若背，直痛所，一刺前，一刺后，以治心痹。刺此者，傍针之也。二曰报刺，报刺者，刺痛无常处也。上下行者，直内无拔针，以左手随病所按之，乃出针，复刺之也。三曰恢刺，恢刺者1，直刺傍之，举之前后，恢筋急，以治筋痹也。四曰齐刺，齐刺者，直入一，傍入二，以治寒气小深者；或曰三刺，三刺者，治痹气小深者也。五曰扬刺，扬刺者，正内一，傍内四，而浮之，以治寒气之搏大者也。六曰直针刺，直针刺者，引皮乃刺之，以治寒气之浅者也。七曰输针，输刺者，直入直出，稀发针而深之，以治气盛而热者也。八曰短刺，短刺者，刺骨痹，稍摇而深之，致针骨所，以上下摩骨也。九曰浮刺，浮刺者，傍入而浮之，以治肌急而寒者也。十曰阴刺，阴刺者，左右率刺之，以治寒厥；中寒厥，足踝后少阴也。十一曰傍针刺，傍针刺者，直刺傍刺各一，以治留痹久居者也。十二曰赞刺，赞刺者，直入直出，数发针而浅之，出血是谓治痈肿也。1. 者 : 旧脱。
脉之所居，深不见者，刺之微内针而久留之，以致其空脉气也。脉浅者，勿刺，按绝其脉乃刺之，无令精出，独出其邪气耳。
所谓三刺，则谷气出者。先浅刺绝皮，以出阳邪，再刺则阴邪出者，少益深绝皮，致肌肉，未入分肉间也；已入分肉之间，则谷气出。故刺法曰：始刺浅之，以逐邪气，而来血气，后刺深之，以致阴气之邪，最后刺极深之，以下谷气。此之谓也。
故用针者，不知年之所加，气之盛衰，虚实之所起，不可以为工也。
凡刺有五，以应五藏，一曰半刺，半刺者，浅内而疾发针，无针伤肉，如拔毛状，以取皮气，此肺之应也。
二曰豹文刺，豹文刺者，左右前后针之，中脉为故，以取经络之血者，此心之应也。
三曰关刺，关刺者，直刺左右尽筋上，以取筋痹，慎无出血，此肝之应也；或曰渊刺；一曰岂刺。
四曰合谷刺，合谷刺者，左右鸡足，针于分肉之间，以取肌痹，此脾之应也。
五曰输刺，输刺者，直入直出，深内之至骨，以取骨痹，此肾之应也。
In all needling, the essential point is the proper matching of needle to disease — the standard of official needling (guanzhen) is the most refined of all. The nine needles are each suited to a particular purpose; long, short, large, and small, each has its own proper application. If one fails to use the needle appropriately, the disease cannot be moved or resolved. If the disease is shallow but the needle is inserted deep, this will injure the healthy flesh within, and the skin will develop an abscess. If the disease is deep but the needle is inserted shallow, the disease qi will not be drained, and it will instead branch out and form a great festering sore. If the disease is slight but a large needle is used, the qi will be drained excessively, and this will certainly cause harm. If the disease is severe but a small needle is used, the qi cannot be released and drained, and this too will result in failure. To lose the proper match of the needle in this way — where the disease is large, using too small a needle fails to move it. Having already spoken of these errors, let me now speak of the proper applications of each needle.
When disease lies in the skin without a fixed location, one should select the arrow-head needle (chanzhen) at the site of disease; if the skin is pale, do not needle. When disease lies between the divisions of the flesh, one should select the round needle (yuanzhen) at the site of disease. When disease lies in the channels and network vessels as a stubborn, chronic impediment, one should select the pointed needle (fengzhen). When disease lies in the vessels and the qi is scant, requiring supplementation, one should select the round-sharp needle (dizhen) at the well, brook, and other transport points. When disease has formed a great festering sore, one should select the lancet needle (pizhen). When disease is an impediment with qi erupting suddenly, one should select the round-and-sharp needle (yuanlizhen). When disease is an impediment with lingering pain that does not depart, one should select the filiform needle (haozhen). When disease lies deep within the body, one should select the long needle (changzhen). When disease is water swelling that cannot pass through the joints, one should select the great needle (dazhen). When disease lies fixed and lodged within the five viscera, one should select the pointed needle, draining at the well, brook, and other transport points, choosing the points according to the four seasons.
In all, there are nine methods of needling, corresponding to the nine variations of disease. The first is called transport-point needling (shuci): transport-point needling means needling the brook and transport points of the various channels, as well as the transport points of the viscera. The second is called far-reaching needling (yuandaoci): far-reaching needling means that when disease is located in the upper body, one selects points in the lower body, needling the transport points of the bowels. The third is called channel needling (jingci): channel needling means needling the knotted network vessels and channel divisions of the great channels. The fourth is called network needling (luoci): network needling means needling the blood vessels of the small network vessels. The fifth is called divisional needling (fenci): divisional needling means needling between the divisions of the flesh. The sixth is called great-draining needling (daxieci): great-draining needling means using the lancet needle to drain a great festering sore. The seventh is called hair needling (maoci): hair needling means needling floating impediment in the skin. The eighth is called great opposite-side needling (juci): great opposite-side needling means selecting the right side when the disease is on the left, and the left side when the disease is on the right. The ninth is called searing needling (cuici): searing needling means using a fire-heated needle to treat impediment.
In all, there are twelve techniques of needling, corresponding to the twelve channels. The first is called paired needling (ouci): paired needling means placing one hand directly over the heart or over the back, aligned with the exact site of pain, and inserting one needle in front and one behind, in order to treat impediment of the heart. When needling in this manner, the needle is angled obliquely. The second is called repeated needling (baoci): repeated needling is used when pain has no fixed location, moving up and down. One inserts the needle straight in without withdrawing it, and with the left hand presses along the site of the disease as it shifts, then withdraws the needle and needles again at the new location. The third is called relaxing needling (huici): relaxing needling means inserting the needle straight in and then to the side of it as well, lifting and moving it forward and backward so as to relax sinew tension, in order to treat impediment of the sinews. The fourth is called aligned needling (qici): aligned needling means inserting one needle straight in and two needles to either side, in order to treat cold qi that is somewhat deep; some call this triple needling (sanci), used to treat impediment qi that is somewhat deep. The fifth is called scattered needling (yangci): scattered needling means inserting one needle straight in the center and four needles around it, all shallowly, in order to treat cold qi that has spread over a large area. The sixth is called straight needling (zhizhenci): straight needling means drawing up the skin and then inserting the needle, in order to treat cold qi that lies shallow. The seventh is called transport needling (shuci): transport needling means inserting the needle straight in and withdrawing it straight out, needling infrequently but deeply, in order to treat qi that is exuberant and hot. The eighth is called brief needling (duanci): brief needling means, in treating bone impediment, gently rocking the needle while advancing it deeper, so that the needle reaches the bone, rubbing the bone up and down with the needle tip. The ninth is called floating needling (fuci): floating needling means inserting the needle to the side and keeping it shallow, in order to treat tension of the muscles accompanied by cold. The tenth is called yin needling (yinci): yin needling means needling both the left and right sides together, in order to treat cold reversal; this targets the Shaoyin point behind the medial ankle in cases of cold reversal. The eleventh is called flanking needling (pangzhenci): flanking needling means inserting one needle straight in and one needle to the side, in order to treat a lingering impediment that has resided in the body for a long time. The twelfth is called assisting needling (zanci): assisting needling means inserting the needle straight in and withdrawing it straight out repeatedly, keeping it shallow, so as to let out blood — this is what is meant by treating welling-abscess and swelling.
Where a vessel lies deep and cannot be seen, one should needle it by inserting the needle slightly and retaining it for a long while, so as to draw forth the qi of the vessel's cavity. Where a vessel lies shallow, one should not needle it directly; rather, one should press upon it to block off the flow of the vessel, and only then needle it, so as not to let the essential qi escape, but to let only the evil qi be released.
What is called the three insertions (sanci) is the method by which grain qi is made to emerge. First one needles shallowly, penetrating only the skin, so as to release yang evil; the second insertion releases yin evil, going a little deeper past the skin, reaching the flesh but not yet entering between its divisions; once the needle has entered between the divisions of the flesh, the grain qi emerges. Hence the method of needling states: at the first insertion, needle shallowly, so as to expel the evil qi and bring forth the blood and qi; at the second insertion, needle more deeply, so as to draw out the evil residing in the yin qi; and at the final insertion, needle to the greatest depth, so as to bring down the grain qi. This is precisely what is meant.
Hence, one who practices needling but does not understand the increase brought by the patient's age, the flourishing or decline of the qi, and the origin of deficiency and excess, cannot be considered a skilled physician.
In all, there are five methods of needling, corresponding to the five viscera. The first is called half needling (banci): half needling means inserting the needle shallowly and withdrawing it quickly, without letting the needle injure the flesh, resembling the plucking of a hair, in order to draw upon the qi of the skin — this corresponds to the lung.
The second is called leopard-pattern needling (baowenci): leopard-pattern needling means needling to the left and right, front and back, aiming deliberately to strike the vessel, in order to draw out the blood of the channels and network vessels — this corresponds to the heart.
The third is called joint needling (guanci): joint needling means needling straight in on the left and right, exactly at the point where the sinew ends, in order to treat impediment of the sinews, taking care not to let blood escape — this corresponds to the liver; it is also called deep-pool needling (yuanci), or, in another rendering, qici.
The fourth is called converging-valley needling (hegu ci): converging-valley needling means needling in a chicken-foot pattern to the left and right, between the divisions of the flesh, in order to treat impediment of the muscles — this corresponds to the spleen.
The fifth is called transport needling (shuci): transport needling means inserting the needle straight in and withdrawing it straight out, inserting it deeply until it reaches the bone, in order to treat impediment of the bones — this corresponds to the kidney.