素问·四时刺逆从论 Discourse on Compliance and Contrariety in Needling through the Four Seasons
厥阴有馀病阴痹，不足病生热痹，滑则病狐疝，风涩则病少腹积气。少阴有馀病皮痹，隐轸不足病肺痹，滑则病肺风疝，涩则病积溲血。太阴有馀病肉痹，寒中不足病脾痹，滑则病脾风疝，涩则病积心腹时满。阳明有馀病脉痹身时热，不足病心痹，滑则病心风疝，涩则病积时善惊。太阳有馀病骨痹身重，不足病肾痹，滑则病肾风疝，涩则病积善时巅疾。少阳有馀病筋痹脇满，不足病肝痹，滑则病肝风疝，涩则病积时筋急目痛。
是故春气在经脉，夏气在孙络，长夏气在肌肉，秋气在皮肤，冬气在骨髓中。帝曰：余愿闻其故。歧伯曰：春者，天气始开，地气始泄，冻解冰释，水行经通，故人气在脉。夏者，经满气溢，入孙络受血，皮肤充实。长夏者，经络皆盛，内溢肌中。秋者，天气始收，腠理闭塞，皮肤引急。冬者盖藏，血气在中，内著骨髓，通于五藏。是故邪气者，常随四时之气血而入客也，至其变化不可为度，然必从其经气，辟除其邪，除其邪，则乱气不生。
帝曰：逆四时而生乱气，柰何。歧伯曰：春刺络脉，血气外溢，令人少气。春刺肌肉，血气环逆，令人上气。春刺筋骨，血气内著，令人腹胀。夏刺经脉，血气乃竭，令人解㑊。夏刺肌肉，血气内却，令人善恐。夏刺筋骨，血气上逆，令人善怒。秋刺经脉，血气上逆，令人善忘。秋刺络脉，气不外行，令人卧不欲动。秋刺筋骨，血气内散，令人寒栗。冬刺经脉，血气皆脱，令人目不明。冬刺络脉，内气外泄，留为大痹。冬刺肌肉，阳气竭绝，令人善忘。凡此四时刺者大逆之病，不可不从也，反之则生乱气相淫病焉。故刺不知四时之经，病之所生，以从为逆，正气内乱，与精相薄，必审九候，正气不乱，精气不转。
帝曰：善。刺五藏，中心一日死，其动为噫。中肝五日死，其动为语。中肺三日死，其动为咳。中肾六日死，其动为嚏欠。中脾十日死，其动为吞。刺伤人五藏必死，其动，则依其藏之所变候知其死也。
When the terminal yin (jueyin) is in excess, it causes yin impediment (bi); when it is deficient, it causes heat impediment; when the pulse is slippery, it causes fox hernia; when the pulse is rough with wind, it causes accumulation of qi in the lower abdomen. When the lesser yin (shaoyin) is in excess, it causes skin impediment with urticaria; when deficient, it causes lung impediment; when slippery, it causes lung wind-hernia; when rough, it causes accumulations and bloody urine. When the greater yin (taiyin) is in excess, it causes flesh impediment with cold in the middle; when deficient, it causes spleen impediment; when slippery, it causes spleen wind-hernia; when rough, it causes accumulations with periodic fullness of the heart and abdomen. When yang brightness (yangming) is in excess, it causes vessel impediment with periodic fever of the body; when deficient, it causes heart impediment; when slippery, it causes heart wind-hernia; when rough, it causes accumulations with frequent fright. When greater yang (taiyang) is in excess, it causes bone impediment with heaviness of the body; when deficient, it causes kidney impediment; when slippery, it causes kidney wind-hernia; when rough, it causes accumulations with recurrent disorders of the crown of the head. When lesser yang (shaoyang) is in excess, it causes sinew impediment with fullness of the rib-side; when deficient, it causes liver impediment; when slippery, it causes liver wind-hernia; when rough, it causes accumulations with periodic tension of the sinews and eye pain.
Therefore in spring the qi is in the channels; in summer the qi is in the minute connecting vessels; in late summer the qi is in the muscles and flesh; in autumn the qi is in the skin; in winter the qi is in the bone marrow. Huangdi said: I wish to hear the reason for this. Qibo said: In spring, the qi of heaven begins to open and the qi of earth begins to release; the ice thaws and melts, water flows and the channels open, so people's qi is in the vessels. In summer, the channels are full and the qi overflows, entering the minute connecting vessels and receiving blood, so the skin becomes full and firm. In late summer, the channels and connecting vessels are all abundant, and qi overflows internally into the flesh. In autumn, the qi of heaven begins to contract, the interstices close up, and the skin becomes tight and drawn. In winter, qi is stored away; blood and qi reside in the interior, lodging in the bone marrow, and communicate with the five viscera. Therefore pathogenic qi always follows the qi and blood of the four seasons in order to enter and lodge in the body; when it comes to its transformations these cannot be measured by a fixed rule, but one must follow the channel qi proper to the season in order to expel the pathogen — once the pathogen is expelled, disordered qi will not arise.
Huangdi said: How does disordered qi arise from acting contrary to the four seasons? Qibo said: If one needles the connecting vessels in spring, blood and qi will overflow outward, causing the person to lack qi. If one needles the muscles and flesh in spring, blood and qi will circulate in counterflow, causing the person's qi to rise. If one needles the sinews and bones in spring, blood and qi will lodge internally, causing the person's abdomen to distend. If one needles the channels in summer, blood and qi will become exhausted, causing the person to become languid and weak. If one needles the muscles and flesh in summer, blood and qi will withdraw internally, causing the person to become prone to fear. If one needles the sinews and bones in summer, blood and qi will rise in counterflow, causing the person to become prone to anger. If one needles the channels in autumn, blood and qi will rise in counterflow, causing the person to become forgetful. If one needles the connecting vessels in autumn, qi will not move outward, causing the person to lie down and be unwilling to move. If one needles the sinews and bones in autumn, blood and qi will disperse internally, causing the person to shiver with cold. If one needles the channels in winter, blood and qi will both be drained away, causing the person's eyes to become dim. If one needles the connecting vessels in winter, internal qi will leak outward and linger to form a great impediment. If one needles the muscles and flesh in winter, yang qi will become exhausted and cut off, causing the person to become forgetful. In all these cases, needling contrary to the four seasons is a grave transgression that gives rise to disease, and one must not fail to comply with the seasons; acting contrary to them gives rise to disordered qi that spreads and generates disease. Therefore, if in needling one does not know the channel proper to the season and the place where the disease arises, taking compliance for contrariety, the true qi becomes disordered within and clashes with the essence; one must carefully examine the nine indicators of the pulse — then the true qi will not become disordered, and the essential qi will not be diverted.
Huangdi said: Good. When needling wounds the five viscera: if it strikes the heart, death comes in one day, and its sign is belching. If it strikes the liver, death comes in five days, and its sign is disordered speech. If it strikes the lung, death comes in three days, and its sign is coughing. If it strikes the kidney, death comes in six days, and its sign is sneezing and yawning. If it strikes the spleen, death comes in ten days, and its sign is swallowing. Needling that wounds a person's five viscera will invariably result in death; as for its signs, one may know the time of death according to the changing indications proper to each viscus.