Loading...
Chapter 51 of 78
黄帝内经·素问
This chapter, "Discussion on Needling Uniformity," addresses the "boundaries" of needling depth. The Yellow Emperor asks: I wish to hear how the depth of needling is distinguished. Qi Bo replies:
Conversely:
The Yellow Emperor says this is still unclear and asks for further explanation. Qi Bo elaborates:
By "when needling the bone, do not merely injure the sinew," it is meant that the needle is withdrawn as soon as it reaches the sinew without reaching the bone—this is a case of "insufficiency"—needling too shallowly. By "when needling the sinew, do not merely injure the flesh," it is meant that the needle is withdrawn as soon as it reaches the flesh without reaching the sinew. By "when needling the flesh, do not merely injure the vessel," it is meant that the needle is withdrawn as soon as it reaches the vessel without reaching the flesh. By "when needling the vessel, do not merely injure the skin," it is meant that the needle is withdrawn as soon as it reaches the skin without reaching the vessel.
By "when needling the skin, do not injure the flesh," it is meant that when the disease is in the skin, the needle need only enter the skin without injuring the flesh—this is the correct depth. By "when needling the flesh, do not injure the sinew," if the needle passes through the flesh and strikes the sinew, it is too deep; by "when needling the sinew, do not injure the bone," if the needle passes through the sinew and strikes the bone, it is also too deep. These are all cases of "excess"—violating the proper boundaries of shallowness and depth.
⚠️ This chapter is for the study of needling principles and is not intended as operational guidance for acupuncture.
The core of this chapter is "Needling Uniformity" (Ci Qi).
The term "uniformity" here carries the meaning of "boundary, limit, and striking the right measure." The ancients classified the body from shallow to deep into five layers—skin, vessels, flesh, sinew, bone—and held that since pathogenic factors invade at different layers, needling must also precisely reach the site of disease:
The chapter therefore establishes its argument from two aspects: "insufficiency" and "excess." The first half—"when needling the bone, do not injure the sinew... when needling the vessel, do not injure the skin"—addresses "insufficiency": where one should go deep but goes shallow instead. The second half—"when needling the skin, do not injure the flesh; when needling the flesh, do not injure the sinew; when needling the sinew, do not injure the bone"—addresses "excess": where one should go shallow but goes deep instead. Only by aligning depth precisely with the level of disease can the needling be considered correct in the ancient view.
This embodies the consistent principle of "neither excess nor insufficiency" found throughout the Huangdi Neijing—a philosophy that applies not only to needling technique but also to therapeutic methodology in general.
From a modern standpoint, the most valuable contribution of this chapter is its emphasis on "layered operation."
Needling must pass through the skin, subcutaneous tissue, fascia, muscle, and other layers. Modern safe acupuncture practice also stresses the importance of respecting the local anatomical structures at each acupoint, controlling needling direction and depth to avoid damaging nerves, blood vessels, and internal organs. This shares a common principle with the ancients' layered thinking of "skin, vessels, flesh, sinew, bone."
However, it should also be recognized that the ancient terms "sinew" and "vessel" do not correspond exactly to tendons and blood vessels in modern anatomy; the classification of "bone, sinew, flesh, vessel, skin" is macroscopic and functional, carrying the limitations of its era. Therefore, this chapter constitutes a statement of principles, not an operational safety standard in the modern sense. Modern acupuncture practice must rely on systematic anatomy, imaging, and standardized training, and should not be attempted solely on the basis of ancient texts.
The "needling uniformity" emphasis on "striking the right measure" can be translated into daily life:
These are general life philosophies in traditional culture that help us cultivate a sense of "moderation" and proportion in daily life, without being directed at any specific disease.
Related Concepts:
Needling Uniformity (Ci Qi), Five Bodies (skin, vessels, flesh, sinew, bone), insufficiency and excess, correspondence between needling depth and disease location.
Further Reading:
Suwen · "Discussion on the Essentials of Needling": specifically discusses how "disease has depth and shallowness, needling has depth and shallowness, each reaching its proper principle without exceeding its path."
Lingshu · "Official Needles": describes various needling methods and their appropriate depth combinations.
Lingshu · "Final Beginning": addresses the relationship between needling depth, constitution, and disease location.
Suwen · "Needle Explanation": elaborates on some principles of needling practice.
— Bu Gua
This content is based on classical Chinese medicine texts, provided solely for traditional cultural study and research. It does not constitute any medical diagnosis, medication, or treatment advice. Please consult a healthcare professional if you feel unwell.