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Capítulo 51 de 78
黄帝内经·素问
This chapter, Ci Qi Lun, discusses the "boundaries" of acupuncture depth. The Yellow Emperor asks: "I would like to hear how the shallowness and depth of needling are distinguished." Qi Bo answers:
Conversely:
The Yellow Emperor says he still does not understand and asks for further explanation. Qi Bo elaborates:
What is meant by "when needling the bone, do not merely injure the sinews" is that the needle is withdrawn as soon as it reaches the sinews, and does not reach the bone — this is "insufficiency" — needling too shallowly. What is meant by "when needling the sinews, do not merely injure the flesh" is that the needle is withdrawn upon reaching the flesh, without reaching the sinews. What is meant by "when needling the flesh, do not merely injure the vessels" is that the needle is withdrawn upon reaching the vessels, without reaching the flesh. What is meant by "when needling the vessels, do not merely injure the skin" is that the needle is withdrawn upon reaching the skin, without reaching the vessels.
What is meant by "when needling the skin, do not injure the flesh" is that the disease lies in the skin; the needle may be inserted only into the skin, and the flesh should not be injured — this is the correct depth. What is meant by "when needling the flesh, do not injure the sinews" — if the needle penetrates through the flesh and strikes the sinews, it is too deep. What is meant by "when needling the sinews, do not injure the bone" — if the needle penetrates through the sinews and strikes the bone, it is also too deep. These all belong to "transgression" — violating the proper boundaries of shallowness and depth.
⚠️ This chapter is for the study of acupuncture principles and theory, and is not intended as a guide for acupuncture practice.
The core of this chapter is "Ci Qi" (刺齐).
"Qi" here carries the meaning of "boundary, limit, just the right measure." The ancients divided the body, from superficial to deep, into five layers — skin, vessels, flesh, sinews, bone — holding that according to the layer at which the pathogenic factor resides, needling must reach precisely the affected site:
Thus the text establishes its argument from two aspects — "insufficiency" and "excess." The first half, "when needling bone, do not injure the sinews ... when needling vessels, do not injure the skin," speaks of "insufficiency" — being too shallow when depth is required. The second half, "when needling skin, do not injure the flesh; when needling flesh, do not injure the sinews; when needling sinews, do not injure the bone," speaks of "excess" — being too deep when shallowness is required. Only when depth matches the disease site can it be considered the correct needling method in the ancient view.
This embodies the consistent principle found throughout the Huangdi Neijing of "no excess, no insufficiency" — a doctrine of the mean. This is not merely an acupuncture technique, but a methodological approach to treatment as well.
From a modern viewpoint, the most valuable contribution of this chapter is its awareness of "layered operation."
Needling requires penetration of the skin, subcutaneous tissue, fascia, muscle, and other tissues. Modern safe acupuncture practice likewise emphasizes mastering needling direction and depth according to the regional anatomy of each point, so as to avoid damaging nerves, blood vessels, and internal organs. This shares common ground in principle with the ancient layered framework of "skin, vessels, flesh, sinews, bone."
It must be acknowledged, however, that the ancient terms "sinews" and "vessels" do not correspond exactly to the tendons and blood vessels of modern anatomy. "Bone, sinew, flesh, vessel, skin" is a macro-level, functional classification that carries limitations of its era. This chapter is therefore a statement of principles rather than a modern operational safety standard. Modern acupuncture practice must rely on systematic anatomy, imaging, and standardized training, and must not be attempted solely on the basis of classical texts.
"Ci Qi" emphasizes "the just right measure," and this mentality can be extended to daily life:
These are general life philosophies in traditional culture that help us perceive the sense of "moderation" in daily life and are not targeted at any specific disease.
Related Concepts:
Ci Qi (needling within boundaries), Five Bodies (skin, vessels, flesh, sinews, bone), Insufficiency and Excess, correspondence between needling depth and disease site.
Further Reading:
Su Wen · Ci Yao Lun (刺要论): Devoted to the discussion, "Disease may be superficial or deep; needling may be shallow or deep; each should reach its proper level, without exceeding its course."
Ling Shu · Guan Zhen (官针): Discusses various needling methods and their appropriate depths.
Ling Shu · Zhong Shi (终始): Addresses the relationship between needling depth, constitution, and disease site.
Su Wen · Zhen Jie (针解): Elaborates on certain operational principles of needling.
— Bu Gua
This content is based on classical Chinese medical texts and is provided solely for the study of traditional culture. It does not constitute any medical diagnosis, prescription, or treatment advice. If you feel unwell, please seek medical attention promptly.