Where and when not to needle, and the consequences of disregarding the prohibitions.
Su Wen (素问)Needling Contraindications
ENGLISH TRANSLATION
The English is translated from the Chinese vernacular. The original text and its pinyin sit beneath each sentence in smaller type; hide them whenever you prefer to read the translation alone.
The viscera have their vital points; they must be examined with care.
ORIGINAL脏有要害,不可不察。
zàng yǒu yào hài,bù kě bù chá。
The liver issues on the left, the lung stores on the right, the heart spreads to the exterior, the kidney governs the interior; the spleen is the messenger and the stomach the marketplace.
Follow it and there is blessing; oppose it and there is blame.
ORIGINAL从之有福,逆之有咎。
cóng zhī yǒu fú,nì zhī yǒu jiù。
A wound to the heart kills in a day, its sign is sighing. To the liver, in five days, its sign is talkativeness. To the kidney, in six days, its sign is sneezing. To the lung, in three days, its sign is coughing. To the spleen, in ten days, its sign is swallowing. To the gallbladder, in a day and a half, its sign is vomiting.
cì zhòng xīn,yī rì sǐ,qí dòng wéi yī。cì zhòng gān,wǔ rì sǐ,qí dòng wéi yǔ。cì zhòng shèn,liù rì sǐ,qí dòng wéi tì。cì zhòng fèi,sān rì sǐ,qí dòng wéi ké。cì zhòng pí,shí rì sǐ,qí dòng wéi tūn。cì zhòng dǎn,yī rì bàn sǐ,qí dòng wéi ǒu。
Do not needle one who is deeply drunk: it disorders the qi. Do not needle one in great anger: it makes qi rebel. Do not needle the greatly exhausted, the newly fed, the very hungry, the very thirsty, or the greatly frightened.
Ci Jin Lun is a concise catalogue of danger. It names the anatomical regions that must not be needled deeply, the internal organs beneath them, and the specific injuries that follow a mistake.
What makes the chapter remarkable is its candour: it describes the consequences of each prohibited puncture in clinical detail, from pneumothorax to injury of the liver, spleen and kidney. Any modern discussion of acupuncture safety that claims ancient authority is in fact drawing on this chapter, and it is worth reading in full before needling the chest, back or abdomen.
ANNOTATION
Above the diaphragm and membrane lie father and mother (膈肓之上,中有父母): heart and lungs above the diaphragm sustain life and are therefore called father and mother.
Beside the seventh vertebra is the small heart (七节之傍,中有小心): interpretations differ — some take it as the pericardium, others as the gate of life.
Its movement is a sigh (其动为噫): 动 is the presenting sign; 噫 is belching.
COMMENTARY
This chapter should be required reading for every practitioner. Adverse needling events are reported from time to time, and on examination the causes fall mostly within what is prohibited here: deep insertion on chest and back, disregard of the patient’s condition, the pursuit of strong sensation. The ancients closed with eight characters — “follow this and there is blessing, oppose it and there is blame” — and they carry great weight.