七十七难曰∶经言上工治未病，中工治已病者，何谓也？然∶所谓治未病者，见肝之病，则知
肝当传之与脾，故先实其脾气，无令得受肝之邪，故曰治未病焉。中工者，见肝之病，不晓相传，
但一心治肝，故曰治已病也。
七十八难曰∶针有补泻，何谓也？然∶补泻之法，非必呼吸出内针也。知为针者，信其左∶
不知为针者，信其右。当刺之时，先以左手厌按所针荥俞之处，弹而努之，爪而下之，其气
之来，如动脉之状，顺针而刺之。得气因推而内之，是谓补；动而伸之，是谓泻。不得气，乃与男外
女内；不得气，是谓十死不治也。
七十九难曰∶经言迎而夺之，安得无虚？随而济之，安得无实？虚之与实，若得若失；实之与
虚，若有若无。何谓也？
然∶迎而夺之者，泻其子也；随而济之者，补其母也。假令心病泻手心主俞，是谓迎而夺
之者也，补手心主井，是谓随而济之者也。
所谓实之与虚者，牢濡之意也。气来实牢者为得，濡虚者为失，故曰若得若失也。
八十难曰∶经言有见如入，有见如出者，何谓也？然∶所谓有见如入者，谓左手见气来至乃内针，
针入见气尽，乃出针。是谓有见如入，有见如出也。
八十一难曰∶经言无实实虚虚，损不足而益有余。是寸口脉耶？将病自有虚实耶？其损益
奈何？然∶是病非谓寸口脉也，谓病自有虚实也。假令肝实而肺虚，肝者木也，肺者金也，金木当更
相平，当知金平木。假令肺实而肝虚，微少气，用针不补其肝，而反重实其肺，故曰实实虚虚，损
不足而益有余。此者中工之所害也。
第七十七难说：医经中说，高明的医生治疗未发生的疾病，一般的医生治疗已发生的疾病，这是什么意思呢？回答说：所谓治疗未发生的疾病，是指看到肝脏有病，就知道肝病会传变给脾脏，所以先使脾脏充实（增强其功能），不让它受到肝邪的侵害，这就叫做治疗未发生的疾病。一般的医生，看到肝脏有病，不懂得疾病传变的规律，只一心一意地治疗肝脏，所以叫做治疗已发生的疾病。
第七十八难说：针刺有补法和泻法，这是什么意思呢？回答说：补泻的方法，不一定在于呼吸时进针或出针。懂得针刺的人，信赖左手的作用；不懂针刺的人，信赖右手。在应当针刺的时候，先用左手按压所针刺的荥穴、俞穴部位，用手指弹击穴位使其隆起，用指甲切按穴位，当经气到来时，感觉像动脉搏动一样，顺着针势刺入。得气后，将针向内推进，这叫做补法；将针向外提引摇动，这叫做泻法。如果不得气，就根据男女不同采取不同的手法（男取阳分浅刺，女取阴分深刺）；如果仍然不得气，这就称为十种无法治愈的情况之一。
第七十九难说：医经中说“迎而夺之”，怎么能不导致虚证呢？“随而济之”，怎么能不导致实证呢？虚和实的变化，好像得到了又好像失去了；实和虚的状态，好像存在又好像不存在。这是什么意思呢？
回答说：“迎而夺之”，是泻子脏；“随而济之”，是补母脏。例如心病，泻手厥阴心包经的俞穴，这叫“迎而夺之”；补手厥阴心包经的井穴，这叫“随而济之”。
所谓“实”与“虚”，指的是脉象坚实与濡软的区别。脉气来势坚实有力的为得气，濡软无力的为失气，所以说好像得到了又好像失去了。
第八十难说：医经中说“见气至而入针，见气尽而出针”，这是什么意思呢？回答说：所谓“见气至而入针”，是指左手感觉到经气来到时才进针；针入后，等到经气散尽，才出针。这就叫“见气至而入针，见气尽而出针”。
第八十一难说：医经中说不要对实证用补法，不要对虚证用泻法，不要损伤不足的正气而增加有余的邪气。这是指寸口脉而言吗？还是指疾病本身自有虚实呢？损益的原则是怎样的呢？回答说：这里说的不是指寸口脉，而是指疾病本身自有虚实。例如肝实而肺虚，肝属木，肺属金，金和木应当相互制约平衡，应当知道是用金（肺）来平抑木（肝）。假如肺实而肝虚，气息微弱，此时如果用针不补肝，反而加重补肺，这就叫做“实实虚虚”，即损伤不足的正气而增加有余的邪气。这是普通医生造成的危害。
Difficulty 77 states: The classic texts say that excellent physicians treat diseases before they occur, while average physicians treat diseases after they have occurred. What does this mean? The answer is: Treating diseases before they occur means that when one observes a disease of the Liver, one knows that the Liver disease will transmit to the Spleen. Therefore, one first strengthens the Qi of the Spleen (Pi) so that it cannot receive pathogenic factors from the Liver. This is called treating diseases before they occur. Average physicians, upon observing a Liver disease, do not understand the theory of disease transmission and focus solely on treating the Liver. This is called treating diseases after they have occurred.
Difficulty 78 states: Acupuncture involves tonification and sedation techniques. What are these? The answer is: The methods of tonification and sedation do not necessarily depend on respiration during needle insertion or withdrawal. A skilled acupuncturist relies on the left hand; an unskilled one relies on the right hand. When ready to puncture, first use the left hand to press down on the Ying-Spring (Ying) and Shu-Stream (Shu) points to be needled, flick them to make them protrude, and mark them with fingernails. When the Qi arrives, feeling like a pulsating artery, insert the needle in accordance with this sensation. Upon obtaining Deqi (arrival of Qi), push the needle inward; this is tonification. Move and withdraw the needle slightly; this is sedation. If Deqi is not obtained, adjust technique based on gender (superficial for males, deep for females); if Deqi is still not obtained, it is considered one of the ten untreatable conditions.
Difficulty 79 states: The classic texts say, "To intercept and drain, how can there be no deficiency?" and "To follow and assist, how can there be no excess?" The changes between deficiency and excess seem as if one has gained something and then lost it; the states of excess and deficiency seem as if they exist and then vanish. What does this mean?
The answer is: "Intercepting and draining" refers to sedating the Son organ; "Following and assisting" refers to tonifying the Mother organ. For example, in Heart disease, sedating the Shu-Stream point of the Pericardium (Hand Jueyin) is called "intercepting and draining"; tonifying the Jing-Well point of the Pericardium is called "following and assisting."
Regarding "excess" and "deficiency," this refers to the sensation of firmness versus softness. A Qi response that feels firm and solid indicates successful acquisition of Qi; one that feels soft and empty indicates failure. Hence, it is said to seem as if gained and then lost.
Difficulty 80 states: The classic texts mention "inserting the needle when Qi arrives" and "withdrawing the needle when Qi dissipates." What does this mean? The answer is: "Inserting when Qi arrives" means waiting until the left hand perceives the arrival of Qi before inserting the needle. After insertion, wait until the Qi dissipates before withdrawing the needle. This is referred to as inserting when Qi arrives and withdrawing when Qi dissipates.
Difficulty 81 states: The classic texts warn against tonifying excess and sedating deficiency, thereby damaging what is insufficient and augmenting what is already excessive. Does this refer to the Cun Kou pulse, or does it refer to the inherent excess and deficiency of the disease itself? How should tonification and sedation be applied? The answer is: This does not refer merely to the Cun Kou pulse but to the inherent excess and deficiency of the disease itself. For instance, if the Liver is in excess and the Lung is deficient, since the Liver belongs to Wood and the Lung to Metal, Metal and Wood should mutually restrain each other to maintain balance. One should understand that Metal (Lung) should regulate Wood (Liver). Conversely, if the Lung is in excess and the Liver is deficient, manifesting as shortness of breath, failing to tonify the Liver with acupuncture and instead over-tonifying the Lung constitutes "tonifying excess and sedating deficiency," which damages the insufficient and augments the excessive. This error causes harm and is typical of average physicians.