（《灵枢·九针十二原篇》《小针解》《素问·宝命全角论》）
凡用针者，虚则实之，满则泄之
（《灵枢·九针十二原篇》）。此篇言用针之要，全凭虚实以为补泻，实即补也，泄即泻也。）宛陈则除之，邪胜则虚
之。（宛，郁同。陈，积也。除之去其滞，虚之泄其邪也。）大要曰∶徐而疾则实，疾而徐则虚，（徐出针而疾按之为补，
故虚者可实。疾出针而徐按之为泻，故实者可虚。）言实与虚，若有若无，（实之与虚，在有气无气耳。气本无形，故若
有若无。善察之者，神悟于有无之间也。）察后与先，若存若亡，（察后与先，求病所急而治分先后也。若存若亡，察气
之行与不行，以为针之去留也。）为虚为实，若得若失，（欲虚而虚，欲实而实，是得法也。粗工妄为，则失之矣。）虚实
之要，九针最妙，（各有所宜之要也。）补泻之时，以针为之。（当补当泻，用有其时，在气会之顷。详如下文。）泻曰必
持内之，放而出之，排阳得针，邪气得泄，（凡用泻者，必持内之，谓持之坚而入之锐也。放而出之，谓因其气来，出之
疾而按之徐也。故可排开阳道以泄邪气。）按而引针，是谓内温，血不得散，气不得出也。（凡用补者，必按其穴而引退
其针，是谓内温，故血不散、气不出而虚者实矣。）补曰随之，随之意若妄之，若行若按，若蚊虻止，（此下皆言补法也。
随者，因其气去，追而济之也。妄，虚妄也。意若妄之，言意会于有无之间也。若行若按，言行其气按其处也。若蚊虻
止，言当轻巧无迹而用得其精也。）如留如还，去如弦绝，（留，留针也。还，出针也。去如弦绝，轻且捷也，故无损而
能补。）令左属右，其气故止，外门已闭，中气乃实，（右手出针，左手随而按扪之，是令左属右也。故门户闭于外，中
气实于内。）必无留血，急取诛之。（凡取血络者，不可使有留血，宜急去之也。）持针之道，坚者为宝，正指直刺，无针
左右，（坚而有力，则直达病所。正而不斜，则必中气穴。）神在秋毫，属意病者，审视血脉者，刺之无殆。（医之神见，
在悉秋毫，必精必确，加意病者，详审血脉，然后刺之，庶无危殆。）方刺之时，必在悬阳，及与两卫，（悬，犹言举也。
阳，神气也。凡刺之时，必先举神气为主，故曰悬阳。两卫者，卫气在阳，肌表之卫也；脾气在阴，脏腑之卫也。二者
皆神气所居，不可伤犯，凡用针者，首宜顾此，故曰两卫。师传篇曰∶脾者主为卫。详藏象类二十九。）神属勿去，知病
存亡。（此即悬阳之义，故存亡系之。）血脉者，在 横居，视之独澄，切之独坚。（上文言神气之所居，此言血脉之所在
也。视之独澄者，必欲索其隐。切之独坚者，必欲拔其本也。）
帝曰∶何如而虚？何如而实（《素问·宝命全角论》。此下言虚实之治，并及诸所当慎也。）岐伯曰∶刺虚者须其实，
刺实者须其虚，经气已至，慎守勿失，深浅在志，远近若一，如临深渊，手如握虎，神无营于众物。（此节详注见下文。）
《小针解》曰∶所谓虚则实之者，气口虚而当补之也。满则泄之者，气口盛而当泻之也。（此与下文针解篇皆释前篇
之义，但此以气口言虚实，彼以针下气至言虚实，义虽若异，然互有发明，皆当察也。）宛陈则除之者，去血脉也。邪盛
则虚之者，言诸经有盛者，皆泻其邪也。（此云泻其邪，与下文出针勿按义同。）徐而疾则实者，言徐内而疾出也。疾而
徐则虚者 ，言疾内而徐出也。（此二句释义其用似反，当以下文针解篇者为得。）言实与虚若有若无者，言实者有气，虚
者无气也。察后与先若亡若存者，言气之虚实，补泻之先后也，察其气之已下与常存也。（已下，言已退也。）为虚与实
若得若失者，言补者 然若有得也，泻则恍然若有失也。（此释与下编不同，其义皆通。 音弼，诗云∶威仪 。）
《针解篇》∶黄帝问曰∶愿闻九针之解，虚实之道。（自此至下文补泻之时，九针之名者，皆释前九针十二原篇之义。）
岐伯对曰∶刺虚则实之者，针下热也，气实乃热也。满而泄之者，针下寒也，气虚乃寒也。（针下热者，自寒而热也，热
则正气至而虚者实矣，故为补。针下寒者，自热而寒也，寒则邪气去而实者虚矣，故为泻。此释当与上解者参阅。）宛陈
则除之者，出恶血也。邪盛则虚之者，出针勿按。（出针勿按，即泻其邪也。本经宛、菀皆通用，通作郁。）徐而疾则实
者，徐出针而疾按之。疾而徐则虚者，疾出针而徐按之。（针下得气已盛而徐出之，则经脉无伤，疾按之则真气不泄，此
补法也，故能实。若针已及病而疾出之，徐按之，则菀滞行，邪气去，此泻法也，故能虚。）言实与虚者，寒温气多少也。
（寒为虚，温为实；气少为虚，气多为实。）若无若有者，疾不可知也。（气至之有无，针下之虚实，诚不易知也。疾不
可知故若无，明能察之故若有。）察后与先者，知病先后也。（病有标本，先者为本，后者为标。）为虚与实者，工勿失其
法。若得若失者，离其法也。（虚当补，实当泻，法不可失也。若有得若有失者，粗工妄为，离其法耳。）虚实之要九针
最妙者，为其各有所宜也。（九针之用，各有所宜。详见前二章。）补泻之时者，与气开阖相合也。（气至应时谓之开，已
过未至谓之阖。补泻之时者，凡诸经脉气昼夜周行五十度，各有所至之时，如经络类营气卫气营运之次二章者是也。故
《卫气行篇》曰∶谨候其气之所在而刺之，是谓逢时。此所谓补泻之时也。又若针下气来谓之开，可以迎而泻之；针下
气去谓之阖，可以随而补之。此皆针与气开阖相合之义。）九针之名各不同形者，针穷其所当补泻也。（各不同形，故补
泻各有所用。）
刺实须其虚者，留针，阴气隆至，乃去针也。刺虚须其实者，阳气隆至，针下热，乃去针也。（自此至下文神无营于
众物者，皆释前宝命全角论之义。阴气隆至，针下寒也，阳邪已退，实者虚矣。阳气隆至，针下热也，元气已复，虚者
实矣。故皆可去针也。）经气已至慎守勿失者，勿更改也。（慎守勿失勿更改者，戒其主持不定，多生惑乱，不惟无益，
反招损也。）浅深在志者，知病之内外也。（内宜刺深，外宜刺浅，最当在意，不可忽也。）近远如一者，深浅其候等也。
（深者取气远，浅者取气近，远近虽不同，以得气为候则如一也。）如临深渊者，不敢堕也。（言行针之际，当敬慎若此
也。）手如握虎者，欲其壮也。（持针如握虎，欲其坚而有力也。）神无营于众物者，静志观病患，无左右视也。（神志不
定，先从目始，目静则神静，神静则志专，病以静观，方无失也，故无左右视。）义无邪下者，欲端以正也。（此即前篇
正指直刺、无针左右之义。）必正其神者，欲瞻病患目，制其神，令气易行也。（目者神之窍，欲正病者之神，必瞻其目，
制彼精神，令无散越，则气为神使，脉道易行也。）
所谓三里者，下膝三寸也。（三里有二，此言足三里，足阳明经穴也。按∶此下言取穴之法，非本篇上下之义，意必
他篇之文脱误于此者。）所谓跗之者，举膝分易见也。（跗之当作跗上，即足阳明冲阳穴也。盖三里冲阳，一脉相贯，举
膝下三里而重按之，则冲阳之脉不动矣，故举其膝分则易见也。）巨虚者，跷足 独陷者。（巨虚有二，上廉、下廉也。
跷，举也。此言巨虚上廉当跷足取之，在 骨外侧独陷者之中也。）下廉者，陷下者也。（此言巨虚下廉，又在独陷者之
下，盖上廉下廉相去三寸耳。）
（《灵枢·九针十二原篇》《小针解》《素问·宝命全角论》）
凡是使用针刺治疗，对于虚证要用补法使其充实，对于实证（邪气盛满）要用泻法使其泄出。
（出自《灵枢·九针十二原篇》）。这一篇论述针刺的要领，完全依据虚实情况来决定补泻，所谓的“实”就是补法，“泄”就是泻法。）对于瘀血积滞要清除它，对于邪气亢盛要使其虚弱。（宛，通“郁”，指郁结；陈，指积聚。清除它是为了去除体内的滞涩，使其虚弱是为了泄除邪气。）总的原则说：缓慢进针而快速出针并立即按压针孔为补法（使正气充实），快速进针而缓慢出针且不立即按压针孔为泻法（使邪气排出）。（徐出针而疾按之属于补法，所以虚证可以变得充实；疾出针而徐按之属于泻法，所以实证可以变得虚弱。）谈论补泻时，感觉若有若无，（补法和泻法的运用，关键在于察知经气的有和无。经气本来是无形的，所以感觉若有若无。善于观察的人，能在有无之间通过神悟来把握。）观察治疗的先后顺序，感觉似存似亡，（观察先后，是探求病情的急缓以决定治疗的次序；似存似亡，是观察经气的运行与否，以此决定留针或出针。）判断虚实的得失，感觉若得若失，（想要使虚者变虚、实者变实，这是掌握了方法。粗疏的医生胡乱操作，就会失去正确的方法。）虚实的要领，九针最为精妙，（因为各种针具各有其适宜的用途。）补泻的时机，要通过针具来体现。（应当补还是应当泻，使用时机很重要，要在经气汇聚的时刻进行。详细内容见下文。）施行泻法时，必须持针稳固地刺入，放出血液后拔出，推开阳分皮肤以便进针，使邪气得以泄出，（凡是用泻法，必须持针坚固地刺入，意味着持针要稳且进针要锐利。放出后拔出，是指趁着经气来潮时，快速出针而缓慢按压。因此可以排开阳道以泄除邪气。）出针后按压穴位并引导针体退出，这叫做“内温”（使内部温暖），血液不会散乱，气也不会外泄。（凡是用补法，必须按住穴位并引退针体，这叫做内温，所以血液不散、气不外泄，从而使虚证变得充实。）施行补法时要顺随经气，意念上好像没有施术一样，动作轻柔如行如按，又像蚊虻叮咬般轻微，（以下都是讲述补法。所谓“随”，是顺着经气离去的方向，追踪并资助它。“妄”意为虚妄、无迹可寻。意念若妄，意思是意念领会在有无之间。如行如按，意思是推行其气并按压穴位。像蚊虻止息，意思是手法应当轻巧无痕而达到精准。）留针时间要恰当，出针要迅速，出针时像弓弦断裂一样快捷，（留，指留针；还，指出针。去如弦绝，形容轻快敏捷，这样既无损又能起到补益作用。）左手配合右手，使经气停止外泄，外部门户关闭，内部中气才能充实，（右手出针，左手随即按压扪住穴位，这就是令左属右。所以外部门户关闭，内部中气充实。）决不能留有瘀血，发现就要紧急祛除。（凡是要刺络放血，不可让瘀血停留，应该立即去除它。）持针的原则，坚定有力最为宝贵，端正手指直刺，不要左右偏斜，（坚定有力，就能直达病所。端正不斜，就一定能中穴位。）精神集中在毫毛般的细微之处，专心致志于病人，审视血脉状况，针刺就不会有危险。（医生的神见，在于洞察秋毫，必须精确无误，关注病人，详细审察血脉，然后才进行针刺，这样才能避免危殆。）在针刺的时候，必须高举神气（保持精神集中），以及顾护两卫（肌表与脏腑的卫气），（悬，同“举”。阳，指神气。凡是在针刺时，必须先以举起神气为主，所以叫悬阳。两卫，指卫气在体表肌表的护卫，脾气在体内脏腑的护卫。这两者都是神气所在的地方，不可损伤冒犯，凡是用针的人，首先应当顾念这一点，所以叫两卫。《师传篇》说：脾主为卫。详见藏象类第二十九章。）精神专注不要离开，就能知道病情的存亡。（这就是悬阳的含义，所以病情的存亡系于此。）血脉，横卧于皮下，看时清澈可见，摸时坚实可辨。（上文讲神气所在的地方，这里讲血脉所在的位置。视之独澄，一定要探寻其隐蔽处；切之独坚，一定要拔除其根本。）
黄帝问：怎样才算使实证变虚？怎样才算使虚证变实？（出自《素问·宝命全角论》。以下内容讲述虚实的治疗，以及诸种应当谨慎的事项。）岐伯回答：针刺虚证必须使其充实，针刺实证必须使其虚弱，经气已经到来，谨慎守护不要失误，深浅由心意控制，远近道理一致，就像面临深渊一样小心，手像握着老虎一样坚定，精神不被其他事物扰乱。（这一节的详细注释见下文。）
《小针解》说：所谓“虚则实之”，是指脉口虚弱而应当用补法。所谓“满则泄之”，是指脉口盛实而应当用泻法。（这与下文的《针解篇》都在解释前一篇的意义，但这里以脉口的虚实来说明，那里以针下气至的虚实来说明，意义虽然看似不同，然而互相发明，都应当考察。）所谓“宛陈则除之”，是指去除血脉中的瘀血。所谓“邪胜则虚之”，是说各条经脉如果有邪气盛实，都要用泻法来祛除邪气。（这里说泻其邪，与下文出针不按的意义相同。）所谓“徐而疾则实”，是说缓慢进针而快速出针。所谓“疾而徐则虚”，是说快速进针而缓慢出针。（这两句释义看起来用法相反，应当以下文《针解篇》的解释为准。）所谓“言实与虚若有若无”，是说实证有经气，虚证无经气。所谓“察后与先若亡若存”，是说经气的虚实和补泻的先后顺序，观察经气是否已退或依然存在。（已下，指已经消退。）所谓“为虚与实若得若失”，是说补法时好像有所获得，泻法时好像有所丧失。（此处的解释与下编不同，两种意义都通顺。弼音bì，《诗经》云：威仪棣棣。）
《针解篇》：黄帝问道：希望听闻关于九针的解释，以及虚实之道。（从这到下文“补泻之时，以针为之”及九针名称的部分，都是在解释前文《九针十二原篇》的意义。）岐伯回答说：针刺虚证使其充实，是指针下出现热感，阳气实才会产生热感。实证使其泄出，是指针下出现寒感，经气虚才会产生寒感。（针下热，是从冷变热，热则正气到达而虚证变实，所以是补法。针下寒，是从热变冷，寒则邪气离去而实证变虚，所以是泻法。此解释应当与上面的解说参考阅读。）所谓“宛陈则除之”，是指出恶血。所谓“邪盛则虚之”，是指出针后不按针孔。（出针后不按，就是泻除邪气。本经中“宛”、“菀”通用，通作“郁”。）所谓“徐而疾则实”，是缓慢出针而快速按压。所谓“疾而徐则虚”，是快速出针而缓慢按压。（在针下得气已经旺盛时缓慢出针，则经脉不受伤害，快速按压则真气不泄漏，这是补法，所以能充实。如果针已到达病所就快速出针，缓慢按压，则郁滞通行，邪气离去，这是泻法，所以能虚弱。）所谓“言实与虚”，是指寒温和经气的多少。（寒代表虚，温代表实；气少为虚，气多为实。）所谓“若无若有”，是指变化迅速难以察觉。（经气到来的有无，针下虚实的表现，确实不容易知晓。因为变化快所以显得若无，因为能明察所以显得若有。）所谓“察后与先”，是了解病情的先后（标本）。（病有标本，先发生的是本，后发生的是标。）所谓“为虚与实”，工匠不要失去法则。所谓“若得若失”，是背离了法则。（虚应当补，实应当泻，法度不可丢失。如果表现得若得若失，那是粗工胡乱作为，背离了法度。）所谓“虚实之要，九针最妙”，是因为九针各有所宜。（九针的使用，各有所适宜。详见前两章。）所谓“补泻之时”，是与经气的开阖相符合。（经气到来应时称为开，已过或未至称为阖。补泻的时机，凡是各条经脉之气昼夜周行五十周次，各有到达的时间，如经络类营气卫气营运次序第二章所述。所以《卫气行篇》说：谨慎等候经气所在之处而针刺，这叫逢时。这就是所说的补泻时机。另外，针下气来称为开，可以迎而泻之；针下气去称为阖，可以随而补之。这都是针与气开阖相合的意义。）九针的名称各不相同，形状也不同，是因为它们穷尽了应当补泻的情况。（形状各不相同，所以补泻各有用途。）
针刺实证须使其变虚，需要留针，等到阴气隆盛到达时，才去针。针刺虚证须使其变实，等到阳气隆盛到达，针下发热时，才去针。（从这到下文“神无营于众物”的部分，都在解释前文《宝命全角论》的意义。阴气隆盛到达，针下发寒，阳邪已退，实证变虚。阳气隆盛到达，针下发热，元气已复，虚证变实。所以都可以去针了。）所谓“经气已至，慎守勿失”，是指不要更改治疗方案。（谨慎守护不要失误、不要更改，是告诫医生主持不定，多生惑乱，不仅无益，反而招致损害。）所谓“浅深在志”，是了解病位的内外。（内病宜刺深，外病宜刺浅，最重要的是在意念中明确，不可忽视。）所谓“近远如一”，是指无论深浅，候气的标准是一样的。（深部取气较远，浅部取气较近，远近虽然不同，但以得气为标准则是一致的。）所谓“如临深渊”，是不敢懈怠。（言行针之际，应当如此恭敬谨慎。）所谓“手如握虎”，是想要力量壮健。（持针像握虎，想要坚定有力。）所谓“神无营于众物”，是静心观察病患，不左右顾盼。（神志不定，先从眼睛开始，眼睛静止则神静，神静则意志专一，病以静观，才不会失误，所以不左右视。）所谓“义无邪下”，是想要端正正直。（这就是前篇正指直刺、无针左右的含义。）所谓“必正其神”，是想要瞻望病患的眼睛，控制其神气，使经气容易运行。（眼睛是神的窍穴，想要端正病人的神，必须瞻望其眼睛，控制其精神，使其不散乱，那么气为神所使，脉道就容易运行。）
所谓“三里”，是膝下三寸处。（三里有两个穴位，这里说的是足三里，属于足阳明胃经的穴位。按：以下内容讲述取穴的方法，不是本篇上下文的义理，意思一定是其他篇章的文字脱误在此处。）所谓“跗之”，是抬起膝盖容易看见。（“跗之”应当是“跗上”，即足阳明胃经的冲阳穴。大概三里和冲阳在同一脉线上贯通，抬起膝盖下三里并重按时，冲阳的脉搏就不动了，所以抬起膝盖分界处就容易看见。）所谓“巨虚”，是跷起脚单独凹陷的地方。（巨虚有两个，上廉和下廉。跷，是举起的意思。这里说巨虚上廉应当跷足取穴，在腓骨外侧单独凹陷的地方。）所谓“下廉”，是凹陷更低的地方。（这里说巨虚下廉，又在单独凹陷处的下方，大概上廉和下廉相距三寸耳。）
(From *Ling Shu: Nine Needles and Twelve Origins*, *Xiao Zhen Jie*, *Su Wen: Bao Ming Quan Jiao Lun*)
In all cases of using acupuncture, for deficiency patterns (Xu Zheng), apply tonification to make them solid; for fullness patterns (excess of pathogenic factors), apply sedation to drain them.
(From *Ling Shu: Nine Needles and Twelve Origins*). This chapter discusses the essentials of acupuncture, relying entirely on determining deficiency and excess to decide between tonification and sedation. "Solidifying" refers to tonification, and "draining" refers to sedation.) For stagnation and old blood, remove it; for overwhelming pathogenic factors, weaken them. ("Wan" is synonymous with "Yu," meaning stagnation; "Chen" means accumulation. Removing it eliminates internal stasis; weakening it drains the pathogenic factors.) The general principle states: Slow insertion and rapid withdrawal with immediate pressure constitutes tonification (making deficiency solid); rapid insertion and slow withdrawal without immediate pressure constitutes sedation (making excess empty). (Slow withdrawal with rapid pressing belongs to tonification, thus deficiency can become solid; rapid withdrawal with slow pressing belongs to sedation, thus excess can become empty.) Discussing tonification and sedation, the sensation may seem present or absent. (The application of tonification and sedation lies in perceiving the presence or absence of Jing Qi. Since Jing Qi is formless, the sensation seems present or absent. Those skilled in observation can grasp this through spiritual insight between existence and non-existence.) Observe the sequence of treatment, the sensation may seem lingering or gone. (Observing the sequence involves seeking the urgency of the disease to determine the order of treatment; the sensation seeming lingering or gone involves observing whether Jing Qi is moving or not, thereby deciding whether to retain or withdraw the needle.) Determine deficiency and excess, the feeling may be one of gain or loss. (Desiring to make deficiency deficient [corrected context: making deficiency solid] and excess excess [corrected context: making excess empty] indicates mastering the method. Crude practitioners act recklessly and lose the correct method.) The essence of deficiency and excess lies in the Nine Needles being most excellent, (as each has its specific suitability.) The timing of tonification and sedation is manifested through the needle. (Whether to tonify or sedate depends on the timing, specifically at the moment when Qi converges. Details follow below.) When applying sedation, hold the needle firmly and insert it steadily, release and withdraw it, push aside the Yang aspect to allow entry, so that pathogenic Qi can be drained. (When applying sedation, one must hold the needle firmly and insert it sharply. Releasing and withdrawing implies taking advantage of the arrival of Qi, withdrawing rapidly and pressing slowly. Thus, one can open the Yang channels to drain pathogenic Qi.) After withdrawing the needle, press the acupoint and guide the needle out; this is called "Nei Wen" (internal warming), ensuring blood does not scatter and Qi does not escape. (When applying tonification, one must press the acupoint and draw back the needle, which is called Nei Wen, so that blood remains undisturbed and Qi does not escape, thereby transforming deficiency into solidity.) When applying tonification, follow the flow of Qi; mentally, it should feel as if no manipulation is occurring; movements should be like walking or pressing, light as a mosquito or horsefly landing. (The following describes tonification methods. "Following" means chasing and assisting the departing Qi. "Wang" means illusory or traceless. Mental state of Wang implies understanding between existence and non-existence. Like walking or pressing refers to promoting Qi flow and pressing the site. Like a mosquito landing implies techniques should be light, traceless, and precise.) Retain the needle appropriately, withdraw it quickly; withdrawal should be swift like a breaking bowstring. (Retain refers to retaining the needle; Huan refers to withdrawing the needle. Qu Ru Xian Jue describes swiftness and agility, achieving tonification without damage.) Let the left hand assist the right, stopping the leakage of Qi; the external gate closes, and the central Qi becomes solid. (Withdrawing with the right hand while the left immediately presses and covers the point is "Left belonging to Right." Thus, the external gate closes, and internal Central Qi solidifies.) Do not leave behind stagnant blood; take urgent measures to eliminate it. (When treating collateral vessels, do not allow stagnant blood to remain; it should be removed promptly.) The principle of holding the needle values firmness and strength; point straight and pierce directly, avoiding deviation left or right. (Firm and strong force reaches the disease site directly. Straight and unslanted ensures hitting the acupoint accurately.) Focus spirit on the finest details (autumn down), attend to the patient, examine the blood vessels carefully, and acupuncture will be free from danger. (The physician's spiritual perception focuses on minute details, requiring precision and attention to the patient, carefully examining blood vessels before needling, thus avoiding peril.) During needling, one must elevate the Spirit (Xuan Yang) and protect the Two Wei (Defensive Qi). (Xuan means to raise; Yang refers to Spirit/Qi. In needling, one must first elevate the Spirit. The Two Wei refer to Defensive Qi protecting the muscle-surface (Yang) and Spleen Qi protecting the organs (Yin). Both are dwellings of Spirit and must not be harmed; practitioners must prioritize guarding these, hence "Two Wei." The *Shi Chuan* chapter states: The Spleen governs Defense. See Zang-Xiang Category 29.) Keep the spirit focused and do not depart, knowing whether the disease will survive or perish. (This is the meaning of Xuan Yang; thus, survival or demise depends on it.) Blood vessels lie horizontally under the skin; they appear clear upon inspection and feel firm upon palpation. (The above discussed the dwelling of Spirit; this discusses the location of blood vessels. "Clear upon inspection" requires searching for hidden aspects; "firm upon palpation" requires addressing the root cause.)
The Yellow Emperor asked: How does one make excess empty? How does one make deficiency solid? (From *Su Wen: Bao Ming Quan Jiao Lun*. The following discusses treatments for deficiency and excess, along with precautions.) Qibo replied: To treat deficiency, ensure solidity is achieved; to treat excess, ensure emptiness is achieved. Once Jing Qi arrives, guard it carefully and do not lose it. Depth and distance are governed by intention, consistent in principle regardless of location. Be like facing an abyss, hold the needle like grasping a tiger, let the spirit not be distracted by other things. (Detailed notes for this section are below.)
*Xiao Zhen Jie* states: "Making deficiency solid" means the pulse at the Cun Kou is weak and requires tonification. "Draining fullness" means the pulse at the Cun Kou is vigorous and requires sedation. (This and the following *Zhen Jie* chapter explain the previous chapter. Here, deficiency and excess are discussed via the Cun Kou pulse, whereas there, they are discussed via the arrival of Qi under the needle. Although the meanings seem different, they complement each other and should both be examined.) "Removing stagnation and old blood" means removing blood from the vessels. "Weakening overwhelming pathogens" means draining excess in any meridian. (Saying "drain the pathogen" here is consistent with the meaning of not pressing after withdrawal in the text below.) "Slow insertion and rapid withdrawal makes solid" means slow insertion and rapid withdrawal. "Rapid insertion and slow withdrawal makes empty" means rapid insertion and slow withdrawal. (These two phrases seem contradictory in explanation; the interpretation in the *Zhen Jie* chapter below is preferred.) "Discussing excess and deficiency as if present or absent" means excess has Qi, while deficiency lacks Qi. "Observing sequence as if lingering or gone" refers to the sequence of tonification and sedation based on the deficiency or excess of Qi, observing whether Qi has retreated or persists. ("Retreated" means subsided.) "For deficiency and excess, feeling gain or loss" means tonification feels like gaining something, while sedation feels like losing something. (This explanation differs from the lower compilation but both interpretations are valid. Bi sound bì, from *Shi Jing*: Wei Yi Di Di.)
*Zhen Jie Chapter*: The Yellow Emperor asked: I wish to hear the explanation of the Nine Needles and the way of deficiency and excess. (From here to "timing of tonification and sedation" and the names of the Nine Needles, all explain the meaning of the previous *Nine Needles and Twelve Origins* chapter.) Qibo answered: Treating deficiency to make it solid results in heat under the needle, as excess of Yang Qi produces heat. Draining fullness results in cold under the needle, as deficiency of Qi produces cold. (Heat under the needle changes from cold to hot; heat indicates the arrival of healthy Qi, transforming deficiency into solidity, hence tonification. Cold under the needle changes from hot to cold; cold indicates the departure of pathogenic Qi, transforming excess into emptiness, hence sedation. This explanation should be read in conjunction with the above commentary.) "Removing stagnation and old blood" means evacuating foul blood. "Weakening overwhelming pathogens" means not pressing the needle hole after withdrawal. (Not pressing after withdrawal is draining the pathogen. In the classic, Wan and Wan are interchangeable, commonly written as Yu.) "Slow insertion and rapid withdrawal makes solid" means slow withdrawal and rapid pressing. "Rapid insertion and slow withdrawal makes empty" means rapid withdrawal and slow pressing. (Withdrawing slowly after Qi arrival prevents meridian injury; pressing rapidly prevents leakage of True Qi. This is tonification, hence solidifying. Withdrawing rapidly after reaching the disease site and pressing slowly allows stagnation to move and pathogens to depart. This is sedation, hence emptying.) "Discussing excess and deficiency" refers to the degree of cold/warmth and the amount of Qi. (Cold represents deficiency, warmth represents excess; less Qi is deficiency, more Qi is excess.) "As if present or absent" means the change is too fast to perceive. (The presence or absence of Qi arrival, and the deficiency or excess under the needle, are indeed difficult to know. Because it is fast, it seems absent; because it can be observed clearly, it seems present.) "Observing sequence" means knowing the priority of the disease. (Disease has root and branch; the primary/earlier aspect is the root, the secondary/later aspect is the branch.) "For deficiency and excess" the practitioner must not lose the method. "Feeling gain or loss" means deviating from the method. (Deficiency requires tonification, excess requires sedation; the method cannot be lost. Feeling gain or loss indicates crude practitioners acting recklessly and deviating from the method.) "The essence of deficiency and excess, the Nine Needles are best" because each is suitable for specific situations. (The use of the Nine Needles varies by suitability. See the first two chapters.) "Timing of tonification and sedation" harmonizes with the opening and closing of Qi. (Qi arrival at the appropriate time is Opening; past or not yet arrived is Closing. The timing of tonification and sedation relates to the daily circulation of Qi through the meridians, which occurs fifty times a day, with specific times for each meridian, as described in the Circulation of Ying and Wei Qi chapters. Thus, the *Wei Qi Xing* chapter says: Carefully await the location of Qi to needle, this is called meeting the time. This is the timing of tonification and sedation. Also, Qi arrival under the needle is Opening, allowing迎 (meeting) and sedation; Qi departure is Closing, allowing 随 (following) and tonification. These are the meanings of needle and Qi opening/closing harmony.) The Nine Needles have different names and shapes because they exhaust the possibilities for tonification and sedation. (Different shapes mean different applications for tonification and sedation.)
To make excess empty, retain the needle until Yin Qi arrives abundantly, then remove the needle. To make deficiency solid, wait until Yang Qi arrives abundantly and the needle feels hot, then remove the needle. (From here to "spirit not distracted by many things" explains the *Bao Ming Quan Jiao Lun*. Abundant Yin Qi arrival causes cold under the needle; Yang pathogens retreat, excess becomes empty. Abundant Yang Qi arrival causes heat under the needle; Yuan Qi recovers, deficiency becomes solid. Thus, the needle can be removed in both cases.) "Jing Qi has arrived, guard carefully and do not lose it" means do not change the treatment plan. (Guarding carefully and not changing warns against indecision and confusion, which brings harm rather than benefit.) "Depth in intention" means knowing if the disease is internal or external. (Internal diseases require deep needling, external diseases require shallow needling; this must be kept in mind and not ignored.) "Near and far as one" means the criteria for obtaining Qi are equal regardless of depth. (Deep needling obtains Qi from afar, shallow needling from near; although distances differ, the criterion of obtaining Qi is the same.) "Like facing an abyss" means not being negligent. (Conduct yourself with reverence and caution during needling.) "Hand like grasping a tiger" means desiring strength. (Holding the needle like a tiger implies firmness and strength.) "Spirit not distracted by other things" means quietly observing the patient, not looking left or right. (If the spirit is unsettled, it starts with the eyes; quiet eyes lead to quiet spirit, quiet spirit leads to focused will. Observing the disease quietly prevents error, hence no looking left or right.) "Meaning no oblique insertion" means desiring uprightness. (This corresponds to the previous chapter's meaning of pointing straight and piercing directly without deviation.) "Must rectify the spirit" means gazing at the patient's eyes to control their spirit, facilitating Qi movement. (The eyes are the orifices of the spirit. To rectify the patient's spirit, gaze at their eyes, restrain their mental scattering, so that Qi is guided by spirit and the vessel pathways move easily.)
Regarding "San Li" (Three Mile), it is three cun below the knee. (There are two San Li points; this refers to Zusanli, an acupoint of the Foot-Yangming Stomach Meridian. Note: The following content discusses acupoint selection methods, which does not fit the context of this chapter; it is likely a textual error where text from another chapter was misplaced here.) Regarding "Fu Zhi" (Foot Top), lifting the knee makes it visible. ("Fu Zhi" should be "Fu Shang," referring to Chongyang, an acupoint of the Foot-Yangming Stomach Meridian. Since Zusanli and Chongyang are on the same continuous meridian, pressing heavily below Zusanli while lifting the knee makes the Chongyang pulse disappear, so lifting the knee crease makes it easy to see.) Regarding "Ju Xu" (Great Void), it is found in the depression when raising the foot. (There are two Ju Xu points: Shang Lian and Xia Lian. Qiao means to raise. This states that Shang Lian of Ju Xu is located in the distinct depression on the lateral side of the fibula when the foot is raised.) Regarding "Xia Lian" (Lower Lian), it is in the lower depression. (This refers to Xia Lian of Ju Xu, located below the distinct depression mentioned above; the distance between Shang Lian and Xia Lian is approximately three cun.)