（《素问·离合真邪论》）
帝曰∶候气奈何？（此欲候其邪气也，非针下气至之谓。）岐伯曰∶夫邪去络入于经也，舍于血脉之中，（邪气由浅
而深，故必自络，然后入经。舍，居也。）其寒温未相得，如涌波之起也，时来时去，故不常在。（邪气寒，正气温，故
不相得。血气本静而邪扰之，亦犹水本静而风扰之，故如涌波之起也。邪气之至，善行数变，或往或来，故无常处。）故
曰方其来也，必按而止之，止而取之，（方其来也，邪气尚微，故可按其处而止之，取而泻之，早遏其势，则大邪可散，
无深害矣。）无逢其冲而泻之，（不为早治，其邪必甚。邪气虽盛，恐其气未必实，故宜详审，不可因逢其冲辄泻之也。）
真气者经气也，经气太虚，故曰其来不可逢，此之谓也。（真气不实，迎而泻之，邪气虽去，真气必太虚矣，故曰其来不
可逢也。按∶《小针解》曰∶其来不可逢者，气盛不可补也。彼言补，此言泻，文若相反，各有深义，当两察之。）故曰
候邪不审，大气已过，泻之则真气脱，脱则不复，邪气复至而病益蓄，（过，往也。不能审察虚实而泻其已去之邪，反伤
真气，邪必乘虚复至而益甚矣。）故曰其往不可追，此之谓也。（《小针解》曰∶其往不可追者，气虚不可泻也。）不可挂
以发者，待邪之至而发针泻矣，若先若后者，血气已尽，其病不可下，（发针泻者，施泻法也。欲泻其邪，在气至之顷。
不可挂以发者，言丝毫之不可失也。若先若后者，先之则邪未至，后之则大气已过，徒有伐尽其血气而病不可下。下者，
降服之谓。）故曰知其可取如发机，不知其取如扣椎，故曰知机道者不可挂以发，不知机者扣之不发，此之谓也。（机，
弩机也。椎，木椎也。知而取之，必随拨而应，如发机之易；不知而攻之，则顽钝莫入，如扣椎之难也。按∶上文诸义
俱见前第一、第七，二章。）帝曰∶补泻奈何？（此承上文而问邪方去络入于经也，将先固正气而补之，或先攻邪气而泻
之也。）岐伯曰∶此攻邪也，疾出以去盛血而复其真气。（言既中于邪，即当攻邪，但治之宜早，必使疾出其邪以去盛血，
则真气自复，此泻中亦有补也。）此邪新客，溶溶未有定处也，推之则前，引之则止，逆而刺之温血也，刺出其血，其病
立已。（溶溶，流动貌。邪之新客于人者，其浅在络，未有定处，故推之则可前，引之则可止，言取之甚易也。凡取络者，
必取其血，刺出温血，邪必随之而去矣，故病可立已。温血，热血也。）帝曰∶善。然真邪以合，波陇不起，候之奈何？
（真邪以合，邪正初相犯也。波陇不起，病形未见也。察此不真，最易惑乱。）岐伯曰∶审扪循三部九候之盛虚而调之，
（但审察三部九候之脉，则盛虚可得而调治可施矣。）察其左右上下相失及相减者，审其病脏以期之。（相失者，如七诊
之类，失其常体，不相应也。相减者，形气虚脱也。察三部九候之左右上下，则知其病之所在，脏之所属，阴阳气候皆
可期矣。三部九候相失相减等义，见脉色类五及二十五。）不知三部者，阴阳不别，天地不分。（阴阳不别，则不知脏腑
逆顺。天地不分，则不知升降浮沉。）地以候地，天以候天，人以候人，调之中府，以定三部。（知三部者，可以候上中
下之病。中府，藏气也。凡三部九候脉证皆以藏气为主，气顺则吉，气逆则凶，故调之中府，可以定三部。）故曰刺不知
三部九候，病脉之处，虽有大过且至，工不能禁也。（大过，大邪之过也。）诛罚无过，命曰大惑，反乱大经，真不可复，
用实为虚，以邪为真，用针无义，反为气贼，夺人正气，以从为逆，荣卫散乱，真气已失，邪独内着，绝人长命，予人
夭殃，不知三部九候，故不能久长。（不知邪正虚实而妄施攻击，是谓诛伐无过，夺人真元，杀人于冥冥之中，莫此为甚，
欲遗阴德于子孙者，当以此为切戒。）因不知合之四时五行，因加相胜，释邪攻正，绝人长命。（不知合之四时五行，因
加相胜，失天和也。释邪攻正，不当伐而伐也，故绝人长命。）邪之新客来也，未有定处，推之则前，引之则止，逢而泻
之，其病立已。（此重言之者，深示人以治病宜早也。）
黄帝问道：如何诊察邪气？（这里是指诊察侵入体内的邪气，而不是指针刺后得气的现象。）岐伯回答说：当邪气由络脉进入经脉时，会停留在血脉之中。（邪气由浅入深，所以必然先从络脉进入，然后才传入经脉。舍，指停留居住。）此时邪气的寒性与正气的温性尚未调和，就像波浪涌起一样，时而到来，时而离去，因此没有固定的时刻。（邪气性质偏寒，正气性质偏温，所以两者不相协调。血气本应安静，但被邪气扰乱，也如同水本平静却被风搅动，所以像波浪涌起。邪气侵袭人体，善于变化移动，或来或去，所以没有固定位置。）所以说，在邪气刚来的时候，必须按压以阻止其深入，并趁机施针泻除。（在邪气初来时，邪气尚微弱，所以可以按压病处以遏制它，随即施针泻法，及早阻断病势，这样大的邪气就能消散，不会产生深重的危害。）不要迎着邪气最盛的时候去泻它。（如果不尽早治疗，邪气必定强盛。虽然邪气很盛，但恐怕经气未必充实，所以应当详细审察，不可因为遇到邪气冲盛就随意泻之。）真气就是经气，如果经气过于虚弱，所以说“邪气来袭时不可逢迎而补”，就是这个意思。（如果真气不充实，迎着邪气去泻，虽然邪气去了，但真气会更加虚弱，所以说“邪气来袭时不可逢迎”。按：《小针解》说：“其来不可逢”，是指气盛时不可用补法。那里讲的是补法，这里讲的是泻法，文字看似相反，但各有深意，应当两方面仔细考察。）所以说，诊察邪气如果不审慎，等到大邪之气已经过去，再去泻它，就会使真气脱失，一旦脱失就无法恢复，邪气再次侵袭，病情就会更加积聚加重。（过，指过去。如果不能审察虚实，对已经离去的邪气进行泻治，反而损伤了真气，邪气必定乘虚再次入侵而使病情更重。）所以说“邪气已去不可追”，就是这个意思。（《小针解》说：“其往不可追”，是指气虚时不可用泻法。）时机不容许丝毫延误，要等待邪气到达时才进针泻邪，无论是过早还是过晚，都会导致血气耗竭，疾病难以治愈。（发针泻，指施行泻法。想要泻除邪气，关键在于邪气到达的那一刻。不容许丝毫延误，是说连一根头发丝的时间都不能错过。如果过早，邪气还未到达；如果过晚，大邪之气已经离去，徒然伐尽血气而疾病无法控制。下，指降服、制服。）所以说，知道把握时机取穴施治，就像触动弩机一样灵敏；不知道把握时机，就像敲击木椎一样迟钝。所以说，懂得机道的人不会错失丝毫时机，不懂机道的人即使敲击也不会发出反应，就是这个意思。（机，指弩机的扳机。椎，指木槌。知道时机并加以利用，必然随拨而动，像发射弩箭一样容易；不知道时机而盲目攻治，则顽固钝滞无法奏效，像敲击木椎一样困难。按：上文的各种意义在前面第一、第七两章中都已见到。）黄帝问道：补法和泻法该如何运用？（这是承接上文提问，既然邪气刚从络脉进入经脉，是先固护正气进行补益，还是先攻逐邪气进行泻除呢？）岐伯回答说：这是攻逐邪气的方法，快速出针以去除瘀滞的血液，从而使真气恢复。（既然已经遭受邪气侵袭，就应当立即攻邪，但治疗宜早，务必快速出针以排出恶血，那么真气自然恢复，这就是泻法中也包含了补法的意义。）这种邪气是新近客犯的，流动不定，还没有固定的位置，推按它可以向前移动，牵引它可以停止，逆着邪气方向针刺以放出温热之血，刺出这些血液，疾病立刻痊愈。（溶溶，流动的样子。邪气新近侵犯人体，位置浅表在络脉，没有固定位置，所以推按它可以向前，牵引它可以停止，说明取治很容易。凡是治疗络脉病变，必须取其瘀血，刺出温热之血，邪气必定随之而去，所以疾病可以立刻痊愈。温血，指热血。）黄帝说：好。然而当真气和邪气相合，脉象波动不明显时，如何诊察呢？（真邪相合，指邪气与正气刚开始交争。波陇不起，指病症表现尚未显现。对此观察不真切，最容易造成困惑和混乱。）岐伯回答说：仔细审察三部九候脉象的盛衰虚实来进行调治，（只要审察三部九候的脉象，就能得知盛衰情况，从而实施调治。）观察其左右上下脉象失常及相互减弱的情况，审察病变所在的脏腑以预测预后。（相失，如七诊脉象之类，失去了常态，互不相应。相减，指形体与元气虚脱。通过察看三部九候的左右上下脉象，就能知道病变的部位和所属的脏腑，阴阳气候的变化都可以预测。三部九候相失、相减等含义，见《脉色类》第五及第二十五章。）不懂得三部九候诊法的人，分不清阴阳，辨不明天地。（分不清阴阳，就不知道脏腑的顺逆关系。辨不明天地，就不知道气机的升降浮沉规律。）用地部脉候察下部病变，用天部脉候察上部病变，用人部脉候察中部病变，调理中焦脾胃之气，以确定三部脉象的主次。（懂得三部诊法，就可以候察上、中、下三部的病变。中府，指藏气。凡是三部九候的脉证都以脏气为主，气顺则吉，气逆则凶，所以调理中焦脏气，就可以确定三部脉象的基准。）所以说，针刺如果不了解三部九候和病脉所在，即使有大邪侵袭，医生也不能禁止其危害。（大过，指大邪之气过度侵袭。）无故诛伐，称为大惑，反而扰乱了人体的大经，导致真气无法恢复，把实证当作虚证，把邪气当作真气，用针失去原则，反而成为气的贼害，夺取人的正气，把顺证当作逆证，使营卫散乱，真气丧失，邪气独自内留，断绝人的寿命，给人带来夭折的灾祸，这都是因为不了解三部九候，所以不能长久生存。（不了解邪正虚实而妄加攻击，这叫诛伐无过，掠夺人的真元，在不知不觉中杀人，没有比这更严重的了，想要给子孙留下阴德的人，应当以此为深切警戒。）又因为不了解结合四时五行，因而错误地施加相克的治疗，放弃攻邪而攻击正气，断绝人的寿命。（不了解结合四时五行，错误地施加相克之法，违背了天和。放弃攻邪而攻击正气，是不当伐而伐，所以断绝人的寿命。）邪气新近入侵时，没有固定位置，推按它可以向前，牵引它可以停止，遇到它就泻除它，疾病立刻痊愈。（这里重复强调这一点，是深深向人们展示治病宜早的道理。）
Huangdi asked: How should one observe the pathogenic qi? (This refers to observing the pathogenic qi that has invaded the body, not the arrival of needle qi after acupuncture.) Qibo replied: When pathogenic qi moves from the collaterals into the meridians, it resides within the blood vessels. (Pathogenic qi enters from shallow to deep, so it must first enter from the collaterals and then proceed into the meridians. "Reside" means to stay or dwell.) At this time, the coldness of the pathogenic qi and the warmth of the healthy qi have not yet harmonized, resembling waves rising; they come and go at times, thus having no fixed presence. (The nature of pathogenic qi is cold, while that of healthy qi is warm, hence they do not accord. Blood and qi are originally still but are disturbed by pathogenic qi, just as water is originally calm but stirred by wind, thus resembling rising waves. The arrival of pathogenic qi is characterized by rapid movement and change, coming and going without a fixed location.) Therefore, it is said that when the pathogenic qi arrives, one must press to stop its progression and immediately apply acupuncture to drain it. (When the pathogenic qi first arrives, it is still weak, so one can press the affected area to restrain it and then apply draining techniques. By early obstructing its momentum, major pathogenic factors can be dispersed, preventing severe harm.) One should not drain when encountering the peak surge of the pathogen. (If treatment is not initiated early, the pathogen will surely become strong. Although the pathogen may be abundant, the meridian qi might not necessarily be solid; therefore, careful examination is required, and one should not indiscriminately drain simply because the pathogen appears vigorous.) True qi is equivalent to meridian qi. If meridian qi is too deficient, it is said that "one should not meet [the arriving pathogen] with tonification," which is what this refers to. (If true qi is not substantial, meeting the pathogen with draining will cause the true qi to become excessively deficient even if the pathogen is expelled; hence, it is said that "one should not meet the arriving pathogen." Note: *Xiao Zhen Jie* states: "One should not meet the arriving pathogen" refers to not using tonification when qi is excessive. That text discusses tonification, whereas this passage discusses draining; although the texts seem contradictory, each holds profound meaning and should be examined from both perspectives.) Therefore, it is said that if observing the pathogen is not prudent, and one drains after the major pathogenic qi has passed, true qi will be depleted. Once depleted, it cannot recover; the pathogen will return, and the disease will accumulate further. (Pass refers to having gone by. Failing to examine deficiency and excess, and draining the pathogen that has already left, instead damages true qi. The pathogen will inevitably take advantage of the deficiency to return, worsening the condition.) Hence, it is said that "one cannot pursue [the departing pathogen]," which is what this refers to. (*Xiao Zen Jie* states: "One cannot pursue the departing pathogen" means one should not use draining when qi is deficient.) There should be no delay of even a hair's breadth; one must wait for the pathogen to arrive before inserting the needle to drain. Whether acting too early or too late results in the exhaustion of blood and qi, making the disease incurable. (Inserting the needle to drain refers to applying draining methods. To drain the pathogen, timing is crucial at the moment of the pathogen's arrival. No delay of even a hair's breadth means not missing the slightest opportunity. If done too early, the pathogen has not yet arrived; if done too late, the major pathogenic qi has passed. This merely exhausts blood and qi without controlling the disease. "Xia" here means to subdue or control.) Therefore, it is said that knowing how to seize the opportunity for treatment is like triggering a crossbow mechanism, while not knowing how to seize it is like striking a wooden mallet. Thus, it is said that those who understand the Dao of timing will not miss an opportunity of even a hair's breadth, while those who do not understand timing will strike without effect. This is what is meant. (Ji refers to the trigger mechanism of a crossbow. Zhui refers to a wooden mallet. Knowing the timing and acting accordingly allows for immediate response, easy as firing a crossbow; ignoring timing and attacking blindly leads to stubborn ineffectiveness, difficult as striking a wooden mallet. Note: The meanings discussed above are also found in Chapters 1 and 7.) Huangdi asked: How should tonification and draining be applied? (This follows up on the previous discussion regarding whether to first consolidate healthy qi via tonification or attack pathogenic qi via draining when it moves from collaterals into meridians.) Qibo replied: This is a method of attacking the pathogen. Withdraw the needle quickly to remove stagnant blood, thereby restoring true qi. (Once infected by pathogen, one should immediately attack it, but treatment should be prompt. Quickly withdrawing the needle to expel bad blood allows true qi to restore itself; this demonstrates that draining contains elements of tonification.) This pathogen is newly acquired, flowing freely without a fixed location. Pushing it moves it forward, pulling it stops it. Needling against its direction to release warm blood, and extracting this blood, cures the disease immediately. ("Rongrong" describes a flowing state. For pathogens newly invading the human body, they reside superficially in the collaterals without a fixed location, so pushing moves them forward and pulling stops them, indicating ease of treatment. Whenever treating collateral diseases, one must extract blood. Releasing warm blood ensures the pathogen departs with it, curing the disease immediately. Warm blood refers to hot blood.) Huangdi said: Excellent. However, when true qi and pathogenic qi combine, and there is no significant pulse fluctuation, how should one observe? (True and pathogen combining refers to the initial clash between healthy and pathogenic qi. Lack of pulse fluctuation indicates that clinical manifestations have not yet appeared. Failure to observe this accurately easily leads to confusion.) Qibo replied: Carefully examine the fullness and emptiness of the three regions and nine pulses to regulate the condition. (By examining the pulses of the three regions and nine positions, one can determine fullness and emptiness and apply regulation.) Observe instances where the pulses on the left and right, upper and lower, are discordant or diminished, and examine the affected zang organs to predict the outcome. (Discordance refers to deviations from normal patterns, such as in the Seven Diagnoses, where pulses do not correspond appropriately. Diminution refers to the depletion of form and qi. By observing the left-right and upper-lower pulses of the three regions and nine positions, one can identify the location of the disease and the associated zang organ, allowing prediction of yin-yang and climatic conditions. The meanings of discordance and diminution in the three regions and nine pulses are detailed in Pulse and Color Classification, Chapters 5 and 25.) Those who do not understand the three regions cannot distinguish yin and yang, nor differentiate heaven and earth. (Inability to distinguish yin and yang means ignorance of the reversals and順逆 of zang-fu organs. Inability to differentiate heaven and earth means ignorance of the ascending-descending and floating-sinking dynamics of qi.) Use the Earth region to observe lower-level pathology, Heaven region for upper-level pathology, and Human region for middle-level pathology. Regulate the Middle Palace (Zang Qi) to stabilize the three regions. (Understanding the three regions allows observation of pathology in the upper, middle, and lower parts. Middle Palace refers to Zang Qi. All pulse and symptom manifestations of the three regions and nine positions are primarily governed by Zang Qi. When qi is smooth, auspiciousness prevails; when qi rebels, misfortune ensues. Thus, regulating the Middle Palace stabilizes the three regions.) Therefore, it is said that if one does not know the three regions, nine pulses, and the location of pathological pulses, even if major pathogens overwhelm the body, the physician cannot prevent the harm. (Da Guo refers to the excessive invasion of major pathogens.) Punishing the innocent is called great confusion, disrupting the great meridians, causing true qi to become irrecoverable, mistaking excess for deficiency, pathogen for true qi, practicing acupuncture without principle, becoming a thief of qi, depriving people of healthy qi, treating compliance as rebellion, scattering Ying and Wei, losing true qi, leaving pathogen alone inside, cutting off life span, bringing premature death—all due to ignorance of the three regions and nine pulses, thus failing to sustain longevity. (Ignorance of pathogen-healthy balance and deficiency-excess states leading to reckless attacks is termed punishing the innocent, robbing true yuan, killing people secretly. This is the most severe error. Those wishing to leave merit to descendants should take this as a stern warning.) Furthermore, ignorance of integrating the four seasons and five phases leads to incorrect application of mutual overcoming, abandoning the attack on pathogen to attack healthy qi, cutting off life span. (Ignoring integration with four seasons and five phases and incorrectly applying mutual overcoming violates heavenly harmony. Abandoning pathogen attack to assault healthy qi is inappropriate伐, thus cutting off life span.) When pathogen newly arrives, it has no fixed location; pushing moves it forward, pulling stops it. Encountering it and draining it cures the disease immediately. (Repeating this emphasizes the importance of early treatment.)