此篇论审症候气，引针补泻之法，至详且尽，为后世针家所宗祖，亟录之以示模范。
黄帝问曰∶余闻九针九篇，夫子乃因而九之，九九八十一篇，余尽通其意矣。经言气之盛衰，左右倾移，
以上调下，以左调右，有余不足，补泻于荥输，余知之矣。此皆荣卫之倾移，虚实之所生，非邪气从外入于经
也。余愿闻邪气之在经也，其病患何如？取之奈何？岐伯对曰∶夫圣人之起度数，必应于天地，故
天有宿度，地有经水，人有经脉。天地温和，则经水安静；天寒地冻，则经水凝泣；天暑地热，则经水沸溢；
卒风暴起，则经水波涌而陇起，夫邪之入于脉也，寒则血凝泣，暑则气淖泽，虚邪因而入客，亦如经水之得
风也，经之动脉，其至也亦时陇起，其行于脉中循循然，其至寸口中手也，时大时小，大则邪至，小则
平，其行无常处，在阴与阳，不可为度，从而察之，三部九候，卒然逢之，早遏其路。吸则内针，无令气忤，
静以久留，无令邪布，吸则转针，以得气为故，候呼引针，呼尽乃去，大气皆出，故命曰泻。帝曰∶不足者
补之奈何？岐伯曰∶必先扪而循之，切而散之，推而按之，弹而怒之，抓而下之，通而取之，外引其
门，以闭其神，呼尽内针，静以久留，以气至为故，如待所贵，不知日暮，其气以至，适而自护，候吸引
针，气不得出，各在其处，推阖其门，令神气存，大气留止，故命曰补。帝曰∶候气奈何？岐伯曰∶夫邪去
络入于经也，舍于血脉之中，其寒温未相得，如涌波之起也，时来时去，故不常在。故曰方其来也，
必按而止之，止而取之，无逢其冲而泻之。真气者，经气者，经气太虚，故曰其来不可逢，此之谓也。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，故曰其往不可追，此之谓也。不可挂
以发者，待邪之至时而发针泻矣，若先若后者，血气已尽，其病不可下，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。帝曰∶补泻奈何？岐伯曰∶此攻
邪也，疾出以去盛血，而复其真气，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。帝曰∶善。然真邪以合，波陇不起，候之奈何？岐伯曰∶审扪循三部九候之盛虚
而调之，察其左右上下相失及相减者，审其病藏以期之。不知三部者，阴阳不别，天地不分。地以候地，天
以候天，人以候人，调之中府，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。
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，其气已失，邪独内着，绝人长命，予人天殃，不知三部九候，故不能久长。因不知合之四
时五行，因加相胜，释邪攻正，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。
这一篇论述了审察症候与经气的方法，以及运用针刺进行补泻的手法，内容详尽完备，被后世的针灸家奉为宗师典范，因此必须记录下来以作为示范。
黄帝问道：我听说《九针》有九篇，先生又将其推演为九倍，共成八十一篇，我已经完全通晓其中的意旨了。经文说，根据经气的盛衰情况，以及左右气血的偏倾移易，可以通过上部的病变来调节下部，通过左侧的病变来调节右侧，对于有余（实证）和不足（虚证），在荥穴和输穴上进行补泻，这些我都知道了。但这都是营卫之气的偏倾移易，是由虚实产生的，并非邪气从外部侵入经脉所致。我希望听听邪气在经脉中的情况，它引起的病症是怎样的？应当如何取穴治疗？岐伯回答说：圣人制定医疗法度，必定与天地相应，所以天有星辰度数，地有江河水流，人有经脉系统。天地温和时，江河水流就平静；天气寒冷大地冻结时，江河水流就凝滞不畅；天气暑热大地炎热时，江河水流就沸腾溢出；突然狂风大作，江河水流就波涛汹涌并隆起。邪气侵入血脉，也是如此，寒则血液凝滞，暑则气机淖泽（濡润滑利），虚邪趁机侵入，也像江河之水遇到风一样，经脉的动脉，其搏动也时常隆起，它在脉中运行是循序渐进的，当它到达寸口部位时，手下的感觉有时大有时小，大表示邪气已至，小表示平和，它的运行没有固定的位置，或在阴分或在阳分，不可用常规标准衡量，顺此规律加以考察，通过三部九候诊法，一旦偶然发现邪气，应尽早阻断其去路。吸气时进针，不要让经气逆乱，安静地长时间留针，不让邪气扩散，吸气时转动针具，以得气为目的，呼气时引出针具，呼尽时拔针，大气（邪气）随之排出，所以称为泻法。黄帝说：正气不足该如何补呢？岐伯说：必须先用手扪摸并顺着经络推循，切按并散结，推动并按压穴位，弹击使血脉怒张，抓捏向下引导，疏通经络以取气，向外拉开皮肤门户，以闭合神气，呼气尽时进针，安静地长时间留针，以气至为标志，如同等待尊贵客人到来，不知时间流逝，待气至之后，适度保护正气，吸气时进针，使气不得外出，各安其位，推合皮肤门户，令神气留存，大气停留止息，所以称为补法。黄帝说：如何候气？岐伯说：邪气由络脉进入经脉，停留在血脉之中，其寒温性质尚未与人体之气相协调，像涌波一样起伏，时而来时去去，所以不固定存在。所以说，当邪气刚来的时候，必须按压以阻止其深入，阻止后随即施治，不要迎着邪气冲盛之时进行泻法。真气即经气，如果经气太虚弱，所以说“邪气初来不可逢（迎而泻之）”，说的就是这个道理。所以说，候邪如果不审慎，邪气的大势已经过去，此时若用泻法，会导致真气脱失，脱失后无法恢复，邪气会再次聚集，病情更加深重，所以说“邪气已去不可追”，说的就是这个道理。时机把握不能有一丝一毫的差错，要等待邪气到达时再发针泻邪，如果过早或过晚，血气已经耗尽，病就无法治愈，所以说知道可取时机的人就像弩机发射一样精准，不知道取时机的人就像敲椎头一样无反应，所以说懂得机道的人不会错失良机，不懂机道的人即使敲击也不会发出声音，说的就是这个道理。黄帝说：补泻具体怎么做？岐伯说：这是攻逐邪气的方法，快速出针以去除盛血，从而恢复真气，这是因为邪气是新近客居的，流动不定没有固定位置，推之则向前，引之则停止，逆着邪气方向刺之，放出温热血（瘀血）。刺出其血，病立刻痊愈。黄帝说：好。然而真邪相混，波浪不起，如何候察？岐伯说：仔细扪摸审查三部九候的盛虚情况并加以调节，观察其左右上下相互失调及减弱的地方，审察病变所在的脏腑以预测预后。不懂得三部九候的人，分不清阴阳，辨不明天地。地部候下部，天部候上部，人部候中部，调和中央胃腑之气，以确定三部，所以说针刺不懂得三部九候病脉所在之处，虽然有大的过失即将发生，医生也不能禁止。诛罚无罪（误泻正气），叫做大惑，反而扰乱大经，真气不可恢复，将实证当作虚证，将邪气当作真气，用针没有义理，反成为气的贼害，夺取人的正气，将以顺为逆，营卫散乱，气已丧失，邪气独自内着，断绝人的寿命，给人带来天灾祸殃，这都是因为不懂得三部九候，所以不能长寿。又因为不懂得结合四时五行，因而加重相克关系，放弃邪气而攻击正气，断绝人的寿命。邪气新近来到，没有固定位置，推之则前，引之则止，逢其来势而泻之，病立刻痊愈。
This chapter discusses the examination of symptoms and Qi dynamics, as well as the methods of needle insertion for tonification (Bu) and sedation (Xie). The content is extremely detailed and comprehensive, serving as a foundational model for later generations of acupuncturists. It is therefore recorded here to serve as an example.
The Yellow Emperor asked: I have heard that the *Nine Needles* consists of nine chapters, and you have expanded this by multiplying by nine, resulting in eighty-one chapters. I have thoroughly understood their meanings. The classics state that regarding the excess or deficiency of Qi, and its shifting tendencies to the left or right, one can regulate the lower through the upper, and the right through the left. For conditions of excess and deficiency, tonification and sedation are applied at the Ying-Spring (Yingxue) and Shu-Stream (Shuxue) points. I am aware of these principles. However, these refer only to the shifting of Ying (Nutritive) and Wei (Defensive) Qi, arising from deficiency and excess, not to pathogenic factors invading the meridians from the exterior. I wish to hear about the presence of pathogenic factors within the meridians; what are the clinical manifestations? How should they be treated?
Qibo replied: The sage establishes medical standards corresponding to Heaven and Earth. Thus, Heaven has the degrees of stars, Earth has the flowing waters of rivers, and humans have the meridian channels. When Heaven and Earth are mild and warm, the river waters remain calm; when Heaven is cold and Earth frozen, the river waters become stagnant; when Heaven is hot and Earth scorching, the river waters boil and overflow; when sudden storms arise, the river waters surge and rise in waves. Similarly, when pathogenic factors enter the vessels, cold causes blood to stagnate, while heat makes Qi fluid and lubricated. Deficient pathogens take advantage of this to invade, just as river water reacts to wind. The arterial pulses of the meridians also rise and fall periodically. Within the vessels, they move steadily. When reaching the Cun Kou pulse position, the sensation under the fingers varies—sometimes large, sometimes small. A large pulse indicates the arrival of pathogenic factors; a small pulse indicates peace/normality. Their movement has no fixed location, oscillating between Yin and Yang, defying standard measurement. By observing according to this pattern, using the Three Regions and Nine Palpations (Sanbu Jiuhou) method, if one encounters them suddenly, one should block their path early. During inhalation, insert the needle, ensuring the Qi does not rebel. Leave it quietly for a long time to prevent the spread of pathogens. During inhalation, rotate the needle until Deqi (arrival of Qi) is achieved. During exhalation, withdraw the needle, removing it completely at the end of exhalation. The "Great Qi" (pathogenic Qi) exits, hence this is called Sedation (Xie).
The Yellow Emperor asked: How should deficiency be tonified? Qibo said: First, palpate and follow the meridian, press and disperse, push and press the area, flick to distend the vessels, grasp and guide downward, unblock to obtain Qi, draw open the external aperture to close the Shen (Spirit), and insert the needle at the end of exhalation. Leave it quietly for a long time until Qi arrives, waiting as if for a honored guest, unaware of the passing day. Once Qi arrives, protect it appropriately. Insert the needle during inhalation so Qi cannot escape, keeping it in place. Push and close the skin aperture to retain Shen and Qi, stopping the "Great Qi." Hence, this is called Tonification (Bu).
The Yellow Emperor asked: How does one wait for Qi? Qibo said: When pathogenic factors move from collaterals into meridians and lodge in the blood vessels, their cold or warm nature has not yet harmonized with the body's Qi. Like rising waves, they come and go, thus lacking a fixed presence. Therefore, it is said that when they arrive, one must press to stop their advance and treat immediately. Do not sedate when they are surging violently. The True Qi is the Meridian Qi. If Meridian Qi is too deficient, it is said "do not meet the arriving [pathogen] with sedation," which refers to this situation. It is also said that if one fails to carefully observe the pathogen, and the main wave of the pathogen has passed, sedation will cause the True Qi to leak. Once leaked, it cannot recover; the pathogen returns, and the disease accumulates further. Thus, it is said "do not chase the departing [pathogen]," referring to this. The timing must not be off by a hair. One must wait for the pathogen to arrive before inserting the needle for sedation. If one acts too early or too late, the Blood and Qi are exhausted, and the disease cannot be cured. Therefore, knowing the correct time to treat is like triggering a crossbow; not knowing it is like striking a wooden mallet without effect. Those who understand the Dao of mechanism do not miss the slightest opportunity; those who do not understand strike but get no response. This is what is meant.
The Yellow Emperor asked: How exactly are tonification and sedation performed? Qibo said: This is attacking the pathogen. Withdraw the needle quickly to remove excessive blood and restore True Qi. Since the pathogen is newly arrived and fluid/unsettled, pushing it moves it forward, pulling it stops it. Puncture against its direction to release warm blood (stasis). Removing the blood cures the disease immediately.
The Yellow Emperor said: Excellent. But when True Qi and Pathogen mix, and no wave-like pulse arises, how should one observe? Qibo said: Carefully palpate and examine the excess or deficiency in the Three Regions and Nine Palpations to regulate accordingly. Observe where the left/right and upper/lower aspects are discordant or diminished. Examine the affected Zang-Fu organs to predict the outcome. One who does not know the Three Regions distinguishes neither Yin nor Yang, nor Heaven nor Earth. The Earth region observes the lower body, the Heaven region observes the upper body, and the Human region observes the middle body. Harmonize the Central Fu organs (Stomach) to define the Three Regions. Therefore, it is said that if an acupuncturist does not know the locations of the Three Regions and Nine Palpations pulse sites, even if major errors occur, they cannot prevent them. Punishing the innocent (tonifying when empty/sedating when full incorrectly) is called great confusion. It disrupts the Great Meridians, making True Qi irrecoverable. Treating excess as deficiency, or pathogen as True Qi, using needles without principle, becomes a thief of Qi, depriving the person of righteous Qi. Turning compliance into rebellion, scattering Ying and Wei, losing Qi, allowing pathogen to lodge alone, cuts short life and brings disaster. This is due to ignorance of the Three Regions and Nine Palpations, leading to short life. Furthermore, failing to integrate the Four Seasons and Five Elements leads to exacerbating mutual overcoming relationships. Abandoning the pathogen to attack the righteous Qi cuts short life. When a pathogen is newly arrived and unsettled, pushing moves it forward, pulling stops it. Meeting it with sedation cures the disease immediately.