一用磁石（即吸铁石）引其肉中，针即出。
一用象牙屑碾细，水和涂上即出。
一用车脂成膏子，摊纸上如钱大，日换三五次，即出。
一用鸟翎三五枝，火炙焦为末，好醋调成膏，涂上，纸盖一二次，其针自出。
一用腊姑脑子，捣烂涂上即出。
一用硫黄研细，调涂上，以纸花贴定，觉痒时，针即出。
一用双杏仁捣烂，以鲜脂调匀，贴针疮上，针自出。倘经络有伤，脓血不止，用黄 、
当归、肉桂、木香、乳香、沉香，别研绿豆粉糊丸，每五十丸，热水服之。
帝曰∶余闻刺法，有余者泻之，不足者补之。岐伯曰∶百病之生，皆有虚实，而补泻行
焉。泻虚补实，神去其室，致邪失正，真不可定，粗之所败，谓之天命。补虚泻实，神归其
室，久塞其空，谓之良工。
凡用针者，随而济之，迎而夺之，虚则实之，满则泻之，菀陈则除之，邪盛则虚之。徐
而疾则实，疾而徐则虚。言实与虚，若有若无。察后与先，若存若亡。为虚与实，若得若失
。虚实之要，九针最妙。补泻之时，以针为之。泻曰迎之，必持内之，放而出之，排阳得针
，邪气得泄。按而引针，是谓内温，血不得散，气不得出也。补曰随之，随之意若妄之。若
行若按，如蚊虻止，如留如还，去如弦绝，令左属右，其气故止。外门已闭，中气乃实，必
无留血，急取诛之。
刺之而气不至，无问其数，刺之而气至，乃去之，勿复针。
针有悬布天下者五∶一曰治神，二曰知养身，三曰知毒药，四曰制砭石大小，五曰知腑脏血
气之诊。五法俱立，各有所先。今末世之刺也，虚者实之，满者泄之，此皆众工所共知也。
若夫法天则地随应而动，和之者若响，随之者若影，道无鬼神，独来独往。帝曰∶愿闻其道
？岐伯曰∶凡刺之真，必先治神，五脏已定，九候已备，后乃存针。众脉不见，众凶弗闻，
外内相得，无以形先，可玩往来，乃施于人；人有虚实，五虚勿近，五实勿远。至其当发，
不容睫。手动若务，针耀而匀，静意视义，观适之变，是谓冥冥，莫知其形。见其乌乌，见
其稷稷，从见其飞，不知其谁？伏如横弩，起如发机。
刺虚者须其实，刺实者须其虚，经气已至，慎守勿失，浅深在志，远近若一，如临深渊
，手如握虎，神无营于众物，义无邪下，必正其神。
小针之要，易陈而难入。粗守形，上守神，神乎，神客在门。未睹其疾，恶知其原？刺
之微，在速迟。粗守关，上守机，机之动，不离其空。空中之机，清净而微。其来不可逢，
其往不可追。知机之道者，不可挂以发。不知机道，扣之不发。知其往来，要与之期。粗之
暗乎。妙哉，工独有之。往者为逆，来者为顺，明知逆顺，正行无问，迎而夺之，恶得无虚
？随而济之，恶得无实？迎之随之，以意和之，针道毕矣。
凡用针者，虚则实之，满则泄之，菀陈则除之，邪盛则虚之。大要曰∶持针之道，坚者
为实，正指直刺，无针左右。神在秋毫，属意病者。审视血脉，刺之无殆。方刺之时，必在
悬阳，及与两卫。神属勿去，知病存亡。血脉者在 横居，视之独澄，切之独坚。
刺虚则实之者，针下热也，气实乃热也。满则泄之者，针下寒也。菀陈则除之者，出恶
血也。邪盛则虚之者，出针勿按也。徐而疾则实者，徐出针而疾按之也。疾而徐则虚者，疾
出针而徐按之也。言实与虚者，察血气多少也。若有若无者，疾不可知也。察后与先者，知
病先后也。若存若亡者，脉时有无也。为虚与实者，工勿失其法也。若得若失者，离其法也
。虚实之要，九针最妙者，谓其各有所宜也。补泻之时者，与气开阖相合也。九针之名各有
不同形者，针穷其所当补泻也。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。经气已至慎守勿失者，勿更改也。浅深
在志者，知病之内外也。远近如一者，浅深其候等也。如临深
渊者，不敢堕也。手
如握虎者，欲其壮也。神无营于众物者，静志观病患，无左右视也。义无邪下者，欲端以正
也。必正其神者，欲瞻病患，自制其神，令气易行也。
所谓易陈者，易言也。难入者，难着于人也。粗守形者，守刺法也。上守神者，守人之
血气有余不足，可补泻也。神客者，正邪共会也。神者，正气也。客者，邪气也。在门者，
邪循正气之所出入也。未睹其疾者，先知邪正何经之疾也。恶知其原者，先知何经之病，所
取之处也。刺之微在速迟者，徐疾之意也。粗守关者，守四肢而不知血气正邪之往来也。上
守机者，知守气也。机之动不离其空中者，知气之虚实，用针之徐疾也。空中之机清净而微
者，针以得气，密意守气勿失也。其来不可逢者，气盛不可补也。其往不可追者，气虚不可
泻也。不可挂以发者，言气易失也。扣之不发者，言不知补泻之意也。血气已尽，而气不下
也。知其往来者，知气之逆顺盛虚也。要与之期者，知气之可取之时也。粗之暗者，冥冥不
知气之微密也。妙哉，工独有之者，尽知针意也。往者为逆者，言气之虚而小，小者逆也。
来者为顺者，言形气之平，平者顺也。明知逆顺正行无问者，言知所取之处也。逆而夺之者
，泻也。随而济之者，补也。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。菀陈则除之者，去血脉也。邪盛则虚之者，言诸经有盛者，皆泻其邪也。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。言实与虚，若有若无者，言实者
气，虚者无气也。察后与先，若存若亡者，言气之虚实，补泻之先后，察其气之以下与常存
也。为虚与实，若得若失者，言补者 然若有得也，泻者恍然若有失也。
是故工之用针也，知气之所在，而守其门户，明于调气补泻所在，徐疾之意，所取之处
。泻必用圆，切而转之，其气乃行，疾而徐出，邪气乃出，伸而逆之，摇大其穴，气出乃疾
。补必用方，外引其皮，令当其门，左引其枢，右推其肤，微旋而徐推之，必端以正，安以
静，坚心无解，欲微以留气，气下而疾出之，推其皮，盖其外门，神气乃存，用针之要，无
泻必用方者，以气方盛也，以月方满也，以日方温也，以身方定也，以息方吸而内针；
乃复候其方吸而转针，乃复候其方呼而徐引针，故曰泻必用方，其气而行焉。补必用圆者，
圆者行也；行者移也。刺必中其荣，复以吸排针也，故圆与方非针也。
泻实者，气盛乃内针，针与气俱内，以开其门，如利其户，针与气俱出，精气不伤，邪
气乃下，外门不闭，以出其实，摇大其道，如利其路，是谓大泻。必切而出，大气乃出，持
针勿置，以定其意，候呼内针，气出针入，针孔四塞，精无从出，方实而疾出针，气入针出
，热不得还，闭塞其门，邪气布散，精气乃得存，动气候时，近气不失，远气乃来，是谓追
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。扪而循之，切而散之，推而按之，弹而努之，爪而下之，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
气已至，适而自护，候吸引针，气不得出，各在所处，推阖其门，令神气存，大气留止，故
补泻弗失，与天地一。经气已至，慎守勿失，浅深在志，远近如一，如临深渊，手如握
虎，神无营于众物。
持针之道，欲端以正，安以静，先知虚实，而行疾徐，左手执骨，右手循之，无与肉裹
。泻欲端以正，补必闭肤，辅针导气，邪得淫 ，真气得居。
帝曰∶捍皮开腠理奈何？岐伯曰∶因其分肉，左别其肤，微内而徐端之，适神不散，邪
知其气所在，先得其道，稀而疏之，稍深以留，故能徐入之。大热在上，推而下之，从
上下者引而去之，视先痛者常先取之。大寒在外，留而补之。入于中者，从合泻之。上气不
足，推而扬之。下气不足，积而从之。寒入于中，推而行之。
夫实者，气入也。虚者，气出也。气实者，热也。气虚者，寒也。入实者，左手开针孔
也。入虚者，右手闭针孔也。
形气不足，病气有余，是邪盛也，急泻之。形气有余，病气不足，此阴阳俱不足也，不可刺
；刺之则重不足，重不足则阴阳俱竭，血气皆尽，五脏空虚，筋骨髓枯，老者绝灭，壮者不
复矣。形气有余，病气有余，此谓阴阳俱有余也，急泻其邪，调其虚实。故曰有余者泻之，
不足者补之，此之谓也。故曰刺不知逆顺，真邪相搏，满而补之，则阴阳四溢，肠胃
充郭，肝肺内 ，阴阳相错；虚而泻之，则经脉空虚，血气竭枯，肠胃
HT辟，皮肤薄者，毛腠夭焦，子知死期。
凡用针之类，在于调气。气积于胃，以通荣卫，各行其道，宗气留于海。其下者，注于
气冲，其直者，走于息道。故厥在于足，宗气不下，脉中之血，凝而留止，弗之火调，弗能
散气可收，聚气可布，深居静处，占神往来，闭户塞牖，魂魄不散，专意一神，精气之
分，毋闻人声，以收其精，必一其神，令志在针。浅而留之，微而浮之，以移其神，气至乃
休。男内女外，坚拒勿出，谨守勿内，是谓得气。
刺之而气不至，无问其数，刺之而气至，乃去之，勿复针。针各有所宜，各不同形，各
任其所，为刺之要。气至而有效，效之信，若风之吹云明乎若见苍天，刺之道毕矣。
用针者，必先察其经络之虚实，切而循之，按而弹之，视其应动者，乃复取之而下之。六
经调者谓之不病，虽病谓之自己，一经上实下虚而不通者，此必有横络盛加于大经，令之不
，视而泻之，此所谓解结也。上寒下热，先刺其项太阳久留之，已刺即熨项与肩胛令热下合
乃止，此所谓推而上之者也。上热下寒，视其脉虚而陷之于经络者取之，气下乃止，此所谓
引而下之者也。大热遍身，狂而妄见、妄闻、妄语，视足阳明及大络取之，虚者补之，血而
实者泻之。因其偃卧，居其头前，以两手四指侠按颈动脉，久持之，卷而切推，下至缺盆中
而复止如前，热去乃止，此所谓推而散之者也。
帝曰∶余闻刺法言曰∶有余者泻之，不足者补之，何谓有余？何谓不足？岐伯曰∶有余有
五，不足亦有五，帝欲何问？帝曰∶愿尽闻之；岐伯曰∶神有有余，有不足，气有有余有不
足，血有有余有不足，形有有余有不足，志有有余有不足，凡此十者，其气不等也。帝曰∶
人有精气津液，四肢九窍，五脏十六部，三百六十五节，乃生百病，百病之生，皆有虚实
。今夫子乃言有余有五，不足亦有五，何以生之乎？岐伯曰∶皆生于五脏也。夫心藏神，肺
藏气，肝藏血，脾藏肉，肾藏志，而此成形。志意通，内连骨髓而成形五脏。五脏之道，皆
出于经隧，以行血气。血气不和，百病乃变化而生，是故守经隧焉。帝曰∶神有余不足何
如？岐伯曰∶神有余则笑不休，神不足则悲。血气未并，五脏安定，邪客于形，洒淅起于毫
毛，未入于经络也。故命曰神之微。帝曰∶补泻奈何？岐伯曰∶神有余则泻其小络之穴出血，
勿之深斥，无中其大经，神气乃平。神不足者，视其虚络，按而致之，刺而利之，无出其血
，无泄其气，以通其经，神气乃平。帝曰∶刺微奈何？岐伯曰∶按摩勿释，着针勿斥，移气
于不足，神气乃得复。帝曰∶气有余不足奈何？岐伯曰∶气有余则喘咳上气，不足则息利少
气，血气未并，五脏安定，皮肤微病，命曰白气微泄。帝曰∶补泻奈何？岐伯曰∶气有余则
泻其经隧，无伤其经，无出其血，无泄其气。不足则补其经隧，无出其气。帝曰∶刺微奈何
？岐伯曰∶按摩勿释，出针视之曰∶我将深之。适人必革，精气自伏，邪气散乱，无所休息
，气泄腠理，真气乃相得。帝曰∶血有余不足奈何？岐伯曰∶血有余则怒，不足则恐，血气
未并，五脏安定，孙络水溢，则经有留血。帝曰∶补泻奈何？岐伯曰∶血有余则泻其盛经，
出其血；不足则补其虚经，内针其脉中，久留而视，脉大疾出其针，无令血泄。帝曰∶刺留
血奈何？岐伯曰∶视其血络，刺出其血，无令恶血得入于经，以成其疾。帝曰∶形有余不足
奈何？岐伯曰∶形有余则腹胀，泾溲不利；不足则四肢不用，血气未并，五脏安定，肌肉蠕
动，命曰微风。帝曰∶补泻奈何？岐伯曰∶形有余则泻其阳经，不足则补其阳络。帝曰∶刺
微奈何？岐伯曰∶取分肉间，无中其经，无伤其络，卫气得复，邪气乃索。帝曰∶志有余不
足奈何？岐伯曰∶志有余则腹胀飧泄，不足则厥，血气未并，五脏安定，骨节有动。帝曰∶
补泻奈何？岐伯曰∶志有余则泻然骨之前出血，不足则补其复溜。帝曰∶刺未并奈何？岐伯曰
∶即取之无中其经，邪乃立虚。
血清气滑，疾泻之则气易竭；血浊气涩，疾泻之则经可通。
（关于折针的处理方法）：
一种方法是用磁石（即吸铁石）靠近肌肉中的断针，针就会被吸出来。
一种方法是将象牙屑研磨成细粉，用水调和后涂抹在患处，针即可取出。
一种方法是用车脂制成膏状，摊在纸上如铜钱大小，每天更换三到五次，针就会出来。
一种方法是取乌鸦或喜鹊的羽毛三五根，用火烤焦研成粉末，用好醋调成膏状，涂抹在患处，用纸覆盖一两次，针自然会出来。
一种方法是用腊月制作的蜡烛芯脑（蜂蜡），捣烂后涂抹，针即可取出。
一种方法是用硫黄研细，调和涂抹，用纸花贴定，当感到发痒时，针就会出来。
一种方法是用双杏仁捣烂，用新鲜动物油脂调匀，贴在针孔伤口上，针自会出来。如果经络受损，脓血不止，使用黄芪、当归、肉桂、木香、乳香、沉香，另外单独研磨绿豆粉用糊剂做成丸药，每次服用五十丸，用热水送服。
黄帝说：我听说针刺的方法，有余的要用泻法，不足的要用补法。岐伯说：各种疾病的发生，都有虚和实的区别，因此要施行补法和泻法。如果误将虚证当作实证来泻，将实证当作虚证来补，就会导致神气离去，招致邪气而丧失正气，真气无法安定，这是粗劣医生造成的败坏，却归咎于天命。如果是补其不足、泻其有余，神气就会回归体内，长久地充实空虚之处，这就称为高明的医生。
凡是使用针法，都要遵循随顺经气而资助它（补法），逆迎经气而夺取它（泻法），虚证则用补法使其充实，实证则用泻法使其泄减，瘀血陈积则清除它，邪气盛实则使之虚弱。缓慢进针快速出针为补法，快速进针缓慢出针为泻法。谈论虚实，感觉若有若无。观察治疗的先后顺序，感觉似存似亡。处理虚实，感觉若得若失。虚实的关键，九针最为奇妙。补泻的时机，通过针具来操作。泻法叫作“迎”，必须持针插入，放出并拔出，推开阳侧以取得针感，使邪气得以宣泄。按压并引导出针，这叫作“内温”，血液不会散乱，气也不会外泄。补法叫作“随”，跟随经气，意念仿佛若无其事。动作像行走又像按压，如同蚊虻叮咬停留，似留似还，拔针时像弓弦断裂一样迅速，使左手属阴右手属阳的气机协调，经气自然停止于该处。外部门户已关闭，内部正气乃充实，必定没有留血，急取针具诛除邪气。
针刺后经气未至，不问针刺次数多少；针刺后经气已至，就停止针刺，不再继续刺。
针道有五项悬布天下的准则：一是治神，二是知养身，三是知毒药，四是制砭石的大小，五是知脏腑气血的诊断。这五种法则都确立后，各有其优先次序。如今末世的针刺，虚者实之，满者泄之，这些都是众工匠所共知的。至于效法天地之道，随之响应而动，调和者如回声相应，跟随者如影子相随，大道没有鬼神，独自往来。黄帝说：希望听听这个道？岐伯说：凡针刺的真谛，必先治神，五脏功能已确定，三部九候脉象已具备，然后才考虑下针。众多脉象不见异常，众多凶兆不闻，内外相合，不以形体为先，可以玩味经气的往来，然后施用于人；人有虚实，五虚证不要靠近（指病情危重不宜深刺或需谨慎），五实证不要远离（指病势亢盛需及时干预）。到了应当发针的时候，不容许有睫毛眨动般的迟疑。手部动作专注，针体光亮均匀，静心观察义理，观察适应的变化，这叫做冥冥之中，不知其形。看见气聚如乌群，看见气盛如禾穗，跟随看见气的飞动，不知是谁？潜伏时如横放的弩弓，发起时如发射机括。
刺虚证须使其充实，刺实证须使其虚弱，经气已至，谨慎守护不要丢失，深浅在意念中把握，远近感受一致，如同面临深渊，手如握虎，精神不被外界事物干扰，意无邪曲地下针，必须端正心神。
小针的要领，容易陈述但难以深入。粗劣的医生固守形体，高明的医生守护神气。神气微妙，正邪交会于门户。尚未诊察疾病，怎么知道根源？针刺的精微，在于速度的快慢。粗劣医生固守四肢关节，高明医生守护气机，气机的变动，不离空窍。空窍中的气机，清净而细微。气盛来的时候不可用补法逢迎，气虚去的时候不可用泻法追击。懂得气机之道的人，失误不会超过一根头发丝。不懂气机之道，叩问也不会有反应。知道气的往来，要把握时机。粗劣医生对此昏暗不明。精妙啊，只有工匠独有。气去为逆，气来为顺，明知逆顺，正确施行无需疑问，逆而夺之，怎么会不虚？随而济之，怎么会不实？迎随并用，以意念调和，针道也就完备了。
凡是使用针法，虚则实之，满则泄之，菀陈则除之，邪盛则虚之。大要说：持针的法则，坚实者为实证，直指正刺，不偏左右。精神集中在毫毛细微之处，意念关注病人。审视血脉，针刺就没有危险。正在针刺的时候，必须在悬阳（目）及两卫（耳）之间观察。精神专注不要离开，了解病的存亡。血脉在横向居处，看它独清澈，切按它独坚硬。
刺虚证使其充实，是针下发热，气实则热。满证使其泄减，是针下发寒。菀陈积聚清除它，是排出恶血。邪盛使其虚弱，是出针不按。徐而疾则实，是缓慢出针快速按压。疾而徐则虚，是快速出针缓慢按压。谈论实与虚，是观察血气的多少。若有若无，是疾速不可知晓。察后与先，是知道病的先后。若存若亡，是脉象时有时无。为虚与实，工匠不要丢失其法则。若得若失，是背离其法则。虚实的关键，九针最妙的，是说它们各有所宜。补泻的时机，与气的开阖相合。九针的名称各有不同形状，是因为针穷尽了其所应当补泻的作用。刺实证须使其虚，是留针直到阴气隆至，才去针。刺虚证须使其实，是阳气隆至，针下热，才去针。经气已至谨慎守护不要丢失，是不更改手法。浅深在意志，是知道病的内外。远近如一，是浅深候气相等。如临深渊，是不敢懈怠。手如握虎，是想要强壮有力。神无营于众物，是静志观察病患，不左右顾视。义无邪下，是想要端正正直。必正其神，是想要瞻望病患，自制其神，令气易行。
所谓易陈，是容易言说。难入，是难着于人。粗守形，是固守刺法。上守神，是守护人的血气有余不足，可补泻。神客，是正邪共会。神，是正气。客，是邪气。在门，是邪循正气之所出入。未睹其疾，是先知邪正何经之疾。恶知其原，是先知何经之病，所取之处。刺之微在速迟，是徐疾之意。粗守关，是固守四肢而不知血气正邪之往来。上守机，是知守气。机之动不离其空中，是知气之虚实，用针之徐疾。空中之机清净而微，是针以得气，密意守气勿失。其来不可逢，是气盛不可补。其往不可追，是气虚不可泻。不可挂以发，是说气易失。扣之不发，是说不知补泻之意。血气已尽，而气不下。知其往来，是知气之逆顺盛虚。要与之期，是知气之可取之时。粗之暗，是冥冥不知气之微密。妙哉工独有之，是尽知针意。往者为逆，是说气之虚而小，小者逆也。来者为顺，是说形气之平，平者顺也。明知逆顺正行无问，是说知所取之处。逆而夺之，是泻。随而济之，是补。所谓虚则实之，是气口虚而当补之。满则泄之，是气口盛而当泻之。菀陈则除之，是去血脉。邪盛则虚之，是说诸经有盛者，皆泻其邪。徐而疾则实，是说徐内而疾出。疾而徐则虚，是说疾内而徐出。言实与虚，若有若无，是说实者气，虚者无气。察后与先，若存若亡，是说气之虚实，补泻之先后，察其气之以下与常存。为虚与实，若得若失，是说补者恍然若有得，泻者恍然若有失。
因此工匠用针，知道气之所在，而守其门户，明于调气补泻所在，徐疾之意，所取之处。泻必用圆，切而转之，其气乃行，疾而徐出，邪气乃出，伸而逆之，摇大其穴，气出乃疾。补必用方，外引其皮，令当其门，左引其枢，右推其肤，微旋而徐推之，必端以正，安以静，坚心无解，欲微以留气，气下而疾出之，推其皮，盖其外门，神气乃存。用针之要，无泻必用方者，以气方盛也，以月方满也，以日方温也，以身方定也，以息方吸而内针；乃复候其方吸而转针，乃复候其方呼而徐引针，故曰泻必用方，其气而行焉。补必用圆者，圆者行也；行者移也。刺必中其荣，复以吸排针也，故圆与方非针也。
泻实，气盛乃内针，针与气俱内，以开其门，如利其户，针与气俱出，精气不伤，邪气乃下，外门不闭，以出其实，摇大其道，如利其路，是谓大泻。必切而出，大气乃出，持针勿置，以定其意，候呼内针，气出针入，针孔四塞，精无从出，方实而疾出针，气入针出，热不得还，闭塞其门，邪气布散，精气乃得存，动气候时，近气不失，远气乃来，是谓追吸则内针，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。扪而循之，切而散之，推而按之，弹而努之，爪而下之，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，其气已至，适而自护，候吸引针，气不得出，各在所处，推阖其门，令神气存，大气留止，故补泻弗失，与天地一。经气已至，慎守勿失，浅深在志，远近如一，如临深渊，手如握虎，神无营于众物。
持针之道，欲端以正，安以静，先知虚实，而行疾徐，左手执骨，右手循之，无与肉裹。泻欲端以正，补必闭肤，辅针导气，邪得淫 ，真气得居。
黄帝说：捍皮开腠理怎么做？岐伯说：因其分肉，左别其肤，微内而徐端之，适神不散，邪知其气所在，先得其道，稀而疏之，稍深以留，故能徐入之。大热在上，推而下之，从上下者引而去之，视先痛者常先取之。大寒在外，留而补之。入于中者，从合泻之。上气不足，推而扬之。下气不足，积而从之。寒入于中，推而行之。
夫实者，气入也。虚者，气出也。气实者，热也。气虚者，寒也。入实者，左手开针孔也。入虚者，右手闭针孔也。
形气不足，病气有余，是邪盛也，急泻之。形气有余，病气不足，此阴阳俱不足也，不可刺；刺之则重不足，重不足则阴阳俱竭，血气皆尽，五脏空虚，筋骨髓枯，老者绝灭，壮者不复矣。形气有余，病气有余，此谓阴阳俱有余也，急泻其邪，调其虚实。故曰有余者泻之，不足者补之，此之谓也。故曰刺不知逆顺，真邪相搏，满而补之，则阴阳四溢，肠胃充郭，肝肺内 ，阴阳相错；虚而泻之，则经脉空虚，血气竭枯，肠胃 辟，皮肤薄者，毛腠夭焦，子知死期。
凡用针之类，在于调气。气积于胃，以通荣卫，各行其道，宗气留于海。其下者，注于气冲，其直者，走于息道。故厥在于足，宗气不下，脉中之血，凝而留止，弗之火调，弗能散气可收，聚气可布，深居静处，占神往来，闭户塞牖，魂魄不散，专意一神，精气之分，毋闻人声，以收其精，必一其神，令志在针。浅而留之，微而浮之，以移其神，气至乃休。男内女外，坚拒勿出，谨守勿内，是谓得气。
刺之而气不至，无问其数，刺之而气至，乃去之，勿复针。针各有所宜，各不同形，各任其所，为刺之要。气至而有效，效之信，若风之吹云明乎若见苍天，刺之道毕矣。
用针者，必先察其经络之虚实，切而循之，按而弹之，视其应动者，乃复取之而下之。六经调者谓之不病，虽病谓之自己，一经上实下虚而不通者，此必有横络盛加于大经，令之不 ，视而泻之，此所谓解结也。上寒下热，先刺其项太阳久留之，已刺即熨项与肩胛令热下合乃止，此所谓推而上之者也。上热下寒，视其脉虚而陷之于经络者取之，气下乃止，此所谓引而下之者也。大热遍身，狂而妄见、妄闻、妄语，视足阳明及大络取之，虚者补之，血而实者泻之。因其偃卧，居其头前，以两手四指侠按颈动脉，久持之，卷而切推，下至缺盆中而复止如前，热去乃止，此所谓推而散之者也。
黄帝说：我听说刺法说：有余者泻之，不足者补之，什么是有余？什么是不足？岐伯说：有余有五，不足亦有五，帝欲何问？黄帝说：愿尽闻之；岐伯说：神有余，有不足，气有余有不足，血有余有不足，形有余有不足，志有余有不足，凡此十者，其气不等也。黄帝说：人有精气津液，四肢九窍，五脏十六部，三百六十五节，乃生百病，百病之生，皆有虚实。今夫子乃言有余有五，不足亦有五，何以生之乎？岐伯说：皆生于五脏也。夫心藏神，肺藏气，肝藏血，脾藏肉，肾藏志，而此成形。志意通，内连骨髓而成形五脏。五脏之道，皆出于经隧，以行血气。血气不和，百病乃变化而生，是故守经隧焉。黄帝说：神有余不足如何？岐伯说：神有余则笑不休，神不足则悲。血气未并，五脏安定，邪客于形，洒淅起于毫毛，未入于经络也。故命曰神之微。黄帝说：补泻如何？岐伯说：神有余则泻其小络之穴出血，勿之深斥，无中其大经，神气乃平。神不足者，视其虚络，按而致之，刺而利之，无出其血，无泄其气，以通其经，神气乃平。黄帝说：刺微如何？岐伯说：按摩勿释，着针勿斥，移气于不足，神气乃得复。黄帝说：气有余不足如何？岐伯说：气有余则喘咳上气，不足则息利少气，血气未并，五脏安定，皮肤微病，命曰白气微泄。黄帝说：补泻如何？岐伯说：气有余则泻其经隧，无伤其经，无出其血，无泄其气。不足则补其经隧，无出其气。黄帝说：刺微如何？岐伯说：按摩勿释，出针视之曰∶我将深之。适人必革，精气自伏，邪气散乱，无所休息，气泄腠理，真气乃相得。黄帝说：血有余不足如何？岐伯说：血有余则怒，不足则恐，血气未并，五脏安定，孙络水溢，则经有留血。黄帝说：补泻如何？岐伯说：血有余则泻其盛经，出其血；不足则补其虚经，内针其脉中，久留而视，脉大疾出其针，无令血泄。黄帝说：刺留血如何？岐伯说：视其血络，刺出其血，无令恶血得入于经，以成其疾。黄帝说：形有余不足如何？岐伯说：形有余则腹胀，泾溲不利；不足则四肢不用，血气未并，五脏安定，肌肉蠕动，命曰微风。黄帝说：补泻如何？岐伯说：形有余则泻其阳经，不足则补其阳络。黄帝说：刺微如何？岐伯说：取分肉间，无中其经，无伤其络，卫气得复，邪气乃索。黄帝说：志有余不足如何？岐伯说：志有余则腹胀飧泄，不足则厥，血气未并，五脏安定，骨节有动。黄帝说：补泻如何？岐伯说：志有余则泻然骨之前出血，不足则补其复溜。黄帝说：刺未并如何？岐伯说：即取之无中其经，邪乃立虚。
血清气滑，疾泻之则气易竭；血浊气涩，疾泻之则经可通。
(Methods for Broken Needles)
One method is to use a lodestone (magnet) to attract the broken needle from within the muscle, and the needle will be extracted.
One method is to grind ivory shavings into fine powder, mix with water to form a paste, apply it, and the needle will be extracted.
One method is to use axle grease made into a paste, spread on paper the size of a coin, change three to five times daily, and the needle will emerge.
One method is to take three or five crow or magpie feathers, roast them until charred, grind into powder, mix with good vinegar to form a paste, apply it, cover with paper one or two times, and the needle will naturally come out.
One method is to crush candle wax (from December candles), apply it, and the needle will be extracted.
One method is to grind sulfur finely, mix and apply, secure with a paper flower patch; when itching is felt, the needle will emerge.
One method is to crush two apricot kernels, mix with fresh animal fat, apply to the needle wound, and the needle will self-extract. If meridians are injured and pus/blood does not stop, use Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Rougui (Cinnamomi Cortex), Muxiang (Aucklandiae Radix), Ruxiang (Olibanum), Chenxiang (Aquilariae Lignum), separately ground with mung bean flour paste to make pills. Take fifty pills each time, administered with warm water.
The Yellow Emperor said: I have heard that in acupuncture, excess conditions are treated by reducing (Xie), and deficiency conditions by tonifying (Bu). Qibo said: The onset of all diseases involves either deficiency or excess, thus tonification and reduction methods are applied. Reducing deficiency and tonifying excess causes the Shen (Spirit) to leave its chamber, inviting pathogenic factors and losing righteous Qi, making the true condition indeterminate; this ruin is caused by incompetent practitioners but blamed on fate. Tonifying deficiency and reducing excess allows the Shen to return to its chamber and fills the emptiness over time; this is called a skilled artisan.
In using needles, one follows the flow to assist (tonify), opposes the flow to drain (reduce), tonifies deficiency to make it solid, reduces fullness to drain it, removes stagnation and old blood, and reduces pathogenic excess. Slow insertion and rapid withdrawal constitutes tonification; rapid insertion and slow withdrawal constitutes reduction. Discussing excess and deficiency feels like something there and then gone. Observing sequence and priority feels like presence and absence. Addressing deficiency and excess feels like gaining and losing. The key to deficiency and excess lies in the Nine Needles. The timing of tonification and reduction is achieved through the needle. Reduction is termed "opposing"; one must hold and insert the needle, release and withdraw it, push away the Yang aspect to obtain needle sensation, allowing pathogenic Qi to vent. Pressing and guiding the needle out is called "internal warming," preventing blood dispersion and Qi escape. Tonification is termed "following"; follow the Qi as if it were nothing. Movements resemble walking or pressing, like a mosquito bite lingering, staying then returning, withdrawing like a snapping bowstring, coordinating Left (Yin) and Right (Yang) so Qi stops naturally. The external gate closes, internal Qi becomes solid, no blood remains, and the needle is quickly removed to purge the pathogen.
If Qi does not arrive after needling, do not limit the number of manipulations. If Qi arrives, remove the needle and do not re-needle.
There are five principles of acupuncture suspended for the world: 1. Regulating the Shen (Spirit); 2. Knowing how to nourish the body; 3. Knowing medicinal drugs; 4. Determining the size of bian stones (lithic tools); 5. Diagnosing Zang-Fu organs and Qi-Blood. When these five laws are established, each has its priority. In modern times, practitioners simply tonify deficiency and reduce excess, which is common knowledge among artisans. However, following Heaven and Earth, responding spontaneously, harmonizing like an echo, following like a shadow—the Dao has no ghosts or gods, coming and going alone. The Yellow Emperor asked: I wish to hear this Dao. Qibo replied: The truth of needling requires first regulating the Shen. Once the Five Zang organs are stabilized and the Three Pulses (Jiu Hou) are prepared, then consider the needle. Do not see abnormal pulses, do not hear ominous signs; internal and external must correspond, not prioritizing form. Play with the coming and going of Qi before applying to the patient. Regarding deficiency and excess, avoid treating severe deficiency (Wu Xu) closely and severe excess (Wu Shi) distantly. When the moment to needle arrives, hesitate not. Hand movements should be focused, needles bright and even. Calmly observe the meaning, watch for changes in adaptation; this is the unseen realm, unknown in form. See Qi gathering like crows, seeing Qi abundant like grain; follow its flight, knowing not who it is. Lie still like a drawn crossbow, rise like releasing a trigger.
Tonifying deficiency requires making it solid; reducing excess requires making it empty. Once Jing Qi arrives, guard it carefully without loss. Depth is determined by intent; proximal and distal sensations are uniform. Be like facing an abyss; hand like holding a tiger. Let Shen not be distracted by worldly objects. Insert the needle straight without deviation; must rectify the Shen.
The essence of small needles is easy to state but hard to master. Incompetent doctors guard form; superior doctors guard Shen. Shen is subtle; the guest (pathogen) meets at the gate. Before seeing the disease, how can one know its origin? The subtlety of needling lies in speed. Incompetent doctors guard joints; superior doctors guard the mechanism (Ji). The movement of the mechanism does not leave the void (acupoint). The mechanism in the void is pure and subtle. Its arrival cannot be met with tonification; its departure cannot be chased with reduction. One knowledgeable in the Dao of Ji does not err by a hair's breadth. One ignorant of Ji knocks but receives no response. Knowing the coming and going, seize the opportunity. Incompetent doctors are dark to this. Wonderful indeed, only artisans possess this. Departing Qi is Ni (Rebellious/Reverse); arriving Qi is Shun (Smooth/Favorable). Knowing Ni and Shun, proceed correctly without doubt. Opposing and draining—how can it not become deficient? Following and assisting—how can it not become solid? Opposing and following, harmonizing with intent, completes the Dao of needling.
In using needles: tonify deficiency, reduce fullness, remove stagnation, reduce pathogenic excess. Generally: holding the needle firmly is solid; point straight, do not deviate left or right. Focus spirit on the finest details, attend to the patient. Examine blood vessels; needling will be safe. During needling, focus on Xuan Yang (eyes) and Liang Wei (ears). Keep Shen attached, know if the disease survives. Blood vessels lie horizontally; they appear clear upon viewing and firm upon palpation.
Tonifying deficiency makes the needle feel hot; Qi becoming solid generates heat. Reducing fullness makes the needle feel cold. Removing stagnation expels evil blood. Reducing pathogenic excess means not pressing the needle hole upon withdrawal. Slow withdrawal and rapid pressing constitutes tonification (Xu Er Ji Ze Shi). Rapid withdrawal and slow pressing constitutes reduction (Ji Er Xu Ze Xu). Discussing excess and deficiency refers to observing the abundance or scarcity of Qi and Blood. "Something there and then gone" refers to the unpredictability of speed. Observing sequence and priority refers to knowing the order of the disease. "Presence and absence" refers to the intermittent nature of the pulse. Addressing deficiency and excess means the artisan must not lose the method. "Gaining and losing" refers to deviating from the method. The Nine Needles are best for deficiency/excess because each suits specific indications. The timing of tonification/reduction aligns with the opening and closing of Qi. The different shapes of the Nine Needles allow them to exhaust their respective tonifying/reducing functions. To reduce excess, retain the needle until Yin Qi arrives abundantly, then remove. To tonify deficiency, wait until Yang Qi arrives abundantly and the needle feels hot, then remove. Guarding Qi once arrived means not changing techniques. Depth depends on knowing interior/exterior pathology. Uniformity of distance implies equal waiting for Qi at different depths. "Facing an abyss" means not being negligent. "Holding a tiger" implies strength. "Shen not distracted" means quiet observation of the patient, no looking around. "Straight insertion" implies uprightness. "Rectifying Shen" means observing the patient to control one's own Shen, facilitating Qi flow.
"Easy to state" means easy to speak of. "Hard to enter" means hard to grasp by others. "Guarding form" means adhering to technique. "Guarding Shen" means monitoring the surplus or deficit of Qi and Blood for tonification/reduction. "Shen Guest" is the meeting of Righteous and Pathogenic Qi. Shen is Righteous Qi; Guest is Pathogenic Qi. "At the gate" means the pathogen enters/exits via the Righteous Qi. "Not seeing the disease" means knowing which meridian is affected by pathogen or righteousness. "Knowing the origin" means knowing the disease location and selection points. "Subtlety in speed" refers to slow/fast manipulation. "Guarding joints" means focusing on limbs without knowing Qi/Blood dynamics. "Guarding the mechanism" means guarding Qi. "Mechanism in the void" means understanding Qi's deficiency/excess and manipulating speed accordingly. "Pure and subtle" means securing Qi once obtained. "Cannot meet arrival" means Qi is excessive, do not tonify. "Cannot chase departure" means Qi is deficient, do not reduce. "Not erring by a hair" means Qi is easily lost. "Knocking yields no response" means ignorance of tonification/reduction intent. "Qi exhausted but not descending." "Knowing coming and going" means knowing Qi's direction and strength. "Seizing the period" means knowing the optimal time to needle. "Incompetent darkness" means ignorance of Qi's subtlety. "Artisan's wonder" means complete understanding of needle intent. "Departing is Reverse" means Qi is weak and small. "Arriving is Smooth" means Form and Qi are balanced. "Knowing Reverse/Smooth" means knowing point selection. "Opposing drains" is reduction. "Following assists" is tonification. "Tonifying deficiency" means tonifying when the Qi Kou (Radial artery) is deficient. "Reducing fullness" means reducing when Qi Kou is excessive. "Removing stagnation" means clearing blood vessels. "Reducing pathogenic excess" means draining all meridians with excess. "Slow in, fast out" is tonification. "Fast in, slow out" is reduction. "Excess is Qi, Deficiency is No Qi." "Sequence and priority" refers to the order of tonification/reduction based on Qi status. "Gaining/Losing" describes the feeling of tonification (as if gaining) and reduction (as if losing).
Therefore, artisans know where Qi resides, guard the gates, understand adjustment and tonification/reduction locations, speed, and point selection. Reduction uses "Round" (Yuan): press and rotate, Qi flows, withdraw rapidly and slowly, pathogen exits, extend and oppose, enlarge the aperture, Qi exits swiftly. Tonification uses "Square" (Fang): pull skin externally to align with the gate, draw the pivot left, push skin right, rotate slightly and push slowly, keep upright and calm, firm heart without relaxation, retain Qi slightly, then withdraw Qi rapidly, push skin to close the gate, Shen Qi remains. The essence of needling: Reduction uses Fang because Qi is flourishing, moon is full, day is warm, body is stable, and inhaling to insert; wait for inhalation to rotate, exhalation to withdraw slowly. Thus "Reduction uses Fang." Tonification uses Yuan because Yuan means movement; movement means shifting. Puncture Ying (Nutrient) points, exhale to withdraw. Thus Yuan and Fang refer to methods, not needles.
Reducing excess: Insert when Qi is excessive. Needle and Qi enter together, opening the gate like a door. Needle and Qi exit together, preserving Essence Qi, expelling pathogen. External gate remains open to drain excess. Enlarge the path like a road. This is Great Reduction. Press to withdraw, major Qi exits. Hold needle steady, fix intent. Wait for exhalation to insert, Qi out/Needle in. Close needle hole, Essence cannot escape. When full, withdraw rapidly, Qi in/Needle out. Heat cannot return, gate closed, pathogen disperses, Essence preserved. Move with Qi timing, near Qi not lost, far Qi arrives. This is Pursuing Inhalation to Insert, preventing Qi conflict. Retain quietly, prevent pathogen spread. Rotate on inhalation until Qi arrives. Guide out on exhalation, remove completely when breath ends. Major Qi exits. This is named Reduction. Palpate and rub, press and scatter, push and press, flick and tense, nail down, penetrate and extract. Pull external gate to close Shen. Insert on end of exhalation, retain quietly until Qi arrives. Wait like a valued guest, ignoring time. Once Qi arrives, protect appropriately. Withdraw on inhalation, Qi cannot exit. Each stays in place. Push and close gate, let Shen Qi remain, Major Qi stay. Thus tonification/reduction is not lost, harmonizing with Heaven and Earth. Guard Qi once arrived, depth by intent, uniform sensation, face abyss, hold tiger, Shen undistracted.
Holding the needle: upright and calm. Know deficiency/excess first, then apply speed. Left hand holds bone, right hand guides, avoid wrapping flesh. Reduction requires upright insertion; Tonification requires closing skin, assisting needle to guide Qi, preventing pathogen invasion, preserving True Qi.
Yellow Emperor asked: How to open skin and interstices? Qibo replied: Follow the muscle layers, separate skin with left hand, insert slightly and slowly upright. Ensure Shen does not scatter, know pathogen location, find the Dao first, prick sparsely and lightly, deepen slightly to retain, thus entering slowly. High heat above: push downward. From top to bottom: guide and remove. Treat prior pain points first. External cold: retain and tonify. Internal entry: drain from He-Sea points. Upper Qi deficiency: push and raise. Lower Qi deficiency: accumulate and follow. Cold entering middle: push and circulate.
Excess is Qi entering. Deficiency is Qi exiting. Qi excess is heat. Qi deficiency is cold. Entering excess: open needle hole with left hand. Entering deficiency: close needle hole with right hand.
Form/Qi deficiency, Disease Qi excess: Pathogen is strong, urgently reduce. Form/Qi excess, Disease Qi deficiency: Both Yin and Yang are deficient, do not needle. Needling causes double deficiency, exhausting Yin/Yang, depleting Blood/Qi, emptying Five Zang, drying sinews/marrow/bones. Elderly perish, strong do not recover. Form/Qi excess, Disease Qi excess: Both Yin and Yang are excessive, urgently drain pathogen, adjust deficiency/excess. Thus: excess reduce, deficiency tonify. If needling ignores reverse/smooth, True/Pathogenic clash, tonifying fullness causes Yin/Yang overflow, gut/bladder distension, Liver/Lung internal pressure, Yin/Yang confusion. Reducing deficiency causes meridian emptiness, Blood/Qi exhaustion, gut/bladder collapse, thin skin, burnt hair/follicles. Know the time of death.
All needling aims to regulate Qi. Qi accumulates in Stomach, connects Ying/Wei, follows its paths, Zong Qi stays in Sea (Chest). Downward flows to Qichong. Straight flows to Respiration Path. Jue in feet: Zong Qi does not descend, blood in vessels coagulates/stagnates. Without fire regulation, Qi cannot disperse. Qi can be gathered, Qi can be distributed. Dwell quietly, observe Shen's coming/going. Close doors/windows, Hun/Po do not scatter. Focus on one Shen, divide Jing/Essence. Do not hear human voices. Gather Essence, unify Shen, focus mind on needle. Shallow retention, slight floating, shift Shen, rest when Qi arrives. Male retain internally, Female retain externally. Firmly reject outward, carefully guard inward. This is obtaining Qi.
If Qi does not arrive, ignore number. If Qi arrives, remove and do not re-needle. Needles have specific suitability, different shapes, serving their purpose. This is the essence of needling. Qi arrival brings effect. Proof of effect: like wind blowing clouds away, clearly seeing blue sky. The Dao of needling is complete.
Practitioners must first examine meridian deficiency/excess, palpate and rub, press and flick, observe reactive areas, then select and needle. Six Meridians harmonious means no disease; if diseased, it resolves itself. If one meridian has upper excess/lower deficiency with blockage, there must be transverse collaterals overflowing onto main meridians causing blockage. View and reduce this. This is untying knots. Upper cold/lower heat: needle Neck Taiyang, retain long. After needling, moxa/warm neck and scapula until heat merges downward, then stop. This is pushing upward. Upper heat/lower cold: view deficient/collapsed meridians, needle until Qi descends, then stop. This is pulling downward. Generalized high heat, mania, hallucinations, delirium: view Foot Yangming and large collaterals. Tonify deficiency, reduce blood excess. Patient lying supine, position head forward. Press carotid arteries with four fingers of both hands, hold long, roll and press, move down to Supraclavicular fossa, stop as before. Stop when heat dissipates. This is pushing and dispersing.
Yellow Emperor asked: Excess reduce, deficiency tonify. What is excess? What is deficiency? Qibo: Five types of excess, five types of deficiency. What do you ask? Emperor: Tell me all. Qibo: Shen has excess/deficiency, Qi has excess/deficiency, Blood has excess/deficiency, Form has excess/deficiency, Zhi (Will) has excess/deficiency. These ten differ in Qi. Emperor: Humans have Jing/Essence/Jin/Fluids, four limbs/nine orifices, five Zang/sixteen parts, 365 joints, generating hundred diseases, all having deficiency/excess. Why five excess/five deficiency? Qibo: All originate from Five Zang. Heart stores Shen, Lung stores Qi, Liver stores Blood, Spleen stores Flesh, Kidney stores Zhi, forming the body. Intent connects to marrow, forming Five Zang. Paths of Five Zang emerge from Jing-Tunnels, circulating Qi/Blood. Qi/Blood disharmony generates hundred diseases. Thus guard Jing-Tunnels. Emperor: Shen excess/deficiency? Qibo: Shen excess laughs incessantly; Shen deficiency weeps. Qi/Blood not combined, Zang stable, pathogen in form, chills start at hairs, not yet in meridians. Called Shen's subtlety. Emperor: Tonification/Reduction? Qibo: Shen excess: bleed small collaterals, do not pierce deep, avoid main meridians, Shen Qi balances. Shen deficiency: view deficient collaterals, press to gather, needle to facilitate, do not bleed, do not leak Qi, open meridians, Shen Qi balances. Emperor: Subtle needling? Qibo: Massage without releasing, needle without deep piercing, transfer Qi to deficiency, Shen Qi recovers. Emperor: Qi excess/deficiency? Qibo: Qi excess: panting, coughing, rebellious Qi. Qi deficiency: smooth breathing but shortness of breath. Qi/Blood not combined, Zang stable, slight skin disease, called White Qi slight leakage. Emperor: Tonification/Reduction? Qibo: Qi excess: drain Jing-Tunnels, do not injure meridian, do not bleed, do not leak Qi. Qi deficiency: tonify Jing-Tunnels, do not leak Qi. Emperor: Subtle needling? Qibo: Massage without releasing. Remove needle, say: "I will deepen." Patient reacts, Jing/Essence subside, pathogen scatters, Qi leaks from pores, True Qi obtains harmony. Emperor: Blood excess/deficiency? Qibo: Blood excess: anger. Blood deficiency: fear. Qi/Blood not combined, Zang stable, Sun-collaterals overflow, blood stasis in main meridians. Emperor: Tonification/Reduction? Qibo: Blood excess: drain vigorous meridians, bleed. Blood deficiency: tonify deficient meridians, insert into vessel, retain long, observe, withdraw quickly when pulse is large, do not bleed. Emperor: Stasis needling? Qibo: View blood collaterals, bleed, prevent evil blood entering meridians to cause disease. Emperor: Form excess/deficiency? Qibo: Form excess: abdominal fullness, difficult urination/defecation. Form deficiency: limbs unusable. Qi/Blood not combined, Zang stable, muscle twitching, called Mild Wind. Emperor: Tonification/Reduction? Qibo: Form excess: drain Yang meridians. Form deficiency: tonify Yang collaterals. Emperor: Subtle needling? Qibo: Select between muscles, avoid meridians/collaterals, Wei Qi recovers, pathogen vanishes. Emperor: Zhi excess/deficiency? Qibo: Zhi excess: abdominal fullness, undigested stool diarrhea. Zhi deficiency: reversal cold. Qi/Blood not combined, Zang stable, joint movement. Emperor: Tonification/Reduction? Qibo: Zhi excess: bleed anterior to Ran Gu. Zhi deficiency: tonify Fuliu. Emperor: Uncombined needling? Qibo: Select points, avoid meridians, pathogen immediately becomes deficient.
Clear Qi slippery: rapid drainage exhausts Qi easily. Turbid Qi stagnant: rapid drainage opens meridians.