黄帝问曰∶有余不足，余已闻虚实之形，不知其何以生？岐伯曰∶气血以并，阴阳相倾
，气乱于卫，血逆于经。血气离居，一实一虚。血并于阴，气并于阳，故为惊狂；血并于阳，
气并于阴，乃为炅中；血并于上，气并于下，心烦惋喜怒；血并于下，气并于上，乱而喜忘
。上下谓鬲上下。
帝曰∶血并于阴，气并于阳，如是血气离居，何者为实？何者为虚？岐伯
曰∶血气者，喜温而恶寒，寒则泣不能流，温则消而去之，是故气之所并为血虚，血之所并
帝曰∶人之所有者，血与气耳。今夫子乃言血并为虚，气并为虚，是无实乎？岐伯曰∶
有者为实，无者为虚，故气并则无血，血并则无气，今血与气相失，故为虚焉。络之与孙脉
，俱输于经，血与气并，则为实焉。血之与气，并走于上，则为大厥，厥则暴死，气复反则
生，不反则死。
帝曰∶实者何道从来？虚者何道从去？虚实之要，愿闻其故。岐伯曰∶夫阴与阳皆有俞会
。阳注于阴，阴满之外，阴阳匀平，以充其形，九候若一，命曰平人。夫邪之生也，或生于
阴，或生于阳。其生于阳者，得之风雨寒暑；其生于阴者，得之饮食居处，阴阳喜怒。
帝曰∶风雨之伤人奈何？曰∶风雨之伤人也，先客于皮肤，传入于孙脉，孙脉满则传入
于络脉，络脉满则输于大经脉，血气与邪并客于分腠之间，其脉坚大，故曰实。实者外坚充
满，不可按之，按之则痛。
帝曰∶寒湿之伤人奈何？曰∶寒湿之中人也，皮肤不收，肌肉坚紧，荣血泣，卫气去
，故曰虚。虚者聂辟气不足，按之则气足以温之，故快然而不痛。
帝曰∶阴之生实奈何？曰∶喜怒不节，则阴气上逆，上逆则下虚，下虚则阳气走之，故
曰实矣。帝曰∶阴之生虚奈何？曰∶喜则气下，悲则气消，消则脉虚空，因寒饮食，寒气熏
满，则血泣气去，故曰虚矣。
帝曰∶经言阳虚则外寒，阴虚则内热，阳盛则外热，阴盛则内寒，余已闻之矣，不知其
所由然也。岐伯曰∶阳受气于上焦，以温皮肤分肉之间，今寒气在外，则上焦不通，上焦不
通，则寒气独留于外，故寒栗。帝曰∶阴虚生内热奈何？曰∶有所劳倦，形气衰少，谷
气不盛，上焦不行，下脘不通，胃气热，热气熏胸中，故内热。帝曰∶阳盛生外热奈何
？曰∶上焦不通利，则皮肤致密，腠理闭塞，玄府不通，卫气不得泄越，故外热。帝曰
∶阴盛生内寒奈何？曰∶厥气上逆，寒气积于胸中而不泻，不泻则温气去，寒独留，则血凝
泣，凝则脉不通，其脉盛大以涩，故中寒。
帝曰∶阴与阳并，血气以并，病形以成，刺以奈何？曰∶刺此者，取之经隧，取血于营
，取气于卫。用形哉，因四时多少高下。
帝曰∶夫子言虚实者有十，生于五脏，五脏五脉耳。夫十二经脉，皆生其病，今夫子独
言五脏，夫十二经脉者，皆络三百六十五节，节有病，必被经脉，经脉之病，皆有虚实，何
以合之？岐伯曰∶五脏者故得六腑与为表里，经络支节，各生虚实，其病所居，随而调之。
病在脉，调之血；病在血，调之络；病在气，调之卫；病在肉，调之分肉；病在筋，调之筋
；病在骨，调之骨。燔针劫刺其下及与急者，病在骨淬针药熨。病不知所痛，两跷为上。
身形有痛，九候莫病，则缪刺之。痛在于左而右脉病者，巨刺之。必谨察其九候，针道备矣
黄帝问道：有余和不足，我已经听过了虚实的外在表现，但不知道它们是如何产生的？岐伯回答说：气血相互偏聚，阴阳相互倾轧，气在卫分紊乱，血在经脉中逆乱。血和气分离居住，一处实而一处虚。血偏聚于阴分，气偏聚于阳分，所以产生惊狂；血偏聚于阳分，气偏聚于阴分，就会产生内热（炅中）；血偏聚于上部，气偏聚于下部，就会心烦郁闷、喜怒无常；血偏聚于下部，气偏聚于上部，就会神志混乱且容易遗忘。这里的上下是指膈肌的上下方。
黄帝说：血偏聚于阴分，气偏聚于阳分，像这样血气分离居住，哪一个是实？哪一个是虚？岐伯说：血和气，喜欢温暖而厌恶寒冷，寒冷时血液凝涩不能流通，温暖时则消散流动而去除病邪，因此气偏聚的地方血就虚，血偏聚的地方气就虚。
黄帝说：人拥有的东西，不过是血与气罢了。现在先生您说血并聚为虚，气并聚也为虚，难道就没有实证了吗？岐伯说：有者为实，无者为虚，所以气偏聚则导致该处无血（相对血虚），血偏聚则导致该处无气（相对气虚），如今血与气分离失和，所以表现为虚证。络脉和孙脉都输送血液到经脉，如果血与气相并聚，那么就成为实证。血与气一起向上冲逆，就会发生大厥证，厥证发作时会突然死亡，如果气能回复下行则生，不能回复则死。
黄帝说：实证是从什么途径来的？虚证是从什么途径去的？虚实的关键，希望听听其中的缘故。岐伯说：阴和阳都有腧穴交会之处。阳气注入阴分，阴气充满于外，阴阳平衡均匀，以充实形体，三部九候脉象一致，这叫做平人（健康人）。邪气的产生，有的生于阴分，有的生于阳分。那些生于阳分的，是由于风雨寒暑侵袭；那些生于阴分的，是由于饮食起居不当，以及情绪上的喜怒失调。
黄帝说：风雨伤害人体是怎样的情况？岐伯说：风雨伤人，先客居于皮肤，传入孙脉，孙脉满盛则传入络脉，络脉满盛则输注到大经脉，血气与邪气共同客居在分肉腠理之间，脉象坚实盛大，所以称为实证。实证表现为体表坚硬充满，不可按压，按压就会疼痛。
黄帝说：寒湿伤害人体是怎样的情况？岐伯说：寒湿中人，皮肤松弛不收摄，肌肉坚紧，营血凝涩，卫气耗散，所以称为虚证。虚证表现为肌肤颤动收缩、气不足，按压后气得以温煦，所以感到舒适而不痛。
黄帝说：阴分产生实证是怎么回事？岐伯说：喜怒没有节制，会导致阴气上逆，上逆则下部虚，下部虚则阳气趋向于填补它，所以说这是实证。
黄帝说：阴分产生虚证是怎么回事？岐伯说：喜则气缓而下陷，悲则气消减，消减则脉道空虚，再加上吃冷食，寒气熏蒸满布，导致血行凝涩、气机耗散，所以称为虚证。
黄帝说：经文说阳虚则体表恶寒，阴虚则体内发热，阳盛则体表发热，阴盛则体内寒冷，我已经听说了，但不知道其中的原因。岐伯说：阳气受气于上焦，用来温煦皮肤和分肉之间，现在寒气在外，导致上焦不通畅，上焦不通畅，则寒气独自留滞于体表，所以出现寒战。
黄帝说：阴虚产生内热是怎么回事？岐伯说：由于过度劳累，形体之气衰少，谷气不旺盛，上焦不能宣通，下脘不能通畅，胃气郁而化热，热气熏蒸于胸中，所以产生内热。
黄帝说：阳盛产生外热是怎么回事？岐伯说：上焦不通利，导致皮肤致密，腠理闭塞，汗孔不通，卫气不能宣泄越出，所以产生外热。
黄帝说：阴盛产生内寒是怎么回事？岐伯说：厥气上逆，寒气积聚在胸中而不能排泄，不能排泄则温煦之气离去，寒气独留，导致血液凝涩，凝涩则脉道不通，脉象盛大而涩，所以产生内寒。
黄帝说：阴与阳相并，血与气相并，病形已经形成，针刺应当如何治疗？岐伯说：针刺此病，取用经隧，从营分取血，从卫分调气。要根据患者的体质形态，因应四季气候的变化，决定针刺的深浅和次数。
黄帝说：先生所说的虚实有十种，都生于五脏，五脏对应五脉而已。十二经脉都能产生疾病，现在先生只谈五脏，十二经脉都联络三百六十五个关节，关节有病，必然波及经脉，经脉的病都有虚实，为什么把它们合在一起论述呢？岐伯说：五脏本来与六腑互为表里，经络肢节，各自产生虚实，根据病变所在的部位，随之进行调理。病在脉，调理血；病在血，调理络脉；病在气，调理卫气；病在肉，调理分肉；病在筋，调理筋；病在骨，调理骨。用燔针劫刺其下方及拘急的部位，病在骨则用淬针配合药熨。如果身体疼痛但无法指出具体痛点，且三部九候脉象无明显异常，则采用缪刺法。疼痛在左侧而右侧脉象有病者，采用巨刺法。必须仔细诊察三部九候脉象，针刺的道理就完备了。
Huangdi asked, saying: Regarding excess and deficiency, I have already heard of the forms of Xu (Deficiency) and Shi (Excess), but do not know how they arise. Qibo replied: When Qi and Xue (Blood) merge together, Yin and Yang incline against each other; Qi becomes chaotic in the Wei (Defensive) level, and Xue (Blood) rebels in the Jing (Main) channels. When Xue (Blood) and Qi separate from their proper residence, one part becomes Shi (Excess) and the other Xu (Deficiency). If Xue (Blood) merges into Yin and Qi merges into Yang, it results in Jing Kuang (Fright and Mania); if Xue (Blood) merges into Yang and Qi merges into Yin, it results in Jiong Zhong (Internal Heat); if Xue (Blood) merges upward and Qi merges downward, it causes Xin Fan Wan Nuxi (Mental restlessness, depression, anger, and joy); if Xue (Blood) merges downward and Qi merges upward, it causes Luan er Xi Wang (Confusion and forgetfulness). "Up and down" refers to above and below the Ge (Diaphragm).
The Emperor said: When Xue (Blood) merges into Yin and Qi merges into Yang, thus Xue (Blood) and Qi separate from their residence, which is Shi (Excess) and which is Xu (Deficiency)? Qibo said: Xue (Blood) and Qi prefer warmth and dislike cold. Cold causes them to congeal and fail to flow, while warmth causes them to dissipate and move away. Therefore, where Qi merges, Xue (Blood) is deficient; where Xue (Blood) merges, Qi is deficient.
The Emperor said: What humans possess are merely Xue (Blood) and Qi. Now you say that when Xue (Blood) merges it is Deficient, and when Qi merges it is also Deficient. Is there no Excess? Qibo said: That which is present is Excess, that which is absent is Deficient. Thus, when Qi merges, there is no Xue (Blood) [in that specific location], and when Xue (Blood) merges, there is no Qi [in that specific location]. Since Xue (Blood) and Qi have lost each other, it is considered Deficiency. However, Luo (Collateral) vessels and Sun (Fine) vessels all transport to the Jing (Main) channels; when Xue (Blood) and Qi merge together, it becomes Excess. If Xue (Blood) and Qi both rush upward, it results in Da Jue (Great Revulsion/Jue Syndrome), which can cause sudden death. If the Qi returns [downward], the patient lives; if it does not return, the patient dies.
The Emperor said: From what path does Excess come? From what path does Deficiency go? I wish to hear the reason for the essence of Excess and Deficiency. Qibo said: Both Yin and Yang have Shu Hui (Acupoints and Intersections). Yang flows into Yin, and Yin fills outwardly. When Yin and Yang are balanced and even, filling the form, and the Nine Palpations are uniform, this is called a Ping Ren (Healthy Person). The generation of Xie (Pathogenic factors) occurs either from Yin or from Yang. Those generated from Yang result from Wind, Rain, Cold, and Summer-Heat; those generated from Yin result from Diet and Dwelling, and emotions of Joy and Anger.
The Emperor said: How do Wind and Rain injure the human body? He replied: When Wind and Rain injure people, they first lodge in the Skin, transmit to the Sun (Fine) vessels; when Sun vessels are full, they transmit to the Luo (Collateral) vessels; when Luo vessels are full, they transport to the Da Jing (Large/Main) channels. Xue (Blood) and Qi merge with the Pathogen and lodge between the Fen Cou (Intervals of skin and flesh). The pulse is firm and large, hence it is called Excess. Excess manifests as external firmness and fullness; it cannot be pressed, and pressing causes pain.
The Emperor said: How do Cold and Dampness injure the human body? He replied: When Cold and Dampness strike people, the Skin fails to contract, the Muscles become firm and tight, Ying (Nutritive) Blood congeals, and Wei (Defensive) Qi departs; hence it is called Deficiency. Deficiency manifests as Nie Pi (Trembling and contraction) due to Qi insufficiency. Pressing it replenishes Qi to warm the area, so it feels comfortable and painless.
The Emperor said: How does Yin generate Excess? He replied: Unregulated Joy and Anger cause Yin Qi to rebel upward. Upward rebellion leads to Deficiency below; Deficiency below causes Yang Qi to rush toward it, hence it is called Excess.
The Emperor said: How does Yin generate Deficiency? He replied: Joy causes Qi to sink downward, Sorrow causes Qi to dissipate. Dissipation leads to empty and deficient pulses. Combined with consuming cold food, Cold Qi steams and fills, causing Blood to congeal and Qi to depart; hence it is called Deficiency.
The Emperor said: The Classics state: Yang Deficiency leads to external Cold, Yin Deficiency leads to internal Heat, Yang Excess leads to external Heat, and Yin Excess leads to internal Cold. I have heard this, but do not know its origin. Qibo said: Yang receives Qi from the Shang Jiao (Upper Burner) to warm the Skin and Fen Rou (Muscle intervals). Now, if Cold Qi is outside, the Shang Jiao (Upper Burner) becomes blocked. If the Shang Jiao (Upper Burner) is blocked, Cold Qi remains alone on the exterior, causing Han Li (Chills/Shivering).
The Emperor said: How does Yin Deficiency generate Internal Heat? He replied: Due to labor and fatigue, the Form and Qi decline, Gu Qi (Grain Qi) is insufficient, the Shang Jiao (Upper Burner) fails to circulate, and the Xia Wan (Lower Stomach/Epigastrium) fails to open. Wei Qi (Stomach Qi) becomes hot, and Hot Qi steams the Chest Center, thus generating Internal Heat.
The Emperor said: How does Yang Excess generate External Heat? He replied: If the Shang Jiao (Upper Burner) is not unobstructed, the Skin becomes dense, the Cou Li (Pores) close, and the Xuan Fu (Sweat Pores) are blocked. Wei (Defensive) Qi cannot vent and escape, thus generating External Heat.
The Emperor said: How does Yin Excess generate Internal Cold? He replied: Jue Qi (Revulsing Qi) rebels upward, and Cold Qi accumulates in the Chest Center without being discharged. Without discharge, Warm Qi departs, leaving Cold alone. This causes Blood to congeal and stagnate; stagnation blocks the Pulse. The pulse is large and rough, thus generating Internal Cold.
The Emperor said: When Yin and Yang merge, and Xue (Blood) and Qi merge, forming the disease pattern, how should acupuncture be applied? He replied: To treat this, utilize the Jing Sui (Channel tunnels), extract Xue (Blood) from the Ying (Nutritive) level, and regulate Qi from the Wei (Defensive) level. Use appropriate techniques based on the patient's constitution and adjust the depth and frequency according to the Four Seasons.
The Emperor said: You mentioned ten types of Excess and Deficiency, originating from the Five Zang Organs, corresponding to five pulses. The Twelve Jing Mai (Meridians) all generate diseases. Why do you only speak of the Five Zang Organs? The Twelve Jing Mai (Meridians) connect with the 365 Jie (Joints), and joint diseases must affect the meridians. Meridian diseases all have Excess and Deficiency. How do these combine? Qibo said: The Five Zang Organs naturally have the Six Fu Organs as their interior-exterior pairs. The Jing Luo (Meridians and Collaterals) and limbs/joints each generate Excess and Deficiency. According to the location of the disease, adjust it accordingly. Disease in the Pulse, regulate the Blood; disease in the Blood, regulate the Luo (Collaterals); disease in the Qi, regulate the Wei (Defensive); disease in the Flesh, regulate the Fen Rou (Muscle intervals); disease in the Sinews, regulate the Sinews; disease in the Bone, regulate the Bone. Use Fan Zhen (Fire-needling) to劫刺 (rapidly puncture/stimulate) the lower areas and sites of spasm. For bone diseases, use Cui Zhen (Quenched needles) combined with Yao Re (Medicated heat packs). If the body has pain but the patient cannot locate it, and the Nine Palpations show no abnormality, apply Miu Ci (Lateral Puncture). If pain is on the left but the right pulse is diseased, apply Ju Ci (Major Puncture). One must carefully observe the Nine Palpations; thus, the principles of needling are complete.