太阳为开。(谓阳气发于外。为三阳之表也。)开折。则肉节渎。而暴病起矣。(折。损
伤也。)渎者皮肉宛 而弱也。(消瘦干苦之谓。)阳明为阖。(谓阳气蓄于内。为三阳之里也。)
阖折。则气无所止息。而痿疾起矣。无所止息者。真气稽留。(谓胃气不行。)邪气居之矣少
阳为枢。(谓阳气在表里之间可出可入如枢机也。)枢折。即骨徭而不安于地。骨徭者。节缓
而不收也。太阴为开。(居阴分之表也。)开折则仓廪无所输。(不营运也。)膈洞。(膈。隔
塞。洞者。食不化。下嗌还出也。)厥阴为阖。(居阴分之里也。)阖折即气绝而喜悲。(肝伤
。则肺气乘之也。)少阴为枢。(居阴。分之中也。)枢折。则脉有所结而不通。(下焦不通也
。○素问。阴阳离合篇与此略同。)
王公大人。血食之君。身体柔脆肌肉软弱。血气剽悍滑利。其刺之徐疾浅深多少者。气
滑则
浅则欲疾。以此观之。刺布衣者深以留之。刺大人者。微以徐之。此皆因气剽悍滑利也。形
气不足。病气有余。是邪胜也。急泻之。形气有余。病气不足(正气衰也)急补之。形气不足
。病气不足。此阴阳俱不足也。不可刺之刺之。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
写其邪。调其虚实(既刺之后防其骤虚故宜调之也。)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(补泻反施。乃为之逆。不知逆顺则真气与。邪气相搏病必
甚也)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 。子之死期。(HT 丑涉切畏怯也辟邪 不正也。薄着。
瘦而涩也夭短折也。)故曰用针之要。在于知调阴与阳。调阴与阳。精气乃光。合形与气。
使神内藏。故曰上工平气。中工乱脉。下工绝气危生。故曰下工。不可不慎也。必审五脏变
化之病。五脉之应。经络之实虚。皮之柔粗而后取之也。
太阳主开。（意思是阳气发散于体表，是三阳经的表层。）如果“开”的功能受损，就会导致肌肉关节松弛涣散，从而引发突发的疾病。（“折”，意为损伤。）所谓“渎”，是指皮肉消瘦干枯且软弱无力。
阳明主阖。（意思是阳气蓄积于体内，是三阳经的里层。）如果“阖”的功能受损，则气机无法停留安息，从而引发痿证（肢体萎软无力之病）。所谓气机无法停留安息，是因为真气停滞不行。（意思是胃气运行不畅。）邪气便占据其中。
少阳主枢。（意思是阳气处于表里之间，可出可入，如同门轴枢纽一样。）如果“枢”的功能受损，就会出现骨骼动摇、站立不稳的情况。所谓“骨徭”，是指关节弛缓而不能收敛固摄。
太阴主开。（居于阴分的表层。）如果“开”的功能受损，则脾胃运化功能失常，水谷精微无法正常输布。（即不能正常营运。）导致膈塞不通、洞泄不止。（“膈”，指隔塞；“洞”，指食物不消化，吃下去又从口中吐出。）
厥阴主阖。（居于阴分的里层。）如果“阖”的功能受损，则气机断绝而容易悲伤。（因为肝受伤，肺气就会乘虚侵袭。）
少阴主枢。（居于阴分的中间。）如果“枢”的功能受损，则经脉会有结滞而不通畅。（指下焦气机不通畅。）○《素问·阴阳离合篇》与此处内容大致相同。
王公大人，是享受肉食供养的君主贵族，他们的身体柔嫩脆弱，肌肉软弱，但血气却剽悍滑利。对他们进行针刺时，进针的快慢、深浅和多少应当如何把握？因为他们的血气滑利，所以进针宜浅且速度要快。由此看来，对平民百姓（布衣）针刺应深刺并留针；对权贵大人针刺应轻刺且缓慢。这都是因为他们的血气剽悍滑利所致。
形体正气不足，而病邪之气有余，这是邪气盛实的表现，应当急用泻法。形体正气有余，而病邪之气不足（指正气衰微），应当急用补法。如果形体正气不足，病邪之气也不足，这是阴阳两虚的表现，不可针刺。如果强行针刺，就会造成双重亏损。双重亏损，会导致阴阳俱竭，血气耗尽，五脏空虚，筋脉失养，骨髓枯竭。老年人会因此死亡，强壮的人也无法恢复。如果形体正气有余，病邪之气也有余，这叫做阴阳俱实，应当急泻其邪气，并调理虚实（既然已经施针，为了防止正气骤然虚弱，所以适宜进行调理）。所以说，实证用泻法，虚证用补法，就是这个道理。
所以说，如果针刺不懂得辨别逆顺（补泻的反向操作即为逆，不懂逆顺则真气与邪气相互搏结，病情必然加重），对于实证反而用补法，则阴阳之气四溢，肠胃胀满，肝肺受到压迫，阴阳之气错乱。对于虚证反而用泻法，则经脉空虚，血气枯竭，肠胃枯槁，皮肤薄脆，毛发憔悴，这是病人死亡的预兆。（“HT”音丑涉切，意为畏怯；“辟”通“僻”，不正之意。“薄着”指瘦弱涩滞，“夭”指短折。）
所以说，用针的要领，在于懂得调和阴阳。调和阴阳，精气就能光明旺盛。结合形体与气机，使神气内藏。所以说，高明的医生能平调气机，一般的医生会使经脉紊乱，低劣的医生则会耗绝正气，危及生命。所以说，使用针灸不可不谨慎啊。必须详细审察五脏变化的病症，五脉的应象，经络的虚实，皮肤的柔粗，然后才决定取穴治疗。
The Taiyang governs the opening. (This means that Yang Qi emanates outward, serving as the exterior of the three Yang meridians.) If the opening function is impaired (Zhe, meaning damage), the flesh and joints become lax and disordered, leading to the sudden onset of disease. "Du" refers to the emaciation and weakness of the skin and muscles.
The Yangming governs the closing. (This means that Yang Qi is stored within, serving as the interior of the three Yang meridians.) If the closing function is impaired, Qi has no place to rest or settle, giving rise to Wei syndrome (flaccidity syndrome). The state of Qi having no place to rest implies that the True Qi stagnates (meaning Stomach Qi fails to circulate), allowing Pathogenic Qi to occupy the space.
The Shaoyang governs the pivot. (This means that Yang Qi resides between the exterior and interior, capable of exiting and entering like a door hinge.) If the pivot function is impaired, the bones sway unsteadily, making it difficult to stand firmly on the ground. "Gu Yao" refers to loose joints that fail to contract and hold firm.
The Taiyin governs the opening. (Residing at the exterior of the Yin aspect.) If the opening function is impaired, the granary (Spleen/Stomach) fails to transport and transform nutrients. (i.e., normal physiological operation ceases.) This leads to diaphragmatic obstruction and洞泄 (turbid diarrhea/food regurgitation). "Ge" refers to blockage; "Dong" refers to undigested food being vomited back up after swallowing.
The Jueyin governs the closing. (Residing at the interior of the Yin aspect.) If the closing function is impaired, Qi becomes severed, leading to a predisposition for sorrow/grief. (Because Liver injury allows Lung Qi to invade.)
The Shaoyin governs the pivot. (Residing in the center of the Yin aspect.) If the pivot function is impaired, there are knots in the meridians causing obstruction and lack of flow. (Referring to the obstruction of the Lower Jiao.) ○ This content is roughly consistent with the *Suwen: Yin-Yang Li He Pian* (Chapter on the Separation and Union of Yin and Yang).
Kings and nobles, who consume meat and are rulers, have bodies that are soft and fragile with weak muscles, yet their Blood and Qi are swift, fierce, and slippery. When needling them, one must consider the speed, depth, and quantity of insertion. Because their Qi is slippery, shallow insertion and rapid manipulation are required. From this perspective, needling commoners (buyi) requires deep insertion and retention, whereas needling nobles requires light and slow manipulation. This is all due to their swift, fierce, and slippery Qi.
If physical constitution and Zheng Qi (Upright Qi) are insufficient, but pathogenic Qi is excessive, this indicates an excess of evil. Urgent application of the reducing method is required. If physical constitution and Zheng Qi are excessive, but pathogenic Qi is insufficient (indicating decline of Righteous Qi), urgent application of the reinforcing method is required. If both physical constitution/Zheng Qi and pathogenic Qi are insufficient, this represents insufficiency of both Yin and Yang. Needling should not be performed. If needled, it causes double insufficiency. Double insufficiency leads to exhaustion of both Yin and Yang, depletion of Blood and Qi, emptiness of the Five Zang organs, withering of sinews, and exhaustion of bone marrow. The elderly will perish, and even the robust will not recover. If both physical constitution and pathogenic Qi are excessive, this is termed excess of both Yin and Yang. Urgent reduction of the pathogen is required, followed by regulation of deficiency and excess (after needling, to prevent sudden collapse of Qi, regulation is appropriate). Thus it is said: excess is reduced, deficiency is reinforced. This is what is meant.
Therefore, if one does not understand the principles of reversal and compliance (applying reinforcement where reduction is needed is called 'reversal'; failing to understand this leads to conflict between True Qi and Pathogenic Qi, worsening the disease), applying reinforcement to fullness causes Yin and Yang to overflow, intestines and stomach to distend, liver and lungs to be compressed, and Yin and Yang to become disordered. Applying reduction to emptiness causes meridians to become empty, Blood and Qi to exhaust, intestines and stomach to wither, skin to become thin, and hair/coat to deteriorate, signaling the approach of death. ("HT" pronounced 'che', meaning fear/timidness; "Pi" means crooked/abnormal. "Bo zhuo" means thin and emaciated; "Yao" means short-lived/fractured.)
Thus it is said: the essence of acupuncture lies in knowing how to regulate Yin and Yang. Regulating Yin and Yang allows Jing Qi (Essence Qi) to shine brightly. Harmonizing form and Qi allows Shen (Spirit) to remain internally stored. Thus it is said: superior practitioners level Qi; average practitioners disrupt meridians; inferior practitioners exhaust Qi and endanger life. Therefore, inferior practitioners must exercise extreme caution. One must carefully examine diseases arising from changes in the Five Zang, the responses of the five pulses, the excess and deficiency of meridians, and the texture of the skin before selecting acupoints.