夫圣人之起度数。必应于天地。故天有宿度。(二十八宿三百六十五度)地有经水。人有
经脉
。(清渭。海湖汝渑淮漯江河济漳。以合人之十二经脉。)天地温和。则经水安静。天寒地冻
。则经水凝泣。(不行也)天暑地热。则经水沸溢。(讥滥也)卒风暴起。则经水波涌而陇起。
(阴阳不和也。)夫邪之八于脉也。寒则血凝泣。暑则气淖泽。(皆由于寒热之变。)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。(其因虚而
入客于经。亦如经水之得风。即血脉之得气也。故致经脉亦时陇起盖邪在脉中。随正气往来
以为之动静耳。循循。随顺貌)至其寸口中手也。时大时小。大则邪至。小则平。其行无常
处。(邪气随脉。必至寸口。有邪则陇起而大。无邪则平和而小。随其所在。而为形见。故
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。(遏者。制
也。)吸则内针。无令气忤。(吸则气至刺实者去其逆气故令无忤。)静以久留。无令邪布。(
前气未除。后气将至。故当静留其针。俟而泻之无令邪气复布也。)吸则转针。以得气为度
。(邪气未泄。候病者再吸。乃搓转其针。以针下得气之故为度。)候呼引针。呼尽乃去。大
气皆出。故命曰泻。(引。引退也○入气曰吸出气曰呼。呼尽则次其吸。吸至则不兼呼。此
言泻法吸则内针。下言补法呼尽内针。可知泻法中原有先补之义)不足者补之。必先扪而循
之。(先以左手扪摸循按者。欲得其穴也。)切而散之。(以指切捺其穴。欲其气之行散也。)
推而按之。(再以指揉。按其肌肤。欲针道之流利也。)弹而怒之。(以指弹其穴。欲其意有
所注。则气必随之。故脉络 满如怒起也。)抓(音爪)而下之。(用法如前。然后以左手爪甲
掐其正穴。方下针也)通而取之。(下针之后。必候气通以取病邪)外引其门。以闭其神。(门
穴门也此得气出针之法。)呼尽内针。静以久留以气至为故。如待所贵。不知日暮。(即静以
久留候气至也。)其气以(已同至适而自护。(调适爱护。))候吸引针。气不得出。各在其处
。(候吸引针则气充于内。)推阖其门。令神气存。大气留止。故命曰补。(推阖其门则气固
于外。神气存留。故谓之补○呼尽内针以下。详言补法)
圣人制定针灸的度量标准，必定与天地自然相应。所以天有二十八宿和三百六十五度（指周天度数），地有经水（清、渭、海、湖、汝、渑、淮、漯、江、河、济、漳等十二条河流，对应人体的十二经脉）。当天地气候温和时，经水就平静；天气寒冷、大地冻结时，经水就会凝结流动不畅；天气暑热、大地炎热时，经水就会沸腾溢出；突然刮起暴风时，经水就会波涛汹涌、隆起波浪。（这是阴阳不和的表现。）
邪气侵入脉道时，遇寒则血液凝滞不通，遇暑则气血濡润滑泽。（这都是由于寒热变化引起的。）虚邪趁机侵入体内，也如同经水遇到风一样。经脉中的动脉，其搏动到达时，也会时而隆起。它在脉中运行，顺从脉道而行。（因为邪气因正气虚弱而侵入经脉，也如同经水遇风，即血脉受气的影响，所以导致经脉时而隆起。这是因为邪气在脉中，随着正气的往来而产生动静变化。“循循”意为顺从的样子。）
诊察寸口脉时，脉搏有时大有时小：脉大说明邪气已至，脉小说明病情平和。邪气在脉中的运行没有固定的处所。（邪气随脉运行，必然到达寸口，有邪气则脉隆起变大，无邪气则平和变小，随邪气所在之处而显现形态，所以说运行无常处。）无论病在阴分还是阳分，都没有固定的法度，需要顺着脉象来察辨。通过三部九候诊法，突然逢遇邪气，应尽早遏制其传变之路。（“遏”意为制约。）
泻法操作：吸气时进针，不要使正气逆乱。（吸气时气至，刺实证需去除逆气，所以不让气逆乱。）安静地长时间留针，不要让邪气扩散。（前一种气未除，后一种气将至，所以应当静留针具，等待时机以泻邪，不让邪气再次散布。）吸气时转针，以得气为度。（邪气未泄，等待病人再次吸气，然后搓转针具，以针下获得气感为标准。）呼气时引退针具，呼尽时拔针，大气（邪气）全部排出，所以称为泻法。（“引”意为引退。入气叫吸，出气叫呼。呼尽后接着是吸，吸满后不再兼呼。这里讲泻法，吸气时进针；下文讲补法，呼尽时进针，可知泻法中原先包含先补的意义。）
对于正气不足者用补法，必须先扪摸并循按穴位。（先用左手扪摸、循按，是为了准确找到穴位。）切捺并散开郁结。（用手指切捺穴位，是为了让经气行散。）推揉并按压肌肤。（再用手指揉按肌肤，是为了使进针通道流利。）弹击穴位使其充盈。（用手指弹击穴位，是为了让意念专注，气必随之而来，所以脉络充满如怒起状。）用爪甲掐穴后进针。（用法同上，然后用左手指甲掐住正穴，才下针。）疏通经络以取邪。（下针之后，必须等待气通后再取病邪。）向外牵引穴门，以闭合神气。（“门”指穴门，这是得气后出针的方法。）
补法操作：呼气尽时进针，安静地长时间留针，以气至为标准。就像等待尊贵的客人一样，不知时间已过傍晚。（即安静久留，等待气至。）气已经到达，随即自我保护（调适爱护）。等待吸气时拔针，使气不得外出，各守其位。（等待吸气时拔针，则气充实于内。）推动并闭合穴门，令神气留存，大气停留止息，所以称为补法。（推动闭合穴门，则气固守于外，神气存留，所以称为补法。以下详细讲述补法。）
The sage established the measurements for acupuncture and moxibustion, ensuring they correspond to Heaven and Earth. Thus, Heaven has the constellations and 365 degrees (referring to the celestial degrees), and Earth has its main rivers (the Qing, Wei, Hai, Hu, Ru, Mian, Huai, Luo, Jiang, He, Ji, and Zhang rivers, corresponding to the twelve meridians of the human body). When the climate of Heaven and Earth is mild, the river waters remain calm; when it is cold and the earth freezes, the river waters congeal and flow sluggishly; when it is hot and the earth is warm, the river waters boil and overflow; when sudden storms arise, the river waters surge and rise in waves (indicating disharmony of Yin and Yang).
When pathogenic factors enter the vessels, cold causes blood to congeal and stagnate, while heat makes Qi fluid and moist (both resulting from changes in cold and heat). Deficient pathogens take the opportunity to invade, much like river water encountering wind. The pulsating arteries in the meridians also rise intermittently as their movement reaches a certain point. Moving within the vessels, they follow the course smoothly (Just as pathogens invade the meridians due to deficiency, similar to river water meeting wind—i.e., blood vessels responding to Qi—the meridians thus rise intermittently. This is because pathogens within the vessels move dynamically with the fluctuation of healthy Qi. "Xunxun" describes a state of compliance or following along.)
Upon palpating the Cun Kou pulse, it may appear large or small at times: a large pulse indicates the arrival of pathogenic factors, while a small pulse indicates peace (normalcy). Pathogens move within the vessels without a fixed location (Pathogens travel with the vessels and inevitably reach the Cun Kou; presence of pathogens causes swelling and enlargement, while absence results in calmness and smallness, manifesting according to their location, hence described as moving without a fixed place). Whether affecting Yin or Yang, there is no rigid standard; one must observe by following the pulse. Through the Three Regions and Nine Palpation sites, if pathogens are suddenly encountered, their pathway should be obstructed early (To "e" means to restrain).
For the reducing method: Insert the needle during inhalation, preventing Qi rebellion (During inhalation, Qi arrives; for excess conditions, reverse Qi is removed, so one avoids causing rebellion). Retain the needle quietly for a long time to prevent the spread of pathogens (While the previous Qi remains uneliminated and new Qi approaches, retain the needle quietly to wait for the opportune moment to reduce, preventing the re-spread of pathogens). Rotate the needle during inhalation, using the arrival of De Qi as the measure (While pathogens remain, wait for the patient's next inhalation, then rotate the needle, taking the sensation of De Qi as the standard). Withdraw the needle during exhalation, removing it completely upon the end of exhalation, allowing the major Qi (pathogenic Qi) to exit entirely; this is called reduction (To "yin" means to withdraw. Inhalation is entering Qi, exhalation is exiting Qi. After complete exhalation comes inhalation; after full inhalation, exhalation does not accompany it. This text discusses the reducing method where the needle is inserted during inhalation; the subsequent text discusses tonification where the needle is inserted after complete exhalation, implying that tonification precedes reduction in the reducing method).
For deficiency, apply tonification. First, palpate and stroke the area (Using the left hand first to palpate and stroke aims to locate the acupoint accurately). Press and disperse (Pressing the acupoint with fingers aims to disperse the Qi). Push and press (Rubbing and pressing the skin with fingers aims to facilitate smooth needle insertion). Tap until distended (Tapping the acupoint focuses intention, causing Qi to follow, making the vessels full and distended like anger). Scratching and inserting (As before, use the left thumb nail to scratch the exact acupoint before inserting the needle). Unblock and extract (After insertion, wait for Qi circulation before extracting the pathogenic factor). Draw outward from the gate to close the Shen (The "gate" refers to the acupoint gate; this is the method of withdrawing the needle after obtaining De Qi).
For the tonifying method: Insert the needle after complete exhalation, retain it quietly for a long time until De Qi arrives. Wait as if for a honored guest, unaware of the passing day (This means retaining the needle quietly until Qi arrives). Once Qi has arrived, protect it carefully (Adjust and care for it). Withdraw the needle during inhalation so that Qi does not escape, remaining in its place (Withdrawing during inhalation keeps Qi filled internally). Push and close the gate, allowing Shen and Qi to remain, keeping the major Qi contained; this is called tonification (Closing the gate secures Qi externally and retains Shen and Qi, hence termed tonification. The following details the tonifying method).