刺虚则实之者。针下热也。气实乃热也。满而泄之者。针下寒也。气虚乃寒也。菀陈则
除之
者。出恶血也。(菀积陈久也言络脉中有积久恶血则宜除之。)邪盛则虚之者。出针勿按也。
(不按针孔以虚其在经之盛邪。)徐而疾则实者。徐出针而疾按之。(经气不泄。乃实之也)疾
而徐则虚者。疾出针而徐按之。(邪气得泄。乃虚之也。)言实与虚者。寒(虚)温(实)气多少
也。(气少为虚气多为实)若无若有者疾不可知也。(言针下气至疾速难知也)察后与先者。知
病先后也。为虚与实者。工勿失其法。(勿失虚补实泻之法)若得若失者离其法也。(言不能
守其法)虚实之要。九针最妙者为其各有所宜也。补泻之时者与气开阖相合也。(气至应时谓
之开。已过未至谓之阖又若针下气来谓之开可以迎而泻之针下气去谓之阖。可以随而补之
此皆针与气开阖相合之义○以上解灵枢九针十二原篇文)九针之名。各不同形者。针穷其所
当补泻也。则实须其虚者。留针阴气隆至针下寒乃去针也。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深浅其候
等也(四肢胸背之孔穴。虽有远近不同。其浅深。取气则一也。)如临深渊者。不敢堕也。手
如握虎者。欲其壮也。(壮。持针坚而定也。)神无营于众物者静志观病患无左右视也。(以
上解宝命全角论文。)义无邪下者。欲端以正也。必正其神者。欲瞻病患目制其神令气易行
也。(下下针也。目者。神之窍。欲正病者之神。必瞻其目制彼精神。令无散越。则气为神
使。脉道易行也。此即九针十二原篇正指直刺。无针左右。神在秋毫。属意病者。审视血脉
。刺之无殆等文之义。)
夫一天二地三人四时五音六律。七星。八风。九野。身形亦应之针各有所宜故曰九针。
人皮
应天。(无物不包。天之象也)人肉应地。(温柔博浓。地之象也)人脉应人。(内营外卫人在
气交之中之象)人筋应时(长短大小四时盈虚之象)人声应音。(清浊长短。五音之生也)人阴
阳
合气应律。(六阴六阳天地之气十二律之象也。)人齿面目应星(森罗布列星之象也。)人出入
气应风(呼吸出入风之象也)人九窍三百六十五络。应野。(形骸周遍野之象也)故一针皮二针
肉三针脉。四针筋五针骨。六针调阴阳。七针益精。八针除风。九针通九窍除三百六十五节
气。此之谓各有所主也。(总结上文。)人心意应八风。(人之心意多变天之八风无常故相应)
人气应天(气属阳而营运不息故应天)人发齿耳目五声应五音六律(发之多齿之列耳之聪目之
明五声之抑扬清浊皆纷纷不乱各有条理。故应五音六律。)人阴阳脉血气应地(人阴阳脉血气
之行于肉中。亦由经水之在土也。故应于地○自人心意应八风下复明上文不尽之意也)
刺虚证用补法，是指针下产生热感。气充实才会产生热感。泻实证，是指针下产生寒感。气虚弱才会产生寒感。“菀陈则除之”，是指出血以去除瘀血。（“菀”指郁积，“陈”指久留，意思是络脉中有久留的恶血，应当清除。）邪气盛时用泻法，是指出针时不按闭针孔。（不按针孔以使在经的盛邪得以虚泄。）“徐而疾则实”，是指缓慢出针并迅速按压针孔。（使经气不致外泄，从而达到补益的效果。）“疾而徐则虚”，是指快速出针并缓慢按压针孔。（使邪气得以外泄，从而达到泻实的效果。）所谓“言实与虚”，是指针下感觉的寒（虚）温（实）以及气的多少。（气少为虚，气多为实。）“若无若有者，疾不可知也”，是指针下气至的感觉迅速且难以察觉。（形容得气迅速，难以捉摸。）“察后与先者”，是指了解病证的先后缓急。“为虚与实者，工勿失其法”，是指医生不要违背补虚泻实的法则。“若得若失者，离其法也”，是指如果感觉气来或气去没有把握，就是偏离了操作法则。虚实治疗的要领，九针最为精妙，因为它们各自有适宜的适应症。“补泻之时者与气开阖相合也”，是指补泻的时机要与气的开阖相适应。（气至应时称为“开”，已过未至称为“阖”。另外，针下气来称为“开”，可以迎而泻之；针下气去称为“阖”，可以随而补之。这都是针与气开阖相合的意义。以上解释《灵枢·九针十二原》篇的文义。）九针的名称不同，形状各异，是因为它们穷尽了应当进行的补泻作用。对于实证需要使其转虚的，要留针，待阴气隆至，针下出现寒感后再去针。对于虚证需要使其转实的，要等待阳气隆至，针下出现热感后再去针。“经气已至，慎守勿失者”，是指不要更改已得的经气状态。“浅深在志者”，是指心中要清楚病位的内外深浅。“远近如一者，深浅其候等也”，是指虽然四肢胸背的穴位位置远近不同，但取气的深浅标准是一致的。（四肢胸背的穴位，虽然有远近不同，但其取气的深浅是一样的。）“如临深渊者”，是指不敢懈怠坠落。“手如握虎者”，是指希望持针有力坚定。（“壮”指持针坚固稳定。）“神无营于众物者”，是指静心观察病患，不要左右顾盼。（以上解释《素问·宝命全形论》的文义。）“义无邪下者”，是指下针要端正正直。“必正其神者”，是指要注视患者的眼睛以安定其精神，使经气易于运行。（下针时，眼睛是神的窍穴，要想端正病人的神志，必须注视其眼睛，控制其精神，使其不散乱，这样气就能被神所驱使，脉道就容易通行。这也就是《九针十二原》篇中“正指直刺，无针左右，神在秋毫，属意病者，审视血脉，刺之无殆”等文义的意思。）
至于天一、地二、人三、四时、五音、六律、七星、八风、九野，身形也都与之相应。因为针各有所宜，所以称为九针。人的皮肤对应天。（无所不包，是天之象。）人的肌肉对应地。（温柔浓厚，是地之象。）人的经脉对应人。（内营外卫，是人处于气交之中的象。）人的筋对应四时。（长短大小，是四时盈虚之象。）人的声音对应五音。（清浊长短，是五音产生的原理。）人的阴阳合气对应六律。（六阴六阳天地之气，是十二律之象。）人的齿、面、目对应七星。（森罗布列，是星之象。）人的呼吸出入对应八风。（呼吸出入，是风之象。）人的九窍和三百六十五络对应九野。（形骸周遍，是野之象。）所以第一针治皮，第二针治肉，第三针治脉，第四针治筋，第五针治骨，第六针调阴阳，第七针益精气，第八针除风邪，第九针通九窍、除三百六十五节气。这就叫做各有所主。（总结上文。）人的心意对应八风。（人的心意多变，如同天之八风无常，所以相应。）人的气对应天。（气属阳而营运不息，所以应天。）人的头发、牙齿、耳朵、眼睛和五种声音对应五音六律。（头发的茂密、牙齿的排列、耳朵的灵敏、眼睛的明亮、五种声音的抑扬清浊，都纷纷不乱，各有条理，所以对应五音六律。）人的阴阳脉、血、气对应地。（人的阴阳脉、血、气运行于肌肉之中，也就像河水在土壤中一样，所以应于地。○从“人心意应八风”以下，再次阐明上文未尽之意。）
Treating deficiency with tonification means that heat is felt under the needle. Heat arises when Qi becomes full. Treating excess with sedation means that cold is felt under the needle. Cold arises when Qi becomes deficient. "Removing stagnation and old blood" refers to bleeding to eliminate evil blood. ("Wen" implies accumulation, and "Chen" implies long-standing; it means that if there is accumulated evil blood in the collaterals for a long time, it should be removed.) When pathogenic factors are excessive, use sedation: do not press the needle hole upon withdrawal. (Not pressing the needle hole allows the excess pathogenic factors in the meridians to dissipate.) "Slow withdrawal and rapid pressing constitutes tonification": withdraw the needle slowly and press it rapidly. (This prevents the leakage of meridian Qi, thereby achieving tonification.) "Rapid withdrawal and slow pressing constitutes sedation": withdraw the needle rapidly and press it slowly. (This allows the pathogenic factors to escape, thereby achieving sedation.) The statement "speaking of excess and deficiency" refers to the sensations of cold (deficiency) and warmth (excess), and the quantity of Qi. (Little Qi indicates deficiency; abundant Qi indicates excess.) "As if present but as if absent, swift and unknowable" refers to the sensation of Qi arrival being rapid and difficult to discern. (It describes the Qi arriving swiftly, making it hard to grasp.) "Observing what comes after and what comes before" refers to understanding the sequence and urgency of the disease. "Addressing deficiency and excess, the practitioner must not lose the method": do not deviate from the methods of tonifying deficiency and sedating excess. "If one feels as if having obtained or lost [the Qi], it is because one has departed from the method": failing to maintain control over the Qi arrival or departure indicates a deviation from the proper technique. The key to treating deficiency and excess lies in the nine needles, which are most excellent because each is suitable for specific indications. "The timing of tonification and sedation corresponds with the opening and closing of Qi": the timing of these techniques should align with the opening and closing of Qi. (When Qi arrives at the appropriate time, it is called "opening"; when it has passed or not yet arrived, it is called "closing". Furthermore, when Qi comes under the needle, it is "opening," allowing for迎 (Ying, meeting/attacking) to sedate; when Qi goes away under the needle, it is "closing," allowing for 随 (Sui, following/supporting) to tonify. These are all meanings of the harmony between the needle and the opening/closing of Qi. The above explains the text from the *Lingshu* chapter "Nine Needles and Twelve Origins.") The names of the nine needles differ, and their shapes vary, because they exhaustively cover the necessary tonification and sedation functions. For excess conditions requiring them to become deficient, retain the needle until Yin Qi arrives abundantly and cold is felt under the needle, then remove it. For deficiency conditions requiring them to become sufficient, wait until Yang Qi arrives abundantly and heat is felt under the needle, then remove it. "When meridian Qi has arrived, guard it carefully and do not lose it": do not alter the state of the acquired Qi. "Depth and shallowness depend on intention": one must know whether the disease is internal or external. "Distance and nearness are treated equally regarding depth": although acupoints on the limbs, chest, and back vary in distance, the depth required to obtain Qi is consistent. (For acupoints on the limbs, chest, and back, although their distances differ, the depth for obtaining Qi is the same.) "Like standing on the edge of an abyss": do not dare to be negligent or drop [the needle]. "Hand like holding a tiger": desire strength and stability. ("Zhuang" refers to holding the needle firmly and steadily.) "Spirit not engaged with many things": calm the mind and observe the patient without looking left or right. (The above explains the text from the *Suwen* chapter "Treasure Life and Complete Formulation.") "Meaningful insertion without deviation": desire to insert the needle upright and correct. "Must rectify the spirit": gaze at the patient's eyes to stabilize their spirit, facilitating the flow of Qi. (Upon inserting the needle, since the eyes are the orifices of the spirit, to rectify the patient's spirit, one must gaze at their eyes to control their mental focus, preventing distraction. Thus, Qi is directed by the spirit, and the vessel pathways become easy to navigate. This embodies the meaning of the text in "Nine Needles and Twelve Origins": "Straight insertion, no deviation left or right, spirit focused on the finest details, attention on the patient, observing the blood vessels, so that needling is without danger.")
Regarding Heaven One, Earth Two, Man Three, Four Seasons, Five Tones, Six Pitch-pipes, Seven Stars, Eight Winds, Nine Fields, the human body also corresponds to them. Because each needle has its specific suitability, they are called the Nine Needles. Human skin corresponds to Heaven. (Encompassing everything, this is the image of Heaven.) Human flesh corresponds to Earth. (Gentle and thick, this is the image of Earth.) Human meridians correspond to Man. (Nourishing internally and guarding externally, this is the image of Man residing in the intersection of Qi.) Human sinews correspond to the Seasons. (Length and size reflect the waxing and waning of the four seasons.) Human voice corresponds to the Five Tones. (Clarity, turbidity, length, and shortness generate the five tones.) Human Yin-Yang combined Qi corresponds to the Six Pitch-pipes. (Six Yin and Six Yang represent the Qi of Heaven and Earth, corresponding to the twelve pitch-pipes.) Human teeth, face, and eyes correspond to the Seven Stars. (Densely arranged, this is the image of stars.) Human inhalation and exhalation correspond to the Eight Winds. (Breathing in and out mirrors the wind.) Human nine orifices and 365 collaterals correspond to the Nine Fields. (The physical form encompasses the fields like the earth.) Therefore, the first needle treats the skin, the second the flesh, the third the meridians, the fourth the sinews, the fifth the bones, the sixth regulates Yin and Yang, the seventh benefits Jing (Essence), the eighth dispels wind, and the ninth opens the nine orifices and removes the 365 joint-related Qi issues. This is called having specific dominions. (Summarizing the above.) Human intent corresponds to the Eight Winds. (Human intent is changeable, just as the eight winds of heaven are unpredictable, hence they correspond.) Human Qi corresponds to Heaven. (Qi belongs to Yang and circulates ceaselessly, thus corresponding to Heaven.) Human hair, teeth, ears, eyes, and five sounds correspond to the Five Tones and Six Pitch-pipes. (The abundance of hair, the arrangement of teeth, the acuity of hearing, the clarity of vision, and the modulation of the five sounds are orderly and distinct, thus corresponding to the five tones and six pitch-pipes.) Human Yin-Yang meridians, blood, and Qi correspond to Earth. (The movement of Yin-Yang meridians, blood, and Qi within the flesh is like water flowing in the soil, thus corresponding to Earth. ○ From "Human intent corresponds to the Eight Winds" onwards, further clarifies the未尽 (unexpressed) meaning of the previous text.)