补者呼气。初针刺至皮内。号曰天才。少停进针。刺至肉内。号曰人才。又停进针。刺
至筋
经走气。尽在其中。 写者吸气。针至天部。少停直至地部。得气写之。再停良久。退针人
部。待气沉紧。倒针朝病。施法同前。少停者。三息也。再停者。五息也。
经曰。徐而疾则实。疾而徐则虚者。谓徐出针而疾按之。则真气不泄而实也。疾出针而
徐按
大不相合。且针出内而分三才。肉浓穴分。用之无碍。肉薄去处。法将何施。故针者惟当察
其肉之浓薄。而酌其宜。庶几无害。经曰。刺有浅深。各正其理。此之谓也。他篇又云。补
法三次进。一次退。（假如此穴五分。先针入二分。候得气。再入二分。候得气。更入一分
。撞五分止。然后急出其针。便以左手大指按其针孔。勿令出血。）写法一次进。三次退。（
假如此穴合针五分。便针入五分。候得气。便退针二分。少停。又退二分。少停。候得气。
则起针。慢出不闭针孔。令其气出。）与此补作三次进。二次退。写作二次进。三次退。前
后所言。亦自相矛盾矣。经曰。义无斜下者。欲端以正也。谓指直刺。针无左右也。惟针阳
分。或卧针取之。赋言倒针朝病。与经相反。其曰飞经走气。考经无载。不敢妄议。
病未退者。针下如根。推之不动。转之不移。此为邪气。吸拔其针。未可出针。出则病复
。再
。搓而停之。补者吸之去疾。急扪其穴。写者呼之去徐。不闭其穴。
经曰。八正者。所以候八风之虚邪。以时至者也。四时者。所以分春夏秋冬之气所在。
以时
大刚风。东北方凶风。东南方弱风。西南方谋风。西北方折风。）虚邪也。谓乘人之虚而为
病者也。以时至者谓天应。太乙移居以八节之前后。风朝中宫而至者也。（义具天元玉册。
○
后数日。宜东风。若遇西风。亦谓之虚邪。应时者为正。冲时者为邪。）八正虚邪。宜避之
而勿犯。若以身之虚而逢天之虚。两虚相感。其气至骨。入则伤五脏。故曰天忌不可不知
也。四时之气所在。谓春气在经脉。夏气在孙络。秋气在皮肤。冬气在骨髓也。机按。此以
八节之正气。候八风之虚邪。应时而来者。谓之正。非时而至者。谓之邪。人能候而避之。
无用于针刺也。或有所犯。当随四时之气所在而调之。此亦候气之法也。故集见于此。
经曰。凡刺必候日月星辰四时八正之气。气定乃刺之。如二分二至前后五日。气未定也
。然
气实。肌肉坚。月郭空。则肌肉减。经络虚。卫气去。形独居。是以天寒无刺。天温无凝。月
生
疾温。离左酉南。月死朔而速冷。此以月之生死为期。午前卯后者。辰巳二时也。当此之时
。太阴月生。是故月郭空无写。宜疾温之。离左酉南者。未申二时也。当此之时。太阴月死
。是故月郭盈无补。宜速冷之。将一月比一日也。又云。望不补。晦不写。弦不夺。而
朔不济者。望。每月十五日也。晦。每月三十日也。弦。有上下弦。上弦。或初七或初八。
下弦。
于太乙者也。（义具天元玉册中）谨候其气之所在而刺之。气定乃刺者。谓八节之风。气静定
乃可以刺经络之虚实。故历忌云。八节前后各五日。不可刺灸。以气未定故也。机按。此亦
因天时而用针刺。皆候气之法也。故附次焉。
经曰。水下一刻。人气在阳分。水下二刻。人气在阴分。故病在三阳。必候气在阳分而
刺之。病在三阴。必候气在阴分而刺之。谨候气之所在。是谓逢时。是知气之所在。谓之实
。谓之来。气之不在。谓之虚。谓之去。故云刺实者。刺其来也。刺虚者。刺其去也。此言
气之存亡之时。以候虚实而刺之是也。故曰。谨候其时。病可与期。失时反候。百病不治。
此之谓也。又曰。邪气者。常随四时之气血而入客也。至其变化。不可为度。然必从其经气
。辟除其邪。则乱气不生。失时反候者。如春气在经脉。反刺络脉。令人少气。夏气在孙络
。反刺经脉。令人解 。秋气在皮肤。反刺筋骨。令人寒栗。冬气在骨髓。反刺肌肉。令人
善忘。故刺不知四时之经。病之所在。反之则生乱气。
经曰。写实者。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。
（切。急也。疾出其针也。大气。大邪之气。）补虚者。持针勿置。以定其意。候呼内针。气
出针入。针孔四塞。精无从去。方实而疾出针。气入针出。热不得还。闭塞其门。邪气布散
。精神乃存。动气候时。近气不失。远气乃来。是谓追之。（言但闭密其穴俞。勿令其气散
写。近气。已至之气。远气。未至之气。欲动经气而为补。必候水刻气之所在而刺之。是谓
得时而调之追补也。）
经曰。邪气中人。因其阴气。则入阴经。因其阳气。则入阳脉。无常处也。在阳与阴。
不可
矣。此所谓迎而夺之也。）帝曰。候气奈何。岐伯曰。夫邪去络入于经也。舍于血脉之中。
如涌波之起。时来时去。不常在于所候之处。故曰。方其来也。必按而止之。止而取之。又
曰。无逢其冲而写之。（冲。谓应水刻数之平气也。工以为邪而写之。则误矣。）故曰。其来
不可逢也。候邪不审。若邪已过而写之。则真气脱。脱则不复。邪气复至。而病益蓄。故曰
。其往不可追也。（邪已随经脉流去。不可复追使还也。）待邪至时。发针写矣。若先若后。
血气已虚。其病不可取。故曰。知其可取如发机。不知其取如扣椎。（机者。动之微。应之
速。椎者。动之甚。觉之迟。智者。动之微而即知。故先时而早治。愚者。动之甚尚不觉。
故后时而失治。机微椎大。因以喻之。）故曰。知机道者。不可挂以发。不知机者。扣之亦
不发
气。乃救其萌芽是也。椎者。大杵也。言气已大动。彼冥顽者。犹且不觉。正如以杵撞击。
亦不知也。故曰。下工守其已成。因败其时是也。）
经曰。真邪以合。波陇不起。候之奈何。曰。审扪循三部九候之盛虚而调之。察其左右
上下
则候气在阴分
经曰。三部九候者。头为上部。手为中部。足为下部。部各有三候。三而三之。合则为
九。
气。中部天。手太阴经渠动脉以候肺。中部地。手阳明合谷动脉以候胸中。中部人。手少阴
神门动脉以候心。下部天。足厥阴五里动脉以候肝。下部地。足少阴太溪动脉以候肾。下部人
。足太阴箕门动脉以候脾胃。经曰。人身三阴三阳。其气以何月各旺几日。难经云。冬至之
后。得甲子。少阳王。复得甲子。阳明王。复得甲子。太阳王。复得甲子。太阴王。复得甲
子。少阴王。复得甲子。厥阴王。王各六十日。此三阴三阳之王时日也。少阳之至。阳气尚
微
。故其脉洪大而长。阳极盛。则变而之阴。故夏至后为三阴用事之始。太阴之至。阴气尚微
。故其脉紧大而长。少阴之至。阴渐盛也。故其脉紧细而微。厥阴之至。阴极盛也。故其脉
沉短以敦。阴盛极。则变而之阳。仍复三阳用事之始也。此则三阴三阳之王脉。
春温夏暑秋凉冬寒。故人六经之脉。亦随四时阴阳消长送运而至也。故曰。治不本四时
。不知日月。不审逆从。不可以为工。（逆从。谓病有可治不可治也。）
经云。厥阴之至。其脉弦。少阴之至。其脉钩。太阴之至。其脉沉。少阳之至。大而浮
。阳
五运六气四时。亦皆应之而见于脉耳。难经所论。以阴阳始生之浅深而言之也。
经曰。客气谓六气更临之气。主气谓应四时正王。春夏秋冬也。○五脏各以时受病。非
其时
故各传以与之。）○邪气客于身。取之以时。故曰。春取络脉。夏取分腠。秋取气口。冬取
经输。凡此四时。各以其时为齐。络脉治皮肤。分腠治肌肉。气口治筋脉。经输治骨髓。（
邪者。不正之名。风寒暑湿饥饱劳逸。皆是邪。候可取之时而取之。如春气在经脉之类。）
○合人形以法四时五行而治。五行者。更贵更贱。（当时贵。失时贱。）以知死生而定五脏之
气。间甚之时。机按。赋言针下沉紧。为邪气盛。针下微松。为正气至。此但可以候气于针
下也。必须参究素难诸说。始知四时八节。何者为邪。何者为正。犯之而有其时。中之而有
其处。或以波陇之起。而察其外。或以三部九候。而诊其内。知脉之异于常者为邪。审脉之
应于时者为正。如此。则取之以时。治之有准。庶几万举而万全也。苟不知此。徒以赋言针
下沉紧为邪。微松为正。或逢其冲而误作邪者有也。或追其往而谬为正者有也。宁免偏之为
害哉。故比次素难诸说于此。实所以发赋之所未发欤。
或曰。灵枢经言水下一刻。人气在太阳。二刻。人气在少阳。三刻。人气在阳明。四刻
。人
五度。夜行阴二十五度。昼夜周身五十度之说不合。今医才言候气。多从此说。是欤非欤。
灵枢卫气行篇云。荣气周身五十度。无分昼夜。卫气昼但行阳二十五度。不能入于阴。
夜但
三阳。水下二刻。人气在阴分。水下三刻。人气在三阳。水下四刻。人气在阴分。是一时八
刻。周身四度有奇。方合昼夜周身五十度之说。此指荣气言也。他篇又谓。一时八刻。周身
二度。虽亦灵枢经文。以理言之。当从衍也。
补法配合呼气操作。初次针刺进入皮下，称为“天才”；稍作停顿后继续进针至肌肉层，称为“人才”；再停顿后继续进针至筋部，使经气运行通畅，这些步骤都包含在补法的操作中。
泻法配合吸气操作。将针刺入天部（浅层），稍作停顿后一直刺入地部（深层），待得气后进行泻法操作；再长时间停顿，退针至人部（中层）。待针下感觉沉紧时，倒转针尖方向朝向病所，施术方法同前。所谓的“少停”，是指三次呼吸的时间；所谓的“再停”，是指五次呼吸的时间。
《内经》说：“徐缓出针而迅速按压针孔则充实，快速出针而缓慢按压针孔则虚泄。”意思是：缓慢出针并迅速按压针孔，真气就不会外泄从而达到补益的效果；快速出针并缓慢按压针孔，邪气就能排出从而达到泻实的效果。这与将进针分为天、人、地三才的做法大不相符。况且，对于肌肉丰厚的穴位，使用三才分层进针没有妨碍；但对于肌肉薄弱的部位，又该采用什么方法呢？因此，针刺时应当观察肌肉的厚薄，酌情选择适宜的方法，这样才几乎不会造成伤害。《内经》说：“针刺有深浅之分，要符合各自的道理。”说的就是这个意思。其他篇章又说：补法是三次进针，一次退针。（假设这个穴位深五分，先刺入二分，等待得气；再刺入二分，等待得气；又刺入一分，达到五分深度为止。然后迅速拔出针，立即用左手大拇指按住针孔，不让出血。）泻法是一次进针，三次退针。（假设这个穴位应刺五分深，便直接刺入五分，等待得气；随即退针二分，稍作停顿；又退针二分，稍作停顿；等待得气后，起针。缓慢出针且不闭合针孔，让邪气排出。）这与前面所说的补法三次进、二次退，泻法二次进、三次退，前后说法自相矛盾。
《内经》说：“义无斜下者，欲端以正也。”意思是手指要直刺，针身不能左右倾斜。唯独针刺阳分时，有时需要卧针（平刺）取穴。赋文中提到的“倒针朝病”，与经文相反。至于文中提到的“飞经走气”，考证经典并无记载，不敢妄加议论。
如果病邪未退，针下感觉像有根一样，推之不动，转之不移，这是邪气盛的表现。应在患者吸气时拔针，不可立即出针，否则病会复发。再次操作时，搓针并停顿。补法在患者吸气时迅速拔针，急按针孔；泻法在患者呼气时缓慢拔针，不闭针孔。
《内经》说：“八正，是用来观察八方风邪随节气而至的情况。”四时，是用来区分春夏秋冬之气所在位置的。所谓“八风”，指来自八个方向的风：北方的大刚风，东北方的凶风，东南方的弱风，西南方的谋风，西北方的折风等，这些都是虚邪。所谓“虚邪”，是指乘人体正气虚弱之时而致病的邪气。“以时至者”是指天体运行对气候的感应，太乙神移居到各方位的前后，风从中央宫位吹向四方。（含义详见《天元玉册》）。例如，冬至后数日，宜刮东风，若遇西风，也称为虚邪。顺应时节的风为正风，违背时节的风为邪风。八节期间的虚邪，应当避开而不触犯。如果以人体的虚弱去逢天时之虚，两虚相感，邪气深入骨髓，侵入则损伤五脏。所以说，天时的禁忌不可不知。
四时之气的位置，谓春气在经脉，夏气在孙络，秋气在皮肤，冬气在骨髓。汪机按语：这里是以八节的正气，来候察八方风的虚邪。顺应时节而来的叫正风，非时而至的叫邪风。人能候察并避开它，就不需要使用针刺了。或者有所触犯，应当随着四时之气所在的位置来调理。这也是候气的方法。所以收集于此。
《内经》说：“凡针刺必须候察日月星辰和四时八正之气，气机安定后再进行针刺。如春分、秋分、夏至、冬至前后五日，气机尚未安定。”然而……（此处原文似有缺漏或排版错误，结合上下文意为：若遇到气实、肌肉坚硬的体质，或者月郭空亏时，肌肉减损，经络空虚，卫气离去，形体独存。因此天寒时不宜针刺，天温时气血不凝滞。月生之时……病势温和；月死朔之时……病势寒冷。这是以月亮的盈亏为周期。午前卯时之后，是辰、巳两个时辰。此时太阴月生，所以月郭空时不可用泻法，宜疾温之。离左酉南之时，是未、申两个时辰。此时太阴月死，所以月郭盈时不可用补法，宜速冷之。这是将一月比作一日。又说：望日（每月十五）不补，晦日（每月三十）不泻，弦日（初七、初八上弦，二十二、二十三下弦）不夺其正，朔日（初一）不济其虚。这些原则都是针对太乙神运行的规律。（含义详见《天元玉册》中）。谨慎候察气机所在位置再针刺，气定乃刺，是指八节之风，气静定时才可以刺经络的虚实。所以历书忌讳说：八节前后各五日，不可针刺艾灸，因为气机未定的缘故。汪机按语：这也是因天时而用针刺，都是候气的方法。所以附列在此。
《内经》说：水下一刻，人气在阳分；水下二刻，人气在阴分。所以病在三阳经，必须候察气在阳分时再刺；病在三阴经，必须候察气在阴分时再刺。谨慎候察气机所在，这叫“逢时”。知道气机所在，就叫“实”，叫“来”；气机不在，就叫“虚”，叫“去”。所以说：刺实证，是刺其气之来；刺虚证，是刺其气之去。这是说根据气机存亡的时机，来候察虚实而进行针刺。所以说：谨慎候察时机，病就可以预期治愈；错失时机，违背常理，百病不治。说的就是这个道理。又说：邪气常常随着四时气血的变化而入客体内。到了变化程度，无法度量。但必须顺从其经气，辟除邪气，则乱气不生。失时反候的情况，如春天气气在经脉，反而刺络脉，使人少气；夏天气在孙络，反而刺经脉，使人懈惰；秋天气在皮肤，反而刺筋骨，使人寒栗；冬天气在骨髓，反而刺肌肉，使人善忘。所以针刺不知四时经脉和病位所在，反之就会产生乱气。
《内经》说：写实者，气盛时才内针，针与气俱内，以打开门户，如同利其户。针与气俱出，精气不伤。（切，急也，疾出其针也。大气，大邪之气。）补虚者，持针勿置，以定其意，候呼内针，气出针入，针孔四塞，精无从去。方实而疾出针，气入针出，热不得还，闭塞其门，邪气布散，精神乃存。动气候时，近气不失，远气乃来，是谓追之。（言但闭密其穴俞，勿令其气散。写，近气，已至之气。远气，未至之气。欲动经气而为补，必候水刻气之所在而刺之，是谓得时而调之追补也。）
《内经》说：邪气中人，因其阴气，则入阴经；因其阳气，则入阳脉，无常处也。在阳与阴，不可……矣。此所谓迎而夺之也。）帝曰：候气奈何？岐伯曰：夫邪去络入于经也，舍于血脉之中，如涌波之起，时来时去，不常在于所候之处。故曰：方其来也，必按而止之，止而取之。又曰：无逢其冲而写之。（冲，谓应水刻数之平气也。工以为邪而写之，则误矣。）故曰：其来不可逢也。候邪不审，若邪已过而写之，则真气脱，脱则不复，邪气复至，而病益蓄。故曰：其往不可追也。（邪已随经脉流去，不可复追使还也。）待邪至时，发针写矣。若先若后，血气已虚，其病不可取。故曰：知其可取如发机，不知其取如扣椎。（机者，动之微，应之速。椎者，动之甚，觉之迟。智者，动之微而即知，故先时而早治。愚者，动之甚尚不觉，故后时而失治。机微椎大，因以喻之。）故曰：知机道者，不可挂以发。不知机者，扣之亦不发。气，乃救其萌芽是也。椎者，大杵也。言气已大动，彼冥顽者，犹且不觉。正如以杵撞击，亦不知也。故曰：下工守其已成，因败其时是也。）
《内经》说：真邪以合，波陇不起，候之奈何？曰：审扪循三部九候之盛虚而调之。察其左右上下……则候气在阴分。
《内经》说：三部九候者，头为上部，手为中部，足为下部。部各有三候，三而三之，合则为九。气。中部天，手太阴经渠动脉以候肺。中部地，手阳明合谷动脉以候胸中。中部人，手少阴神门动脉以候心。下部天，足厥阴五里动脉以候肝。下部地，足少阴太溪动脉以候肾。下部人，足太阴箕门动脉以候脾胃。
《内经》说：人身三阴三阳，其气以何月各旺几日？《难经》云：冬至之后，得甲子，少阳王。复得甲子，阳明王。复得甲子，太阳王。复得甲子，太阴王。复得甲子，少阴王。复得甲子，厥阴王。王各六十日。此三阴三阳之王时日也。少阳之至，阳气尚微……故其脉洪大而长。阳极盛，则变而之阴。故夏至后为三阴用事之始。太阴之至，阴气尚微……故其脉紧大而长。少阴之至，阴渐盛也……故其脉紧细而微。厥阴之至，阴极盛也……故其脉沉短以敦。阴盛极，则变而之阳，仍复三阳用事之始也。此则三阴三阳之王脉。
春温夏暑秋凉冬寒，故人六经之脉，亦随四时阴阳消长送运而至也。故曰：治不本四时，不知日月，不审逆从，不可以为工。（逆从，谓病有可治不可治也。）
经云：厥阴之至，其脉弦。少阴之至，其脉钩。太阴之至，其脉沉。少阳之至，大而浮。阳……五运六气四时，亦皆应之而见于脉耳。《难经》所论，以阴阳始生之浅深而言之也。
《内经》说：客气谓六气更临之气，主气谓应四时正王，春夏秋冬也。○五脏各以时受病，非其时……故各传以与之。）○邪气客于身，取之以时，故曰：春取络脉，夏取分腠，秋取气口，冬取经输。凡此四时，各以其时为齐。络脉治皮肤，分腠治肌肉，气口治筋脉，经输治骨髓。（邪者，不正之名，风寒暑湿饥饱劳逸，皆是邪，候可取之时而取之，如春气在经脉之类。）○合人形以法四时五行而治，五行者，更贵更贱。（当时贵，失时贱。）以知死生而定五脏之气。间甚之时。汪机按语：赋言针下沉紧，为邪气盛。针下微松，为正气至。此但可以候气于针下也。必须参究素难诸说，始知四时八节，何者为邪，何者为正。犯之而有其时，中之而有其处，或以波陇之起，而察其外，或以三部九候，而诊其内。知脉之异于常者为邪，审脉之应于时者为正。如此，则取之以时，治之有准，庶几万举而万全也。苟不知此，徒以赋言针下沉紧为邪，微松为正，或逢其冲而误作邪者有也。或追其往而谬为正者有也。宁免偏之为害哉。故比次素难诸说于此，实所以发赋之所未发欤。
有人问：《灵枢经》说水下一刻，人气在太阳；二刻，人气在少阳；三刻，人气在阳明；四刻……五度。夜行阴二十五度。昼夜周身五十度之说，与此不合。今医才言候气，多从此说，是欤非欤？
《灵枢·卫气行篇》云：荣气周身五十度，无分昼夜。卫气昼但行阳二十五度，不能入于阴。夜但……三阳。水下二刻，人气在阴分。水下三刻，人气在三阳。水下四刻，人气在阴分。是一时八刻，周身四度有奇，方合昼夜周身五十度之说。此指荣气言也。他篇又谓：一时八刻，周身二度。虽亦《灵枢》经文，以理言之，当从衍也。
Tonification follows exhalation. Initially, the needle is inserted into the skin layer, termed "Heavenly Origin" (Tiancai). After a brief pause, the needle is advanced into the muscle layer, termed "Human Origin" (Rencai). Following another pause, it is further advanced to the tendon level to facilitate the flow of Qi through the meridians; all these steps are encompassed within the tonification method.
Evacuation follows inhalation. The needle is inserted to the Heavenly layer (superficial), paused briefly, and then advanced directly to the Earthly layer (deep). Upon obtaining Deqi (arrival of Qi), evacuation is performed. After a prolonged pause, the needle is withdrawn to the Human layer (middle). When the needle sensation becomes heavy and tight, the needle tip is inverted to face the disease site, and the manipulation proceeds as before. The term "brief pause" refers to three breaths, while "prolonged pause" refers to five breaths.
The Classic states: "Slow withdrawal with rapid pressure results in repletion; rapid withdrawal with slow pressure results in deficiency." This means that withdrawing the needle slowly and pressing the aperture rapidly prevents the loss of True Qi, thereby achieving tonification. Conversely, withdrawing the needle rapidly and pressing the aperture slowly allows the pathogen to exit, thereby achieving evacuation. This contradicts the division of insertion into the Three Origins (Heaven, Human, Earth). Moreover, for acupoints with thick muscles, using the Three-Origin layered insertion causes no harm. However, for areas with thin muscles, what method should be applied? Therefore, when needling, one must observe the thickness of the muscle and choose an appropriate method accordingly, so as to avoid harm. The Classic states: "Puncture has depth and shallowness; each must conform to its principle." This is what is meant. Other chapters state: Tonification involves three insertions and one withdrawal. (For example, if an acupoint requires a depth of 5 cun, first insert 2 cun, wait for Deqi, insert another 2 cun, wait for Deqi, then insert the final 1 cun to reach 5 cun. Then, quickly withdraw the needle and immediately press the hole with the left thumb to prevent bleeding.) Evacuation involves one insertion and three withdrawals. (For example, if an acupoint requires a depth of 5 cun, insert directly to 5 cun, wait for Deqi, withdraw 2 cun, pause slightly, withdraw another 2 cun, pause slightly, wait for Deqi, then remove the needle. Withdraw slowly without closing the hole to allow the pathogen to exit.) This contradicts the earlier statement that tonification uses three insertions and two withdrawals, and evacuation uses two insertions and three withdrawals. The preceding statements are self-contradictory.
The Classic states: "There is no oblique downward [insertion]; this is to maintain uprightness." It means the finger must guide a straight puncture, and the needle body must not tilt left or right. Only when needling Yang regions might horizontal needling (lying needle) be used. The statement in the Ode regarding "inverting the needle to face the disease" contradicts the Classic. Regarding "Flying Meridian Moving Qi," since it is not recorded in the Classics, I dare not speculate rashly.
If the pathogen has not receded, the needle feels rooted under the skin; pushing it does not move it, rotating it does not shift it. This indicates strong pathogenic Qi. One should pull the needle during inhalation and not withdraw it completely; otherwise, the disease will recur. Repeat the procedure by搓 (rubbing/rolling) the needle and pausing. For tonification, withdraw rapidly during inhalation and urgently press the acupoint. For evacuation, withdraw slowly during exhalation and do not close the acupoint.
The Classic states: "The Eight Normals are used to observe the empty evils of the Eight Winds arriving according to solar terms." The Four Seasons are used to distinguish the locations of Qi in Spring, Summer, Autumn, and Winter. The so-called "Eight Winds" refer to winds from eight directions: Great Rigid Wind from the North, Inauspicious Wind from the Northeast, Weak Wind from the Southeast, Strategic Wind from the Southwest, and Breaking Wind from the Northwest. These are all Empty Evils. "Empty Evil" refers to pathogens that cause disease by taking advantage of the body's deficiency. "Arriving according to time" refers to heavenly resonance; Taiyi moves to positions before and after the Eight Solar Terms, and wind blows from the Central Palace to the four directions. (Meanings are detailed in *Tianyuan Yuce*). For instance, a few days after the Winter Solstice, East Wind is appropriate; if West Wind occurs, it is also called an Empty Evil. Wind conforming to the season is Proper Wind; wind opposing the season is Evil Wind. Empty Evils during the Eight Solar Terms should be avoided. If human deficiency meets heavenly deficiency, and the two emptinesses interact, the Qi reaches the bones, and entering the body damages the Five Zang Organs. Thus, it is said that heavenly taboos must not be ignored.
The location of Qi in the Four Seasons is described as: Spring Qi in the Meridians, Summer Qi in the Collaterals (Sunluo), Autumn Qi in the Skin, and Winter Qi in the Bone Marrow. Wang Ji notes: Here, the Proper Qi of the Eight Solar Terms is used to observe the Empty Evils of the Eight Winds. Those arriving in accordance with the season are called Proper; those arriving out of season are called Evil. If one can observe and avoid them, acupuncture is unnecessary. If one is affected, regulation should follow the location of Qi in the Four Seasons. This is also a method of observing Qi. Hence, it is collected here.
The Classic states: "All punctures must observe the Qi of the Sun, Moon, Stars, Four Seasons, and Eight Normals. Puncture only when the Qi is settled. For example, five days before and after the Equinoxes and Solstices, the Qi is not yet settled." However... (The text seems to have gaps or formatting errors here; context implies: If encountering excess Qi and firm muscles, or during a waning moon when muscles diminish, meridians are empty, Wei Qi departs, and the form stands alone. Therefore, do not puncture in cold weather; in warm weather, Qi does not coagulate. When the moon is waxing... diseases are mild; when the moon is new... diseases are cold. This takes the lunar cycle as a period. Before noon, after Mao hour, are Chen and Si hours. At this time, the Yin moon is waxing; thus, when the moon is hollow, do not use evacuation; quick warming is suitable. Li Zuo You Nan times are Wei and Shen hours. At this time, the Yin moon is waning; thus, when the moon is full, do not use tonification; quick cooling is suitable. This compares one month to one day. It is also said: Do not tonify on the Full Moon day (15th); do not evacuate on the Dark Moon day (30th); do not deprive on the Quarter Moon days (7th/8th upper quarter, 22nd/23rd lower quarter); do not supplement on the New Moon day. These principles apply to the movement of Taiyi. (Meanings are detailed in *Tianyuan Yuce*.) Carefully observe where the Qi is located before puncturing; puncture only when the Qi is settled. This refers to the winds of the Eight Solar Terms; only when the Qi is calm and settled can one puncture the deficiency and excess of the meridians. Hence, almanacs prohibit puncture and moxibustion for five days before and after each solar term because the Qi is unsettled. Wang Ji notes: This is also using acupuncture according to heaven's timing, all being methods of observing Qi. Hence, they are appended here.
The Classic states: At one water mark, Human Qi is in the Yang portion; at two water marks, Human Qi is in the Yin portion. Therefore, for diseases in the Three Yang meridians, one must wait for Qi to be in the Yang portion before puncturing; for diseases in the Three Yin meridians, one must wait for Qi to be in the Yin portion before puncturing. Carefully observing the location of Qi is called "Meeting the Time." Knowing where the Qi is located is called "Repletion" and "Coming"; where Qi is absent is called "Deficiency" and "Going." Thus, it is said: To puncture Repletion, puncture its Coming; to puncture Deficiency, puncture its Going. This speaks of timing the presence and absence of Qi to observe deficiency and excess for treatment. Hence, it is said: Carefully observe the time, and the disease can be expected to heal; missing the time and reversing the observation leads to untreatable diseases. This is what is meant. It is also said: Pathogenic Qi often enters the body following the changes of Qi and Blood in the Four Seasons. Its variations are immeasurable. However, one must follow the Meridian Qi to dispel the pathogen, so that chaotic Qi does not arise. Missing the time and reversing the observation, such as when Spring Qi is in the Meridians but one punctures the Collaterals, causes Qi deficiency; when Summer Qi is in the Collaterals but one punctures the Meridians, causes flaccidity; when Autumn Qi is in the Skin but one punctures the Bones and Muscles, causes chills; when Winter Qi is in the Bone Marrow but one punctures the Muscles, causes forgetfulness. Thus, if one does not know the Four Seasons' meridians and the location of the disease, doing the opposite generates chaotic Qi.
The Classic states: To evacuate Excess, insert the needle when Qi is abundant. The needle and Qi enter together, opening the gate like a door. The needle and Qi exit together, preserving Essence and not injuring it. (Qie means urgent/fast; withdrawing the needle rapidly. Da Qi refers to major pathogenic Qi.) To tonify Deficiency, hold the needle without placing it down, stabilizing the mind. Insert the needle during exhalation; as Qi exits, the needle enters. The four sides of the needle hole become sealed, preventing Essence from leaving. When the Qi is substantial, withdraw the needle rapidly; as Qi enters, the needle exits, heat cannot return, the gate is closed, pathogenic Qi disperses, and Spirit is preserved. Move the Qi and observe the time; the near Qi is not lost, and the distant Qi arrives. This is called "Pursuing." (It means only sealing the acupoint securely to prevent Qi dispersion. Jin Qi is the Qi that has arrived; Yuan Qi is the Qi that has not yet arrived. To move Meridian Qi for tonification, one must wait for the water mark and the location of Qi to puncture. This is called regulating and pursuing tonification according to the proper time.)
The Classic states: When pathogenic Qi enters the person, depending on Yin Qi, it enters Yin meridians; depending on Yang Qi, it enters Yang vessels, having no fixed location. In Yang and Yin, one cannot... This is called "Greeting and Depriving." The Emperor asked: How to observe Qi? Qibo replied: When pathogenic Qi leaves the collaterals and enters the meridians, it resides in the blood vessels, rising like waves, coming and going, not always staying in the observed place. Thus, it is said: When it comes, one must press and stop it, stop and then treat. It is also said: Do not meet its peak to evacuate. (Chong refers to the balanced Qi corresponding to the water mark count. Practitioners who mistake this for pathogenic Qi and evacuate make an error.) Thus, it is said: Its coming cannot be met. If observing the pathogen is unexamined, and one evacuates after the pathogen has passed, True Qi will deplete. Once depleted, it will not recover; the pathogen returns, and the disease accumulates. Thus, it is said: Its going cannot be pursued. (The pathogen has already flowed away with the meridians and cannot be pursued back.) Wait for the pathogen to arrive, then release the needle to evacuate. If too early or too late, Blood and Qi are already deficient, and the disease cannot be treated. Thus, it is said: Knowing when to treat is like triggering a mechanism; not knowing how to treat is like striking a club. (Ji refers to subtle movement and rapid response. Zhui refers to heavy movement and slow perception. The wise perceive subtle movements immediately and treat early. The foolish do not perceive heavy movements until late and miss treatment. Ji is subtle, Zhui is large, hence the metaphor.) Thus, it is said: One who knows the Way of the Mechanism cannot let a hair hang; one who does not know, even if struck, will not react. Qi is saving the sprout. Zhui is a large pestle. It means when Qi moves greatly, the stubborn ones still do not perceive. Just as hitting with a pestle, they do not know. Thus, it is said: Low-grade practitioners guard what is already formed, ruining the time.
The Classic states: When True and Pathogenic merge, and waves do not rise, how to observe? Answer: Examine and palpate the abundance and deficiency of the Three Parts and Nine Hopes to regulate. Observe left, right, above, below... then observe if Qi is in the Yin portion.
The Classic states: The Three Parts and Nine Hopes are: Head is the Upper Part, Hands are the Middle Part, Feet are the Lower Part. Each part has three hopes. Three times three makes nine. Qi. Middle Part Heaven: Hand Taiyin Jingqu artery to observe Lung. Middle Part Earth: Hand Yangming Hegu artery to observe Chest/Middle Jiao. Middle Part Human: Hand Shaoyin Shenmen artery to observe Heart. Lower Part Heaven: Foot Jueyin Wuli artery to observe Liver. Lower Part Earth: Foot Shaoyin Taixi artery to observe Kidney. Lower Part Human: Foot Taiyin Jimen artery to observe Spleen/Stomach.
The Classic states: In the human body, the Three Yin and Three Yang, in which months and days does their Qi prosper? *Nan Jing* says: After the Winter Solstice, upon getting Jiazi, Shaoyang prospers. Upon getting another Jiazi, Yangming prospers. Upon getting another Jiazi, Taiyang prospers. Upon getting another Jiazi, Taiyin prospers. Upon getting another Jiazi, Shaoyin prospers. Upon getting another Jiazi, Jueyin prospers. Each prospers for sixty days. These are the days and times of prosperity for the Three Yin and Three Yang. When Shaoyang arrives, Yang Qi is still slight... thus its pulse is洪大 (Hongda, broad and long). When Yang reaches extreme abundance, it transforms into Yin. Thus, after the Summer Solstice begins the operation of the Three Yin. When Taiyin arrives, Yin Qi is still slight... thus its pulse is tight, large, and long. When Shaoyin arrives, Yin gradually increases... thus its pulse is tight, fine, and slight. When Jueyin arrives, Yin reaches extreme abundance... thus its pulse is deep, short, and solid. When Yin reaches extreme abundance, it transforms into Yang, resuming the operation of the Three Yang. These are the prosperous pulses of the Three Yin and Three Yang.
Spring warmth, Summer heat, Autumn coolness, Winter cold. Thus, the pulses of the Six Meridians in humans also arrive following the waxing and waning of Yin and Yang in the Four Seasons. Hence, it is said: Treatment not based on the Four Seasons, not knowing the Sun and Moon, not examining reversal and compliance, cannot make a skilled practitioner. (Reversal and compliance refer to whether a disease is treatable or not.)
The Classic says: When Jueyin arrives, its pulse is Xian (string-like). When Shaoyin arrives, its pulse is Gou (hook-like). When Taiyin arrives, its pulse is Chen (deep). When Shaoyang arrives, it is Da (large) and Fu (floating). Yang... The Five Movements and Six Qi of the Four Seasons also respond and appear in the pulse. The discussion in *Nan Jing* speaks of the shallowness and depth of the initial generation of Yin and Yang.
The Classic states: Ke Qi (Guest Qi) refers to the Qi of the Six Qi succeeding each other. Zhu Qi (Host Qi) refers to the Proper Prosperity corresponding to the Four Seasons, Spring, Summer, Autumn, Winter. ○ The Five Zang Organs each suffer disease according to the time; if not the time... thus they transmit to give it. ○ When pathogenic Qi lodges in the body, take it according to time. Hence, it is said: In Spring, take Collateral vessels; in Summer, take Fen Cou (interstices); in Autumn, take Qi Kou (radial artery); in Winter, take Jing Shu (transport points). All these Four Seasons, each uses its time as the standard. Collateral vessels treat the Skin; Fen Cou treats the Muscles; Qi Kou treats the Tendons and Vessels; Jing Shu treats the Bone Marrow. (Xie refers to the name of the abnormal; Wind, Cold, Summer Heat, Dampness, hunger, fullness, labor, and rest are all Xie. Observe the time for taking and take it, such as Spring Qi in the Meridians.) ○ Combine human form to model the Four Seasons and Five Elements for treatment. The Five Elements alternate in nobility and baseness. (Noble when in time, base when out of time.) To know life and death and determine the Qi of the Five Zang Organs. Times of interval and severity. Wang Ji notes: The Ode states that heaviness and tightness under the needle indicate strong pathogenic Qi. Slight looseness under the needle indicates arrival of Proper Qi. This can only be used to observe Qi under the needle. One must consult the theories of *Su Wen* and *Nan Jing* to know which of the Four Seasons and Eight Solar Terms are Evil and which are Proper. Offending it has its time; hitting it has its place. Either observe the outside by the rising of waves, or diagnose the inside by the Three Parts and Nine Hopes. Knowing the pulse different from normal is Evil; examining the pulse responding to the time is Proper. Thus, taking according to time and treating with precision ensures ten thousand successes and ten thousand wholes. If one does not know this, merely taking the Ode's statement that heaviness and tightness under the needle is Evil and slight looseness is Proper, there are those who mistake meeting the Chong as Evil. There are those who pursue the past and erroneously consider it Proper. Can one avoid the harm of bias? Hence, compiling the theories of *Su Wen* and *Nan Jing* here is truly to reveal what the Ode did not express.
Someone asked: *Ling Shu Jing* states that at one water mark, Human Qi is in Taiyang; at two marks, in Shaoyang; at three marks, in Yangming; at four marks... five degrees. Night travels Yin twenty-five degrees. The theory of fifty degrees around the body day and night does not match. Now, medical practitioners speaking of observing Qi mostly follow this theory. Is it correct or incorrect?
*Ling Shu · Wei Qi Xing Pian* states: Ying Qi circulates the body fifty degrees,不分昼夜 (regardless of day or night). Wei Qi travels only in Yang twenty-five degrees during the day and cannot enter Yin. At night it travels... Three Yang. At two water marks, Human Qi is in the Yin portion. At three water marks, Human Qi is in the Three Yang. At four water marks, Human Qi is in the Yin portion. This is eight marks per shichen, four degrees plus remainder around the body, which fits the theory of fifty degrees around the body day and night. This refers to Ying Qi. Another chapter states: Eight marks per shichen, two degrees around the body. Although this is also *Ling Shu* text, logically speaking, it should be considered a derivative/error.