七十九难曰∶经言迎而夺之，安得无虚？随而济之，安得无实？虚之与实，若得若失；实之
与虚，若有若无，何谓也？
经言《灵枢·九针十二原篇》曰∶迎而夺之，恶得无虚，随而济之，恶得无实。迎之随之，
以意和之，针道毕矣。小针解曰∶言实与虚，若有若无者，言实者有气，虚者无气也。为虚为实，
若得若失者，言补者 然若有得也，泻则恍然若有失也，此节全引经文问补泻虚实之义也。
然∶迎而夺之者，泻其子也；随而济之者，补其母也。假令心病，泻手心主输，是谓迎而夺之
者也；补手心主井，是谓随而济之者也。
迎而夺之者，泻也。随而济之者，补也。假令心病，泻手心主输者，心为君主，法不受病，受
病者，手心主包络也。《灵枢》所谓少阴无输者是也。心，火也，包络属手厥阴，相火也。其
输大陵，土也。土为火之子，泻其输，乃实则泻其子也。迎谓取气，夺谓泻气也。心主之井，
中冲木也，木为火之母，今补心主之井，乃虚则补其母也，随谓自卫取气，济谓补不足之经也。
所谓实之与虚者，牢濡之意也。气来实牢者为得，濡虚者为失，故曰若得若失也。
五脏虚即补其母，是谓随而济之也；实即泻其子，是谓迎而夺之也。欲为补泻，当先候针下
之气；如气来充实坚牢者为得，可泻之；如气来濡弱虚微者为失，可补之。设不明实牢虚濡，
安能辨其若得若失也哉！
按∶汪机曰∶《内经》岐伯曰∶迎而夺之，恶得无虚，言邪之将发也，先迎而亟夺之，无令
邪布，故曰卒然逢之，早遏其路。又曰∶方其来也，必按而止之，此皆迎而夺之，不使其传经而
走络也。仲景曰∶太阳病头痛，七日以上自愈者，以行其经尽故也。若欲作再经者，针足阳明，
使经不传则愈。刺疟篇曰∶疟发身方热，刺跗上动脉，开其孔，出其血立寒。疟方欲寒，刺手
阳明太阴，足阳明太阴，随井输而刺之，出其血，此皆迎而夺之之验也。夫如是者，譬如贼将
临境，则先夺其便道，断其来路，则贼失其所利，恶得不虚，而流毒移害，于此可免矣。随而
济之，恶得无实，言邪之已过也，随后以济助之，无令气忤。故曰神不足者，视其虚络，按而
致之，刺而利之，无出其血，无泄其气，以通其经，神气乃平。谓但通经脉，使其和利，抑按
虚络，令其气致。又曰∶太阴疟，病至则善呕，呕已乃衰，即取之，言其衰即取之也。此皆随
而济之，因其邪过经虚，而气或滞郁也。经曰∶刺微者，按摩勿释，着针勿斥，移气于不足，
神气乃得复。岐伯曰∶补必用员，员者行也，行者移也，谓行未行之气，移未复之脉，此皆随
而济之之证也。所以然者，譬如人弱难步，则随助之以力，济之以舟，则彼得有所资，恶得不
实，其经虚气之郁，于此可免矣。迎夺随济，其义如此。《难经》曰∶迎而夺之者，泻其子也，
随其济之者，补其母也。假令心病，火也，土为火之子，手心主之输，大陵也，实则泻之，是
迎而夺之也。木者火之母，手心主之井，中冲也，虚则补之，是随而济之也。迎者迎于前，随
者随其后，此假心为例，余可类椎。补泻之云手心主，所谓少阴无输，手少阴与手厥阴同治也。
调气必在阴阳者，内为阴，外为阳，里为阴，表为阳，察其病之在阴在阳而调之也。如阴虚阳
实，则补阴泻阳，阳虚阴实，则补阳泻阴。或阳并于阴，阴并于阳，或阳阴俱虚俱实，皆随其
所见而调之。《内》《难》所论迎随不同者，《内经》通各经受病言，《难经》主一经受病言，
病合于《内经》者，宜从《难经》子母迎随之法治之，各适其宜，庶合经意。又《玄珠经》曰∶
五运之中，必折其郁气，先取化源，其法∶太阳司天，取九月泻水之源；阳明司天，取六月泻
金之源；少阴司天，取三月泻火之源；太阴司天，取五月泻土之源；厥阴司天，取年前十二月
泻木之源，乃用针迎而取之之法也。详此迎取之法，乃治气运胜实淫郁，故用此法以治之，与
《内》《难》之法不同也。汪氏会通《内》《难》，释明迎随补泻之义，亦颇晓畅，有益来兹，
不嫌重复，故并录之。
第七十九难说：经文中讲“迎而夺之”，怎么能不导致虚证呢？“随而济之”，怎么能不导致实证呢？虚与实的变化，就像得到了又像失去了；实与虚的表现，就像存在又像不存在，这是什么意思呢？
经文引用《灵枢·九针十二原篇》的话说：“迎而夺之”，怎么会不虚呢？“随而济之”，怎么会不实呢？迎着病气方向针刺以削弱它，顺着病气方向针刺以资助它，用意念来调和经气，针刺的道理就完备了。《小针解》解释说：所谓虚实表现若有若无，是说实证时经气充实，虚证时经气空虚。所谓补泻效果若得若失，是说补法后患者感觉好像有所收获（舒适），泻法后患者感觉好像有所丧失（轻松）。这一节完全引用经文来询问补泻虚实含义的问题。
回答：所谓“迎而夺之”，是指泻其子穴；所谓“随而济之”，是指补其母穴。例如心病，泻手厥阴心包经的输穴，这就叫“迎而夺之”；补手厥阴心包经的井穴，这就叫“随而济之”。
“迎而夺之”就是泻法，“随而济之”就是补法。例如心病，泻手厥阴心包经的输穴，因为心为君主之官，法则不受邪气侵犯，受邪的是手厥阴心包络。这就是《灵枢》所说的“少阴无输”的意思。心属火，心包络属于手厥阴，属相火。心包络的输穴是大陵，五行属土。土是火的子行，泻其输穴，就是“实则泻其子”的原则。“迎”指迎着经气方向取气，“夺”指泻除邪气。心包经的井穴是中冲，五行属木，木是火的母行，现在补心包经的井穴，就是“虚则补其母”的原则。“随”指顺着经气方向自卫取气，“济”指资助不足的经脉。
所谓“实之与虚”，指的是脉象牢实与濡弱的意蕴。经气来势坚实牢固的是“得”（有效/正气存），濡弱虚微的是“失”（无效/正气去），所以说“若得若失”。
五脏虚证就补其母穴，这叫“随而济之”；五脏实证就泻其子穴，这叫“迎而夺之”。想要进行补泻操作，应当先候察针下的经气变化；如果经气来势充实坚牢，说明邪气盛，可以泻之；如果经气来势濡弱虚微，说明正气虚，可以补之。如果不明白实牢与虚濡的区别，怎么能辨别什么是“若得若失”呢！
按语：汪机说：《内经》中岐伯说：“迎而夺之”，怎么会不虚呢？这是说在邪气将要发作时，先迎着它迅速夺取它，不让邪气散布，所以说“卒然逢之，早遏其路”。又说：“方其来也，必按而止之”，这些都是“迎而夺之”，不让邪气传经走络。张仲景说：太阳病头痛，七天以上自愈的，是因为邪气在经脉中运行已尽的缘故。如果想要传入下一经（再经），针刺足阳明经，使邪气不传变就能痊愈。《刺疟篇》说：疟疾发作身体正发热时，刺足背上的动脉，打开孔穴，放出血液，立刻退热。疟疾正要发冷时，刺手阳明、手太阴、足阳明、足太阴经，顺着井穴和输穴针刺，放出血液，这些都是“迎而夺之”的验证。像这样的情形，譬如贼寇即将临境，就先夺取其便利通道，切断其来路，那么贼寇就失去了利益，怎么能不虚呢？流毒转移危害，由此可以避免。
“随而济之”，怎么会不实呢？这是说邪气已经过去的时候，随后资助扶助正气，不让经气逆乱。所以说“神不足者，视其虚络，按而致之，刺而利之，无出其血，无泄其气，以通其经，神气乃平”。意思是只疏通经脉，使其和利，抑按虚损的络脉，使经气汇聚。又说：“太阴疟，病至则善呕，呕已乃衰，即取之”，是说邪气衰退时就取穴治疗。这些都是“随而济之”，因为邪气已过经脉导致虚弱，或者气机滞郁。经文说：“刺微者，按摩勿释，着针勿斥，移气于不足，神气乃得复”。岐伯说：“补必用员，员者行也，行者移也”，意思是运行未运行的气，移动未恢复的脉，这些都是“随而济之”的例证。之所以这样，譬如人虚弱难以行走，就跟随并助力他，用车船渡济他，那么他就能有所依靠，怎么能不实呢？经脉虚弱气机郁滞，由此可以避免。
“迎夺随济”的意义就是这样。《难经》说：“迎而夺之者，泻其子也；随而济之者，补其母也。”例如心病，属火，土为火之子，手厥阴心包经的输穴是大陵，实证就泻它，这叫“迎而夺之”。木为火之母，手厥阴心包经的井穴是中冲，虚证就补它，这叫“随而济之”。“迎”是迎向前方，“随”是跟随其后，这里以心为例，其余脏腑可类推。补泻提到手厥阴心包经，是因为所谓“少阴无输”，手少阴心经与手厥阴心包经共同治疗。
调气必须分辨阴阳，内为阴，外为阳，里为阴，表为阳，察看病位在阴在阳而进行调理。如阴虚阳实，则补阴泻阳；阳虚阴实，则补阳泻阴。或者阳并于阴，阴并于阳，或者阴阳俱虚俱实，都根据所见情况加以调理。《内经》与《难经》所论迎随不同之处，《内经》泛指各经受病的情况，《难经》主要指一经受病的情况。病情符合《内经》理论的，宜采用《难经》子母迎随之法治疗，各自适合其宜，才合乎经义。另外《玄珠经》说：在五运之中，必须折服其郁结之气，先取化源。其方法是：太阳司天之年，取九月泻水之源；阳明司天之年，取六月泻金之源；少阴司天之年，取三月泻火之源；太阴司天之年，取五月泻土之源；厥阴司天之年，取年前十二月泻木之源，这是用针“迎而取之”的方法。详细考察这种迎取之法，是治疗气运胜实淫溢郁结的，所以用此法治疗，与《内经》《难经》的方法不同。汪氏融会贯通《内经》《难经》，阐明迎随补泻的意义，也很晓畅，有益于后人，不嫌重复，所以一并录下。
Chapter 79 states: The Classics say, "If one meets and deprives (Ying Er Duo Zhi), how can there be no deficiency?" "If one follows and assists (Sui Er Ji Zhi), how can there be no excess?" The changes between deficiency and excess are like gaining and losing; the manifestations of excess and deficiency are like existing and not existing. What does this mean?
The Classics quote from *Ling Shu · Jiu Zhen Shi Er Yuan* (Spiritual Pivot · Nine Needles and Twelve Origins): "If one meets and deprives, how can it not become deficient? If one follows and assists, how can it not become excessive? Meeting and following, harmonizing with intention, completes the Dao of needling." *Xiao Zhen Jie* (Explanation of the Small Needle) explains: Regarding the manifestation of excess and deficiency as if existing or not existing, it means that in excess conditions, Qi is present; in deficiency conditions, Qi is absent. Regarding the effects of tonification and sedation as if gained or lost, it means that after tonification, the patient feels as if they have gained something (comfort); after sedation, the patient feels as if they have lost something (relief). This section entirely quotes the Classics to inquire about the meaning of tonification, sedation, excess, and deficiency.
Answer: "Meeting and depriving" refers to sedating the Son point; "Following and assisting" refers to tonifying the Mother point. For example, in Heart disease, sedating the Shu point of the Pericardium Meridian of Hand-Jueyin is called "meeting and depriving"; tonifying the Jing-Well point of the Pericardium Meridian of Hand-Jueyin is called "following and assisting."
"Meeting and depriving" is sedation; "following and assisting" is tonification. For example, in Heart disease, sedating the Shu point of the Pericardium Meridian of Hand-Jueyin: The Heart is the Sovereign Monarch and, by principle, does not accept pathogenic factors; the factor accepted is the Pericardium (Bao Luo). This corresponds to what *Ling Shu* calls "Shaoyin has no Shu points." The Heart belongs to Fire; the Pericardium belongs to Hand-Jueyin and represents Ministerial Fire. Its Shu point, Daling (PC7), belongs to Earth. Earth is the Son of Fire; sedating its Shu point is the principle of "sedating the Son in excess conditions." "Ying" (Meet) refers to taking Qi against the flow; "Duo" (Deprive) refers to draining pathogenic Qi. The Jing-Well point of the Pericardium Meridian is Zhongchong (PC9), belonging to Wood. Wood is the Mother of Fire; now, tonifying the Jing-Well point of the Pericardium Meridian is the principle of "tonifying the Mother in deficiency conditions." "Sui" (Follow) refers to taking Qi along the defensive flow for self-protection; "Ji" (Assist) refers to supplementing the meridian lacking sufficiency.
Regarding "excess and deficiency," it refers to the sensation of firmness and softness. When Qi arrives firmly and solidly, it is "gain" (effective/presence of Zheng Qi); when it arrives soft and weak, it is "loss" (ineffective/absence of Zheng Qi). Hence, it is said "as if gained, as if lost."
When the Five Zang organs are deficient, tonify their Mother points; this is called "following and assisting." When they are excess, sedate their Son points; this is called "meeting and depriving." To perform tonification or sedation, one must first observe the Qi under the needle. If the Qi arrives full, solid, and firm, indicating excess, it can be sedated; if the Qi arrives soft, weak, and minute, indicating deficiency, it can be tonified. If one does not understand the difference between firm/solid and soft/weak, how can one distinguish between "gain" and "loss"?
Commentary: Wang Ji stated: In *Nei Jing*, Qibo said, "'Meeting and depriving,' how can it not be deficient? This refers to when pathogens are about to erupt; one first meets them and quickly deprives them, preventing the spread of pathogens. Thus it is said, 'Suddenly encountering them, block their path early.' It also says, 'When they arrive, press and stop them.' These are all examples of 'meeting and depriving,' preventing transmission through meridians and collaterals." Zhang Zhongjing said: "In Taiyang disease with headache, if it heals spontaneously after seven days or more, it is because the pathogen has exhausted its course in the meridian. If it is about to transmit to another meridian, needle the Foot-Yangming meridian to prevent transmission and achieve cure." The *Ci Nie Pian* (Chapter on Acupuncture for Malaria) states: "When malaria fever is just rising, needle the arterial pulse on the dorsum of the foot, open the aperture, and release blood to immediately reduce fever. When malaria chills are about to start, needle the Hand-Yangming, Hand-Taiyin, Foot-Yangming, and Foot-Taiyin meridians, following the Jing-Well and Shu points to release blood. These are all validations of 'meeting and depriving.'" Such cases are like bandits approaching the border; one first seizes their convenient routes and cuts off their approach. Then the bandits lose their advantage. How can they not become deficient? The spread of toxicity and harm can be avoided thereby.
"'Following and assisting,' how can it not be excessive? This refers to when pathogens have already passed; one follows to assist and support the body's Qi, preventing Qi rebellion. Thus it is said, 'For those with insufficient Shen, observe the deficient collaterals, press to gather Qi, needle to facilitate flow, do not release blood, do not vent Qi, to unblock the meridians so that Shen Qi becomes balanced.' This means only unblocking the meridians to make them harmonious, pressing the deficient collaterals to cause Qi to gather. It also says: 'In Taiyin malaria, upon onset, there is frequent vomiting; after vomiting, the condition declines, so treat it then.' This means treating when the pathogen has declined. These are all examples of "following and assisting," addressing the deficiency after the pathogen passes or stagnation/depression of Qi. The Classic states: 'For mild conditions, massage without releasing, insert the needle without pushing away, transfer Qi to the deficient area, and Shen Qi will recover.' Qibo said: 'Tonification must use circular movements; circular means movement; movement means shifting.' This means moving Qi that has not yet moved, shifting meridians that have not yet recovered. These are all proofs of "following and assisting." The reason is like a person too weak to walk; one follows to help with strength and assists with a boat/cart. Then they have support. How can they not become substantial? Deficient meridians and depressed Qi can be avoided thereby.
Thus is the meaning of "meeting/depriving" and "following/assisting." *Nan Jing* states: "'Meeting and depriving' is sedating the Son; 'following and assisting' is tonifying the Mother." For example, Heart disease belongs to Fire; Earth is the Son of Fire. The Shu point of the Pericardium Meridian is Daling; in excess, sedate it—this is "meeting and depriving." Wood is the Mother of Fire; the Jing-Well point of the Pericardium Meridian is Zhongchong; in deficiency, tonify it—this is "following and assisting." "Ying" (Meet) is ahead; "Sui" (Follow) is behind. This uses the Heart as an example; others can be inferred by analogy. Mentioning the Pericardium Meridian for tonification/sedation is due to the saying "Shaoyin has no Shu points"; Hand-Shaoyin (Heart) and Hand-Jueyin (Pericardium) are treated together.
Regulating Qi requires distinguishing Yin and Yang: interior is Yin, exterior is Yang; inside is Yin, outside is Yang. Observe whether the disease is in Yin or Yang and regulate accordingly. If Yin is deficient and Yang is excess, tonify Yin and sedate Yang; if Yang is deficient and Yin is excess, tonify Yang and sedate Yin. Or if Yang merges into Yin, Yin merges into Yang, or both Yin and Yang are deficient/excess, regulate according to the observed pattern. The difference between *Nei Jing* and *Nan Jing* regarding Ying-Sui is that *Nei Jing* discusses diseases affecting various meridians generally, while *Nan Jing* focuses on diseases affecting a single meridian. When the disease conforms to *Nei Jing* principles, one should adopt the *Nan Jing* method of mother-son Ying-Sui regulation, each fitting its appropriateness, thus conforming to the Classic's intent. Furthermore, *Xuan Zhu Jing* states: Among the Five Movements, one must break the stagnant Qi and first take the source of transformation. The method is: In years ruled by Taiyang, in the ninth month, drain the source of Water; in years ruled by Yangming, in the sixth month, drain the source of Metal; in years ruled by Shaoyin, in the third month, drain the source of Fire; in years ruled by Taiyin, in the fifth month, drain the source of Earth; in years ruled by Jueyin, in the twelfth month of the previous year, drain the source of Wood. This is the method of using needles to "meet and take." Detailed examination shows this "meeting and taking" method treats excessive, overflowing, and stagnant Qi patterns caused by climatic influences, differing from the methods in *Nei Jing* and *Nan Jing*. Wang Ji integrated *Nei Jing* and *Nan Jing*, clarifying the meaning of Ying-Sui tonification and sedation clearly. It benefits future generations, so despite repetition, it is recorded here.