黄帝问曰。愿闻九针之解。虚实之道。（按针经首篇。论九针虚实之道。而小针解有未尽之义。故帝复有此问焉。）
岐伯对曰。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。
（菀音郁。所谓虚则实之者。气口虚而当补之也。候其阳气隆至。针下既热。乃去针也。盖气实乃热也。满而泄之者。
气口盛而当泻之也。候其阴气隆至。针下已寒。乃去针也。盖气虚乃寒也。菀、积也。陈、久也。菀陈则除之者。去血
脉也。盖以恶血积久于脉络之中。所当除去之也。）邪胜则虚之者。出针勿按。（言诸经有盛者。皆当泻其邪。出针之时。
勿按其 。令邪气之随针而外泄也。）徐而疾则实者。徐出针而疾按之。疾而徐则虚者。疾出针而徐按之。（徐而疾则虚
者。谓针已得气。乃徐出之。针既出穴。则速按之。使正气不泄而实。此补虚之法也。疾而徐则虚者。言邪气已至。乃
疾出之。针既出穴。则徐按之。使邪实可泄而虚。此泻实之法也。按此论与小针解不同。小针解曰。徐而疾则实者。言
徐内而疾出也。疾而徐则虚者。言疾内而徐出也。盖以针之出入分疾徐也。本篇之所谓疾徐者。论出针之疾徐。按 之
疾徐也。故名之曰针解者。解小针解之未尽也。夫刺之微在迟速疾徐。而两经各尽其妙。所谓迎之随之。以意和之。针
道始备。）言实与虚者。寒温气多少也。（言实与虚者。谓针下寒而气少者为虚。邪气已去也。针下热而气多者为实。正
气已复也。）若无若有者。疾不可知也。（气之虚实。若有若无。当静守其气。疾则不可知也。）察后与先者。知病先后也。
（夫病有标本。先病为本。后病为标。治有取标而得者。有取本而得者。故当知病之先后。察其应后者后取之。应先者
先取之。）为虚与实者。工勿失其法。若得若失者。离其法也。（虚则实之。实则虚之。补泻之法。当守而勿失。若有得
若有失者。是失其法也。）虚实之要。九针最妙者。为其各有所宜也。九针之用。热在头身宜 针。取分肉间气宜圆针。
取气出邪宜 针。刺痈热出血宜锋针。刺大痈出脓热宜铍针。调阴阳去瘫痹宜圆利针。去寒热痛痹宜毫针。取深邪远痹
宜长针。人气留于关节宜大针。为其各有所宜也。）补泻之时者。与气开阖相合也。（气来谓之开。可以迎而泻之。气去
谓之阖。可以随而补之。补泻之时。与气开阖相合。故曰刺实者。刺其来也。刺虚者。刺其去也。）凡针之名。各不同形
者。针穷其所当补泻也。（九针之名。有 圆 锋之殊分。九针之形。有大小长短之不等。各尽其所当补泻之用而制之也。）
刺实须其虚者留针。阴气隆至。乃去针也。刺虚须其实者。阳气隆至。针下热。乃去针也。（留针所以候气也。阴气隆至。
针下寒也。阳气已退。实者虚矣。阳气隆至。针下热也。元气已复。虚者实矣。俱当候其气至。而后乃可去针。）经气已
至。慎守勿失者。勿更改也。（针已得气。慎守而勿失。勿使其气有更改也。）深、浅在志者。知病之内外也。（志者。心
之所之也。病在外者宜刺浅。病在内者宜刺深。当属意病者。知所取之处也。）近远如一者。深浅其候等也。（刺之或浅
或深。虽有远近不同。然俱以得气为期。故其候相等无二也。）如临深渊者。不敢惰也。（行针之际。当谨慎之至。）手如
握虎者。欲其壮也。（持针如握虎。欲其坚定而不怯也。）神无营于众物者。静志观病患。无左右视也。（行针之道。贵在
守神。静志以观病患。以候其气。无左右视。以惑乱其神志焉。按小针解云。上守神者。守人之血气有余不足。可补泻
也。此篇先论守己之神。以合彼之神。所谓神乎神。耳不闻。昭然独明。若风吹云。）义无邪下者。欲端以正也。（下针
之法。义不容邪。故当端以正。）必正其神者。欲瞻病患目。制其神。令气易行也。（正其神者。定病患之神也。瞻病患
之目。无使其邪视。制彼之神气专一。令病者之气易行也。按以上诸节之上句。与九针篇相同。下句则与小针解各别。
盖复解九针虚实之道。以补未尽之义。）所谓三里者。下膝三寸也。所谓跗之者。举膝分易见也。巨虚者。跷足 独陷者。
下廉者。陷下者也。（三里在膝下三寸。跗之者。足跗上之冲阳脉也。下三里三寸为巨虚上廉。复下上廉三寸为巨虚下廉。
自三里循上廉下廉而至跗上冲阳之动脉。皆属足阳明胃经。独举此胃经而言者。言针之候气。候阳明所出之营卫也。故
针经曰。用针之类。在于调气。气积于胃。以通营卫。又曰。胃者。水谷气血之海也。海之所行云气者天下也。胃之所
出气血者经隧也。经隧者。五脏六腑之大络也。迎而夺之而已矣。如迎夺太过。则反伤其性命。是取气在阳明。而绝命
亦在阳明矣。故特举此以令民之勿犯也。卢良侯曰。针经云。迎之五里。中道而止。本经云。三里在膝下三寸。盖三里
五里。皆阳明穴。然当先定足经而上合于手也。）帝曰。余闻九针。上应天地四时阴阳。愿闻其方。令可传于后世以为常
也。岐伯曰。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。（夫
九针之应。已详悉于针经。故帝曰。余闻九针。上应天地四时阴阳。然应于人之身形。及用针之法。有未尽焉。故曰。
愿闻其方。令可传于后世以为常也。是以伯所答者。与针经之多有不同。后之学人。当合而参之。针道始备。斯可以为
常法。）人皮应天。（一者天也。天者阳也。五脏之应天者肺。肺者五脏六腑之盖也。皮者肺之合也。人之阳也。故人皮
以应天。）人肉应地。（二者地也。人之所以应土者肉也。故人肉应地。）人脉应人。（三者人也。人之所以成生者血脉也。
故人脉应人。按此三者。与针经之理论相同。盖天地人三者不易之道也。）人筋应时。（四时之气。皆归始春。筋乃春阳
甲木之所生。故人筋应时。）人声应音。（人之发声。以备五音。）人阴阳合气应律。（合气者。六脏六腑。阴阳相合而为
六也。以六气之相合而应六律。卢良侯曰。律吕应十二月。六气应十二经。可分而可合者也。合则为六。故曰合气应律。）
人齿面目应星。（七者星也。人面有七窍。以应七星。灵枢经曰。天有列星。人有牙齿。）人出入气应风。（人气之行于周
身。犹风之遍于六合。）人九窍三百六十五络应野。（阴阳应象大论曰。地有九野。人有九窍。九野者。九州之分野也。
人之三百六十五络。犹地之百川流注。通会于九州之间。）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。（一至五针。刺形层浅深之次序。人之声音。
由肾之所发。故五针骨也。阴阳二气。分而为三阴三阳。故六针调阴阳气。阴精七损。故当益之。八风为邪。故当除之。
节之交。三百六十五会。络脉之渗灌诸节者也。故九窍节气。闭者通之。实者除而去之。此之谓九针之各有所主也。夫
圣人起天地之数也。一而九之。故以立九野。九而九之。九九八十一。以起黄钟数焉。盖以针应数也。是九针之道；。一
中有九。九九八十一以应律数。若谓一针在皮。六针调气。又不可与言针矣。）人心意应八风。（八风不常。而心意之
变动如之。）人气应天。（天运不息。而人气之出入如之。）人发齿耳目五声应五音六律。（发齿耳目共六。齿又为六六之
数。而发之数不可数矣。律吕之数。推而广之。可千可万而万之外不可数矣。此又反复言之者。谓天地人之相应。通变
之无穷也。）人阴阳脉血气应地。（地有十二经水。人有十二经脉。水循地行。脉随气转。）人肝目应之九。（肝开窍于目。
九窍之一也。一之九者。九而九之。九九八十一也。）九窍三百六十五。（六节脏象论曰。天以六六之节。以成一岁。人
以九九制会。计人亦有三百六士五节。以为天地久矣。是人之经脉有三百六十五穴。孙络有三百六十五穴。溪谷之分。
亦有三百六十五穴。节之交亦有三百六十五会。皆外通于九窍。内本于九脏者也。）人一以观动静。天二以候五色。七星
应之以候发母泽。五音一以候宫商角征羽。六律有余不足应之。二地一以候高下有余。九野一节俞应之以候闭节。三人
变一分人候齿泄多血少。十分角之变。五分以候缓急。六分不足。三分寒关节。第九分四时人寒温燥湿四时一应之。以
候相反一。四方各作解。（王冰曰。此一百二十四字。蠹简烂文。义理残缺。莫可寻究。而上古书。姑且载之。以伫后之
具本也。按王冰乃隋唐时人。为唐太仆令。注素问八十一篇。年八十余。太宗幸其宅。自唐至今千有余岁。一百二十四
字中。又亡一字矣。卢良侯曰。一百二十四字。连九窍三百六十五七字在内。然其间尚有成句可意会者。惜乎蠹损之文。
不模传也。按此亦见太素卷十九。杨注已谓章句难分。）
黄帝问道：我希望了解九针的原理，以及运用针刺治疗虚实病证的法则。（按：《针经》首篇论述了九针治疗虚实的方法，但《小针解》中仍有未尽之意，所以黄帝再次提出这个问题。）
岐伯回答说：针刺虚证使其充实，表现为针下产生热感。气充实才会产生热感。对于实证采用泻法，表现为针下产生寒感。气虚弱才会产生寒感。“菀陈则除之”是指排出恶血。（“菀”音同“郁”。所谓“刺虚则实之”，是指脉口处气虚应当用补法。等待阳气隆盛到达时，针下发热，然后起针。因为气实才会发热。所谓“满而泄之”，是指脉口处气盛应当用泻法。等待阴气隆盛到达时，针下发凉，然后起针。因为气虚才会发凉。“菀”是积聚的意思，“陈”是久远的意思。“菀陈则除之”，是指去除血脉中的瘀血。因为恶血积聚在脉络中已久，应当将其除去。）邪气盛实应当使之虚衰，出针时不要按压针孔。（意思是各条经脉如果有邪气盛实的情况，都应当泻其邪气。出针的时候，不要按压针孔，使邪气随着针的拔出而向外泄出。）缓慢出针并迅速按压针孔（徐而疾则实），是为了使正气充实；快速出针并缓慢按压针孔（疾而徐则虚），是为了使邪气泄出。（“徐而疾则实”的意思是，当针已得气后，缓慢出针，针既离开穴位，就迅速按压针孔，使正气不致外泄而得以充实，这是补虚的方法。“疾而徐则虚”的意思是，邪气已经到来，就快速出针，针既离开穴位，就缓慢按压针孔，使邪实可以泄出而变得虚衰，这是泻实的方法。按照这种论述与《小针解》不同。《小针解》说：“徐而疾则实”，意思是缓慢进针而快速出针；“疾而徐则虚”，意思是快速进针而缓慢出针。这是以进针和出针的速度来区分疾徐。本篇所说的疾徐，是指出针的疾徐和按压的疾徐。之所以命名为《针解》，是为了解释《小针解》中未尽的含义。针刺的精微之处在于迟速、疾徐，而这两篇经文各自穷尽了其中的奥妙。这就是所谓的“迎之随之，以意和之”，针道才算完备。）所谓“言实与虚者”，是指针下寒温及气感的多少。（所谓“实与虚”，是指针下感觉寒冷且气感微弱的是虚证，说明邪气已去；针下感觉温热且气感强盛的是实证，说明正气已恢复。）所谓“若无若有者”，是指气至的感觉难以捉摸，不可急于求成。（气的虚实变化，若有若无，应当静心守候其气，如果急躁则无法感知到气至。）“察后与先者”，是指了解疾病的先后顺序。（疾病有标本之分，先发生的病为本，后发生的病为标。治疗有从标论治而获效的，也有从本论治而获效的。因此应当了解疾病的先后，观察那些应当后治的就后取穴，应当先治的就先取穴。）“为虚与实者”，医生不要违背其法则。如果感觉“若得若失”，就是背离了法则。（虚证用补法，实证用泻法，补泻的法则应当遵守而不违背。如果感觉好像得到了又好像失去了，那就是失去了正确的法则。）虚实治疗的要领，九针最为奇妙，是因为它们各有适宜的用途。九针的运用：热在头身适宜用镵针；取分肉间的气适宜用圆针；取气外出驱邪适宜用鍉针；刺痈热出血适宜用锋针；刺大痈排脓清热适宜用铍针；调和阴阳、去除瘫痹适宜用圆利针；去除寒热痛痹适宜用毫针；取深部邪气和远端痹症适宜用长针；人气留滞于关节适宜用大针。因为它们各有适宜的用途。）“补泻之时者”，是与气的开阖相符合。（气到来称为“开”，可以迎着它来泻之；气离去称为“阖”，可以顺着它去补之。补泻的时机，与气的开阖相符合，所以说“刺实者，刺其来也；刺虚者，刺其去也”。）“凡针之名，各不同形者”，是因为针具穷尽了其所应当进行的补泻作用。（九针的名称，有镵、圆、鍉、锋、铍、圆利、毫、长、大的区别。九针的形状，有大小的不同、长短的差异。各自尽其应当补泻的作用而制成。）“刺实须其虚者留针”，是指阴气隆盛到达时，才去针。（留针是为了候气。阴气隆盛到达，针下发凉，阳气已退，实证变为虚证了。“刺虚须其实者”，是指阳气隆盛到达，针下发热，才去针。元气已恢复，虚证变为实证了。都应当等候气至，然后才可以去针。）“经气已至，慎守勿失者”，是指不要更改手法。（针已得气，谨慎地守住而不丢失，不要让气感发生变化。）“深浅在志者”，是指了解病位的内外。（“志”指心意所向。病在表浅的适宜浅刺，病在深层的适宜深刺。应当用心关注病患，知道取穴的部位。）“近远如一者”，是指无论深浅，候气的标准是一样的。（针刺或浅或深，虽然有远近的不同，但都以得气为标准，所以候气的标准相等没有二致。）“如临深渊者”，是不敢懈怠。（行针的时候，应当极其谨慎。）“手如握虎者”，是想要保持坚定有力。（持针像握住老虎一样，想要坚定而不胆怯。）“神无营于众物者”，是静心观察病患，不左右顾视。（行针之道，贵在守神。静心观察病患，以候气，不左右顾视，以免扰乱自己的神志。按《小针解》说：“上守神”，是守人的血气有余不足，可以进行补泻。本篇先论述守己之神，以合彼之神。所谓“神乎神，耳不闻，昭然独明，若风吹云”。）“义无邪下者”，是想要端正正直地下针。（下针的法度，不容许偏邪，所以应当端正正直。）“必正其神者”，是想要瞻望病患的眼睛，制约其神志，令气容易运行。（“正其神”是安定病患的神志。瞻望病患的眼睛，不使其邪视，制约彼之神气专一，令病者的气容易运行。按以上各节的上句，与《九针十二原》篇相同，下句则与《小针解》各不相同。大概是重新解释九针虚实之道，以补充未尽的含义。）所谓“三里”，是在膝下三寸的地方。所谓“跗之”，是抬起膝盖容易看见的地方。所谓“巨虚”，是跷足时单独凹陷的地方。所谓“下廉”，是凹陷下去的地方。（三里在膝下三寸。“跗之”，指足背上的冲阳脉。在三里下三寸是巨虚上廉，再在上廉下三寸是巨虚下廉。自三里循行至上廉、下廉而至足背冲阳的动脉，都属于足阳明胃经。特别举出这条胃经来说，是说明针刺候气，是候阳明所出的营卫之气。所以《针经》说：“用针之类，在于调气。气积于胃，以通营卫。”又说：“胃者，水谷气血之海也。海之所行云气者天下也。胃之所出气血者经隧也。经隧者，五脏六腑之大络也。迎而夺之而已矣。”如果迎夺太过，反而会伤害性命。这是在阳明取气，而在阳明断命也是可能的。所以特别举出此穴以告诫民众不要犯此禁忌。卢良侯说：《针经》云：“迎之五里，中道而止。”《本经》云：“三里在膝下三寸。”盖三里、五里都是阳明穴，然而应当先确定足经而上合于手经。）黄帝说：我听说九针上应天地四时阴阳，希望了解其方术，以便流传后世作为常法。岐伯说：一天、二地、三人、四时、五音、六律、七星、八风、九野，人的身形也与之相应。针各有适宜的用途，所以称为九针。（九针的对应关系，已在《针经》中详细论述，所以黄帝说：“我听说九针上应天地四时阴阳。”然而对应于人的身形，以及用针的方法，还有未尽之处，所以说：“希望了解其方术，以便流传后世作为常法。”因此岐伯的回答与《针经》多有不同，后世的学人应当综合参详，针道才算完备，这才可以作为常法。）人的皮肤应天。（一是天。天属阳。五脏中应天的是肺，肺是五脏六腑的华盖。皮是肺的外合，属于人之阳，所以人的皮肤应天。）人的肌肉应地。（二是地。人之所以应土的是肌肉，所以人的肌肉应地。）人的血脉应人。（三是人。人之所以能生存的是血脉，所以人的血脉应人。按这三点，与《针经》的理论相同，大概天地人三者是不变的道理。）人的筋应时。（四时的气候，都归于初春。筋乃春阳甲木所生，所以人的筋应时。）人的声音应五音。（人发声，具备五音。）人的阴阳合气应六律。（合气，指六脏六腑，阴阳相合而为六。以六气之相合而应六律。卢良侯说：律吕应十二月，六气应十二经，可分而可合。合则为六，所以说合气应律。）人的齿、面、目应七星。（七是星。人面有七窍，以应七星。《灵枢经》说：“天有列星，人有牙齿。”）人的出入之气应八风。（人气行于周身，犹如风遍于六合。）人的九窍、三百六十五络应九野。（《阴阳应象大论》说：“地有九野，人有九窍。”九野，即九州的分野。人的三百六十五络，犹如地的百川流注，通会于九州之间。）所以第一针刺皮，第二针刺肉，第三针刺脉，第四针刺筋，第五针刺骨，第六针调阴阳，第七针益精，第八针除风，第九针通九窍，除三百六十五节气。这就叫各有所主。（一至五针，是刺形体层浅深的次序。人的声音，由肾所发，所以第五针刺骨。阴阳二气，分为三阴三阳，所以第六针调阴阳气。阴精易损，所以应当益之。八风为邪，所以应当除之。节的交会处，三百六十五会，是络脉渗灌诸节的地方。所以九窍节气，闭塞的通之，实邪的除而去之。这就叫九针各有所主。圣人建立天地之数，一而九之，所以确立九野。九而九之，九九八十一，以起黄钟之数。大概是以针应数。这是九针的道理；一中有九，九九八十一以应律数。如果说一针只在皮，六针只调气，那就不可与谈论针道了。）人的心意应八风。（八风无常，而心意的变动也是如此。）人的气应天。（天运不息，而人的气出入也是如此。）人的发、齿、耳、目、五声应五音六律。（发、齿、耳、目共六项，齿又是六六之数，而发的数量不可数。律吕之数，推而广之，可千可万，万之外不可数。这是反复言之，谓天地人之相应，通变无穷。）人的阴阳脉血气应地。（地有十二经水，人有十二经脉。水循地行，脉随气转。）人的肝、目应之九。（肝开窍于目，是九窍之一。一之九者，九而九之，九九八十一。）九窍三百六十五。（《六节脏象论》说：“天以六六之节，以成一岁。人以九九制会，计人亦有三百六十五节，以为天地久矣。”是说人的经脉有三百六十五穴，孙络有三百六十五穴，溪谷之分，亦有三百六十五穴，节之交亦有三百六十五会，皆外通于九窍，内本于九脏。）人一以观动静，天二以候五色，七星应之以候发母泽，五音一以候宫商角徵羽，六律有余不足应之，二地一以候高下有余，九野一节俞应之以候闭节，三人变一分人候齿泄多血少，十分角之变，五分以候缓急，六分不足，三分寒关节，第九分四时人寒温燥湿四时一应之，以候相反一，四方各作解。（王冰说：这一百二十四字，是虫蛀腐烂的文字，义理残缺，无法寻究。而上古之书，姑且记载下来，以等待后来有版本的人。按王冰是隋唐时人，任唐太仆令，注释《素问》八十一篇，年八十多岁。太宗曾幸临其宅。自唐至今一千多年，这一百二十四字中，又亡失一字了。卢良侯说：一百二十四字，连同“九窍三百六十五”七字在内，然而其间尚有成句可以意会的，可惜被虫蛀损坏，不能摹传。按这也见于《太素》卷十九，杨注已谓章句难分。）
Huangdi asked, "I wish to hear the explanation of the Nine Needles and the principles of deficiency and excess." (Note: The first chapter of *Zhen Jing* discusses the principles of deficiency and excess regarding the Nine Needles, but there are meanings not fully explained in *Xiao Zhen Jie*. Therefore, the Emperor asks this question again.)
Qibo replied, "To tonify deficiency by needling, one waits for warmth under the needle. Warmth indicates that Qi has become full. To drain excess by needling, one waits for coldness under the needle. Coldness indicates that Qi has become deficient. 'Removing stagnation and old blood' refers to evacuating bad blood. ('Wen' sounds like 'Yu'.) What is meant by 'tonifying deficiency' is that when the pulse at the cun kou is deficient, one should tonify it. One waits until Yang Qi arrives vigorously; once warmth is felt under the needle, the needle is removed. This is because warmth signifies Qi fullness. What is meant by 'draining excess' is that when the pulse at the cun kou is excessive, one should sedate it. One waits until Yin Qi arrives vigorously; once coldness is felt under the needle, the needle is removed. This is because coldness signifies Qi deficiency. 'Wen' means accumulation; 'Chen' means long-standing. 'Removing stagnation and old blood' refers to removing blood stasis from the vessels. Since bad blood has accumulated in the collaterals for a long time, it must be removed.) When pathogenic factors are excessive, one should reduce them by withdrawing the needle without pressing the puncture site. (This means that if any meridian has excess, one should sedate the pathogen. Upon withdrawing the needle, do not press the hole, allowing the pathogenic Qi to escape with the needle.) 'Slow withdrawal and rapid pressing' (Xu Er Ji Ze Shi) tonifies; 'Rapid withdrawal and slow pressing' (Ji Er Xu Ze Xu) reduces. ('Slow withdrawal and rapid pressing' means that after obtaining Deqi, withdraw the needle slowly. Once the needle leaves the acupoint, press rapidly to prevent the loss of healthy Qi and thereby tonify. This is the method for tonifying deficiency. 'Rapid withdrawal and slow pressing' means that once the pathogenic Qi has arrived, withdraw the needle rapidly. Once the needle leaves the acupoint, press slowly to allow the pathogenic excess to escape and thus reduce it. This is the method for reducing excess. This discussion differs from *Xiao Zhen Jie*. *Xiao Zhen Jie* states: 'Slow withdrawal and rapid pressing' means slow insertion and rapid withdrawal; 'Rapid withdrawal and slow pressing' means rapid insertion and slow withdrawal. This distinguishes speed based on insertion and withdrawal. The 'speed' mentioned in this chapter refers to the speed of withdrawal and pressing. It is named *Zhen Jie* (Explanation of Needling) to explain the未尽 (unfinished) aspects of *Xiao Zhen Jie*. The subtlety of needling lies in slowness, speed, and tempo, and both texts exhaust their respective profundities. This is what is meant by 'following and opposing, harmonizing with intention,' completing the Dao of Needling.) When discussing 'excess and deficiency,' it refers to the degree of cold/warmth and the amount of Qi sensation. (By 'excess and deficiency,' it means that coldness under the needle with weak Qi sensation indicates deficiency, as pathogens have departed; warmth under the needle with strong Qi sensation indicates excess/fullness, as healthy Qi has recovered.) 'As if present, as if absent' means the arrival of Qi is difficult to discern precisely. (The fluctuation of Qi between deficiency and excess is subtle. One must calmly guard the Qi; rushing makes it impossible to perceive.) 'Observing sequence' means understanding the chronological order of the disease. (Diseases have root (Ben) and branch (Biao). The primary disease is the root; the secondary is the branch. Treatment may succeed by addressing the branch or the root. Thus, one must know the sequence of the disease: treat those that should be treated later last, and those that should be treated first first.) 'Treating deficiency and excess' requires the physician not to lose the correct method. If the sensation is 'as if gained, as if lost,' it indicates deviation from the method. (Tonify deficiency, sedate excess. The methods of tonification and sedation must be adhered to strictly. Feeling as if one has gained and lost simultaneously implies losing the correct technique.) The key to treating deficiency and excess lies in the Nine Needles, which are most excellent because each is suited for specific indications. Applications of the Nine Needles: Chan Needle (Cang Needle) for heat in the head and body; Yuan Needle (Round Needle) for Qi in the intermuscular spaces; Di Needle (Beak Needle) for expelling Qi and pathogens; Feng Needle (Sharp Needle) for abscesses and bleeding; Pi Needle (Sword Needle) for large abscesses, draining pus and clearing heat; Yuanli Needle (Round-Sharp Needle) for regulating Yin-Yang and treating paralysis/obstruction; Hao Needle (Filiform Needle) for cold-heat pain and obstruction; Chang Needle (Long Needle) for deep pathogens and distant obstructions; Da Needle (Large Needle) for Qi stagnation in joints. Each is suited for its specific indication.) 'The timing of tonification and sedation' harmonizes with the opening and closing of Qi. (Qi arriving is called 'Opening'; one can oppose it to sedate. Qi departing is called 'Closing'; one can follow it to tonify. The timing of tonification and sedation aligns with Qi's opening and closing. Hence, 'To sedate excess, needle its arrival; to tonify deficiency, needle its departure.') 'The names of the needles differ in shape' because each shape fulfills a specific tonification or sedation function. (The Nine Needles have distinct names: Cang, Yuan, Di, Feng, Pi, Yuanli, Hao, Chang, Da. Their shapes vary in size and length, designed to fulfill their respective therapeutic roles.) 'When sedating excess, retain the needle until it becomes deficient': remove the needle when Yin Qi arrives vigorously. (Retaining the needle allows waiting for Qi. When Yin Qi arrives, coldness is felt under the needle; Yang Qi retreats, and excess transforms into deficiency. 'When tonifying deficiency, retain the needle until it becomes full': remove the needle when Yang Qi arrives vigorously and warmth is felt. Healthy Qi recovers, and deficiency transforms into fullness. In both cases, wait for Qi arrival before removing the needle.) 'Once Jing Qi has arrived, guard it carefully and do not lose it' means do not change the manipulation. (Once Deqi is obtained, guard it carefully without altering the sensation.) 'Depth and shallowness depend on intent' means knowing whether the disease is internal or external. ('Intent' refers to mental focus. Superficial diseases require shallow needling; deep diseases require deep needling. One must focus on the patient to determine the appropriate depth.) 'Near and far are uniform' means the criteria for awaiting Qi are the same regardless of depth. (Whether needling is shallow or deep, the goal is always Deqi; thus, the standard for awaiting Qi is identical.) 'Like standing at the edge of an abyss' means being vigilant and not negligent. (During needling, extreme caution is required.) 'Hand like holding a tiger' means maintaining firmness and strength. (Holding the needle like a tiger ensures stability and lack of fear.) 'Spirit not distracted by myriad things' means calmly observing the patient without looking left or right. (The essence of needling is guarding the Spirit. Calmly observe the patient to await Qi. Do not look around, lest you disturb your own Spirit. Note: *Xiao Zhen Jie* says 'Guarding the Spirit' refers to monitoring the surplus or deficit of Blood and Qi for tonification/sedation. This chapter first discusses guarding one's own Spirit to harmonize with the patient's Spirit. 'Spirit! Spirit! You hear not with ears, shining alone clearly, like wind blowing clouds away.') 'Needle downward without deviation' means intending to insert the needle upright and correctly. (The principle of needling forbids deviation; thus, one must be upright.) 'Must rectify the patient's Spirit' means gazing at the patient's eyes to control their Spirit, facilitating the movement of Qi. ('Rectifying the Spirit' stabilizes the patient's mind. Gaze at the patient's eyes to prevent distraction, focusing their Spirit so that Qi moves easily. Note: The first half of these sentences matches *Jiu Zhen Er Shi Er Pian*; the second half differs from *Xiao Zhen Jie*. This re-explains the principles of deficiency/excess in the Nine Needles to supplement unfinished meanings.) Regarding 'Sanli': it is three cun below the knee. 'Fu' refers to the area where lifting the knee makes it visible. 'Juxu' refers to the depression formed when raising the foot. 'Xialian' refers to the depressed area. (Sanli is three cun below the knee. 'Fu' refers to the Chongyang pulse on the dorsum of the foot. Three cun below Sanli is Shangjuxu; another three cun below is Xiajuxu. From Sanli through Shangjuxu and Xiajuxu to the pulsating Chongyang on the dorsum, all belong to the Foot-Yangming Stomach Meridian. Specifically citing this meridian explains that needling awaits Qi from the Ying and Wei emanating from Yangming. Thus, *Zhen Jing* states: 'The class of using needles lies in regulating Qi. Qi accumulates in the Stomach to circulate Ying and Wei.' It also states: 'The Stomach is the Sea of Water and Grain and Source of Qi and Blood. As the Sea generates clouds and Qi across the world, the Qi and Blood emanating from the Stomach flow through the Jing-Luo. The Jing-Luo are the great collaterals of the Zang-Fu.' Simply opposing and seizing (sedating) can be done. However, if opposing/seizing is too excessive, it harms life. Taking Qi from Yangming can also cut off life. Thus, this point is specifically cited to warn people against error. Lu Lianghou said: *Zhen Jing* states: 'Opposing Wuli stops midway.' *Ben Jing* states: 'Sanli is three cun below the knee.' Both Wuli and Sanli are Yangming points, but one must first determine the Foot meridians connecting to the Hand meridians.) Huangdi said, "I have heard that the Nine Needles correspond to Heaven, Earth, the Four Seasons, and Yin-Yang. I wish to hear the methodology so it may be passed down as a constant practice." Qibo said, "One corresponds to Heaven, Two to Earth, Three to Man, Four to Seasons, Five to Tones, Six to Pitch-pipes, Seven to Stars, Eight to Winds, Nine to Fields. The human body also corresponds to these. Each needle has its specific suitability, hence the name Nine Needles." (The correspondence of the Nine Needles was detailed in *Zhen Jing*, hence the Emperor's query. However, the correspondence to the human body and the methods of use had further explanations needed. Thus, he asked for the methodology to establish a constant law. Therefore, Qibo's answer differs significantly from *Zhen Jing*. Later students should integrate both to complete the Dao of Needling, establishing a constant law.) Human skin corresponds to Heaven. (One is Heaven. Heaven is Yang. Among the Zang organs, Lung corresponds to Heaven. Lung is the canopy of the Zang-Fu. Skin is the exterior association of Lung and belongs to Human Yang. Thus, human skin corresponds to Heaven.) Human flesh corresponds to Earth. (Two is Earth. Humans correspond to Earth through flesh. Thus, human flesh corresponds to Earth.) Human vessels correspond to Man. (Three is Man. Humans survive through blood vessels. Thus, human vessels correspond to Man. Note: These three align with the theory in *Zhen Jing*, representing the unchanging Dao of Heaven, Earth, and Man.) Human tendons correspond to Time. (Four corresponds to Seasons. Seasonal Qi converges in early Spring. Tendons are generated by Spring Yang and Wood (Jia-Mu). Thus, human tendons correspond to Time.) Human voice corresponds to Tones. (Human vocalization encompasses the Five Tones.) Human Yin-Yang combined Qi corresponds to Pitch-pipes. ('Combined Qi' refers to the six Fu and six Zang organs, where Yin and Yang combine to form six. This corresponds to the Six Pitch-pipes via the combination of Six Qi. Lu Lianghou noted: Pitch-pipes correspond to twelve months; Six Qi correspond to twelve meridians. They can be divided or combined. Combined, they form six, hence 'Combined Qi corresponds to Pitch-pipes'.) Human teeth, face, and eyes correspond to Stars. (Seven corresponds to Stars. The human face has seven orifices, corresponding to the Seven Stars. *Ling Shu* states: 'Heaven has constellations; humans have teeth.') Human inhalation and exhalation correspond to Winds. (The circulation of Qi throughout the body is like Wind pervading the universe.) Human nine orifices and 365 collaterals correspond to Fields. (*Yin Yang Ying Xiang Da Lun* states: 'Earth has Nine Fields; humans have nine orifices.' Nine Fields refer to the divisions of the Nine Provinces. The 365 collaterals of humans are like rivers flowing into the Nine Provinces.) Therefore, the first needle penetrates the skin, the second the flesh, the third the vessels, the fourth the tendons, the fifth the bone, the sixth regulates Yin-Yang, the seventh benefits Essence, the eighth eliminates Wind, and the ninth opens the nine orifices and eliminates the 365 joint nodes. This is called 'each having its specific dominion.' (Needles 1-5 indicate the sequence of penetrating physical layers. Voice originates from Kidney, hence the fifth needle targets bone. Yin-Yang Qi divides into Three Yin and Three Yang, hence the sixth regulates Yin-Yang. Yin Essence is prone to damage, hence it needs benefitting. Eight Winds are pathogens, hence they need eliminating. The intersections of joints, the 365 meetings, are where collaterals seep into joints. Thus, blocked orifices/joints are opened, and excess is removed. This defines the specific dominion of the Nine Needles. The Sage established the numbers of Heaven and Earth: One multiplied by nine creates Nine Fields. Nine multiplied by nine yields eighty-one, initiating the number of Huangzhong. Needles correspond to numbers. In the Dao of Nine Needles, One contains Nine; 9x9=81 corresponds to pitch-pipe numbers. To say one needle only affects skin and six only regulate Qi would be to misunderstand needling.) Human intention corresponds to Eight Winds. (Eight Winds are unpredictable, just as human intentions change.) Human Qi corresponds to Heaven. (Heaven's motion is ceaseless, just as human Qi circulates.) Human hair, teeth, ears, eyes, and five sounds correspond to Five Tones and Six Pitch-pipes. (Hair, teeth, ears, and eyes constitute six items; teeth also represent the number 6x6. Hair count is incalculable. Pitch-pipe numbers, extended, reach thousands and beyond, becoming incalculable. This reiterates the infinite variation in the correspondence between Heaven, Earth, and Man.) Human Yin-Yang vessels, Blood, and Qi correspond to Earth. (Earth has twelve major waters; humans have twelve main meridians. Water flows along the earth; vessels follow Qi.) Human Liver and Eyes correspond to Nine. (Liver opens into the eyes, one of the nine orifices. 'One to Nine' implies 9x9=81.) Nine Orifices and 365 [points]. (*Liu Jie Zang Xiang Lun* states: 'Heaven uses 6x6 solar terms to complete a year. Humans use 9x9 to organize, counting 365 joints.' This means humans have 365 acupoints in main meridians, 365 in Sun collaterals, 365 in Xi-Gu spaces, and 365 joint intersections. All connect externally to the nine orifices and internally to the nine Zang organs.) 'One by Man observes movement/stillness; Two by Heaven observes five colors; Seven Stars respond to observe hair/nails/luster; Five Tones by One observe Gong-Shang-Jue-Zhi-Yu; Six Pitch-pipes respond to surplus/deficiency; Two by Earth observe high/low surplus; Nine Fields by one Joint-Shu respond to blocked joints; Three by Man varies to observe teeth/drainage/blood abundance/scarcity; Ten parts Tone variation; Five parts observe slack/tightness; Six parts deficiency; Three parts cold joints; Ninth part Four Seasons observe human cold/warm/dry/damp annually; Observe opposites; Four Directions each provide explanations.' (Wang Bing stated: These 124 characters are damaged text with incomplete meaning, irretrievable. Ancient books preserve them for future scholars with better versions. Wang Bing was a Tang official who annotated *Su Wen* at over 80 years old. Over a millennium since Tang, more text has been lost. Lu Lianghou noted: Including 'Nine Orifices 365', some phrases remain intelligible, but damage prevents transcription. This also appears in *Tai Su* Vol. 19, where Yang notes sentence structure is hard to divide.)