上实下虚，切而从之，索其结络脉，刺出其血，以见通之。
《灵枢·刺节真邪》论曰，六经调者，谓之不病。一经上实下虚，而不通者，此必有横络盛加
于大经，令之不通，视而泻之，此所谓解结也。此上实下虚者，有横络加于经外，外为上，内为下，
故上实下虚。切而从之者，切其经之所组而从治之。索其结络脉者，索其络脉之结也。刺出其血，以
见通之者，血出结去，见其络脉之通，病可愈也。凡此皆视其经络浮沉，以上下逆从而循之之法也。
瞳子高者，太阳不足；戴眼者，太阳已绝。此决死生之要，不可不察也。手指及手
外踝上五指留针。
经脉血气，本于先天水火之所生，故举太阳以终经脉之义。瞳子高者，乃太阳水火之精，不足
于上。戴眼者，乃太阳生阳之气，已绝于下，此以先天水火之精，决死生之要，以九候而决死生者，
不可不察也。夫病在阴者，补阳以治之，病在足者，补手以治之，此阴阳上下，相为表里之义。手指，
及手外踝上五指，留针者，言
足太阳经脉不足，当补手太阳以治之，手太阳之脉，起于小指之端，循手外侧，出踝中，故太阳不足，当
取手指，及手指外踝之上，乃第五指者，留针以补之，使手太阳之经脉充溢；而交于足太阳，乃为治之之法也。
此一节，言九候七诊，经络浮沉，以决死生，以知病之所在，亦必指而导之，乃以为真也。
上实下虚，切而从之，索其结络脉，刺出其血，以见通之。
对于上部邪气盛实、下部正气虚弱的病证，诊察时应顺着经脉的走向进行切按，寻找那些有结节阻滞的络脉，针刺放出瘀血，以此来观察经络是否通畅。
《灵枢·刺节真邪》论曰，六经调者，谓之不病。一经上实下虚，而不通者，此必有横络盛加于大经，令之不通，视而泻之，此所谓解结也。
《灵枢·刺节真邪篇》中说：六条经脉气血调和，就称为没有疾病。如果其中一条经脉出现上部实、下部虚且气血不通的情况，这必定是因为横向的络脉（横络）亢盛并压迫了主干经脉，导致气血不通。通过观察并进行泻法治疗，这就是所谓的“解结”（解开经络的结滞）。
此上实下虚者，有横络加于经外，外为上，内为下，故上实下虚。
这种上实下虚的情况，是因为有横络加在经脉的外面，体表部位属上，体内部位属下，所以表现为上实下虚。
切而从之者，切其经之所组而从治之。索其结络脉者，索其络脉之结也。刺出其血，以见通之者，血出结去，见其络脉之通，病可愈也。
所谓“切而从之”，是指切按经脉循行的路径，并顺着其走向进行治疗。所谓“索其结络脉”，是指寻找络脉中发生结滞的部位。所谓“刺出其血，以见通之”，是指放出瘀血后结滞去除，看到络脉变得通畅，疾病就可以痊愈。
凡此皆视其经络浮沉，以上下逆从而循之之法也。
所有这些方法，都是根据经络在体表的浮显或深沉，按照上下逆顺的规律来循经诊治的方法。
瞳子高者，太阳不足；戴眼者，太阳已绝。此决死生之要，不可不察也。手指及手外踝上五指留针。
眼球向上凝视不能转动（瞳子高），是足太阳膀胱经之气不足的表现；两眼固定向上翻白（戴眼），是足太阳膀胱经之气已经竭绝的表现。这是判断生死的关键要点，不可以不仔细考察。治疗时应在手指以及手外踝上方第五指处留针。
经脉血气，本于先天水火之所生，故举太阳以终经脉之义。
经脉中的血气，根本来源于先天的水火精气，因此这里列举太阳经作为结束，以总结经脉的理论意义。
瞳子高者，乃太阳水火之精，不足于上。戴眼者，乃太阳生阳之气，已绝于下，此以先天水火之精，决死生之要，以九候而决死生者，不可不察也。
眼球上视，是因为太阳经的水火精气在上部不足。两眼上翻，是因为太阳经的生发阳气在下部已经竭绝。这里通过先天的水火精气来判断生死的关键，运用三部九候诊法来判断生死，是不可以不仔细考察的。
夫病在阴者，补阳以治之，病在足者，补手以治之，此阴阳上下，相为表里之义。
凡是病在阴分的，就通过补益阳气来治疗；凡是病在足部的，就通过补益手部经脉来治疗，这是阴阳上下相互表里的理论含义。
手指，及手外踝上五指，留针者，言足太阳经脉不足，当补手太阳以治之，手太阳之脉，起于小指之端，循手外侧，出踝中，故太阳不足，当取手指，及手指外踝之上，乃第五指者，留针以补之，使手太阳之经脉充溢；而交于足太阳，乃为治之之法也。
所谓在手指以及手外踝上方第五指处留针，意思是说：足太阳膀胱经之气不足，应当补益手太阳小肠经来治疗。手太阳小肠经的经脉，起始于小指的末端，沿着手的尺侧（外侧），出于腕关节，所以当太阳经气不足时，应当选取手指，以及手指外踝上方的第五指（即小指），留针以补益它，使手太阳小肠经的气脉充盈，进而与足太阳膀胱经相交，这就是治疗的方法。
此一节，言九候七诊，经络浮沉，以决死生，以知病之所在，亦必指而导之，乃以为真也。
这一节内容，讲述了运用三部九候和七种诊法，观察经络的浮沉变化，以此判断生死，知晓疾病的所在，同时也必须用手指指示并引导经气，这才是真正的诊疗方法。
Upper excess and lower deficiency: palpate and follow the meridian, seek out the knotted collateral vessels, puncture to release blood, thereby observing the restoration of flow.
The *Ling Shu · Ci Jie Zhen Xie* (Needling to Resolve Knots and True/False Pathogens) states: When the six meridians are harmonious, it is called disease-free. If one meridian exhibits upper excess and lower deficiency with obstruction, this must be due to a flourishing transverse collateral (Heng Luo) pressing upon the main meridian, causing obstruction. Observing this and applying draining methods is what is termed "resolving knots." In cases of upper excess and lower deficiency here, there is a transverse collateral added outside the meridian; the exterior represents the upper, and the interior represents the lower, hence the presentation of upper excess and lower deficiency. "Palpating and following" refers to palpating the course of the meridian and treating along its direction. "Seeking the knotted collateral vessels" refers to identifying the knotting within the collateral vessels. "Puncturing to release blood to observe patency" means that once blood is released and the knot dissipates, the patency of the collateral vessels is observed, and the disease can be cured. All these methods involve observing the superficial or deep nature of the meridians and collaterals, following the principles of upward/downward and reverse/concordant flows for treatment.
Elevated eyeballs (Tong Zi Gao) indicate insufficiency of the Taiyang (Greater Yang); fixed upward gaze (Dai Yan) indicates exhaustion of the Taiyang. This is a critical factor in determining life and death, which must not be overlooked. Retain needles at the fingers and at the fifth digit above the lateral malleolus of the hand.
Meridian blood and Qi originate from the generation of innate Water and Fire. Therefore, citing the Taiyang meridian concludes the meaning of the meridians. Elevated eyeballs signify that the essence of Water and Fire of the Taiyang is insufficient in the upper part. Fixed upward gaze signifies that the generating Yang Qi of the Taiyang has exhausted in the lower part. Using the essence of innate Water and Fire to determine the critical factors of life and death, and using the Nine Palpations (Jiu Hou) to decide life and death, must be carefully examined.
When disease is in Yin, tonify Yang to treat it; when disease is in the feet, tonify the hands to treat it. This illustrates the principle of mutual exterior-interior relationships between Yin/Yang and upper/lower. Regarding retaining needles at the fingers and the fifth digit above the lateral malleolus of the hand: this indicates that when the Foot-Taiyang meridian is insufficient, one should tonify the Hand-Taiyang meridian to treat it. The Hand-Taiyang Small Intestine meridian originates at the tip of the little finger, follows the lateral aspect of the hand, and emerges at the wrist joint. Therefore, when Taiyang is insufficient, one should select the fingers, specifically the fifth digit above the lateral malleolus of the hand (the little finger), retain needles to tonify it, causing the Hand-Taiyang meridian to become abundant, thereby interacting with the Foot-Taiyang meridian. This is the method of treatment.
This section discusses the Nine Palpations and Seven Diagnostic Methods, the superficial or deep state of meridians, to determine life and death and locate the disease. It also emphasizes that one must point to and guide the Qi, which constitutes the true practice.