离合真邪者，真气邪气，彼此相离，勿使合也。邪入经脉，则真邪相合，从而察之，必使真气弗失，
邪气弗入。盖邪之新客来也，未有定处，推之则前，引之则止，逢而泻之，其病立已，泻之
立已，则合者使离，故曰离合真邪也。
黄帝问曰∶余闻九针九篇，夫子乃因而九之，九九八十一篇，余尽通其意矣。
承上编先知《针经》之意，而言九针之道，备载针经八十一篇，余已尽通其意。
经言气之盛衰，左右倾移，以上调下，以左调右，有余不足，补泻于荣输，余知之矣。
《针经》大意如此，余已知之。
此皆荣卫之倾移，虚实之所生，非邪气从外入于经也。余愿闻邪气之在经也，其
病患何如，取之奈何？
针经多论正气之虚实，未详邪气入经，故以为问。
岐伯对曰∶夫圣人之起度数，必应于天地，故天有宿度，地有经水，人有经脉。
起，犹立也。圣人立人身脉度循行之数，必上应天，下应地。故天有二十八宿之度，人有十
二经脉，以应于天；地有十二经水，人有十二经脉，以应于地。
天地温和，则经水安静；天寒地冻，则经水凝泣；天暑地热，
则经水沸溢；卒风暴起，则经水波涌而陇起。
泣，作涩。卒，音促，俱下同。地之经水，气通于天，故天地温和，则经水安静。如天寒地冻，
则经水凝涩。凝涩，不行也。天暑地热，则经水沸溢。沸溢，汛滥也。若阴阳不和，卒风暴起，风
行水涣，则经水波涌而陇起。
夫邪之入于脉也，寒则血凝泣，暑则气淖泽，虚邪因而入客，
亦如经水之得风也，经之动脉，其至也亦时陇起，其行于脉中，循循然。
人之经脉，合于经水，气通于天。若夫邪气之入于脉也，天寒则人血凝涩，犹之天寒地冻，经水凝涩
也。天暑则人气淖泽，犹之天暑地热，经水沸溢也。虚乡之邪，因人经脉虚而入客，犹之卒风
暴起，故亦如经水之得风也。经之动脉犹言风入于经，而动其脉也。其至也亦时陇起，犹之经水遇风，波
涌而陇起也。其不因于邪，则血气之行于脉中，循循然。循循，次序貌，犹之天地温和，
而经水安静也，此人之度数，所以应于天地也。
其至寸口中手也，时大时小，大则邪至，小则平，其行无常
处，在阴与阳，不可为度，从而察之，三部九候，卒然逢之，早遏其路。
中，去声。处，去声，下处同。脉之大会，在于寸口，其至寸口而中手也，则时大时小，大则脉
气有余，故邪至；小则脉气凝实，故平。邪气之至，其行无常处，或在血分之阴，或在气分之
阳，而不可为度，从其在阴在阳而察之，审其三部九候之中，邪之所在，卒然逢之，勿使真邪相合，是当
早遏其路。下文云，逢而泻之，其病立已，同一义也。
吸则内针，无令气忤；静以久留，无令邪布，吸则转针，以得
气为故；候呼引针，呼尽乃去，大气皆出，故命曰泻。
内，音纳，下内针之内同。忤，逆也。大气，针下所聚之气也。方吸则内针，其气始行，无令逆
也。宁静其心，久留其针，以针引邪，无令邪之四布也。方吸则转针，欲以得气，为复其故。候
呼则引针，呼尽针乃去，使针下所聚之气皆出，此泻邪之法，故命曰泻。
此一节，言人身经脉，应于天地，邪气卒至，当急泻之，勿使真邪相合也。
帝曰∶不足者补之，奈何？
邪气卒至，当急泻之，真气不足，则当补之，故为此问。
岐伯曰∶必先扪而循之，切而散之，推而按之，弹而怒之，抓而下之，通而取之，外引其门，以
闭其神，呼尽内针，静以久留，以气至为故，如待所贵，不知日暮，其气以至，适而自护，候吸引针，
气不得出，各在其处，推阖其门，令神气存，大气留止，故命曰补。
推，退，平声，下同。弹，平声。以至之以已通，下以合之以同。抓，犹引也。补不足者，当知
其经脉之不足，故必先以手扪而循之，得其穴道之真，次则切而散之，推而按之，分掰其穴，不使
倾移，然后弹而怒之，以进其针，引而下之，以深其针，通而取之，以调其经，外引其门，使气脉流
通，以闭其神，使真气内存。针刺留呼，其数不同，留呼数尽，更当内针，而静以久留，久留
者，欲以气至，为复其故，候气之法，如待所贵，不知日暮，其气已至，仍当调适而自护。上文候呼
引针，大气皆出，此候吸引针，使气不得出，各在其针刺之处，推阖其门，令神气存，针下所聚之
大气，留止于内，此补正之法，故命曰补。
帝曰∶候气奈何？
如待所贵，不知日暮，其气已至，适而自护，此候气之法，帝复问之。
岐伯曰∶夫邪去络入于经也，舍于血脉之中，其寒温未相得，如涌波之起也，时来时去，故
不常在，故曰∶方其来也，必按而止之，止而取之，无逢其冲而泻之，真气者，经气也，经
气大虚，故曰其来不可逢，此之谓也。
邪之中人，由络而经，由经而脉，故邪去络入于经也，则舍于血脉之中，邪气始入，未为寒病，
未为温病，其寒温未相得时，如涌波之初起也，起如涌波，则时来时去，时来时去，故不常在，邪
不常在，治之常早，故曰∶方其来也，必按而止之，止而取之。邪气冲突，宜避其锐，无逢其冲而
泻之，逢冲而泻，伤其经气，则真气亦伤。夫真气者，经气也，泻之则经气大虚，故《九针十二原》论
曰∶其来不可逢，即此无逢其冲而泻之之谓也。
故曰∶候邪不审，大气已过，泻之则真气脱，脱则不复，邪气
复至，而病益蓄。故曰其往不可追，此之谓也。
上文言大盛的可泻，此言已过亦不可泻。故曰候邪不审，针下所聚之大气已过，而复泻之，则真
气外脱，脱则不复矣。由是则邪气复至，而病益蓄，故《九针十二原》论曰∶其往不可追，即此大
气已过，不可泻之之谓也。
不可挂以发者，待邪之至时，而发针泻矣。若先若后者，血气已尽，其病不可下。故曰∶知
其可取，如发机，不知其取，如扣椎。故曰∶知机道者，不可挂以发，不知机者，扣之不发，此之谓也。
针道至微，先后之间，不差毫发。不可挂以发者，待邪气之至时，而发针以泻矣。发针不得其
时，若先若后者，伤其血气，则血气已尽，其病留中，而不可下。下，犹退也。取刺之道，贵得其
时，故曰知其可取而取之，则如发机之神速，不知其可取而取之，则如扣椎之钝朴。故《九针十二原》
论曰∶知机道者，不可挂以发，不知机者，扣之不发，即其知其可取如发机，不知其可取如扣椎之谓也。
帝曰∶补泻奈何？
帝先问补不足，未问泻有余，故为是问。
岐伯曰∶此攻邪也。
不足者补之，帝先问之矣，此复为补泻之问，则所问专在于
泻，故曰此攻邪也。犹言此攻邪之问也。
疾出以去盛血，而复其真气，此邪新客，溶溶未有定处也。推
之则前，引之则止，逆而刺之，温血也，刺出其血，其病立已。
溶溶，流动貌。逆，迎也。温，通调也。攻邪之法，当疾出其针，以去盛血，而复其真气，所以
然者，此邪新客于身，流动而未有定处也。未有定处，故推之则可前，引之则可止，若迎而刺之，
所以通调其血也。通调而刺出其血，其病立已。此攻邪之法为然，
不使真邪相合也的。
帝曰∶善。然真邪以合，波陇不起，候之奈何？
伯言经之动脉，其至也，亦时陇起，又言寒温未相得，如涌波
之起，然有真邪相合，而波陇不起，则候之奈何？
岐伯曰∶审扪、循三部九候之盛虚而调之，察其左右上下相失，及相减者，审其病脏以期之。
不知三部者，阴阳不别，天地不分。地以候地，天以候天，人以候人，调之中府，以定三部。故
曰∶刺不知三部九候病脉之处，虽有大过且至，工不能禁也。
别，音逼。邪入而波陇不起，则直气内虚，邪气内陷。候之之法，当以心审之，以手扪之，循其
三部九候之盛虚而调之，察其左右上下之相失，及相减者，审其病脏以期之。《三部九候论》云∶
“上下左右相失者死，中部之候相减者死”。期者，计其死生之时日也。不知三部者，不能循三部之盛
虚而调之也。阴阳不别，不能察其左右。天地不分，不能察其上下矣。地以候地，天以候天，人
以候人，不能察其相失及相减矣。能循三部之盛虚而调之，必调之中府，以定三部，三部之中，胃气为
本，中府，胃腑也。三部之中，又有九候，故曰刺不知三部九候病脉之处，则不能审其病脏以
期之。虽有死期之大过且至，而工不能禁也。大过，死期也。工不能禁，不能预料也。
诛罚无过，命曰大惑，反乱大经，真不可复，用实为虚，以邪为真，用针无义，反为气贼，夺人正气。
无过诛罚，则攻邪不当，故命曰大惑。大经反乱，则正气受伤，故真不可复。用实为虚，则虚实不
明。以邪为真，则真邪不别。如是以治，则用针无义，反为气贼，而夺人正气矣。
以从为逆，荣工散乱，真气已失，邪独内着，绝人长命，予人夭殃。不知三部九候，故不能久长。
予与同。用针无义，必至以从为逆，而荣卫散乱。反为气贼，必至真气已失，而邪独内着。夺人
正气，必至绝人长命，而予人夭殃。因此不知三部九候之理，故不能使人久长于人世也。
因不知合之四时五行，因加相胜，释邪攻正，绝人长命。
不知人之三部九候，因不知合之天之四时，地之五行，不知人之三部九候，因不知天之六气。因
加地之五运相胜，邪反释之，正反攻之，而绝人长命矣。
此一节，申明候气补泻，当知三部九候，以为补正泻邪之法也。
邪之新客来也，未有定处，推之则前，引之则止，逢而泻之，其病立已。
上文已言者，而复言之，以明邪气新客，当急治之，勿使真邪相合也。
“离合真邪”，是指真气与邪气彼此分离，不要使它们相合。当邪气侵入经脉时，真气与邪气就会相合，此时应当仔细诊察，务必使真气不致耗散，邪气不再深入。大概邪气刚刚客犯人体时，还没有固定的停留部位，推按它它就向前移动，牵引它它就停止不动，遇到它就用泻法，疾病立刻就能痊愈。通过泻法使相合的真邪分离，所以称为“离合真邪”。
黄帝问道：我听说《九针》有九篇，先生又将其演绎为九九八十一篇，我已经完全通晓其中的意旨了。
（这是承接上文，先知晓《针经》的意旨，说明九针之道详细记载在《针经》的八十一篇中，我已经完全理解了。）
经文说：气的盛衰变化，左右倾斜移易，可以上病下治，左病右治，对于有余和不足的证候，在荣穴和输穴上进行补泻，这些我都知道了。
（《针经》的大意大致如此，我已经知道了。）
这些都是荣卫之气的倾斜移易，以及虚实产生的原因，并非邪气从外部侵入经脉的情况。我希望听听邪气在经脉中的情况，它的病症表现是怎样的？应该如何取穴治疗呢？
（《针经》多论述正气的虚实，未详细说明邪气入经的情况，所以以此发问。）
岐伯回答说：圣人确立人体的脉度循行规律，必定与天地相应。所以天有二十八宿的度数，地有十二条经水，人有十二条经脉。
（起，即建立的意思。圣人建立人身脉度循行的规律，必定上应天时，下应地理。所以天有二十八宿的度数，人有十二经脉，以对应天；地有十二条经水，人有十二经脉，以对应地。）
天地气候温和，则经水安静；天气寒冷大地冻结，则经水凝涩不通；天气暑热大地炎热，则经水沸腾溢流；突然刮起暴风，则经水波涛汹涌并隆起。
（泣，通“涩”，指涩滞。卒，音促，急促之意，下文同此。地上的经水之气与天相通，所以天地温和，经水就安静。如果天寒地冻，经水就凝涩。凝涩，就是不行。天暑地热，经水就沸腾溢流。沸溢，就是泛滥。如果阴阳不和，突然刮起暴风，风行则水涣散，经水就像波涛汹涌并隆起一样。）
邪气侵入血脉时，遇寒则血液凝涩，遇暑则气机淖泽（濡润滑利），虚邪趁机侵入，也像经水遇到风一样，经脉的动脉，其搏动也时常隆起，它在脉中运行，是有次序的。
（人的经脉合于经水，气与天相通。至于邪气侵入血脉，天寒则人血凝涩，犹如天寒地冻，经水凝涩。天暑则人气淖泽，犹如天暑地热，经水沸溢。来自虚乡的邪气，因人体经脉虚弱而侵入，犹如突然刮起暴风，所以也像经水遇到风一样。经之动脉，犹言风入于经，而动其脉。其搏动也时常隆起，犹如经水遇风，波涌而陇起。如果不因于邪气，那么血气在脉中运行，是循循有序的。循循，是次序的样子，犹如天地温和，而经水安静。这就是人的脉度所以应合天地的道理。）
诊察寸口脉时，有时大有时小，大表示邪气已至，小表示平和。邪气运行没有固定处所在，或在阴分或在阳分，不可作为固定的标准，顺着它在阴或阳的位置去诊察，通过三部九候诊法，突然遇到邪气，要尽早阻断它的通路。
（中，读去声。处，读去声，下文的“处”同此。脉的会合之处，在于寸口，脉气到达寸口而应手时，则有时大有时小，大则脉气有余，所以是邪气已至；小则脉气凝实，所以是平和。邪气到来，其运行没有固定处所，或在血分的阴，或在气分的阳，不可作为固定的标准，顺着它在阴或在阳的位置去诊察，审视其三部九候之中，邪气所在的位置，突然遇到它，不要让真气和邪气相合，这应当尽早阻断它的通路。下文说“逢而泻之，其病立已”，意思是一样的。）
吸气时进针，不让气机逆乱；静心长时间留针，不让邪气扩散；吸气时转针，以得气为目的；呼气时引针，呼尽时才拔针，针下聚集的大气都随之排出，所以称为泻法。
（内，音纳，下文的“内针”之内同此。忤，逆也。大气，指针下所聚之气。正在吸气时进针，气机刚开始运行，不让其逆乱。宁静心神，长时间留针，用针引导邪气，不让邪气四处扩散。正在吸气时转针，想要得到气，以恢复正气。等候呼气时引针，呼尽针才去除，使针下所聚之气全部排出，这是泻邪的方法，所以称为泻。）
这一节，讲的是人身经脉应合天地，邪气突然到来，应当急泻，不要让真气和邪气相合。
黄帝问：正气不足时用补法，该怎么做呢？
（邪气突然到来，应当急泻；真气不足，则应当补益，所以有此一问。）
岐伯说：必须先用手扪摸并循按穴位，切按并分散郁结，推按穴位，弹击使血脉怒张，抓捏向下导引，疏通后取穴，向外拉开皮肤门户，以闭守神气。呼气尽时进针，静心长时间留针，以气至为目的，如同等待尊贵的客人，不知天色已晚。气已到来，适当调适并自我保护，等候吸气时拔针，使气不得外出，各留在针刺之处，推合皮肤门户，令神气留存，针下聚集的大气留止体内，所以称为补法。
（推，退，平声，下文同此。弹，平声。以至之以已通，下文的以合之以同。抓，犹引也。补益不足，应当知道经脉的不足，所以必须先用手指扪摸并循按，找到穴位的真谛，其次切按并分散郁结，推按穴位，分开掰弄穴位，不让其倾移，然后弹击使血脉怒张，以进针，引而下之，以加深针刺，疏通后取穴，以调和经脉，向外拉开皮肤门户，使气脉流通，以闭守神气，使真气内存。针刺留针的时间与呼吸次数不同，留针数尽，更应当进针，而静心长时间留针，久留是为了气至，以恢复常态。候气的方法，如同等待尊贵的客人，不知天色已晚。气已到来，仍当调适并自我保护。上文说候呼引针，大气皆出；这里说候吸引针，使气不得出，各留在针刺之处，推合皮肤门户，令神气存留，针下所聚的大气，留止于内，这是补正的方法，所以称为补。）
黄帝问：如何候气呢？
（如待所贵，不知日暮，气已到来，适当调适并自我保护，这是候气的方法，黄帝再次询问。）
岐伯说：邪气由络脉进入经脉，停留在血脉之中，其寒温属性尚未与机体相适应，像涌波兴起一样，时而来时而去，所以不常停留。所以说：当邪气刚来时，必须按压并阻止它，阻止后进行治疗，不要迎着邪气冲盛之时进行泻法。真气，就是经气，经气大虚，所以说邪气来时不可迎而泻之，说的就是这个意思。
（邪气中人，由络而经，由经而脉，所以邪气由络脉进入经脉，则停留在血脉之中。邪气初入，尚未形成寒病，也未形成温病，其寒温属性尚未与机体相适应时，像涌波初起一样。起如涌波，则时而来时而去，所以不常停留。邪气不常停留，治疗应当趁早，所以说：当邪气刚来时，必须按压并阻止它，阻止后进行治疗。邪气冲突，宜避其锐气，不要迎着邪气冲盛之时进行泻法。迎着冲盛而泻，会损伤经气，则真气也会受伤。夫真气者，经气也，泻之则经气大虚，所以《九针十二原》论中说：其来不可逢，即此不迎着冲盛而泻的意思。）
所以说：如果候邪不审慎，针下聚集的大气已经过去，再用泻法，则真气脱失，脱失后就不能恢复，邪气再次到来，而病情更加积聚。所以说邪气已去不可追，说的就是这个意思。
（上文讲大盛时可泻，这里讲已过也不可泻。所以说候邪不审慎，针下聚集的大气已经过去，如果再泻，则真气外脱，脱失后就不能恢复了。由此则邪气再次到来，而病情更加积聚，所以《九针十二原》论中说：其往不可追，即此大气已过，不可再泻的意思。）
时机不能差毫发，要等待邪气到来时，才发针泻邪。如果先于邪气或未等到邪气就施针，血气已尽，疾病就无法治愈。所以说：知道可取刺的时机，就像发射弩机一样神速；不知道可取刺的时机，就像敲击木椎一样迟钝。所以说：懂得机道的人，不差毫发；不懂机道的人，敲击而不发，说的就是这个意思。
（针道极其微妙，先后之间，不差毫发。不可挂以发者，等待邪气到来时，才发针泻邪。发针不得其时，如果先于邪气或未等到邪气就施针，伤其血气，则血气已尽，病邪留中，而无法退除。下，犹退也。取刺之道，贵在得其时机，所以说知道可取刺而取之，则像发射弩机一样神速；不知道可取刺而取之，则像敲击木椎一样钝朴。所以《九针十二原》论中说：知机道者，不可挂以发，不知机者，扣之不发，即此知道可取刺像发机，不知道可取刺像扣椎的意思。）
黄帝问：补法和泻法具体怎么做呢？
（黄帝先问补不足，未问泻有余，所以有此问。）
岐伯说：这是攻邪的方法。
（不足者补之，黄帝先问了，这里再次问补泻，则所问专门在于泻，所以说这是攻邪的方法。犹言这是关于攻邪的提问。）
快速出针以去除盛血，从而恢复真气，这是因为邪气是新近客犯的，流动而没有固定处所。推按它它就向前，牵引它它就停止，逆着邪气方向刺入，是通调血脉，刺出其血，疾病立刻痊愈。
（溶溶，流动貌。逆，迎也。温，通调也。攻邪之法，应当快速出针，以去除盛血，从而恢复真气。之所以这样，是因为此邪新近客犯身体，流动而没有固定处所。没有固定处所，所以推之则可前，引之则可止，若迎着邪气刺入，是为了通调其血。通调后刺出其血，疾病立刻痊愈。这是攻邪之法，不使真邪相合。）
黄帝说：好。但是如果真邪已经相合，脉象没有隆起波动，该如何诊察呢？
（岐伯说经之动脉，其搏动也时常隆起，又说寒温未相得，像涌波兴起。然而如果有真邪相合，而脉象没有隆起波动，则该如何诊察？）
岐伯说：仔细扪摸、循按三部九候的盛虚状况来进行调理，诊察其左右上下是否相失，以及是否有相减的情况，审察病变所在的脏腑以预测预后。
（不知道三部九候，就无法辨别阴阳，区分天地。地以候地，天以候天，人以候人，调节中府，以确定三部。所以说：针刺不知道三部九候病脉的部位，即使有大过且至的死期，医生也不能预料。）
（别，音逼。邪入而波陇不起，则直气内虚，邪气内陷。候之之法，应当用心审察，用手扪摸，循按三部九候的盛虚状况来调理，诊察其左右上下之相失，及相减的情况，审察病变所在的脏腑以预测死生之时日。《三部九候论》说：“上下左右相失者死，中部之候相减者死”。期者，计算其死生之时日。不知道三部，就不能循按三部的盛虚来调理。阴阳不别，不能诊察左右。天地不分，不能诊察上下。地以候地，天以候天，人以候人，不能诊察其相失及相减。能循按三部的盛虚来调理，必须调节中府，以确定三部。三部之中，胃气为本，中府，即胃腑。三部之中，又有九候，所以说针刺不知道三部九候病脉的部位，则不能审察病变所在的脏腑以预测预后。虽有死期之大过且至，而医生不能预料。大过，死期。工不能禁，不能预料。）
诛罚无过，命曰大惑，反而扰乱大经，真气不可恢复，将实证误作虚证，将邪气误作真气，用针没有义理，反而成为气的贼害，剥夺人的正气。
（无过诛罚，则攻邪不当，所以命曰大惑。大经反乱，则正气受伤，所以真气不可恢复。用实为虚，则虚实不明。以邪为真，则真邪不别。像这样治疗，则用针没有义理，反而成为气的贼害，而剥夺人的正气。）
把顺证当作逆证，营卫散乱，真气已经丧失，邪气独自内着，断绝人的寿命，给人带来夭折的灾殃。因为不知道三部九候，所以不能使人长寿。
（予与同。用针没有义理，必至把顺证当作逆证，而营卫散乱。反为气贼，必至真气已经丧失，而邪气独自内着。剥夺人的正气，必至断绝人的寿命，而给人带来夭折的灾殃。因此不知道三部九候的道理，所以不能使人长久生存于世。）
因为不知道结合四时五行，因而加上相胜的关系，释放邪气而攻击正气，断绝人的寿命。
（不知道人的三部九候，因而不知道合于天的四时，地的五行，不知道人的三部九候，因而不知道天的六气。因而加上地的五运相胜，邪气反而被释放，正气反而被攻击，而断绝人的寿命。）
这一节，申明候气补泻，应当知道三部九候，作为补正泻邪的方法。
邪气是新近客犯的，没有固定处所，推按它它就向前，牵引它它就停止，遇到它就用泻法，疾病立刻痊愈。
（上文已经说过的，再次重申，以明确邪气新客，应当急治，不要让真邪相合。）
"Li He Zhen Xie" (Separating True and Pathogenic Qi) refers to the separation of True Qi (Zheng Qi, healthy vital energy) and Pathogenic Qi (Xie Qi, evil factors), ensuring they do not combine. When pathogenic qi invades the meridians, true qi and pathogenic qi will combine; at this time, one must carefully examine the pulse, striving to ensure that true qi is not depleted and pathogenic qi does not penetrate further. Generally, when pathogenic qi first invades the body, it has no fixed location; pushing it moves it forward, pulling it stops it. Upon encountering it, apply the reducing method, and the disease will be cured immediately. By using the reducing method to separate the combined true and pathogenic qi, it is called "Li He Zhen Xie" (Separating True and Pathogenic Qi).
The Yellow Emperor asked: I have heard that *Jiu Zhen* (Nine Needles) consists of nine chapters, and you have expanded them into eighty-one chapters through multiplication by nine. I have fully understood their meaning.
(This follows from the previous text, first understanding the intent of *Zhen Jing* (Classic of Acupuncture), stating that the way of the Nine Needles is detailed in the eighty-one chapters of *Zhen Jing*, which I have fully comprehended.)
The classic states: The fluctuation of qi's abundance and deficiency, shifting left and right, can be treated by addressing the lower for upper disorders and the right for left disorders. For conditions of excess and deficiency, tonification and reduction are applied to the Ying (Nutrient) and Shu (Stream) acupoints. I am aware of these principles.
(The general idea of *Zhen Jing* is as stated above, and I am aware of it.)
These refer to the shifting of Ying (Nutrient) and Wei (Defensive) qi, and the generation of deficiency and excess, not the invasion of pathogenic qi from outside into the meridians. I wish to hear about the situation when pathogenic qi is within the meridians; what are its clinical manifestations? How should points be selected for treatment?
(*Zhen Jing* discusses the deficiency and excess of healthy qi extensively but does not detail the invasion of pathogenic qi into meridians, hence this inquiry.)
Bai Hu replied: The establishment of human physiological measurements by sages must correspond to Heaven and Earth. Thus, Heaven has the degrees of the twenty-eight mansions, Earth has twelve major rivers, and humans have twelve main meridians.
("Qi" here means establishing. Sages established the measurements and pathways of human meridians, which must correspond to Heaven above and Earth below. Thus, Heaven has the degrees of the twenty-eight mansions, and humans have twelve main meridians to correspond to Heaven; Earth has twelve major rivers, and humans have twelve main meridians to correspond to Earth.)
When Heaven and Earth are mild and warm, the rivers remain calm; when Heaven is cold and Earth frozen, the rivers become sluggish and stagnant; when Heaven is hot and Earth scorching, the rivers boil and overflow; when sudden storms arise, the rivers surge with waves and rise in mounds.
("Qi" acts as "Se" (sluggish/stagnant). "Cu" sounds like "Cu" (sudden/abrupt), same for subsequent instances. The qi of Earth's rivers connects with Heaven; thus, when Heaven and Earth are mild and warm, the rivers are calm. If Heaven is cold and Earth frozen, the rivers become sluggish. Sluggishness means stagnation. When Heaven is hot and Earth scorching, the rivers boil and overflow. Overflowing means flooding. If Yin and Yang are discordant and sudden storms arise, wind blows and water disperses, causing the rivers to surge with waves and rise in mounds, similar to the effect on human meridians.)
When pathogenic qi enters the vessels, cold causes blood to coagulate and become sluggish, while heat makes qi fluid and lubricated. Deficient pathogens take advantage to invade, just as rivers react to wind. The arterial pulses of the meridians also rise in mounds intermittently; their movement within the vessels follows a sequence.
(Human meridians correspond to rivers, and their qi connects with Heaven. Regarding pathogenic qi entering the vessels: cold weather causes human blood to become sluggish, akin to frozen earth and sluggish rivers. Heat causes human qi to become fluid, akin to boiling rivers. Deficient pathogens invade due to vessel weakness, akin to sudden storms affecting rivers. "Arterial pulse of the meridian" implies wind entering the meridian and agitating the pulse. Its intermittent mound-like rising is like rivers surging with wind. Without pathogenic influence, blood and qi flow sequentially within the vessels, akin to calm rivers under mild weather. This is why human measurements correspond to Heaven and Earth.)
At the Cun Kou (Radial Artery) pulse point, the pulse may appear large or small. A large pulse indicates the arrival of pathogenic qi; a small pulse indicates peace/health. Pathogenic qi moves without a fixed location, existing in either Yin or Yang aspects, making it unpredictable. One must examine it according to its presence in Yin or Yang, using the Three Regions and Nine Palpations method. Upon suddenly detecting it, block its path early.
("Zhong" is pronounced with the departing tone. "Chu" is pronounced with the departing tone, same as below. The convergence of pulses is at Cun Kou. When the pulse reaches Cun Kou and is felt by hand, it varies in size. Large indicates excess pulse qi, signifying pathogenic arrival; small indicates solid/concentrated pulse qi, signifying health. Pathogenic qi has no fixed location, possibly in the Yin of blood or Yang of qi, defying fixed standards. Examine based on its Yin/Yang location, scrutinizing the Three Regions and Nine Palpations to find the pathogen. Upon sudden detection, prevent the combination of true and pathogenic qi by blocking its path early. This aligns with the later statement: 'Upon encountering it, reduce it, and the disease is cured immediately.')
Insert the needle during inhalation to avoid qi rebellion; retain the needle quietly for a long time to prevent the spread of pathogenic qi; rotate the needle during inhalation until De Qi (arrival of qi) is achieved; withdraw the needle during exhalation, removing it only after exhalation is complete, so that the accumulated "Da Qi" (major qi/vital force under the needle) exits. This is called the Reducing Method.
("Nei" sounds like "Na" (insert), same as below. "Wu" means reverse/rebel. "Da Qi" refers to the qi gathered under the needle. Inserting during inhalation allows qi to begin moving, preventing rebellion. Calm the mind and retain the needle to guide pathogenic qi out, preventing its dispersion. Rotating during inhalation aims to achieve De Qi and restore normalcy. Withdrawing during exhalation, removing upon completion, expels the gathered qi. This is the method for reducing pathogens, hence called Reducing.")
This section explains that human meridians correspond to Heaven and Earth; when pathogenic qi arrives suddenly, it must be urgently reduced to prevent the combination of true and pathogenic qi.
The Yellow Emperor asked: How should tonification be applied for deficiency?
(Pathogenic qi arriving suddenly requires urgent reduction; true qi deficiency requires tonification, hence this question.)
Bai Hu said: First, palpate and stroke the area, press and disperse, push and press, flick to distend the vessels, grasp and guide downward, unblock and select the point, pull the skin opening outward to close the spirit gate. Insert the needle at the end of exhalation, retain it quietly for a long time until De Qi is achieved. Wait as if for a honored guest, unaware of the passing day. Once qi arrives, adjust and protect it appropriately. Withdraw the needle during inhalation so qi cannot escape, remaining at the needle site. Push the skin pore closed to keep the spirit and qi inside, allowing the major qi under the needle to stay. This is called the Tonifying Method.
("Tui" is "Tui" (retreat/push), level tone. "Dan" is level tone. "Zhua" is like guiding. To tonify deficiency, one must know the meridian's deficiency. First, palpate and stroke to locate the true acupoint. Then press and disperse, push and press, separating the point to prevent displacement. Flick to distend vessels for insertion, guide downward to deepen penetration, unblock and select to regulate the meridian. Pull the skin opening to facilitate qi flow and close the spirit gate, retaining true qi internally. Needle retention times vary with respiration. After retention, insert again and retain quietly for De Qi. Waiting for qi is like awaiting a honored guest. Once qi arrives, adjust and protect. Previously, withdrawing during exhalation expelled qi; now, withdrawing during inhalation retains qi. Closing the pore keeps spirit and qi inside, retaining major qi. This is the method for tonifying true qi, hence called Tonifying.")
The Yellow Emperor asked: How should one wait for qi?
(Waiting as for a honored guest, unaware of time, until qi arrives and adjusting/protecting it—this is the method for waiting for qi. The Yellow Emperor asks again.)
Bai Hu said: When pathogenic qi moves from collateral vessels into meridians, it lodges in the blood vessels. Initially, its cold or warm nature has not yet harmonized with the body, resembling the rising of waves—coming and going, thus not staying long. Therefore, it is said: When it comes, press and stop it, then treat it. Do not attack when it is at its peak. True Qi is Meridian Qi. Since Meridian Qi is greatly deficient, it is said that one should not meet the incoming pathogen with reduction. This is what is meant.
(Pathogens enter humans via collaterals to meridians, then to vessels. Lodging in blood vessels, initially the pathogen hasn't formed distinct cold or warm diseases. When its nature hasn't harmonized, it resembles rising waves, coming and going, not staying long. Treatment should be timely. Thus, 'when it comes, press and stop it, then treat.' Avoid attacking when the pathogen is rushing/peaking. Attacking the peak damages Meridian Qi, harming True Qi. True Qi is Meridian Qi; reducing it causes great deficiency. Hence, *Jiu Zhen Shi Er Yuan* states: 'Do not meet the incoming [pathogen],' meaning do not attack the peak rush.)
Therefore, it is said: If monitoring the pathogen is imprecise and the accumulated major qi has already passed, applying reduction will cause True Qi to collapse. Once collapsed, it cannot recover. The pathogen will return, and the disease will accumulate further. Thus, it is said that once the pathogen has gone, it cannot be pursued. This is what is meant.
(The previous text discussed reducing when excessive; this discusses not reducing when the pathogen has passed. If monitoring is imprecise and the accumulated qi has passed, reducing it causes True Qi to collapse externally, unable to recover. The pathogen returns, and the disease worsens. Hence, *Jiu Zhen Shi Er Yuan* states: 'Once gone, do not pursue,' meaning do not reduce after the major qi has passed.)
The timing must not differ by a hair's breadth. Wait for the pathogen to arrive before inserting the needle to reduce. If one needles too early or too late, the blood and qi will be exhausted, and the disease cannot be resolved. Thus, it is said: Knowing when to needle is like firing a crossbow mechanism; not knowing when is like striking a wooden mallet. It is said: Those who understand the Dao of opportunity do not miss by a hair; those who do not understand strike without effect. This is what is meant.
(Acupuncture is subtle; timing is critical. Not missing by a hair means waiting for the pathogen's arrival to needle. Incorrect timing harms blood and qi, exhausting them and trapping the disease. 'Xia' means retreat/resolution. Selecting points requires correct timing. Knowing the right time is like a swift crossbow shot; not knowing is like a dull mallet strike. Hence, *Jiu Zhen Shi Er Yuan* states: 'Know the opportunity... strike without effect,' referring to knowing vs. not knowing the right time.)
The Yellow Emperor asked: How are tonification and reduction performed?
(The Yellow Emperor previously asked about tonifying deficiency, not reducing excess, hence this question.)
Bai Hu said: This refers to attacking the pathogen.
(Deficiency was addressed earlier; this question focuses on reduction, hence 'attacking the pathogen'.)
Withdraw the needle quickly to remove abundant blood, thereby restoring True Qi. This is because the pathogen is newly arrived, flowing without a fixed location. Pushing it moves it forward; pulling it stops it. Pricking against the direction of flow regulates the blood. Pricking to bleed cures the disease immediately.
("Rong Rong" means flowing. "Ni" means facing/opposing. "Wen" means regulating/unblocking. The method for attacking pathogens involves quick needle withdrawal to remove abundant blood and restore True Qi. This is because the new pathogen flows without a fixed location. Without a fixed location, pushing moves it forward, pulling stops it. Pricking against the flow regulates blood. Regulating and bleeding cures the disease immediately. This is the method for attacking pathogens, preventing the combination of true and pathogenic qi.)
The Yellow Emperor said: Excellent. However, if true and pathogenic qi have combined and there is no mound-like pulsation, how should one monitor it?
(Bai Hu mentioned arterial pulses rising in mounds and cold/warm disharmony resembling waves. But if true and pathogenic qi combine without mound-like pulsation, how to monitor?)
Bai Hu said: Carefully palpate and stroke the abundance and deficiency in the Three Regions and Nine Palpations to regulate. Observe if the left/right and upper/lower pulses are discordant or diminished. Examine the affected zang organs to predict the outcome.
(Not knowing the Three Regions means failing to distinguish Yin/Yang and Heaven/Earth. Earth monitors Earth, Heaven monitors Heaven, Human monitors Human. Regulate the Middle Palace (Stomach) to define the Three Regions. Thus, it is said: If one does not know the locations of the Three Regions and Nine Palpations, even if a fatal condition approaches, the physician cannot foresee it.)
("Bie" sounds like "Bi". If pathogen enters without mound-like pulsation, healthy qi is internally deficient, and pathogen sinks inward. Monitoring requires careful mental examination and manual palpation of the Three Regions/Nine Palpations' abundance/deficiency. Observe discordance/diminution in left/right/upper/lower. Examine affected zang organs to predict death/life timing. *San Bu Jiu Hou Lun* states: 'Discordance in upper/lower/left/right leads to death; diminution in middle leads to death.' 'Qi' means calculating life/death timing. Not knowing the Three Regions prevents regulation based on abundance/deficiency. Failing to distinguish Yin/Yang prevents observing left/right. Failing to distinguish Heaven/Earth prevents observing upper/lower. Earth/Heaven/Human monitoring fails to detect discordance. Regulating based on Three Regions requires regulating the Middle Palace (Stomach Qi as root). Within the Three Regions are Nine Palpations. Hence, not knowing the locations prevents examining zang organs for prediction. Even if death approaches, the physician cannot foresee it. 'Da Guo' means death term. 'Gong bu neng jin' means inability to predict.)
Punishing the innocent is called great confusion. It reverses and disrupts the Great Meridians, making True Qi irrecoverable. Treating excess as deficiency and pathogen as true qi renders acupuncture meaningless, turning the practitioner into a thief of qi, depriving people of healthy qi.
(Punishing without fault means improper pathogen attack, called great confusion. Disruption of Great Meridians injures healthy qi, making True Qi irrecoverable. Treating excess as deficiency obscures truth/excess. Treating pathogen as true qi confuses true/pathogen. Such treatment makes acupuncture meaningless, acting as a qi thief, depriving healthy qi.)
Treating compliance as reversal scatters Ying and Wei qi. True qi is lost, and pathogen lingers internally alone, cutting off long life and bringing premature death. Because the Three Regions and Nine Palpations are unknown, longevity cannot be ensured.
('Yu' is the same as 'Tong'. Meaningless acupuncture leads to treating compliance as reversal, scattering Ying/Wei. Acting as a qi thief leads to loss of True qi and internal lingering of pathogen. Depriving healthy qi cuts off long life and brings premature death. Ignorance of Three Regions/Nine Palpations prevents ensuring longevity in the world.)
Failing to integrate the Four Seasons and Five Elements leads to adding mutual overcoming relationships, releasing the pathogen while attacking the true qi, cutting off long life.
(Ignorance of human Three Regions/Nine Palpations leads to ignorance of Heaven's Four Seasons, Earth's Five Elements, and Heaven's Six Qi. Adding Earth's Five Movements' mutual overcoming releases the pathogen and attacks the true qi, cutting off long life.)
This section clarifies that monitoring qi and performing tonification/reduction requires knowledge of the Three Regions and Nine Palpations as methods for tonifying true qi and reducing pathogenic qi.
Pathogenic qi is newly arrived, without a fixed location. Pushing it moves it forward; pulling it stops it. Upon encountering it, apply reduction, and the disease is cured immediately.
(Repeated from earlier to emphasize that newly arrived pathogens require urgent treatment to prevent the combination of true and pathogenic qi.)