难经云。经言能知迎随之气。可令调之。调气之方。必在阴阳。何谓也。然所谓迎
随者。知营卫之流行。经脉之往来。随其逆顺而取之。故曰迎随。调气之方。必在阴阳
者。知其内外表里。随其阴阳而调之。故曰调气之方。必在阴阳。
张世贤注云。手足三阳。手走头而头走足。手足三阴。足走胸而胸走手。此乃经脉
往来定规。凡欲泻者。用针芒向其经脉所来之处。迎其气之方来未盛。乃逆针以夺其
气。是谓之迎。凡欲补者。用针芒向其经脉所去之路。随其气之方去未虚。乃顺针以济
其气。是谓之随。迎随之施。将以调气。调气之术。必在知其病之在阴在阳。随其阴阳
虚实。而施迎随补泻。以调其气焉。内里为阴。外表为阳。内有表里。外亦有表里也。
古人有曰表之表。里之里。正此意也。阳虚阴实。则泻阴而补其阳。阳实阴虚。则泻阳
而补其阴。随其阴阳而调之也。
按男子午前。女子午后。照补泻正法用之。如女子午前。男子午后。则当反其例而
用之。盖男子应日。女子应月。
阴阳升降不同。用针者不可不辨。
例如男子午前。针左手阳经。针芒从外往上为随。针芒从内往下为迎。针左足阳
经。针芒从内往下为随。针芒从外往上为迎。针左足阴经。针芒从外往上为随。针芒从
内往下为迎。针左手阴经。针芒从内往下为随。针芒从外往上为迎。
李南丰注云。手上阳进阴退。足上阳退阴进（一）。合六经起止故也。凡针起穴。
针芒向上气顺行之道。凡针止穴。针芒向下气所止之处。左外右内。令气上行。右外左
内。令气下行。或问午前补泻。与午后相反。男子补泻。与女子相反（二）。盖男子之
气。早在上而晚在下。女子之气。早在下而晚在上。故男子阳经午前呼为补。吸为泻。女
子阳经。午前以吸为补。呼为泻。午后亦反之。或者又曰。补泻必资呼吸。假令尸厥中
风。不能使之呼吸者奈何。曰候其自然之呼吸而转针。若当吸不转。令人以手掩其口
鼻。鼓动其气可也。
噫补泻提插。分男女早晚。其理深微。原为奇经不拘十二经常度。故参互错综如
是。若流注穴。但分左右阴阳可也。
尝爱雪心歌云。
如何补泻有两般。盖是经从两边发。
古人补泻左右分。今人乃为男女别。
男女经脉一般生。昼夜循环无暂歇。
此诀出自梓桑君。我今授汝心已雪。
此子午兼八法而后全也。
The *Nan Jing* (Classic of Difficult Issues) states: The classic text mentions that if one can understand the Qi of Ying and Sui (Following and Opposing), one can regulate it. The method for regulating Qi must lie in Yin and Yang. What does this mean? It is answered that what is meant by Ying and Sui is knowing the circulation of Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi), and the direction of flow in the meridians. By taking points according to whether the flow is against or with the current, it is called Ying and Sui. The statement that the method for regulating Qi must lie in Yin and Yang means knowing the interior and exterior, the deep and superficial aspects, and regulating them according to their Yin or Yang nature. Hence, it is said that the method for regulating Qi must lie in Yin and Yang.
Zhang Shixian commented: The three Yang meridians of the hand and foot run from the hand to the head, and from the head to the foot. The three Yin meridians of the hand and foot run from the foot to the chest, and from the chest to the hand. This is the fixed rule for the direction of meridian flow. Whenever one wishes to apply the reducing method, the needle tip should be directed toward the source from which the meridian Qi comes, opposing the Qi before it becomes abundant, thus inserting the needle against the flow to drain the pathogenic Qi. This is called "Ying" (Opposing). Whenever one wishes to apply the reinforcing method, the needle tip should be directed toward the path where the meridian Qi departs, following the Qi before it becomes deficient, thus inserting the needle with the flow to support the healthy Qi. This is called "Sui" (Following). The application of Ying and Sui aims to regulate Qi. The technique of regulating Qi must depend on knowing whether the disease is in Yin or Yang, and applying Ying-Sui reinforcing and reducing methods according to the deficiency or excess of Yin and Yang to regulate the Qi. The interior is Yin, the exterior is Yang; within the interior there are distinctions of deep and superficial, and similarly on the exterior. The ancients said, "Superficial of the superficial, Interior of the interior," which conveys this meaning. If Yang is deficient and Yin is excessive, one reduces Yin and tonifies Yang. If Yang is excessive and Yin is deficient, one reduces Yang and tonifies Yin. This is regulating according to Yin and Yang.
For men before noon, and for women after noon, apply the standard reinforcing and reducing methods as prescribed. For women before noon, and for men after noon, reverse these principles. This is because men correspond to the Sun (Yang), and women correspond to the Moon (Yin).
The ascending and descending of Yin and Yang differ; those who use acupuncture must distinguish these carefully.
For example, for a man before noon, when needling the Yang meridians of the left hand, directing the needle tip outward and upward constitutes "Sui" (Following); directing it inward and downward constitutes "Ying" (Opposing). When needling the Yang meridians of the left foot, directing the needle tip inward and downward constitutes "Sui"; directing it outward and upward constitutes "Ying". When needling the Yin meridians of the left foot, directing the needle tip outward and upward constitutes "Sui"; directing it inward and downward constitutes "Ying". When needling the Yin meridians of the left hand, directing the needle tip inward and downward constitutes "Sui"; directing it outward and upward constitutes "Ying".
Li Nanfeng commented: On the upper limbs, Yang Qi advances and Yin Qi retreats; on the lower limbs, Yang Qi retreats and Yin Qi advances. This is based on the starting and ending points of the six meridians. When needling a starting point, directing the needle tip upward follows the natural course of Qi flow. When needling an ending point, directing the needle tip downward indicates where Qi stops. Needling the lateral side of the left limb and the medial side of the right limb causes Qi to ascend; needling the lateral side of the right limb and the medial side of the left limb causes Qi to descend. One might ask: Why are reinforcing and reducing methods reversed between morning and afternoon, and why do they differ between men and women? The answer is: Men's Qi is higher in the morning and lower in the evening; women's Qi is lower in the morning and higher in the evening. Therefore, for men's Yang meridians before noon, exhalation is used for reinforcing and inhalation for reducing. For women's Yang meridians before noon, inhalation is used for reinforcing and exhalation for reducing. Afternoon practices are the reverse. Some argue that reinforcing and reducing must rely on respiration. What if one encounters a patient with *Shi Jue* (Corpse-like Fainting) or stroke who cannot breathe voluntarily? The response is: Wait for the patient's natural breathing rhythm to manipulate the needle. If manipulation is needed during inhalation but the patient cannot inhale, another person may cover the patient's mouth and nose with their hand to stimulate airflow.
Alas! The techniques of lifting and thrusting (Lifting and Thrusting) in reinforcing and reducing, differentiated by gender and time of day, involve profound and subtle principles. Originally, this complexity arises because the Eight Extraordinary Vessels (Chong, Ren, Du, Dai, Yin Wei, Yang Wei, Yin Qiao, Yang Qiao) do not strictly follow the regular measures of the Twelve Regular Meridians, leading to such intricate interrelations. However, for acupoints selected via Zi Wu Liu Zhu (Midnight-Noon Ebb-Flow), one only needs to differentiate left and right Yin and Yang.
I have long cherished the *Xue Xin Ge* (Song of Snow-Clear Heart):
Why are there two types of reinforcing and reducing?
Because meridians originate from both sides of the body.
The ancients distinguished reinforcing and reducing by left and right;
Modern practitioners distinguish them by male and female.
Male and female meridians develop identically,
Cycling through day and night without pause.
This secret was passed down by Master Zisang;
Today I impart it to you, clearing your heart like snow.
This completes the theory by combining Zi Wu Liu Zhu with the Ling Gui Ba Fa (Spirit Turtle Eight Methods).