（《素问·离合真邪论》）
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。（针经之数，共八十一篇也。）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。此皆荣卫之倾移，虚实之所生，非邪气
从外入于经也。（荣卫倾移，谓阴阳偏胜，则虚实内生而为病，非邪气在经之谓也。）余愿闻邪气之在经也，其病患何如？
取之奈何？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。（宿，谓二十八宿。度，谓三
百六十五度。经水，谓清渭海湖汝渑淮漯江河济漳，以合人之三阴三阳、十二经脉也。）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。（人气与天地相通，故温和寒冷暑热卒风暴至，而经脉
之应，必随时为变，邪之中人亦然也，详如下文。泣，涩同。陇，隆同。）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。（邪气之自外而入者，或为凝泣，
或为淖泽，皆由于寒热之变。其入客于经，亦如经水之得风，即血脉之得气也，故致经脉亦时陇起。盖邪在脉中，无非
随正气往来以为之动静耳。循循，随顺貌。淖，乃豹切。）至其寸口中手也，时大时小，大则邪至，小则平，其行无常处。
（邪气随脉，必至寸口，有邪则陇起而大，无邪则平和而小，随其所在而为形见，故行无常处。）在阴与阳，不可为度。
（随阳经则入阳分，随阴经则入阴分。）从而察之，三部九候，卒然逢之，早遏其路，（见邪所在，则当遏之。遏者，制
也。早绝其路，庶无深大之害。三部九候，详脉色类五。）
吸则内针，无令气忤，（此下言呼吸补泻之法也。吸则内针，泻其实也。盖吸则气至而盛，迎而夺之，其气可泄，所
谓刺实者，刺其来也。去其逆气，故令无忤。）静以久留，无令邪布，（前气未除，后气将至，故当静留其针，俟而泻之，
无令邪气复布也。）吸则转针，以得气为故，（邪气未泄，候病者再吸，乃转其针。转，搓转也，谓之催气。得气为故，
以针下得气之故为度也。）候呼引针，呼尽乃去，大气皆出，故命曰泻。（入气曰吸，出气曰呼。引，引退也。去，出针
也。候呼引至其门，则气去不能复聚；呼尽乃离其穴，则大邪之气随泄而散，经气以平，故谓之泻。《调经论》曰∶泻实
者气盛乃内针，针与气俱内，以开其门，如利其户，针与气俱出，精气不伤，邪气乃下，外门不闭，以出其疾，摇大其
道，如利其路，是谓大泻，必切而出，大气乃屈。）帝曰∶不足者补之奈何？岐伯曰∶必先扪而循之，（先以手扪摸其处，
欲令血气温舒也。扪，音门。）切而散之，（次以指切捺其穴，欲其气之行散也。）推而按之，（再以指揉按其肌肤，欲针
道之流利也。）弹而怒之，（以指弹其穴，欲其意有所注则气必随之，故脉络 满如怒起也。）抓而下之，（用法如前，然
后以左手爪甲掐其正穴，而右手方下针也。抓，爪同，又平、去二声。）通而取之，（下针之后，必候气通以取其疾，如
下文者。）外引其门，以闭其神，（门，穴门也。此得气出针之法，详下文。）呼尽内针，静以久留，以气至为故，（此详
言用补之法也。呼尽则气出，气出内针，追而济之也，故虚者可实，所谓刺虚者刺其去也。气至义见后，为故义如前。）
如待所贵，不知日暮，（静以久留，以候气至，如待贵人，毋厌毋忽也。）其气以至，适而自护，（以，已同。适，调适也。
护，爱护也。《宝命全角论》曰∶经气已至，慎守勿失。即此谓也。义如下文。）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。（候吸引针则气充于内，推阖其门则气固于外，神存气留故谓之补。《调经论》
曰∶补虚者，持针勿置，以定其意，候呼内针，气出针入，针空四塞，精无从去，方实而疾出针，气入针出，热不得还，
闭塞其门，邪气布散，精气乃得存，动气候时，近气不失，远气乃来，是谓追之。愚按∶近代用针撮要，凡足以发明本
经、开导后人等法，有不可不知者。如用针之道，以气为主，知虚知实，方可无误。虚则脉虚而为痒为麻，实则脉实而
为肿为痛。虚则补之，气至则实；实则泻之，气去则虚。故用补用泻，必于呼吸之际，随气下针，则其要也。下针之法，
先以左手扪摸其处，随用大指爪重按切掐其穴，右手置针于穴上。凡用补者，令病患咳嗽一声，随嗽下针，气出针入。
初刺入皮，天之分也；少停进针，次至肉中，人之分也；又停进针，至于筋骨之间，地之分也。然深浅随宜，各有所用。
针入之后，将针摇动搓弹，谓之催气。觉针下沉紧，倒针朝病，向内搓转，用法补之。或针下气热，是气至足矣，令病
者吸气一口，退针至人之分，候吸出针，急以指按其穴，此补法也。凡用泻者，令其吸气，随吸入针，针与气俱内。初
至天分，少停进针，直至于地，亦深浅随宜而用。却细细摇动，进退搓捻其针如手颤之状，以催其气。约行五六次，觉
针下气紧，即倒针迎气，向外搓转以用泻法。停之良久，退至人分，随嗽出针，不闭其穴，此为泻法。故曰欲补先呼后
吸，欲泻先吸后呼，即此法也。所谓转针者，搓转其针，如搓线之状，慢慢转之，勿令太紧，泻左则左转，泻右则右转，
故曰拈针向外泻之方，拈针向内补之诀也。所谓候气者，必使患者精神已潮，而后可入针；针既入矣，又必使患者精神
宁定，而后可行气。若气不潮针，则轻滑不知疼痛，如插豆腐，未可刺也。必候神气既至，针下紧涩，便可根据法施用。
入针后轻浮虚滑迟慢，如闲居静室、寂然无闻者，乃气之未到；入针后沉重涩滞紧实，如鱼吞钓、或沉或浮而动者，乃
气之已来。虚则推内进搓以补其气，实在循扪弹怒以引其气。气未至则以手循摄，以爪切 ，以针摇动，进拈搓弹，其
气必至。气既至，必审寒热而施治。刺热须其寒者，必留针候其阴气隆至也，刺寒须其热者，必留针候其阳气隆至也，
然后可以出针。然气至速者，效亦速而病易痊；气至迟者，效亦迟而病难愈。生者涩而死者虚，候气不至，必死无疑，
此因气可知吉凶也。所谓出针者，病势既退，针气必松；病未退者，针气固涩，推之不动，转之不移，此为邪气吸拔其
针。真气未至，不可出而出之，其病即复，必须再施补泻以待其气，直候微松，方可出针豆许，摇而少停，补者候吸，
徐出针而急按其穴；泻者候呼，疾出针而不闭其穴。故曰下针贵迟，太急伤血；出针贵缓，太急伤气也。所谓迎随者，
如手之三阴，从脏走手；手之三阳，从手走头。足之三阳，从头走足；足之三阴，从足走腹。逆其气为迎为泻，顺其气
为随为补也。所谓血气多少者，如阳明多血多气，刺之者出血气；太阳厥阴多血少气，刺之者出血恶气；少阳少阴太阴
多气少血，刺之者出气恶血也。所谓子母补泻者，济母益其不足，夺子平其有余。如心病虚者补其肝木，心病实者泻其
脾土，故曰虚则补其母，实则泻其子。然本经亦有补泻，心虚者取少海之水，所以伐其胜也；心实者取少府之火，所以
泄其实也。又如贵贱之体有不同者，贱者硬而贵者脆也。男女之取法有异者，男子之气早在上而晚在下，女子之气早在
下而晚在上；午前为早属阳，午后为晚属阴。男女上下，其分在腰，足不过膝，手不过肘，补泻之宜，各有其时也。又
如阴阳经穴取各有法者，凡阳部阳经多在筋骨之侧，必取之骨旁陷下者为真，如合谷、三里、阳陵泉之类是也。凡阴部
阴经，必取于 隙之间动脉应手者为真，如箕门、五里、太冲之类是也。至于针制有九，所以应阳九之数也。针义有五，
所以合五行之用也。古人以砭石，后人代以九针，其体则金也。长短小大各随所宜，其劲直象木也。川原壅塞，可决于
江河，血气凝滞，可疏于经络，其流通象水也。将欲行针，先摸其穴，含针于口，然后刺之，借我之阳气，资彼之虚寒，
其气温象火也。入针以按，出针以扪，按者镇其气道，扪者闭其气门，其填补象土也。诸如此类，皆针家之要，所不可
不知者。）
(From *Suwen: Lilun Zhenxie Lun* [Treatise on the Separation and Union of True and Evil])
The Yellow Emperor asked, "I have heard that the *Nine Needles* consists of nine chapters. You have multiplied this by nine, resulting in eighty-one chapters. I have comprehended their general meaning. (The number of chapters in the *Zhenjing* [Classic of Acupuncture] is eighty-one.) The classics state that regarding the flourishing and declining states of Qi, its shifting to the left or right, one can treat lower disorders by manipulating upper points, and right-sided disorders by manipulating left-sided points. For excess and deficiency conditions, tonification and sedation are applied at the Ying (Spring) and Shu (Stream) acupoints. I understand these principles. These shifts in Ying and Wei (Defensive) Qi generate internal excess and deficiency; they do not refer to evil Qi invading from outside into the meridians. (A shift in Ying and Wei Qi refers to an imbalance of Yin and Yang leading to internal excess and deficiency causing disease, not the presence of evil Qi within the meridians.) I wish to hear about evil Qi residing within the meridians. What symptoms does it produce? How should it be treated?"
Qibo replied, "When the Sages established the measurements for acupuncture, they aligned them with Heaven and Earth. Thus, Heaven has the degrees of the constellations, Earth has the flowing waters, and Humanity has the meridians. (Constellations refer to the Twenty-Eight Mansions. Degrees refer to the 365.25 days/degrees. Flowing waters refer to rivers such as the Wei, Hai, Hu, Ru, Mian, Huai, Luo, Jiang, He, Ji, and Zhang, corresponding to the Three Yin and Three Yang, and the Twelve Meridians of Humanity.) When Heaven and Earth are mild and warm, the flowing waters remain calm; when Heaven is cold and Earth frozen, the waters become stagnant and sluggish; when Heaven is hot and Earth scorching, the waters boil and overflow; when sudden storms arise, the waters surge and rise in waves. (Human Qi communicates with Heaven and Earth. Therefore, responses to mildness, cold, heat, and sudden storms cause changes in the meridians accordingly. The same applies to evil Qi invading the body, as detailed below. 'Qi' here is synonymous with 'severe/sluggish'. 'Long' is synonymous with 'swelling/protrusion'.) When evil Qi enters the vessels, cold causes blood to coagulate and become sluggish, while heat makes Qi fluid and abundant. Deficient evil takes this opportunity to invade, much like wind affecting flowing waters. The arterial pulse of the meridines swells and rises intermittently, moving smoothly within the vessels. (External evil Qi may cause stagnation or fluidity due to cold or heat variations. Upon entering the meridians, similar to water affected by wind, it affects the blood vessels, causing intermittent swelling. Essentially, evil within the vessels moves dynamically in accordance with the fluctuation of healthy Qi. 'Xunxun' describes a smooth, following manner. 'Nao' is pronounced 'naibao'.) When palpating the Cun Kou (Radial Pulse), the pulse size varies—large when evil arrives, small when peaceful. Its movement has no fixed location. (Evil follows the meridians to the Cun Kou. Presence of evil causes swelling and enlargement; absence results in peace and smallness. It manifests where it resides, hence having no fixed path.) It traverses Yin and Yang meridians without a fixed standard. (Following Yang meridians, it enters the Yang aspect; following Yin meridians, it enters the Yin aspect.) By observing carefully through the Three Regions and Nine Hopes (Sanbu Jiuhou) pulse diagnosis, if evil is suddenly detected, one must intercept it early to block its path. (Upon identifying the location of evil, it should be restrained. 'E' means to control. Blocking its path early prevents severe harm. See Section 5 on Pulse and Color for details on Sanbu Jiuhou.)
"When inhaling, insert the needle, ensuring no disturbance to the Qi. (This section discusses respiration-based tonification and sedation. Inserting during inhalation sedates excess. Since Qi is vigorous during inhalation, attacking it there allows for drainage, known as 'needling the arrival' for excess conditions. This removes adverse Qi, preventing disturbance.) Leave the needle still for a long time to prevent the spread of evil. (Since the previous Qi has not cleared and new Qi is approaching, retaining the needle statically allows for subsequent sedation, preventing the re-spread of evil.) Rotate the needle during inhalation until Deqi (arrival of Qi) is achieved. (If evil remains, wait for another inhalation before rotating. Rotation involves搓转 (cubbing/turning), termed 'urging Qi'. Deqi is the goal, measured by the sensation of Qi under the needle.) Withdraw the needle during exhalation, removing it only after exhalation is complete, so that the major Qi (evil) exits. Hence, this is called Sedation. (Inhalation brings Qi in; exhalation pushes Qi out. 'Yin' means withdrawal. 'Qu' means removal. Withdrawing to the threshold during exhalation prevents Qi re-aggregation; removing at the end of exhalation allows major evil to dissipate, leveling Meridian Qi. Thus, it is Sedation. *Tiaojing Lun* states: To sedate excess, insert when Qi is strong. Needle and Qi enter together, opening the gate like a door. Needle and Qi exit together, sparing Essence, expelling evil, keeping the outer gate open to release illness quickly, widening the path like a thoroughfare. This is Great Sedation. Press and remove; major Qi yields.)
"The Yellow Emperor said, 'How do we tonify deficiency?' Qibo answered, 'First, palpate and stroke the area. (Palpate with hand first to warm and soothe Blood and Qi. 'Men' is the pronunciation.) Then press and disperse. (Press the acupoint with fingers to disperse Qi.) Push and press. (Rub and press the skin/muscle to ensure smooth needle passage.) Flick and distend. (Flick the acupoint to focus intent, causing Qi to follow and vessels to swell/distend like anger.) Scratching (nail-pressing) then insert. (As before, use left thumb nail to press the exact point, then insert with right hand. 'Zhua' is same as 'Zhao' [nail], also pronounced ping/qu.) Unblock and extract. (After insertion, wait for Qi flow to address the condition, as described below.) Pull the exterior gate to close the Shen (Spirit). (Gate refers to the acupoint gate. This is the method for withdrawing after Deqi, see below.) Insert at the end of exhalation, leave still for a long time, aiming for Deqi. (This details Tonification. End of exhalation means Qi is out; inserting then chases and supports it, turning deficiency into sufficiency. Known as 'needling the departure' for deficiency. Meaning of Deqi and 'goal' as above.) Wait as if for a noble person, unaware of the passing day. (Leave still waiting for Qi, like awaiting a VIP, without boredom or neglect.) Once Qi arrives, adjust and protect it appropriately. ('Yi' is same as 'yi' [already]. 'Shi' is adjustment. 'Hu' is protection. *Baoming Quanxing Lun* says: When Jing Qi arrives, guard it carefully. This refers to that. See below.) Withdraw during inhalation so Qi does not escape, staying in place. Push and close the gate, letting Shen and major Qi remain. Hence, this is Tonification. (Withdrawing during inhalation fills Qi internally; closing the gate secures Qi externally. Spirit stays, Qi remains, thus Tonification. *Tiaojing Lun* states: To tonify deficiency, hold needle firmly, stabilize mind. Insert during exhalation, Qi out/needle in. Seal the needle hole, preventing Essence loss. Remove quickly when full. Qi enters/needle exits, heat cannot return. Close the gate, scatter evil, preserve Essence. Time movements with Qi, keep near Qi, attract far Qi. This is 'Pursuing'.)
"I note: Modern summaries of acupuncture emphasize methods clarifying the classics and guiding successors. Key points include: Acupuncture relies on Qi; knowing deficiency/excess prevents error. Deficiency shows as empty pulse, itching, numbness; Excess shows as full pulse, swelling, pain. Tonify deficiency (Qi arrival leads to sufficiency); Sedate excess (Qi departure leads to emptiness). Tonification/Sedation must occur during respiration, following Qi descent.
Insertion technique: Palpate with left hand, press firmly with left thumb nail, insert with right hand. For Tonification: Patient coughs once; insert as Qi exits. Depth: Skin = Heaven; Flesh = Human; Sinew/Bone = Earth. Adjust depth as needed. After insertion, shake/rub/flick to urge Qi. If heavy/tight sensation occurs, tilt needle toward disease, rotate inward for Tonification. If warmth felt, Qi is sufficient. Patient inhales, withdraw to Human level, remove during inhalation, press point immediately. This is Tonification.
For Sedation: Patient inhales, insert as Qi enters. Needle and Qi enter together. Depth: Skin to Bone, adjusted as needed. Gently shake, advance/retract, rub/roll like trembling hands to urge Qi. Repeat 5-6 times. If tightness felt, tilt against Qi, rotate outward for Sedation. Wait, withdraw to Human level, remove with cough, leave hole open. This is Sedation. Thus, Tonify: Exhale then Inhale; Sedate: Inhale then Exhale.
Rotation: Rub/roll like twisting thread, slowly, not too tight. Sedate Left by rotating Left, Sedate Right by rotating Right. 'Pulling needle outward' sedates; 'pulling needle inward' tonifies.
Waiting for Qi: Patient spirit must be focused before insertion. After insertion, spirit must be calm before manipulating Qi. If Qi hasn't arrived, needle feels light/slippery/painless (like inserting tofu); do not proceed. Must wait for tightness/roughness under needle.
Sensation signs: Light/slippery/slow/silent = Qi not arrived. Heavy/rough/tight/firm/swaying like fish biting hook = Qi arrived.
Tonify deficiency by pushing in/rubbing; Sedate excess by stroking/palpating/flicking/distending. If Qi hasn't arrived, use hand stroking, nail pressing, needle shaking, advancing/pulling/rubbing/flicking to induce Qi.
Once Qi arrives, assess Cold/Heat. For Heat, retain needle until Coolness (Yin Qi) arrives. For Cold, retain until Warmth (Yang Qi) arrives. Then remove. Fast Qi arrival = fast effect/easy cure. Slow Qi arrival = slow effect/hard cure. Alive pulses are rough; dead pulses are empty. No Qi arrival = death certain. Qi indicates prognosis.
Removal: If disease recedes, needle feels loose. If disease persists, needle feels stuck/unmovable (evil sucking needle). Do not remove if True Qi hasn't arrived, or disease returns. Re-tonify/sedate until slightly loose. Withdraw slightly, pause. Tonify: Withdraw during inhalation, press point quickly. Sedate: Withdraw during exhalation, leave hole open.
Thus: Insert slowly (hurrying injures Blood); Remove slowly (hurrying injures Qi).
Following/Facing (Ying/Sui): Hand Yin meridians go from Zang to Hand; Hand Yang from Hand to Head. Foot Yang from Head to Foot; Foot Yin from Foot to Abdomen. Against flow is Facing (Sedation); With flow is Following (Tonification).
Blood/Qi Quantity: Yangming has much Blood/Qi (bleed both). Taiyang/Jueyin have much Blood/little Qi (bleed, avoid Qi). Shaoyang/Shaoyin/Taiyin have much Qi/little Blood (drain Qi, avoid Blood).
Mother-Son Tonification/Sedation: Nourish Mother for deficiency, drain Son for excess. Heart deficiency tonify Liver Wood; Heart excess sedate Spleen Earth. 'Tonify Mother, Sedate Son.' However, Same-Meridian methods exist: Heart deficiency take Shaohai (Water) to overcome overacting; Heart excess take Shaofu (Fire) to drain excess.
Body Types: Low status (hard/stiff) vs High status (fragile/delicate). Gender differences: Men's Qi is high early/low late; Women's Qi is low early/high late. Morning is Early/Yang; Afternoon is Late/Yin. Division between men/women is at waist. Legs stop at knees, arms at elbows. Timing varies.
Acupoint Selection: Yang meridians often near bone/muscle junctions; select depressions beside bones (e.g., Hegu, Zusanli, Yanglingquan). Yin meridians often in gaps with pulsating arteries; select these (e.g., Jimen, Wuli, Taichong).
Nine Needles correspond to Yang numbers. Five Needle meanings correspond to Five Elements. Ancient Bi stones replaced by Nine Needles (Metal body). Length/size vary (Wood-like straightness). Obstructions in rivers cleared by channels; stagnation in meridians cleared by needles (Water-like flow). Heating needle in mouth warms cold (Fire-like warmth). Pressing on insertion, patting on removal seals gates (Earth-like filling). These are essential acupuncture knowledge.)