此篇以气血随谷脉为虚实，叮咛反复，以免误针。可见针灸家于虚实寒热补泻之道，亟应讲求，不
得笼统施治。
黄帝问曰∶愿闻虚实之要。岐伯对曰∶气实形实，气虚形虚，此其常也，反此者病。谷盛气盛，谷虚气
虚，此其常也，反此者病。脉实血实，脉虚血虚，此其常也，反此者病。帝曰∶如何而反？岐伯曰∶气虚
身热，此谓反也。谷入多而气少，此谓反也。谷不入而气多，此谓反也。脉盛血少，此谓反也。脉小血
多，此谓反也。气盛身寒，得之伤寒。气虚身热，得之伤暑。谷入多而气少者，得之有所脱血，湿居下也。
谷入少而气多者，邪在胃及与肺也。脉小血多者，饮中热也。脉大血少者，脉有风气，水浆不入，此之谓也。
夫实者，气入也。虚者，气出也。气实者，热也。气虚者，寒也。入实者，左手开针空也，入虚者，
左手闭针空也。
此篇与《灵枢·小针解》大同小异，后半所释，非《九针十二原》篇之文。疑另有九针一篇，或在外
经，今佚不传。篇末百二十四字，王冰已称义理残缺，莫可寻究，因上古之书，故且载之，以示一字千金之义。
黄帝问曰∶愿闻九针之解，虚实之道。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。邪胜则虚之者，出针勿按。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。言实与虚者，寒温气多少也。若无若有者，疾不可知也。察
后与先者，知病先后也。为虚与实者，工勿失其法。若得若失者，离其法也。虚实之要，九针最妙者，为其各
有所宜也。补泻之时者，与气开阖相合也。九针之名，各不同形者，针穷其所当补泻也。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。经气已至，慎守勿失者，勿变
更也。深浅在志者，知病之内外也。近远如一者，深浅其候等也。如临深渊者，不敢堕也。手如握虎者，欲其
壮也。神无营于众物者，静志观病患，无左右视也。义无邪下者，欲端以正也。必正其神者，欲瞻病患目制
其神，令气易行也。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。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。人
皮应天，人肉应地，人脉应人，人筋应时，人声应音，人阴阳合气应律，人齿面目应星，人出入气应
风，人九窍三百六十五络应野。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。
人心意应八风，人气应天，人发齿耳目五声应五音六律，人阴阳脉血气应地，人肝目应之九。九窍三百六十
五。人一以观动静，天二以候五色，七星应之，以候发毋泽。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。
This chapter repeatedly emphasizes the deficiency and excess of Qi and Blood in relation to dietary intake and pulse conditions, to avoid erroneous acupuncture. Thus, it is evident that acupuncturists must diligently study the principles of deficiency/excess, cold/heat, and tonification/sedation, rather than treating indiscriminately.
The Yellow Emperor asked: "I wish to hear about the essentials of deficiency and excess." Qibo replied: "When Qi is excess, the body is full; when Qi is deficient, the body is weak. This is the normal state; the opposite indicates disease. When dietary intake is abundant, Qi is excess; when dietary intake is scant, Qi is deficient. This is the normal state; the opposite indicates disease. When the pulse is excess, Blood is excess; when the pulse is deficient, Blood is deficient. This is the normal state; the opposite indicates disease." The Emperor said: "How does one identify the opposite?" Qibo said: "Qi deficiency with body heat is called 'opposite'. Abundant food intake but scant Qi is called 'opposite'. No food intake but excessive Qi is called 'opposite'. Excessive pulse but scant Blood is called 'opposite'. Small pulse but abundant Blood is called 'opposite'."
"Qi excess with cold body results from Cold Injury (Shanghan). Qi deficiency with body heat results from Summer-heat Injury (Shangshu). Abundant food intake but scant Qi results from blood loss or dampness accumulating below. Scant food intake but excessive Qi results from pathogenic factors in the Stomach and Lung. Small pulse but abundant Blood results from fluid retention with internal heat. Large pulse but scant Blood results from wind pathogens in the vessels, where fluids are not ingested; this is what is meant."
Excess refers to the inward entry of pathogens. Deficiency refers to the outward leakage of Zheng Qi. Qi excess manifests as heat; Qi deficiency manifests as cold. To treat excess (expelling pathogens), the left hand should open the needle aperture. To treat deficiency (retaining Zheng Qi), the left hand should close the needle aperture.
This chapter is largely similar to *Ling Shu: Xiao Zhen Jie*. The latter half's explanation does not originate from *Jiu Zhen Shi Er Yuan*. It is suspected that there was another chapter dedicated to the Nine Needles, perhaps in the *Wai Jing*, which is now lost. Wang Bing noted that the last 124 characters have incomplete logic and are difficult to investigate. Since these are ancient texts, they are retained to demonstrate their immense value.
The Yellow Emperor asked: "I wish to understand the interpretation of the Nine Needles and the way of deficiency and excess." Qibo replied: "To tonify deficiency, one seeks warmth under the needle; this warmth arises when Zheng Qi becomes sufficient. To sedate fullness, one seeks coldness under the needle; this coldness arises when pathogenic Qi becomes deficient. 'Removing stasis and old blood' means evacuating bad blood. When pathogenic excess requires sedation, do not press the needle hole after withdrawal. Slow withdrawal and rapid pressing (Tonification) consolidates Qi. Rapid withdrawal and slow pressing (Sedation) disperses pathogens. 'Excess and Deficiency' refer to the degree of cold/warmth and Qi quantity. 'As if present, as if absent' refers to the elusive sensation of the needle. Observing order determines knowledge of the disease's progression. Treating deficiency and excess requires strict adherence to method. Deviation leads to a sense of loss. The Nine Needles are superior for managing deficiency/excess because each is suited to specific indications. Tonification and sedation timing aligns with the opening and closing of Qi. The different names and shapes of the Nine Needles correspond to the specific sites requiring tonification or sedation. For excess, retain the needle until Yin Qi arrives abundantly before removing it. For deficiency, retain the needle until Yang Qi arrives abundantly and warmth is felt before removing it. Once Jing Qi arrives, guard it carefully without changing the approach. Depth is determined by intent to know interior/exterior locations. Proximity and distance are treated equally regarding palpation. Approach with caution like standing at an abyss. Hold the needle firmly like grasping a tiger. Keep the mind undistracted, observing the patient quietly without looking around. Insert the needle upright and correctly. Stabilize the patient's Shen by gazing into their eyes to facilitate Qi flow."
"The point Sanli is three cun below the knee. 'Fu' refers to the area easily seen when lifting the knee. 'Juxu' is the depression visible when raising the foot. 'Xialian' is the depressed area."
The Emperor said: "I have heard the Nine Needles correspond to Heaven, Earth, Four Seasons, and Yin-Yang. I wish to learn the theory to pass it down." Qibo said: "One Heaven, Two Earth, Three Man, Four Seasons, Five Tones, Six Pitch-pipes, Seven Stars, Eight Winds, Nine Fields. The human body corresponds to these. Each needle has its suitability, hence 'Nine Needles'. Skin corresponds to Heaven. Flesh corresponds to Earth. Vessels correspond to Man. Tendons correspond to Seasons. Voice corresponds to Tones. Yin-Yang combined Qi corresponds to Pitch-pipes. Teeth and face correspond to Stars. Respiration corresponds to Winds. Nine Orifices and 365 collaterals correspond to Fields. Thus, Needle 1 treats skin, Needle 2 treats flesh, Needle 3 treats vessels, Needle 4 treats tendons, Needle 5 treats bone, Needle 6 regulates Yin-Yang, Needle 7 benefits Essence, Needle 8 dispels Wind, Needle 9 opens the nine orifices and removes 365 joint diseases. These are their respective dominions. Human intent corresponds to Eight Winds. Human Qi corresponds to Heaven. Hair, teeth, ears, eyes, and five sounds correspond to Five Tones and Six Pitch-pipes. Yin-Yang vessels and Blood/Qi correspond to Earth. Liver and eyes correspond to Nine. Nine orifices and 365 [collaterals]. 'One' observes movement/stillness. 'Two' observes five colors. 'Seven Stars' observe hair luster. 'Five Tones' observe Gong, Shang, Jue, Zhi, Yu. 'Six Pitch-pipes' respond to surplus/deficiency. 'Two Earth' observes height/depth and surplus. 'Nine Fields' one section, Shu points respond, observing joint closure. 'Three Man' changes to 'One', observing teeth, blood loss vs abundance, corresponding to Jue variations. Changes to 'Five Parts' observe slack/tightness. 'Six Parts' deficiency, 'Three Parts' cold joints. 'Ninth Part' Four Seasons, human cold/warmth/dryness/dampness correspond to seasons. Observe opposites. One direction, four directions, each explained."