太阳为开。(谓阳气发于外。为三阳之表也。)开折。则肉节渎。而暴病起矣。(折。损
伤也。)渎者皮肉宛 而弱也。(消瘦干苦之谓。)阳明为阖。(谓阳气蓄于内。为三阳之里也。)
阖折。则气无所止息。而痿疾起矣。无所止息者。真气稽留。(谓胃气不行。)邪气居之矣少
阳为枢。(谓阳气在表里之间可出可入如枢机也。)枢折。即骨徭而不安于地。骨徭者。节缓
而不收也。太阴为开。(居阴分之表也。)开折则仓廪无所输。(不营运也。)膈洞。(膈。隔
塞。洞者。食不化。下嗌还出也。)厥阴为阖。(居阴分之里也。)阖折即气绝而喜悲。(肝伤
。则肺气乘之也。)少阴为枢。(居阴。分之中也。)枢折。则脉有所结而不通。(下焦不通也
。○素问。阴阳离合篇与此略同。)
王公大人。血食之君。身体柔脆肌肉软弱。血气剽悍滑利。其刺之徐疾浅深多少者。气
滑则
浅则欲疾。以此观之。刺布衣者深以留之。刺大人者。微以徐之。此皆因气剽悍滑利也。形
气不足。病气有余。是邪胜也。急泻之。形气有余。病气不足(正气衰也)急补之。形气不足
。病气不足。此阴阳俱不足也。不可刺之刺之。则重不足。重不足。则阴阳俱竭。血气皆尽
。五脏空虚筋骨髓枯。老者绝灭。壮者不复矣。形气有余病气有余。此谓阴阳俱有余也。急
写其邪。调其虚实(既刺之后防其骤虚故宜调之也。)故曰有余者泻之。不足者补之。此之谓
也。故曰刺不知逆顺。真邪相搏(补泻反施。乃为之逆。不知逆顺则真气与。邪气相搏病必
甚也)满而补之。则阴阳四溢肠胃充郭肝肺内 阴阳相错。虚而泻之。则经脉空虚血气竭。
枯肠胃。HT 辟。皮肤薄者。毛腠夭 。子之死期。(HT 丑涉切畏怯也辟邪 不正也。薄着。
瘦而涩也夭短折也。)故曰用针之要。在于知调阴与阳。调阴与阳。精气乃光。合形与气。
使神内藏。故曰上工平气。中工乱脉。下工绝气危生。故曰下工。不可不慎也。必审五脏变
化之病。五脉之应。经络之实虚。皮之柔粗而后取之也。
The Taiyang governs the opening. (This means that Yang Qi emanates outward, serving as the exterior of the three Yang meridians.) If the opening function is impaired (Zhe, meaning damage), the flesh and joints become lax and disordered, leading to the sudden onset of disease. "Du" refers to the emaciation and weakness of the skin and muscles.
The Yangming governs the closing. (This means that Yang Qi is stored within, serving as the interior of the three Yang meridians.) If the closing function is impaired, Qi has no place to rest or settle, giving rise to Wei syndrome (flaccidity syndrome). The state of Qi having no place to rest implies that the True Qi stagnates (meaning Stomach Qi fails to circulate), allowing Pathogenic Qi to occupy the space.
The Shaoyang governs the pivot. (This means that Yang Qi resides between the exterior and interior, capable of exiting and entering like a door hinge.) If the pivot function is impaired, the bones sway unsteadily, making it difficult to stand firmly on the ground. "Gu Yao" refers to loose joints that fail to contract and hold firm.
The Taiyin governs the opening. (Residing at the exterior of the Yin aspect.) If the opening function is impaired, the granary (Spleen/Stomach) fails to transport and transform nutrients. (i.e., normal physiological operation ceases.) This leads to diaphragmatic obstruction and洞泄 (turbid diarrhea/food regurgitation). "Ge" refers to blockage; "Dong" refers to undigested food being vomited back up after swallowing.
The Jueyin governs the closing. (Residing at the interior of the Yin aspect.) If the closing function is impaired, Qi becomes severed, leading to a predisposition for sorrow/grief. (Because Liver injury allows Lung Qi to invade.)
The Shaoyin governs the pivot. (Residing in the center of the Yin aspect.) If the pivot function is impaired, there are knots in the meridians causing obstruction and lack of flow. (Referring to the obstruction of the Lower Jiao.) ○ This content is roughly consistent with the *Suwen: Yin-Yang Li He Pian* (Chapter on the Separation and Union of Yin and Yang).
Kings and nobles, who consume meat and are rulers, have bodies that are soft and fragile with weak muscles, yet their Blood and Qi are swift, fierce, and slippery. When needling them, one must consider the speed, depth, and quantity of insertion. Because their Qi is slippery, shallow insertion and rapid manipulation are required. From this perspective, needling commoners (buyi) requires deep insertion and retention, whereas needling nobles requires light and slow manipulation. This is all due to their swift, fierce, and slippery Qi.
If physical constitution and Zheng Qi (Upright Qi) are insufficient, but pathogenic Qi is excessive, this indicates an excess of evil. Urgent application of the reducing method is required. If physical constitution and Zheng Qi are excessive, but pathogenic Qi is insufficient (indicating decline of Righteous Qi), urgent application of the reinforcing method is required. If both physical constitution/Zheng Qi and pathogenic Qi are insufficient, this represents insufficiency of both Yin and Yang. Needling should not be performed. If needled, it causes double insufficiency. Double insufficiency leads to exhaustion of both Yin and Yang, depletion of Blood and Qi, emptiness of the Five Zang organs, withering of sinews, and exhaustion of bone marrow. The elderly will perish, and even the robust will not recover. If both physical constitution and pathogenic Qi are excessive, this is termed excess of both Yin and Yang. Urgent reduction of the pathogen is required, followed by regulation of deficiency and excess (after needling, to prevent sudden collapse of Qi, regulation is appropriate). Thus it is said: excess is reduced, deficiency is reinforced. This is what is meant.
Therefore, if one does not understand the principles of reversal and compliance (applying reinforcement where reduction is needed is called 'reversal'; failing to understand this leads to conflict between True Qi and Pathogenic Qi, worsening the disease), applying reinforcement to fullness causes Yin and Yang to overflow, intestines and stomach to distend, liver and lungs to be compressed, and Yin and Yang to become disordered. Applying reduction to emptiness causes meridians to become empty, Blood and Qi to exhaust, intestines and stomach to wither, skin to become thin, and hair/coat to deteriorate, signaling the approach of death. ("HT" pronounced 'che', meaning fear/timidness; "Pi" means crooked/abnormal. "Bo zhuo" means thin and emaciated; "Yao" means short-lived/fractured.)
Thus it is said: the essence of acupuncture lies in knowing how to regulate Yin and Yang. Regulating Yin and Yang allows Jing Qi (Essence Qi) to shine brightly. Harmonizing form and Qi allows Shen (Spirit) to remain internally stored. Thus it is said: superior practitioners level Qi; average practitioners disrupt meridians; inferior practitioners exhaust Qi and endanger life. Therefore, inferior practitioners must exercise extreme caution. One must carefully examine diseases arising from changes in the Five Zang, the responses of the five pulses, the excess and deficiency of meridians, and the texture of the skin before selecting acupoints.