黄帝问于伯高曰。余闻气有逆顺。脉有盛衰。刺有大约。可得闻乎。伯高曰。气之逆顺者
。所以应天地阴阳四时五行也。脉之盛衰者。所以候血气之虚实有余不足也。刺之大约者。必明知
病之可刺。与其未可刺。与其已不可刺也。
余伯荣曰。此论病气亦随血气出入于皮肤经脉之外内而刺之有法也。气有逆顺者。谓经脉外内
之气。交相逆顺而行。所以应天地阴阳。四时五行之升降出入。脉有盛衰者。谓经脉外内之血气。有
出有入。是以有虚有实。有有余有不足也。刺之大约者。必明知病之方来之可刺也。与其方盛之未
可刺也。与其已过之不可刺也。
黄帝曰。候之奈何。伯高曰。兵法曰。无迎逢逢之气。无击堂堂之阵。刺法曰。无刺 之热。
无刺漉漉之汗。无刺浑浑之脉。无刺病与脉相逆者。黄帝曰。候其可刺奈何。伯高曰。上工刺其未生者
也。其次刺其未盛者也。其次
刺其已衰者也。下工刺其方袭者也。与其形之盛者也。与其病之与脉相逆者也。故曰方其盛也。勿
敢毁伤。刺其已衰。事必大昌。故曰上工治未病。不治已病。此之谓也。（逢叶彭）
此言刺法有如兵法。当避其来锐。击其惰归。按史记轩辕之时。神农时世衰。诸侯相侵伐。及蚩
尤作乱。轩辕乃习用干戈。以征不享。故即以用兵之法。而为刺之大约。夫战。勇气也。一鼓作气。
再而衰。三而竭。是以无迎逢逢之气。无击堂堂之阵。俟其气衰阵乱。然后击之。无有不克者矣。
之热。热盛于皮肤也。漉漉之汗。邪盛在肌腠也。浑浑之脉。邪入于经脉也。病与脉相逆者。真
邪相攻也。离合真邪论曰。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。方其来也。必按而止之。无逢其冲而泻之。知机之道。不可挂以发。盖邪之方盛不可迎。邪
之以往不可追。俟其来去之时。如发机之速。不可差之毫发者也。刺其未生者。未生于脉中也。未盛
者。邪来之未盛。已衰者。邪去之已衰。故曰方其盛也。勿敢毁伤。谓邪气方盛。则真气大虚。故勿
敢泻邪以伤正气。刺其已衰。事必大昌。上工治未病者。未病于脉中也。盖传溜于血脉。则有入腑干
脏之患矣。余伯荣曰。按此篇篇名逆顺。而伯高曰。气之逆顺。所以应天地阴阳。四时五行也。
是虽论刺之大约。而重在气之逆顺。夫天道右迁。地道左转。四时之气。寒往则暑来。暑往则寒来。
升降出入于天地之外内者也。五脏者。生长化收藏之气。此皆阴阳相贯。环转无端。夫人皮以应天。
肌肉应地。血脉应地之经水。气之逆顺。谓气之环转于经脉皮肤之外内。交相逆顺而行。以应天地阴
阳。四时五行之气。是以下工刺其方袭者。谓病之方袭于脉中也。与其形之盛者。谓病之盛于皮腠。
而为 之热。漉漉之汗也。与其病
之与脉相逆者。谓病邪始入于脉也。盖脉气之出于皮肤。从经而脉。脉而络。络而孙。孙络绝而后
出于气街。邪之入于经脉。去皮肤而入于络。去络而入于经。是以病与脉之相逆也。夫邪去络入于经
也。如涌波之起。时来时去。无有常在。其病气已衰。则顺脉而行矣。故曰刺其已衰。事必大昌。
此篇重在知人气之逆顺。应天地四时五行。则知邪病之盛虚出入矣。
Huangdi asked Bo Gao: I have heard that Qi has the aspects of reversal and compliance (Ni Shun), pulses have the states of fullness and deficiency, and acupuncture has general principles. May I ask you to explain them? Bo Gao replied: The reversal and compliance of Qi correspond to the Yin and Yang of Heaven and Earth, as well as the changes of the Four Seasons and Five Elements. The fullness and deficiency of pulses are used to observe the excess or deficiency, surplus or insufficiency of Blood and Qi. The general principles of acupuncture require one to clearly know when a disease is suitable for needling, when it is not suitable, and when it is no longer suitable for needling.
Yu Borong stated: This section discusses how pathogenic Qi moves in and out of the skin and meridians along with Healthy Qi, establishing specific methods for needling. "Qi has reversal and compliance" refers to the Qi inside and outside the meridians moving in alternating patterns of reversal and compliance, thereby corresponding to the ascending, descending, exiting, and entering movements of Heaven and Earth's Yin and Yang, the Four Seasons, and the Five Elements. "Pulses have fullness and deficiency" refers to the Blood and Qi inside and outside the meridians having exits and entries, resulting in states of emptiness and fullness, surplus and insufficiency. "The general principles of needling" means one must clearly understand that needling is permissible when pathogenic Qi is approaching, impermissible when it is at its peak, and contraindicated after it has passed.
Huangdi asked: How should these be observed? Bo Gao said: As military strategy states, do not confront an army with overwhelming momentum, and do not attack a formation that is solid and formidable. Acupuncture principles state: Do not needle patients with intense heat; do not needle those with profuse sweating; do not needle those with chaotic and turbid pulses; do not needle cases where the symptoms contradict the pulse. Huangdi asked: How does one observe the appropriate time for needling? Bo Gao said: A superior practitioner needles before the disease arises; a secondary practitioner needles when the pathogenic factor is not yet flourishing; a third-tier practitioner needles when the pathogenic factor has already declined. An inferior practitioner needles when the pathogenic factor is just invading, when the physical manifestation is flourishing, or when the disease contradicts the pulse. Therefore, it is said: When the pathogen is flourishing, do not dare to damage [the healthy Qi]; needle after it has declined, and the outcome will surely be prosperous. Thus, it is said that a superior practitioner treats disease before it arises, rather than treating it after it has arisen. This is what is meant by this statement. (Note: "Feng" is interchangeable with "Peng", meaning grand or vigorous.)
This passage illustrates that acupuncture principles are akin to military strategy: one should avoid the enemy's sharp vigor and strike when they are weary or retreating. According to the *Records of the Grand Historian*, during the time of Xuanyuan (Yellow Emperor), the era of Shennong was declining, and feudal lords were invading each other. When Chiyou rebelled, Xuanyuan practiced the use of weapons to punish those who did not pay tribute. Thus, military tactics were adopted as the general principles for needling. Warfare relies on courage. The first drumbeat rouses the spirit; the second causes it to decline; the third exhausts it. Therefore, one does not confront vigorous armies nor attack solid formations, but waits until their morale declines and formation breaks, then attacks, ensuring victory.
"Intense heat" refers to heat flourishing in the skin. "Profuse sweating" indicates pathogenic factors flourishing in the muscle interstices. "Chaotic pulses" signify that pathogens have entered the meridians. Disease contradicting the pulse indicates the conflict between True Qi and Pathogenic Factors. The *Treatise on Separating and Combining True and Evil* states: When evil travels from the collaterals into the meridians, it resides in the blood vessels. At this stage, cold and warmth are not yet harmonized, rising like waves, coming and going intermittently. When it arrives, one must press and restrain it, avoiding the surge to apply draining techniques. Understanding the timing of opening and closing requires precision without any deviation. Generally, one should not confront evil when it is flourishing, nor chase it once it has departed. One must wait for its arrival and departure with the speed of a trigger mechanism, allowing no error.
"Needling before the disease arises" refers to intervention before the pathogen enters the meridians. "Not yet flourishing" refers to the pathogen arriving but not yet strong. "Already declined" refers to the pathogen having weakened. Thus, "when flourishing, do not dare to damage" means that when pathogenic Qi is strong, True Qi is greatly deficient, so one dares not drain the pathogen and harm the healthy Qi. "Needling after it has declined ensures prosperity." A superior practitioner treats disease before it manifests in the meridians, because if the pathogen transmits through the blood vessels, it risks entering the Fu organs and damaging the Zang organs.
Yu Borong stated: Although the chapter title is "Reversal and Compliance," Bo Gao emphasizes that the reversal and compliance of Qi correspond to Heaven and Earth's Yin and Yang and the Four Seasons and Five Elements. While discussing general needling principles, the focus is on the reversal and compliance of Qi. The Way of Heaven moves rightward, the Way of Earth moves leftward. In the Four Seasons, as cold departs, heat arrives; as heat departs, cold arrives. These are the ascensions, descents, exits, and entries within and outside Heaven and Earth. The Five Zang organs govern the Qi of growth, transformation, and storage. All these involve the continuous circulation of Yin and Yang, turning in a cycle without end. Human skin corresponds to Heaven, muscles to Earth, and blood vessels to the rivers of the Earth. The reversal and compliance of Qi refer to the circular movement of Qi inside and outside the meridians and skin, moving in alternating patterns to correspond to the Qi of Heaven and Earth's Yin and Yang, the Four Seasons, and the Five Elements. Therefore, an inferior practitioner needles when the disease is just invading the meridians, meaning the pathogen has just entered. They needle when the physical form is flourishing, meaning the pathogen is strong in the skin and interstices, manifesting as intense heat and profuse sweating. They needle when disease contradicts the pulse, meaning the pathogen has just entered the meridians. Generally, when evil travels from collaterals to meridians, it rises like waves, coming and going without constancy. When the disease Qi declines, it follows the flow of the pulse. Hence, "needling after it has declined ensures prosperity." This chapter emphasizes understanding the reversal and compliance of human Qi corresponding to Heaven, Earth, the Four Seasons, and Five Elements, thereby knowing the fluctuations, deficiency, and movement of pathogenic diseases.