岐伯曰。天地相感。寒暖相移。阴阳之道。孰少孰多。阴道偶阳道奇。发于春夏。阴气少。阳气多。阴阳不调。何
补何泻。发于秋冬。阳气少。阴气多。阴气盛而阳气衰。故茎叶枯槁。湿雨下归。（刺节真邪曰热则滋雨而在上根 少汁
义正与此相证）阴阳相移。何泻何补。奇邪离经不可胜数不知根结五脏六腑折关败枢开阖而走阴阳大失不可复取。九针
之玄。要在终始。故能知终始一言而毕。不知终始。针道咸绝。（以上总括大意是通篇之总冒也）太阳根于至阴。结于命
门。命门者目也。阳明根于厉兑。结于颡大。颡大者钳耳也。少阳根于窍阴。结于窗笼。窗笼者。耳中也。太阳为开阳
明为阖。少阳为枢故开折。则内节渎而暴病起矣。故暴病者。取之太阳。视有余不足。渎者。皮肉宛 而弱也。（宛 音
郁焦蓄 也）阖折。则气无所止息而痿疾起矣。故痿疾者。取之阳明。视有余不足。无所止息者。真气稽留。邪气居之
也。枢折。即骨繇而不安于地。故骨繇者。取之少阳。视有余不足。骨繇者。节缓而不收也。所谓骨繇者。摇故也。当
穷其本也。太阴根于隐白结于太仓。少阴。根于涌泉。结于廉泉。厥阴根于大敦。结于玉英。络于膻中。太阴为开厥阴
为阖。少阴为枢。故开折。则仓廪无所输。膈洞。膈洞者取之太阴。视有余不足。故开折者。气不足而生病也。阖折。
即气绝而喜悲。悲者取之厥阴。视有余不足。枢折。则脉有所结而不通。不通者取之少阴。视有余不足。有结者皆取之
不足。（以上根结之事毕矣下乃推论阴阳多少之事）足太阳根于至阴。溜于京骨。注于昆仑。入于天柱飞扬也。足少阳根
于窍阴。溜于丘墟。注于阳辅。入于天容光明也。足阳明根于厉兑。溜于冲阳。注于下陵。入于人迎丰隆也。手太阳根
于少泽。溜于阳谷。注于少海。入于天窗支正也。手少阳根于关冲。溜于阳池。注于支沟。入于天牖外关也。手阳明根
于商阳。溜于合谷。注于阳溪。入于扶突偏历也。此所谓十二经者。盛络皆当取之。（此节叙三阳之盛络是阳多之极致也）
一日一夜五十营。以营五脏之精不应数者名曰狂生。所谓五十营者。五脏皆受气。持其脉口。数其至也。五十动而不一
代者。五脏皆受气。四十动一代者。一脏无气。三十动一代者。二脏无气。二十动一代者。三脏无气。十动一代者。四
脏无气。不满十动一代者。五脏无气。予之短期。要在终始。所谓五十动而不一代者。以为常也。以知五脏之气。予之
短期者。乍数乍疏也（此节叙五脏之无气是阴少之极致也。二节固是分叙阴阳多少而上节每条承前节根字此节以五十营
承上十二经草蛇灰线钩连有致）黄帝曰。逆顺五体者。言人骨节之小大。肉之坚脆。皮之浓薄。血之清浊。气之滑涩。
脉之长短。血之多少。经络之数。余已知之矣。此皆布衣匹夫之士也。夫王公大人血食之君。身体柔脆。肌肉软弱。血
气悍滑利。其刺之徐疾浅深多少。可得同之乎。岐伯答曰。膏粱菽藿之味。何可同也。气滑即出疾。气涩则出迟。气
悍则针小而入浅。气涩则针大而入深。深则欲留。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
因气之 悍滑利也。（此节言膏粱菽藿之治不同者是为形气有余不足立影也）黄帝曰。形气之逆顺奈何。岐伯曰。形气不
足病气有余。是邪胜也。急泻之。形气有余病气不足。急补之。形气不足病气不足。此阴阳气俱不足也。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。急泻其邪。调其虚实。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。皮肤薄着。毛腠天 。
予之死期。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。
以阴阳为纲领以补泻为注脚。前半重发阴阳。后半重发补泻。如两大比文式中间加一枢纽。与前后文似不相续。深
得事外间。情通体笔亦坚老不蔓不支。
岐伯说：天地相互感应，寒暖交替转移。阴阳的规律，哪一方少，哪一方多？阴数偶，阳数奇。在春夏季节，阴气少，阳气多；若阴阳不调，该如何补泻？在秋冬季节，阳气少，阴气多；阴气盛而阳气衰，所以茎叶枯槁，雨水下降。（《刺节真邪》篇说热则滋润雨水在上，根少汁，义理正与此相印证）阴阳相互推移，该如何补泻？奇邪离开经脉，不可胜数。如果不了解根结理论，五脏六腑就会折损机关、败坏枢纽，开阖失常，导致阴阳大失，无法再取效。九针的精妙，关键在于“终始”。所以能知晓终始，一句话就能概括。不知道终始，针刺之道就完全断绝了。（以上总括大意，是通篇的总纲）
足太阳经根于至阴穴，结于命门。命门就是眼睛。足阳明经根于厉兑穴，结于颡大（指额颅部）。颡大是指夹耳上方的部位。足少阳经根于窍阴穴，结于窗笼。窗笼就是耳朵内部。足太阳主“开”，足阳明主“阖”，足少阳主“枢”。如果“开”的功能衰竭，则体内关节紊乱，暴病就会发生。所以暴病，要取足太阳经，视其有余或不足。所谓“渎”，是指皮肉郁结焦蓄而虚弱。“阖”的功能衰竭，则气无所止息，痿证就会发生。所以痿证，要取足阳明经，视其有余或不足。所谓气无所止息，是指真气滞留，邪气占据。“枢”的功能衰竭，即骨骼动摇而不能安立于地。所以骨骼动摇，要取足少阳经，视其有余或不足。所谓骨骼动摇，是指关节松弛而无法收摄。所说的骨骼动摇，是因为摇动之故。应当穷究其根本。
足太阴经根于隐白穴，结于太仓（指胃）。足少阴经根于涌泉穴，结于廉泉穴。足厥阴经根于大敦穴，结于玉英穴，络于膻中。足太阴主“开”，足厥阴主“阖”，足少阴主“枢”。如果“开”的功能衰竭，则仓廪（脾胃）无法输布精气，出现膈洞（胸膈堵塞、洞泄）。膈洞，要取足太阴经，视其有余或不足。所谓“开”衰竭，是气不足而生病。“阖”的功能衰竭，即气绝而喜欢悲伤。悲伤，要取足厥阴经，视其有余或不足。“枢”的功能衰竭，则脉气有结滞而不通。不通，要取足少阴经，视其有余或不足。凡有结滞的，都取用不足之法。（以上根结的理论讲完了，下面推论阴阳多少的事情）
足太阳经根于至阴，流经京骨，注于昆仑，入于天柱、飞扬。足少阳经根于窍阴，流经丘墟，注于阳辅，入于天容、光明。足阳明经根于厉兑，流经冲阳，注于下陵（足三里），入于人迎、丰隆。手太阳经根于少泽，流经阳谷，注于少海，入于天窗、支正。手少阳经根于关冲，流经阳池，注于支沟，入于天牖、外关。手阳明经根于商阳，流经合谷，注于阳溪，入于扶突、偏历。这叫做十二经脉，盛络都应当取治。（这一节叙述三阳经的盛络，是阳气多的极致）
一昼夜气血运行五十周，以滋养五脏的精气。如果不按这个次数，名叫狂生（妄生变异）。所谓的五十周，是五脏都受气。切按脉口，计数脉搏跳动。五十次跳动而没有一次代脉（间歇）的，说明五脏都受气。四十次跳动出现一次代脉的，说明一脏无气。三十次跳动出现一次代脉的，说明二脏无气。二十次跳动出现一次代脉的，说明三脏无气。十次跳动出现一次代脉的，说明四脏无气。不满十次跳动就出现一次代脉的，说明五脏无气。这就给予短命的期限。关键仍在于终始。所谓五十次跳动没有一次代脉的，视为正常。以此知晓五脏之气。给予短命期限的，是脉搏忽快忽慢。（这一节叙述五脏无气，是阴气少的极致。这两节虽然分叙阴阳多少，但上节每条承接前节的“根”字，此节以“五十营”承接上文的“十二经”，如草蛇灰线，钩连有致）
黄帝说：关于逆顺五体，讲的是人的骨节大小，肌肉坚脆，皮肤厚薄，血液清浊，气机滑涩，脉象长短，血量多少，经络数量，我已经知道了。这些都是平民百姓的情况。至于王公大人、食肉享福的君主，身体柔脆，肌肉软弱，血气悍利滑疾。他们针刺的徐疾、浅深、多少，可以和他们一样吗？
岐伯回答说：吃膏粱厚味和菽藿粗食的人，治疗怎么可以相同呢？气滑利的，出针就要快；气涩滞的，出针就要慢。气悍利的，针具要小且进针浅；气涩滞的，针具要大且进针深。进针深就要留针久，进针浅就要出针快。由此看来，刺平民百姓要深刺并留针，刺王公大人要轻刺并缓慢操作。这都是因为他们的血气悍利滑涩不同。（这一节说膏粱与菽藿的治疗不同，是为形气有余不足设立对照）
黄帝问：形气和病气的逆顺是怎样的？岐伯说：形体气虚而病气有余，这是邪气盛，必须急泻。形体气盛而病气虚，必须急补。形体气虚而病气也虚，这是阴阳之气都不足，不可针刺。如果针刺，就会造成双重不足。双重不足则阴阳俱竭，血气皆尽，五脏空虚，筋骨髓枯。老年人会死亡，壮年人也不能恢复。形体气盛而病气也盛，这叫阴阳俱有余，必须急泻其邪，调和虚实。所以说，有余的用泻法，不足的用补法，就是这个道理。
所以说，针刺不知道逆顺，真邪相搏。实证用补法，则阴阳四溢，肠胃充满胀满，肝肺内郁，阴阳错乱。虚证用泻法，则经脉空虚，血气枯竭，肠胃收缩闭塞，皮肤薄弱附着，毛腠疏松。这会给予患者死期。所以说，用针的要领，在于知道调和阴阳。调和阴阳，精气才能明亮。结合形体与气机，使神气内藏。所以说，上工平调气机，中工扰乱脉气，下工断绝生气危害生命。所以下工不可不谨慎。必须审察五脏变化的病症，五脉的应象，经络的虚实，皮肤的柔粗，然后才施针。
以阴阳为纲领，以补泻为注脚。前半部分重在阐述阴阳，后半部分重在阐述补泻。如同两篇大赋中间加一个枢纽，与前后文似乎不相连续，深得事外之意，情通体笔，坚实老练，不蔓不枝。
Qibo said: Heaven and Earth interact with each other, and cold and warmth shift alternately. Regarding the principles of Yin and Yang, which is less and which is more? The number of Yin is even, and the number of Yang is odd. In spring and summer, Yin Qi (Yin energy) is scarce, and Yang Qi (Yang energy) is abundant; if Yin and Yang are not in harmony, how should one tonify or drain? In autumn and winter, Yang Qi is scarce, and Yin Qi is abundant; when Yin Qi is excessive and Yang Qi declines, stems and leaves wither, and rain falls downward. (The chapter "Ci Jie Zhen Xie" [Needling Joint and True Pathogens] states that heat causes nourishing rain to stay above, where roots have little juice; the meaning here corresponds to this.) When Yin and Yang shift alternately, how should one drain or tonify? If strange pathogens leave the meridians, their number is innumerable. Without understanding the Gen (Root) and Jie (Knot) theory, the Five Zang organs and Six Fu organs will suffer from broken hinges and ruined pivots, leading to abnormal opening and closing, causing a great loss of Yin and Yang that cannot be retrieved. The profoundness of the Nine Needles lies in the concept of Zhong Shi (End and Beginning). Thus, knowing Zhong Shi allows one to summarize it in a single sentence. Not knowing Zhong Shi means the Dao of needling is completely severed. (The above summarizes the main idea, serving as the general introduction for the entire passage.)
The Foot-Taiyang Meridian originates at Zhiyin (BL67) and knots at Mingmen (Gate of Life), which refers to the eyes. The Foot-Yangming Meridian originates at Lidui (ST45) and knots at Sangda (Upper Palate/Forehead region); Sangda refers to the area clamping the ears. The Foot-Shaoyang Meridian originates at Qiaoyin (GB45) and knots at Chuanglong (Window Basket), which refers to the interior of the ear. The Foot-Taiyang governs "Opening," the Foot-Yangming governs "Closing," and the Foot-Shaoyang governs the "Pivot." If the Opening function fails, internal joints become disordered, and sudden illnesses arise. Therefore, for sudden illnesses, one should select points from the Taiyang meridian, assessing excess or deficiency. "Du" refers to skin and muscle stagnation and weakness. If the Closing function fails, Qi has no place to rest, and flaccidity syndromes arise. Therefore, for flaccidity syndromes, one should select points from the Yangming meridian, assessing excess or deficiency. "Qi having no place to rest" means true Qi stagnates while pathogenic Qi resides there. If the Pivot function fails, bones sway and cannot stand firmly on the ground. Therefore, for swaying bones, one should select points from the Shaoyang meridian, assessing excess or deficiency. "Swaying bones" refers to joints being lax and unable to contract. The term "swaying" implies instability. One must investigate the root cause thoroughly.
The Foot-Taiyin Meridian originates at Yinbai (SP1) and knots at Taicang (Stomach). The Foot-Shaoyin Meridian originates at Yongquan (KI1) and knots at Lianquan (CV23). The Foot-Jueyin Meridian originates at Dacun (LR1), knots at Yuying (CV24), and connects to Danzhong (CV17). The Foot-Taiyin governs "Opening," the Foot-Jueyin governs "Closing," and the Foot-Shaoyin governs the "Pivot." If the Opening function fails, the granary (Spleen/Stomach) cannot transport essence, leading to Ge Dong (diaphragmatic blockage and洞泄/diarrhea). For Ge Dong, one should select points from the Taiyin meridian, assessing excess or deficiency. Failure of the Opening function indicates Qi deficiency causing disease. If the Closing function fails, Qi severs, leading to sorrowfulness. For sorrowfulness, one should select points from the Jueyin meridian, assessing excess or deficiency. If the Pivot function fails, pulse Qi becomes knotted and obstructed. For obstruction, one should select points from the Shaoyin meridian, assessing excess or deficiency. Any knotting should be treated by tonifying deficiency. (The discussion on Gen and Jie is now complete; below follows the deduction regarding the abundance and scarcity of Yin and Yang.)
The Foot-Taiyang Meridian originates at Zhiyin, flows through Jinggu (BL64), pours into Kunlun (BL60), and enters Tianzhu (BL10) and Feiyang (BL58). The Foot-Shaoyang Meridian originates at Qiaoyin, flows through Qiuxu (GB40), pours into Yangfu (GB38), and enters Tianrong (SI17) and Guangming (GB37). The Foot-Yangming Meridian originates at Lidui, flows through Chongyang (ST42), pours into Xiaoling (Zusanli ST36), and enters Yingchang (ST9) and Fenglong (ST40). The Hand-Taiyang Meridian originates at Shaoze (SI1), flows through Yanggu (SI7), pours into Shaohai (SI19), and enters Tianchuang (SI16) and Zhizheng (SI7). The Hand-Shaoyang Meridian originates at Guanchong (TE1), flows through Yangchi (TE4), pours into Zhigou (TE6), and enters Tianyou (TE15) and Waiguan (TE5). The Hand-Yangming Meridian originates at Shangyang (LI1), flows through Hegu (LI4), pours into Yangxi (LI5), and enters Futu (LI18) and Pianli (LI6). These are called the Twelve Meridians; all flourishing collaterals should be treated. (This section describes the flourishing collaterals of the Three Yang meridians, representing the extreme abundance of Yang.)
In one day and night, Qi and Blood circulate fifty times to nourish the essence of the Five Zang organs. If they do not follow this count, it is called "Kuang Sheng" (wild generation/abnormality). The so-called fifty circuits mean that all Five Zang organs receive Qi. By holding the Cun Kou pulse and counting its beats: if there are fifty beats without an intermittent pulse (Dai Mai), all Five Zang organs receive Qi. If there is one intermittent beat in forty beats, one Zang lacks Qi. If there is one intermittent beat in thirty beats, two Zangs lack Qi. If there is one intermittent beat in twenty beats, three Zangs lack Qi. If there is one intermittent beat in ten beats, four Zangs lack Qi. If there is an intermittent beat in fewer than ten beats, all Five Zangs lack Qi. This indicates a short life expectancy. The key remains in Zhong Shi. Fifty beats without an intermittent beat is considered normal, allowing one to know the Qi of the Five Zangs. Those given a short life expectancy exhibit irregular pulse rhythms (alternating fast and slow). (This section describes the lack of Qi in the Five Zangs, representing the extreme scarcity of Yin. Although these two sections discuss Yin/Yang abundance/scarcity separately, the previous section's items connect to the "Gen" character mentioned earlier, while this section connects to the "Twelve Meridians" via "Fifty Circuits," linked like a snake in grass or gray thread, with coherent structure.)
Huangdi said: Regarding the reversals and順 (compliance) of the five bodies, I already know about the size of bone joints, the firmness or fragility of flesh, the thickness or thinness of skin, the clarity or turbidity of blood, the slipperiness or roughness of Qi, the length of pulses, the quantity of blood, and the number of meridians. These conditions apply to commoners. However, for kings, dukes, and rulers who consume rich foods, their bodies are soft and fragile, muscles are weak, and their Qi and Blood are vigorous, slippery, and rapid. Can the speed, depth, and quantity of needling be the same for them as for commoners?
Qibo answered: How can the treatment be the same for those who eat rich pastries and meat versus those who eat beans and coarse grains? For those with slippery Qi, the needle should be withdrawn quickly; for those with rough/stagnant Qi, the needle should be withdrawn slowly. For those with vigorous Qi, small needles should be used and inserted shallowly; for those with stagnant Qi, large needles should be used and inserted deeply. Deep insertion requires retention, while shallow insertion requires quick withdrawal. From this, we see that needling commoners involves deep insertion and retention, while needling nobles involves light manipulation and slow operation. This is due to differences in their Qi being vigorous, sluggish, clear, or turbid. (This section explains that treatments differ between rich and coarse diets, setting up a contrast for excess and deficiency of form and Qi.)
Huangdi asked: What is the reversal and compliance of Form-Qi and Disease-Qi? Qibo said: When Form-Qi is deficient but Disease-Qi is excessive, this is pathogenic excess, requiring urgent draining. When Form-Qi is excessive but Disease-Qi is deficient, urgent tonification is required. When both Form-Qi and Disease-Qi are deficient, this indicates deficiency of both Yin and Yang Qi; needling is contraindicated. If needled, it leads to double deficiency. Double deficiency results in the exhaustion of both Yin and Yang, depletion of Qi and Blood, emptiness of the Five Zang organs, and withering of tendons, marrow, and bones. The elderly will perish, and the strong will not recover. When both Form-Qi and Disease-Qi are excessive, this indicates excess of both Yin and Yang; one must urgently drain the pathogens and regulate excess and deficiency. Thus, it is said: Excess is drained, deficiency is tonified. This is the principle.
Therefore, if one does not understand reversals and compliance in needling, true Qi and pathogens clash. Tonifying excess causes Yin and Yang to overflow, filling the intestines and stomach, causing internal depression of the Liver and Lung, and disorder of Yin and Yang. Draining deficiency causes emptiness of the meridians, exhaustion of Qi and Blood, contraction of the intestines and stomach, thinning of the skin, and loosening of hair follicles. This gives the patient a death date. Thus, the essential point of needling lies in knowing how to harmonize Yin and Yang. Harmonizing Yin and Yang makes Jing Qi bright. Integrating form and Qi allows Shen (Spirit) to remain inwardly stored. Thus, it is said: The superior physician regulates Qi evenly; the average physician disrupts the pulses; the inferior physician severs Qi and endangers life. Therefore, the inferior physician must be extremely cautious. One must carefully examine diseases of the Five Zang changes, the responses of the Five Pulses, the excess or deficiency of meridians, and the texture of the skin before applying needles.
Using Yin and Yang as the outline and tonification/draining as the commentary, the first half emphasizes Yin and Yang, while the second half emphasizes tonification and draining. Like two major fu poems connected by a pivot, seemingly discontinuous with the preceding and following text, it deeply captures meaning beyond the events, with emotions flowing through the structure, writing that is solid, mature, unadorned, and concise.