凡刺之道。毕于终始。明知终始。五脏为纪（四字似衍）阴阳定矣。阴者主脏。阳者主腑。阳受气于四末。阴受气
于五脏。故泻者迎之。补者随之。知迎知随。气可令和。和气之方。必通阴阳。五脏为阴。六腑为阳。（先从阴阳脏腑说
到气复从气说到阴阳脏腑小小段落用笔亦有往复回环之致）传之后世。以血为盟。敬之者昌。慢之者亡。无道行私。必
得夭殃。谨奉天道。请言终始。（以上叙阴阳补泻大意总冒通篇）终始者。经脉为纪。持其脉口人迎以知阴阳。有余不足。
平与不平。天道毕矣。所谓平人者。不病。不病者。脉口人迎应四时也。上下相应而俱往来也。六经之脉不结动也。本
末之寒温之相守司也。形肉血气必相称也。是谓平人少气者。脉口人迎俱小而不称尺寸也。如是者则阴阳俱不足。补阳
则阴竭。泻阴则阳脱。如是者。可将以甘药。不可饮以至剂。如此者弗灸。（据此是古法固以灸为补也）不已者。因而泻
之。则五脏气坏矣。（此节凡三段总叙平与不平一段分叙平字一段不足一段而以有余一层留于下文发挥支对参差详略互出
极篇法之变幻。少气者一段前半句法与上段起处作对待后半句法与下节收处作对待）人迎一盛。病在足少阳。一盛而躁。
病在手少阳。人迎二盛。病在足太阳二盛而躁。病在手太阳。人迎三盛。病在足阳明。三盛而躁。病在手阳明。人迎四
盛。且大且数。名曰溢阳。溢阳为外格。脉口一盛。病在足厥阴。厥阴一盛而躁。在手心主。脉口二盛。病在足少阴。
二盛而躁。在手少阴。脉口三盛。病在足太阴。三盛而躁。在手太阴。脉口四盛。且大且数者。名曰溢阴。溢阴为内关。
内关不通。死不治。人迎与太阴脉口俱盛四倍以上。命曰关格。关格者。与之短期。人迎一盛。泻足少阳。而补足厥阴。
二泻一补。日一取之。必切而验之。疏取之上。（上指所验之病脉上也）气和乃止。人迎二盛。泻足太阳。而补足少阴。
二泻一补。二日一取之。必切而验之。疏取之上。气和乃止。人迎三盛。泻足阳明。而补足太阴。二泻一补。日二取之。
必切而验之。疏取之上。气和乃止。脉口一盛。泻足厥阴。而补足少阳。二泻一补。日一取之。必切而验之。疏取之上。
气和乃止。脉口二盛。泻足少阴。而补足太阳。二补一泻。二日一取之。必切而验之。疏取之上。气和乃止。脉口三盛。
泻足太阴。而补足阳明。二补一泻。日二取之。必切而验之。疏取之上。气和乃止。所以日二取之者。阳明主胃大富于
谷气。故可日二取之也。人迎与脉口俱盛。四倍以上。命曰阴阳俱溢。如是者不开。（据此是古法固以刺为泻也）则血脉
闭塞气无所行流淫于中。五脏内伤如此者。则变易而为他病矣。（此节叙有余将病与治法分作两截写上节则平与不足两项
连写详略悬殊无理而有趣盖凡事之对待而头绪多寡不同者均可用此体例也）凡刺之道气调而止。补阴泻阳。音气益彰。
耳目聪明。反此者。血气不行。（此下当接邪气来也紧而疾至其脉皆实下再当接凡刺之属三刺至谷气）所谓气至而有效者。
泻则益虚。虚者脉大如其故。而不坚也。坚如其故者。适虽言故（故字疑误）病未去也。补则益实。实者脉大如其故而
益坚也。大如其故而不坚者。适虽言快病未去也。故补则实。泻则虚。痛虽不随针。病必衰去。必先通十二经脉之所生
病。而后可得传于终始矣。故阴阳不相移。虚实不相倾。取之其经。（以下当接阴盛而阳虚文义相属也）凡刺之属。三刺
至谷气。邪僻妄合。阴阳易居。逆顺相反。沉浮异处。四时不得。稽留淫 。须针而去。故一刺则阳邪出。再刺则阴邪
出。三刺则谷气至。谷气至而止。所谓谷气至者。已补而实。已泻而虚。故以知谷气至也。邪气独去者。阴与阳未能调
而病知愈也。故曰补则实。泻则虚。痛虽不随针。病必衰去矣。（此下当接所谓气至而有效者正申释此段之义也）阴盛而
阳虚。先补其阳。后泻其阴。而和之。阴虚而阳盛先补其阴。后泻其阳而和之。（此下当接故曰从腰以上者）三脉动于足
大趾之间必审其实虚。虚而泻之。是谓重虚。重虚病益甚。凡刺此者。以指按之。脉动而实且疾者。疾泻之。虚而徐者。
则补之。反此者。病益甚。其动也。阳明在上。厥阴在中。少阴在下。（自三脉动于足大趾之间至重虚病益甚当在此下）
膺中膺。背 中背。肩膊虚者。取之上。重舌。刺舌柱。以铍针也。手屈而不伸者。其病在筋。伸而不屈者。其病在
骨。在骨守骨。在筋守筋。补须（补须二字疑有脱误下文所叙乃一人之病虚实互见而各据于一偏者非可以补字统之也）
一方实。深取之。稀按其 。以极出其邪气。一方虚。浅刺之。以养其脉。疾按其 。无使邪气得入。（自凡刺此者至此
当在后一刺阳也之下）邪气来也紧而疾。谷气来也徐而和。脉实者。深刺之。以泄其气。脉虚者。浅刺之。使精气无得
出。以养其脉。独出其邪气。刺诸痛者。其脉皆实。（自邪气来也至此当在前反此者血气不行之下。自三脉动于足大趾之
间至此皆前后文错简今各分移前后擅易经文非徒论文亦欲明理也读者谅之）故曰从腰以上者。手太阴阳明皆主之。从腰
以下者。足太阴阳明皆主之。病在上者下取之。病在下者高取之。病在头者取之足。病在腰者取之 。病生于头者头重。
生于手者臂重。生于足者足重。治病者先刺其病。所从生者也。春气在毛。夏气在皮肤。秋气在分肉。冬气在筋骨。刺
此病者。各以其时为齐。故刺肥人者。以秋冬之齐。刺瘦人者。以春夏之齐。病痛者阴也。痛而以手按之不得者阴也。
深刺之。病在上者阳也。病在下者阴也。痒者阳也。浅刺之。病先起阴者。先治其阴。而后治其阳。病先起阳者。先治
其阳。而后治其阴。刺热厥者。留针反为寒。刺寒厥者。留针反为热。刺热厥者。二阴一阳。刺寒厥者。二阳一阴。所
谓二阴者。二刺阴也。一阳者。一刺阳也。（前文凡刺此者至少阴在下再自三脉动于足大趾之间至重虚病益甚再自膺 中
膺至无使邪气得入当根据次移置于此）久病者。邪气入深。刺此病者。深内而久留之。间日而复刺之。必先调其左右。去
其血脉。刺道毕矣。（自凡刺之道气调而止至此新订次序当分两节上节从凡刺之道至可得传于终始矣是重发气字下节从故
阴阳不相移至此是重发阴阳补泻之事也）凡刺之法。必察其形气。形肉未脱。少气而脉又躁。躁厥者必为缪刺之。散气
可收聚气可布。深居静处。占神往来。闭户塞牖。魂魄不散。精气之分。专意一神。毋闻人声。以收其精。必一其神。
令志在针。浅而留之。微而浮之。以移其神。气至乃休。男内女外。坚拒勿出。谨守勿内。是谓得气。凡刺之禁。新内
勿刺。新刺勿内。已醉勿刺。已刺勿醉。新怒勿刺。已刺勿怒。新劳勿刺。已刺勿劳。已饱勿刺。已刺勿饱。已饥勿刺。
已刺勿饥。已渴勿刺。已刺勿渴。大惊大恐。必定其气乃刺之乘车来者。卧而休之。如食顷。乃刺之。出行来者。坐而
休之。如行十里顷。乃刺之。凡此十二禁者。其脉乱气散。逆其营卫。经气不次。因而刺之。则阳病入于阴。阴病出为
阳。则邪气复生。粗工勿察。是谓伐身。形体淫 。乃消脑髓。津液不化。脱其五味。是谓失气也。太阳之脉其终也。
戴眼反折螈 。其色白绝皮乃绝汗。绝汗则终矣。少阳终者。耳聋。百节尽纵。目系绝。目系绝。一日半则死矣。其死
也。色青白乃死。阳明终者。口目动作。喜惊。妄言。色黄。其上下之经。盛而不行。则终矣。少阴终者。面黑齿长而
垢。腹胀闭塞。上下不通。而终矣。厥阴终者。中热。嗌干。喜溺。心烦甚。则舌卷卵上缩。而终矣。太阴终者。腹胀。
闭不得息。气噫。善呕。呕则逆。逆则面赤。不逆则上下不通。上下不通。则面黑皮毛 。而终矣。
以经气终始为纲。以虚实补泻为纬。前叙经脉阴阳之气。虚实之诊。随手拖到治法中间。即接叙刺法。处处跟定气
字后。分叙得气失气两段。是从补泻推出。末叙六经终证。近承失气。远映关格。有神龙掉尾之势。通篇看似散乱不续
无意为文。而局阵自工。其训词之深浓。每读一句。即令人涵味不尽。以炼字精也。篇中有意绪不相承接者。略根据事理
重订。而分注之。以待高明之指正。
凡是针刺的道理，都终结于“终始”这一原则。明确了终始的规律，五脏就成为纲领，阴阳也就确定了。阴经主要主管五脏，阳经主要主管六腑。阳气在四肢末端受气，阴气在五脏受气。所以，泻法要逆着经气运行的方向刺（迎），补法要顺着经气运行的方向刺（随）。懂得迎随的方法，经气就可以调和。调和经气的方法，必须通晓阴阳。五脏属阴，六腑属阳。（此处从阴阳脏腑说到气，又从气说回阴阳脏腑，段落用笔有往复回环的韵味）将此传承给后世，以血为盟誓。尊敬它的人昌盛，轻慢它的人灭亡。违背正道、行私欲的人，必定遭受早夭的灾祸。恭敬地奉行天道，请让我讲述终始的道理。（以上叙述了阴阳补泻的大意，总领全篇）所谓终始，是以经脉为纲领。通过持按脉口和人迎穴来了解阴阳的有余和不足，平和与不平和的情况，天道的规律就完备了。所谓平人，就是不生病的人。不生病的人，其脉口和人迎的脉搏应合四季的变化，上下相应且同时往来。六经的脉搏没有结滞或躁动的现象，本末的寒温变化相互守司，形体、肌肉、血液和气的状态必然相称，这就叫作平人。少气的人，脉口和人迎的脉搏都细小，且与寸尺部的脉象不相称。像这种情况，说明阴阳都不足。如果补阳，阴液就会枯竭；如果泻阴，阳气就会脱失。像这样的人，可以用甘缓的药物来调治，不可使用峻烈的药剂。像这样的人也不宜施灸。（据此可知，古法确实将灸视为补法）如果病情不愈，进而采用泻法，那么五脏之气就会败坏。（此节共三段，总述平和与不平：一段分述“平”，一段述“不足”，而将“有余”一层留待下文发挥。支离参差，详略互出，极尽篇章变幻之能事。少气者一段，前半句法与上段起处形成对待，后半句法与下节收处形成对待）人迎脉比寸口脉大一倍，病在足少阳经；一倍且躁动，病在手少阳经。人迎脉大两倍，病在足太阳经；两倍且躁动，病在手太阳经。人迎脉大三倍，病在足阳明经；三倍且躁动，病在手阳明经。人迎脉大四倍，既大又快，名叫溢阳。溢阳属于外格证。寸口脉比人迎脉大一倍，病在足厥阴经；一倍且躁动，病在手厥阴心包经。寸口脉大两倍，病在足少阴经；两倍且躁动，病在手少阴经。寸口脉大三倍，病在足太阴经；三倍且躁动，病在手太阴经。寸口脉大四倍，既大又快，名叫溢阴。溢阴属于内关证。内关不通，死亡无法医治。人迎脉和太阴脉口（寸口）都盛大四倍以上，名叫关格。关格证，预示其生命即将终结。人迎脉大一倍，泻足少阳经，补足厥阴经。二泻一补，每天取穴一次。必须切脉验证，疏泄上部邪气。经气调和才停止治疗。人迎脉大二倍，泻足太阳经，补足少阴经。二泻一补，每两天取穴一次。必须切脉验证，疏泄上部邪气。经气调和才停止治疗。人迎脉大三倍，泻足阳明经，补足太阴经。二泻一补，每天取穴两次。必须切脉验证，疏泄上部邪气。经气调和才停止治疗。寸口脉大一倍，泻足厥阴经，补足少阳经。二泻一补，每天取穴一次。必须切脉验证，疏泄上部邪气。经气调和才停止治疗。寸口脉大二倍，泻足少阴经，补足太阳经。二补一泻，每两天取穴一次。必须切脉验证，疏泄上部邪气。经气调和才停止治疗。寸口脉大三倍，泻足太阴经，补足阳明经。二补一泻，每天取穴两次。必须切脉验证，疏泄上部邪气。经气调和才停止治疗。之所以每天取穴两次的情况，是因为阳明经主胃，胃多谷物精气，所以可以每天取穴两次。人迎脉和脉口（寸口）都盛大四倍以上，名叫阴阳俱溢。像这种情况如果不加以疏导（不开），血脉就会闭塞，气无处运行流散于体内，五脏内部受伤。像这样的情况，就会变异而产生其他疾病。（此节叙述有余将病与治法分为两部分写。上一节则将平和与不足两项连写，详略悬殊，看似无理却有趣。盖凡事相对待而头绪多寡不同者，均可用此体例）凡是针刺的道理，以经气调和为终止。补阴泻阳，声音和气色会更加彰显，耳目聪明。与此相反，血气就不能通行。（此处原文可能有错简，当接“邪气来也紧而疾至其脉皆实”及“凡刺之属三刺至谷气”）所谓气至而有效的，是指泻法后邪气更虚。虚的时候，脉搏虽然变大如旧，但不坚实。如果依然坚实，虽然患者说舒服，但病邪未去。补法后更加充实。实的时候，脉搏虽然变大如旧，但更加坚实。如果变大如旧但不坚实，虽然患者感觉痛快，但病邪未去。所以补则使正气实，泻则使邪气虚。疼痛即使不随着针刺立即消失，病邪也必然会衰退去除。必须先通晓十二经脉所生的病症，然后才可以将其纳入终始的理论体系中。所以阴阳不相移易，虚实不相倾夺，取穴就在其所属的经脉。（以下当接“阴盛而阳虚”，文义相连）凡是针刺的种类，经过三次针刺达到谷气。邪气妄乱相合，阴阳位置互换，逆顺相反，沉浮异处，不合四时规律，稽留体内，需要针刺去除。所以第一次针刺，阳邪外出；第二次针刺，阴邪外出；第三次针刺，谷气到来。谷气到来就停止针刺。所谓谷气到来，是指已经补而变实，已经泻而变虚。因此可以知道谷气已至。只有邪气单独去除，而阴阳尚未调和，但病已知痊愈。所以说补则实，泻则虚。疼痛即使不随针消失，病邪也必然会衰退去除。（此处当接“所谓气至而有效者”，正是申释此段之义）阴盛而阳虚，先补其阳，后泻其阴，从而调和它。阴虚而阳盛，先补其阴，后泻其阳，从而调和它。（此处当接“故曰从腰以上者”）足部三条经脉在足大趾之间跳动，必须审察其虚实。虚而用泻法，这叫重虚。重虚会使病情加重。凡是针刺这些情况，用手指按压，脉搏跳动坚实且急疾的，迅速泻之；虚弱且缓慢的，则补之。与此相反，病情会加重。这三条脉的跳动，阳明在上，厥阴在中，少阴在下。（自“三脉动于足大趾之间”至“重虚病益甚”应当在此之下）胸膺中痛，背脊中痛，肩膊虚弱的，取上部穴位治疗。重舌，刺舌柱，使用铍针。手弯曲不能伸展的，病在筋；伸展不能弯曲的，病在骨。病在骨，守其骨位施治；病在筋，守其筋位施治。一方实证，深刺，稀疏按压针孔，以彻底排出邪气。一方虚证，浅刺，以养护经脉，快速按压针孔，不让邪气进入。（自“凡刺此者”至此应当放在“一刺阳也”之后）邪气来的时候，脉象紧而急疾；谷气来的时候，脉象徐缓和平。脉实的，深刺，以泄出其气；脉虚的，浅刺，使精气不得外出，以养护经脉，只排出邪气。针刺各种痛症，其脉象都是实的。（自“邪气来也”至此应当放在“反此者血气不行”之下。自“三脉动于足大趾之间”至此皆是前后文错简，今分别移动前后，擅自调整易经经文，不仅是为了论文，也是为了明理，读者谅之）所以说，腰部以上，手太阴肺经和手阳明大肠经主治；腰部以下，足太阴脾经和足阳明胃经主治。病在上部的，从下部取穴；病在下部的，从上部取穴。病在头部的，取足部穴位；病在腰部的，取相应穴位。病生于头部，头部沉重；病生于手部，手臂沉重；病生于足部，足部沉重。治病的人，先针刺病邪产生的部位。春气在毫毛，夏气在皮肤，秋气在分肉，冬气在筋骨。针刺这些病症，要根据季节来确定深浅标准。所以针刺肥人，用秋冬的标准（较深）；针刺瘦人，用春夏的标准（较浅）。病痛属于阴证。疼痛而用手按压找不到的，属于阴证，深刺。病在上部的属于阳证，病在下部的属于阴证。瘙痒属于阳证，浅刺。病先从阴分起的，先治其阴，而后治其阳；病先从阳分起的，先治其阳，而后治其阴。针刺热厥，留针反而产生寒感；针刺寒厥，留针反而产生热感。针刺热厥，二刺阴一刺阳；针刺寒厥，二刺阳一刺阴。所谓二阴，是刺阴经两次；一阳，是刺阳经一次。（前文“凡刺此者”至少阴在下，再自“三脉动于足大趾之间”至“重虚病益甚”，再自“膺中膺”至“无使邪气得入”，应当根据次序移置于此）久病的人，邪气深入。针刺这种病，深进针并长时间留针，隔日再刺。必须先调理左右气血，去除瘀血，针刺之道就完备了。（自“凡刺之道气调而止”至此新订次序，分为两节：上节从“凡刺之道”至“可得传于终始矣”，是重申“气”字；下节从“故阴阳不相移”至此，是重申阴阳补泻之事）凡是针刺的方法，必须观察患者的形气。形体肌肉未脱耗，但少气且脉象躁动，躁厥的人，必须用缪刺法。散乱的气可以收敛，聚积的气可以布散。身处深静之处，占测神气的往来，关闭门户窗户，魂魄不散。专注精气，专心一意，不要听到人声，以收敛精气。必须统一精神，让意志集中在针上。浅刺并留针，轻微提插，以转移患者的神气，气至才休息。男子固守精气勿外泄，女子固守精气勿内陷。谨慎守住，这就是得气。凡是针刺的禁忌：刚行房事勿刺，刚针刺完勿行房事。刚喝醉勿刺，刚针刺完勿喝酒。刚发怒勿刺，刚针刺完勿发怒。刚劳累勿刺，刚针刺完勿劳累。刚吃饱勿刺，刚针刺完勿进食过饱。刚饥饿勿刺，刚针刺完勿饥饿。刚口渴勿刺，刚针刺完勿饮水。大惊大恐，必须安定其气后再刺。乘车来的，让其躺下休息，约一顿饭的时间，再刺。步行来的，让其坐下休息，约行走十里路所需的时间，再刺。以上十二条禁忌，如果违反，脉气紊乱，正气散失，违背营卫规律，经气次序颠倒。因而针刺，则阳病入于阴，阴病出于阳，邪气复生。粗工不察觉，这叫伐身。形体淫佚过度，就会消损脑髓，津液不化，脱失五味之精，这叫失气。太阳经气终绝时，戴眼反折抽搐，面色苍白，绝汗出，绝汗出则死。少阳经气终绝时，耳聋，全身关节松弛纵缓，目系断绝。目系断绝，一日半则死。死时，面色青白。阳明经气终绝时，口目抽动，易惊，胡言乱语，面色黄，上下经脉盛大而不运行，则终绝。少阴经气终绝时，面色黑，牙齿变长且垢秽，腹胀闭塞，上下不通，则终绝。厥阴经气终绝时，心中发热，咽喉干燥，喜欢小便，心烦严重，则舌卷缩，睾丸上缩，则终绝。太阴经气终绝时，腹胀，闭阻不得呼吸，嗳气，善呕，呕吐则气逆，气逆则面赤，不逆则上下不通，上下不通，则面色黑，皮毛枯槁，则终绝。
本篇以经气终始为纲，以虚实补泻为纬。前面叙述经脉阴阳之气、虚实诊法，随手牵引到治法中间，接着叙述刺法，处处紧扣“气”字，随后分叙得气、失气两段，是从补泻推导出来的。最后叙述六经终证，近承失气，远映关格，有神龙掉尾的气势。通篇看似散乱不连续，无意为文，但章法自然工整。其训词深浓，每读一句，即令人涵味不尽，因为炼字精妙。篇中有意思绪不相承接的地方，略根据事理重新订正，并加上分注，以待高明指正。
The principles of acupuncture are concluded in the concept of "Zhong Shi" (Ends and Beginnings). Once the laws of Zhong Shi are clearly understood, the Five Zang Organs serve as the framework, and Yin and Yang are determined. Yin meridians primarily govern the Five Zang Organs, while Yang meridians primarily govern the Six Fu Organs. Yang Qi receives its energy at the four extremities, whereas Yin Qi receives its energy within the Five Zang Organs. Therefore, the reducing method involves needling against the direction of the meridian flow (Ying), and the tonifying method involves needling with the direction of the meridian flow (Sui). Understanding Ying and Sui allows the Qi to be harmonized. The method for harmonizing Qi must involve a thorough understanding of Yin and Yang. The Five Zang Organs belong to Yin, and the Six Fu Organs belong to Yang. (This section moves from Yin/Yang and Zang/Fu to Qi, and then back to Yin/Yang and Zang/Fu, demonstrating a cyclical rhetorical structure.) This knowledge is passed down to posterity with a blood oath. Those who respect it will prosper; those who slight it will perish. Those who act unrighteously and selfishly will inevitably suffer premature death. Reverently following the Way of Heaven, let me speak of Zhong Shi. (The above summarizes the general principles of Yin/Yang tonification and reduction, serving as an introduction to the entire chapter.) What is meant by Zhong Shi is that the meridians serve as the framework. By palpating the Mai Kou (Cunkou pulse) and Ren Ying pulses, one can ascertain the excess or deficiency of Yin and Yang, and whether the state is balanced or imbalanced; thus, the patterns of Heaven are fully revealed. A person of balance (Ping Ren) is one who is not ill. One who is not ill has Mai Kou and Ren Ying pulses that correspond to the four seasons, moving up and down in response to each other simultaneously. The pulses of the six meridians do not show knotting or restlessness; the cold and warmth at the root and branch maintain their respective controls; and the form, flesh, blood, and Qi are mutually proportional. This is called a person of balance. In cases of Qi deficiency, both the Mai Kou and Ren Ying pulses are small and do not correspond to the Cun and Chi positions. Such a condition indicates a deficiency of both Yin and Yang. If Yang is tonified, Yin fluids will be exhausted; if Yin is reduced, Yang Qi will collapse. For such patients, sweet and mild herbs may be used, but potent or harsh medicines should not be administered. Moxibustion should also be avoided in these cases. (From this, it is evident that ancient methods regarded moxibustion as a tonifying technique.) If the condition does not improve, proceeding to reduce would damage the Qi of the Five Zang Organs. (This section consists of three paragraphs: generally describing balanced vs. imbalanced states; specifically describing "balance"; specifically describing "deficiency"; leaving "excess" for later elaboration. The structure varies in detail and brevity, showcasing the flexibility of composition. The paragraph on Qi deficiency contrasts structurally with the beginning of the previous paragraph and the end of the next.) When the Ren Ying pulse is one-fold larger than the Mai Kou, the disease is in the Foot Shaoyang Gallbladder Meridian; if one-fold larger and restless, it is in the Hand Shaoyang Sanjiao Meridian. When the Ren Ying pulse is two-fold larger, the disease is in the Foot Taiyang Bladder Meridian; if two-fold larger and restless, it is in the Hand Taiyang Small Intestine Meridian. When the Ren Ying pulse is three-fold larger, the disease is in the Foot Yangming Stomach Meridian; if three-fold larger and restless, it is in the Hand Yangming Large Intestine Meridian. When the Ren Ying pulse is four-fold larger, being both large and rapid, it is named Yi Yang (Overflowing Yang), which constitutes Wai Ge (External Grid). When the Mai Kou pulse is one-fold larger than the Ren Ying, the disease is in the Foot Jueyin Liver Meridian; if one-fold larger and restless, it is in the Hand Juexin Pericardium Meridian. When the Mai Kou pulse is two-fold larger, the disease is in the Foot Shaoyin Kidney Meridian; if two-fold larger and restless, it is in the Hand Shaoyin Heart Meridian. When the Mai Kou pulse is three-fold larger, the disease is in the Foot Taiyin Spleen Meridian; if three-fold larger and restless, it is in the Hand Taiyin Lung Meridian. When the Mai Kou pulse is four-fold larger, being both large and rapid, it is named Yi Yin (Overflowing Yin), which constitutes Nei Guan (Internal Closure). If Nei Guan is obstructed, death is incurable. When both the Ren Ying and the Taiyin Mai Kou pulses are more than four times larger, it is called Guan Ge (Gridlock). Patients with Guan Ge have a short life expectancy. For Ren Ying one-fold larger, reduce the Foot Shaoyang and tonify the Foot Jueyin. Two reductions and one tonification, performed once daily. Palpate to verify, and disperse from the upper areas. Stop when Qi harmonizes. For Ren Ying two-fold larger, reduce the Foot Taiyang and tonify the Foot Shaoyin. Two reductions and one tonification, performed every two days. Palpate to verify, and disperse from the upper areas. Stop when Qi harmonizes. For Ren Ying three-fold larger, reduce the Foot Yangming and tonify the Foot Taiyin. Two reductions and one tonification, performed twice daily. Palpate to verify, and disperse from the upper areas. Stop when Qi harmonizes. For Mai Kou one-fold larger, reduce the Foot Jueyin and tonify the Foot Shaoyang. Two reductions and one tonification, performed once daily. Palpate to verify, and disperse from the upper areas. Stop when Qi harmonizes. For Mai Kou two-fold larger, reduce the Foot Shaoyin and tonify the Foot Taiyang. Two tonifications and one reduction, performed every two days. Palpate to verify, and disperse from the upper areas. Stop when Qi harmonizes. For Mai Kou three-fold larger, reduce the Foot Taiyin and tonify the Foot Yangming. Two tonifications and one reduction, performed twice daily. Palpate to verify, and disperse from the upper areas. Stop when Qi harmonizes. The reason for twice-daily treatment in certain cases is that the Yangming Meridian governs the Stomach, which is rich in Grain Qi, allowing for more frequent intervention. When both Ren Ying and Mai Kou pulses are more than four times larger, it is called Yin Yang Ju Yi (Both Yin and Yang Overflowing). If such conditions are not unblocked, the blood vessels become obstructed, and Qi cannot circulate, leading to internal damage to the Five Zang Organs. Such changes result in other diseases. (This section separates the discussion of impending illness due to excess from its treatment. The previous section combined balance and deficiency, showing unequal detail, yet possessing an interesting logic applicable to various contrasting situations.) The principle of all acupuncture is to stop when Qi is harmonized. Tonifying Yin and reducing Yang enhances voice and complexion, making ears and eyes clear. The opposite leads to stagnation of Blood and Qi. (Textual corruption likely here; should connect to "When pathogenic Qi arrives, it is tight and rapid...") What is meant by "Qi arrival brings efficacy" is that after reduction, the patient becomes emptier. In emptiness, the pulse may appear large as before but lacks firmness. If it remains firm despite the patient feeling better, the disease has not left. After tonification, the patient becomes fuller. In fullness, the pulse may appear large as before but becomes firmer. If it appears large but lacks firmness despite the patient feeling relieved, the disease has not left. Thus, tonification makes the Righteous Qi solid, and reduction makes the Pathogenic Qi deficient. Even if pain does not vanish immediately with the needle, the disease will surely recede. One must first understand the diseases generated by the twelve meridians to apply the theory of Zhong Shi. Therefore, Yin and Yang do not shift arbitrarily, and excess and deficiency do not tilt unfairly; treatment targets the affected meridian. (Connects to "Yin excess and Yang deficiency".) Regarding all types of acupuncture, three needles reach the Grain Qi. Pathogenic Qi mixes chaotically, Yin and Yang exchange places, reverse and contrary states occur, floating and sinking differ, and they do not accord with the four seasons, lingering in the body requiring needle removal. The first needle expels Yang pathogenic Qi; the second expels Yin pathogenic Qi; the third brings Grain Qi. Treatment stops when Grain Qi arrives. Grain Qi arrival means the patient has been tonified to solidity and reduced to emptiness. Only when pathogenic Qi alone is removed, while Yin and Yang are not yet fully harmonized, does the recovery begin. Thus, tonification solidifies, reduction empties. Pain may not cease instantly, but the disease will surely decline. (Connects to "Qi arrival brings efficacy," explaining this section.) In Yin excess and Yang deficiency, tonify Yang first, then reduce Yin to harmonize. In Yin deficiency and Yang excess, tonify Yin first, then reduce Yang to harmonize. (Connects to "Therefore, from the waist up...") The three meridians pulsate between the big toes; examine their excess or deficiency. Reducing deficiency results in double deficiency, worsening the disease. For such cases, press with fingers. If the pulse is solid and rapid, reduce quickly. If weak and slow, tonify. The opposite worsens the disease. These pulsations are located: Yangming above, Jueyin middle, Shaoyin below. (Sections regarding toe pulsations and double deficiency should be placed here.) Chest pain, back pain, and shoulder/arm weakness are treated by selecting points above. Double tongue is treated by needling the lingual pillar with a Bi Needle. Inability to bend the hand indicates a disorder in the sinews; inability to extend indicates a disorder in the bones. Treat bone disorders by focusing on the bone; treat sinew disorders by focusing on the sinew. For excess in one area, needle deeply, press the aperture sparingly to exhaust pathogenic Qi. For deficiency in one area, needle shallowly to nourish the meridian, pressing the aperture quickly to prevent pathogenic entry. (These sections should follow "One needle to Yang.") When pathogenic Qi arrives, the pulse is tight and rapid; when Grain Qi arrives, the pulse is slow and harmonious. Solid pulses require deep needling to drain Qi; empty pulses require shallow needling to preserve Essence and Qi, draining only pathogenic Qi. All painful conditions present with solid pulses. (These sections are misplaced in the text; corrections applied.) Therefore, the Hand Taiyin Lung and Hand Yangming Large Intestine meridians govern the upper body (waist up); the Foot Taiyin Spleen and Foot Yangming Stomach meridians govern the lower body (waist down). Diseases above are treated by taking points below; diseases below are treated by taking points above. Head diseases are treated with foot points; waist diseases are treated with corresponding points. Disease originating in the head causes heaviness in the head; originating in the hand causes arm heaviness; originating in the foot causes foot heaviness. Treaters must first needle the site where the disease originates. Spring Qi resides in the hair; Summer Qi in the skin; Autumn Qi in the muscle layers; Winter Qi in the sinews and bones. Needling these conditions requires depth standards adjusted to the season. Fat individuals are needled using winter/summer standards (deeper); thin individuals using spring/autumn standards (shallower). Painful conditions are Yin. Pain that cannot be localized by pressure is Yin; needle deeply. Upper body diseases are Yang; lower body diseases are Yin. Itching is Yang; needle shallowly. If disease starts in Yin, treat Yin first, then Yang. If it starts in Yang, treat Yang first, then Yin. For Heat Jue, retain the needle to induce cold; for Cold Jue, retain the needle to induce heat. For Heat Jue, needle Yin twice and Yang once; for Cold Jue, needle Yang twice and Yin once. (Placement of preceding sections corrected here.) For chronic diseases where pathogenic Qi has penetrated deeply, needle deeply and retain for a long time, treating every other day. First regulate the Left and Right, remove blood stasis, and complete the acupuncture method. (Revised order: First part reiterates "Qi"; second part reiterates Yin/Yang tonification/reduction.) Acupuncture requires observing Form and Qi. If form and flesh are not wasted but Qi is deficient and the pulse is restless, indicating Jue reversal, use Mi Ci (Lateral Puncture). Scattered Qi can be gathered; accumulated Qi can be distributed. Stay in quiet places, observe the movement of Shen, close doors and windows, keep Hun and Po intact. Focus on Jing, concentrate the spirit, ignore external sounds to gather essence. Unify the spirit, focus intent on the needle. Needle shallowly and retain, lift and thrust slightly to shift Shen, resting only when Qi arrives. Men guard against leakage; women guard against intrusion. Guard carefully; this is De Qi (Arrival of Qi). Prohibitions: Do not needle after intercourse; do not have intercourse after needling. Do not needle when drunk; do not drink after needling. Do not needle when angry; do not get angry after needling. Do not needle when fatigued; do not exert after needling. Do not needle when full; do not overeat after needling. Do not needle when hungry; do not starve after needling. Do not needle when thirsty; do not drink excessively after needling. After great fright or fear, stabilize Qi before needling. Those arriving by carriage lie down and rest for the duration of a meal before needling. Those arriving by walking sit and rest for the duration of walking ten Li before needling. Violating these twelve prohibitions causes chaotic pulses and scattered Qi, disrupting Ying and Wei and meridian order. Needling under these conditions causes Yang diseases to enter Yin and Yin diseases to emerge as Yang, regenerating pathogenic Qi. Incompetent physicians fail to notice this, causing harm to the body. Excessive indulgence depletes brain marrow, hinders fluid transformation, and loses the five flavors; this is loss of Qi. Termination of the Taiyang Meridian: Eyes fixed upward, opisthotonos, convulsions, pale complexion, cessation of sweat (Jue Han). With Jue Han, death occurs. Termination of the Shaoyang Meridian: Deafness, flaccidity of all joints, severance of the Eye System. Death occurs within one and a half days; complexion turns blue-white. Termination of the Yangming Meridian: Twitching of mouth and eyes, fearfulness, delirious speech, yellow complexion, excessive pulsation of upper and lower meridians without flow, leading to termination. Termination of the Shaoyin Meridian: Black complexion, elongated and dirty teeth, abdominal distension and blockage, failure of upper and lower communication, leading to termination. Termination of the Jueyin Meridian: Internal heat, dry throat, frequent urination, severe irritability, curling of the tongue and retraction of the testes, leading to termination. Termination of the Taiyin Meridian: Abdominal distension, dyspnea, belching, vomiting. Vomiting leads to counterflow Qi turning the face red; if no counterflow, upper and lower blockage leads to black complexion and dry skin/hair, resulting in termination.