夫能知迎随之理。可令调气。调气之方。必在阴阳。然所谓迎随者。知荣卫之流行。经
脉之
阳而调之。故曰。调气之方。必在阴阳也。夫用针刺者。须明其孔穴。补虚泻实。送坚付软
以急随缓。荣卫常行。勿失其理。故经云。虚
则补之。实则泻之。不虚不实。以经取之。然。虚者补其母。实
者泻其子。当先补而后泻。不实不虚。以经取之
者。然。是正经自生其病。不中他邪。当自取其经。故言。以经取之。又云。刺荣无伤于卫
刺卫无伤于荣。然。针阳者卧针而刺之。刺阴者。先以左手捻按所针荣俞之处。候气散乃
内针。是谓刺荣无伤于卫。刺卫无伤于荣也。
又云。东方实。西方虚。泻南方。补北方者。然。是金木水火土当互相平也。缘东方木
西方金。木欲实金当平之。土欲实木当平之。金欲实火当平之。水欲实土当平之。东方者肝也。
则知肝实。西方者肺也。则知肺虚。泻南方补北方者。南方火。火者木之子也。北方水。水
者木之母也。水胜火。子能令母实。母能令子虚。故泻火补水。欲令金不得平木也。经言。
不能治其虚。何问其余。此之谓也。
夫言气实者热。气虚者寒也。针实者。以右手持针。左手捻按开针穴以泻之。针虚者。
以左手闭针穴以补之。补泻之时。与气开阖相应。是谓针容以豆。补泻之理也。又虚者。徐而疾
实者。疾而徐。徐即是泻。疾即是补。补泻之法一根据此也。下针之时。捏取穴。置针于荣
上三十六息。以左手捏穴令定。法其地不动。右手持针。象其天而运转也。于此三十六息。
然定得针。右手存意捻针。左手捏穴。可重五两以来。计其针如转如不转。徐徐下之。若觉
痛。即可重二两。若不觉。以针下之入。人荣至徐。卫至疾。得气如有鱼食钩。即得其病气
也。量其轻重。经以取之。名曰疾徐者。至病即得气。欲出针时。子午缓缓而出。令引病气
不绝。名曰徐也。既引气多。一向无补。名之曰泻。问曰。凡下针时。若是为好。答曰。徐
徐下之。坚持为实。凡下针先须持针坚得安稳。不用饱食。亦不用空肚。患人欲针者。有乘
车来者。有步行来者。如人行十里许。须令坐息。安神定气。乘车者。如人行三里许。患人嘿嘿
而不言。安久坐候。气脉安定。乃可下针。又云。夫针之者。不离身心。口如衔索。目欲内
视。消息真气而不得妄行针。针入一分。知天地之气。针入二分。知呼吸之气。针入三分。
知逆顺之气。针皮毛者。无伤肌肉。针肌肉者。无伤筋脉。针筋脉者。无伤骨髓。针骨髓者
无伤诸络。东方甲乙木。主人筋膜。南方丙丁火。主人血脉。西方庚辛金。主人皮毛。北
方壬癸水。主人骨髓。中央戊己土。主人肌肉。针伤筋膜者。令人视失魂。针伤血脉者。
令人烦乱。针伤皮毛者。令人上气失魂。针伤骨髓者。令人呻吟失志。针伤肌肉者。令人四
肢不收失智也。刺若中心一日死。刺若中肝五日死。刺若中肾六日死。刺若中肺三日死。刺
若中脾十日死。刺若中胆一日半死。
又云。勿刺大醉。勿刺大怒。勿刺大劳。勿刺大饱。勿刺大饥。勿刺大渴。勿刺大惊。
以上古之深诫也。
能够掌握“迎随”的道理，就可以调节经气。调节经气的方术，关键在于阴阳。所谓“迎随”，是指了解营卫之气的流行规律和经脉的走向。顺着经脉走向为“随”，逆着经脉走向为“迎”。因此说，调节经气的方术，必然在于调和阴阳。
使用针刺时，必须明确穴位的位置，通过补虚泻实、使坚硬的邪气消散而柔和正气恢复、使急迫的状态舒缓来治疗。营卫之气常行不息，不要违背其规律。所以《内经》说：虚证用补法，实证用泻法，不虚不实则取本经穴位治疗。然而，虚证要补其母穴，实证要泻其子穴。应当先补后泻。对于不虚不实的病症，取本经穴位治疗，是因为这是本经自生的疾病，没有受到其他外邪侵袭，所以应当直接取本经穴位，因此说“以经取之”。又说：“刺荣分不要伤及卫分，刺卫分不要伤及荣分。”针刺阳分（浅层）时，要卧针平刺；针刺阴分（深层）时，先用左手捻按所要针刺的荣俞之处，待气散后再进针，这就叫做“刺荣无伤于卫，刺卫无伤于荣”。
又说：“东方实，西方虚，泻南方，补北方。”这是因为金、木、水、火、土五行应当互相平衡。东方属木，西方属金。如果木气太盛，金气应当制约它；如果土气太盛，木气应当制约它；如果金气太盛，火气应当制约它；如果水气太盛，土气应当制约它。东方对应肝脏，所以知道肝气实；西方对应肺脏，所以知道肺气虚。泻南方（心/火）、补北方（肾/水），因为南方属火，火是木之子；北方属水，水是木之母。水能胜火，子能令母实，母能令子虚。所以泻火补水，目的是为了让金气不能去克制木气（即保护肝木）。经文说：“如果不能治疗虚证，还问其他的干什么呢？”就是这个意思。
所谓气实表现为热，气虚表现为寒。针刺实证时，右手持针，左手捻开穴位以泻其实邪；针刺虚证时，左手闭合穴位以补其正气。补泻的时机，要与经气的开阖相应，这就是所谓的“针容以豆”（形容补泻手法细微精妙）的补泻原理。另外，虚证宜慢进快出（徐入疾出），实证宜快进慢出（疾入徐出）。这里的“徐”指的是泻法，“疾”指的是补法。补泻的方法都依据这个原则。
下针时，捏定穴位，将针置于荣分之上，停留三十六次呼吸的时间，用左手固定穴位使其像大地一样不动，右手持针，像天体运行一样转动。在这三十六息的时间里，确定好针位，右手意念集中在捻针上，左手捏住穴位，重量控制在五两左右。感觉针如转又不转，徐徐深入。如果感到疼痛，重量可减至二两；如果不觉得痛，则将针继续深入。进入荣分要慢，进入卫分要快。得气时感觉如同鱼儿吞钩，这就是取得了病气。根据轻重程度，经文中有相应的取穴方法，名为“疾徐”。到了病所即得气，欲出针时，采用子午流注之法缓缓而出，使病气不断引出，这叫做“徐”。既然引出了很多气，且一直偏向于泻，就称为“泻”。
问：凡是在下针的时候，什么算是好的？答：徐徐下针，坚持针体坚实稳固。凡是下针，必须先持针坚固安稳。不让病人饱食，也不让病人空腹。患病的人来针灸，有乘车来的，有步行来的。如果是步行十里左右，必须让病人坐下休息，安神定气。如果是乘车来的，相当于走了三里路，病人沉默不语，应让其安静坐久一点，等气脉安定后，才可以下针。
又说：施针不离身心，口中如衔绳索般紧闭，目光内视，观察真气运行而不妄行针。针入一分，感知天地之气；针入二分，感知呼吸之气；针入三分，感知逆顺之气。针刺皮毛者，不要伤及肌肉；针刺肌肉者，不要伤及筋脉；针刺筋脉者，不要伤及骨髓；针刺骨髓者，不要伤及诸络。
东方甲乙木，主管人的筋膜；南方丙丁火，主管人的血脉；西方庚辛金，主管人的皮毛；北方壬癸水，主管人的骨髓；中央戊己土，主管人的肌肉。如果针刺伤了筋膜，会让人视物不清、失魂；针刺伤了血脉，会让人烦躁混乱；针刺伤了皮毛，会让人气逆上冲、失魂；针刺伤了骨髓，会让人呻吟、失志；针刺伤了肌肉，会让人四肢不收、失智。
如果误刺中心脏，一天死亡；误刺中肝脏，五天死亡；误刺中肾脏，六天死亡；误刺中肺脏，三天死亡；误刺中脾脏，十天死亡；误刺中胆腑，一天半死亡。
又说：不要在大醉时针刺，不要在大怒时针刺，不要在极度疲劳时针刺，不要在过饱时针刺，不要在极度饥饿时针刺，不要在极度口渴时针刺，不要在大惊时针刺。以上是古人的深刻告诫。
One who understands the principle of *Ying-Sui* (Following and Opposing) can regulate Qi. The method for regulating Qi must lie in Yin and Yang. What is meant by *Ying-Sui* is knowing the circulation of Ying (Nutritive) and Wei (Defensive) Qi, and the direction of the meridians. Following the meridian flow is *Sui*, opposing it is *Ying*. Therefore, it is said that the method for regulating Qi necessarily lies in balancing Yin and Yang.
When using acupuncture, one must clearly understand the acupoints, employing tonification for deficiency and sedation for excess, dissipating hardness (pathogenic factors) to restore softness (healthy Qi), and relieving urgency with slowness. Ying and Wei Qi circulate constantly; do not violate their principles. Thus, the Classics state: "Tonify deficiency, sedate excess, and treat non-deficient/non-excess conditions by selecting points from the affected meridian." However, for deficiency, tonify its Mother point; for excess, sedate its Child point. One should tonify first, then sedate. For conditions that are neither deficient nor excessive, selecting points from the affected meridian implies that the disease originates within the meridian itself, without invasion by other pathogens, so one should directly select from that meridian, hence "treat by selecting from the meridian." It also states: "When needling Ying, do not injure Wei; when needling Wei, do not injure Ying." To needle Yang layers (superficial), use a horizontal insertion (lying needle); to needle Yin layers (deep), first use the left hand to twist and press the Ying-Shu point to be needled, wait for the Qi to disperse, then insert the needle. This is called "needling Ying without injuring Wei, needling Wei without injuring Ying."
It further states: "East is Excess, West is Deficiency; Sedate South, Tonify North." This refers to the mutual balance of Metal, Wood, Water, Fire, and Earth. East corresponds to Wood, West to Metal. If Wood is excessive, Metal should restrain it; if Earth is excessive, Wood should restrain it; if Metal is excessive, Fire should restrain it; if Water is excessive, Earth should restrain it. East corresponds to the Liver, indicating Liver Excess; West corresponds to the Lungs, indicating Lung Deficiency. Sedating South (Heart/Fire) and tonifying North (Kidney/Water): Fire is the Child of Wood; Water is the Mother of Wood. Water overcomes Fire. The Child can make the Mother full, and the Mother can make the Child empty. Thus, sedating Fire and tonifying Water aims to prevent Metal from restraining Wood. The Classics say: "If you cannot treat deficiency, what else is there to ask about?" This is what it means.
It is said that Qi Excess manifests as Heat, and Qi Deficiency manifests as Cold. For needling Excess, hold the needle with the right hand and use the left hand to open the acupoint to sedate. For needling Deficiency, use the left hand to close the acupoint to tonify. The timing of tonification and sedation should correspond with the opening and closing of Qi. This is the principle of "needle capacity like a bean" regarding tonification and sedation. Furthermore, for Deficiency, insert slowly and withdraw quickly (Xu Ru Ji Chu); for Excess, insert quickly and withdraw slowly (Ji Ru Xu Chu). Here, "Slow" refers to Sedation, and "Quick" refers to Tonification. The methods of tonification and sedation are based on this.
When inserting the needle, pinch the acupoint, place the needle at the Ying level, retain for thirty-six breaths, use the left hand to fix the acupoint making it immovable like the earth, while the right hand holds the needle rotating like the heavens. During these thirty-six breaths, once the needle is settled, focus the right hand's intention on twisting the needle, while the left hand pinches the acupoint with a weight of up to five taels. The sensation should be as if turning but not turning, advancing slowly. If pain is felt, reduce the weight to two taels; if no pain is felt, advance the needle deeper. Entering Ying requires slowness, entering Wei requires speed. Obtaining Deqi feels like a fish biting a hook, which indicates obtaining the pathogenic Qi. Measure the heaviness and lightness according to the Classics' methods, named "Ji-Xu" (Fast-Slow). Upon reaching the disease site and obtaining Deqi, when withdrawing the needle, withdraw slowly using Zi-Wu flow principles to ensure the pathogenic Qi is continuously drawn out, named "Xu" (Slow). Having drawn out much Qi and consistently leaning towards sedation, it is named "Xie" (Sedation).
Question: What is considered good when inserting needles? Answer: Insert slowly, maintaining firm stability of the needle. Before needling, the needle must be held firmly and stably. Do not needle after a full meal, nor on an empty stomach. Patients coming for needling may have arrived by carriage or walking. If they walked about ten li, they must sit and rest to calm the Shen and stabilize the Qi. If they came by carriage (equivalent to walking three li), they should sit quietly for a long time until the Qi and pulse are stable before needling.
It also states: Needling involves body and mind. Keep the mouth closed as if holding a rope, gaze inward, observe the Zhen Qi movement, and do not needle recklessly. Needle depth of one fen perceives Heaven and Earth Qi; two fen perceives Respiration Qi; three fen perceives Reverse and Smooth Qi. When needling skin/hair, do not injure muscle; when needling muscle, do not injure sinews/vessels; when needling sinews/vessels, do not injure bone/marrow; when needling bone/marrow, do not injure collateral vessels.
East Jia-Yi Wood governs sinews; South Bing-Ding Fire governs blood vessels; West Geng-Xin Metal governs skin/hair; North Ren-Gui Water governs bone/marrow; Central Wu-Ji Earth governs muscle. Injuring sinews causes vision loss and Soul (Hun) loss; injuring blood vessels causes agitation and confusion; injuring skin/hair causes upward rushing Qi and Soul loss; injuring bone/marrow causes groaning and Will (Zhi) loss; injuring muscle causes inability to control limbs and Wisdom (Zhi) loss.
Accidental puncture of the Heart leads to death in one day; Liver in five days; Kidneys in six days; Lungs in three days; Spleen in ten days; Gallbladder in one and a half days.
Furthermore: Do not needle during severe drunkenness, severe anger, extreme fatigue, fullness, hunger, thirst, or shock. These are profound warnings from antiquity.