诸本无篇字。马云。内论气有逆顺。用针者当顺治。不可逆治。故名篇。
气之逆顺者（止）五行也 张云。人与天地相参。与日月相应。其阴阳升降盛衰之气。当其位而和者
为顺。不当其位而乖者为逆。
脉之盛衰者 张云。以有力无力言。故可以候血气之虚实。
刺之大约者 张云。三刺义具如下文。又若明知病之可刺者。以其实邪在经也。如脉度篇所谓盛者
泻之。虚者饮药以补之是也。与其未可刺者。谓有所避忌也。如终始篇所谓新内新劳。已饱已饥。大惊大恐者
勿刺。及八正神明论所谓天忌。五禁篇所谓五禁之类。皆是也。与其已不可刺者。言败坏无及也。如本神篇所
谓五者已伤。针不可以治之也。凡此三者。皆本节切近之义。
兵法曰 马云。逢逢之气。势来迫而甚盛者也。堂堂之阵。阵方整而甚众者也。故无迎者。当避其
来锐耳。无击者。当击其惰归耳。志云。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。俟其气衰辙乱。然后击之。无有不克者矣。简案、孙子云。无邀整整之兵。无击堂堂之隈。注。
堂堂、广大也。逢逢、鼓声。诗、大雅。鼍鼓逢逢是也。
刺法曰 马云。三句及下方其盛也四句。又见素问疟论。 、音靠。诗板篇。多将 。朱注云。
炽、盛也。张云。 、热之甚也。漉漉、汗之多也。浑浑、虚实未辨也。病与脉相逆。形证阴阳不合也。是
皆未可刺者也。
上工（止）与脉相逆者也 甲乙。未盛、作未成。袭者也。盛者也。并无也字。张云。未生者。治
其几也。未盛者。治其萌也。已衰者。知其有隙可乘也。是皆可刺者也。刺其方袭者。不避来锐也。与其形之
盛者。见其外不知其内也。病之与脉相逆者。逆有微甚。微逆者。防有所伤。未可刺也。甚逆者。阴阳相离。
形气相失。已不可刺也。医不达此而强刺之。未有不偾事者矣。故曰下工。
故曰方其盛也（止）大昌 张云。盛邪当泻。何惧毁伤。正恐邪之所凑。其气必虚。攻邪未去。正气
先夺耳。故曰。方其盛也。勿敢毁伤。病既已衰。可无刺矣。不知邪气似平。病本方固。乘势拔之。易为力也。
故曰刺其已衰。事必大昌。马云。按此节与疟论。皆言邪气甚盛。发为甚寒甚热之际。不可轻刺。正以病势与
脉气相逆。然则用药者。亦当先用药于寒热未至之先。不分外感内伤之寒热。皆当如此。若邪气方盛而用药。
则寒药反助其寒。热药反助其热。不能解病而适以增病矣。医者不可不知也。
上工治未病不治已病 马云。二句又见素问四气调神论。
各版本中均无“篇”字。马云认为：本篇主要论述气的逆顺变化，使用针刺疗法时应当顺应气机进行治疗，不可逆其气机而治，因此命名为《逆顺》篇。
气的逆顺（指）五行（的生克制化关系）。张云指出：人与天地相互参合，与日月相应。人体阴阳升降、盛衰的气机，当其位且调和的为“顺”，不当其位且乖违的为“逆”。
脉象的盛衰（反映气血状况）。张云指出：这是从有力无力来论述的，因此可以候察血气的虚实。
针刺的大约原则（基本法则）。张云指出：“三刺”的含义详见下文。另外，如果明知疾病可以针刺，是因为实邪在经脉中，如《脉度》篇所说“盛者泻之，虚者饮药以补之”就是这种情况。对于那些暂时不可以针刺的情况，是指有所避忌，如《终始》篇所说新行房事、新近劳累、刚吃饱、刚挨饿、大惊大恐等情况不要针刺，以及《八正神明论》所说的“天忌”，《五禁》篇所说的“五禁”之类，都是这种情况。至于那些已经不可针刺的情况，是指病情败坏，无法救治了，如《本神》篇所说五脏精气已伤，针不能治疗它一样。以上这三种情况，都是本节切近的意义。
兵法说：马云指出：“逢逢之气”，气势来袭紧迫且非常强盛的样子。“堂堂之阵”，军阵方正且兵力众多。所以“无迎逢逢之气”，应当避开敌人初来时的锐气；“无击堂堂之阵”，应当攻击敌人懈怠归来的时机。《志》书说：作战靠的是勇气，第一次击鼓能振作士气，第二次就衰退了，第三次就耗尽了。因此不要迎着逢逢而来的锐气，不要攻击堂堂正正的军阵，等到他们气衰辙乱时，然后攻击，没有不胜利的。简案按语：孙子说：“无邀整整之兵，无击堂堂之隈。”注解说：“堂堂”是广大的意思，“逢逢”是鼓声，《诗经·大雅》中说“鼍鼓逢逢”就是这个意思。
刺法说：马云指出：这三句及下方“方其盛也”四句，又见于《素问·疟论》。“熇熇”音靠。《诗经·板》篇有“多将熇熇”。朱熹注解说：“熇”是炽盛的意思。张云指出：“熇熇”是热得厉害，“漉漉”是汗出很多，“浑浑”是虚实未辨清。病证与脉象相逆，形体症状与阴阳不合，这些都是暂时不可针刺的情况。
上工（高明医生）（至）与脉相逆者也。《甲乙经》中，“未盛”写作“未成”，“袭者也”、“盛者也”后面都没有“也”字。张云指出：病未生时，治疗其萌芽；病未盛时，治疗其萌动；病已衰时，知道有机可乘。这些都可以针刺。针刺正在侵袭的病邪，不避开敌人的锐气；对于形体表现强盛的病，是只见外表不知内里。病与脉相逆，逆的程度有轻微和严重之分。轻微相逆，担心有所损伤，暂时不可针刺；严重相逆，则是阴阳分离，形气相失，已经不可针刺了。医生如果不通晓这些道理而强行针刺，没有不把事情搞砸的。所以称为下工（低劣医生）。
所以说方其盛也（至）大昌。张云指出：盛邪应当泻除，何必害怕毁伤？只是恐怕邪气聚集之处，正气必然虚弱，攻伐邪气尚未去除，正气先被剥夺罢了。所以说：“方其盛也，勿敢毁伤。”既然病势已经衰退，可以不针刺了。但不知道邪气看似平静，病根正稳固，趁势拔除，容易奏效。所以说：“刺其已衰，事必大昌。”马云指出：这一节与《疟论》都说明邪气非常强盛，发作时出现极寒极热的症状，此时不可轻率针刺，正是因为病势与脉气相逆。那么用药的人，也应当在寒热未发作之前先用药物干预，不分外感或内伤的寒热，都应当如此。如果邪气正盛时用药，寒药反而助长寒邪，热药反而助长热邪，不仅不能解除疾病，反而会增加病情。医者不可不知道这一点。
All versions lack the character "Pian" (Chapter). Ma Yun states: This chapter primarily discusses the reversal and compliance of Qi. When using acupuncture, one should treat in accordance with the Qi's movement, not against it; hence the chapter is named "Ni Shun" (Reversal and Compliance).
The reversal and compliance of Qi refers to the Five Elements (Wu Xing, the five phases of material transformation and energy flow). Zhang Yun notes: Humans are interconnected with Heaven and Earth, and correspond to the Sun and Moon. The Qi of Yin-Yang ascending and descending, flourishing and declining, that is in its proper position and harmonious is called "Shun" (Compliance); that which is out of position and discordant is called "Ni" (Reversal).
The flourishing and declining of the pulse reflects the condition of Blood and Qi. Zhang Yun notes: This is discussed in terms of forcefulness or weakness, thus allowing for the observation of the deficiency or excess of Blood and Qi.
The general principles of needling. Zhang Yun notes: The meaning of "three needlings" is detailed in the following text. Furthermore, if one knows a disease is suitable for needling, it is because the Excess pathogen resides in the meridians, as stated in the *Mai Du* Chapter: "Flourishing conditions are drained, deficient conditions are supplemented with herbal decoctions." For those temporarily unsuitable for needling, there are taboos to observe, such as those in the *Zhong Shi* Chapter: do not needle after recent sexual intercourse, recent exertion, fullness, hunger, great fright, or great fear. Also, the "Heavenly Taboos" mentioned in the *Ba Zheng Shen Ming Lun* Chapter and the "Five Taboos" in the *Wu Jin* Chapter are examples. As for those already unsuitable for needling, it means the condition is deteriorated beyond repair, such as in the *Ben Shen* Chapter where it says if the Five Viscera are injured, needles cannot treat it. These three cases represent the immediate significance of this section.
Military strategy states: Ma Yun explains: "Peng Peng Qi" refers to an imposing momentum that arrives urgently and is very strong. "Tang Tang Zhen" refers to a square formation that is well-ordered and populous. Therefore, "Do not meet Peng Peng Qi" means avoiding the enemy's initial sharp vigor. "Do not strike Tang Tang Zhen" means striking when they are sluggish and returning. The Book of Zhi states: Warfare relies on courage. The first drumbeat rouses the spirit, the second weakens it, and the third exhausts it. Thus, do not face the Peng Peng incoming vigor, nor strike the Tang Tang grand formation; wait until their Qi declines and their tracks become chaotic, then attack, and victory is assured. Jian An's commentary notes: Sun Tzu said, "Do not intercept troops that are orderly, do not strike formations that are grand." The annotation explains: "Tang Tang" means vast/grand; "Peng Peng" refers to the sound of drums, as seen in the *Da Ya* section of the *Book of Songs*: "The alligator drums beat Peng Peng."
Needling methods state: Ma Yun notes: These three sentences and the subsequent four sentences starting with "Fang Qi Sheng Ye" also appear in the *Su Wen: Nu Lun* Chapter. "He He" (pronounced kao) appears in the *Ban* poem of the *Book of Songs*. Zhu Xi's commentary states: "He" means blazing/intense. Zhang Yun notes: "He He" indicates extreme heat; "Lu Lu" indicates profuse sweating; "Hun Hun" indicates indistinguishable deficiency and excess. When the disease pattern contradicts the pulse, and the physical symptoms contradict Yin-Yang principles, these are all conditions where needling is currently inappropriate.
The superior practitioner (Zhi) ... and those contradictory to the pulse. The *Jia Yi Jing* reads "Wei Cheng" (not yet formed) instead of "Wei Sheng"; "Xi Zhe Ye" and "Sheng Zhe Ye" lack the particle "Ye". Zhang Yun notes: Treating before the disease arises addresses its potential; treating before it flourishes addresses its germination; treating after it declines exploits the opening. All these are suitable for needling. Needling the pathogen as it invades does not avoid its sharp vigor. Regarding the flourishing form, one sees the exterior but not the interior. Disease contradicting the pulse has degrees of contradiction. Slight contradiction warrants caution to prevent injury and is temporarily unsuitable for needling; severe contradiction implies separation of Yin and Yang, loss of correspondence between Form and Qi, and is already unsuitable for needling. If physicians do not understand this and force needling, they will surely fail. Hence they are called inferior practitioners.
Thus it is said: Fang Qi Sheng Ye (While it is flourishing) ... Da Chang. Zhang Yun notes: Flourishing pathogens should be drained; why fear damage? One merely fears that where the pathogen gathers, the Righteous Qi must be deficient, and attacking the pathogen without removing it may deplete the Righteous Qi first. Thus it is said: "While it is flourishing, do not dare to cause damage." Once the disease has declined, needling is unnecessary. However, unaware that the pathogen seems calm while the root is solid, one can easily eradicate it by taking advantage of the situation. Thus it is said: "Needle when it has declined, and the matter will surely prosper greatly." Ma Yun notes: This section and the *Nu Lun* both indicate that when pathogenic Qi is extremely strong, causing severe cold and heat, one should not lightly needle, precisely because the disease trend contradicts the pulse Qi. Therefore, when using herbs, one should administer medication before the cold or heat arrives, regardless of whether it is external contraction or internal injury. If herbs are used while the pathogen is flourishing, cold herbs will aggravate the cold, and hot herbs will aggravate the heat, failing to resolve the disease and merely increasing it. Physicians must know this.
The superior practitioner treats the undiseased, not the diseased: Ma Yun notes: These two sentences also appear in the *Su Wen: Si Qi Diao Shen Lun* Chapter.