（《灵枢·逆顺篇》全）
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。（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，
所以候血气之虚实有余不足也。（脉之盛衰者，以有力无力言，故可以候血气之虚实。）刺之大约者，必明知病之可刺，
与其未可刺，与其已不可刺也。（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、已饱已饿、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。）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。（逢逢之气盛，堂
堂之阵整，无迎无击，避其锐也。逢音蓬。）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。
（ ，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。 ，郝、
嚣二音。漉音鹿。）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。（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。）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。（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，勿敢毁伤，刺其已衰，事必大昌。（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。）故曰上工治未病，不治已病，此之谓也。（此与《四气调神论》同，见摄生类七。）
（《灵枢·逆顺篇》全文）
黄帝向伯高问道：我听说气有逆乱与顺行的区别，脉象有盛衰的变化，针刺治疗有大概的原则，可以讲给我听吗？伯高回答说：气的逆顺，是用来对应天地阴阳、四季和五行变化的。（人与天地相互参合，与日月相应，体内阴阳升降盛衰之气，当在正确的位置且调和的称为“顺”，不在正确位置且乖违的称为“逆”。）脉象的盛衰，是用来诊察血气虚实有余不足情况的。（脉象的盛衰，是以有力无力来描述的，因此可以用来候察血气的虚实。）针刺的大概原则，必须明确知道疾病是可以针刺治疗的，还是不可以针刺治疗的，或者是已经不可针刺治疗的。（关于三次针刺的含义详见下文。另外，如果明确知道疾病可以针刺，是因为实邪在经脉中，如《脉度篇》所说的实证用泻法、虚证用药饮来补益的方法。对于不可以针刺的情况，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、大惊大恐时不要针刺，以及《八正神明论》所说的天忌，《五禁篇》所说的五禁等情况都是。对于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，针刺不能治疗的情况。以上这三种情况，都是本节贴近义理的内容。）黄帝说：如何诊察呢？伯高说：兵法上说：不要迎击气势旺盛的敌军，不要攻击阵容严整的军队。（逢逢指气势盛大，堂堂指阵容整齐，不迎不击是为了避开敌人的锐气。逢音同蓬。）针刺法则说：不要针刺高热炽盛的病人，不要针刺大汗淋漓的病人，不要针刺脉象浑混乱浊的病人，不要针刺病症与脉象相逆的病人。（熇熇是热势极盛的样子。漉漉，形容汗出很多。浑浑，指虚实难以分辨。病与脉相逆，指形体症状与阴阳属性不合。这些都是不可以针刺的情况。熇，郝、嚣二音。漉音鹿。）黄帝问：如何诊察可以针刺的情况呢？伯高说：高明的医生在病未发生时就进行干预，其次是在病势未盛时进行干预，再次是在病势已衰退时进行干预。（未发生，是指在萌芽阶段治疗。未盛，是指在初起阶段治疗。已衰，是指知道有机可乘。这些都是可以针刺的情况。）低劣的医生却在病势正猛烈侵袭时进行针刺，或者在形体正气亢盛时进行针刺，或者在病症与脉象相逆时进行针刺。（刺其方袭者，是不避开敌人锐气。刺其形之盛者，是只见外表不知内里虚实。病与脉相逆，逆乱有轻微和严重之分，轻微逆乱要防止造成伤害，尚不可针刺；严重逆乱则是阴阳分离，形气相失，已经不可针刺。医生如果不通晓这些而强行针刺，没有不把事情搞砸的，所以称为下工。）所以说，当病势正盛时，不敢随意攻伐损伤，要在病势衰退后针刺，事情必定大吉大利。（盛实的邪气应当泻除，何必害怕损伤？只是担心邪气聚集之处，正气必然虚弱，攻伐邪气尚未去除，正气先被剥夺，所以说病势正盛时不敢随意攻伐。既然病势已经衰退，似乎可以不治了，但不知道邪气看似平静，病根其实坚固，趁势拔除病根，容易奏效，所以说在病势衰退后针刺，事情必定大吉大利。）所以说，高明的医生治疗未病，不治疗已病，说的就是这个道理。（这与《四气调神论》的观点相同，见摄生类第七部分。）
(The full text of "Ni Shun Pian" from *Ling Shu*)
Huangdi asked Bo Gao: I have heard that Qi has distinctions between reversal (Ni) and smooth flow (Shun), pulses exhibit fluctuations in excess and deficiency, and acupuncture treatment follows general principles. May I inquire about these? Bo Gao replied: The reversal and smooth flow of Qi correspond to the Yin and Yang of Heaven and Earth, as well as the Four Seasons and Five Elements. (Humans are interconnected with Heaven and Earth and resonate with the Sun and Moon; when the ascending and descending, excessive and deficient Qi of Yin and Yang is in its proper position and harmonious, it is termed "Shun" (smooth/normal); when it is not in its proper position and discordant, it is termed "Ni" (reversed/abnormal).) The excess and deficiency of pulses serve to diagnose the excess or deficiency, surplus or insufficiency of Blood and Qi. (The excess and deficiency of pulses are described in terms of forcefulness or lack thereof, thus allowing for the diagnosis of the excess or deficiency of Blood and Qi.) The general principles of acupuncture require clearly knowing whether a disease is amenable to acupuncture, not amenable to acupuncture, or beyond the point where acupuncture can be effective. (The meaning of three-stage needling is detailed below. Furthermore, if one knows a disease is amenable to needling because excess pathogenic factors reside in the meridians, this aligns with what is stated in *Mai Du Pian*: use draining methods for excess conditions and medicinal decoctions for tonification in deficiency conditions. Regarding conditions not amenable to needling, this refers to contraindications, such as those mentioned in *Zhong Shi Pian*: do not needle after recent sexual intercourse, recent exertion, fullness, hunger, great fright, or great fear; and also includes the "Heavenly Taboos" from *Ba Zheng Shen Ming Lun* and the "Five Taboos" from *Wu Jin Pian*. Regarding conditions beyond the point of effectiveness, this refers to deterioration where recovery is impossible, such as stated in *Ben Shen Pian*: if the five Zang organs are already damaged, acupuncture cannot treat them. These three categories represent the immediate relevance of this section.) Huangdi said: How does one observe/diagnose these? Bo Gao said: As military strategy states: Do not engage an army with overwhelming momentum, and do not attack a formation that is solid and organized. (Peng peng describes overwhelming momentum; tang tang describes an organized formation. Not engaging or attacking is to avoid their sharpness. Peng sounds like 'peng'.) Acupuncture methodology states: Do not needle patients with intense heat (He he), do not needle patients with profuse sweating (Lu lu), do not needle patients with chaotic and turbid pulses (Hun hun), and do not needle patients whose symptoms contradict their pulse. (He he indicates extreme heat. Lu lu indicates profuse sweating. Hun hun indicates difficulty in distinguishing excess from deficiency. Symptoms contradicting the pulse indicate a mismatch between physical signs and Yin-Yang nature. All these are conditions not amenable to needling. He is pronounced Hao or Xiao; Lu is pronounced Lu.) Huangdi asked: How does one observe conditions amenable to needling? Bo Gao said: Expert physicians intervene before the disease arises; next best is intervening before the disease becomes excessive; next is intervening after the disease has declined. (Intervening before arising means treating at the embryonic stage. Intervening before excess means treating at the initial stage. Intervening after decline means recognizing an opportunity to capitalize on the weakness. All these are conditions amenable to needling.) Incompetent physicians needle when the pathogen is just attacking, when the physical constitution is excessively strong, or when symptoms contradict the pulse. (Needling when the pathogen is attacking fails to avoid the sharpness of the incoming evil. Needling when the constitution is strong reflects seeing only the exterior without knowing the interior. Contradiction between symptoms and pulse varies in severity; slight contradiction requires caution to avoid harm and is not yet suitable for needling; severe contradiction indicates separation of Yin and Yang and loss of harmony between form and Qi, making needling impossible. Physicians who do not understand this and force needling will inevitably fail, hence they are called incompetent.) Therefore, it is said: When the pathogen is in excess, do not dare to damage [the healthy Qi]; needle after it has declined, and success is guaranteed. (Excess pathogens should be drained; why fear damage? One merely fears that where pathogenic qi gathers, healthy qi must be deficient; if attacking pathogens without removing them, healthy qi may be depleted first. Hence, when in excess, do not dare to damage. Although the disease seems to have declined and might seem unnecessary to treat, one must realize that while pathogenic qi appears calm, the root of the disease is solid; capitalizing on this momentum to extract the root is easy and effective. Hence, needling after decline guarantees success.) Therefore, it is said: Experts treat disease before it arises, not after it has arisen. This is what is meant. (This view is consistent with *Si Qi Tiao Shen Lun*, see Category 7 on Preservation of Health.)