脉气盛而血虚者，刺之则脱气，脱气则仆。血气俱盛而阴气多者，其血滑，刺之则射阳
气。
蓄积久留而不泻者，其血黑以浊，故不能射。新饮而液渗于络，而未合和于血也，故血出而
汁别焉。其不新饮者，身中有水，久则为肿。阴气积于阳，其气因于络，故刺之血未出，而
气
先行故肿。阴阳之气，其新相得，而未和合，因而泻之，则阴阳俱脱，表里相离。故脱色而
苍苍然，刺之血出多。色不变烦 者，刺络而虚经，虚经之属于阴者，阴脱故烦闷。阴阳相
得而合为痹者，此为内溢于经，外注于络。如是者阴阳俱有余，虽多出血，而弗能虚也。帝
曰∶相之奈何？曰∶血脉者盛，坚横以赤。上下无常处，小者如针，大者如筋，则而泻之万
全也。故无失数矣。失数而反。各如其度。帝曰∶针入而肉着者何也？曰∶热气因于针，则
针热，热则着于针，故坚焉。妄用砭石，后遗身咎，此冶之二失也。窥门而刺之者死于家中
，入门而刺之者死于堂上。
帝曰∶余闻九针于夫子，而行之于百姓，百姓之血气，各不同形，或神动而气先针行，
或气
与针相逢，或针以出气独行，或数刺乃知，或发针而气逆，或数刺病益剧。凡此六者，各不
同形，愿闻其方。岐伯曰∶重阳之人，其神易动，其气易往也。重阳之人， 高高，言语
善疾，举足善高，心肺之脏气有余，阳气滑盛而扬，故神动而气先行。重阳之人，而神不先
行者，此人颇有阴者也。多阳者多喜，多阴者多怒，数怒者易解，故曰颇有阴。其阴阳之离
合难，故其神不能先行。阴阳和调，而血气淖泽滑利，故针入而气出疾，而相逢也。其阴气
多而阳气少，阴气沉而阳气浮者五内，故针已出，气乃随其后，故独行也。人之多阴而少阳
其气沉，而气往难，故数刺乃知也。针入而气逆者，其气逆与其数刺病益甚者，非阴阳之气
浮沉之势也。此皆粗工之所败，工之所失，其形气无过焉。
脉气旺盛而血液亏虚的人，施针会导致气脱，气脱则人会昏倒。血液和脉气都旺盛且阴气偏多的人，其血液流动滑利，施针时血液会喷射而出，甚至损伤阳气。
如果邪气蓄积停留时间较长而未得到宣泄，其血液颜色黑且浑浊，所以不能喷射。刚喝完水，津液渗入络脉，但尚未与血液融合调和，所以出血时血与水汁分离。如果不刚喝水，体内有水湿停留，时间久了就会形成水肿。阴气积聚在阳分，阻滞于络脉，所以施针时血还未出来，气先运行导致局部肿胀。阴阳之气刚刚相遇但未调和，此时若强行泻法，会导致阴阳俱脱，表里分离。因此面色苍白，针刺出血量多。如果面色不变但感到烦闷，是因为刺络脉使经脉空虚，归属于阴的经脉空虚，阴气耗脱所以烦闷。阴阳之气相得并合导致痹证，这是因为邪气内溢于经，外注于络。像这种情况，阴阳都有余邪，即使放出很多血，也不能使正气虚弱（即无法通过放血达到祛邪目的）。黄帝问：如何辨识？回答说：血脉盛大，坚硬横斜且色赤。位置上下无常，小的如针尖，大的如筋脉，顺着这些特征进行泻法可以万无一失。所以不要违背这个原则。违背了原则反而会根据病情的程度产生相应的后果。黄帝问：针扎进去后肌肉附着在针上是什么原因？回答说：热气依附于针，针变热，热则使肌肉紧附于针，所以感觉坚硬。乱用砭石，会给身体留下后患，这是医生犯下的两个过失之一。“窥门而刺之”指浅刺，“死于家中”比喻病情轻微或治疗得当；“入门而刺之”指深刺，“死于堂上”比喻病情危重或治疗失误导致严重后果。（注：此处原文为比喻，意指深浅不当的危害）
黄帝说：我从老师那里听闻九针的道理，并在百姓身上施行。百姓的血气形态各不相同，有的神气已动而气在针之前先行，有的气与针相逢，有的针拔出后气才单独跟随，有的多次针刺后才见效，有的拔针后气机逆乱，有的多次针刺后病情加重。这六种情况形态各异，希望听听其中的道理。岐伯说：重阳之人，其神志容易激动，其气机容易前行。重阳之人，举止高傲，说话语速快，抬脚高，心肺脏气有余，阳气滑利旺盛而飞扬，所以神志一动气就先行。重阳之人，如果神志不先行的，这个人体内颇有阴气。阳气多的人多喜悦，阴气多的人多愤怒，经常发怒的人容易平息，所以说他颇有阴气。他的阴阳离合困难，所以神志不能先行。阴阳调和，血液和津液滋润滑利，所以针入而气出迅速，气与针相逢。阴气多而阳气少，阴气下沉而阳气浮越于五脏的人，所以针拔出后，气才跟随其后，所以气独行。人如果阴多阳少，气机下沉，气机前行困难，所以多次针刺后才见效。针入后气机逆乱的，或者多次针刺后病情加重的，并不是因为阴阳之气浮沉的自然趋势。这都是粗劣医生的失误，是医生操作上的过错，病人的形体和气机并没有过错。
In individuals where the Qi of the pulse is abundant but the Blood is deficient, needling may lead to Qi depletion (Qi Tuop), resulting in collapse. In those where both Blood and Qi are abundant, with an excess of Yin Qi, the Blood flows smoothly; needling may cause the Blood to jet out, potentially damaging Yang Qi.
If pathogenic factors have accumulated and remained stagnant for a long time without being drained, the Blood becomes dark and turbid, thus unable to jet out. If one has recently drunk fluids, the essence seeps into the collateral vessels before harmonizing with the Blood; consequently, when bleeding occurs, the fluid separates from the Blood. If no recent drinking occurred, water-dampness remains in the body, which over time leads to edema. When Yin Qi accumulates in the Yang aspect and stagnates in the collaterals, needling may result in swelling before any Blood emerges, as the Qi moves first. If the Qi of Yin and Yang has just met but not yet harmonized, applying a draining method at this stage will cause both Yin and Yang to deplete, separating the interior from the exterior. This results in a pale complexion and excessive bleeding. If the complexion does not change but the patient feels vexed, it is because needling the collaterals empties the meridians; emptiness in the Yin meridians leads to Yin depletion, causing vexation. When Yin and Yang Qi interact and combine to form Bi syndrome (obstruction), it is due to pathogens overflowing into the main meridians and pouring into the collaterals. In such cases, both Yin and Yang have excess pathogens; even if significant amounts of Blood are released, it cannot effectively reduce the excess (i.e., it fails to achieve the desired therapeutic voiding). The Yellow Emperor asked: How should one identify these conditions? Bo Zi replied: The blood vessels are full, hard, transverse, and red. Their location varies above and below; some are small like needle points, others large like sinews. Following these signs to apply draining methods ensures complete safety. Therefore, do not deviate from these principles. Deviating will yield results corresponding to the severity of the condition. The Yellow Emperor asked: Why does the flesh adhere to the needle after insertion? Bo Zi replied: Heat attaches to the needle, making it hot; the heat causes the flesh to adhere tightly, making it feel firm. Misuse of bian stones (lithic therapy) leaves lasting harm on the body; this constitutes two errors made by physicians. "Piercing the door" refers to superficial needling, associated with death at home (metaphorically indicating minor error or mild outcome); "entering the gate" refers to deep needling, associated with death in the hall (metaphorically indicating major error or severe outcome).
The Yellow Emperor said: I learned about the Nine Needles from my master and applied them to the common people. The Blood and Qi of different people vary in form. Sometimes Shen (Spirit) moves and Qi precedes the needle; sometimes Qi meets the needle upon insertion; sometimes Qi follows only after the needle is withdrawn; sometimes multiple insertions are needed before effect is felt; sometimes Qi rebels after needle withdrawal; sometimes symptoms worsen after multiple insertions. These six scenarios differ in manifestation. I wish to hear the explanation. Bo Zi replied: Individuals with excessive Yang have spirits that are easily aroused and Qi that moves forward readily. Such individuals often display haughty behavior, speak quickly, and lift their feet high. They have excess Qi in the Heart and Lungs, with smooth, vigorous, and soaring Yang Qi; thus, when the Spirit moves, the Qi advances first. If an individual with excessive Yang does not have Qi advancing first, they possess considerable Yin. Those with more Yang tend to be joyful; those with more Yin tend to be irritable. Frequent angerers are quick to calm down, hence described as having considerable Yin. Their Yin and Yang are difficult to separate and combine, so their Spirit cannot advance first. When Yin and Yang are harmonious, and Blood and fluids are moist and smooth, Qi exits rapidly upon needle insertion, meeting the needle. In those with more Yin and less Yang, where Yin sinks and Yang floats within the five Zang organs, Qi follows only after the needle is withdrawn, moving independently. In individuals with much Yin and little Yang, the Qi sinks and moves forward with difficulty, requiring multiple insertions before effect is felt. Cases where Qi rebels upon insertion, or where symptoms worsen after multiple insertions, are not due to the natural floating and sinking trends of Yin and Yang Qi. These are failures caused by incompetent physicians, errors in technique, while the patient's physical constitution and Qi were not at fault.