黄帝问曰∶余闻刺法言，有余泻之，不足补之，何谓有余？何谓不足？岐伯对曰∶有余有五，不足亦有
五，帝欲何问？帝曰∶愿尽闻之。岐伯曰∶神有余有不足，气有余有不足，血有余有不足，形有余有不足，
志有余有不足，凡此十者，其气不等也。帝曰∶人有精气津液，四肢九窍，五脏十六部，三百六十五节，
乃生百病，百病之生，皆有虚实。今夫子乃言有余有五，不足亦有五，何以生之乎？岐伯曰∶皆生于五脏也。
夫心藏神，肺藏气，肝藏血，脾藏肉，肾藏
志，而此成形。志意通，内连骨髓，而成身形五脏。五脏之道，皆出于经隧，以行血气，血气不和，百病
乃变化而生，是故守经隧焉。帝曰∶神有余不足何如？岐伯曰∶神有余则笑不休，神不足则悲。血气未并，
五脏安定，邪客于形，洒淅起于毫毛，未入于经络也，故命曰神之微。帝曰∶补泻奈何？岐伯曰∶神有余，则
泻其小络之血，出血勿之深斥，无中其大经，神气乃平。神不足
者，视其虚络，按而致之，刺而利之，无出其血，无泄其气，以通其经，神气乃平。帝曰∶刺微奈何？岐
伯曰∶按摩勿释，着针勿斥，移气于不足，神气乃得复。帝曰∶善。有余不足奈何？岐伯曰∶气有余则喘咳
上气，不足则息利少气。血气未并，五脏安定，皮肤微病，命曰白气微泄。帝曰∶补泻奈何？岐伯曰∶气有余，
则泻其经隧，无伤其经，无出其血，无泄其气。不足，则补其经隧，无出其气。帝曰∶
刺微奈何？岐伯曰∶按摩勿释，出针视之，曰我将深之，适人必革，精气自伏，邪气散乱，无所休息，气泄
腠理，真气乃相得。帝曰∶善。血有余不足奈何？岐伯曰∶血有余则怒，不足则恐。血气未并，五脏安定，
孙络外溢，则经有留血。帝曰∶补泻奈何？岐伯曰∶血有余，则泻其盛经出其血。不足，则视其虚经内针其脉
中，久留而视，脉大，疾出其针，无令血泄。帝曰∶刺留血奈何？岐伯曰∶视其血络，刺出其血，无令恶血
得入于经，以成其疾。帝曰∶善。形有余不足奈何？岐伯曰∶形有余
则腹胀泾溲不利，不足则四肢不用。血气未并，五脏安定，肌肉蠕动，命曰微风。帝曰∶补泻奈何？岐伯
曰∶形有余则泻其阳经，不足则补其阳络。帝曰∶刺微奈何？岐伯曰∶取分肉间，无中其经，无伤其络，卫
气得复，邪气乃索。帝曰∶善。志有余不足奈何？岐伯曰∶志有余则腹胀飧泄，不足则厥。血气未并，五脏安
定，骨节有动。帝曰∶补泻奈何？岐伯曰∶志有余则泻然筋血者，不足则补其复溜。
帝曰∶刺未并奈何？岐伯曰∶即取之，无中其经，邪所乃能立虚。
帝曰∶善。余已闻虚实之形，不知其何以生。岐伯曰∶气血以并，阴阳相倾，气乱于卫，血逆于经，血
气离居，一实一虚。血并于阴，气并于阳，故为惊狂。血并于阳，气并于阴，乃为炅中。血并于上，气并于下，
心烦惋善怒。血并于下，气并于上，乱而喜忘。帝曰∶血并于阴，气并于阳，如是血气离居，何者为实？何者
为虚？岐伯曰∶血气者，喜温而恶寒，寒则泣不能流，温则消而去之，是故气之所并为血虚，血之所并为气
虚。帝曰∶人之所有者，血与气耳。今夫子乃言血并为虚，气并为虚，是无实乎？岐伯曰∶有者为实，无者为
虚，故气并则无血，血并则无气，今血与气相失，故为虚焉。络之与孙脉俱输
于经，血与气并，则为实焉。血之与气并走于上，则为大厥，厥则暴死，气复反则生，不反则死。帝曰∶实者
何道从来？虚者何道从去？虚实之要，愿闻其故。岐伯曰∶夫阴与阳皆有俞会，阳注于阴，阴满之外，阴阳
匀平，以充其形，九候若一，命曰平人。夫邪之生也，或生于阴，或生于阳。其生于阳者，得之风雨寒暑。
其生于阴者，得之饮食居处，阴阳喜怒。帝曰∶风雨之伤人奈何？岐伯曰∶风雨之伤人也，先客于皮肤，传入
于孙脉，孙脉满则传入于络脉，络脉满则输于大经脉，血气与邪并客于分腠之间，其脉坚大，故曰实。实者外
坚充满，不可按之，按之则痛。帝曰∶寒湿之伤人奈何？岐伯曰∶寒湿之中人也，皮肤不收，肌肉坚紧，荣血
泣，卫气去，故曰虚。虚者聂辟气不足，按之则气足以温之，故快然而不痛。帝曰∶善。阴之生实奈何？岐
伯曰∶喜怒不节则阴气上逆，上逆则下虚，下虚则阳气走之，故曰实矣。帝曰∶阴之生虚奈何？岐伯曰∶喜则气下，
悲则气消，消则脉虚空，因寒饮食，寒气熏满，则血泣气去，故曰虚矣。帝曰∶经言阳虚则外寒，阴虚则内
热，阳盛则外热，阴盛则内寒，余已闻之矣，不知其所由然也。岐伯曰∶阳受气于上焦，以温皮肤分肉之间，
今寒气在外，则上焦不通，上焦不通，则寒气独留于外，故寒栗。帝曰∶阴虚生内热奈何？岐伯曰∶有所劳倦，
形气衰少，谷气不盛，上焦不行，下脘不通。胃气热，热气熏胸中，故内热。帝曰∶阳盛生外热奈何？岐伯曰∶
上焦不通利，则皮肤致密，腠理闭塞，玄府不通，卫气不得泄越，故外热。帝曰∶阴盛生内寒奈何？岐伯曰∶
厥气上逆，寒气积于胸中而不泻，不泻则温气去，寒独留，则血凝泣，凝则脉不通，其脉盛大以涩，故中寒。
帝曰∶阴与阳并，血气以并，病形以成，刺之奈何？岐伯曰∶刺此者取之经隧，取血于营，取气于卫，用形哉，
因四时多少高
下。帝曰∶血气以并，病形以成，阴阳相倾，补泻奈何？岐伯曰∶泻实者气盛乃内针，针与气俱内，以开其
门如利其户，针与气俱出，精气不伤，邪气乃下，外门不闭，以出其疾，摇大其道，如利其路，是谓大泻，必
切而出，大气乃屈。帝曰∶补虚奈何？岐伯曰∶持针勿置，以定其意，候呼内针，气出针入，针空四塞，精无
从去，方实而疾出针，气入针出，热不得还，闭塞其门，邪气布散，精气乃得存，动气候时，近气不失，远
气乃来，是谓追之。帝曰∶夫子言虚实者有十，生于五脏，五脏五脉耳。夫十二经脉皆生其病，今夫子独言五
脏。夫十二经脉者，皆络三百六十五节，节有病必被经脉，经脉之病皆有虚实，何以合之？岐伯曰∶五脏者，
故得六腑与为表里，经络支节，各生虚实，其病所居，随而调之。病在脉，调之血；
病在血，调之络；病在气，调之卫；病在肉，调之分肉；病在筋，调之筋；病在骨，调之骨。燔针劫刺
其下及与急者；病在骨，淬针药熨；病不知所痛，两跷为上；身形有痛，九候莫病，则缪刺之；痛在于
左而右脉病者，巨刺之。必谨察其九候，针道备矣。
调经论∶隧（音遂）飧（音孙）燔（音烦）
黄帝问道：我听说针刺法则，有余的病症用泻法，不足的病症用补法，什么叫有余？什么叫不足？岐伯回答说：有余有五种情况，不足也有五种情况，您想问哪一方面呢？黄帝说：希望听您详尽地讲解。岐伯说：神有余和神不足，气有余和气不足，血有余和血不足，形有余和形不足，志有余和志不足，这十种情况，都是由于人体气血不平衡造成的。黄帝说：人拥有精气、津液、四肢、九窍、五脏以及全身三百六十五个穴位，从而产生各种疾病，百病的产生，都有虚证和实证的区别。现在您却说有余有五种，不足也有五种，这是如何产生的呢？岐伯说：都源于五脏。心藏神，肺藏气，肝藏血，脾主肌肉（原文作“脾藏肉”，实指脾主肌肉），肾藏志，这些构成了人的形体。意志通畅，内连骨髓，从而形成身形和五脏。五脏之间的通道，都出于经络隧道，用来运行血气，如果血气不和，百病就会变化而生，所以要守护好经络隧道。
黄帝问：神有余和不足是怎么回事？岐伯说：神有余就会笑个不停，神不足就会悲伤。在血气尚未偏聚，五脏功能安定的时候，邪气客留于体表，使人感到洒淅恶寒，毫毛竖起，但尚未进入经络，所以称为神的轻微病变。黄帝问：如何补泻？岐伯说：神有余，就泻其小络中的血液，出血即可，不要深刺推按，以免伤及大经脉，这样神气就能恢复平衡。神不足的人，观察其虚弱的络脉，按压以引导正气，针刺以疏通经气，不要使其出血，也不要泄其正气，以此疏通经络，神气就能恢复平衡。黄帝问：对于轻微的病变如何针刺？岐伯说：按摩时不要松手，下针时不要用力推按，将正气移至不足之处，神气就能恢复。黄帝说：很好。气有余和不足是怎么回事？岐伯说：气有余就会气喘、咳嗽、气逆上冲；气不足就会呼吸顺畅但气息微弱。在血气尚未偏聚，五脏安定时，皮肤出现轻微病变，称为白气微泄。黄帝问：如何补泻？岐伯说：气有余，就泻其经络隧道，但不要损伤经脉本身，不要出血，不要泄气。气不足，就补其经络隧道，不要泄气。黄帝问：对于轻微病变如何针刺？岐伯说：按摩时不要松手，出针时注视患处，说要深刺，病人必然紧张改变体位，此时精气自然伏藏，邪气散乱无处停留，随腠理外泄，真气就能恢复。黄帝说：很好。血有余和不足是怎么回事？岐伯说：血有余就会发怒，血不足就会恐惧。在血气尚未偏聚，五脏安定时，孙络外溢，导致经脉中有瘀血停留。黄帝问：如何补泻？岐伯说：血有余，就泻其充盛的经脉并放出血液。血不足，就观察其虚弱的经脉，将针刺入脉中，长时间留针观察，当脉搏变大时，迅速出针，不要让血液流出。黄帝问：对于经脉中留存的瘀血如何针刺？岐伯说：观察其血络，刺破放出血液，不要让恶血进入经脉，以免形成疾病。黄帝说：很好。形有余和不足是怎么回事？岐伯说：形有余就会腹胀、大小便不利；形不足就会四肢不能随意运动。在血气尚未偏聚，五脏安定时，肌肉跳动，称为微风。黄帝问：如何补泻？岐伯说：形有余就泻阳经，形不足就补阳络。黄帝问：对于轻微病变如何针刺？岐伯说：取分肉之间进针，不要刺中经脉，不要损伤络脉，卫气得以恢复，邪气就会消散。黄帝说：很好。志有余和不足是怎么回事？岐伯说：志有余就会腹胀、完谷不化的腹泻；志不足就会四肢厥冷。在血气尚未偏聚，五脏安定时，骨节会有颤动。黄帝问：如何补泻？岐伯说：志有余就泻然谷穴附近的血液，志不足就补复溜穴。
黄帝问：对于血气尚未偏聚的情况如何针刺？岐伯说：立即取穴针刺，不要刺中主经，针对病邪所在之处，能使邪气立刻虚弱。黄帝说：很好。我已经知道了虚实的表现，不知道它们是如何产生的。岐伯说：血气相互搏结，阴阳失衡，气乱于卫分，血逆于经脉，血气分离居住，一处实一处虚。血偏聚于阴分，气偏聚于阳分，就会产生惊狂。血偏聚于阳分，气偏聚于阴分，就会产生内热。血偏聚于上部，气偏聚于下部，就会心烦易怒。血偏聚于下部，气偏聚于上部，就会神志混乱、健忘。黄帝问：血并于阴，气并于阳，像这样血气分离居住，什么是实？什么是虚？岐伯说：血气喜欢温暖而厌恶寒冷，寒冷则凝涩不能流动，温暖则消散流通，所以气偏聚的地方血就虚，血偏聚的地方气就虚。黄帝说：人所拥有的主要是血和气。现在您说血偏聚导致气虚，气偏聚导致血虚，难道就没有实证了吗？岐伯说：有邪气积聚的是实，正气亏损的是虚，所以气偏聚则无血，血偏聚则无气，现在血与气分离失和，所以表现为虚。络脉和孙脉都输送到经脉，如果血与气并聚于经脉，就表现为实。血与气同时向上逆行，就会发生大厥，厥证会突然死亡，如果气能回复则生，不能回复则死。黄帝问：实证是从哪里来的？虚证是到哪里去的？虚实的要领，希望能听听其中的缘故。岐伯说：阴和阳都有腧穴交会，阳气注入阴分，阴气充满于外，阴阳匀平，形体充实，三部九候脉象一致，称为平人。邪气的产生，有的生于阴，有的生于阳。生于阳的，是由于风雨寒暑侵袭。生于阴的，是由于饮食起居不当，以及喜怒情绪失调。黄帝问：风雨伤人是怎么回事？岐伯说：风雨伤人，先客于皮肤，传入孙脉，孙脉满则传入络脉，络脉满则输注于大经脉，血气与邪气并合客居于分肉腠理之间，脉象坚实盛大，所以称为实。实证外部坚硬充满，不可按压，按压则疼痛。黄帝问：寒湿伤人是怎么回事？岐伯说：寒湿中人，皮肤松弛不收，肌肉坚紧，营血凝涩，卫气离去，所以称为虚。虚证表现为肌表疏松气不足，按压则气足可以温煦，所以舒适而不痛。黄帝问：阴分产生实证是怎么回事？岐伯说：喜怒不节制则阴气上逆，上逆则下部虚，下部虚则阳气趋向于下部填补，所以说下部是实。黄帝问：阴分产生虚证是怎么回事？岐伯说：喜则气缓而下，悲则气消，气消则脉道虚空，再加上吃冷的饮食，寒气熏满，导致血凝涩、气离去，所以称为虚。黄帝说：经文说阳虚则外寒，阴虚则内热，阳盛则外热，阴盛则内寒，我已经听说了，不知道其中的原理。岐伯说：阳气受气于上焦，以温煦皮肤分肉之间，现在寒气在外，则上焦不通畅，上焦不通畅，则寒气独留于体表，所以寒战。黄帝问：阴虚生内热是怎么回事？岐伯说：因为劳倦过度，形体之气衰少，水谷之气不盛，上焦不通行，下脘不通畅，胃气郁热，热气熏蒸胸中，所以内热。黄帝问：阳盛生外热是怎么回事？岐伯说：上焦不通利，则皮肤致密，腠理闭塞，汗孔不通，卫气不得宣泄，所以外热。黄帝问：阴盛生内寒是怎么回事？岐伯说：厥气上逆，寒气积于胸中而不能排泄，不排泄则温气离去，寒气独留，则血液凝涩，凝涩则脉道不通，脉象盛大而涩，所以中寒。
黄帝问：阴与阳并，血气相并，病形已成，如何针刺？岐伯说：针刺此症取之于经络隧道，从营分取血，从卫分取气，根据病人的形体状况，因应四季的变化，决定针刺的深浅和多少。黄帝问：血气相并，病形已成，阴阳失衡，如何补泻？岐伯说：泻实的方法是在患者吸气时进针，针与气一起进入，打开门户如同打开窗户，针与气一起退出，精气不伤，邪气随之排出，外部门户不闭，以排出病邪，摇大针孔如畅通道路，这叫大泻，必须切按而出，大气才能屈折消散。黄帝问：补虚的方法是什么？岐伯说：持针不要放置，以安定心意，等候呼气时进针，气出针入，针孔四周紧密闭合，精气无从流失，待正气充实时迅速出针，气入针出，热气不得返还，关闭门户，使邪气布散，精气得以保存，动静合乎时机，近处的精气不丢失，远处的精气才会来，这叫追之。
黄帝说：您说虚实有十种，生于五脏，五脏对应五脉罢了。十二经脉都会产生疾病，现在您只谈五脏。十二经脉都联络三百六十五个穴位，穴位有病必定波及经脉，经脉的病都有虚实，如何综合起来看？岐伯说：五脏本来与六腑互为表里，经络支节各自产生虚实，根据病变所在的位置，随之进行调理。病在脉，调理血；病在血，调理络；病在气，调理卫；病在肉，调理分肉；病在筋，调理筋；病在骨，调理骨。用燔针劫刺治疗下肢及拘急的病症；病在骨，用淬针配合药熨；病痛部位不明，取两跷脉（阴跷、阳跷）为主；身形有痛但三部九候脉象无病，采用缪刺法；疼痛在左侧而右侧脉象有病，采用巨刺法。必须仔细诊察三部九候，针刺的道理就完备了。
调经论：隧（音遂）飧（音孙）燔（音烦）
Huangdi asked: I have heard the saying regarding acupuncture methods, that excess should be drained and deficiency should be tonified. What is meant by "excess"? What is meant by "deficiency"? Qibo replied: There are five types of excess and five types of deficiency. Which aspect do you wish to inquire about? Huangdi said: I wish to hear it in full detail. Qibo said: There is excess and deficiency of Shen (Spirit), Qi (Vital Energy), Blood, Xing (Form/Body), and Zhi (Will). These ten conditions all arise from an imbalance of Qi within the body. Huangdi said: Humans possess Jing Qi (Essential Energy) and Jin Ye (Body Fluids), four limbs, nine orifices, five Zang organs, sixteen regions, and three hundred and sixty-five acupoints, which give rise to myriad diseases. The generation of these diseases involves both deficiency and excess patterns. Now you speak of five types of excess and five types of deficiency; how do they arise? Qibo said: They all originate from the Five Zang Organs. The Heart stores Shen, the Lungs store Qi, the Liver stores Blood, the Spleen governs the muscles (text says "Spleen stores flesh"), and the Kidneys store Zhi, thereby forming the physical body. When Yi Zhi (Intent and Will) flows smoothly, connecting internally with the Marrow, it forms the shape and the Five Zang Organs. The pathways of the Five Zang Organs all emerge from the Jing Mai (Meridians) and Shu Mai (Collaterals), which circulate Blood and Qi. If Blood and Qi are disharmonious, myriad diseases arise through transformation; therefore, one must guard the Jing Mai (Meridian Channels).
Huangdi asked: How does excess and deficiency of Shen manifest? Qibo said: Excess of Shen leads to unceasing laughter; deficiency of Shen leads to sorrow. When Blood and Qi have not yet aggregated and the Five Zang Organs are stable, pathogenic factors lodge in the exterior, causing chills and goosebumps, but have not yet entered the meridians. This is termed a slight disorder of Shen. Huangdi asked: How should tonification and drainage be performed? Qibo said: For excess of Shen, drain the blood from the small collaterals. Allow bleeding without deep insertion or pushing, avoiding the major meridians, so that Shen Qi may return to balance. For deficiency of Shen, observe the deficient collaterals, press to guide Qi, insert the needle to facilitate flow, without causing bleeding or draining Qi, thereby unblocking the meridians so that Shen Qi may return to balance. Huangdi asked: How to treat slight disorders? Qibo said: Massage without releasing pressure; insert the needle without forceful pushing. Transfer Qi to the deficient area, and Shen Qi will recover. Huangdi said: Excellent. How do excess and deficiency of Qi manifest? Qibo said: Excess of Qi leads to panting, coughing, and rebellious Qi ascending; deficiency of Qi leads to smooth breathing but shortness of breath. When Blood and Qi have not yet aggregated and the Five Zang Organs are stable, there is a slight skin disorder, termed Wei Qi (White Qi) slight leakage. Huangdi asked: How should tonification and drainage be performed? Qibo said: For excess of Qi, drain the meridian channels without damaging the meridians themselves, without causing bleeding, and without draining Qi. For deficiency, tonify the meridian channels without draining Qi. Huangdi asked: How to treat slight disorders? Qibo said: Massage without releasing pressure; upon withdrawing the needle, gaze at the site. Say you will insert deeply; the patient will tense up, causing Essence Qi to settle and pathogenic Qi to scatter. As Qi leaks out through the Cou Li (interstices), True Qi will be restored. Huangdi said: Excellent. How do excess and deficiency of Blood manifest? Qibo said: Excess of Blood leads to anger; deficiency of Blood leads to fear. When Blood and Qi have not yet aggregated and the Five Zang Organs are stable, Sun Luo (branching collaterals) overflow, leading to stagnant Blood in the main meridians. Huangdi asked: How should tonification and drainage be performed? Qibo said: For excess of Blood, drain the full meridians and release blood. For deficiency, observe the deficient meridians, insert the needle into the vessel, retain it for a long time while observing. When the pulse becomes large, quickly withdraw the needle without allowing blood to escape. Huangdi asked: How to treat stagnant Blood in the meridians? Qibo said: Observe the blood vessels, puncture to release blood, preventing evil blood from entering the meridians and causing disease. Huangdi said: Excellent. How do excess and deficiency of Xing (Form) manifest? Qibo said: Excess of Xing leads to abdominal distension and difficulty in urination and defecation; deficiency of Xing leads to inability to use the four limbs. When Blood and Qi have not yet aggregated and the Five Zang Organs are stable, there is twitching of the muscles, termed Wei Feng (Light Wind). Huangdi asked: How should tonification and drainage be performed? Qibo said: For excess of Xing, drain the Yang meridians; for deficiency, tonify the Yang collaterals. Huangdi asked: How to treat slight disorders? Qibo said: Insert needles between the muscle bundles, avoiding the meridians and damaging the collaterals. When Wei Qi recovers, pathogenic Qi will dissipate. Huangdi said: Excellent. How do excess and deficiency of Zhi (Will) manifest? Qibo said: Excess of Zhi leads to abdominal distension and undigested stool diarrhea; deficiency of Zhi leads to cold extremities. When Blood and Qi have not yet aggregated and the Five Zang Organs are stable, there is movement in the bone joints. Huangdi asked: How should tonification and drainage be performed? Qibo said: For excess of Zhi, drain the blood at Ran Gu (KI2); for deficiency, tonify Fu Liu (KI7).
Huangdi asked: How to treat cases where Blood and Qi have not yet aggregated? Qibo said: Immediately select the points and needle them, avoiding the main meridians. Targeting the location of the pathogen can immediately weaken it. Huangdi said: Excellent. I have heard the forms of deficiency and excess, but I do not know how they are generated. Qibo said: When Blood and Qi contend with each other, Yin and Yang tilt against each other. Qi becomes chaotic in the Wei level, and Blood rebels in the meridians. Blood and Qi separate and reside apart, resulting in one area being excess and another deficiency. If Blood aggregates in Yin and Qi aggregates in Yang, it results in fright and mania. If Blood aggregates in Yang and Qi aggregates in Yin, it results in internal heat. If Blood aggregates in the upper part and Qi aggregates in the lower part, it results in vexation and irritability. If Blood aggregates in the lower part and Qi aggregates in the upper part, it results in confusion and forgetfulness. Huangdi asked: When Blood aggregates in Yin and Qi aggregates in Yang, as described above where Blood and Qi separate, what constitutes excess and what constitutes deficiency? Qibo said: Blood and Qi favor warmth and dislike cold. Cold causes stagnation and prevents flow; warmth promotes dissolution and dispersion. Therefore, where Qi aggregates, Blood is deficient; where Blood aggregates, Qi is deficient. Huangdi said: What humans possess is primarily Blood and Qi. Now you say that Blood aggregation leads to Qi deficiency and Qi aggregation leads to Blood deficiency. Does this mean there is no such thing as excess? Qibo said: Presence of pathogen is excess; absence of healthy Qi is deficiency. Thus, when Qi aggregates, Blood is absent; when Blood aggregates, Qi is absent. Since Blood and Qi have lost harmony, it manifests as deficiency. Collaterals and Sun Luo all transport to the Jing Mai. When Blood and Qi aggregate in the meridians, it manifests as excess. If Blood and Qi both rush upward, it results in Da Jue (Great Syncope), which causes sudden death. If Qi returns, life is preserved; if it does not return, death ensues. Huangdi asked: From where does excess come? To where does deficiency go? I wish to hear the principles behind deficiency and excess. Qibo said: Both Yin and Yang have Shu and Hui points. Yang Qi pours into Yin, and Yin fills the exterior. When Yin and Yang are balanced, the form is nourished, and the Nine Pulses are uniform, this is called a healthy person. Pathogens arise either from Yin or from Yang. Those arising from Yang result from wind, rain, cold, and summer heat. Those arising from Yin result from improper diet and lifestyle, and emotional fluctuations of joy and anger. Huangdi asked: How do wind and rain injure the body? Qibo said: Wind and rain first lodge in the skin, then transmit to the Sun Luo. When Sun Luo are full, they transmit to the Luo Mai. When Luo Mai are full, they transport to the major Jing Mai. Blood and Qi combine with pathogens and lodge in the Fen Rou (muscle intervals). The pulse becomes firm and large, hence termed "Excess." Excess patterns present with external hardness and fullness; they cannot be pressed, and pressing causes pain. Huangdi asked: How do cold and dampness injure the body? Qibo said: Cold and dampness cause the skin to relax and fail to contract, and the muscles to become tight. Ying Blood stagnates, and Wei Qi departs, hence termed "Deficiency." Deficiency patterns present with flaccidity and lack of Qi; pressing generates sufficient Qi to warm the area, bringing comfort and relieving pain. Huangdi asked: How does Yin generate excess? Qibo said: Unregulated joy and anger cause Yin Qi to rebel upward. Upward rebellion leads to deficiency below; deficiency below causes Yang Qi to rush downward to fill the void, thus the lower part is considered excess. Huangdi asked: How does Yin generate deficiency? Qibo said: Joy causes Qi to sink; grief causes Qi to dissipate. Dissipation leads to empty vessels. Combined with cold food and drink, cold Qi fills the interior, causing Blood stagnation and Qi departure, hence termed "Deficiency." Huangdi said: The classics state that Yang deficiency leads to external cold, Yin deficiency leads to internal heat, Yang excess leads to external heat, and Yin excess leads to internal cold. I have heard this, but I do not understand the mechanism. Qibo said: Yang receives Qi from the Upper Jiao to warm the skin and muscle intervals. Now, if cold Qi is outside, the Upper Jiao becomes blocked. If the Upper Jiao is blocked, cold Qi remains solely on the exterior, causing chills. Huangdi asked: How does Yin deficiency generate internal heat? Qibo said: Due to overwork and fatigue, the form and Qi decline, Grain Qi is insufficient, the Upper Jiao fails to function, and the Lower Wan (stomach outlet) is obstructed. Stomach Qi becomes hot, and hot Qi steams the chest, causing internal heat. Huangdi asked: How does Yang excess generate external heat? Qibo said: If the Upper Jiao is not unobstructed, the skin becomes dense, the Cou Li close, and the Xuan Fu (pores) block. Wei Qi cannot vent, causing external heat. Huangdi asked: How does Yin excess generate internal cold? Qibo said: Jue Qi rebels upward, and cold Qi accumulates in the chest without dispersing. Without dispersal, warming Qi departs, leaving only cold. Blood coagulates and stagnates, blocking the vessels. The pulse becomes large and choppy, causing internal cold.
Huangdi asked: When Yin and Yang combine, and Blood and Qi contend, and the disease form is established, how should one needle? Qibo said: Needle the Jing Mai channels. Extract Blood from the Ying level and Qi from the Wei level. Consider the patient's constitution and adjust according to the seasons, determining depth and quantity based on high and low positions. Huangdi asked: When Blood and Qi contend, disease form is established, and Yin and Yang tilt, how should tonification and drainage be performed? Qibo said: To drain excess, insert the needle during the patient's inspiration. The needle and Qi enter together, opening the gate like a door. Withdraw the needle and Qi together. Healthy Qi is not damaged, and pathogenic Qi descends. The external gate remains open to expel the disease. Widen the needle tract like clearing a path; this is called Great Drainage. Press firmly upon withdrawal to subdue the strong pathogenic Qi. Huangdi asked: How to tonify deficiency? Qibo said: Hold the needle without placing it down, stabilizing your mind. Insert the needle during expiration. As Qi exits, the needle enters. Seal the needle tract tightly so Essence Qi cannot escape. When the healthy Qi is substantial, quickly withdraw the needle. As Qi enters, the needle exits, preventing heat from returning. Close the gate, allowing pathogenic Qi to disperse and healthy Qi to be preserved. Move in accordance with the timing of Qi. Do not lose the nearby Qi, so distant Qi may arrive. This is called "Pursuing" (Zhui Zhi).
Huangdi said: You stated there are ten types of deficiency and excess, originating from the Five Zang Organs, corresponding to the five meridians. However, the Twelve Main Meridians all generate diseases. Why do you speak only of the Five Zang Organs? The Twelve Main Meridians connect with the three hundred and sixty-five acupoints. Disease in any point must affect the meridians, and meridian diseases all involve deficiency and excess. How should these be integrated? Qibo said: The Five Zang Organs naturally have a Exterior-Interior relationship with the Six Fu Organs. The meridians, collaterals, branches, and joints each generate deficiency and excess. According to the location of the disease, regulate it accordingly. Disease in the pulses, regulate the Blood; disease in the Blood, regulate the Collaterals; disease in the Qi, regulate the Wei; disease in the muscles, regulate the Muscle Intervals; disease in the sinews, regulate the Sinews; disease in the bones, regulate the Bones. Use burning needle therapy (Cao Ci) for lower body conditions and spasms. For bone diseases, use quenched needles combined with herbal compresses. If the painful location is unknown, prioritize the two Chong Mai (Yin and Yang Heel Vessels). If the body has pain but the Nine Pulses show no disease, employ Miao Ci (Lateral Puncture). If pain is on the left but the right pulse is diseased, employ Ju Ci (Cross Puncture). One must carefully examine the Nine Pulses; thus, the principles of acupuncture are complete.
Tiao Jing Lun: Sui (pronounced sui), Sun (pronounced sun), Fan (pronounced fan).