八正，天地八方之正位也。天之八正，日月星辰也。地之八正，四方四隅也。合人形于天地四时，
阴阳虚实，以为用针之法，神乎神，独悟独见独明，故曰八正神明也。
黄帝问曰∶用针之服，必有法则焉，今何法何则？
服，事也。上编云凡刺之真，必先治神，然虽治神，必有法则，以为用针之事，帝故问之。
岐伯对曰∶法天则地，合以天光。
天光，日月星辰也。用针之道，上法天时，下则地理，更合天之日月星辰，以为法则也。
帝曰∶愿卒闻之。
法天则地，合以天光，愿尽闻之。
岐伯曰∶凡刺之法，必候日月星辰，四时八正之气，气定乃刺之。
合以天光者，凡刺之法，必候日月星辰也。法天者，候四时之气也。则地者，候八正之气也。定，
安静也。人气安静乃行针以刺之。此为用针之事也。
是故天温日明，则人血淖液，而卫气浮，故血易泻，气易行，天寒日阴，则人血凝泣，而卫气沉。
易，去声。泣，作涩。人身血气，上应于天，是故天气温和，日色光明，则人血淖液，而卫气浮。
淖液，滋灌也。浮，外行也。血淖液，故血易泻；卫气浮，故气易行。若天不温和而寒，日不光
明而阴，则人血凝涩而卫气沉。凝涩，不淖液也。沉，不浮也。
月始生，则血气始精，卫气始行；月郭满，则血气实，肌肉坚；月郭空，则肌肉减，经
络虚，卫气去，形独居。是以因天时而调血气也。
人身血气，不但应天日，且应天月也。月始生，月朔也，月生之日，卫气大会于风府，则血气始精，
卫气始行；月郭满，月望也，月望则血气充盛，故血气实，而肌肉坚；月郭空，月晦也，月
晦则血气虚微，故肌肉凝，经络虚，卫气去，形独居。伤寒论云∶血弱气尽，腠理开者是也。是以人当因
天时而调血气也。
是以天寒无刺，天温无凝，月生无泻，月满无补，月郭空无治，是谓得时而调之。
因天时而调血气，是以天寒无刺，寒则坚凝，故无刺也；天温无凝，温则流通，故无凝也；月生无泻，
不伐其生气也；月满无补，不益其有余也，月郭空无治，正气虚邪，不能去也，凡此是谓得时而调之。
因天之序，盛虚之时，移光定位，正立而待之。
得时而调，乃因天序之盛虚，故曰因天之序，盛虚之时也。移光，去形晦而光明也。定位，日月中天
而位定也。正立而待，整肃其体，待天人气盛，然后行针以刺也，凡此皆得时而调也。
故曰∶月生而泻，是谓脏虚；月满而补，血气扬溢，络有留血，命曰重实；月郭空而治，是
谓乱经，阴阳相错，真邪不别，沉以留止，外虚内乱，淫邪乃起。
重，平声。别，音逼。月生无泻，故曰月生而泻，是谓脏虚；月满无补，月满而补，则血气扬溢于外，
则络有留血，命曰重实；月郭空无治，月郭空而治，是谓乱经，乱经则阴阳相错，阴阳相
错，则真邪不别，真邪不别，则邪气内沉，沉以留止，真气不充，则外虚；邪气相薄，则内乱。外虚
内乱，则淫邪乃起，凡此皆不能得时而调也。
帝曰∶星辰八正何候？
星辰躔度，八正定位，何以候之？
岐伯曰∶星辰者，所以制日月之行也。八正者，所以候八风之
虚邪，以时至者也。四时者，所以分春秋冬夏之气所在，以时调之也。八正之邪虚，而避之勿犯也。
日月之行，星辰为之卫，是星辰者，所以制日月之行也。制日月之行，则星辰可候矣。八风之邪，八
正为之位，是八正者，所以候八风之虚邪，以时至者也。知八风之邪，则八正可候矣。天有四
时，四时者，所以分春秋冬夏之气所在，人候其气，以时调之也。春秋之气温和，冬夏之气寒暑，以时
调之，则八正之虚邪，而避之勿犯也。
以身之虚，而逢天之虚，两虚相感，其气至骨，入则伤五脏，工候救之，弗能伤也。
人之受邪，身之虚也。天之有邪，天之虚也。以身之虚，而逢天之虚，两虚相感，其气内至于骨，内
至于骨，则入伤五脏，其两虚相感之时，而工候救之，弗能入伤五脏也。
故曰∶天忌不可不知也。
《灵枢·九针论》云∶“大禁太一所在之日，及诸戊己。凡此九者，善候八正所在之处，所主左右
上下，身体有痈肿者，欲治之，无以其所直之日渍治之，是谓天忌日也”。故曰天忌不可不知
也。凡此皆星辰八正之候也。
此一节，言法日月星辰，四时八正之气，以为刺法也。
帝曰∶善其法星辰者，余闻之矣，愿闻法往古者。
上古之世，以针治病，故承上文法星辰之义，而愿闻法往古者。
岐伯曰∶法往古者，先知《针经》也。
黄帝法往古而着《针经》，《针经》，《灵枢经》也。灵枢首篇，黄帝有先立针经之语，故欲法往
古者，先知针经也。
验于来今者，先知日之寒温，月之虚盛，以候气之浮沉，而调之于身，观其立有验也。
法往古而知针经，必有验于来今。夫验于来今者，先知日之寒温，月之虚盛，如冬日寒而夏日温，
晦朔虚而弦望盛也。即以十月而候四气之浮沉，如春夏日月则气浮，秋冬日月则气沉也。以四气
浮沉而调之于身，可观其气之立有验于身也。
观其冥冥者，言形气荣卫之不形于外，而工独知之，以日之寒温，月之虚盛，四时气之浮沉，参
伍相合而调之，工常先见之，然而不形于外，故曰观于冥冥焉。
法往古而知针经，可以观其冥冥，夫观其冥冥者，言形气荣卫之不行于外，冥冥然也。而工独之，有可观
矣。工之所以独之者，亦以日之寒温，月之虚盛，并四时气之浮沉，与人参伍相合而调
之，日月四时之理明，则人身之理亦明，故工常先见之。然理微而不形于外，故曰观于冥冥焉尔。
通于无穷者，可以传于后世也，是故工之所以异也。然而不形
见于外，故俱不能见也。视之无形，尝之无味，故谓冥冥，若神仿佛。
形见之见，去声。法往古而知针经，可以通于无穷。夫通于无穷者，可以传于后世也。可传后世，是
故工之所以异也。然而不形见于外，故俱不能见也，而工独知之，惟不形见于外，故视之无
形，尝之无味。视无形、尝无味故谓冥冥而若神仿佛也。
虚邪者，八正之虚邪气也。正邪者，身形若用力，汗出腠理开，逢虚风，其中人也微，故莫知其
情，莫见其形。
中，去声，下同。邪之中人，有虚邪，有正邪。虚邪者，乃八正之虚乡邪气，而中于人身也。正邪者，
身形若用力，用力则汗出，汗出则腠理开，腠理开，而逢虚风，不同于八正之邪，故中人
也微，微则莫知其情，莫见其形也。
上工救其萌芽，必先见三部九候之气尽调不败而救之，故曰上工。
萌芽，病之微也。上工治病，救其萌芽，必先见三部九候之气尽调，乘其正气不败而救之，故曰上工。
下工救其已成，救其已败。救其已成者，言不知三部九候之相失，因病而败之也。
若邪病已成，正气已败而救之，斯为下工。救其已成者，言不
知三部九候之相失，而病已成也。救其已败者，因病而败之也。
知其所在者，知诊三部九候之病脉处而治之，故曰守其门户焉，莫知其情，而见邪形也。
处，去声。虚邪正邪，深浅不同，知其所在者，知诊三部九候之病脉处而调治之，使经脉无伤，正
气内存，故曰守其门户焉。能如是也，是虽莫知其情，而能见邪形也。上文云莫知其情，莫见其
形，今莫知其情者，而能知其情，莫见其形者，而能见邪形也。
帝曰∶余闻补泻，未得其意。
补正泻邪，各有其法，帝故问之。
岐伯曰∶泻必用方。方者以气方盛也，以月方满也，以日方温也，以身方定也，以息方吸，而内
针，乃复候其方吸，而转针，乃复候其方呼而徐引针，故曰泻必用方，其气而行焉。
内，音纳。刺欲泻之，则大指退后，食指进前，其孔似方，故泻必用方。就方义而申解之，则方者
以天人之气方盛也。天气盛以月方满也，以日方温也；人气盛，以身方定也，以息方吸也。息方
吸，气始入，故方吸而内针，复候其方吸而转针，复候其方呼，气出之始，而徐引针。引，犹出也，故泻
必用方，候其气盛而行焉尔。
补必用员。员者，行也。行者，移也。刺必中其荣，复以吸排针也。故员与方，非针也。
员，圆通。刺欲补之，则大指进前，食指退后，其孔似员，故补必用员。就员义而申解之，则员者，
员活其气，行于周身，故员者行也，行者移其有余，补其不足，故行者移也，深入为补，故刺
必中其荣。排，转也，复从吸排针，候吸入而转针也。吸入而转，所以补之，故员与方乃之员活，气
之方盛，非但针之方员也。
故养神者，必知形之肥瘦，荣卫血气之盛衰。血气者，人之神，不可不谨养。
泻之补之，贵得其神，故养神者，必知形之肥瘦，荣卫血气之盛衰，知形之肥瘦，则知用针之浅
深矣，知荣卫血气盛衰，则知方员之补泻矣。由此观之，则血气者，乃人之神，而不可不谨养也。
帝曰∶妙乎哉论也，合人形于阴阳四时虚实之应，冥冥之期，
其非夫子孰能通之，然夫子数言形与神，何谓形，何为神，愿卒闻之。
数，音朔，承知形养神之论，而赞其妙，因举形神而复问之。
岐伯曰∶请言形，形乎形，目冥冥，问其所病，索之于经，慧然在前，按之不得，不知其情，故曰形。
未言神，先言形。形乎形，是有形之可形也。目冥冥，是无形之可形也。有形可形，当问其所病，
而索之于经。无形可形，则慧然在前，而按之不得。此有形无形之间，而不知其情，故曰形。
情，犹实也，若泥迹求形，则非形矣。
帝曰∶何谓神？岐伯曰∶请言神，神乎神，耳不闻，目明心开
而志先，慧然独悟，口弗能言，俱视独见，适若昏，昭然独明，若风吹云，故曰神。
神乎神，是至神而莫若神也。耳不闻，是无声也。虽曰无声，觉目明心开，而志先慧觉然独悟矣。
口弗能言，是无臭也，虽曰无臭，觉与众俱视而我独见矣。适若昏，是无象也，虽曰无象，觉昭
然独明，若风吹云而见苍天矣。夫无声无臭无象，而独悟独见独明故曰神。
三部九候为之原，九针之论，不必存也。
诊三部九候之法，而以形神为之原，则《灵枢》九针之论，所言天忌者，可不必存于胸中也。
此一节，言用针之道，贵得其神，得其神而形可不存也。
八正，指的是天地八方所对应的正当方位。天上的八正，是指日、月、星、辰；地上的八正，是指东、南、西、北四方以及东南、西南、东北、西北四隅。将人体形体与天地四时相结合，依据阴阳的虚实变化，作为运用针刺的方法，其神妙之处在于独自领悟、独自看见、独自明了，所以称为“八正神明”。
黄帝问道：运用针刺的技术，必定有法则存在，现在应当遵循什么法则呢？
服，指从事的工作。上篇说：“凡针刺的根本，必先调治神气”，虽然要调治神气，但也必须有法则，作为施行针刺的依据，所以黄帝这样问。
岐伯回答说：效法天道，准则地理，并配合天光（日月星辰）的变化。
天光，指日、月、星、辰。运用针刺的道理，向上效法天时，向下准则地理，再结合天上的日月星辰变化，以此作为法则。
黄帝说：我希望详尽地听您讲解。
效法天道，准则地理，配合天光，希望听您讲完。
岐伯说：大凡针刺的方法，必须观察日月星辰的运行，以及四时和八方正气的气候变化，待气候安定之后再进行针刺。
所谓“合以天光”，是说大凡针刺的方法，必须观察日月星辰。所谓“法天”，是观察四时之气。所谓“则地”，是观察八方正气。定，指安静。人气安静时才施行针刺。这就是运用针刺的原则。
因此，天气温暖、日照明亮时，人的血液流动滑润，卫气浮越于体表，所以血液容易泻出，气机容易运行；天气寒冷、日照阴暗时，人的血液凝滞涩少，卫气沉伏于体内。
易，读去声。泣，通“涩”，意为涩滞。人身血气，上应合于天象。所以天气温和，日色光明，则人血滑润，卫气浮越。淖液，指滋润流布。浮，指向外运行。血既滑润，所以容易泻出；卫气既浮越，所以气机容易运行。如果天气不温和而寒冷，日色不光耀而阴暗，则人血凝滞涩少，卫气沉伏。凝涩，即不滑润。沉，即不浮越。
月亮初生时，人的血气开始精微，卫气开始运行；月亮圆满时，人的血气充实，肌肉坚实；月亮亏空时，人的肌肉消瘦，经络空虚，卫气离去，只有形体独存。因此要根据天时的变化来调摄血气。
人身血气，不仅应合于太阳，也应合于月亮。月亮初生，即农历初一，此时卫气大会于风府穴，血气开始精微，卫气开始运行；月亮圆满，即农历十五，此时血气充盛，所以血气实，肌肉坚；月亮亏空，即农历月末，此时血气虚微，所以肌肉消瘦，经络空虚，卫气离去，形体独存。《伤寒论》中说：“血弱气尽，腠理开”就是这种情况。因此人应当根据天时的变化来调摄血气。
所以，天气寒冷时不要针刺，天气温暖时气血不会凝滞，月亮初生时不要用泻法，月亮圆满时不要用补法，月亮亏空时不要治疗，这叫做顺应天时来调摄血气。
顺应天时调摄血气，所以天气寒冷时不宜针刺，因为寒则气血坚凝，故不宜刺；天气温暖时气血流通，故无凝滞；月亮初生时不可用泻法，以免损伤新生的生气；月亮圆满时不可用补法，以免助长有余之邪；月亮亏空时不可治疗，因为此时正气虚弱，无法驱除邪气。以上这些，都叫做顺应天时来调摄。
顺应天道的次序，把握盛衰的时机，观察日影移动以确定位置，端正身体站立等待适宜的时刻。
顺应天时调摄，是顺应天道盛衰的次序，所以说“因天之序，盛虚之时”。移光，指从晦暗到光明的变化。定位，指日中天的位置固定。正立而待，指整肃身体，等待天人气血旺盛，然后行针针刺，这些都是顺应时机的表现。
所以说：月亮初生时用泻法，会导致脏腑虚弱；月亮圆满时用补法，会使血气洋溢溢出，络脉中有留血，这叫作重实；月亮亏空时进行治疗，会扰乱经脉，导致阴阳错乱，真邪不分，邪气沉留体内，外表虚弱内部混乱，淫邪之气于是产生。
重，读平声。别，音逼。月亮初生时不用泻法，所以说月亮初生时用泻法，这叫脏腑虚弱；月亮圆满时不用补法，如果说月亮圆满时用补法，那么血气就会洋溢于外，络脉中会有留血，这叫重实；月亮亏空时不用治疗，如果说月亮亏空时进行治疗，这叫扰乱经脉。扰乱经脉则阴阳错乱，阴阳错乱则真邪不分，真邪不分则邪气内沉，沉留体内，真气不充则外表虚弱；邪气相搏则内部混乱。外表虚弱内部混乱，淫邪之气于是产生。以上这些都未能顺应天时调摄。
星辰的度数，八正的定位，该如何观察它们？
岐伯说：星辰，是用来制约日月运行的。八正，是用来观察八方虚邪风气按时到来的。四时，是用来区分春夏秋冬之气所在位置的，以便按时调摄。对于八方正气中的虚邪，要避开它而不触犯。
日月的运行，由星辰护卫，所以星辰是用来制约日月运行的。制约了日月的运行，就可以观察星辰了。八风的邪气，由八正定位，所以八正是用来观察八方虚邪风气按时到来的。了解了八风的邪气，就可以观察八正了。天有四时，四时是用来区分春夏秋冬之气所在的，人观察这些气候，按时调摄自己。春秋气候温和，冬夏气候寒暑，按时调摄，就能避开八方正气中的虚邪而不触犯。
以人体的虚弱，遇到天时的虚弱，两虚相互感应，邪气深入至骨，进入体内则伤害五脏。如果医生能候察并及时救治，邪气就不能伤害五脏。
人感受邪气，是因为人体虚弱。天时有邪气，是因为天时虚弱。以人体的虚弱，遇到天时的虚弱，两虚相互感应，邪气内至于骨，内至于骨则进入伤害五脏。在两虚相互感应的时刻，如果医生能候察并及时救治，邪气就不能进入伤害五脏。
所以说：天忌（禁忌的日子）是不可不知道的。
《灵枢·九针论》说：“大禁之日是太一所在的日子，以及所有的戊己日。凡是这九天，善于观察八正所在的位置，其所主的左右上下，如果身体有痈肿想要治疗，不要在与其部位相对的日子进行浸渍治疗，这叫做天忌日。”所以说天忌是不可不知道的。以上这些都涉及星辰八正的观察。
黄帝说：很好，效法星辰的道理，我已经听说了，希望听听效法古代的事情。
上古时代，用针刺治病，所以承接上文效法星辰的意义，希望听听效法古代的事情。
岐伯说：效法古代的人，必须先了解《针经》。
黄帝效法古代而著成《针经》，《针经》就是《灵枢经》。《灵枢》首篇，黄帝有先确立《针经》的话语，所以想效法古代的人，必须先了解《针经》。
验证于当今的人，必须先了解日子的寒温，月亮的盈亏，以候察气机的浮沉，并在身上进行调摄，观察其立即见效的情况。
效法古代而了解《针经》，必然要在当今得到验证。所谓验证于当今，是先了解日子的寒温，月亮的盈亏，比如冬天寒冷夏天温暖，月末月初虚弱弦望满月强盛。就以十月为例来候察四气的浮沉，比如春夏日月则气浮，秋冬日月则气沉。根据四气浮沉来调摄身体，可以观察其气机立即在身体上见效。
观察那些隐微难见的事物，是说形气营卫的表现不显露于外，但医生独自知道，通过日子的寒温，月亮的盈亏，四时气机的浮沉，综合参伍相合来进行调摄，医生常常能预先察觉，然而这些并不显露于外，所以叫作“观于冥冥”。
效法古代而了解《针经”，就可以观察隐微难见的事物。所谓观察隐微难见，是说形气营卫不在外显现，处于隐微状态。但医生独自知道，这是可以观察到的。医生之所以能独自知道，也是因为将日子的寒温，月亮的盈亏，以及四时气机的浮沉，与人体的情况综合参伍相合来进行调摄。日月四时的道理明白了，那么人体的道理也就明白了，所以医生常常能预先察觉。然而道理微妙且不显露于外，所以叫作“观于冥冥”。
通达无穷境界的人，可以将医术传给后世，所以医生的高明之处就在于此。然而这些道理不显露于外，所以普通人看不见。看它没有形状，尝它没有味道，所以称之为冥冥，好像神灵隐约可见。
形见的见，读去声。效法古代而了解《针经》，可以通达无穷。所谓通达无穷，是可以传给后世的。可以传给后世，所以是医生高明的地方。然而这些道理不显露于外，所以普通人看不见，只有医生独自知道。正因为不显露于外，所以看它没有形状，尝它没有味道。看无形、尝无味，所以称之为冥冥，好像神灵隐约可见。
虚邪，是指八方虚乡来的邪气。正邪，是指人体身形劳累或用力出汗，腠理开放时，遇到虚风，这种邪气侵入人体很轻微，所以人们不知道它的实情，也看不见它的形态。
中，读去声，下同。邪气侵入人体，有虚邪，有正邪。虚邪，是从八方虚乡来的邪气，侵入人体。正邪，是人体身形劳累，用力则出汗，出汗则腠理开放，腠理开放时遇到虚风，不同于八方的邪气，所以侵入人体很轻微，轻微到人们不知道它的实情，也看不见它的形态。
上工（高明的医生）在病邪萌芽阶段就进行救治，必须先观察到三部九候的气机全部调和而没有败坏，然后进行救治，所以叫作上工。
萌芽，指病邪微弱。上工治病，在病邪萌芽阶段就救治，必须先观察到三部九候的气机全部调和，乘正气尚未败坏时进行救治，所以叫作上工。
下工（低劣的医生）在病邪已经形成、正气已经败坏后才进行救治。救治已经形成的病邪，是说不知道三部九候气机的失调，反而因病邪而导致正气败坏。
如果邪病已经形成，正气已经败坏才去救治，这就是下工。救治已经形成的病邪，是说不知道三部九候气机的失调，导致病邪已经形成。救治已经败坏的正气，是说因病邪而导致正气败坏。
知道病邪所在的地方，是指知道诊察三部九候的病脉位置并进行治疗，所以叫作守住门户。虽然不知道邪气的实情，却能看见邪气的形态。
处，读去声。虚邪和正邪，深浅不同。知道病邪所在，是指知道诊察三部九候的病脉位置并加以调治，使经脉不受伤，正气内存留，所以叫作守住门户。能做到这样，虽然不知道邪气的实情，却能看见邪气的形态。上文说“不知道它的实情，看不见它的形态”，这里说“不知道它的实情”却能知道它的实情，“看不见它的形态”却能看见邪气的形态。
岐伯说：泻法必须用“方”。方，是指气机正旺盛，月亮正圆满，日子正温暖，身体正安定，呼吸正吸气的时候进针，然后再等候吸气时转针，再等候呼气时慢慢拔针，所以叫作“泻必用方”，借此使气机运行。
内，音纳。刺欲泻之，则大拇指退后，食指进前，针孔似方形，所以泻必用方。就方的意义来解释，方是指天地人之气正旺盛。天气盛表现为月亮正圆满，日子正温暖；人气盛表现为身体正安定，呼吸正吸气。吸气时气始入，所以在吸气时进针，再等候吸气时转针，再等候呼气，气出之初，慢慢拔针。引，犹指出，所以泻必用方，是候察气盛时使其运行。
补法必须用“员”。员，通“圆”，指行气。行者，指移气。针刺必须中取荣穴，再在呼气时排针。所以员和方，不仅仅指针的形状。
员，圆通。刺欲补之，则大拇指进前，食指退后，针孔似圆形，所以补必用员。就员的意义来解释，员是指圆活其气，行于周身，所以员者行也，行者移其有余，补其不足，所以行者移也，深入为补，所以刺必中其荣穴。排，转也，再从呼气时转针，候吸入而转针。吸入而转，是为了补益，所以员和方乃是指圆活气机，气机方盛，不仅仅是指针的方圆。
所以调养神气的人，必须知道形体的肥瘦，营卫血气的盛衰。血气，是人的神气，不可以不谨慎调养。
泻法和补法，贵在得其神，所以调养神气的人，必须知道形体的肥瘦，营卫血气的盛衰。知道形体的肥瘦，就知道针刺的深浅；知道营卫血气的盛衰，就知道方圆补泻的方法。由此看来，血气就是人的神气，不可以不谨慎调养。
黄帝说：论述得多么美妙啊！将人体形体与阴阳四时虚实的变化相合，在隐微难见的时期，除了先生您谁能通达呢？然而先生多次提到形与神，什么是形，什么是神，希望详尽地听您讲解。
数，音朔，承继知道形体、调养神气的论述，赞叹其妙处，因而提起形神再次发问。
岐伯说：请允许我说说形。形，是有形的，看似隐微难见。询问病人的疾病，在经脉中寻求答案，虽然清晰地在眼前，但按之却得不到，不知道其实情，所以叫作形。
未说神，先说形。形乎形，是指有形迹可供描绘。目冥冥，是指无形迹可供描绘。有形迹可描绘，应当询问病人的疾病，而在经脉中寻求。无形迹可描绘，则清晰地在眼前，但按之却得不到。在这有形无形之间，不知道其实情，所以叫作形。
黄帝问：什么是神？岐伯说：请允许我说说神。神啊神，耳朵听不见，眼睛明亮心灵开通而意志先行，独自领悟，口不能言，大家都能看到而我独自看见，起初好像昏暗，突然独自明朗，像风吹云散一样，所以叫作神。
神乎神，是最神妙没有比得上神的。耳不闻，是没有声音。虽然没有声音，但觉得眼睛明亮心灵开通，意志先行，独自领悟。口弗能言，是没有气味，虽然没有气味，但觉得与众人一起看而我独自看见。适若昏，是没有形象，虽然没有形象，但觉得独自明朗，像风吹云散见到苍天一样。夫无声无臭无象，而独自领悟、独自看见、独自明朗，所以叫作神。
诊察三部九候是根本，《灵枢》九针的论述，不必死记硬背了。
Ba Zheng (Eight Correct Directions) refers to the proper positions corresponding to the eight directions of Heaven and Earth. The Ba Zheng of Heaven are the Sun, Moon, Stars, and Constellations. The Ba Zheng of Earth are the four cardinal directions (East, South, West, North) and the four intercardinal directions (Southeast, Southwest, Northeast, Northwest). By integrating human physiology with the Four Seasons and the movements of Heaven and Earth, and utilizing the principles of Yin-Yang deficiency and excess as methods for acupuncture, its subtlety lies in independent comprehension, independent perception, and independent clarity; thus it is called "Ba Zheng Shen Ming" (Eight Correct Directions and Divine Illumination).
Huang Di asked: In the practice of acupuncture, there must be laws and principles. What laws and principles should be followed now?
Fu (Service/Practice) refers to the work undertaken. As stated in the previous chapter: "The true essence of all needling lies first in regulating Shen (Spirit/Mind)." Although regulating Shen is essential, there must also be laws and principles to guide the practice of acupuncture, which is why Huang Di posed this question.
Qi Bo replied: One should model oneself after Heaven and follow the patterns of Earth, harmonizing with the Tian Guang (Heavenly Light, i.e., Sun, Moon, Stars, and Constellations).
Tian Guang refers to the Sun, Moon, Stars, and Constellations. The way of acupuncture involves modeling after Heavenly timing above, following geographical patterns below, and further combining these with the changes of the Sun, Moon, and Stars to establish one's principles.
Huang Di said: I wish to hear this in full.
Modeling after Heaven, following Earth, and harmonizing with Heavenly Light—I wish to hear everything you have to say.
Qi Bo said: Generally, the method of needling requires observing the movements of the Sun, Moon, Stars, and Constellations, as well as the Qi of the Four Seasons and the Eight Correct Directions. One should only perform needling when the atmospheric conditions are stable.
"Harmonizing with Tian Guang" means that generally, the method of needling requires observing the Sun, Moon, Stars, and Constellations. "Modeling after Heaven" means observing the Qi of the Four Seasons. "Following Earth" means observing the Qi of the Eight Correct Directions. Ding (Stable) refers to tranquility. One should perform needling only when the patient's Qi is tranquil. This constitutes the principle of using acupuncture.
Therefore, when the weather is warm and the sun is bright, human blood flows smoothly, and Wei Qi (Defensive Qi) floats on the surface; thus, blood is easily discharged, and Qi moves readily. When the weather is cold and the sun is obscured, human blood becomes stagnant and sluggish, and Wei Qi sinks inward.
Yi (Easy) is pronounced with the departing tone. Qi (Weeping/Stagnant) is synonymous with Se (Sluggish/Stagnant). Human Blood and Qi correspond upwards to the celestial phenomena. Thus, when the weather is mild and the sunlight is bright, human blood is smooth and Wei Qi floats outward. Nao Ye (Moist Fluids) refers to nourishing and circulating flow. Fu (Floating) refers to moving outward. Because the blood is smooth, it is easily discharged; because Wei Qi is floating, Qi moves readily. If the weather is not mild but cold, and the sunlight is not bright but dim, then human blood becomes stagnant and sluggish, and Wei Qi sinks inward. Stagnant and sluggish means not smooth. Sinking means not floating.
When the moon begins to wax, human Blood and Qi begin to become refined, and Wei Qi begins to circulate; when the moon is full, human Blood and Qi are substantial, and muscles are firm; when the moon wanes to emptiness, muscles diminish, meridians become empty, Wei Qi departs, and only the physical form remains. Therefore, one must regulate Blood and Qi according to the heavenly seasons.
Human Blood and Qi respond not only to the Sun but also to the Moon. When the moon begins to wax (the first day of the lunar month), Wei Qi gathers at Fengfu (GV16), causing Blood and Qi to become refined and Wei Qi to begin circulating. When the moon is full (the fifteenth day of the lunar month), Blood and Qi are abundant, so they are substantial and muscles are firm. When the moon is empty (the last day of the lunar month), Blood and Qi are weak and minute, so muscles diminish, meridians become empty, Wei Qi departs, and the form stands alone. As stated in Shang Han Lun (Treatise on Cold Damage): "Blood is weak, Qi is exhausted, and the pores open." This is the situation described. Therefore, humans should regulate their Blood and Qi according to the changes of heaven and time.
Thus, one should not needle when the weather is cold; when the weather is warm, Qi and Blood will not coagulate; when the moon is waxing, one should not use the reducing method; when the moon is full, one should not use the reinforcing method; when the moon is empty, one should not treat. This is called regulating according to the appropriate time.
Regulating Blood and Qi according to heavenly timing means that one should not needle when it is cold, because cold causes hardness and coagulation, hence no needling; when it is warm, Qi and Blood flow freely, hence no coagulation; when the moon is waxing, one should not reduce, to avoid destroying the newly generated Sheng Qi (Vital Generating Qi); when the moon is full, one should not reinforce, to avoid augmenting what is already excessive; when the moon is empty, one should not treat, because Zheng Qi (Upright Qi) is deficient and unable to expel pathogenic factors. All of these are called regulating according to the appropriate time.
Following the order of Heaven and grasping the times of abundance and deficiency, one observes the movement of shadows to determine position, stands upright, and waits.
Regulating according to time follows the order of Heaven's abundance and deficiency, hence it is said "following the order of Heaven, the times of abundance and deficiency." Yi Guang (Moving Light) refers to the transition from darkness to brightness. Ding Wei (Fixed Position) refers to the sun reaching its zenith and stabilizing. Zheng Li Er Dai (Standing Upright and Waiting) means straightening the body and waiting for the time when both heavenly and human Qi are abundant before performing needling. All of these constitute regulating according to time.
It is said: Using the reducing method when the moon is waxing leads to Zang Organ deficiency; using the reinforcing method when the moon is full causes Blood and Qi to overflow, leaving residual blood in the collaterals, a condition called Chong Shi (Double Excess); treating when the moon is empty disrupts the meridians, causing Yin and Yang to become confused, distinguishing neither True nor Pathogenic factors, allowing pathogens to sink and remain, resulting in external deficiency and internal chaos, thereby giving rise to excessive pathogenic factors.
Chong (Heavy/Double) is pronounced with the level tone. Bie (Distinguish) is pronounced bi. Since one should not reduce when the moon is waxing, using reduction at this time is called Zang deficiency. Since one should not reinforce when the moon is full, using reinforcement at this time causes Blood and Qi to overflow externally and leaves residual blood in the collaterals, called Chong Shi (Double Excess). Since one should not treat when the moon is empty, treating at this time disrupts the meridians. Disrupting meridians confuses Yin and Yang; confusing Yin and Yang fails to distinguish True from Pathogenic; failing to distinguish True from Pathogenic allows Pathogenic Qi to sink internally and remain; if True Qi does not fill, there is external deficiency; if Pathogenic factors clash, there is internal chaos. External deficiency and internal chaos cause excessive pathogenic factors to arise. All of these represent a failure to regulate according to time.
Huang Di asked: How should one observe the Stars and the Eight Correct Directions?
How should one observe the degrees of the stars and the fixed positions of the Eight Correct Directions?
Qi Bo said: The Stars serve to regulate the movement of the Sun and Moon. The Eight Correct Directions serve to observe the Xu Xie (Deficient Pathogens) of the Eight Winds arriving at their proper times. The Four Seasons serve to distinguish the locations of the Qi of Spring, Summer, Autumn, and Winter, allowing for regulation according to time. One should avoid the Xu Xie of the Eight Correct Directions and not offend them.
The movement of the Sun and Moon is guarded by the Stars; thus, the Stars regulate the movement of the Sun and Moon. By regulating the movement of the Sun and Moon, the Stars can be observed. The pathogens of the Eight Winds have positions defined by the Eight Correct Directions; thus, the Eight Correct Directions serve to observe the Xu Xie of the Eight Winds arriving at their proper times. Knowing the pathogens of the Eight Winds allows one to observe the Eight Correct Directions. Heaven has Four Seasons; the Four Seasons distinguish the locations of the Qi of Spring, Summer, Autumn, and Winter. Humans observe this Qi and regulate themselves according to time. The Qi of Spring and Autumn is mild; the Qi of Winter and Summer is cold and hot. Regulating according to time allows one to avoid the Xu Xie of the Eight Correct Directions without offending them.
Using the deficiency of the human body to encounter the deficiency of Heaven, the two deficiencies interact; the Qi reaches the bone, enters the interior, and damages the Five Zang Organs. If a skilled physician observes and rescues at this moment, the damage cannot occur.
Humans contract pathogens due to bodily deficiency. Heaven has pathogens due to heavenly deficiency. Encountering heavenly deficiency with bodily deficiency, the two deficiencies interact; the Qi enters internally to the bone, and entering the bone damages the Five Zang Organs. However, if a skilled physician observes and rescues during the interaction of the two deficiencies, the pathogens cannot enter and damage the Five Zang Organs.
Therefore, it is said: One must not ignore the Tian Ji (Heavenly Taboos).
Ling Shu · Jiu Zhen Lun (Spiritual Pivot · Discussion on Nine Needles) states: "The great taboos are the days when Tai Yi resides, and all Wu and Ji days. Of these nine days, one should skillfully observe the location of the Eight Correct Directions and their dominance over the left, right, upper, and lower parts of the body. If treating a carbuncle or swelling on the body, do not apply treatment on the day corresponding to that location. This is called a Heavenly Taboo Day." Therefore, it is said that Heavenly Taboos must not be ignored. All of the above pertains to the observation of Stars and the Eight Correct Directions.
This section discusses modeling after the Sun, Moon, Stars, Constellations, Four Seasons, and Eight Correct Directions to establish needling methods.
Huang Di said: Excellent. I have heard of modeling after the Stars; I now wish to hear about modeling after the ancients.
In ancient times, diseases were treated with needles. Thus, continuing the meaning of modeling after the Stars from the previous text, he wishes to hear about modeling after the ancients.
Qi Bo said: Those who model after the ancients must first know the Zhen Jing (Classic of Acupuncture).
Huang Di modeled after the ancients and composed the Zhen Jing. The Zhen Jing is the Ling Shu Jing (Spiritual Pivot Classic). In the first chapter of Ling Shu, Huang Di mentions having previously established the Zhen Jing. Therefore, those wishing to model after the ancients must first know the Zhen Jing.
Those who verify in the present and future must first know the cold and warmth of the days, the waxing and waning of the moon, to observe the floating and sinking of Qi, and regulate the body accordingly, observing immediate efficacy.
Modeling after the ancients and knowing the Zhen Jing must yield verification in the present. Verifying in the present means first knowing the cold and warmth of days and the waxing and waning of the moon—for example, winter is cold and summer is warm; the new and full moons are strong, while the dark and crescent moons are weak. Taking October as an example to observe the floating and sinking of the Four Qi: in spring and summer, the Sun and Moon indicate floating Qi; in autumn and winter, they indicate sinking Qi. Regulating the body based on the floating and sinking of the Four Qi allows one to observe immediate efficacy in the body.
Observing the obscure and invisible refers to the fact that the manifestations of Xing Qi (Form Qi), Ying Qi (Nutritive Qi), and Wei Qi (Defensive Qi) do not appear externally, yet the physician knows them alone. By combining the cold and warmth of days, the waxing and waning of the moon, and the floating and sinking of seasonal Qi through comprehensive analysis, the physician often perceives them beforehand. However, these do not manifest externally, hence it is called "Guan Yu Ming Ming" (Observing in the Obscure).
Modeling after the ancients and knowing the Zhen Jing allows one to observe the obscure. Observing the obscure means that the movements of Form Qi, Ying Qi, and Wei Qi do not manifest externally, remaining hidden. Yet the physician knows them alone, which is observable. The reason the physician knows them alone is by combining the cold and warmth of days, the waxing and waning of the moon, and the floating and sinking of seasonal Qi with the human condition for regulation. When the principles of the Sun, Moon, and Four Seasons are understood, the principles of the human body are also understood; thus, the physician often perceives them beforehand. However, the principles are subtle and do not manifest externally, hence it is called "Guan Yu Ming Ming."
One who understands the infinite can transmit [this knowledge] to future generations; thus, this is why physicians differ [from others]. However, since these principles do not manifest externally, ordinary people cannot see them. They have no visible form and no tangible taste, hence they are called Ming Ming (Obscure), appearing like faint spirits.
Jian (See) is pronounced with the departing tone. Modeling after the ancients and knowing the Zhen Jing allows one to understand the infinite. Understanding the infinite means being able to transmit to future generations. Being transmissible to future generations is why physicians are distinguished. However, since these principles do not manifest externally, ordinary people cannot see them; only the physician knows them alone. Precisely because they do not manifest externally, they have no visible form and no tangible taste. Having no visible form and no tangible taste is why they are called Ming Ming, appearing like faint spirits.
Xu Xie (Deficient Pathogens) refers to the pathogenic Qi from the deficient directions of the Eight Correct Directions. Zheng Xie (Correct/Regular Pathogens) refers to situations where the body is fatigued or exerted, sweating opens the Cou Li (pores/skin texture), and one encounters Xu Feng (Deficient Wind). Such pathogens invade the body slightly, so people do not perceive their nature nor see their form.
Zhong (Strike/Infect) is pronounced with the departing tone, same below. Pathogens invading the body include Xu Xie and Zheng Xie. Xu Xie is the pathogenic Qi from the deficient directions of the Eight Correct Directions invading the human body. Zheng Xie occurs when the body is fatigued; exertion causes sweating; sweating opens the Cou Li; opening the Cou Li exposes one to Xu Feng. Unlike the pathogens of the Eight Correct Directions, Zheng Xie invades slightly, so slightly that people do not perceive its nature nor see its form.
Shang Gong (Superior Physicians) rescue at the sprout stage. They must first observe that the Qi of the San Bu Jiu Hou (Three Regions and Nine Palpation Sites) is fully harmonious and not yet defeated before rescuing; thus they are called Shang Gong.
Meng Ya (Sprout) refers to the slightness of disease. Superior physicians treat disease by rescuing at the sprout stage. They must first observe that the Qi of the San Bu Jiu Hou is fully harmonious and intervene while Zheng Qi is not yet defeated; thus they are called Shang Gong.
Xia Gong (Inferior Physicians) rescue after the disease has formed and after it has been defeated. Rescuing after the disease has formed means not recognizing the loss of harmony in the San Bu Jiu Hou, thereby allowing the disease to defeat the body.
If one rescues only after the pathogenic disease has formed and Zheng Qi has been defeated, this is Xia Gong. Rescuing after the disease has formed means not recognizing the disharmony of the San Bu Jiu Hou, leading to the formation of disease. Rescuing after Zheng Qi has been defeated means being defeated by the disease.
Knowing the location means knowing the pulse sites of disease in the San Bu Jiu Hou for diagnosis and treatment; thus it is called guarding the gateways. Although one may not know the nature of the pathogen, one can see its form.
Chu (Location) is pronounced with the departing tone. Xu Xie and Zheng Xie differ in depth. Knowing the location means diagnosing the pulse sites of disease in the San Bu Jiu Hou and regulating them, ensuring the meridians are not damaged and Zheng Qi remains internal; thus it is called guarding the gateways. If one can do this, although one may not know the nature of the pathogen, one can see its form. The text previously stated "not knowing its nature, not seeing its form"; here it says "not knowing its nature" yet knowing its nature, and "not seeing its form" yet seeing the pathogenic form.
Huang Di said: I have heard of reinforcing and reducing methods, but I have not grasped their intent.
Reinforcing Zheng Qi and reducing Pathogenic Qi each have their methods; thus Huang Di asks.
Qi Bo said: Reducing must use Fang (Square/Upright). Fang refers to the time when Qi is just becoming abundant, the moon is just becoming full, the day is just becoming warm, the body is just settled, and the breath is just inhaling. Insert the needle, wait for the inhalation to rotate the needle, then wait for the exhalation to slowly withdraw the needle. Thus it is called "Reducing must use Fang," allowing the Qi to move.
Na (Insert) is pronounced na. To needle for reducing, the thumb retreats backward and the index finger advances forward, making the needle hole square-like; thus reducing must use Fang. Interpreting the meaning of Fang, it refers to the time when Heavenly, Earthly, and Human Qi are just becoming abundant. Heavenly abundance is marked by the moon just being full and the day just being warm. Human abundance is marked by the body just being settled and the breath just inhaling. At inhalation, Qi begins to enter; thus, insert the needle during inhalation, wait for inhalation to rotate the needle, and wait for exhalation (the beginning of Qi exiting) to slowly withdraw the needle. Yin (Withdraw) implies exiting. Thus, reducing must use Fang, waiting for abundant Qi to facilitate its movement.
Reinforcing must use Yuan (Round/Circular). Yuan means moving. Moving means shifting. Needling must strike the Ying (Nutritive) point, and then withdraw the needle during exhalation. Thus, Yuan and Fang do not refer merely to the shape of the needle.
Yuan means circular flexibility. To needle for reinforcing, the thumb advances forward and the index finger retreats backward, making the needle hole round-like; thus reinforcing must use Yuan. Interpreting the meaning of Yuan, it means making Qi flexible and circulating it throughout the body; thus Yuan means moving. Moving means shifting excess and reinforcing deficiency. Deep insertion serves reinforcement; thus, needling must strike the Ying point. Pai (Exhale/Push out) means rotating. Rotating the needle upon exhalation facilitates reinforcement. Thus, Yuan and Fang refer to the flexibility of Qi and its abundance, not merely the square or round shape of the needle.
Therefore, those who nourish Shen must know the leanness and plumpness of the form, and the abundance and deficiency of Ying Qi, Wei Qi, Blood, and Qi. Blood and Qi are the Shen of humans; they must be carefully nourished.
Reducing and reinforcing aim to obtain Shen; thus, those who nourish Shen must know the leanness and plumpness of the form, and the abundance and deficiency of Ying Qi, Wei Qi, Blood, and Qi. Knowing the leanness and plumpness determines the depth of needling; knowing the abundance and deficiency of Ying, Wei, Blood, and Qi determines the application of Yuan and Fang for reinforcing and reducing. From this, we see that Blood and Qi are the Shen of humans and must be carefully nourished.
Huang Di said: Wonderful is this discourse! Integrating human form with the responses of Yin-Yang, Four Seasons, and Deficiency-Excess, in the period of the obscure—except for you, Master, who could comprehend this? Yet you frequently mention Form and Shen. What is Form? What is Shen? I wish to hear this in full.
Shuo (Frequently) is pronounced shuo. Continuing the discussion on knowing Form and nourishing Shen, praising its subtlety, he raises Form and Shen again to ask.
Qi Bo said: Let me speak of Form. Form is visible, yet seemingly obscure. Ask about the patient's illness, search within the meridians, and although it appears clearly before you, palpation yields nothing; not knowing its reality, it is called Form.
Before speaking of Shen, speak of Form. Xing Hu Xing means there is a visible form to depict. Mu Ming Ming means there is no visible form to depict. For the visible form, ask about the illness and search the meridians. For the invisible form, it appears clearly before you, yet palpation yields nothing. Between the visible and invisible, not knowing its reality, it is called Form.
Qing (Reality/Nature) is akin to substance. If one clings to traces to seek form, it is no longer true Form.
Huang Di asked: What is Shen? Qi Bo said: Let me speak of Shen. Shen! Shen! The ears do not hear; the eyes are bright, the heart opens, and the will precedes. There is solitary enlightenment, ineffable in speech. All look, yet I see alone; initially seeming dim, suddenly clear alone, like wind blowing away clouds. Thus it is called Shen.
Shen! Shen! denotes the utmost divinity, surpassing all else. "Ears do not hear" means there is no sound. Although there is no sound, one perceives the eyes brightening, the heart opening, the will preceding, and solitary enlightenment. "Ineffable in speech" means there is no odor. Although there is no odor, one perceives seeing alone among the multitude. "Initially seeming dim" means there is no image. Although there is no image, one perceives solitary clarity, like wind clearing clouds to reveal the blue sky. Having no sound, no odor, and no image, yet achieving solitary enlightenment, solitary vision, and solitary clarity, it is called Shen.
San Bu Jiu Hou (Three Regions and Nine Palpation Sites) serves as the origin. The theories of the Nine Needles need not be retained [as rigid rules].
The method of diagnosing San Bu Jiu Hou, with Form and Shen as the origin, means that the discussions on Tian Ji (Heavenly Taboos) in the Ling Shu's Nine Needles need not be rigidly kept in mind.
This section discusses the way of acupuncture, emphasizing the importance of obtaining Shen. Obtaining Shen allows one to transcend rigid adherence to Form.