充其形，既充其形，则形身之三部九候，上下若一，命曰平人。平
人，血气调和之人也，是知阴阳来去，由于俞会，不由俞会，而血气相并，则有阴阳之虚实也。
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。
上文血气交并，阴阳虚实，乃经脉不得其平，非六淫外感，七情内伤，故承上文而复论外感
内伤，阴阳寒热之病。夫邪气之生病也。或有生于阴者，或有生于阳者，其生于阳者，得之风雨寒暑之
外感，其生于阴者，得之饮食居处阴阳喜怒之内伤，言风雨寒暑而六气可该，言喜怒而七情可该，随举
即是，不必悉具，故或言风雨寒暑，或言风雨寒湿，或言喜怒，或言喜悲，有如下文之问答也。
帝曰∶风雨之伤人奈何？
帝承岐伯之言，更欲阐明其义，故屡问而详悉之。
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。
凡风雨之伤人也，由浅入深，故先客于皮肤，从皮肤而传入于孙脉，孙脉满则传入于络脉，络脉
满则输于大经脉，由外入内，则血气与邪并客于分腠之间，故其脉坚大。脉者，孙脉络脉经脉也。
其脉坚大，故曰实。实，即满也。因言所谓实者，其外坚大充满，故不可按之，按之则痛者是也。
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。
其寒湿之中人也，在于皮肤肌肉之间，故皮肤不收，肌肉坚紧。不收，汗出而不闭密也。坚紧，涩滞
而不柔和也。故肌肉坚紧，则荣血涩。涩，凝涩也。皮肤不收，则卫气去。去，失守也。
血涩气去，故曰虚。虚者，血气皆虚，故聂辟，谓肌肉皮肤，聂聂然而辟动也。气不足者，气不足以内温
其血也。上文充满而实，不
可按之，按之则痛，此血气不足，故按之则气足以温之，言气足以内温其血，故快然而不痛。上文云生
于阳者，得之风雨寒暑，故举风雨寒湿以明外感之病生于阳，而有实有虚也。
帝曰∶善。阴之生实奈何？
生于阳者，得之风雨寒暑，生于阴者，得之饮食居处，阴阳喜
怒，生于阳者，上文已详论之，此举阴之生实生虚，以明喜怒饮食之义。
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。
喜怒人之情也。喜怒不节，则内伤其阴，而阴气上逆，阴气上
逆则下虚，下虚则阳气走之而并于阴，故曰实矣，此言阴之生实也。
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。
喜而怒则气上，喜而悲则气下，故喜则气下，悲则气消，消则经脉虚空，复因于寒冷之饮食，寒
气熏满，则营血涩，卫气去，故曰虚矣，此言阴之生虚也。上文云∶生于阴者，得之饮食居处，阴
阳喜怒，故举喜怒悲寒饮食，以明内伤之病，生于阴，而有实有虚也。
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。
岐伯云∶邪之生也，或生于阴，或生于阳，夫阳主外，阴主
内，阳虚阴虚，有外内之寒热，阳盛阴盛，有外内之寒热，故引经言而探其所由然也。
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。
所谓阳虚则外寒者，以阳受气于上焦，上焦开发，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，故寒栗而外寒也。
帝曰∶阴虚生内热奈何？岐伯曰∶有所劳倦，形气衰少，谷气
不盈，上焦不行，下脘不通，胃气热，热气熏胸中，故内热。
中，去声，下同。所谓阴虚生内热者，有所劳倦，致形气衰少，胃中谷气不盈，谷入少，则上焦不能
宣五谷味，故上焦不行，下脘不能化谷之精，故下脘不通，中土虚而胃气热。热气熏于胸
中，故阴虚则内热也。
帝曰∶阳盛外热奈何？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。
所谓阳盛生外热者，阳主上，主外，上焦不通利，则在外之皮肤致密，内则因之腠理闭塞，玄府不通。
腠理者，肌腠之文理。玄府者，毛窍之汗孔，玄府皮肤腠理，不相通贯，则卫气壅滞，不得
泄越，故阳盛则外热也。
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。
中，如字。所谓阴盛生内寒者，阴主下、主内、厥气上逆、寒厥之气、从下而逆于上也，阴在内，故寒
气积于胸中而不泻，寒气不泻，则温气去，寒独留，留则血凝涩，凝则脉不通，脉不通者，
其脉盛大以涩，故阴盛则内寒，中，犹内也。
帝曰∶阴与阳并，血气以并，病形以成，刺之奈何？
复承上文阴阳血气病形，问补泻虚实之刺，以为调经之法也。
岐伯曰∶刺此者，取之经隧，取血于荣，取气于卫，用形哉，因四时多少高下。
上文云∶五脏之道，皆出于经隧，以行血气，故刺此者，当取之经隧，取血于荣，取气于卫者，以
行其血气也，夫荣卫血气，周于人身，合于四时，今取之经隧，虽曰用形哉，必因天之四时，以
为针之多少高下耳。《缪刺论》云∶以月生死为数。即多少之谓也。《金匮真言论》云∶春俞在颈项，夏
俞在胸胁，秋俞在肩背。冬俞在腰股，即高下之谓也。
帝曰∶血气以并，病形以成，阴阳相倾，补泻奈何？
血气并，病形成，阴阳相倾，自有补泻，不必因于四时，故复问之。
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。
相并为实，相失为虚。泻实者，泻其血气之并，故气盛乃内针，气盛内针，所以泻实也，针与气俱内，
针道相并之气而深之也，以开其门，泻之也，如利其户，大泻也，既开既利，则针与气
俱出，谓针出而相并之气亦出也，泻其外邪，不伤正气，故精气不伤，而邪气乃下，所谓开其门者，外门
不闭，以出其疾也，所谓利其户者，摇大其道，如利其路也，夫开门出疾，是谓泻之，如利
其路，是谓大泻，切，按也，必切而出，谓右手持针，左手必切其穴，而使之外出，然后大气乃屈。大气，
即相并之盛气也。
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。
空，作孔。补者，补其血气相失，故当持针勿置，以定其补之之意。吸则气入，呼则气出，候呼内针，
乃气出而针入也。内针，则当针孔四塞，使精无从去、其出针也，候气聚方实，则当疾出其
针，使气入而针则出，针出则热不得还，气入则闭塞其门，热不得还，则邪气布散，闭塞其门，则精气
乃得存，夫持针勿置，以定其意者，乃动气候时，谓穴俞动气，必候其时，候时则近气不失，远
气乃来，是谓追之，追之所以补之，此补虚之法为然也。
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？
上文岐伯云∶有余有五，不足亦有五，皆生于五脏，帝谓五脏
止五脉，五脉虚实何以合十二经脉，及三百六十五节，故举而复问之。
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。
人身五脏，属于五行，五行合六气，故五脏得六腑与为表里，五脏六腑，十二经络也，十二经络，
周身肢节也，故经络肢节，各生虚实之病，随其病之所居而调治之。
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。
五行之中有二火，以合六气，故举包络所主之脉，心主之血，肺主之气，脾主之肉，肝主之筋，肾主
之骨，以明五脏六腑，为十二经脉也。包络主脉，心主血，血脉无分，故病在脉，调之血，病
在血，调之络，络，犹脉也。肺主气而卫外，故病在气，调之卫。其余则随其病之所在而调之。
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。
此举经脉肢节之痹痛，在于形身上下左右，合三部九候，以为调经之法也。燔针劫刺其下者，治
痹证也。《灵枢·经筋》篇有十二筋痹证，皆治以燔针劫刺。痹发于阴，故刺其下也，及与急者，谓筋痹
也。经筋篇云∶腹筋急，引缺盆，及颊、卒口僻。颊筋有寒，则急引颊，移口，以马膏膏，白酒和桂以涂。
病在骨者，骨痹也，痹在骨，则淬针。病在筋，则药熨也。痹病在五脏之外合者，必痛。若
痹病不知所痛，则从奇经之脉而上，故曰两跷为上。两跷，足之阳跷阴跷也。为上，从跷脉而上行也。阳
跷脉病，阴缓阳急。阴跷脉病，阳缓阴急。故虽病而不知所痛。若痹病在于肌肉，则身形有痛，
无关经脉，故九候莫病，则为缪刺之法以治之。《缪刺论》云∶凡痹在分肉间痛而刺之，左刺右，
右刺左者是也。若痛在左而右脉病者，邪客经脉也，则为巨刺之法以治之。巨刺者，长针深刺，所以
取深邪远痹也。凡此痹痛之证，在于形身上下左右，故必谨察其九
候。九候者，上中下三部，一部三候，三部九候，合于经脉，候其形神，谨察于此，针道备矣。
使形体充实，既然形体已经充实，那么形身三部九候的脉象，上下协调一致，这就称为平人。平人，就是血气调和的人，由此可知阴阳之气的往来，是通过腧穴和会穴进行的；如果不通过腧穴和会穴，而血气相互搏结，就会产生阴阳的虚实变化。
邪气的产生，有的生于阴分，有的生于阳分。那些生于阳分的邪气，是由于风雨寒暑等外感因素引起的；那些生于阴分的邪气，是由于饮食、起居以及情绪（如喜怒）等内伤因素引起的。
上文提到的血气交并、阴阳虚实，是指经脉失去了平衡，并非指六淫外感和七情内伤，因此承接上文进一步论述外感与内伤，以及阴阳寒热性质的疾病。邪气致病，有的生于阴分，有的生于阳分。生于阳分的，是由于风雨寒暑的外感；生于阴分的，是由于饮食起居及阴阳喜怒的内伤。这里提到风雨寒暑，就可以概括六气；提到喜怒，就可以概括七情。随便列举其中几项即可，不必全部具备，所以有时说风雨寒暑，有时说风雨寒湿，有时说喜怒，有时说喜悲，就像下文的问答一样。
黄帝问：风雨伤害人体是怎样的？
黄帝承接岐伯的话，想要进一步阐明其中的义理，所以多次提问以详尽了解。
岐伯说：风雨伤害人，先客居于皮肤，传入孙脉，孙脉充满则传入络脉，络脉充满则输注到大经脉，血气与邪气结合停留在分肉腠理之间，脉象坚实盛大，所以称为实。实证表现为外部坚实充满，不可按压，按压就会疼痛。
凡是风雨伤害人，是由浅入深的，所以先客居于皮肤，从皮肤传入孙脉，孙脉充满则传入络脉，络脉充满则输注到大经脉，由外向内，血气与邪气结合停留在分肉腠理之间，所以脉象坚实盛大。脉，包括孙脉、络脉和经脉。脉象坚实盛大，所以称为实。实，就是满的意思。所谓实，是指外部坚实大且充满，所以不可按压，按压就疼痛，说的就是这个道理。
黄帝问：寒湿伤害人体是怎样的？岐伯说：寒湿中人，皮肤松弛不收摄，肌肉坚硬紧绷，营血运行涩滞，卫气耗散离去，所以称为虚。虚证表现为肌肉皮肤颤动开合不定，气不足，按压时，气足以温煦身体，所以感到舒适而不痛。
寒湿伤害人，在于皮肤肌肉之间，所以皮肤松弛不收摄，肌肉坚硬紧绷。不收摄，是指汗出而不能闭合紧密。坚紧，是指涩滞而不柔和。所以肌肉坚紧，则营血涩滞。涩，是凝涩的意思。皮肤不收摄，则卫气离去。去，是失守的意思。
血行涩滞、卫气离去，所以称为虚。虚证，是血气都虚弱，所以聂辟，是指肌肉皮肤聂聂然而开合颤动的样子。气不足，是指气不足以在内温煦血液。上文说充满而实，不可按压，按压则痛；这里是血气不足，所以按压时气足以温煦血液，意思是气足以在内温煦血液，所以感到舒适而不痛。上文说生于阳分的，是由于风雨寒暑，所以举风雨寒湿来说明外感病生于阳分，而有实有虚的区别。
黄帝说：好。阴分产生实证是怎么回事？
生于阳分的，是由于风雨寒暑；生于阴分的，是由于饮食起居、阴阳喜怒。生于阳分的，上文已经详细论述了，这里提出阴分产生实和虚，来说明喜怒和饮食的意义。
岐伯说：喜怒没有节制，就会导致阴气上逆，上逆则下部空虚，下部空虚则阳气奔趋填补它，所以称为实。
喜怒是人的常情。喜怒没有节制，就会内伤阴分，导致阴气上逆；阴气上逆则下部空虚，下部空虚则阳气奔趋并合于阴分，所以称为实，这是说阴分产生实证的情况。
黄帝问：阴分产生虚证是怎么回事？岐伯说：喜则气下行，悲则气消减，消减则经脉虚空，再加上寒冷饮食，寒气熏蒸充满，则血行涩滞、卫气离去，所以称为虚。
喜极生怒则气上逆，喜极生悲则气下行，所以说喜则气下行，悲则气消减，消减则经脉虚空，又因为寒冷饮食，寒气熏蒸充满，则营血涩滞，卫气离去，所以称为虚，这是说阴分产生虚证的情况。上文说：生于阴分的，是由于饮食起居、阴阳喜怒，所以举喜怒、悲、寒冷饮食，来说明内伤病生于阴分，而有实有虚的区别。
黄帝说：经文说阳虚则体表发冷，阴虚则体内发热，阳盛则体表发热，阴盛则体内发冷，我已经听说了，但不知道它们产生的原因。
岐伯说：邪气的产生，有的生于阴分，有的生于阳分。阳主外，阴主内，阳虚阴虚，涉及内外寒热；阳盛阴盛，也涉及内外寒热，所以引用经文来探究其产生的原因。
岐伯说：阳气受气于上焦，用来温煦皮肤和分肉之间。现在寒气在体表，则上焦不通畅，上焦不通畅，则寒气独自留滞在体表，所以出现寒战。
所谓阳虚则体表发冷，是因为阳气受气于上焦，上焦开发，用来温煦皮肤和分肉之间。现在寒气在体表，则上焦不通畅，上焦不通畅，则寒气独自留滞在体表，所以出现寒战而体表发冷。
黄帝问：阴虚产生内热是怎么回事？岐伯说：由于劳倦过度，形体和气衰少，谷气不充盈，上焦不能宣通，下脘不能运化，胃气生热，热气熏蒸胸中，所以产生内热。
“中”读去声，以下同。所谓阴虚生内热，是因为劳倦过度，导致形体和气衰少，胃中谷气不充盈，谷物摄入少，则上焦不能宣散五谷的精微气味，所以上焦不通畅；下脘不能化生谷物的精微，所以下脘不通畅，中土虚弱而胃气生热。热气熏蒸于胸中，所以阴虚则产生内热。
黄帝问：阳盛产生外热是怎么回事？岐伯说：上焦不通利，则皮肤致密，腠理闭塞，玄府不通，卫气不得宣泄越出，所以产生外热。
所谓阳盛生外热，阳主上、主外，上焦不通利，则在外的皮肤致密，在内则因此腠理闭塞，玄府不通。腠理，是肌腠的纹理。玄府，是毛窍的汗孔。玄府、皮肤、腠理不相贯通，则卫气壅滞，不得宣泄越出，所以阳盛则产生外热。
黄帝问：阴盛产生内冷是怎么回事？岐伯说：厥气上逆，寒气积聚在胸中而不能排泄，不能排泄，则温气离去，寒气独自留存，则血液凝涩，凝涩则脉道不通，脉象盛大而涩，所以体内发冷。
“中”按字面意思理解。所谓阴盛生内冷，阴主下、主内，厥气上逆，寒厥之气从下向上逆行于上，阴在内，所以寒气积聚在胸中而不能排泄。寒气不排泄，则温气离去，寒气独自留存，留存则血液凝涩，凝涩则脉道不通。脉道不通，脉象盛大而涩，所以阴盛则体内发冷，“中”在这里相当于“内”。
黄帝问：阴与阳相并，血气相并，病形已经形成，针刺治疗该怎么办？
再次承接上文关于阴阳血气病形的内容，询问补泻虚实的针刺方法，作为调理经脉的方法。
岐伯说：针刺这类病症，要选取经隧，取血于荣分，取气于卫分，根据患者的身形大小，并依据四季的变化决定针刺的深浅和多少。
上文说：五脏之道，都出于经隧，用来运行血气，所以针刺这类病症，应当选取经隧，取血于荣分，取气于卫分，以此来运行血气。荣卫血气，周流于人身，与四时相合，现在选取经隧，虽然说是根据身形，但必须依据天的四时，来决定针刺的多少和高下深浅。《缪刺论》说：以月亮的盈亏为针刺数量的标准。这就是所说的“多少”。《金匮真言论》说：春俞在颈项，夏俞在胸胁，秋俞在肩背，冬俞在腰股。这就是所说的“高下”。
黄帝问：血气相并，病形已成，阴阳相互倾轧，补泻该怎么办？
血气相并，病形已成，阴阳相互倾轧，自然有补泻之法，不一定非要依据四时，所以再次提问。
岐伯说：泻实的方法，要在气盛的时候进针，针与气一起进入，以打开门户，如同打开窗户；针与气一起退出，精气不受伤，邪气才排出，外门不关闭，以使疾邪外出，摇大针孔通道，如同疏通道路，这叫做大泻。出针时必须切按穴位，盛大的邪气才能屈折消散。
相并为实，相失为虚。泻实，是泻除血气的相并，所以在气盛时进针，气盛进针是为了泻实。针与气一起进入，是顺着相并之气深入，以打开门户进行泻法，如同打开窗户，这是大泻。既开又利之后，针与气一起退出，意思是针退出而相并之气也随之退出，泻除外邪而不伤正气，所以精气不受伤，而邪气才排出。所谓“开其门”，是指外门不闭，以使疾邪外出；所谓“利其户”，是指摇大其道，如同疏通道路。开门出疾，这叫泻法；如疏通道路，这叫大泻。“切”，是按压的意思。必切而出，是指右手持针，左手必须切按穴位，使其向外出针，然后盛大的邪气才能屈折消散。大气，即相并的盛气。
黄帝问：补虚该怎么办？岐伯说：持针不要放置，以安定意念，等候呼气时进针，气出针入，针孔四周闭合，精气无从流失，待气聚方实时迅速出针，气入针出，热气不得返还，闭塞针孔，邪气布散，精气得以保存，观察穴位动气与时令相应，近处的真气不失，远处的真气乃来，这叫做追气。
“空”作孔解。补，是补益血气的相失，所以当持针不要放置，以安定补益的意念。吸气则气入，呼气则气出，等候呼气时进针，是气出而针入。进针后，应当使针孔四周闭合，使精气无从流失。出针时，等候气聚方实，则应当迅速出针，使气入而针出，针出则热气不得返还，气入则闭塞其门，热气不得返还，则邪气布散，闭塞其门，则精气得以保存。所谓持针勿置，以定其意，是指观察穴位动气，必须等候其时，候时则近处的真气不失，远处的真气乃来，这叫做追气，追气就是为了补益，这种补虚的方法是这样的。
黄帝说：先生所说虚实有十种，生于五脏，五脏对应五脉罢了，但是十二经脉都能产生疾病，现在先生只谈五脏，十二经脉都联络三百六十五个关节，关节有病，必然波及经脉，经脉的病都有虚实，如何合并起来看？
上文岐伯说：有余有五，不足也有五，都生于五脏。黄帝认为五脏只有五脉，五脉的虚实如何与十二经脉及三百六十五个关节相合，所以再次提出疑问。
岐伯说：五脏本来与六腑互为表里，经络肢节，各自产生虚实之病，根据病变所在之处，随之进行调治。
人身五脏，属于五行，五行合六气，所以五脏与六腑互为表里，五脏六腑对应十二经络，十二经络遍布周身肢节，所以经络肢节，各自产生虚实之病，随着病变所在之处而调治。
病在脉，调治血；病在血，调治络；病在气，调治卫；病在肉，调治分肉；病在筋，调治筋；病在骨，调治骨。
五行中有二火，合于六气，所以举出心包络所主的脉，心所主的血，肺所主的气，脾所主的肉，肝所主的筋，肾所主的骨，来说明五脏六腑对应十二经脉。心包络主脉，心主血，血脉不分，所以病在脉，调治血；病在血，调治络，络，也就是脉。肺主气而护卫体表，所以病在气，调治卫。其余则随病变所在之处而调治。
用燔针劫刺患处下方，以及筋急者，病在骨，用淬针药熨，病处不知疼痛的，取两跷脉为主，身形有疼痛但三部九候无病的，用缪刺法。痛在左侧而右侧脉象异常的，用巨刺法。必须仔细诊察三部九候，针刺的道理就完备了。
这里列举经脉肢节的痹痛，在于身体上下左右，结合三部九候，作为调理经脉的方法。燔针劫刺其下，是治疗痹证。《灵枢·经筋》篇有十二筋痹证，都用燔针劫刺治疗。痹发于阴，所以刺其下方。以及筋急者，指的是筋痹。《经筋》篇说：腹筋急，牵引缺盆，以及脸颊，突然口眼歪斜。颊筋受寒，则急迫牵引脸颊，移转口角，用马膏涂敷，白酒和桂涂抹。病在骨，是骨痹，痹在骨，则用淬针。病在筋，则用药熨。痹病在五脏之外合之处，必定疼痛。如果痹病不知疼痛，则从奇经之脉上行，所以说两跷脉为主。两跷，指足部的阳跷脉和阴跷脉。为上，指从跷脉上行。阳跷脉病，阴缓阳急；阴跷脉病，阳缓阴急。所以即使有病也不知疼痛。如果痹病在肌肉，则身形有疼痛，无关经脉，所以三部九候无病，就用缪刺法治疗。《缪刺论》说：凡是痹在分肉间疼痛而刺之，左刺右，右刺左，就是这样。如果痛在左侧而右侧脉象异常，是邪气客居经脉，就用巨刺法治疗。巨刺，是用长针深刺，以取深层的邪气和远端的痹证。凡此痹痛之证，在于身体上下左右，所以必须仔细诊察三部九候。九候，指上中下三部，一部三候，三部九候，合于经脉，候察形神，谨慎地考察于此，针刺的道理就完备了。
To fill the form, once the form is filled, then the three regions and nine examinations of the body's pulse will be consistent above and below, which is called a "Ping Ren" (Normal Person). A Ping Ren is a person with harmonious Blood and Qi. From this, we know that the coming and going of Yin and Yang occur through the Shu points and Hui points; if they do not pass through these points, but rather if Blood and Qi contend with each other, there will be deficiency and excess in Yin and Yang.
The generation of pathogenic factors may originate from the Yin aspect or the Yang aspect. Those originating from the Yang are caused by external wind, rain, cold, and heat. Those originating from the Yin are caused by internal injuries such as diet, living conditions, and emotions like joy and anger.
The previous text discussed the intermingling of Blood and Qi, and the deficiency and excess of Yin and Yang, referring to the imbalance of meridians, not specifically to the six exogenous pathogens or seven internal emotions. Therefore, it continues to discuss diseases of exogenous and endogenous origin, as well as those characterized by Yin-Yang and cold-heat. The generation of pathogenic factors causing disease may originate from the Yin aspect or the Yang aspect. Those originating from the Yang are due to external wind, rain, cold, and heat; those originating from the Yin are due to internal injuries from diet, living conditions, and emotions. Mentioning wind, rain, cold, and heat covers the Six Qi; mentioning joy and anger covers the Seven Emotions. Any specific example suffices; it is not necessary to list all. Thus, sometimes it mentions wind, rain, cold, and heat; sometimes wind, rain, cold, and dampness; sometimes joy and anger; sometimes joy and sorrow, as seen in the Q&A below.
The Yellow Emperor asked: How do wind and rain injure the human body?
The Yellow Emperor, following Qi Bo's words, wished to further elucidate the meaning, so he asked repeatedly to understand in detail.
Qi Bo said: When wind and rain injure a person, they first lodge in the skin, then transmit to the Sun vessels (fine branches of collateral vessels). When the Sun vessels are full, they transmit to the Luo vessels (collateral vessels). When the Luo vessels are full, they transport to the large Jing vessels (main meridians). Blood and Qi combine with the pathogen and reside between the Fen Li (muscle intervals) and Cou Li (interstices). The pulse becomes firm and large, hence it is called "Shi" (Excess). Excess manifests as external firmness and fullness; it cannot be pressed, and pressing causes pain.
Whenever wind and rain injure a person, the invasion proceeds from shallow to deep. Thus, it first lodges in the skin, transmits to the Sun vessels from the skin; when the Sun vessels are full, they transmit to the Luo vessels; when the Luo vessels are full, they transport to the large Jing vessels. Moving from outside to inside, Blood and Qi combine with the pathogen and reside between the Fen Li and Cou Li, so the pulse becomes firm and large. The pulse refers to the Sun, Luo, and Jing vessels. Because the pulse is firm and large, it is called Excess. Excess means fullness. What is meant by Excess is that the exterior is firm, large, and full, so it cannot be pressed, and pressing causes pain. This is what is described.
The Yellow Emperor asked: How do cold and dampness injure the human body? Qi Bo said: When cold and dampness invade a person, the skin loses its ability to contract and close, the muscles become hard and tight, Ying Blood (Nutritive Blood) flows sluggishly, and Wei Qi (Defensive Qi) dissipates and departs. Hence, it is called "Xu" (Deficiency). Deficiency manifests as trembling and opening/closing irregularly (Nie Pi), with insufficient Qi. Upon pressing, the Qi is sufficient to warm the body, so one feels comfortable and pain-free.
When cold and dampness invade a person, they affect the area between the skin and muscles. Thus, the skin does not contract tightly, and the muscles become hard and tight. "Not contracting" means sweat escapes without closing tightly. "Hard and tight" means sluggish and lacking flexibility. Therefore, hard and tight muscles cause Ying Blood to flow sluggishly. "Sluggish" means congealed and slow. Skin failing to contract means Wei Qi departs. "Depart" means losing its post/guarding function.
With sluggish Blood and departing Qi, it is called Deficiency. In Deficiency, both Blood and Qi are deficient, leading to Nie Pi, which describes the muscle and skin trembling and moving irregularly. "Insufficient Qi" means Qi is insufficient to internally warm the Blood. The previous text stated that Excess is full and firm, cannot be pressed, and causes pain upon pressing. Here, because Blood and Qi are insufficient, pressing allows Qi to sufficiently warm the blood. Since Qi sufficiently warms the blood internally, one feels comfortable and pain-free. The previous text mentioned that things originating from the Yang are due to wind, rain, cold, and heat, so wind, rain, and cold/dampness were cited to illustrate that exogenous diseases originating from the Yang can present as either Excess or Deficiency.
The Yellow Emperor said: Excellent. How does the Yin aspect generate Excess?
Things originating from the Yang are due to wind, rain, cold, and heat; things originating from the Yin are due to diet, living conditions, and emotions like joy and anger. The Yang aspect was already discussed in detail above. Here, the generation of Excess and Deficiency in the Yin aspect is raised to clarify the significance of emotions and diet.
Qi Bo said: If joy and anger are unregulated, Yin Qi will rebel upwards. Upward rebellion leads to deficiency in the lower part. When the lower part is deficient, Yang Qi rushes to fill it. Hence, it is called Excess.
Joy and anger are normal human emotions. Unregulated joy and anger internally injure the Yin, causing Yin Qi to rebel upwards. Upward rebellion of Yin Qi leads to deficiency in the lower part. When the lower part is deficient, Yang Qi rushes to join the Yin. Hence, it is called Excess. This explains how the Yin aspect generates Excess.
The Yellow Emperor asked: How does the Yin aspect generate Deficiency? Qi Bo said: Joy causes Qi to descend, and sorrow causes Qi to dissipate. Dissipation leads to emptiness in the meridians. Combined with cold food and drink, the cold Qi steams and fills the interior, causing Blood to flow sluggishly and Qi to depart. Hence, it is called Deficiency.
Extreme joy leading to anger causes Qi to rise; extreme joy leading to sorrow causes Qi to descend. Thus, joy causes Qi to descend, and sorrow causes Qi to dissipate. Dissipation leads to emptiness in the meridians. Furthermore, due to cold food and drink, cold Qi steams and fills the interior, causing Ying Blood to flow sluggishly and Wei Qi to depart. Hence, it is called Deficiency. This explains how the Yin aspect generates Deficiency. The previous text stated: Things originating from the Yin are due to diet, living conditions, and emotions. Therefore, joy, anger, sorrow, cold, and diet are cited to illustrate that endogenous diseases originating from the Yin can present as either Excess or Deficiency.
The Yellow Emperor said: The classic states 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 know the reason behind it.
Qi Bo said: Pathogens may originate from the Yin aspect or the Yang aspect. Yang governs the exterior, and Yin governs the interior. Yang Deficiency and Yin Deficiency involve external and internal cold/heat; Yang Excess and Yin Excess also involve external and internal cold/heat. Thus, citing the classic helps explore the reasons.
Qi Bo said: Yang receives Qi from the Upper Jiao (Upper Burner) to warm the skin and muscle intervals. Now, if cold pathogen is on the exterior, the Upper Jiao becomes obstructed. If the Upper Jiao is obstructed, cold pathogen remains alone on the exterior, causing chills.
What is meant by "Yang Deficiency leads to external cold" is that Yang receives Qi from the Upper Jiao. The Upper Jiao opens and disseminates to warm the skin and muscle intervals. Now, if cold pathogen is on the exterior, the Upper Jiao becomes obstructed. If the Upper Jiao is obstructed, cold pathogen remains alone on the exterior, causing chills and external cold.
The Yellow Emperor asked: How does Yin Deficiency generate internal heat? Qi Bo said: Due to fatigue and overwork, the form and Qi decline and become scarce. Grain Qi does not fill adequately. The Upper Jiao fails to circulate, and the Lower Wan (Lower Stomach) fails to communicate. The Stomach Qi becomes hot, and hot Qi steams the chest cavity, thus generating internal heat.
"Zhong" is pronounced with the falling tone, same for subsequent instances. What is meant by "Yin Deficiency generates internal heat" is that fatigue and overwork cause the form and Qi to decline. Grain Qi in the stomach is insufficient. With less grain intake, the Upper Jiao cannot disseminate the flavors of the five grains, so the Upper Jiao fails to circulate. The Lower Wan cannot transform the essence of the grain, so the Lower Wan is obstructed. The Middle Earth is deficient, and Stomach Qi becomes hot. Hot Qi steams the chest cavity, so Yin Deficiency leads to internal heat.
The Yellow Emperor asked: How does Yang Excess generate external heat? Qi Bo said: If the Upper Jiao is not smooth and unobstructed, the skin becomes dense, the Cou Li (interstices) close, and the Xuan Fu (pores) are blocked. Wei Qi cannot diffuse and escape, thus generating external heat.
What is meant by "Yang Excess generates external heat" is that Yang governs the upper and the exterior. If the Upper Jiao is not smooth, the skin on the exterior becomes dense, and consequently, the Cou Li inside close, and the Xuan Fu are blocked. Cou Li refers to the texture of the muscle layers. Xuan Fu refers to the pores/sweat ducts. If the Xuan Fu, skin, and Cou Li are not interconnected, Wei Qi becomes stagnant and cannot diffuse and escape. Thus, Yang Excess leads to external heat.
The Yellow Emperor asked: How does Yin Excess generate internal cold? Qi Bo said: Jue Qi (Rebellious Qi) rebels upwards. Cold Qi accumulates in the chest cavity and cannot be discharged. If not discharged, the warming Qi departs, leaving only cold Qi. The cold Qi causes Blood to congeal and flow sluggishly. Congealing leads to obstruction in the vessels. The pulse becomes large and choppy/sluggish, thus resulting in internal cold.
"Zhong" is taken literally. What is meant by "Yin Excess generates internal cold" is that Yin governs the lower and the interior. Jue Qi rebels upwards; the cold Jue Qi reverses from the lower part upwards. Since Yin is within, cold Qi accumulates in the chest cavity and cannot be discharged. If cold Qi is not discharged, the warming Qi departs, leaving only cold Qi. Remaining cold Qi causes Blood to congeal and flow sluggishly. Congealing leads to obstruction in the vessels. Obstruction in the vessels means the pulse is large and choppy/sluggish. Thus, Yin Excess leads to internal cold. "Zhong" here is equivalent to "internal".
The Yellow Emperor asked: When Yin and Yang merge, and Blood and Qi merge, and the disease manifestation has formed, how should acupuncture be performed?
This again follows the previous discussion on Yin-Yang, Blood-Qi, and disease manifestations, asking about tonifying and reducing acupuncture methods for deficiency and excess, as a method for regulating the meridians.
Qi Bo said: To treat this, select the Jing Sui (meridian tunnels). Take Blood from the Ying (Nutritive) level, and take Qi from the Wei (Defensive) level. Use the body's form [as a guide], and adjust according to the four seasons, varying the depth and number of needles.
The previous text stated: The pathways of the Five Zang organs all emerge from the Jing Sui to circulate Blood and Qi. Therefore, to treat this, one should select the Jing Sui, take Blood from the Ying level, and take Qi from the Wei level, to circulate their Blood and Qi. Ying, Wei, Blood, and Qi circulate throughout the body and harmonize with the four seasons. Now, selecting the Jing Sui, although it involves using the body's form, one must base it on the heavenly four seasons to determine the number and depth of the needles. The *Miao Ci Lun* (Treatise on Miao Acupuncture) states: Use the waxing and waning of the moon as the basis for quantity. This refers to "more or fewer." The *Jin Gui Zhen Yan Lun* (Treatise on True Words in the Golden Cabinet) states: Spring Shu points are in the neck and nape; Summer Shu points are in the chest and hypochondrium; Autumn Shu points are in the shoulders and back; Winter Shu points are in the waist and thighs. This refers to "high or low."
The Yellow Emperor asked: When Blood and Qi merge, the disease manifestation forms, and Yin and Yang tilt against each other, how should tonification and reduction be applied?
When Blood and Qi merge, the disease forms, and Yin and Yang tilt against each other, there are naturally tonification and reduction methods, which need not necessarily depend on the four seasons, so he asks again.
Qi Bo said: To reduce Excess, insert the needle when the Qi is abundant. Insert the needle along with the Qi. Open the gate, like opening a door. Withdraw the needle along with the Qi. The Essence Qi is not injured, and the Pathogenic Qi is expelled. The outer gate remains open to let the disease out. Widen the channel, like clearing a road. This is called Great Reduction. One must press at the point upon withdrawal, so that the great Pathogenic Qi yields.
Merging constitutes Excess; separation constitutes Deficiency. Reducing Excess means reducing the merging of Blood and Qi. Therefore, insert the needle when Qi is abundant. Inserting when Qi is abundant is to reduce Excess. Inserting the needle along with the Qi means driving the needle deep along with the merged Qi to open the gate for reduction, like opening a door, which is Great Reduction. Once opened and cleared, withdraw the needle along with the Qi. This means withdrawing the needle while the merged Qi also exits, expelling external pathogens without injuring healthy Qi. Thus, Essence Qi is not injured, and Pathogenic Qi is expelled. "Opening the gate" means keeping the outer gate open to expel the disease. "Clearing the door" means widening the channel, like clearing a road. Opening the gate to expel disease is reduction; clearing the road is Great Reduction. "Qie" means to press. Pressing upon withdrawal means holding the needle with the right hand while the left hand presses the acupoint to facilitate outward withdrawal, after which the great Pathogenic Qi yields. "Da Qi" (Great Qi) refers to the abundant Qi of the merger.
The Yellow Emperor asked: How should Deficiency be tonified? Qi Bo said: Hold the needle without placing it down, to stabilize your intention. Wait for exhalation to insert the needle. As Qi exits, the needle enters. The needle hole closes on all sides, preventing Essence from escaping. When Qi gathers and becomes solid, quickly withdraw the needle. As Qi enters, the needle exits. Heat cannot return. Close the gate. Pathogenic Qi disperses, and Essence Qi is preserved. Observe the movement of Qi at the acupoint and align with the season. Do not lose the nearby Qi, so that distant Qi may arrive. This is called "Zhui" (Pursuing).
"Kong" means pore. Tonification means restoring the loss of Blood and Qi. Therefore, hold the needle without placing it down to stabilize the intention to tonify. Inhalation brings Qi in; exhalation sends Qi out. Waiting for exhalation to insert the needle means inserting as Qi exits. After insertion, the needle hole should close on all sides, preventing Essence from escaping. For withdrawal, wait until Qi gathers and becomes solid, then quickly withdraw the needle. As Qi enters, the needle exits. Upon needle exit, heat cannot return. As Qi enters, it closes the gate. Heat not returning causes Pathogenic Qi to disperse. Closing the gate preserves Essence Qi. Holding the needle without placing it down stabilizes the intention. Observing the movement of Qi at the acupoint means waiting for the appropriate time. Waiting for the time ensures nearby Qi is not lost, allowing distant Qi to arrive. This is called "Zhui" (Pursuing). Pursuing is used for tonification. This is the method for tonifying Deficiency.
The Yellow Emperor said: You spoke of ten types of Excess and Deficiency, originating from the Five Zang organs. The Five Zang correspond to five pulses. However, the twelve Jing meridians can all produce disease. Why do you only speak of the Five Zang? The twelve Jing meridians connect with 365 joints. Disease in a joint must affect the meridian. Meridian diseases all have Excess and Deficiency. How do we reconcile this?
In the previous text, Qi Bo said: There are five types of Surplus and five types of Insufficiency, all originating from the Five Zang. The Yellow Emperor reasoned that the Five Zang have only five pulses, so how do the Excess and Deficiency of these five pulses relate to the twelve Jing meridians and the 365 joints? He raises this question again.
Qi Bo said: The Five Zang originally have the Six Fu organs as their interior-exterior pairs. The meridians and joints each generate Excess and Deficiency diseases. Adjust them according to where the disease resides.
The human body's Five Zang belong to the Five Elements. The Five Elements combine with the Six Qi. Thus, the Five Zang have the Six Fu organs as interior-exterior pairs. The Five Zang and Six Fu correspond to the twelve meridians. The twelve meridians extend to the limbs and joints. Therefore, the meridians and joints each generate Excess and Deficiency diseases. Treat them according to the location of the disease.
If the disease is in the pulse, regulate the Blood. If the disease is in the Blood, regulate the Luo vessels. If the disease is in the Qi, regulate the Wei Qi. If the disease is in the flesh, regulate the Fen Rou (muscle intervals). If the disease is in the sinews, regulate the sinews. If the disease is in the bone, regulate the bone.
Among the Five Elements, there are two Fires combining with the Six Qi. Thus, the pulse governed by the Pericardium, the Blood governed by the Heart, the Qi governed by the Lungs, the Flesh governed by the Spleen, the Sinews governed by the Liver, and the Bones governed by the Kidneys are cited to illustrate that the Five Zang and Six Fu correspond to the twelve meridians. The Pericardium governs the pulse; the Heart governs Blood. Pulse and Blood are undivided. So, if the disease is in the pulse, regulate the Blood; if in the Blood, regulate the Luo vessels. Luo vessels are essentially pulses. The Lungs govern Qi and protect the exterior. So, if the disease is in the Qi, regulate the Wei Qi. The rest are regulated according to the location of the disease.
Use burning needles (Candle Needles) to rapidly puncture below the affected area, and for cases of spasm/tightness. For bone diseases, use quenched needles and herbal compresses. For diseases where the pain location is unknown, prioritize the Two Qiao vessels. If there is bodily pain but no abnormality in the Nine Pulses, use Miao Acupuncture. If pain is on the left but the pulse on the right is diseased, use Ju Acupuncture. One must carefully examine the Nine Pulses; then the principles of acupuncture are complete.
This section lists bi-syndrome (painful obstruction) of the meridians and joints, located in the upper/lower and left/right of the body, combined with the Three Regions and Nine Pulses, as a method for regulating the meridians. Using burning needles to rapidly puncture below is for treating Bi-syndrome. The *Ling Shu: Jing Jin* chapter lists twelve tendon Bi-syndromes, all treated with burning needles and rapid puncture. Bi originating from Yin is treated by puncturing below. Cases of spasm refer to tendon Bi. The *Jing Jin* chapter states: Abdominal tendon spasm pulls to the clavicle and cheek, causing sudden facial paralysis. Cheek tendon cold causes spasm pulling the cheek and deviating the mouth; treat with horse fat plaster and white wine mixed with cinnamon. Bone disease is Bone Bi. If Bi is in the bone, use quenched needles. If Bi is in the sinews, use herbal compresses. Bi affecting the exterior connections of the Five Zang definitely causes pain. If Bi causes no known pain, ascend via the extraordinary meridians, hence "Two Qiao vessels are primary." The Two Qiao refer to the Foot Yang Qiao and Foot Yin Qiao. "Primary" means ascending via the Qiao meridians. Yang Qiao disease causes Yin slackness and Yang tension; Yin Qiao disease causes Yang slackness and Yin tension. Thus, even with disease, pain may not be felt. If Bi is in the muscles, there is bodily pain unrelated to meridians, so the Nine Pulses show no disease. Treat with Miao Acupuncture. The *Miao Ci Lun* states: For Bi pain in the muscle intervals, puncture left to right, right to left. If pain is on the left but the right pulse is diseased, the pathogen is in the meridian. Treat with Ju Acupuncture. Ju Acupuncture uses long needles for deep insertion to extract deep pathogens and distant Bi. All these Bi-pain syndromes are located in the body's upper/lower and left/right. Therefore, one must carefully examine the Nine Pulses. The Nine Pulses refer to the Upper, Middle, and Lower regions, three examinations each. The Three Regions and Nine Pulses correspond to the meridians, observing form and spirit. Carefully examining this completes the principles of acupuncture.