1
黃帝曰：余以小鍼爲細物也，夫子乃言上合之于天，下合之于地，中合之于人，余以爲過鍼之意矣，願聞其故。
黄帝曰：余以小针为细物也，夫子乃言上合之于天，下合之于地，中合之于人，余以为过针之意矣，愿闻其故。 Huáng Dì yuē: yú yǐ xiǎo zhēn wéi xì wù yě, fū zǐ nǎi yán shàng hé zhī yú tiān, xià hé zhī yú dì, zhōng hé zhī yú rén, yú yǐ wéi guò zhēn zhī yì yǐ, yuàn wén qí gù.
黄帝说：我把小针看作细小的物件，先生却说它上合于天、下合于地、中合于人，我认为这超过了针本身的意义，想听听其中的缘故。
The Emperor said: I have regarded the small needle as a trifling thing, yet you say it joins above with heaven, below with earth, and in the middle with man. I think that exceeds what the needle means, and I should like to hear the reason.
2
歧伯曰：何物大於天乎？夫大于鍼者，惟五兵者焉。五兵者，死之備也，非生之具。且夫人者，天地之鎮也，其不可不參乎？夫治民者，亦唯鍼焉。夫鍼之與五兵，其孰小乎？
歧伯曰：何物大于天乎？夫大于针者，惟五兵者焉。五兵者，死之备也，非生之具。且夫人者，天地之镇也，其不可不参乎？夫治民者，亦唯针焉。夫针之与五兵，其孰小乎？ Qí Bó yuē: hé wù dà yú tiān hū? fū dà yú zhēn zhě, wéi wǔ bīng zhě yān. wǔ bīng zhě, sǐ zhī bèi yě, fēi shēng zhī jù. qiě fū rén zhě, tiān dì zhī zhèn yě, qí bù kě bù cān hū? fū zhì mín zhě, yì wéi zhēn yān. fū zhēn zhī yǔ wǔ bīng, qí shú xiǎo hū?
岐伯说：什么东西比天更大呢？比针大的，只有五种兵器。五种兵器是死亡的装备，不是养生的器具。况且人是天地的镇守，怎能不与之相参呢？治理百姓，也只用针。针与五种兵器相比，哪一个更小呢？
Qi Bo said: What is greater than heaven? Of things greater than the needle there are only the five weapons. The five weapons are the equipment of death, not the instruments of life. Moreover man is the guarantor of heaven and earth — how can he not take part with them? And in governing the people, nothing is used but the needle. Between the needle and the five weapons, which is the smaller?
3
黃帝曰：病之生時，有喜怒不測，飲食不節，陰氣不足，陽氣有餘，營氣不行，乃發爲癰疽。陰陽不通，兩𤍠相摶，乃化爲膿。小鍼能取之乎？
黄帝曰：病之生时，有喜怒不测，饮食不节，阴气不足，阳气有余，营气不行，乃发为痈疽。阴阳不通，两𤍠相抟，乃化为脓。小针能取之乎？ Huáng Dì yuē: bìng zhī shēng shí, yǒu xǐ nù bù cè, yǐn shí bù jié, yīn qì bù zú, yáng qì yǒu yú, yíng qì bù xíng, nǎi fā wéi yōng jū. yīn yáng bù tōng, liǎng rè xiāng tuán, nǎi huà wéi nóng. xiǎo zhēn néng qǔ zhī hū?
黄帝说：疾病发生的时候，有的喜怒没有节制，饮食没有节制，阴气不足，阳气有余，营气不能运行，于是发为痈疽。阴阳不通，两热相搏，于是化成脓。小针能取掉它吗？
The Emperor said: When disease arises, sometimes joy and anger are unregulated, food and drink are immoderate, yin qi is insufficient and yang qi excessive, and the nutritive qi does not move; then abscess and deep-seated sore break out. Yin and yang do not communicate, two heats strike together, and pus forms. Can the small needle remove that?
4
歧伯曰：聖人不能使化者爲之，邪不可留也。故兩軍相當，旗幟相望，白刃陳于中野者，此非一日之謀也。能使其民令行禁止，士卒無白刃之難者，非一日之教也，須臾之得也。夫至使身被癰疽之病，膿血之聚者，不亦離道遠乎？夫癰疽之生，膿血之成也，不從天下，不從地出，積微之所生也。故聖人自治于未有形也，愚者遭其已成也。
歧伯曰：圣人不能使化者为之，邪不可留也。故两军相当，旗帜相望，白刃陈于中野者，此非一日之谋也。能使其民令行禁止，士卒无白刃之难者，非一日之教也，须臾之得也。夫至使身被痈疽之病，脓血之聚者，不亦离道远乎？夫痈疽之生，脓血之成也，不从天下，不从地出，积微之所生也。故圣人自治于未有形也，愚者遭其已成也。 Qí Bó yuē: shèng rén bù néng shǐ huà zhě wéi zhī, xié bù kě liú yě. gù liǎng jūn xiāng dāng, qí zhì xiāng wàng, bái rèn chén yú zhōng yě zhě, cǐ fēi yī rì zhī móu yě. néng shǐ qí mín lìng xíng jìn zhǐ, shì zú wú bái rèn zhī nán zhě, fēi yī rì zhī jiào yě, xū yú zhī dé yě. fū zhì shǐ shēn bèi yōng jū zhī bìng, nóng xuè zhī jù zhě, bù yì lí dào yuǎn hū? fū yōng jū zhī shēng, nóng xuè zhī chéng yě, bù cóng tiān xià, bù cóng dì chū, jī wēi zhī suǒ shēng yě. gù shèng rén zì zhì yú wèi yǒu xíng yě, yú zhě zāo qí yǐ chéng yě.
岐伯说：圣人不能使已经化成脓的病变回原样，邪气不可久留。所以两军相当，旗帜相望，白刃陈列在原野上，这不是一天的谋划；能使百姓令行禁止，士卒没有白刃之难，这不是一天的教育，而是片刻之间得到的。等到身体遭受痈疽之病、脓血积聚，不是离道很远了吗？痈疽的发生，脓血的形成，不从天上降下，不从地下生出，是微小之处积累而成的。所以圣人在还没有成形的时候自己调治，愚昧的人则遭遇它已经成形。
Qi Bo said: The sage cannot make what has already transformed return to its former state, for evil cannot be kept waiting. When two armies face one another and their banners are in sight, with bare blades laid out on the open field, that is not the work of a single day’s planning. To make the people obey orders and refrain from what is forbidden, so that soldiers meet no peril of the blade, is not the work of a single day’s teaching, but of a moment’s gain. To let the body suffer abscess and sore, with pus and blood gathered — is that not far from the way? The arising of abscess and the forming of pus do not come down from heaven nor rise from the earth; they are born of what accumulates in small amounts. Hence the sage governs himself before a form exists, while the fool meets it after it has formed.
5
黃帝曰：其已形，不予遭，膿已成，不予見，爲之奈何？
黄帝曰：其已形，不予遭，脓已成，不予见，为之奈何？
Huáng Dì yuē: qí yǐ xíng, bù yǔ zāo, nóng yǐ chéng, bù yǔ jiàn, wéi zhī nài hé?
黄帝说：病已成形，没有遇上，脓已成，没有见到，怎么办呢？
The Emperor said: If the form already exists and one has not met it, if the pus is already formed and one has not seen it, what then?
6
歧伯曰：膿已成，十死一生，故聖人弗使已成，而明爲良方，著之竹帛，使能者踵而傳之後世，無有終時者，爲其不予遭也。
歧伯曰：脓已成，十死一生，故圣人弗使已成，而明为良方，著之竹帛，使能者踵而传之后世，无有终时者，为其不予遭也。 Qí Bó yuē: nóng yǐ chéng, shí sǐ yī shēng, gù shèng rén fú shǐ yǐ chéng, ér míng wéi liáng fāng, zhuó zhī zhú bó, shǐ néng zhě zhǒng ér chuán zhī hòu shì, wú yǒu zhōng shí zhě, wéi qí bù yǔ zāo yě.
岐伯说：脓已成，十死一生，所以圣人不让病到已成，而明确地立下良方，写在竹帛上，使有能力的人接续传于后世，没有终止的时候，就是因为病往往遇不上。
Qi Bo said: When pus is formed, ten die and one lives. Hence the sage does not let it become formed, but sets out good prescriptions clearly and writes them on bamboo and silk, so that able men may follow and transmit them to later ages without end — because the disease is often not met in time.
7
黃帝曰：其已有膿血而後遭乎？不導之以小鍼治乎？
黄帝曰：其已有脓血而后遭乎？不导之以小针治乎？ Huáng Dì yuē: qí yǐ yǒu nóng xuè ér hòu zāo hū? bù dǎo zhī yǐ xiǎo zhēn zhì hū?
黄帝说：病已有脓血之后才遇上，不用小针引导治疗吗？
The Emperor said: If pus and blood already exist when one meets it, should one not guide it out with the small needle?
8
歧伯曰：以小治小者，其功小，以大治大者，多害。故其已成膿血者，其唯砭石鈹鋒之所取也。
歧伯曰：以小治小者，其功小，以大治大者，多害。故其已成脓血者，其唯砭石铍锋之所取也。 Qí Bó yuē: yǐ xiǎo zhì xiǎo zhě, qí gōng xiǎo, yǐ dà zhì dà zhě, duō hài. gù qí yǐ chéng nóng xuè zhě, qí wéi biān shí pī fēng zhī suǒ qǔ yě.
岐伯说：用小针治小病，功效小；用大针治大病，害处多。所以已成脓血的，只有砭石和铍锋能够取除。
Qi Bo said: To treat a small thing with a small instrument gives little result; to treat a great thing with a great instrument does much harm. Hence what has already formed pus and blood can be removed only by the stone and the lancet.
9
黃帝曰：多害者，其不可全乎？
黄帝曰：多害者，其不可全乎？
Huáng Dì yuē: duō hài zhě, qí bù kě quán hū?
黄帝说：害处多的，就不能保全吗？
The Emperor said: When the harm is great, can it not still be made whole?
Qí Bó yuē: qí zài nì shùn yān.
岐伯说：那在于逆顺。
Qi Bo said: That depends on whether it runs counter or follows.
Huáng Dì yuē: yuàn wén nì shùn.
黄帝说：我想听听逆顺。
The Emperor said: I should like to hear of counter and follow.
12
歧伯曰：以爲傷者，其白眼青，黑眼小，是一逆也；内藥而嘔者，是二逆也；腹痛渴甚，是三逆也；肩項中不便，是四逆也；音嘶色脱，是五逆也。除此五者，爲順矣。
歧伯曰：以为伤者，其白眼青，黑眼小，是一逆也；内药而呕者，是二逆也；腹痛渴甚，是三逆也；肩项中不便，是四逆也；音嘶色脱，是五逆也。除此五者，为顺矣。 Qí Bó yuē: yǐ wéi shāng zhě, qí bái yǎn qīng, hēi yǎn xiǎo, shì yī nì yě; nèi yào ér ǒu zhě, shì èr nì yě; fù tòng kě shèn, shì sān nì yě; jiān xiàng zhōng bù biàn, shì sì nì yě; yīn sī sè tuō, shì wǔ nì yě. chú cǐ wǔ zhě, wéi shùn yǐ.
岐伯说：已成痈疽创伤的，白眼发青，黑眼变小，这是第一逆；服药而呕吐，是第二逆；腹痛而口渴很甚，是第三逆；肩项活动不便，是第四逆；声音嘶哑、面色脱败，是第五逆。除这五种之外，就是顺了。
Qi Bo said: In an injury, if the white of the eye is green and the black of the eye small, that is the first counter; if medicine taken by mouth is vomited, the second; if abdominal pain with extreme thirst, the third; if the shoulder and neck do not move freely, the fourth; if the voice is hoarse and the complexion collapses, the fifth. Apart from these five, it follows.
13
黃帝曰：諸病皆有逆順，可得聞乎？
黄帝曰：诸病皆有逆顺，可得闻乎？ Huáng Dì yuē: zhū bìng jiē yǒu nì shùn, kě dé wén hū?
黄帝说：各种病都有逆顺，可以讲给我听吗？
The Emperor said: All diseases have counter and follow; may I hear of them?
14
歧伯曰：腹脹，身𤍠，脉大，是一逆也；腹鳴而滿，四肢清泄，其脉大，是二逆也；衄而不止，脉大，是三逆也；咳且溲血，脱形，其脉小勁，是四逆也；欬，脱形，身𤍠，脉小以疾，是謂五逆也。
歧伯曰：腹胀，身𤍠，脉大，是一逆也；腹鸣而满，四肢清泄，其脉大，是二逆也；衄而不止，脉大，是三逆也；咳且溲血，脱形，其脉小劲，是四逆也；欬，脱形，身𤍠，脉小以疾，是谓五逆也。 Qí Bó yuē: fù zhàng, shēn rè, mài dà, shì yī nì yě; fù míng ér mǎn, sì zhī qīng xiè, qí mài dà, shì èr nì yě; nǜ ér bù zhǐ, mài dà, shì sān nì yě; ké qiě sōu xuè, tuō xíng, qí mài xiǎo jìng, shì sì nì yě; kài, tuō xíng, shēn rè, mài xiǎo yǐ jí, shì wèi wǔ nì yě.
岐伯说：腹部胀满，身体发热，脉大，是第一逆；腹中鸣响而胀满，四肢清冷泄泻，脉大，是第二逆；鼻出血不止，脉大，是第三逆；咳嗽而尿血，形体消瘦，脉小而劲，是第四逆；咳嗽，形体消瘦，身体发热，脉小而数，这叫做第五逆。
Qi Bo said: Abdominal distension, bodily heat and a large pulse — the first counter. Rumbling fullness of the abdomen, cold limbs with watery discharge, and a large pulse — the second. Nosebleed that will not stop, with a large pulse — the third. Cough with blood in the urine, emaciation, and a small, tense pulse — the fourth. Cough, emaciation, bodily heat, and a small, rapid pulse — the fifth.
15
如是者，不過十五日而死矣。
如是者，不过十五日而死矣。
rú shì zhě, bù guò shí wǔ rì ér sǐ yǐ.
像这样的，不过十五天就会死。
Cases like these die within fifteen days.
16
其腹大脹，四末清，脱形，泄甚，是一逆也；腹脹便血，其脉大，時絶，是二逆也；欬溲血，形内脱，脉摶，是三逆也；嘔血，胸滿引背，脉小而疾，是四逆也；欬嘔，腹脹，且飱泄，其脉絶，是五逆也。
其腹大胀，四末清，脱形，泄甚，是一逆也；腹胀便血，其脉大，时绝，是二逆也；欬溲血，形内脱，脉抟，是三逆也；呕血，胸满引背，脉小而疾，是四逆也；欬呕，腹胀，且飧泄，其脉绝，是五逆也。 qí fù dà zhàng, sì mò qīng, tuō xíng, xiè shèn, shì yī nì yě; fù zhàng biàn xuè, qí mài dà, shí jué, shì èr nì yě; kài sōu xuè, xíng nèi tuō, mài tuán, shì sān nì yě; ǒu xuè, xiōng mǎn yǐn bèi, mài xiǎo ér jí, shì sì nì yě; kài ǒu, fù zhàng, qiě sūn xiè, qí mài jué, shì wǔ nì yě.
腹部大为胀满，四肢清冷，形体消瘦，泄泻很甚，是第一逆；腹部胀满而便血，脉大，时有断绝，是第二逆；咳嗽尿血，形体向内消瘦，脉搏，是第三逆；呕血，胸满牵引背部，脉小而数，是第四逆；咳嗽呕吐，腹部胀满，而且飱泄，脉绝，是第五逆。
Great abdominal distension, cold extremities, emaciation and profuse discharge — the first counter. Abdominal distension with blood in the stool, a large pulse that intermittently fails — the second. Cough with blood in the urine, emaciation inward, and a bounding pulse — the third. Vomiting of blood, fullness of the chest drawing on the back, and a small, rapid pulse — the fourth. Cough and vomiting, abdominal distension and undigested discharge, with a pulse that fails — the fifth.
17
如是者，不及一時而死矣。
如是者，不及一时而死矣。
rú shì zhě, bù jí yī shí ér sǐ yǐ.
像这样的，不到一个时辰就会死。
Cases like these die within a single double-hour.
18
工不察此者而刺之，是謂逆治。
工不察此者而刺之，是谓逆治。
gōng bù chá cǐ zhě ér cì zhī, shì wèi nì zhì.
医者不察这些而针刺，就叫做逆治。
A physician who does not examine these and needles anyway is said to needle against the current.
19
黃帝曰：夫子之言鍼甚駿，以配天地，上數天文，下度地紀，内别五藏，外次六府，經脉二十八會，盡有周紀。能殺生人，不能起死者。子能反之乎？
黄帝曰：夫子之言针甚骏，以配天地，上数天文，下度地纪，内别五藏，外次六府，经脉二十八会，尽有周纪。能杀生人，不能起死者。子能反之乎？ Huáng Dì yuē: fū zǐ zhī yán zhēn shèn jùn, yǐ pèi tiān dì, shàng shǔ tiān wén, xià duó dì jì, nèi bié wǔ zàng, wài cì liù fǔ, jīng mài èr shí bā huì, jìn yǒu zhōu jì. néng shā shēng rén, bù néng qǐ sǐ zhě. zǐ néng fǎn zhī hū?
黄帝说：先生讲针，说得很宏大，以它配天地，上数天文，下度地纪，内别五脏，外次六腑，经脉二十八会，都有周密的纲纪。它能杀死活人，却不能使死人复生。你能把它反过来吗？
The Emperor said: Your words on the needle are grand indeed — matched to heaven and earth, counting the patterns of heaven above and measuring the ordering of earth below, distinguishing the five viscera within and ordering the six palaces without, with the twenty-eight meetings of the channels all having their full record. It can kill a living man, but cannot raise the dead. Can you reverse that?
20
歧伯曰：能殺生人，不能起死者也。
歧伯曰：能杀生人，不能起死者也。
Qí Bó yuē: néng shā shēng rén, bù néng qǐ sǐ zhě yě.
岐伯说：能杀死活人，不能使死人复生。
Qi Bo said: It can kill a living man; it cannot raise the dead.
21
黃帝曰：余聞之，則爲不仁。然願聞其道，弗行於人。
黄帝曰：余闻之，则为不仁。然愿闻其道，弗行于人。 Huáng Dì yuē: yú wén zhī, zé wéi bù rén. rán yuàn wén qí dào, fú xíng yú rén.
黄帝说：我听了这话，就觉得是不仁。然而我想听听其中的道理，不会施行于人。
The Emperor said: Hearing this, I call it inhuman. Yet I wish to hear the way of it, and will not put it into practice on anyone.
22
歧伯曰：是明道也，其必然也。其如刀劍之可以殺人，如飲酒使人醉也，雖勿診，猶可知矣。
歧伯曰：是明道也，其必然也。其如刀剑之可以杀人，如饮酒使人醉也，虽勿诊，犹可知矣。
Qí Bó yuē: shì míng dào yě, qí bì rán yě. qí rú dāo jiàn zhī kě yǐ shā rén, rú yǐn jiǔ shǐ rén zuì yě, suī wù zhěn, yóu kě zhī yǐ.
岐伯说：这是明白的道理，是必然的。它像刀剑可以杀人，像饮酒可以使人醉，即使不诊察，也可以知道。
Qi Bo said: It is a clear way, and a necessary one. It is like a blade that can kill a man, or wine that can make him drunk: even without diagnosis, it can be known.
23
黃帝曰：願卒聞之。
黄帝曰：愿卒闻之。
Huáng Dì yuē: yuàn zú wén zhī.
黄帝说：我希望听到底。
The Emperor said: I wish to hear it to the end.
24
歧伯曰：人之所受氣者，穀也。穀之所注者，胃也。胃者，水穀氣血之海也。海之所行雲氣者，天下也。胃之所出氣血者，經隧也。經隧者，五藏六府之大絡也，迎而奪之而已矣。
歧伯曰：人之所受气者，谷也。谷之所注者，胃也。胃者，水谷气血之海也。海之所行云气者，天下也。胃之所出气血者，经隧也。经隧者，五藏六府之大络也，迎而夺之而已矣。 Qí Bó yuē: rén zhī suǒ shòu qì zhě, gǔ yě. gǔ zhī suǒ zhù zhě, wèi yě. wèi zhě, shuǐ gǔ qì xuè zhī hǎi yě. hǎi zhī suǒ xíng yún qì zhě, tiān xià yě. wèi zhī suǒ chū qì xuè zhě, jīng suì yě. jīng suì zhě, wǔ zàng liù fǔ zhī dà luò yě, yíng ér duó zhī ér yǐ yǐ.
岐伯说：人所承受的气，来自水谷。水谷所注入的，是胃。胃是水谷气血之海。海所运行的云气，布于天下；胃所输出的气血，行于经隧。经隧是五脏六腑的大络，迎而夺之就是了。
Qi Bo said: The qi a person receives comes from grain. What grain flows into is the stomach. The stomach is the sea of water, grain, blood and qi. The clouds that the sea sends forth spread over the world; the blood and qi that the stomach sends forth move in the channels. The channels are the great network of the five viscera and six palaces: meet them and seize them, that is all.
25
黃帝曰：上下有數乎？
黄帝曰：上下有数乎？
Huáng Dì yuē: shàng xià yǒu shù hū?
黄帝说：上下有定数吗？
The Emperor said: Is there a number for above and below?
26
歧伯曰：迎之五里，中道而止，五至而已，五徃而藏之氣盡矣，故五五二十五，而竭其輸矣。此所謂奪其天氣者也，非能絶其命而傾其壽者也。
歧伯曰：迎之五里，中道而止，五至而已，五往而藏之气尽矣，故五五二十五，而竭其输矣。此所谓夺其天气者也，非能绝其命而倾其寿者也。 Qí Bó yuē: yíng zhī wǔ lǐ, zhōng dào ér zhǐ, wǔ zhì ér yǐ, wǔ wǎng ér zàng zhī qì jìn yǐ, gù wǔ wǔ èr shí wǔ, ér jié qí shū yǐ. cǐ suǒ wèi duó qí tiān qì zhě yě, fēi néng jué qí mìng ér qīng qí shòu zhě yě.
岐伯说：迎刺五里，到中途就止，五至而已，五往而脏气就尽了，所以五五二十五，就竭尽它的输注。这是所谓夺去它的天气，并不能断绝它的性命、倾覆它的寿数。
Qi Bo said: Meet it at the five li, and stop halfway; five arrivals and no more. Five goings and the qi of the viscera is exhausted; hence five times five, twenty-five, and its transports are drained dry. This is what is called seizing its heavenly qi; it cannot cut off a life or overturn a span.
27
黃帝曰：願卒聞之。
黄帝曰：愿卒闻之。
Huáng Dì yuē: yuàn zú wén zhī.
黄帝说：我希望听到底。
The Emperor said: I wish to hear it to the end.
28
歧伯曰：闚門而刺之者，死于家中。入門而刺之者，死于堂上。
歧伯曰：窥门而刺之者，死于家中。入门而刺之者，死于堂上。
Qí Bó yuē: kuī mén ér cì zhī zhě, sǐ yú jiā zhōng. rù mén ér cì zhī zhě, sǐ yú táng shàng.
岐伯说：窥门而刺的，死在家的中间；入门而刺的，死在堂上。
Qi Bo said: Needle one who peeps at the gate, and he dies in the middle of the house. Needle one who enters the gate, and he dies in the hall.
29
黃帝曰：善乎！方明哉道！請著之玉版，以爲重寶，傳之後世，以爲刺禁，令民勿敢犯也。
黄帝曰：善乎！方明哉道！请著之玉版，以为重宝，传之后世，以为刺禁，令民勿敢犯也。 Huáng Dì yuē: shàn hū! fāng míng zāi dào! qǐng zhuó zhī yù bǎn, yǐ wéi zhòng bǎo, chuán zhī hòu shì, yǐ wéi cì jìn, lìng mín wù gǎn fàn yě.
黄帝说：好啊！道真是明白啊！请把它刻在玉版上，作为重宝，传于后世，作为针刺的禁忌，使百姓不敢违犯。
The Emperor said: Excellent! How clear is the way! I beg that it be inscribed on a jade tablet, kept as a precious treasure, transmitted to later ages, and made a prohibition in needling, so that the people dare not transgress it.