Classica Sinica Medica

A Discourse on the Signs of Needling

刺志論

Cì zhì lùn

The fourth of the Suwen's needling treatises in this run, and the one that turns from the hand to the rule behind it. Asked for the essential point of vacuity and repletion (虚實之要), Qibo answers with three pairings that hold in health — qi replete and the body replete, grain abundant and qi abundant, vessel replete and blood replete — and says of each: this is the constant, to be the reverse of it is illness. Pressed on what the reverse looks like, he gives five: qi vacuous yet the body hot, much grain taken in yet little qi, no grain taken in yet qi abundant, the vessel full yet the blood scant, the vessel small yet the blood abundant. He then gives each its cause — cold damage, summerheat damage, blood lost with dampness lodged below, evil in the stomach and in the lung, rheum with heat within, wind qi in the vessel so that water and gruel will not go down — and closes on the exchange of qi at the needle hole: repletion is qi entering, vacuity is qi going out; qi replete is heat, qi vacuous is cold; and so for repletion the left hand opens the needle hole and for vacuity it closes it. The title graph 志, read zhì, is to note down: what is written here is how the signs are to be read.

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22 paragraphs
黄帝問曰：願聞虚實之要。 黄帝问曰：愿闻虚实之要。
Huáng dì wèn yuē: yuàn wén xū shí zhī yào.
黄帝问道：希望听一听虚与实的关键所在。
The Yellow Emperor asks: I wish to hear the essential point of vacuity and repletion.
歧伯對曰：氣實形實，氣虚形虚，此其常也，反此者病。 歧伯对曰：气实形实，气虚形虚，此其常也，反此者病。
Qí bó duì yuē: qì shí xíng shí, qì xū xíng xū, cǐ qí cháng yě, fǎn cǐ zhě bìng.
歧伯回答说：气实则形体实，气虚则形体虚，这是常理；与此相反的，就是病。
Qibo answers: when qi is replete the body is replete, when qi is vacuous the body is vacuous — this is the constant, and to be the reverse of this is illness.
榖盛氣盛，榖虚氣虚，此其常也，反此者病。 谷盛气盛，谷虚气虚，此其常也，反此者病。
Gǔ shèng qì shèng, gǔ xū qì xū, cǐ qí cháng yě, fǎn cǐ zhě bìng.
谷物充足则气盛，谷物不足则气虚，这是常理；与此相反的，就是病。
When grain is abundant the qi is abundant, when grain is scant the qi is scant — this is the constant, and to be the reverse of this is illness.
脉實血實，脉虚血虚，此其常也，反此者病。 脉实血实，脉虚血虚，此其常也，反此者病。
Mài shí xuè shí, mài xū xuè xū, cǐ qí cháng yě, fǎn cǐ zhě bìng.
脉实则血实，脉虚则血虚，这是常理；与此相反的，就是病。
When the vessel is replete the blood is replete, when the vessel is vacuous the blood is vacuous — this is the constant, and to be the reverse of this is illness.
帝曰：如何而反？ 帝曰：如何而反？
Dì yuē: rú hé ér fǎn?
黄帝问：怎样才算是反呢？
The Emperor asks: how does one come to be the reverse?
歧伯曰：氣虚身熱，此謂反也； 歧伯曰：气虚身热，此谓反也；
Qí bó yuē: qì xū shēn rè, cǐ wèi fǎn yě;
歧伯说：气虚而身体发热，这叫做反；
Qibo says: qi vacuous while the body is hot — this is called the reverse;
榖入多而氣少，此謂反也； 谷入多而气少，此谓反也；
Gǔ rù duō ér qì shǎo, cǐ wèi fǎn yě;
进食多而气反少，这叫做反；
much grain taken in yet the qi scant — this is called the reverse;
榖不入而氣多，此謂反也； 谷不入而气多，此谓反也；
Gǔ bù rù ér qì duō, cǐ wèi fǎn yě;
不进食而气反多，这叫做反；
no grain taken in yet the qi abundant — this is called the reverse;
脉盛血少，此謂反也； 脉盛血少，此谓反也；
Mài shèng xuè shǎo, cǐ wèi fǎn yě;
脉盛而血少，这叫做反；
the vessel full yet the blood scant — this is called the reverse;
脉少血多，此謂反也。 脉少血多，此谓反也。
Mài shǎo xuè duō, cǐ wèi fǎn yě.
脉小而血多，这叫做反。
the vessel small yet the blood abundant — this is called the reverse.
氣盛身寒，得之傷寒； 气盛身寒，得之伤寒；
Qì shèng shēn hán, dé zhī shāng hán;
气盛而身体寒冷，是得之于伤寒；
Qi replete while the body is cold — this is got from cold damage;
氣虚身熱，得之傷暑。 气虚身热，得之伤暑。
Qì xū shēn rè, dé zhī shāng shǔ.
气虚而身体发热，是得之于伤暑。
qi vacuous while the body is hot — this is got from summerheat damage.
榖入多而氣少者，得之有所脫血，濕居下也。 谷入多而气少者，得之有所脱血，湿居下也。
Gǔ rù duō ér qì shǎo zhě, dé zhī yǒu suǒ tuō xuè, shī jū xià yě.
进食多而气少的，是得之于曾经脱血，湿气居留在下部。
Much grain taken in yet the qi scant: it is got from having lost blood, with dampness lodged below.
榖入少而氣多者，邪在胃及與肺也。 谷入少而气多者，邪在胃及与肺也。
Gǔ rù shǎo ér qì duō zhě, xié zài wèi jí yǔ fèi yě.
进食少而气反多的，是邪气在胃以及肺。
Little grain taken in yet the qi abundant: the evil is in the stomach and in the lung.
脉小血多者，飲中熱也。 脉小血多者，饮中热也。
Mài xiǎo xuè duō zhě, yǐn zhōng rè yě.
脉小而血多的，是水饮在内而生热。
The vessel small yet the blood abundant: rheum within has produced heat.
脉大血少者，脉有風氣，水漿不入，此之謂也。 脉大血少者，脉有风气，水浆不入，此之谓也。
Mài dà xuè shǎo zhě, mài yǒu fēng qì, shuǐ jiāng bù rù, cǐ zhī wèi yě.
脉大而血少的，是脉中有风气，水浆不能入口，说的就是这种情况。
The vessel large yet the blood scant: wind qi is in the vessel and water and gruel do not go down — this is what is meant.
夫實者，氣入也； 夫实者，气入也；
Fú shí zhě, qì rù yě;
凡是实，是气入于内；
Now repletion is qi entering;
虚者，氣出也。 虚者，气出也。
Xū zhě, qì chū yě.
虚，是气泄于外。
vacuity is qi going out.
氣實者，熱也； 气实者，热也；
Qì shí zhě, rè yě;
气实的，属热；
Where qi is replete, that is heat;
氣虚者，寒也。 气虚者，寒也。
Qì xū zhě, hán yě.
气虚的，属寒。
where qi is vacuous, that is cold.
入實者，左手開鍼空也； 入实者，左手开针空也；
Rù shí zhě, zuǒ shǒu kāi zhēn kǒng yě;
刺实证的，左手要张开针孔；
Entering into repletion, the left hand opens the needle hole;
入虚者，左手閉鍼空也。 入虚者，左手闭针空也。
Rù xū zhě, zuǒ shǒu bì zhēn kǒng yě.
刺虚证的，左手要闭合针孔。
entering into vacuity, the left hand closes the needle hole.

Textual notes

Readings follow the base edition; significant variants are recorded here.

  1. 黄帝問曰：願聞虚實之要黄帝问曰：愿闻虚实之要

    來稿於四處「曰」下加現代引號「“”」，底本無之；此从底本，四組引號並回刪，不入正文。

  2. 脉小血多者，飲中熱也脉小血多者，饮中热也

    來稿作俗體之「飮」；此从全站定例作「飲」，讀 yǐn。全站十八篇皆作「飲」，本篇一見。

  3. 歧伯對曰歧伯对曰

    底本作「歧」，从止支聲，讀 qí；來稿作从山之「岐」。全站前五十二篇皆从止，此从底本。本篇二見。

  4. 得之有所脫血得之有所脱血

    底本作「脫」，从肉，讀 tuō；來稿作「脱」。第五十二篇同例，此从底本。本篇一見。

  5. 左手開鍼空也左手开针空也

    「鍼空」之「空」讀 kǒng，孔也，王冰注「空，孔也」；第四十四篇「大經空虚」之「空」讀 kōng，與此異讀。本篇「空」二見。

  6. 榖盛氣盛谷盛气盛

    底本作「榖」，讀 gǔ；通行本多作从禾之「穀」。全站十一篇皆作「榖」，此从底本。本篇六見。

Cite this page

APA

Huangdi Neijing · Suwen 黃帝內經素問 (c. 3rd c. BCE – 1st c. CE; recension c. 762 CE). Cì zhì lùn 刺志論 [A Discourse on the Signs of Needling], Chapter 53. In Classica Sinica Medica. Base text: 《重廣補註黃帝內經素問》二十四卷，唐·王冰注，宋·林億、孫奇、高保衡等校正，宋·孫兆重改誤。據上海涵芬樓《四部叢刊初編》影印明嘉靖二十九年（1550）顧從德覆宋刊本錄入，卷一牌記題「上海涵芬樓景印明顧氏翻宋本」。底本與影印本均屬公有領域。 Retrieved 9 October 2026, from https://classicstcm.com/classics/huangdi-neijing-suwen/signs-of-needling/

MLA

"Cì zhì lùn 刺志論 [A Discourse on the Signs of Needling]." Huangdi Neijing · Suwen 黃帝內經素問, chapter 53, Classica Sinica Medica, 2026, https://classicstcm.com/classics/huangdi-neijing-suwen/signs-of-needling/. Accessed 9 Oct. 2026. Base text: 《重廣補註黃帝內經素問》二十四卷，唐·王冰注，宋·林億、孫奇、高保衡等校正，宋·孫兆重改誤。據上海涵芬樓《四部叢刊初編》影印明嘉靖二十九年（1550）顧從德覆宋刊本錄入，卷一牌記題「上海涵芬樓景印明顧氏翻宋本」。底本與影印本均屬公有領域。

Chinese scholarly

《黃帝內經素問·刺志論》（Huángdì Nèijīng Sùwèn）。《重廣補註黃帝內經素問》二十四卷，唐·王冰注，宋·林億、孫奇、高保衡等校正，宋·孫兆重改誤。據上海涵芬樓《四部叢刊初編》影印明嘉靖二十九年（1550）顧從德覆宋刊本錄入，卷一牌記題「上海涵芬樓景印明顧氏翻宋本」。底本與影印本均屬公有領域。Classica Sinica Medica，2026 年 10 月 9 日 存取，https://classicstcm.com/classics/huangdi-neijing-suwen/signs-of-needling/。

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