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Qibo said: Heaven and Earth interact with each other, and cold and warmth shift alternately. Regarding the principles of Yin and Yang, which is less and which is more? The number of Yin is even, and the number of Yang is odd. In spring and summer, Yin Qi (Yin energy) is scarce, and Yang Qi (Yang energy) is abundant; if Yin and Yang are not in harmony, how should one tonify or drain? In autumn and winter, Yang Qi is scarce, and Yin Qi is abundant; when Yin Qi is excessive and Yang Qi declines, stems and leaves wither, and rain falls downward. (The chapter "Ci Jie Zhen Xie" [Needling Joint and True Pathogens] states that heat causes nourishing rain to stay above, where roots have little juice; the meaning here corresponds to this.) When Yin and Yang shift alternately, how should one drain or tonify? If strange pathogens leave the meridians, their number is innumerable. Without understanding the Gen (Root) and Jie (Knot) theory, the Five Zang organs and Six Fu organs will suffer from broken hinges and ruined pivots, leading to abnormal opening and closing, causing a great loss of Yin and Yang that cannot be retrieved. The profoundness of the Nine Needles lies in the concept of Zhong Shi (End and Beginning). Thus, knowing Zhong Shi allows one to summarize it in a single sentence. Not knowing Zhong Shi means the Dao of needling is completely severed. (The above summarizes the main idea, serving as the general introduction for the entire passage.)

The Foot-Taiyang Meridian originates at Zhiyin (BL67) and knots at Mingmen (Gate of Life), which refers to the eyes. The Foot-Yangming Meridian originates at Lidui (ST45) and knots at Sangda (Upper Palate/Forehead region); Sangda refers to the area clamping the ears. The Foot-Shaoyang Meridian originates at Qiaoyin (GB45) and knots at Chuanglong (Window Basket), which refers to the interior of the ear. The Foot-Taiyang governs "Opening," the Foot-Yangming governs "Closing," and the Foot-Shaoyang governs the "Pivot." If the Opening function fails, internal joints become disordered, and sudden illnesses arise. Therefore, for sudden illnesses, one should select points from the Taiyang meridian, assessing excess or deficiency. "Du" refers to skin and muscle stagnation and weakness. If the Closing function fails, Qi has no place to rest, and flaccidity syndromes arise. Therefore, for flaccidity syndromes, one should select points from the Yangming meridian, assessing excess or deficiency. "Qi having no place to rest" means true Qi stagnates while pathogenic Qi resides there. If the Pivot function fails, bones sway and cannot stand firmly on the ground. Therefore, for swaying bones, one should select points from the Shaoyang meridian, assessing excess or deficiency. "Swaying bones" refers to joints being lax and unable to contract. The term "swaying" implies instability. One must investigate the root cause thoroughly.

The Foot-Taiyin Meridian originates at Yinbai (SP1) and knots at Taicang (Stomach). The Foot-Shaoyin Meridian originates at Yongquan (KI1) and knots at Lianquan (CV23). The Foot-Jueyin Meridian originates at Dacun (LR1), knots at Yuying (CV24), and connects to Danzhong (CV17). The Foot-Taiyin governs "Opening," the Foot-Jueyin governs "Closing," and the Foot-Shaoyin governs the "Pivot." If the Opening function fails, the granary (Spleen/Stomach) cannot transport essence, leading to Ge Dong (diaphragmatic blockage and洞泄/diarrhea). For Ge Dong, one should select points from the Taiyin meridian, assessing excess or deficiency. Failure of the Opening function indicates Qi deficiency causing disease. If the Closing function fails, Qi severs, leading to sorrowfulness. For sorrowfulness, one should select points from the Jueyin meridian, assessing excess or deficiency. If the Pivot function fails, pulse Qi becomes knotted and obstructed. For obstruction, one should select points from the Shaoyin meridian, assessing excess or deficiency. Any knotting should be treated by tonifying deficiency. (The discussion on Gen and Jie is now complete; below follows the deduction regarding the abundance and scarcity of Yin and Yang.)

The Foot-Taiyang Meridian originates at Zhiyin, flows through Jinggu (BL64), pours into Kunlun (BL60), and enters Tianzhu (BL10) and Feiyang (BL58). The Foot-Shaoyang Meridian originates at Qiaoyin, flows through Qiuxu (GB40), pours into Yangfu (GB38), and enters Tianrong (SI17) and Guangming (GB37). The Foot-Yangming Meridian originates at Lidui, flows through Chongyang (ST42), pours into Xiaoling (Zusanli ST36), and enters Yingchang (ST9) and Fenglong (ST40). The Hand-Taiyang Meridian originates at Shaoze (SI1), flows through Yanggu (SI7), pours into Shaohai (SI19), and enters Tianchuang (SI16) and Zhizheng (SI7). The Hand-Shaoyang Meridian originates at Guanchong (TE1), flows through Yangchi (TE4), pours into Zhigou (TE6), and enters Tianyou (TE15) and Waiguan (TE5). The Hand-Yangming Meridian originates at Shangyang (LI1), flows through Hegu (LI4), pours into Yangxi (LI5), and enters Futu (LI18) and Pianli (LI6). These are called the Twelve Meridians; all flourishing collaterals should be treated. (This section describes the flourishing collaterals of the Three Yang meridians, representing the extreme abundance of Yang.)

In one day and night, Qi and Blood circulate fifty times to nourish the essence of the Five Zang organs. If they do not follow this count, it is called "Kuang Sheng" (wild generation/abnormality). The so-called fifty circuits mean that all Five Zang organs receive Qi. By holding the Cun Kou pulse and counting its beats: if there are fifty beats without an intermittent pulse (Dai Mai), all Five Zang organs receive Qi. If there is one intermittent beat in forty beats, one Zang lacks Qi. If there is one intermittent beat in thirty beats, two Zangs lack Qi. If there is one intermittent beat in twenty beats, three Zangs lack Qi. If there is one intermittent beat in ten beats, four Zangs lack Qi. If there is an intermittent beat in fewer than ten beats, all Five Zangs lack Qi. This indicates a short life expectancy. The key remains in Zhong Shi. Fifty beats without an intermittent beat is considered normal, allowing one to know the Qi of the Five Zangs. Those given a short life expectancy exhibit irregular pulse rhythms (alternating fast and slow). (This section describes the lack of Qi in the Five Zangs, representing the extreme scarcity of Yin. Although these two sections discuss Yin/Yang abundance/scarcity separately, the previous section's items connect to the "Gen" character mentioned earlier, while this section connects to the "Twelve Meridians" via "Fifty Circuits," linked like a snake in grass or gray thread, with coherent structure.)

Huangdi said: Regarding the reversals and順 (compliance) of the five bodies, I already know about the size of bone joints, the firmness or fragility of flesh, the thickness or thinness of skin, the clarity or turbidity of blood, the slipperiness or roughness of Qi, the length of pulses, the quantity of blood, and the number of meridians. These conditions apply to commoners. However, for kings, dukes, and rulers who consume rich foods, their bodies are soft and fragile, muscles are weak, and their Qi and Blood are vigorous, slippery, and rapid. Can the speed, depth, and quantity of needling be the same for them as for commoners?

Qibo answered: How can the treatment be the same for those who eat rich pastries and meat versus those who eat beans and coarse grains? For those with slippery Qi, the needle should be withdrawn quickly; for those with rough/stagnant Qi, the needle should be withdrawn slowly. For those with vigorous Qi, small needles should be used and inserted shallowly; for those with stagnant Qi, large needles should be used and inserted deeply. Deep insertion requires retention, while shallow insertion requires quick withdrawal. From this, we see that needling commoners involves deep insertion and retention, while needling nobles involves light manipulation and slow operation. This is due to differences in their Qi being vigorous, sluggish, clear, or turbid. (This section explains that treatments differ between rich and coarse diets, setting up a contrast for excess and deficiency of form and Qi.)

Huangdi asked: What is the reversal and compliance of Form-Qi and Disease-Qi? Qibo said: When Form-Qi is deficient but Disease-Qi is excessive, this is pathogenic excess, requiring urgent draining. When Form-Qi is excessive but Disease-Qi is deficient, urgent tonification is required. When both Form-Qi and Disease-Qi are deficient, this indicates deficiency of both Yin and Yang Qi; needling is contraindicated. If needled, it leads to double deficiency. Double deficiency results in the exhaustion of both Yin and Yang, depletion of Qi and Blood, emptiness of the Five Zang organs, and withering of tendons, marrow, and bones. The elderly will perish, and the strong will not recover. When both Form-Qi and Disease-Qi are excessive, this indicates excess of both Yin and Yang; one must urgently drain the pathogens and regulate excess and deficiency. Thus, it is said: Excess is drained, deficiency is tonified. This is the principle.

Therefore, if one does not understand reversals and compliance in needling, true Qi and pathogens clash. Tonifying excess causes Yin and Yang to overflow, filling the intestines and stomach, causing internal depression of the Liver and Lung, and disorder of Yin and Yang. Draining deficiency causes emptiness of the meridians, exhaustion of Qi and Blood, contraction of the intestines and stomach, thinning of the skin, and loosening of hair follicles. This gives the patient a death date. Thus, the essential point of needling lies in knowing how to harmonize Yin and Yang. Harmonizing Yin and Yang makes Jing Qi bright. Integrating form and Qi allows Shen (Spirit) to remain inwardly stored. Thus, it is said: The superior physician regulates Qi evenly; the average physician disrupts the pulses; the inferior physician severs Qi and endangers life. Therefore, the inferior physician must be extremely cautious. One must carefully examine diseases of the Five Zang changes, the responses of the Five Pulses, the excess or deficiency of meridians, and the texture of the skin before applying needles.

Using Yin and Yang as the outline and tonification/draining as the commentary, the first half emphasizes Yin and Yang, while the second half emphasizes tonification and draining. Like two major fu poems connected by a pivot, seemingly discontinuous with the preceding and following text, it deeply captures meaning beyond the events, with emotions flowing through the structure, writing that is solid, mature, unadorned, and concise.