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The discussion on the frequent opposition between deficiency and excess is an unchangeable principle, not only applicable to acupuncturists. However, regarding acupuncture specifically, only the last four sentences of the entire chapter relate to the meaning of filiform needles and needling techniques; the preceding content has nothing to do with needling. It is unclear why the chapter is named "Ci Zhi" (Stirring Qi).

The Yellow Emperor asked: I wish to hear about the essentials of deficiency and excess. Qibo replied: When Qi is excess, the form is full; when Qi is deficient, the form is weak. This is the normal state. Opposite to this indicates pathology. (*Yin Yang Ying Xiang Da Lun* states: "Form returns to Qi." Thus, deficiency and excess are consistent here. "Opposite" means non-correspondence, deviating from the normal equilibrium. Pathology arises when form and Qi oppose each other; here, Qi refers to pulse Qi, and Form refers to the physical body.) When food intake is abundant, Qi is excess; when food intake is scanty, Qi is deficient. This is the normal state. Opposite to this indicates pathology. (*Ling Shu Jing* states: "The way of Ying Qi treasures internal Gu Qi. Gu Qi enters the Stomach, Qi transmits to the Lung, and the pure essence ascends through the meridians." Thus, the deficiency or excess of Gu Qi and Qi must correspond. If signs do not correspond, it is disease.) When the pulse is excess, Blood is excess; when the pulse is deficient, Blood is deficient. This is the normal state. Opposite to this indicates pathology. (Pulse is the mansion of Blood, so deficiency and excess are consistent. Non-correspondence indicates disease.)

The Emperor asked: How does one become opposite? Qibo said: Qi excess with cold body, Qi deficiency with hot body—this is called opposite. (Commentary: Qi belongs to Yang. Yang excess leads to Fire dominance, making the body hot; now it is not hot but cold. Yang deficiency leads to Fire decline, making the body cool; now it is not cool but hot. This represents pathological contradiction and abnormality. Note: The phrase "Qi excess with cold body" is absent in Wang Bing's edition but recorded in *Jia Yi Jing*, corresponding to the following text, which is correct, so it is added here. Abundant food intake with little Qi—this is called opposite. Scanty food intake with much Qi—this is called opposite. Pulse surging with little Blood—this is called opposite. Pulse faint with much Blood—this is called opposite. Commentary: Whether Qi is abundant or scanty depends on food intake; whether the pulse surges or declines depends on Blood. Such opposites must have a cause.)

Qi excess with cold body results from Cold Injury (Shang Han). Qi deficiency with hot body results from Summerheat Injury (Shang Shu). ("Injury" implies exposure/contact. Cold damages the Form, hence Qi excess with cold body; Heat damages Qi, hence Qi deficiency with hot body. Commentary: Cold causes contraction and anhidrosis, trapping Qi internally, leading to Qi excess and cold body. Summerheat causes profuse sweating and Qi leakage, allowing Fire Qi to reach outward, leading to Qi deficiency and hot body. Treatment for cold body uses Acrid-Sweet herbs; treatment for hot body favors Sweet-Cool herbs. This is the general principle for Cold Injury and Summerheat Injury. Although symptoms seem opposite, the diseases are treatable. Failure to distinguish carefully leads to immeasurable harm.)

Abundant food intake with little Qi results from blood loss or Dampness residing below. (Commentary: Blood loss leads to Qi leakage; Dampness below leads to Fire flaming upward. Qi leakage prevents Gu Qi from transforming into Qi; Fire flaming upward causes hunger but emaciation. Hence, abundant food but little Qi. Scanty food intake with much Qi results from pathogenic factors in the Stomach and Lung. (Commentary: Pathogens invading Lung and Stomach cause Qi stagnation and abundance. The Stomach is occupied by pathogens, hence scanty food intake but much Qi.) Small pulse with much Blood results from retained fluid transforming into heat. ("Retained fluid" refers to Yin accumulation. Commentary: Fluid retention transforms into heat. A small pulse indicates insufficient righteous Qi. Much Blood is not true excess, but stimulation by heat.) Large pulse with little Blood results from Wind Qi in the pulse and inability to ingest water or gruel. (Commentary: Wind Qi aggregation dries up Blood, Wood pathogen attacks the Stomach, resulting in a surging pulse and blood-deficient symptoms, along with inability to ingest fluids. The annotation stating fluids do not enter the pulse is erroneous.)

Excess involves Qi entering; Deficiency involves Qi exiting. (Entering is Yang, Exiting is Yin. Yin originates internally, hence exiting; Yang originates externally, hence entering.) Qi excess manifests as Heat; Qi deficiency manifests as Cold. (Yang excess with Yin resisting internally causes Heat; Yin excess with Yang weak externally causes Cold. Commentary: Pathogenic entry constitutes Excess; Righteous Qi exit constitutes Deficiency. Deficiency must be Cold, Excess must be Heat; this is natural law.)

For Excess (Qi entering), the left hand opens the needle aperture; for Deficiency (Qi exiting), the left hand closes the needle aperture. This describes tonification and sedation via needling. The right hand holds the needle, the left hand manipulates the acupoint. Thus, for Excess, the right hand opens the aperture to sedate; for Deficiency, the left hand closes the aperture to tonify. (Commentary: Although this chapter is named "Ci Zhi," no word before this section discusses needling. Only this section discusses needling. This is not the profound essence of acupuncture masters; it is preserved tentatively to explain the chapter's title.)