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Huangdi asked: Among the Nine Needles, the small ones cannot penetrate inward, and the large ones do not extend outward. Their changes are elusive and infinite, overflowing without limit. I know that they conform to the Heavenly Dao, human affairs, and the changes of the four seasons. I wish to comprehensively explore them and unify my understanding; is this possible? Qibo replied: Only by grasping the Dao can one achieve this. Without the Dao, how can size, depth, and separation/union be unified? Therefore, observing from the exterior allows one to infer the interior, and observing from the interior allows one to infer the exterior. This is called the ultimate of Yin and Yang, the canopy of Heaven and Earth. Huangdi asked: How should one manage the insertion and withdrawal (Zongshe) of needles? Qibo said: One must first clearly understand the origins and endings of the Twelve Meridians, observe the coldness or heat of the skin, and palpate the pulse for excess or deficiency, smoothness or roughness. A pulse that is smooth and excessive indicates a progressing disease; a pulse that is deficient and thin indicates a chronic condition; a pulse that is large and rough indicates painful obstruction (Tongbi); when Yin and Yang pulses are identical, the disease is difficult to treat. Examining the root and branch, upper and lower: if there is heat, the pathogen remains; if the heat has subsided, the pathogen departs. Thus, palpate the Chi skin (skin of the forearm), observing the firmness or fragility, size, smoothness or roughness, coldness or heat, dryness or dampness of the flesh. Observe the five colors of the eyes to ascertain the state of the Zang organs and determine life and death. Inspect the blood vessels and observe the five colors to understand cold, heat, bi-syndrome, and pain. Huangdi said: Regarding the technique of needle insertion and withdrawal, I have not yet grasped its meaning. Qibo said: The principle of holding the needle requires uprightness and stillness. First distinguish deficiency and excess, then apply rapid or slow techniques. The left hand fixes the bone at the acupoint, while the right hand guides along the skin, ensuring no muscle wraps around the needle. For reducing methods, insert squarely; for reinforcing methods, close the skin upon withdrawal. Rotate the needle to guide Qi, preventing the pathogenic factor from dispersing and allowing the True Qi to reside. Huangdi asked: How does one protect the skin and open the Couli (pores)? Qibo said: Follow the intermuscular spaces, use the left hand to part the skin, insert the needle slightly and slowly with an upright motion, ensuring Shen (Spirit) does not scatter, so that the pathogenic factor may depart.

Huangdi asked: Why do diseases manifest similarly across different years? What Qi causes this? Shaoshi replied: This relates to the observations of the Eight Critical Periods (Bazheng). These observations are typically made on the day of the Winter Solstice. Wind coming from the south is called Xu Feng (Deficient Wind), a thief-wind that harms people. If it arrives at midnight, people are asleep and unharmed, so fewer people fall ill that year. If it arrives during the day, people are lax and susceptible to the wind, so many people fall ill. When Xu Xie (Deficient Evil) enters the bones but does not manifest externally, and arrives at Li Chun (Start of Spring) when Yang Qi expands and Couli open, if wind comes from the west on that day, people are struck by the deficient wind. These two pathogens collide, causing stagnation in the meridians. Those who encounter such wind and rain are said to suffer from "Sui Lu" (Yearly Dew). If the year is harmonious with few thief-winds, people are few in illness and death; if there are many thief-winds and evil Qi, with discordant cold and warmth, people suffer much illness and death.
Huangdi asked: What is the severity of Xu Xie winds, and how should they be observed? Shaoshi said: On the first day of the first lunar month, if the wind from the west is strong, it is called "White Bone" wind, indicating disaster for the state and high mortality. On the first day of the first month, if northwest wind prevails at dawn, many people will be ill (three out of ten). If north wind blows at noon on the first day of the first month, many people will die (or fall ill) in summer. If north wind blows at dawn, many people will die in spring. If north wind blows at dusk, many people will die in autumn. If the weather is warm and windless on the first day, people are healthy; if there is severe cold and gale-force wind, many people fall ill. If there is no wind on the first day of the second month, people suffer heart and abdominal diseases. If it is not warm on the first day of the third month, people suffer cold-heat diseases. If it is not hot on the first day of the fourth month, people suffer jaundice. If it is not cold on the first day of the tenth month, people suffer sudden death. Winds described here are those capable of blowing off roofs, uprooting trees, raising sand and stones, raising body hair, and opening Couli. Wind coming from the direction opposite to the prevailing seasonal wind is called Xu Feng (Deficient Wind), a thief-wind that causes harm and death; one must carefully observe and avoid it. The way to avoid evil is like avoiding arrows and stones; thus, evil cannot harm.
Wind from the south is called Da Ruo Feng (Great Weak Wind). It harms people by lodging internally in the Heart and externally affecting the Mai (Vessels), its nature being Heat.
Wind from the southwest is called Mou Feng. It harms people by lodging internally in the Spleen and externally affecting the Muscles, its nature being Weakness.
Wind from the west is called Gang Feng (Rigid Wind). It harms people by lodging internally in the Lung and externally affecting the Skin, its nature being Dryness.
Wind from the northwest is called Zhe Feng (Broken Wind). It harms people by lodging internally in the Small Intestine and externally affecting the Hand Taiyang Meridian; if the vessel is severed, there is diarrhea; if blocked, there is stagnation, leading to sudden death.
Wind from the north is called Da Gang Feng (Great Rigid Wind). It harms people by lodging internally in the Kidney and externally affecting the Bones and the Spinalis Dorsi muscles of the shoulder and back, its nature being Cold.
Wind from the northeast is called Xiong Feng (Fierce Wind). It harms people by lodging internally in the Large Intestine and externally affecting the hypochondrium, axilla, and joints.
Wind from the east is called Ying Er Feng (Infant Wind). It harms people by lodging internally in the Liver and externally affecting the Tendons, its nature being Dampness.
Wind from the southeast is called Ruo Feng (Weak Wind). It harms people by lodging internally in the Stomach and externally affecting the Flesh, its nature being Heaviness of the body.
All these eight winds come from directions lacking substantial Qi, thereby causing disease. The combination of three deficiencies leads to sudden death. Two deficiencies and one excess lead to Linlu (dew exposure) and cold-heat syndromes. Treading on wet ground causes Wei syndrome (flaccidity). Thus, sages avoid evil as they would avoid arrows and stones. If three deficiencies are combined with attack by wind evil, it results in collapse and hemiplegia. Huangdi asked: When invaded by the four seasons' eight winds, due to cold and heat: cold makes the skin tight and Couli close; heat makes the skin loose and Couli open. Do thief-winds and evil Qi enter because of this? Or must they rely on the Eight Critical Period winds to harm people? Shaoshi said: Thief-winds and evil Qi do not adhere to specific times. However, they must take advantage of open Couli to enter deeply, causing urgent internal pathology and rapid, sudden onset. If they enter when Couli are closed, the invasion is shallow and lingering, resulting in slow and delayed onset. Huangdi asked: If climate is moderate and Couli are not open, why do sudden illnesses occur? Shaoshi said: Even in daily life, the opening and closing of Couli follow natural rhythms. Humans correspond to Heaven and Earth and the Sun and Moon. When the moon is full, seawater swells westward, human Qi and Blood accumulate, muscles are full, skin is dense, hair is hard, and Couli close, with dirt adhering. At this time, even if thief-wind encounters the body, the invasion is shallow and does not go deep. When the moon is new (empty), seawater swells eastward, human Qi and Blood are deficient, Wei Qi (Defensive Qi) departs, the form stands alone, muscles diminish, skin relaxes, Couli open, hair thins, and dirt washes away. At this time, if thief-wind encounters the body, the invasion is deep, and the disease manifests suddenly and severely. Huangdi asked: What causes sudden death? Shaoshi said: Those who obtain the "Three Deficiencies" die quickly; those who obtain the "Three Excesses" are not harmed by evil. Being affected by the decline of the previous year's Qi, encountering the empty moon, and losing the harmony of the season, leading to depleted human Qi, makes one vulnerable to thief-winds and evil Qi; this is called the Three Deficiencies. Therefore, physicians who do not understand the Three Deficiencies are considered crude. Conversely, if one encounters the prosperity of the year, the fullness of the moon, and the harmony of the season, even if thief-winds and evil Qi exist, they cannot cause harm.