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If the sensation of Qi under the needle seems to exist and not exist, this refers to the effects of tonification and sedation, akin to gaining or losing Zheng Qi (True Qi). The concepts of gain/loss and existence/non-existence are essentially identical in meaning; they are merely elliptical expressions used for mutual illustration.

Chapter 81 of the *Nan Jing* (Classic of Difficult Issues) states: "The classics mention 'entering as if seeing' and 'exiting as if seeing'. What does this mean?" The answer is: By "entering as if seeing," it means that when the left hand presses the acupoint and the arrival of Qi is perceived, the needle is inserted. Once the needle is inserted, one waits until the Qi has dissipated before withdrawing the needle. This is called "entering as if seeing" and "exiting as if seeing."

Hua Shou (Master Hua) states: Below the phrase "entering as if seeing," the four characters "exiting as if seeing" should be added. If one reads "er" (而) as "ru" (如), as seen in the *Mencius* text "gazing at the Dao but not yet seeing it," where "er" is interchangeable with "ru," this indicates common usage. "Entering and exiting upon perceiving [Qi]" means pressing the acupoint with the left hand, waiting for the arrival of Qi before inserting the needle, and observing within the needle until the Qi should have exhausted itself before withdrawing it.

Ji Yun (Master Ji) states: The insertion and withdrawal of the needle all follow the coming and going of Qi. As stated in the *Su Wen* (Basic Questions): "You see it gathering like a flock of birds, you see it abundant like millet stalks, following its flight, unaware of who drives it; it lies hidden like a crossbow ready to fire, and rises suddenly like the release of an arrow mechanism." (From the *Su Wen*, Chapter on Complete Preservation of Life Form).

Chapter 81 of the *Nan Jing* further states: "The classics say: Do not tonify excess and sedate deficiency, do not damage what is insufficient and benefit what is already excessive." Does this refer to the Cun Kou pulse, or does it refer to the disease itself possessing excess and deficiency? How should these tonifications and sedations be applied? The answer is: Here, "disease" does not refer to the Cun Kou pulse, but rather to the inherent excess and deficiency of the disease itself. For example, if the Liver is Excess and the Lung is Deficient: The Liver belongs to Wood, and the Lung belongs to Metal. Metal and Wood should mutually balance each other; one must understand using Metal to level Wood. Conversely, if the Lung is Excess and the Liver is Deficient, resulting in scanty Qi, and the practitioner uses acupuncture without tonifying the Liver but instead reinforces the Lung's Excess, this is termed "tonifying excess and sedating deficiency," damaging the insufficient and benefiting the excessive. This is the harm caused by average physicians (Zhong Gong).

Hua Shou (Master Hua) states: The two characters "shi bing" (this disease) are either an error or a superfluous addition. In cases of Liver Excess and Lung Deficiency, Metal should level Wood, as explained in Chapter 75. If the Lung is Excess and the Liver is Deficient, one should suppress Metal and support Wood. If the practitioner fails to tonify the Liver and instead reinforces the Lung's Excess, this is called "making the excess truly excess and the deficiency truly deficient." Damaging the insufficient and benefiting the excessive will certainly lead to death. "Zhong Gong" (average physician) is synonymous with "Cu Gong" (crude physician).

Chapter 12 of the *Nan Jing* states: When the internal Qi of the Zang organs has exhausted internally, the practitioner wrongly tonifies the exterior. When the external Qi of the Zang organs has exhausted externally, the practitioner wrongly tonifies the interior. How can one distinguish between internal and external exhaustion? The answer is: When the Qi of the Zang organs has exhausted internally, it means the Qi of the Kidney and Liver has exhausted internally, yet the physician wrongly tonifies the Heart and Lung. When the Qi of the Zang organs has exhausted externally, it means the Qi of the Heart and Lung has exhausted externally, yet the physician wrongly tonifies the Kidney and Liver. Tonifying Yin when Yang is exhausted, and tonifying Yang when Yin is exhausted, constitutes "tonifying excess and sedating deficiency," damaging the insufficient, and benefiting the excessive. Those who die in such manner are killed by the physician.

Hua Shou (Master Hua) states: The first chapter of the *Ling Shu* (Spiritual Pivot) says: "Whenever one intends to use needles, one must first diagnose the pulse, observe the severity and ease of the Qi, and only then can treatment proceed." The third chapter also states: "What is meant by the Qi of the Five Zang organs exhausting internally is that the pulse at the Cun Kou does not reach internally [on deep pressure]. If one wrongly selects diseased areas externally and the He-Sea points of the Yang meridians, retaining the needle to draw out Yang Qi, the arrival of Yang Qi will cause double depletion internally, leading to death due to total exhaustion. Upon death, there is no Qi to move, hence the body is still. What is meant by the Qi of the Five Zang organs exhausting externally is that the pulse at the Cun Kou does not reach externally [on superficial pressure]. If one wrongly selects the Shu points of the four extremities, retaining the needle to draw out Yin Qi, the arrival of Yin Qi will cause Yang Qi to retreat inward. Retreating inward leads to reversal, and reversal leads to death. Upon death, there is excess Yin Qi, hence the body is restless." This is how the *Ling Shu* distinguishes Yin and Yang based on the internal and external aspects of the Cun Kou pulse. Yue Ren (Bian Que) distinguishes Yin and Yang based on the internal and external aspects of the Heart/Lung and Kidney/Liver; the principle remains the same. Master Ji considers this chapter to discuss needle techniques, while Master Feng believes it should be classified under the application of acupuncture tonification and sedation methods.