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Ping An: This section, from the beginning to the end of the chapter, is found in Volume 10, Chapter 67 "Xing Zhen" (Needling Techniques) of the *Ling Shu* (Spiritual Pivot). From "or Shen moves and Qi moves before the needle arrives" to the end, it is also found in Volume 1, Chapter 16 of the *Jia Yi Jing* (Classified Classic of Acupuncture and Moxibustion).

Huang Di asked Qi Bo: I have learned the Nine Needles from you Master and applied them to the common people. The blood and Qi of the common people vary in form. In some cases, Shen (Spirit/Mind) moves and Qi moves before the needle arrives; in others, Qi meets the needle simultaneously; in some, after the needle is withdrawn, Qi moves alone; in some, multiple needlings are required for effect; in some, withdrawing the needle causes Qi to move counterflow; in some, multiple needlings cause the disease to worsen. These six conditions present different forms. I wish to hear the principles behind them. Qi Bo replied: Persons with Repeated Yang (Chong Yang) have Shen that is easily aroused and Qi that easily moves forward. (The method of needling takes regulating Qi as its foundation; thus, these six questions concern the movement of Qi. Ping An: The *Jia Yi Jing* lacks the twenty-eight characters from "Huang Di asked" to "vary in form"; "bing yi ju" is written as "bing yi shen" [disease becomes more severe]; "chong yang zhi ren" is written as "chong yang zhi sheng ren" [persons of excessive Yang].)

Huang Di said: What is meant by a person with Repeated Yang? Qi Bo said: A person with Repeated Yang is restless (Haohao), speaks rapidly, and lifts their feet high. (A person with Repeated Yang refers to one who has an excess of Yang. "Haohao," traditionally pronounced as Xu Jiao fan. "Haohao" describes such a person as being unrefined or rash. Ping An: The *Jia Yi Jing* writes "Jiaojiao." The *Ling Shu* writes "Gaogao." The Yuan edition commentary writes "Huang.") The Qi of the Heart and Lung organs is in excess; Yang Qi is smooth, abundant, and soaring. Therefore, when Shen moves, Qi moves first. (Among the Five Zang organs, Heart and Lung belong to Yang, while Liver, Spleen, and Kidney belong to Yin. Thus, excess in Heart and Lung constitutes Repeated Yang. For a person with Repeated Yang, as soon as Shen moves, Qi moves because there is much Yang. Hence, upon seeing the needle held ready to puncture, Shen moves and Qi advances immediately; without waiting for the needle to enter, the interaction between the person and the needle is subtle and easy.)

Huang Di said: Why does Shen not move first in persons with Repeated Yang? (There are persons with Repeated Yang who must wait for the needle to enter before Qi moves; hence the question arises. Ping An: The *Jia Yi Jing* omits this section.) Qi Bo said: This person has an underlying condition of Yin excess. Huang Di said: How do you know they have underlying Yin excess? Qi Bo said: Those with much Yang tend toward joy; those with much Yin tend toward anger. Those who become angry frequently but easily calm down are said to have underlying Yin. Their Yin and Yang are difficult to harmonize, so Shen cannot move first. (To know if a person with Repeated Yang still has Yin, observation suffices. Generally, those with much Yang are prone to joy, and those with much Yin are prone to anger. If one becomes angry frequently but easily resolves it, this indicates a person with Repeated Yang and underlying Yin. In persons with Repeated Yang and underlying Yin, Qi cannot move before the needle. Ping An: Corresponding texts in the *Ling Shu* and *Jia Yi Jing* include the character "Li" [separation/disunion].)

Huang Di said: What happens when Qi meets the needle? Qi Bo said: When Yin and Yang are harmonized and Blood and Qi are moist, lubricated, and smooth, the needle enters and Qi exits, meeting swiftly. (In persons with balanced Yin and Yang, because their Qi is harmonious, Qi responds and meets the needle immediately upon insertion.)

Huang Di said: What causes Qi to move alone after the needle is withdrawn? Qi Bo said: There is much Yin and little Yang; Yin Qi is sunken while Yang Qi is floating. Sunken Qi is stored internally. Therefore, after the needle is withdrawn, Qi follows behind, moving alone. (In persons with much Yin and little Yang, Yin Qi is deep and stored internally; thus, after needle withdrawal, Qi moves alone. Ping An: The *Ling Shu* writes "Zhen yi chu" [after needle withdrawal] instead of "Zhen yi chu"; "Yang Qi fu chen zhe cang" is written as "Yang Qi fu zhe nei cang"; the *Jia Yi Jing* is the same.)

Huang Di said: What causes effect only after multiple needlings? Qi Bo said: This person has much Yin and little Yang; their Qi is sunken and difficult to advance, so multiple needlings are required for effect. ("Zhi" here means recovery from illness. This person has much Yin and little Yang, making Qi difficult to circulate freely; thus, multiple needlings are needed for healing. Ping An: "Qi zhu nan" is written as "Qi wang nan" in the *Ling Shu* and *Jia Yi Jing*. Given the earlier text states "Qi yi wang" [Qi easily moves], it is likely that "wang" was a transcription error for "zhu".)

Huang Di said: What causes Qi to move counterflow upon needle insertion? Qi Bo said: Qi moving counterflow, and the disease worsening after multiple needlings, are not due to the nature of Yin-Yang Qi or the tendency of floating and sinking. These are failures of the incompetent physician and errors of the skilled practitioner; there is no fault in the patient's Form and Qi. (When needling causes Qi counterflow and further needling worsens the disease, it is because the physician does not understand the floating and sinking of Qi; this is not an error of Yin-Yang or Form-Qi.)