黄帝问曰。愿闻虚实之要。岐伯对曰。气实形实。气虚形虚。此其常也。反此者病。（形归气。气生形。形气之宜相
应也。反此者。谓气盛身寒。气虚身热。皆为寒暑之所病。）谷盛气盛。谷虚气虚。此其常也。反此者病。（人受气于谷。
谷入于胃。以传于肺。五脏六腑。皆以受气。清者为营。浊者为卫。是以谷之多少。与气之盛虚。宜相应也。反此者。
谓谷入多而气少。谷不入而气多。亦为邪病之所致。）脉实血实。脉虚血虚。此其常也。反此者病。（脉者血之府。故虚
实之宜相应也。反此者。或因饮中热。或风气留于脉中。亦因病之所致也。夫志意者。所以御精神。收魂魄。适寒温。
和喜怒者也。是以营卫调。志意和。则筋骨强健。腠理致密。精神专直。身不受邪。如形气谷气之相反。血脉虚实之变
常。皆缘志意不和。以致邪气从之。故名之曰刺志论）帝曰。如何而反。岐伯曰。气虚身热。此谓反也。谷入多而气少。
此谓反也。谷不入而气多。此谓反也。脉盛血少。此谓反也。脉少血多。此谓反也。（盛者。实也。少者。虚也。脉盛者。
脉大也。脉少者。脉小也。按此节当有气盛身寒。此为反也八字。或古文之简脱与。抑经语之错综耶。）气盛身寒。得之
伤寒。气虚身热。得之伤暑。（此申明形气虚实之相反者。为邪气之所伤也。气盛身寒者。邪气实也。气虚身热者。形气
虚也。寒伤形。故气盛身寒。暑伤气。故气虚身热。）谷入多而气少者。得之有所脱血。淫居下也。谷入少而气多者。邪
在胃及与肺也。（夫肾为生气之原。胃为血气之海。谷入多而气反少者。得之有所脱血。湿居下也。盖脱血者。阴气下泄。
湿居下则下焦受伤。以致生原亏损而气少。病不在上。故谷入多也。夫上焦主纳。中焦主化。邪在肺胃。则不能纳化水
谷。而谷入少矣。谷入少而反气多者。生气之原不伤也。此言气之发于下焦也。卢良侯曰。凡下病者。下行极而上。此
言下焦受病。不及中上。故曰居。）脉小血多者。饮中热也。脉大血少者。脉有风气。水浆不入。此之谓也。（经云。水
入于经。而血乃成。又曰。中焦之汁。奉心化赤而为血。热者。心火之气也。饮中热。则饮皆化赤而为血。故血多。脉
中之气不盛。故脉小也。风气乘于脉中。故脉大。水浆不入。则血无所资生。故血少也。此言血之生于中焦也。卢良侯
曰。经云。浅深在志。远近若一。又曰。始浅刺。以去阳分之邪。再深刺之。以去阴分之邪。按此篇帝问虚实之要。而
伯所答者。皆为邪病所伤。盖邪实则正虚矣。然取邪气之浅深。在用志之专一。故曰刺志论。张兆璜曰。邪气去则正气
自复。泻实之中。而有补虚在焉。）夫实者气入也。虚者气出也。（夫虚者须其实。气入则实矣。实者须其虚。气出则
虚矣。此言气之开阖也。）气实者热也。气虚者寒也。（虚者补之。针下热则实矣。实者泻之。针下寒则虚矣。此言阴阳
之气至也。）入实者。右手开针空也。入虚者。左手闭针空也。（针空者。容针之空处也。凡用针之法。右手持针。左手
掐穴。方其入针泻实之时。以右手开针空以泻之。方其入针补虚之时。以左手闭针空以补之。开针空则气出。闭针空则
气入。所谓补泻之时。与气开阖之相合也。张兆璜曰。开阖者。三阳之气发于下焦。营卫者。中焦水谷之所生也。用
针取气。在于营卫。而此篇独论气出下焦。血出中焦。候下焦所生之气。出入开阖。以行补泻之法。又一法也。然三阳
之气。发原于肾脏水腑。肾主藏志。故曰刺志论。）
Huangdi asked, saying: I wish to hear about the essentials of deficiency and excess. Qibo replied, saying: When Qi is excess, the form is solid; when Qi is deficient, the form is weak. This is the normal state. Opposite to this indicates disease. (Form relies on Qi; Qi generates Form. It is appropriate for Form and Qi to correspond to each other. "Opposite to this" refers to cases where Qi is excess but the body feels cold, or Qi is deficient but the body feels hot; these are all diseases caused by Cold or Summerheat.) 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 disease. (Humans obtain Qi from food. Food enters the Stomach, is transmitted to the Lung, and all Zang-Fu organs receive Qi from it. The clear part becomes Ying-Qi (Nutritive Qi), and the turbid part becomes Wei-Qi (Defensive Qi). Therefore, the amount of food should correspond to the abundance or deficiency of Qi. "Opposite to this" refers to cases where one eats much but has little Qi, or does not eat but has much Qi; these are also caused by pathogenic factors causing disease.) When the pulse is excess, Blood is solid; when the pulse is deficient, Blood is deficient. This is the normal state. Opposite to this indicates disease. (The pulse is the residence of Blood, so the deficiency and excess of the pulse and Blood should correspond. "Opposite to this" may be due to heat retention in drinking fluids, or Wind pathogen remaining in the vessels; these are also caused by disease. Human will and intention are used to control spirit, gather soul and魄 (ethereal soul), adapt to cold and warmth, and harmonize joy and anger. Therefore, if Ying-Qi and Wei-Qi are harmonious and will/intention is peaceful, then sinews and bones will be strong, interstices dense, spirit focused and upright, and the body will not be invaded by pathogens. If there is opposition between form and Qi, or between grain-Qi and normal blood vessel deficiency/excess, it is all due to disharmony of will/intention, leading to pathogenic invasion. Hence, it is named "Treatise on Needling and Will/Intention".)
Huangdi asked: How does one know when it is opposite? Qibo said: Qi deficiency with body heat is called opposite; abundant food intake with little Qi is called opposite; no food intake with much Qi is called opposite; full pulse with little Blood is called opposite; small pulse with much Blood is called opposite. ("Full" means excess; "little" means deficiency. A full pulse means a large pulse; a small pulse means a tiny pulse. In this section, the eight characters "Qi excess with body cold, this is called opposite" should likely exist, perhaps omitted due to textual brevity or complexity in the original scripture.") Qi excess with body cold results from Cold damage; Qi deficiency with body heat results from Summerheat damage. (This clarifies that the opposition of form and Qi deficiency/excess is caused by pathogenic injury. Qi excess with body cold indicates pathogenic excess; Qi deficiency with body heat indicates form and Qi deficiency. Cold damages form, hence Qi excess with body cold; Summerheat damages Qi, hence Qi deficiency with body heat.) Abundant food intake with little Qi results from significant blood loss, with dampness residing in the lower Jiao; scanty food intake with much Qi results from pathogen in the Stomach and Lung. (The Kidney is the source of generating Qi; the Stomach is the sea of water and grain and Qi/Blood. Abundant food intake but relatively little Qi results from significant blood loss and dampness residing in the lower Jiao. Significant blood loss causes Yin Qi to leak downward; dampness residing in the lower Jiao injures the Lower Jiao, leading to depletion of the source of Qi generation and thus little Qi. Since the disease is not in the Upper Jiao, food intake remains abundant. The Upper Jiao governs reception; the Middle Jiao governs transformation. Pathogen in the Lung and Stomach prevents proper reception and transformation of water and grain, resulting in scanty food intake. Scanty food intake but relatively much Qi indicates the source of Qi generation is not injured. This discusses Qi originating from the Lower Jiao. Lu Lianghou stated: Generally, diseases in the lower part may reverse upwards after reaching an extreme. Here, it refers to the Lower Jiao being diseased, affecting neither the Middle nor Upper parts, hence "dampness resides in the lower."") Small pulse with much Blood is due to heat in drinking fluids; full pulse with little Blood is due to Wind pathogen in the pulse and inability to take in water/grain. This is what is meant. (The Scripture states: Water enters the vessels, and Blood is formed. It also states: Fluids from the Middle Jiao, transformed by Heart Fire, become red Blood. Heat is the Qi of Heart Fire. Heat in drinking fluids transforms all fluid into red Blood, hence much Blood. Qi in the pulse is not excessive, hence the pulse is small. Wind pathogen invades the vessels, hence the pulse is full. Inability to take in water/grain means Blood lacks nourishment, hence little Blood. This discusses Blood generated in the Middle Jiao. Lu Lianghou stated: The Scripture says: Depth lies in will/intention; near and far are as one. It also says: Initially needle shallowly to remove Yang-pathogen; then needle deeply to remove Yin-pathogen. In this treatise, Huangdi asks about the essentials of deficiency and excess, while Qibo's answers concern injuries by pathogens. Generally, pathogenic excess implies righteous deficiency. However, determining the depth of extracting pathogens depends on the unity of will/intention. Hence, it is called "Treatise on Needling and Will/Intention". Zhang Zhaohuang stated: Once pathogens are removed, righteous Qi naturally recovers; within reducing excess, there is tonifying deficiency.)
Excess involves Qi entering; deficiency involves Qi exiting. (Deficiency requires filling; Qi entering makes it solid. Excess requires emptying; Qi exiting makes it deficient. This discusses the opening and closing of Qi.) Qi excess manifests as heat; Qi deficiency manifests as cold. (Tonify deficiency; feeling warmth upon needling indicates excess. Reduce excess; feeling cold upon needling indicates deficiency. This discusses the arrival of Yin-Yang Qi.) To enter and treat excess, open the needle aperture with the right hand. To enter and treat deficiency, close the needle aperture with the left hand. (Needle aperture refers to the space accommodating the needle. In general needling technique, the right hand holds the needle, and the left hand presses the acupoint. When inserting the needle to reduce excess, use the right hand to open the aperture to drain. When inserting the needle to tonify deficiency, use the left hand to close the aperture to tonify. Opening the aperture allows Qi to exit; closing it allows Qi to enter. This is the timing of tonification and reduction, harmonizing with the opening and closing of Qi. Zhang Zhaohuang stated: Opening and closing refer to San-Yang Qi originating from the Lower Jiao; Ying-Qi and Wei-Qi are generated from water and grain in the Middle Jiao. Using needles to extract Qi focuses on Ying-Qi and Wei-Qi, yet this treatise alone discusses Qi emerging from the Lower Jiao and Blood from the Middle Jiao. Observing the entry and exit/opening and closing of Qi generated in the Lower Jiao to perform tonification and reduction is another method. However, San-Yang Qi originates from the Kidney Water-Fu organ. The Kidney stores will/intention. Hence, it is called "Treatise on Needling and Will/Intention".)