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Huangdi asked, saying: 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; the opposite indicates disease. When food intake is abundant, Qi is excess; when food intake is scanty, Qi is deficient. This is the normal state; the opposite indicates disease. When the pulse is excess, Blood is excess; when the pulse is deficient, Blood is deficient. This is the normal state; the opposite indicates disease. The Emperor said: How does one become the opposite? Qibo said: Qi deficiency with body heat is called the opposite. Abundant food intake but scanty Qi is called the opposite. Scanty food intake but excessive Qi is called the opposite. Excessive pulse but scanty Blood is called the opposite. Deficient pulse but abundant Blood is called the opposite. Qi excess with cold body results from contracting Cold Injury (Shanghan). Qi deficiency with body heat results from contracting Summerheat Injury (Shangshu). Those with abundant food intake but scanty Qi result from prior severe blood loss, with dampness residing in the lower part. Those with scanty food intake but excessive Qi result from pathogenic factors remaining in the Stomach and Lung. Deficient pulse with abundant Blood results from hot fluids retained within. Excessive pulse with scanty Blood results from Wind pathogen in the pulse, inability to ingest water or soup; this is what is meant. What is called Excess is Qi entering inward; what is called Deficiency is Qi exiting outward. Qi excess manifests as Heat; Qi deficiency manifests as Cold. For treating Excess, the left hand opens the needle aperture (to vent Qi). For treating Deficiency, the left hand closes the needle aperture (to secure Qi).

Huangdi asked, saying: I wish to understand the explanation of the Nine Needles (Jiu Zhen) and the principles of deficiency and excess. Qibo said: To tonify deficiency, one must achieve a sensation of heat under the needle, because Qi excess generates heat. To drain fullness, one must achieve a sensation of cold under the needle, because Qi deficiency generates cold. To remove stagnation and old accumulation means to evacuate evil blood. To weaken excessive pathogens, do not press the needle hole upon withdrawal. Slow withdrawal and rapid pressing tonifies (Xu Chu Ji An). Rapid withdrawal and slow pressing reduces (Ji Chu Xu An). Speaking of Excess and Deficiency refers to the degree of Cold and Warmth Qi. Speaking of "as if there were not" refers to the unpredictability of the disease. Observing sequence and priority means understanding the chronological order of the disease. Treating deficiency and excess requires that the practitioner does not lose the method. Feeling gain or loss implies deviation from the method. The essence of deficiency and excess lies in the Nine Needles being most excellent, as each has its specific suitability. The timing of tonification and reduction corresponds with the opening and closing of Qi. The names and shapes of the Nine Needles differ because they exhaust the sites requiring tonification or reduction. To treat Excess until it becomes Deficient (pathogen removed), retain the needle until Yin Qi arrives abundantly, then remove the needle. To treat Deficiency until it becomes Excess (Zheng Qi returns), wait until Yang Qi arrives abundantly and the needle feels hot, then remove the needle. Once Jing Qi has arrived, guard it carefully without losing it; do not change techniques. Depth is determined by intention to know whether the disease is internal or external. Distance and nearness are consistent, meaning the depth of sensing Qi is equal regardless of location. Being like standing at the edge of an abyss means not daring to be lazy. Hands like holding a tiger imply a desire for strength/steadiness. Spirit not engaged with myriad objects means calming the mind to observe the patient, without looking left or right. Inserting the needle upright and without deviation implies a desire for seriousness and correctness. One must rectify the patient's Shen (Spirit) by gazing into their eyes to restrain their spirit, making Qi flow easily. "Sanli" refers to three cun below the knee. "Fu" refers to lifting the knee where it is easily visible. "Juxu" refers to the depression seen when standing on tiptoes. "Xialian" refers to the depressed area. The Emperor said: I have heard that the Nine Needles correspond to Heaven, Earth, Four Seasons, and Yin-Yang. I wish to hear the methods so they may be passed down to posterity as constants. Qibo said: One Heaven, Two Earth, Three Person, Four Seasons, Five Tones, Six Pitch-pipes, Seven Stars, Eight Winds, Nine Fields; the human body also corresponds to these. Each needle has its suitability, hence called Nine Needles. Human skin corresponds to Heaven, flesh to Earth, vessels to Person, sinews to Seasons, voice to Tones, Yin-Yang combined Qi to Pitch-pipes, teeth and face to Stars, breath to Winds, nine orifices and 365 collaterals to Nine Fields. Thus, the first needle treats skin, second muscle, third vessel, fourth sinew, fifth bone, sixth regulates Yin-Yang, seventh benefits Essence, eighth dispels Wind, ninth opens nine orifices and eliminates 365 seasonal pathogens. This is what is meant by each having its master. Human intention corresponds to Eight Winds, human Qi to Heaven, hair, teeth, ears, eyes, and five sounds to Five Tones and Six Pitch-pipes, Yin-Yang vessels and Blood-Qi to Earth, Liver to Eyes, Eyes to nine orifices and 365 [collaterals]. One person observes movement and stillness; Two Heaven observes five colors; Seven Stars observe luster; Five Tones observe Gong, Shang, Jue, Zhi, Yu; Six Pitch-pipes observe surplus and insufficiency; Two Earth observes high/low and surplus; Nine Fields observe joints and acupoints to detect blockage; Three Person changes divide to observe teeth, leakage, much blood/little blood, ten parts, angle changes, five parts to observe slack/tight, six parts insufficiency, three parts cold joints, ninth part Four Seasons observe cold/warm/dry/damp, Four Seasons one observe opposition, Four Directions each make explanations.