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Huangdi asked: Heaven covers above, Earth supports below, all things are complete, and nothing is more precious than humans. Humans are born from the Qi of Heaven and Earth, and their formation follows the laws of the Four Seasons. Whether kings or commoners, everyone desires to preserve their form and avoid disease. However, people often do not understand the nature of diseases affecting their bodies, allowing pathogenic factors to linger and deepen over time, eventually attaching to the bone marrow. This causes me private concern. I wish to use acupuncture to eliminate these diseases; how should I proceed?

Qibo replied: The reason salt tastes salty is that its property causes moisture to exude from vessels; when a string breaks, its sound becomes hoarse and ruined; when wood rots, its leaves fall off; when a disease is deep-seated, the patient exhibits hiccups (Yue). If a person presents with these three signs, it is called "failure of the Zang-Fu organs." At this stage, medicinal drugs cannot cure it, and short needles are ineffective. This indicates that the skin and flesh have been damaged, and the Blood and Qi are chaotic and darkened.

Huangdi said: I pity the pain of the patients, and my mind becomes confused and disturbed, even more so than theirs. This disease cannot be treated arbitrarily, and if the people hear of such failures, they will consider the physicians cruel and harmful. What should be done?

Qibo said: Humans originate from the Earth, and their life is suspended from Heaven. When the Qi of Heaven and Earth combines, it is called "Human." Those who can align with the Four Seasons regard Heaven and Earth as their parents; those who understand the laws of all things are called "Son of Heaven" (Emperor). Heaven has Yin and Yang, and humans have twelve meridians (corresponding to the twelve months); Heaven has cold and heat, and humans have deficiency and excess patterns. One who can master the transformation of Heaven and Earth's Yin and Yang will not deviate from the Four Seasons; one who understands the principles of the twelve meridians cannot be deceived by even the wisest sages; one who can perceive the changes of the Eight Movements and the mutual overcoming of the Five Elements can enter and exit the Dao independently, chanting and exploring the subtlest details, seeing them as clearly as an autumn down.

Huangdi said: Humans have form, which does not depart from Yin and Yang. Heaven and Earth combine their Qi, dividing into Nine Regions and four seasons. The moon has waxing and waning, and the days have long and short lengths. All things arrive together, in numbers too great to count. Regarding the subtle manifestations of deficiency and excess, may I ask for the method?

Qibo said: Wood is felled by Metal, Fire is extinguished by Water, Earth is loosened by Wood, Metal is diminished by Fire, and Water is blocked by Earth. This applies to all things and cannot be exhausted. Therefore, there are five principles of acupuncture that can be displayed to the world, yet the common people share food and clothing without knowing them. First is regulating Shen (Spirit); second is knowing how to nourish the body; third is understanding the true nature of medicinal drugs; fourth is mastering the size and shape of bi-shi (stone needles); fifth is diagnosing the Zang-Fu organs and the state of Blood and Qi. Once these five methods are established, each has its priority. In modern times, practitioners treat deficiency by tonifying to make it full, and treat excess by draining to empty it. These are known to all ordinary craftsmen. However, regarding the principle of modeling after Heaven and Earth, responding dynamically, harmonizing with the patient like an echo, and following the pathology like a shadow—there are no ghosts or spirits involved; it is a solitary journey through the Dao.

Huangdi said: I wish to hear about this Dao.

Qibo said: The essence of acupuncture requires first regulating the Shen. After the condition of the five Zang organs is determined and the nine pulse positions are prepared, only then should one contemplate the needle insertion. When the myriad pulses show no abnormality and no ominous signs are heard, and internal and external factors are in harmony, without being misled by superficial forms, one can skillfully manipulate the flow of Qi and then apply treatment to the patient. Humans present with deficiency or excess patterns; one should not approach the "Five Deficiencies" lightly, nor stay away from the "Five Excesses." When the moment for needling arrives, there is no room for delay. Hand movements must be focused, needles bright and uniform. Calmly observe the meaning, watch for changes in Deqi (arrival of Qi). This is called "Mingming" (obscure/subtle), where the form is unknown. One sees Qi gathering like crows, Qi surging like grain, following its flight like birds, unaware of its source. Stillness resembles a drawn crossbow; action resembles releasing the trigger.

Huangdi asked: How does one identify deficiency? How does one identify excess?

Qibo said: To treat excess, wait until the pathogenic Qi subsides (becomes deficient); to treat deficiency, wait until the Healthy Qi returns (becomes sufficient). Once the Jing-Qi (Meridian Qi) has arrived, guard it carefully and do not lose it. Depth is determined by intention, and distance feels uniform. Proceed with caution as if facing an abyss, holding the hand steady as if grasping a tiger, and let the Shen not be distracted by external objects.