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Huangdi asked: What are deficiency and excess? Qibo replied: When pathogenic factors are flourishing, it is termed excess; when essential qi is depleted, it is termed deficiency. Huangdi asked: How are deficiency and excess manifested? Qibo said: Qi deficiency corresponds to Lung deficiency; Qi rebellion manifests as cold feet. If this occurs during a time that does not clash (e.g., Spring does not overcome Autumn), the prognosis is favorable; if it occurs during a clashing time (e.g., Spring overcomes Autumn), the prognosis is fatal. The same principle applies to other Zang organs. Huangdi asked: What is called "double excess"? Qibo said: Double excess refers to a severe heat disease where Qi is hot and the pulse is full, which constitutes double excess. Huangdi asked: What if both the meridians and collaterals present with excess? How should it be treated? Qibo said: When both meridians and collaterals are in excess, the Cun position of the radial pulse is rapid/tight while the Chi position is slow/relaxed. Both require treatment. Therefore, a slippery pulse indicates compliance (favorable), while a choppy pulse indicates resistance (unfavorable). Deficiency and excess conditions are inferred from their corresponding categories. Thus, if the five Zang organs and bones/flesh are smooth and unobstructed, longevity can be achieved. Huangdi asked: What if the collateral Qi is insufficient while the meridian Qi is in excess? Qibo said: In cases where collateral Qi is insufficient and meridian Qi is in excess, the Kou position (radial artery at wrist) feels hot while the Chi area (wrist skin) feels cold. This pattern is unfavorable in Autumn and Winter but favorable in Spring and Summer. Treatment should target the primary diseased area. Huangdi asked: What if the meridian is deficient and the collateral is full? Qibo said: When the meridian is deficient and the collateral is full, the Chi area is hot and the pulse is full, while the Kou position is cold and choppy. Such patients die in Spring and Summer but survive in Autumn and Winter. Huangdi asked: How to treat these conditions? Qibo said: For collateral fullness and meridian deficiency, moxa the Yin meridians and needle the Yang meridians; for meridian fullness and collateral deficiency, needle the Yin meridians and moxa the Yang meridians. Huangdi asked: What is called "double deficiency"? Qibo said: When both the upper pulse Qi and the Chi position are deficient, it is called double deficiency. Huangdi asked: How to treat it? Qibo said: Qi deficiency is characterized by disordered speech. Chi deficiency is characterized by unsteady gait. Pulse deficiency is characterized by a lack of Yin-like softness. In such cases, a slippery pulse indicates life, while a choppy pulse indicates death. Huangdi asked: What if cold Qi suddenly rises and the pulse is full and excess? Qibo said: If the pulse is excess and slippery, there is survival; if excess and rebellious/unsmooth, there is death. Huangdi asked: What if the pulse is full and excess, yet the hands and feet are cold and the head is hot? Qibo said: Survival is possible in Spring and Autumn, but death in Winter and Summer. If the pulse is floating and choppy, accompanied by body heat, death ensues. Huangdi asked: What if the entire body is fully distended? Qibo said: In cases of total body distension, the pulse is rapid, large, and firm, while the Chi position is choppy and does not correspond to the Cun position. If the pulse complies (is smooth), there is survival; if it resists, there is death. Huangdi asked: What defines compliance leading to survival and resistance leading to death? Qibo said: Compliance means warm hands and feet. Resistance means cold hands and feet. Huangdi asked: If an infant suffers from heat disease and the pulse is suspended and small, what is the prognosis? Qibo said: Warm hands and feet indicate survival; cold hands and feet indicate death. Huangdi asked: If an infant contracts wind-heat, manifesting as wheezing with barking sounds and shoulder breathing, what is the pulse like? Qibo said: Wheezing with barking sounds and shoulder breathing typically presents with a large and excess pulse. A slow/relaxed pulse indicates survival; a rapid/tight pulse indicates death. Huangdi asked: Regarding Changpi (dysentery) with bloody stool, what is the prognosis? Qibo said: Body heat indicates death; absence of body heat indicates survival. Huangdi asked: Regarding Changpi with white mucus discharge, what is the prognosis? Qibo said: A sinking pulse indicates survival; a floating pulse indicates death. Huangdi asked: Regarding Changpi with pus and blood discharge, what is the prognosis? Qibo said: A suspended/extreme pulse indicates death; a slippery and large pulse indicates survival. Huangdi asked: Regarding Changpi-type diseases where the body is not hot and the pulse is not extreme, what is the prognosis? Qibo said: A slippery and large pulse indicates survival; a suspended and choppy pulse indicates death. The time of death can be predicted based on the associated Zang organ's seasonal correspondence. Huangdi asked: What about Dianji (epilepsy)? Qibo said: If the pulse is large and slippery, the condition will resolve spontaneously over time; if the pulse is small, firm, and urgent, it is fatal and untreatable. Huangdi asked: Regarding the pulse of Dianji, how do deficiency and excess manifest? Qibo said: Deficiency is treatable; excess is fatal. Huangdi asked: Regarding Xiaodan (wasting-thirst syndrome), how do deficiency and excess manifest? Qibo said: A large and excess pulse in a chronic case is treatable; a suspended, small, and firm pulse in a chronic case is untreatable.

Huangdi asked: How are Xingdu (body form), Guduo (bone structure), Maiduo (pulse characteristics), and Jinduo (tendon condition) assessed? Huangdi further stated: In Spring, one should urgently treat the meridians; in Summer, the acupoints; in Autumn, the Fu organs; and in Winter, the Qi and Blood are closed/stagnant. During periods of closure, medication is used rather than needles and stones. "Using few needles and stones" does not apply to Yongju (carbuncles and sores), as these cannot be delayed even for an instant. If the location of a carbuncle is unknown, pressing yields no response, and symptoms come and go, needle three points lateral to the Hand Taiyin Meridian and two points on the Ying Mai (neck arteries). For axillary carbuncles with high fever, needle five points on the Foot Shaoyang Meridian. If fever persists after needling, needle three points on the Hand Jueyin Pericardium Meridian, and three points each at the Hand Taiyin Meridian Luo point and the Hui-meeting point of the large bones. For sudden carbuncles causing tendon spasms and localized pain, with incomplete sweating and insufficiency of Baoqi (Bladder Qi), treatment should focus on the meridian acupoints. For sudden abdominal fullness that cannot be relieved by pressure, take the Luo point of the Hand Taiyang Small Intestine Meridian, which is the Mu-point of the Stomach (Zhongwan), and the Shushu point of the Foot Shaoyin Kidney Meridian, located three cun lateral to the spine and five cun lateral to the midline, using a Yuanli needle. For Huoluan (cholera-like disorder), needle five points beside the Back-Shu points, the Foot Yangming Stomach Meridian, and three points above the ankle. For treating epilepsy and惊厥 (convulsions), needle five points at the Maihui (Pulse Meeting) point, five points on the Hand Taiyin Lung Meridian, five points on the Foot Taiyang Bladder Meridian, one point beside the Hand Shaoyin Heart Meridian Luo, one point on the Foot Yangming Stomach Meridian, and three needles at five cun above the medial malleolus. Generally, treating Xiaodan, Pujì (sudden collapse), Piangu (hemiplegia), Weijue (flaccidity and cold limbs), and Qi man fa ni (chest fullness with rebellious Qi) often involves wealthy individuals who consume rich foods, constituting diseases caused by Gao Liang (rich and sweet foods). Ge sai bi jue (blockage and obstruction between upper and lower jiao) results from sudden excessive grief. Sudden jue (fainting) with deafness and unilateral blockage results from sudden internal Qi oppression. Diseases not caused by external wind or internal injury result in emaciation and lingering pathogens. Bo (limping) is caused by invasion of cold, wind, and dampness. Huangdi stated: Huangdan (jaundice), sudden pain, Dianji, Jue, and Kuang are generated by long-term Qi rebellion. Imbalance of the Five Zang organs arises from closure of the Six Fu organs. Headache, tinnitus, and dysfunction of the nine orifices arise from disorders of the intestines and stomach.