本经有《血气形志篇》，血气之立乎外者，为形；血气之存乎内者，为志。刺志者，得其内之所存以为刺
也。如形本乎气，气本乎谷，血本乎脉，而形气谷气血脉，有虚实常反之道，得其虚实常反而刺治之，斯为刺志也。
黄帝问曰∶愿闻虚实之要。
虚实之形，见于外；虚实之原，根乎内。故愿闻虚实之要，认为刺志之道。
岐伯对曰∶气实形实，气虚形虚，此其常也，反此者病。谷盛
气盛，谷虚气虚，此其常也，反此者病。脉实血实，脉虚血虚，此其常也，反此者病。
虚实之要，有常有反。人之形身，气为之主，故气实则形实，气虚则形虚，此虚实之常也。若反常也，气
实而形反虚，气虚而形反实，则病。人身之气，谷为之主，故谷盛则气盛，谷虚则气虚，
此其常也。若谷盛而气反虚，谷虚而气反盛，则病。人身之血，脉为之主，故脉实则血实，脉虚则血虚，
此其常也。若脉实而血反虚，脉虚而血反实，则病。
帝曰∶如何而反？
岐伯三言反此者病，故问如何而反。
岐伯曰∶气盛身寒，此谓反也。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。
气盛身寒，此谓反也，八字，古本简脱，今补。夫气实则形实，若气盛身寒，则气实形虚，此谓反也。
气虚则形虚，若气虚身热，则气虚形实，此谓反也。谷盛则气盛，若谷入多而气少，则谷盛气
虚，此谓反也。谷虚则气虚，若谷不入而气多，则谷虚气盛，此谓反也脉实则血实，若脉盛血少，则
脉实血虚，此谓反也。脉虚则血虚，若脉少血多，则脉虚血实，此谓反也。
气盛身寒，得之伤寒。气虚身热，得之伤暑。谷入多而气少者，得之有所脱血，湿居下也。谷
入少而气多者，邪在胃，及与肺也。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。
中，去声。承上文诸反而言其病。小，犹少也。大、犹盛也。
上文云气盛身寒，夫气盛身反寒，其内则得之伤寒之病。上文云气
虚身热，夫气虚身反热，其内则得之伤暑之病。上文云，谷入多而气少。夫谷入多而气反少者，其内则得之
有所脱血，或湿邪居下之病，脱血湿居下，故气少，病不在上，故谷入多。上文云，谷不入而
气多，夫谷入少而气反多者，其内必邪在胃。及于肺之病，肺胃有邪，故谷入少，病不在下，故气多。上文
云，脉少血多，夫脉小血反多者，其内必饮酒、中热之病。酒行络脉，故血多，行于外而虚于内，故脉小。
上文，云脉盛血少，夫脉大血反少者，其内必脉有风气，致水浆不入之病，风气乘于脉，故脉大，水浆不
入故血少。所谓反此者病，即此诸病之谓也。
夫实者，气入也。虚者，气出也。气实者，热也。气虚者，寒
也。入实者，右手开针空也。入虚者，左手闭针空也。
空，作孔。此言气之虚实，即为刺之虚实也。夫实者，乃气之内入也。虚者，乃气之外出也。气实者，
有余而热也。气虚者，不足而寒也。入针刺其实者，右手开针孔以泻之也。入针刺其虚者，
左手闭针孔以补之也。此气之虚实，即为刺之虚实也。合常反虚实，刺得其宜，斯为刺志也。
The *Ben Jing* (i.e., the *Huangdi Neijing*) contains the chapter "Blood, Qi, Form, and Will" (*Xueqi Xingzhi Pian*), which states: What manifests externally from blood and qi is called "Form" (*Xing*); what resides internally within blood and qi is called "Will" (*Zhi*). The term "Stimulating the Will" (*Ci Zhi*) refers to acquiring knowledge of what resides internally in order to perform acupuncture. For instance, the form originates from Qi, Qi originates from Grain (nutritive essence), and Blood originates from the Vessels. There are laws regarding the normal correspondence or reversal of deficiency and excess among Form, Qi, Grain, Blood, and Vessels. By mastering these laws of normal and reversed deficiency/excess and treating them with acupuncture, one achieves "Stimulating the Will."
The Yellow Emperor asked: I wish to hear about the essentials of deficiency and excess.
The manifestations of deficiency and excess appear externally; their origins lie internally. Therefore, wishing to understand the essentials of deficiency and excess is to understand the way of Stimulating the Will.
Qibo replied: When Qi is excess, the Form is solid; when Qi is deficient, the Form is weak. This is the norm. Reversal of this indicates disease. When Grain intake is abundant, Qi is excess; when Grain intake is scant, Qi is deficient. This is the norm. Reversal of this indicates disease. When the Pulse is full, Blood is excess; when the Pulse is empty, Blood is deficient. This is the norm. Reversal of this indicates disease.
The essentials of deficiency and excess involve both norms and reversals. The human body is governed by Qi; thus, when Qi is excess, the Form is solid, and when Qi is deficient, the Form is weak. This is the normal state of deficiency and excess. If it deviates from the norm—where Qi is excess but the Form appears weak, or Qi is deficient but the Form appears solid—then disease occurs. The body's Qi is governed by Grain; thus, when Grain is abundant, Qi is excess, and when Grain is scant, Qi is deficient. This is the norm. If Grain is abundant but Qi is deficient, or Grain is scant but Qi is excess, then disease occurs. The body's Blood is governed by the Vessels; thus, when the Pulse is full, Blood is excess, and when the Pulse is empty, Blood is deficient. This is the norm. If the Pulse is full but Blood is deficient, or the Pulse is empty but Blood is excess, then disease occurs.
The Yellow Emperor said: How does such a reversal occur?
Since Qibo mentioned three times that "reversal of this indicates disease," the Yellow Emperor asked how exactly this reversal happens.
Qibo said: Qi is excess while the body is cold; this is called a reversal. Qi is deficient while the body is hot; this is called a reversal. Grain intake is abundant yet Qi is scant; this is called a reversal. No grain enters yet Qi is abundant; this is called a reversal. The Pulse is full/surging yet Blood is scant; this is called a reversal. The Pulse is small/deficient yet Blood is abundant; this is called a reversal.
"The eight characters 'Qi is excess, body is cold, this is called a reversal' were omitted in ancient texts and are now supplemented. When Qi is excess, the Form should be solid. If Qi is excess but the body is cold, it means Qi is excess but the Form is deficient; this is called a reversal. When Qi is deficient, the Form should be weak. If Qi is deficient but the body is hot, it means Qi is deficient but the Form is solid; this is called a reversal. When Grain is abundant, Qi should be excess. If Grain intake is abundant but Qi is scant, it means Grain is abundant but Qi is deficient; this is called a reversal. When Grain is deficient, Qi should be deficient. If no grain enters but Qi is abundant, it means Grain is deficient but Qi is excess; this is called a reversal. When the Pulse is full, Blood should be excess. If the Pulse is surging but Blood is scant, it means the Pulse is full but Blood is deficient; this is called a reversal. When the Pulse is empty, Blood should be deficient. If the Pulse is small but Blood is abundant, it means the Pulse is deficient but Blood is excess; this is called a reversal."
Qi is excess and the body is cold; this results from Cold Damage (*Shang Han*). Qi is deficient and the body is hot; this results from Heat Damage (*Shang Shu*). Those who consume much grain but have little Qi suffer from significant blood loss, or dampness residing in the lower part. Those who consume little grain but have abundant Qi have pathogenic factors in the Stomach and affecting the Lungs. A small pulse with abundant blood indicates heat from drinking alcohol. A large pulse with scant blood indicates wind pathogen in the vessels, leading to an inability to ingest fluids/water and gruel.
"Zhong" (middle) is pronounced with the departing tone here. This continues the previous discussion on various reversals to explain the pathology. "Small" implies scanty. "Large" implies surging/full.
Regarding the previous statement "Qi is excess, body is cold": Since Qi is excess but the body is cold, internally this is due to Cold Damage disease. Regarding "Qi is deficient, body is hot": Since Qi is deficient but the body is hot, internally this is due to Heat Damage disease. Regarding "Grain intake is abundant but Qi is scant": Since grain intake is abundant but Qi is scant, internally this is due to blood loss or dampness pathogen residing in the lower jiao. Because of blood loss and dampness in the lower part, Qi is scant; because the disease is not in the upper part, grain intake remains abundant. Regarding "Grain intake is scant but Qi is abundant": Since grain intake is scant but Qi is abundant, internally there must be pathogen in the Stomach extending to the Lungs. Because the Lung and Stomach have pathogens, grain intake is scant; because the disease is not in the lower part, Qi appears abundant. Regarding "Pulse is small, Blood is abundant": Since the pulse is small but Blood is abundant, internally this is due to alcohol consumption and internal heat. Alcohol travels through the collaterals, so Blood is abundant; it moves outward leaving the interior empty, so the pulse is small. Regarding "Pulse is surging, Blood is scant": Since the pulse is surging but Blood is scant, internally this is due to wind pathogen in the vessels causing an inability to ingest fluids. Wind pathogen attacks the vessels, so the pulse is surging; inability to ingest fluids leads to scant Blood. The phrase "reversal of this indicates disease" refers precisely to these conditions.
Excess refers to Qi entering inward. Deficiency refers to Qi exiting outward. Excess of Qi manifests as Heat. Deficiency of Qi manifests as Cold. To needle an Excess condition, the right hand opens the needle aperture. To needle a Deficiency condition, the left hand closes the needle aperture.
"Kong" (empty) refers to the hole/aperture. This passage explains that the deficiency and excess of Qi corresponds to the tonification and sedation techniques of acupuncture. Excess refers to Qi moving inward. Deficiency refers to Qi moving outward. Qi excess implies surplus and Heat; Qi deficiency implies insufficiency and Cold. When needling for Excess, the right hand opens the needle hole to sedate (drain). When needling for Deficiency, the left hand closes the needle hole to tonify (supplement). The deficiency and excess of Qi constitutes the deficiency and excess of the acupuncture technique. Combining the norms and reversals of deficiency and excess, and applying acupuncture appropriately, constitutes "Stimulating the Will."