经，经脉也。十二经脉，内通五脏六腑，外络三百六十五节，相
并为实，相失为虚，寒热阴阳，血气虚实，随其病之所在而调之，
是为《调经论》也。
黄帝问曰∶余闻刺法言，有余泻之，不足补之。何谓有余，何谓不足？
举刺法之泻有余、补不足以为问，盖欲调和其经脉也。
岐伯对曰∶有余有五，不足亦有五，帝欲何问？帝曰∶愿尽闻之。岐伯曰∶神有余有不足，气
有余有不足，血有余有不足，形有余有不足，志有余有不足，凡此十者，其气不等也。
神气血形志，各有有余，各有不足，凡此有余不足之气，不相同等，故于下文详论之。
帝曰∶人有精气津液，四肢九窍，五脏十六部，三百六十五
节，乃生百病；百病之生，皆有虚实。今夫子乃言有余有五，不足亦有五，何以生之乎？
百病之众，有余不足，不止于五，故言人身有五内之精，营运之气，腠理之津，骨属之液，手足
之四肢，上下之九窍，肝心脾肺肾之五脏。形体之十六部，谓两肘两臂两 两股，身之前后左右，
头之前后左右也。大谷小溪之三百六十五节，合之乃生百病。是百病之生，皆有虚实。今夫子乃言有余止
有五，不足亦止有五，凡此百病之众，果何以生之乎？
岐伯曰∶皆生于五脏也。夫心藏神，肺藏气，肝藏血，脾藏肉，肾藏志，而此成形。
下五脏，如字。百病之生，不外五脏，故皆生于五脏也。脏者，藏也。夫心藏神，则神有余不足，心
所主也。肺藏气，则气有余不足，肺所主也。肝藏血，则血有余不足，肝所主也。脾藏身形之肉，则形有余
不足，脾所主也。肾藏志，则志有余不足，肾所主也。合神气血肉志，而此成形，犹言此形乃成也。
志意通，内连骨髓，而成身形。五脏。
五脏，二字衍文，疑下有五脏误重于此。肾藏志，复藏精。脾藏意，复藏肉。志意通，则内连肾精之
骨髓，而成脾肉之身形，以明志通则髓通，意通则形通。推之于心，神通则脉通。推之于肺，
气通则魄通。推之于肝，血通则魂通。词虽未及，而意已该，贵学人之能善悟也。
五脏之道，皆出于经隧，以行血气，血气不和，百病乃变化而生，是故守经隧焉。
道，犹路也。五脏循行之路，皆从出于经脉之隧道，以行血气
于周身，血气不和，则百病乃变化而生，是故调经者，当守其经隧焉。
帝曰∶神有余不足何如？
伯言神有余有不足，气有余有不足，血有余有不足，形有余有
不足，志有余有不足，帝则一一以问。
岐伯曰∶神有余则笑不休，神不足则悲，血气未并，五脏安
定，邪客于形，洒淅起于毫毛，未入于经络也，故命曰神之微。
神藏于心，在志为喜，神有余则笑不休，心气有余也；神不足则悲，心气不足也。灵枢本神论云∶心气
虚则悲，实则笑不休。夫血气相并，内动五脏，为病则甚。若血气未并，五脏安定之时，虽
邪客于形身，洒淅起于毫毛，是为微邪，未入于经络也，故命曰神之微。犹言心主之神，外受微邪也。
帝曰∶补泻奈何？
不足则补，有余则泻，故论神气血形志之有余不足，皆问补泻奈何？
岐伯曰∶神有余，则泻其小络之血，出血，勿之深斥，无中其大经，神气乃平。神不足者，视其
虚络，按而致之，刺而利之，无出其血，无泄其气，以通其经，神气乃平。
中，去声，下同。小络，孙络也。神有余，则泻其孙络之血，然虽出血，勿之深斥。斥，开拓也。下
斥仿此。无中其大经，即勿之深斥之义。刺得其义，则神气乃平，此泻有余之法也。若神不足
者，视其不足之虚络，先按而致之，然后刺而利之，无出其血，无泄其气，以通其经，刺得其宜，则神气
乃平，此补不足之法也。
帝曰∶刺微奈何？
邪客于形，未入于经络，命曰神之微，故问刺微奈何？
岐伯曰∶按摩勿释，着针勿斥，移气于不足，神气乃得复。
刺微之法，当按摩勿释，使聚其气，着针勿斥，微泄其邪，移
气于不足之处而补之，则神气乃得复，此微泻兼补之法也。
帝曰∶善。气有余不足奈何？岐伯曰∶气有余则喘咳上气，不足则息
利少气，血气未并，五脏安定，皮肤微病，命曰白气微泄。
喘咳上气者，肺气内逆而有余，息利少气者，肺气内虚而不足。息利，鼻气出入也。本神论云∶肺气
虚，则鼻塞不利少气。实则喘喝胸盈仰息。当血气未并，五脏安定之时，若皮肤微病，命曰
白气微泄。白气，肺气也。肺主皮肤，故曰白气。微泄，犹言微虚也。
帝曰∶补泻奈何？岐伯曰∶气有余则泻其经隧，无伤其经，无
出其血，无泄其气。不足则补其经隧，无出其气。
肺气有余则气机内逆，故当泻其经隧，泻经隧者，通经脉之隧道，故必无伤其经，无出其血，无泄其
气，而肺气乃平，此泻有余之法也。若肺气不足，则当补其经隧，更当无出其气，此补不足之法也。
帝曰∶刺微奈何？
皮肤微病，命曰白气微泄，故问刺微奈何。
岐伯曰∶按摩勿释，出针视之，曰∶我将深之，适人必革，精
气自伏，邪气散乱，无所休息，气泄腠理，真气乃相得。
按摩勿释，使聚其气也，刺之极浅，故出针视之，其意若曰，皮肤微病，刺不可深，我将深之，适
人必革。适、及也。革、变也。谓深刺及人，血气虚微，必内变也。精气自伏者，精气退伏，
不濡空窍也。邪气散乱者，散乱于经，邪无从出也。无所休息者，正虚邪盛，病无已时也。惟刺之极浅，使
邪气泄于腠理，泄腠理者，从腠理而外泄也。经脉无伤，故真气乃相得，其意中之言若
此，此微泻兼补之法也。
帝曰∶善。血有余不足，奈何？岐伯曰∶血有余则怒，不足则
恐，血气未并，五脏安定，孙络水溢，则经有留血。
血有余而肝气盛则怒，血不足而肝气虚则恐。本神论云∶肝气虚则恐，实则怒。当血气未并，五脏安定之
时，若外有微邪，而孙络水溢，则经有留血。夫肝主冲任之血，热肉充肤，澹渗皮毛，今
外有微邪而水溢孙络，致经脉有留积之血矣。
帝曰∶补泻奈何？岐伯曰∶血有余则泻其盛经，出其血；不足
则视其虚经，内针其脉中，久留，而视脉大疾，出其针，无令血泄。
内，作纳，下同。中，如字。肝血有余，则泻其有余之盛经，而出其血，此泻有余之法也。肝血不足，
则视其不足之虚经，内针于其脉中，久留，而视脉大疾，然后出其针，久留出针，所以候气，
更当无令血泄，此补不足之法也。
帝曰∶刺留血奈何？
孙络水溢，则经有留血，故问刺留血奈何？
岐伯曰∶视其血络，刺出其血，无令恶血得入于经，以成其疾。
刺留血者，当视其在外之血络，而刺出其血，无令恶血得入于
经，以成其留血之疾，此微泻兼补之法也。
帝曰∶善。形有余不足奈何？岐伯曰∶形有余则腹胀，泾溲不
利。不足则四肢不用。血气未并，五脏安定，肌肉蠕动，命曰微风。
形肉有余，则土气壅滞，故腹胀而泾溲不利，形肉不足，则土气不达，故四肢不用。《本神》论云∶
脾气虚则四肢不用∶实则腹胀泾溲不利，当血气未并，五脏安定之时，风邪入于肌肉，则肌肉蠕动，
命曰微风，言微风在肌肉也。
帝曰∶补泻奈何？岐伯曰∶形有余则泻其阳经，不足则补其阳络。
阳经，阳明经也。阳络，阳明络也。形肉有余，则土气实，故泻阳明之经。泻经者，从内而出于外，此
泻有余之法也。形肉不足，则土气虚，故补阳明之络。补络者，从外而入于内，此补不足之法
也。
帝曰∶刺微奈何？
肌肉蠕动，命曰微风。故问刺微奈何？
岐伯曰∶取分肉间，无中其经，无伤其络，卫气得复，邪气乃索。
肌肉蠕动，当取刺于分肉间，分肉在经之外，络之内，故刺之内无中其经，外无伤其络，刺得其宜，
使卫气得复。卫气者，所以温分肉，充皮肤，肥腠理，司开阖者也。卫气得复，则邪气乃索。
索，消索也。此微泻兼补之法也。
帝曰∶善。志有余不足奈何？岐伯曰∶志有余则腹胀飧泄，不
足则厥。血气未并，五脏安定，骨节有动。
肾志有余则水气盛，故腹胀飧泄。肾志不足则生阳内虚，故厥。厥，手足逆冷也。本神论云∶肾
气虚则厥，实则胀，当血气未并，五脏安定之时，微邪伤肾，则骨节有动。有动，不安之意。
帝曰∶补泻奈何？岐伯曰∶志有余，则泻然筋血者。不足，则补其复溜。
然筋，即然谷，在足心斜上内侧两筋间，故曰然筋。肾志有余则泻然筋，出其血者，此泻有余
之法也。肾志不足，则补肾经之复溜。复溜，在内踝后上二寸。此补不足之法也。
帝曰∶刺未并奈何？
血气未并，五脏安定，骨节有动，故问刺未奈何？
岐伯曰∶即取之，无中其经，邪所乃能立虚。
血气未并，骨节有动之时，当即取之，使病无中其经，庶受邪
之所，乃能立虚。立虚者，使邪即去，毋容缓也。此微泻兼补之法也。
帝曰∶善。余已闻虚实之形，不知其何以生？
虚，不足也。实，有余也。神气血形志，各有有余不足之形，帝已闻之，而有余不足之形，
从何以生，故复问之。
岐伯曰∶气血以并，阴阳相倾，气乱于卫，血逆于经，血气离
居，一实一虚。
并，交并也。倾，欹也，不平也。气血交并，虚实乃生，故气血以并，则阴阳相倾，阴阳相倾，不得
其平，有气乱于卫而为气实者，有血逆于经而为血实者，有血气离居而为血虚气虚者。乱卫逆
经，实也。离居，虚也。故曰一实一虚。此血气虚实之大概也。
血并于阴，气并于阳，故为惊狂。血并于阳，气并于阴，乃为炅中。
中，如字。此即上文而申明之。血并于阴，是血逆于经也。气并于阳，是气乱于卫也。并阴并阳，血
气不平，故为惊狂。并阴则惊，并阳则狂也。血并于阳，是血离其居也。气并于阴，是气离其
居也。并阳并阴，血气离居，乃为炅中，炅，热也。血气离居，中生热也。
血并于上，气并于下，心烦惋善怒。血并于下，气并于上，乱而善忘。
此即并阳并阴、惊狂、炅中而申明之。血并于上，是血并于阳也。气并于下，是气并于阴也。不但炅中，
必有心烦惋善怒之病。血并于下，是血并于阴也。气并于上，是气并于阳也。不但惊狂，必有乱而喜忘之病。
帝曰∶血并于阴，气并于阳，如血气离居，是何者为实，何者为虚？
旧本如是二字相连，今改。血并气并，有实有虚，血气离居，有实有虚，故举血并于阴，气并于阳。如
血气离居，而问是何者为实，何者为虚？交并为实，亦有虚。离居为虚，亦有实。故复问之。
岐伯曰∶血气者，喜温而恶寒，寒则泣不能流，温则消而去
之，是故气之所并为血虚，血之所并为气虚。
恶，去声。泣，作涩，下同。承何实何虚之问，言实之所在，皆虚之所在，但有虚而无实也，如
人身血气者，喜温暖而恶寒冷，以寒冷则血气凝涩，不能流行，惟温暖则消而去之。消，不凝也。
去，流也。夫寒为虚，温为实。涩不能流，似乎实矣，然寒则为虚，不寒而温，似乎实矣，然消去为虚。是故
气之所并，气实也，而为血虚。血之所并，血实也，而为气虚。此实之所在，即虚之所在，但有虚而无实也。
帝曰∶人之所有者，血与气耳，今夫子乃言血并为虚，气并为虚，是无实乎？
帝谓有虚必有实，如岐伯血并为气虚，气并为血虚之言，岂但有虚而无实乎？
岐伯曰∶有者为实，无者为虚，故气并则无血，血并则无气，今血与气相失，故为虚焉。络
之与孙脉，俱输于经。血与气并，则为实焉。血之与气，并走于上，则为大厥，厥
则暴死，气复反则生，不反则死。
虚者，血气相失。实者，大厥暴死。是虚者固虚，而实者尤虚也。凡虚实之道，有者为实，无者为
虚，故气并则阴阳皆在于气而无血，血并则阴阳皆在于血而无气。今无血无气，是血与气相失，
相失，故为虚焉。人身血气，内外循行，各有其部，孙脉居外，络脉居中，经脉居内，络脉与孙脉之血
气，俱输于经，是血与气并，谓血与气并于经也，皆并于经，则为实焉。既并于经，则血之与
气，从经而并走于上，上而不下，则为大厥，厥则阴阳不相顺接，故一时暴死，若气复反于下则生，不反于
下则上厥下脱而死，是知血气相失，虚者固虚，而大厥暴死，则实者尤虚也。
帝曰∶实者何道从来？虚者何道从去？虚实之要，愿闻其故。
承上文之意，谓血气并走于上而为实者，从何道来？血气相失而为虚者，从何道去？去来虚实之要，
愿闻其故。
岐伯曰∶夫阴与阳，皆有俞会，阳注于阴，阴满之外，阴阳匀
平，以充其形，九候若一，命曰平人。
俞会者，五五二十五俞，六六三十六俞，与周身阴阳血气相会合也，夫阴与阳皆有俞会，从阳而阴，则
阳注于阴，从阴而阳，则阴满之外，阳注阴满，斯为阴阳匀平，阴阳匀平，则血气调和，以
Meridians refer to the meridian system. The twelve meridians internally connect with the five zang organs and six fu organs, and externally link with the three hundred and sixty-five joints of the body. When qi and blood are abundant, it manifests as excess syndrome; when deficient, it manifests as deficiency syndrome. Cold and heat, yin and yang, and the excess or deficiency of blood and qi are regulated according to the location of the disease. This is the main theme of the *Treatise on Regulating the Meridians* (Diao Jing Lun).
The Yellow Emperor asked: I have heard that in acupuncture methods, excess should be drained (Xie), and deficiency should be tonified (Bu). What constitutes excess? What constitutes deficiency?
This question regarding draining excess and tonifying deficiency in acupuncture aims to harmonize the meridians.
Qibo replied: There are five types of excess and five types of deficiency. Which one does Your Majesty wish to ask about? The Yellow Emperor said: I wish to hear them all. Qibo said: There is excess and deficiency of Shen (Spirit), Qi (Vital Energy), Blood, Xing (Form/Body), and Zhi (Will). These ten conditions involve unequal qi dynamics.
Shen, Qi, Blood, Xing, and Zhi each have states of excess and deficiency. Since these qi dynamics vary, they will be discussed in detail below.
The Yellow Emperor said: Humans possess essence, Jing (Essence), Jin Ye (Body Fluids), four limbs, nine orifices, five zang organs and sixteen parts, and three hundred and sixty-five joints, from which a hundred diseases arise. The generation of these diseases involves both excess and deficiency. Now you say there are only five types of excess and five types of deficiency. How do these numerous diseases arise?
The multitude of diseases involves more than five types of excess and deficiency. Here, "five" refers to the essence of the five internal organs, circulating qi, fluids of the interstices (Cou Li), fluids of the bones, the four limbs, the nine orifices above and below, and the liver, heart, spleen, lung, and kidney. The "sixteen parts" of the form refer to two elbows, two arms, two thighs (Bi/Gu), and the anterior/posterior and left/right aspects of the torso and head. The three hundred and sixty-five joints of the major valleys and small streams collectively give rise to a hundred diseases. Thus, all diseases involve excess and deficiency. Why did you say there are only five types of excess and deficiency?
Qibo said: They all originate from the five zang organs. The Heart stores Shen (Spirit), the Lung stores Qi, the Liver stores Blood, the Spleen stores flesh, and the Kidney stores Zhi (Will), thereby forming the physical body.
The term "xia" (below) is understood literally. The generation of diseases does not exceed the five zang organs; thus, they all originate from the five zang organs. "Zang" means to store. The Heart storing Shen means that excess or deficiency of Shen is governed by the Heart. The Lung storing Qi means that excess or deficiency of Qi is governed by the Lung. The Liver storing Blood means that excess or deficiency of Blood is governed by the Liver. The Spleen storing flesh means that excess or deficiency of Xing (Form) is governed by the Spleen. The Kidney storing Zhi means that excess or deficiency of Zhi is governed by the Kidney. Combining Shen, Qi, Blood, Flesh, and Zhi forms the body.
Zhi and Yi (Intent) are interconnected, linking internally to the bone marrow, thereby forming the physical body.
The characters "Wu Zang" (Five Zang) are likely interpolations. The Kidney stores Zhi and also Essence. The Spleen stores Yi and also flesh. The connection of Zhi and Yi links internally to the Kidney's essence and bone marrow, forming the Spleen's flesh and body, illustrating that when Zhi flows, Marrow flows, and when Yi flows, Form flows. Extending this to the Heart, when Shen flows, Mai (Vessels) flow. To the Lung, when Qi flows, Po (Ethereal Soul) flows. To the Liver, when Blood flows, Hun (Corporeal Soul) flows. Although not explicitly stated, the meaning is implied, relying on the student's ability to comprehend.
The pathways of the five zang organs all emerge from the meridians' tunnels to circulate blood and qi. When blood and qi are disharmonious, a hundred diseases change and arise. Therefore, one must guard the meridians' tunnels.
"Dao" (Path) is like a road. The pathways of the five zang organs emerge from the tunnels of the meridians to circulate blood and qi throughout the body. When blood and qi are disharmonious, diseases arise. Therefore, those regulating the meridians must maintain these tunnels.
The Yellow Emperor asked: How about excess and deficiency of Shen?
Qibo mentioned excess and deficiency of Shen, Qi, Blood, Xing, and Zhi, and the Yellow Emperor asked about each one.
Qibo said: Excess of Shen leads to incessant laughter; deficiency of Shen leads to sorrow. If blood and qi have not yet merged, and the five zang organs are stable, pathogenic factors reside in the exterior form, causing chills and goosebumps, but have not entered the meridians. This is called "minor Shen pathology."
Shen resides in the Heart and corresponds to joy. Excess of Shen causes incessant laughter due to Heart Qi excess; deficiency causes sorrow due to Heart Qi deficiency. The *Ling Shu: Ben Shen Lun* states: Deficiency of Heart Qi leads to sorrow, while excess leads to incessant laughter. If blood and qi merge and disturb the five zang organs internally, the disease becomes severe. However, if blood and qi have not merged and the five zang organs are stable, even if pathogenic factors affect the exterior form causing chills and goosebumps, this is minor pathogen, not yet in the meridians. Hence, it is called "minor Shen pathology," meaning the Spirit of the Heart is affected by minor external pathogens.
The Yellow Emperor asked: What are the methods for tonification and drainage?
Deficiency requires tonification; excess requires drainage. Thus, regarding the excess and deficiency of Shen, Qi, Blood, Xing, and Zhi, the method of tonification and drainage is questioned.
Qibo said: For excess of Shen, drain the blood of the small collaterals (Sun Luo). Allow bleeding, but do not puncture deeply, and avoid damaging the major meridians. Then Shen Qi will be balanced. For deficiency of Shen, observe the deficient collaterals, press to guide qi, then needle to promote flow. Do not cause bleeding or leak qi. Unblock the meridians, and Shen Qi will be balanced.
"Zhong" is pronounced as a departing tone. Small collaterals refer to Sun Luo (Branch Collaterals). For excess of Shen, drain the blood of the Sun Luo. Although bleeding occurs, do not puncture deeply. "Chi" means to expand. "Avoid damaging the major meridians" implies avoiding deep puncture. Proper needling balances Shen Qi; this is the method for draining excess. For deficiency of Shen, observe the deficient collaterals, press to gather qi, then needle to promote flow. Do not bleed or leak qi. Unblock the meridians. Proper needling balances Shen Qi; this is the method for tonifying deficiency.
The Yellow Emperor asked: How to treat minor pathology?
Pathogens residing in the exterior form without entering the meridians are called "minor Shen pathology." Thus, the method for treating minor pathology is asked.
Qibo said: Massage without releasing, insert the needle without deep thrusting. Shift qi to the deficient area, and Shen Qi will recover.
To treat minor pathology, massage continuously to gather qi. Insert the needle shallowly without deep thrusting to slightly drain the pathogen. Shift qi to the deficient area for tonification, and Shen Qi will recover. This is a method of minor drainage combined with tonification.
The Yellow Emperor said: Excellent. How about excess and deficiency of Qi? Qibo said: Excess of Qi leads to panting, coughing, and rebellious Qi. Deficiency leads to free breathing but shortness of breath. If blood and qi have not merged, and the five zang organs are stable, with slight skin pathology, it is called "minor leakage of White Qi."
Panting, coughing, and rebellious Qi indicate Lung Qi excess internally. Free breathing but shortness of breath indicates Lung Qi deficiency internally. "Xi Li" refers to nasal breathing. The *Ben Shen Lun* states: Deficiency of Lung Qi causes nasal congestion, difficulty breathing, and shortness of breath. Excess causes panting, chest fullness, and仰息 (looking up to breathe). When blood and qi have not merged and the five zang organs are stable, slight skin pathology is called "minor leakage of White Qi." "White Qi" refers to Lung Qi. The Lung governs the skin, hence "White Qi." "Minor leakage" means slight deficiency.
The Yellow Emperor asked: What are the methods for tonification and drainage? Qibo said: For excess of Qi, drain its Jing Sui (Meridian Tunnels). Do not damage the meridians, do not cause bleeding, and do not leak qi. For deficiency, tonify its Jing Sui. Do not leak qi.
Excess of Lung Qi causes internal rebellion of Qi mechanism. Therefore, drain the Jing Sui. Draining the Jing Sui means unblocking the meridian tunnels. One must not damage the meridians, cause bleeding, or leak qi, so that Lung Qi becomes balanced. This is the method for draining excess. For deficiency of Lung Qi, tonify the Jing Sui and ensure no qi is leaked. This is the method for tonifying deficiency.
The Yellow Emperor asked: How to treat minor pathology?
Slight skin pathology is called "minor leakage of White Qi." Thus, the method for treating minor pathology is asked.
Qibo said: Massage without releasing. Upon withdrawing the needle, look at the patient and say, "I will puncture deeply," but actually, the patient's reaction changes. Jing Qi naturally submerges, pathogenic qi scatters, having nowhere to rest. Qi leaks through the Cou Li, and True Qi becomes harmonious.
Continuous massage gathers qi. Puncture extremely shallowly. Upon withdrawing the needle, looking at the patient conveys the intent: "Skin pathology requires shallow puncture. I say I will go deep, but touching the body causes change." "Shi" means reaching. "Ge" means changing. Deep puncture affecting the body causes internal changes due to weak blood and qi. "Jing Qi naturally submerges" means Jing Qi retreats and fails to nourish the orifices. "Pathogenic qi scatters" means it scatters in the meridians with no exit. "Nowhere to rest" means righteous qi is deficient and pathogenic qi is strong, leading to endless disease. Only by extremely shallow puncturing can pathogenic qi leak through the Cou Li. Leaking through Cou Li means exiting outward. The meridians remain undamaged, so True Qi becomes harmonious. This is a method of minor drainage combined with tonification.
The Yellow Emperor said: Excellent. How about excess and deficiency of Blood? Qibo said: Excess of Blood leads to anger. Deficiency leads to fear. If blood and qi have not merged, and the five zang organs are stable, with water overflowing in the Sun Luo, stagnant blood remains in the meridians.
Excess of Blood with strong Liver Qi leads to anger. Deficiency of Blood with weak Liver Qi leads to fear. The *Ben Shen Lun* states: Deficiency of Liver Qi leads to fear, excess leads to anger. When blood and qi have not merged and the five zang organs are stable, if external minor pathogens cause water overflow in the Sun Luo, stagnant blood accumulates in the meridians. The Liver governs the Chong and Ren vessels' blood, warming muscles and filling the skin, permeating the hair follicles. With external minor pathogens causing water overflow in the Sun Luo, stagnant blood accumulates in the meridians.
The Yellow Emperor asked: What are the methods for tonification and drainage? Qibo said: For excess of Blood, drain the full meridians and release blood. For deficiency, observe the deficient meridians, insert the needle into the pulse, retain it for a long time, observe the pulse becoming large and rapid, then withdraw the needle. Do not allow blood to leak.
"Na" means to insert. "Zhong" is read as written. For excess of Liver Blood, drain the full meridians and release blood. This is the method for draining excess. For deficiency of Liver Blood, observe the deficient meridians, insert the needle into the pulse, retain it for a long time, observe the pulse becoming large and rapid, then withdraw. Long retention and withdrawal await qi arrival. Do not allow blood to leak. This is the method for tonifying deficiency.
The Yellow Emperor asked: How to treat stagnant blood?
Water overflow in the Sun Luo leads to stagnant blood in the meridians. Thus, the method for treating stagnant blood is asked.
Qibo said: Observe the blood collaterals, puncture to release blood. Do not allow evil blood to enter the meridians, preventing the formation of disease.
To treat stagnant blood, observe the external blood collaterals and puncture to release blood. Do not allow evil blood to enter the meridians, preventing stagnant blood disease. This is a method of minor drainage combined with tonification.
The Yellow Emperor said: Excellent. How about excess and deficiency of Xing (Form)? Qibo said: Excess of Xing leads to abdominal distension and difficult urination and defecation. Deficiency leads to inability to use the four limbs. If blood and qi have not merged, and the five zang organs are stable, with muscle twitching, it is called "minor wind."
Excess of flesh and muscle leads to stagnation of Earth Qi, causing abdominal distension and difficult urination/defecation. Deficiency of flesh and muscle leads to failure of Earth Qi to reach, causing inability to use the four limbs. The *Ben Shen Lun* states: Deficiency of Spleen Qi leads to inability to use the four limbs; excess leads to abdominal distension and difficult urination/defecation. When blood and qi have not merged and the five zang organs are stable, if wind pathogen enters the muscles, causing muscle twitching, it is called "minor wind," meaning minor wind resides in the muscles.
The Yellow Emperor asked: What are the methods for tonification and drainage? Qibo said: For excess of Xing, drain the Yang meridians. For deficiency, tonify the Yang collaterals.
Yang meridians refer to the Yangming meridians. Yang collaterals refer to the Yangming collaterals. Excess of flesh and muscle leads to solid Earth Qi, so drain the Yangming meridians. Draining meridians moves from interior to exterior. This is the method for draining excess. Deficiency of flesh and muscle leads to deficient Earth Qi, so tonify the Yangming collaterals. Tonifying collaterals moves from exterior to interior. This is the method for tonifying deficiency.
The Yellow Emperor asked: How to treat minor pathology?
Muscle twitching is called "minor wind." Thus, the method for treating minor pathology is asked.
Qibo said: Select points between the muscle bundles. Do not strike the meridians, do not damage the collaterals. When Wei Qi recovers, pathogenic qi dissipates.
For muscle twitching, select points between the muscle bundles. Muscle bundles are outside the meridians and inside the collaterals. Puncture such that it does not hit the meridians internally nor damage the collaterals externally. Proper needling restores Wei Qi. Wei Qi warms the muscle bundles, fills the skin, plumps the Cou Li, and controls opening and closing. When Wei Qi recovers, pathogenic qi dissipates. "Suo" means to dissipate. This is a method of minor drainage combined with tonification.
The Yellow Emperor said: Excellent. How about excess and deficiency of Zhi (Will)? Qibo said: Excess of Zhi leads to abdominal distension and incomplete defecation. Deficiency leads to Jue (Cold extremities/reversal). If blood and qi have not merged, and the five zang organs are stable, with movement in the bone joints.
Excess of Kidney Zhi leads to abundance of Water Qi, causing abdominal distension and incomplete defecation. Deficiency of Kidney Zhi leads to internal deficiency of generating Yang, causing Jue. Jue refers to cold extremities. The *Ben Shen Lun* states: Deficiency of Kidney Qi leads to Jue, excess leads to distension. When blood and qi have not merged and the five zang organs are stable, if minor pathogens injure the Kidney, there is movement in the bone joints. "Movement" implies instability.
The Yellow Emperor asked: What are the methods for tonification and drainage? Qibo said: For excess of Zhi, drain the blood of Ranjin (Rangu). For deficiency, tonify Fuliu.
Ranjin refers to Rangu, located diagonally upward on the medial side between two tendons above the sole of the foot. For excess of Kidney Zhi, drain Rangu and release blood. This is the method for draining excess. For deficiency of Kidney Zhi, tonify Fuliu of the Kidney meridian. Fuliu is located two cun above the posterior aspect of the medial malleolus. This is the method for tonifying deficiency.
The Yellow Emperor asked: How to treat non-merged states?
Blood and qi have not merged, the five zang organs are stable, and there is movement in the bone joints. Thus, the method for treating non-merged states is asked.
Qibo said: Immediately select points and needle. Do not strike the meridians. The site of the pathogen will immediately become empty.
When blood and qi have not merged and there is movement in the bone joints, immediately select points and needle. Ensure the disease does not strike the meridians. The site of the pathogen will immediately become empty. "Li Xu" means expelling the pathogen immediately without delay. This is a method of minor drainage combined with tonification.
The Yellow Emperor said: Excellent. I have heard the manifestations of excess and deficiency, but I do not know how they arise.
Deficiency is insufficiency. Excess is superabundance. Shen, Qi, Blood, Xing, and Zhi each have manifestations of excess and deficiency. The Yellow Emperor has heard of them, but asks how these manifestations arise.
Qibo said: When blood and qi merge, yin and yang tilt. Qi becomes chaotic in the Wei level, and Blood rebels in the Jing meridians. Blood and qi separate from their proper locations, resulting in one excess and one deficiency.
"Bing" means merging. "Qing" means tilting or imbalance. When blood and qi merge, excess and deficiency arise. Merging causes yin and yang to tilt, losing balance. Qi chaotic in the Wei level results in Qi excess. Blood rebelling in the Jing meridians results in Blood excess. Blood and qi separating from their locations result in Blood and Qi deficiency. Chaotic Wei and rebelling Jing are excess. Separation is deficiency. Thus, one excess and one deficiency. This is the general principle of blood and qi excess and deficiency.
When Blood merges into Yin and Qi merges into Yang, it leads to惊狂 (Fright and Mania). When Blood merges into Yang and Qi merges into Yin, it leads to Jiong Zhong (Internal Heat).
"Zhong" is read as written. This elaborates on the previous statement. Blood merging into Yin is Blood rebelling in the meridians. Qi merging into Yang is Qi chaotic in the Wei level. Merging into Yin and Yang causes blood and qi imbalance, leading to Fright and Mania. Merging into Yin causes Fright; merging into Yang causes Mania. Blood merging into Yang is Blood leaving its residence. Qi merging into Yin is Qi leaving its residence. Merging into Yang and Yin, with blood and qi separated from their locations, leads to Jiong Zhong. "Jiong" means heat. Separation of blood and qi generates internal heat.
When Blood merges upward and Qi merges downward, it causes vexation, resentment, and irritability. When Blood merges downward and Qi merges upward, it causes confusion and forgetfulness.
This elaborates on merging into Yang and Yin, Fright/Mania, and Internal Heat. Blood merging upward is merging into Yang. Qi merging downward is merging into Yin. Besides Internal Heat, there will be vexation, resentment, and irritability. Blood merging downward is merging into Yin. Qi merging upward is merging into Yang. Besides Fright and Mania, there will be confusion and forgetfulness.
The Yellow Emperor asked: Regarding Blood merging into Yin and Qi merging into Yang, and states like separation of blood and qi, what is excess and what is deficiency?
In old editions, these phrases were connected. Now corrected. Merging of blood and qi involves both excess and deficiency. Separation of blood and qi involves both excess and deficiency. Thus, citing Blood merging into Yin and Qi merging into Yang, and asking about separation of blood and qi, what is excess and what is deficiency? Merging is excess, but also involves deficiency. Separation is deficiency, but also involves excess. Thus, the question is repeated.
Qibo said: Blood and Qi prefer warmth and dislike cold. Cold causes stagnation and inability to flow; warmth causes dissolution and removal. Therefore, where Qi merges, Blood is deficient; where Blood merges, Qi is deficient.
"E" is pronounced as a departing tone. "Qi" means stagnation/astringency, read as "Se" below. Responding to the question of excess and deficiency, it states that where there is excess, there is also deficiency; there is only deficiency, no true excess. Human blood and qi prefer warmth and dislike cold. Cold causes stagnation and inability to flow. Warmth causes dissolution and removal. "Xiao" means non-stagnation. "Qu" means flow. Cold is deficiency, warmth is excess. Stagnation and inability to flow seem like excess, but cold is deficiency. Non-cold and warmth seem like excess, but dissolution is deficiency. Therefore, where Qi merges, Qi is excess, making Blood deficient. Where Blood merges, Blood is excess, making Qi deficient. Where there is excess is where there is deficiency; there is only deficiency, no excess.
The Yellow Emperor said: What humans possess is only blood and qi. Now you say blood merging leads to deficiency, and qi merging leads to deficiency. Is there no excess?
The Yellow Emperor argues that deficiency implies excess. If blood merging leads to qi deficiency and qi merging leads to blood deficiency, is there only deficiency and no excess?
Qibo said: That which exists is excess; that which is absent is deficiency. Thus, when Qi merges, Blood is absent; when Blood merges, Qi is absent. Now, blood and qi have lost each other, hence it is deficiency. Collaterals and Sun Luo all transport to the Jing meridians. When blood and qi merge, it is excess. If blood and qi merge and rush upward, it leads to Da Jue (Great Reversal). Jue leads to sudden death. If Qi returns, life is preserved; if not, death ensues.
Deficiency is the loss of blood and qi. Excess is Da Jue and sudden death. Thus, deficiency is indeed deficiency, and excess is even more critical. The principle of excess and deficiency is: existence is excess, absence is deficiency. When Qi merges, yin and yang are all in Qi with no Blood. When Blood merges, yin and yang are all in Blood with no Qi. Now, with no blood and no qi, blood and qi have lost each other, hence deficiency. Human blood and qi circulate internally and externally, each having its region. Sun Luo is external, Luo Mai is middle, Jing Mai is internal. Blood and qi from Luo Mai and Sun Luo all transport to Jing Mai. "Merging of blood and qi" means merging into the Jing meridians. All merging into Jing meridians constitutes excess. Having merged into the Jing meridians, blood and qi rush upward from the meridians and do not descend, leading to Da Jue. Jue means yin and yang fail to connect smoothly, causing sudden death. If Qi returns downward, life is preserved; if not, upper reversal and lower collapse lead to death. Thus, knowing that blood and qi have lost each other, deficiency is deficiency, but Da Jue and sudden death show that excess is critically deficient.
The Yellow Emperor asked: From where does excess come? From where does deficiency depart? I wish to hear the essence of excess and deficiency.
Continuing from the previous context, regarding excess caused by blood and qi rushing upward, from where does it come? Regarding deficiency caused by the loss of blood and qi, from where does it depart? I wish to hear the essence of their coming and going.
Qibo said: Yin and Yang both have Shu Hui (Acupoints of Convergence). Yang pours into Yin, and Yin overflows outward. Yin and Yang are balanced, filling the form. If the nine pulses are uniform, it is called a healthy person.
Shu Hui refers to the twenty-five Shu points of the five zang organs and the thirty-six Shu points of the six fu organs, converging with the body's yin and yang blood and qi. Yin and Yang both have Shu Hui. From Yang to Yin, Yang pours into Yin. From Yin to Yang, Yin overflows outward. Yang pouring and Yin overflowing create balance. Balanced yin and yang mean harmonized blood and qi, filling the form.