论虚实常反，自是不易之理，不特针家为然。然即以针论，通篇惟
末后四语，其前毫与针刺之义无涉，不知何故以刺志名篇也。
黄帝问曰∶愿闻虚实之要。岐伯对曰∶气实形实，气虚形虚，此其常也，反此者病。（阴阳应象大论曰∶“形
归气。”由是故虚实同焉。反谓不相合应，失常平之候也。形气相反故病生，气谓脉气，形谓身形也。）谷盛
气盛，谷虚气虚，此其常也，反此者病。（灵枢经曰∶“荣气之道，内谷为宝，谷入于胃，气传与肺，精专者
上行经隧。”由是故谷气虚实，占必同焉。候不相应，则为病也。）脉实血实，脉虚血虚，此其常也，反此者
病。（脉者血之府，故虚实同焉。反不相应，则为病也。）
帝曰∶如何而反？岐伯曰∶气盛身寒，气虚身热，此谓反也。（按∶气为阳，阳盛则火胜而身宜热，今不
热而反寒，阳虚则火衰而身应凉，今不凉而反热，是病证乖舛，为反常也。按气盛身寒四字，王本所无，甲乙
经载之，与下文相应，是也，今增入之。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。按∶气多气少，惟谷是视，脉盛脉衰，惟血是分，相反若此，必有故矣。）
气盛身寒，得之伤寒。气虚身热，得之伤暑。（伤谓触冒也。寒伤形，故气盛身寒；热伤气，故气虚身热。
按∶寒则收引而无汗，气闭于内，故气盛而身寒。暑则多汗而气泄，火气外达，故气虚而身热。身寒者治用
辛甘，身热者药尚甘凉，此伤寒伤暑之大旨。证虽似反，而其病则可治。辨之不审，则害不胜言也）
谷入多而气少者，得之有所脱血，湿居下也。（按∶血脱则气泄，湿居下则火炎上，气泄则谷不能化气，
火炎上则善食而瘦，故谷虽多而气少也。谷入少而气多者，邪在胃及与肺也。按∶邪入肺胃，则气壅盛。胃
为邪踞，故谷不入而气多也。）脉小血多者，饮中热也。（饮谓留饮也。按∶饮停则化而为热。脉小者，
正气不足。血多者，非真有余，热所激也。）脉大血少者，脉有风气，水浆不入，此之谓也。（按∶风气辏泊，
令血枯干，木邪乘胃，故脉见洪大而证见血少，更且水浆不入也。注言水浆不入于脉，误矣。）
夫实者气入也，虚者气出也。（入为阳，出为阴。阴生于内故出，阳生于外故入。）气实者热也，气虚者寒
也。（阳盛而阴内拒，故热；阴盛而阳外微，故寒。按∶邪气入则实，正气出则虚。虚必寒，实必热，自然之
理也。）
入实者，左手开针孔也；入虚者，左手闭针孔也。言用针之补泻也。右手持针，左手捻穴。故实者右手开
针孔以泻之，虚者左手闭针孔以补之也。（按∶本篇以刺志为名，然自此节以前，并无一字论针。其论针者，惟
此节而已。本非针家妙旨，姑存之，以见名篇之意耳。）
论述虚实往往相反，这是不可改变的道理，不仅针灸医生是这样认为。然而仅就针刺而言，全篇只有最后四句话涉及毫针和针刺的意义，前面的内容都与针刺无关，不知道为什么要用“刺志”作为篇名。
黄帝问道：我想了解虚实的要领。岐伯回答说：气实则形体充实，气虚则形体虚弱，这是正常情况，与此相反的则是病态。（《阴阳应象大论》说：“形归属于气。”因此虚实是相同的。所谓“反”，是指不相符合，失去了平常的状态。形体与气相反，所以生病，这里的气指脉气，形指身形。）饮食充足则气盛，饮食不足则气虚，这是正常情况，与此相反的则是病态。（《灵枢经》说：“营气的运行之道，以内含的谷气为宝，谷气进入胃中，气传导给肺，精纯的部分上行于经脉隧道。”因此谷气和气的虚实，占候必然相同。如果征候不相应，就是疾病。）脉象实则血液实，脉象虚则血液虚，这是正常情况，与此相反的则是病态。（脉是血液汇聚之所，所以虚实相同。如果不相应，就是疾病。）
黄帝说：怎样才是相反的情况？岐伯说：气盛而身体寒冷，气虚而身体发热，这叫做相反。（按：气属于阳，阳盛则火旺而身体应当热，现在不热反而寒；阳虚则火衰而身体应当凉，现在不凉反而热，这是病证乖谬，属于反常。按“气盛身寒”这四个字，王冰注本中没有，《甲乙经》记载了它，与下文相应，是正确的，现在增补进去。进食多而气少，这叫做相反。进食少而气多，这叫做相反。脉象盛大而血少，这叫做相反。脉象微弱而血多，这叫做相反。按：气多气少，只看饮食如何；脉盛脉衰，只看血液多少，相反到这种地步，一定有原因了。）
气盛身寒，是由于感受伤寒所致。气虚身热，是由于感受伤暑所致。（“伤”意为触冒。寒邪伤害形体，所以气盛身寒；热邪伤害气，所以气虚身热。按：寒邪导致收敛无汗，气闭郁于内，所以气盛而身寒；暑邪导致多汗而气泄，火气外达，所以气虚身热。身体寒冷的治疗使用辛甘药物，身体发热的用药崇尚甘凉，这是伤寒和伤暑的大致原则。证候虽然看似相反，但病情是可以治疗的。辨别如果不仔细，那么危害就不胜言说了。）
进食多而气少的，是由于失血或湿气居于下部所致。（按：血脱则气泄，湿气居于下部则火炎上，气泄则谷气不能转化为气，火炎上则容易饥饿但消瘦，所以虽然进食多但气少。进食少而气多的，是因为邪气在胃和肺。（按：邪气侵入肺胃，则气壅盛。胃被邪气占据，所以进食少而气多。）脉小但血多的，是因为体内有留饮化热。（“饮”指留饮。按：饮停聚则化为热。脉小，是正气不足。血多，并非真正的有余，是被热邪激发的结果。）脉大但血少的，是因为脉中有风气，且水浆不入，说的就是这种情况。（按：风气聚集，使血液枯干，木邪乘袭胃，所以脉见洪大而证见血少，并且水浆不入。注释说水浆不入于脉，是错误的。）
所谓的实证，是气入；所谓的虚证，是气出。（入为阳，出为阴。阴生于内所以出，阳生于外所以入。）气实表现为热，气虚表现为寒。（阳盛而阴在内抗拒，所以热；阴盛而阳在外微弱，所以寒。按：邪气入则为实，正气出则为虚。虚必寒，实必热，这是自然的道理。）
对于实证（气入），左手要张开针孔；对于虚证（气出），左手要闭合针孔。这是讲用针的补泻方法。右手持针，左手捻动穴位。所以实证时右手张开针孔以泻之，虚证时左手闭合针孔以补之。（按：本篇以“刺志”命名，但从这一节以前，没有一个字讨论针刺。讨论针刺的，只有这一节而已。这并不是针灸家的精妙旨意，姑且保留它，以显示篇名的用意罢了。）
The discussion on the frequent opposition between deficiency and excess is an unchangeable principle, not only applicable to acupuncturists. However, regarding acupuncture specifically, only the last four sentences of the entire chapter relate to the meaning of filiform needles and needling techniques; the preceding content has nothing to do with needling. It is unclear why the chapter is named "Ci Zhi" (Stirring Qi).
The Yellow Emperor asked: 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. Opposite to this indicates pathology. (*Yin Yang Ying Xiang Da Lun* states: "Form returns to Qi." Thus, deficiency and excess are consistent here. "Opposite" means non-correspondence, deviating from the normal equilibrium. Pathology arises when form and Qi oppose each other; here, Qi refers to pulse Qi, and Form refers to the physical body.) When food intake is abundant, Qi is excess; when food intake is scanty, Qi is deficient. This is the normal state. Opposite to this indicates pathology. (*Ling Shu Jing* states: "The way of Ying Qi treasures internal Gu Qi. Gu Qi enters the Stomach, Qi transmits to the Lung, and the pure essence ascends through the meridians." Thus, the deficiency or excess of Gu Qi and Qi must correspond. If signs do not correspond, it is disease.) When the pulse is excess, Blood is excess; when the pulse is deficient, Blood is deficient. This is the normal state. Opposite to this indicates pathology. (Pulse is the mansion of Blood, so deficiency and excess are consistent. Non-correspondence indicates disease.)
The Emperor asked: How does one become opposite? Qibo said: Qi excess with cold body, Qi deficiency with hot body—this is called opposite. (Commentary: Qi belongs to Yang. Yang excess leads to Fire dominance, making the body hot; now it is not hot but cold. Yang deficiency leads to Fire decline, making the body cool; now it is not cool but hot. This represents pathological contradiction and abnormality. Note: The phrase "Qi excess with cold body" is absent in Wang Bing's edition but recorded in *Jia Yi Jing*, corresponding to the following text, which is correct, so it is added here. Abundant food intake with little Qi—this is called opposite. Scanty food intake with much Qi—this is called opposite. Pulse surging with little Blood—this is called opposite. Pulse faint with much Blood—this is called opposite. Commentary: Whether Qi is abundant or scanty depends on food intake; whether the pulse surges or declines depends on Blood. Such opposites must have a cause.)
Qi excess with cold body results from Cold Injury (Shang Han). Qi deficiency with hot body results from Summerheat Injury (Shang Shu). ("Injury" implies exposure/contact. Cold damages the Form, hence Qi excess with cold body; Heat damages Qi, hence Qi deficiency with hot body. Commentary: Cold causes contraction and anhidrosis, trapping Qi internally, leading to Qi excess and cold body. Summerheat causes profuse sweating and Qi leakage, allowing Fire Qi to reach outward, leading to Qi deficiency and hot body. Treatment for cold body uses Acrid-Sweet herbs; treatment for hot body favors Sweet-Cool herbs. This is the general principle for Cold Injury and Summerheat Injury. Although symptoms seem opposite, the diseases are treatable. Failure to distinguish carefully leads to immeasurable harm.)
Abundant food intake with little Qi results from blood loss or Dampness residing below. (Commentary: Blood loss leads to Qi leakage; Dampness below leads to Fire flaming upward. Qi leakage prevents Gu Qi from transforming into Qi; Fire flaming upward causes hunger but emaciation. Hence, abundant food but little Qi. Scanty food intake with much Qi results from pathogenic factors in the Stomach and Lung. (Commentary: Pathogens invading Lung and Stomach cause Qi stagnation and abundance. The Stomach is occupied by pathogens, hence scanty food intake but much Qi.) Small pulse with much Blood results from retained fluid transforming into heat. ("Retained fluid" refers to Yin accumulation. Commentary: Fluid retention transforms into heat. A small pulse indicates insufficient righteous Qi. Much Blood is not true excess, but stimulation by heat.) Large pulse with little Blood results from Wind Qi in the pulse and inability to ingest water or gruel. (Commentary: Wind Qi aggregation dries up Blood, Wood pathogen attacks the Stomach, resulting in a surging pulse and blood-deficient symptoms, along with inability to ingest fluids. The annotation stating fluids do not enter the pulse is erroneous.)
Excess involves Qi entering; Deficiency involves Qi exiting. (Entering is Yang, Exiting is Yin. Yin originates internally, hence exiting; Yang originates externally, hence entering.) Qi excess manifests as Heat; Qi deficiency manifests as Cold. (Yang excess with Yin resisting internally causes Heat; Yin excess with Yang weak externally causes Cold. Commentary: Pathogenic entry constitutes Excess; Righteous Qi exit constitutes Deficiency. Deficiency must be Cold, Excess must be Heat; this is natural law.)
For Excess (Qi entering), the left hand opens the needle aperture; for Deficiency (Qi exiting), the left hand closes the needle aperture. This describes tonification and sedation via needling. The right hand holds the needle, the left hand manipulates the acupoint. Thus, for Excess, the right hand opens the aperture to sedate; for Deficiency, the left hand closes the aperture to tonify. (Commentary: Although this chapter is named "Ci Zhi," no word before this section discusses needling. Only this section discusses needling. This is not the profound essence of acupuncture masters; it is preserved tentatively to explain the chapter's title.)