黄帝曰。气为上膈者。食饮入而还出。余已知之矣。虫为下膈。下膈者。食 时乃出。余未得其意。愿卒闻之。岐
伯曰。喜怒不适。食饮不节。寒温不时。则寒汁流于肠中。流于肠中则虫寒。虫寒则积聚。守于下管。则肠胃充郭。卫
气不营。邪气居之。人食则虫上食。虫上食则下管虚。下管虚则邪气胜之。积聚已留。留则痈成。痈成则下管约。其痈
在管内者。即而痛深。其痈在外者。则痈外而痛。浮痈上皮热。黄帝曰。刺之奈何。岐伯曰微按其痈。视气所行。先浅
刺其旁。稍内益深。还而刺之。无过三行。察其沉浮。以为深浅。已刺必熨。令热入中。日使热内。邪气益衰。大痈乃
溃。伍以参禁。以除其内。恬淡无为。乃能行气。后以咸苦。化谷乃下矣。（此句重在后字若早用咸苦则大误矣血得咸则
凝而苦又令人呕也）
陈义既高铸词亦洁源流俱备。使读者无简略之憾。
黄帝问于少师曰。人之卒然忧恚。而言无音者。何道之塞。何气出行。使音不彰。愿闻其方。少师答曰。咽喉者。
水谷之道也。喉咙者。气之所以上下者也。会厌者。音声之户也。口唇者。音声之扇也。舌者。音声之机也。悬雍垂者。
音声之关也。颃颡者。分气之所泄也。横骨者。神气所使。主发舌者也。故人之鼻洞涕出不收者。颃颡不开分气失也。
是故厌小而薄。则发气疾。其开阖利。其出气易。其厌大而浓。则开阖难。其气出迟。故重言也。人卒然无音者。寒气
客于厌。则厌不能发。发不能下至。（似当作上至）其开阖不致。故无音。黄帝曰。刺之奈何。岐伯曰。足之少阴。上系
于舌。络于横骨。终于会厌。两泻其血脉。浊气乃辟。会厌之脉。上络任脉。取之天突。其厌乃发也。
文体直而少。曲而事理颇精。唇口之内分析。功用莫详于此矣。尝论会厌关于督脉。读此乃自信其说之不误也。
Huangdi said: Regarding Qi causing upper Jie (obstruction in the upper digestive tract), where food and drink enter and are immediately vomited, I already understand this. Parasites cause lower Jie; in lower Jie, food is expelled long after eating. I do not yet grasp the underlying mechanism and wish to hear it explained thoroughly.
Qibo replied: Inappropriate emotions of joy or anger, irregular diet, and failure to adjust to cold and warmth lead to the flow of cold fluids into the intestines. When cold fluids flow into the intestines, parasites become cold. Cold parasites stagnate and accumulate, residing in the lower Guan (pylorus), causing fullness and distension of the stomach and intestines. Wei Qi (Defensive Qi) fails to circulate, allowing pathogenic factors to occupy the space. When a person eats, the parasites move upward to feed. As they feed upward, the lower Guan becomes deficient. Deficiency of the lower Guan allows pathogenic factors to prevail. The accumulated stagnation remains; prolonged retention leads to the formation of an abscess. Once the abscess forms, the lower Guan becomes constricted. If the abscess is within the lumen, pressure elicits deep pain. If the abscess is outside the lumen, there is an external swelling with pain, and superficial abscesses present with heat on the skin surface.
Huangdi asked: How should acupuncture be applied?
Qibo answered: Gently palpate the abscess area to observe the course of Qi and Blood. First, insert the needle shallowly around the periphery, then gradually deepen the insertion. Perform rotary manipulation. Do not exceed three needle insertions. Determine the depth of insertion based on the floating or sunken nature of the condition. After needling, apply moxibustion or warming therapy to ensure heat penetrates inward. Daily application of internal heat will cause pathogenic factors to decline, leading to the eventual rupture of large abscesses. Observe contraindications based on the Five Elements interactions to eliminate internal pathogens. Maintain a state of tranquility and non-action (Wu Wei) to facilitate the smooth flow of Qi. Subsequently, administer salty and bitter substances to help digest food and promote downward movement. (The emphasis of this sentence lies in the word "subsequently"; using salty and bitter agents too early would be a major error, as salt causes blood coagulation, and bitterness induces vomiting.)
The meaning here is profound, the diction concise, and the theoretical lineage complete, leaving no regret for brevity in the reader's mind.
Huangdi asked Shaoshi: Why does sudden grief or indignation cause aphonia (loss of voice)? Which pathway is obstructed? Which Qi mechanism malfunctions, preventing sound from resonating? I wish to hear the treatment method.
Shaoshi replied: The throat (Yanhou) is the passage for water and grain. The windpipe (Houlong) is the channel through which Qi ascends and descends. The epiglottis (Huiyan) is the gate of voice production. The lips are the fan that projects sound. The tongue is the mechanism of voice articulation. The uvula (Xuan Yong Chui) is the latch of voice. The nasopharynx (Hang Sang) is the outlet for divided Qi. The transverse bone (Heng Gu, referring to the hyoid bone/root of tongue) is directed by Shen Qi (Spirit Qi) and primarily governs tongue movement. Therefore, when nasal discharge flows freely without cessation, it is due to the failure of the nasopharynx to open and close properly, resulting in the loss of Qi division. Consequently, if the epiglottis is small and thin, Qi emission is rapid, opening and closing are agile, and exhalation is easy. If the epiglottis is large and thick, opening and closing are difficult, Qi emission is slow, resulting in a heavy voice. Sudden aphonia occurs when cold pathogens lodge in the epiglottis, preventing its movement; if it cannot move up and down, opening and closing fail to coordinate, resulting in silence. (The text "cannot move down" likely should read "cannot move up").
Huangdi asked: How should acupuncture be applied?
Qibo answered: The Foot-Shaoyin Kidney Meridian ascends to tie with the tongue, connects to the transverse bone, and terminates at the epiglottis. Bleed the vessels at these points to dispel turbid Qi. The meridians of the epiglottis ascend to connect with the Ren Mai (Conception Vessel). Needling Tian Tu (CV22) allows the epiglottis to function properly.
The style is direct yet subtle, with principles intricately detailed. The analysis of the structures within the mouth and lips is unparalleled in its thoroughness. I had previously argued for the connection between the epiglottis and the Du Mai (Governing Vessel); reading this confirms my theory is correct.