病成而变，不可不预。（成言病之本，变言病之标。标本不同，是谓之变。预，早识也。）风成为寒
热，（风，阳邪也，善行而数变。或并于里则阳虚，阳虚则外寒；或并于表则阳实，阳实生外热，因于
露风，乃生寒热，是风成而变为寒热也。）瘅成为消中，（瘅，热邪也。热积于内，当病为消中，善食易
饥也。）厥成为巅疾，（厥，逆气也。气逆于上，则或为疼痛，或为眩仆，而成顶巅之疾也，一曰气逆则神
乱，而病为巅狂。）久风为飧泄，（风从木化，久风不已，则脾土受伤，病为飧泄而下利清谷也。）
脉风成为疠。（风寒客于血脉，久而不去，则肤肉败坏，其病为疠。）病之变化，不可胜数。（此举风热之
邪，以见致病之概，其他变化百出，有不可以数计者，亦犹此也。）
凡治消瘅、仆击、偏枯、痿、厥、气满发逆、肥贵人，则高粱之疾也。（消瘅，热消也。仆击，暴仆
如击也。偏枯，半身不随也。痿，痿弱无力也。厥，四肢厥逆也。高粱，膏粱也。肥贵之人，每多
浓味。夫肥者令人热中，甘者令人中满，热蓄于内，多伤其阴，故为此诸病。）隔则闭绝，上下不通，则暴忧
之病也。（愁忧者，气闭塞而不行，故或上或下，致为痞隔，而水谷有不通也。）暴厥而聋，偏塞闭不
通，内气暴薄也。（暴厥，气暴逆也，此以内气之逆，暴有所簿而然，
薄，侵迫之谓。）不从内外中风之病，故瘦留着也。（有病不从内而外中风寒，藏蓄不去，则伏而为热，故致
燔烁消瘦。此以表邪留薄而着于肌肉、筋骨之间也。） 跛，寒、风、湿之病也。（足不可行谓之 ，
一足偏废谓之跛。此在下者，必风、寒、湿气之病也。 ，音只。跛，波上声。）黄胆暴痛，癫疾厥狂，久
逆之所生也。（此以气逆之久，而阴阳营卫有所不调，然后成此诸症，皆非一朝所致也。）五脏不平，六腑
闭塞之所生也。（六腑闭塞，则水谷无以化，津液无以行，精气失所养，故五脏有不平矣。）头痛耳鸣，九
窍不利，肠胃之所生也。（头耳九窍，皆手、足阳明经脉所及，故病由肠胃之所生，然“肠胃”二字，实兼六
腑为言，盖六腑俱属三阳，三阳偏于九窍也。）
人之欠者，卫气昼日行于阳，夜半则行于阴。阴者主夜，夜者卧。阳者主上，阴者主下。故阴气积
于下，阳气未尽，阳引而上，阴引而下，阴阳相引，故数欠。（欠者，张口呼吸，或伸臂展腰，以阴阳相引
而然也。夫阳主昼，阴主夜，阳主升，阴主降。凡人之寤寐，由于卫气。卫气者，昼行于阳则动而为寤，夜
行于阴则静而为寐。故人于欲卧未卧之际，欠必先之者，正以阳气将入阴分，阴积于下，阳犹未静，故阳欲
引而升，阴欲引而降，上下相引而欠由生也。今人有神疲劳倦而为欠者，即阳不胜阴之候。）阳气尽，阴气
盛，则目瞑；阴气尽而阳气盛，则寤矣。（卫气不得入于阴，当留于阳，留于阳则阳气满，阳气满则阳跷盛，
不得入于阴，则阴气虚而目不瞑矣。卫气留于阴，不得行于阳，留于阴则阴气盛，阴气盛则阴跷满，不得入
于阳，则阳气虚，故目闭也。觉与阳合，寐与阴并。寤多者魂强，寐久者魄壮。魂强者生之
徒，魄壮者死之徒。是皆阴阳盛衰之义。）泻足少阴，补足太阳。（卫气之行于阳者，自足太阳始，行于
阴者，自足少阴始。阴盛阳衰，所以为欠。又曰“肾主为欠”，故当泻少阴之照海，阴跷所出也；补太阳之
申脉，阳跷所出也。药法准此。）人之哕者，谷入于胃，胃气上注于肺，今有
故寒气与新谷气俱还入于胃，新故相乱，真邪相攻，气并相迎，复出于胃，故为哕。（人之水谷入胃，其精
微之气必上注于肺而后行于脏腑、荣卫。若中焦先有寒气，则新入之谷气凝聚而不行，气不行
则新故真邪，还留于胃；留则逆而上出，故为哕也。又曰“肺主为哕”，盖寒气上逆而为哕气，病于胃而主
于肺也。）补手太阴，泻足少阴。（手太阴，肺经也；足少阴，肾经也。寒气自下而升，逆则为哕，故当补肺于
上，以壮其气，泻肾于下，以引其寒。盖寒从水化，哕之标在胃，哕之本在肾也。）人之唏者，此阴气盛而
阳气虚，阴气疾而阳气徐，阴气盛而阳气绝，故为唏。（唏、欷同， 欷也，悲泣气咽而抽息
也。一云泣余声，一云哀而不泣曰唏。悲忧之气，生于阴惨，故为阴盛阳虚之候。又曰阴与阳绝，则阳不附
阴，故当补足太阳，泻足少阴，使刚柔相济，则乖者和矣。）补足太阳，泻足少阴。（亦是阳跷申脉，阴跷照
海也。）人之振寒者，寒气客于皮肤，阴气盛，阳气虚，故为振寒寒栗，补诸阳。（振寒者，身怯寒而振栗
也。补诸阳者，凡手、足三阳之原合及阳跷等穴，皆可酌而用之。）人之噫者，寒气客于胃，
厥逆从下上散，复出于胃，故为噫。（噫，嗳气也，如饱食息也。此与上文之哕，皆以寒气在胃而然。但彼
云“故寒气”者，以久寒在胃，言其深也；此云寒客于胃者，如客之寄，言其浅也。故厥逆之气从下上散，
则复出于胃而为噫也。）补足太阴、阳明，一曰补眉本也。（补足太阴、阳明二经，使脾胃气温，则客寒自
散而噫可除。眉本，即足太阳经攒竹穴，是亦补阳气也。）人之嚏者，阳气和利，满于心，出于鼻，
故为嚏。（阳气和平顺利而满溢于心，必上达于肺，故出于鼻而为嚏，然人有感于风寒而为嚏者，以寒邪束
于皮毛则阳气无从泄越，故嚏而上出，是嚏从阳而发，益又可知。仲景曰∶“欲嚏不能，此人肚中寒。”正
谓其阳虚也，故人病阳虚等症者，久无嚏而忽得之，则阳气渐回之佳兆也。）补足
太阳眉本，一曰眉上也。（凡阳虚于下，则不能上达而为嚏，补足太
阳之荣于眉本者，其名“攒竹”，又名“眉上”。盖太阳与肾为表里，所以补阴中之阳也。）人之 者，胃
不实则诸脉虚，诸脉虚则经脉懈惰，经脉懈惰则行阴用力，气不能复，故为 。（ ，懈惰貌，
不自持也。盖胃为五脏六腑之海，故胃不实则诸脉虚而懈惰生，再有行阴用力，则阳气益虚，故为 。
王实甫词云∶“ 着香肩。”即此义也。 ，音妥。）因其所在，补分肉间。（四体各有分部，胃者肉其应，
故当因病所在，补分肉间以壮其胃气。）人之哀而泣涕出者，心为五脏六腑之主也，目为宗脉之所聚，上液之
道也，口、鼻为气之门户也。故悲哀愁忧则心动，心动则五脏六腑皆摇，摇则宗脉感，宗脉感则液道开，液
道开故泣涕出焉。（宗，总也。凡五脏六腑之精气皆上注于目而为之精，故目为宗脉之所聚，又为上液之道。
气由口、鼻出入，故为气之门户，然气之所至，液必随之，如涎出于口，涕出于鼻，泣出于目，是皆上液之属
也。人之泣涕上出者，皆本乎心，盖心为五脏六腑之主，若悲哀忧愁动其心，则五脏六腑皆应而摇，脏腑摇
则宗脉皆应而动，动则液道开而泣涕所以出也。）液者，所以灌精濡空窍者也，故上液之道开则泣，泣不止则
液竭，液竭则精不灌，精不灌则目无所见矣，故名曰夺精。（精由液而化，孔窍得液而充，故以灌
精濡孔窍也。液去精伤则目昏以至渐无所见者，是夺其精也。世之因泣而丧目者，盖亦不少矣。）补天柱，
经挟颈。（天柱，足太阳膀胱经穴。其经挟颈项之后，又曰头中分也。）人之太息者，忧思则心系急，心
系急则气道约，约则不利，故太息以伸出之。（太息者，息长而大，即叹息也。约，犹束缚也。忧愁思虑则气
抑不伸而心系急，气道约，约则满闷于中，此叹息之不容已也。）补手少阴、心主、足少阳，留
之也。（手少阴，心经也。心主，手厥阴经也。足少阳，胆经也。助木火之脏，则阳气可舒，抑郁可解，故
皆宜留针补之。以针喻药，字字当体会入微。）人之涎下者，饮食入胃，胃中有热则虫动，虫动则胃
缓，胃缓则廉泉开，故涎下。（足阳明之脉出于口，胃中有热则虫动胃缓，故廉泉开而涎下。凡目之多泪，
鼻之多涕，亦皆因热而上液之道开也，有谓肺热甚则鼻涕出者，义亦犹此。）补足少阴。（肾为胃关，而脉
系于舌，故当补之以壮水制火，则液有所主而涎自止，脾强亦能制涎，不可泥也。）人之耳中鸣者，耳为
宗脉之所聚也，故胃中空则宗脉虚，虚则下溜，脉有所竭者，故耳鸣。（手足三阳、三阴之脉，皆
入耳中，故耳亦宗脉之所聚也。阳明为诸脉之海，故胃中空而宗脉虚，宗脉虚则阳气不升而下溜，下溜则
上竭，轻则为鸣，甚则为聋矣。然少阳太甚，壅窒为鸣者亦有之，但虚者渐而实者暴，虚者多而实者少，其
辨在有邪、无邪耳。学人当推展之。）补客主人，手大指爪甲上与肉交者也。（客主人，足少阳经穴，为手
足少阳、足阳明之会。手大指爪甲上者，手太阴之少商穴，为肺气所出之井，故皆当补之以助其阳气。）人
之自啮舌者，此厥逆走上，脉气辈至也。少阴气至则啮舌，少阳气至则啮颊，阳明气至则啮唇矣。（辈者，类
也。厥逆走上，则血涌气腾，至生奇疾。所至之处，各有其部，如少阴之脉行舌本，少阳之脉循耳
颊，阳明之脉环唇口。故或为肿胀，或为怪痒，各因其处随而啮之，不独止于舌也。）视主病者则补之。（
察主病之经以补之也。）凡此十二邪者，皆奇邪之走空窍者也。（不同常疾，故曰奇邪。）故邪之所在，
皆为不足。（惟正气不足，然后邪得乘之。《难经》曰∶“不能治其虚，安问其余？”则深意可知矣。）
故上气不足，脑为之不满，耳为之苦鸣，头为之苦倾，目为之眩。（倾者，沉重不能支也。）中气不足，
溲便为之变，肠为之苦鸣。（水由气化，故中气不足则溲便变常而或为黄赤，或为短涩，多由情欲劳倦，过
伤精气而然。昧者概认为火，鲜不误矣。且中气不足则浊气居之，故肠胃为之苦鸣也。）下气不足，则为
痿厥、心 。痿，足痿弱也。厥，四肢清冷也。 ，闷也。下气不足，则升降不交，故心气不舒而为闷 。）
补足外踝下留之。（此昆仑穴也，
为足太阳所行之经，凡于上、中、下气虚之病，皆可留针补之。）
Diseases undergo transformation after formation, which must be anticipated in advance. ("Cheng" refers to the root of the disease, "Bian" refers to the manifestation of the disease. When the root and manifestation differ, it is called "transformation". Yu means early recognition.) Wind pathogen transforming into cold-heat syndrome: (Wind is a Yang pathogen, agile and prone to rapid changes. If wind merges into the interior, it causes Yang deficiency, leading to exterior cold; if wind merges into the exterior, it causes Yang excess, generating exterior heat. Due to exposure to wind and dew, cold-heat symptoms arise. This is wind transforming into cold-heat.) Dan-re heat transforming into Xiao Zhong (Middle Jiao consumption): (Dan refers to heat pathogen. Heat accumulating internally leads to Xiao Zhong, characterized by excessive appetite and easy hunger.) Qi rebellion transforming into Dian top disease: (Jue refers to rebellious Qi. Qi rebelling upward may cause pain or dizziness and collapse, resulting in diseases of the vertex; alternatively, Qi rebellion causes mental disorder, leading to Dian Kuang [mania].) Long-standing wind transforming into Sun Xie (undigested food diarrhea): (Wind transforms according to Wood. Prolonged wind injures Spleen Earth, causing Sun Xie with diarrhea containing undigested food.) Wind entering meridians transforming into Li Feng (leprosy): (Cold-wind pathogens lodging in blood vessels for a long time cause skin and flesh decay, known as Li Feng.) The transformations of diseases are countless. (This lists wind-heat pathogens to illustrate the general pattern of disease causation; other myriad changes are incalculable, similar to this.)
Treating Xiao Dan [heat consumption], Pu Ji [sudden collapse], Pian Ku [hemiplegia], Wei [flaccidity], Jue [cold limbs], Qi Man Ni [fullness and rebellious Qi], and diseases of obese nobles belong to illnesses caused by rich foods (Gao Liang). (Xiao Dan refers to heat-type consumption. Pu Ji refers to sudden collapse as if struck. Pian Ku refers to hemiplegia. Wei refers to flaccid weakness. Jue refers to cold extremities. Gao Liang refers to rich, fatty, and sweet foods. Obese nobles often consume strong-flavored foods. Fatty foods cause heat accumulation in the center; sweet foods cause fullness in the center. Heat蓄积 internally damages Yin, causing these diseases.) Ge [diaphragm obstruction] with blockage and lack of communication between upper and lower parts is caused by sudden sorrow/worry. (Sorrow/worry blocks Qi mechanism, causing痞隔 [stagnation/blockage] and obstruction of water and grain passage.) Sudden Jue with deafness, and unilateral blockage/obstruction, are caused by sudden internal Qi invasion/rebellion. (Sudden Jue is sudden Qi rebellion, caused by internal Qi rebelling and being suddenly invaded/threatened; Bo means invasion/threat.) Diseases not caused by external wind-strike, but characterized by emaciation and lingering pathogens, are due to pathogens lingering in muscles and sinews. (Pathogens lodge internally without going out, transforming into heat, causing burning and emaciation. This is exterior pathogens lingering and invading muscles/sinews.) Bi [limping] is caused by cold, wind, and dampness. (Inability to walk is Bi; one-sided paralysis is also Bi. Lower limb issues are必定 caused by wind-cold-dampness. Bi sounds like 'zhi'. Limping sounds like 'bo'.) Jaundice with sudden pain, Dian [epilepsy], Jue, and Kuang [mania] are generated by long-term Qi rebellion. (Long-term Qi rebellion causes imbalance of Yin-Yang, Ying, and Wei, leading to these symptoms, not occurring overnight.) Wuzang [Five Zang organs] imbalance is generated by Liufu [Six Fu organs] obstruction. (Liufu obstruction prevents digestion of water/grain and movement of Jin Ye [body fluids], depriving Jing Qi [essence-Qi] of nourishment, causing Wuzang imbalance.) Headache, tinnitus, and poor function of the Nine Orifices are generated by Chang Wei [Stomach and Intestines]. (Head, ears, and Nine Orifices are reached by Hand-Foot Yangming meridians; thus, pathology arises from Changwei. "Changwei" here implies all Six Fu organs, as they belong to Three Yang meridians distributed to the Nine Orifices.)
Yawning occurs because Wei Qi [defensive Qi] travels in Yang during the day and in Yin at midnight. Yin governs night/sleep; Yang governs ascent/descent. Yin accumulates below, Yang remains above; Yin pulls down, Yang pulls up, causing frequent yawning. (Yawning involves opening the mouth or stretching arms/back, caused by Yin-Yang interaction. Yang governs day/ascent; Yin governs night/descent. Wakefulness/sleep depends on Wei Qi. Before sleep, Yang enters Yin, Yin accumulates below, Yang is restless; their interaction causes yawning. Fatigue-induced yawning indicates Yang failing to overcome Yin.) When Yang exhausts and Yin prevails, eyes close; when Yin exhausts and Yang prevails, one wakes. (If Wei Qi cannot enter Yin, it stays in Yang, causing Yang excess and Shenyang Qiao [Yang Heel Vessel] fullness, preventing eye closure. If Wei Qi stays in Yin, it causes Yin excess and Shenyin Qiao [Yin Heel Vessel] fullness, preventing eye opening. Awakening combines with Yang; sleep combines with Yin. Strong Hun [ethereal soul] indicates life; strong Po [corporeal soul] indicates death. This reflects Yin-Yang abundance/deficiency.) Drain Foot Shaoyin, Tonify Foot Taiyang. (Wei Qi enters Yang via Foot Taiyang and Yin via Foot Shaoyin. Yin excess/Yang deficiency causes yawning. "Kidney governs yawning," so drain Shaoyin's Zhaohai [Yin Qiao source] and tonify Taiyang's Shenmai [Yang Qiao source]. Medicinal principles follow this.) Hiccups occur when old cold and new food Qi clash in the Stomach. (Food essence should ascend to Lung. Old cold in Middle Jiao stagnates new food Qi, causing rebellion and hiccups. "Lung governs hiccups"; pathology is in Stomach but governed by Lung.) Tonify Hand Taiyin, Drain Foot Shaoyin. (Hand Taiyin is Lung meridian; Foot Shaoyin is Kidney meridian. Cold rises from below, causing hiccups. Tonify Lung above to boost Qi, drain Kidney below to guide cold. Cold transforms from Water; hiccups' branch is Stomach, root is Kidney.) Sighing occurs due to Yin excess and Yang deficiency, with fast Yin and slow Yang. (Xi [sighing] relates to sadness/crying, indicating Yin excess/Yang deficiency. Yin-Yang separation requires tonifying Taiyang and draining Shaoyin to harmonize.) Tonify Foot Taiyang, Drain Foot Shaoyin. (Tonify Shenmai [Yang Qiao], drain Zhaohai [Yin Qiao].) Chills/shivering occur when cold lodges in skin, causing Yin excess/Yang deficiency. Tonify all Yang meridians. (Chills indicate fear of cold. Tonify Hand/Foot Three Yang sources/combines and Yang Qiao points.) Belching occurs when cold lodges in Stomach, causing rebellious Qi to scatter upward. (Belching is like post-meal sighing. Unlike deep "old cold" in hiccups, this is superficial "lodged cold." Rebellious Qi exits Stomach as belching.) Tonify Hand Taiyin and Foot Yangming, or tonify Meiben [Zanzhu]. (Tonifying Taiyin/Yangming warms Spleen/Stomach, dispersing cold. Meiben is Zanzhu [Foot Taiyang], boosting Yang.) Sneezing occurs when Yang Qi is smooth and fills the Heart, exiting via Nose. (Smooth Yang fills Heart/Lung, exiting nose. Wind-cold sneezing is due to blocked Yang release. Zhang Zhongjing noted inability to sneeze indicates interior cold. Sudden sneezing in Yang deficiency signals Yang recovery.) Tonify Foot Taiyang Meiben [Zanzhu/Mei Shang]. (Lower Yang deficiency fails to reach head. Tonifying Zanzhu [Foot Taiyang/Kidney pair] boosts Yin-Yang.) Flaccidity/laziness occurs when Stomach Qi is weak, causing vessel emptiness and meridian laxity. (Stomach is Sea of Zang-Fu. Weak Stomach causes vessel emptiness. Physical exertion worsens Yang deficiency. "Leaning on fragrant shoulder" illustrates this.) Treat based on location, tonify muscle spaces. (Limbs correspond to Stomach/Muscles. Tonify local muscle spaces to boost Stomach Qi.) Crying/tearing results from Heart agitation affecting Zang-Fu. (Heart governs Zang-Fu; Eyes gather Zong Mai [major vessels]; Mouth/Nose are Qi gates. Sadness moves Heart, shaking Zang-Fu, activating Zong Mai, opening fluid pathways, causing tears.) Fluids nourish essence and orifices. Excessive crying depletes fluids and essence, causing blindness (Duo Jing). (Fluids transform essence. Depletion leads to vision loss. Many lose sight due to excessive weeping.) Tonify Tianzhu [Foot Taiyang]. (Tianzhu is Foot Taiyang point behind neck.) Sighing occurs when worry/tension tightens Xin Mai [Heart connection], constricting Qi pathway. (Deep breathing relieves constriction. Worry restricts Qi, causing胸闷 [chest fullness].) Tonify Hand Shaoyin, Pericardium, Foot Shaoyang, retaining needle. (Tonify Heart, Pericardium, Gallbladder to soothe Wood/Fire Yang, resolving depression. Needle retention mirrors medicinal action.) Drooling occurs when Stomach heat agitates parasites, relaxing Stomach and opening Lianquan. (Foot Yangming emerges at mouth. Heat relaxes Stomach, opening Lianquan. Similar to nasal/ocular discharge from heat.) Tonify Foot Shaoyin. (Kidney controls Stomach; meridians connect to tongue. Tonify Kidney to control Fire/Water, stopping drool. Spleen strength also helps.) Tinnitus occurs when Stomach emptiness causes Zong Mai deficiency, leading to sinking Qi. (All meridians enter ear. Yangming is Sea of Vessels. Empty Stomach causes vessel deficiency, Qi sinks, upper depletion causes tinnitus/deafness. Deficiency is gradual; excess is sudden.) Tonify Keyuren [Shangyang? Note: Text says Keyuren is GB21/SI19 area, but describes SI/Shangyang context? Text says Keyuren is GB meeting, and thumb nail corner is LI11/Shaoshang? Text says Shaoshang. Correcting: Tonify Keyuren [GB21] and Shaoshang [LU11]. (Keyuren is GB21, meeting of Shaoyang/Yangming. Shaoshang is LU11, Jing well point. Tonify to boost Yang.) Self-biting tongue/jaw/lip occurs due to rebellious Qi rising to specific meridians. (Rebellious Qi causes swelling/itching/biting along meridian paths: Shaoyin-tongue, Shaoyang-cheek, Yangmouth-lip.) Tonify the affected meridian. (Identify primary pathology meridian and tonify.) These twelve anomalies are Qi Xie [odd pathogens] affecting orifices. (Unlike common diseases, hence "Qi".) Pathogenic sites indicate deficiency. (Deficiency allows pathogen entry. Nan Jing: "Treat deficiency first.") Upper Qi deficiency causes brain emptiness, tinnitus, heavy head, dizziness. (Qing means heaviness/inability to support.) Middle Qi deficiency causes urinary/fecal abnormalities and intestinal borborygmi. (Qi transforms water. Middle deficiency alters excretion, often misdiagnosed as fire. Turbid Qi occupies empty space, causing bowel sounds.) Lower Qi deficiency causes Wei [flaccidity], Jue [cold limbs], and chest oppression. (Wei is leg weakness; Jue is cold limbs; Yun is oppression. Lower Qi failure disrupts ascending/descending, causing heart Qi stagnation.) Tonify Kunlun [Foot Taiyang], retain needle. (Kunlun is Foot Taiyang Jing stream point. Effective for upper/middle/lower Qi deficiency.)