诸本无篇字。马云。内论五脏之邪。故名篇。
上气喘 汗出 志云。上气喘者。肺气逆也。
膺中外 马云。云门、中府等穴。
背三节五藏之旁 藏、张本作节。马云。背三节旁之肺俞。及五椎旁之心俞穴。志云。乃肺俞旁之魄
户也。简案、甲乙作背三椎之旁。乃谓肺俞。甲乙为是。原注颧字当作 。史音 。音椎可证。
按之快然 张云。觉快爽者。即其真穴。
取之缺盆中以越之 张云。缺盆、足阳明经穴也。手太阴之脉。上出于此。故当取之。以散越肺邪。
但忌大深。令人逆息。志云。缺盆中者。手阳明经之扶突。盖从腑以越阴脏之邪。
邪在肝（止）时脚肿 张云。两胁中痛。肝之经也。寒中水乘脾胃也 恶血在内。肝所主也。行善牵掣
其关节。肝主筋而邪居之也。肝经自足大趾上内联踝。故时为脚肿。甲乙。掣、作 。简案、掣纵、又作 。
知二字义同。
取耳间青脉 以去其掣 甲乙。掣、作 。张云。足少阳经循耳前后。足厥阴主诸筋。而与少阳为
表里。故取耳间青脉。可以去掣节。志云。耳间青脉。一名鸡足青。简案、甲乙 脉。一名资脉。在耳本后。
鸡足青络脉。盖谓此穴。
阳气有余 阴气不足 简案、诸注以阴阳分说脾胃。恐非。
阴痹 马云。阴痹者。痛无定所。按之而不可得。即痹论之所谓以寒胜者为痛痹也。（后世以为白虎
历节风又曰痛风）志云。在外者筋骨为阴。病在阴者名曰痹。阴痹者。病在骨也。按之而不得者。邪在骨髓也。
简案、至真要大论云。阴痹者按之不得。即是。
肩背颈项痛时眩 马云。此皆膀胱经脉所行。以肾与膀胱为表里也。且时时眩晕。亦兼膀胱与肾邪也。
喜悲 马云。本神篇曰。心气虚则悲。然实则亦然。
调之其输也 马云。邪客篇曰。少阴心脉也。心者五脏六腑之大主也。精神之所舍也。其脏坚固。邪
弗能容也。容之则心伤。心伤则神去。神去则死矣。故诸邪之在心者。皆在心之包络。包络者。心主之脉也。
故独无 焉。其外经病而内不病。故独取其经于掌后锐骨之端。
All versions lack the character "Pian" (Chapter). Ma Yun states that this chapter discusses the pathogenic factors of the five Zang organs, hence the title.
Wheezing with upward qi and sweating. Zhang Zhicong comments: Upward wheezing is caused by rebellious Lung Qi.
Anterior chest lateral region. Ma Yun points out that this refers to acupoints such as Yunmen (LU 2) and Zhongfu (LU 1).
Lateral to the three vertebrae in the back, beside the Shu points of the five Zang organs. The character "Zang" is written as "Jie" (vertebra) in Zhang's edition. Ma Yun explains it as the Feishu (BL 13) point lateral to the third thoracic vertebra, and Xinshu (BL 15) point lateral to the fifth thoracic vertebra. Zhang Zhicong comments that this refers to Pohu (BL 42), which is lateral to Feishu. Jian An notes: *Jia Yi Jing* writes "lateral to the third thoracic vertebra," referring to Feishu. *Jia Yi Jing* is correct. The character "Quan" in the original annotation should be "Zhui" (vertebra). Shi Yin's phonetic notation confirms that "Zhui" is pronounced similarly to "Zhui."
Feeling comfortable and relieved upon pressure. Zhang Jingyue comments: The area that feels relieving and pleasant is the true acupoint.
Needle at Quepen (ST 12) to disperse the pathogen. Zhang Jingyue comments: Quepen belongs to the Foot-Yangming Stomach Meridian. The Hand-Taiyin Lung Meridian emerges upwards from this location; therefore, one should needle here to disperse Lung pathogens. However, deep insertion must be avoided, as it may cause rebellious breathing. Zhang Zhicong comments: The center of Quepen refers to Futu (LI 18) of the Hand-Yangming Large Intestine Meridian. This likely involves dispersing Yin Zang pathogens via the Fu meridians.
Pathogen in the Liver... Occasional swelling of the feet. Zhang Jingyue comments: Pain in the middle of both hypochondria is along the Liver Meridian. Cold invading internally allows Water to overact on the Spleen and Stomach. Stasis of evil blood within is governed by the Liver. Walking causes pulling sensations in the joints because the Liver governs the tendons, and the pathogen resides there. The Liver Meridian ascends from the medial side of the big toe and connects internally to the ankle; thus, foot swelling occurs occasionally. *Jia Yi Jing* writes "Che" (pulling/spasm) as a variant character. Jian An notes: "Che Zong" are synonymous, also written as another variant. These two characters have the same meaning.
Select the blue vessels between the ears to remove the spasm. *Jia Yi Jing* writes "Che" as a variant. Zhang Jingyue comments: The Foot-Shaoyang Gallbladder Meridian circulates around the front and back of the ear. The Foot-Jueyin Liver Meridian governs all tendons and forms an interior-exterior relationship with Shaoyang. Therefore, selecting the blue vessels between the ears can relieve joint spasms. Zhang Zhicong comments: The blue vessels between the ears are also known as "Ji Zu Qing" (Chicken-Foot Blue). Jian An notes: In *Jia Yi Jing*, this vessel is also named "Zi Mai," located behind the root of the ear. The so-called "Chicken-Foot Blue collateral" likely refers to this specific point/area.
Excess Yang Qi, Deficiency Yin Qi. Jian An notes: Various annotations divide Yin and Yang to explain the Spleen and Stomach separately, which is likely incorrect.
Yin Bi (Obstruction Syndrome). Ma Yun explains: Yin Bi is characterized by pain without a fixed location, and pressing cannot locate the pain. This corresponds to what is called "Tong Bi" (Painful Bi) caused by Cold dominance in the *Bi Lun* chapter. (Later generations referred to this as White Tiger Wandering Joint Wind, or Gout.) Zhang Zhicong comments: Exterior筋骨 (muscles and bones) belong to Yin. Disease in Yin is called Bi. Yin Bi means the disease is in the bone. Pressing and not finding relief indicates the pathogen is in the marrow. Jian An notes: *Su Wen: Zhi Zhen Yao Da Lun* states, "In Yin Bi, pressing yields no relief." This matches exactly.
Pain in the shoulder, back, neck, and nape, accompanied by occasional dizziness. Ma Yun explains: These are all areas traversed by the Bladder Meridian. Since Kidney and Bladder are interior-exterior pairs, occasional dizziness also implies pathogenic factors in both the Bladder and Kidney.
Disposition towards sadness. Ma Yun cites the *Ben Shen* chapter: Deficiency of Heart Qi leads to sadness. However, Excess conditions can also cause this.
Regulate its Shu points. Ma Yun cites the *Xie Ke* chapter: The Shaoyin Heart pulse. The Heart is the great master of the five Zang and six Fu organs, the residence of Spirit. Its organ is solid, and pathogens cannot accommodate themselves within it. If they do, the Heart is damaged. If the Heart is damaged, Spirit departs. If Spirit departs, death ensues. Therefore, for any pathogens affecting the Heart, they reside in the Pericardium (Bao Luo). The Pericardium is the meridian of the Heart Master. Thus, the Heart itself does not directly suffer from external pathogens (implied context). If the exterior meridian is diseased but the interior organ is not, one should only select the point at the end of the sharp bone posterior to the palm (Shenmen, HT 7).