诸本无篇字。
卫气之留于腹中（止）何以去之 甲乙腹中作脉中。肢胁作 （简案与技同）胁无胃字。马志。
搐、作 。是。张云。卫气者。水谷之悍气也。其气循皮肤之中。分肉之间。熏于肓膜。散于胸腹。此卫气之
常也。失其常则随邪内陷。留于腹中。 积不行。而苑蕴为病。故禁腹篇曰。卫气为百病母也。
大迎天突喉中 甲乙道藏赵府元本正脉胀本。大、作人。张云。积于上者为喘呼逆息。故当泻之于上。
人迎、足阳明经穴。大突喉中。俱任脉穴。喉中即廉泉也。
三里与气街 张云积于腹中者。当泻其下。三里、气街。俱足阳明经穴。马云。对胸中而言。故谓腹为下。
季胁之下一寸 甲乙云。季胁之下深一寸。马云。即足厥阴肝经章门穴。简案、脉经云。脾以胃合为
腑。合于中
焦脾胃之间。名曰章门。在季胁前一寸半。与马注符。
鸡足取之 楼氏云。正入一针。左右斜入二针。如鸡足。足、三爪也。张云。谓攒而刺之也。即官针
篇。合谷刺之谓。志云。以足缓伸缓缩。如鸡足之践地。盖以疏阳明之经脉。以通卫气之所出也。简案、志注
非是。
大而弦急（止）不可刺也 甲乙。弦、作强。腹皮急作腹皮绞。张云。脉大而弦急。阴虚而真脏见也。
绝不至者。营气脱也。腹皮急甚者。中和气绝。而脾元败也。不宜刺矣。
色起两眉 张云。两眉者阙中也。其应主肺。故病在皮。
病在肌肉 张云。脾气通于唇。故病在肌肉。
营气霈然者 诸本霈、作濡。马云。欲知血气有病。当观之于营气。但营气无形。而濡然多汗。则知
病之在血气也。张云。濡、湿也。营本无形。若肤腠之汗。肌肉之胀。二便之泄利。皆濡然之谓。其病在营。
则气血濡也。（玉篇霈大雨也）
病在筋 张云。目为肝之窍。肝主筋也。
病在骨 张云。耳为肾之窍。肾主骨也。
皮之部输于四末 张云。病在皮者。在阳分也。阳受气于四末。以其皮浅气浮也。故皮之部。输于四末。
肉之柱 张云。病在肌肉。当治其柱。柱者 之属也。坚浓之肉。多在手足三阳分肉间。以肉主于脾。
而脾主四肢也。足少阴之经。自足心循内踝。后人足跟以上 肉。出 内廉。上股肉后廉。会于尻臀贯脊。其
肉俱浓。故亦为肉之柱。
血气之输 张云。病在血气。当治其输。输于诸络。谓诸经之络穴也。气血留居。则经络壅盛。故当取之。
筋部（止）候病所在 张云。病在筋者。不必分其阴阳左右。但当随病所在而治之。
骨之属者（止）益脑髓者也 甲乙。上益字作液。下益字作溢。是。张云。病在骨之属者。当治骨空。
以益其髓。髓者骨之充也。故益髓即所以治骨。简案、属者趺属之属。（见骨度篇）两骨相交之处。十二关节
皆是。是所以受液而溢脑髓者。故骨病当求其所属而取之。
各在其处 马云。取穴以刺之者。亦惟于皮肉气血筋骨。各视其处。
间者小之（止）故曰上工 甲乙。小、作少。是。张云。间者病轻。故用针宜浅宜小。甚者病重。故
用针宜深宜众。病变无穷。能随其变而调治得宜者。故曰上工。
大小寒温 马云。大小者。身之大小也。寒温者。身寒暖也。
人年五十（止）为小 马云。十八以上六岁以上之上字。俱当作下。王弘义云。数始于一。成于三。
三而两之为六。三而三之成九。十八者。二九之数也。二十者。阴阳之生数始也。五十者。五行之生数终也。
简案、千金引短剧方云。凡人年六岁以上为小。十六岁以上为少。三十岁以上为壮。五十岁以上为老。由此考
之。以上不必以下之误。
肉坚（止）不相离者肉 甲乙。 、作 。肥、作脂。张。 、作 。注云。肥者。即下文所谓脂
也。 肉。肉之聚处也。此言伟壮之人。而有脂膏肉三者之异。脂者紧而满。故下文曰。肉紧身小。膏者泽而
大。故下文曰。肉淖垂腴。皮肉连实。而上下相应者曰肉。故下文曰。身体容大。志云。腠理者。肌肉之文理。
如豕之精肉。条分而有理路。理中之白膜曰脂肉。外连皮之肥肉曰肥。膏者。即肥之脂膏。谓如
豕肉之红白相间。而有数层者为膏。简案、韵会云。凝者曰脂。泽者曰膏。博雅云。人一月而膏。二月而脂。
又汉五行志。在人腹中肥而包裹心者脂也。经文。皮之满缓。可以证其凝与否也。马云。膏者油也。脂者骨中
髓也。误。
膏者（止）粗理者寒 甲乙。细理者热之热、作和非。张云。淖柔而润也。膏者肉淖。脂者肉坚。若其
寒热。则粗理者皆寒。细理者皆热。志云。粗理者。卫气外泄。故身寒。细理者。卫气收藏。故身热。
膏者多气（止）其身收小 张云。纵、宽纵也。腴、脂肥也。膏者纵腹垂腴。脂者其身收小。是膏肥于
脂也。肉为皮肉连实。自与脂膏者有间。志云。卫气盛则腠理肥。是以膏者多气。而皮纵缓。故能纵腹垂腴。
腴者。脐下之少腹也。肉者身体容大。此卫气盛而满于分肉也。脂者其身收小。此卫气深沉。不能充乎分肉。
以致脂膜相连。而肌肉紧密。故其身收小也。简案、说文。腴、腹下肥也。又礼少仪注。腴、腹下也。通雅云。
凡肉肥软处曰腴。志直为少腹。恐非也。
膏也多气（止）故不能大 张云。膏者多气。气为阳。故质热而耐寒也。肉者多血。血养形。故形充而
气质平也。脂者血清而气滑少。故不能大。若此三者。虽肥盛皆别于众人。而脂者之气血。似不及乎膏肉也。
愚按世传肥白之人多气虚。而此云膏者多气。不无相左。若据余闻见之验。则苍瘦之气虚者。固不减于肥白。
是以不宜胶柱也。
泉人皮肉（止）命曰众人 张云。众人者。言三者之外。众多之常人也。其皮肉脂骨血气。各有品格。
故不能相加。亦不能相多。而形体大小。皆相称而已。余伯荣云。不能相加者。谓血气和平。则皮肉脂膏。不
能相加于肥大也。血气之浮沉浅深。各有常所。不能相多于肥肉间也。皮肉筋骨。
各自称其身。故其形不大不小也。
必先别其三形（止）不能大也 甲乙。膏人下有者字。张云。三形既定。血气既明。则宜补宜泻。自
可勿失常经矣。是故膏人以下。此重言其详也。
There is no character "Pian" (Chapter) in various editions.
How should the Wei Qi (Defensive Qi) retained in the abdomen be removed? In *Jia Yi Jing* (Systematic Classic of Acupuncture and Moxibustion), "abdomen" is written as "pulse". Limb and hypochondrium are written as "fullness" (Note: synonymous with "Zhi"). There is no character "Wei" (Stomach) in the hypochondrium. Ma Shi's annotation. "Chu" is written as "Cu" (rapid). This is correct. Zhang Jingyue says: Wei Qi is the fierce Qi generated from food and fluids. Its path runs through the skin and between the muscle layers, steaming the Huang membrane, and dispersing in the chest and abdomen. This is the normal course of Wei Qi. If it loses its normal state, it sinks inward following the pathogenic factors, remaining in the abdomen. Accumulating and failing to move, it stagnates and condenses to cause disease. Therefore, the *Jin Ci* (Prohibition of Needling) chapter states: Wei Qi is the mother of a hundred diseases.
Daying, Tiantu, and Houzhong acupoints. *Jia Yi Jing*, *Dao Zang* Zhao Fu Yuan Ben, Zheng Mai Ben, and Zhang Ben are all correct. "Da" is written as "Ren". Zhang Jingyue says: Accumulation in the upper part manifests as panting and labored breathing. Therefore, one should drain it from the upper acupoints. Renying is an acupoint of the Foot-Yangming Stomach Meridian. Tiantu and Houzhong are both acupoints of the Ren Mai (Conception Vessel). Houzhong is equivalent to Lianquan.
Zusanli and Qijie acupoints. Zhang Jingyue says: For accumulation in the abdomen, one should drain it from the lower acupoints. Zusanli and Qijie are both acupoints of the Foot-Yangming Stomach Meridian. Ma Yun says: Relative to the chest, the abdomen is considered the lower part.
One cun below the costal margin. *Jia Yi Jing* states: One cun deep below the costal margin. Ma Yun says: This is Zhangmen (LR13), an acupoint of the Foot-Jueyin Liver Meridian. Note: *Mai Jing* (Pulse Classic) states: The Spleen combines with the Stomach to form the Fu organs, combining in the Middle Jiao between the Spleen and Stomach, named Zhangmen. It is located one and a half cun anterior to the costal margin. This matches Ma's annotation.
Needle like a chicken's foot. Lou Shi says: Insert one needle straight, and two needles obliquely to the left and right, resembling a chicken's foot. "Foot" refers to three claws. Zhang Jingyue says: This means gathering and needling. It refers to the "He Gu Ci" (Valley Combination Needling) mentioned in the *Guan Zhen* (Official Needles) chapter. Zhang Zhicong says: Because the foot extends and retracts slowly, like a chicken walking on the ground. This is likely to dredge the Yangming meridians to unblock the exit of Wei Qi. Note: Zhicong's annotation is incorrect.
If the pulse is large, wiry, and rapid (or forceful), do not needle. *Jia Yi Jing*: "Wiry" is written as "Qiang" (strong). Abdominal skin tension is written as "twisted/tight". Zhang Jingyue says: A large and wiry pulse indicates Yin deficiency and the appearance of the True Zang pulse. Absence of pulse indicates the depletion of Ying Qi (Nutritive Qi). Severe abdominal skin tension indicates the exhaustion of Central Qi and the failure of Spleen Yuan. Needling is contraindicated.
Color appears between the two eyebrows. Zhang Jingyue says: The area between the eyebrows is Quezhong. It corresponds to the Lung. Therefore, the disease is in the skin.
Disease in the muscles. Zhang Jingyue says: Spleen Qi connects to the lips. Therefore, the disease is in the muscles.
When Ying Qi is damp/moist. Various editions have "Pei" written as "Ru". Ma Yun says: To know if there is pathology in Blood and Qi, one should observe Ying Qi. However, Ying Qi is formless. If there is excessive sweating (Ru Ran), one knows the disease is in Blood and Qi. Zhang Jingyue says: Ru means damp/wet. Ying Qi is inherently formless. Sweating from skin pores, swelling of muscles, and diarrhea/urinary issues are all referred to as Ru Ran. Disease in Ying implies dampness in Blood and Qi. (*Yu Pian*: Pei means heavy rain).
Disease in the sinews. Zhang Jingyue says: The eyes are the orifice of the Liver. The Liver governs the sinews.
Disease in the bones. Zhang Jingyue says: The ears are the orifice of the Kidney. The Kidney governs the bones.
The transmission points of the Skin are at the four extremities. Zhang Jingyue says: Disease in the skin is in the Yang aspect. Yang receives Qi from the four extremities. Because the skin is superficial and Qi is floating, the transmission of the Skin section is at the four extremities.
The pillars of flesh. Zhang Jingyue says: For disease in muscles, one should treat their pillars. Pillars refer to areas of thick muscle. Firm and dense muscles are mostly found between the muscle layers of the Three Yang meridities of the hands and feet. Since flesh is governed by the Spleen, and the Spleen governs the four limbs, this applies. The Foot-Shaoyin Kidney Meridian starts from the sole, follows the medial malleolus upward. Later traditions associate the area above the heel with this meridian. It emerges from the medial aspect of the ankle, ascends along the posterior-medial thigh, meets at the sacrum/gluteal region, and penetrates the spine. These muscles are dense, so they are also called pillars of flesh.
The transmission of Blood and Qi. Zhang Jingyue says: For disease in Blood and Qi, one should treat their transmission points. Transmission occurs at the Luo (Connecting) vessels, i.e., the Luo-Connecting points of the various meridians. When Blood and Qi stagnate, the meridians become congested. Therefore, these points should be selected.
The sections of sinews (to) wait for the location of the disease. Zhang Jingyue says: For disease in sinews, there is no need to distinguish Yin/Yang or left/right. One should simply treat according to the location of the disease.
The associations of bones (to) benefit the brain marrow. *Jia Yi Jing*: The first "Yi" (benefit/nourish) is written as "Ye" (fluid). The second "Yi" is written as "Yi" (overflow). This is correct. Zhang Jingyue says: For disease in the bone associations, one should treat the bone cavities to nourish the marrow. Marrow fills the bones. Therefore, nourishing marrow is treating the bone. Note: "Shu" refers to the association of the dorsum of the foot (see *Gu Du* chapter). The junctions where two bones meet, including the twelve joints, are such places. These are where fluid enters and overflows into the brain marrow. Therefore, for bone diseases, one should seek their associations and select points accordingly.
Each in its place. Ma Yun says: When selecting points for needling, one only looks at the specific locations of the skin, flesh, blood, Qi, sinews, and bones.
For mild cases use small techniques (to) thus called Shang Gong (Superior Physician). *Jia Yi Jing*: "Small" is written as "Shao" (few/little). This is correct. Zhang Jingyue says: Jian (mild/distant) cases are light, so needling should be shallow and minimal. Shen (severe/close) cases are heavy, so needling should be deep and extensive. Pathological changes are infinite. Those who can adjust treatment according to changes are called Shang Gong.
Large/Small and Cold/Warm. Ma Yun says: Large/Small refers to the size of the body. Cold/Warm refers to the body temperature.
A person aged fifty (to) is called Xiao (Small/Child category). Ma Yun says: The character "Shang" (above) in "eighteen and above" and "six years and above" should both be read as "Xia" (below). Wang Hongyi says: Numbers start at one and complete at three. Three times two is six. Three times three is nine. Eighteen is the number of two nines. Twenty is the beginning of the generative numbers of Yin and Yang. Fifty is the end of the generative numbers of the Five Elements. Note: *Qian Jin Fang* cites *Duan Ju Fang* stating: People above six years old are Xiao (Small). Above sixteen are Shao (Young). Above thirty are Zhuang (Strong). Above fifty are Lao (Old). Based on this, the text above does not necessarily contain an error regarding "Xia".
Flesh is firm (to) those that do not separate are flesh. *Jia Yi Jing*: [Character] is written as "Fei" (fat). Fei is written as "Zhi" (adipose). Zhang Jingyue notes: [Character] is written as "Fei". Annotation: Fei refers to what is later called Zhi. [Character] Rou (flesh) is the aggregation of flesh. This describes robust individuals having differences among Zhi, Gao, and Rou. Zhi is tight and full, hence later it says: flesh is tight, body is small. Gao is moist and large, hence later it says: flesh is soft, hanging fat. Rou is skin and flesh connected solidly, corresponding up and down, hence later it says: body is voluminous. Zhang Zhicong says: Cou Li (pores/cuticle) are the textures of muscles. Like pork lean meat, divided into strips with visible grain. The white membrane within the grain is called Zhi Rou. The fatty flesh connected externally to the skin is called Fei. Gao is the adipose of Fei, like pork with red and white layers intermixed. Note: *Yun Hui* states: Congealed is Zhi. Moist is Gao. *Bo Ya* states: Humans generate Gao in the first month and Zhi in the second. Also *Han Wu Xing Zhi* states: The fat wrapping the heart in the abdomen is Zhi. The text mentions skin fullness and laxity to verify congealation. Ma Yun says: Gao is oil. Zhi is bone marrow. This is incorrect.
Gao people (to) coarse texture leads to cold. *Jia Yi Jing*: The "Re" (heat) in "fine texture leads to heat" is written as "He" (harmonious/correct?). Incorrect. Zhang Jingyue says: Na Rou means soft and moist. Gao people have soft flesh; Zhi people have firm flesh. Regarding cold/heat: coarse texture leads to cold; fine texture leads to heat. Zhang Zhicong says: Coarse texture allows Wei Qi to escape, causing cold body. Fine texture stores Wei Qi, causing hot body.
Gao people have much Qi (to) their bodies are compact/small. Zhang Jingyue says: Zong means loose/relaxed. Yu means fatty belly. Gao people have loose bellies with hanging fat; Zhi people have compact/small bodies. Thus Gao is fatter than Zhi. Rou is solid connection of skin and flesh, distinct from Zhi and Gao. Zhang Zhicong says: Strong Wei Qi makes Cou Li plump. Thus Gao people have much Qi, loose skin, and can hang fat from the belly. Yu refers to the lower abdomen below the umbilicus. Rou people have voluminous bodies because Wei Qi is strong and fills the muscle layers. Zhi people have compact bodies because Wei Qi is deep and cannot fill the muscle layers, causing Zhi membranes to connect and muscles to be tight, resulting in a compact body. Note: *Shuo Wen*: Yu is fat below the abdomen. *Li Ji - Shao Yi* note: Yu is the lower abdomen. *Tong Ya* states: Any fleshy, soft part is called Yu. Interpreting it directly as lower abdomen is likely incorrect.
Gao has much Qi (to) therefore cannot be large. Zhang Jingyue says: Gao people have much Qi. Qi is Yang, so constitution is hot and resistant to cold. Rou people have much Blood. Blood nourishes form, so physique is full and temperament is balanced. Zhi people have thin Blood and slippery/scant Qi, so they cannot be large. Among these three types, although all are obese, they differ from ordinary people. The Blood and Qi of Zhi seem inferior to Gao and Rou. My opinion: It is commonly believed that fat and pale people have Qi deficiency. Here it says Gao people have much Qi, which seems contradictory. However, based on my experience, thin and sallow people with Qi deficiency are indeed no less common than fat and pale ones. Thus, one should not be dogmatic.
Common people's skin and flesh (to) named Common People. Zhang Jingyue says: Common people refer to the numerous ordinary people outside the three types. Their skin, flesh, Zhi, bone, Blood, and Qi each have their own characteristics. They cannot be added together nor exceed each other. Their body sizes are all proportional. Yu Borong says: Cannot be added means when Blood and Qi are harmonious, skin, flesh, Zhi, and Gao cannot add up to obesity. The floating/sinking and shallow/deep nature of Blood and Qi have their fixed places and cannot exceed the fat tissue. Skin, flesh, bone, and tendons each fit their body, so their shape is neither too big nor too small.
Must first distinguish the three forms (to) cannot be large. *Jia Yi Jing*: There is a "Zhe" (particle) after Gao Ren. Zhang Jingyue says: Once the three forms are determined and Blood/Qi clarified, tonification and sedation will naturally follow the constant classics. Therefore, the following text repeats the details.