（《灵枢·厥病篇》《杂病篇》）
厥心痛与背相控，善 ，如从后触其心，伛偻者，肾心痛也，先取京骨、昆仑，发针不已，取然谷
（《灵枢·厥病篇》。五脏逆气，上干于心而为痛者，谓之厥心痛。下仿此。控，引也。善 ，拘急如风也。伛偻，
背曲不伸也。足少阴之经，由股内后廉贯脊属肾，其直者，从肾上贯肝膈入肺中。凡疼痛如从脊后触其心而伛偻者，以
肾邪干心，是为肾心痛也。肾与膀胱为表里，故当先取足太阳之京骨、昆仑。如痛不已，仍当取肾经之然谷。控，苦贡
切。伛，雍主切。偻，吕、娄二音。）厥心痛，腹胀胸满，心尤痛甚，胃心痛也，取之大都、太白。（足阳明之经，由缺
盆下膈属胃络脾，其支者下循腹里。凡腹胀胸满而为痛者，以胃邪干心，是为胃心痛也。胃与脾为表里，故当取足太阴
之大都、太白二穴。）厥心痛，痛如以锥针刺其心，心痛甚者，脾心痛也，取之然谷、太溪。（脾之支脉，注于心中。若
脾不能运而逆气攻心，其痛必甚，有如锥刺者，是为脾心痛也。但然谷、太溪，皆足少阴之穴，取此治脾，其义何居？
盖湿因寒滞，则相挟乘心，须泄肾邪，当刺此也。）厥心痛，色苍苍如死状，终日不得太息，肝心痛也，取之行间、太冲。
（苍苍，肝色也。如死状，肝气逆也。终日不得太息，肝系急，气道约而不利也。是皆肝邪上逆，所谓肝心痛也。行间、
太冲，皆足厥阴经穴，故当取以治之。）厥心痛，卧若徒居，心痛间动作痛益甚，色不变，肺心痛也，取之鱼际、太渊。
（徒，空也。卧若徒居，无倚傍也。间或动作则益甚者，气逆不舒，畏于动也。色不变，不在血也。是皆病在气分，故
曰肺心痛也。鱼际、太渊，皆手太阴经穴，故宜取之。）真心痛，手足 至节，心痛甚，旦发夕死，夕发旦死。（真心痛
者，邪气直犯心主也。毒深阴甚，故手足之 至节，其死之速如此。愚按∶本篇所言五脏之滞，皆为心痛，刺治分经，
理甚明悉，至若舍针用药，尤宜察此详义。盖肾心痛者，多由阴邪上冲，故善 如从后触其心。胃心痛者，多由停滞，
故胸腹胀满。脾心痛者，多由寒逆中焦，故其病甚。肝心痛者，多由木火之郁，病在血分，故色苍苍如死状。肺心痛者，
多由上焦不清，病在气分，故动作则病益甚。若知其在气则顺之，在血则行之，郁则开之，滞则逐之，火多实，则或散
或清之，寒多虚，则或温或补之，必真心痛者乃不可治，否则但得其本，则必随手而应，其易如探囊也。 音倩，寒冷
也。）心痛不可刺者，中有盛聚，不可取于 。（中有盛聚，谓有形之症，或积或血，停聚于中，病在脏而不在经，故不
可取于 穴，当从内以调治之也。）肠中有虫瘕及蛟蛔，皆不可取以小针，心肠痛 作痛，肿聚，往来上下行，痛有休止，
腹热喜渴，涎出者，是蛟蛔也。（此言虫瘕在肠胃中，亦为心腹痛也。瘕，结聚也。蛟，即蛔属。蛔， 也。不可取以小
针，谓其力小不能制也。虫瘕之证，其痛则懊 难忍，或肚腹肿起而结聚于内，或往来上下而行无定处，或虫动则痛、
静则不痛而有时休止，或腹热喜渴而口涎出者，是皆蛟蛔之为患也。瘕，加、驾二音。蛔音回。 ，乃包切。）以手聚按
而坚持之，无令得移，以大针刺之，久持之，虫不动，乃出针也。（此即治虫瘕蛟蛔之法。大针，第九针也。久持之而虫
不动，中其虫矣，故可出针也。）HT 腹 痛，形中上者。HT ，满也。此重言证之如此，其形自中自上而渐升者，即
当以虫治之也。HT ，并同，音烹。）
心痛引腰脊，欲呕，取足少阴（《灵枢·杂病篇》。心痛而后引腰脊、前则欲呕者，此肾邪上逆也，故当取足少阴经
以刺之。）心痛腹胀，啬啬然大便不利，取足太阴。（啬啬，涩滞貌。此病在脾，故当取足太阴经以刺之。啬音色。）心痛
引背不得息，刺足少阴；不已，取手少阳。（足少阴之脉贯脊，故痛引于背。手少阳之脉布膻中，故不得息。宜刺此二经
也。）心痛引小腹满，上下无常处，便溲难，刺足厥阴。（足厥阴之脉抵小腹结于阴器，凡心痛而下引小腹者，当刺之也。）
心痛但短气不足以息，刺手太阴。（肺主气，故短气者当刺手太阴。）心痛当九节刺之，按已刺，按之立已；不已，上下
求之，得之立已。（此总言刺心痛之法也。九节，即督脉之筋缩穴。宜先按之，按已而刺，刺后复按之，其痛当立已。如
不已，则上而手经，下而足经，求得其故而刺之，则立已矣。）
(From *Lingshu: Juebing Pian* and *Zabing Pian*)
True heart pain (Zhenxin Tong) with mutual traction pain between the heart and back, prone to spasms (chi), feeling as if the heart is being touched from behind, accompanied by a stooped posture unable to straighten, is Kidney Heart Pain. Treat first by needling Jinggu (BL-64) and Kunlun (BL-60). If the pain does not cease after needling, then select Ran Gu (KI-2).
(*Lingshu: Juebing Pian*: When the rebellious qi of the five zang organs ascends to invade the heart causing pain, it is called Jue Heart Pain. The following cases follow this pattern. Kong means traction. Shan chi refers to spasms similar to wind-induced conditions. Yu Lou refers to a curved back that cannot extend. The Foot-Shaoyin Kidney Meridian runs along the posterior medial aspect of the thigh, pierces the spine, and connects with the Kidney. Its straight branch ascends from the Kidney, passes through the Liver and Diaphragm, and enters the Lung. Whenever pain feels like it originates from touching the heart from the posterior spine and involves stooping, it is because Kidney pathogenic factors invade the Heart; this is Kidney Heart Pain. Since the Kidney and Bladder are interior-exteriorly related, one should first select Jinggu and Kunlun of the Foot-Taiyang Bladder Meridian. If pain persists, one should still select Ran Gu of the Foot-Shaoyin Kidney Meridian.)
Jue Heart Pain accompanied by abdominal distension and chest fullness, with severe heart pain, is Stomach Heart Pain. Select Dadu (SP-3) and Taibai (SP-3).
(The Foot-Yangming Stomach Meridian descends from the Clavicle, passes through the Diaphragm, belongs to the Stomach, and connects with the Spleen. Its branch descends along the interior of the abdomen. Whenever abdominal distension and chest fullness occur with pain, it is because Stomach pathogenic factors invade the Heart; this is Stomach Heart Pain. Since the Stomach and Spleen are interior-exteriorly related, one should select Dadu and Taibai of the Foot-Taiyin Spleen Meridian.)
Jue Heart Pain where the pain feels like being pierced by an awl, with severe heart pain, is Spleen Heart Pain. Select Ran Gu (KI-2) and Taixi (KI-3).
(The collateral branch of the Spleen injects into the Heart. If the Spleen fails to transport and rebellious qi attacks the Heart, the pain will be severe, resembling an awl piercing; this is Spleen Heart Pain. However, Ran Gu and Taixi are both points on the Foot-Shaoyin Kidney Meridian. Why select these to treat the Spleen? This is because dampness combined with cold stagnation mutually assists in invading the Heart; one must drain the Kidney pathogenic factors, hence these points are needled.)
Jue Heart Pain with a pale green complexion resembling death, and inability to sigh deeply all day, is Liver Heart Pain. Select Xingjian (LR-2) and Taichong (LR-3).
(Pale green is the color associated with the Liver. Resembling death indicates rebellious Liver Qi. Inability to sigh all day indicates tension in the Liver system, constraining the airway and hindering smooth flow. These are all manifestations of rebellious Liver pathogenic factors ascending, known as Liver Heart Pain. Xingjian and Taichong are points on the Foot-Jueyin Liver Meridian, so they should be selected for treatment.)
Jue Heart Pain where pain alleviates when lying down or sitting idly, but worsens significantly upon movement, with unchanged complexion, is Lung Heart Pain. Select Yuji (LU-10) and Taiyuan (LU-9).
(Tu means empty. Lying down or sitting idly without support implies a state of emptiness. Pain worsening upon movement indicates rebellious qi failing to soothe and fear of movement. An unchanged complexion indicates the pathology is not in the Blood. These indicate the disease is in the Qi level, hence called Lung Heart Pain. Yuji and Taiyuan are points on the Hand-Taiyin Lung Meridian, so they are suitable for selection.)
True Heart Pain (Zhenxin Tong) with cold limbs extending to the joints, severe heart pain, death if onset occurs in the morning and death by evening, or death if onset occurs in the evening and death by morning.
(True Heart Pain occurs when pathogenic factors directly invade the Heart Master. The toxicity is deep and yin-cold is extreme, hence limbs become cold up to the joints, leading to such rapid death. Commentary: The heart pains described in this chapter due to stagnation of the five zang organs all fall under the category of heart pain. Needling treatments are differentiated by meridian, making the principles clear. Regarding the use of herbs instead of needles, one must carefully examine these detailed meanings. Generally, Kidney Heart Pain often arises from upward rushing of yin-cold pathogens, hence spasms and sensation of posterior touch. Stomach Heart Pain often arises from stagnation, hence chest and abdominal distension. Spleen Heart Pain often arises from cold rebellion in the middle jiao, hence severe illness. Liver Heart Pain often arises from stagnation of wood-fire, involving the blood level, hence a pale green complexion resembling death. Lung Heart Pain often arises from uncleanness in the upper jiao, involving the qi level, hence worsening with movement. If one knows that disease in the qi level should be harmonized, disease in the blood level should be circulated, stagnation should be opened, and blockage should be expelled; fire excess should be dispersed or cleared, while cold deficiency should be warmed or tonified. Only True Heart Pain is incurable; otherwise, once the root is identified, treatment responds immediately, as easily as taking something from a pocket. Qian denotes coldness.)
Heart pain that cannot be needled indicates there is a substantial accumulation within; such cases should not be treated by selecting acupoints.
(Substantial accumulation within refers to tangible pathological products, such as masses or blood stasis, accumulating internally. The disease is in the zang organs rather than the meridians, so acupoint needling is contraindicated; internal regulation and treatment are required.)
Ascaris (Chongjia) and roundworms (Jiaohui) in the intestines should not be treated with small needles. When heart-intestine pain erupts severely, with swelling and aggregation, moving up and down, with intermittent pain, abdominal heat, thirst, and salivation, these are signs of Jiaohui (roundworms).
(This states that ascaris in the intestines also causes heart and abdominal pain. Jia refers to aggregation. Jiao refers to roundworms. Small needles should not be used because their force is insufficient to subdue them. The syndrome of ascaris involves unbearable distressing pain, or abdominal swelling with internal aggregation, or movement up and down without fixed location, or pain only when worms move and cessation when they rest, or abdominal heat with thirst and salivation. All these are caused by roundworms.)
Press and hold firmly with the hand to prevent movement, then needle with a large needle. Retain the needle for a long time until the worm stops moving, then remove the needle.
(This is the method for treating ascaris and roundworms. The Large Needle is the ninth of the nine needles. Retaining the needle until the worm stops moving indicates the worm has been struck, allowing for needle removal.)
Abdominal pain where the shape manifests rising from the center upwards.
Man means fullness. This reiterates the symptom profile: when the shape naturally rises from the center upwards, it should be treated as a parasitic condition. Peng is synonymous with Man, pronounced peng.)
Heart pain radiating to the lower back and spine, with desire to vomit, select Foot-Shaoyin points.
(*Lingshu: Zabing Pian*: Heart pain followed by radiation to the lower back and spine, and anterior nausea, indicates rebellious Kidney qi ascending. Therefore, the Foot-Shaoyin Meridian should be needled.)
Heart pain with abdominal distension, roughness/stagnation, and difficulty in defecation, select Foot-Taiyin points.
(Sese describes a rough or stagnant sensation. This disease resides in the Spleen, so the Foot-Taiyin Meridian should be needled. Se is pronounced se.)
Heart pain radiating to the back with dyspnea, needle Foot-Shaoyin; if ineffective, select Hand-Shaoyang points.
(The Foot-Shaoyin pulse penetrates the spine, hence pain radiates to the back. The Hand-Shaoyang pulse distributes in the Chest Center, hence dyspnea. It is appropriate to needle these two meridians.)
Heart pain radiating to lower abdominal fullness, with unpredictable locations, and difficulty in urination and defecation, needle Foot-Jueyin.
(The Foot-Jueyin pulse reaches the lower abdomen and knots at the genitalia. For heart pain radiating downward to the lower abdomen, this meridian should be needled.)
Heart pain characterized only by shortness of breath and insufficient respiration, needle Hand-Taiyin.
(The Lung governs qi, so shortness of breath requires needling the Hand-Taiyin Meridian.)
For heart pain, needle at the ninth vertebral segment. After pressing the needled area, pain ceases immediately; if not, search above and below, locate the cause, and needle, and pain will cease immediately.
(This summarizes the method for needling heart pain. The ninth segment refers to Jinsuo (GV-9) of the Du Meridian. One should press first, then needle, and press again after needling; pain should cease immediately. If not, search the Hand meridians above and Foot meridians below to find the cause and needle, and pain will cease immediately.)