马云。论治水治热之穴。故名篇。
肿 吴云。浮肿曰 。张同。高云。 肿者。皮肌胀满。水气不行。简按 。音符。山海经。竹山
有草焉。其名曰黄 。浴之已疥。又可以已 。郭璞注云。治 肿也。马则云。其 必肿。误。
肾汗出 经脉别论云。持重远行。汗出于肾。
玄府者汗空也 马云。汗空虽细微。最为玄远。故曰玄。张云。汗属水。水色玄。汗之所居。故曰玄
府。从孔而出。故曰汗空。然汗由气化。出乎玄微。是亦玄府之义。
分为相输 马云。此二经之分。本为相输相应。俱受其病者。以水气之留也。张云。言水能分行诸气。
相为输应。而俱受病者。正以水气同类。水病则气应。气病则水应。留而不行。俱为病。志云。此水分为相输。
而上下俱受病者。盖肾俞之循尻而下。复循腹而上。贯肺中。水气之留于经俞故也。高云。肾气上升。肺气下
降。上下分行。相为输布。今俱受病者。乃水气之所留聚也。
伏兔上各二行 简按伏兔。诸家以为足阳明经穴。恐非也。此盖谓膝上有肉起。如兔之状。故名之。
又据辅骨考之。取义于车伏兔。 。一名伏兔。又作 。考工记郑注。 。伏兔也。贾疏云。汉时名。今人谓
之车屐也。志云。上。谓伏兔上。非上下之上也。此说可从。行五。盖今无可考。诸注为腹上。亦恐非。高云。
并伏兔之穴。在内旁两行。其一有血海阴陵泉地机筑宾交信五穴。其一有阴包曲泉膝关中都蠡沟五穴。以上诸
穴。并在膝下。不得言伏兔上。注高误耳。
三阴之所交 张云。三阴。肝脾肾三阴也。三经所交。俱结于脚。故足太阴有三阴交。高作三阴交之
所结于脚也。注云。三阴交。旧本讹三阴之所交。今改正。两行并行。三阴交总结于下。上连于胫。下贯于脚。
故曰三阴交之所结于
脚也。简按今仍旧文。经脉篇云。足太阴。交出厥阴之前。上膝股内前廉。足少阴。上股内后廉。足厥阴。交
出太阴之后。上 内廉。循股入毛中。此所谓三阴所交结于脚。是也。
踝上各一行行六 志云。谓照海水泉大钟大溪然谷涌泉六穴也。高云。谓三阴交漏谷商丘公。孙太白
大都六穴。
名曰太冲 志云。夫圣人南面而立。前曰广明。后曰大冲。大冲之地。名曰少阴。少阴根起于涌泉。
是泉在地之下。从至阴而涌出。故曰。肾者至阴也。
帝曰春取络脉分肉 高云。本输篇云。春取络脉诸荣。大筋分肉之间。故问春取络脉之分肉。刺极浅
者何也。简按本输篇。四时气篇。寒热病篇。终始篇。四时刺逆从论。诊要经终篇。并论四时刺法。本节最详。
而义互异。然与水热穴。义不太涉。疑是他篇错简。
夏取盛经分腠 高云。四时气篇云。夏取盛经孙络。取分间。绝皮肤。故问夏取盛经分腠。刺稍深者。
何也。
脉瘦气弱 马云。脏气始长。其脉尚瘦。其气尚弱。志高同。
阳气留溢 甲乙。留。作流。
热熏分腠 甲乙。作温于腠内。
绝肤而病去 马云。用刺法者。必取此盛经分腠以治之。先以左手按。绝其皮肤。而右手刺之。即
病去者。邪尚浅也。吴云。绝其邪气于肤间。高云。夏时亦有绝皮肤。取孙络之病。故又言绝肤而病去者。邪
居浅也。今所谓取盛经者。乃盛阳之经脉。不在皮肤也。
秋取经输 马云。各经之经穴输穴也。高云。四时气篇云。秋取经输。邪在腑。取之合。故问秋取
经输。刺之深者。何也。
收杀 高云。收。收敛。杀。肃杀也。
取输以泻阴邪 高云。时方清肃。故阴气初胜。白露乃下。故湿气及体。阴气初胜。则阴气未盛。湿
气及体。则未能深入。故取输。以泻阴湿之邪。俞。经输也。所以答帝秋取经俞之问。
取合以虚阳邪 高云。秋时亦有阳邪内入之病。若果阳气在合。则取合以虚阳邪。所以然者。秋时阳
气始衰。故当更取于合。不但取于经输也。简按马云。此节。帝分明以经输为问。而伯乃对言所取在合。其阴
经则取输。要知伯之所答者为是。而帝之所问者误也。此说不可从。皇甫士安既云。是谓始秋之治变。是也。
故曰冬取井荥 吴云。故曰。古语也。冬时既取其在下之井荥。则下无逆阴。故春时木气升发。亦无
鼽衄之患也。高云。金匮真言论云。冬不按 。春不鼽衄。不按 者。使之藏。取井荥者。亦使之藏。故不曰
冬不按跷。而冬取井荥也。○马云。按此篇。秋曰治合。则阳气尚在合而治之。冬曰井荥。以阴邪欲下逆而出
之。其春必刺络脉分肉处。夏必刺盛经分腠矣。难经以春为刺井。夏为刺荥。秋为刺经。冬为刺合。与此大反。
要知经之所言者是。而难经则非也。简按灵顺气一日分为四时篇。冬刺井。春刺荥。夏刺输。长夏刺经。秋刺
合。又本输篇云。春荥。夏输。秋合。冬井。并与此篇同。新校正云。与九卷义相通。即是也。
领别 札记仲尼燕居郑注。领。犹治也。
膺俞 高云。膺中第一俞两旁。俞府穴也。简按甲乙。俞府。在巨骨下。去璇玑旁各二寸。陷者中。
宜是言膺中第一俞。而甲乙。中府。一名膺中俞。则高注却非。
背俞 高云。背中第一俞。两旁肺俞穴也。简按与旧注
异。未知孰是。新校正。亦疑王注其说不一。
髓空 志云。即横骨穴。所谓股际骨空。在毛中动下。高云。骨空论云。髓空。在脑后三分。锐骨之
下。悬颅二穴。简按甲乙。大迎。一名髓孔。若为督脉之腰俞。则不合此八者之数。王注恐非。志注亦无征。
然若为悬颅大迎等穴。则并在头部。不宜次于委中之下。亦似可疑。
热之左右也 吴云。左右。习近也。马云。皆治热之左右穴也。
Ma Yun states: This chapter discusses the acupoints for treating edema and heat diseases, hence it is named "Treatise on Water and Heat Acupoints."
Wu Yun states: Edematous swelling is referred to as "Fu Zhong" (edematous swelling). Zhang Tong quotes Gao Yun: "Fu Zhong" refers to distension and fullness of the skin and muscles due to the stagnation of water qi. Jian An notes: The character is pronounced "Yin Fu". *Shan Hai Jing* records: In Zhu Mountain, there grows a herb named Huang Pi. Bathing with it can cure scabies and also treat Fu Zhong. Guo Pu's commentary states: This treats Fu Zhong. Ma Yun, however, says "its Fu must be swollen," which is an error.
Sweat from Kidney: *Jing Mai Bie Lun* states: Carrying heavy loads and traveling long distances causes sweat to emanate from the Kidney.
Xuan Fu are Sweat Pores: Ma Yun states: Although sweat pores are minute, they are profound and distant, hence called Xuan (profound/mysterious). Zhang Yun states: Sweat belongs to Water; Water's color is black (Xuan); the residence of sweat is thus called Xuan Fu. Emerging from the orifice, it is called a sweat pore. However, sweat is generated by Qi transformation and emerges from the subtle and mysterious, which is also the meaning of Xuan Fu.
Divided into Mutual Transmission: Ma Yun states: The distribution of these two meridians is originally for mutual transmission and correspondence. If both are affected by disease, it is due to the retention of water qi. Zhang Yun states: This means that water can distribute various Qi, mutually transmitting and responding. The reason both are diseased is precisely because water qi is of the same category; when water is diseased, Qi responds, and when Qi is diseased, water responds. Retained and not flowing, both become diseased. Zhi Yun states: Regarding this water division where both upper and lower parts are diseased, it is because the Shenshu follows down along the sacrum, then up along the abdomen, penetrating the Lungs. It is the retention of water qi in the meridians and shu points. Gao Yun states: Kidney Qi ascends, Lung Qi descends, distributing mutually up and down. Now that both are diseased, it is due to the accumulation and retention of water qi.
Two Rows Above Futu: Jian An notes: Futu is considered by various schools as an acupoint of the Foot-Yangming Meridian, but this is likely incorrect. This probably refers to the fleshy prominence above the knee, shaped like a rabbit, hence the name. Furthermore, based on the examination of the auxiliary bone, the term derives from the "Futu" (a part of a chariot wheel cover). "Gu" is also known as "Futu," alternatively written as "Qu." Zheng Xuan's commentary on *Kaogong Ji*: "Qu" is Futu. Jia Gongyan's subcommentary states: A Han dynasty term, now called cheji (chariot tread) by people. Zhi Yun states: "Shang" (above) refers to above Futu, not the "shang" of up and down. This explanation can be adopted. "Hang Wu" (five rows/points) cannot be verified today. Various annotations claim it is on the abdomen, which is likely incorrect. Gao Yun states: Parallel to the Futu point, there are two rows on the inner side. One row contains five points: Xuehai, Yinlingquan, Diji, Zhubin, and Jiaoxin. The other row contains five points: Yinbao, Ququan, Xiguan, Zhongdu, and Ligou. All the aforementioned points are below the knee and cannot be described as above Futu. This is an error in Gao's annotation.
Where the Three Yin Intersect: Zhang Yun states: The Three Yin refer to the Liver, Spleen, and Kidney Yin meridians. These three meridians intersect and gather at the foot. Hence, the Foot-Taiyin has the Sanjiao (Three Yin Intersection) point. Gao's text reads "The place where the Three Yin Intersection gathers at the foot." The annotation states: Sanjiao was erroneously printed as "San Yin Zhi Suo Jiao" in old editions, now corrected. The two rows run parallel; Sanjiao summarizes at the bottom, connecting upwards to the tibia and downwards through the foot. Thus it is said "The place where the Three Yin Intersection gathers at the foot." Jian An notes: We retain the original text here. *Jing Mai Pian* states: The Foot-Taiyin meridian exits before the Jueyin, ascending to the anterior aspect of the medial knee and thigh; the Foot-Shaoyin ascends to the posterior aspect of the medial thigh; the Foot-Jueyin exits after the Taiyin, ascending to the medial popliteal fossa, following the thigh into the pubic region. This is what is meant by "the Three Yin intersecting and gathering at the foot."
One Row of Six Points Above the Malleolus: Zhi Yun states: Refers to the six points: Zhaohai, Shuiquan, Dazhong, Daxi, RanGu, and Yongquan. Gao Yun states: Refers to the six points: Sanjiao, Lougu, Shangqiu, Gongson, Taibai, and Dadu.
Named Taichong: Zhi Yun states: When the Sage faces south, the front is called Guangming, and the back is called Da Chong. The area of Da Chong is named Shaoyin. Shaoyin originates from Yongquan. The spring is beneath the earth, gushing forth from the Supreme Yin. Thus it is said: The Kidney is the Supreme Yin.
The Emperor said: In Spring, select Collateral Vessels and Divisions of Muscle: Gao Yun: *Ben Shu Pian* states: In Spring, select Luo vessels and Ying points, between large tendons and muscle divisions. Hence, why ask about selecting collateral vessel muscle divisions in Spring and needling extremely shallowly? Jian An notes: *Ben Shu Pian*, *Si Shi Qi Pian*, *Han Re Bing Pian*, *Zhong Shi Pian*, *Si Shi Ci Ni Cong Lun*, and *Zhen Yao Jing Zhong Pian* all discuss seasonal acupuncture methods. This section is the most detailed, yet the meanings differ. However, it does not relate much to the meaning of *Shui Re Xue Lun*. It is suspected to be misplaced slips from another chapter.
In Summer, select Full Meridians and Intercellular Spaces: Gao Yun: *Si Shi Qi Pian* states: In Summer, select Full Meridians and Sun Luo vessels, taking the intercellular spaces, piercing the skin. Hence, why ask about selecting Full Meridian intercellular spaces in Summer and needling slightly deeper?
Pulse Thin and Qi Weak: Ma Yun states: The Zang Qi is just beginning to grow; its pulse is still thin, and its Qi is still weak. Zhi and Gao agree.
Yang Qi Stagnates and Overflows: *Jia Yi Jing* reads "Liu" as "Liu" (flow).
Heat Steams the Intercellular Spaces: *Jia Yi Jing* reads as "Warmth within the Cou Li."
Piercing the Skin and Disease Departs: Ma Yun states: Those using acupuncture must select these Full Meridian intercellular spaces to treat. First, press with the left hand to block the skin, then needle with the right hand. If the disease departs immediately, the pathogen is still superficial. Wu Yun states: Blocking the pathogen between the skin layers. Gao Yun: In Summer, there is also blocking of the skin to treat Sun Luo diseases. Hence it again says "piercing the skin and disease departs," indicating the pathogen resides superficially. What is now called selecting Full Meridians refers to the meridians of abundant Yang, not the skin level.
In Autumn, select Jing and Shu Points: Ma Yun states: The Jing and Shu points of each meridian. Gao Yun: *Si Shi Qi Pian* states: In Autumn, select Jing and Shu points; if the pathogen is in the Fu organs, select He points. Hence, why ask about selecting Jing and Shu points in Autumn and needling deeply?
Gathering and Killing: Gao Yun: Gathering refers to convergence; Killing refers to desiccation/severity.
Select Shu to Drain Yin Pathogens: Gao Yun: The season is clear and dry, so Yin Qi initially prevails. White dew falls, and dampness reaches the body. Since Yin Qi initially prevails, Yin is not yet strong; since dampness reaches the body, it cannot penetrate deeply. Therefore, select Shu points to drain Yin-damp pathogens. Shu refers to Jing-Shu points. This answers the Emperor's question about selecting Jing-Shu in Autumn.
Select He to Empty Yang Pathogens: Gao Yun: In Autumn, there are also diseases of Yang pathogens entering internally. If Yang Qi is indeed at the He points, select He points to empty Yang pathogens. The reason is that Yang Qi begins to decline in Autumn, so one should additionally select He points, not only Jing-Shu points. Jian An notes: Ma Yun argues that in this section, the Emperor clearly asks about Jing-Shu, while Bo Gao replies that the selection is at He points. For Yin meridians, Shu points are selected. One must know that Bo Gao's answer is correct, and the Emperor's question is mistaken. This view should not be followed. Huangfu Mi stated: "This is called the treatment variation of early Autumn," which is correct.
Therefore it is said: In Winter, select Jing and Ying Points: Wu Yun: "Therefore it is said" is an ancient phrase. In Winter, selecting the Jing and Ying points located inferiorly prevents rebellious Yin from below. Thus, in Spring, when Wood Qi ascends, there will be no rhinitis or epistaxis. Gao Yun: *Jin Gui Zhen Yan Lun* states: If one does not perform An Qiao (massage/exercise) in Winter, one will not suffer rhinitis in Spring. Not performing An Qiao makes the Qi store; selecting Jing and Ying also makes the Qi store. Hence it does not say "Do not do An Qiao in Winter," but "Select Jing and Ying in Winter." ○ Ma Yun: Looking at this chapter, Autumn mentions treating He points, meaning Yang Qi is still at the He points and treated there. Winter mentions Jing and Ying because Yin pathogens desire to reverse downward and exit. Thus, in Spring, one must needle the Collateral Vessel muscle divisions; in Summer, one must needle the Full Meridian intercellular spaces. *Nan Jing* holds that Spring needles Jing, Summer needles Ying, Autumn needles Jing, and Winter needles He, which is largely contrary to this chapter. One must know that this chapter is correct and *Nan Jing* is wrong. Jian An notes: *Ling Shu: Shun Qi Yi Ri Fen Wei Si Shi Pian* states: Winter needles Jing, Spring needles Ying, Summer needles Shu, Late Summer needles Jing, Autumn needles He. Also, *Ben Shu Pian* states: Spring Ying, Summer Shu, Autumn He, Winter Jing. Both align with this chapter. Xin Zheng Jiao states: It connects with the meaning of Volume 9, which is correct.
Ling Bie: Zha Ji cites Zheng Xuan's commentary on *Zhong Ni Yan Ju*: Ling means governance/treatment.
Ying Shu: Gao Yun: On both sides of the first Shu point in the chest is the Yu Fu point. Jian An notes: *Jia Yi Jing* states: Yu Fu is below Jugu, two cun lateral to Xuanji, in the depression. It should refer to the first Shu point in the chest. However, in *Jia Yi Jing*, Zhongfu is also named Yingzhong Shu. Thus, Gao's annotation is incorrect.
Bei Shu: Gao Yun: On both sides of the first Shu point on the back is the Feishu point. Jian An notes: Different from old annotations; unknown which is correct. Xin Zheng Jiao also suspects Wang Bing's annotations vary.
Sui Kong: Zhi Yun states: It is the Henggu point, also known as the Gu Ji Gu Kong, located below the moving point in the pubic region. Gao Yun: *Gu Kong Lun* states: Sui Kong is three fen behind the head, below the sharp bone, the Xuanlu points. Jian An notes: *Jia Yi Jing* states: Daying is also named Sui Kong. If it were Yaoshu of the Du Meridian, it would not fit the count of eight. Wang Bing's annotation is likely incorrect. Zhi's annotation also lacks evidence. However, if it were Xuanlu or Daying, they are all in the head and should not follow Weizhong, which is also suspicious.
Heat on the Left and Right: Wu Yun: Left and right mean nearby/accompanying. Ma Yun: These are the left and right points for treating heat.