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。）
疾病形成后会发生传变，不能不预先察觉。（“成”指疾病的根本，“变”指疾病的表象。根本与表象不同，这就称为“变”。预，即早期识别。）风邪久留可转化为寒热证，（风为阳邪，善于游走且变化迅速。若风邪并入体内则导致阳气虚，阳气虚则体表发冷；若风邪并入体表则导致阳气实，阳气实则体表发热，因受风露侵袭，从而产生寒热症状，这就是风邪形成后转化为寒热证。）瘅热可转化为消中病，（瘅指热邪。热邪积聚于体内，会导致消中病，表现为食欲旺盛、容易饥饿。）气逆可转化为巅顶之疾，（厥指气机逆乱。气逆向上，则可能引起疼痛，或导致眩晕跌倒，从而形成头顶部的疾病；另一种说法是气逆导致神志紊乱，从而患癫狂病。）风邪久留可转化为飧泄，（风从木化，风邪久治不愈，会损伤脾土，导致飧泄病，出现大便中含有未消化食物的腹泻症状。）脉中风邪可转化为疠风，（风寒邪气客居血脉，久久不去，会导致皮肤肌肉败坏，这种病称为疠风。）疾病的种种变化，数不胜数。（这里列举风热之邪，以展示致病的概况，其他变化多端，无法一一计数，也与此类似。）
凡是治疗消瘅、仆击、偏枯、痿证、厥证、气满上逆等病，以及肥胖贵人的疾病，都属于饮食膏粱厚味所致的疾病。（消瘅，指热性消渴病。仆击，指突然昏倒如同被打击一样。偏枯，指半身不遂。痿，指肢体痿弱无力。厥，指四肢逆冷。高粱，即膏粱，指肥甘厚味的食物。肥胖尊贵的人，往往多吃浓味食物。肥腻食物使人热积于中，甘甜食物使人中焦胀满，热邪蓄积于内，多损伤阴液，因此产生这些疾病。）膈塞不通，上下隔绝，这是暴怒忧愁所致疾病。（愁忧情绪使气机闭塞而不运行，从而导致上部或下部痞塞阻隔，水谷通道不通。）突然昏厥并伴有耳聋，半身麻木闭塞不通，这是体内气机突然迫逆所致。（暴厥，指气机突然逆乱，这是因为体内气机逆乱，突然受到侵迫而造成的，薄，意为侵迫。）不是由内外中风引起的疾病，而是消瘦且病邪留滞不去。（有病并非由外感风寒引起，而是邪气藏蓄不去，伏而化热，导致身体灼热消瘦。这是由于表邪留滞侵迫在肌肉、筋骨之间所致。）跛行，是寒、风、湿邪所致疾病。（脚不能行走称为跛，一只脚偏废不用也称为跛。这在下肢的病变，必定是风、寒、湿气致病，跛，音只。跛，波上声。）黄疸突发疼痛，癫疾、厥证、狂证，都是长期气逆所产生的。（这是由于气逆日久，导致阴阳营卫失调，然后形成这些症状，都不是一朝一夕造成的。）五脏功能不平，是由六腑闭塞不通所产生的。（六腑闭塞，则水谷无法消化，津液无法运行，精气失去滋养，所以五脏会出现不平的情况。）头痛耳鸣，九窍不利，是由肠胃问题所产生的。（头、耳及九窍，都是手、足阳明经脉所到达的地方，所以病症由肠胃引起，然而“肠胃”二字，实际上兼指六腑而言，因为六腑都归属于三阳经，三阳经主要分布于九窍。）
人打哈欠，是因为卫气白天行于阳分，半夜则行于阴分。阴分主夜间，夜间主睡眠。阳分主上升，阴分主下降。所以阴气积聚在下部，阳气未尽，阳气牵引向上，阴气牵引向下，阴阳相互牵引，所以频繁打哈欠。（哈欠，是指张口呼吸，或伸臂展腰，是由于阴阳相互牵引而形成的。阳主昼，阴主夜，阳主升，阴主降。人的清醒与睡眠，取决于卫气。卫气，白天行于阳分则活动而清醒，夜晚行于阴分则安静而入睡。所以人在想睡还没睡着的时候，先打哈欠，正是因为阳气将要进入阴分，阴气积聚在下部，阳气尚未平静，所以阳气想要引而上行，阴气想要引而下行，上下相互牵引，哈欠由此产生。现在有人精神疲劳疲倦而打哈欠，就是阳气不胜阴气的征候。）阳气耗尽，阴气旺盛，眼睛就闭合；阴气耗尽，阳气旺盛，人就清醒了。（卫气不能进入阴分，应当留在阳分，留在阳分则阳气满盛，阳气满盛则阳跷脉旺盛，不能进入阴分，则阴气虚弱而眼睛闭不上。卫气留在阴分，不能行于阳分，留在阴分则阴气旺盛，阴气旺盛则阴跷脉满盛，不能进入阳分，则阳气虚弱，所以眼睛闭合。觉醒与阳气结合，睡眠与阴气合并。清醒多的人魂强，睡眠久的人魄壮。魂强的人是生的一类，魄壮的人是死的一类。这都是阴阳盛衰的道理。）泻足少阴经，补足太阳经。（卫气行于阳分，从足太阳经开始；行于阴分，从足少阴经开始。阴盛阳衰，所以打哈欠。又说“肾主为欠”，所以应当泻足少阴经的照海穴，这是阴跷脉发出的穴位；补足太阳经的申脉穴，这是阳跷脉发出的穴位。用药法则以此为准。）人呃逆，是因为谷物进入胃中，胃气上注于肺，现在如果有旧的寒气与新入的谷气一起返还入胃，新旧之气相乱，真气与邪气相攻，气机并合相迎，再次出于胃，所以发生呃逆。（人的水谷进入胃，其精微之气必须上注于肺而后运行于脏腑、营卫。如果中焦先有寒气，那么新进入的谷气就会凝聚而不运行，气不运行则新旧真气邪气，还留滞在胃；留滞则逆而上出，所以发生呃逆。又说“肺主为呃”，寒气上逆导致呃逆，病位在胃但主宰在于肺。）补手太阴经，泻足少阴经。（手太阴，是肺经；足少阴，是肾经。寒气自下而上升，逆乱则导致呃逆，所以应当补肺在上，以壮大肺气，泻肾在下，以引导寒气。因为寒从水化，呃逆的标在胃，呃逆的本在肾。）人叹息，这是因为阴气盛而阳气虚，阴气运行快而阳气运行慢，阴气盛而阳气绝，所以发生叹息。（唏、欷同义，指悲泣时气息哽咽抽吸的样子。一说为哭泣后的余声，一说为悲哀但不哭泣叫唏。悲忧之气，生于阴惨的环境，所以是阴盛阳虚的征候。又说阴与阳绝，则阳不依附阴，所以应当补足太阳经，泻足少阴经，使刚柔相济，那么乖戾之气就能调和了。）补足太阳经，泻足少阴经。（也是补阳跷脉的申脉穴，泻阴跷脉的照海穴。）人战栗发冷，是因为寒气客居在皮肤，阴气盛，阳气虚，所以战栗发冷，应补诸阳经。（战栗发冷，是指身体怯寒而颤抖。补诸阳经，凡手、足三阳经的原穴、合穴及阳跷脉等穴位，都可以酌情使用。）人嗳气，是因为寒气客居在胃，厥逆之气从下往上散，再次出于胃，所以发生嗳气。（嗳气，即打饱嗝，像吃饱后休息时的声音。这与上文提到的呃逆，都是因为胃中有寒气所致。但前文说“故寒气”，是指久寒在胃，言其深；这里说寒客于胃，如客人寄居，言其浅。所以厥逆之气从下往上散，则再次出于胃而为嗳气。）补足太阴经、阳明经，一说补眉本穴。（补足太阴、阳明二经，使脾胃气温和，则客寒自然消散而嗳气可除。眉本，即足太阳经的攒竹穴，这也是补阳气的方法。）人打喷嚏，是因为阳气和平顺利，充满于心，出于鼻，所以打喷嚏。（阳气和平顺利而满溢于心，必然上达于肺，所以出于鼻而为喷嚏，然而有人感受风寒而打喷嚏，是因为寒邪束缚于皮毛，阳气无处宣泄，所以喷嚏而上出，这说明喷嚏从阳而发，更加可知。张仲景说：“想打喷嚏却打不出来，这个人肚子里有寒。”正是指阳气虚，所以人患阳气虚等症状时，很久不打喷嚏忽然打了，则是阳气逐渐恢复的好兆头。）补足太阳经眉本穴，一说补眉上穴。（凡是阳气虚于下部，就不能上达而导致打喷嚏，补足太阳经在眉毛部位的荣穴，名叫“攒竹”，又名“眉上”。因为太阳经与肾经互为表里，所以这是补阴中之阳的方法。）人懈怠无力，是因为胃气不实则诸脉空虚，诸脉空虚则经脉懈惰，经脉懈惰则从事阴事用力，气不能恢复，所以发生懈怠。（懈惰，是不自在持重的样子。因为胃是五脏六腑的海，所以胃不实则诸脉空虚而生懈惰，再有从事阴事用力，则阳气更虚，所以发生懈怠。王实甫词云：“靠着香肩。”就是这个意思，妥，音妥。根据病变所在部位，补分肉间穴位。（四肢各有分部，胃对应肌肉，所以应当因病所在部位，补分肉间穴位以壮大胃气。）人悲哀哭泣流泪，是因为心是五脏六腑的主宰，目是宗脉汇聚之处，是上液通行的道路，口、鼻是气的门户。所以悲哀愁忧则心动，心动则五脏六腑都摇动，摇动则宗脉感应，宗脉感应则液道打开，液道打开所以眼泪鼻涕流出。（宗，总括的意思。凡五脏六腑的精气都上注于目而成为眼珠，所以目是宗脉汇聚之处，又是上液的通道。气由口、鼻出入，所以是气的门户，然而气到达的地方，液必然随之，如涎出于口，涕出于鼻，泪出于目，这些都是上液所属。人的眼泪鼻涕上出，都本源于心，因为心是五脏六腑的主宰，如果悲哀忧愁动了心，则五脏六腑都会响应而摇动，脏腑摇动则宗脉都会响应而动，动则液道打开，眼泪鼻涕因此流出。）液，是用来灌注精髓、濡润空窍的，所以上液之道打开则流泪，流泪不止则液枯竭，液枯竭则精髓得不到灌注，精髓得不到灌注则眼睛看不见东西了，所以名叫夺精。（精髓由液转化，孔窍得到液而充盈，所以用灌精濡孔窍来描述。液去精伤则眼睛昏花以至渐渐看不见东西，这是剥夺了其精髓。世上因为哭泣而失明的人，大概也不少。）补天柱穴，在颈部旁开的经脉上。（天柱，是足太阳膀胱经的穴位。该经脉挟持颈项之后，又称头中分处。）人长叹气，是因为忧愁思虑则心系紧急，心系紧急则气道约束，约束则不通利，所以长叹气以伸展它。（长叹气，即呼吸深长而大，也就是叹息。约，犹如束缚。忧愁思虑则气机压抑不伸而心系紧急，气道约束，约束则心中满闷，这是叹息不得不发的原因。）补手少阴经、心主经（手厥阴经）、足少阳经，留针。（手少阴，是心经。心主，是手厥阴经。足少阳，是胆经。助益木火之脏，则阳气可舒展，抑郁可解除，所以都适宜留针补之。以针刺比喻用药，每个字都应当体会入微。）人流口水，是因为饮食进入胃，胃中有热则虫动，虫动则胃缓，胃缓则廉泉穴开，所以流口水。（足阳明经脉出于口，胃中有热则虫动胃缓，所以廉泉开而流口水。凡是眼睛多泪，鼻子多鼻涕，也都是因为热而上液之道打开，有人说肺热甚则鼻涕出，道理也与此相同。）补足少阴经。（肾为胃之关，而经脉系于舌，所以应当补之以壮水制火，则液有所主而口水自止，脾强也能制约口水，不可拘泥。）人耳朵鸣响，是因为耳是宗脉汇聚之处，所以胃中空虚则宗脉虚，虚则下溜，脉有所竭者，所以耳鸣。（手足三阳、三阴经脉，都进入耳中，所以耳也是宗脉汇聚之处。阳明经是诸脉之海，所以胃中空而宗脉虚，宗脉虚则阳气不升而下溜，下溜则上部枯竭，轻则为鸣，重则为聋。然而少阳经过盛，壅塞窒闷导致鸣响的也有，但虚证是渐进的，实证是突发的，虚证多而实证少，辨别关键在于有邪无邪。学者应当推展思考。）补客主人穴，手大拇指指甲角与肉交接处。（客主人，是足少阳经穴位，为手足少阳、足阳明经交会穴。手大拇指指甲上者，是手太阴经的少商穴，为肺气所出的井穴，所以都应当补之以助其阳气。）人自己咬舌头，这是因为厥逆之气走上，脉气类聚而至。少阴气至则咬舌，少阳气至则咬颊，阳明气至则咬唇了。（辈，同类之意。厥逆之气走上，则血涌气腾，产生怪病。所到之处，各有其部位，如少阴经脉行于舌本，少阳经脉循行耳颊，阳明经脉环绕唇口。所以有的肿胀，有的怪痒，各因其处随而咬之，不仅限于舌头。）观察主要病变的经脉则补之。（考察主要病变的经脉进行补法。）凡是这十二种邪气，都是奇邪走窜空窍所致。（不同于常疾，所以叫奇邪。）所以邪气所在的部位，都是因为正气不足。（只有正气不足，然后邪气才能乘虚而入。《难经》说：“不能治其虚，安问其余？”则深意可知了。）所以上部气不足，头脑就会感觉不满，耳朵会痛苦鸣响，头部会沉重倾斜，眼睛会眩晕。（倾，指沉重不能支撑。）中部气不足，大小便就会异常，肠道会痛苦鸣响。（水由气化，所以中气不足则大小便改变常态而或为黄赤，或为短涩，多由情欲劳倦，过度损伤精气所致。愚昧的人一概认为是火，很少不误诊的。而且中气不足则浊气占据，所以肠胃会痛苦鸣响。）下部气不足，则会导致痿证、厥证、心中烦闷。痿，指足部痿弱。厥，指四肢清冷。 ，指闷。下部气不足，则升降不交，所以心气不舒而为烦闷。）补足外踝下的昆仑穴，留针。（这是昆仑穴，为足太阳经所行的经穴，凡是在上、中、下气虚的病，都可以留针补之。）
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.)