寒热瘰 在于颈腋者，此皆鼠 ，寒热之毒瓦斯
也，留于脉而不去者也。（瘰 者，其状累然而历贯上下也。故于颈腋之间皆能有之，因其形如鼠穴，塞
其一复穿其一，故又名为鼠 。盖以寒热之毒，留于经脉，所以联系不止。一曰结核，连续者为瘰 ，形长
如蚬蛤者为马刀。又曰，胁肋下者为马刀。）鼠 之本，皆在于脏，其末上出于颈腋之间。其浮于脉中，而未
内着于肌肉而外为脓血者，易去也。（瘰 必起于少阳，而后延及阳明。二经表里相传，乃至厥阴、太阴，
俱能为病。大抵因郁气之积，食味之浓，或风热之毒结聚而成，故其所致之本，皆出于脏，而标则见乎颈腋
之间也。若其毒之未甚，则但浮见脉中，尚未着于肌肉以化脓血者，去之犹易，若其脓血既
成，则为力较难也。）从其本，引其末，可使衰去而绝其寒热。（谓去其致之之本，则外见之末，自可引而
衰也。）审按其道以予之，徐徐往来以去之。（予，与之针也。审按其道，审脉气所由之道也，徐往
徐来，即补泻之法，所谓徐而疾则实，疾而徐则虚也。）其小如麦者，一刺知，三刺而已。（小如麦者，其
初起也，故一刺即知其效，三刺其病可已；所以治在宜早，不可因小而忽之。）决其生死，反其目视之∶
其中有赤脉上下贯瞳子，见一脉，一岁死；见一脉半，一岁半死；见二脉，二岁死；见二脉半，二岁半死；
见三脉，三岁而死。见赤脉不下贯瞳子，可治也。（目者，宗脉之所聚也。瞳子者，骨之精也。赤脉下贯
瞳子，以邪毒之陷，深贼阴分而然，死之征也，然脉见二三者，其气散而缓，脉聚为一者，其毒锐而专，
此又死期迟速之有异也。又有诊寒热者，亦同此法。）
颈腋部位出现的寒热型瘰疬，这都是鼠瘰，是寒热毒气滞留于经脉而未能去除的病证。（所谓瘰疬，是指其形态累累相连、上下贯穿的症状。因此它可以在颈腋之间任何地方发生，因为它的形状像老鼠打洞一样，堵住一个洞口，另一个洞口又穿通出来，所以又被称为鼠瘰。这是因为寒热毒邪留滞于经脉，导致病灶相互联系不止。另一种说法叫结核，连续成串的叫瘰疬，形状像蚬蛤那样长条形的叫马刀。还有一种说法认为，发生在胁肋下方的称为马刀。）鼠瘰的根本原因都在于内脏，其表现向上延伸出现在颈腋之间。如果病邪浮现在脉中，尚未深入肌肉内部并转化为脓血，那么比较容易去除。（瘰疬必定起于少阳经，然后蔓延波及阳明经。这两条经脉表里相传，甚至影响到厥阴经和太阴经，都能引发疾病。大抵是因为郁结之气积聚，饮食滋味浓厚，或者风热毒邪结聚而成，所以其致病根本都出于内脏，而外在表现则见于颈腋之间。如果毒邪尚不严重，只是浮现在脉中，尚未附着在肌肉上化生脓血，那么治疗还比较容易；如果脓血已经形成，那么治疗就比较困难了。）从疾病的根本入手，引导其末梢表现，可以使病情衰退并断绝寒热的发作。（意思是去除了致病的根本，那么外在显现的末梢症状，自然可以引导其衰退。）仔细审察经络气血运行的道路来施治，通过缓慢进针、出针的手法来祛除病邪。（“予”，指给予针刺。审察其道，即审察脉气所经过的道路。徐往徐来，就是补泻的方法，所说的“徐入疾出则为实，疾入徐出则为虚”。）对于小如麦粒大小的结节，刺一次见效，刺三次即可痊愈。（小如麦粒，说明是初起阶段，所以刺一次就能知道疗效，刺三次病就可以治愈；所以治疗应当宜早不宜迟，不能因为结节小而忽视它。）判断患者的生死预后，要反过来观察他的眼睛：如果看到有赤色的脉络上下贯穿瞳孔，见到一条赤脉，一年死；见到一条半赤脉，一年半死；见到两条赤脉，两年死；见到两条半赤脉，两年半死；见到三条赤脉，三年死。如果见到赤色脉络但不向下贯穿瞳孔，是可以治疗的。（眼睛，是众多经脉汇聚的地方。瞳孔，是肾骨之精气的体现。赤色脉络向下贯穿瞳孔，是由于邪毒深陷，严重损伤阴分所致，这是死亡的征兆。然而，脉象显现为二条或三条的，说明正气散漫而缓和；脉象聚集为一道的，说明毒邪锐利而专一，这又是死亡时间早晚不同的原因。另外，诊断寒热病的方法，也同此理。）
Lymphadenopathy (Luoli, 瘰疬) presenting with alternating chills and fever in the neck and axillary regions is essentially Shulou (Rat Abscess, 鼠瘰), caused by toxic qi of cold and heat lingering in the meridians without being expelled. (Luoli refers to a condition where nodules are clustered and connected vertically. Thus, it can occur anywhere between the neck and axilla. Because its shape resembles rat burrows—blocking one hole only for another to appear—it is also named Shulou. This occurs because cold-heat toxins remain in the meridians, causing continuous connection of lesions. Another term is Jiehe (Tubercle). Continuous clusters are called Luoli, while those shaped like clam shells are called Madao (Horse Knife). Alternatively, lesions located under the ribs are called Madao.) The root of Shulou lies within the Zang organs, manifesting upwards in the neck and axilla. If the pathogen floats within the vessels but has not yet penetrated the muscles to form pus and blood externally, it is easy to eliminate. (Luoli typically originates from the Shaoyang channel and subsequently spreads to the Yangming channel. These two channels transmit disease via their interior-exterior relationship, potentially affecting the Jueyin and Taiyin channels as well. Generally, it arises from accumulated stagnant Qi, rich dietary flavors, or aggregation of wind-heat toxins. Thus, the root cause stems from the Zang organs, while the branch manifestation appears in the neck and axilla. If the toxin is not severe, floating only in the vessels without adhering to muscles to generate pus and blood, removal is still relatively easy; however, once pus and blood have formed, treatment becomes more difficult.) By addressing the root and guiding the branch, the condition can be made to recede, cutting off the alternating chills and fever. (This means that by eliminating the underlying cause, the external manifestations will naturally subside.) Carefully examine the pathways of Qi and Blood to administer treatment, using slow insertion and withdrawal techniques to dispel the pathogen. ("Yu" refers to administering acupuncture. Examining the "Dao" means examining the pathway through which pulse Qi travels. Slow advancement and withdrawal refer to tonification and sedation methods: "slow entry and rapid exit tonifies; rapid entry and slow exit sedates".) For nodules as small as wheat grains, one needling session brings improvement, and three sessions cure the disease. (Being small like wheat grains indicates early onset; thus, efficacy is seen after one session, and the disease resolves after three. Treatment should be initiated early and not neglected due to the small size.) To determine life and death prognosis, observe the eyes in reverse: if red vessels are seen traversing the pupil vertically, seeing one vessel predicts death in one year; one and a half vessels predict death in one and a half years; two vessels predict death in two years; two and a half vessels predict death in two and a half years; three vessels predict death in three years. If red vessels are seen but do not traverse downwards into the pupil, the condition is treatable. (The eyes are the gathering point of numerous vessels. The pupil represents the essence of bone/kidney. Red vessels traversing the pupil indicate deep entrapment of evil toxins damaging the Yin aspect, signaling death. However, when two or three vessels are visible, the Qi is scattered and sluggish; when the vessel gathers into one, the toxin is sharp and focused, explaining variations in the timing of death. Additionally, diagnosing cold-heat diseases follows similar principles.)