诸本无篇字。马云。篇内所论。不止厥病。然首节有厥头痛、厥心痛等病。故名篇。然此厥之为义。乃气
逆而以此连彼之谓。实与素问之厥论不同。
厥头痛（止）太阴 张云。厥、逆也。邪逆于经。上干头脑而为痛者。曰厥头痛也。下仿此。足阳明之
脉。上行于面。其悍气上冲头者。循眼系入络脑。足太阴支者注心中。故以头痛而兼面肿烦心者。当取足之阳
明太阴也。
头脉痛（止）调足厥阴 张云。头脉痛者。痛在皮肉血脉之间也。心悲善泣者。气逆在肝也。故当
先视头脉之动而盛者。刺去其血。以泄其邪。然后取足厥阴肝经而调补之。以肝脉会于巅也。
贞贞头重而痛（止）取足少阴 甲乙。贞贞、作员员。张云。贞贞、坚固貌。其痛不移也。头上五行。
行五即前篇五十九俞之穴。所以散诸阳之热逆也。先取手少阴心经。泻南方以去火也。后取足少阴肾经。补北
方以壮水也。简案、刺热篇。头痛员员。知贞贞字讹。甲乙为是。志注。员员、周转也。
介按、员员头重而痛。即头痛而眩晕也。盖以脑为髓海。其髓由肾系贯脊。通于脊髓。肾精足。则入脊
化髓。上循入脑。而为脑髓。兹以肾精不足。未能化髓。上循于脑。而为眩晕。故宜取足少阴即虚则补之之义。
意善忘（止）取足太阴 甲乙。意、作噫。注。九墟作意。太阴作太阳。张云。脾藏意。意伤则善忘。
阳邪在头而无定所。则按之不得。故当先取头面左右动脉。以泄其邪。后取足太阴经。以补脾气也。莫 从云。
头面左右之动脉。足阳明之脉也。
脉涌有热（止）后取足少阳 甲乙。脉涌有热、作脉骨先热。张云。耳之前后。足少阳经也。其脉涌而
热者。当泻出热血。仍取本经之穴。
真头痛（止）死不治 张云。头痛有二。上文言厥头痛者可治。此言真头痛者不可治。盖头为诸阳之会。
四肢为诸阳之本。若头痛甚而遍尽于脑。手足寒至节者。以元阳败竭。阴邪直中髓海。故最为凶兆。六十难云。
手三阳之脉受风寒。伏留而不去者。则名厥头痛。入连在脑者。名真头痛。
若肉伤痛未已 可则刺 甲乙。肉、作内。则、作即。刺下有之字。马云。可取针以侧刺其头痛之处。
志云。有所击堕。恶血在于内。若肉伤痛未已。则可在此痛处而刺之。不可远取之俞也。简案、则、马读为侧。
然甲乙作即。则志注为是。
人痹为恶 日作者 甲乙。日上有风字。张云。痹之甚者谓之大痹。其证则风寒湿三气杂至。合成恶
患。令人头痛不可刺也。若日作者。则犹有间止。故刺之可令少愈。终亦不能全已也。简案、此谓大痹为患。
每逢风日必作者。今世多头风。如是者可令少愈。而不可令全愈。经文必脱风字。
头半寒痛（止）阳明 甲乙。无半字。张云。头半寒痛者。偏头冷痛也。手足少阳阳明之脉。皆循耳上。
行头角。故当先取手经以取其标。后取足经以去其本也。
厥心痛（止）取然谷 甲乙。发针下有立已二字。六十难
云。五脏气相干。名厥心痛。
杨注。诸经络皆属于心。若一经有病。其脉逆行。逆则乘心。乘心则心痛。故曰厥心痛。是五脏气冲逆
致痛。非心家自痛也。张云。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。
介按、从涌泉上行。足内踝前。起大骨下陷之中。即然谷穴也。凡取此穴。主治实热之症。然则厥心痛
者。系是热厥。而非寒厥可知矣。宜针三分。留三呼。灸三壮。而不宜见血。
腹胀胸满（止）太白 甲乙。腹上有暴泄二字。张云。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。简案、外台引短剧云。厥心痛。腹胀满。不欲食。食则不消。心痛尤甚者胃心痛也。（出甲乙经第一卷
中）与本节及甲乙文。少异。
脾心痛也（止）大溪 甲乙。然谷作后谷。张云。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、大溪。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。志云。然谷当作漏谷。大溪当作天溪。盖上古之文。不无鲁鱼之误。楼氏
云。脾心痛而取然谷、大溪者。故孙真人、张洁古、谓之忘经也。简案、志考作漏谷、天溪。似是。
如死状（止）太冲 千金、外台、作如死灰状。张云。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。
卧若徒居（止）大渊 甲乙。闲上有乃字。楼氏云。徒居谓间居。间谓痛缓。心痛卧与间居则痛缓。
动作则益甚者。取肺。其兼短气者。亦取肺。经云。心痛但短气不足以息。刺手太阴者是也。
真心痛 手足青 脉经、千金、外台。青、作清。熊本同。赵府本、张本、作清。张云。真心痛者。
邪气直犯心主也。毒深阴甚。故手足之清至节。其死之速如此。清、音倩。寒冷也。
中有盛聚 不可取于 千金。盛、作成。张云。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。志云。盛聚者。五脏之逆气太盛。聚于中而为心痛。
非循脉之上乘也。
虫瘕及蛟 （止）乃出针也 甲乙。作肠中有虫瘕。有 蛟。心肠作心腹。 作痛。作发作二字。
涎、作羡。蛟、 也。作 蛟也。脉经、千金、作心腹痛懊 。发作肿聚。是蛟 也。作蛔蛟也。外台引甲乙
左无懊 字。张云。此言虫瘕在肠胃中。亦为心腹痛也。瘕、结聚也。蛟即 。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 之为患也。简案、 、 蛔同。音回。说文。腹中
长虫也。口问篇云。胃中有热则虫动。虫动则胃缓。胃缓则廉泉开。故涎下。巢源云。蛔虫者。是九虫内之一
虫也。长一尺。亦有长五六寸。蛟、张注未见所据。当是蛟误。说
文。蛟龙之属。则非 属。
HT 腹 痛 形中上者 甲乙无此八字。张云。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 、 同。音烹。简案、HT 、字典 重文。HT 、玉篇普行切。满也。龙龛手鉴。心闷也。形
中上者一句。疑有脱误。义不明晰。
耳中 马云。听宫穴。系手太阳小肠经。
耳前动脉 马云。耳门穴系手少阳三焦经。
于耵聍 甲乙 作干 抵。史云上都领切。耳中垢也。下乃顶切。巢源云。耳 聍者。耳里津液结聚
所成。人耳皆有之。轻者不能为患。若加以风热乘之。则结 成丸核塞耳。亦令耳暴聋。张云。或痛或无闻者。
皆不可刺之。脓垢去而耳自愈矣。
耳聋（止）后取足 马云。当取手小指之次指。爪甲上与肉交者。即手少阳三焦经关冲穴也。先取之后。
又取足少阳胆经之窍阴。
耳鸣（止）后取足 马云。当取手之中指爪甲上。即手厥阴心包络经中冲穴后。取足厥阴肝经大敦穴。
足髀（止）不可刺 甲乙。合、作阖。张云。髀、足股也。侧、侧卧也。枢合、中髀枢中也。即足少阳
经之环跳穴。宜治以员利针。第六针也。忌用大针。
病注下血 马云。此言下血者。有当刺之穴也。凡病注下血者。以肝不能纳血也。当取肝经之曲泉以
刺之。
风痹淫HT （止）死也 甲乙。淫泺、作注一字。恐、作怒。履水、诸本作履冰。当改。马云。已、以
同。风痹者其邪气淫溢消泺。病难得愈。张云。病在阳命曰风。病作阴命曰痹。阴阳俱病命曰风痹。淫泺者浸淫日
深之谓。足如履冰之寒。
又如入汤之热。下而股胫。中而腹心。上而头目。无所不病。在表则汗出。在里则短气不乐。或为悲哀。或为
喜恐。此阴阳俱病之候。虽尚可支持。然不能出三年也。简案、素骨空论。淫泺胫 。不能久立。王注。淫泺
谓似酸疼而无力也。考之原文。张注似是。（详见于素问识）
各版本中无“篇”字。马云认为，本篇所论述的内容，不仅仅是厥病。然而开篇第一节提到了厥头痛、厥心痛等疾病，因此以“厥”命名此篇。但这处的“厥”的含义，是指气逆而由此牵连彼处，实际上与《素问·厥论》中的含义不同。
厥头痛（止）取足太阴 张云：厥，即逆也。邪气逆乱于经脉，上扰头脑而导致疼痛的，称为厥头痛。以下仿照此例解释。足阳明胃经的脉气，上行于面部；其慓悍之气上冲头部者，沿着眼系进入并联络脑部。足太阴脾经的支脉注入心中。因此，若头痛兼见面部肿胀、心烦，应当选取足阳明胃经和足太阴脾经的穴位进行治疗。
头脉痛（止）调足厥阴 张云：头脉痛，是指疼痛位于皮肉血脉之间。患者悲伤且容易哭泣，是因为气逆在肝。因此应当先观察头部血脉跳动旺盛之处，刺破出血以泄除邪气，然后再选取足厥阴肝经进行调理补益，因为肝经会合于头顶。
贞贞头重而痛（止）取足少阴 《甲乙经》将“贞贞”写作“员员”。张云：“贞贞”，是坚固的样子，指疼痛位置固定不移。头上有五行，每行五个穴位，即前篇提到的五十九个俞穴，用来疏散诸阳之气的热逆。先取手少阴心经，泻南方之火以去火；后取足少阴肾经，补北方之水以壮水。简案：《刺热篇》中提到“头痛员员”，可知“贞贞”字有误，《甲乙经》是正确的。志注认为，“员员”意为周转。介按：“员员头重而痛”，就是头痛伴有眩晕。因为脑为髓海，髓由肾系贯穿脊柱，通于脊髓。肾精充足，则入脊化为髓，上循进入脑部成为脑髓。如今因肾精不足，未能化髓上循于脑，从而产生眩晕，所以适宜取足少阴肾经，这符合“虚则补之”的道理。
意善忘（止）取足太阴 《甲乙经》中“意”写作“噫”。注：《九墟》作“意”，《太阴》作“太阳”。张云：脾藏意，意受伤则容易遗忘。阳邪在头部且没有固定位置，按压时找不到痛点，所以应当先取头面左右的动脉，以泄除邪气，后取足太阴脾经，以补脾气。莫从云：头面左右的动脉，属于足阳明胃经。
脉涌有热（止）后取足少阳 《甲乙经》中“脉涌有热”写作“脉骨先热”。张云：耳的前后，是足少阳胆经循行部位。其脉搏涌动且有热象的，应当泻出热血，仍取本经的穴位治疗。
真头痛（止）死不治 张云：头痛有两种，上文所说的厥头痛是可以治疗的，这里说的真头痛是不可治疗的。因为头是诸阳之会，四肢是诸阳之本。如果头痛剧烈且遍及整个脑部，手足寒冷直到关节，这是因为元阳败竭，阴邪直接侵入髓海，所以是最凶险的征兆。《六十难经》说：手三阳经的脉受风寒侵袭，潜伏停留而不去的，名叫厥头痛；深入连及脑部的，名叫真头痛。
若肉伤痛未已 可则刺 《甲乙经》中“肉”写作“内”，“则”写作“即”，“刺”下多一“之”字。马云：可以取针侧刺其头痛之处。志云：若有击打跌堕，恶血留在体内，如果肌肉疼痛尚未停止，则可以在此痛处刺之，不可远取其他俞穴。简案：“则”，马读为“侧”。但《甲乙经》作“即”，所以志注是正确的。
人痹为恶 日作者 《甲乙经》中“日”上有“风”字。张云：痹证严重的称为大痹。其症状是风寒湿三气杂至，合成恶患，令人头痛不可刺。如果是每日发作的，说明还有间歇停止的时候，所以刺之可以让病情稍有好转，但最终也不能完全痊愈。简案：这是说大痹为患，每逢风日必定发作的，现在人多患头风，像这种情况可以让病情稍有好转，而不能令其完全痊愈。经文必定脱漏了“风”字。
头半寒痛（止）取阳明 《甲乙经》中无“半”字。张云：头半寒痛，即偏头冷痛。手足少阳、阳明经的脉，都循行经过耳朵上方，行于头角，所以应当先取手经以治其标，后取足经以治其本。
厥心痛（止）取然谷 《甲乙经》在“发针”下有“立已”二字。《六十难经》说：五脏之气相互干犯，名叫厥心痛。
杨注：诸经络皆属于心，如果一经有病，其脉逆行，逆则乘心，乘心则心痛，所以叫厥心痛。这是五脏之气冲逆导致疼痛，不是心脏自身疼痛。张云：控，牵引之意。善 ，拘急如中风状。伛偻，背曲不能伸直。足少阴肾经，由大腿内侧后缘，贯穿脊柱属肾。其直行者从肾上贯肝膈，入肺中。凡是疼痛感觉从脊后触及心脏且身体伛偻的，是因为肾邪干犯心脏，这叫肾心痛。肾与膀胱互为表里，所以应当先取足太阳膀胱经的京骨、昆仑穴，如果疼痛不止，仍当取肾经的然谷穴。
介按：从涌泉穴上行，到足内踝前，起于大骨下的凹陷中，就是然谷穴。凡取此穴，主治实热病症。那么厥心痛，既然是热厥，而非寒厥，就可以知道了。宜针刺三分，留针三呼，灸三壮，而不宜见血。
腹胀胸满（止）取太白 《甲乙经》中“腹”上有“暴泄”二字。张云：足阳明胃经，由缺盆，下膈，属胃络脾。其支脉下行循行于腹里。凡是腹胀胸满而疼痛的，是因为胃邪干犯心脏，这叫胃心痛。胃与脾互为表里，所以应当取足太阴脾经的大都、太白二穴。简案：《外台秘要》引用《短剧》说：厥心痛，腹胀满，不欲食，食则不消，心痛特别严重的是胃心痛。（出自《甲乙经》第一卷中）与本节及《甲乙经》文字略有不同。
脾心痛也（止）取大溪 《甲乙经》中“然谷”作“后谷”。张云：脾的支脉，注入心中。如果脾不能运化，而逆气攻心，其疼痛必然很剧烈，像锥子刺一样，这叫脾心痛。但是然谷、大溪，都是足少阴肾经的穴位，取这些穴位治疗脾病，其中的道理何在？大概是因为湿气因寒滞，则挟带邪气乘心，必须泄除肾邪，所以应当刺这些穴位。志云：然谷应当作漏谷，大溪应当作天溪。大概是上古文献没有避免鲁鱼亥豕的错误。楼氏说：脾心痛而取然谷、大溪，所以孙真人、张洁古称之为忘经。简案：志考证作漏谷、天溪，似乎是正确的。
如死状（止）取太冲 《千金方》、《外台秘要》作“如死灰状”。张云：苍苍，是肝的颜色。如死状，是肝气逆乱。整天不能深呼吸，肝系紧急，气道约束而不通畅。这些都是肝邪上逆，所谓肝心痛。行间、太冲，都是足厥阴肝经的穴位，所以应当取用以治疗。
卧若徒居（止）取大渊 《甲乙经》中“闲”上有“乃”字。楼氏说：徒居谓间居，间谓痛缓。心痛卧着或静居则疼痛缓解，动作则更加严重。取肺经，其兼有短气的，也取肺经。经文说：心痛只是短气不足以息，刺手太阴肺经是对的。
真心痛 手足青 《脉经》、《千金方》、《外台秘要》中“青”作“清”。熊本同。赵府本、张本作“清”。张云：真心痛，是邪气直接侵犯心主。毒深阴甚，所以手足寒冷直到关节，死亡如此迅速。清，音倩，寒冷之意。
中有盛聚 不可取于 《千金方》中“盛”作“成”。张云：中有盛聚，指有形的病症，或是积滞或是瘀血，停聚在中焦。病在脏而不在经，所以不可取用...穴，应当从内部进行调理治疗。志云：盛聚者，是五脏的逆气太盛，聚于中而形成心痛，并非循脉上冲所致。
虫瘕及蛟 （止）乃出针也 《甲乙经》作“肠中有虫瘕，有...蛟”。心肠作心腹。...作痛。...作发作二字。涎，作羡。蛟，...也。作...蛟也。《脉经》、《千金方》作“心腹痛懊...发作肿聚，是...蛟...也”。作“蛔蛟也”。《外台秘要》引《甲乙经》左无“懊...”字。张云：这是说虫瘕在肠胃中，也会引起心腹痛。瘕，结聚之意。蛟即...，属于蛔...类。不可用小针，是说小针力量小不能制服它。虫瘕的病症，其疼痛则懊...难忍，或者肚腹肿起而结聚于内，或者往来上下而行无定处，或者虫动则痛，静则不痛，而有时休止，或者腹热喜渴而口涎出者，这都是...蛟...为患。简案：...、...蛔同，音回。《说文解字》：腹中长虫。《口问篇》说：胃中有热则虫动，虫动则胃缓，胃缓则廉泉开，故涎下。《巢源》说：蛔虫，是九虫中的一虫，长一尺，也有长五六寸的。蛟，张注未见所据，应当是“蛟”误。《说文解字》：蛟龙之属，则非...属。
HT 腹 痛 形中上者 《甲乙经》无此八字。张云：HT...，满也。这是重复陈述证候如此。其形状自中自上而渐升者，就应当以杀虫法治之。HT...、...同，音烹。简案：HT...，《字典》重文。HT...，《玉篇》普行切，满也。《龙龛手鉴》：心闷也。“形中上者”一句，疑有脱误，义不明晰。
于耵聍 《甲乙经》作“干...抵”。史云上都领切，耳中垢也。下乃顶切。《巢源》说：耳...聍者，耳里津液结聚所成，人耳皆有之。轻者不能为患，若加以风热乘之，则结...成丸核塞耳，亦令耳暴聋。张云：或痛或无闻者，皆不可刺之。脓垢去而耳自愈矣。
耳聋（止）后取足 ... 马云：当取手小指之次指，爪甲上与肉交者，即手少阳三焦经关冲穴也。先取之后，又取足少阳胆经之窍阴。
耳鸣（止）后取足 ... 马云：当取手之中指爪甲上，即手厥阴心包络经中冲穴后，取足厥阴肝经大敦穴。
足髀（止）不可刺 《甲乙经》中“合”作“阖”。张云：髀，足股也。侧，侧卧也。枢合，中髀枢中也。即足少阳经之环跳穴。宜治以员利针，第六针也。忌用大针。
病注下血 马云：此言下血者，有当刺之穴也。凡病注下血者，以肝不能纳血也。当取肝经之曲泉以刺之。
风痹淫HT （止）死也 《甲乙经》中“淫泺”作“注”一字。“恐”作“怒”。“履水”，诸本作“履冰”，当改。马云：已，以同。风痹者其邪气淫溢消泺，病难得愈。张云：病在阳命曰风，病作阴命曰痹，阴阳俱病命曰风痹。淫泺者浸淫日深之谓。足如履冰之寒。又如入汤之热。下而股胫，中而腹心，上而头目，无所不病。在表则汗出，在里则短气不乐。或为悲哀，或为喜恐。此阴阳俱病之候，虽尚可支持，然不能出三年也。简案：《素问·骨空论》：淫泺胫...，不能久立。王注：淫泺谓似酸疼而无力也。考之原文，张注似是。（详见于《素问识》）
In various versions, the character "Pian" (Chapter) is absent. Ma Yun states that the content discussed in this chapter is not limited to Jue diseases. However, since the first section mentions diseases such as Jue Headache and Jue Heartache, the chapter is named after "Jue". The meaning of "Jue" here refers to Qi rebellion connecting one part to another, which is actually different from the concept in the *Suwen: Lun Jue* (Treatise on Jue).
Jue Headache (End) Select Foot Taiyin Zhang Yun: Jue means rebellion. When pathogenic factors rebel within the meridians and disturb the head causing pain, it is called Jue Headache. The following explanations follow this pattern. The meridian of Foot Yangming ascends on the face; its vigorous Qi rushing upward enters the eye system and connects with the brain. The branch of Foot Taiyin injects into the heart. Therefore, if headache is accompanied by facial swelling and vexation, points from Foot Yangming and Foot Taiyin should be selected.
Head Vessel Pain (End) Regulate Foot Jueyin Zhang Yun: Head vessel pain refers to pain located between the skin, flesh, and vessels. Sadness and frequent crying indicate Qi rebellion in the Liver. Thus, one should first observe where the head vessels are pulsating vigorously, puncture them to bleed and drain the pathogen, and then regulate and tonify Foot Jueyin Liver meridian, as the Liver meridian converges at the vertex.
Heavy and Painful Head (End) Select Foot Shaoyin The *Jiayi Jing* writes "Zhenzhen" as "Yuanyuan". Zhang Yun: "Zhenzhen" implies a solid state, meaning the pain does not shift. There are five rows on the head, five acupoints per row, referring to the fifty-nine acupoints mentioned in the previous chapter, used to dissipate rebellious heat of all Yang meridians. First select Hand Shaoyin Heart meridian to drain South Fire; subsequently select Foot Shaoyin Kidney meridian to tonify North Water. Jian An notes: In the *Cire Re Pian* (Chapter on Acupuncture for Heat), "headache with dizziness" is mentioned, indicating that "Zhenzhen" is an error and *Jiayi Jing* is correct. Zhi's annotation explains "Yuanyuan" as rotating. Jie An adds: "Yuanyuan heavy and painful head" refers to headache accompanied by vertigo. Since the brain is the sea of Marrow, and Marrow is connected via the Kidney system through the spine to the spinal cord, sufficient Kidney Essence transforms into Marrow in the spine, ascends to the brain to form Brain Marrow. Now, due to insufficient Kidney Essence failing to transform into Marrow and ascend to the brain, vertigo occurs. Hence, selecting Foot Shaoyin aligns with the principle of "tonifying deficiency".
Forgetfulness (End) Select Foot Taiyin In *Jiayi Jing*, "Yi" is written as "Yi" (belching). Annotation: *Jiuxu* writes "Yi", *Taiyin* writes "Taiyang". Zhang Yun: The Spleen stores Yi (Intent/Thought); injury to Yi leads to forgetfulness. Yang pathogens in the head have no fixed location, so pressing yields no specific tenderness. Therefore, one should first select arteries on the left and right sides of the head and face to drain pathogens, then select Foot Taiyin Spleen meridian to tonify Spleen Qi. Mo Congyun states: The arteries on the left and right of the head and face belong to Foot Yangming Stomach meridian.
Surging Pulse with Heat (End) Subsequently Select Foot Shaoyang In *Jiayi Jing*, "Surging pulse with heat" is written as "Bone pulse with initial heat". Zhang Yun: The areas anterior and posterior to the ear are traversed by Foot Shaoyang Gallbladder meridian. Where the pulse surges with heat, bloodletting should be performed, followed by selecting points from the same meridian.
True Headache (End) Death, Untreatable Zhang Yun: There are two types of headaches. The previously mentioned Jue Headache is treatable; True Headache mentioned here is untreatable. The head is the convergence of all Yang meridians, and the limbs are the root of all Yang meridians. If headache is severe and pervades the entire brain, and hands and feet are cold up to the joints, it indicates exhaustion of Primordial Yang and direct invasion of Yin pathogens into the Sea of Marrow, representing the most ominous sign. The *Sixty Nanjing* states: When the three Yang meridians of the hand are invaded by Wind-Cold, which lingers without departing, it is named Jue Headache; when it penetrates and connects to the brain, it is named True Headache.
If Muscle Pain Persists, Puncture *Jiayi Jing*: "Rou" (Flesh/Muscle) is written as "Nei" (Inside); "Ze" (Then) is written as "Ji" (Immediately); there is an extra "Zhi" character after "Ci" (Puncture). Ma Yun: One may use a needle to obliquely puncture the site of headache. Zhi states: Following trauma or falls, if evil blood remains inside and muscle pain persists, one can puncture the painful area directly, rather than selecting distant acupoints. Jian An notes: Ma reads "Ze" as "Ce" (Oblique). However, *Jiayi Jing* uses "Ji", making Zhi's annotation correct.
Severe Bi Syndrome Daily Attack *Jiayi Jing*: The character "Feng" (Wind) appears before "Ri" (Daily). Zhang Yun: Severe Bi syndrome is called Great Bi. Its symptoms involve the mixture of Wind, Cold, and Dampness forming malignant conditions causing headache, which should not be punctured. If it attacks daily, there are intervals of relief, so acupuncture can provide slight improvement, but complete cure is unlikely. Jian An comments: This describes Great Bi, which attacks whenever wind is present. Modern cases of "Head Wind" behave similarly; treatment can alleviate symptoms but rarely achieves full recovery. The text likely omits the character "Wind".
Half-Head Cold Pain (End) Select Yangming *Jiayi Jing*: Omits the character "Ban" (Half). Zhang Yun: Half-head cold pain refers to unilateral cold pain in the head. The meridians of Hand/Foot Shaoyang and Yangming all traverse above the ears and along the temporal angles. Therefore, one should first select Hand meridians to treat the branch (symptoms), then Foot meridians to treat the root (cause).
Jue Heartache (End) Select Rangu *Jiayi Jing*: Adds "Li Yi" (Immediate Cure) after "Fa Zhen" (Remove Needle). The *Sixty Nanjing* states: When Qi of the Five Zang organs interferes with each other, it is named Jue Heartache.
Yang's Annotation: All meridians connect to the Heart. If a disease exists in one meridian, its pulse rebels; rebellion leads to attacking the Heart, causing heartache, hence "Jue Heartache". This is pain caused by rebellious Qi of the Five Zang organs, not intrinsic Heart pathology. Zhang Yun: "Kong" means pulling/drawing. "Shan ..." refers to spasmodic stiffness like wind stroke. "Yu Lou" means hunchbacked inability to straighten. Foot Shaoyin Kidney meridian runs along the posterior medial thigh, pierces the spine, and belongs to the Kidney. Its straight branch ascends from the Kidney through the Liver and Diaphragm into the Lung. Pain felt originating from the spine and touching the heart, accompanied by hunching, is Kidney Evil attacking the Heart, called Kidney Heartache. Kidney and Bladder are interior-exterior pairs; thus, first select Jinggu and Kunlun of Foot Taiyang Bladder meridian. If pain persists, select Rangu of the Kidney meridian.
Jie An notes: Ascending from Yongquan, to the anterior aspect of the medial malleolus, starting in the depression below the large bone, is the Rangu acupoint. This point treats excess-heat syndromes. Thus, Jue Heartache here is Heat Jue, not Cold Jue. Needling depth: 3 cun; retention: 3 breaths; moxibustion: 3 cones; avoid bleeding.
Abdominal Distension and Chest Fullness (End) Select Taibai *Jiayi Jing*: Adds "Bao Xie" (Sudden Diarrhea) before "Fu" (Abdomen). Zhang Yun: Foot Yangming Stomach meridian descends from Quepen through the Diaphragm, belonging to Stomach and connecting to Spleen. Its branch descends along the interior abdomen. Abdominal distension, chest fullness, and pain indicate Stomach Evil attacking the Heart, called Stomach Heartache. Stomach and Spleen are interior-exterior pairs; thus, select Dadu and Taibai of Foot Taiyin Spleen meridian. Jian An notes: *Waitai Mi Yao* cites *Duanju*: Jue Heartache with abdominal distension, loss of appetite, indigestion, and severe heart pain is Stomach Heartache (from *Jiayi Jing* Vol 1). This differs slightly from the current text and *Jiayi Jing*.
Spleen Heartache (End) Select Daixi *Jiayi Jing*: Writes "Rangu" as "Hougu". Zhang Yun: Branches of Spleen inject into the Heart. If Spleen fails to transport and rebellious Qi attacks the Heart, pain is severe, like needle pricking, called Spleen Heartache. However, Rangu and Daixi are points on Foot Shaoyin Kidney meridian. Why select these for Spleen? Likely because Dampness combined with Cold stagnation attacks the Heart via the Kidney, requiring drainage of Kidney Evil. Zhi states: Rangu should be Loudu, and Daixi should be Tianxi. Ancient texts often contain errors. Lou Shi argues that Sun Simiao and Zhang Jieguzhu criticized taking Rangu/Daixi for Spleen Heartache as forgetting the classics. Jian An notes: Zhi's correction to Loudu/Tianxi seems plausible.
Like Dead State (End) Select Taichong *Qianjin Fang* and *Waitai Mi Yao* write "Ru Si Hui Zhuang" (Like Ashes). Zhang Yun: Cangcang refers to the color of Liver. Like dead state indicates Liver Qi rebellion. Inability to sigh deeply throughout the day indicates tightness of the Liver tendon and constrained Qi channels. These are all manifestations of Liver Evil rebelling upward, known as Liver Heartache. Xingjian and Taichung are points on Foot Jueyin Liver meridian, suitable for treatment.
Lying Down or Resting (End) Select Dayuan *Jiayi Jing*: Adds "Nai" before "Xian". Lou Shi states: Tu Ju means resting; Xian means pain easing. Heartache pain eases when lying down or resting, and worsens with movement. Select Lung meridian; if accompanied by shortness of breath, also select Lung meridian. The classic states: Heartache with only shortness of breath and insufficient respiration should be treated by needling Hand Taiyin.
True Heartache Hands and Feet Blue/Cold *Mai Jing*, *Qianjin Fang*, *Waitai Mi Yao*: Write "Qing" as "Qing" (Clear/Cold). Kumamoto edition agrees. Zhao Fu edition and Zhang edition write "Qing". Zhang Yun: True Heartache involves pathogens directly invading the Heart Master. Deep toxicity and extreme Yin cause hands and feet to become cold up to the joints, leading to rapid death. Qing sounds like Qian, meaning cold.
Accumulation Inside Cannot Be Treated By ... *Qianjin Fang*: Writes "Sheng" as "Cheng". Zhang Yun: Accumulation inside refers to tangible pathological products, such as masses or blood stasis, stagnant in the middle. The disease is in the Zang organs, not the meridians; thus, it cannot be treated by ... acupoints but requires internal regulation. Zhi states: Accumulation refers to excessive rebellious Qi of the Five Zang organs gathering in the middle to cause heartache, not merely ascending along the meridians.
Worm Masses and ... (End) Withdraw Needle *Jiayi Jing*: Writes "Chang Zhong You Chong Jia, You ... Jiao". Xin Chang becomes Xin Fu. ... becomes Tong (Pain). ... becomes Fa Zuo (Attack/Onset). Xian becomes Xian. Jiao is ... . Becomes ... Jiao. *Mai Jing*, *Qianjin Fang* write "Xin Fu Tong Ao ... Fa Zuo Zhong Ju, Shi ... Jiao ... Ye". Becomes "Hui Jiao Ye". *Waitai Mi Yao* citing *Jiayi Jing* lacks "Ao ...". Zhang Yun: This describes worm masses in the intestines/stomach causing heart and abdominal pain. Jia means knotting/gathering. Jiao is ..., belonging to roundworms. Small needles cannot be used as their force is insufficient to control them. Symptoms of worm masses include unbearable discomfort, abdominal swelling and internal knots, wandering pain without fixed location, pain upon worm movement ceasing when still, intermittent episodes, abdominal heat, thirst, and salivation. These are all caused by ... worms. Jian An notes: ... and ... are synonyms for Huai (Roundworm), pronounced Hui. *Shuowen*: Long worms in the abdomen. *Kouwen Pian*: Heat in Stomach causes worms to move; moving worms relax the Stomach; relaxed Stomach opens Lianquan, causing salivation. *Chaoyuan*: Roundworms are one of the Nine Worms, one chi long, sometimes 5-6 cun. Jiao: Zhang's annotation lacks basis; likely an error. *Shuowen*: Jiao refers to dragons/snakes, not worms.
HT Abdominal Pain Shape Rising from Middle to Top *Jiayi Jing*: Omits these eight characters. Zhang Yun: HT... means fullness. This reiterates the symptom. If the shape rises gradually from the middle to the top, treat with vermifuge methods. HT... and ... are the same, pronounced Peng. Jian An notes: HT..., *Zidian* variant character. HT..., *Yupian* pronunciation Puxingqie, meaning fullness. *Longkan Shoujian*: Chest oppression. The phrase "Shape rising from middle to top" is suspected to have missing/corrupted text, unclear in meaning.
Ear ... Ma Yun: Tinggong acupoint, belongs to Hand Taiyang Small Intestine meridian.
Artery Anterior to Ear Ma Yun: Ermen acupoint, belongs to Hand Shaoyang Sanjiao meridian.
On Cerumen *Jiayi Jing*: Writes "Gan ... Di". Shi states: Upper pronunciation Shanglingqie, ear dirt. Lower pronunciation Naidingqie. *Chaoyuan*: Ear cerumen is formed by coagulation of fluids in the ear. Everyone has it. Mild cases cause no issues; if Wind-Heat invades, it forms hard nodules blocking the ear, causing sudden deafness. Zhang Yun: If painful or hearing loss occurs, do not puncture. Once pus and dirt are removed, the ear heals itself.
Deafness (End) Subsequently Select Foot ... Ma Yun: Select the secondary finger next to the little finger of the hand, where the nail meets the flesh, i.e., Guanchong of Hand Shaoyang Sanjiao meridian. After selecting this, select Qiaoyin of Foot Shaoyang Gallbladder meridian.
Tinnitus (End) Subsequently Select Foot ... Ma Yun: Select the middle finger of the hand, above the nail bed, i.e., Zhongchong of Hand Jueyin Pericardium meridian. Afterwards, select Dazhun of Foot Jueyin Liver meridian.
Foot Thigh (End) Cannot Puncture *Jiayi Jing*: Writes "He" as "He" (Close). Zhang Yun: Bi refers to the thigh. Ce refers to side-lying. Shu He refers to the pivot of the thigh, i.e., Huantiao of Foot Shaoyang meridian. Treat with Yuanli needle (the sixth type of needle). Avoid large needles.
Disease With Flowing Bloody Stool Ma Yun: This discusses lower bleeding having specific acupoints for treatment. For diseases with flowing bloody stool, the Liver fails to store blood. Select Ququan of Liver meridian for needling.
Wind-Bi and Yin ... (End) Death *Jiayi Jing*: Writes "Yin Luo" as "Zhu" (one character). "Kong" as "Nu" (Anger). "Lv Shui" (Walking on water) in all versions is "Lv Bing" (Walking on ice), which should be corrected. Ma Yun: Yi is same as Yi. In Wind-Bi, pathogens overflow and dissipate; the disease is hard to cure. Zhang Yun: Disease in Yang is named Wind; disease manifesting in Yin is named Bi; both Yin and Yang diseased is named Wind-Bi. Yin Luo means progressively deepening infiltration. Feet feel cold as if walking on ice. It feels like entering hot soup. Below affects thighs and calves, middle affects abdomen and heart, above affects head and eyes, affecting everywhere. Exterior presents with sweating; interior presents with shortness of breath and unhappiness. May manifest as sorrow or fear. This is a syndrome of both Yin and Yang being diseased. Although supportable, life will not exceed three years. Jian An notes: *Suwen: Gukong Lun*: "Yin Luo leg weakness, unable to stand long." Wang Bing's annotation: Yin Luo means feeling like soreness and weakness. Examining the original text, Zhang's annotation seems correct. (See detailed discussion in *Suwen Shi*)