诸本无篇字。马云。篇内所谓诸证。不止寒热。然首节所论在寒热。故名篇。但此寒热。主外感言。与
瘰之寒热不同。
不可附席 张云。邪在外。故畏于近席。
鼻槁腊 马云。鼻孔枯腊。腊者、干也。
取三阳之络 马云。当取足太阳膀胱经之络穴。飞扬以泻之。盖太阳为三阳也。
取三阳于下 马云。不言穴者。必俱是络穴。
病无所安（止）死不治 病、甲乙作痛。张云。阴腾者必躁。故无所安也。阴伤则液脱。故汗注不
休也。齿者骨之余。若齿未稿者。阴气尚充。独为可治。当取足少阴之络穴大钟以刺之。若齿有枯色。则阴气
竭矣。其死无疑。近以愚见。则不独在齿。凡爪枯者亦危候也。骨寒而厥者皆然。简案、马以从皮寒热。至骨
寒热。为从浅而及深。遂至死之证。恐非也。又考文例。不及脉寒热、筋寒热者。岂其脱漏乎。
骨厥 志云。谓肾脏为病。而肾气厥热也。简案、足少阴之病为骨厥者。经脉篇。
骨痹（止）补之 张云。骨痹者。病在阴分也。支节不用而痛。汗注烦心者。亦病在阴分也。真阴
不足。则邪气得留于其间。故当取三阴之经。察病所在而补之。按、五邪篇曰。邪在肾。则病骨痛阴痹。取之
涌泉、昆仑。视见血者尽取之。
与此互有发明。所当参阅。简案、举。合也。谓支节尽痛。马云骨痹已成节。不能举而痛。非也。马又根据一本
改阴作阳。志仍之。亦非。
身有所伤（止）关元也 懈惰、甲乙作解 。马云。身有所伤。出血已多。而伤处中于风寒。（此证近
于后世之所谓破伤风）或有所坠堕。不必身伤出血也。四肢懈惰。其名曰体惰。当取小腹脐下三结交之穴以刺
之。盖本经为任脉。而足阳明胃足太阴脾经之脉。亦结于此。故谓之三结交也。即脐下三寸之关元穴耳。简案、
张亦云。破伤风之属。此恐不然。甲乙云。关元、足三阴任脉之会。故曰三结交。
厥痹者（止）补阴经也 张云。厥必起于四肢。厥而兼痹。其气上及于腹者。当取足太阴之络穴公孙。
足阳明之络穴丰隆。以腹与四肢。治在脾胃也。然必视其主病者或阴或阳而取之。阳明多实。故宜泻。太阴多
虚。故宜补。简案、马至名曰天府为一节。并为治厥痹之穴。恐非。
颈侧之动脉人迎 张云。颈前中行任脉也。二行动脉。即足阳明之人迎穴。
婴筋 张云。说文曰。婴、颈饰也。故颈侧之筋曰婴筋。通评虚实论。痈疽不知所。刺缨脉。王注云。
缨脉亦足阳明脉也。近缨之脉。故曰缨脉。缨、谓冠带也。
扶突 张云。在颈之第三行。
足少阳脉 马云。当作手少阳。观前本输篇。第十三节云手少阳也。名曰天牖。六次脉可证。张同。
天牖 张云。在颈之第六行。
天柱 张云。在颈之第七行。
臂太阴 张云。即手太阴也。以上五穴。本输篇言之尤详。即所以治下文之病者也。
阳迎头痛 甲乙。迎、作逆。张云。迎、逆也。阳邪逆于阳经。而为头痛胸满者。当取之人迎也。
简案、张本于楼氏纲目。马改阳明。误。
暴喑气硬 甲乙。 、作硬。张云。喑、声 不能言也。气硬、喉舌强硬也。凡言暴者。皆一时之
气逆。非宿病也。马云。硬、当作梗。志云。硬、梗同。简案、今从张注。
暴聋气蒙 张云。经气蒙蔽。而耳目暴有不明者。当取天牖。
暴挛痫眩足不任身 甲乙足下有痛欲折三字。马云。暴挛者。拘挛也。暴痫者。癫痫也。暴眩者。
眩晕也。合三证而足不任身。当取天柱。
暴瘅内逆 甲乙。瘅、作痹。马云。暴时大热。而在内气逆。乃肝肺两经之火邪相为搏击。以致血溢
于鼻口。张云。瘅、热病也。志云。瘅、消瘅。暴瘅、暴渴也。肝脉贯肺。故手太阴之气逆。则肝肺相搏。肺
主气而肝主血。气逆于中。则血亦留聚而上溢矣。肺乃水之生原。搏则津液不生而暴瘅矣。皆当取手太阴之天
府。以疏其搏逆。夫暴疾。一时之厥证也。此因于气厥。故用数暴字。简案、志。暴渴之解。不可从。
此为大牖五部 甲乙作此为胃之大 五部也。马云。大、当作天。此句总结上文五节。其穴为天牖
五部也。曰天牖五部者。举一穴以统五穴耳。犹后世立汤药之方。举一品以概众品也。张云。以天牖居中。统
前后上下而言也。志云。牖、窗也。头面之穴窍。如楼阁之大牖。所以通气者也。简案、志注尤牵强。
臂阳明（止）不恶寒泻之 马云。臂阳明。即手阳明大肠经也。以其脉行于臂。故不称曰手而曰臂也。
手阳明之脉。
其支者从缺盆、上颈循天鼎、扶突。上贯于颊。入下齿缝中。还出挟口。交人中。左之右。右之左。上挟鼻孔。
循和 、迎香、以交于足阳明。故曰臂阳明。有入 遍齿者。其名曰大迎。正以大迎出足阳明穴。而手阳明之
脉。则入而交之也。齿有痛病谓之龋。故下齿病龋者当取此臂阳明之穴。（商阳二间三间皆治痛齿）如恶寒饮
者虚也。宜补之。不恶寒饮者实也。宜泻之。张云。 。音求。颧也。但臂恶寒者多虚。故宜补。不恶寒者多
实。故宜泻。简案、马以臂字接上句。似是。然以恶寒为恶寒饮。亦未允妥。
足太阳（止）出鼻外 甲乙足作手。一曰取之出鼻外。作一曰取之出眉外。方病之时。盛泻虚补。马云。
足太阳膀胱经之脉。亦入 遍齿。其所入之脉。乃手少阳三焦经之角孙穴。其上齿龋者。正足阳明胃经脉气之
所历。取之在鼻与 前。乃地仓、巨 等穴也。如正痛之时。其脉必盛。盛则宜泻之。或虚则宜补之。一曰当
取之。出于鼻外。即本经之和 、迎香等穴也。
足阳明（止）益不足 诸本不足下有反者益其四字。甲乙。其、作甚。张云。其、当作甚。马志以其字
接下节。非也。张云。足阳明之脉。有挟鼻入于面者。道出于足少阳之悬颅。其下行者属于口。其上行者对口
入系目本。或目或口。凡有过者。皆可取之。然必察其有余不足。以施补泻。若反用之。病必益甚。简案、志
云。足阳明当作手太阳。非也。对口盖指玉枕下边而言。脑疸有对口发之称。可以见耳。
足太阳（止）盛则瞑目 马云。此言头目痛者。当取玉枕。而又言睛明为阴阳二跷之所交。乃寤寐之所
以分病也。足太阳膀胱经。有通项入于脑者。名曰玉枕。（开督脉一寸半脑户枕骨上入发际二寸）此正属于目
之根。两眼中之系。皆系于此。故名之曰
眼系。凡苦头痛。或苦目痛者。皆取之。其脉在项中两筋间。入于脑与阴跷、阳跷相别。实各阴阳诸经交会之
所也。又阳跷之脉入于阴。阴跷之脉出于阳。交于目锐 之睛明穴。阳跷之气盛。则目 而不得闭。阴跷之气
盛。则目瞑而不得开也。张云。按脉度篇。言跷脉属目内 。合于太阳。下文热病篇曰。目中赤痛。从内 始。
取之阴跷。然则此云锐 者。当作内 也。志云。目之尖角曰锐。故外内皆名锐 。简案、志注误。癫狂篇云。
目外决于面者为锐目。张注。本于楼氏纲目。今从之。
热厥（止）皆留之 张云。热厥者。阳邪有余。阴气不足也。故当取足太阴而补之。足少阳而泻之。
寒厥者。阴邪有余。阳气不足也。故当取足阳明而补之。足少阴而泻之。补者补脾胃二经以实四肢。泻者泻水
火二经以泄邪气。然必皆久留其针。则泻者可去。补者乃至矣。此当与终始篇义。相参为用。简案、马云。少
阳当作少阴。少阴当作少阳。未为得矣。
舌纵涎下 张云。此下三节。皆兼寒热二厥而言也。舌纵不收。及涎下烦闷者。肾阴不足。不能收
摄也。故当取足少阴经而补之。
振寒洒洒止取手太阴 张云。鼓颔、振寒鼓腮也。凡此诸证。皆阳气不足之候。故当取手太阴肺经
而补之。
刺虚者（止）刺其来也 张云。刺其去。追而济之也。刺其来。迎而夺之也。卫气行篇。亦有此二句。
春取络脉（止）治骨髓 张云。春夏之取。与前四时气篇水热穴论皆同。秋取气口者。手太阴肺脉应秋
金也。冬取经俞者。经穴通脏气。藏主冬也。络脉浮浅。故治皮肤。分腠有理。故治肌肉。气口者脉之大会。故
治筋脉。经输连脏。
故治骨髓。按、此言经输者。总言经穴也。非诸经之经穴俞穴。盖水热穴论以五输言。故云秋取经俞。冬取井
荥。此以内外言。故云络脉治皮肤。经输治骨髓也。当解其意。齐、剂同。药曰药剂。针曰砭剂也。
五脏身有五部（止）有痈疽者死 简案、五脏在内。而关系于身者有五部。其一在伏兔。（在膝上六寸
起肉间足阳明胃经之要害也）其二在腓 。（即小腿肚也足太阳少阴及三焦下 之所系者腓音肥 音篆）其三
在背。背之中行曰督脉。而背旁四行。皆足太阳膀胱经穴。脏气所系之要害也。其四在五脏之俞。（肺俞三椎
旁心俞五椎旁肝俞九椎旁脾俞十一椎旁肾俞十四椎旁各开中行一寸半）其五在项。亦系督脉。统诸阳之纲领也。
凡上五部。皆要害之所。忌生痈疽。生者多死。（以上系马张二注节录）汪云。按阳毒起发者尚可治。若阴毒
不起者。断难治也。刘氏玉机微义云。大抵所言地分。皆脉络所会。内系腑脏。然患者得而早言。医者审证案
法治之。则皆为不死矣。
介按、痈之与疽。截然两途。阳症为痈。阴症为疽。治法迥殊。若以痈疽连称。未免贻害。惟王洪绪之全
生集。分辨甚明。可参考焉。至于此条。原注是系阴疽。其一即伏兔疽。其二为腓 发。其三是发背。其四是
脾发疽、肾俞发之类。其五即天柱疽之类也。
病始手臂（止）止之于阴 简案、甲乙此一节。载伤寒热病中。又从病始手臂。至取足阳明而汗出。
见素刺热篇。马张以为承上文刺痈疽法。误也。张云。臂、太阴肺经也。足、阳明胃经也。按、热病篇曰。脉
顺可汗者。取之鱼际、太渊、大都、太白。泻之则热去。补之则汗出。按以上四穴。皆手足太阴经之荥输也。
此言臂太阴者。即鱼际、太渊二穴。然则足阳明者。亦当取之荥输。则内庭、陷谷是也。补太阴而
汗出甚者。阴之胜也。当补阳明。可以止之。泻太阴而汗出甚者。阳之胜也。当泻阳明。可以止之。盖以阴阳
平而汗自止也。取阳而汗出甚者。其止法亦然。
凡刺之害（止）生为痈疽也 此一节。见九针十二原篇。
各版本原文中均无“篇”字。马云认为，本篇中所论述的各种证候，并不仅限于寒热病，但首节主要讨论的是寒热，因此以“寒热”命名此篇。然而，这里的寒热，主要针对外感邪气引起的病症，与瘰疬（颈部淋巴结结核）引起的寒热不同。
不可附席：张云指出，邪气在体表，所以患者畏惧靠近床席。
鼻槁腊：马云解释，“腊”意为干燥。指鼻孔干枯如腊。
取三阳之络：马云说，应当选取足太阳膀胱经的络穴飞扬来泻邪。因为太阳经属于三阳经。
取三阳于下：马云说，文中未提及具体穴位名称，必定都是指络穴。
病无所安（止）死不治：《甲乙经》中“病”字作“痛”。张云说，阴气亢盛则必然烦躁，所以患者身体无处安放。阴液损伤则津液脱失，所以汗出不止。牙齿是骨骼的余气所生，如果牙齿尚未枯槁，说明阴气尚且充盛，唯独这种情况还可以治疗，应当选取足少阴肾经的络穴大钟进行针刺。如果牙齿出现枯槁之色，则说明阴气已竭，死亡无疑。近观我的见解，不仅牙齿枯槁是危重征象，凡是指甲枯槁者也是危重征象。骨寒而四肢厥冷者皆是如此。简案认为，马氏将从皮寒热到骨寒热的过程，理解为由浅入深直至死亡的证候，恐怕不对。又考证文章体例，未提及脉寒热、筋寒热等，难道是文本脱漏了吗？
骨厥：志云，指肾脏发病，导致肾气厥逆发热。简案认为，足少阴经的病称为骨厥，见《经脉篇》。
骨痹（止）补之：张云说，骨痹是病在阴分。肢节不能活动且疼痛，汗出淋漓且心烦，也是病在阴分。真阴不足，则邪气得以留滞其间，所以应当选取三阴经的经穴，观察病变所在并进行补法治疗。按，《五邪篇》说：“邪气在肾，则发生骨痛和阴痹，取涌泉、昆仑穴，视其出血情况，全部刺出。”这与本文互相发明，应当参阅。简案认为，“举”意为合拢。意思是肢节完全疼痛，无法合拢且痛。马云说骨痹已成关节病，不能举而痛，这是错误的。马氏又根据另一个版本将“阴”改为“阳”，志书沿用了这一说法，这也是错误的。
身有所伤（止）关元也：《甲乙经》中“懈惰”作“解”。马云说，身体受到外伤，出血过多，且伤口处感受风寒。（此证接近后世所谓的破伤风）或者是遭受坠落伤害，不一定非要身体受伤出血。四肢懈怠无力，这种病名叫“体惰”。应当选取小腹脐下三结交的穴位进行针刺。因为本经是任脉，而足阳明胃经和足太阴脾经的脉气也结聚于此，所以叫作三结交。即脐下三寸的关元穴。简案认为，张氏也说这属于破伤风一类，但这恐怕不对。《甲乙经》说，关元穴是足三阴经和任脉的交会穴，所以叫三结交。
厥痹者（止）补阴经也：张云说，厥逆一定起于四肢，厥逆兼有痹症，气机上逆波及腹部的，应当选取足太阴脾经的络穴公孙，足阳明胃经的络穴丰隆，因为腹部和四肢的病变，治疗关键在于脾胃。然而必须视其主病的经络或阴或阳来选择穴位。阳明经多实证，所以宜用泻法；太阴经多虚证，所以宜用补法。简案认为，马氏将直到“名曰天府”作为一节，并列为治疗厥痹的穴位，恐怕不对。
颈侧之动脉人迎：张云说，颈前正中是任脉。两侧跳动的动脉，即是足阳明胃经的人迎穴。
婴筋：张云说，《说文解字》记载：“婴，颈饰也。”所以颈侧的筋叫作婴筋。《通评虚实论》中提到痈疽不知何处刺痛，应刺缨脉。王冰注解说，缨脉也是足阳明脉，靠近缨带的脉，所以叫缨脉。缨，指冠带。
扶突：张云说，位于颈部第三行。
足少阳脉：马云说，应当作“手少阳”。看前面的《本输篇》第十三节说“手少阳”，名为天牖，六次脉动可以证明。张氏同意此观点。
天牖：张云说，位于颈部第六行。
天柱：张云说，位于颈部第七行。
臂太阴：张云说，即手太阴肺经。以上五个穴位，在《本输篇》中论述得尤为详细，也就是用来治疗下文所述疾病的穴位。
阳迎头痛：《甲乙经》中，“迎”作“逆”。张云说，迎即逆。阳邪逆乱于阳经，导致头痛胸满的，应当取用人迎穴。简案认为，张氏依据楼氏《纲目》，马氏改为“阳明”，是错误的。
暴喑气硬：《甲乙经》中，“ ”作“硬”。张云说，喑，指声音嘶哑不能说话。气硬，指喉舌强硬。凡是说“暴”的，都是一时之气逆，不是宿疾。马云说，“硬”当作“梗”。志书说，“硬”、“梗”同义。简案认为，现在采纳张氏的注释。
暴聋气蒙：张云说，经气蒙蔽，导致耳目突然不明亮的，应当取用天牖穴。
暴挛痫眩足不任身：《甲乙经》中“足”下有“痛欲折”三字。马云说，暴挛，指拘挛。暴痫，指癫痫。暴眩，指眩晕。综合这三种证候且双脚无法支撑身体，应当取用天柱穴。
暴瘅内逆：《甲乙经》中，“瘅”作“痹”。马云说，突然的大热，且体内气机逆乱，这是肝肺两经的火邪相互搏击，导致血液从鼻口溢出。张云说，瘅，指热病。志书说，瘅，指消瘅。暴瘅，指突发口渴。肝脉贯穿肺部，所以手太阴肺气逆乱，则肝肺相搏。肺主气而肝主血，气逆于中，则血也留聚而上溢。肺是水液的生化之源，相搏则津液不生而突发暴瘅。这些都应当取用手太阴肺经的天府穴，以疏通其搏逆之气。夫暴疾，是一时的厥证，这是因为气厥所致，所以用多个“暴”字。简案认为，志书对“暴渴”的解释不可采纳。
此为胃之大牖五部：《甲乙经》作“此为胃之大五部也”。马云说，“大”当作“天”。这句话总结上文五节，其穴位是天牖五部。所谓天牖五部，是举出一个穴位来统摄五个穴位，就像后世制定汤药方剂，举出一味药来概括众多药物一样。张云说，以天牖穴居中，统摄前后上下而言。志书说，牖，即窗户。头面部的穴位窍道，如同楼阁的大窗，是用来通气的地方。简案认为，志书的注解尤其牵强。
臂阳明（止）不恶寒泻之：马云说，臂阳明，即手阳明大肠经。因为其经脉行于手臂，所以不称“手”而称“臂”。手阳明经脉，其分支从缺盆上行至颈部，循行经过天鼎、扶突，上贯脸颊，进入下齿缝中，回转出来挟口，交叉于人中正中线，左向右，右向左，上挟鼻孔，循行经过禾髎、迎香，与足阳明经交接，所以叫臂阳明。有进入遍齿的，名字叫大迎。正因为大迎是足阳明经的穴位，而手阳明经的脉气则是进入并与之交会的。牙齿有疼痛疾病叫做龋齿，所以下齿患龋齿的应当取用此臂阳明经的穴位。（商阳、二间、三间都治疗龋齿疼痛）如果怕冷饮水，说明是虚证，宜用补法；不怕冷饮水，说明是实证，宜用泻法。张云说，“ ”音求，指颧骨。但手臂怕冷的多为虚证，所以宜补；不怕冷的多为实证，所以宜泻。简案认为，马氏将“臂”字接在上句之后，似乎合理，但以“恶寒”为“恶寒饮”，也不够妥当。
足太阳（止）出鼻外：《甲乙经》中“足”作“手”。一说取用出于鼻外的穴位，一作取用出于眉外的穴位。在患病初期，实证宜泻，虚证宜补。马云说，足太阳膀胱经的脉气，也进入遍齿。其所入的脉气，乃是手少阳三焦经的角孙穴。其上齿龋齿，正是足阳明胃经脉气所经过的地方。取穴在鼻翼和颧骨前，乃地仓、巨髎等穴位。如果正值疼痛之时，其脉气必盛，盛则宜泻；若虚则宜补。一说应当取用出于鼻外的穴位，即本经的禾髎、迎香等穴位。
足阳明（止）益不足：各版本在“不足”下有“反者益其”四字。《甲乙经》中，“其”作“甚”。张云说，“其”当作“甚”。马氏和志书将其字接下节，是不对的。张云说，足阳明经脉，有挟鼻入面的，道路出于足少阳经的悬颅穴。其下行者属于口，其上行者对口进入系目本。无论是眼部还是口部，凡有过错的，都可以取用。然而必须察其有余和不足，以施行补泻。如果反过来使用，病情必定加重。简案认为，志书说足阳明应当作手太阳，这是不对的。“对口”指玉枕下方而言，脑疽有对口的称呼，由此可见。
足太阳（止）盛则瞑目：马云说，这里说头目疼痛的，应当取用玉枕穴。又说睛明穴是阴阳二跷脉的交会处，是清醒和睡眠的分界点。足太阳膀胱经，有通过项部进入脑部的，名叫玉枕。（开督脉一寸半，脑户枕骨上入发际二寸）这正是属于眼睛的根本，两眼中的脉络都系于此，所以叫眼系。凡是苦于头痛或苦于目痛的，都取用此穴。其脉在项中两筋之间，进入脑部与阴跷、阳跷分开。实际上是各阴阳诸经交会之处。另外，阳跷脉进入阴分，阴跷脉出于阳分，交于目锐眦的睛明穴。阳跷之气盛，则眼睛睁开而无法闭合；阴跷之气盛，则眼睛闭合而无法睁开。张云说，按《脉度篇》所说，跷脉属目内眦，合于太阳经。下文《热病篇》说：“目中赤痛，从内眦开始，取阴跷脉。”既然如此，这里说的“锐眦”，应当作“内眦”。志书说，眼的尖角叫锐，所以内外都叫锐眦。简案认为，志书的注解错误。《癫狂篇》说：“目外决于面者为锐眦。”张氏注解说，这依据于楼氏《纲目》，现在采纳这个说法。
热厥（止）皆留之：张云说，热厥，是阳邪有余，阴气不足。所以应当取足太阴脾经进行补法，取足少阳胆经进行泻法。寒厥，是阴邪有余，阳气不足。所以应当取足阳明胃经进行补法，取足少阴肾经进行泻法。补法是补脾胃二经以充实四肢，泻法是泻水火二经以泄除邪气。然而都必须长时间留针，这样泻法才能去邪，补法才能达到效果。这应当与《终始篇》的意义相互参照运用。简案认为，马云说少阳应当作少阴，少阴应当作少阳，这并没有得到正确的理解。
舌纵涎下：张云说，下面三节，都兼有寒热两种厥逆而言。舌头松弛不收，以及流涎、烦闷的，是肾阴不足，不能收摄。所以应当取足少阴肾经进行补法。
振寒洒洒止取手太阴：张云说，鼓颔，指打寒战时腮帮抖动。凡是这些证候，都是阳气不足的征候。所以应当取手太阴肺经进行补法。
刺虚者（止）刺其来也：张云说，刺其去，是追随着正气而资助它。刺其来，是迎着邪气而夺取它。《卫气行篇》也有这两句话。
春取络脉（止）治骨髓：张云说，春夏季节的取穴方法，与前文《四时气篇》和《水热穴论》相同。秋季取气口穴，是因为手太阴肺脉对应秋天的金气。冬季取经俞穴，是因为经穴通达脏气，脏气主冬。络脉浮浅，所以治疗皮肤疾病。分腠有理，所以治疗肌肉疾病。气口是脉之大会，所以治疗筋脉疾病。经输连通脏腑，所以治疗骨髓疾病。按，这里说的经输，总称经穴，并非指各经的经穴和俞穴。大概《水热穴论》是以五输穴来说的，所以说秋取经俞，冬取井荥。这里是以内外来区分，所以说络脉治皮肤，经输治骨髓。应当领会其意。齐，通“剂”。药叫药剂，针叫砭剂。
五脏身有五部（止）有痈疽者死：简案认为，五脏在内，而在身体上有五个要害部位。其一在伏兔。（在膝上六寸起肉间，是足阳明胃经的要害）其二在腓肠。（即小腿肚，是足太阳、少阴及三焦下合穴所系之处，腓音肥， 音篆）。其三在背部。背的中行是督脉，而背旁四行，都是足太阳膀胱经的穴位，是脏气所系的要害。其四在五脏的俞穴。（肺俞在三椎旁，心俞在五椎旁，肝俞在九椎旁，脾俞在十一椎旁，肾俞在十四椎旁，各距中行一寸半）。其五在颈部，也系于督脉，统率诸阳的纲领。以上五个部位，都是要害所在，忌讳生痈疽，生了的多会死亡。（以上是摘录马氏和张氏的注释）。汪氏说，按阳毒起发的尚可治疗，若阴毒不起发的，断难治疗。刘氏《玉机微义》说，大体所说的地段，都是脉络交会之处，内连脏腑。然而患者能及早诉说，医生审证按法治之，则都不会死亡。
介按，痈与疽，截然两途。阳症为痈，阴症为疽，治法截然不同。若将痈疽连称，未免贻害后人。只有王洪绪的《全生集》分辨得很清楚，可以参考。至于这一条，原注是系阴疽。其一即伏兔疽，其二为腓 发，其三是发背，其四是脾发疽、肾俞发之类，其五即天柱疽之类。
病始手臂（止）止之于阴：简案认为，《甲乙经》这一节记载在伤寒热病中，又从“病始手臂”到“取足阳明而汗出”，见于《素问·刺热篇》。马氏和张氏认为承接上文刺痈疽的方法，是错误的。张云说，臂，指太阴肺经。足，指阳明胃经。按，《热病篇》说：“脉顺可汗者，取鱼际、太渊、大都、太白。泻之则热去，补之则汗出。”按以上四个穴位，都是手足太阴经的荥穴和输穴。这里说的臂太阴，即鱼际、太渊二穴。那么足阳明，也应当取用其荥输穴，即内庭、陷谷。补太阴而汗出甚多的，是阴胜，应当补阳明，可以止住汗。泻太阴而汗出甚多的，是阳胜，应当泻阳明，可以止住汗。大概是因为阴阳平和而汗自止。取阳经而汗出甚多的，其止法也是如此。
凡刺之害（止）生为痈疽也：这一节，见于《九针十二原篇》。
None of the various versions contain the character "Pian" (Chapter). Ma Yun states that the various syndromes discussed in this chapter are not limited to chills and fever, but since the first section mainly discusses chills and fever, the chapter is named accordingly. However, the chills and fever here primarily refer to conditions caused by external pathogenic factors, which differ from the chills and fever associated with scrofula (lymph node tuberculosis of the neck).
Cannot lean on the mat: Zhang Yun explains that because the pathogen is in the exterior, the patient fears coming close to the bed or mat.
Dry and shriveled nose: Ma Yun explains that "La" means dry. It refers to the nostrils becoming dry and shriveled like cured meat.
Take the collaterals of the Three Yang meridians: Ma Yun says one should select the Luo-connecting point Feiyang (BL58) of the Foot-Taiyang Bladder Meridian to drain the pathogen, as the Taiyang meridian belongs to the Three Yang meridians.
Take the Three Yang below: Ma Yun notes that since no specific acupoint names are mentioned, they must all refer to Luo-connecting points.
No place for comfort (ends in death and incurable): In the *Jia Yi Jing* (Systematic Classic of Acupuncture and Moxibustion), the character "Bing" (Disease) is written as "Tong" (Pain). Zhang Yun states that when Yin qi overacts, restlessness inevitably occurs, so the patient feels unable to find a comfortable position. If Yin fluid is damaged, body fluids are depleted, leading to incessant sweating. Teeth are considered the surplus of bone; if the teeth are not yet withered, it indicates that Yin qi is still sufficient, and this condition alone can be treated by needling the Luo-connecting point Dazhong (KI11) of the Foot-Shaoyin Kidney Meridian. If the teeth show a withered color, it signifies exhaustion of Yin qi, and death is inevitable. From my recent observation, not only withered teeth indicate a critical prognosis; any case with withered fingernails is also critical. This applies equally to cases of cold bones and cold extremities. The commentary notes that Ma's interpretation—that the progression from skin chills/fever to bone chills/fever represents a deepening process leading to death—is likely incorrect. Furthermore, examining the textual style, the absence of mentions regarding pulse chills/fever or tendon chills/fever suggests possible textual loss.
Bone Jue (Reversal): Zhi Yun states this refers to disease of the Kidney organ resulting in rebellious heat of Kidney Qi. The commentary notes that diseases of the Foot-Shaoyin Meridian are called Bone Jue, as seen in the *Meridians Chapter*.
Bone Bi (Obstruction) (ends in tonify): Zhang Yun states that Bone Bi is a disease in the Yin aspect. Pain and inability to move the joints, along with profuse sweating and vexation, also indicate a disease in the Yin aspect. When true Yin is insufficient, pathogens remain stagnant within; therefore, one should select the Jing-River points of the Three Yin meridians, observe the location of the pathology, and apply tonification. According to the *Five Pathogens Chapter*: "When pathogen is in the Kidney, it causes bone pain and Yin Bi; take Yongquan (KI1) and Kunlun (BL60); if blood appears, drain all of it." This complements the current text and should be consulted. The commentary clarifies that "Ju" means to join together, implying joint pain preventing movement. Ma's statement that Bone Bi has become a joint disease causing pain upon movement is incorrect. Ma also altered "Yin" to "Yang" based on another version, which Zhi Yun followed; this is also incorrect.
Body injury (ends at Guanyuan): In the *Jia Yi Jing*, "Xie Duo" (Lassitude) is written as "Jie". Ma Yun explains that after a bodily injury with significant blood loss, if wind-cold invades the wound (this condition resembles what later medicine calls tetanus), or due to falling trauma regardless of bleeding, the limbs become lassaude. This syndrome is named "Ti Duo" (Body Lassitude). One should needle the acupoint where the three meridians intersect below the umbilicus. Since this meridian is the Ren Mai (Conception Vessel), and the meridians of the Foot-Yangming Stomach and Foot-Taiyin Spleen also converge here, it is called the "Three Meridian Intersection." This refers to the acupoint Guanyuan (CV4), located three cun below the umbilicus. The commentary notes that Zhang also classifies this under tetanus, but this is likely incorrect. The *Jia Yi Jing* states that Guanyuan is the intersection of the Foot Three Yin meridians and the Ren Mai, hence the name.
Jue Bi (ends in tonify Yin meridians): Zhang Yun states that Jue (reversal/cold extremities) originates in the four limbs. When Jue is accompanied by Bi obstruction and the qi rebels upward to the abdomen, one should select the Luo-connecting point Gongsun (SP4) of the Foot-Taiyin Spleen Meridian and Fenglong (ST40) of the Foot-Yangming Stomach Meridian, as the treatment for abdominal and limb disorders lies in the Spleen and Stomach. However, one must determine whether the primary disease involves Yin or Yang meridians to select points. The Yangming meridians tend toward excess, so draining is appropriate; the Taiyin meridians tend toward deficiency, so tonifying is appropriate. The commentary criticizes Ma for grouping points up to Tianfu (LU6) as treatments for Jue Bi, which is likely incorrect.
Arterial pulse on the side of the neck - Renying: Zhang Yun states that the midline of the anterior neck is the Ren Mai. The pulsating arteries on both sides are the Renying (ST9) acupoints of the Foot-Yangming Stomach Meridian.
Ying Jin (Neck Tendons): Zhang Yun cites the *Shuo Wen Jie Zi*: "Ying means neck ornament." Thus, the tendons on the side of the neck are called Ying Jin. The *Tong Ping Xu Shi Lun* mentions stabbing the Ying Mai for abscesses. Wang Bing's commentary states that Ying Mai is also the Foot-Yangming meridian, named so because it is near the ribbon of a hat (Ying).
Futu: Zhang Yun states it is located in the third row of the neck.
Foot-Shaoyang Meridian: Ma Yun argues this should read "Hand-Shaoyang," citing the *Ben Shu Chapter* (Section 13) which mentions Hand-Shaoyang named Tianyou, supported by the six pulses. Zhang agrees.
Tianyou: Zhang Yun states it is located in the sixth row of the neck.
Tianzhu: Zhang Yun states it is located in the seventh row of the neck.
Arm-Taiyin: Zhang Yun states this is the Hand-Taiyin Lung Meridian. The above five acupoints are detailed in the *Ben Shu Chapter* and are used to treat the diseases described below.
Yang Ying Headache: The *Jia Yi Jing* writes "Ying" as "Ni" (Rebellious). Zhang Yun states Ying means Ni. When Yang pathogen rebels in the Yang meridians causing headache and chest fullness, one should select Renying (ST9). The commentary notes Zhang follows Lou's *Gang Mu*, while Ma's alteration to "Yangming" is erroneous.
Sudden Aphonia and Stiff Qi: The *Jia Yi Jing* writes the character as "Ying" (Stiff). Zhang Yun explains "Yin" means hoarse voice/inability to speak. "Qi Ying" means stiffness of the throat and tongue. "Sudden" implies acute Qi rebellion, not chronic disease. Ma Yun suggests "Ying" should be "Geng" (Blockage). Zhi Yun states "Ying" and "Geng" are synonymous. The commentary adopts Zhang's note.
Sudden Deafness and Mental Clouding: Zhang Yun states that when meridian Qi is clouded, causing sudden hearing and vision impairment, one should select Tianyou (TE16).
Sudden Spasm, Epilepsy, Vertigo, and Inability to Bear Weight: The *Jia Yi Jing* adds "pain wanting to break" after "foot." Ma Yun explains sudden spasm as contracture, sudden epilepsy as seizures, and sudden vertigo as dizziness. Combined with the inability to bear weight on the feet, one should select Tianzhu (BL10).
Sudden Dan and Internal Rebellion: The *Jia Yi Jing* writes "Dan" as "Bi." Ma Yun describes sudden high fever with internal Qi rebellion as fighting between Fire pathogens of the Liver and Lung meridians, causing blood to overflow from the nose and mouth. Zhang Yun defines "Dan" as a heat disease. Zhi Yun defines "Dan" as Xiao Dan (wasting-thirst syndrome) and "Su Dan" as sudden thirst. The Liver meridian passes through the Lung; thus, rebellion of Hand-Taiyin Qi causes Liver-Lung conflict. The Lung governs Qi and the Liver governs Blood; Qi rebellion leads to Blood stagnation and upward overflow. As the source of water metabolism, conflict prevents fluid generation, causing sudden Dan. All these should be treated by selecting Tianfu (LU4) of the Hand-Taiyin Lung Meridian to smooth the rebellious Qi. These sudden diseases are acute Jue syndromes caused by Qi rebellion, hence the use of "sudden." The commentary rejects Zhi's interpretation of "sudden thirst."
This is the Great Window of the Stomach, Five Parts: The *Jia Yi Jing* reads "This is the Great Five Parts of the Stomach." Ma Yun states "Da" should be "Tian." This sentence summarizes the previous five sections, referring to the Tianyou Five Parts. "Tianyou Five Parts" uses one acupoint to represent five, similar to how a prescription uses one herb to represent many. Zhang Yun states Tianyou is central, governing front, back, upper, and lower. Zhi Yun compares the head and face acupoints to large windows of a building for ventilation. The commentary finds Zhi's explanation forced.
Arm-Yangming (ends in drain if no aversion to cold): Ma Yun identifies Arm-Yangming as the Hand-Yangming Large Intestine Meridian, called "Arm" because its pathway runs along the arm. Its branch ascends from Quepen, passes Tianding (SI11) and Futu (LI16), enters the cheek, goes into the lower gum, emerges around the mouth, crosses the philtrum, and ascends alongside the nostrils, connecting with the Foot-Yangming via Heliao (SI18) and Yingxiang (LI20). Thus, it is called Arm-Yangming. The point Daying (ST5) is where the Hand-Yangming meridian intersects with the Foot-Yangming. Tooth pain is called Qu (caries); thus, lower tooth caries should be treated using Arm-Yangming points (Shangyang LI1, Erjian LI2, Sanjian LI3 treat tooth pain). Aversion to cold and drinking indicates deficiency (tonify); lack of aversion indicates excess (drain). Zhang Yun notes "Qiu" refers to the zygoma. Arm aversion to cold is mostly deficiency (tonify); lack of aversion is mostly excess (drain). The commentary finds Ma's connection of "Arm" to the previous sentence plausible but questions interpreting "aversion to cold" as "aversion to cold drinks."
Foot-Taiyang (ends in emerge outside the nose): The *Jia Yi Jing* changes "Foot" to "Hand." One version says take points emerging outside the nose; another says outside the eyebrow. At the onset of disease, excess requires draining, deficiency requires tonifying. Ma Yun states the Foot-Taiyang Bladder Meridian also enters the gums via the Jiaosun (TE17) point of the Hand-Shaoyang Sanjiao Meridian. Upper tooth caries involve the Foot-Yangming Stomach Meridian; points include Dicang (ST4) and Juliao (ST3). During peak pain, the pulse is excess (drain); if deficient, tonify. Another view suggests taking points outside the nose, such as Heliao (SI18) and Yingxiang (LI20).
Foot-Yangming (ends in benefit insufficiency): Some versions add "Fan Zhe Yi Qi" (If reversed, increase it) after "insufficiency." The *Jia Yi Jing* writes "Qi" as "Shen" (Very). Zhang Yun agrees "Qi" should be "Shen." Ma and Zhi incorrectly connect this to the next section. Zhang Yun explains the Foot-Yangming meridian passes through the nose to the face via Xuanlu (GB5), descends to the mouth, and ascends to the eyes. Any pathology in the eye or mouth can be treated, but one must assess excess or deficiency to apply tonification or draining. Reversing this will worsen the disease. The commentary rejects Zhi's claim that Foot-Yangming should be Hand-Taiyang. "Duikou" refers to below Yuzhen; brain abscesses are known as "Duikou," illustrating this.
Foot-Taiyang (ends in excess causes closed eyes): Ma Yun states that for head and eye pain, select Yuzhen (BL9). Jingming (BL1) is the intersection of Yin and Yang Qiao vessels, dividing wakefulness and sleep. The Foot-Taiyang Bladder Meridian enters the brain via Yuzhen (1.5 cun lateral to Du Mai, 2 cun above hairline on occiput). This is the root of the eyes; all eye connections attach here, hence "Eye System." For headache or eye pain, select this point. The pulse is between the two tendons in the neck, entering the brain and separating from Yin/Yang Qiao. It is an intersection of Yin/Yang meridians. The Yang Qiao enters Yin, and Yin Qiao exits Yang, intersecting at Jingming (BL1) in the outer canthus. Excess Yang Qiao Qi causes inability to close the eyes; excess Yin Qiao Qi causes inability to open them. Zhang Yun cites the *Mai Du Chapter* stating Qiao vessels belong to the inner canthus and merge with Taiyang. The *Re Bing Chapter* states red painful eyes start from the inner canthus, treated by Yin Qiao. Thus, "outer canthus" here should be "inner canthus." Zhi Yun defines outer corner as sharp, applying to both; the commentary rejects this, citing the *Dian Kuang Chapter* and Lou's *Gang Mu* supporting Zhang's view.
Heat Jue (ends in retain needle): Zhang Yun states Heat Jue is excess Yang pathogen and insufficient Yin Qi; treat by tonifying Foot-Taiyin and draining Foot-Shaoyang. Cold Jue is excess Yin pathogen and insufficient Yang Qi; treat by tonifying Foot-Yangming and draining Foot-Shaoyin. Tonification strengthens Spleen/Stomach to fill limbs; draining clears Water/Fire to expel pathogens. Needles must be retained long enough for draining to remove pathogen and tonification to arrive. This应与 *Zhong Shi Chapter* cross-referenced. The commentary notes Ma's swap of Shaoyang/Shao Yin is incorrect.
Tong Flaccidity and Drooling: Zhang Yun states the following three sections discuss both cold and heat Jue. Tong flaccidity, drooling, and vexation indicate insufficient Kidney Yin failing to secure fluids; treat by tonifying Foot-Shaoyin.
Chills and Shivering (ends in only take Hand-Taiyin): Zhang Yun explains "Gu Han" is shivering cheeks. These signs indicate insufficient Yang Qi; treat by tonifying Hand-Taiyin Lung Meridian.
Tonify Deficiency (ends in pierce its arrival): Zhang Yun explains piercing "departure" follows and supports Qi; piercing "arrival" meets and drains pathogen. This phrase appears in the *Wei Qi Xing Chapter*.
Spring Take Collaterals (ends in treat Marrow): Zhang Yun states spring/summer point selection matches *Si Shi Qi Chapter* and *Shui Re Xue Lun*. Autumn takes Qikou (LU9) corresponding to Metal/Lung. Winter takes Jing-Shu points connecting to Zang organs. Collaterals are superficial, treating skin; Fen Li (interstices) treat muscle; Qikou is the meeting of pulses, treating sinews; Jing-Shu connects to Zang, treating marrow. Note: "Jing-Shu" here generally means Jing points, not specifically Shu points. *Shui Re Xue Lun* uses Five Shu points (Autumn Jing-Shu, Winter Jing-Ring); this text uses interior/exterior distinction (Collaterals-Skin, Jing-Shu-Marrow). Understand the intent. "Qi" equals "Ji" (dose/formula). Herbs have herbal formulas; needles have bi-doses.
Five Parts of the Body Related to Five Zang (ends in those with carbuncles die): The commentary lists five critical areas related to internal Zang: 1. Fubu (ST32 area, Stomach Meridian vital point); 2. Feichang (Calf, connected to Bladder, Kidney, Sanjiao); 3. Back (Du Mai midline, Bladder Meridian sides, vital for Zang Qi); 4. Back-Shu points of Five Zang (Feishu BL13 to Shenshu BL23, 1.5 cun lateral); 5. Neck (Du Mai, governor of Yang). Carbuncles/ulcers here are fatal. Wang notes Yang toxins may be treatable; Yin toxins are not. Liu's *Yu Ji Wei Yi* states these are pulse intersections connected to viscera; early diagnosis and correct treatment prevent death. The commentator distinguishes Yang (carbuncle) and Yin (ulcer), criticizing their conflation, referencing Wang Hongxu's *Quan Sheng Ji*. The five parts correspond to Yin ulcers: Fubu ulcer, calf ulcer, back ulcer, Spleen/Kidney Shu ulcers, and Tianzhu ulcer.
Disease Starts in Arm (ends in stop in Yin): The commentary notes this section appears in *Jia Yi Jing* under Cold Damage/Heat Disease and *Su Wen: Ci Re Pian*. Ma and Zhang incorrectly link it to carbuncle treatment. Zhang Yun identifies Arm as Taiyin Lung and Foot as Yangming Stomach. The *Re Bing Chapter* states for sweating, take Yuji (LU10), Taiyuan (LU9), Dadu (SP2), Taibai (SP3). Draining removes heat; tonifying induces sweat. These are Ying-Shu points of Hand/Foot Taiyin. "Arm Taiyin" refers to Yuji and Taiyuan. "Foot Yangming" should similarly use Ying-Shu points: Neiting (ST44) and Xianggu (ST43). Tonifying Taiyin with excessive sweating indicates Yin excess; tonify Yangming to stop it. Draining Taiyin with excessive sweating indicates Yang excess; drain Yangming to stop it. Balance Yin/Yang to stop sweat. The same logic applies to Yang meridians.
Harm of Needling (ends in generates carbuncles): This section is found in the *Jiu Zhen Shi Er Yuan Chapter*.