少师 甲乙作岐伯。
阴中有阴 阳中有阳 甲乙作阴中有阳。阳中有阴。据下文甲乙非是。张云。刚、柔、强、弱、
短、长。无非阴阳之化。然曰阴曰阳。人皆知之。至若阴中复有阴。阳中复有阳。则人所不知也。故当详审阴
阳。则刺得其方矣。
得病所始 张云。谓知其或始于阴。或始于阳。故刺之有理也。
谨度病端 张云。谓察其风因木化。热因火化。湿因土化。燥因金化。寒因水化。故与时相应也。
故曰病在阴之阴者（止）刺络脉 张云。阴之阴者。阴病在阴分也。当刺其荥输。以诸经荥输气
微亦阴之类。如手太阴经鱼际为荥。太渊为输者是也。阳之阳者。阳病在阳分也。当刺其合穴。盖所入为合。
犹在阳分。刺此以防深入。如手阳明经曲池之类是也。阳之阴者。阳病在阴也。当刺阴之经穴。盖所行为经。
其气正盛。即阴中之阳。如手太阴经渠之类是也。阴之阳者。阴病在阳也。当刺诸络脉。盖络脉浮浅。皆在阳
分。如手阳明经偏历之类是也。简案、络脉甲乙作阳之络。义尤明矣。马以阴阳为五脏六腑皮肤筋骨之义。觉
不允当。
故曰病在阳者（止）命曰风痹 马云。病在阳经者其名曰风。（义见素问风论）病在阴经者其名
曰痹。（义见素问痹论）阴阳两经俱受其病。其名曰风痹。东垣李氏云。病在阳者命曰风。此病在阳。因十二
经各受风邪。以高言之气分也。故身半以上。风之中也。病在阴者命曰痹。身半以下。湿之中也。楼氏曰。
阴阳俱病。言阴阳气血俱病也。简案、二氏所取义各异。然以上文阴阳推之。马注为得。张意亦同。（张氏医
通云行痹者走注无定风之用也经云病在阳者命曰风在阴者命曰痹阴阳俱病命曰风痹越脾加术附汤）
病有形（止）阴之类也 张云。有形而不痛者病浅在外也。无形而痛者病深在内也。志云。有形者
皮肉筋骨之有形。无形者五脏六腑之气也。病有形而不痛者。病在外之阳也。病无形而痛者。气伤痛也。
其阳完而阴伤之也 马云。阳经不伤。而阴经受伤耳。
急治其阴 无攻其阳 甲乙作急治其阳。无攻其阴。
其阴完而阳伤之也 甲乙注云。九墟。完、作缓。马云。阴经不伤。而阳经受伤耳。
急治其阳 无攻其阴 甲乙作急治其阴。无攻其阳。
阴阳俱动（止）其形不久 张云。阴阳俱动。表里皆病也。乍有形。乍无形。往来不常也。加以烦
心。阴病甚于阳也。大凡治病必求于本。若求其在表面里亦病。求其在里而表亦病。此以阴阳并伤。故曰不表
不里。治之为难。形将不久矣。
形气病之先后 张云。形见于外。气运于中。病伤形气。则或先或后。必各有所应。
风寒伤形（止）相应也 张云。风寒外袭。故伤于形。情欲内劳。故伤于气。内伤则病在脏腑。外
伤则应于皮毛。若风伤筋脉。则居于外内之间。故应于筋脉。此形气表里之有辨也。
病九日者（止）衰之 马云。衰、去声。人之感病不同。日数各有多少远近。以此大略。病三日
而刺一次者之法。等而杀之。
久痹（止）出其血 马云。惟久痹而其身不能往来者。则见其血络尽出其血。不必拘于三日一刺
之法也。简案、不去身。谓留着而不退去也。马及张并为行去之去。恐非。
形先病（止）倍其日 马云。风寒伤形。形先病而未入脏者。其病尚在于表。犹甚浅也。刺之日
数。一半而已。如病九日而刺二次。病一月而刺五次之谓也。忧、恐、喜、怒、伤气。气伤脏而外形又应者。
其病表里皆然。殊为深也。刺之日数。必加倍之。如病九日而刺三次。病一月而刺十次之谓也。
此月内难易之应也 月字甲乙道藏吴本并作外。是。
张云。病有浅深。故治有难易耳。
相任则寿 张云。相任者。相当也。
相果则寿不相果则夭 二果字甲乙作裹。是。简案、马云。相果者如果木之果。皮肉相称。即所
谓坚果也。志云。果、成也。并不可从。蒋示吉望色启微云。果、裹也。皮所以裹肉。皮浓肉坚。则相果。若
皮浓肉脆。皮薄肉坚。则不相果也。
血气经络（止）则夭 张云。血气经络者。内之根本也。形体者。外之枝叶也。根本胜者寿。枝叶
胜者夭也。
形充而（止）则危矣 张云。形充而皮肤和缓者。气脉从容故当寿。形充而皮肤紧急者。气脉促
迫故当夭。形充脉大者。表里如一。故曰顺。形充脉弱者。外实内虚。故曰危。
颧不起者 马云。颧为诸骨之宗。颧大则一身之骨皆大。而胜其形体之充大。张同。志云。颧乃
肾之外候。故颧不起者骨小。骨小则夭。此先天之气薄也。简案、颧者骨之标于面。尤易见者。可以此相周身
之骨也。
大肉 坚而有分者 张云。大肉臀肉也。 者筋肉结聚之处。坚而浓者是也。有分者。肉中分理
明显也。此言形体虽充。又必以肉之坚脆分寿夭。其必验于大肉者。以大肉为诸肉之宗也。故凡形充而臀削者。
必非福寿之兆。简案、史音 。渠永切。腹中 脂。马仍此。非也。（玉篇 渠陨切腹中 脂）玉机真藏论。
说肉破 。王注。 、谓肘膝后肉如块者。
墙基卑高不及其地 马云。面部四旁为墙。其基甚卑。不及明堂阙庭等地之高。张云。墙基者面
部四旁骨骼也。地者面部之肉也。墙基不及其地者。骨衰肉胜也。志云。墙基者面部之四方也。地、地阁也。
墙基卑高不及地者。四方之平陷也。蒋氏望色启微云。耳边为墙基。耳前肉为地。言耳
卑小。高不及其肉也。简案、诸说未知孰是。天年篇曰。基墙高以方。五阅五使篇曰。墙下无基垂角去外。如
是者虽平常。殆乃蒋说似是。
有因加疾者 马云。盖不慎守。而或为外感内伤也。
平人（止）危矣 张云。人之生死由乎气。气胜则神全。故平人以气胜形者寿。设外貌虽充而中气不
足者。必非寿器。若病而至于形肉脱。虽其气尚胜形。亦所必死。盖气为阳。形为阴。阴以配阳。形以寓气。阴
脱则阳无所附。形脱则气难独留。故不免于死。或形肉未脱。而元气衰竭者。形虽胜气。不过阴多于阳。病必危矣。
刺有三变 马云。法有不同。谓之变也。
刺营者出血 马云。正以血者营气之所化。营卫生会篇云。营气化血以奉生身。素问调经论云。取
血于营。
刺卫者出气 马云。正以卫气属阳。痹论云。卫气循于皮肤之中。分肉之间。熏于肓膜。散于胸次。
调经论云。取气于卫。
寒热少气血上下行 张云。营主血。阴气也。病在阴分。则阳胜之。故为寒热往来。阴病则阴虚。
阴虚则无气。故为少气。邪在血。故为上下妄行。所以刺营者。当刺其血分。
气痛（止）客于肠胃之中 张云。卫属阳。为水谷之悍气。病在阳分。故为气痛。气无定形。故时
来时去。怫、郁怒也。忾、大息也。贲响、腹鸣如奔也。皆气分之病。风寒外袭。而客于肠胃之间。以六腑属
表。而阳气归之。故病亦生于卫气。简案、怫、史云郁也。忾、广雅满也。怫忾盖郁懑之义。马云。怒意也。
张则以郁怒大息释之。并非。千金方痈疽门云。身中忽有痛处。如遭打扑之伏。名曰气痛。痛不可忍。
游走不住。服五香连翘汤。盖与此证自异。
内热 张云。谓温其经也。张氏医通云。内、纳同。谓温其经。使热气内入。血脉流通也。
刺布衣（止）熨之 马云。布衣气血涩浊。刺其寒痹之后。当以火 之。大人气血清滑。刺其寒
痹之后。当以药熨之。张云。以火 之。即近世所用雷火针。及芥、蒜、蒸、灸、之类。 、音翠。灼也。
干姜一斤桂心一斤 甲乙。斤、作升。无心字。玉函经方药炮制云。桂削去皮。用里黑润有味者
为佳。丹溪心法云。桂心者皮之肉浓。去其粗浓而无味者。止留近其木一层、而味辛甘者。故名之曰心。美之
之辞也。
咀 马云。以口 药如豆粒也。后世虽以刀代。而犹有 咀之称者。本此。
渍酒中 马云。渍、浸也。
马矢 中 张云。燃干马屎而煨之也。此西北方所常用者。前苏武传。置 火。注。聚火无焱也。
盖封涂勿使泄 甲乙。盖、作善。使下有气字。张云。涂、盐泥封固也。
马云。周日也。
复布为复巾 张云。重布为巾。如今之夹袋。所以盛贮绵絮药滓也。滓、 也。
生桑灰炙巾 张云。炙巾以生桑炭者。桑能利关节。除风寒湿痹诸痛也。
以巾试身 甲乙作炙巾以拭身。王子接古方选注云。药熨大人之寒痹。大人者富贵之人也。寒痹
者时痛而皮肤不仁也。其血、脉、筋、骨、虽痹。而禀气清灵。但以药熨导引。即可蠲痹。非若刺布衣而必以
火之也。椒、酒、姜、
桂、专通营气以散血分之寒。清酒置马矢。 中马矢。西北方常用之。取其微火。非有他义也。 、尽日也。复
巾、夹袋也。熨至于汗。庶营气得通。熨凡三十遍者。欲其寒邪去尽。以巾拭身亦必三十遍者。恐汗液之气留也。
起步内中 张云。刺后起步于密室内中。欲其血气行而慎避风寒也。凡此者皆所谓内热之法。
少师（《甲乙经》中作岐伯）。
阴中有阴，阳中有阳。（《甲乙经》作“阴中有阳，阳中有阴”。根据下文，《甲乙经》的说法不正确。张景岳说：刚、柔、强、弱、短、长，无非是阴阳变化的表现。然而说到阴和阳，人们都知道；至于说阴中还有阴，阳中还有阳，则是人们所不知道的。因此应当详细审察阴阳，这样针刺就能得其方法了。）
得知疾病起始的部位。（张景岳说：指知道疾病或是始于阴分，或是始于阳分，所以针刺就有依据了。）
谨慎地度量病情的端绪。（张景岳说：指观察风因木气而化生，热因火气而化生，湿因土气而化生，燥因金气而化生，寒因水气而化生，因此与季节时令相应。）
所以说，病在阴之阴者（此处省略中间文字），刺络脉。（张景岳说：所谓“阴之阴”，是指阴病位于阴分。应当刺其荥穴和输穴，因为各经的荥穴和输穴之气微弱，也属于阴类。例如手太阴肺经的鱼际穴为荥穴，太渊穴为输穴。所谓“阳之阳”，是指阳病位于阳分。应当刺其合穴，因为所入为合，仍然在阳分，刺此穴是为了防止病邪深入。例如手阳明大肠经的曲池穴之类。所谓“阳之阴”，是指阳病位于阴分。应当刺阴分的经穴，因为所行为经，其气正盛，即阴中之阳。例如手太阴肺经的经渠穴之类。所谓“阴之阳”，是指阴病位于阳分。应当刺诸络脉，因为络脉浮浅，都在阳分。例如手阳明大肠经的偏历穴之类。按语：络脉在《甲乙经》中作“阳之络”，意义更加明确。马莳将阴阳解释为五脏六腑、皮肤筋骨的意义，我觉得不恰当。）
所以说，病在阳者（此处省略中间文字），命曰风痹。（马莳说：病在阳经的，名叫风。（义理见《素问·风论》）病在阴经的，名叫痹。（义理见《素问·痹论》）阴阳两经都受病邪侵袭的，名叫风痹。李东垣说：病在阳的叫做风。这是病在阳分，因为十二经各自感受风邪，从高处而言是气分受病。所以身体半以上，风邪容易侵袭。病在阴的叫做痹。身体半以下，湿邪容易侵袭。楼氏说：阴阳俱病，是说阴阳气血都病了。按语：两位先生的取义不同，但根据上文阴阳推究，马注更为妥当。张景岳的意思也相同。（《张氏医通》说：行痹者走注无定，是风的作用。经文说：病在阳的命曰风，在阴的命曰痹，阴阳俱病的命曰风痹。可用越脾加术附汤治疗））
病有形（此处省略中间文字），属于阴的一类。（张景岳说：有形状但不痛的，病位浅在外表。无形状但痛的，病位深在内里。张志聪说：有形是指皮肉筋骨的有形，无形是指五脏六腑的气。病有形而不痛的，是病在外表的阳分。病无形而痛的，是气伤痛。这是阳气完好而阴气受伤的情况。）
急治其阴，不要攻伐其阳。（《甲乙经》作“急治其阳，无攻其阴”。）
这是阴气完好而阳气受伤的情况。（《甲乙经》注云：“九墟”篇中，“完”字作“缓”。马莳说：阴经没有受伤，而是阳经受伤了。）
急治其阳，不要攻伐其阴。（《甲乙经》作“急治其阴，无攻其阳”。）
阴阳俱动（此处省略中间文字），形体寿命不长。（张景岳说：阴阳俱动，说明表里都病了。乍而有形，乍而无形，往来无常。加上心烦，说明阴病比阳病严重。大凡治病必须求本。如果求其在表而里也病，求其在里而表也病，这是因为阴阳都受伤了，所以说既不专主表也不专主里，治疗起来很难，形体寿命就不长了。）
形气和病气的先后关系。（张景岳说：形表现在外面，气运行于内部。病伤形和气，则或先或后，必然各有对应。）
风寒伤形（此处省略中间文字），相互对应。（张景岳说：风寒外袭，所以伤形；情欲内劳，所以伤气。内伤则病在脏腑，外伤则应于皮毛。如果风伤筋脉，则居于内外之间，所以应于筋脉。这是形、气、表、里的区别。）
患病九天的（此处省略中间文字），逐渐衰减。（马莳说：衰，读去声。人感病不同，日数各有多少远近，以此作为大概。患病三天刺一次的法则，依次递减。）
久痹（此处省略中间文字），放出血液。（马莳说：只有久痹且身体不能活动的，才看到其血络，放尽血液。不必拘泥于三天一刺的法则。按语：不去身，指留着而不退去。马莳和张景岳都将“去”解释为行去，恐怕不对。）
形体先病（此处省略中间文字），加倍日数。（马莳说：风寒伤形，形体先病而未入脏的，病还在表，还很浅。针刺的天数，减半而已。如病九天刺两次，病一月刺五次，说的就是这个意思。忧、恐、喜、怒伤气，气伤脏而外形又应验的，病在表里都深重。针刺的天数，必须加倍。如病九天刺三次，病一月刺十次，说的就是这个意思。）
这是本月内难易的对应。（“月”字在《甲乙经》、道藏本、吴本中都作“外”，是正确的。）
张景岳说：病有深浅，所以治疗有难易罢了。）
相任则长寿。（张景岳说：相任，就是相当。）
相果则长寿，不相果则夭折。（两个“果”字在《甲乙经》中作“裹”，是正确的。按语：马莳说：相果就像果树的果实，皮肉相称，即所谓的坚果。张志聪说：果，是成的意思。都不可以听从。蒋示吉《望色启微》说：果，就是裹。皮用来裹肉，皮厚肉坚，就相果。如果皮厚肉脆，皮薄肉坚，就不相果。）
血气经络（此处省略中间文字），就会夭折。（张景岳说：血气经络，是内在的根本。形体，是外在的枝叶。根本胜的就长寿，枝叶胜的就夭折。）
形体充实而（此处省略中间文字），就危险了。（张景岳说：形体充实而皮肤和缓的，气脉从容，所以应当长寿。形体充实而皮肤紧急的，气脉促迫，所以应当夭折。形体充实而脉大的，表里如一，所以叫顺。形体充实而脉弱的，外实内虚，所以叫危。）
颧骨不起的。（马莳说：颧是众骨之首领，颧大则一身之骨皆大，胜过形体的充实高大。张景岳同意。张志聪说：颧是肾的外候，所以颧不起的是骨小。骨小则夭折。这是先天之气薄弱。按语：颧是骨骼标显于面部，最容易看见的，可以用它来推测周身之骨。）
大肉（此处省略中间文字），坚实而有纹理的。（张景岳说：大肉是臀肉。䐃（音qūn）是筋肉结聚之处，坚实浓密的就是。有分，是指肉中分理明显。这句话说形体虽然充实，还必须以肉的坚脆来分辨寿夭。必定验证在大肉上，是因为大肉是众肉之首领。所以凡是形体充实而臀部消瘦的，必定不是福寿的征兆。按语：史注音qūn，渠永切。腹中脂。马莳仍用此音，不对。（《玉篇》音qūn，渠陨切，腹中脂）《素问·玉机真脏论》说肉破䐃。王冰注：䐃，谓肘膝后肉如块者。）
墙基卑高不及其地。（马莳说：面部四旁为墙，其基很低，不及明堂、阙庭等地的高。张景岳说：墙基是面部四旁的骨骼。地是面部的肉。墙基不及其地，是骨衰肉胜。张志聪说：墙基是面部的四方。地，是地阁。墙基卑高不及地，是四方平陷。蒋氏《望色启微》说：耳边为墙基，耳前肉为地。说耳低小，高不及其肉。按语：各种说法不知哪个正确。《灵枢·天年》篇说：基墙高以方。《灵枢·五阅五使》篇说：墙下无基垂角去外。像这样的人即使平常，也近乎夭折。蒋说的似乎合理。）
有因病加重的人。（马莳说：大概是不慎守养生之道，而导致外感内伤。）
普通人（此处省略中间文字），就危险了。（张景岳说：人的生死取决于气。气胜则神全，所以普通人以气胜形的长寿。假设外貌虽然充实而中气不足的，必定不是长寿之器。如果病到形体肌肉脱失，虽然气尚胜形，也必死。因为气为阳，形为阴，阴以配阳，形以寓气。阴脱则阳无所依附，形脱则气难独留，所以不免于死。或者形体肌肉未脱，而元气衰竭的，形虽胜气，不过是阴多于阳，病一定危险了。）
刺法有三种变化。（马莳说：法有不同，叫做变。）
刺营者出血。（马莳说：正因为血是由营气化生的。《灵枢·营卫生会》篇说：营气化血以奉养身体。《素问·调经论》说：取血于营。）
刺卫者出气。（马莳说：正因为卫气属阳。《素问·痹论》说：卫气循行于皮肤之中，分肉之间，熏于肓膜，散于胸次。《调经论》说：取气于卫。）
寒热少气气血上下行。（张景岳说：营主血，属阴气。病在阴分，则阳胜之，所以为寒热往来。阴病则阴虚，阴虚则无气，所以为少气。邪在血，所以为上下妄行。所以刺营者，应当刺其血分。）
气痛（此处省略中间文字），客于肠胃之中。（张景岳说：卫属阳，是水谷的悍气。病在阳分，所以为气痛。气无定形，所以时来时去。怫，郁怒也。忾，大息也。贲响，腹鸣如奔也。都是气分的病。风寒外袭，而客于肠胃之间，因为六腑属表，而阳气归之，所以病也生于卫气。按语：怫，史书说是郁也。忾，《广雅》说是满也。怫忾大概是郁懑的意思。马莳说是怒意。张景岳则以郁怒大息解释，并不对。《千金方·痈疽门》说：身中忽有痛处，如遭打扑之伏，名叫气痛，痛不可忍，游走不住，服五香连翘汤。这与这个证候自然不同。）
内热。（张景岳说：指温其经脉。《张氏医通》说：内，同纳。指温其经脉，使热气内入，血脉流通。）
刺布衣（此处省略中间文字），熨之。（马莳说：布衣气血涩浊，刺其寒痹之后，应当用火灼之。大人气血清滑，刺其寒痹之后，应当用药熨之。张景岳说：以火灼之，就是近世所用的雷火针，以及芥、蒜、蒸、灸之类。焠，音翠，灼也。）
干姜一斤桂心一斤。（《甲乙经》中，“斤”作“升”。无“心”字。《玉函经·方药炮制》说：桂削去皮，用里黑润有味者为佳。《丹溪心法》说：桂心是皮的肉浓部分，去掉粗浓而无味的，只留靠近木质的一层，味辛甘的，所以名叫心。是美称之辞。）
㕮咀。（马莳说：用口咬药如豆粒大小。后世虽然用刀代，但仍有㕮咀之称，源于此。）
渍酒中。（马莳说：渍，浸也。）
马矢（此处省略中间文字）中。（张景岳说：燃干马屎而煨之。这是西北方常用的。前苏武传置焠火，注：聚火无焰也。盖封涂勿使泄。（《甲乙经》中，“盖”作“善”，“使”下有“气”字。张景岳说：涂，盐泥封固也。）
㬪。（马莳说：周日也。）
复布为复巾。（张景岳说：重布为巾，如今之夹袋，所以盛贮绵絮药滓也。滓，䊵也。）
生桑灰炙巾。（张景岳说：炙巾用生桑炭，桑能利关节，除风寒湿痹诸痛。）
以巾试身。（《甲乙经》作“炙巾以拭身”。王子接《古方选注》说：药熨大人的寒痹。大人是富贵之人。寒痹是时痛而皮肤不仁。其血、脉、筋、骨虽痹，而禀气清灵，但以药熨导引，即可蠲痹，不像刺布衣而必以火焠之。椒、酒、姜、桂，专门通营气以散血分之寒。清酒置马矢中，马矢是西北方常用之，取其微火，没有其他含义。㬪，尽日也。复巾，夹袋也。熨至于汗，庶营气得通。熨凡三十遍，欲其寒邪去尽。以巾拭身亦必三十遍，恐汗液之气留也。起步内中。（张景岳说：刺后起步于密室内中，欲其血气行而慎避风寒也。凡此者皆所谓内热之法。）
Shao Shi (in the *Jia Yi Jing*, he is referred to as Qibo).
Yin contains Yin, and Yang contains Yang. (*The Jia Yi Jing* states "Yang contains Yin, and Yin contains Yang." Based on the following text, the statement in the *Jia Yi Jing* is incorrect. Zhang Jingyue stated: Gang (firmness), Rou (softness), Qiang (strength), Ruo (weakness), Duan (short), Chang (long) are all transformations of Yin and Yang. However, while everyone knows about Yin and Yang, few know that there is Yin within Yin and Yang within Yang. Therefore, one must carefully examine Yin and Yang to ensure the acupuncture method is correct.)
Understand where the disease originated. (Zhang Jingyue explained: This means knowing whether the disease started in the Yin or Yang aspect, thus providing a rationale for acupuncture.)
Carefully assess the onset of the illness. (Zhang Jingyue explained: This refers to observing how Wind transforms via Wood, Heat via Fire, Dampness via Earth, Dryness via Metal, and Cold via Water, thereby corresponding with the seasons.)
Therefore, it is said that when the disease is in the Yin of Yin (omitted text here), puncture the collateral vessels. (Zhang Jingyue explained: The "Yin of Yin" refers to a Yin disease located in the Yin aspect. One should puncture its Ying-Spring and Shu-Stream points, as the Qi at these points in various meridians is weak and belongs to the Yin category. For example, Yuji (LU 10) is the Ying-Spring point, and Taiyuan (LU 9) is the Shu-Stream point of the Hand-Taiyin Lung Meridian. The "Yang of Yang" refers to a Yang disease located in the Yang aspect. One should puncture its He-Sea points, as the entry point is the He-Sea, which remains in the Yang aspect; puncturing this prevents the pathogen from penetrating deeper. For example, Quchi (LI 11) of the Hand-Yangming Large Intestine Meridian. The "Yang of Yin" refers to a Yang disease located in the Yin aspect. One should puncture the Jing-River points of the Yin meridians, as the flow point is the Jing-River, where the Qi is vigorous, representing Yang within Yin. For example, Jingqu (LU 8) of the Hand-Taiyin Lung Meridian. The "Yin of Yang" refers to a Yin disease located in the Yang aspect. One should puncture the collateral vessels, as collaterals are superficial and located in the Yang aspect. For example, Pianli (LI 6) of the Hand-Yangming Large Intestine Meridian. Note: In the *Jia Yi Jing*, "collateral vessels" is written as "collaterals of Yang," which makes the meaning clearer. Ma Shi's interpretation of Yin and Yang as referring to Zang-Fu organs, skin, and bones seems inappropriate.)
Therefore, it is said that diseases in Yang (omitted text here) are called Feng-Bi. (Ma Shi explained: Diseases in the Yang meridians are named Feng (Wind). (See *Su Wen: Lun Feng*). Diseases in the Yin meridians are named Bi (Obstruction). (See *Su Wen: Lun Bi*). When both Yin and Yang meridians are affected, it is called Feng-Bi. Li Dongyuan stated: Disease in Yang is called Feng. This implies disease in the Yang aspect, where the twelve meridians each receive Wind pathogens. From a high perspective, it affects the Qi aspect. Thus, the upper half of the body is susceptible to Wind. Disease in Yin is called Bi. The lower half of the body is susceptible to Dampness. Lou stated: "Both Yin and Yang diseased" means both Yin and Yang Qi and Blood are diseased. Note: The interpretations of these two scholars differ, but deducing from the preceding text, Ma's annotation is more accurate. Zhang Jingyue's view is also similar. (*Zhang Shi Yi Tong* states: Xing-Bi (Wandering Bi) moves without fixed location due to the action of Wind. The Classic says: Disease in Yang is called Feng, in Yin is called Bi, and in both is called Feng-Bi. Yue Pi Jia Zhu Fu Tang may be used).)
Diseases with physical form (omitted text here) belong to the Yin category. (Zhang Jingyue explained: Having a physical form but no pain indicates the disease is shallow and external. Having no physical form but pain indicates the disease is deep and internal. Zhang Zhicong explained: Physical form refers to the tangible skin, flesh, tendons, and bones; non-physical form refers to the Qi of the Zang-Fu organs. Disease with physical form but no pain is disease in the external Yang. Disease without physical form but with pain is Qi causing pain. This occurs when Yang is intact but Yin is injured.)
Urgently treat the Yin; do not attack the Yang. (*The Jia Yi Jing* reads "Urgently treat the Yang; do not attack the Yin".)
This occurs when Yin is intact but Yang is injured. (*The Jia Yi Jing* note says: In the *Jiu Xu* chapter, "Wan" (intact) is written as "Huan" (slow/relaxed). Ma Shi explained: The Yin meridians are uninjured, but the Yang meridians are injured.)
Urgently treat the Yang; do not attack the Yin. (*The Jia Yi Jing* reads "Urgently treat the Yin; do not attack the Yang".)
When Yin and Yang both move (omitted text here), the physical lifespan will be short. (Zhang Jingyue explained: Yin and Yang both moving indicates pathology in both exterior and interior. Fluctuating between having form and lacking form, coming and going irregularly. Accompanied by vexation in the heart, indicating Yin pathology is worse than Yang. Generally, treating disease requires seeking the root. If seeking the exterior results in interior pathology, or seeking the interior results in exterior pathology, it is because both Yin and Yang are injured. Thus, it is neither purely exterior nor purely interior, making treatment difficult, and the physical lifespan will be shortened.)
The sequence of Form-Qi and Pathogenic Qi. (Zhang Jingyue explained: Form manifests externally, while Qi circulates internally. When disease injures Form and Qi, the sequence may vary, but each has its correspondence.)
Wind-Cold injures the Form (omitted text here), corresponding accordingly. (Zhang Jingyue explained: Wind-Cold attacks externally, thus injuring the Form; emotional desires cause internal strain, thus injuring the Qi. Internal injury places disease in the Zang-Fu; external injury corresponds to the skin and hair. If Wind injures tendons and vessels, it resides between interior and exterior, thus corresponding to tendons and vessels. This distinguishes Form, Qi, Exterior, and Interior.)
For those ill for nine days (omitted text here), gradually reduce the frequency. (Ma Shi explained: "Shuai" is pronounced with the departing tone. People contract diseases differently, with varying durations. This provides a general rule. The method of puncturing once every three days is reduced progressively.)
For chronic Bi (omitted text here), release the blood. (Ma Shi explained: Only in cases of chronic Bi where the body cannot move should one observe the blood collaterals and release the blood completely. One need not adhere strictly to the puncture-every-three-days rule. Note: "Bu qu shen" means lingering and not retreating. Both Ma and Zhang interpreted "qu" as moving away, which is likely incorrect.)
If the Form is diseased first (omitted text here), double the number of days/treatments. (Ma Shi explained: Wind-Cold injures the Form. If the Form is diseased first but has not entered the Zang, the disease is still in the exterior and very shallow. The number of puncture days is halved. For example, if ill for nine days, puncture twice; if ill for a month, puncture five times. Sorrow, fear, joy, and anger injure the Qi. If Qi injury affects the Zang and the exterior responds, the disease is profound in both interior and exterior. The number of puncture days must be doubled. For example, if ill for nine days, puncture three times; if ill for a month, puncture ten times.)
This is the correspondence of difficulty/ease within the month. (The character "Yue" (month) is written as "Wai" (outside) in the *Jia Yi Jing*, Daozang edition, and Wu edition, which is correct.)
Zhang Jingyue explained: Diseases have depth, so treatments have varying degrees of difficulty.)
If they correspond, longevity ensues. (Zhang Jingyue explained: "Xiang ren" means being equivalent or balanced.)
If they correspond tightly, longevity ensues; if not, premature death occurs. (The two characters "Guo" are written as "Guo" (wrap) in the *Jia Yi Jing*, which is correct. Note: Ma Shi explained: "Xiang guo" is like the fruit of a tree, where skin and flesh match, i.e., solid nuts. Zhang Zhicong explained: Guo means completion. Neither should be followed. Jiang Shiji in *Wang Se Qi Wei* explained: Guo means wrap. Skin wraps flesh; thick skin and firm flesh constitute "Xiang guo". Thick skin with brittle flesh, or thin skin with firm flesh, does not constitute "Xiang guo".)
Blood, Qi, and meridians (omitted text here), then premature death occurs. (Zhang Jingyue explained: Blood, Qi, and meridians are the internal root. The physical form is the external branch. If the root prevails, there is longevity; if the branches prevail, there is premature death.)
If the form is full but (omitted text here), it is dangerous. (Zhang Jingyue explained: If the form is full and the skin is relaxed, the Qi and pulses are leisurely, indicating longevity. If the form is full but the skin is tight, the Qi and pulses are hurried, indicating premature death. If the form is full and the pulse is large, interior and exterior are consistent, termed "Shun" (smooth/favorable). If the form is full but the pulse is weak, exterior is solid but interior is deficient, termed "Wei" (dangerous).)
If the cheekbones do not protrude. (Ma Shi explained: The cheekbone is the chief of all bones. Large cheekbones indicate large bones throughout the body, surpassing the fullness of the form. Zhang Jingyue agreed. Zhang Zhicong explained: The cheekbone is an external indicator of the Kidney. Thus, non-protruding cheekbones indicate small bones. Small bones lead to premature death due to thin congenital Qi. Note: The cheekbone is the most visible marker of bone structure on the face and can be used to infer the state of the whole body's bones.)
The large muscles (omitted text here), firm and with distinct separations. (Zhang Jingyue explained: "Da rou" refers to the gluteal muscles. "Qun" refers to areas where muscles and tendons gather, specifically those that are firm and dense. "You fen" means the muscle fibers are clearly distinct. This passage states that although the form is full, longevity must be judged by the firmness or brittleness of the muscles. Verification is sought in the large muscles because they are the chiefs of all muscles. Therefore, anyone with a full form but sunken buttocks is unlikely to have fortune or longevity. Note: Shi pronounces it qun, qú yǒng qiè. Fat in the abdomen. Ma Shi retained this pronunciation, which is incorrect. (*Yu Pian* pronounces it qun, qú yǔn qiè, fat in the abdomen). *Su Wen: Yu Ji Zhen Zang Lun* mentions broken meat qun. Wang Bing's commentary: Qun refers to lumps of flesh behind the elbows and knees.)
The wall base is low and does not reach the level of the ground. (Ma Shi explained: The four sides of the face are the wall. If the base is very low, it does not reach the height of the Ming Tang, Que, or Ting areas. Zhang Jingyue explained: The wall base refers to the bones on the four sides of the face. The ground refers to the flesh of the face. Wall base not reaching the ground indicates bone decline and flesh excess. Zhang Zhicong explained: The wall base is the four directions of the face. The ground is the chin. Wall base low and not reaching the ground indicates flattening or sinking in the four directions. Jiang's *Wang Se Qi Wei* explained: The area beside the ear is the wall base; the flesh in front of the ear is the ground. It means the ear is low and small, higher than the flesh? No, the ear is lower than the flesh. Note: It is unclear which theory is correct. *Ling Shu: Tian Nian* states: The base and wall are high and square. *Ling Shu: Wu Yue Wu Shi* states: No base below the wall, corners hanging outward. Such people, even if seemingly normal, are close to premature death. Jiang's explanation seems plausible.)
There are those whose illness worsens due to additional causes. (Ma Shi explained: Likely due to failing to guard properly, leading to external contraction or internal injury.)
Ordinary people (omitted text here), then it is dangerous. (Zhang Jingyue explained: Human life and death depend on Qi. If Qi prevails, Shen (Spirit) is complete. Thus, ordinary people live long if Qi prevails over Form. Even if the exterior appears full, if the middle Qi is insufficient, they are not built for longevity. If disease progresses to emaciation of flesh, even if Qi still prevails over Form, death is inevitable. Because Qi is Yang, Form is Yin; Yin complements Yang, and Form houses Qi. If Yin departs, Yang has no attachment; if Form departs, Qi cannot remain alone, hence death. Or, if flesh is not yet emaciated but Yuan Qi is exhausted, although Form exceeds Qi, it is merely Yin exceeding Yang, and the disease is critical.)
There are three variations in acupuncture. (Ma Shi explained: Different methods exist, called variations.)
Puncturing Ying releases blood. (Ma Shi explained: Precisely because blood is transformed from Ying Qi. *Ling Shu: Ying Wei Sheng Hui* states: Ying Qi transforms into blood to nourish the body. *Su Wen: Tiao Jing Lun* states: Take blood from Ying.)
Puncturing Wei releases Qi. (Ma Shi explained: Precisely because Wei Qi belongs to Yang. *Su Wen: Bi Lun* states: Wei Qi circulates within the skin, between the muscle clefts, steams through the Huang-Membrane, and scatters in the chest cavity. *Tiao Jing Lun* states: Take Qi from Wei.)
Chills, fever, shortness of Qi, and abnormal movement of Blood and Qi up and down. (Zhang Jingyue explained: Ying governs Blood and belongs to Yin Qi. Disease in the Yin aspect causes Yang to overcome it, resulting in alternating chills and fever. Yin disease leads to Yin deficiency; Yin deficiency leads to lack of Qi, resulting in shortness of Qi. Pathogen in Blood causes erratic movement up and down. Therefore, when puncturing Ying, one should target the Blood aspect.)
Qi pain (omitted text here), lodging in the stomach and intestines. (Zhang Jingyue explained: Wei belongs to Yang and is the fierce Qi of water and grain. Disease in the Yang aspect results in Qi pain. Qi has no fixed form, so it comes and goes intermittently. Fu represents depression/anger; Kai represents deep sighing; Benxiang represents abdominal rumbling like running water. These are all diseases of the Qi aspect. Wind-Cold attacks externally and lodges between the stomach and intestines. Since the Six Fu organs belong to the exterior and Yang Qi returns to them, the disease also arises from Wei Qi. Note: Fu is described as depression in historical texts. Kai is described as fullness in *Guang Ya*. Fu-Kai likely means depressed frustration. Ma Shi interpreted it as anger. Zhang Jingyue interpreted it as depression/anger and deep sighing, which is not entirely accurate. *Qian Jin Fang: Yong Ju Men* states: Sudden pain in the body, as if beaten or bruised, is called Qi pain. It is unbearable and migratory, treated with Wu Xiang Lian Qiao Tang. This differs from the condition described here.)
Internal heat. (Zhang Jingyue explained: Refers to warming the meridians. *Zhang Shi Yi Tong* states: Nei is synonymous with Na (enter). It means warming the meridians so that heat enters internally, promoting blood vessel circulation.)
Puncturing commoners (omitted text here), moxibustion/warming. (Ma Shi explained: Commoners have turbid and sluggish Qi and Blood. After puncturing their cold-Bi, one should use fire to cauterize/warm them. Nobles/adults have clear and smooth Qi and Blood. After puncturing their cold-Bi, one should use herbal plasters. Zhang Jingyue explained: Using fire to cauterize/warm refers to modern Lei Huo Zhen (Thunder Fire Needle) and applications involving mustard, garlic, steaming, and moxibustion. Cui (焠) sounds like cui, meaning cauterization/burning.)
One jin of Gan Jiang (Dried Ginger) and one jin of Gui Xin (Cinnamon Heart). (*The Jia Yi Jing* writes "jin" as "sheng" (measure unit). No "xin" character. *Yu Han Jing: Fang Yao Pao Zhi* states: Peel cinnamon, using the inner dark, moist, flavorful part is best. *Dan Xi Xin Fa* states: Gui Xin is the thick inner bark, removing the coarse, flavorless parts, keeping only the layer near the wood which is pungent and sweet, hence named Xin (Heart). It is a term of endearment.)
Chew the herbs. (Ma Shi explained: Chewing the herbs into bean-sized pieces with the mouth. Although knives replaced chewing later, the term "Ju Ju" remained, originating from this.)
Soak in wine. (Ma Shi explained: Zi means soak/immersion.)
In horse dung (omitted text here). (Zhang Jingyue explained: Roasting/warming by burning dry horse dung. This was commonly used in the northwest. Reference to Su Wu's biography: placing Cui fire. Commentary: Gathering fire without flame. Seal and coat to prevent leakage. (*The Jia Yi Jing* writes "Gai" as "Shan", and adds "Qi" after "Shi". Zhang Jingyue explained: Tu means sealing with salt mud.)
All day. (Ma Shi explained: Zhou Ri means a full day.)
Double cloth becomes a double towel. (Zhang Jingyue explained: Double-layered cloth forms a towel, like modern pockets, used to store cotton wadding and herb dregs. Zi means residue.)
Heat the towel with raw mulberry ash. (Zhang Jingyue explained: Heating the towel with raw mulberry charcoal. Mulberry benefits joints and eliminates pain from wind-cold-damp-bi.)
Wipe the body with the towel. (*The Jia Yi Jing* reads "Heat the towel and wipe the body". Wang Zijie in *Gu Fang Xuan Zhu* explained: Herbal plastering for adults with cold-Bi. Adults refer to wealthy people. Cold-Bi involves intermittent pain and insensitivity of the skin. Although blood, vessels, tendons, and bones are obstructed, their innate Qi is clear and agile. Herbal plastering and guidance can eliminate bi, unlike puncturing commoners who require fire cauterization. Pepper, wine, ginger, and cinnamon specifically unblock Ying Qi to disperse cold in the Blood aspect. Clear wine placed in horse dung: Horse dung is commonly used in the northwest, taken for its mild heat, with no other meaning. Lu means all day. Fu Jin means pocket. Plaster until sweating allows Ying Qi to circulate. Plaster thirty times to ensure cold pathogen is eliminated. Wiping the body thirty times prevents sweat vapor from lingering. Step out inside (omitted text here). Zhang Jingyue explained: After puncturing, step out inside a sealed room to allow Qi and Blood to circulate while avoiding wind-cold. All these methods are referred to as Internal Heat therapy.)