振寒洒洒鼓颔，不得汗出，腹胀烦 。取手太阴。刺虚者，刺其去也；刺实者，刺其来也。
振寒洒洒鼓颔者，身寒如冷水洒之而战 也。此寒闭于表，内阳郁勃，故不得汗出而腹胀烦闷。若无头痛
发热等证，其邪不在太阳经，而在手太阴肺也。故刺手太阴经，当分虚实也。刺虚者，随其去气而补之；刺实
者，迎其来气而泻之。补者补其正气，泻者泻其邪气。此在候其呼吸来去而入针出针，以为补泻之法，故曰∶知
迎知随，气可与期。
春取络脉，夏取分腠，秋取气口，冬取经输，凡此四时，各以时为齐。络脉治皮肤，分腠治肌肉，气口治
经脉，经输治骨髓。
人身气血，随四时升降之气而浮沉，其感邪随身中之气而进止，故刺法按时而分浅深，用药之道亦然矣。
此言常理之轨则，亦不可以拘执也。盖病之变化无尽，要必随宜而施。故仲景先辨脉证，以定治法，方为至当。
前卷虚风贼邪篇《素问·四时刺逆从论》曰∶春气在经脉，夏气在孙络，长夏气在肌肉，秋气在皮肤，冬气在
骨髓中。是言身中旺气所在，此言刺法以泄其邪，互明其义理也。
《灵枢·寒热篇》帝曰∶寒热瘰 ，在于颈腋者，何气使然？岐伯曰∶此皆鼠 寒热之毒瓦斯也，留于脉而不
去者。帝曰∶去之奈何？岐伯曰∶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，
其外为脓血者，易去也，请从其本引其末，可使衰去而绝其寒热。审按其道以予之，徐往徐来以去之。其小如麦
者，一刺知，三刺而已。
瘰 生于颈腋间，甚者连贯成串，是肝胆两经之脉所行者。始由七情郁结，阳化为热，而外邪乘之，致寒
热邪毒留于经脉，
与血气胶结而成此病。先因内伤兼外邪，故其病本在脏，其未出于颈腋，而浮于脉中，未内着于肌肉。如外为
脓血者，病邪尚浅，得从脓血而泄，故易去也。从本引末者，先调脏气，然后疏通经脉，以和营卫，可使其邪
衰去，而绝其寒热也。审按其经脉之道路，徐往徐来，皆用针之法，以邪在经脉血气中，非能骤去，必用缓治
之法，而用药亦然矣。如其初起小如麦者，易治，故三刺可已；若久而病深 大，则难治，如下文所云。
寒战、身体发抖、下巴打颤，无法出汗，腹部胀满且心中烦闷。应当取用手太阴肺经的穴位进行针刺。对于虚证，顺着经气离去的方向施针（补法）；对于实证，迎着经气到来的方向施针（泻法）。
所谓寒战、身体发抖、下巴打颤，是指身体寒冷如同被冷水泼洒而战栗。这是因为寒邪闭塞于体表，体内的阳气郁结勃发，所以导致无法出汗并且出现腹部胀满和烦闷。如果没有头痛、发热等症状，说明病邪不在太阳经，而是在手太阴肺经。因此针刺手太阴经时，应当区分虚实。治疗虚证时，顺着经气离去的方向进针以补益正气；治疗实证时，迎着经气到来的方向进针以泻除邪气。补法是补益人体的正气，泻法是祛除病邪之气。这种方法在于观察呼吸的进出来决定进针和出针的时机，以此作为补泻的手法，所以说：懂得迎随补泻的道理，就能把握经气的变化。
春季取络脉，夏季取分肉腠理，秋季取气口（寸口），冬季取经穴输穴，这四种季节的刺法，各自顺应时令的特点。络脉用于治疗皮肤层面的病变，分肉腠理用于治疗肌肉层面的病变，气口用于治疗经脉层面的病变，经穴输穴用于治疗骨髓层面的病变。
人体气血随着四季升降的气机而浮沉，感受病邪后随体内气机的运行而进退，所以针刺方法要按时令区分深浅，用药的原则也是如此。这是阐述一般的规律法则，也不可以拘泥固执。因为疾病的变化无穷无尽，一定要根据具体情况灵活施治。所以张仲景先辨别脉象和症状，以确定治疗方法，这才是最恰当的。
前卷《虚风贼邪篇》引用《素问·四时刺逆从论》说：春气在经脉，夏气在孙络，长夏气在肌肉，秋气在皮肤，冬气在骨髓中。这是说人体内旺盛之气所在的部位，这里说的是通过针刺来泄除病邪，两者互相阐明其义理。
《灵枢·寒热篇》黄帝问：颈部腋下出现寒热瘰疬，是什么气导致的？岐伯回答：这都是鼠瘰寒热毒气，停留在脉管中而不消散。黄帝问：如何去除它？岐伯说：鼠瘰的根本在于内脏，其末端向上显现于颈部腋下之间。那些浮游在脉管中，尚未深入附着于肌肉，或者外部已经化为脓血的，容易去除。请从根本引导至末端，可以使病势衰退并断绝寒热。仔细审察其经络路径进行针刺，缓慢进针、缓慢出针以祛除病邪。如果肿块小如麦粒，刺一次见效，刺三次即可痊愈。
瘰疬生于颈部腋下之间，严重的连成串珠状，这是足少阳胆经和足厥阴肝经循行所过的部位。起初由七情郁结，阳气化为热邪，外邪乘虚而入，导致寒热邪毒留滞于经脉，与血气胶结而形成此病。起因是内伤兼有外邪，所以病的根本在内脏，病邪未出于颈腋，而是浮游在脉管中，未深入附着于肌肉。如果外部已经化为脓血，说明病邪尚浅，可以通过脓血排出，所以容易去除。所谓“从本引末”，是先调理脏腑之气，然后疏通经脉，调和营卫，可以使病邪衰退，从而断绝寒热。仔细审察经脉的道路，缓慢进针、缓慢出针，都是用针的方法，因为邪气在经脉血气之中，不能骤然去除，必须使用缓治的方法，用药也是如此。如果是初起时小如麦粒的，容易治疗，所以刺三次可以痊愈；如果日久病深且肿大，则难治疗，如下文所述。
Chills, shivering with the jaw trembling, inability to sweat, abdominal distension, and vexation. One should select points on the Hand-Taiyin Lung Meridian for acupuncture. For deficiency patterns, needle in the direction of the departing Qi (tonification); for excess patterns, needle against the direction of the arriving Qi (sedation).
The description of chills, shivering, and jaw trembling refers to the body feeling cold as if splashed with cold water, causing tremors. This occurs because cold pathogenic factors close the exterior, while internal Yang Qi is stagnant and vigorous, leading to an inability to sweat, abdominal distension, and mental vexation. In the absence of symptoms such as headache and fever, the pathogen is not in the Taiyang Meridian but in the Hand-Taiyin Lung Meridian. Therefore, when needling the Hand-Taiyin Meridian, one must distinguish between deficiency and excess. To treat deficiency, insert the needle following the direction of the departing Qi to tonify; to treat excess, insert the needle against the direction of the arriving Qi to sedate. Tonification replenishes the healthy Qi, while sedation expels the pathogenic Qi. This method relies on observing respiration to determine the timing of needle insertion and withdrawal, serving as a technique for tonification and sedation. Thus it is said: "Knowing Ying (welcoming) and Sui (following), one can anticipate the Qi."
In spring, select collateral vessels; in summer, select the intermuscular spaces and cutaneous pores; in autumn, select the Qi Kou (Cunkou pulse); in winter, select Jing-River and Shu-Stream points. These four seasonal methods each conform to the characteristics of their respective seasons. Collateral vessels treat diseases at the skin level; intermuscular spaces and cutaneous pores treat diseases at the muscle level; Qi Kou treats diseases at the meridian level; Jing-River and Shu-Stream points treat diseases at the bone marrow level.
Human Qi and Blood float and sink according to the ascending and descending Qi of the four seasons. When affected by pathogens, they advance or retreat according to the movement of Qi within the body. Therefore, acupuncture methods must vary in depth according to the season, and the principles of medication are the same. This describes general rules, which should not be rigidly adhered to. Since disease changes are endless, treatment must be applied flexibly according to circumstances. Thus, Zhang Zhongjing first differentiates pulse and symptom patterns to determine treatment methods, which is most appropriate.
The previous volume, *Chapter on Deficient Wind and Rogue Pathogens*, quotes from *Su Wen: Treatise on Four Seasons' Acupuncture Contradictions*: "Spring Qi is in the meridians, Summer Qi is in the sun-collaterals, Long Summer Qi is in the muscles, Autumn Qi is in the skin, Winter Qi is in the bone marrow." This refers to where the prosperous Qi of the body resides. The current text discusses using acupuncture to drain pathogens; the two texts mutually clarify their theoretical principles.
In *Ling Shu: Chapter on Cold and Heat*, the Yellow Emperor asked: "Cold-heat scrofula located in the neck and axilla, what Qi causes this?" Qibo replied: "These are all toxic vapors of mouse scrofula and cold-heat, lingering in the vessels without dispersing." The Yellow Emperor asked: "How to remove them?" Qibo said: "The root of mouse scrofula lies in the Zang organs, while its branches emerge above between the neck and axilla. Those floating in the vessels, not yet deeply attached to the muscles, or those externalized as pus and blood, are easy to remove. Please guide from the root to the branch, so that the pathogenic decline can be achieved and the cold-heat severed. Carefully examine its pathway and apply treatment; proceed slowly and withdraw slowly to eliminate the pathogen. If small like wheat grains, one insertion brings improvement, three insertions cure it."
Scrofula arises between the neck and axilla; severe cases connect into strings. This follows the pathways of the Foot-Shaoyang Gallbladder Meridian and Foot-Jueyin Liver Meridian. Initially caused by emotional stagnation, where Yang transforms into heat, and external pathogens take advantage, leading to cold-heat toxic pathogens lingering in the meridians and binding with Qi and Blood to form this disease. Due to internal injury combined with external pathogens, the root of the disease lies in the Zang organs. Before emerging in the neck and axilla, it floats in the vessels and has not yet deeply attached to the muscles. If externalized as pus and blood, the pathogen is still shallow and can be drained through pus and blood, making it easy to remove. "Guiding from the root to the branch" means first regulating Zang organ Qi, then unblocking the meridians to harmonize Ying and Wei (Defensive and Nutritive Qi), allowing the pathogen to decline and severing the cold-heat. Carefully examining the meridian pathways and using slow insertion and withdrawal are acupuncture techniques. Because the pathogen is within the meridian Qi and Blood, it cannot be removed abruptly; a gradual treatment method is required, which also applies to medication. If initially small like wheat grains, it is easy to treat, so three insertions suffice for a cure; if prolonged and deep-seated with large swelling, it is difficult to treat, as described in the following text.