来见者,是土败而木贼之也,故死。木生数三,故期不过三日。)少阳之脉色荣颊,筋热病也。(按∶旧本筋
作前,读作颊前,注云即颧骨,是与前太阳无异矣。新校正云∶“甲乙经、太素前字并作筋。杨上善云∶足少
阳部在颊,赤色荣之,即知筋热病也。”今改从之,盖少阳亦属木也。)荣未交,曰今且得汗,待时而已。
与少阴争见者死,期不过三日。(少阳受病,当传入于太阴,今反少阴脉来见,亦土败而木贼之也,故死不过三
日,亦木之数然。按∶新校正云∶“旧本及甲乙、太素并无期不过三日五字,此盖王氏足成此文也。”)
热病气穴∶三椎下间主胸中热,四椎下间主膈中热,五椎下间主肝热,六椎下间主脾热,七椎下间主肾热,
荣在 也。(脊节之谓椎,脊穷之谓 ,言肾热之气,外通尾 也。椎间所主神脏之热,又不正当其脏俞,而
云主疗,在理未详。按∶脊节二十一节,督脉道也。身之有脊,犹屋之有柱,盖一身之骨干也。今经所主,盖
就上中下部分而言,非若穴俞之相配,故不与脏俞相当,王氏未之思也。)项上三椎,陷者中也。(此举数脊
椎大法也。言三椎下间主胸中热者,何以数之?言皆当以陷者中为气发之所。按∶言项三椎,而其余可以类推矣。)
颊下逆颧为大瘕,下牙车为腹满,颧后为胁痛,颊上者膈上也。(此所以候面部之色,发明腹中之病诊。按∶
逆,自下而上也。颊在颧下,逆颧谓由颊上至于颧。瘕,气块也。)
如果面色在热病初期就显现出来,这是脾土衰败而肝木乘虚侵袭的表现,所以预后不良,会导致死亡。木的生数是三,所以死亡期限不超过三天。)少阳经脉的气色反映在脸颊部位,这是筋热病。(按语:旧版书籍中“筋”字写作“前”,读作“颊前”,注释说就是颧骨,这与太阳经的情况没有区别了。新校正指出:“《甲乙经》、《太素》中‘前’字都写作‘筋’。杨上善说:足少阳经的部位在脸颊,赤色反映在上面,就知道是筋热病。”现在改正并采用这个说法,大概是因为少阳也属于木行。)如果气色尚未与脉象相交错(即色脉不符),今天应当能够出汗,等到其本气旺盛的时候病就好了。如果同时出现少阴经的脉象,就会死亡,期限不超过三天。(少阳经受邪,应当传入太阴经,现在反而出现少阴经的脉象,这也是脾土衰败而肝木乘虚侵袭的表现,所以三天内会死亡,这也是符合木的生数三的规律。按语:新校正指出:“旧版以及《甲乙经》、《太素》都没有‘期不过三日’这五个字,这大概是王冰补足了这篇文章。”)
治疗热病的穴位:第三椎骨下间隙主治胸中热,第四椎骨下间隙主治膈中热,第五椎骨下间隙主治肝热,第六椎骨下间隙主治脾热,第七椎骨下间隙主治肾热,气色反映在尾骶部。(脊骨的节段称为椎,脊骨尽头称为骶,意思是肾热的之气,外通于尾骶部。椎间所主治的神脏之热,并不正好对应其脏腑的背俞穴,却说主治,道理尚不明确。按语:脊骨共有二十一节,是督脉循行的道路。身体有脊柱,就像房屋有柱子一样,是一身的骨干。现在经文所主治的,大概是就上、中、下三部分而言,不像穴位与背俞穴那样一一对应,所以不与脏腑的背俞穴相当,王冰没有考虑到这一点。)项部的第三椎骨,凹陷处即是取穴点。(这里列举的是计算脊椎的大法。说第三椎骨下间隙主治胸中热,怎么计算呢?意思是都应该以凹陷处作为气机发散的所在。按语:提到项部的第三椎,其余的可以类推了。)
下巴逆冲至颧骨是大瘕病,向下延伸至牙车穴是腹满,颧骨后方是胁痛,脸颊上方是膈上部。(这是通过观察面部气色来诊断腹部疾病的方法。按语:逆,是从下往上。脸颊在颧骨下方,逆颧是指从脸颊向上直到颧骨。瘕,是气聚成的块状物。)
If the complexion appears early in the course of febrile disease, it indicates that Spleen Earth is failing and Liver Wood is invading, thus leading to death. The generative number of Wood is three; therefore, the period will not exceed three days.) When the color of the Shaoyang (Lesser Yang) meridian manifests on the cheek, it signifies Jin Re Bing (Heat Disease of the Tendons). (Note: In older editions, the character "Jin" (Tendon) was written as "Qian" (Front), read as "front of the cheek," with annotations stating this refers to the zygomatic bone, which would be indistinguishable from Taiyang (Greater Yang). The New Correction states: "'Qian' in both *Jia Yi Jing* and *Tai Su* is written as 'Jin'. Yang Shangshan said: The region of Foot-Shaoyang is on the cheek; if redness manifests there, one knows it is Heat Disease of the Tendons." We now adopt this correction, as Shaoyang also belongs to the Wood element.) If the Qi color has not yet intersected with the pulse (indicating a mismatch between color and pulse), sweating should occur today, and the illness will resolve when its own Qi time arrives. If it appears simultaneously with Shaoyin (Lesser Yin) signs, death ensues, within a period not exceeding three days. (When Shaoyang is affected, it should transmit to Taiyin (Greater Yin); however, the appearance of Shaoyin pulses instead indicates Spleen Earth failing and Liver Wood invading, hence death within three days, consistent with the generative number of Wood being three. Note: The New Correction states: "Old editions, as well as *Jia Yi Jing* and *Tai Su*, lack the five characters 'period not exceeding three days'; these were likely added by Wang Bing to complete the text.")
Acupoints for treating heat diseases: The space below the third vertebra governs heat in the chest; the space below the fourth vertebra governs heat in the diaphragm; the space below the fifth vertebra governs Liver heat; the space below the sixth vertebra governs Spleen heat; the space below the seventh vertebra governs Kidney heat; the Qi color manifests at the Wei Zhui (coccyx/sacral region). (Vertebral segments are called Zhui; the end of the spine is called Wei, meaning the Qi of Kidney heat externally connects to the coccyx. The heat of the Shen Zang (Spirit Organs) governed by the interspaces does not exactly correspond to their respective Back-Shu points, yet it is stated to govern treatment, the rationale of which is unclear. Note: There are twenty-one vertebral segments, forming the pathway of the Du Mai (Governing Vessel). The body's spine is like the pillars of a house, serving as the main structural support. The governance described in the classic here likely refers to the upper, middle, and lower sections generally, rather than a specific pairing with acupoints or Back-Shu points, so they do not align directly with the Zang-Back-Shu points; Wang Bing did not consider this.) The third vertebra in the nape of the neck, where there is a depression, is the location. (This illustrates the general method for counting spinal vertebrae. Regarding why the space below the third vertebra governs chest heat, how is it counted? It means that all such locations should be identified by the depression, which serves as the site where Qi emerges. Note: Mentioning the third vertebra in the nape allows for extrapolation to the others.)
Ni Quan (reversal toward the zygoma from the chin) indicates Da Jia (Large Mass/Abdominal Mass); downward extension to Ya Che (masseter region) indicates Fu Man (Abdominal Fullness); behind the zygoma indicates Xie Tong (Hypochondriac Pain); above the cheek indicates Ge Shang (Upper Diaphragm Region). (This explains how to diagnose internal abdominal diseases by observing facial complexion. Note: Ni means moving upward from below. The cheek is below the zygoma; Ni Quan refers to the area extending from the cheek up to the zygoma. Jia refers to a mass formed by Qi stagnation.)