《黄帝针经》云∶上气不足，脑为之不满，耳为之苦鸣，头为之苦倾，目为之瞑。中气不
足，溲便为之变，肠为之苦鸣。下气不足，则为痿厥心 ，补足外踝下留之。
此三元真气衰惫，皆由脾胃先虚，而气不上行之所致也。加之以喜、怒、悲、忧、恐
，危亡速矣。
《黄帝针经》云∶手阳明大肠，手太阳小肠，皆属足阳明胃。小肠之穴，在巨虚下廉，
大肠之穴，在巨虚上廉，此二穴，皆在足阳明胃三里穴下也。大肠主津，小肠主液。大肠、
小肠受胃之荣气，乃能行津液于上焦，溉灌皮毛，充实腠理。若饮食不节，胃气不及，大肠
、小肠无所禀受，故津液涸竭焉。《内经》云∶耳鸣、耳聋，九窍不利，肠胃之所生也。此
胃弱不以滋养手太阳小肠、手阳明大肠。故有此证。然亦止从胃弱而得之，故圣人混言肠
胃之所生也。或曰∶子谓混言肠胃所生，亦有据乎？予应之曰∶《玉机真脏论》云∶脾不及
，令人九窍不通，谓脾为死阴，受胃之阳气，能上升水谷之气于肺，上充皮毛，散入四脏；
今脾无所禀，不能行气于脏腑，故有此证，此则脾虚九窍不通之谓也。虽言脾虚，亦胃之不
足所致耳。此不言脾，不言肠胃，而言五脏者又何也？予谓∶此说与上二说无以异也，盖谓
脾不受胃之禀命，致五脏所主九窍，不能上通天气，皆闭塞不利也，故以五脏言之。此三者
，止是胃虚所致耳。然亦何止于此，胃虚则五脏、六腑、十二经、十五络、四肢，皆不得营
运之气，而百病生焉，岂一端能尽之乎。
《黄帝针经》说：上焦之气不足，脑部就会感觉空虚不满，耳朵会痛苦地鸣响，头部会因虚弱而难以支撑（或感到沉重欲倾），眼睛会视物昏花。中焦之气不足，大小便就会发生异常变化，肠道会痛苦地鸣响。下焦之气不足，就会出现痿证和厥证，治疗时应补足外踝下方的穴位并留针。
这些三元真气（指元气）的衰败疲惫，都是由脾胃先期虚弱，导致气不能向上运行所引起的。如果再加上喜、怒、悲、忧、恐等情志刺激，病情危重，死亡就会迅速到来。
《黄帝针经》说：手阳明大肠经和手太阳小肠经，都隶属于足阳明胃经。小肠的穴位在巨虚下廉穴，大肠的穴位在巨虚上廉穴，这两个穴位都在足阳明胃经的足三里穴下方。大肠主管津液，小肠主管液。大肠和小肠接受胃输送来的荣气（水谷精微之气），才能将津液输送到上焦，灌溉皮毛，充实腠理。如果饮食没有节制，胃气供应不及，大肠和小肠就无所禀受，因此津液就会枯竭。《内经》说：耳鸣、耳聋，九窍不通利，都是肠胃产生的病变。这是因为胃气虚弱，不能滋养手太阳小肠和手阳明大肠，所以出现这些症状。然而这些病症也只是从胃气虚弱这一根源得来的，所以圣人笼统地说这是“肠胃之所生”。有人问：你说这是笼统的说法，有依据吗？我回答说：《玉机真脏论》说：脾脏功能不及，会导致九窍不通，因为脾属于死阴，接受胃的阳气，能将水谷之气上升到肺，向上充养皮毛，散布到五脏；现在脾无所禀受，不能向脏腑行气，所以出现这些症状，这就是脾虚导致九窍不通的意思。虽然说的是脾虚，其实也是胃气不足所导致的。这里为什么不提脾，不提肠胃，却提五脏呢？我认为：这种说法与上面两种说法没有区别，大概是因为脾不接受胃的禀命，导致五脏所主的九窍，不能上通天气，全部闭塞不利，所以从五脏的角度来说。这三者，仅仅是由胃虚引起的罢了。然而又何止于此呢，胃虚则五脏、六腑、十二经脉、十五络脉、四肢，都不能得到营运之气，从而百病丛生，难道能只用一端来概括吗？
The *Huangdi Zhenjing* (Yellow Emperor's Classic of Acupuncture) states: When the Qi of the Upper Jiao is insufficient, the brain feels empty and unsatisfied; the ears suffer from tinnitus; the head feels heavy and difficult to hold upright; and the eyes become dim. When the Qi of the Middle Jiao is insufficient, urination and defecation become abnormal; the intestines suffer from borborygmus. When the Qi of the Lower Jiao is insufficient, flaccidity syndromes (Wei syndrome) and cold extremities syndromes (Jue syndrome) occur; treatment involves tonifying the acupoint below the lateral malleolus and retaining the needle.
The decline and exhaustion of these Three Yuan True Qi (Yuan Qi) are all caused by the prior deficiency of the Spleen and Stomach, resulting in the failure of Qi to ascend. If compounded by emotions such as joy, anger, sorrow, worry, and fear, the condition becomes critical, and death may follow swiftly.
The *Huangdi Zhenjing* states: The Hand-Yangming Large Intestine Meridian and the Hand-Taiyang Small Intestine Meridian both belong to the Foot-Yangming Stomach Meridian. The acupoint for the Small Intestine is located at Xiabianli (ST39); the acupoint for the Large Intestine is located at Shangbianli (ST37). These two acupoints are both located below Zusanli (ST36) of the Foot-Yangming Stomach Meridian. The Large Intestine governs Jin Ye (thin body fluids), and the Small Intestine governs Ye (thick body fluids). The Large Intestine and Small Intestine receive Ying Qi (Nutritive Qi derived from food and drink) from the Stomach, thereby enabling the transport of Jin Ye to the Upper Jiao, irrigating the skin and hair, and filling the Cou Li (interstices). If dietary habits are irregular and Stomach Qi fails to provide sufficient nourishment, the Large Intestine and Small Intestine have nothing to receive, leading to the depletion of Jin Ye. The *Neijing* states: Tinnitus, deafness, and dysfunction of the nine orifices arise from disorders of the intestinal tract and stomach. This is because a weak Stomach fails to nourish the Hand-Taiyang Small Intestine and Hand-Yangming Large Intestine, thus causing these symptoms. However, these conditions stem solely from Stomach weakness; therefore, the sages broadly stated that they originate from the "intestines and stomach." One might ask: Is there evidence for your claim that this is a broad statement? I reply: The *Yuji Zhenzang Lun* chapter of the *Suwen* states: Insufficiency of the Spleen leads to obstruction of the nine orifices. This is because the Spleen is considered Yin of the Dead State, receiving Yang Qi from the Stomach, which allows it to ascend the Qi of water and grain to the Lungs, nourishing the skin and hair upwards, and distributing it to the five Zang organs. Now, since the Spleen receives no nourishment, it cannot distribute Qi to the Zang and Fu organs, hence these symptoms arise; this refers to the obstruction of the nine orifices due to Spleen deficiency. Although it speaks of Spleen deficiency, it is ultimately caused by Stomach insufficiency. Why does this passage not mention the Spleen or the intestines and stomach, but instead mentions the Five Zang organs? I believe this explanation is no different from the previous two. It implies that because the Spleen does not accept the directives from the Stomach, the nine orifices governed by the Five Zang organs cannot connect with Heaven Qi above, resulting in blockage and dysfunction; thus, it is discussed in terms of the Five Zang organs. These three scenarios are merely caused by Stomach deficiency. Moreover, is this all there is? If the Stomach is deficient, the Five Zang organs, Six Fu organs, Twelve Primary Meridians, Fifteen Luo Vessels, and four limbs will all fail to receive the Qi of circulation and transformation, giving rise to myriad diseases. How could one end suffice to describe them all?