黄帝问曰∶厥之寒热者，何也？岐伯对曰∶阳气衰于下则为寒厥，阴气衰于下则为
热厥。曰∶热厥必起于于足下者，何也？曰∶阳气起于足五指之表。阴脉者，集于足下而聚
于足心，故阳胜则足下热。曰∶寒厥必起于五指而上于膝者，何也？曰∶阴气起于五指之里，
集于膝下而聚于膝上，故阴气盛则从五指到膝上寒。其寒也，不从外，皆从内。曰∶寒厥何
失而然也？曰厥阴者，众筋之所聚（《素问》作前阴者宗筋之所聚），太阴、阳明之所
合。春夏则阳气多而阴气少，秋冬则阴气盛而阳气衰。此人质壮，以秋冬夺于所用，下气上
争不能复，精气溢下，邪气从而上之。所中（《素问》所中二字作气因于中）阳气衰，不能渗
营其经络，阳气日损，阴气独在，故手足为之寒。曰∶热厥何如？曰∶酒入于胃，则络
脉满而经脉虚。脾主为胃行其津液者也。阴气虚则
阳气入，阳气入则胃不和，胃不和则精气竭，精气竭则不营其四肢。此人必数醉，若饱以入
房，气聚于脾中不得散，酒气与谷气相搏，热遍于身，内热而溺赤。夫酒气盛而 悍，肾
气日衰，阳气独盛，故手足为之热。曰∶厥或令人腹满，或令人暴不知人，或至半日，远
至一日，乃知人者，何谓也？曰∶阴气盛于上则下虚，下虚则腹满，腹满（《素问》腹满二字
作阳气盛于上）则下气重上而邪气逆，逆则阳气乱，阳气乱则不知人矣。太阳之厥则肿
首，头重，足不能行，发为眩仆。阳明之厥，则癫疾，欲走呼，腹满不得卧，面赤而热，妄
见妄言。少阳之厥，则暴聋，颊肿而热，胁痛， 不可以运。太阴之厥，则腹满
胀，后不利，不欲食，食则呕，不得卧。少阴之厥，则舌干溺赤，腹满心痛。厥阴之厥，则
少腹肿痛， 胀，泾溲不利，好卧屈膝，阴缩， 内热。盛则泻之，虚则补之，不
盛不虚，以经取之。
请言解论，与天地相应，四时相副，人参天地，故可为解。下有渐洳，上生薄苇，此
所
外，皮肤缓，腠理开，血气盛，汗大泄，皮淖泽。寒则地冻水冰，人气在中，皮肤致，腠理闭
，汗不泄，血气强，皮坚涩。当是之时，善行水者，不能往冰；善穷地者，不能凿冻。夫善
用针者，亦不能取四逆，血脉凝结，坚搏不往来，亦不可即柔。故行水者，必待天温冰释
；穷地者，必待冻解，而后地可穷。人脉犹是，治厥者，必先熨火以调和其经，掌与腋，肘与
脚，项与脊，以调其气。大道已通，血脉乃行。后视其病，脉淖泽者，刺而平之，坚紧者，
破而决之，气下乃止，此所谓解结。用针之类，在于调气。气积于胃，以通营卫，各行其道。
宗气留积在海，其下者注于气街，上行者注于息道。故厥在足，宗气不下，脉中之血
凝而留止，弗之火调，针弗能取。用针者，必先察其经络之虚实，切而循之，按而弹之，视
其应动者，乃后取而下之。六经调者，谓之不病，虽病谓之自已。一经上实下虚而不通者，
此必有横络盛加于大经，令之不通。视而泻之，通而决之，是所谓解结者也。上寒下热，先
刺其项太阳久留之，已刺则火熨项与肩臂，令热下合（一本作冷）乃止，所谓推而上之者也
。上热下寒，视其虚脉而陷下于经络者取之，气下而止，所谓引而下之者也。
刺热厥者，留针反为热；刺热厥者，二阴一阳；刺寒厥者，一阴二阳。所谓二阴者，二
刺阴；所谓二阳者，二刺阳。热厥取太阴、少阳。寒厥取阳明、少阴，于足留之。厥胸满面
肿者，肩中热，暴言难，甚则不能言，取足阳明。厥气走喉而不言，手足微满清，大便不
利，取足少阴。厥而腹膨膨，多寒气，腹中 （音最，《九墟》作荣），便溲难，取足太
阴。
，清取足阳明，清则补之，温则泻之。厥逆腹满胀，肠鸣，胸满不得息，取之下胸三肋间咳
而动应手者，与背俞以指按之立快。足厥喘逆，足下清至膝，涌泉主之。
黄帝问道：厥证出现寒热症状，是什么原因呢？岐伯回答说：阳气在下部衰弱，就会发生寒厥；阴气在下部衰弱，就会发生热厥。黄帝问：热厥一定从足底开始，为什么呢？岐伯说：阳气起始于足五指的外侧。阴脉汇聚于足底并聚集在足心，所以阳胜则足底发热。黄帝问：寒厥一定从足五指向上发展到膝盖，为什么呢？岐伯说：阴气起始于足五指的里面，汇聚于膝下并聚集在膝上，所以阴气盛时，寒气会从足五指蔓延到膝盖以上。这种寒冷，不是从外部侵入的，都是由内部产生的。黄帝问：寒厥是由于什么失误而造成的呢？岐伯说：厥阴经是众多筋脉汇聚的地方（《素问》中作“前阴是宗筋汇聚之处”），也是太阴经和阳明经相合的部位。春夏季节阳气多而阴气少，秋冬季节阴气盛而阳气衰。如果这个人身体强壮，在秋冬季节过度使用体力或房事，导致下部之气与上部之气争竞而不能恢复，精气向下流失，邪气便随之上行。此时阳气受损，不能渗透滋养经络，阳气日渐损耗，阴气独存，所以手足发冷。黄帝问：热厥又是怎样的呢？岐伯说：酒进入胃中，络脉充满而经脉空虚。脾的功能是为胃输送津液。阴气虚弱则阳气内入，阳气内入则胃功能不和，胃不和则精气枯竭，精气枯竭则不能滋养四肢。这种人一定是经常醉酒，或者饱食后行房事，导致气聚积在脾中无法散开，酒气与谷气相互搏结，热气遍布全身，出现内热和小便赤黄。酒的性质盛大而猛烈，导致肾气日渐衰弱，阳气独盛，所以手足发热。黄帝问：有的厥证使人腹部胀满，有的使人突然昏倒不省人事，有的半天甚至一天后才苏醒，这是什么原因呢？岐伯说：阴气盛于上部则下部虚，下部虚则腹部胀满，腹部胀满（《素问》中“腹满”二字作“阳气盛于上”）则下部之气重滞而上逆，邪气随之上逆，逆乱则阳气紊乱，阳气紊乱就会使人昏倒不省人事。太阳经发生厥逆，则头部肿胀，头重脚轻，足不能行走，引发眩晕仆倒。阳明经发生厥逆，则患癫狂病，想奔跑呼叫，腹部胀满不能安卧，面色发红发热，胡言乱语，看见不存在的东西。少阳经发生厥逆，则突然耳聋，脸颊肿胀发热，胁肋疼痛，肢体不能转动。太阴经发生厥逆，则腹部胀满，大便不通畅，不想吃东西，吃了就呕吐，不能安卧。少阴经发生厥逆，则舌干小便赤黄，腹部胀满心痛。厥阴经发生厥逆，则小腹胀痛，腹部胀大，大小便不利，喜欢蜷曲膝盖躺着，生殖器收缩，体内发热。实证用泻法，虚证用补法，不虚不实则取本经穴位治疗。
请允许我阐述其中的道理，这与天地相应，与四季相符，人参赞天地之化育，所以可以解释清楚。地下潮湿，上面生长着芦苇，这是自然现象。皮肤松弛，腠理开张，血气旺盛，汗出如注，皮肤润泽。寒冷时地面冻结水冰，人气潜藏在内，皮肤致密，腠理闭合，汗不出，血气强盛，皮肤坚硬涩滞。在这个时候，善于治水的人，不能使冰流动；善于探求土地的人，不能凿开冻土。同样，善于用针的人，对于四肢逆冷的情况，也不能立即见效，因为血脉凝结，坚硬搏动而不流通，也不可立刻使其柔和。所以治水的人，必须等待天气温暖冰融化；探地的人，必须等待冻土解冻，然后才能深入挖掘。人的脉络也是如此，治疗厥证，必须先用火熨法来调和经脉，熨烫手掌与腋窝、肘部与脚部、颈部与脊背，以调畅气机。大道通畅后，血脉才能运行。之后观察病情，脉象濡润泽滑的，用针刺平复它；脉象坚紧的，破开决断它，气下行后停止，这就是所谓的“解结”。用针的关键在于调气。气积聚在胃中，用来通调营卫，各自运行其道。宗气留积在海（指膻中穴附近），其向下的注入气街穴，向上的注入息道（呼吸之道）。所以厥证发生在足部，是因为宗气不能下行，脉中的血液凝滞停留，如果不先进行火调，针刺是无法取效的。使用针刺的人，必须先观察经络的虚实，切按循摸，按压弹拨，看到有反应跳动的地方，然后才选取穴位进行治疗。六经调和的，称为没有病，即使有病也会自愈。如果一经出现上实下虚而不通的状况，这一定有横行的络脉盛实加在大经之上，导致不通。观察后用泻法，疏通决断，这就是所谓的解结。上寒下热的情况，先针刺项部的太阳经，长时间留针，刺完后用火熨项部和肩臂，使热气下行融合（另一版本作“冷”）后停止，这叫作“推而上之”。上热下寒的情况，观察虚陷于经络的脉象并选取穴位，气下行后停止，这叫作“引而下之”。
针刺热厥，留针反而助热；针刺热厥，应二刺阴经一刺阳经；针刺寒厥，应一刺阴经二刺阳经。所谓“二阴”，就是刺两个阴经穴位；所谓“二阳”，就是刺两个阳经穴位。热厥取太阴经和少阳经。寒厥取阳明经和少阴经，在足部留针。厥证导致胸部和面部肿胀，肩部中间发热，突然说话困难，严重时不能说话，取足阳明经穴位。厥气冲击喉咙导致不能说话，手足轻微胀满发凉，大便不通利，取足少阴经穴位。厥证导致腹部膨隆，多寒气，腹中鸣响（音最，《九墟》作“荣”），大小便困难，取足太阴经穴位。腹部发凉，取足阳明经，凉则用补法，温则用泻法。厥逆导致腹部胀满，肠鸣，胸满呼吸困难，取下胸部第三肋间咳嗽时手指按压感到震动的穴位，以及背部的俞穴，用手指按压后立刻感觉舒适。足厥阴经气喘逆乱，足底发凉直到膝盖，涌泉穴主治。
Huangdi asked: What is the cause of cold and heat symptoms in Jue syndrome (Jue, a condition characterized by cold or heat extremities)? Qibo replied: When Yang Qi (vital energy associated with warmth and activity) declines at the lower part of the body, Cold Jue occurs; when Yin Qi (vital energy associated with cooling and substance) declines at the lower part, Heat Jue occurs. Huangdi asked: Why does Heat Jue always start from the sole of the foot? Qibo said: Yang Qi originates from the exterior of the five toes of the foot. The Yin meridians gather at the sole and converge at the center of the foot; therefore, when Yang is excessive, the sole becomes hot. Huangdi asked: Why does Cold Jue always start from the five toes and ascend to the knees? Qibo said: Yin Qi originates from the interior of the five toes, gathers below the knees, and converges above the knees; thus, when Yin Qi is excessive, coldness spreads from the five toes up to the knees. This coldness does not come from the exterior but arises from within. Huangdi asked: What mistake leads to this condition? Qibo said: The Jueyin Meridian (Liver Meridian of Foot-Jueyin) is where numerous tendons gather (Suwen states: "The anterior yin is where the Zong Jin / master tendons gather"), and it is the convergence point of the Taiyin (Spleen Meridian of Foot-Taiyin) and Yangming (Stomach Meridian of Foot-Yangming). In spring and summer, Yang Qi is abundant and Yin Qi is scarce; in autumn and winter, Yin Qi is abundant and Yang Qi declines. If a robust person overexerts themselves during autumn and winter, causing the Qi below to contend with the Qi above without recovery, essence and Qi leak downward, allowing pathogenic factors to ascend. At this time, Yang Qi declines and cannot permeate and nourish the meridians; as Yang Qi diminishes day by day, only Yin Qi remains, causing the hands and feet to become cold. Huangdi asked: What about Heat Jue? Qibo said: When wine enters the stomach, the collateral vessels become full while the main meridians become empty. The Spleen's function is to transport fluids for the Stomach. When Yin Qi is deficient, Yang Qi enters inwardly; when Yang Qi enters inwardly, the Stomach becomes disharmonious; when the Stomach is disharmonious, essence and Qi are exhausted; when essence and Qi are exhausted, the four limbs are not nourished. Such individuals often drink heavily or engage in sexual intercourse after full meals, causing Qi to accumulate in the Spleen without dispersing. The Qi of wine and grain fight each other, spreading heat throughout the body, resulting in internal heat and dark red urine. Wine Qi is vigorous and fierce, causing Kidney Qi to decline daily while Yang Qi becomes excessive alone, leading to hot hands and feet. Huangdi asked: Some cases of Jue cause abdominal fullness, others cause sudden unconsciousness, and some take half a day or even a full day to regain consciousness. What is the reason? Qibo said: When Yin Qi is excessive in the upper part, the lower part becomes deficient. Lower deficiency causes abdominal fullness. Abdominal fullness (Suwen reads: "Yang Qi is excessive in the upper") causes Qi from below to become heavy and ascend, with pathogenic Qi reversing upward. Reversal causes Yang Qi to become chaotic; chaotic Yang Qi leads to loss of consciousness. Jue of the Taiyang Meridian (Bladder Meridian of Foot-Taiyang) causes head swelling, heaviness of the head, inability to walk, and dizziness with falling. Jue of the Yangming Meridian (Stomach Meridian of Foot-Yangming) causes manic epilepsy, desire to run and shout, abdominal fullness preventing sleep, red and hot face, hallucinations, and delirious speech. Jue of the Shaoyang Meridian (Gallbladder Meridian of Foot-Shaoyang) causes sudden deafness, swollen and hot cheeks, flank pain, and immobility of the limbs. Jue of the Taiyin Meridian (Spleen Meridian of Foot-Taiyin) causes abdominal distension, difficult defecation, anorexia, vomiting after eating, and inability to sleep. Jue of the Shaoyin Meridian (Kidney Meridian of Foot-Shaoyin) causes dry tongue, dark red urine, abdominal fullness, and heart pain. Jue of the Jueyin Meridian (Liver Meridian of Foot-Jueyin) causes lower abdominal swelling and pain, abdominal distension, difficulty in urination and defecation, preference for lying with knees flexed, retraction of the genitals, and internal heat. Excess conditions are treated with draining methods; deficiency conditions with tonifying methods; neither excess nor deficiency is treated by selecting points on the affected meridian.
Let me explain the principles, which correspond to Heaven and Earth and follow the Four Seasons, allowing humans to assist Heaven and Earth, thus making them understandable. Where the ground is damp, thin reeds grow above; this is a natural phenomenon. When skin is loose, pores open, blood and Qi are abundant, sweat flows profusely, and the skin is moist. In cold weather, the ground freezes and water turns to ice; human Qi resides internally, skin becomes tight, pores close, no sweat is excreted, blood and Qi become strong, and the skin becomes hard and rough. At such times, even a skilled water controller cannot make ice flow; a skilled land explorer cannot drill frozen earth. Similarly, a skilled acupuncturist cannot immediately treat Si Ni (Cold Extremities) because blood vessels are congealed, hard, and pulsating without smooth flow, and cannot be instantly softened. Therefore, water controllers must wait for warm weather and melting ice; land explorers must wait for thawed ground before digging. Human meridians are the same. To treat Jue, one must first use moxibustion or warming techniques to harmonize the meridians, warming the palms and axillae, elbows and feet, neck and spine to regulate Qi. Once the Great Dao is unblocked, blood vessels can flow. Then observe the condition: if the pulse is soft and moist, puncture to calm it; if hard and tight, break and drain it. Stop when Qi descends; this is called "untying knots." The key to acupuncture lies in regulating Qi. Qi accumulates in the Stomach to circulate Ying (Nutrient) and Wei (Defensive) Qi, each following its own path. Zong Qi (Pectoral Qi) stays accumulated in the Sea of Qi (Shanzhong/Renzhong area); the descending part flows into the Qichuan (Gas Street), and the ascending part flows into the respiratory tract. Thus, if Jue affects the feet, it is because Zong Qi fails to descend, causing blood in the vessels to stagnate. Without prior warming regulation, acupuncture cannot be effective. Acupuncturists must first examine the emptiness or fullness of the meridians, palpate and trace them, press and flick them, and select points only where there is a reactive movement. When the Six Meridians are harmonized, it is called disease-free; even if diseased, it will self-heal. If one meridian shows upper excess and lower deficiency with blockage, there must be an overfull horizontal collateral compressing the main meridian, causing obstruction. Observe and drain it, unblock and decide it; this is also called "untying knots." For upper cold and lower heat, first puncture the Taiyang points in the neck and retain the needle for a long time. After needling, apply warming patches to the neck and arms until heat merges downward, then stop; this is called "pushing upward." For upper heat and lower cold, observe the deficient pulses sunken into the meridians and select points; stop when Qi descends; this is called "pulling downward."
When needling Heat Jue, retaining the needle may increase heat; for Heat Jue, puncture two Yin points and one Yang point. For Cold Jue, puncture one Yin point and two Yang points. "Two Yin" means puncturing two Yin meridian points; "Two Yang" means puncturing two Yang meridian points. Heat Jue selects Taiyin and Shaoyang points. Cold Jue selects Yangming and Shaoyin points, retaining needles in the feet. For Jue with chest and facial swelling, heat in the middle of the shoulder, sudden difficulty speaking, or severe inability to speak, select Foot Yangming points. For Jue Qi rushing to the throat causing muteness, slight fullness and coldness in hands and feet, and constipation, select Foot Shaoyin points. For Jue with distended abdomen, excessive cold Qi, abdominal rumbling (Zui, Suwen reads Rong), and difficulty in urination and defecation, select Foot Taiyin points. For coldness, select Foot Yangming points; cold requires tonification, warmth requires drainage. For Jue with abdominal fullness, borborygmus, chest fullness, and dyspnea, select points in the third intercostal space below the chest that move upon coughing, along with Back Shu points; pressing these with fingers brings immediate relief. For Foot Jueyin asthma and counterflow Qi, with coldness from the sole to the knee, Yongquan (KI1) is the primary point.