厥心痛与背相控，善 如从后触其心。偃偻者，肾心痛也，先取京骨昆仑发针不已，取
然谷
。厥心痛腹胀胸满，心尤痛甚，胃心痛也，取之大都太白。厥心痛痛如以针刺其心，心痛甚
者，脾心痛也，取之然谷太溪。厥心痛色苍苍如死状，终日不得太息。肝心痛也，取之行间
太冲。厥心痛卧若徒居，心痛间动作痛益甚，色不变，肺心痛也，取之鱼际太渊。真心痛手
足清至节，心痛甚，旦发夕死，夕发旦死。心痛不可刺者中有盛聚，不可取于俞。心痛引腰
脊欲呕，取足太阴；心痛腹胀，啬啬然大便不利，取足少阴；心痛引背不得息，刺足少阴，
不已取手少阳；心痛引小腹，上下无常处
，便溲难，刺足厥阴；心痛但短气不足以息，刺手太阴。心痛当九节刺之，按已，刺按之立
已，上下求之，得之立已。背与心相控而痛，所治天突十椎及上纪，上纪者胃脘也，下纪者
关元也，背胸邪击阴阳左右如此。
帝曰∶脉之应于寸口如何而胀？岐伯曰∶其脉大坚以涩者胀也。曰∶何以知脏腑之胀也？
曰∶
阴为脏，阳为腑。曰∶夫气之令人胀也，在于血脉之中耶，脏腑之内乎？曰∶三者皆存焉，
然非胀之舍也。曰∶愿闻胀之舍。曰∶夫胀者，皆在脏腑之外，排脏腑而郭胸胁，胀皮肤，
故命曰胀。曰∶脏腑之在胸胁腹里之内也，若匣匮之脏禁器也，各有次舍虚名，而同处一域
之中，其气各异，愿闻其故。曰∶未解其意，再问。曰∶夫胸腹脏腑之郭也，膻中者，心主
之宫城也；胃者，太仓也；咽喉小肠者，传送也；胃之五窍，闾里门户也；廉泉玉英者，津
液之道也。故五脏六腑，各有畔界，其病各有形状。营气循脉，卫气逆为脉胀，卫气并脉循
分为肤胀，三里而泻，近者一下，远者三下，无问虚实，工在疾泻。曰∶愿闻胀形。曰∶夫
心胀者，烦心短气，卧不安；肺胀者，虚满而喘咳；肝胀者，胁下满而痛引小腹；脾胀者善
哕，四肢烦 ，体重不能胜衣，卧不安；肾胀腹满引背，央央然腰髀痛；六腑胀，胃胀者，
腹满胃腕痛，鼻闻焦臭，妨于食，大便难；大肠胀者，肠鸣而痛濯濯，冬日重感于寒，则飧
泄不化；小肠胀者，小腹 胀，引腰而痛；膀胱胀者，小腹满而气癃；三焦胀者，气满于皮
肤中，轻轻然而不坚；胆胀者，胁下痛胀，口中苦善太息。凡此诸胀者，其道在一，明知逆
顺，针数不失。泻虚补实，神去其室，致邪失正，真不可定，粗之所败，谓之夭命。补虚泻
实，神归其室，久塞其空，谓之良工。曰∶胀者焉生，何因而有？曰∶卫气之在身也，常然
并脉循分肉，行有逆顺，阴阳相随，乃得天和，五脏更始，四时循序，五谷乃化，然后厥气
在下，营气留止，寒气逆上，真邪相攻，两气相搏，乃合为胀也。曰∶善！何以解惑？曰∶合
之于真，三合而得。曰∶善！曰∶胀论言无问虚实，工在疾泻。近者一下，远者三下。今有
其三，而不下者，其过焉在？曰∶此言陷于肉肓，而中气穴者也，不中气穴，则气内闭，针
不陷肓，则气不行上越，中肉则卫气相乱，阴阳相逐，其于胀也。当泻不泻，气故不下，三
而不下。必更其道，气下乃止。不下复始，可以万全，乌有殆者乎！其干胀也，必审其胗，
当泻则泻，当补则补，如鼓应桴，恶有不下者乎？帝曰∶肤胀鼓胀可刺邪？曰∶先泻其胀之血
络，后调其经，刺去血络也。腹暴满，按之不下，取太阳经络者，胃之募也。少阴俞者，去
脊椎三寸傍五，用员利针，卫气逆而脉胀，卫气并脉为肤胀，三里而泻。近者一下，远者三
下，无问虚实，三里疾泻。
厥心痛与背部相互牵引疼痛，患者常感觉好像有人从背后触碰他的心脏。身体蜷缩弯腰的，是肾心痛，应先针刺京骨穴、昆仑穴，出针后若症状未缓解，再取然谷穴。厥心痛伴有腹胀、胸满，心脏疼痛特别剧烈的，是胃心痛，应取大都穴、太白穴。厥心痛疼痛像被针刺入心脏，心痛非常严重的，是脾心痛，应取然谷穴、太溪穴。厥心痛面色青苍，如同死状，整天不能深呼吸（叹气）的，是肝心痛，应取行间穴、太冲穴。厥心痛平卧或居家静坐时疼痛稍减，活动后疼痛加剧，面色没有改变的，是肺心痛，应取鱼际穴、太渊穴。真心痛手足发凉直到关节，心痛剧烈，早晨发病晚上死亡，晚上发病早晨死亡。如果心内有实邪积聚导致的心痛不可针刺，不可取用俞穴治疗。心痛牵引腰脊并想呕吐的，取足太阴脾经穴位；心痛伴腹胀，怕冷且大便不通利的，取足少阴肾经穴位；心痛牵引背部且呼吸困难的，针刺足少阴肾经穴位，若无效再取手少阳三焦经穴位；心痛牵引小腹，疼痛部位上下无常处，大小便困难的，针刺足厥阴肝经穴位；心痛仅表现为气短、呼吸不足的，针刺手太阴肺经穴位。心痛应当针刺第九节脊椎处，按压后针刺，按压的同时针刺可立即止痛，上下寻找痛点，找到痛点针刺即可立即止痛。背部与心脏相互牵引而痛，治疗的穴位是天突穴、第十椎旁穴位以及上纪穴（即中脘穴），下纪穴即关元穴，背部与胸部邪气侵袭阴阳左右两侧的情况大致如此。
黄帝问：脉象在寸口如何反映胀病？岐伯回答：脉象大而坚涩的，就是胀病。黄帝问：如何知道脏腑的胀病呢？岐伯回答：阴脉主脏，阳脉主腑。黄帝问：导致胀病的邪气，是在血脉之中，还是在脏腑之内呢？岐伯回答：三者都存在，但都不是胀病的居所。黄帝说：我想听听胀病的居所在哪里。岐伯回答：所谓的胀病，都在脏腑之外，排挤脏腑，扩张胸胁，充胀皮肤，所以命名为胀。黄帝说：脏腑位于胸胁腹里之内，就像匣子和柜子中的禁器一样，各有位置和名称，同处一个区域，但它们的性质各异，我想听听其中的缘故。岐伯说：没理解你的意思，请再问。黄帝说：胸腹是脏腑的外廓，膻中是心主的宫城；胃是太仓；咽喉和小肠是传导之官；胃的五窍，是闾里的门户；廉泉和玉英，是津液运行的通道。因此五脏六腑各有边界，它们的病变各有形态。营气循行于脉中，卫气逆乱则形成脉胀，卫气并入脉中循行于分肉之间则形成肤胀。针刺三里穴进行泻法，病程短的泻一次，病程长的泻三次，不论虚实，关键在于迅速泻邪。黄帝说：我想听听各种胀病的形态。岐伯回答：心胀的患者，心烦气短，睡眠不安；肺胀的患者，虚满且喘咳；肝胀的患者，胁下满痛并牵引小腹；脾胀的患者，容易呃逆，四肢烦重，身体沉重连衣服都穿不住，睡眠不安；肾胀的患者，腹部满痛牵引背部，腰部和大腿酸痛；六腑胀病中，胃胀的患者，腹部满痛，胃脘痛，鼻子闻到焦臭味，妨碍进食，大便困难；大肠胀的患者，肠鸣且疼痛如濯濯声，冬天再次感受寒邪，则完谷不化的泄泻；小肠胀的患者，小腹胀满，牵引腰部疼痛；膀胱胀的患者，小腹胀满且小便不利；三焦胀的患者，气充满于皮肤中，轻轻软软但不坚实；胆胀的患者，胁下痛胀，口苦且喜欢叹气。所有这些胀病，其治疗原则在于一，明确逆顺，针刺次数不失当。泻虚补实，若神气离去，会导致邪气深入、正气丧失，真气无法安定，这是粗劣医生造成的败坏，称为夭折。补虚泻实，使神气回归，长久充实空虚之处，这称为良工。黄帝问：胀病是怎么产生的，因何而有？岐伯回答：卫气在体内，通常并行于脉中，循行于分肉之间，运行有逆有顺，阴阳相随，才能得天和之气，五脏功能更替恢复，四时顺序正常，五谷才能消化。然后厥气在下，营气留滞，寒气逆上，真气与邪气相攻，两气相搏，从而合成为胀病。黄帝说：好！如何解除疑惑？岐伯回答：结合真气的运行，综合三个方面就能明白。黄帝说：好！《胀论》中说无论虚实，关键在于迅速泻邪。病程短的泻一次，病程长的泻三次。现在有的患者泻了三次仍不见效，过错在哪里？岐伯回答：这是因为针刺陷于肌肉间的脂膜（肓），而没有刺中气穴。如果没有刺中气穴，气就会在内闭结；针刺没有陷入肓膜，气就不能上行外越；如果只刺中肌肉，卫气就会紊乱，阴阳互相追逐，这就导致了胀病。应当泻邪而不泻，气故而不能下行，所以泻了三次仍不下行。必须改变方法，气下行后才停止。如果不行就重新开始，可以达到万全，哪里有危险的呢！对于干胀病，必须仔细诊察脉象，应当泻的就泻，应当补的就补，效果就像鼓槌击鼓那样即时响应，哪有不下行的呢？黄帝问：肤胀和鼓胀可以针刺吗？岐伯回答：先泻胀病部位的血络，然后调理经脉，刺去血络即可。腹部突然胀满，按压不凹陷的，取太阳经络穴位，即胃的募穴。少阴俞穴，距离脊椎三寸旁开五寸，使用圆利针。卫气逆乱导致脉胀，卫气并入脉中导致肤胀，针刺三里穴进行泻法。病程短的泻一次，病程长的泻三次，不论虚实，快速针刺三里穴泻邪。
Jue heartache (Heartache due to Jue syndrome) with mutual traction pain in the back, patients often feel as if someone is touching their heart from behind. Those who curl up and bend over have Kidney Heartache (Ren Xin Tong), first needle Jinggu (BL64) and Kunlun (BL60); if symptoms persist after withdrawal, then acquire Ran Gu (KI2). Jue heartache accompanied by abdominal distension and chest fullness, with severe heart pain, is Stomach Heartache (Wei Xin Tong), acquire Da Du (SP2) and Tai Bai (SP3). Jue heartache where pain feels like a needle piercing the heart, with very severe heart pain, is Spleen Heartache (Pi Xin Tong), acquire Ran Gu (KI2) and Tai Xi (KI3). Jue heartache with a cyan complexion resembling death, unable to sigh deeply all day, is Liver Heartache (Gan Xin Tong), acquire Xing Jian (LR2) and Tai Chong (LR3). Jue heartache where pain alleviates when lying down or staying indoors, but worsens with movement, with unchanged complexion, is Lung Heartache (Fei Xin Tong), acquire Yu Ji (LU10) and Tai Yuan (LU9). True Heartache (Zhen Xin Tong) presents with cold extremities reaching the joints, severe heart pain; onset in the morning leads to death in the evening, onset in the evening leads to death in the morning. If heartache is caused by accumulation of excess pathogens within the heart, it cannot be needled, and Shu points should not be acquired. Heartache radiating to the lower back and spine with desire to vomit, acquire Foot-Taiyin points; heartache with abdominal distension, aversion to cold, and difficult defecation, acquire Foot-Shaoyin points; heartache radiating to the back with dyspnea, needle Foot-Shaoyin points, if ineffective acquire Hand-Shaoyang points; heartache radiating to the lower abdomen with wandering pain location and difficulty in urination and defecation, needle Foot-Jueyin points; heartache presenting only with shortness of breath and insufficient respiration, needle Hand-Taiyin points. For heartache, needle at the ninth vertebral segment; pressing while needling can immediately relieve pain; seek above and below for the tender point, and needling upon finding it will immediately relieve pain. Mutual traction pain between the back and heart is treated at Tiantu (CV22), the point beside the tenth vertebra, and Shangji (Zhongwan CV12); Xiaji refers to Guanyuan (CV4). The situation of evil qi invading the yin and yang on left and right sides of the back and chest is generally as described.
The Yellow Emperor asked: How does the pulse at Cun Kou reflect distension? Qibo answered: A pulse that is large, firm, and choppy indicates distension. The Yellow Emperor asked: How to know about Zang-Fu distension? Qibo answered: Yin pulses correspond to Zang organs, Yang pulses correspond to Fu organs. The Yellow Emperor asked: Is the qi causing distension located within the blood vessels, or inside the Zang-Fu organs? Qibo answered: It exists in both, but neither is the residence of distension. The Yellow Emperor said: I wish to hear about the residence of distension. Qibo answered: Distension occurs outside the Zang-Fu organs, pushing against them, expanding the chest and hypochondrium, and swelling the skin, hence named distension. The Yellow Emperor said: The Zang-Fu are located within the chest, hypochondrium, and abdomen, like forbidden objects in boxes and cabinets, each having its own position and name, sharing the same region but differing in nature; I wish to understand the reason. Qibo said: You do not understand my meaning, please ask again. The Yellow Emperor said: The chest and abdomen are the outer boundaries of the Zang-Fu; Dan Zhong (CV17) is the palace city of the Heart Master; the Stomach is the Great Granary; the pharynx and Small Intestine are for transmission; the five orifices of the Stomach are the gates of the neighborhoods; Lian Quan (CV23) and Yu Ying are the pathways for fluids. Therefore, the Five Zang and Six Fu organs have their respective boundaries, and their diseases have different manifestations. Ying Qi circulates within the vessels; Wei Qi rebellion causes Mai Distension (Distension of Vessels); Wei Qi merging with the vessels and circulating along the muscle intervals causes Fu Distension (Distension of Skin). Needling San Li (ST36) with draining method: for recent cases, drain once; for distant cases, drain three times, regardless of deficiency or excess, the key lies in rapid draining. The Yellow Emperor said: I wish to hear the forms of various distensions. Qibo answered: Heart Distension manifests as vexation, shortness of breath, and restless sleep; Lung Distension manifests as empty fullness, wheezing, and coughing; Liver Distension manifests as fullness and pain under the hypochondrium radiating to the lower abdomen; Spleen Distension manifests as frequent hiccups, heaviness and discomfort in the four limbs, body weight so heavy one cannot bear clothes, and restless sleep; Kidney Distension manifests as abdominal fullness radiating to the back, soreness and pain in the waist and thighs; among the Six Fu Distensions, Stomach Distension manifests as abdominal fullness and epigastric pain, smelling burnt odors in the nose, food intolerance, and difficult defecation; Large Intestine Distension manifests as borborygmus and gurgling pain, and if exposed to cold in winter, results in undigested diarrhea; Small Intestine Distension manifests as lower abdominal distension radiating to the lower back with pain; Bladder Distension manifests as lower abdominal fullness and urinary retention; San Jiao Distension manifests as qi filling the skin, feeling soft but not firm; Gallbladder Distension manifests as pain and distension under the hypochondrium, bitter taste in the mouth, and frequent sighing. All these distensions share one principle: clearly understanding reversal and smoothness, and accurate needle count. Draining deficiency and tonifying excess, if Shen (Spirit) leaves, evil enters and righteousness is lost, true Qi cannot be stabilized; this failure by crude practitioners is called premature death. Tonifying deficiency and draining excess, returning Shen to its chamber, and filling emptiness for a long time, is called a skilled practitioner. The Yellow Emperor asked: How is distension generated, and what is its cause? Qibo answered: Wei Qi in the body usually runs parallel to the vessels and along the muscle intervals. Its movement has reversal and smoothness, Yin and Yang follow each other, achieving Heavenly Harmony, allowing the Five Zang organs to restart, following the four seasons' sequence, and digesting grains. Then, Jue Qi stays below, Ying Qi stagnates, Cold Qi rebels upward, True Qi and Evil Qi attack each other, two Qi clash, resulting in distension. The Yellow Emperor said: Excellent! How to resolve doubts? Qibo answered: Combine with True Qi, integrate three aspects to understand. The Yellow Emperor said: Excellent! The Treatise on Distension states that regardless of deficiency or excess, the key is rapid draining. Recent cases drain once, distant cases drain three times. Now some patients do not improve after three drainages, where is the fault? Qibo answered: This is because the needle sank into the muscular adipose tissue (Huang) without hitting the Qi Acupoint. If the Qi Acupoint is not hit, Qi closes internally; if the needle does not sink into Huang, Qi cannot move upward and outward; if only muscle is pierced, Wei Qi becomes chaotic, Yin and Yang chase each other, leading to distension. When draining is indicated but not performed, Qi fails to descend, hence three drainages fail. One must change the approach; stop when Qi descends. If it doesn't descend, start again, ensuring safety, how could there be danger? For dry distension, carefully examine the pulse; drain if indicated, tonify if indicated, effective like a drumstick striking a drum, how could it not descend? The Yellow Emperor asked: Can Skin Distension and Drum Distension be needled? Qibo answered: First drain the collateral vessels of the distended area, then regulate the meridians, removing the blood collaterals. Sudden abdominal fullness that does not depress on pressure, acquire the Foot-Taiyang meridian collaterals, which is the Front-Mu point of the Stomach. The Foot-Shaoyin Shu point is located 3 cun lateral to the spine, 5 cun further out; use a round-sharp needle. Wei Qi rebellion causes Mai Distension; Wei Qi merging with vessels causes Fu Distension. Drain San Li (ST36). Recent cases drain once, distant cases drain three times, regardless of deficiency or excess, rapidly drain San Li.