腹暴满。按之不下。取太阳经络者。胃之募也。(手太阳经之络。即任脉之中脘。中脘
为手
太阳少阳足阳明脉所生故云太阳经络者。胃之募也。)少阴俞。去脊椎三寸旁五。(又取肾俞
穴脊椎。两旁共为三寸。各五 也。)用员利针。霍乱。刺俞旁五。(即肾俞旁志室穴各刺五
)足阳明及上傍三。(又刺胃俞及脾俞之外意舍。各三 。)刺痫惊。脉五。(五脉如下支。
)针手太阴各五。(左右各五 。)刺经。(经渠)大阳五。(阳谷穴各五 。)刺手少阴经络旁
者一。(手少阴之经灵道穴。在络穴通里之旁一。各一 也)足阳明一。(亦言经穴解 也。)
上踝五寸刺三针。足少阳之络光明穴。各刺三 。
肝热病者。小便先黄。腹痛。多卧。身热。热争则狂言及惊。胁满痛。手足躁。不得安
卧。
庚辛甚。甲乙大汗。气逆则庚辛死(庚辛属金。克肝木也。甲乙属木肝当王也。逆为邪胜藏
也。)刺足厥阴少阳。(少阳为厥阴之表。故皆当刺之。)其逆则头痛员员。(靡定貌。)脉引
冲头也 心热病者。先不乐。数日乃热热争则卒。心痛烦闷善呕。头痛面赤无汗。壬癸甚丙
丁大汗。气逆则壬癸死。(壬癸属水。克心火也丙丁属火。心当王也。)刺手少阴太阳。(太
阳为少阴之表故皆当刺之)脾热病者。先头重。颊痛。烦心。颜青。欲呕。身热。热争则腰
痛。不可用俯仰。腹满泄。两颔痛。甲乙甚。戊己大汗。气逆则甲乙死。(甲乙属木。克脾
土也。戊己属土。脾当王也。)刺足太阴阳明。(阳明为太阴之表故皆当刺之)肺热病者。先
淅然厥起毫毛。恶风寒。舌上黄。身热。热争则喘咳。痛走胸膺背。不得太息。头痛不堪。
汗出而寒。丙丁甚。庚辛大汗。气逆则丙丁死。(丙丁属火。克肺金也。庚辛属金。肺当王
也。)刺手太阴阳明。(肺大肠二经)出血如豆大立已。(取其络脉之盛者。)肾热病者。先腰
痛。 酸苦渴数饮。身热。热争则项痛而强。 寒且酸。足下热不欲言。其逆则项痛员员。
澹澹然。(精神短少貌。)戊己甚。壬癸大汗。气逆则戊己死。(戊己属土克肾水也。壬癸属
水。肾当下也。)刺足少阴太阳。(肾膀胱二经。)肝热病者。左颊先赤。心热病者。颜先赤
。脾热病者。鼻先赤。肺热病者。右颊先赤。肾热病者。颐先赤。病虽未发。见赤色者刺之
。名曰治未病。(赤色见于五部。则为病之先兆。当求其藏而预治之)热病从部所起者。至期
而已。(至其王日如肝病则甲乙是也。)其刺之反者。三周而已。(反谓泻虚补实也。三周三
日也。)重逆则死。(一误者。尚待三周。再误者。邪益深而正益敝故死。)诸治热病。以饮
之寒水乃刺之。必寒衣之。居止寒处身寒而止也。(欲其阴气自内达表。热泄于外也。)热病
先胸胁痛。手足躁。刺足少阳。补足太阴。(胸胁痛。丘虚主之。补足太阴者。当于井荥取
也。)病甚者。为五十九刺。(见灵枢热病篇。)热病始手臂痛者。刺手阳明太阴。而汗出止
。(商阳列缺等穴)热病始于头首者刺项太阳(天柱。)而汗出止。热病始于足胫者。刺足阳明
而汗出止。(足阳明可汗出。当刺内庭陷谷。)热病先身重骨痛。耳聋。好瞑。刺足少阴。病
甚为五十九刺。(刺足少阴者。据经无正主穴当取井荥耳。若其病甚。则当用五十九刺。)热
病先眩冒而热。胸胁满。刺足少阴少阳。(头脑运转曰眩。眼目蒙昧曰冒。骨之充为脑。骨
之精为瞳子皆主于肾。又足少阳之脉起目锐 。循胁里。皆为此症。故当在二经酌取之。亦
热病气穴。三椎下间(魄户)主胸中热。四椎下间(膏肓俞)主鬲中热。五椎下间(神堂)主肝热
。六椎下间(噫嘻)主脾热。七椎下间(膈关)主肾热。荣在 也。(此总言治热之藏俞也。独
刺上之七节。主疗阳邪。椎。脊骨节也。荣。阴气也。 。尾 也。阳邪治在上。若刺下之
七椎。则虚其阴。故戒之曰荣在 也。)项上三椎陷者中也(取脊骨之法。项骨三节之下陷者
中穴名大椎由此而下数之。则循序可得矣)
腹部突然胀满，按压后胀满感不消退。应取足太阳经的络穴，即胃的募穴中脘。（注：手太阳经的络穴实际上是指任脉上的中脘穴，因为中脘是手太阳、手少阳和足阳明经脉所生之处，所以称为“太阳经络者，胃之募也”。）再取肾俞穴，距离脊椎旁开三寸，再向外五寸。（注：又取位于脊椎两侧的肾俞穴，两旁共宽三寸，各距中线五寸。）使用圆利针进行针刺。对于霍乱病，刺肾俞旁五寸处的志室穴，每穴刺五壮。再刺足阳明胃经及上傍三寸处的穴位。（注：又刺胃俞及脾俞外侧的意舍穴，每穴刺三壮。）治疗癫痫惊厥，刺五脉（如下肢相关经脉）。针刺手太阴肺经两侧各五壮。刺经渠穴。刺大阳经（指手太阳小肠经）的阳谷穴，每穴刺五壮。刺手少阴心经的络穴通里旁一指的灵道穴，每穴刺一壮。足阳明经刺一壮。（这也指经穴解溪穴。）在内踝上五寸处刺三针，这是足少阳胆经的络穴光明穴，每穴刺三壮。
肝热病患者，小便先变黄，腹痛，嗜睡，身体发热。邪正相争剧烈时，会出现胡言乱语和惊悸，胁肋部胀满疼痛，手足躁动不安，无法安稳躺卧。病情在庚辛日加重，在甲乙日大汗出而愈。若气机逆乱，则在庚辛日死亡。（庚辛属金，克制肝木；甲乙属木，肝气当旺。逆乱表示邪气胜过脏气。）针刺足厥阴肝经和足少阳胆经。（少阳为厥阴之表，所以两经都应针刺。）若气机逆乱，则出现头晕目眩，脉气牵引至头部。
心热病患者，先感到心情不悦，几天后才发热。邪正相争剧烈时，突发心痛，烦闷，容易呕吐，头痛，面色发红，无汗。病情在壬癸日加重，在丙丁日大汗出而愈。若气机逆乱，则在壬癸日死亡。（壬癸属水，克制心火；丙丁属火，心气当旺。）针刺手少阴心经和手太阳小肠经。（太阳为少阴之表，所以两经都应针刺。）
脾热病患者，先感到头重，脸颊痛，心烦，面色发青，想呕吐，身体发热。邪正相争剧烈时，腰痛，不能俯仰，腹部胀满腹泻，两侧下颌疼痛。病情在甲乙日加重，在戊己日大汗出而愈。若气机逆乱，则在甲乙日死亡。（甲乙属木，克制脾土；戊己属土，脾气当旺。）针刺足太阴脾经和足阳明胃经。（阳明为太阴之表，所以两经都应针刺。）
肺热病患者，先感到寒冷战栗，毫毛竖起，怕风怕冷，舌苔发黄，身体发热。邪正相争剧烈时，气喘咳嗽，疼痛放射至胸膺背部，不能深呼吸，头痛难忍，出汗后感到寒冷。病情在丙丁日加重，在庚辛日大汗出而愈。若气机逆乱，则在丙丁日死亡。（丙丁属火，克制肺金；庚辛属金，肺气当旺。）针刺手太阴肺经和手阳明大肠经。（肺与大肠二经。）出血如豆粒大小，症状立即停止。（选取络脉气血旺盛之处放血。）
肾热病患者，先腰痛，小腿酸软，口苦口渴，频繁饮水，身体发热。邪正相争剧烈时，颈项疼痛且僵硬，恶寒且酸痛，脚底发热，不想说话。若气机逆乱，则颈项疼痛头晕，精神萎靡不振。病情在戊己日加重，在壬癸日大汗出而愈。若气机逆乱，则在戊己日死亡。（戊己属土，克制肾水；壬癸属水，肾气当旺。）针刺足少阴肾经和足太阳膀胱经。（肾与膀胱二经。）
肝热病患者，左颊先发红。心热病患者，颜面先发红。脾热病患者，鼻头先发红。肺热病患者，右颊先发红。肾热病患者，下巴先发红。即使疾病尚未发作，见到这些部位发红就应当针刺治疗，这叫做“治未病”。（赤色出现在五脏对应的面部区域，是疾病的先兆，应当寻找相应的脏腑预先治疗。）热病从特定部位起始的，到了该脏气旺盛的日子就会痊愈。（例如肝病在甲乙日，即木气旺盛之日。）如果针刺方法错误，则需要经过三个周期（三日）才能痊愈。（错误指针刺虚证用补法、实证用泻法的反向操作。三周即三日。）如果再次逆乱误治，则会导致死亡。（一次错误尚需等待三个周期恢复，再次错误则邪气更深，正气更衰，故致死。）所有治疗热病的方法，应先让患者喝冷水，然后再针刺。必须给患者穿薄衣，居住在凉爽的地方，直到身体感觉凉爽为止。（目的是使阴气由内达外，让热邪从体表泄出。）
热病首先表现为胸胁疼痛、手足躁动的，针刺足少阳胆经，补足太阴脾经。（胸胁痛以丘墟穴为主穴。补足太阴应在井穴和荥穴选取。）病情严重的，采用“五十九刺”法。（见《灵枢·热病》篇。）热病始于手臂疼痛的，针刺手阳明大肠经和手太阴肺经，直到出汗停止。（如商阳、列缺等穴。）热病始于头首部的，针刺项部的足太阳膀胱经（天柱穴），直到出汗停止。热病始于足胫部的，针刺足阳明胃经，直到出汗停止。（足阳明经可致汗出，应刺内庭、陷谷穴。）热病首先表现为身体沉重、骨痛、耳聋、喜欢闭眼的，针刺足少阴肾经。病情严重的，采用“五十九刺”法。（针刺足少阴经，据经文没有特定的主穴，应取井穴和荥穴。若病情严重，则应用五十九刺法。）热病首先表现为眩晕发热、胸胁满闷的，针刺足少阴肾经和足少阳胆经。（头脑旋转称为眩，眼睛昏花称为冒。骨骼充养脑髓，骨骼的精气反映在瞳孔，这些都由肾主宰。另外足少阳经脉起于目锐眦，循行于胁肋内部，都与此症有关，所以应当在两经中斟酌选取穴位。）这也是热病的穴位。第三椎下方间隙（魄户穴）主治胸中热，第四椎下方间隙（膏肓俞穴）主治膈中热，第五椎下方间隙（神堂穴）主治肝热，第六椎下方间隙（噫嘻穴）主治脾热，第七椎下方间隙（膈关穴）主治肾热。荣穴位于尾骶部。（这里总述治疗热病脏腑背俞穴的方法。只刺上面的七节，主治阳邪。椎，指脊骨节。荣，指阴气。尾骶部。阳邪治在上部，如果刺下面的七椎，则会损伤阴气，所以告诫说荣气在尾骶部，不可妄刺。）项部第三椎下方的凹陷处是大椎穴（取脊骨的方法：从项骨第三节下的凹陷处名为大椎，由此向下数，即可按顺序找到各椎骨穴位）。
The abdomen suddenly becomes distended, and pressing it does not relieve the fullness. One should puncture the Luo-connecting vessel of the Foot-Taiyang channel, which is the Front-Mu point of the Stomach, Zhongwan (CV 12). (Note: The Luo-connecting vessel of the Hand-Taiyang channel actually refers to Zhongwan on the Ren Mai, because Zhongwan is where the Hand-Taiyang, Hand-Shaoyang, and Foot-Yangming channels originate, hence it is called "the Taiyang Luo-vessel, the Mu-point of the Stomach".) Then take Shenshu (BL 23), located three cun lateral to the spine, and another five cun outward. (Note: Also take the Shenshu points on both sides of the spine, spanning three cun in total width, each five cun from the midline.) Use a Yuanli needle. For Huoluan (cholera-like syndrome with vomiting and diarrhea), puncture Zhishi (BL 52), located five cun lateral to Shenshu, five times at each point. Then puncture the Foot-Yangming channel and the points three cun lateral to the upper back. (Note: Also pierce Yishe (BL 48), located lateral to Weishu (BL 21) and Pishu (BL 20), three times at each point.) To treat epilepsy and惊厥 (convulsions), puncture the Five Channels (referring to lower limb meridians as detailed below). Puncture the Hand-Taiyin Lung channel, five times on each side. Puncture Jingqu (LU 8). Puncture the Daiyang channel (referring to the Hand-Taiyang Small Intestine channel), Yanggu (SI 5), five times at each point. Puncture Lingdao (HT 4), located one finger-breadth beside the Luo-connecting point Tongli (HT 5) of the Hand-Shaoyin Heart channel, once at each point. Puncture the Foot-Yangming channel once. (This also refers to the Jing-river point Jiexi (ST 41).) Puncture three needles at five cun above the medial malleolus; this is the Luo-connecting point Guangming (GB 37) of the Foot-Shaoyang Gallbladder channel, puncture three times at each point.
In Liver Heat disease, urination turns yellow first, accompanied by abdominal pain, excessive sleepiness, and body heat. When pathogenic heat contends with healthy qi, there may be delirious speech and惊悸 (palpitations/fright), distension and pain in the hypochondrium, restlessness of the hands and feet, and inability to lie down peacefully. The condition worsens on Geng-Xin days (Metal days), and profuse sweating occurs on Jia-Yi days (Wood days), leading to recovery. If Qi rebels (reverses flow), death occurs on Geng-Xin days. (Geng-Xin belong to Metal, which overacts on Liver Wood; Jia-Yi belong to Wood, when Liver Qi is prosperous. Rebellion indicates pathogenic excess overcoming the organ's qi.) Puncture the Foot-Jueyin Liver channel and the Foot-Shaoyang Gallbladder channel. (Shaoyang is the exterior counterpart of Jueyin, so both should be punctured.) If Qi rebels, dizziness and vertigo occur, with pulse tension pulling towards the head.
In Heart Heat disease, there is initially a sense of unhappiness, followed by fever after several days. When heat contends with healthy qi, sudden heart pain, vexation, irritability, frequent vomiting, headache, flushed face, and anhidrosis occur. The condition worsens on Ren-Gui days (Water days), and profuse sweating occurs on Bing-Ding days (Fire days), leading to recovery. If Qi rebels, death occurs on Ren-Gui days. (Ren-Gui belong to Water, which overacts on Heart Fire; Bing-Ding belong to Fire, when Heart Qi is prosperous.) Puncture the Hand-Shaoyin Heart channel and the Hand-Taiyang Small Intestine channel. (Taiyang is the exterior counterpart of Shaoyin, so both should be punctured.)
In Spleen Heat disease, there is initially heaviness of the head, cheek pain, mental vexation, bluish complexion, desire to vomit, and body heat. When heat contends with healthy qi, lower back pain occurs, making flexion and extension difficult, along with abdominal fullness, diarrhea, and pain in both mandibles. The condition worsens on Jia-Yi days (Wood days), and profuse sweating occurs on Wu-Ji days (Earth days), leading to recovery. If Qi rebels, death occurs on Jia-Yi days. (Jia-Yi belong to Wood, which overacts on Spleen Earth; Wu-Ji belong to Earth, when Spleen Qi is prosperous.) Puncture the Foot-Taiyin Spleen channel and the Foot-Yangming Stomach channel. (Yangming is the exterior counterpart of Taiyin, so both should be punctured.)
In Lung Heat disease, there is initially chills, piloerection (goosebumps), aversion to wind and cold, yellow tongue coating, and body heat. When heat contends with healthy qi, wheezing and coughing occur, pain radiating to the chest, epigastrium, and back, inability to take deep breaths, unbearable headache, sweating followed by coldness. The condition worsens on Bing-Ding days (Fire days), and profuse sweating occurs on Geng-Xin days (Metal days), leading to recovery. If Qi rebels, death occurs on Bing-Ding days. (Bing-Ding belong to Fire, which overacts on Lung Metal; Geng-Xin belong to Metal, when Lung Qi is prosperous.) Puncture the Hand-Taiyin Lung channel and the Hand-Yangming Large Intestine channel. (Lung and Large Intestine channels.) Bleed until the amount resembles a bean size, and symptoms will stop immediately. (Select areas where the collateral vessels are abundant.)
In Kidney Heat disease, there is initially lower back pain, soreness and weakness in the legs, bitter taste, thirst with frequent drinking, and body heat. When heat contends with healthy qi, stiff and painful neck, aversion to cold with soreness, hot soles, and reluctance to speak occur. If Qi rebels, there is stiff and painful neck with dizziness, and a listless spirit. The condition worsens on Wu-Ji days (Earth days), and profuse sweating occurs on Ren-Gui days (Water days), leading to recovery. If Qi rebels, death occurs on Wu-Ji days. (Wu-Ji belong to Earth, which overacts on Kidney Water; Ren-Gui belong to Water, when Kidney Qi is prosperous.) Puncture the Foot-Shaoyin Kidney channel and the Foot-Taiyang Bladder channel. (Kidney and Bladder channels.)
In Liver Heat disease, the left cheek becomes red first. In Heart Heat disease, the forehead becomes red first. In Spleen Heat disease, the nose becomes red first. In Lung Heat disease, the right cheek becomes red first. In Kidney Heat disease, the chin becomes red first. Even if the disease has not yet manifested, if redness is seen in these areas, one should puncture them. This is called "treating disease before it arises." (Redness appearing in the five facial zones corresponding to organs is a precursor of disease; one should identify the affected organ and treat it preemptively.) For Heat diseases originating from specific regions, recovery occurs when the corresponding prosperous day arrives. (For example, Liver disease recovers on Jia-Yi days, when Wood Qi is prosperous.) If the acupuncture method is reversed (incorrectly tonifying deficiency or reducing excess), recovery takes three cycles (three days). If one errs again (double rebellion), death results. (One error requires waiting for three cycles; a second error deepens the pathogen and depletes Zheng Qi further, leading to death.) All treatments for Heat diseases involve having the patient drink cold water before puncturing. The patient must wear light clothing and reside in cool places until the body feels cool. (The aim is to allow Yin Qi to reach the exterior from within, allowing Heat to dissipate externally.)
For Heat diseases starting with chest/hypochondriac pain and restlessness of hands/feet, puncture the Foot-Shaoyang Gallbladder channel and tonify the Foot-Taiyin Spleen channel. (Chronic hypochondriac pain is primarily treated with Qiuxu (GB 40). Tonifying Foot-Taiyin involves selecting Jing-Well and Ying-Spring points.) For severe cases, use the "Fifty-Nine Acupoints" needling method. (See *Ling Shu: Re Bing* chapter.) For Heat diseases starting with arm pain, puncture the Hand-Yangming Large Intestine and Hand-Taiyin Lung channels until sweating stops. (Points such as Shangyang (LI 1) and Lieque (LU 7).) For Heat diseases starting with head/neck pain, puncture the Foot-Taiyang Bladder channel at the nape (Tianzhu BL 10) until sweating stops. For Heat diseases starting with leg/calf pain, puncture the Foot-Yangming Stomach channel until sweating stops. (Foot-Yangming can induce sweating; puncture Neiting (ST 44) and Xangu (ST 43).) For Heat diseases starting with body heaviness, bone pain, deafness, and a preference for closing eyes, puncture the Foot-Shaoyin Kidney channel. For severe cases, use the "Fifty-Nine Acupoints" method. (Puncturing Foot-Shaoyin: according to the text, there is no single primary point; select Jing-Well and Ying-Spring points. If severe, use the Fifty-Nine Acupoints method.) For Heat diseases starting with dizziness, vertigo, fever, and chest/hypochondriac fullness, puncture the Foot-Shaoyin Kidney and Foot-Shaoyang Gallbladder channels. (Dizziness refers to spinning sensation; vertigo refers to visual obscurity. Bone nourishes the brain; eye pupils reflect bone essence, both governed by Kidney. Additionally, Foot-Shaoyang starts at the outer canthus and runs through the hypochondrium, relevant to these symptoms; thus, points should be selected from both channels.) These are also acupoints for Heat diseases. The interspace below the third thoracic vertebra (Pohu BL 42) treats chest heat; below the fourth (Gaohuang BL 43) treats diaphragm heat; below the fifth (Shentang BL 44) treats Liver heat; below the sixth (Yixi BL 45) treats Spleen heat; below the seventh (Geguan BL 46) treats Kidney heat. The Ying-Spring points are located at the tailbone. (This summarizes treating Heat in Zang organs via Back-Shu points. Only puncturing the upper seven segments treats Yang pathogens. Vertebrae refer to spinal joints. Ying refers to Yin Qi. Tailbone. Treating Yang pathogens in the upper region; puncturing the lower seven vertebrae would damage Yin Qi, hence the warning: Ying Qi is at the tailbone, do not puncture recklessly.) The depression below the third cervical vertebra in the neck is Dazhui (GV 14). (Method for locating vertebrae: locate the depression below the third cervical vertebra named Dazhui; counting downwards sequentially allows identification of other vertebral levels.)