平按∶此篇自篇首至末，见《素问》卷九第三十二《刺热》篇，又见《甲乙经》
卷七第一。
肝热病者，小便先黄，腹痛多卧身热，热争则狂言及惊，胁痛，手足躁，不安卧，
（肝脉足厥阴环阴器，故热小便黄也。上行挟胃，故身热多卧卧不安也。肝动，语言也，
故热争狂言及惊也。其脉属肝络胆，故胁痛也。肝脉出足上，连手厥阴，今热，故手足
躁也。平按∶胁痛《素问》作胁满痛，《甲乙》作胸中胁满痛，安上均有得字。）庚
辛甚，甲乙大汗，气逆则庚辛死，（金以克木，故庚辛甚也。甲乙木王，故大汗也。余
四仿此。加气逆者，则庚辛死也。平按∶注王袁刻作旺，加作如。）刺足厥阴少阳，其
头痛员员，脉引冲头。（足厥阴、足少阳表里行脏腑之气，故刺之也。厥阴上额与督脉
会于巅，故头痛员员脉引冲头。员，都耕反，头切痛也。平按∶《素问》、《甲乙》
头上有逆则二字。）心热病者，先不乐，数日乃热，热争则卒心痛，烦俯喜呕，头痛
面赤无汗，（心主喜乐，热病将发，故不乐数日乃热。手少阴脉起心中，挟咽系目系，
手太阳至目内外 ，故热甚心痛烦 喜呕头痛面赤无汗也。平按∶《甲乙》无卒痛二字。
喜《素问》、《甲乙》作闷善。注内外 ，袁刻脱外字。按手太阳脉支者，上颊至
目锐 ，别者抵鼻至目内 ，故云内外 也。）至壬癸甚，丙丁大汗，气逆则壬癸死，
刺手少阴太阳。（手少阴太阳，此心脏腑表里脉也。）脾热病者，先头重颜痛，心烦
欲呕，身热，热争则腰痛不用，腹满泄，两颔痛，〔脾腑之阳明脉，循发际至额颅，
故头重颜痛（一曰颊，足阳明亦循颊也）及两颔痛。足太阴脉注心中，故心烦也。足阳
明下循喉咙下膈属胃络脾主肌，故欲呕身热腹满泄也。足阳明之正，入腹里属胃，故
腰痛不用也。平按∶颜痛心烦《素问》作颊痛烦心颜青，新校正云∶“《甲乙》、《太
素》云∶脾热病者，先头重颜痛。无颜青二字。”与此同。不用《素问》、《甲乙》
作“不可用俯仰”五字。〕甲乙甚，戊己大汗，气逆则甲乙死，刺足太阴阳明。（平按∶
太阴袁刻误作太阳。）肺热病者，先淅然起毛恶风，舌上黄，身热，热争则喘咳，痹
走胸膺背，不得太息，头痛不甚，汗出而寒，（肺主毛腠，内热，淅然起毛恶风也。肺
热上熏，故舌上黄也。肺主行气于身，故身热也。肺以主咳，在于胸中，故热争喘咳，
痹走胸膺，此为热痹，痛行胸中，不得太息也。肺热冲头，以肺脉不至，故头痛不甚也。
有本为堪，言气冲甚，故头痛甚也。冷汗虽出，无发热也。平按∶淅然起毛《素问》作
淅然厥起毫毛，《甲乙》作 然厥起皮毛。恶风《素问》、《甲乙》作恶风寒，痹均
作痛。不甚《素问》作不堪。）丙丁甚，庚辛大汗，气逆则丙丁死，刺手太阴阳明，
其血如大豆，立已。（肺热之病，取肺大肠表里输穴。出血如豆，言其少也。恐泄气
虚，故不多也。）肾热病者，先腰痛 ，苦渴数饮食身热，热争则项痛而强， 寒
且，足下热，不欲言，其项痛员员淡淡，（肾足少阴脉上 内，出 内廉，贯脊属
肾络膀胱，上贯肝膈入肺中，循喉咙挟舌本，故热病先腰痛 、苦渴数饮也。足太阳
脉别项，本支行背，合有四道，以下合 贯 ，至足小趾外侧，故身热项强痛而足
寒且 也。足少阴起于足心，故足下热也。从肺出络心，
故热不欲言也。淡，徒滥反，动也，谓不安动也。平按∶其项痛《素问》、《甲乙》作
其逆则项痛。《素问》淡下有然字。《甲乙》无淡淡二字。）戊己甚，壬癸大汗，气
逆则戊己死，刺足少阴太阳。（平按∶《素问》太阳下有“诸汗者至其所胜日汗出也”
十一字，与下重复，新校正云宜删去。）肝热病者左颊先赤，心热病者颜先赤，（平按∶
《甲乙》颜下有颔字。）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，见其赤色者刺之，名曰治未病。（次言热病色候也。五脏部中赤色见者，即五
脏热病之征，热病已有，未成未发，斯乃名为未病之病，宜急取之。平按∶注热病之征，
袁刻征作微。）热病从部所起者，至其期而已；（部所者，色部所也。假令赤色从肝
部起，刺之顺者，相传还至肝部本位，病已也。平按∶《素问》、《甲乙》期上无其
字。袁刻部下有中字，注从肝部起，脱部字。）其刺之反者，三周而已；重逆则死。（刺
之不顺其气，传之三周而已。若刺之更反，死矣。）诸当汗出者，至病所胜日，汗大出。
（病之胜者，第七日，是病所胜也。又如肝病至甲乙日，是病之胜日也。平按∶病《素
问》作其。）诸治热病，已饮之寒水，乃刺之，必寒衣之，居寒多，身寒而止。（诸病
热病，以寒疗之，凡有四别∶一，饮寒水使其内寒；二，刺于穴令其脉寒；三，以寒
衣使其外寒；四，以寒居令其体寒。以四寒之，令身内外皆寒，故热病止也。平按∶
已《素问》作以，《甲乙》作先。居寒多《素问》、《甲乙》作居止寒处。）热病先胸
胁痛，手足躁，刺足少阳手太阴，病甚为五十九刺。
（足少阳脉下颈合缺盆下胸中贯膈络肝属胆循胁里过季胁下外辅骨之前下抵绝骨循足跗下
至趾间；手太阴上属肺，从肺出腋下，故胸胁痛手足躁，刺此二脉也。平按∶痛下《甲
乙》有满字。手太阴《素问》、《甲乙》作补足太阴，王注云∶“补足太阴之脉，当
于井荥取之。”新校正云∶“足太阴全元起本及《太素》作手太阴。杨上善云∶手太阴
上属肺，从肺出腋下，故胸胁痛。”又引《灵枢·热病》之文，以此决知作手太阴者
为是。）热病先手臂痛，刺手阳明太阴而汗出。（手阳明行于手表，太阴行在手里，故
手臂痛，刺此阴阳表里二脉取汗也。平按∶先《素问》、《甲乙》作始。《素问》汗
出下有止字。）热病始于头首者，刺项太阳而汗出。（项太阳者，足太阳从巅入脑还出
挟项以下挟脊，故热病始头首，刺此太阳输穴出汗也。平按∶刺《甲乙》作先取二字。
汗出下《素问》有止字。详自上节热病先手臂痛至本节而汗出，《甲乙》编次在后。
此节下《素问》有“热病始于足胫者，刺足阳明而汗出止”十五字，新校正云∶“此条
《素问》本无，《太素》亦无，今按《甲乙》添入。”与本书合。）热病者，先身重骨
痛，耳聋好瞑，刺足少阳，病甚为五十九刺。（足少阳脉起目锐 ，络身骨节，入耳中，
故热病先身重耳聋好瞑，所以取此脉之输穴者也。有本为足少阴也。平按∶《素问》、
《甲乙》足少阳作足少阴。）热病先眩，胃热胸胁满，刺足少阴少阳太阳之脉，（足太
阳起目内 ，上额交巅入脑；足少阳起目锐 ，下胸循胁里；足少阴从肾上贯肝膈，入
肺中，故眩胃热胸胁满，刺此三脉者也。平按∶胃热，胃《素问》、《甲乙》作冒。）
色荣颧，骨热病也，（赤色荣颧，此之三脉皆生于骨，故此三脉为病，有赤色荣颧者，
骨热病也。平按∶《素问》王注谓太阳合火，故见色赤。新校正云∶“杨上善云∶赤色
荣颧者，骨热病也。与王注不同。”荣未夭日，令且得汗，待时自已，
赤色未夭之日，且得汗者，至胜时病自得已也。平按∶夭《素问》作交，日作曰，王注
云∶“曰者，引古经法之端由也。”令《素问》、《甲乙》作今。新校正云∶《甲乙》、
《太素》作荣未夭，下同。）与厥阴脉争见者死，期不过三日，其热病气内连肾。（足
太阳，水也。足厥阴，木也。水以生木，木盛水衰，故太阳水色见时，有木争见者，水
死。以其热病内连于肾，肾为热伤，其数至三日故死也。平按∶《素问》、《甲乙》病
下无气字，肾下有少阳之脉色也六字。《素问》王注云∶“病或为气，恐字误也。若赤
色气内连鼻两旁者，是少阳之脉色，非厥阴色。何者？肾部近于鼻也。”新校正云∶
“详或者欲改肾作鼻，按《甲乙》、《太素》并作肾，杨上善云∶太阳，水也。厥阴，
木也。水以生木，木盛水衰，故太阳水色见时，有木争见者，水死。以其热病内连于
肾，肾为热伤，故死。本旧无少阳之脉色也六字，乃王氏所添，王注非，当从上善之义。”
据此则本书足证《素问》王注之失。）少阳之脉，色荣颊，筋热病也，荣未夭日，令
且得汗，待时自已，与少阴脉争见者死。（足少阳，胆脉也。足少阳部在颊，赤色荣
之，即知筋热病也。当荣时且得汗者，至其木时病自已也。少阳为木，少阴为水，少阳
脉见之时，少阴争见者，是母胜子，故肝木死也。平按∶筋《素问》作前，王注云∶
“颊前，即颧骨下近鼻两旁也。”新校正云∶“《太素》、《甲乙》前字作筋，杨上善
云∶足少阳部在颊，赤色荣之，即知筋热病也。”死字下《素问》有“期不过三日”五
字，王注云∶“少阴脉来见，亦土败而木贼之。”新校正云∶“详或者欲改少阴作厥
阴，按《甲乙》、《太素》作少阴，杨上善云∶少阳为木，少阴为水，少阳色见之时，
少阴争见者，是母胜子，故木死。王作此注亦非。旧本及《甲乙》、《太素》并无期
不过三日五字，此是王氏成足此文。”据此则本书之存，足纠正《素问》王注不少也。）
三椎下间主胸中热，（《明堂》及
《九卷》背五脏俞，并以第三椎为肺俞，第五椎为心俞，第七椎为膈俞，第九椎为肝俞，
第十一椎为脾俞，第十四椎为肾俞，皆两箱取之，当中第三椎以上无疗脏热，故五脏
俞及候五脏热，并第三椎以下数之。第三椎以上与颊车相当，候色。第三椎下间肺俞中
间，可以泻热也。平按∶《素问》、《甲乙》三椎上有“热病气穴”四字。）四椎下
间主膈热，五椎下间主肝热，六椎下间主脾热，七椎下间主肾热。（四椎下间，计次
当心，心不受邪，故乘言膈也。次第推之，下间各主一脏之热，不同《明堂》通取五脏
之输者也。平按∶膈《素问》作膈中，《甲乙》作胃中。肾热下《素问》、《甲乙》
并有“荣在 也”四字。）荣在项上三椎陷者中，颊下逆椎为大瘦，（从肺输以上，三
椎在项，故曰项上三椎，即大椎上陷者中也。当颊下迎椎，故曰逆椎。逆，迎也。是为
颊下。当椎前有色见者，腹有大瘦病者也。平按∶《素问》、《甲乙》无荣在二字。
《甲乙》陷上有骨字。《素问》、《甲乙》逆椎作逆颧，大瘦作大瘕。）下牙车为腹
满，（下牙车色见者，腹满病也。）椎后为胁痛，（大椎左右箱为椎后，有色见者，胁
痛也。平按∶椎后《素问》、《甲乙》作颧后。）颊上者膈上者也。（颊以上无椎可准，
故颊以上有色者，主膈上也。）
【平按】：本篇从篇首到篇末，见于《素问》卷九第三十二《刺热》篇，又见于《甲乙经》卷七第一。
肝发生热病时，小便先变黄，腹痛、嗜睡且身体发热；若邪正相争剧烈，则出现胡言乱语和惊骇，胁肋疼痛，手足躁动不安，无法安卧。（足厥阴肝脉环绕生殖器，所以热邪致小便发黄。肝脉上行夹胃，所以身热、多卧但卧不安。肝主发声，所以热邪相争时胡言乱语及惊骇。肝脉属肝络胆，所以胁痛。肝脉出于足部上行，连系手厥阴心包经，现在受热邪，所以手足躁动。平按：胁痛在《素问》中作“胁满痛”，在《甲乙》中作“胸中胁满痛”，杨上善注均认为有“得”字。）病情在庚辛日加重，在甲乙日大汗出而解，若气机逆乱则在庚辛日死亡。（金克木，所以庚辛日病情加重。甲乙为木旺之日，故大汗出而解。其余脏腑仿照此理。若加气逆，则在庚辛日死亡。平按：注文王宗望、袁刻本作“旺”，加字作“如”。）治疗应针刺足厥阴肝经和足少阳胆经。若伴有头痛眩晕，脉气上冲头部。（足厥阴与足少阳互为表里，运行脏腑之气，所以针刺这两条经脉。厥阴脉上额与督脉会于头顶，所以头痛眩晕，脉气上冲头部。“员”音都耕反，意为头切痛。平按：《素问》、《甲乙》在“头”上有“逆则”二字。）
心发生热病时，先心情不悦，数日后才发热；若邪正相争剧烈，则突然心痛，烦闷喜欢呕吐，头痛面赤无汗。（心主喜乐，热病将发时，所以先不悦，数日后才发热。手少阴心脉起于心中，挟咽喉连系目系，手太阳小肠脉至目内眦和外眦，所以热甚则心痛、烦闷、喜呕、头痛、面赤、无汗。平按：《甲乙》无“卒痛”二字。“喜”在《素问》、《甲乙》中作“闷善”。注文中“内外眦”，袁刻脱漏“外”字。按手太阳脉支者，上颊至目锐眦，别者抵鼻至目内眦，所以说内外眦。）病情在壬癸日加重，在丙丁日大汗出而解，若气机逆乱则在壬癸日死亡，治疗应针刺手少阴心经和手太阳小肠经。（手少阴和手太阳，是心脏腑的表里经脉。）
脾发生热病时，先头重、颜面疼痛，心烦想呕吐，身体发热；若邪正相争剧烈，则腰痛不能俯仰，腹部胀满泄泻，两侧下颌疼痛。（脾腑的阳明脉，循行发际至额颅，所以头重、颜面疼痛（一说为颊痛，足阳明也循行颊部）及两侧下颌痛。足太阴脾脉注入心中，所以心烦。足阳明胃脉下行循喉咙下膈属胃络脾主肌肉，所以想呕吐、身热、腹满、泄泻。足阳明之正，入腹里属胃，所以腰痛不能俯仰。平按：颜痛心烦在《素问》中作“颊痛烦心颜青”，林亿新校正说：“《甲乙》、《太素》云：脾热病者，先头重颜痛。无‘颜青’二字。”与此相同。“不用”在《素问》、《甲乙》中作“不可用俯仰”五字。）病情在甲乙日加重，在戊己日大汗出而解，若气机逆乱则在甲乙日死亡，治疗应针刺足太阴脾经和足阳明胃经。（平按：太阴在袁刻中误作太阳。）
肺发生热病时，先淅然恶风，毫毛竖起，舌苔发黄，身体发热；若邪正相争剧烈，则气喘咳嗽，痹痛走窜于胸膺背部，不能深呼吸，头痛不严重，出汗且怕冷。（肺主皮毛腠理，内热则淅然恶风，毫毛竖起。肺热上熏，所以舌苔发黄。肺主行气于全身，所以身热。肺主咳，位于胸中，所以热邪相争时气喘咳嗽，痹痛走窜胸膺，此为热痹，痛行胸中，不能深呼吸。肺热冲头，因肺脉不上达头部，所以头痛不严重。有的版本作“堪”，言气冲严重，所以头痛严重。冷汗虽出，无发热现象。平按：“淅然起毛”在《素问》中作“淅然厥起毫毛”，在《甲乙》中作“漐然厥起皮毛”。“恶风”在《素问》、《甲乙》中作“恶风寒”，“痹”均作“痛”。“不甚”在《素问》中作“不堪”。）病情在丙丁日加重，在庚辛日大汗出而解，若气机逆乱则在丙丁日死亡，治疗应针刺手太阴肺经和手阳明大肠经，出血如大豆大小，病立即痊愈。（肺热病，取肺和大肠的表里输穴。出血如豆，言其量少。恐泄气伤正，所以不多放血。）
肾发生热病时，先腰痛，口渴多饮，身体发热；若邪正相争剧烈，则项部疼痛且强直，足寒且战栗，足心发热，不想说话，项部疼痛眩晕且动摇不定。（足少阴肾脉上入腘内，出腘内廉，贯脊属肾络膀胱，上贯肝膈入肺中，循喉咙挟舌本，所以热病先腰痛、口渴多饮。足太阳膀胱脉别行于项，本支行背，合有四道，以下合腘贯臀，至足小趾外侧，所以身热、项强痛而足寒且战栗。足少阴肾脉起于足心，所以足心发热。从肺出络心，所以热邪致不想说话。“淡”音徒滥反，意为动，谓不安动。平按：“其项痛”在《素问》、《甲乙》中作“其逆则项痛”。《素问》“淡”下有“然”字。《甲乙》无“淡淡”二字。）病情在戊己日加重，在壬癸日大汗出而解，若气机逆乱则在戊己日死亡，治疗应针刺足少阴肾经和足太阳膀胱经。（平按：《素问》“太阳”下有“诸汗者至其所胜日汗出也”十一字，与下文重复，林亿新校正认为宜删去。）
肝发生热病时，左颊先发红；心发生热病时，颜面先发红；脾发生热病时，鼻子先发红；肺发生热病时，右颊先发红；肾发生热病时，下巴先发红。病虽然未发作，见到这些部位发红即可针刺，这叫做“治未病”。（接下来论述热病的色候。五脏对应的面部区域出现赤色，即是五脏热病的征象，热病已有但未成形未发作，这称为“未病之病”，应及时针刺。平按：注文中“热病之征”，袁刻“征”作“微”。）热病从相应部位开始发展的，到了其相克的日期就会痊愈；（“部所”指面色出现的部位。假如赤色从肝部开始，针刺后顺其气机传变，最终回到肝部本位，病就好了。平按：《素问》、《甲乙》“期”上无“其”字。袁刻“部”下有“中”字，注文中“从肝部起”脱漏“部”字。）如果针刺方向相反，经过三个周期才会痊愈；若再次逆乱则会死亡。（针刺不顺其气机，传变三个周期而已。若针刺更逆乱，则死。）所有应当出汗的热病，到了病所被克的日期，会大汗出。（病之所胜，即第七日，是病所胜之日。又如肝病至甲乙日，是病之胜日。平按：“病”在《素问》中作“其”。）所有治疗热病的方法，应先让患者喝冷水，然后再针刺，必须穿凉衣服，居住在凉爽处，直到身体感到寒冷为止。（所有热病，用寒凉疗法，共有四种区别：一，饮寒水使其内部寒凉；二，针刺穴位令经脉寒凉；三，穿寒衣使其外部寒凉；四，居寒处令体表寒凉。用这四种寒凉之法，使身体内外皆寒，所以热病停止。平按：“已”在《素问》中作“以”，在《甲乙》中作“先”。“居寒多”在《素问》、《甲乙》中作“居止寒处”。）
热病先出现胸胁痛、手足躁动的，针刺足少阳胆经和手太阴肺经，病重的采用五十九刺法。（足少阳脉下颈合缺盆下胸中贯膈络肝属胆循胁里过季胁下外辅骨之前下抵绝骨循足跗下至趾间；手太阴上属肺，从肺出腋下，所以胸胁痛、手足躁，针刺这两条经脉。平按：“痛”下《甲乙》有“满”字。手太阴在《素问》、《甲乙》中作“补足太阴”，王冰注云：“补足太阴之脉，当于井荥取之。”林亿新校正云：“足太阴全元起本及《太素》作手太阴。杨上善云：手太阴上属肺，从肺出腋下，故胸胁痛。”又引《灵枢·热病》之文，以此决知作“手太阴”的是正确的。）
热病先出现手臂痛的，针刺手阳明大肠经和手太阴肺经令其出汗。（手阳明行于手臂外侧，太阴行在手臂内侧，所以手臂痛，针刺这两条阴阳表里经脉以取汗。平按：“先”在《素问》、《甲乙》中作“始”。《素问》“汗出”下有“止”字。）
热病始于头部的，针刺项部足太阳膀胱经令其出汗。（项太阳者，足太阳从巅入脑还出挟项以下挟脊，所以热病始发于头部，针刺此太阳输穴出汗。平按：“刺”在《甲乙》中作“先取”二字。“汗出”下《素问》有“止”字。详细看从上节“热病先手臂痛”至本节“而汗出”，《甲乙》编次在后。此节下《素问》有“热病始于足胫者，刺足阳明而汗出止”十五字，林亿新校正云：“此条《素问》本无，《太素》亦无，今按《甲乙》添入。”与本书相符。）
热病先出现身重骨痛、耳聋、喜欢闭目的，针刺足少阳胆经，病重的采用五十九刺法。（足少阳脉起于目锐眦，络身骨节，入耳中，所以热病先身重、耳聋、喜欢闭目，所以取此脉的输穴。有的版本作足少阴。平按：《素问》、《甲乙》“足少阳”作“足少阴”。）
热病先出现眩晕、胃热、胸胁满的，针刺足少阴肾经、足少阳胆经、足太阳膀胱经的经脉，（足太阳起于目内眦，上额交巅入脑；足少阳起于目锐眦，下胸循胁里；足少阴从肾上贯肝膈，入肺中，所以眩、胃热、胸胁满，针刺这三条经脉。平按：“胃热”，“胃”在《素问》、《甲乙》中作“冒”。）
面色赤色显现于颧骨，是骨热病。（赤色显现于颧骨，这三条经脉皆生于骨，所以这三条经脉生病，若有赤色显现于颧骨，就是骨热病。平按：《素问》王冰注谓太阳合火，故见色赤。林亿新校正云：“杨上善云：赤色荣颧者，骨热病也。与王注不同。”若赤色未呈枯夭之色，暂时可得汗出，等待时机病自然痊愈。（赤色未呈枯夭之日的，暂且得汗者，至相胜之时病自然痊愈。平按：“夭”在《素问》中作“交”，“日”作“曰”，王冰注云：“曰者，引古经法之端由也。”“令”在《素问》、《甲乙》中作“今”。林亿新校正云：《甲乙》、《太素》作“荣未夭”，下同。）若与厥阴脉的症状同时出现则死亡，期限不超过三日，因为热病之气内连于肾。（足太阳属水，足厥阴属木。水生木，木盛则水衰，所以当太阳水色出现时，若有木色争现，则水死。因为热病内连于肾，肾被热邪所伤，其数至三日故死。平按：《素问》、《甲乙》“病”下无“气”字，“肾”下有“少阳之脉色也”六字。《素问》王冰注云：“病或为气，恐字误也。若赤色气内连鼻两旁者，是少阳之脉色，非厥阴色。何者？肾部近于鼻也。”林亿新校正云：“详或者欲改肾作鼻，按《甲乙》、《太素》并作肾，杨上善云：太阳，水也。厥阴，木也。水以生木，木盛水衰，故太阳水色见时，有木争见者，水死。以其热病内连于肾，肾为热伤，故死。本旧无少阳之脉色也六字，乃王氏所添，王注非，当从上善之义。”据此则本书的存在，足以证明《素问》王注的错误。）
少阳经脉，赤色显现于颊部，是筋热病。若赤色未呈枯夭之色，暂时可得汗出，等待时机病自然痊愈；若与少阴脉的症状同时出现则死亡。（足少阳，胆脉也。足少阳部在颊，赤色显现于颊，即知为筋热病。当赤色显现时暂且得汗者，至其木旺之时病自然痊愈。少阳属木，少阴属水，少阳脉见之时，少阴争现者，是母胜子，故肝木死。平按：“筋”在《素问》中作“前”，王冰注云：“颊前，即颧骨下近鼻两旁也。”林亿新校正云：“《太素》、《甲乙》前字作筋，杨上善云：足少阳部在颊，赤色荣之，即知筋热病也。”“死”字下《素问》有“期不过三日”五字，王冰注云：“少阴脉来见，亦土败而木贼之。”林亿新校正云：“详或者欲改少阴作厥阴，按《甲乙》、《太素》作少阴，杨上善云：少阳为木，少阴为水，少阳色见之时，少阴争见者，是母胜子，故木死。王作此注亦非。旧本及《甲乙》、《太素》并无期不过三日五字，此是王氏成足此文。”据此则本书的存在，足以纠正《素问》王注不少错误。）
第三椎下间主治胸中热，（《明堂》及《九卷》背部五脏俞穴，均以第三椎为肺俞，第五椎为心俞，第七椎为膈俞，第九椎为肝俞，第十一椎为脾俞，第十四椎为肾俞，皆左右两傍取之，当中第三椎以上无疗脏热之法，故五脏俞及候五脏热，并自第三椎以下数之。第三椎以上与颊车相当，候面色。第三椎下间肺俞中间，可以泻热。平按：《素问》、《甲乙》“三椎”上有“热病气穴”四字。）第四椎下间主治膈热，第五椎下间主治肝热，第六椎下间主治脾热，第七椎下间主治肾热。（第四椎下间，计次当心，心不受邪，所以乘言膈热。次第推之，下间各主一脏之热，不同于《明堂》通取五脏之输穴。平按：“膈”在《素问》中作“膈中”，在《甲乙》中作“胃中”。肾热下《素问》、《甲乙》并有“荣在颐也”四字。）
赤色显现于项上第三椎陷者中，颊下逆对椎骨处有大瘕病，（从肺输以上，第三椎在项，故曰项上三椎，即大椎上陷者中也。当颊下迎对椎骨，故曰逆椎。逆，迎也。是为颊下。当椎前有色见者，腹有大瘕病者也。平按：《素问》、《甲乙》无“荣在”二字。《甲乙》“陷”上有“骨”字。《素问》、《甲乙》“逆椎”作“逆颧”，“大瘦”作“大瘕”。）
下牙车处有色见者为腹满，（下牙车色见者，腹满病也。）椎后处有色见者为胁痛，（大椎左右两傍为椎后，有色见者，胁痛也。平按：“椎后”在《素问》、《甲乙》中作“颧后”。）颊上部者对应膈上也。（颊以上无椎可准，故颊以上有色者，主膈上也。）
[Ping An]: This chapter, from the beginning to the end, is found in Volume 9, Chapter 32 "Needling for Heat" (Ci Re) of the *Suwen* (Basic Questions), and also in Volume 7, Chapter 1 of the *Jiayi Jing* (Systematic Classic of Acupuncture and Moxibustion).
When Liver Heat Disease occurs, urination turns yellow first, accompanied by abdominal pain, lethargy, and body heat. If there is a severe struggle between pathogenic heat and healthy qi, delirious speech and惊骇 (fright/panic) occur, along with hypochondriac pain, restlessness of the hands and feet, and inability to lie down comfortably. (The Foot Jueyin Liver Meridian circles the genitalia, hence heat causes yellow urine. The Liver Meridian ascends alongside the stomach, hence body heat, lethargy, and restless sleep. The Liver governs speech, hence delirium and fright during heat struggle. The meridian belongs to the Liver and connects to the Gallbladder, hence hypochondriac pain. The Liver Meridian emerges from the foot and connects to the Hand Jueyin Pericardium; now affected by heat, hence restlessness of limbs. Ping An: "Hypochondriac pain" is written as "hypochondriac fullness and pain" in *Suwen*, and "chest and hypochondriac fullness and pain" in *Jiayi*. Yang Shangshan's notes suggest the character "de" should be present.) Symptoms worsen on Geng-Xin days, resolve with profuse sweating on Jia-Yi days, and result in death on Geng-Xin days if Qi rebels. (Metal overcomes Wood, hence worsening on Geng-Xin days. Jia-Yi are Wood prosperous days, hence resolution with sweat. Other organs follow this pattern. If Qi rebels, death occurs on Geng-Xin days. Ping An: Wang Zongwang and Yuan editions write "Wang" instead of "Wang", and "Ru" instead of "Jia".) Treatment involves needling the Foot Jueyin and Foot Shaoyang meridians. If accompanied by dizziness/headache with pulse sensation rushing to the head. (Foot Jueyin and Foot Shaoyang are exterior-interior pairs governing Zang-Fu Qi, hence needling them. Jueyin meets Du Mai at the vertex, hence dizziness and pulsating headache. "Yuan" is pronounced "Du Geng Fan", meaning sharp head pain. Ping An: *Suwen* and *Jiayi* add "Ni Ze" before "Tou".)
When Heart Heat Disease occurs, one first feels unhappy, developing fever after several days. If heat struggles severely, sudden heart pain, irritability, frequent vomiting, headache, red face, and anhidrosis occur. (Heart governs joy; pre-fever state causes unhappiness. Hand Shaoyin Heart Meridian originates in the heart, runs along the throat to the eye system; Hand Taiyang Small Intestine Meridian reaches the inner and outer canthi, hence severe heat causes heart pain, irritability, vomiting, headache, facial redness, and no sweat. Ping An: *Jiayi* omits "Cu Tong". "Xi" is written as "Men Shan" in *Suwen* and *Jiayi*. Note: "Inner and outer canthi" misses "outer" in Yuan edition. Hand Taiyang branch goes to outer canthus, another to inner canthus, hence "inner and outer".) Symptoms worsen on Ren-Gui days, resolve with profuse sweating on Bing-Ding days, and result in death on Ren-Gui days if Qi rebels. Treatment involves needling the Hand Shaoyin and Hand Taiyang meridians. (Hand Shaoyin and Hand Taiyang are the interior-exterior meridians of the Heart.)
When Spleen Heat Disease occurs, one first experiences heavy head and facial pain, irritability, desire to vomit, and body heat. If heat struggles severely, lower back pain with inability to bend or stretch, abdominal fullness, diarrhea, and bilateral mandible pain occur. (Yangming Meridian of Spleen/Foot Yangming runs along hairline to forehead, hence heavy head and facial/mandible pain. Foot Taiyin Spleen Meridian enters the heart, hence irritability. Foot Yangming Stomach Meridian descends through throat, diaphragm, belongs to Stomach, connects to Spleen, governs muscles, hence vomiting, heat, fullness, diarrhea. Foot Yangming proper enters abdomen, belongs to Stomach, hence lower back pain. Ping An: "Yan Tong Xin Fan" is "Jia Tong Fan Xin Yan Qing" in *Suwen*; Lin Yi notes *Jiayi*/*Taisu* lack "Yan Qing". "Bu Yong" is "Bu Ke Yong Fu Yang" in *Suwen*/*Jiayi*.) Symptoms worsen on Jia-Yi days, resolve with profuse sweating on Wu-Ji days, and result in death on Jia-Yi days if Qi rebels. Treatment involves needling the Foot Taiyin and Foot Yangming meridians. (Ping An: "Taiyin" is mistakenly printed as "Taiyang" in Yuan edition.)
When Lung Heat Disease occurs, one first feels chilly with aversion to wind, goosebumps, yellow tongue coating, and body heat. If heat struggles severely, wheezing and coughing occur, bi-pain wanders across chest, epigastrium, and back, inability to take deep breaths, mild headache, sweating with chills. (Lung governs skin and pores; internal heat causes chilliness and goosebumps. Lung heat steams upward, causing yellow tongue coating. Lung governs Qi distribution, hence body heat. Lung governs cough, located in chest, hence wheezing/coughing and bi-pain in chest preventing deep breathing. Lung heat rushes to head, but Lung Meridian does not reach head directly, hence mild headache. Some versions say "Kan", implying severe Qi rush causing severe headache. Cold sweat without fever. Ping An: "Xi Ran Qi Mao" is "Xi Ran Jue Qi Hao Mao" in *Suwen*, "Zhi Ran Jue Qi Pi Mao" in *Jiayi*. "E Feng" is "E Feng Han" in *Suwen*/*Jiayi*. "Bi" is "Tong". "Bu Shen" is "Bu Kan" in *Suwen*.) Symptoms worsen on Bing-Ding days, resolve with profuse sweating on Geng-Xin days, and result in death on Bing-Ding days if Qi rebels. Treatment involves needling the Hand Taiyin and Hand Yangming meridians; bleeding like a soybean size cures immediately. (Lung heat disease: needle exterior-interior Shu points of Lung and Large Intestine. Bleeding like a bean indicates small amount to avoid Qi depletion.)
When Kidney Heat Disease occurs, one first experiences lower back pain, bitter thirst with frequent drinking, and body heat. If heat struggles severely, neck pain with stiffness, cold feet with tremors, hot soles, and reluctance to speak occur, with neck pain feeling dizzy and unstable. (Foot Shaoyin Kidney Meridian enters popliteal fossa, ascends spine, belongs to Kidney, connects to Bladder, passes through Liver/Diaphragm to Lung, follows throat to tongue base, hence lower back pain, thirst. Foot Taiyang Bladder Meridian branches at neck, runs down back, joins popliteal/femoral regions to little toe, hence body heat, neck stiffness, cold trembling feet. Kidney Meridian starts at sole, hence hot soles. Connects to Heart via Lung, hence reluctance to speak. "Dan" is pronounced "Tu Lan Fan", meaning movement/restlessness. Ping An: "Qi Xiang Tong" is "Qi Ni Ze Xiang Tong" in *Suwen*/*Jiayi*. *Suwen* adds "Ran" after "Dan". *Jiayi* lacks "Dan Dan".) Symptoms worsen on Wu-Ji days, resolve with profuse sweating on Ren-Gui days, and result in death on Wu-Ji days if Qi rebels. Treatment involves needling the Foot Shaoyin and Foot Taiyang meridians. (Ping An: *Suwen* adds "Zhu Han Zhe Zhi Qi Suo Sheng Ri Han Chu Ye" after "Taiyang", repeated, Lin Yi suggests deletion.)
In Liver Heat Disease, the left cheek reddens first; in Heart Heat Disease, the chin/face reddens first; in Spleen Heat Disease, the nose reddens first; in Lung Heat Disease, the right cheek reddens first; in Kidney Heat Disease, the chin/jaw reddens first. Even if the disease has not fully manifested, seeing these colors indicates it is time to needle, called "Treating Before Disease Occurs" (Zhi Wei Bing). (Next discusses color signs of heat disease. Redness in corresponding facial zones indicates Zang heat. Though not fully formed, it is "disease of non-disease," requiring immediate treatment. Ping An: Note "Zheng" is "Wei" in Yuan edition.) Heat diseases starting from specific zones resolve when they reach their overcoming day. ("Zone" refers to facial area. If redness starts at Liver zone, needling following Qi transmission returns it to origin, curing disease. Ping An: *Suwen*/*Jiayi* lack "Qi" before "Qi". Yuan edition adds "Zhong" after "Bu"; note misses "Bu".) If needling opposes the Qi flow, it takes three cycles to cure; if further opposed, death ensues. (Opposing Qi flow delays cure to three cycles. Further opposition leads to death.) For all heat diseases requiring sweating, profuse sweating occurs on the day the disease is overcome. (Overcoming day is the 7th day. E.g., Liver disease resolves on Jia-Yi days. Ping An: "Bing" is "Qi" in *Suwen*.) All treatments for heat disease: drink cold water first, then needle, wear cool clothes, stay in cool places, until body feels cold. (Four cold therapies: internal cold via water, meridian cold via needling, external cold via clothing, environmental cold via location. Internal/external cold stops heat. Ping An: "Yi" is "Yi" in *Suwen*, "Xian" in *Jiayi*. "Ju Han Duo" is "Ju Zhi Han Chu" in *Suwen*/*Jiayi*.)
Heat disease starting with chest/hypochondriac pain and limb restlessness: needle Foot Shaoyang and Hand Taiyin. Severe cases use 59-point needling. (Foot Shaoyang descends neck/chest/flank; Hand Taiyin rises to lung/armpit, hence symptoms. Needle these two. Ping An: *Jiayi* adds "Man" after "Tong". *Suwen*/*Jiayi* write "Bu Zu Taiyin"; Wang Bing says needle Jing-River points. Lin Yi confirms *Taisu* writes "Shou Taiyin", supporting Yang Shangshan's view that Hand Taiyin connects to Lung/armpit, fitting symptoms.)
Heat disease starting with arm pain: needle Hand Yangming and Hand Taiyin to induce sweating. (Hand Yangming runs on lateral arm, Taiyin on medial arm, hence arm pain. Needle these exterior-interior pairs to sweat. Ping An: "Xian" is "Shi" in *Suwen*/*Jiayi*. *Suwen* adds "Zhi" after "Han Chu".)
Heat disease starting at head: needle Neck Taiyang to induce sweating. (Foot Taiyang enters brain from vertex, exits nape, runs down back, hence head heat treated by nape Taiyang Shu points. Ping An: *Jiayi* writes "Xian Qu" for "Ci". *Suwen* adds "Zhi" after "Han Chu". *Jiayi* ordering differs. *Suwen* adds "Heat disease starting at legs..." which Lin Yi says is absent in *Suwen*/*Taisu* but added from *Jiayi*, matching this book.)
Heat disease starting with heavy body, bone pain, deafness, and desire to close eyes: needle Foot Shaoyang. Severe cases use 59-point needling. (Foot Shaoyang starts at outer canthus, connects bones/joints, enters ear, hence symptoms. Needle its Shu points. Some versions say Foot Shaoyin. Ping An: *Suwen*/*Jiayi* write "Zu Shao Yin" for "Zu Shao Yang".)
Heat disease starting with vertigo, stomach heat, and chest/hypochondriac fullness: needle Foot Shaoyin, Foot Shaoyang, and Foot Taiyang meridians. (Foot Taiyang starts at inner canthus, crosses vertex to brain; Foot Shaoyang starts at outer canthus, descends chest/flank; Foot Shaoyin rises from Kidney through Liver/Diaphragm to Lung, hence vertigo, stomach heat, fullness. Needle these three. Ping An: "Wei Re", "Wei" is "Mao" in *Suwen*/*Jiayi*.)
Redness shining on the zygomatic arch indicates Bone Heat Disease. (Redness on zygoma relates to these three meridians originating from bone, indicating Bone Heat. Ping An: Wang Bing notes Taiyang combines with Fire, hence redness. Lin Yi contrasts with Yang Shangshan. If redness is not withered, sweat may temporarily occur; wait for the overcoming day for natural resolution. (If redness is not withered, temporary sweat is possible; resolve naturally at the overcoming day. Ping An: "Yao" is "Jiao", "Ri" is "Yue" in *Suwen*. Wang Bing: "Yue" means ancient method. "Ling" is "Jin" in *Suwen*/*Jiayi*. Lin Yi: *Jiayi*/*Taisu* write "Rong Wei Yao".) If symptoms of Jueyin appear simultaneously, death occurs within three days, as heat Qi internally connects to the Kidney. (Foot Taiyang is Water, Foot Jueyin is Wood. Water generates Wood; Wood prosperity depletes Water. When Water color appears, if Wood color competes, Water dies. Heat connects to Kidney, damaging it, leading to death in three days. Ping An: *Suwen*/*Jiayi* lack "Qi" after "Bing", add "Shao Yang Zhi Mai Se Ye" after "Shen". Wang Bing: "Bing" might be "Qi"; redness near nose is Shaoyang, not Jueyin, as Kidney zone is near nose. Lin Yi: Wang likely meant change Kidney to Nose. *Jiayi*/*Taisu* write Kidney. Yang Shangshan explains Water/Wood relationship. Old texts lack the six characters added by Wang Bing; Wang is wrong, follow Yang Shangshan. This proves Wang Bing's error.)
Shaoyang Meridian: Redness shining on the cheek indicates Sinew Heat Disease. If redness is not withered, temporary sweat is possible; wait for natural resolution. If Shaoyin symptoms appear simultaneously, death ensues. (Foot Shaoyang is Gallbladder Meridian. Zone is cheek; redness indicates Sinew Heat. Sweat at appearance resolves at Wood day. Shaoyang is Wood, Shaoyin is Water. If Shaoyin competes with Shaoyang, Mother overcomes Child, Wood dies. Ping An: "Jin" is "Qian" in *Suwen*. Wang Bing: "Qian" is below zygoma near nose. Lin Yi: *Taisu*/*Jiayi* write "Jin". Yang Shangshan: Cheek zone indicates Sinew Heat. *Suwen* adds "Qi Bu Guo San Ri" after "Si". Wang Bing: Shaoyin arrival means Earth failure attacking Wood. Lin Yi: Wang likely meant change Shaoyin to Jueyin. *Jiayi*/*Taisu* write Shaoyin. Yang Shangshan: Shaoyang Wood, Shaoyin Water, Mother overcomes Child, Wood dies. Wang is wrong. Old texts lack the five characters added by Wang Bing. This proves correction of Wang Bing.)
Third vertebral interspace treats Chest Heat. (*Mingtang* and *Jiu Juan* Back Shu points: 3rd Thoracic = Lung, 5th = Heart, 7th = Diaphragm, 9th = Liver, 11th = Spleen, 14th = Kidney, bilateral. Above 3rd thoracic, no Zang heat treatment exists, so counting starts from 3rd. 3rd thoracic aligns with Jiache point for color observation. 3rd thoracic lower interspace (Lung Shu center) clears heat. Ping An: *Suwen*/*Jiayi* add "Re Bing Qi Xue" before "San Zhui".) Fourth interspace treats Diaphragm Heat; Fifth treats Liver Heat; Sixth treats Spleen Heat; Seventh treats Kidney Heat. (Fourth interspace corresponds to Heart; Heart does not accept evil, hence Diaphragm Heat is mentioned. Sequentially, each lower interspace treats one Zang heat, differing from *Mingtang* general Zang Shu. Ping An: "Ge" is "Ge Zhong" in *Suwen*, "Wei Zhong" in *Jiayi*. *Suwen*/*Jiayi* add "Rong Zai Yi Ye" after Kidney Heat.)
Redness appearing in the depression above the third cervical vertebra indicates Da Liu (large mass) disease opposite the jaw. (Above Lung Shu, 3rd cervical vertebra is in neck, hence "above 3rd cervical", i.e., Dazhui depression. Opposite jaw against vertebra, hence "Ni Zhui". Ni means Ying (meet). Color before vertebra indicates abdominal Da Liu. Ping An: *Suwen*/*Jiayi* lack "Rong Zai". *Jiayi* adds "Gu" before "Xian". *Suwen*/*Jiayi* write "Ni Quan" for "Ni Zhui", "Da Jia" for "Da Shou".)
Color at lower jaw indicates Abdominal Fullness. (Color at lower jaw signifies abdominal fullness.) Color at back of vertebra indicates Hypochondriac Pain. (Sides of Dazhui are "back of vertebra"; color indicates pain. Ping An: "Zhui Hou" is "Quan Hou" in *Suwen*/*Jiayi*.) Upper cheek corresponds to Upper Diaphragm. (No vertebra above cheek for reference; color above cheek indicates upper diaphragm issues.)