平按∶此篇自篇首至伤肺则死，见《素问》卷九第三十三《评热病论》篇。自篇首至饮之汤，
见《甲乙》卷七第一中篇，唯编次前后小异。自黄帝问曰劳风为病至伤肺则死，见《甲乙》卷十
一第七。自偏枯身偏不用
至末，见《灵枢》卷五第二十三《热病》篇。自偏枯身偏不用至浮而取之，见《甲乙》
卷十第二下编。自热病热三日而气口静至末，见《甲乙》卷七第一中篇。
黄帝问于岐伯曰∶有病温者，汗出辄复热而脉躁疾，不为汗衰，狂言不能食，病名
为何？岐伯曰∶病名阴阳交，交者死。（汗者，阴液也。热者，阳盛气也。阳盛则无汗，
汗出则热衰。今出而热不衰者，是阳邪盛而复阴起，两者相交，故名阴阳交也。）黄帝
曰∶愿闻其说。（请说阴阳交争，死之所由。）岐伯曰∶人所以汗出者，皆生于谷，谷
生于精。今邪气交争于骨肉而得汗者，是邪却而精胜也，精胜则当食而不复热。热者，
邪气也。汗者，精气也。今汗出而辄复热者，是邪胜也。（精者，谷之精液，谓之汗也。
伤寒邪气，谓之热也。今邪气与精气交争于骨肉之间，精胜则邪却，邪胜则精消。今虽
汗出而复热者，是邪战胜精，故致死也。平按∶热者邪气也《素问》、《甲乙》作复热
者邪气也。）不能食者精毋，精毋，瘅也，而留者，其尽可立而伤也。（热邪既胜则精
液无，精液无者唯有热也。瘅，热也。其热留而不去者，五脏六腑尽可伤之，能食也。
平按∶精毋精毋瘅也《素问》、《甲乙》作精无裨也。而留者《素问》作病而留者，
《甲乙》作热而留者。新校正云∶“《甲乙》作而热留者。”其尽可立而伤《素问》、
《甲乙》作其寿可立而倾。注尽可伤之能食也句，费解，疑“能食也”上脱“故不”二
字。）是夫《热论》曰∶汗出而脉尚躁盛者死。今脉不与汗相应，此不胜其病也，其死
明矣。（夫汗出则可脉静，今汗出脉犹躁盛，是为邪胜明矣，知定死也。平按∶是夫
《素问》作且夫。《甲乙》无热论曰三字，脉下无尚字。注“知定死也”，袁刻脱此四
字。）狂言者，是失
志，失志者死。（志者，记也，肾之神也。肾间动气，人之生命，动气衰矣，则神志
去之，故死也。）今见三死，不见一生，虽愈必死。（汗出而热不衰，死有三候∶一不
能食，二犹脉躁，三者失志。汗出而热，有此三死之候，未见一生之状，虽瘥必死。
又有三分之死，未见一分之生也。平按∶《甲乙》作此有三死。）黄帝问于岐伯曰∶
有病身热汗出烦满，烦满不为汗解，此为何病？（身热烦满，当为汗解。今不解，故问。
平按∶《甲乙》作病身热汗出而烦满不解者何也。）岐伯曰∶汗出而身热者风也，汗
出而烦满不解者厥也，病名曰风厥。（风热开于腠理为汗，非精气为汗，故身热不解
名为风也。烦心满闷不解，名厥病也。有风有厥，名曰风厥也。）问曰∶愿闻之。答
曰∶巨阳主气，故先受邪，少阴与其为表里也，得热则上从之，从之则厥。（肾间动气，
足太阳所王，足太阳与足少阴表里，故太阳先受邪气，循脉而上于头，得热则足太阳上
者从之受热，即为上热下寒，以为厥逆汗出不解烦满之病也。）问曰∶治之奈何？答
曰∶表里刺之，饮之汤。（可刺阴阳表里之脉，以攻其外，饮之汤液，以疗其内，此为
疗风厥之法也。平按∶《素问》、《甲乙》汤上有胀字。）黄帝曰∶劳风为病何如？
岐伯曰∶劳风法在肺下，其为病也，使人强上冥视晚，唾出若涕，恶风即振寒，此为劳
中之病也。（劳中得风为病，名曰劳中，亦曰劳风。肺下，病居处也。强上，好仰也。冥
视晚，晚，迟也，谓合眼迟视不见也。唾若涕者，唾如脓也。不用见风，见风即便振寒，
此为劳中之病状也。平按∶《素问》、《甲乙》视下无晚字，即振寒作而振寒，劳中
作劳风。《素问》新校正云∶“杨上善云∶冥视，谓合眼视不明也。”与此小异。《千
金》冥视作目眩。）问曰∶治之奈何？答曰∶以救俯仰，（此病多为俯仰，故救之。）
巨阳引精者三日，中
者五日，不精者七日，微出青黄涕，其状如稠脓，大如弹丸，从口中若鼻孔中出，不
出则伤肺，伤肺则死。（以针引巨阳精者三日，俯仰即愈，引阳明精者五日，少阳不
精引之七日，方有青黄浊涕，从口鼻中出，其病得愈。若不出者，上伤于肺，不免死也。
平按∶《素问》、《甲乙》中者作中年者。《素问》新校正云∶“《甲乙》作中若五日。”
今本《甲乙》仍作中年者五日。《千金》作“候之三日及五日中不精明者，是其症也。”
与此不同。又微出《素问》、《甲乙》作咳出，如下无稠字。《素问》鼻下无孔字。
《甲乙》孔作空。）
偏枯，身偏不用而痛，言不变，知不乱，病在分腠之间，巨针取之，益其不足，
损其有余，乃可复也。（偏枯病有五别∶有偏一箱不收，一也；有偏不痛，此不用并痛，
二也；其言不异于常，三也；神智不乱，四也；病在分肉间，五也。具此五者，名曰
偏枯病也。平按∶《灵枢》知不乱作志不乱，《甲乙》作智不乱。）痱为病也，身无痛
者，四肢不收，知乱不甚，其言微知，可治，甚则不能言，不可治也。（痱，扶非反，
风病也。痱风之状，凡有四别∶身无痛处，一也；四肢不收，二也；神智错乱，三也；
不能言，四也。具此四者，病甚不可疗也。身虽无痛，四肢不收，然神不乱，又少能言，
此可疗也。俗称此病种种名字，皆是近代医人相承立名，非古典也。平按∶注此病，袁
刻病误作痛。）病先起于阳，后入于阴者，先取其阳，后取其阴，浮而取之。（疗法先
取其本，后取其标，不可深取也。平按∶病下袁刻脱先字。浮而取之《甲乙》作必审
其气之浮沉而取之。）热病三日，而气口静、人迎躁者，取之诸阳，五十九刺，以泻
其热而出其汗，实其阴以补其不足者。（三阳受病未入于阴至三日也。未入于阴，故气
口静也。三阳已病，故人迎躁也。人迎，谓是足阳明脉结喉左右人
迎脉者也。以诸阳受病，故取诸阳五十九刺泻其热气。以阳并阴虚，故补阴也。平按∶
实其阴，实字原抄缺下半，袁刻作泻，恐误，《灵枢》、《甲乙》作实，本注云故补
阴也，亦宜作实。）身热甚，阴阳皆静者，勿刺也；其可刺者急取之，不汗则泄。所
谓勿刺者，有死征也。（阴阳之脉皆静，谓为阴阳交争，是其死征，故不可刺也。非
阴阳争，宜急取之，若不泄汗，即泄利也。平按∶汗下《灵枢》有出字。）热病七八日，
脉口动喘而眩者，急刺之，汗且自出，浅刺手指间。（七日太阳病衰，八日阳明病衰，
二阳病衰，气口之脉则可渐和，而脉喘动头眩者，热犹未去。汗若出急，刺手小指外
侧前谷之穴，浅而取之；汗不出，可深刺之。平按∶《灵枢》、《甲乙》作手大指间，
与杨注异。）热病七八日，脉微小，病者溲血，口中干，一日半而死，（热病至七八日，
二阳病衰，其脉则可渐和，而微小者，即热甚，所以溲血口干一日半死。脉小者，内热
消瘅之候也。平按∶注而微小者，袁刻而作脉。）脉代者，一日死。（热病七八日脉
代者，内气绝候，故一日死。）热病已得汗，而脉尚躁喘，且复热，勿庸刺，喘甚者死。
（热病已得汗，其脉当调，犹尚躁喘，且复身热，此阴阳交，不可刺也，刺之者危。喘
甚热盛者死，不须刺也。平按∶《灵枢》汗下有出字，勿庸刺作勿刺肤。）热病七八日，
脉不躁，躁不数，数后三日中有汗，三日不汗，四日死，未曾刺者，勿庸刺之。（热
病七八日，二阳病衰，故脉不躁，虽躁不数者，至后三日，合十二日，三阴三阳热衰，
故汗出愈也。若从九日至十二日汗不出者，十三日死，计后三日者三日后也。又曰∶
十二日厥阴衰日，即便汗出。如其不出，至十三日为后三日，从九日后以为四日也。虽
未刺之，不须刺也。庸有本为肤。平按∶《甲乙》躁字不重。《灵枢》、《甲乙》上数
字作散。未曾刺者，《灵枢》刺作汗，《甲乙》作未汗二
字。庸《灵枢》作腠。）热病，先身涩，倚烦 ，干唇嗌，取之以第一针，五十九刺，
肤胀口干寒汗。（身热甚，皮肤粗涩也。倾倚不安烦闷，唇咽干内热，肺热病状也。
第一针， 针也，应肺，针头大末锐，令无得深入，以泻阳气，故用之五十九刺，以
泻诸阳之气，及皮肤胀口干，令汗出也。平按∶倚烦 干唇嗌《灵枢》作欹而热烦
干唇口嗌，《甲乙》作烦而热烦闷唇嗌干。《灵枢》、《甲乙》取之下有皮字，九下无
刺字。肤胀上《甲乙》有热病二字。汗下《灵枢》、《甲乙》有“出，索脉于心，不
得索之水，水者肾也”十四字。注锐字袁刻作细。）热病，嗌干多饮，善惊，卧不能
定，取之肤肉，以第六针，五十九，索肉于脾，不得索之木，木，肝也。（热病，嗌
干多饮，喜惊，卧不得安，肉病者，可以第六员利针。员利针应脾，故用取之肤肉五十
有九，于脾输穴以求其肉，不得求于肝输穴也。以肝为木，克土故名也。平按∶《灵枢》
作卧不能起，《甲乙》作卧不能安。九下《灵枢》有目 青三字，《甲乙》有刺目
赤四字。）热病而胸胁痛，手足躁，取之筋间，以第四针，于四逆筋辟目浸，索筋于
肝，不得索之金，金，肺也。（热病胸胁痛，手足动，筋之病，可以第四针。应肝，故
于筋间针于四逆筋辟目浸。求肝输穴，不得于肺输穴以求筋也，以其肺金克木肝也。索，
求也。辟，筋挛也。目浸，目 泪出也。平按∶而胸胁痛《灵枢》作面青胸痛。四针下
《甲乙》重针字，筋辟作筋 。）热病先肤痛窒鼻充面，取之皮，以第一针，五十九，
（窒鼻，鼻塞也。充面，面皮起也。肤痛鼻塞面皮起，皆是肺合皮毛热病者也。第一 针，大其
头，锐其末，令无得深入，但去皮中之病，故五十九取之皮也。平按∶先肤痛，先字袁
刻误作充。）苛轸鼻，索皮于肺，不得索之火，火者，心也。（苛，贺多反，鼻病，有
本作苟。热病殃苛轸在于鼻，鼻主于肺，故此皮毛病求于肺输，不得求之心输，以其心
火克肺金也。平按∶轸鼻《甲乙》作鼻干。自上文热病先肤痛至此段心也，《灵枢》、
《甲乙》在热病先身涩之上。）热病数惊，螈 而狂，取之脉，以第四针，急泻有余
者，癫疾毛髦去，（惊螈 狂，此为血病，故取之脉。第四针者，锋针也，刃参隅，
应心，可以泻热出血，痼癫疾及毛髦落，皆得愈也。平按∶螈《甲乙》作 。髦《灵枢》、
《甲乙》作发。）索血于心，不得索之水，水，肾也。（血脉索于心输，不得索之肾
输者，水克火也。）热病身重骨痛，耳聋而好瞑，取之骨，以第四针，五十九，骨病
食啮齿耳青，索骨于肾，不得索之土，土，脾也。一云脊强。（身重骨痛，耳聋好瞑，
皆肾之合骨热病，故取骨第四针，锋针也，长一寸六分，锋其末，主泻热出血，故用五
十九刺，并疗食啮齿耳青等骨痛。求之肾输穴，不得求脾之输穴，以土克水也。平按∶
《灵枢》、《甲乙》九下有刺字，食上有不字。青下《甲乙》有赤字。一云脊强四字
《灵枢》、《甲乙》无。）热病不知所痛，不能自收，口干，阳热甚，阴颇有寒者，
热在髓，死不治。（阳热病者，其阳脉热甚，阴脉颇寒也。此人热在髓中，必死不疗。
平按∶所痛《甲乙》作所病，下有耳聋二字，《灵枢》同。）热病头痛，颞 、目 脉，
善衄，厥热也，取以第三针，视有余不足，寒热痔。（热病头痛，颞 及目边脉 ，
善衄，此为厥热者也。第三针， 针也，状如黍粟之锐，长二寸半，主按脉取气，令邪气独出，故并用疗厥热寒热
痔病。平按∶目 脉《灵枢》作目HT 脉痛，《甲乙》作目脉紧。厥热下《灵枢》、《甲
乙》有病字。）热病体重肠中热，取之以第四针，于其输及下诸指间，索气于胃络得气。
（体重肠中热，胃热病也。第四针，锋针也。此胃热病，以锋针取胃输及手足指间八
处胃络，以得气为限也。平按∶输《灵枢》作 ，《甲乙》作俞。）热病挟脐痛急，胁
胸满，取之涌泉与阴陵泉，以第四针，针嗌。（挟脐痛，脾经热病也。胸胁满，肾经热
病也。可以锋针取此二穴也。平按∶《灵枢》、《甲乙》痛急胁胸满作急痛胸胁满，嗌
下有里字。）热病汗且出，及脉顺可汗者，取之鱼际、太泉、大都、太白，泻之则热
去，补之则汗出，汗出太甚，取踝上横脉以止之。（热病汗出及脉顺不逆可令汗者，
取鱼际在手大指本节后内侧，太泉在掌后陷者中，大都在足大趾本节后陷中，太白在足
内侧核骨下陷中，此之四穴并是手足太阴疗热之穴，故皆泻去其热，还于此穴补取。其
汗出太甚，取踝上横脉，量是足太阴于踝上见者，可取之以止其汗也。平按∶《灵枢》、
【平按】：本篇从篇首到“伤肺则死”，见于《素问》卷九第三十三《评热病论》篇。从篇首到“饮之汤”，见于《甲乙经》卷七第一中篇，只是编排顺序略有不同。从黄帝问“劳风为病”到“伤肺则死”，见于《甲乙经》卷十一第七。从“偏枯身偏不用”到末尾，见于《灵枢》卷五第二十三《热病》篇。从“偏枯身偏不用”到“浮而取之”，见于《甲乙经》卷十第二下编。从“热病热三日而气口静”到末尾，见于《甲乙经》卷七第一中篇。
黄帝问岐伯说：有一种温病，患者出汗后随即又发热，脉搏躁动疾速，不因出汗而减弱，胡言乱语且不能进食，这叫什么病？岐伯回答说：这种病名叫阴阳交，所谓交，就是死证。（汗是阴液。热是阳盛之气。阳盛应当无汗，出汗则热势衰退。现在出汗而热势不衰退，这是阳邪盛复而阴气起，两者相交，所以叫阴阳交。）黄帝说：我想听听其中的道理。（请说说阴阳交争致死的原因。）岐伯说：人之所以出汗，都是源于水谷精微，水谷精微化生为精气。现在邪气在骨肉之间与正气交争而能出汗的，是邪气退却而精气胜利，精气胜利就应当能进食而不复发热。发热，是邪气；出汗，是精气。现在出汗后随即又发热的，是邪气胜利了。（精气，是水谷的精液，称为汗。伤寒邪气，称为热。现在邪气与精气在骨肉之间交争，精气胜则邪气退，邪气胜则精气消。现在虽然出汗却又发热，是邪气战胜了精气，所以导致死亡。平按：原文“热者邪气也”，《素问》、《甲乙经》作“复热者邪气也”。）不能进食是因为精气匮乏，精气匮乏就是瘅热（高热），如果热邪停留不去，五脏六腑都会受到损伤，生命也就危在旦夕了。（热邪既然胜利，精气就会枯竭，精气枯竭就只有热邪存在。瘅，就是热。如果热邪停留不去，五脏六腑都可以被伤害，这里指病情危重。平按：原文“精毋精毋瘅也”，《素问》、《甲乙经》作“精无裨也”。而留者，《素问》作“病而留者”，《甲乙经》作“热而留者”。新校正说：“《甲乙经》作‘而热留者’。”其尽可立而伤，《素问》、《甲乙经》作“其寿可立而倾”。注解说“尽可伤之能食也”句费解，怀疑“能食也”上面脱漏了“故不”二字。）正如《热论》所说：出汗后脉搏仍然躁动旺盛的会死亡。现在脉搏与出汗不相适应，这是不胜任疾病的表现，死亡是显而易见的。（既然出汗，脉搏应该平静，现在出汗后脉搏依然躁动旺盛，这是邪气胜利的明证，知道必定死亡。平按：原文“是夫”，《素问》作“且夫”。《甲乙经》没有“热论曰”三字，脉字下没有“尚”字。注文中“知定死也”四字，袁刻本脱漏。）胡言乱语，是神志丧失，神志丧失就会死亡。（志，是记忆，是肾的神气。肾间动气，是人的生命根本，动气衰弱，神志就会离去，所以死亡。）现在见到三种死征，没见到一种生机，即使暂时好转也必死无疑。（出汗而热不退，有三种死候：一是不能进食，二是脉搏依然躁动，三是神志丧失。出汗发热，具备这三种死候，没见到一种生的迹象，即使病愈也必死。又有三分之死，未见一分之生。平按：《甲乙经》作“此有三死”。）
黄帝问岐伯说：有一种病，身体发热，出汗，心烦胀满，出汗后烦满不解，这是什么病？（身体发热烦满，应当通过出汗来解除。现在不解，所以询问。平按：《甲乙经》作“病身热汗出而烦满不解者何也”。）岐伯说：出汗而身体发热的，是风邪；出汗而心烦胀满不解的，是厥逆，病名叫风厥。（风热打开腠理导致出汗，这不是精气导致的出汗，所以身体发热不解叫做风。心烦闷胀满不解，叫做厥病。既有风又有厥，名叫风厥。）问：我想听听其中的道理。答：足太阳膀胱经主一身之气，所以先受邪气，足少阴肾经与它互为表里，受热则向上顺从，顺从则发生厥逆。（肾间动气，由足太阳所主，足太阳与足少阴互为表里，所以太阳先受邪气，循经脉上行至头部，受热则足太阳上行的部分顺从受热，这就造成上热下寒，形成厥逆、出汗不解、烦满的病状。）问：怎么治疗？答：针刺表里两经，服用汤药。（可以针刺阴阳表里的经脉，以攻逐外邪，服用汤液，以调理内脏，这是治疗风厥的方法。平按：《素问》、《甲乙经》汤字上有“胀”字。）
黄帝说：劳风病怎么样？岐伯说：劳风病通常在肺下，它的病症，使人颈项强直、视物昏暗迟缓，咳吐像鼻涕一样的痰，怕风并伴有振颤恶寒，这就是劳中的病状。（劳倦中风邪致病，名叫劳中，也叫劳风。肺下，是病变部位。强上，喜欢仰头。冥视晚，晚，迟缓，指闭眼困难、视物不清。唾如涕，指痰像脓一样。不见风则已，见风就立即振颤恶寒，这是劳中的病状。平按：《素问》、《甲乙经》视字下无“晚”字，“即振寒”作“而振寒”，“劳中”作“劳风”。《素问》新校正说：“杨上善说：冥视，指闭眼视物不明。”与此略有不同。《千金方》将“冥视”作“目眩”。）问：怎么治疗？答：救治俯仰困难的症状。（此病多表现为俯仰不便，所以要救治它。）精气充足的人三天，中等的人五天，精气不足的人七天，排出青黄色的鼻涕，形状像浓稠的脓，大小如弹丸，从口中或鼻孔中排出，如果不排出就会损伤肺，损伤肺就会死亡。（用针引导足太阳经精气的人，三天就好；引导阳明经精气的人，五天好；少阳经精气不足不引导的人，七天，才有青黄浊涕，从口鼻中排出，病才能痊愈。如果不排出，上伤于肺，不免死亡。平按：《素问》、《甲乙经》“中者”作“中年者”。《素问》新校正说：“《甲乙经》作‘中若五日’。”今本《甲乙经》仍作“中年者五日”。《千金方》作“候之三日及五日中不精明者，是其症也。”与此不同。另外“微出”，《素问》、《甲乙经》作“咳出”，如下文无“稠”字。《素问》鼻字下无“孔”字。《甲乙经》“孔”作“空”。）
偏枯，身体一侧不能活动且疼痛，说话正常，神智不乱，病在分肉腠理之间，用巨针取治，补益不足的，损害有余的，才可以恢复。（偏枯病有五种区别：有一侧肌肉萎缩不收缩的，这是一类；有偏瘫但不痛的，这是不用力并疼痛，这是二类；言语与常人无异，这是三类；神智不乱，这是四类；病在分肉之间，这是五类。具备这五种情况，名叫偏枯病。平按：《灵枢》“知不乱”作“志不乱”，《甲乙经》作“智不乱”。）痱病，身体没有疼痛，四肢不能收持，神智稍微混乱，言语还能让人听懂，可以治疗；如果严重到不能说话，就无法治疗了。（痱，音扶非反，是风病。痱风的症状，凡有四类区别：身体无痛处，是一类；四肢不能收持，是二类；神智错乱，是三类；不能说话，是四类。具备这四类，病重不可疗治。身体虽无痛，四肢不能收持，然而神智不乱，又能勉强说话，这是可以治疗的。俗称此病种种名字，都是近代医生相传立名，不是古典医籍中的名称。平按：注文中“此病”，袁刻本“病”误作“痛”。）
病先从阳分起，后传入阴分的，先取阳分穴位，后取阴分穴位，浅刺。（疗法先取本，后取标，不可深刺。平按：病字下袁刻本脱漏“先”字。“浮而取之”，《甲乙经》作“必审其气之浮沉而取之”。）
热病三天，气口脉安静、人迎脉躁动的，取诸阳经穴位，用五十九刺法，以泻热出汗，充实阴分以补其不足。（三阳经受病未入于阴，到了第三天。未入于阴，所以气口脉安静。三阳已病，所以人迎脉躁动。人迎，是指足阳明脉结喉左右的人迎脉。因为诸阳受病，所以取诸阳经的五十九刺法泻其热气。因为阳盛并阴虚，所以补阴。平按：“实其阴”，实字原抄本缺下半，袁刻本作“泻”，恐怕错误，《灵枢》、《甲乙经》作“实”，本注说“故补阴也”，也应该作“实”。）
身体发热很厉害，阴阳脉都安静的，不要针刺；可以针刺的，要急取穴位，不出汗就要泄利。所谓不要针刺的，是有死征。（阴阳之脉都安静，说明阴阳交争，这是死征，所以不可针刺。如果不是阴阳争，宜急取穴位，如果不泄汗，就是泄利。平按：汗字下，《灵枢》有“出”字。）
热病七八天，脉口动喘且头晕的，急刺穴位，汗将会自然流出，浅刺手指间。（第七天太阳病衰，第八天阳明病衰，二阳病衰，气口之脉则可逐渐平和，如果脉喘动头眩，说明热邪还未去除。如果汗若出急，刺手小指外侧前谷穴，浅而取之；如果汗不出，可深刺。平按：《灵枢》、《甲乙经》作“手大指间”，与杨注不同。）
热病七八天，脉搏微小，病人尿血，口中干燥，一天半后死亡，（热病到七八天，二阳病衰，其脉则可逐渐平和，如果脉搏微小，就是热甚，所以尿血口干，一天半后死亡。脉小，是内热消烁精气的征象。平按：注文中“而微小者”，袁刻本“而”作“脉”。）脉搏代乱的，一天后死亡。（热病七八天脉搏代乱的，是内气绝灭的征候，所以一天后死亡。）
热病已经出汗，但脉搏仍然躁动气喘，并且又发热，不要庸俗地针刺，气喘严重的会死亡。（热病已经出汗，其脉应当调和，如果仍然躁动气喘，并且又身热，这是阴阳交，不可针刺，针刺者危险。气喘甚热盛者死亡，不需要针刺。平按：《灵枢》汗字下有“出”字，“勿庸刺”作“勿刺肤”。）
热病七八天，脉搏不躁动，躁动但不数急，数急之后三天中有汗，三天无汗，第四天死亡，未曾针刺的，不要庸俗地针刺。（热病七八天，二阳病衰，所以脉搏不躁动，虽然躁动但不数急，到了后三天，合十二日，三阴三阳热衰，所以出汗痊愈。如果从九日到十二日不出汗，十三日死亡，计算后三天就是三日后。又说：十二日是厥阴衰日，即便出汗。如果不出，到十三日为后三日，从九日后算作四天。虽然未刺，不需要刺。庸有本为肤。平按：《甲乙经》“躁”字不重复。《灵枢》、《甲乙经》上“数”字作“散”。未曾刺者，《灵枢》“刺”作“汗”，《甲乙经》作“未汗”二字。庸，《灵枢》作“腠”。）
热病，先身体涩滞，倚靠不安，烦躁，嘴唇干，咽喉燥，用第一针，五十九刺，皮肤胀，口干，出冷汗。（身体热甚，皮肤粗涩。倾倚不安烦闷，唇咽干内热，是肺热病的症状。第一针，镵针，应肺，针头大末端锐，令不得深入，以泻阳气，所以用五十九刺，以泻诸阳之气，以及皮肤胀口干，令汗出。平按：“倚烦 干唇嗌”，《灵枢》作“欹而热烦干唇口嗌”，《甲乙经》作“烦而热烦闷唇嗌干”。《灵枢》、《甲乙经》取字下有“皮”字，九字下无“刺”字。肤胀上，《甲乙经》有“热病”二字。汗字下，《灵枢》、《甲乙经》有“出，索脉于心，不得索之水，水者肾也”十四字。注文中“锐”字，袁刻本作“细”。）
热病，咽喉干，多饮，容易惊恐，卧不安定，取治肌肤，用第六针，五十九刺，求气于脾，不得求于肝，肝属木。（热病，咽喉干多饮，喜惊，卧不安，肉病者，可以用第六针员利针。员利针应脾，所以用取治肌肤五十九刺，于脾输穴以求其肉，不得求于肝输穴。因为肝为木，克土，所以 named 如此。平按：《灵枢》作“卧不能起”，《甲乙经》作“卧不能安”。九字下，《灵枢》有“目 青”三字，《甲乙经》有“刺目赤”四字。）
热病且胸胁痛，手足躁动，取治筋间，用第四针，于四逆筋辟目浸，求气于肝，不得求于肺，肺属金。（热病胸胁痛，手足动，是筋的病，可以用第四针。应肝，所以在筋间针于四逆筋辟目浸。求肝输穴，不得于肺输穴以求筋，因为肺金克木肝。索，求也。辟，筋挛也。目浸，目泪出也。平按：“而胸胁痛”，《灵枢》作“面青胸痛”。四针下，《甲乙经》重“针”字，“筋辟”作“筋 ”。）
热病先皮肤痛，鼻塞，面部浮肿，取治皮部，用第一针，五十九刺，（鼻塞，鼻子堵塞。充面，面部皮肤隆起。肤痛鼻塞面皮起，都是肺合皮毛的热病。第一针，头大末锐，令不得深入，只去皮中之病，所以五十九取之皮。平按：“先肤痛”，先字袁刻本误作“充”。）鼻生疮疹，求气于肺，不得求于心，心属火。（苛，贺多反，鼻病，有本作苟。热病殃苛轸在于鼻，鼻主于肺，所以此皮毛病求于肺输，不得求之心输，因为心火克肺金。平按：“轸鼻”，《甲乙经》作“鼻干”。自上文“热病先肤痛”至此段“心也”，《灵枢》、《甲乙经》在“热病先身涩”之上。）
热病多次惊恐，抽搐且狂乱，取治血脉，用第四针，急泻有余者，癫疾毛发脱落，（惊抽搐狂，这是血病，所以取治血脉。第四针，是锋针，刃参隅，应心，可以泻热出血，痼癫疾及毛发落，都能痊愈。平按：“螈”，《甲乙经》作“ ”。“髦”，《灵枢》、《甲乙经》作“发”。）求气于心，不得求于肾，肾属水。（血脉求于心输，不得求之肾输，因为水克火。）
热病身体沉重骨痛，耳聋且喜欢闭目，取治骨部，用第四针，五十九刺，骨病咬齿耳青，求气于肾，不得求于脾，脾属土。一说脊强。（身体沉重骨痛，耳聋好瞑，都是肾合骨的热病，所以取骨第四针，锋针，长一寸六分，锋其末，主泻热出血，所以用五十九刺，并疗咬齿耳青等骨痛。求之肾输穴，不得求脾之输穴，因为土克水。平按：《灵枢》、《甲乙经》九字下有“刺”字，食字上有“不”字。青字下，《甲乙经》有“赤”字。“一云脊强”四字，《灵枢》、《甲乙经》无。）
热病不知疼痛，不能自我约束控制，口干，阳热甚，阴颇有寒，热在髓，死亡无法治疗。（阳热病者，其阳脉热甚，阴脉颇寒。此人热在髓中，必死不疗。平按：“所痛”，《甲乙经》作“所病”，下有“耳聋”二字，《灵枢》同。）
热病头痛，颞颥痛，目眶脉痛，容易流鼻血，这是厥热，用第三针，视有余不足，治疗寒热痔。（热病头痛，颞颥及目边脉络痛，容易流鼻血，这是厥热病。第三针，是鍉针，状如黍粟之锐，长二寸半，主按脉取气，令邪气独出，所以并用治疗厥热寒热痔病。平按：“目 脉”，《灵枢》作“目HT 脉痛”，《甲乙经》作“目脉紧”。厥热下，《灵枢》、《甲乙经》有“病”字。）
热病身体沉重肠中热，用第四针，取其输穴及下肢各指间，求气于胃络得气。（身体沉重肠中热，是胃热病。第四针，是锋针。此胃热病，以锋针取胃输及手足指间八处胃络，以得气为限。平按：“输”，《灵枢》作“ ”，《甲乙经》作“俞”。）
热病挟脐痛急，胁胸满，取涌泉与阴陵泉，用第四针，针治咽喉。（挟脐痛，是脾经热病。胸胁满，是肾经热病。可以用锋针取此二穴。平按：《灵枢》、《甲乙经》“痛急胁胸满”作“急痛胸胁满”，嗌字下有“里”字。）
热病汗将要出来，以及脉顺可汗的，取鱼际、太泉、大都、太白，泻之则热去，补之则汗出，汗出太多，取踝上横脉以止之。（热病汗出及脉顺不逆可令汗者，取鱼际在手大指本节后内侧，太泉在掌后陷者中，大都在足大趾本节后陷中，太白在足内侧核骨下陷中，此四穴并是手足太阴疗热之穴，所以皆泻去其热，还于此穴补取。其汗出太甚，取踝上横脉，量是足太阴于踝上见者，可取之以止其汗也。平按：《灵枢》、）
[Ping An]: This section from the beginning of the chapter to "injury to the lung leads to death" is found in *Suwen* (Basic Questions), Volume 9, Chapter 33, "Commentary on Heat Disease". From the beginning to "drink the decoction", it is found in *Jiayi Jing* (Systematic Classic of Acupuncture and Moxibustion), Volume 7, Part 1, Middle, with only slight differences in arrangement. From Huangdi's question "What is the disease of labor wind?" to "injury to the lung leads to death", it is found in *Jiayi Jing*, Volume 11, Chapter 7. From "hemiplegia, one side of the body unusable" to the end, it is found in *Lingshu* (Spiritual Pivot), Volume 5, Chapter 23, "Heat Disease". From "hemiplegia, one side of the body unusable" to "superficially extract them", it is found in *Jiayi Jing*, Volume 10, Part 2, Lower. From "heat disease, three days later, Qi Kou pulse is quiet" to the end, it is found in *Jiayi Jing*, Volume 7, Part 1, Middle.
Huangdi asked Qibo: There is a person suffering from a warm disease (Wen Bing). After sweating, the fever returns immediately, the pulse is rapid and restless, and does not subside with sweating. The patient speaks deliriously and cannot eat. What is this disease called? Qibo replied: This disease is called Yin-Jiao (Yin-Yang Intersection). "Jiao" implies death. (Sweat is Yin fluid. Fever is excessive Yang Qi. When Yang is excessive, there should be no sweat; when sweat occurs, heat should subside. Now, sweat occurs but heat does not subside; this means Yang pathogen is excessive while Yin rises, and the two intersect, hence the name Yin-Jiao.) Huangdi said: I wish to hear the explanation. (Please explain the struggle between Yin and Yang and the reason for death.) Qibo said: Humans produce sweat because of grain (food), and grain produces essence (Jing). Now, if pathogens contend with healthy Qi in the muscles and bones, and sweat results, it means the pathogen is retreating and the essence is victorious. If the essence is victorious, the patient should be able to eat and not have recurrent fever. Fever represents the pathogen; sweat represents the essence. Now, sweating is followed immediately by recurrent fever, which indicates the pathogen has won. (Essence refers to the refined fluids of food, which become sweat. Cold damage pathogens are referred to as heat. Now, when pathogens and essence contend in the muscles and bones, if essence wins, the pathogen retreats; if the pathogen wins, essence diminishes. Although sweat occurs and then fever returns, it is because the pathogen has defeated the essence, leading to death. Ping An: The text "Fever is the pathogen" appears as "Recurrent fever is the pathogen" in *Suwen* and *Jiayi Jing*.) Inability to eat means essence is depleted. Essence depletion is termed "Dan" (intense heat). If this heat remains and does not dissipate, the five Zang and six Fu organs will all be injured, and life will be imperiled. (Since the heat pathogen has won, essence fluids are exhausted. With exhausted essence fluids, only heat remains. "Dan" means heat. If this heat lingers and does not leave, the five Zang and six Fu organs can all be damaged, implying imminent danger. Ping An: The text "Jing wu jing wu dan ye" appears as "Jing wu bi ye" in *Suwen* and *Jiayi Jing*. "Er liu zhe" appears as "Bing er liu zhe" in *Suwen* and "Re er liu zhe" in *Jiayi Jing*. New Correction states: "*Jiayi Jing* reads 'er re liu zhe'." "Qi jin ke li shang" appears as "Qi shou ke li qing" in *Suwen* and *Jiayi Jing*. The note explaining "jin ke shang zhi neng shi ye" is confusing; it is suspected that the characters "gu bu" were omitted before "neng shi ye".) As stated in the *Re Lun* (Treatise on Heat): "If the pulse remains rapid and vigorous after sweating, death ensues." Now, the pulse does not correspond with the sweating, indicating the body cannot overcome the disease; death is evident. (Since sweating occurs, the pulse should calm down. Now, despite sweating, the pulse remains rapid and vigorous, clearly indicating pathogen victory, confirming certain death. Ping An: "Shi fu" appears as "Qie fu" in *Suwen*. *Jiayi Jing* lacks the three characters "Re lun yue". There is no "shang" character after "mai". The four characters "zhi ding si ye" in the note are missing in Yuan Ke edition.) Delirious speech indicates loss of Zhi (will/mind). Loss of Zhi leads to death. (Zhi refers to memory and is the spirit of the Kidney. The Moving Qi in the Kidney region is the root of human life. If this Moving Qi declines, the spirit and mind depart, leading to death.) Now, seeing three signs of death and no sign of life, even if there is temporary improvement, death is inevitable. (Sweating with persistent heat presents three signs of death: one, inability to eat; two, persistent rapid pulse; three, loss of mind. Having these three signs of death without any sign of life, even if the illness seems to remit, death is certain. There is three parts death and no one part life. Ping An: *Jiayi Jing* reads "ci you san si".)
Huangdi asked Qibo: There is a disease characterized by body heat, sweating, and vexation/fullness, where sweating does not relieve the vexation/fullness. What is this disease? (Body heat and vexation/fullness should resolve with sweating. Since it does not, the question is asked. Ping An: *Jiayi Jing* reads "bing shen re han chu er fan man bu jie zhe he ye".) Qibo said: Sweating accompanied by body heat is due to Wind. Sweating accompanied by unresolved vexation/fullness is due to Jue (reversal). The disease is named Feng-Jue (Wind-Jue). (Wind-heat opens the Couli (pores) causing sweat; this is not sweat from essence/Qi, so persistent body heat is named Wind. Vexation and fullness not resolving is named Jue disease. Having both Wind and Jue, it is named Feng-Jue.) Asked: I wish to hear the explanation. Answered: Taiyang (Greater Yang) governs the Qi of the body and thus receives the pathogen first. Shaoyin (Lesser Yin) is its interior-exterior pair. When heated, Shaoyin follows Taiyang upward. Following upward leads to Jue. (The Moving Qi in the Kidney region is governed by Foot-Taiyang. Foot-Taiyang and Foot-Shaoyin are interior-exterior pairs. Thus, Taiyang receives the pathogen first, ascending along the meridian to the head. Upon receiving heat, the ascending part of Foot-Taiyang follows the heat, resulting in upper heat and lower cold, manifesting as Jue reversal, sweating, unresolved vexation, and fullness.) Asked: How to treat it? Answered: Needle the exterior and interior meridians, and administer decoctions. (One may needle the meridians of Yin-Yang and exterior-interior to attack the exterior, and administer liquid medicines to treat the interior. This is the method for treating Feng-Jue. Ping An: *Suwen* and *Jiayi Jing* have the character "zhang" before "tang".)
Huangdi said: What about the disease of Lao-Feng (Labor Wind)? Qibo said: Lao-Feng typically resides below the Lung. Its symptoms include stiffness and extension of the neck, dim and delayed vision, expectoration of thick phlegm resembling mucus, aversion to wind with chills and tremors. This is a disease of Lao-Zhong (Labor Injury). (Contracting wind due to labor injury is named Lao-Zhong, also Lao-Feng. "Below the Lung" refers to the location of the pathology. "Qiang Shang" means tendency to extend the neck backward. "Ming Shi Wan" means delayed closing of eyes and blurred vision. "Tuo ruo ti" means sputum like pus. Exposure to wind causes immediate chills and tremors; these are the manifestations of Lao-Zhong. Ping An: *Suwen* and *Jiayi Jing* omit "wan" after "shi"; "ji zhen han" reads "er zhen han"; "lao zhong" reads "lao feng". New Correction in *Suwen* says: "Yang Shangshan states: Ming Shi means unclear vision with closed eyes." This differs slightly. *Qian Jin* reads "mu xuan" for "ming shi".) Asked: How to treat it? Answered: Rescue the difficulty in bending and extending. (This disease often manifests as difficulty in bending and extending, so rescue this symptom.) For those with abundant Jing (Essence), recovery takes three days; for average individuals, five days; for those with deficient Jing, seven days. Clear, yellow-green nasal discharge, resembling thick pus and sized like a pill, should be expelled from the mouth or nose. If not expelled, the Lung will be injured, and injury to the Lung leads to death. (Needling to guide the Jing of Taiyang leads to recovery in three days; guiding the Jing of Yangming leads to recovery in five days; for Shaoyang with insufficient Jing, guiding takes seven days, after which clear-yellow turbid nasal discharge appears from the mouth and nose, and the disease resolves. If not expelled, it injures the Lung upwards, inevitably leading to death. Ping An: *Suwen* and *Jiayi Jing* read "zhong zhe" as "zhong nian zhe". New Correction in *Suwen* says: "*Jiayi Jing* reads 'zhong ruo wu ri'." Current *Jiayi Jing* still reads "zhong nian zhe wu ri". *Qian Jin* reads "hou zhi san ri ji wu ri zhong bu jing ming zhe, shi qi zheng ye," which differs. Also, "wei chu" appears as "ke chu" in *Suwen* and *Jiayi Jing*, lacking "chou" below. *Suwen* lacks "kong" after "bi". *Jiayi Jing* reads "kong" as "kong".)
Pian Ku (Hemiplegia): One side of the body is unusable and painful, speech is unchanged, and consciousness is not confused. The disease is located between the Fen-Rou (muscle intervals). Use a large needle to treat, tonify deficiency, and reduce excess, then recovery is possible. (There are five distinctions of Pian Ku: one, hemiplegia with muscle atrophy/retraction; two, hemiplegia without pain (this case involves both non-use and pain); three, speech is normal; four, consciousness is not confused; five, disease is in the muscle intervals. Possessing these five characteristics defines Pian Ku. Ping An: *Lingshu* reads "zhi bu luan" for "zhi bu luan"; *Jiayi Jing* reads "zhi bu luan".) Fei Disease: Body has no pain, limbs cannot be controlled, consciousness is slightly confused, speech is faint but understandable; this is treatable. If severe, unable to speak, it is untreatable. (Fei, pronounced Fu-Fei, is a wind disease. Four characteristics of Fei Wind: one, no body pain; two, limbs cannot be controlled; three, mental confusion; four, inability to speak. Possessing all four indicates severe, untreatable disease. Although no pain and limbs uncontrolled, if consciousness is clear and speech is partially intact, it is treatable. Common names for this disease today were established by modern physicians and are not from classical texts. Ping An: Note "ci bing", Yuan Ke edition mistakenly prints "tong" for "bing".)
Diseases starting in Yang and entering Yin: First treat Yang, then treat Yin, using superficial needling. (Treatment first addresses the root, then the branch; deep needling is not appropriate. Ping An: Yuan Ke edition omits "xian" after "bing". "Fu er qu zhi" appears as "bi shen qi zhi fu chen er qu zhi" in *Jiayi Jing*.)
Heat disease for three days, with Qi Kou pulse quiet and Ren Ying pulse rapid: Treat the Yang meridians, use the Fifty-Nine Points Needling method to vent heat and induce sweating, and solidify Yin to supplement insufficiency. (Three Yang meridians affected, not yet entered Yin, up to the third day. Not yet entered Yin, so Qi Kou is quiet. Three Yang are diseased, so Ren Ying is rapid. Ren Ying refers to the Ren Ying pulse on either side of the Adam's apple of the Foot-Yangming meridian. Since various Yang meridians are affected, the Fifty-Nine Points of Yang are used to vent heat. Because Yang abundance leads to Yin deficiency, Yin is supplemented. Ping An: "Shi qi yin", the bottom half of "shi" is missing in the original manuscript; Yuan Ke prints "xie", likely an error. *Lingshu* and *Jiayi Jing* print "shi". The note "gu bu yin ye" suggests it should be "shi".")
If body heat is severe and both Yin and Yang pulses are quiet: Do not needle. If needling is possible, act quickly; if no sweat, there will be diarrhea. The instruction "do not needle" applies when there are signs of death. (Quiet Yin and Yang pulses indicate Yin-Yang intersection, a sign of death, hence needling is contraindicated. If not Yin-Yang conflict, needle urgently; if no sweat, expect diarrhea. Ping An: *Lingshu* adds "chu" after "han".")
Heat disease for seven or eight days, with Pulse Kou moving, panting, and dizziness: Needle urgently. Sweat will occur spontaneously. Superficially needle the spaces between fingers. (On the seventh day, Taiyang disease declines; on the eighth day, Yangming disease declines. With Two Yang declining, the Pulse Kou should gradually harmonize. If pulse moves/pants and head spins, heat persists. If sweat comes easily, needle the Qi Gu point on the lateral side of the little finger, superficially. If no sweat, needle deeper. Ping An: *Lingshu* and *Jiayi Jing* read "shou da zhi jian" (between thumb and index finger), differing from Yang's note.)
Heat disease for seven or eight days, with minute and weak pulse, hematuria, and dry mouth: Death occurs within one and a half days. (At seven or eight days, Two Yang decline, and the pulse should harmonize. A minute/weak pulse indicates intense heat, leading to hematuria, dry mouth, and death in one and a half days. A small pulse is a sign of internal heat consuming essence. Ping An: Note "er wei xiao zhe", Yuan Ke prints "mai" for "er".")
With a Dai (knotted/intermittent) pulse: Death occurs within one day. (A Dai pulse at seven or eight days of heat disease indicates the cessation of internal Qi, hence death in one day.)
Heat disease where sweat has occurred, but the pulse remains rapid and panting, with recurrent fever: Do not use vulgar needling. Severe panting indicates death. (After sweat, the pulse should regulate. If it remains rapid/panting with recurrent fever, this is Yin-Jiao; do not needle, as needling is dangerous. Severe panting with intense heat indicates death; no needling required. Ping An: *Lingshu* adds "chu" after "han"; "wu yong ci" reads "wu ci fu".")
Heat disease for seven or eight days, pulse not rapid, or rapid but not frequent. If sweat occurs within three days after frequency, good. If no sweat after three days, death on the fourth day. For those not yet needled, do not use vulgar needling. (At seven or eight days, Two Yang decline, so pulse is not rapid. Even if rapid, if not frequent, by the third subsequent day (totaling twelve days), heat declines in all Three Yin and Three Yang, leading to sweat and recovery. If no sweat from day nine to twelve, death on day thirteen. Calculating "three days after" means three days later. Alternatively: Day twelve is the decline of Jueyin; sweat should occur. If not, by day thirteen (four days after day nine), death occurs. Even if not needled, no needling is necessary. Yong originally meant skin. Ping An: *Jiayi Jing* does not repeat "zao". *Lingshu* and *Jiayi Jing* read "san" for the first "shu". "Wei zeng ci zhe", *Lingshu* reads "han", *Jiayi Jing* reads "wei han" two characters. Yong, *Lingshu* reads "cou".")
Heat disease initially presenting with rough skin, leaning posture, vexation, dry lips, and dry throat: Use the First Needle, Fifty-Nine Points. Skin distension, dry mouth, cold sweat. (Intense body heat, coarse skin. Leaning uneasily, vexation, dry lips/throat, internal heat—symptoms of Lung heat disease. The First Needle is Chan Zhen (pointed needle), corresponding to Lung. Large head, sharp tip, shallow insertion to vent Yang Qi. Used with Fifty-Nine Points to vent Yang Qi, skin distension, dry mouth, inducing sweat. Ping An: "Yi fan xi gan chun ai" appears as "qi er re fan gan chun kou ai" in *Lingshu* and "fan er re fan men chun ai gan" in *Jiayi Jing*. *Lingshu* and *Jiayi Jing* add "pi" after "qu"; omit "ci" after "jiu". *Jiayi Jing* adds "re bing" before "fu zhang". *Lingshu* and *Jiayi Jing* add fourteen characters after "han": "Chu, suo mai yu xin, bu de suo zhi shui, shui zhe shen ye". Note "rui", Yuan Ke prints "xi".)
Heat disease with dry throat, polydipsia, frequent fright, and restlessness in bed: Treat the flesh, use the Sixth Needle, Fifty-Nine Points. Seek Qi in Spleen, not Liver (Wood). (Heat disease with dry throat, polydipsia, fright, restlessness, affecting flesh: Use the Liu-1 (Yuan-Li) needle. Corresponding to Spleen, use Fifty-Nine Points on flesh, seeking Splein Shu points, not Liver Shu points, because Liver (Wood) controls Spleen (Earth). Ping An: *Lingshu* reads "wo bu neng qi"; *Jiayi Jing* reads "wo bu neng an". Below "jiu", *Lingshu* has "mu qing" three characters; *Jiayi Jing* has "ci mu chi" four characters.)
Heat disease with chest/hypochondriac pain and restless hands/feet: Treat the sinews, use the Fourth Needle, at Si-Ni, Jin-Bi, Mu-Jin. Seek Qi in Liver, not Lung (Metal). (Chest/hypochondriac pain and restless extremities indicate Sinew disease. Use Fourth Needle. Corresponding to Liver, needle at Si-Ni, Jin-Bi, Mu-Jin. Seek Liver Shu, not Lung Shu, because Lung (Metal) controls Liver (Wood). Suo means seek. Bi means tendon spasm. Mu-Jin means tearing eyes. Ping An: "Er xiong xie tong" appears as "mian qing xiong tong" in *Lingshu*. Below "si zhen", *Jiayi Jing* repeats "zhen"; "jin bi" reads "jin ".)
Heat disease initially with skin pain, nasal obstruction, and facial swelling: Treat the skin, use the First Needle, Fifty-Nine Points. Nasal obstruction means blocked nose. Chong Mian means raised facial skin. Skin pain, nasal obstruction, and facial swelling are Lung-skin Heat diseases. First Needle (Chan Zhen) has large head and sharp tip, shallow insertion to remove skin pathology, hence Fifty-Nine Points for skin. Ping An: "Xian fu tong", Yuan Ke mistakenly prints "chong" for "xian".)
Skin eruptions on the nose: Seek Qi in Lung, not Heart (Fire). (Ke, pronounced He-Duo, refers to nasal disease; some versions read Gou. Heat disease with Ke-Zhen on the nose: Nose belongs to Lung, so skin disease seeks Lung Shu, not Heart Shu, because Heart (Fire) controls Lung (Metal). Ping An: "Zhen bi" appears as "bi gan" in *Jiayi Jing*. From "Re bing xian fu tong" above to "xin ye" here, *Lingshu* and *Jiayi Jing* place this section before "Re bing xian shen se".)
Heat disease with frequent fright, convulsions, and mania: Treat the vessels, use the Fourth Needle, urgently reduce excess. Epilepsy and hair loss will heal. (Fright, convulsions, and mania are Blood diseases, hence treat vessels. Fourth Needle is Feng Zhen (sharp needle), corresponding to Heart. Can vent heat and bleed. Stubborn epilepsy and hair loss will heal. Ping An: "Yong", *Jiayi Jing* reads " ". "Mao", *Lingshu* and *Jiayi Jing* read "fa".)
Seek Qi in Heart, not Kidney (Water). (Blood vessels seek Heart Shu, not Kidney Shu, because Water controls Fire.)
Heat disease with heavy body, bone pain, deafness, and desire to close eyes: Treat the bones, use the Fourth Needle, Fifty-Nine Points. Bone disease with teeth grinding and blue ears: Seek Qi in Kidney, not Spleen (Earth). Another version says stiff spine. (Heavy body, bone pain, deafness, desire to close eyes are Kidney-bone Heat diseases. Treat bones with Fourth Needle, Feng Zhen, 1.6 cun long, sharp tip, vents heat and bleeds. Use Fifty-Nine Points to treat teeth grinding, blue ears, and bone pain. Seek Kidney Shu, not Spleen Shu, because Earth controls Water. Ping An: *Lingshu* and *Jiayi Jing* add "ci" after "jiu"; add "bu" before "shi". *Jiayi Jing* adds "chi" after "qing". "Yi yun ji qiang" four characters are absent in *Lingshu* and *Jiayi Jing*.)
Heat disease with unawareness of pain, inability to control the body, dry mouth, extreme Yang heat, and significant Yin cold: Heat is in the Marrow. Death, untreatable. (Yang heat disease: Yang pulse is very hot, Yin pulse is quite cold. Heat in the marrow leads to certain death and untreatability. Ping An: "Suo tong", *Jiayi Jing* reads "suo bing", adding "er long" two characters; *Lingshu* agrees.)
Heat disease with headache, temporal pain, orbital vessel pain, and frequent epistaxis: This is Jue-Re (Reversal Heat). Use the Third Needle. Assess excess/deficiency. Treat cold-heat hemorrhoids. (Headache, temporal/orbital vessel pain, and epistaxis indicate Jue-Re. Third Needle is Di Zhen (mound needle), sharp like millet, 2.5 cun long. Presses vessels to extract Qi, allowing pathogen to exit alone. Used for Jue-Re, cold-heat, and hemorrhoid diseases. Ping An: "Mu mai", *Lingshu* reads "mu HT mai tong"; *Jiayi Jing* reads "mu mai jin". Below "Jue Re", *Lingshu* and *Jiayi Jing* add "bing".)
Heat disease with heavy body and intestinal heat: Use the Fourth Needle, at Shu points and between toes/fingers. Seek Qi in Stomach Collaterals until Qi arrives. (Heavy body and intestinal heat are Stomach Heat diseases. Fourth Needle is Feng Zhen. For Stomach heat, use Feng Zhen on Stomach Shu and eight Stomach collateral points on hands/feet, stopping when Qi arrives. Ping An: "Shu", *Lingshu* reads " "; *Jiayi Jing* reads "Yu".)
Heat disease with periumbilical pain/tightness, hypochondriac/chest fullness: Yong Quan and Yin Ling Quan. Use Fourth Needle, needle the throat. (Periumbilical pain is Spleen Meridian Heat. Chest/hypochondriac fullness is Kidney Meridian Heat. Use Feng Zhen on these two points. Ping An: *Lingshu* and *Jiayi Jing* read "ji tong xiong xie man" for "tong ji xiong xie man"; add "li" after "ai".)
Heat disease where sweat is about to appear, or pulse is smooth allowing sweat: Yu Ji, Tai Quan (Tai Yuan), Da Du, Tai Bai. Reduce to eliminate heat; Tonify to induce sweat. If sweat is excessive, take the transverse vein above the ankle to stop it. (For heat disease with sweat or smooth pulse allowing sweat, use Yu Ji (medial base of thumb), Tai Yuan (wrist depression), Da Du (base of big toe depression), Tai Bai (medial foot, medial cuneiform depression). These four points belong to Hand/Foot Taiyin and treat heat. Reduce to eliminate heat, tonify to induce sweat. If sweat is excessive, take the visible Foot-Taiyin transverse vein above the ankle to stop sweat. Ping An: *Lingshu*,)