期不过三日。(颊前、颐也。外见少阳之脉。少阳之热病也。色荣颊前。肾脏之热病也。)热病气穴。三椎下间主胸中
热。四椎下间主膈中热。五椎下间主肝热。六椎下间主脾热。七椎下间主肾热。(此言刺未病者。当取之气穴也。气穴者。
泻五脏气分之热。故曰三椎下间。四椎下间。乃溪谷之穴会。与五脏之俞穴不同也。胸中膈上。乃心肺之宫城。主胸中
热者。泻肺热也。膈中热者。泻心热也。不曰心肺。而曰胸中膈中者。意言热在气分。而不干于脏真也。)荣在 也。项
上三椎。陷者中也。(此言五脏之热。入于经荣者。当取之骨穴也。脊背之尽处曰 。谓如取荣穴。当在 而至项上之三
椎。陷者中而取之。盖气为阳。荣血为阴。故取气穴。在三椎至七椎之间。从上而下也。取荣俞之穴。在 骨之十四椎。
而上至项上之三椎。陷者中而取之也。灵枢经曰。穷骨者 骨也。张兆璜曰。此所谓刺之反者。)颊下逆颧为大瘕。
下牙车为腹满。颧后为胁痛。颊上者。膈上也。(此复结内病五脏之热。不重感于外邪者。无外内之交争。而止于在内之
脏腑。自相乘传也。颊下为颐。如颊下之色。上逆于颧。是肾热乘肝。当为大瘕泄。如下于牙车。是肾热乘胃。当主腹
满。逆于颧后。是热邪乘胆。当为胁痛。如逆于颊上者。是在膈上心肺之分也。盖言五脏之热。色见于面部。而有外邪
之热者。当治其未病交争。勿使外内相合。而成不救之死证。如五脏之热。见于面部而无外因之热病者。亦当治未病乘
传。勿使其有瘕泄腹满之病。张兆璜曰。此篇首言五脏之热病。末结五脏之热色。自相乘传。盖五脏之热。有重感外邪
者。必有外因之交争。如止病在内。而不感于外邪者。只当于在内之脏腑中求之。张应略曰。有在外之热病。有在内之
热病。有病在外而内不病者。有病在内而外不病者。不必定有外内之交争。故复以此证明之。)
热病发作的周期不超过三天。(颊前、颐部。外现少阳经脉之象。为少阳经的热病。面色红赤显现于颊前,为肾脏的热病。)治疗热病的穴位:第三椎骨下方间隙主治胸中热;第四椎骨下方间隙主治膈中热;第五椎骨下方间隙主治肝热;第六椎骨下方间隙主治脾热;第七椎骨下方间隙主治肾热。(此处论述针刺预防未发病者,应当选取的气穴。气穴,用于泻五脏气分之热,所以说第三椎下间、第四椎下间,乃是溪谷之穴会合处,与五脏的俞穴不同。胸中、膈上,是心肺所在的宫城,主治胸中热,即泻肺热;主治膈中热,即泻心热。不直接说心肺,而说胸中、膈中,意在说明热在气分,而未波及脏真。)色荣显于颏部(承浆穴附近)。项上第三椎骨,凹陷处即是。(此处论述五脏之热邪入于经荣时,应当选取的骨穴。脊背的最下端称为骶骨(穷骨)。谓如取荣穴,应当在骶骨向上至项上第三椎骨,凹陷处进行取穴。盖因气属阳,营血属阴,所以取气穴,在第三椎至第七椎之间,从上往下取。取荣俞之穴,在骶骨第十四椎,而上至项上第三椎,在凹陷处取穴。《灵枢经》说:穷骨就是骶骨。张兆璜说:这就是所谓“刺之反者”。)颊下逆乱至颧骨为大瘕(腹中结块病),向下至牙车穴为腹部胀满,颧骨后方为胁痛,颊上部对应膈上部。(此处再次总结内伤五脏之热,若不再感外邪,则无内外交争,仅止于内部脏腑,相互乘传。颊下为颐部,如果颊下的颜色上逆至颧骨,是肾热乘袭肝脏,应当发生大瘕泄;如果向下至牙车穴,是肾热乘袭胃腑,应当主症为腹部胀满;逆乱至颧后,是热邪乘袭胆腑,应当发生胁痛;如果逆乱至颊上,是在膈上心肺的分野。大概意思是说五脏之热,色见于面部,若有外邪之热,当治其未病时的交争,勿使内外相合,而成不可救治的死证。如五脏之热见于面部而无外因热病者,也当治未病时的乘传,勿使其产生瘕泄、腹满等病。张兆璜说:本篇首段论述五脏的热病,末段总结五脏的热色自相乘传。大概五脏之热,有重感外邪者,必有外因的交争;如仅病在内,而不感外邪者,只应当在内部脏腑中寻求病因。张应略说:有在外部的热病,有在内部的热病,有病在外而内不病的,有病在内而外不病的,不一定非要有内外交争,所以再次以此证明。)
The period will not exceed three days. (The area in front of the cheek and the chin. The manifestation of the Shaoyang meridian externally indicates a Shaoyang heat disease. Redness appearing on the front of the cheek indicates a Kidney heat disease.) Acupoints for treating heat diseases: The space below the third vertebra governs heat in the chest; the space below the fourth vertebra governs heat in the diaphragm; the space below the fifth vertebra governs Liver heat; the space below the sixth vertebra governs Spleen heat; the space below the seventh vertebra governs Kidney heat. (This discusses acupuncture for preventing disease before it occurs, specifically selecting Qi acupoints. These are points to drain heat from the Qi aspect of the Five Zang organs. Thus, the spaces below the third and fourth vertebrae are considered convergences of Xi Gu (valley) points, distinct from the Shu points of the Five Zang organs. The chest and above the diaphragm are the palaces of the Heart and Lung. Governing heat in the chest involves draining Lung heat; governing heat in the diaphragm involves draining Heart heat. The terms "chest" and "diaphragm" are used instead of "Heart and Lung" to indicate that the heat resides in the Qi aspect without affecting the true essence of the Zang organs.) Redness manifests at the Chengjiang point area. The third vertebra at the nape, where there is a depression, is the location. (This discusses taking bone acupoints when heat from the Five Zang organs enters the Jing-Rong level. The lowest part of the spine is called the Qionggu (coccyx). When selecting Rong acupoints, one should locate the depression between the Qionggu ascending to the third vertebra at the nape. Since Qi is Yang and Ying-Blood is Yin, Qi acupoints are selected from the third to the seventh vertebrae, moving downwards. Rong-Shu acupoints are located from the fourteenth vertebra relative to the coccyx, ascending up to the third vertebra at the nape, taken at the depression. The *Ling Shu* states: "Qionggu refers to the coccyx." Zhang Zhaohuang stated: This is what is referred to as "reverse needling".) Reversal of color from the lower jaw to the zygomatic arch indicates Da Jia (large abdominal mass); downward to the Jiache point indicates abdominal fullness; behind the zygomatic arch indicates hypochondriac pain; the upper cheek corresponds to the upper diaphragm. (This reiterates the internal heat of the Five Zang organs. If not re-infected by external pathogens, there is no conflict between interior and exterior, and the pathology remains within the internal Zang-Fu, transmitting among themselves. The lower jaw is the chin. If the color on the lower jaw reverses upward to the zygomatic arch, it indicates Kidney heat attacking the Liver, leading to Da Jia diarrhea. If it extends downward to the Jiache point, it indicates Kidney heat attacking the Stomach, leading to abdominal fullness. If it reverses behind the zygomatic arch, it indicates Heat pathogen attacking the Gallbladder, leading to hypochondriac pain. If it reverses to the upper cheek, it affects the region of the Heart and Lung above the diaphragm. The implication is that if heat from the Five Zang organs appears on the face accompanied by external heat pathogens, treatment should address the pre-disease state of conflict, preventing internal and external factors from combining into a fatal condition. If heat from the Five Zang organs appears on the face without external causes, treatment should still address the pre-disease state of transmission, preventing conditions like masses, diarrhea, or abdominal fullness. Zhang Zhaohuang stated: The beginning of this chapter discusses heat diseases of the Five Zang organs, while the end summarizes the self-transmission of heat colors of the Five Zang organs. Heat of the Five Zang organs may involve re-infection by external pathogens, causing external conflicts; if the disease is solely internal without external infection, the cause should be sought within the internal Zang-Fu. Zhang Yinglue stated: There are heat diseases external, heat diseases internal, diseases external but not internal, and diseases internal but not external. It is not necessary to always have an internal-external conflict, hence this clarification.)