黄帝问曰。少阴何以主肾。肾何以主水。（此言肾为阴而阴主水也。）岐伯曰。肾者。至阴也。至阴者。盛水也。肺
者。太阴也。少阴者。冬脉也。故其本在肾。其末在肺。皆积水也。（此言水由地中生。上升于天。下归于泉。天气与水
气上下相通。故在地为水。而在天为寒。夫天为阳。地为阴。泉在地之下。故为至阴而盛水。盛者。受盛而多也。夫肺
主天。太阴之气主湿土。土气上升于天而为云。天气下降而为水。是水由天降。云自地生。故曰。肺者。太阴也。谓天
地之气相合也。少阴主水而司冬令。其脉贯膈入肺中。故其本在肾。其末在肺。上下皆积水也。兆璜曰。肺主气而发
原在肾。是气从下而生。水亦从下而上。下则为溲。上则为汗。留聚则溢于皮肤而为 肿矣。）帝曰。肾何以能聚水而
生病。岐伯曰。肾者。胃之关也。关门不利。故聚水而从其类也。（此言水由中焦入胃之饮而生。从下焦决渎而出。故关
门不利。则聚水而从其类。盖肾者主水。水不沾流。则水亦类聚矣。张兆璜曰。关者。关戾也。即金匮之所谓了戾不
利。则不得溺。）上下溢于皮肤。故为 肿。 肿者。聚水而生病也。（ 肿、胀也。皮肤者。肺之合。水聚于下。则反
溢于上。故肿胀于皮肤之间。盖因水聚而生此病也。张兆璜曰。下文云。外不得越于皮肤。谓水溢于皮肤。尚可从汗
解。故金匮要略云。腰以下肿。当利小便。腰以上肿。当发汗乃愈。）帝曰。诸水皆生于肾乎。岐伯曰。肾者。牝脏也。
地气上者。属于肾而生水液也。故曰至阴。（此复言水生于中焦之胃土。然由下焦之气。上升以合化。夫胃为阳腑。肾为
牝脏。肾气上交于阳明。戊癸合化。而后入胃之饮。从地土之气。上输于肺。肺气通调。而下输决渎。故曰。地气上者。
属于肾而生水液也。夫水在地之下。地气上者。直从泉下之气而生。故曰至阴。是地气上通于天。而水气亦上通于天也。
以上论水液生始之原。聚则为水为肿。和则清中之浊者。从决渎而下行。清中之清者。为精为液。为气为血。生肌肉而
充皮肤。濡筋骨而利关节。莫不由此入胃之饮。医者知此。能通调其生始出入之原。不唯病之不生。且使其形体不敝。
益寿延年。斯可谓之国手。）勇而劳甚则肾汗出。肾汗出。逢于风。内不得入于脏腑。外不得越于皮肤。客于玄府。行
于皮里。传为 肿。本之于肾。名曰风水。所谓玄府者。汗空也。（上节论关门不利。水聚于下。溢于上而为 肿。此言
劳动肾液上出为汗。逢于风而闭溢于皮肤之间为 肿。当知 肿之有二因也。经云。用力过度则伤肾。又曰。持重远行。
汗出于肾。盖勇而劳甚则伤骨。骨即为肾。肾气动。则水液上升而为汗矣。逢于风则内不得入于脏腑。外不得越于皮肤。
客于玄府。行于皮里。传为 肿。本之于肾。名曰风水。盖因风而致水肿于皮肤间也。玄府者。乃汗所出之空孔。又名
鬼门。盖幽玄而不可见者也。夫肾者主水。受胃腑之津液而藏之。肾之津液。复还入胃中。而资养其脏腑。又入心为汗。
入肝为泪。入肺为涕。入脾为涎。自入为唾。是五液皆出于肾。而五脏六腑之气。亦藉肾脏之津液以濡养。故曰内不得
入于脏腑。此论水从上降。而复从下升。乃津液环转之道。医者知此。能积此精。而还养五脏之神。并可益寿延年。）
帝曰。水俞五十七处者。是何主也。岐伯曰。肾俞五十七穴。积阴之所聚也。水所从出入也。尻上五行。行五者。
此肾俞。故水病下为 肿大腹。上为喘呼。不得卧者。标本俱病。故肺为喘呼。肾为水肿。肺为逆。不得卧。分为相输
俱受者。水气之所留也。（此言水随经而上下也。肾者。至阴也。穴者。气之所聚。故肾五十七穴。积阴之所聚也。水随
此经俞而外内出入者也。尻、臀也。尻上五行。中行乃督脉之所循。旁四行乃太阳之经脉。盖督脉起于至阴。循阴器。
绕篡后。别绕臀。合少阴太阳。贯脊入肾。太阳为少阴之寒府。是此五行乃水阴之所注。故皆为肾俞。是以病水。则下
为肿大腹。上则为喘呼。不得卧者。此标本俱病。盖肾为本。肺为标。在肺则为喘呼。在肾则为水肿。肺为气逆。故
不得卧也。此水分为相输而上下俱受病者。盖肾俞之循尻而下。复循腹而上贯肺中。水气之留于经俞故也。夫有形之血。
行于脉中。无形之气。行于脉外。是以有形之水。行于无形之气分。无形之水气。行于有形之脉中。水随经而行于上下。
而水气亦随经而留于脉中也。故 肿大腹者。水所从出入于外内。喘呼不得卧者。水气上逆于脉中。）伏兔上各二行。行
五者。此肾之街也。三阴之所交结于脚也。（伏兔、在膝上六寸起肉。以左右各三指按膝上。有肉起如兔之状。故以为名。
各二行者。谓少阴之大络与少阴之经。左右各二。共四行也。行五者。谓少阴经之阴谷、筑阴、交信、复溜。及三阴之
所交结之三阴交穴也。街、气街也。气街者。气之径路也。经络者。经别之大络也。如经络之气结。则别走于气街。故
络绝则经通。此少阴之经。同少阴之大络下行于脚。而交结于三阴。故曰肾之街也。按灵枢经。黄帝问曰。少阴之脉独
下行。何也。岐伯曰。夫冲脉者。五脏六腑之海也。五脏六腑皆禀焉。其上者出于颃颡。渗诸阳。灌诸精。其下者。注
少阴之大络。出于气街。循阴股内廉。入 中。伏行 骨内。下至内踝之后属而别。其下者。并于少阴之经。渗三阴。
此冲脉之注于少阴之大络。而交结三阴于足 之间。故曰伏兔上各二行。此肾之街也。详灵枢经集注。）踝上各一行。行
六者。此肾脉之下行也。名曰太冲。（此言少阴之本。直起于至阴之下也。踝上各一行者。左右二足各一行也。行六者。
谓照海、水泉、大钟、太溪、然谷、涌泉六穴也。此肾脉之直下行于至阴也。夫圣人南面而立。前曰广明。后曰太冲。
太冲之地。名曰少阴。少阴根起于涌泉。是泉在地之下。从至阴而涌出。故曰。肾者。至阴也。至阴者。盛水也。）凡五
十七穴者。皆脏之阴络。水之所客也。（凡此五十七穴。皆水脏之阴络。水之所客也。客者。谓留舍于脉络之间。非入于
脉中也。）帝曰。春取络脉分肉何也。（按灵枢四时气篇内。风水肤胀。为五十七 。取皮肤之血者。尽取之。而首论
四时。各有浅深之所在。帝复引经而问。故曰。春取络脉分肉何也。而伯复详析其旨焉）岐伯曰。春者木始治。肝气始
生。肝气急。其风疾。经脉常深。其气少。不能深入。故取络脉分肉间。（治、主也。东方生风。风生木。木生肝。风木
之气。其性急疾。而直达于络脉分肉之间。其经脉之气。随冬令伏藏。久深而始出。其在经之气尚少。故不能深入而取
之经。当浅取之络脉分肉间也。按针刺之道。有皮肉筋骨之浅深。病有浮沉。刺有浅深。此病之有浅深也。四时各有所
取。四时之有浅深也。故曰。四时之气。各有所在。灸刺之道。得气穴为定。）帝曰。夏取盛经分腠何也。岐伯曰。夏
者火始治。心气始长。脉瘦气弱。阳气留溢。热熏分腠。内至于经。故取盛经分腠。绝肤而病去者。邪居浅也。所谓盛
经者。阳脉也。（南方生热。热生火。火生心。而心主血脉。心气始长。故脉气尚瘦弱也。其阳盛之气。留溢于外。而
外之暑热。熏蒸于分腠。内至于经脉。故当取之盛经分腠。绝肤者。谓绝其肤腠之邪。不使内入于经脉。盖邪居肤腠之
浅也。阳脉谓浮见于皮肤之脉。阳盛于外。故曰盛经。按此二节。论取气而不论脉。）帝曰。秋取经俞何也。岐伯曰。
秋者金始治。肺将收杀。金将胜火。阳气在合。阴气初胜。湿气及体。阴气未盛。未能深入。故取俞以泻阴邪。取合以
虚阳邪。阳气始衰。故取于合。（夫秋、刑官也。于时为金。其令收降。故肺气将收。而万物当杀。清肃之气。将胜炎热。
阳气始降。而在所合之腑。其脏阴之气。始升而初胜也。夫立秋处暑。乃太阴湿土主气。故湿气及体。其阴气未盛。故
未能深入而取之。当刺俞上。以泻太阴之湿。取合穴以虚阳腑之邪。以阳气始衰。故取之于合。盖秋时阳气下降。始归
于腑。而后归于阴也。）帝曰。冬取井荥何也。岐伯曰。冬者水始治。肾方闭。阳气衰少。阴气坚盛。巨阳伏沉。阳脉
乃去。故取井以下阴逆。取荥以实阳气。故曰冬取井荥。春不鼽衄。此之谓也。（肾为水脏。冬令闭藏。阳气已衰。而阴
寒之气。坚盛于外。太阳之气伏沉。其阳脉亦乃去阳而归伏于内矣。故当取井。以下阴逆之气。取荥以实沉伏之阳。顺
时令也。夫井。木也。木生于水。故取井木以下阴气。勿使其发生而上逆也。荥、火也。故取荥穴以实阳气。乃助其伏
藏也。盖冬令闭藏。以奉春生之气。故冬取井荥。助藏太阳少阴之气。至春时阳气外出。卫固于表。不使风邪有伤肤腠
络脉。故春不鼽衄。此之谓也。以上论刺风水。所取五十七俞。而又有四时之分别也。）帝曰。夫子言治热病五十九俞。
余论其意。未能领别其处。愿闻其处。因闻其意。（气穴论中。言热俞有五十九穴。故帝曰夫子言治热病五十九穴。余论
其意。但未能别其处。因闻其意者。因其处而知其泻热之意也。）岐伯曰。头上五行行五者。以越诸阳之热逆也。（头上
五行。每行有五穴。俱在头之巅顶。诸阳之气上升于头。故取刺以越诸阳之热逆。中行属督脉之上星。囟会、前顶、百
会、后顶五穴。旁两行系足太阳经之五处、承光、通天、络却、玉枕十穴。又旁两行。系足少阳经之临泣。目窗、正营、
承灵、脑空十穴。）大杼、膺俞、缺盆、背俞。此八者。以泻胸中之热也。（大杼穴在项大椎两旁。属足太阳膀胱经。膺
俞一名中府。在胸中行两旁。各开六寸。属手太阴肺经。缺盆穴在肩上横骨陷者中。属足阳明胃经。背俞即风门穴。在
大椎下第二椎两旁。各开一寸五分。属足太阳膀胱经。此八者。在胸中前后之上。以泻胸中之热。）气街、三里、巨虚
上下廉。此八者。以泻胃中之热也。（气街在少腹下横骨两端。动脉应手。三里在膝下三寸。 骨外大肉分间。巨虚上廉。
在三里下三寸。巨虚下廉。在上廉下三寸。并足阳明胃经。刺之以泻胃中之热。）云门、 骨、委中、髓空。此八者以泻
四肢之热也。（云门在巨骨下。胸中行两旁。相去各六寸。属手太阴肺经。 骨在肩端两骨间。属手阳明大肠经。委中在
足膝后屈处。 中央约纹中。动脉应手。属足太阳膀胱经。髓空即横骨穴。所谓股际骨空。在阴上曲骨旁。属足少阴肾
经。盖手太阴与阳明为表里。足少阴与太阳为表里。手之太阴。从腹走手。手之阳明。从手走头。足之少阴。从足走腹。
足之太阳。从头走足。并主血气。故此八者。以泻手足之热也。按王氏辈以督脉之腰俞为髓空。是止七穴而非八矣。王
芳侯曰。骨髓皆属于肾。）五脏俞旁五。此十者。以泻五脏之热也。凡此五十九穴者。皆热之左右也。（五脏俞。各开中
行一寸五分。肺俞在三椎间。心俞在五椎间。肝俞在九椎间。脾俞在十一椎间。肾俞在十四椎间。左右各五。并属足太
阳膀胱经。以泻五脏之热。凡此五十九穴。皆热之左右而泻之也。）帝曰。人伤于寒。而传为热何也。岐伯曰。夫寒甚则
为热也。（夫在地为水。在天为寒。寒极生热。是热生于寒。而寒生于水也。故曰水热穴论。）
黄帝问道：少阴经为什么由肾脏所主？肾脏为什么主管水液代谢？（这是说肾属阴，而阴气主司水液。）岐伯回答说：肾属于至阴。所谓至阴，是指水气最盛的地方。肺属于太阴。少阴经对应冬季的脉象。所以水液的根本在肾，其标末在肺，两者都涉及水液的积聚。（这是说水从地中产生，上升于天，下降回归为泉水。天气与水气上下相通，所以在地下表现为水，而在天上表现为寒。天属阳，地属阴。泉水在地面之下，所以称为至阴且水气旺盛。“盛”意为受纳和充盈。肺主天，太阴之气主湿土。土气上升于天形成云，天气下降化为雨。这样看来，水从天降，云自地生。所以说“肺者，太阴也”，意指天地之气相合。少阴主水并掌管冬令，其经脉贯穿膈肌进入肺中。所以根本在肾，标末在肺，上下皆有水液积聚。兆璜说：肺主气，但气的源头在肾，这说明气是从下而生；水也是从下而上。在下则成为尿液，在上则成为汗液。如果停留积聚，就会溢出皮肤而形成水肿。）
黄帝又问：肾脏为什么能积聚水液从而引发疾病？岐伯回答说：肾是胃的关口。如果这个关口功能不利，就会导致水液积聚并同类相聚。（这是说水液由中焦进入胃中的饮食而产生，从下焦通过决渎之官排出。所以如果关口不利，水液就会积聚。盖因肾主水，如果水流不沾滞，水液也会类聚。张兆璜说：“关”意为关隘、阻碍，即《金匮要略》所说的“了戾不利”，导致小便不通。）水液向上向下溢出到皮肤，所以形成水肿。水肿，就是水液积聚引发的疾病。（水肿，即胀满。皮肤是肺的外合部位。水液积聚在下部，反而向上溢出，所以在皮肤之间出现肿胀。这是因为水液积聚而产生的疾病。张兆璜说：下文提到“外不得越于皮肤”，意思是水液溢出皮肤，还可以通过发汗来解除。所以《金匮要略》说：腰部以下浮肿，应当利小便；腰部以上浮肿，应当发汗才能痊愈。）
黄帝问：所有的水病都是源于肾脏吗？岐伯回答说：肾是牝脏（阴性脏器）。地气上升的部分，归属于肾，并由肾化生水液。所以称肾为至阴。（这里再次说明水液生于中焦的胃土，但由下焦的气机上升以配合化生。胃为阳腑，肾为牝脏。肾气上交于阳明，戊癸合化，然后进入胃中的饮食物，借助地土之气，向上输送到肺。肺气通调水道，向下输注到决渎之官。所以说“地气上者，属于肾而生水液”。水在地面之下，地气上升，直接从泉下的气机产生，所以称为至阴。这意味着地气上通于天，水气也上通于天。以上论述水液生成和起始的根源。水液积聚则成为水病或水肿；调和状态下，清中之浊的部分，通过决渎下行；清中之清的部分，转化为精、液、气、血，滋养肌肉，充实皮肤，濡润筋骨，滑利关节，无不来源于进入胃中的饮食物。医生懂得这些，能够通调水液生成、起始、出入的根源，不仅能使疾病不生，而且能使形体不衰败，益寿延年，这才可以称为国手。）
人如果勇猛用力且过度劳累，就会导致肾汗出。肾汗出后，若遭遇风邪侵袭，内不能进入脏腑，外不能透达皮肤，风邪客居于玄府，行走在皮里肉间，传变而成水肿。这种病本源于肾，名叫风水。所谓玄府，就是汗孔。（上一节论述因关门不利，水液积聚在下部，溢出上部而形成水肿。这一节论述劳动导致肾液上出为汗，遇到风邪闭塞，溢于皮肤之间而形成水肿。应当知道水肿有两种成因。经文说：用力过度会伤肾。又说：负重远行，汗出于肾。大概是因为勇猛劳作过度会伤骨，骨即为肾。肾气动荡，则水液上升变为汗液。遇到风邪，则内不能入于脏腑，外不能越于皮肤，客居玄府，行于皮里，传变为水肿。本源于肾，名叫风水。这是因为风邪导致皮肤间出现水肿。玄府，是汗液排出的空孔，又名鬼门，幽深隐秘不可见。肾主水，接受胃腑的津液并储藏它。肾的津液，又返还进入胃中，以此资养脏腑。另外进入心成为汗，进入肝成为泪，进入肺成为涕，进入脾成为涎，自入成为唾。这五液都出于肾，而五脏六腑的气，也借助肾脏的津液来濡养。所以说“内不得入于脏腑”。这一段论述水从上降，又从下升，这是津液循环流转的道路。医生懂得这些，能积存这些精气，从而反哺滋养五脏的神气，也可以益寿延年。）
黄帝问：治疗水病的俞穴有五十七处，它们主要主治什么？岐伯回答说：肾俞有五十七个穴位，这是阴气积聚的地方，是水液出入的途径。尻骨上方有五行，每行五个穴位，这就是肾俞。所以水病患者，下部会出现腹部肿大，上部会出现气喘呼叫、不能平卧的症状，这是标本俱病。所以肺表现为气喘呼叫，肾表现为水肿。肺表现为气逆，不能平卧。分为相互输注、共同受病的，是水气停留所致。（这是说水随经络上下运行。肾属于至阴。穴位是气机汇聚之处，所以肾的五十七个穴位，是阴气积聚的地方。水随着这些经络穴位在外内出入。尻，即臀部。尻上方的五行，中行是督脉循行的路线，旁四行是足太阳膀胱经的经脉。督脉起于至阴，循行经过阴器，绕过肛门后方，别行绕过臀部，与少阴、太阳汇合，贯穿脊柱进入肾脏。太阳是少阴的寒府，所以这五行是水阴之气灌注的地方，因此都称为肾俞。因此患水病时，下部出现腹部肿大，上部出现气喘呼叫、不能平卧，这是标本俱病。肾为本，肺为标。在肺则气喘呼叫，在肾则水肿。肺主气逆，所以不能平卧。这种水病分为相互输注，上下同时受病，是因为水气停留在经络穴位中。有形之血，运行在脉管之中；无形之气，运行在脉管之外。所以有形之水，运行在无形之气分；无形之水气，运行在有形之脉中。水随经络运行于上下，水气也随经络停留在脉中。所以腹部肿大，是水液从内外出入的表现；气喘呼叫不能平卧，是水气上逆于脉中的表现。）
伏兔穴上方各有两行，每行五个穴位，这是肾经的气街。是三阴经交汇结于脚部的地方。（伏兔穴，位于膝盖上方六寸处隆起的肌肉，用左右各三指按压膝上，有肌肉隆起如兔子形状，因此得名。各二行，是指少阴经的大络与少阴经本身，左右各两行，共四行。每行五个穴位，是指少阴经的阴谷、筑宾、交信、复溜，以及三阴经交汇处的三阴交穴。街，即气街，是气运行的径路。经络是经别的大络。如果经络之气郁结，就会别走于气街。所以络脉隔绝时经气通畅。这条少阴经，连同少阴的大络下行于脚部，并与三阴经交汇，所以称为肾之街。参考《灵枢经》，黄帝问道：少阴脉为何单独下行？岐伯回答：冲脉是五脏六腑的海，五脏六腑都禀受于此。冲脉上行部分出于颃颡，渗灌诸阳经，灌溉诸精窍；下行部分注入少阴的大络，出于气街，沿大腿内侧廉，进入腘中，伏行于骨内，下行至内踝之后分支。其下行部分，并入少阴经，渗灌三阴经。这是冲脉注入少阴大络，并在足部与三阴经交汇，所以说“伏兔上各二行，此肾之街”。详见《灵枢经集注》。）
脚踝上方各有一行，每行六个穴位，这是肾脉下行的路线，名叫太冲。（这是说少阴的本源，直接起于至阴之下。脚踝上方各一行，是指左右两只脚各一行。每行六个穴位，是指照海、水泉、大钟、太溪、然谷、涌泉这六个穴位。这是肾脉直接下行至至阴。圣人面南而坐，前方叫广明，后方叫太冲。太冲之地，名为少阴。少阴根起于涌泉，泉水在地面之下，从至阴处涌出，所以说“肾者，至阴也。至阴者，盛水也。”）
总共五十七个穴位，都是脏的阴络，是水液停留客居的地方。（这五十七个穴位，都是水脏的阴络，是水液客居的地方。“客”意为停留舍于脉络之间，并非进入脉管之中。）
黄帝问：春季取络脉和分肉的原因是什么？（参考《灵枢·四时气篇》，对于风水肤胀，取五十七穴，取皮肤中的血络全部刺破出血。首先论述四季，各有深浅所在。黄帝引用经文提问，所以问“春取络脉分肉何也”，岐伯详细分析其旨意。）岐伯回答说：春季木气开始主事，肝气开始生发。肝气急，风气疾速。经脉通常位置较深，此时经气尚少，不能深入，所以取络脉和分肉之间。（治，即主。东方生风，风生木，木生肝。风木之气，性质急疾，直达络脉分肉之间。其经脉之气，随着冬季的伏藏，久深后才发出。此时在经之气尚少，所以不能深入取经穴，应当浅取络脉分肉之间。按针刺之道，有皮肉筋骨之深浅，病有浮沉，刺有深浅。这是病的深浅。四季各有取穴原则，这是四季深浅的不同。所以说：四时之气，各有所在；灸刺之道，以得气穴为准。）
黄帝问：夏季取盛经和分腠的原因是什么？岐伯回答说：夏季火气开始主事，心气开始生长。脉气尚瘦弱。阳气留溢，热气熏蒸分腠，内至于经脉。所以取盛经和分腠。切断皮肤就能使病去，是因为邪气居处较浅。所谓盛经，是指阳脉。（南方生热，热生火，火生心，心主血脉。心气始长，所以脉气尚瘦弱。阳盛之气，留溢于外，外界的暑热熏蒸于分腠，内至于经脉，所以应当取盛经和分腠。绝肤，意为断绝其肤腠之邪，不使其内入经脉。因为邪气居处于肤腠之浅表。阳脉指浮见于皮肤的脉。阳盛于外，所以称为盛经。按这两节，论述的是取气而不论脉。）
黄帝问：秋季取经穴和合穴的原因是什么？岐伯回答说：秋季金气开始主事，肺气将收敛肃杀。金将胜火。阳气在合穴（腑）。阴气初胜，湿气及体。阴气未盛，未能深入，所以取经穴以泻阴邪，取合穴以虚阳邪。阳气始衰，所以取于合穴。（秋，象征刑官，时令属金，政令主收降。所以肺气将收，万物当杀。清肃之气，将胜炎热。阳气始降，而在所合之腑。脏阴之气，始升而初胜。立秋处暑，乃太阴湿土主气，所以湿气及体。其阴气未盛，所以未能深入取穴。应当刺俞穴，以泻太阴之湿；取合穴以虚阳腑之邪。因为阳气始衰，所以取之于合。盖秋时阳气下降，始归于腑，而后归于阴。）
黄帝问：冬季取井穴和荥穴的原因是什么？岐伯回答说：冬季水气开始主事，肾方闭藏。阳气衰少，阴气坚盛。巨阳（太阳）伏沉，阳脉乃去。所以取井穴以下阴逆，取荥穴以实阳气。所以说冬季取井荥，春季就不会发生鼻衄等症状，说的就是这个道理。（肾为水脏，冬令闭藏。阳气已衰，而阴寒之气，坚盛于外。太阳之气伏沉，其阳脉也离开阳位而归伏于内。所以应当取井穴，以下降阴逆之气；取荥穴以充实沉伏之阳，顺应时令。井穴属木，木生于水，所以取井木穴以下阴气，勿使其发生而上逆。荥穴属火，所以取荥穴以实阳气，乃助其伏藏。盖冬令闭藏，以奉春生之气。所以冬季取井荥，助藏太阳少阴之气。到了春季，阳气外出，卫固于表，不使风邪伤害肤腠络脉，所以春季不发生鼻衄。说的就是这个道理。以上论述治疗风水所取的五十七个俞穴，又有四季的区别。）
黄帝问：先生您说治疗热病有五十九个俞穴，我讨论其意，未能辨别其具体位置。希望听您讲讲这些位置，并借此了解其用意。（《气穴论》中说热俞有五十九穴，所以黄帝说：先生言治热病五十九穴，我讨论其意，但未能辨别其位置。借闻其意，是通过其位置来了解其泻热的用意。）岐伯回答说：头上五行，每行五个穴位，用来发散诸阳经上逆的热邪。（头上五行，每行五个穴位，都在头顶。诸阳之气上升于头，所以取刺以发散诸阳之热逆。中行属督脉的上星、囟会、前顶、百会、后顶五穴。旁两行系足太阳膀胱经的五处、承光、通天、络却、玉枕十穴。再旁两行，系足少阳胆经的临泣、目窗、正营、承灵、脑空十穴。）
大杼、膺俞、缺盆、背俞。这八个穴位，用来泻胸中之热。（大杼穴在项部大椎两旁，属足太阳膀胱经。膺俞一名中府，在胸中行两旁，各开六寸，属手太阴肺经。缺盆穴在肩上横骨陷者中，属足阳明胃经。背俞即风门穴，在大椎下第二椎两旁，各开一寸五分，属足太阳膀胱经。这八个穴位，在胸中前后之上，用以泻胸中之热。）
气街、三里、巨虚上下廉。这八个穴位，用来泻胃中之热。（气街在少腹下横骨两端，动脉应手。三里在膝下三寸，胫骨外大肉分间。巨虚上廉，在三里下三寸。巨虚下廉，在上廉下三寸。均属足阳明胃经。刺之以泻胃中之热。）
云门、髃骨、委中、髓空。这八个穴位，用来泻四肢之热。（云门在巨骨下，胸中行两旁，相去各六寸，属手太阴肺经。髃骨在肩端两骨间，属手阳明大肠经。委中在足膝后屈处，腘中央约纹中，动脉应手，属足太阳膀胱经。髓空即横骨穴，所谓股际骨空，在阴上曲骨旁，属足少阴肾经。盖手太阴与阳明为表里，足少阴与太阳为表里。手之太阴，从腹走手；手之阳明，从手走头；足之少阴，从足走腹；足之太阳，从头走足。并主血气。所以这八个穴位，用来泻手足之热。按王氏辈以督脉之腰俞为髓空，那就只有七穴而非八穴了。王芳侯说：骨髓皆属于肾。）
五脏俞旁五。这十个穴位，用来泻五脏之热。（五脏俞，各开中行一寸五分。肺俞在三椎间，心俞在五椎间，肝俞在九椎间，脾俞在十一椎间，肾俞在十四椎间。左右各五，并属足太阳膀胱经。用以泻五脏之热。凡此五十九穴，皆是热邪所在的左右两侧，予以泻之。）
黄帝问：人受寒邪侵袭，为什么会传变为热证？岐伯回答说：寒甚则化为热。（在地为水，在天为寒。寒极生热，是热生于寒，而寒生于水。所以称为《水热穴论》。）
Huangdi asked: Why is the Shaoyin meridian governed by the Kidney? Why does the Kidney govern water metabolism? (This states that the Kidney belongs to Yin, and Yin governs water.) Qibo replied: The Kidney is Zhiyin (Extreme Yin). Zhiyin refers to where water qi is most abundant. The Lung belongs to Taiyin. The Shaoyin meridian corresponds to the pulse of winter. Therefore, the root of water lies in the Kidney, its branch in the Lung, and both involve the accumulation of water. (This explains that water arises from the earth, rises to heaven, and descends back to springs. Heaven's qi and water qi communicate up and down; thus, underground it manifests as water, while in the sky it manifests as cold. Heaven is Yang, Earth is Yin. Springs are below ground, hence called Zhiyin and abundant in water. "Abundant" means receiving and filling. The Lung governs heaven; Taiyin qi governs damp earth. Earth qi rises to heaven to form clouds, and heaven's qi descends to become rain. Thus, water falls from heaven, and clouds arise from earth. Hence, "The Lung is Taiyin," meaning heaven and earth qi combine. Shaoyin governs water and controls the winter season; its meridian passes through the diaphragm into the Lung. Thus, the root is in the Kidney, the branch in the Lung, and water accumulates both above and below. Zhaohuang said: The Lung governs Qi, but the source of Qi is in the Kidney, indicating that Qi arises from below; similarly, water rises from below. Below it becomes urine, above it becomes sweat. If it stagnates and accumulates, it overflows the skin causing edema.)
Huangdi asked again: Why can the Kidney accumulate water and thereby cause disease? Qibo replied: The Kidney is the gate of the Stomach. If this gate functions improperly, water accumulates and gathers with its kind. (This explains that water is generated from fluids entering the Stomach at the Middle Jiao and exits via the drainage organs at the Lower Jiao. Thus, if the gate is obstructed, water accumulates. Since the Kidney governs water, if flow is not adherent, water also gathers. Zhang Zhaohuang said: "Guan" means barrier or obstruction, referring to what is described in the *Jingui Yaolue* as "obstructed and ineffective," leading to inability to urinate.) Water overflows upward and downward onto the skin, thus forming edema. Edema is a disease caused by the accumulation of water. (Edema refers to distension. The skin is the exterior correspondence of the Lung. When water accumulates below, it overflows upward, causing swelling between the skin. This disease arises from water accumulation. Zhang Zhaohuang said: The text later mentions "externally unable to reach the skin," meaning that when water overflows the skin, it can still be resolved through sweating. Thus, the *Jingui Yaolue* states: For swelling below the waist, promote urination; for swelling above the waist, induce sweating to cure.)
Huangdi asked: Are all water diseases originated from the Kidney? Qibo replied: The Kidney is a Pin Zang (Yin organ). The part of Earth qi that rises belongs to the Kidney, which generates fluid. Hence, it is called Zhiyin. (This reiterates that water is generated from the Stomach Earth at the Middle Jiao, but rises via Lower Jiao Qi to transform. The Stomach is a Yang Fu, the Kidney is a Yin organ. Kidney Qi ascends to interact with Yangming; Wu and Gui combine to transform, allowing ingested fluids to rise via Earth Qi to the Lung. Lung Qi regulates the water passages, descending to the drainage organs. Hence, "Earth qi rising belongs to the Kidney and generates fluids." Water is below ground; rising Earth qi arises directly from spring Qi, hence called Zhiyin. This means Earth Qi connects to Heaven, and Water Qi also connects to Heaven. The above discusses the origin of fluid generation. Accumulated water becomes water disease or edema; harmonized, the turbid part of the clear descends via drainage; the clear part of the clear transforms into Essence, Fluid, Qi, and Blood, nourishing muscles, filling the skin, moistening sinews and bones, and lubricating joints, all originating from ingested fluids. A physician who understands this can regulate the origin, start, and exit of fluid generation, preventing disease, maintaining physical integrity, promoting longevity, and thus qualifying as a master physician.)
If one exerts oneself vigorously and labors excessively, Kidney Sweat occurs. If Kidney Sweat encounters Wind pathogen, it cannot enter the Zang-Fu internally nor penetrate the skin externally. The pathogen lodges in the Xuanfu (pores), travels within the skin layers, and transmits into edema. Originating from the Kidney, this condition is named Fengshui (Wind Edema). The so-called Xuanfu refers to sweat pores. (The previous section discussed edema caused by improper gate function, with water accumulating below and overflowing above. This section discusses edema caused by labor inducing Kidney fluid to emerge as sweat, which is blocked by Wind and overflows the skin. One must know there are two causes of edema. The classic states: Excessive force injures the Kidney. Also: Carrying heavy loads and traveling far results in sweat from the Kidney. Vigorous labor injures the bones, and bones correspond to the Kidney. When Kidney Qi moves, water rises to become sweat. Encountering Wind prevents internal entry into Zang-Fu and external penetration of the skin; it lodges in the Xuanfu, travels within the skin, and transmits into edema. Originating from the Kidney, it is named Fengshui. This is edema induced by Wind. Xuanfu are the pores for sweat emission, also called Guimen (Ghost Gates), deep and invisible. The Kidney governs water, storing fluids received from the Stomach. Kidney fluids return to the Stomach to nourish the Zang-Fu. Entering the Heart, they become sweat; entering the Liver, tears; entering the Lung, nasal mucus; entering the Spleen, saliva; self-entering, spittle. These five fluids originate from the Kidney, and the Qi of the Five Zang and Six Fu also relies on Kidney fluids for nourishment. Hence, "internally unable to enter the Zang-Fu." This section discusses water descending from above and ascending from below, the cycle of fluid transformation. Physicians who understand this can accumulate essence to nourish the Spirit of the Five Zang, promoting longevity.)
Huangdi asked: There are fifty-seven acupoints for treating water disease. What do they primarily treat? Qibo replied: There are fifty-seven points of the Shenshu (Kidney Transport), which are the gathering place of Yin Qi and the pathway for water entry and exit. Above the sacrum, there are five rows, each with five points; these are the Shenshu. Therefore, patients with water disease present with abdominal distension below and wheezing/calling out with inability to lie flat above, indicating simultaneous disease of the root and branch. The Lung manifests as wheezing, the Kidney as edema. The Lung manifests as rebellious Qi, causing inability to lie flat. Divided into mutual transmission and simultaneous reception, this is due to the retention of Water Qi. (This explains that water moves up and down along the meridians. The Kidney is Zhiyin. Acupoints are gatherings of Qi; thus, the fifty-seven Kidney points gather Yin Qi. Water enters and exits externally and internally along these meridian points. Sacrum refers to the buttocks. The five rows above the sacrum: the middle row follows the Du Mai (Governor Vessel); the four lateral rows follow the Foot-Taiyang Bladder Meridian. The Du Mai originates at Zhiyin, circulates around the genitalia, passes behind the anus, diverges around the buttocks, converges with Shaoyin and Taiyang, penetrates the spine, and enters the Kidney. Taiyang is the Cold Mansion of Shaoyin; thus, these five rows are where Water-Yin Qi pours, hence all called Shenshu. In water disease, abdominal distension occurs below, and wheezing/inability to lie flat above, indicating root and branch disease. Kidney is root, Lung is branch. In the Lung, wheezing; in the Kidney, edema. Lung governs Qi rebellion, causing inability to lie flat. This water disease involves mutual transmission and simultaneous affliction because Water Qi remains in the meridian points. Form-blood runs inside the vessels; formless-Qi runs outside. Thus, formless-water runs in the formless-Qi space; formless-Water-Qi runs inside the form-blood vessels. Water moves up and down with the meridians; Water-Qi stays in the vessels with the meridians. Abdominal distension indicates water entering/exiting internally/externally; wheezing/inability to lie flat indicates Water-Qi rebelling upward in the vessels.)
Above the Futu point, there are two rows on each side, each with five points; these are the Qi Street of the Kidney. This is where the Three Yin meridians intersect at the foot. (Futu is located six cun above the knee on the raised muscle. Pressing above the knee with three fingers on each side reveals a muscle raised like a rabbit, hence the name. "Two rows each" refers to the Great Luo of Shaoyin and the Shaoyin Meridian itself, two rows on left and right, totaling four rows. "Five points each" refers to the Shaoyin points YinGu, ZhuBin, JiaoXin, FuLiu, and the SanYinJiao point where the Three Yin intersect. "Street" refers to Qi Street, the pathway of Qi. Meridians are large collaterals of Jing-Bie. If Qi in meridians stagnates, it diverges to Qi Streets. Thus, when collaterals are blocked, meridian Qi flows freely. This Shaoyin Meridian, along with its Great Luo, descends to the foot and intersects with the Three Yin, hence called the Street of the Kidney. Referencing the *Ling Shu*, Huangdi asked: Why does the Shaoyin pulse descend alone? Qibo replied: The Chong Mai is the Sea of the Five Zang and Six Fu. All Zang-Fu receive from it. Its ascending branch emerges at the pharynx, seeps into Yang meridians, and irrigates essences. Its descending branch injects into the Great Luo of Shaoyin, emerges at Qi Street, follows the medial thigh, enters the popliteal fossa, runs deep within the bone, descends behind the medial malleolus, and branches. Its lower part joins the Shaoyin Meridian and seeps into the Three Yin. This is the Chong Mai injecting into the Great Luo of Shaoyin and intersecting the Three Yin at the foot, hence "two rows above Futu, the Street of the Kidney." See *Ling Shu Ji Zhu*.)
Above each ankle, there is one row, with six points; this is the descending path of the Kidney Meridian, named Taichong. (This states the root of Shaoyin originates directly below Zhiyin. "One row above each ankle" refers to one row on each foot. "Six points each" refers to the six points: ZhaoHai, ShuiQuan, DaZhong, TaiXi, RanGu, and YongQuan. This is the Kidney Meridian descending directly to Zhiyin. The sage faces south; the front is GuangMing, the back is TaiChong. The land of TaiChong is named Shaoyin. Shaoyin roots at YongQuan. Spring is below ground, gushing forth from Zhiyin, hence "Kidney is Zhiyin. Zhiyin is abundant in water.")
In total, these fifty-seven points are all the Yin Collaterals of the Zang, where Water Qi resides. (These fifty-seven points are the Yin Collaterals of the Water Organ, where Water Qi resides. "Reside" means lodging between the collaterals, not entering the vessels themselves.)
Huangdi asked: Why are Luomaio (Collateral Vessels) and Fenrou (Intermuscular Spaces) selected in Spring? (Referencing *Ling Shu · Four Seasons Qi*, for Fengshui and Fuzhang, select the fifty-seven points and bleed the skin collaterals fully. First discussing the four seasons, each has specific depths. Huangdi cites the classic to ask, hence "Why select Luomaio and Fenrou in Spring?" Qibo analyzes the intent.) Qibo replied: In Spring, Wood Qi begins to govern, and Liver Qi begins to generate. Liver Qi is urgent, Wind Qi is rapid. Meridians are usually deep; at this time, Qi is scarce and cannot penetrate deeply. Therefore, select between the Luomaio and Fenrou. (Govern means control. East generates Wind, Wind generates Wood, Wood generates Liver. Wind-Wood Qi is urgent and reaches directly into Luomaio and Fenrou. Meridian Qi, having hidden during Winter, emerges after being deep for long. The Qi in the meridians is currently scarce, so it cannot penetrate deeply to select meridian points; instead, shallow selection of Luomaio and Fenrou is appropriate. Regarding needling, there are depths corresponding to skin, flesh, sinew, and bone; diseases have floating/sinking levels, and needling has shallow/deep methods. This addresses the depth of disease. Each season has specific selection principles, addressing seasonal depth. Hence: "Qi of the four seasons has its location; the way of moxibustion and needling is determined by obtaining Qi at the acupoint.")
Huangdi asked: Why are Shengjing (Full Meridians) and Fencou (Skin Pores/Clefts) selected in Summer? Qibo replied: In Summer, Fire Qi begins to govern, and Heart Qi begins to grow. Pulse Qi is thin and weak. Yang Qi remains abundant, heat steams the Fencou, and internally reaches the meridians. Therefore, select Shengjing and Fencou. Cutting the skin removes the disease because the pathogen is shallow. The so-called Shengjing refers to Yang Meridians. (South generates Heat, Heat generates Fire, Fire generates Heart. Heart governs blood vessels. Heart Qi begins to grow, so pulse Qi is thin and weak. Abundant Yang Qi remains externally, and external summer heat steams the Fencou, reaching the meridians internally. Thus, one should select Shengjing and Fencou. "Cutting skin" means cutting off the pathogen in the skin/clefts to prevent internal entry into meridians. Since the pathogen is shallow in the skin/clefts. Yang Meridians refer to pulses visible on the skin surface. Yang is abundant externally, hence called Shengjing. These two sections discuss selecting Qi rather than pulses.)
Huangdi asked: Why are Ying-Shu (Stream-Spring) and He-Sea points selected in Autumn? Qibo replied: In Autumn, Metal Qi begins to govern, and Lung Qi begins to收敛 (gather/restrain). Metal will overcome Fire. Yang Qi is at the He-Sea points. Yin Qi begins to prevail, dampness affects the body. Yin Qi is not yet strong and cannot penetrate deeply. Therefore, select Ying-Shu points to drain Yin pathogens, and He-Sea points to empty Yang pathogens. Yang Qi begins to decline, so select He-Sea points. (Autumn symbolizes the executioner; the season is Metal, the decree is gathering and descending. Lung Qi gathers, and all things are harvested/killed. Clear and肃 (solemn) Qi will overcome heat. Yang Qi begins to descend and reside in the He-Fu (Yang Fu). Zang Yin Qi begins to rise and initially prevail. Lichu and Chushu are governed by Taiyin Damp Earth Qi, hence dampness affects the body. Yin Qi is not yet strong, so it cannot penetrate deeply for selection. One should needle the Ying-Shu points to drain Taiyin Dampness, and select He-Sea points to empty Yang Fu pathogens. Because Yang Qi begins to decline, select He-Sea points. In Autumn, Yang Qi descends, first returning to the Fu, then to Yin.)
Huangdi asked: Why are Jing-Well and Ying-Spring points selected in Winter? Qibo replied: In Winter, Water Qi begins to govern, and the Kidney closes/stores. Yang Qi is declining and scarce; Yin Qi is firm and abundant. Juyang (Taiyang) hides and sinks; Yang Meridians depart. Therefore, select Jing-Well points to subdue Yin rebellion, and Ying-Spring points to tonify Yang Qi. Hence, "Winter selects Jing-Well and Ying-Spring," so that in Spring, there will be no epistaxis (nosebleed). This is what is meant. (Kidney is the Water Organ; Winter governs storage. Yang Qi has declined, while Yin-Cold Qi is firm and abundant externally. Taiyang Qi hides and sinks; its Yang Meridians leave the Yang position and hide internally. Thus, one should select Jing-Well points to subdue Yin rebellious Qi, and Ying-Spring points to tonify sunken Yang, following the season. Jing-Well points belong to Wood; Wood is born from Water. Selecting Jing-Wood points subdues Yin Qi, preventing it from arising and rebelling upward. Ying-Spring points belong to Fire; selecting Ying points tonifies Yang Qi, aiding its storage. Winter storage supports Spring generation. Thus, selecting Jing-Well and Ying-Spring in Winter assists in storing Taiyang and Shaoyin Qi. By Spring, Yang Qi moves outward, guarding the exterior, preventing Wind pathogen from damaging skin/collaterals, hence no nosebleed in Spring. This is the meaning. The above discusses the fifty-seven points for treating Fengshui, differentiated by the four seasons.)
Huangdi asked: You mentioned fifty-nine acupoints for treating Febrile Diseases. I have discussed their intent but cannot distinguish their locations. I wish to hear about their locations and thereby understand their purpose. (The *Qi Xue Lun* states there are fifty-nine points for heat. Thus, Huangdi says: You mentioned fifty-nine points for febrile disease. I discussed the intent but could not distinguish the locations. Hearing the intent allows understanding the heat-draining purpose through the locations.) Qibo replied: Five rows on the head, each with five points, are used to disperse the rebellious heat of all Yang meridians. (Five rows on the head, five points each, are all on the vertex. Yang Qi of all meridians rises to the head; thus, needling disperses the rebellious heat of all Yang. The middle row belongs to the Du Mai: ShangXing, XiHui, QianDing, BaiHui, HouDing (5 points). The two lateral rows belong to the Foot-Taiyang Bladder Meridian: WuShu, ChengGuang, TongTian, LuoQue, YuZhen (10 points). The next two lateral rows belong to the Foot-Shaoyang Gallbladder Meridian: LinQi, MuChuang, ZhengYing, ChengLing, NaoKong (10 points).)
DaZhu, YingShu (ZhongFu), QuePen, BeiShu (FengMen). These eight points are used to drain heat in the chest. (DaZhu is beside the greater vertebra at the nape, Foot-Taiyang Bladder Meridian. YingShu, also ZhongFu, is six cun lateral to the midline of the chest, Hand-Taiyin Lung Meridian. QuePen is in the depression of the clavicle, Foot-Yangming Stomach Meridian. BeiShu, also FengMen, is 1.5 cun lateral to the second thoracic vertebra below the greater vertebra, Foot-Taiyang Bladder Meridian. These eight points are anterior and superior to the chest, draining chest heat.)
QiJie, SanLi, JuXu ShangLian, JuXu XiaLian. These eight points are used to drain heat in the Stomach. (QiJie is at the ends of the horizontal bone in the lower abdomen, where the artery beats. SanLi is three cun below the knee, between the large muscles outside the tibia. JuXu ShangLian is three cun below SanLi. JuXu XiaLian is three cun below ShangLian. All belong to the Foot-Yangming Stomach Meridian. Needling drains Stomach heat.)
YunMen, GuGu (YuGu), WeiZhong, MeiKong (HengGu). These eight points are used to drain heat in the four limbs. (YunMen is below JuGu, six cun lateral to the midline, Hand-Taiyin Lung Meridian. GuGu is between the two bones at the shoulder end, Hand-Yangming Large Intestine Meridian. WeiZhong is in the center of the popliteal crease, where the artery beats, Foot-Taiyang Bladder Meridian. MeiKong is HengGu, also known as the hollow of the thigh bone, beside QuGu, Foot-Shaoyin Kidney Meridian. Hand-Taiyin and Yangming are interior-exterior pairs; Foot-Shaoyin and Taiyang are interior-exterior pairs. Hand-Taiyin goes from abdomen to hand; Hand-Yangming from hand to head; Foot-Shaoyin from foot to abdomen; Foot-Taiyang from head to foot. They all govern blood and Qi. Thus, these eight points drain heat in the hands and feet. Note: Wang's school identifies YaoShu of the Du Mai as MeiKong, leaving only seven points. Wang Fanghou said: Bone marrow belongs to the Kidney.)
WuZang Shu (Back-Shu of Five Zang) plus five on each side. These ten points are used to drain heat from the Five Zang. (The Back-Shu points are 1.5 cun lateral to the midline. FeiShu is between the third and fourth thoracic vertebrae; XinShu between fifth and sixth; GanShu between ninth and tenth; PiShu between eleventh and twelfth; ShenShu between fourteenth and fifteenth. Five on each side, all Foot-Taiyang Bladder Meridian. They drain heat from the Five Zang. Of these fifty-nine points, all are on the sides of heat pathogens to drain them.)
Huangdi asked: Humans are injured by Cold, yet it transmits into Heat. Why? Qibo replied: Extreme Cold transforms into Heat. (On earth it is Water, in heaven it is Cold. Extreme Cold generates Heat; thus, Heat is born from Cold, and Cold from Water. Hence, this chapter is titled "Water and Heat Acupoints".)