黄帝问于岐伯曰。邪气之中人也奈何。岐伯答曰。邪气之中人高也。黄帝曰。高下有度乎。岐伯曰。身半以上者邪
中之也。身半以下者湿中之也。故曰。邪之中人也。无有常中于阴则溜于腑中于阳则溜于经。黄帝曰。阴之与阳也。异
名同类。上下相会。经络之相贯。如环无端。邪之中人。或中于阴。或中于阳。上下左右。无有恒常。其故何也。岐伯
曰。诸阳之会皆在于面。邪之中人也。方乘虚时。及新用力。若饮食汗出腠理开。而中于邪中于面则下。阳明中于项则
下。太阳中于颊则下。少阳其中于膺背两胁亦各下其经。黄帝曰。其中于阴奈何。岐伯答曰。中于阴者常从臂 始。夫
臂与 其阴皮薄。其肉淖泽。故俱受于风独伤其阴。黄帝曰。此故伤其脏乎。岐伯答曰。身之中于风也。不必动脏也。
故邪入于阴经。则脏气实邪气入而不能客故还之于腑。故中阳则溜于经。中阴则溜于腑。黄帝曰。邪之中人脏。奈何。
岐伯曰。愁忧恐惧。则伤心形寒。寒饮则伤肺以其两寒。相感中外皆伤故气逆。而上行有所堕坠。恶血留内。有所大怒。
气上而不下。积于胁下。则伤肝。有所击仆。若醉入房。汗出当风。则伤脾。有所用力举重。若入房过度。汗出浴水。
则伤肾。黄帝曰。五脏之中风。奈何。岐伯曰。阴阳俱感邪。乃得往。黄帝曰。善哉。（以上叙邪气脏腑之义是发明病之
机也阴阳脏腑四项本自极对而布局运笔参差曲背变幻不测却是风水相遭毫无造作岂非至文）黄帝问于岐伯曰。首面与身
形也。属骨连筋同血合于气耳。天寒则裂地凌冰。其卒寒。或手足懈惰。然而其面不衣。何也。岐伯答曰。十二经脉。
三百六十五络。其血气皆上于面而走空窍。其精阳气上走于目而为睛。其别气走于耳而为听。其宗气上出于鼻而为臭。
其浊气出于胃。走唇舌而为味。其气之津液。皆上熏于面。而皮又浓。其肉坚。故大热甚寒。不能胜之也。（以上为前半
篇叙邪气脏腑正意余意俱到下乃叙病形也）黄帝曰。邪之中人。其病形何如。岐伯曰。虚邪之中身也。洒淅动形。正邪
之中人也微。先见于色。不知于身。若有若无。若亡若存。有形无形。莫知其情。黄帝曰。善哉。（此从邪气卸到病形是
全篇之中枢也）黄帝问于岐伯曰。余闻之。见其色。知其病。命曰明。按其脉。知其病。命曰神。问其病。知其处。命
曰工。余愿闻见而知之。按而得之。问而极之。为之奈何。岐伯答曰。夫色脉与尺之相应也。如桴鼓影响之相应也。不
得相失也。此亦本末根叶之出候也。故根死则叶枯矣。色脉形肉。不得相失也。故知一则为工。知二则为神。知三则神
且明矣。（此段提唱色脉尺三项为病形提纲是后半篇之总冒。色脉尺三项平提下文分叙却重在脉上）黄帝曰。愿卒闻之。
岐伯答曰。色青者其脉弦也。赤者其脉钩也。黄者其脉代也。白者其脉毛。黑者其脉石。见其色而不得其脉。反得其相
胜之脉。则死矣。得其相生之脉。则病已矣。黄帝曰五脏之所生。变化之病形。何如。岐伯答曰先定其五色五脉之应。
其病乃可别也。（此段叙色字带定脉字五色所主病形只浑写一笔顿住）黄帝曰色脉已定。别之奈何。岐伯曰。调其尺之缓
急小大滑涩。而病变定矣。（调字重读尺原作脉今寻上下文义改之上云色脉已定此处固当言尺下文方不嫌突且所谓调者即
合色脉以参之之谓也故下文跟定脉字）黄帝曰。调之奈何。岐伯答曰。脉急者尺之皮肤亦急。脉缓者尺之皮肤亦缓。脉
小者尺之皮肤亦减而少气。脉大者尺之皮肤亦贲而起。脉滑者尺之皮肤亦滑。脉涩者尺之皮肤亦涩。凡此变者有微有甚。
故善调尺者不待于寸。善调脉者不待于色。能参合而行之者。可以为上工。上工十全九。行二者为中工。中工十全七。
行一者为下工。下工十全六。（此段跟定脉字叙尺字尺肤所主病形亦只用浑写顿住。以上色尺两项病形俱用略笔留于下文
五脉发挥）黄帝曰。请问脉（脉字重读是总承上六个脉字来前人盖因此句而将前文尺字妄改作脉字）之缓急小大滑涩之
病形。何如。岐伯曰。臣请言五脏之病变也。心脉急甚者。为螈 。微急为心痛引背。食不下。缓甚。为狂笑。微缓。
为伏梁。在心下。上下行。时唾血。大甚。为喉 。微大为心痹引背。善泪出。小甚为善哕。微小为消瘅。滑甚为善渴。
微滑为心疝引脐。小腹鸣。涩甚为喑。微涩为血溢。维厥。耳鸣颠疾（维厥即肢厥也四肢谓之四维）肺脉急甚。为颠疾。
微急为肺寒热。怠惰。咳唾血。引腰背胸。若鼻息肉不通。缓甚为多汗。微缓为痿 偏风。头以下汗出不可止。大甚为
胫肿。微大为肺痹。引胸背。起恶日光。小甚为泄。微小为消瘅。滑甚为息贲。上气。微滑为上下出血。涩甚为呕血。
微涩为鼠 。在颈。支腋之间。下不胜其上。其应善 矣。肝脉。急甚。为恶言。微急。为肥气。在胁下。若覆杯。缓
甚。为善呕。微缓。为水瘕痹也。大甚。为内痈。善呕衄微大。为肝痹。阴缩。咳引小腹。小甚。为多饮。微小。为消
瘅。滑甚。为 疝。微滑。为遗溺。涩甚。为溢饮。微涩。为螈挛筋痹。脾脉急甚。为螈 。微急。为膈中。食饮入而
还出。后沃沫。缓甚。为痿疾。微缓。为风痿。四肢不用。心慧然若无病。（此燥病也燥极风生内不濡心外不濡筋也心失
所养筋脉内弛神明外散其脉微弦而长按之 而薄带散故曰微缓）大甚。为击仆。微大。为疝气。腹裹大。（腹裹肚囊也作
里误）脓血在肠胃之外。小甚。为寒热微小为消瘅。滑甚。为 癃。微滑。为虫毒 蝎。腹热。涩甚。为肠溃微涩。为
内。多下脓血。（溃 二字脉经互易为是）肾脉。急甚。为骨癫疾。微急。为沉厥。奔豚。足不收。不得前后。缓甚。
为折脊微缓。为洞。洞者食不化。下嗌还出。大甚。为阴痿。微大。为石水。起脐以下至小腹 然。上至胃脘。死不
治。小甚。为洞泄微小。为消瘅。滑甚。为癃 。微滑。为骨痿。坐不能起。起则目无所见。涩甚。为大痈。微涩。为
不月。沉痔。（以上详叙六脉微甚之病即补叙五色尺肤所主之病也前叙色尺笔势下趋如过脉文本接叙六脉笔势即堂堂正大
是色尺必以脉为主也五脏即暗承五色六变微甚即隐赅尺肤读者须目光四射乃得）黄帝曰。病之六变者。刺之奈何。岐伯
答曰。诸急者多寒。缓者多热。大者多气少血。小者血气皆少。滑者阳气盛微有热。涩者多血少气微有寒。是故刺急者。
深内而久留之。刺缓者。浅内而疾发针。以去其热。刺大者。微泻其气。无出其血。刺滑者。疾发针而浅内之。以泻其
阳气。而去其热。刺涩者。必中其脉。随其逆顺而久留之。必先按而循之。已发针。疾按其 。无令其血出。以和其脉。
诸小者。阴阳形气俱不足。勿取以针。而调以甘药也。黄帝曰。余闻五脏六腑之气荥输所入为合。令何道从入。入安连
过。愿闻其故。岐伯答曰。此阳脉之别。入于内。属于腑者也。黄帝曰。荥输与合。各有名乎。岐伯答曰。荥输治外经。
合治内腑。黄帝曰。治内腑奈何。岐伯曰。取之于合。黄帝曰。合各有名乎。岐伯答曰。胃合于三里。大肠合入于巨虚
上廉。小肠合入于巨虚下廉。三焦合入于委阳。膀胱合入于委中央。胆合入于阳陵泉。黄帝曰。取之奈何。岐伯答曰。
取之三里者。低跗取之。巨虚者。举足取之。委阳者。屈伸而索之。委中者。屈而取之。阳陵泉者。正竖膝。予之齐。
下至（至直也）委阳之阳取之。（谓坐而正竖其膝折其胫引线与膝后大筋相齐又折而下直委阳之外是穴也）取诸外经者。
申而从之。（ 申当作揄伸骨空论注云揄摇也谓或摇或伸而寻之也）黄帝曰。愿闻六腑之病。（前文说得天花乱缀读者
几忘其遗却六腑矣读至此乃愕然）岐伯答曰。面热者。足阳明病。鱼络血者。手阳明病。两跗之上。脉坚陷者。足阳明
病。此胃脉也。大肠病者。肠中切痛而鸣。濯濯冬日重感于寒。即泄。当脐而痛。不能久立。与胃同候。取巨虚上廉。
胃病者。腹 胀。胃脘当心而痛。上支两胁。膈咽不通。食饮不下。取之三里也。小肠病者。小腹痛腰脊控睾而痛。时
窘之后。（窘迫于后阴也）当耳前热。若寒甚若独肩上热甚。及手小指次指之间热。若脉陷者。此其候也。手太阳病也。
取之巨虚下廉。三焦病者。腹气满。小腹尤坚。不得小便。窘急溢则水。留则为胀。候在足太阳之外大络。大络在太阳
少阳之间。亦见于脉。取委阳。膀胱病者。小腹偏肿而痛。以手按之。即欲小便而不得。肩上热。若脉陷。及足小趾外
廉及胫踝后皆热。若脉陷。取委中央。胆病者。善太息。口苦呕宿汁。心下澹澹。恐人将捕之。嗌中 然数唾。在足
少阳之本末。亦视其脉之陷下者灸之。其寒热者取阳陵泉。（以上叙六腑病形逐段搀入上节钩连有致）黄帝曰。刺之有道
乎。岐伯答曰。刺此者必中气穴。无中肉节。中气穴则针染于巷中肉节则皮肤痛。补泻反。则病益笃。中筋则筋缓邪气
不出。与其真相搏。乱而不去。反还内着。用针不审以顺为逆也。
前半叙邪气后半叙病形而各以脏腑。纬之尤妙在前从腑卸脏中用枢纽。后从脏卸腑中用枢纽。中间从邪气卸病形中
用枢纽。遂使板局极活。令读者迷不知其本指之所在。此篇叙邪气之伤。有浅深与病形之各异也。初看似略无奇处。细
读乃无处不奇。灵枢八十一篇布局之穿插变幻如此篇者不过三四而已。讵可以平淡忽之。
黄帝问：这种高下有规律吗？
岐伯说：身体半以上的部分，多被风邪所中；身体半以下的部分，多被湿邪所中。所以说，邪气侵袭人体，没有固定的常位。如果侵入阴经，则流注于腑；如果侵入阳经，则流注于经脉。
黄帝说：阴和阳，名称不同但同类，上下相互会合，经络相互贯通，像圆环一样没有端点。邪气侵袭人体，有时侵入阴经，有时侵入阳经，在上、下、左、右，没有恒定的常规。这是什么原因呢？
岐伯说：所有阳经的交会穴都在面部。邪气侵袭人体，往往趁着人体正气虚弱的时候，以及刚用力过度、或者饮食后出汗导致腠理（皮肤毛孔）开泄的时候。如果邪气从面部侵入，则向下行入阳明经；从项部侵入，则向下行入太阳经；从颊部侵入，则向下行入少阳经；从胸膺、背部或两胁侵入，也各自下行进入相应的经脉。
岐伯回答说：邪气侵入阴经，通常从手臂或小腿内侧开始。因为手臂和小腿内侧的皮肤薄，肌肉柔润滑泽，所以容易受风邪侵袭而单独损伤阴经。
黄帝问：这难道一定会伤及内脏吗？
岐伯回答说：身体遭受风邪侵袭，不一定就会动及内脏。所以，邪气侵入阴经，由于脏气充实，邪气进入后不能停留，于是返还流注于腑。因此，侵入阳经则流注于经脉，侵入阴经则流注于腑。
岐伯说：忧愁恐惧，会伤心；形体受寒，饮用冷食，会伤肺。这是因为内外两种寒气相互感应，导致表里都受伤，所以气逆而上行。如果有堕坠受伤，恶血留滞体内，或者大怒导致气机上逆而不能下行，积聚在胁下，就会伤肝。如果有击打跌倒，或者醉酒后进行房事，出汗时当风受凉，就会伤脾。如果用力的举重，或者房事过度，出汗后洗冷水澡，就会伤肾。
黄帝说：说得好。（以上叙述了邪气与脏腑的关系，这是阐明发病机理。阴阳、脏腑四项本自相对，但文章布局运笔参差错落，变幻莫测，却如风水相遭般毫无造作，真是至文。）
黄帝又问岐伯：头部面部与身体四肢，属于骨骼连接筋脉，共同气血调和于气机之中。天气寒冷时，大地开裂，冰凌凝结，突然受寒，有时手足懈怠无力，然而面部却不穿衣服保暖，为什么呢？
岐伯回答说：十二经脉，三百六十五络脉，它们的气血都上行于面部并通达各个孔窍。其中精纯阳气上行出于目而为视觉；别行之气上行出于耳而为听觉；宗气上行出于鼻而为嗅觉；浊气出于胃，上行至唇舌而为味觉。这些气中的津液，都向上熏蒸于面部，而且面部皮肤厚实，肌肉坚实，所以即使大热或极寒，也不能伤害它。
岐伯说：虚邪贼风侵袭身体，使人洒淅恶寒，动摇不定；正邪侵袭人体则轻微，先见于面色变化，身体感觉不明显，若有若无，似存似亡，形态有无不定，没有人能知晓其真情。
黄帝问岐伯：我听说，观察面色就能知道病情，称为“明”；切按脉搏就能知道病情，称为“神”；询问病情就能知道病位，称为“工”。我希望听听如何通过观察、切按和询问来极致地掌握病情，该怎么做呢？
岐伯回答说：面色、脉象与尺肤（前臂内侧皮肤）是相互对应的，就像鼓槌与鼓声、影子与物体那样相应，不会失去联系。这也是根本与枝叶的表现。所以根死了，叶子就枯了。面色、脉象、形体肌肉，不能相互背离。所以懂得其中一项的算是“工”，懂得两项的算是“神”，懂得三项的就既神且明了。
黄帝说：我想详尽地听听。
岐伯回答说：面色青的，其脉弦；面色赤的，其脉钩；面色黄的，其脉代；面色白的，其脉毛（浮）；面黑色的，其脉石（沉）。看到面色却得不到相应的脉象，反而得到相克制的脉象，就会死亡；得到相生之脉象，病就会痊愈。
黄帝问：五脏所产生的病变及其变化的病形，是怎样的？
岐伯回答说：先确定五色与五脉的对应关系，那么病情就可以辨别了。
黄帝问：面色和脉象已经确定，如何进一步辨别？
岐伯说：通过诊察尺肤的缓、急、小、大、滑、涩，那么病变就确定了。
黄帝问：如何诊察？
岐伯回答说：脉象紧急的，尺肤也紧张；脉象缓和的，尺肤也松弛；脉象细小的，尺肤也瘦减且少气；脉象粗大的，尺肤也隆起；脉象滑利的，尺肤也滑润；脉象涩滞的，尺肤也涩滞。所有这些变化有轻有重。所以善于诊察尺肤的人，不需要再诊寸口脉；善于诊察脉象的人，不需要再看面色。能将三者结合运用的人，可以称为上工，十次治疗能治愈九次；运用两项的为中工，十次治疗能治愈七次；只运用一项的为下工，十次治疗能治愈六次。
黄帝问：请问脉象的缓、急、小、大、滑、涩所对应的病形是怎样的？
岐伯说：请允许我讲述五脏的病变。心脉紧急严重的，表现为抽搐；轻微的，为心痛牵引背部，饮食不下。心脉缓和严重的，为狂笑；轻微的，为伏梁病，在心下，上下移动，时常唾血。心脉粗大严重的，为喉痹；轻微的，为心痹，牵引背部，容易流泪。心脉细小严重的，为呃逆；微小的，为消瘅。心脉滑利严重的，为口渴；轻微的，为心疝，牵引脐部，小腹鸣响。心脉涩滞严重的，为失音；轻微的，为血溢，四肢厥冷，耳鸣，头顶疾病。
肺脉紧急严重的，为癫疾；轻微的，为肺寒热，倦怠乏力，咳嗽唾血，牵引腰背胸部，若鼻塞不通。肺脉缓和严重的，为多汗；轻微的，为痿证偏风，头以下汗出不止。肺脉粗大严重的，为胫肿；轻微的，为肺痹，牵引胸背，起身厌恶阳光。肺脉细小严重的，为泄泻；微小的，为消瘅。肺脉滑利严重的，为息贲，气逆上冲；轻微的，为上下出血。肺脉涩滞严重的，为呕血；轻微的，为鼠瘘，在颈部腋下之间，下肢不胜其上肢，反应迟钝。
肝脉紧急严重的，为恶言妄语；轻微的，为肥气，在胁下，如倒扣的杯子。肝脉缓和严重的，为善呕；轻微的，为水瘕痹。肝脉粗大严重的，为内痈，善呕血鼻衄；轻微的，为肝痹，阴缩，咳嗽牵引小腹。肝脉细小严重的，为多饮；微小的，为消瘅。肝脉滑利严重的，为疝气；轻微的，为遗尿。肝脉涩滞严重的，为溢饮；轻微的，为抽搐拘挛筋痹。
脾脉紧急严重的，为抽搐；轻微的，为膈中，饮食入胃即吐出，大便排出涎沫。脾脉缓和严重的，为痿疾；轻微的，为风痿，四肢不用，心中清醒好像没病（这是燥病，燥极生风，内不濡养心神，外不濡养筋脉，心神失养，筋脉弛缓，神明外散，其脉微弦而长，按之软弱而薄，带散象，所以说微缓）。脾脉粗大严重的，为击仆倒地；轻微的，为疝气，腹部胀大。脓血在肠胃之外。脾脉细小严重的，为寒热；微小的，为消瘅。脾脉滑利严重的，为癃闭；轻微的，为虫毒蝎螫，腹热。脾脉涩滞严重的，为肠溃；轻微的，为内痈，多下脓血。
肾脉紧急严重的，为骨癫疾；轻微的，为沉厥，奔豚，足不能收持，二便不通。肾脉缓和严重的，为折脊痛；轻微的，为洞泄，洞泄是指食物不消化，咽下后又吐出。肾脉粗大严重的，为阳痿；轻微的，为石水，从脐以下至小腹肿胀坚硬，上至胃脘，死不治。肾脉细小严重的，为洞泄；微小的，为消瘅。肾脉滑利严重的，为癃闭；轻微的，为骨痿，坐不能起，起来则视物不清。肾脉涩滞严重的，为大痈；轻微的，为月经不来，沉痔。
黄帝问：疾病的六种变化（急、缓、大、小、滑、涩），针刺治疗该怎么办？
岐伯回答说：诸种紧急的多属寒证，缓和的多属热证，粗大的多气少血，细小的血气皆少，滑利的阳气盛而有微热，涩滞的多血少气而有微寒。所以针刺紧急的，要深刺并久留针；针刺缓和的，要浅刺并快出针，以去除热邪；针刺粗大的，微泻其气，不要放血；针刺滑利的，快出针并浅刺，以泻去阳气，去除热邪；针刺涩滞的，必须中其血脉，顺着气的逆顺方向久留针，必须先按压循摸，出针后迅速按住针孔，不让出血，以调和血脉。对于诸种细小的，阴阳形气都不足，不要用针刺，而要用甘味药物来调治。
黄帝说：我听说五脏六腑之气在荥穴、输穴处进入，在合穴处汇合。它们是从什么道路进入的？进入后连接经过哪里？希望听您讲讲。
黄帝问：治疗内腑病怎么办？
岐伯回答说：胃的合穴在足三里，大肠的合穴在巨虚上廉，小肠的合穴在巨虚下廉，三焦的合穴在委阳，膀胱的合穴在委中，胆的合穴在阳陵泉。
黄帝问：如何取穴？
岐伯回答说：取足三里，要低跗（脚背平放）取之；取巨虚，要举足取之；取委阳，要屈伸寻找；取委中，要屈膝取之；取阳陵泉，要正竖膝盖，与膝齐平，向下直至于委阳之阳取之。取用各条外经的穴位，要摇动伸展筋骨来寻找。
黄帝说：希望听听六腑的病证。
岐伯回答说：面部发热的，是足阳明胃经的病；鱼际络脉血的，是手阳明大肠经的病；两足背之上，脉坚陷下的，是足阳明胃经的病，这是胃脉。大肠病的症状，肠中切痛且鸣响，濯濯有声，冬天再次感寒，就发生泄泻，痛在脐旁，不能久立，与胃病同候，取巨虚上廉。胃病的症状，腹胀，胃脘当心而痛，上撑两胁，膈咽不通，饮食不下，取足三里。小肠病的症状，小腹痛，腰脊牵引睾丸而痛，时常窘迫于后阴，当耳前发热，或寒冷，或肩上特别热，以及手小指次指之间发热，或脉陷下，这是手太阳小肠经的病，取巨虚下廉。三焦病的症状，腹部气满，小腹尤其坚硬，小便不通，窘急溢出如水，留滞则为胀，征候在足太阳经之外的大络，大络在太阳、少阳之间，也见于脉象，取委阳。膀胱病的症状，小腹偏肿而痛，用手按压，就想小便却不得，肩上热，或脉陷下，以及足小趾外侧及胫踝后都热，或脉陷下，取委中。胆病的症状，喜欢叹气，口苦，呕吐宿汁，心慌胆怯，恐人将捕之，咽喉中窒塞感，频频吐唾，病在足少阳经的本末，也观察其脉之陷下者进行艾灸，有寒热的取阳陵泉。
黄帝问：针刺有法度吗？
岐伯回答说：针刺此等病症，必须中气穴，不要中肉节。中气穴则针感传导如入巷道，中肉节则皮肤痛。补泻反了，病就会加重。中筋则筋缓，邪气不出，与其真相搏结，混乱而不离去，反而向内附着。用针不审慎，以顺为逆啊。
Huangdi asked Qibo: How does pathogenic qi invade the human body?
Qibo replied: The invasion of pathogenic qi into the body has distinctions in high and low locations.
Huangdi asked: Is there a regularity to this highness and lowness?
Qibo said: The upper half of the body is mostly invaded by wind pathogens, while the lower half is mostly invaded by damp pathogens. Therefore, it is said that when pathogenic qi invades the body, there is no fixed constant location. If it enters the Yin meridians, it flows into the Fu organs; if it enters the Yang meridians, it flows into the channels.
Huangdi said: Yin and Yang have different names but are of the same category. They meet above and below, and the meridians interconnect like a circle without beginning or end. Pathogenic qi invading the body may enter the Yin meridians or the Yang meridians, with no constant pattern in the upper, lower, left, or right regions. What is the reason for this?
Qibo said: All intersections of the Yang meridians are located on the face. When pathogenic qi invades the body, it often takes advantage of times when the body's healthy qi is deficient, such as after strenuous exertion, or when pores (couli) are open due to sweating after eating or drinking. If the pathogen enters from the face, it descends into the Stomach Meridian of Foot-Yangming; if it enters from the nape, it descends into the Bladder Meridian of Foot-Taiyang; if it enters from the cheek, it descends into the Gallbladder Meridian of Foot-Shaoyang; if it enters from the chest, back, or flanks, it also descends into their respective meridians.
Huangdi asked: How does pathogenic qi invade the Yin meridians?
Qibo answered: Invasion into the Yin meridians usually begins at the inner aspect of the arm or leg. Because the skin on the inner arms and legs is thin, and the muscles are soft and lustrous, they are susceptible to wind pathogens and easily injure the Yin meridians alone.
Huangdi asked: Does this necessarily damage the Zang organs?
Qibo answered: When the body is attacked by wind pathogens, it does not necessarily affect the Zang organs. Therefore, when pathogenic qi enters a Yin meridian, because the Zang qi is substantial, the pathogen cannot take residence and thus returns to flow into the Fu organs. Thus, invasion of Yang leads to flow in the meridians, while invasion of Yin leads to flow in the Fu organs.
Huangdi asked: How does pathogenic qi invade the five Zang organs?
Qibo said: Sorrow and fear damage the Heart; exposure to cold and consumption of cold drinks damage the Lungs. This is because internal and external colds interact, injuring both interior and exterior, causing Qi to rebel and ascend. Falling injuries with retained blood stasis, or extreme anger causing Qi to rise and not descend, accumulating under the flanks, damages the Liver. Striking, falling, or sexual intercourse while drunk, sweating and exposed to wind, damages the Spleen. Heavy lifting, excessive sexual activity, or bathing in cold water while sweating, damages the Kidneys.
Huangdi asked: How do the five Zang organs contract wind pathogens?
Qibo said: Only when both Yin and Yang are affected by pathogens can the pathogen travel inward to the viscera.
Huangdi said: Well said.
Huangdi again asked Qibo: The head and face, along with the body and limbs, belong to bones connecting tendons, sharing blood and harmonizing with Qi. When the weather is cold, the earth cracks and ice forms. Sudden cold may cause limbs to become slack and weak, yet the face remains uncovered. Why is this?
Qibo answered: The twelve primary meridians and three hundred and sixty-five collaterals all carry Qi and Blood upward to the face and through the orifices. Pure Yang Qi ascends to the eyes for vision; separate Qi ascends to the ears for hearing; Zong Qi (Gathering Qi) ascends through the nose for smell; turbid Qi comes from the Stomach, ascending to the lips and tongue for taste. The fluids of these Qi all steam upward to the face. Moreover, the facial skin is thick and the muscles firm, so even extreme heat or cold cannot overcome it.
Huangdi asked: When pathogenic qi invades the body, what are the manifestations of the disease?
Qibo said: When false pathogens (Xu Xie) invade the body, they cause shivering and trembling of the form. When true pathogens (Zheng Xie) invade, the effect is slight; changes appear first in the complexion, with little bodily sensation, seeming present yet absent, existing yet non-existent, with unclear form, making it difficult to know the true condition.
Huangdi said: Well said.
Huangdi asked Qibo: I have heard that observing the complexion to know the disease is called "Ming" (Bright); palpating the pulse to know the disease is called "Shen" (Divine); asking about the disease to know its location is called "Gong" (Worker). I wish to hear how to observe, palpate, and inquire to fully understand the condition. How should this be done?
Qibo answered: Complexion, pulse, and Chi skin (skin of the forearm) correspond to each other, just like a drumstick and drum sound, or an object and its shadow; they must not lose connection. This is the manifestation of root and branch. If the root dies, the branches wither. Complexion, pulse, and physical form must not contradict each other. Knowing one aspect makes one a "Gong"; knowing two makes one "Shen"; knowing all three makes one both Shen and Ming.
Huangdi said: I wish to hear this in detail.
Qibo said: A green complexion corresponds to a wiry pulse; red to a hook-like pulse; yellow to a moderate pulse; white to a floating pulse; black to a sunken pulse. If the complexion is seen but the corresponding pulse is not found, and instead a controlling pulse is found, death will occur; if a generating pulse is found, the disease will resolve.
Huangdi asked: What are the pathological forms generated by the five Zang organs?
Qibo answered: First determine the correspondence between the five colors and five pulses, then the diseases can be distinguished.
Huangdi asked: Once complexion and pulse are determined, how to distinguish further?
Qibo said: By adjusting the examination of the Chi skin for tension, relaxation, smallness, largeness, slipperiness, and roughness, the pathology is determined.
Huangdi asked: How to examine?
Qibo said: If the pulse is tense, the Chi skin is also tense; if the pulse is relaxed, the Chi skin is also relaxed; if the pulse is small, the Chi skin is reduced and lacks Qi; if the pulse is large, the Chi skin bulges; if the pulse is slippery, the Chi skin is smooth; if the pulse is rough, the Chi skin is rough. These variations have degrees of severity. Therefore, one skilled in examining Chi skin needs not rely on the Cun Kou pulse; one skilled in examining the pulse need not rely on the complexion. One who combines all three can be considered a Superior Physician (Shang Gong), achieving nine cures out of ten; using two aspects makes a Middle Physician (Zhong Gong), seven cures out of ten; using only one aspect makes an Inferior Physician (Xia Gong), six cures out of ten.
Huangdi asked: Please describe the pathological forms corresponding to tense, relaxed, small, large, slippery, and rough pulses.
Qibo said: Let me speak of the pathologies of the five Zang organs. A severely tense Heart pulse indicates convulsions; mildly tense indicates heart pain radiating to the back and inability to eat. A severely relaxed Heart pulse indicates manic laughter; mildly relaxed indicates Fu Liang disease below the heart, moving up and down with bloody saliva. A severely large Heart pulse indicates throat obstruction; mildly large indicates Heart Bi with back pain and frequent tearing. A severely small Heart pulse indicates frequent hiccups; minimally small indicates Xiao Dao disease. A severely slippery Heart pulse indicates excessive thirst; mildly slippery indicates Heart Shan with umbilical radiation and abdominal borborygmi. A severely rough Heart pulse indicates aphonia; mildly rough indicates blood extravasation, limb coldness, tinnitus, and head disorders.
A severely tense Lung pulse indicates epilepsy; mildly tense indicates Lung cold-heat, lethargy, coughing blood, pain radiating to waist/back/chest, and nasal polyps. A severely relaxed Lung pulse indicates excessive sweating; mildly relaxed indicates Wei syndrome with hemihypohidrosis stopping only at the head. A severely large Lung pulse indicates shin swelling; mildly large indicates Lung Bi with back pain and aversion to sunlight. A severely small Lung pulse indicates diarrhea; minimally small indicates Xiao Dao disease. A severely slippery Lung pulse indicates Xi Ben with rebellious Qi; mildly slippery indicates bleeding from upper and lower orifices. A severely rough Lung pulse indicates vomiting blood; mildly rough indicates Shu Lou in the neck/axilla with lower body weakness and sluggish response.
A severely tense Liver pulse indicates irritable speech; mildly tense indicates Fei Qi mass under the flank like an inverted cup. A severely relaxed Liver pulse indicates frequent vomiting; mildly relaxed indicates Water Jian Bi. A severely large Liver pulse indicates internal abscess with vomiting blood/nosebleed; mildly large indicates Liver Bi with genital retraction and cough radiating to lower abdomen. A severely small Liver pulse indicates polydipsia; minimally small indicates Xiao Dao disease. A severely slippery Liver pulse indicates Hernia; mildly slippery indicates enuresis. A severely rough Liver pulse indicates Yi Yin; mildly rough indicates convulsions and tendon Bi.
A severely tense Spleen pulse indicates convulsions; mildly tense indicates Ge Zhong with regurgitation of food and salivary stool. A severely relaxed Spleen pulse indicates Wei syndrome; mildly relaxed indicates Feng Wei with limb paralysis but clear mind (due to dryness generating wind). A severely large Spleen pulse indicates sudden collapse; mildly large indicates Hernia with abdominal distension and pus/blood outside intestines. A severely small Spleen pulse indicates cold-heat; minimally small indicates Xiao Dao disease. A severely slippery Spleen pulse indicates Long Bi; mildly slippery indicates insect toxin/stinging with abdominal heat. A severely rough Spleen pulse indicates intestinal ulceration; mildly rough indicates internal abscess with purulent bloody stool.
A severely tense Kidney pulse indicates bone epilepsy; mildly tense indicates deep厥 (Jue), Ben Tun, foot inability to support, and urinary/fecal retention. A severely relaxed Kidney pulse indicates spinal fracture pain; mildly relaxed indicates Dong Xie (food passing undigested and regurgitated). A severely large Kidney pulse indicates impotence; mildly large indicates Shi Shui with swelling from navel to stomach, which is fatal. A severely small Kidney pulse indicates Dong Xie; minimally small indicates Xiao Dao disease. A severely slippery Kidney pulse indicates Long Bi; mildly slippery indicates Bone Wei with inability to sit/rise and visual impairment. A severely rough Kidney pulse indicates large abscess; mildly rough indicates amenorrhea and hemorrhoids.
Huangdi asked: Regarding the six variations of disease (tense, relaxed, large, small, slippery, rough), how should acupuncture be applied?
Qibo answered: Tense conditions mostly involve Cold; relaxed conditions mostly involve Heat; large conditions involve excess Qi and deficient Blood; small conditions involve deficiency of both Qi and Blood; slippery conditions involve excess Yang Qi with slight Heat; rough conditions involve deficient Qi and Blood with slight Cold. Therefore, for tense conditions, needle deeply and retain long; for relaxed conditions, needle shallowly and withdraw quickly to dispel Heat; for large conditions, slightly drain Qi without bleeding; for slippery conditions, withdraw quickly and needle shallowly to drain Yang Qi and Heat; for rough conditions, ensure needle enters the vessel, follow Qi direction, retain long, massage beforehand, and press acupoint quickly after withdrawal to prevent bleeding and harmonize vessels. For small conditions, where Yin/Yang and Form/Qi are both deficient, do not use needles but regulate with sweet medicines.
Huangdi said: I have heard that Qi of the five Zang and six Fu organs enters at Ying and Shu points and converges at He points. From what pathway do they enter? Where do they connect and pass? Please explain.
Qibo answered: These are the divergent branches of Yang meridians entering the interior and belonging to the Fu organs.
Huangdi asked: Do Ying, Shu, and He points have specific names?
Qibo answered: Ying and Shu points treat exterior meridian diseases; He points treat interior Fu organ diseases.
Huangdi asked: How to treat Fu organ diseases?
Qibo answered: Use the He points.
Huangdi asked: What are the names of the He points?
Qibo answered: Stomach He point is Zusanli (ST36); Large Intestine He point is Shangjuxu (ST37); Small Intestine He point is Xiajuxu (ST39); San Jiao He point is Weiyang (BL39); Bladder He point is Weizhong (BL40); Gallbladder He point is Yanglingquan (GB34).
Huangdi asked: How to locate them?
Qibo answered: For Zusanli, place the foot flat; for Juxu points, lift the foot; for Weiyang, flex and extend to find; for Weizhong, flex the knee; for Yanglingquan, stand knee upright level with the knee, extending down to the Yang side of Weiyang. For exterior meridians, shake and stretch the bones to locate.
Huangdi said: I wish to hear about diseases of the six Fu organs.
Qibo answered: Facial heat indicates Foot-Yangming disease; blood in fish-mouth collateral indicates Hand-Yangming disease; hard/depressed pulse on dorsum of foot indicates Foot-Yangming disease (Stomach meridian). Large Intestine disease presents as cutting abdominal pain with borborygmi, worse in winter cold, diarrhea around navel, inability to stand long; treat Shangjuxu. Stomach disease presents as abdominal distension, epigastric pain radiating to flanks, blocked throat/esophagus, inability to eat; treat Zusanli. Small Intestine disease presents as lower abdominal pain radiating to loin/testicles, urgency in defecation, heat in ear/front of shoulder/small finger; treat Xiajuxu. San Jiao disease presents as abdominal fullness, hard lower abdomen, urinary retention leading to edema/distension; treat Weiyang. Bladder disease presents as unilateral lower abdominal swelling/pain, urge to urinate but unable, heat in shoulder/lower leg/little toe; treat Weizhong. Gallbladder disease presents with sighing, bitter taste, vomiting old bile, palpitations/fear, sore throat with frequent spitting; moxa depressed vessels or treat Yanglingquan for cold/heat.
Huangdi asked: Is there a method for acupuncture?
Qibo answered: Acupuncture must hit the Qi acupoints, not flesh joints. Hitting Qi acupoints allows needle sensation to spread like entering a lane; hitting flesh joints causes skin pain. Incorrect tonification/sedation worsens the disease. Hitting tendons causes flaccidity; pathogenic qi remains and binds internally. Unskilled acupuncture reverses natural order.