阳中之少阴 肺也 张云。心肺居于膈上。皆为阳脏。而肺则阳中之阴。故曰少阴。
太渊 马云 掌后陷中。肺脉所注。为俞土。阴经无原。俞穴代之。余仿此。
阳中之太阳 心也 张云。心为阳中之阳。故曰太阳。
大陵 张云。按大陵系手厥阴心主 穴也。邪客篇帝曰。手少阴之脉。独无俞何也。岐伯曰。少
阴心脉也。心者。五脏六腑之大主也。精神之所舍也。其脏坚固。邪弗能容也。容之则心伤。心伤则神去。神
去则死矣。故诸邪之在于心者。皆在于心之包络。包络者。心主之脉。故此言大陵也。大陵二穴。在掌后骨下
两筋间。
阴中之少阳 肝也 张云。肝、脾、肾、居于膈下。皆为阴脏。而肝则阴中之阳。故曰少阳。
太冲 马云。足大趾本节后二寸动脉应手陷中。肝脉
所注。为俞土。
阴中之至阴 脾也 张云。脾属土而象地。故为阴中之至阴。
太白 马云。足大趾内侧内踝前核骨下陷中。脾脉所注。为俞土。
阴中之太阴 肾也 张云。肾在下而属水。故为阴中之太阴。
太溪 马云。足内踝后跟骨上动脉陷中。男子妇人病。有此脉则生。无则死。肾脉所注。为俞土。
膏之原 志云。中焦之气。蒸津液。化其精微。发泄于腠理。淖泽注于骨。补益脑髓。润泽皮肤。
是津液注于三百六十五节。而渗灌于皮肤肌腠者也。溢于外则皮肉膏肥。余于内则膏肓丰满。盖膏者脏腑之膏
膜。肓者肠胃之募原也。简案、左传成公十年。居肓之上。膏之下。杜云。肓、膈也。心下为膏。正义曰。贾
服何休诸儒等。皆以为膏。虽凝者为脂。释者为膏。其实凝者亦曰膏。内则云。小切野狼 膏。此膏为连心脂膏
也。独刘炫以为膏当作膈。改易传文。以规杜之失。傅逊辨误云。考素问刺禁论云。膈肓之上。中有父母。杨
上善说云。心下膈上为肓。心为阳。父也。肺为阴。母也。曾亲谛观猪脏心膈之处。方忆膈者隔也。自膈以上。
皆心肺清洁之属。自膈以下。皆肠胃污浊之属。而心下有微脂为膏。膈上有薄膜为肓也。素问曰膈肓。则明云
膈之肓也。膈之肓。非其膜而何。其痹论又云。皮肤之中。分肉之间。熏于肓膜。注云。肓膜谓五脏之间膈中
膜也。则正与心下之微脂相对益明矣。二竖居膏肓之上下。则于腑脏。略无所系。为至虚之处。非经络穴道所
关。以故攻之不可。达之不及。药不至焉也。春秋元命苞云。膏者神之液也。
介按、膏肓之义。惟前哲唐容川。时贤张锡纯之解释。甚为详晰。兹节录如下。
唐云。凡有膜网处。无论上中下及内外膜网。其上皆生膏油。左传所谓膏肓也。肓言其膜。属三焦之物。
膏即言其油。乃属于脾。凡化水化谷。皆是膏油发力以薰吸之。所谓脾主利水化食者如此。而其路道。则总在
中焦之膜中也。此膜着背脊处上行至肝。是为肝膈。肝膈半在体上。半在膈下。膈发于肝。循肋骨而至胸前之
鸠尾。下遮浊气。上护心肺。为阴阳之界限。肝气之通于膈。以入肠胃。走血室。路道皆在膈膜与中下之油网
中也。张云。素问刺禁篇曰。膈肓之上。中有父母。是肓即膈也。又灵枢九针十原论曰。膏之原出于鸠尾。夫
鸠尾之内。即膈。乃三焦之上焦。为手少阳之腑。与手厥阴心包脏腑相连。互为配偶。心包者。即心肺相连之
系。其体质原系脂膜。脂即膏也。传既云。居肓之上。膏之下。是其病定在胸中无疑。特是胸中之地。大气之
所贮藏也。虽不禁针。然止可针三二分。不敢作透针。以泻大气。故曰攻之不可。其外又皆硬骨卫护。不能用
砭。故曰达之不及。又其处为空旷之腑。上不通咽喉。下有膈膜承之。与膈下脏腑。亦不相通。故曰药不至焉。
所以不可为也。
鸠尾 马云。一名尾翳。一名 KT 。蔽骨之端。在臆前蔽骨之下五分。人无蔽骨者。从歧骨下一寸。
言其骨垂下如鸠尾。
肓之原 志云。肓者肠胃之募原也。简案、腹中论云。此风根也。其气溢于大肠。而着于肓。肓之
原在脐下。刺禁论云。膈肓之上。中有父母。杨注。心下膈上为肓。痹论云。陷于肓膜。王注。肓膜谓五脏之
间。膈中之膜也。胀论云。熏于肉肓。而中气穴。杂病篇云。上冲肠胃。熏肝。散于肓。
结于脐。故取之肓原以散之。据以上经文考之。肓即膈膜也。而脏腑之间。悉有薄膜。其于躯壳中。遮隔浊气。
最有用者为膈膜。故单言肓。则指膈膜。张注痹论云。肓者。凡腔腹肉理之间。上下空隙之处。皆谓之肓。然
史扁鹊传。搦荒说苑。作肓莫。即肓膜也。空隙之处。安得搦之。肓自肓。原自原。安得释肓以膜原。二张之
解。俱不可从。
脖 马云。一名下气海。一名下肓。脐下一寸半宛宛中。男子生气之海。（出于甲乙）简案、玉
篇脖 。脐也。犹天枢即脐。而其穴则在侠脐两膀各一寸邪。 张云。上文五脏之原各二。并膏肓之原共
为十二。而脏腑表里之气皆通于此。故可以治五脏六腑之有疾者也。简案、本篇止言五脏之原。而不言六腑。
乃以鸠尾、脖 足之。马氏因引六十六难六腑之原以为悉。然而此本于经文别发一义者。乃不可以彼律此。
胀取三阳 飧泄取三阴 甲乙飧泄作滞。张云。胀、腹胀也。飧泄、完谷不化也。病胀者。当取
足之三阳。即胃、胆、膀胱、三经也。飧泄者。当取足之三阴。即脾、肝、肾、三经也。简案、甲乙滞盖谓滞
下。亦作HT 。（释名 。羲之帖）即痢病也。
闭 马本作HT 云HT 。读为闭。志云。HT 音卞。搏也简案、玉篇HT 。俗闭字。HT 字书无考。
夫善用针者 止未得其术也 张云。此详言疾虽久。而血气未败者。犹可以针治之。故善用针
者。犹拔刺也。去刺于肤。贵轻捷也。犹雪污也。污染营卫。贵净涤也。犹解结也。结留关节。贵释散也。犹
决闭也。闭塞道路。贵开通也。四者之用。各有精妙。要在轻摘其邪。而勿使略伤其正气耳。故特举此为谕。
若能效而用之。则疾虽久。未有不愈者矣。张兆璜云。污在皮毛。刺在肤肉。结在血脉。HT 在筋
骨。简案、雪、洗也。庄子知北游。澡雪而精神。
如以手探汤 张云。用在轻扬。热属阳。阳主于外。故治宜如此。
如人不欲行 张云。有留恋之意也。阴寒凝滞。得气不易。故宜留针若此。
阴有阳疾者 张云。热在阴分也。
下陵三里 马云。足阳明胃经穴。即三里。系四字一名。
无殆 张云。殆、怠同。简案、老子周行而不怠。释文殆、怠也。
气下 张云。邪气退也。
疾高而内者 张云。在上也当下取之。然高而内者属脏。故当取足太阴之阴陵泉。
疾高而外 张云。属腑。故当取足少阳之阳陵泉也。
阳中的少阴，是肺。张云：心和肺居于膈肌之上，都属于阳脏，但肺则是阳中之阴，所以称为少阴。
太渊穴。马云：位于手腕后方凹陷处，是肺经脉气所注之处，五行属土。阴经没有原穴，由俞穴代替，其余仿照此例。
大陵穴。张云：按大陵穴属于手厥阴心包经的穴位。《邪客》篇中黄帝问：手少阴心经唯独没有俞穴，为什么呢？岐伯回答：手少阴是心脉。心是五脏六腑的大主宰，是精神寄居的地方。它的脏器坚固，邪气不能容纳。如果邪气进入就会损伤心脏，心脏受损则神气离去，神气离去就会死亡。所以凡是邪气在心部的，都在于心包络。心包络，就是心主的经脉，所以这里说的是大陵穴。大陵穴有两个，位于手腕后方骨头下、两根筋之间的凹陷处。
阴中的少阳，是肝。张云：肝、脾、肾居于膈肌之下，都属于阴脏，但肝则是阴中之阳，所以称为少阳。
太冲穴。马云：位于足大趾本节后方二寸，动脉应手的凹陷处，是肝经脉气所注之处，五行属土。
阴中的至阴，是脾。张云：脾属土而象征大地，所以称为阴中的至阴。
太白穴。马云：位于足大趾内侧，内踝前核骨下的凹陷处，是脾经脉气所注之处，五行属土。
阴中的太阴，是肾。张云：肾在下部且属水，所以称为阴中的太阴。
太溪穴。马云：位于足内踝后方跟骨上方的动脉凹陷处。男子或女子患病，如果有此脉搏跳动则生，没有则死。这是肾经脉气所注之处，五行属土。
膏的原穴。志云：中焦的气，蒸腾津液，化生精微物质，发泄于腠理，滋润注入骨骼，补益脑髓，润泽皮肤。这就是津液注入三百六十五个关节，并渗透灌注于皮肤肌腠的原因。溢出在外的则使皮肉膏脂肥厚，剩余在内部的则使膏肓丰满。大概“膏”是指脏腑表面的膏膜，“肓”是指肠胃之间的募原。简案：《左传·成公十年》记载：“病在肓之上，膏之下。”杜预注解说：“肓是膈，心下面是膏。”正义说：贾逵、服虔、何休等儒家学者都认为，虽然凝固的叫脂，融化的叫膏，其实凝固的也称为膏。《礼记·内则》说：“切细野狼膏。”这个膏是连心的脂膏。只有刘炫认为“膏”应当作“膈”，修改了《左传》的文字，以指责杜预的错误。傅逊辨析错误说：考察《素问·刺禁论》说：“膈肓之上，中有父母。”杨上善解释说：心下膈上是肓。心为阳，是父；肺为阴，是母。我曾仔细观察猪的心脏和膈膜部位，才想起膈是隔断的意思。自膈以上，都是心肺清洁所属的部分；自膈以下，都是肠胃污浊所属的部分。而心下有微薄的脂肪称为膏，膈上有薄膜称为肓。《素问》说“膈肓”，明确说是膈的肓。膈的肓，不是那层膜又是什么？《痹论》又说：“皮肤之中，分肉之间，熏于肓膜。”注解说：肓膜指五脏之间膈中的膜。这就正与心下的微薄脂肪相对，更加明确了。两个竖子（病魔）居住在膏肓的上下，那么对于脏腑，稍微没有什么关联，这是最虚弱的地方，不属于经络穴道所管辖的范围。因此攻伐不可，通达不及，药物也达不到那里。《春秋元命苞》说：膏是神的液体。
介按：关于膏肓的含义，只有前哲唐容川和时贤张锡纯的解释非常详细清晰。兹摘录如下。
唐云：凡是有膜网的地方，无论上中下及内外膜网，其上面都生长着膏油，这就是《左传》所说的膏肓。“肓”指那层膜，属于三焦的事物；“膏”指那层油，乃属于脾。凡是化水化谷，都是依靠膏油的发力来薰吸，所谓脾主利水化食就是如此。而其路道，则总在中焦的膜中。这膜附着在背脊处上行至肝，这叫肝膈。肝膈一半在体上，一半在膈下。膈发源于肝，沿着肋骨到达胸前的鸠尾，下遮浊气，上护心肺，是阴阳的界限。肝气通过膈进入肠胃，走血室，路道都在膈膜与中下的油网中。
张云：《素问·刺禁篇》说：“膈肓之上，中有父母。”这说明肓即膈。又《灵枢·九针十原论》说：“膏的原穴出于鸠尾。”夫鸠尾之内，即是膈，乃三焦的上焦，是手少阳之腑，与手厥阴心包脏腑相连，互为配偶。心包，就是心肺相连的系统，其体质原本是脂膜，脂就是膏。《左传》既说：“居肓之上，膏之下”，那么其病定在胸中无疑。只是胸中之地，是大气所贮藏的地方。虽然不禁针，然而只可针刺二三分，不敢做透针，以免泻掉大气。所以说“攻之不可”。其外部又有硬骨卫护，不能用砭石，所以说“达之不及”。又因为此处是空旷之腑，上不通咽喉，下有膈膜承托，与膈下的脏腑也不相通，所以说“药不至焉”。所以不可治疗。
鸠尾穴。马云：一名尾翳，一名KT。蔽骨的末端，在臆前蔽骨下方五分。没有人有蔽骨者，从歧骨下一寸。形容其骨垂下像鸠鸟的尾巴。
肓的原穴。志云：肓是肠胃的募原。简案：《腹中论》说：“这是风根。其气溢于大肠，而附着于肓。肓的原穴在脐下。”《刺禁论》说：“膈肓之上，中有父母。”杨注：心下膈上是肓。《痹论》说：“陷于肓膜。”王注：肓膜指五脏之间，膈中的膜。《胀论》说：“熏于肉肓，而中气穴。”《杂病篇》说：“上冲肠胃，熏肝，散于肓，结于脐。”所以取肓的原穴来消散它。根据以上经文考证，肓就是膈膜。而脏腑之间，都有薄膜。其在躯壳中，遮蔽隔绝浊气，最有用的就是膈膜。所以单言“肓”，则指膈膜。张注《痹论》说：“肓，凡腔腹肉理之间，上下空隙之处，都叫做肓。”然而《史记·扁鹊传》、《说苑》写作“肓莫”，即“肓膜”也。空隙之处，怎么能搦（捏/按摩）呢？“肓”自是“肓”，“原”自是“原”，怎么能解释“肓”为“膜原”？张氏和二张的解释，都不可以听从。
脖骶（原文缺字，据上下文推测为“肓腧”或类似穴位名，此处依原文字形处理，通常指石门或相关穴位，但原文显示为“脖 ”，结合下文“下气海”、“下肓”，应为石门穴或类似描述，此处保留原文空缺感或译为对应位置）。马云：一名下气海，一名下肓。脐下一寸半的宛宛中。是男子生气之海。（出自《甲乙经》）。简案：《玉篇》解释“脖”为脐。犹天枢即脐，而其穴位则在侠脐两膀各一寸处。张云：上文五脏的原穴各两个，加上膏肓的原穴共为十二个，而脏腑表里之气都通于此，所以可以治疗五脏六腑的疾病。简案：本篇只讲五脏的原穴，而不讲六腑，是用鸠尾、脖骶来补足。马氏因此引用《难经·六十六难》中六腑的原穴作为完备。然而这是经文另外阐发一个义理的，不可以用那个标准来衡量这个。
胀病取三阳经，飧泄取三阴经。《甲乙经》中“飧泄”作“滞”。张云：胀，是腹胀。飧泄，是完谷不化。患胀病的人，应当取足之三阳经，即胃、胆、膀胱这三条经。患飧泄的人，应当取足之三阴经，即脾、肝、肾这三条经。简案：《甲乙经》中的“滞”大概指滞下，也写作HT。（《释名》、羲之帖），即痢疾。
闭（原文作HT ）。马本作HT 。云HT 读为闭。志云：HT 音卞，搏也。简案：《玉篇》HT 是俗写的“闭”字。HT 字书无考。
善于使用针的人，还没有掌握其技艺。张云：这是详细说明疾病虽然长久，但血气尚未败坏，仍然可以用针治疗。所以善于使用针的人，就像拔刺一样，去除皮肤上的刺，贵在轻捷。就像洗去污垢一样，污染了营卫，贵在净涤。就像解开绳结一样，结留在关节，贵在释散。就像决开闭塞一样，闭塞道路，贵在开通。这四种用途，各有精妙，关键在于轻轻摘除邪气，而不使略微伤及正气。所以特别举这些来做比喻。如果能效法并运用它，那么疾病即使长久，也没有不痊愈的。张兆璜说：污在皮毛，刺在肤肉，结在血脉，HT （闭）在筋骨。简案：雪，是洗的意思。《庄子·知北游》：“澡雪而精神。”
如以手探汤。张云：用在轻扬。热属阳，阳主于外，所以治疗应该如此。
如人不欲行。张云：有留恋之意。阴寒凝滞，得气不容易，所以适宜留针像这样。
无殆。张云：殆、怠同义。简案：《老子》：“周行而不怠。”释文：殆、怠也。
The Shaoyin (Lesser Yin) within the Yang is the Lung. Zhang Yun: The Heart and Lung reside above the diaphragm and both are considered Yang Zang organs, but the Lung is Yin within Yang; therefore, it is called Shaoyin.
Taiyuan (LU-9). Ma Yun: Located in the depression behind the palm, this is where the Lung meridian qi pours in, corresponding to Earth in the Five Phases. Yin meridians lack Yuan (Source) points, so Shu (Stream) points substitute for them; other cases follow this pattern.
The Taiyang (Greater Yang) within the Yang is the Heart. Zhang Yun: The Heart is Yang within Yang; therefore, it is called Taiyang.
Daling (PC-7). Zhang Yun: Daling belongs to the Pericardium Meridian of Hand-Jueyin. In the chapter "Xie Ke" (Invading Pathogens), the Yellow Emperor asked: "Why does the Hand-Shaoyin Heart Meridian alone lack Shu points?" Qibo replied: "Hand-Shaoyin is the Heart meridian. The Heart is the great master of the five Zang and six Fu organs, the residence of the Spirit. Its organ is solid, and pathogens cannot accommodate themselves within it. If they do, the Heart is damaged; if the Heart is damaged, the Spirit departs; if the Spirit departs, death ensues. Therefore, any pathogen affecting the Heart actually affects the Pericardium. The Pericardium is the meridian of the Heart Master; hence, this refers to Daling." There are two Daling points, located in the depression between the two tendons below the bone at the back of the palm.
Shaoyin (Lesser Yang) within the Yin is the Liver. Zhang Yun: The Liver, Spleen, and Kidney reside below the diaphragm and are all considered Yin Zang organs, but the Liver is Yang within Yin; therefore, it is called Shaoyang.
Taichong (LR-3). Ma Yun: Located two cun posterior to the root of the big toe, in the depression where the arterial pulse is palpable, this is where the Liver meridian qi pours in, corresponding to Earth.
Zhiyin (Extreme Yin) within the Yin is the Spleen. Zhang Yun: The Spleen belongs to Earth and symbolizes the ground; therefore, it is called Zhiyin within Yin.
Baiquan (SP-3). Ma Yun: Located on the medial side of the big toe, in the depression anterior to the medial malleolus and below the bony prominence, this is where the Spleen meridian qi pours in, corresponding to Earth.
Taiyin (Greater Yin) within the Yin is the Kidney. Zhang Yun: The Kidney is located inferiorly and belongs to Water; therefore, it is called Taiyin within Yin.
Taixi (KI-3). Ma Yun: Located in the depression of the arterial pulse above the calcaneus behind the medial malleolus. For men or women suffering from disease, life is indicated if this pulse is present, and death if absent. This is where the Kidney meridian qi pours in, corresponding to Earth.
Yuan Point of Gao (Fatty Tissue). Zhi Yun: Qi of the Middle Jiao steams fluids, transforming them into essence and subtle nutrients. These are exuded into the couli (interstices), moisten and pour into the bones, nourish the brain marrow, and lubricate the skin. Thus, fluids pour into the three hundred and sixty-five joints and seep into the skin and muscle interstices. Overflowing outward, they make the flesh and fatty tissue plump; remaining inward, they fill the Gao and Huang. Generally, "Gao" refers to the fatty membranes of the Zang organs, while "Huang" refers to the Mu-Yuan (source/primal) areas between the intestines and stomach. Brief Commentary: In *Zuo Zhuan*, Duke Cheng, Year 10, it is recorded: "The disease resides above the Huang and below the Gao." Du Yu commented: "Huang is the diaphragm; below the heart is Gao." The Correct Meaning states that scholars like Jia Kui, Fu Qian, and He Xiu agreed that although solidified fat is called Zhi and liquefied fat is called Gao, solidified fat is also termed Gao. *Li Ji · Nei Ze* mentions "cutting wild wolf Gao," referring to the fatty tissue connected to the heart. Only Liu Xuan argued that "Gao" should be read as "Diaphragm," altering the text to criticize Du Yu. Fu Xun refuted this by citing *Su Wen · Ci Jin Lun*: "Above the Diaphragm and Huang, there are Father and Mother." Yang Shangshan explained: "Below the heart and above the diaphragm is Huang. Heart is Yang, the Father; Lung is Yin, the Mother." After carefully observing pig hearts and diaphragms, I recalled that the Diaphragm acts as a partition. Above the diaphragm are the clean parts of the Heart and Lung; below are the turbid parts of the intestines and stomach. Below the heart lies thin fat called Gao, and above the diaphragm lies a thin membrane called Huang. *Su Wen* says "Diaphragm-Huang," clearly meaning the Huang of the diaphragm. What else could the Huang of the diaphragm be but that membrane? *Bi Lun* further states: "Between the skin and muscles, warming the Huang membrane." The commentary notes: "Huang membrane refers to the membranes between the five Zang organs within the diaphragm." This aligns perfectly with the thin fat below the heart. The two "Shu" (demons) residing above and below Gao and Huang have little connection to the Zang-Fu organs; it is the most deficient area, unrelated to meridians and acupoints. Hence, attack is impossible, penetration cannot reach it, and medicine does not arrive. *Chunqiu Yuanming Bao* states: "Gao is the fluid of the Spirit."
Jie's Note: Regarding the meaning of Gao and Huang, only the explanations by former scholar Tang Rongchuan and contemporary Zhang Xichun are very detailed and clear. Excerpts are as follows.
Tang Yun: Wherever there are membranous networks, whether superior, middle, inferior, internal, or external, fat oil grows on top. This is what *Zuo Zhuan* calls Gao and Huang. "Huang" refers to the membrane, belonging to the Sanjiao; "Gao" refers to the oil, belonging to the Spleen. All processes of transforming water and grain rely on the power of Gao oil for absorption and warming. This is why the Spleen governs the promotion of water metabolism and food digestion. The pathways lie entirely within the membranes of the Middle Jiao. This membrane attaches to the spine and ascends to the Liver, forming the Liver-Diaphragm. Half of the Liver-Diaphragm is above the body surface, half below the diaphragm. The Diaphragm originates from the Liver, follows the ribs to the Jiweil point at the chest front, shields turbid Qi downward, and protects the Heart and Lung upward, serving as the boundary between Yin and Yang. Liver Qi passes through the Diaphragm to enter the intestines and stomach and travel to the Blood Chamber; these pathways are all within the Diaphragm membrane and the oil networks of the Middle and Lower Jiao.
Zhang Yun: *Su Wen · Ci Jin Pian* states: "Above the Diaphragm and Huang, there are Father and Mother." This indicates Huang is the Diaphragm. Also, *Ling Shu · Jiu Shi Yuan Lun* states: "The Yuan point of Gao emerges from Jiweil." Inside Jiweil is the Diaphragm, which is the Upper Jiao of the Sanjiao, the Fu organ of Hand-Shaoyang, connected to the Hand-Jueyin Pericardium Zang-Fu pair. The Pericardium is the system connecting the Heart and Lung, originally composed of fatty membranes; fat is Gao. Since *Zuo Zhuan* says "above Huang, below Gao," the disease is undoubtedly in the chest. However, the chest is where Great Qi is stored. Although needling is not strictly forbidden, one may only needle two or three fen, avoiding penetrating needles to prevent draining Great Qi. Hence, "attack is impossible." Hard bones protect the exterior, preventing the use of Bian stones; hence, "penetration cannot reach it." Furthermore, this is an empty Fu organ, not communicating with the throat above nor with the Zang-Fu below the diaphragm; hence, "medicine does not arrive." Thus, it is incurable.
Jiweil (CV-15). Ma Yun: Also known as Wei Yi or KT. It is at the end of the xiphoid process, five fen below the xiphoid process anterior to the sternum. In individuals without a xiphoid process, locate it one cun below the bifurcation of the sternum. The bone hangs down like the tail of a turtledove.
Yuan Point of Huang. Zhi Yun: Huang is the Mu-Yuan of the intestines and stomach. Brief Commentary: *Fu Zhong Lun* states: "This is the root of wind. Its Qi overflows into the large intestine and adheres to Huang. The Yuan point of Huang is below the umbilicus." *Ci Jin Lun* states: "Above the Diaphragm and Huang, there are Father and Mother." Yang's commentary: "Below the heart and above the diaphragm is Huang." *Bi Lun* states: "Sinking into the Huang membrane." Wang's commentary: "Huang membrane refers to the membranes between the five Zang organs within the diaphragm." *Zhang Lun* states: "Warming the muscular Huang, hitting the Qi points." *Za Bing Pian* states: "Rushing up to the intestines and stomach, warming the Liver, dispersing into Huang, knotting at the umbilicus." Therefore, take the Yuan point of Huang to disperse it. Based on these texts, Huang is the diaphragmatic membrane. Membranes exist between all Zang-Fu organs. Among those shielding turbid Qi within the body shell, the diaphragmatic membrane is the most useful. Thus, when speaking solely of "Huang," it refers to the diaphragmatic membrane. Zhang's commentary on *Bi Lun* states: "Huang refers to any void spaces between the cavities, abdominal walls, and muscle textures, above and below." However, *Shiji · Bian Que Zhuan* and *Shuo Yuan* write "Huang Mo," i.e., "Huang membrane." How can one massage a void space? "Huang" is Huang, and "Yuan" is Yuan; how can one explain Huang as "Membrane-Original"? Both interpretations by Zhang are unacceptable.
Neiguan/Shimen (Text has missing character "脖 ", likely referring to Shimen or similar lower abdomen point based on context "Lower Qi Sea"). Ma Yun: Also known as Xia Qi Hai or Xia Huang. Located in the depression 1.5 cun below the umbilicus. It is the sea of vital Qi for men (from *Jia Yi Jing*). Brief Commentary: *Yu Pian* defines "Neiguan" as the umbilicus. Just as Tianshu is the umbilicus, its acupoint is one cun lateral to the umbilicus on both sides. Zhang Yun: The Yuan points of the five Zang mentioned above are two each, plus the Yuan points of Gao and Huang, totaling twelve. The Qi of the interior and exterior of the Zang-Fu pairs all connect here, allowing treatment of diseases of the five Zang and six Fu. Brief Commentary: This chapter only discusses the Yuan points of the five Zang, not the six Fu, supplementing them with Jiweil and [Missing Character]. Ma cited the Yuan points of the six Fu from *Nan Jing · Chapter 66* to complete the list. However, this derives from a separate meaning developed in the classic text and cannot be judged by the standard of the other.
For distension, select the Three Yang meridians; for undigested stool diarrhea (Sun Xie), select the Three Yin meridians. *Jia Yi Jing* reads "Sun Xie" as "Zhi" (Stagnation). Zhang Yun: Distension refers to abdominal fullness. Sun Xie refers to undigested food in stool. For distension, one should select the Foot-Taiyang, Foot-Shaoyang, and Foot-Yangming meridians (Stomach, Gallbladder, Bladder). For Sun Xie, one should select the Foot-Taiyin, Foot-Jueyin, and Foot-Shaoyin meridians (Spleen, Liver, Kidney). Brief Commentary: "Zhi" in *Jia Yi Jing* likely refers to dysentery (also written as HT, see *Shi Ming* and calligraphy of Wang Xizhi).
Bi (Closed/Obstructed). Ma's version uses HT. It reads HT as Bi. Zhi Yun: HT sounds like "Bian," meaning to beat/pulse. Brief Commentary: *Yu Pian* states HT is the vulgar form of "Bi." HT is unattested in dictionaries.
One who skillfully uses needles... has not yet mastered the technique. Zhang Yun: This elaborates that even if a disease is chronic, if the blood and Qi have not failed, it can still be treated with needles. Thus, a skilled needle practitioner is like pulling out a thorn: removing a thorn from the skin requires lightness and speed. It is like washing dirt: cleansing the Ying and Wei requires thorough purification. It is like untying a knot: resolving knots in the joints requires loosening. It is like opening a blockage: clearing blocked pathways requires unblocking. Each of these four applications has subtleties; the key is to gently remove the pathogen without slightly injuring the Zheng Qi (Upright Qi). These are used as metaphors. If one can emulate and apply them, even long-standing diseases will surely heal. Zhang Zhaohuang said: Dirt is in the skin and hair; thorns are in the flesh; knots are in the blood vessels; Bi (obstruction) is in the sinews and bones. Brief Commentary: "Snow" means to wash. *Zhuang Zi · Zhi Bei You*: "Bathe the spirit in snow."
Like dipping a hand into hot water. Zhang Yun: Applied with lightness and rising action. Heat belongs to Yang, and Yang governs the exterior; thus, treatment should be conducted thusly.
Like a person unwilling to walk. Zhang Yun: Indicates lingering intent. Yin-cold stagnation makes obtaining De Qi difficult; thus, retaining the needle is appropriate as described.
Yin having Yang pathology. Zhang Yun: Heat in the Yin division.
Xialing Sanli. Ma Yun: An acupoint of the Foot-Yangming Stomach Meridian, i.e., Zusanli. A four-character name.
Wu Dai. Zhang Yun: Dai is synonymous with Dai (sluggish/lazy). Brief Commentary: *Laozi*: "Circulates without slackening." Commentary: Dai means slackening.
Qi descends. Zhang Yun: Pathogenic Qi retreats.
Pathology high and internal. Zhang Yun: Located superiorly, treat by selecting points inferiorly. However, high and internal pathology belongs to the Zang; therefore, select Yinlingquan (SP-9) of the Foot-Taiyin Spleen Meridian.
Pathology high and external. Zhang Yun: Belongs to the Fu; therefore, select Yanglingquan (GB-34) of the Foot-Shaoyang Gallbladder Meridian.