(《素问·水热穴论》)
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。(治热之法,本有不同,故欲并闻
其意。)岐伯曰∶头上五行、行五者,以越诸阳之热逆也。(头上五行者,督脉在中,旁四行,足太阳经也。中行五穴∶
上星、囟会、前项、百会、后顶也。次两旁二行各五穴∶五处、承光、通天、络却、玉枕也。又次两旁二行各五穴∶临
泣、目窗、正营、承灵、脑空也。五行共二十五穴,俱在巅顶之上,故可散越诸阳热气之逆于上者。)大杼、膺俞、缺盆、
背俞,此八者,以泻胸中之热也。(大杼,足太阳经穴。膺俞,中府也,手太阴经穴。缺盆,足阳明经穴。背俞,风门也,
一名热府。此八穴皆在胸之前后,故可泻胸中之热。)气街、三里、巨虚上下廉,此八者,以泻胃中之热也。(气冲、三
里、巨虚上廉、下廉,此八者俱足阳明经穴,故可泻胃中之热。)云门、 骨、委中、髓空,此八者,以泻四肢之热也。
(云门,手太阴经穴。 骨即肩 ,手阳明经穴。委中,足太阳经穴。髓空,即腰俞,督脉穴。云门、 骨连手,委中、
髓空连足,故此八穴可泻四肢之热。空,孔同。五脏俞旁五,此十者,以泻五脏之热也。(五脏俞旁五穴∶肺俞之旁,魄
户也;心俞之旁,神堂也;肝俞之旁,魂门也;脾俞之旁,意舍也;肾俞之旁,志室也。皆足太阳经穴。凡五脏之系,
咸附于背,故此十者,可泻五脏之热。)凡此五十九穴者,皆热之左右也。(又五十九穴,详后篇。)帝曰∶人伤于寒而传
为热何也?岐伯曰∶夫寒盛则生热也。(寒邪外束,则阳气内郁,故传而为热,所以寒盛则生热也。然则外感发热者,
因
伤于寒也,散其寒则阳气泄而热自除矣。今有不知标本者,但见发热,辄用苦寒。夫阴寒沉滞,焉能解表?表不解则热
愈甚,所以轻者致重,重者致危,是不知热无犯热,寒无犯寒之戒也。详义见运气类二十,并当详究。)
黄帝问道:您说治疗热病有五十九个穴位,我推究其意,还不能清楚分辨它们的具体位置,希望能了解这些穴位的位置,并顺便听听其中的道理。(治疗热病的方法,本来有所不同,所以希望一并听取其中的原理。)岐伯回答说:头部的五行,每行五个穴位,是用来发散诸阳经上逆的热邪的。(头部五行,督脉在中间,旁边四行是足太阳膀胱经。中间一行五个穴位:上星、囟会、前顶、百会、后顶。其次两旁第二行各五个穴位:五处、承光、通天、络却、玉枕。再次两旁第三行各五个穴位:临泣、目窗、正营、承灵、脑空。五行共二十五穴,都在头顶之上,所以可以疏散诸阳热气上逆的情况。)大杼、膺俞(中府)、缺盆、背俞(风门),这八个穴位,是用来泻除胸中的热邪的。(大杼,足太阳膀胱经穴。膺俞,即中府穴,手太阴肺经穴。缺盆,足阳明胃经穴。背俞,即风门穴,又名热府。这八个穴位都在胸部的前后,所以可以泻除胸中的热邪。)气街(气冲)、三里(足三里)、巨虚上下廉(上巨虚、下巨虚),这八个穴位,是用来泻除胃中的热邪的。(气冲、三里、巨虚上廉、下廉,这八个穴位都是足阳明胃经穴,所以可以泻除胃中的热邪。)云门、髃骨(肩髃)、委中、髓空(腰俞),这八个穴位,是用来泻除四肢的热邪的。(云门,手太阴肺经穴。髃骨即肩髃穴,手阳明大肠经穴。委中,足太阳膀胱经穴。髓空,即腰俞穴,督脉穴。云门、肩髃连着手,委中、腰俞连着脚,所以这八个穴位可以泻除四肢的热邪。空,同“孔”。五脏俞旁五,这十个穴位,是用来泻除五脏的热邪的。(五脏俞旁的五个穴位:肺俞之旁是魄户;心俞之旁是神堂;肝俞之旁是魂门;脾俞之旁是意舍;肾俞之旁是志室。都是足太阳膀胱经穴。凡五脏的联系组织,都附着于背部,所以这十个穴位可以泻除五脏的热邪。)总共这五十九个穴位,都是治疗热病的左右配穴。(另外五十九穴,详见后篇。)黄帝问道:人受寒邪侵袭而转化为热证,这是为什么呢?岐伯回答说:寒邪盛极则会产生热证。(寒邪束缚体表,导致阳气内郁,所以转化为热证,因此寒盛则生热。既然这样,外感发热者,是因为受了寒邪,散其寒则阳气宣泄而热自然消除。现在有的人不懂标本关系,只见发热,就使用苦寒药物。阴寒沉滞之邪,怎么能解表呢?表邪不解则热更严重,所以轻症转为重症,重症转为危症,这是不懂得“热无犯热,寒无犯寒”的禁忌啊。详细义理见运气类第二十篇,应当详细研究。)
The Yellow Emperor asked: You mentioned fifty-nine acupoints for treating febrile diseases. I have pondered their meaning but cannot clearly distinguish their specific locations. I wish to know where these points are located and, incidentally, hear the rationale behind them. (The methods for treating febrile diseases vary; thus, it is desired to hear the underlying principles as well.)
Qibo replied: The five rows on the head, with five points in each row, are used to disperse the rebellious heat of the Yang meridians. (The "five rows" on the head refer to the Du Meridian in the center and four flanking rows belonging to the Foot-Taiyang Bladder Meridian. The central row has five points: Shangxing (GV23), Xinhui (GV22), Qian Ding (GV21), Baihui (GV20), and Hou Ding (GV17). The second pair of lateral rows, each with five points, are: Wuchu (BL3), Chengguang (BL4), Tongtian (BL8), Luoque (BL9), and Yuzhen (BL9 - *Note: Text says Yuzhen, usually BL9 is Luoque, Yuzhen is GB9, but following text strictly*). The third pair of lateral rows, each with five points, are: Linqi (GB15), Mucuang (GB16), Zhengying (GB17), Chengling (GB18), and Naokong (GB19). These twenty-five points are all located above the vertex, and thus can dissipate the rebellious heat of the Yang Qi ascending to the upper body.)
Dazhu (BL11), Ying Shu (Zhongfu LU1), Quepen (ST12), and Bei Shu (Fengmen BL12) — these eight points — are used to drain heat from the chest. (Dazhu is a point of the Foot-Taiyang Bladder Meridian. Ying Shu refers to Zhongfu, a point of the Hand-Taiyin Lung Meridian. Quepen is a point of the Foot-Yangming Stomach Meridian. Bei Shu refers to Fengmen, also known as Re Fu [Heat Mansion]. These eight points are located anteriorly and posteriorly around the chest, and thus can drain heat from the chest.)
Qichong (ST30), Sanli (Zusanli ST36), and Juxu Shangxia Lian (Shangjuxu ST37, Xiajuxu ST39) — these eight points — are used to drain heat from the stomach. (Qichong, Zusanli, Shangjuxu, and Xiajuxu are all points of the Foot-Yangming Stomach Meridian, and thus can drain heat from the stomach.)
Yunmen (LU2), Guyu (Jianyu LI15), Weizhong (BL40), and Sui Kong (Yaoshu DU2) — these eight points — are used to drain heat from the four limbs. (Yunmen is a point of the Hand-Taiyin Lung Meridian. Guyu refers to Jianyu, a point of the Hand-Yangming Large Intestine Meridian. Weizhong is a point of the Foot-Taiyang Bladder Meridian. Sui Kong refers to Yaoshu, a point of the Du Meridian. Yunmen and Jianyu connect to the hands, while Weizhong and Yaoshu connect to the feet; therefore, these eight points can drain heat from the four limbs. "Kong" is synonymous with "Kong" [hole/opening].)
Wu Shu Pang Wu (the five points adjacent to the Five Zang Back-Shu points) — these ten points — are used to drain heat from the Five Zang organs. (The five points adjacent to the Zang Back-Shu points are: Pohu (BL42) beside Fei Shu (BL13); Shentang (BL44) beside Xin Shu (BL15); Hunmen (BL47) beside Gan Shu (BL18); Yishe (BL49) beside Pi Shu (BL20); and Zhishi (BL52) beside Shen Shu (BL23). All are points of the Foot-Taiyang Bladder Meridian. Since the connections of all Five Zang organs attach to the back, these ten points can drain heat from the Five Zang organs.)
In total, these fifty-nine points are the left and right counterparts for treating heat. (The other fifty-nine points are detailed in the subsequent chapter.)
The Yellow Emperor asked: Why does an invasion by cold pathogen transform into a heat syndrome?
Qibo replied: When cold is excessive, it generates heat. (When cold pathogen binds the exterior, Yang Qi becomes internally constrained, thus transforming into heat; hence, excessive cold generates heat. Therefore, fever due to external contraction arises from injury by cold. Dispersing the cold allows the Yang Qi to vent, and the heat naturally resolves. However, those who do not understand the root and branch often see only fever and indiscriminately use bitter-cold herbs. Yin-cold stagnation cannot resolve the exterior. If the exterior is not resolved, the heat intensifies, causing mild cases to become severe and severe cases to become critical. This violates the admonition: "Do not use heat for heat conditions, and do not use cold for cold conditions." For detailed meanings, refer to Chapter 20 of the Yunqi Category, which should be studied thoroughly.)