（《灵枢·卫气失常篇》）
黄帝曰∶卫气之留于腹中，搐积不行，苑蕴不得常所，使人肢胁胃中满、喘呼逆息者，何以去之？（卫气者，水谷
之悍气也。其气循皮肤之中，分肉之间，熏于肓膜，散于胸腹，此卫气之常也。失其常，则随邪内陷，留于腹中，搐积
不行而苑蕴为病，故《禁服篇》曰卫气为百病母也。苑，郁同。）伯高曰∶其气积于胸中者上取之，积于腹中者下取之，
上下皆满者旁取之。黄帝曰∶取之奈何？伯高对曰∶积于上，泻人迎、天突、喉中；（积于上者为喘呼逆息，故当泻之于
上。人迎，足阳明经穴。天突、喉中，俱任脉穴。喉中，即廉泉也。）积于下者，泻三里与气街；（积于腹中者，当泻其
下。三里、气街，俱足阳明经穴。）上下皆满者，上下取之，与季胁之下一寸，重者鸡足取之。（上下皆病，则上下俱当
取之，如以上五穴是也。季胁之下一寸，当是足厥阴经章门穴。病之重者仍当鸡足取之，谓攒而刺之也，即《官针篇》
合谷刺之谓，详见前六。一本云季胁之下深一寸。）诊视其脉大而弦急，及绝不至者，及腹皮急甚者，不可刺也。黄帝曰∶
善。（脉大而弦急，阴虚而真脏见也。绝不至者，营气脱也。腹皮急甚者，中和气绝而脾元败也。不宜刺矣。）
黄帝问于伯高曰∶何以知皮肉气血筋骨之病也？伯高曰∶色起两眉薄泽者，病在皮。（两眉者，阙中也。其应主肺，
故病在皮。）唇色青黄赤白黑者，病在肌肉。（脾气通于唇，故病在肌肉。）营气濡然者，病在血气。（濡，湿也。营本无
形，若肤腠之汗，肌肉之胀，二便之泄利，皆濡然之谓。其病在营，则气血也。）目色青黄赤白黑者，病在筋。（目为肝
之窍，肝主筋也。）耳焦枯受尘垢，病在骨。（耳为肾之窍，肾主骨也。）黄帝曰∶病形何如？取之奈何？伯高曰∶夫百病
变化，不可胜数，然皮有部，肉有柱，血气有输，骨有属。黄帝曰∶愿闻其故。伯高曰∶皮之部，输于四末。（病在皮者，
在阳分也。阳受气于四末，以其皮浅气浮也，故皮之部输于四末。）肉之柱，在臂胫诸阳分肉之间，与足少阴分间。（病
在肌肉，当治其柱。柱者， 之属也。坚浓之肉，多在手足三阳分肉间，以肉主于脾，而脾主四肢也。足少阴之经，自
足心，循内踝后，入足跟，以上 内，出 内廉，上股内后廉，会于尻臀，贯脊，其肉俱浓，故亦为肉之柱。）血气之输，
输于诸络，气血留居，则盛而起。（病在血气，当治其输。输于诸络，谓诸经之络穴也。气血留居，则经络壅盛，故当取
之。）筋部无阴无阳，无左无右，候病所在。（病在筋者，不必分其阴阳左右，但当随病所在而治之。）骨之属者，骨空之
所以受益而益脑髓者也。（病在骨之属者，当治骨空以益其髓。髓者骨之充也，故益髓即所以治骨。骨空义详经络类十九。）
黄帝曰∶取之奈何？伯高曰∶夫病变化浮沉深浅，不可胜穷，各在其处，病间者浅之，甚者深之，间者小之，甚者众之，
随变而调气，故曰上工。（间者病轻，故用针宜浅宜小。甚者病重，故用针宜深宜众。病变无穷，能随其变而调治得宜者，
故曰上工。）
（出自《灵枢·卫气失常篇》）
黄帝问道：卫气停留在腹部，积聚而不运行，郁结在不能正常流通的地方，导致四肢、胁肋和胃脘部胀满，气喘呼吸急促，这种情况该如何去除？（卫气，是水谷精微中慓悍滑疾的部分。它通常循行于皮肤之中，肌肉间隙之间，熏蒸于肓膜，散布于胸腹，这是卫气的正常运行规律。一旦失去常态，就会随着邪气内陷，停留在腹部，积聚不运而郁结致病，所以《禁服篇》说“卫气是百病之母”。苑，通“郁”，即郁结之意。）
伯高回答说：卫气积聚在胸中的，应当从上部的穴位取治；积聚在腹中的，应当从下部的穴位取治；上下都胀满的，应当从侧旁取治。
黄帝问：具体怎么取治呢？
伯高回答：积聚在上部的，泻人迎穴、天突穴、喉中穴；（积聚在上部表现为气喘呼吸急促，所以应当从上部的穴位泻之。人迎穴，属于足阳明胃经。天突穴、喉中穴，都属于任脉。喉中穴，就是廉泉穴。）积聚在下部的，泻足三里穴和气街穴；（积聚在腹中，应当泻下部的穴位。足三里穴、气街穴，都属于足阳明胃经。）上下都胀满的，上下部都取治，加上季胁下一寸处，病情严重的用“鸡足刺”法。（上下都患病，则上下部都要取治，如上述五个穴位。季胁下一寸处，应该是足厥阴肝经的章门穴。病情严重的仍然应当用鸡足刺法，意思是像鸡爪一样聚拢针刺，也就是《官针篇》所说的合谷刺，详见前文第六条。另一版本说是季胁之下深一寸。）如果诊察到脉搏大而弦急，或者脉搏断绝摸不到的，以及腹部皮肤紧绷严重的，都不可针刺。（脉搏大而弦急，说明阴虚而真脏脉现。脉搏断绝摸不到，说明营气脱失。腹部皮肤紧绷严重，说明中和之气断绝而脾元败坏。不宜针刺了。）
黄帝说：好。
伯高说：两眉部位色泽浮薄润泽的，病在皮。（两眉之间称为阙中，其对应脏腑为肺，肺主皮毛，所以病在皮。）嘴唇颜色呈现青、黄、赤、白、黑异常的，病在肌肉。（脾气通于口唇，所以病在肌肉。）营气湿濡表现的，病在血气。（濡，意为湿润。营气本无形体，若皮肤腠理的汗出，肌肉的肿胀，大小便的泄利，都称为濡然的表现。病在营分，则涉及气血。）眼睛颜色呈现青、黄、赤、白、黑异常的，病在筋。（目为肝之窍，肝主筋，所以病在筋。）耳朵干枯焦黑沾染尘垢的，病在骨。（耳为肾之窍，肾主骨，所以病在骨。）
黄帝问：病症表现是怎样的？如何取治呢？
伯高说：各种疾病的变化，数不胜数，但皮有分部，肉有柱状支撑点，血气有输注之处，骨有所属部位。
黄帝说：我想听听其中的道理。
伯高说：皮的部属，输注于四肢末端。（病在皮者，属于阳分。阳气受气于四肢末端，因为皮浅气浮，所以皮的部属输注于四肢末端。）肉的柱状支撑点，位于手臂和小腿各阳经分肉之间，以及足少阴经的分肉间。（病在肌肉，应当治疗其柱状支撑点。柱，指肌肉丰厚隆起之处。坚厚浓密的肌肉，多分布在手足三阳经的分肉间，因为肉由脾所主，而脾主四肢。足少阴肾经，自足心出发，沿内踝后侧，进入足跟，上行至腘窝内侧，出于腘窝内侧廉，上行大腿内侧后缘，会合于尻臀，贯穿脊柱，其处的肌肉都很浓密，所以也是肉的柱状支撑点。）血气的输注，分布于各络脉，气血停留积聚，就会充盈隆起。（病在血气，应当治疗其输注点。输注于各络脉，指各经的络穴。气血停留积聚，则经络壅盛，所以应当取治这些部位。）筋的部属不分阴阳左右，只需根据病痛所在部位来治疗。（病在筋者，不必区分阴阳左右，只要随病痛所在而治之。）骨的所属，是指骨空（骨节空隙），通过补益骨空可以滋养脑髓。（病在骨的所属，应当治疗骨空以益髓。髓是充养骨骼的物质，所以益髓即是治骨。骨空的含义详见经络类第十九条。）
黄帝问：具体怎么取治呢？
伯高说：疾病的变化有浮沉深浅，无穷无尽，各自位于不同的层次。病情轻浅的，针刺宜浅；病情深重的，针刺宜深；病情轻浅的，取穴宜少；病情深重的，取穴宜多。随着病情的变化来调气，这就叫做上工（高明的医生）。（轻浅的病，所以用针宜浅宜少。深重的病，所以用针宜深宜多。病变无穷，能随其变化而调治得当的，所以称为上工。）
(From *Ling Shu: Wei Qi Shi Chang* Chapter)
Huang Di asked: When Wei Qi (Defensive Qi, 卫气) remains in the abdomen, accumulates and fails to circulate, becoming stagnant and unable to flow normally, causing fullness in the limbs, hypochondrium, and epigastrium, as well as wheezing and dyspnea (喘呼逆息), how should this be treated? (Wei Qi is the vigorous and rapid aspect of the essence derived from food and water. Normally, it circulates within the skin, between the muscle layers, steams into the Hui membrane (肓膜), and disperses throughout the chest and abdomen; this is the normal state of Wei Qi. When it loses its normal course, it sinks inward with pathogenic factors, remaining in the abdomen, accumulating without moving, and stagnating to cause disease. Thus, the *Jin Fu* chapter states that "Wei Qi is the mother of a hundred diseases." Yuan (苑) is synonymous with Yu (郁), meaning stagnation.)
Bo Gao replied: If the Qi accumulates in the chest, treat it by selecting points above; if it accumulates in the abdomen, treat it by selecting points below; if both upper and lower regions are full, treat it by selecting points on the sides.
Huang Di asked: How exactly should one select these points?
Bo Gao answered: For accumulation in the upper region, reduce Renying (ST9, Human Well), Tiantu (CV22, Heavenly Tower), and Houzhong (CV23, Throat Middle); (Accumulation in the upper region manifests as wheezing and dyspnea, so reduction should be applied at the upper points. Renying belongs to the Foot-Yangming Stomach Meridian. Tiantu and Houzhong belong to the Ren Mai (Conception Vessel). Houzhong is identical to Lianquan (CV23, Spring under the Chin).) For accumulation in the lower region, reduce Zusanli (ST36, Three Mile) and Qijie (ST30, Street of the Hip); (Accumulation in the abdomen requires reducing the lower points. Zusanli and Qijie both belong to the Foot-Yangming Stomach Meridian.) For fullness in both upper and lower regions, treat both upper and lower areas, plus the point one cun below the costal margin; for severe cases, use the "Chicken-Foot" needling technique. (When both upper and lower regions are diseased, points in both areas should be selected, such as the five points mentioned above. The point one cun below the costal margin corresponds to Zhangmen (LR13, Gate of the Rib), belonging to the Foot-Jueyin Liver Meridian. For severe diseases, the Chicken-Foot technique should still be used, which means clustering needles like chicken claws, also known as Hegu Ci (合谷刺, Valley-Needle) described in the *Guan Zhen* chapter, detailed in item six previously. Another version states one cun deep below the costal margin.) If pulse diagnosis reveals a large and wiry-taut pulse, or an absent pulse, or severe tension of the abdominal skin, acupuncture is contraindicated. (A large and wiry-taut pulse indicates Yin deficiency and the manifestation of the True Organ pulse. An absent pulse indicates the depletion of Ying Qi (Nutritive Qi). Severe abdominal skin tension indicates the severance of Zhonghe Qi (Central Harmonizing Qi) and the failure of Spleen Yuan (Spleen Primordial Qi). Acupuncture is not suitable.)
Huang Di said: Excellent.
Huang Di asked Bo Gao: How can one identify diseases of the Skin, Flesh, Qi, Blood, Tendons, and Bones?
Bo Gao said: When the complexion shows thin luster at the glabella (two eyebrows), the disease is in the Skin. (The area between the two eyebrows is called Guazhong; it corresponds to the Lung, which governs the skin, hence the disease is in the skin.) When the lips display colors of green, yellow, red, white, or black abnormally, the disease is in the Flesh/Muscle. (The Spleen's Qi connects to the lips, hence the disease is in the flesh.) When Ying Qi presents with dampness/moisture signs, the disease is in the Qi and Blood. (Ru implies wetness. Ying Qi is originally formless; manifestations such as sweating at the skin pores, swelling of muscles, and diarrhea/dysuria are all considered Ru signs. Disease in the Ying level involves Qi and Blood.) When the eyes show abnormal colors of green, yellow, red, white, or black, the disease is in the Tendons. (The eyes are the orifices of the Liver, and the Liver governs the tendons, hence the disease is in the tendons.) When the ears appear dry, withered, scorched, and covered in dust, the disease is in the Bones. (The ears are the orifices of the Kidney, and the Kidney governs the bones, hence the disease is in the bones.)
Huang Di asked: What are the clinical manifestations? How should they be treated?
Bo Gao said: The changes of myriad diseases are countless, but the Skin has its sectors, the Muscle has its pillars, Qi and Blood have their transport points, and the Bone has its attachments.
Huang Di said: I wish to hear the rationale.
Bo Gao said: The sector of the Skin transports to the four extremities. (Disease in the skin belongs to the Yang level. Yang Qi receives energy from the four extremities because the skin is superficial and Qi is floating; thus, the skin sector transports to the four extremities.) The pillars of the Muscle are located in the intermuscular spaces of the Yang meridians of the arms and legs, and in the intermuscular spaces of the Foot-Shaoyin meridian. (For disease in the muscle, one should treat its pillars. Pillars refer to thick, firm muscle masses. Firm and dense muscles are mostly found in the intermuscular spaces of the Hand and Foot Three-Yang meridians because flesh is governed by the Spleen, which governs the four limbs. The Foot-Shaoyin Kidney Meridian originates from the sole of the foot, follows behind the medial malleolus, enters the heel, ascends along the medial aspect of the popliteal fossa, emerges from the medial edge of the popliteal fossa, ascends along the posterior-medial aspect of the thigh, meets at the sacrum and buttocks, penetrates the spine; the muscles here are dense, so they also serve as muscle pillars.) The transport of Qi and Blood distributes through the collateral vessels; when Qi and Blood stagnate, they become abundant and raised. (For disease in Qi and Blood, one should treat the transport points. Transporting to various collaterals refers to the Luo-Connecting points of the various meridians. When Qi and Blood stagnate, the meridians become congested and prominent, so these points should be selected.) The sector of the Tendons has no Yin/Yang distinction and no Left/Right distinction; one should observe and treat according to the location of the disease. (For disease in the tendons, there is no need to distinguish Yin/Yang or Left/Right; treatment should follow the site of the pathology.) The attachment of the Bone refers to the bone cavities (joint spaces), which benefit the brain and marrow. (For disease in the bone attachments, one should treat the bone cavities to nourish the marrow. Marrow fills the bones, so nourishing marrow is equivalent to treating the bone. The meaning of bone cavities is detailed in the Meridians category, item nineteen.)
Huang Di asked: How exactly should one select the points?
Bo Gao said: The changes of disease vary in floating/sinking and shallow/deep levels, which are inexhaustible and located in different places. For mild diseases, needle shallowly; for severe diseases, needle deeply. For mild diseases, use few points; for severe diseases, use many points. By adjusting Qi according to the variations of the disease, one is called a Shang Gong (Superior Physician). (Mild disease implies light severity, so needling should be shallow and sparse. Severe disease implies heavy severity, so needling should be deep and extensive. Pathological changes are infinite; those who can adjust treatment appropriately according to these changes are called Superior Physicians.)