（《灵枢·厥病篇》《杂病篇》）
厥心痛与背相控，善 ，如从后触其心，伛偻者，肾心痛也，先取京骨、昆仑，发针不已，取然谷
（《灵枢·厥病篇》。五脏逆气，上干于心而为痛者，谓之厥心痛。下仿此。控，引也。善 ，拘急如风也。伛偻，
背曲不伸也。足少阴之经，由股内后廉贯脊属肾，其直者，从肾上贯肝膈入肺中。凡疼痛如从脊后触其心而伛偻者，以
肾邪干心，是为肾心痛也。肾与膀胱为表里，故当先取足太阳之京骨、昆仑。如痛不已，仍当取肾经之然谷。控，苦贡
切。伛，雍主切。偻，吕、娄二音。）厥心痛，腹胀胸满，心尤痛甚，胃心痛也，取之大都、太白。（足阳明之经，由缺
盆下膈属胃络脾，其支者下循腹里。凡腹胀胸满而为痛者，以胃邪干心，是为胃心痛也。胃与脾为表里，故当取足太阴
之大都、太白二穴。）厥心痛，痛如以锥针刺其心，心痛甚者，脾心痛也，取之然谷、太溪。（脾之支脉，注于心中。若
脾不能运而逆气攻心，其痛必甚，有如锥刺者，是为脾心痛也。但然谷、太溪，皆足少阴之穴，取此治脾，其义何居？
盖湿因寒滞，则相挟乘心，须泄肾邪，当刺此也。）厥心痛，色苍苍如死状，终日不得太息，肝心痛也，取之行间、太冲。
（苍苍，肝色也。如死状，肝气逆也。终日不得太息，肝系急，气道约而不利也。是皆肝邪上逆，所谓肝心痛也。行间、
太冲，皆足厥阴经穴，故当取以治之。）厥心痛，卧若徒居，心痛间动作痛益甚，色不变，肺心痛也，取之鱼际、太渊。
（徒，空也。卧若徒居，无倚傍也。间或动作则益甚者，气逆不舒，畏于动也。色不变，不在血也。是皆病在气分，故
曰肺心痛也。鱼际、太渊，皆手太阴经穴，故宜取之。）真心痛，手足 至节，心痛甚，旦发夕死，夕发旦死。（真心痛
者，邪气直犯心主也。毒深阴甚，故手足之 至节，其死之速如此。愚按∶本篇所言五脏之滞，皆为心痛，刺治分经，
理甚明悉，至若舍针用药，尤宜察此详义。盖肾心痛者，多由阴邪上冲，故善 如从后触其心。胃心痛者，多由停滞，
故胸腹胀满。脾心痛者，多由寒逆中焦，故其病甚。肝心痛者，多由木火之郁，病在血分，故色苍苍如死状。肺心痛者，
多由上焦不清，病在气分，故动作则病益甚。若知其在气则顺之，在血则行之，郁则开之，滞则逐之，火多实，则或散
或清之，寒多虚，则或温或补之，必真心痛者乃不可治，否则但得其本，则必随手而应，其易如探囊也。 音倩，寒冷
也。）心痛不可刺者，中有盛聚，不可取于 。（中有盛聚，谓有形之症，或积或血，停聚于中，病在脏而不在经，故不
可取于 穴，当从内以调治之也。）肠中有虫瘕及蛟蛔，皆不可取以小针，心肠痛 作痛，肿聚，往来上下行，痛有休止，
腹热喜渴，涎出者，是蛟蛔也。（此言虫瘕在肠胃中，亦为心腹痛也。瘕，结聚也。蛟，即蛔属。蛔， 也。不可取以小
针，谓其力小不能制也。虫瘕之证，其痛则懊 难忍，或肚腹肿起而结聚于内，或往来上下而行无定处，或虫动则痛、
静则不痛而有时休止，或腹热喜渴而口涎出者，是皆蛟蛔之为患也。瘕，加、驾二音。蛔音回。 ，乃包切。）以手聚按
而坚持之，无令得移，以大针刺之，久持之，虫不动，乃出针也。（此即治虫瘕蛟蛔之法。大针，第九针也。久持之而虫
不动，中其虫矣，故可出针也。）HT 腹 痛，形中上者。HT ，满也。此重言证之如此，其形自中自上而渐升者，即
当以虫治之也。HT ，并同，音烹。）
心痛引腰脊，欲呕，取足少阴（《灵枢·杂病篇》。心痛而后引腰脊、前则欲呕者，此肾邪上逆也，故当取足少阴经
以刺之。）心痛腹胀，啬啬然大便不利，取足太阴。（啬啬，涩滞貌。此病在脾，故当取足太阴经以刺之。啬音色。）心痛
引背不得息，刺足少阴；不已，取手少阳。（足少阴之脉贯脊，故痛引于背。手少阳之脉布膻中，故不得息。宜刺此二经
也。）心痛引小腹满，上下无常处，便溲难，刺足厥阴。（足厥阴之脉抵小腹结于阴器，凡心痛而下引小腹者，当刺之也。）
心痛但短气不足以息，刺手太阴。（肺主气，故短气者当刺手太阴。）心痛当九节刺之，按已刺，按之立已；不已，上下
求之，得之立已。（此总言刺心痛之法也。九节，即督脉之筋缩穴。宜先按之，按已而刺，刺后复按之，其痛当立已。如
不已，则上而手经，下而足经，求得其故而刺之，则立已矣。）
（出自《灵枢·厥病篇》和《杂病篇》）
真心痛与背部相互牵引疼痛，容易拘急痉挛，感觉像从背后触碰心脏一样，身体弯曲无法伸直，这是肾心痛。治疗时先针刺京骨穴、昆仑穴，如果针后疼痛未止，再取然谷穴。
（《灵枢·厥病篇》记载：五脏的逆气上犯于心导致疼痛，称为厥心痛。以下类推。控，即牵引之意。善瘛，指拘急痉挛如同风邪所致。伛偻，指背部弯曲不能伸展。足少阴肾经，从大腿内侧后缘贯穿脊柱归属肾脏，其直行支脉，从肾脏向上穿过肝脏和膈肌进入肺部。凡是疼痛感觉像从脊背后方触碰到心脏且伴有弯腰曲背症状的，是因为肾邪侵犯心脏，这就是肾心痛。肾与膀胱互为表里，所以应当先取足太阳膀胱经的京骨穴、昆仑穴。如果疼痛不止，仍应取足少阴肾经的然谷穴。控，读音为苦贡切。伛，读音为雍主切。偻，读音为吕或娄。）
厥心痛，伴有腹胀胸满，心脏特别疼痛剧烈，这是胃心痛。治疗取大都穴、太白穴。
（足阳明胃经，从缺盆向下穿过膈肌归属胃并联络脾脏，其分支向下沿着腹腔内部下行。凡是出现腹胀胸满并伴随疼痛的，是因为胃邪侵犯心脏，这就是胃心痛。胃与脾互为表里，所以应当取足太阴脾经的大都穴、太白穴两个穴位。）
厥心痛，疼痛感觉像用锥子针刺心脏，心痛非常剧烈，这是脾心痛。治疗取然谷穴、太溪穴。
（脾的支脉注入心中。如果脾运化功能失常而逆气攻心，疼痛必然剧烈，如同锥刺一般，这就是脾心痛。然而然谷、太溪都是足少阴肾经的穴位，取这两个穴位来治疗脾病，其中的道理何在？这是因为湿气因寒邪停滞，两者相互勾结侵犯心脏，必须泄除肾中的邪气，所以应当针刺这两个穴位。）
厥心痛，面色青苍如同死状，整天不能深呼吸叹气，这是肝心痛。治疗取行间穴、太冲穴。
（苍苍，是肝对应的颜色。如死状，表示肝气上逆。整天不能深呼吸叹气，是因为肝系紧张，气道约束而不通畅。这些都是肝邪上逆的表现，所谓肝心痛。行间、太冲都是足厥阴肝经的穴位，所以应当取这些穴位来治疗。）
厥心痛，躺着或静坐时疼痛缓解，活动后疼痛加剧，面色没有改变，这是肺心痛。治疗取鱼际穴、太渊穴。
（徒，意为空。卧若徒居，指没有依靠地躺着或坐着。偶尔活动时疼痛更加严重，是因为气机逆乱不舒畅，畏惧活动。面色不变，说明病不在血分。这些都是病在气分，所以称为肺心痛。鱼际、太渊都是手太阴肺经的穴位，所以适宜取用。）
真心痛，手足发凉直到关节，心痛非常剧烈，早晨发病晚上死亡，晚上发病第二天早晨死亡。
（真心痛，是指邪气直接侵犯心主。毒邪深重，阴寒极盛，所以手足发凉直到关节，死亡速度如此迅速。我按语道：本篇所说的五脏气滞引起的心痛，都属于心痛范畴，针刺治疗分别依据经络，道理非常明确详尽。至于舍弃针刺而用药物的情况，尤其应该仔细考察这里的详细义理。大概肾心痛，多由阴寒邪气上冲引起，所以容易拘急痉挛，感觉像从背后触碰心脏。胃心痛，多由气食停滞引起，所以胸腹胀满。脾心痛，多由寒邪逆居中焦引起，所以病情严重。肝心痛，多由木火郁结引起，病在血分，所以面色青苍如同死状。肺心痛，多由上焦不清爽引起，病在气分，所以活动后病情加重。如果知道病在气分就顺其气机，在血分就行其血液，郁结就开散它，停滞就驱逐它，火热多属实证，就发散或清泻它，寒邪多属虚证，就温补或滋养它。只有真心痛是不可治愈的，否则只要找到病根，治疗就会立刻见效，就像从口袋里拿东西一样容易。 音倩，寒冷之意。）
心痛不可针刺的情况，是因为体内有盛实的积聚，不可取用腧穴进行针刺。
（体内有盛实的积聚，指的是有形的病症，或者是积块或者是瘀血，停聚在体内，病在脏腑而不在经络，所以不可取用腧穴针刺，应当从内部进行调理治疗。）
肠中有虫瘕以及蛟蛔，都不可用小针治疗，心肠疼痛发作时疼痛剧烈，腹部肿胀结聚，疼痛往来上下移动，疼痛有休止时间，腹部发热喜欢口渴，流涎水的，这是蛟蛔。
（这里说的是虫瘕在肠胃中，也会引起心腹疼痛。瘕，指结聚。蛟，即蛔虫一类。蛔，即 。不可用小针，是说小针的力量不足以制服它们。虫瘕的证候，疼痛令人懊恼难以忍受，或者肚腹肿胀而起结聚于内，或者往来上下移动没有固定位置，或者虫动则痛、虫静则不痛且有定时休止，或者腹部发热喜欢口渴且口出涎水，这些都是蛟蛔造成的危害。瘕，读音为加或驾。蛔，读音为回。 ，乃包切。）
用手聚集按压并坚持按住患处，不让虫体移动，用大针针刺，长时间留针，虫子不动了，才拔出针。
（这就是治疗虫瘕蛟蛔的方法。大针，是九针中的第九种。长时间留针而虫子不动，说明已经刺中了虫子，所以可以拔针。）
腹痛，形态表现为从中部向上逐渐升高的。
，即满的意思。这里是重复强调证候如此，其形态自然从中间向上升高，就应当用治虫的方法来治疗。 ，与 相同，读音为烹。）
心痛牵引腰脊，想要呕吐，取足少阴经穴位针刺。
（《灵枢·杂病篇》记载：心痛之后牵引腰脊，前面则想要呕吐，这是肾邪上逆，所以应当取足少阴经进行针刺。）
心痛伴有腹胀，涩滞不畅且大便不通利，取足太阴经穴位针刺。
（啬啬，形容涩滞的样子。此病在脾，所以应当取足太阴经进行针刺。啬，读音为色。）
心痛牵引背部，呼吸不畅，针刺足少阴经；如果无效，取手少阳经穴位。
（足少阴经脉贯穿脊柱，所以疼痛牵引到背部。手少阳经脉布散于膻中，所以呼吸不畅。适宜针刺这两条经络。）
心痛牵引小腹满胀，疼痛位置上下无常，小便和大便困难，针刺足厥阴经。
（足厥阴经脉抵达小腹并结于阴器，凡心痛向下牵引小腹的，应当针刺此经。）
心痛只是短气，呼吸不足，针刺手太阴经。
（肺主气，所以短气的应当针刺手太阴经。）
心痛应当在第九节脊椎处针刺，按压已针刺的部位，疼痛立刻停止；如果不停止，上下寻找病因，找到后针刺，疼痛立刻停止。
（这是总述治疗心痛的方法。九节，即督脉的筋缩穴。应当先按压，按压后针刺，针刺后再按压，疼痛应当立刻停止。如果不停止，则向上查找手经，向下查找足经，找到病因而针刺，疼痛就会立刻停止。）
(From *Lingshu: Juebing Pian* and *Zabing Pian*)
True heart pain (Zhenxin Tong) with mutual traction pain between the heart and back, prone to spasms (chi), feeling as if the heart is being touched from behind, accompanied by a stooped posture unable to straighten, is Kidney Heart Pain. Treat first by needling Jinggu (BL-64) and Kunlun (BL-60). If the pain does not cease after needling, then select Ran Gu (KI-2).
(*Lingshu: Juebing Pian*: When the rebellious qi of the five zang organs ascends to invade the heart causing pain, it is called Jue Heart Pain. The following cases follow this pattern. Kong means traction. Shan chi refers to spasms similar to wind-induced conditions. Yu Lou refers to a curved back that cannot extend. The Foot-Shaoyin Kidney Meridian runs along the posterior medial aspect of the thigh, pierces the spine, and connects with the Kidney. Its straight branch ascends from the Kidney, passes through the Liver and Diaphragm, and enters the Lung. Whenever pain feels like it originates from touching the heart from the posterior spine and involves stooping, it is because Kidney pathogenic factors invade the Heart; this is Kidney Heart Pain. Since the Kidney and Bladder are interior-exteriorly related, one should first select Jinggu and Kunlun of the Foot-Taiyang Bladder Meridian. If pain persists, one should still select Ran Gu of the Foot-Shaoyin Kidney Meridian.)
Jue Heart Pain accompanied by abdominal distension and chest fullness, with severe heart pain, is Stomach Heart Pain. Select Dadu (SP-3) and Taibai (SP-3).
(The Foot-Yangming Stomach Meridian descends from the Clavicle, passes through the Diaphragm, belongs to the Stomach, and connects with the Spleen. Its branch descends along the interior of the abdomen. Whenever abdominal distension and chest fullness occur with pain, it is because Stomach pathogenic factors invade the Heart; this is Stomach Heart Pain. Since the Stomach and Spleen are interior-exteriorly related, one should select Dadu and Taibai of the Foot-Taiyin Spleen Meridian.)
Jue Heart Pain where the pain feels like being pierced by an awl, with severe heart pain, is Spleen Heart Pain. Select Ran Gu (KI-2) and Taixi (KI-3).
(The collateral branch of the Spleen injects into the Heart. If the Spleen fails to transport and rebellious qi attacks the Heart, the pain will be severe, resembling an awl piercing; this is Spleen Heart Pain. However, Ran Gu and Taixi are both points on the Foot-Shaoyin Kidney Meridian. Why select these to treat the Spleen? This is because dampness combined with cold stagnation mutually assists in invading the Heart; one must drain the Kidney pathogenic factors, hence these points are needled.)
Jue Heart Pain with a pale green complexion resembling death, and inability to sigh deeply all day, is Liver Heart Pain. Select Xingjian (LR-2) and Taichong (LR-3).
(Pale green is the color associated with the Liver. Resembling death indicates rebellious Liver Qi. Inability to sigh all day indicates tension in the Liver system, constraining the airway and hindering smooth flow. These are all manifestations of rebellious Liver pathogenic factors ascending, known as Liver Heart Pain. Xingjian and Taichong are points on the Foot-Jueyin Liver Meridian, so they should be selected for treatment.)
Jue Heart Pain where pain alleviates when lying down or sitting idly, but worsens significantly upon movement, with unchanged complexion, is Lung Heart Pain. Select Yuji (LU-10) and Taiyuan (LU-9).
(Tu means empty. Lying down or sitting idly without support implies a state of emptiness. Pain worsening upon movement indicates rebellious qi failing to soothe and fear of movement. An unchanged complexion indicates the pathology is not in the Blood. These indicate the disease is in the Qi level, hence called Lung Heart Pain. Yuji and Taiyuan are points on the Hand-Taiyin Lung Meridian, so they are suitable for selection.)
True Heart Pain (Zhenxin Tong) with cold limbs extending to the joints, severe heart pain, death if onset occurs in the morning and death by evening, or death if onset occurs in the evening and death by morning.
(True Heart Pain occurs when pathogenic factors directly invade the Heart Master. The toxicity is deep and yin-cold is extreme, hence limbs become cold up to the joints, leading to such rapid death. Commentary: The heart pains described in this chapter due to stagnation of the five zang organs all fall under the category of heart pain. Needling treatments are differentiated by meridian, making the principles clear. Regarding the use of herbs instead of needles, one must carefully examine these detailed meanings. Generally, Kidney Heart Pain often arises from upward rushing of yin-cold pathogens, hence spasms and sensation of posterior touch. Stomach Heart Pain often arises from stagnation, hence chest and abdominal distension. Spleen Heart Pain often arises from cold rebellion in the middle jiao, hence severe illness. Liver Heart Pain often arises from stagnation of wood-fire, involving the blood level, hence a pale green complexion resembling death. Lung Heart Pain often arises from uncleanness in the upper jiao, involving the qi level, hence worsening with movement. If one knows that disease in the qi level should be harmonized, disease in the blood level should be circulated, stagnation should be opened, and blockage should be expelled; fire excess should be dispersed or cleared, while cold deficiency should be warmed or tonified. Only True Heart Pain is incurable; otherwise, once the root is identified, treatment responds immediately, as easily as taking something from a pocket. Qian denotes coldness.)
Heart pain that cannot be needled indicates there is a substantial accumulation within; such cases should not be treated by selecting acupoints.
(Substantial accumulation within refers to tangible pathological products, such as masses or blood stasis, accumulating internally. The disease is in the zang organs rather than the meridians, so acupoint needling is contraindicated; internal regulation and treatment are required.)
Ascaris (Chongjia) and roundworms (Jiaohui) in the intestines should not be treated with small needles. When heart-intestine pain erupts severely, with swelling and aggregation, moving up and down, with intermittent pain, abdominal heat, thirst, and salivation, these are signs of Jiaohui (roundworms).
(This states that ascaris in the intestines also causes heart and abdominal pain. Jia refers to aggregation. Jiao refers to roundworms. Small needles should not be used because their force is insufficient to subdue them. The syndrome of ascaris involves unbearable distressing pain, or abdominal swelling with internal aggregation, or movement up and down without fixed location, or pain only when worms move and cessation when they rest, or abdominal heat with thirst and salivation. All these are caused by roundworms.)
Press and hold firmly with the hand to prevent movement, then needle with a large needle. Retain the needle for a long time until the worm stops moving, then remove the needle.
(This is the method for treating ascaris and roundworms. The Large Needle is the ninth of the nine needles. Retaining the needle until the worm stops moving indicates the worm has been struck, allowing for needle removal.)
Abdominal pain where the shape manifests rising from the center upwards.
Man means fullness. This reiterates the symptom profile: when the shape naturally rises from the center upwards, it should be treated as a parasitic condition. Peng is synonymous with Man, pronounced peng.)
Heart pain radiating to the lower back and spine, with desire to vomit, select Foot-Shaoyin points.
(*Lingshu: Zabing Pian*: Heart pain followed by radiation to the lower back and spine, and anterior nausea, indicates rebellious Kidney qi ascending. Therefore, the Foot-Shaoyin Meridian should be needled.)
Heart pain with abdominal distension, roughness/stagnation, and difficulty in defecation, select Foot-Taiyin points.
(Sese describes a rough or stagnant sensation. This disease resides in the Spleen, so the Foot-Taiyin Meridian should be needled. Se is pronounced se.)
Heart pain radiating to the back with dyspnea, needle Foot-Shaoyin; if ineffective, select Hand-Shaoyang points.
(The Foot-Shaoyin pulse penetrates the spine, hence pain radiates to the back. The Hand-Shaoyang pulse distributes in the Chest Center, hence dyspnea. It is appropriate to needle these two meridians.)
Heart pain radiating to lower abdominal fullness, with unpredictable locations, and difficulty in urination and defecation, needle Foot-Jueyin.
(The Foot-Jueyin pulse reaches the lower abdomen and knots at the genitalia. For heart pain radiating downward to the lower abdomen, this meridian should be needled.)
Heart pain characterized only by shortness of breath and insufficient respiration, needle Hand-Taiyin.
(The Lung governs qi, so shortness of breath requires needling the Hand-Taiyin Meridian.)
For heart pain, needle at the ninth vertebral segment. After pressing the needled area, pain ceases immediately; if not, search above and below, locate the cause, and needle, and pain will cease immediately.
(This summarizes the method for needling heart pain. The ninth segment refers to Jinsuo (GV-9) of the Du Meridian. One should press first, then needle, and press again after needling; pain should cease immediately. If not, search the Hand meridians above and Foot meridians below to find the cause and needle, and pain will cease immediately.)