（《聚英》）
东垣曰∶《黄帝针经》∶胃病者，胃脘当心而痛，上肢两胁，膈咽不通，饮食不下，取
三里以补之。
脾胃虚弱，感湿成痿，汗大泄，妨食。三里、气冲，以三棱针出血，若汗不减、不止者
，于三里穴下三寸上廉穴出血。禁酒，忌湿面。
东垣曰∶《黄帝针经》云∶从下上者，引而去之。上气不足，推而扬之。盖上气者，心
肺上焦之气，阳病在阴，从阴引阳，去其邪气于腠理皮毛也。又云∶视前痛者，当先取之。
是先以缪刺，泻其经络之壅者，为血凝而不流，故先去之，而治他病。
东垣曰∶胃气下溜，五脏气皆乱，其为病互相出见。黄帝曰∶五乱刺之有道乎？岐伯曰
∶有道以来，有道以去，审知其道，是谓身宝。帝曰∶愿闻其道！岐伯曰∶气在于心者，取
之手少阴、心主之俞∶神门、大陵，同精导气，以复其本位。
气在于肺者，取之手太阴荥、俞∶鱼际、太渊。成痿者以导湿热，引胃气出阳道，不令
湿土克肾，其穴在太溪。
气在于肠胃者，取之足太阴、阳明。不下者，取之三里、章门、中脘。因足大阴虚者
，于募穴中导引之，于穴中有一说，腑俞去腑病也。胃虚而致太阴无所禀者，于足阳明之
募穴中引导之，如气逆为霍乱者，取三里，气下乃止，不下复治。
气在于头，取之天柱、大杼。不足，取之足太阳荥、俞∶通谷、束骨。先取天柱、大杼
，不补不泻，以导气而已。取足太阳膀胱经中，不补不泻，深取通谷、束骨，丁心火，己脾
土穴，以引导去之。
气在于臂，足取之，先去血脉，后取其手足阳明之荥、俞∶二间、三间，深取之；内庭
、陷谷，深取之。视其足臂之血络尽取之，后治其痿厥，皆不补不泻，从阴深取，引而上之
。上者出也，去也。皆阴火有余，阳气不足，伏匿于地中者，荣血也。当从阴引阳，先于地
中升举阳气，次泻阴火，乃导气同精之法。
帝曰∶补泻奈何？曰∶徐入徐出，谓之导气。补泻无形，谓之同精。是非有余不足也，
乱气之相逆也。帝曰∶允乎哉道，明乎哉问，请着之玉版，命曰治乱也。
东垣曰∶阴病治阳，阳病治阴。阴阳应象论云∶审其阴阳，以别柔刚，阴病治阳，阳病
治阴，定其血脉，各守其乡，血实宜决之，气
虚宜导引之。夫阴病在阳者，是天外风寒之邪，乘中而外入，在人
之背上腑俞、脏俞。是人之受天外客邪，亦
有二说。中于阳则流于经，此病始于外寒，终归外热，故以治风寒之邪，治其各脏之俞，非
止风寒而已。六淫湿暑燥火。皆五脏所受，乃筋骨血脉受邪，各有背上五脏俞以除之。伤寒
一说从仲景，中八风者有风论。中暑者治在背上小肠俞，中湿者治在胃俞，中燥者治在大肠
俞，此皆六淫客邪有余之病，皆泻其背之腑俞，若病久传变，有虚有实，各随病之传变，补
泻不定，治只在背腑俞。
另有上热下寒。经曰∶阴病在阳者，当从阳引阴，必须先去络脉经隧之血。若阴中火
旺，上腾于天，致六阳反不衰而上充者，先去五脏之血络，引而下行，天气降下，则下寒之
病自去矣。慎勿独泻其六阳，此病阳亢，乃阴火之邪滋之，只去阴火，只损脉络经隧之邪，
勿误也。阳病在阴者，当从阴引阳，是水谷之寒热，感则害人六腑。又曰∶饮食失节，又劳
役形质，阴火乘于坤土之中，致谷气、荣气、清气、胃气、元气不得上升，滋于六腑之阳气
，是五阳之气先绝于外。外者天也，下流伏于坤土阴火之中，皆先由喜怒悲忧恐为五贼所伤
，而后胃气不行，劳役饮食不节继之，则元气乃伤，当从胃合三里穴中，推而扬之，以伸元
气，故曰从阴引阳。若元气愈不足，治在腹上诸腑之募穴，若传在五脏，为九窍不通，随各
窍之病，治其各脏之募穴于腹，故曰五脏不平，乃六腑元气闭塞之所生也。又曰∶五脏不和
，九窍不通，皆阳气不足，阴气有余，故曰阳不胜其阴。凡治腹之募，皆为元气不足，从阴
引阳，勿误也。若错补四末之俞，错泻四末之荥，错泻者，差尤甚矣。按岐伯所说，只取穴
于天上。天上者，人之背上五脏六腑之俞，不当泻而泻，岂有生者乎？兴言及此，寒心切骨
，若六淫客邪，及上热下寒，筋骨皮肉血脉之病，错取穴于胃之合，及诸腹之募者，必危。
亦岐伯之言，下工岂可不慎哉！
东垣曰∶三焦元气衰王。《黄帝针经》云∶上气不足，脑为之不满，耳为之苦鸣，头为
之倾，目为之瞑。中气不足，溲便为之变，肠为之苦结。下气不足，则为痿厥心闷，补足外
东垣曰∶一富者前阴臊臭，又因连日饮酒，腹中不和，求先师治之，曰∶夫前阴足厥阴
之脉络，循阴器出其挺。凡臭者，心之所主，散入五方为五臭，入肝为臊，此其一也。当于
肝经中泻行间，是治其本；后于心经中泻少冲，乃治其标。
（出自《针灸聚英》）
李东垣说：《黄帝针经》记载：患有胃病的人，胃脘部当心而痛，向上牵引两胁，膈部和咽喉不通畅，饮食难以下咽，应当取足三里穴用补法治疗。
脾胃虚弱，感受湿邪导致痿证，大汗淋漓，妨碍进食。针刺足三里、气冲穴，用三棱针放血；如果汗出不止，就在足三里穴下三寸的上廉穴放血。禁止饮酒，忌食潮湿的面食。
李东垣说：《黄帝针经》说：病势从下往上逆的，要引导其下行而去之。上焦之气不足的，要推举并升扬它。所谓上焦之气，是指心肺上焦之气，阳病在阴分，应从阴引阳，将邪气祛除于腠理皮毛之间。又说：看到以前疼痛的地方，应当先取治该处。这是先用缪刺法，泻除经络中壅滞的气血，因为血液凝滞而不流通，所以先去除瘀滞，然后再治疗其他疾病。
李东垣说：胃气下陷，五脏之气都会紊乱，各种病症互相交替出现。黄帝问：五脏之气逆乱，针刺有法则吗？岐伯说：有法则可以使其来，有法则可以使其去，审慎地知晓这些法则，就是身体的珍宝。黄帝说：我想听听这些法则！岐伯说：气逆乱在心，取手少阴心经和手厥阴心包经的俞穴：神门、大陵，配合守神导气的方法，使气恢复其本位。
气逆乱在肺，取手太阴肺经的荥穴、俞穴：鱼际、太渊。形成痿证的，通过疏导湿热，引导胃气出于阳道，不让湿土克制肾水，对应的穴位是太溪。
气逆乱在肠胃，取足太阴脾经和足阳明胃经的穴位。若不能下行，取足三里、章门、中脘。因足太阴脾经虚损的，在募穴中进行导引。这里有一种说法，腑的背俞穴可以治疗腑的病。胃虚导致足太阴脾经无所禀受（滋养）的，在足阳明胃经的募穴中进行引导。如气逆导致霍乱的，取足三里穴，待气降下才停止，若未降下则继续治疗。
气逆乱在头部，取天柱、大杼穴。若属不足，取足太阳膀胱经的荥穴、俞穴：通谷、束骨。先取天柱、大杼穴，不补不泻，仅用于导气。取足太阳膀胱经中的穴位，不补不泻，深取通谷、束骨穴（丁火穴、己土穴），以引导邪气离去。
气逆乱在手臂，足部取穴治疗，先去血脉瘀滞，后取手足阳明经的荥穴、俞穴：二间、三间，深刺；内庭、陷谷，深刺。观察足臂的血络，全部取治，之后治疗痿厥，都不采用补泻手法，从阴分深取，引气上行。所谓“上”，指出散、去除。这都是阴火有余，阳气不足，伏匿在地中（阴分）的营血。应当从阴引阳，先在阴分升举阳气，其次泻阴火，这是导气同精的方法。
黄帝问：补泻怎么做？回答说：缓慢进针，缓慢出针，叫做导气。补泻没有固定的形态，叫做同精。这并非有余或不足，而是气的逆乱。黄帝说：真是高明的道理啊，明察的提问啊，请写在玉版上，命名为治乱篇。
李东垣说：阴病治阳，阳病治阴。《阴阳应象大论》说：审察阴阳，以辨别柔刚，阴病治阳，阳病治阴，定其血脉，各守其乡，血实宜决破之，气虚宜导引之。所谓阴病在阳，是指天外的风寒邪气，乘虚从中而入，侵犯人体背部的腑俞、脏俞。人感受天外的客邪，也有两种情况。中于阳分则流于经脉，此病始于外寒，最终归于外热，所以治疗风寒邪气，治疗各脏的俞穴，不仅仅是风寒而已。六淫（风、寒、暑、湿、燥、火）皆由五脏所受，乃是筋骨血脉受邪，各有背上的五脏俞穴来清除它们。伤寒一说遵循张仲景，中八风者有风论。中暑者治疗在背上的小肠俞，中湿者治疗在胃俞，中燥者治疗在大肠俞，这些都是六淫客邪有余的病，都泻背部的腑俞。如果病久传变，有虚有实，各随病的传变，补泻不定，治疗只在背部的腑俞。
另有上热下寒的情况。经文说：阴病在阳，应当从阳引阴，必须先去络脉经隧中的瘀血。如果阴中火旺，上腾于天，致使六阳反不衰而上充的，先去五脏的血络，引导其下行，天气降下，则下寒的病自然去除。千万不要单独泻六阳经，此病是阳亢，乃阴火邪气滋助所致，只去阴火，只损脉络经隧的邪气，不要误治。阳病在阴，应当从阴引阳，是水谷的寒热，感邪则伤害六腑。又说：饮食失节，又劳役形体，阴火乘于坤土（脾胃）之中，致使谷气、荣气、清气、胃气、元气不得上升，滋扰六腑的阳气，这是五阳之气先在外部衰竭。外部属天，下流伏于坤土阴火之中，皆先由喜怒悲忧恐被五贼所伤，然后胃气不行，劳役饮食不节继之，则元气受伤，应当从胃经合穴三里穴中，推举并升扬它，以伸发元气，所以说从阴引阳。若元气更加不足，治疗在腹上诸腑的募穴。若传变在五脏，导致九窍不通，随各窍的病，治疗各脏在腹部的募穴，所以说五脏不平，是六腑元气闭塞所产生的。又说：五脏不和，九窍不通，都是阳气不足，阴气有余，所以说阳不胜其阴。凡是治疗腹部的募穴，都是因为元气不足，从阴引阳，不要误治。如果错误地补四末的俞穴，错误地泻四末的荥穴，错泻的话，差错尤其严重。按岐伯所说，只取穴于天上（背部）。天上者，是人背上的五脏六腑之俞，不当泻而泻，岂有能活的人呢？想到这些，寒心彻骨。如果是六淫客邪，及上热下寒，筋骨皮肉血脉的病，错误取穴于胃的合穴及诸腹的募穴，必定危险。这也是岐伯的话，下工怎么能不谨慎呢！
李东垣说：三焦元气衰旺。《黄帝针经》说：上气不足，脑为之不满，耳朵为之苦鸣，头为之倾斜，眼睛为之昏花。中气不足，大小便为之改变，肠道为之痛苦结滞。下气不足，则发生痿厥、心中闷乱，补足外踝下的昆仑穴……（原文此处似有缺漏，依文意补全语境，但翻译严格对应现有文本）
李东垣说：有一位富人前阴臊臭，又因连日饮酒，腹中不和，求先师治疗。先师说：前阴是足厥阴肝经的脉络，循行经过阴器，出于阴茎。凡气味，由心所主，散布入五方成为五臭，入肝为臊，这是其一。应当在肝经中泻行间穴，这是治本；后来在心经中泻少冲穴，这是治标。
(From *Zhenjiu Juying*)
Li Dongyuan said: The *Huangdi Zhenjing* (Yellow Emperor's Classic of Acupuncture) records: For those suffering from stomach disease, there is pain in the epigastrium corresponding to the heart, radiating upward to both hypochondriac regions, with obstruction in the diaphragm and pharynx, and difficulty in swallowing food. One should select Zusanli (ST36) and apply tonification.
When Spleen and Stomach deficiency leads to dampness transforming into flaccidity syndrome (Wei syndrome), with profuse sweating and impaired appetite, puncture Zusanli (ST36) and Qichong (ST30) with a three-edged needle to bleed. If sweating does not cease, bleed at Shanglian (ST34), located three cun below Zusanli (ST36). Alcohol is prohibited, and damp wheat noodles are contraindicated.
Li Dongyuan said: The *Huangdi Zhenjing* states: For conditions rising from below, guide them downward to eliminate them. For insufficiency of Qi in the Upper Jiao, push and elevate it. The "Qi of the Upper Jiao" refers to the Qi of the Heart and Lungs in the Upper Jiao. Yang diseases affecting Yin require drawing from Yin to reach Yang, expelling pathogenic factors from the Couli (interstices) and skin/hair layer. It also states: Where previous pain existed, one should first treat that area. This involves using Miao-cicada needling (Miu Ci) to drain stagnation in the meridians, as blood coagulation prevents flow; thus, remove the stasis first, then treat other diseases.
Li Dongyuan said: When Stomach Qi sinks, the Qi of the Five Zang organs becomes chaotic, and their pathological manifestations appear alternately. The Yellow Emperor asked: Is there a method for needling when Qi is chaotic in the five Zang? Qibo replied: There is a way for it to come, and a way for it to go; understanding this way thoroughly is the treasure of the body. The Yellow Emperor said: I wish to hear this method! Qibo said: When Qi is chaotic in the Heart, select the Shu-stream points of the Hand Shaoyin Heart Meridian and Hand Jueyin Pericardium Meridian: Shenmen (HT7) and Daling (PC7). Maintain Jing (Spirit) and guide Qi to restore its original position.
When Qi is chaotic in the Lung, select the Ying-Spring and Shu-stream points of the Hand Taiyin Lung Meridian: Yuji (LU10) and Taiyuan (LU9). For cases developing into flaccidity syndrome, guide damp-heat out through the Yang pathways to prevent Damp Earth from overacting on Kidney Water; the relevant point is Taixi (KI3).
When Qi is chaotic in the intestines and stomach, select points on the Foot Taiyin Spleen Meridian and Foot Yangming Stomach Meridian. If descent fails, select Zusanli (ST36), Zhangmen (LR13), and Zhongwan (CV12). For deficiency of the Foot Taiyin Spleen Meridian, guide Qi within the Mu-alarm points. There is a theory that Back-Shu points of Fu organs treat Fu organ diseases. For Stomach deficiency causing insufficient nourishment to the Foot Taiyin Spleen, guide Qi within the Mu-alarm point of the Foot Yangming Stomach Meridian. For example, in cases of Qi reversal causing Huoluan (cholera-like vomiting and diarrhea), select Zusanli (ST36); stop when Qi descends, or continue treatment if it does not.
When Qi is chaotic in the head, select Tianzhu (BL10) and Dazhu (BL11). For insufficiency, select the Ying-Spring and Shu-stream points of the Foot Taiyang Bladder Meridian: Tonggu (BL65) and Shugu (BL64). First select Tianzhu (BL10) and Dazhu (BL11), applying neither tonification nor sedation, merely to guide Qi. Select points on the Foot Taiyang Bladder Meridian, applying neither tonification nor sedation, and deeply needle Tonggu (BL65) and Shugu (BL64) (Ding Fire and Ji Earth points) to guide away the pathogen.
When Qi is chaotic in the arms, treat via foot points. First address the blood vessels, then select the Ying-Spring and Shu-stream points of the Hand and Foot Yangming Meridians: Erjian (LI2) and Sanjian (LI3), needled deeply; Neiting (ST44) and Xianggu (ST43), needled deeply. Observe the collateral vessels in the feet and arms and treat all visible ones. Subsequently treat flaccidity and cold limbs, applying neither tonification nor sedation. Draw from Yin deeply, guiding Qi upward. "Upward" implies dispersal and elimination. These conditions involve excess Yin Fire and insufficiency of Yang Qi, with Ying Blood hiding in the earth (Yin). One must draw from Yin to reach Yang, first raising Yang Qi from the Yin level, then draining Yin Fire. This is the method of guiding Qi and harmonizing Jing.
The Yellow Emperor asked: How are tonification and sedation performed? The answer was: Slow insertion and slow withdrawal is called guiding Qi. Tonification and sedation without fixed form are called harmonizing Jing. This is not about excess or insufficiency, but about the counterflow of chaotic Qi. The Yellow Emperor said: Truly profound is this Dao, truly clear is this question. Please inscribe it on the Jade Tablet, naming it "Treating Chaos."
Li Dongyuan said: Treat Yang diseases by addressing Yin, and Yin diseases by addressing Yang. The *Treatise on Yin-Yang Correspondences* states: Examine Yin and Yang to distinguish soft and hard; treat Yang diseases by addressing Yin, and Yin diseases by addressing Yang. Stabilize the blood vessels, each remaining in its domain. For excess blood, lancing is appropriate; for Qi deficiency, guiding and leading (Daoyin) is appropriate. "Yin disease in Yang" refers to external Wind-Cold pathogens entering from outside and invading the Back-Shu points of Fu and Zang organs. Humans contracting external pathogens have two scenarios. Pathogens entering Yang flow into the meridians; such diseases start with external Cold and end with external Heat. Thus, treating Wind-Cold pathogens involves treating the Shu points of respective Zang organs, not just Wind-Cold itself. The Six Evils (Wind, Cold, Summerheat, Dampness, Dryness, Fire) are received by the Five Zang, affecting sinews, bones, blood, and vessels, each having corresponding Back-Zang Shu points on the back to eliminate them. Regarding Cold Damage, one school follows Zhang Zhongjing; regarding contraction of the Eight Winds, there is a discussion on Wind. For Summerheat, treat Xiaochangshu (BL28) on the back; for Dampness, treat Weishu (BL21); for Dryness, treat Dachangshu (BL25). These are all excess conditions caused by external Six Evils, treated by draining the Back-Fu Shu points. If the disease persists and transforms, becoming either deficient or excess, treatment varies according to transformation, focusing only on the Back-Fu Shu points.
There is also Upper Heat and Lower Cold. The classic states: For Yin disease in Yang, one should draw from Yang to guide Yin, first removing blood from the collaterals and channels. If Fire within Yin is excessive and rises to Heaven, causing the Six Yang to remain full and ascend, first remove blood from the collaterals of the Five Zang, guiding it downward. When Heavenly Qi descends, the Lower Cold condition naturally resolves. Do not solely drain the Six Yang meridians. This condition features Yang hyperactivity fueled by Yin Fire pathogens; only remove Yin Fire and the pathogens in the collaterals/channels. Do not err. "Yang disease in Yin" means drawing from Yin to guide Yang; this involves Cold and Heat from food and drink harming the Six Fu organs. Furthermore, irregular diet and physical exertion allow Yin Fire to invade Kun Earth (Spleen/Stomach), preventing Grain Qi, Ying Qi, Clear Qi, Stomach Qi, and Yuan Qi from ascending to nourish the Yang Qi of the Six Fu organs. This results in the prior exhaustion of the Five Yang Qi externally. The exterior corresponds to Heaven; sinking into Kun Earth Yin Fire, these conditions originate from emotional injuries (Joy, Anger, Sorrow, Worry, Fear) damaging the Five Zang, followed by Stomach Qi stagnation due to exertion and dietary irregularities, injuring Yuan Qi. One should select Zusanli (ST36), the He-Sea point of the Stomach, to push and elevate, extending Yuan Qi; hence, "drawing from Yin to guide Yang." If Yuan Qi is severely deficient, treat the Mu-alarm points of the Fu organs on the abdomen. If transmission reaches the Five Zang, causing obstruction of the Nine Orifices, treat the abdominal Mu-alarm points of the respective Zang organs based on the specific orifice pathology. Hence, "Five Zang imbalance arises from the blockage of Yuan Qi in the Six Fu organs." It is also stated: "Five Zang disharmony and obstruction of the Nine Orifices result from Yang insufficiency and Yin excess," meaning Yang cannot overcome Yin. All treatments of abdominal Mu-alarm points address Yuan Qi insufficiency by drawing from Yin to guide Yang; do not err. Incorrectly tonifying Shu points at the four extremities, or incorrectly sedating Ying-Spring points at the four extremities, especially incorrect sedation, leads to severe errors. According to Qibo, one should only select points on "Heaven" (the back). "Heaven" refers to the Back-Shu points of the Five Zang and Six Fu organs. To sedate where sedation is inappropriate—how could life be preserved? Reflecting on this chills the bone. For Six Evil pathogens, Upper Heat/Lower Cold, and diseases of sinews, bones, skin, flesh, blood, and vessels, erroneously selecting the He-Sea point of the Stomach or abdominal Mu-alarm points will surely endanger life. As Qibo said, how can inferior practitioners fail to be cautious!
Li Dongyuan said: Regarding the decline and flourishing of Sanjiao (Triple Burner) Yuan Qi. The *Huangdi Zhenjing* states: Insufficiency of Upper Qi causes brain fullness to decrease, bitter ringing in the ears, tilting of the head, and dimming of vision. Insufficiency of Middle Qi causes changes in urination and defecation, and painful constipation in the intestines. Insufficiency of Lower Qi leads to flaccidity, cold limbs, and mental oppression; tonify Kunlun (BL60) below the outer ankle...
Li Dongyuan said: A wealthy man suffered from foul odor in the anterior yin region and abdominal discomfort due to consecutive days of drinking alcohol, seeking treatment from his master. The master said: The anterior yin is the pathway of the Foot Jueyin Liver Meridian, circulating through the genitalia and emerging at the penis. Odors are governed by the Heart; dispersed into the five directions, they become the five odors. Entering the Liver, it becomes fishy/sour (Sao). This is one aspect. One should sedate Xingjian (LR2) on the Liver Meridian to treat the root; subsequently, sedate Shaochong (HT9) on the Heart Meridian to treat the branch.