平按∶此篇自篇首至末，见《灵枢》卷五第二十《五邪》篇，又见《甲乙经》卷九自第三至
第八等篇。
邪在肺，则病皮肤寒热，上气，喘，汗出，咳动肩背。（肺病有五。平按∶皮肤下《灵枢》
有痛
字，《甲乙》有痛发二字。）取之膺中外输，背三椎五椎之旁，以手疾按之快然，乃刺之，取之
缺盆中以起之。（膺中内输，在膺前也。膺中外输，肺输也，在背第三椎两旁，心输在第五椎两
旁，各相去三寸，按之快然，此为输也。肺之五病，取于肺输及肺缺盆中也。平按∶输《灵枢》
作，《甲乙》作俞。三椎五椎《灵枢》作三节五脏，《甲乙》无五椎二字。以起之《灵枢》、
《甲乙》作以越之。）邪在肝，则两胁中痛，寒中，恶血在内行者，善螈节时肿。（肝病有四也。
平按∶则两胁中痛《甲乙》作则病两胁中痛。行者善螈节时肿《灵枢》作行善掣节时脚肿，《甲乙》
作节时肿善螈。）取之行间以引胁下，（行间，足厥阴脉荥，肝脉也，在大趾间。肝在胁下，
故引两胁下痛，与《明堂》少异也。）补三里以温胃中，（三里，足阳明胃脉。人病寒中，阳虚
也。故取三里补足阳明，即胃中温也。）取血脉以散恶血，（恶血在内上下行者，取其病处脉血
见者，刺而散之也。）取耳间青脉以去其痹。（耳间青脉，附足少阳脉 脉，一名资脉，在耳本，
如鸡足青脉络，刺出血如豆，可以去痹也。平按∶痹《灵枢》作掣，《甲乙》作 。注附袁刻作跗。）
邪在脾胃，则肌肉痛。阳气有余，阴气不足，则热中、善饥；阳气不足，阴气有余，则寒中、肠
鸣、腹痛；阴阳俱有余，若俱不足，则有寒有热，皆调于三里。（阳气，即足阳明也。阴气，即足
太阴也。此脾之七病，皆取三里以行补泻，故曰调之。平按∶则肌肉痛《灵枢》、《甲乙》作病
肌肉痛。善饥袁刻误作善肌。皆调于三里《甲乙》作皆调其三里。）邪在肾，则骨痛阴痹。阴痹
者，按如不得，腹胀腰痛，大便难，肩背颈项痛，时眩。取之涌泉、昆仑，视有血者尽取之。（涌
泉，足少阴脉井，足心陷中，屈足卷趾宛中。昆仑，足太阳经，在外踝后跟骨上陷中。肾之痹病，
皆取此
二穴，刺去血也。平按∶则骨痛《灵枢》、《甲乙》作则病骨痛，按如不得作按之而不得。颈项
痛《甲乙》作颈项强痛。）邪在心，则病心痛，喜悲，时眩仆。视有余不足而调之其输。（心病
三种，皆调其手心主经脉之输也。平按∶《甲乙》喜悲作善悲，而调之其输作而调其俞。）
【平按】：本篇从开头到结尾，内容见于《灵枢》卷五第二十篇《五邪》，同时也见于《甲乙经》卷九的第三至第八等篇。
邪气侵犯肺脏，就会引起皮肤恶寒发热、气逆上冲、喘息、出汗、咳嗽时牵引肩背疼痛。（肺病有五种表现。【平按】：《灵枢》中“皮肤”后有“痛”字，《甲乙经》中有“痛发”二字。）治疗应取胸前的外侧腧穴（膺中外输），以及背部第三椎和第五椎两侧的穴位，用手快速按压患者感觉舒适的地方，然后进行针刺，也可取缺盆穴以宣通肺气。（膺中的内侧腧穴位于胸前；膺中的外侧腧穴即肺之背俞穴，位于背部第三椎两旁，心之背俞穴在第五椎两旁，各相距三寸，按压后感到舒适，这就是腧穴。肺的五种病症，取肺之背俞穴及缺盆穴治疗。【平按】：“输”字在《灵枢》中作“腧”，在《甲乙经》中作“俞”。关于“三椎五椎”，《灵枢》作“三节五脏”，《甲乙经》无“五椎”二字。“以起之”在《灵枢》和《甲乙经》中作“以越之”。）
邪气侵犯肝脏，就会导致两胁中间疼痛，内脏虚寒，体内有瘀血运行不畅，容易发生筋脉抽搐、关节定时肿胀。（肝病有四种表现。【平按】：“则两胁中痛”在《甲乙经》中作“则病两胁中痛”。“行者善螈节时肿”在《灵枢》中作“行善掣节时脚肿”，在《甲乙经》中作“节时肿善螈”。）治疗应取行间穴以疏导胁下气机，（行间穴是足厥阴肝经的荥穴，位于大脚趾和第二脚趾之间。肝位于胁下，所以此穴能引导缓解两胁下的疼痛，这与《明堂经》记载略有不同。）补足三里穴以温煦胃中，（三里穴即足三里，属于足阳明胃经。人患内脏虚寒，是因为阳气虚弱。所以取三里穴补益足阳明经，就能使胃中温暖。）刺破瘀阻的血脉以消散恶血，（对于在体内上下运行的恶血，选取病变部位可见瘀血的脉络，针刺使其散开。【平按】：“痹”字在《灵枢》中作“掣”，在《甲乙经》中作“挛”。注：附袁刻本作“跗”。）刺破耳间的青色血脉以祛除痹症。（耳间的青色血脉，附着于足少阳胆经，又名资脉，位于耳根处，形状像鸡爪的青色脉络，针刺出血如豆粒大小，可以祛除痹症。）
邪气侵犯脾胃，就会导致肌肉疼痛。如果阳气有余、阴气不足，就会出现热中症、容易饥饿；如果阳气不足、阴气有余，就会出现寒中症、肠鸣、腹痛；如果阴阳都有余或都不足，就会出现既怕冷又怕热的症状，这些情况都可以通过调理三里穴来解决。（这里的阳气指足阳明胃经之气，阴气指足太阴脾经之气。这是脾的七种病症，都通过取三里穴施行补泻手法来治疗，所以说“调之”。【平按】：“则肌肉痛”在《灵枢》和《甲乙经》中作“病肌肉痛”。“善饥”在袁刻本中误作“善肌”。“皆调于三里”在《甲乙经》中作“皆调其三里”。）
邪气侵犯肾脏，就会导致骨痛和阴痹。所谓阴痹，表现为按压时感觉不到痛处或无法触及痛点，伴有腹胀、腰痛、大便困难、肩背颈项疼痛、时常头晕目眩。治疗应取涌泉穴和昆仑穴，观察是否有瘀血，若有则全部刺出。（涌泉穴是足少阴肾经的井穴，位于足心凹陷处，屈足卷趾时的宛陷中。昆仑穴是足太阳膀胱经穴位，位于外踝后方跟骨上方的凹陷中。肾的痹症，都取这两个穴位，针刺放血。【平按】：“则骨痛”在《灵枢》和《甲乙经》中作“则病骨痛”，“按如不得”作“按之而不得”。“颈项痛”在《甲乙经》中作“颈项强痛”。）
邪气侵犯心脏，就会导致心痛，喜欢悲伤，时常头晕跌倒。根据虚实情况，调节其所属经脉的腧穴。（心病有三种表现，都通过调节手厥阴心包经的腧穴来治疗。【平按】：《甲乙经》中“喜悲”作“善悲”，“而调之其输”作“而调其俞”。）
[Ping An]: This section, from the beginning to the end, is found in Chapter 20 "Wu Xie" (Five Pathogens) of Volume 5 of *Ling Shu* (Spiritual Pivot), and also appears in Chapters 3 through 8 of Volume 9 of *Jia Yi Jing* (The Classified Classic of Acupuncture and Moxibustion).
When pathogenic factors invade the Lung, symptoms include coldness and heat in the skin, upward rushing of Qi, panting, sweating, and coughing that pulls on the shoulders and back. (There are five types of Lung diseases. [Ping An]: The text in *Ling Shu* includes the character "pain" after "skin," while *Jia Yi Jing* includes "pain erupts.") Treatment should select the lateral acupoints on the chest (Yingzhong Waishu), as well as the areas beside the third and fifth thoracic vertebrae on the back. Press these areas quickly with the hand until a comfortable sensation is felt, then needle them. Additionally, Qimen (Clavicular Fossa) can be selected to disperse the pathogen. (The medial Yingzhong acupoint is located on the front of the chest; the lateral Yingzhong acupoint is the Back-Shu point of the Lung, located beside the third thoracic vertebra. The Back-Shu point of the Heart is beside the fifth thoracic vertebra, each separated by three cun. If pressing produces a comfortable sensation, it is the correct acupoint. For the five diseases of the Lung, treat using the Lung's Back-Shu point and Qimen. [Ping An]: The character "Shu" is written as "Yu" in *Ling Shu* and as "Shu" in *Jia Yi Jing*. Regarding "third and fifth vertebrae," *Ling Shu* writes "three joints, five zang organs," while *Jia Yi Jing* omits "fifth vertebra." "To raise it" in *Ling Shu* and *Jia Yi Jing* is written as "to transcend it.")
When pathogenic factors invade the Liver, pain occurs in the middle of both hypochondria, internal cold arises, and if evil blood stagnates within, there may be frequent spasms of the tendons and periodic swelling of the joints. (There are four types of Liver diseases. [Ping An]: "Then pain in the middle of both hypochondria" in *Jia Yi Jing* is written as "then disease pain in the middle of both hypochondria." "Movement, good spasms, periodic joint swelling" in *Ling Shu* is written as "movement, good pulling of joints, periodic foot swelling," while in *Jia Yi Jing* it is "periodic joint swelling, good spasms.") Treatment should select Xingjian (LR-2) to guide Qi under the hypochondria, (Xingjian is the Ying-Spring point of the Foot-Jueyin Liver Meridian, located between the big toe and the second toe. Since the Liver resides under the hypochondria, this point guides relief for pain in the hypochondria, which differs slightly from the description in *Ming Tang*.) Tonify Zusanli (ST-36) to warm the Middle Jiao, (Zusanli belongs to the Foot-Yangming Stomach Meridian. Internal cold arises due to deficiency of Yang Qi. Therefore, tonifying the Foot-Yangming via Zusanli warms the Stomach.) Puncture the collaterals containing stagnant blood to dissipate the evil blood, (For evil blood moving up and down within, select the visible blood vessels at the diseased site and needle them to dissipate the stagnation. [Ping An]: "Bi" (obstruction) in *Ling Shu* is written as "Che" (pulling), and in *Jia Yi Jing* as "Luan" (spasm). Note: Yuan edition writes "Fu".) Puncture the blue veins between the ears to remove Bi syndrome. (The blue veins between the ears attach to the Foot-Shaoyang Gallbladder Meridian, also known as Zi Mai, located at the root of the ear. They resemble the blue vascular network of a chicken's foot. Pricking them to bleed like a bean can remove Bi syndrome.)
When pathogenic factors invade the Spleen and Stomach, muscle pain occurs. If Yang Qi is excessive and Yin Qi is deficient, Heat in the Middle Jiao arises with frequent hunger; if Yang Qi is deficient and Yin Qi is excessive, Cold in the Middle Jiao arises with borborygmus and abdominal pain; if both Yin and Yang are excessive or both are deficient, there will be alternating sensations of cold and heat. All these conditions are regulated by adjusting Zusanli. (Here, Yang Qi refers to the Qi of the Foot-Yangming Stomach Meridian, and Yin Qi refers to the Qi of the Foot-Taiyin Spleen Meridian. These seven diseases of the Spleen are all treated by selecting Zusanli to apply tonification or sedation methods, hence it is said "regulate it." [Ping An]: "Then muscle pain" in *Ling Shu* and *Jia Yi Jing* is written as "disease muscle pain." "Good hunger" in the Yuan edition is erroneously written as "good muscle." "All regulated by Zusanli" in *Jia Yi Jing* is written as "all regulate their Zusanli.")
When pathogenic factors invade the Kidney, bone pain and Yin Bi arise. Yin Bi is characterized by an inability to locate pain upon pressure, abdominal distension, lower back pain, difficulty in defecation, pain in the shoulders, back, neck, and nape, and occasional dizziness. Treatment should select Yongquan (KI-1) and Kunlun (BL-60). Observe for blood stasis; if present, exhaustively puncture to release blood. (Yongquan is the Jing-Well point of the Foot-Shaoyin Kidney Meridian, located in the depression of the sole when the toes are curled. Kunlun is a point on the Foot-Taiyang Bladder Meridian, located in the depression posterior to the lateral malleolus and above the calcaneus. For Kidney Bi diseases, these two acupoints are selected to needle and release blood. [Ping An]: "Then bone pain" in *Ling Shu* and *Jia Yi Jing* is written as "then disease bone pain"; "press as if unable to find" is written as "press and cannot find." "Neck and nape pain" in *Jia Yi Jing* is written as "neck and nape stiffness/pain.")
When pathogenic factors invade the Heart, heart pain arises, along with a tendency toward sorrowfulness and occasional dizziness leading to collapse. Regulate the Shu points of the affected meriodian based on excess or deficiency patterns. (There are three types of Heart diseases, all treated by regulating the Shu points of the Pericardium Meridian of Hand-Jueyin. [Ping An]: In *Jia Yi Jing*, "likes sorrow" is written as "good sorrow," and "and regulate its Shu" is written as "and regulate its Yu".)