平按∶此篇自篇首至此其候也黄帝曰善，见《灵枢》卷十二第八十一《痈疽》篇。又自篇首
至藏伤故死矣，见《甲乙经》卷十一第九上编。又自黄帝曰愿尽闻痈疽之形至此其候也黄帝曰善，
见《甲乙经》卷十一第九下编。又自黄帝问于岐伯曰有病痈肿致痛至可使全黄帝曰善，见《素问》
卷十三第四十《腹中论》篇。又自黄帝问曰诸痈肿筋挛至末，见《素问》卷五第十七《脉要精微
论》篇，《甲乙》同上。
黄帝问于岐伯曰∶余闻肠胃受谷，上焦出气，以温分肉，而养骨节，通腠理。（上焦出卫气，
卫气为阳，故在分肉能温之也。气润骨节，骨节脑髓皆悉滋长，故为养也。令腠理无痈，故为通。）
中焦出气如露，上注溪谷，而渗孙脉孙络，津液和调，变化而赤为血，血和则孙脉先满，满乃注
于络脉皆盈，乃注于经脉。（出气，谓营气也。经络及孙络有内有外，内在脏腑，外在筋骨肉间。
谷入于胃，精液渗诸孙络，入于大络，大络入经，流注于外。外之孙络，以受于寒温四时之气，入
络行经以注于内。令明水谷津液，入于孙络，乃至于经也。内外经络行于脏腑，脏腑气和乃得生
也。平按∶露《甲乙》作雾。孙络二字《灵枢》、《甲乙》不重。而赤《甲乙》作赤而。先满满
乃注于络脉《灵枢》作先满溢乃注于络脉，《甲乙》满字不重。络脉下重络脉二字。注渗
诸孙络，诸袁刻作于。）阴阳已张，因息乃行，行有经纪，周有道理，与天协议，不得休止。（张，
□张也。阴，营气也。阳，卫气也。神之动也故出入息动，息之动也营卫气行，营卫气行必有经
纪，营卫周行道理，人与天道同运，天运非常之道故不休也。平按∶《甲乙》已张作乃张，乃行
作而行。）切而调之，从虚去实，泻则不足，疾则气减，留则先后；从实去虚，补则有余。血气
已调，形神乃持，余已知血气之平与不平，未知痈疽之所从生，成败之时，死生之期，期有远近，
何以度之，可得闻乎？（切，专志也。用心专至，调虚实也。泻者□顺于虚，专去盛实，泻之甚
者，则不足也。气至因而疾泻，则便气盛。气至留而不泻，则针与气先后不相得也。若顺实唯去
于虚，补之甚者，则有余也。是以切而调之者，得之于心，不可过虚实也。故善调者，补泻血气，
使形与神相保守也。持者，保守也。如此调养，血气平与不平，言已知之；然犹未通痈疽三种之
论，故请所闻。平按∶形神《灵枢》作形气，《甲乙》作神气。平与不平《甲乙》作至与不至。）
岐伯曰∶经脉留行不止，与天同度，与地合纪。（此言天有度数，地有经纪。）故天宿失度，日
月薄蚀，地经失纪，水道流溢，草 不成，五谷不殖，径路不通，民不往来，巷聚邑居，别离异
处。（ ，采古切，草名也，亦节枯也。此言天度地纪有失致损也。平按∶ 《灵枢》作 ，注云∶
“鱼饥切。”详《玉篇》 本作宜，鹿葱也。《广韵》
，采古切，草死也。与杨注节枯之意同，较 义为长。）血气犹然，请言其故。夫血脉营卫，
同流不休，上应星宿，下应经数。（此言人之血气合于天地。平按∶《甲乙》星宿作天宿。）寒
气客于经络之中则血泣，血泣则不通，不通则卫气归之，不得复反，故痈肿。寒气化为热，热
盛则腐肉，肉腐则为脓，脓不泻则烂筋，筋烂则伤骨，骨伤则髓消，不当骨空，不得泄泻，煎枯
空虚，则筋骨肌肉不相营，经脉败漏，熏于五脏，脏伤故死矣。（此言血气行失，有损有病也。
平按∶煎枯空虚《灵枢》作血枯空虚，《甲乙》作“则筋骨枯空，枯空”。《灵枢》营作荣，《甲
乙》作亲，经脉作经络，故死作则死。）黄帝曰∶愿尽闻痈疽之形与忌日名。（凡有三问∶一问
痈疽形状，二问痈疽死生忌日，三问痈疽名字也。）岐伯曰∶痈发于嗌中，名曰猛疽，猛疽不治，
化为脓，脓不泻，塞咽，半日死；其化为脓者，泻已已，则含豕膏，毋冷食，三日而已。（下答
痈疽形状及名并所发处，合二十一种∶一十八种有名有状，有所发处；三种但有所发之处，无名
与状。二十一种中，七种无死生忌日，余十四种皆有忌日。凡痈疽所生，皆以寒气客于经络之中，
令血凝涩不通，卫气归之，寒极化为热气，□成痈疽，腐肉为痈，烂筋坏骨为疽，轻者疗之可生，
重者伤脏致死。名猛疽等，痈疽之名，圣人见其所由立之名状如下，随变为形，亦应不可胜数也。
近代医人，元不识本名之旨，随意立称，不可为信。嗌，咽也。寒气客脉之处，即发热以为痈疽，
无常处也。平按∶泻已已，《灵枢》无两已字，《甲乙》作脓泻已。《灵枢》、《甲乙》含作合，
膏下无毋宇。注热气下原缺一字，袁刻作郁积二字，不合，谨空一格。）发于颈，名
曰夭疽，其痈大以赤黑，不急治，则热气下入泉液，前伤任脉，内熏肝肺，熏肝肺十余日而死矣。
（项前曰颈。平按∶泉《灵枢》、《甲乙》作渊，说见前。）阳气大发，消脑留项，名曰脑铄，
其色不乐，项痛而刺以针，烦心者，死不治。（脑后白项。平按∶阳气《灵枢》作阳留。《甲乙》
留项作溜项。铄《灵枢》、《甲乙》作烁。项痛而刺以针，《灵枢》刺上有如字，《甲乙》作脑
项痛如刺以针。《灵枢》治上有可字。）发于肩及 ，名曰疵痈，其状赤黑，急治之，此令人汗
出至足，不害五脏，痈发四五日，逆 之。（肩前臂上 肉名 。）发于掖下赤坚，名曰米疽，治
之砭石，欲细而长，数砭之，涂以豕膏，六日已，勿裹之。（砭，甫廉反，HT 同，以石刺病也。
欲细而长者，伤形深也。平按∶《灵枢》、《甲乙》坚下有者字，治之下有以字，数砭作疏砭。注
HT同二字袁刻脱。）其痈坚而不溃者，为马刀侠瘿，急治之。（马刀亦谓痈不脓溃者是也。颈前曰
婴也。）发于胸，名曰井疽，其状如大豆，三四日起，不早治，下入腹，不治，七日死。（井疽起
三四日，不疗下入腹，寒热不去十日死也。平按∶发于胁上《灵枢》、《甲乙》有“发于膺，名曰
甘疽，色青，其状如谷实栝蒌，常苦寒热，急治之，去其寒热，十岁死，死后出脓。”一条。）发
于胁，名曰败疵，败疵者女子之病也，灸之，其病大痈脓，治之，其中乃有生肉，大如赤小豆，
锉翘草根各一升，水一斗六升煮之，竭为三升，即强饮，浓衣坐釜上，令汗出至足已。（败亦曰改，量
谓此病。生于女子，故釜上蒸之，出汗即已。有本翘、松各一升。平按∶《甲乙》其中上无治之
二字， 上无锉字，有治之以三字，各一升上有及赤松子根五字，竭上有令字，为三升作得三升，
《灵枢》作为取三升。）发于股 ，名脱疽，其状不甚变而痈脓搏骨，不急治，三十日死。（髀
内曰股，股外曰髀，膝上股下骨称曰股 也。平按∶《灵枢》、《甲乙》 作胫，脱疽作股胫疽。
《甲乙》变下有色字，搏骨作内薄于骨急治之。）发于尻，名曰兑疽，其状赤坚大，急治之，不
治，三十日死矣。（尻， 也。 音谁。平按∶兑《灵枢》、《甲乙》作锐。三十日日本《医心
方》作四十日。）发于股阴，名曰赤施，不急治，六日死，在两股之内，不治，六十日而死。（阴
下之股。平按∶《甲乙》施作弛。《灵枢》六日作六十日，六十日作十日，《甲乙》同。）发于膝，
名曰疵疽，其状大痈，色不变，寒热而坚，勿石，石之死，须其柔乃石之者，生。（勿石之者，
准例皆砭之，此唯言石之，或以冷石熨之，所以坚而不石，以其寒聚结，听柔乃石之。平按∶《灵
枢》疵疽作疵痈，而坚作如坚石。《甲乙》须其柔作须其色异柔。）诸痈疽之发于节而相应者，
不可治也。（当节生痈，脓入节间伤液，故不可疗也。平按∶《甲乙》无疽字。）发于阳者，百
日死；发于阴者，四十日死也。（丈夫阴器曰阳，妇人阴器曰阴。平按∶四十日《灵枢》作三十日。）
发于胫，名曰兔啮，其状赤至骨，急治，不治，害
人也。（胫，谓膝下胫骨也。平按∶《甲乙》 作啮，赤作如赤豆三字，害人作杀人。）发于踝，
名曰走缓，其状色不变，数石其输而止其寒热，不死。（色不变者，肉色不变也。石其输者，以
冷石熨其所由之输也。平按∶《灵枢》、《甲乙》踝上有内字。《灵枢》状下有痈也二字。输《甲
乙》作俞。）发于足上下，名曰四淫，其状大痈，不色变，不治，百日死。（足上下者，足趺上下
也。平按∶《灵枢》、《甲乙》无不色变三字。）发于足旁，名曰厉疽，其状不大，初如小指发，
急治之，去其黑者，不消辄益，不治，百日死。（旁，谓足内外之侧也。平按∶初如《甲乙》作初
从，之去作去之，黑上有状字，不消作不可消。）发于足趾，名曰脱疽，其状赤黑，死不治，不赤
黑，不死，治之不衰，急斩去之活，不然则死矣。（不则死者，不斩去死也。平按∶《灵枢》不
衰上无治之二字，斩下无去字。《灵枢》、《甲乙》无活字。不然《甲乙》作不去。《灵枢》无然
字。）黄帝曰∶夫子言痈疽，何以别之？岐伯曰∶营卫稽留于经脉之中，则血泣而不行，不行则
卫气从之，从之而不通，壅遏而不得行，故曰大热不止，热胜则肉腐，肉腐则为脓，然不能陷于
骨髓，骨髓不为焦枯，五脏不为伤，故命曰痈。（营卫稽留经脉泣不行者，寒气客之，血泣不行，
卫气归在泣血之中也。平按∶《甲乙》稽留作积留，经脉作经络。《灵枢》从之二字不重，《甲
乙》作归之。故曰《灵枢》作故热，《甲乙》作故曰热。《灵枢》骨髓二字不重。陷于骨髓《甲
乙》作陷肌肤于骨髓，命曰作名曰。）黄帝曰∶何谓疽？岐伯曰∶热气淳盛，下陷肌肤，筋髓骨
枯，内连五脏，血气竭，当其痈下筋骨、良肉皆毋余，故命曰疽。（痈下者，即前之痈甚，肌、
肤、肉、筋、骨、髓，斯之六种，皆悉破坏，命之曰疽
也。平按∶淳《甲乙》作纯，骨枯作骨肉，《灵枢》无骨字。竭下《甲乙》有绝字。）疽者，上之
皮夭以坚，上如牛领之皮；痈者，其皮上薄以泽，此其候也。黄帝曰∶善。（此言其痈疽之候异。
平按∶《甲乙》上之作其上，夭下有瘀字，上如作状如。）
黄帝问于岐伯曰∶有病痈肿，颈痛胸满腹胀，此为何病？何以得之？（因于痈肿，有此三病，
未知所由，故请之也。平按∶《素问》痈作膺。《甲乙》颈作胫。）岐伯曰∶名厥逆。（因痈肿
热聚，气失逆上，上盛故颈痛，下虚故胸满腹胀也。平按∶《甲乙》作病名曰厥逆。注失字袁刻
脱。）曰∶治之奈何？曰∶灸之则喑，石之则狂，须其气并，乃可治。曰∶何以然？曰∶阳气重
上，有余于上，灸之则阳气入阴，则喑；石之则阳气虚，虚则狂；须其气并而治之，可使全。黄
帝曰∶善。（灸之喑者，阳气上实，阴气下虚，灸之火壮，阳盛溢入阴，故喑。以冷石熨之，则
阴气独盛，阳气独虚，以阳气独虚，发于狂。可任自和，然后疗之，使之全也。平按∶则喑《素问》
作入则喑，《甲乙》同。使全《甲乙》作使愈。）
黄帝问曰∶诸痈肿筋挛骨痛，此皆安生？（因于痈肿，有此二病，故请所生。平按∶生《甲乙》
作在，袁刻作主。）岐伯曰∶此寒气之肿也，八风之变也。曰∶治之奈何？曰∶此四时之病也，以
其胜，治其输。（筋骨是阴，加以寒气，故为寒肿也。此乃四时八正虚风变所为也，引其所胜克之
则愈也。平按∶治其输《素问》作治之愈也。《甲乙》输作俞。）
【按语】：本篇从篇首至“此候也黄帝曰善”，见于《灵枢》卷十二第八十一《痈疽》篇。又自篇首至“藏伤故死矣”，见于《甲乙经》卷十一第九上编。又自“黄帝曰愿尽闻痈疽之形”至“此候也黄帝曰善”，见于《甲乙经》卷十一第九下编。又自“黄帝问于岐伯曰有病痈肿致痛”至“可使全黄帝曰善”，见于《素问》卷十三第四十《腹中论》篇。又自“黄帝问曰诸痈肿筋挛”至篇末，见于《素问》卷五第十七《脉要精微论》篇，《甲乙经》同上。
黄帝向岐伯问道：我听说肠胃受纳水谷，上焦（胸膈以上部位）发出卫气，用以温煦分肉（肌肉间隙），滋养骨节，疏通腠理（皮肤纹理及汗孔）。（上焦发出的卫气，卫气属于阳，所以在分肉间能发挥温煦作用。气滋润骨节，骨节和脑髓都得以滋长，所以称为滋养。使腠理不发生痈肿，所以称为疏通。）中焦（脾胃所在部位）发出的气像露水一样，向上灌注到溪谷（肌肉间的凹陷处），并渗入孙脉（最细小的脉络）和孙络，津液调和，变化而成赤色的血，血液调和则孙脉先充盈，满了之后注入络脉使其充满，再注入经脉。（所谓发出的气，指的是营气。经络及孙络有内在外在之分，内在联系脏腑，外在分布于筋骨肌肉之间。谷物进入胃中，精微液体渗入各种孙络，进入大络，大络进入经脉，流注于外。体外的孙络，接受寒、温、四时之气，进入络脉运行于经脉以注入体内。以此说明水谷津液，进入孙络，进而到达经脉。内外经络行于脏腑，脏腑之气调和才能生存。）阴阳之气已经张开，随着呼吸而运行，运行有一定的规律，循环有一定的道理，与天道相合，不会停止。（张，是扩张的意思。阴，指营气。阳，指卫气。神的运动导致出入息的运动，呼吸的运动导致营卫气的运行，营卫气的运行必有经纬秩序，营卫周行有一定的道理，人与天道共同运转，天道的运行是非常之道所以不停止。）诊察并调治虚实，从虚证去除实证，泻法会导致不足，疾速泻法则气盛减少，留针过久则先后次序混乱；从实证去除虚证，补法会导致有余。血气已经调和，形体与精神得以保持，我已经知道血气的平和与不平和，但还不知道痈疽产生的原因、成败的时机、死生的期限，期限有远近，如何衡量它，可以讲给我听吗？（切，是专志的意思。用心专一，调治虚实。泻法是顺应虚证，专门去除盛实的邪气，泻得太过，就会造成不足。气至因而疾速泻之，就会使气盛。气至留针而不泻，则针刺与气机不相协调。如果顺应实证只去其虚，补得太过，就会造成有余。所以切而调治的方法，在于心得意会，不可过分对待虚实。所以善于调治的人，补泻血气，使形与神相互保守。持，就是保守。如此调养，血气的平与不平，是说已知晓；然而仍未通晓痈疽三种的理论，所以请教所听到的知识。）
岐伯回答说：经脉中的气血运行不止，与天的度数相同，与地的纪纲相合。（这是说天有度数，地有纪纲。）所以天上的星宿失去度数，日月发生亏蚀，地上的经线失去纪纲，水道泛滥，草类枯死，五谷不能种植，道路不通，百姓不能往来，村落城邑分离，各自居住。（ ，采古切，是一种草名，也是节令枯萎的意思。这是说天度地纪有失导致损伤。）人体的血气也是这样，请让我讲讲其中的缘故。人的血脉营卫，同流不息，上对应星宿，下对应地里的经纬度数。（这是说人的血气合于天地。）寒气客居在经络之中则血液凝涩，血液凝涩则不通，不通则卫气归附于此，不能再返回，所以发生痈肿。寒气转化为热，热盛则腐坏肌肉，肌肉腐坏则化为脓，脓液不排出则烂筋，筋烂则伤骨，骨伤则骨髓消减，如果不发生在骨空之处，不得泄泻，煎熬枯空虚，则筋骨肌肉互不营养，经脉败漏，熏灼五脏，脏气受伤所以死亡。
黄帝说：我希望详尽地听闻痈疽的形状和忌日名称。（共有三问：一问痈疽形状，二问痈疽死生忌日，三问痈疽名字。）岐伯说：痈发于咽喉中间，名叫猛疽，猛疽不治疗，化为脓，脓不排出，堵塞咽喉，半天就会死亡；如果已经化为脓，排脓后含服猪脂膏，不要吃冷的食物，三天就好了。（下面回答痈疽形状及名称并所发部位，共二十一种：十八种有名有状，有发病部位；三种只有发病部位，没有名称和形状。二十一种中，七种无死生忌日，其余十四种都有忌日。凡是痈疽的产生，都是因为寒气客居在经络之中，使血液凝涩不通，卫气归附于此，寒极转化为热气，形成痈疽，腐肉为痈，烂筋坏骨为疽，轻者治疗可生，重者伤脏致死。名为猛疽等，是痈疽的名称，圣人看到它们产生的缘由而立下的名称和形状如下，随着病情变化形成的形态，也应该数不胜数。近代医生，原本不认识本名的宗旨，随意立称，不可相信。嗌，就是咽。寒气客居脉处的地方，就发热成为痈疽，没有固定的位置。）
发于颈部，名叫夭疽，它的痈大而呈赤黑色，不紧急治疗，则热气向下流入泉液（唾液或津液），向前损伤任脉，向内熏灼肝肺，熏灼肝肺十余日后就会死亡。（颈的前面叫颈。）
阳气大发，消烁脑髓停留于项部，名叫脑铄，患者面色不乐，项痛如针刺，心烦意的，死亡无法治疗。（脑后白色部分叫项。）
发于肩部及腋下，名叫疵痈，它的形状赤黑，紧急治疗，这使人出汗直到脚底，不伤害五脏，痈发四五日，逆乱之气消散。（肩前臂上的肉叫 。）
发于腋窝下且坚硬发红，名叫米疽，治疗用砭石，砭石要细而长，多次刺之，涂上猪脂膏，六天痊愈，不要包扎。（砭，甫廉反，同HT，是用石头刺病。要细而长的原因是损伤较深。）
如果痈坚硬而不溃破的，叫做马刀侠瘿，紧急治疗。（马刀也是指痈不化脓溃破的情况。颈的前面叫婴也。）
发于胸部，名叫井疽，它的形状像大豆，三四天起病，不早治疗，向下传入腹部，不治疗，七天死亡。（井疽起病三四天，不治疗向下传入腹部，寒热不去十天死亡。）
发于胁部，名叫败疵，败疵是女子的病，用灸法治疗，如果变成大痈有脓，治疗时，其中会长出像赤小豆大小的生肉，锉翘草根各一升，用水一斗六升煮它，煮干成三升，立即强力饮用，穿厚衣服坐在锅上蒸，使出汗直到脚底就好了。（败也叫改，量度认为这个病。生于女子，所以在锅上蒸之，出汗即好。有的版本翘、松各一升。）
发于大腿内侧，名叫脱疽，它的形状变化不明显但痈脓紧贴骨头，不紧急治疗，三十天死亡。（髀内叫股，股外叫髀，膝上股下的骨叫股 ）
发于臀部，名叫兑疽，它的形状赤黑坚硬，紧急治疗，不治疗，三十天死亡。（尻，音谁。）
发于大腿内侧下方，名叫赤施，不紧急治疗，六天死亡，如果在两腿内侧，不治疗，六十天死亡。（阴下的大腿。）
发于膝盖，名叫疵疽，它的形状是大痈，颜色不变，有寒热且坚硬，不要用石刺，石刺会致死，等到它变软再用石刺的，能活。（不用石刺的原因，按照惯例都是砭刺，这里只说石刺，或者用冷石熨之，所以坚硬而不刺，因为寒聚结，等待变软再刺。）
凡是痈疽发于关节且相应的，不可治疗。（当关节生痈，脓入关节间伤液，所以不可疗。）
发于阳部的，一百天死亡；发于阴部的，四十天死亡。（男子生殖器叫阳，女子生殖器叫阴。）
发于小腿，名叫兔啮，它的形状红直到骨头，紧急治疗，不治疗，害人。（胫，指膝下胫骨。）
发于脚踝，名叫走缓，它的形状颜色不变，多次刺其输穴并停止寒热，不死。（颜色不变是指肉色不变。刺其输穴是用冷石熨其所由之输穴。）
发于足上下方，名叫四淫，它的形状是大痈，颜色不变，不治疗，一百天死亡。（足上下方指足背上下方。）
发于足旁，名叫厉疽，它的形状不大，起初像小指头那样突起，紧急治疗，去掉黑色的部分，不消退则增加，不治疗，一百天死亡。（旁指足内外侧。）
发于足趾，名叫脱疽，它的形状赤黑，死不治，不赤黑，不死，治疗无效，紧急斩除可活，不然则死。（不斩除死者，是不斩除而死。）
黄帝说：先生谈论痈疽，如何区别它们？岐伯说：营卫稽留在经脉之中，则血液凝涩而不行，不行则卫气随之，随之而不通，壅遏而不能运行，所以说大热不止，热胜则肉腐，肉腐则为脓，然而不能陷于骨髓，骨髓不为焦枯，五脏不为伤，所以命名为痈。
黄帝说：什么叫疽？岐伯说：热气淳盛，下陷肌肤，筋髓骨枯，内连五脏，血气竭，当其痈下筋骨、良肉皆无余，所以命名为疽。
疽的上皮色枯槁且坚硬，上面像牛颈的皮肤；痈的皮上薄而有光泽，这就是它们的征候。黄帝说：好。
黄帝问岐伯说：有病痈肿，颈痛胸满腹胀，这是什么病？怎么得的？（因为痈肿，有此三病，不知道由来，所以请教。）岐伯说：名叫厥逆。（因为痈肿热聚，气失逆上，上盛所以颈痛，下虚所以胸满腹胀。）
问：怎么治疗？答：灸它则会失音，用石刺它会发狂，必须等气并合，才可以治疗。问：为什么这样？答：阳气重在上，有余于上，灸之则阳气入阴，则失音；石之则阳气虚，虚则发狂；必须等气并合而治之，可以使痊愈。黄帝说：好。
黄帝问：各种痈肿筋挛骨痛，这些是怎么产生的？（因为痈肿，有此二病，所以请教产生原因。）岐伯说：这是寒气引起的肿，是八风的变化造成的。问：怎么治疗？答：这是四时的病，用克制它的方法，治疗其输穴。（筋骨是阴，加上寒气，所以为寒肿。这是四时八正虚风变化所为，引其所胜克之则愈。）
[Note]: This section from the beginning of the chapter to "the signs are so, the Yellow Emperor said 'Excellent'" is found in *Ling Shu* (Spiritual Pivot), Volume 12, Chapter 81, "Yong Ju" (Carbuncles and Ulcers). Also, from the beginning of the chapter to "injury to the Zang organs leads to death," it is found in *Jia Yi Jing* (The Classic of A-Bian Points), Volume 11, Part 9 Upper. Also, from "The Yellow Emperor said, I wish to hear fully about the forms of Yong Ju" to "the signs are so, the Yellow Emperor said 'Excellent'," it is found in *Jia Yi Jing*, Volume 11, Part 9 Lower. Also, from "The Yellow Emperor asked Qi Bo, saying: There is a disease of swelling and pain" to "can be made whole, the Yellow Emperor said 'Excellent'," it is found in *Su Wen* (Basic Questions), Volume 13, Chapter 40, "Fu Zhong Lun" (Discourse on Abdominal Diseases). Also, from "The Yellow Emperor asked, all swellings, tendon cramping, bone pain" to the end, it is found in *Su Wen*, Volume 5, Chapter 17, "Mai Yao Jing Wei Lun" (Essential Discourse on the Pulse as the Essential Subtlety), and *Jia Yi Jing* is the same.
The Yellow Emperor asked Qi Bo, saying: I have heard that the Stomach and Intestines receive grain, the Upper Jiao (Upper Burner) emits Qi, which warms the Fen Rou (muscle spaces), nourishes the joints, and unblocks the Cou Li (skin texture and pores). [The Qi emitted by the Upper Jiao is Wei Qi (Defensive Qi); Wei Qi belongs to Yang, so it can warm the Fen Rou. The Qi moistens the joints; the joints and brain marrow all grow, so it is called nourishment. It prevents carbuncles in the Cou Li, so it is called unblocking.] The Qi emitted by the Middle Jiao (Middle Burner) is like dew, flowing upward into the Xi Gu (valleys between muscles), and seeping into the Sun Mai (finest collaterals) and Sun Luo (collateral vessels). The Jin Ye (Body Fluids) are harmonized, change, and become red blood. When the blood is harmonized, the Sun Mai fill first; when full, they pour into the Luo Mai (collateral vessels) until they are full, then pour into the Jing Mai (Main Meridians). [The emitted Qi refers to Ying Qi (Nutritive Qi). The meridians and collateral vessels have internal and external aspects; internally they connect to the Zang-Fu organs, externally they distribute among the sinews, bones, and muscles. Grain enters the Stomach, its essence and fluids seep into various Sun Luo, enter the Da Luo (Large Collaterals), the Da Luo enter the Jing Mai, and flow outward. The external Sun Luo receive the Qi of Cold, Warmth, and the Four Seasons, enter the Luo Mai, travel through the Jing Mai, and inject inward. This clarifies how water and grain fluids enter the Sun Luo and reach the Jing Mai. Internal and external meridians travel within the Zang-Fu organs; only when the Qi of the Zang-Fu organs is harmonized can life be sustained.] Yin and Yang Qi have expanded, and move with respiration. Movement has its order, circulation has its principles, conforming to the Heavenly Dao, never ceasing. [Expanded means dilation. Yin refers to Ying Qi. Yang refers to Wei Qi. The movement of Shen (Spirit) causes the movement of inhalation and exhalation; the movement of respiration causes the movement of Ying and Wei Qi. The movement of Ying and Wei Qi must have meridional order; the circulation of Ying and Wei has principles. Man and Heaven operate together; the operation of Heaven follows extraordinary ways, thus it does not stop.] Palpate and regulate deficiency and excess. Remove excess from deficiency; using the reducing method leads to insufficiency. Rapid reduction reduces Qi abundance; retention leads to disorder of sequence. Remove deficiency from excess; using the reinforcing method leads to surplus. Once Blood and Qi are regulated, Form and Spirit are maintained. I already know the balance and imbalance of Blood and Qi, but I do not yet know the origin of Carbuncles and Ulcers, the timing of success and failure, the periods of life and death, whether near or far. How can we measure this? May I ask you to explain? [Palpate implies focused attention. Using focused mind to regulate deficiency and excess. Reducing methods follow deficiency, specifically removing excessive excess; if reduced too much, it leads to insufficiency. If Qi arrives and is rapidly reduced, Qi becomes abundant. If Qi arrives and is retained without reduction, the needle and Qi do not coordinate. If following excess only removes deficiency, reinforcing too much leads to surplus. Therefore, the method of palpating and regulating lies in mental comprehension and cannot overemphasize deficiency or excess. Thus, those skilled in regulation reinforce and reduce Blood and Qi, allowing Form and Spirit to mutually preserve. 'Maintain' means to preserve. Through such regulation, knowing the balance of Blood and Qi is stated as known; however, one has not yet understood the theory of the three types of Carbuncles and Ulcers, hence asking for what is heard.]
Qi Bo replied: The flow of Qi and Blood in the meridians never stops, matching the degrees of Heaven and the measures of Earth. [This states that Heaven has degrees and Earth has measures.] Thus, if celestial bodies lose their degrees, eclipses occur; if earthly meridians lose their measures, waterways overflow, grass withers, grains fail to grow, paths are blocked, people cannot travel, villages and cities separate and dwell apart. [ , pronounced Cai Gu Qie, is a name of a grass, also meaning withering due to seasonal changes. This states that loss of Heavenly degrees and Earthly measures causes damage.] Human Qi and Blood are the same; let me explain the cause. Human blood vessels, Ying, and Wei flow together without rest, corresponding above to the stars and below to the measures of the earth. [This states that human Qi and Blood combine with Heaven and Earth.] When Cold Qi lodges in the meridians, Blood becomes stagnant and does not flow. When Blood does not flow, Wei Qi returns to it and cannot return elsewhere, resulting in swelling (Yong). Cold Qi transforms into Heat. When Heat is excessive, flesh rots; when flesh rots, pus forms. If pus is not drained, tendons rot; when tendons rot, bones are injured; when bones are injured, marrow diminishes. If it does not occur at bone openings and cannot drain, it boils and dries up the void, causing sinews, bones, and muscles to fail to nourish each other. Meridians break and leak, fuming upon the Five Zang organs. Injury to the Zang organs leads to death.
The Yellow Emperor said: I wish to hear fully about the forms and taboo days/names of Carbuncles and Ulcers. [There are three questions: 1. Forms of Carbuncles and Ulcers; 2. Taboo days for life and death; 3. Names of Carbuncles and Ulcers.] Qi Bo said: A Carbuncle appearing in the throat is called Meng Ju (Fierce Carbuncle). If Meng Ju is not treated, it turns to pus. If pus is not drained, it blocks the throat, leading to death within half a day. If it has turned to pus, after draining, hold pig fat in the mouth, avoid cold food, and it will heal in three days. [Below answers the shape, name, and location of twenty-one types of Carbuncles and Ulcers: eighteen have names, shapes, and locations; three have only locations. Among the twenty-one, seven have no life/death taboo days; the remaining fourteen do. All Carbuncles and Ulcers arise because Cold Qi lodges in the meridians, causing Blood stagnation and blockage. Wei Qi gathers there. Extreme Cold transforms into Heat, forming Carbuncles/Ulcers. Rotting flesh is Yong (Carbuncle); rotting tendons and damaging bones is Ju (Ulcer). Mild cases can be cured; severe cases injure Zang organs and cause death. Names like Meng Ju are established by Sages based on origins and forms. As conditions change, forms are countless. Modern doctors do not understand the original intent of names and create arbitrary ones, which cannot be trusted. 'Yi' means throat. Where Cold Qi lodges in the pulse, heat arises forming Carbuncles/Ulcers, with no fixed location.]
A Carbuncle appearing on the neck is called Tian Ju (Premature Death Carbuncle). Its swelling is large and dark red/black. If not treated urgently, Heat Qi descends into the fluids, injuring the Ren Mai (Conception Vessel) forward, and internally steaming the Liver and Lungs. Steaming the Liver and Lungs leads to death in ten-plus days. [The front of the neck is called neck.]
Excessive Yang Qi expands, consuming brain marrow and lingering in the nape, called Nao Shuo (Brain Fusing). The complexion is unhappy, the nape hurts as if pierced by a needle, and irritability indicates death that cannot be treated. [The white part behind the head is called the nape.]
A Carbuncle appearing on the shoulder and axilla is called Ci Yong. Its appearance is red and black. Treat urgently; this causes sweating down to the feet but does not harm the Five Zang organs. If the Carbuncle appears for four to five days and the rebellious Qi dissipates... [The muscle on the upper arm before the shoulder is called ...].
A hard, red swelling under the armpit is called Mi Ju (Rice Carbuncle). Treat with Bian stones (stone needles), which should be fine and long. Puncture frequently, apply pig fat ointment, and it heals in six days. Do not bandage it. [Bian, pronounced Fu Lian Fan, uses stone to treat disease. Fine and long because the injury is deep.]
If a swelling is hard and does not suppurate, it is called Ma Dao Xia Ying (Horse Knife and Adjacent Goiter). Treat urgently. [Ma Dao also refers to a Carbuncle that does not suppurate. The front of the neck is called Ying.]
A Carbuncle appearing in the chest is called Jing Ju (Well Ulcer). Its shape is like a soybean. It starts in three to four days. If not treated early, it descends into the abdomen. If untreated, death occurs in seven days. [Jing Ju starting in three to four days, if not treated and descending into the abdomen, with persistent chills and fever, death occurs in ten days.]
A Carbuncle appearing on the hypochondrium is called Bai Ci (Failed Blemish). Bai Ci is a disease of women. Moxibustion treats it. If it becomes a large abscess with pus, treatment reveals raw flesh inside, the size of a red adzuki bean. Decoct one sheng each of Qiao Cao Gen (Radix Consolidae) and Chi Xiao Dou (Red Bean), boil in one dou six sheng of water until reduced to three sheng. Drink strongly while sitting on a hot pot wrapped in thick clothes, inducing sweat down to the feet, and it heals. [Bai also means change. Considering this disease arises in women, steaming on a pot induces sweat and healing. Some versions have Qiao and Song each one sheng.]
A Carbuncle appearing on the inner thigh is called Tuo Ju (Falling Off Ulcer). Its appearance shows little change, but the abscess presses against the bone. If not treated urgently, death occurs in thirty days. [Inner thigh is Gu; outer thigh is Bi; the bone between knee and thigh is called Gu ...]
A Carbuncle appearing on the buttocks is called Dui Ju. Its appearance is red, hard, and large. Treat urgently. If untreated, death occurs in thirty days. [Kao, pronounced Shui.]
A Carbuncle appearing on the lower inner thigh is called Chi Shi. If not treated urgently, death occurs in six days. If in both inner thighs, untreated death occurs in sixty days. [Lower thigh of the Yin.]
A Carbuncle appearing on the knee is called Ci Ju. Its shape is a large abscess, color unchanged, with chills/fever and hardness. Do not puncture with stone; stone puncture causes death. Wait until it softens before puncturing with stone; this ensures survival. [Reason for not puncturing: normally all are bled/punctured, but here only stone is mentioned, possibly using cold stone moxibustion. Because it is hard due to cold accumulation, wait for softness before puncturing.]
Any Carbuncle or Ulcer appearing at a joint and corresponding to it cannot be treated. [When a Carbuncle arises at a joint, pus enters the joint space and damages fluid, so it cannot be healed.]
Those appearing in Yang areas die in one hundred days; those appearing in Yin areas die in forty days. [Male genitalia are Yang; female genitalia are Yin.]
A Carbuncle appearing on the calf is called Tu Nie (Rabbit Bite). Its redness extends to the bone. Treat urgently. If untreated, it harms the person. [Ting refers to the tibia below the knee.]
A Carbuncle appearing on the ankle is called Zou Huan. Its color is unchanged. Frequent puncturing of its Shu points and stopping chills/fever ensures survival. [Color unchanged means skin color is unchanged. Puncturing Shu points means using cold stone to moxa the relevant Shu point.]
A Carbuncle appearing on the top and bottom of the foot is called Si Yin. Its shape is a large abscess, color unchanged. Untreated, death occurs in one hundred days. [Top and bottom of foot refers to dorsum and plantar surface.]
A Carbuncle appearing on the side of the foot is called Li Ju. Its shape is not large, initially like a small finger protruding. Treat urgently. Remove the black parts. If it does not subside, it increases. Untreated, death occurs in one hundred days. [Side refers to medial and lateral sides of the foot.]
A Carbuncle appearing on the toe is called Tuo Ju. Its color is red and black; death is incurable. If not red and black, death is avoidable. If treatment fails, amputation is urgent for survival; otherwise, death ensues. [Not amputating leads to death.]
The Yellow Emperor said: Master, regarding Carbuncles and Ulcers, how do we distinguish them? Qi Bo said: When Ying and Wei Qi stagnate in the meridians, Blood stagnates and does not flow. When Blood does not flow, Wei Qi follows it. Following it but failing to circulate, it obstructs and cannot move, causing persistent high heat. Excessive Heat rots flesh; rotted flesh becomes pus. However, it cannot sink into the bone marrow, so marrow does not scorch, and the Five Zang organs are not injured. Hence, it is named Yong (Carbuncle).
The Yellow Emperor said: What is Ju (Ulcer)? Qi Bo said: When Heat Qi is dense and excessive, sinking into the skin, it withers sinews, marrow, and bones, connects internally to the Five Zang organs, exhausts Blood and Qi. At the site of the Yong, sinews, bones, and healthy flesh are completely destroyed. Hence, it is named Ju (Ulcer).
For Ju, the skin is pale and hard, resembling the hide of an ox's neck. For Yong, the skin is thin and glossy. These are their signs. The Yellow Emperor said: Excellent.
The Yellow Emperor asked Qi Bo, saying: There is a disease of swelling, neck pain, chest fullness, and abdominal distension. What disease is this? How did it arise? [Due to swelling, these three diseases exist, but the cause is unknown, hence the question.] Qi Bo said: It is named Jue Ni (Rebellious Counterflow). [Due to heat aggregation in swelling, Qi rebels upward. Upper excess causes neck pain; lower deficiency causes chest fullness and abdominal distension.]
Question: How to treat? Answer: Moxibustion causes aphonia; stone puncture causes mania. One must wait for the Qi to merge before treating. Question: Why? Answer: Yang Qi is heavy above, excessive in the upper body. Moxibustion drives Yang Qi into Yin, causing aphonia; stone puncture depletes Yang Qi, leading to mania due to deficiency. Treating after Qi merges allows for complete recovery. The Yellow Emperor said: Excellent.
The Yellow Emperor asked: Various swellings, tendon cramping, and bone pain—how do they arise? [Due to swelling, these two diseases exist, hence asking for origin.] Qi Bo said: These are swellings caused by Cold Qi and changes from the Eight Winds. Question: How to treat? Answer: These are diseases of the Four Seasons. Treat by overcoming them via their Shu points. [Sinews and bones are Yin; adding Cold Qi causes cold swelling. These are caused by deficient winds of the Four Seasons and Eight Directions. Invoking the controlling element cures them.]