平按∶此篇见《灵枢》卷一第四《邪气脏腑病形》篇。自五脏六腑之气至此胃脉也，见《甲
乙经》卷四第二下编。自大肠腑者至取三里，见《甲乙经》卷九第七。自小肠病者至取巨虚上廉，
见《甲乙经》卷九第八。自三焦病者至取之委中央，见《甲乙经》卷九第九。自胆病者至阳陵泉，
见《甲乙经》卷九第五。自刺此者必中气穴至末，见《甲乙经》卷五第一下编。惟自大肠以下，《甲
乙经》文义虽同，编次前后小异。
黄帝曰∶余闻五脏六腑之气，荥输所入为合。今何道从入？入安连过？愿闻其故。（问脏腑
脉之荥输之合，行处至处也。平按∶输《甲乙》作俞。今《灵枢》、《甲乙》均作令。连过《甲乙》
作从道，无愿闻其故及下岐伯答七字。）岐伯答曰∶此阳脉之别入于内，属于腑者也。（此言合
者，取三阳之脉别属腑者称合，不取阴脉。以阳脉内属于腑，邪入先至于腑，后至于脏故也。）
黄帝曰∶荥输与合，各有名乎？岐伯答曰∶荥输治外经，合治内腑。（五脏六腑，荥输未至于内，
故但疗外经之病。此言合者，唯取阳经属内腑者，以疗内腑病也。平按∶《甲乙》外下有脏字。）
黄帝曰∶治内腑奈何？岐伯答曰∶取之于合。黄帝曰∶合各有名乎？岐伯答曰∶胃合入于三里，
（胃气，循足阳明脉，合于三里，故胃有病，取之三里，疗胃腑也。平按∶《灵枢》无入字。）
大肠合入于巨虚上廉，（大肠之气，循胃足阳明脉，合巨虚上廉，故大肠有病，疗巨虚上廉也。）
小肠合入于巨虚下廉，（小肠之气，循足阳明脉，合巨虚下廉，故小肠有病，疗巨虚下廉也。）
三焦合入于委阳，（三焦之气，循足太阳合于委阳，故三焦有病，疗于委阳也。）膀胱合入于委
中，（膀胱之气，循足太阳脉，下合委中，故膀胱有病，疗于委中也。平按∶中下《灵枢》、
《甲乙》均有央字。）胆合入于阳陵泉。（胆气，循足少阳脉，下合阳陵泉，故胆有病，疗阳陵
泉也。）黄帝曰∶取之奈何？答曰∶取之三里者，低跗；取之巨虚者，举足；取之委阳者，屈伸
而索之；委中者，屈而取之；阳陵泉者，正立竖膝，予之齐下，至委阳之阳取之；取诸外经者，
揄伸而从之。（以下取六合之输，疗内府法也。正立则膝
竖。揄，与朱反，引也。平按∶《甲乙》索作取，屈而取之作屈膝而取之。《灵枢》竖上无立字，
伸作申。）黄帝曰∶愿闻六腑之病。（六腑与六输而合疗内腑之病，而未知腑病之形也。）岐伯
曰∶面热者，足阳明病，（以下言手足阳明病。面热，阳明脉起面，故足阳明病，面热为候也。）
鱼络血者，手阳明病，（手阳明脉行于鱼后，故鱼络血见，手阳明病候也。）两跗之上脉坚若陷
者，足阳明病，此胃脉也。（足阳明下足跗入大指间，故跗上脉紧若陷，足阳明病候。平按∶《灵
枢》坚若二字作竖。）大肠病者，肠中切痛而鸣濯濯，冬日重感于寒则泄，当齐而痛，不能久立，
与胃同候，取巨虚上廉。（以下言六腑病形并取穴所在。当齐痛者，回肠，大肠也，大肠当齐，
故病当齐痛也。与胃同候者，大肠之气，与胃足阳明合巨虚上廉，故同候之。濯，徒角反，肠中
水声也。平按∶则泄《灵枢》作即泄，《甲乙》无此二字。）胃病者，腹 胀，胃管当心而痛，上
交两胁，鬲咽不通，饮食不下，取之三里。（胃管当心痛者，胃脉足阳明之正，上至髀，入于腹
里，属胃散脾，上通于心，上循咽，其足阳明大络，循胫骨外廉，上络头，故胃管及当心而痛，
上交于胁，鬲中并咽，并不得通也。平按∶胃管《灵枢》、《甲乙》作胃脘。上交《灵枢》作上肢，
《甲乙》作上 。鬲《灵枢》作膈。）小肠病者，少腹痛，腰脊控尻而痛，时窘之后，（小肠当少
腹附脊，左环叶积，故少腹腰脊控尻而痛，时急之 大便之处也。平按∶少腹《灵枢》作小腹。
控尻《灵枢》、《甲乙》作控睾。注左环，左字袁刻误作空。）当耳前热，若寒甚，若独眉
上热甚，（小肠手太阳，上 至目锐 ，却入耳中，故小肠病，循此寒及热也。平按《甲乙》耳上
无当字。眉《灵枢》、《甲乙》作肩。）及手小指次指之间热，若脉陷者，此其候手太阳也，取
巨虚下廉。（手太阳脉出行之处，故此处热、脉陷以为候也。平按∶《灵枢》太阳下有病字。）
三焦病者，腹气满，少腹尤坚，不得小便，窘急，（尤，甚也。平按∶《甲乙》腹下有胀字，尤
坚作尤甚坚。）溢则为水，留则为胀，候在足太阳之外大络，络在太阳少阳之间，亦见于脉，取
之委阳。（下焦溢则为水也。太阳少阳之间，三焦下输委阳也。平按∶《灵枢》水上无为字，留
则作留即。委阳《甲乙》作委中。）膀胱病，少腹偏肿而痛，以手按之，则欲小便而不得，（偏
肿者，大腹不肿也，此府病也。平按∶则欲《灵枢》作即欲。）肩上热若脉陷，及足小指外侧及
胫踝后皆热若脉陷，取之委中央。（膀胱足太阳脉，起目内 ，上额下项，循胫踝后至足小指外
侧，故膀胱病，循脉行处热及脉陷以为候也。平按∶肩上《甲乙》作眉上，注云∶“一本作肩。”
《灵枢》外侧作外廉。取之委中央《甲乙经》作取委中。）胆病者，善太息，（胆病则魂神不畅，
故好太息也。）口苦呕宿汁，（胆热溢水精，故口苦呕宿胆汁。平按∶汁《甲乙》作水。）心下澹
澹恐，如人将捕之，（胆病心动怖畏，故如人将捕也。平按∶《甲乙》恐上有善字。《灵枢》无
如字。）嗌中 然数唾，候在足少阳之本末，（ 谓阂，咽嗌之中，如有物阂也，居薤反。
足少阳本在窍阴之间，标在窗笼，即本末也。平按∶数唾《甲乙》作数咳唾。《灵枢》唾下无候
字。）亦视其脉之陷下者灸之，其寒热也，取之阳陵泉。（脉陷下者寒，故灸之也。寒热取阳陵
泉，通行针灸也。）黄帝曰∶刺之有道乎？岐伯曰∶刺此者，必中气穴，毋中肉节，中气穴
则针游于巷，中肉节则肉肤痛，（以下行针法也。中于肉者，不着分肉之间，中于节者，不针骨
穴之内，皆不游巷也。巷，谓街巷，空穴之处也。平按∶游《灵枢》作染，注云∶“一作游。”
肉肤《灵枢》、《甲乙》作皮肤。）补泻反则病益笃，（虚而泻之，实而补之，故曰反也。）中筋
则筋缓，（中筋不中其痛，则筋伤无力，故缓也。）邪气不出，与真气相薄，乱而不去，反还内
着，用针不审，以顺为逆。黄帝曰∶善。（若中肉节及中于筋，不当空穴，邪气不出，与真气相
薄，正邪相乱，更为内病也，以其用针不审，乖理故也。平按∶与真气相薄《灵枢》作与其真相
搏，《甲乙》作与真相薄。注内病袁刻误作内痛。）
【平按】：此篇见于《灵枢》卷一第四《邪气脏腑病形》篇。从“五脏六腑之气”至此处的“胃脉”，见于《甲乙经》卷四第二下编。从“大肠腑者”至“取三里”，见于《甲乙经》卷九第七。从“小肠病者”至“取巨虚上廉”，见于《甲乙经》卷九第八。从“三焦病者”至“取之委中央”，见于《甲乙经》卷九第九。从“胆病者”至“阳陵泉”，见于《甲乙经》卷九第五。从“刺此者必中气穴”至文末，见于《甲乙经》卷五第一下编。唯独从“大肠”以下，《甲乙经》的文义虽然相同，但编排顺序略有差异。
黄帝说：我听说五脏六腑的气，荥穴、输穴和合穴是气血深入汇聚的地方。现在它们是从什么途径进入的？进入后连接经过哪里？我想听听其中的道理。（这是询问脏腑经脉的荥穴、输穴和合穴的运行路径及终点。平按：《甲乙经》中“输”写作“俞”。现今《灵枢》、《甲乙经》均作“令”。《甲乙经》中“连过”写作“从道”，没有“愿闻其故”及下文岐伯回答的七个字。）
岐伯回答说：这是阳经别行的支脉进入体内，归属于六腑的。（这里所说的“合”，是指选取三阳经别行分支归属于六腑的穴位称为合，不选取阴经的穴位。因为阳经内属于六腑，邪气侵入时先到达六腑，然后才到达五脏。）
黄帝说：荥穴、输穴和合穴，各自有名称吗？
岐伯回答说：荥穴和输穴治疗外经的病，合穴治疗内腑的病。（五脏六腑的荥穴和输穴尚未深入内部，所以只治疗外经的疾病。这里所说的合穴，仅选取阳经中归属于内腑的穴位，用来治疗内腑的疾病。平按：《甲乙经》在“外”字下有“脏”字。）
黄帝说：治疗内腑的方法是怎样的？
岐伯回答说：选取合穴来治疗。
黄帝说：合穴各自有名称吗？
岐伯回答说：胃的合穴在足三里，（胃气，沿着足阳明胃经运行，汇合于足三里，所以胃有病，取足三里，治疗胃腑。平按：《灵枢》中没有“入”字。）
大肠的合穴在上巨虚（巨虚上廉），（大肠之气，沿着足阳明胃经运行，汇合于上巨虚，所以大肠有病，治疗上巨虚。）
小肠的合穴在下巨虚（巨虚下廉），（小肠之气，沿着足阳明胃经运行，汇合于下巨虚，所以小肠有病，治疗下巨虚。）
三焦的合穴在委阳，（三焦之气，沿着足太阳膀胱经运行，汇合于委阳，所以三焦有病，治疗委阳。）
膀胱的合穴在委中，（膀胱之气，沿着足太阳膀胱经下行，汇合于委中，所以膀胱有病，治疗委中。平按：《灵枢》、《甲乙经》在“中”字下有“央”字。）
胆的合穴在阳陵泉。（胆气，沿着足少阳胆经下行，汇合于阳陵泉，所以胆有病，治疗阳陵泉。）
黄帝说：如何取这些穴位？
回答说：取足三里穴时，脚背要放低；取上巨虚和下巨虚穴时，要抬起脚；取委阳穴时，要屈伸腿部并寻找；取委中穴时，要弯曲膝盖来取；取阳陵泉穴时，身体正直站立，竖起膝盖，将手放在与膝齐平的高度，向下至委阳外侧来取；取外经的穴位时，要牵引伸展肢体来寻找。（以下是取六合之输穴，治疗内腑的方法。正立则膝盖竖起。揄，音朱，意为牵引。平按：《甲乙经》中“索”写作“取”，“屈而取之”写作“屈膝而取之”。《灵枢》中“竖”字上没有“立”字，“伸”写作“申”。）
黄帝说：我想听听六腑的疾病表现。
（六腑与六个合穴相配合来治疗内腑的疾病，但还不知道腑病的具体形态。）
岐伯说：面部发热的，是足阳明胃经的病，（以下讲述手足阳明经的病。面热，是因为阳明经脉起于面部，所以足阳明经有病，面部发热是其征候。）
手掌大鱼际络脉处见血的，是手阳明大肠经的病，（手阳明经脉行于大鱼际后方，所以大鱼际络脉出血，是手阳明经病的征候。）
双脚背上方脉搏坚硬或凹陷的，是足阳明胃经的病，这就是胃的经脉。（足阳明经下行至足背，进入大脚趾之间，所以足背上脉搏紧硬或凹陷，是足阳明经病的征候。平按：《灵枢》中“坚若”二字写作“竖”。）
大肠有病的人，肠中剧烈疼痛且发出濯濯的水声，冬天再次受寒就会腹泻，肚脐周围疼痛，不能久站，这与胃的病候相同，取上巨虚穴治疗。（以下讲述六腑疾病的形态以及取穴所在。当脐部疼痛的，是因为回肠即大肠位于脐部，所以大肠有病会在脐部疼痛。与胃同候的，是因为大肠之气与足阳明胃经汇合于上巨虚，所以征候相同。濯，音徒角，指肠中的水声。平按：《灵枢》中“则泄”写作“即泄”，《甲乙经》没有这两个字。）
胃病的人，腹部胀满，胃脘当心口疼痛，向上牵连两胁，膈咽不通畅，饮食难以下咽，取足三里穴治疗。（胃脘当心口疼痛的，是因为足阳明胃经的正脉，上行至大腿，进入腹腔，属胃散脾，上行通心，沿咽部上行；其大的络脉，沿胫骨外侧上行，联络头部，所以胃脘及当心口疼痛，向上牵连胁肋，膈中和咽喉都不通畅。平按：《灵枢》、《甲乙经》中“胃管”写作“胃脘”。《灵枢》中“上交”写作“上肢”，《甲乙经》写作其他字形。“鬲”《灵枢》写作“膈”。）
小肠有病的人，小腹部疼痛，腰脊牵引臀部疼痛，时常感到大便急迫，（小肠位于小腹附着于脊柱，左侧环绕积聚，所以小腹、腰脊牵引臀部疼痛，时常急需排便之处。平按：《灵枢》中“少腹”写作“小腹”。《灵枢》、《甲乙经》中“控尻”写作“控睾”。注解说左环，左字袁刻误作空。）
耳前发热，或者寒冷严重，或者单独眉毛上方发热严重，（小肠经属手太阳，上行至目外眦，却进入耳中，所以小肠有病，循行此处会出现寒热症状。平按：《甲乙经》耳字上没有“当”字。眉《灵枢》、《甲乙经》写作“肩”。）
以及手小指和次指之间发热，或者脉搏凹陷的，这是手太阳小肠经的征候，取下巨虚穴治疗。（手太阳经脉出行的地方，所以此处发热、脉搏凹陷作为征候。平按：《灵枢》中“太阳”下有“病”字。）
三焦有病的人，腹部气机胀满，小腹部尤其坚硬，小便不通，窘迫急迫，（尤，意思是甚。平按：《甲乙经》腹字下有“胀”字，“尤坚”写作“尤甚坚”。）
水液溢出则为水肿，停留则为胀满，征候出现在足太阳膀胱经外侧的大络，该络脉位于太阳经和少阳经之间，也表现在脉象上，取委阳穴治疗。（下焦水液溢出则为水肿。太阳少阳经之间，是三焦下输穴委阳所在。平按：《灵枢》中“水上”没有“为”字，“留则”写作“留即”。《甲乙经》中“委阳”写作“委中”。）
膀胱有病，小腹部偏侧肿胀且疼痛，用手按压，就想小便却解不出来，（偏肿，是大腹不肿的意思，这是腑病。平按：《灵枢》中“则欲”写作“即欲”。）
肩膀发热或者脉搏凹陷，以及足小指外侧和小腿脚踝后方都发热或者脉搏凹陷的，取委中穴治疗。（膀胱足太阳经脉，起于目内眦，上行额部，下行项部，沿小腿脚踝后至足小指外侧，所以膀胱有病，循经脉运行处发热及脉搏凹陷作为征候。平按：《甲乙经》中“肩上”写作“眉上”，注云：“一本作肩。”《灵枢》中“外侧”写作“外廉”。《甲乙经》中“取之委中央”写作“取委中”。）
胆有病的人，喜欢叹气，（胆病则魂神不畅，所以喜欢叹气。）
口苦，呕吐宿存的胆汁，（胆热溢出水精，所以口苦呕吐宿存胆汁。平按：《甲乙经》中“汁”写作“水”。）
心中悸动恐惧，像被人将要抓捕一样，（胆病导致心动怖畏，所以像被人将要抓捕。平按：《甲乙经》中“恐”上有“善”字。《灵枢》没有“如”字。）
咽喉中有异物感，频繁吐唾沫，征候在足少阳胆经的本末处，（ 谓阂，咽喉之中，如有物阻隔也，音居薤反。足少阳经的本部在窍阴之间，标部在窗笼，即本末。平按：《甲乙经》中“数唾”写作“数咳唾”。《灵枢》中“唾”字下没有“候”字。）
也要观察其脉搏凹陷下陷的，用灸法治疗；如果有寒热症状，取阳陵泉穴治疗。（脉搏陷下的属于寒证，所以用灸法治疗。寒热取阳陵泉，是通行的针灸治法。）
黄帝说：针刺有门道吗？
岐伯回答说：针刺此等穴位，必须准确刺中气穴，不要刺中肉节。刺中气穴，则针能自由游走在巷陌（经络通道）中；刺中肉节，则肌肉皮肤会疼痛，（以下讲述行针方法。刺中肉的，不着分肉之间；刺中节的，不针骨穴之内，都不能游走于巷陌。巷，指街巷，空穴之处。平按：《灵枢》中“游”写作“染”，注云：“一作游。”《灵枢》、《甲乙经》中“肉肤”写作“皮肤”。）
补泻手法相反则病情加重，（虚证用泻法，实证用补法，所以叫反。）
刺中筋则筋弛缓无力，（刺中筋而不中其痛处，则筋受伤无力，所以弛缓。）
邪气不能排出，与真气相互搏结，混乱而不能去除，反而向内滞留，使用针法如果不审慎，就会把顺理变为逆乱。
黄帝说：说得好。（如果刺中肉节及刺中筋，不当空穴，邪气不能排出，与真气相互搏结，正邪相乱，反而成为内病，是因为使用针法不审慎，违背医理。平按：《灵枢》中“与真气相薄”写作“与其真相搏”，《甲乙经》写作“与真相薄”。注解说内病，袁刻误作内痛。）
[Ping An]: This chapter appears in *Ling Shu* (Spiritual Pivot), Volume 1, Chapter 4, "Disease Forms of Evil Qi and Zang-Fu Organs". From "the Qi of the Five Zang and Six Fu Organs" to here at the "Stomach Meridian", it is found in *Jia Yi Jing* (Systematic Classic of Acupuncture and Moxibustion), Volume 4, Part 2. From "the Large Intestine Fu organ" to "selecting Zusanli (ST36)", it is found in *Jia Yi Jing*, Volume 9, Chapter 7. From "diseases of the Small Intestine" to "selecting Shangjixu (ST37)", it is found in *Jia Yi Jing*, Volume 9, Chapter 8. From "diseases of the San Jiao (Triple Burner)" to "selecting Weiyang (BL39)", it is found in *Jia Yi Jing*, Volume 9, Chapter 9. From "diseases of the Gallbladder" to "Yanglingquan (GB34)", it is found in *Jia Yi Jing*, Volume 9, Chapter 5. From "when needling this, one must hit the Qi-Acumen" to the end, it is found in *Jia Yi Jing*, Volume 5, Part 1. Only from the "Large Intestine" downwards, although the meaning of the text in *Jia Yi Jing* is the same, the order of arrangement is slightly different.
Huang Di said: I have heard that for the Qi of the Five Zang and Six Fu organs, the Ying-Spring points, Shu-Stream points, and He-Sea points are where the Qi enters and gathers. Now, through what pathway do they enter? Where do they connect and pass after entering? I wish to hear the reason behind this. (This asks about the running path and destination of the Ying-Spring, Shu-Stream, and He-Sea points of the Zang-Fu meridians. Ping An: In *Jia Yi Jing*, "Shu" is written as "Yu". Currently, both *Ling Shu* and *Jia Yi Jing* write it as "Ling". In *Jia Yi Jing*, "Lian Guo" is written as "Cong Dao", lacking the seven characters "Yuan Wen Qi Gu" and the subsequent answer by Qi Bo.)
Qi Bo answered: These are the divergent branches of the Yang meridians that enter the interior and belong to the Fu organs. (What is stated here regarding "He" refers to selecting the points where the divergent branches of the Three Yang meridians belong to the Fu organs, called "He", and not selecting Yin meridian points. This is because Yang meridians internally belong to the Fu organs; when evil qi invades, it first reaches the Fu organs and then reaches the Zang organs.)
Huang Di asked: Do the Ying-Spring points and He-Sea points each have their own names?
Qi Bo answered: The Ying-Spring points treat diseases of the exterior meridians, while the He-Sea points treat diseases of the interior Fu organs. (The Ying-Spring and Shu-Stream points of the Five Zang and Six Fu organs have not yet reached the interior, so they only treat diseases of the exterior meridians. What is stated here regarding "He" refers only to selecting those belonging to the interior Fu organs from the Yang meridians to treat diseases of the interior Fu organs. Ping An: In *Jia Yi Jing*, there is a character "Zang" after the word "Wai".)
Huang Di asked: How are interior Fu organ diseases treated?
Qi Bo answered: By selecting the He-Sea points.
Huang Di asked: Do the He-Sea points each have specific names?
Qi Bo answered: The He-Sea point of the Stomach enters at Zusanli (ST36). (The Qi of the Stomach follows the Foot-Yangming Stomach Meridian and converges at Zusanli; therefore, when the Stomach has disease, Zusanli is selected to treat the Stomach Fu. Ping An: The character "Ru" is absent in *Ling Shu*.)
The He-Sea point of the Large Intestine enters at Shangjixu (ST37). (The Qi of the Large Intestine follows the Foot-Yangming Stomach Meridian and converges at Shangjixu; therefore, when the Large Intestine has disease, Shangjixu is treated.)
The He-Sea point of the Small Intestine enters at Xiajixu (ST39). (The Qi of the Small Intestine follows the Foot-Yangming Stomach Meridian and converges at Xiajixu; therefore, when the Small Intestine has disease, Xiajixu is treated.)
The He-Sea point of the San Jiao (Triple Burner) enters at Weiyang (BL39). (The Qi of the San Jiao follows the Foot-Taiyang Bladder Meridian and converges at Weiyang; therefore, when the San Jiao has disease, Weiyang is treated.)
The He-Sea point of the Bladder enters at Weizhong (BL40). (The Qi of the Bladder follows the Foot-Taiyang Bladder Meridian downward and converges at Weizhong; therefore, when the Bladder has disease, Weizhong is treated. Ping An: Both *Ling Shu* and *Jia Yi Jing* have the character "Yang" after "Zhong".)
The He-Sea point of the Gallbladder enters at Yanglingquan (GB34). (The Qi of the Gallbladder follows the Foot-Shaoyang Gallbladder Meridian downward and converges at Yanglingquan; therefore, when the Gallbladder has disease, Yanglingquan is treated.)
Huang Di asked: How should these points be accessed?
The answer was: When accessing Zusanli (ST36), lower the dorsum of the foot; when accessing Shangjixu (ST37) or Xiajixu (ST39), lift the foot; when accessing Weiyang (BL39), flex and extend the leg to search for it; when accessing Weizhong (BL40), flex the knee to access it; when accessing Yanglingquan (GB34), stand upright with the knee vertical, place your hand level with the knee, and go down to the Yang side of Weiyang to access it; when accessing points of the exterior meridians, draw and extend the limb to follow them. (Below describes the method of accessing the six He-Sea points to treat interior Fu diseases. Standing upright makes the knee vertical. Yu means to pull or draw. Ping An: In *Jia Yi Jing*, "Suo" is written as "Qu"; "Qu Er Qu Zhi" is written as "Qu Xi Er Qu Zhi". In *Ling Shu*, there is no "Li" before "Shu", and "Shen" is written as "Shen".)
Huang Di said: I wish to hear about the diseases of the Six Fu organs.
(The Six Fu organs and their six corresponding He-Sea points are used to treat interior Fu diseases, but the forms of Fu organ diseases are unknown.)
Qi Bo said: Heat in the face indicates a disease of the Foot-Yangming [Stomach] meridian. (Below discusses diseases of the Hand and Foot Yangming meridians. Heat in the face occurs because the Yangming meridian originates in the face; thus, heat in the face is a sign of Foot-Yangming disease.)
Blood visible in the collaterals of the thenar eminence (Yuji area) indicates a disease of the Hand-Yangming [Large Intestine] meridian. (The Hand-Yangming meridian runs behind the thenar eminence; thus, blood in the collaterals of the thenar eminence is a sign of Hand-Yangming disease.)
A pulse that is firm or depressed on the dorsum of the feet indicates a disease of the Foot-Yangming [Stomach] meridian; this is the Stomach meridian. (The Foot-Yangming meridian descends to the dorsum of the foot and enters between the big toe; thus, a tight or depressed pulse on the dorsum of the foot is a sign of Foot-Yangming disease. Ping An: In *Ling Shu*, "Jian Ruo" is written as "Shu".)
For diseases of the Large Intestine, there is cutting pain in the intestines accompanied by gurgling sounds (zhuozhuo); if exposed to cold again in winter, diarrhea occurs; there is pain around the navel, and the patient cannot stand for long periods. This presents with the same signs as Stomach diseases, and Shangjixu (ST37) should be selected. (Below describes the forms of Six Fu organ diseases and the locations of the points to be selected. Pain at the navel is due to the transverse colon, which is part of the Large Intestine, being located at the navel; thus, Large Intestine disease causes pain at the navel. "Presenting with the same signs as the Stomach" means that the Qi of the Large Intestine converges with the Foot-Yangming Stomach meridian at Shangjixu, hence the shared signs. Zhuo, pronounced tu jiao, refers to the sound of water in the intestines. Ping An: In *Ling Shu*, "Ze Xie" is written as "Ji Xie"; *Jia Yi Jing* lacks these two characters.)
For diseases of the Stomach, there is abdominal distension, pain in the epigastrium centered at the heart region, radiating upward to both hypochondria, obstruction in the diaphragm and pharynx, and difficulty swallowing food. Zusanli (ST36) should be selected. (Pain in the epigastrium centered at the heart region occurs because the main branch of the Foot-Yangming Stomach meridian ascends to the thigh, enters the abdomen, belongs to the Stomach and disperses to the Spleen, ascends to connect with the Heart, and follows the pharynx upward; its major collateral runs along the lateral aspect of the tibia, ascends to connect with the head. Thus, pain in the epigastrium and heart region radiates to the hypochondria, causing obstruction in the diaphragm and pharynx. Ping An: In *Ling Shu* and *Jia Yi Jing*, "Wei Guan" is written as "Wei Wan". In *Ling Shu*, "Shang Jiao" is written as "Shang Zhi"; in *Jia Yi Jing*, it is written differently. In *Ling Shu*, "Ge" is written as "Ge".)
For diseases of the Small Intestine, there is pain in the lower abdomen, pain radiating from the waist and spine to the buttocks, and frequent urgency to defecate. (The Small Intestine is located in the lower abdomen attached to the spine, looping on the left; thus, pain in the lower abdomen, waist, spine, and buttocks occurs, along with frequent urgency to defecate. Ping An: In *Ling Shu*, "Shao Fu" is written as "Xiao Fu". In *Ling Shu* and *Jia Yi Jing*, "Kong Kao" is written as "Kong Gao". Note: The character "Zuo" (left) in Yuan's edition was mistakenly printed as "Kong".)
Heat in front of the ear, severe cold, or excessive heat above the eyebrows alone. (The Small Intestine meridian belongs to the Hand-Taiyang, ascending to the outer canthus and entering the ear; thus, Small Intestine disease manifests as cold and heat in these areas. Ping An: In *Jia Yi Jing*, there is no "Dang" before "Er". In *Ling Shu* and *Jia Yi Jing*, "Mei" is written as "Jian".)
Heat between the little finger and the adjacent finger, or a depressed pulse, are signs of Hand-Taiyang [Small Intestine] disease; Xiajixu (ST39) should be selected. (These are sites where the Hand-Taiyang meridian exits; thus, heat here and a depressed pulse serve as signs. Ping An: In *Ling Shu*, the character "Bing" (disease) appears after "Tai Yang".)
For diseases of the San Jiao (Triple Burner), there is abdominal fullness of Qi, especially hardness in the lower abdomen, inability to urinate, and distress/urgency. (You means excessive. Ping An: In *Jia Yi Jing*, "Zhang" is added after "Fu"; "You Jian" is written as "You Shen Jian".)
If fluids overflow, edema results; if they remain, distension results. The signs appear in the large collateral outside the Foot-Taiyang [Bladder] meridian, located between the Taiyang and Shaoyang meridians, and are also visible in the pulse. Weiyang (BL39) should be selected. (Overflow of fluids in the Lower Jiao results in edema. Between the Taiyang and Shaoyang meridians lies the Lower He-Sea point of the San Jiao, Weiyang. Ping An: In *Ling Shu*, there is no "Wei" after "Shui Shang"; "Liu Ze" is written as "Liu Ji". In *Jia Yi Jing*, "Weiyang" is written as "Weizhong".)
For diseases of the Bladder, there is unilateral swelling and pain in the lower abdomen; pressing with the hand creates the urge to urinate but prevents it. (Unilateral swelling means the rest of the abdomen is not swollen; this is a Fu organ disease. Ping An: In *Ling Shu*, "Ze Yu" is written as "Ji Yu".)
Heat in the shoulder or a depressed pulse, as well as heat or a depressed pulse on the lateral side of the little toe and behind the ankle/tibia, indicate that Weizhong (BL40) should be selected. (The Foot-Taiyang Bladder meridian originates at the inner canthus, ascends to the forehead, descends to the neck, follows the tibia and ankle to the lateral side of the little toe; thus, Bladder disease manifests as heat and depressed pulses along the meridian's path. Ping An: In *Jia Yi Jing*, "Jian Shang" is written as "Mei Shang", with a note saying "Another version reads Jian." In *Ling Shu*, "Wai Ce" is written as "Wai Lian". In *Jia Yi Jing*, "Qu Zhi Wei Zhong Yang" is written as "Qu Weizhong".)
For diseases of the Gallbladder, there is frequent sighing. (Gallbladder disease leads to restless Hun spirit, hence the desire to sigh.)
Bitter taste in the mouth and vomiting of old bile. (Gallbladder heat overflows fluid essence, causing bitter taste and vomiting of stored bile. Ping An: In *Jia Yi Jing*, "Zhi" is written as "Shui".)
Palpitations and fear, as if someone were about to capture them. (Gallbladder disease causes heart palpitations and terror, hence the sensation of being hunted. Ping An: In *Jia Yi Jing*, "Shan" appears before "Kong". *Ling Shu* lacks "Ru".)
A sensation of obstruction in the throat with frequent spitting. The signs are located at the root and tip of the Foot-Shaoyang [Gallbladder] meridian. ( refers to obstruction; a sensation of something blocking the throat, pronounced ju xie fan. The root of the Foot-Shaoyang meridian is between Qiaoyin points, and the tip is at Chuanglong, representing the root and tip. Ping An: In *Jia Yi Jing*, "Shuo Tuo" is written as "Shu Ke Tuo". In *Ling Shu*, "Hou" is absent after "Tuo".)
Also observe if the pulse is depressed; apply moxibustion. If there are alternating chills and fever, select Yanglingquan (GB34). (Depressed pulses indicate cold, hence moxibustion is applied. For chills and fever, Yanglingquan is selected, which is a standard acupuncture and moxibustion treatment.)
Huang Di asked: Is there a principle for needling?
Qi Bo answered: When needling these points, one must accurately strike the Qi-Acumen (energy centers) and avoid striking the flesh joints. Striking the Qi-Acumen allows the needle to roam freely within the alleys (meridian channels); striking the flesh joints causes pain in the muscle and skin. (Below describes the method of inserting the needle. Striking the flesh without hitting the spaces between muscles, or striking the joints without hitting the bone acupoints, does not allow roaming in the alleys. Alley refers to streets, places of empty cavities. Ping An: In *Ling Shu*, "You" is written as "Ran", with a note saying "Another version reads You." In *Ling Shu* and *Jia Yi Jing*, "Ru Fu" is written as "Pi Fu".)
If tonification and sedation are reversed, the disease will worsen. (Sedating deficiency and tonifying excess is called reversal.)
Striking the tendon causes flaccidity. (Striking the tendon without targeting the painful spot injures the tendon, causing weakness and flaccidity.)
Evil qi will not exit; it will contend with the True Qi, causing chaos that cannot be removed, and instead lodge internally. If the use of the needle is not prudent, it turns order into disorder.
Huang Di said: Excellent. (If one strikes the flesh joints or tendons, missing the empty cavities, the evil qi will not exit, contending with the True Qi, causing chaos between righteous and evil qi, leading to internal disease, because the use of the needle was imprudent and contrary to principles. Ping An: In *Ling Shu*, "Yu Zhen Qi Xiang Bo" is written as "Yu Qi Zhen Xiang Bo"; in *Jia Yi Jing*, it is written as "Yu Zhen Xiang Bo". Note: Internal disease was mistakenly printed as internal pain in Yuan's edition.)