岐伯承上编《热论》，而立刺热之篇，以明热病之在经脉也。经脉内连五脏，故上编言经脉之热，此
言五脏之热。而五脏之热，有在于脉者，有见于色者。在脉、在色，证有先兆，知其先兆而刺治之，则得矣。
肝热病者，小便先黄，腹痛、多卧、身热，热争，则狂言及惊，胁满痛、手足躁、不得安卧。庚
辛甚，甲乙大汗，气逆则庚辛死，刺足厥阴少阳。其逆，则头痛员员，脉引冲头也。
腹，小腹也。员员，周转也。肝主疏泄，故肝热病者，小便先黄。肝脉过阴器，抵小腹，故腹痛。木
气不达，故多卧，火气有余，故身热。邪正相持，则为热争，热争则狂言，热伤血分也。及
惊，东方肝木，其病发惊骇也。胁满痛，肝脉布胁肋，邪客之而满痛也。手足躁，风淫末疾，肝病风生，躁
扰也。不得安卧，卧则血归于肝。肝病而血不归也。庚辛甚，金克木也。甲乙大汗，自得其位
而起也。气逆，肝气自逆也。始焉热争，继则气逆，不但庚辛甚，而庚辛且死。治之之法，当取阴阳脏腑
之相为表里者，而均刺之，故刺足厥阴少阳。申明气逆者，其经脉之气自逆也。肝与督脉会于
巅，故其逆，则头痛员员而周转。所以致头痛员员者，以肝脉与督脉，相引而上冲于头也。
心热病者，先不乐数日，乃热，热争则卒心痛，烦闷、善呕，
头痛面赤，无汗，壬癸甚，丙丁大汗，气逆则壬癸死。刺手少阴太阳。
卒，音促。乐，喜乐也。心气舒缓则乐，故心热病者，先不乐
数日，然后乃热。邪正相持，而热争，则卒心痛，而烦闷也。善
呕，火热上炎也。头痛，阳气上逆也。面赤，心热也。无汗，不得阴液以相滋也。壬癸甚，水克火也。丙丁大汗，
自得其位而起也。气逆，心气自逆也。始焉热争，继则气逆，故气逆则壬癸死，当急刺手少阴太阳，以救其逆。
脾热病者，先头重，颊痛，烦心，颜青，欲呕，身热，热争则
腰痛，不可用俯仰，腹满泄，两颔痛，甲乙甚，戊己大汗，气逆则甲乙死，刺足太阴阳明。
头重，土虚疲倦之象，故脾热病者，先头重。头重下视，则颊痛，脾络注心中，故烦心。土虚木刑，故颜
青。脾病善噫，故欲呕。脾热病故身热，邪正相持，而热争，致身半以下。身半以上，气机不和，则腰痛
而不可用俯仰也。腹满泄，脾热下行也。两颔痛，脾热上行也。甲乙甚，水克土也。戊己大汗，自得其
位而起也。始焉热争，继则气逆，逆则甲乙死。当刺足太阴阳明以救其逆。
肺热病者，先淅然厥起毫毛，恶风寒，舌上黄，身热。热争则喘咳，痛走胸膺背，不得太息，头痛
不堪，汗出而寒，丙丁甚，庚辛大汗。气逆，则丙丁死，刺手太阴阳明。
恶，去声，淅然，如水洒身之意。厥，寒厥也。肺主皮毛，故肺热病者，先淅然寒厥。从毫毛而起。厥
起毫毛，故恶风寒。舌上黄，内热也。身热，外热也，邪正相持而热争，则喘咳，肺主膺胸，其俞在背，
故痛走胸膺背，既喘既咳，则不得太息，气上不下，则头痛不堪，皮毛开发，肌表不和，故汗出而寒，丙
丁甚，火克金也。庚辛大汗，自得其位而起也。肺气自逆，则丙丁死，当急刺手太阴阳明以救其逆。
肾热病者，先腰痛， 酸，苦渴，数饮，身热，热争，则项痛而强， 寒且酸足下热，不
欲言，其逆，则项痛员员，淡淡然，戊己甚，壬癸大汗，气逆则戊己死。刺足少阴太阳。
数，音朔。强，去声。腰乃肾腑，故肾热病者，先腰痛，肾主
骨，故 酸。肾为水脏，不能上济其火，故苦渴，数饮水。肾虚病
热，故身热，邪正相持而热争。争于上则项痛而强，争于下则骨行寒且酸，足下热，争于中，则不欲言，
其肾气自逆，精髓不能循脊注项，故项痛员员。申明员员者，乃精气不充。而淡淡然，非若头痛员员之周转
也。戊己甚，土克水也，壬癸大汗，自得其位而起也。肾气逆，则戊己死，当急刺足少阴太阳，以救其逆。
出血如大豆，立已。
此七字旧本在刺手太阴阳明下，今改正于此。承上文诸刺，而言若出针之时，出血如大豆，则邪
热去而经脉和，其病当立己。
诸汗者，至其所胜日，汗出也。
此衍文也，下文云诸当汗者，至其所胜日，汗大出也，误重于此。
肝热病者，左颊先赤，心热病者，颜先赤，脾热病者，鼻先赤，肺热病者，右颊先赤，
肾热病者，颐先赤，病虽未发，见赤色者，刺之，名曰治未病。
上文五脏热病，在于经脉，此言五脏热病，见于气色也。热，火病也。赤，火色也。肝木居左，故肝
热病者，左颊先赤。心火居上，故心热病者，颜先赤。《五色》论云，庭者颜也。庭，犹额也。
脾土居中，故脾热病者，鼻先赤，肺金居右，故肺热病者，右颊先赤。肾水居下，故肾热病者，颐先赤。
颐，腮间口角也。五脏病虽未发，先见赤色于面部者，当即刺之，勿使其病，此名曰治未病也。
热病从部所起者，至期而已，其刺之反者，三周而已。重逆则死，诸当汗者，至其所胜日，汗
大出也。诸治热病以饮之寒水，乃刺之，必寒衣之，居止寒处，身寒而止也。
重，平声。总结上文之义而言寒可治热也，热病从部所起者，如肝热病，小便先黄。心热病，先不乐。
脾热病，先头重。肺热病，先淅然。肾热病，先腰痛，又如肝热病，左颊先赤。心热病，颜先
赤。脾热病，鼻先赤。肺热病，右颊先赤。肾热病，颐先赤者是也。至期而已者，如肝病期甲乙，心病期
丙丁，脾病期戊己，肺病期庚辛，肾病期壬癸。至本位日期而病已也。其刺之反者，如肝病
刺足厥阴少阳，心病刺手少阴太阳，脾病刺足太阴阳明，肺病刺手太阴阳明，肾病刺足少阴太阳。皆刺之，
而反逆为从，至三周而病已。三周，三日也。重逆则死者，如肝病气逆庚辛死，心病气逆壬癸死，脾病气逆
甲乙死，肺病气逆丙丁死，肾病气逆戊己死。气逆而治之复逆，是谓重逆，重逆则死，不待庚辛壬癸等日也。
诸当汗者，至其所胜日，汗大出，如甲乙大汗，丙丁大汗等，乃本气胜王之日而大汗也。诸热病者，如五
脏经脉热病，五脏气色热病也。治之之法，以饮之寒水，乃刺之，以治其热，里热既愈，外热未除，
必寒衣之，居止寒处，至身寒无热而止也。总结上文，而言热以寒治也。
热病先胸胁痛，手足躁，刺足少阳，补足太阴，病甚者，为五十九刺。
足少阳之脉，循胸过胁，故热病先胸胁痛，胸胁痛，则手足躁，当刺足少阳，以通其经，少阳病不
己，应传太阴，故补足太阴，以禁其传，刺之不愈，而病甚者，当为五十九刺。水热穴论
云，头上五行行五者，以越诸阳之热也。大杼，膺俞，缺盆，背俞，此八者以泻胸中之热也。气街、三里、
巨虚、上下廉，此八者以泻胃中之热也，云门、KT 骨、委中、髓空，此八者，以泻四肢之
热也。五脏俞旁五，此十者，以泻五脏之热也。凡此五十九穴者，皆热之左右也。
热病始手臂痛者，刺手阳明太阴，而汗出止。
始，犹先也。手阳明之脉，起于手指，循臂而上，故热病始手臂痛者，当刺手阳明太阴。而
汗出止，手太阴之脉，亦循手臂，故兼言之。
热病始于头首者，刺项太阳，而汗出止。
足太阳之脉，上额交巅，络脑下项，故热病始于头首者，当刺项太阳，而汗出止，项太阳，犹言足太阳也。
热病始终足胫者，刺足阳明，而汗出止。
足阳明之脉，循胫下足，故热病始于足胫者，当刺足阳明而汗
出止。
热病先身重，骨痛，耳聋，好瞑，刺足少阴，病甚，为五十九刺。
好，去声。热病先身重者，少阴枢转不利也。少阴主骨，故骨痛肾气不注于耳，故耳聋，肾精不
充于目，故好瞑。当刺足少阴，以通其经，刺之不愈，而病甚者，亦为五十九刺。
热病先眩冒而热，胸胁满，刺足少阴少阳。
眩冒而热，乃少阴肾精不升，热病之起于少阴也。胸胁满，乃少阳经脉不和，热病之起于少阳也。少
阴为阴枢，少阳为阳枢，枢转有乖而病热，故合少阴少阳而并刺之。
太阳之脉，色荣颧骨，热病也，荣未交，曰今且得汗，待时而
已。与厥阴脉争见者，死期不过三日。其热病内连肾，少阳之脉色也。
见，音现，下同。脉，经脉也，色，赤色也。颧骨属肾，少阴之所主也。上文热病，有在脉者，有在
色者，此合脉色而并论之，故言太阳之脉，而赤色荣于颧骨，是太阳脉色之热病也。其病但在于
脉，未荣颧骨之时，则荣未交，医工必曰今且得汗，待其王时，而病可已。若王时无汗，病不能已。复与
厥阴经脉相争，而见赤色者，虚阳外浮，死期不过三日，盖六气营运，三日三阳，三日三阴。阴病不能出阳，
阳病不能合阴，则死。申明色荣颧骨，是其热病内连于肾，《本俞》论云，少阳属肾，故曰少阳之脉色也。
少阳之脉，色荣颊前，热病也。荣未交，曰今且得汗，待时而
已，与少阴脉争见者，死期不过三日。
面旁曰颊。颊前，亦颧骨也。夫少阳虽属肾，而少阳为阳，少阴为阴，故少阳热病之脉色，亦与
少阴争见，大义与上文同。
热病气穴，三椎下间，主胸中热；四椎下间，主膈中热，五椎下间，主肝热；六椎下间，主
脾热；七椎下间，主肾热，荣在 也。项上三椎，陷者中也。
热病气穴，犹言热病刺法，当取气穴而刺之也。三椎下间，主
刺胸中之肺热。四椎下间，主刺膈中之心热。五椎下间，主刺肝热。六椎下间，主刺脾热。七椎下间，主
刺肾热。此五脏气分之热病，而取气穴以刺之。盖气为阳，主上，荣为阴，主下。若荣血之热病，其穴在脊骨
尽处，故曰荣在 也。申明三椎者，从项上数之而为三椎也，下间者，椎下椎上，陷者中也。盖大椎乃脊骨
之第一椎，从项上数之，则大椎为三椎，如是椎之，诸椎皆得矣。
颊下逆颧，为大瘕，下牙车，为腹满，颧后为胁痛，颊上者，膈上也。
观面色所见之部，而知五内所主之病，颊下赤色，上逆于颧，则为大瘕，而主肾病，其色下逆于牙车，
则为腹满而主脾病，其色逆于颧后，则为腰痛而主肝病，其色在由颊上者，则病在膈上，而
为心肺之病也。此复举面部上下所见之色，以征五脏热病之义。
岐伯承接上一篇《热论》，撰写了这篇《刺热篇》，以阐明热病在经脉中的表现。经脉内连五脏，所以上一篇讲的是经脉的热证，这里讲的是五脏的热证。而五脏的热证，有的表现在脉象上，有的表现在面色上。在脉象、面色上的表现，都有先兆，知道了这些先兆并加以针刺治疗，就能取得疗效。
肝热病患者，小便先变黄，腹痛，嗜睡，身体发热；热邪与正气相争时，则胡言乱语且易受惊，胁肋部胀满疼痛，手足躁动不安，无法安稳躺卧。病情在庚辛日加重，在甲乙日大汗出后痊愈；若出现气逆症状，则在庚辛日死亡。治疗应针刺足厥阴肝经和足少阳胆经。若气逆，则头痛头晕旋转，这是因为经脉之气上冲头部所致。
腹，指小腹。员员，意为周转、旋转。肝主疏泄，所以肝热病患者小便先变黄。肝经脉经过阴器，抵于小腹，所以腹痛。木气不达，所以嗜睡；火气有余，所以身热。邪正相持，称为热争，热争则胡言乱语，因为热邪损伤血分。至于惊恐，是因为东方属肝木，其病发作时常有惊骇之象。胁肋胀满疼痛，是因为肝经脉布散于胁肋，邪气客居于此导致胀满疼痛。手足躁动，是因为风邪淫溢导致四肢疾病，肝病生风，故见躁扰。不能安卧，是因为卧则血归于肝，肝病则血不归肝。庚辛日加重，是因为金克木。甲乙日大汗出，是因为自得其位（本气旺盛）而起愈。气逆，是肝气自逆。起初是热争，随后则是气逆，不仅庚辛日加重，甚至庚辛日会死亡。治疗方法，应当选取阴阳脏腑中互为表里的经脉，同时针刺，所以针刺足厥阴肝经和足少阳胆经。说明气逆的情况，是指经脉之气自行上逆。肝脉与督脉交会于头顶，所以气逆时，头痛头晕旋转。之所以导致头痛头晕旋转，是因为肝脉与督脉相互牵引而上冲于头。
心热病患者，先数日心情不愉快，然后才发热；热争时突然心痛，烦闷，容易呕吐，头痛面赤，无汗。病情在壬癸日加重，在丙丁日大汗出后痊愈；若出现气逆症状，则在壬癸日死亡。治疗应针刺手少阴心经和手太阳小肠经。
卒，音促。乐，指喜乐。心气舒缓则乐，所以心热病患者先数日心情不愉快，然后才发热。邪正相持而热争，则突然心痛且烦闷。容易呕吐，是因为火热上炎。头痛，是因为阳气上逆。面赤，是因为心热。无汗，是因为缺乏阴液滋润。壬癸日加重，是因为水克火。丙丁日大汗出，是因为自得其位而起愈。气逆，是心气自逆。起初是热争，随后则是气逆，所以气逆则壬癸日死亡，应当紧急针刺手少阴心和手太阳小肠经，以挽救气逆。
脾热病患者，先感到头重，脸颊痛，心烦，面色发青，想呕吐，身体发热；热争时腰痛，不能俯仰，腹部胀满腹泻，两侧下颌疼痛。病情在甲乙日加重，在戊己日大汗出后痊愈；若出现气逆症状，则在甲乙日死亡。治疗应针刺足太阴脾经和足阳明胃经。
头重，是土虚疲倦的现象，所以脾热病患者先感到头重。头重下视，则脸颊痛，脾络注入心中，所以心烦。土虚被木克制，所以面色发青。脾病容易嗳气，所以想呕吐。脾热病所以身热，邪正相持而热争，导致半身以下……半身以上，气机不和，则腰痛而不能俯仰。腹部胀满腹泻，是脾热下行。两侧下颌疼痛，是脾热上行。甲乙日加重，是因为水克土。戊己日大汗出，是因为自得其位而起愈。起初是热争，随后则是气逆，气逆则甲乙日死亡。应当针刺足太阴脾经和足阳明胃经以挽救气逆。
肺热病患者，先感觉寒冷如冷水洒身，毫毛竖起，恶风寒，舌苔发黄，身体发热。热争时气喘咳嗽，疼痛游走于胸膺背部，不能深吸气，头痛剧烈，出汗后怕冷。病情在丙丁日加重，在庚辛日大汗出后痊愈；若出现气逆症状，则在丙丁日死亡。治疗应针刺手太阴肺经和手阳明大肠经。
恶，去声。淅然，像冷水洒在身上的意思。厥，寒厥。肺主皮毛，所以肺热病患者先感觉寒冷如冷水洒身，从毫毛竖起开始。厥起毫毛，所以恶风寒。舌苔黄，是内热。身热，是外热。邪正相持而热争，则气喘咳嗽，肺主胸膺，其俞穴在背部，所以疼痛游走于胸膺背部。既喘又咳，则不能深吸气，气上不下，则头痛剧烈。皮毛开发，肌表不和，所以出汗后怕冷。丙丁日加重，是因为火克金。庚辛日大汗出，是因为自得其位而起愈。肺气自逆，则丙丁日死亡，应当紧急针刺手太阴肺经和手阳明大肠经以挽救气逆。
肾热病患者，先腰痛，骨酸，口苦口渴，多次饮水，身体发热；热争时项部疼痛且僵硬，恶寒且足下发热，不想说话。若气逆，则项部疼痛头晕旋转，神情淡漠。病情在戊己日加重，在壬癸日大汗出后痊愈；若出现气逆症状，则在戊己日死亡。治疗应针刺足少阴肾经和足太阳膀胱经。
数，音朔。强，去声。腰是肾府，所以肾热病患者先腰痛。肾主骨，所以骨酸。肾为水脏，不能上济心火，所以口苦口渴，多次饮水。肾虚生病热，所以身热。邪正相持而热争。争于上则项痛且僵硬，争于下则骨骼行寒且酸，足下发热，争于中则不想说话。若肾气自逆，精髓不能沿脊柱注入项部，所以项部疼痛头晕旋转。说明员员，是精气不充。淡淡然，不像头痛员圆的旋转感。戊己日加重，是因为土克水。壬癸日大汗出，是因为自得其位而起愈。肾气逆，则戊己日死亡，应当紧急针刺足少阴肾经和足太阳膀胱经以挽救气逆。
出血如大豆大小，病立即停止。
这七个字旧版刻本在“刺手太阴阳明”之下，现在改正放在此处。承接上文各种针刺方法，说如果在出针时，出血如大豆大小，则邪热去除而经脉调和，病应当立即痊愈。
凡是应当发汗的，到了其所胜之日，就会汗出。
这是衍文（多余的文字），下文说“诸当汗者，至其所胜日，汗大出也”，误重复在此处。
肝热病患者，左颊先发红；心热病患者，额部先发红；脾热病患者，鼻部先发红；肺热病患者，右颊先发红；肾热病患者，下巴先发红。病虽然尚未发作，但见到红色者，应当针刺，这叫作“治未病”。
上文讲的五脏热病，是在经脉中，这里讲的五脏热病，是表现在气色上。热，是火病。赤，是火色。肝木居左，所以肝热病患者左颊先红。心火居上，所以心热病患者额部先红。《五色》论说，庭就是颜。庭，就是额头。脾土居中，所以脾热病患者鼻部先红。肺金居右，所以肺热病患者右颊先红。肾水居下，所以肾热病患者下巴先红。颐，是腮间口角处。五脏病虽然未发作，先在面部见到红色者，应当立即针刺，不要使其发病，这叫作“治未病”。
热病从部位所起的，到了相应的日期就会痊愈。如果针刺方法相反，则需要三周（三日）才能痊愈。反复逆治则会死亡。凡是应当发汗的，到了其所胜之日，会大汗出。
重，平声。总结上文的意思来说明寒可以治热。热病从部位所起的，比如肝热病，小便先黄。心热病，先心情不愉快。脾热病，先头重。肺热病，先感觉寒冷。肾热病，先腰痛。又如肝热病，左颊先红。心热病，额部先红。脾热病，鼻部先红。肺热病，右颊先红。肾热病，下巴先红。所谓“至期而已”，比如肝病期在甲乙，心病期在丙丁，脾病期在戊己，肺病期在庚辛，肾病期在壬癸。到了本位日期病就痊愈了。所谓“刺之反者”，比如肝病刺足厥阴少阳，心病刺手少阴太阳，脾病刺足太阴阳明，肺病刺手太阴阳明，肾病刺足少阴太阳。都进行针刺，而将逆治转为顺治，到三周病就痊愈。三周，就是三日。所谓“重逆则死”，比如肝病气逆在庚辛日死，心病气逆在壬癸日死，脾病气逆在甲乙日死，肺病气逆在丙丁日死，肾病气逆在戊己日死。气逆而治疗反而再次逆乱，这叫重逆，重逆则死，不需要等到庚辛壬癸等日子。
凡是应当发汗的，到了其所胜之日，会大汗出，如甲乙大汗，丙丁大汗等，是本气旺盛之日而大汗出。各种热病，如五脏经脉热病，五脏气色热病。治疗方法，让患者喝冷水，然后进行针刺，以治疗其热。里热既已痊愈，外热未除，必须穿凉衣服，居住在凉爽的地方，直到身体变凉没有热度为止。总结上文，说明热用寒来治。
热病先胸胁痛，手足躁动，针刺足少阳胆经，补足太阴脾经。病重的，进行五十九刺。
足少阳经脉，循行经过胸胁，所以热病先胸胁痛。胸胁痛，则手足躁动，应当针刺足少阳胆经，以疏通其经脉。少阳病不愈，应传太阴，所以补足太阴脾经，以禁止其传变。针刺后不愈，且病重的，应当进行五十九刺。《水热穴论》说，头上五行每行五个穴位，用来发散诸阳之热。大杼、膺俞、缺盆、背俞，这八个穴位用来泻胸中之热。气街、三里、巨虚上下廉，这八个穴位用来泻胃中之热。云门、髃骨、委中、髓空，这八个穴位用来泻四肢之热。五脏俞旁各五个穴位，这十个穴位用来泻五脏之热。凡此五十九个穴位，都是治疗热的左右配穴。
始，犹先也。手阳明经脉，起于手指，循臂而上，所以热病始于手臂痛的，应当针刺手阳明大肠经和手太阴肺经。汗出即止。手太阴经脉，也循行手臂，所以兼而言之。
足太阳经脉，上额交巅，络脑下项，所以热病始于头首的，应当针刺项部的足太阳膀胱经，汗出即止。项太阳，犹言足太阳。
足阳明经脉，循胫下足，所以热病始于足胫的，应当针刺足阳明胃经，汗出即止。
热病先身重，骨痛，耳聋，喜闭目，针刺足少阴肾经。病重的，进行五十九刺。
好，去声。热病先身重，是少阴枢转不利。少阴主骨，所以骨痛。肾气不注于耳，所以耳聋。肾精不充于目，所以喜闭目。应当针刺足少阴肾经，以疏通其经脉。针刺后不愈，且病重的，也进行五十九刺。
眩晕发热，是少阴肾精不升，热病起于少阴。胸胁满闷，是少阳经脉不和，热病起于少阳。少阴为阴枢，少阳为阳枢，枢转失常而病热，所以合刺少阴和少阳。
太阳经脉，赤色荣于颧骨，是热病。荣气未相交，医生说今且得汗，等待时机而已。若与厥阴经脉争见，死期不超过三天。其热病内连于肾，是少阳经脉的色泽表现。
见，音现，下同。脉，经脉也。色，赤色也。颧骨属肾，是少阴所主。上文热病，有的在脉，有的在色，这里合脉色并论，所以说太阳经脉，赤色荣于颧骨，是太阳脉色之热病。其病仅在脉，未荣于颧骨之时，则荣未交，医生必说今且得汗，待其王时，病可愈。若王时无汗，病不能愈。复与厥阴经脉相争，而见赤色者，虚阳外浮，死期不超过三天，盖六气营运，三日三阳，三日三阴。阴病不能出阳，阳病不能合阴，则死。说明色荣颧骨，是其热病内连于肾，《本俞》论说，少阳属肾，所以说少阳之脉色。
少阳经脉，赤色荣于颊前，是热病。荣气未相交，医生说今且得汗，等待时机而已。若与少阴经脉争见，死期不超过三天。
面旁曰颊。颊前，也是颧骨。夫少阳虽属肾，而少阳为阳，少阴为阴，所以少阳热病的脉色，也与少阴争见，大义与上文相同。
治疗热病的穴位：第三椎下间，主治胸中热；第四椎下间，主治膈中热；第五椎下间，主治肝热；第六椎下间，主治脾热；第七椎下间，主治肾热，荣气热在脊骨尽处。项上第三椎，是凹陷处。
热病气穴，犹言热病刺法，应当取气穴而刺之。第三椎下间，主治刺胸中之肺热。第四椎下间，主治刺膈中之心热。第五椎下间，主治刺肝热。第六椎下间，主治刺脾热。第七椎下间，主治刺肾热。这是五脏气分之热病，而取气穴来刺。盖气为阳，主上；荣为阴，主下。若是荣血之热病，其穴在脊骨尽处，所以说荣在脊骨尽处。说明三椎，是从项上数下来的第三椎。下间，是椎下椎上，凹陷处。盖大椎是脊骨的第一椎，从项上数下来，则大椎为三椎，依此类推，诸椎皆可得。
颊下逆颧，为大瘕；下牙车，为腹满；颧后为胁痛；颊上者，为膈上病。
观面色所见之部位，而知五内所主之病。颊下赤色，上逆于颧，则为大瘕，主肾病。其色下逆于牙车，则为腹满，主脾病。其色逆于颧后，则为腰痛，主肝病。其色在由颊上者，则病在膈上，为心肺之病。这是再次列举面部上下所见之色，以征验五脏热病的意义。
Qibo, continuing from the previous chapter "Treatise on Heat" (Re Lun), composed this chapter "Acupuncture for Heat" (Ci Re Pian) to clarify the manifestation of heat diseases in the meridians. The meridians connect internally with the five zang organs; thus, the previous chapter discussed heat in the meridians, while this chapter discusses heat in the five zang organs. Heat in the five zang organs may manifest in the pulse or in the complexion. Both pulse and complexion changes have prodromal signs. Recognizing these prodromes and applying acupuncture treatment yields success.
In liver heat disease, urine turns yellow first, accompanied by abdominal pain, excessive sleepiness, and body fever. When pathogenic heat contends with healthy qi (heat contention), delirium and fright occur; there is distension and pain in the hypochondrium, restlessness of the hands and feet, and inability to lie down peacefully. Symptoms worsen on Geng-Xin days, and profuse sweating on Jia-Yi days indicates recovery. If qi rebellion occurs, death ensues on Geng-Xin days. Treatment involves needling the Foot-Jueyin (Liver) and Foot-Shaoyang (Gallbladder) meridians. In cases of qi rebellion, headache with dizziness and rotation occurs due to meridian qi rushing upward to the head.
The abdomen refers to the lower abdomen. "Yuan yuan" denotes rotation or spinning. The Liver governs free flow; hence, in liver heat disease, urine turns yellow first. The Liver meridian passes through the genitalia and reaches the lower abdomen, causing abdominal pain. Stagnation of Wood qi leads to lethargy; excess Fire qi causes body fever. Pathogen-qi contention is termed "heat contention," leading to delirium as heat damages the blood level. Fright arises because the East corresponds to Liver Wood, whose diseases often manifest as惊骇 (fright and panic). Hypochondriac distension and pain result from pathogenic invasion of the Liver meridian distributing over the costal region. Restlessness of extremities stems from Wind affecting the limbs; Liver disease generates Wind, causing agitation. Inability to lie down occurs because blood returns to the Liver during sleep; Liver disease prevents this return. Worsening on Geng-Xin days reflects Metal overcoming Wood. Recovery with sweating on Jia-Yi days reflects the self-strengthening of its own phase. Qi rebellion is spontaneous reversal of Liver qi. Initially heat contention, subsequently qi rebellion leads not only to worsening on Geng-Xin days but also death. Treatment selects mutually exterior-interior paired meridians of Yin-Yang and Zang-Fu, hence needling Foot-Jueyin and Foot-Shaoyang. This clarifies that qi rebellion refers to meridian qi reversing spontaneously. The Liver meridian converges with the Du vessel at the vertex; thus, rebellion causes rotational headache. This occurs because Liver and Du meridians pull upward to the head.
In heart heat disease, one feels unhappy for several days before fever develops. During heat contention, sudden heart pain, irritability, frequent vomiting, headache, facial redness, and anhidrosis occur. Symptoms worsen on Ren-Gui days, and profuse sweating on Bing-Ding days indicates recovery. If qi rebellion occurs, death ensues on Ren-Gui days. Treatment involves needling the Hand-Shaoyin (Heart) and Hand-Taiyang (Small Intestine) meridians.
"Cu" sounds like "cu." "Le" means joy. Heart qi relaxation brings joy; thus, heart heat disease begins with days of unhappiness before fever. Pathogen-qi contention causes sudden heart pain and irritability. Frequent vomiting results from flaming fire rising. Headache results from Yang qi rebelling upward. Facial redness indicates Heart heat. Anhidrosis indicates lack of Yin fluid to nourish. Worsening on Ren-Gui days reflects Water overcoming Fire. Recovery with sweating on Bing-Ding days reflects self-strengthening. Qi rebellion is spontaneous reversal of Heart qi. Initial heat contention leads to qi rebellion, causing death on Ren-Gui days if rebellious. Urgent needling of Hand-Shaoyin and Hand-Taiyang is required to save the rebellion.
In spleen heat disease, heaviness of the head, cheek pain, mental distress, bluish complexion around the mouth, desire to vomit, and body fever occur initially. During heat contention, lower back pain preventing flexion and extension, abdominal fullness, diarrhea, and bilateral mandibular pain appear. Symptoms worsen on Jia-Yi days, and profuse sweating on Wu-Ji days indicates recovery. If qi rebellion occurs, death ensues on Jia-Yi days. Treatment involves needling the Foot-Taiyin (Spleen) and Foot-Yangming (Stomach) meridians.
Head heaviness signifies Spleen Earth deficiency and fatigue. Looking downward exacerbates cheek pain; Spleen collaterals connect to the Heart, causing mental distress. Earth deficiency allows Wood to oppress, causing bluish complexion. Spleen disease often involves belching, hence desire to vomit. Body fever characterizes spleen heat. Pathogen-qi contention affects the lower half of the body, while disharmony in the upper half causes lower back pain preventing movement. Abdominal fullness and diarrhea indicate descending spleen heat. Bilateral mandibular pain indicates ascending spleen heat. Worsening on Jia-Yi days reflects Water overcoming Earth. Recovery with sweating on Wu-Ji days reflects self-strengthening. Initial heat contention leads to qi rebellion, causing death on Jia-Yi days. Needling Foot-Taiyin and Foot-Yangming saves the rebellion.
In lung heat disease, initial symptoms include chills resembling water splashing, erection of hair follicles, aversion to wind and cold, yellow tongue coating, and body fever. During heat contention, wheezing and coughing occur; pain radiates across the chest, epigastrium, and back; deep breathing is difficult; severe headache occurs; sweating is followed by coldness. Symptoms worsen on Bing-Ding days, and profuse sweating on Geng-Xin days indicates recovery. If qi rebellion occurs, death ensues on Bing-Ding days. Treatment involves needling the Hand-Taiyin (Lung) and Hand-Yangming (Large Intestine) meridians.
"E" is pronounced with a departing tone. "Xi ran" resembles water splashing on the body. "Jue" refers to cold reversal. The Lung governs skin and hair; thus, lung heat disease begins with chills and hair erection. Aversion to wind/cold follows hair erection. Yellow tongue coating indicates internal heat. Body fever indicates external heat. Pathogen-qi contention causes wheezing/coughing; the Lung governs the chest/epigastrium, with Shu points on the back, causing radiating pain. Wheezing/coughing prevents deep breathing; ascending qi causes severe headache. Open pores and disharmonious surface cause sweating followed by cold. Worsening on Bing-Ding days reflects Fire overcoming Metal. Recovery with sweating on Geng-Xin days reflects self-strengthening. Lung qi rebellion causes death on Bing-Ding days. Urgent needling of Hand-Taiyin and Hand-Yangming saves the rebellion.
In kidney heat disease, initial symptoms include lower back pain, bone soreness, bitter taste, thirst with frequent drinking, and body fever. During heat contention, neck pain and stiffness, aversion to cold with cold/sore legs, and heat under the feet occur; speech is reluctant. If qi rebellion occurs, neck pain with dizziness and a listless demeanor appear. Symptoms worsen on Wu-Ji days, and profuse sweating on Ren-Gui days indicates recovery. If qi rebellion occurs, death ensues on Wu-Ji days. Treatment involves needling the Foot-Shaoyin (Kidney) and Foot-Taiyang (Bladder) meridians.
"Shuo" is the pronunciation for frequency. "Qiang" is pronounced with a departing tone. The waist is the mansion of the Kidney; thus, lower back pain appears first. The Kidney governs bones; thus, bone soreness. As the Water organ failing to ascend and moisten Heart Fire, bitterness and thirst with frequent drinking occur. Deficient Kidney generating heat causes body fever. Pathogen-qi contention: contention above causes neck pain/stiffness; below causes bone cold/soreness and foot heat; middle causes reluctance to speak. Kidney qi rebellion prevents essence/marrow from flowing up the spine to the neck, causing rotational neck pain. "Yuan yuan" indicates insufficient essence. "Dan dan ran" describes a listless state, distinct from rotational headache. Worsening on Wu-Ji days reflects Earth overcoming Water. Recovery with sweating on Ren-Gui days reflects self-strengthening. Kidney qi rebellion causes death on Wu-Ji days. Urgent needling of Foot-Shaoyin and Foot-Taiyang saves the rebellion.
Bleeding the size of a soybean stops the condition immediately.
These seven characters were originally placed after "needling Hand-Taiyin and Yangming" in old editions but are corrected here. Following previous acupuncture methods, it states that if bleeding upon needle withdrawal amounts to a soybean size, pathogenic heat is expelled, meridians harmonize, and the disease resolves immediately.
For all conditions requiring sweating, sweating occurs on the day of their conquering phase (Sheng Ri).
This is a redundant text. The following text says "All conditions requiring sweating, on the day of their conquering phase, sweat profusely," which was mistakenly duplicated here.
In liver heat disease, the left cheek reddens first. In heart heat disease, the forehead reddens first. In spleen heat disease, the nose reddens first. In lung heat disease, the right cheek reddens first. In kidney heat disease, the chin reddens first. Even if the disease has not yet manifested, seeing redness warrants acupuncture, known as "treating disease before it arises" (Zhi Wei Bing).
The previous section discussed heat in meridians; this section discusses heat in Qi and color. Heat is a Fire disease. Red is the color of Fire. Liver Wood resides on the left, so the left cheek reddens first. Heart Fire resides above, so the forehead reddens first. The "Wu Se" treatise states: Ting is the Yan (forehead). Ting implies the forehead. Spleen Earth resides in the center, so the nose reddens first. Lung Metal resides on the right, so the right cheek reddens first. Kidney Water resides below, so the chin reddens first. Yi refers to the corner of the mouth near the cheek. If five zang diseases show facial redness before onset, immediate acupuncture prevents disease development, termed "treating disease before it arises."
Heat diseases originating from specific locations resolve upon reaching their corresponding dates. If acupuncture is performed contrary to principles, three weeks (three days) are needed for resolution. Repeated contravention leads to death. All conditions requiring sweating sweat profusely on their conquering days.
"Zhong" is pronounced with a level tone. This summarizes the principle that cold treats heat. Heat diseases originating from locations include: liver heat (yellow urine), heart heat (unhappiness), spleen heat (head heaviness), lung heat (chills), kidney heat (back pain); and facial signs: liver heat (left cheek red), heart heat (forehead red), spleen heat (nose red), lung heat (right cheek red), kidney heat (chin red). "Resolving upon reaching the date" means: Liver disease resolves on Jia-Yi days, Heart on Bing-Ding, Spleen on Wu-Ji, Lung on Geng-Xin, Kidney on Ren-Gui. "Contrary acupuncture" refers to: Liver disease needling Foot-Jueyin/Shao-yang, Heart needling Hand-Shaoyin/Taiyang, Spleen needling Foot-Taiyin/Yangming, Lung needling Hand-Taiyin/Yangming, Kidney needling Foot-Shaoyin/Taiyang. Performing these correctly transforms rebellion into compliance, resolving in three weeks (three days). "Repeated contravention leads to death" refers to: Liver qi rebellion dying on Geng-Xin, Heart on Ren-Gui, Spleen on Jia-Yi, Lung on Bing-Ding, Kidney on Wu-Ji. Treating rebellion with further rebellion is repeated contravention, leading to death without waiting for specific days. Profuse sweating on conquering days (e.g., Jia-Yi, Bing-Ding) represents the peak of the dominant phase. Treatment involves drinking cold water then needling to clear heat. After internal heat resolves, if external heat persists, wear cool clothes, stay in cool places, until body temperature normalizes. This summarizes treating heat with cold.
For heat disease starting with hypochondriac pain and restless extremities, needle Foot-Shaoyang and tonify Foot-Taiyin. For severe cases, perform the Fifty-Nine Acupoint method.
Foot-Shaoyang meridians traverse the chest and hypochondrium; thus, pain starts there. Restlessness follows. Needling Foot-Shaoyang unblocks the meridian. If Shaoyang disease persists, it transmits to Taiyin; tonifying Foot-Taiyin prevents transmission. If needling fails and disease is severe, use the Fifty-Nine Acupoints. "Shui Re Xue Lun" states: Five rows of five points on the head disperse Yang heat. Dazhu, Ying Shu, Quepen, Bei Shu (8 points) drain chest heat. Qichuan, Zusanli, Shangjixu, Xiajixu (8 points) drain stomach heat. Yunmen, Guyu, Weizhong, Suikong (8 points) drain limb heat. Five points beside each Zang Shu (10 points) drain Zang heat. These 59 points treat heat on both sides.
For heat disease starting with arm pain, needle Hand-Yangming and Hand-Taiyin until sweating stops.
"Shi" means initially. Hand-Yangming originates at fingers and ascends the arm; thus, needle these meridians. Sweating stops the condition. Hand-Taiyin also traverses the arm, hence mentioned jointly.
For heat disease starting at the head, needle the Neck-Taiyang (Foot-Taiyang) until sweating stops.
Foot-Taiyang crosses the forehead, meets at the vertex, connects to the brain, and descends to the neck. Thus, needle Neck-Taiyang. Sweating stops the condition. "Neck-Taiyang" refers to Foot-Taiyang.
For heat disease starting at the shins, needle Foot-Yangming until sweating stops.
Foot-Yangming follows the shin down to the foot; thus, needle this meridian. Sweating stops the condition.
For heat disease starting with body heaviness, bone pain, deafness, and preference for closing eyes, needle Foot-Shaoyin. For severe cases, perform the Fifty-Nine Acupoint method.
"Hao" is pronounced with a departing tone. Body heaviness indicates impaired Shao Yin pivot. Shao Yin governs bones, causing bone pain. Kidney Qi not entering the ears causes deafness. Kidney Essence not filling the eyes causes preference for closing eyes. Needle Foot-Shaoyin to unblock the meridian. If ineffective and severe, use the Fifty-Nine Acupoints.
For heat disease starting with vertigo, fever, and hypochondriac fullness, needle Foot-Shaoyin and Foot-Shaoyang.
Vertigo and fever indicate Shao Yin Kidney Essence failing to ascend; heat originates in Shao Yin. Hypochondriac fullness indicates Shaoyang meridian disharmony; heat originates in Shaoyang. Shao Yin is the Yin pivot; Shaoyang is the Yang pivot. Pivot dysfunction causes heat; thus, needle both together.
If Taiyang meridian redness shines on the cheekbones, it is heat disease. If Ying Qi has not yet intersected, it is said that sweating will occur now, awaiting the proper time. If competing with Jueyin meridian signs, death occurs within three days. The heat disease internally connects to the Kidney, showing Shaoyang meridian color.
"Xian" is pronounced "xian." Meridian refers to Jing Mai; color refers to redness. Cheekbones belong to the Kidney, governed by Shao Yin. Previous sections discussed heat in meridians or colors; this combines them. Taiyang meridian redness on cheekbones indicates Taiyang heat. If pathology is only in the meridian, before Ying reaches cheekbones (Ying not intersected), doctors predict sweating and waiting for the peak time for resolution. If no sweating at peak time, disease persists. Competition with Jueyin meridian redness indicates floating deficient Yang; death occurs within three days. Six Qi circulation takes six days (three Yang, three Yin). Yin disease cannot exit to Yang, Yang disease cannot merge with Yin, leading to death. This clarifies that redness on cheekbones indicates heat connecting internally to the Kidney. "Ben Shu" treatise states Shaoyang belongs to the Kidney; hence, Shaoyang meridian color.
If Shaoyang meridian redness shines on the front of the cheeks, it is heat disease. If Ying Qi has not yet intersected, it is said that sweating will occur now, awaiting the proper time. If competing with Shao Yin meridian signs, death occurs within three days.
The sides of the face are cheeks. Front of cheeks are also cheekbones. Although Shaoyang belongs to the Kidney, Shaoyang is Yang and Shao Yin is Yin. Thus, Shaoyang heat meridian/color competes with Shao Yin, sharing the same principle as above.
Acupoints for treating heat: Between the third and fourth thoracic vertebrae governs chest heat; between fourth and fifth governs diaphragm heat; between fifth and sixth governs liver heat; between sixth and seventh governs spleen heat; between seventh and eighth governs kidney heat. Ying heat is located at the end of the spine. The third vertebra from the neck is the depression.
"Heat Qi acupoints" refers to acupuncture methods for heat, selecting Qi points. Third intervertebral space treats Lung heat in the chest. Fourth treats Heart heat in the diaphragm. Fifth treats Liver heat. Sixth treats Spleen heat. Seventh treats Kidney heat. These treat Qi-level heat of the five Zang organs using Qi points. Qi is Yang, governing upper; Ying is Yin, governing lower. For Ying-Blood heat, points are at the end of the spine, hence "Ying is at the end of the spine." Clarification: Counting from the neck, the third vertebra is Dazhu. Intervertebral space is the depression between vertebrae. Dazhu is the first thoracic vertebra; counting from the neck makes it the third.
Redness reversing from below the cheek to the cheekbone indicates large mass (Da Jia); reversing down to the jaw indicates abdominal fullness; behind the cheekbone indicates hypochondriac pain; above the cheek indicates supra-diaphragmatic disease.
Observing facial color locations diagnoses internal diseases. Redness below cheek reversing to cheekbone indicates Da Jia (Kidney disease). Redness reversing to jaw indicates abdominal fullness (Spleen disease). Redness behind cheekbone indicates lower back pain (Liver disease). Redness moving upward from cheek indicates supra-diaphragmatic disease (Heart/Lung disease). This reiterates facial color signs to verify five Zang heat diseases.