灵枢·上隔 Miraculous Pivot·Upper Obstruction
黄帝曰：气为上膈者，食饮入而还出，余已知之矣。虫为下膈，下膈者，食晬时乃出，余未得其意，愿卒闻之。The Yellow Emperor said, "I already know about the condition where qi causes upper obstruction, in which food and drink are regurgitated after being ingested. However, I don't quite understand the situation where worms cause lower obstruction, where food is vomited out after a long time. I would like to hear a detailed explanation."
黄帝问：因为气机郁结在上，形成食后即吐的上膈症，我已经知道了。至于因虫积在下所形成的下膈症，下膈症的表现是食后经过一天左右才吐出，我还不甚了解其中的道理，我想尽快地知道其中的道理。
岐伯曰：“喜怒不适，食饮不节，寒温不时，则寒汁流于肠中，Qi Bo said, "Improper control of emotions such as anger and joy, irregular eating and drinking, and exposure to cold or heat at inappropriate times can cause cold fluids to flow into the intestines.
岐伯答道：“喜怒不能适度，饮食不加节制，衣着不能随气候变化增减，时而衣少身寒，时而衣多过暖，以致损伤了胃气；胃如受寒，则寒汁流于肠内；
流于肠中则虫寒，虫寒则积聚，守于下管，则肠胃充郭，卫气不营，邪气居之。When the worms in the intestines are exposed to this cold, they will accumulate and gather around the lower part of the alimentary canal. As a result, the intestines and stomach become distended, the defensive qi fails to nourish them properly, and pathogenic qi lodges there.
寒汁流肠内，则肠内寄生虫感觉寒冷；虫觉寒冷，就会拥挤在一起，聚守于下脘部，因而使肠胃充满、张大，以致卫气不能营运护养，而邪气留止其中。
人食则虫上食，虫上食则下管虚，When a person eats, the worms move upward to feed. When the worms move upward to feed, the lower part of the alimentary canal becomes empty.
人吃进东西，虫即上而取食；虫上而取食，则下脘虚空；
下管虚则邪气胜之，积聚以留，留则痈成，痈成则下管约。When the lower part of the alimentary canal becomes empty, the pathogenic qi prevails, and the accumulations remain. If these accumulations remain, abscesses will form. Once abscesses form, the lower part of the alimentary canal will become constricted.
下脘虚空，则邪气占了上风，积聚而滞留不去；邪气滞留，就形成为痈；痈成，则下脘收束。
其痈在管内者，即而痛深；其痈在外者，则痈外而痛浮，痈上皮热。”If the abscess is inside the canal, the pain will be deep; if the abscess is outside the canal, the pain will be superficial and the skin over the abscess will be hot."
其痈在下脘之内的，一经碰触，则疼痛剧烈；其痈在下脘之外的，则痈外显而痛轻，痈上的皮肤发热。”
黄帝曰：刺之奈何？The Yellow Emperor asked, "How should one perform acupuncture for this condition?"
黄帝问：下膈症怎样用针刺治疗呢？
岐伯曰：“微按其痈，视气所行，先浅刺其傍，稍内益深，逐（别本作还）而刺之，毋过三行，察其沉浮，以为深浅。Qi Bo said, "Gently press on the abscess to observe the flow of qi. First, make shallow punctures on the side of the abscess. Then, gradually insert the needle a bit deeper and continue to puncture in this way. Do not exceed three punctures. Observe whether the qi is floating or sinking to determine the appropriate depth of puncture.
岐伯答道：“针刺的方法是，应当用手轻轻地按摩痈肿的部位，以观察痈肿部位的大小和病气发展的动向，先浅刺痈肿周边，再逐渐深刺，如此反复行针但不要超过三次，进针的深浅，要根据病位的深度来决定。
已刺必熨，令热入中，日使热内，邪气益衰，大痈乃溃。After acupuncture, it is necessary to apply moxibustion to make the heat penetrate inside. Do this every day to make the heat enter the interior, so that the pathogenic qi will gradually weaken and the large abscess will eventually rupture.
针刺后必须使用温熨法，使热气直达体内，只要使阳气日渐温通，邪气日趋衰退，内痈就会溃散。
伍以参禁，以除其内；恬憺无为，乃能行气。后以咸苦化谷，乃下矣。”Combine with appropriate dietary and lifestyle restrictions to eliminate the pathogenic factors from the interior. Only by maintaining a calm and peaceful state of mind can qi circulate smoothly. Later, use salty and bitter substances to promote the digestion of food, and then the condition will improve."
上述治疗要综合参依日月四时等气候情况及患者身体内部的状况，注意不要违犯针刺的禁忌，用泻法排除体内郁结的邪气；同时患者本人也须保持心境的安恬澹泊，这样才能使正气畅行。然后再服用含有酸味、苦味的食品、药物以助谷物的消化，则痈即除去，下膈症愈。”
