上热下寒、脾胃差,爷爷说:归来配尺泽,两个穴
Upper-body heat with lower-body cold and a weak spleen: Grandpa says to use Guilai and Chize.
曾事物语
我十五岁那年,爷爷考过我一个问题。
他说:“鼻翼红、嗓子冒烟、睡不着;下面腿凉、脚冰、拉肚子,中间胃还胀得像塞了棉花——这种上热下寒的,你用几个穴?”
我翻着经络图,嘴里念叨着涌泉、太溪、足三里、中脘、内庭,一口气说了七八个。
爷爷摇头,就说了四个字:“归来,尺泽。”
我当时觉得老爷子在糊弄我。上热下寒,一个人身上两个季节,又得清火又得温阳,哪能只用两个穴?后来自己独立调治,碰见形形色色的上热下寒,才明白这两个穴的组合有多精妙。
热在上面、寒在下面,都是脾胃堵在中间
爷爷跟我说,上热下寒的人,十个有八个脾胃是坏的。脾胃像身体里的一个十字路口。正常情况下,心火从上面往下降,温肾水;肾水从下面往上升,润心火。这个循环圈一转动,上面不烫下面不冰。脾胃就站在这个圈的中间,是火下去、水上来的必经之路。
脾胃一堵,火下不去,全浮在上面,就成了口疮、咽干、心烦、失眠。水也上不来,全沉在下面,就成了腿凉、脚冷、拉稀、尿频。看起来是两头的毛病,根子全在脾胃这个十字路口。
归来——把胃气往下降,火才能下去
归来穴,在胃经上,下腹部,脐下四寸,旁开两寸。肚脐往下四寸,再往两侧旁开三个横指就是。

爷爷教我的时候说,这个穴的名字取得好。归来归来,气回来,火也回来。胃气本来应该是往下降的,胃气一降,心火就跟着往下走。但长期脾胃不好的人,胃气不降反升,堵在胸口,火被顶着下不去。归来就是让胃气“归位”——把上逆的气往回收、往下引,爷爷说对于情志问题也是特效,后面有机会和大家分享。
手法很简单:仰卧,双腿微屈,肚子放松。用中指指腹按住归来穴,做左右方向的推按,不是上下按。推到感觉小腹有酸胀感往下走,有时候会感觉一股暖意往大腿根方向走,或者肚子开始咕噜噜响。这就是胃气开始往下走了。
操作手法视频演示
胃气一降,上面的火就有路下去。很多上热下寒的人,揉归来穴揉个三五分钟,就会感觉胸口不那么堵了,嗓子也不那么干了。
尺泽——把肺气往下降,水才能上来
尺泽在肘横纹上,肱二头肌腱桡侧的凹陷里,弯起胳膊就能摸到。肺经的合穴。

爷爷说,有归来降胃气还不够,肺气也得降。肺在上焦,是水之上源。肺气一降,水才能往下走,肾水才能得到补充。肾水足了,底下的寒才能从根上解决。
从易理上讲,肺属金,主肃降。尺泽是合穴,合穴管“逆气而泄”,专管气往上冲的毛病。肺气一降,就像天上下雨,水自然往低处流。肾水得到雨露滋润,底下就不旱了。
手法:用拇指指腹按住尺泽,做左右来回的动作,不是上下揉。按到感觉肘窝酸胀感往下走,往小臂方向放射,就是得气。每边按两到三分钟。
两个穴配合,一个降胃气,一个降肺气
这套组合的妙处,是上下一起降。归来降胃气,上面的火有路下去;尺泽降肺气,上面的水有路下去。火下去暖肾,底下不寒了;水下去润燥,上面不热了。中间脾胃的十字路口通了,上热下寒自己就好了,具体操作按照我视频所说和顺序。
有个三十多岁的姑娘让我印象特别深。她毛囊炎很严重,下巴尤其多,口干舌燥,动不动就上火,但一吃凉的就去厕所拉肚子,冬天手脚冰凉,夏天也不敢穿凉鞋。吃过清热的药,会一点,胃更难受;吃过温阳的药,手脚暖和了,痘痘又爆发。
我教她揉归来和尺泽,双侧都做,每个穴三分钟。先尺泽,再归来。顺序有讲究——先降肺气,让水先下来滋润;再降胃气,让火往下走温煦。
她坚持了不到两周,给我发消息说,后脑勺的痘没再长新的,旧的也消了。最让她高兴的是手脚开始暖和了,而且能喝温水了——以前喝温水都觉得烧心,现在胃不顶了。
火不下者胃不降,水不上者肺不肃。我每次碰到上热下寒的人,都会想起这个操作。现在的上热下寒太多了,熬夜、焦虑、饮食不节,把脾胃全伤了。上面火在烧,下面冰在结,中间堵得死死的。喝了多少清热药、温阳药,好的有限,是因为没通中间的枢纽。
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你要是也这样:上面反复冒痘长口疮,下面腿凉脚凉拉肚子,先别急着清火也别急着补阳。试试归来和尺泽。先揉尺泽,再揉归来,每边三分钟。坚持几天,感受一下。身体会告诉你,十字路口通了,上面自然凉,下面自然暖。
When I was fifteen, my grandfather tested me with a question.
He said: "Red nose, dry throat, insomnia; cold legs, icy feet, and diarrhea below; and a stomach in the middle that feels stuffed with cotton—for this 'upper heat and lower cold' condition, how many points would you use?"

I flipped through the meridian charts, muttering Yongquan, Taixi, Zusanli, Zhongwan, and Neiting, rattling off seven or eight points in one breath.
Grandfather shook his head and said only four words: "Guilai, Chize."
At the time, I thought the old man was fooling me. With upper heat and lower cold, a person is living in two seasons at once; you have to clear fire and warm the yang, so how could you use only two points? It wasn't until I started treating patients independently and encountered all kinds of upper heat and lower cold cases that I realized how ingenious this combination is.
Heat above and cold below are both caused by the Spleen and Stomach being blocked in the middle.
Grandfather told me that eight out of ten people with upper heat and lower cold have a compromised Spleen and Stomach. The Spleen and Stomach act like a crossroads in the body. Under normal conditions, Heart fire descends to warm the Kidney water, and Kidney water ascends to moisten the Heart fire. When this cycle turns, the top isn't scorched and the bottom isn't frozen. The Spleen and Stomach stand in the middle of this circle; they are the mandatory passage for fire to descend and water to ascend.
Once the Spleen and Stomach are blocked, the fire cannot descend and floats to the top, resulting in mouth ulcers, dry throat, irritability, and insomnia. The water cannot ascend and sinks to the bottom, resulting in cold legs, cold feet, diarrhea, and frequent urination. It looks like problems at both ends, but the root cause lies entirely at the Spleen and Stomach crossroads.
Guilai—descending the Stomach qi so the fire can go down.
Guilai point is on the Stomach meridian, in the lower abdomen, four cun below the navel and two cun lateral to the midline. It is four cun below the navel and three finger-widths to the side.

When Grandfather taught me, he said this point was well-named. "Guilai" means "return"—let the qi return, and let the fire return. Stomach qi should naturally descend, and when it does, Heart fire follows it downward. But for those with long-term Spleen and Stomach issues, Stomach qi rises instead of descending, getting stuck in the chest and blocking the fire from going down. Guilai is meant to make the Stomach qi "return to its position"—retracting and guiding the rebellious qi downward. Grandfather said it is also highly effective for emotional issues, which I will share with you another time.
The technique is simple: Lie on your back with your legs slightly bent and your abdomen relaxed. Use the pads of your middle fingers to press on the Guilai points, pushing side-to-side, not up-and-down. Push until you feel a dull, aching sensation moving downward in the lower abdomen; sometimes you may feel a wave of warmth moving toward the groin, or your stomach may start to gurgle. This means the Stomach qi has begun to descend.
Video demonstration of the technique.
Once the Stomach qi descends, the fire above has a path to go down. Many people with upper heat and lower cold feel less chest congestion and less throat dryness after massaging the Guilai points for three to five minutes.
Chize—descending the Lung qi so the water can ascend.
Chize is located on the transverse cubital crease, in the depression on the radial side of the biceps brachii tendon; you can feel it when you bend your arm. It is the He-Sea point of the Lung meridian.

Grandfather said that having Guilai to descend Stomach qi is not enough; Lung qi must also descend. The Lungs are in the upper burner and are the source of water. Only when Lung qi descends can water flow downward, allowing Kidney water to be replenished. Once Kidney water is sufficient, the cold below can be resolved at the root.
In terms of Yi-theory, the Lungs belong to Metal and govern "purifying descent." Chize is a He-Sea point, and He-Sea points are used to "drain rebellious qi," specifically managing problems where qi surges upward. When Lung qi descends, it is like rain falling from the sky; water naturally flows to lower ground. Once Kidney water is nourished by this rain, the bottom is no longer parched.
Technique: Use the pad of your thumb to press on Chize, moving side-to-side, not rubbing up-and-down. Press until you feel a dull, aching sensation radiating down toward the forearm; this is "obtaining the qi." Press for two to three minutes on each side.
The two points work together: one descends Stomach qi, the other descends Lung qi.
The brilliance of this combination is that it descends both above and below. Guilai descends Stomach qi so the fire above has a path down; Chize descends Lung qi so the water above has a path down. The fire descends to warm the kidneys, so the bottom is no longer cold; the water descends to moisten dryness, so the top is no longer hot. Once the Spleen and Stomach crossroads in the middle are cleared, the upper heat and lower cold resolve themselves. Follow the sequence and instructions in my video.
I remember a woman in her thirties particularly well. She had severe folliculitis, especially on her chin, along with a dry mouth and tongue; she would get "inflamed" easily, yet eating anything cold would send her to the bathroom with diarrhea. Her hands and feet were icy in winter, and she didn't dare wear sandals in summer. She had taken heat-clearing medicine, which helped a little but made her stomach worse; she had taken yang-warming medicine, which warmed her hands and feet but caused a breakout of acne.
I taught her to massage Guilai and Chize, doing both sides for three minutes each. Massage Chize first, then Guilai. The sequence matters—descend the Lung qi first to let the water descend and nourish, then descend the Stomach qi to let the fire descend and warm.
She persisted for less than two weeks and messaged me to say that no new acne had appeared on the back of her head, and the old ones had faded. What made her happiest was that her hands and feet started to warm up, and she could drink warm water—previously, even warm water made her feel heartburn, but now her stomach no longer felt blocked.
If fire does not descend, the stomach does not go down; if water does not ascend, the lungs are not purified. Every time I encounter someone with upper heat and lower cold, I think of this method. There is so much upper heat and lower cold nowadays—staying up late, anxiety, and irregular eating have all damaged the Spleen and Stomach. Fire is burning above, ice is forming below, and the middle is completely blocked. Taking heat-clearing or yang-warming medicine only helps so much because the central hub hasn't been cleared.
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Scan the code to add the consulting assistant.If you are also like this: recurring acne and mouth ulcers above, cold legs and feet and diarrhea below, don't rush to clear fire or replenish yang. Try Guilai and Chize. Massage Chize first, then Guilai, three minutes on each side. Persist for a few days and feel the difference. Your body will tell you: once the crossroads are clear, the top will naturally be cool, and the bottom will naturally be warm.This article is reprinted from the Qizheng Yidao official account; highly recommended!