仲景方剂。并按古法锱铢分两。与今不同。（所附千金外台等方亦然。）谓如 咀者。即今之锉如麻豆大是也。云一
升者。即今之大白盏也。云铢者。六铢为一分。（即二钱半也。）二十四铢。为一两也。云三两者。
即今之一两。云二两。即今之六钱半也。料例大者只合三分之一。足矣。
（并附图。此系仲景原文）
资生经云。凡治伤寒。惟阴证可灸。余皆当针。阴证者。中寒也。其余伤寒。皆热病之类。热病宜刺。刺者。以
针泄其热也。前篇用烧针。是反助其热。因而致逆。针用火烧。针犹灸也。大抵灸者。补多而泻少。针者。泻多而补少。
明乎针灸之道。则治病其庶几乎。
太阳病初服桂枝汤。反烦。不解者。先刺风池。风府却。与桂枝汤。则愈。（此条太阳病。当是中风。发热。汗出。
恶风。脉缓者。是为桂枝汤证也。成注云。烦者。热也。初服桂枝汤后。当汗出而身凉和。若反烦不解者。风甚而未能
散也。先刺风池风府。以通太阳之经。而泄风气。却与桂枝汤。解散则愈。）
\r风池风府穴图\pt68a13.bmp\r
风池二穴。图经云在颞 后。发际陷中。（活人书云在项后。当是项侧后。盖颞 穴。本挟玉枕骨下。陷中。此二穴。
又在颞 之后。后之为言下也。）足少阳阳维之会。宜刺三分。肌肉浓者。可五分。留七呼。禁灸。
琥按图经原云。针入七分。今止刺三分者。从甲乙经之说也。留七呼。言留针于穴中。至七呼气之久。以泄其风
热之邪。
风府一穴。图经云。一名舌本。在项发际上一寸。大筋内宛宛中。（活人书云。在项后。入发际一寸。疾言。其肉立
起。言休。立下。）督脉阳维之会。宜刺。止三分。肌肉薄者。针入二分。候病患呼气。即出针。禁不可灸。使人失喑。
或问风池。风府本属足少阳经。及督脉所行之部分。与太阳经无与。而仲景刺之。何也。余答云。风池穴。在偃
伏头部第三行。风府穴。在中行。其第二行穴。即太阳经所行之地。则是风池风府。实挟太阳经而行者也。况二穴。皆
为阳维之会。阳维者。诸阳之总也。诸阳之气得泄。何患太阳之风热不去哉。
以上太阳可刺病一条。（自原论中第二卷太阳治法上集入于此）
伤寒腹满。谵语。寸口脉浮而紧。此肝乘脾也。名曰纵刺期门。（伤寒腹满。谵语者。以其人病初起。本太阳伤寒。
其后见证。又得腹满谵语。夫腹满为邪传脾。谵语为邪传胃。若寸口脉见浮紧。此非太阳之邪传里矣。诊法。脉浮而紧
者。为弦。两关之前脉弦。乃知此腹满谵语证。为肝经风热之邪。自旺而乘脾也。脾病见肝脉。为木行乘土。木乘所胜。
名曰纵。纵者。直也。言木本克土。其乘。则甚直也。期门者。肝之募。成注云。刺之以泻肝经之盛气。）
或问太阳伤寒。脉本浮紧。此条证寸口脉浮而紧。仲景独云肝乘脾。成注又云肝经气盛。医者何以别之。余答云。
太阳伤寒。脉尺寸俱浮紧。以人两尺主膀胱。为太阳寒水之经。浮紧者。风寒之气特盛也。兹则但言寸而不言尺。知非
膀胱经气盛矣。且也。仲景脉法。言尺寸。则关在其中。左关主肝。右关主脾。寸口脉浮而紧。则两关以前之脉皆弦。
谓非肝乘脾之诊邪。斯时欲用泻脾之药。则土受木贼。已不胜其攻克。理宜泻肝以去其风热。斯议药不如议针之神速矣。
张仲景的方剂，均按照古法以铢、两为单位计量，这与现代不同。（所附《千金方》《外台秘要》等书中的方剂也是如此。）所谓“咀”，就是现在锉成麻子、豆子大小的颗粒。说“一升”，就是指现在的大白盏。说“铢”的，六铢为一分（即二钱半）。二十四铢为一两。说“三两”的，就是现在的一两。说“二两”的，就是现在的六钱半。剂量大的方子，只需取原方的三分之一即可。
（并附图，此为张仲景原文）
《资生经》说：凡是治疗伤寒，只有阴证可以施灸，其余都应当针刺。阴证，就是中寒。其余的伤寒，都属于热病一类。热病适宜用刺法，刺法是用针来泄除体内的热邪。前篇提到的用烧针，是反而助长热邪，因而导致逆证。针用火烤，其实就相当于灸。大抵来说，灸法补益多而泻除少；针法泻除多而补益少。明白了针灸的道理，治病就差不多可以成功了。
太阳病初服桂枝汤后，反而出现烦闷，症状未解的，先针刺风池穴、风府穴，然后再给予桂枝汤，病就会痊愈。（此条所述的太阳病，应当是中风证，表现为发热、汗出、恶风、脉缓，这是桂枝汤证。成无己注解说：烦，是热的表现。初服桂枝汤后，应当汗出而身体凉爽平和，如果反而烦闷不解，说明风邪盛而不能散。先针刺风池、风府，以疏通太阳经脉，泄除风气，然后再给予桂枝汤，解散风邪则病愈。）
【风池风府穴图】
风池穴有两个。《图经》说在颞顬后方，发际凹陷处。（《活人书》说在项后，应当是项侧后方。因为颞顬穴，本来位于玉枕骨下方凹陷处，这两个穴位又在颞顬之后。“后”在这里的意思是下。）足少阳胆经与阳维脉的交会穴。适宜进针三分，肌肉厚的人，可进针五分。留针七次呼吸的时间。禁止施灸。
王琥按：《图经》原文说进针七分，现在只刺三分，是遵从《甲乙经》的说法。留七呼，意思是把针留在穴位中，直到七次呼吸那么久，以泄除风热之邪。
风府穴有一个。《图经》说，又名舌本，在项部发际上一寸，大筋内侧宛宛之中。（《活人书》说：在项后，入发际一寸，大声说话时，肌肉立刻隆起，停止说话时，立刻平复。）督脉与阳维脉的交会穴。适宜针刺，只进针三分。肌肉薄的人，进针二分。等候病人呼气时，立即出针。禁止施灸，否则会导致失音。
有人问：风池、风府本属于足少阳经及督脉循行的部位，与太阳经无关，为什么张仲景要针刺它们？我回答说：风池穴，在俯卧头部第三行；风府穴，在中行。其第二行穴位，正是太阳经循行的地方。那么风池、风府实际上是夹着太阳经而行的。况且这两个穴位，都是阳维脉的交会穴。阳维脉，是诸阳经的总汇。诸阳之气得以泄除，还担心太阳经的风热不去除吗？
以上是一条关于太阳病可针刺的内容。（从原论第二卷太阳治法上集中收录于此）
伤寒出现腹部胀满、胡言乱语，寸口脉浮而紧，这是肝木乘脾土，名叫纵刺期门穴。（伤寒腹满、谵语，是因为病人起初是太阳伤寒，后来出现的症状又是腹满和谵语。腹满是邪气传变至脾，谵语是邪气传变至胃。如果寸口脉见浮紧，这不是太阳邪气传入里了。诊法认为，脉浮而紧者，为弦脉。两关之前的脉象呈弦，才知道这腹满谵语的证候，是肝经风热之邪旺盛而乘袭脾土。脾病见到肝脉，是木行乘土，木克土，称为“纵”。纵，就是直的意思。说木本克土，其乘袭之势非常直接。期门穴，是肝的募穴。成无己注解说：针刺它是以泻除肝经的盛气。）
有人问：太阳伤寒，脉象本应浮紧。此条证候寸口脉浮而紧，张仲景唯独说是肝乘脾，成无己又说是肝经气盛，医生如何辨别呢？我回答说：太阳伤寒，脉象尺寸俱浮紧，因为人的两尺脉主膀胱，为太阳寒水之经，浮紧表示风寒之气特别盛。这里只说寸脉而不说尺脉，就知道不是膀胱经气盛了。而且，张仲景的脉法，说“尺寸”，则“关”在其中。左关主肝，右关主脾。寸口脉浮而紧，则两关之前的脉皆呈弦象。难道不是肝乘脾的诊断吗？此时如果想用泻脾的药物，则脾土受肝木克制，已经不能承受攻伐，理应泻肝以去除风热。这种议针的方法比议药更为神速。
Zhang Zhongjing's prescriptions all adhere to the ancient method of weighing with units of zhu (2.5 grams) and liang (37.5 grams), which differs from modern practice. (The prescriptions attached from *Qianjin Fang* and *Waitai Miyao*, etc., are also like this.) The term "ju" (chewing/crushing) refers to today's method of chopping herbs into pieces the size of hemp seeds or beans. When it says "one sheng" (a unit of volume), it refers to a large white cup today. When it mentions "zhu", six zhu constitute one fen (which is equivalent to two qian and half). Twenty-four zhu constitute one liang. When it says "three liang", it means one liang today. When it says "two liang", it means six qian and half today. For prescriptions with larger dosages, taking only one-third of the original amount is sufficient.
(And accompanying diagrams; this is the original text by Zhang Zhongjing.)
*Zisheng Jing* states: In treating Shanghan (Cold Damage), moxibustion is applicable only for Yin syndromes, while acupuncture should be used for all others. Yin syndrome refers to Zhonghan (Strike of Cold). The remaining types of Shanghan all belong to the category of heat diseases. Heat diseases are suitable for needling; needling involves using needles to drain heat. The use of burning needles mentioned in the previous chapter actually aids heat, thereby leading to adverse conditions. Needles heated by fire are essentially similar to moxibustion. Generally speaking, moxibustion tonifies more and drains less; acupuncture drains more and tonifies less. Understanding the principles of acupuncture and moxibustion allows one to treat diseases with reasonable success.
In Taiyang disease, if after the initial administration of Guizhi Tang (Cinnamon Twig Decoction), the patient experiences contrary irritability and the condition does not resolve, first needle Fengchi (GB20) and Fengfu (GV16), then administer Guizhi Tang, and the disease will heal. (This clause regarding Taiyang disease should be Wind Strike syndrome, characterized by fever, sweating, aversion to wind, and a slow pulse, which constitutes the indication for Guizhi Tang. Cheng Wuji's commentary notes: Irritability indicates heat. After the initial dose of Guizhi Tang, sweating should occur, leading to a cool and harmonious body. If contrary irritability persists unresolved, it indicates that the wind pathogen is severe and has not yet dispersed. First needle Fengchi and Fengfu to unblock the Taiyang meridians and vent the wind qi, then administer Guizhi Tang to disperse the pathogen, resulting in healing.)
[Diagram of Fengchi and Fengfu Acupoints]
Fengchi (GB20) consists of two points. *Tujing* states they are located behind the temporal region, in the depression at the hairline. (*Huoren Shu* states they are at the back of the neck, which should be interpreted as the lateral posterior neck. This is because the Temporal acupoint is originally located in the depression below the Yuzhen bone; these two points are further posterior/inferior to the Temporal point. Here, "posterior" implies inferior.) They are the intersection of the Foot-Shaoyang Gallbladder Meridian and the Yang-Linking Vessel. It is appropriate to insert the needle 3 cun; for individuals with thick muscles, insertion may be up to 5 cun. Retain the needle for seven breaths. Moxibustion is contraindicated.
Wang Hu notes: *Tujing* originally stated an insertion depth of 7 cun, but now we only insert 3 cun, following the说法 of *Jiayi Jing*. "Retain for seven breaths" means retaining the needle in the acupoint for the duration of seven exhalations to vent wind-heat pathogens.
Fengfu (GV16) is a single point. *Tujing* states it is also known as Sheben, located one cun above the nape hairline, within the depression inside the major tendons. (*Huoren Shu* states: At the back of the neck, one cun into the hairline. Upon speaking loudly, the muscle immediately rises; upon ceasing speech, it immediately flattens.) It is the intersection of the Du Vessel and the Yang-Linking Vessel. It is suitable for needling, with an insertion depth of only 3 cun. For individuals with thin muscles, insert 2 cun. Withdraw the needle while the patient exhales. Moxibustion is strictly contraindicated, as it can cause aphonia (loss of voice).
A question arises: Fengchi and Fengfu belong to the pathways of the Foot-Shaoyang Meridian and the Du Vessel, having no direct relation to the Taiyang Meridian. Why did Zhang Zhongjing needle them? I answer: Fengchi is located on the third row of acupoints when the head is in a prone position; Fengfu is on the central row. The second row of acupoints is precisely where the Taiyang Meridian travels. Thus, Fengchi and Fengfu actually run alongside the Taiyang Meridian. Moreover, both points are intersections with the Yang-Linking Vessel. The Yang-Linking Vessel is the general gathering of all Yang meridians. Once the qi of all Yang meridians is vented, why worry about the wind-heat of the Taiyang meridian not being expelled?
The above is one case of Taiyang disease suitable for acupuncture. (Extracted from Volume 2, Taiyang Treatment Methods, of the original treatise and included here.)
In Shanghan, if abdominal fullness and delirium occur, and the Cun Kou (radial) pulse is floating and tight, this is Liver Wood overacting on Spleen Earth, named Zong (Vertical/Unrestrained) needling of Qimen (LR14). (Shanghan presenting with abdominal fullness and delirium occurs because the patient initially had Taiyang Shanghan, and subsequent symptoms include abdominal fullness and delirium. Abdominal fullness indicates pathogen transmission to the Spleen; delirium indicates transmission to the Stomach. If the Cun Kou pulse presents as floating and tight, this is not the Taiyang pathogen transmitting inward. Diagnostic methods state that a floating and tight pulse corresponds to a Xian (wiry) pulse. A wiry pulse anterior to both Guan positions indicates that the abdominal fullness and delirium are caused by excessive wind-heat from the Liver Meridian overacting on the Spleen. When Spleen disease presents with a Liver pulse, it is Wood overacting on Earth, termed "Zong". Zong means straight/direct, indicating that since Wood naturally controls Earth, its overaction is particularly direct. Qimen is the Front-Mu point of the Liver. Cheng Wuji's commentary states: Needling it drains the excess qi of the Liver Meridian.)
A question arises: In Taiyang Shanghan, the pulse is typically floating and tight. In this case, the Cun Kou pulse is floating and tight, yet Zhang Zhongjing exclusively attributes it to Liver overacting on Spleen, and Cheng Wuji adds that it is due to excess Qi in the Liver Meridian. How should physicians distinguish this? I answer: In Taiyang Shanghan, the Chi and Cun positions both present floating and tight pulses, because the Chi position governs the Bladder, which is the Taiyang Cold-Water meridian; floating and tight indicates exceptional abundance of wind-cold qi. Here, only the Cun position is mentioned, not the Chi, indicating that the Bladder meridian qi is not excessive. Furthermore, according to Zhang Zhongjing's pulse methodology, mentioning "Chi and Cun" includes the "Guan". The Left Guan governs the Liver, and the Right Guan governs the Spleen. If the Cun Kou pulse is floating and tight, the pulses anterior to both Guan positions become wiry. Is this not a diagnosis of Liver overacting on Spleen? At this time, if one were to use herbs to purge the Spleen, the Earth would suffer from Wood encroachment and could not withstand the attack. It is appropriate to drain the Liver to remove wind-heat. This discussion of acupuncture is far more rapid and effective than discussing herbal medicine.