凡刺之法,不过补泻经络,祛邪纳气而已。其取穴甚少,惟水病风 肤胀,必刺五十七
穴。
又云∶皮肤之血尽取之,何也?盖水旺必克脾土,脾土衰,则遍身皮肉皆肿,不特一经之中
有水气矣。若仅刺一经,则一经所过之地,水自渐消,而他经之水不消,则四面会聚并一经
,已泻之水亦仍满矣。故必周身肿满之处,皆刺而泻之,然后其水不复聚耳。此五十七穴者
,皆脏之经络,水之所容也。此与大禹治洪水之法同。盖洪水泛溢,必有江淮河济,各引其
所近之众流以入海必不能使天下之水只归一河以入海也。又,出水之后,更必调其饮食。经
云∶方饮无食,方食无饮,(欲使饮食异居,则水不从食,以至于脾客观存在湿之处也。)无
食他食百三十五日,此症之难愈如此。余往时治此病,轻者多愈,重者必复肿。盖由五十七
穴未能全刺,而病患亦不能守戒一百三十五日也。此等大症,少违法度,即无愈理,可不慎
哉!
病有经有纬,有常有变,有纯有杂,有正有反,有整有乱。并有从医书所之病,历来无
治法
者,而其病又实可愈。既无陈法可守,是必熟寻《内经》、《难经》等书,审其经络脏受病
之处,及七六气相感之因,与夫内外分合,气血聚散之形,必有凿凿可征者,而后立为治法
。或先或后,或并或分,或上或下,或前或后,取药极当,立方极正。而寓以巧思奇法,深
入病机,不使 格。如 丁之解牛,虽筋骨关节之间,亦游刃有余。然后天下之病,千绪万
端,而我之设法亦千变化,全在平时于极难极险之处参悟通澈,而后能临事不眩。否则一遇疑难
,即束手无措,冒昧施治,动辄得咎,误人不少矣!
凡针刺的方法,不过是补益或泻除经络中的邪气,祛除病邪、接纳正气罢了。其选取的穴位很少,只有在水病导致皮肤肿胀(风肤胀)时,才必须刺五十七个穴位。
又说:要把皮肤下的瘀血全部刺出,为什么呢?因为水气旺盛必然克制脾土,脾土衰弱,则全身皮肉都会浮肿,不仅仅是某一条经络中有水气。如果只刺一条经络,那么这条经络经过的地方,水气自然会逐渐消退,但其他经络的水气不消,就会向这一条经络汇聚,已经泻去的水也会重新充满。所以必须将周身肿胀满溢之处都进行针刺并泻除,然后水气才不会再次聚集。这五十七个穴位,都是脏腑的经络,是水气容纳的地方。这与大禹治理洪水的方法相同。大概洪水泛滥时,必定有江、淮、河、济四条大河,各自引导靠近它们的众多支流流入大海,绝不能让天下的水只归入一条河流再入海。另外,在排出水气之后,还必须调理饮食。经书说:刚喝完水不要吃东西,刚吃完东西不要喝水。(目的是使饮食分开,这样水就不会随着食物进入脾胃,从而避免产生湿邪。)不吃其他食物一百三十五天,这种病症难以治愈的原因就在于此。我过去治疗这种病,轻症大多痊愈,重症必定复发肿胀。这是由于未能完全刺齐五十七个穴位,而且病人也不能遵守戒律一百三十五天。这种大病,稍微违反法度,就没有痊愈的道理,能不谨慎吗!
疾病有经有纬,有常法有变局,有单纯有复杂,有正证有反证,有整齐有混乱。并且还有从医书中找不到的病,历来没有固定治法的,但这种病确实是可以治愈的。既然没有旧法可以遵循,就必须仔细搜寻《内经》、《难经》等书籍,审察经络脏腑受病的部位,以及六气七情相互感应的成因,还有内外分合、气血聚散的表现,一定有确凿可征的依据,然后制定治疗方法。或先或后,或合并或分开,或上或下,取药极其恰当,立方极其端正。并融入巧妙的构思和奇特的方法,深入病机,不被表象所格拒。就像庖丁解牛一样,即使是筋骨关节之间,也能游刃有余。然后天下的疾病,千头万绪,而我的治疗方法也能千变万化,全在于平时在极难极险之处参悟透彻,这样才能在遇到事情时不感到眩惑。否则一遇到疑难病症,就束手无策,冒昧施治,动不动就招致过错,误人不浅啊!
The methods of acupuncture are nothing more than tonifying or reducing the meridians and collaterals, expelling pathogenic factors, and admitting healthy qi. The selection of acupoints is minimal; only in cases of water disease manifesting as skin swelling (windy skin distension) must fifty-seven acupoints be needled.
It is also stated: "Extract all the blood from the skin." Why? Because excessive water qi necessarily overcomes Spleen Earth. When Spleen Earth is deficient, the flesh and skin of the entire body become swollen, not merely within a single meridian. If only one meridian is needled, water qi will gradually dissipate in the areas traversed by that meridian, but water qi in other meridians will remain. This remaining water will converge into the needled meridian, causing the previously drained area to fill up again. Therefore, all areas of generalized swelling and fullness must be needled and reduced so that water qi does not re-aggregate. These fifty-seven acupoints belong to the meridians of the Zang organs, which are the reservoirs for water qi. This approach is analogous to the method Yu the Great used to control the floods. When floodwaters overflow, the Yangtze, Huai, Yellow, and Ji rivers each guide their nearby tributaries into the sea; it is impossible to force all the water of the world into a single river before entering the sea. Furthermore, after draining the water, dietary regulation is essential. The Classics state: "Do not eat immediately after drinking, and do not drink immediately after eating." (This aims to separate food and fluid intake so that water does not enter the Spleen and Stomach with food, thereby preventing the generation of Dampness.) One must abstain from other foods for 135 days; this is why such diseases are difficult to cure. In my past treatments of this disease, mild cases mostly recovered, while severe cases inevitably relapsed with swelling. This was due to failing to needle all fifty-seven points and the patients' inability to observe the abstinence for 135 days. For such major diseases, any deviation from proper protocol renders a cure impossible; how can one not be cautious!
Diseases possess longitudinal and latitudinal aspects, constancy and variation, purity and complexity, orthodoxy and reversal, order and chaos. There are also conditions not found in medical texts, for which no established treatment methods have existed historically, yet these conditions are indeed curable. Since there are no conventional methods to follow, one must meticulously consult the *Neijing* (Classic of Internal Medicine), *Nanjing* (Classic of Difficult Issues), and other texts. One must examine the location of pathology in the meridians and Zang-Fu organs, the causes of interaction among the Six Qi and Seven Emotions, and the manifestations of internal-external division/convergence and the gathering/scattering of Qi and Blood. There must be solid evidence upon which to base treatment strategies. Treatments may be administered sequentially or simultaneously, separately or jointly, superiorly or inferiorly. The selection of herbs must be highly appropriate, and the formulation of prescriptions must be strictly correct. Ingenious thoughts and unique methods should be incorporated to penetrate the pathogenesis without being obstructed by superficial symptoms. Like Cook Ding dissecting an ox, even between muscles, sinews, bones, and joints, there is ample room for maneuver. Only then can one handle the myriad complexities of diseases with adaptable methods. This capability stems entirely from profound comprehension achieved during ordinary times through studying extremely difficult and critical scenarios, enabling one to remain unconfused when facing clinical situations. Otherwise, upon encountering difficulties, one would be at a loss, resorting to rash treatments, frequently committing errors, and harming many patients!