形容已脱,一夺也∶大脱血之后,是三夺也,大汗出之后,是二夺也;大泄之后,是
四夺也;新产大血之后,是五夺也。此皆不可泻。
《金针赋》云∶先须爪按,重而切之,次令咳嗽一声,随咳下针。凡补,先呼气,
初针刺至皮肉,乃曰天才;少停进针,刺至肉内,是曰人才;又停进针,刺至筋骨之
间,名曰地才。此为极处,就当补之。再停良久,却须退针,至人之分,待气沉紧,
倒针朝病,进退往来,飞经走气尽在其中矣。凡泻者,吸气初针,至天少停,进针直至
于地,得气泻之。再停良久,却须退针,复至于人,待气沉紧,倒针朝病,法同
前矣。
及夫调气之法,下针至地之后,复人之分,欲气上行,将针右捻;欲气下行,将
针左捻。欲补,先呼后吸;
欲泻,先吸后呼。气不至者,以手循摄,以爪切掐,以针摇动,进捻搓弹,直待气
至,以龙虎升腾之法,按之在前,使气在后;按之在后,使气在前。运气走之疼痛之
所,以纳气之法,扶针直插,复向下纳,使气不回。若关节阻滞,气不过者,以龙虎
龟凤、通经接气大段之法,驰而运之。仍以循摄爪切,无不应矣,此通仙之妙。
先说平针法,含针口内温。按揉令气散,掐穴故教深。持针安穴上,令他嗽一
声。随嗽归天部,停针再至人。再停归地部,待气候针沉。气若不来至,指甲切其经。
次提针向病,针退地天人。补必随经刺,令他吹气频。随吹随左转,遂归天地人。待气
停针久,三弹更熨温。出针口吸气,急急闭其门。泻欲迎经取,吸则纳其
针。吸则须右转,他次进天人。转针仍复吸,根据法再停针。出针吹出气,摇动大其门。
形体消瘦、精气耗竭,这是第一种“夺”;大量失血之后,是第二种“夺”;大汗淋漓之后,是第三种“夺”;严重腹泻之后,是第四种“夺”;刚分娩且大量出血之后,是第五种“夺”。这些情况都不可使用泻法。
《金针赋》说:下针前必须先用手指爪切按压穴位,用力重按以定位,然后让患者咳嗽一声,随着咳嗽声进针。凡是补法,先在患者呼气时进针,初次针刺至皮部,称为“天才”;稍作停顿继续进针,刺入肌肉层,称为“人才”;再次停顿继续进针,刺至筋骨之间,称为“地才”。这是针刺的极深之处,此时应当施行补法。再停留较长时间后,将针退至肌肉层(人部),等待针下感觉沉紧,调整针尖方向朝向病所,通过进退、往来等手法,飞经走气的作用就包含在其中了。凡是泻法,在患者吸气时初针,至天部稍作停顿,继续进针直达地部,得气后施行泻法。再停留较长时间后,将针退至肌肉层(人部),等待针下感觉沉紧,调整针尖方向朝向病所,方法同前所述。
至于调气的方法,下针到达地部之后,退至人部,想要使经气上行,就将针向右捻转;想要使经气下行,就将针向左捻转。想要补法,先呼后吸;想要泻法,先吸后呼。如果经气未至,用手循按穴位,用指甲掐切,摇动针体,进行进捻、搓弹等操作,直待经气到来。运用龙虎升腾之法,按压在前方可使气行于后方;按压在后方可使气行于前方。引导经气运行至疼痛部位,运用纳气之法,扶持针身直插,再向下纳入,使经气不致回散。如果关节阻滞,经气不能通过,运用龙虎龟凤、通经接气的大段手法,迅速运针以推动经气。仍然配合循按、掐切等手法,没有不应验的,这是通达仙妙的技法。
先讲述平补平泻法:将针含在口中温热。按摩揉捏使经气散开,掐穴使定位更深。手持针安放在穴位上,令患者咳嗽一声。随着咳嗽声将针归入天部,停针后再进至人部。再次停顿归入地部,等待针下感觉沉紧如鱼吞钩饵。如果经气不来,用指甲切按经脉。其次提针转向病所,将针从地、人、天各部退出。补法必须顺着经脉走向刺入,令患者频繁吹气。随着吹气同时向左捻转,依次经过天地人三部。等待经气停留,久留针后,弹针三次并熨烫温暖。出针时口吸气,迅速闭合针孔以防气泄。泻法要逆着经脉走向取穴,吸气时纳入针体。吸气时须向右捻转,依次进入天人部。转针的同时再次吸气,根据法则再次留针。出针时吹出气体,摇大针孔以泄邪气。
When the physical appearance is emaciated and essence is depleted, this is the first type of "Du" (exhaustion); after massive hemorrhage, this is the second type; after profuse sweating, this is the third type; after severe diarrhea, this is the fourth type; after recent childbirth with massive blood loss, this is the fifth type. In all these conditions, the reducing method (Xie Fa) must not be used.
The *Jin Zhen Fu* (Ode to the Golden Needle) states: One must first press and cut the acupoint with fingernails, applying heavy pressure for localization. Then, instruct the patient to cough once, and insert the needle following the cough. For tonification (Bu), begin insertion during exhalation. Initially, insert the needle into the skin layer, termed "Heaven Talent" (Tian Cai); pause slightly and advance into the muscle layer, termed "Human Talent" (Ren Cai); pause again and advance between the muscles and bones, termed "Earth Talent" (Di Cai). This is the deepest point, where tonification should be performed. After remaining there for a considerable time, withdraw the needle to the human level (Ren Fen), waiting for the sensation of heaviness and tightness (De Qi). Adjust the needle tip towards the disease site; through advancing, withdrawing, and other manipulations, the techniques of guiding qi along meridians are encompassed. For reduction (Xie), initiate insertion during inhalation. Advance to the Heaven level, pause slightly, then continue inserting directly to the Earth level. Upon obtaining De Qi, perform the reducing technique. After remaining there for a considerable time, withdraw the needle to the human level, waiting for the sensation of heaviness and tightness. Adjust the needle tip towards the disease site; the method is the same as described above.
Regarding the methods for regulating qi, after inserting the needle to the Earth level, withdraw it to the Human level. To move qi upward, rotate the needle to the right; to move qi downward, rotate the needle to the left. For tonification, exhale first then inhale; for reduction, inhale first then exhale. If qi does not arrive, use hand circling (Xun), pressing (She), and nail cutting (Qia). Shake the needle, advance and twist, rub and flick until qi arrives. Employ the Long-Hu Sheng-Teng (Dragon and Tiger Ascending and Soaring) method: pressing anteriorly causes qi to move posteriorly; pressing posteriorly causes qi to move anteriorly. Guide the qi to the painful area. Use the Na Qi (Receiving Qi) method: support the needle body and insert it straight, then push it down further to prevent qi from retreating. If joint blockage prevents qi passage, employ the grand techniques of Long-Hu-Gui-Feng and Tong Jing Jie Qi (Connecting Meridian Qi), manipulating rapidly to drive the qi. Continue with circling, pressing, and nail cutting; no case will fail to respond. This is the miraculous skill of reaching immortality.
First, describe the Ping-Zhen (Neutral Needling) method: warm the needle in the mouth. Massage and knead to disperse qi; press the acupoint deeply with nails. Hold the needle over the acupoint, ask the patient to cough once. Following the cough, return the needle to the Heaven section. Pause, then advance to the Human section. Pause again, then return to the Earth section. Wait for the needle sensation to become heavy and tight. If qi does not arrive, cut the meridian with fingernails. Next, lift the needle towards the disease site, withdrawing from Earth, Human, and Heaven sections. Tonification requires needling along the direction of the meridian; ask the patient to blow air frequently. Simultaneously with blowing, rotate left, passing through Heaven, Earth, and Human sections. Wait for qi to settle, leave the needle for a long time, flick three times, and apply warmth. Upon withdrawal, inhale through the mouth and quickly close the pore. Reduction requires taking points against the meridian flow; insert the needle during inhalation. Rotate right during inhalation, entering Heaven and Human sections. Rotate the needle while inhaling again, pausing according to the method. Upon withdrawal, exhale to open the pore widely by shaking the needle.