阴阳应象篇 岐伯曰∶善用针者,从阴引阳,从阳引阴,以右治左,以左治右,以我
知彼,以表知里,以观过与不及之理,见微得过,用之不殆。
从阴引阳二句,言在上者治下,在下者治上。以我知彼,欲体察也。以表知里,达内外也。
过与不及,总结上文,观夫阴阳左右表里之过与不及也。善针者不待病形已具,方知过与不及,
若微见征兆便知其过,其明如此,用针岂有至危殆哉?
八正神明篇 岐伯曰∶天温日明,则人血淖(多也)液而卫气浮,故血易泻而气易行;
天寒日阴,则人血凝泣
而卫气沉。月始生,则气血始精,卫气始行;月郭满,则血气实,肌肉坚;月郭空,则肌肉减,
经络虚,卫气去,形独居。是以因天时而调血气也。是以天寒无刺,天温无凝。月生无泻,月满
无补,月郭空无治,(攻也)。是谓得时而调之。因天之序,盛虚之时,移光定位,正立而待之。故
月生而泻,是谓脏虚;月满而补,血气扬溢,络有留血,命名重实;月郭空而治,是谓乱经。阴
阳相错,真邪不辨,沉以留止,外虚内乱,淫邪乃起。
帝曰∶星辰八正何候?岐伯曰∶星辰者,所以制日月之行也。八正者,所以候八风之虚邪以
时至者也。四时者,所以分春秋冬夏之气所在,以时调之也。八正之虚邪,而避之勿犯也。以身
之虚,而逢天之虚,两虚相感,其气至骨,入则伤五脏,工候救之,弗能伤也,故曰∶天忌不可
不知也。(人忌于天,故云天忌。)帝曰∶善。其法星辰者,余闻之矣。愿闻法往古者。岐伯曰∶
法往古者,先知《针经》也。验于来今者,先知日之寒温,月之虚盛,以候气之浮沉,而调之于
身,观其立有验也。观其冥冥者,言形气荣卫之不形于外,而工独知之。
观其冥冥者,言形气荣卫之不形于外,而工独知之,以日之寒温、月之虚盛、四时气之浮
沉,参伍相合,而调之至常,先见之,然而不形于外,故曰∶观于冥冥。
帝曰∶余闻补泻,未得其意。岐伯对曰∶泻必用方,方者,以气方盛也,以月方满也,以日
方温也,以身方定也,以息方吸而内针,乃复候其方吸而转针,乃复候其方呼而徐引针,故曰泻
必用方,其气而行焉。补必用员,员者行也,行者移也,刺必中其荣,复以吸排针也。吸则内针,
无令气忤。静以久留,无令邪布。吸则转针,以得气为故。候呼引针,呼尽乃去。大气皆出,故
命曰泻。
补则久留,今泻而曰静以久留而先补者,若真气不足,针乃泻之,则经脉不满,邪气无所
排遣,故先补真气令足,后乃泻出其邪矣。引,谓引出。去,谓离穴,候呼而引至其门,呼尽乃
离穴户,则经气审以平定,邪气无所拘留,故大邪之气随针而出也。呼,谓气出。吸,谓气入。
转,谓转动大气。大邪之气,谓错乱阴阳者。
宝命全角篇 岐伯曰∶凡刺之真,必先治神,五脏已定,九候已备,后乃存针,众脉
不见,众凶弗闻,内外相得,无以形先,可玩往来,乃施于人。人有虚实,五虚勿近,五实勿远,
至其当发,间不容 。(瞬也。)手动若务,针耀而匀,静意视义,观适之变,是谓冥冥,莫知其形。
见其乌乌,见其稷稷,从见其飞,不知其谁。
乌乌,叹其气至。稷稷嗟其已应,言所针得失,如从空中见飞鸟之往来,岂复知其所使之
元主耶?是但见脉经盈虚而为信,亦不知其谁之所召遣尔。
伏如横弩,起如发机。
血气之未应针,伏如横弩之安静,其应针也,则起如机发之迅速。
帝曰∶何如而虚?何如而实?岐伯曰∶刺虚者须其实,刺实者须其虚。经气已至,慎守勿失。
浅深在志,远近若一。如临深渊,手如握虎,无营于众物。
离合真邪篇 岐伯曰∶天地温和,则经水安静;天寒地冻,则经水凝泣;天暑地热,
则经水沸溢;卒风暴起,则经水波涌而陇起。夫邪之入于脉也,寒则血凝泣,暑则气淖泽,虚邪
因而入客,亦如经水之得风也,经之动脉,其至也亦时陇起,其行于脉中循循然。其至寸口中手
也,时大时小,大则邪至,小则平。其行无常处,在阴与阳,不可为度。从而察之,三部九候,
卒然逢之,早遏其路。曰∶候气奈何?曰∶夫邪去络入经也,舍于血脉之中,其寒温未相得,如
涌波之起也,时来时去,故不常在。故曰方其来也,必按而止之,止而取之,无逢其冲而泻之。
冲,谓应水刻数之平气也。《灵枢经》曰∶水下一刻,人气在太阳;水下二刻,人气在少
阳;水下三刻,人气在阳明;水下四刻,人气在阴分。然气在太阳,则太阳独盛;气在少阳,则
少阳独盛。夫见独盛者,便谓邪来,以针泻之,则反伤其真气,故下文云云。
真气者,经气也,经气太虚,故曰其来不可逢,此之谓也。故曰候邪不审,大气已过,泻之
则真气脱,脱则不复,邪气复至,而病益蓄,故曰其往不可追,此之谓也。不可挂以发者,待邪
之至时而发针泻矣。若先若后者,血气已尽,其病不可下,故曰知其可取如发机,知其不可取如
扣椎,故曰知机道者不可挂以发,不知机者扣之不发,此之谓也。
帝曰∶不足者补之奈何?岐伯曰∶必先扪而循之,切而散之,推而按之,弹而怒之,抓而下
之,通而取之,外引其门,以闭其神,呼尽内针,静以久留,以气至为故,如待所贵,不知日暮,
其气以至,适而自护,候吸引针,气不得出,各在其处,推阖其门,令神气存,大气留止,故命曰补。
候吸引针,大气不泄,补之为义,断可知矣。推阖其门以下,乃解上文三句义也。大气谓
大经之气,流行营卫者也。
调经篇 岐伯曰∶泻实者气盛乃内针,针与气俱内,以开其门而利其户。针与气俱出,
精气不伤,邪气乃下。外门不闭,以出其疾,摇大其道,而利其路,是谓大泻。必切而出,大气
乃屈。补虚者持针勿置,以定其意,候呼内针。气出针入,针孔四塞,精无从去,方实而疾出针。
气入针出,热不得还,闭塞其门,邪气布散,精气乃得存。动气候时,近气不失,远气乃来,是谓追之。
离合真邪篇 帝曰∶补泻奈何?岐伯对曰∶此攻邪也,疾出以去盛血,而复其真气。
此邪新客,溶溶未有定处也,推之则前,引之则止。逆而刺之,刺出其血,其病立已。
去血,须视血盛而邪拥甚,故刺去其血而立已。
针解篇 岐伯曰∶刺虚则实之者,针下热也,气实乃热也。满而泄之者,针下寒也,
气虚乃寒也。菀陈则除之者,出恶血也。邪盛则虚之者,出针勿按。徐而疾则实者,徐出针而疾
按之。疾而徐则虚者,疾出针而徐
按之。刺实须其虚者,留针阴气隆至,乃去针也。刺虚须其实者,阳气隆至,针下热乃去针也。
经气已至,慎守勿失者,勿更改也。浅深在志者,知病之内外也。远近如一者,浅深其候等也。
刺志论篇 曰∶夫实者,气入也。虚者,气出也。气实者,热也。气虚者,寒也。
入实者,右手开针空也。入虚者,左手闭针空也。
右手持针,左手捻穴,故实者右手开针空以泻之;虚者左手开针空以补之。
三部九候篇 曰∶经病者治其经,孙络病者治其孙络血。
有血留正,剌而去之。《灵枢》曰∶经脉为里,支而横者为络,络之别者为孙络。是以知
孙络则络之别支而横者也。
血病身有痛者治其经络,其病者在奇邪,奇邪之脉则缪刺之。
奇谓奇缪不偶之气,而与脉经缪处也,故缪刺。缪剌者剌络脉,左取右,右取左也。
留瘦不移,节而刺之,上实下虚,切而从之,索其结络脉,刺出其血,以见通之。
通评虚实篇 帝曰∶春亟治经络,夏亟治经俞,秋亟治六腑,冬则闭塞。闭塞者,用
药而少针石也。所谓少针石者,非痈疽之谓也,痈疽不得顷时回。
诊要经终篇 曰∶凡刺胸腹,必避五脏,中心者环死,其动为噫。中肝者五日死,其
动为语。中脾者十日死,其动为吞。中肾者二日死,其动为嚏。中肺者三日死,其动为咳。中胆
者一日半死,其动为呕。中鬲者皆为伤中,其病虽愈,不过一岁必死。刺避五脏者,知逆从也。
所谓从者,鬲与脾肾之处,不知者反之。刺胸腹者,必以布HT 着之,乃从单布上刺,刺之不愈,
复刺必肃,刺肿摇针,经刺勿摇,此刺之道也。
刺禁论 岐伯曰∶藏有要害,不可不察。肝生于左,肺藏于右,心部于表,肾治于里,
脾谓之使,胃为之
市。鬲肓之上,中有父母,(父母,心肺阴阳是也。)七节之傍,中有小心,从之有福,逆之有咎。
刺 上中大脉,血出不止者死。(跗为足跗,大脉动而不止者,乃胃之大经。)刺面中溜脉,
不幸为盲。刺头中脑户,入脑立死。刺舌下中脉太过,出血不止为喑。刺足下布络中脉,血不出
为肿。刺 中大脉,令人仆脱色。刺气街中脉,血不出,为肿鼠伏。(如伏鼠也。)刺脊间中髓,
为伛。刺乳上中乳房,为肿根蚀。刺缺盆中内陷,气泄,令人喘逆咳。刺手鱼腹内陷,为肿。无
刺大醉,令人气乱。无刺大怒,令人气逆。无刺大劳人,无刺新饱人,无刺大饥人,无刺大渴人,
无刺大惊人。
《灵枢经》云∶新内无刺,已剌无内;大怒无剌,已刺无怒;大劳无剌,已剌勿劳;大醉无
刺,已刺勿醉;大饱无刺,已刺勿饱;大饥无剌,已剌勿饥;大渴无刺,已刺勿渴;大惊大恐,
必定其气,乃刺之也。
刺阴股中大脉,血出不止死。刺客主人内陷中脉,为内漏为聋。刺膝髓出液,为跛。刺臂大
阴脉,出血多立死。刺足少阴脉,重虚出血,为舌难以言。刺膺中陷中肺,为喘逆仰息。刺肘中
内陷,气归之,为不屈伸。
刺阴股下三寸内陷,令人遗溺。刺腋下胁间内陷,令人咳。刺少腹中膀胱溺出,令人少腹满。
刺肠内陷,为肿。刺匡目眶。上陷骨中脉,为漏为盲。刺关节中液出,不得屈伸。
调经论篇 帝曰∶夫子言虚实者有十,生于五脏五脉耳。夫十二经脉皆生其病,今
夫子独言五脏。夫十二经脉者,皆络三百六十五节,节有病必被经脉,经脉之病皆有虚实,何以
合之?岐伯曰∶五脏者,故得六腑与为表里,经络支节,各生虚实,其病所居,随而调之。病在
脉,调之血;病在血,调之络;病在气,调之卫;病在肉,调之分肉;病在筋,调之筋;病在骨,
调之骨。燔针劫刺其下及与急者;病在骨, 针药熨;病不知所痛,两跷为上;身形有痛,九候
莫病,则缪刺之;痛在于左,而右脉病者,巨刺之。必谨察
其九候,针道备矣。
离合真邪篇 帝曰∶真邪以合,波陇不起,候之奈何?岐伯对曰∶审扪循三部九候之
盛虚而调之,察其左右上下相失及相减者,审其病脏以期之。不知三部者,阴阳不别,天地不分。
地以候地,天以候天,人以候人,调之中府,以定三部。故曰刺不知三部九候病脉之处,虽有太
过且至,工不能禁也。
禁,禁止也。然候邪之处,尚未能知,复能禁止其候气耶?虽有太过之邪,至于其经,
工亦不能用针以禁绝也。
诛伐无过,命曰大惑。反乱大经,真不可复。用实为虚,以邪为真,用针无义,反为气贼,
夺人正气。以从为逆,荣卫散乱,真气已失,邪独内着。绝人长命,予人夭殃,不知三部九候,
故不能久长。
三部,言人身中之有上中下三部,经队由之,故察候存亡,悉由于是。部各有三候,如上
部天,两额之动脉以应手也,足少阳脉气所行。上部地,两颊之动脉,在鼻孔下两旁动脉应手,
近巨 之分,足阳明脉气所行。上部人,在前耳动脉应手少阳脉气所行。中部天,在掌后寸口经
渠动脉。中部地,在阳明合谷之分动脉。中部人,在少阳神门之分动脉。下部天,足厥阴羊矢下
一寸半五里之分,卧而取之,动脉应手;女子取太冲,在足大指本节后二寸。下部地,足少阴太
溪之分动脉。下部人,足太阴在鱼腹上,起筋间,直五里下箕门之分动脉。下部巩足单衣沉取乃
得至。如候胃气者,当取足上冲阳之分动脉应手。此二部中之三部也。
《阴阳应象大论》篇:岐伯说:善于运用针刺的人,从阴经引导阳气,从阳经引导阴气,治疗左侧的病症取右侧穴位,治疗右侧的病症取左侧穴位,通过自身(医者)的状态来推知患者(彼)的情况,通过体表的征象来了解体内的病变,以此观察阴阳、左右、表里之间太过与不及的道理,在细微之处发现过失,这样使用针法就不会有危险。
“从阴引阳”和“从阳引阴”这两句,意思是病在上部的治下部,病在下部的治上部。“以我知彼”,是为了体察病情。“以表知里”,是为了通达内外关系。“过与不及”,是对上文内容的总结,即观察阴阳、左右、表里的太过与不及。善于针刺的人,不需要等到病症完全显现才知晓太过与不及,如果在细微征兆出现时就能知道其过失,其高明之处如此,使用针法怎么会有危及生命的情况呢?
《八正神明论》篇:岐伯说:天气温暖、阳光明亮时,人的血液滑润流动,卫气浮越于体表,所以血液容易泻出,气机容易运行;天气寒冷、阴雨昏暗时,人的血液凝滞涩少,卫气沉伏于体内。月亮刚开始生起时,人的气血开始精纯,卫气开始运行;月亮圆满时,血气充实,肌肉坚实;月亮亏缺时,肌肉减损,经络空虚,卫气离去,只有形体独自存在。因此要根据天时来调节血气。所以天气寒冷时不要针刺,天气温暖时不要担心气血凝滞。月亮初生时不要用泻法,月亮圆满时不要用补法,月亮亏缺时不要进行治疗(攻邪)。这叫做顺应时机来调治。依据天时的规律,把握盛衰的时机,观察日影位置的变化,端正站立等待合适的时机。所以在月亮初生时用泻法,会导致脏腑虚损;在月亮圆满时用补法,会使血气洋溢,络脉中有留血,这叫做重实;在月亮亏缺时进行治疗,会扰乱经脉。导致阴阳错乱,真气与邪气难以分辨,邪气沉伏停留,外表虚弱内部混乱,淫邪之气于是产生。
黄帝问:星辰和八正节气有什么作用?岐伯回答:星辰的作用,是用来制定日月运行的规律。八正节气,是用来观测八方虚邪之风按时到来的情况。四季,是用来区分春秋冬夏四时之气的所在,以便按时进行调理。对于八正节气的虚邪,要避开它不要触犯。如果人体正气虚弱,又遇到天时虚邪,两虚相感,邪气深入至骨,侵入则伤害五脏,医生若能及时守候救治,就不会造成伤害,所以说:天的禁忌不可不知道。(人受限于天时,所以称天忌。)黄帝说:好。关于效法星辰的方法,我已经听说了。希望能听听效法古代经验的方法。岐伯说:效法古代经验的人,必须先精通《针经》。验证于当今的人,必须先了解日子的寒温变化,月亮的盈亏盛衰,以此来候察气机的浮沉,并在身上进行调理,观察是否立即见效。所谓“观其冥冥”,是说形气营卫的变化不显露于外,而只有医生独自知晓。
所谓“观其冥冥”,是说形气营卫的变化不显露于外,而只有医生独自知晓,结合日子的寒温、月亮的盈亏、四时气机的浮沉,综合参伍相互印证,从而将调理达到常规标准,先于病形显现之前预见并处理,然而这些变化并不显露于外,所以称为“观于冥冥”。
黄帝说:我听说补法和泻法,但未得其意。岐伯回答说:泻法必须用“方”,所谓“方”,是指气机正旺盛的时候,月亮正圆满的时候,日子正温暖的时候,身体正安定的时候,在病人吸气时进针,然后再等候病人吸气时转针,再等候病人呼气时慢慢拔针,所以叫泻法必须用“方”,这样气机才能运行。补法必须用“员”(圆),所谓“员”就是行,行的意思就是移动,针刺必须中其荣穴,再在吸气时排针。吸气时进针,不要让气机逆乱。安静地长时间留针,不要让邪气散布。吸气时转针,以得气为目的。等候呼气时拔针,呼尽时才离开。大气都出去了,所以命名为泻。
补法需要久留针,现在泻法却说“静以久留”且先补,如果是真气不足,直接针刺泻之,则经脉不满,邪气无处排遣,所以要先补真气使其充足,然后才能泻出邪气。“引”,是谓引出。“去”,是谓离开穴位,等候呼气时将针引至穴门,呼尽时才离穴户,那么经气就会平稳安定,邪气无处拘留,所以大邪之气随针而出。“呼”,是谓气出。“吸”,是谓气入。“转”,是谓转动大气。大邪之气,是指错乱阴阳的邪气。
《宝命全形论》篇:岐伯说:凡针刺的真谛,必先治神,五脏功能已确定,九候脉象已具备,然后才存心于针,虽然众脉不见,众凶弗闻,但内外相合,不以形迹为先,可以玩味气机的往来,然后施用于人。人有虚实之分,五虚证不要靠近(慎用),五实证不要远离(必治),到了应当发针的时候,间不容瞬(眨眼)。手法专一,针具光亮均匀,静心观察义理,观察适应性的变化,这叫做“冥冥”,没有人能看到它的形状。看到气至如乌乌之声,看到气应如稷稷之状,如同看见飞鸟飞翔,却不知是谁在驱使。
“乌乌”,是感叹气至的声音。“稷稷”,是赞叹已经应验,说明针刺的得失,如同从空中看见飞鸟的往来,哪里还知道是谁在驱使主宰呢?这只是看到脉经的盈虚作为信验,也不知道是谁所召遣。
血气尚未应针时,潜伏得像横放的弩弓一样安静;当它应针时,则像弩机发射一样迅速。
黄帝问:怎样算是虚?怎样算是实?岐伯说:刺虚证必须使其实,刺实证必须使其虚。经气已经到来,谨慎守护不要失掉。深浅在于心意,远近感觉如一。就像面临深渊一样小心,手像握着老虎一样稳重,不被其他事物干扰。
《离合真邪论》篇:岐伯说:天地温和时,经脉之水安静;天寒地冻时,经脉之水凝滞涩少;天暑地热时,经脉之水沸腾溢出;突然刮起暴风时,经脉之水波涛汹涌隆起。邪气进入脉中,寒则血液凝滞涩少,暑则气机滑润泽利,虚邪趁机侵入,也像经脉之水遇到风一样,经脉动脉的搏动,有时隆起,它在脉中循行有序。诊察寸口脉时,有时大有时小,大则邪气至,小则平和。邪气行走没有固定处所,在阴经与阳经之间,无法规定度数。顺着脉象来考察,通过三部九候诊法,突然遇到邪气,要尽早阻断其路径。问:如何候察邪气?答:邪气从络脉进入经脉,停留在血脉之中,其寒温尚未与正气相得,像涌波兴起一样,时而来时去,所以不常停留。所以说当邪气刚来时,必须按压以阻止它,按住后取穴针刺,不要迎着邪气冲盛之时泻之。“冲”,是指对应水刻数平气之时。《灵枢经》说:水下第一刻,人气在太阳经;水下第二刻,人气在少阳经;水下第三刻,人气在阳明经;水下第四刻,人气在阴分。然而气在太阳经,则太阳经独盛;气在少阳经,则少阳经独盛。见到独盛的经脉,便认为是邪气来了,如果用针泻之,反而伤害真气,所以下文接着说。
真气,就是经气,经气太虚,所以说邪气来的时候不可逢迎(不可泻),就是这个意思。所以说候察邪气如果不审慎,大气(邪气)已经过去,此时泻之则真气脱失,脱失就不能恢复,邪气再次到来,而病情更加积聚,所以说邪气过去不可追,就是这个意思。不可挂以毫发(指时机稍纵即逝),要等待邪气到达时发针泻之。如果先于邪气或后于邪气,血气已尽,病就无法治愈,所以知道可取的时机像弩机发射一样迅速,知道不可取的时机像敲击木椎一样无反应,所以说懂得机道的人不会错失毫发,不懂机道的人敲击也不会发出声音,就是这个意思。
黄帝问:不足(虚证)如何补?岐伯说:必须先扪摸并循按穴位,切散结聚,推按局部,弹拨使血脉怒张,抓捏向下导引,疏通后取穴,向外牵引穴门,以闭合神气,呼气尽时进针,安静地长时间留针,以气至为目的,像等待尊贵的人一样,不知日暮,气机一到,适当自护,等候吸气时拔针,气不得外出,各守其处,推闭穴门,令神气留存,大气留止,所以命名为补。
等候吸气时拔针,大气不泄,补法的意义,断然可知了。“推阖其门”以下,是解释上文三句的含义。大气指大经之气,流行于营卫之间。
《调经论》篇:岐伯说:泻实证要在气盛时进针,针与气一同进入,以打开门户以利出路。针与气一同退出,精气不伤,邪气乃下。外门不闭,以排出疾病,摇大其道,以利通路,这叫做大泻。必须切脉后出针,大气乃屈。补虚者持针不要放置,以定其心意,等候呼气时进针。气出针入,针孔四塞,精气无从离去,脉气方实而疾速出针。气入针出,热气不得返还,闭塞其门,邪气布散,精气乃得保存。动气候时,近处的正气不失,远处的正气乃来,这叫做追之。
《离合真邪论》篇:黄帝问:补泻如何做?岐伯回答说:这是攻邪的方法,疾速出针以去除盛血,从而恢复真气。此邪气新近客居,溶溶未有定处,推之则向前,引之则停止。逆着邪气方向针刺,刺出其血,病立刻痊愈。
《针解》篇:岐伯说:刺虚证使之实,是针下发热,气实则热。满盛而泄之,是针下发寒,气虚则寒。菀陈则除之,是排出恶血。邪盛则虚之,是出针勿按。徐而疾则实,是慢出针快按之。疾而徐则虚,是快出针慢按之。刺实证须使其虚,是留针待阴气隆至,然后去针。刺虚证须使其实,是阳气隆至,针下热然后去针。经气已至,谨慎守护不要失掉,是不更改手法。浅深在志,是知道病的内外。远近如一,是浅深候气相等。
《刺志论》篇:说:实证,是气入。虚证,是气出。气实者,热。气虚者,寒。
右手持针,左手捻穴,所以实证右手开针空以泻之;虚证左手闭针空以补之。
《三部九候论》篇:说:经病治其经,孙络病治其孙络血。
有血留滞正经,刺而去之。《灵枢》说:经脉为里,分支而横者为络,络的别支者为孙络。所以知道孙络就是络的别支而横者。
血病身有痛者治其经络,其病在奇邪,奇邪之脉则用缪刺法。
奇谓奇缪不偶之气,而与脉经交错之处,所以用缪刺。缪刺者刺络脉,左取右,右取左。
留瘦不移,节而刺之,上实下虚,切而从之,索其结络脉,刺出其血,以见通之。
《通评虚实论》篇:黄帝说:春季亟治经络,夏季亟治经俞,秋季亟治六腑,冬季则闭塞。闭塞者,用药而少用针石。所谓少用针石,不是指痈疽,痈疽不得片刻延误。
《诊要经终论》篇:说:凡刺胸腹,必须避开五脏,中心者环死,其动作为噫气。中肝者五日死,其动作为多言。中脾者十日死,其动作为吞咽。中肾者二日死,其动作为喷嚏。中肺者三日死,其动作为咳嗽。中胆者一日半死,其动作为呕吐。中膈者皆为伤中,其病虽愈,不过一岁必死。刺避五脏,是知道逆从。所谓从,是指膈与脾肾之处,不知道的人则相反。刺胸腹,必须用布覆盖,然后从单布上刺,刺之不愈,复刺必须严肃,刺肿摇针,经刺勿摇,这是刺法之道。
《刺禁论》:岐伯说:脏有要害,不可不察。肝生于左,肺藏于右,心部于表,肾治于里,脾谓之使,胃为之市。膈肓之上,中有父母(父母,指心肺阴阳)。七节之傍,中有小心,顺之有福,逆之有咎。
刺跗上中大脉,血出不止者死。(跗为足背,大脉动而不止者,是胃之大经。)刺面中溜脉,不幸致盲。刺头中脑户,入脑立死。刺舌下中脉太过,出血不止致喑。刺足下布络中脉,血不出为肿。刺腨中大脉,令人仆倒面色改变。刺气街中脉,血不出,为肿如鼠伏。(如伏鼠也。)刺脊间中髓,为伛偻。刺乳上中乳房,为肿根蚀。刺缺盆中内陷,气泄,令人喘逆咳。刺手鱼腹内陷,为肿。无刺大醉人,令人气乱。无刺大怒人,令人气逆。无刺大劳人,无刺新饱人,无刺大饥人,无刺大渴人,无刺大惊人。
《灵枢经》说:新行房事无刺,已刺无行房事;大怒无刺,已刺无怒;大劳无刺,已刺勿劳;大醉无刺,已刺勿醉;大饱无刺,已刺勿饱;大饥无刺,已刺勿饥;大渴无刺,已刺勿渴;大惊大恐,必定其气,乃刺之。
刺阴股中大脉,血出不止死。刺客主人内陷中脉,为内漏为聋。刺膝髓出液,为跛。刺臂大阴脉,出血多立死。刺足少阴脉,重虚出血,为舌难以言。刺膺中陷中肺,为喘逆仰息。刺肘中内陷,气归之,为不屈伸。
刺阴股下三寸内陷,令人遗溺。刺腋下胁间内陷,令人咳。刺少腹中膀胱溺出,令人少腹满。刺肠内陷,为肿。刺匡目眶。上陷骨中脉,为漏为盲。刺关节中液出,不得屈伸。
《调经论》篇:黄帝说:先生言虚实者有十,生于五脏五脉而已。十二经脉皆生其病,今先生独言五脏。十二经脉,皆络三百六十五节,节有病必被经脉,经脉之病皆有虚实,何以合之?岐伯说:五脏,本来与六腑互为表里,经络支节,各生虚实,病所居处,随而调之。病在脉,调之血;病在血,调之络;病在气,调之卫;病在肉,调之分肉;病在筋,调之筋;病在骨,调之骨。燔针劫刺其下及与急者;病在骨,用焠针药熨;病不知所痛,两跷为上;身形有痛,九候莫病,则缪刺之;痛在于左,而右脉病者,巨刺之。必须谨慎察其九候,针道备矣。
《离合真邪论》篇:黄帝问:真邪相合,波陇不起,如何候察?岐伯回答说:审察扪循三部九候的盛虚而调之,察其左右上下相失及相减者,审其病脏以期之。不知道三部的人,阴阳不别,天地不分。地以候地,天以候天,人以候人,调之中府,以定三部。所以说刺不知三部九候病脉之处,虽有太过且至,医生不能禁止。
禁,禁止也。然而候邪之处,尚且不知道,又能禁止其候气吗?虽有太过之邪,至于其经,医生也不能用针以禁绝。
诛伐无过,命曰大惑。反乱大经,真气不可复。用实为虚,以邪为真,用针无义,反为气贼,夺人正气。以从为逆,营卫散乱,真气已失,邪独内着。绝人长命,予人夭殃,不知三部九候,故不能久长。
三部,指人身中之有上中下三部,经脉由此通行,所以察候存亡,全由于此。部各有三候,如上部天,两额之动脉以应手也,足少阳脉气所行。上部地,两颊之动脉,在鼻孔下两旁动脉应手,近巨髎之分,足阳明脉气所行。上部人,在前耳动脉应手少阳脉气所行。中部天,在掌后寸口经渠动脉。中部地,在阳明合谷之分动脉。中部人,在少阳神门之分动脉。下部天,足厥阴羊矢下一寸半五里之分,卧而取之,动脉应手;女子取太冲,在足大指本节后二寸。下部地,足少阴太溪之分动脉。下部人,足太阴在鱼腹上,起筋间,直五里下箕门之分动脉。下部巩足单衣沉取乃得至。如候胃气者,当取足上冲阳之分动脉应手。此二部中之三部也。
Chapter on Yin and Yang Resonating with Images: Qibo said: Those who skillfully apply acupuncture guide Yang from Yin, and guide Yin from Yang; they treat the left side by selecting points on the right, and treat the right side by selecting points on the left. They understand the patient (the other) through their own state, and perceive internal conditions through external manifestations. By observing the principles of excess and deficiency in Yin-Yang, left-right, and interior-exterior, they detect faults at their subtle beginnings. Thus applied, there is no danger.
The phrases "guide Yang from Yin" and "guide Yin from Yang" mean treating lower disorders via upper points, and upper disorders via lower points. "Understanding the other through oneself" refers to empathetic examination. "Perceiving the interior through the exterior" refers to comprehending internal-external relationships. "Excess and deficiency" summarizes the preceding text, referring to the observation of excess and deficiency in Yin-Yang, left-right, and interior-exterior. A skilled acupuncturist does not wait for full-blown symptoms to identify excess or deficiency; if they can recognize faults at the slightest sign, their insight is such that using needles would never lead to peril.
Chapter on Eight Regularities and Divine Spirit: Qibo said: When the weather is warm and sunny, human blood flows smoothly, and Wei Qi (Defensive Qi) floats superficially; thus, blood is easily released, and Qi moves freely. When the weather is cold and cloudy, human blood becomes stagnant and sluggish, and Wei Qi sinks internally. As the moon begins to wax, Qi and Blood become refined, and Wei Qi begins to circulate. When the moon is full, Qi and Blood are abundant, and muscles are firm. When the moon wanes, muscles diminish, meridians become empty, Wei Qi departs, and only the physical form remains. Therefore, one must regulate Qi and Blood according to heavenly timing. Hence, do not puncture when the weather is cold; do not worry about stagnation when the weather is warm. Do not use reducing methods when the moon is waxing; do not use tonifying methods when the moon is full; do not treat (attack pathogens) when the moon is new. This is called regulating according to the proper time. Following the order of heaven, grasping the times of abundance and emptiness, observing the position of sunlight, standing upright and waiting. Thus, reducing when the moon is waxing causes visceral deficiency; tonifying when the moon is full causes Qi and Blood to overflow, leaving residual blood in collaterals, termed "Double Excess." Treating when the moon is new disrupts the meridians. Yin and Yang become confused, true Qi and pathogenic factors indistinguishable, pathogens sink and linger, causing external deficiency and internal chaos, allowing excessive pathogens to arise.
The Yellow Emperor asked: What is the function of the stars and the Eight Regularities? Qibo replied: The stars regulate the movement of the sun and moon. The Eight Regularities monitor the arrival of deficient evils from the eight winds according to time. The four seasons distinguish the Qi of Spring, Summer, Autumn, and Winter, allowing for timely regulation. One must avoid the deficient evils of the Eight Regularities. If a person's deficiency meets heavenly deficiency, the two deficiencies interact, reaching the bone; entering inward, it damages the five Zang organs. If a physician monitors and rescues promptly, damage can be avoided. Thus, it is said: The taboos of Heaven must not be unknown. (Humans are restricted by Heaven, hence called Heavenly Taboos.) The Yellow Emperor said: Excellent. I have heard of the method of following the stars. I wish to hear of the method of following antiquity. Qibo said: To follow antiquity, one must first know the *Classic of Acupuncture*. To verify in the present, one must first know the cold and warmth of days, the waxing and waning of the moon, to monitor the floating and sinking of Qi, and regulate the body, observing immediate efficacy. "Observing the unseen" means that changes in Xing Qi (Form Qi), Ying Qi (Nutritive Qi), and Wei Qi do not manifest externally, yet the physician alone knows them.
"Observing the unseen" means that changes in Form Qi, Nutritive Qi, and Defensive Qi do not manifest externally, yet the physician alone knows them. By combining day temperature, moon phase, and seasonal Qi floating/sinking, verifying through mutual correlation, and regulating to constancy, one perceives beforehand. However, these changes do not manifest externally, hence "observing the unseen."
The Yellow Emperor said: I have heard of tonification and reduction but do not grasp their meaning. Qibo answered: Reduction must use "Fang" (Square/Upright). "Fang" means Qi is flourishing, the moon is full, the day is warm, the body is stable, and the needle is inserted during inhalation. Then, rotate the needle during inhalation, and slowly withdraw it during exhalation. This is why reduction uses "Fang," allowing Qi to move. Tonification must use "Yuan" (Round/Circular). "Yuan" means movement; movement means shifting. Puncture must hit the Ying (Spring) point, and withdraw the needle during exhalation. Insert during inhalation, preventing Qi rebellion. Retain quietly for a long time, preventing pathogen spread. Rotate during inhalation until De Qi (arrival of Qi) is achieved. Withdraw during exhalation, removing only after exhalation ends. Great Qi exits, hence named "Reduction."
Tonification requires long retention. Now, reduction mentions "quiet long retention" and tonifying first: if True Qi is insufficient, direct reduction leaves meridians empty, with nowhere for pathogens to drain. Thus, one must first tonify True Qi to sufficiency, then reduce pathogens. "Yin" means drawing out. "Qu" means leaving the acupoint. Withdrawing to the gate during exhalation, and leaving upon exhalation end, stabilizes Meridian Qi, leaving no room for pathogens, so great pathogenic Qi exits with the needle. "Hu" (Exhale) means Qi exiting. "Xi" (Inhale) means Qi entering. "Zhuan" (Rotate) means moving Great Qi. Great pathogenic Qi refers to pathogens disrupting Yin-Yang.
Chapter on Precious Life and Complete Form: Qibo said: The essence of all acupuncture is first to govern Shen (Spirit). Once the Five Zang organs are settled and the Nine Pulses prepared, one focuses on the needle. Though many pulses are unseen and many omens unheard, internal and external harmonize; not relying on form first, one plays with the coming and going of Qi before applying it to the person. People have deficiency and excess; approach the Five Deficiencies cautiously, stay close to the Five Excesses. At the moment of need, there is no time for a blink. Hand movements must be focused, needles bright and even. Calmly observe principles, watch for adaptive changes—this is "unseen," shapeless. Seeing like "Wu Wu" (sound of Qi arrival), seeing like "Ji Ji" (sound of response), like seeing birds fly, yet not knowing who drives them.
"Wu Wu" sighs at Qi arrival. "Ji Ji" marvels at the response, indicating success or failure of acupuncture, like seeing birds fly in the air, not knowing who commands them. It is merely seeing pulse meridian fullness/emptiness as signs, not knowing who summoned them.
"Lying still like a crossbow, rising like releasing the trigger."
When Qi and Blood have not yet responded to the needle, they lie still like a crossbow ready to fire. When they respond, they rise swiftly like the trigger release.
The Yellow Emperor asked: How is one deficient? How is one excess? Qibo said: To puncture deficiency, make it excess; to puncture excess, make it deficient. Once Meridian Qi arrives, guard it carefully and do not lose it. Depth depends on intent; near and far feel alike. Be like facing an abyss, hand like holding a tiger, undistracted by worldly things.
Chapter on Separating True and Pathogenic: Qibo said: When Heaven and Earth are mild, meridian waters are calm; when cold and frozen, meridian waters stagnate; when hot and dry, meridian waters boil over; when sudden storms rise, meridian waters surge and swell. When pathogens enter the vessels, cold causes blood stagnation, heat causes Qi lubrication. Deficient evils invade opportunistically, just as meridian water reacts to wind. The pulsation of arterial meridians swells intermittently, moving orderly within the vessels. At the Cun Kou pulse, it varies in size: large indicates pathogen arrival, small indicates peace. Pathogens move without fixed location, between Yin and Yang, beyond measure. Observe accordingly; through Three Regions and Nine Pulses, suddenly encountering them, block their path early. Question: How to monitor Qi? Answer: Pathogens move from collaterals to meridians, lodging in blood vessels. Their cold/heat has not yet matched the body, like waves rising, coming and going, thus not constant. Therefore, when they come, press to stop them, then puncture. Do not reduce against their rushing peak. "Chong" refers to the level Qi corresponding to water clock measurements. The *Ling Shu* says: At the first water drop, Qi is in Tai Yang; second drop, Shao Yang; third, Yang Ming; fourth, Yin division. When Qi is in Tai Yang, Tai Yang alone is strong; in Shao Yang, Shao Yang alone is strong. Seeing this solitary strength, if one assumes it is pathogen and reduces, they harm True Qi. Hence the following text.
True Qi is Meridian Qi. If Meridian Qi is too deficient, it is said "do not meet its arrival," which is what this means. Thus, if monitoring pathogens is unexamined, and Great Qi (pathogen) has passed, reducing it causes True Qi depletion. Depletion cannot recover; pathogens return, disease accumulates. Thus, "do not chase its departure." There is no room for a hair's breadth delay; wait for pathogen arrival to reduce. If acting before or after, Qi and Blood are exhausted, disease cannot be cured. Knowing the appropriate time is like a trigger; knowing the inappropriate time is like striking a mallet. Thus, those who know the Way of Opportunity do not miss a hair; those who do not strike without effect. This is what is meant.
The Yellow Emperor asked: How to tonify insufficiency? Qibo said: First, palpate and stroke, cut and disperse, push and press, flick to engorge, grasp and descend, clear and take. Draw outward the gate to close Shen. Insert at end of exhalation, retain quietly for a long time, aiming for Qi arrival. Wait as for a noble one, ignoring the passing of days. When Qi arrives, protect appropriately. Withdraw at inhalation, preventing Qi exit. Each stays in place. Push and close the gate, letting Shen Qi remain and Great Qi stay. Hence named "Tonification."
Withdrawing at inhalation prevents Great Qi leakage; the meaning of tonification is clear. "Push and close the gate" explains the previous three sentences. Great Qi refers to the Qi of major meridians, circulating Ying and Wei.
Chapter on Regulating Jing: Qibo said: To reduce excess, insert when Qi is strong. Needle and Qi enter together, opening the gate to facilitate exit. Needle and Qi exit together, Jing Essence is not harmed, pathogens descend. Keep the outer gate open to expel disease, widen the path to facilitate flow, this is "Great Reduction." Must cut pulse before withdrawing, so Great Qi yields. To tonify deficiency, hold the needle without placing it, settle the mind, insert at exhalation. Qi exits, needle enters; needle hole closes, Jing Essence cannot leave. Remove quickly when Qi is solid. Qi enters, needle exits; heat cannot return, gate closed, pathogens disperse, Jing Essence preserved. Move and monitor timing, keep nearby Qi, attract distant Qi, this is "Pursuing."
Chapter on Separating True and Pathogenic: The Yellow Emperor asked: How to tonify and reduce? Qibo answered: This attacks pathogens. Withdraw quickly to remove abundant blood, restoring True Qi. This pathogen is newly arrived, fluid and unsettled; pushing moves it forward, pulling stops it. Puncture against it, draw out blood, disease resolves immediately.
Removing blood requires assessing blood abundance and pathogen congestion; thus, puncturing removes blood and cures immediately.
Chapter on Explaining Needling: Qibo said: Tonifying deficiency makes it real; heat under the needle indicates Qi excess generating heat. Reducing fullness makes it empty; cold under the needle indicates Qi deficiency generating cold. Removing stasis and old blood means evacuating evil blood. Reducing pathogen excess means not pressing after withdrawal. Slow withdrawal and fast pressing tonifies. Fast withdrawal and slow press reduces. Reducing excess requires waiting for deficiency; retain needle until Yin Qi arrives fully, then remove. Tonifying deficiency requires waiting for reality; remove needle when Yang Qi arrives fully and needle feels hot. "Meridian Qi arrived, guard carefully" means do not change technique. "Depth in intent" means knowing interior/exterior disease. "Near and far alike" means equal monitoring of depth.
Chapter on Needling Talents: It says: Excess is Qi entering. Deficiency is Qi exiting. Qi excess is heat. Qi deficiency is cold.
Entering excess involves opening the needle hole with the right hand. Entering deficiency involves closing the needle hole with the left hand.
Right hand holds needle, left hand manipulates acupoint. Thus, excess: right hand opens hole to reduce. Deficiency: left hand closes hole to tonify.
Chapter on Three Regions and Nine Pulses: It says: Jing disease treats the Jing; Sun Luo disease treats Sun Luo blood.
If blood remains in the main vessel, puncture to remove it. *Ling Shu* says: Jing meridians are inner; branching horizontally are Luo; branches of Luo are Sun Luo. Thus, Sun Luo are the horizontal branches of Luo.
Blood disease with body pain treats Jing-Luo. If disease is in Qi Xie (Odd Evils), use Miao Ci (Mirror Needling).
Qi Xie refers to odd, unpaired Qi located in交错 (interlaced) places relative to Jing meridians, hence Miao Ci. Miao Ci involves puncturing Luo meridians, taking left for right, right for left.
For lingering emaciation that does not shift, puncture joints. For upper excess and lower deficiency, palpate and follow, seek knotted Luo vessels, puncture to bleed, observing clearance.
Chapter on General Evaluation of Deficiency and Excess: The Yellow Emperor said: In Spring, urgently treat Jing-Luo; in Summer, urgently treat Jing-Shu points; in Autumn, urgently treat Six Fu organs; in Winter, they are closed. Closed means using medicine and sparing needles/stones. "Sparing needles/stones" does not refer to abscesses/carbuncles, which cannot be delayed.
Chapter on Essential Classics and Termination of Meridians: It says: When puncturing chest and abdomen, avoid the Five Zang organs. Hitting the Heart causes death in a cycle, manifested as belching. Hitting the Liver causes death in five days, manifested as talking excessively. Hitting the Spleen causes death in ten days, manifested as swallowing. Hitting the Kidney causes death in two days, manifested as sneezing. Hitting the Lung causes death in three days, manifested as coughing. Hitting the Gallbladder causes death in one and a half days, manifested as vomiting. Hitting the Diaphragm causes internal injury; even if healed, death occurs within a year. Avoiding Zang organs shows knowledge of reversal and compliance. Compliance refers to the Diaphragm, Spleen, and Kidney areas; ignorance leads to reversal. When puncturing chest/abdomen, cover with cloth, puncture through single cloth. If not healed, re-puncture solemnly. For swelling, shake needle; for Jing puncture, do not shake. This is the way of needling.
Chapter on Needling Taboos: Qibo said: Organs have vital points, must be examined. Liver generates on the left, Lung stores on the right, Heart governs the surface, Kidney regulates the interior, Spleen is called the Envoy, Stomach is the Market. Above the Diaphragm and Huang, there are Parents (Heart and Lung, Yin and Yang). Beside the seventh vertebra, there is the Small Heart. Following brings fortune, opposing brings blame.
Puncturing the Da Mai on the foot (Dadu) with unceasing bleeding causes death. (Da Mai is the Great Meridian of Stomach.) Puncturing flowing vessels on the face may cause blindness. Puncturing Brain House on the head entering the brain causes immediate death. Over-puncturing sublingual vessels causing unceasing bleeding causes aphonia. Puncturing network vessels on the sole with no blood exit causes swelling. Puncturing the calf Da Mai causes collapse and pallor. Puncturing the Qi Chong vessel with no blood exit causes swelling like a rat. Puncturing the spine entering the marrow causes kyphosis. Puncturing above the breast causing root erosion/swelling. Puncturing the Que Pen acupoint causing internal collapse and Qi leakage leads to wheezing and cough. Puncturing the Yu Ji area causing internal collapse leads to swelling. Do not puncture the heavily drunk, causing Qi chaos. Do not puncture the greatly angry, causing Qi rebellion. Do not puncture the greatly fatigued, newly full, greatly hungry, greatly thirsty, or greatly startled.
*Ling Shu* says: Do not puncture after intercourse; if punctured, do not have intercourse. Do not puncture in great anger; if punctured, do not get angry. Do not puncture in great fatigue; if punctured, do not labor. Do not puncture when drunk; if punctured, do not drink. Do not puncture when overly full; if punctured, do not eat heavily. Do not puncture when hungry; if punctured, do not starve. Do not puncture when thirsty; if punctured, do not thirst. For great fear/fright, stabilize Qi before puncturing.
Puncturing the Da Mai in the thigh with unceasing bleeding causes death. Puncturing the Ci Zhu Ren acupoint causing internal collapse leads to internal leakage and deafness. Puncturing knee marrow causing fluid exit leads to limping. Puncturing the Great Yin vessel of the arm with excessive bleeding causes immediate death. Puncturing the Foot Sha Yin vessel with double deficiency and bleeding causes difficulty speaking. Puncturing the Ying area entering the lung causes wheezing and仰息 (breathing with head thrown back). Puncturing the elbow causing internal collapse where Qi gathers leads to inability to flex/extend.
Puncturing three cun below the thigh causing internal collapse leads to urinary incontinence. Puncturing under the armpit and between ribs causing internal collapse leads to coughing. Puncturing the lower abdomen entering the bladder causing urine exit leads to abdominal fullness. Puncturing the intestine causing internal collapse leads to swelling. Puncturing the eye socket entering bone vessels leads to leakage and blindness. Puncturing joint fluid causing exit leads to inability to flex/extend.
Chapter on Regulating Jing: The Yellow Emperor said: You mentioned ten types of deficiency/excess, arising from Five Zang and Five Pulses. All twelve Jing meridians generate disease, yet you speak only of Five Zang. The twelve Jing meridians connect to 365 joints; joint disease affects meridians, which have deficiency/excess. How do they combine? Qibo said: Five Zang naturally pair with Six Fu as interior-exterior. Meridians, branches, and joints each generate deficiency/excess. Treat according to the disease location. Disease in vessels, regulate Blood; in Blood, regulate Luo; in Qi, regulate Wei; in flesh, regulate Fen Rou (divided flesh); in sinews, regulate sinews; in bone, regulate bone. For burning needle劫刺 (robbing puncture) below and in acute cases; for bone disease, use Cui Zhen (fire needle) and herbal hot compress. For unknown pain with normal Nine Pulses, use Miao Ci. For left pain with right pulse disease, use Ju Ci (Giant Puncture). Carefully examine the Nine Pulses; the Way of Needling is complete.
Chapter on Separating True and Pathogenic: The Yellow Emperor asked: When True and Pathogenic merge, and waves do not rise, how to monitor? Qibo answered: Examine and palpate the fullness/emptiness of Three Regions and Nine Pulses to regulate. Observe discrepancies and reductions between left/right and upper/lower. Examine the diseased Zang to predict outcome. Not knowing the Three Regions means failing to distinguish Yin/Yang and Heaven/Earth. Earth monitors Earth, Heaven monitors Heaven, Human monitors Human. Regulate the Middle Fu to define the Three Regions. Thus, if one does not know the locations of Three Regions/Nine Pulses disease, even with excessive pathogens arriving, the physician cannot prevent/control it.
"Jin" means prohibit. But if one does not know where to monitor pathogens, how can they prohibit Qi monitoring? Even with excessive pathogens reaching the meridian, the physician cannot use needles to banish them.
Punishing the innocent is called great confusion. Reversing and confusing the Great Meridians, True Qi cannot recover. Treating excess as deficiency, pathogen as truth, using needles without principle, becoming a thief of Qi, stealing righteous Qi. Treating compliance as reversal, Ying/Wei scatter, True Qi lost, pathogen lingers internally. Cutting off long life, bringing premature disaster, due to not knowing Three Regions/Nine Pulses, hence cannot last long.
Three Regions refer to Upper, Middle, Lower in the human body, through which meridians pass. Thus, monitoring survival depends on this. Each Region has three pulses. Upper Heaven: temporal artery, Foot Shaolin Qi pathway. Upper Earth: cheek artery below nostrils, Foot Yangming Qi pathway. Upper Human: pre-auricular artery, Shaolin Qi pathway. Middle Heaven: radial artery at Cun Kou/Jing Qu. Middle Earth: Hegu artery, Yangming pathway. Middle Human: Shenmen artery, Shaolin pathway. Lower Heaven: Wuli point, 1.5 cun below Yang Shi, Foot Jueyin pathway; women use Taichong, 2 cun behind big toe base. Lower Earth: Taixi artery, Foot Shaoyin pathway. Lower Human: Yibao area, Jinmen point below Wuli, Foot Taiyin pathway. Lower巩足 (foot) requires deep pressure. To monitor Stomach Qi, take Chongyang artery on the foot. These are the Three Regions within the Two Parts.