内经曰。留瘦不移节。而刺之。十二经无遏绝。假令如见十二经中是何经络不通行。当
针不
通。以疑滞俱令气过节次。无问其病。以平如期。如诸经俱虚。补之。诸经俱实。泻之。补
当随而济之。泻当迎而夺之。又补母亦名随而济之。泻子亦名迎而夺之。又随呼吸出纳。亦
名迎随也。
两胁痛。少阳丘墟。腰痛。昆仑及委中出血。呕哕无度。手厥阴太陵。头痛。手足太阳
原穴
心痛。少阳太溪。涌泉足厥阴原穴。热无度。不可止。陷谷出血。喘满疾实。口中如胶。
足少阴太溪。百节疼痛。实无所知。三棱刺绝骨出血。血衄不止。大小便血。妇人血不止。
刺足太阴井。喉闭。手足少阳井。并少商。手足太阴井穴。太烦热不止。昼夜无度。刺十指
间出血。谓八关大刺。阴头中痛。不可忍。卒疝痛。妇人阴中痛。皆刺足厥阴井。骨热不可
治。前板齿干燥。当灸骨大椎山。小肠疝痛。足厥阴太冲。眼发睛欲出者。大刺八关。眼大
痛。刺手太阳井。眼小 痛。刺足太阳井。心痛。脉沉肾原穴。脉弦。肝原穴。脉涩。肺
原穴。脉浮。心原穴。脉缓。脾原穴。腰痛。身之前足阳明原穴。身之后。足太阳原穴。身
之侧。足少阳原穴。此针之撮要也。
凡着灸疗病。历春夏秋冬不效者。灸炷虽然数足。得疮发脓坏。所患即瘥。如不得疮发
脓坏
其疾不愈。甲乙经云。灸疮不发者。用故履底。灸令热熨之。三日即发。脓出自然愈疾。
今用赤皮葱三五茎。去其葱青于炉灰火中煨热。拍破。热熨灸疮十余遍。其疮三日自发立坏
脓出即愈。资生经王氏云。予见人灸不发者。频用生麻油渍之而发。亦有皂角煎汤候冷频
点之而发。亦有恐气血衰不发。于灸前后煎四物汤服。以此汤滋养血气故也。盖不可一概论
也。予尝灸三里各七壮。数日过不发。再各灸两壮。右足发。左足不发。更左足一壮遂发。
是亦在人以智取之。若任其自然。则终不发矣。此人事所以当尽也。
卫生宝鉴云。国信副使覃郎中。年四十九岁。病脐腹冷痛。完谷不化。足 寒而逆。皮
肤不
仁。精神困弱。诊其脉沉细而微。遂投其甘辛大热之剂。又灸气海穴百余壮。灸三里穴各三
七壮。又灸阳辅穴各二七壮。三日复以葱熨灸疮。皆不发复。灸前穴又十日后。疮亦不作脓
疮口皆干。初癸丑岁。学针于窦子声。因循穴 曰。凡用针者。气不至而不效。灸之亦不
发。大抵本气空虚。不能作脓。失其所养。故而更加。不损邪气。加之病必不起。异日因语
针灸科忽教授。亦以为然。戊辰春。副使除益都府判。到任未几时风疾半身麻木。自汗恶风
好喜笑。多妄言。语微涩。医以续命汤复发其汗。津液重竭。其证愈甚。因求医还家。日
久神气昏愦。体羸瘦。饮食无味。便溺遗失。扶而后起。屡易医药。皆不能效。因思内经有
云。阳气者。若天与日。失其所养则折寿而不彰。今因此病。而知子声之言矣。或曰。副使
肥甘足于口。轻暖足于体。使令足于前。所为无不如意。君言失其所养。何也。对曰。汝言
所养。养口体者也。予论所养。养性命者也。且覃氏壮年得志。不知所养之正。务快其心。
精神耗散。气血空虚。因此致疾。予因思灵枢经云。人年十岁。五脏始定。血气以通。其气
在下。故好走。二十岁。血气始盛。肌肉方长。故好趋。三十岁。五脏大定。肌肉坚。血脉
盛满。故好起。四十岁。五脏六腑。十二经脉皆大盛。以平定。腠理始疏。荣华颓落。发颇
斑白。平盛不摇。故好坐。五十岁。肝气始衰。肝叶始薄。胆汁始减。目始不明。六十岁。
心气始衰。善忧悲。血气懈惰。故好卧。七十岁。脾气虚。皮肤枯。八十岁。肺气衰。魄魂
离。故言善误。九十岁。肾气焦。脏枯。经脉空虚。百岁。五脏皆虚。神气皆去。形骸独居
而终矣。盖精神有限。嗜欲无穷。轻丧其命。一失难复。其覃氏之谓欤。
《黄帝内经》说：对于形体消瘦、病邪固结不移的患者，应当根据经络穴位进行针刺。这样十二经脉的气血就不会被阻断。假如发现十二经中某条经络气血不通畅，就应当对不通的经络进行针刺，使郁滞的气机得以疏通，经过各个穴位节段。不论是什么疾病，只要使气血恢复平衡，就能如期痊愈。如果各条经脉都虚弱，就用补法；如果各条经脉都实证，就用泻法。补法应当顺着经气运行的方向施针以资助正气（随而济之）；泻法应当迎着经气运行的方向施针以夺取邪气（迎而夺之）。另外，补其母经也叫“随而济之”，泻其子经也叫“迎而夺之”。此外，配合呼吸的进针出针，也称为“迎随”补泻法。
两胁疼痛，取足少阳胆经的原穴丘墟。腰痛，取昆仑穴及委中穴放血。呕吐呃逆不止，取手厥阴心包经的原穴太陵。头痛，取手足太阳经的原穴。心痛，取足少阳胆经和足少阴肾经的原穴太溪，以及涌泉穴（足厥阴肝经井穴）。发热不退，无法停止，取陷谷穴放血。气喘胸满且病势急实，口中黏腻如胶状，取足少阴肾经的原穴太溪。全身关节疼痛，神识昏蒙不知人事，用三棱针在绝骨穴放血。鼻出血不止，大小便出血，妇女崩漏不止，刺足太阴脾经的井穴。喉痹闭塞，刺手足少阳经的井穴，以及少商穴（手太阴肺经井穴）、手足太阴经的井穴。烦躁热盛不止，昼夜无度，刺十指间放血，这称为“八关大刺”。阴头中疼痛，难以忍受，突发疝痛，妇女阴中疼痛，都刺足厥阴肝经的井穴。骨蒸热不可治，前板齿干燥，应当灸督脉的大椎穴。小肠疝痛，取足厥阴肝经的原穴太冲。眼球突出欲脱者，重刺“八关”。眼睛剧烈疼痛，刺手太阳小肠经的井穴。眼睛轻微疼痛，刺足太阳膀胱经的井穴。心痛，若脉沉，取肾经原穴；若脉弦，取肝经原穴；若脉涩，取肺经原穴；若脉浮，取心经原穴；若脉缓，取脾经原穴。腰痛，身体前方取足阳明胃经原穴，身体后方取足太阳膀胱经原穴，身体侧面取足少阳胆经原穴。这是针刺的要诀。
凡是施用艾灸治病，经历春夏秋冬四季都不见效的，虽然艾炷的数量已经足够，但如果疮口不发脓溃烂，所患的疾病就不会痊愈。如果疮口不发脓溃烂，疾病就不能治愈。《甲乙经》说：灸疮不发的，用旧的鞋底，加热后熨烫患处，三天后就会发脓，自然痊愈。现在使用赤皮葱三五根，去掉葱青部分，在炉灰火中煨热，拍破，趁热熨烫灸疮十余遍，疮口三天内自然会发脓溃烂而痊愈。《资生经》王氏说：我见人灸疮不发的，频繁用生麻油浸泡患处从而使其发脓。也有用皂角煎汤冷却后频繁点涂使其发脓的。也有人担心气血衰弱导致不发，在灸前后服用四物汤，以此汤滋养气血的缘故。大概不能一概而论。我曾经灸双侧足三里穴各七壮，几天后仍不发，又各加灸两壮，右足发了，左足没发，再给左足加灸一壮才发。这也是靠人的智慧去争取的，如果听任其自然，那就始终不会发了。这就是人事应当尽力之处。
《卫生宝鉴》记载：国信副使覃郎中，四十九岁，患脐腹冷痛，完谷不化（大便中有未消化的食物），脚冷且逆冷，皮肤麻木不仁，精神困倦虚弱。诊察他的脉象沉细而微弱，于是投用甘辛大热的药剂。又灸气海穴百余壮，灸足三里穴各三七二十一壮，又灸阳辅穴各二七十四壮。三天后用葱熨烫灸疮，但疮仍未发。再次灸前面的穴位，又过了十天，疮也不作脓，疮口皆干枯。起初在癸丑年，向窦子声学习针灸，窦子声指出穴位时说：凡是用针，气不至则无效，灸也不发。大体上是本气空虚，不能化脓，失去了其所养的根本，所以更加亏损，不仅不能损伤邪气，反而加重病情，病必定不能起死回生。后来有一天，与针灸科的忽教授交谈，他也认为是对的。戊辰年春天，副使升任益都府判，到任不久，患风疾导致半身麻木，自汗恶风，喜欢笑，多胡言乱语，言语轻微涩滞。医生用续命汤再次发汗，津液再次枯竭，症状更加严重。于是请求回家就医，日久神气昏愦，身体羸瘦，饮食无味，大小便失禁，扶才能起身。多次更换医药，都不能见效。于是想起《内经》中说：阳气，就像天空中的太阳，失去它所养护的作用，就会折损寿命而不显赫。如今因为这场病，才明白窦子声的话了。有人说：副使口中肥甘充足，身上轻暖充足，手下仆役充足，所做无不如意，您说失去所养，为什么呢？回答说：你所说的养，是养口腹和身体的；我所论述的养，是养性命精神的。况且覃氏在壮年得志，不知道保养的正道，只追求快意于心，导致精神耗散，气血空虚，因此致病。我又想到《灵枢经》说：人十岁时，五脏始定，血气通畅，气在下部，所以喜欢跑。二十岁时，血气始盛，肌肉方长，所以喜欢快走。三十岁时，五脏大定，肌肉坚实，血脉盛满，所以喜欢站立行走。四十岁时，五脏六腑、十二经脉都盛大且平稳安定，腠理开始疏松，荣华颓落，头发开始斑白，平盛不再动摇，所以喜欢坐。五十岁时，肝气始衰，肝叶始薄，胆汁始减，眼睛开始不明。六十岁时，心气始衰，容易忧悲，血气懈惰，所以喜欢卧。七十岁时，脾气虚，皮肤枯。八十岁时，肺气衰，魄魂离，所以说话常出错。九十岁时，肾气焦枯，脏腑枯槁，经脉空虚。百岁，五脏皆虚，神气皆去，只剩形骸独居而终。大概精神有限，嗜欲无穷，轻视丧命，一旦失去难以恢复。说的就是像覃氏这样的人吧。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: For patients who are emaciated and where the pathogenic factor is fixed and unyielding, one should puncture according to the meridians and acupoints. In this way, the qi and blood of the twelve meridians will not be obstructed. If it is observed that the qi and blood in a specific meridian of the twelve meridians are not flowing smoothly, one should puncture the blocked meridian to clear the stagnation and allow the qi to pass through the acupoint segments. Regardless of the disease, as long as the qi and blood are balanced, recovery can be expected on schedule. If all meridians are deficient, apply the tonifying method; if all meridians are excess, apply the reducing method. The tonifying method should follow the direction of the meridian qi flow to assist the healthy qi (*Sui Er Ji Zhi*, "Following to Assist"). The reducing method should oppose the direction of the meridian qi flow to drain the pathogenic qi (*Ying Er Duo Zhi*, "Meeting to Deprive"). Furthermore, tonifying the Mother meridian is also called "Following to Assist," and reducing the Child meridian is also called "Meeting to Deprive." Additionally, coordinating needle insertion and withdrawal with respiration is also referred to as *Ying Sui* (Meeting and Following) manipulation.
For pain in both hypochondria, select Qiuxu (GB40), the Yuan-Source point of the Foot-Shaoyang Gallbladder Meridian. For lower back pain, select Kunlun (BL60) and Weizhong (BL40) for bloodletting. For incessant vomiting and hiccups, select Taichong (PC7), the Yuan-Source point of the Hand-Jueyin Pericardium Meridian. For headache, select the Yuan-Source points of the Hand-Taiyang Small Intestine and Foot-Taiyang Bladder Meridians. For heart pain, select Taixi (KI3), the Yuan-Source point of the Foot-Shaoyang Gallbladder Meridian [Note: Text likely implies Kidney or other, but strictly translating text], Yongquan (KI1), the Jing-Well point of the Foot-Jueyin Liver Meridian. For unremitting fever that cannot be stopped, select Xangu (ST43) for bloodletting. For wheezing, chest fullness, and acute excess conditions with a sticky sensation in the mouth like glue, select Taixi (KI3), the Yuan-Source point of the Foot-Shaoyin Kidney Meridian. For pain in all joints and unconsciousness/disorientation, use a three-edged needle to bleed at Jiegu (GB39). For persistent epistaxis, hematochezia, hematuria, or metrorrhagia in women, puncture the Jing-Well point of the Foot-Taiyin Spleen Meridian. For throat obstruction (Bi), puncture the Jing-Well points of the Hand-Shaoyang Sanjiao and Foot-Shaoyang Gallbladder Meridians, along with Shaoshang (LU11, Jing-Well of Hand-Taiyin Lung) and the Jing-Well points of the Hand-Taiyin Lung and Foot-Taiyin Spleen Meridians. For incessant irritability and heat, day and night without limit, bleed between the ten fingers, known as the "Eight Passages Great Puncture" (Ba Guan Da Ci). For unbearable pain in the glans penis, sudden hernia pain, or pain in the female genitalia, all puncture the Jing-Well point of the Foot-Jueyin Liver Meridian. For incurable bone-steaming heat and dryness of the anterior teeth, moxa should be applied to Dazhui (GV14) on the Governor Vessel. For small intestine hernia pain, select Taichong (LR3), the Yuan-Source point of the Foot-Jueyin Liver Meridian. For eyes protruding as if about to fall out, perform the heavy "Eight Passages Great Puncture." For severe eye pain, puncture the Jing-Well point of the Hand-Taiyang Small Intestine Meridian. For mild eye pain, puncture the Jing-Well point of the Foot-Taiyang Bladder Meridian. For heart pain: if the pulse is deep, select the Kidney Yuan-Source point; if wiry, the Liver Yuan-Source point; if choppy, the Lung Yuan-Source point; if floating, the Heart Yuan-Source point; if slow, the Spleen Yuan-Source point. For lower back pain: anterior body selects the Foot-Yangming Stomach Yuan-Source point; posterior body selects the Foot-Taiyang Bladder Yuan-Source point; lateral body selects the Foot-Shaoyang Gallbladder Yuan-Source point. This is the essence of acupuncture.
Whenever moxibustion is used to treat illness and yields no effect throughout the four seasons, even if the number of moxa cones is sufficient, if the sore does not suppurate and ulcerate, the disease will not heal. If the sore does not suppurate and ulcerate, the disease cannot be cured. The *Jia Yi Jing* (Classical Book of Acupuncture and Moxibustion) states: For moxa sores that do not develop, use an old shoe sole, heat it, and apply it as a hot compress to the area. After three days, suppuration will occur, and the disease will naturally heal. Currently, use three to five stalks of red-skin scallions, remove the green tops, warm them in stove ashes, crush them, and apply as a hot compress to the moxa sore for more than ten times. The sore will spontaneously suppurate within three days, and healing will follow. Wang Shi in the *Zisheng Jing* (Aid to Life) says: I have seen cases where moxa sores did not develop; frequently soaking the area in raw sesame oil caused them to develop. Others used decoctions of Gleditsia sinensis (Zao Jiao) cooled down and frequently applied to cause development. Some, fearing deficiency of qi and blood prevented development, administered Siwu Tang (Four Substance Decoction) before and after moxibustion to nourish qi and blood. Generally, one cannot generalize. I once moxified bilateral Zusanli (ST36) with seven cones each. Several days later, they still had not developed. I added two cones to each. The right foot developed, but the left did not. I added one cone to the left foot, and then it developed. This relies on human wisdom to achieve results. If left to nature, it would never develop. This is where human effort must be exerted.
The *Weisheng Baojian* (Precious Mirror of Health) records: Qin Langzhong, Vice Commissioner of State Trust, aged forty-nine, suffered from cold pain in the umbilical and abdominal region, undigested food in stool, cold and inverted limbs, insensibility of the skin, and mental fatigue and weakness. His pulse was deep, fine, and faint. He was prescribed sweet, pungent, and greatly heating herbs. One hundred-plus cones were applied to Qihai (CV6), twenty-one cones to each Zusanli (ST36), and fourteen cones to each Yangfu (GB38). Three days later, scallion compresses were applied to the moxa sores, but they still did not develop. The previous points were moxicated again. Ten days later, no pus formed, and the sore mouths were dry. Initially, in the Guichou year, I studied acupuncture with Dou Zisheng. Dou pointed out the acupoints and said: When using needles, if qi does not arrive, there is no effect; moxibustion also fails to develop. Generally, this is due to emptiness of the root qi, inability to form pus, loss of its nourishment, leading to further depletion. It does not damage the pathogen; instead, the condition worsens, and the disease will certainly not recover. Later, speaking with Professor Hu of the Acupuncture Department, he agreed. In the spring of the Wuchen year, the Vice Commissioner was appointed Judge of Yidu Prefecture. Shortly after taking office, he contracted wind-disease causing half-body numbness, spontaneous sweating, aversion to wind, excessive laughter, delirious speech, and slight slurring. Physicians used Xuming Tang (Continuing Life Decoction) to induce sweating again, depleting body fluids further, and the symptoms worsened. He requested to return home for medical care. Over time, his spirit became confused, his body emaciated, he lost appetite, and suffered urinary and fecal incontinence, requiring support to stand. Many medicines were tried without effect. He then recalled the *Neijing*: "Yang qi is like the sun in the sky. If it loses its proper nourishment, lifespan is shortened and brilliance is obscured." Now, because of this illness, I understand Dou Zisheng's words. Someone asked: "The Vice Commissioner has abundant rich foods, comfortable clothing, and ample servants. Everything goes as he wishes. You say he lacks nourishment, why?" I replied: "You speak of nourishing the mouth and body. I speak of nourishing life and spirit. Moreover, Qin achieved success in his prime but did not know the correct way to nourish himself, seeking only mental gratification. This led to dissipation of spirit and emptiness of qi and blood, causing this disease." I also recalled the *Lingshu* (Spiritual Pivot): "At age ten, the five zang organs begin to stabilize, qi and blood flow freely, and qi is located below, so one likes to run. At twenty, qi and blood become vigorous, muscles grow, so one likes to walk briskly. At thirty, the five zang organs are fully set, muscles are firm, and blood vessels are full, so one likes to stand and walk. At forty, the five zang organs, six fu organs, and twelve meridians are in peak condition and stable, pores begin to loosen, luster declines, hair turns gray, stability is reached, so one likes to sit. At fifty, Liver qi begins to decline, the liver lobes thin, bile decreases, and vision dims. At sixty, Heart qi begins to decline, sorrow and grief increase, qi and blood become sluggish, so one likes to lie down. At seventy, Spleen qi is deficient, skin becomes dry. At eighty, Lung qi declines, Po and Hun separate, so speech is often erroneous. At ninety, Kidney qi is exhausted, organs wither, meridians are empty. At one hundred, all five zang organs are deficient, spirit and qi depart, leaving only the physical form until death." Spirit is limited, while desires are infinite. Neglecting life leads to loss, which is hard to restore. This describes someone like Qin.