拯救之法妙用者针
夫今人愈疾岂离于医治劫病之功莫妙于针刺故经云拘于鬼神不可与言至德恶于针石者不可与
言至巧正此之谓也
察岁时于天道
夫人身十二经三百六十节以应一岁十二月三百六十日岁时者春暖夏热秋凉冬寒此四时之正气
苟或春应暖而反寒夏应热而反凉秋应凉而反热冬应寒而反暖是故冬伤于寒春必温病春伤于风
夏必飧泄夏伤于暑秋必 疟秋伤于湿上逆而咳岐伯曰凡刺之法必候日月星辰四时入正之气气
定乃刺焉是故天温日明则人血淖液而卫气浮故血易泻气易行天寒日阴则人血凝滞而卫气沉月
始生则气血始精卫气始行月廓满则气血实肌肉生月廓空则肌肉减经络虚卫气去形独居是以因
天时而调血气也天寒无刺天温无凝月生无泻月满无补月廓空无治是谓得天时而调之若日月生
而泻是谓脏虚月满而补血气扬溢络有留血名曰虚实月廓空而治是谓乱经阴阳相错真邪不别沉
以留止外虚内乱淫邪乃起又曰天有五运金水木火土也地有六气风寒暑湿燥是也学人必察
斯焉
定形气于予心
经云凡用针者必先度其形之肥瘦以调其气之虚实实则泻之虚则补之必先去其血脉而后调之无
问其病平调理期细察形气得于心矣形盛脉细少气不足以息者危形瘦脉大胸中多气者死形气相
得者生不调者病相失者死是故色脉不顺而莫针戒之戒之
春夏瘦而刺浅秋冬肥而刺深
经云病有沉浮刺有浅深各至其理无过其道过之则内伤不及则外壅壅则邪从之浅深不得反为大
贼内伤五脏后生大病故曰春病在毫毛腠理夏病在皮肤故春夏之人阳气轻浮肌肉瘦薄四气未
盛宜刺之浅秋病在肌肉脉冬病在筋骨秋冬则阳气收藏肌肉肥浓血气充满刺之宜深又云春刺十
二井夏刺十二荣季夏刺十二俞秋刺十二经冬刺十二络合以配木火土金水理见子午流注
不穷经络阴阳须逢刺禁
经有十二手太阴肺少阴心厥阴心包络太阳小肠少阳三焦阳明大肠足太阴脾少阴肾厥阴肝大肠
膀胱少阳胆阳明胃也络有十五肺络列缺心络通里心包络内关小肠络支正三焦络外关大肠络偏
历脾络公孙肾络大钟肝络蠡沟膀胱络飞扬胆络光明胃络丰隆阴跷络照海阳跷络
申脉脾之大
络大包督脉络长强任脉络屏翳也阴阳者天之阴阳平旦至日中天之阳阳中之阳也日中至黄昏天
之阳阳中之阴也合夜至鸡鸣天之阴阴中之阴也鸡鸣至平旦天之阴阴中之阳也故人亦应之夫言
人之阴阳则外为阳内为阴言身之阴阳则背为阳腹为阴手足皆以赤白肉分之言脏腑之阴阳则五
脏为阴六腑为阳是以春夏之病在阳秋冬之病在阴皆视其所在典施针石也又言背为阳阳中之阳
心也阳中之阴肺也腹为阴阴中之阴肾也阴中之阳肝也阴中之至阴脾也此皆阴阳表里内外雌雄
相输应也是以应天之阴阳学人苟不明此经络阴阳升降左右不同之理如病在阳明反攻厥阴病在
太阳反和太阴遂致贼邪未除本气受弊则有劳无功禁刺之犯岂可勉哉
既论脏腑虚实须向经寻
脏者心肝脾肺肾也腑者胆胃大小肠三焦膀胱也虚者痒麻也实者肿痛也脏腑居于内经络行乎外
虚则补其母实则泻其子如心病虚则补肝木实则泻脾土又且本经亦有子母如心之虚取少海穴以
补之实则取少府穴以泻之诸经皆然并不离乎五行相生之理矣
原夫起自中焦水初下以太阴为始至厥阴而方终穴出云门抵期门而最后
此言乎人气象气脉行于十二经一周为身除任督之外计三百九十三穴一日一夜有百刻分于十二
时每一时有八刻二分每一刻计六十分一时共计五百分每日寅时太阴肺脉生自中焦中府穴出于
云门起至少商穴至卯时阳明大肠经自商阳穴至迎香穴辰时阳明胃经自头维至厉兑巳时太阴脾
经自隐白至大包午时少阴心经自极泉至少冲未时太阳小肠经自少泽至听宫申时太阳膀胱经自
睛明至至阴酉时少阴肾经自涌泉至俞府戌时心包络经自天池至中冲亥时少阳三焦经自关冲至
禾子时少阳胆经自童子 至窍阴丑时厥阴肝经自大敦至期门而终
经十二别络走三百余支
十二经者即手足三阴三阳之正经也别络者除十五络又有横络丝络孙络不知其纪HT 走于三百
余支之脉也
正侧偃伏气四有六百余候
此言经络或正或侧或仰或覆而气血循行孔一周于身荣行脉中三百余候卫行脉外三百余候
手足三阳手走头而头走足手足三阴足走腹而胸走手
此言经络阴升阳降气血出入之机男女无以异矣
要识迎随须明逆顺
迎随者要知荣卫之流注经脉之往来也明其阴阳之经逆顺而取之迎者以针头朝其源而逆之随者
以针头从其流而顺之是故逆之为泻为迎顺之为补为随若能知迎知随令气必和和气之方必通阴
阳升降上下源流往来逆顺之道明矣
况夫阴阳气血多少为最厥阴太阳少气多血太阴少阴少血多气而又气多血少者少阳之分气盛血
多者阳明之位此言三阴三阳气血多少之不同取之必记为最要也
先详多少之宜次察应至之气
言用针者先明止文气血之多少次观针气之来应也
轻滑慢而未来沉涩紧而已至
轻浮滑虚慢迟也入针之后直此三者乃真气之未到也沉重涩滞紧实入针之后直此三者是正气之
已到也
既至也量寒热而留疾
留住也疾速也此言正气既至必审寒热而施之故经云刺热须至寒者必留针阴气隆至乃呼之去徐
其穴不扪刺也须至热者阳气隆至针气必热乃吸之去疾一穴急扪
未至也据虚实而 气
此言针气之未来也经云虚则推内进搓以补其气实则循扪弹怒以引其气
气之至如鱼吞钓饵之浮沉气未至如闲处幽堂之深也
邃气既至则针自涩紧似鱼吞钓或沉或浮而动其气不来针自轻滑如闲居静室之中寂然无所闻也
气至速而效速气迟至而不治
言下针若得气来速则病则痊而效亦速也气若来迟则病难愈而有不治之忧故赋云气速效速气迟
效迟候之不至必死无疑矣
观夫九针之法毫针最微七星可应众穴主持
昔黄帝制九针者上应天地下应阴阳四时九针之名各不同形一曰 针以应天长一寸六分头尖末
锐去泻阳气二曰圆针以应地长一寸六分针如卯样形揩磨分肉间不得伤肌肉以泻分气三曰 针
以应人长三寸半锋如黍粟之锐主脉勿陷以致其气四曰锋针以应四时长一寸六分刃三隅以发痼
疾五曰铍针以应五音长四寸广二分半末如剑锋以取大脓六曰员利针以应六律长一寸六分大如
厘且员且锐中身微大以取暴气七曰毫针以应七星长三寸六分尖如蚊虻喙静以徐往微以久留之
而痒以取痛痹八曰长针以应八风长七寸锋利身薄可以取远痹九曰大针以应九野长四寸其锋微
员尖如挺以泻机关之水九针毕矣此言九针之妙毫针最精能应七星又为三百六十穴之备也
本形金也有蠲邪扶正之道
本形言针也针本出于金古人以砭石今人以铁代之蠲除也邪气盛针能除之扶辅也正气衰针能辅
短长水也有决疑开滞之机
此言针有长短犹水之长短也人之气血凝滞而不通犹水之凝滞而不通也水之不通决之使流于湖海气
血不通针之使周于经络故言针应水也
定刺象木或斜或正
此言木有斜正而用针亦有或斜或正之不同刺阳经者必斜卧其针无中其卫刺阴分者必正立其针
毋伤其荣故言针应未也
口藏此火进阳补羸
口藏以针含于口也气之温如火之温也羸瘦也凡欲下针之时必效方真人口温针暖使荣卫相接
进己之阳气补彼之瘦弱故言针应火也
循机扪而可塞以象土
循者用手上下循之使气血往来也机扪者针毕以手扪闲其穴如用上填塞之义故言针应土也
实应五行而可知
五行者金木水土也此结上文针能应五行之理可知矣
然是一寸六分包含妙理
言针虽但长一寸六分能巧运神机之妙中含水火回倒阴阳其理最玄妙也
或细HT 于毫发何贯多岐
HT 针之干也岐气血往来之路也言针之干虽如毫发之微小能贯通诸经血气之道也
可平五脏之寒热能调六腑之虚实
平治也调理也言针能调治脏腑之疾有寒则温之有热则清之虚则补之实则泻之
拘挛闭塞遣八邪而去矣
拘挛者筋脉之拘速也闭塞者气血不通也八邪者所以候八风之虚邪也言疾有挛闭者必驱散八风
之邪也
寒热痛痹开四关而已之
寒者身作颤而发寒也热者身作潮而发热也痛疼痛也痹麻木也四关者五脏有六腑六腑有十二原
十二原出于四关太冲合谷是也
凡刺者使本神朝而后入既刺也使本神定而气随神不朝而勿刺神已之而可施
凡用针者必使患人精神已朝而后方可入针既刺之必使疾者精神才定而后施针行气若气不朝、
其针必轻滑、不知疼痛如插豆腐者莫与进之必死、之候如神、气既至针自紧涩可与根据法察虚
实而施之
定脚处取气血为主意
言欲下针之时必取阴阳气血多少为主见上文
下手处认水木是根基
济母裨其不足夺子平其有余此言用针必先认子母相结之义举水木而不及土金火者省文也
天地人三才也涌泉同璇玑百会
百会一穴在头以应乎天璇玑一穴在胸以应乎人涌泉二穴在足掌心以应乎地是谓三才也
上中下三部也大包与天枢地机
大包二穴在乳后为上部天枢二穴在脐旁为中部地机二穴在足 为下部是谓三部也
阳跷阳维并督脉主肩背腰腿在表之病
阳跷脉起于足跟中循外踝上入风池阳维脉维持诸阳之会如腑会太仓之类督脉起自下极之 并
与春里上行风府过脑额鼻入龈交穴也言此奇经三脉属阳主治肩背腰腿在表之疾也
阴跷阴维任冲带去心腹胁肋在里之疑
阴跷脉亦起于足跟循内踝上行至咽喉交贯冲脉阴维脉维持诸阴之交如足太阴之脉交出厥阴之
前任脉起于中极之下循腹上至咽喉而终冲脉起于气冲并足阳明之经夹脐上行至胸中而散也带
脉起于季脉回身一周如系带也言此奇经五脉属阴能治心腹胁肋在里之疾也
二陵二跷二交似续而交五大也
二陵者阴陵泉阳陵泉也二跷者阴跷阳跷也二交者阴交阳交也续接续也五大者五体也言此六穴
递相交接于两手两足并头也
两间两商两井相根据而列两支
两间者二间三间也两商者少商商阳也两井者天井肩井也言此六穴相根据而分别于手之两支也
另见取穴之法有分寸先审自意次观肉分
此言取量穴法必以男左女右中指与大指相屈如环取内侧纹两角为一寸各随长短大小取之此乃
同身之寸先审病者是何病属何经用何穴于我意次察病者瘦肥长短大小肉分骨节发际之间量度
以取之
或伸屈而得之或平直而安定
伸屈者如取环跳之穴必须伸下足屈上足以取之乃得其穴平直者或平卧而取之或正坐而取之或
直立而取之自然安定如承浆在唇下宛宛中之类也
在阳部筋骨之侧陷下为真在阴分 之间动脉相应
阳部者诸阳之经也如合谷三里阳陵泉等穴必取侠骨侧指陷中为真也阴分者诸阴之经也如萁门
五里太冲等穴在屈心之间必以动脉应指乃始为真穴也
取五穴用一穴而必端取三经用一经而可正
此言取穴之法必须点取五穴之中而用一穴则可为端的矣若用一经必虽取三穴而正一经之是非
矣
头部与肩部详分督脉与任脉异定(异当作易)
头部与肩部则穴繁多但医者以自意详审大小肥瘦而分之督任二脉值乎背腹行中而有分寸则易
定也
明标与本论刺深浅之经
标本者非止一端也有六经之标本有天地阴阳之标本有传病之标本夫六经之标本者足太阳之本
在足跟上五寸标在目也足少阳之本在窍阴标在耳也足阳明之本在厉兑标在人迎颊挟项颡也足
太阴之本在中封前上四寸标在背脾俞与舌本也足少阴之本在内踝上三寸中标在背肾俞与舌下
两脉也足厥阴之本在行间上五寸中所标在背肝俞也手太阳之本在手外踝后标在命门之上一寸
也手少阳之本在小指次指之间上一寸标在耳后上角下外 也手阳明之本在肘骨中上别阳标在
额下合钳上也手太阴之本在寸口之中标在腋内动脉也手少阴之本在锐骨之端标在背心俞也手
厥阴之本在掌后两筋之间二寸中标在筋下三寸也此乃十二经之行取也
经云病有标本刺有逆从浅深之理凡刺之方必别阴阳前后相应逆从得施标本相移故曰有其在标
而求之于标有其在本而求之于本有其在本而求之于标有其在标而求之于本故治有取标而得者
有取本而得者有逆取而得者有从取而得者故知逆从正行无问明知标本者万举万当不知标本者
从谓妄行夫阴阳标本逆从之道也小而言大一而知百病之害少而多浅而博可以言一而知百也以
浅而知深察近而知远标本易言而世人识见无能及也治反为逆治得为从先病而后逆者先逆而后
病者先病而后生寒者先热而后生病此五者俱治其本也先热而后中满者治其标先病而后泄者治
其本先泄而后生他病者治其本必且调之乃治其他病先病而后中满者治其标先中满而后烦心者
治其本大小便不利治其标大小便利治其本大小不利而病生病者治其本病发而有余本而标之先
治其本后治其标病发而不足标而本之先治其标后治其本又云得病日为本传病为标也浅深者刺
阳经必中荣须浅而卧针无伤于卫也刺阴分必中卫须深而立针无损于荣也此谓阴阳标本浅深之
道也
住痛移疼取相交相贯之迳
拯救疾病的高妙方法在于针刺。
如今人们治愈疾病,难道能离开医治劫除病邪的功效吗?没有比针刺更精妙的了。所以《内经》说:“拘泥于鬼神迷信的人,不可以与他谈论至高的医德;厌恶针石治疗的人,不可以与他谈论高明的医术。”正是这个意思。
人的身体有十二经脉、三百六十个关节,对应着一年的十二月和三百六十天。“岁时”指的是春天温暖、夏天炎热、秋天凉爽、冬天寒冷,这是四季的正常气候。如果春天本该温暖却反而寒冷,夏天本该炎热却反而凉爽,秋天本该凉爽却反而炎热,冬天本该寒冷却反而温暖,那么就会发生“冬季感受寒邪,春季必然发生温病;春季感受风邪,夏季必然发生完谷不化的泄泻;夏季感受暑邪,秋季必然发生疟疾;秋季感受湿邪,湿气上逆导致咳嗽”的情况。岐伯说:“凡是针刺的方法,必须等待日月星辰运行及四时正常的正气到来,气机安定之后才能施针。”因此,天气温暖、阳光明媚时,人的血液流动滑润,卫气浮越于表,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,卫气沉伏于里。月亮初生时,气血开始精纯,卫气开始运行;月亮圆满时,气血充实,肌肉丰满;月亮亏空时,肌肉消瘦,经络空虚,卫气离去,形体独自存在。所以要依据天时来调节血气。天气寒冷不要针刺,天气温暖不要使气血凝滞(指避免过度发汗导致阳气外泄),月亮初生时不要用泻法,月亮圆满时不要用补法,月亮亏空时不要进行治疗。这叫做顺应天时来调治。如果在月亮初生时用泻法,这叫使内脏虚弱;在月亮圆满时用补法,会使气血扬溢,络脉中有留血,这就叫虚实错乱;在月亮亏空时进行治疗,这叫扰乱经脉,阴阳交错,真邪不分,邪气沉潜停留,外表虚弱内部混乱,淫邪之气于是产生。又说:天有五行运化(金、水、木、火、土),地有六气(风、寒、暑、湿、燥)。学习针灸的人必须考察这些道理。
在心中确定患者的形气状态。
《内经》说:“凡是使用针刺的人,必须先衡量患者体型的肥瘦,以调节其气的虚实。实证用泻法,虚证用补法。必须先去除血脉中的瘀滞,然后调理气机。不论病情如何,都要进行调理,仔细审察形气,心中要有数。”如果形体壮盛但脉象细弱,气息短少不足以呼吸的,属于危证;形体消瘦但脉象洪大,胸中气盛的,属于死证;形与气相得的,预后良好;形气不相得的,预后不良。所以面色与脉象不相顺应的,禁止针刺,要警惕啊,警惕啊!
春夏季节体型瘦者刺宜浅,秋冬季节体型肥者刺宜深。
《内经》说:“疾病有深浅之分,针刺也有浅深之别,各达到其应有的层次,不要超过其道。超过了就会内伤脏腑,达不到就会外邪壅滞,壅滞则邪气随之深入。浅深不当,反而成为大害,内伤五脏,日后生出大病。”所以说,春季病在毫毛腠理,夏季病在皮肤,所以春夏之人阳气轻浮,肌肉瘦薄,四气未盛,适宜浅刺;秋季病在肌肉,冬季病在筋骨,秋冬则阳气收藏,肌肉肥厚,血气充满,适宜深刺。又说:春刺十二井穴,夏刺十二荥穴,长夏刺十二输穴,秋刺十二经穴,冬刺十二络穴,配合配属木、火、土、金、水,道理见于子午流注学说。
不能穷尽经络阴阳的变化,必须避开刺禁。
经文记载的十二经脉是:手太阴肺经、手少阴心经、手厥阴心包络经、手太阳小肠经、手少阳三焦经、手阳明大肠经;足太阴脾经、足少阴肾经、足厥阴肝经、足太阳膀胱经、足少阳胆经、足阳明胃经。络脉有十五别络:肺经络穴列缺,心经络穴通里,心包络经络穴内关,小肠经络穴支正,三焦经络穴外关,大肠经络穴偏历,脾经络穴公孙,肾经络穴大钟,肝经络穴蠡沟,膀胱经络穴飞扬,胆经络穴光明,胃经络穴丰隆,阴跷脉络穴照海,阳跷脉络穴申脉,脾之大络穴大包,督脉络穴长强,任脉络穴屏翳(即鸠尾)。
阴阳是天之阴阳。从平旦到日中,是天的阳,阳中之阳;从日中到黄昏,是天的阳,阳中之阴;从合夜到鸡鸣,是天的阴,阴中之阴;从鸡鸣到平旦,是天的阴,阴中之阳。人也顺应这一规律。如果说人的阴阳,则外为阳,内为阴;说身体的阴阳,则背为阳,腹为阴;手足都以赤白肉分界来说阴阳;说脏腑的阴阳,则五脏为阴,六腑为阳。所以春夏的病多在阳分,秋冬的病多在阴分,都要视其所在部位而施以针石。又说到背部为阳,阳中之阳是心,阳中之阴是肺;腹部为阴,阴中之阴是肾,阴中之阳是肝,阴中之至阴是脾。这些都是阴阳表里内外雌雄相互对应的关系。所以要顺应天之阴阳。学习的人如果不明白经络阴阳升降左右不同的道理,比如病在阳明经却反向厥阴经施治,病在太阳经却反向太阴经施治,就会导致贼邪未除,本气受损,劳而无功。触犯刺禁,怎么可以勉强呢?
既然论述了脏腑的虚实,就必须向经脉中寻找答案。
脏包括心、肝、脾、肺、肾;腑包括胆、胃、大肠、小肠、三焦、膀胱。虚证表现为痒、麻;实证表现为肿、痛。脏腑居于体内,经络行于体外。虚证则补其母,实证则泻其子。例如心病虚证则补肝木,实证则泻脾土。而且本经也有子母关系,如心之虚证取少海穴来补它,实证取少府穴来泻它。其他各经都是如此,都不离乎五行相生之理。
追溯起源,始于中焦,水液初下,以太阴经为起始,到厥阴经才结束。穴位出自云门,终于期门。
这是讲人体气象,气脉行于十二经脉,一周循环全身。除去任督二脉,共计三百九十三穴。一日一夜有一百刻,分配于十二个时辰,每一时有八刻二分,每一刻计六十分,一时共计五百分。每日寅时,太阴肺脉生起,自中焦始,从中府穴出于云门,起至少商穴;卯时,阳明大肠经自商阳穴至迎香穴;辰时,阳明胃经自头维至厉兑;巳时,太阴脾经自隐白至大包;午时,少阴心经自极泉至少冲;未时,太阳小肠经自少泽至听宫;申时,太阳膀胱经自睛明至至阴;酉时,少阴肾经自涌泉至俞府;戌时,心包络经自天池至中冲;亥时,少阳三焦经自关冲至禾髎;子时,少阳胆经自瞳子髎至窍阴;丑时,厥阴肝经自大敦为期门而终。
十二正经之外还有别络,行走三百余条分支。
十二经就是手三阴、手三阳、足三阴、足三阳的正经。别络除了十五别络之外,还有横络、丝络、孙络等,数量不知有多少,行走于三百余条分支的脉道中。
正、侧、仰、伏四种姿势,气血运行有六百多个候点。
这是讲经络或正或侧或仰或覆,气血循行周身。营气行于脉中,有三百余候;卫气行于脉外,有三百余候。
手足三阳经,手走向头,头走向足;手足三阴经,足走向腹,胸走向手。
这是讲经络阴升阳降、气血出入的机理,男女没有不同。
迎随,要知道营卫的流注和经脉的往来。明确其阴阳经脉的逆顺而取之。“迎”是指针头朝向源头而逆着经气方向进针;“随”是指针头顺着流向而顺着经气方向进针。所以逆着为泻,称为迎;顺着为补,称为随。如果能知道迎随,令气必调和,和气的方法必定通畅。阴阳升降、上下源流往来的逆顺之道就明白了。
况且阴阳气血的多少最为重要。厥阴经少气多血,太阳经少气多血;太阴经少血多气,少阴经少血多气;又有气多血少的,属于少阳之分;气盛血多的,属于阳明之位。这是说三阴三阳气血多少的不同,取穴时必须牢记,这是最重要的。
先详细辨别气血多少的适宜性,其次观察应时的气候。
这是说用针的人先明了文中所述气血的多少,其次观察针气的来应。
感觉轻、滑、慢而真气未来;感觉沉、涩、紧而真气已至。
轻、浮、滑、虚、慢、迟,入针后出现这三种情况,是真气未到;沉重、涩滞、紧实,入针后出现这三种情况,是正气已到。
“留”指留针,“疾”指快速。这是说正气既至,必须审察寒热而施治。所以《内经》说:“刺热病须待寒感至,必留针,直到阴气隆至,才呼出针去,慢慢拔针,不扪闭针孔;刺寒病须待热感至,阳气隆至,针下必热,才吸入针去,快速出针,急扪闭针孔。”
真气未至,要根据虚实来引导气机。
这是说针气未来。《内经》说:“虚证则推内、进搓以补其气;实证则循、扪、弹、怒以引其气。”
气至的感觉像鱼吞钩饵一样忽沉忽浮;气未至的感觉如同闲处在幽深堂屋之中。
真气既至,则针自感涩紧,像鱼吞钩饵,或沉或浮而动其气;气不来,针自感轻滑,如同闲居静室之中,寂然无所闻。
气至得快则疗效快,气至得慢则难治。
这是说下针若得气来速,则病痊愈且疗效也快;气若来迟,则病难愈而有不治之忧。所以赋中说:“气速效速,气迟效迟。”候气不至,必死无疑。
从前黄帝制作九针,上应天地,下应阴阳四时。九针之名各不相同,形状也不同。一曰镵针,以应天,长一寸六分,头尖末锐,用于泻阳气;二曰圆针,以应地,长一寸六分,针如卵样形状,揩磨分肉间,不得伤肌肉,以泻分气;三曰鍉针,以应人,长三寸半,锋如黍粟之锐,主按脉勿陷,以致其气;四曰锋针,以应四时,长一寸六分,刃有三隅,以发痼疾;五曰铍针,以应五音,长四寸,广二分半,末如剑锋,以取大脓;六曰员利针,以应六律,长一寸六分,大如厘,且圆且锐,中身微大,以取暴气;七曰毫针,以应七星,长三寸六分,尖如蚊虻喙,静以徐往,微以久留之,而痒以取痛痹;八曰长针,以应八风,长七寸,锋利身薄,可以取远痹;九曰大针,以应九野,长四寸,其锋微圆,尖如挺,以泻机关之水。九针毕矣。这是说九针的奥妙,毫针最精,能应七星,又是三百六十穴的备用针具。
“本形”指针。针原本出自金(金属),古人用砭石,今人以铁代之。“蠲”即除去。邪气盛,针能除之;“扶辅”即辅助。正气衰,针能辅之。
长短如水,有决疑开滞的机制。
这是说针有长短,犹如水有长短。人之气血凝滞而不通,犹如水之凝滞而不通。水之不通,决之使流于湖海;气血不通,针之使周于经络。故言针应水。
定刺象木,或斜或正。
这是说木有斜正,而用针亦有或斜或正之不同。刺阳经者必斜卧其针,无中其卫;刺阴分者必正立其针,毋伤其荣。故言针应木。
口含此火,进阳补羸。
“口含”指将针含于口中。气之温如火之温也。“羸”指瘦弱。凡欲下针之时,必效仿方真人温针暖,使营卫相接,进己之阳气,补彼之瘦弱。故言针应火。
循机扪而可塞,以象土。
“循”指用手上下循按,使气血往来;“机扪”指针毕以手扪闭其穴,如用上填塞之义。故言针应土。
实则应五行而可知。
五行者金、木、水、火、土也。这是总结上文,针能应五行之理,可知矣。
然而是一寸六分,包含妙理。
这是说针虽只长一寸六分,能巧运神机之妙,中含水火,回倒阴阳,其理最玄妙也。
或细如毫发,何贯多岐。
“锟”指针之干,“岐”指气血往来之路。言针之干虽如毫发之微小,能贯通诸经血气之道也。
“平”即治,“调”即调理。言针能调治脏腑之疾,有寒则温之,有热则清之,虚则补之,实则泻之。
“拘挛”者筋脉之拘急也;“闭塞”者气血不通也;“八邪”者所以候八风之虚邪也。言疾有挛闭者,必驱散八风之邪也。
“寒”者身作颤而发寒也;“热”者身作潮而发热也;“痛”疼痛也;“痹”麻木也。“四关”者,五脏有六腑,六腑有十二原,十二原出于四关,太冲、合谷是也。
凡刺者,使本神朝而后入;既刺也,使本神定而气随。神不朝而勿刺,神已之而可施。
凡用针者,必使患人精神已朝(集中)而后方可入针。既刺之,必使疾者精神才定而后施针行气。若气不朝,其针必轻滑,不知疼痛,如插豆腐者,莫与进之,必死之候。如神气既至,针自紧涩,可与根据法察虚实而施之。
定脚处,取气血为主意。
下手处,认水木是根基。
济母裨其不足,夺子平其有余。此言用针必先认子母相结之义。举水木而不及土金火者,省文也。
百会一穴在头,以应乎天;璇玑一穴在胸,以应乎人;涌泉二穴在足掌心,以应乎地。是谓三才也。
大包二穴在乳后,为上部;天枢二穴在脐旁,为中部;地机二穴在足,为下部。是谓三部也。
阳跷、阳维并督脉,主肩背腰腿在表之病。
阳跷脉起于足跟中,循外踝上入风池;阳维脉维持诸阳之会,如腑会太仓之类;督脉起自下极之腧,并与脊里上行,风府过脑额鼻入龈交穴也。言此奇经三脉属阳,主治肩背腰腿在表之疾也。
阴跷、阴维、任、冲、带,去心腹胁肋在里之疑。
阴跷脉亦起于足跟,循内踝上行至咽喉,交贯冲脉;阴维脉维持诸阴之交,如足太阴之脉交出厥阴之...;任脉起于中极之下,循腹上至咽喉而终;冲脉起于气冲,并足阳明之经,夹脐上行至胸中而散也;带脉起于季胁,回身一周,如系带也。言此奇经五脉属阴,能治心腹胁肋在里之疾也。
二陵、二跷、二交,似续而交五大也。
二陵者,阴陵泉、阳陵泉也;二跷者,阴跷、阳跷也;二交者,阴交、阳交也。“续”接续也。“五大”者五体也。言此六穴递相交接于两手两足并头也。
两间、两商、两井,相根据而列两支。
两间者,二间、三间也;两商者,少商、商阳也;两井者,天井、肩井也。言此六穴相根据而分别于手之两支也。
另见取穴之法,有分寸。先审自意,次观肉分。
此言取量穴法,必以男左女右,中指与大指相屈如环,取内侧纹两角为一寸,各随长短大小取之。此乃同身之寸。先审病者是何病,属何经,用何穴,于我意;次察病者瘦肥长短大小,肉分骨节发际之间,量度以取之。
或伸屈而得之,或平直而安定。
伸屈者,如取环跳之穴,必须伸下足,屈上足以取之,乃得其穴。平直者,或平卧而取之,或正坐而取之,或直立而取之,自然安定,如承浆在唇下宛宛中之类也。
在阳部筋骨之侧,陷下为真;在阴分动脉之间,相应为真。
阳部者,诸阳之经也,如合谷、三里、阳陵泉等穴,必取侠骨侧指陷中为真也。阴分者,诸阴之经也,如箕门、五里、太冲等穴,在屈膝之间,必以动脉应指乃始为真穴也。
取五穴用一穴而必端,取三经用一经而可正。
此言取穴之法,必须点取五穴之中而用一穴,则可为端的矣。若用一经,必虽取三穴而正一经之是非矣。
头部与肩部,详分督脉与任脉异(异当作易)。
头部与肩部则穴繁多,但医者以自意详审大小肥瘦而分之。督任二脉值乎背腹行中,而有分寸,则易定也。
明标与本,论刺深浅之经。
标本者非止一端也。有六经之标本,有天地阴阳之标本,有传病之标本。夫六经之标本者:足太阳之本在足跟上五寸,标在目也;足少阳之本在窍阴,标在耳也;足阳明之本在厉兑,标在人迎颊挟项颡也;足太阴之本在中封前上四寸,标在背脾俞与舌本也;足少阴之本在内踝上三寸中,标在背肾俞与舌下两脉也;足厥阴之本在行间上五寸中所,标在背肝俞也;手太阳之本在手外踝后,标在命门之一寸也;手少阳之本在小指次指之间上一寸,标在耳后上角下外眦也;手阳明之本在肘骨中上别阳,标在额下合钳上也;手太阴之本在寸口之中,标在腋内动脉也;手少阴之本在锐骨之端,标在背心俞也;手厥阴之本在掌后两筋之间二寸中,标在筋下三寸也。此乃十二经之行取也。
经云:“病有标本,刺有逆从,浅深之理。”凡刺之方,必别阴阳,前后相应,逆从得施,标本相移。故曰:有其在标而求之于标,有其在本而求之于本,有其在本而求之于标,有其在标而求之于本。故治有取标而得者,有取本而得者,有逆取而得者,有从取而得者。故知逆从正行,无问明知,标本者万举万当,不知标本者,从谓妄行。夫阴阳标本逆从之道也,小而言大,一而知百病之害,少而多,浅而博,可以言一而知百也,以浅而知深,察近而知远。标本易言,而世人识见无能及也。治反为逆,治得为从。先病而后逆者,先逆而后病者,先病而后生寒者,先热而后生病,此五者俱治其本也。先热而后中满者,治其标;先病而后泄者,治其本;先泄而后生他病者,治其本,必且调之,乃治其他病;先病而后中满者,治其标;先中满而后烦心者,治其本;大小便不利,治其标;大小便利,治其本;大小不利而病生者,治其本;病发而有余,本而标之,先治其本,后治其标;病发而不足,标而本之,先治其标,后治其本。又云:得病日为本,传病为标也。浅深者,刺阳经必中营,须浅而卧针,无伤于卫也;刺阴分必中卫,须深而立针,无损于营也。此谓阴阳标本浅深之道也。
住痛移疼,取相交相贯之径。
The exquisite method for rescuing [patients from] disease lies in acupuncture.
How can people today cure diseases without relying on the efficacy of medical treatment to劫 (rescue/overcome) illness? Nothing is more exquisite than needle therapy. Thus, the *Classic* states: "One who is bound by ghosts and spirits cannot be spoken to regarding the highest virtue; one who dislikes needles and stones cannot be spoken to regarding supreme skill." This is precisely what is meant.
Observe the seasons and years in accordance with the Heavenly Dao.
The human body has twelve meridians and three hundred and sixty joints, corresponding to the twelve months and three hundred and sixty days of a year. "Seasons and years" refer to the normal qi of the four seasons: warmth in spring, heat in summer, coolness in autumn, and cold in winter. If spring should be warm but turns cold, summer should be hot but turns cool, autumn should be cool but turns hot, and winter should be cold but turns warm, then one will encounter situations such as: "Winter injury by cold leads to warm diseases in spring; spring injury by wind leads to undigested diarrhea in summer; summer injury by summer-heat leads to malaria in autumn; autumn injury by dampness leads to upward reversal and coughing." Qibo said: "In all methods of needling, one must wait for the moon, sun, stars, and the normal qi of the four seasons to arrive. Only when the qi is settled should one needle." Therefore, when the weather is warm and the sun is bright, human blood flows smoothly, and Wei Qi (Defensive Qi) floats on the surface; thus, blood is easily drained, and qi moves easily. When the weather is cold and the sky is overcast, human blood becomes stagnant, and Wei Qi sinks. When the moon begins to wax, blood and qi begin to refine, and Wei Qi begins to circulate. When the moon is full, blood and qi are substantial, and muscles grow. When the moon wanes, muscles diminish, meridians become empty, Wei Qi departs, and the form stands alone. Hence, one must regulate blood and qi according to the heavenly timing. Do not needle when it is cold; do not allow stagnation when it is warm; do not use draining methods when the moon is waxing; do not use tonifying methods when the moon is full; do not treat when the moon is waning. This is called regulating according to heavenly timing. If one drains when the moon is waxing, this causes visceral deficiency. If one tonifies when the moon is full, qi overflows, and collateral vessels retain blood, named as disorder of excess and deficiency. If one treats when the moon is waning, this disrupts the meridians, confuses yin and yang, fails to distinguish true pathogenic factors from false ones, allowing evil to sink and remain, causing external weakness and internal chaos, so that licentious pathogens arise. It is also said: Heaven has Five Movements (Metal, Water, Wood, Fire, Earth); Earth has Six Qi (Wind, Cold, Summer-heat, Dampness, Dryness). Students must observe these principles.
Determine the patient's form and qi within your mind.
The *Classic* states: "In all cases of using needles, one must first measure the fatness or thinness of the form to regulate the emptiness or fullness of qi. Fullness requires draining; emptiness requires tonifying. One must first remove blood stasis before regulating qi. Regardless of whether the disease is stable, regulation is required. Carefully observe form and qi; they must be understood in the heart." If the form is robust but the pulse is fine, and there is shortness of breath insufficient for respiration, this is critical. If the form is emaciated but the pulse is large, and there is excessive qi in the chest, this is fatal. If form and qi are harmonious, life prevails; if they are discordant, death ensues. Therefore, if the complexion and pulse are incompatible, avoid needling. Beware, beware!
In spring and summer, for thin individuals, needle shallowly; in autumn and winter, for fat individuals, needle deeply.
The *Classic* states: "Diseases have depth and superficiality; needling has shallowness and profundity. Each must reach its proper level without exceeding the pathway. Exceeding it causes internal injury; falling short causes external obstruction. Obstruction allows pathogens to enter. Improper depth becomes a great thief, injuring the five zang internally and giving rise to major diseases later." Thus, it is said: Spring diseases are in the hair follicles and interstices; summer diseases are in the skin. Therefore, in spring and summer, people's Yang qi is light and floating, muscles are thin, and the four qi are not yet abundant; shallow needling is appropriate. Autumn diseases are in the muscles; winter diseases are in the sinews and bones. In autumn and winter, Yang qi is stored, muscles are thick, and blood and qi are abundant; deep needling is appropriate. It is also said: Spring needling targets the Twelve Jing-Well points; Summer, the Twelve Ying-Spring points; Late Summer, the Twelve Shu-Stream points; Autumn, the Twelve Jing-River points; Winter, the Twelve Luo-Connecting points. These correspond to Wood, Fire, Earth, Metal, and Water, following the principles of the Zi Wu Liu Zhu (Midnight-Noon Ebb-Flow) theory.
Meridians and Yin-Yang cannot be exhausted; one must encounter and respect contraindications.
The Classics record the Twelve Meridians: Hand Taiyin Lung, Hand Shaoyin Heart, Hand Jueyin Pericardium, Hand Taiyang Small Intestine, Hand Shaoyang Sanjiao, Hand Yangming Large Intestine; Foot Taiyin Spleen, Foot Shaoyin Kidney, Foot Jueyin Liver, Foot Taiyang Bladder, Foot Shaoyang Gallbladder, Foot Yangming Stomach. There are Fifteen Collateral Vessels: Lung collateral Lieque, Heart tongli, Pericardium Neiguan, Small Intestine Zhizheng, Sanjiao Waiguan, Large Intestine Pianli, Spleen Gongson, Kidney Dazhong, Liver Ligou, Bladder Feiyang, Gallbladder Guangming, Stomach Fenglong, Yin Qiao Zhaohai, Yang Qiao Shenmai, Great Collateral of Spleen Dabao, Du Mai Changqiang, Ren Mai Pingyi.
Yin and Yang are the Yin and Yang of Heaven. From dawn to noon is Heaven's Yang, Yang within Yang; from noon to dusk is Heaven's Yang, Yin within Yang; from nightfall to rooster crow is Heaven's Yin, Yin within Yin; from rooster crow to dawn is Heaven's Yin, Yang within Yin. Humans correspond to this. Speaking of human Yin and Yang, exterior is Yang, interior is Yin; speaking of body Yin and Yang, back is Yang, abdomen is Yin; hands and feet are divided by red and white flesh boundaries; speaking of Zang-Fu Yin and Yang, Five Zang are Yin, Six Fu are Yang. Therefore, spring and summer diseases are mostly in Yang, autumn and winter diseases are mostly in Yin. One must view their locations and apply needles and stones accordingly. Furthermore, the back is Yang: Yang within Yang is Heart, Yang within Yin is Lung; the abdomen is Yin: Yin within Yin is Kidney, Yin within Yang is Liver, Ultimate Yin within Yin is Spleen. These are all mutual correspondences of Yin-Yang, interior-exterior, male-female. Thus, one must correspond to Heavenly Yin-Yang. If students do not understand the principles of meridian Yin-Yang ascending-descending and left-right differences, such as treating Yangming by attacking Jueyin, or Taiyang by harmonizing Taiyin, the pathogenic factor will not be removed, and the original qi will suffer, resulting in labor without merit. Violating contraindications, how can one proceed rashly?
Having discussed the emptiness and fullness of Zang and Fu, one must seek answers in the meridians.
Zang includes Heart, Liver, Spleen, Lung, Kidney; Fu includes Gallbladder, Stomach, Large Intestine, Small Intestine, Sanjiao, Bladder. Emptiness manifests as itching and numbness; fullness manifests as swelling and pain. Zang reside inside, meridians travel outside. Emptiness requires tonifying the Mother; fullness requires draining the Child. For example, Heart emptiness tonifies Liver Wood; Heart fullness drains Spleen Earth. Moreover, the same meridian has Mother-Child relationships: Heart emptiness tonifies Shaohai point; Heart fullness drains Shaofu point. All meridians follow this, adhering to the principle of Mutual Generation of the Five Elements.
Tracing the origin, it starts at the Middle Jiao, where water descends initially, beginning with the Taiyin meridian and ending with the Jueyin meridian. Points emerge from Yunmen and end at Qimen.
This describes human Qi and Pulse traveling through the Twelve Meridians, completing one cycle around the body. Excluding Ren and Du, there are three hundred and ninety-three points. In one day and night, there are one hundred Ke (time units), distributed among the Twelve Shi (two-hour periods). Each Shi has eight Ke and two Fen; each Ke has sixty Fen, totaling five hundred Fen per Shi. At Yin hour, Taiyin Lung meridian arises from the Middle Jiao, emerging from Zhongfu at Yunmen, starting at Shaoshang. At Mao hour, Yangming Large Intestine meridian goes from Shangyang to Yingxiang. At Chen hour, Yangming Stomach meridian goes from Touwei to Lidui. At Si hour, Taiyin Spleen meridian goes from Yinbai to Dabao. At Wu hour, Shaoyin Heart meridian goes from Jiquan to Shaochong. At Wei hour, Taiyang Small Intestine meridian goes from Shaoze to Tinggong. At Shen hour, Taiyang Bladder meridian goes from Jingming to Zhiyin. At You hour, Shaoyin Kidney meridian goes from Yongquan to Shufu. At Xu hour, Pericardium meridian goes from Tianchi to Zhongchong. At Hai hour, Shaoyang Sanjiao meridian goes from Guanchong to Heliao. At Zi hour, Shaoyang Gallbladder meridian goes from Tongziliao to Qiaoyin. at Chou hour, Jueyin Liver meridian goes from Dadun to Qimen, concluding the cycle.
The Twelve Regular Meridians have Extraordinary Collaterals, traveling through over three hundred branches.
The Twelve Meridians are the regular meridians of the Three Yin and Three Yang of the Hands and Feet. The Collaterals, besides the Fifteen Major Collaterals, include Hengluo, Siluo, and Sunluo, whose numbers are incalculable, traveling through the pulses of over three hundred branches.
Upright, side-lying, supine, and prone positions involve over six hundred acupoints for Qi circulation.
This refers to meridians being upright, oblique, supine, or prone, with Qi and Blood circulating around the body. Ying Qi travels within the vessels (over three hundred points); Wei Qi travels outside the vessels (over three hundred points).
Hand and Foot Three Yang meridians: Hands go to the Head, Head goes to the Feet. Hand and Foot Three Yin meridians: Feet go to the Abdomen, Chest goes to the Hands.
This describes the mechanism of Yin ascending, Yang descending, and Qi-Blood entering and exiting, which is no different for men and women.
To recognize Ying and Suai techniques, one must understand Reversal and Following.
Ying and Suai require knowing the flow of Ying and Wei and the coming and going of meridians. Clarify the Yin-Yang meridians' reversal and following to select them. "Ying" means the needle head faces the source against the flow (Reversal); "Sui" means the needle head follows the flow (Following). Thus, Reversal is Draining (Ying); Following is Tonifying (Sui). If one knows Ying and Sui, Qi will harmonize, and the method of harmonizing Qi will be unobstructed. The principles of Yin-Yang ascending-descending, upper-lower source-flow, and coming-going reversal/following will be clear.
Moreover, the abundance and scarcity of Yin-Yang Qi and Blood are most important. Jueyin and Taiyang have little Qi and much Blood; Taiyin and Shaoyin have little Blood and much Qi; Shaoyang has much Qi and little Blood; Yangming has abundant Qi and abundant Blood. This discusses the differences in Qi and Blood abundance among the Three Yin and Three Yang. One must remember this when selecting points; it is crucial.
First, detail the suitability of abundance and scarcity; second, observe the seasonal Qi.
This means the practitioner must first understand the abundance and scarcity of Qi and Blood mentioned above, and secondly observe the arrival of the needle Qi.
Light, slippery, slow, and delayed indicate Qi has not arrived; heavy, choppy, tight, and firm indicate Qi has arrived.
Light, floating, slippery, empty, slow, and delayed—after inserting the needle, these three conditions indicate True Qi has not arrived. Heavy, choppy, stagnant, tight, and firm—after inserting the needle, these three conditions indicate Righteous Qi has arrived.
Once Qi arrives, gauge Cold and Heat to determine retention time.
"Retention" means keeping the needle; "Rapid" means quick withdrawal. This states that once Righteous Qi arrives, one must examine Cold and Heat to apply treatment. Thus, the *Classic* says: "For Heat, wait for Cold sensation; retain the needle until Yin Qi is abundant, then exhale and withdraw slowly without pressing the hole. For Cold, wait for Heat sensation; when Yang Qi is abundant and the needle feels hot, inhale and withdraw quickly, pressing the hole immediately."
If Qi has not arrived, guide it based on Emptiness and Fullness.
This refers to the non-arrival of Needle Qi. The *Classic* says: "For Emptiness, push inward and advance/rub to tonify Qi; for Fullness, stroke, press, flick, and tense to draw out Qi."
The sensation of Qi arriving is like a fish swallowing bait, rising and sinking; the sensation of Qi not arriving is like sitting quietly in a deep, secluded hall.
Once Qi arrives, the needle feels tight and choppy, like a fish on a hook, moving up and down, stirring the Qi. If Qi does not arrive, the needle feels light and slippery, like sitting in a quiet room, silent and hearing nothing.
Fast Qi arrival brings fast results; slow Qi arrival brings difficult-to-treat outcomes.
This means if Qi arrives quickly after insertion, the disease cures quickly and effects are rapid. If Qi arrives slowly, the disease is hard to heal, with risks of untreatability. Thus, the Ode states: "Fast Qi, fast effect; slow Qi, slow effect." If Qi does not arrive after waiting, death is certain.
Observing the Nine Needles, the Filiform Needle is the finest, corresponding to the Seven Stars for various points, governing treatment.
In ancient times, the Yellow Emperor created the Nine Needles, corresponding to Heaven and Earth, Yin-Yang, and Four Seasons. Their names and shapes differ. 1. Chan Needle (Lancet): Corresponds to Heaven, 1.6 cun long, sharp tip, for draining Yang Qi. 2. Yuan Needle (Round): Corresponds to Earth, 1.6 cun long, egg-shaped, rubbed between muscles without damaging them, to drain muscle Qi. 3. Di Needle (Probe): Corresponds to Man, 3.5 cun long, blunt tip like millet, presses meridians without penetrating to gather Qi. 4. Feng Needle (Three-edged): Corresponds to Four Seasons, 1.6 cun long, three edges, for chronic diseases. 5. Pi Needle (Broadsword): Corresponds to Five Tones, 4 cun long, 0.25 cun wide, sword-like tip, for draining large abscesses. 6. Yuanli Needle (Sharp/Round): Corresponds to Six Laws, 1.6 cun long, slightly thicker in the middle, sharp and round, for acute conditions. 7. Hao Needle (Filiform): Corresponds to Seven Stars, 3.6 cun long, mosquito-bite-like tip, gentle insertion, prolonged retention, for pain and bi-syndrome. 8. Chang Needle (Long): Corresponds to Eight Winds, 7 cun long, sharp and thin, for distant bi-syndrome. 9. Da Needle (Large): Corresponds to Nine Fields, 4 cun long, slightly rounded tip, for draining joint fluid. These are the Nine Needles. The filiform needle is the most refined, corresponding to the Seven Stars, suitable for the three hundred and sixty points.
Its form is Metal, possessing the way to dispel Evil and support Righteousness.
"Form" refers to the needle. Needles were originally made of metal (or stone in antiquity). "Juan" means to eliminate. When Evil Qi is strong, the needle eliminates it; "Fu" means to assist. When Righteous Qi is weak, the needle assists it.
Lengths vary like Water, having the mechanism to resolve doubts and open stagnation.
This compares needle lengths to water levels. Human Qi and Blood stagnation is like blocked water. Blocked water is diverted to lakes and seas; blocked Qi and Blood are circulated through meridians by needles. Thus, the needle corresponds to Water.
Needling posture resembles Wood, either oblique or upright.
Wood grows obliquely or uprightly; needling varies similarly. For Yang meridians, insert obliquely to avoid Wei Qi; for Yin divisions, insert uprightly to avoid Ying Qi. Thus, the needle corresponds to Wood.
Holding the needle in the mouth adds Yang and tonifies emaciation.
"Holding in mouth" warms the needle. "Lei" means emaciation. Before inserting, warm the needle in the mouth to connect Ying and Wei, advancing one's own Yang Qi to tonify the patient's weakness. Thus, the needle corresponds to Fire.
Stroking and closing the aperture resembles Earth.
"Stroking" guides Qi and Blood with hand movements; "Closing" presses the acupoint after needling to seal it. Thus, the needle corresponds to Earth.
Fullness corresponds to the Five Elements and can be known.
The Five Elements are Metal, Wood, Water, Fire, Earth. This concludes that the needle's correspondence to the Five Elements is evident.
Yet, an inch and six fen contains profound principles.
Although the needle is only 1.6 cun long, it skillfully manipulates divine mechanisms, containing Water and Fire, reversing Yin and Yang, with profound principles.
Though fine as a hair, it penetrates many branches.
"The shaft" is fine as a hair, yet it penetrates the pathways of Qi and Blood in numerous meridians.
It can balance Cold and Heat of the Five Zang and regulate Emptiness and Fullness of the Six Fu.
"Balance" means to treat; "Regulate" means to adjust. The needle treats Zang-Fu disorders: warming Cold, clearing Heat, tonifying Emptiness, draining Fullness.
For spasms and blockages, expel the Eight Evils.
"Spasms" are tendon contractions; "Blockages" are Qi-Blood stagnation; "Eight Evils" refer to the Eight Wind pathogens. For spasms and blockages, one must disperse the Eight Wind evils.
For Cold, Heat, Pain, and Bi, open the Four Gates to stop them.
"Cold" is trembling chills; "Heat" is tidal fever; "Pain" is painful obstruction; "Bi" is numbness. "Four Gates" refer to the Twelve Source Points originating from the Four Gates: Taichong and Hegu.
In all needling, ensure the Spirit gathers before insertion; after insertion, ensure the Spirit settles and Qi follows. If the Spirit does not gather, do not needle. If the Spirit settles, proceed.
When needling, ensure the patient's Spirit is focused before insertion. After insertion, ensure the patient's Spirit stabilizes before manipulating Qi. If the Spirit is not gathered, the needle will feel light and slippery, painless like inserting into tofu; do not proceed, as this indicates impending death. If Qi arrives, the needle feels tight; proceed with methods to examine Emptiness/Fullness.
At the fixed point, prioritize Qi and Blood.
When preparing to needle, prioritize the abundance/scarcity of Yin-Yang Qi and Blood (see above).
At the starting point, recognize Water and Wood as the foundation.
Tonify the Mother to supplement deficiency; drain the Child to balance excess. This emphasizes the Mother-Child relationship. Mentioning Water and Wood implies omitting Earth, Metal, and Fire for brevity.
Heaven, Earth, and Man: Yongquan, Xuanji, and Baihui.
Baihui (Head) corresponds to Heaven; Xuanji (Chest) corresponds to Man; Yongquan (Foot sole) corresponds to Earth. This is the Three Realms.
Upper, Middle, Lower Parts: Dabao, Tianshu, and Diji.
Dabao (Under breast) is Upper; Tianshu (Beside navel) is Middle; Diji (Leg) is Lower. This is the Three Parts.
Yang Qiao, Yang Wei, and Du Mai govern shoulder, back, waist, leg exterior diseases.
Yang Qiao starts at heel, ascends outer ankle to Fengchi; Yang Wei maintains Yang convergence (e.g., Stomach meeting point); Du Mai starts at lower extremity, ascends spine, passes brain, enters nose to Yinjiao. These three extraordinary meridians are Yang, treating exterior shoulder/back/waist/leg diseases.
Yin Qiao, Yin Wei, Ren, Chong, and Dai Mai address interior heart, abdomen, flank, rib diseases.
Yin Qiao starts at heel, ascends inner ankle to throat, intersects Chong; Yin Wei maintains Yin convergence (e.g., Spleen intersecting Liver); Ren Mai starts below Zhongji, ascends abdomen to throat; Chong Mai starts at Qichong, runs alongside Stomach meridian up chest; Dai Mai starts at hypochondrium, encircles body like a belt. These five extraordinary meridians are Yin, treating interior heart/abdomen/flank diseases.
Er Ling, Er Qiao, Er Jiao: Successively connecting the Five Bodies.
Er Ling: Yinlingquan, Yanglingquan; Er Qiao: Yin Qiao, Yang Qiao; Er Jiao: Yin Jiao, Yang Jiao. "Connect" means succession. "Five Bodies" refers to physical structures. These six points connect sequentially in hands, feet, and head.
Liang Jian, Liang Shang, Liang Jing: Arranged along two arm branches.
Liang Jian: Erjian, Sanjian; Liang Shang: Shaoshang, Shangyang; Liang Jing: Tianjing, Jianjing. These six points are arranged along the two arm branches.
Regarding point location methods, there are measurements. First judge mentally, then observe flesh distribution.
To measure points, use the "Same-Body Cun": flex thumb and middle finger to form a ring; the distance between the creases is one Cun. Adjust for size. First identify the disease and meridian; then measure the patient's thinness/thickness, bone structure, and hairline to locate points accurately.
Some points are found by extending/flexing; others by lying straight or sitting upright.
Extending/Flexing: e.g., Huantiao requires extending the lower leg and flexing the upper. Straight/Upright: Lying flat, sitting upright, or standing naturally, e.g., Chengjiang under the lip.
In Yang regions, beside sinews/bone depressions are true points; in Yin regions, corresponding arterial pulses indicate true points.
Yang regions (e.g., Hegu, Zusanli, Yanglingquan): Locate in the depression beside the bone. Yin regions (e.g., Qimen, Wuli, Taichong): Locate where the arterial pulse responds to touch.
Selecting one point from five ensures accuracy; selecting one meridian from three corrects the diagnosis.
Choosing one precise point from five candidates ensures accuracy. Selecting one meridian among three helps verify the diagnosis.
Head and Shoulder: Differentiate Du and Ren meridians easily.
Head and shoulder points are numerous. By assessing size and fatness, and noting Du (Back/Midline) and Ren (Front/Midline) paths, location is easy.
Clarify Root and Branch, discuss depth of needling.
Root and Branch have multiple meanings: Six Meridians, Heaven/Earth Yin/Yang, Disease progression.
Six Meridians Roots/Branches:
Taiyang: Root at heel, Branch at eye.
Shaoyang: Root at Qiaoyin, Branch at ear.
Yangming: Root at Lidui, Branch at Renying/Jaw.
Taiyin: Root at Zhongfeng, Branch at Back Shu/Tongue base.
Shaoyin: Root at Inner Ankle, Branch at Back Shu/Sublingual veins.
Jueyin: Root at Xingjian, Branch at Back Shu.
Hand Taiyang: Root at Outer Ankle, Branch at Mingmen +1 cun.
Hand Shaoyang: Root at Finger web, Branch at Ear posterosuperior angle.
Hand Yangming: Root at Elbow, Branch at Forehead.
Hand Taiyin: Root at Cun Kou, Branch at Axillary artery.
Hand Shaoyin: Root at Sharp Bone end, Branch at Back Shu.
Hand Jueyin: Root at Wrist crease, Branch at Under tendon.
The *Classic* states: "Disease has Root/Branch; needling has Reversal/Following and Depth."
Principles:
1. Treat Branch for Branch symptoms; Root for Root symptoms.
2. Treat Root for Branch origin; Branch for Root origin.
3. Specific rules:
- Prioritize Root generally.
- Exceptions (Treat Branch first): Fullness of middle jiao (regardless of cause); Diarrhea followed by other diseases (Treat Root/Diarrhea first); Fullness followed by irritability (Treat Root/Fullness first).
- Urinary/Bowel issues: Obstruction treated as Branch; Normal function treated as Root.
- Excess diseases: Treat Root first, then Branch.
- Deficiency diseases: Treat Branch first, then Root.
- Time-based: Onset date is Root; Transmission is Branch.
Depth: Yang meridians need shallow needling (avoid damaging Wei); Yin meridians need deep needling (avoid damaging Ying).
To stop pain and move stiffness, select intersecting and crossing pathways.