(《灵枢·寿夭刚柔篇》)
黄帝问于少师曰∶“余闻人之生也,有刚有柔,有弱有强,有短有长,有阴有阳,愿闻其方。少师答曰∶阴中有阴,
阳中有阳,审知阴阳,刺之有方,(刚柔强弱短长,无非阴阳之化,然曰阴曰阳,人皆知之,至若阴中复有阴,阳中复有
阳,则人所不知也,故当详审阴阳,则刺得其方矣。)得病所始,刺之有理,谨度病端,与时相应,内合于五脏六腑,外
合于筋骨皮肤。(得病所始者,谓知其或始于阴,或始于阳,故刺之有理也。谨度病端者,谓察其风因木化,热因火化,
湿因土化,燥因金化,寒因水化,故与时相应也。内而五脏六腑,外而筋骨皮肤,莫非此理,合而求之,得其病之原矣。)
是故内有阴阳,外亦有阴阳。在内者五脏为阴,六腑为阳;在外者筋骨为阴,皮肤为阳。(内为阴,外为阳,理之常也。
然内有阴阳,外亦有阴阳。故在内者五脏为阴,脏属里也;六腑为阳,腑属表也。在外者筋骨深而为阴,皮肤浅而为阳。
所以阴阳之中,复有阴阳。即如五脏皆有血气,六腑亦有血气。血在六腑则阳中之阴,气则阳中之阳也;气在五脏则阴
中之阳,血则阴中之阴也。皮肤筋骨,无不皆然。故《天元纪大论》曰∶天有阴阳,地亦有阴阳。其义即此。由此观之,
可见阴阳合一之道,则无往不在。)故曰病在阴之阴者,刺阴之荥输;(阴之阴者,阴病在阴分也,当刺其荥输。以诸经
荥输气微,亦阴之类,如手太阴经鱼际为荥、太渊为输者是也。)病在阳之阳者,刺阳之合;(阳之阳者,阳病在阳分也,
当刺其合穴。盖所入为合,犹在阳分,刺此以防深入,如手阳明经曲池之类是也。)病在阳之阴者,刺阴之经;(阳之阴
者,阳病在阴也,当刺阴之经穴。盖所行为经,其气正盛,即阴中之阳,如手太阴经渠之类是也。)病在阴之阳者,刺络
脉。(阴之阳者,阴病在阳也,当刺诸络脉。盖络脉浮浅,皆在阳分,如手阳明经偏历之类是也。)故曰病在阳者命曰风,
病在阴者命曰痹病,阴阳俱病命曰风痹。(阳受风气,故在阳者命曰风。邪入于阴则痹,故在阴者命曰痹。)病有形而不
痛者,阳之类也;(病浅在外也。)无形而痛者,阴之类也。(病深在内也。)无形而痛者,其阳完而阴伤之也,急治其阴,
无攻其阳;有形而不痛者,其阴完而阳伤之也,急治其阳,无攻其阴。(完,固也。病在阴者勿攻其阳,病在阳者勿攻其
阴,凡表里虚实,其治皆然。)阴阳俱动,乍有形,乍无形,加以烦心,命曰阴胜其阳,此谓不表不里,其形不久。(阴
阳俱动,表里皆病也。乍有形、乍无形,往来不常也。加以烦心,阴病甚于阳也。大凡治病必求于本,若求其在表而里
亦病,求其在里而表亦病,此以阴阳并伤,故曰不表不里,治之为难,形将不久矣。)
黄帝问于伯高曰∶余闻形气病之先后,外内之应奈何?(形见于外,气运于中。病伤形气,则或先或后,必各有所
应。)伯高答曰∶风寒伤形,忧恐忿怒伤气。气伤脏,乃病脏;寒伤形,乃应形;风伤筋脉,筋脉乃应。此形气外内之相
应也。(风寒外袭,故伤于形。情欲内劳,故伤于气。内伤则病在脏腑,外伤则应于皮毛。若风伤筋脉,则居于外内之间,
故应于筋脉。此形气表里之有辨也。)黄帝曰∶刺之奈何?伯高答曰∶病九日者,三刺而已;病一月者,十刺而已。多少
远近,以此衰之。(大约病三日者,可一刺而已,故九日者当三刺,一月者当十刺。凡病之多少远近,当推此以衰去之,
是刺之大法也。)久痹不去身者,视其血络,尽出其血。(久痹不去身者,其身不能往来,以阴邪在于血脉,故当视其血
络而尽去之。)黄帝曰∶外内之病,难易之治奈何?(上文言久近之难易,故此复问外内之难易。)伯高答曰∶形先病而
未入脏者,刺之半其日;(外病而内不病者其病浅,故当半其日,谓减于前法日数之半,如病一月者,可五刺而已也。)
脏先病而形乃应者,刺之倍其日。此月内难易之应也。(内病而应于外者其病深,故当倍其日,如浅者一月五刺,重者一
月十刺也。病有浅深,故治有难易耳。)
(出自《灵枢·寿夭刚柔篇》)
黄帝向少师问道:“我听说人的体质,有的刚强有的柔和,有的虚弱有的强壮,有的矮小有的高大,有的属阴有的属阳,我想听听其中的道理。少师回答说:阴中有阴,阳中有阳,若能详审阴阳,针刺就有方法。(刚柔、强弱、短长,无非都是阴阳变化的表现,然而人们只知道说阴说阳,至于阴中还有阴、阳中还有阳,则是人们所不知道的,所以应当详细审察阴阳,这样针刺就能得其要领了。)得知疾病起始的部位,针刺就有条理;谨慎度量病情的开端,与天时相应,内合于五脏六腑,外合于筋骨皮肤。(得知疾病起始部位,是指知道疾病是始于阴分还是始于阳分,所以针刺就有条理。谨慎度量病情开端,是指观察风因木气而化、热因火气而化、湿因土气而化、燥因金气而化、寒因水气而化,从而与四时气候相应。内至五脏六腑,外至筋骨皮肤,没有不遵循这一道理的,综合考察,就能得到疾病的本源了。)因此体内有阴阳,体外也有阴阳。在体内的,五脏为阴,六腑为阳;在体外的,筋骨为阴,皮肤为阳。(内部为阴,外部为阳,这是常理。但内部有阴阳,外部也有阴阳。所以在体内的,五脏属阴,因为脏位于里;六腑属阳,因为腑位于表。在体外的,筋骨深在故为阴,皮肤浅表故为阳。所以在阴阳之中,又复含有阴阳。就像五脏都有血和气,六腑也都有血和气。血在六腑中属于阳中之阴,气则属于阳中之阳;气在五脏中属于阴中之阳,血则属于阴中之阴。皮肤和筋骨,无不如此。所以《天元纪大论》说:天有阴阳,地也有阴阳。其意义就在这里。由此看来,可见阴阳合一的道理,无处不在。)所以说,病在阴之阴的,针刺阴经的荥穴和输穴;(阴之阴,指阴病在阴分,应当针刺其荥穴和输穴。因为各经的荥穴和输穴经气微弱,也属于阴类,例如手太阴肺经的鱼际穴为荥穴、太渊穴为输穴就是这类。)病在阳之阳的,针刺阳经的合穴;(阳之阳,指阳病在阳分,应当针刺其合穴。因为所入为合,仍在阳分,针刺此处以防病邪深入,例如手阳明大肠经的曲池穴就是这类。)病在阳之阴的,针刺阴经的经穴;(阳之阴,指阳病涉及阴分,应当针刺阴经的经穴。因为所行为经,其经气正盛,即阴中之阳,例如手太阴肺经的渠穴就是这类。)病在阴之阳的,针刺络脉。(阴之阳,指阴病涉及阳分,应当针刺诸络脉。因为络脉浮浅,都在阳分,例如手阳明大肠经的偏历穴就是这类。)所以说,病在阳分的叫做风病,病在阴分的叫做痹病,阴阳都病的叫做风痹。(阳经受风气侵袭,所以在阳分的叫风。邪气侵入阴分则导致痹阻,所以在阴分的叫痹。)病症表现为有形但不觉疼痛的,属于阳的范畴;(病位浅在外表。)无形但觉疼痛的,属于阴的范畴。(病位深在内里。)无形而疼痛的,说明阳气完好而阴气受损,应紧急治疗阴分,不要攻伐阳气;有形而不痛的,说明阴气完好而阳气受损,应紧急治疗阳气,不要攻伐阴气。(完,指固守、完好。病在阴分的不要攻伐阳气,病在阳分的不要攻伐阴气,凡是表里虚实的治疗原则都是如此。)如果阴阳之气都躁动不安,时而显现症状,时而消失,再加上心烦,这叫做阴胜其阳,这叫作不表不里,病人的寿命不会长久。(阴阳俱动,指表里都生病了。时而显现症状、时而消失,指病情往来无常。加上心烦,说明阴病比阳病严重。大凡治病必须求本,如果求治在表而里也病了,求治在里而表也病了,这是因为阴阳都受伤了,所以叫作不表不里,治疗起来很困难,形体将难以维持长久。)
黄帝向伯高问道:“我听说形、气、病的先后顺序,以及内外相应的关系是怎样的?”(形体表现于外,气运行于中。病邪损伤形和气,则有先有后,必然各有相应的表现。)伯高回答说:“风寒伤害形体,忧恐忿怒伤害气机。气伤及脏腑,就产生脏病;寒邪伤害形体,就应验在形体上;风邪伤害筋脉,筋脉就会应验。这就是形、气、外、内之间的相应关系。(风寒从外侵袭,所以伤害形体。情志欲望从内劳损,所以伤害气机。内伤则病在脏腑,外伤则应验在皮毛。如果风邪伤害筋脉,则处于外内之间,所以应验在筋脉。这就是形气表里的区别。)”黄帝问:“如何针刺?”伯高回答说:“患病九天的,针刺三次即可痊愈;患病一个月的,针刺十次即可痊愈。刺数的多少和疗程的远近,根据这个规律递减推算。(大约患病三天的,可以只刺一次就好,所以患病九天的应当刺三次,患病一个月的应当刺十次。凡是病情的轻重缓急,都应当据此来推算减少,这是针刺的大法。)久痹之邪不去身者,观察其血络,放尽瘀血。(久痹之邪不去身,是因为身体气血不能通畅往来,由于阴邪存在于血脉中,所以应当观察其血络并彻底放出瘀血。)”黄帝问:“外病和内病,治疗的难易程度如何?”(上文讲的是病程久近的难易,所以这里又问外内病变的难易。)伯高回答说:“形体先发病而未传入脏腑的,针刺天数按原法减半;(外病而内未病,病位浅,所以天数应当减半,即少于前法日数的一半,例如患病一个月,可只刺五次即可。)脏腑先发病而后反映到形体上的,针刺天数按原法加倍。这是一个月内难易程度的对应关系。(内病而反映到外部,病位深,所以天数应当加倍,例如病浅者一月刺五次,病重者一月刺十次。病情有深浅,所以治疗有难易之分。)”
(From *Ling Shu: Shou Yao Gang Rou Pian*)
Huangdi asked Shaoshi, "I have heard that human constitutions vary: some are rigid and some are flexible; some are weak and some are strong; some are short and some are tall; some are Yin and some are Yang. I wish to hear the principles behind this." Shaoshi replied, "Within Yin there is Yin, and within Yang there is Yang. If one carefully examines Yin and Yang, there will be a method for acupuncture. (Rigidity and flexibility, weakness and strength, shortness and tallness are all transformations of Yin and Yang. Although people know to speak of Yin and Yang, they do not know that there is Yin within Yin and Yang within Yang. Therefore, one must carefully examine Yin and Yang so that acupuncture techniques can be correctly applied.) Knowing where the disease originated allows for logical needling; carefully assessing the onset of the illness and aligning it with the times ensures internal harmony with the Zang-Fu organs and external harmony with the sinews, bones, tendons, and skin. (Knowing the origin means understanding whether the disease began in the Yin or Yang aspect, thus allowing for reasoned needling. Assessing the onset involves observing how Wind transforms via Wood, Heat via Fire, Dampness via Earth, Dryness via Metal, and Cold via Water, thereby corresponding to the seasons. From the internal Zang-Fu to the external sinews, bones, and skin, all follow this principle; integrating these aspects reveals the root of the disease.) Therefore, there is Yin and Yang internally, and also externally. Internally, the Five Zang organs are Yin and the Six Fu organs are Yang; externally, the sinews and bones are Yin and the skin is Yang. (Internal is Yin and external is Yang is the general rule. However, there is Yin and Yang within both. Thus, internally, the Zang organs are Yin because they reside in the interior; the Fu organs are Yang because they reside in the exterior. Externally, the deep sinews and bones are Yin, and the superficial skin is Yang. Hence, within Yin and Yang, there is further differentiation into Yin and Yang. Just as each of the Five Zang organs contains Blood and Qi, so do the Six Fu organs. In the Fu organs, Blood is Yin within Yang, while Qi is Yang within Yang; in the Zang organs, Qi is Yang within Yin, while Blood is Yin within Yin. The same applies to skin and bones. Thus, the *Tian Yuan Ji Da Lun* states: 'Heaven has Yin and Yang, and Earth also has Yin and Yang.' This is the meaning. From this, we see that the unity of Yin and Yang is present everywhere.) Therefore, it is said that when the disease is in the Yin of Yin, one should needle the Ying-Spring and Shu-Stream points of the Yin meridians; (Yin of Yin refers to Yin pathology located in the Yin division; one should needle the Ying-Spring and Shu-Stream points. Since the Qi at these points is relatively weak, they belong to the Yin category, such as Yuji (LU 10) as the Ying-Spring point and Taiyuan (LU 9) as the Shu-Stream point of the Hand-Taiyin Lung Meridian.) When the disease is in the Yang of Yang, one should needle the He-Sea points of the Yang meridians; (Yang of Yang refers to Yang pathology located in the Yang division; one should needle the He-Sea points. As the He-Sea points are where Qi enters, still within the Yang division, needling them prevents the pathogen from penetrating deeper, such as Quchi (LI 11) of the Hand-Yangming Large Intestine Meridian.) When the disease is in the Yang of Yin, one should needle the Jing-River points of the Yin meridians; (Yang of Yin refers to Yang pathology affecting the Yin; one should needle the Jing-River points of the Yin meridians. As the Jing-River points are where Qi flows strongly, representing Yang within Yin, such as Qu (LU 5) of the Hand-Taiyin Lung Meridian.) When the disease is in the Yin of Yang, one should needle the Luo-Connecting vessels. (Yin of Yang refers to Yin pathology affecting the Yang; one should needle the various Luo-Connecting vessels. Since these vessels are superficial and located in the Yang division, such as Pianli (LI 6) of the Hand-Yangming Large Intestine Meridian.) Therefore, it is said that disease in the Yang is called Feng (Wind); disease in the Yin is called Bi (Obstruction); disease involving both Yin and Yang is called Feng-Bi. (The Yang meridians receive Wind, hence disease in the Yang is called Feng. Pathogens entering the Yin cause obstruction, hence disease in the Yin is called Bi.) Manifestations that are visible/formidable but painless belong to the Yang category; (the disease is shallow and external.) Manifestations that are invisible/intangible but painful belong to the Yin category; (the disease is deep and internal.) Intangible yet painful conditions indicate that Yang is intact but Yin is injured; urgently treat the Yin and do not attack the Yang; tangible yet painless conditions indicate that Yin is intact but Yang is injured; urgently treat the Yang and do not attack the Yin. ('Intact' means solid/undamaged. Do not attack Yang when the disease is in Yin, nor attack Yin when the disease is in Yang; this applies to all treatments regarding exterior-interior and deficiency-excess.) If both Yin and Yang Qi are agitated, with symptoms appearing intermittently, accompanied by vexation and heart discomfort, this is called 'Yin prevailing over Yang,' known as neither exterior nor interior; the patient's condition will not last long. (Agitation of both Yin and Yang indicates disease in both exterior and interior. Intermittent symptoms indicate fluctuating irregularity. Vexation indicates severe Yin pathology surpassing Yang. Generally, treating disease requires seeking its root. If treating the exterior affects the interior, or treating the interior affects the exterior, it is because both Yin and Yang are injured. Thus, it is termed neither exterior nor interior, making treatment difficult, and the physical form will not endure long.)
Huangdi asked Boga, "I have heard of the sequence of Xing (Form), Qi (Energy), and Bing (Disease), and their correspondence between interior and exterior. What is it?" (Xing manifests externally, while Qi circulates internally. Disease damaging Xing and Qi occurs sequentially, each having specific correspondences.) Boga replied, "Wind and Cold damage Xing; Worry, Fear, Anger, and Resentment damage Qi. Damage to Qi affects the Zang organs, resulting in Zang disease; Cold damaging Xing corresponds to Xing manifestations; Wind damaging sinews and vessels results in vessel manifestations. This is the correspondence among Xing, Qi, exterior, and interior. (Wind and Cold invade from outside, thus damaging Xing. Emotional labor originates from inside, thus damaging Qi. Internal injury leads to disease in the Zang-Fu; external injury corresponds to the skin and hair. If Wind damages sinews and vessels, which lie between exterior and interior, it corresponds to the sinews and vessels. This distinguishes the relationships of Xing, Qi, and interior-exterior.)" Huangdi asked, "How should one needle?" Boga replied, "For a disease lasting nine days, three needleings suffice; for a disease lasting one month, ten needleings suffice. The number and duration depend on this reduction principle. (Generally, a three-day disease may require only one needle ing; thus, a nine-day disease requires three, and a one-month disease requires ten. For any disease, the frequency and duration should be calculated by reducing according to this principle; this is the major law of needling.) For chronic Bi syndrome that does not leave the body, observe the blood collaterals and drain all the stagnant blood. (Chronic Bi persisting in the body implies blocked circulation due to Yin pathogens in the blood vessels; therefore, one must observe the blood collaterals and completely evacuate the blood.)" Huangdi asked, "Regarding diseases of the exterior and interior, what is the difference in treatment difficulty?" (The previous text discussed difficulty based on duration; here, the question concerns difficulty based on location.) Boga replied, "If Xing is diseased first but has not entered the Zang organs, reduce the number of needleings by half compared to the standard; (Exterior disease without interior involvement is shallow, so the number of needleings should be halved; e.g., for a one-month disease, five needleings suffice.) If the Zang organs are diseased first and then manifest in the Xing, double the number of needleings. This is the correspondence of difficulty within a month. (Interior disease manifesting externally is deep, so the number of needleings should be doubled; e.g., shallow disease requires five needleings per month, while severe disease requires ten. Diseases have depth, hence treatment has varying degrees of difficulty.)"