（《灵枢·刺节真邪篇》）
请言解论，与天地相应，与四时相副，人参天地，故可为解。（解论，解结之论也。人与天地相参应，必知其道，斯
可与言解结矣。）下有渐洳，上生苇蒲，此所以知形气之多少也。（渐洳，伏泉也。下有渐洳，则上生苇蒲，内外之应，
理所皆然，人之表里，可察盛衰，亦犹是也。渐，平声。洳音如。）阴阳者，寒暑也。热则滋雨而在上，根 少汁，人气
在外，皮肤缓，腠理开，血气减，汗大泄，皮淖泽。（暑热则地气蒸为滋雨而气在上，故草木之气亦在枝叶，而根 少汁
也。其于人气，热则阳浮在表，故血气减、汗大泄，然热则易行，故宜于用针。 音该。淖，乃豹切。）寒则地冻水冰，
人气在中，皮肤致，腠理闭，汗不出，血气强，肉坚涩。当是之时，善行水者不能往冰，善穿地者不能凿冻，善用针者
亦不能取四厥；血脉凝结，坚搏不往来者，亦未可即柔。故行水者，必待天温冰释冻解，而水可行、地可穿也，人脉犹
是也。（寒则地气坚凝，人气结聚而经脉难行，即善用针者，亦不能取四肢之厥逆，故必待天温冰释，阳气营运，而后人
气流通，乃可用针矣。）治厥者，必先熨调和其经，掌与腋、肘与脚、项与脊以调之，火气已通，血脉乃行，然后视其病
脉淖泽者刺而平之，坚紧者破而散之，气下乃止，此所谓以解结者也。（此治厥之法。倘天时未温而必欲用针，则必借火
气以熨调其经，凡掌腋肘脚项脊之间，皆溪谷大节之交会，故当熨之温之，则火气通而血脉行。然后视其病脉淖泽者，
卫气浮也，故可刺而平之。坚紧者，邪气实也，故当破而散之。厥逆除而宗气下，乃可止针矣。结者，邪之所聚，刺去
其邪，即解结之谓也。）用针之类，在于调气，气积于胃，以通营卫，各行其道，宗气留于海，其下者注于气街，其上者
走于息道。（凡用针者，必在调气，人受气于谷，故气积于胃。然气义有三∶曰营气，曰卫气，曰宗气。清者为营，营在
脉中，浊者为卫，卫在脉外，故各行其道也。宗气，大气也。大气者，留止于上下之气海。其下者蓄于丹田，注足阳明
之气街而下行于足；其上者积于胸中，出于息道而为呼吸。凡此三者，皆所谓气，当各求其属而调之者也。按∶气街义，
如卫气篇曰∶知六腑之气街者，能知解结契绍于门户。当与此参阅，详经络类十二。）故厥在于足，宗气不下，脉中之血，
凝而留止，弗之火调，弗能取之。（厥者，逆也，阴寒之气也。厥逆在足，则阳道不行，故宗气不下而血脉凝滞，不以火
温，不能取也。）用针者，必先察其经络之实虚，切而循之，按而弹之，视其应动者，乃后取之而下之。（凡察虚实，所
验在气，故必循之弹之，视其气之应手而动者，其微其甚，则虚实可知，然后用法取之，而气自下矣。）六经调者，谓之
不病，虽病，谓自已也。（经脉调者，虽病亦微，故必自已。）一经上实下虚而不通者，此必有横络盛加于大经，令之不
通，视而泻之，此所谓解结也。（一经之脉本相流贯，而横络盛加于大经，则经有不通者矣。视而泻之，其经则调，亦所
谓解结也。）上寒下热，先刺其项太阳，久留之，已刺则熨项与肩胛令热，下合乃止，此所谓推而上之者也。（上寒下热
者，阳虚于上而实于下也。当先刺项间足太阳经大杼、天柱等穴，久留其针而补之，仍温熨肩项之间候其气至，上热与
下相合，乃止其针，此所谓推其下者而使之上也。）上热下寒，视其虚脉而陷之于经络者取之，气下乃止，此所谓引而下
之者也。（上热下寒者，阳实于上而虚于下也。故当视其在下虚陷之经，取而补之，必使其阳气下行而后止，此引而下之
之谓也。按∶此二节言上下寒热者，非若前节所谓一经上实下虚而不通者，必有横络加于大经之比，盖彼言中有所隔，
此言本末盛衰也，证自不同，不可混看。）大热遍身，狂而妄见、妄闻、妄言，视足阳明及大络取之，虚者补之，血而实
者泻之。因其偃卧，居其头前，以两手四指挟按颈动脉，久持之，卷而切推，下至缺盆中而复止如前，热去乃止，此所
谓推而散之者也。（上文言上下之寒热，所治不同；此言遍身之大热，当取足之阳明也。盖阳明经多气多血，为五脏六腑
之海，故但察其在经在络或虚或实而取之，则遍身之热可除也。然又当因病患之偃卧，医者居其头之前，以两手大食四
指，挟其颈中动脉于人迎、大迎等处，自上而下按而久持之，卷而切推之，下至缺盆，止复如前，候其热去乃已。盖三
阳在头，故可独取人迎而推散其热也。卷， 同。）
（出自《灵枢·刺节真邪篇》）
请允许我阐述关于“解结”的理论，这一理论应与天地自然相应，与四季变化相配合，人能够参悟并顺应天地之道，因此才能进行关于解除经络郁结的论述。（所谓“解论”，就是解除经络郁结的论述。人与天地相互参应，必须通晓其中的道理，才可以谈论解除经络郁结的方法。）地下有潜伏的泉水（渐洳），地上就会生长芦苇和蒲草，这就是通过观察外在形态来推断内部气血盛衰的方法。（“渐洳”指伏藏的泉水。地下有伏泉，上面就生长芦苇蒲草，这是内外相应的必然规律，人体的表里关系，可以借此察知盛衰情况，也是同样的道理。“渐”读平声，“洳”音同“如”。）阴阳对应着寒暑。天气炎热时，地气蒸腾化为雨水上升，草木的汁液多集中在枝叶上，而根部汁液减少；人体在热天时，人气浮越于体表，皮肤松弛，腠理开泄，血气外泄减少，汗出量大，皮肤湿润光泽。（暑热时地气蒸发成雨而气聚于上，所以草木的气也汇聚在枝叶，根部汁液就少了。对于人体而言，天热则阳气浮越在表，所以血气耗散、大汗淋漓，然而热则气血运行通畅，所以适宜使用针刺。“淖”音“该”，意为湿润；“淖”切音为“乃豹”，意为润泽。）天气寒冷时，地面冻结水结冰，人体之气内守于体内，皮肤致密，腠理闭合，不出汗，血气强盛，肌肉坚实涩滞。在这个时候，善于游泳的人无法在冰面上行走，善于挖掘的人无法凿开冻土，善于用针的人也难以治疗四肢厥逆之症；如果血脉凝结，坚硬搏动而不流通，也不能立即使其柔和。所以，善于行船的人，必须等待天气温暖、冰块融化解冻之后，水才能流动、土地才能开凿；人体的经脉也是如此。（寒冷时地气坚凝，人气结聚而经脉难以通行，即使是善于用针的人，也无法治疗四肢厥逆，所以必须等待天气温暖、冰雪消融，阳气运行通畅后，人气才能流通，这时才可以使用针刺。）治疗厥逆症，必须先用火熨法调和其经脉，对掌心与腋下、肘部与脚部、颈部与背部等部位进行熨烫以调畅气血，火气贯通后，血脉才能运行，然后视病情而定：脉象濡润光泽的，用针刺使其平和；脉象坚硬紧束的，破散其邪气，待气机下行后再停止针刺，这就是所谓的“解结”。（这是治疗厥逆的方法。如果天气尚未转暖却一定要用针，就必须借助火气来熨烫调和经脉，凡是手掌、腋窝、肘部、脚部、颈部、脊柱之间，都是溪谷大节的交会之处，所以应当熨烫温煦它们，这样火气通达而血脉运行。然后视病脉，若脉象濡润光泽，说明卫气浮越，故可针刺使其平和；若脉象坚硬紧束，说明邪气实盛，故当破散其邪。厥逆消除而宗气下行，才可以停针。所谓“结”，就是邪气聚集之处，刺去邪气，就是所谓的“解结”。）使用针刺的关键，在于调气。气积聚于胃，用来通调营气和卫气，各自沿着不同的路径运行；宗气留止于气海，其向下的一部分注入气街穴，向上的部分走向息道（呼吸道）。（凡是用针的人，必定在于调气，人受纳谷气，所以气积聚于胃。然而气的含义有三种：叫作营气、卫气、宗气。清轻的为营气，营气在脉中运行；重浊的为卫气，卫气在脉外运行，所以各自走不同的道路。宗气，就是大气。大气者，停留于上下气海之中。其向下的一部分蓄积于丹田，注入足阳明胃经的气街穴而下行至足；其向上的一部分积聚于胸中，出于息道而为呼吸。以上这三种气，都称为气，应当分别探究它们的归属并进行调理。按：关于“气街”的意义，如在《卫气篇》中说：懂得六腑之气街的，就能懂得解结契绍于门户的道理。应当与此处参考阅读，详见经络类第十二部分。）所以，如果厥逆发生在足部，宗气不能下行，脉中的血液就会凝结停留，如果不借助火法调理，就不能用针刺治疗。（“厥”是逆乱的意思，指阴寒之气。厥逆在足部，则阳道不通，所以宗气不能下行而血脉凝滞，不用火温灸，就无法施针。）使用针刺的人，必须先诊察经络的虚实，用手切按、循摸、弹击穴位，观察哪里跳动反应明显，然后再取穴施针使气下行。（凡诊察虚实，验证在于气，所以必须循摸弹击，观察气应手而动的情况，其微弱或盛大，虚实就知道了，然后用法取穴，气自然就会下行。）六条经脉调和的，叫做不生病，即使生病，也会自行痊愈。（经脉调和的，即使生病也很轻微，所以必定自愈。）如果一条经脉上部实而下部虚且不通畅的，这一定有横行的络脉盛满并压迫在大经脉上，导致不通畅，观察后泻除其邪气，这就是所谓的“解结”。（一条经脉的本脉本是连贯流注的，但如果横行的络脉盛满并加在大经脉上，经脉就会有不通畅的地方了。观察后泻除邪气，经脉就调和了，这也叫作“解结”。）上部寒冷下部发热，先针刺项部的足太阳膀胱经穴位，长时间留针，刺完后熨烫项部和肩胛部使其发热，直到上下热气合并才停止，这就是所谓的“推而上之”（将下部的热气推引到上部）。（上部寒下部热，是上部阳气虚而下部阳气实。应当先针刺项间足太阳经的大杼、天柱等穴位，长时间留针并补益，同时温熨肩项之间等待气至，使上部热与下部相合，才停止进针，这就是所谓的推引下部之气使其上行。）上部发热下部寒冷，视其虚陷的经脉并在经络中取穴，待气机下行后停止，这就是所谓的“引而下之”（将上部的热气引向下方）。（上部热下部寒，是上部阳气实而下部阳气虚。所以应当视其在下部虚陷的经脉，取穴并补益，必须使其阳气下行后才停止，这就是所谓的“引而下之”。按：这两节讲上下寒热的情况，不像前一节所说的“一条经脉上实下虚不通，必有横络加于大经”那样，那是说中间有所阻隔，这里说的是本末盛衰，证候自然不同，不可混淆观看。）全身大热，发狂而幻视、幻听、胡言乱语，视诊足阳明胃经及大的络脉进行治疗，虚证用补法，血实者用泻法。让病人仰卧，医者坐在其头前，用双手的四指挟持按压颈动脉，长时间按住，卷曲手指并切推，向下至缺盆穴处再像前面一样操作，热退为止，这就是所谓的“推而散之”（推散郁热）。（上文讲的上下寒热，治疗方法不同；这里讲的是遍身的大热，应当取足阳明经。因为阳明经多气多血，是五脏六腑的海，所以只要察看在经在络或虚或实而取穴，遍身的热就可以去除。然而又应当根据病人仰卧的姿势，医者位于其头部前方，用双手食指和大拇指四指，挟持颈中动脉在人迎、大迎等处，从上往下按压并长时间按住，卷曲手指切推，向下至缺盆穴，停止后再重复前面的动作，等候热退才结束。因为三阳经在头部，所以可以独取人迎穴来推散其热。“卷”同“拳”。）
(From *Ling Shu: Ci Jie Zhen Xie Pian*)
Please allow me to expound on the theory of "Jie Jie" (Untying Knots), which should correspond with Heaven and Earth, and align with the Four Seasons. Since humans can participate in and accord with the Way of Heaven and Earth, one is qualified to discuss the untying of knots. ("Jie Lun" refers to the discourse on untying knots. Humans and Heaven and Earth are mutually responsive; only by understanding this principle can one speak of untying knots.) Where there are subterranean springs beneath, reeds and rushes grow above; this is how one knows the abundance or scarcity of form and Qi. ("Jian Ru" refers to hidden springs. If there are hidden springs below, reeds and rushes grow above; this internal-external correspondence is a matter of natural law. The relationship between the exterior and interior of the human body allows us to observe excess and deficiency, just as it is here. "Jian" is pronounced with the level tone; "Ru" sounds like "ru".) Yin and Yang correspond to Cold and Heat. When it is hot, moisture evaporates into rain and rises upward; the roots have less juice, and the Qi of humanity floats outward. The skin becomes relaxed, the cou li (pores) open, blood and Qi diminish, sweat pours out profusely, and the skin becomes moist and lustrous. (When summer heat steams the earth's Qi into rain, the Qi gathers above, so the Qi of grass and trees also gathers in the branches and leaves, leaving the roots with less juice. Regarding human Qi, when it is hot, Yang floats to the surface, so blood and Qi are depleted and sweat pours out. However, heat facilitates movement, so acupuncture is suitable. "Nao" sounds like "gai", meaning moist; "Nao" is cut at "nai bao", meaning glossy.) When it is cold, the ground freezes and water turns to ice. Human Qi remains within. The skin is tight, the cou li are closed, sweat does not come out, blood and Qi are strong, and the flesh is firm and stiff. At such times, even those skilled in swimming cannot traverse ice, and those skilled in digging cannot pierce frozen earth. Similarly, those skilled in acupuncture cannot treat Si Jue (Four Reversals/Cold Extremities); if the blood vessels are coagulated and hard, pulsating without flow, they cannot be immediately softened. Therefore, those skilled in navigation must wait for the sky to warm, ice to melt, and frost to thaw before water can flow and earth can be penetrated; the meridians of the human body are the same. (When cold, the earth's Qi is solid and condensed, and human Qi is knotted, making meridians difficult to navigate. Even those skilled in acupuncture cannot treat limb reversal, so one must wait for warmth, melting ice, and the circulation of Yang Qi before human Qi flows freely, allowing acupuncture to be used.) To treat Jue Ni (Reversal of Qi), one must first use moxibustion or warming techniques to harmonize the meridians. Warm the palms and axillae, elbows and feet, neck and spine to regulate them. Once the fire Qi has circulated, the blood vessels will flow. Then, observe the condition: if the pulse is moist and lustrous, puncture to calm it; if it is hard and tight, break and disperse it. Stop when the Qi descends. This is what is meant by "Untying Knots." (This is the method for treating Jue Ni. If the weather is not yet warm but one insists on using needles, one must borrow Fire Qi to warm and harmonize the meridians. All areas between the palms, axillae, elbows, feet, neck, and spine are intersections of large joints and valleys, so they should be warmed. Thus, Fire Qi passes and blood vessels flow. Then observe the diseased pulse: if moist and lustrous, Wei Qi is floating, so it can be punctured to calm it. If hard and tight, Evil Qi is excessive, so it should be broken and dispersed. Once Jue Ni is removed and Zong Qi descends, the needle can be stopped. A "Knot" is where Evil gathers; puncturing away the Evil is called "Untying the Knot.") The essence of acupuncture lies in regulating Qi. Qi accumulates in the Stomach, facilitating the circulation of Ying Qi (Nutrient Qi) and Wei Qi (Defensive Qi), each following its own path. Zong Qi (Pectoral Qi) remains in the Sea of Qi; the portion that goes downward injects into the Qi Street, and the portion that goes upward travels to the Xi Dao (Respiratory Pathway). (All who use acupuncture must focus on regulating Qi. Humans receive Qi from grain, so Qi accumulates in the Stomach. However, Qi has three meanings: Ying Qi, Wei Qi, and Zong Qi. The clear part is Ying Qi, which circulates within the vessels; the turbid part is Wei Qi, which circulates outside the vessels, hence they follow different paths. Zong Qi is Great Qi. Great Qi resides in the Upper and Lower Qi Seas. The lower portion accumulates in the Dantian, injects into the Qi Street of the Foot-Yangming Meridian, and descends to the foot; the upper portion accumulates in the Chest, exits via the Xi Dao, and governs respiration. These three types of Qi are all referred to as Qi, and one should seek their respective affiliations to regulate them. Note: Regarding the meaning of "Qi Street," as stated in the *Wei Qi* chapter: "One who understands the Qi Streets of the Six Fu Organs can understand tying and untying knots at the gates." Refer to this section and see the Twelve Meridians category for details.) Therefore, if Jue occurs in the feet, Zong Qi fails to descend, and blood in the vessels coagulates and stagnates. Without Fire regulation, it cannot be treated with needles. ("Jue" means reversal, referring to Yin-Cold Qi. If Jue Ni is in the feet, the Yang pathway is blocked, so Zong Qi does not descend and blood vessels stagnate. Without warming with Fire, needling is impossible.) Those who use acupuncture must first examine the excess or deficiency of the meridians. Palpate, trace, press, and flick the points. Observe where the response and movement occur, then select points to drain the Qi downward. (To examine excess and deficiency, verification relies on Qi. Therefore, one must trace and flick to observe Qi responding to touch. Whether weak or strong, excess and deficiency become known. Then apply methods to select points, and Qi will naturally descend.) When the Six Meridians are harmonious, it is called disease-free. Even if illness occurs, it will resolve itself. (When meridians are harmonious, even if illness occurs, it is mild and will inevitably self-resolve.) If one meridian exhibits excess above and deficiency below with blockage, there must be an overfull transverse collateral compressing the main meridian, causing obstruction. Observe and drain it; this is called "Untying Knots." (The main meridian normally flows continuously. If a transverse collateral is overfull and presses on the main meridian, obstruction occurs. Observing and draining it harmonizes the meridian, which is also called "Untying Knots.") For Cold Above and Heat Below, first puncture the Foot-Taiyang Bladder Meridian points in the neck region, retaining the needle for a long time. After needling, moxa/warm the neck and shoulder blades until heat is generated. Stop when the upper and lower heats merge. This is called "Pushing Upward." (Cold above and heat below indicates Deficiency of Yang above and Excess below. One should first puncture points such as Dazhu and Tianzhu of the Foot-Taiyang Bladder Meridian in the neck, retain the needle for a long time to tonify, and simultaneously warm the neck and shoulders to await Qi arrival. When upper heat merges with lower heat, stop the needle. This is pushing the lower Qi to ascend.) For Heat Above and Cold Below, observe the deficient and sunken meridians in the lower body and select points. Stop when the Qi descends. This is called "Drawing Downward." (Heat above and cold below indicates Excess of Yang above and Deficiency below. Therefore, observe the deficient and sunken meridians below, select points to tonify, ensuring Yang Qi descends before stopping. This is "Drawing Downward." Note: These two sections discuss upper/lower cold/heat, which differs from the previous section regarding "one meridian with excess above/deficiency below due to transverse collaterals." That case involves physical obstruction; this case involves root-and-branch excess/deficiency. The syndromes differ and should not be confused.) For generalized severe heat, mania, hallucinations (seeing/hearing things that aren't there), and delirious speech, examine the Foot-Yangming Stomach Meridian and major collaterals. Tonify deficiency; drain blood excess. With the patient supine, position yourself at the head. Use four fingers of both hands to clamp and press the carotid artery. Hold firmly for a long time, curl the fingers, and push downwards to the Quepen point, then repeat as before. Stop when the heat dissipates. This is called "Pushing and Scattering." (The preceding text discusses different treatments for upper/lower cold/heat; this section addresses generalized severe heat, requiring treatment of the Foot-Yangming Meridian. The Yangming Meridian is rich in Qi and Blood, serving as the Sea of the Five Zang and Six Fu Organs. Thus, by examining whether the pathology is in the meridian or collateral, or in excess/deficiency, and selecting points accordingly, generalized heat can be eliminated. Furthermore, with the patient supine, the practitioner sits at the head, using the index and middle fingers (four fingers total) to clamp the carotid artery at Renying and Daying points. Press firmly from top to bottom, hold, curl fingers, and push down to Quepen, then repeat. Wait for heat to dissipate. Since the Three Yang Meridians converge at the head, one can exclusively select Renying to push and scatter the heat. "Juan" is synonymous with "Quan" [fist].)