(《素问·通评虚实论》)
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。(亟,急也。凡用针取病者,
春宜治各经之络穴;夏宜治各经之俞穴;秋气未深,宜治六腑阳经之穴;冬寒阳气闭塞,脉不易行,故当用药而少施针
石,此用针之大法也。亟音棘。塞,入声。)所谓少针石者,非痈疽之谓也,痈疽不得顷时回。(冬月气脉闭塞,宜少针
石者,乃指他病而言,非谓痈疽亦然也。盖痈疽毒盛,不泄于外,必攻于内,故虽冬月,亦急宜针石泻之。不得顷时回
者,谓不可使顷刻内回也,内回则毒瓦斯攻脏,害不小矣。)痈不知所,按之不应手,乍来乍已,刺手太阴旁三 与缨脉各
二。(痈疽已生,未知的所,故按之不应手也。乍来乍已,痛无定处也。刺手太阴旁者,太阴之脉,自腋下出中府,中府
之旁,乃足阳明气户、库房之次。刺瘢曰 ,三 ,三刺也。缨脉,结缨两旁之脉,亦足阳明颈中水突、气舍等穴。)掖
痈大热,刺足少阳五,刺而热不止,刺手心主三,刺手太阴经络者,大骨之会各三。(刺足少阳五者,少阳近掖之穴,则
渊腋、辄筋也。刺手心主三者,天池在腋下也。刺手太阴经络者,列缺也。大骨之会各三者,谓肩后骨解中,手太阳肩
贞穴也。)暴痈筋 ,随分而痛,魄汗不尽,胞气不足,治在经俞。( ,缩也。随分而痛,随各经之分也。魄汗,阴汗
也。胞气不足,水道不利也。治在经俞,随痈所在,以治各经之俞穴,如手太阴之俞,太渊之类是也。 音软。)
黄帝问道:春季应当急切地治疗经络,夏季应当急切地治疗经穴和俞穴,秋季应当急切地治疗六腑,冬季则气血闭塞。所谓闭塞,是指用药而少用针石。(亟,意为急迫。凡是使用针刺取效治病的方法,春季适宜治疗各经的络穴;夏季适宜治疗各经的俞穴;秋季气机尚未深藏,适宜治疗六腑阳经的穴位;冬季寒冷,阳气闭塞,脉气不易运行,所以应当用药而少施针石,这是使用针刺的大法。亟音同“棘”。塞,读入声。)所谓少用针石,并不是指痈疽而言,因为痈疽病不能片刻延误。(冬季气脉闭塞,适宜少用针石,这是针对其他疾病而言,并非说痈疽也是如此。大概痈疽毒邪炽盛,如果不从外部泄出,必定攻伐内部,所以即使是冬季,也应当急切地用针石泻除毒邪。所谓“不得顷刻回”,意思是不可让毒邪在顷刻之间回转体内,如果毒邪内返,就会攻犯脏腑,危害就不小了。)对于位置不确定的痈疽,按压时没有明显的硬块反应,疼痛忽来忽去,应当刺手太阴肺经旁侧三处以及颈侧结缨两旁之脉各两处。(痈疽已经生成,但不知道具体位置,所以按压时没有明显的硬块反应。乍来乍已,是指疼痛部位不固定。刺手太阴旁的,是因为手太阴肺经的经脉,从腋下出于中府穴,中府穴的旁边,就是足阳明胃经的气户、库房等穴的位置。刺三次称为“三”,即针刺三次。缨脉,是指系帽带两侧颈部的脉络,也是足阳明胃经颈部的水突、气舍等穴位。)腋部发生痈疽且高热,应刺足少阳胆经五穴,如果针刺后热势不退,再刺手厥阴心包经三穴,刺手太阴肺经的络穴,以及大骨交会处各三处。(刺足少阳胆经五穴,指的是靠近腋下的穴位,如渊腋、辄筋穴。刺手厥阴心包经三穴,指的是位于腋下的天池穴。刺手太阴肺经络穴,指的是列缺穴。刺大骨交会处各三处,是指肩后方骨缝中的手太阳小肠经肩贞穴。)突发性的痈疽导致筋脉拘挛收缩,随着经络分布而疼痛,冷汗不止,膀胱之气不足,治疗应在经俞。(缩,即收缩之意。随分而痛,是指沿着各经的循行部位疼痛。魄汗,即阴汗。胞气不足,指水道通调功能不利。治在经俞,是指根据痈疽所在的位置,治疗相应各经的俞穴,例如手太阴肺经的俞穴太渊穴之类。 音同“软”。)
The Yellow Emperor asked: In spring, one should urgently treat the collaterals; in summer, one should urgently treat the Jing-River and Shu-Stream points; in autumn, one should urgently treat the Six Fu-organs; in winter, the Qi and Blood are closed. By "closed," it means relying on herbal medicine and using acupuncture and moxibustion sparingly. (Urgent implies promptness. Generally, when using acupuncture to treat disease: in spring, it is suitable to treat the Luo-Connecting points of each meridian; in summer, it is suitable to treat the Shu-Stream points of each meridian; in autumn, when the Qi has not yet deeply stored, it is suitable to treat the Yang meridian points of the Six Fu-organs; in winter, due to cold causing Yang Qi closure and difficulty in pulse flow, one should rely on herbal medicine and apply acupuncture and moxibustion sparingly. This is the general principle of acupuncture. 'Ji' is pronounced like 'ji'. 'Sai' is pronounced with entering tone.) The phrase "using acupuncture and moxibustion sparingly" does not refer to carbuncles and sores, because carbuncles and sores cannot be delayed for even a moment. (In winter, when Qi and pulse are closed, using acupuncture and moxibustion sparingly refers to other diseases, not implying that carbuncles and sores are treated similarly. Since the toxic heat of carbuncles and sores is abundant, if not drained externally, it will attack internally. Therefore, even in winter, it is urgent to use acupuncture and moxibustion to drain them. "Cannot return in an instant" means the pathogenic factor must not be allowed to retreat inward within a short time; if it retreats inward, it will attack the Zang-organs, causing significant harm.) For a carbuncle whose location is unknown, where palpation yields no distinct response, and pain comes and goes intermittently, one should puncture three points beside the Lung Meridian of Hand-Taiyin and two points on the Ying Mai (cervical collateral vessels) on each side. (When a carbuncle has formed but its exact location is unknown, palpation yields no distinct response. Intermittent pain indicates shifting locations. Puncturing beside the Hand-Taiyin refers to the area near the Zhongfu point, from which the Lung Meridian emerges from the axilla; beside Zhongfu are located the Qihu and Kufang points of the Stomach Meridian of Foot-Yangming. Puncturing three times is referred to as "San". Ying Mai refers to the vessels on both sides of the neck where the hat ribbon ties, corresponding to the Shuitu and Qishe points of the Stomach Meridian of Foot-Yangming.) For axillary carbuncles with high fever, puncture five points of the Gallbladder Meridian of Foot-Shaoyang. If the fever persists after needling, puncture three points of the Pericardium Meridian of Hand-Jueyin. Puncture the Luo-Connecting point of the Lung Meridian of Hand-Taiyin and the intersection of the large bones, three times each. (Puncturing five points of the Gallbladder Meridian refers to points near the axilla, such as Yuanye and Zhejin. Puncturing three points of the Pericardium Meridian refers to Tianchi, located in the axilla. Puncturing the Luo-Connecting point of the Lung Meridian refers to Lieque. Puncturing the intersection of the large bones three times refers to the Jianzhen point of the Small Intestine Meridian of Hand-Taiyin, located in the posterior shoulder bone gap.) For sudden onset of carbuncles causing tendon contraction and pain along the meridians, with profuse sweating and insufficiency of Bladder Qi, treatment should focus on the Shu-Stream points. (Contraction refers to shrinking. Pain along the meridians follows the distribution of each channel. Profuse sweating refers to Yin sweat. Insufficiency of Bladder Qi refers to dysfunction of water passage regulation. Treating the Shu-Stream points means treating the Shu-Stream points of the respective meridians according to the location of the carbuncle, such as Taiyuan, the Shu-Stream point of the Lung Meridian of Hand-Taiyin. 'Ruan' is pronounced like 'ruan'.)