问∶九针之法,始于岐伯,其数必有取矣。而灸法独无数焉,乃至定穴,均一审慎,
所谓奇穴,又皆不可不知也。试言以考术业之专工。
尝谓针灸之疗疾也,有数有法,而惟精于数法之原者,斯足以窥先圣之心。圣人之定穴
也,有奇有正,而惟通于奇正之外者,斯足以神济世之术,何也?法者,针灸所立之规,而
数也者,所以纪其法,以运用于不穷者也。穴者,针灸所定之方,而奇也者,所以翊夫正以
旁通于不测者也。数法肇于圣人,固精蕴之所寓,而定穴兼夫奇正,尤智巧之所存。善业医
者,果能因法以详其数,缘正以通其奇,而于圣神心学之要,所以默蕴于数法奇正之中者,
又皆神而明之焉,尚何术之有不精,而不足以康济斯民也哉?
执事发策,而以针灸之数法奇穴,下询承学,盖以术业之专工者望诸生也。而愚岂其人
哉?虽然,一介之士,苟存心于爱物,于人必有所济,愚固非工于医业者,而一念济物之心
,特 焉。矧以明问所及,敢无一言以对。夫针灸之法,果何所 乎?粤稽
上古之民,太朴未散,元醇未漓,与草木蓁蓁然,与鹿豕 然,方将相忘于浑噩
之天,而何有于疾,又何有于针灸之施也。自羲、农以还,人渐流于不古,而朴者散,醇者
漓,内焉伤于七情之动,外焉感于六气之侵,而众疾胥此乎交作矣。岐伯氏有忧之,于是量
其虚实,视其寒温,酌其补泻,而制之以针刺之法焉,继之以灸火之方焉。至于定穴,则
自正穴之外,又益之以奇穴焉。非故为此纷纷也,民之受疾不同,故所施之术或异,而要之
非得已也,势也,势之所趋,虽圣人亦不能不为之所也已。然针固有法矣,而数必取于九者
,何也?盖天地之数,阳主生,阴主杀,而九为老阳之数,则期以生人,而不至于杀人者,
固圣人取数之意也。今以九针言之,燥热侵头身,则法乎天,以为 针,头大而末锐
焉。气满于肉分,则法乎地,以为圆针,身圆而末锋焉。锋如黍米之锐者为 针,主按
脉取气法乎人也。刃有三隅之象者为锋针,主泻导痈血,法四时也。 针以法音,而末
如剑锋者,非所以破痈脓乎?利针以法律,而支似毫毛者,非所以调阴阳乎?法乎星则为毫针
,尖如蚊虻,可以和经络,却诸疾也。法乎风则为长针,形体锋利,可以去深邪,疗痹痿也
。至于燔针之刺,则其尖如挺,而所以主取大气不出关节者,要亦取法于野而已矣。所谓九
针之数,此非其可考者耶!然灸亦有法矣,而独不详其数者,何也?盖人之肌肤,有浓薄,有
深浅,而火不可以概施,则随时变化而不泥于成数者,固圣人望人之心也。今以灸法言之,
有手太阴之少商焉,灸不可过多,多则不免有肌肉单薄之忌。有足厥阴之章门焉,灸不可不
及,不及则不免有气血壅滞之嫌。至于任之承浆也,督之脊中也,手之少冲,足之涌泉也,
是皆犹之少商焉,而灸之过多,则致伤矣。脊背之膏肓也,腹中之中脘也,足之三里,手之
曲池也,是皆犹之章门焉,而灸之愈多,则愈善矣。所谓灸法之数,此非其仿佛者耶!夫有
针灸,则必有会数法之全,有数法则必有所定之穴,而奇穴者,则又旁通于正穴之外,以随
时疗症者也。而其数维何?吾尝考之《图经》,而知其七十有九焉,以鼻孔则有迎香,以鼻
柱则有鼻准,以耳上则有耳尖,以舌下则有金津、玉液,以眉间则有鱼腰,以眉后则有太阳
,以手大指则有骨空,以手中指则有中魁;至于八邪、八风之穴,十宣、五虎之处,二白、
肘尖、独阴、囊底、鬼眼、髋骨、四缝、中泉、四关,凡此皆奇穴之所在。而九针之所刺者
,刺以此也。灸法之所施者,施以此也。苟能即此以审慎之,而临症定穴之余,有不各得其
当者乎?虽然,此皆迹也,而非所以论于数法奇正之外也。圣人之情,因数以示,而非数之
所能拘,因法以显,而非法之所能泥,用定穴以垂教,而非奇正之所能尽,神而明之,亦存
乎其人焉耳。故善业医者,苟能旁通其数法之原,冥会其奇正之奥,时可以针而针,时可以
灸而灸,时可以补而补,时可以泻而泻,或针灸可并举,则并举之,或补泻可并行,则并行
之,治法因乎人,不因乎数,变通随乎症,不随乎法,定穴主乎心,不主乎奇正之陈迹。譬
如老将用兵,运筹攻守,坐作进退,皆运一心之神以为之。而凡鸟占云 、金版六韬
之书,其所具载方略,咸有所不拘焉。则兵惟不动,动必克敌;医惟不施,施必疗疾。如是
虽谓之无法可也,无数可也,无奇无正亦可也,而有不足以称神医于天下也哉!管见如斯,
惟执事进而教之!
问:九针的方法,始于岐伯,其数量必然有所取意。而灸法唯独没有固定的数量规定,至于确定穴位,都应当审慎对待,所谓的奇穴,也都不可不知。请试着谈谈以考察医术的专业精通程度。
我曾认为,针灸治疗疾病,既有数量又有法则,只有精通于数与法的本源的人,才足以窥探先圣的心意。圣人确立穴位,有奇穴和正穴之分,只有通晓奇正之外道理的人,才足以使济世之术达到神妙的境界,为什么呢?法则是针灸所建立的规范,而数量是用来记录这些法则,以便无穷无尽地运用的。穴位是针灸所确定的部位,而奇穴是用来辅助正穴,从而旁通于不可测度的变化中的。数与法起源于圣人,固然蕴含着精微的义理,而定穴兼用奇正,更是智慧巧思所在。善于从事医学的人,如果能依据法则来详究其数量,沿着正穴来通达奇穴,并且对于圣神心学的要领,那些默然蕴藏在数、法、奇、正之中的内容,又能神明而领悟它,那么还有什么医术不精通,不足以救济百姓呢?
主考官提出策问,询问关于针灸的数量、法则和奇穴,这是期望学生们成为医术专精的人才。而我哪里配得上这样的人选呢?虽然如此,一个普通的读书人,如果心存爱护万物之心,对人一定会有所帮助。我固然不是精通医业的人,但那一念济助万物的诚心,特别深切。况且既然明问涉及于此,怎敢不献上一言以对答。那针灸的方法,究竟依据什么呢?回想上古时期的百姓,质朴未散,元气醇厚,与草木茂盛共生,与鹿猪和谐相处,正要在浑噩自然的天地中相忘,哪里会有疾病,又哪里会有针灸施行的必要呢?自从伏羲、神农以来,人们逐渐变得不如古时淳朴,质朴消散,醇厚变薄,内在受到七情波动的伤害,外在感受六气的侵袭,于是各种疾病都由此交互发作了。岐伯对此感到忧虑,于是衡量病人的虚实,观察寒温情况,斟酌补泻方法,从而制定了针刺之法,继而又制定了灸火之法。至于确定穴位,则在正穴之外,又增加了奇穴。这并不是故意搞得纷繁复杂,而是百姓所受疾病不同,所以施用的方法或许各异,但这终究是不得已而为之,是形势所趋,即使是圣人也不能不顺应这种形势啊。
然而针刺固然有法则,而数量为何一定要取“九”呢?这是因为天地的数理中,阳主生发,阴主肃杀,而“九”是老阳之数,所以期望它能救人而不是杀人,这固然是圣人选取这个数量的用意。现在以九针来说:燥热侵犯头身,则效法天,制成鑱针(chan zhen),针头大而末端锐利;气充满在肌肉间隙,则效法地,制成圆针,针身圆而末端锋锐;锋利如黍米尖端的为鍉针(di zhen),主要用于按压经脉以获取经气,效法人;刃部有三棱形状的为锋针,主要用于泻导痈脓之血,效法四季;铍针(pi zhen)效法音律,末端如剑锋,难道不是用来破溃痈脓的吗?毫针效法律令,针体细似毫毛,难道不是用来调和阴阳的吗?效法星辰则为毫针,尖端如蚊虻,可以疏通经络,祛除各种疾病;效法风则为长针,形体锋利,可以去深部的邪气,治疗痹症痿证;至于燔针(fan zhen)的刺法,其尖端如挺直的棍棒,主要用来取关节内不出来的大气,大概也是效法野外环境罢了。所谓九针的数量,这不就是可以考证的依据吗!
然而灸法也有法则,却唯独不详细规定数量,为什么呢?因为人的肌肤,有厚薄、深浅之分,而火不能一概施用,所以随时变化而不拘泥于固定数量,这固然是圣人希望人们灵活运用的心意。现在以灸法来说:手太阴肺经的少商穴,灸量不可过多,过多则不免有损伤单薄肌肉的忌讳;足厥阴肝经的章门穴,灸量不可不及,不及则不免有气血壅滞的嫌疑。至于任脉的承浆穴,督脉的脊中穴,手少阴心的少冲穴,足少阴肾的涌泉穴,这些都如同少商穴一样,灸量过多就会造成伤害。背部膀胱经的膏肓穴,腹部的中脘穴,足阳明胃经的三里穴,手阳明大肠经的曲池穴,这些都如同章门穴一样,灸量越多越好。所谓灸法的数量,这不就是大致的参照吗!
有了针灸,就必然要会通数与法的全面;有了数与法,就必然有所确定的穴位;而奇穴,则是旁通于正穴之外,以随时间病症变化而施治的。它的数量是多少呢?我曾经考证《图经》,知道共有七十九个。鼻孔处有迎香穴,鼻柱处有鼻准穴,耳上有耳尖穴,舌下有金津、玉液穴,眉间有鱼腰穴,眉后有太阳穴,手大拇指处有骨空穴,手中指处有中魁穴;至于八邪、八风穴,十宣、五虎处,二白、肘尖、独阴、囊底、鬼眼、髋骨、四缝、中泉、四关,凡此这些都是奇穴所在之处。九针所刺的部位,就是刺在这些地方;灸法所施行的部位,也是施行在这些地方。如果能够据此加以审慎对待,那么在临症定穴之余,难道还有不得当的吗?虽然如此,这些都只是表象,并非是在数、法、奇、正之外的讨论范围。圣人的情意,是通过数量来展示的,而非被数量所拘束;通过法则来显现,而非被法则所僵化;通过定穴来垂示教化,而非被奇正所能穷尽。神明而领悟它,也在于个人罢了。所以善于从事医学的人,如果能旁通数与法的本源,冥合奇正的奥妙,该用针时用针,该用灸时用灸,该用补法时用补法,该用泻法时用泻法,或者针灸可以同时并举,就同时举之,或者补泻可以同时并行,就同时行之。治疗方法因人而异,不因循固定数量;变通随病症而定,不僵守固定法则;定穴主导于心,不执着于奇正的陈旧痕迹。譬如老将用兵,筹划攻守,坐作进退,都是运用一心之神明来运作。而那些鸟占云气、金版六韬等书籍中所记载的策略方略,都有不拘泥的地方。所以军队只要不动,一动就必能克敌;医生只要不施治,一施治就必能疗疾。像这样,即使说无法、无数、无奇无正也可以,难道还不足以被称为天下的神医吗?我的浅见如此,恳请主考官进言教导!
Question: The method of the Nine Needles originated from Qibo, and its number must have a specific significance. However, the moxibustion method uniquely lacks a fixed number. Regarding the determination of acupoints, all should be treated with caution; the so-called Extraordinary Acupoints (Qi Xue) are also indispensable to know. Please discuss this to examine one's professional expertise in medical arts.
I have always held that acupuncture and moxibustion for treating diseases involve both numbers and methods. Only those who master the origin of these numbers and methods can sufficiently understand the mind of the Sages. When the Sages established acupoints, they distinguished between Ordinary Acupoints (Zheng Xue) and Extraordinary Acupoints (Qi Xue). Only those who comprehend what lies beyond the distinction between ordinary and extraordinary can make their healing arts divine. Why is this? Methods are the norms established for acupuncture and moxibustion, while numbers serve to record these methods, allowing for endless application. Acupoints are the locations determined for acupuncture and moxibustion, while Extraordinary Acupoints (Qi Xue) assist Ordinary Acupoints (Zheng Xue), enabling access to unpredictable variations. Numbers and methods originated from the Sages, inherently containing profound essence; however, determining acupoints by combining ordinary and extraordinary ones reflects wisdom and skill. A proficient practitioner, if able to detail the numbers based on methods, connect the extraordinary through the ordinary, and spiritually comprehend the essential teachings hidden within the numbers, methods, and the interplay of ordinary/extraordinary, would surely possess impeccable skills sufficient to benefit the people.
The examiner’s inquiry regarding the numbers, methods, and extraordinary acupoints of acupuncture and moxibustion reflects an expectation for students to become specialists. Yet, am I such a person? Nevertheless, even a common scholar, if harboring a heart to cherish all things, will inevitably benefit others. Although I am not a skilled medical practitioner, my intention to aid beings is particularly sincere. Given the explicit question, how dare I refrain from offering a word? What is the basis of acupuncture and moxibustion methods? Tracing back to ancient times, when people were simple and uncorrupted, living harmoniously with flora and fauna, forgetting themselves in the natural state, there were no diseases, nor any need for acupuncture or moxibustion. Since the eras of Fuxi and Shennong, humanity gradually deviated from antiquity; simplicity dissipated, purity thinned. Internally injured by the Seven Emotions (Qi Qing), externally invaded by the Six Evils (Liu Qi), various illnesses arose simultaneously. Qibo, concerned by this, assessed deficiency and excess, observed cold and heat, deliberated tonification and sedation, thereby establishing needle therapy, followed by moxibustion. Regarding acupoint selection, beyond Ordinary Acupoints (Zheng Xue), Extraordinary Acupoints (Qi Xue) were added. This was not done arbitrarily; because patients suffer from different ailments, treatments vary accordingly. It was a necessity driven by circumstances, which even the Sages could not ignore.
Needle therapy has its methods, but why specifically adopt the number "Nine"? In the cosmology of Heaven and Earth, Yang governs life, Yin governs death. "Nine" represents the number of Old Yang, symbolizing the hope to save lives rather than take them; this is the Sage’s intent in choosing this number. Consider the Nine Needles: For dry-heat invading the head and body, resembling Heaven, the Chan Needle (Chan Zhen) is used, characterized by a large head and sharp tip. For qi stagnating in muscle layers, resembling Earth, the Yuan Needle (Yuan Zhen) is used, with a round body and blunt tip. The Di Needle (Di Zhen), sharp as a millet grain, presses meridians to gather qi, resembling Humanity. The Feng Needle (Feng Zhen), with a triangular blade, drains pus and blood from carbuncles, resembling the Four Seasons. The Pi Needle (Pi Zhen), resembling musical tones, has a sword-like tip to lance abscesses. The Hao Needle (Hao Needle), resembling legal precision, is fine as hair to regulate Yin and Yang. Resembling Stars, the Hao Zhen (Mao Zhen, Filiform Needle) is sharp as a mosquito bite, capable of unblocking meridians and curing diseases. Resembling Wind, the Chang Needle (Chang Zhen) is long and sharp to expel deep pathogens and treat Bi syndrome and flaccidity. The Fan Needle (Fan Zhen), resembling wild terrain, has a straight tip to extract trapped qi from joints. Thus, the number nine is verifiable.
However, moxibustion has methods but lacks fixed numbers. Why? Because human skin varies in thickness and depth, and fire cannot be applied uniformly. Flexibility without rigid adherence to fixed numbers reflects the Sage’s desire for adaptability. For instance, Shaoshang (LU11) of the Hand Taiyin Lung Meridian should not receive excessive moxa, as it risks damaging thin flesh. Zhangmen (LR13) of the Foot Jueyin Liver Meridian requires adequate moxa; insufficient application risks qi and blood stagnation. Chengjiang (CV24) of the Ren Mai, Jizhong (GV12) of the Du Mai, Shaochong (HT9) of the Hand Shaoyin Heart Meridian, and Yongquan (KI1) of the Foot Shaoyin Kidney Meridian are like Shaoshang; excessive moxa here causes harm. Conversely, Gaohuang (BL43) on the back, Zhongwan (CV12) in the abdomen, Zusanli (ST36) on the foot, and Quchi (LI11) on the hand are like Zhangmen; more moxa is beneficial. These illustrate the approximate principles of moxibustion quantities.
With acupuncture and moxibustion comes the mastery of numbers and methods; with these comes the determination of acupoints. Extraordinary Acupoints (Qi Xue) extend beyond Ordinary Acupoints (Zheng Xue) to treat conditions dynamically. How many are there? According to the *Tu Jing*, there are seventy-nine. Examples include Yingxiang (LI20) at the nostril, Bizhun at the nasal bridge, Erjian at the ear, Jinjin and Yuye under the tongue, Yuyao between the eyebrows, Taiyang behind the brow, Gu Kong at the thumb, Zhongkui at the middle finger, plus Baxie, Bafeng, Shixuan, Wuhu, Erbai, Zhoujian, Duyin, Nangdi, Guiyan, Kuangu, Sifeng, Zhongquan, and Siguan. These are the locations of Extraordinary Acupoints (Qi Xue). Both needle insertion and moxibustion application target these points. If one exercises caution based on these, clinical accuracy is assured. Yet, these are merely traces. The Sage’s intent uses numbers to demonstrate but is not bound by them; uses methods to reveal but is not rigidified by them; uses acupoints to teach but is not exhausted by ordinary/extraordinary distinctions. Spiritual comprehension depends on the individual.
A skilled practitioner masters the origins of numbers and methods, intuitively grasps the mysteries of ordinary and extraordinary, applies needles or moxa, tonifies or sedates according to timing, combines therapies as needed. Treatment adapts to the patient, not fixed numbers; variation follows symptoms, not rigid methods; point selection relies on the mind, not static categories of ordinary/extraordinary. Like a veteran general planning offense and defense, movement and stillness rely on mental agility. Strategies in texts like Bird Omens or Six Secret Teachings are guidelines, not absolute rules. Thus, military action ensures victory; medical intervention ensures cure. One may speak of having no fixed methods, numbers, or distinctions between ordinary and extraordinary, yet still be hailed as a Divine Physician. Such is my humble opinion, awaiting your instruction.