或问《铜人》、《千金》等书空穴多,《十四经发挥》所载空穴少,如风市、督俞、金
津玉液等,彼有此无,不同何也?曰∶《十四经发挥》据《素问》骨空篇论及王注,若《铜
人》、《千金》等皆偏书,非黄岐正经也。
或问∶睛明、迎香、承泣、丝竹空,皆禁灸何也?曰∶四穴近目,目畏火,故禁灸也。
以是推之,则知睛明不可灸,王注误矣。
或问∶用针浑是泻而无补,古人用之,所以导气,治之以有余之病也。今人鲜用之,或
知其无补而不用欤?抑元气禀赋之薄而不用欤?或斫丧之多而用针无益欤?抑不善用而不用
欤?经曰∶阳不足者温之以气,精不足者补之以味。针乃砭石所制,即无气,又无味,破皮
损肉,发窍于身,气皆从窍出矣,何得为补?经曰∶气血阴阳俱不足,勿取以针,和以甘药
,是也,又曰∶形气不足,病气不足,此阴阳皆不足也,不可刺之;刺之重竭其气,老者绝
灭,壮者不复矣。若此谓者,皆是有泻而无补也。
或问∶病有在气分者,有在血分者,不知针家,亦分气与血否?曰∶气分、血分之病,
针家亦所当知。病在气分,游行不定;病在血分,沉着不移。以积块言之,腹中或上或下,
或有或无者,是气分也;或在两胁,或在心下,或在脐上下左右,一定不移,以渐而长者,
是血分也。以病风言之,或左手移于右手,右足移于左足,移动不常者,气分也;或常在左
足,或偏在右手,着而不走者,血分也。凡病莫不皆然。须知在气分者,上有病,下取之,
下有病,上取之;在左取右,在右取左。在血分者,随其血之所在,应病取之。苟或血病泻
气,气病泻血,是谓诛伐无过,咎将谁归!
或问∶今医用针,动辄以袖复手,暗行指法,谓其法之神秘,弗轻示人,惟恐盗取其法
者,不知果何法耶?曰∶《金针赋》十四法,与夫青龙摆尾等法,可谓已尽之矣;舍此而求
他法之神秘,吾未之信也。今若此者,不过过为诡妄,以欺人耳。纵为至巧,殆必神亦不
,针亦不灵也。奚足尚哉!
或问∶有医置针于穴,略不加意,或谈笑,或饮酒,半饷之间,又将针拈几拈,令呼几
呼
,仍复登筵以饮,然后起针,果能愈病否乎?曰∶经云∶凡刺之真,必先治神。又云∶手动
若务,针耀而匀,静意视义,观适之变。又云∶如临深渊,手如握虎,神无营于众物。又云
∶如侍所贵,不知日暮。凡此数说,敬乎怠乎?若谈笑饮酒,不敬孰甚,安能愈病哉?业医者
,当深长思矣!
有人问:《铜人腧穴针灸图经》、《千金方》等书中记载的空穴较多,《十四经发挥》中记载的空穴较少,例如风市、督俞、金津、玉液等穴位,那些书里有而这本书里没有,为什么不同呢?回答说:《十四经发挥》依据的是《素问·骨空论》及王冰的注释,而像《铜人》、《千金》等书属于偏颇之书,并非黄帝与岐伯的正统经典。
有人问:睛明、迎香、承泣、丝竹空这四个穴位,都禁止施灸,为什么呢?回答说:这四个穴位靠近眼睛,眼睛畏惧火邪,所以禁止施灸。由此类推,可知睛明穴不可施灸,王冰的注释是错误的。
有人问:使用针刺完全是泻法而没有补法,古人使用它,是用来疏导气机,治疗有余之病(实证)的。现在的人很少使用它,是知道它没有补益作用而不使用吗?还是因为元气禀赋薄弱而不使用吗?或者是因过度耗损身体,认为用针没有益处而不使用吗?又或者是不会正确使用而不使用吗?《内经》说:阳气不足者,用气来温煦;精气不足者,用味来补益。针是由砭石制成的,既没有气,也没有味,刺破皮肤损伤肌肉,使孔窍开放于身上,气都会从孔窍中散出,怎么能起到补的作用呢?《内经》又说:气血阴阳都不足的情况,不要用针刺治疗,应用甘药调和,这是对的。又说:形体之气不足,病邪之气也不足,这是阴阳都不足的表现,不可针刺;如果针刺,会使其气更加衰竭,老年人会因此死亡,壮年人也不能恢复。像这样的说法,都是指只有泻法而没有补法。
有人问:疾病有的在气分,有的在血分,不知针灸医生是否也区分气和血?回答说:气分和血分的病变,针灸医生也是应当知道的。病在气分,游走不定;病在血分,沉着固定不移。以积聚肿块来说,腹中或上或下,或有或无的,是气分病;如果在两胁,或在心下,或在脐部上下左右,位置固定不移,且逐渐长大的,是血分病。以风病来说,或左手移到右手,右足移到左足,移动不固定的,是气分病;或常在左足,或偏在右手,附着而不移动的,是血分病。大凡疾病没有不是这样的。必须知道病在气分的,上面有病取下面的穴位,下面有病取上面的穴位;左边有病取右边的穴位,右边有病取左边的穴位。病在血分的,随着血所在的部位,对应病症选取穴位。如果血病却泻气,气病却泻血,这叫做诛伐无罪之人,过错归于谁呢!
有人问:现在的医生用针时,动辄用袖子遮住手,暗中施行指法,称其方法神秘,不轻易示人,惟恐别人盗取他们的技法,不知道到底是什么技法呢?回答说:《金针赋》中的十四种手法,以及青龙摆尾等手法,可以说已经穷尽了;舍去这些而去寻求其他手法的奥秘,我不相信。现在像这样的人,不过是过于诡诈妄诞,用来欺骗人罢了。即使技巧极高,恐怕神灵也不会保佑,针也不会灵验。有什么值得推崇的呢!
有人问:有医生将针置于穴位上,完全不在意,或者谈笑,或者饮酒,半顿饭的功夫之间,又将针捻动几次,让病人呼喊几次,然后重新回到宴席上饮酒,之后才起针,真的能治愈疾病吗?回答说:《内经》说:凡是针刺的真谛,必须先治神。又说:手部动作要专注,针体要光亮均匀,静心观察义理,观察适宜的变化。又说:如同面临深渊,手如握虎,精神不被众物所干扰。又说:如同侍奉尊贵的人,忘记日暮。以上几种说法,是恭敬还是怠慢呢?如果谈笑饮酒,还有什么比这更不恭敬的,怎么能治愈疾病呢!从事医学的人,应当深思啊!
Questioner: The *Tongren* (Bronze Man) and *Qianjin* (Thousand Gold Formulas) texts record more empty acupoints, whereas the *Shisi Jing Fahui* (Elucidation of the Fourteen Meridians) records fewer. For instance, Fengshi (GB31), Dushu (BL16), Jinjin (EX-UE10), and Yuye (EX-UE11) are present in the former but absent in the latter. Why is there such a discrepancy?
Responder: The *Shisi Jing Fahui* is based on the "Gu Kong" (Empty Bones) chapter of the *Suwen* (Basic Questions) and Wang Bing’s commentary. In contrast, texts like the *Tongren* and *Qianjin* are considered partial works and not the orthodox classics of Huangdi (Yellow Emperor) and Qibo (Qibo).
Questioner: Jingming (BL1), Yingxiang (LI20), Chengqi (ST1), and Sizhukong (SJ23) are all contraindicated for moxibustion. Why is this so?
Responder: These four points are located near the eyes. Since the eyes fear fire, moxibustion is prohibited at these locations. By inference from this, it is known that Jingming (BL1) should not be moxaed; Wang Bing’s commentary was erroneous.
Questioner: Needle manipulation seems to consist entirely of reducing methods without any tonifying methods. The ancients used needles to guide Qi and treat diseases of excess. Nowadays, people rarely use them. Is it because they know needles lack tonifying effects and thus avoid them? Or is it due to weak constitutional Qi? Or perhaps because excessive depletion renders needle therapy ineffective? Or is it simply due to improper usage? The Classics state: "For deficiency of Yang Qi, warm with Qi; for deficiency of Essence, tonify with Flavor." Needles are made from Bian stones; they possess neither Qi nor Flavor. They pierce the skin, damage the flesh, and open apertures on the body, causing Qi to escape through these apertures. How can they provide tonification? The Classics further state: "When Qi, Blood, Yin, and Yang are all deficient, do not use needles; instead, harmonize with sweet herbs." This is correct. It also states: "When both Form-Qi and Pathogenic-Qi are deficient, this indicates a deficiency of both Yin and Yang; do not puncture. Puncturing will severely deplete their Qi; the elderly will perish, and the robust will fail to recover." Such statements imply that needle therapy offers only reduction and no tonification.
Questioner: Diseases may reside in the Qi level or the Blood level. Do acupuncture practitioners distinguish between Qi and Blood?
Responder: Acupuncture practitioners must understand diseases of the Qi and Blood levels. Disease in the Qi level is migratory and unstable; disease in the Blood level is fixed and immovable. Regarding accumulations and masses: if the mass moves up or down in the abdomen, appearing or disappearing, it belongs to the Qi level. If it is located in the hypochondrium, below the heart, or above/below/left/right of the umbilicus, remaining fixed and gradually enlarging, it belongs to the Blood level. Regarding wind diseases: if symptoms move from the left hand to the right hand, or from the right foot to the left foot, changing frequently, it is a Qi-level disease. If symptoms remain fixed in the left foot or right hand, adhering without moving, it is a Blood-level disease. This applies to all diseases. One must know that for Qi-level diseases, treat upper disorders by selecting lower points, lower disorders by selecting upper points, left-sided disorders by selecting right points, and right-sided disorders by selecting left points. For Blood-level diseases, select points corresponding to the location of the blood pathology. If one reduces Qi when treating Blood disorders, or reduces Blood when treating Qi disorders, this is called punishing the innocent; who shall bear the blame!
Questioner: Modern physicians often cover their hands with sleeves while needling, secretly performing techniques, claiming these methods are mysterious and not shown to others, fearing theft of their skills. What exactly are these methods?
Responder: The fourteen techniques in the *Jinzhen Fu* (Ode to the Golden Needle), along with methods like Qinglong Baiwei (Green Dragon Wags Tail), are comprehensive. To seek mystery beyond these, I cannot believe it. Those who act thus are merely being deceitful and fraudulent to deceive people. Even if highly skilled, surely the Spirit will not bless them, and the needles will not be effective. What is there to admire!
Questioner: Some physicians insert needles into acupoints with little attention, chatting or drinking wine. After half a meal's time, they twirl the needle a few times, ask the patient to call out a few times, return to the banquet to drink, and then remove the needle. Can this truly cure disease?
Responder: The Classics state: "The essence of needling requires first governing the Shen (Spirit)." It also states: "Hand movements must be focused; the needle must be bright and even. Calmly observe the meaning, watching for changes in appropriateness." It further states: "As if facing an abyss, hand like holding a tiger, let the Shen not be distracted by myriad objects." And again: "As if serving a noble person, unaware of the sunset." Do these sayings suggest reverence or negligence? Chatting and drinking wine—what could be more irreverent? How can disease be cured? Practitioners of medicine should reflect deeply on this!