先疼至不疼时宜退针,先不疼至疼时宜退针即先紧至不紧时出针,先不紧至紧时出针之
谓也。
凡出针以指头肚急按穴眼,勿泄其气,使不出血,复以土按穴上,多揉为妙。如血多揉
必止,此止血法也。再令病患不时揉之,永无后患。
今人习针少而用药多者,恐晕针也。独不知晕针者无不获效,用药不当,难以保全。针
与药较,针易而药难也,胡不学。晕针详后。
神气虚也。古云∶色脉不顺而莫针,并忌风雨雪阴天,及醉劳房事,惊饥居丧之人。先
治三
,今以指甲掐病患鼻下正中肉上,醒而方去,较前更捷。然晕针者,必获大效,以血气交泰
之故,俗云,针不伤人,此之谓也。
南丰李先生治晕针法,晕针不可起针,宜以别针就旁刺之,用袖掩病患口鼻回气,与热
汤饮之即醒,良久再针。甚者针手膊上侧筋骨陷中,即虾蟆肚肉上,名醒醒穴。或三里穴即醒,
其病必愈,若起针坏人。
《难经·六十一难》曰∶经言望而知之谓之神,闻而知之谓之圣,问而知之谓之工,切
脉而知之谓之巧,何谓也?盖望而知之者,望见其五色,以知其病。
《素问·五脏生成篇》云∶色见青如草滋,黄如枳实,黑如 ,赤如 血,白如枯骨者
皆死。青如翠羽,赤如鸡冠,黄如蟹腹,白如豕膏,黑如乌翎者皆生。
闻而知之者,闻其五音以别其病。四明陈氏曰∶五脏有声,而声有音,肝声呼,心声笑
,脾声歌,肺声哭,肾声呻。常则安,变则病,闻何声,则知何经之病也。
问而知之者,问其所欲五味,以知其病所起所在也。(所欲者偏嗜、偏多食之物也。)
切脉而知之者,诊其寸口,视其虚实,以知其所病在何脏腑也。王氏脉法赞曰∶脉有三
部,
漏刻周旋,水下二刻,脉一周身,旋复寸口,虚实见焉。
经言∶以外知之曰圣,以内知之曰神,此之谓也。
凡认真病名,详察后书,诸先生认症定穴,相对不二。病名之下,开用何穴,有二、三
、五
针几分,或灸几壮,或补或泻,或迎或随,或半补半泻,以活经络。或飞经走气,引导气血
。或久留,或去疾。或提或插,或出血、或不出血,俱在前手法之内也。先屡用屡效。
凡后言穴不言针灸者,以针刺之。言灸不言针者,禁针也。言针不言灸者,禁灸也。又
言三分五分者,针刺三分五分深也。言三壮五壮者,艾灸三壮五壮也。
《灵枢·杂症论》∶人身上部病,取手阳明大肠;中部病,取足太阴脾经;下部病,取
足厥
可选一、二穴治之。
在针刺过程中,如果原本疼痛的部位变得不痛了,或者原本不痛的部位开始疼痛了,此时应当退针。这就是所谓的:先紧后松时出针,或先松后紧时出针。
凡起针时,应用手指指腹迅速按压穴位处,以防止经气外泄,并避免出血,随后用泥土覆盖并按压穴位,多揉动为佳。如果出血较多,通过揉搓必然能止血,这是止血的方法。再让患者不时揉按该处,可永久杜绝后患。
如今人们练习针灸少而用药多,是害怕出现晕针现象。殊不知晕针者往往都能获得疗效,而用药不当则难以保全生命。比较针与药,针灸容易而药物难治,为何不学习针灸呢?关于晕针的详细情况见后文。
晕针是因为神气虚弱所致。古语说:面色与脉象不相顺应的情况下不要施针,并且要忌讳风雨雪阴天,以及醉酒、劳累、房事之后,还有受惊、饥饿或处于丧期的人。先前治疗三阴经相关病症(注:此处原文“三”后缺字,结合语境及下文指甲掐人中醒神法,通常指急救或特定虚证,但依原文仅提取明确实体,此处暂译为泛指或保留原意),现在采用指甲掐按患者鼻下正中肉上(水沟穴/人中)的方法,患者苏醒后再离开,比之前的方法更快捷。然而晕针者,必定能获得大效,这是因为气血得以交泰的缘故,俗话所说“针不伤人”,就是这个道理。
南丰李先生治疗晕针的方法是:发生晕针时不可立即起针,宜用另一根针在旁边刺入,用袖子遮盖患者的口鼻以回气,并喂服热汤,患者即可苏醒,过一段时间后再行针刺。病情严重者,针刺手膊外侧筋骨凹陷处(即虾蟆肚肉上),名为“醒醒穴”。或者针刺足三里穴,患者即可苏醒,其病必愈;若此时强行起针则会伤害病人。
《难经·六十一难》说:医经中说望诊而知病情称为神,闻诊而知病情称为圣,问诊而知病情称为工,切脉而知病情称为巧,这是什么意思呢?所谓望而知之,是通过观察五色来知道疾病所在。
《素问·五脏生成篇》说:面色呈现青如枯草、黄如枳实、黑如炭灰、赤如凝血、白如枯骨的都是死证。面色呈现青如翠羽、赤如鸡冠、黄如蟹腹、白如猪脂、黑如乌鸦羽毛的都是生证。
所谓闻而知之,是通过听五音来辨别疾病。四明陈氏说:五脏有声,而声表现为音,肝的声音为呼,心的声音为笑,脾的声音为歌,肺的声音为哭,肾的声音为呻。正常则安康,异常则生病,听到什么声音,就知道是哪条经络的疾病。
所谓问而知之,是询问患者对五味(酸苦甘辛咸)的偏好,从而知道疾病的起因和所在。(所谓“所欲”,是指偏嗜或偏多食用的食物。)
所谓切脉而知之,是诊察寸口脉,观察其虚实,从而知道疾病所在的脏腑。王氏脉法赞说:脉有三部,随着漏刻(古代计时器)的旋转,水下二刻的时间,脉气运行一周身,复回到寸口,虚实之象便显现出来。
经文说:从外部征象判断称为圣,从内部机理判断称为神,说的就是这些。
凡是认真确定病名,详细查阅后书,各位先生认症定穴,观点一致没有二致。在病名之下,列出使用哪些穴位,是一针、二针、三针还是五针,几分深,或者艾灸几壮,或者用补法或泻法,或者用迎随手法,或者半补半泻,以灵活调理经络。或者运用飞经走气法,引导气血。或者久留针,或者疾去针。或者提插,或者出血或不出血,这些都包含在前述的手法之内。先前多次使用都屡试不爽。
凡是后文只言穴位而不言针灸的,表示用针刺。言灸不言针的,禁止针刺。言针不言灸的,禁止艾灸。又说三分、五分的,是指针刺深度为三分或五分。说三壮、五壮的,是指艾灸三壮或五壮。
《灵枢·杂症论》说:人体上部疾病,取手阳明大肠经;中部疾病,取足太阴脾经;下部疾病,取足厥阴肝经。可选一、两个穴位进行治疗。
When acupuncture is performed, if the area that was initially painful becomes painless, or if an initially painless area becomes painful, the needle should be withdrawn. This refers to withdrawing the needle when the sensation changes from tight to loose, or from loose to tight.
Upon withdrawing the needle, one should immediately press the acupoint with the fleshy part of the finger to prevent the leakage of Qi and avoid bleeding. Subsequently, covering the acupoint with earth and massaging it repeatedly is advisable. If there is excessive bleeding, massaging will stop it; this is a hemostatic method. Instructing the patient to massage the area occasionally can permanently prevent future complications.
Currently, people practice acupuncture less and use more medication because they fear syncope during acupuncture (Yun Zhen). They fail to realize that patients who experience syncope often achieve therapeutic effects, whereas improper medication use makes it difficult to preserve life. Comparing needles and drugs, acupuncture is easier while drug therapy is harder; why not learn acupuncture? Details regarding syncope are provided later.
Syncope occurs due to deficiency of Shen Qi (Spiritual Energy). Ancient texts state: "Do not needle when complexion and pulse are discordant," and one must avoid windy, rainy, snowy, or cloudy days, as well as treating individuals who are drunk, exhausted, engaged in sexual activity, startled, hungry, or mourning. Previously, [text missing] was treated first; now, pressing the notch above the upper lip (Shuigou/GV26) with a fingernail wakes the patient quickly, which is faster than before. However, those who experience syncope invariably achieve significant therapeutic effects because their Blood and Qi become harmonious. As the saying goes, "Needles do not harm people," referring to this phenomenon.
Mr. Li from Nanfang's method for treating syncope is: Do not withdraw the needle immediately upon syncope; instead, insert another needle nearby, cover the patient's mouth and nose with a sleeve to help restore Qi, give hot water to drink, and the patient will wake up. After some time, resuming acupuncture is appropriate. For severe cases, needle the depression between the tendons on the lateral aspect of the forearm (referred to as Xiamadu), named "Xingxing" (Waking Up Acupoint). Alternatively, needling Zusanli (ST36) will wake the patient, and the illness will surely heal; withdrawing the needle at this moment would harm the person.
The *Nan Jing* (Classic of Difficult Issues), Chapter 61, states: "The classics say that knowing through observation is called 'Divine' (Shen), knowing through listening/smelling is called 'Sage' (Sheng), knowing through inquiry is called 'Skilled' (Gong), and knowing through palpation is called 'Clever' (Qiao). What does this mean?" Knowing through observation involves seeing the five colors to identify the disease.
The *Su Wen* (Basic Questions), Chapter on the Generation of the Five Zang Organs, says: Complexions appearing green like dead grass, yellow like the fruit of the wild orange, black like charcoal, red like clotted blood, or white like dry bones indicate death. Complexions appearing green like kingfisher feathers, red like chicken combs, yellow like crab bellies, white like pig fat, or black like crow feathers indicate survival.
Knowing through listening involves distinguishing diseases by the five tones. Chen from Siming said: The Zang organs have sounds, manifested as tones. The liver tone is shouting, the heart tone is laughing, the spleen tone is singing, the lung tone is weeping, and the kidney tone is groaning. Normalcy implies health; alteration implies disease. Hearing a specific tone reveals the disease in the corresponding meridian.
Knowing through inquiry involves asking about preferences for the five flavors to determine the origin and location of the disease. ("Desired" refers to foods that are craved or excessively consumed.)
Knowing through palpation involves examining the Cun Kou (radial artery) pulse, observing its excess or deficiency, to identify the affected Zang-Fu organ. Wang's Praise of Pulse Diagnosis states: There are three positions of the pulse. As the clepsydra (water clock) turns, after two units of time, the pulse completes one circulation of the body and returns to the Cun Kou, where excess and deficiency become visible.
The classics state: Knowing from external signs is called 'Sage'; knowing from internal mechanisms is called 'Divine.' This is what is meant.
Regarding the serious determination of disease names, detailed consultation of subsequent texts shows that masters agree on identifying symptoms and selecting acupoints without contradiction. Under each disease name, the text lists which acupoints to use, whether to apply one, two, three, or five needles, the depth (in fen), or the number of moxa cones (zhuang). It specifies whether to use tonification or sedation, Ying-Sui techniques, half-tonification half-sedation, to flexibly regulate meridians. It may involve Fei Jing Zou Qi (Flying Meridian and Moving Qi) methods to guide Blood and Qi. It may involve long retention or rapid withdrawal. Techniques include lifting and thrusting, bleeding or non-bleeding, all contained within the aforementioned manual techniques. These have been used successfully many times.
Where only acupoints are mentioned without specifying acupuncture or moxibustion, it implies needle insertion. Where moxibustion is mentioned but not needles, needle insertion is prohibited. Where needles are mentioned but not moxibustion, moxibustion is prohibited. Measurements of three or five fen refer to needle insertion depth. Mentions of three or five zhuang refer to the number of moxa cones.
The *Ling Shu* (Spiritual Pivot), Chapter on Miscellaneous Diseases, states: Diseases of the upper body are treated by selecting the Hand-Yangming Large Intestine Meridian; diseases of the middle body by the Foot-Taiyin Spleen Meridian; and diseases of the lower body by the Foot-Jueyin Liver Meridian. One or two acupoints can be selected for treatment.