清气在阴,浊气在阳,荥气顺脉,卫气逆行,清浊相干,乱于胸中,是谓大 。故气乱
于心
则烦心密嘿,俯首静伏,乱于肺则俯仰喘喝,按手以呼;乱于肠胃则为霍乱;乱于臂胫则为
四厥乱于头则为厥逆。头重眩仆。曰∶五乱,刺者刺之有道乎?曰∶有道以来,有道以去,
审知其道,是谓身宝。曰∶愿闻其道。曰∶气在于心者,取之手少阴心主之俞;气在于肺者
,取之于手太阴荥,足少阴俞;气在于肠胃者,取之足太阴;阳明不下者,取之三里;气在
于头者,取之天柱大杼,不知取足太阳荥俞;气在臂足,取之先去血脉后取其阳明少阳之荥
俞。曰∶补泻奈何?曰∶徐入徐出,谓之道气;补泻无形,谓之同精。是非有余不足也,乱
气之相逆也。
足阳明之上,血气盛则髯美长,血少气多则髯短,故气少血多则髯少,血气皆少则无髯
,两
吻多尽。足阳明之下,血气盛则下毛美长至胸,血多气少则下毛美短至脐,行则善高举足,
足趾少肉,足善寒,血少气多则肉而善瘃,血气皆少则无毛。有则稀枯悴,善痿厥足痹。足
少阳之上,气血盛则通髯美长,血多气少则通髯美短,血少气多则少髯,血气皆少则无须,
感于寒湿则善痹骨痛爪枯也。足少阳之下,血气盛则胫毛美长。外踝肥,血多气少则胫毛美
短,外踝皮坚而浓,血少气多则 毛少外踝皮薄而软,血气皆少则无毛,外踝瘦而无肉。足
太阳之上,血气盛则眉美,眉有毫毛,血多气少则恶眉,面多少理,血少气多则面多肉,血
气和则美色。足太阴之下,血气盛则跟肉满踵坚,气少血多则瘦跟空,血气皆少则善转筋,
踵下痛。手阳明之上,血气盛则髭美,血少气多则髭恶,血气皆少则无髭。手阳明之下,血
气盛则腋下毛美,手鱼肉以温,气血皆少则手瘦以寒。手少阳之上,血气盛则眉美以长,耳
色美。血气皆少则耳焦恶色。手少阳之下,血气盛则手卷多肉以温,血气皆少则寒以瘦,气
少血多则瘦以多脉。手太阳之上,血气盛则有多须。面多肉以平,血气皆少则面瘦恶色。手
太阳之下,血气盛则掌肉充满,血气皆少则掌瘦以寒。曰∶刺之有约乎?曰∶眉美者足太阳
之脉气血多;恶眉者气血少,其肥而泽者血气有余;肥而不泽者气有余而血不足;瘦而无泽
者,气血俱不足。审察其形气有余不足而调之,可以知逆顺矣。曰∶妇人无须者,无血气乎
?曰∶冲脉任脉,皆起于胞中,上循背里,为经络之海。其浮而外者循腹右上行会于咽喉,
别而络唇口,血气盛则充肤热肉,血独盛则澹渗皮肤生毫毛。今妇人之生,有余于气,不足
于血,以其数脱血也。冲任之脉不荥口唇,故须不生焉。曰∶士人有伤于阴,阴气绝而不起
,阴不用,然其须不去,其故何也?宦者独去何也?曰∶宦者去其宗筋,伤其冲脉,血泻不复
,皮肤内结,唇口不荥,故须不生。曰∶其有天宦者,未尝被伤,不脱于血,然其须不生,
其故何也?曰∶此天之所不足也,其任冲不盛,宗筋不成,有气无血唇口不荥,故须不生。
清气运行于阴分,浊气运行于阳分,荣气顺行于经脉之中,卫气却逆乱而行。清浊二气相互干扰,扰乱于胸中,这就称为“大悗”(指心胸烦闷、神志昏蒙的症状)。
因此,若气机紊乱于心,则会出现心烦意乱、沉默寡言、低头静伏的症状;气机紊乱于肺,则会出现呼吸急促、喘息有声,需用手按压胸部以助呼吸;气机紊乱于肠胃,则会发生霍乱(上吐下泻的急性胃肠病);气机紊乱于手臂和小腿,则会导致四肢厥冷;气机紊乱于头部,则会导致厥逆,出现头重脚轻、眩晕跌倒的症状。
有人问:对于这五种气机逆乱的病症,针刺治疗有规律可循吗?回答说:有进针的道理,也有出针的道理。若能审慎掌握这些道理,就堪称身体的珍宝。
又问:愿闻其详。回答说:气机紊乱在心部的,取用手少阴心经和手厥阴心包经的输穴;气机紊乱在肺部的,取用手太阴肺经的荥穴,以及足少阴肾经的输穴;气机紊乱在肠胃的,取用足太阴脾经;如果效果不佳,则取用足三里穴;气机紊乱在头部的,取用天柱穴和大杼穴,若无效,则取用足太阳膀胱经的荥穴和输穴;气机紊乱在手臂和腿足的,先刺破瘀阻的血脉放血,然后再取用阳明经和少阳经的荥穴和输穴。
又问:补法和泻法如何操作?回答说:缓慢进针、缓慢出针,这叫做“导气”;补泻时不追求外在形式的差异,而注重调和精气。这并不是因为正气有余或不足,而是由于气机逆乱所致。
足阳明胃经循行部位的上方,气血旺盛则胡须美观且长;血少气多则胡须短;气少血多则胡须稀少;气血皆少则没有胡须,口角两侧往往光秃无毛。足阳明胃经循行部位的下方,气血旺盛则阴部毛发美观且长至胸部;血多气少则阴部毛发美观但短至脐部,走路时喜欢高抬脚,脚趾肌肉少,脚容易发凉;血少气多则肌肉消瘦且容易生冻疮;气血皆少则没有阴毛,即使有也稀疏枯槁憔悴,容易发生痿证、厥逆和足痹。
足少阳胆经循行部位的上方,气血旺盛则络腮胡美观且长;血多气少则络腮胡美观但短;血少气多则胡须稀少;气血皆少则没有胡须,感受寒湿邪气则容易发生骨节痹痛、指甲干枯。足少阳胆经循行部位的下方,气血旺盛则小腿毛发美观且长,外踝丰满;血多气少则小腿毛发美观但短,外踝皮肤坚硬厚实;血少气多则小腿毛发稀少,外踝皮肤薄而软;气血皆少则没有小腿毛,外踝瘦削无肉。
足太阳膀胱经循行部位的上方,气血旺盛则眉毛美观,眉中有毫毛;血多气少则眉毛枯恶,面部皱纹多;血少气多则面部肌肉丰隆;气血调和则面色红润美丽。足太阴脾经循行部位的下方,气血旺盛则脚跟肌肉饱满、脚后跟坚实;气少血多则脚跟瘦弱空虚;气血皆少则容易发生转筋(抽筋),脚后跟疼痛。
手阳明大肠经循行部位的上方,气血旺盛则胡须美观;血少气多则胡须枯恶;气血皆少则没有胡须。手阳明大肠经循行部位的下方,气血旺盛则腋下毛发美观,手掌肌肉温暖;气血皆少则手部瘦削且寒冷。
手少阳三焦经循行部位的上方,气血旺盛则眉毛美观且长,耳色润泽美丽;气血皆少则耳朵焦枯、色泽晦暗。手少阳三焦经循行部位的下方,气血旺盛则手部卷曲处肌肉丰满且温暖;气血皆少则手部寒冷且瘦削;气少血多则手部瘦削但血管显露明显。
手太阳小肠经循行部位的上方,气血旺盛则胡须较多,面部肌肉丰满平整;气血皆少则面部瘦削、色泽晦暗。手太阳小肠经循行部位的下方,气血旺盛则手掌肌肉充实;气血皆少则手掌瘦削且寒冷。
有人问:针刺是否有简明的原则?回答说:眉毛美观的人,是足太阳膀胱经的气血充盛;眉毛枯恶的人,是气血不足。形体肥胖且润泽的,说明血气有余;肥胖但不润泽的,说明气有余而血不足;瘦削且不润泽的,说明气血俱不足。审察其形体和气机的有余与不足并进行调理,就可以知晓病情的顺逆了。
又问:妇女没有胡须,是因为没有血气吗?回答说:冲脉和任脉,都起于胞宫,向上沿脊柱内部上行,成为经络之海。其中浮行于体表的分支,沿着腹部右侧上行,会合于咽喉,别出联络唇口。血气旺盛则充盈肌肤、温暖肌肉;若血特别旺盛,则渗透皮肤,生长毫毛。现在妇女之所以不长胡须,是因为她们气有余而血不足,这是因为她们经常失血(月经)的缘故。冲脉和任脉不直接荣润口唇,所以胡须不生。
又问:男子中有人损伤了生殖器,导致宗筋之气断绝而不能勃起,性功能丧失,但是胡须却不脱落,这是什么原因呢?宦官为什么胡须不生呢?回答说:宦官切除了宗筋,损伤了冲脉,血液泻出后不能恢复,皮肤内部结滞,口唇得不到荣润,所以胡须不生。
又问:有一种叫“天宦”的人,未曾受过外伤,也没有失血,但是胡须也不生,这是什么原因呢?回答说:这是先天禀赋不足,他的任脉和冲脉不旺盛,宗筋发育不全,只有气而没有血,口唇得不到荣润,所以胡须不生。
Clear Qi circulates in the Yin aspects, while Turbid Qi circulates in the Yang aspects. Ying (Nutrient) Qi flows smoothly along the meridians, whereas Wei (Defensive) Qi moves in reverse. When Clear and Turbid Qi interfere with each other and become disordered in the chest and heart region, it is termed "Da Man" (severe mental confusion and oppression).
Therefore, if Qi becomes disordered in the Heart, one experiences vexation, silence, a desire to bow the head and remain still. If Qi becomes disordered in the Lung, one suffers from dyspnea and wheezing, often pressing the hands against the chest to aid respiration. If Qi becomes disordered in the Stomach and Intestines, Huoluan (acute gastroenteritis with vomiting and diarrhea) occurs. If Qi becomes disordered in the arms and legs, Si Jue (cold extremities) results. If Qi becomes disordered in the head, Jue Ni (reversal of Qi leading to fainting) occurs, characterized by heavy head, dizziness, and collapse.
A question was asked: Regarding these five types of Qi disorder, is there a principle for acupuncture? The answer was: There is a way for insertion and a way for withdrawal. To carefully understand this way is considered the treasure of the body.
Another question arose: I wish to hear the details. The answer was: For Qi disorder in the Heart, select the Shu (Stream) points of the Hand Shaoyin Heart Meridian and the Hand Jueyin Pericardium Meridian. For Qi disorder in the Lung, select the Ying (Spring) point of the Hand Taiyin Lung Meridian and the Shu (Stream) point of the Foot Shaoyin Kidney Meridian. For Qi disorder in the Stomach and Intestines, select the Foot Taiyin Spleen Meridian; if ineffective, select Zusanli (ST36). For Qi disorder in the Head, select Tianzhu (BL10) and Dazhu (BL11); if ineffective, select the Ying (Spring) and Shu (Stream) points of the Foot Taiyang Bladder Meridian. For Qi disorder in the arms and feet, first puncture the collateral vessels to release blood, then select the Ying (Spring) and Shu (Stream) points of the Yangming and Shaoyang meridians.
Another question arose: How are tonification and sedation performed? The answer was: Slow insertion and slow withdrawal is called "Dao Qi" (guiding Qi). Tonification and sedation without distinct external forms are called "Tong Jing" (harmonizing Essence). This is not due to excess or deficiency of Zheng Qi (Upright Qi), but rather due to the counterflow of disordered Qi.
In the upper part of the Foot Yangming Stomach Meridian, abundant Blood and Qi result in beautiful and long facial hair; less Blood and more Qi result in short hair; less Qi and more Blood result in sparse hair; both deficient Blood and Qi result in no hair, with the corners of the mouth often bare. In the lower part of the Foot Yangming Stomach Meridian, abundant Blood and Qi result in beautiful pubic hair extending to the chest; more Blood and less Qi result in pubic hair extending only to the umbilicus, with a tendency to lift the feet high when walking, thin toes, and cold feet; less Blood and more Qi result in emaciated muscles prone to chilblains; both deficient Blood and Qi result in no pubic hair, or if present, sparse, dry, and withered hair, predisposing to Wei syndrome (flaccidity), Jue Ni, and Bi syndrome (pain/numbness) of the foot.
In the upper part of the Foot Shaoyang Gallbladder Meridian, abundant Blood and Qi result in beautiful and long beard hair; more Blood and less Qi result in short beard hair; less Blood and more Qi result in sparse beard hair; both deficient Blood and Qi result in no beard hair, and susceptibility to Bi syndrome with bone pain and dry nails upon exposure to Cold-Damp. In the lower part of the Foot Shaoyang Gallbladder Meridian, abundant Blood and Qi result in beautiful and long leg hair and a full lateral malleolus; more Blood and less Qi result in short leg hair and thick, hard skin at the lateral malleolus; less Blood and more Qi result in sparse leg hair and thin, soft skin at the lateral malleolus; both deficient Blood and Qi result in no leg hair and a thin, fleshless lateral malleolus.
In the upper part of the Foot Taiyang Bladder Meridian, abundant Blood and Qi result in beautiful eyebrows with terminal hairs; more Blood and less Qi result in ugly eyebrows and many facial wrinkles; less Blood and more Qi result in fleshy faces; harmonious Blood and Qi result in a beautiful complexion. In the lower part of the Foot Taiyin Spleen Meridian, abundant Blood and Qi result in full heel flesh and firm heels; less Qi and more Blood result in thin, hollow heels; both deficient Blood and Qi result in frequent muscle cramps and pain under the heels.
In the upper part of the Hand Yangming Large Intestine Meridian, abundant Blood and Qi result in beautiful mustaches; less Blood and more Qi result in ugly mustaches; both deficient Blood and Qi result in no mustaches. In the lower part of the Hand Yangming Large Intestine Meridian, abundant Blood and Qi result in beautiful axillary hair and warm thenar eminences; both deficient Blood and Qi result in thin, cold hands.
In the upper part of the Hand Shaoyang Sanjiao Meridian, abundant Blood and Qi result in beautiful, long eyebrows and healthy ear color; both deficient Blood and Qi result in dry, dull ears. In the lower part of the Hand Shaoyang Sanjiao Meridian, abundant Blood and Qi result in fleshy, warm hands; both deficient Blood and Qi result in cold, thin hands; less Qi and more Blood result in thin hands with prominent veins.
In the upper part of the Hand Taiyang Small Intestine Meridian, abundant Blood and Qi result in abundant facial hair and smooth, fleshy faces; both deficient Blood and Qi result in thin, dull-faced appearances. In the lower part of the Hand Taiyang Small Intestine Meridian, abundant Blood and Qi result in full palm flesh; both deficient Blood and Qi result in thin, cold palms.
A question was asked: Is there a concise principle for acupuncture? The answer was: Beautiful eyebrows indicate abundant Qi and Blood in the Foot Taiyang Bladder Meridian; ugly eyebrows indicate deficient Qi and Blood. Those who are fat and lustrous have excess Blood and Qi; those who are fat but not lustrous have excess Qi but deficient Blood; those who are thin and not lustrous have both Qi and Blood deficient. By examining the form and Qi for excess or deficiency and regulating accordingly, one can understand the favorable and unfavorable prognoses.
Another question arose: Do women lack Qi and Blood because they do not grow beards? The answer was: The Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) both originate in the Bao Zhong (uterus), ascend along the interior of the back, and serve as the Sea of the Meridians. Their superficial branches ascend along the right side of the abdomen, meet at the throat, and branch out to connect with the lips and mouth. Abundant Blood and Qi nourish the skin and warm the muscles; if Blood is particularly abundant, it渗 (seeps) into the skin and generates fine hair. Women, however, have excess Qi but deficient Blood due to frequent blood loss (menstruation). Since the Chong and Ren meridians do not directly nourish the lips and mouth, beards do not grow.
Another question arose: Why do men who have injured their genitals, causing the Zong Jin (confluence of tendons) to fail to erect and function, yet retain their beards? And why do eunuchs not grow beards? The answer was: Eunuchs have had their Zong Jin removed and their Chong Mai damaged, causing blood loss that does not recover. Internal adhesion of the skin prevents nourishment of the lips and mouth, so beards do not grow.
Another question arose: What about "Tian Huan" (heavenly eunuchs/congenitally barren men) who have suffered no injury, lost no blood, yet do not grow beards? The answer was: This is due to congenital insufficiency. Their Ren and Chong meridians are not vigorous, the Zong Jin fails to develop, there is Qi but no sufficient Blood, and the lips and mouth are not nourished, so beards do not grow.