东垣针法。悉本素、难。近世医者。止读玉龙、金针、标幽等歌赋。而于先生之所以垂
教者
东垣曰。黄帝针经。胃病者。胃脘当心而痛。上支两胁。膈咽不通。饮食不下。取三里
以补之。
脾胃虚弱。感湿成痿。汗大泄。妨食。三里、气冲以三棱针出血。若汗不减。不止者。
于三里穴下三寸上廉穴出血。禁酒湿面。
东垣曰。黄帝针经云。从下上者。引而去之。上气不足。推而扬之。盖上气者。心肺上
焦之
刺。泻其经络之壅者。为血凝而不流。故先去之而治他病。
东垣曰。胃气下溜。五脏气皆乱。其为病互相出见。黄帝曰。五乱刺之有道乎。岐伯曰
。有
少阴心主之输神门、大陵。同精导气。以复其本位。
气在于肺者。取之手太阴荥足少阴输鱼际、太 。成痿者。以导温热引胃气出阳道。不
令湿土克肾。其穴在太 。
气在于肠胃者。取之足太阴阳明。不下者。取之三里、章门、中脘。因足太阴虚者。于
募穴
之。如气逆为霍乱者。取三里。气下乃止。不下复始。
气在于头。取之天柱、大杼。不足。取之足太阳荥输通谷、束骨。先取天柱、大杼。不
补不
导去之。
气在于臂足。取之先去血脉。后取其阳明少阴之荥输二间、三间。深取之。内庭、陷谷
深取
去
泻阴火。乃导气同精之法。
帝曰。补泻奈何。曰。徐入徐出。谓之导气。补泻无形。谓之同精。是非有余不足也。
乱气之相逆也。帝曰。允乎哉道。明乎哉问。请着之玉版。命曰治乱也。
东垣曰。阴病治阳。阳病治阴。阴阳应象论云。审其阴阳。以别柔刚。阳病治阴。阴病
治阳
中而外入。在人之背上腑 脏 。是人之受天外客邪。亦有二说。中于阳。则流于经。此病
始于外寒。终归外热。故以治风寒之邪。治其各脏之俞。非止风寒而已。六淫湿暑燥火。皆
五脏所受。乃筋骨血脉受邪。各有背上五脏 以除之。伤寒一说。从仲景。中八风者。有风
论。中暑者。治在背上小肠俞。中湿者。治在胃俞。中燥者。治在大肠俞。此皆六淫客邪
有余之病。皆泻其背之腑俞。若病久传变。有虚有实。各随病之传变。补泻不定。只治在背
腑俞。别有上热下寒。经曰。阴病在阳。当从阳引阴。必须先去络脉经隧之血。若阴中火旺
。上腾于天。致六阳反不衰而上充者。先去五脏之血络。引而下行。天气降下。则下寒之病
自去矣。慎勿独泻其六阳。此病阳亢。乃阴火之邪滋之。只去阴火。只损脉络经隧之邪。勿
误也。阳病在阴者。病从阴引阳。是水谷之寒热。感则害人六腑。又曰。饮食失节。及劳役
形质。阴火乘于坤土之中。致谷气、营气、清气、胃气、元气不得上升。滋于六腑之阳气。
是五阳之气先绝于外。外者天也。下流伏于坤土阴火之中。皆先由喜怒悲忧恐为五贼所伤。
而后胃气不行。劳役饮食不节。继之则元气乃伤。当从胃俞合三里穴中。推而扬之。以伸元
气。故曰从阴引阳。若元气愈不足。治在腹上诸腑之募穴。若传在五脏。为九窍不通。随各
窍之病。治其各脏之募穴于腹。故曰五脏不平。乃六腑元气闭塞之所生也。又曰。五脏不和
。九窍不通。皆阳气不足。阴气有余。故曰。阳不胜其阴。凡治腹之募。皆为元气不足。从
阴引阳。勿误也。若错补四末之 。错泻四末之 。皆非也。错泻者。差尤甚矣。按岐伯所
说。只取穴于天上。天上者。人之背上。五脏六腑之俞。不当泻而泻。岂有生者乎。兴言及
此。寒心切骨。若六淫客邪。及上热下寒。筋骨皮肉血脉之病。苟错取穴于胃之合。及诸腹
之募者必危。亦岐伯之言。下工岂可不慎哉。
东垣曰。三焦元气衰王。黄帝针经云。上气不足。脑为之不满。耳为之苦鸣。头为之倾
。目
东垣曰。一富者前阴臊臭。又因连日饮酒。腹中不和。求先师治之。曰。夫前阴足厥阴
之脉
经中泻行间。是治其本。后于心经中泻少冲。乃治其标。
东垣的针刺方法，完全依据《黄帝内经》和《难经》。近世的医生，只读诵《玉龙歌》、《金针赋》、《标幽赋》等歌赋，而对于李东垣先生所传授的教学内容……
李东垣说：《黄帝针经》记载，胃病表现为胃脘部当心而痛，向上支撑两侧胁肋，膈部和咽喉不通畅，饮食无法下咽。治疗应取足三里穴，采用补法。
脾胃虚弱，感受湿邪导致痿证，大汗淋漓，妨碍进食。治疗取足三里、气冲穴，用三棱针放血。如果汗出不止，就在足三里穴下三寸的上廉穴放血。禁止饮酒及食用面食。
李东垣说：《黄帝针经》云：“病势从下往上发展的，要引导邪气使其离去。”上焦之气不足，要推扬其气。所谓上焦之气，是指心肺所属的上焦部分。
刺法中，泻除经络中壅滞的气血，是因为血液凝滞而不流动，所以先去除壅滞之血，再治疗其他疾病。
李东垣说：胃气下陷，五脏之气都会紊乱，各种病症相互交替出现。黄帝问：五乱（心、肝、脾、肺、肾之气逆乱）针刺有法则吗？岐伯回答：有。
对于少阴心包经的输穴神门、大陵，通过调和精气以引导气机，使其恢复本位。
气逆在肺部的，取手太阴肺经的荥穴鱼际、足少阴肾经的输穴太溪。形成痿证的，通过导引温热之气以引出胃气出于阳道，不让湿土克制肾水。该穴位位于太溪。
气逆在肠胃的，取足太阴脾经和足阳明胃经的穴位。如果效果不佳，取足三里、章门、中脘。因为足太阴脾经虚损，应在募穴处施治。如气逆导致霍乱的，取足三里穴，待气降则停止，若未降则继续操作。
气逆在头部的，取天柱、大杼穴。若属不足，取足太阳膀胱经的荥穴通谷、输穴束骨。先取天柱、大杼穴，不补也不泻，导引而去之。
气逆在手臂和足部的，先取血脉放血，后取其阳明、少阴经的荥穴、输穴二间、三间。深刺内庭、陷谷穴，以泻阴火，这是导气同精的方法。
黄帝问：补法和泻法如何操作？答：缓慢进针，缓慢出针，称为导气。补泻无形，称为同精。这并非针对有余或不足的实证虚证，而是针对逆乱之气。黄帝说：道理确实如此啊！问题问得明明白白。请记录在玉版上，命名为“治乱”。
李东垣说：阴病治阳，阳病治阴。《阴阳应象大论》云：审察阴阳属性，以辨别柔刚。阳病治阴，阴病治阳。
外邪从中而入，侵入人体背部的腑脏。这是人体受外界客邪侵袭，也有两种说法。中于阳经，则流注于经脉。此病始于外寒，最终归于外热。因此治疗风寒之邪，治疗各脏的背俞穴，不仅仅是风寒而已。六淫（风、寒、暑、湿、燥、火）皆由五脏所受，乃是筋骨血脉受邪，各有背上的五脏俞穴以祛除之。关于伤寒的说法，遵从张仲景的观点。中八风者，有《风论》；中暑者，治疗在背上的小肠俞；中湿者，治疗在胃俞；中燥者，治疗在大肠俞。这些都是六淫客邪有余的病证，都泻其背部的腑俞。如果病久传变，有虚有实，各随病情的传变，补泻不定，只治疗背部的腑俞。另有上热下寒的情况，《内经》说：阴病在阳，应当从阳引阴。必须先去络脉经隧中的瘀血。如果阴中火旺，上腾于天，致使六阳反不衰而上充的，先去五脏的血络，引导下行。天气降下，则下寒之病自然去除。千万不要单独泻六阳经。此病为阳亢，乃阴火之邪滋助所致。只去阴火，只损脉络经隧之邪，不要弄错。阳病在阴者，病从阴引阳，是水谷的寒热，感邪则伤害六腑。又说：饮食失节，以及劳役形体，阴火乘于坤土（脾土）之中，致使谷气、营气、清气、胃气、元气不得上升，滋于六腑的阳气。这是五阳之气先在外部衰竭。外部属天，下部伏于坤土阴火之中，皆先由喜怒悲忧恐五种情绪被贼邪所伤，然后胃气不行，劳役饮食不节，接着元气乃伤。应当从胃俞、合三里穴中，推扬其气，以伸展元气。所以说从阴引阳。如果元气更加不足，治疗在腹部的诸腑募穴。如果传变在五脏，导致九窍不通，随各窍的病，治疗各脏的腹部募穴。所以说五脏不平，是六腑元气闭塞所产生的。又说：五脏不和，九窍不通，都是阳气不足，阴气有余。所以说：阳不胜其阴。凡是治疗腹部的募穴，都是因为元气不足，从阴引阳，不要弄错。如果错误地补四肢末端的穴位，或者错误地泻四肢末端的穴位，都不对。错误地泻，差别尤其严重。按照岐伯所说的，只取穴于天上。天上者，指人的背部，即五脏六腑的俞穴。不当泻而泻，哪有能活的人呢？想到这些，令人寒心切骨。如果是六淫客邪，以及上热下寒、筋骨皮肉血脉的病，如果错误地取穴于胃的合穴及诸腹的募穴，必定危险。这也是岐伯的话，下工（低水平的医生）怎么能不谨慎呢？
李东垣说：三焦元气衰弱。《黄帝针经》云：上气不足，脑为之不满，耳为之苦鸣，头为之倾斜，目为之眩。
李东垣说：一位富家子前阴臊臭，又因连日饮酒，腹中不和，求先师治疗。说：前阴是足厥阴肝经所过之处。在肝经中泻行间穴，是治其本。后来在心经中泻少冲穴，是治其标。
Dongyuan's acupuncture methods are entirely based on the *Huangdi Neijing* (Yellow Emperor's Inner Canon) and the *Nan Jing* (Classic of Difficult Issues). Physicians in recent times only read chants such as the *Yulong Ge* (Jade Dragon Song), *Jinzhen Fu* (Golden Needle Ode), and *Biao You Fu* (Standard of Profoundness), but neglect what Master Dongyuan taught.
Dongyuan said: The *Huangdi Zhenjing* records that stomach diseases manifest as pain in the epigastrium corresponding to the heart, radiating upward to support both hypochondria, obstruction in the diaphragm and pharynx, and inability to swallow food. Treatment should involve selecting the ST36 (Zusanli) acupoint and applying the tonification method.
When Spleen and Stomach Qi are weak, dampness is contracted leading to flaccidity syndromes (Wei syndrome), with profuse sweating and impaired appetite. Treatment involves selecting ST36 (Zusanli) and ST30 (Qichong) acupoints, using a three-edged needle for bloodletting. If sweating does not cease, bleed at the Shanglian point located three cun below ST36. Alcohol and wheat products must be prohibited.
Dongyuan said: The *Huangdi Zhenjing* states: "For conditions rising from below, guide them away." When Upper Jiao Qi is insufficient, push and elevate it. The so-called Upper Jiao Qi refers to the Upper Jiao region governed by the Heart and Lung.
In needling, draining the stagnation in meridians and collaterals addresses cases where blood coagulates and fails to flow; thus, one first removes the stagnation before treating other diseases.
Dongyuan said: When Stomach Qi sinks, the Qi of the Five Zang organs becomes chaotic, and various pathologies appear alternately. The Yellow Emperor asked: Is there a principle for needling the Five Disorders (disorder of Qi in Heart, Liver, Spleen, Lung, Kidney)? Qibo answered: Yes.
For the Shu-stream points of the Shaoyin Pericardium meridian, Shenmen (HT7) and Daling (PC7), harmonize Jing and guide Qi to restore its original position.
When Qi rebels in the Lung, select the Ying-Spring point of the Hand Taiyin Lung meridian, Yuji (LU10), and the Shu-stream point of the Foot Shaoyin Kidney meridian, Taixi (KI3). For flaccidity syndromes caused by this, guide warm heat to draw Stomach Qi out through the Yang pathways, preventing Damp Earth from overacting on Kidney Water. This point is located at Taixi (KI3).
When Qi rebels in the intestines and stomach, select points on the Foot Taiyin Spleen and Foot Yangming Stomach meridians. If ineffective, select ST36 (Zusanli), LR13 (Zhangmen), and CV12 (Zhongwan). Because the Foot Taiyin Spleen is deficient, treatment should focus on the Front-Mu points. If Qi rebellion causes cholera-like vomiting and diarrhea, select ST36 (Zusanli); stop when Qi descends, or continue if it has not descended.
When Qi rebels in the head, select BL11 (Tianzhu) and BL12 (Dazhu). If deficiency is present, select the Ying-Spring point Tonggu (BL65) and Shu-stream point Shugu (BL60) of the Foot Taiyang Bladder meridian. First select BL11 (Tianzhu) and BL12 (Dazhu), neither tonifying nor reducing, but guiding the pathogen away.
When Qi rebels in the arms and legs, first bleed the collateral vessels, then select the Ying-Spring and Shu-stream points Erjian (LI2) and Sanjian (LI3) of the Yangming and Shaoyin meridians. Deeply needle Neiting (ST44) and Xianggu (ST43) to drain Yin Fire. This is the method of guiding Qi and harmonizing Jing.
The Yellow Emperor asked: How are tonification and reduction performed? Answer: Slow insertion and slow withdrawal is called Guiding Qi. Tonification and reduction without form is called Harmonizing Jing. This does not refer to excess or deficiency patterns, but to rebellious Qi. The Yellow Emperor said: Truly profound is this Dao! Clearly asked is this question. Please record it on the Jade Tablet, naming it "Treating Chaos."
Dongyuan said: Treat Yang diseases via Yin, and Yin diseases via Yang. The *Yin Yang Ying Xiang Da Lun* states: Examine Yin and Yang to distinguish soft and hard. Treat Yin diseases via Yang, and Yang diseases via Yin.
External pathogens enter from outside, affecting the Fu organs on the back. This represents external pathogenic factors invading the body. There are two explanations. Pathogens entering Yang channels flow into the meridians. Such diseases begin with external Cold and ultimately transform into external Heat. Therefore, to treat Wind-Cold pathogens, one treats the Back-Shu points of the respective Zang organs, not just for Wind-Cold. The Six Excesses (Wind, Cold, Summerheat, Dampness, Dryness, Fire) affect the Five Zang organs, damaging sinews, bones, blood, and vessels, each having corresponding Back-Shu points on the back for removal. Regarding Cold Damage (Shanghan), following Zhang Zhongjing: for Eight Winds, refer to the *Feng Lun*; for Summerheat, treat the Small Intestine Back-Shu point on the back; for Dampness, treat the Stomach Back-Shu point; for Dryness, treat the Large Intestine Back-Shu point. These are all excess conditions caused by external Six Excesses pathogens, treated by draining the Back-Fu Shu points. If the disease persists and transforms, presenting with deficiency or excess, follow the transformation of the disease, adjusting tonification and reduction accordingly, focusing only on the Back-Fu Shu points. In cases of Upper Heat and Lower Cold, the Classic states: Yin disease in Yang should be drawn from Yang to Yin. One must first remove blood stasis from the collaterals and sinews. If Yin Fire is excessive and rises to Heaven, causing the Six Yang channels to remain hyperactive rather than descending, first remove blood stasis from the Five Zang organs and guide it downward. When Heavenly Qi descends, the Lower Cold pathology will naturally resolve. Do not solely drain the Six Yang channels. This condition is Yang hyperactivity fueled by Yin Fire pathogens. Only remove the Yin Fire and the pathogens in the collaterals and sinews; do not err. Yang diseases in Yin should be drawn from Yin to Yang; this involves cold and heat from food and drink, which damage the Six Fu organs when contracted. It is also stated: Irregular diet and physical labor cause Yin Fire to attack Kun Earth (Spleen/Stomach), preventing Grain Qi, Ying Qi, Clear Qi, Stomach Qi, and Yuan Qi from ascending to nourish the Yang Qi of the Six Fu organs. This results in the Five Yang Qi failing externally first. The exterior corresponds to Heaven, while the lower part lies dormant in Kun Earth Yin Fire. All this begins with injury from the Five Thieves (emotions: joy, anger, worry, grief, fear), followed by Stomach Qi stagnation, irregular diet and labor, subsequently injuring Yuan Qi. One should select the ST36 (Zusanli) and GV20 (Baihui - implied contextually or specifically Wei Shu + Zusanli as per text "Wei Shu He San Li") to push and elevate Qi to extend Yuan Qi. Thus it is said: Draw Yang from Yin. If Yuan Qi is severely deficient, treat the Front-Mu points of the Fu organs on the abdomen. If transmitted to the Five Zang organs, causing blockage of the Nine Orifices, treat the Front-Mu points of the respective Zang organs on the abdomen according to the specific orifice pathology. Thus it is said: Disharmony of the Five Zang arises from blockage of Yuan Qi in the Six Fu organs. It is also said: Disharmony of the Five Zang leads to blockage of the Nine Orifices, due to insufficient Yang Qi and excess Yin Qi. Thus: Yang cannot overcome Yin. All treatments of abdominal Front-Mu points address Yuan Qi deficiency, drawing Yang from Yin; do not err. Incorrectly tonifying the extremities or incorrectly reducing the extremities is wrong. Incorrect reduction is even more severe. According to Qibo, one should only select points on "Heaven," which refers to the human back, the Back-Shu points of the Five Zang and Six Fu organs. Reducing when one should not reduce—how could life be preserved? Reflecting on this chills the bone. If Six Excesses pathogens, Upper Heat/Lower Cold, or diseases of sinews, bones, skin, flesh, and blood vessels are mistakenly treated by selecting the He-Sea points of the Stomach or Front-Mu points of the abdomen, danger is certain. This is also Qibo's teaching; how can inferior physicians not be cautious?
Dongyuan said: Sanjiao (Triple Burner) Yuan Qi is weak. The *Huangdi Zhenjing* states: Insufficient Upper Qi leads to a feeling of emptiness in the brain, bitter ringing in the ears, dizziness of the head, and blurred vision.
Dongyuan said: A wealthy man suffered from foul odor in the anterior genitalia. Due to consecutive days of drinking alcohol, his abdomen was uncomfortable. He sought treatment from the Master. He said: The anterior genitalia is traversed by the Foot Jueyin Liver meridian. Draining Xingjian (LR2) in the Liver meridian treats the root. Subsequently, draining Shaochong (HT9) in the Heart meridian treats the branch.