济生拔萃云。有随针而晕者何。曰。一则不知刺禁。如刺中心一日死之类也。二则不明
脉候。如下利其脉忽大者死之类。凡针灸者。先须审详脉候。观察病证。然后知其刺禁。其
经络穴道远近气候息数深浅分寸。
金针赋云。其或晕针者。神气虚也。以针补之。以袖掩之。口鼻气回。热汤与之。略停
少顷。根据前再施。
按以针补之。以所内之针施补也。以袖掩之。掩其口毋令气泄。掩其面毋令迎风也。
指微赋注云。医人深明气血往来。取穴部分不瘥。补泻得宜。必无晕针昏倒之疾。或匆
忙之
穴之络。假令针肝络血晕。以补本经曲泉穴之络。针入复苏。效如起死。余皆仿此。
刘宗浓曰。晕针者。夺命穴救之。男左女右取之。不回。却再取右。女亦然。此穴正在
手膊上侧筋骨陷中虾蟆儿上。自肩至肘正在当中。
按晕针三法。指微赋有理。刘氏止言夺命穴。而不言何经何络。今按此穴分是肺大肠脉
分。而古亦无夺命穴之名也。
危氏书云。治针灸伤经络。脓血不止。黄 八两、当归三两、肉桂、木香、乳香别研、
沉
素问遗篇注云。用圆利针、长针。未刺时。先口温针暖而用之。又曰。先以口衔针令温
。又曰。毫针于人近体暖针至温。又曰。着身温之。
按口体温针。欲针入经穴。气得温而易行也。今或投针于热汤中。亦此意耳。口温与体
温微有不同。口温者。针头虽热而柄尚寒。不若着身温之。则针通身皆热矣。
《济生拔萃》说:有随着进针而发生晕针现象的,是什么原因呢?回答说:一是不知道针刺的禁忌,比如刺中心脏一天后死亡之类的情形。二是不明了脉象的变化,比如腹泻患者脉象突然变大导致死亡之类的情形。凡是进行针灸的人,必须先仔细审察脉象,观察病症,然后才能知晓针刺的禁忌。对于经络穴道的远近、气候(指人体对气候的反应或针刺时的气机变化)、呼吸次数、深浅分寸等,都需要了解。
《金针赋》说:如果出现晕针现象,是因为神气虚弱。应当用补法施针,用袖子遮挡住患者,待口鼻气息恢复后,给予热汤饮用,稍作休息片刻后,再根据之前的情况重新施针。
按语解释:“用补法施针”,是指对所留之针施行补法。“用袖子遮挡”,是遮住口部不让气泄出,遮住面部不让受风。
《指微赋》注解说:医生如果深刻明白气血的往来规律,取穴部位没有差错,补泻手法得当,必然不会出现晕针昏倒的疾病。如果是匆忙间误伤了穴位络脉,例如针刺肝经络脉导致血晕,可以通过补益本经曲泉穴的络脉来治疗,针入后患者即可复苏,效果如同起死回生。其余情况都仿照此法处理。
刘宗浓说:发生晕针时,用夺命穴急救。男性取左侧,女性取右侧。如果无效,再取另一侧。女性亦然。这个穴位正好在手臂外侧筋骨凹陷处,虾蟆骨上方,从肩到肘的正中间位置。
按语评论:关于晕针的三种治疗方法,《指微赋》讲得有理。刘氏只提到了夺命穴,却没有说明属于哪条经络和络脉。现在考证这个穴位分属肺经和大肠经脉,而且古代也没有“夺命穴”这个名称。
危氏的书说:治疗因针灸损伤经络导致的脓血不止,使用黄芪八两、当归三两、肉桂、木香、乳香(另研细末)。
《素问遗篇注》说:使用圆利针、长针时,在未针刺之前,先用口将针暖热后再使用。又说:先含在口中让针变温。又说:毫针在使用前要在人身体附近暖热至温热程度。又说:贴身温暖它。
按语解释:用口温针,是想让针进入经络穴位时,经气因为温暖而容易运行。现在有人把针投入热汤中,也是这个意思。口温与体温略有不同。口温的话,针头虽然热但针柄还是冷的,不如贴身温暖它,这样针身通体皆热了。
The *Jisheng Bacui* states: What is the reason for syncope occurring simultaneously with needle insertion? The answer is: First, ignorance of acupuncture contraindications, such as puncturing the heart leading to death within one day. Second, failure to understand pulse indications, such as a sudden enlargement of the pulse in patients with diarrhea leading to death. In all cases of acupuncture and moxibustion, one must first carefully examine the pulse and observe the disease manifestations to know the contraindications. One must also be familiar with the distance between meridians and acupoints, climate factors (referring to the body's reaction to climate or qi dynamics during needling), respiration counts, depth, and measurements.
The *Jinzhen Fu* (Golden Needle Ode) states: If syncope occurs, it is due to deficiency of Shen Qi (Spiritual Qi). It should be treated with tonification methods. Cover the patient with a sleeve. Wait until breath returns to the mouth and nose, then provide hot water. Allow them to rest for a short while, then re-treat according to the previous condition.
Commentary explains: "Treating with tonification" refers to applying tonifying techniques to the retained needle. "Covering with a sleeve" means covering the mouth to prevent qi leakage and covering the face to prevent exposure to wind.
The commentary on the *Zhiwei Fu* (Ode to Subtle Meanings) states: If a physician thoroughly understands the flow of Qi and Blood, selects acupoints accurately without error, and applies tonification and sedation appropriately, there will certainly be no instances of syncope or fainting. However, if an acupoint collateral is accidentally injured due to haste—for example, causing blood syncope by needling the Liver meridian collateral—one can treat it by tonifying the collateral of the Ququan (LR 8) acupoint of the same meridian. Upon needle insertion, the patient revives, with effects akin to raising the dead from the grave. Other cases should follow this pattern.
Liu Zongnong stated: For syncope, use the Duoming (Life-Saving) acupoint for rescue. For males, select the left side; for females, the right side. If ineffective, switch to the other side. Females follow the same rule. This acupoint is located precisely in the depression between the tendons and bones on the lateral aspect of the arm, above the "toad bone," exactly midway from the shoulder to the elbow.
Commentary notes: Regarding the three methods for treating syncope, the *Zhiwei Fu* provides sound reasoning. Liu only mentioned the Duoming acupoint but did not specify which meridian or collateral it belongs to. Current analysis indicates this point is divided between the Lung and Large Intestine meridians. Furthermore, the name "Duoming acupoint" does not exist in ancient texts.
Wei Shi’s book states: To treat continuous pus and blood discharge caused by acupuncture damaging the meridians, use Huangqi (Astragali Radix, 8 liang), Danggui (Angelicae Sinensis Radix, 3 liang), Rougui (Cinnamomi Cortex), Muxiang (Aucklandiae Radix), and Ruxiang (Olibanum, separately ground).
The commentary on the *Suwen Yipian* (Lost Chapters of the Yellow Emperor’s Inner Canon) states: When using Yuanli needles or Chang needles, warm the needle with one's mouth before insertion. It also states: Hold the needle in the mouth to warm it first. It further states: Warm the filiform needle near the body until it is lukewarm. It also states: Keep it close to the body to warm it.
Commentary explains: Warming the needle with the mouth aims to facilitate the smooth flow of Jing Qi (Meridian Qi) upon entry into the acupoint due to warmth. Placing the needle in hot water achieves a similar intent. There is a slight difference between mouth-warming and body-warming. Mouth-warming heats the needle tip while the handle remains cold. Body-warming is superior, as it heats the entire needle uniformly.