鬼哭穴以两手大指相并缚。用艾炷骑缝灸之。令两甲角后肉四处着火。一处不着则不效
按丹溪治一妇人久积怒与酒。病痫。目上视。扬手踯足。筋牵喉响流涎。定则昏昧。腹
胀痛
为肝气所侮而为痛。酒性喜动。出入升降。入内则痛。出外则痫。用竹沥、姜汁、参术膏等
药甚多。痫痛间作无度。乘痛时灸大敦、行间、中脘。间以陈皮、芍药、甘草、川芎汤调石
膏与竹沥服之。无数。又灸太冲、然谷、巨阙。及大指甲肉。且言鬼怪怒骂巫者。丹溪曰。
邪乘虚而入。理或有之。与前药。佐以荆、沥防痰。又灸鬼哭穴。余证调理而安。
本草云。马衔铁无毒。日华子云。古旧铤者好。或作医工针也。
武按本草柔铁即熟铁。有毒。故用马衔则无毒。以马属午、属火。火克金。解铁毒。故
用以作针。古曰。金针者。贵之也。又金为总名。铜铁金银之属皆是也。
危氏书云。乌头、巴豆各一两。硫黄、麻黄各五钱。木鳖子十个。用乌梅药同入磁石器
内。
用皂角水洗。再于犬肉内煮一日。仍用瓦屑打磨净。端直。松子油涂。常近人气为妙。
按煮针非素问意。今根据法煮之。以解铁毒。此有益无害也。
经曰。 针者。以麻油满盏。灯草令多如大指许。丛其灯火烧针。频以麻油蘸其针。烧
令通
针。医者临时用之。以免致手热。才觉针红。医即取针。先以针安穴上。自然干。针之亦佳
。凡行针点灸相似。以墨记之。使针时无差。穴道差。则无功。火针甚难。须有屠儿心、刽
子手。方可行针。先以左手按定其穴。然后针之。切忌太深。深则反伤经络。不可太浅。浅
则治病无功。但消息取中也。凡大醉之后。不可行针。不适浅深。有害无利。凡行火针。必
先安慰病患。令勿惊心。较之火针及灸。灸则直守艾灼烧过。痛则久也。火针虽则视之畏人
。其针下快疾。一针便去。疼不久也。以此则知灸壮候数满足。疼之久也。火针止是一针。
不再则痛过也。凡行火针。一针之后。疾速便去。不可久留。寻即以左手速按针孔上。则疼
止。不按则疼甚。凡下针。先以手按穴。令端正。频以眼视无差。方可下针。烧针之人。委
令定心烧之。恐视他处。针冷治病无功。亦不入内也。人身诸处皆可行针。面上忌之。凡季
夏。大经血盛皆下流两脚。切忌妄行火针于两脚内及足。则溃脓肿疼难退。其如香港脚多发于
夏。血气湿气。皆聚两脚。或误行火针。则反加肿疼。不能行履也。当夏之时。香港脚若发。
药治无效。不免灸之。每一穴上但可灸三壮。劫其病退。壮数之年亦不苦。溃肿脓疮亦易平
。火针者。宜破痈毒发背。溃脓在内。外皮无头者。但按肿软不坚者以溃脓。阔大者按头尾
及中。以点记。宜下三针。决破出脓。一针肿上。不可按之。即以指从两旁捺之。令脓随
手而出。或肿大脓多。针时须侧身回避。恐脓射出污身。孙氏曰。凡下火针。须隔一日报之
。报之后。当脓水大出。疾则效矣。凡 块结积之病。甚宜火针。此非万效之功。火针甚妙
。于结块之上。须停针慢出。仍转动其针。以发出污滞。凡下火针。经一宿。身上发热恶寒
。此为中病。无害事也。火针亦行气。火针惟假火力。无补泻虚实之害。惟怕太深有害。余
则无妨。气针者。有浅有深。有补有泻。候气候邪之难。不可误行。恐虚者反泻。实者不宣
。又以为害。世之制火针者。皆用马衔铁。思之令喜意也。此针惟是要久受火气。铁熟不生
为上。莫如火炉中用废火箸制针为佳也。初制火针。必须一日一夜。不住手以麻油灯火频频
蘸烧。如是终一日一夜。方可施用。凡治瘫痪。尤宜火针易获功效。盖火针大开其孔穴。不
塞其门。风邪从此而出。若气针微细。一出其针。针孔即闭。风邪不出。故功不及火针。灸
者。亦闭门赶贼。其门若闭。邪无出处故也。若风湿寒三者。在于经络不出者。宜用火针。
以外发其邪。针假火力。故功效胜气针也。破痈坚积结瘤等。皆以火针猛热可用。又如川僧
多用煨针。其针大于鞋针、火针。以火烧之可用。即九针之中之大针是也。其针大于气针。
故曰大针者。其功能治风邪入舍于筋骨间不出者宜用之。火针之次也。孙曰。三针者。是锋
针、铍针、火针也。火针即煨针也。
按烧针法仲景以前多用之以致祸。故伤寒书屡言之。如曰。用烧针必惊。烧针令汗。针
处被寒。核起发奔豚。加烧针因胸烦之类。今世或用以出痈脓为便。
鬼哭穴的操作方法是将两手的大拇指并拢捆绑在一起。在两个大拇指指甲后方的缝隙处放置艾炷进行艾灸。要在四个指甲角后的肉际处同时点燃施灸。如果有一处没有烧到，就不会见效。
据记载，朱丹溪曾治疗一位长期郁怒且饮酒的妇女，她患有痫病，表现为眼睛上翻、挥手踢腿、筋脉牵引喉咙发出声响、流口水，发作时意识昏沉，腹部胀满疼痛。这是因为肝气横逆克制脾胃所致疼痛。酒性善于流动，出入升降，进入体内则引起疼痛，排出体外则引发痫病。丹溪使用了大量的竹沥、姜汁、参术膏等药物，但痫痛交替发作，无休无止。在疼痛发作时，他艾灸大敦、行间、中脘穴；平时用陈皮、芍药、甘草、川芎煎汤调服石膏粉和竹沥。经过多次治疗，又艾灸太冲、然谷、巨阙穴以及大指甲肉处。患者甚至出现像被鬼怪附体般愤怒辱骂巫医的情况。丹溪说：“邪气乘虚而入，道理上或许有这种情况。”于是给予之前的药物，并辅以荆芥、竹沥以防痰，再次艾灸鬼哭穴，其余症状通过调理而痊愈。
《本草》记载：马衔铁无毒。日华子说：古旧的铁锭较好。或者将其制成医工用的针。
高武按语：《本草》中的柔铁即熟铁，有毒，所以使用马衔铁则无毒。因为马属午，五行属火，火能克金，从而化解铁的毒性，因此用它来制作针具。古人说“金针”，是表示珍贵之意。另外，“金”是总称，铜、铁、金、银都属于此类。
危氏医书云：乌头、巴豆各一两，硫黄、麻黄各五钱，木鳖子十个。将上述药材与乌梅一起放入磁石器中，用皂角水清洗，再放入犬肉中煮一天。取出后用瓦屑打磨干净，使其端正笔直，涂上松子油，最好经常接近人气（人体温度）为佳。
高武按语：煮针的方法并非出自《素问》的本意，如今依据此法煮针，以解除铁的毒性，这是有益无害的。
《内经》说：制针的方法是，用一盏麻油，灯草要多如大拇指粗细，聚集灯火燃烧针具，频繁地用麻油蘸湿针身，烧至通红。医生临时取用，以避免手受热。刚觉得针红时，医生就取下针，先让针在穴位上自然冷却干燥，然后再针刺，效果也很好。这类似于行针点灸，先用墨汁做标记，使针刺时不致偏差。穴位稍有偏差，就没有疗效。火针很难掌握，必须有屠夫的心肠和刽子手的果断，才可以施行。先用左手按住穴位，然后下针。切忌刺得太深，深了反而损伤经络；不可刺得太浅，浅了治病无功。只要斟酌取其中度即可。凡是喝大醉之后，不可行针，深浅不适，有害无利。凡施行火针，必须先安慰病患，使其不要惊慌。比较火针和艾灸，艾灸是直接守着艾火烧灼，疼痛时间较长；火针虽然看起来让人畏惧，但针下动作快速疾速，一针即去，疼痛时间不久。由此可知，艾灸需要壮数满足，疼痛持续较久；火针只是一针，不再重复，否则疼痛过度。凡施行火针，一针之后，迅速离开，不可久留。随即用左手迅速按压针孔，则疼痛停止；不按则疼痛剧烈。凡下针，先用手按压穴位，使其端正，频繁用眼观察无误，方可下针。烧针的人务必定心烧针，恐怕看别处导致针冷，治病无功，也进不去体内。人身各处都可以行针，面部忌讳。凡在季夏（夏季最后一个月），经脉气血旺盛都向下流向双腿，切忌妄行火针于两脚内侧及足部，否则会导致溃烂脓肿，疼痛难退。比如香港脚（脚气病）多发于夏季，血气湿气都聚集在两脚，如果误行火针，反而加重肿痛，不能行走。当夏季之时，如果香港脚发作，药物治疗无效，不免采用艾灸。每一穴上只可灸三壮，劫夺病势使其消退，即使每年灸也不痛苦，溃肿脓疮也容易平复。火针适宜用于破溃痈毒发背，脓液已在内部，外皮没有脓头的情况。只要按压肿块柔软不坚的地方以排脓，对于阔大的肿块，按压头尾及中间，做点记号，宜下三针，决破排出脓液。一针扎在肿处，不可按压，即用手指从两旁捺压，令脓液随手指流出。如果肿大脓多，针刺时必须侧身回避，恐怕脓液射出污染身体。孙思邈说：凡下火针，须隔一天再次治疗（报之）。治疗后，脓水大量排出，迅速就会见效。凡是结块积聚的疾病，非常适宜用火针。这不是万无一失的功效，但火针非常奇妙。在结块之上，须停留针慢出，并转动针具，以发出污滞之物。凡下火针，过了一夜，身上发热恶寒，这是中病（药效到达病灶），没有害处。火针也能行气。火针只借助火力，没有补泻虚实方面的危害，只怕刺得太深有害，其他则无妨。气针（普通毫针）有浅有深，有补有泻，要候气、候邪气的难易，不可误行，恐怕虚证反泻，实证不宜，又造成伤害。世上制作火针的人，都用马衔铁，思考起来令人喜悦。这种针关键是要长久受火气，铁熟不生为上品，不如在火炉中用废火箸制作针为佳。初制火针，必须一日一夜，不停地用麻油灯火频频蘸烧。这样终了一日一夜，才可以施用。凡治疗瘫痪，尤其适宜用火针，容易获得功效。因为火针大开其孔穴，不堵塞门户，风邪从此而出。若气针微细，一出针，针孔即闭，风邪不出，所以功效不及火针。艾灸也是闭门赶贼，如果门关闭了，邪气没有出路。如果风湿寒三者，停留在经络出不来的，适宜用火针，从外部发散邪气。针借火力，所以功效胜过气针。破溃痈坚积结瘤等，都以火针猛热可用。又如四川僧人多用煨针，其针大于鞋针、火针，用火烧后可用，就是九针中的大针。其针比气针大，所以说大针。其功能治疗风邪入舍于筋骨间出不来的，适宜使用，次于火针。孙思邈说：三针，是指锋针、铍针、火针。火针即煨针。
高武按语：烧针的方法在张仲景以前多用，以致造成祸患，所以《伤寒论》书中屡次提及。如说：用烧针必惊，烧针令汗，针处被寒，核起发奔豚，加烧针因胸烦之类。如今世人有时用它来排出痈脓，较为方便。
Guiku (Ghost Cry) acupoint: Bind the two thumbs together. Place a moxa cone on the seam between them and moxibustion. Ignite the fire at the four fleshy areas behind the nail corners of both thumbs. If one area is not ignited, it will be ineffective.
According to records, Zhu Danxi treated a woman who had long-term anger and consumed alcohol. She suffered from epilepsy (seizure disorder), with eyes rolling upward, waving hands and kicking legs, tendons pulling causing throat sounds, salivation, and unconsciousness during episodes, accompanied by abdominal distension and pain. This was due to Liver Qi invading and causing pain. Alcohol's nature is active, moving up, down, in, and out; entering the interior causes pain, while exiting triggers epilepsy. Danxi used many medicines such as Bamboo Sap (Zhuli), Ginger Juice (Jiangzhi), and Ginseng-Atractylodes Paste (Shenzhu Gao). The epilepsy and pain alternated incessantly. During pain episodes, he moxibusted Dacun (LR1), Xingjian (LR2), and Zhongwan (CV12). Between episodes, he administered Stone Gypsum (Shigao) mixed with Bamboo Sap using a decoction of Tangerine Peel (Chenpi), White Peony Root (Shaoyao), Licorice Root (Gancao), and Szechuan Lovage Rhizome (Chuanxiong). After numerous treatments, he also moxibussed Taichong (LR3), Ran Gu (KI2), Juque (CV14), and the flesh around the big toenail. The patient even exhibited behavior like being possessed by ghosts, angrily scolding shamans. Danxi said, "Evil pathogens enter when deficiency exists; this may be true." He prescribed the previous medicines, assisted by Schizonepeta (Jingjie) and Bamboo Sap to prevent phlegm, and again moxibussed the Guiku acupoints. The remaining symptoms were regulated and she recovered.
The *Bencao* states: Horse bit iron is non-toxic. Rihua Zi says: Old iron ingots are good. Or they can be made into needles for medical use.
Wu's commentary: The *Bencao* mentions that soft iron (shu tie) is actually wrought iron, which is toxic. Therefore, horse bit iron is used because it is non-toxic. Since horses belong to Wu (noon) and the Fire element, and Fire overcomes Metal, it resolves the toxicity of iron. Thus, it is used to make needles. Ancient texts refer to "Gold Needles" (Jin Zhen) to indicate preciousness. Furthermore, "Metal" is a general term encompassing copper, iron, gold, and silver.
Wei Shi's book states: Aconite Root (Wutou) and Croton Seed (Badou) each 1 liang, Realgar (Liuhuang) and Ephedra Herb (Mahuang) each 5 qian, and 10 Momordica Charantia Seeds (Mubiezi). Place these herbs along with a sour plum (Wumei) into a ceramic vessel. Wash with soap pod water, then boil in dog meat for one day. Remove and polish clean with tile dust until straight. Coat with pine nut oil; keeping it close to human body heat is ideal.
Wu's commentary: Boiling needles is not the intent of the *Suwen*. However, following this method to boil needles today helps resolve iron toxicity, which is beneficial and harmless.
The Classics state: To prepare the needle, fill a cup with sesame oil. Use a rush wick as thick as a thumb. Gather the lamp flame to burn the needle. Frequently dip the needle in sesame oil while burning it until it glows red-hot. The physician uses it immediately to avoid heating their hand. As soon as the needle feels red-hot, the physician removes it. First, place the needle on the acupoint to let it cool naturally and dry, then insert it; this is also excellent. This is similar to acupuncture and moxibustion techniques. Mark the point with ink to ensure accuracy during insertion. If the acupoint is off, there will be no effect. Fire needling is difficult and requires the heart of a butcher and the decisiveness of an executioner. Press the acupoint firmly with the left hand first, then insert the needle. Avoid inserting too deeply, as this damages meridians and collaterals. Avoid inserting too shallowly, as this fails to treat the disease. Find the middle ground. Do not perform needling after heavy drunkenness; improper depth is harmful. Before fire needling, comfort the patient to prevent fright. Compared to moxibustion, moxibustion involves direct burning, causing prolonged pain. Fire needling looks intimidating but is quick; the needle is removed immediately after one insertion, so pain is short-lived. Moxibustion requires multiple cones (zhuang), causing longer pain. Fire needling involves only one insertion; repeating it causes excessive pain. After fire needling, remove the needle quickly. Immediately press the puncture site with the left hand to stop pain; otherwise, pain intensifies. Before inserting, press the acupoint to ensure it is centered. Observe carefully with your eyes before inserting. The person burning the needle must focus; looking away may result in a cold needle that fails to treat or penetrate. Needling can be performed on most parts of the body, but the face is contraindicated. In late summer, blood and qi flow heavily to the lower limbs. Be extremely cautious about using fire needling on the inner legs and feet, as it may cause ulceration, abscesses, and persistent pain. For example, Hong Kong Foot (foot odor/athlete's foot or gouty arthritis, here referring to damp-heat bi syndrome) often occurs in summer, with blood, qi, and dampness accumulating in the feet. Misusing fire needling worsens swelling and pain, making walking impossible. In summer, if Hong Kong Foot occurs and medicine is ineffective, moxibustion is unavoidable. Apply only three cones per acupoint to curb the disease progression. Even annual moxibustion is tolerable, and ulcers/abscesses heal easily. Fire needling is suitable for breaking open carbuncles and back boils where pus is internal but the skin has no head. Press the soft, non-hard swelling to drain pus. For large swellings, mark the head, tail, and center. Insert three needles to break open and drain pus. Insert one needle into the swelling without pressing; instead, press from both sides with fingers to guide pus out. If swollen with much pus, stand aside during needling to avoid splashing. Sun Simiao said: After fire needling, repeat treatment every other day. After treatment, large amounts of pus discharge, leading to rapid efficacy. Fire needling is very suitable for masses and accumulations. It is not a universal cure, but very effective. On the mass, keep the needle in place slowly withdrawing, rotating it to expel turbid stagnation. One night after fire needling, fever and aversion to wind/chill occur; this indicates the pathogen is being addressed (Zhong Bing) and is harmless. Fire needling also moves Qi. It relies solely on fire power, avoiding harms of tonification/reduction or excess/deficiency manipulation, except for the risk of deep insertion. Other aspects are safe. Regular acupuncture (Qi Zhen) varies in depth and technique (tonification/reduction), requiring careful timing of Qi and pathogen difficulty. Mistakes can harm deficient patients by reducing them or fail to benefit excess patients. Modern makers of fire needles use horse bit iron, which is a pleasing choice. The key is long exposure to fire; well-heated, non-crystallized iron is best. Using waste fire chopsticks from a furnace is ideal. New fire needles must be burned continuously with sesame oil lamp fire for one day and night before use. Fire needling is especially effective for paralysis because it opens acupoints widely, not sealing the gate, allowing Wind Pathogens to exit. Fine regular needles close the pore immediately upon withdrawal, trapping Wind. Moxibustion is like locking the door to chase thieves; if closed, pathogens have no exit. For Wind-Damp-Cold stuck in meridians, fire needling is suitable to vent pathogens externally via fire power, surpassing regular acupuncture. For breaking hard carbuncles, tumors, and nodules, the intense heat of fire needles is useful. Sichese monks often use heated needles (Wei Zhen), thicker than shoe needles or standard fire needles, heated by fire, corresponding to the Large Needle (Da Zhen) of the Nine Needles. Larger than regular needles, it treats Wind Pathogens trapped in bones and sinews, second only to fire needles. Sun said: The Three Needles refer to Feng Zhen (Pricking Needle), Pi Zhen (Sword Needle), and Huo Zhen (Fire Needle). Fire needle is equivalent to Wei Zhen.
Wu's commentary: Burning needles were commonly used before Zhang Zhongjing, causing disasters, hence frequently mentioned in *Shanghan Lun*. Examples include: burning needles cause fright; inducing sweat via burning needles leads to cold affecting the needle site, forming knots and triggering Running Piglet syndrome (Ben Tun); adding burning needles causes chest irritability. Today, some use it conveniently to discharge pus from carbuncles.