千金云、病有须针者。即针刺以补泻之。不宜针者。直尔灸之。然灸之大法。其孔穴与
针无
忌。即下白针或温针讫乃灸之。此为良医。其香港脚一病。最宜针。若针而不灸。灸而不针。
非良医也。针灸而药。药不针灸。亦非良医也。但恨下里间知针者鲜尔。所以学人须解用针
。燔针白针皆须妙解。知针知药。固是良医。此言针灸与药之相须也。今人或但知针而不灸
。灸而不针。或惟用药而不知针灸者。皆犯孙真人所戒也。而世所谓医者。则但知有药而已
。针灸则未尝过而问焉。人或诰之。则曰、是外科也。业贵精不贵杂也。否则曰、富贵之家
。未必肯针灸也。皆自文其过尔。吾故详着千金之说以示人云。
千金云、夫用针者。先明其孔穴。补虚泻实。勿失其理。针毛皮腠理、勿伤肌肉。针肌
肉、
勿伤筋脉。针筋脉、勿伤骨髓。针骨髓、勿伤诸络。伤筋膜者、愕视失魂。伤血脉者、烦乱
失
神。伤皮毛者、上气失魄。伤骨髓者、呻吟失志。伤肌肉者、四肢不收。失智。此为五乱。
因针所生。若更失度。有死之忧也。素问亦云、刺骨无伤筋。刺筋无伤肉。刺肉无伤脉。
刺脉无伤皮。刺皮无伤肉。刺肉无伤筋。刺筋无伤骨。刺中心、一日死。中肝、五日死。中
肾、六日死。中肺、三日死。中脾、十日死。中胆、一日半死。刺跗上中大脉、血出不止死
。刺头中脑户、入脑立死。（又无刺大醉大怒大劳大饥大渴大惊新饱云云。详见素问。）
《千金方》说：疾病中有必须用针刺治疗的。就应当用针刺来进行补泻治疗。不适宜用针刺的，就直接施灸。然而艾灸的大法原则是，其选用的孔穴与针刺没有禁忌区别。即在施行普通针刺或温针之后，再进行艾灸。这才是高明的医生。对于香港脚（一种以足部肿痛、麻木为主要表现的疾病）这一病症，最适宜用针刺。如果只针刺而不艾灸，或者只艾灸而不针刺，都不是高明的医生。既用针灸又用药，或者只用药而不知用针灸，也都不是高明的医生。只是遗憾民间懂得针刺的人很少。所以学习医学的人必须懂得运用针刺。燔针（烧红的针）和普通白针都需要精妙地掌握。懂得针刺和药物，固然是高明的医生。这是论述针灸与药物的相互依存关系。现在有的人只知道针刺而不知道艾灸，或者只艾灸而不知道针刺；或者只用药物而不知道针灸，这些都犯了孙思邈真人所告诫的错误。而世间所谓的医生，则只知道有药物罢了。对于针灸却从未过问。有人责问他们，他们就回答说：“这是外科的事。”“职业贵在专精而不贵在杂乱。”否则又说：“富贵人家，未必肯接受针灸。”这都是为自己过失找借口罢了。所以我详细记录《千金方》的说法来展示给人看。
《千金方》说：使用针刺的人，首先要明确穴位。进行补虚泻实的治疗，不要违背其原理。针刺皮毛腠理时，不要伤及肌肉；针刺肌肉时，不要伤及筋脉；针刺筋脉时，不要伤及骨髓；针刺骨髓时，不要伤及诸络脉。损伤筋膜的人，会瞪眼直视、失魂；损伤血脉的人，会心烦意乱、失神；损伤皮毛的人，会上逆气喘、失魄；损伤骨髓的人，会呻吟不止、失志；损伤肌肉的人，会四肢不能收持、失去智慧。这称为五乱，是由针刺不当引起的。如果再失于法度，就有死亡的忧患。《素问》也说：刺骨不要伤筋，刺筋不要伤肉，刺肉不要伤脉，刺脉不要伤皮，刺皮不要伤肉，刺肉不要伤筋，刺筋不要伤骨。针刺中心脏，一天后死亡；刺中肝脏，五天后死亡；刺中肾脏，六天后死亡；刺中肺脏，三天后死亡；刺中脾脏，十天后死亡；刺中胆腑，一天半后死亡。针刺足背上的大脉，出血不止会导致死亡。针刺头部脑户穴，进针深入脑部立即死亡。（另外还有不可在大醉、大怒、大劳、大饥、大渴、大惊、刚吃饱等情况下针刺的规定，详见《素问》。）
The *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) states: Among diseases, there are those that require acupuncture. In such cases, one should use needle insertion to apply tonification or sedation techniques. For conditions not suitable for acupuncture, moxibustion should be applied directly. However, the general principle of moxibustion is that the acupoints selected have no contraindications compared to acupuncture. One may perform standard needle insertion (Bai Zhen) or warm needle therapy first, followed by moxibustion. This constitutes the practice of an excellent physician. Regarding Hongjiao (a disease characterized by swelling and pain in the feet), it is most suitable for acupuncture. If one uses acupuncture but not moxibustion, or moxibustion but not acupuncture, they are not an excellent physician. Using both acupuncture/moxibustion and herbal medicine, or using only herbal medicine without knowledge of acupuncture/moxibustion, also fails to constitute an excellent physician. It is regrettable that few people in common society understand acupuncture. Therefore, students of medicine must learn to utilize acupuncture. Both burning needles (Fan Zhen) and standard needles (Bai Zhen) require profound understanding. Knowing both acupuncture and herbs makes one an excellent physician. This statement illustrates the interdependence of acupuncture, moxibustion, and herbal medicine. Nowadays, some people know only acupuncture but not moxibustion, or only moxibustion but not acupuncture; or rely solely on herbs while ignoring acupuncture and moxibustion. All these violate the warnings given by Sun Simiao (Sun Zhenren). Physicians in the world today merely know about herbs. They never inquire about acupuncture and moxibustion. When questioned, they reply, "This belongs to external medicine," or "A profession values specialization over eclecticism." Others say, "Wealthy families may not consent to acupuncture and moxibustion." These are merely excuses to cover their faults. Thus, I have detailed the statements from the *Qianjin Fang* to show to others.
The *Qianjin Fang* states: Those who use needles must first clearly understand the acupoints. When applying tonification for deficiency and sedation for excess, do not deviate from the principles. When needling the skin, hair, and pores (Cou Li), do not injure the muscles. When needling the muscles, do not injure the sinews and vessels. When needling the sinews and vessels, do not injure the bone marrow. When needling the bone marrow, do not injure the collateral vessels. Injury to the fascia leads to staring eyes and loss of Hun (ethereal soul). Injury to the blood vessels leads to restlessness and loss of Shen (spirit). Injury to the skin and hair leads to upward rushing of Qi and loss of Po (corporeal soul). Injury to the bone marrow leads to groaning and loss of Zhi (willpower). Injury to the muscles leads to inability to control the four limbs and loss of wisdom. These are called the Five Disorders (Wu Luan), caused by improper needling. If further deviations occur, there is danger of death. The *Su Wen* (Basic Questions) also states: Needling the bone should not injure the sinew; needling the sinew should not injure the flesh; needling the flesh should not injure the vessels; needling the vessels should not injure the skin; needling the skin should not injure the flesh; needling the flesh should not injure the sinew; needling the sinew should not injure the bone. Puncturing the Heart results in death within one day; puncturing the Liver results in death within five days; puncturing the Kidney results in death within six days; puncturing the Lung results in death within three days; puncturing the Spleen results in death within ten days; puncturing the Gallbladder results in death within half a day. Puncturing the large vessels on the dorsum of the foot with unceasing bleeding leads to death. Puncturing the Naohu (DU-16) point on the head, if the needle enters the brain, causes immediate death. (Furthermore, there are prohibitions against needling during states of severe drunkenness, anger, fatigue, hunger, thirst, shock, or immediately after a full meal; see the *Su Wen* for details.)