黄帝问岐伯曰余子万民养百姓而收其租税余哀其不终属有疾病余欲勿令被毒药无用砭石欲以微针通其经脉调其血
气营其逆顺出入之会令可传于后世。(五方疗病各不同术今圣人量其所宜杂令行之取十全故次言之子者圣人爱百姓犹赤
子也中有邪伤属诸疾病不终天年有疗之者行于毒药或以砭石伤肤毒药损中可九种微针通经调气以传后代也。)必明为之
法令终而不灭久而不绝。(法令即针经法也。)易用难忘。(毒药砭石粗术之法难用易忘九种针要道易用难忘也。)为之经
纪。(可为微针之经纪也。)异其篇章。(可为微针篇目章句也。)别其表里。(取其腑输为表脏输为里。)为之终始。(微
针之数始之于一终之九也。)令各有形先立针经愿闻其情。(为前五法必须各立形状立前五形之本须作仿经法故请先立针
经欲闻叙针之情也。)岐伯曰臣请推而次之令有纲纪始于一而终于九请言其道。(次之者推九针之序纲纪之次也。)小针
之要易陈而难入也粗守形工守神神乎神客在门未视其疾恶知其源刺之微在速迟粗守关工守机机之动不离空空中之机清
静以微其来不可迎其往不可追知机道者不可挂以发不知机者 之不发知其往来要与之期粗之暗乎眇哉工独有之往者为
逆来者为顺明知逆顺正行无问迎而夺之恶得无虚追而济之恶得无实。(但九针要道下成解中自当其释也之。)迎之随之以
意和之针道毕矣。(逆顺察之于阴阳迎夺施之于补泻。)凡用针者虚则实之满则泄之宛陈则除之邪胜则虚之大要曰徐而疾
则实疾而徐则虚言实与虚若有若无察后与先若亡若存为虚与实若得若失。(言以意调于补泻则针道可穷矣也。)虚实之要
九针最妙补泻之时以针为之。(五方别疗莫先于针所以补泻以针为之也。)泻曰必持而内之放而出之排阳出针疾气得泄。
(凡泻之道内针必持出针必放之摇火其穴排阳耶而出针疾病之气得泄谓之泻也。)按而引针是谓内温血不得散气不得
出。(以手按其所针引之后暖气内聚以心持针不令营血得散外 其门令卫气不得泄出谓之补也。)补曰随随之意若忘之。
(随气呼吸而微动针之也。)若行若悔如蚊虻上。(欲去欲作为行悔也针在皮肤之中去来微动如彼蚊虻止又皮肤微觉有之
也。)如留如还。(针在皮肤之中若似留停人如还去此皆言其候气者也。)去如绝弦。(得气已去即此补阴□补得之也即疾
出针如绝弦者言其速也。)令左属右其气故止。(左手按穴右手行针内气已补右手出针左手 门使气相续不灭也属续
也。)外门已 中气乃实。( 孔为外门也补已不泄故内气得实也。)必无留血急取诛之。(补者留其气也不可留于客邪血
也邪血留者可刺去之故曰急诛之也。)持针之道坚者为实。(持针不坚则气散不从针。)正指直刺针无左右。(刺者欲中其
病若针入左右不当于穴其病不愈也。)神在秋豪。(秋豪谓秋时兔新生豪毛其端锐微也谓怡神在针端调气故曰神在秋豪
也。)属意病者。(念其针下病无邪也。)审视血脉刺之无殆。(审视十二经脉及诸络虚实刺之无殆也殆危也。)方刺之时
必在悬阳及与两衡神属勿去知病存亡。(以所言方刺之时先观气色者也悬阳鼻也悬于衡下也鼻为明堂五脏六腑气色皆见
明堂及与眉上两衡之中故将针者先观气色知死生之候然后刺也。)血所在输横居视之独满切之独坚。(血脉络脉也有脉横
居输穴之中视之满实切之独坚者是横居络脉也。)夫气之在脉也邪气在上浊气在中清气在下故针陷脉则邪气出针中脉则
浊气出针太深则邪气反沉病益甚故曰皮肉筋脉各有所处病各有所含针各有所宜各不同形各以任其所宜无实实无虚虚无
损不之而益有余是谓重病病益甚取五脉者死取三脉者 夺阴者死夺阳者狂针害毕矣。( 区方反怯也气少故怯针害者言
前所禁甚也。)刺之而气不至无问甚数刺之气至乃去之勿复针针各有所宜各不同形任其所为刺之要气至而有效效之候若
风之吹云照乎若见苍天刺之道毕矣。(针入不得其气无由补泻故转针以待气不问其数也得气行补泻已即便出针其病愈速
故譬恶风吹云见苍天也。)黄帝曰愿闻五脏六腑所出之处岐伯曰五脏五输五五二十五输六腑六输六六三十六输经脉十二
络脉十五凡二十七气以上下所出为井所溜为荥所注为输所行为经所入为合也。(二十七气所行皆有五输。)节之交三百六
十五会知其要者一言而终不知其要流散无穷所言节者神气之所游行出入也非皮肉筋骨也睹其色察其目知其散复一其形
听其动静知其邪正右主推之左推之而御持之气至而去凡将用针必先诊脉视气之剧易乃可以治病五脏之气已绝于内而用
针者又实其外是谓重竭重竭则必其死其死也静治之者辄反其气取掖与膺五脏之气已绝于外而用针者又实其内是谓逆厥
逆厥则必死也躁治之者反取四末。(言刺必须诊也。)刺之害中不去则精泄不中而去则致气精泄则病甚而 致气则生为痈
疡。(不中病中精故精泄不中病病虽暂去史致弗气为痈疡也精泄病甚故 也。)
黄帝问岐伯说:我养育万民,安抚百姓并征收他们的租税。我哀怜他们不能终享天年,患有各种疾病,我想不让百姓遭受毒药的伤害,也不使用砭石(一种石器医疗工具),而是希望通过微针来疏通经脉,调和气血,使营卫之气在逆顺出入的交会处正常运行,让这种方法能够流传于后世。(注释:五方治疗疾病的方法各不相同,如今圣人衡量适宜的方法,混合运用以求得十全的效果,所以接着讲述。所谓“子”,是指圣人爱护百姓如同爱护初生的婴儿。体内有邪气损伤,导致各种疾病,不能活到自然寿命终结。如果有治疗者,使用毒药或砭石会损伤皮肤和内脏;而九种微针可以疏通经络、调和气机,以便传给后代。)
必须明确制定相关的法令规范,使其长久存在而不灭绝,经久不衰且易于使用、不易遗忘。(注释:这里的“法令”即指《针经》的法度。)
要将其作为准则加以确立。(注释:可以作为微针治疗的准则。)
要区分篇章结构。(注释:可以作为微针治疗的篇目章节。)
要辨别表里关系。(注释:取六腑的腧穴为表,五脏的腧穴为里。)
要确立始末规律。(注释:微针的数量从一开始,以九结束。)
要使每种针具都有特定的形状,先建立《针经》,我希望了解其中的详细情况。(注释:为了前五种治疗方法,必须各自确立其形态。确立前五种针具的根本,需要仿照《针经》的法度,所以请先建立《针经》,想要听闻叙述关于针道的详细情状。)
岐伯回答说:请允许我按次序推演,使其有纲纪,从一到九,请让我阐述其道。(注释:“次之”是指推演九针的顺序,梳理纲纪的次第。)
小针的要领,容易陈述却难以深入掌握。粗工只拘泥于形体,巧工则注重神气。神妙啊!客邪之气在于门户。尚未观察病情,就要知道病源。针刺的精妙在于速度的快慢。粗工只关注四肢关节,巧工则把握气机。气机的变动不离空虚之处。空中的气机,清静而微妙。邪气来时不可迎击,邪气去时不可追击。懂得气机之道的人,不会因为一丝一毫的偏差而失误;不懂气机之道的人,连气至都不知道。知晓气机的往来,要与之约定时机。粗工愚昧无知,真是渺茫啊!只有巧工才具备这种能力。气去者为逆,气来者为顺。明知逆顺,正行无问。迎而夺之,怎么会不虚?追而济之,怎么会不实?(注释:但这九种针的要道,在下文的成解中自会有相应的解释。)迎随补泻,以意调和,针道就完备了。(注释:通过阴阳察知逆顺,通过迎夺实施补泻。)
大凡用针的原则是:虚证用补法使其充实,实证用泻法使其泄出,瘀血陈积则去除它,邪气盛则削弱它。纲要说:缓进疾出则为补,疾进缓出则为泻。言虚实,好像有又好像无;察先后,好像失又好像存。对待虚证与实证,好像得到又好像失去。(注释:意思是用心调治补泻,那么针道就可以穷尽了。)
虚实的关键,九针最为奇妙。补泻的时机,依靠针具来完成。(注释:五方不同的疗法,没有比针更优先的,所以补泻依靠针具来进行。)
泻法:必须持针进入,摇动而出,推开阳分,出针迅速,使邪气得泄。(注释:凡是泻的方法,进针必须持稳,出针必须放开,摇动针体,推开阳气,使针从阳分出,疾病之气得以泄出,称为泻。)
补法:按压穴位并引导针身,这叫内温,血液不得散逸,气不得外出。(注释:用手按住所针之处,引针之后,暖气向内聚集,用心持针,不让营血散逸,封闭外门,不让卫气泄出,称为补。)
补法:随着气机而行,意念若忘。像行走又像后悔,如蚊虻叮咬。(注释:随着呼吸微微动针。想离去又想行动叫作“行”,想停止叫作“悔”。针在皮肤之中,来来往往微微移动,就像蚊虻停驻,皮肤微微感觉到一样。)
像停留又像返回。(针在皮肤之中,好像停留,人好像返回,这都是形容候气的状态。)
出针时像断弦一样迅速。(得气后随即出针,这就是补阴……补得气后,立即出针,像断弦一样,形容速度很快。)
令左手属右,气机因此止息。(左手按穴,右手行针,内气已补;右手出针,左手封穴,使气相续不灭。“属”通“续”。)
外门已闭,中气乃实。(“孔”为外门。补益后不再泄出,所以内气得实。)
必定不要留血,急取诛除它。(补法要留住正气,不可留有客邪之血。邪血留滞者可刺去,所以说急诛之。)
持针之道,坚定者为实。(持针不坚,则气散而不从针。)
正指直刺,针无左右偏斜。(刺者欲中其病,如果针入左右不当于穴位,病就不会痊愈。)
精神集中在毫毛尖端。(秋毫指秋天兔子新长出的细毛,其端锐微。谓怡神在针端调气,所以说神在秋毫。)
专注在意病人。(念其针下病无邪也。)
审视血脉,刺之无危殆。(审视十二经脉及诸络脉的虚实,刺之无危险。“殆”意为危险。)
当针刺之时,必须在观察鼻部(悬阳)和眉上两衡(眉毛上方两侧)。神志专注勿去,以此知晓病情的存亡。(因为所说的“方刺之时”,是先观察气色。“悬阳”指鼻子,“悬于衡下”。鼻子为明堂,五脏六腑的气色皆见于明堂及眉上两衡之中。所以将针者先观气色,知晓死生之候,然后刺。)
血所在之处,输穴横居,视之独满,切之独坚。(血脉络脉,有脉横居于输穴之中,视之满实,切之独坚,这是横居的络脉。)
夫气在脉中,邪气在上,浊气在中,清气在下。所以针刺陷脉则邪气出,针刺中脉则浊气出。针刺太深则邪气反沉,病益加重。所以说皮肉筋脉各有所处,病各有所含,针各有所宜,各不相同。形各以任其所宜,不要实实,不要虚虚,无损不益,有余是谓重病,病益加重。取五脉者死,取三脉者……夺阴者死,夺阳者狂。针害至此极矣。(“区”音方反,怯也。气少故怯。针害者,言前所禁甚也。)
刺之而气不至,不问次数多少,刺之气至乃去之,勿复针。针各有所宜,各不相同,形任其所为。刺之要,气至而有效。效之候,若风之吹云,豁然见青天。刺之道毕矣。(针入不得其气,无由补泻,故转针以待气,不问其数。得气行补泻已即便出针,其病愈速,故譬恶风吹云见苍天也。)
黄帝说:愿闻五脏六腑所出之处。岐伯说:五脏有五输,五五二十五输;六腑有六输,六六三十六输。经脉十二,络脉十五,凡二十七气以上下。所出为井,所溜为荥,所注为输,所行为经,所入为合。(二十七气所行皆有五输。)
节之交三百六十五会,知其要者一言而终,不知其要,流散无穷。所言节者,神气之所游行出入也,非皮肉筋骨也。睹其色,察其目,知其散复;一其形,听其动静,知其邪正。右主推之,左推之,而御持之。气至而去。凡将用针,必先诊脉,视气之剧易,乃可以治病。
五脏之气已绝于内,而用针者又实其外,是谓重竭。重竭则必死,其死也静。治之者辄反其气,取掖与膺。五脏之气已绝于外,而用针者又实其内,是谓逆厥。逆厥则必死也,躁。治之者反取四末。(言刺必须诊也。)
刺之害:中不去则精泄,不中而去则致气。精泄则病甚而……致气则生为痈疡。(不中病中精,故精泄;不中病,病虽暂去,史致弗气,为痈疡也。精泄病甚,故……也。)
Huangdi asked Qibo, saying: "I nurture the myriad people, comfort the commoners, and collect their taxes. I pity them for not living out their natural lifespan and suffering from diseases. I wish to prevent them from being harmed by toxic medicines and avoid using bian stones (a type of stone medical tool). Instead, I intend to use fine needles to unblock the meridians, regulate qi and blood, and ensure that Ying and Wei Qi circulate normally at their intersections of reversal, smooth flow, entry, and exit, so that this method can be passed down to future generations. (Note: The methods for treating diseases vary across the five directions. Now, the Sage evaluates what is appropriate and combines them to achieve perfect results, hence the following discussion. 'Zi' refers to the Sage's love for the commoners, akin to loving one's own infant. Internal evil injuries lead to various diseases, preventing a full natural life. If treated with toxic medicines or bian stones, skin and internal organs may be damaged; whereas nine types of fine needles can unblock meridians and regulate qi, allowing transmission to descendants.)
One must clearly establish relevant laws and regulations, ensuring they endure without extinction, lasting long and being easy to use yet difficult to forget. (Note: Here, 'laws and regulations' refer to the principles of the *Classic of Acupuncture*.)
It should be established as a standard. (Note: It can serve as the standard for fine needle therapy.)
Chapters and sections should be distinguished. (Note: These can form the chapters and sections of fine needle treatment.)
Exterior and interior relationships should be differentiated. (Note: Take the Shu points of the Six Fu Organs as Exterior, and the Shu points of the Five Zang Organs as Interior.)
A beginning and an end should be established. (Note: The number of fine needles starts from one and ends with nine.)
Each needle should have a specific shape. First, establish the *Classic of Acupuncture*. I wish to hear the details. (Note: To apply the first five methods, each must have its specific form. To establish the foundation of these five needles, one must follow the principles of the *Classic of Acupuncture*. Therefore, let us first establish the *Classic of Acupuncture*, and I wish to hear the detailed description of the Dao of Needling.)
Qibo replied: "Please allow me to deduce them in order, establishing a framework starting from one and ending with nine. Let me explain the Dao." (Note: 'Ci zhi' refers to deducing the sequence of the Nine Needles and organizing the framework.)
The essence of the small needle is easy to state but difficult to master thoroughly. Crude practitioners focus only on physical forms, while skilled practitioners focus on Shen (Spirit/Energy). How profound! The pathogenic factor resides at the gate. Before observing the illness, one must know its source. The subtlety of needling lies in the speed—fast or slow. Crude practitioners guard only the joints of the limbs, while skilled practitioners grasp the movement of Qi. The movement of Qi does not depart from emptiness. The Qi in the void is clear, quiet, and subtle. When the pathogen comes, do not meet it head-on; when it goes, do not pursue it. Those who understand the Dao of Qi will not err by even a hair's breadth; those who do not understand will not even perceive the arrival of Qi. Knowing the coming and going of Qi requires timing. Crude practitioners are ignorant and obscure; only skilled practitioners possess this ability. The departing Qi is Ni (Reversal), the arriving Qi is Shun (Smoothness). Clearly knowing Reversal and Smoothness, proceed correctly without hesitation. Meeting and draining (Ying Er Duo Zhi) leads to deficiency; chasing and supplementing (Zhui Er Ji Zhi) leads to excess. (Note: However, the essentials of the Nine Needles below will be explained in the subsequent commentary.) Meeting and following, harmonized by intention, completes the Dao of Needling. (Note: Observe Reversal and Smoothness through Yin and Yang; implement Draining and Supplementing through Ying and Sui.)
In general, the principle of using needles is: For deficiency, use supplementation to make it solid; for excess, use draining to empty it; for stagnant blood and old accumulation, remove it; for prevailing pathogenic factors, weaken them. The summary states: Slow insertion and rapid withdrawal constitute Supplementation; rapid insertion and slow withdrawal constitute Draining. Speaking of Excess and Deficiency, it seems present yet absent; observing sequence, it seems lost yet existing. Treating Deficiency and Excess feels like gaining and losing. (Note: This means that by mentally regulating Supplementation and Draining, the Dao of Needling can be fully understood.)
The key to Excess and Deficiency lies in the Nine Needles, which are most excellent. The timing of Supplementation and Draining relies on the needle. (Note: Among therapies in the five directions, none is prior to acupuncture; thus, Supplementation and Draining are performed via needles.)
Draining: One must hold the needle upon insertion, release it upon withdrawal, shake it, push away the Yang aspect, withdraw rapidly, and allow the pathogenic Qi to escape. (Note: In all draining methods, insert the needle steadily, release it upon withdrawal, shake the needle body, push away Yang Qi, and withdraw the needle from the Yang layer so that disease Qi escapes. This is called Draining.)
Supplementation: Press the acupoint and guide the needle; this is called 'Internal Warmth'. Blood must not scatter, and Qi must not escape outward. (Note: Use your hand to press the needled area. After guiding the needle, warmth gathers internally. Hold the needle with your mind, preventing Ying Blood from scattering and closing the exterior gate to prevent Wei Qi from escaping. This is called Supplementation.)
Supplementation: Follow the Qi, acting as if forgetting. Move like walking or hesitating, like a mosquito or horsefly biting. (Note: Move the needle slightly with respiration. 'Xing' (walking) implies moving forward; 'Hui' (regret/hesitation) implies stopping. The needle is in the skin, moving slightly back and forth, like a mosquito landing, causing slight sensation in the skin.)
Like staying and returning. (The needle remains in the skin, seeming to stay, while the person seems to return. This describes the state of waiting for Qi.)
Withdraw the needle swiftly, like breaking a string. (After obtaining Qi, withdraw immediately. This supplements Yin... Upon obtaining Qi during supplementation, withdraw quickly, described as swift as a broken string.)
Let the left belong to the right, so the Qi stops. (Left hand presses the acupoint, right hand manipulates the needle; internal Qi is supplemented. Right hand withdraws, left hand seals the pore, ensuring Qi continues without interruption. 'Shu' connects to 'Xu' meaning continuity.)
Once the exterior gate is closed, the internal Qi becomes solid. ('Kong' [pore] is the exterior gate. After supplementation, leakage ceases, so internal Qi becomes solid.)
Do not leave blood; urgently remove it. (Supplementation retains Zheng Qi, not allowing pathogenic blood to remain. Stagnant pathogenic blood can be punctured away, hence 'urgently purge'.)
The way to hold the needle requires firmness to ensure solidity. (If holding the needle is not firm, Qi scatters and does not follow the needle.)
Point straight and pierce vertically; the needle must not deviate left or right. (To hit the disease, if the needle enters incorrectly off the acupoint, the disease will not heal.)
Focus your spirit on the tip of the finest hair. (Autumn Hao refers to the fine new hairs of a rabbit in autumn, sharp and minute. Focusing spirit on the needle tip to regulate Qi is why it says 'Spirit is at the Autumn Hao'.)
Attend to the patient. (Focus on the absence of pathogenic factors under the needle.)
Examine the blood vessels; puncture without danger. (Examine the excess and deficiency of the Twelve Meridians and collateral vessels; puncture without peril. 'Dai' means danger.)
At the time of needling, observe the Xuan Yang (nose) and Liang Heng (areas above the eyebrows). Keep your spirit focused, knowing whether the disease survives or perishes. (Since 'at the time of needling' refers to observing complexion first. 'Xuan Yang' is the nose, hanging below the 'Heng'. The nose is the Ming Tang, where the complexions of the Five Zang and Six Fu organs appear, including the areas above the eyebrows. Thus, the practitioner observes complexion to determine prognosis before needling.)
Where blood resides, collaterals lie horizontally. Visually, they appear full; palpating, they feel uniquely hard. (Blood vessels and collaterals. Collaterals lying horizontally within Shu points appear full upon viewing and hard upon palpation; these are horizontal collaterals.)
Qi resides in the meridians. Pathogenic Qi is in the upper part, turbid Qi in the middle, and clear Qi in the lower part. Therefore, needling deep veins expels pathogenic Qi; needling mid-level veins expels turbid Qi. Needling too deeply causes pathogenic Qi to sink further, worsening the disease. Thus, skin, flesh, sinews, and bones each have their proper locations, diseases have their specific containment, and needles have their specific suitability, all different. Each form serves its appropriate purpose. Do not tonify excess, do not drain deficiency. Do not harm without benefit. Having excess is called severe disease, worsening the condition. Puncturing the Five Pulses leads to death; puncturing the Three Pulses... Depriving Yin leads to death; depriving Yang leads to mania. The harm of needling reaches its peak here. ('Qu' sounds like 'fang fan', meaning timid. Low Qi causes timidity. 'Harm of needling' refers to the severe prohibitions mentioned earlier.)
If Qi does not arrive after needling, regardless of the number of manipulations, wait until Qi arrives, then stop; do not needle again. Each needle has its suitability, differing in form, serving its purpose. The essence of needling is that effectiveness follows the arrival of Qi. The sign of effectiveness is like wind blowing clouds away, revealing the blue sky. The Dao of Needling is complete. (If Qi does not arrive, supplementation and draining cannot occur. Thus, manipulate the needle to await Qi, regardless of count. Once Qi arrives and supplementation/draining is performed, withdraw the needle. The disease heals quickly, likened to bad winds blowing clouds to reveal the clear sky.)
Huangdi said: "I wish to hear about the origins of the Five Zang and Six Fu organs." Qibo said: "The Five Zang have five Shu points, totaling twenty-five. The Six Fu have six Shu points, totaling thirty-six. There are twelve Meridian Qi and fifteen Collateral Qi, totaling twenty-seven Qi moving up and down. Where they emerge are Jing (Well) points; where they trickle are Ying (Spring) points; where they pour are Shu (Stream/Transport) points; where they flow are Jing (River) points; where they enter are He (Sea) points. (All twenty-seven Qi movements have Five Shu points.)"
There are 365 junctions. Knowing the essence allows one to conclude with a single word; not knowing the essence leads to endless dispersion. The 'junctions' referred to are where Shen Qi travels, enters, and exits—not merely skin, flesh, sinew, or bone. Observe the complexion, examine the eyes, to know if Qi is scattered or restored. Unify the form, listen to movements, to know if it is pathogenic or healthy. The right hand pushes forward, the left hand supports and holds. Withdraw when Qi arrives. Generally, to use needles, one must first diagnose the pulse, assess the severity and ease of the Qi condition, and then treat the disease.
If the Qi of the Five Zang is exhausted internally, and the practitioner tonifies the exterior, this is called Double Exhaustion. Double Exhaustion leads to certain death, characterized by stillness. If the practitioner reverses this by taking the axillary and chest regions, it exacerbates the error. If the Qi of the Five Zang is exhausted externally, and the practitioner tonifies the interior, this is called Reverse Jue. Reverse Jue leads to certain death, characterized by restlessness. If the practitioner mistakenly treats the four extremities, it worsens the condition. (This emphasizes that needling must be preceded by diagnosis.)
The harms of needling: If the needle hits the target but is not withdrawn, Essence leaks; if it misses the target and is withdrawn, it causes Qi stagnation. Essence leakage worsens the disease... Qi stagnation generates carbuncles and ulcers. (Hitting the Essence instead of the disease causes leakage; missing the disease leaves residual Qi, forming carbuncles. Essence leakage worsens the disease...)