也,故申明所谓 癃疝肤胀者,犹曰阴气亦盛,而经脉胀不通,故曰 癃疝而肤胀也。
所谓甚则嗌干热中者,阴阳相薄而热,故嗌干也。
《经脉》论云∶足厥阴病,甚则嗌干。手厥阴病,心中热,故申明所谓甚则嗌干热中者,阴
阳相薄而热,热盛于中,故嗌干也。此厥阴外合少阳而为春之终也。
此篇首论刺法之要,各有浅深,浅深不得,致有五脏四时之病。虽欲无之,然不去矣,刺要不綦重欤。
黄帝问曰∶愿闻刺要。
上古以针治病,帝举刺法之要,以教天下后世,故特问之。
岐伯对曰∶病有浮沉,刺有浅深,各至其理,无过其道。
过,平声,下同。浮沉,即浅深。病有浮沉,刺有浅深。犹言病有浅深,而刺因有浅深也。各至其理,
各至皮肉脉筋骨之文理,刺所当至,毋容浅也。无过其道,无过其皮肉脉筋骨之道。刺中其道,毋容过也。
过之则内伤,不及则生外壅,壅则邪从之。
所谓无过其道者,过之则内伤,是太过而反伤其内也。所谓各至其理者,若不及则外生壅肿。
壅则邪从之,是不及而徒伤其外也。
浅深不得,反为大贼,内动五脏,后生大病。
贼,害也。所谓病有浮沉、刺有浅深者,若浅深不得,反为大害。内动五脏,后生四时之大病,如下文所云也。
故曰∶病有在毫毛腠理者,有在皮肤者,有在肌肉者,有在脉
者,有在筋者,有在骨者,有在髓者。
毫毛腠理,毫毛中之腠理也。皮肤,肺之主也。肌肉,脾之主
也。脉,心之主也。筋,肝之主也。骨,肾之主也。髓,骨中精髓
也。肺主皮肤,其外更有毫毛之浅。肾主骨,其内更有髓之深。此病各有在,当分别浅深以为刺也。
是故刺毫毛腠理,无伤皮,皮伤则内动肺,肺动则秋病温疟,溯溯然寒栗。
溯,音素,余篇仿此。此下申明内动五脏,后生大病之意。毫毛腠理,在皮之外。是故刺毫毛腠理
无伤皮,皮伤则内动肺脏之气。肺主秋,动肺则秋病温疟。温疟先热后寒,故溯溯然而寒栗。
刺皮无伤肉。肉伤则内动脾,脾动则七十二日四季之月,病腹胀,烦,不嗜食。
皮在肉之外,故刺皮无伤肉。肉伤则内动脾脏之气。脾主四
季,每季各十八日,共七十二日。动脾则七十二日四季之月,有腹胀之病,腹胀则心烦,而不嗜食。
刺肉无伤脉,脉伤则内动心,心动则夏病心痛。
肉在脉之外,故刺肉无伤脉。脉伤则内动心脏之气,心主夏。心动则夏有心痛之病。
刺脉无伤筋,筋伤则内动肝,肝动则春病热而筋弛。
脉在筋之外,故刺脉无伤筋。筋伤则内动肝脏之气,肝主春,肝动则春病热而筋弛。
刺筋无伤骨,骨伤则内动肾,肾动则冬病胀、腰痛。
筋在骨之外,故刺筋无伤骨,骨伤则内动肾脏之气,肾主冬,肾动则冬病胀而腰痛。
刺骨无伤髓,髓伤则消烁 酸体解 。
酸,作 。骨在髓之外,故刺骨无伤髓。髓伤则动肾脏之精,故精气消烁而 ,精气消烁而体解 。
然不去矣。
总结上文而言。刺伤五内,则有四时之病,其病必生。虽欲无之,然不去矣。刺法之要,所当审也。
因此,进一步阐明所谓“癃疝肤胀”的情况,是说阴气也盛,导致经脉胀满不通,所以称为癃疝而肤胀。
所谓病情严重到咽喉干燥、心中烦热的情况,是因为阴阳之气相互搏结而产生热邪,所以咽喉干燥。
《经脉》篇论述说:足厥阴经发病,严重时会出现咽喉干燥;手厥阴经发病,会出现心中发热。因此进一步阐明所谓“甚则嗌干热中”,是指阴阳相互搏结产生热邪,热邪在体内炽盛,所以出现咽喉干燥。这是厥阴经与少阳经外相配合,对应春季的末尾。
本篇首先论述针刺方法的要点,深浅各有不同,如果深浅不当,会导致五脏和四时发生病变。虽然希望不生病,但病一旦形成就无法消除了,针刺的原则难道不是极其重要吗?
黄帝问道:我希望了解针刺的要领。
上古时代用针治病,黄帝提出针刺法的要点,用来教导天下后世,所以特别询问这一点。
岐伯回答说:疾病有浮(浅)沉(深)之分,针刺也有浅深之别,应当各自达到其应有的层次,不要超过这个限度。
“过”,读平声,以下同此。“浮沉”,即指浅深。疾病有浅深之分,针刺也就有浅深之别。意思是说病位有浅深,针刺也就相应有浅深。所谓“各至其理”,是指各自到达皮、肉、脉、筋、骨的纹理层次,针刺应当达到的深度,不能太浅。所谓“无过其道”,是指不要超过皮、肉、脉、筋、骨的层次。针刺正中其层次,不能太深。
如果刺得太深就会内伤脏腑,刺得太浅则会在体表产生壅滞,壅滞了邪气就会乘虚而入。
所谓“无过其道”,是指刺得太深会内伤,这是太过反而伤害了内部。所谓“各至其理”,是指如果刺得太浅,体表就会产生壅肿。壅滞了邪气就会从之,这是不及反而只伤害了外部。
如果深浅不得当,反而会成为大害,扰动五脏,随后引发严重的疾病。
“贼”,意为危害。所谓疾病有浮沉、针刺有浅深,如果深浅掌握不当,反而成为大的危害。扰动五脏,随后在四季发生大病,就像下文所说的那样。
所以说:疾病有的位于毫毛腠理,有的位于皮肤,有的位于肌肉,有的位于脉,有的位于筋,有的位于骨,有的位于髓。
毫毛腠理,是毫毛中的腠理。皮肤,由肺所主。肌肉,由脾所主。脉,由心所主。筋,由肝所主。骨,由肾所主。髓,是骨中的精髓。肺主皮肤,其外还有更浅的毫毛。肾主骨,其内还有更深的髓。这些病位各不相同,应当分别根据深浅来进行针刺。
因此,针刺毫毛腠理时,不要损伤皮肤,如果损伤皮肤,就会内动肺气,肺气被扰动,则在秋季患温疟,表现为瑟瑟发抖、寒战。
“溯”,音素,其余篇章仿照此类注音。此处下文明确阐述内动五脏、后生大病的意义。毫毛腠理,位于皮肤之外。因此针刺毫毛腠理时不要损伤皮肤,如果损伤皮肤,就会内动肺脏之气。肺主秋,扰动肺则秋季患温疟。温疟先热后寒,所以瑟瑟然地寒战。
针刺皮肤时,不要损伤肌肉。如果损伤肌肉,就会内动脾气,脾气被扰动,则在每季最后十八天(共七十二日,属四季之交)的月份里,出现腹胀、心烦、不想吃东西的症状。
皮肤在肌肉之外,所以针刺皮肤不要损伤肌肉。如果损伤肌肉,就会内动脾脏之气。脾主四季,每季各十八日,共七十二日。扰动脾则在这七十二日四季之交的月份里,出现腹胀的病证,腹胀则心烦,且食欲不振。
针刺肌肉时,不要损伤脉。如果损伤脉,就会内动心气,心气被扰动,则在夏季患心痛。
肌肉在脉之外,所以针刺肌肉不要损伤脉。如果损伤脉,就会内动心脏之气,心主夏。扰动心则夏季患心痛。
针刺脉时,不要损伤筋。如果损伤筋,就会内动肝气,肝气被扰动,则在春季患热病且筋脉弛缓。
脉在筋之外,所以针刺脉不要损伤筋。如果损伤筋,就会内动肝脏之气,肝主春。扰动肝则春季患热病且筋脉弛缓。
针刺筋时,不要损伤骨。如果损伤骨,就会内动肾气,肾气被扰动,则在冬季患腹胀、腰痛。
筋在骨之外,所以针刺筋不要损伤骨。如果损伤骨,就会内动肾脏之气,肾主冬。扰动肾则冬季患腹胀且腰痛。
针刺骨时,不要损伤髓。如果损伤髓,则精气消烁,身体酸软懈怠。
“酸”,通“痠”。骨在髓之外,所以针刺骨不要损伤髓。如果损伤髓,就会扰动肾脏之精,所以精气消烁而身体痠痛懈怠。
然而病就无法消除了。
总结上文而言。针刺损伤五脏,就会产生四季的疾病,这些病必然会发生。虽然希望没有这些病,但病既已发生,就无法消除了。针刺法的要点,应当仔细审察。
Therefore, it further elucidates the condition referred to as "Leng Shan Fu Zhang" (Leng hernia and skin distension), stating that when Yin Qi (Yin energy) is also excessive, causing the Jing Mai (Meridians) to become distended and obstructed, it is thus called Leng hernia accompanied by skin distension.
When the condition becomes severe, manifesting as dryness of the throat and heat in the center (internal heat), this occurs because Yin and Yang Qi interact and clash, generating Heat pathogenic factor; hence, the throat becomes dry.
The *Jing Mai* (Meridian) chapter states: When the Foot Jueyin Meridian is diseased, severe cases present with dryness of the throat; when the Hand Jueyin Pericardium Meridian is diseased, there is heat in the heart. Thus, it further elucidates that for "severe dryness of the throat and heat in the center," it refers to Yin and Yang clashing to generate Heat, with Heat flourishing internally, leading to dryness of the throat. This represents the Jueyin channel externally harmonizing with the Shaoyang channel, corresponding to the end of Spring.
This chapter first discusses the essentials of Needling methods, noting that depth varies according to the condition. If the depth is inappropriate, it may cause diseases in the Zang-Fu organs and correspond to the Four Seasons. Although one wishes to avoid illness, once established, it cannot be removed. Are not the principles of needling extremely important?
The Yellow Emperor asked: I wish to hear about the essentials of needling.
In ancient times, needles were used to treat diseases. The Emperor highlighted the essentials of needling to teach the world and future generations, hence he specifically inquired.
Qibo replied: Diseases have superficial (Fu) and deep (Chen) locations, and needling has shallow and deep depths. One must reach the appropriate level of each without exceeding the proper pathway.
"Guo" (exceed/excess) is pronounced with the flat tone, as below. "Fu Chen" refers to shallow and deep. Just as diseases have shallow and deep levels, needling must correspondingly be shallow or deep. "Each reaching its Li" (texture/principle) means reaching the specific layers of skin, flesh, vessels, sinews, and bones where the needle should penetrate, avoiding being too shallow. "Not exceeding its Dao" (pathway/level) means not penetrating beyond the layers of skin, flesh, vessels, sinews, and bones. The needle must hit the correct level, avoiding being too deep.
If one goes too deep, internal injury occurs; if one does not go deep enough, external stagnation arises, allowing pathogens to enter through this stagnation.
"Not exceeding its Dao" means going too deep causes internal injury, which is excess harming the interior. "Each reaching its Li" means if one does not go deep enough, external swelling/stagnation arises. Stagnation allows pathogens to enter, which is deficiency harming only the exterior.
If the depth is incorrect, it becomes a great harm, disturbing the Five Zang organs and subsequently generating major illnesses.
"Zei" (thief/harm) means damage. Regarding diseases having superficial/deep locations and needling having shallow/deep depths, if the depth is mishandled, it becomes a major harm. Disturbing the Five Zang organs leads to major seasonal illnesses later, as described below.
Thus it is said: Diseases may reside in the Hao Mao Cou Li (hair follicles and interstices), in the Pi Fu (skin), in the Ji Rou (muscle), in the Mai (vessels), in the Jin (sinews/tendons), in the Gu (bones), or in the Sui (marrow).
Hao Mao Cou Li refers to the interstices within the hair follicles. Pi Fu (Skin) is governed by the Lung. Ji Rou (Muscle) is governed by the Spleen. Mai (Vessels) is governed by the Heart. Jin (Sinews) is governed by the Liver. Gu (Bone) is governed by the Kidney. Sui (Marrow) is the essence within the bone. The Lung governs the skin, with the hair being even more superficial. The Kidney governs the bone, with marrow being even deeper. Since these disease locations vary, one must distinguish their depth to determine the needling approach.
Therefore, when needling the Hao Mao Cou Li, do not injure the Pi (skin). If the skin is injured, it internally disturbs the Lung Qi. Disturbance of the Lung leads to Wen Nue (Warm Malaria) in Autumn, characterized by shivering and chills.
"Suo" is pronounced "su," following this pattern for other chapters. The following text clarifies the meaning of internally disturbing the Zang organs and subsequently generating major diseases. Hao Mao Cou Li is outside the skin. Therefore, when needling Hao Mao Cou Li, do not injure the skin. If the skin is injured, it internally disturbs the Lung organ's Qi. The Lung governs Autumn; disturbing the Lung leads to Warm Malaria in Autumn. Warm Malaria presents with heat first and cold later, hence the shivering chills.
When needling the Pi (skin), do not injure the Rou (flesh/muscle). If the flesh is injured, it internally disturbs the Spleen Qi. Disturbance of the Spleen leads to abdominal distension, irritability, and loss of appetite during the 72 days of the Four Seasons (the last 18 days of each season).
Skin is outside the flesh, so when needling the skin, do not injure the flesh. If the flesh is injured, it internally disturbs the Spleen organ's Qi. The Spleen governs the Four Seasons, with 18 days per season totaling 72 days. Disturbing the Spleen leads to abdominal distension during these 72 days of seasonal transition; abdominal distension causes irritability and lack of desire to eat.
When needling the Rou (muscle), do not injure the Mai (vessels). If the vessels are injured, it internally disturbs the Heart Qi. Disturbance of the Heart leads to Heart pain in Summer.
Muscle is outside the vessels, so when needling muscle, do not injure the vessels. If the vessels are injured, it internally disturbs the Heart organ's Qi. The Heart governs Summer; disturbing the Heart leads to Heart pain in Summer.
When needling the Mai (vessels), do not injure the Jin (sinews). If the sinews are injured, it internally disturbs the Liver Qi. Disturbance of the Liver leads to Heat disease and flaccidity of sinews in Spring.
Vessels are outside the sinews, so when needling vessels, do not injure the sinews. If the sinews are injured, it internally disturbs the Liver organ's Qi. The Liver governs Spring; disturbing the Liver leads to Heat disease and flaccidity of sinews in Spring.
When needling the Jin (sinews), do not injure the Gu (bone). If the bone is injured, it internally disturbs the Kidney Qi. Disturbance of the Kidney leads to abdominal distension and lower back pain in Winter.
Sinews are outside the bone, so when needling sinews, do not injure the bone. If the bone is injured, it internally disturbs the Kidney organ's Qi. The Kidney governs Winter; disturbing the Kidney leads to abdominal distension and lower back pain in Winter.
When needling the Gu (bone), do not injure the Sui (marrow). If the marrow is injured, Essence and Qi are depleted, leading to soreness and physical exhaustion.
"Suan" (sour/sore) corresponds to "Suan" (sore/aching). Bone is outside the marrow, so when needling bone, do not injure the marrow. If the marrow is injured, it disturbs the Kidney's Essence. Thus, Essence and Qi are depleted, resulting in soreness and physical exhaustion.
However, the disease will not disappear.
Summarizing the above: If needling injures the Five Internal Organs, seasonal diseases will arise and inevitably occur. Although one wishes to avoid them, once the disease is established, it cannot be eliminated. The essentials of needling must be carefully examined.