因药之性,资火之神,由皮肤而行血脉,使郁者散,屈者伸,则熨引为力多矣,引取舒
伸之义,以熨能然,《血气形志论》曰∶病生于筋,治以熨引。《玉机真藏论》曰∶痹不仁
肿痛,可汤熨及火灸刺之。盖病生于筋,则拘急挛缩,痹而不仁,则经血凝泣。二者皆由外
有所感,熨能温之,血性得温则宣流,能引凝泣也。
可按可摩,时兼而用,通谓之按摩。按之弗摩,摩之弗按,按止以手,摩或兼以药,曰
按曰摩,适所用也。《血气形志论》曰∶形数惊恐,经络不通,病生于不仁,治之以按摩,
此按摩之通谓也。《阴阳应象论》曰∶其剽悍者,按而收之。《通评虚实论》曰∶痈不知所
,按之不应,乍来乍已,此按不兼于摩也。华佗曰∶伤寒始得一日在皮肤,当摩膏火灸即愈
,此摩不兼于按必资之药也。世之论按摩,不知析而治之,乃合导引而解之,夫不知析而治
之,固已疏矣。又合以导引,益见其不思也,大抵按摩法,每以开达抑遏为义,开达则壅蔽
者以之发散,抑遏则剽悍者有所归宿,是故按一也,有施于病之相传者,有施于痛而痛止者
,有施于痛而无益者,有按之而痛甚者,有按之而快然者,概得陈之,风寒客于人,毫毛毕
直,皮肤闭而为热,或痹不仁而肿痛,既传于肝,胁痛出食,斯可按也。肝传之脾,名曰脾
风,发瘅腹中热,烦心出黄,斯可按也。脾传之肾,名曰疝瘕,少腹冤热而痛出白,一名为
蛊,斯可按也。前所谓施于病之相传有如此者,寒气客于脉外,则脉寒。寒则缩蜷,缩蜷则
脉络急,外引小络,卒然为痛。又与热气相搏,则脉满而痛,脉满而痛,不可按也。寒气客
于肠胃之间,膜原之下,血不得散,小络急引,是痛也。按之则血气散而痛止,迨夫客于侠
脊之脉。其藏深矣,按不能及,故按之为无益也。风雨伤人,自皮肤入于大经脉,血气与邪,
并客于分腠间,其脉坚大,若可按也。然按之则痛甚,寒湿中人,皮肤不收,肌肉坚紧,营
血泣,卫气除,此为虚也。虚则聂辟气乏。惟按之则气足以温之,快然而不痛,前所谓按之。
痛止,按之无益,按之痛甚,按之快然有如此者,夫可按不可按若是,则摩之所施,亦可以
理推矣。养生法,凡小有不安,必按摩 捺。令百节通利,邪气得泄,然则按摩有资于外。
岂小补哉,摩之别法,必与药俱,盖欲浃于肌肤,而其势快利。若疗伤寒以白膏摩体,手当
千遍,药力乃行,则摩之用药,又不可不知也。
Relying on the properties of herbs and leveraging the power of fire, penetrating through the skin into the blood vessels, dispersing stagnation and extending contracture, the therapeutic effect of *yunyin* (hot compress and stretching) is significant. The term "yin" (stretching) implies the meaning of relaxation and extension, as hot compresses can achieve this. The *Suwen: Xueqi Xingzhi Lun* (Treatise on Blood, Qi, Shape, and Will in the Classic of Difficult Issues) states: "Diseases arising from sinews are treated with hot compress and stretching." The *Suwen: Yuji Zhenzang Lun* (Treatise on the True Viscera of the Jade Machine) states: "Bi syndrome causing numbness, pain, and swelling can be treated with hot compresses, moxibustion, and acupuncture." Generally, diseases arising from sinews result in spasm and contracture; Bi syndrome causing numbness indicates stagnation and sluggishness of meridians and blood. Both conditions are caused by external pathogenic factors. Hot compresses can warm them; since blood flows freely when warmed, it can guide the stagnant blood to flow again.
Pressing (*an*) and rubbing (*mo*) can be used simultaneously or separately, collectively referred to as massage. Pressing without rubbing, or rubbing without pressing, constitutes a distinction. Pressing uses only manual force, while rubbing may involve the application of medicinal plasters or oils. The choice between "an" and "mo" depends on appropriate application. The *Suwen: Xueqi Xingzhi Lun* states: "Frequent fright and panic cause meridian obstruction, leading to numbness, which is treated with massage." This is the general definition of massage. The *Suwen: Yin-Ying-Xiang Da Lun* (Great Treatise on Yin and Yang Correspondences) states: "For fierce and rapid pathogens, use pressing to subdue them." The *Suwen: Tongping Xu-Shi Lun* (Treatise on Excess and Deficiency in General Evaluation) states: "If an abscess is painless, unresponsive to pressure, and comes and goes suddenly, this is pressing without rubbing." Hua Tuo said: "When Shanghan (Cold Damage) begins on the first day in the skin, applying medicated plaster massage and fire moxibustion will cure it." This refers to rubbing without pressing, relying necessarily on medicines. People discussing massage today often fail to analyze and treat these methods distinctly, instead combining them with Dao Yin (guiding and pulling exercises) for explanation. Failing to distinguish and treat them separately is already superficial. Combining them with Dao Yin further shows a lack of deep thought. Broadly speaking, the principle of massage lies in "opening and unblocking" and "suppressing and restraining." Opening and unblocking allows obstructed pathogens to disperse; suppressing and restraining gives fierce pathogens a place to settle. Therefore, although pressing is one method, its effects vary: it may apply to the transmission of disease, stop pain, have no benefit, exacerbate pain, or bring comfort. To summarize: When Wind-Cold invades the body, hair stands erect, skin closes up causing heat, or Bi syndrome causes numbness, pain, and swelling. If the pathogen transmits to the Liver, causing hypochondriac pain and vomiting, pressing is applicable. If the Liver transmits to the Spleen, named Pi Feng (Spleen Wind), manifesting as jaundice, abdominal heat, irritability, and yellow discharge, pressing is applicable. If the Spleen transmits to the Kidney, named Shan Jia (Hernia Mass), causing lower abdominal burning pain and white discharge, also known as Gu (Parasitic Disease), pressing is applicable. This illustrates pressing applied to disease transmission. When Cold Qi lodges outside the meridians, the meridians become cold. Cold causes contraction and curling, making meridians tense, pulling on small collaterals, resulting in sudden pain. If combined with Heat Qi, the meridians become full and painful; in such cases of fullness and pain, pressing is contraindicated. When Cold Qi lodges between the stomach and intestines, below the membrane source, blood cannot disperse, small collaterals tense and pull, causing pain. Here, pressing disperses Qi and Blood, stopping pain. However, if Cold Qi lodges in the deep meridians alongside the spine, pressing cannot reach, so it is ineffective. When Wind and Rain injure the body, entering large meridians from the skin, Qi and Blood combine with pathogens in the fenli (intermuscular spaces). The pulse becomes firm and large; if pressing is attempted, pain increases. When Cold-Dampness enters the body, the skin becomes lax, muscles tight, Ying Blood becomes sluggish, and Wei Qi dissipates, constituting a Deficiency pattern. In deficiency, the surface is flaccid and Qi is insufficient. Only pressing can replenish Qi to warm the body, bringing comfort and stopping pain. As mentioned earlier, pressing stops pain, has no effect, worsens pain, or brings comfort depending on the situation. Given that applicability of pressing varies thus, the application of rubbing can also be deduced by reasoning. For health preservation, whenever there is slight discomfort, massage and kneading should be performed to ensure joint mobility and expel pathogens externally. Thus, massage provides external support, which is certainly beneficial. Another method of rubbing must be combined with medicines, aiming for penetration into the skin and muscle for rapid efficacy. For example, treating Shanghan with White Plaster massage requires a thousand strokes of the hand for the medicinal power to take effect. Therefore, the principles of using medicines in rubbing must not be ignored.