行针之士。要辨浮沉。脉明虚实。针别浅深。经脉络脉之别。巨刺缪刺之分。经络闭塞
。须
络流注。各应其时。先脉诀病。次穴蠲 。左手掐穴。右手置针。刺荣无伤卫。刺卫无伤荣
。气悍则针小而入浅。气涩则针大而入深。气滑出疾。气涩出迟。深则欲留。浅则欲疾。候
其气至。必辨于针。徐而疾者实。实而迟者虚。虚则实之。满则泄之。菀陈则除之。邪胜则
虚之。刺虚者须其实。刺实者须其虚。经气已至。慎守勿失。谨守其法。勿更变也。贼邪新
客。未有定处。推之则前。引之则止。其来不可逢。其往不可追。损其有余。补其不足。先
去血脉。而后调之。无问其病。以平为期。若有若无。若得若失。五脏以定。九候以备。诊
脉病明。行针病愈。众脉不见。众凶不闻。外内相得。无以形先。可玩往来。乃施于人。手
动若务。针耀而匀。伏如横弩。起如发机。见其鸟鸟。见其稷稷。从见其飞。不知其谁。静
意是义。观适之变。是谓冥冥。莫知其形。如临深渊。手如握虎。如待所贵。不知日暮。其
气已至。适而自护。五虚勿近。五实不远。扪而循之。切而散之。推而按之。弹而怒之。爪
而下之。通而取之。阴募在腹。阳俞在背。藏病取原。府病取合。藏俞治脏病。府募治腑病
。出入导气。补泻同精。善行水者。不能注水。善穿水者。不能凿冻。权衡以平。气口成寸
。以决死生。饮食入胃。游溢精气。上输于脾。脾气散精。上归于肺。通调水道。下输膀胱
。食气入胃。散精于肝。淫气于筋。食气入胃。浊气归心。淫精于肺。五劳五痹。九气七情
。六淫六腑。九窍九州。四气三因。伤风伤寒。杂病奇病。妇人小儿。盛则泻之。虚则补之
。不盛不虚。以经取之。
上铜人指要赋。多取内经词语。末后权衡以平。文不相属。
Physicians performing acupuncture must distinguish between floating and sinking pulses. By clarifying the deficiency and excess through pulse diagnosis, one can determine whether to needle superficially or deeply. One must differentiate between meridians (Jingluo) and collateral vessels (Luomai), as well as between Great Puncture (Juci) and Counter Puncture (Mouci). When meridians are obstructed, it is necessary to unblock the flow of Qi and Blood in the collaterals.
Acupuncture should correspond to the timing of Qi and Blood flow. First, diagnose the disease according to Pulse Formulas (Maijue), then select acupoints to eliminate the pathology. The left hand presses the acupoint for positioning, while the right hand places the needle. When penetrating the Ying (Nutrient/Blood) level, do not injure the Wei (Defensive/Qi) level; when penetrating the Wei level, do not injure the Ying level. If the patient's Qi is vigorous and rapid, use a small needle and insert it shallowly. If the Qi is sluggish, use a large needle and insert it deeply. If the Qi is smooth, withdraw the needle quickly; if the Qi is sluggish, withdraw it slowly. For deep insertion, retain the needle; for shallow insertion, withdraw it rapidly. When waiting for the arrival of Qi, one must carefully discern the sensation at the needle. A pulse that is slow yet changes rapidly indicates Excess; a pulse that is full yet slow indicates Deficiency. Treat Deficiency with tonification, treat Fullness with sedation. Remove stagnation and old blood (Wanchen). Drain excessive pathogenic factors. When needling Deficiency, aim to achieve fullness (of Zheng Qi); when needling Excess, aim to achieve emptiness (of Xie Qi). Once the Jing Qi has arrived, guard it carefully and do not lose it. Strictly adhere to these methods without arbitrary changes.
For newly invaded pathogenic factors (Zei Xie) that have not settled in a fixed location, pushing them moves them forward, pulling them stops them. Their arrival cannot be met head-on, and their departure cannot be pursued. Reduce what is excessive, supplement what is deficient. First remove blood stasis from the vessels, then regulate the body. Regardless of the specific disease, the goal is balance (Ping). The sensation may seem present yet absent, obtained yet lost. The Five Zang organs become stable, and the Nine Palpations (Jiu Hou) become complete. With clear diagnosis of pulse and disease, acupuncture can cure the illness. Amidst numerous complex pulses, ignore ominous signs. Internal and external aspects must harmonize; do not rely solely on physical appearance. Observe the coming and going of Qi before applying treatment. Focus your mind on the task; the needle should be bright and movements even. Remain still like a drawn crossbow, but strike swiftly like releasing a trigger. Observe the subtle movements like flying birds or growing crops, following the flight without knowing the source. Calmly contemplate the meaning, observe the changes of adaptation. This is called "Ming Ming" (obscure/subtle), where the form is unknown. Approach with caution as if standing by a deep abyss; hold the needle firmly as if grasping a tiger; treat the moment with reverence as if awaiting a noble guest, forgetting the passing of time.
When Qi has arrived, maintain appropriate control and self-protection. Do not needle lightly in cases of Five Deficiencies; do not stay away from cases of Five Excesses. Palpate and follow the channels, press to disperse, push and press to guide, flick to distend vessels, use fingernails to mark the spot, unblock and extract. Yin Mu points are on the abdomen, Yang Shu points are on the back. For Zang diseases, select Yuan-Source points; for Fu diseases, select He-Sea points. Use Shu points of Zang to treat Zang diseases; use Mu points of Fu to treat Fu diseases. Guide Qi in and out; tonification and sedation require precision. Those skilled in managing water cannot force water to pour; those skilled in drilling ice cannot force frozen ground to break. Use balance as a standard; the Cun Kou pulse determines life and death.
Food enters the Stomach, its essence floats and overflows, moving upward to the Spleen. The Spleen scatters the essence, sending it upward to the Lung. The Lung regulates water passages, transmitting downward to the Bladder. Food Qi enters the Stomach, scattering essence to the Liver, nourishing the sinews. Food Qi enters the Stomach, turbid Qi returns to the Heart, and refined essence goes to the Lung. Whether dealing with Five Fatigues, Five Bi syndromes, Nine Qi disturbances, Seven Emotions, Six Exogenous Pathogens, Six Fu organs, Nine Orifices, Nine Provinces, Four Qi, or Three Causes; whether Wind-Cold, common cold, miscellaneous diseases, or strange diseases; whether in women or children—the principle remains: Sedate if Excessive, Tonify if Deficient. If neither excessive nor deficient, treat via the affected meridian itself.
This is the *Tongren Zhiyao Fu* (Ode to the Essentials of the Bronze Man). It heavily borrows terminology from the *Neijing*. The final section regarding "balance and peace" seems disconnected from the preceding text.