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。）
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.)