拯救之法妙用者针 言劫病之功莫妙于针刺 察岁时于天道 夫人身有十二经三百六十
节以
应一岁十二月三百六十日岁者素问云必先岁气兼代天和是谓至治时者四时也经六四时者所以
分春夏秋冬之气所在以调之也天道者经云天气温和则经水安静天寒地冻则经水凝滞天暑地热
则经水沸溢卒风暴热则经水沸而HT 起又天温日明则人血淖液而卫气浮故血易泄气易行天寒日
阴则人血凝滞而卫气沉月始生则气血始精卫气始行月廓满则气血实肌肉坚月廓空则肌肉减经
络虚卫气去形独居是以因天时而调气血也 定形气于予心 此言用针者当识岁时之气候察天
道之寒温月廓之盈亏以定患人形之肥瘦气之虚实于我心实则泻之虚则补之以平调为期斯则形
气已得予心而所谓顺天之道也 春夏瘦而刺浅秋冬肥而刺深 内经云病有浮沉刺有深浅各正
其理兼过其道过之则内伤不及则外壅壅则邪从之深浅不得及为大贼内伤五脏后生大病故曰春
病在毫毛腠理夏病在皮肤故春夏之气在外人之气亦轻浮肌肉瘦薄血气未盛凡刺者应当浅取之
秋病在肌肉冬病在筋骨故秋冬之气收藏在内人气亦藏肥肉肥浓血气充满凡刺者故当深取之
不穷经络阴阳多逢刺禁经有十二经络有十五络阴阳者天之阴阳平旦至日中天之阳阳中之阳也
曰中至黄昏天之阳阳中之阴也合夜至鸡鸣天之阴阴中之阴也鸡鸣至平旦天之阴阴中之阳也人
之阴阳则外为阳内为阴身之阴阳则背为阳腹为阴手足皆以赤白际分之
言脏腑之阴阳则脏为阴府为阳是以春夏之病在阳秋冬之病在阴皆视其所在与施针后也 既论
脏腑虚实须向经寻 脏居乎内经络行乎外其脏腑之虚实既定乃取其经而治之虚则补其母实则
泄其子如心病虚则补肝木实则泄脾土又本经亦有子母如心之虚取少海以补之实则取少府泄之
又如太阳肺属金病实则泄本经之合水尺泽水是子虚则补本经之俞土太渊上是母故曰须向经寻
诸经皆然并不离五形相生之理也 原夫起自中焦水初下漏太阴为始至厥阴而方终穴出云门抵
期门而最后 此言平人气血气脉行于十二经为周身除任督之外计三百九十三穴一日一夜有百
刻分于十二时每一时有八刻二分每一刻计六十分一时共计五百分起至中焦者盖中焦在胃中腕
当脐上四寸不上不下之分五脏皆禀于胃胃者五脏之本故五脏气不能自致于手太阴肺经必因胃
气乃致于手太阴肺经经云谷入于胃播气于肺故脉假胃气自寅时起沿中焦上注于肺初行一时呼
吸气计一千一百二十五息血行计六十七丈五尺至卯时注大肠经呼吸气计二千二百五十息血行
一百三十五丈至辰时注于胃经呼吸气计三千三百七十五息血行二百二丈五尺己时注于脾经呼
吸气计四千五百息血行二百七十丈午时注于心经呼吸气计五千六百二十五息血行三百三十七
丈五尺未时注小肠经呼吸气计六千七百五十息血行四百五文申时注于膀胱经呼吸气计七千八
百七十五息酉时注于肾经呼吸气计九千息血行五百四十丈戌时注于心包络呼吸气计一万一百二
十五息血行六百七丈五尺亥时注于三焦经呼吸气计一万一千二百五十息血行六百七十五丈子
时注于胆经呼吸气计一万二千三百七十五息血行七百四十二丈五尺丑时注于肝经呼吸气计
一万三千五百息血行八百一十丈故曰太阴为始至厥阴而方终矣手
太阴肺经自寅时起从中府穴出注于手阳明经历胃脾心小肠膀胱中焦胃腕致于肾心包络三焦胆
至厥阴肝经而终此盖引其经之传注而言则云门而如其经传注从第其穴则自期门而止所谓穴出
云门抵期而最后也 正经十二别络走三百余支
凡人手足三阴三阳之脉各为正经其经之别走者为络盖三百六十五支而络三百六十五穴故
曰正经十二别络走三百余支也。
拯救疾病的方法中,最精妙的是针刺。要说祛除病邪的功效,没有比针刺更巧妙的了。
观察岁时变化要顺应天道规律。人的身体有十二经脉和三百六十个关节,用来对应一年的十二月和三百六十天。年份的变化,《素问》说必须首先了解当年的岁气,同时兼顾天地自然之和气,这叫做最高明的治疗原则。“时”指的是四季。《内经》提到,四季是划分春、夏、秋、冬四时之气所在以进行调理的依据。所谓天道,经文中说:天气温和,则人体经络中的气血运行平静;天气寒冷大地冻结,则气血凝滞不通;天气暑热地热,则气血沸腾溢出;突然遭遇风暴炎热,则气血沸腾并伴有瘀血积聚。另外,天气温暖阳光明亮,则人体血液稀薄流动顺畅,卫气浮越于表,所以血液容易泄出,气机容易运行;天气寒冷阴雨连绵,则人体血液凝滞,卫气沉伏于里。月亮初生时,气血开始精纯,卫气开始运行;月亮圆满时,气血充实,肌肉坚实;月亮亏空时,肌肉减损,经络空虚,卫气离去,形体独自存在。因此,要根据天时来调理气血。
在内心确定患者的形气状态。这是说使用针刺的人,应当识别岁时的气候,观察天道的寒温变化、月亮的盈亏情况,从而在心中判断患者身体的肥瘦、气的虚实。实证用泻法,虚证用补法,以平和调畅为最终目的。这样,患者的形气状况就能掌握在我的心中,这就是所谓的顺应天道。
春夏季节身体消瘦者针刺宜浅,秋冬季节身体肥胖者针刺宜深。《内经》说:病位有浮沉之分,针刺就有深浅之别,各自符合其道理,并且不超越应有的限度。如果刺得过深,就会内伤脏腑;如果刺得不够深,就会使邪气在外壅滞。壅滞则邪气乘虚而入。针刺深浅不当,会成为巨大的祸害,内伤五脏,随后引发大病。所以说,春季的病位在毫毛腠理,夏季的病位在皮肤,因此春夏时节阳气在外,人体的气也轻浮,肌肉瘦薄,血气未盛,凡是用针的人应当浅取。秋季的病位在肌肉,冬季的病位在筋骨,因此秋冬时节阳气收藏在内,人体的气也潜藏,肥肉丰浓,血气充满,凡是用针的人应当深取。
不要拘泥于经络阴阳的教条,否则常会触犯针刺禁忌。经中有十二正经,有十五别络。阴阳是天之阴阳:从黎明到正午,属于天之阳,是阳中之阳;从正午到黄昏,属于天之阳,是阳中之阴;从合夜到鸡鸣,属于天之阴,是阴中之阴;从鸡鸣到黎明,属于天之阴,是阴中之阳。人体的阴阳则是外为阳、内为阴;躯体的阴阳则是背为阳、腹为阴;手足则以赤白肉际为分界。
论述脏腑的阴阳,则脏为阴,腑为阳。因此春夏的病多在阳分,秋冬的病多在阴分,都要视其病变所在而施针。
既然讨论了脏腑的虚实,就必须向本经寻求治法。脏居于内,经络行于外。确定了脏腑的虚实后,就选取相应的经脉进行治疗。虚证则补其母经(或母穴),实证则泻其子经(或子穴)。例如心病,虚证则补肝木(母),实证则泻脾土(子)。在本经中也有子母关系,如心经虚证取少海穴以补之,实证取少府穴以泻之。又如肺属金,病实则泻本经的合水穴尺泽,水是金之子;虚证则补本经的俞土穴太渊,土是金之母。所以说必须向本经寻求治法,其他各经都是如此,都不离五行相生之理。
原本气血从中焦开始生成,水谷精微初次渗漏,始于太阴肺经,终于厥阴肝经。穴位出自云门穴,抵达期门穴而最后结束。
这是说正常人的气血脉运行于十二经脉,遍布全身。除去任督二脉,共计三百九十三穴。一天一夜有一百刻,分配给十二个时辰,每个时辰有八刻二分,每一刻计六十分,一个时辰共计五百分。气血起自中焦,是因为中焦位于胃脘部,当脐上四寸,不上不下的位置。五脏都禀受于胃气,胃是五脏的根本,所以五脏的气不能自行到达手太阴肺经,必须借助胃气才能到达手太阴肺经。经文说:“谷入于胃,播气于肺。”所以脉象假借胃气,从寅时开始,沿中焦上注于肺。起初运行一个时辰,呼吸一千一百二十五息,血行六十七丈五尺;到卯时注入大肠经,呼吸二千二百五十息,血行一百三十五丈;到辰时注入胃经,呼吸三千三百七十五息,血行二百零二丈五尺;到巳时注入脾经,呼吸四千五百息,血行二百七十丈;到午时注入心经,呼吸五千六百二十五息,血行三百三十七丈五尺;到未时注入小肠经,呼吸六千七百五十息,血行四百五丈;到申时注入膀胱经,呼吸七千八百七十五息;到酉时注入肾经,呼吸九千息,血行五百四十丈;到戌时注入心包络,呼吸一万一百二十五息,血行六百零七丈五尺;到亥时注入三焦经,呼吸一万一千二百五十息,血行六百七十五丈;到子时注入胆经,呼吸一万二千三百七十五息,血行七百四十二丈五尺;到丑时注入肝经,呼吸一万三千五百息,血行八百一十丈。所以说“太阴为始,至厥阴而方终”。
手太阴肺经从寅时开始,从中府穴出发,注入手阳明大肠经,经过胃、脾、心、小肠、膀胱、中焦、胃脘,致于肾、心包络、三焦、胆,至厥阴肝经而终结。这是引用经脉的传注而言,所以说“穴出云门”,如果按照经脉传注的顺序,则从期门穴止住。所谓“穴出云门,抵期门而最后”。
十二正经与别络行走,共有三百余支分支。
凡是人的手足三阴三阳的脉,各自称为正经,其经脉别走他处的称为络。大概有三百六十五支络脉,对应三百六十五穴,所以说“正经十二,别络走三百余支”。
The method for saving lives and curing diseases is most exquisite in acupuncture. Regarding the merit of eliminating disease, nothing is more wonderful than needle therapy.
Observing the changes of years and seasons requires conforming to the Way of Heaven. The human body possesses twelve meridians and three hundred and sixty joints, corresponding to the twelve months and three hundred and sixty days of a year. Concerning the variation of years, *Suwen* (Basic Questions) states that one must first understand the Qi of the annual climate, while simultaneously harmonizing with the natural harmony of Heaven and Earth; this is called the highest level of treatment. "Seasons" refer to the four seasons. The *Neijing* (Inner Canon) mentions that the four seasons are used to divide the Qi of Spring, Summer, Autumn, and Winter according to their locations for regulation. The so-called Way of Heaven is described in the classics: when the heavenly Qi is mild and warm, the fluids in the meridians remain calm; when it is cold and the earth freezes, the fluids become stagnant; when it is hot and the earth is warm, the fluids boil and overflow; when sudden storms and intense heat occur, the fluids boil and stasis arises. Furthermore, when the weather is warm and sunny, human blood becomes thin and fluid, and Wei Qi (Defensive Qi) floats on the surface, so blood is easily discharged and Qi moves readily; when the weather is cold and cloudy, human blood becomes stagnant, and Wei Qi sinks inward. When the moon begins to wax, Blood and Qi begin to refine, and Wei Qi starts to circulate; when the moon is full, Blood and Qi are abundant, and muscles are firm; when the moon wanes, muscles diminish, meridians become empty, Wei Qi departs, and the form remains alone. Therefore, one must regulate Blood and Qi according to the celestial timing.
One must determine the patient's Form and Qi within one's own mind. This means that the practitioner using needles must recognize the climatic conditions of the year and season, observe the cold and warmth of the Heavenly Way, and the waxing and waning of the moon, thereby assessing the patient's corpulence or emaciation and the deficiency or excess of Qi in their heart-mind. Excess patterns require draining (reducing), deficiency patterns require tonifying, with the goal of achieving balance and smooth flow. In this way, the patient's Form and Qi are grasped by the practitioner, which is what is meant by following the Way of Heaven.
In Spring and Summer, when the body is lean, needling should be shallow; in Autumn and Winter, when the body is obese, needling should be deep. The *Neijing* states: diseases have superficial and deep locations, and needling has corresponding depths, each adhering to its principle without exceeding the proper limit. If needling is too deep, it causes internal injury; if not deep enough, it leads to external stagnation. Stagnation allows pathogenic factors to enter. Improper depth of needling can become a great disaster, injuring the Zang organs internally and subsequently causing severe illness. Thus, it is said that in Spring, disease resides in the hair follicles and interstices; in Summer, in the skin. Therefore, in Spring and Summer, Yang Qi is outward, human Qi is also light and floating, muscles are thin, and Blood and Qi are not yet vigorous; practitioners should needle superficially. In Autumn, disease resides in the muscles; in Winter, in the sinews and bones. Therefore, in Autumn and Winter, Yang Qi is stored inward, human Qi is also hidden, fat is thick, and Blood and Qi are abundant; practitioners should needle deeply.
Do not rigidly adhere to the dogmas of meridians and Yin-Yang, lest you frequently encounter contraindications for needling. There are twelve regular meridians and fifteen collaterals. Yin and Yang are the Yin and Yang of Heaven: from dawn to noon, it is Heaven's Yang, specifically Yang within Yang; from noon to dusk, it is Heaven's Yang, specifically Yin within Yang; from twilight to cockcrow, it is Heaven's Yin, specifically Yin within Yin; from cockcrow to dawn, it is Heaven's Yin, specifically Yang within Yin. For the human body, the exterior is Yang and the interior is Yin; for the torso, the back is Yang and the abdomen is Yin; for the limbs, the boundary is marked by the junction of red and white flesh.
Regarding the Yin and Yang of Zang-Fu organs, Zang organs are Yin and Fu organs are Yang. Therefore, diseases in Spring and Summer often affect the Yang aspect, while those in Autumn and Winter often affect the Yin aspect; treatment should be applied based on the location of the pathology.
Having discussed the deficiency and excess of Zang-Fu organs, one must seek treatment within the respective meridians. Zang organs reside internally, while meridians run externally. Once the deficiency or excess of the Zang-Fu is determined, select the corresponding meridian for treatment. Tonify the Mother element/point in deficiency, and drain the Child element/point in excess. For example, in Heart disease, tonify Liver Wood (Mother) in deficiency, and drain Spleen Earth (Child) in excess. Within the same meridian, there are also Mother-Child relationships. For instance, in Heart meridian deficiency, tonify Shaohai (HT3) to supplement; in excess, drain Shaofu (HT8) to reduce. Similarly, Lung belongs to Metal. In excess, drain the He-Sea Water point Chize (LU5) of the same meridian, as Water is the Child of Metal; in deficiency, tonify the Shu-Stream Earth point Taiyuan (LU9) of the same meridian, as Earth is the Mother of Metal. Thus, it is said that one must seek treatment within the meridian. This applies to all meridians, never departing from the principle of the mutual generation of the Five Elements.
Originally, Qi and Blood originate from the Middle Jiao. After water and grain are initially processed, the circulation begins at the Hand-Taiyin Lung Meridian and ends at the Foot-Jueyin Liver Meridian. Acupoints emerge from Yunmen (LU2) and finally reach Qimen (LR14).
This explains that in a healthy person, Qi and Blood circulate through the twelve regular meridians throughout the body. Excluding the Ren and Du vessels, there are three hundred and ninety-three acupoints. A day and night consist of one hundred ke (time units), distributed among twelve double-hours (shi). Each shi contains eight ke and two fen; each ke consists of sixty fen, totaling five hundred fen per shi. Qi and Blood originate from the Middle Jiao because the Middle Jiao is located at the stomach region, four cun above the umbilicus, neither high nor low. All five Zang organs rely on Stomach Qi; the Stomach is the root of the five Zang organs. Therefore, the Qi of the five Zang organs cannot reach the Hand-Taiyin Lung Meridian on its own but must rely on Stomach Qi to do so. The classic states: "Grain enters the Stomach, and Qi is disseminated to the Lung." Thus, the pulse borrows Stomach Qi. Starting from Yin hour, it flows up from the Middle Jiao into the Lung. During the first shi, respiration counts 1,125 breaths, and blood travels 67 zhang and 5 chi. At Mao hour, it enters the Large Intestine Meridian; respiration counts 2,250 breaths, and blood travels 135 zhang. At Chen hour, it enters the Stomach Meridian; respiration counts 3,375 breaths, and blood travels 202 zhang and 5 chi. At Si hour, it enters the Spleen Meridian; respiration counts 4,500 breaths, and blood travels 270 zhang. At Wu hour, it enters the Heart Meridian; respiration counts 5,625 breaths, and blood travels 337 zhang and 5 chi. At Wei hour, it enters the Small Intestine Meridian; respiration counts 6,750 breaths, and blood travels 405 zhang. At Shen hour, it enters the Bladder Meridian; respiration counts 7,875 breaths. At You hour, it enters the Kidney Meridian; respiration counts 9,000 breaths, and blood travels 540 zhang. At Xu hour, it enters the Pericardium; respiration counts 10,125 breaths, and blood travels 607 zhang and 5 chi. At Hai hour, it enters the Sanjiao (Triple Burner) Meridian; respiration counts 11,250 breaths, and blood travels 675 zhang. At Zi hour, it enters the Gallbladder Meridian; respiration counts 12,375 breaths, and blood travels 742 zhang and 5 chi. At Chou hour, it enters the Liver Meridian; respiration counts 13,500 breaths, and blood travels 810 zhang. Thus, it is said that "Taiyin is the beginning, ending only at Jueyin."
The Hand-Taiyin Lung Meridian begins at Yin hour, exiting Zhongfu (LU1), and injects into the Hand-Yangming Large Intestine Meridian, passing through the Stomach, Spleen, Heart, Small Intestine, Bladder, Middle Jiao, Stomach region, reaching the Kidney, Pericardium, Sanjiao, and Gallbladder, finally terminating at the Foot-Jueyin Liver Meridian. This refers to the transmission of meridians; thus, it is said "acupoints emerge from Yunmen." If referring to the sequence of acupoint transmission, it ends at Qimen. Hence, "acupoints emerge from Yunmen and reach Qimen last."
The twelve regular meridians and collateral vessels travel, forming over three hundred branches.
The meridians of the hand and foot, Three Yin and Three Yang, are each called regular meridians. The branches that diverge from these regular meridians are called collaterals. There are approximately three hundred and sixty-five collateral branches, corresponding to three hundred and sixty-five acupoints. Therefore, it is stated: "Twelve regular meridians, with collaterals branching into over three hundred divisions."