先说平针法。含针口内温。按揉令气散。陷穴故教深。持针安穴上。令他嗽一声。随嗽
归天
部。停针再至人。再停归地部。待气候针沉。气若不来至。指甲切其经。次提针向病。针退
天地人。
先以揉按令其气散。次掏穴定力。重此最好。右手持针。安于穴上。随令患者嗽一声。
左右
用针转入天部。皮肤之间也。少时左右进至人部。肌肉之间也。再少时进至地部。筋骨之间
也。凡穴当一寸许。如此作三次进之。大抵疼痛实泻。麻痹虚补。经云。针法手如握虎。如
待贵人。凡取穴手指。前哲又有八法。弹而怒之。迎而夺之。使经气腹满。令邪气散而正气
行也。循而扪之。随而济之。抚摩上下。见动脉之处。摄而按之。推而纳之。以手指加力按
所针之穴。使邪气泄而易散。病者不知其针。爪而下之。切而散之。方寸既见。其穴端正。
使针易入不瘥。病患亦不知其痛。
补必随经刺。令他吹气频。随吹随左转。逐归天地人。待气停针久。三弹更熨温。出针
口吸
气。急急闭其门。泻欲迎经取。吸则内其针。吸时须右转。根据次进天人。转针仍复吸。根据法
要停针。出针吹出气。摇动大其门。
凡出针不可猛出。必须作两三次。徐徐转而出之。则无血。若猛出者。必见血也。有晕
针者
。夺命穴救之。男左女右。取左不回。却再取右。女亦然。此穴正在手膊上。侧筋骨陷中。
即是虾蟆儿上边也。从肩至肘。正在当中。凡刺之道。必须知禁忌。经云。毋刺浑浑之脉。
之热。漉漉之汗。如大风大雨。严寒盛暑。卑湿烦躁。便黑吐血。暴然失听。失明。失
意。失便溺。失神。及七情五伤醉饱。皆不可刺。乘车马远来。亦候气。血定。然后刺之。
首先阐述平针法。将针含在口中使其温热。按压揉搓穴位使经气散开。因为穴位深陷,所以教导要深刺。手持针具,安稳地置于穴位之上。让患者咳嗽一声。随着咳嗽声,将针刺入天部(浅层)。停留片刻,再进针至人部(中层)。再次停留,进针至地部(深层)。等待经气到来,感觉针下沉紧。如果经气尚未到来,用指甲切按经脉。然后提针向病所方向。退针时依次经过地、人、天三部。
先用揉按的方法使经气散开,接着掏挖穴位以确立定力,反复操作效果最好。右手持针,安放在穴位上。随令患者咳嗽一声。左右转动针具转入天部(皮肤之间)。稍作停留,左右进退进至人部(肌肉之间)。再过一会儿进至地部(筋骨之间)。一般穴位深度约为一寸。如此操作三次进针。大抵疼痛实证用泻法,麻痹虚证用补法。医经说:针刺手法要像手握老虎一样坚定,像对待贵人一样恭敬谨慎。凡选取穴位的手指技法,前代哲人又有八种方法:弹而怒之,迎而夺之,使经气腹满,令邪气散而正气行也。循而扪之,随而济之,抚摩上下,见动脉之处。摄而按之,推而纳之,以手指加力按所针之穴,使邪气泄而易散,病者不知其针。爪而下之,切而散之,方寸既见,其穴端正,使针易入不瘥,病患亦不知其痛。
补法必须顺着经脉方向刺入,让患者频繁吹气。随着吹气向左旋转针具,逐渐归入天地人三部。等待经气停驻,久留针后,用手指弹击针柄并熨烫温暖。出针时让患者吸气,迅速闭合针孔。泻法要迎着经脉方向取穴,吸气时进针。吸气时须向右旋转针具,依次进天人三部。转针仍配合吸气。根据此法需要停留针体。出针时让患者吹气,摇动针具扩大针孔。
凡是出针不可猛力拔出,必须分两三次,徐徐旋转而出,则不出血。若猛力拔出,必定见血。有晕针的情况,用夺命穴急救。男子取左侧,女子取右侧。取左侧无效,再取右侧。女子亦然。此穴正在手臂上,侧边筋骨凹陷中,即是虾蟆儿上边。从肩至肘,正在当中。凡是针刺之道,必须知晓禁忌。医经说:不要刺脉象混乱如浑浑的,不要刺大汗淋漓如漉漉的,不要在狂风大雨、严寒盛暑、卑湿烦躁的环境下施针,不要在便黑吐血、突然失听、失明、失意、大小便失禁、神志丧失的情况下施针,以及七情五伤、醉酒饱食之后,都不可施针。乘车马远道而来的人,也要等待气血安定,然后才能施针。
First, the Ping Zhen Fa (Flat Needle Method) is explained. The needle is kept warm inside the mouth. Acupoints are pressed and rubbed to disperse the Qi. Because acupoints may be sunken, deep insertion is taught. Holding the needle, it is placed securely on the acupoint. The patient is asked to cough once. Following the cough, the needle is inserted into the Tian Bu (Heaven Layer). After pausing, the needle is advanced to the Ren Bu (Human Layer). Pausing again, it is advanced to the Di Bu (Earth Layer). One waits for the Qi arrival, feeling the needle sink and tighten. If the Qi has not yet arrived, the meridians are cut with fingernails. Then, the needle is lifted towards the disease site. When withdrawing, the needle passes through the Di, Ren, and Tian layers sequentially.
First, rubbing and pressing are used to disperse the Qi. Next, digging at the acupoint establishes stability; repeating this is best. The right hand holds the needle and places it on the acupoint. As the patient coughs once, the needle is rotated left and right to enter the Tian Bu (Skin Layer). After a short while, advancing left and right reaches the Ren Bu (Muscle Layer). A little later, it advances to the Di Bu (Sinew-Bone Layer). Generally, an acupoint depth is about one cun. This process of three-stage insertion is performed three times. Broadly speaking, pain indicates excess and requires draining (Xie); numbness indicates deficiency and requires tonifying (Bu). The classics state: "The needle technique should be firm as if holding a tiger, and respectful as if awaiting a noble person." Regarding finger techniques for selecting acupoints, ancient sages proposed eight methods: "Tan Er Nu Zhi" (tapping to make it angry), "Ying Er Duo Zhi" (meeting and seizing), causing abdominal fullness of Jing Qi, dispersing pathogenic Qi and promoting healthy Qi. "Xun Er Men Zhi" (stroking and touching), "Sui Er Ji Zhi" (following and assisting), massaging up and down, observing where the artery pulses. "She Er An Zhi" (grasping and pressing), "Tui Na Zhi" (pushing and inserting), applying finger pressure to the needled acupoint to drain and easily disperse pathogenic Qi, so the patient does not feel the needle. "Zhua Er Xia Zhi" (scratching downwards), "Qie Er San Zhi" (cutting and dispersing), once the square-inch area is visible and the acupoint is centered, the needle enters easily without failure, and the patient feels no pain.
Tonification (Bu) must follow the direction of the meridian. The patient is instructed to exhale frequently. With each exhalation, the needle is rotated leftward, gradually entering the Tian, Ren, and Di layers. Wait for the Qi to settle, keep the needle in place for a long time, then flick the needle handle three times and apply warmth. Upon withdrawal, the patient inhales, and the pore is closed quickly. Draining (Xie) requires taking points against the meridian flow. The needle is inserted during inhalation. During inhalation, the needle is rotated rightward, entering the Tian, Ren, and Di layers sequentially. Rotating the needle still coordinates with inhalation. According to this method, the needle must be retained. Upon withdrawal, the patient exhales, and the needle is shaken to enlarge the pore.
Needles must never be withdrawn forcefully. They must be withdrawn slowly over two or three rotations to avoid bleeding. Forceful withdrawal will certainly cause bleeding. In cases of fainting from needling (Yun Zhen), the Du Ming point (Life-Saving Point) is used for rescue. For men, the left side is taken; for women, the right side. If the left side fails, take the right side. The same applies to women. This point is located on the arm, in the depression between the tendons and bones on the side, just above the 'toad child' (a specific anatomical landmark). It is exactly in the middle from the shoulder to the elbow. In all needling practices, contraindications must be known. The classics state: Do not needle when the pulse is chaotic ("Hun Hun"), do not needle when sweating profusely ("Lu Lu"), do not needle during strong winds and heavy rain, extreme cold or heat, dampness and irritability, black stool or hematemesis, sudden deafness, blindness, loss of mental clarity, incontinence, loss of spirit, or after emotional injuries, drunkenness, or overeating. Patients who have traveled far by carriage or horse must wait for their Qi and blood to stabilize before needling.