假令针肝经感气运,以补肝经合曲泉穴之络;假令针肝络血运,以补本经曲泉穴之经,针入
复苏,效如起死,他皆仿此。
疼实痒虚,泻子随母要指。病之虚实者,痒则为虚,痛者为实。刺法云∶虚则补
其母
,实则泻其子。假令肝脏实,泻肝之荣行间穴,属火是子;肝脏虚,补肝之合曲泉穴,属水
是母。凡刺只取木经井荥俞经合五行,子母补泻,此乃大要也。
想夫先贤迅效,无出于针经;今人愈疾,岂离于医法。古之治疾,特论针石,《
素问
》先论刺,后论脉;《难经》先论脉,后论刺。刺之与脉,不可偏废。昔之越人起死,华佗
愈,非有神哉,皆此法也。离圣久远,后学难精,所以针之玄妙,罕闻于世。今时有疾,
多求医命药,用针者寡矣。
徐文伯泻孕于苑内,斯由其速;昔宋太子性善医书,出苑见一有孕妇人,太子自
为诊
之,是一女。令徐文伯亦诊之,乃一男一女。太子性急,欲剖腹视之。文伯因自请针之令落
,于是泻足三阴交,补手阳明合谷,胎应针而落,果如文伯之言也。
范九思疗咽于江夏,闻见言稀。传曰∶嘉 中有太傅程公,守任于江夏,因母之
暴患
咽中有痈,卒然而长,寒气不通,命医者止可用药治之,勿施针以损之。医曰∶咽中气尚不
通,岂能用药,药即下之,岂能卒效,故众医不敢措治。寻有医博范九思云∶有药须用未使
新笔点之,痈疽即便差。公遂取新笔与之,九思乃以点药上痈,药到则有紫血顿出,渐气通
而瘥。公曰∶此达神圣之妙矣。公命九思饮,而求其方,九思大笑曰∶其患是热毒结于喉中
,塞之气不宣通,病以危甚。公坚执只可用药,不可用针,若从公意,则必误命,若不从公
意,固不能施治,九思当日,曾以小针藏于笔头中,妄以点药,乃针开其痈而效也,若非如
此,何如紫血顿下也。公方省而欢曰∶针有劫病之功,验于今日。古人云∶为将不察士卒之
能否,则不能决胜,为医不察药性之主治,则不能便瘥,文将无深谋远虑,则无必胜,医无
先机远见,治无必效也。
大抵古今遗迹,后世皆师。昔圣人留轨范,使后人仿学,不可独强也。况于针术
,隐奥难究,妙门出乎其类者,今之世谁能之,故圣人云∶不可不遵先圣遗文也。
王纂针魅而立康,獭从被出;传曰∶王纂少习医方,尤精针石,远近知名,嘉
中县
人张方女,因暮宿于广陵庙中,下有一物,假作其 ,因被魅感而病,纂为治之,一针有一
祟从女被中走出,而病愈矣。
秋夫疗鬼而获效,魂免伤悲。昔宋徐熙字秋夫,善医方,为丹阳令,常闻鬼神吟
呻甚
凄苦。秋夫曰∶汝是鬼何须知此!答曰∶我患腰病,死虽为鬼,痛苦尚不可忍,闻君善医,
愿相救济。秋夫曰∶吾闻鬼无形,何由措置?鬼云∶缚草作人,子根据之,但取孔穴针之。秋
夫
如其言,为针腰俞二穴,肩井二穴,设祭而埋之。明日见一人来谢曰∶蒙君医疗,复为设祭
,病今已愈,感惠实深,忽然不见。公曰∶夫鬼为阴物,病由告医,医既愈矣,尚能感激,
况于人乎?鬼姓斛名斯。
既而感指幽微,用针直诀。此皆指微论中,用针幽微之直诀也。
窍齐于筋骨,皮肉刺要;窍者穴也,齐者浅深之宜也。经曰∶刺皮无伤骨,刺骨
无伤
髓。病有浮沉,刺有浅深,各至其理,无过其道。过则伤,不及则生外壅,壅则邪从之,浅
深不得,反为大贼,内动五脏,故生大病。
痛察于久新,腑脏寒热。痛者病也,夫人病有久新,脏病腑病,寒热虚实,宜细
详审调。针形短长锋类不等,穷其补泻,各随病所宜用之。
接气通经,短长根据法;本论曰∶夫欲取偏枯久者荣卫诸疾,多是愈而复作者,由
气不
接而经不通流,虽有临时之块,客气胜真,病当未愈也,当此乃上接而下引。呼吸多少,经
脉长短,各有定数之法。手三阳接而九呼,过经四寸,乎三阴接而七呼,过经五寸;足之三
阳接而一十四呼,过经四寸,足之三阴接而一十二呼,过经五寸。重者倍之,吸亦同数,此
接气通经,呼吸长短之法也。
里外之绝,羸盈必别。夫五脏里外者,谓心肺在鬲上,通于天气也。心主于脉,
肺主
于气,外华荣于皮肤,故言外也。肾肝在下,通于地气,以藏精血,实于骨髓。心肺外绝,
则皮聚毛落;肾肝内绝,则骨痿筋缓。其时学人,不能别里外虚实,致使针药误投,所以实
实虚虚,损不足益有余,如此死者,医杀之耳。
勿刺大劳,使人气乱而神隳;《禁刺论》曰∶无刺大劳人,劳则喘息汗出,里外
昏越,故气耗乱,神隳散也。
慎妄呼吸,防他针昏而闭血。呼吸者,使阴阳气行流上下,经历五脏六腑,若针
刺妄行呼吸,阴阳交错,则针昏闭血,气不行也。
又以常寻古义,由有藏机;遇高贤真趣,则超然得悟。逢达人示教,则表我扶危。先
贤之书,文理幽深,隐义难穷;或字中隐义,或假令一隅,妙要难穷,遇高达之士,方得其
趣,不可穿凿。
男女气脉,行分时合度;本论云∶夫男女老幼,气候不同,春夏秋冬,寒暑各异
。春
气生而脉气缓,夏暑热而脉行速,秋气燥而脉行急,冬气寒而脉凝涩。小儿之脉应春,壮年
之脉应夏,四十以上如秋,六十以后如冬。其病有寒热,脉有迟速,一一参详,不可一概与
天同度矣。《难经》云∶一呼脉行三寸,一吸脉行三寸者,平人脉法也。微抱病之人皆失天
之度,地之纪,脉之用,不可与平人脉相合也。其诊取法∶当以一息五至为与天同度;不及
应春,不及应冬;太过应秋,太过应夏。应春冬者,宜留针待气至;应秋夏者,呼吸数毕便
宜去针,此之谓也。
养子时克,注穴必须根据。养子时克注穴者,谓逐时干旺气注脏腑井荥之法也。每
一时
辰,相生养子五度,各注井荥俞经合五穴。昼夜十二时,气血行过六十俞穴也。每一穴血气
分得一刻六十分六厘六毫六丝六忽六杪,此是一穴之数也。六十穴共成百刻,要求日下井荥
,用五子建元日时取之。设令甲日甲戌时,胆统气初出窍阴穴为井木,流至小肠为荥火,气
过前谷穴注至胃为俞土,气过陷谷穴又并过本原丘墟穴。但是六腑各有一原穴,则不系属井
荥相生之法,即是阴阳二气出入门户也。行之大肠为经金,气过阳溪穴,所入膀胱为合水,
气入委中穴而终。此是甲戌时木火土金水相生五度一时辰流注五穴毕也。他皆仿此。
今详定疗病之宜,神针法式,广搜难素之秘文密辞,深考诸家之肘函妙臆,故称泸江流
注之指微,以为后学之规则。
假设针刺肝经感受气运(指随时间变化的经气运行规律),应补益肝经合穴曲泉的络脉;假设针刺肝经络血运,应补益本经曲泉穴的经气,针入后患者即刻苏醒,疗效如同起死回生,其他情况都仿照此法。
疼痛属实证,瘙痒属虚证,泻子法与随母法(即补母泻子法)是手指间的关键法则。疾病的虚实表现中,瘙痒属于虚证,疼痛属于实证。《刺法》说:虚证则补其母,实证则泻其子。假设肝脏实证,泻肝经荥穴行间穴,行间属火,火为木之子;肝脏虚证,补肝经合穴曲泉穴,曲泉属水,水为木之母。凡针刺只取木经(肝、胆经)的井、荥、俞、经、合五输穴,运用五行子母补泻法,这是最重要的原则。
想那先贤医术迅速有效,没有超出《针经》范围的;如今人治愈疾病,难道能离开医法吗?古代治疗疾病,特别论述针石,《素问》先论述针刺,后论述脉诊;《难经》先论述脉诊,后论述针刺。针刺与脉诊,不可偏废。昔日扁鹊(越人)使人起死回生,华佗治愈疾病,并非有神助,都是运用了这些方法。远离圣人时代已久,后学者难以精通,所以针刺的玄妙之处,很少在世间听闻。现在人有疾病,多求医生开药,使用针刺的人很少了。
徐文伯通过针刺使孕妇流产,是因为手法迅速;从前宋太子擅长医书,出宫苑时见到一位孕妇,太子亲自为她诊脉,判断是女孩。令徐文伯也诊脉,徐文伯说是龙凤胎(一男一女)。太子性情急躁,想要剖腹查看。徐文伯于是自请针刺使其流产,于是泻足三阴交穴,补手阳明经合谷穴,胎儿随着针刺而落下,果然像徐文伯所说的那样。
范九思在江夏治疗咽喉疾病,听闻此事的人很少。传说中说:嘉州有位太傅程公,在江夏任职,因为母亲突然患咽喉长痈,忽然肿大,寒气不通,命令医者只能用药物治疗,不要施针以免损伤。医生说:咽喉中气息尚且不通,怎么能用药?药服下去,怎能立刻见效,所以众医不敢进行治疗。不久有位医学博士范九思说:有药必须用未使用过的新笔蘸取,痈疽立刻就会痊愈。程公于是取来新笔给他,范九思就用它蘸药点在痈上,药到就有紫血顿时流出,逐渐气息通畅而病愈。程公说:这达到了神圣的奥妙境界啊。程公邀请范九思饮酒,并寻求他的方子,范九思大笑说:这个病患是热毒结于喉中,阻塞气息不能宣通,病情非常危急。程公坚持认为只能用药,不能用针,如果顺从程公的意思,就一定会误人性命,如果不顺从程公的意思,确实无法进行治疗。范九思当天,曾将小针藏在笔头中,假装点药,实际上是针刺打开了痈肿从而见效,如果不是这样,怎么会有紫血顿时流出呢。程公这才醒悟并高兴地说:针刺有劫除病邪的功效,在今天得到了验证。古人说:作为将领不考察士兵的能力,就不能决胜;作为医生不考察药物的主治功效,就不能使病痊愈;文人如果没有深谋远虑,就没有必胜把握;医生如果没有先见之明和远见,治疗就没有必然的疗效。
大体上古今留下的遗迹,后世都效法。从前圣人留下规范,使后人模仿学习,不能独自强求。何况针术,隐晦深奥难以探究,精妙之门出自其中杰出者,当今世上谁能做到呢?所以圣人说:不可不遵循先圣遗留的文章。
王纂针刺驱除魅鬼而立致康复,獭皮被取出;传说中说:王纂年轻时学习医方,尤其精通针石,远近闻名。嘉州县人张方的女儿,因为晚上住宿在广陵庙中,下面有个东西,假冒成她的丈夫,因此被魅鬼感染而生病,王纂为她治疗,一针下去有一个祟物从女子被子中走出,病就好了。
秋夫治疗鬼怪而获得疗效,魂魄免于悲伤。从前宋朝徐熙字秋夫,擅长医方,担任丹阳令,常听到鬼神吟唱呻吟声非常凄苦。秋夫说:你是鬼为什么要知道这些!回答说:我患有腰痛病,虽然死了成为鬼,痛苦仍然不可忍受,听说你擅长医术,希望你救济我。秋夫说:我听说鬼没有形体,从哪里安置呢?鬼说:扎草做成人的形状,你依据它,只要选取穴位针刺即可。秋夫按照他的话,针刺腰俞二穴、肩井二穴,设祭品埋葬它。第二天看见一个人来道谢说:承蒙您医疗,又为我设祭,病现在已经好了,感激恩惠实在很深,忽然不见了。程公说:鬼是阴物,生病告知医生,医生既然治好了,还能感激,何况是人呢?鬼姓斛名斯。
接着感悟指向幽微之处,使用针刺的直接诀窍。这些都是《指微论》中,关于使用针刺幽微之处的直接诀窍。
窍穴与筋骨齐平,皮肉针刺要有要点;窍就是穴,齐就是深浅适宜。经文说:刺皮不要伤骨,刺骨不要伤髓。病有浮沉,刺有浅深,各到达其理,不要超过其道。超过了就会受伤,不够就会产生外部壅滞,壅滞则邪气随之而来,深浅不得当,反而成为大害,内动五脏,所以产生大病。
痛症要察辨久病与新病,脏腑寒热。痛就是病,人患病有久有新,脏病腑病,寒热虚实,应当仔细详审调理。针的形状长短锋类不等,穷尽补泻之法,各自根据病情适宜使用。
接气通经,长短根据法规;本论说:如果想治疗偏枯日久等营卫诸疾,多是痊愈后又复发的,由于气不接续而经气不通流,虽然有暂时的肿块,客气胜过真气,病应当未愈,这时应当上接而下引。呼吸多少,经脉长短,各有定数的法规。手三阳经接气需九次呼吸,经过经脉四寸;手三阴经接气需七次呼吸,经过经脉五寸;足三阳经接气需十四次呼吸,经过经脉四寸;足三阴经接气需十二次呼吸,经过经脉五寸。重症加倍,吸气也同此数,这就是接气通经,呼吸长短的方法。
里外之绝,虚弱充盈必须辨别。所谓五脏里外,是指心肺在膈膜之上,通于天气。心主脉,肺主气,外表荣华于皮肤,所以说外。肾肝在下,通于地气,以藏精血,充实于骨髓。心肺外绝,则皮肤聚拢毛发脱落;肾肝内绝,则骨骼痿软筋脉松弛。当时的学习者,不能辨别里外虚实,致使针药误投,所以实证实治、虚证虚治(此处原文意指错误地实其实、虚其虚,即实证用补法,虚证用泻法,导致损不足益有余),损害不足的,增加有余的,这样的死者,是医生杀死的罢了。
不要针刺过度疲劳的人,使人气机紊乱而神气崩溃;《禁刺论》说:不要针刺过度劳累的人,劳累则喘息出汗,里外昏乱超越常态,所以气耗散紊乱,神气崩溃消散。
谨慎妄动呼吸,防止其他针刺昏厥而闭阻血脉。呼吸,是使阴阳之气运行流动上下,经历五脏六腑,如果针刺时妄动呼吸,阴阳交错,则针昏闭血,气不行走。
又常常寻访古义,因为有隐藏之机;遇到高贤的真趣,则超然领悟。逢达之人示教,则表白我扶持危难。先贤的书,文理幽深,隐义难以穷尽;或者字中隐藏义理,或者假令一隅,妙要难以穷尽,遇到通达高尚之士,才能得其趣味,不可穿凿附会。
男女气脉,运行时分结合度;本论说:男女老幼,气候不同,春夏秋冬,寒暑各异。春气生发而脉气缓和,夏暑炎热而脉行快速,秋气干燥而脉行急迫,冬气寒冷而脉凝涩。小儿的脉象对应春,壮年的脉象对应夏,四十岁以上如秋,六十岁以后如冬。其病有寒热,脉有迟速,一一参详,不可一概与天同度(指不可机械套用标准)。《难经》说:一呼脉行三寸,一吸脉行三寸,是正常人的脉法。稍微抱病的人都失去了天的度数,地的纪纲,脉的作用,不可与正常人脉相合。其诊取法:应当以一息五至为与天同度;不及应春,不及应冬;太过应秋,太过应夏。应春冬者,宜留针等待气至;应秋夏者,呼吸数毕便宜去针,说的就是这个道理。
养子时克,注穴必须根据。养子时克注穴,是指逐时辰天干旺气注入脏腑井荥穴的方法。每一个时辰,相生养子五次,各注井、荥、俞、经、合五穴。昼夜十二个时辰,气血行过六十俞穴。每一穴血气分得一刻六十分六厘六毫六丝六忽六杪,这是一个穴的数值。六十穴共成一百刻,要求日下井荥,用五子建元日时取之。假设甲日甲戌时,胆统气初出窍阴穴为井木,流至小肠为荥火,气过前谷穴注至胃为俞土,气过陷谷穴又并过本原丘墟穴。凡是六腑各有一原穴,则不系属井荥相生之法,即是阴阳二气出入门户也。行之大肠为经金,气过阳溪穴,所入膀胱为合水,气入委中穴而终。这是甲戌时木火土金水相生五度一时辰流注五穴完毕。其他都仿照此法。
现在详细审定治疗疾病的适宜,神针法式,广泛搜集《难经》《素问》的秘文密辞,深入考证诸家肘后方中的妙意,所以称为泸江流注之指微,作为后学的规则。
Suppose needling the Liver Meridian affected by Qi movement (referring to the rhythmic flow of meridian Qi according to time), one should tonify the Luo-connecting vessel of the He-sea point Ququan (LR8) of the Liver Meridian; suppose needling the Liver Meridian's blood movement, one should tonify the Jing-stream Qi of the He-sea point Ququan of this meridian. Upon needle insertion, the patient revives instantly, with efficacy as if raising the dead from the grave; other situations follow this pattern.
Pain indicates excess, itching indicates deficiency; the methods of draining the child and following the mother (i.e., tonifying the mother and draining the child) are key principles at the fingertips. Regarding the excess and deficiency of diseases, itching belongs to deficiency, while pain belongs to excess. The *Needling Methods* states: For deficiency, tonify its mother; for excess, drain its child. Suppose the Liver is in excess, drain the Ying-spring point Xingjian (LR2) of the Liver, which belongs to Fire, the child of Wood; suppose the Liver is deficient, tonify the He-sea point Ququan (LR8) of the Liver, which belongs to Water, the mother of Wood. In all needling, only select the Five Shu points (Jing-well, Ying-spring, Shu-stream, Jing-river, He-sea) of the Wood meridians (Liver and Gallbladder), applying the Five Elements' mother-child tonification and drainage method; this is the major principle.
Thinking of the ancient sages whose rapid and effective treatments never exceeded the scope of the *Classic of Acupuncture*; how can modern people cure diseases without relying on medical methods? In ancient times, treating diseases specifically discussed needles and stones; the *Suwen* discusses needling first, then pulse diagnosis; the *Nanjing* discusses pulse diagnosis first, then needling. Needling and pulse diagnosis cannot be neglected. In the past, Bian Que (Yue Ren) raised the dead, and Hua Tuo cured diseases, not by divine aid, but by employing these methods. Having been far from the sages for a long time, later learners find it difficult to master them thoroughly; thus, the profound mysteries of needling are rarely heard of in the world. Nowadays, when people are ill, they mostly seek doctors for medicine, and few use needling.
Xu Wenbo induced abortion through needling due to his swift technique; formerly, the Crown Prince of Song was skilled in medical texts. Upon seeing a pregnant woman in the palace garden, the Crown Prince diagnosed her himself and determined she carried a girl. He asked Xu Wenbo to diagnose her as well, who said she carried both a boy and a girl. Impatient, the Crown Prince wanted to perform a cesarean section to verify. Xu Wenbo volunteered to induce miscarriage via needling. He drained the intersection point Sanyinjiao (SP6) on the foot and tonified the He-sea point Hegu (LI4) on the hand. The fetus fell immediately upon needling, exactly as Xu Wenbo predicted.
Fan Jiusi treated throat ailments in Jiangxia, a story rarely heard. It is recorded that Cheng Gong, Grand Tutor of Jiazhou, was serving in Jiangxia. His mother suddenly suffered from a throat abscess, swelling abruptly with blocked cold qi. She ordered physicians to use only medicine and avoid needling to prevent damage. The physician replied, "If qi does not even pass through the throat, how can medicine work? Medicine taken orally will not take immediate effect." Thus, no physician dared to treat. Soon, Medical Doctor Fan Jiusi said, "Use medicine applied with a brand-new unused brush, and the abscess will heal immediately." Cheng Gong provided a new brush. Fan Jiusi dipped the brush in medicine and applied it to the abscess. Immediately, purple blood flowed out, qi circulation gradually restored, and the illness healed. Cheng Gong said, "This reaches the divine mystery!" Inviting Fan Jiusi to drink, he sought his prescription. Fan Jiusi laughed loudly and said, "The disease is heat-toxin knotting in the throat, blocking qi transmission, critically severe. Cheng Gong insisted on using only medicine, not needling. If I had followed his wish, lives would have been lost; if I did not follow him, treatment could not proceed. That day, I hid a small needle inside the brush tip, pretending to apply medicine, but actually needling to open the abscess, achieving efficacy. Otherwise, how could purple blood have flowed out?" Cheng Gong realized and rejoiced, saying, "Needling has the power to seize and eliminate pathogenic factors, verified today." The ancients said: A general who does not assess soldiers' capabilities cannot win battles; a doctor who does not understand drug properties cannot cure illnesses; a scholar without deep foresight lacks sure victory; a doctor without prior insight and vision lacks guaranteed efficacy in treatment.
Generally, relics of past and present are emulated by later generations. Formerly, sages left standards for others to imitate; one cannot force innovation alone. Especially regarding needling techniques, which are obscure and difficult to explore, those who emerge from the subtle gate as outstanding figures—who in today's world can achieve this? Therefore, the sage says: One must not fail to follow the legacy of former sages.
Wang Zuan cured possession by spirits through needling, causing evil entities to exit; it is recorded that Wang Zuan studied medical formulas in his youth, specializing in needling and stone therapy, becoming famous near and far. Zhang Fang's daughter, a resident of Jiazhou, stayed overnight in the Guangling Temple. An entity below pretended to be her husband, infecting her with spirit possession. Wang Zuan treated her; with one needle insertion, a malevolent entity walked out from under the woman's quilt, and she recovered.
Qiufu treated ghosts and achieved results, sparing souls from sorrow. Previously, Xu Xi, courtesy name Qiufu of the Song dynasty, was skilled in medical formulas and served as Magistrate of Danyang. He often heard ghosts chanting and groaning bitterly. Qiufu asked, "You are a ghost, why do you know this?" The ghost replied, "I suffer from lower back pain. Although dead and a ghost, the pain is unbearable. I hear you are skilled in medicine; please help me." Qiufu said, "I hear ghosts have no form; how can I treat them?" The ghost said, "Bind straw into a human shape, base your treatment on it, and simply select acupoints to needle." Qiufu followed his words, needled two points of Yaoshu (BL23) and two points of Jianjing (GB21), set up sacrifices, and buried the straw figure. The next day, a person appeared to thank him, saying, "Thanks to your medical treatment and sacrifice, my illness is now healed. I am deeply grateful," then vanished. Duke Gong said, "Ghosts are yin entities; falling ill and informing a doctor, once cured, they still feel gratitude. How much more so for humans?" The ghost's surname was Hu, given name Si.
Subsequently, sensing the subtle directions, using the direct guidelines of needling. These are the direct guidelines within the *Zhiwei Lun* regarding the subtle aspects of using needling.
Orifices align with sinews and bones; skin and flesh needling requires precision. "Orifice" refers to acupoints; "align" refers to appropriate depth. The classics state: When needling the skin, do not injure the bone; when needling the bone, do not injure the marrow. Diseases have superficial or deep locations; needling has shallow or deep depths. Each must reach its proper rationale without exceeding the correct pathway. Exceeding causes injury; falling short generates external stagnation, allowing pathogens to enter. Improper depth becomes a great disaster, disturbing the internal five zang organs, thereby causing severe illness.
Pain requires distinguishing between chronic and acute conditions, and organ vs. fu-organ, cold vs. heat. Pain is a disease. Human illnesses vary by duration (old/new), zang/fu involvement, and cold/heat/excess/deficiency patterns; these must be carefully examined and regulated. Needle shapes vary in length and tip type; mastering tonification and drainage methods allows selection based on the specific needs of the disease.
Connecting Qi and unblocking meridians depends on length and method. The main text states: To treat chronic hemiplegia and various Ying-Wei disorders, which often recur after apparent recovery, it is due to disconnected Qi and blocked meridian flow. Even if temporary masses appear, if pathogenic Qi overcomes healthy Qi, the disease remains unresolved. In such cases, one should connect Qi upwards and guide downwards. The number of breaths and meridian lengths have fixed numerical rules. For the Three Yang meridians of the hand, connecting Qi requires nine breaths, covering four cun of the meridian; for the Three Yin meridians of the hand, seven breaths cover five cun; for the Three Yang meridians of the foot, fourteen breaths cover four cun; for the Three Yin meridians of the foot, twelve breaths cover five cun. For severe cases, double these numbers; inhalation follows the same count. This is the method of connecting Qi and unblocking meridians via breath length.
Distinguishing interior-exterior extremes, differentiating between emaciation and fullness. The concept of interior-exterior of the five zang organs refers to the Heart and Lung being above the diaphragm, communicating with heavenly Qi. The Heart governs vessels, the Lung governs Qi, manifesting externally on the skin; hence termed "exterior." The Kidney and Liver are below, communicating with earthly Qi, storing essence and blood, filling the bone marrow. If exterior Heart/Lung Qi is severed, skin gathers and hair falls; if interior Kidney/Liver Qi is severed, bones become flaccid and sinews relax. Students of that era failed to distinguish interior-exterior excess-deficiency, leading to erroneous needle and drug administration. Thus, reinforcing excess and depleting deficiency (treating excess with tonification and deficiency with drainage), damaging what is insufficient and adding to what is excessive—such deaths are caused by the physician's error.
Do not needle individuals in extreme fatigue, as this disrupts Qi and collapses Shen (Spirit). The *Prohibitions on Needling* states: Do not needle those in extreme labor; labor causes panting and sweating, leading to internal and external confusion, resulting in scattered and chaotic Qi, and collapsed Spirit.
Be cautious with erratic breathing to prevent needle-induced syncope and blood stasis. Breathing facilitates the upward and downward flow of Yin and Yang Qi through the five zang and six fu organs. Erratic breathing during needling causes Yin-Yang disarray, leading to needle-induced coma, closed blood flow, and stagnant Qi.
Furthermore, constantly seeking ancient meanings reveals hidden mechanisms; encountering true wisdom from high sages leads to transcendent enlightenment. Meeting enlightened teachers clarifies how to support the critical. Ancient texts have profound literary logic and elusive meanings; hidden meanings may lie within characters or hypothetical scenarios. Their subtleties are hard to exhaust. Only by meeting highly accomplished scholars can one grasp their essence; one must not force interpretations.
Male and female Qi and pulses move according to time and degree. The main text states: Men, women, the elderly, and the young differ in climate responses; spring, summer, autumn, and winter have distinct cold and heat variations. Spring Qi generates slow pulse flow; Summer heat accelerates pulse flow; Autumn dryness makes pulse flow urgent; Winter cold causes pulse flow to congeal and stall. Children's pulses correspond to Spring; adults' pulses correspond to Summer; those over forty resemble Autumn; those over sixty resemble Winter. Illnesses have cold/heat distinctions; pulses have slow/fast rates. Each must be analyzed individually; one cannot mechanically apply standard measures to all. The *Nanjing* states: "One exhalation moves Qi three cun, one inhalation moves Qi three cun" is the normal pulse method. Those slightly ill lose the measure of Heaven and Earth, altering pulse function; their pulses cannot match normal individuals. Diagnostic method: Consider five beats per respiration as matching Heavenly measure. Pulses slower than this correspond to Spring/Winter; faster correspond to Autumn/Summer. For Spring/Winter patterns, retain the needle until Qi arrives; for Autumn/Summer patterns, remove the needle after completing breath counts. This is the principle.
"Nourishing Child Time Stems" (Yangzi Shike) dictates that acupoint injection must follow specific rules. "Nourishing Child Time Stem Injection" refers to the method where the prosperous Qi of each hour's Heavenly Stem injects into the Jing-well and Ying-spring points of the zang-fu organs. Each two-hour period involves five stages of generation/nourishment, injecting into the five points: Jing-well, Ying-spring, Shu-stream, Jing-river, and He-sea. Over twelve periods day and night, Qi and Blood traverse sixty acupoints. Each acupoint receives 1/60th of an hour (approx. 6.66 minutes). Sixty acupoints constitute one hundred ke (time units). To determine daily Jing-well/Ying-spring points, use the Wuzi Jianyuan method based on day and hour. For example, on a Jia day during Jia-Xu hour, the Gallbladder governs Qi initially emerging from the Jing-well point Qiaoyin (GB44) as Wood, flowing to the Small Intestine as Ying-fire, passing the Shu-point Qiangu (SI3) to the Stomach as Shu-earth, passing Xangu (ST41) and merging with the Yuan-source point Qiuxu (GB40). All six fu-organs have one Yuan-source point, which does not belong to the Jing-well/Ying-spring generation sequence but serves as the portal for Yin-Yang Qi entry and exit. Flowing to the Large Intestine as Jing-metal, passing Yangxi (LI5), entering the Bladder as He-water, concluding at Weizhong (BL40). This completes the five-stage generation of Wood-Fire-Earth-Metal-Water for one Jia-Xu hour. Other hours follow this pattern.
Now detailing the appropriateness of treating diseases, the sacred needle methods, extensively searching the secret texts of the *Nanjing* and *Suwen*, deeply examining the profound insights of various family manuals (Elbow Manuals). Hence, it is called the *Zhiwei* (Finger Subtleties) of Lujiang Liu Zhu, serving as a rule for later learners.