夫行针者。当刺之时。口温针暖。先以左手揣按其所针荣 之处。弹而弩之。爪而下之
扪
而循之。通而取之。随病咳嗽一声。右手持针而刺之。春夏二十四息。秋冬三十六息。徐出
徐入。气来如动脉之状。补者。随经脉推而内之。左手闭针空。徐出针。而疾按之。泻者。
迎经脉动而伸之。左手开针空。疾出针而徐按之。随而济之。是谓补。迎而夺之是谓泻。刺
实须其虚者。留针阴气隆至乃去针。刺虚须其实者。阳气隆至。针下热乃去针。一十二经之
病。盛则泻之。虚则补之。热则疾之。寒则留之。陷则灸之。不盛不虚。以经取之。
凡四肢者。身之支干也。其气系于五脏六腑。其身度浅薄。灸之不欲过多。须根据经数也
过
谓余病。则宜根据之。若香港脚。不拘此例。风毒灸之。务欲多也。根据此经数。则卒难愈疾。小
品论灸有八木火。明堂论灸之补泻法。若能根据之。应有道理。八木之火。凡灸用松木火则难
愈。柏木火则疮多汁。橘木火则伤皮。桑木火则肉枯。枣木火则
体消。竹木火则伤筋。多壮则筋纵。枳木火则陷脉溃。榆木火则
伤骨。多壮则骨枯。凡八木
之火。皆不可用也。火用阳燧之火。其次用KT 石之火。天阴则用槐木之火。阳燧是以火珠向
日下
以艾于下承之。便得火也。KT 石似玉坚。以此石击镔铁。即火出。仍以极烂榆木承之即得
亦用艾取之。此是匈奴火法。今北人犹尔。灸有补泻者。甲乙经云。用灸补者。无吹其火
须自灭也。以灸泻者。疾吹其火。付其艾。须其火灭也。此言以口吹艾炷令疾灭。即是泻
也。不吹听其自灭者。即补也。短剧又云。黄帝曰。灸不过三分。是谓从穴。此言作艾炷欲
令根下阔三分也。若减此。则不履孔穴。不中经脉。火气不行。不能除病也。若江南岭南寒
气既少。当二分为准。燧小不得减一分半也。婴儿以意减之。凡灸疮得脓增坏。其病乃出。
疮不坏则病不除已。甲乙经云。灸不发者。用故履底灸热熨之。三日即发也。甚宜解此。又
近
有苏恭。善医此疾。驰名于上京。显誉于下邑。撰香港脚方卷论。则信为指南。叙灸亦未成胶
柱。乃云。毒瓦斯如贼。何必要在大门出。腹背手足。皆须灸也。愚谓灸痛风毒所攻腹。则引
贼入室。如何令贼出门。特宜知之。不可轻脱。若手指疾闷。灸无妨也。若病患患热病者。
觉针气至病所。即退针三二分。令病患口吸气。鼻出气。根据经生成数数之。觉针下阴气隆至
根据前法出针。若病患患寒病者。觉针气至病所。即进针至二三分。令病患鼻吸口呼。根据本
经生成数数之。觉针下阳气隆至。根据前法出针。假令补冷。先令病患咳嗽一声。得入腠理。
复
令病患吹气一口。随吹下针。至六七分。渐进肾肝之部。停针。徐徐良久。复退针一豆许。
乃捻针。问病患觉热否。然后针至三四分。及心肺之部。又令病患吸气内针。捻针。使气下
行至病所。却外捻针。使气上行。直过所针穴一二寸。乃吸而外捻针出。以手速按其穴。此
为补。夫病后热者。治之以寒也何如。须其寒者。先刺入阳之分。后得气推内至阴之分。复
令
病患地气入而天气出。谨按生成之息数足。其病患自觉清凉矣。夫病恶寒者。治之以热也何
如。须其热者。先刺入阴之分。后得气徐引针。至阳之分。复令病患天气入而地气出。亦谨
按生成之息数足。其病患自觉和暖矣。
施行针刺时，应当口温针具使其温暖。先以左手揣按所针刺的荣穴之处，用手指弹击使经气弩张，用指甲切按定位，然后扪摸并循推经脉以通调气血，待患者随病情咳嗽一声时，右手持针进行刺入。春夏季节行针二十四次呼吸，秋冬季节行针三十六次呼吸，缓慢出针、缓慢进针，经气来复时感觉如动脉搏动之状。补法：顺着经脉走向将针推入体内，左手闭合针孔，缓慢出针并迅速按压针孔。泻法：迎着经脉气血流动的方向退针，左手张开针孔，快速出针并缓慢按压针孔。顺其势而资助正气，称为补；逆其势而夺其实邪，称为泻。治疗实证须使其转为虚证，需留针，待阴气隆盛至时才去针；治疗虚证须使其转为实证，待阳气隆盛至、针下产生热感时才去针。十二经脉的疾病，邪气盛则用泻法，正气虚则用补法，热证则速刺不留针，寒证则留针久候，脉陷下者用灸法，不盛不虚的病证则取本经穴位治疗。
凡是四肢，是身体的支干，其气血联系于五脏六腑，其皮肉浅薄，施灸不宜过多，必须根据经脉的常规壮数。若是其他疾病，则应依据此原则。若患香港脚（脚气病），不拘泥于此例，因风毒所致，施灸务必多壮。若严格遵循此经数，则难以迅速治愈疾病。《小品方》论及灸法有八种木火，《明堂经》论及灸法的补泻，若能依据这些理论，应有道理。八种木火中，凡是用松木火施灸则难愈，柏木火则疮面多汁，橘木火则损伤皮肤，桑木火则肌肉枯槁，枣木火则身体消瘦，竹木火则损伤筋脉，多壮则筋弛纵，枳木火则陷入脉络导致溃烂，榆木火则损伤骨骼，多壮则骨骼枯槁。这八种木火皆不可使用。火源应用阳燧之火，其次用碫石之火。天阴时用槐木之火。阳燧是以火珠向日下，以艾草在下承接，即可得火。碫石似玉般坚硬，以此石敲击镔铁，即迸出火花，仍以极烂的榆木承接即可得火，也用艾草取得，这是匈奴的火法，如今北方人仍如此使用。灸法有补泻之分，《甲乙经》说：用灸补法，不要吹火，须让其自然熄灭；用灸泻法，快速吹火，促使艾炷燃烧直至熄灭。这是指用口吹艾炷令其快速熄灭，即是泻法；不吹听其自然熄灭，即是补法。《短剧方》又说：黄帝曰，施灸不超过三分，这叫顺应穴位。这是指制作艾炷时欲令根部宽三分。如果少于这个尺寸，则不能深入孔穴，不中经脉，火气不能运行，不能除去疾病。若江南岭南寒气既少，当以二分为准，阳燧小不得减至一分半。婴儿施灸酌情减少。凡灸疮化脓溃破，病邪才能排出，疮不溃破则病不能去除。《甲乙经》说：灸后不发疮的，用旧鞋底加热熨烫，三日即发疮。这点很值得理解。又有苏恭，擅长医治此疾，在上京闻名，在下邑享有声誉，撰写了香港脚方卷论述，确实可作为指南。叙述灸法也未固守成见，他说：毒瓦斯如同盗贼，何必一定要从大门出去？腹背手足，都需要施灸。我认为灸治痛风毒所攻之腹部，则是引贼入室，如何能让贼出门？特此知晓，不可轻率脱略。若手指疾闷，施灸无妨。若病患患热病，觉针气至病所，即退针二三分，令病患口吸气、鼻出气，根据经脉生成之数计数，觉针下阴气隆盛，根据前法出针。若病患患寒病，觉针气至病所，即进针至二三分，令病患鼻吸口呼，根据本经生成之数计数，觉针下阳气隆盛，根据前法出针。假令补冷，先令病患咳嗽一声，得入腠理，再令病患吹气一口，随吹下针，至六七分，渐进肾肝之部，停针，徐徐良久，再退针一豆许，乃捻针，问病患觉热否，然后针至三四分，及心肺之部，又令病患吸气内针，捻针，使气下行至病所，却外捻针，使气上行，直过所针穴一二寸，乃吸而外捻针出，以手速按其穴，此为补。夫病后发热者，治之以寒法如何？须使其寒者，先刺入阳之分，后得气推内至阴之分，复令病患地气入而天气出，谨按生成之息数足，其病患自觉清凉矣。夫病恶寒者，治之以热法如何？须使其热者，先刺入阴之分，后得气徐引针，至阳之分，复令病患天气入而地气出，亦谨按生成之息数足，其病患自觉和暖矣。
When performing acupuncture, the needle should be warmed in the mouth. First, use the left hand to palpate and press the Ying (Nutrient) point area where the needle is to be inserted. Flick the area with a finger to distend the meridians, press down with the fingernail for positioning, then palpate and stroke along the meridian to unblock and regulate Qi. When the patient coughs once following their condition, insert the needle with the right hand. In spring and summer, perform twenty-four breaths; in autumn and winter, perform thirty-six breaths. Withdraw slowly and insert slowly. When Qi arrives, it feels like a pulsating artery. For tonification: push the needle into the body following the direction of the meridian flow. Close the needle hole with the left hand, withdraw the needle slowly, and press it quickly. For sedation: withdraw the needle against the direction of the meridian flow. Open the needle hole with the left hand, withdraw the needle quickly, and press it slowly. Following the flow to assist is called tonification; opposing the flow to deprive excess is called sedation. To treat excess syndromes and make them deficient, retain the needle until Yin Qi becomes abundant before removing it. To treat deficiency syndromes and make them solid, remove the needle when Yang Qi becomes abundant and heat is felt under the needle. For diseases of the twelve meridians: sedate if excess, tonify if deficient; puncture quickly without retention for heat syndromes; retain for cold syndromes; moxa for sinking conditions; and select points from the affected meridian for neither excess nor deficient conditions.
The four limbs are the branches and trunks of the body, with Qi connected to the Zang and Fu organs. Their flesh and skin are shallow, so moxibustion should not be excessive; one must follow the standard number of moxa cones according to the meridian. For other diseases, this principle applies. However, for Hong Kong foot (Gouty Arthritis/Jiaqi), this rule does not apply strictly; since it is caused by wind-toxin, moxibustion should be copious. If one strictly follows the standard meridian counts, the disease will be difficult to cure quickly. The *Xiao Pin Fang* discusses eight types of wood fires for moxibustion, and the *Ming Tang Jing* discusses moxibustion tonification and sedation methods; following these theories yields correct results. Among the eight wood fires: pine wood fire makes healing difficult; cypress wood fire causes excessive discharge from sores; orange wood fire damages the skin; mulberry wood fire causes muscle withering; date wood fire causes emaciation; bamboo wood fire damages tendons; too many cones cause tendon flaccidity; bitternut tree wood fire causes sinking into collaterals and ulceration; elm wood fire damages bones; too many cones cause bone withering. None of these eight wood fires should be used. One should use fire from a Yang Sui (bronze mirror), or secondarily from a grinding stone (Dun Shi). On cloudy days, use locust wood fire. The Yang Sui involves holding a bronze mirror towards the sun with mugwort underneath to catch the flame. Dun Shi is hard like jade; striking it against bloomery iron produces sparks, which are caught on rotten elm wood to ignite mugwort. This is the Xiongnu fire method, still used by people in the north today. Regarding moxibustion tonification and sedation, the *Jia Yi Jing* states: for tonification, do not blow on the fire; let it extinguish naturally. For sedation, blow rapidly on the fire to hasten the burning of the mugwort cone until it extinguishes. Blowing rapidly to extinguish is sedation; letting it extinguish naturally is tonification. The *Duan Ju Fang* adds: Huang Di said, moxibustion should not exceed three fen, which is called following the acupoint. This means the base of the moxa cone should be three fen wide. If less than this, it will not penetrate the acupoint, fail to reach the meridian, prevent Qi flow, and cannot eliminate disease. In Jiangnan and Lingnan, where cold Qi is scarce, two fen is the standard; for small mirrors, do not reduce below one and a half fen. Reduce dosage for infants. Generally, moxa sores must suppurate and break open for the disease to exit; if the sore does not break, the disease remains. The *Jia Yi Jing* states: if moxibustion fails to produce a sore, apply hot compresses using old shoe soles; the sore will appear within three days. This is worth understanding. Su Gong, skilled in treating this disease, was famous in the capital and renowned in lower regions. He wrote volumes on Hong Kong foot formulas, serving as a guide. His discussion on moxibustion was not rigid. He stated: "Toxic vapors are like thieves; why must they exit through the main gate? Moxibustion is required on the abdomen, back, hands, and feet." I argue that moxing the abdomen attacked by wind-toxin is inviting the thief into the house; how can one expect the thief to leave? This must be known carefully and not treated lightly. Moxibustion on fingers for stiffness is permissible. If a patient has a heat syndrome, upon feeling Qi arrival at the disease site, withdraw the needle two or three fen. Have the patient inhale through the mouth and exhale through the nose. Count according to the generative numbers of the meridian. When Yin Qi becomes abundant under the needle, remove it according to the previous method. If a patient has a cold syndrome, upon feeling Qi arrival, advance the needle two or three fen. Have the patient inhale through the nose and exhale through the mouth. Count according to the generative numbers of the meridian. When Yang Qi becomes abundant under the needle, remove it according to the previous method. For example, in tonifying cold: first have the patient cough once to enter the interstices. Then have the patient blow air once, insert the needle while blowing, to a depth of six or seven fen. Gradually advance to the Kidney and Liver areas. Retain the needle for a long time. Withdraw slightly (one bean's width), twirl the needle, and ask if the patient feels heat. Then advance to three or four fen, reaching the Heart and Lung areas. Have the patient inhale while inserting, twirl to direct Qi downward to the disease site, then twirl outward to direct Qi upward, passing one or two cun beyond the needled point. Inhale while twirling outward to withdraw, and quickly press the acupoint with the hand. This is tonification. For post-illness heat, how to treat with cold methods? To induce coolness, first puncture the Yang aspect. After obtaining Qi, push inward to the Yin aspect. Have the patient draw Earth Qi in and release Heaven Qi out. Carefully count the generative breaths until complete; the patient will feel cool. For aversion to cold, how to treat with heat methods? To induce warmth, first puncture the Yin aspect. After obtaining Qi, slowly withdraw to the Yang aspect. Have the patient draw Heaven Qi in and release Earth Qi out. Carefully count the generative breaths until complete; the patient will feel warm.