经云。东方实而西方虚。泻南方而补北方。何谓也。此实母泻子之法。非只刺一经而已
假令肝木之病实。泻心火之子。补肾水之母。其肝经自得其平矣。五脏皆根据此而行之。
左手掏穴。右手置针于穴上。令病患咳嗽一声。针入透于腠理。令病患吹气一口。随吹
针至
分寸。待针头沉紧。时转针头。以手循扪。觉气至却回。针头向下。觉针头沉紧。令病患吸
气一口。随吸出针。乃闭其穴(谓一手急捻孔是也)。虚羸气弱痒麻者。补之。
左手掏穴右手置针于穴上。令病患咳嗽一声。针入腠理。复令病患吸气一口。随吸气入
针至
分寸。觉针沉紧。转针头向病所。觉气至病。若觉病退。便转针头下以手循扪。觉针沉闷。
令病患吹气一口。随吹气一口而徐出其针。则不闭其穴。命之曰泻。丰肥坚硬疼痛者。泻之
夫泻必用方。以气方盛也。以月方满也。以日方温也。以身方定也。以息方吸而内针。
及复
候其方吸而转。及复候其方呼而徐引针。故曰泻。夫补必用圆。圆者行也。行者移也。谓行
不宜之气。移未复之脉。故刺必中其荣。又复候吸而推针至血。故圆与方非针也。余不知圣
人之意。请后之明达之士详究焉。
内经曰。病有浮沉。刺有深浅。各正其理。无反其道。然春夏为阳。其气在外。人气亦
浮。
凡刺者。故浅取之。秋冬为阴。其气在内。人气在脏。凡刺者。故当深取之。又言。春夏各
致一阴。秋冬各致一阳者。谓春夏为阳。谓阴所养。故刺之各致一阴。秋冬为阴。谓阳所养
故刺之各致一阳。春夏温必致一阴者。谓下针深刺至肾肝之部。得其气针便出之。是以引
持之阴也。秋冬寒必致一阳者。谓下针浅刺至心肺之部。得其气推而内之良久出针。是推内
之阳也。故素问曰。春夏养阳。秋冬养阴也。
《内经》说:东方(肝)实证而西方(肺)虚证,应当泻南方(心)并补北方(肾)。这是什么意思呢?这是“实者泻其子,虚者补其母”的方法,不仅仅局限于针刺某一条经脉。
假设是肝木的病症表现为实证,就泻心火(肝之子),补肾水(肝之母)。这样肝经自然就能恢复平衡了。五脏的疾病都依据这个原则来施治。
左手定位穴位,右手将针置于穴上,让病人咳嗽一声,进针穿透腠理(皮肤纹理与肌肉间隙)。让病人吹气一口,随着吹气的动作将针刺入分寸深度。等到针下感觉沉紧时,转动针头,用手循按抚摸穴位周围,感觉到“得气”后,将针尖向下。再次感觉针下沉紧,让病人吸气一口,随着吸气的动作出针,随即闭合其穴位(即一只手迅速捻转孔穴以闭合)。对于身体虚弱、气血不足、感到瘙痒麻木的患者,采用补法。
左手定位穴位,右手将针置于穴上,让病人咳嗽一声,进针至腠理。再让病人吸气一口,随着吸气的动作将针刺入分寸深度。感觉针下沉紧,转动针头朝向病所。感觉到气至病所,如果感觉病痛减退,便转动针头向下,用手循按抚摸。感觉针下沉闷,让病人吹气一口,随着吹气的动作缓慢出针,此时不闭合穴位。这被称为泻法。对于身体肥胖、肌肉坚硬、疼痛的患者,采用泻法。
所谓泻法必须用“方”的原则。因为此时正气正盛,月亮正圆,日子正温暖,身体正安定。在病人吸气时进针,等待病人再次吸气时运针,等待病人呼气时缓慢出针,所以称为泻法。所谓补法必须用“圆”的原则。“圆”代表运行,“行”代表移动。意思是运行不畅的气,移动尚未恢复的脉象。所以刺法必须中于荣分,又等待病人吸气时将针推入血分。因此,“圆”与“方”指的并不是针具本身,而是操作的原则和意境。我不明白圣人的深意,请后世明达之士详细探究吧。
《内经》说:疾病有浮在表、沉在里的区别,针刺就有浅有深,各自符合其道理,不要违背这一规律。春夏季节属于阳,人气在外,凡针刺,故应浅取。秋冬季节属于阴,人气在脏,凡针刺,故应当深取。又说:春夏各致一阴,秋冬各致一阳。意思是春夏为阳,但阴在其中涵养,所以针刺时要各致一阴;秋冬为阴,但阳在其中涵养,所以针刺时要各致一阳。春夏温热,必须致一阴,意思是下针深刺至肝肾之部,得到气感后立即出针,这是引导阴气。秋冬寒冷,必须致一阳,意思是下针浅刺至心肺之部,得到气感后推动针体深入并停留良久再出针,这是推进阳气。所以《素问》说:春夏养阳,秋冬养阴。
The *Neijing* states: When the East (Liver) is excess and the West (Lung) is deficient, one should drain the South (Heart) and tonify the North (Kidney). What does this mean? This is the method of "draining the son of an excess condition and tonifying the mother of a deficiency condition," which applies not merely to needling a single meridian.
For example, if there is a Liver Wood disease presenting as excess, one drains the Heart Fire (the son of Liver Wood) and tonifies Kidney Water (the mother of Liver Wood). In this way, the Liver Meridian naturally returns to balance. The diseases of all five Zang organs follow this principle.
With the left hand locating the acupoint, place the needle on the right hand over the point. Ask the patient to cough once; insert the needle penetrating the Couli (interstitial spaces between skin and muscle). Ask the patient to exhale forcefully once; while they do so, insert the needle to a depth of one cun. Wait until the needle feels heavy and tight (Deqi sensation). Rotate the needle head, and use your hand to palpate around the point. Once you feel the arrival of Qi, withdraw the needle slightly with the tip pointing downward. When the needle again feels heavy and tight, ask the patient to inhale deeply once; while they inhale, withdraw the needle completely, then close the acupoint (meaning to rapidly twist the needle or press the hole with one hand to seal it). For patients who are emaciated, weak in Qi and Blood, and experiencing itching or numbness, apply the Tonification method.
With the left hand locating the acupoint, place the needle on the right hand over the point. Ask the patient to cough once; insert the needle into the Couli. Then ask the patient to inhale deeply once; while they inhale, insert the needle to a depth of one cun. Feel for heaviness and tightness in the needle. Rotate the needle head towards the site of the disease. Feel for the arrival of Qi at the disease site. If you perceive the disease receding, rotate the needle head downward and palpate with your hand. Feel for a dull heaviness in the needle. Ask the patient to exhale forcefully once; while they exhale, slowly withdraw the needle. Do not close the acupoint. This is called the Drainage method. For patients who are obese, with hard muscles and pain, apply the Drainage method.
Drainage must utilize the "Square" (Fang) principle. This is because the Qi is currently flourishing, the moon is full, the day is warm, and the body is stable. Insert the needle during the patient's inhalation. Wait for the next inhalation to manipulate the needle. Wait for exhalation to slowly withdraw the needle. Hence, it is called Drainage. Tonification must utilize the "Circle" (Yuan) principle. "Circle" implies movement; "movement" implies shifting. It means to move stagnant Qi and shift meridians that have not yet recovered. Therefore, the puncture must hit the Ying (Nutrient) level. Again, wait for inhalation to push the needle into the Blood level. Thus, "Circle" and "Square" do not refer to the needles themselves, but to the principles and imagery of operation. I do not understand the profound intent of the Sages; I leave it to enlightened scholars of later generations to investigate in detail.
The *Neijing* states: Diseases manifest as superficial or deep; accordingly, needling must be shallow or deep, each conforming to its rationale, without violating this principle. Spring and Summer belong to Yang; Qi resides externally, and human Qi also floats outward. Therefore, in needling, one shall generally take points shallowly. Autumn and Winter belong to Yin; Qi resides internally within the Zang organs, and human Qi sinks inward. Therefore, in needling, one shall generally take points deeply. It is also stated: "In Spring and Summer, each induces one Yin; in Autumn and Winter, each induces one Yang." This means that although Spring and Summer are Yang, Yin is nurtured within them; thus, needling aims to induce one Yin. Although Autumn and Winter are Yin, Yang is nurtured within them; thus, needling aims to induce one Yang. In the warmth of Spring and Summer, inducing one Yin means inserting the needle deeply to the regions of the Liver and Kidneys. Upon obtaining Deqi, withdraw the needle immediately; this draws forth Yin. In the cold of Autumn and Winter, inducing one Yang means inserting the needle shallowly to the regions of the Heart and Lungs. Upon obtaining Deqi, push the needle deeper and retain it for a long time before withdrawing; this pushes forward Yang. Thus, the *Suwen* states: "Nourish Yang in Spring and Summer; nourish Yin in Autumn and Winter."