观夫针道捷法最奇须要明于补泻方可起于倾危先分病之上下次定穴之高低头有病而足取之左
有病而右取之男子之气早在上而晚在下取之必明其理女子之气早在下而晚在上用之必识其时午
前为早属阳午后为晚属阴男女上下凭腰分之手足三阳手走头而头走足手足三阴足走腹而胸走
手阴升阳降出入之机逆之者为泄泻为逆顺之者为补为随春夏刺浅者以瘦秋冬刺深以肥更观原
气浓薄浅深之刺尤宜
原夫补泻之法妙在呼吸手指男子者大指进前左转呼之为补退后右转吸之为泻提针为热插针为
寒女子者大指退后右转吸之为补进前左转呼之为泻插针为热提针为寒左与右有异胸与背不
同午前者如此午后者反之是故爪而切之下针之法摇而退之出针之法动而进之催针之法循而摄
之行气之法搓则去病弹则补虚肚腹盘旋扪为穴闭沉重豆许曰按轻浮豆许曰提一十四法针要所
备补者一退三飞真气自归泻者一飞三退邪气自避补则补其不足泻则泻其有余
余者为肿为痛
曰实不足者为痒为麻曰虚气速效速气迟效迟死生富贵针下皆知贱者硬而贵者脆生者涩而死者
虚为之不至必死无疑
且夫下针之法先须爪按重而切之次令咳嗽一声随咳下之妙
凡补者呼气初至针刺皮肉乃曰天才少停进之针刺至肉内是曰人才又停进针刺至筋骨之间名曰
地才此为极处就当补之再停良久却须退之针至人之分待气沉紧倒针朝病进退往来飞经走气尽
在其中矣凡泻者吸气初针至天少停进针直至于地得气之泻丹停良久却须退针复至于人待气沉
紧倒针朝病法同前矣其或晕针者神气虚也以针补之以袖捣之口鼻而气回热汤与之略停少刻根据
及夫调气之法下针至地之后复人之分欲气上行将针右捻欲气下行将针左捻欲补先呼后吸欲泻
先吸后呼气不至者以手循 以爪切掏以针摇动进捻搓弹直待气至以龙虎升腾之法按之在前使
气在后按之在后使气在前运气走至疼痛之所以纳气之法扶针直插复向下纳使气不回若关节阻
涩气不过者以龙虎龟凤通经接气大假之法驱而运之仍以循摄爪切无不应矣此通仙之妙
况夫出针之法病势既退针气微松病未退者针气如根推之不动转之不移此为邪气吸拔其针乃真
气未至不可出之出之者其病即复再须补泻停以符之直候微松方可出针豆许摇而停之补者吸之
去疾其穴急扪泻者呼之去徐其穴不闭欲令凑密然后吸气故曰下针贵迟大急伤血出针贵缓大急
伤气以上捻要于斯尽矣
考夫治病之法有八一曰烧山火治顽麻冷痹先浅后深用九阳而三进三退慢提紧按热至紧闭插针
除寒之有准二曰治肌热骨蒸先深后浅用六阴而三出三入紧提慢按徐徐举针退热之可凭 细细
搓之去病准绳三曰阳中之阳先寒后热浅而深以九六之法则先补后泻也四曰阴中之阳先热后寒
深而浅以六九之方则先
浅法在浅则用浅法在深则用深二者不可兼而紊之也五曰子午捣臼水蛊膈气落穴之后调气均匀针行上下九入
六出左右转之千遭自平六曰进气之诀腰背肘膝痛浑身走注疼刺九分行九补卧针五七吸待气上
行亦可龙虎交战左捻九而右捻六是亦住痛之针七曰留气之诀 瘕癖 瘕刺七分用纯阳然后乃
直插针气来深刺提针再停八曰抽添之诸瘫痪疮癞取其要穴使九阳得气提按搜索大要运气周遍
扶针直插复向下纳回阳倒阴指下玄微胸中活法一有未应反复冈施
若夫过关过节催运气以飞经走气其法有四一曰青龙摆尾如扶舡舵不进不退一左一右慢慢拨动
二曰白虎摇头似手摇铃退方进九兼之左右摇而振之三曰苍蝇探穴如入土之象一退三进钻(剔)
四方四曰赤凤迎源展翅之HT 入针至地提针至天候针自摇复进其元上下左右四围飞旋病在上吸而退
之病在下呼而进之
至夫久患偏枯通经接气之法已有定息寸数手足三阳上几而下十四过经四寸手足三阴上七而下
十二过经五寸在乎摇动出纳呼吸同法驱运气血顷刻周流上下通接可使寒者暖而热者凉痛者
止而胀者消若开渠之决水立见时功何倾危之不起哉虽曰病有三因皆从气血针分八法不离阴阳
盖经络昼夜之循环呼吸往来之不息和则身体康健否则疾病而生譬如天下国家地方山海田园江
河溪谷值岁时风雨均调则水道疏利民安物阜其或一方一所风雨不均遭以旱涝使水道涌竭不同
灾伤遂至人之气血受蠲邪扶正故曰医最奇者哉
嗟夫轩岐古远卢扁死亡此道幽深非一言而可尽斯文细密在久习而能通岂世上之常辞庸流之乏
术得之者若科之及弟而悦于心用之者如射之发中而进于目述自先贤传之学用针之士有志于斯
果能洞造玄微而尽其精妙则世之伏枕之 有缘者遇针到病除随而愈
观察那针刺的捷法最为奇妙,必须精通补泻手法,才能挽救危重病人。首先要分辨病位的上下,其次确定穴位的高低。头有病而取足部的穴位,左有病而取右部的穴位。男子的经气早晨在上部而晚上在下部,施治时必须明白其中的道理;女子的经气早晨在下部而晚上在上部,施治时必须识别其中的时机。午前为早,属阳;午后为晚,属阴。男女经气的上下分布以腰部为分界。手三阳经从手走头,头走足;手三阴经从胸走手;足三阳经从头走足,足走腹;足三阴经从足走腹而胸走手(注:原文此处表述略有混淆,通常足三阴从足走腹胸,手三阴从胸走手,原文“手足三阴足走腹而胸走手”意指阴经总体走向及阴阳交接规律)。阴气上升,阳气下降,这是出入的机枢。逆其势者为泄,顺其势者为补。春夏季节针刺宜浅,针对瘦人;秋冬季节针刺宜深,针对肥人。更要观察原气的浓薄,决定针刺的深浅,这尤为适宜。
追溯补泻之法,奥妙在于呼吸与手指的运用。男子补法:大指向前进针并左转,呼气时操作为补;退后并向右转,吸气时操作为泻。提针可产生热感,插针可产生寒感。女子补法:大指向后退针并右转,吸气时操作为补;向前进针并左转,呼气时操作为泻。插针可产生热感,提针可产生寒感。左右方向有差异,胸背部位也不相同。午前操作如上述,午后则相反。因此,用指甲按压切掐是下针的方法,摇动并后退是出针的方法,动而前进是催针的方法,循按和摄持是行气的方法。搓针可以祛除疾病,弹针可以补益虚损。肚腹部的穴位要盘旋寻找,用手扪按来确定穴位。沉重地按压豆许大小称为“按”,轻浮地提起豆许大小称为“提”。这十四种方法是针刺的要诀所具备的。补法是一退三飞,真气自然回归;泻法是一飞三退,邪气自然避开。补法是补其不足,泻法是泻其有余。有余表现为肿胀、疼痛;不足表现为瘙痒、麻木。
所谓实证,不足为虚。虚实在针下的感觉,富贵者脉象脆软,贫贱者脉象坚硬;生者脉象涩滞,死者脉象空虚。如果气至而不至,必定死亡无疑。
况且下针的方法,先须用指甲重按切掐,然后令患者咳嗽一声,随着咳嗽声进针,非常巧妙。
凡是补法,在呼气初至时,针刺入皮肉,这叫“天才”;稍停片刻,进针至肌肉内,这叫“人才”;再停片刻,进针至筋骨之间,这叫“地才”。这是极深处,应当在此处进行补法。再停留良久,然后将针退至“人”的分层,等待气沉紧,倒转针身朝向病所,进退往来,飞经走气的手法全包含在其中了。凡是泻法,在吸气初时,针至天部,稍停进针直达地部,得气后行泻法。停留良久,将针退至人部,等待气沉紧,倒转针身朝向病所,方法同前。如果出现晕针,是因为神气虚弱,应用补法,并用袖子擦拭口鼻,气息就会恢复,给予热汤,稍作休息。
至于调气的方法,下针至地部之后,退至人部分,想要气上行,就将针向右捻;想要气下行,就将针向左捻。想要补,先呼后吸;想要泻,先吸后呼。气不至者,用手循按,用爪切掏,用针摇动,进捻、搓、弹,直待气至。运用龙虎升腾之法,按在前使气在后,按在后使气在前,运气到达疼痛之处。至于纳气的方法,扶住针直插,再向下纳,使气不回。如果关节阻滞涩滞,气过不去,就用龙虎龟凤通经接气的大法来驱赶运行它,仍然配合循按、爪切,没有不奏效的。这是通仙的妙法。
何况出针的方法,病势已退,针气微松;病未退者,针气如根,推之不动,转之不移,这是因为邪气吸拔着针,这是真气未至,不可出针。如果出了针,病就会复发,再须补泻,停以待符,直候微松方可出针。出针时豆许摇动并停顿。补法在吸气时去针,疾速闭合穴孔;泻法在呼气时去针,徐缓,穴孔不闭。欲令凑密(闭合),然后吸气。所以说下针贵在迟,太急伤血;出针贵在缓,太急伤气。以上的捻转要领都在这里了。
考察治病的方法有八种:一曰烧山火,治疗顽麻冷痹。先浅后深,用九阳数,三进三退,慢提紧按,热至紧闭插针,除寒有准。二曰透天凉,治疗肌热骨蒸。先深后浅,用六阴数,三出三入,紧提慢按,徐徐举针,退热可凭。细细搓之,去病准绳。三曰阳中之阳,先寒后热,浅而深,以九六之法,则先补后泻也。四曰阴中之阳,先热后寒,深而浅,以六九之法,则先泻后补也。浅法在浅则用浅法,在深则用深法,二者不可兼而紊乱。五曰子午捣臼,治疗水蛊膈气。落穴之后调气均匀,针行上下,九入六出,左右转之千遭,自平。六曰进气之诀,治疗腰背肘膝痛,浑身走注疼。刺九分行,行九补,卧针五七吸,待气上行。亦可龙虎交战,左捻九而右捻六,这也是住痛的针法。七曰留气之诀,治疗瘕癖。刺七分,用纯阳,然后乃直插针,气来深刺,提针再停。八曰抽添之法,治疗诸瘫痪疮癞。取其要穴,使九阳得气,提按搜索,大要运气周遍,扶针直插,复向下纳,回阳倒阴,指下玄微,胸中活法。一有未应,反复冈施(注:原文“冈施”疑为“更施”或类似含义,意为再次施行)。
若夫过关过节,催运气以飞经走气,其法有四:一曰青龙摆尾,如扶船舵,不进不退,一左一右慢慢拨动。二曰白虎摇头,似手摇铃,退方进圆,兼之左右摇而振之。三曰苍蝇探穴,如入土之象,一退三进,钻剔四方。四曰赤凤迎源,展翅之翼。入针至地,提针至天,候针自摇,复进其元,上下左右四围飞旋。病在上,吸而退之;病在下,呼而进之。
至于久患偏枯,通经接气之法已有定息寸数。手足三阳经上几而下十四过经四寸;手足三阴经上七而下十二过经五寸。在乎摇动出纳,呼吸同法,驱运气血,顷刻周流,上下通接。可使寒者暖而热者凉,痛者止而胀者消。若开渠之决水,立见时功,何倾危之不起哉?虽曰病有三因,皆从气血;针分八法,不离阴阳。盖经络昼夜之循环,呼吸往来之不息。和则身体康健,否则疾病而生。譬如天下国家地方山海田园江河溪谷,值岁时风雨均调,则水道疏利,民安物阜。其或一方一所,风雨不均,遭以旱涝,使水道涌竭不同,灾伤遂至。人之气血受蠲邪扶正,故曰医最奇者哉。
嗟夫!轩岐古远,卢扁死亡,此道幽深,非一言而可尽。斯文细密,在久习而能通。岂世上之常辞,庸流之乏术得之者若科之及弟而悦于心,用之者如射之发中而进于目。述自先贤传之学,用针之士有志于斯,果能洞造玄微而尽其精妙,则世之伏枕之有缘者,遇针到病除,随而愈。
Observing the swift methods of acupuncture, they are most wondrous; one must master tonification and sedation to rescue patients from critical peril. First, distinguish the upper and lower aspects of the disease; second, determine the high and low points of the acupoints. When there is a disease in the head, take points on the feet; when there is a disease on the left, take points on the right. For men, Qi (vital energy) is higher in the morning and lower in the evening; treatment must understand this principle. For women, Qi is lower in the morning and higher in the evening; treatment must recognize this timing. Before noon is morning, belonging to Yang; after noon is evening, belonging to Yin. The upper and lower distribution of Qi for men and women is divided by the waist. The Hand-Yang meridians go from hand to head and head to foot; the Hand-Yin meridians go from chest to hand; the Foot-Yang meridians go from head to foot and foot to abdomen; the Foot-Yin meridians go from foot to abdomen and chest to hand. Yin ascends, Yang descends; this is the mechanism of entry and exit. Opposing this flow constitutes sedation (Xie), while following it constitutes tonification (Bu). In spring and summer, needling should be shallow, especially for thin individuals; in autumn and winter, needling should be deep, especially for fat individuals. One must also observe the thickness or thinness of Yuan Qi (Source Qi) to decide the depth of needling, which is particularly appropriate.
Tracing back the methods of tonification and sedation, their subtlety lies in respiration and finger manipulation. For men, the tonification method involves advancing the needle forward with the thumb turning left during exhalation; withdrawing backward with the thumb turning right during inhalation constitutes sedation. Lifting the needle generates heat; inserting the needle generates cold. For women, the tonification method involves withdrawing the needle backward with the thumb turning right during inhalation; advancing forward with the thumb turning left during exhalation constitutes sedation. Inserting the needle generates heat; lifting the needle generates cold. Left and right directions differ, as do the chest and back. The above applies to before noon; after noon, it is reversed. Therefore, pressing and cutting with the fingernail is the method for inserting the needle; shaking and withdrawing is the method for removing the needle; moving and advancing is the method for urging Qi; circling and grasping is the method for guiding Qi. Twisting the needle removes disease; flicking the needle tonifies deficiency. For abdominal and visceral points, rotate to locate; palpate to confirm the point. Pressing heavily for a bean-sized area is called "An" (Press); lifting lightly for a bean-sized area is called "Ti" (Lift). These fourteen methods are prepared in the essentials of needling. Tonification: one withdrawal and three flights, and True Qi returns naturally. Sedation: one flight and three withdrawals, and Evil Qi avoids naturally. Tonify insufficiency; sedate excess. Excess manifests as swelling and pain; insufficiency manifests as itching and numbness.
It is said that excess presents as swelling and pain; insufficiency presents as itching and numbness. Regarding reality and insufficiency, under the needle, one knows if the patient is noble or humble, alive or dead. Noble pulses are crisp and soft; humble pulses are hard. Living pulses are choppy; dead pulses are empty. If Qi arrives but does not reach, death is certain.
Furthermore, the method of inserting the needle requires first pressing heavily with the fingernail, then having the patient cough once, and inserting the needle with the cough, which is wonderful.
For tonification, at the beginning of exhalation, insert into the skin and flesh, called "Tian Cai" (Heavenly Talent); pause slightly, advance into the muscle, called "Ren Cai" (Human Talent); pause again, advance to between tendon and bone, called "Di Cai" (Earthly Talent). This is the deepest point; perform tonification here. Pause for a long time, then withdraw to the "Ren" level, wait for Qi to sink and tighten, invert the needle towards the disease, advance and retreat, flying through meridians and moving Qi—all contained within. For sedation, at the beginning of inhalation, insert to Tian level, pause, advance straight to Di level, obtain Qi, and perform sedation. Pause for a long time, then withdraw to Ren level, wait for Qi to sink and tighten, invert the needle towards the disease, same method as before. If fainting occurs due to Shen Qi (Spirit Qi) deficiency, use tonification, wipe the mouth and nose with a sleeve until Qi returns, give hot soup, and rest briefly.
As for regulating Qi, after inserting to Di level, withdraw to Ren level. To move Qi upward, twist the needle to the right; to move Qi downward, twist to the left. To tonify, exhale first then inhale; to sedate, inhale first then exhale. If Qi does not arrive, circle with hand, cut with nail, shake needle, advance, twist, rub, and flick until Qi arrives. Use Long Hu Sheng Teng (Dragon and Tiger Ascending and Soaring) method: press front to make Qi go back, press back to make Qi come forward, guide Qi to the painful area. As for gathering Qi, hold needle straight, insert, then push down to gather Qi so it does not return. If joints are blocked and Qi cannot pass, use Long Hu Gui Feng Tong Jing Jie Qi Da Fa (Great Method of Dragon, Tiger, Turtle, Phoenix to Unblock Meridians and Connect Qi) to drive and transport it, still combining circling, grasping, and cutting—nothing will fail. This is the wonder of Tong Xian.
Moreover, regarding removing the needle: if the disease trend recedes and needle Qi loosens slightly, good; if disease remains, needle Qi is like a root, immovable and unturnable, because Evil Qi is sucking the needle. This means True Qi has not arrived; do not remove. If removed, disease recurs; re-tonify and sedate, wait for harmony, only remove when slightly loose. Shake slightly upon removal and pause. For tonification, remove during inhalation, quickly close the acupoint. For sedation, remove during exhalation, slowly, leave acupoint open. To ensure closure, inhale afterwards. Thus, inserting the needle should be slow; too fast injures Blood. Removing the needle should be slow; too fast injures Qi. The above twisting essentials are complete here.
Examining the eight methods of treating disease: 1. Shao Shan Huo (Fire Mountain Burning): treats stubborn numbness and cold bi. Shallow then deep, use Nine Yang numbers, three advances and three withdrawals, slow lift, firm press, heat arrives, close tightly, insert needle, standard for removing cold. 2. Tou Tian Liang (Cooling Heaven from Below): treats muscular heat and bone-steaming fever. Deep then shallow, use Six Yin numbers, three exits and three entries, firm lift, slow press, slowly raise needle, reliable for reducing heat. Fine twisting removes disease accurately. 3. Yang Zhong Zhi Yang (Yang within Yang): chills first, heat later, shallow to deep, using Nine-Six method, tonify first then sedate. 4. Yin Zhong Zhi Yang (Yang within Yin): heat first, chills later, deep to shallow, using Six-Nine method, sedate first then tonify. Shallow method uses shallow technique, deep method uses deep technique; do not mix and confuse. 5. Zi Wu Dao Jiu (Pestle Grinding at Rat and Horse hours): treats water distension and diaphragmatic qi. After setting the point, regulate Qi evenly, move needle up and down, nine inserts, six exits, rotate left and right a thousand times, naturally balanced. 6. Jin Qi Zhi Jue (Secret of Advancing Qi): treats pain in waist, back, elbows, knees, and wandering pain throughout body. Insert 9 fen, perform nine tonifications, lie flat, inhale five to seven times, wait for Qi to ascend. Also Long Hu Jiao Zhan (Dragon and Tiger Battle): twist left nine times, right six times; this is also a stopping-pain needle. 7. Liu Qi Zhi Jue (Secret of Retaining Qi): treats masses and fixed lumps. Insert 7 fen, use pure Yang, then insert straight, when Qi arrives, deepen, lift needle, pause again. 8. Chou Tian Zhi Fa (Method of Drawing and Adding): treats paralysis, sores, and leprosy. Take essential points, let Nine Yang obtain Qi, lift and press to search, major essence is circulating Qi, hold needle straight, insert, push down, restore Yang and reverse Yin, subtle under fingers, active in mind. If one response fails, repeat.
Regarding passing through passes and joints, urging Qi to fly through meridians and move Qi, there are four methods: 1. Qing Long Bai Wei (Green Dragon Wags Tail): like steering a boat rudder, no advance or retreat, one left one right, slowly拨动 (拨动 means to move/adjust). 2. Bai Hu Yao Tou (White Tiger Shakes Head): like shaking a bell, retreat square advance circle, combined with left-right shaking and vibrating. 3. Cang Ying Tan Xue (Fly Probes Hole): like entering soil, one retreat three advances, drill and pick four directions. 4. Chi Feng Ying Yuan (Red Phoenix Welcomes Source): spreading wings. Insert to Di, lift to Tian, wait for needle to shake naturally, re-enter its origin, fly around up/down/left/right. Disease above, retreat during inhalation; disease below, advance during exhalation.
For chronic hemiplegia, the method of connecting meridians and Qi has fixed breath counts and cun measurements. Hand-Foot Yang meridians: up [implied count], down 14, crossing meridians 4 cun. Hand-Foot Yin meridians: up 7, down 12, crossing meridians 5 cun. Rely on shaking, insertion/extraction, and respiration same method, driving and circulating Qi, flowing instantly, connecting up and down. Can make cold warm and heat cool, stop pain and reduce distension. Like opening a canal to release water, immediate effect seen, how can critical illness not rise? Although diseases have three causes, all stem from Qi and Blood; needles divide into eight methods, not departing from Yin and Yang. Meridians circulate day and night, respiration comes and goes without ceasing. Harmony means health; otherwise, disease arises. Like countries, places, mountains, seas, fields, rivers, and valleys: when seasons and wind/rain are balanced, waterways are smooth, people are safe, goods abundant. If one region suffers uneven wind/rain, droughts or floods cause waterways to surge or dry up, disasters follow. Human Qi and Blood suffer, evil is dispelled, righteousness supported. Thus, medicine is the most wondrous.
Alas! Xuanyuan and Qibo are ancient, Lu and Bian are dead; this path is profound, not exhausted in one word. This text is detailed; understanding comes from long practice. It is not common talk of the world, nor lack of skill by mediocre streams. Those who obtain it are like passing imperial exams, joyful in heart; those who use it are like archers hitting the target, progressing to the eye. Narrated from the learning passed down by sages, practitioners aspiring to this, if they can thoroughly penetrate the profound subtleties and exhaust their essence and wonder, then those in the world lying in bed, destined to meet, will encounter needle arrival and disease removal, healing accordingly.