尝闻古之医者识天时知气运通四诊之精微熟诸经之奇正洞见垣一方人神乎伎矣故自
灵素传书
但其书有论无方特示人以大经大法令心领而神悟惟针灸之治语焉必详以针灸有定穴不得不辨明经络指
示荣俞使后之业此者得按经而取穴也以是知古圣人
其用心之细而立法之密欤夫针灸由来久矣灵枢为针灸之宗本自后明医辈出殆且百家如扁鹊仓
公张机元化以及东垣河间丹溪诸贤此皆名之最着者无不各有着述发明先圣之经义秦汉而下代
有传人至明有越人张会卿集诸家之要旨着为类经而针灸之学益显然犹有未尽者惟我
国朝纂宗鉴一书为医林之总汇如众水之归宗其言针灸审穴分寸的无差谬诚哉卓越千古惜
医流学焉者寡治针者百无一二治灸者十无二三惟汤液之治比比皆然是岂汤液易而针灸难欤非
也凡人受天地之气以生莫不具有经络脏腑其中病也或在经在络入腑入脏则必待明经络脏腑者
方可以去病岂为汤液者可舍经络脏腑而别为治乎吾知必无是理也然则何为治此者多而习彼者
寡盖以汤液之治易于藏拙其用柔而取效可缓即彼读汤头记本草者遂可以医名若夫针灸之治苟
不明经络俞穴无从下手且其用刚而得失易见人之不乐为此而乐为彼者由此故也不知针灸汤液
其为用不同而为医则一也独是用针之要先重手法手法不调不可以言针灸法亦与针并重而其要
在审穴审得其穴立可起死回生所以古人合而言之分而用之务期于中病而已矣是编置针言灸非
以针
难而灸易以针之手法未可以言传灸之穴法尚可以度识也苟能精意讲求由灸而知针由针而知道
绍先圣之渊源补汤液所不及其功效岂浅鲜哉爰命孙云路草订成编以为家藏备要云尔
时
咸丰元年岁次辛亥仲秋月古歙吴亦鼎砚丞氏自志
我曾听说，古代的医生能够识别天时变化，知晓气运流转，精通四诊（望、闻、问、切）的精微之处，熟悉各经脉的常规与变通之法，洞察病机如隔墙见物一般清晰，其医术可谓神妙。因此，自从《灵枢》和《素问》流传下来后，虽然这两部书有理论论述却缺乏具体方药，主要是为了向人们展示大的经络法则，让人用心领会、精神感悟；唯独针灸的治疗，讲解必定详尽，因为针灸有固定的穴位，不得不辨明经络，指出五输穴（井、荥、输、经、合），使后世从事这一行业的人能够按照经络来选取穴位。由此可知，古代圣人用心的细致和立法的严密啊！
针灸的历史由来已久，《灵枢》是针灸的宗师。自后世名医辈出，几乎达到百家之多，如扁鹊、仓公、张机（张仲景）、华元化（华佗），以及金元时期的李东垣、刘河间、朱丹溪等诸位贤人，这些都是名声最显赫的，无不各有著作以阐发先圣的经典义理。从秦汉到明代，代代都有传人。到了明代，有张会卿（张介宾）汇集各家要旨，撰写了《类经》，使得针灸之学更加显著，但仍有未尽之处。只有我朝编纂的《医宗金鉴》一书，成为医学界的总汇，如同众水归宗。书中关于针灸的论述，审察穴位分寸准确无误，确实卓越千古。可惜学习针灸的医者很少，治疗针症的百无一二，治疗灸症的十无二三，而使用汤液（中药方剂）治疗的比比皆是。这难道是汤液容易而针灸难吗？不是这样的。凡是人受天地之气而生，无不具有经络脏腑。其中病时，或在经在络，入腑入脏，则必须等待懂得经络脏腑的人才能去除疾病，难道使用汤液就可以舍弃经络脏腑而另作治疗吗？我知道必然没有这个道理。那么为什么从事针灸的人多，而练习汤液的人少呢？大概是因为汤液治疗易于隐藏不足，用药柔和且见效可缓，即使只是熟读汤头歌诀、记忆本草知识的人，也可以凭借此获得医名。至于针灸治疗，如果不明白经络俞穴，就无从下手，而且其作用刚猛，得失容易显现，人们不喜欢做这个而喜欢做那个，原因就在这里。不知道针灸和汤液，它们的作用不同，但作为医生的本质是一样的。
然而，使用针法的首要任务是重视手法，手法不协调，就不能称之为针灸。针法和灸法并重，而其关键在于审察穴位，审察得准确的穴位，立刻可以起死回生。所以古人将二者合而言之，分而用之，务必以求中病（治愈疾病）而已。这部书放置针法在前，言说灸法在后，并非因为针法难而灸法易，而是因为针法的手法难以通过言语完全传授，而灸法的穴位尚可以通过度量来认识。如果能够精心研究探讨，由灸而知针，由针而知道，继承先圣的渊源，补充汤液的不足之处，其功效难道浅薄吗？于是命令孙子云路草拟编订成册，作为家藏备要罢了。
时间是咸丰元年，岁次辛亥，仲秋月，古歙人吴亦鼎砚丞氏自志。
I have heard that ancient physicians could discern the changes of heaven and time, understand the flow of qi and fortune, master the subtleties of the Four Diagnostic Methods (inspection, auscultation/olfaction, inquiry, palpation), be familiar with the standard and variant patterns of the meridians, and perceive pathological mechanisms as clearly as seeing through a wall. Their medical skills were indeed divine. Therefore, since the transmission of the *Ling Shu* (Spiritual Pivot) and *Su Wen* (Basic Questions), although these texts contain theoretical discussions but lack specific prescriptions, they primarily aim to demonstrate the great principles of meridians to people, urging them to comprehend with their minds and realize with their spirits. Only in the treatment of acupuncture and moxibustion are the explanations necessarily detailed, because acupuncture and moxibustion rely on fixed acupoints, necessitating the clear differentiation of meridians and the indication of the Five Shu Points (Jing-Well, Ying-Spring, Shu-Stream, Jing-River, He-Sea), so that later practitioners may select points according to the meridians. From this, we can know how meticulous the ancient sages were in their thinking and how rigorous their establishment of laws!
The origin of acupuncture and moxibustion is long-standing; the *Ling Shu* serves as the ancestor of these disciplines. Since then, famous physicians emerged one after another, nearly reaching a hundred schools, such as Bian Que, Cang Gong, Zhang Ji (Zhang Zhongjing), Hua Tuo, as well as the virtuous scholars Li Dongyuan, Liu Wansu, and Zhu Danxi from the Jin-Yuan period. All these individuals were most renowned and each had writings that elucidated the classic meanings of the ancient sages. From the Qin and Han dynasties down to the Ming Dynasty, there were inheritors generation after generation. In the Ming Dynasty, Zhang Huiqing (Zhang Jiebin) collected the essential points of various schools and wrote the *Lei Jing* (Classified Classic), making the study of acupuncture and moxibustion even more prominent, yet there remained incomplete aspects. It was only in our dynasty that the compilation of the *Yi Zong Jin Jian* (Golden Mirror of Medicine) became the general repository for the medical field, like all waters returning to their source. Its statements on acupuncture and moxibustion carefully examine the proportions of acupoints without error; truly, it stands outstanding for millennia. Unfortunately, few medical practitioners learn it; among those treating with needles, not one or two out of a hundred do so; among those treating with moxa, not two or three out of ten do so. Yet, treatments using decoctions (herbal medicine) are everywhere. Is it that herbal medicine is easy while acupuncture and moxibustion are difficult? No. Human beings are born receiving the qi of heaven and earth, possessing meridians and zang-fu organs within. When disease strikes, whether in the meridians or collaterals, entering the fu-zang or zang-organs, one must wait for someone who understands meridians and zang-fu to remove the disease. Could it be that those using herbal medicine can abandon meridians and zang-fu to treat differently? I know such a principle does not exist. Then why are there many treating with acupuncture/moxibustion and few practicing herbal medicine? [Note: The original text actually says "why are there many treating [with acupuncture/moxibustion] and few practicing [the other]" - wait, re-reading original: "然则何为治此者多而习彼者寡". Context implies "Why are there many doing [acupuncture/moxibustion?] and few doing [herbs?]". Actually, looking at the next sentence "盖以汤液之治易于藏拙... 若夫针灸之治... 人之不乐为此而乐为彼者", it implies people prefer herbs (easy to hide flaws) over acupuncture (hard, obvious errors). So "治此" refers to Acupuncture/Moxibustion? Or Herbs? Let's look closer: "惟汤液之治比比皆然" (Herb treatments are everywhere). "岂为汤液易而针灸难欤... 非也". "然则何为治此者多而习彼者寡". If herbs are everywhere, then "many" = herbs, "few" = acupuncture. But the text says "人之不乐为此而乐为彼者" (People do not like to do 'this' but like to do 'that'). Usually, 'this' refers to the subject just mentioned or the harder task. Let's trace: "治针者百无一二... 汤液... 比比皆然". So Few=Acupuncture, Many=Herbs. "为何治此(Many/Herbs?)多而习彼(Few/Acupuncture?)寡". The explanation follows: "盖以汤液之治易于藏拙... 若夫针灸之治... 人之不乐为此(Acupuncture)而乐为彼(Herbs)". So "此" in "治此者多" likely refers to Herbs (Tangye) and "彼" to Acupuncture. Wait, the prompt text says "然则何为治此者多而习彼者寡". If "此" is Herbs, then it matches "比比皆然". The reasoning "汤液... 易于藏拙" supports that Herbs are the "many". So "此" = Herbs, "彼" = Acupuncture. However, the book is about Acupuncture/Moxibustion ("神灸经纶"). The author might be lamenting that few do acupuncture. Let's stick to the literal translation: "Why is it that those treating with [Herbs] are many, while those practicing [Acupuncture/Moxibustion] are few?"
Actually, let's re-read carefully: "惟汤液之治比比皆然... 然则何为治此者多而习彼者寡". "此" usually points forward or backward. Given the context of "Moxibustion" being the focus, he might be saying "Why are there few doing THIS (Moxibustion/Acupuncture) and many doing THAT (Herbs)?". But grammatically "治此" often refers to the topic at hand. If the topic is Acupuncture, and he says "治此者多", it contradicts "百无一二". So "此" must refer to Herbs (Tangye) which were just described as "比比皆然". And "彼" refers to Acupuncture. The explanation "汤液... 易于藏拙" confirms Herbs are the preferred/easy path. So: Why are Herb-treatments many and Acupuncture-practice few? Because Herb-treatment hides deficiencies easily... whereas Acupuncture requires knowing meridians... and its effects are obvious/gentle vs harsh? No, "其用刚" (its use is firm/harsh/direct). People don't like doing Acupuncture ("为此") but like doing Herbs ("为彼").
However, the final conclusion is "独是用针之要先重手法... 是编置针言灸...". The author advocates for Acupuncture/Moxibustion.
Let's translate based on: Many = Herbs, Few = Acupuncture/Moxibustion.
Translation adjustment: "Then why is it that those treating with herbal decoctions are many, while those practicing acupuncture and moxibustion are few? This is because herbal treatment allows one to easily conceal inadequacies; its application is gentle, and its efficacy can be gradual..."
Back to English:
The history of acupuncture and moxibustion is long; the *Ling Shu* is the ancestor of these arts. Since then, famous physicians emerged, numbering nearly a hundred schools, such as Bian Que, Cang Gong, Zhang Ji, Hua Tuo, and the virtuous scholars Li Dongyuan, Liu Wansu, and Zhu Danxi. All were highly renowned and each authored works expounding the classics of the ancient sages. From the Qin and Han dynasties to the Ming, there were inheritors in every generation. In the Ming, Zhang Huiqing (Zhang Jiebin) compiled the essentials of various schools into the *Lei Jing*, making the study of acupuncture and moxibustion increasingly clear, though still incomplete. Only in our dynasty was the *Yi Zong Jin Jian* (Golden Mirror of Medicine) compiled, serving as the comprehensive repository of medicine, like rivers flowing to the sea. Its discussions on acupuncture and moxibustion accurately determine point locations and measurements, truly outstanding for millennia. Regrettably, few medical practitioners learn it; among those treating with needles, not one or two out of a hundred do so; among those treating with moxa, not two or three out of ten do so. Yet, treatments using herbal decoctions are ubiquitous. Is it that herbal medicine is easy while acupuncture and moxibustion are difficult? No. Humans are born receiving the qi of heaven and earth, possessing meridians and zang-fu organs internally. When disease occurs, whether in meridians or collaterals, entering fu or zang organs, one must rely on those who understand meridians and zang-fu to cure the disease. Can those using herbal medicine abandon meridians and zang-fu to treat differently? I know this is impossible. Then why are there many treating with herbal medicine and few practicing acupuncture and moxibustion? This is because herbal treatment makes it easier to conceal one's shortcomings; its application is gentle, and results can be slow. Even those who merely memorize herbal formulas and materia medica can gain fame as physicians. In contrast, acupuncture and moxibustion treatment requires understanding meridians and acupoints to begin; otherwise, one has no starting point. Moreover, its application is direct/firm, and success or failure is easily seen. Thus, people are unwilling to practice this (acupuncture/moxibustion) but prefer that (herbal medicine). They do not realize that although acupuncture/moxibustion and herbal medicine differ in application, the essence of being a physician is the same.
However, the priority in needle therapy is to emphasize manual technique. If the technique is not harmonious, one cannot speak of acupuncture and moxibustion. Needle therapy and moxibustion are equally important, but the key lies in selecting accurate points. Once the correct point is identified, life can be revived from death. Therefore, the ancients discussed them together but used them separately, aiming solely to hit the disease. This book places needle therapy first and discusses moxibustion second, not because needle therapy is difficult and moxibustion is easy, but because needle techniques are hard to convey by words, whereas moxibustion point locations can still be understood through measurement. If one can study diligently, learning needle therapy through moxibustion, and understanding the Dao through needle therapy, inheriting the source of the ancient sages and supplementing what herbal medicine lacks, would the efficacy not be significant? Thus, I ordered my grandson Yunlu to draft and compile this work as a family treasure.
This was written in the first year of Xianfeng, in the year Xin Hai, during the mid-autumn month, by Wu Yiding, styled Yanchen, of Gushao.