(《素问·骨空论》《长刺节论》《灵枢四时气论》《热病论》)
黄帝问曰∶余闻风者百病之始也,以针治之奈何?
(《素问·骨空论》。风之中人,必先皮毛而后及于经络脏腑,由浅入深,自微而甚,善行数变,所以为百病之始。
故圣人之避风,如避矢石者,正以防其微也。)岐伯对曰∶风从外入,令人振寒,汗出头痛,身重恶寒,(风邪外袭,阳
气内拒,邪正分争,故振寒。风伤卫,故汗出。邪客三阳,故头痛身重。卫伤则表怯,故恶寒。)治在风府,调其阴阳,
不足则补,有余则泻。(风府,督脉穴。察其正气不足则补之,邪气有余则泻之。)大风颈项痛,刺风府,风府在上椎。(上
椎,谓项骨椎上,入发际一寸也。)大风汗出,灸 , 在背下侠脊旁三寸所,厌之令病者呼 , 应手。(
,足太阳经穴。厌之,以指按其穴也。乃令病患呼 之声,则应手而动,故即以为名。)从风憎风,刺眉头。(病由
于风则憎风。刺眉头者,足太阳之攒竹穴也。憎,早登切。)
病风且寒且热,炅汗出,一日数过,先刺诸分理络脉;
(《素问·长刺节论》。《风论》曰∶风之伤人也,或为寒热,或为热中,或为寒中,或为疠风,或为偏枯,或为风也。
即此之谓。炅汗,热汗也。刺诸分理络脉者,贵乎多也。炅,居永切。)汗出且寒且热,三日一刺,百日而已。(既汗而
复寒热者,邪盛患深,非可以旦夕除也,故当三日一刺,百日始已。)
病大风,骨节重,须眉堕,名曰大风,刺肌肉为故,汗出百日,(大风,即风论及四时气篇之所谓疠也。其浅者遍腠
理,故当刺肌肉为故,所以泄阳分之毒,风从汗散也。)刺骨髓,汗出百日,(刺深者须取骨髓,所以泄阴分之风毒也。)
凡二百日,须眉生而止针。(风毒去尽,然后营卫气复,眉发重生,是病已愈,方可止针矣。)
疠风者,素刺其肿上,已刺,以锐针针其处,按出其恶气,肿尽乃止,
(《灵枢·四时气篇》。疠,大风也。风论曰∶疠者,有营气热 ,其气不清,故使鼻柱坏而色败,皮肤疡溃,风寒
客于脉而不去,名曰疠风也。其治法,当于常素刺其肿上,已刺之后,又必数以锐针针其患处,仍用手按出其恶毒之气,
必待肿尽,乃可止针。盖毒深气甚,非多刺不可也。疠,癞同,又音利。)常食方食,无食他食。(食得其法,谓之方食。
无食他食,忌动风发毒等物也。)
偏枯,身偏不用而痛,言不变,志不乱,病在分腠之间,巨针取之,益其不足,损其有余,乃可复也(《灵枢·热病
篇》。偏枯者,半身不随,风之类也,其身偏不用而痛。若言不变、志不乱,则病不在脏而在于分肉腠理之间,可用巨针
取之,即第九针也。察其虚实以施补泻,其元可复矣。)
痱之为病也,身无痛者,四肢不收,(痱亦风属,犹言废也。上节言身偏不用而痛,此言身不知痛而四肢不收,是偏
枯痱病之辨也。痱,肥、沸二音。)智乱不甚,其言微知,可治,甚则不能言,不可治也。(智乱不甚,其言微有知者,
神气未为全去,犹可治也;神失,则无能为矣。)病先起于阳,后入于阴者,先取其阳,后取其阴,浮而取之。(此治必
先其本也。病先起于阳分,故当先刺其表,浮而取之,而后取其阴。此下不言先起于阴者,盖病始于阴,直中脏也,多
不可治,故不复言之。)
风痉,身反折,先取足太阳及 中及血络出血;中有寒,取三里。(痉,强直也。身反折,反张向后也。此风证之在
膀胱经者,故当取足太阳经穴。 中,委中穴也。血络,浮浅之络也。皆当刺出其血。若中气有寒,仍当取足阳明之三
里,温补胃气而风寒可除也。痉,求影切,中原韵音敬。)
(出自《素问·骨空论》《长刺节论》《灵枢·四时气论》《热病论》)
黄帝问道:我听说风邪是各种疾病的起始原因,用针刺治疗风病应当怎么做呢?
(《素问·骨空论》。风邪侵袭人体,必定先侵犯皮毛,然后才波及经络和脏腑,由浅入深,从轻到重,且风邪善于游走变化,所以成为百病的开端。
因此圣人躲避风邪,就像躲避箭矢石头一样,正是为了在疾病萌芽阶段加以预防。)岐伯回答说:风邪从外部侵入,使人出现寒战、出汗、头痛、身体沉重、怕冷等症状。(风邪外袭,阳气在内抵抗,邪气与正气相互争斗,所以出现寒战。风邪损伤卫气,所以出汗。邪气客居在三阳经,所以头痛且身体沉重。卫气受损则体表怯弱,所以怕冷。)治疗应取风府穴,调节阴阳平衡,正气不足就采用补法,邪气有余就采用泻法。(风府,是督脉的穴位。观察如果正气不足就进行补益,如果邪气有余就进行泻除。)患严重的风病导致颈项疼痛,针刺风府穴,风府穴位于上椎骨处。(上椎,指的是项骨椎骨上方,距离发际线一寸的位置。)患严重的风病导致出汗,艾灸 穴,该穴位于背部下方脊柱旁开三寸处,按压此穴让患者呼喊 的声音,手指会有应手跳动的感觉。( ,是足太阳膀胱经的穴位。厌之,是用手指按压穴位。于是让病患呼喊 的声音,手指就会随之跳动,因此以这个声音命名。)因风病而厌恶风吹,针刺眉头部位。(疾病由于风邪引起所以厌恶风。刺眉头,指的是足太阳膀胱经的攒竹穴。憎,读音为早登切。)
患风病同时感到寒冷和发热,出热汗,一天发作多次,先针刺各个分肉纹理间的络脉;
(《素问·长刺节论》。《风论》说:风邪伤人,有的表现为寒热往来,有的表现为热中,有的表现为寒中,有的表现为疠风,有的表现为偏枯,有的表现为风痹。
说的就是这种情况。炅汗,即热汗。针刺各个分肉纹理间的络脉,关键在于多刺。炅,读音为居永切。)如果出汗且伴有寒热交替,每隔三天针刺一次,一百天后病愈。(既然出汗后又出现寒热,说明邪气盛、病情深,不能指望早晚就能消除,所以应当每隔三天针刺一次,经过一百天才能痊愈。)
患严重的风病,关节沉重,眉毛胡须脱落,这种病称为大风,以针刺肌肉使出汗为治疗原则,持续一百天,(大风,就是《风论》及《四时气篇》中所说的疠风。病位较浅的遍及腠理,所以应当以针刺肌肉并使其出汗为原则,以此来泄除阳分的毒气,风邪随汗液发散。)如果针刺至骨髓,也需出汗一百天,(刺得深的必须取骨髓,以此来泄除阴分的风毒。)总共二百天,等到眉毛胡须重新长出就可以停止针刺了。(风毒完全去除后,营气和卫气恢复,眉毛头发重新生长,这是病已痊愈的标志,才可以停止针刺。)
患疠风的人,平时要常刺其肿胀部位,刺过后,用尖针再刺患处,按压排出恶浊之气,直到肿胀消退为止,
(《灵枢·四时气篇》。疠,即大风。《风论》说:疠风,是因为营气有热,气血不清,所以导致鼻梁塌陷、面色败坏,皮肤溃疡,风寒邪气客居在脉中而不离去,称为疠风。其治疗方法,应当在平时常刺其肿胀部位,刺完之后,又必须多次用尖针刺患处,仍用手按压排出恶毒之气,必须等到肿胀完全消退,才可以停止针刺。因为毒气深、邪气盛,不多次针刺是不行的。疠,同“癞”,又读作利。)饮食上要只吃常规的食物,不要吃其他食物。(吃得合乎法则,称为方食。不吃其他食物,是为了忌口那些动风、诱发毒气的食物。)
患偏枯病,半身不能活动且疼痛,但言语不变,神志不乱,病位在分肉腠理之间,用巨针取治,补益不足,削减有余,这样才可以恢复(《灵枢·热病篇》。偏枯,即半身不遂,属于风类疾病,其半身不能活动且疼痛。如果言语不变、神志不乱,那么病不在脏腑而在于分肉腠理之间,可以用巨针取治,即第九种针具。观察虚实来施行补泻,元气就可以恢复了。)
痱病的特点是,身体没有疼痛感,四肢无法收持(痱也属于风病,意思相当于废用。上一节说的是半身不能活动且疼痛,这一节说的是身体不知疼痛而四肢无法收持,这是偏枯和痱病的区别。痱,读音为肥、沸二音。)智力混乱不严重,说话还能让人听懂一点,可以治疗;如果严重到不能说话,就无法治疗了。(智力混乱不严重,说话还能隐约表达意思,说明神气没有完全丧失,还可以治疗;如果神气丧失,就没有办法了。)疾病先从阳分起,后来传入阴分的,先取阳分穴位,后取阴分穴位,浅刺即可。(这是治疗必须先治本的原则。疾病先从阳分起,所以应当先刺其表浅部位,浅刺取之,然后再取其阴分。下文没有讲先从阴分起的,大概是因为病始于阴分,是直接中伤脏腑,大多不可治愈,所以不再赘述。)
患风痉病,身体向后反折,先取足太阳经及委中穴及血络放血;如果体内有寒,取足三里穴。(痉,指强直。身反折,指身体向后反张。这是风证在膀胱经的表现,所以应当取足太阳膀胱经的穴位。委中,即委中穴。血络,指浮浅的络脉。都应当刺出其血液。如果中气有寒,仍然应当取足阳明胃经的三里穴,温补胃气,风寒邪气就可以消除了。痉,读音为求影切,中原韵音敬。)
(From *Suwen: Gukong Lun*, *Chang Cijie Lun*, *Lingjiu: Sishiqi Lun*, *Rebing Lun*)
The Yellow Emperor asked, "I have heard that wind is the beginning of all diseases. How should acupuncture be used to treat wind-related conditions?"
(*Suwen: Gukong Lun*. When wind pathogen invades the human body, it first affects the skin and hair (mao pi), then spreads to the meridians and zang-fu organs. It moves from superficial to deep levels, progressing from mild to severe. Wind is agile and variable, thus becoming the origin of myriad diseases.
Therefore, sages avoid wind as they would avoid arrows and stones, precisely to prevent disease at its nascent stage.) The Grand Master Qi Bo replied, "When wind enters from the exterior, it causes chills (zhen han), sweating, headache, heaviness of the body, and aversion to cold. (Wind pathogen attacks from outside, while yang qi resists internally; the struggle between pathogen and healthy qi results in chills. Wind damages the Wei qi (Defensive Qi), leading to sweating. Pathogen lodges in the Three Yang meridians, causing headache and body heaviness. Damage to Wei qi leads to surface weakness, hence aversion to cold.) Treatment should focus on Fengfu (GV16) to regulate Yin and Yang. If there is deficiency, apply tonification; if there is excess, apply sedation. (Fengfu (GV16) is an acupoint of the Du Meridian. Observe if healthy qi is deficient and tonify it; observe if pathogenic qi is excessive and sedate it.) In severe wind cases causing neck and nape pain, puncture Fengfu (GV16). Fengfu (GV16) is located at the upper vertebra. (Upper vertebra refers to the cervical vertebrae above, one cun above the hairline.) In severe wind cases with sweating, moxa the [missing character] point, located three cun lateral to the lower spine on the back. Press this point and ask the patient to shout [missing character]; the hand will feel a pulsation. ([Missing character] is an acupoint of the Foot-Taiyang Bladder Meridian. 'Press' means to press the acupoint with fingers. The patient shouts the sound '[missing character]', causing the area to pulse under the finger, hence the name.) For wind-induced aversion to drafts, puncture the eyebrow region. (Disease caused by wind leads to aversion to wind. Puncturing the eyebrow region refers to Zanzhu (BL2), an acupoint of the Foot-Taiyang Bladder Meridian. 'Zeng' is pronounced 'zao deng qie'.)
For wind disease presenting with both cold and heat, accompanied by hot sweats occurring multiple times a day, first puncture the collateral vessels in various flesh compartments;
(*Suwen: Chang Cijie Lun*. *Feng Lun* states: "When wind pathogen injures people, it may manifest as alternating cold and heat, or internal heat, or internal cold, or leprosy (Li Feng), or hemiplegia, or wind bi. This refers to such cases." Jiong sweat refers to hot sweat. Puncturing collateral vessels in flesh compartments emphasizes frequent needling. 'Jiong' is pronounced 'ju yong'.) If sweating occurs with alternating cold and heat, needle once every three days until recovery after one hundred days. (If sweating recurs with cold and heat, it indicates strong pathogen and deep illness, which cannot be resolved overnight. Thus, needle every three days for one hundred days before cessation.)
In severe wind disease (Big Wind) with heavy joints and loss of eyebrows and beard, known as Big Wind, treatment involves needling muscles to induce sweating for one hundred days. (Big Wind refers to Li Feng mentioned in *Feng Lun* and *Sishiqi Pian*. Superficial cases affect the interstices (cou li); thus, needling muscles to induce sweating is the principle to vent toxic heat from the Yang aspect, allowing wind to disperse via sweat.) If needling reaches the bone marrow, induce sweating for another one hundred days. (Deep needling targets bone marrow to vent wind-toxicity from the Yin aspect.) After a total of two hundred days, when eyebrows and beard regrow, stop needling. (Once wind-toxicity is fully eliminated, Ying (Nutritive) and Wei (Defensive) qi recover, and hair regrows, indicating cure; only then can needling cease.)
For patients with Leprosy (Li Feng), routinely needle the swollen areas. After initial needling, use a sharp needle to puncture the site again, pressing to expel foul qi until swelling subsides.
(*Lingjiu: Sishiqi Pian*. Li refers to Big Wind. *Feng Lun* states: "Li Feng arises from heat in Ying qi, causing turbid qi, leading to collapse of the nasal bridge, deterioration of complexion, and skin ulcers. Cold and wind pathogens lodge in the vessels and do not depart, termed Li Feng." The treatment method involves routinely needling swollen areas. After needling, repeatedly puncture the lesion with a sharp needle and press to expel toxic qi. Only stop when swelling completely resolves. Because toxicity is deep and pathogen is strong, frequent needling is required. 'Li' is synonymous with 'Lei' (leprosy/ulcer) and pronounced 'li'.) Diet should consist only of regular foods; avoid other foods. (Eating according to proper rules is called 'Fang Shi'. Avoiding other foods prevents triggering wind or aggravating toxins.)
Hemiplegia (Pian Ku) presents with unilateral immobility and pain, but speech remains unchanged and mental state is stable. The pathology lies between the muscle layers and interstices. Treat with large needles (Ju Zhen), tonifying deficiency and reducing excess, to restore function. (*Lingjiu: Rebing Pian*. Hemiplegia is unilateral paralysis, a type of wind disorder, characterized by unilateral immobility and pain. If speech and consciousness are intact, the disease is not in the Zang-Fu organs but in the muscles and interstices. Large needles (the ninth type of needle) can be used. Assess excess and deficiency to apply tonification or sedation; original vitality can be restored.)
Fei disease is characterized by absence of body pain and inability to control the limbs. (Fei also belongs to wind disorders, meaning 'useless' or 'paralyzed'. The previous section described unilateral immobility with pain; this section describes lack of pain sensation with limb flaccidity, distinguishing Pian Ku from Fei. 'Fei' is pronounced 'fei' or 'fei'.) If cognitive confusion is mild and speech is partially intelligible, it is treatable; if severe to the point of muteness, it is untreatable. (Mild confusion with partial intelligibility indicates that Shen Qi (Spirit Qi) is not entirely lost, so treatment is possible. If Spirit is lost, no action can be taken.) If the disease originates in the Yang aspect and later enters the Yin aspect, first treat the Yang aspect, then the Yin aspect, using shallow needling. (This follows the principle of treating the root first. Since the disease starts in the Yang aspect, initially needle the exterior superficially, then treat the Yin aspect. The text does not mention diseases starting in the Yin aspect because direct invasion of Zang organs from Yin onset is mostly untreatable, hence omitted.)
Wind-Jing (Spasm) presents with backward arching of the body. First, bleed the Foot-Taiyang meridian, Weizhong (BL40), and blood collaterals. If there is internal cold, select Zusanli (ST36). (Jing refers to stiffness. Backward arching is opisthotonos. This wind syndrome affects the Bladder Meridian, so select Foot-Taiyang acupoints. Weizhong (BL40) is the acupoint. Blood collaterals refer to superficial vessels. All should be pricked to release blood. If there is cold in the Middle Jiao/Stomach Qi, select Zusanli (ST36) of the Foot-Yangming Stomach Meridian to warm and tonify Stomach Qi, eliminating wind-cold. 'Jing' is pronounced 'qiu ying qie', rhyming with 'jing' in Central Plains dialect.)