(《灵枢·寒热病篇》《素问·长刺节论》)
皮寒热者,不可附席,毛发焦,鼻槁腊,不得汗,取三阳之络,以补手太阴
(《灵枢·寒热病篇》。肺主皮毛,开窍于鼻,皮寒热者邪在外,故畏于近席而毛发焦、鼻槁腊也。如不得汗,当泻
足太阳之络穴飞阳,补手太阴之鱼际、太渊。盖太阳即三阳,主在表之热,而臂之太阴可以取汗也。腊音昔,干也。)肌
寒热者,肌痛,毛发焦而唇槁腊,不得汗,取三阳于下以去其血者,补足太阴以出其汗。(脾主肌肉,其荥在唇。肌寒热
者邪在脾,故当肌痛、毛发焦而唇槁腊也。取三阳法如上文。补足太阴之大都、太白,可以出汗。义见前章。)骨寒热者,
病无所安,汗注不休。齿未槁,取其少阴于阴股之络;齿已槁,死不治。骨厥亦然。(肾主骨,骨寒热者,邪在至阴也,
阴虚者必躁,故无所安也。阴伤则液脱,故汗注不休也。齿者骨之余,若齿未槁者,阴气尚充,犹为可治,当取足少阴
之络穴大钟以刺之。若齿有枯色,则阴气竭矣,其死无疑。近以愚见,则不独在齿,凡爪枯者亦危候也,骨寒而厥者皆
然。)
阴刺,入一,旁四处,治寒热,
(《素问·长刺节论》。阴刺疑误。按∶《官针篇》云∶五曰扬刺,扬刺者,正内一,旁内四,以治寒气之博大者也。
十曰阴刺,阴刺者,左右率刺之,以治寒厥。此云阴刺者当是扬刺。详本类前五。)深专者,刺大脏。(深专者,邪气深
而专在一脏也,治当求其大脏而直取之,凡五脏皆为大脏。)迫脏刺背,背俞也,(欲迫取其大脏之气,当刺其背,以五
脏之俞在于背也。)刺之迫脏,脏会,(刺背俞而能迫脏者,为脏气之所会也。)腹中寒热去而止,(刺背俞者,无问其数,
必使腹中寒热去而后止针。)与刺之要,发针而浅出血。(言凡与刺脏俞者,不宜出血太多,其要在发针浅而少出其血也。)
(出自《灵枢·寒热病篇》和《素问·长刺节论》)
皮部受寒热邪气侵袭的症状是:患者身体极度不适,无法贴近席子躺卧,毛发枯焦,鼻腔干燥萎缩,无汗。治疗应取足三阳经的络穴,并补益手太阴肺经。(《灵枢·寒热病篇》注:肺主皮毛,开窍于鼻。皮部寒热说明邪气在体表,所以患者畏惧靠近席子,出现毛发枯焦、鼻腔干燥萎缩的症状。如果无汗,应当泻足太阳膀胱经的络穴飞阳,补益手太阴肺经的鱼际穴和太渊穴。因为太阳经即三阳经,主管体表的发热,而手太阴肺经可以引导出汗。“腊”音同“昔”,意为干枯。)
肌部受寒热邪气侵袭的症状是:肌肉疼痛,毛发枯焦,嘴唇干燥萎缩,无汗。治疗应在下部取足三阳经的穴位以放血去瘀,同时补益足太阴脾经以发汗。(脾主肌肉,其荣色反映在嘴唇。肌部寒热说明邪气在脾,所以会出现肌肉疼痛、毛发枯焦、嘴唇干燥萎缩的症状。取足三阳经的方法如上文所述。补益足太阴脾经的大都穴和太白穴,可以促使出汗。原理见前章。)
骨部受寒热邪气侵袭的症状是:病人坐卧不安,大汗淋漓不止。如果牙齿尚未枯槁,可取足少阴肾经在大腿内侧的络穴进行治疗;如果牙齿已经枯槁,则属死证,无法治愈。骨厥证也是如此。(肾主骨,骨部寒热说明邪气侵入至阴之脏。阴虚则必然烦躁,所以病人坐卧不安。阴液受损则津液脱失,所以大汗淋漓不止。牙齿是骨骼的余气所生,如果牙齿未枯槁,说明阴气尚且充足,还可以治疗,应当取足少阴肾经的络穴大钟进行针刺。如果牙齿呈现枯槁之色,说明阴气已竭,死亡无疑。依我个人的见解,不仅牙齿枯槁是危重征象,凡是指甲枯槁的也是危重征象,骨寒而导致的厥逆证都是如此。)
阴刺法,是一针直入,旁边四针斜刺,用于治疗寒热证,(《素问·长刺节论》注:“阴刺”二字可能有误。按《官针篇》记载:第五种是扬刺,扬刺法是正中刺一针,旁边刺四针,用来治疗寒气广泛深大的病症。第十种是阴刺,阴刺法是左右对称地针刺,用来治疗寒厥证。此处所说的“阴刺”应当是“扬刺”。详见本类前五条内容。)
邪气深聚专一的,针刺大脏。(所谓邪气深聚专一,是指邪气深入且专攻某一脏腑,治疗时应当寻求该大脏并直接针刺,五脏皆称为大脏。)
邪气逼迫内脏的,针刺背部背俞穴。(想要迫近并获取大脏之气,应当针刺背部,因为五脏的俞穴都在背部。)
针刺背部背俞穴能迫近内脏,是因为这里是脏气汇聚之处。(针刺背俞穴之所以能迫近内脏,是因为这是脏气所会合的地方。)
(From *Ling Shu: Han Re Bing Pian* and *Su Wen: Chang Ci Jie Lun*)
**Skin Cold-Heat:** The symptoms include extreme discomfort such that the patient cannot lie close to the mat, scorched hair, withered and dry nose, and absence of sweating. Treatment involves selecting the collateral points of the Foot Yangming channels (San Yang) and tonifying the Hand Taiyin Lung channel.
*(Note from Ling Shu: The Lung governs the skin and hair and opens into the nose. Skin cold-heat indicates pathogenic factors are on the exterior; thus, the patient fears proximity to mats, presenting with scorched hair and a withered, dry nose. If sweating is absent, one should drain Feiyang (BL59), the collateral point of the Foot Taiyang Bladder channel, and tonify Yuji (LU10) and Taiyuan (LU9), the points of the Hand Taiyin Lung channel. Since the Taiyang channel corresponds to the San Yang governing exterior heat, the Hand Taiyin Lung channel can induce sweating. "La" sounds like "Xi," meaning dry.)*
**Muscle Cold-Heat:** The symptoms include muscle pain, scorched hair, withered and dry lips, and absence of sweating. Treatment involves selecting points on the lower part of the Foot Yangming channels to remove blood stasis, while tonifying the Foot Taiyin Spleen channel to induce sweating.
*(The Spleen governs the muscles, and its luster manifests in the lips. Muscle cold-heat indicates pathogenic factors are in the Spleen; thus, muscle pain, scorched hair, and withered, dry lips occur. The method for selecting Foot Yangming channels is as described above. Tonifying Dadu (SP2) and Taibai (SP3) of the Foot Taiyin Spleen channel can induce sweating. See previous chapter for principles.)*
**Bone Cold-Heat:** The symptoms include restlessness with no place to feel at ease, and continuous profuse sweating. If the teeth have not yet withered, treat by selecting the collateral point of the Foot Shaoyin Kidney channel in the inner thigh; if the teeth have already withered, it is a death case and untreatable. Bone Jue (reversal) presents similarly.
*(The Kidney governs the bones. Bone cold-heat indicates pathogenic factors have entered the Zhi Yin [Extreme Yin] organ. Yin deficiency leads to irritability, causing restlessness. Damage to Yin results in fluid depletion, leading to continuous profuse sweating. Teeth are the surplus of bone. If teeth are not withered, Yin Qi is still sufficient, and treatment is possible by needling Datong (KI4), the collateral point of the Foot Shaoyin Kidney channel. If teeth show signs of withering, Yin Qi is exhausted, and death is inevitable. In my opinion, not only withered teeth but also withered nails indicate a critical condition; all cases of bone cold leading to Jue are alike.)*
**Yin Needling:** One needle inserted centrally and four inserted laterally, used to treat cold-heat conditions.
*(Note from Su Wen: "Yin Needling" may be an error. According to Guan Zhen Pian: The fifth method is Yang Needling, where one needle is inserted centrally and four laterally, treating extensive and deep cold qi. The tenth method is Yin Needling, involving symmetrical needling on left and right sides to treat Cold Jue. The "Yin Needling" mentioned here likely refers to "Yang Needling." See Section 5 of this category for details.)*
**Deep and Focused Pathogens:** Needle the Major Zang Organs.
*(This refers to pathogens that are deep and focused on a single Zang organ. Treatment requires directly needling the corresponding Major Zang organ. All five Zang organs are considered Major Zang.)*
**Pathogens Pressing on Zang Organs:** Needle the Back-Shu Points.
*(To approach and access the Qi of the Major Zang organs, one must needle the back, as the Back-Shu points of the five Zang organs are located on the back.)*
**Needling the Back-Shu to Approach the Zang:** This works because it is the convergence of Zang Qi.
*(Needling the Back-Shu points can approach the Zang organs because these are the sites where Zang Qi converges.)*
**Cessation upon Relief:** Stop when abdominal cold-heat resolves.
*(When needling Back-Shu points, the number of insertions does not matter; stop only after the cold-heat in the abdomen has resolved.)*
**Key of Needling:** Induce slight superficial bleeding upon withdrawal.
*(This means that when needling Zang-Shu points, excessive bleeding should be avoided. The key is shallow insertion and inducing only minimal bleeding upon needle withdrawal.)*