(左右凡一十二穴)
1.章门∶二穴,脾之募,一名长平,一名胁 。在大横外,直季胁肋端。侧卧,屈上足,伸下足,举
臂取之,足厥阴、少阳之会。治肠鸣盈盈然,食不化,胁痛不得卧,烦热口干,不嗜食,胸胁支满,喘息,
心痛,腰不得转侧,伤饱,身黄羸瘦,贲豚,腹肿,脊强,四肢懈惰,善恐少气厥逆,肩臂不
举。可灸百壮,针入六分,忌如常法。
2.京门∶二穴,肾之募,一名气 ,一名气府,在监骨下腰中,季胁本侠脊,治腰痛不得俯仰,寒热,
胀引背不得息,水道不利,溺黄,少腹急肿,肠鸣洞泄,髀枢引痛。可灸三壮,针入三分,留七呼。
3.带脉∶二穴在季胁下一寸八分。治妇人少腹坚痛,月
事不调,带下赤白,里急,螈 。可灸五壮,针入六分。
4.五枢∶二穴在带脉下三寸,一云在水道傍一寸五分。治男子寒疝,阴卵上入小腹痛。针入一寸,可灸五壮。
5.维道∶二穴在章门下五寸三分,足少阳、带脉之会。治呕逆不止,三焦不调,水肿,不嗜食。针入
八分,可灸三壮。
6.居 ∶二穴在章门下八寸三分,监骨上陷中,阳跷、足少
阳之会。治腰引少腹痛,肩引胸臂挛急,手臂不得举而至肩。灸三壮,针入八分。
予编《秘传》竟,或有进而问者曰∶诸家所言某穴主某病,某病必宜取某穴,其说确不可易乎?曰∶此
不过示以大概,其实治病无定穴也。大凡邪中于人,与正周流上下,或在气分,或在血分,无有定止,故喻用
针正如用兵,彼动则此应,或出以奇,或守以正,无有定制。如医者不究病因,不察传变,惟守某穴主
某病之说,执中无权,按谱施治,譬之狂潦泛溢,欲塞下流而获安者,亦偶然耳。夫病变无穷,针法亦无穷,
病或在上而从下取之,病或在下而从上取之,或正取,或直取,审经与络,分气与血,病随经而在,穴随经而
取,庶得随机应变之理。予所以选录《灵枢》、《素问》、《难经》置于卷首,使人熟读深思者,正
欲人知此随机应变之理,而得圆机活法也。
或又曰∶圆机活法,既得闻命矣,但学人望洋无下手处,奈何?曰∶譬犹匠者教人以规矩,取方圆也。
规矩之法在师,方圆之法则在弟子矣。夫圣人之于针,非经络孔穴,无以教后学。后学非经络孔穴,无以受
之师。苟不知变通,徒执孔穴,所谓按图索骥,安能尽其法哉!故曰∶粗守形,上守神,粗守关,上守
机,机之动,不离其空,此之谓也。
或曰∶今有专取奇穴治病,亦多有效,究竟是否?曰∶人身正经十二,奇经有八,大络十五,小络三百
余,皆所以行气血也。圣人取穴三百六十有六,按岁之三百六十六日也,后人以为未尽,更取奇穴,是犹置
闰月也。奇穴者,络穴六,经穴二。余络余经,置而不用,速求巧捷,遂悖圣经。又有六十六穴,拘于
日时开合用之,犹未周备,而况拘于八穴者乎。盖八穴病在气分,则有可劫之功。若在血分,徒损元气,病何
由安,正是血病而泻气也。邪在血分,则直求病之所在而取之可也。今人泥而不用,岂非可笑。
或曰∶针灸宜避天忌日,何也?曰∶经云∶左足应立春,其日戊子己丑。左胁应春分,其日己卯。左手
应立夏,其日戊辰己巳。膺喉首头应夏至,其日丙午。右手应立秋,其日戊申己未。右胁应秋分,其日辛酉。
右足应立冬,其日戊戌己亥。腰尻下窍应冬至,其日壬子。六腑膈下三藏应四季中州,其日戊己。大
禁太乙所在日(即前所云)。凡此九者,善候八正所在之处,所主左右上下体有痈肿者欲治之,无以其所值
之日溃治之,是谓天忌日也。
或曰∶后世有子午流注之说,始于南唐何若愚。谓三焦是阳气之父,心包络是阴气之母,二经尊重,不
系五行所摄,主受纳十经气血养育,故只言十经阴阳二脉,逐日各注井荥俞经合,各五时,晨毕。每日遇阳
干合处,注于三焦,遇阴干合处,注于包络,此二经亦各注井荥俞经合五穴,阳干注府,阴干注藏。如
甲日甲戌时,胆气初出为井,乙日乙酉时,肝出穴为井云云,其
说甚长。盖谓左转从子,能外行诸阳,右转从午,能内行诸阴,其说于经亦有据乎?曰∶此皆臆说。《内
经》、《难经》所不载,不惟悖其经旨,而所说亦自相矛盾者多矣。彼谓阳日阳时阳经穴开,故甲子日甲戌
时甲胆窍阴井开,此固然矣。丙子时属于乙丑日辰,乃阴日阳时也,而谓丙小肠前谷荥穴开,其与阳日阳
时之说,合乎否乎?举此一端,其余可推类而知,其自相矛盾不待言矣。经言荣卫之气,五十度大会于手太
阴。终古不改其常度,此谓阳日气先血后,阴日血先气后,其乱经旨也大矣,岂可为法于天下后世哉!
或曰∶针灸家动谓各有秘法,不轻示人,信乎?曰∶传世所传十四法、十六法,如青龙摆尾云云,可谓已
尽之矣。舍此谓更有神秘,吾未之信也。况此等法,证之于经,则有悖于经,质之于理,则有违于理,彼以
为神,我以为诡,彼以为秘,我以为妄。此编虽亦罗列诸法于前,因既为世俗之所通行,固不可不知
其法。且外间所传者,往往名是而实非,予故为之考证其说,归于至当,免其以讹传讹,且可与《内》、
《难》诸法,考究异同,俾能实验于针下。如果精研经旨,深明古法,则于近世之所谓秘密,虽全弃
而不可用也。
或曰∶诸家针科书所载,某穴针几分,留几呼,灸几壮,出于经欤否欤?曰∶此多出于后世,于经
并无考也。经曰∶病有浮沉,刺有浅深。浅深不得,反为大贼。过之则内伤,不及则生外壅。古人治法,惟视
病之浮沉,而为刺之浅深,岂以定穴分寸为拘哉!又谓某穴宜留几呼,悻理尤甚。经曰∶刺实须其虚者,
留针,阴气隆至(针下寒),乃去针也。经气已至,慎守勿失。
又曰∶刺之而气不至,无问其数,刺之而气至,乃去之,勿复
针。针各有所宜,各不同形,各任其所为。刺之要,气至而有效,效之信,若风之吹云,明乎若见苍天。岂留
呼而可为定准耶?经又云∶静以久留,以气至为故,不以息之多数而便去针。是古人用针,惟以气至为期,而
不以呼之多少为候。若根据留呼之说,气至则可,气若不至,亦根据呼数而去针,徒使破皮损肉,有
何益于病哉。故曰∶凡刺之害,中而不去则精泄,不中而去则致气,精泄则病甚而 ,致气则生为痈疽也。
又谓某穴宜灸几壮,亦非至言,惟当视其穴俞肉之浓薄,病之轻重,而为灸之多少大小则可耳,不必守其成
规。所言某穴针几分,灸几壮,谓病宜针某穴,则宜入几分,病宜灸某穴,则宜灸几壮。针则不灸,
灸则不针。不知其说者,既针复灸,既灸复针,为害不浅。
或曰∶《内经》明言足阳明者,五脏六腑之海也,其脉大血多气甚热壮。刺此者,不深不散,不留不
泻也。足阳明刺深六分,留十呼;足太阳深五分,留七呼;足少阳深四分,留五呼;足太阴深三分,留四呼;
足少阴深二分,留三呼,足厥阴深一分,留二呼。手之阴阳,其受气之道近,其气之来疾,其刺深者,
皆无过二分,其留皆无过一呼,灸之亦然。灸而过此者,得恶火则骨枯脉涩;刺而过此者,则脱气,此皆古
法也。如先生所说,则经中所论,并皆非欤?曰∶此古人特论其理之常如此耳。凡用刺法,自有所宜,初不必
以是为拘也。经曰∶邪气在上,浊气在中,清气在下。故针陷脉则邪气出,针中脉则浊气出。针太深则
邪气反沉而病益。又曰∶少长小大肥瘦,以心撩之。又曰∶其可为度量者,不甚脱肉,而血气不衰也。若
夫瘠瘦而形肉脱者,恶可以度量刺乎?审切循扪按,视其寒温盛衰而调之,是谓因适
而为之真者是也。
或曰∶近世针法,刺左边之穴,将针右拈而气上行,将针左拈而气下行,刺右边则反之。欲补先呼后吸,
欲泻先吸后呼,其法亦可师欤?曰∶经络周于人身,无有左右上下之别。今针左右不同如此,将谓左之经络,
与右之上下两不相同耶?经曰∶刺不知经络之往来,血气之流行,不足以为工。此亦可谓不知经络之往来矣。
或问近世补泻之法,男用大指进前左转,呼之为补,退后右转,吸之为泻,提针为热,插针为寒;女用
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,午前如此,午后反之。其法是耶非
耶?曰∶经云∶冬至四十五日,阳气微上,阴气微下,夏至四十五日,阴气微上,阳气微下。此论一
年阴阳之升降也,即此一日阴阳之升降,午前阳升阴降,午后阴升阳降,无分于男女也。考之《内》、《
难》,男女脏腑经络穴俞血气昼夜周流,无不同。今言午前午后,男女补泻颠倒错乱如此,悖经旨也甚矣。
故曰∶诊不知阴阳逆从之理,此治之一失也。又曰∶刺实须其虚者,针下寒也,刺虚须其实者,针下
热也。曰寒曰热,以针下为候,何尝以提按而分男与女哉!
(左右共十二个穴位)
1.章门:两个穴位,是脾的募穴,又名长平,又名胁。位于大横穴外侧,正对季肋的末端。侧卧时,屈起上面的腿,伸直下面的腿,举起手臂来取穴,是足厥阴肝经和足少阳胆经的交会穴。主治肠鸣声漉漉,食物不消化,胁痛导致无法躺卧,烦热口干,食欲不振,胸胁胀满支撑感,喘息,心痛,腰部不能转动,伤食饱胀,身体发黄消瘦,奔豚气,腹部肿胀,脊柱强直,四肢懈怠无力,容易恐惧、气短、厥逆,肩臂无法抬起。可艾灸一百壮,针刺入六分,禁忌同常规方法。
2.京门:两个穴位,是肾的募穴,又名气,又名气府,在髂骨下方腰中,季肋根部靠近脊柱处。主治腰痛不能俯仰,寒热往来,腹胀牵引背部导致呼吸不畅,水道不通利,小便黄,小腹急迫肿胀,肠鸣洞泄,大腿枢轴部位牵引疼痛。可艾灸三壮,针刺入三分,留针七次呼吸的时间。
3.带脉:两个穴位,位于季肋下一寸八分。主治妇人小腹坚硬疼痛,月经不调,白带赤白相间,里急后重,肌肉抽搐痉挛。可艾灸五壮,针刺入六分。
4.五枢:两个穴位,位于带脉下三寸,另一种说法是在水道穴旁一寸五分。主治男子寒疝,阴囊上缩入小腹引起疼痛。针刺入一寸,可艾灸五壮。
5.维道:两个穴位,位于章门下五寸三分,是足少阳胆经和带脉的交会穴。主治呕吐逆气不止,三焦功能失调,水肿,食欲不振。针刺入八分,可艾灸三壮。
6.居髎:两个穴位,位于章门下八寸三分,髂骨上方的凹陷中,是阳跷脉和足少阳胆经的交会穴。主治腰部牵引少腹疼痛,肩部牵引胸臂挛急,手臂无法抬举至肩部。艾灸三壮,针刺入八分。
我编撰完《金针秘传》后,有人进而问道:“各家医书所说的某穴主治某病,某病必须选取某穴,这种说法确实不可改变吗?”我说:“这不过是展示大概规律,其实治病并没有固定的穴位。大凡邪气侵入人体,与正气上下周流运行,有时在气分,有时在血分,没有固定的停留之处,所以比喻用针就像用兵打仗,对方动则我方应,有时出奇招,有时守正道,没有固定的制度。如果医者不探究病因,不观察病证传变,只死守某穴主某病的说法,固执不知变通,按照图谱施治,这就好比洪水泛滥,想要通过堵塞下游来获得安宁,也只是偶然罢了。病变无穷无尽,针法也无穷无尽,病在上而从下部取穴,病在下而从上部取穴,或正取,或直取,审察经脉与络脉,区分气与血,病随经脉所在,穴随经脉而取,这样才能得到随机应变的道理。我之所以在卷首选录《灵枢》、《素问》、《难经》,让人熟读深思,正是希望人们懂得随机应变的道理,从而获得圆机活法。”
又有人问:“圆机活法,既然已经听您教诲了,但学习者面对浩瀚知识如望洋兴叹,不知从何下手,怎么办?”我说:“这就好比工匠教人使用规矩来取方圆。规矩的方法在于老师,方圆的结果在于弟子。圣人对于针灸,如果没有经络孔穴,就无法教导后学;后学如果没有经络孔穴,就无法从老师那里接受知识。如果不了解变通,仅仅执着于孔穴,这就是所谓的‘按图索骥’,怎么能穷尽针灸的法度呢!所以说:粗陋的医生坚守形体(穴位),高明的医生坚守神机;粗陋的医生坚守关节,高明的医生坚守气机,气机的变动,不离其空窍,说的就是这个道理。”
有人说:“现在有人专门选取奇穴治病,也有很多疗效,究竟是否正确?”我说:“人身正经十二条,奇经有八条,大络十五条,小络三百多条,都是用来运行气血的。圣人选取穴位三百六十六个,对应一年的三百六十六天,后人认为不够,又选取奇穴,这就像设置闰月一样。奇穴中,属于络穴的有六个,属于经穴的有两个。其余的络和经,放置不用,追求快捷巧妙,于是违背了经典。还有六十六个穴位,拘泥于日时的开合来使用,尚且不够周全,何况拘泥于八个穴位的呢?大概这八个穴位病在气分,或许有劫夺邪气的功效。如果在血分,只会损伤元气,病怎么能安愈呢?这正是血病却泻气啊。邪气在血分,就直接寻找病所在的位置来取穴就可以了。现在的人拘泥于此而不使用其他方法,难道不可笑吗?”
又问:“针灸应当避开天忌日,为什么呢?”我说:“经文说:左足对应立春,那天是戊子、己丑日。左胁对应春分,那天是己卯日。左手对应立夏,那天是戊辰、己巳日。胸膺咽喉头首对应夏至,那天是丙午日。右手对应立秋,那天是戊申、己未日。右胁对应秋分,那天是辛酉日。右足对应立冬,那天是戊戌、己亥日。腰尻下窍对应冬至,那天是壬子日。六腑、膈下三脏对应四季中的中州,那天是戊己日。大禁日是太乙所在的日期(即前面所说的)。凡是这九种情况,善于观察八正节气所在之处,所主管的左右上下身体部位如果有痈肿想要治疗它,不要在那些对应的日子进行溃破治疗,这就叫天忌日。”
又问:“后世有子午流注的说法,始于南唐何若愚。他说三焦是阳气的父亲,心包络是阴气的母亲,这两条经脉地位尊贵,不属于五行管辖,主要受纳十经的气血养育,所以只讲十经阴阳二脉,每天各注入井、荥、俞、经、合穴,每个时辰五个,早晨完成。每天遇到阳干相合的时候,注入三焦,遇到阴干相合的时候,注入包络,这两条经脉也各注入井、荥、俞、经、合五个穴位,阳干注入腑,阴干注入脏。比如甲日甲戌时,胆气初出为井穴,乙日乙酉时,肝出穴为井穴等等,这种说法很长。大概意思是说左转从子时开始,能外行诸阳经,右转从午时开始,能内行诸阴经,这种说法在经典中有依据吗?”我说:“这都是主观臆测的说法。《内经》、《难经》中没有记载,不仅违背了经旨,而且所说的内容也有很多自相矛盾的地方。他们说阳日阳时阳经穴开放,所以甲子日甲戌时甲胆窍阴井穴开放,这固然没错。但丙子时属于乙丑日的时辰,乃是阴日阳时,却说丙小肠前谷荥穴开放,这与阳日阳时的说法,符合吗?举这一个例子,其余的可以类推而知,其自相矛盾是不言而喻的。经文说营卫之气,五十周大会于手太阴肺经。自古不变其常度,这里说阳日气先血后,阴日血先气后,这严重扰乱了经旨,怎么可以作为天下后世的法则呢!”
又问:“针灸家动不动就说各有秘法,不轻易示人,是真的吗?”我说:“传世所传的十四法、十六法,如青龙摆尾等,可以说已经很详尽的了。舍弃这些还说有更神秘的,我不相信。况且这些方法,验证于经典,就违背经典;质问于道理,就违反道理,他们认为是神奇的,我认为怪诞,他们认为是秘密的,我认为荒谬。这本著作虽然也在前面罗列了各种方法,因为既然已经是世俗通行的,固然是不可不知道其方法的。而且外界所传的,往往名实不符,所以我考证这些说法,归于最恰当的解释,避免以讹传讹,并且可以与《内》、《难》诸法考究异同,以便能在针下实验验证。如果真的精研经旨,深明古法,那么对于近世所谓的秘密,即使全部抛弃也不用担心。”
又问:“各家针科书籍所载,某穴针刺几分,留针几次呼吸,艾灸几壮,出自经典吗?”我说:“这些大多出于后世,在经典中并无考证。经文说:病有浮沉,刺有浅深。浅深不得当,反而成为大害。过深则内伤,过浅则生外壅滞。古人治疗方法,只看病的浮沉,来决定刺的浅深,哪里会拘泥于定穴的分寸呢!又说某穴宜留针几次呼吸,违背道理尤其严重。经文说:刺实证须使其虚,留针,直到阴气隆至(针下感觉寒冷),才去针。经气已至,谨慎守护不要失掉。又说:刺之而气不至,不问次数多少;刺之而气至,就去针,不再刺。针具各有适宜,形状各不相同,各自任其所为。刺的要领,气至而有效,效果的验证,像风吹云散,明朗得像看见青天一样。哪里是把留针次数作为定准呢?经文又说:安静地长久留针,以气至为目的,不要因为呼吸次数多就提前去针。这是古人用针,只以气至为期,而不以呼吸多少为候。如果根据留呼的说法,气至还可以,气若不至,也根据呼数去针,徒然使皮肤破损肌肉受损,对病有什么好处呢?所以说:凡刺的害处,中病不去则精气泄漏,不中而去则导致气滞,精气泄漏则病加重而虚弱,导致气滞则生为痈疽。又说某穴宜灸几壮,也不是至理名言,只应当看穴俞处肌肉的厚薄,病的轻重,来决定灸的多少大小就可以了,不必遵守成规。所说某穴针几分,灸几壮,是说病宜针某穴,则宜入几分;病宜灸某穴,则宜灸几壮。该针的不灸,该灸的不针。不懂这个道理的人,既针又灸,既灸又针,危害不小。”
又问:“《内经》明确说足阳明胃经,是五脏六腑的海,其脉大血多气甚热壮。刺此经,不深不散,不留不泻。足阳明刺深六分,留十呼;足太阳深五分,留七呼;足少阳深四分,留五呼;足太阴深三分,留四呼;足少阴深二分,留三呼;足厥阴深一分,留二呼。手的阴阳经,其受气之道近,其气来疾,其刺深的,都不超过二分,其留针都不超过一呼,艾灸也是如此。灸而过此者,得恶火则骨枯脉涩;刺而过此者,则脱气,这些都是古法。如先生所说,那么经中所论,都错了吗?”我说:“这是古人特别论述其常理如此罢了。凡是用刺法,自有其适宜之处,起初不必以此为拘束。经文说:邪气在上,浊气在中,清气在下。所以针陷脉则邪气出,针中脉则浊气出。针太深则邪气反而下沉而病加重。又说:老少小大肥瘦,要用心揣摩。又说:可以作为度量标准的,是不甚消瘦,且血气不衰的人。如果是消瘦而形肉脱落的人,怎么可以用度量来刺呢?审察切循扪按,视其寒温盛衰而调治,这叫因适而为之真法。”
又问:“近世针法,刺左边的穴位,将针向右捻而气上行,将针向左捻而气下行,刺右边则相反。欲补先呼后吸,欲泻先吸后呼,这种方法也可以效法吗?”我说:“经络周流于人身,没有左右上下的区别。现在针左右不同如此,难道认为左边的经络,与右边的上下两不相同吗?经文说:刺不知经络的往来,血气的流行,不足以称为工。这也算是不知道经络的往来了。”
又问近世补泻之法,男用大拇指进前左转,呼气时为补,退后右转,吸气时为泻,提针为热,插针为寒;女用大拇指退后右转,吸气时为补,进前左转,呼气时为泻,插针为热,提针为寒,午前如此,午后反之。这种法是对还是错?”我说:“经文说:冬至四十五日,阳气微上,阴气微下,夏至四十五日,阴气微上,阳气微下。这是论述一年阴阳的升降。即以此一日阴阳的升降而言,午前阳升阴降,午后阴升阳降,不分男女。考之《内》、《难》,男女脏腑经络穴俞血气昼夜周流,无不相同。现在说午前午后,男女补泻颠倒错乱如此,违背经旨太严重了。所以说:诊不知阴阳逆从的道理,这是治疗的一大失误。又说:刺实证须使其虚,针下寒;刺虚证须使其实,针下热。说寒说热,以针下感觉为候,何尝以提按来分男女呢!”
(There are twelve acupoints in total on both sides.)
1. Zhangmen (LR13, Gate of the Rib): Two points, the Front-Mu point of the Spleen, also known as Changping or Xie. Located lateral to Daren (SP15), directly at the end of the costal margin. When lying on the side, flex the upper leg, extend the lower leg, and raise the arm to locate it. It is an intersection of the Foot-Jueyin Liver Meridian and the Foot-Shaoyang Gallbladder Meridian. Indications: Borborygmus with a gurgling sound, indigestion, hypochondriac pain preventing supination, irritability, fever, dry mouth, loss of appetite, chest and hypochondriac fullness and distension, panting, heart pain, inability to turn the waist, food stagnation, jaundice with emaciation, running piglet syndrome (Benten), abdominal swelling, spinal stiffness, flaccidity of the four limbs, fearfulness, shortness of breath, syncope, and inability to raise the shoulder and arm. Moxibustion: 100 moxa cones; Acupuncture: Insert 6 fen; Contraindications follow standard methods.
2. Jingmen (GB25, Door of the Kidney): Two points, the Front-Mu point of the Kidney, also known as Qi or Qifu. Located below the iliac crest in the lumbar region, at the root of the costal margin adjacent to the spine. Indications: Low back pain preventing bending forward and backward, alternating chills and fever, abdominal distension radiating to the back causing dyspnea, dysfunction of water passages, yellow urine, acute swelling of the lower abdomen, borborygmus with watery diarrhea, pain radiating from the hip joint. Moxibustion: 3 moxa cones; Acupuncture: Insert 3 fen; Retain needle for 7 breaths.
3. Daimai (GB26, Belt Vessel): Two points, located 1.8 cun below the costal margin. Indications in women: Hard and painful lower abdomen, irregular menstruation, leukorrhea that is red and white, tenesmus, and muscle spasms. Moxibustion: 5 moxa cones; Acupuncture: Insert 6 fen.
4. Wushu (GB27, Five Pivots): Two points, located 3 cun below Daimai; another source says 1.5 cun lateral to Shuidao (ST28). Indications in men: Cold hernia, retraction of the scrotum into the lower abdomen causing pain. Acupuncture: Insert 1 cun; Moxibustion: 5 moxa cones.
5. Weidao (GB28, Pathway of Maintenance): Two points, located 5.3 cun below Zhangmen (LR13). It is an intersection of the Foot-Shaoyang Gallbladder Meridian and the Dai Mai (Belt Vessel). Indications: Incessant vomiting and regurgitation, dysfunction of the Sanjiao (Triple Burner), edema, and loss of appetite. Acupuncture: Insert 8 fen; Moxibustion: 3 moxa cones.
6. Juliao (GB29, Abode of the Liao): Two points, located 8.3 cun below Zhangmen (LR13), in the depression above the iliac crest. It is an intersection of the Yang Qiao Mai (Yang Heel Vessel) and the Foot-Shaoyang Gallbladder Meridian. Indications: Low back pain radiating to the lower abdomen, shoulder pain radiating to the chest and arm causing spasm, inability to raise the arm to the shoulder level. Moxibustion: 3 moxa cones; Acupuncture: Insert 8 fen.
After I completed compiling the *Jin Zhen Mi Chuan* (Secret Transmission of the Golden Needle), someone advanced and asked: "The various medical texts state that certain acupoints treat certain diseases, and certain diseases must be treated by selecting specific acupoints. Is this theory absolutely unchangeable?" I replied: "This merely indicates general principles. In reality, there are no fixed acupoints for treating diseases. Generally, when pathogenic factors invade the human body, they circulate up and down with the healthy Qi, sometimes residing in the Qi level and sometimes in the Blood level, without a fixed abode. Therefore, using needles can be likened to using troops in war: as the enemy moves, we respond; sometimes we use unconventional tactics, sometimes we hold the orthodox position, without a rigid system. If a physician does not investigate the cause of the disease or observe its transmission, but only adheres to the saying that 'this acupoint treats this disease,' being stubborn and lacking flexibility, applying treatment according to a chart, it is like trying to find peace by blocking the downstream flow during a flood—it is merely accidental. Diseases change infinitely, and so do needle techniques. If the disease is in the upper part, one may select points from the lower part; if in the lower part, from the upper part; either direct or indirect selection should be made. One must examine the meridians and collaterals, distinguish between Qi and Blood, understand that the disease resides along the meridian, and select points accordingly. Only then can one grasp the principle of adapting to changes. This is why I selected and recorded the *Ling Shu*, *Su Wen*, and *Nan Jing* at the beginning of this volume, hoping people will read them carefully and think deeply, so as to understand the principle of adapting to changes and acquire flexible methods."
Another person asked: "I have heard your teaching on flexible methods, but learners face the vast ocean of knowledge and do not know where to start. What should they do?" I said: "It is like a craftsman teaching someone to use compasses and squares to draw circles and squares. The method of using the tools lies with the teacher, but the resulting shapes lie with the student. For the sages regarding acupuncture, without meridians and acupoints, they cannot teach future generations; and without meridians and acupoints, future generations cannot receive instruction from teachers. If one does not understand flexibility and merely clings to acupoints, this is what is called 'searching for a steed according to a picture.' How can one exhaust the art? Thus it is said: A crude doctor guards the form (acupoints), while a superior doctor guards the spirit (Qi mechanism); a crude doctor guards the joints, while a superior doctor guards the mechanism. The movement of the mechanism never leaves the empty space (acupoint); this is what is meant."
Someone said: "Nowadays, some people specifically select Extra Points (Qi Xue) to treat diseases, and many are effective. Is this ultimately correct?" I said: "The human body has twelve Regular Meridians, eight Extraordinary Vessels, fifteen Major Collaterals, and over three hundred Minor Collaterals, all used to circulate Qi and Blood. The Sages selected 366 acupoints, corresponding to the 366 days of the year. Later generations thought this was insufficient and added Extra Points, which is like adding a leap month. Among these Extra Points, six belong to the Collateral Meridians and two to the Regular Meridians. By neglecting the rest of the collaterals and meridians and seeking quick shortcuts, one violates the sacred classics. There are also sixty-six points used based on the opening and closing of days and hours, which is still not comprehensive enough, let alone restricting oneself to just eight points. Generally, for these eight points, if the disease is in the Qi level, there may be merit in劫夺 (intercepting/draining) the pathogen. However, if the disease is in the Blood level, it will only damage the Healthy Qi, and how can the disease be cured? This is draining Qi when the disease is in the Blood. If the pathogen is in the Blood level, one should directly seek the location of the disease and select points there. People today cling to this and do not use other methods, is this not laughable?"
Another asked: "Why should acupuncture and moxibustion avoid Heavenly Taboo Days?" I said: "The Classics state: The left foot corresponds to Li Chun (Start of Spring), on the days of Wu Zi and Ji Chou. The left hypochondrium corresponds to Chun Fen (Spring Equinox), on the day of Ji Mao. The left hand corresponds to Li Xia (Start of Summer), on the days of Wu Chen and Ji Si. The chest, throat, head, and neck correspond to Xia Zhi (Summer Solstice), on the day of Bing Wu. The right hand corresponds to Li Qiu (Start of Autumn), on the days of Wu Shen and Ji Wei. The right hypochondrium corresponds to Qiu Fen (Autumn Equinox), on the day of Xin You. The right foot corresponds to Li Dong (Start of Winter), on the days of Wu Xu and Ji Hai. The lower back, sacrum, and lower orifices correspond to Dong Zhi (Winter Solstice), on the day of Ren Zi. The Six Fu Organs and the Three Zang Organs below the diaphragm correspond to the Central Earth of the four seasons, on the days of Wu and Ji. The Great Taboo Day is the day when Tai Yi resides (as mentioned previously). For these nine categories, one who is skilled observes the locations of the Eight Rectitudes (Solstices and Equinoxes). If there is an abscess or swelling in the corresponding left/right, upper/lower parts of the body that needs treatment, one should not perform puncture or drainage on those specific days. This is called the Heavenly Taboo Day."
Another asked: "In later times, there arose the theory of Zi Wu Liu Zhu (Midnight-Noon Ebb-Flow), starting with He Ruoyu of the Southern Tang. He stated that the Sanjiao is the father of Yang Qi, and the Pericardium is the mother of Yin Qi. These two meridians are respected and not governed by the Five Elements; they primarily accept and nourish the Qi and Blood of the ten other meridians. Therefore, only the Yin and Yang pulses of the ten meridians are discussed, with each day injecting into the Jing-Well, Ying-Spring, Shu-Stream, Jing-River, and He-Sea points, five per time period, completing in the morning. Whenever there is a match with a Yang Stem, the Qi injects into the Sanjiao; whenever there is a match with a Yin Stem, it injects into the Pericardium. These two meridians also each inject into their five Well-Spring-Stream-River-Sea points: Yang Stems inject into the Fu organs, and Yin Stems inject into the Zang organs. For example, on the Jia day at Jia Xu hour, the Gallbladder Qi first emerges as the Well point; on the Yi day at Yi You hour, the Liver emerges as the Well point, etc. This theory is very long. It generally means that turning left from Zi hour allows the Qi to travel externally through the Yang meridians, and turning right from Wu hour allows it to travel internally through the Yin meridians. Does this theory have any basis in the Classics?" I said: "These are all speculative theories. They are not recorded in the *Nei Jing* or *Nan Jing*. Not only do they violate the essence of the Classics, but their statements also contain many self-contradictions. They claim that on Yang days and Yang hours, Yang Meridian points open. Thus, on the Jia Zi day at Jia Xu hour, the Jia Gallbladder's Well point, Qiaoyin, opens. This is true. However, the Bing Zi hour belongs to the Yi Chou day, which is a Yin day and a Yang hour. Yet they claim that the Bing Small Intestine's Ying-Spring point, Qian Gu, opens. Does this conform to the theory of Yang days and Yang hours? Taking this one instance, the rest can be inferred. Their self-contradiction goes without saying. The Classics state that Ying and Wei Qi meet fifty times at the Hand-Taiyin Lung Meridian. This constant rule has never changed since ancient times. Here, they say that on Yang days, Qi precedes Blood, and on Yin days, Blood precedes Qi. This greatly disrupts the essence of the Classics. How can this serve as a model for the world and future generations!"
Another asked: "Acupuncture practitioners often claim to have secret methods that they do not lightly reveal to others. Is this true?" I said: "The transmitted fourteen methods and sixteen methods, such as Qing Long Bai Wei (Green Dragon Wagging Tail), etc., can be considered exhaustive. To claim there is something more mysterious beyond these, I do not believe it. Moreover, these methods, when verified against the Classics, contradict them; when questioned against reason, they defy logic. What they consider miraculous, I consider bizarre; what they consider secret, I consider absurd. Although this compilation lists various methods at the beginning, because they are already common in the secular world, it is indeed necessary to know them. Furthermore, methods circulated outside often have false names and real contents. Therefore, I have examined these theories and returned them to the most appropriate explanations, avoiding the spread of errors, and allowing comparison with the methods in the *Nei Jing* and *Nan Jing* to verify differences and similarities, so that they can be practically tested under the needle. If one truly studies the essence of the Classics and deeply understands ancient methods, then even if one completely discards the so-called secrets of recent times, it would be unusable anyway."
Another asked: "The acupuncture books of various schools record specific depths of insertion (e.g., several fen), retention time (e.g., several breaths), and moxibustion dosage (e.g., several cones) for certain acupoints. Do these come from the Classics?" I said: "Most of these originate from later periods and have no verification in the Classics. The Classics state: Diseases have superficial and deep levels, and needling has shallow and deep applications. If the depth is incorrect, it becomes a major harm. Too deep causes internal injury; too shallow causes external obstruction. Ancient treatment methods depended solely on the superficial or deep nature of the disease to determine the depth of needling, rather than being bound by fixed measurements for specific points. To say that a certain point should be retained for a specific number of breaths is even more contrary to reason. The Classics state: To reduce excess, retain the needle until the Yin Qi arrives (the sensation of cold under the needle), then remove it. Once the Jing Qi has arrived, guard it carefully and do not lose it. Also: If upon needling the Qi does not arrive, do not worry about the number of times; if the Qi arrives upon needling, remove the needle and do not needle again. Each needle has its suitability and different shapes, performing their respective functions. The key to needling is that effectiveness comes when Qi arrives. The confirmation of effect is like wind blowing away clouds, clearly revealing the blue sky. How can the number of retained breaths be the standard? The Classics also state: Remain quiet and retain the needle for a long time, taking the arrival of Qi as the goal. Do not remove the needle early just because the number of breaths is few. This shows that ancient practitioners used needling with the arrival of Qi as the deadline, not the number of breaths as the indicator. If one follows the theory of retaining breaths, and Qi arrives, fine; but if Qi does not arrive, one still removes the needle after the prescribed breaths, merely damaging skin and flesh, what benefit is there to the disease? Thus it is said: The harm of needling is that if the needle hits the target but is not removed, Essence leaks out; if it misses the target and is removed, Qi stagnates. Leaking Essence makes the disease worse and leads to weakness; causing Qi stagnation generates carbuncles and ulcers. To say that a certain point requires a specific number of moxa cones is also not the ultimate truth. One should only look at the thickness of the flesh at the acupoint and the severity of the disease to determine the amount and size of moxibustion, without sticking to established rules. The statement that 'insert X fen for needling, burn Y cones for moxibustion' implies that if a disease requires needling at a certain point, insert X fen; if it requires moxibustion at a certain point, burn Y cones. Needling without moxibustion, moxibustion without needling. Those who do not understand this theory may needle and then moxa, or moxa and then needle, causing significant harm."
Another asked: "The *Nei Jing* explicitly states that the Foot-Yangming Stomach Meridian is the Sea of the Five Zang and Six Fu Organs; its pulse is large, blood is abundant, Qi is strong, and heat is intense. To needle this meridian, one must not be shallow (or it won't disperse), must not retain (or it won't drain). Foot-Yangming: insert 6 fen, retain 10 breaths; Foot-Taiyang: insert 5 fen, retain 7 breaths; Foot-Shaoyang: insert 4 fen, retain 5 breaths; Foot-Taiyin: insert 3 fen, retain 4 breaths; Foot-Shaoyin: insert 2 fen, retain 3 breaths; Foot-Jueyin: insert 1 fen, retain 2 breaths. For the Hand Yin and Yang meridians, the pathway of receiving Qi is close, and Qi arrives quickly. The deepest insertion should not exceed 2 fen, and retention should not exceed 1 breath. Moxibustion is the same. Moxibustion exceeding this results in evil fire, leading to dry bones and stagnant pulses; needling exceeding this leads to depletion of Qi. These are all ancient methods. Given what you said, are the discussions in the Classics all wrong?" I said: "This is what the ancients specially discussed as the general principle. Any needling method has its own appropriateness and should not initially be rigidly bound by these numbers. The Classics state: Pathogenic Qi is in the upper part, turbid Qi is in the middle, clear Qi is in the lower part. Therefore, needling the sunken vessels expels pathogenic Qi, and needling the middle vessels expels turbid Qi. Needling too deeply causes pathogenic Qi to sink further and the disease to worsen. It also states: Consider age, size, and obesity/emaciation, and ponder with your mind. It also states: Those who can serve as standards for measurement are those who are not severely emaciated and whose Qi and Blood are not declining. As for those who are thin and whose flesh has wasted away, how can one use measurements for needling? Examine, palpate, press, and adjust according to cold/heat and excess/deficiency. This is called treating according to suitability, which is the true method."
Another asked: "In recent acupuncture methods, when needling points on the left side, twisting the needle to the right makes Qi move upward, and twisting to the left makes Qi move downward; needling the right side reverses this. To tonify, one exhales first then inhales; to sedate, one inhales first then exhales. Can this method be imitated?" I said: "Meridians and vessels circulate throughout the human body without distinction of left/right or upper/lower. Now, needling left and right differs thusly; does this mean the meridians on the left are fundamentally different from those on the right in terms of upper/lower flow? The Classics state: One who does not know the course of meridians and the circulation of Qi and Blood is not qualified to be a practitioner. This also counts as not knowing the course of meridians."
Another asked about recent tonification and sedation methods: For men, advancing the thumb forward and turning left during exhalation is tonification; retreating backward and turning right during inhalation is sedation; lifting the needle creates heat; inserting the needle creates cold. For women, retreating backward and turning right during inhalation is tonification; advancing forward and turning left during exhalation is sedation; inserting the needle creates heat; lifting the needle creates cold. This applies before noon, and reverses after noon. Is this method correct or incorrect?" I said: "The Classics state: Forty-five days after Winter Solstice, Yang Qi slightly ascends, Yin Qi slightly descends; forty-five days after Summer Solstice, Yin Qi slightly ascends, Yang Qi slightly descends. This discusses the annual rise and fall of Yin and Yang. Applying this to a single day, before noon Yang rises and Yin falls; after noon Yin rises and Yang falls. This applies regardless of gender. Examining the *Nei Jing* and *Nan Jing*, the daily circulation of Zang-Fu, meridians, acupoints, and Qi/Blood is identical for men and women. Now, claiming that before and after noon, tonification and sedation are reversed for men and women is a chaotic disorder that severely violates the essence of the Classics. Thus it is said: Not knowing the principles of Yin/Yang and reverse/direct flow is a major error in treatment. It also states: To sedate excess, the needle should feel cold; to tonify deficiency, the needle should feel hot. Whether cold or hot is determined by the sensation under the needle, not by lifting/pressing to distinguish between men and women!"