或针风，先向风府、百会中。或针水，水分侠脐上边取。或针结，针着大肠泄水穴。或
针劳，须向膏肓及百劳。或针虚，气海、丹田、委中奇。或针气，膻中一穴分明记。或针嗽
，肺俞、风门须用灸。或针痰，先针中脘、三里间。或针吐，中脘、气海、膻中补；番胃吐
食一般医，针中有妙少人知。
十二阴阳气血，凝滞全凭针 ，细推十干五行，谨按四时八节。出入要知先后，开合慎
毋妄别，左手按穴分明，右手持针亲切。刺荣无伤卫气，刺卫无伤荣血，循扪引导之因，呼
吸调和寒热。补即慢慢出针，泻即徐徐闭穴。发明难、素玄微，俯仰岐黄秘诀，若能劳心劳
力，必定愈明愈哲。譬如闭户造车，端正出门合辙，倘逢志士细推，不是知音莫说，了却个
中规模，便是医中俊杰。
先说平针法，含针口内温，按揉令气散，掐穴故教深，持针安穴上，令他嗽一声，随嗽
归天部，停针再至人，再停归地部，待气候针沉，气若不来至，指甲切其经，次提针向病，
补必随经刺，令他吹气频，随吹随左转，逐归天地人，待气停针久，三弹更熨温，出针
口吸气，急急闭其门。泻欲迎经取，吸则内其针，吸时须右转，根据次进天人，转针仍复吸
，根据法要停针，出针吹口气，摇动大其门。
问∶人之一身，犹之天地，天地之气，不能以恒顺，而必待于范围之功，人身之气，不
能以恒平，而必待于调摄之技。故其致病也，既有不同，而其治之，亦不容一律，故药与针
灸不可缺一者也。然针灸之技，昔之专门者固各有方书，若《素问》、《针灸图》、《千金
方》、《外台秘要》，与夫补泻灸刺诸法，以示来世矣。其果何者而为之原欤？亦岂无得失
去取于其间欤？诸生以是名家者，请详言之！
对曰∶天地之道，阴阳而已矣。夫人之身，亦阴阳而已矣。阴阳者，造化之枢纽，人类
之根抵也，惟阴阳得其理则气和，气和则形亦以之和矣。如其拂而戾焉，则赞助调摄之功，
自不容已矣。否则，在造化不能为天地立心，而化工以之而息；在夫人不能为生民立命，而
何以臻寿考无疆之休哉。此固圣人赞化育之一端也，而可以医家者流而小之耶？
愚尝观之易曰∶大哉干元，万物资始；至哉坤元，万物资生。是一元之气，流行于天地
之间，一合一辟，往来不穷，行而为阴阳，布而为五行，流而为四时，而万物由之以化生
，此则天地显仁藏用之常，固无庸以赞助为也。然阴阳之理也，不能以无愆，而雨
寒暑，不能以时若，则范围之功，不能无待于圣人也。故易曰∶后以裁成天地之道，辅相天
地之宜，以左右民，此其所以人无夭札，物无疵厉，而以之收立命之功矣。然而吾人同得天
地之理以为理，同得天地之气以为气，则其元气流行于一身之间，无异于一元之气流行于天
地间也。夫何喜怒哀乐心思嗜欲之 于中，寒暑风雨温凉燥湿之侵于外，于是有疾在腠理者
焉，有疾在血脉者焉，有疾在肠胃者焉。然而疾在肠胃，非药饵不能以济；在血脉，非针刺
不能以及；在腠理，非熨 不能以达，是针灸药者，医家之不可缺一者也。夫何诸家之
术惟以药，而于针灸则并而弃之，斯何以保其元气，以收圣人寿民之仁心哉？然是针与灸也
，亦未易言也。孟子曰∶离娄之明，不以规矩，不能成方圆；师旷之聪，不以六律，不能正
五音。若古之方书，固离娄之规矩，师旷之六律也。故不溯其源，则无以得古人立法之意，
不穷其流，则何以知后世变法之弊。今以古之方书言之，有《素问》、《难经》焉，有《灵
枢
焉。然《灵枢》之图，或议其太繁而杂；于《金兰循经》，或嫌其太简而略；于《千金方》，
或诋其不尽伤寒之数；于《外台秘要》，或议其为医之蔽；于《针灸杂集》，或论其未尽针
灸之妙，溯而言之，则惟素、难为最要。盖素、难者，医家之鼻祖，济生之
心法，垂之万世而无弊者也。夫既由素、难以溯其源，又由诸家以穷其流，探脉络，
索荣卫，诊表里，虚则补之，实则泻之，热则凉之，寒则温之，或通其气血，或维其真元，
以律天时，则春夏刺浅，秋冬刺深也。以袭水土则湿致高原，热处风凉也。以取诸人，肥则
刺深，瘠则刺浅也。又由是而施之以动摇进退，搓弹摄按之法，示之以喜怒忧惧，思劳醉
饱之忌，穷之以井荥俞经合之源，究之以主客标本之道，迎随开合之机。夫然后阴阳和，五
气顺，荣卫固，脉络绥，而凡腠理血脉，四体百骸，一气流行，而无壅滞痿痹之患矣。不犹
圣人之裁成辅相，而一元之气，周流于天地之间乎。先儒曰∶吾之心正，则天地之心亦正，
吾之气顺，则天地之气亦顺。此固赞化育之极功也，而愚于医之灸刺也亦云。
或者治疗风病，首先针刺风府穴和百会穴。或者治疗水病（水肿），在水分穴（脐上一寸）旁开取穴。或者治疗结聚之证，针刺大肠经的泄水穴（下巨虚）。或者治疗劳损，必须针刺膏肓穴和百劳穴。或者治疗虚证，气海穴、丹田穴和委中穴奇效显著。或者治疗气滞，膻中穴位置明确且疗效确切。或者治疗咳嗽，肺俞穴和风门穴必须配合艾灸。或者治疗痰饮，先针刺中脘穴和足三里穴。或者治疗呕吐，采用中脘、气海、膻中穴进行补法；反胃吐食的治疗方法与此相同，针法中的奥妙很少有人知晓。
十二经脉的阴阳气血凝滞，完全依靠针刺来调理；仔细推演十天干与五行的关系，谨慎地按照四季和八个节气来施治。进针出针要知先后次序，开合手法务必谨慎不要随意区别。左手按压穴位要分明，右手持针操作要亲切细致。刺营分不要损伤卫气，刺卫分不要损伤营血，运用循按引导的方法，通过呼吸来调和寒热。补法要慢慢出针，泻法要徐徐闭合穴孔。阐发《难经》、《素问》的玄妙道理，探究岐伯、黄帝的秘诀，如果能够用心用力钻研，必定会越来越明智通达。这就像关起门来造车，只要端正出门就能合乎车辙，倘若遇到有志之士细细推究，不是知音就不要多说，弄通了其中的规模法则，就是医学中的俊杰。
先说平补平泻的针法，将针含在口中温热，按揉穴位使经气散开，掐压穴位故意为之加深，手持针安放在穴位上，让患者咳一声，随着咳嗽将针退至天部（浅层），停留片刻再推进至人部（中层），再次停留退至地部（深层），等待得气的感觉像针下沉一样，如果气感没有到来，用指甲切按经络，然后次提针向病所方向，补法必须顺着经络方向刺入，让患者频繁吹气，随着吹气向左旋转，逐渐回归天地人三部，等待气感停止后久留针，弹击针身三次并熨烫温暖，出针时让患者吸气，迅速闭合针孔。泻法要逆着经络方向取穴，吸气时进针，吸气时向右旋转，依次进入天人三部，转针时仍然配合吸气，根据方法要停留针体，出针时让患者呼气，摇动针体扩大针孔。
问：人的身体，就像天地一样，天地的元气，不能永远顺遂，必须依靠人为的调节之功；人身的气机，不能永远平和，必须依靠调摄的技术。所以致病的原因，既然各不相同，那么治疗方法，也不容许千篇一律，所以药物与针灸是不可缺少的。然而针灸的技术，过去专门从事的人固然各有方书，如《素问》、《针灸图》、《千金方》、《外台秘要》，以及补泻灸刺等各种方法，用来展示给后世。究竟哪一个是源头呢？其中难道没有得失取舍吗？各位以针灸名家自居的学生，请详细谈谈！
回答说：天地的规律，不过是阴阳罢了。人的身体，也不过是阴阳罢了。阴阳，是造化的枢纽，人类的根本，只有阴阳得其理，气机才能调和，气机调和，形体也随之和谐。如果违背了它，那么赞助调摄的工作，自然不能停止。否则，造化不能为天地确立心志，而化工就会停止；人不能为百姓确立生命，又怎么能达到长寿无疆的美好境界呢？这确实是圣人赞颂化育的一个方面，怎么能因为医家就轻视它呢？
我曾经观察《易经》说：伟大啊乾元，万物以此开始；至极啊坤元，万物以此生长。这是一元之气，流行于天地之间，一合一开，往来无穷，运行成为阴阳，分布成为五行，流动成为四季，万物由此化生，这是天地显现仁德隐藏功用的常态，本来不需要借助赞助之力。然而阴阳的道理，不可能没有差错，风雨寒暑，不可能随时节适宜，那么调节之功，就不能不依赖圣人。所以《易经》说：君主裁成天地的规律，辅助天地的适宜，以辅佐百姓，这就是人们没有夭折疾病，万物没有瘟疫灾害，从而收成立命之功的原因。然而我们人类同样获得天地的理作为理，同样获得天地的气作为气，那么元气流行于一身之中，无异于一元之气流行于天地间。为什么喜怒哀乐心思嗜欲在心中干扰，寒暑风雨温凉燥湿在外侵袭，于是有疾在腠理的，有疾在血脉的，有疾在肠胃的。然而疾在肠胃，非药物不能救治；在血脉，非针刺不能到达；在腠理，非熨贴不能达及，所以针灸药三者，是医家不可缺少的。为什么各家医术只重视药物，而将针灸一并抛弃，这怎么能保全元气，收得圣人爱护百姓的仁心呢？然而针与灸，也不是轻易能说的。孟子说：离娄那样的视力，不用圆规曲尺，不能画出方圆；师旷那样的听力，不用六律，不能校正五音。古代的方书，固然是离娄的规矩，师旷的六律。所以不追溯源头，就无法得到古人立法的意图，不穷尽流变，怎么知道后世变法弊端。现在拿古代的方书来说，有《素问》、《难经》，有《灵枢》。然而《灵枢》的图，有人议论它太繁杂；对于《金兰循经》，有人嫌弃它太简单粗略；对于《千金方》，有人诋毁它没有详尽伤寒的数量；对于《外台秘要》，有人议论它是医家的弊病；对于《针灸杂集》，有人论述它没有穷尽针灸的奥妙，追溯而言，只有《素问》、《难经》最为重要。大概《素问》、《难经》是医家的鼻祖，济世救人的心法，流传万世而没有弊病。既然由《素问》、《难经》追溯其源，又由诸家著作穷尽其流，探求脉络，索求营卫，诊察表里，虚则补之，实则泻之，热则凉之，寒则温之，或者通调气血，或者维护真元，依据天时，春夏刺浅，秋冬刺深。依据水土，湿处致高原，热处取风凉。依据人体，肥胖者刺深，瘦弱者刺浅。又由此施用动摇进退、搓弹摄按的方法，示以喜怒忧惧、思劳醉饱的禁忌，穷究井荥俞经合的源头，究查主客标本的道理，迎随开合的机理。这样之后阴阳调和，五气顺遂，营卫坚固，脉络安宁，凡是腠理血脉，四肢百骸，一气流行，而没有壅滞痿痹的祸患了。这不就像圣人裁成辅助，而一元之气，周流于天地之间吗？先儒说：我的心正，那么天地的心也正；我的气顺，那么天地的气也顺。这确实是赞颂化育的极致功夫，我在针灸方面也是如此认为。
For treating Wind disease (Wind Syndrome), first needle Fengfu (GV16) and Baihui (GV20). For treating Water disease (Edema), take points beside Shuifen (CV9, one cun above the umbilicus). For treating Knots/accumulations, needle Xiashui (ST39, Lower He-Sea point of Large Intestine). For treating Consumption/Lao injury, must needle Gaohuang (BL43) and Bailao (EX-HN24). For treating Deficiency, Qihai (CV6), Dantian (CV12 or CV4 depending on context, here likely referring to lower abdomen points generally or specifically CV4/Renying area but text says Dantian which often refers to CV4 in some contexts or CV12; given "Qihai, Dantian, Weizhong", it implies tonifying points. Let's stick to literal: Qihai (CV6), Dantian (often synonymous with Mingmen GV4 or Zhongwan CV12 in different texts, but here listed separately from Zhongwan later, so likely refers to a specific Dantian point or general concept. In *Zhenjiu Dacheng*, Dantian often refers to CV4 or the general region. However, standard translation for Dantian is Elixir Field. Let's use Elixir Field.), and Weizhong (BL40) are remarkably effective. For treating Qi stagnation, Danzhong (CV17) is clearly recorded as effective. For treating Cough, Feishu (BL13) and Fengmen (BL12) must be used with moxibustion. For treating Phlegm, first needle Zhongwan (CV12) and Zusanli (ST36). For treating Vomiting, apply tonification method to Zhongwan (CV12), Qihai (CV6), and Danzhong (CV17); the treatment for Fanwei (Rebellious Stomach/Vomiting) is the same; the subtleties of needling are known by few.
The Yin and Yang of the twelve meridians and the flow of Qi and Blood, if stagnant, rely entirely on needling to regulate; carefully deduce the Ten Heavenly Stems and Five Elements, and strictly observe the Four Seasons and Eight Solar Terms. Know the sequence of entering and exiting needles, be cautious not to arbitrarily distinguish opening and closing techniques. Press the acupoint clearly with the left hand, hold the needle intimately with the right hand. When penetrating Ying (Nutrient) level, do not injure Wei (Defensive) Qi; when penetrating Wei level, do not injure Ying blood. Use following and rubbing guidance methods, harmonize cold and heat through respiration. For tonification, withdraw the needle slowly; for sedation, close the acupoint gradually. Elucidate the profound mysteries of *Nanjing* (Classic of Difficult Issues) and *Suwen* (Basic Questions), explore the secrets of Qibo and Huangdi. If one can exert mind and effort, one will surely become more wise and enlightened. It is like building a cart behind closed doors; if upright, it will fit the tracks upon exiting. If met by a determined scholar for careful deduction, do not speak unless they are a kindred spirit. Mastering this framework makes one a hero among physicians.
First, describe the Ping (Neutral/Balanced) needling method: warm the needle in the mouth, press and rub to disperse Qi, pinch the acupoint to deepen it, place the needle securely on the acupoint, ask the patient to cough once, then withdraw to Tian (Heaven/Superficial) layer during the cough, pause, then advance to Ren (Human/Middle) layer, pause again, then withdraw to Di (Earth/Deep) layer. Wait for the sensation of Deqi (arrival of Qi) feeling like the needle sinking. If Qi does not arrive, cut the meridian with fingernails, then lift the needle towards the pathogenic site. For tonification, needle along the direction of the meridian, ask the patient to blow air frequently, turn the needle left while blowing, gradually returning through Heaven, Human, and Earth layers. Wait for Qi to settle, leave the needle for a long time, tap the needle three times and apply warmth. Withdraw the needle while the patient inhales, quickly closing the pore. For sedation, take the point against the meridian direction, insert during inhalation, turn right during inhalation, sequentially enter Heaven, Human, and Earth layers. Turn the needle still coordinating with inhalation, pause according to method. Withdraw the needle while the patient exhales, shake the needle to enlarge the pore.
Question: The human body is like Heaven and Earth. The Qi of Heaven and Earth cannot always be smooth without the work of regulation; the Qi of the human body cannot always be balanced without the skill of adjustment. Therefore, since causes of disease differ, treatments cannot be uniform; thus, herbs and acupuncture/moxibustion are indispensable. However, regarding the technique of acupuncture/moxibusture, past specialists certainly had their own books, such as *Suwen*, *Zhenjiu Tu* (Acupuncture and Moxibustion Diagrams), *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold), *Waitai Miyao* (Secret Essentials of the Outer Cabinet), and various methods of tonification, sedation, moxibustion, and needling, shown to future generations. Which one is the source? Are there gains and losses to be selected among them? Students who claim expertise in this field, please speak in detail!
Answer: The way of Heaven and Earth is merely Yin and Yang. The human body is also merely Yin and Yang. Yin and Yang are the hub of creation and the root of humanity. Only when Yin and Yang follow their principles is Qi harmonious, and when Qi is harmonious, the form is also harmonious. If violated, the work of assistance and adjustment becomes unavoidable. Otherwise, Creation cannot establish its heart for Heaven and Earth, and the creative force would cease; humans could not establish life for the people, how could they achieve boundless longevity? This is indeed one aspect of the Sage's assistance in creation, how can it be belittled because it belongs to medical practitioners?
I have observed the *Yijing* (Book of Changes): Great is the Yuan Qi of Qian, by which all things begin; Supreme is the Yuan Qi of Kun, by which all things grow. This is One Yuan Qi circulating between Heaven and Earth, combining and opening, coming and going endlessly, operating as Yin and Yang, distributing as Five Elements, flowing as Four Seasons, and all things transform from it. This is the constant manifestation of benevolence and concealment of utility by Heaven and Earth, originally requiring no assistance. However, the principle of Yin and Yang cannot be without error, and wind, rain, cold, and heat cannot always be timely; thus, the work of regulation cannot but depend on Sages. Hence the *Yijing* says: The Sovereign shapes the ways of Heaven and Earth, assists the suitability of Heaven and Earth, to support the people. This is why people avoid premature death and disease, and objects avoid pestilence, thereby achieving the merit of establishing life. However, we humans equally receive the Principle of Heaven and Earth as our Principle, and the Qi of Heaven and Earth as our Qi. Thus, the circulation of Primordial Qi within the body is no different from the circulation of One Yuan Qi between Heaven and Earth. Why, then, with joy, anger, sorrow, happiness, thoughts, and desires disturbing within, and cold, heat, wind, rain, warmth, coolness, dryness, and dampness invading from without, do diseases arise in the Couli (skin and interstices), in the vessels and blood, and in the stomach and intestines? Diseases in the stomach and intestines require herbs to treat; those in vessels and blood require needling to reach; those in Couli require moxibustion/warming applications to penetrate. Thus, acupuncture, moxibustion, and herbs are indispensable to medical practitioners. Why do some schools only value herbs and discard acupuncture and moxibustion? How can they preserve Primordial Qi and realize the benevolent heart of Sages saving lives? Yet acupuncture and moxibustion are not easy to discuss. Mencius said: Li Lou's keen sight, without compasses and squares, cannot make circles and squares; Shi Kuang's keen hearing, without the six pitches, cannot correct the five tones. Ancient medical texts are indeed the compasses and squares of Li Lou, and the six pitches of Shi Kuang. Therefore, without tracing the source, one cannot understand the intent of ancient legislation; without exhausting the stream, one cannot know the flaws of later changes. Speaking of ancient texts, there are *Suwen* and *Nanjing*, and *Lingshu*. However, the diagrams in *Lingshu* are criticized for being too complex and mixed; *Jinlan Xunjing* is disliked for being too simple and brief; *Qianjin Fang* is condemned for not detailing all Shaoyang diseases; *Waitai Miyao* is discussed as having medical biases; *Zhenjiu Zajie* is argued to not fully reveal the wonders of acupuncture and moxibustion. Tracing back, *Suwen* and *Nanjing* are the most important. They are the ancestors of medicine and the core methods for saving lives, handed down for ten thousand years without flaw. Having traced the source from *Suwen* and *Nanjing*, and exhausted the stream through various schools, exploring meridians, seeking Ying and Wei, diagnosing interior and exterior, tonifying deficiency, sedating excess, cooling heat, warming cold, either unblocking Qi and Blood or maintaining True Yuan, aligning with heavenly timing (shallow needling in Spring/Summer, deep in Autumn/Winter), adapting to earth and water (high ground for dampness, windy cool places for heat), and considering the person (deep needling for fat, shallow for thin), and applying methods of shaking, advancing, retreating, rubbing, plucking, pressing, indicating taboos of joy, anger, sorrow, fear, thought, fatigue, drunkenness, and fullness, exhausting the sources of Jing-Ru-Shu-Jing-Ying points, investigating the paths of Main-Guest and Root-Branch, meeting-following, opening-closing mechanisms. Only then can Yin and Yang harmonize, Five Qi flow smoothly, Ying and Wei solidify, meridians calm, and all Couli, vessels, limbs, and bones circulate with one Qi without obstruction, atrophy, or bi-syndrome. Is this not like the Sage shaping and assisting, with One Yuan Qi circulating throughout Heaven and Earth? Former Confucians said: If my heart is upright, the heart of Heaven and Earth is also upright; if my Qi is smooth, the Qi of Heaven and Earth is also smooth. This is indeed the ultimate merit of assisting creation, and I say the same regarding acupuncture and moxibustion.