帝曰∶余闻缪刺,未得其意。岐伯曰∶邪客于皮毛,入于孙络,留而不去,闭塞不通,
不得
入于经,流溢于大络,而生奇病也。夫邪客大络者,左注右,右注左,上下左右,与经相干
,而布于四末,其气无常处,不入于经俞,命曰缪刺。帝曰∶愿闻缪刺,以左取右,以右取
左奈何?其与巨刺,何以别之?曰∶络病者,其痛与经脉缪处,故命曰缪刺。邪客于足少阴之
络,令人卒心痛暴胀,胸胁支满,无积者刺然骨之前出血,如食顷而已,左取右,右取左。
病新发者,取五日已。邪客于手少阳之络令人喉痹舌卷,口干心烦,臂外廉痛,手不及头,
刺手中指次指爪甲上去端如韭叶各一 ,壮者立已,老者有顷已,左取右,右取左,此新病
数日已。邪客于手足厥阴之络,令人卒疝暴痛,刺足大指爪甲上与肉交者各一 。男子立已
,女子有顷已,左取右,右取左。邪客于足太阳之络,令人头项肩痛,刺足小指爪甲上与肉
交者,各一 立已,不已刺外踝下三 ,左取右,右取左,如食顷已。邪客于阳明之络令人
气满,胸中喘息,而支 胸中热,刺手大指次指爪甲上去端如韭叶各一 ,左取右,右取左
,如食顷已。邪客于臂掌之间,不可得屈,刺其踝后,先以指按之,痛乃刺之,以月死生为
数,月生一日一 ,二日二 ,十五日十五 ,十六日十四 。邪客于足阳跷之脉,令人目
痛从内 始,刺外踝之下半寸所各二 ,左刺右,右刺左,如行十里顷而已。人有所堕坠,
恶血留内,腹中满胀,不得前后,先饮利药,此上伤厥阴之脉,下伤少阴之络。刺足内踝之
下然骨之前血脉。出血,刺足跗上动脉,不已,刺三毛上各一 ,见血立已,左刺右,右刺
左。邪客于手阳明之络,令人耳聋,时不闻音,刺手大指次指爪甲上去端如韭叶各一 立闻
,不已刺中指爪甲上与肉交者立闻,其不时闻者,不可刺也。耳中生风者,亦刺之如此数。
左刺右,右刺左。凡痹往来无常处者,在分肉间痛而刺之,以月死生为数。用针者随气盛衰
,以为 数,针过其日数则脱气,不及日数则气不泻,左刺右,右刺左,病已止,不已,复
刺之如法。月生一日一 ,二日一 ,渐多至十五日十五 ,十六日十四 ,渐少之。邪客
于足阳明之经,令人鼽衄上齿寒,刺足中趾次指爪甲上与肉交者,各一 ,左刺右,右刺左
。邪客于足少阳之络,令人胁痛不得息咳而汗出,刺足小趾次者爪甲上与肉交者各一 ,不
得息立已,汗出立止,咳者温衣饮食,一日已,左刺右,右刺左,病立已。不已,复刺如法
。邪客于足少阴之络,令人嗌痛,不可内食,无故善怒,气上走贲上,刺足下中央之脉各三
,凡六刺立已。左刺右,右刺左。邪客于足太阴之络,令人腰痛引小腹控 ,不可以仰息
,刺腰尻之两胂之上,是腰俞,以月死生为 数,发针立已。左刺右,右刺左。邪客于足太
阳之络,令人拘挛背急引胁而痛,刺之从项始,数脊椎侠脊疾按之应手如痛,傍刺之三 立
已。邪客于足少阳之络,令人留于枢中,痛髀不可以举,刺枢中以毫针,寒则久留针,以月
死生为数,立已。治诸经刺之所过者,不病则缪刺之,耳聋刺手阳明,不已,刺其通脉出耳
前者。齿龋刺手阳明,不已,刺其脉入齿中者立已。邪客于五脏之间,其病也,脉引而痛,
时来时止,视其病缪刺之,于手足爪甲上视其脉,出其血,间一日一刺,一刺不已,五刺已
。缪传引上齿,齿唇寒痛,视其手背脉血者出之,足阳明中趾爪甲上一 ,手大指次指爪甲
上一 ,立已,左取右,右取左。邪客于手足少阴太阴足阳明之络,此五络皆会于耳中,上
络左角,五络俱竭,令人身脉皆动,而形无知也,其状若尸,或曰尸厥。刺其足大趾内侧爪
甲
上去端如韭叶后,刺足心,后刺足中趾爪甲上各一 ,后刺手大指内侧去端如韭叶,后刺手
心主少阴锐骨之端各一 立已。不已,以竹管吹其两耳,易其左角之发方一寸,燔治,饮以
美酒一怀,不能饮者,灌之立已。有痛而经不痛者,缪刺之,视其皮部有血络者,尽取之。
此缪刺之数也。身形有病,九候莫病,由缪刺之。
黄帝说:我听说缪刺,但还没理解它的含义。岐伯说:邪气侵犯皮毛,进入孙络(最细小的络脉),停留不去,导致闭塞不通,不能进入经脉,而是流溢到大络(较大的络脉),从而产生奇特的病症。当邪气客居在大络时,左侧的邪气流注到右侧,右侧的邪气流注到左侧,上下左右交错,与经脉相互干扰,并散布于四肢末端,其气机没有固定的位置,不进入经穴,这种刺法称为缪刺。
黄帝说:我想了解缪刺,为什么以左取右、以右取左?它与巨刺有什么区别呢?
岐伯说:络脉生病时,其疼痛部位与经脉的循行部位错杂不同,所以称为缪刺。
如果邪气客居于足少阴肾经的络脉,会导致突然心痛、暴胀、胸胁支撑满闷。如果没有积聚实邪,应刺然骨穴前方的出血点,大约一顿饭的时间病就好了,采用左病右取、右病左取的方法。如果是新发的病,针刺五次即可痊愈。
如果邪气客居于手少阳三焦经的络脉,会导致喉痹、舌体卷缩、口干、心烦、手臂外侧疼痛、手举不过头,应刺手中指和次指(无名指)指甲角旁,距离指尖约韭菜叶宽的地方各一针,体质壮实的人立刻就好,年老体弱者过了一会儿就好,采用左病右取、右病左取的方法,新病数日可愈。
如果邪气客居于手足厥阴心包经和肝经的络脉,会导致突然疝气、剧烈疼痛,应刺足大趾指甲角与肉交界处各一针,男性立刻就好,女性过了一会儿就好,采用左病右取、右病左取的方法。
如果邪气客居于足太阳膀胱经的络脉,会导致头项肩痛,应刺足小趾指甲角与肉交界处各一针,立刻就好;如果不好,再刺外踝下方三寸处,采用左病右取、右病左取的方法,大约一顿饭的时间就好。
如果邪气客居于阳明经的络脉,会导致气满、胸中喘息、胸中支撑发热,应刺手大指和次指指甲角旁,距离指尖约韭菜叶宽的地方各一针,采用左病右取、右病左取的方法,大约一顿饭的时间就好。
如果邪气客居于臂掌之间,导致关节不可屈伸,应刺其踝后部,先用手指按压,感到疼痛处再下针,针刺的次数根据月亮的盈亏变化而定:月亮初生第一天刺一针,第二天刺两针,第十五天刺十五针;第十六天刺十四针,以此类推。
如果邪气客居于足阳跷脉,会导致眼睛疼痛从内眼角开始,应刺外踝下半寸处各二针,左病右取,右病左取,大约行走十里路的时间病就好了。
人如果有跌坠受伤,恶血留滞体内,导致腹部胀满,大小便不通,应先服用通利药物。这属于上伤厥阴之脉,下伤少阴之络。应刺足内踝下方然骨穴前方的血脉出血,再刺足背上的动脉,如果不好,再刺足大趾丛毛处(大敦穴)各一针,见血立刻就好,左病右取,右病左取。
如果邪气客居于手阳明大肠经的络脉,会导致耳聋,时常听不见声音,应刺手大指和次指指甲角旁,距离指尖约韭菜叶宽的地方各一针,立刻能听见;如果不好,再刺中指指甲角与肉交界处,也能立刻听见;如果不时常失聪,则不可针刺。耳中有风声者,也按此法针刺,左病右取,右病左取。
凡是痹症往来无常处,在分肉间疼痛的,就针刺该处,针刺次数根据月亮的盈亏变化而定。用针者要根据患者气血的盛衰来确定针刺次数,针刺超过规定的天数会耗脱正气,不足规定的天数则邪气不能排出,采用左病右取,右病左取,病好了就停止,如果没好,再按此法针刺。月亮初生第一天刺一针,第二天刺一针,逐渐增加直到第十五天刺十五针;第十六天刺十四针,逐渐减少。
如果邪气客居于足阳明胃经,会导致鼻塞流涕、鼻衄、上齿寒冷,应刺足中趾和次趾指甲角与肉交界处各一针,左病右取,右病左取。
如果邪气客居于足少阳胆经的络脉,会导致胁痛、呼吸不畅、咳嗽且出汗,应刺足小趾和次趾指甲角与肉交界处各一针,呼吸不畅立刻好转,出汗立刻停止,咳嗽者注意保暖穿衣、饮食调理,一天即可痊愈,左病右取,右病左取,病立刻就好。如果没好,再按此法针刺。
如果邪气客居于足少阴肾经的络脉,会导致咽喉疼痛,无法吞咽食物,无故容易发怒,气向上冲至贲门之上,应刺足底中央的脉(涌泉穴)各三针,共六针,立刻就好,左病右取,右病左取。
如果邪气客居于足太阴脾经的络脉,会导致腰痛牵引小腹,牵掣季胁,不能仰卧呼吸,应刺腰尻部两侧肌肉上方的腰俞穴,针刺次数根据月亮的盈亏变化而定,拔针后立刻就好,左病右取,右病左取。
如果邪气客居于足太阳膀胱经的络脉,会导致拘挛、背部僵硬、牵引胁肋疼痛,针刺应从颈部开始,沿脊椎旁数椎骨,快速按压如有痛点,旁边斜刺三针,立刻就好。
如果邪气客居于足少阳胆经的络脉,会导致邪气留滞于枢骨(髋关节)中,髀部疼痛不能抬举,应用毫针刺入枢中,寒证则久留针,针刺次数根据月亮的盈亏变化而定,立刻就好。
治疗各经穴位所经过之处,如果不发病则用缪刺法。耳聋刺手阳明大肠经,如果不好,刺其通向耳朵前方的脉络。牙齿龋痛刺手阳明大肠经,如果不好,刺其进入牙齿中的脉络,立刻就好。
邪气客居于五脏之间,其病症表现为脉道牵引疼痛,时来时止,观察病情进行缪刺,在手足指甲上观察血脉,放出血液,每隔一天刺一次,一次不好,刺五次即愈。
如果缪传导致上齿牵引疼痛,嘴唇寒冷疼痛,观察手背血脉有瘀血者放出血液,刺足阳明胃经中趾爪甲上一针,手大指和次指爪甲上一针,立刻就好,左病右取,右病左取。
邪气客居于手足少阴、太阴及足阳明经的络脉,这五条络脉都汇聚于耳中,上行联络左额角,如果五络全部衰竭,会导致全身脉搏跳动而形体无知觉,状如尸体,有的称为尸厥。应刺足大趾内侧指甲角旁,距离指尖约韭菜叶宽后的地方,再刺足心,再刺足中趾指甲上各一针,再刺手大指内侧距离指尖约韭菜叶宽处,再刺手心主(心包经)和少阴心经锐骨端(神门穴)各一针,立刻就好。如果没好,用竹管吹双耳,剪取左额角方一寸的头发,烧制成炭,用美酒一杯送服,不能饮酒者灌服,立刻就好。
有疼痛但经脉本身不痛的,用缪刺法,观察其皮部是否有血络,全部取之。这就是缪刺的法则。身体有病,但三部九候的脉象没有异常,由缪刺法来治疗。
The Yellow Emperor said: I have heard of Miao Ci (Mysterious Puncture), but I do not yet understand its meaning.
Qibo said: When pathogenic factors invade the skin and hair, they enter the Sun Luo (finest collateral vessels). If they remain there without being expelled, they cause blockage and obstruction, preventing entry into the main meridians. Instead, they overflow into the Da Luo (major collaterals), generating strange diseases. When pathogenic factors lodge in the major collaterals, those on the left flow to the right, and those on the right flow to the left. They move up and down, left and right, interfering with the meridians and distributing to the four extremities. Their qi has no fixed location and does not enter the Jing Shu (acupoints of the meridians). This method is called Miao Ci (Mysterious Puncture).
The Yellow Emperor said: I wish to learn about Miao Ci. Why is it that we treat the left by needling the right, and the right by needling the left? How does it differ from Ju Ci (Giant Puncture)?
Qibo replied: When disease resides in the collaterals, the pain occurs at locations distinct from the meridian pathways; hence it is called Miao Ci (Mysterious Puncture).
If pathogenic factors lodge in the Luo Mai (collateral) of Foot-Shaoyin (Kidney Meridian), it causes sudden heart pain, acute distension, and fullness/supporting sensation in the chest and hypochondrium. If there is no accumulation of pathological products, needle the blood vessels anterior to Ran Gu (KI1) until bleeding occurs. The condition will resolve after approximately the time it takes to eat a meal. Treat the left side by needling the right, and the right side by needling the left. For newly onset conditions, five treatments are sufficient for cure.
If pathogenic factors lodge in the Luo Mai (collateral) of Hand-Shaoyang (Sanjiao Meridian), it causes throat obstruction, tongue retraction, dry mouth, mental restlessness, pain along the lateral aspect of the arm, and inability to raise the hand to the head. Needle each of the two points located at the corner of the nail of the middle finger and the fourth finger (ring finger), approximately the width of a leek leaf away from the nail tip. In robust individuals, relief is immediate; in the elderly, relief comes after a short while. Treat the left side by needling the right, and the right side by needling the left. Newly onset conditions resolve within a few days.
If pathogenic factors lodge in the Luo Mai (collaterals) of Hand-Jueyin (Pericardium Meridian) and Foot-Jueyin (Liver Meridian), it causes sudden hernia and acute pain. Needle each of the two points located at the junction of the nail and flesh on the big toe. Relief is immediate in men; in women, it comes after a short while. Treat the left side by needling the right, and the right side by needling the left.
If pathogenic factors lodge in the Luo Mai (collateral) of Foot-Taiyang (Bladder Meridian), it causes pain in the head, neck, and shoulder. Needle each of the two points located at the junction of the nail and flesh on the little toe. Relief is immediate. If not relieved, needle three cun below the lateral malleolus. Treat the left side by needling the right, and the right side by needling the left. Relief comes after approximately the time it takes to eat a meal.
If pathogenic factors lodge in the Luo Mai (collateral) of Yangming (Stomach/Large Intestine Meridians), it causes abdominal fullness, wheezing in the chest, and a supporting hot sensation in the chest. Needle each of the two points located at the corner of the nail of the thumb and index finger, approximately the width of a leek leaf away from the nail tip. Treat the left side by needling the right, and the right side by needling the left. Relief comes after approximately the time it takes to eat a meal.
If pathogenic factors lodge between the arm and palm, causing inability to flex, needle the posterior aspect of the ankle. First press with the finger; when pain is elicited, then needle. The number of needles should correspond to the waxing and waning of the moon: on the first day of the waxing moon, one needle; on the second day, two needles; on the fifteenth day, fifteen needles. On the sixteenth day, fourteen needles, decreasing gradually thereafter.
If pathogenic factors lodge in the Foot-Yangqiao Mai (Yang Heel Vessel), it causes eye pain starting from the inner canthus. Needle each of the two points located half a cun below the lateral malleolus. Treat the left side by needling the right, and the right side by needling the left. Relief comes after the time it takes to walk ten li.
If a person suffers a fall or drop injury, causing evil blood to remain internally, leading to abdominal fullness and distension, and inability to pass stool or urine, first administer purgative medicines. This constitutes an upper injury to the Jueyin Meridian and a lower injury to the Shaoyin Collateral. Bleed the blood vessels anterior to Ran Gu (KI1) below the medial malleolus. Then needle the arterial pulse on the dorsum of the foot. If not relieved, needle each of the two points at the tuft of hair on the big toe (Dadun, LR1) until bleeding occurs. Relief is immediate. Treat the left side by needling the right, and the right side by needling the left.
If pathogenic factors lodge in the Luo Mai (collateral) of Hand-Yangming (Large Intestine Meridian), it causes deafness and intermittent hearing loss. Needle each of the two points located at the corner of the nail of the thumb and index finger, approximately the width of a leek leaf away from the nail tip. Hearing is restored immediately. If not relieved, needle the point at the junction of the nail and flesh on the middle finger; hearing is restored immediately. If hearing loss is not intermittent, this condition cannot be treated by needling. If wind is felt in the ear, needle according to the same protocol. Treat the left side by needling the right, and the right side by needling the left.
For all Bi syndromes where pain moves without a fixed location, if pain is felt between the muscle layers, needle that area. The number of needles should correspond to the waxing and waning of the moon. The practitioner must adjust the number of needles based on the abundance or deficiency of Qi. Needling beyond the prescribed number depletes Qi; needling fewer than the prescribed number fails to expel pathogenic factors. Treat the left side by needling the right, and the right side by needling the left. Stop when the disease resolves. If not resolved, repeat the treatment according to these rules. On the first day of the waxing moon, one needle; on the second day, one needle, increasing gradually to fifteen needles on the fifteenth day. On the sixteenth day, fourteen needles, decreasing gradually.
If pathogenic factors lodge in the Foot-Yangming (Stomach Meridian), it causes rhinitis, epistaxis, and coldness in the upper teeth. Needle each of the two points located at the junction of the nail and flesh on the second and third toes. Treat the left side by needling the right, and the right side by needling the left.
If pathogenic factors lodge in the Luo Mai (collateral) of Foot-Shaoyang (Gallbladder Meridian), it causes hypochondriac pain, dyspnea, cough, and sweating. Needle each of the two points located at the junction of the nail and flesh on the second and third toes. Dyspnea resolves immediately; sweating stops immediately. For cough, keep warm, dress appropriately, and regulate diet; resolution occurs within one day. Treat the left side by needling the right, and the right side by needling the left. The disease resolves immediately. If not resolved, repeat the treatment according to these rules.
If pathogenic factors lodge in the Luo Mai (collateral) of Foot-Shaoyin (Kidney Meridian), it causes sore throat, inability to swallow food, spontaneous irritability, and Qi rushing upward to Fen Shang (above the贲门/pylorus region). Needle each of the three points on the central vessel of the sole (Yongquan, KI1), totaling six needle insertions. Relief is immediate. Treat the left side by needling the right, and the right side by needling the left.
If pathogenic factors lodge in the Luo Mai (collateral) of Foot-Taiyin (Spleen Meridian), it causes lumbar pain radiating to the lower abdomen and flanks, with inability to breathe while lying supine. Needle the Yaoshu (BL23) points located above the two fleshy parts of the lumbosacral region. The number of needles should correspond to the waxing and waning of the moon. Relief is immediate upon needle withdrawal. Treat the left side by needling the right, and the right side by needling the left.
If pathogenic factors lodge in the Luo Mai (collateral) of Foot-Taiyang (Bladder Meridian), it causes spasms, back stiffness, and pain radiating to the ribs. Needling should start from the neck. Count the vertebrae alongside the spine. Press rapidly; if tenderness is elicited, perform oblique needling nearby. Three needle insertions provide immediate relief.
If pathogenic factors lodge in the Luo Mai (collateral) of Foot-Shaoyang (Gallbladder Meridian), it causes stagnation at the Shu (hip joint pivot), with hip pain and inability to lift the leg. Use a filiform needle to needle the Shu point. In cases of cold, retain the needle for a long time. The number of needles should correspond to the waxing and waning of the moon. Relief is immediate.
To treat various meridians, needle the areas traversed by the meridians. If there is no disease in the meridian itself, use Miao Ci (Mysterious Puncture). For deafness, needle Hand-Yangming (Large Intestine Meridian); if not relieved, needle the channel emerging anterior to the ear. For dental caries/pain, needle Hand-Yangming (Large Intestine Meridian); if not relieved, needle the channel entering the teeth. Relief is immediate.
If pathogenic factors lodge between the Zang organs, the symptoms include pulling pain in the pulses, coming and going intermittently. Observe the condition and apply Miao Ci (Mysterious Puncture). Examine the vessels on the fingernails and toenails, and release blood. Needle once every other day. If one session is insufficient, five sessions are required.
If Mu Chuan (misdirection/transmission) causes pulling pain in the upper teeth and cold pain in the lips, examine the vessels on the dorsum of the hand for blood stasis and release it. Needle one point on the big toe of Foot-Yangming (Stomach Meridian) at the nail, and one point on the thumb and index finger of Hand-Yangming (Large Intestine Meridian) at the nail. Relief is immediate. Treat the left side by needling the right, and the right side by needling the left.
If pathogenic factors lodge in the Luo Mai (collaterals) of Hand-Shaoyin (Heart Meridian), Foot-Shaoyin (Kidney Meridian), Hand-Taiyin (Lung Meridian), Foot-Taiyin (Spleen Meridian), and Foot-Yangming (Stomach Meridian), these five collaterals all converge in the ear and ascend to connect with the left corner of the head. If all five collaterals are exhausted, it causes movement of all body pulses while the form remains insensible, resembling a corpse. This is sometimes called Shi Jue (Corpse Stupor). Needle the point on the medial side of the big toe, approximately the width of a leek leaf behind the nail tip. Then needle the center of the foot (Yongquan, KI1). Then needle one point on the nail of the middle toe. Then needle the medial side of the thumb, approximately the width of a leek leaf from the tip. Then needle one point each at the sharp bone end of Hand-Jueyin (Pericardium Meridian) and Hand-Shaoyin (Heart Meridian). Relief is immediate. If not relieved, blow air into both ears using a bamboo tube. Cut a square inch of hair from the left corner of the head, burn it to ash, and drink it mixed with a cup of fine wine. If the patient cannot drink, force-feed them. Relief is immediate.
If there is pain but no pain in the main meridian, use Miao Ci (Mysterious Puncture). Examine the skin regions for blood vessels; if present, extract all of them. This is the principle of Miao Ci (Mysterious Puncture).
When the body has disease but the Nine Pulses (Jiu Hou) show no abnormality, treat it with Miao Ci (Mysterious Puncture).