金针赋云。病势既退。针气微松。病未退者。针气始根。推之不动。转之不移。此为邪
气吸
可出针豆许。摇而停之。补者吸之去疾。其穴急扪。泻者呼之去徐。其穴不闭。欲令腠密。
然后吸气。故曰下针贵迟。太急伤血。出针贵缓。太急伤气。刘宗浓曰。出针不可猛出。必
须作三四次。徐徐转而出之。则无血。若猛出必见血也。
神应经曰。人身左边右手以大指进前捻针为补。大指退后捻针为泻。右边以右手大指退
后捻针为补。进前捻针为泻。
捻针左右。已非素问意矣。而人身左右不同。谬之甚也。
金针赋云。男子之气。早在上而晚在下。取之必明其理。女子之气。早在下而晚在上。
用之必识其时。午前为早属阳。午后为晚属阴。男女上下。平腰分之。
按针灸当随经络气至十二时候。如寅肺卯大肠经之类。男女所同。男女气血上下之分。
固非素、难意。亦不必然也。
一妇人患热入血室。医者不识。用补血药。数日成结胸证。许学士曰。小柴胡汤已迟。
不可行也。可刺期门。予不能针。请善针者针之。如言而愈。
针灸药。皆医家分内事。后世分门专科之医出。而各有所长矣。
本草云。艾。味苦。气微温。阴中之阳。无毒。主灸百病。三月三日。五月五日。采曝
干。
干燥。入臼捣之。以细筛去尘屑。每入石臼捣取。洁白为上。须令焙太燥。则灸有力。火易
燃。如润无功。
证类本草云。出明州。图经云。旧不着所出州土。但云生田野。今在处有之。以复道者
为佳
。七年之病。求三年之艾。丹溪云。艾性至热。入火灸则上行。入药服则下行。
《金针赋》说:病势已经衰退,针下的气机变得微松;病势未退的,针下的气机仍然根深蒂固(指有抵抗感),推之不动,转之不移。这时邪气吸附于针体,可以出针少许,摇动针柄并停留片刻。补法要在患者吸气时快速出针,出针后迅速按压穴位;泻法要在患者呼气时缓慢出针,出针后不闭合穴位,以使腠理致密。因此说,下针贵在缓慢,太急会伤血;出针贵在缓和,太急会伤气。刘宗浓说:出针不可猛力拔出,必须分三四次,徐徐旋转而出,这样就不会出血。如果猛力拔出,必然见血。
《神应经》说:人身左边,用右手大指向前捻针为补,向后捻针为泻;右边则相反,用右手大指向后捻针为补,向前捻针为泻。
(高武按语):捻针分左右手法,这已经不是《素问》的本意了。而且人体左右不同,这种说法谬误得很。
《金针赋》说:男子的阳气,早晨在上部而晚上在下部,取穴时必须明白其中的道理。女子的阳气,早晨在下部而晚上在上部,使用针灸时必须识别时机。午前为早,属阳;午后为晚,属阴。男女气血上下之分,以腰部为界平分。
(高武按语):按照针灸理论,应当随着经络之气到达的时间对应十二时辰,比如寅时肺经、卯时大肠经等,这是男女相同的。至于男女气血上下之分,本来就不是《素问》和《难经》的本意,也不一定必然如此。
有一个妇人患热入血室证,医生不认识此病,用了补血药,几天后形成了结胸证。许学士说:“用小柴胡汤已经晚了,不能使用了。可以针刺期门穴。”我(许学士自称或叙述者)不会针刺,请擅长针刺的人来刺。按照这个方法治疗后痊愈了。
针灸和药物,都是医家分内之事。后世出现分科专科的医生,于是各有所长了。
《本草》说:艾,味苦,气微温,属于阴中之阳,无毒。主治灸治各种疾病。三月三日、五月五日采集并晒干。干燥后放入臼中捣碎,用细筛去掉尘屑。每次放入石臼中捣取,以洁白者为上品。必须让它焙得过于干燥,这样艾灸才有力,火容易燃烧。如果湿润则没有功效。
《证类本草》说:艾出产于明州。《图经》说:旧籍没有记载其出产的州土,只说生长在田野中,现在到处都有,以经过复道(陈放日久)者为佳。“七年的病,求三年的艾”。丹溪说:艾性至热,入火灸则上行,入药服用则下行。
The *Jin Zhen Fu* (Golden Needle Ode) states: When the pathogenic force has receded, the qi under the needle becomes slightly loose; when the disease has not yet receded, the qi under the needle remains deeply rooted (indicating resistance), immovable upon pushing and unshifted upon rotating. At this time, the pathogenic qi adheres to the needle. The needle may be withdrawn slightly, shaking the handle and pausing. For tonification, withdraw the needle quickly while the patient inhales, and immediately press the acupoint upon withdrawal. For sedation, withdraw the needle slowly while the patient exhales, leaving the acupoint open without closing it, to ensure the integrity of the interstices (Cou Li). Therefore, it is said that inserting the needle should be slow; too rapid insertion injures the blood. Withdrawing the needle should be gentle; too rapid withdrawal injures the qi. Liu Zongnong stated: The needle must not be pulled out forcefully. It must be withdrawn gradually over three or four times by rotating slowly; thus, no bleeding will occur. If pulled out forcefully, bleeding will inevitably appear.
The *Shen Ying Jing* (Divine Response Classic) states: On the left side of the body, using the right hand's thumb to rotate the needle forward constitutes tonification, and rotating backward constitutes sedation. On the right side, it is reversed: rotating backward with the right thumb is tonification, and rotating forward is sedation.
(Gao Wu's commentary): Distinguishing rotation methods for left and right hands deviates from the intent of the *Su Wen* (Basic Questions). Furthermore, claiming differences based on the left and right sides of the body is highly erroneous.
The *Jin Zhen Fu* states: In men, qi is higher in the upper part in the morning and lower in the evening; one must understand the principle when selecting points. In women, qi is lower in the morning and higher in the evening; one must recognize the timing when applying treatment. Forenoon is early and belongs to Yang; afternoon is late and belongs to Yin. The division of qi and blood between upper and lower parts for men and women is divided equally at the waist level.
(Gao Wu's commentary): According to acupuncture theory, one should follow the arrival of meridian qi corresponding to the twelve double-hour periods, such as the Lung Meridian at Yin hour and the Large Intestine Meridian at Mao hour; this applies to both men and women. The concept of the division of qi and blood between upper and lower parts for men and women is not the intent of the *Su Wen* or *Nan Jing*, nor is it necessarily true.
A woman suffered from Heat Entering the Blood Chamber (Re Ru Xue Shi). The physician did not recognize this condition and administered blood-nourishing herbs. After several days, a Chest Binding syndrome (Jie Xiong Zheng) developed. Scholar Xu stated: "Using Xiao Chai Hu Tang (Minor Bupleurum Decoction) is now too late and cannot be applied. One may puncture Qi Men (Liv 14)." I [Xu] could not perform acupuncture, so I requested a skilled practitioner to do so. Following this advice, she recovered.
Acupuncture, moxibustion, and herbal medicine are all within the duties of a physician. In later generations, physicians specializing in specific branches emerged, each possessing their own strengths.
The *Ben Cao* (Materia Medica) states: Ai Ye (Artemisiae Argyi Folium) tastes bitter and has a slightly warm nature; it is Yang within Yin and non-toxic. It primarily treats various diseases via moxibustion. It should be collected on the third day of the third lunar month and the fifth day of the fifth lunar month, then dried. Once dry, it is pounded in a mortar and sifted through a fine sieve to remove dust and debris. Each time it is pounded in a stone mortar; the whitest material is considered superior. It must be baked until very dry so that moxibustion is potent and the fire ignites easily. If moist, it is ineffective.
The *Zheng Lei Ben Cao* states: Ai Ye originates from Ming Zhou. The *Tu Jing* (Illustrated Canon) notes that older texts did not specify its origin, only stating it grows in fields. Now it is found everywhere, but that which has been stored for a long time (via 'Fu Dao') is best. "For a seven-year illness, seek three-year-old Ai Ye." Danxi stated: Ai Ye is extremely hot in nature. When used in moxibustion, it ascends; when taken as an oral decoction, it descends.