黄帝问于岐伯曰。余闻九针于夫子众多矣。不可胜数。余推而论之。以为一纪。余司诵之。子听
其理。非则语余。请正其道。令可久传后世无患。得其人乃传。非其人勿言。岐伯稽首再拜曰。请听
圣王之道。黄帝曰。用针之理。必知形气之所在。左右上下。阴阳表里。血气多少。行之逆顺。出入
之合。谋伐有过。知解结。知补虚泻实。上下气
门。明通于四海。审其所在。寒热淋露。以输异处。审于调气。明于经隧。左右支络。尽知其会。寒
与热争。能合而调之。虚与实邻。知决而通之。左右不调。犯而行之。明于逆顺。乃知可治。阴阳不
奇。故知起时。审于本末。察其寒热。得邪所在。万刺不殆。知官九针。刺道毕矣。
此章论用针之理。必明知阴阳血气之流行出入。逆顺浅深。五脏六腑之经输配合。虚实疾徐而
针论毕矣。形气之所在。左右上下。阴阳表里。血气多少。此形中之阴阳血气也。行之逆顺者。皮肤
经脉之血气。交相逆顺而行也。出入之合者。经脉外内之气血。有本标之出入。有离而有合也。谋伐
有过者。谓有过之脉。宜伐而去之。知解结者。谓契绍之门户。有所结而不通者宜解之。此言血气之
流行于经脉外内之间。或留积于脉内。或阻滞于气街之门也。知补虚泻实。上下气门者。知六腑气街
之门户。虚实之坚软者。则知补泻之所在也。明通于四海者。知膻中冲脉。胃腑脑髓之出入也。寒热。
阴阳血气也。淋露。中焦所生之津液也。审其所在。以输异处者。当知膻中之宗气。输于经脉之外内。
以应呼吸漏下者也。冲脉之血气。半输于十二经脉之中。半散于皮肤之外者也。胃腑所生之津液。淖
泽注于骨。而补益脑髓者也。审于调气。明于经隧者。知胃腑所出之血气。注于经隧。经隧者。五脏六
腑之大络也。左右肢络尽知其会者。左注右而右注左。左右上下。与经相干。布于四肢。出于络脉。与
脉外之气血。相会于皮肤分肉间也。寒与热争者。阴阳之气不和也。故当合而调之。虚与实邻者。血
与气之不和也。故知决而通之。左右不调者。人迎气口之不调。故当犯而行之。阴阳不奇者。脏腑阴
阳。交相配合。十二经脉。交相贯通也。故知起时者。如乘秋则肺先受邪。乘春则肝先受邪之类
也。如春甲乙伤于风者为肝风。以夏丙丁伤于风者为心风之类也。以冬遇此者为骨痹。以春遇此者
为筋痹之类也。如正月太阳寅。故为腰 肿痛。阳明者午也。阳盛而一阴加之。故洒洒振寒之类也。
如手太阳之筋病。名曰仲春痹。足少阳之筋病。名曰孟秋痹也。盖知脏腑之阴阳。故知病起之时也。
本末。病之本标也。寒热。阴阳之邪也。用针之理。知阴阳血气之流行出入。则知邪之所在矣。按此
篇乃全经之总纲。帝平时详析咨访于伯。已得其宗旨。故复宣扬以发明之。故曰余闻九针于夫子众多
矣。不可胜数。余推而论之。以为一纪。纪、纲也。
明于五输徐疾所在。屈伸出入。皆有条理。言阴与阳。合于五行。五脏六腑。亦有所藏。四时八
风。尽有阴阳。各得其位。合于明堂。各处色部。五脏六腑。察其所痛。左右上下。知其寒温。何经
所在。审皮肤之寒温滑涩。知其所苦。膈有上下。知其气所在。先得其道。稀而疏之。稍深以留。故
能徐入之。大热在上。推而下之。从下上者。引而去之。视前病者。常先取之。大寒在外。留而补之。
入于中者。从合泻之。针所不为。灸之所宜。上气不足。推而扬之。下气不足。积而从之。阴阳皆虚。
火自当之。厥而寒甚。骨廉陷下。寒过于膝。下陵三里。阴络所过。得之留止。寒入于中。推而行之。
经陷下者。火则当之。结络坚紧。火所治之。不知所苦。两跷之下。男阴女阳。良工所禁。针论毕矣。
五输者。五脏五输。五五二十五输。六腑六输。六六三十六输。本经云。因其气之实虚疾徐而取
之。故明知五输之实虚。则知疾徐之所在矣。其脏腑之十二经脉。屈伸出入。皆有循度之条理也。言
阴与阳。合于五行者。言五脏六腑。合于天之阴阳。地之五行也。五脏六腑。亦有所藏者。五脏藏五
神志。六腑传导水谷。胆为中精
之府。膀胱为津液之所藏也。四时八风。尽有阴阳。各得其位。合于明堂者。五色篇之所谓黄赤为
风。青黑为痛。白为寒。五色各见其部。察其浮沉。以知浅深。视色上下。以知病处也。五脏六腑。
察其所痛。在身形之左右上下。则知寒温之邪。在于脏腑之何经也。审皮肤之寒温滑涩。知其所苦者。
邪气脏腑篇之所谓脉滑者。尺之皮肤亦滑。脉涩者。尺之皮肤亦涩。心脉滑甚为善渴。涩甚为喑是也。
膈有上下。知其气所在者。膈上为宗气之海。上焦开发宣五谷味。熏肤充身泽毛者也。膈下乃胃腑
中焦之分。三焦出气以温肌肉。充皮肤者也。故知其气之所在。先得其所出之道路。稀而疏之。以导
气之出也。稍深以留。以致谷气。知谷气已至。故能徐而入之。复使气之入也。身半以上为阳。身半以
下为阴。大热在上。故当推而下之。使下和于阴也。从下上者。热厥也。热厥之为热也。起于足而上。
故当引行于上而去之。夫大热在上。由中焦之所生。热厥于下。因酒入于胃。气聚于脾中不得散。故视
身以前痛者。常先取之。此气因于中。当先取之中焦也。太阳之上。寒气主之。太阳之气。主于肤表。
大寒在外。寒水之气在表也。故当留而补之。候阳气至而针下热。补其阳以胜其寒也。如寒邪上入于
中者。从合以泻之。夫合治内腑。使寒邪从肠胃以泻出之也。夫寒气之甚于外而入于中者。因阳气之在
下也。故针所不能为者。灸之所宜也。上气不足者。推而扬之。下气不足者。积而从之。谓气本于
下之所生也。阴阳皆虚。火自当之。盖艾能于水中取火。能启阳气于阴中也。厥而寒甚。起于廉骨下
之陷中。而上逆于膝。此寒厥也。寒厥起于足五趾之里。集于膝下。而聚于膝上。盖气因于中。阳气衰。
不能渗营其经络。阳气日损。阴气独在。故为之寒。是以取阳明之下陵三里以补之。此寒厥之在气
也。若寒气从络之所过。
得之则留而止之。如寒入于中。则当推而行之。此治寒厥之法也。经气陷下。以火灸之。结络坚紧者。
中有着血。血寒。故火所治之。调经论曰。病不知所痛。两跷为上。盖阳跷阴跷。并起于足踝。上循
胸里。故痛在跷脉之上者。不知痛处也。是以不知所苦痛者。当取两跷于踝下也。男子数其阳。女子
数其阴。故男取阴而女取阳。此良工之所禁也。能知脏腑阴阳。寒热虚实。表里上下。补泻疾徐。针
论毕矣。
用针之服。必有法则。上视天光。下司八正。以辟奇邪。而观百姓。审于虚实。无犯其邪。是得
天之露。遇岁之虚。救而不胜。反受其殃。故曰必知天忌。
闵士先曰。服、事也。言用针之事。当合于天时也。夫针者。所以候气也。故当上视天光。因天
之序。盛虚之时。移光定位。正立而待。盖俟天之阳。以助人之气也。下司八正。所以候八风之虚邪。
以时至者也。虚实者。人气之有盛衰也。得天之露者。清邪中上。阳中雾露之气也。遇岁之虚者。逢年
之虚。值月之空。失时之和。救而不能胜邪。则反受其殃。故曰必知天忌。
乃言针意。法于往古。验于来今。观于窈冥。通于无穷。粗之所不见。良工之所贵。莫知其形。
若神仿佛。
闵氏曰。法于往古者。先知针经也。验于来今者。先知日之寒温。月之虚盛。以候气之浮沉。而
调之于身。观其立有验也。观于窈冥者。言形气营卫之不形于外。而工独知之。通于无穷者。可以传于
后世也。是故工之所以异也。然而不形见于外。故俱不能见也。视之无形。尝之无味。故莫知其形。
若神仿佛。
邪气之中人也。洒淅动形。正邪之中人也微。先见于色。不知于其身。若有若无。若亡若存。有
形无形。莫知其情。
是故上工之取气。乃救其萌芽。下工守其已成。因败其形。
闵士先曰。此言虚邪伤形。而正邪中气也。虚邪者。虚乡不正之邪风。如春时之风从西方来。
夏时之风从北方来。盖人秉地之五行而成此形。是以五方不正之气。而伤人之形也。正邪者。风寒
暑湿燥火。天之正气也。天有此六气。而人亦有此六气。是以正邪中气者。同气相感也。中于气故
先见于色。不知于其身。若有若无。莫知其情。是故上工之取气。乃救其萌芽。必先见三部九候之
气。尽调不败而救之。下工守其已成。救其已败。救其已败者。不知三部九候之相失。因病而败之也。
是故工之用针也。知气之所在。而守其门户。明于调气。补泻所在。徐疾之意。所取之处。泻
必用圆。切而转之。其气乃行。疾而徐出。邪气乃出。伸而迎之。摇大其穴。气出乃疾。补必用方。
外引其皮。令当其门。左引其枢。右推其肤。微旋而徐推之。必端以正。安以静。坚心无懈。欲微以
留。气下而疾出之。推其皮。盖其外门。真气乃存。用针之要。无忘其神。
闵氏曰。知气之所在者。知病气之所在。而守其门户。门者。邪循正气之所出入也。明于调气者。
知气之实虚。而为之补泻。以疾徐之意而取之也。泻必用圆者。圆活而转之。其气乃行也。疾内而徐
出者。疾而徐则虚也。邪气乃出。则实者虚矣。摇大其穴。以出其针。则邪气乃疾出矣。补必用方者。
外引其皮。令当其穴门。左手引其枢转。右手推其肤。微旋转其针而徐推之。其针必端以正。安静以
候气至。坚心而无懈惰。微留其针。候气下而疾出之。推其皮以盖其外门。则真气乃存于内矣。用针
之要。贵在得神。盖存己之神。以俟彼之神也。
朱卫公曰。按、素问八正神明论曰。泻必用方。补必用圆。盖方与圆。非针也。乃用针之意耳。且
方圆者。天地之象也。天气下降。气流于地。地气上升。气腾于天。天地之气。上下相交。是以方
圆之意。皆可圆活用之。
雷公问于黄帝曰。针论曰。得其人乃传。非其人勿言。何以知其可传。黄帝曰。各得其人。任
之其能。故能明其事。雷公曰。愿闻官能奈何。黄帝曰。明目者可以见色。聪耳者可以听音。捷疾
辞语者。可使传论语。徐而安静。手巧而心审谛者。可使行针艾。理血气而调诸逆顺。察阴阳而兼
诸方。缓节柔筋。而心和调者。可使导引行气。疾毒言语轻人者。可使吐痈咒病。爪苦手毒。为事善
伤人者。可使按积抑痹。各得其人。方乃可行。其名乃彰。不得其人。其功不成。其师无名。故曰得
其人乃言。非其人勿传。此之谓也。手毒者。可使试按龟。置龟于器下而按其上。五十日而死矣。手
甘者复生如故也。
闵士先曰。官之为言司也。言各因其所能。而分任之。以司其事。故曰官能。如目之明者。可使
之察色。耳之聪者。可使之听音。可使行针艾者。任之其艾针之能。可使导引行气者。任之其导引
之能。口毒者。可使唾痈咒病。手毒者。可使按积抑痹。各得其能。方乃可行。其名乃彰。不得其
人。其功不成。盖圣人欲得其人。量材而官。授任而治。己不与于其间。而总司其成也。试按龟者。言
手毒之人。不可使之行针。即灵寿之物。亦遭其毒手。而况病患乎。惟手巧而甘美者。能活人也。
朱卫公曰。五十。乃大衍之数。谓不能尽百岁之天年。按、阴阳别论篇。论五脏气绝。亦合五十之
数。此皆出于理数之自然也。夫麟凤龟龙。谓之四灵。圣人制九针之法。所以救民之灾异。岂试以毒
手。而伤其灵瑞乎。盖以深戒夫非其人勿传。非其人勿任耳。
黄帝向岐伯问道:我从您那里听闻关于九针的论述非常多,数不胜数。我推究并总结这些内容,将其归纳为一个大纲(纪)。我将诵读出来,请您聆听其中的道理。如果有错误,请告诉我,以便我纠正其中的道理,使其能够长久地流传给后世,不留隐患。得到合适的人选才传授,如果不是合适的人选就不要谈论。
岐伯叩头拜了两拜说:请允许我聆听圣王的道理。
黄帝说:运用针刺的道理,必须了解形体与正气所在的位置,包括左右、上下、阴阳、表里,以及血气的多少、运行的逆顺、出入的汇合之处。谋划攻伐有过错的病邪,懂得解开结滞,懂得补虚泻实,通晓上下气街的门户,明了四海(膻中、冲脉、胃腑、脑髓)的出入,审慎地确定病邪所在。对于寒热、淋露(津液外泄等症),通过不同的腧穴来治疗。审慎地调理气机,明了经络隧道,通晓左右支络的交会之处。寒与热相争,能调和它们;虚与实相邻,能决断并疏通它们。如果左右不调和,违背规律而行针,就要明了逆顺关系,从而知道是否可以治疗。阴阳不偏颇,就能知道疾病发作的时间。审察疾病的本末,观察其寒热性质,得知邪气所在,那么万刺都不会有危险。精通九针的功能,针刺的道理就完备了。
这一章论述用针的道理,必须明辨阴阳血气的流行出入、逆顺浅深,以及五脏六腑经输的配合,虚实疾徐的针法,针刺的理论就完备了。“形气之所在,左右上下,阴阳表里,血气多少”,这是指形体中的阴阳血气。“行之逆顺”,是指皮肤经脉中的血气,相互交错逆顺运行。“出入之合”,是指经脉内外的气血,有根本与标部的出入,有分离又有汇合。“谋伐有过”,是说有过错的经脉,应当攻伐而去掉它。“知解结”,是说契绍(连接)的门户,如果有结滞不通的,应当解开它。这是说血气在经脉内外之间流行,有的留积在脉内,有的阻滞在气街之门。“知补虚泻实,上下气门”,是知晓六腑气街的门户,根据虚实导致的坚软情况,就知道补泻的位置。“明通于四海”,是知晓膻中、冲脉、胃腑、脑髓的气血出入。“寒热”指的是阴阳血气,“淋露”指的是中焦产生的津液。“审其所在,以输异处”,是应当知晓膻中的宗气,输送到经脉的外内,以应呼吸漏下;冲脉的血气,一半输送到十二经脉中,一半散布在皮肤之外;胃腑产生的津液,滋润注入骨骼,而补益脑髓。“审于调气,明于经隧”,是知晓胃腑输出的血气,注入经隧。经隧,就是五脏六腑的大络。“左右肢络尽知其会”,是指左注右而右注左,左右上下,与经脉相交,布散于四肢,出于络脉,与脉外的气血,在皮肤分肉间相会。“寒与热争”,是阴阳之气不和,所以应当调和它们。“虚与实邻”,是血与气不和,所以懂得决断并疏通它们。“左右不调”,是人迎、气口的不调和,所以应当干预而行针。“阴阳不奇”,是脏腑阴阳交相配合,十二经脉交相贯通。所以“知起时”,比如乘秋则肺先受邪,乘春则肝先受邪之类。如春甲乙日伤于风者为肝风,夏丙丁日伤于风者为心风之类。冬遇此者为骨痹,春遇此者为筋痹之类。如正月对应太阳寅时,所以出现腰肿痛;阳明对应午时,阳气盛而一阴加之,所以出现洒洒振寒之类。如手太阳筋病,名叫仲春痹;足少阳筋病,名叫孟秋痹。大概因为知晓脏腑的阴阳,所以知道疾病发起的时间。“本末”,是病的本标。“寒热”,是阴阳的邪气。用针的道理,知晓阴阳血气的流行出入,就知道邪气所在了。按此篇是全经的总纲,黄帝平时详细分析咨询于岐伯,已经得其宗旨,所以再次宣扬以发明它。所以说“我从夫子那里听闻九针众多矣,不可胜数。我推究并论述它,以为一纪”。纪,就是纲。
明了五输穴徐疾所在的位置,屈伸出入,都有条理。这是说阴与阳,合于五行,五脏六腑,也有所藏。四时八风,尽有阴阳,各得其位,合于明堂(面部色诊部位)。各处色部,五脏六腑,观察其所痛,左右上下,知晓其寒温,属于哪条经脉。审慎观察皮肤的寒温滑涩,知晓其所苦。膈有上下,知晓气所在。先得其道,稀疏疏之,稍深以留,所以能缓慢进针。大热在上,推而下之;从下上者,引而去之。视前病者,常先取之。大寒在外,留而补之;入于中者,从合泻之。针所不能为,灸之所宜。上气不足,推而扬之;下气不足,积而从之。阴阳皆虚,火自当之。厥而寒甚,骨廉陷下,寒过于膝,取之下陵三里。阴络所过,得之留止。寒入于中,推而行之。经陷下者,火则当之。结络坚紧,火所治之。不知所苦,两跷之下,男阴女阳,良工所禁。针刺理论至此完毕。
五输,是指五脏五输,五五二十五输;六腑六输,六六三十六输。《本经》说:因其气之实虚疾徐而取之。所以明知五输的实虚,就知道疾徐所在了。其脏腑的十二经脉,屈伸出入,都有循度的条理。说阴与阳合于五行,是说五脏六腑合于天之阴阳、地之五行。五脏六腑亦有所藏,是说五脏藏五神志,六腑传导水谷,胆为中精之府,膀胱为津液之所藏。四时八风尽有阴阳,各得其位,合于明堂,是《五色篇》所说的黄赤为风,青黑为痛,白为寒,五色各见其部,察其浮沉以知浅深,视色上下以知病处。五脏六腑,察其所痛,在身形之左右上下,则知寒温之邪在于脏腑之何经。审慎皮肤之寒温滑涩,知其所苦,是《邪气脏腑篇》所说的脉滑者,尺之皮肤亦滑;脉涩者,尺之皮肤亦涩;心脉滑甚为善渴,涩甚为喑。膈有上下,知其气所在,膈上为宗气之海,上焦开发宣五谷味,熏肤充身泽毛;膈下乃胃腑中焦之分,三焦出气以温肌肉,充皮肤。故知其气之所在,先得其所出之道路,稀而疏之,以导气之出;稍深以留,以致谷气。知谷气已至,故能徐而入之,复使气之入。身半以上为阳,身半以下为阴。大热在上,故当推而下之,使下和于阴也。从下上者,热厥也。热厥之为热,起于足而上,故当引行于上而去之。夫大热在上,由中焦之所生;热厥于下,因酒入于胃,气聚于脾中不得散,故视身以前痛者,常先取之,此气因于中,当先取之中焦。太阳之上,寒气主之。太阳之气,主于肤表。大寒在外,寒水之气在表也,故当留而补之,候阳气至而针下热,补其阳以胜其寒也。如寒邪上入于中者,从合以泻之。夫合治内腑,使寒邪从肠胃以泻出之也。夫寒气之甚于外而入于中者,因阳气之在下也,故针所不能为者,灸之所宜也。上气不足者,推而扬之;下气不足者,积而从之,谓气本于下之所生也。阴阳皆虚,火自当之,盖艾能于水中取火,能启阳气于阴中也。厥而寒甚,起于廉骨下之陷中,而上逆于膝,此寒厥也。寒厥起于足五趾之里,集于膝下,而聚于膝上。盖气因于中,阳气衰,不能渗营其经络,阳气日损,阴气独在,故为之寒。是以取阳明之下陵三里以补之,此寒厥之气也。若寒气从络之所过,得之则留而止之;如寒入于中,则当推而行之,此治寒厥之法也。经气陷下,以火灸之;结络坚紧者,中有着血,血寒,故火所治之。《调经论》曰:病不知所痛,两跷为上。盖阳跷阴跷,并起于足踝,上循胸里,故痛在跷脉之上者,不知痛处也。是以不知所苦痛者,当取两跷于踝下也。男子数其阳,女子数其阴,故男取阴而女取阳,此良工之所禁也。能知脏腑阴阳,寒热虚实,表里上下,补泻疾徐,针论毕矣。
使用针刺的法度,必须有法则。上视天光,下司八正,以辟奇邪,而观百姓,审于虚实,无犯其邪。这是得天之露,遇岁之虚,救而不胜,反受其殃。所以说必须知晓天的禁忌。
闵士先说:服,就是事。言用针之事,应当合乎天时。针,是用来候气的,所以应当上视天光,因天之序,盛虚之时,移光定位,正立而待,大概是等待天之阳,以助人之气。下司八正,是用来候八风的虚邪,按时令而至的。虚实,是人气有盛衰。得天之露,是清邪中上,阳中雾露之气。遇岁之虚,是逢年之虚,值月之空,失时之和,救而不能胜邪,则反受其殃。所以说必须知晓天的禁忌。
这就是针意。效法古代,验证于来今,观察于窈冥,通达于无穷。粗工所不见,良工所贵。不知道它的形状,好像神灵隐约可见。
闵氏说:法于往古,是先知晓《针经》。验于来今,是先知晓日的寒温,月的虚盛,以候气之浮沉,而调之于身,看其立竿见影的效果。观于窈冥,是说形气营卫不显于外,而医生独自知晓。通于无穷,是可以传给后世。所以医生的不同之处在于此,然而不显见于外,所以大家都看不见。视之无形,尝之无味,所以不知道它的形状,好像神灵隐约可见。
邪气伤人,洒淅动形。正邪伤人很轻微,先见于面色,身体不知道。若有若无,若亡若存,有形无形,不知道它的情状。
所以上工取气,是在萌芽阶段救治;下工守着已成之病,反而败坏其形体。
闵士先说:这是说虚邪伤形,而正邪中气。虚邪,是虚乡不正之邪风,如春时之风从西方来,夏时之风从北方来。人秉地之五行而成此形,所以五方不正之气伤人之形。正邪,是风寒暑湿燥火,天之正气。天有此六气,人亦有此六气,所以正邪中气,是同气相感。中于气所以先见于色,身体不知道,若有若无,不知道它的情状。所以上工取气,是在萌芽阶段救治,必先见三部九候之气,尽调不败而救之。下工守着已成之病,救其已败,救其已败是因为不知道三部九候的相失,因病而败坏它。
所以医生用针,知晓气所在,而守其门户,明了调气,补泻所在,徐疾之意,所取之处。泻必用圆,切而转之,其气乃行,疾而徐出,邪气乃出,伸而迎之,摇大其穴,气出乃疾。补必用方,外引其皮,令当其门,左引其枢,右推其肤,微旋而徐推之,必端以正,安以静,坚心无懈,欲微以留,气下而疾出之,推其皮,盖其外门,真气乃存。用针的要领,不要忘记神。
闵氏说:知气之所在,是知晓病气所在,而守其门户。门,是邪循正气出入的地方。明于调气,是知晓气之实虚,而为之补泻,以疾徐之意取之。泻必用圆,是圆活而转之,其气乃行。疾内而徐出,是疾而徐则虚,邪气乃出,则实者虚矣。摇大其穴,以出其针,则邪气乃疾出。补必用方,是外引其皮,令当其穴门,左手引其枢转,右手推其肤,微旋转其针而徐推之,其针必端以正,安静以候气至,坚心而无懈惰,微留其针,候气下而疾出之,推其皮以盖其外门,则真气乃存于内。用针的要领,贵在得神,保存自己的神,以等待病人的神。
朱卫公说:按《素问·八正神明论》说:泻必用方,补必用圆。方与圆,不是指针具,而是用针的意思。方圆是天地之象。天气下降,气流于地;地气上升,气腾于天。天地之气,上下相交,所以方圆之意,皆可圆活用之。
雷公问黄帝说:针论说:得其人乃传,非其人勿言。怎么知道可以传授?黄帝说:各得其人,任之其能,所以能明其事。雷公说:愿闻官能如何。黄帝说:明目者可以见色,聪耳者可以听音,捷疾辞语者,可使传论语,徐而安静,手巧而心审谛者,可使行针艾,理血气而调诸逆顺,察阴阳而兼诸方,缓节柔筋而心和调者,可使导引行气,疾毒言语轻人者,可使吐痈咒病,爪苦手毒,为事善伤人者,可使按积抑痹。各得其人,方乃可行,其名乃彰。不得其人,其功不成,其师无名。所以说得其人乃言,非其人勿传,就是这个意思。手毒的人,可以使他试按龟。把龟放在器下而按其上,五十天后龟死了。手甘的人,龟复活如故。
闵士先说:官,就是司。言各因其所能,而分任之,以司其事,所以叫官能。如目之明者,可使之察色;耳之聪者,可使之听音;可使行针艾者,任之其艾针之能;可使导引行气者,任之其导引之能;口毒者,可使唾痈咒病;手毒者,可使按积抑痹。各得其能,方乃可行,其名乃彰。不得其人,其功不成。圣人想要得人,量材而官,授任而治,自己不参与其中,而总司其成。试按龟,是说手毒之人,不可使之行针,即使是灵寿之物,也遭其毒手,何况病患呢?只有手巧而甘美者,能活人。
朱卫公说:五十,是大衍之数,谓不能尽百岁之天年。按《阴阳别论篇》,论五脏气绝,也合五十之数。这都是出于理数的自然。麟凤龟龙,叫做四灵。圣人制定九针之法,是为了救民之灾异,岂能试以毒手而伤其灵瑞?大概是深深告诫非其人勿传,非其人勿任罢了。
Huangdi asked Qibo: I have heard from you, Master, many discussions on the Nine Needles, too numerous to count. I have deduced and summarized them into a general principle (Ji). I will recite it; please listen to its rationale. If there are errors, please inform me so that I may correct the principles, allowing them to be passed down for generations without worry. Only transmit to those who are suitable; do not speak of it to those who are not.
Qibo bowed twice with his head touching the ground and said: Please allow me to listen to the Way of the Sage King.
Huangdi said: The principles of using needles require knowing the location of form and Qi, including left and right, upper and lower, Yin and Yang, exterior and interior, as well as the quantity of blood and Qi, their courses of retrograde and順顺 (smooth flow), and the convergence of their entry and exit. One must plan to attack pathological excesses, know how to untie knots, understand tonifying deficiency and draining excess, comprehend the gates of Qi in the upper and lower regions, clarify the entry and exit of the Four Seas (Zongchong, Chongmai, Stomach, Brain/Marrow), carefully determine the location of pathogens. For conditions of cold and heat, or dripping/leaking (excretion of fluids), treat them via different Shu points. Carefully regulate Qi, clarify the meridians and collaterals, and fully understand the intersections of the left and right branch collaterals. When cold and heat contend, harmonize them; when deficiency and excess are adjacent, resolve and unblock them. If left and right are unharmonized, acting against this rule requires understanding retrograde and smooth flow to know if treatment is possible. If Yin and Yang are not abnormal, one can know the time of onset. Examine the root and branch, observe cold and heat, identify the location of pathogens, and then ten thousand needle insertions will be without danger. Knowing the functions of the Nine Needles completes the theory of needling.
This chapter discusses the principles of needling, requiring clear knowledge of the circulation, entry, exit, retrograde/smooth flow, depth, and superficiality of Yin-Yang and Blood-Qi, the coordination of Shu points of the Zang-Fu organs, and the speed and manipulation for deficiency/excess. "The location of form and Qi, left/right, upper/lower, Yin/Yang, exterior/interior, quantity of blood/Qi" refers to the Yin-Yang and Blood-Qi within the form. "Retrograde and smooth flow" refers to the interlaced retrograde and smooth movement of Blood-Qi in skin and meridians. "Convergence of entry and exit" refers to the entry and exit of Blood-Qi inside and outside meridians, having roots and branches, separating and converging. "Planning to attack excess" means attacking and removing pathological meridians. "Untying knots" means resolving obstructions at connecting portals. This describes Blood-Qi circulating inside and outside meridians, sometimes accumulating internally or blocking at the Qi Street. "Knowing tonify deficiency/drain excess, upper/lower Qi gates" means knowing the portals of the Six Fu organs' Qi Streets; based on firmness/softness caused by deficiency/excess, one knows where to tonify or drain. "Clarifying the Four Seas" means knowing the entry/exit of Qi-Blood in the Chest Sea (Dan Zhong), Penetrating Vessel (Chong Mai), Stomach, and Brain/Marrow. "Cold and Heat" refer to Yin-Yang Blood-Qi; "Dripping/Leaking" refers to fluids generated in the Middle Jiao. "Examining locations, treating via different Shu points" means knowing how the Zong Qi of Dan Zhong transmits to the interior/exterior of meridians to correspond with respiration; how half of the Chong Mai's Blood-Qi transmits to the twelve meridians and half scatters to the skin; and how fluids from the Stomach nourish bones and benefit the brain. "Carefully regulating Qi, clarifying meridians" means knowing how Blood-Qi from the Stomach injects into the meridian tunnels (the great collaterals of Zang-Fu). "Understanding intersections of left/right branch collaterals" means left flows to right and right to left, interacting with meridians, distributing to limbs, emerging from collaterals, and meeting extra-meridional Blood-Qi between skin and muscle. "Cold contending with Heat" indicates disharmony of Yin-Yang Qi, requiring harmonization. "Deficiency adjacent to Excess" indicates disharmony of Blood and Qi, requiring resolution and unblocking. "Left/Right unharmonized" refers to disharmony between Renying and Qikou pulses, requiring intervention. "Yin/Yang not abnormal" means Zang-Fu Yin-Yang coordinate and twelve meridians connect mutually. Thus, "knowing onset times": e.g., Autumn affects Lung first; Spring affects Liver first. E.g., Wind injury on Jia/Yi days in Spring causes Liver Wind; Bing/Ding days in Summer causes Heart Wind. Winter encounters cause Bone Bi; Spring encounters cause Sinew Bi. E.g., First Month corresponds to Taiyang/Yin, causing waist swelling/pain; Yangming corresponds to Wu, Yang excess with Yin addition, causing shivering/chills. Hand Taiyang sinew disease is called Mid-Spring Bi; Foot Shaoyang sinew disease is called Early-Autumn Bi. Knowing Zang-Fu Yin-Yallow allows knowing disease onset. "Root/Branch" is the origin and manifestation of disease. "Cold/Heat" are Yin-Yang pathogens. Knowing Blood-Qi circulation identifies pathogen location. This chapter is the general outline of the Classic. Huangdi previously consulted Qibo thoroughly and grasped the essence, so he reiterates to elucidate. "Ji" means guideline.
Knowing the locations of the Five Shu points regarding slow/fast manipulation, flexion/extension, entry/exit, all follow order. This states Yin and Yang combine with Five Elements; Zang-Fu have specific stores. Four Seasons and Eight Winds possess Yin-Yang, each in proper position, corresponding to the Ming Tang (facial color diagnosis areas). Observing color zones of Zang-Fu, examining pain locations, left/right/upper/lower, determining cold/warmth and meridian involvement. Examining skin cold/warmth/slippery/astringent reveals suffering. Diaphragm has upper/lower, indicating Qi location. First grasp the pathway, disperse sparsely, penetrate slightly deeper to retain, allowing slow insertion. High heat above, push downward; rising from below, draw upward/remove. For prior diseases, often select points first. Exterior cold, retain and tonify; internal invasion, drain via He-Sea points. Where needles fail, moxibustion is suitable. Upper Qi deficiency, push and elevate; Lower Qi deficiency, accumulate and follow. Both Yin/Yang deficient, fire (moxa) applies. Cold reversal with severe cold, depression below bone margin, cold exceeding knee, select Xiaguan (Lower Ridge) and Zusanli. Path through Yin collaterals, stagnation occurs. Cold entering interior, push and move. Collapsed meridians, apply fire. Knotted/tight collaterals, treated by fire. Unknown suffering, take both Qiao vessels below ankles; male Yin, female Yang, forbidden by skilled practitioners. Needle theory concludes.
Five Shu: Five Zang have five Shu (25 total); Six Fu have six Shu (36 total). The Classic states: select based on Qi excess/deficiency and speed. Knowing Five Shu excess/deficiency determines speed. Twelve meridians have orderly flexion/extension/entry/exit. Yin/Yang combining with Five Elements means Zang-Fu match Heaven's Yin-Yang and Earth's Five Elements. Zang-Fu storage: Zang store five spirits; Fu conduct food/water. Gallbladder is palace of essence; Bladder stores fluids. Eight Winds have Yin-Yang, matching Ming Tang positions (Yellow/Red for wind, Green/Black for pain, White for cold; floating/sinking indicates depth; upper/lower indicates location). Examining pain locations determines meridian involvement. Skin examination correlates with pulse (slippery/astringent). Diaphragm upper is Sea of Zong Qi (Upper Jiao); lower is Middle Jiao/Stomach (San Jiao warms muscles/skin). Knowing pathways allows guiding Qi out (sparse) and retaining Grain Qi (deeper). Slow insertion follows Grain Qi arrival. Upper body is Yang, lower is Yin. High heat above pushes down to harmonize with Yin. Rising heat is Heat Reversal (starting feet, moving up), requiring drawing upward. Heat above originates from Middle Jiao; Heat reversal below from wine/stomach/spleen stagnation. Prior pain suggests selecting Middle Jiao points. Taiyang governs cold on surface. Exterior cold requires retention/tonification to generate warmth. Internal cold drains via He-Sea. External/internal cold due to low Yang requires moxibustion. Upper Qi deficiency elevates; Lower Qi deficiency accumulates (Qi originates below). Yin/Yang deficiency uses moxa (fire from water/Yin). Cold reversal starts below knee, rises to knee, originating from foot toes, gathering at knees. Yang deficiency fails to nourish meridians, Yin dominates causing cold. Select Zusanli (Yangming) to tonify. Cold in collaterals stagnates; internal cold moves. Collapsed Qi uses moxa; knotted collaterals with blood stasis/cold use moxa. Painless illness takes Qiao vessels (originating ankles, ascending chest). Male selects Yin, female selects Yang (forbidden by experts). Knowing Zang-Fu Yin-Yang, cold/hot, def/exc, exterior/interior, tonify/drain, speed completes needle theory.
Needling rules require observing heavenly light (sky), monitoring eight directions (seasons), avoiding strange evils, observing people, assessing excess/deficiency, avoiding harming healthy Qi. Ignoring heavenly taboos leads to failure and harm. Min Shixian notes: "Fu" means affairs. Needling must align with heaven. Needles await Qi. Observe sky light, follow seasonal order, stand upright waiting for Heavenly Yang to assist Human Qi. Monitor eight directions for evil winds. Excess/deficiency reflects human Qi fluctuation. "Heavenly dew" refers to clear evil affecting upper Yang (fog/mist). "Year void" refers to unfavorable year/month/season. Failure to overcome evil brings harm.
This is the intent of needling. Following ancient methods, verifying in present, observing the profound/invisible, accessing the infinite. Coarse practitioners miss what skilled ones value. Formless yet spirit-like. Min notes: Ancient methods rely on *Needle Classic*. Present verification relies on observing day/night temperature and moon phases to adjust Qi. Profound observation perceives invisible Ying-Wei Qi. Infinite transmission passes to future. Skilled doctors differ but remain unseen. Invisible, tasteless, spirit-like.
Pathogenic invasion causes shivering (empty evil damages form). Correct evil (normal climate) is subtle, appearing first in complexion, unnoticed by body. Seeming existing/non-existing, form/formless, unknown state. Superior practitioners treat Qi at the sprouting stage; inferior practitioners wait for established disease, damaging form. Min notes: Empty evil (misaligned wind) damages form; Correct evil (normal wind/cold/heat/damp/dry/fire) affects Qi via resonance. Affecting Qi shows in complexion first. Superior practitioners adjust Three Regions/Nine Hopes Qi early. Inferior practitioners fail to see disharmony, letting disease damage the body.
Skilled needling knows Qi location, guards portals, regulates Qi, selects tonify/drain, controls speed/location. Draining uses "Round": press and rotate, Qi flows, fast insertion/slow withdrawal, extend/oscillate, enlarge aperture, Qi exits quickly. Tonifying uses "Square": pull skin to aperture, left hand guides pivot, right hand pushes skin, slight rotation/slow insertion, upright/still/focused, slight retention, fast withdrawal upon Qi descent, push skin to close aperture, True Qi remains. Key is Spirit. Min notes: Portal is path of Qi/Evil. Round draining circulates Qi, empties excess. Square tonifying secures aperture, retains True Qi. Preserving one's Spirit awaits patient's Spirit. Zhuweigong notes: *Suwen* says draining is Square, tonifying is Round. Square/Round represent Heaven/Earth interaction. Apply flexibly.
Leigong asks: How to know who is suitable to teach? Huangdi: Match person to ability. Leigong asks about "Official Functions". Huangdi: Clear vision sees colors; acute hearing hears sounds; quick speakers convey teachings; calm/skilled/deliberate perform acupuncture/moxibustion, regulate Qi/Yin-Yang; flexible joints/harmonious mind guide Qi/movement; harsh speech/contemptuous tone expel abscesses/curses; sharp nails/toxic hands harm others, massage masses/blockages. Each suited to task succeeds; unsuited fails. Toxic hands tested on turtles (death in 50 days); sweet/gentle hands revive them. Min notes: "Guan" means manage. Assign tasks by ability. Toxic hands cannot needle; even spiritual creatures suffer. Only gentle hands heal. Zhuweigong notes: 50 is the Great Expansion number. Turtles/Dragons are Spiritual Beings. Needles save disasters, not test toxicity. Warning: Do not teach/assign to unfit persons.