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《nejing》1

已有 890 次阅读2015-3-10 21:50 |个人分类:中医

Chapter 1

Jiu Zhen Shi Er Yuan

Yellow Emperor ask Qi Bo: I love my country people, I feed my people, I take their tax. I am sad my people get sick and poor can not pay their tax. I want my people avoid the medicine poison, no longer use stone needle the old way to do acupuncture, I will use thin metal needle to sooth body meridian Qi and Blood, balance the Qi in and out, come and goes flow ways. And promote this kind of acupuncture to future’s generations to understand this knowledge never end. This acupuncture theory is easy to understand and difficult forget, I will make out the acupuncture system clearly separate them to different chapters to explain. From begin to end, from external to internal to make clear the different concepts to create the acupuncture scripture book. I like the hear your idea.

Qi Bo answer: you majestic, I will try my best, from 1 to 9, step by step talk about it, to make the acupuncture theory clearly in order. The small needle acupuncture, looks like easy, but it is more difficult to reach high level techniques. Normal doctor just look the patient’s surface condition, they don’t know the condition will change. The high level doctor can check out the patient’s Shen and Qi’s strong or weak conditions, with the sick Qi’s deficiency or excess, use tonify or sedate techniques to adjust the Shen. Because the Qi and blood move in the meridians must have certainly door ways, the sick Qi will attack body from those door ways, if the doctor without checking the detail sick condition, how can he/she find out the true reason of the illness? About the skills of needling, the important is the correct needling location and the fast or slow needling techniques, normal doctor just know to needling the points of limbs for treatment, but the high level doctor will inspect the meridian Qi’s movement and check out the deficiency or excess changing of the Qi’s condition. the meridian Qi must flow in the points’ space, the sick Qi will follow the meridian Qi flow, the points shows very tiny change of the deficiency or excess condition, doctor must check it very detail by heart, if the sick Qi excess, the doctor should not use tonify techniques to avoid stronger the sick Qi. If the sick Qi gone, but body Qi is weak, the doctor should not use sedate techniques to avoid more weak the body Qi. If the doctor understand the Qi flowing deficiency or excess changing condition, he/she will correct use tonify and sedate techniques to acupuncture without mistakes. If the doctor don’t understand the Qi flowing deficiency or excess changing condition, it will like lost the aim to shoot an arrow, will not reach the treatment’s affection. So the doctor must control the way of Qi’s come or go, strong or weak conditions, and then control the correct needling time, normal doctor don’t know this, only the high level doctor will check it out. About the counter or follow direction of Qi, if the Qi gone, the meridian space will empty and thin, if the Qi come, the meridian space will full and thick, to understand this, the doctor will bravely do the acupuncture will correct techniques. If the doctor can counter the meridian Qi flow direction needling to sedate, this will sedate out the sick Qi. If the doctor follow the meridian Qi flow direction needling to tonify, this will stronger the body meridian Qi. Hence, to correct use the counter or follow meridian Qi flow direction needling to sedate or tonify Qi, also with detail check out the Qi condition and needling time, control the sick Qi deficiency or excess condition, the sick Qi will easy to disperse. If the doctor know these techniques of needling theory, he/she will be good in acupuncture treatment. During needling, the doctor should based on the condition of sick Qi deficiency or excess to use the techniques of tonify or sedate. If the body Qi deficiency, doctor should use tonify way to needling, if the Sick Qi excess, doctor should use sedate way to needling, if the Qi and blood stagnation, doctor should remove the Qi and blood stagnation and active Qi and blood movement, if the sick Qi too strong, doctor should directly attack the sick Qi to clear it out. said: slow insert needle and fast pull out needle then close the needle hole is the tonify technique, fast insert needle and slow pull out needle without close the needle hole is the sedate technique. If needling the point easy de Qi is excess, if needling points not easy de Qi is deficiency. The Qi is unshaped thing, it seems like in the middle condition of shape and unshaped thing. Doctor should based on the condition of the acute or chronic illness with the Qi’s deficiency or excess to decide the tonify or sedate techniques’ order, based on the Qi move or stop, to decide the time of the needling detention. If doctor know these techniques, he/she will correct use deficiency to tonify and excess to sedate techniques in acupuncture treatment, and the patient will has the feeling of tonify body Qi and sedate out the sick Qi. The important of deficiency to tonify and excess to sedate is to use the nine kind of needles, the affection to tonify or sedate will based on the needling techniques. To sedate, doctor should fast insert the needle, after de Qi then slowly pull needle back way and swing the needle to make the hole bigger and let the surface of body yang Qi come out to sedate out the sick Qi. If the patient should use sedate way needling, but the doctor mistake to tonify needling, press the point and slow insert needle, this will make the Qi and blood gathered in the point, the sick Qi will not sedate out of body. During tonify needling, doctor should follow the meridian Qi flow direction to insert the needle, just relax and slightly insert the needle, and then move the needle to active the Qi, during press the point to insert the needle, it looks like a mosquito bite the skin, the patient can feel it even sometimes can not feel it, pull out the needle should fast agile like the arrow out of bowstring, right hand pull out needle, left hand press to close the needle hole, so the meridian Qi will stop inside the point without lose out of body, and then the body Qi will be enrich, and good to tonify the deficiency body Qi. If the blood stasis under the skin, doctor should not let this condition go on, doctor should clear the blood stasis at once. Hold the needle should use correct way, the important is hold tight the needle handle, when insert the needle, should aim correct the point, upright and straight needling, should not turn needle to left or right ways, doctor should concentrate the tip of the needle, focus on the patient, avoid the blood vessel beside the point to needling, so use this way will not dangerous condition happen. During needling, the doctor should pay attention the patient’s face, eyes and shen’s changing condition, check in detail the patient’s Shen and Qi’s strong or weak, doctor should not ignore those conditions, so the doctor will know the sick condition’s changing and transformation condition. If the blood vessels surround the point, look very clear, use hand touch it feel hard, so the doctor should avoid those blood vessel to needling. About the nine kind of needles, their shape are different, first named Chan Zhen which is long one cun six fen; second named Yuan Zhen which is long one cun six fen; third named Shi Zhen which is three and half cun; fourth named Feng Zhen which is long one cun six fen; fifth named Pi Zhen which is long four cun, width two and half fen; sixth named Li Zhen which is long one cun six fen; seventh named Hao Zhen which is long three cun six fen; eighth named Chang Zhen which is long seven cun; ninth named Da Zhen which is long four cun. Chan Zhen’s tip is big and sharp good to shallow needling and sedate surface yang Qi; Yuan Zhen’s tip is round and dull good to massage the muscle and not hurt the muscle tissue, also can sedate the sick Qi out of muscle; Shi Zhen like little rice round, good to massage the meridian, and sooth the Qi and blood, but not deep insert the skin, good to sedate sick Qi and tonify body Qi also; Feng Zhen has three sharp edges, good for treatment of obstinate illness; Pi Zhen’s tip like sword sharp, good for open the skin for carbuncle and let the pus come out. Yuan Zhen and Li Zhen’s shape like long spear, tip is round and sharp, the needle’s body is little thick, good for acute illness treatment. Hao Zhen’s tip is very thin like mosquito’s mouth, can slightly stab insert skin and muscle tissue, and do the movements of up and down needling, also can long time detention needling, good for enrich body meridian Qi and disperse the sick Qi, recover body’s Zhen Qi, after pull out the needles, the patient should take good rest body, very good for pain syndromes treatment. Chang Zhen’s tip very sharp, needle’s body is long and thin, good for chronic pain treatment. Da Zhen’s body is thick and tip is piercing, the needle’s shape like cane, the tip is sharp with little round, good to cut and sedate out the swell liquid of joints. The above is the nine kind of needles’ description. The sick Qi attack body meridian different locations, the wind heat sick Qi most attack above part of body; food irregular and cold heat unbalance sick Qi more stay in the middle part of body; cold Qi and dampness Qi will hurt body lower part. Hence, the needling place should be different, such as, if you needling the tendon and bone concave location points will sooth the meridian Qi and let the wind heat sick Qi out; if you needling the yang ming meridian He Sea points, this can adjust the stomach and intestine’s Qi, let the sick Qi come out; if the sick Qi in the shallow place, but needling too deep, will cause sick Qi go deep inside body, and more heavy the sick condition. So, skin, muscle, tendon and meridian’s location have different sick Qi, the depth of needling also are different. The nine kind of needles have different shapes, they have different use for different syndromes, so must based on the sick condition to use different needle to acupuncture, the sick condition have deficiency and excess situations, so the treatment should not sedate deficiency and tonify excess syndromes, if sedate deficiency and tonify the excess syndromes will cause more serious sick condition happen, such as Jing and Qi deficiency patient mistake sedate five internal organs Shu Stream points, will cause yin deficiency and die, if the patient’s yang Qi deficiency, but mistake sedate the three yang meridians Shu stream points, this will cause body Qi deficiency and disorder the mind cause mental problem. Hence, mistake sedate the yin meridians Qi, will run out the internal organs’ Qi and die; mistake sedate yang meridians Qi, will run out the yang Qi, will cause the patient maniac syndromes, these are the bad affection of mistake use tonify and sedate needling, must pay attention it. During needling, must wait the Qi gather into the point(de Qi), if the Qi not come, you should wait for the Qi come, if the Qi come, you can pull out the needle. The nine kind of needles(Jiu Zhen) have different shapes, different use, must based on different sick condition to use them, if the needling de Qi, will good affection of treatment, like wind disperse the dark cloud, the sky will become bright from dark, needling are the same theory.

Yellow emperor said: I want know the condition of five Zang and six Fu’s meridian Qi flowing locations. Qi Bo said: five Zang have different five meridians, each meridian has Jing well, Ying spring, Shu stream, Jing river and He sea five kind of shu points, totally twenty five shu points, six Fu have different six meridians, each meridian has Jing well, Ying spring, Shu stream, Yuan, Jing river and He sea six kind of shu points, totally thirty six shu points. Those shu points are the locations of the Zang Fu meridian Qi flowing. Human body total has twelve main meridians, each meridian has one Luo meridian, plus spleen big Luo meridian with Du and Ren Luo meridians, totally fifteen Luo meridians, twelve main meridians plus fifteen Luo meridian, the twenty seven meridians Qi circle body up and down flow on whole body, from Jing well begin come out like mountain spring water, flow through Ying spring become Shu stream and Jing river bigger and bigger to strongest He sea, the twenty seven meridians’ Qi like water gathered in the He sea points at elbow and knee joints locations, from those five shu points gathered into Zang Fu, day and night circling whole body without stop, human body main Qi points totally three hundred sixty five locations, those locations are the places of the Jing Luo meridians Shen Qi flow and gathered, not the tissues of skin, muscle, tendon and bone. Clear these theory, one or two sentence will speak out the correct meaning, otherwise it will not be understand. Inspect the patient’s face color dark or bright, also check the patient’s eyes’ light clear or turbid, then the doctor will know the patient’s body sick Qi be dispersed and meridian Qi be restored or no, from the patient’s body shape movement, voice changing, the doctor will diagnosis out the patient’s condition of excess or deficiency, and then right hand insert the needle, left hand protect the needle body, till “de Qi” the patient can feel the needle feeling, the doctor can pull out the needle. About the needling, the doctor must diagnosis the patient’s pulse first, to check the patient’s pulse Qi condition of deficiency or excess, and then decide the way of treatment. If the patient’s five Zang pulse Qi deficiency interior (yin Qi deficiency) “rapid and thin”, but the doctor mistake to sedate the exterior Qi(yang Qi), this will cause double exhaust Qi(yin and yang Qi both run out), the patient be surely died, and died in quiet. The correct treatment way is to tonify interior Zang Qi at chest and under shoulder points. If the five Zang pulse Qi deficiency exterior(yang Qi deficiency) “deep, weak and slow”, but the doctor mistake to sedate the interior Qi, this will cause the yang Qi contrary flow(to interior), yang Qi contrary flow, the patient be surely died, and died in maniac syndrome. The correct treatment way is to tonify the exterior yang Qi, use the limbs shu points. About the detention needle, the doctor must control the time to detention needle, if needling the correct points de Qi should pull out needle at once, too long time without pull out needles, will cause the patient lose too much body Jing and Qi, the patient’s body will become more deficiency and weak; If the doctor mistake needling the location not de Qi and pull out the needles, this will not only make patient lose Jing and Qi, but also gather the sick Qi in the location cause carbuncle. Five Zang in the interior with six Fu on the exterior, Zang and Fu connected by twelve yuan points, the twelve yuan points’ Qi come out at four gates points, so the four gates points and twelve yuan points can treat the five Zang illness. Based on twelve yuan points’ Qi, the five Zang’s Qi spread to three hundred sixty five points to nourish whole body. So if five Zang sick, it will show out at the twelve yuan points, and the twelve yuan points’ condition show the five Zang’s sick conditions. The doctor just check the twelve yuan points location, will know the five Zang’s illness condition. The five Zang above diaphragm is yang location, below the diaphragm is yin location, at the yang location’s shao yin Zang is lung(metal), lung’s yuan Qi come out at Lu9, totally two points. At the yang location’s tai yang Zang is heart(fire), heart’s yuan Qi come out at Pc7, totally two points. At the yin location’s shao yang Zang is liver(wood), liver’s yuan Qi come out at Lv3, totally 2 points. At the yin location’s zhi yin Zang is spleen(earth), spleen’s yuan Qi come out at Sp3, totally two points. At the yin location’s tai yin Zang is kidney(water), kidney’s yuan Qi come out at Kd3, totally two points. The left Ub43′s yuan Qi come out at Ren15, the right Ub43′s yuan Qi come out at Ren6. So the above points totally twelve yuan points can treat the five Zang and six Fu’s illness, if the patient has stomach swell Qi illness, the doctor can use three yang Zang yuan points to do the treatment, for digestion no good cause diarrhea patient, the doctor can use three yin Zang yuan points to do the treatment. The patient’s body five Zang sickness like be stabbed by a thorn, like be dirtied by filth, like a rope be knotted, like a river be choked by silt. No matter how long time the sickness, the thorn can be pull out, the filth can be cleaned, the knot can be opened, the choked of river can be soothed. Some doctor think some sickness too long time to be cured, this is wrong thinking, a good skill doctor can cure the sickness just like pull out the thorn, wash to clean the dirt, open the rope knot, sooth the river silt, no matter how long time of the sickness, they all can be cured. Too long time to be cured, actually is the doctor not get the correct treatment techniques. For wind cold or wind heat cause body heat, the sick Qi at the surface of the body, the doctor should shallow needling and fast needling, like use hand touch the boil water should pull out the needle at once. For yin cold stasis sickness patient, the doctor should deep needling and detention needle, wait till de Qi, like a person stay on the road, don’t want walk away. If the patient heat sick Qi is inside the yin level, the doctor should needling the St36, fast insert needle, slow pull out the needle without stop, de Qi the sick Qi will follow the needle be pulled out, if the heat sick Qi still no come out, the doctor can repeat needling the St36. If the sick Qi on the body of Zang, the doctor should needling the Sp9, if the sick Qi on the body of Fu, the doctor should needling the Gb34.

九鍼十二原第一

黃帝問於岐伯曰:余子萬民,養百姓而收其租稅;余哀其不給而屬有疾病。余欲勿使被毒藥,無用砭石,欲以微針通其經脈,調其血氣,榮其逆順出入之會。令可傳於後世,必明為之法,令終而不滅,久而不絕,易用難忘,為之經紀,異其章,別其表裏,為之終始。令各有形,先立針經。願聞其情。

岐伯答曰:臣請推而次之,令有綱紀,始於一,終於九焉。請言其道!小針之要,易陳而難入。粗守形,上守神。神乎神,客在門。未赭其疾,惡知其原?刺之微在速遲。粗守關,上守機,機之動,不離其空。空中之機,清靜而微。其來不可逢,其往不可追。知機之道者,不可掛以發。不知機道,扣之不發。知其往來,要與之期。粗之闇乎,妙哉,工獨有之。往者為逆,來者為順,明知逆順,正行無問。迎而奪之,惡得無虛?追而濟之,惡得無實?迎之隨之,以意和之,針道畢矣。

凡用針者,虛則實之,滿則泄之,宛陳則除之,邪勝則虛之。大要曰:徐而疾則實,疾而徐則虛。言實與虛,若有若無。察後與先。若存若亡。為虛與實,若得若失。

虛實之要,九針最妙,補瀉之時,以針為之。瀉曰,必持內之,放而出之,排陽得針,邪氣得泄。按而引針,是謂內溫,血不得散,氣不得出也。補曰,隨之隨之,意若妄之。若行若按,如蚊虻止,如留如還,去如弦絕,令左屬右,其氣故止,外門已閉,中氣乃實,必無留血,急取誅之。

持針之道,堅者為寶。正指直刺,無針左右。神在秋毫,屬意病者。審視血脈者,刺之無殆。方刺之時,必在懸陽,及與兩衛。神屬勿去,知病存亡。血脈者在俞橫居,視之獨澄,切之獨堅。

九針之名,各不同形。一曰鑱針,長一寸六分;二曰員針,長一寸六分;三曰提針,長三寸半;四曰鋒針,長一寸六分;五曰鈹針,長四寸,廣二分半;六曰員利針,長一寸六分;七曰毫針,長三寸六分;八曰長針,長七寸;九曰大針,長四寸。鑱針者,頭大末銳,去瀉陽氣;員針者,針如卵形,揩摩分間,不得傷肌肉者,以瀉分氣;提針者,鋒如黍粟之銳,主按脈勿陷,以致其氣;鋒針者,刃三隅以發痼疾,鈹針者,末如劍鋒,以取大膿;員利針者,大如釐,且員且銳,中身微大,以取暴氣;毫針者,尖如蚊虻喙,靜以徐往,微以久留之而養,以取痛痺;長針者,鋒利身薄,可以取遠痺;大針者,尖如梃,其鋒微員,以瀉機關之水也。九針畢矣。

夫氣之在脈也,邪氣在上,濁氣在中,清氣在下。故針陷脈則邪氣出,針中脈則濁氣出,針太深則邪氣反沉、病益。故曰:皮肉筋脈,各有所處。病各有所宜。各不同形,各以任其所宜,無實無虛。損不足而益有餘,是謂甚病。病益甚,取五脈者死,取三脈者恇;奪陰者死,奪陽者狂,針害畢矣。

刺之而氣不至,無問其數。刺之而氣至,乃去之,勿復針。針各有所宜,各不同形,各任其所,為刺之要。氣至而有效,效之信,若風之吹云,明乎若見蒼天,刺之道畢矣。

黃帝曰:願聞五臟六腑所出之處。岐伯曰:五臟五俞,五五二十五俞,六腑六俞,六六三十六俞,經脈十二,絡脈十五,凡二十七氣,以上下。所出為井,所溜為滎,所注為俞,所行為經,所入為合,二十七氣所行,皆在五俞也。

節之交,三百六十五會,知其要者,一言而終,不知其要,流散無窮。所言節者,神氣之所遊行出入也。非皮肉筋骨也。

觀其色,察其目,知其散復。一其形,聽其動靜,知其邪正,右主推之,左持而御之,氣至而去之。

凡將用針,必先診脈,視氣之劇易,乃可以治也。五臟之氣,已絕於內,而用針者反實其外,是謂重竭。重竭必死,其死也靜。治之者輒反其氣,取腋與膺。五臟之氣,已絕於外,而用針者反實其內,是謂逆厥。逆厥則必死,其死也躁。治之者反取四末。

刺之害中而不去,則精泄;害中而去,則致氣。精泄則病益甚而恇,致氣則生為癰瘍。

五臟有六腑,六腑有十二原,十二原出於四關,四關主治五臟。五臟有疾,當取之十二原。十二原者,五臟之所以稟三百六十五節氣味也。五臟有疾也,應出十二原。十二原各有所出。明知其原,睹其應,而知五臟之害矣。陽中之少陰,肺也,其原出於太淵,太淵二。陽中之太陽,心也,其原出於大陵,大陵二。陰中之少陽,肝也,其原出於太沖,太沖二。陰中之至陰,脾也,其原出於太白,太白二。陰中之太陰,腎也,其原出於太溪,太溪二。膏之原,出於鳩尾,鳩尾一。肓之原,出於脖胦,脖胦一。凡此十二原者,主治五臟六腑之有疾者也。

脹取三陽,飧泄取三陰。

稟今夫五臟之有疾也,譬猶刺也,猶污也,猶結也,猶閉也。刺雖久猶可拔也,污雖久猶可雪也,結雖久猶可解也,閉雖久猶可決也。或言久疾之不可取者,非其說也。夫善用針者,取其疾也,猶拔刺也,猶雪污也,猶解結也,猶決閉也。疾雖久,猶可畢也。言不可治者,未得其術也。

刺諸熱者,如以手探湯;刺寒清者,如人不欲行。陰有陽疾者,取之下陵三里,正往無殆,氣下乃止,不下復始也。疾高而內者,取之陰之陵泉;疾高而外者,取之陽之陵泉也。


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