赵京生  中国中医科学院针灸研究所

       针灸疗法，包含诸多刺灸方式方法及其运用原则，其思想方法是“针道自然”，体现为“顺势”的总体方法特征。

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   “针道自然”概念始见于《针灸甲乙经》，这一观念源自《黄帝内经》，是中国古代哲学思想“道法自然”在医学中的体现，为贯穿于针灸理法的一种思维方式。

    “自然”，即自然而然。万物以自然为本质，道是自发性的，道的统一性贯穿于万物。万物都有其自然的（活动）趋势。因此，处理问题的方法，就要依事物的内在本性和自然趋势来行事，有意识地取法自然，而非相反。

“针道”，就是针灸的运用方法规律。《黄帝内经》强调针道必须合于天道。天道即自然之道，符合自然之道的行事方法是因势利导。用针也是如此，制定的具体针灸方法，在特征上要与治疗对象的特征对应一致，即“顺势”的方法。

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       对人体和疾病的认识，受思想观念支配，也决定着治疗处理的方式方法。

体质特点

      形壮肤深唇厚者，呈现重浊之势——刺取强势之法，深刺久留针；形瘦肤白唇薄言者，呈轻清之势——刺法以弱势对应，浅刺不留针。

身体时间(节律)状态

        一年之中，春夏刺浅，秋冬刺深，刺之浅深与气浮沉相合。一月之中，月盈时不用补法，月缺时不用泻法。

经脉气血多少不同：

多血多气的经脉，针刺适用出血出气，反之则不宜出血或出气。

针灸补泻操作：

针刺补法——轻柔徐静为特征，以对应虚证不足之势；针刺泻法——力重动疾为特征，以合于实证有余之势。

艾灸补法——火力温和持久；艾灸泻法——火势强猛而时短。

病证刺法：

寒证——深刺久留；热证——浅刺疾出（不留针）。

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       顺其势而治针灸理法的体现，大致可归纳为两个方面：一是随顺生理特性，二是随顺病证特征，强调针灸方法特征须与其一致。领会这一思想观念和方法，有助在总体上去更好的理解、传承传统针灸疗法，创新运用。

针道自然 (Acu Taking Advantage of the Spontaneity)

Acu-moxa therapy, including numerous operations as well as principles guiding them, roots in the core idea of 针道自然 (Acu taking advantage of the spontaneity) and embodies as “following the trend” in practice.

a)

The idea of 针道自然 is firstly found in Zhenjiu Jiayi Jing, which developed earlier thinking in Huangdi Neijing. 针道自然 can be regarded as a medical use of ancient Chinese wisdom “Dao following the nature”. It influences both theories and operations of acu-moxa in most aspects.

自然, was also stated as 自然而然 (naturally, spontaneously). In ancient Chinese philosophy, the world had intrinsic nature, and Dao was spontaneous. Dao expressed its unitarity in universe, and vice versa. Everything got its natural trend of activity. As far as practice is concerned, one has to take the nature and trend of objects into account and learn from nature as well.

The 针道 used in this article, refers to methods and regularities of acu-moxa. In the statements in Huangdi Neijing, 针道was emphasized to be corresponded to the Dao of heaven, i.e. the natural law. The way corresponding to the natural Dao is acting in the light of general trends. This principle can be used to guide acu-moxa operation as well. Thus, specific operations have to be chosen according to features of the patient. The principle is exactly “following the trend”.

b)

Ideas about the body and disease are always decided by thinking ways, and influence operations and methods used in treatment.

Feature of physique

One with stronger shape, darker skin and thick lips tends to have weighty and turbid feature of physique and is able to accept powerful needling in longer time.

Comparatively, one with slimmer shape, lighter skin and thinner lips tends to have weak and pure feature of physique and can bear gentle treatment with shorter duration.

Time rhythm and condition of the body

The deepness of needling should be in accordance with the rises and falls of qi in the whole year, namely, shallow insertion in spring and summer and deep insertion in autumn and winter. While in a month, the reinforcing methods are forbidden at the full moon, and reducing methods are forbidden at the new moon.

Lavish and weak status of qi-blood in diverse channels

Needling on channels with lavish qi-blood is better reducing, whereas on ones with weak qi-blood is better preserving.

Reinforcing and reducing operations in acu-moxa

Reinforcing operations have features of gentle, slow and less active to treat patients with weak and insufficient trend.

Reducing operations have features of powerful, fast and more active to treat patients with strong and redundant trend.

As for moxibustion, to reinforce means to use gentle thermal power with longer duration. To reduce means to use strong thermal power with shorter duration.

Syndromes oriented needling methods 

Cold syndromes are best fitted for deep and lasting needling. Heat syndromes are best fitted for shallow and instant needling.

c)

The idea of following the trend manifested in theories and operations of acu-moxa can be summarized in physiological and pathological aspects. The latter one emphasizes the coherence of operational features and symptomatic trends. Therefore, a better understand on this idea and thinking way may bring forth a better use of ancient practical methods.