“以痛为输”:基于十二经筋治则语境的解读

“Pain-point needling”:an interpretation based on the context and therapeutic principles of muscles along the twelve regular meridians

“以痛为输”语出《灵枢·经筋》,为针灸施治处的选取原则之一,是经筋理论的组成部分。《灵枢》中经筋理论的陈述体例仿照了十二经脉理论,从经脉理论演进过程看,是启于简帛文献承至《黄帝内经》的接续。在此背景下,经脉病取腧穴而治,经筋病则“以痛为输”,而非痛处即腧穴,两者理论架构严整相对。这样的现象是缘于彼时经脉腧穴理论的强势地位,影响了针灸文献的说理习惯。对“以痛为输”的正确理解,还会关涉对“阿是穴”及其与腧穴关系的认识,以助于明晰腧穴的概念,进而建构“刺灸处”的范畴,方可能解决当下针灸理论体系所存在的问题。

“Pain-point needling”,a term of acupuncture medicine from the Chapter Jingjin(Muscles along Meridians)of Lingshu Jing(Miraculous Pivot),is one of the selection principles of acupuncture and moxibustion stimulation spots,and is an integral part of the theory of Jingjin.The statement style of the Jingjin theory in Lingshu imitates that of the twelve regular meridians theory.From the perspective of the evolution process of the meridian theory,it is a continuation of the literature from Jianbo Maishu(Bamboo Slips Book and Silk Book on Meridians)to Huangdi Neijing(The Yellow Emperor’s Internal Classic).In this context,meridian diseases are treated with acupoints,while Jingjin disorders are treated with“pain-point needling”rather than acupoints.The theoretical framework of the two is strictly relative.This phenomenon is due to the strong position of the meridian and acupoint theory at that time,which affects the reasoning habit of acupuncture and moxibustion literature.The correct understanding of“pain-point needling”will also involve the understanding of“Ashi point”and its relationship with the acupoints,so as to help us clarify the concept of the acupoints,and then construct the category of“acupuncture and moxibustion stimulating points”,which may solve the problems existing in the current theoretical system of acupuncture and moxibustion.