千金云、凡言壮数者。若丁壮病根深笃。可倍于方数。老少羸弱。可减半。(又云。小
儿七
日以上。周年以还。不过七壮。炷如雀屎。)扁鹊灸法、有至五百壮千壮。曹氏灸法、有百
壮有五十壮。短剧诸方亦然。惟明堂本经多云针入六分。灸三壮。更无余论。故后人不准。
惟以病之轻重而增损之。凡灸头顶止于七壮。积至七七壮止。(铜人)若治风则灸上星、前顶
、百会。皆至二百壮。腹背宜灸五百壮。若鸠尾巨阙亦不宜多。四肢但去风邪。不宜多灸
。灸多则四肢细而无力。(明上)而千金于足三里穴、乃云多至三二百壮。心俞禁灸。若中风
则急灸至百壮。皆视其病之轻重而用之。不可泥一说。而又不知其有一说也。下经只云若是
禁穴。明堂亦许灸一壮至三壮。恐未尽也。
千金云、凡宦游吴蜀。体上常须三两处灸之。勿令疮暂差。则瘴疠温疟毒瓦斯不能着人。
故吴
蜀多行灸法。有阿是之法。言人有病。即令捏其上。若里当其处。不问孔穴即得。便快成痛
处。即云阿是。灸刺皆验。故曰阿是穴。
千金云、黄帝曰、灸不三分。是谓徒冤。炷务大也。小弱乃小作之。(又云。小儿七日
以上
。周年以还。不过七壮。炷如雀粪。)明堂下经云、凡灸欲艾炷根下广三分。若不三分。即
火气不能远达。病未能愈。则是艾炷欲其大。惟头与四肢欲小尔。至明堂上经乃云、艾炷根据
小竹箸头作。其病脉粗细状如细线。但令当脉灸之。雀粪大炷。亦能愈疾。又有一途。如腹
内疝瘕 癖块伏梁气等。惟须大艾炷。故短剧曰、腹背烂烧。四肢则但去风邪而已。如巨阙
鸠尾、虽是胸腹穴。灸之不过四七炷。只根据竹箸头大。但令正当脉灸之。艾炷若大。复灸多
。其人永无心力。如头上灸多。令人失精神。臂脚灸多。令人血脉枯渴。四肢细而无力。既
失精神。又加于细。即令人短寿。(见承浆穴。)此论甚当。故备着之。
Qianjin Fang (Essential Prescriptions Worth a Thousand Gold) states: Regarding the number of moxa cones (Zhuang, a unit of measure for moxibustion quantity), if the patient is robust and the disease root is deep and severe, the number can be doubled compared to the standard prescription. For the elderly, children, or those who are frail and weak, the number should be halved. (It also states: For infants older than seven days but less than one year old, do not exceed seven Zhuang; the moxa cone should be as small as a sparrow's droppings.) The Bianque Moxibustion Method records cases of up to five hundred or one thousand Zhuang. The Cao Shi Moxibustion Method records one hundred or fifty Zhuang. Formulas in the Duanju text are similar. However, the Mingtang Benjing (Classic of the Acupuncture Points) mostly specifies needle insertion depth of six fen and three Zhuang of moxibustion, with no further discussion. Consequently, later practitioners lacked a uniform standard, adjusting the number based on the severity of the illness.
When moxibusting the top of the head, limit it to seven Zhuang, accumulating up to forty-nine Zhuang (seven times seven). (From Tongren Shuxue Zhenjiu Tujing [Illustrated Manual of Acupoints of the Copper Man]). If treating wind diseases, moxa points Shangxing (Yintang + 1 cun), Qianding (Baihui - 2 cun), and Baihui (GV20) should all be treated with two hundred Zhuang. The abdomen and back are suitable for five hundred Zhuang. However, Jiuwei (CV15) and Juque (CV14) should not be over-moxa'd. For the limbs, merely dispelling wind pathogens is sufficient; excessive moxibustion is inadvisable. Too much moxibustion on the limbs causes them to become thin and weak. (From Mingtang Shangjing [Upper Classic of Acupoints]). Conversely, Qianjin Fang suggests that for Zusanli (ST36), one may moxa up to two or three hundred Zhuang. Xinshu (BL15) is contraindicated for moxibustion. In cases of stroke (Zhongfeng), urgent moxibustion up to one hundred Zhuang is indicated. These applications depend on the severity of the condition and should not be rigidly adhered to as a single rule, nor should other perspectives be ignored. Xiajing (Lower Classic) only states that for contraindicated points, Mingtang allows one to three Zhuang, which may be insufficient.
Qianjin Fang states: For those traveling through Wu and Shu regions, it is necessary to perform moxibustion on two or three locations on the body, ensuring the sores do not heal temporarily. This prevents miasma, pestilence, warm malaria, and toxic vapors from afflicting the person. Thus, moxibustion is commonly practiced in Wu and Shu. There is a method called "Ashi" (Ah-Shi). It means when a person has an ailment, they press on their body; if the pressure corresponds to the internal pathology, regardless of whether it is a specific acupoint, relief or pain indicates the spot. This spot is called "Ashi," and both moxibustion and acupuncture at this point are effective, hence the name Ashi Point.
Qian Jin Fang states: Huangdi said: "If moxibustion does not reach a depth of three fen, it is considered a futile suffering." The moxa cone must be large. If it is small or weak, make it smaller. (It also states: For infants older than seven days but less than one year old, do not exceed seven Zhuang; the cone size like sparrow feces.) Mingtang Xiajing states: "For all moxibustion, the base of the moxa cone should be wide by three fen. If not three fen, the fire qi cannot reach far, and the disease will not heal." This implies moxa cones should generally be large, except for the head and limbs where they should be small. However, Mingtang Shangjing states: "Make the moxa cone the size of the head of a small bamboo chopstick." If the patient's pulse is thin like a fine thread, simply align the moxa cone with the meridian; even a sparrow-dropping-sized cone can cure the disease. Another scenario involves abdominal conditions such as hernia (Shan), masses (Jia), accumulations (Pi), and Fu Liang Qi; these require large moxa cones. Thus, Duanju states: "The abdomen and back can be cauterized until ulceration occurs, while the limbs are merely for dispelling wind pathogens." Although Juque (CV14) and Jiuwei (CV15) are chest and abdominal points, moxibustion there should not exceed twenty-eight cones (four times seven), sized like a bamboo chopstick head, aligned with the meridian. If the cones are too large and the quantity excessive, the person will permanently lack mental and physical strength. Excessive moxibustion on the head causes loss of spirit. Excessive moxibustion on arms and legs causes blood vessels to dry up, leading to thin, weak limbs. Loss of spirit combined with limb weakness leads to a shortened lifespan. (See Chengjiang point entry). This argument is very appropriate, so it is recorded in detail.