通里腕侧后,去腕一寸中。欲言声不出,懊 及怔忡,实则四肢重,头腮面颊红,声平
仍数欠,喉痹气难通,虚则不能食,暴喑面无容,毫针微微刺,方信有神功。
【注】通里穴,其穴在腕侧后一寸陷中。主治声哑,心烦极甚,怔忡不宁,四肢重痛,
头腮面颊红肿,倦言,数欠,喉咽疼痛,气息不通,虚损不思食,暴喑面无润泽。针三
分,灸三壮。
\r通里穴图\p06-d43a133.bmp\r
列缺腕侧上,次指手交叉,善疗偏头患,
遍身风痹麻,痰涎频上壅,口噤不开牙,若能明补泻,应手即能瘥。
【注】列缺穴,其穴在腕后侧上一寸五分,两手交叉,当食指末筋骨罅中。主治偏风头
痛,遍身风痹麻木,痰壅气堵,口噤不开等证。针二分,留三呼,灸三壮。
\r列缺穴图\p06-d43a134.bmp\r
四季针灸坐向理,宜从四季顺自然,东南西北四维向,以迎生气本乎天。
【注】针灸坐向,避忌之理,《医学入门》∶“春坐东向西,夏坐南向北,秋坐西向
东,冬坐北向南。”皆背四季生气之向,不可为法。宜从春向东,夏向南,秋向西,冬向
北,四土旺月向四维,以迎生气,本乎天理,顺其自然为是也。
点穴坐卧立直正,炷用蕲艾火珠良,灸病古忌八木火,令时通行一炷香。
【注】凡灸法,坐点穴则坐灸,卧点穴则卧灸,立点穴则立灸。须四体平直,毋令倾
侧,若倾侧穴即不正。其炷所用之艾,必用蕲艾,艾令干燥,入臼捣去净尘屑,作炷坚
实,置穴上,用葱涎粘固。上古用火珠映日取火点之,忌松、柏、枳、橘、榆、枣、桑、
竹八木之火;今时惟用香火灼艾,亦通行简便之法也。
通里穴位于手腕内侧后方,距离腕横纹一寸处。如果患者想说话却发不出声音,感到心中烦闷懊恼以及心悸怔忡,实证表现为四肢沉重,头部、面颊发红;若声音平和但频繁打哈欠,咽喉肿痛且气息不通;虚证则表现为不能进食,突然失音且面色无华。用毫针轻微针刺,方知此法有神奇功效。
【注】通里穴,穴位在手腕内侧后方一寸的凹陷处。主治声音嘶哑,极度心烦,心悸不安,四肢沉重疼痛,头、腮、面颊红肿,倦怠少言,频繁打哈欠,咽喉疼痛,气息不通,虚损导致的食欲不振,突然失音且面色缺乏润泽。针刺三分,艾灸三壮。
列缺穴位于手腕侧上方,定位方法为两手交叉,当食指末端的筋骨缝隙中。善于治疗偏头痛,全身风痹麻木,痰涎频繁上涌壅塞,牙关紧闭无法张口。如果能明白补泻手法,疗效立竿见影。
【注】列缺穴,穴位在手腕后侧上方一寸五分处,两手交叉时,位于食指末端筋骨之间的缝隙中。主治偏头痛,全身风痹麻木,痰气壅堵,牙关紧闭等证候。针刺二分,留针三个呼吸的时间,艾灸三壮。
四季针灸时的坐向原理,应当顺应四季的自然规律。东南西北及四维方位,是为了迎接生气,这源于天理。
【注】关于针灸时的坐向避忌道理,《医学入门》记载:“春季坐东向西,夏季坐南向北,秋季坐西向东,冬季坐北向南。”这些都是背对四季生气的方向,不可效法。应当顺应春天向东,夏天向南,秋天向西,冬天向北,四个土旺之月面向四维方位,以迎接生气,这符合天理,顺其自然才是正确的。
点穴时身体要坐、卧、站立端正,艾炷使用蕲州艾绒制成的火珠状艾柱最好。古代灸病忌讳使用松、柏、枳、橘、榆、枣、桑、竹八种木材燃烧的火,现在通行的简便方法是点燃一炷香进行施灸。
【注】凡是灸法,坐着点穴就坐着灸,躺着点穴就躺着灸,站着点穴就站着灸。必须使四肢躯干平直,不要倾斜,如果倾斜穴位就不准确了。所用的艾炷,必须使用蕲艾,艾叶要干燥,放入臼中捣碎去除干净的尘屑,做成坚实的小艾柱,放置在穴位上,用葱汁粘固。上古时期用火珠对着太阳聚焦取火来点燃艾炷,忌讳松、柏、枳、橘、榆、枣、桑、竹八种木柴的火;现在只使用香火灼烧艾炷,这也是通行简便的方法。
Tongli (HT5) is located posterior to the wrist crease, one cun proximal to the transverse crease of the wrist. If a patient desires to speak but cannot produce sound, and experiences restlessness (Ao Nu) and palpitations (Zheng Chong), excess patterns manifest as heaviness in the four limbs and redness of the head, cheeks, and face. If the voice is normal but there is frequent yawning, or if there is throat obstruction (Hou Bi) with difficulty in breathing; deficiency patterns manifest as inability to eat, sudden loss of voice (Bao Yin), and a lackluster complexion. A filiform needle should be inserted slightly, and one will believe in its miraculous efficacy.
[Note] Tongli (HT5) is located in the depression one cun posterior to the wrist crease. It treats hoarseness, extreme mental restlessness, palpitations and uneasiness, heaviness and pain in the four limbs, redness and swelling of the head, cheeks, and face, reluctance to speak, frequent yawning, throat and pharyngeal pain, obstruction of qi flow, loss of appetite due to deficiency, sudden loss of voice, and a complexion lacking luster. Needle 0.3 cun, moxa 3 moxibustion cones.
Lieque (LU7) is located superior to the radial side of the wrist. The location method involves crossing both hands, where the point lies in the gap between the bone and tendon at the tip of the index finger. It is effective for treating hemicephalic headache, generalized wind-bi numbness, frequent accumulation of phlegm-saliva obstructing upwards, and trismus (mouth locked shut). If one understands tonification and sedation techniques, recovery follows immediately upon needling.
[Note] Lieque (LU7) is located 1.5 cun superior to the radial wrist crease on the dorsal-radial side. When the hands are crossed, it lies in the depression between the bone and tendon at the end of the index finger. It treats symptoms such as hemicephalic headache, generalized wind-bi numbness, phlegm and qi obstruction, and trismus. Needle 0.2 cun, retain for three breaths, moxa 3 moxibustion cones.
The principle of sitting orientation for acupuncture and moxibustion in the four seasons should follow natural laws. The directions of East, South, West, North, and the four intermediate corners are used to welcome the vital qi (Sheng Qi), which originates from Heaven.
[Note] Regarding the principles of avoidance for sitting orientation during acupuncture and moxibustion, *Yixue Rumen* states: "In spring, sit facing west; in summer, sit facing north; in autumn, sit facing east; in winter, sit facing south." These orientations turn one's back to the vital qi of the four seasons and should not be followed. Instead, one should face East in spring, South in summer, West in autumn, and North in winter. During the four months when Earth is prosperous, face the four intermediate corners to welcome the vital qi. This conforms to heavenly principles and follows nature naturally.
When locating points, the body must be upright whether sitting, lying, or standing. Use moxa cones made from Qizhou mugwort (*Artemisia argyi*) shaped like fire pearls. In ancient times, eight types of wood fires were taboo for moxibustion; currently, using a single incense stick is a common and convenient method.
[Note] For all moxibustion methods, if points are located while sitting, moxa is applied while sitting; if located while lying, apply while lying; if located while standing, apply while standing. The limbs and torso must be kept straight and not tilted, otherwise the points will not be accurate. The mugwort used for the cones must be Qizhou mugwort. The mugwort leaves should be dry, pounded in a mortar to remove dust and debris, and formed into firm cones. Place the cone on the point and secure it with green onion juice. In ancient times, fire was gathered using a crystal lens reflecting sunlight to ignite the moxa. Fires from pine, cypress, zanthoxylum, tangerine, elm, jujube, mulberry, and bamboo were taboo. Currently, only incense sticks are used to burn the moxa, which is also a widely accepted and convenient method.