丹溪曰。诸项灸法皆好。惟骑竹马灸法尤为切要。此消患于未形也。先令病患以肘凭几
臂腕。腰直。用篾一条自臂腕中曲纹尽处。男左女右。贴肉量起。直至中指尖尽处为则。不量
指甲。却用竹杠一条。令病患脱衣骑定。令身正直。前后二人扛起。令脚不着地。又令二人
扶定。勿令僵仆。却将所量臂腕。篦从竹扛坐处尾 骨尽处。直竖竹上贴脊背。量至篾尽为
则。用墨点。此只是取中。非灸穴也。另用薄篾。量病患中指节。相去两横为则。男左女右
。截为一则。就前所点记处两边。各量开尽处。即是灸穴。两穴各灸五壮或七壮。不可多灸
。不问痈在何处及乳痈。并用此法灸之。无不愈者。一云。疽发于左。灸左。发于右。灸右
。甚则左右皆灸。盖此二穴。心脉所过处。经曰。诸痛痒疮疡皆属心火。又云。心主血。心
气滞则血不行。故逆于肉理而生痈。灸此穴使心火调畅。血脉流通。即能奏效。起死回生。
河间谓灸刺疮疡。须分经络部分。气血多少。俞穴远近。从背出者。当从太阳五穴选用
、(在足小指外侧。去爪甲角如韭叶。)通谷、(在足小指外侧。本节前陷中。)束骨、(在足
小指外侧。本节后陷中。)昆仑、(在足外踝后跟骨上陷中。)委中。(在胸中央约绞中动脉。
)从鬓出者。当从少阳五穴、选用窍阴、(在足小指之次指端。去爪甲如韭叶。)夹溪、(在足
小指次指岐骨间、本节前陷中。)临泣、(在足小指次指。本节后间陷中。)阳辅、(在足外踝
上四寸辅骨前绝骨端如前三分。)阳陵泉。(在膝下一寸外廉陷中。)从髭出者。当从阳明五
穴选用厉兑、(在足大指次指。去爪甲如韭叶。)内庭、(在足大指次指外间陷中。)陷谷、(
在足大指间。本节后陷中。)冲阳、(在足跌上五寸骨间动脉去陷谷三寸。)解溪。(在冲阳后
一寸五分腕上陷中。)从脑出者。则以绝骨一穴。(在外踝上三寸动脉中。)
一说。痈疽初发。必先当头灸之。以开其户。次看所发分野属何经脉。即内用所属经脉
之药。引经以发其表。外用所属经脉之俞穴针灸。以泄其邪。内外交治。邪无容矣。
朱丹溪说:各种项部的灸法都很好,只有骑竹马灸法尤为关键重要。这是在疾病尚未显现时就消除隐患的方法。先让病人用手肘支撑在几案上,手臂手腕伸直,腰部挺直。取一条篾片(细长的竹片),从男左女右的手臂腕部弯曲纹路的尽头处开始,紧贴皮肤量起,一直量到中指尖的尽头为止作为标准长度,不计算指甲的长度。然后取一根竹杠,让病人脱去衣服跨坐定好,保持身体正直。前后各由一人抬起竹杠,使病人的脚不着地,另外再让两人扶住病人,防止其跌倒。接着将之前量好的臂腕长度的篾片,从竹杠坐着位置的尾骨尽头处开始,竖直贴在竹杠上并沿脊柱向上量,直到篾片的尽头为止作为标准。用墨汁在此处做点标记。这只是为了取中点位置,并非直接的灸穴。另取一条薄篾片,测量病人中指节的长度,以两指横宽为标准截取一段。根据男左女右的原则,在前文所点的标记处两侧,分别向外量出该长度,这两处即为灸穴。两个穴位各灸五壮或七壮,不可多灸。无论痈疽发生在何处,包括乳痈,都使用这种方法施灸,没有不痊愈的。另一种说法是:疽发于左侧就灸左侧,发于右侧就灸右侧,病情严重的则左右都灸。因为这两个穴位是心脉经过的地方。经书说:“各种疼痛、瘙痒、疮疡都属于心火。”又说:“心主血脉。”如果心气郁滞,血液就不能正常运行,从而逆乱于肌肉纹理之间而生痈疽。灸这些穴位能使心火调畅,血脉流通,就能奏效,甚至能起死回生。
刘河间认为,治疗疮疡的灸法和刺法,必须区分经络部位、气血的多少以及腧穴的远近。从背部发出的疮疡,应当从足太阳膀胱经的五穴中选择选用:通谷穴(位于足小趾外侧,距离爪甲角如韭菜叶宽度处)、束骨穴(位于足小趾外侧,本节前凹陷中)、昆仑穴(位于足外踝后方跟骨上的凹陷中)、委中穴(位于腘窝中央动脉搏动处)。从鬓角发出的疮疡,应当从足少阳胆经的五穴中选择选用:窍阴穴(位于足次趾端,距离爪甲如韭菜叶宽度处)、侠溪穴(位于足次趾与小趾歧骨之间,本节前凹陷中)、临泣穴(位于足次趾与本节后间的凹陷中)、阳辅穴(位于足外踝上四寸,辅骨前绝骨端前方三分处)、阳陵泉穴(位于膝下一寸,外侧凹陷中)。从胡须部位发出的疮疡,应当从足阳明胃经的五穴中选择选用:厉兑穴(位于足大趾次趾,距离爪甲如韭菜叶宽度处)、内庭穴(位于足大趾次趾外侧凹陷中)、陷谷穴(位于足大趾与次趾间,本节后凹陷中)、冲阳穴(位于足背五寸骨间动脉处,距离陷谷三寸)、解溪穴(位于冲阳后一寸五分,腕上凹陷中)。从脑部发出的疮疡,则选取绝骨穴一穴(位于外踝上三寸动脉中)。
还有一种说法:痈疽初发时,必须先在其顶部施灸,以打开邪气外出的门户;其次观察发病部位属于哪条经脉,内部服用该所属经脉的药物,引导药力发散到体表;外部使用该所属经脉的俞穴进行针灸,以泄除邪气。内外同时治疗,邪气就没有容身之地了。
Zhu Danxi stated: All moxibustion methods for the neck region are good, but the "riding bamboo horse" moxibustion method is particularly crucial. This prevents illness before it manifests. First, instruct the patient to rest their elbows on a table with arms and wrists extended and back straight. Take a thin strip of bamboo (Bamboo Strip) and measure from the end of the wrist crease on the left side for men or the right side for women, placing it against the skin until the tip of the middle finger. Do not include the fingernail in the measurement. Then, take a bamboo pole and have the patient disrobe and straddle it securely, maintaining an upright posture. Two people should lift the pole so that the patient's feet do not touch the ground, while two others support the patient to prevent falling. Next, take the measured bamboo strip from the wrist and place it vertically against the bamboo pole starting from the end of the coccyx where the patient sits, extending up along the spine to the end of the strip as the standard. Mark this point with ink. This is merely to find the midpoint, not the actual acupoint. Take another thin bamboo strip and measure the length of the middle finger joint, using the width of two transverse knuckles as the standard. Cut a piece to this length. Based on the principle of left for men and right for women, measure this distance outward from both sides of the previously marked point. These two locations are the moxibustion points. Moxa cones (Moxa Cones) of five or seven moxa moxibustions (Moxibustion) should be applied to each point; do not over-moxa. Regardless of where the carbuncle (Carbuncle) occurs, including mastitis (Mastitis), this method can be used, and there will be no failure to heal. Another view states: if the ulcer (Ulcer) appears on the left, moxa the left; if on the right, moxa the right; if severe, moxa both sides. This is because these two points lie on the pathway of the Heart Meridian (Heart Meridian). The classics state: "All pain, itching, sores, and ulcers belong to Heart Fire." It also says: "The Heart governs blood vessels." If Heart Qi stagnates, blood cannot flow smoothly, leading to rebellion within the muscle tissue and causing sores. Moxing these points regulates Heart Fire and promotes blood circulation, thereby achieving efficacy, even rescuing patients from death.
Liu Wansu believed that for moxibustion and acupuncture treating sores and ulcers, one must distinguish the meridian regions, the abundance or scarcity of Qi and Blood, and the proximity or distance of acupoints. For sores emerging from the back, select from the five acupoints of the Foot-Taiyang Bladder Meridian (Foot-Taiyang Bladder Meridian): Tonggu (Tonggu, BL65) (located on the lateral side of the fifth toe, about the width of a leek leaf from the corner of the nail); Shugu (Shugu, BL65) (located in the depression anterior to the metatarsophalangeal joint on the lateral side of the fifth toe); Kunlun (Kunlun, BL60) (located in the depression between the lateral malleolus and the calcaneus); Weizhong (Weizhong, BL40) (located in the center of the popliteal fossa where the artery pulses). For sores emerging from the temples, select from the five acupoints of the Foot-Shaoyang Gallbladder Meridian (Foot-Shaoyang Gallbladder Meridian): Qiaoyin (Qiaoyin, GB44) (located at the tip of the fourth toe, about the width of a leek leaf from the corner of the nail); Xiaxi (Xiaxi, GB43) (located in the depression anterior to the metatarsophalangeal joint between the fourth and fifth toes); Linqi (Linqi, GB41) (located in the depression posterior to the metatarsophalangeal joint of the fourth toe); Yangfu (Yangfu, GB38) (located four cun above the lateral malleolus, anterior to the end of the fibula, three fen forward); Yanglingquan (Yanglingquan, GB34) (located one cun below the knee, in the depression on the lateral aspect). For sores emerging from the beard area, select from the five acupoints of the Foot-Yangming Stomach Meridian (Foot-Yangming Stomach Meridian): Lidui (Lidui, ST45) (located at the tip of the second toe, about the width of a leek leaf from the corner of the nail); Neiting (Neiting, ST44) (located in the depression between the second and third toes); Xangu (Xangu, ST43) (located in the depression posterior to the metatarsophalangeal joint between the first and second toes); Chongyang (Chongyang, ST42) (located on the dorsal foot, in the bone interval artery, three cun from Xangu); Jiexi (Jiexi, ST41) (located one cun and five fen posterior to Chongyang, in the depression above the ankle). For sores emerging from the head/brain, select only the Juegu point (Juegu, GB39) (located three cun above the lateral malleolus in the artery).
Another theory suggests: when a carbuncle or ulcer first appears, one must first apply moxibustion to the head of the lesion to open its "door." Then, observe which meridian the affected area belongs to. Internally, administer herbs corresponding to that meridian to guide the treatment to the exterior. Externally, use acupuncture and moxibustion on the Shu points of that meridian to drain the pathogenic factors. Treating both internally and externally leaves no room for the pathogen.