按四花灸穴。诸书所载不一。苏沈良方。校成诸本。序文如所言。而鲁鱼居多。今以万
校之。他书之文大不同。始取其句差异者注之。再阅颇觉其烦。仍悉削去之。只注一二字异而
义易通者。崔氏序曰具图形状而其图不载。诸书亦无焉。今据万安方所图省其无用。而其文一
从圣济万安二书。记图上入门曰。灸此六穴。亦要灸足三里。以泻火气为妙。是古书所不论
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以上第一次。点二穴。
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以上是第二次点二穴
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以上是第三次点二穴。以上图状。
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按资生曰。凡取四花穴。以稻秆心。量口缝如何阔。断其长多少。以如此长。裁纸四方
中剪小孔。别用长稻秆。蹈脚下前取脚大指为止。后取脚曲 横纹中为止。断了却环在结喉。
下垂向背后看秆止处。即以前小孔纸。当中安分。为四花。盖灸纸四角也。今按此法世俗所
谓略四花。针灸聚英曰。初疑四花穴。古人恐人不识点穴。故立此捷法。当必有合于五脏俞
也。今根据此法点穴。果合太阳行背二行。膈俞胆俞四穴。难经曰。血会膈俞。 曰。血病治此
。盖骨蒸劳热。血虚火旺。故取此补之。胆者肝之腑。藏血。故亦取是俞也。崔氏。止言四
花。而不言膈俞胆俞四穴者。为粗工告也。今只根据揣摸。脊骨膈俞胆俞。为正。然人口有大小
阔
狭不同故四花亦不准。更按。高武说崔氏四花而不据其法。漫为膈胆二俞。学人思诸。又资
生
曰。一医传一法。先横量口吻。取长短。以所量草。就背上三椎骨下。直量至草尽处。两头用
笔。点了。再量中指长短为准。却将量中指草。横直量两头。用笔圈四角。其圈者是穴。是
又略法不可从。
经门四花 入门曰。即崔氏四花穴。不灸背上二穴。各开两旁。共成六穴上二穴共阔一
寸。
下四花相等。俱吊线比之以离卦变作坤卦。降心火生脾土之意也。然此皆阳虚所宜。华佗云
。风虚冷热惟有虚者。不宜灸。但方书又云。虚损痨瘵。只宜早灸膏肓四花。乃虚损未成之
际。如瘦弱兼火。虽灸亦只宜灸内关三里。以散其痰火。早年欲作阴火。不宜灸论而未果。
骑竹马灸法 用薄篾。量患人手上尺泽穴横纹比起循肉至中指尖止截断。外用竹杠一条
。以
竹杠两头。置凳上。令患人去衣骑竹杠。以足微点地以先比篾安杠上。竖篾循背。直上篾尽
处以墨点记。只是取中。非灸穴。更以薄篾量手中指节两横纹为一寸。将篾于所点墨上。两
旁各
量一寸是穴。各灸五壮或七壮。止不可多灸。此法灸之。无不愈者盖此二穴心脉所过。凡痈
疽之疾
。皆心气留滞。故生此毒。灸此则心脉流通。实时安愈。可以起死回生有非常效。(神应)
按类经曰。一本作各开二寸。聚英曰。根据法量穴在督脉脊中至阳。筋束二穴中。外太阳
行背二
行膈俞肝俞之内。非正当穴也。疑必后人传讹以三寸为二寸耳。岂有不得正穴。徒破好肉。
而能愈病哉。此不能疑也。阿是要穴曰。此穴出诸书未知其始。
关于四花灸穴。各种书籍记载不一。《苏沈良方》经过校勘的版本中,序文内容如前所述,但文字错误(如“鲁鱼”之误)很多。现在以万安方的版本进行校对,发现其他书籍的文字差异很大。起初只标注那些句子有差异的地方,再次阅读时觉得颇为繁琐,于是全部删去,只保留了一两个字不同但意义容易通晓的注释。崔氏在序言中说提供了图形和形状,但图中并未收录这些图形,其他书籍也没有。现在依据《万安方》所绘制的图形,省去无用的部分,而文字完全遵循《圣济总录》和《万安方》两书。记录图上的入门方法说:灸这六个穴位,也要灸足三里穴,以泻除火气为妙。这是古书中未讨论的内容。
以上第一次,点取两个穴位。
以上是第二次点取两个穴位。
以上是第三次点取两个穴位。以上图形状貌。
按《资生经》说:凡是选取四花穴,用稻秆心,量口缝有多宽,截断其长度多少。用这样长的稻草,裁成四方形的纸,中间剪一个小孔。另外用一根长稻秆,从脚底下向前量到大脚趾为止,向后量到脚部横纹中为止,截断后环绕在结喉处,下垂指向背后看稻秆停止的地方,即把前面那个小孔的纸,正中间安放分开,作为四花。大概是指灸纸片的四个角。现在考察这种方法,是世俗所谓的“略四花”。《针灸聚英》说:起初怀疑四花穴,古人恐怕人们不认识点穴的位置,所以设立这种简便的方法,应当必定与五脏俞穴相合。现在根据此法点穴,果然符合太阳经行于背部的第二行中的膈俞、胆俞这四个穴位。《难经》说:血会穴在膈俞。又说:血病治疗此穴。大概是针对骨蒸劳热、血虚火旺的情况,所以取此穴来补益。胆是肝的腑,藏血,所以也取这个俞穴。崔氏只说四花,而不说膈俞、胆俞这四个穴位,是为了告诉粗疏的医生。现在只根据揣测摸拟,脊骨旁的膈俞、胆俞,才是正确的。然而人的口有大小宽窄不同,所以四花穴也不准确。再考证,高武批评崔氏有四花之名却不依据其法,随意说是膈俞、胆俞二俞,学习的人请思考。又《资生经》说:一位医生传授一种方法,先横向测量口吻的长短,用所量的草,就在背上第三椎骨下,直量至草尽之处,两头用笔点上。再量中指长短为准,却将量中指的草,横直量两头,用笔圈出四个角,那个圈出的就是穴位。这又是简便之法,不可采用。
经门四花:入门说:即崔氏四花穴,不灸背上的两个穴位,各自开向两旁,共成六个穴位。上两个穴位共宽一寸,下四个花相等。都用吊线比对,以离卦变作坤卦,有降心火、生脾土的意思。然而这些都适宜于阳虚之人。华佗说:风虚冷热,只有虚证不宜灸。但方书又说:虚损痨瘵,只宜早灸膏肓、四花,这是在虚损尚未形成之际。如果瘦弱兼有火邪,虽然灸也只宜灸内关、足三里,以散其痰火。早年想论述阴火不宜灸的理论而未完成。
骑竹马灸法:用薄篾片,量患者手上尺泽穴横纹起,顺着肌肉至中指尖止,截断。外用竹杠一条,将竹杠两头置于凳子上,令患者脱去衣服骑在竹杠上,以脚微微点地,先用比好的篾片安放在竹杠上,竖立篾片顺着背部,直上至篾片尽头处,用墨点标记。这只是取中点,并非灸穴。再用薄篾片量手中指节两横纹为一寸,将篾片在所点的墨上,两旁各量一寸,即为穴位。各灸五壮或七壮,止住不可多灸。此法灸之,没有不痊愈的。大概这两个穴位是心脉所经过的地方,凡是痈疽的疾病,都是心气留滞,所以产生此毒。灸此穴则心脉流通,实时安宁痊愈,可以起死回生,有非常显著的疗效。(出自《神应经》)
按《类经》说:一本写作各开二寸。《针灸聚英》说:根据此法量取的穴位在督脉脊中线的至阳穴、筋缩穴之间,外侧太阳经行于背部的第二行膈俞、肝俞之内,不是正当的穴位。怀疑一定是后人传抄错误,把三寸写成二寸罢了。哪有不得到正确穴位,白白破坏好肉,却能治愈疾病的道理呢?这一点不能怀疑。阿是穴说:此穴出自各种书籍,不知其始源。
Regarding the Sihuacupping acupoints (Four Flowers Moxibustion points). Various books record them differently. In the collated version of *Su Shen Liang Fang* (Excellent Prescriptions by Su and Shen), as stated in the preface, there are numerous textual errors (such as "Lu Yu" confusions). Now, comparing with the *Wan An Fang* (Prescriptions of Wan An), the texts in other books differ significantly. Initially, I annotated only those sentences with differences, but upon re-reading, found it rather tedious, so I deleted them all, retaining only annotations for one or two characters that differed but were easily understood in meaning. Cui's preface states that diagrams and shapes were provided, but these diagrams are not included, nor are they found in other books. Now, based on the diagrams in *Wan An Fang*, useless parts are omitted, and the text follows entirely the *Sheng Ji Zong Lu* (General Records of Benevolent Sage) and *Wan An Fang*. The introductory note on the diagram says: Moxa these six acupoints, and also moxa Zusanli (ST36, Three Mile Point) to vent fire qi is excellent. This is a matter not discussed in ancient texts.
Above: First session, mark two acupoints.
Above: Second session, mark two acupoints.
Above: Third session, mark two acupoints. The above diagrams and shapes.
According to *Zisheng Jing* (Classic of Nourishing Life): Whenever selecting the Sihuacupping acupoints, use the pith of a rice straw to measure the width of the mouth corner, cut it to that length. Cut a square piece of paper of such length, and cut a small hole in the center. Use another long rice straw, measuring from the sole of the foot forward to the big toe, and backward to the middle of the foot crease, cut it off, then place it around the Adam's apple (Jiehou), letting it hang down towards the back to see where the straw stops. Place the previously mentioned paper with the small hole in the center, dividing it into four parts, which constitutes the Four Flowers. Essentially, this refers to moxaing the four corners of the paper. Now, examining this method, it is what the secular world calls "Lue Sihuacupping" (Brief Four Flowers). *Zhenjiu Juying* (Gathering of Acupuncture and Moxibustation Brilliance) says: Initially suspecting the Sihuacupping acupoints, perhaps the ancients feared people would not know how to locate them, so they established this convenient method; it must correspond to the Five Zang Shu acupoints. Now, locating acupoints according to this method indeed corresponds to the Ge Shu (BL17, Diaphragm-Shu) and Dan Shu (BL19, Gallbladder-Shu) acupoints in the second row of the Bladder Meridian of Foot-Taiyang running along the back. *Nan Jing* (Classic of Difficult Issues) states: Blood converges at Ge Shu. It also says: For blood diseases, treat this acupoint. This is likely for cases of bone-steaming consumption fever and blood deficiency with hyperactive fire, so this acupoint is taken to tonify. The Gallbladder is the interior-exterior partner of the Liver, stores blood, so this Shu point is also selected. Cui only mentions Sihuacupping without specifying Ge Shu and Dan Shu because he was instructing crude practitioners. Now, relying only on palpation and estimation, Ge Shu and Dan Shu adjacent to the spine are correct. However, since people's mouths vary in size and width, the Sihuacupping method is inaccurate. Further research shows Gao Wu criticized Cui for having the name Sihuacupping but not following its method, arbitrarily calling it Ge and Dan Shu; students should ponder this. Also, *Zisheng Jing* says: A doctor transmitted a method: first measure horizontally across the mouth corners to get the length, take that measured straw, place it under the third thoracic vertebra on the back, measure vertically until the straw ends, mark both ends with a pen. Then measure the length of the middle finger as a standard, take that straw, measure horizontally and vertically from the two marked ends, circle the four corners with a pen; the circled spots are the acupoints. This is another simplified method and should not be followed.
Jing Men Sihuacupping: The introduction says: These are Cui's Sihuacupping acupoints. Do not moxa the two acupoints on the back; instead, open them to both sides, totaling six acupoints. The upper two acupoints are together one cun wide; the lower four flowers are equal. All are compared using hanging lines, transforming Li Gua (Fire Trigram) into Kun Gua (Earth Trigram), intending to descend Heart Fire and generate Spleen Earth. However, these are suitable only for Yang deficiency. Hua Tuo said: For wind, deficiency, cold, and heat, only deficiency patterns are unsuitable for moxa. But medical formularies also state: For deficiency damage and tuberculosis, early moxa of Gaohuang (BL43, Gallbladder-Huang) and Sihuacupping is appropriate, when deficiency damage has not yet fully formed. If thin and weak with accompanying fire, even if moxa is used, only Neiguan (PC6, Inner Pass) and Zusanli (ST36) should be moxaed to dissipate phlegm-fire. In my early years, I intended to write a treatise on why Yin Fire should not be moxaed, but did not complete it.
Riding Bamboo Horse Moxibustion Method: Use a thin bamboo strip, measure from the transverse crease of the Chize acupoint (LU5, Pool at the Crossroads) on the patient's hand, following the flesh to the tip of the middle finger, and cut it off. Take a bamboo pole externally, place the two ends of the pole on stools, have the patient disrobe and ride the bamboo pole, with feet slightly touching the ground. First, place the measured bamboo strip on the pole, stand the strip vertically along the back, go straight up to the end of the strip, and mark with ink. This merely finds the midpoint, not an acupoint. Then, use a thin bamboo strip to measure two transverse creases of the middle finger joint as one cun. Place this strip on the marked ink point, measure one cun to each side; these are the acupoints. Moxa five or seven moxa cones at each, do not exceed this amount. This method, when moxaed, results in no case that is not cured. Generally, these two acupoints are where the Heart Meridian passes. Any disease of carbuncles and sores is due to stagnation of Heart Qi, thus generating this toxicity. Moxaing here unblocks the Heart Meridian, leading to immediate peace and recovery, capable of bringing the dead back to life, with extraordinary efficacy. (From *Shen Ying*)
According to *Lei Jing* (Classified Classic): One version reads "open two cun each." *Zhenjiu Juying* says: According to this method, the located acupoints are between Zhizhong (DU9, Middle of Vertebrae) and Jinshu (DU12, Muscle Binding) on the Du Meridian in the midline of the spine, inside the second row of the Foot-Taiyang Bladder Meridian on the back (Ge Shu BL17 and Gan Shu BL18), not the proper acupoints. It is suspected that later generations transmitted errors, writing two cun instead of three cun. How could one fail to obtain the correct acupoint, merely damaging good flesh, yet cure the disease? This cannot be doubted. Ashi acupoints say: This acupoint appears in various books, but its origin is unknown.