(凡十九穴)
骨度篇曰。结喉以下。至缺盆长四寸。
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廉泉(灵枢)一名本池。(甲乙)一名舌本。(资生)颔下结喉上。舌本下。(甲乙)当颐直下
骨后。陷者中。(千金诸风篇)结喉上中央。(类经)
按舌本。大成。作舌水。大全。作吉本。气府论曰。喉中央。二。次注曰。谓廉泉天突
二穴也。刺疟篇曰。舌下两脉廉泉也。是谓两脉中央也。千金。并翼方。圣济。发挥。无舌本下
之下字。入门。宝鉴。下作间。聚英。医统作颔下结喉上四寸。此穴。何须折量。类经曰。
仰而取之。说见下。
人迎(素问)一名天五会。(甲乙)挟喉之动脉也。又颈侧。在婴筋之前。(灵枢)颈大脉。
动应手。挟结喉。以候五脏气。(甲乙)不灸。禁深刺。(甲乙)
按资生。圣济。聚英。医统。大全。吴文炳。宝鉴。大成。无天字。千金翼。作大筋脉
。次注。发挥。类经。聚英。入门。医统。大成。金鉴。作结喉侧。一寸五分。此根据甲乙。扶突注
。然颈侧诸穴。不须分寸。但取筋之前后。此古法也。此穴挟结喉。圣济曰。仰而取之。不取
水突(甲乙)一名水门。(甲乙)颈大筋前。直人迎下。气舍上。(甲乙)人迎下。气舍上。二穴之中。(入门)
按突。甲乙作天。字误类经曰。挟气舍上。内贴气喉。千金注曰。曲颊下一寸。近后。并非。
气舍(甲乙)颈。直人迎下。挟天突。陷者中。(甲乙)贴骨尖上有缺。(类经)
按类经。作挟天突边。入门。宝鉴作挟旁。拘矣。金鉴。作结喉下一寸。非。
扶突(素问)一名水穴。(外台)婴筋之后。(灵枢)人迎后一寸五分。(甲乙)
按一寸五分。说见前。与人迎。隔一大筋。是穴也。千金。作气舍后一寸半。发挥。吴文炳
。宝鉴。聚英。从之。大成。作气舍上。并非。千金翼。外台。次注。作曲颊下一寸人迎后
。拘矣。次注曰。仰而取之。非是。凡颈侧诸穴。仰则筋脉难摸索。故正面而取之。
天鼎(甲乙)一名天顶。(大全)缺盆上。直扶突。气舍后一寸五分。(甲乙)侧颊。(入门)
按天突侧皆言缺盆。取其形状。故灵枢指天突言缺盆之中者。可见焉。直扶突绝句。言
此穴在扶突直下当气舍后也。扶突与人迎隔筋。其直下就气舍后取之。次注。作半寸。盖寸半之误
。资生。圣济以下诸书。作扶突后一寸。拘矣。千金。作颈缺盆。直扶突。曲颊下一寸。人
迎后。与扶突注。混。不可从。明堂。作天顶。盖音通。人以为一名。暂从之。
天窗(素问)一名窗笼。(甲乙)挟扶突。(素问)曲颊下。扶突后。动脉应手。陷者中。(
甲乙)颈大筋前。(资生)
按窗。资生。作 。笼。外台作聋。聚英。大全。作龙。灵枢云。窗笼者。耳中也。
张介宾曰。即听宫。与此不同。入门曰。完骨下发际上。颈上大筋处。误也。前大成。作间。又奇穴
部有天窗。与之不同。
天容(灵枢)耳下曲颊之后。(灵枢)颊车后陷中。(入门)
按甲乙。无下字。千金。外台等。皆作耳下。千金翼。无曲字。
天牖(素问)颈筋间。缺盆上。天容后。天柱前。完骨后。发际上(甲乙)禁灸(资生○医
统曰
诸书作完骨下。不是。气府论云。下完骨后。各一。次注曰。天牖二穴可以见也。灵枢。任
脉侧。七次动脉。一次人迎。足阳明也。二次扶突。手阳明也。三次天窗。手太阳也。四次天
容。足少阳也。五次天牖。手少阳也。六次天柱。足太阳也。七次风府。督脉也。发挥。作天
窗后。窗。容字相似故误耳。千金。作发际上一寸。入门。从之。就发际上。求之于婴筋颈
筋间。乃上两筋合。下发际也。故不须折量分寸。其言一寸者。误。入门。作耳下大筋外。
类经云上挟耳后一寸。亦误矣。明堂云。貌骨穴下发际。宛宛中。貌骨穴。未详。恐完骨之
误。
缺盆(素问)一名天盖。(甲乙)肩上横骨。陷者中。(甲乙)禁深刺。(甲乙)
按天。聚英。吴文炳。作尺。骨空论云。失枕在肩上横骨间。次注曰。谓缺盆穴也。资
生。发挥。聚英医统吴文炳。并作下。非是。入门。宝鉴。作前。马莳。注证发微。作去中行寸半非
(本节共记载十九个穴位)
[项颈部穴位图]
廉泉穴(出自《灵枢》),又名本池(出自《甲乙经》),又名舌本(出自《资生篇》)。位置在颔下、结喉上方、舌根下方(出自《甲乙经》)。正当下颌直下,骨头后方凹陷处(出自《千金方·诸风篇》)。结喉上方的正中央(出自《类经》)。
按语:关于“舌本”,《针灸大成》写作“舌水”,《针灸大全》写作“吉本”。《气府论》说:“喉中央,二穴。”次注解释说,指的是廉泉和天突这两个穴位。《刺疟篇》说:“舌下两脉即廉泉穴。”这是指两脉的中央。《千金方》、《备急千金要方》、《圣济总录》、《发挥》等书中,没有“舌本下”的“下”字。《入门》、《医宗金鉴》中,“下”写作“间”。《针灸聚英》、《医统》写作“颔下结喉上四寸”。这个穴位,何必非要折算度量呢?《类经》说:“仰头取穴。”说法见下文。
人迎穴(出自《素问》),又名天五会(出自《甲乙经》)。是挟持喉咙的动脉。又说在颈侧,位于婴筋(胸锁乳突肌前缘)之前(出自《灵枢》)。颈侧大脉,跳动应手,挟持结喉,用来候察五脏之气(出自《甲乙经》)。禁灸,禁止深刺(出自《甲乙经》)。
按语:《资生篇》、《圣济总录》、《针灸聚英》、《医统》、《针灸大全》、吴文炳、《医宗金鉴》、《针灸大成》中,没有“天”字。《千金翼方》写作“大筋脉”。次注,《发挥》、《类经》、《针灸聚英》、《入门》、《医统》、《针灸大成》、《医宗金鉴》写作“结喉侧一寸五分”。这是依据《甲乙经》中扶突穴的注释。然而颈侧各穴,不需要用分寸来衡量,只需取筋的前后位置,这是古法。此穴挟持结喉,《圣济总录》说:“仰头取之。”不取水突穴(出自《甲乙经》),又名水门(出自《甲乙经》)。位于颈大筋前,直于人迎穴之下,气舍穴之上(出自《甲乙经》)。在人迎与气舍两穴之间(出自《入门》)。
按语:“突”字,《甲乙经》作“天”,属误字。《类经》说:“挟持气舍穴上方,内贴气喉。”《千金方》注说:“曲颊下一寸,偏后,并非如此。”
气舍穴(出自《甲乙经》)。在颈部,直于人迎穴之下,挟持天突穴,凹陷处(出自《甲乙经》)。贴附于骨尖上有缺口处(出自《类经》)。
按语:《类经》写作“挟持天突穴边”。《入门》、《医宗金鉴》写作“挟持旁边”,过于拘泥。《医宗金鉴》写作“结喉下一寸”,不对。
扶突穴(出自《素问》),又名水穴(出自《外台秘要》)。位于婴筋之后(出自《灵枢》)。人迎穴后一寸五分(出自《甲乙经》)。
按语:一寸五分的说法见前文。此穴与人迎穴隔着一根大筋。《千金方》写作“气舍穴后一寸半”。《发挥》、吴文炳、《医宗金鉴》、《针灸聚英》都遵从这一说法。《针灸大成》写作“气舍穴上”,并不正确。《千金翼方》、《外台秘要》、次注写作“曲颊下一寸,人迎穴后”,过于拘泥。次注说:“仰头取之”,不对。凡是颈侧各穴,仰头则筋脉难以触摸,所以应正面取穴。
天鼎穴(出自《甲乙经》),又名天顶(出自《针灸大全》)。缺盆穴上方,直对扶突穴,气舍穴后一寸五分(出自《甲乙经》)。侧颊(出自《入门》)。
按语:天突穴两侧都提到缺盆,是取其形状,所以《灵枢》指天突穴为缺盆之中,由此可见。直对扶突穴是一句完整的话,意思是此穴在扶突穴直下,正当气舍穴后方。扶突与人迎穴隔筋,其直下就气舍穴后方取穴。次注写作“半寸”,大概是“寸半”的误写。《资生篇》及《圣济总录》以下诸书,写作“扶突穴后一寸”,过于拘泥。《千金方》写作“颈缺盆,直对扶突,曲颊下一寸,人迎穴后”,与扶突穴的注释混淆,不可遵从。《明堂》写作“天顶”,大概音通,人们以为是一个别名,暂且遵从它。
天窗穴(出自《素问》),又名窗笼(出自《甲乙经》)。挟持扶突穴(出自《素问》)。曲颊下,扶突穴后,动脉应手,凹陷处(出自《甲乙经》)。颈大筋前(出自《资生篇》)。
按语:“窗”字,《资生篇》写作某字(原文模糊或异体)。“笼”字,《外台秘要》作“聋”,《针灸聚英》、《针灸大全》作“龙”。《灵枢》说:“窗笼者,耳中也。”张介宾说:“即听宫穴,与此不同。”《入门》说:“完骨下发际上,颈上大筋处”,是错误的。以前的《针灸大成》写作“间”。另外奇穴部也有天窗穴,与此不同。
天容穴(出自《灵枢》)。耳下曲颊之后(出自《灵枢》)。颊车穴后凹陷中(出自《入门》)。
按语:《甲乙经》没有“下”字。《千金方》、《外台秘要》等都写作“耳下”。《千金翼方》没有“曲”字。
天牖穴(出自《素问》)。颈筋间,缺盆上,天容穴后,天柱穴前,完骨穴后,发际上(出自《甲乙经》)。禁灸(出自《资生篇》○《医统》说:诸书写作“完骨下”,不对。《气府论》说:“下完骨后,各一穴。”次注说:“天牖二穴可以看见。”《灵枢》记载任脉侧面有七次动脉:第一次是人迎穴,足阳明经;第二次是扶突穴,手阳明经;第三次是天窗穴,手太阳经;第四次是天容穴,足少阳经;第五次是天牖穴,手少阳经;第六次是天柱穴,足太阳经;第七次是风府穴,督脉。《发挥》写作“天窗后”,是因为“窗”、“容”字形相似故误。《千金方》写作“发际上一寸”。《入门》遵从这一说法。就在发际上,求之于婴筋、颈筋之间,乃是上面两根筋汇合,下面发际之处。所以不需要折算度量分寸。说是一寸,是错误的。《入门》写作“耳下大筋外”。《类经》说“上挟耳后一寸”,也是错误的。《明堂》说:“貌骨穴下发际,宛宛中。”貌骨穴,不详,恐怕是完骨穴之误。)
缺盆穴(出自《素问》),又名天盖(出自《甲乙经》)。肩上横骨,凹陷处(出自《甲乙经》)。禁深刺(出自《甲乙经》)。
按语:“天”字,《针灸聚英》、吴文炳写作“尺”。《骨空论》说:“失枕在肩上横骨间。”次注说:“谓缺盆穴也。”《资生篇》、《发挥》、《针灸聚英》、《医统》、吴文炳,都写作“下”,不对。《入门》、《医宗金鉴》写作“前”。马莳注《证治发微》,写作“去中行寸半”,不对。
(There are nineteen acupoints in total)
The "Bone Measurement Chapter" (Gu Du Pian) states: From below the laryngeal prominence (Jie Hou) to the supraclavicular fossa (Que Pen), the length is four cun.
[Diagram of Neck and Nape Acupoints]
Lianquan (CV23, Lianquan) [Ling Shu], also known as Benchi (Jia Yi Jing), also known as Sheben (Zi Sheng Pian). Location: Below the chin, above the laryngeal prominence, below the root of the tongue (Jia Yi Jing). Directly below the chin, in the depression behind the bone (Qian Jin Fang - Chapter on Various Wind Diseases). In the center above the laryngeal prominence (Lei Jing).
Note: Regarding "Sheben" (Root of Tongue), Da Cheng writes "Sheshui", Da Quan writes "Jiben". The "Qi Fu Lun" states: "Two points in the center of the throat." The secondary annotation explains: This refers to the two acupoints Lianquan and Tiantu. The "Ci Nie Pian" states: "The two vessels under the tongue are Lianquan." This refers to the center between the two vessels. Qian Jin Fang, Yi Fang, Sheng Ji Zong Lu, Fa Hui do not include the character "xia" (below) in "Sheben xia". Ru Men, Bao Jian write "jian" (between) instead of "xia". Ju Ying, Yi Tong write "four cun above the laryngeal prominence below the chin". For this acupoint, why is it necessary to measure precisely? Lei Jing states: Take the point with the head extended. See the explanation below.
Renying (ST9, Renying) [Su Wen], also known as Tian Wuhui (Jia Yi Jing). It is the pulsating artery flanking the throat. Also located on the side of the neck, anterior to the yingjin (sternocleidomastoid muscle) (Ling Shu). The large vessel on the side of the neck pulses palpably, flanking the laryngeal prominence, used to observe the qi of the five zang organs (Jia Yi Jing). Moxibustion is prohibited; deep needling is forbidden (Jia Yi Jing).
Note: Zi Sheng Pian, Sheng Ji Zong Lu, Ju Ying, Yi Tong, Da Quan, Wu Wenbing, Bao Jian, Da Cheng do not have the character "tian". Qian Jin Yi Fang writes "da jin mai" (large tendon vessel). Secondary annotations in Fa Hui, Lei Jing, Ju Ying, Ru Men, Yi Tong, Da Cheng, Jin Jian write "one cun five fen lateral to the laryngeal prominence". This is based on the annotation for Futu in Jia Yi Jing. However, for acupoints on the side of the neck, precise measurement in cun is not required; one should simply locate them relative to the tendons. This is the ancient method. This acupoint flanks the laryngeal prominence. Sheng Ji Zong Lu states: Take the point with the head extended. Do not take Shuitu (Jia Yi Jing), also known as Shuimen (Jia Yi Jing). Located anterior to the large tendon of the neck, directly below Renying and above Qishe (Jia Yi Jing). Between Renying and Qishe (Ru Men).
Note: The character "tu" is written as "tian" in Jia Yi Jing, which is an error. Lei Jing states: Flanking the upper part of Qishe, adhering internally to the airway. Qian Jin Fang annotation states: One cun below the angle of the jaw, posteriorly, which is incorrect.
Qishe (ST10, Qishe) [Jia Yi Jing]. On the neck, directly below Renying, flanking Tiantu, in the depression (Jia Yi Jing). Adhering to the bony prominence, there is a gap (Lei Jing).
Note: Lei Jing writes "flanking the side of Tiantu". Ru Men, Bao Jian write "flanking the side", which is too rigid. Jin Jian writes "one cun below the laryngeal prominence", which is incorrect.
Futu (ST17, Futu) [Su Wen], also known as Shuixue (Wai Tai Mi Yao). Posterior to the yingjin (Ling Shu). One cun five fen posterior to Renying (Jia Yi Jing).
Note: The measurement of one cun five fen is explained earlier. This acupoint is separated from Renying by a large tendon. Qian Jin Fang writes "one cun half posterior to Qishe". Fa Hui, Wu Wenbing, Bao Jian, Ju Ying follow this. Da Cheng writes "above Qishe", which is incorrect. Qian Jin Yi Fang, Wai Tai Mi Yao, secondary annotation write "one cun below the angle of the jaw, posterior to Renying", which is too rigid. The secondary annotation also states: Take the point with the head extended, which is incorrect. For all acupoints on the side of the neck, extending the head makes the tendons difficult to palpate; therefore, they should be taken with the face forward.
Tianding (SI11, Tianding) [Jia Yi Jing], also known as Tian Ding (Da Quan). Above Que Pen, directly opposite Futu, one cun five fen posterior to Qishe (Jia Yi Jing). Lateral cheek (Ru Men).
Note: Both sides of Tiantu mention Que Pen, referring to its shape. Thus, Ling Shu refers to Tiantu as being in the middle of Que Pen, which can be seen here. "Directly opposite Futu" is a complete sentence, meaning this acupoint is directly below Futu, corresponding to the posterior aspect of Qishe. Futu and Renying are separated by a tendon; taking the point directly below Futu at the posterior aspect of Qishe. The secondary annotation writes "half cun", likely a typo for "one cun five fen". Zi Sheng Pian and subsequent books like Sheng Ji Zong Lu write "one cun posterior to Futu", which is too rigid. Qian Jin Fang writes "neck and Que Pen, directly opposite Futu, one cun below the angle of the jaw, posterior to Renying", which confuses the annotation for Futu and should not be followed. Ming Tang writes "Tian Ding", likely due to phonetic similarity, considered an alias, tentatively accepted.
Tianchuang (SI16, Tianchuang) [Su Wen], also known as Chuang Long (Jia Yi Jing). Flanking Futu (Su Wen). Below the angle of the jaw, posterior to Futu, where the artery pulses palpably, in the depression (Jia Yi Jing). Anterior to the large tendon of the neck (Zi Sheng Pian).
Note: The character "chuang" in Zi Sheng Pian is written as [missing/variant]. The character "long" is written as "long" (deaf) in Wai Tai Mi Yao, and "long" (dragon) in Ju Ying, Da Quan. Ling Shu states: "Chuang long refers to the ear." Zhang Jiebin states: This is Tinggong (SI19), which is different. Ru Men states: Above the hairline below Wanggu, at the large tendon of the neck, which is incorrect. Previous editions of Da Cheng write "jian". Additionally, there is a Tianchuang acupoint in the Extraordinary Points section, which is different.
Tianrong (SI17, Tianrong) [Ling Shu]. Posterior to the angle of the jaw below the ear (Ling Shu). In the depression posterior to Jiache (Ru Men).
Note: Jia Yi Jing does not have the character "xia". Qian Jin Fang, Wai Tai Mi Yao, etc., all write "below the ear". Qian Jin Yi Fang lacks the character "qu".
Tianyou (SI15, Tianyou) [Su Wen]. Between the neck tendons, above Que Pen, posterior to Tianrong, anterior to Tianzhu, posterior to Wanggu, above the hairline (Jia Yi Jing). Moxibustion is prohibited (Zi Sheng Pian ○ Yi Tong states: All books write "below Wanggu", which is incorrect. Qi Fu Lun states: "One below each point posterior to Wanggu." Secondary annotation states: The two Tianyou points can be seen. Ling Shu lists seven arterial pulses on the side of the Ren Mai. First is Renying, Foot Yangming; second is Futu, Hand Yangming; third is Tianchuang, Hand Taiyang; fourth is Tianrong, Foot Shaoyang; fifth is Tianyou, Hand Shaoyang; sixth is Tianzhu, Foot Taiyang; seventh is Fengfu, Du Mai. Fa Hui writes "posterior to Tianchuang", an error due to the similarity of "chuang" and "rong". Qian Jin Fang writes "one cun above the hairline". Ru Men follows this. Seeking it just above the hairline, between the yingjin and neck tendons, where the two upper tendons converge and the lower hairline begins. Therefore, precise measurement is unnecessary. Those stating "one cun" are mistaken. Ru Men writes "lateral to the large tendon below the ear". Lei Jing states "one cun posterior to the ear", which is also incorrect. Ming Tang states: "In the hollow above the hairline at the Miaogu acupoint." Miaogu acupoint is unknown, likely a typo for Wanggu.
Que Pen (ST12, Quepen) [Su Wen], also known as Tian Gai (Jia Yi Jing). In the depression of the transverse bone on the shoulder (Jia Yi Jing). Deep needling is prohibited (Jia Yi Jing).
Note: The character "tian" is written as "chi" in Ju Ying, Wu Wenbing. Gu Kong Lun states: "Stiff neck occurs in the transverse bone on the shoulder." Secondary annotation states: This refers to the Quepen acupoint. Zi Sheng Pian, Fa Hui, Ju Ying, Yi Tong, Wu Wenbing all write "xia" (below), which is incorrect. Ru Men, Bao Jian write "qian" (anterior). Ma Shi's annotation in Zheng Fa Wei writes "one cun half from the midline", which is incorrect.