足阳明胃经之脉。起于鼻之交 中旁。约太阳之脉。下循鼻外。上入齿中。还出侠口环出唇下交承浆。却循颐后下
廉出大迎。循颊车上耳前循发际至额颅。其支者。从大迎前下人迎。循喉咙入缺盆下膈属胃络脾。其直者。 从缺
盆下乳内廉。下挟脐入气街中。其支者。起于胃下口。循腹里。下至气街中。而合以下髀关。抵伏兔下膝膑中。下
循胫外廉。下足跗入中指外间。其支者。下廉三寸。而别入中指外间。其支者。别跗上大指间出其端。凡四十五穴。
今取八穴。
头维 在额角入发际。神庭旁开四寸五分。足少阳阳明之会。刺三分。没皮向下。禁灸。主治头风疼痛如破目
疼泪出不明。玉龙赋云。兼攒竹能治目痛头痛。
颊车(一名曲 一名曲牙) 在耳下曲颊端。近前陷中。侧卧开口取之。刺三分。灸三壮。一曰灸七壮。至七
七壮。炷如小麦。主治中风牙关不开。失音不语。口眼歪斜。颊肿齿痛。不能嚼物。颈强不得回顾。凡口眼 斜者。
则左泻右补。斜则左泻右补。灵光赋云。针齿痛。
地仓(一名会准) 夹口吻旁四分外如近下微有动脉。若久患风。其脉亦有不动者。手阳明足阳明任脉阳跷之
会。刺三分。留五呼。灸七壮。病左治右。病右治左。若过大口反 。却灸承浆即愈。主治偏风口眼歪斜。牙关不
开。齿痛颊肿。灵光赋云。地仓能止口流涎。
缺盆(一名天盖) 在肩上横骨陷中。为五脏六腑之通。刺三分。留七呼。灸三壮。刺太深令人逆息。孕妇禁
针。主治喉闭汗出瘰 寒热。缺盆中肿外溃。伤寒胸中热不已。
阴市(一名阴鼎) 在膝上三寸。伏兔下陷中。拜而取之。刺三分。留七呼。禁灸主治腰膝寒如注水。痿痹不
仁。不得屈伸。寒疝小腹痛满少气。千金云。水肿腹大灸。随年壮。
犊鼻 在膝膑下 骨上。骨解大筋陷中。形如牛鼻。故名。一曰在膝头下。近外窟解中。刺六分。灸三壮。一
曰刺三分。主治膝痛不仁。难跪起。香港脚。灵光赋云。善治风邪湿。
足三里(即下陵穴) 在膝眼下三寸。 骨外廉大筋内宛宛中 。坐而竖膝低跗取之。极重按之。则跗上动脉
正矣。足阳明所入为合。刺五分。留七呼。灸三壮。千金云。灸二百壮。至五百壮止。一云。小儿忌灸三里。三十
外方可灸。不尔反生疾。秋月不宜出血。恐土虚也。主治胃寒心腹胀痛。逆气上攻。藏气虚惫。胃气不足。恶闻食
臭。腹痛肠鸣。食不化。大便不通。小肠气。华陀云。疗五劳七伤。羸瘦虚乏瘀血乳痈外台明堂云。人年三十已外。
若不灸三里。令气上冲目使眼无光盖以三里能下气也。千金云。凡邪病大呼骂走。三里主之。名鬼邪。太乙歌云。
兼束骨刺。治项强肿痛。体重腰瘫。又云合太冲中封。治行步艰难。百证赋云。兼阴交。治中邪霍乱。天星秘诀云。
兼二间。治牙疼头痛。并喉痹小便不利等症。
厉兑 在足大指次指之端。去爪甲如韭叶。按本轮篇曰。厉兑者。足大指内次指之端也。经脉经筋等篇。俱云
中指缪刺篇曰。邪客于足阳明之络。刺足中指次指爪甲上。各一 。据此诸篇之说。可见中指次指之间。皆阳明脉
所发也。足阳明所出为井。刺一分。留一呼。灸一壮。主治面肿喉痹。齿龋恶风。百证赋云。与隐白相偕。治梦魇
不宁。
足阳明胃经的经脉,起始于鼻翼旁,与鼻根部相交,联络太阳经的脉气,向下沿鼻外侧行走,向上进入上齿中,然后退出,环绕口唇,在颏唇沟处左右交叉(承浆穴),随后沿着下颌后侧下行,经过大迎穴,沿着颊车穴上行至耳前,循行发际到达额颅。其分支从大迎穴前方下行至人迎穴,沿着喉咙进入缺盆,向下穿过膈肌,属于胃,联络脾脏。其直行者,从缺盆向下,沿乳内侧下行,挟脐两旁进入气街(腹股沟动脉搏动处)。另一分支,起于胃的下口,沿着腹腔内部下行,至气街处与前一支汇合,然后下行经过髀关穴,抵达伏兔穴,下行至膝膑骨中央,再向下沿胫骨外侧下行,经过足背,进入中趾的外侧端。又一支分支,在膝下三寸处分出,别入中趾外侧端。还有一支分支,从足背分出,进入大趾与次趾之间,出于其末端。本经共有四十五个穴位,现选取其中八个穴位进行介绍。
头维穴:位于额角入发际处,神庭穴旁开四寸五分。是足少阳胆经与足阳明胃经的交会穴。针刺深度三分,针尖向下斜刺,禁止艾灸。主治头风疼痛如破裂感、目痛流泪、视物不明。《玉龙赋》记载:配合攒竹穴能治疗目痛头痛。
颊车穴(又名曲牙):位于耳下曲颊骨端前方凹陷处。侧卧张口时取穴。针刺深度三分,艾灸三壮,一说灸七壮,最多可灸七七四十九壮,艾炷如小麦大小。主治中风引起的牙关紧闭、失音不语、口眼歪斜、颊部肿胀牙齿疼痛、不能咀嚼食物、颈部僵硬不能回顾。凡口眼歪斜者,若面左斜则泻右侧补左侧,面右斜则泻左侧补右侧。《灵光赋》记载:针刺此穴可治齿痛。
地仓穴(又名会准):位于口角旁四分处,略下方微有动脉跳动。若久患中风,此处脉搏也可能不跳动。是手阳明大肠经、足阳明胃经、任脉和阳跷脉的交会穴。针刺深度三分,留针五呼的时间,艾灸七壮。遵循“病左治右,病右治左”的原则。若口角歪斜过大反而松弛下垂,可加灸承浆穴即可痊愈。主治偏风口眼歪斜、牙关不开、齿痛颊肿。《灵光赋》记载:地仓穴能止住口角流涎。
缺盆穴(一名天盖):位于肩上横骨(锁骨)的凹陷中。为五脏六腑之气通行的要道。针刺深度三分,留针七呼的时间,艾灸三壮。针刺过深会导致气息逆乱。孕妇禁针。主治喉闭、汗出、瘰疬伴寒热、缺盆中肿胀外溃、伤寒胸中热不退。
阴市穴(一名阴鼎):位于膝上三寸,伏兔穴下方的凹陷中。跪拜姿势取穴。针刺深度三分,留针七呼的时间,禁止艾灸。主治腰膝寒冷如水注、痿痹麻木不仁、关节屈伸不利、寒疝小腹痛满、少气。《千金方》记载:水肿腹大者可灸,随患者年龄决定壮数。
犊鼻穴:位于膝膑骨下方,髌韧带外侧的凹陷中,形状像牛鼻子,因此得名。一说在膝盖头下方,靠近外侧骨缝凹陷处。针刺六分,艾灸三壮,一说针刺三分。主治膝痛麻木、难以跪起、脚气病。《灵光赋》记载:善于治疗风邪湿痹。
足三里穴(即下陵穴):位于膝眼下三寸,胫骨外侧缘与大筋之间的凹陷中。坐位竖膝,低放足背取穴。用力重按时,足背上动脉跳动明显。足阳明经气深入汇聚于此为合穴。针刺五分,留针七呼,艾灸三壮。《千金方》记载:可灸二百壮至五百壮为止。一说小儿忌灸三里,三十岁以后方可灸,否则反而生疾病。秋季不宜在此穴出血,恐伤土气。主治胃寒心腹胀痛、气逆上攻、脏腑气虚疲惫、胃气不足、厌恶闻食物气味、腹痛肠鸣、饮食不化、大便不通、小肠气痛。华佗说:治疗五劳七伤、羸瘦虚乏、瘀血、乳痈。《外台秘要》和《明堂》记载:人年三十岁以上,若不灸三里穴,会使气上冲头部,导致眼睛无光泽,因为三里穴能降气。《千金方》记载:凡是邪气致病,大声骂詈、奔走狂乱者,三里穴主治之,名为鬼邪。《太乙歌》记载:配合束骨穴针刺,治疗项强肿痛、体重腰瘫。又说配合太冲、中封穴,治疗行走艰难。《百证赋》记载:配合阴交穴,治疗中邪霍乱。《天星秘诀》记载:配合二间穴,治疗牙疼头痛、喉痹、小便不利等症。
厉兑穴:位于足大趾与次趾(第二趾)的末端,距离爪甲边缘如韭菜叶宽度。按《灵枢·本输》篇记载:“厉兑者,足大指内次指之端也。”《经脉》、《经筋》等篇也都说是中指(此处指第二趾,古称中指或次指,需结合语境,通常厉兑在大趾次趾间,但原文此处引用有误或版本差异,原文写“中指”,后文又提“足中指次指”,根据标准解剖,厉兑在大趾外侧端,但此处依原文翻译)。《缪刺》篇记载:“邪客于足阳明之络,刺足中指次指爪甲上。”据此诸篇之说,可见大趾与次趾之间,皆属阳明脉所发之处。足阳明经气由此发出为井穴。针刺一分,留针一呼的时间,艾灸一壮。主治面肿、喉痹、龋齿恶风。《百证赋》记载:与隐白穴相配,治疗梦魇不安。
The meridian of Foot-Yangming Stomach starts at the side of the nose, intersecting with the root of the nose, connecting with the meridians of Taiyang (Greater Yang), descends along the lateral aspect of the nose, enters the upper teeth, then emerges, surrounds the lips, crosses at Chengjiang (Chin Groove) below the lower lip, and then follows the posterior aspect of the mandible, descending to Daying (Great Meeting). It proceeds along Jiache (Chejia) to the front of the ear, follows the hairline to the forehead. A branch descends from the anterior aspect of Daying to Renying (Human Well), follows the throat, enters Quepen (Clavicular Fossa), passes through the diaphragm, belongs to the Stomach, and connects with the Spleen. The main trunk descends from Quepen, along the medial aspect of the mammary region, down alongside the umbilicus into Qichong (Femoral Artery). Another branch originates from the lower opening of the Stomach, runs within the abdominal cavity, and meets the previous branch in Qichong, then descends to Bituan (Hip Joint), reaches Futu (Thigh Rabbit), descends to the center of the patella, continues down the lateral aspect of the tibia, passes over the dorsum of the foot, and enters between the toes of the second toe. Another branch diverges three cun below the knee, entering between the toes of the second toe. Yet another branch diverges from the dorsum of the foot, enters between the first and second toes, and emerges at their tips. There are forty-five acupoints in this meridian; eight are selected here for description.
Touwei: Located at the corner of the forehead, entering the hairline, 4.5 cun lateral to Shenting (Spirit Hall). It is the meeting point of Foot-Shaoyang Gallbladder and Foot-Yangming Stomach meridians. Puncture 0.3 cun obliquely downwards; moxibustion is contraindicated. It treats headache resembling bursting sensation due to wind, eye pain with tearing, and blurred vision. *Yulong Fu* states: Combined with Zanzhu, it treats eye pain and headache.
Jiache (also known as Quya): Located in the depression anterior to the angle of the mandible below the ear. Take the point with the mouth open while lying on the side. Puncture 0.3 cun; moxibustion 3 moxa cones, or alternatively 7 cones, up to 49 cones, with cone size like a wheat grain. It treats trismus (lockjaw), aphonia, facial paralysis (deviation of mouth and eyes), swelling of the cheek, toothache, inability to chew, neck stiffness preventing turning the head. For facial deviation, if the face deviates to the left, reduce the right and tonify the left; if to the right, reduce the left and tonify the right. *Lingguang Fu* states: Needling this point treats toothache.
Dicang (also known as Huizhun): Located 0.4 cun lateral to the corner of the mouth, slightly inferior where a slight arterial pulse may be felt. In chronic wind-stroke cases, the pulse might not be palpable. It is the meeting point of Hand-Yangming Large Intestine, Foot-Yangming Stomach, Ren Mai (Conception Vessel), and Yangqiao Mai. Puncture 0.3 cun; retain needle for five breaths; moxibustion 7 cones. Follow the principle of treating the opposite side for disease on one side. If the mouth deviation is severe with flaccidity, adding moxibustion at Chengjiang can cure it. It treats hemifacial paralysis, trismus, toothache, and cheek swelling. *Lingguang Fu* states: Dicang stops drooling.
Quepen (also known as Tian Gai): Located in the depression of the clavicle on the shoulder. It is a thoroughfare for the Qi of the five Zang and six Fu organs. Puncture 0.3 cun; retain needle for seven breaths; moxibustion 3 cones. Deep puncture may cause dyspnea. Contraindicated in pregnancy. It treats laryngeal obstruction, sweating, scrofula with chills and fever, swelling and ulceration in the supraclavicular fossa, and persistent chest heat from Cold Damage (Shanghan).
Yinshi (also known as Yinding): Located 3 cun above the knee, in the depression below Futu. Take the point in a kneeling position. Puncture 0.3 cun; retain needle for seven breaths; moxibustion is contraindicated. It treats coldness in the waist and knees as if water is pouring, flaccidity and numbness, difficulty in flexion and extension, cold hernia with lower abdominal fullness and pain, and shortness of breath. *Qianjin Fang* states: For edema and abdominal distension, apply moxibustion according to the patient's age in number of cones.
Dubi: Located below the patella, in the depression lateral to the patellar ligament, shaped like an ox's nose, hence the name. Alternatively described as below the knee cap, near the lateral joint space. Puncture 0.6 cun; moxibustion 3 cones, or alternatively puncture 0.3 cun. It treats knee pain and numbness, difficulty in kneeling and rising, and gout (Hong Kong foot). *Lingguang Fu* states: It effectively treats wind-damp bi syndrome.
Zusanli (also known as Xialing): Located 3 cun below the knee eye, in the depression between the lateral border of the tibia and the large tendon. Take the point sitting with the knee vertical and foot lowered. Press heavily to feel the arterial pulse on the dorsum of the foot. The Qi of Foot-Yangming enters here to become the He-Sea point. Puncture 0.5 cun; retain needle for seven breaths; moxibustion 3 cones. *Qianjin Fang* states: Moxibustion can be applied from 200 to 500 cones. Some say children should avoid moxibustion on Zusanli; it is suitable only after age thirty, otherwise it may cause illness. Bleeding from this point in autumn is unfavorable as it may weaken Earth Qi. It treats stomach cold with epigastric fullness and pain, rebellious Qi attacking upward, deficiency exhaustion of Zang-Fu Qi, insufficient Stomach Qi, aversion to food odors, abdominal pain with borborygmus, indigestion, constipation, and intestinal Qi pain. Hua Tuo stated: It treats five labors and seven injuries, emaciation, deficiency, blood stasis, and mastitis. *Waitai Mingtang* states: For those over thirty, failing to moxa Zusanli allows Qi to rush upward, causing dull eyesight, because Zusanli directs Qi downward. *Qianjin Fang* states: For manic disorders involving shouting and running, Zusanli is indicated, termed "Ghost Evil". *Taiyi Ge* states: Combined with Shugu needling, it treats neck stiffness and swelling, heavy body, and lumbar paralysis. Also combined with Taichong and Zhongfeng, it treats difficulty walking. *Baizheng Fu* states: Combined with Yinjiao, it treats epidemic cholera due to pathogenic invasion. *Tianxing Mijue* states: Combined with Erjian, it treats toothache, headache, pharyngolaryngeal obstruction, and dysuria.
Lidui: Located at the tip of the second toe, about the width of a leek leaf from the nail. According to *Lingshu · Benshu*: "Lidui is the end of the inner second toe." Other chapters like *Jingmai* and *Jingjin* also refer to this area. *Miuci* chapter states: "When evil invades the collaterals of Foot-Yangming, puncture the nails of the middle and second toes." Based on these texts, the area between the first and second toes is where Yangming meridians emerge. The Qi of Foot-Yangming exits here as the Jing-Well point. Puncture 0.1 cun; retain needle for one breath; moxibustion 1 cone. It treats facial swelling, pharyngolaryngeal obstruction, dental caries with aversion to wind. *Baizheng Fu* states: Paired with Yinbai, it treats nightmare anxiety.