宝鉴曰。邪在五脏。则阴脉不和。不和则血留之。结阴之病。阴气内结。不得外行。无
所禀。渗入肠间。故便血。灸中脘、三里、气海等穴。便血不止。灸劳宫、太白、会阳。
丹溪曰。气逆也。气自脐下直冲。上出于口。而作声也。人之阴气。根据胃为养。胃土伤
损。
。严氏曰。灸乳下一指。男左女右。与乳相直问陷中。灸三壮。妇人屈乳头向下尽处。宝鉴
曰。病甚者。灸二七壮。武按。此穴名乳根也。
丹溪曰。是人受得天地间杀厉之风。以其酷烈暴悍可畏也。不外乎阳明一经。病机云。
灸承
也。内经云。数刺肿上出血。子和曰。刺其面大脉。出血如墨。刺三次。血色变。每刺自额
至颐。针上下俱刺。每隔一日一刺。刺至二十余日方已。刘氏曰。委中皆可出血。同汗也。
刘氏曰。此疾与中风颠狂。小儿急慢惊相类。原其所由。或在母腹中受惊。或因闻大惊
而得
心窍。治法必当寻火寻痰而治。丹溪曰。不必分六畜牛马鸡犬。大率主痰火。
洁古云。昼发灸阳跷。夜发灸阴跷。各二七壮。千金方。惊痫按图灸之。一小儿四岁。
与长
阴厥脉绝。气海脏结。阴汗不止。腹胀肠鸣。面黑。指甲青。石关、关元。宜灸百壮。
阳陵
刘氏曰。大抵不可刺者。宜灸之。一则沉寒痼冷。二则无脉知阳绝也。三则腹皮急而阳陷也
。舍此三者。余皆不可灸。医学发明云。陷下则灸之。天地间阴阳二气而已。阳在外在上。
阴在内在下。今言陷下者。阳气下陷入阴血之中。是阴反居其上而覆其阳。脉证俱见寒在外
者。则灸之。异法方宜论云。北方之人。宜灸 也。为冬寒火旺。伏阳在内。皆宜灸之。以
至理论。则肾主脏。藏阳气在内。冬三月。主闭藏是也。若太过则病。固宜灸 。此阳明陷
入阴水之中是也。难经曰。热病在内。取会之气穴。为阳陷入阴中。取阳气通天之窍穴。以
火引火而道之。此宜灸 也。若将有病。一概灸之。岂不误哉。如仲景云。微数之脉。慎不
可灸。因火为邪。则为烦逆。追虚逐实。血散脉中。火气虽微。内攻有力。焦骨伤筋。血难
复也。又云。脉浮宜以汗解。用火灸之。邪无从出。因火而盛。病从腰以下必重而痹。名火
逆也。脉浮热甚而灸之。此为实实而虚虚治。因火而动。必咽燥唾血。又云。身之穴三百六
十有五。其三十穴灸之有害。七十九穴刺之为灾。并中髓也。此仲景伤寒例。
按明堂针经条下。所说禁忌明矣。内经云。脉之所见邪之所在。脉沉者。邪气在内。脉
浮者
不渴。欲覆浓衣。常恶寒。手足厥。皮肤干枯。其脉必沉细而迟。但有一二证。皆宜灸之。
阳气陷故也。若身热恶热。时见躁作。或面赤黄。咽干嗌干口干。舌上黄赤。时渴。咽嗌痛
。皆热在外也。但有一二证。皆不宜灸。其脉必浮数。或但数亦不可灸。灸之灾害立生。若
有鼻不闻香臭。鼻流清涕。或欠或嚏。恶寒。其脉必沉。是脉证相应也。或轻手得弦紧者。
是阴伏其阳也。虽面赤宜灸之。不可拘于面赤色而禁之也。
《宝鉴》说:邪气侵犯五脏,就会导致阴脉不和。阴脉不和则血液停滞。结阴病,是阴气在体内凝结,不能向外运行,无所禀受,渗入肠间,所以导致便血。灸中脘、足三里、气海等穴位。如果便血不止,灸劳宫、太白、会阳穴。
丹溪说:这是气逆。气从脐下直冲而上,出于口,发出声音。人的阴气,依靠胃来滋养。如果胃土受损……(原文此处有缺漏)。严氏说:灸乳头下一指处,男性取左侧,女性取右侧,与乳头垂直对应的凹陷中,灸三壮。妇女将乳头向下弯曲至尽头处……(原文此处有缺漏)。《宝鉴》说:病情严重的,灸十四壮。我(高武)按语:这个穴位名叫乳根。
丹溪说:这是人感染了天地间杀厉的风邪,因为这种风邪酷烈暴悍,令人畏惧。不外乎阳明一经。《病机》说……(原文此处有缺漏)。《内经》说:多次针刺肿处使其出血。子和说:刺其面部的较大脉络,放出如墨色的血。刺三次,血色改变。每次从额头刺到下巴,上下都刺。每隔一天刺一次,刺二十多天才能痊愈。刘氏说:委中穴都可以放血,这与发汗道理相同。
刘氏说:这种病与中风、癫狂、小儿急慢惊风相似。追溯其根源,有的在母腹中受惊,有的因听到巨大惊吓而得病……(原文此处有缺漏)心窍。治疗方法必须寻找火和痰来治疗。丹溪说:不必区分牛马鸡犬六畜。大体上主治痰火。洁古说:白天发作灸阳跷脉,夜间发作灸阴跷脉,各灸十四壮。《千金方》记载:惊痫按照图谱灸治。有一个四岁的小儿……(原文此处有缺漏)。
阴厥脉绝,气海脏结,阴汗不止,腹胀肠鸣,面色黑,指甲青。石关、关元穴,宜灸百壮。阳陵……(原文此处有缺漏)。刘氏说:大体上不可针刺的病症,宜用灸法。一是沉寒痼冷,二是无脉可知阳气绝脱,三是腹皮紧急而阳气下陷。除了这三种情况,其余都不宜灸。《医学发明》说:脉象陷下的就灸它。这只是天地间的阴阳二气罢了。阳在外在上,阴在内在下。现在说的陷下,是指阳气下陷入阴血之中,这是阴反而居其上覆盖住阳。脉证都表现为寒在外的,就用灸法。《异法方宜论》说:北方的人,宜用灸法……(原文此处有缺漏)。这是因为冬寒火旺,伏阳在内,都适宜灸法。以《至真要大论》的理论来看,肾主脏,藏阳气在内,冬三月主闭藏。如果太过就会生病,固宜灸……(原文此处有缺漏)。这是阳明陷入阴水之中。《难经》说:热病在内,取会穴之气穴。因为阳陷入阴中,取阳气通天之窍穴,以火引火而导之,这适宜灸……(原文此处有缺漏)。如果有病,一概都用灸法,难道不错误吗?如张仲景说:脉微数,慎重不可灸。因为火成为邪气,就会产生烦逆,追虚逐实,血散于脉中。火气虽然微弱,内攻却有力,焦骨伤筋,血难以恢复。又说:脉浮适宜用发汗解表,如果用火灸,邪气无从出路,因火而盛,病从腰以下必定沉重而麻痹,名叫火逆。脉浮热甚而灸之,这是实实而虚虚的治疗,因火而动,必然咽干唾血。又说:身上的穴位三百六十五个,其中三十个穴位灸之有害,七十九个穴位刺之为灾,并中髓也。这是张仲景《伤寒例》的内容。
按《明堂针经》条下,所说的禁忌很明确。《内经》说:脉所见之处即邪气所在之处。脉沉的,邪气在内;脉浮的……(原文此处有缺漏)不渴,想要盖厚衣服,经常怕冷,手足厥冷,皮肤干枯。其脉必沉细而迟。只要有一两个症状,都适宜灸法。这是阳气下陷的缘故。如果身热恶热,时常躁动发作,或者面赤黄,咽干嗌干口干,舌上黄赤,时常口渴,咽嗌痛,这都是热在外的表现。只要有一两个症状,都不宜灸。其脉必浮数,或者只是数脉也不可以灸。灸之灾害立刻产生。如果有鼻不闻香臭,鼻流清涕,或者打哈欠或打喷嚏,恶寒,其脉必沉,这是脉证相应。或者轻手触取得弦紧脉,这是阴伏其阳。虽然面赤,适宜灸之,不可拘泥于面赤色而禁止灸法。
*Baojian* states: When pathogenic factors invade the five zang organs, the yin meridians become disharmonious. Disharmony leads to blood stasis. In the disease of Jieyin (Knotted Yin), yin qi knots internally and cannot circulate externally. Lacking nourishment, it seeps into the intestines, thus causing hematochezia (blood in stool). Moxibustion is applied to Zhongwan (CV12), Zusanli (ST36), Qihai (CV6), and other acupoints. If hematochezia persists, moxibustion is applied to Laogong (PC8), Taibai (SP3), and Huiyang (BL35).
Danxi states: This is qi rebellion. Qi rushes straight up from below the umbilicus, emerges from the mouth, and produces sound. Human yin qi relies on the Stomach for nourishment. If the Earth element of the Stomach is damaged... [text missing]. Yan Shi states: Moxibustion is applied one finger-width below the nipple, on the left side for males and the right side for females, in the depression directly vertical to the nipple, three moxa cones. For women, at the end where the nipple points downward when bent... [text missing]. *Baojian* states: For severe cases, fourteen moxa cones are applied. I (Gao Wu) note: This acupoint is named Rugen (ST12).
Danxi states: This is caused by contracting the lethal wind from heaven and earth, which is fierce and terrifying. It does not exceed the Yangming meridian. The *Pathogenesis* states... [text missing]. The *Neijing* states: Repeatedly puncture the swollen area to induce bleeding. Hezi states: Puncture the large vessels on the face until blood like ink flows. Puncture three times until the blood color changes. Each session involves puncturing from the forehead to the chin, both upper and lower. Puncture every other day; treatment lasts over twenty days. Liu Shi states: Bleeding can also be induced from Weizhong (BL40); this is equivalent to sweating.
Liu Shi states: This disease resembles stroke, mania, and pediatric convulsions. Tracing its origin, it may stem from fright received in the womb or from a sudden loud shock... [text missing] affecting the heart orifices. Treatment must target fire and phlegm. Danxi states: There is no need to distinguish among the six domestic animals. Generally, the main treatment is for phlegm-fire. Jiegu states: Daytime onset is treated with moxibustion on the Yangqiao vessel; nighttime onset with the Yinqiao vessel, fourteen cones each. The *Qianjin Fang* records treating infantile convulsions according to diagrams. A four-year-old child... [text missing].
Yin jue (cold reversal) with absent pulse, Qi Hai organ knotting, continuous cold sweat, abdominal distension and borborygmi, black complexion, and cyan nails. Shiguan (ST22) and Guanyuan (CV4) should be treated with one hundred moxa cones. Yangling... [text missing]. Liu Shi states: Generally, conditions unsuitable for acupuncture are suitable for moxibustion. First, deep-seated cold and chronic cold; second, absence of pulse indicates yang collapse; third, tight abdominal skin indicates sinking of yang. Apart from these three, moxibustion is contraindicated elsewhere. The *Yixue Faming* states: "Sinking requires moxibustion." This concerns only the yin and yang qi of heaven and earth. Yang is external and superior; yin is internal and inferior. "Sinking" here refers to yang qi sinking into yin blood, where yin reverses to cover yang. When pulse and symptoms indicate cold externally, moxibustion is used. The *Yifang Fangyi Lun* states: People in the north are suited for moxibustion... [text missing]. This is because winter cold makes fire vigorous, with latent yang inside, all suitable for moxibustion. According to the *Zhihen Yao Lun*, the Kidney governs the zang organs and stores yang qi internally; the winter months govern closure and storage. Excess causes disease, so moxibustion is appropriate... [text missing]. This is Yangming sinking into yin water. The *Nanjing* states: For interior heat diseases, select the meeting acupoints. Since yang sinks into yin, select acupoints connecting yang qi to heaven, using fire to guide fire. This is suitable for moxibustion... [text missing]. If all diseases are treated uniformly with moxibustion, would it not be erroneous? As Zhang Zhongjing states: With a faint and rapid pulse, moxibustion must be avoided cautiously. Fire becomes a pathogen, causing irritability and rebellion, chasing deficiency and pursuing excess, scattering blood within the vessels. Although fire qi is slight, its internal attack is powerful, scorching bones and damaging sinews, making blood difficult to restore. He further states: Floating pulses require resolution through sweating; if moxibustion is used, pathogens have no exit, intensifying due to fire. The disease will cause heaviness and numbness from the waist down, termed fire-ni (reversal). If moxibustion is applied to floating pulses with intense heat, this treats excess as excess and deficiency as deficiency. Fire agitation will inevitably cause dry throat and hemoptysis. He also states: Of the 365 acupoints on the body, thirty are harmful if moxibusted, and seventy-nine are disastrous if needled, potentially penetrating the marrow. This is from Zhang Zhongjing's *Shanghan Li*.
According to the entries in the *Mingtang Zhenjing*, the contraindications are clear. The *Neijing* states: Where the pulse is felt is where the pathogen resides. A deep pulse indicates interior pathogens; a floating pulse... [text missing] without thirst, desiring thick clothing, frequent aversion to cold, cold extremities, and dry skin. The pulse must be deep, fine, and slow. If one or two such signs exist, moxibustion is suitable. This is due to sinking of yang qi. If there is body heat and aversion to heat, occasional restlessness, red or yellow complexion, dry throat and mouth, yellow-red tongue coating, and frequent thirst or sore throat, these indicate exterior heat. If one or two such signs exist, moxibustion is unsuitable. The pulse must be floating and rapid, or merely rapid, which also contraindicates moxibustion. Moxibustion would immediately cause disaster. If there is anosmia, clear nasal discharge, yawning or sneezing, and aversion to cold, the pulse must be deep, indicating correspondence between pulse and symptoms. Or, a light touch yields a string-tight pulse, indicating yin hiding yang. Even with a red face, moxibustion is suitable; one must not rigidly forbid it based solely on facial redness.