\r侧颈项部左右十八穴\pf-f14.bmp\r
天容二穴。在耳下曲颊后。灸三壮。
天牖二穴。在颈筋缺盆上。天容后。天柱前。完骨下。发际上。(明云。发际上一寸陷
中。)
针一寸。留七呼。不宜补。亦不宜灸。若灸、面肿眼合。先取 。后针天牖风池即瘥。若
不先针 。即难疗。明云、针五分。得气即泻。泻尽、更留三呼。泻三吸。不宜补。亦
不宜灸。下云、灸三壮。素注同。
铜人明堂上经皆云不宜灸。下经素问注乃云、灸三壮。恐凡禁穴许灸一壮至三壮也。
天窗二穴。一名窗笼。在颈大筋前。曲颊下侠突后、动脉应手陷中。灸三壮。针三分。
天鼎二穴。在颈缺盆直扶突后一寸。灸三壮。针三分。忌同。明下云、天顶在项缺盆
直扶
突气舍后一寸陷中。灸七壮。素气府注云、天鼎在颈缺盆上直扶突气舍后同身寸之半。按甲
乙经作寸半。
扶突二穴。一名水穴。在人迎后寸半。灸三壮。针三分。素注、在颈当曲颊下一寸人
迎后。仰而取之。
缺盆二穴。一名天盖。在肩下横骨陷中。灸三壮。针三分。(素云。二分。)不宜刺太深
。使人逆息也。明云、肩上横骨陷中。(素同)一名天盖。肩上是穴。
铜人云、在肩下横骨陷中。明堂乃云、在肩上横骨陷中。又云、肩上是穴。恐铜人误下
字也。
人迎二穴。一名五会。在颈大脉动脉应手侠结喉旁。仰而取之。以候五脏气。足阳明脉
气所发。
禁灸。灸之不幸伤人。针四分。
水突二穴。一名水门。在颈大筋前。直人迎下气舍上。针三分。灸三壮。
气舍二穴。在颈直人迎侠天突陷中。针三分。灸三壮。
侧颈项部左右十八穴
天容穴,左右各一穴。位于耳垂下方、下颌角后方的凹陷处。可艾灸三壮。
天牖穴,左右各一穴。位于颈部筋脉旁、缺盆穴上方。在天容穴之后,天柱穴之前,完骨穴之下,发际线之上。(王明云:发际线上一寸的凹陷处。)针刺深度一寸,留针七次呼吸的时间。不宜用补法,也不宜艾灸。如果艾灸,会导致面部肿胀、眼睛闭合。治疗时应先针刺翳风穴,再针刺天牖穴和风池穴,病症即可痊愈。如果不先针刺翳风穴,则难以治愈。王明云:针刺五分,得气后即行泻法。泻法结束后,再留针三次呼吸的时间,然后进行三次呼吸时间的泻法操作。不宜用补法,也不宜艾灸。下文又说:艾灸三壮。《素问》注与上述说法相同。
《铜人腧穴针灸图经》、《明堂》、《上经》都说不宜艾灸,《下经》和《素问》注却说艾灸三壮。恐怕是对于所有禁灸穴位,允许艾灸一至三壮。
天窗穴,左右各一穴。又名窗笼。位于颈部大筋前方。下颌角下方、颧骨弓后方、动脉搏动应手的凹陷处。艾灸三壮。针刺三分。
天鼎穴,左右各一穴。位于颈部缺盆穴直上,扶突穴后方一寸处。艾灸三壮。针刺三分。禁忌同上。王明在下文中说:天顶穴在颈部缺盆穴直上,扶突穴和气舍穴后方一寸的凹陷处。艾灸七壮。《素问·气府论》注说:天鼎穴在颈部缺盆穴直上,扶突穴和气舍穴后方同身寸的一半处。按《甲乙经》记载是一寸半。
扶突穴,左右各一穴。又名水穴。位于人迎穴后方一寸半处。艾灸三壮。针刺三分。《素问》注说:位于颈部正对下颌角下方一寸,人迎穴后方。仰卧并抬头取穴。
缺盆穴,左右各一穴。又名天盖。位于肩部锁骨上方的凹陷处。艾灸三壮。针刺三分。(《素问》说:二分。)不宜刺得太深,否则会导致气息上逆。王明云:肩上横骨的凹陷处。(《素问》说法相同)又名天盖。肩上是该穴位所在。
《铜人腧穴针灸图经》说:在肩下横骨(锁骨)的凹陷处。《明堂》却说:在肩上横骨的凹陷处。又说:肩上是穴位所在。恐怕是《铜人》误将“下”字写错了。
人迎穴,左右各一穴。又名五会。位于颈部大动脉搏动应手处,结喉旁。仰卧并抬头取穴。用于候察五脏之气。是足阳明胃经经气所发之处。
禁止艾灸。如果艾灸不幸会伤人。针刺四分。
Eighteen Acupoints on the Left and Right Sides of the Lateral Neck and Nape
Tianrong (TI 17), bilateral. Located posterior to the angle of the mandible, below the earlobe. Moxibustion: 3 moxa cones.
Tianyao (TE 16), bilateral. Located in the neck, superior to the clavicle (Quepen), posterior to Tianrong, anterior to Tianzhu, inferior to Wanggu, and superior to the hairline. (Wang Ming states: one cun above the hairline, in the depression.) Needle depth: 1 cun. Retain needle for seven respiratory cycles. Tonification is contraindicated; moxibustion is also contraindicated. If moxibustion is applied, facial swelling and eye closure may occur. Treatment should first involve needling Yifeng (SJ 17), followed by needling Tianyao (TE 16) and Fengchi (GB 20), after which the condition will resolve. If Yifeng (SJ 17) is not needled first, the condition is difficult to treat. Wang Ming states: Needle depth 5 fen. Upon arrival of Deqi, apply reduction method. After reduction is complete, retain the needle for three respiratory cycles, then perform reduction for three respiratory cycles. Tonification is contraindicated; moxibustion is also contraindicated. The text below states: Moxibustion 3 cones. This aligns with the annotation in *Suwen* (Basic Questions).
*Copper Person*, *Mingtang*, and *Shangjing* all state that moxibustion is contraindicated. However, *Xiajing* and the *Suwen* annotation state moxibustion of 3 cones. It is likely that for acupoints where moxibustion is generally prohibited, a small amount of 1 to 3 cones is permitted.
Tianchuang (SI 16), bilateral. Also known as Chuanglong. Located anterior to the large tendon of the neck. Below the angle of the mandible, posterior to the zygomatic arch, in the depression where the arterial pulse is palpable. Moxibustion: 3 moxa cones. Needle depth: 3 fen.
Tianding (SI 17), bilateral. Located in the neck, directly superior to Quepen (ST 12), one cun posterior to Futu (LI 18). Moxibustion: 3 moxa cones. Needle depth: 3 fen. Contraindications are the same as above. Wang Ming states in the lower section: Tianding (likely referring to Tianchuang or a variant name contextually) is located in the neck, directly superior to Quepen (ST 12), one cun posterior to Futu (LI 18) and Qishe (ST 10), in the depression. Moxibustion: 7 moxa cones. The annotation in *Suwen: Qifu Lun* states: Tianding (SI 17) is located in the neck, directly superior to Quepen (ST 12), half a cun posterior to Futu (LI 18) and Qishe (ST 10) using the body-cun measurement. According to *Jiayi Jing* (Systematic Classic of Acupuncture and Moxibustion), it is one and a half cun.
Futu (LI 18), bilateral. Also known as Shui Xue. Located one and a half cun posterior to Renying (ST 9). Moxibustion: 3 moxa cones. Needle depth: 3 fen. *Suwen* annotation states: Located in the neck, directly below the angle of the mandible, one cun posterior to Renying (ST 9). Take the point with the patient supine and head tilted back.
Quepen (ST 12), bilateral. Also known as Tian Gai. Located in the depression of the clavicle below the shoulder. Moxibustion: 3 moxa cones. Needle depth: 3 fen. (*Suwen* states: 2 fen.) Do not needle too deeply, as this may cause reverse flow of Qi (dyspnea). Wang Ming states: In the depression of the transverse bone on the shoulder. (*Suwen* agrees). Also known as Tian Gai. The location is on the shoulder.
*Copper Person* states: In the depression of the transverse bone below the shoulder. *Mingtang* states: In the depression of the transverse bone on the shoulder. It also states: The location is on the shoulder. It is likely that *Copper Person* erroneously included the character "below" (xia).
Renying (ST 9), bilateral. Also known as Wu Hui. Located beside the laryngeal prominence, where the carotid artery pulsates. Take the point with the patient supine and head tilted back. Used to observe the Qi of the five Zang organs. It is the site where the Qi of the Foot-Yangming Stomach Meridian emerges.
Moxibustion is strictly prohibited. Improper application may cause injury. Needle depth: 4 fen.
Shuitu (ST 10), bilateral. Also known as Shui Men. Located anterior to the large tendon of the neck, directly inferior to Renying (ST 9) and superior to Qishe (ST 11). Needle depth: 3 fen. Moxibustion: 3 moxa cones.
Qishe (ST 11), bilateral. Located in the neck, directly opposite Renying (ST 9), in the depression flanking Tiantu (CV 22). Needle depth: 3 fen. Moxibustion: 3 moxa cones.