手有三里五里。足亦有三里五里。手有上廉下廉。足亦有上廉下廉。侧头部有窍阴。足
少阳
亦有窍阴。偃伏部有临泣。足少阳亦有临泣。既有五里矣。劳宫亦名五里。既有光明矣。攒
竹亦名光明。肩有肩井。又有所谓中肩井。足有昆仑。又有所谓下昆仑。太渊太泉之名或殊
。天鼎天顶之字有异。丹田初非石门。和 (明堂上经误作和字。)亦非禾 。阳跷实为申脉
。本非跗阳。阴跷实为照海。本非交信。肩 之名扁骨。见于外台。悬钟之名绝骨。童子
之名前关。见于千金注。如此者众。可不审处而针灸耶。苟不审处。则差之毫厘。有寻丈之
谬矣。于是举其略以示世医。俾之谨于求穴云。
千金云、人有老少。体有长短。肤有肥瘦。皆须精思商量。准而折之。又以肌肉文理
节解
缝会宛陷之中。及以手按之。病者快然。如此子细安详用心者。乃能得之耳。许希亦云、或
身短而手长。或手短而身长。或胸腹短。或胸腹长。或瘠或肥。又不可以一概论也。
千金云、凡点灸法。皆须平直四体。无使倾侧。灸时恐穴不正。徒破好肉尔。(明堂云
。须
得身体平直。四肢无令拳缩坐点无令俯仰。立点无令倾侧。)若坐点则坐灸。卧点则卧灸
。立点则立灸。反此则不得其穴。
千金云、凡灸当先阳后阴。言从头向左而渐下。次后从头向右而渐下。先上后下。
明堂下云、先灸于上。后灸于下。先灸于少。后灸于多。皆宜审之。
手经有三里穴和五里穴。足经也有三里穴和五里穴。手经有上廉穴和下廉穴,足经也有上廉穴和下廉穴。侧头部有窍阴穴,足少阳胆经也有窍阴穴。身体俯伏部位(背部)有临泣穴,足少阳胆经也有临泣穴。既然已经有名为“五里”的穴位了,劳宫穴也叫做五里。既然已经有名为“光明”的穴位了,攒竹穴也叫做光明。肩部有肩井穴,又有被称为中肩井的穴位。足部有昆仑穴,又有被称为下昆仑的穴位。太渊穴与太泉穴的名称或许不同。天鼎穴与天顶穴的字形有所差异。丹田穴起初并非石门穴。和髎穴(《明堂上经》误写为“和”字。)也并非禾髎穴。阳跷脉实际上对应的是申脉穴,原本并不是跗阳穴。阴跷脉实际上对应的是照海穴,原本并不是交信穴。肩髃穴的名字源于扁骨,记载见于《外台秘要》。悬钟穴的名字即绝骨穴。童子里穴的名字即前关穴,记载见于《千金方》注。像这样的情况很多,如果不仔细审察就进行针灸,难道可以吗?如果不仔细审察,那么起初只有毫厘之差,最终却会产生寻丈(极远)的巨大谬误。于是列举其中的大略情况以展示给世间的医生看,使他们谨慎地寻找穴位。
《千金方》说:人有年老和年少之分,身体有高矮之别,皮肤有肥瘦之异,都必须精心思考商量,加以衡量折中确定。又依据肌肉纹理、关节缝隙、凹陷之处,以及用手按压时患者感到舒适的地方,如此细致安详用心的人,才能准确取穴。许希也说:有的人身材短而手臂长,有的人手臂短而身材长,有的人胸腹短,有的人胸腹长,有的人消瘦,有的人肥胖,又不可以用一种标准来概括。
《千金方》说:凡是点穴施灸的方法,都必须使四肢平直,不要使其倾斜歪侧。施灸时恐怕穴位不准确,白白损伤好肉罢了。(《明堂经》说:必须使身体平直,四肢不要拳缩;坐位取穴不要俯仰,站立取穴不要倾斜歪侧。)如果是坐位取穴,就采用坐位施灸;卧位取穴就采用卧位施灸;立位取穴就采用立位施灸。与此相反就不能得到正确的穴位。
The Hand Taiyin and Yangming meridians have the Sanli (Three Li) and Wuli (Five Li) acupoints. The Foot Taiyin and Yangming meridians also have Sanli and Wuli acupoints. The Hand meridians have Shanglian (Upper Margin) and Xialian (Lower Margin) acupoints, and the Foot meridians also have Shanglian and Xialian acupoints. On the lateral aspect of the head, there is the Qiaoyin (Pierced Yin) acupoint, and the Foot Shaoyang Gallbladder Meridian also has a Qiaoyin acupoint. In the prone position (back), there is the Linqi (Flowing Through) acupoint, and the Foot Shaoyang Gallbladder Meridian also has a Linqi acupoint. Since there is already an acupoint named Wuli, the Laogong (Palace of Toil) acupoint is also called Wuli. Since there is already an acupoint named Guangming (Bright Light), the Cuanzhu (Gathered Bamboo) acupoint is also called Guangming. There is the Jianjing (Shoulder Well) acupoint on the shoulder, and there is also what is referred to as Zhongjianjing (Middle Shoulder Well). There is the Kunlun (Kunlun Mountain) acupoint on the foot, and there is also what is referred to as Xia Kunlun (Lower Kunlun). The names Taiyuan (Great Abyss) and Taiquan (Great Spring) may differ. The characters Tianding (Heavenly Cauldron) and Tiding (Heavenly Peak) are distinct. Dantian (Elixir Field) was initially not Shimen (Stone Gate). Heliao (Harmony Pierced) [the character "He" in the original text is a typo for Heliao according to *Mingtang Shangjing*] is not He Liao (Grain Pierced). Yangqiao Mai (Yang Heel Vessel) actually corresponds to Shenmai (Spirit Pass), which is originally not Fuyang (Foot Yang). Yinqiao Mai (Yin Heel Vessel) actually corresponds to Zhaohai (Shining Sea), which is originally not Jiaoxin (Connecting Heart). The name Jianyu (Shouldly Bone) derives from the flat bone, as recorded in *Waitai Miyao*. The name Xuanzhong (Hanging Middle) is identical to Juegu (Broken Bone). Tongzi (Child) is identical to Qianguan (Front Pass), as recorded in the commentary on *Qianjin Fang*. There are many such cases; how can one perform acupuncture and moxibustion without careful examination? If one does not examine carefully, a difference of a hair's breadth at the start will result in an error of several zhang (a unit of length) later. Therefore, I list the general principles here to show them to physicians of the world, so that they may be cautious in seeking acupoints.
*Qianjin Fang* states: People vary in age (old and young), stature (tall and short), and body constitution (fat and thin). One must think carefully and consult, measuring and adjusting accordingly. Furthermore, one should rely on muscle textures, joint fissures, depressions, and areas where pressure by hand brings relief to the patient. Only those who are meticulous, calm, and attentive can accurately locate these points. Xu Xi also stated: Some people have short bodies but long arms, some have short arms but long bodies, some have short chests and abdomens, some have long chests and abdomens, some are emaciated, and some are obese. These cannot be generalized by a single standard.
*Qianjin Fang* states: In all methods of point location and moxibustion, the limbs must be kept straight and level, avoiding any tilting or slanting. During moxibustion, if the acupoint is not accurate, it merely damages healthy flesh. (*Mingtang Jing* states: The body must be kept straight and level; the limbs should not be curled up. When locating points while sitting, avoid bending forward or backward; when locating points while standing, avoid tilting.) If points are located while sitting, moxibustion should be performed while sitting; if located while lying down, moxibustion should be performed while lying down; if located while standing, moxibustion should be performed while standing. Reversing this will result in failing to obtain the correct acupoint.
*Qianjin Fang* states: In all moxibustion, one should first treat the Yang meridians and then the Yin meridians. This means starting from the head and moving downwards gradually to the left, and subsequently from the head moving downwards gradually to the right, treating the upper parts before the lower parts.
*Mingtang Jing* (lower section) states: First moxa the upper parts, then the lower parts. First moxa the areas with fewer points, then the areas with more points. All of these should be carefully examined.