直寸用中行寸横寸用乳间寸
方曰腹无热痛治在足三阴经及五脏俞穴若冷气留注痛针刺付缸灸法在腹胁门末
胃脘痛肝俞脾俞下三里膈俞太冲独阴两乳下各一寸灸二十壮
饮食不下腹中雷鸣大便不节小便黄赤中脘针大肠俞膀胱俞魂门在九椎下两旁各三寸半可
灸三壮
冷热不调绕脐攻注疼痛气海三七壮天枢百壮大肠俞三壮太溪三壮
腹胀坚脐小腹亦坚水分中极各百壮三焦俞膈俞各三壮肾俞以年壮太溪太冲三阴交脾俞中
脘针
肠鸣痛三阴交公孙
腹胁及诸处流注刺痛不可忍用体长缸而缸口以手三指容入乃能吸毒也随其痛每一处以三
棱针刺四五穴并入缸口内付缸灸七壮随痛随针亦付缸灸累次神效
满身卒肿面浮洪大内踝下白肉际三壮立效
水肿腹胀水分三阴交阴交并百壮并治五脏俞穴中脘针后按其孔勿令出水阴跷七壮
四肢面目浮肿照海入中合谷下三里绝骨曲池中腕针腕骨脾俞胃俞三阴交
脬肿及鼓胀脾俞胃俞大肠俞膀胱俞水分中脘针下三里小肠俞三阴交
浮肿鼓胀乃脾胃不和水谷妄行皮肤大小便不利之致也方书云针水分水尽则毙然而水胀甚
则不
能饮食腹如抱鼓气息奄奄心神闷乱死在顷刻当其时若不救急则终未免死亡愚自臆料以谓等死
莫
如救急针水分出水三分之二胀下至脐未至脐水急用血竭末或寒水石末涂敷针穴即塞止水未针
之前预备急用如无血竭即以槐花炒黄不至过黑作末以热手满握敷贴慎勿动手移时成痂乃塞
止
水且百草霜末敷接亦能止水出水三日观风稍歇便治右诸穴效○且浮肿之人或有外肾及肾囊亦
致肿者针刺肾皮囊皮多出黄水则安如或出血则不吉之兆也盖针外肾出水者乃通利小便之义也
吉针手足出水者妄行皮肤之义也凶凡病加与少愈都在慎摄而已○脉法止脉雀啄脉虾游脉皆危
也
直寸取任脉中线,横寸取两乳之间。
腹部无热痛者,治疗应选取足三阴经及五脏的背俞穴。若是冷气停留注滞引起的疼痛,针刺后需配合附缸灸法,具体方法详见腹胁门末尾。
胃脘痛:取肝俞、脾俞、足三里、膈俞、太冲、独阴穴;在两乳下方各一寸处施灸,每处二十壮。
饮食难以下咽,腹中肠鸣如雷,大便失禁,小便黄赤:针刺中脘穴,并配大肠俞、膀胱俞、魂门穴(位于第九椎下,脊柱两侧各旁开三寸半),可灸三壮。
冷热不调,气绕脐攻冲注滞而疼痛:灸气海穴三七壮,天枢穴百壮,大肠俞三壮,太溪三壮。
腹部胀满坚硬,肚脐及小腹部也坚硬:灸水分穴、中极穴各百壮,三焦俞、膈俞各三壮,肾俞穴按患者年龄决定壮数,太溪、太冲、三阴交、脾俞穴针刺,中脘穴针刺。
腹胁及其他部位流注刺痛,疼痛难以忍受:使用体长且缸口能容纳三根手指的罐具,才能吸附药液。根据疼痛部位,每处用三棱针刺四五穴,将针纳入罐口内,进行附缸灸七壮。随痛随针,每次均施以附缸灸,多次治疗神效。
全身突然浮肿,面部浮肿洪大:针刺内踝下白肉际处(照海穴附近),三壮即见效。
水肿腹胀:灸水分、三阴交、阴交穴各百壮,并配合治疗五脏俞穴;中脘穴针刺,针后按压针孔,防止出水;阴跷穴灸七壮。
四肢面目浮肿:针刺照海、入中、合谷、足三里、绝骨、曲池、中脘、腕骨、脾俞、胃俞、三阴交穴。
膀胱肿胀及鼓胀:取脾俞、胃俞、大肠俞、膀胱俞、水分、中脘穴针刺,足三里、小肠俞、三阴交穴针刺。
浮肿和鼓胀,是由于脾胃不和,水谷精微妄行于皮肤,导致大小便不利所致。医书说针刺水分穴若水流尽则人死,然而水胀严重时,患者不能饮食,腹部像抱着鼓一样,气息微弱,心神烦闷混乱,随时可能死亡。在这个时候,如果不急救,终究难免死亡。我凭主观推测认为,与其等待死亡,不如紧急救治。针刺水分穴,让水流出三分之二,待肿胀消退至肚脐但未到肚脐时,若水势急迫,用血竭末或寒水石末涂抹敷贴针穴,即可塞住止水。在针之前,预备好急需的药物,若无血竭,可用槐花炒黄(不要炒得过黑)研成末,用热手满握敷贴在针穴上,切勿动手移动,过一会儿结成痂皮,从而塞住止水。此外,百草霜末敷接也能止水。出水三天后,观察风邪稍歇,再治疗上述诸穴,有效。另外,浮肿之人,有时外肾及阴囊也会肿胀,针刺肾皮囊放出较多黄水则平安;如果出血,则是不吉之兆。大概针刺外肾出水,是通利小便的意思,为吉;针刺手足出水,是妄行于皮肤的意思,为凶。凡是疾病加重或稍有好转,都在于谨慎调摄而已。○脉法中提到雀啄脉、虾游脉,都是危重之象。
For vertical measurements, use the midline of the Ren Mai (Conception Vessel); for horizontal measurements, use the distance between the nipples.
If there is abdominal distension without heat or pain, treatment should focus on the Foot-Yin meridians and the Back-Shu points of the Five Zang organs. If the pain is caused by cold qi stagnation and retention, acupuncture should be followed by Fu-Gang Moxibustion (moxibustion using a glass jar). For specific methods, refer to the end of the Abdomen and Hypochondrium section.
For epigastric pain: Select Ganshu (BL-18), Pishu (BL-20), Zusanli (ST-36), Ge Shu (BL-17), Taichong (LR-3), and Duyin (EX-SP-8). Apply moxibustion at each point one cun below the nipples, 20 moxa cones per site.
For difficulty in swallowing, borborygmus in the abdomen, uncontrolled defecation, and yellow-red urine: Needle Zhongwan (CV-12), and pair with Dachangshu (BL-25), Pangguangshu (BL-28), and Hunmen (BL-47) [located three and a half cun lateral to the lower border of the spinous process of the ninth thoracic vertebra]. Moxibustion may be applied, three cones.
For irregular cold and heat, with qi attacking around the umbilicus causing pain: Moxibustion on Qihai (CV-6), 37 cones; Tianshu (ST-25), 100 cones; Dachangshu (BL-25), three cones; Taixi (KI-3), three cones.
For abdominal distension and hardness, with hardness also extending to the umbilicus and lower abdomen: Moxibustion on Shuifen (CV-9) and Zhongji (CV-3), 100 cones each; Sanjiaoshu (BL-22) and Geshu (BL-17), three cones each; Shenshu (BL-23), number of cones determined by patient's age; needle Taixi (KI-3), Taichong (LR-3), Sanyinjiao (SP-6), Pishu (BL-20), and Zhongwan (CV-12).
For borborygmus and abdominal pain: Select Sanyinjiao (SP-6) and Gongsun (SP-4).
For stabbing pain from flowing and depositing qi in the abdomen, hypochondrium, and other areas, unbearable in intensity: Use a long glass jar whose mouth can accommodate three fingers of the hand, so that it can effectively absorb fluid. For each painful area, puncture four or five acupoints with a three-edged needle, insert the needles into the jar mouth, and apply Fu-Gang Moxibustion for seven cones. Puncture according to the pain location and apply Fu-Gang Moxibustion repeatedly; this yields miraculous effects.
For sudden generalized edema with severe facial swelling: Puncture the white flesh margin below the medial malleolus (near Zhaohai KI-6), three cones, immediate effect.
For edema and abdominal distension: Moxibustion on Shuifen (CV-9), Sanyinjiao (SP-6), and Yinjiao (CV-13), 100 cones each; treat the Back-Shu points of the Five Zang organs; needle Zhongwan (CV-12). After needling, press the needle hole to prevent fluid leakage; moxibustion on Yinqiao (EX-NC-6), seven cones.
For edema of the limbs and face: Needle Zhaohai (KI-6), Ruzhong (EX-UE-10), Hegu (LI-4), Zusanli (ST-36), Jiegu (GB-39), Quchi (LI-11), Zhongwan (CV-12), Wangu (SI-4), Pishu (BL-20), Weishu (BL-21), and Sanyinjiao (SP-6).
For bladder swelling and drum-like distension (Gu Zhang): Needle Pishu (BL-20), Weishu (BL-21), Dachangshu (BL-25), Pangguangshu (BL-28), Shuifen (CV-9), and Zhongwan (CV-12); needle Xialiao (BL-34? *Note: Text says Xiaochangshu BL-27*), Sanyinjiao (SP-6), and Zusanli (ST-36).
Edema and drum-like distension result from spleen and stomach disharmony, where water and grain fluids flow recklessly into the skin, leading to dysfunction of urination and defecation. Medical texts state that if water flows out completely after needling Shuifen (CV-9), death ensues. However, when water swelling is severe, patients cannot eat, the abdomen resembles a held drum, breath is faint, and the mind is confused and restless, leading to imminent death. At such times, if emergency rescue is not performed, death is inevitable. I speculate that rather than waiting for death, one should attempt emergency rescue. Needle Shuifen (CV-9) to allow two-thirds of the fluid to drain. When the swelling subsides to the level of the umbilicus but has not yet reached it, if fluid discharge is urgent, apply powder of Xuejie (Dragon's Blood) or Hanshuishi (Calcitum) to seal the needle site. Prepare emergency materials before needling. If Xuejie is unavailable, stir-fry Huaihua (Sophorae Flos) until yellow but not too dark, grind into powder, hold a full handful in hot hands, and apply firmly to the needle site. Do not move it by hand; wait until a scab forms to seal the fluid. Additionally, Baicaoshuang (Soot) powder can also stop fluid discharge. After three days of fluid drainage, observe if wind pathogens have subsided slightly, then treat the aforementioned acupoints for efficacy. Furthermore, in cases of edema, the external genitalia and scrotum may also swell. Puncturing the scrotal skin to release yellow fluid brings relief; however, if blood appears, it is an inauspicious sign. Generally, puncturing the external genitalia to release fluid corresponds to promoting diuresis, which is auspicious; puncturing the hands and feet to release fluid corresponds to pathological exudation through the skin, which is inauspicious. Whether a disease worsens or improves slightly depends on careful nursing and regulation. ○ Regarding pulse diagnosis: Quezhuo (Sparrow Pecking) pulse and Xiayou (Shrimp Swimming) pulse are both critical signs.