骨空论 髓空在脑后五分，颅际锐骨之下。（即风府穴是也。）一在断基下，一在项
下中复骨下，一在脊骨上空在风府上。脊骨下空，在尻骨下空。数髓空在面侠鼻，或骨空在口下
当两肩。两膊骨空，在膊中之阳。臂骨空在
臂阳，去踝四寸两骨空之间，股骨上空在股阳，出上膝四寸。 骨空在辅骨之上端。股际骨空在
毛中动下。尻骨空在髀骨之后，相去四寸。扁骨有渗理凑，无髓孔，易骨无空。
此言人身骨节有空，则髓有孔。若骨无空，体亦无孔，何以渗凑精微而相滋养者也？凡灸
关节，多用此空。
国初置医学提举司，后改太医监，又改太医院，设院使、同知及典簿等官职，专诊视疾病、
修合药饵等事。洪武十四年定为五品等衙门，更设太医院令、丞、吏目及御医，始根据文职授散官。
二十二年复改院令为院使，丞为院判。其属置惠民药局，又于本衙门置生药库，各设大使副使。
凡本院习业分十三科，自御医以下，与医土医生各专一科。
凡本院院使、院判、御医，日于内府御药局分两班轮直供事。
凡医士俱以父祖世业代补，或令在外访保医官、医士以充，其精通医术者，本院奏进御药局供事。
凡收受四方进贡及诸蓄上用药品，俱于内府收掌供用。药饵国初令医官就内局修制。本院官
诊视御脉，御医参看校同，会内臣就内局合药，将药贴连名封记，具本开泻本方药性、治证之法
于日用之下，医官、内臣书名以进，置簿历，用中书省印合缝进药。奏本既具，随即附簿，年月
下书名，内臣收掌，以凭稽考。烹调御药，本院官与内臣监视，每二服合为一服，候熟分为二器，
其一器御医先尝，次院判，次内臣，其一器进御。
凡各王府差人请医视疾，本院奉旨差官或医士往视。若文武大臣及外夷酋长有疾，亦奉旨往
视，其治疗可否，皆具本覆奏。或军中缺医，亦凭总兵巡抚官奏请拨用。
凡医家子弟，旧例选入本院教习医术，弘治五年奏复行之，推堪任教师者二三人教习。每季
考试，三年或五年堂上官一员同医官二员考试，通晓本科者收充医士，食粮当差；未通晓者听令
习学一年再试，三试不中者黜之。若五年考试成材多，其教师奏请量加升授。
凡医士医生，洪武间各有额数，其后增减不一，俱于本院修合药饵。若医官医士仍差委各处用药。
东直房（医士三十六名）安乐堂（医官三员医士三十六名）司礼监（医士二名）书堂（医士六
名）干明门（医士三名）浣衣局（医士二名）天寿山（医士二名）松林灵台（医士三名）团营（医
官一员医士十二名）五军营（医士三名）三千营（医士四名）锦衣卫（医士三名）神机营（医官一
员，医士四名）府军前卫（医士三名）惠民局（医士三名）会同馆（医士三名）大慈恩寺（医士
三名）宣府（医士一名）紫荆关（医士二名）居庸关（医士一名）龙门千户所（医士一名）万全
右卫（医士一名）怀来卫（医士一名）山海关（医士一名）广宁卫（医士二名）寺子峪（医士一
名）开原（医士一名）永宁卫（医士一名）独石（医士一名）倒马关（医士一名）白羊口（医士一名）
凡医士食粮月支七斗，医生月支四斗，医官先年月支二石，弘治间照医士例止支七斗。
凡各王府缺良医，从本院推举医士，送吏部选用。
凡本院取充医役者，洪武以来例免原籍民差。弘治二年令御药局供事者免二丁，本院应役者免一丁。
凡医官生理残障，及年七十以上不堪应役者放免。
凡天下岁办药材，俱于出产地方派纳，永乐以后，例共五万五千四百七十四斤。成化以来，
其数渐增，今共计一十六万三千五百五十七斤有零，蜈蚣、蛇六十四条，蛤蚧、天雄二十一对，
虫蛀木瓜二十个。
【浙江布政司】三万一千八百五十一斤七两，金箔一百八贴，银箔七十二贴。
【江西布政司】七千五百五十六斤一十二两。
【湖广布政司】四千八百四十九斤七两七钱二分六厘，白花蛇九条，乌蛇十条。
【福建布政司】二千七百六十五斤一两九钱一分。
【四川布政司】一万六千四百二十斤八两，天雄四对。
【广东布政司】九千九百二十九斤三两四钱，蛤蚧一十七对。
【广西布政司】九千七百二十三斤一十两。
【山西布政司】八千九百五十五斤四钱五分。
【山东布政司】八千七百三十八斤六两。
【河南布政司】八千六百四十九斤四两。
【陕西布政司】一万一千七百四十四斤七两。
【辽东都司】八百斤。
【应天府】三千六百五十八斤八两。
【镇江府】三千七百一十七斤六两六钱，赤头蜈蚣四十五条。
【苏州府】一万八千七十九斤三两。
【松江府】一千四百四十斤。
【徽州府】九百四十九斤八两。
【宁国府】四千九百九十四斤一十两二钱，乌烂虫蛀下木瓜二十个。
【太平府】一百八十一斤七两六钱。
【池州府】六百一十三斤。
【凤阳府】二千七斤。
【扬州府】七百四十五斤三两二钱。
【淮安府】三千一百二十七斤八两。
【庐州府】八十五斤一十二两五钱九分。
【安庆府】四百五十八斤。
【广德州】六百三十斤。
【滁州】一千五百九十二斤一十一两二钱五分。
【徐州】六十三斤。
【和州】二百二十三斤一十四两。
【永平府】二百一十五斤。
【庆州】七百斤。
【保安州】七百斤。
【大名府】一千五十斤。
【河间府】二千一百七十七斤。
【保定府】五十斤。
【真定府】七百六十五斤。
凡天下解纳药材，俱贮本院生药库，以御医二员与大使一员辨验收放，礼部仍委官一员监收。
至年终照例造册二本，一留本院备照，一送礼部查考。
凡药材如丹砂、鹿茸等项，先因在外镇守等官额外进贡，沿途害人，成化二十三年诏禁止勿进。
凡军中马病，本院给与药饵。
凡天下府州县举到医士，堪任医官者，俱从礼部送本院考试，仍委该司官一员会考。中者送
吏部选用；不中者发回原籍为民，原保官吏治罪。
凡本院合用纸札，俱令府州县举到医士考中者量纳应用，后不行，成化十八年奏准仍照旧例。
骨空论：髓孔位于脑后五分处，即颅骨边缘锐骨之下（这就是风府穴）。一个在断基下，一个在颈部下方正中复骨之下，一个在脊骨上方的风府穴之上。脊骨下方的空窍，位于尾骶骨下方的空窍。数个髓孔位于面部鼻翼两侧，或者口骨空位于口下正对两肩处。双侧臂骨的空窍，位于上臂外侧。前臂骨的空窍位于手臂外侧，距离踝关节四寸，在两骨之间的空隙处。大腿骨上方的空窍位于大腿外侧，向上至膝盖四寸处。膝部辅骨上方的骨空。大腿根部毛际中搏动下方的骨空。尾骶骨后的骨空，位于髀骨之后，相距四寸。扁平的骨头有渗理汇聚，没有髓孔，容易化生骨骼而无空窍。
这里说的是人身骨节有空隙，那么髓就有孔道。如果骨头没有空隙，身体也就没有孔道，靠什么来渗透汇聚精微物质并相互滋养呢？凡是艾灸关节时，多使用这些空窍。
明朝初年设立医学提举司，后来改为太医监，又改为太医院，设置院使、同知及典簿等官职，专门负责诊视疾病、调制药物等事务。洪武十四年定为五品衙门，增设太医院令、丞、吏目及御医，开始依据文职授予散官。二十二年再次将院令改为院使，丞改为院判。其下属机构设有惠民药局，又在本院衙门内设置生药库，各设大使、副使。
凡本院学业分为十三科，从御医以下，与医士、医生各自专攻一科。
凡本院院使、院判、御医，每日在内府御药局分两班轮流值班供职。
凡医士都通过父祖世业继承补任，或令在外地访查保举医官、医士来充任，其中精通医术者，由本院奏请进入御药局供职。
凡收受各地进贡及宫廷使用的药品，都在内府收掌供用。药物调制在国初时期令医官在内局修制。本院官员诊视御脉，御医参看校订相同，会同内臣在内局合药，将药贴连名封记，撰写奏本开列本方药性、治疗证候的方法于日用之下，医官、内臣署名后进呈，登记入簿历，使用中书省印合缝进药。奏本既已具备，随即附簿，在年月下书名，内臣收掌，以便稽查考核。烹调御药，本院官员与内臣监视，每两服合并为一服，煮熟后分为两器，其一器由御医先尝，其次院判，其次内臣，另一器进献皇帝。
凡各王府差人请求派医诊治疾病，本院奉旨派遣官员或医士前往诊治。若文武大臣及外夷酋长有病，也奉旨前往诊治，其治疗是否可行，都撰写奏本覆奏。或军中缺医，也凭总兵巡抚官奏请拨用。
凡医家子弟，旧例选拔进入本院教习医术，弘治五年奏请恢复实行，推举可担任教师者二三人进行教习。每季度考试，三年或五年由堂上官一员会同医官二员考试，通晓本科者收录充任医士，领取粮饷当差；未通晓者听令学习一年再试，三次考试不中者罢黜。若五年考试成才者多，其教师奏请酌情加升授职。
凡医士医生，洪武年间各有定额，其后增减不一，都在本院调制药物。若医官医士仍被差遣到各处用药。
东直房（医士三十六名）安乐堂（医官三员医士三十六名）司礼监（医士二名）书堂（医士六名）干明门（医士三名）浣衣局（医士二名）天寿山（医士二名）松林灵台（医士三名）团营（医官一员医士十二名）五军营（医士三名）三千营（医士四名）锦衣卫（医士三名）神机营（医官一员，医士四名）府军前卫（医士三名）惠民局（医士三名）会同馆（医士三名）大慈恩寺（医士三名）宣府（医士一名）紫荆关（医士二名）居庸关（医士一名）龙门千户所（医士一名）万全右卫（医士一名）怀来卫（医士一名）山海关（医士一名）广宁卫（医士二名）寺子峪（医士一名）开原（医士一名）永宁卫（医士一名）独石（医士一名）倒马关（医士一名）白羊口（医士一名）
凡医士每月支粮七斗，医生每月支粮四斗，医官以前每月支粮二石，弘治年间依照医士例只支七斗。
凡各王府缺少良医，从本院推举医士，送吏部选用。
凡本院选取充任医役者，自洪武以来例免原籍民差。弘治二年令御药局供事者免二丁，本院应役者免一丁。
凡医官生理残障，及年七十以上不堪应役者放免。
凡天下每年办理的药材，都在出产地方派纳，永乐以后，例共五万五千四百七十四斤。成化以来，其数渐增，如今共计一十六万三千五百五十七斤有余，蜈蚣、蛇六十四条，蛤蚧、天雄二十一对，虫蛀木瓜二十个。
【浙江布政司】三万一千八百五十一斤七两，金箔一百八贴，银箔七十二贴。
【江西布政司】七千五百五十六斤一十二两。
【湖广布政司】四千八百四十九斤七两七钱二分六厘，白花蛇九条，乌蛇十条。
【福建布政司】二千七百六十五斤一两九钱一分。
【四川布政司】一万六千四百二十斤八两，天雄四对。
【广东布政司】九千九百二十九斤三两四钱，蛤蚧一十七对。
【广西布政司】九千七百二十三斤一十两。
【山西布政司】八千九百五十五斤四钱五分。
【山东布政司】八千七百三十八斤六两。
【河南布政司】八千六百四十九斤四两。
【陕西布政司】一万一千七百四十四斤七两。
【辽东都司】八百斤。
【应天府】三千六百五十八斤八两。
【镇江府】三千七百一十七斤六两六钱，赤头蜈蚣四十五条。
【苏州府】一万八千七十九斤三两。
【松江府】一千四百四十斤。
【徽州府】九百四十九斤八两。
【宁国府】四千九百九十四斤一十两二钱，乌烂虫蛀下木瓜二十个。
【太平府】一百八十一斤七两六钱。
【池州府】六百一十三斤。
【凤阳府】二千七斤。
【扬州府】七百四十五斤三两二钱。
【淮安府】三千一百二十七斤八两。
【庐州府】八十五斤一十二两五钱九分。
【安庆府】四百五十八斤。
【广德州】六百三十斤。
【滁州】一千五百九十二斤一十一两二钱五分。
【徐州】六十三斤。
【和州】二百二十三斤一十四两。
【永平府】二百一十五斤。
【庆州】七百斤。
【保安州】七百斤。
【大名府】一千五十斤。
【河间府】二千一百七十七斤。
【保定府】五十斤。
【真定府】七百六十五斤。
凡天下解纳药材，都贮存在本院生药库，以御医二员与大使一员辨别验收放，礼部仍委派官员一员监收。至年终照例造册二本，一本留本院备查，一本送礼部查考。
凡药材如丹砂、鹿茸等项，先前因在外镇守等官额外进贡，沿途害人，成化二十三年诏令禁止勿进。
凡军中马病，本院给予药饵。
凡天下府州县举荐的医士，堪任医官者，都从礼部送本院考试，仍委派该司官一员会考。中者送吏部选用；不中者发回原籍为民，原保官吏治罪。
凡本院合用纸札，都令府州县举荐的医士考中者量纳应用，后来不行，成化十八年奏准仍照旧例。
Bone Cavity Treatise: The marrow cavities are located five fen behind the head, below the sharp bone at the edge of the skull (this is the Fengfu acupoint). One is below the Duanji, one is below the central compound bone in the lower neck, and one is above the spinal bone, above the Fengfu point. The cavity below the spinal bone is located in the empty space below the sacral bone. Several marrow cavities are on the face flanking the nose, or the bone cavity below the mouth corresponds to the two shoulders. The cavities of the bilateral arm bones are located in the Yang aspect of the upper arm. The cavity of the forearm bone is located in the Yang aspect of the arm, four cun away from the ankle, between the two bones. The cavity above the femur is located in the Yang aspect of the thigh, extending four cun above the knee. The bone cavity above the auxiliary bone of the knee. The bone cavity below the movement in the pubic hair at the root of the thigh. The bone cavity behind the sacrum is located behind the hip bone, four cun apart. Flat bones have converging permeation lines but no marrow pores; they easily transform into bone without cavities.
This discusses that if human body joints have gaps, then there are channels for marrow. If bones have no gaps, the body has no pores, how can it penetrate and gather subtle essence to nourish each other? When moxibustion is applied to joints, these cavities are mostly used.
At the beginning of the Ming Dynasty, the Medical Bureau was established, later changed to the Imperial Medical Supervisory Office, and then to the Imperial Medical Academy. Positions such as Director, Vice-Director, and Clerk were set up to specialize in diagnosing diseases and preparing medicines. In the 14th year of Hongwu, it was designated as a fifth-rank office, with additional positions of Director, Assistant Director, Medical Officer, and Imperial Physician created, starting to grant honorary titles based on civil service ranks. In the 22nd year, the Director was again changed to President, and Assistant Director to Vice-President. Its subordinate agencies included the Hui Min Medicine Bureau, and a Raw Medicine Warehouse was also set up within the academy, each with a Chief and Deputy Chief.
All studies in the academy are divided into thirteen departments. From Imperial Physicians downwards, medical officers and doctors each specialize in one department.
The President, Vice-President, and Imperial Physicians of the academy take turns on duty every day in two shifts at the Imperial Medicine Bureau within the inner court.
Medical officers are generally inherited through family lineage or appointed by recommendation from outside. Those proficient in medical arts are recommended by the academy to serve in the Imperial Medicine Bureau.
All medicines submitted as tribute from various regions and used by the imperial household are stored and managed in the inner court. At the beginning of the dynasty, medical officers prepared medicines in the internal bureau. Officials of the academy diagnose the imperial pulse, Imperial Physicians review and verify, and together with eunuchs, prepare medicines in the internal bureau. The medicine packets are sealed jointly, and a memorial is submitted detailing the properties of the herbs in the prescription and the methods for treating the symptoms. Medical officers and eunuchs sign their names before submission, records are kept in registers, and the medicine is sealed with the seal of the Secretariat. Once the memorial is complete, it is attached to the register, signed under the date, and kept by eunuchs for inspection. Cooking imperial medicines is supervised by academy officials and eunuchs. Every two doses are combined into one, cooked, and then divided into two vessels. One vessel is tasted first by the Imperial Physician, then the Vice-President, then the eunuch, and the other vessel is presented to the Emperor.
When princes' mansions request physicians to treat illnesses, the academy dispatches officials or medical officers upon imperial decree. If civil or military ministers and foreign chieftains fall ill, they are also dispatched upon decree. Whether the treatment is appropriate is reported back in memorials. If the army lacks physicians, requests are made by the Commander-in-Chief or Governor-General for allocation.
Children of medical families were traditionally selected to study medicine in the academy. This practice was restored in the 5th year of Hongzhi, with two or three teachers appointed. Examinations are held quarterly. Every three or five years, one senior official and two medical officers conduct exams. Those who master their specialty are admitted as medical officers, receiving rations and duties. Those who do not pass are allowed to study for another year and re-examined. Those who fail three times are dismissed. If many students succeed after five years, the teachers may be promoted upon recommendation.
During the Hongwu era, there were fixed quotas for medical officers and doctors, which varied thereafter. All prepared medicines in the academy. If medical officers and doctors were still dispatched to various places for medication use.
Dongzhi Room (36 medical officers), Anle Hall (3 medical officers, 36 medical officers), Directorate of Palace Attendants (2 medical officers), Study Hall (6 medical officers), Ganming Gate (3 medical officers), Laundry Bureau (2 medical officers), Tianshou Mountain (2 medical officers), Songling Lingtai (3 medical officers), Tuan Ying (1 medical officer, 12 medical officers), Five Camps Army (3 medical officers), Three Thousand Camps (4 medical officers), Embroidered Uniform Guard (3 medical officers), Shenji Camp (1 medical officer, 4 medical officers), Front Guard of Fu Army (3 medical officers), Hui Min Bureau (3 medical officers), Huitong Guesthouse (3 medical officers), Daci'en Temple (3 medical officers), Xuanfu (1 medical officer), Jingxing Pass (2 medical officers), Juyong Pass (1 medical officer), Longmen Qianhu Suo (1 medical officer), Wanquan Right Guard (1 medical officer), Huailai Guard (1 medical officer), Shanhaiguan (1 medical officer), Guangning Guard (2 medical officers), Siziyu (1 medical officer), Kaiyuan (1 medical officer), Yongning Guard (1 medical officer), Dushi (1 medical officer), Daomaguan (1 medical officer), Baiyangkou (1 medical officer).
Medical officers receive seven dou of grain per month, doctors receive four dou, and previously medical officers received two shi per month. In the Hongzhi era, this was reduced to seven dou like medical officers.
If princes' mansions lack good physicians, the academy recommends medical officers to the Ministry of Personnel for selection.
Since the Hongwu era, those selected for medical service in the academy were exempted from local corvée in their home counties. In the 2nd year of Hongzhi, those serving in the Imperial Medicine Bureau were exempted for two households, and those serving in the academy for one household.
Medical officers with physical disabilities or over seventy years old unable to serve are exempted.
Annual medicinal materials required nationwide are collected from producing areas. Since the Yongle era, the quota was 55,474 jin. Since the Chenghua era, the number has gradually increased to over 163,557 jin currently, including 64 centipedes and snakes, 21 pairs of Gekko gecko and Aconitum carmichaelii, and 20 worm-eaten papayas.
[Zhejiang Provincial Administration Commission] 31,851 jin 7 liang, 108 sheets of gold foil, 72 sheets of silver foil.
[Jiangxi Provincial Administration Commission] 7,556 jin 12 liang.
[Huguang Provincial Administration Commission] 4,849 jin 7 liang 7 qian 2 fen 6 li, 9 white-banded kraits, 10 black snakes.
[Fujian Provincial Administration Commission] 2,765 jin 1 liang 9 qian 1 fen.
[Sichuan Provincial Administration Commission] 16,420 jin 8 liang, 4 pairs of Aconitum carmichaelii.
[Guangdong Provincial Administration Commission] 9,929 jin 3 liang 4 qian, 17 pairs of Gekko gecko.
[Guangxi Provincial Administration Commission] 9,723 jin 10 liang.
[Shanxi Provincial Administration Commission] 8,955 jin 4 qian 5 fen.
[Shandong Provincial Administration Commission] 8,738 jin 6 liang.
[Henan Provincial Administration Commission] 8,649 jin 4 liang.
[Shaanxi Provincial Administration Commission] 11,744 jin 7 liang.
[Liaodong Military Commission] 800 jin.
[Yingtian Prefecture] 3,658 jin 8 liang.
[Zhenjiang Prefecture] 3,717 jin 6 liang 6 qian, 45 red-headed centipedes.
[Suzhou Prefecture] 18,079 jin 3 liang.
[Songjiang Prefecture] 1,440 jin.
[Huizhou Prefecture] 949 jin 8 liang.
[Ningguo Prefecture] 4,994 jin 10 liang 2 qian, 20 inferior worm-eaten papayas.
[Taiping Prefecture] 181 jin 7 liang 6 qian.
[Chizhou Prefecture] 613 jin.
[Fengyang Prefecture] 2,007 jin.
[Yangzhou Prefecture] 745 jin 3 liang 2 qian.
[Huaian Prefecture] 3,127 jin 8 liang.
[Luzhou Prefecture] 85 jin 12 liang 5 qian 9 fen.
[Anqing Prefecture] 458 jin.
[Guangde Prefecture] 630 jin.
[Chuzhou] 1,592 jin 11 liang 2 qian 5 fen.
[Xuzhou] 63 jin.
[Hezhou] 223 jin 14 liang.
[Yongping Prefecture] 215 jin.
[Qingzhou] 700 jin.
[Bao'an Prefecture] 700 jin.
[Daming Prefecture] 1,050 jin.
[Hejian Prefecture] 2,177 jin.
[Baoding Prefecture] 50 jin.
[Zhendin Prefecture] 765 jin.
All medicinal materials delivered from across the country are stored in the Raw Medicine Warehouse of the academy. Two Imperial Physicians and one Chief verify and accept them, with an official from the Ministry of Rites supervising. At the end of the year, two copies of the ledger are made according to regulations: one kept in the academy for reference, and one sent to the Ministry of Rites for inspection.
Medicinal materials such as Cinnabar and Deer Antler were previously subject to extra tributes by border garrison officials, causing harm along the way. In the 23rd year of Chenghua, an edict prohibited further submissions.
For equine diseases in the army, the academy provides medicinal preparations.
Medical officers recommended by prefectures and counties nationwide who are suitable for the rank of medical officer are sent by the Ministry of Rites to the academy for examination, assisted by an official from the relevant department. Those who pass are sent to the Ministry of Personnel for appointment; those who fail are returned to their hometowns as commoners, and the original guarantor officials are punished.
Paper and stationery required by the academy are to be contributed by passed medical officers from prefectures and counties. This practice was later discontinued, but in the 18th year of Chenghua, it was approved to resume the old regulation.