坐炷下火时。令患人一根据点穴时。正坐伸臂。头项肩背手足腕膝不得少有欹侧。伸缩改
易。
即臂中举按用力轻重。亦常令匀。若一事稍异于前。胛骨便辄相近。覆背灸穴艾炷。即在骨
上。或胛骨开而相远。动争寸余。火气不入穴中。徒受苦楚。无所益也。若不失其穴。灸至
数壮。觉胛骨中通热而不甚痛。意自快畅。至数十壮后。或若腕中酸辛。若以几支。或用软
帛于肘上腕中。连束二臂。令缓急得所。亦能少助。盖手欲按而臂欲举。故腕中费力。或少
休顷刻亦无害。但要安顿身体四肢一如前耳。如日灸五十壮。累至数百为佳。千金方云。灸
六百壮。至千壮。当觉气下砻砻然。如流水状。亦当有所下。其治疾之效甚众且敏（有上气
喘满。实时平减者。有妇人经候不通已八月。灸两日而下者。如此之数甚多）。穴在上而最
能下气。非他穴药石之比。而又无所不治。有疾者宜留意焉。
石藏用。字用之。京师大医也。其治疗方术一从古法。亦多为人灸此穴。其取穴法。令
患人
床榻上盘膝正坐。随人之肥瘠大小。置栲栳或塾枕之类。以衾絮冒之。令两臂相交。平伏其
上。余亦相同。仍用千金方不能久坐伸臂使伏衣袱上之意也。其用坚物云。欲大小高下常定
胜于衣袱。但臂之伸屈。与古异耳。其治皆效。盖医者意也。随事增损。初无定方。孙真人
笑秦缓之拙。不能求得此穴。但知针药之不及。不知火气之能彻。则求之浸巧。是不为过也
绍兴己未岁。余守武昌时。总领邵户部玉云。少时病瘵得泉州僧为灸膏肓。令伏于栲栳上
僧以指节极力按寻其穴。令病者觉中指麻乃是穴。若指不麻。或虽麻而非中指者。皆
非也。已而求得之。遂一灸而愈。壬戌四月。增记于此。
在点燃艾炷施灸时，应让患者依据特定方法取穴。此时患者需端正坐姿，双臂伸展，头部、颈部、肩背以及手足、手腕、膝盖均不得有丝毫倾斜或侧歪，也不得随意伸缩或改变姿势。
在手臂中间进行按压时，用力轻重应当保持均匀。如果某一处与之前的情况稍有不同，两侧肩胛骨就会变得靠近，导致背部施灸的穴位正好位于骨头之上；或者肩胛骨张开而相距较远，移动距离超过一寸，这样火气就无法进入穴位之中，只是徒然受苦，没有任何益处。如果没有偏离穴位，灸到一定壮数后，会感觉肩胛骨之间有热气通达且并不十分疼痛，内心自然感到畅快舒适。灸至数十壮之后，可能会感觉手腕中酸楚刺痛，这就像是用几根树枝支撑着一样。可以用软帛垫在肘部和手腕处，将两臂连束在一起，使松紧适度，也能起到一定的辅助作用。这是因为手想要按压而手臂想要举起，所以手腕处费力。稍作片刻休息也无妨，但必须确保身体和四肢安置得像之前一样安稳。如果每天灸五十壮，累积达到数百壮为佳。《千金方》记载：灸六百壮，甚至一千壮，应当感觉到气向下运行，隆隆作响，像流水一样，同时也会有排泄物排出。其治疗疾病的功效非常多且迅速（例如上气喘满的症状，灸后立刻平复减轻；还有妇女月经不通长达八个月，灸两天后就通畅了，这样的例子很多）。此穴位于上部却最能降气，不是其他穴位和药物所能比拟的，而且没有治不好的病，患病者应当留意这一点。
石藏用，字用之，是京城的大医。他的治疗方法完全遵循古法，也常为人灸此穴。他取穴的方法是：让患者在床榻上盘膝正坐，根据人的胖瘦高矮，放置栲栳（一种圆形竹器）或塾枕之类的物品，并用被褥棉絮包裹它，让两臂交叉平伏在上面。其余部分与以前相同，但仍采用《千金方》中不能久坐、伸臂使其伏在衣袱上的意思。他使用坚硬物体的理由是：希望大小高低固定不变，胜过衣袱。只是手臂的伸展弯曲与古法不同罢了。其治疗效果都很好。大概医者在于心意，随事情增减变化，本来就没有固定的方案。孙思邈嘲笑秦越人（秦缓）笨拙，不能找到这个穴位，只知道针药达不到，不知道火气能透彻深入，那么追求这种技巧，并不算过分。
绍兴己未年，我守卫武昌时，总领邵户部玉云，年轻时患痨病，得到泉州僧人为其灸膏肓穴。让他伏在栲栳上，僧人用手指节极力按压寻找穴位，让病人感觉到中指发麻，这才是穴位。如果手指不麻，或者虽然麻但不是中指，都不是正确的穴位。后来找到了穴位，于是灸了一次就痊愈了。壬戌年四月，在此补充记录。
When igniting the moxa cone for application, the patient should be instructed to locate the acupoint according to a specific method. At this time, the patient must sit upright with arms extended; the head, neck, shoulders, back, hands, feet, wrists, and knees must not tilt or deviate in the slightest degree, nor should they extend, retract, or change position arbitrarily.
When pressing on the middle of the arm, the pressure applied should remain uniform. If any part differs slightly from the previous state, the scapulae will draw closer together, causing the moxibustion point on the back to lie directly on the bone. Conversely, if the scapulae spread apart, moving more than one cun, the heat energy cannot enter the acupoint, resulting in suffering without benefit. If the acupoint is accurately located, after applying a certain number of moxa cones (Zhuang), one will feel heat penetrating through the area between the scapulae without severe pain, leading to a sense of mental comfort and relaxation. After dozens of Zhuang, there may be a sensation of soreness or tingling in the wrists, resembling the strain of supporting weight with branches. Placing soft cloth under the elbows and wrists and binding both arms together can provide appropriate support and assistance. This occurs because the hand presses down while the arm lifts, straining the wrist. A brief rest is harmless, provided that the body and limbs are positioned as before. Applying fifty Zhuang per day, accumulating to several hundred, is considered ideal. The *Qianjin Fang* records: upon reaching six hundred or even one thousand Zhuang, one should feel Qi descending with a rumbling sound, like flowing water, accompanied by excretion. The therapeutic efficacy for various diseases is numerous and rapid (e.g., symptoms of upper Qi rebellion and wheezing subside immediately; women with amenorrhea lasting eight months resumed menstruation after two days of treatment; such cases are numerous). This acupoint, located in the upper body, is particularly effective in directing Qi downward, surpassing other acupoints and medicinal herbs, and is capable of treating almost all ailments. Patients should pay close attention to it.
Shi Cangyong, courtesy name Yongzhi, was a prominent physician in the capital. His treatment methods strictly followed ancient practices, and he frequently performed moxibustion on this acupoint for others. His method for locating the acupoint involves having the patient sit upright with crossed legs on a bed or couch. Depending on the patient's size and build, a basket-like object (Kaolao) or a bolster pillow is placed and wrapped in quilts or cotton padding. The patient then crosses their arms and rests them flat on top. The remainder of the procedure remains consistent with previous descriptions, adhering to the intent in the *Qianjin Fang* regarding the inability to sit for long periods with arms extended resting on fabric. Shi used hard objects because he believed that fixed dimensions were superior to fabric. However, the extension and flexion of the arms differ from ancient methods. Nevertheless, the therapeutic effects are equally effective. Essentially, medical practice relies on the practitioner's insight, allowing for adjustments based on circumstances, without rigid formulas. Sun Simiao mocked Qin Huan (Bian Que) for being inept at finding this acupoint, knowing only the limitations of acupuncture and herbs but unaware of the penetrating power of fire therapy. Pursuing such refined techniques is not excessive.
In the Jiwei year of the Shaoxing era, while I was guarding Wuchang, Shao Yuyun, a Ministry of Revenue official, who had suffered from consumption (Phthisis) since youth, was treated by a monk from Quanzhou. The monk performed moxibustion on the Gohuang acupoint. The patient was instructed to lie prone on a Kaolao. The monk pressed firmly with his finger joints to locate the acupoint, instructing the patient to identify the correct spot when numbness was felt in the middle finger. If there was no numbness, or if the numbness was not in the middle finger, the location was incorrect. Upon correctly locating the acupoint, a single session of moxibustion resulted in a cure. This account was added in the fourth month of the Renxu year.