孙真人千金方论曰。膏肓 穴。无所不治。主羸瘦虚损。梦中失精。上气咳逆。狂惑忘
误。
取穴法。令人正坐。曲脊伸两手。以臂着膝前。令正直手大指与膝头齐。以物支肘。勿令臂
得动摇。从胛骨上角摸索胛骨下头。其间当有四肋三间。灸中间。根据胛骨之里肋间空处。去
胛骨容侧指许。摩KT 肉之表筋间空处。按之自觉牵引肩户中。灸两胛中各一壮。至六百壮。
多至千壮。当觉气下砻砻然。如流水状。亦当有所不出。若无停痰宿疾。则无所下也。若病
久已困不能正坐。当令侧卧。挽一臂令前求取穴灸之也。又求穴大较以右手从右肩上住指头
表所不及者是也。左手亦然。乃以前法灸之。若不能久正坐。常伸两臂者亦可伏衣袱上。伸
两臂。令人挽两胛骨使相离。不尔。胛骨覆穴。不可得也。所伏衣袱。当令大小常定。不尔
则失其穴也。此灸讫后。令人阳气康盛。当消息以自补养。取身体平复。其穴近第五椎。
相准望取之。四椎下两旁。相去各三寸。
论曰。昔秦缓不救晋侯之疾。以其在膏之上。肓之下。针药所不及。即此穴是也。时人
拙。
不能求得此穴。所以宿 难遣。若能用心方便。求得灸之。无疾不愈矣。王唯一明堂铜人灸
经云。膏肓 二穴。在第四顾下两旁各相去三寸。主无所不疗。羸瘦虚损。梦中失精。上气
咳逆。发狂健忘。又取穴之法。令人正坐。曲脊伸两手。以臂着膝前。令正直手大指与膝头
齐。以物支肘勿令臂动摇也。从胛骨上角摸索至骨下头。其间当有四肋三间。灸中间。从胛
骨之里。去胛容侧指许。摩KT 去表肋间空处。按之自觉牵引于肩中。灸两胛中各一处。至百
壮。多至五百壮。当觉气下砻砻似流水之状。亦当有所不出。若得痰疾。则无所不下也。如
病患已困。不能正坐。当令侧卧挽上臂。令前取穴灸之。又以右手从左肩上住。指头所不及
者。是穴也。左取亦然。乃以前法灸之。若不能久坐。当伸两臂令人挽两胛骨使相离。不尔
即胛骨覆其穴。灸之无验。此灸讫后。令人阳气康盛。当消息以自补养。
孙思邈在《千金方》中论述道：膏肓穴，没有治不好的病。主要治疗身体消瘦、虚损劳伤，睡梦中遗精，气逆上冲、咳嗽气喘，精神狂乱、迷惑及健忘失误等症状。
取穴方法：让患者端正坐姿，弯曲脊柱并伸直双手，将手臂放在膝盖前方，使正直的手的大拇指与膝盖头齐平，用物体支撑手肘，不要使手臂发生动摇。从肩胛骨的上角摸索到肩胛骨的下端，其间应当有四根肋骨和三个间隙，灸中间的间隙。根据肩胛骨内侧的肋骨间空隙处，距离肩胛骨约侧指宽的地方，摩擦胸大肌表面的筋间空隙处，按压时自觉有牵引感通向肩井穴。灸两侧肩胛中间各一壮，累计可达六百壮，多则一千壮。此时应当感觉到气向下流动，像流水一样顺畅。也应当有痰浊排出。如果没有停滞的痰饮和旧疾，就不会有东西排出来。如果病情长久且困顿不能端正坐立，应当让患者侧卧，挽起一只手臂向前以寻找穴位进行艾灸。另外，求取穴位的大致方法是：用右手从右肩上方按住，手指头够不到的地方就是穴位。左手也是如此。然后用前面的方法施灸。如果不能长时间端正坐立，常伸展双臂的人也可以趴在衣袱上，伸展双臂，让人帮助拉开两侧肩胛骨使其分离，否则肩胛骨会覆盖住穴位，无法找到。所趴的衣袱，应当保持大小固定不变，否则就会失去准确的穴位位置。此灸法结束后，能使人的阳气健康旺盛，应当酌情自我调补养护，使身体恢复平衡。该穴位靠近第五椎，参照标准取穴。第四椎下方两旁，相距各三寸。
论述说：从前秦缓没能治好晋侯的病，因为病位在膏之上、肓之下，是针药所达不到的地方，就是指这个穴位。当时的人技艺拙劣，不能求得此穴，所以宿疾难以消除。如果能用心巧妙的方法，求得并施灸此穴，没有治不好的疾病。王唯一在《明堂铜人灸经》中说：膏肓二穴，在第四椎下两旁，各相距三寸。主治无所不疗，身体消瘦虚损，睡梦中遗精，气逆咳嗽，发狂健忘。另外取穴的方法是：让患者端正坐立，弯曲脊柱伸直双手，将手臂放在膝盖前，使正直的手大拇指与膝头齐平，用物体支撑手肘不让手臂动摇。从肩胛骨上角摸索至骨下端，其间应有四肋三间，灸中间。从肩胛骨内侧，距离肩胛骨约侧指宽处，摩擦去表层的肋间空隙处，按压自觉牵引于肩中。灸两侧肩胛中间各一处，累计一百壮，多则五百壮。应当感觉气向下流动，像流水一样的状态。也应当有所排出。如果有痰疾，就没有什么不能排出的。如果病患已经困顿，不能端正坐立，应当让其侧卧挽起上臂，向前取穴施灸。又用右手从左肩上方按住，手指头够不到的地方，就是穴位。左侧取穴也是如此。然后用前面的方法施灸。如果不能久坐，应当伸展双臂，让人帮助拉开两侧肩胛骨使其分离，否则肩胛骨会覆盖穴位，施灸无效。此灸法结束后，使人阳气健康旺盛，应当酌情自我调补养护。
Sun Simiao discussed in the *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold): The Gao Huang acupoints (Gao Huang, BL-43/BL-44) can treat all diseases. They primarily manage emaciation and deficiency exhaustion, nocturnal seminal emission, rebellious Qi with cough and asthma, manic confusion, and forgetfulness or errors.
Acupoint location method: Have the patient sit upright, bend the spine, and extend both hands, placing the arms in front of the knees. Align the thumb of the extended hand with the knee cap. Support the elbow with an object to prevent arm movement. Palpate from the upper angle of the scapula down to its lower end. Between them are four ribs and three intercostal spaces; moxa the middle space. Locate the empty space between the ribs on the inner side of the scapula, approximately one finger-width away from the scapula edge. Rub the space between the tendons on the surface of the pectoralis major muscle. Pressing here should produce a sensation of traction extending to the Jian Jing acupoint (GB-21). Moxa one cone on each side of the mid-scapular region, accumulating up to 600 cones, or as many as 1,000 cones. At this point, one should feel Qi descending smoothly like flowing water. Phlegm turbidity should also be expelled. If there is no stagnant phlegm or old disease, nothing will be discharged. If the condition has been prolonged and severe, preventing the patient from sitting upright, have the patient lie on their side, pull one arm forward to locate the acupoint for moxibustion. Alternatively, a general method to find the acupoint is: use the right hand to press from above the right shoulder; the spot unreachable by the fingertips is the acupoint. The same applies to the left hand. Then apply moxibustion using the previous method. If the patient cannot sit upright for long or frequently extends their arms, they may lie prone on a cloth pad, extend both arms, and have someone help separate the two scapulae. Otherwise, the scapulae will cover the acupoints, making them inaccessible. The cloth pad used for lying must remain fixed in size and position; otherwise, the accurate acupoint location will be lost. After this moxibustion treatment, the person's Yang Qi will become robust and vigorous. One should adjust and nourish oneself accordingly to restore physical balance. The acupoints are located near the fifth thoracic vertebra. Referencing standard measurements, they are located bilaterally three cun lateral to the lower border of the fourth thoracic vertebra.
Discussion states: In ancient times, Qin Huan failed to cure the Marquis of Jin because the disease was located above the "Gao" (heart fat) and below the "Huang" (diaphragm fat), areas beyond the reach of acupuncture and herbal medicine. This refers to these acupoints. People at that time lacked skill and could not locate these acupoints, so chronic ailments were difficult to dispel. If one uses careful and convenient methods to locate and moxa these points, no disease will remain uncured. Wang Weiyi stated in the *Mingtang Tongren Jiu Jing* (Illustrated Manual of Acupuncture and Moxibustion on Bronze Figures): The Gao Huang acupoints are located bilaterally three cun lateral to the lower border of the fourth thoracic vertebra. They treat all conditions, including emaciation and deficiency exhaustion, nocturnal seminal emission, rebellious Qi with cough, mania, and amnesia. Another method for locating the acupoints: Have the patient sit upright, bend the spine, and extend both hands, placing the arms in front of the knees. Align the thumb of the extended hand with the knee cap. Support the elbow with an object to prevent arm movement. Palpate from the upper angle of the scapula to its lower end. There are four ribs and three intercostal spaces; moxa the middle space. From the inner side of the scapula, about one finger-width away, rub the intercostal space superficially. Pressing should produce a sensation of traction in the shoulder. Moxa one site in the middle of each scapular region, accumulating 100 cones, or up to 500 cones. One should feel Qi descending like flowing water. Discharge should occur. If phlegmatic diseases are present, everything can be expelled. If the patient is too weak to sit upright, have them lie on their side, pull the upper arm forward to locate the acupoint for moxibustion. Use the right hand to press from above the left shoulder; the unreachable spot is the acupoint. The same applies to the left side. Then apply moxibustion using the previous method. If unable to sit for long, extend both arms and have someone separate the scapulae. Otherwise, the scapulae will cover the acupoints, rendering moxibustion ineffective. After this moxibustion, the person's Yang Qi becomes robust. Adjust and nourish oneself accordingly.