千金方云。凡言壮数。若丁壮病根深笃。可倍于壮数。老少羸弱。可减半（又云。小儿
七日
以上。周年以还。不过七壮。炷如雀屎）。扁鹊灸法。有至五百壮千壮。曹氏灸法。有百壮
有五十壮。短剧诸方亦然。惟明堂本经多云。针入六分灸三壮。更无余论。故后人用法不准
惟以病之轻重而增损之。凡灸头顶止于七壮。积至七七壮止。同人若治风。则灸上星前顶
百会皆至二百壮。腹背宜灸五百壮。若鸠尾巨阙。亦不宜多。四肢但去风邪。不宜多灸。灸
则四肢细而无力。明堂上经而千金。于足三里穴乃云。多至二三百壮。心俞禁灸。若中风则
急
灸至百壮。皆视其病之轻重而用之。不可泥一说而又不知其有一说也。下经只云。若是禁穴
明堂亦许灸一壮至三壮。恐未尽也。又云。凡宦游吴蜀。体上常须三两处灸之。切令疮渐瘥
则瘴疠瘟疟毒瓦斯不能着人。故吴蜀多行灸法。有阿是之法。言人有病。即令捏其上。若里
当其处。不问孔穴。即得便快。或痛处即云阿是。灸刺皆验。故曰。阿是穴。
呼不过三。吸不过五。呼外捻针回经气。吸内捻针行经气。
千金方云。病有须针者。即针刺以补泻之。不宜针者。直而灸之。然灸之大法其孔穴与
针无
忌。即下白针或湿针讫乃灸之。此为良医。其香港脚一病。最宜针。若针而不灸。灸而不针。
非良医也。针灸而药。药而不针。亦非良医也。但恨下里间。知针者鲜尔。所以学人须解用
针。燔针白针皆须妙解。固是良医。此言针灸与药之相须也。今人或但针而不灸。灸而不针
或惟用药而不知针灸者。皆犯孙真人所戒也。而世所谓医者。则但知有药而已。针灸则未
尝过而问焉。人或诘之。则曰。是外科也。业贵精。不贵杂也。否则曰。富贵之家。未必肯
针灸也。皆自文其过尔。吾故详着千金之说。以示人云。
《千金方》说：凡是提到艾灸的壮数，如果身体强壮、病根深重的人，艾炷数量可以加倍；老人、小孩及体弱之人，艾炷数量可以减少一半。（又说：出生七天以上、不满一周岁的婴儿，艾灸不超过七壮，艾炷大小如麻雀屎。）扁鹊的灸法中，有达到五百壮或一千壮的。曹氏的灸法中，有一百壮或五十壮的。《短剧》等医方也是如此。只有《明堂本经》大多记载：针刺入六分深，艾灸三壮，没有其他更多的论述。所以后人的用法不统一，只是根据病情的轻重来增减艾炷数量。
凡是艾灸头顶部位，最多止于七壮，累计至七七四十九壮为止。如果是治疗风病，那么艾灸上星、前顶、百会等穴位都可以达到二百壮。腹部和背部适宜艾灸五百壮。如果是鸠尾、巨阙穴，也不宜多灸。四肢只要祛除风邪即可，不宜多灸，否则会导致四肢细弱无力。《明堂上经》和《千金方》在足三里穴上却说：可以多灸到二三百壮。心俞穴禁止艾灸，但如果发生中风，则紧急艾灸至一百壮。这都是视病情的轻重而使用，不可拘泥于一种说法，而不知道还有另一种说法。《下经》只说：如果是禁灸穴，《明堂》也允许灸一壮到三壮，恐怕这还不够全面。
又说：凡是宦游吴蜀之地的人，身上常须艾灸两三处，务必让疮口逐渐愈合，这样瘴气、疠气、瘟疟毒气就不能侵袭人体。所以吴蜀地区多施行灸法。还有“阿是”之法，意思是人若有病痛，就让他捏按疼痛部位，如果里面正好对应病灶所在，不问是否是特定穴位，只要感到舒适或疼痛缓解，就说“阿是”，此时施以艾灸或针刺都有效验，所以称为“阿是穴”。
呼气时不要超过三次，吸气时不要超过五次。呼气时向外捻转针具以引导经气外出，吸气时向内捻转针具以推动经气运行。
《千金方》说：疾病中有需要针刺的，就用针刺来进行补泻；不适宜针刺的，就直接用艾灸。然而艾灸的大法中，其孔穴与针刺没有禁忌区别。即在刺完白针（不加热）或湿针（可能指含水或特殊手法）之后再进行艾灸，这才是良医的做法。对于香港脚（脚气病）这一病症，最适宜针刺。如果只针刺不艾灸，或只艾灸不针刺，都不是良医。只针灸而不用药，或只用药而不知针灸，也都不是良医。只是遗憾民间懂得针刺的人很少，所以学习者必须理解如何使用针具。燔针（烧红的针）和白针都需要精妙地掌握，这样才能成为良医。这是说针灸与药物相辅相成的关系。现在有些人只针刺不艾灸，或只艾灸不针刺，或者只用药物而不懂针灸，都犯了孙真人所告诫的错误。而世间所谓的医生，只知道有药物罢了，对于针灸却从未过问。如果有人责问他们，他们就推脱说：“这是外科的事。”“行业贵在专精，不在杂乱。”或者说：“富贵人家未必肯接受针灸。”这些都是为了掩饰自己的过错罢了。所以我详细记录《千金方》的说法，以此示人。
The *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) states: Regarding the number of moxa cones (Zhuang, a unit of measurement for moxibustion), if the patient is robust and the disease root is deep-seated, the number may be doubled compared to standard amounts; for the elderly, children, or those who are emaciated and weak, the number should be halved. (It further states: For infants older than seven days but less than one year old, moxibustion shall not exceed seven Zhuang, with cone sizes no larger than a sparrow's droppings.) The moxibustion methods of Bian Que include up to five hundred or one thousand Zhuang. Cao's moxibustion methods include one hundred or fifty Zhuang. Formulas in the *Duanju* (Short Treatise) and other texts follow similar patterns. However, the *Mingtang Benjing* (Classic of the Acupoints) mostly records that needle insertion depth is six fen, and moxibustion consists of three Zhuang, with no further elaboration. Consequently, later practitioners' methods were inconsistent, adjusting the number of Zhuang solely based on the severity of the illness.
For moxibustion on the head, it should stop at seven Zhuang, accumulating up to forty-nine Zhuang (seven times seven). If treating wind-pathogens, moxibustion on acupoints such as Shangxing, Qianding, and Baihui can reach two hundred Zhuang. The abdomen and back are suitable for five hundred Zhuang. However, for acupoints such as Jiawei and Jueque, excessive moxibustion is inadvisable. For the limbs, if the goal is merely to dispel wind-pathogens, excessive moxibustion is contraindicated, as it may lead to thinness and weakness of the limbs. The *Mingtang Shangjing* (Upper Classic of the Acupoints) and the *Qianjin Fang* state regarding Zusanli (ST36): moxibustion can extend to two or three hundred Zhuang. Xinshu (BL15) is contraindicated for moxibustion; however, in cases of stroke (Zhongfeng), emergency moxibustion up to one hundred Zhuang is indicated. These applications depend on the severity of the condition; one must not rigidly adhere to one rule while ignoring another. The *Xiajing* (Lower Classic) only states that for contraindicated acupoints, the *Mingtang* permits one to three Zhuang, which may be insufficient.
Furthermore, it is stated that individuals traveling or residing in the Wu and Shu regions should undergo moxibustion on two or three areas of the body regularly. It is crucial to allow the moxibustion blisters to heal gradually, thereby preventing miasma, pestilence, epidemic fevers, and malaria toxins from affecting the person. Hence, moxibustion is commonly practiced in the Wu and Shu regions. There is also the method of "A-Shi" (Ah-Shi) points. This refers to pressing on a painful area; if tenderness corresponds to the internal pathology, regardless of whether it is a specific named acupoint, relief or sensation indicates the correct spot. Moxibustion or acupuncture applied here yields effective results, hence the term "A-Shi point."
Exhalation should not exceed three cycles, and inhalation should not exceed five cycles. During exhalation, twirl the needle outward to guide the Jing-Qi (Meridian Qi) outwards; during inhalation, twirl the needle inward to promote the circulation of Jing-Qi.
The *Qianjin Fang* states: For conditions requiring acupuncture, use needles for tonification or sedation; for conditions unsuitable for needling, apply moxibustion directly. In principle, there are no contraindications for acupoints used in moxibustion compared to acupuncture. After performing white needle (unheated needle) or wet needle techniques, applying moxibustation is the practice of a skilled physician. For the disease known as Hongjiao (Hongjiao disease, often corresponding to Beriberi or gouty arthritis), acupuncture is most suitable. A physician who uses only acupuncture without moxibustion, or only moxibustion without acupuncture, is not a skilled doctor. Similarly, one who relies solely on acupuncture and herbs but neglects the integration, or uses only herbs without understanding acupuncture and moxibustion, is also not a skilled doctor. Regrettably, few laypeople understand acupuncture; therefore, students must master needle manipulation. Both burning needles (Fan Zhen) and white needles require profound understanding to become a skilled physician. This emphasizes the mutual reliance of acupuncture, moxibustion, and herbal medicine. Currently, some practitioners use only acupuncture without moxibustion, or vice versa, or rely solely on herbs while ignoring acupuncture and moxibustion, all of which violate the warnings of Sun Simiao. Yet, physicians in society often know only of herbs, never inquiring about acupuncture and moxibustion. When questioned, they excuse themselves by saying, "This belongs to surgery," or "Professionals should specialize, not dabble in杂 (miscellaneous) fields," or "Wealthy families may not consent to acupuncture and moxibustion." These are merely excuses to cover their deficiencies. Therefore, I have detailed the statements from the *Qianjin Fang* to instruct others.