\r肩膊部左右二十六穴\pf-f10.bmp\r
肩井二穴。一名膊井。在肩上陷。（明堂此有 中二字。）缺盆上大骨前寸半。以三指按
。当中指下陷中。甲乙经云、只可针五分。此膊井脉、足阳明之会。乃连入五脏气。若刺
、则令人闷倒不识人。即速须三里下气。先补不泻。须臾平复如故。凡针肩井。皆以三里下
其气。大良。灸七壮。明云、针四分。先补而后泻。特不宜灸。针不得深。深即令人闷。
若妇人胎落后微损。手足弱者。针肩井立瘥。灸乃胜针。日灸七壮。止一百。若针肩井。必
三里下气。如不灸三里。即拔气上。
明堂即云特不宜灸。又云灸乃胜针。日灸七壮。至百壮罢。则是又可灸矣。不知何自畔
其说也。或者肩井不可灸。惟胎落后手足弱者可灸耶。
天 二穴。在肩缺盆中上毖骨之际。陷中央。针八分。灸三壮。
巨骨二穴。在肩端上行两叉骨间陷中。灸五壮。针寸半。明云、巨骨一穴。在心脾骨
日灸三壮至七壮。禁针。针则倒悬。一食顷乃得下针。针入四分。泻之勿补。针出始得正卧
。忌同。下云、巨骨二穴。在肩端上两行骨陷中。灸一壮。（铜云∶云门在巨骨下夹气户旁
各二寸。俞府在巨骨下璇玑旁各二寸。气户在巨骨下俞府两旁各二寸。）
铜人云、巨骨一穴。在肩端上两叉骨间。明堂下经亦同。但明堂上经云、巨骨一穴。在
心脾
骨头。不特一穴字不同。而穴在心脾骨头亦异。岂其所谓一穴在心脾头者。非巨骨耶。不然
、即是误写二字作一字。肩胛为心脾也。
会二穴。一名 。在肩前廉去肩头三寸宛宛中。针七分。留三呼。得气即泻。灸
（素注∶臂前廉肩端。）肩 二穴。在膊头骨肩端两骨间陷宛宛中。举臂取之。灸七壮。至二
七。以瘥为度。若灸偏风不遂。可七七壮。不宜多。恐手臂细。若风病筋骨无力。久不瘥。
灸不畏细也。刺即泄肩臂热气。唐库狄钦患风痹。手足不得伸。甄权针此穴。令将弓箭射之
。如故。明云、针八分。留三呼。泻五吸。灸不及针。以平手取其穴。日灸七壮。增至二
七。若灸偏风不随。可至二百。若更多灸。恐手臂细。若刺风 风 风病。当其火艾。不畏
细也。忌同。（千云∶肩头正中两骨间一名中肩井。外台名扁骨。）
肩 二穴。在肩端 上陷中。举臂取之。针七分。灸三壮。明云、五壮。
肩贞二穴。在肩胛下两骨解间。肩 后陷中。针五分。
天宗二穴。在秉风后大骨下陷中。灸三壮。针五分。留六呼。
秉风二穴。在肩上小 后。举臂有空。灸五壮。针五分。
俞二穴。在肩 后大骨下胛上廉陷中。针八分。灸三壮。素在肩 后。举臂取之。
曲垣二穴。在肩中央曲胛陷中。按之应手痛。灸三壮。针五分。明云、九分。
肩外俞二穴。在肩胛上廉。去脊骨三寸陷中。针六分。灸三壮。明上云、一壮。
肩中俞二穴。在肩胛内廉。去脊二寸陷中。针三分。留七呼。灸十壮。
肩膊部左右二十六穴
肩井二穴。又名膊井。位于肩上凹陷处。（《明堂》此处有“中”二字。）在缺盆上方大骨前一寸半处。用三指按压，当中指下方的凹陷处即是。《甲乙经》记载：只能针刺五分。此处的膊井脉，是足阳明胃经的交会穴，其气连入五脏。如果针刺过深，会导致人昏厥不省人事。此时必须立即针刺足三里穴以引气下行。先施行补法，后施行泻法，片刻后即可恢复如常。凡是针刺肩井穴，都必须配合足三里穴来降气，效果很好。艾灸七壮。《明堂》记载：针刺四分。先补后泻。特别不宜艾灸。针刺不得过深，过深就会使人昏闷。如果是妇女胎衣不下且身体轻微受损、手足软弱无力者，针刺肩井穴可立即痊愈。艾灸胜过针刺。每日艾灸七壮，累计一百壮。如果针刺肩井穴，必须配合足三里穴降气。如果不灸足三里穴，就会导致气机上逆。
《明堂》说特别不宜艾灸，又说艾灸胜过针刺，每日七壮，至一百壮为止。这又是可以艾灸的说法了。不知道是从哪里违背了自己的说法呢？或许肩井穴不可艾灸，只有胎衣不下且手足软弱者才可以艾灸吗？
天鼎二穴。在肩缺盆中上锁骨之际，凹陷中央。针刺八分，艾灸三壮。
巨骨二穴。在肩端上行两叉骨间的凹陷中。艾灸五壮，针刺一寸半。《明堂》记载：巨骨一穴，在心脾骨头处，每日艾灸三壮至七壮。禁止针刺。如果针刺，会导致患者倒悬感，约一顿饭的时间才能恢复平卧姿势。针刺入四分，施行泻法，不要补法。针出后才能正卧。禁忌同上。下文又说：巨骨二穴，在肩端上两行骨的凹陷中。艾灸一壮。（《铜人腧穴针灸图经》记载：云门穴在巨骨下，夹气户旁各二寸；俞府穴在巨骨下璇玑旁各二寸；气户穴在巨骨下俞府两旁各二寸。）
《铜人腧穴针灸图经》记载：巨骨一穴，在肩端上两叉骨间。《明堂下经》也相同。但《明堂上经》记载：巨骨一穴，在心脾骨头处。不仅“一穴”字样不同，而且穴位在心脾骨头处也不同。难道所谓“一穴在心脾头者”，不是巨骨穴吗？否则，就是误将“二”字写成了“一”字。肩胛部位属于心脾。
会二穴。又名[缺字]。在肩前廉，距肩头三寸的宛宛凹陷中。针刺七分，留针三次呼吸时间。得气后立即施行泻法。艾灸（《素问》注：臂前廉肩端。）肩髃二穴。在膊头骨肩端两骨间的宛宛凹陷中。举臂取穴。艾灸七壮，至十四壮。以病愈为度。如果治疗偏瘫不遂，可灸七七四十九壮。不宜过多，恐怕手臂会变细。如果风病导致筋骨无力，久治不愈，艾灸不怕手臂变细。针刺可泄去肩臂的热气。唐代库狄钦患风痹，手足不能伸展。甄权针刺此穴，让他拿着弓箭射箭，结果恢复如常。《明堂》记载：针刺八分，留针三次呼吸时间，泻法五次吸气时间。艾灸不如针刺有效。以平手取穴。每日艾灸七壮，增至十四壮。如果治疗偏瘫不随，可至二百壮。如果灸更多，恐怕手臂变细。如果针刺风痹、风痱等风病，当用火艾，不怕手臂变细。禁忌同上。（《千金方》记载：肩头正中两骨间一名中肩井。《外台秘要》名为扁骨。）
肩髎二穴。在肩端髆骨上凹陷中。举臂取穴。针刺七分，艾灸三壮。《明堂》记载：五壮。
天宗二穴。在秉风后大骨下凹陷中。艾灸三壮，针刺五分，留针六次呼吸时间。
俞二穴。在肩髎后大骨下胛上廉凹陷中。针刺八分，艾灸三壮。《素问》记载在肩髎后。举臂取穴。
曲垣二穴。在肩中央曲胛凹陷中。按压时感到疼痛。艾灸三壮，针刺五分。《明堂》记载：九分。
Twenty-six Acupoints on the Left and Right of the Shoulder and Upper Arm Region
Jianjing (GB21, Shoulder Well) [two points]. Also known as Bojing. Located in the depression on the shoulder. (*Mingtang* has the character "Zhong" here.) It is located one-and-a-half cun anterior to the greater bone above the Keyhole (Quepen). Press with three fingers; the point is where the middle finger falls into the depression. The *Jia Yi Jing* states: only needle five fen. This Bojing pulse is an intersection of the Foot-Yangming Stomach Meridian, and its qi connects to the Five Zang Organs. If needled too deeply, it may cause fainting and loss of consciousness. One must immediately needle Zusanli (ST36) to direct the Qi downward. Apply tonification first, then sedation. After a short while, the patient will recover as usual. Whenever needling Jianjing, one must always use Zusanli to descend the Qi; this is highly effective. Moxibustion: seven moxa cones. *Mingtang* states: needle four fen. Tonify first, then sedate. Specifically, moxibustion is contraindicated. Do not needle deeply; deep needling causes faintness and stuffiness. In cases where a woman suffers from retained placenta with slight injury and weakness of the limbs, needling Jianjing brings immediate cure. Moxibustion is superior to needling. Moxa seven cones daily, up to one hundred cones. If needling Jianjing, one must use Zusanli to descend the Qi. If Zusanli is not moxa-ed, the Qi will ascend rebelliously.
*Mingtang* says moxibustion is specifically contraindicated, yet also says moxibustion is superior to needling, seven cones daily, up to one hundred cones. This implies moxibustion is permissible. I do not know where this contradicts its own statement. Perhaps Jianjing is generally contraindicated for moxibustion, except in cases of retained placenta and limb weakness?
Tianding (SI10, Heavenly Tripod) [two points]. Located at the junction of the shoulder and Quepen, above the clavicle, in the central depression. Needle eight fen, moxa three cones.
Jugu (SI11, Great Bone) [two points]. Located in the depression between the two diverging bones ascending from the acromion. Moxa five cones, needle one-and-a-half cun. *Mingtang* states: Jigu one point, located at the heart-spleen bone. Moxa three to seven cones daily. Needling is prohibited. If needled, it causes a sensation of inversion/hanging upside down; after about the time it takes to eat one meal, normal posture can be resumed. Needle four fen, apply sedation, do not tonify. Only lie flat after removing the needle. Contraindications are the same. The text below states: Jugu two points, located in the depression between the two rows of bones above the acromion. Moxa one cone. (*Tongren* states: Yunmen (LU2) is two cun lateral to Qihu (ST15) below Jugu; Shufu (BL14) is two cun lateral to Xuanji (CV15) below Jugu; Qihu (ST15) is two cun lateral to Shufu below Jugu.)
*Tongren* states: Jugu one point, located between the two diverging bones above the acromion. *Mingtang Xiajing* agrees. However, *Mingtang Shangjing* states: Jugu one point, located at the heart-spleen bone. Not only does the number of points differ ("one" vs "two"), but the location description differs as well. Could the "one point at the heart-spleen head" refer to a different point than Jugu? Otherwise, it might be a scribal error writing "one" instead of "two". The scapula region corresponds to the Heart and Spleen.
Huizong (SI13, Meeting) [two points]. Also known as [missing character]. Located in the hollow depression three cun anterior to the shoulder tip. Needle seven fen, retain for three breaths. Upon obtaining Deqi, apply sedation. Moxibustion. (*Suwen* annotation: anterior border of the arm, shoulder tip.) Jianyu (LI15, Shoulder Joint) [two points]. Located in the hollow depression between the two bones at the shoulder joint. Locate by raising the arm. Moxa seven cones, up to fourteen cones. Stop when cured. For hemiplegia or paralysis, moxa forty-nine cones. Do not exceed this amount, lest the arm become thin. If wind-disease causes weakness of sinews and bones with chronic non-resolution, moxibustion is safe even if the arm becomes thin. Needling drains heat and Qi from the shoulder and arm. In the Tang Dynasty, Kudi Qin suffered from wind-bi syndrome with inability to extend his limbs. Zhen Quan needled this point and instructed him to shoot arrows with bow and arrow, resulting in recovery. *Mingtang* states: needle eight fen, retain for three breaths, sedate during five inhalations. Moxibustion is less effective than needling. Locate with the arm relaxed. Moxa seven cones daily, increasing to fourteen cones. For hemiplegia, moxa up to two hundred cones. If moxa more, fear the arm becoming thin. If needling wind-bi or wind-paralysis, use fire-moxa; fear not the arm becoming thin. Contraindications are the same. (*Qianjin* states: the midpoint between the two bones at the shoulder tip is named Zhongjianjing. *Waitai* names it Bangu.)
Jianliao (TE14, Shoulder Crevice) [two points]. Located in the depression above the humerus at the shoulder tip. Locate by raising the arm. Needle seven fen, moxa three cones. *Mingtang* states: five cones.
Jianzhen (SI9, Shoulder Truth) [two points]. Located in the depression between the two bone joints below the scapula, posterior to Jianliao. Needle five fen.
Tianzong (SI11, Heavenly Palace) [two points]. Located in the depression below the great bone posterior to Bingfeng. Moxa three cones, needle five fen, retain for six breaths.
Bingfeng (SI12, Holding Wind) [two points]. Located posterior to the small bone on the shoulder. An empty space appears when raising the arm. Moxa five cones, needle five fen.
Shenmai (SI12? Note: Text says "Yu", likely referring to a specific point contextually, possibly Shenmai or similar, but literally "Yu") [two points]. Located in the depression on the upper edge of the scapula below the great bone posterior to Jianliao. Needle eight fen, moxa three cones. *Suwen* states posterior to Jianliao. Locate by raising the arm.
Quyuan (SI13, Shoulder Curved Wall) [two points]. Located in the curved depression of the scapula in the center of the shoulder. Tender to palpation. Moxa three cones, needle five fen. *Mingtang* states: nine fen.
Jianwaishu (SI14, Shoulder External Shu) [two points]. Located on the upper edge of the scapula, three cun from the spine, in the depression. Needle six fen, moxa three cones. *Mingtang Shangjing* states: one cone.
Jianzhongshu (SI15, Shoulder Middle Shu) [two points]. Located on the medial edge of the scapula, two cun from the spine, in the depression. Needle three fen, retain for seven breaths, moxa ten cones.