明堂曰。灸炷下广三分。若不三分。则火气不达。病不愈则是灸炷欲大。惟头与四肢欲
小耳
。又曰。艾炷根据小箸头作其病脉粗细。状如细线。但令当脉灸之。雀粪大炷亦能愈疾。如腹
胀疝瘕。 癖伏梁气等。须大艾炷。短剧曰。腹背烂烧。四肢但去风邪而已不宜大炷。如巨
阙鸠尾。当脉上灸之。不过四五壮。艾炷宜小。若艾炷大而复灸多。其人永无心力。头上灸
多令人失精神。背脚灸多令人血脉枯竭。四肢细而无力 外台云。人年三十以上灸头不灸三
里。令人气上冲目。明堂云。先灸上。后灸下先灸少后灸多皆宜审之 资生云。凡灸当先阳
后阴言从头向左而渐下。次从头向右而渐下。
千金云。凡言壮数者若丁壮。病根深笃。可倍于方数。老少羸弱。可减半。扁鹊灸法。
有至
三五百壮千壮。此亦太过。曹氏灸法。有百壮五十壮。短剧诸方亦然惟明堂云针入六分。灸
三壮。更无余治故后人无准。惟以病之轻重而增损之凡灸头项止于七壮。积至七七壮止 灸
法坐点穴则坐灸。卧点穴则卧灸。立点穴则立灸须得身体平直毋令倾侧。若倾侧穴不正。徒
破好肉耳。
图翼云。灸法有二报三报。以至连年不绝者。前后相催其效尤速或自三壮五壮。以至百
壮千
壮者。由渐而增也凡以火补者。勿吹其火。必待其从容彻底自灭。灸毕即可用膏贴之。以养
火气。若欲报者直待报毕。贴之可也。以火泻者。可吹其火。传其艾宜于迅速须待灸。疮溃
发然后贴膏。此补泻之法也然用火之法。惟阳虚多寒经络凝滞者为宜。若诊其脉数口干咽痛
。面赤内热等症。俱不宜灸也。
《明堂》记载：艾炷底部直径应为三分。如果不足三分，则热力无法透达，疾病难以痊愈。因此，艾炷宜大，唯独头部和四肢的艾炷宜小。
又记载：艾炷的大小应根据患者脉象的粗细来定。若脉象细如丝线，只需在脉上施灸，即使像麻雀粪粒大小的艾炷也能治愈疾病。如果是腹胀、疝气、瘕积、癖块、伏梁气等病证，则必须使用较大的艾炷。
《短剧》记载：腹部和背部可以烧灼至皮肤溃烂（指化脓灸），而四肢仅用于祛除风邪，不宜使用大艾炷。例如巨阙穴、鸠尾穴，应在经脉上施灸，不超过四五壮。艾炷宜小，如果艾炷过大且灸治次数过多，会导致患者永远没有精力；头部灸治过多会使人精神丧失；背部和脚部灸治过多会使血脉枯竭，四肢纤细无力。
《外台秘要》记载：人年过三十，若只灸头部而不灸足三里穴，会导致气机上冲至眼部。
《明堂》记载：应先灸上部，后灸下部；先灸少处，后灸多处，这些都应当仔细审察。
《资生经》记载：凡是施灸，应当先阳经后阴经，即先从头部向左逐渐向下灸，再从头部向右逐渐向下灸。
《千金方》记载：凡提到壮数的，如果是身体强壮、病根深固的人，壮数可加倍于处方规定的数量；如果是老人、小孩或体弱之人，壮数可减少一半。
《扁鹊灸法》中，有灸至三五百壮甚至千壮的，这也太过分了。曹氏灸法，有一百壮、五十壮，《短剧》中的各方也是如此。只有《明堂》记载针刺入六分，灸三壮，没有其他治疗方法，所以后人没有标准，只能根据病情的轻重来增减壮数。凡是灸头项部，止于七壮，累计至七七四十九壮为止。
施灸时，取穴是坐着就坐着灸，躺着就躺着灸，站着就站着灸。必须使身体保持平直，不要倾斜。如果身体倾斜，穴位就不准确，只会白白损伤好肉罢了。
《图翼》记载：灸法有“二报”、“三报”，甚至连续多年不断灸的，前后相继催促疗效尤其迅速；也有从三壮、五壮逐渐增加到百壮、千壮的，这是循序渐进地增加。
凡是采用火补法，不要吹火，必须等待火焰从容彻底自然熄灭。灸毕即可用膏药贴敷，以养护火气。如果想要“报灸”（二次灸），直接等到报灸结束后再贴膏药即可。
凡是采用火泻法，可以吹火，传递艾火应迅速，必须等待灸疮溃烂发作后再贴膏药。这就是补泻的方法。然而用火的方法，只适用于阳气虚弱、多寒、经络凝滞的情况。如果诊察到脉数、口干、咽痛、面赤、内热等症状，都不适宜施灸。
The *Mingtang* records: The base diameter of the moxa cone should be three fen. If it is less than three fen, the fire qi will not penetrate, and the disease will not heal. Therefore, the moxa cone should be large, except for those on the head and limbs, which should be small.
It further records: The size of the moxa cone should correspond to the thickness or thinness of the patient's pulse. If the pulse is fine like a thread, one need only moxibustion directly on the pulse; even a moxa cone as small as a sparrow's droppings can cure the disease. However, for conditions such as abdominal distension, hernia, mass accumulation (Jia), fixed masses (Pi), and Fu-Liang Qi, large moxa cones are required.
The *Duanju* records: For the abdomen and back, burning until skin ulceration (suppurative moxibustion) is permissible; but for the limbs, it is only to dispel wind pathogens, and large moxa cones should not be used. For example, at Jueque (CV14) and Jiutui (CV15), moxibustion should be applied on the meridian, limited to no more than four or five moxae (Zhuang). The moxa cone should be small; if the cone is too large and the number of moxae is excessive, the person will permanently lose vitality. Excessive moxibustion on the head causes loss of spirit; excessive moxibustion on the back and feet leads to exhaustion of blood vessels, resulting in thin and weak limbs.
The *Waitai Mi Yao* records: For individuals over thirty years old, if one moxibusts the head but not Zusanli (ST36), it causes Qi to rush upward to the eyes.
The *Mingtang* records: One should moxibust the upper part first, then the lower part; moxibust fewer points first, then more points. All these require careful consideration.
The *Zisheng Jing* records: Generally, moxibustion should follow the Yang meridians first and Yin meridians second. That is, start from the head and gradually move downward to the left, then from the head and gradually move downward to the right.
The *Qianjin Fang* records: Regarding the number of moxae (Zhuang): for robust individuals with deep-rooted diseases, the number may be doubled compared to the prescription; for the elderly, children, or frail individuals, the number should be halved.
The *Bian Que Jiu Fa* mentions moxibustion up to three or five hundred Zhuang, or even a thousand Zhuang, which is excessive. Cao Shi's method involves one hundred or fifty Zhuang, similar to methods in *Duanju*. Only the *Mingtang* specifies inserting the needle six fen and applying three Zhuang, lacking other treatments, leaving later generations without a standard. Thus, one must increase or decrease the Zhuang count based on the severity of the disease. Moxibustion on the head and neck should stop at seven Zhuang, accumulating up to forty-nine Zhuang (seven times seven).
When performing moxibustion, if the acupoint is located while sitting, perform moxibustion while sitting; if lying down, perform while lying; if standing, perform while standing. The body must remain straight and not tilted. If tilted, the acupoint position will be inaccurate, merely damaging healthy flesh in vain.
The *Tu Yi* records: Moxibustion methods include "two reports" (secondary applications) and "three reports," continuing year after year, where successive applications accelerate efficacy. Others gradually increase from three or five Zhuang to hundreds or thousands, increasing step by step.
For fire tonification (Bu), do not blow on the fire; wait for it to burn out naturally and completely. After moxibustion, apply a plaster immediately to nourish the fire qi. If secondary moxibustion ("report") is desired, apply the plaster only after the secondary session is complete.
For fire sedation (Xie), one may blow on the fire to hasten the burning of the moxa. This requires speed. Apply the plaster only after the moxibustion sore has ulcerated and discharged. This constitutes the method of tonification and sedation. However, fire therapy is suitable only for cases of Yang deficiency with cold, and stagnation of the collaterals. If the pulse is rapid, accompanied by dry mouth, sore throat, red face, and internal heat, moxibustion is contraindicated.