二十九难曰∶奇经之为病何如?然∶阳维维于阳,阴维维于阴,阴阳不能自相维,则怅然失志,溶溶不
能自收持。阳维为病苦寒热,阴维为病苦心痛。阴跷为病,阳缓而阴急,阴跷为病,阴缓而阳急。
冲之为病,逆气而里急。督之为病,脊强而厥。任之为病,其内苦结,男子为七疝,女子为瘕聚。
带之为病,腹满,腰溶溶,若坐水中。此奇经八脉之为病也。
三十难曰∶荣气之行,常与卫气相随不?然∶经言人受气于谷,谷入于胃,乃传与五脏六腑,
五脏六腑皆受于气。其清者为荣,浊者为卫,荣行脉中,卫行脉外,营周不息,五十而复大会。
阴阳相贯,如环之无端,故知荣卫相随也。
三十一难曰∶三焦者,何禀、何生?何始、何终?其治常在何许?可晓以不?然∶三焦者,水
谷之道路,气之所终始也。上焦者,在心下,下膈、在胃上口,主内而不出。其治在膻中,玉堂下
一寸六分,直两乳间陷者是。中焦者,在胃中脘,不上不下,主腐熟水谷。其治在脐傍。下焦者,
当膀胱上口,主分别清浊,主出而不内,以传道也。其治在脐下一寸,故名曰三焦,其腑在气街。
三十二难曰∶五脏俱等,而心肺独在膈上者何也?然∶心者血,肺者气。血为荣,气为卫;
相随上下,谓之荣卫。通行经络,营周于外,故令心肺在膈上也。
第二十九难问:奇经八脉发生病变会怎样呢?回答说:阳维脉维系着诸阳经,阴维脉维系着诸阴经,如果阴阳二气不能互相维系,就会感到心中惆怅、意志消沉,身体软弱无力,不能自主控制。阳维脉发病时,主要症状是恶寒发热;阴维脉发病时,主要症状是心痛。阴跷脉发病时,表现为阳气侧松弛而阴气侧拘急;阴跷脉(此处原文重复提及,实指阴跷与阳跷之病机对比,或指阴跷病及阳跷)发病时,表现为阴气侧松弛而阳气侧拘急。冲脉发病时,出现气逆和腹部拘急疼痛。督脉发病时,出现脊柱强直和厥冷。任脉发病时,体内感觉痞结不通,男子发为七疝,女子发为瘕聚(腹内结块)。带脉发病时,腹部胀满,腰部松软无力,好像坐在冷水里一样。这就是奇经八脉的病变情况。
第三十难问:营气的运行,总是随着卫气一起行走吗?回答说:经书说人从饮食中摄取精气,食物进入胃后,便传送给五脏六腑,五脏六腑都接受这些精气。其中清轻的部分成为营气,重浊的部分成为卫气,营气行于脉管之中,卫气行于脉管之外,它们循环往复,永不休止,每运行五十周次后会在大肠处再次大会合。阴阳经脉相互贯通,像圆环一样没有尽头,因此知道营气和卫气是相随运行的。
第三十一难问:三焦禀受什么而生?从哪里开始,到哪里结束?它的治疗部位通常在哪里?可以说明白吗?回答说:三焦是水谷运行的道路,也是元气终结和起始的地方。上焦位于心下,横膈膜之上,胃的上口处,主要负责受纳水谷而不外泄。它的治疗部位在膻中穴,即玉堂穴下一寸六分,正对两乳之间凹陷处的穴位。中焦位于胃的中脘部,不上不下的位置,主要负责腐熟消化水谷。它的治疗部位在肚脐旁边。下焦位于膀胱上口处,主要负责分别清浊,主管排泄而不纳入,起到传导作用。它的治疗部位在脐下一寸处,所以称为三焦,其腑气汇聚于气街穴。
第三十二难问:五脏的位置大体相等,为什么唯独心和肺在横膈膜之上呢?回答说:心主血,肺主气。血构成营气,气构成卫气;它们上下相随运行,这就叫做营卫。它们通行于经络,在体表内外循环,所以使得心和肺位于横膈膜之上。
Chapter 29 asks: What are the pathologies of the extraordinary vessels? The response is: Yang Wei Mai (Yang Linking Vessel) links the yang meridians, and Yin Wei Mai (Yin Linking Vessel) links the yin meridians. If yin and yang cannot mutually link and support each other, one will feel despondent and lose spirit, with a sensation of looseness and inability to control one's body movements. When Yang Wei Mai is diseased, the patient suffers from aversion to cold and fever; when Yin Wei Mai is diseased, the patient suffers from heart pain. In diseases of Yin Qiao Mai (Yin Heel Vessel), the yang side is lax while the yin side is tense; conversely, in diseases involving Yang Qiao Mai (Yang Heel Vessel), the yin side is lax while the yang side is tense. In diseases of Chong Mai (Penetrating Vessel), there is rebellious qi and abdominal tension. In diseases of Du Mai (Governing Vessel), there is rigidity of the spine and cold extremities (Jue). In diseases of Ren Mai (Conception Vessel), there is internal knottedness; in men, this manifests as seven types of hernia (Qi Shi); in women, it manifests as zhajju (abdominal masses). In diseases of Dai Mai (Girdle Vessel), there is abdominal fullness and a sensation of weakness in the waist, as if sitting in water. These are the pathologies of the eight extraordinary vessels.
Chapter 30 asks: Does Ying Qi (Nutrient Qi) always travel together with Wei Qi (Defensive Qi)? The response is: The classics state that humans derive qi from grain. Once grain enters the stomach, it is transmitted to the five zang organs and six fu organs, all of which receive qi. The clear and refined portion becomes Ying Qi, while the turbid portion becomes Wei Qi. Ying Qi circulates within the vessels, and Wei Qi circulates outside the vessels. They cycle endlessly without rest, meeting again after fifty cycles. The yin and yang meridians interconnect like a circle without beginning or end; thus, we know that Ying Qi and Wei Qi travel together.
Chapter 31 asks: What is the origin and generation of San Jiao (Triple Burner)? Where does it begin and where does it end? Where is its treatment location? Can this be explained? The response is: San Jiao is the pathway for water and grain, and the starting and ending point of qi. Shang Jiao (Upper Burner) is located below the heart, above the diaphragm, at the upper opening of the stomach. It governs intake and does not allow leakage. Its treatment point is Dan Zhong (Chest Center), specifically one cun and six fen below Yu Tang, directly between the two breasts in the depression. Zhong Jiao (Middle Burner) is located at the middle jiu of the stomach, neither high nor low, governing the rotting and ripening of food and drink. Its treatment area is beside the navel. Xia Jiao (Lower Burner) is located at the upper opening of the bladder. It governs the separation of clear and turbid substances, managing excretion without reabsorption, serving as a channel for transmission. Its treatment point is one cun below the navel. Hence it is called San Jiao, and its fu organ qi gathers at Qi Jie (Street of Qi).
Chapter 32 asks: The five zang organs are generally equal in position, but why are only Xin (Heart) and Fei (Lung) located above the diaphragm? The response is: Xin governs blood, and Fei governs qi. Blood constitutes Ying Qi, and qi constitutes Wei Qi. They follow each other up and down, which is referred to as Ying and Wei. They circulate through the meridians and nourish the exterior, which is why Xin and Fei are located above the diaphragm.