阳维为病。苦寒热。阴维为病。苦心痛。阴阳不能相维。则怅然失志。溶溶不能自收。阳维动苦肌肉痹痒。皮肤痛。
下部不仁。汗出而寒。又苦颠仆羊鸣。手足相引。甚者失音不能言。阴维动苦颠痫僵仆。羊鸣失音。肌肉痹痒。应时自
发。汗出恶风。身洗洗然。阳维脉浮。暂起目眩。阳盛实者。若肩息洒洒如寒。阴维脉沉大而实者。苦胸中痛。胁下支
满心痛。其脉如贯珠者。男子两胁下实。女子阴中痛。如有心状。
阳维维于诸阳。其所谓维者。起于诸阳之交。发于足太阳之金门。而与手足少阳阳明。会于阳白。阴维维于诸阴。
起于诸阴之交。发于足少阴之筑宾。上至顶前而终。是二维者。虽有经络之别。而实为阴阳之盛气所持。盖阳莫盛于太
阳。是以能维持诸阳。阴莫盛于少阴。是以能维持诸阴。故二维之盛。其盛不在络而在气。二维之病虽在络。而实亦在
气。盖唯本阳本阴有衰耗之气。则必至总见于诸阳诸阴。是以阳维为病。必太阳衰于下。失升腾之和气。而先见于少阳。
故苦寒热。阴维为病。必少阴竭于里。而见穷阴之厥逆。故苦心痛。若阴阳不能相维。是谓阴阳两虚。其证心肾不交。
水火两乖。神明无所主。故怅然失志。溶溶不能自收。以水散涣。无相养之道也。又阳维苦肌肉痹痒者。阳衰则卫不行
而气滞。气滞则阳不能率先。而阴行迟。故痹痒。又令人身如虫行。如是则阳气不摄。而阴气独滞。故皮肤痛。阳衰于
本起。故下部不仁。并汗出而寒。此阳之不固不至。而营亦不行。是以阴袭之也。他若颠仆羊鸣。手足相引者。阳去则
经络凝涩。停湿在经而为痰。异时阴袭之。则经阻而筋掣。故迫而相引。又阻其气道。故声溢而不能发。若羊鸣也。至
若阴维之不维。是阴不副阳。而不能为阳守。则阳离而不入于阴。重阴充塞隧道。九窍皆沉故亦病颠痫僵仆羊鸣。或失
音也。若肌肉痹痒。汗出恶风。似若稍轻于前症。要亦营虚无阳而畏寒。卫亦不能为之卫。故阴维之虚为阴虚。而实亦
无阳之虚。特少异于阳维云耳。
阳维脉发生病变,患者会感到恶寒与发热交替。阴维脉发生病变,患者会感到心痛。如果阴阳二脉不能相互维系,患者就会神情恍惚、意志消沉,身体软弱无力,无法自主控制肢体。
阳维脉异常时,容易引发肌肉麻木瘙痒、皮肤疼痛。下部感觉迟钝,出汗且怕冷,又常伴有突然跌倒、发出羊叫声、手足抽搐牵引的症状,严重的甚至失音不能说话。阴维脉异常时,容易引发癫痫僵仆、发出羊叫声、失音、肌肉麻木瘙痒,发作时自然出汗、怕风,身体有寒冷感。
阳维脉脉象浮,突然起身时会头晕目眩;若阳气盛实,则会出现耸肩呼吸、战栗如冷的症状。阴维脉脉象沉大而实,患者会感到胸中疼痛、胁肋部支撑胀满及心痛。如果脉象像串珠一样连续不断,男子表现为两胁下实证,女子表现为阴部疼痛,感觉心中不适。
阳维脉维系着各条阳经,所谓的“维”,是指它起于各阳经交汇之处,发源于足太阳膀胱经的金门穴,并与手少阳、足少阳、手阳明、足阳明经在阳白穴相会合。阴维脉维系着各条阴经,起于各阴经交汇之处,发源于足少阴肾经的筑宾穴,向上行至头顶前方结束。这两条维脉,虽然经络归属不同,但实际上是由阴阳旺盛之气所主持。大概阳气没有比太阳经更盛的,所以能维持诸阳经;阴气没有比少阴经更盛的,所以能维持诸阴经。因此,二维脉的旺盛,其盛不在络脉而在气机。二维脉的病证虽然在络脉表现,但实质也在气机。因为只有本源的阳气和阴气出现衰耗,才必然会在诸阳经和诸阴经上总体显现出来。所以,阳维脉发病,必然是太阳经在下部衰败,失去了升腾的和顺之气,从而先在少阳经显现,因此患者苦于寒热往来。阴维脉发病,必然是少阴经在内部枯竭,出现穷尽之阴的厥逆,因此患者苦于心痛。如果阴阳不能相互维系,这就叫做阴阳两虚,其证候表现为心肾不交,水火失调,神明失去主宰,所以神情恍惚、意志消沉,身体软弱无法收摄,就像水散涣一样,没有相互滋养的道理。
另外,阳维脉导致肌肉麻木瘙痒,是因为阳气衰败则卫气不行而气机阻滞,气机阻滞则阳气不能率先运行,而阴气运行迟缓,所以出现麻木瘙痒。又让人身上感觉像虫子爬行,这样阳气不能固摄,而阴气独自停滞,所以皮肤疼痛。阳气在本源衰败,所以下部感觉迟钝,并伴有出汗和怕冷。这是阳气不固导致营气也不运行,从而被阴邪侵袭的缘故。其他如突然跌倒、发出羊叫、手足牵引的症状,是因为阳气离去则经络凝涩,湿气停留在经脉中化为痰饮,过些时候阴邪侵袭,则经脉阻塞而筋脉拘挛,所以逼迫肢体相互牵引。又阻遏了气道,所以声音溢出而不能发出,如同羊叫一般。至于阴维脉不能维系,是阴气不能配合阳气,不能为阳气守持,那么阳气就会离散而不入于阴,重阴充塞隧道,九窍都陷入沉滞,所以也病发癫痫僵仆、羊叫或失音。如果肌肉麻木瘙痒、出汗怕风,似乎比前面的症状稍轻,但也同样是营血虚无而阳气不足导致的畏寒,卫气也不能为之护卫。所以阴维脉的虚证属于阴虚,但实际上也是无阳的虚证,只是与阳维脉略有不同罢了。
When the Yang Linking Vessel (Yangwei Mai) is diseased, the patient suffers from alternating aversion to cold and fever. When the Yin Linking Vessel (Yinwei Mai) is diseased, the patient suffers from heart pain. If the Yin and Yang vessels cannot mutually link and support each other, the patient will experience mental confusion and loss of will, with a flaccid body unable to control its movements voluntarily.
Abnormalities in the Yang Linking Vessel often induce muscle numbness and itching, and skin pain. There may be insensitivity in the lower body, sweating accompanied by coldness, as well as sudden falls, bleating like a sheep, and pulling/twisting of the hands and feet. In severe cases, aphonia (loss of voice) occurs. Abnormalities in the Yin Linking Vessel often induce epilepsy, stiff falling, bleating like a sheep, aphonia, muscle numbness and itching. Upon onset, there is spontaneous sweating, aversion to wind, and a sensation of coldness throughout the body.
The pulse of the Yang Linking Vessel is floating; upon suddenly rising, the patient experiences dizziness. If Yang Qi is excess and solid, symptoms include orthopnea (breathing with shoulders raised) and shivering as if cold. The pulse of the Yin Linking Vessel is deep, large, and solid; the patient suffers from chest pain, distension and fullness under the hypochondrium, and heart pain. If the pulse feels like a string of pearls, men present with excess conditions in both hypochondria, while women present with pain in the genital region and a sensation of discomfort in the heart area.
The Yang Linking Vessel links all Yang meridians. Its "linking" function originates at the intersection of various Yang meridians, emerging from Jingmen (BL63, Metal Gate) of the Foot-Taiyang Bladder Meridian, and meeting the Hand-Shaoyang, Foot-Shaoyang, Hand-Yangming, and Foot-Yangming meridians at Yangbai (GB14). The Yin Linking Vessel links all Yin meridians, originating at the intersection of various Yin meridians, emerging from Zhubin (KI9, Building Guest) of the Foot-Shaoyin Kidney Meridian, and ascending to terminate before the vertex. Although these two linking vessels have distinct meridian pathways, they are essentially governed by the vigorous Qi of Yin and Yang. Generally, no Yang is more vigorous than Taiyang, hence it can maintain the various Yang meridians; no Yin is more vigorous than Shaoyin, hence it can maintain the various Yin meridians. Therefore, the vigor of the two linking vessels lies not in the collaterals but in the Qi. Although diseases of the two linking vessels manifest in the collaterals, their essence lies in the Qi. Only when the root Yang and root Yin Qi are depleted do they necessarily manifest across all Yang and Yin meridians. Thus, disease of the Yang Linking Vessel implies that Taiyang is deficient below, having lost the harmonious ascending Qi, thereby first manifesting in Shaoyang, causing suffering from alternating chills and fever. Disease of the Yin Linking Vessel implies that Shaoyin is exhausted internally, presenting with Jue-ni (cold extremities due to extreme Yin), causing suffering from heart pain. If Yin and Yang cannot mutually link, this is termed deficiency of both Yin and Yang. The syndrome manifests as failure of Heart-Kidney interaction and disharmony of Water and Fire, leaving the Shen (Spirit) without a master. Hence, mental confusion and loss of will occur, with a flaccid body unable to self-restrain, resembling scattered water lacking mutual nourishment.
Furthermore, muscle numbness and itching caused by the Yang Linking Vessel occur because Yang deficiency leads to stagnation of Wei Qi (Defensive Qi) and Qi obstruction. Qi obstruction prevents Yang from leading, causing Yin to move slowly, resulting in numbness and itching. It also causes a sensation of insects crawling on the body. In such cases, Yang fails to secure, and Yin stagnates alone, leading to skin pain. Since Yang declines at its root, lower-body insensitivity occurs, along with sweating and coldness. This is due to Yang failing to consolidate, causing Ying Qi (Nutritive Qi) to cease moving, allowing Yin pathogens to invade. Other symptoms such as sudden falls, bleating, and limb pulling occur because when Yang departs, meridians become stagnant, dampness stops in the meridians transforming into Phlegm, and later Yin invasion blocks the meridians causing tendon spasms, forcing limbs to pull together. Airway obstruction also prevents sound emission, resulting in bleating sounds. Regarding the failure of the Yin Linking Vessel to link, it means Yin cannot coordinate with Yang and cannot guard Yang for Yin. Consequently, Yang disperses and does not enter Yin, while heavy Yin obstructs the tunnels, causing the nine orifices to sink. Thus, epilepsy, stiff falling, bleating, or aphonia also occur. Muscle numbness, itching, sweating, and aversion to wind seem slightly milder than previous symptoms, but they still indicate Ying deficiency with Yang insufficiency leading to cold aversion, and Wei Qi failing to provide protection. Therefore, the deficiency of the Yin Linking Vessel is Yin deficiency, but essentially it is also a deficiency of Yang without Yang, differing only slightly from the Yang Linking Vessel.