(先生讳世 注《灵枢》,《素问》二种行世。
部位者,头、面、胸、背、胁、腹、手、足,各有所属之部,所主之位也。头为三阳之
首,三阳者,太阳也。自印堂至额颅,上颠顶,从脑下项皆足太阳经脉之部,故曰头为三阳之首也。
两颧属肾,《刺热论》云∶“色荣颧骨,其热内连肾也。”两目为肝之窍,而五脏精华皆注
于目,故瞳神属肾,黑目属肝,白眼属肺,内外 肉属心,眼包属脾。两鼻为肺窍,而位居
中央,又属乎脾,鼻内口鼻交通之处,则为颃颡,又为畜门。乃肝肺相交之部也。口为脾窍
,内外唇肉,脾所主也。舌为心苗,齿为骨余,而齿龈则为牙床,又属乎胃。舌之下腮之内
,为廉泉、玉英,乃水液之上源也。耳为肾窍,又心亦开窍于耳。胃足阳明之脉,起于鼻,
交中,循鼻外,入齿中,挟口环唇。胆足少阳之脉,起于目锐 ,上抵头角,循耳后,
入
耳中,出走耳前,此头面之部位,各有所属也。头面以下,前有咽喉,后有颈项,喉居右,
咽居左,喉为气管而硬,咽为食管而软。咽喉之中,则为吭嗓,吭嗓之上,则为舌本,舌本
居下 之尽,而上 之尽,则为小舌,所谓会厌也。太阴脾脉络舌本,少阴肾脉络舌本,阳
明胃脉络舌本。咽喉之外,则有动脉,居乎两旁,所谓人迎之脉,乃胃足阳明之脉也。人迎
之下,锁骨空处,则为缺盆,肺所主也。又阳明经脉行身之前,自面部而至胸膈,皆阳明经
脉所主也。缺盆之下,两乳之上,谓之膺中,膺中之中,谓之上膈,即上焦也。《经》云∶
“上焦开发,宣五谷味,熏肤,充身,泽毛,若雾露之溉也。”上膈而下,谓之膈中,即胸
膈也。胸膈之间,谓之膻中,膻中即心包络也。心包主血,主脉横通四布,包络之下,即有
胃络,两络而相通,横布于经络之间。胸乃心主之宫城,而包络包乎心之外。肺为五脏之
长,而盖乎心之上。心窝之下,谓之中焦,胃有三焦,上焦之旁,即上脘也,中焦之旁,即
中脘也,下焦之旁,即下脘也。头面之下,后有颈项,项之中央,名为风府,项之两旁,名
为风池,项下高耸大椎,乃脊骨之骨一椎,第自脊而下,至七节之两旁,名为鬲俞。《经》
云∶“七节之旁,中有小心。”以明鬲俞之穴,乃心气之游行出入,而太阳经脉行身之背,
此胸背之部位,各有所属也。胸膈之下,腹也,胸膈下侧,胁也。前胸后背,而胁则居胸背
之间,行身之侧,胁之上为腋,胁之下为季胁。太阳行身之背而主开,阳明行身之前而主阖
,少阳行身之侧而主枢。舍开则不能阖,舍阖则不能开,舍枢则不能为开阖,是枢者,乃开
阖之关键也。大腹名为坤土,坤土,太阴之脾土也。大腹之上,下脘之间,名为中土,中土
,阳明之胃土也。大肠名回肠,盘旋于腹之左右,小肠居大肠之前,脐乃小肠之结总,而贴
脐左右,乃冲脉所出。《经》云∶“冲脉于脐左右之动脉者是也。”脐之下则为小腹,小腹
两旁,名为少腹。小腹者,少阴水脏,膀胱水腑之所属也。少阴者,厥阴肝脏,胞中血海之
所居也。血海居膀胱之外,名曰胞中,膀胱居血海之内,故曰膀胱者,胞之室也。从小腹而
入前阴,乃少阴、太阴、阳明三经之属。《经》云∶“肾开窍于前后二阴。”是前阴者,属
少阴也。《经》云∶“前阴者,宗筋之所聚,太阴、阳明之所合也。”又∶“阳明主润宗筋
。”是前阴又属太阴,阳明也,阴囊卵核,乃厥阴肝经之所属,故《经》云∶“厥阴病则舌
卷囊缩。”舌卷手厥阴,囊缩足厥阴也。又云∶“厥阴气绝,则卵上缩而终。”此胁腹之部位
,各有所属也。两手两足曰四肢,两手之上,则有肘腋,两足之上,则有 脾,两肘两腋
两两脾名曰八溪。从臂至手,乃手太阴肺金所出,而兼手少阴厥阴,此手之三阴,从胸走
手也。从足至股,乃足太阴脾经所出,而兼足少阴厥阴,此足之三阴,从足走腹也。夫手足
三阴三阳,十二经脉,交相贯通,行于周身,手之三阴,从胸走手,手之三阳,从手走头,
是手三阴三阳而循行于手臂矣。足之三阳,从头走足,足之三阴,从足走腹,是足三阳三阴
而循行于足股矣。此手足之部位,各有所属也。
(先生名世,注解了《灵枢》和《素问》这两部著作,并在世间流传。
所谓“部位”,是指头、面、胸、背、胁、腹、手、足,它们各自有所属的区域和所主管的位置。头部是三阳经的首领,三阳经中指的是太阳经。从印堂到额颅,向上至头顶,从脑后下行至项部,都是足太阳膀胱经脉所经过的区域,所以说头部是三阳经的首领。
两颧骨属于肾,《刺热论》说:“面色显现于颧骨,其热邪内连于肾。”两眼是肝的窍道,而五脏的精气都灌注于眼睛,所以瞳孔属于肾,黑眼球属于肝,白眼珠属于肺,内外眦的肉属于心,眼睑属于脾。两个鼻孔是肺的窍道,且位居面部中央,又归属于脾,鼻腔与口腔相通的地方,称为颃颡(háng sǎng,鼻咽部),也称为畜门。这是肝气与肺气相交会的部位。口是脾的窍道,上下嘴唇的肉,由脾所主管。舌是心的苗窍,牙齿是骨骼的余气,而牙龈则是牙床,又归属于胃。舌头下方的腮内,有廉泉穴和玉英穴,这是津液上行的源头。耳朵是肾的窍道,同时心也开窍于耳。足阳明胃经的经脉,起于鼻翼旁,交会于鼻根,沿鼻外侧下行,进入上齿中,环绕口唇。足少阳胆经的经脉,起于目外眦,向上到达头角,沿耳后下行,进入耳中,再走出耳前,这些是头面部各部位各有归属的情况。
头面以下,前面有咽喉,后面有颈项。喉居右侧,咽居左侧。喉是气管,质地坚硬;咽是食管,质地柔软。咽喉之中,称为吭嗓(kēng sǎng,喉咙发声处)。吭嗓之上,称为舌本(舌根)。舌本位于下颌骨的尽头,而上颌骨的尽头,称为小舌,也就是会厌。足太阴脾经的脉络联系舌本,足少阴肾经的脉络联系舌本,足阳明胃经的脉络联系舌本。咽喉的外侧,有动脉,位于两旁,这就是人迎脉,属于足阳明胃经。人迎脉之下,锁骨上方的凹陷处,称为缺盆,由肺所主管。另外,阳明经脉行走在身体前面,自面部直至胸膈,都由阳明经脉所主管。
缺盆之下,两乳之上,称为膺中。膺中的中间部分,称为上膈,即上焦。《内经》说:“上焦开发,宣发五谷的气味,熏蒸皮肤,充实身体,润泽毛发,就像雾露灌溉一样。”上膈之下,称为膈中,即胸膈。胸膈之间,称为膻中,膻中即心包络。心包主血,主脉,横向通达分布。心包络之下,就有胃的络脉,两条络脉相互贯通,横向分布在经络之间。胸部是心主的宫城,而心包络包裹在心之外。肺是五脏之长,覆盖在心之上。心窝之下,称为中焦。胃关联三焦,上焦的旁边,就是上脘;中焦的旁边,就是中脘;下焦的旁边,就是下脘。
头面之下,后面有颈项。颈项的中央,名为风府穴。颈项的两旁,名为风池穴。颈下高耸的大椎穴,是脊骨的第一节椎骨。从脊柱向下,至第七节椎骨的两旁,名为膈俞穴。《内经》说:“第七节椎骨的旁边,中有小心。”以此说明膈俞穴,是心气游行出入的地方,而足太阳膀胱经行走在身体的背部,这是胸背部各部位各有归属的情况。
胸膈之下,是腹部;胸膈的两侧,是胁部。前胸后背,而胁部位于胸背之间,行走在身体侧面。胁的上部为腋窝,胁的下部为季胁。足太阳膀胱经行走在身体背部而主“开”,足阳明胃经行走在身体前面而主“阖”(闭合),足少阳胆经行走在身体侧面而主“枢”(枢纽)。舍弃了开就不能阖,舍弃了阖就不能开,舍弃了枢就不能实现开阖,所以枢,是开阖的关键。
大腹称为坤土,坤土,即太阴脾土。大腹之上,下脘之间,称为中土,中土,即阳明胃土。大肠称为回肠,盘旋在腹部的左右两侧,小肠位于大肠的前面,肚脐是小肠的结聚汇总之处,贴附于肚脐左右的是冲脉发出的地方。《内经》说:“冲脉就是在肚脐左右跳动的动脉。”肚脐之下则为小腹,小腹的两旁,称为少腹。小腹,是少阴水脏(肾)和水腑(膀胱)所属的部位。少阴经,以及厥阴肝脏,是胞中血海所在的地方。血海位于膀胱之外,名称叫胞中,膀胱位于血海之内,所以说膀胱是胞的居室。从小腹向前进入前阴,是少阴、太阴、阳明三条经脉所属的范围。《内经》说:“肾开窍于前后二阴。”所以前阴,属于少阴经。《内经》说:“前阴,是宗筋汇聚的地方,是太阴、阳明经会合之处。”又说:“阳明经主润养宗筋。”所以前阴又归属于太阴、阳明经。阴囊和睾丸,是足厥阴肝经所属,所以《内经》说:“厥阴病则舌卷缩、阴囊收缩。”舌卷缩是手厥阴心包经的病,阴囊收缩是足厥阴肝经的病。又说:“厥阴经气绝,则睾丸上缩而死。”这是胁腹部各部位各有归属的情况。
两手两足称为四肢。两手的上部,有肘部和腋部;两足的上部,有腘窝(膝盖后方凹陷处)。两肘、两腋、两腘,共六个部位加上两膝?原文此处可能有误或特指,通常八溪指两肘、两腋、两髀(大腿根部)、两腘。根据原文“两两腘名曰八溪”,这里应理解为手臂和腿部的关节凹陷处。从臂到手,是手太阴肺金经所出,兼及手少阴心经和手厥阴心包经,这是手三阴经,从胸部走向手部。从足到大腿,是足太阴脾经所出,兼及足少阴肾经和足厥阴肝经,这是足三阴经,从足部走向腹部。
手足三阴三阳,十二条经脉,相互贯通,行走在全身。手三阴经,从胸部走向手部;手三阳经,从手部走向头部,这样手三阴三阳就在手臂上循行了。足三阳经,从头部走向足部;足三阴经,从足部走向腹部,这样足三阳三阴就在足和大腿上循行了。这是手足各部位各有归属的情况。
(Mr. Shi annotated the *Ling Shu* and *Su Wen*, two works that are circulated in the world.
The term "regions" refers to the head, face, chest, back, flanks, abdomen, hands, and feet, each having its specific domain and governing position. The head is the chief of the Three Yang meridians, specifically referring to the Taiyang (Greater Yang) meridian. From the Yintang point to the forehead, upward to the vertex, and from the occiput down to the neck, these are all regions traversed by the Foot-Taiyang Bladder Meridian; thus, it is said that the head is the chief of the Three Yang.
The zygomatic bones belong to the Kidney. The *Ci Re Lun* (Treatise on Acupuncture for Heat) states: "When color manifests on the zygomatic bones, the heat internally connects with the Kidney." The eyes are the orifices of the Liver, and the essence of the Five Zang organs pours into them. Therefore, the pupil belongs to the Kidney, the iris (black part) belongs to the Liver, the sclera (white part) belongs to the Lung, the inner and outer canthi fleshy parts belong to the Heart, and the eyelids belong to the Spleen. The nostrils are the orifices of the Lung, positioned centrally, and also belong to the Spleen. The junction where the nasal cavity communicates with the oral cavity is called the *hangsang* (nasopharynx), also known as the *xumen*. This is the region where Liver Qi and Lung Qi intersect. The mouth is the orifice of the Spleen, and the flesh of the upper and lower lips is governed by the Spleen. The tongue is the sprout of the Heart, teeth are the surplus of bone, and the gums are the dental bed, belonging to the Stomach. Inside the sublingual area, there are the Lianquan and Yuying points, which are the source of fluid ascent. The ears are the orifices of the Kidney, and the Heart also opens into the ears. The Foot-Yangming Stomach Meridian originates at the side of the nose, crosses at the root of the nose, follows the lateral aspect of the nose, enters the upper teeth, and circles the lips. The Foot-Shaoyang Gallbladder Meridian originates at the outer canthus, ascends to the temporal angle, follows behind the ear, enters the ear, exits anterior to the ear. These illustrate how the regions of the head and face have their respective affiliations.
Below the head and face, anteriorly are the throat and pharynx, posteriorly is the nape. The larynx (throat) is on the right, and the pharynx is on the left. The larynx is the airway and is hard; the pharynx is the food pipe and is soft. Within the throat and pharynx lies the *kengsangs* (voice box). Above the *kengsangs* is the root of the tongue (*sheben*). The root of the tongue is at the end of the mandible, and the apex of the maxilla is the uvula, also known as the epiglottis. The Foot-Taiyin Spleen Meridian connects to the root of the tongue, the Foot-Shaoyin Kidney Meridian connects to the root of the tongue, and the Foot-Yangming Stomach Meridian connects to the root of the tongue. Outside the throat and pharynx, there are arteries on both sides, known as the Renying pulse, which belongs to the Foot-Yangming Stomach Meridian. Below the Renying, the hollow space above the clavicle is called the Quepen region, governed by the Lung. Furthermore, the Yangming meridians run along the anterior body, from the face to the chest and diaphragm, all governed by the Yangming meridians.
Below the Quepen and above the nipples is the Yingzhong region. The center of Yingzhong is called Shangge, which corresponds to the Upper Jiao. The *Classic* states: "The Upper Jiao develops and disseminates, distributing the flavors of grain and food, steaming the skin, filling the body, and moistening the hair, like mist and dew irrigating." Below Shangge is Gezhi, i.e., the thoracic diaphragm. Between the chest and diaphragm is Danzhong, which is the Pericardium (Ying Belt). The Pericardium governs blood and vessels, extending horizontally and spreading throughout. Below the Pericardium are the collateral vessels of the Stomach, connecting with each other and spreading horizontally among the meridians. The chest is the palace city of the Heart Master, with the Pericardium enveloping the exterior of the Heart. The Lung is the leader of the Five Zang organs, covering the top of the Heart. Below the heart pit is the Middle Jiao. The Stomach relates to the Triple Burner; beside the Upper Jiao is the Shangwan point, beside the Middle Jiao is the Zhongwan point, and beside the Lower Jiao is the Xiawan point.
Below the head and face, posteriorly is the nape. The center of the nape is named Fengfu. The sides of the nape are named Fengchi. The prominent Dazhui below the neck is the first vertebra of the spinal column. Descending from the spine to the sides of the seventh vertebra is the Geshu point. The *Classic* states: "Beside the seventh vertebra, there is the 'Small Heart'." This clarifies that the Geshu point is where Heart Qi travels in and out, while the Foot-Taiyang Bladder Meridian runs along the back. This illustrates how the chest and back regions have their respective affiliations.
Below the chest and diaphragm is the abdomen; the sides of the chest and diaphragm are the flanks. Anteriorly is the chest, posteriorly is the back, and the flanks lie between them, running along the lateral aspect of the body. Above the flanks is the axilla; below the flanks is the hypochondrium (costal margin). The Foot-Taiyang Bladder Meridian runs along the back and governs "opening"; the Foot-Yangming Stomach Meridian runs along the front and governs "closing"; the Foot-Shaoyang Gallbladder Meridian runs along the side and governs the "pivot". Without opening, closing cannot occur; without closing, opening cannot occur; without the pivot, opening and closing cannot function. Thus, the pivot is the key to opening and closing.
The large abdomen is called Kun Earth, which is the Taiyin Spleen Earth. Above the large abdomen, between the Xiawan and Zhongwan, is called Central Earth, which is the Yangming Stomach Earth. The Large Intestine is called Huichang, coiling around the left and right sides of the abdomen. The Small Intestine is located anterior to the Large Intestine. The umbilicus is the convergence of the Small Intestine, and adjacent to the umbilicus on both sides is the origin of the Chong Mai (Penetrating Vessel). The *Classic* states: "The Chong Mai is the pulsating artery on both sides of the umbilicus." Below the umbilicus is the lower abdomen. The sides of the lower abdomen are called Shaofu. The lower abdomen belongs to the Shaoyin Water Zang (Kidney) and Water Fu (Bladder). The Shaoyin channel, along with the Jueyin Liver, is where the Baozhong Blood Sea resides. The Blood Sea is outside the Bladder, named Baozhong. The Bladder is inside the Blood Sea, hence it is said that the Bladder is the chamber of the Baozhong. Entering anteriorly from the lower abdomen leads to the anterior yin, which belongs to the Shaoyin, Taiyin, and Yangming meridians. The *Classic* states: "The Kidney opens into the two yins (anterior and posterior)." Thus, the anterior yin belongs to the Shaoyin. The *Classic* states: "The anterior yin is the gathering place of the Zongjin (tendons), where the Taiyin and Yangming merge." It also says: "The Yangming moistens the Zongjin." Therefore, the anterior yin also belongs to the Taiyin and Yangming. The scrotum and testes belong to the Foot-Jueyin Liver Meridian, so the *Classic* states: "In Jueyin disease, the tongue curls and the scrotum retracts." Tongue curling relates to the Hand-Jueyin Pericardium, and scrotal retraction relates to the Foot-Jueyin Liver. It also says: "When Jueyin Qi perishes, the testes retract upward, leading to death." This illustrates how the flank and abdominal regions have their respective affiliations.
The two hands and two feet are called the Four Limbs. Above the hands are the elbows and axillae; above the feet are the popliteal fossae. The two elbows, two axillae, and two popliteal fossae (and knees/thighs depending on interpretation of 'Ba Xi') are collectively called the Eight Creeks. From the arm to the hand, this is where the Hand-Taiyin Lung Metal meridian originates, involving the Hand-Shaoyin Heart and Hand-Jueyin Pericardium. These are the Three Yin meridians of the hand, traveling from the chest to the hand. From the foot to the thigh, this is where the Foot-Taiyin Spleen meridian originates, involving the Foot-Shaoyin Kidney and Foot-Jueyin Liver. These are the Three Yin meridians of the foot, traveling from the foot to the abdomen.
The Three Yin and Three Yang meridians of the hands and feet, totaling twelve meridians, interconnect and circulate throughout the body. The Hand Three Yin meridians travel from the chest to the hand; the Hand Three Yang meridians travel from the hand to the head. Thus, the Hand Three Yin and Yang circulate along the arms. The Foot Three Yang meridians travel from the head to the feet; the Foot Three Yin meridians travel from the feet to the abdomen. Thus, the Foot Three Yang and Yin circulate along the legs and thighs. This illustrates how the regions of the hands and feet have their respective affiliations.