脉有损至。何谓也。然至之脉。一呼再至曰平。三至曰离经。四至曰夺精。五至曰困。
六至
此
落。二损损于血脉。血脉虚少。则不能营于五脏六腑。三损损于肌肉。肌肉消瘦。则食饮不
为
病也
于肺
肾者
脉有奇经八脉者何谓也。然有阳维有阴维。有阳跷有阴跷。有冲。有督。有任。有带
之脉。
何独
十二
既
夫
一
任脉者起于中极之下。以上毛际。循腹里。上关元。至咽喉。夫任者妊也。此是人之生
养之本。故曰任脉中极之下。长强之上也。此是奇经之二脉也。
冲脉者。起于气冲。并阳明之经。夹脐上行。至胸中而散。夫冲脉者阴脉之海也。冲者
通也。言此脉下至于足。上至于头。通受十二经之气血。故曰冲焉。此奇经之三脉也。
带脉者。起于季胁。回身一周。夫带者。言束也。言总束诸脉。使得调柔也。季胁在肋
下。下接髋骨之间是也。回。绕也。绕身一周。犹如腰带焉。此奇经之四脉也。
阳跷脉者。起于跟中。循外踝。上行入风池。夫跷者捷疾也。言此脉是人行走之机要。
动足之所由也。故曰跷脉焉。此奇经之五脉也。
阴跷脉者。亦起于跟中。循内踝。上行至咽喉。交贯冲脉。其阴跷义与阳跷同。此奇经
之六脉也。
阳维阴维者。经络于身溢蓄。不能环流溉灌诸经者也。故阳维起于诸阳会也。阴维起于
诸阴
经之
入于
内。
故
奇经之为病何如。然阳维维于阳。阴维维于阴。阴阳不能相维。则怅然失志。容容不能
自收持。夫怅然者其人惊。惊即病。维脉缓。故令人不能自收持。惊即失志。喜忘恍惚也。
阳跷为病。阴缓而阳急。阳跷在外踝。病即其脉。当从外踝上急。内踝以上缓也。
阴跷为病。阳缓而阴急。阴跷在内踝。病即其脉。当从内踝以上急。外踝以上缓也。
冲脉之为病。逆气而里急。冲脉从关元至咽喉。故其脉为病。逆气而里急也。
督脉之为病。脊强而厥。督脉在脊。病则其脉急。故令脊强也。
任脉之为病。其内苦结。男子为七疝。女子为瘕聚。任脉起于胞门子户。故其病结为七
疝瘕聚也。
带脉之为病。苦腹满。腰容容若坐水中。带脉者。回带人之身体。病即其脉缓。故令腰
容容也。
阳维为病苦寒热。阴维为病苦心痛。阳为卫。卫为气。气主肺。故寒热。阴为营。营为
血。血主心。故心痛。此奇经八脉之为病也。
又云∶冲脉者起于关元。循腹里。直上至咽喉中。任脉者起于胞门子户。夹脐上行至胸
中。二本虽不同。亦俱有所据。并可以依用也。
寸口脉。来大而渐小者。阴络也。苦风痹痈时自发。
寸口脉。来小而渐大者。阳络也。苦皮肤淫痛汗出恶寒。
寸口脉。来紧细而长至关者。任脉也。苦绕脐及横有痛。
诊得任脉。横寸口迟迟者。苦腹中有气上抢心。不得俯仰拘急也。
诊得阳维浮者。暂起即目眩。阳气盛实。苦肩息洒洒如寒。
诊得阴维沉大而实者。苦胸中痛。胁下支满心痛也。
诊得阴维如贯珠者。男子两胁实。腰中痛。女子阴中痛。如有热也。
诊得带脉左右绕脐。腰脊痛。冲阴股也。
两手脉浮。阴阳皆盛实者。此为冲督之脉也。冲督之脉者。十二经之道路。冲督用事者
十二经不复朝见于寸口。其人皆苦恍惚狂痴不定也。
两手脉细微绵绵。阴脉亦微细绵绵。此为阴跷阳跷之脉。
尺寸俱浮直下。此为督脉。腰背强痛。不得俯仰。大人癫病。小儿风痫也。
诊得阳跷病则急。阴跷病则缓。
尺寸牢。直上直下。为冲脉。胸中有寒疝也。
脉象有“损”和“至”的区别。这是什么意思呢？答：“至”脉是指脉搏跳动次数增多的脉象。医生一呼之间，脉搏跳动两次，这是正常的平脉。如果一呼之间跳动三次，称为“离经”，意味着病情已偏离常态。如果一呼之间跳动四次，称为“夺精”，意味着精气被剥夺。如果一呼之间跳动五次，称为“困”，意味着正气困顿。如果一呼之间跳动六次，称为“落”，意味着生机陨落。
“损”脉则相反，是脉搏跳动次数减少的脉象。一吸之间脉搏跳动两次，称为“再损”。二损损伤于血脉，血脉虚弱稀少，就不能滋养五脏六腑。三损损伤于肌肉，肌肉消瘦，饮食虽然进入体内却不能转化为营养，导致身体衰弱成为疾病。
什么是奇经八脉呢？答：有阳维脉、阴维脉；有阳跷脉、阴跷脉；有冲脉、督脉、任脉、带脉。为什么唯独这八条经脉不隶属于十二正经呢？因为它们各自独立运行，不直接参与十二正经的气血循环，而是起到蓄积和调节的作用。
任脉起始于中极穴下方，向上经过阴毛际，沿着腹部内部上行，经过关元穴，到达咽喉部。“任”字通“妊”，意为孕育。这是人体生命养育的根本，所以叫作任脉。它位于中极穴之下，长强穴之上。这是奇经中的第二条脉。
冲脉起始于气冲穴，与足阳明胃经并行，夹着肚脐两侧上行，到达胸部后散开。“冲”意为通达。说这条脉下至于足，上至于头，能够通受十二经脉的气血，所以叫作冲脉。这是奇经中的第三条脉。
带脉起始于季胁（侧肋下部），环绕身体一周。“带”意为束带。说它能总束所有的经脉，使它们调和柔顺。季胁在肋骨下方，下面连接髋骨之间的部位。回，就是绕的意思。环绕身体一周，就像腰带一样。这是奇经中的第四条脉。
阳跷脉起始于足跟中部，沿着外踝上行，进入风池穴。“跷”意为捷疾、轻快。说这条脉是人行走的关键所在，是活动足部的缘由，所以叫作跷脉。这是奇经中的第五条脉。
阴跷脉也起始于足跟中部，沿着内踝上行，到达咽喉部，与冲脉交会贯通。其阴跷的含义与阳跷相同。这是奇经中的第六条脉。
阳维脉和阴维脉，是经络在全身溢出蓄积，不能像环流一样灌溉各条正经的脉络。所以阳维脉起于诸阳经交会之处，阴维脉起于诸阴经交会之处。
奇经八脉发生病变会怎样呢？答：阳维脉维系一身之阳，阴维脉维系一身之阴。如果阴阳不能相互维系，人就会感到惆怅失意，神情恍惚，不能自我控制。所谓“怅然”，是指人受到惊吓，惊则致病，维脉脉势缓弱，所以使人不能自我收持。惊恐会导致意志丧失，喜欢遗忘，精神恍惚。
阳跷脉发病时，阴侧松弛而阳侧拘急。阳跷脉在外踝，发病时其脉象表现为从外踝向上拘急，内踝以上松弛。
阴跷脉发病时，阳侧松弛而阴侧拘急。阴跷脉在内踝，发病时其脉象表现为从内踝向上拘急，外踝以上松弛。
冲脉发病时，出现气逆和腹中拘急疼痛。因为冲脉从关元穴到咽喉，所以它的病证表现为气逆和腹中拘急。
督脉发病时，出现脊柱强直和厥逆。因为督脉行于脊柱，发病时经脉拘急，所以导致脊柱强直。
任脉发病时，内部感觉苦闷结滞。男子表现为七疝，女子表现为瘕聚（腹中结块）。因为任脉起始于胞门子户（子宫口），所以它的病证表现为结滞为七疝或瘕聚。
带脉发病时，苦于腹部胀满，腰部松软无力，好像坐在冷水里一样。带脉环绕束缚人的身体，发病时经脉弛缓，所以导致腰部松软无力。
阳维脉发病，苦于寒热往来。阴维脉发病，苦于心痛。阳主卫气，卫气主肺，所以出现寒热症状。阴主营血，营血主心，所以出现心痛。这就是奇经八脉的病变表现。
又说：冲脉起始于关元穴，沿着腹部内部，直上到达咽喉中。任脉起始于胞门子户，夹着肚脐上行到达胸中。这两者的记载虽然不同，但也都有依据，都可以参照使用。
寸口脉，来势大而逐渐变小的，是阴络的病脉。苦于风痹痈肿时常自发。
寸口脉，来势小而逐渐变大的，是阳络的病脉。苦于皮肤瘙痒疼痛、出汗、恶寒。
寸口脉，来势紧细且长，直达关部的，是任脉的病脉。苦于绕脐及横向腹痛。
诊察得任脉病，寸口脉迟滞缓慢的，苦于腹中有气上冲心胸，不能俯仰，身体拘急。
诊察得阳维脉浮的，突然站起即头晕目眩，阳气盛实，苦于肩背呼吸急促，洒洒然如怕冷。
诊察得阴维脉如贯珠般圆滑有力的，男子两胁胀实，腰中痛；女子阴中痛，如有热感。
两手脉象都浮，阴阳皆盛实，这是冲脉和督脉的病脉。冲脉和督脉是十二经脉的道路，当冲脉和督脉主导病变时，十二经脉不再正常朝见于寸口，病人都会苦于精神恍惚、狂乱痴呆、情绪不定。
两手脉象细微绵绵，阴脉也细微绵绵，这是阴跷脉和阳跷脉的病脉。
The pulse presents with "Sun" (Loss/Deficiency) and "Zhi" (Excess/Increase). What does this mean? Answer: The "Zhi" pulse refers to an increase in the frequency of heartbeats per breath. In one exhalation, if the pulse beats twice, it is a normal Ping (Level/Healthy) pulse. If it beats three times in one exhalation, it is called Li Jing (Departing from the Canon), indicating the disease has deviated from the norm. If it beats four times, it is called Duo Jing (Deprivation of Essence), indicating the depletion of essence. If it beats five times, it is called Kun (Distress), indicating the exhaustion of righteous Qi. If it beats six times, it is called Luo (Fall), indicating the loss of vitality.
Conversely, the "Sun" pulse is characterized by a decrease in pulse frequency. Two beats per inhalation are termed Zai Sun (Double Loss). Second-degree Sun injury damages the Blood Vessels (Xue Mai); when blood vessels are deficient and sparse, they cannot nourish the Five Zang and Six Fu organs. Third-degree Sun injury damages the Muscles; when muscles emaciate, although food and drink enter, they fail to transform into nutrients, leading to physical debility and disease.
What are the Eight Extraordinary Vessels (Qi Jing Ba Mai)? Answer: There are Yang Wei Mai (Yang Linking Vessel) and Yin Wei Mai (Yin Linking Vessel); Yang Qiao Mai (Yang Heel Vessel) and Yin Qiao Mai (Yin Heel Vessel); Chong Mai (Penetrating Vessel), Du Mai (Governing Vessel), Ren Mai (Conception Vessel), and Dai Mai (Girdle Vessel). Why do these eight vessels not belong to the Twelve Regular Meridians? Because they operate independently, accumulating and regulating Qi and Blood rather than directly participating in the circulation of the Twelve Regular Meridians.
Ren Mai (Conception Vessel) originates below Zhongji (CV5), ascends through the pubic hair region, follows the interior of the abdomen, passes through Guanyuan (CV4), and reaches the throat. "Ren" shares the phonetic and semantic root with "Ren" (Pregnancy/Nurturing), signifying the foundation of human life and nurturing. Thus, it is named Ren Mai. It is located below Zhongji (CV5) and above Changqiang (GV1). This is the second of the extraordinary vessels.
Chong Mai (Penetrating Vessel) originates at Qichong (ST30), runs parallel to the Foot-Yangming Stomach Meridian, ascends on both sides of the umbilicus, and disperses in the chest. "Chong" means penetration or thoroughfare. This vessel extends from the feet to the head, receiving and distributing the Qi and Blood of all Twelve Regular Meridians; hence it is called Chong Mai. This is the third of the extraordinary vessels.
Dai Mai (Girdle Vessel) originates at the Hypochondrium (Ji Xie), encircling the body once. "Dai" means girdle or belt. It binds all meridians together, ensuring their harmony and flexibility. The hypochondrium is located below the ribs, connecting to the area between the iliac bones. "Hui" means to circle. Encircling the body once, like a waist belt, this is the fourth of the extraordinary vessels.
Yang Qiao Mai (Yang Heel Vessel) originates in the center of the heel, follows the lateral malleolus, ascends, and enters Fengchi (GB20). "Qiao" means agile or swift. This vessel is crucial for walking and is the origin of foot movement; hence it is called Qiao Mai. This is the fifth of the extraordinary vessels.
Yin Qiao Mai (Yin Heel Vessel) also originates in the center of the heel, follows the medial malleolus, ascends to the throat, and intersects with Chong Mai. Its meaning parallels that of Yang Qiao Mai. This is the sixth of the extraordinary vessels.
Yang Wei Mai and Yin Wei Mai are vessels where meridian Qi overflows and accumulates in the body, unable to circulate continuously to irrigate the regular meridians. Therefore, Yang Wei Mai originates from the intersection of all Yang meridians, and Yin Wei Mai originates from the intersection of all Yin meridians.
How do diseases of the Eight Extraordinary Vessels manifest? Answer: Yang Wei Mai links the Yang aspects of the body, and Yin Wei Mai links the Yin aspects. If Yin and Yang cannot mutually link, the person experiences melancholy and loss of will, appearing disorganized and unable to control themselves. "Chang Ran" refers to a state of fright; fright causes disease. When the Wei Mai pulse is slow and weak, it leads to an inability to self-regulate. Fright causes loss of memory and mental confusion.
When Yang Qiao Mai is diseased, the Yin side is lax while the Yang side is tense. Yang Qiao Mai is located at the lateral malleolus; upon disease, the pulse becomes tense ascending from the lateral malleolus and lax above the medial malleolus.
When Yin Qiao Mai is diseased, the Yang side is lax while the Yin side is tense. Yin Qiao Mai is located at the medial malleolus; upon disease, the pulse becomes tense ascending from the medial malleolus and lax above the lateral malleolus.
When Chong Mai is diseased, there is rebellious Qi and abdominal urgency/pain. Since Chong Mai runs from Guanyuan (CV4) to the throat, its pathology manifests as rebellious Qi and abdominal urgency.
When Du Mai is diseased, there is spinal rigidity and cold extremities (Jue). Since Du Mai runs along the spine, disease causes tension in the vessel, leading to spinal rigidity.
When Ren Mai is diseased, there is internal stagnation and knotting. In men, this manifests as Seven Types of Hernia (Qi She); in women, as Jia Ju (abdominal masses). Since Ren Mai originates from the Bao Men Zi Hu (uterine opening), its pathology manifests as knotting leading to hernias or masses.
When Dai Mai is diseased, there is abdominal fullness and a sensation of the waist being loose and flaccid, as if sitting in water. Dai Mai girdles the body; when diseased, the vessel becomes lax, causing waist flaccidity.
When Yang Wei Mai is diseased, there is aversion to cold and fever. When Yin Wei Mai is diseased, there is heart pain. Yang governs Wei Qi (Defensive Qi), which is associated with the Lung; thus, cold and fever occur. Yin manages Ying Qi (Nutritive Qi), which is associated with the Heart; thus, heart pain occurs. These are the pathologies of the Eight Extraordinary Vessels.
It is also stated: Chong Mai originates at Guanyuan (CV4), follows the interior of the abdomen, and ascends straight to the throat. Ren Mai originates from Bao Men Zi Hu, ascends alongside the umbilicus to the chest. Although these two descriptions differ, both have basis and can be applied clinically.
At the Cun Kou (Radial Pulse) position, if the pulse comes large and gradually becomes small, it indicates disease in the Yin Collaterals (Yin Luo). The patient suffers from wind-bi syndrome and carbuncles that spontaneously flare up.
At the Cun Kou position, if the pulse comes small and gradually becomes large, it indicates disease in the Yang Collaterals (Yang Luo). The patient suffers from skin itching/pain, sweating, and aversion to cold.
If the Cun Kou pulse is tight, thin, and long, reaching the Guan position, it indicates Ren Mai disease. The patient suffers from peri-umbilical and transverse abdominal pain.
If Ren Mai disease is diagnosed with a slow and sluggish Cun Kou pulse, the patient suffers from Qi rushing upward from the abdomen to the heart, preventing flexion and extension, accompanied by stiffness.
If Yang Wei Mai is diagnosed as floating, sudden standing causes dizziness. Yang Qi is excessive and solid, causing shoulder breathing and a shivering sensation akin to cold.
If Yin Wei Mai is diagnosed as deep, large, and excess, the patient suffers from chest pain, flank distension/fullness, and heart pain.
If Yin Wei Mai feels like threaded pearls (smooth and rolling), men suffer from fullness in the hypochondrium and lower back pain; women suffer from vaginal pain with a sensation of heat.
If Dai Mai disease is diagnosed, there is pain encircling the umbilicus, lower back and spine pain, and impact on the inner thighs.
If pulses in both hands are floating, with both Yin and Yang aspects excess and solid, this indicates Chong and Du Mai disease. Chong and Du Mai serve as pathways for the Twelve Regular Meridians. When Chong and Du Mai dominate pathology, the Twelve Regular Meridians no longer regularly reflect at the Cun Kou. The patient suffers from mental confusion, mania, dementia, and instability.
If pulses in both hands are fine, minute, and continuous, and the Yin pulse is also fine, minute, and continuous, this indicates Yin Qiao and Yang Qiao Mai disease.
If both Chi (Cun) and Cun (Chi - note: context implies radial positions) pulses are floating and straight downward, this indicates Du Mai disease. Symptoms include stiff and painful back, inability to bend or extend. In adults, it manifests as Dian illness (epilepsy/psychosis); in children, as Feng Xian (wind epilepsy).
Diagnosis reveals that Yang Qiao disease presents with tense pulses, while Yin Qiao disease presents with lax pulses.
If Chi and Cun pulses are firm (Lao) and move straight up and down, this indicates Chong Mai disease. Symptoms include cold hernia in the chest.