素问骨空论云∶督脉生疾,从少腹上冲心而痛,不得前后,为冲疝,女子为不孕、癃痔、遗溺、嗌干。治在
骨上,(谓腰横骨上毛际中,曲骨穴也)甚者在脐下营。(脐下一寸,阴交穴也)
王启玄曰∶此乃任冲二脉之病,不知何以属之督脉。李濒湖曰∶督脉虽行于背,而别络自长强走任脉者,则
由少腹直上贯脐,中贯心,入喉,上颐,环唇,而入于目之内 。故显此诸证,启玄盖未深考尔。
素问曰∶督脉实则脊强反折,虚则头重高摇之,挟骨之有过者,取之所别也。
秦越人难经曰∶督脉为病,脊强而厥。
王海脏曰∶此病宜用羌活、独活、防风、荆芥、细辛、 本、黄连、大黄、附子、乌头、苍耳之类。
张仲景金匮云∶脊强者,五 之总名。其证卒口噤背反张而螈 。诸药不已,可灸身柱、大椎、陶道穴。
又曰∶ 家脉,筑筑而弦直上下行。
王叔和脉经曰∶尺寸俱浮,直上直下,此为督脉。腰背强痛,不得俯仰,大人癫病,小儿风痫。
又曰∶脉来中央浮直,上下动者,督脉也。动苦腰背膝寒,大人癫,小儿痫,宜灸顶上三壮。
素问风论曰∶风气循风府而上,则为脑风。风入系头。则为目风眼寒。
王启玄云∶脑户乃督脉、足太阳之会故也。
带脉者。起于季胁足厥阴之章门穴,同足少阳循带脉穴,(章门足厥阴少阳之会,在季肋骨端,肘尖尽处是穴。
带脉穴属足少阳经,在季胁下一寸八分陷中)围身一周,如束带然。又与足少阳会于五枢、(带脉下三寸)维道,
(章门下五寸三分)凡八穴。
灵枢经曰∶足少阴之正,至 中,别走太阳而合,上至肾,当十四椎,出属带脉。
杨氏曰∶带脉总束诸脉,使不妄行,如人束带而前垂,故名。妇人恶露,随带脉而下,故谓之带下。
《素问·骨空论》记载:督脉发生病变,气从少腹向上冲至心脏并引起疼痛,大小便不通利,称为“冲疝”;女性则表现为不孕、小便淋漓或痔疮、遗尿、咽喉干燥。治疗部位在腰部的横骨上方(即耻骨联合上缘毛发际中的曲骨穴),病情严重的则在脐下营室(即脐下一寸的阴交穴)。
王启玄认为:这实际上是任脉和冲脉的病变,不知道为何归属于督脉。李濒湖(李时珍)说:督脉虽然行走在背部,但其别络从长强穴走向任脉,由此由少腹直上贯穿脐部,中间贯穿心脏,进入喉咙,上行至面颊,环绕嘴唇,并进入目内眦。因此显现出上述各种症状,王启玄大概是没有深入考证罢了。
《素问》说:督脉实证表现为脊柱僵硬、身体向后反折;虚证表现为头部沉重、摇晃不定。对于挟持骨骼部位的病变,应取该经脉的别络进行治疗。
秦越人(扁鹊)在《难经》中说:督脉为病,表现为脊柱僵硬且四肢厥冷。
王海藏说:这种病症适宜使用羌活、独活、防风、荆芥、细辛、藁本、黄连、大黄、附子、乌头、苍耳子等药物。
张仲景在《金匮要略》中说:“脊强”是痉病的总称。其症状为突然牙关紧闭、背部反张且肢体抽搐。如果诸药无效,可以艾灸身柱、大椎、陶道穴。
又说:痉病患者的脉象,搏动有力而弦直,上下行走。
王叔和在《脉经》中说:寸尺脉都浮,脉势直上直下,这是督脉的脉象。症状为腰背强痛,不能俯仰,成人患癫病,小儿患风痫。
又说:脉来中央浮起且直,上下跳动,这是督脉的脉象。患者苦于腰背膝盖寒冷,成人患癫病,小儿患痫病,适宜在头顶百会穴处灸三壮。
《素问·风论》说:风气顺着风府穴上行,就会形成脑风。风邪侵入系连头目的经络,就会形成目风眼寒。
带脉,起始于季胁部的足厥阴肝经章门穴,与足少阳胆经循行经过带脉穴(章门穴是足厥阴肝经与足少阳胆经的交会穴,位于季肋骨的末端,肘尖尽处即是此穴。带脉穴属于足少阳胆经,位于季胁下一寸八分的凹陷中),环绕身体一周,如同束带一样。又与足少阳胆经在五枢穴(带脉穴下三寸)、维道穴(章门穴下五寸三分)交会,共有八个穴位。
《灵枢经》说:足少阴肾经的正经,到达膻中穴,别走足太阳膀胱经而汇合,上行至肾脏,当第十四椎处,外出归属于带脉。
杨氏说:带脉总束各条经脉,使它们不妄行,就像人束带向前垂下一样,所以得名。妇女的恶露,随着带脉下行,所以称之为“带下”。
The *Suwen* (Basic Questions) chapter "Gu Kong Lun" states: When the Du vessel (Governing Vessel) is diseased, Qi rushes upward from the lower abdomen to the heart causing pain, accompanied by difficulty in urination and defecation, known as "Chong Hernia" (Chong Shanzhong). In women, it manifests as infertility, strangury or hemorrhoids, urinary incontinence, and dryness of the throat. Treatment should be applied at the bone above (referring to the Qu Gu acupoint located in the hairline above the transverse bone of the waist), and in severe cases, at the Ying area below the navel (referring to the Yin Jiao acupoint, one cun below the navel).
Wang Qixuan stated: This is actually a disease of the Ren vessel (Conception Vessel) and Chong vessel (Penetrating Vessel); he did not understand why it was attributed to the Du vessel. Li Binhu (Li Shizhen) said: Although the Du vessel runs along the back, its collateral branch travels from the Chang Qiang acupoint to the Ren vessel, going straight up from the lower abdomen through the navel, piercing through the heart, entering the throat, ascending to the cheeks, circling the lips, and entering the inner canthus of the eye. Therefore, these various symptoms appear; Wang Qixuan likely failed to conduct a deep investigation.
The *Suwen* states: Excess in the Du vessel results in spinal stiffness and backward arching of the body; deficiency results in heaviness of the head and unsteady swaying. For diseases affecting the bones alongside the vessel, treat the collateral branch of that vessel.
Qin Yue-ren (Bian Que) in the *Nanjing* (Classic of Difficult Issues) stated: Disease of the Du vessel presents with spinal stiffness and cold extremities.
Wang Haizang stated: This condition is suitable for treatment with herbs such as Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Fang Feng (Saposhnikoviae Radix), Jing Jie (Schizonepetae Spica), Xi Xin (Asari Radix et Rhizoma), Gao Ben (Ligustici Rhizoma et Radix), Huang Lian (Coptidis Rhizoma), Da Huang (Rhei Radix et Rhizoma), Fu Zi (Aconiti Lateralis Radix Praeparata), Wu Tou (Aconiti Radix), and Cang Er Zi (Xanthii Fructus).
Zhang Zhongjing in the *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) stated: "Spinal stiffness" is the general term for Jing disease (Spasm Disorder). Its symptoms include sudden lockjaw, opisthotonos, and convulsions. If various medicines are ineffective, moxibustion can be applied to the Shen Zhu, Da Zhui, and Tao Dao acupoints.
It further states: The pulse of a patient with Jing disease beats vigorously, wiry, and straight, moving up and down.
Wang Shuhe in the *Maijing* (Pulse Classic) stated: When both Cun and Chi pulses are floating and move straight up and down, this indicates the Du vessel. Symptoms include stiffness and pain in the waist and back, inability to bend forward or backward, epilepsy in adults, and wind-epilepsy in children.
It further states: A pulse that floats centrally, is straight, and moves up and down indicates the Du vessel. Patients suffer from coldness in the waist, back, and knees, epilepsy in adults, and epileptic seizures in children. Moxibustion of three moxa cones on the top of the head is appropriate.
The *Suwen* chapter "Feng Lun" (Wind Discussion) states: When wind pathogen follows the Feng Fu acupoint upward, it becomes Brain Wind. When wind enters the meridians connecting to the head, it becomes Eye Wind with cold eyes.
Wang Qixuan stated: This is because the Nao Hu acupoint is the meeting point of the Du vessel and the Foot-Taiyang Bladder Meridian.
The Dai vessel (Girdle Vessel) originates at the Zhang Men acupoint of the Foot-Jueyin Liver Meridian in the hypochondriac region, and follows the Dai Mai acupoint of the Foot-Shaoyang Gallbladder Meridian (Zhang Men is the intersection of the Foot-Jueyin Liver and Foot-Shaoyang Gallbladder meridians, located at the end of the costal cartilage, where the tip of the elbow reaches. The Dai Mai acupoint belongs to the Foot-Shaoyang Gallbladder Meridian, located in the depression 1.8 cun below the hypochondriac region). It encircles the body once, like a belt. It also intersects with the Foot-Shaoyang Gallbladder Meridian at the Wu Shu (3 cun below the Dai Mai acupoint) and Wei Dao (5.3 cun below the Zhang Men acupoint) acupoints, totaling eight acupoints.
The *Ling Shu* (Spiritual Pivot) states: The regular pathway of the Foot-Shaoyin Kidney Meridian reaches the chest center, diverges to join the Foot-Taiyang Bladder Meridian, ascends to the kidney, at the level of the fourteenth thoracic vertebra, emerges and connects to the Dai vessel.
Yang Shi stated: The Dai vessel binds all the vessels, preventing them from acting recklessly, similar to how a person wears a belt hanging forward; hence its name. In women, lochia flows downward along the Dai vessel, thus it is referred to as "Dai Xia" (Leukorrhea/Below-the-Belt discharge).