\r手阳明大肠经之图\p06-d34a4.bmp\r
手阳明大肠之经手走头而头走腹是经气血俱多起于商阳止于迎香计二十穴左右共四十穴大肠
为腑长二丈一尺广四寸当脐右回十六曲
手阳明是大肠经商阳二间三间行合谷阳溪两筋内
灵枢第十篇云手阳明之脉起于大指次指之端循指上廉出合谷两骨之间上人两筋之中○滑氏曰
大指次指大指之次指谓食指也手阳明大肠经也凡经脉之道阴脉行手足之里阳脉行手足之表
此
两骨之间复上入阳溪两筋之中
商阳 在手表大指次指内侧去爪甲如韭叶
二间 在手表大指次指本节前内侧陷中
三间 在手表大指次指本节后内侧陷中
合谷 在手表大指次指岐骨间陷中动脉
阳溪 在手表腕中上侧两筋陷中
循臂偏历温溜升下廉上廉三里去曲池肘 来五里臂 肩 两骨间
灵枢第十篇云循臂上廉入肘外廉循 外前廉上肩○滑氏曰自阳溪而上循臂上廉之偏历温溜下
廉上廉三里入肘外廉之曲池循 外前廉历肘 五里臂 络 会上肩至肩 穴也○ 会见手少
阳经手阳明之络也
偏历 在腕中后三寸别走太阴
温溜 取腕后小士六寸大士五寸间动脉中
下廉 在辅骨下去上廉一寸去曲池四寸
上廉 在三里下一寸
三里 在曲池下二寸按之肉起
曲池 在肘外辅骨屈肘曲骨之中以手拱胸取之
肘 在肘大骨外廉陷中
五里 在肘上三寸行向里大脉中禁针
臂 在肘上七寸 向端阳明之络
肩 在肩端两骨间陷者宛宛中举臂有空阳明跷脉之会
巨骨上与大椎会
灵枢第十篇云出 骨之前廉上出于柱骨之会上○滑氏曰肩端两骨间为 骨肩胛上际会处为天
柱骨出 骨前廉循巨骨穴上出柱骨之会上会于大椎○大椎见督脉手足三阳督脉之会
巨骨 在肩端上行两叉骨间陷中阳明跷脉之会
此经直下缺盆行陷中本属是阳明阳明外络绕肺脏下膈竟属大肠停
灵枢第十篇云下入缺盆络肺下膈属大肠○滑氏曰自大椎而下入缺盆循足阳明经脉外络绕肺脏
复下膈当天枢之分会属于大肠也○缺盆天枢俱见足阳明经
其支又自缺盆别上行天鼎扶突接贯腮及入于下齿
灵枢第十篇云其支别者从缺盆上头贯腮入下齿中○滑氏曰头茎为颈耳以下曲处为一口前小者
为齿其支别者自缺盆上行于颈循天鼎扶突上贯于颊入下齿缝中
天鼎 在颈缺盆直扶突后一寸仰首取之
扶突 在气舍后一寸五分又云在人迎后一寸五分仰首取之气舍人迎见足阳明经
上唇交互人中穴左右相交挟鼻孔任督手阳明会总禾 一寸是迎香交足阳明经胃统
灵枢第十篇 云还出挟口交人中左之右右之左上挟鼻孔○滑氏曰口唇上鼻柱下为人中既入齿
缝复出夹两口吻相交于人中之分左脉之右右脉之左上挟鼻孔循禾 迎香而终以交于足阳明也
○人中见督脉手阳明督之会
禾 在鼻孔下侠水沟旁五分禁灸
迎香 在禾 上一寸鼻孔旁五分手足阳明之会禁灸
总歌曰
手阳明脉起商阳过臂交肩络大肠再出缺盆还入齿上行侠鼻到迎香
愚按手阳明大阳之脉起于大指次指手表内侧端上终于络肺会属大肠其支者从缺盆入于下齿左
之右右之左相交 中横至两目之下承泣穴长五尺交于足阳明胃经故足阳明之脉起于承泣穴始
穴歌曰
手中阳明始商阳二间三间合谷藏阳溪偏历及温溜下廉上廉三里长曲池肘 迎五里臂 肩 巨
骨当天鼎扶突禾 接终以迎香二十穴
是动所生歌曰
此经气盛血亦盛是动颈肿并齿痛所生病者为鼻衄目黄口干喉痹生大指次指难为用肩前 外痛
相仍灵枢第十篇云是动则病齿痛颈肿是主津液○所生病者目黄口干鼽衄喉痹肩前 痛大指次指痛
不用气有余则当脉所过者热肿虚则寒栗不复为此诸病盛则泻之虚则补之热则疾之寒则留之陷
下则灸之不盛不虚以经取之盛者人迎大三倍于寸口虚者人迎反小于寸口也
音释
（渠殒也） 胛（音甲背胛也） 颊（右胁反结腮也） 吻（音文上声）鼽（音求鼻塞）
手阳明大肠经之图
手阳明大肠经，其走向是从手部走向头部，再由头部走向腹部。这条经脉的气血都很旺盛，起始于商阳穴，终止于迎香穴，共计二十个穴位，左右两侧共四十个穴位。大肠作为六腑之一，长度二丈一尺，宽度四寸，位于肚脐右侧，迂回曲折十六处。
手阳明大肠经的穴位包括：商阳、二间、三间、合谷、阳溪（位于两筋之间）。
《灵枢》第十篇记载：“手阳明大肠经的脉气，起始于食指末端，沿食指桡侧上行，出于合谷穴两骨之间，上行进入两筋之中。”滑寿氏解释说：所谓“大指次指”，即食指。手阳明大肠经的循行规律是：阴经行于手足内侧（里），阳经行于手足外侧（表）。从两骨之间再上行进入阳溪穴的两筋之中。
商阳穴：在手部，食指内侧，距指甲角如韭菜叶宽处。
二间穴：在手部，食指本节（掌指关节）前内侧凹陷中。
三间穴：在手部，食指本节（掌指关节）后内侧凹陷中。
合谷穴：在手部，第一、二掌骨之间凹陷中，可触及动脉搏动。
阳溪穴：在手部腕横纹桡侧，两筋之间的凹陷中。
接着沿手臂向上，经过偏历、温溜，到达下廉、上廉、三里，至曲池穴在肘部；再上行至五里、臂臑、肩髃，在两骨之间。
《灵枢》第十篇记载：“沿手臂上侧上行，入肘外侧，沿肱骨外缘前侧上行至肩部。”滑寿氏解释说：从阳溪穴以上，沿手臂上侧的偏历、温溜、下廉、上廉、三里穴，进入肘外侧的曲池穴，沿肱骨外缘前侧，经过肘髎、五里、臂臑、络穴，会上肩至肩髃穴。此处与手少阳经及手阳明经的络脉相会。
偏历穴：在腕横纹后三寸，别走手太阴肺经。
温溜穴：取腕后小指侧六寸，或大拇指侧五寸间的动脉中。
下廉穴：在辅骨（尺骨鹰嘴）下方，距离上廉穴一寸，距离曲池穴四寸。
上廉穴：在三里穴下一寸。
三里穴：在曲池穴下二寸，按压时肌肉隆起。
曲池穴：在肘部外侧辅骨屈肘时曲骨之中，以双手拱胸姿势取穴。
肘髎穴：在肘部大骨外侧凹陷中。
五里穴：在肘上三寸，向内侧的大脉中，禁止针刺。
臂臑穴：在肘上七寸，向端部为手阳明经的络穴。
肩髃穴：在肩端两骨间凹陷宛宛中，举臂时有空隙，为手阳明经与跷脉的交会穴。
巨骨穴：上方与大椎穴相会。
《灵枢》第十篇记载：“出锁骨上窝之前缘，上行出于柱骨（颈椎）的交会处。”滑寿氏解释说：肩端两骨间为锁骨上窝，肩胛上际会处为天柱骨，出锁骨上窝前缘，循行经过巨骨穴，上行出柱骨的交会处，会于大椎穴。大椎穴见督脉，为手足三阳经与督脉的交会穴。
巨骨穴：在肩端上行两叉骨（锁骨与肩峰）间凹陷中，为手阳明经与跷脉的交会穴。
此经直行向下进入缺盆（锁骨上窝），行于凹陷中，本属足阳明胃经的外络，环绕肺脏，下行穿过膈肌，最终归属于大肠而停留。
《灵枢》第十篇记载：“下行进入缺盆，联络肺脏，下行穿过膈肌，归属于大肠。”滑寿氏解释说：自大椎穴向下进入缺盆，沿足阳明经脉外络，环绕肺脏，复下行穿过膈肌，当天枢穴的分会，属于大肠。缺盆、天枢均见足阳明经。
其支脉又从缺盆别出，上行至天鼎、扶突，贯穿腮部，并进入下齿龈。
《灵枢》第十篇记载：“其支脉者，从缺盆上行至头，贯穿腮部，进入下齿中。”滑寿氏解释说：头颈相连处为颈，耳以下弯曲处为一口，前面较小者为齿。其支脉从缺盆上行于颈部，循行经过天鼎、扶突，上贯于颊部，进入下齿缝中。
天鼎穴：在颈部缺盆直上，扶突穴后一寸，仰首取之。
扶突穴：在气舍穴后一寸五分，又说在人迎穴后一寸五分，仰首取之。气舍、人迎见足阳明经。
上行至唇部，交叉于人中穴，左右相交，挟持鼻孔，任脉、督脉与手阳明经在此总汇。禾髎穴与迎香穴相距一寸，迎香穴与足阳明胃经交接。
《灵枢》第十篇记载：“还出挟口，交于人中，左脉向右，右脉向左，上行挟持鼻孔。”滑寿氏解释说：口唇之上、鼻柱之下为人中。既入齿缝，复出夹两口吻，相交于人中的分界，左脉行至右侧，右脉行至左侧，上行挟持鼻孔，循行经过禾髎、迎香而终，以交于足阳明经。人中见督脉，为手阳明经与督脉的交会穴。
禾髎穴：在鼻孔下，侠水沟旁五分，禁止艾灸。
迎香穴：在禾髎上一寸，鼻孔旁五分，为手足阳明经的交会穴，禁止艾灸。
总歌曰：
手阳明脉起商阳，过臂交肩络大肠，再出缺盆还入齿，上行侠鼻到迎香。
愚按：手阳明大肠经之脉，起于食指（大指次指）手表内侧端，上终于络肺，会属大肠。其支者从缺盆入于下齿，左之右，右之左，相交于人中，横至两目之下承泣穴，长五尺，交于足阳明胃经。故足阳明之脉起于承泣穴。
始穴歌曰：
手中阳明始商阳，二间三间合谷藏，阳溪偏历及温溜，下廉上廉三里长，曲池肘髎迎五里，臂臑肩髃巨骨当，天鼎扶突禾髎接，终以迎香二十穴。
是动所生歌曰：
此经气盛血亦盛，是动颈肿并齿痛，所生病者为鼻衄，目黄口干喉痹生，大指次指难为用，肩前臑外痛相仍。
《灵枢》第十篇记载：“是动则病齿痛、颈肿，是主津液所生病者。所生病者：目黄、口干、鼽衄、喉痹、肩前臑痛、大指次指痛不用。气有余则当脉所过者热肿，虚则寒栗不复。为此诸病，盛则泻之，虚则补之，热则疾之，寒则留之，陷下则灸之，不盛不虚以经取之。盛者人迎大三倍于寸口，虚者人迎反小于寸口也。”
音释：
（渠殒也） 胛（音甲，背胛也） 颊（右胁反，结腮也） 吻（音文，上声） 鼽（音求，鼻塞）
Figure of the Hand-Yangming Large Intestine Meridian
The Hand-Yangming Large Intestine Meridian (Shou Yangming Da Chang Jing) runs from the hand to the head, and from the head to the abdomen. The Qi and Blood in this meridian are abundant. It starts at Shangyang (LI1) and ends at Yingxiang (LI20), totaling twenty acupoints on each side, or forty acupoints bilaterally. As a Fu organ (hollow organ), the Large Intestine is two zhang one chi long and four cun wide, located to the right of the umbilicus, with sixteen curves.
The acupoints of the Hand-Yangming Large Intestine Meridian include: Shangyang (LI1), Erjian (LI2), Sanjian (LI3), Hegu (LI4), and Yangxi (LI5, located between the two tendons).
*Jingluo* Chapter 10 states: "The pulse of the Hand-Yangming meridian originates at the end of the second finger, follows the radial aspect of the finger, emerges between the two bones at Hegu (LI4), and ascends into the space between the two tendons." Master Hua Shou explains: The term "second finger" refers to the index finger. The circulation principle of meridians is that Yin meridians run along the medial (inner) aspect of the hands and feet, while Yang meridians run along the lateral (outer) aspect. From between the two bones, it ascends again into the space between the two tendons at Yangxi (LI5).
Shangyang (LI1): Located on the hand, on the radial side of the index finger, approximately the width of a leek leaf from the corner of the nail.
Erjian (LI2): Located on the hand, in the depression on the radial side proximal to the metacarpophalangeal joint of the index finger.
Sanjian (LI3): Located on the hand, in the depression on the radial side distal to the metacarpophalangeal joint of the index finger.
Hegu (LI4): Located on the hand, in the depression between the first and second metacarpal bones, where an arterial pulse can be felt.
Yangxi (LI5): Located on the wrist, in the depression between the two tendons on the radial side of the wrist crease.
Proceeding up the arm, it passes through Pianli (LI6), Wenliu (LI7), Xialian (LI8), Shanglian (LI9), Sanli (LI10), reaches Quchi (LI11) at the elbow; then ascends to Wuli (LI13), Binao (LI14), and Jianyu (LI15), between the two bones.
*Jingluo* Chapter 10 states: "It ascends along the lateral aspect of the arm, enters the lateral aspect of the elbow, follows the anterior lateral aspect of the humerus, and ascends to the shoulder." Master Hua Shou explains: From Yangxi (LI5) upwards, it follows the lateral aspect of the arm through Pianli (LI6), Wenliu (LI7), Xialian (LI8), Shanglian (LI9), Sanli (LI10), enters Quchi (LI11) at the lateral aspect of the elbow, follows the anterior lateral aspect of the humerus through Zhouliao (LI12), Wuli (LI13), Binao (LI14), and the Luo-connecting point, meeting at Jianyu (LI15). This area intersects with the Hand-Shaoyang meridian and the Luo-connecting vessel of the Hand-Yangming meridian.
Pianli (LI6): Located three cun distal to the wrist crease, diverging to connect with the Hand-Taiyin Lung Meridian.
Wenliu (LI7): Located in the arterial pulse six cun proximal to the wrist on the ulnar side, or five cun on the radial side.
Xialian (LI8): Located below the olecranon process, one cun distal to Shanglian (LI9) and four cun proximal to Quchi (LI11).
Shanglian (LI9): Located one cun distal to Sanli (LI10).
Sanli (LI10): Located two cun distal to Quchi (LI11); the muscle bulges upon pressure.
Quchi (LI11): Located in the depression at the lateral end of the elbow when the elbow is flexed; take the point with arms crossed over the chest.
Zhouliao (LI12): Located in the depression at the lateral aspect of the large bone of the elbow.
Wuli (LI13): Located three cun proximal to the elbow, in the large vessel towards the interior; acupuncture is prohibited here.
Binao (LI14): Located seven cun proximal to the elbow; towards the tip, it is the Luo-connecting point of the Hand-Yangming meridian.
Jianyu (LI15): Located in the depression between the two bones at the shoulder tip; when the arm is raised, there is a gap. It is the intersection of the Hand-Yangming meridian and the Qiao vessels.
Gugu (LI16): Intersects with Dazhui (GV14) superiorly.
*Jingluo* Chapter 10 states: "It emerges from the anterior border of the clavicle, ascends out to the intersection of the vertebral column." Master Hua Shou explains: The space between the two bones at the shoulder tip is the clavicular fossa; the upper margin of the scapula meets at the Tianzhu bone. Emerging from the anterior border of the clavicle, it follows the Gugu (LI16) acupoint, ascends out to the intersection of the vertebral column, and meets at Dazhui (GV14). Dazhui (GV14) belongs to the Du Mai (Conception Vessel), serving as the intersection of the Hand and Foot Three Yang meridians and the Du Mai.
Gugu (LI16): Located in the depression between the two forked bones (clavicle and acromion) ascending from the shoulder tip; it is the intersection of the Hand-Yangming meridian and the Qiao vessels.
This meridian descends straight into the Quepen (supraclavicular fossa), running in the depression. It originally belongs to the exterior connections of the Foot-Yangming Stomach Meridian, surrounds the Lungs, descends through the diaphragm, and finally connects to the Large Intestine.
*Jingluo* Chapter 10 states: "It descends into the Quepen, connects with the Lungs, descends through the diaphragm, and connects to the Large Intestine." Master Hua Shou explains: From Dazhui (GV14) downwards, it enters the Quepen, follows the exterior connections of the Foot-Yangming Stomach Meridian, surrounds the Lungs, descends through the diaphragm, meets the Tianshu (ST25) branch, and connects to the Large Intestine. Quepen and Tianshu are both found in the Foot-Yangming Stomach Meridian.
Its branch diverges from the Quepen, ascends to Tianding (LI17) and Futu (LI18), passes through the cheek, and enters the lower teeth.
*Jingluo* Chapter 10 states: "Its branch goes up from the Quepen to the head, passes through the cheek, and enters the lower teeth." Master Hua Shou explains: The neck connects the head. The curved part below the ear forms the mouth; the smaller front part contains the teeth. Its branch ascends from the Quepen through the neck, passing through Tianding (LI17) and Futu (LI18), passes through the cheek, and enters the lower gum line.
Tianding (LI17): Located on the neck, directly above Quepen, one cun posterior to Futu (LI18); take the point with the head tilted back.
Futu (LI18): Located one cun five fen posterior to Qishe (ST12), or one cun five fen posterior to Renying (ST9); take the point with the head tilted back. Qishe and Renying are found in the Foot-Yangming Stomach Meridian.
Ascending to the lip, it crosses at the Renzhong (GV26) acupoint, intersecting left and right, flanking the nostrils. The Ren Mai (Conception Vessel), Du Mai (Governing Vessel), and Hand-Yangming meridian converge here. He liao (LI19) and Yingxiang (LI20) are one cun apart. Yingxiang (LI20) connects with the Foot-Yangming Stomach Meridian.
*Jingluo* Chapter 10 states: "It returns, emerging beside the mouth, crossing at Renzhong (GV26); the left channel goes to the right, the right channel goes to the left, ascending beside the nostrils." Master Hua Shou explains: Above the lips and below the nasal columella is Renzhong (GV26). After entering the gum line, it emerges beside the corners of the mouth, crossing at Renzhong (GV26); the left channel moves to the right, the right channel moves to the left, ascending beside the nostrils, following Heliao (LI19) and Yingxiang (LI20) to terminate, connecting with the Foot-Yangming Stomach Meridian. Renzhong (GV26) belongs to the Du Mai, serving as the intersection of the Hand-Yangming and Du Mai meridians.
Heliao (LI19): Located below the nostril, five fen lateral to the Philtrum (Shuigou); moxibustion is prohibited.
Yingxiang (LI20): Located one cun superior to Heliao (LI19), five fen lateral to the nostril; it is the intersection of the Hand and Foot Yangming meridians; moxibustion is prohibited.
General Song:
Hand-Yangming meridian starts at Shangyang, passes the arm, crosses the shoulder, connects to the Large Intestine,
Emerges again from Quepen, enters the teeth, ascends beside the nose to Yingxiang.
Commentary: The pulse of the Hand-Yangming Large Intestine meridian originates at the medial end of the index finger, ascends to connect with the Lungs, and joins the Large Intestine. Its branch enters the lower teeth from Quepen, crossing left to right and right to left at Renzhong (GV26), extending horizontally to Chengqi (ST1) under the eyes. It is five chi long and connects with the Foot-Yangming Stomach Meridian. Thus, the Foot-Yangming meridian starts at Chengqi (ST1).
Song of Starting Acupoints:
Hand-Yangming begins at Shangyang, Erjian and Sanjian, Hegu resides there,
Yangxi, Pianli, and Wenliu follow, Xialian, Shanglian, and Sanli extend,
Quchi at the elbow, Zhouliao, Wuli, Binao, Jianyu, and Gugu stand tall,
Tianding, Futu, Heliao connect, ending finally at Yingxiang, twenty acupoints total.
Song of Disorders Arising from Movement and Generation:
When Qi is abundant, Blood is also abundant; movement disorders cause neck swelling and toothache,
Generated diseases include epistaxis, yellow eyes, dry mouth, and throat obstruction,
The index and middle fingers become difficult to use, pain persists in the anterior shoulder and lateral arm.
*Jingluo* Chapter 10 states: "Disorders arising from movement include toothache and neck swelling; it governs diseases related to Jin Ye (Body Fluids). Generated diseases include yellow eyes, dry mouth, rhinorrhea/epistaxis, throat obstruction, pain in the anterior shoulder and arm, and pain/uselessness of the index and middle fingers. Excess Qi causes heat and swelling along the meridian path; deficiency causes cold shivering without recovery. For these diseases: excess is drained, deficiency is tonified, heat is treated quickly, cold is retained, sinking points are moxa-ed, and neither excess nor deficiency is treated by selecting points from the meridian itself. In excess cases, the Renying pulse is three times larger than the Cunkou pulse; in deficiency cases, the Renying pulse is smaller than the Cunkou pulse."
Phonetic Glossary:
(Ju yun ye) Jia (pronounced Jia, dorsal scapula) Jia (You Xie fan, jaw/cheek) Wen (pronounced Wen, rising tone) Qiu (pronounced Qiu, nasal congestion)