灵枢九针十二原篇云∶肺之原出于太渊,心之原出于大陵,肝之原出于太冲,脾之原出
于太白,肾之原出于太溪,膏之原出于鸠尾,肓之原出于脖 ,凡此十二原者,主治五脏
六腑之有疾者也。本输篇乃以太渊、大陵、太冲、太白、太溪等五原为五脏之 ,六腑则膀
胱之束骨为 ,京骨为原;胆之临泣为 ,丘墟为原;胃之陷谷为 ,冲阳为原;三焦之中渚
为,阳池为原,小肠之后溪为 ,腕骨为原;大肠之三间为 ,合谷为原。又曰∶心出于中
冲,溜于劳宫,注于大陵,行于间使,入于曲泽,手少阴也。(中冲以下皆手心主经穴,本篇直指为手少
阴,而少明经 ,别无载者。)邪客篇∶帝曰∶手少阴之脉独无 何也?岐伯曰∶诸邪之在于心者,皆
在于心之包络,包络者,心主之脉也,故独无 焉。帝曰∶少阴独无 者,不病乎?岐伯曰∶
其外经病而脏不病,故独取其经于掌后锐骨之端。(即神门穴,手少阴 也。)其余脉出入屈折,行
之徐疾;皆如手少阴心主之脉行也。故王氏注气穴论脏 五十穴,亦惟有心主井 ,而无
心经之五 。惟独缪刺篇曰∶少阴锐骨之端各一 。王氏注谓神门穴为手少阴之 者,盖
亦本于邪客篇也。
愚按前三篇之说,各有不同。在九针十二原篇止言五脏之原左右各二,而复有膏之
原,肓之原,共为十二原。在本输篇则以前篇五脏之原为五 ,复有六腑之原,而无膏肓之
原,且手少阴之脉独无 ,而以手厥阴之 代之。在邪客篇则明指手少阴之 ,在掌后锐
骨之端,而亦皆无少阴井荥经合并膏肓等原。难经亦然。及查甲乙经乃云∶少冲者木也,
少阴脉所出为井;少府者火也,少阴脉所溜为荥;神门者土也,少阴脉所注为 ;灵道者金
也,少阴脉所行为经;少海者水也,少阴脉所入为合,而十二经之井荥始全矣。然详求 原
之义,如九针十二原篇及本输篇所云,则阴经之原即 也;阳经虽有 原之分,而 过于
原,亦为同气。故阳经治原,即所以治 也;阴经治 ,即所以治原也。六十六难曰∶十二
经皆以 为原者何也?然。五脏 者,三焦之所行,气之所留止也。又曰∶原者,三焦之尊号也,故
所止辄为原。五脏六腑之有病者,皆取其原也。及考之顺气一日分为四时篇,则
曰原独不应五时,以经合之,以应其数。然则 可合原,经亦可合原矣。盖 在原之前,经
在原之后,穴邻脉近,故其气数皆相应也。义见针刺类十七。
\r上中下本标中气图\pt13a100.bmp\r
六经之气,以风寒热湿火燥为本,三阴三阳为标,本标之中见者为中气。中气者,
如少阳厥阴为表里,阳明太阴为表里,太阳少阴为表里,表里相通,则彼此互为中气。义出六微
旨大论,详运气类六。
\r脏腑应天本标中气图\pt13a101.bmp\r
脏腑经络之标本,脏腑为本居里,十二经为标居表,表里相络者为中气
居中。所谓相络者,乃表里互相维络,如足太阳膀胱经络于肾,足少阴肾经亦络于膀胱也。余仿此。
《灵枢·九针十二原》篇记载:肺的原穴出于太渊,心的原穴出于大陵,肝的原穴出于太冲,脾的原穴出于太白,肾的原穴出于太溪,膏的原穴出于鸠尾,肓的原穴出于脖胦。这十二个原穴,主治五脏六腑的疾病。
《灵枢·本输》篇则将太渊、大陵、太冲、太白、太溪这五个原穴作为五脏的输穴(Shu-Stream points),六腑方面,膀胱的束骨为输穴,京骨为原穴;胆的临泣为输穴,丘墟为原穴;胃的陷谷为输穴,冲阳为原穴;三焦的中渚为输穴,阳池为原穴;小肠的后溪为输穴,腕骨为原穴;大肠的三间为输穴,合谷为原穴。又说:心经的气血出于中冲,流注于劳宫,灌注于大陵,运行于间使,进入曲泽,这是手少阴心经。(中冲以下的穴位都属于手厥阴心包经的穴位,本篇直接称之为手少阴经,而手少阴经在其他篇章中并无此类记载。)
《灵枢·邪客》篇记载:黄帝问:手少阴心经独独没有输穴,为什么呢?岐伯回答:凡是邪气侵犯心脏的,都侵犯心包络,心包络是代心受邪的经脉,所以手少阴心经单独没有输穴。黄帝问:手少阴经单独没有输穴,难道就不会生病吗?岐伯回答:如果其体表经络发病而内脏不病,所以只取掌后锐骨端(即神门穴,属于手少阴心经)的穴位。其余脉气的出入屈折,运行的快慢,都像手少阴心经和手厥阴心包经的循行一样。所以王冰注释《素问·气穴论》时提到脏俞五十穴,也只有心包经的五输穴,而没有心经的五输穴。唯独在《素问·缪刺论》中提到:“少阴锐骨之端各一穴”。王冰注释认为神门穴是手少阴心经的输穴,这大概也是依据《邪客》篇的说法。
我按语分析前三篇的说法,各有不同。在《九针十二原》篇中只说五脏的原穴左右各两个,再加上膏的原穴、肓的原穴,共为十二原穴。在《本输》篇中,则把前一篇五脏的原穴作为五输穴中的输穴,另外有六腑的原穴,而没有膏肓的原穴,并且手少阴心经独独没有输穴,而以手厥阴心包经的输穴代替。在《邪客》篇中,则明确指出手少阴心经的输穴在掌后锐骨端,但也都没有少阴经的井、荥、经、合以及膏肓等原穴。《难经》也是如此。等到查阅《针灸甲乙经》却说:少冲属木,是手少阴脉所出的井穴;少府属火,是手少阴脉所流的荥穴;神门属土,是手少阴脉所注的输穴;灵道属金,是手少阴脉所行的经穴;少海属水,是手少阴脉所入的合穴,这样十二经脉的井、荥、输、经、合五输穴才齐全了。然而详细推求“原”与“输”的含义,如《九针十二原》篇及《本输》篇所说,那么阴经的原穴即是输穴;阳经虽然有输穴和原穴的区别,但输穴经过原穴,二者也是同气相求。所以治疗阳经的原穴,就是治疗其输穴;治疗阴经的输穴,就是治疗其原穴。《难经·六十六难》说:十二经脉都以输穴为原穴,为什么呢?回答说:五脏的输穴,是三焦之气运行的通道,是元气停留的地方。又说:原穴,是三焦的尊称,所以气停留的地方就称为原穴。五脏六腑有了疾病,都要取用原穴。再考察《灵枢·顺气一日分为四时》篇,则说原穴单独不与四季相应,而是通过经脉配合,以对应其数理。既然这样,输穴可以合并到原穴中,经穴也可以合并到原穴中。因为输穴在原穴之前,经穴在原穴之后,穴位邻近、经脉接近,所以它们的气和数都是相应的。这一义理见《针刺类》第十七篇。
[图片:上中下本标中气图]
六经之气,以风、寒、热、湿、火、燥为本,三阴三阳为标,在本与标之间相见的是中气。中气者,如少阳与厥阴互为表里,阳明与太阴互为表里,太阳与少阴互为表里,表里相通,则彼此互为中气。这一义理出自《素问·六微旨大论》,详见《运气类》第六部分。
[图片:脏腑应天本标中气图]
脏腑经络的标本关系,脏腑为本居于体内,十二经脉为标居于体表,表里相互联络的经脉作为中气居中。所谓相络,是指表里经脉互相维系联络,例如足太阳膀胱经络于肾,足少阴肾经也络于膀胱。其余仿照此例。
The chapter "Nine Needles and Twelve Originals" (Jiuzhen Shier Yuan) in the *Ling Shu* states: The Yuan-Source point of the Lung meridian is Taiyuan (LU 9); the Yuan-Source point of the Heart meridian is Daling (PC 7); the Yuan-Source point of the Liver meridian is Taichong (LR 3); the Yuan-Source point of the Spleen meridian is Taibai (SP 3); the Yuan-Source point of the Kidney meridian is Taixi (KI 3); the Yuan-Source point of the Gao (pericardial fat/mesentery) is Jiawei (CV 15); and the Yuan-Source point of the Huang (diaphragmatic cavity) is Bo Yang (CV 16). These twelve Yuan-Source points are used to treat diseases of the Zang and Fu organs.
The chapter "Ben Shu" (Roots and Transmissions) in the *Ling Shu* designates Taiyuan, Daling, Taichong, Taibai, and Taixi as the Shu-Stream points of the five Zang organs. For the six Fu organs: for the Bladder, Shugu (BL 65) is the Shu-Stream point, and Jinggu (BL 64) is the Yuan-Source point; for the Gallbladder, Linqi (GB 41) is the Shu-Stream point, and Qiuxu (GB 40) is the Yuan-Source point; for the Stomach, Xangu (ST 43) is the Shu-Stream point, and Chongyang (ST 42) is the Yuan-Source point; for the Sanjiao (Triple Burner), Zhongzhu (TE 3) is the Shu-Stream point, and Yangchi (TE 4) is the Yuan-Source point; for the Small Intestine, Houxi (SI 3) is the Shu-Stream point, and Wanggu (SI 4) is the Yuan-Source point; for the Large Intestine, Sanjian (LI 3) is the Shu-Stream point, and Hegu (LI 4) is the Yuan-Source point. It further states: The Qi of the Heart emerges from Zhongchong (PC 9), flows into Laogong (PC 8), pours into Daling (PC 7), travels through Jianshi (PC 5), and enters Quze (PC 3). This refers to the Hand-Shaoyin Heart Meridian. (Note: The points from Zhongchong downwards belong to the Hand-Jueyin Pericardium Meridian. This chapter directly refers to them as the Hand-Shaoyin Meridian, whereas other chapters do not record such points for the Hand-Shaoyin Meridian.)
The chapter "Xie Ke" (Evil Intrusion) in the *Ling Shu* records: The Yellow Emperor asked, "Why does the Hand-Shaoyin Heart Meridian alone lack [specific acupoints]?" Qibo answered, "Any pathogenic factors affecting the Heart actually affect the Pericardium (Bao Luo). The Pericardium is the meridian that protects the Heart. Therefore, the Hand-Shaoyin Heart Meridian alone lacks [these specific points]." The Yellow Emperor asked, "If the Shaoyin meridian alone lacks these points, does it mean it never becomes diseased?" Qibo replied, "If the exterior meridian is diseased but the interior organ is not, one should only select the point at the end of the sharp bone behind the palm." (This refers to Shenmen (HT 7), which belongs to the Hand-Shaoyin Heart Meridian.) The flow, exit, entry, and curvature of the remaining meridians, as well as their speed of movement, are all similar to the circulation of the Hand-Shaoyin Heart Meridian and the Hand-Jueyin Pericardium Meridian. Consequently, when Wang Bing annotated the "Qi Xue Lun" (Discussion on Acupoints) in the *Su Wen*, mentioning the fifty acupoints of the Zang organs, he only included the Five Shu points of the Pericardium meridian, without those of the Heart meridian. Only in the "Miao Ci Lun" (Discussion on Mysterious Puncture) does it mention: "One point at each end of the sharp bone of Shaoyin." Wang Bing's annotation identifies Shenmen as the Shu-Stream point of the Hand-Shaoyin Heart Meridian, likely based on the "Xie Ke" chapter.
In my analysis, the statements in these three chapters differ. The "Jiuzhen Shier Yuan" chapter mentions only the two Yuan-Source points on the left and right for the five Zang organs, plus the Yuan-Source points of Gao and Huang, totaling twelve Yuan-Source points. The "Ben Shu" chapter treats the five Yuan-Source points of the previous chapter as the Shu-Stream points of the five Zang organs, adds the Yuan-Source points of the six Fu organs, omits the Yuan-Source points of Gao and Huang, and notes that the Hand-Shaoyin Heart Meridian lacks Shu-Stream points, substituting them with those of the Hand-Jueyin Pericardium Meridian. The "Xie Ke" chapter explicitly locates the Shu-Stream point of the Hand-Shaoyin Heart Meridian at the end of the sharp bone behind the palm, yet still omits the Jing, Ying, Jing, He, and Yuan-Source points of Shaoyin, Gao, and Huang. The *Nan Jing* (Classic of Difficult Issues) agrees with this view. However, upon consulting the *Zhen Jiu Jia Yi Jing* (A-B Classic of Acupuncture and Moxibustion), it states: Shaochong (HT 9) is Wood, the Jing-Well point where the Shaoyin meridian emerges; Shaofu (HT 8) is Fire, the Ying-Spring point where the Shaoyin meridian flows; Shenmen (HT 7) is Earth, the Shu-Stream point where the Shaoyin meridian pours; Lingdao (HT 4) is Metal, the Jing-River point where the Shaoyin meridian travels; and Shaohai (HT 3) is Water, the He-Sea point where the Shaoyin meridian enters. Thus, the Five Shu points of the twelve meridians become complete.
However, a detailed inquiry into the meaning of "Yuan" and "Shu" reveals that, as stated in the "Jiuzhen Shier Yuan" and "Ben Shu" chapters, the Yuan-Source point of Yin meridians is identical to the Shu-Stream point. Although Yang meridians distinguish between Shu-Stream and Yuan-Source points, the Shu-Stream point passes through the Yuan-Source point, sharing the same Qi. Therefore, treating the Yuan-Source point of a Yang meridian is equivalent to treating its Shu-Stream point; treating the Shu-Stream point of a Yin meridian is equivalent to treating its Yuan-Source point. The *Nan Jing* (Chapter 66) asks: "Why are the Shu-Stream points considered the Yuan-Source points for all twelve meridians?" The answer is: The Shu-Stream points of the five Zang organs are pathways for Sanjiao Qi and sites where Yuan Qi resides. It further states: "Yuan" is an honorific title for the Sanjiao; thus, wherever Qi stops, it is called a Yuan-Source point. When the Zang and Fu organs are diseased, their Yuan-Source points should be selected. Furthermore, the chapter "Shun Qi Yi Ri Fen Wei Si Shi" (Regulating Qi Divided into Four Times of the Day) in the *Ling Shu* states that the Yuan-Source point alone does not correspond to the four seasons, but corresponds numerically through its connection with the meridians. In this sense, Shu-Stream points can be merged with Yuan-Source points, and Jing-River points can also be merged with Yuan-Source points. Since Shu-Stream points precede Yuan-Source points and Jing-River points follow them, and because the acupoints are adjacent and the meridians are close, their Qi and numerical correspondences are consistent. This principle is discussed in detail in the "Needling Techniques" category, Chapter 17.
[Image: Diagram of Root, Mark, and Middle Qi of Upper, Middle, and Lower Jiao]
The Qi of the Six Meridians takes Wind, Cold, Heat, Dampness, Fire, and Dryness as its Root (Ben), and the Three Yin and Three Yang as its Mark (Biao). The Middle Qi (Zhong Qi) is seen between the Root and the Mark. The Middle Qi arises from the interior-exterior relationship: Shaoyang and Jueyin are interior-exterior pairs; Yangming and Taiyin are interior-exterior pairs; Taiyang and Shaoyin are interior-exterior pairs. Because interior and exterior meridians connect, they serve as each other's Middle Qi. This concept originates from the "Liu Wei Zhi Da Lun" (Great Discussion on the Six Subtle Principles) in the *Su Wen*; see the "Yun Qi" category, Part 6, for details.
[Image: Diagram of Organ-Meridian Correspondence to Heaven's Root, Mark, and Middle Qi]
Regarding the Root and Mark of Zang-Fu organs and meridians: the Zang-Fu organs are the Root, residing internally; the twelve meridians are the Mark, residing externally. The interior-exterior connected meridians serve as the Middle Qi, positioned centrally. "Connected" means the interior and exterior meridians mutually link and support each other. For example, the Foot-Taiyang Bladder Meridian connects to the Kidney, and the Foot-Shaoyin Kidney Meridian connects to the Bladder. The rest follow this pattern.