(灵枢海论 全)
黄帝问于岐伯曰∶余闻刺法对夫子,夫子之所言,不离于营卫血气。夫十二经脉者,内属于腑脏,外络于肢节,夫
子乃合之于四海乎?岐伯答曰∶人亦有四海、十二经水。经水者,皆注于海,海有东西南北,命曰四海。黄帝曰∶以人
应之奈何?岐伯曰∶人有髓海,有血海,有气海,有水谷之海,凡此四者,以应四海也。(十二经水义见后。四海者,百
川之宗。人亦有四海,则髓、血、气、水谷之海也。详如下文。)黄帝曰∶远乎哉,夫子之合人天地四海也,愿闻应之奈
何?岐伯答曰∶必先明知阴阳表里荥输所在,四海定矣。(阴阳者,经脉之阴阳也。表里者,脏腑之内外也。荥输义详前
十四。知此数者,则经络之道明而四海可定矣。输、 、俞,本经皆通用。)黄帝曰∶定之奈何?岐伯曰∶胃者水谷之海,
其输上在气街,下至三里。(人受气于水谷,水谷入口,藏于胃,以养五脏气,故五脏六腑之气味皆出于胃,而胃为水谷
之海也。其胃气营运之输,上者在气街,即气冲穴。下者至三里,在膝下三寸。)冲脉者为十二经之海,其输上在于大杼,
下出于巨虚之上下廉。(此即血海也。冲脉起于胞中,其前行者,并足少阴之经,挟脐上行至胸中而散;其后行者,上循
背里为经络之海;其上行者,出于颃颡;下行者,出于足。故其输上在于足太阳之大杼,下在于足阳明之巨虚上下廉。
愚按∶动输篇曰∶胃为五脏六腑之海。太阴阳明论曰∶阳明者表也,五脏六腑之海也。逆顺肥瘦篇曰∶夫冲脉者,五脏
六腑之海也,五脏六腑皆禀焉。此篇言冲脉者,为十二经之海。若此诸论,则胃与冲脉,皆为十二经之海,亦皆为五脏
六腑之海,又将何以辨之?故本篇有水谷之海、血海之分。水谷之海者,言水谷盛贮于此,营卫由之而化生也。血海者,
言受纳诸经之灌注,精血于此而蓄藏也。此固其辨矣,及考之痿论曰∶阳明者,五脏六腑之海,主润宗筋,宗筋主束骨
而利机关也。冲脉者,经脉之海也,主渗灌溪谷,与阳明合于宗筋,阴阳总宗筋之会,会于气街,而阳明为之长。盖阳
明为多血多气之府,故主润宗筋而利机关。冲脉为精血所聚之经,故主渗灌溪谷。且冲脉起于胞中,并少阴之大络而下
行。阳明为诸经之长,亦会于前阴。故男女精血皆由前阴而降者,以二经血气总聚于此,故均称为五脏六腑十二经之海,
诚有非他经之可比也。又冲脉义,详前二十七,所当互考。)膻中者为气之海,其输上在于柱骨之上下,前在于人迎。(膻
中,胸中也,肺之所居。诸气者皆属于肺,是为真气,亦曰宗气。宗气积于胸中,出于喉咙,以贯心脉而行呼吸,故膻
中为之气海。柱骨,项后天柱骨也。忧恚无言篇曰∶颃颡者,分气之所泄也。故气海营运之输,一在颃颡之后,即柱骨
之上下,谓督脉之喑门大椎也。一在颃颡之前,谓足阳明之人迎也。)脑为髓之海,其输上在于其盖,下在风府。(凡骨
之有髓,惟脑为最巨,故诸髓皆属于脑,而脑为髓之海。盖,脑盖骨也,即督脉之囟会。风府,亦督脉穴。此皆髓海之
上下前后输也。)黄帝曰∶凡此四海者,何利何害?何生何败?岐伯曰∶得顺者生,得逆者败;知调者和,不知调者害。
(凡此四海,俱有顺逆。得顺者,知所养者也,故生。不知所养则逆矣,故败。)黄帝曰∶四海之逆顺奈何?岐伯曰∶气
海有余者,气满胸中 息面赤;气海不足,则气少不足以言。(气有余者,邪气实也。气不足者,正气虚也。下仿此。气
海在胸中而属阳,故气实则胸中 闷喘息,面热而赤。声由气发,气不足则语言轻怯,不能出声。脉要精微论曰∶言而
微,终日乃复言者,此夺气也。 ,母本切,又音瞒。)血海有余,则常想其身大,怫然不知其所病;血海不足,亦常想
其身小,狭然不知其所病。(形以血充,故血有余则常想其身大。怫,怫郁也,重滞不舒之貌。血不足则常想其身小。狭,
隘狭也,索然不广之貌。此皆血海不调之为病,病在血者徐而不显,故茫然不觉其所病。怫音佛。)水谷之海有余,则腹
满;水谷之海不足,则饥不受谷食。(有余者,水谷留滞于中,故腹为胀满。不足者,脾虚则不能运,胃虚则不能纳,故
虽饥不受谷食。)髓海有余,则轻劲多力,自过其度;髓海不足,则脑转耳鸣。胫 眩冒,目无所见,懈怠安卧。(髓海
充足,即有余也,故身轻而劲,便利多力,自有过人之度而无病也。若其不足,则在上者为脑转,以脑空而运,似旋转
也。为耳鸣,以髓虚者精必衰,阴虚则耳鸣也。为胫 ,髓空无力也。为眩冒忽不知人,为目无所见,怠惰安卧,皆以
髓为精类,精衰则气去而诸证以见矣。)黄帝曰∶余已闻逆顺,调之奈何?岐伯曰∶审守其输而调其虚实,无犯其害,顺
者得复,逆者必败。黄帝曰∶善。(审守其输,谓审察其输穴如上文也。无犯其害,无盛盛、无虚虚也。顺者得复,逆者
必败,切戒夫天时人事皆宜慎而不可忽也。)
《灵枢·海论》(全文)
黄帝向岐伯问道:我听说您讲解针刺法则时,所说的内容都离不开营气、卫气和血气。这十二条经脉,内部连接脏腑,外部联络肢体关节,您为什么将它们与“四海”联系起来呢?
岐伯回答说:人也有四海和十二条经水。这些经水,都汇入大海,大海有东、西、南、北之分,称为四海。
黄帝问:如何用人体的情况来对应这种天地自然的海呢?
岐伯说:人体有髓海、血海、气海和水谷之海,这四海正好对应自然界的海。(关于十二条经水的含义见后文。四海是百川的宗主。人也有四海,即髓海、血海、气海和水谷之海。详情如下文所述。)
黄帝说:先生将人与天地四海相合的道理真是深远啊,我希望听听具体是如何对应的?
岐伯回答说:必须首先明确阴阳、表里以及荥穴、输穴的位置,这样四海就能确定了。(这里的阴阳是指经脉的阴阳。表里是指脏腑的内与外。荥穴、输穴的含义详见前文第十四卷。明白了这几个方面,经络的道理就清晰了,四海也能确定了。原文中的“输”、“腧”、“俞”,在本经中都是通用的。)
黄帝问:如何确定它们呢?
岐伯说:胃是水谷之海,它的输穴上部在气街穴,下部在足三里穴。(人从水谷中获取精气,水谷入口后贮藏于胃,用来滋养五脏之气,所以五脏六腑的精微物质都源于胃,因此胃被称为水谷之海。其胃气运行的输注部位,上部在气街穴,也就是气冲穴;下部在足三里穴,位于膝盖下三寸处。)
冲脉是十二经脉之海(即血海),它的输穴上部在大杼穴,下部出于巨虚的上廉和下廉穴。(这就是血海。冲脉起于胞中,它的前行部分,伴随足少阴肾经,夹脐上行至胸中散开;它的后行部分,沿脊柱内部上行,成为经络之海;它的上行部分,出于颃颡;下行部分,出于足部。所以它的输穴上部在足太阳膀胱经的大杼穴,下部在足阳明胃经的巨虚上廉和下廉穴。我按语:《动输篇》说:胃是五脏六腑之海。《太阴阳明论》说:阳明经属表,是五脏六腑之海。《逆顺肥瘦篇》说:冲脉是五脏六腑之海,五脏六腑都禀受于此。本篇说冲脉是十二经之海。像这些论述,胃和冲脉都既是十二经之海,也是五脏六腑之海,又该如何区分呢?所以本篇有水谷之海和血海的区别。水谷之海,是说水谷盛贮在这里,营气和卫气由此化生。血海,是说接受各条经脉的灌注,精血在这里蓄藏。这已经区分清楚了。等到考察《痿论》时说:阳明经是五脏六腑之海,主要滋润宗筋,宗筋主要约束骨骼并利于关节活动。冲脉是经脉之海,主要渗灌溪谷,与阳明经会合于宗筋,阴阳总汇于宗筋,会合于气街,而阳明经为之长。因为阳明经是多血多气的府库,所以主要滋润宗筋并利于关节。冲脉是精血聚集的经脉,所以主要渗灌溪谷。而且冲脉起于胞中,伴随足少阴肾经的大络下行。阳明经为诸经之长,也汇聚于前阴。所以男女的精血都由前阴下降,是因为这两条经脉的血气总聚于此,所以都称为五脏六腑和十二经之海,确实不是其他经脉能比的。另外,关于冲脉的含义,详见前文第二十七卷,应当互相参考。)
膻中是气之海,它的输穴上部在柱骨的上下方,前面在人迎穴。(膻中,就是胸中,是肺居住的地方。所有的气都属于肺,这就是真气,也叫宗气。宗气积聚在胸中,出于喉咙,贯通心脉而行呼吸,所以膻中被称为气海。柱骨,就是颈后的天柱骨。《忧恚无言篇》说:颃颡是分泄气的地方。所以气海运行的输注部位,一个在颃颡之后,即柱骨的上下方,指的是督脉的喑门穴和大椎穴;一个在颃颡之前,指的是足阳明胃经的人迎穴。)
脑是髓之海,它的输穴上部在头顶盖骨处,下部在风府穴。(凡是骨头里有髓的,只有脑最大,所以所有的髓都归属于脑,脑就是髓之海。盖,就是脑盖骨,也就是督脉的囟会穴。风府,也是督脉的穴位。这些都是髓海上下前后的输注部位。)
黄帝问:这四海,什么有利,什么有害?什么导致生存,什么导致败亡?
岐伯回答说:得到顺应则生存,得到违背则败亡;懂得调摄的和不懂得调摄的就会受害。(这四海都有顺逆之分。得到顺应,是知道如何养护的,所以能生存。不知道如何养护就会违背规律,所以败亡。)
岐伯说:气海有余,就会感到胸部胀满,喘息,面色发红;气海不足,就会气息微弱,说话无力。(气有余,是邪气实。气不足,是正气虚。下文仿照此意。气海在胸中且属阳,所以气实则胸中闷塞、喘息、面部发热发红。声音由气发出,气不足则语言轻怯,不能出声。《脉要精微论》说:说话声音细微,整天才说几句话,这是夺气。[字音:母本切,又读瞒]。)
血海有余,就会常常觉得自己身体变大,心情郁结不畅,却不知道哪里病了;血海不足,也会常常觉得自己身体变小,感觉狭隘局促,却不知道哪里病了。(形体靠血液充盈,所以血有余就常想身体大。怫,是郁结的意思,形容沉重滞涩不舒的样子。血不足就常想身体小。狭,是狭隘的意思,形容萧索不广的样子。这都是血海不调引起的病,病在血分的通常发展缓慢且不明显,所以茫然不觉自己病了。怫音佛。)
水谷之海有余,就会腹部胀满;水谷之海不足,就会虽然饥饿却无法进食。(有余,是水谷停滞在中焦,所以腹部胀满。不足,是脾虚不能运化,胃虚不能受纳,所以虽然饥饿却吃不下食物。)
髓海有余,就会身体轻便强劲,力气过大,超过正常限度;髓海不足,就会头晕耳鸣,小腿酸软无力,眩晕昏冒,视物不清,精神倦怠,喜欢静卧。(髓海充足,就是有余,所以身体轻便强劲,便利多力,自有超过常人的状态而没有疾病。如果不足,在上表现为头晕旋转,因为脑中空虚而运转,似在旋转。表现为耳鸣,因为髓虚则精必衰,阴虚则耳鸣。表现为小腿酸软,因为髓空无力。表现为眩晕昏冒突然不知人事,表现为视物不清,表现为怠惰喜卧,都是因为髓属于精类,精衰则气去,各种症状就出现了。)
黄帝说:我已经知道了逆顺的表现,该如何调治呢?
岐伯说:仔细审视并守住相应的输穴,来调节虚实,不要犯禁忌伤害身体,顺应规律的就能恢复,违背规律的必然败亡。
黄帝说:好。(仔细审视输穴,是指审查上文提到的那些输穴。不要犯禁忌伤害身体,指不要使实证更实,不要使虚证更虚。顺应规律的能恢复,违背规律的必然败亡,务必告诫人们天时人事都应当谨慎,不可疏忽。)
*Lingshu: Hai Lun* (Complete Text)
Huangdi asked Qibo, saying: I have heard that when you explain acupuncture methods, your discourse never departs from Ying Qi (Nutritive Qi), Wei Qi (Defensive Qi), and Blood. The twelve meridians connect internally to the Zang-Fu organs and externally to the limbs and joints. Why do you correlate them with the "Four Seas"?
Qibo replied: Humans also possess Four Seas and twelve meridian waters. These meridian waters all flow into the seas. The seas are divided into East, West, South, and North, hence called the Four Seas.
Huangdi asked: How can human physiology correspond to this?
Qibo said: In humans, there is the Sea of Marrow, the Sea of Blood, the Sea of Qi, and the Sea of Water and Grain. These four seas correspond to the four seas [of nature]. ([The meaning of the twelve meridian waters is explained later. The Four Seas are the ancestors of all rivers. Since humans also have four seas, they are the Sea of Marrow, Sea of Blood, Sea of Qi, and Sea of Water and Grain. Details follow below.])
Huangdi said: The way you correlate humans with the Four Seas of Heaven and Earth is profound. I wish to hear how this correspondence works.
Qibo replied: One must first clearly understand Yin-Yang, Interior-Exterior, and the locations of Ying and Shu points; then the Four Seas will be established. (Here, Yin-Yang refers to the Yin-Yang of the meridians. Interior-Exterior refers to the inside and outside of the Zang-Fu organs. The meaning of Ying and Shu points is detailed in Volume 14 previously. Understanding these aspects clarifies the principles of meridians and establishes the Four Seas. In this classic, "Shu" (輸), "Shu" (腧), and "Shu" (俞) are used interchangeably.)
Huangdi asked: How are they established?
Qibo said: The Stomach is the Sea of Water and Grain. Its Shu points are located above at Qichong (Stomach 30) and below at Zusanli (Stomach 36). (Humans derive Qi from water and grain. After entering the mouth, food is stored in the Stomach to nourish the Qi of the five Zang organs. Thus, the essences and qi of all zang-fu organs originate from the Stomach, making it the Sea of Water and Grain. The points where stomach qi circulates and transmits are above at Qichong, also known as Chongxi (Stomach 30); and below at Zusanli, three cun below the knee.)
The Chong Mai (Penetrating Vessel) is the Sea of the Twelve Meridians (also known as the Sea of Blood). Its Shu points are located above at Dazhu (Bladder 11) and below emerging from Shanglian and Xialian of Juxu (Stomach 34 and 37 respectively). (This is the Sea of Blood. The Chong Mai originates in the uterus/baozhong. Its anterior branch runs alongside the Foot Shaoyin Kidney Meridian, flanking the umbilicus upward to the chest where it disperses; its posterior branch ascends along the interior of the spine, becoming the sea of the meridians; its ascending branch emerges at Kangsang; its descending branch emerges at the foot. Therefore, its upper Shu point is at Dazhu of the Foot-Taiyang Bladder Meridian, and its lower Shu points are at Shanglian and Xialian of Juxu of the Foot-Yangming Stomach Meridian. Note: *Dongshu Pian* states: The Stomach is the sea of the five zang and six fu organs. *Taiyin Yangming Lun* states: The Yangming meridian belongs to the exterior and is the sea of the five zang and six fu organs. *Nishun Feishou Pian* states: The Chong Mai is the sea of the five zang and six fu organs, which all receive from it. This chapter states the Chong Mai is the sea of the twelve meridians. Given these discussions, both the Stomach and Chong Mai are described as the sea of the twelve meridians and the sea of the five zang and six fu organs. How should they be distinguished? Hence, this chapter distinguishes between the Sea of Water and Grain and the Sea of Blood. The Sea of Water and Grain implies that water and grain are stored here, and Ying and Wei Qi are generated from it. The Sea of Blood implies receiving infusions from various meridians, where essence and blood are stored. This distinction is clear. However, examining *Fei Lun*: The Yangming meridian is the sea of the five zang and six fu organs, primarily moistening the Zongjin (tendons), which bind bones and facilitate joint movement. The Chong Mai is the sea of the meridians, primarily seeping and irrigating the xigu (valleys/muscle spaces), merging with Yangming at the Zongjin. Yin and Yang converge at the Zongjin, meeting at Qichong, with Yangming as their leader. Because Yangming is a reservoir of abundant blood and qi, it moistens Zongjin and facilitates joints. The Chong Mai is the vessel where essence and blood gather, thus irrigating xigu. Moreover, the Chong Mai originates in the baozhong and descends with the great collateral of Shaoyin. Yangming, as the leader of the meridians, also converges at the anterior yin. Thus, essence and blood in both men and women descend via the anterior yin because the blood and qi of these two vessels gather there. Hence, both are called the sea of the five zang, six fu, and twelve meridians, truly incomparable to other vessels. For further details on the Chong Mai, see Volume 27 previously, for cross-reference.)
The Danzhong (Chest Center) is the Sea of Qi. Its Shu points are located above at the upper and lower parts of the Zhugu (neck vertebrae) and anteriorly at Renying (Stomach 9). (Danzhong refers to the chest, the residence of the Lung. All Qi belongs to the Lung; this is True Qi, also called Zong Qi (Gathering Qi). Zong Qi accumulates in the chest, emerges from the throat, penetrates the heart vessels, and governs respiration; thus, Danzhong is the Sea of Qi. Zhugu refers to the cervical vertebrae at the back of the neck. *Youhui Wu Yan Pian* states: Kangsang is the exit for distributing Qi. Therefore, the Shu points for the circulation of the Qi Sea are one behind Kangsang, at the upper and lower parts of Zhugu, referring to Yimen (Du 18) and Dazhu (Du 14) of the Du Mai; and one in front of Kangsang, referring to Renying of the Foot-Yangming Stomach Meridian.)
The Brain is the Sea of Marrow. Its Shu points are located above at the crown (Gaizi) and below at Fengfu (Du 16). (Among all bones containing marrow, the brain is the largest. Thus, all marrow belongs to the brain, making it the Sea of Marrow. Gaizi refers to the cranial vault bone, specifically Xinhui (Du 22) of the Du Mai. Fengfu is also an acupoint of the Du Mai. These are the superior, inferior, anterior, and posterior Shu points of the Sea of Marrow.)
Huangdi asked: Regarding these four seas, what is beneficial and what is harmful? What leads to life and what to decline?
Qibo replied: Adherence to harmony leads to life; deviation leads to decline. Those who know how to regulate thrive; those who do not suffer harm. (These four seas all have patterns of compliance and deviation. Compliance means knowing how to nourish oneself, leading to life. Deviation means failing to nourish properly, leading to decline.)
Huangdi asked: What are the manifestations of compliance and deviation in the Four Seas?
Qibo said: Excess in the Sea of Qi results in fullness in the chest, panting, and a red face. Deficiency in the Sea of Qi results in shortness of breath and inability to speak. (Excess of Qi indicates pathogenic excess. Deficiency of Qi indicates healthy Qi deficiency. The following follows this logic. The Sea of Qi is in the chest and belongs to Yang. Thus, Qi excess causes chest oppression, panting, and facial heat/redness. Voice emanates from Qi; Qi deficiency leads to faint speech or inability to vocalize. *Maiyao Jingwei Lun* states: Speaking faintly, only speaking after a whole day, indicates loss of Qi. [Pronunciation: mu ben qie, also pronounced man.])
Excess in the Sea of Blood results in a constant sensation of one's body being large, feeling oppressed and uncomfortable without knowing the specific pathology. Deficiency in the Sea of Blood results in a constant sensation of one's body being small, feeling constricted without knowing the specific pathology. (Form is filled by blood; thus, blood excess creates a sensation of largeness. Fu refers to depression/stagnation, describing a heavy and uncomfortable state. Blood deficiency creates a sensation of smallness. Xia refers to narrowness/constriction, describing a desolate and limited state. These are all diseases caused by disharmony of the Sea of Blood. Pathologies in blood tend to develop slowly and subtly, so one feels茫然 (at a loss/oblivious) regarding the illness. Fu is pronounced fo.)
Excess in the Sea of Water and Grain results in abdominal fullness. Deficiency in the Sea of Water and Grain results in hunger but an inability to accept food. (Excess means water and grain stagnate in the middle jiao, causing abdominal distension. Deficiency means Spleen deficiency fails to transport and Stomach deficiency fails to receive, so despite hunger, one cannot eat.)
Excess in the Sea of Marrow results in lightness, agility, excessive strength, exceeding normal limits. Deficiency in the Sea of Marrow results in dizziness, tinnitus, soreness and weakness of the shins, vertigo, blindness, lethargy, and a desire to lie down. (Sufficient Marrow Sea constitutes excess, resulting in a light and agile body, ease of movement, and excessive strength, surpassing ordinary capacity without disease. If deficient, the upper manifestation is dizziness/rotation due to emptiness in the brain causing a spinning sensation. Tinnitus occurs because marrow deficiency leads to essence decline; yin deficiency causes tinnitus. Shin soreness occurs due to empty marrow lacking strength. Vertigo and sudden loss of consciousness occur. Blindness occurs. Lethargy and desire to lie down occur. All these arise because Marrow belongs to Essence; essence decline leads to Qi departure, manifesting these symptoms.)
Huangdi said: I have heard of the compliance and deviation. How should they be regulated?
Qibo replied: Carefully examine and secure the Shu points to regulate deficiency and excess. Do not commit errors that cause harm. Compliance leads to recovery; deviation leads to failure.
Huangdi said: Excellent. (Carefully examining the Shu points refers to inspecting the Shu points mentioned above. Not committing errors means not reinforcing excess or depleting deficiency. Compliance leads to recovery, deviation leads to failure. One must strictly caution that both heavenly timing and human affairs require careful attention and cannot be neglected.)