阳主四肢。经曰∶四肢者,诸阳之本也。又曰∶结阳者肿四肢。又曰∶四肢禀气于胃,而不得至经,必因于脾,乃
得禀也。脾虚则四肢不用。又曰,四肢懈惰,此脾精之不行也。
肝主筋,而各经俱有,大抵随其脉之所在而连属也。详具《灵枢·经筋》篇。
肾主骨,在体为骨,在赃为肾。又曰∶肾之合,骨也;其荣,发也。又曰∶少阴者冬脉也,伏行而温于骨髓。骨病
忌食苦甘,久立。经曰∶多食甘,则骨痛而发落。又曰∶苦走骨。骨病无多食苦。又曰∶久立伤骨,骨病不屈。
经曰∶手屈而不能伸者,病在筋;伸而不能屈者,病在骨。
脾主肉。经曰∶脾主肉,在体为肉,在脏为脾。又曰∶邪在脾胃,则肌肉痛是也。肉之小为会为溪(谓肉少处
也),肉之大会为谷(即多肉处也),分肉之间、溪谷之会,以行荣卫,以会大气。湿伤肉,甘伤肉。又曰∶甘走肉。肉
病无多食甘。久坐伤肉。
皮肤属肺。经曰∶肺之合皮也,其荣毛也。毛折爪枯,为肺绝。经曰∶太阴者,行气温于皮毛者也。气不荣则毛
焦,皮毛焦则津液去,津液既去,则爪枯毛折,皮肤痛,属心实。经曰∶夏脉太过则病身热肤痛(心火克肺也),皮肤
索泽(素∶尽也,精血枯涸,故皮肤润泽之气皆尽也,即仲景皮肤甲错 乃干涩而不滑泽之谓)。
阳气主管四肢。《内经》说:四肢,是诸阳经的根本所在。又说:阳气郁结于阳经,会导致四肢肿胀。又说:四肢的气血禀受于胃,但胃气不能直接到达四肢经脉,必须依赖脾的转输作用,才能将精气输送到四肢。脾气虚弱,则四肢无力使用。又说:四肢倦怠懈怠,这是因为脾的精微物质不能正常布散运行所致。
肝主管筋脉,而各条经脉中都含有筋,大体上随着经脉的循行部位而连接归属。详细内容参见《灵枢·经筋》篇。
肾主管骨骼,在形体表现为骨,在脏腑对应为肾。又说:肾的外合组织是骨;其荣华表现于头发。又说:少阴经(肾经)是冬季的主令之脉,潜行体内以温煦骨髓。患有骨病的人应当忌食苦味和甘味的食物,避免久站。《内经》说:多吃甘味食物,会导致骨痛且头发脱落。又说:苦味入走骨。骨病患者不要多吃苦味食物。又说:久站会损伤骨骼,导致骨病发作时关节僵硬不能弯曲。《内经》说:手能屈而不能伸的,病在筋;能伸而不能屈的,病在骨。
脾主管肌肉。《内经》说:脾主肌肉,在形体表现为肉,在脏腑对应为脾。又说:邪气侵犯脾胃,就会出现肌肉疼痛的症状。肌肉稀疏汇聚的地方称为“溪”(指肌肉较少的地方),肌肉丰厚汇聚的地方称为“谷”(即多肉之处),分肉之间、溪谷交会之处,用来运行营卫之气,汇聚宗气。湿邪伤害肌肉,甘味过度也伤害肌肉。又说:甘味入走肉。患肉病者不要多吃甘味食物。久坐会损伤肌肉。
皮肤归属于肺。《内经》说:肺的外合组织是皮肤,其荣华表现于毫毛。毫毛折断、指甲枯槁,是肺气绝的表现。《内经》说:太阴经(肺经)的功能是将气输送并温养于皮毛。如果气不能荣养皮毛,就会导致毛发焦枯;皮毛焦枯则津液流失;津液既然流失,就会导致指甲枯槁、毫毛折断、皮肤疼痛,这属于心火实证(心火亢盛克制肺金)。《内经》说:夏季脉象太过,则会引发身体发热、皮肤疼痛(这是心火克制肺金的表现);皮肤干枯无光泽(“素”意为尽,指精血枯竭,所以皮肤润泽之气全部耗尽,也就是张仲景所说的“皮肤甲错”,即干涩而不滑润的意思)。
Yang Qi governs the four limbs. The Classics state: "The four limbs are the root of all Yang meridians." It is also stated: "When Yang Qi is knotted, swelling of the four limbs occurs." Furthermore: "The four limbs receive their Qi from the Stomach, but this Qi cannot reach the meridians directly; it must rely on the Spleen to be transmitted and thus nourish the limbs." When the Spleen is deficient, the four limbs become weak and unusable. It is also said: "Laziness and flaccidity of the four limbs indicate that the essence of the Spleen is not circulating properly."
The Liver governs the sinews (tendons), which are present in all meridians, generally connecting and belonging according to the course of the meridians. For details, refer to the chapter *Jing Jin* (Sinew Meridians) in the *Ling Shu*.
The Kidney governs the bones. In the body, it manifests as bones; in the zang organs, it corresponds to the Kidney. It is stated: "The external correspondence of the Kidney is the bone; its flourishing aspect is the hair." It is also said: "The Shaoyin meridian (Kidney meridian) is the pulse of winter, running deep within to warm the bone marrow." Patients with bone diseases should avoid bitter and sweet flavors and prolonged standing. The Classics say: "Excessive consumption of sweet flavor leads to bone pain and hair loss." It is also said: "Bitter flavor travels to the bone." Bone disease patients should not consume excessive bitter foods. It is also said: "Prolonged standing damages the bones, causing bone diseases to manifest with stiffness and inability to bend." The Classics state: "If the hand can flex but not extend, the pathology is in the sinews; if it can extend but not flex, the pathology is in the bones."
The Spleen governs the muscles. The Classics say: "The Spleen governs the muscles; in the body, it manifests as flesh; in the zang organs, it corresponds to the Spleen." It is also said: "When pathogenic factors affect the Spleen and Stomach, muscle pain occurs." Areas where muscle fibers converge sparsely are called "streams" (xi), referring to areas with less muscle mass; areas where muscle masses converge abundantly are called "valleys" (gu), referring to fleshy areas. Between the separated muscles and at the convergence of streams and valleys, Ying and Wei Qi circulate, and Zong Qi (Gathering Qi) gathers. Dampness injures the muscles, and excessive sweet flavor also injures the muscles. It is said: "Sweet flavor travels to the muscles." Those with muscle diseases should not eat excessive sweet foods. Prolonged sitting injures the muscles.
The skin belongs to the Lung. The Classics say: "The external correspondence of the Lung is the skin; its flourishing aspect is the body hair." If body hair breaks and nails wither, it indicates the exhaustion of Lung Qi. The Classics say: "The Taiyin meridian (Lung meridian) distributes Qi to warm the skin and hair." If Qi fails to nourish, the hair becomes scorched; if the skin and hair become scorched, body fluids are lost; once body fluids are lost, nails wither and hair breaks, leading to skin pain, which belongs to Heart Excess (Fire insulting Metal). The Classics say: "An excessive Summer pulse causes fever and skin pain (due to Heart Fire controlling Lung Metal); the skin becomes dry and lusterless ('su' means exhausted, indicating that due to the depletion of essence and blood, the moistening qi of the skin is entirely exhausted, i.e., what Zhang Zhongjing described as 'cracked skin,' meaning rough, dry, and unsmooth)."