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肝重四斤四两,左三叶,右四叶,共七叶,附着于脊之第九椎下。《素问·刺禁论》云∶肝居下左。后世以为其藏
在右,其脉在左者非。肝者,将军之官,谋虑出焉。
《本藏》篇曰∶肝小则藏安,无胁下之病;肝大则逼胃迫咽,迫咽则苦膈中,且膈下痛。肝高则上支贲,切胁 ,
为息贲;肝下则逼胃,胁下空,胁下空则易受邪。肝坚则藏安难伤;肝脆则善病消瘅易伤。肝端正则和利难伤;肝偏倾
则胁下痛也。青色小理者肝小,粗理者肝大。广胸反 者肝高,合胁兔 者肝下。胸胁好者肝坚,胁骨弱者肝脆。膺腹
好相得者肝端正,胁骨偏举者肝偏倾也。
足厥阴一十三穴终,起大敦于行间循大冲,于中封蠡沟中都之会,膝关曲泉之宫,袭阴包于五里,阴廉乃发寻羊矢,
于章门期门可攻。
足大趾端名大敦(内侧为隐白,外侧为大敦),行间大指缝中存,太冲本节后二寸,踝前一寸号中封(足内踝骨前
一寸,筋里宛宛中),蠡沟踝上五寸是(内踝骨前上五寸)中都踝上七寸中(内踝上七寸前骨中),膝关犊鼻下二寸,
曲泉曲膝尽横纹。阴包膝上方四寸(股内廉两筋间,蜷足取之,看膝内侧必有槽中),气冲三寸下五里(气冲下三寸,
阴股中动脉应手),阴廉冲下有二寸,羊矢冲下一寸许,气冲却是胃经穴,鼠鼷之上一寸主,鼠鼷横骨端尽处,相去中
行四寸止,章门下脘旁九寸,肘尖尽处侧卧取,期门又在巨阙旁,四寸五分无差矣(巨阙,任脉穴,脐上六寸五分,计
十三穴,左右共二十六穴)。
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足厥阴肝经图
肝脏重量为四斤四两,左侧有三叶,右侧有四叶,共有七叶,附着于脊柱第九椎骨下方。《素问·刺禁论》中说:“肝脏位于左下。”后世认为其脏器在右、经脉在左的说法是错误的。肝被称为“将军之官”,谋虑功能由此产生。
《灵枢·本藏》篇说:肝脏较小则脏气安宁,不会出现胁下的疾病;肝脏较大则会压迫胃部和咽喉,压迫咽喉会导致胸膈中不适,且膈下疼痛。肝脏位置偏高则向上支撑贲门,切压胁部,导致气息奔迫(息贲);肝脏位置偏低则压迫胃部,使胁下空虚,胁下空虚则容易受邪气侵袭。肝脏质地坚实则脏气安宁,难以受伤;肝脏质地脆弱则容易患消瘅病(类似糖尿病或消耗性疾病),且易受损伤。肝脏位置端正则功能调和,难以受伤;肝脏位置偏斜则胁下会疼痛。面色青而纹理细腻者,肝脏较小;纹理粗糙者,肝脏较大。胸部宽阔且肋骨外翻者,肝脏位置偏高;肋骨合拢且肋骨下端如兔形突出者,肝脏位置偏低。胸胁形态良好者,肝脏坚实;胁骨软弱者,肝脏脆弱。胸廓与腹部比例协调者,肝脏位置端正;胁骨一侧偏举者,肝脏位置偏斜。
足厥阴肝经共有十三个穴位,起始于大敦穴,沿行间穴循行到大冲穴,经过中封、蠡沟、中都的交会处,到达膝关和曲宫(曲泉),再经过阴包和五里,从阴廉发出寻找羊矢穴,最后在章门和期门穴进行诊治。
足大趾末端名为大敦(内侧为隐白穴,外侧为大敦穴),行间穴存在于大脚趾缝中,太冲穴在本节(第一跖骨基底部)后方二寸处,踝前一寸处称为中封(足内踝骨前一寸,筋脉凹陷宛曲之中),蠡沟穴在内踝上五寸处(内踝骨前上方五寸),中都穴在内踝上七寸中间(内踝上七寸前方骨中),膝关穴在犊鼻穴下方二寸,曲泉穴在屈膝时膝关节横纹尽头处。阴包穴在膝盖上方四寸处(大腿内侧两条筋之间,蜷缩足部取穴,看膝内侧必有槽中),气冲穴下方三寸处有五里穴(气冲穴下三寸,大腿内侧动脉应手跳动处),阴廉穴在冲阳穴下方二寸,羊矢穴在冲阳穴下方一寸左右,气冲穴却是胃经的穴位,位于鼠鼷(腹股沟)上一寸为主治部位,鼠鼷穴位于横骨端尽头处,距离中行线四寸止,章门穴在下脘穴旁开九寸,肘尖尽处侧卧取穴,期门穴又在巨阙穴旁开四寸五分没有差错(巨阙穴是任脉穴位,脐上六寸五分,共计十三穴,左右共二十六穴)。
足厥阴肝经之图
Diagram of the Foot-Jueyin Liver Meridian
The liver weighs four jin and four liang. It has three lobes on the left and four lobes on the right, totaling seven lobes, and is attached below the ninth thoracic vertebra of the spine. The *Suwen: Cijian Lun* (Treatise on Acupuncture Taboos in the Classic of Difficult Issues) states: "The liver resides in the lower left." The later view that its organ is on the right and its meridian is on the left is incorrect. The liver is regarded as the "General's Office," from which strategy and deliberation arise.
The *Ben Cang* chapter states: If the liver is small, the viscera are peaceful, and there are no diseases in the hypochondrium; if the liver is large, it presses against the stomach and pharynx, causing obstruction in the epigastrium and pain below the diaphragm. If the liver is high, it extends upward to support the贲门 (cardia), pressing upon the hypochondrium, leading to panting and rushing breath (Xiben); if the liver is low, it presses against the stomach, leaving the hypochondrium empty, and an empty hypochondrium makes one susceptible to pathogenic factors. If the liver is firm, the viscera are peaceful and difficult to injure; if the liver is brittle, it is prone to Xiao Dan disease (a wasting disorder similar to diabetes or consumption) and easily injured. If the liver is upright, its functions are harmonious and difficult to injure; if the liver is tilted, there will be pain in the hypochondrium. A bluish complexion with fine skin texture indicates a small liver; a coarse texture indicates a large liver. A broad chest with outward-flaring ribs indicates a high liver; ribs that converge with a protruding lower rib margin resembling a rabbit indicate a low liver. A well-proportioned chest and hypochondrium indicate a firm liver; weak hypochondrial bones indicate a brittle liver. A harmonious relationship between the chest and abdomen indicates an upright liver; unilateral elevation of the hypochondrial bones indicates a tilted liver.
The Foot-Jueyin Liver Meridian concludes with thirteen acupoints. Starting at Dadun (LR1), it follows Xingjian (LR2) to Taichong (LR3), passes through the intersection of Zhongfeng (LR4), Ligou (LR5), and Zhongdu (LR6), reaches Xiguan (LR7) and Ququan (LR8), then traverses Yinbao (LR9) and Wuli (LR10), emerges from Yinlian (LR11) to locate the Sheep Gland point (Yangshi), and finally treats via Zhangmen (LR13) and Qimen (LR14).
Dadun (LR1) is named at the tip of the big toe (Yinbai is on the medial side, Dadun is on the lateral side). Xingjian (LR2) is stored in the gap between the big toes. Taichong (LR3) is two cun posterior to the metatarsophalangeal joint. Zhongfeng (LR4) is called so because it is one cun anterior to the malleolus (one cun anterior to the medial malleolus, in the depression among the tendons). Ligou (LR5) is five cun above the malleolus (five cun anterior-superior to the medial malleolus). Zhongdu (LR6) is in the middle seven cun above the malleolus (seven cun anterior to the medial malleolus). Xiguan (LR7) is two cun below Dubi (ST35). Ququan (LR8) is at the end of the transverse crease when the knee is flexed. Yinbao (LR9) is four cun above the knee (between the two tendons on the medial aspect of the thigh; take the point with the foot flexed; there must be a groove on the medial side of the knee). Wuli (LR10) is five cun below Qichong (ST30) (three cun below Qichong, where the arterial pulse can be felt in the medial thigh). Yinlian (LR11) is two cun below Chongyang (note: text implies location relative to previous points, typically 2 cun above Guanyuan CR4 on Ren Mai, but here described locally). The Sheep Gland point (Yangshi, extra point) is approximately one cun below Chongyang. Note: Qichong (ST30) is actually a Stomach Meridian point. It governs the area one cun above Shuxi (inguinal region). Shuxi is at the end of the horizontal bone (pubic bone). The distance from the midline is four cun. Zhangmen (LR13) is nine cun lateral to Xiawan (CV10); take the point lying on the side at the end of the elbow tip. Qimen (LR14) is again four cun and five fen lateral to Juque (CV14). Juque is a Ren Meridian point, six cun and five fen above the umbilicus. In total, there are thirteen acupoints per side, making twenty-six acupoints for both sides.
Diagram of the Foot-Jueyin Liver Meridian