绣按∶奇经八脉,前人论之详矣。考诸时珍有言,八脉阳维起于诸阳之会,由外踝而上行于卫分;阴维起
于诸阴之交,由内踝而上行于营分;所以为一身之纲维也。阳 起于跟中,由外踝上行于身之左右∶阴
起于跟中,循内踝上行于身之左右;所以使机关之 捷也。督脉起于会阴,循背而行于身之后,为阳脉之总
督,故曰阳脉之海;任脉起于会阴,循腹而行于身之前,为阴脉之承任,故曰阴脉之海。冲脉起于会阴,
夹脐而行,直冲于上,为诸脉之冲要,故曰十二经之海。带脉则横围于腰,状如束带,所以总约诸脉者也。是
故阳维主一身之表,阴维主一身之里,以乾坤言也,阳 主一身左右之阳,阴 主一身左右之阴,以东
西言也。督主身后之阳,任冲主身前之阴,以南北言也。带脉横束诸脉,以六合言也。又考张洁古有云∶ 者,
捷疾也。二脉起于足,使人 捷也。阳 在肌肉之上,阳脉所行,通贯六腑,主持诸表,故名为阳 之络。阴
在肌肉之下,阴脉所行,贯通五脏,主持诸里,故名为阴 之络。观诸所论八脉,虽在十二经络之外,因别
其名为奇,然亦可为正经正络之辅。盖正经犹于地道之沟渠,奇经犹于沟渠外之湖泽。正经之沟渠不涸,则奇
经之湖泽不致甚竭;正经之沟水既满,则奇经之湖泽必溉。所以昔人有云∶脏气安和,经脉调畅,八脉之形无
从而见,即经络受
邪不致满溢,与奇经无预。若经络之邪热既满,势必溢于奇经。如天雨降下,沟渠满溢,滂霈妄行,流于湖泽
之意,正自相符。且诸经皆为脏腑所配,此则自为起止,不与正经之例相同,故奇经又为十二经之约束。
是以伤寒之邪,有从阳维而始传次三阳,有从阴维而始传次三阴。并脏气内结,邪气外溢,竟从奇经先受。然
此由邪入内,而不于奇是留,非若十二经热满之必见有溢奇之日也。时珍云∶医而知乎八脉,则十二经十
五络之大旨得;仙而知乎八脉;则龙虎升降玄牝幽微之窍妙得。又曰∶医不知此,罔探病机;仙不知此,难安
炉鼎。旨哉斯言,录此以为医之一助。
任脉起于中极底(脐下四寸,穴名中极。任脉起于其下二阴之交会阴之穴。任由会阴而行腹,督由会阴而
行背),以上毛际循腹里(行中极穴),上于关元(脐下三寸穴名)至咽喉,上颐循面入目是(络于承泣)。
冲(脉)起气街并少阴(肾脉),挟脐上行胸中至(任脉当脐中而上,冲脉挟脐旁而上。以上并出素问骨
空论)。冲为五脏六腑海(冲为血海),五脏六腑所禀气。上渗诸阳(经)灌诸精(上出颃颡),从下冲上取
兹义(故名冲)。亦有并肾下行者,注少阴络气街出。阴股内廉入 中(膝后曲处),伏行 骨内踝际。下渗
三阴(肝脾肾)灌诸络,以温肌肉至跗指(循足面下涌泉入足大指。此段出灵枢逆顺肥瘦篇)。督(脉)起少
腹骨中央,入系廷孔(女人阴廷溺孔之端,即窈漏穴)络阴器。合篡(二阴之交名篡)至后别绕臀,与臣阳络
(太阳中络)少阴比(与膀胱、肾二脉相合)。上股(内后廉)贯脊属肾行,上同太阳起(目)内 。上额交
巅络脑间,下项循肩(膊内)仍挟脊。抵腰络肾(此督脉并太阳
而行者)循男茎(男子阴茎),下篡亦与女子类。又从少腹贯脐中(央),贯心入喉颐及唇(环唇)。上系目
下中央际,此为并任(此督脉并任脉而行者)亦同冲(脉)。大抵三脉同一本(冲任督三脉皆起于会阴之下,
一原而三岐,异名而同体),灵素言之每错综(灵枢五音五味篇∶冲脉、任脉,皆起于胸中,上循背
里。是又言冲任行背。故经亦有谓冲脉为督脉者。古图经有以任脉循背者谓之督。自少腹直上者谓之任,亦谓
之督。今人大率以行身背者为督,行身前者为任,从中起者为冲。然考任督二经所行穴道,一在身
前,一在身后;而冲脉居中,则无穴道。似当以此说为正)。督病少腹(上)冲心痛,不得前后(二便不通)
冲疝攻(此督脉为病同于冲脉者)。其在女子为不孕(冲为血海,任主胞络),嗌干(脉循咽喉)遗尿及痔癃
(络阴器,合篡间。此督脉为病同于冲任者)。任病男疝(内结七疝)女瘕带(带下瘕聚即妇人之疝),冲病
里急气逆冲(血不足故急,气有余故逆。此段出素问骨空论。督者,督领诸经之脉也。冲者,其气上冲也。任
者,女子得之以任养也)。 (阴 脉)乃少阴(肾)之别脉,起然骨后(足内踝大骨之下,照海穴)
至内踝。直上阴股入阴间,上循胸入缺盆过。出人迎前(胃经,颈旁动脉)入 (颧) (目内 ,睛明穴),
合于太阳阳 和(阳 脉始于膀胱经之申脉穴,足外踝下陷中。此段出灵枢脉度篇),此皆灵素说奇经,带及
二维未说破。
汪昂按语:奇经八脉,前人论述已很详尽。考证李时珍曾说,阳维脉起于诸阳经交会之处(风府、哑门),沿外踝向上行于卫分;阴维脉起于诸阴经交会之处(筑宾),沿内踝向上行于营分;所以成为一身经脉的纲维。阳跷脉起于足跟中部,沿外踝上行于身体左右两侧;阴跷脉起于足跟中部,沿内踝上行于身体左右两侧;所以使关节动作矫捷。督脉起于会阴穴,沿背部上行于身体后方,为阳脉的总领,所以称为“阳脉之海”;任脉起于会阴穴,沿腹部上行于身体前方,为阴脉的承担,所以称为“阴脉之海”。冲脉起于会阴穴,夹脐上行,直冲于上,为各脉的冲要,所以称为“十二经之海”。带脉则横向环绕腰部,形状像束带,所以总束约束各条经脉。因此,阳维脉主一身之表,阴维脉主一身之里,这是从乾坤方位而言;阳跷脉主一身左右之阳,阴跷脉主一身左右之阴,这是从东西方位而言;督脉主身后之阳,任脉和冲脉主身前之阴,这是从南北方位而言;带脉横向束缚诸脉,这是从六合方位而言。又考证张洁古曾说:“跷”字,意为捷疾。这两条脉起于足部,使人行动敏捷。阳跷脉在肌肉之上,是阳脉所行的路径,通贯六腑,主持诸表,所以称为阳跷之络。阴跷脉在肌肉之下,是阴脉所行的路径,贯通五脏,主持诸里,所以称为阴跷之络。观察上述关于八脉的论述,虽然它们在十二正经之外,因另立名称而称为“奇”,但也可以作为正经正络的辅助。大概正经如同大地上的沟渠,奇经如同沟渠之外的湖泽。如果正经的沟渠不干涸,那么奇经的湖泽就不会极度枯竭;如果正经的沟渠水已满溢,那么奇经的湖泽必然得到灌溉。所以古人说:脏腑之气安和,经脉调畅,八脉的异常形态无从显现,即使经络受邪也不会满溢,与奇经无关。如果经络中的邪热已经满溢,势必会溢出到奇经。这就像天降雨水,沟渠满溢,大雨滂沱妄行,流入湖泽的意思,正是相符的。而且各条经脉都配属于脏腑,而奇经则是自为起止,不与正经的体例相同,所以奇经又是十二经的约束。因此伤寒之邪,有的从阳维脉开始依次传入三阳经,有的从阴维脉开始依次传入三阴经。还有脏气内部结聚,邪气外部溢出,竟然直接从奇经先受邪。然而这是由于邪气入内,而不留滞于奇经,不像十二经热满必定有溢入奇经的时候。李时珍说:医生如果懂得八脉,就能掌握十二经十五络的大旨;修道之人如果懂得八脉,就能领悟龙虎升降、玄牝幽微的窍妙。又说:医生不懂此理,无法探求病机;修道之人不懂此理,难以安顿炉鼎。这话真是有深意啊,记录下来作为医生的帮助。
任脉起于中极穴底部(脐下四寸,穴位名为中极。任脉起于此穴下方两阴之间的会阴穴。任脉由会阴而行于腹部,督脉由会阴而行于背部),以上毛际循行于腹里(经过中极穴),上行至关元穴(脐下三寸,穴位名)直至咽喉,上行至颐部,循面进入目内眦(联络于承泣穴)。
冲脉起于气街,并合少阴肾脉,挟脐上行至胸中(任脉当脐中而上,冲脉挟脐旁而上。以上内容均出自《素问·骨空论》)。冲脉为五脏六腑之海(冲为血海),五脏六腑禀受其气。向上渗灌诸阳经,灌注诸精(上出颃颡),从下冲上取此义(所以名为冲)。也有并肾下行者,注入少阴络脉,出于气街,沿大腿内侧下行入腘中(膝后弯曲处),伏行于胫骨内踝际。向下渗灌三阴经(肝脾肾),灌注诸络,以温养肌肉直至足跗趾(循足面下至涌泉,进入足大指。这段内容出自《灵枢·逆顺肥瘦篇》)。
督脉起于少腹骨中央,入系廷孔(女子阴蒂及溺孔之端,即窈漏穴),联络阴器。合于篡间(二阴之交名为篡),至后别绕臀部,与臣阳络(太阳经中络)及少阴脉相比邻(与膀胱、肾二脉相合)。上行股内侧后廉,贯穿脊柱,归属于肾,上行同太阳经起于目内眦。上行额部,交于巅顶,联络脑部,下行项部,循肩膊内侧,仍挟脊而行。抵腰,联络肾脏(此段督脉并行太阳经而行者),循男子阴茎,下至篡间,也与女子类似。又从少腹贯脐中,贯心,入喉,至颐及唇(环唇)。上行系目下中央际,此为并行任脉(此段督脉并行任脉而行者),也同于冲脉。大体上这三脉同一本源(冲、任、督三脉皆起于会阴之下,一源而三歧,异名而同体),《灵枢》《素问》中言之每有错综(《灵枢·五音五味篇》说:冲脉、任脉,皆起于胸中,上循背里。这是又说冲任行于背部。所以经文中也有称冲脉为督脉的。古代图经有以任脉循背者称为督,自少腹直上者称为任,也称为督。现在人大致以行身背者为督,行身前者为任,从中起者为冲。然而考证任督二经所行穴位,一个在身之前,一个在身之后;而冲脉居中,却没有穴位。似乎应当以这种说法为正解)。督脉病变表现为少腹(上)冲心痛,大小便不通(不得前后),冲疝攻痛(此段督脉为病同于冲脉者)。在女子表现为不孕(冲为血海,任主胞络),咽干(脉循咽喉),遗尿及痔癃(络阴器,合篡间。此段督脉为病同于冲任者)。任脉病变,男子为疝气(内结七疝),女子为瘕聚带下(带下瘕聚即妇人之疝)。冲脉病变为里急气逆冲(血不足故急,气有余故逆。这段内容出自《素问·骨空论》。督者,督领诸经之脉也。冲者,其气上冲也。任者,女子得之以任养也)。
阴跷脉乃少阴肾之别脉,起于然骨后(足内踝大骨之下,照海穴)至内踝。直上阴股入阴间,上行循胸入缺盆,过出人迎前(胃经,颈旁动脉),入颧部,至目内眦(睛明穴),合于太阳经及阳跷脉(阳跷脉始于膀胱经之申脉穴,足外踝下陷中。这段内容出自《灵枢·脉度篇》)。这些都是《灵枢》《素问》对奇经的论述,带脉及二维脉未在此详细解说。
Wang Ang's Commentary: The Eight Extraordinary Vessels have been discussed in detail by predecessors. According to Li Shizhen, the Yang Linking Vessel (Yangwei Mai) originates at the intersection of all Yang vessels, ascends from the lateral malleolus into the Wei (Defensive) level; the Yin Linking Vessel (Yinwei Mai) originates at the intersection of all Yin vessels, ascends from the medial malleolus into the Ying (Nutritive) level; thus serving as the framework for the body's vessels. The Yang Heel Vessel (Yangqiao Mai) originates in the middle of the heel, ascending along the lateral malleolus on both sides of the body; the Yin Heel Vessel (Yinqiao Mai) originates in the middle of the heel, ascending along the medial malleolus on both sides of the body; thus enabling agility of the joints. The Du Meridian (Du Mai) originates at Huiyin (CV1), runs along the back posteriorly, acting as the chief director of all Yang vessels, hence called the "Sea of Yang Vessels"; the Ren Meridian (Ren Mai) originates at Huiyin (CV1), runs along the abdomen anteriorly, acting as the supporter of all Yin vessels, hence called the "Sea of Yin Vessels". The Chong Meridian (Chong Mai) originates at Huiyin (CV1), flanking the umbilicus and rushing upward, serving as the crucial passage for all vessels, hence called the "Sea of the Twelve Regular Vessels". The Dai Meridian (Dai Mai) encircles the waist horizontally, resembling a belt, thereby binding and regulating all other vessels. Therefore, the Yang Linking Vessel governs the exterior of the body, and the Yin Linking Vessel governs the interior, speaking in terms of Qian and Kun; the Yang Heel Vessel governs the left and right Yang aspects of the body, and the Yin Heel Vessel governs the left and right Yin aspects, speaking in terms of East and West; the Du Meridian governs the posterior Yang, while the Ren and Chong meridians govern the anterior Yin, speaking in terms of North and South; the Dai Meridian binds the vessels horizontally, speaking in terms of the Six Directions. Furthermore, Zhang Jiegou stated that "Qiao" means agility. These two vessels originate from the feet, granting agility to movement. The Yang Heel Vessel lies above the muscles, following the path of Yang vessels, penetrating the Six Fu Organs, and governing the exterior, hence named the collateral of the Yang Heel. The Yin Heel Vessel lies below the muscles, following the path of Yin vessels, penetrating the Five Zang Organs, and governing the interior, hence named the collateral of the Yin Heel. Observing these discussions on the Eight Extraordinary Vessels, although they exist outside the Twelve Regular Vessels and are named "Extraordinary," they also serve as assistants to the regular vessels and collaterals. Generally, the regular vessels are like ditches on the earth, while the extraordinary vessels are like lakes and marshes outside these ditches. If the ditches of the regular vessels do not dry up, the lakes of the extraordinary vessels will not become extremely depleted; if the water in the ditches of the regular vessels overflows, the lakes of the extraordinary vessels will inevitably be irrigated. Thus, the ancients said: When the Qi of the Zang organs is harmonious and the vessels are smooth, no abnormal manifestations of the Eight Extraordinary Vessels can appear; even if pathogens invade the vessels, they will not overflow, having no relation to the extraordinary vessels. However, if the pathogenic heat in the vessels becomes excessive, it will inevitably overflow into the extraordinary vessels. This is akin to rain falling, causing ditches to overflow, with heavy rains flowing wildly into the lakes, which is consistent with this meaning. Moreover, each regular vessel is paired with a Zang or Fu organ, whereas the extraordinary vessels have their own origins and endings, differing from the regular vessels' pattern; thus, the extraordinary vessels act as constraints for the Twelve Regular Vessels. Therefore, in Shanghan (Cold Damage) diseases, pathogens may start from the Yang Linking Vessel and sequentially transmit to the Three Yang vessels, or start from the Yin Linking Vessel and sequentially transmit to the Three Yin vessels. Additionally, when internal Zang Qi stagnates and external pathogens overflow, they may directly affect the extraordinary vessels first. However, this occurs because pathogens enter internally and do not remain in the extraordinary vessels, unlike the situation where heat in the Twelve Regular Vessels necessarily overflows into the extraordinary vessels. Li Shizhen said: If a physician understands the Eight Extraordinary Vessels, they grasp the main principles of the Twelve Regular Vessels and Fifteen Collaterals; if an immortal understands them, they comprehend the mysteries of the rising and lowering of Dragon and Tiger, and the subtle apertures of Xuanpin. He also said: A physician who does not know this cannot probe the disease mechanism; an immortal who does not know this cannot stabilize the furnace and tripod. These words are profound. I record this to assist physicians.
The Ren Meridian originates from the bottom of Zhongji (CV3, four cun below the umbilicus, acupoint name Zhongji). The Ren Meridian starts below this point, at the intersection of the two yins, the Huiyin acupoint. The Ren Meridian travels from Huiyin through the abdomen, while the Du Meridian travels from Huiyin through the back. It passes above the pubic hair, running within the abdomen (passing through Zhongji acupoint), ascends to Guanyuan (CV4, three cun below the umbilicus, acupoint name), reaches the throat, ascends to the chin, follows the face, and enters the eyes (connecting with Chengqi ST1).
The Chong Meridian originates at Qichong (ST30) and joins the Shaoyin Kidney Meridian, ascending alongside the umbilicus to the chest (The Ren Meridian ascends through the umbilicus, while the Chong Meridian ascends beside it. All above content is from Suwen, Chapter 68: Bone Empty Discourse). The Chong Meridian is the Sea of the Five Zang and Six Fu Organs (Chong is the Sea of Blood), receiving Qi from the Five Zang and Six Fu Organs. It渗irrigates the Yang vessels upwards (emerging at Hangsang), taking its name "Chong" (Rushing) from the upward rush from below. There are also branches descending with the Kidney, injecting into the Shaoyin collateral, emerging at Qichong, entering the medial aspect of the thigh, and entering the popliteal fossa (the bend behind the knee), running deep within the tibia near the medial malleolus. It downwardly irrigates the Three Yin vessels (Liver, Spleen, Kidney) and the various collaterals, warming the muscles down to the dorsum of the foot and toes (following the sole of the foot down to Yongquan KI1, entering the big toe. This section is from Lingshu, Chapter 52: Reverse and Smooth, Fat and Thin).
The Du Meridian originates from the center of the lower abdominal bone, entering and connecting to Tingkong (the end of the female clitoris and urethral opening, i.e., Yaolou acupoint), connecting to the genitalia. It meets at Cu Jian (the junction of the two yins, named Cu), then diverges posteriorly around the buttocks, joining the Chenyang collateral (Taiyang mid-collateral) and comparing with the Shaoyin (combining with the Bladder and Kidney meridians). It ascends along the posterior-medial aspect of the thigh, penetrates the spine, attaches to the Kidney, ascends together with the Taiyang Meridian starting from the inner canthus of the eye. It ascends to the forehead, crosses the vertex, connects to the brain, descends to the nape, follows the shoulder (inner arm), and still runs alongside the spine. It reaches the waist, connects to the Kidney (this part of the Du Meridian runs parallel with the Taiyang), follows the male penis, descends to Cu Jian, similar to females. It again penetrates from the lower abdomen through the umbilicus, penetrates the Heart, enters the throat, reaches the chin and lips (encircling the lips). It ascends to connect to the center below the eyes, running parallel with the Ren Meridian (this part of the Du Meridian runs parallel with the Ren Meridian), and also parallels the Chong Meridian. Generally, these three meridians share the same root (Chong, Ren, and Du all originate below Huiyin, one source branching into three, different names but same substance). Ling Shu and Su Wen mention them with some complexity (Ling Shu, Chapter 49: Five Tones and Five Flavors states: Chong and Ren meridians both originate in the chest, ascending along the back interior. This again states Chong and Ren run on the back. Hence, some scriptures refer to the Chong Meridian as the Du Meridian. Ancient atlases call the Ren Meridian running on the back "Du", and the one rising straight from the lower abdomen "Ren", also calling it "Du". Modern people generally consider the one running on the back as Du, the one on the front as Ren, and the one rising from the center as Chong. However, examining the acupoints of the Ren and Du meridians, one is on the front of the body, one on the back; while the Chong Meridian is central, it has no acupoints. It seems appropriate to regard this explanation as correct). Du Meridian pathology manifests as pain rushing from the lower abdomen to the heart, inability to pass stool and urine (obstruction of both bowels and urination), and Chong Hernia attacks (this Du pathology is similar to Chong pathology). In women, it manifests as infertility (Chong is the Sea of Blood, Ren governs the uterine collaterals), dry throat (meridian follows the throat), enuresis, and hemorrhoids/strangury (connects to genitalia, meets at Cu Jian. This Du pathology is similar to Ren and Chong pathology). Ren Meridian pathology: in men, hernia (internal knotting of seven types of hernia); in women, leukorrhea and masses (leukorrhea and masses are women's hernias). Chong Meridian pathology: internal urgency and Qi counterflow (blood deficiency causes urgency, Qi excess causes counterflow. This section is from Suwen, Chapter 68: Bone Empty Discourse. Du leads the vessels of all meridians. Chong means Qi rushes upward. Ren means women receive nourishment through it).
The Yin Heel Vessel is a branch of the Shaoyin (Kidney) Meridian, originating behind Ran Gu (below the large bone of the medial malleolus, Zhaohai KI6) to the medial malleolus. It goes straight up the medial thigh into the genital region, ascends along the chest into the Supraclavicular Fossa, passes anterior to Renying (ST9, Stomach Meridian, carotid artery in the neck), enters the cheekbone, reaches the inner canthus of the eye (Jingming BL1), and merges with the Taiyang Meridian and the Yang Heel Vessel (Yang Heel Vessel starts at Shenmai BL62, in the depression below the lateral malleolus. This section is from Ling Shu, Chapter 27: Pulse Degrees). These are all explanations of the extraordinary vessels in Ling Shu and Su Wen; the Dai Meridian and the Two Linking Vessels are not detailed here.