手太阳小肠。为受盛之官。承奉胃司受糟粕。化物而传入大肠。故化物出焉。与心为表里。属南方丙火。用与性情
等。皆不外乎心脉。受心交。心脉终于小指。小肠脉即起于小指之端。循手外侧。上脘出踝中。腕下兑骨为踝。
直上循臂骨下廉。出肘内侧两筋之间。上循 外后廉。故 肘臂痛属小肠。出肩解。膂上两角。为绕肩脾。肩解下成片
骨为肩解。交肩上。入缺盆。故小肠病。肩似拔而痛。络心循咽为嗌痛。下膈抵胃属小肠。其支者。从缺盆
循颈上颊。为颈肿不可以顾。又为颊肿。至目兑 。入耳中。故为目黄。为耳聋。其支者。别颊上 。目下曰 。抵鼻
至目内 。出目内角曰内 。外角曰兑 。小肠之大略如此。
足太阴脾经。仓廪之官。五味出焉。居右手关上。与足阳明胃经为表里。脾脏胃腑。言其体。属中央己土。言其用。
已化物为水谷之海。胃戊化火。火热土湿。其气相通。推磨万物。变化糟粕。其华在唇四白。其窍通于口。故脾和
则口知五味。又上朝肺金。下按命门。心主血。肝藏血。脾则裹血。藉胃气运入命门。男子化而为精。女子盈而为月事。
由是播敷各脏。长养骨髓。荣于一身。肌肉肥泽。故又曰脾主肌肉。脾藏意智。能思记曰意智。血气之主持
也。故又曰谏议出焉。言其性情之杂着。脾主味。自入为甘。其传于五脏者。亦各自有味。其为各脏所传者。脾主声。
入脾为歌。心主臭。入脾为香。肝主色。入脾为黄。肾主液。入脾为涎。其为六淫所中。湿病必起于脾。如五泄皆
湿也。其为七情所害。思虑则意舍不宁。土气凝结。肝木乘之。其有不内外因而病者。饮食劳倦。则伤脾也。大抵土爱
暖。热则伤胃。寒则伤脾。不寒不热。则脾胃和平。脾脉受胃之交。胃脉终于足大指。脾脉即起于足大指之
端。故脾病为足大指不能举用。循指内侧白肉际。过核骨后。即孤拐骨也。上内踝前廉。循胫骨。上膝股内前廉。入腹
属脾络胃。故强立膝股内肿。腹胀呕食溏泄。胃脘痛。客寒于胃。为善噫。皆脾病。从胃上膈挟咽连舌本。散
舌下。为舌本强。其支者。复从胃别上膈。注心中。诊脉如九菽之重浮于九菽者。胃脉也。按至肌肉阿阿缓漫。如微风
轻柳梢之状曰缓。次稍加力。脉道敦实曰大。此平脉也。弦紧则肝脉见于脾部。木来克土为贼邪。主疼
痛。然土衰则木失培养。亦主筋拘急而作呕逆。若沉濡而滑为微邪。沉主积冷气块。忧结中满吞酸。濡则中脘冷痛。滑
则脾家热。主风寒久停。渐成霍乱。实而洪。心火相乘为虚邪。土中有火。火能化物消中。而脾胃皆虚。或
口干。或翻胃。太实主心痛。芤则血在中焦。主大肠成痈。浮涩属金为实邪。浮主风热。热则金不能克木。木来克土。
金乃有病之子。不能顾母。主胃中。空虚。肢体胀满。涩则损食气痞上逆。又有正邪。缓者脾脉。缓甚则病痿厥。
若三部皆缓。土能制水。水衰则火必独炎。亦主脾胃热。口臭翻胃。齿肉浮肿。心力损少。脾之积曰痞气。在胃脘。覆
大如
盘。以冬壬癸日得之。盖肝邪传脾。脾当传肾。肾旺不受邪。脾复欲还肝。肝不受。故留结为积。脾气实梦
歌欢乐。虚则梦争饮食。若脾绝而真藏脉见。如雀之啄。筋肉间连三五下。且坚且锐。忽来顿去。良久复来。如屋之漏。
筋肉间良久一滴。溅起无力。如釜之沸。皮肤间有出无入。涌涌如羹之上沸。其见于形者。鱼口涎不收。唇
青反。人中满。甲日笃。乙日死。死于寅卯时。脾之大略如此。
手太阳小肠经,是负责接受和容纳的器官,承接胃的功能以受纳糟粕,将食物消化后传入大肠,因此食物的转化由此产生。它与心互为表里,归属于南方的丙火。其功能与性情等,都不超出心脉的范围。受到心的交接影响,心脉终止于小指,而小肠脉即起始于小指的末端,沿着手的尺侧(外侧),向上经过腕部踝骨处(腕下高出的骨头称为踝),直上沿着前臂骨的下方边缘,从肘内侧两条肌腱之间穿出,再向上沿着肘臂外侧后缘。因此,肘部和手臂的疼痛属于小肠经的病证。经脉出于肩关节部位,上行至脊柱两旁的肌肉顶端,环绕肩胛骨。肩关节下方成片状的骨骼称为肩解,经脉交会在肩上,进入缺盆(锁骨上窝)。因此,小肠发生病变时,肩部感觉像被拔除一样疼痛。络脉连接心脏,沿着咽喉,会导致咽喉疼痛。向下穿过膈肌,抵达胃部,归属于小肠。它的分支,从缺盆沿着颈部上行至面颊,导致颈部肿胀无法回顾头部,也表现为面颊肿胀。到达目外角,进入耳中,因此会出现目黄、耳聋的症状。另一分支,从面颊分出,上行至目眶下,抵至鼻旁,到达目内角,出目内角称为内眦,外角称为锐眦。小肠经的大致走向如此。
足太阴脾经,是掌管仓廪的器官,五味由此化生。它位于右手关部的脉位,与足阳明胃经互为表里。脾脏与胃腑,是从形体结构而言;归属于中央的己土,是从功能作用而言。脾为水谷之海,已能消化食物;胃属戊土化火,火热与土湿之气相通,推动万物变化,转化糟粕。脾的精华表现于口唇四周的白色部分,其窍穴通于口。因此,脾功能调和则口中能辨别五味。脾又上朝于肺金,下按命门。心主血,肝藏血,脾则包裹血液,借助胃气运入命门。男子将其转化为精,女子充盈成为月经。由此播散到各个脏腑,滋养骨髓,使全身荣润,肌肉丰满润泽。所以又说“脾主肌肉”。脾藏意智,能够思考记忆称为意智,这是气血主持的结果。所以又说“谏议之官”由此产生,指其性情的复杂表现。脾主管味觉,甘味自入于脾。传变到五脏的,也各自有对应的味道。各脏所传变的,脾主管声音,入脾表现为歌谣;心主管气味,入脾表现为香;肝主管颜色,入脾表现为黄色;肾主管体液,入脾表现为涎液。当遭受六淫邪气侵袭时,湿病必定起于脾,如五泄都是湿邪所致。当遭受七情伤害时,思虑过度则意舍不宁,土气凝结,肝木乘虚侵犯。如果有不内外因导致的疾病,饮食不节或劳倦过度,则会损伤脾。大抵来说,土喜欢温暖,热则伤胃,寒则伤脾,不寒不热,则脾胃平和。脾脉受到胃脉的交接影响,胃脉终止于足大趾,脾脉即起始于足大趾的末端。因此,脾病表现为足大趾不能抬举使用。经脉沿着足大趾内侧白肉际,经过核骨后方(即孤拐骨,指内踝),向上经过内踝前缘,沿着胫骨,上行至膝股内侧前缘,进入腹部,归属于脾,联络胃。因此,强行站立会导致膝股内侧肿胀,出现腹胀、呕吐、食少、便溏、胃脘痛等症状。寒气客居于胃,会导致频繁嗳气,这些都是脾病的表现。经脉从胃上行穿过膈肌,夹着咽喉,连系舌根,散布于舌下。它的分支,又从胃别出,上行穿过膈肌,注入心中。诊察脉象时,轻取如九颗豆子的重量浮于表面的是胃脉。重按至肌肉层,脉来和阿缓漫,像微风吹拂柳梢的状态称为缓脉。稍微加重力量,脉道敦实有力称为大脉,这是正常的平脉。如果脉弦紧,则是肝脉出现在脾部,木来克土称为贼邪,主疼痛。然而,如果土气衰弱,则木失去培养,也会主筋脉拘急并伴有呕逆。如果脉沉濡而滑,则为微邪,沉主积冷气块、忧闷结聚、胸中胀满、吞酸;濡则主中脘冷痛;滑则主脾家热,主风寒久留,逐渐形成霍乱。如果脉实而洪大,是心火相乘称为虚邪,土中有火,火能消化食物但导致消中症,而脾胃皆虚,或者口干,或者翻胃。脉太实主心痛。脉芤则主血在中焦,主大肠成痈。脉浮涩属金为实邪,浮主风热,热则金不能克木,木来克土,金乃有病之子,不能顾护母脏,主胃中空虚,肢体胀满;涩则主损食、气痞上逆。又有正邪,缓脉是脾脉,缓甚则病痿厥。如果三部脉都缓,土能制水,水衰则火必独炎,也主脾胃热,口臭、翻胃、齿肉浮肿、心力受损减少。脾的积聚称为痞气,在胃脘部,覆盖面积大如盘子,如果在冬季壬癸日得病,是因为肝邪传脾,脾应当传肾,肾旺不受邪,脾复欲还肝,肝不接受,故留结为积。脾气实则梦见唱歌欢乐,虚则梦见争斗饮食。如果脾绝而出现真脏脉,像麻雀啄食一样,筋肉间连续跳动三五下,既坚硬又尖锐,忽来顿去,很久再来;或者像屋顶漏水,筋肉间很久滴下一滴,溅起无力;或者像锅中的沸水,皮肤间只有出没有入,涌涌如羹汤上面沸腾的样子。表现在形体上的,鱼口涎不收摄,嘴唇青紫反卷,人中饱满。甲日病情加重,乙日死亡,死于寅卯时。脾经的大致情况如此。
The Hand-Taiyang Small Intestine Meridian is the official responsible for reception and containment. It receives waste from the Stomach, transforms food, and transmits it to the Large Intestine; thus, transformation occurs here. It forms an interior-exterior relationship with the Heart, belongs to Bing Fire of the South. Its functions and nature do not extend beyond the Heart Pulse. Receiving the connection from the Heart, while the Heart Pulse terminates at the little finger, the Small Intestine Pulse originates at the tip of the little finger. It follows the lateral aspect of the hand, ascends above the wrist (the prominent bone below the wrist is called the ankle), goes straight up along the lower edge of the forearm bone, emerges between the two tendons on the medial side of the elbow, ascends again along the posterior-lateral edge of the elbow and arm. Therefore, pain in the elbow and arm belongs to the Small Intestine meridian. It emerges from the shoulder joint, ascends to the two angles of the spine muscles, encircles the scapula. The成片 bone below the shoulder joint is called the shoulder solution (Jianjie). It intersects at the shoulders, enters the Clavicular Fossa (Quepen). Therefore, when the Small Intestine is diseased, the shoulder feels as if being pulled out and painful. The collateral connects to the Heart, follows the pharynx, causing sore throat. Descending through the diaphragm to reach the Stomach, it belongs to the Small Intestine. Its branch, from the Clavicular Fossa, follows the neck up to the cheek, causing neck swelling that prevents turning the head, and also manifests as cheek swelling. Reaching the outer canthus, it enters the ear; thus, it causes yellow eyes and deafness. Another branch separates from the cheek, ascends to the infraorbital region, reaches the nose, arrives at the inner canthus, exits the inner canthus called Neicui, and the outer canthus called Ruicui. This is the general outline of the Small Intestine meridian.
The Foot-Taiyin Spleen Meridian is the official managing granaries; the five flavors emerge from it. It is located at the Guan position of the right hand, forming an interior-exterior relationship with the Foot-Yangming Stomach Meridian. The Spleen Zang and Stomach Fu refer to their physical structure; belonging to Ji Earth of the Center refers to their functional use. The Spleen is the Sea of Water and Grain, having transformed food; the Stomach, Wu Earth transforming fire, has fire-heat and earth-dampness qi communicating with each other, pushing the transformation of all things and changing dregs. Its brilliance manifests in the four whites of the lips, its orifice connects to the mouth. Therefore, when the Spleen harmonizes, the mouth knows the five flavors. It also ascends to pay homage to Lung Metal and descends to press upon the Mingmen. The Heart governs blood, the Liver stores blood, while the Spleen wraps blood, utilizing Stomach Qi to transport it into the Mingmen. In men, it transforms into essence; in women, it fills to become menstruation. From this, it spreads to various Zang organs, nourishes marrow bones, and brings prosperity to the whole body, making muscles plump and lustrous. Thus, it is said that "the Spleen governs muscles." The Spleen stores Yi (Intent) and Zhi (Wisdom); the ability to think and remember is called Yi and Zhi, which is the hosting of Blood and Qi. Thus, it is said that the "Official of Remonstrance" arises from it, referring to the complex manifestations of its nature. The Spleen governs taste; sweet flavor enters the Spleen. Those transmitted to the Five Zang organs also have their own respective tastes. For those transmitted by various Zang organs, the Spleen governs sound; entering the Spleen, it manifests as singing. The Heart governs odor; entering the Spleen, it manifests as fragrance. The Liver governs color; entering the Spleen, it manifests as yellow. The Kidney governs fluid; entering the Spleen, it manifests as saliva. When attacked by the Six Excesses, damp diseases must originate in the Spleen; for example, the Five Diarrheas are all due to dampness. When harmed by the Seven Emotions, excessive thinking makes the Yi Residence restless, causing Earth Qi to condense, allowing Liver Wood to invade. If diseases arise from non-internal, non-external causes, improper diet and fatigue will injure the Spleen. Generally, Earth loves warmth; heat injures the Stomach, cold injures the Spleen, neither cold nor heat results in Spleen-Stomach harmony. The Spleen Pulse receives the connection from the Stomach Pulse. The Stomach Pulse terminates at the big toe, while the Spleen Pulse originates at the tip of the big toe. Therefore, Spleen disease manifests as the inability to lift and use the big toe. It follows the medial white flesh margin of the toe, passes behind the nuclear bone (i.e., the malleolus), ascends anterior to the medial malleolus, follows the tibia, ascends to the anterior-medial aspect of the knee and thigh, enters the abdomen, belongs to the Spleen, and connects to the Stomach. Therefore, standing forcibly causes swelling inside the knee and thigh, abdominal distension, vomiting, poor appetite, loose stools, and epigastric pain. Cold pathogen lodging in the Stomach causes frequent belching; these are all Spleen diseases. The meridian ascends from the Stomach through the diaphragm, flanking the pharynx, connecting to the root of the tongue, and spreading under the tongue. Its branch, again separating from the Stomach, ascends through the diaphragm, and pours into the Heart. When diagnosing the pulse, light pressure equivalent to the weight of nine beans floating on the surface indicates the Stomach Pulse. Pressing down to the muscle layer, the pulse is gentle and slow, like a light breeze swaying willow tips, called the Slow (Huan) pulse. Slightly increasing force, the pulse channel becomes solid and substantial, called the Large (Da) pulse; this is the normal Ping Pulse. If the pulse is Wiry and Tight, it is the Liver Pulse appearing in the Spleen area; Wood overcoming Earth is called Thieving Evil, indicating pain. However, if Earth declines, Wood loses nourishment, it also indicates tendon spasms and vomiting/regurgitation. If the pulse is Deep, Soft, and Slippery, it is Minor Evil; Deep indicates accumulation of cold qi and masses, worry and knotting, chest fullness, and acid regurgitation; Soft indicates cold pain in the middle Jiao; Slippery indicates Heat in the Spleen, indicating long-standing Wind-Cold gradually forming Huoluan (Cholera-like syndrome). If the pulse is Full and Surging, it is Heart Fire multiplying, called False Evil; Earth containing Fire, Fire transforms food but causes Xiao Zhong (Consumption with polyphagia), while both Spleen and Stomach are deficient, leading to dry mouth or Fan Wei (Reversal Vomiting). Too Full indicates Heart Pain. Hollow (Kou) indicates blood in the Middle Jiao, indicating abscess formation in the Large Intestine. Floating and Choppy belongs to Metal, representing Real Evil; Floating indicates Wind-Heat; Heat means Metal cannot overcome Wood, so Wood overcomes Earth. Metal, being a sick child, cannot protect its mother, indicating emptiness in the Stomach and limb distension; Choppy indicates damaged food Qi and rebellious Qi stagnation. There is also Righteous Evil; the Slow pulse is the Spleen pulse. If excessively slow, it causes Wei Jue (Atrophy and Cold limbs). If all three positions are slow, Earth controls Water; if Water declines, Fire burns alone, also indicating Spleen-Stomach Heat, bad breath, Fan Wei, swollen gums, and diminished Heart power. The accumulation of the Spleen is called Pi Qi, located in the epigastrium, covering an area large as a plate. If contracted on Ren or Gui days in winter, it is because Liver Evil transmits to the Spleen; the Spleen should transmit to the Kidney, but the Kidney is prosperous and does not accept evil. The Spleen attempts to return evil to the Liver, but the Liver refuses, so it remains and forms an accumulation. When Spleen Qi is Excess, one dreams of singing and joy; when Deficient, one dreams of fighting over food. If the Spleen perishes and the True Organ Pulse appears, it resembles a sparrow pecking, with muscle contractions occurring continuously three to five times, firm and sharp, coming suddenly and leaving abruptly, returning after a long time; or like a leaking roof, with a drop falling every long interval in the muscles, splashing weakly; or like boiling water in a pot, with movement only outward and no inward penetration in the skin, surging like boiling soup. Manifestations in form include inability to retain fish-mouth saliva, cyanotic and inverted lips, fullness of the philtrum. Condition worsens on Jia days, death occurs on Yi days, dying during Yin-Mao hours. This is the general outline of the Spleen.