滑氏曰∶手厥阴心主,又曰心包络,何也?曰∶君火以名,相火以位,手厥阴代君火
行
九穴心包手厥阴,天池、天泉、曲泽深, 门、间使、内关对,大陵、劳宫、中冲
侵(左右一十八穴)。
此一经起于天池,终于中冲,取中冲、劳宫、大陵、间使、曲泽,与井荥俞经合也。
脉起胸中,出属心包,下膈,历络三焦;其支者,循胸出胁,下腋三寸,上抵腋下,下
循内,行太阴、少阴之间,入肘中,下臂,行两筋之间,入掌中,循中指出其端;其
支别者,从掌中循小指次指出其端。多血少气,戌时气血注此。
受足少阴之交,其系与三焦之系连属,故指相火之脏,实乃裹心之膜,此实安身立命之
地,尤宜详察,默会其真。其调剂也,莫执一方;其针灸也,必循其道。达者慎焉,几于神
天池(一名天会)∶腋下三寸,乳后一寸,着胁直腋撅肋间。手足厥阴、少阳
之会。《铜人》灸三壮,针三分。《甲乙》针七分。
主胸中有声,胸膈烦满,热病汗不出,头痛,四肢不举,腋下肿,上气,寒热 疟,
臂痛,目KT KT 不明。
天泉(一名天湿)∶曲腋下二寸,举臂取之。《铜人》针六分,灸三壮。
主目KT KT 不明,恶风寒,心病,胸胁支满,咳逆,膺背胛间、臂内廉痛。
曲泽∶肘内廉陷中,大筋内侧横纹中动脉是。心包络脉所入为合水。《铜人
》灸三壮,针三分,留七呼。
主心痛,善惊,身热,烦渴口干,逆气呕涎血,心下澹澹,身热,风疹,臂肘手腕不时
动摇,头清汗出不过肩,伤寒,逆气呕吐。
门∶掌后去腕五寸,手厥阴心包络脉隙。《铜人》针三分,灸五壮。
主呕血,衄血,心痛呕哕,惊恐畏人,神气不足。
间使∶掌后三寸,两筋间陷中。心包络脉所行为经金。《素注》针六分,留
七呼。《铜人》针三分,灸五壮。《明堂》灸七壮。《甲乙》灸三
主伤寒结胸,心悬如饥,卒狂,胸中澹澹,恶风寒,呕沫,怵惕,寒中少气,掌中热,
腋肿肘挛,卒心痛,多惊,中风气塞,涎上昏危,喑不得语,咽中如梗,鬼邪,霍乱干呕,
妇人月水不调,血结成块,小儿客忤。
内关∶掌后去腕二寸两筋间,与外关相抵。手心主之络,别走少阴。《铜人
》针五分,灸三壮。
主手中风热,失志,心痛,目赤,支满肘挛。实则心暴痛泻之,虚则头强补之。
大陵∶掌后骨下,两筋间陷中。手厥阴心包络脉所注为俞土。心包络实泻之。
《铜人》针五分。《素注》针六分,留七呼,灸三壮。
主热病汗不出,手心热,肘臂挛痛,腋肿,善笑不休,烦心,心悬若饥,心痛掌热,喜
悲泣惊恐,目赤目黄,小便如血,呕 无度,狂言不乐,喉痹,口干,身热头痛,短气,胸
胁痛, 疮疥癣。
劳宫(一名五里,一名掌中)∶掌中央动脉。《铜人》屈无名指取之。《资生
》屈中指取之。滑氏云∶以今观之,屈中
指、无名指两者之间取之为允。心包络脉所溜为荥火。《素注》针三分,留六呼。《铜人》
灸三壮。《明堂》针二分,得气即泻,只一度,针过两度,令人虚。禁灸,灸令人息肉日加
主中风,善怒,悲笑不休,手痹,热病数日汗不出,怵惕,胁痛不可转侧,大小便血,
衄血不止,气逆呕哕,烦渴食饮不下,大小人口中腥臭,口疮,胸胁支满,黄胆目黄,小儿
中冲∶手中指端,去爪甲角如韭叶陷中。心包络脉所出为井木。心包络虚补之
。《铜人》针一分,留三呼。《明堂》灸一壮。
主热病烦闷,汗不出,掌中热,身如火,心痛烦满,舌强。
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滑寿说:手厥阴心主,又叫做心包络,这是为什么呢?回答说:君火(主宰生命活动的阳气)以名分确立地位,相火(辅助君火的阳气)以职能定位,手厥阴经代替君火行使职能。
手厥阴心包经共有九穴:天池、天泉、曲泽深取,郄门、间使、内关相对,大陵、劳宫、中冲依次深入(左右两侧共十八穴)。
这条经脉起始于天池穴,终止于中冲穴。选取中冲、劳宫、大陵、间使、曲泽这五个穴位,分别对应井、荥、输、经、合五类特定穴。
脉气起于胸中,出来归属于心包络,向下穿过膈肌,依次联络三焦;其分支,沿着胸部出于胁部,下行至腋下三寸处,上行抵达腋下,向下沿上臂内侧,行在手太阴肺经和手少阴心经之间,进入肘窝中,向下沿前臂,行在两根肌腱之间,进入手掌中心,沿中指直达末端;另一支别行的经脉,从掌中分出,沿无名指直达末端。此经多血少气,在戌时气血灌注于此经。
此经接受足少阴肾经的气血交接,其系连与三焦的系连相互连接,所以被称为相火之脏,实际上是包裹心脏的膜,这是安身立命的根本之地,尤其应当详细考察,默默领会其真谛。调理此经,不可固执于单一方法;针灸治疗,必须遵循其道。通达之人应谨慎对待,近乎神妙。
天池(又名天会):位于腋下三寸,乳头后方一寸,紧贴胁肋,直对腋窝,处于举肋间隙。是手足厥阴经和手足少阳经的交会穴。《铜人腧穴针灸图经》记载灸三壮,针三分。《甲乙经》记载针七分。
主治胸中有声响,胸膈烦闷胀满,热病汗不出,头痛,四肢不能举动,腋下肿胀,气逆上冲,寒热疟疾,手臂疼痛,眼睛视物模糊不清。
天泉(又名天湿):位于曲腋下二寸处,举起手臂时取穴。《铜人腧穴针灸图经》记载针六分,灸三壮。
主治眼睛视物模糊不清,恶风怕冷,心病,胸胁支撑胀满,咳嗽气逆,胸前背部肩胛间及手臂内侧疼痛。
曲泽:位于肘横纹内侧凹陷中,大筋内侧横纹处的动脉搏动处。是心包络脉气所入为合穴,五行属水。《铜人腧穴针灸图经》记载灸三壮,针三分,留针七次呼吸的时间。
主治心痛,容易受惊,身体发热,烦躁口渴口干,气逆呕吐涎沫或血,心下悸动不安,身体发热,风疹,手臂肘腕不时动摇,头部清汗出不过肩部,伤寒,气逆呕吐。
郄门:位于掌后腕横纹上五寸处,是手厥阴心包络脉气空隙之处。《铜人腧穴针灸图经》记载针三分,灸五壮。
主治呕血,鼻出血,心痛呕吐呃逆,惊恐畏人,神气不足。
间使:位于掌后腕横纹上三寸,两筋之间的凹陷中。是心包络脉气所行为经穴,五行属金。《素问注》记载针六分,留针七次呼吸的时间。《铜人腧穴针灸图经》记载针三分,灸五壮。《明堂经》记载灸七壮。《甲乙经》记载灸三壮。
主治伤寒结胸,心中空虚如饥饿感,突然发狂,胸中悸动不安,恶风怕冷,呕吐泡沫,恐惧警惕,寒气侵袭导致少气,掌心发热,腋下肿胀肘部挛急,突然心痛,易惊,中风气机闭塞,痰涎上涌昏危,失音不能说话,咽喉如有异物梗阻,鬼邪致病,霍乱干呕,妇女月经不调,血结成块,小儿客忤。
内关:位于掌后腕横纹上二寸两筋之间,与外关穴相对。是手心主经的络穴,别走手少阴心经。《铜人腧穴针灸图经》记载针五分,灸三壮。
主治手中风热,意志丧失,心痛,目赤,胸胁支撑胀满肘部挛急。实证表现为心脏突然剧痛,应泻法;虚证表现为头项强直,应补法。
大陵:位于掌后腕骨下方,两筋之间的凹陷中。是手厥阴心包络脉气所注为输穴,五行属土。心包络实证应用泻法。
《铜人腧穴针灸图经》记载针五分。《素问注》记载针六分,留针七次呼吸的时间,灸三壮。
主治热病汗不出,手心发热,肘臂挛痛,腋下肿胀,喜欢笑不止,心烦,心中空虚如饥饿感,心痛掌心热,喜欢悲伤哭泣惊恐,目赤目黄,小便带血,呕吐无度,胡言乱语不快乐,喉痹,口干,身体发热头痛,短气,胸胁痛,疮疥癣。
劳宫(又名五里,又名掌中):位于手掌中央动脉处。《铜人腧穴针灸图经》记载弯曲无名指取穴。《资生经》记载弯曲中指取穴。滑寿说:现在看来,弯曲中指和无名指两者之间取穴比较妥当。是心包络脉气所溜为荥穴,五行属火。《素问注》记载针三分,留针六次呼吸的时间。《铜人腧穴针灸图经》记载灸三壮。《明堂经》记载针二分,得气即泻,只进行一次,针刺超过两次,会导致人体虚弱。禁止艾灸,艾灸会导致息肉日渐增多。
主治中风,易怒,悲笑不止,手部麻木,热病数日汗不出,恐惧警惕,胁痛不可转侧,大小便出血,鼻出血不止,气逆呕吐呃逆,烦躁口渴饮食不下,大小便口中腥臭,口疮,胸胁支撑胀满,黄疸目黄,小儿……
中冲:位于手中指末端,距离指甲角如韭菜叶宽的凹陷中。是心包络脉气所出为井穴,五行属木。心包络虚证应用补法。
《铜人腧穴针灸图经》记载针一分,留针三次呼吸的时间。《明堂经》记载灸一壮。
主治热病烦闷,汗不出,掌心发热,身体如火烧,心痛烦闷,舌强。
Hua Shou said: The Hand-Jueyin Pericardium Master, also called the Pericardium (Pericardium), why is this? The answer is: The Ministerial Fire (Ministerial Fire) establishes its status by name, while the Official Fire (Official Fire) defines its position by function. The Hand-Jueyin channel acts on behalf of the Ruler's Fire to perform its duties.
The Hand-Jueyin Pericardium channel has nine acupoints: Tianchi (Tianchi, Heavenly Pool), Tianquan (Tianquan, Heavenly Spring), Quze (Quze, Curve Marsh) needled deeply; Ximen (Ximen, Gate of the Crotch), Jianshi (Jianshi, Intermittent Mission), Neiguan (Neiguan, Inner Pass) are opposite each other; Daling (Daling, Great Palace), Laogong (Laogong, Laboring in the Palace), Zhongchong (Zhongchong, Central Rush) are penetrated sequentially. (Eighteen points in total on both sides).
This channel originates at Tianchi and terminates at Zhongchong. Selecting Zhongchong, Laogong, Daling, Jianshi, and Quze corresponds to the Jing-Well, Ying-Spring, Shu-Stream, Jing-River, and He-Sea specific acupoints respectively.
The pulse originates in the chest, emerges and belongs to the Pericardium, descends through the diaphragm, and successively connects with the Sanjiao (Triple Burner); its branch follows the chest out to the hypochondrium, descends three cun below the axilla, ascends to reach the axilla, then descends along the medial aspect of the arm, running between the Hand-Taiyin Lung channel and the Hand-Shaoyin Heart channel, enters the cubital fossa, descends along the forearm, runs between two tendons, enters the center of the palm, and follows the middle finger to its tip; another branch from the palm follows the ring finger to its tip. This channel has abundant blood and little Qi, with Qi and Blood pouring into it during the Xu hour (7-9 PM).
It receives intersection from the Foot-Shaoyin Kidney channel, and its connections are linked with those of the Sanjiao, thus being referred to as the organ of Ministerial Fire. It is actually the membrane wrapping the heart, which is the foundation of life and health. It requires careful examination and silent comprehension of its true nature. In regulating it, one must not adhere rigidly to a single method; in acupuncture and moxibustion, one must follow its proper principles. Those who understand should be cautious, approaching divine efficacy.
Tianchi (also known as Tianhui): Located three cun below the axilla, one cun posterior to the nipple, adjacent to the ribs, directly opposite the axilla, within the intercostal space formed by raising the rib. It is the meeting point of the Hand and Foot Jueyin and Hand and Foot Shaoyang channels. The *Tongren* text records moxibustion of three moxa cones or needle insertion of three fen. The *Jiayi* text records needle insertion of seven fen.
Indications include sounds in the chest, chest and diaphragm fullness and irritability, heat disease with inability to sweat, headache, immobility of the four limbs, axillary swelling, rebellious Qi, chills and fever malaria, arm pain, and blurred vision.
Tianquan (also known as Tianshi): Located two cun below the apex of the axilla, taken with the arm raised. The *Tongren* text records needle insertion of six fen or moxibustion of three moxa cones.
Indications include blurred vision, aversion to wind and cold, heart disease, distending fullness of the chest and hypochondrium, cough and rebellious Qi, pain in the anterior chest, back, scapular region, and medial aspect of the arm.
Quze: Located in the depression at the medial end of the transverse cubital crease, on the medial side of the large tendon where the artery throbs. It is the He-Sea point where the Pericardium channel Qi enters, belonging to Water. The *Tongren* text records moxibustion of three moxa cones, needle insertion of three fen, retaining the needle for seven breaths.
Indications include heart pain, susceptibility to fright, body heat, irritability, thirst, dry mouth, rebellious Qi with vomiting of saliva or blood, palpitations in the epigastrium, body heat, wind urticaria, involuntary trembling of the arm, elbow, and wrist, clear sweating on the head not extending beyond the shoulders, cold damage disease, rebellious Qi with vomiting.
Ximen: Located five cun proximal to the palmar wrist crease, representing the gap in the Hand-Jueyin Pericardium channel. The *Tongren* text records needle insertion of three fen or moxibustion of five moxa cones.
Indications include hematemesis, epistaxis, heart pain with vomiting and hiccups, fear and apprehension, and deficiency of Shen-Qi.
Jianshi: Located three cun proximal to the palmar wrist crease, in the depression between two tendons. It is the Jing-River point where the Pericardium channel Qi flows, belonging to Metal. The *Suwen* commentary records needle insertion of six fen, retaining for seven breaths. The *Tongren* text records needle insertion of three fen or moxibustion of five moxa cones. The *Mingtang* text records moxibustion of seven moxa cones. The *Jiayi* text records moxibustion of three moxa cones.
Indications include cold damage with chest binding, a sensation of emptiness in the heart like hunger, sudden mania, palpitations in the chest, aversion to wind and cold, vomiting of froth, fearfulness, deficiency of Qi due to cold invasion, heat in the palms, axillary swelling with elbow contracture, sudden heart pain, excessive fright, stroke with Qi blockage, rising phlegm causing coma, aphasia, sensation of obstruction in the throat, demonic pathogens, cholera with dry heaving, irregular menstruation in women, blood stasis forming masses, and infantile fright.
Neiguan: Located two cun proximal to the palmar wrist crease between two tendons, opposing Waiguan. It is the Luo-Connecting point of the Hand-Yinqing Pericardium channel, diverging to connect with the Hand-Shaoyin Heart channel. The *Tongren* text records needle insertion of five fen or moxibustion of three moxa cones.
Indications include wind-heat affecting the hands, loss of willpower, heart pain, red eyes, distending fullness, and elbow contracture. For excess patterns presenting with sudden severe heart pain, apply draining method; for deficiency patterns presenting with stiff neck, apply tonifying method.
Daling: Located below the wrist bone in the depression between two tendons. It is the Shu-Stream point where the Hand-Jueyin Pericardium channel Qi pours, belonging to Earth. Excess patterns of the Pericardium should be treated with draining.
The *Tongren* text records needle insertion of five fen. The *Suwen* commentary records needle insertion of six fen, retaining for seven breaths, and moxibustion of three moxa cones.
Indications include heat disease with inability to sweat, heat in the palms, contracture and pain of the elbow and arm, axillary swelling, incessant laughter, irritability, sensation of emptiness in the heart like hunger, heart pain with heat in the palms, tendency toward sadness, crying, and fright, red and yellow eyes, blood in urine, incessant vomiting, delirious speech and unhappiness, bi-syndrome of the throat, dry mouth, body heat with headache, shortness of breath, chest and hypochondriac pain, sores, eczema, and tinea.
Laogong (also known as Wuli, also known as Zhangzhong): Located at the arterial pulsation in the center of the palm. The *Tongren* text advises taking the point with the ring finger flexed. The *Zisheng* text advises taking it with the middle finger flexed. Hua Shou stated: Observing now, it is appropriate to take the point between the flexed middle and ring fingers. It is the Ying-Spring point where the Pericardium channel Qi slips, belonging to Fire. The *Suwen* commentary records needle insertion of three fen, retaining for six breaths. The *Tongren* text records moxibustion of three moxa cones. The *Mingtang* text records needle insertion of two fen, draining immediately upon obtaining Deqi, performed only once; inserting more than twice causes deficiency. Moxibustion is contraindicated, as it may lead to progressive growth of polyps.
Indications include stroke, irritability, incessant laughing and crying, hand numbness, heat disease with no sweat after several days, fearfulness, hypochondriac pain preventing turning, bleeding in stool and urine, persistent epistaxis, rebellious Qi with vomiting and hiccups, irritability and thirst with inability to eat or drink, foul odor from mouth and excreta, mouth ulcers, distending fullness of chest and hypochondrium, jaundice with yellow eyes, and pediatric conditions...
Zhongchong: Located at the tip of the middle finger of the hand, in the depression approximately the width of a leek leaf from the corner of the nail. It is the Jing-Well point where the Pericardium channel Qi exits, belonging to Wood. Deficiency patterns of the Pericardium should be treated with tonifying.
The *Tongren* text records needle insertion of one fen, retaining for three breaths. The *Mingtang* text records moxibustion of one moxa cone.
Indications include heat disease with irritability and oppression, inability to sweat, heat in the palms, body feeling like fire, heart pain with irritability and fullness, and stiff tongue.