四十五难曰∶经言八会者何谓也?然腑会太仓,脏会季胁,筋会阳陵泉,髓会绝骨,血
会鬲
俞,骨会大杼,脉会太渊,气会三焦外一筋直两乳内也。热病在内者,取其会之气穴也。
滑氏曰∶太仓一名中脘,在脐上四寸,六腑取禀于胃,故为腑会。季胁章门穴也,在大
横外
直脐季肋端,为脾之募,五脏取禀于脾,故为脏会。足少阳之筋结于膝外廉,阳陵泉也,在
膝下一寸外廉陷中。又胆与肝为配,肝者筋之合,故为筋会。绝骨一名阳辅,在足外踝上四
寸辅骨前绝骨端如前三分,诸髓皆属于骨,故为髓会。鬲俞在背第七椎下,去脊两旁各一寸
半,足太阳脉气所发也。太阳多血,又血乃水之象,故为血会。大杼在项后第一椎下,去脊
两旁各一寸,太渊在掌后陷中动脉,即所谓寸口者,脉之大会也。气会三焦外一筋直两乳内
,即膻中,为气海者也,在玉堂下一寸六分。热病在内者,各视其所属而取之会也。谢氏曰
∶三焦当作上焦。四明陈氏曰∶髓会绝骨,髓属于肾,肾主骨,于足少阳无所关。脑为髓海
,脑有枕骨穴,则当会枕骨,绝骨误也。血会鬲俞,血者心所统,肝所藏,鬲俞在七椎下两
旁,上则心俞,下则肝俞,故为血会。骨会大杼,骨者髓所养,髓自脑下注于大杼,大杼渗
入脊心,下贯尾 ,渗诸骨节,故骨节之气,皆会于此,亦通。古益袁氏曰∶人能健步,以
髓会绝骨也;肩能任重,以骨会大杼也。
《难经》第四十五问说:经文所说的“八会”是指什么?回答说:腑会是太仓,脏会是季胁,筋会是阳陵泉,髓会是绝骨,血会是膈俞,骨会是大杼,脉会是太渊,气会位于三焦之外、一条筋直连两乳内侧的地方。热邪在体内的病证,应当取用这些会穴的气穴来治疗。
滑寿氏说:太仓又名中脘,位于脐上四寸处,六腑的功能禀受于胃,所以它是腑会。季胁指的是章门穴,位于大横穴外侧,正对脐部与肋骨末端,是脾的募穴,五脏的功能禀受于脾,所以它是脏会。足少阳胆经的筋结聚于膝盖外侧,即阳陵泉穴,位于膝下一寸、外侧凹陷处。又因为胆与肝相配属,肝主筋,所以它是筋会。绝骨又名阳辅,位于足外踝上四寸、腓骨前缘、腓骨断端向前三分处,全身的髓都归属于骨,所以它是髓会。膈俞位于背部第七椎棘突下,距离脊柱两旁各一寸半处,是足太阳膀胱经脉气所发之处。太阳经多血,而血是水液代谢的象征(注:此处原文逻辑较晦涩,通常解释为血与水同源或相关),所以它是血会。大杼位于项后第一椎棘突下,距离脊柱两旁各一寸处;太渊位于手腕后方凹陷处的动脉搏动处,也就是所谓的“寸口”,是脉气的汇聚之处。气会位于三焦之外、一条筋直连两乳内侧的地方,即膻中穴,也就是气海,位于玉堂穴下一寸六分处。对于热邪在体内的病证,应当根据病变所属的脏腑,选取相应的会穴进行治疗。
谢氏说:这里的“三焦”应当理解为“上焦”。四明的陈氏说:髓会绝骨,但髓归属于肾,肾主骨,这与足少阳胆经没有直接关系。脑被称为髓海,脑部有枕骨部位的穴位,那么髓会应当在枕骨处,说绝骨是髓会是错误的。血会膈俞,血由心统摄,由肝贮藏,膈俞位于第七椎下方两旁,上方对应心俞,下方对应肝俞,所以它是血会。骨会大杼,骨由髓滋养,髓从脑部向下灌注到大杼,大杼渗入脊心,向下贯穿尾闾,渗透至各个骨节,所以骨节之气都汇聚于此,这种说法也通顺。
Question 45 of the *Nan Jing* (Classic of Difficult Issues) states: What does the term "Eight Hui Points" (Eight Assemblage Points) refer to in the classic texts? The answer is: The Hui Point of the Fu organs is Tai Cang; the Hui Point of the Zang organs is Ji Xie; the Hui Point of the tendons is Yanglingquan (GB34); the Hui Point of the marrow is Juegu (GB39); the Hui Point of the blood is Geshu (BL17); the Hui Point of the bones is Dazhu (BL11); the Hui Point of the vessels is Taiyuan (LU9); and the Hui Point of Qi is located outside the Sanjiao (Triple Burner), along a tendon running straight between the two breasts. For heat diseases located internally, one should select the Qi points of these Hui Points for treatment.
Mr. Hua (Shou) stated: Tai Cang is another name for Zhongwan (CV12), located four cun above the umbilicus. Since the six Fu organs derive their nourishment from the stomach, it serves as the Hui Point of the Fu organs. Ji Xie refers to the Zhangmen point (LR13), located lateral to Dahan (SP15), directly opposite the end of the costal margin at the level of the umbilicus. It is the Front-Mu point of the spleen. Since the five Zang organs derive their nourishment from the spleen, it serves as the Hui Point of the Zang organs. The tendons of the Foot-Shaoyang Gallbladder Meridian converge at the lateral aspect of the knee, which is Yanglingquan (GB34), located one cun below the knee joint in the depression on the lateral side. Furthermore, since the gallbladder and liver are paired, and the liver governs the tendons, this point serves as the Hui Point of the tendons. Juegu is another name for Yangfu (GB38), located four cun above the lateral malleolus, anterior to the fibula, at the end of the bony prominence. Since all marrow belongs to the bones, this point serves as the Hui Point of the marrow. Geshu (BL17) is located below the spinous process of the seventh thoracic vertebra, 1.5 cun lateral to the posterior midline. It is a site where the Qi of the Foot-Taiyang Bladder Meridian emerges. The Taiyang meridian is rich in blood, and blood is associated with water, thus it serves as the Hui Point of blood. Dazhu (BL11) is located below the spinous process of the first thoracic vertebra, 1 cun lateral to the posterior midline. Taiyuan (LU9) is located in the depression at the radial pulse, also known as the "Cunkou," which is the great assembly of vessels. The Hui Point of Qi is located outside the Sanjiao, along a tendon running straight between the two breasts, which is the Shanzhong (CV17) point, also known as the Sea of Qi, located 1.6 cun below Yutang (CV19). For heat diseases located internally, one should examine the affected organ and select its corresponding Hui Point.
Mr. Xie stated: The term "Sanjiao" here should be interpreted as "Upper Jiao." Mr. Chen from Siming stated that the Hui Point of marrow is Juegu; however, marrow belongs to the Kidney, and the Kidney governs the bones, having no direct relation to the Foot-Shaoyang Gallbladder Meridian. The brain is considered the Sea of Marrow. Since there are acupoints at the occipital bone of the brain, the Hui Point of marrow should be at the occipital bone, making the designation of Juegu as the Hui Point of marrow an error. Regarding the Hui Point of blood being Geshu: blood is governed by the Heart and stored by the Liver. Geshu is located bilaterally below the seventh thoracic vertebra; superiorly corresponds to Xinshu (BL15, Heart Shu), and inferiorly corresponds to Ganshu (BL18, Liver Shu). Therefore, it serves as the Hui Point of blood. Regarding the Hui Point of bones being Dazhu: bones are nourished by marrow. Marrow flows downward from the brain into Dazhu, penetrates into the spinal cord, descends through the tailbone, and permeates various bone joints. Thus, the Qi of the bone joints converges here, which is also a valid interpretation.
Mr. Yuan from Guyi stated: Human ability to walk vigorously relies on the function of the Hui Point of marrow, Juegu; the shoulder's ability to bear heavy loads relies on the function of the Hui Point of bones, Dazhu.