\r手厥阴心包络经\pj-j24.bmp\r
手厥阴之脉。起于胸中。出属心包。下鬲。历络三焦。
手厥阴受足少阴之交。起于胸中。出属心包。由是下鬲。历络于三焦之上脘中脘。及脐
下一寸下焦之分也。
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。
胁上际为腋。自属心包上循胸出胁。下腋三寸天池穴。上行抵腋下。下循 内之天泉穴
。以介手太阴、少阴两经之中间。入肘中之曲泽也。
下臂行两筋之间。入掌中。循中指出其端。
由肘中下臂。行臂两筋之间。循 门、间使、内关、大陵入掌中劳宫穴。循中指出其端
之中冲云。
其支别者。从掌中循小指次指出其端。
小指次指。无名指也。自小指而逆数之。则为次指。云其支别者。自掌中劳宫穴别行。
循小指次指出其端。而交于手少阳也。
此经多血少气。戌时气血注此。受足少阴之交。凡九穴。左右共一十八穴。
天池（一名天会） 腋下三寸。乳后一寸。着胁直腋橛肋间。手足厥阴、少阳之会。铜人
。灸
下肿。上气。寒热 疟。
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。膺背胛臂内廉痛。
曲泽 肘内廉下陷中。屈肘得之。心包络脉所入为合。水。铜人。灸三壮。针三分。留
七呼
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 。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
。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。与外关相对。手心主之络。别走少阳。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
烦心。心悬若饥。心痛掌热。喜悲泣惊恐。目赤目黄。小便如血。呕哕无度。狂言不乐。喉
痹口干。身热头痛。短气。胸胁痛。 疮疥癣。东垣曰。胃气下溜。五脏气乱。在于心者。
取之心主之俞大陵。同精导气。以复其本位。
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
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
。小儿龈烂。
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
三焦者。水谷之道路。气之所终始也。上焦者。在心下下鬲。在胃上口。主内而不出。
其治
。其治在脐旁。下焦者。当膀胱上口。主分别清浊。主内而出以传道。其治在脐下一寸。故
名三焦。
三焦者。决渎之官。水道出焉。
滑氏曰。三焦。相火也。火能腐熟水谷。万物焦从火。火亦腐物之气。命名取义。或有
在于
气融会于其间。熏蒸鬲膜。发达皮肤分肉。营运四旁上中下。各随其所属部分而名之。实
元气之别使也。是故虽无其形。倚内外之形而得名。虽无其实。合内外之实而为位者也。
三因方云。古人谓左为肾脏。其腑膀胱。右为命门。其腑三焦。三焦者。有脂膜如手大
。正
。三焦当如此说。有形可见为是。扁鹊乃云。三焦有位无形。而叔和辈失其旨意。遽云无状
有名。俾后学承谬不已。且名以召实。无实奚名。果无其形。尚何藏精系胞为哉。其所谓三
焦者何也。上焦在膻中。内应心。中焦在中脘。内应脾。下焦在脐下。即肾间动气。分布人
身。有上中下之异。方人湛寂。欲想不兴。则精气散在三焦。荣华百脉。及其想念一起。欲
火炽然。翕撮三焦精气流溢。并于命门输泻而去。故号此府为三焦耳。世承叔和之弊而不悟
。可为长太息也。初甚异其说。及为齐从事。（以下医说。载之龙川志。）有一举子徐遁者。
石守道之婿也。少尝医疗病。有精思。曰。齐尝大饥。群丐相脔而食。有一人皮肉尽而骨脉
全者。视其五脏。见右肾之下。有脂膜如手大者。正与膀胱相对。有二白脉。自其中出。夹
脊而上贯脑。意此则导引家所谓夹脊双关者。而不悟脂膜如手大者之为三焦也。所见默合。
可以证古人之谬。
丹溪朱氏曰。三焦以焦。而下焦司肝肾之分。皆阴而主乎下者也。天非此火不能以生物
。人非此火不能以有生。
手厥阴心包络经
手厥阴心包络的经脉，起始于胸中，出来归属于心包络，向下穿过膈肌，依次联络上、中、下三焦。
手厥阴经与足少阴肾经相交接，起始于胸中，出来归属于心包络，由此向下穿过膈肌，依次联络三焦的上脘、中脘部位，以及脐下一寸的下焦部分。
它的分支，沿着胸部出于胁部，下行至腋下三寸处，上行抵达腋下，向下沿上臂内侧运行，行于手太阴肺经和手少阴心经之间，进入肘窝中。
胁部的上际称为腋。从归属于心包络开始，向上沿胸部出于胁部，下行至腋下三寸的天池穴，上行抵达腋下，向下沿上臂内侧的天泉穴运行，位于手太阴肺经和手少阴心经的中间，进入肘中的曲泽穴。
向下沿前臂两筋之间运行，进入手掌中心，沿中指直达其末端。
从肘中向下沿前臂，行于前臂两筋之间，沿郄门、间使、内关、大陵穴进入手掌中心的劳宫穴，沿中指直达其末端的中冲穴。
它的另一分支，从手掌中心分出，沿无名指直达其末端。
无名指即小指旁边的次指。从小指开始逆数，则为次指。所谓分支，是从手掌中心的劳宫穴别行而出，沿无名指直达其末端，并与手少阳三焦经相交会。
这条经脉多血少气，在戌时气血灌注于此。它与足少阴肾经相交接，共有九个穴位，左右两侧共十八个穴位。
天池穴（又名天会）：位于腋下三寸，乳头后方一寸，紧贴胁肋直腋处的肋骨间隙。是手厥阴心包经、手少阳三焦经及足少阳胆经的交会穴。《铜人腧穴针灸图经》记载：主治下部肿胀，上部气逆，寒热往来，疟疾。
天泉穴（又名天湿）：位于曲腋下二寸处，举臂时可取到。《铜人腧穴针灸图经》记载：针深六分，灸三壮。主治视力模糊不明，恶风畏寒，心病，胸胁支撑胀满，咳嗽气逆，胸、背、肩胛及臂内侧疼痛。
曲泽穴：位于肘横纹内侧端凹陷处，屈肘时可取到。为手厥阴心包络脉所入的合穴，五行属水。《铜人腧穴针灸图经》记载：灸三壮，针三分，留针七呼。主治头目清冷汗出不过肩部，伤寒引起的逆气呕吐。
郄门穴：位于掌后腕横纹上五寸，处于手厥阴心包络脉之上。《铜人腧穴针灸图经》记载：针三分，灸五壮。主治呕血、鼻衄，心痛，呕吐呃逆，惊恐畏人，神气不足。
间使穴：位于掌后腕横纹上三寸，两筋之间的凹陷处。为手厥阴心包络脉所行的经穴，五行属金。《素问》注解说：针深六分，留针七呼。《铜人腧穴针灸图经》记载：针深三分。主治呕吐涎沫，恐惧不安，寒邪侵中导致少气，掌心发热，腋肿，肘部挛急，突发心痛，易受惊吓，中风气机闭塞，痰涎上涌致昏危，失音不能言语，咽喉中有异物感，鬼邪作祟，霍乱干呕，妇女月经不调，瘀血结成块状，小儿客忤惊风。
内关穴：位于掌后腕横纹上二寸，两筋之间，与外关穴相对。为手厥阴心包络之络穴，别走手少阳三焦经。《铜人腧穴针灸图经》记载：针五分，灸三壮。主治手部中风热，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；虚证表现为颈项强直，应补法。
大陵穴：位于掌后腕横纹下，两筋之间的凹陷处。为手厥阴心包络脉所注的输穴，五行属土。若心包络实证，应用泻法。《铜人腧穴针灸图经》记载：针五分。主治心烦，心中空虚如饥饿感，心痛，掌心发热，喜欢悲伤哭泣，惊恐，目赤，目黄，小便色如血，频繁呕吐呃逆，胡言乱语，情绪不乐，喉痹口干，身体发热头痛，气短，胸胁痛，疮疡疥癣。李东垣说：若胃气下陷，五脏气机紊乱，影响到心脏的，应取心包络的输穴大陵，通过引导精气以恢复其本位。
劳宫穴（又名五里，又名掌中）：位于手掌中央动脉跳动处。《铜人腧穴针灸图经》记载：屈无名指可取到。《资生经》记载：屈中指可取到。滑寿氏认为：留针六呼。《铜人腧穴针灸图经》记载：灸三壮。《明堂》记载：针二分，得气后立即泻法，只施针一次，若施针超过两次，会导致人体虚弱。禁止艾灸，艾灸会导致息肉增多且日益加重。主治中风，悲笑不止，手部麻痹，热病数日不出汗，恐惧不安，胁痛不可转侧，大小便出血，鼻衄不止，气逆呕吐呃逆烦渴，饮食不下，大小便及口中腥臭，口疮，胸胁支撑胀满，黄疸目黄，小儿牙龈腐烂。
中冲穴：位于手中指末端，距指甲角如韭菜叶宽的凹陷处。为手厥阴心包络脉所出的井穴，五行属木。若心包络虚证，应用补法。《铜人腧穴针灸图经》记载：针三分。
三焦，是水谷运行的道路，也是气终结和起始的地方。上焦，位于心之下、膈肌之上，在胃的上口，主要功能是受纳食物而不排出。其治疗部位在脐以上。下焦，位于膀胱上口，主要功能是分别清浊，受纳糟粕并排出体外以传导。其治疗部位在脐下一寸。因此称为三焦。
滑寿氏说：三焦，属于相火。火能腐熟水谷，万物因火而焦，火也具有腐物的性质。命名取义，或许在于气融会于其间，熏蒸膈膜，发达皮肤肌肉，营运四肢百骸的上、中、下各部，各随其所归属的部分而得名。它实际上是元气的别使。所以虽然无形体，但依托内外形体而得名；虽然无实质脏器，但结合内外实际功能而确立位置。
《三因方》说：古人认为左边是肾脏，其腑为膀胱；右边是命门，其腑为三焦。三焦，有一块像手大的脂膜，正好……（此处原文有缺漏或排版问题，意指对应关系）。三焦应当这样解释，有形可见才是正确的。扁鹊却说三焦有位无形，而王叔和等人误解了其旨意，匆忙说它无形状却有名称，致使后世学者继承谬误不已。况且名是为了召唤实，没有实怎么会有名？如果真的没有形体，还谈什么藏精系胞呢？那所谓的三焦是什么呢？上焦在膻中，内应于心；中焦在中脘，内应于脾；下焦在脐下，即肾间动气，分布于人身，有上、中、下的区别。当人湛然寂静，欲念不起时，精气散在三焦，荣华百脉；等到念头一起，欲火炽盛，翕撮三焦精气流溢，并于命门输泻而去。所以称这个腑为三焦。世人承袭王叔和的弊病而不醒悟，真令人长叹。起初我对这种说法感到奇怪，后来在齐地从事公务时。（以下医说，记载于龙川志。）有一位举子叫徐遁，是石守道的女婿。年轻时曾医疗疾病，有精深的思考。他说：齐地曾经发生大饥荒，一群乞丐互相割肉吃。有一个人皮肉都吃光了，只剩骨骼脉络。观察他的五脏，看到右肾之下，有一块像手大的脂膜，正与膀胱相对，有两根白色脉络，从中发出，夹脊而上贯穿脑部。我想这就是导引家所说的夹脊双关，但没有领悟那块像手大的脂膜就是三焦。我的所见与他默默契合，可以证明古人的谬误。
丹溪朱氏说：三焦以“焦”为名，下焦主管肝肾之分，都属于阴而主司下部。天没有这把火就不能化生万物，人没有这把火就不能生存。
Hand Jueyin Pericardium Meridian
The meridian of Hand Jueyin Pericardium originates in the chest, emerges to connect with the Pericardium (Pericardium), descends through the diaphragm, and successively connects with the Sanjiao (Triple Burner).
The Hand Jueyin meridian intersects with the Foot Shaoyin Kidney meridian. It originates in the chest, emerges to connect with the Pericardium, and from there descends through the diaphragm, successively connecting with the upper epigastrium (Shangwan), middle epigastrium (Zhongwan) areas, and the lower burner area one cun below the umbilicus.
Its branch follows the chest, emerges from 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 meridian and the Hand Shaoyin Heart meridian, entering the elbow fossa.
The upper margin of the hypochondrium is called the axilla. Starting from its connection with the Pericardium, it ascends along the chest, emerges from the hypochondrium, descends three cun below the axilla to the Tianchi (P1) acupoint, ascends to reach the axilla, then descends along the Tianshu (PC2) acupoint on the medial aspect of the arm, positioned between the Hand Taiyin Lung meridian and the Hand Shaoyin Heart meridian, entering the Quze (PC3) acupoint in the center of the elbow.
It descends along the forearm between the two tendons, enters the center of the palm, and follows the middle finger to its tip.
From the elbow fossa, it descends along the forearm, running between the two tendons of the forearm, passing through the Ximen (PC4), Jianshi (PC5), Neiguan (PC6), and Daling (PC7) acupoints, entering the Laogong (PC8) acupoint in the center of the palm, and following the middle finger to its tip at the Zhongchong (PC9) acupoint.
Another branch separates from the center of the palm, follows the ring finger to its tip.
The ring finger is the next finger after the little finger. Counting backwards from the little finger, it is the next finger. This branch separates from the Laogong (PC8) acupoint in the center of the palm, follows the ring finger to its tip, and intersects with the Hand Shaoyang Sanjiao meridian.
This meridian has abundant blood and scarce qi. Qi and blood flow into it during the Xu hour (7-9 PM). It intersects with the Foot Shaoyin Kidney meridian. There are nine acupoints in this meridian, totaling eighteen acupoints on both sides.
Tianchi (P1) (also known as Tianhui): Located three cun below the axilla, one cun posterior to the nipple, in the intercostal space directly under the axilla against the rib. It is the meeting point of the Hand Jueyin Pericardium, Hand Shaoyang Sanjiao, and Foot Shaoyang Gallbladder meridians. *Tongren* records: Treats swelling in the lower body, qi rebellion in the upper body, alternating chills and fever, and malaria.
Tianshu (PC2) (also known as Tianshi): Located two cun below the apex of the axilla when the arm is raised. *Tongren* records: Needle depth six fen, moxa three moxibustions. Treats blurred vision, aversion to wind and cold, heart disease, distending fullness in the chest and hypochondrium, cough with rebellious qi, pain in the chest, back, scapula, and medial aspect of the arm.
Quze (PC3): Located in the depression at the medial end of the transverse cubital crease, obtainable by flexing the elbow. It is the He-Sea point where the Hand Jueyin Pericardium meridian enters, belonging to Water. *Tongren* records: Moxa three moxibustions, needle three fen, retain needle for seven breaths. Treats clear sweat flowing from the head that does not exceed the shoulders, rebellious qi vomiting caused by Cold Damage (Shanghan).
Ximen (PC4): Located five cun proximal to the palmar wrist crease, on the Hand Jueyin Pericardium meridian. *Tongren* records: Needle three fen, moxa five moxibustions. Treats hematemesis, epistaxis, heart pain, vomiting and hiccups, fearfulness and apprehensiveness, insufficiency of spirit qi.
Jianshi (PC5): Located three cun proximal to the palmar wrist crease, in the depression between the two tendons. It is the Jing-River point where the Hand Jueyin Pericardium meridian flows, belonging to Metal. *Suwen* annotations state: Needle depth six fen, retain needle for seven breaths. *Tongren* records: Needle depth three fen. Treats vomiting of saliva, fearfulness and apprehensiveness, qi insufficiency due to cold invading the interior, heat in the palms, axillary swelling, elbow contracture, sudden heart pain, susceptibility to fright, stroke with qi blockage, phlegm salivary fluid rising causing dizziness and danger, aphasia inability to speak, sensation of a lump in the throat, demonic influences, cholera with dry retching, irregular menstruation in women, blood stasis forming masses, pediatric Ke Wu (fright syndrome).
Neiguan (PC6): Located two cun proximal to the palmar wrist crease, between the two tendons, opposite Waiguan. It is the Luo-Connecting point of the Hand Jueyin Pericardium meridian, diverging to the Hand Shaoyang Sanjiao meridian. *Tongren* records: Needle five fen, moxa three moxibustions. Treats wind-heat in the hands, loss of will, heart pain, red eyes, distending fullness and elbow contracture. Excess patterns manifest as sudden severe heart pain; treat with draining method. Deficiency patterns manifest as neck stiffness; treat with tonifying method.
Daling (PC7): Located in the depression between the two tendons, distal to the styloid process of the radius at the palmar wrist crease. It is the Shu-Stream point where the Hand Jueyin Pericardium meridian pours, belonging to Earth. For excess patterns of the Pericardium, use the draining method. *Tongren* records: Needle five fen. Treats vexation, feeling of emptiness in the heart like hunger, heart pain, heat in the palms, propensity to weep and cry, fear and fright, red eyes, jaundice with yellow eyes, urine resembling blood, frequent vomiting and hiccups, delirious speech, unhappiness, bi obstruction of the throat, dry mouth, feverish body and headache, shortness of breath, chest and hypochondriac pain, sores, tinea versicolor, and tinea. Li Dongyuan stated: If stomach qi sinks and the qi mechanism of the five zang organs becomes disordered affecting the heart, select the Shu-Stream point of the Heart Master (Pericardium), Daling, to guide essence and conduct qi to restore its original position.
Laogong (PC8) (also known as Wuli, also known as Zhangzhong): Located at the arterial pulse in the center of the palm. *Tongren* records: Obtain by flexing the ring finger. *Zisheng* records: Obtain by flexing the middle finger. Hua Shi (Hua Shou) states: Retain needle for six breaths. *Tongren* records: Moxa three moxibustions. *Mingtang* records: Needle two fen, drain immediately upon obtaining Deqi. Perform only once; if needled more than twice, it causes weakness. Moxibustion is prohibited; moxibustion leads to increased polyps daily. Treats stroke, incessant sadness and laughter, hand numbness, febrile diseases with no sweat after several days, fearfulness, hypochondriac pain preventing turning, bleeding in stool and urine, persistent epistaxis, rebellious qi with vomiting, hiccups, vexation, and thirst, inability to eat or drink, foul odor from stool, urine, and mouth, mouth ulcers, distending fullness in the chest and hypochondrium, jaundice with yellow eyes, pediatric gingival rot.
Zhongchong (PC9): Located in the depression at the tip of the middle finger of the hand, approximately the width of a leek leaf from the corner of the nail. It is the Jing-Well point where the Hand Jueyin Pericardium meridian exits, belonging to Wood. For deficiency patterns of the Pericardium, use the tonifying method. *Tongren* records: Needle three fen.
The Sanjiao (Triple Burner) is the pathway for water and grain, and the beginning and end of qi. The Upper Burner is located below the heart and above the diaphragm, at the upper opening of the stomach. Its main function is to receive but not discharge. Its treatment area is above the umbilicus. The Lower Burner is located at the upper opening of the bladder. Its main function is to separate the clear from the turbid, receiving waste and discharging it for transmission. Its treatment area is one cun below the umbilicus. Hence it is named Sanjiao.
The Sanjiao is the official responsible for irrigation, from which water passages emerge.
Hua Shou stated: The Sanjiao belongs to Ministerial Fire. Fire can cook and ripen water and grain; all things become scorched by fire, and fire also possesses the quality of decomposing matter. The naming takes meaning perhaps from qi merging within it, steaming the diaphragm, developing the skin and muscles, circulating around the four extremities and the upper, middle, and lower parts, each named according to its respective part. It is actually the special envoy of Yuan Qi (Original Qi). Therefore, although it has no form, it is named relying on internal and external forms; although it lacks substantial organ reality, it establishes its position by combining internal and external realities.
*San Yin Fang* states: The ancients believed the left side was the Kidney, its fu organ being the Bladder; the right side was the Mingmen (Gate of Life), its fu organ being the Sanjiao. The Sanjiao has a fatty membrane about the size of a hand... [text fragment]. The Sanjiao should be explained thusly; having visible form is correct. Bian Que claimed the Sanjiao has location but no form, and Wang Shuhe and others misunderstood its purport, hastily stating it has name but no shape, causing later scholars to perpetuate errors endlessly. Moreover, names summon realities; without reality, how can there be a name? If it truly had no form, what would there be to store essence and bind the uterus? What then is this so-called Sanjiao? The Upper Burner is in the Danzhong area, internally corresponding to the Heart; the Middle Burner is in the Zhongwan area, internally corresponding to the Spleen; the Lower Burner is below the umbilicus, namely the moving qi between the kidneys, distributed throughout the body, differing in upper, middle, and lower sections. When a person is tranquil and silent, without arising desires, essence and qi scatter in the Sanjiao, flourishing the hundred vessels; when thoughts arise and desire-fire blazes, compressing the essence and qi of the Sanjiao to overflow and flow out via the Mingmen, hence this fu organ is called Sanjiao. The world inherits Wang Shuhe's弊端 (flaws) without awakening, truly worthy of long sighs. Initially, I found this theory strange. Later, while serving in Qi... [medical theories follow, recorded in Longchuan Zhi]. A scholar named Xu Dun, son-in-law of Shi Shoudao, who had medical experience in his youth and profound thought, said: "Qi once suffered great famine, and beggars ate each other's flesh. One person had all skin and flesh eaten, leaving only bones and meridians. Observing his five zang organs, I saw below the right kidney a fatty membrane about the size of a hand, exactly opposite the bladder, with two white meridians emerging from it, ascending along the spine and penetrating the brain. I thought this was what Dao Yin practitioners call the double pass of the spine, but did not realize that the fatty membrane about the size of a hand was the Sanjiao. My observations silently coincided, proving the error of the ancients."
Zhu Danxi stated: The Sanjiao is named 'scorched' because the Lower Burner governs the divisions of the Liver and Kidney, both yin governing the lower part. Heaven cannot generate living things without this fire; humans cannot have life without this fire.