六十七难曰∶五脏募皆在阴,而俞在阳者,何谓也?
然∶阴病行阳,阳病行阴,
故云募在阴,俞在阳。
募,音幕,经气结聚处也。俞,输转之义。经气由此而输于彼也。五脏之募皆在腹,肺之募,
中府二穴,在胸博云门下,同身寸之一寸,乳上三肋间动脉陷中,属本经。心之募,巨阙一穴,
在鸠尾下,同身寸之一寸,属任脉。脾之募,章门二穴,在大横外直脐端,属肝经。肝之募,
期门二穴,在不容两旁,各同身寸之一寸五分,直乳第二肋端,属本经。肾之募,京门二穴,
在监骨腰中,挟脊季胁下,属胆经。五脏之俞皆在背,肺俞在第三椎之下,心俞在五椎之下,
肝俞在九椎之下,脾俞在十一椎之下,肾俞在十四椎之下,又有膈俞者,在七椎之下,皆挟脊
两旁,各同身寸之一寸五分,总属足太阳经也。阴病行阳,阳病行阴者,背为阳,腹为阴。俞
在于背,俞者,脏中阴气之所输也,是以阴病行于阳也。募在于腹,募者,脏中阳气之所结也,
是以阳病行于阴也。以见阴阳经络,气相交贯,脏腑腹背,气相通应,故其病气之结聚输转之
处,交相会也。经曰∶从阳引阴,从阴引阳,即此义也。
按∶《内经》六腑亦有募有俞,不独五脏为然也。此章明脏腑阴阳之气,交相通贯,言五脏
而不及六腑者,省文也。胃之募,中脘一穴,在脐上,同身寸之四寸,属任脉。大肠募,天枢
二穴,在肓俞旁,同身寸之一寸五分,挟脐二寸,属胃经。小肠募,关元一穴,在脐下,同身
寸之三寸,属任脉。胆募,日月二穴,在期门下,同身寸之五分,直乳第二肋下,属本经。膀
胱募,中极一穴,在脐下,同身寸之二寸三分,属任脉。三焦募,在脐下,同身寸之二寸,属
任脉。此六腑之募,亦皆在腹。胃俞在十二椎之间,大肠俞在十六椎之间,小肠俞在十八椎之
间,胆之俞在十椎之间,膀胱俞在十九椎之间,三焦俞在十三椎之间。又有心包俞在四椎之间,
亦俱挟脊两旁,各同身寸之一寸五分,属足太阳经也。观阴阳募俞并举为言,则非独指五脏明
矣,故补注之。
第六十七难问道:五脏的募穴都在阴面(腹部),而俞穴都在阳面(背部),这是什么意思呢?
回答说:阴经的病邪会运行到阳经,阳经的病邪会运行到阴经,所以说募穴在阴面,俞穴在阳面。
“募”读音同“幕”,是经气结聚的地方。“俞”是输转的意思,经气从这里输注到那里。五脏的募穴都在腹部:肺的募穴是中府穴(左右各一),位于胸壁云门穴下方一寸处,乳头上方第三肋间隙动脉搏动处的凹陷中,属于肺本经。心的募穴是巨阙穴(一个),位于鸠尾穴下方一寸处,属于任脉。脾的募穴是章门穴(左右各二),位于大横穴外侧,与脐端平齐处,属于肝经。肝的募穴为期门穴(左右各二),位于不容穴两旁,各距中线一寸五分,正对乳头第二肋骨端,属于肝本经。肾的募穴是京门穴(左右各二),位于季胁部的监骨(髂骨)腰部中间,挟持脊柱两侧,属于胆经。五脏的俞穴都在背部:肺俞穴在第三椎骨下方,心俞穴在第五椎骨下方,肝俞穴在第九椎骨下方,脾俞穴在第十一椎骨下方,肾俞穴在第十四椎骨下方。另外还有膈俞穴,在第七椎骨下方,都挟持脊柱两旁,各距中线一寸五分,总属于足太阳膀胱经。所谓“阴病行阳,阳病行阴”,是指背部为阳,腹部为阴。俞穴位于背部,俞穴是脏中阴气所输注之处,所以阴病会反映在阳面。募穴位于腹部,募穴是脏中阳气所结聚之处,所以阳病会反映在阴面。由此可见,阴阳经络之气相互贯通,脏腑的腹背之气相互应和,因此病气的结聚和输转之处,会相互交会。经文说:“从阳引阴,从阴引阳”,就是这个道理。
按语:《黄帝内经》中六腑也有募穴和俞穴,并不只是五脏如此。这一章阐明脏腑阴阳之气交相通贯的道理,只言五脏而不提六腑,是为了文字简省。胃的募穴是中脘穴(一个),位于脐上四寸处,属于任脉。大肠的募穴是天枢穴(左右各二),位于肓俞穴旁,距中线一寸五分,挟脐两侧各二寸处,属于胃经。小肠的募穴是关元穴(一个),位于脐下三寸处,属于任脉。胆的募穴是日月穴(左右各二),位于期门穴下方五分处,正对乳头第二肋骨下,属于胆本经。膀胱的募穴是中极穴(一个),位于脐下二寸三分处,属于任脉。三焦的募穴位于脐下二寸处,属于任脉。这六腑的募穴也都位于腹部。胃俞穴在第十二椎骨之间,大肠俞穴在第十六椎骨之间,小肠俞穴在第十八椎骨之间,胆俞穴在第十椎骨之间,膀胱俞穴在第十九椎骨之间,三焦俞穴在第十三椎骨之间。另外心包络的俞穴在第四椎骨之间,也都挟持脊柱两旁,各距中线一寸五分,属于足太阳膀胱经。观察阴阳募穴和俞穴并列论述的情况,就知道这里并非仅指五脏,因此补充注释于此。
Difficulty 67 states: The Mu (Alarm) points of the Five Zang organs are all located on the Yin aspect, while the Shu (Transport) points are on the Yang aspect. What is the meaning of this?
It is answered: Pathogenic factors from Yin meridians travel to Yang meridians, and those from Yang meridians travel to Yin meridians. Therefore, it is said that Mu points are on the Yin aspect, and Shu points are on the Yang aspect.
"Mu" (pronounced like "mù"), refers to the area where meridian Qi gathers. "Shu" implies the meaning of transporting or transferring; meridian Qi is transported from here to there. The Mu points of the Five Zang organs are all located on the abdomen:
The Mu point of the Lung is Zhongfu (LU-1), one pair of acupoints, located below Yunmen (LU-2) on the chest wall, one Cun (using the patient's body measurement) down, in the depression of the pulsating artery between the third rib above the nipple, belonging to the Lung meridian itself.
The Mu point of the Heart is Jueque (CV-14), a single acupoint, located one Cun below Jiutui (CV-15), belonging to the Ren Mai (Conception Vessel).
The Mu point of the Spleen is Zhangmen (LR-13), two acupoints, located lateral to Dahan (SP-15), level with the umbilicus, belonging to the Liver meridian.
The Mu point of the Liver is Qimen (LR-14), two acupoints, located on both sides of Burong (ST-19), each 1.5 Cun from the midline, directly at the end of the second rib corresponding to the nipple, belonging to the Liver meridian itself.
The Mu point of the Kidney is Jingmen (GB-25), two acupoints, located in the lumbar region of the iliac bone (Jian gu) among the costal margin, flanking the spine, belonging to the Gallbladder meridian.
The Shu points of the Five Zang organs are all located on the back: Feishu (BL-13) is below the third thoracic vertebra; Xinshu (BL-15) is below the fifth thoracic vertebra; Ganshu (BL-18) is below the ninth thoracic vertebra; Pishu (BL-20) is below the eleventh thoracic vertebra; Shenshu (BL-23) is below the fourteenth thoracic vertebra. Additionally, Ge Shu (BL-17) is below the seventh thoracic vertebra. All these flank the spine, each 1.5 Cun from the midline, and collectively belong to the Foot-Taiyang Bladder Meridian.
When it says "Yin disease travels to Yang, Yang disease travels to Yin," it means the back is Yang and the abdomen is Yin. Shu points are on the back; they are the places where Yin Qi of the Zang organs is transported, hence Yin diseases manifest on the Yang aspect. Mu points are on the abdomen; they are the places where Yang Qi of the Zang organs gathers, hence Yang diseases manifest on the Yin aspect. This demonstrates that the Qi of Yin and Yang meridians interpenetrates each other, and the Qi of the Zang-Fu organs' anterior and posterior aspects corresponds to each other. Thus, the sites where pathogenic Qi gathers and transports intersect. As the Classic states: "Draw Yin from Yang, draw Yang from Yin," this is the principle involved.
Note: In the *Nei Jing* (Inner Canon), the Six Fu organs also have Mu and Shu points, not just the Five Zang organs. This chapter clarifies the mutual connection and penetration of Yin and Yang Qi of the Zang and Fu organs. It mentions only the Five Zang organs and omits the Six Fu organs for brevity.
The Mu point of the Stomach is Zhongwan (CV-12), a single acupoint, located four Cun above the umbilicus, belonging to the Ren Mai.
The Mu point of the Large Intestine is Tianshu (ST-25), two acupoints, located beside Huangshu (KI-16), 1.5 Cun from the midline, two Cun flanking the umbilicus, belonging to the Stomach meridian.
The Mu point of the Small Intestine is Guanyuan (CV-4), a single acupoint, located three Cun below the umbilicus, belonging to the Ren Mai.
The Mu point of the Gallbladder is Riyue (GB-24), two acupoints, located below Qimen (LR-14), 0.5 Cun down, directly below the second rib corresponding to the nipple, belonging to the Gallbladder meridian itself.
The Mu point of the Urinary Bladder is Zhongji (CV-3), a single acupoint, located 2.3 Cun below the umbilicus, belonging to the Ren Mai.
The Mu point of the Sanjiao (Triple Burner) is located two Cun below the umbilicus, belonging to the Ren Mai.
These Mu points of the Six Fu organs are also all located on the abdomen.
Weishu (BL-21) is between the twelfth thoracic vertebrae; Dachangshu (BL-25) is between the sixteenth thoracic vertebrae; Xiaochangshu (BL-27) is between the eighteenth thoracic vertebrae; Danshu (BL-19) is between the tenth thoracic vertebrae; Pangguangshu (BL-28) is between the nineteenth thoracic vertebrae; Sanjiaoshu (BL-22) is between the thirteenth thoracic vertebrae. Additionally, Xinbaoshu (BL-14) is between the fourth thoracic vertebrae. All these flank the spine, each 1.5 Cun from the midline, and belong to the Foot-Taiyang Bladder Meridian. Observing that Yin and Yang Mu and Shu points are discussed together, it is clear that this does not refer exclusively to the Five Zang organs. Therefore, supplementary notes are added.