(此图明其经络始终五脏六腑之原。)
手厥阴心包络之经。起于中冲穴。在手中指之端。去爪甲角如韭叶是也。终于天池穴。在腋下乳后一寸。着胁肋间
是也。
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手太阴肺之经。起于少商穴。在手大指内侧。去爪甲角如韭叶是也。终于中府穴。在云门下一寸乳上三肋间是也。
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手阳明大肠之经起于商阳穴。在手大指次指之侧。去爪甲角如韭叶是也。终于迎香穴。在鼻孔旁禾 上是也。
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手太阳小肠之经。起于少泽穴。在手小指之端。去爪甲下一分是也。终于听宫穴。在耳内珠子上是也。
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手少阳三焦之经。起于关冲穴。在手小指次指之侧。去爪甲角如韭叶是也。终于耳门穴。在耳前起肉缺者是也。
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手少阴真心之经。起于少冲穴。在手小指内侧。去爪甲角如韭叶是也。终于极泉穴。在腋下筋间动脉是也。
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灵枢经曰。少阴独无俞者不病乎。言外经病而脏不病也。是治外不治内也。故少阴真心应君火之位。故不治内而治外也。
足厥阴肝之经。起于大敦穴。在足大指之端。去爪甲角如韭叶是也。终于期门穴。在不容旁一寸五分二肋端是也。
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足阳明胃之经。起于厉兑穴。在足大指次指之端。去爪甲角如韭叶是也。终于头维穴。在面五行额角发际本神旁一
寸五分是也。
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足太阳膀胱之经。起于睛明穴。在目内 泪孔边是也。终于至阴穴。在足小指外侧去爪甲角如韭叶是也。
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足少阴肾之经。起于涌泉穴。在足心陷中。屈足卷指宛宛中是也。终于俞府穴。在璇玑旁二寸巨骨下是也。
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足少阳胆之经。起于窍阴穴。在足小指次指之端。去爪甲角如韭叶是也。终于瞳子 穴。在目外 五分是也。
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足太阴脾之经。起于隐白穴。在足大指内侧之间。去爪甲角如韭叶是也。终于大包穴。在渊腋下三寸九肋间是也。
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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。放令募在阴。俞在阳。
丁曰。人背为阳。腹为阴。是言五脏俞皆在阳者。背俞也。故肺俞二穴。在第三椎下两旁。相去同身寸之一寸五分
是也。心俞二穴。在第五椎下两旁、相去同身寸之一寸五分是也。肝俞二穴。在第九椎下两旁。相去同身寸之一寸五分
是也。脾俞二穴。在第十一椎下两旁。相去同身寸之一寸五分是也。肾俞二穴。在第十四椎下两旁。相去同身寸之一寸
五分是也。肺之募。中府二穴。在云门下一寸乳上三肋间是也。心之募。巨阙一穴。在鸠尾下一寸是也。脾之募。章门
二穴。在季胁下直齐是也。肝之募。期门二穴。在不容两旁一寸五分是也。肾之募。京门二穴。在腰中季胁本是也。杨
曰。腹为阴。五脏之募皆在腹。故云募皆在阴。背为阳。五脏之俞皆在背。故云俞皆在阳。五内有病。则出行于阳。阳
俞在背也。外体有病。则入行于阴。阴募在腹也。故针法云。从阳引阴。从阴引阳。此之谓也。
六十八难曰。五脏六腑。各有井荥俞经合。皆何所主。然。经言所出为井。所流为荥。所注为俞。所行为经。所应
为合。井主心下满。
吕曰。井者木。木者肝。肝主满也。虞曰。井法木以应肝脾。位在心下。今邪在肝。肝乘脾。故心下满。今治之于
井。不令木乘土也。
荥主身热。
吕曰。荥者火。火者心。心主身热也。虞曰。荥为火以法心。肺属金。外主皮毛。今心火灼于肺金。故身热。谓邪
在心也。故治之于荥。不令火乘金。则身热必愈也。
俞主体重节痛。
吕曰。俞者土。土者脾。脾主体重也。虞曰。俞者。法土应脾。今邪在土。土必刑水。水者肾。肾主骨。故病则节
痛。邪在土。土自病则体重。宜治于俞穴。
经主喘咳寒热。
吕曰。经者金。金主肺。肺主寒热也。虞曰。经法金应肺。今邪在经。则肺为病。得寒则咳。得热则喘。今邪在金。
金必刑木。木者肝。肝在志为怒。怒则气逆乘肺。故喘。何以然。谓肝之支别。从肝别贯膈上注肺。脉要精微论曰。血
在胁下。令人喘逆。此之谓也。治之于经。则金不刑于木矣。
合主逆气而泄。
吕曰。合者水。水主肾。肾主泄也。虞曰。合法水应肾。肾气不足。伤于冲脉。则气逆而里急。肾主开窍于二阴。
肾气不禁。故泄注。邪在水。水必乘火。火者心。法不受病。肝木为心火之母。为肾水之子,一忧母受邪。二忧子被刑。
肝在志为怒。忧则怒。怒则气逆。故也。此五行更相乘克。故病有异同。今治之于合。不令。水乘火。则肝木不忧。故
气逆止。邪不在肾。则无注泄。以上井荥俞经合。法五行应五脏。邪凑其中。故主病如是。善诊者审而行之。则知自病。
或相乘虚则补之。实则泻之。
此五脏六腑。其井荥俞经合所主病也。
丁曰。此是五脏井荥俞经合也。经言井主心下满者为肝病。即逆满。当取其诸井以主其心下满也。荥主身热者。荥
者、火也。故身热。当取其诸荥以主其热也。俞主体重节痛。俞者、土也。故令体重节痛。当取其诸俞以主其体重节痛
也。经主喘咳寒热。经者、金也。故喘咳而发寒热。当取其诸经以主其喘咳寒热也。合主逆气而泄。合为水。水主泄。
当取其诸合以主逆气而泄也。虞曰。以上井荥俞经合之生病。各根据其时而调治之。谓四时之邪。各凑荥俞中留止也。
(此图阐明经络始终与五脏六腑的原气。)
手厥阴心包络之经。起始于中冲穴。位于手中指末端。距离指甲角如韭菜叶宽度处。终止于天池穴。位于腋下乳后一寸。附着于胁肋之间。
手太阴肺之经。起始于少商穴。位于手大拇指内侧。距离指甲角如韭菜叶宽度处。终止于中府穴。位于云门下一寸,乳房上方第三肋骨间。
手阳明大肠之经起始于商阳穴。位于手食指侧边。距离指甲角如韭菜叶宽度处。终止于迎香穴。位于鼻孔旁禾髎穴处。
手太阳小肠之经。起始于少泽穴。位于手小指末端。距离指甲下方一分处。终止于听宫穴。位于耳内珠子上方。
手少阳三焦之经。起始于关冲穴。位于手小指次指(无名指)侧边。距离指甲角如韭菜叶宽度处。终止于耳门穴。位于耳前隆起肌肉凹陷处。
手少阴真心之经。起始于少冲穴。位于手小指内侧。距离指甲角如韭菜叶宽度处。终止于极泉穴。位于腋下筋脉间的动脉处。
《灵枢经》说:少阴经唯独没有俞穴吗?这是指外经有病而内脏无病。所以治疗外部而不治疗内部。因此少阴真心对应君火之位,所以不治内而治外。
足厥阴肝之经。起始于大敦穴。位于足大拇指末端。距离指甲角如韭菜叶宽度处。终止于期门穴。位于不容穴旁一寸五分,第二肋骨端处。
足阳明胃之经。起始于厉兑穴。位于足第二趾末端。距离指甲角如韭菜叶宽度处。终止于头维穴。位于面部五行额角发际本神穴旁一寸五分处。
足太阳膀胱之经。起始于睛明穴。位于目内眦泪孔边。终止于至阴穴。位于足小指外侧,距离指甲角如韭菜叶宽度处。
足少阴肾之经。起始于涌泉穴。位于足心凹陷中。屈足卷指宛宛中央处。终止于俞府穴。位于璇玑穴旁二寸,巨骨穴下。
足少阳胆之经。起始于窍阴穴。位于足小指次趾(第四趾)末端。距离指甲角如韭菜叶宽度处。终止于瞳子髎穴。位于目外眦五分处。
足太阴脾之经。起始于隐白穴。位于足大拇指内侧缝间。距离指甲角如韭菜叶宽度处。终止于大包穴。位于渊腋穴下三寸,第九肋骨间。
第六十七难问:五脏的募穴都在阴面,而俞穴在阳面,这是什么意思?回答说:阴病行于阳,阳病行于阴,所以令募在阴,俞在阳。
丁氏说:人背为阳,腹为阴,这是说五脏俞穴都在阳面,即背俞穴。所以肺俞两穴,在第三椎下两旁,相距同身寸一寸五分。心俞两穴,在第五椎下两旁,相距同身寸一寸五分。肝俞两穴,在第九椎下两旁,相距同身寸一寸五分。脾俞两穴,在第十一椎下两旁,相距同身寸一寸五分。肾俞两穴,在第十四椎下两旁,相距同身寸一寸五分。肺之募穴,中府两穴,在云门下一寸,乳房上方第三肋骨间。心之募穴,巨阙一穴,在鸠尾下一寸。脾之募穴,章门两穴,在季胁下直对脐部。肝之募穴,期门两穴,在不容穴两旁一寸五分。肾之募穴,京门两穴,在腰中季胁本处。杨氏说:腹为阴,五脏之募皆在腹部,所以说募皆在阴。背为阳,五脏之俞皆在背部,所以说俞皆在阳。内脏有病,则邪气出行于阳(背俞)。体表有病,则邪气入行于阴(腹募)。所以针灸法说:从阳引阴,从阴引阳,说的就是这个道理。
第六十八难问:五脏六腑,各有井、荥、俞、经、合五穴,各主治什么病症?回答说:经文说所出为井,所流为荥,所注为俞,所行为经,所应为合。井主心下满。
吕氏说:井属木,木对应肝,肝主满证。虞氏说:井法象木以应肝脾,位置在心下。现在邪气在肝,肝乘脾,所以心下满。现在治疗井穴,不让木乘土。
荥主身热。
吕氏说:荥属火,火对应心,心主身热。虞氏说:荥为火以法象心。肺属金,外主皮毛。现在心火灼烧肺金,所以身热。这是邪气在心。所以治疗荥穴,不让火乘金,那么身热必愈。
吕氏说:俞属土,土对应脾,脾主身体沉重。虞氏说:俞法象土应脾。现在邪气在土,土必克水。水是肾,肾主骨,所以生病则关节痛。邪气在土,土自病则身体沉重,适宜治疗俞穴。
吕氏说:经属金,金主肺,肺主寒热。虞氏说:经法象金应肺。现在邪气在经,则肺为病,受寒则咳,受热则喘。现在邪气在金,金必克木。木是肝,肝在志为怒,怒则气逆乘肺,所以喘。为什么这样?因为肝的支别,从肝别出贯穿膈肌上注于肺。《脉要精微论》说:血在胁下,令人喘逆,说的就是这个道理。治疗经穴,则金不克木了。
吕氏说:合属水,水主肾,肾主泄泻。虞氏说:合法象水应肾。肾气不足,伤于冲脉,则气逆而里急。肾主开窍于二阴,肾气不禁,所以泄泻。邪气在水,水必乘火。火是心,法不受病。肝木为心火之母,为肾水之子,一忧母受邪,二忧子被刑。肝在志为怒,忧则怒,怒则气逆,所以如此。这是五行更相乘克,所以病有异同。现在治疗合穴,不让水乘火,则肝木不忧,所以气逆止。邪不在肾,则无泄注。以上井、荥、俞、经、合,法象五行应五脏。邪气凑集其中,所以主治病症如上。善于诊察的人审察而行,就知道是自病,或是相乘虚则补之,实则泻之。
这是五脏六腑其井、荥、俞、经、合所主治的病症。
丁氏说:这是五脏井、荥、俞、经、合。经文说井主心下满的是肝病,即逆满,应当取诸井穴来主治心下满。荥主身热者,荥属火,所以身热,应当取诸荥穴来主治热。俞主体重节痛,俞属土,所以令体重节痛,应当取诸俞穴来主治体重节痛。经主喘咳寒热,经属金,所以喘咳而发寒热,应当取诸经穴来主治喘咳寒热。合主逆气而泄,合属水,水主泄,应当取诸合穴来主治逆气而泄。虞氏说:以上井、荥、俞、经、合所生之病,各根据其时而调治之。谓四时之邪,各凑集于荥、俞中留止也。
(This diagram clarifies the beginning and end of the meridians and the source of the five zang organs and six fu organs.)
The Pericardium Meridian of Hand-Jueyin starts at Zhongchong (Zhongchong, PC9). It is located at the tip of the middle finger of the hand, at a distance from the corner of the nail like the width of a leek leaf. It ends at Tianchi (Tianchi, PC1), which is located one cun behind the nipple in the axilla, attached to the intercostal space of the ribs.
The Lung Meridian of Hand-Taiyin starts at Shaoshang (Shaoshang, LU11). It is located on the medial side of the thumb of the hand, at a distance from the corner of the nail like the width of a leek leaf. It ends at Zhongfu (Zhongfu, LU1), which is located one cun below Yunmen, in the third intercostal space above the breast.
The Large Intestine Meridian of Hand-Yangming starts at Shangyang (Shangyang, LI1). It is located on the lateral side of the index finger, at a distance from the corner of the nail like the width of a leek leaf. It ends at Yingxiang (Yingxiang, LI20), which is located beside the nostril at the Heliao point.
The Small Intestine Meridian of Hand-Taiyang starts at Shaoze (Shaoze, SI1). It is located at the tip of the little finger of the hand, one fen below the nail. It ends at Tinggong (Tinggong, SI19), which is located inside the ear above the tragus.
The Sanjiao Meridian of Hand-Shaoyang starts at Guanchong (Guanchong, SJ1). It is located on the lateral side of the ring finger, at a distance from the corner of the nail like the width of a leek leaf. It ends at Ermen (Ermen, SJ21), which is located in the depression of the protruding muscle anterior to the ear.
The Heart Meridian of Hand-Shaoyin starts at Shaochong (Shaochong, HT9). It is located on the medial side of the little finger of the hand, at a distance from the corner of the nail like the width of a leek leaf. It ends at Jiquan (Jiquan, HT1), which is located in the artery between the tendons in the axilla.
The Ling Shu Jing states: "Does the Shaoyin meridian alone have no Shu points? Does it mean disease?" This refers to external meridian disease without internal organ disease. Therefore, treatment focuses on the exterior rather than the interior. Thus, the true Heart corresponds to the position of Ministerial Fire, so it treats the exterior rather than the interior.
The Liver Meridian of Foot-Jueyin starts at Dadun (Dadun, LR14). It is located at the tip of the big toe of the foot, at a distance from the corner of the nail like the width of a leek leaf. It ends at Qimen (Qimen, LR14), which is located 1.5 cun lateral to Burong, at the end of the second rib.
The Stomach Meridian of Foot-Yangming starts at Lidui (Lidui, ST45). It is located at the tip of the second toe of the foot, at a distance from the corner of the nail like the width of a leek leaf. It ends at Touwei (Touwei, ST8), which is located 1.5 cun lateral to Benshen at the hairline of the frontal temple.
The Bladder Meridian of Foot-Taiyang starts at Jingming (Jingming, BL1). It is located beside the inner canthus tear duct. It ends at Zhiyin (Zhiyin, BL67), which is located on the lateral side of the little toe of the foot, at a distance from the corner of the nail like the width of a leek leaf.
The Kidney Meridian of Foot-Shaoyin starts at Yongquan (Yongquan, KI1). It is located in the depression of the sole of the foot, in the center where the foot is flexed and toes are curled. It ends at Shufu (Shufu, KI27), which is located two cun lateral to Xuanji, below Jugu.
The Gallbladder Meridian of Foot-Shaoyang starts at Tonggu (Tonggu, GB44). It is located at the tip of the fourth toe of the foot, at a distance from the corner of the nail like the width of a leek leaf. It ends at Tongziliao (Tongziliao, GB1), which is located five fen lateral to the outer canthus of the eye.
The Spleen Meridian of Foot-Taiyin starts at Yinbai (Yinbai, SP1). It is located in the medial aspect of the big toe of the foot, at a distance from the corner of the nail like the width of a leek leaf. It ends at Dabao (Dabao, SP21), which is located three cun below Yuanye, in the ninth intercostal space.
Difficulty 67 asks: The Mu points of the five zang organs are all on the yin side, while the Shu points are on the yang side. What does this mean? The answer is: Yin diseases travel to yang, and yang diseases travel to yin; thus, Mu points are on the yin side and Shu points are on the yang side.
Mr. Ding says: The back is yang, and the abdomen is yin. This means that the Shu points of the five zang organs are all on the yang side, i.e., the Back-Shu points. Therefore, Fei Shu (BL13) consists of two points, located bilaterally one cun and five fen lateral to the lower border of the third thoracic vertebra, using the same-body cun method. Xin Shu (BL15) consists of two points, located bilaterally one cun and five fen lateral to the lower border of the fifth thoracic vertebra. Gan Shu (BL18) consists of two points, located bilaterally one cun and five fen lateral to the lower border of the ninth thoracic vertebra. Pi Shu (BL20) consists of two points, located bilaterally one cun and five fen lateral to the lower border of the eleventh thoracic vertebra. Shen Shu (BL23) consists of two points, located bilaterally one cun and five fen lateral to the lower border of the fourteenth thoracic vertebra. The Mu point of the Lung is Zhongfu (LU1), consisting of two points, located one cun below Yunmen, in the third intercostal space above the breast. The Mu point of the Heart is Juque (CV14), one point located one cun below Jiutui. The Mu point of the Spleen is Zhangmen (LR13), consisting of two points, located directly opposite the umbilicus under the costal margin. The Mu point of the Liver is Qimen (LR14), consisting of two points, located 1.5 cun bilateral to Burong. The Mu point of the Kidney is Jingmen (GB25), consisting of two points, located at the root of the costal margin in the waist. Mr. Yang says: The abdomen is yin, and the Mu points of the five zang organs are all in the abdomen; hence, it is said that Mu points are all on the yin. The back is yang, and the Shu points of the five zang organs are all on the back; hence, it is said that Shu points are all on the yang. When internal organs are diseased, pathogens travel out to the yang (Back-Shu). When the external body is diseased, pathogens travel in to the yin (Abdominal-Mu). Therefore, the acupuncture method states: "Draw yin from yang, draw yang from yin." This is what is meant.
Difficulty 68 asks: The five zang organs and six fu organs each have Jing-River-Shu-Stream-He-Sea points. What do they primarily govern? The answer is: The classics state that what flows out is Jing, what flows is Ying, what pours is Shu, what travels is Jing, and what enters is He. Jing governs fullness in the epigastrium.
Mr. Lv says: Jing corresponds to Wood, and Wood corresponds to the Liver. The Liver governs fullness. Master Yu says: Jing follows Wood to correspond to the Liver and Spleen. The location is in the epigastrium. Now the pathogen is in the Liver, and the Liver overacts on the Spleen, causing epigastric fullness. Treating the Jing points prevents Wood from overacting on Earth.
Ying governs fever of the body.
Mr. Lv says: Ying corresponds to Fire, and Fire corresponds to the Heart. The Heart governs body fever. Master Yu says: Ying is Fire following the Heart. The Lung belongs to Metal and externally governs skin and hair. Now Heart Fire scorches Lung Metal, causing body fever. This indicates the pathogen is in the Heart. Treating Ying points prevents Fire from overacting on Metal, so body fever will surely heal.
Shu governs heaviness of the body and pain in the joints.
Mr. Lv says: Shu corresponds to Earth, and Earth corresponds to the Spleen. The Spleen governs body heaviness. Master Yu says: Shu follows Earth to correspond to the Spleen. Now the pathogen is in Earth, and Earth must overcome Water. Water is the Kidney, which governs bones; thus, disease causes joint pain. If the pathogen is in Earth, Earth itself becomes diseased causing body heaviness. It is appropriate to treat Shu points.
Jing governs wheezing, coughing, aversion to cold, and fever.
Mr. Lv says: Jing corresponds to Metal, and Metal governs the Lung. The Lung governs aversion to cold and fever. Master Yu says: Jing follows Metal to correspond to the Lung. Now the pathogen is in Jing, causing Lung disease. Cold induces cough, heat induces wheezing. Now the pathogen is in Metal, and Metal must overcome Wood. Wood is the Liver, whose emotion is anger. Anger causes Qi rebellion attacking the Lung, leading to wheezing. Why? Because branches of the Liver separate from the Liver, pierce the diaphragm, and ascend to pour into the Lung. The Mai Yao Jing Wei Lun states: Blood in the hypochondrium causes wheezing and rebellion. This is what is meant. Treating Jing points prevents Metal from overcoming Wood.
He-Sea governs rebellious Qi and diarrhea.
Mr. Lv says: He-Sea corresponds to Water, and Water governs the Kidney. The Kidney governs diarrhea. Master Yu says: He-Sea follows Water to correspond to the Kidney. Insufficiency of Kidney Qi injures the Chong Mai, causing rebellious Qi and abdominal urgency. The Kidney opens into the two yin orifices. If Kidney Qi is not secure, diarrhea occurs. The pathogen is in Water, and Water must overcome Fire. Fire is the Heart, which by law does not easily accept disease. Liver Wood is the mother of Heart Fire and the child of Kidney Water. One worries about the mother receiving the pathogen; the other worries about the child being overcome. The Liver's emotion is anger. Worry leads to anger, anger leads to Qi rebellion. This is due to the mutual overcoming of the Five Elements, so diseases differ. Treating He-Sea points prevents Water from overcoming Fire, so Liver Wood is not worried, and rebellious Qi stops. If the pathogen is not in the Kidney, there is no diarrhea. Above, Jing, Ying, Shu, Jing, and He-Sea follow the Five Elements corresponding to the Five Zang organs. Pathogens gather within, governing diseases as described. Those skilled in diagnosis examine and act accordingly, knowing whether it is self-disease or mutual overcoming. Deficiency is tonified, excess is sedated.
These are the diseases governed by the Jing, Ying, Shu, Jing, and He-Sea points of the five zang and six fu organs.
Mr. Ding says: These are the Jing, Ying, Shu, Jing, and He-Sea points of the five zang organs. The classics state that Jing governs epigastric fullness, which is Liver disease, i.e., rebellious fullness. One should take the various Jing points to govern epigastric fullness. Ying governs body fever; Ying is Fire, so there is body fever. One should take the various Ying points to govern fever. Shu governs body heaviness and joint pain; Shu is Earth, causing body heaviness and joint pain. One should take the various Shu points to govern these symptoms. Jing governs wheezing, coughing, aversion to cold, and fever; Jing is Metal, causing wheezing, coughing, and alternating chills and fever. One should take the various Jing points to govern these symptoms. He-Sea governs rebellious Qi and diarrhea; He-Sea is Water, which governs diarrhea. One should take the various He-Sea points to govern rebellious Qi and diarrhea. Master Yu says: For the diseases generated by Jing, Ying, Shu, Jing, and He-Sea points above, regulate and treat them according to their respective seasons. This means that pathogens of the four seasons gather and remain in the Ying and Shu points.