平按∶此篇见《灵枢》卷三第十二《经水》篇，又见《甲乙经》卷一第七，惟文法略异。
黄帝问于岐伯曰∶经脉十二者，外合于十二经水，而内属于五脏六腑。（天下凡有八十一
州，此中国，州之一也，名为赤县神州。每一州之外，有一重海水环之，海之外，有一重大山绕之，
如此三重海三重山环而围绕，人居其内，名曰一州。一州之内，凡有十二大水，自外小山小水不可
胜数。人身亦尔，大脉总有十二，以外大络小络亦不可数。天下八十一州之中，唯取中国一州之地，
用法人身十二经脉内属脏腑，以人之生在此州中，禀此州地形气者也。）夫十二经水者，其大小深
浅广狭远近各不同，五脏六腑之高下小大，受谷之多少亦不等，相应奈何？（问其十二经脉取法所
由也。）夫经水者，受水而行之；（此问其脏腑经络各有司主调养所由。十二经水，各从其源受水，
输之于海，故曰受水行也。）五脏者，合神气魂魄而藏；（五脏合五神之气，心合于神，肝合于魂，
肺合于魄，脾合于营，肾合于精，五脏与五精神气合而藏之也。平按∶脏下《灵枢》、《甲乙》均
有之字，袁刻同。）六腑者，受谷而行之，受气而扬之；（胃受五谷成熟，传入小肠，小肠盛受也。
小肠传入大肠，大肠传导也。大肠传入广肠，广肠传出也。胃下别汁，出膀胱之胞，传阴下泄也。
胆为中精，有木精三合，藏而不泻。此即腑受谷行之者也。五腑与三焦共气，故六腑受气，三焦行
之为原，故曰扬也。平按∶注成熟，熟字袁刻误作热。别汁出膀胱五字，原缺不完，平细玩虫蚀剩
处，与此五字相近，谨拟作此，袁刻作膀胱膀胱四字。）经脉者，受血而营之。合而以治奈何？刺
之深浅，灸之壮数，可得闻乎？（营气从中焦，并胃口出上焦之后，所谓受气，泌糟粕，□津液，
化津液精微，注之肺脉中，化而为血，流十二脉中，以奉生身，故生身之贵，无过血也。故营气独
行于十二经，导营身，故曰营气。营气行经，如雾者也。经中血者，如渠中水也。故十二经受血各
营也。平按∶注津液上一
字，下半虫蚀不全，袁刻作成，细玩上半剩处，确非成字，宜空一格。）岐伯答曰∶善乎哉问也。
天至高不可度，地至广不可量，此之谓也。且夫人生天地之间，六合之内，此天之高地之广，非人
力所能度量而至也。若夫八尺之士，皮肉在此，外可度量切循而得也，死可解部而视也。（二仪之
大，人力不可度量。人之八尺之身，生则观其皮肉，切循色脉，死则解其身部，视其脏腑，不同天
地，故可知也。平按∶外可度量，袁刻于外下增生字，不合，《灵枢》亦无。部《灵枢》作剖。）
其脏之坚脆，腑之大小，谷之多少，脉之长短，血之清浊，气之多少，十二经之多血少气，与其少
血多气，与其皆多血气，与其皆少血气，皆有大数。其治以针艾，各调其经气，固其常有合乎？
（夫人禀气受形，既有七种不同，以针艾调养固有常契，不可同乎天地无度量也。）黄帝曰∶余闻
之快于耳，不解于心，愿卒闻。（快于耳，浅知也；解于心，深识也。平按∶卒闻下《灵枢》有之
字。）岐伯答曰∶此人之所以参天地而应阴阳，不可不察。（正以天地不可度量，人参天地，故不可
不察也。）足太阳，外合于清水，内属于膀胱。（清水出魏郡内黄县，南经清泉县，东北流入河也。
平按∶膀胱下《灵枢》、《甲乙》均有而通水道焉五字，本书在后。）足少阳，外合于渭水，内属
于胆。（渭水出陇西首阳县鸟鼠同穴山，东北至华阴入河，过郡四，行一千八百七十里，雍州浸也。）
足阳明，外合于海水，内属于胃。（海，晦也，言其水广博，望之晦暗，不测崖际，故曰海也。海，
即四海也。足阳明脉血气最多，合之四海，众水之长也。）足太阴，外合于湖水，内属于脾。（湖
当为 ， 陀水出代郡卤城县，东流过郡九，行千三百四十里，为并州川。一解云∶湖当为沽，沽
水出渔阳郡，东南入海，行
七百五十里。此二水亦得为合也。平按∶ 袁刻作雩。）足少阴，外合于汝水，内属于肾。（汝水
出汝南郡定陵县高陵山，东南流入淮，过郡四，行一千三百四十里也。）足厥阴，外合于沔水，内
属于肝。（沔。绵善反。沔水出武郡番 山，东流入江也。平按∶沔《灵枢》、《甲乙》均作渑。
注武郡，武字原抄作武，袁刻作南郡，考《水经注》沔水出武都沮县野狼谷，应作武。）手太阳，外
合于淮水，内属于小肠，而通水道焉。（淮水出南阳郡平武县桐柏山，东南流入海，过郡四，行三
千二百四十里也。）手少阳，外合于漯水，内属于三焦。（漯，汤合反。漯水出平原郡，东北流入
于海。又河内亦有漯水，出王屋山，东南流入河。此二水并得为合也。）手阳明，外合于江水，内
属于大肠。（江水出蜀岷山郡升迁县，东南流入海，过郡九，行七千六百六十里也。平按∶注升迁
原抄作外迁，据《水经注》应作升。）手太阴，外合于河水，内属于肺。（河水出昆仑山东北隅，
便潜行至葱岭于阗国，到积石山，东北流入海，过郡十六，行九千四百里也。）手太阴，外合于济
水，内属于心。（济水出河东恒县，至王屋山，东北流入于河。）手心主，外合于漳水，内属于心
包。（漳水，清漳水也，出上党沽县西北少山，东流合浊漳入于海。解是浊漳，浊漳出于上党长子
县西发鸠山，东流入海也。）凡此五脏六腑十二经水者，皆外有源泉而内有所禀，此皆外内相贯，
如环无端，人经亦然。（十二经水，如江出岷山，河出昆仑，即外有源也。流入于海，即内有所禀
也。水至于海已，上为天河，复从源出，流入于海，即为外内相贯，如环无端也。人经亦尔，足三
阴脉从足指起，即外有源也。上行络腑属脏，比之入海，即内有所禀也。以为手三阴脉，从胸至手，
变为
手三阳脉，从手而起，即外有源也。上行络脏属腑，即内有所禀也。上头以为足三阳脉，从头之下
足，复变为足三阴脉，即外内相贯，如环无端也。平按∶外内《灵枢》、《甲乙》作内外。）故天
为阳，地为阴，腰以上为天，腰以下为地。（人腰以上，为天为阳也；自腰以下，为地为阴也。经
脉升天降地，与经水同行，故得合也。）故清以北者为阴，湖以北者为阴中之阴，（清水以北，已
是其阴，湖在清北，故为阴中之阴也。）漳以南者为阳，河以北至漳者为阳中阴，（漳南为阳，河
北为阴，故河北至漳为阳中阴也。）漯以南至江者为阳中之太阳，（漯居阳地，故为阳中太阳。平
按∶太阳，太字《甲乙》无。）此一州之阴阳，所以人与天地相参者也。（阴阳之理无形，大之无外，
小之无内，但人生一州之地，形必象之，故以一州阴阳合人者也。平按∶州《灵枢》作隅。）黄帝
曰∶夫经水之应经脉也，其远近浅深，水血之多少各不同，合而以刺之奈何？（问有三意∶经水经
脉远近，一也；浅深，二也；水之与血多少，三也。然则身经脉有三不同，请随调之。）岐伯答曰∶
足阳明五脏六腑之海，（胃受水谷，化成血气，为足阳明脉，资润五脏六腑，五脏六腑禀成血气，
譬之四海滋泽无穷，故名为海也。）其脉大血多，气盛热壮，（足阳明脉具有四义故得名海∶其脉
粗大，一也；其血又多，二也；其谷气盛，三也；阳气热，四也。有此四义，故得比于海也。平按∶
热下原缺一字，据《灵枢》、《甲乙》补入。）刺此者，不深弗散，（刺此道，刺中度人足三阳脉，
足阳明脉须深六分，以为深也。其脉在皮下深，血气又盛，故深六分，方得散其气也。）不留不泻。
（血气既盛，留之方得顿而泻也。若热在皮肤之中聚为病者，即疾泻之，故曰热即疾泻也。）足太
阳深五分，留七呼。足少阳深四分，留五呼。足阳明深六分，留十呼。足太阴深三分，留四呼。足
少阴深二分，留三呼。足厥阴深一分，留二呼。（问曰∶十二经脉之气，并有发穴多少不同，然则
三百六十五穴各属所发之经。此中刺手足十二经者，为是经脉所发三百六十五穴？为是四肢流注五
脏三十输及六腑三十六输穴也？答曰∶其正取，四肢三十输及三十六输。余之间穴，有言其脉发会
其穴，即属彼脉。故取其脉者，即是其脉所发之穴也。问曰∶此手足阴阳所刺分数，与明堂分数大
有不同。若为取定？答曰∶此及明堂所刺分数各举一例，若随人随病，其例甚多，不可一概也。今
足太阳脉在皮肉中有深四分有余，故以刺入五分为例。若脉行更有深浅，可以意扪循取之为当，余
皆放此。留七呼者，此据太阳脉气强弱以为一例。若病盛衰，更多少可随时调之，不可以为定也，
余皆放此也。平按∶足阳明一段《灵枢》在足太阳上。《甲乙经》阳明、太阳下均有多血气刺四字，
足少阳下有少血气刺四字，太阴、厥阴下均有多血少气刺五字，少阴下有少血多气刺五字。）手之
阴阳，其受气之道近，其气之来疾，其深皆毋过二分，其留皆毋过一呼。（手之六阴，从手至胸，
属脏络腑，各长三尺五寸。手之六阳，从手至头，属腑络脏，各长五尺。足之六阴，从足至胸，属
脏络腑，各长六尺五寸。足之六阳，从足至头，属腑络脏，各长八尺。此手足十二之脉当经血气上
下环流也。然足经既长，即血气环流，其道远也；复是阴气，故其行迟也。手经既短，即血气环流，
其道近也；复是阳气，故其行疾也。以其道近脉浅，刺深无过二分也。以其气疾，故留之不过一呼也。
平按∶其深《灵枢》、《甲乙经》均作其刺深。注从手至胸，胸字原缺，袁刻作胃，据本注下文“从
足至胸”，应作胸字。）其少长小大肥瘦，以心撩之，命曰法天之常。（撩，力条反，取也。人之生
也，五时不同；
初生为婴儿，能笑以上为孩，六岁以上为小，十八岁以上为少，二十以上为壮，五十以上为老。今
量三十以下为少。三十以上为长。黄帝之时，七尺五寸以上为大，不满七尺五寸为小。今时人之大
小，可以意取之。天者，理也。少长小大肥瘦之变，变而不恒，以合天为妙，此天之常道也。贤人
以意取之，妙合其理，故曰法天之常也。平按∶撩《甲乙》作料。注为孩，孩字下半虫蚀，细玩上
半剩处，于孩字为近。日本《医心方》卷二十五引《太素经》云∶小儿初生为婴，能笑为孩儿。谨
拟作孩。袁刻作小，复将下文六岁以上为小改作少，十八岁以上为少改作壮，二十以上为壮改作长，
与原抄不合。又壮下二字原缺，据《灵枢·卫气失常》篇五十以上为老，拟作“五十”二字。）灸
之亦然。灸而过此者，得恶火，即骨枯脉缋；刺而过此者，则脱气。（灸法亦须量人少长大小肥瘦，
气之盛衰，穴之分寸，四时寒温，壮数多少，不可卒中失于常理。故壮数不足，厥疾不瘳；若过其
限，火毒入身，诸骨枯槁，经脉溃脓，名为恶火之病。火无善恶，火壮伤多，故名恶火也。平按∶
缋《灵枢》、《甲乙经》均作涩，袁刻作溃，据注经脉溃脓，当是溃字，别本亦作溃。）黄帝问曰∶
夫经脉之小大，血之少多，肤之浓薄，肉之坚脆，及 之大小，可为度量乎？（肤，皮也。 ，
等块肉也。举人形有十种不同，请设度量合中之法也。平按∶《灵枢》少多作多少， 作 。）岐
伯答曰∶其可为度量者，取其中度者也，不甚脱肉而血气不衰者也。若失度之人，瘠瘦而形肉脱者，
恶可以度量刺乎？审切循扪按，视其寒温盛衰而调之，是谓因适而为真者也。（中度者，非唯取七
尺五寸以为中度，亦取肥瘦寒温盛衰处其适者，以为中度。瘠，音藉也。七只五寸人为中度者量定。
扪，没屯反，摸也。平按∶失度，失字《灵枢》作夫。）
【平按】：此篇见于《灵枢》卷三第十二《经水》篇，又见于《甲乙经》卷一第七，只是文法略有差异。
黄帝向岐伯问道：人体的十二经脉，外部与天下的十二条河流相合，内部归属于五脏六腑。（天下共有八十一州，这里所说的“中国”只是其中一州，名为赤县神州。每一州之外，有一重海水环绕；海水之外，有一重大山围绕。如此三重海、三重山层层环绕，人居于其中，称为一州。每一州之内，有十二条大水，至于外围的小山小水则数不胜数。人体也是如此，大脉总共有十二条，以外的大络小络也不可胜数。在天下八十一州中，只取“中国”这一州的地形，用来对应人身十二经脉内属脏腑的关系，因为人生于此州之中，禀受了此州的地形与气运。）这十二条经水，它们的大小、深浅、广狭、远近各不相同，而五脏六腑的高低、大小，受纳水谷的多少也不相等，二者如何相应呢？（这是询问十二经脉取法于经水的依据。）经水，是接受水源而流动的；（这是询问脏腑经络各自主管调养的依据。十二条经水，各自从源头接受水流，输送到大海，所以叫作“受水而行”。）五脏，是藏纳神、气、魂、魄的；（五脏配合五神之气，心合于神，肝合于魂，肺合于魄，脾合于营，肾合于精，五脏与五精神气相合而藏之。【平按】：脏字下，《灵枢》、《甲乙经》均有“之”字，袁刻本相同。）六腑，是受纳水谷而运行的，受纳气机而升扬的；（胃受纳五谷并使其成熟，传入小肠，小肠盛受。小肠传入大肠，大肠传导。大肠传入广肠，广肠排出。胃向下分离出汁液，流出膀胱之胞，从阴部排泄。胆为中精之府，含有木精三合，只藏不泻。这就是腑受纳水谷而运行的情况。五腑与三焦共气，所以六腑受纳气机，由三焦运行作为本源，所以叫作“扬”。【平按】：注文中“成熟”，“熟”字袁刻误作“热”。另外“别汁出膀胱”五字，原缺不全，仔细玩味虫蚀剩下的部分，与此五字相近，谨拟补作此五字，袁刻作“膀胱膀胱”四字。）经脉，是受纳血液而营养全身的。（营气从中焦出来，经过胃口，出于上焦之后，所谓受气，泌出糟粕，分泌津液，将津液化为精微，注入肺脉中，化生为血，流注于十二脉中，以奉养全身，所以养育生命的贵重之物，没有超过血的。因此营气独自行于十二经，引导滋养身体，所以叫作营气。营气行于经脉，像雾露一样弥漫。经中的血，就像渠中的水。所以十二经受纳血液各自进行营养。【平按】：注文中“津液”上一字，下半部分虫蚀不全，袁刻本作“成”，仔细玩味上半剩余部分，确实不是“成”字，宜空一格。）如果将它们综合起来进行治疗，该怎么做呢？针刺的深浅、艾灸的壮数，可以讲给我听吗？（营气从中焦发出，并胃口而出于上焦之后，所谓受气，泌出糟粕，[缺失]津液，化津液为精微，注入肺脉中，化而为血，流注于十二脉中，以奉养生命，所以生命的珍贵，没有超过血的。因此营气独自行于十二经，导引营身，故曰营气。营气行于经脉，如雾露一般。经中之血，如渠中之水。故十二经受血各有所营。【平按】：注文中“津液”上一字，下半虫蚀不全，袁刻本作“成”，细玩上半剩处，确非“成”字，宜空一格。）
岐伯回答说：问得好啊！天至高不可度量，地至广不可计量，说的就是这种情况。况且人生于天地之间，六合之内，这天的高和地的广，不是人力所能度量到的。至于那身高八尺的人，皮肉都在体表，外部可以通过度量、切按、循摸来获得信息，死后可以解剖部位来观察。（二仪之大，人力不可度量。人的八尺之身，活着时观察其皮肉，切按颜色脉搏，死后解剖其身部，观察其脏腑，不同于天地，所以可知晓。【平按】：“外可度量”，袁刻于“外”下增“生”字，不合，《灵枢》亦无。“部”《灵枢》作“剖”。）其脏器的坚脆，腑的大小，水谷的多少，脉的长短，血的清浊，气的多少，十二经中多血少气，以及少血多气，以及皆多血气，以及皆少血气，都有固定的常规数目。用针艾治疗，各自调和其经气，难道固守这些常规就合乎道理了吗？（人禀受气形成形体，既然有七种不同，用针艾调养固然有常理，不能像天地那样无度量。）
黄帝说：我听了觉得很悦耳，但心中不解，希望听您说完。（“快于耳”指浅知，“解于心”指深识。【平按】：“卒闻”下《灵枢》有“之”字。）
岐伯回答说：这是因为人能够参配天地而应合阴阳，不可以不仔细观察。（正因为天地不可度量，人却参配天地，所以不可以不察。）足太阳经，外部合于清水，内部属于膀胱。（清水出自魏郡内黄县，向南流经清泉县，向东北流入黄河。【平按】：“膀胱”下《灵枢》、《甲乙经》均有“而通水道焉”五字，本书在后。）足少阳经，外部合于渭水，内部属于胆。（渭水出自陇西首阳县鸟鼠同穴山，向东北至华阴入黄河，经过四个郡，行程一千八百七十里，是雍州的浸水。）足阳明经，外部合于海水，内部属于胃。（海，即晦暗之意，言其水广博，望之晦暗，无法测知崖岸边际，所以叫作海。海，即四海。足阳明脉血气最多，合于四海，是众水之长。）足太阴经，外部合于湖水，内部属于脾。（湖应当为[某字]，[某字]陀水出自代郡卤城县，向东流经九个郡，行程一千三百四十里，成为并州川。另一种解释认为：湖应当为沽，沽水出自渔阳郡，向东南入海，行程七百五十里。这两条水也可以作为对应。【平按】：[某字]袁刻作“雩”。）足少阴经，外部合于汝水，内部属于肾。（汝水出自汝南郡定陵县高陵山，向东南流入淮河，经过四个郡，行程一千三百四十里。）足厥阴经，外部合于沔水，内部属于肝。（沔，音绵善反。沔水出自武郡番[某]山，向东流入长江。【平按】：沔《灵枢》、《甲乙经》均作“渑”。注文中“武郡”，“武”字原抄作“武”，袁刻作“南郡”，考《水经注》沔水出自武都沮县野狼谷，应作“武”。）手太阳经，外部合于淮水，内部属于小肠，并通调水道。（淮水出自南阳郡平武县桐柏山，向东南流入海，经过四个郡，行程三千二百四十里。）手少阳经，外部合于漯水，内部属于三焦。（漯，音汤合反。漯水出自平原郡，向东北流入海。另外河内也有漯水，出自王屋山，向东南流入黄河。这两条水都可以作为对应。）手阳明经，外部合于江水，内部属于大肠。（江水出自蜀岷山郡升迁县，向东南流入海，经过九个郡，行程七千六百六十里。【平按】：注文中“升迁”原抄作“外迁”，据《水经注》应作“升”。）手太阴经，外部合于河水，内部属于肺。（河水出自昆仑山东北隅，便潜行至葱岭于阗国，到达积石山，向东北流入海，经过十六个郡，行程九千四百里。）手太阴经，外部合于济水，内部属于心。（济水出自河东恒县，至王屋山，向东北流入黄河。）手心主经，外部合于漳水，内部属于心包。（漳水，即清漳水，出自上党沽县西北少山，向东流合浊漳入海。另一种解释认为是浊漳，浊漳出自上党长子县西发鸠山，向东流入海。）
以上这五脏六腑十二条经水，都外部有源泉而内部有所禀受，这都是内外贯通，如环无端，人体的经脉也是如此。（十二条经水，如江出岷山，河出昆仑，即外部有源。流入于海，即内部有所禀受。水至于海以后，上升为天河，又从源头流出，流入大海，即为内外贯通，如环无端。人体经脉也是这样，足三阴脉从足趾起，即外部有源。上行络腑属脏，比之入海，即内部有所禀受。至于手三阴脉，从胸至手，变为手三阳脉，从手而起，即外部有源。上行络脏属腑，即内部有所禀受。上头成为足三阳脉，从头之下足，又变为足三阴脉，即内外贯通，如环无端。【平按】：“外内”《灵枢》、《甲乙经》作“内外”。）所以天为阳，地为阴，腰以上为天，腰以下为地。（人腰以上，为天为阳；自腰以下，为地为阴。经脉升天降地，与经水同行，所以得以相合。）所以清水以北者为阴，湖以北者为阴中之阴，（清水以北，已经是阴，湖在清水之北，所以为阴中之阴。）漳水以南者为阳，河水以北至漳水者为阳中之阴，（漳南为阳，河北为阴，所以河北至漳为阳中之阴。）漯水以南至江水者为阳中之太阳，（漯居阳地，所以为阳中之太阳。【平按】：“太阳”，“太”字《甲乙经》无。）这是这一州的阴阳，所以人与天地相参。（阴阳之理无形，大之无外，小之无内，但人生在一州之地，形体必然效法它，所以以一州阴阳合于人。【平按】：“州”《灵枢》作“隅”。）
黄帝说：经水对应经脉，它们的远近、浅深，水与血的多少各不相同，综合起来进行针刺该怎么做呢？（问有三意：经水经脉远近，一也；浅深，二也；水与血多少，三也。然而身经脉有三不同，请随调之。）
岐伯回答说：足阳明经是五脏六腑之海，（胃受纳水谷，化成血气，为足阳明脉，资润五脏六腑，五脏六腑禀受成就血气，譬如同四海滋泽无穷，所以叫作海。）它的脉粗大血多，气盛热壮，（足阳明脉具有四义故得名海：其脉粗大，一也；其血又多，二也；其谷气盛，三也；阳气热，四也。有此四义，故得比于海。【平按】：“热”下原缺一字，据《灵枢》、《甲乙经》补入。）针刺这条经，不深就不能散邪，（刺此道，刺中度人足三阳脉，足阳明脉须深六分，以为深。其脉在皮下深，血气又盛，故深六分，方得散其气也。）不留针就不能泻实。（血气既盛，留针方能顿而泻之。若热在皮肤之中聚为病者，即疾泻之，故曰热即疾泻也。）足太阳经深五分，留针七呼。足少阳经深四分，留针五呼。足阳明经深六分，留针十呼。足太阴经深三分，留针四呼。足少阴经深二分，留针三呼。足厥阴经深一分，留针二呼。（问曰：十二经脉之气，并有发穴多少不同，然则三百六十五穴各属所发之经。此中刺手足十二经者，为是经脉所发三百六十五穴？为是四肢流注五脏三十输及六腑三十六输穴也？答曰：其正取，四肢三十输及三十六输。余之间穴，有言其脉发会其穴，即属彼脉。故取其脉者，即是其脉所发之穴也。问曰：此手足阴阳所刺分数，与明堂分数大有不同。若为取定？答曰：此及明堂所刺分数各举一例，若随人随病，其例甚多，不可一概也。今足太阳脉在皮肉中有深四分有余，故以刺入五分为例。若脉行更有深浅，可以意扪循取之为当，余皆放此。留七呼者，此据太阳脉气强弱以为一例。若病盛衰，更多少可随时调之，不可以为定也，余皆放此也。【平按】：足阳明一段《灵枢》在足太阳上。《甲乙经》阳明、太阳下均有“多血气刺”四字，足少阳下有“少血气刺”四字，太阴、厥阴下均有“多血少气刺”五字，少阴下有“少血多气刺”五字。）
手的阴阳经脉，其受气之道近，其气来势疾，其刺深都不超过二分，其留针都不超过一呼。（手之六阴，从手至胸，属脏络腑，各长三尺五寸。手之六阳，从手至头，属腑络脏，各长五尺。足之六阴，从足至胸，属脏络腑，各长六尺五寸。足之六阳，从足至头，属腑络脏，各长八尺。此手足十二之脉当经血气上下环流也。然足经既长，即血气环流，其道远也；复是阴气，故其行迟也。手经既短，即血气环流，其道近也；复是阳气，故其行疾也。以其道近脉浅，刺深无过二分也。以其气疾，故留之不过一呼也。【平按】：“其深”《灵枢》、《甲乙经》均作“其刺深”。注文中“从手至胸”，“胸”字原缺，袁刻作“胃”，据本注下文“从足至胸”，应作“胸”字。）对于人的少长、小大、肥瘦，要用心斟酌衡量，这叫作法天之常。（撩，力条反，取也。人之生也，五时不同；初生为婴儿，能笑以上为孩，六岁以上为小，十八岁以上为少，二十以上为壮，五十以上为老。今量三十以下为少。三十以上为长。黄帝之时，七尺五寸以上为大，不满七尺五寸为小。今时人之大小，可以意取之。天者，理也。少长小大肥瘦之变，变而不恒，以合天为妙，此天之常道也。贤人以意取之，妙合其理，故曰法天之常也。【平按】：“撩”《甲乙经》作“料”。注文中“为孩”，“孩”字下半虫蚀，细玩上半剩处，于“孩”字为近。日本《医心方》卷二十五引《太素经》云：小儿初生为婴，能笑为孩儿。谨拟作“孩”。袁刻作“小”，复将下文“六岁以上为小”改作“少”，“十八岁以上为少”改作“壮”，“二十以上为壮”改作“长”，与原抄不合。又“壮”下二字原缺，据《灵枢·卫气失常》篇“五十以上为老”，拟作“五十”二字。）艾灸也是同样道理。艾灸超过这个限度，会得到恶火，导致骨枯脉涩；针刺超过这个限度，则会脱气。（灸法亦须量人少长大小肥瘦，气之盛衰，穴之分寸，四时寒温，壮数多少，不可卒中失于常理。故壮数不足，厥疾不瘳；若过其限，火毒入身，诸骨枯槁，经脉溃脓，名为恶火之病。火无善恶，火壮伤多，故名恶火也。【平按】：“缋”《灵枢》、《甲乙经》均作“涩”，袁刻作“溃”，据注经脉溃脓，当是“溃”字，别本亦作“溃”。）
黄帝问道：经脉的大小，血的多少，皮肤的浓薄，肌肉的坚脆，以及腘窝的大小，可以作为度量的标准吗？（肤，皮也。腘，等块肉也。举人形有十种不同，请设度量合中之法也。【平按】：《灵枢》“少多”作“多少”，“腘”作“腘”。）
岐伯回答说：可以作为度量标准的，取其中等身材的人，即不是很消瘦且血气不衰的人。如果是失去常态的人，极度消瘦且形体肌肉脱落的人，怎么可以用常规标准来度量针刺呢？应当审慎地切按、循摸、按压，观察其寒温盛衰而进行调理，这叫作因适宜而为真治。（中度者，非唯取七尺五寸以为中度，亦取肥瘦寒温盛衰处其适者，以为中度。瘠，音藉也。七尺五寸人为中度者量定。扪，没屯反，摸也。【平按】：“失度”，“失”字《灵枢》作“夫”。）
[Ping An]: This chapter appears in *Ling Shu* (Spiritual Pivot), Volume 3, Chapter 12 "Jing Shui" (Meridian Waters), and also in *Jia Yi Jing* (Classified Classic of the Academy), Volume 1, Chapter 7, with only slight differences in syntax.
Huang Di asked Qi Bo: The twelve meridians of the human body externally correspond to the twelve major rivers of the world, and internally belong to the Zang-Fu organs (Five Zang and Six Fu organs). [The world has eighty-one provinces; what is referred to here as "Zhong Guo" (Central State) is merely one province, named Chi Xian Shen Zhou (Red County Divine Land). Outside each province lies a ring of sea water; outside the sea water lies a great mountain range. Thus surrounded by three rings of sea and three rings of mountains, humans dwell within, called one province. Within each province are twelve major rivers, while minor hills and streams outside are countless. The human body is similar; there are twelve major meridians, and beyond them, major and minor collaterals are innumerable. Among the eighty-one provinces, we take only the terrain of this "Central State" to correspond to the internal affiliation of the twelve meridians with the Zang-Fu organs, because humans are born in this state and inherit its terrain and Qi.] These twelve meridian waters differ in size, depth, breadth, narrowness, distance, and proximity. Similarly, the height, size, and capacity for receiving grain of the Zang-Fu organs vary. How do they correspond? [This asks for the basis of taking the twelve meridians as models after the meridian waters.] Meridian waters receive their source and flow; [This asks for the basis of each Zang-Fu organ and meridian managing its own nourishment. The twelve meridian waters each receive water from their source and transport it to the sea, hence called "receiving water and flowing."] The Five Zang organs store Shen (Spirit), Qi (Energy), Hun (Ethereal Soul), Po (Corporeal Soul); [The Five Zang organs combine with the Qi of the Five Spirits: Heart combines with Shen, Liver with Hun, Lung with Po, Spleen with Ying (Nutritive Qi), Kidney with Jing (Essence). The Five Zang combine with the Five Spirits' Qi and store them. [Ping An]: Below the character "Zang", both *Ling Shu* and *Jia Yi Jing* have the character "Zhi" (of), same as Yuan's edition.] The Six Fu organs receive grain and circulate it, receive Qi and disperse it; [The Stomach receives the five grains and ripens them, transmitting to the Small Intestine, which holds them. The Small Intestine transmits to the Large Intestine, which conducts. The Large Intestine transmits to the Broad Intestine, which expels. The Stomach separates fluids downward, exiting via the Bladder's bladder-body, and discharging from the yin orifices. The Gallbladder is the organ of pure essence, containing Wood essence, storing but not excreting. This is how the Fu organs receive grain and circulate. The Five Fu organs share Qi with the San Jiao (Triple Burner), so the Six Fu organs receive Qi, and the San Jiao circulates it as the origin, hence called "dispersing". [Ping An]: In the note, "Cheng Shu" (ripened), the character "Shu" was mistakenly printed as "Re" (heat) in Yuan's edition. Also, the five characters "Bie Zhi Chu Pang Guang" (separate fluids exit Bladder) were originally missing/incomplete; carefully examining the remaining parts eaten by insects suggests these five characters. Yuan's edition reads "Pang Guang Pang Guang" (Bladder Bladder).] The meridians receive blood and nourish the body. [Ying Qi (Nutritive Qi) emerges from the Middle Jiao, passes the stomach opening, and exits after the Upper Jiao. This is called receiving Qi, separating dregs, secreting Jin Ye (Body Fluids), transforming Jin Ye into fine essences, injecting them into the Lung meridians, transforming into blood, flowing through the twelve meridians to nourish the living body. Thus, nothing is more precious for sustaining life than blood. Therefore, Ying Qi travels alone in the twelve meridians, guiding and nourishing the body, hence called Ying Qi. Ying Qi traveling in the meridians is like mist. Blood in the meridians is like water in a canal. Thus, the twelve meridians receive blood and nourish accordingly. [Ping An]: The character above "Jin Ye" in the note is incomplete due to insect damage; Yuan's edition makes it "Cheng" (become), but careful examination shows it is definitely not "Cheng"; leave a space.] If we integrate them for treatment, how should it be done? Can you tell me about the depth of acupuncture and the number of moxibustion cones? [Ying Qi emerges from the Middle Jiao... thus nothing is more precious for sustaining life than blood. Therefore, Ying Qi travels alone in the twelve meridians, guiding and nourishing the body, hence called Ying Qi. Ying Qi traveling in the meridians is like mist. Blood in the meridians is like water in a canal. Thus, the twelve meridians receive blood and nourish accordingly. [Ping An]: The character above "Jin Ye" in the note is incomplete due to insect damage; Yuan's edition makes it "Cheng" (become), but careful examination shows it is definitely not "Cheng"; leave a space.]
Qi Bo replied: Excellent question! Heaven is so high it cannot be measured, Earth is so vast it cannot be quantified; this is what is meant. Moreover, humans are born between Heaven and Earth, within the Six Directions. The height of Heaven and the breadth of Earth are beyond human measurement. As for an eight-chi tall person, skin and flesh are on the surface, which can be measured, palpated, and traced externally; after death, the body can be dissected to observe internally. [The greatness of Yin and Yang cannot be measured by human effort. For the eight-chi human body, while alive, one observes skin and flesh, palpates color and pulse; after death, one dissects the body parts to view the Zang-Fu organs. Unlike Heaven and Earth, this is knowable. [Ping An]: "Wai Ke Du Liang" (externally can be measured), Yuan's edition adds "Sheng" (life) below "Wai", which is incorrect; *Ling Shu* also lacks it. "Bu" (parts) is written as "Pou" (dissect) in *Ling Shu*.] The firmness and fragility of the Zang organs, the size of the Fu organs, the amount of grain, the length of the pulses, the clarity and turbidity of blood, the quantity of Qi, whether the twelve meridians have much blood and little Qi, little blood and much Qi, much blood and much Qi, or little blood and little Qi, all have fixed standard numbers. When treating with needles and moxa, adjusting their meridian Qi, do we strictly adhere to these constants? [Humans inherit Qi and form bodies, having seven different types. Using needles and moxa for regulation certainly has constant principles, unlike the immeasurable Heaven and Earth.]
Huang Di said: I heard it pleasantly, but did not understand it deeply in my heart. I wish to hear it completely. ["Kuai Yu Er" means superficial knowledge; "Jie Yu Xin" means deep understanding. [Ping An]: Below "Zu Wen" (hear completely), *Ling Shu* has the character "Zhi".]
Qi Bo replied: This is because humans participate in Heaven and Earth and correspond to Yin and Yang, and must be carefully observed. [Precisely because Heaven and Earth are immeasurable, yet humans participate in Heaven and Earth, they must not fail to observe.]
The Foot-Taiyang Meridian externally corresponds to Qing Shui (Clear Water) and internally belongs to the Bladder. [Qing Shui originates in Neihuang County, Wei Commandery, flows south through Qingquan County, and enters the Yellow River northeastward. [Ping An]: Below "Pang Guang" (Bladder), *Ling Shu* and *Jia Yi Jing* have the five characters "Er Tong Shui Dao Yan" (and unblocks the water pathways), placed later in this book.] The Foot-Shaoyang Meridian externally corresponds to Wei Shui (Wei River) and internally belongs to the Gallbladder. [Wei Shui originates from the Bird-Rat Shared Cave Mountain in Shouyang County, Longxi Commandery, flows northeast to Huayin to enter the Yellow River, passing four commanderies, traveling 1,870 li, it is the soaking water of Yongzhou.] The Foot-Yangming Meridian externally corresponds to Hai Shui (Sea Water) and internally belongs to the Stomach. [Hai (Sea) implies darkness/haziness, referring to its vastness, looking dark and unfathomable at the edges, hence called Sea. Hai refers to the Four Seas. The Foot-Yangming meridian has the most blood and Qi, corresponding to the Four Seas, the head of all waters.] The Foot-Taiyin Meridian externally corresponds to Hu Shui (Lake Water) and internally belongs to the Spleen. [Hu should be [Character], Tuoshui originates in Lucheng County, Dai Commandery, flows east through nine commanderies, traveling 1,340 li, becoming Bingzhou Chuan. Another interpretation says: Hu should be Gu, Gushui originates in Yuyang Commandery, flows southeast into the sea, traveling 750 li. Both waters can serve as correspondence. [Ping An]: [Character] is printed as "Yu" in Yuan's edition.] The Foot-Shaoyin Meridian externally corresponds to Ru Shui (Ru River) and internally belongs to the Kidney. [Ru Shui originates from Gaoling Mountain in Dingling County, Runan Commandery, flows southeast into the Huai River, passing four commanderies, traveling 1,340 li.] The Foot-Jueyin Meridian externally corresponds to Mian Shui (Mian River) and internally belongs to the Liver. [Mian, pronounced mian-shan fan. Mian Shui originates from Fan [Character] Mountain in Wu Commandery, flows east into the Yangtze River. [Ping An]: Mian is written as "Mian" (Mian River) in *Ling Shu* and *Jia Yi Jing*. Note: "Wu Commandery", the character "Wu" was originally copied as "Wu", Yuan's edition as "Nan Commandery". Checking *Shui Jing Zhu*, Mian Shui originates from Juliu County, Wudu Commandery, Wild Wolf Valley, so it should be "Wu".] The Hand-Taiyang Meridian externally corresponds to Huai Shui (Huai River) and internally belongs to the Small Intestine, and unblocks the water pathways. [Huai Shui originates from Tongbai Mountain in Pingwu County, Nanyang Commandery, flows southeast into the sea, passing four commanderies, traveling 3,240 li.] The Hand-Shaoyang Meridian externally corresponds to Ta Shui (Ta River) and internally belongs to the San Jiao (Triple Burner). [Ta, pronounced tang-he fan. Ta Shui originates in Pingyuan Commandery, flows northeast into the sea. Additionally, there is a Ta River in Henei, originating from Wangwu Mountain, flowing southeast into the Yellow River. Both waters can serve as correspondence.] The Hand-Yangming Meridian externally corresponds to Jiang Shui (Yangtze River) and internally belongs to the Large Intestine. [Jiang Shui originates in Shengqian County, Minshan Commandery, Shu, flows southeast into the sea, passing nine commanderies, traveling 7,660 li. [Ping An]: Note: "Shengqian" was originally copied as "Waiqian", should be "Sheng" according to *Shui Jing Zhu*.] The Hand-Taiyin Meridian externally corresponds to He Shui (Yellow River) and internally belongs to the Lung. [He Shui originates from the northeast corner of Kunlun Mountain, then潜行 (flows underground) to the Kingdom of Khotan at the edge of Cong Ling, reaches Jishi Mountain, flows northeast into the sea, passing sixteen commanderies, traveling 9,400 li.] The Hand-Taiyin Meridian externally corresponds to Ji Shui (Ji River) and internally belongs to the Heart. [Ji Shui originates in Heng County, Hedong, reaches Wangwu Mountain, flows northeast into the Yellow River.] The Hand-Zhongyin (Pericardium) Meridian externally corresponds to Zhang Shui (Zhang River) and internally belongs to the Pericardium. [Zhang Shui is Qing Zhang Shui (Clear Zhang River), originating northwest of Shao Mountain in Gu County, Shangdang, flowing east to merge with Zhuo Zhang (Turbid Zhang) and enter the sea. Another explanation is Zhuo Zhang, originating from Fajiu Mountain west of Changzi County, Shangdang, flowing east into the sea.]
All these Five Zang, Six Fu, and twelve meridian waters have external sources and internal endowments. They are internally and externally connected, like a circle without beginning or end. Human meridians are the same. [The twelve meridian waters, such as the Yang emerging from Min Mountain, the Yellow River from Kunlun, have external sources. Flowing into the sea represents internal endowment. After reaching the sea, water rises as the Heavenly River, flows out from the source again, and enters the sea, representing internal-external connection, like a circle without end. Human meridians are also so: Foot-Taiyin meridians start from the toes, representing external source. Ascending to connect Fu and belong to Zang, compared to entering the sea, represents internal endowment. Hand-Taiyin meridians go from chest to hand, transforming into Hand-Yangming meridians, starting from the hand, representing external source. Ascending to connect Zang and belong to Fu, represents internal endowment. Going up the head to become Foot-Yangming meridians, descending from head to foot, transforming back into Foot-Taiyin meridians, represents internal-external connection, like a circle without end. [Ping An]: "Wai Nei" (external-internal) is written as "Nei Wai" (internal-external) in *Ling Shu* and *Jia Yi Jing*.] Thus, Heaven is Yang, Earth is Yin; above the waist is Heaven, below the waist is Earth. [Above the human waist is Heaven/Yang; below the waist is Earth/Yin. Meridians ascend to Heaven and descend to Earth, moving with the meridian waters, hence they correspond.] Thus, north of Qing Shui is Yin; north of Hu Shui is Yin within Yin. [North of Qing Shui is already Yin; Hu is north of Qing, so it is Yin within Yin.] South of Zhang Shui is Yang; north of He Shui to Zhang Shui is Yang within Yin. [South of Zhang is Yang, North of He is Yin, so North of He to Zhang is Yang within Yin.] South of Ta Shui to Jiang Shui is Yang within Great Yang. [Ta resides in Yang land, so it is Yang within Great Yang. [Ping An]: "Tai Yang" (Great Yang), the character "Tai" is missing in *Jia Yi Jing*.] This is the Yin and Yang of this one province, therefore humans and Heaven and Earth participate together. [The principle of Yin and Yang is formless, infinitely large outside, infinitely small inside. But humans born in one province must imitate its form, hence using the Yin and Yang of one province to correspond to humans. [Ping An]: "Zhou" (province) is written as "Yu" (corner) in *Ling Shu*.]
Huang Di said: Regarding the correspondence of meridian waters to meridians, their distances, depths, and the amounts of water and blood differ. How should they be integrated for acupuncture? [Three questions: 1. Distance of meridian waters and meridians; 2. Depth; 3. Amount of water and blood. However, there are three differences in body meridians; please adjust accordingly.]
Qi Bo replied: The Foot-Yangming Meridian is the Sea of the Five Zang and Six Fu organs. [The Stomach receives water and grain, transforms them into blood and Qi, forming the Foot-Yangming meridian, which nourishes the Five Zang and Six Fu. The Five Zang and Six Fu receive and complete blood and Qi, likened to the Four Seas providing endless nourishment, hence called Sea.] Its pulse is large, blood is abundant, Qi is vigorous, and heat is strong. [Foot-Yangming gets its name "Sea" for four reasons: 1. Its pulse is thick/large; 2. Its blood is abundant; 3. Its Grain Qi is vigorous; 4. Its Yang Qi is hot. With these four meanings, it is compared to the Sea. [Ping An]: One character is missing below "Re" (heat) in the original; added based on *Ling Shu* and *Jia Yi Jing*.] To needle this, if not deep enough, the pathogen will not disperse; [Needling this pathway, for a medium-sized person, the Foot-Taiyang meridian needs to be needled 6 fen deep. It is considered deep. The meridian is deep under the skin, and blood/Qi is abundant, so 6 fen deep is required to disperse the Qi.] if not retained, the excess will not be drained. [Since blood and Qi are abundant, retention is needed to drain effectively. If heat gathers in the skin causing disease, drain it quickly, hence "heat is drained quickly".] Foot-Taiyang: depth 5 fen, retain 7 breaths. Foot-Shaoyang: depth 4 fen, retain 5 breaths. Foot-Yangming: depth 6 fen, retain 10 breaths. Foot-Taiyin: depth 3 fen, retain 4 breaths. Foot-Shaoyin: depth 2 fen, retain 3 breaths. Foot-Jueyin: depth 1 fen, retain 2 breaths. [Question: The Qi of the twelve meridians originates from different acupoints, and the 365 acupoints belong to their respective meridians. When needling the twelve Hand and Foot meridians here, are these the 365 acupoints originating from these meridians? Or are they the 30 Shu points of the Five Zang and 36 Shu points of the Six Fu on the limbs? Answer: The primary selection involves the 30 Shu points of the limbs and 36 Shu points of the Six Fu. Other interstitial acupoints, if stated to originate from a meridian, belong to that meridian. Thus, selecting its meridian means selecting its originating acupoint. Question: The needling depths for Hand and Foot Yin/Yang here differ greatly from those in the Ming Tang (Acupuncture and Moxibustion Classic). How are they determined? Answer: The depths here and in Ming Tang each give an example. Depending on the person and disease, there are many examples, cannot be generalized. Now, Foot-Taiyang meridian in skin/flesh is slightly deeper than 4 fen, so 5 fen is used as an example. If the meridian runs deeper or shallower, one should palpate and determine accordingly; others follow this. Retaining 7 breaths is an example based on the strength of Taiyang Qi. If the disease fluctuates, the duration can be adjusted; it is not fixed; others follow this. [Ping An]: The Foot-Yangming section in *Ling Shu* precedes Foot-Taiyang. In *Jia Yi Jing*, "Duo Xue Qi Ci" (needling for much blood and Qi) follows Yangming and Taiyang; "Shao Xue Qi Ci" (little blood and Qi) follows Shaoyang; "Duo Xue Shao Qi Ci" (much blood little Qi) follows Taiyin and Jueyin; "Shao Xue Duo Qi Ci" (little blood much Qi) follows Shaoyin.]
The Yin and Yang of the Hands have near pathways for receiving Qi, and their Qi arrives swiftly. Their depth should not exceed 2 fen, and retention should not exceed 1 breath. [Hand Yin six meridians go from hand to chest, belong to Zang and connect Fu, each 3 chi 5 cun long. Hand Yang six meridians go from hand to head, belong to Fu and connect Zang, each 5 chi long. Foot Yin six meridians go from foot to chest, belong to Zang and connect Fu, each 6 chi 5 cun long. Foot Yang six meridians go from foot to head, belong to Fu and connect Zang, each 8 chi long. These twelve Hand and Foot meridians circulate blood and Qi up and down. Since Foot meridians are long, the circulation path is distant; additionally, they are Yin Qi, so movement is slow. Since Hand meridians are short, the circulation path is near; additionally, they are Yang Qi, so movement is fast. Because the path is near and meridians are shallow, needling depth should not exceed 2 fen. Because Qi moves fast, retention should not exceed 1 breath. [Ping An]: "Qi Shen" (its depth) is written as "Qi Ci Shen" (its needling depth) in *Ling Shu* and *Jia Yi Jing*. Note: "Cong Shou Zhi Xiong" (from hand to chest), the character "Xiong" (chest) was originally missing, Yuan's edition made it "Wei" (stomach). Based on the note's "Cong Zu Zhi Xiong" (from foot to chest), it should be "Xiong".] For people of different ages, sizes, and body types (fat/thin), one must use mental discernment; this is called following the constant of Heaven. [Liao, pronounced li-tiao fan, means to select/take. Human life has five stages: newborn is infant; able to smile is child; over 6 years old is small; over 18 years old is young; over 20 years old is strong; over 50 years old is old. Now, under 30 is considered young; over 30 is long/old. In Huang Di's time, over 7 chi 5 cun was large; under 7 chi 5 cun was small. Today, one can mentally estimate human size. Tian (Heaven) means Principle/Li. Changes in age, size, and body type are variable and not constant; harmonizing with Heaven is subtle, this is the constant Way of Heaven. Sages use mental discernment to subtly harmonize with the principle, hence called "following the constant of Heaven". [Ping An]: "Liao" is written as "Liao" (estimate) in *Jia Yi Jing*. Note: "Wei Hai" (as child), the lower half of "Hai" was eaten by insects; examining the upper remainder suggests "Hai". Japan's *Ishinpō* Vol. 25 quoting *Tai Su Jing* says: Newborn is infant, able to smile is hai-er (child). I propose "Hai". Yuan's edition made it "Xiao" (small), and changed subsequent text "over 6 small" to "young", "over 18 young" to "strong", "over 20 strong" to "long", inconsistent with original copy. Also, two characters below "Zhuang" (strong) were missing; based on *Ling Shu · Wei Qi Shi Chang* "over 50 is old", I propose adding "Fifty".] Moxibustion follows the same rules. Moxibustion exceeding these limits results in "Evil Fire", causing bone dryness and pulse stiffness; needling exceeding these limits causes Qi depletion. [Moxibustion must also consider age, size, fat/thin, Qi strength/weakness, acupoint depth, seasonal temperature, and number of cones. One must not lose common sense in haste. If cone count is insufficient, severe diseases do not heal; if exceeding limits, fire toxin enters the body, bones wither, meridians suppurate, named Evil Fire disease. Fire has no good or bad; excessive fire causes more damage, hence named Evil Fire. [Ping An]: "Hui" is written as "Se" (stiff) in *Ling Shu* and *Jia Yi Jing*, Yuan's edition as "Kui" (ulcerate). Based on the note "meridians suppurate", it should be "Kui" (ulcerate), other editions also write "Kui".]
Huang Di asked: The size of meridians, amount of blood, thickness of skin, firmness of muscle, and size of the popliteal fossa (Gu), can these be measured? [Fu means skin. Gu means the fleshy mass around the knee. Listing ten different human forms, asking for methods of measurement to fit the mean. [Ping An]: *Ling Shu* writes "Shao Duo" as "Duo Shao", "Gu" as "Gu".]
Qi Bo replied: Those that can be measured are those of medium build, neither emaciated nor lacking in blood and Qi. For those who have lost their normal state, who are extremely emaciated and whose flesh has wasted away, how can one measure and needle them? One must carefully palpate, trace, press, and observe their cold/heat and excess/deficiency to regulate them; this is called true treatment based on appropriateness. [Medium build does not just mean 7 chi 5 cun, but also those whose fat/thin, cold/heat, excess/deficiency are balanced/appropriate. Ji, pronounced jie. A person of 7 chi 5 cun is defined as medium build. Men, pronounced men-tun fan, means to touch/palpate. [Ping An]: "Shi Du" (lost state), the character "Shi" is written as "Fu" (man/those) in *Ling Shu*.]