黄帝曰。经脉十二。而手太阴足少阴阳明。独动不休何也。岐伯曰。是明胃脉也。胃为五脏六腑
之海。其清气上注于肺。肺气从太阴而行之。其行也。以息往来。故人一呼脉再动。一吸脉亦再动。
呼吸不已。故动而不止。黄帝曰。气之过于寸口也。上十焉息。下八焉伏。何道从还。不知其极。岐
伯曰。气之离脏也。卒然如弓弩之发。如水之下岸。上于鱼以反衰。其余气衰散以上逆。故其行微。
此章论营卫宗气。循度行于经脉之外内。冲脉行于足少阴阳明之经。而出于腹气胫气之街。以明
血气之行于经脉皮肤之间。交相和平俞应者也。帝问手太阴足少阴阳明独动不休者。谓手太阴之太渊
经渠。足阳明之人迎冲阳。足少阴太溪之动脉也。伯言是明胃脉者。谓胃为五脏六腑之海。其营卫宗
气。皆胃腑谷精之所生也。清气上注于肺者。营气宗气也。肺气从太阴而行之者。脉气随三阴三阳之气
而行也。其行也以息往来者。人一呼一吸。脉行六寸。日夜一万三千五百息。脉行八百十丈为一周也。
帝问气之过于寸口。上十焉息者。乃营气卫气宗气。尽走于息道。而变见于寸口也。下八焉伏者。谓流
溢于中之营血。下伏于胞
中。故如水之下岸也。按本经营气篇曰。营气之道。内谷为宝。谷入于胃。乃传之肺。流溢于中。布
散于外。精专者行于经隧。常营无已。终而复始。夫帝言下伏之营血有八。是精专而行于经隧之营止
二分矣。夫营气行于脉中。卫气行于脉外。宗气两行营卫之道。此经脉外内之气。相为和平。而有形
之营血。分行于外内。亦相为匀等者也。夫冲脉起于胞中。上循背里。为经络之海。其浮而外者。循
腹右上行。至胸中而散。充肤热肉。淡渗皮毛。此下伏于胞中之血。半随冲脉而行于脉内。半随冲脉
而散于皮肤。又足阳明之脉。与冲脉于脐左右之动脉。而出于腹气之街。冲脉与少阴之大络。循阴股
而下出于胫气之街。夫精专者。二分行于经隧。随冲脉者。二分出于气街。是经脉外内之气血。相为
匀等矣。皮肤之气血。从指井而溜注于荥输。脉中之血气。从本标而外出于肤表。从道往还。莫知其
极矣。伯言气之离脏。卒然如弓弩之发者。谓五脏之气。至于手太阴而变见于寸口者。应手而动。若
弓弩之发弦。上于鱼际。则动气衰而无动脉矣。其余气衰散以逆上者。谓余气分散。而上注于手阳
明大肠之经。故其脉上鱼。而其行微缓也。此言五脏之气。因胃气而至于手太阴。腹走手而手走头。
头走足而足走腹。常营无已。终而复始。环转之无端也。
黄帝曰。足之阳明。何因而动。岐伯曰。胃气上注于肺。其悍气上冲头者。循咽上走空窍。循眼
系。入络脑。出 。下客主人。循牙车。合阳明。并下人迎。此胃气别走于阳明者也。故阴阳上下。
其动也若一。故阳病而阳脉小者为逆。阴病而阴脉大者为逆。故阴阳俱静俱动。若引绳相倾者病。
(音坎)
此言阳明之气盛。而独动不休者也。阴阳系日月论曰。两阳合于前。故曰阳明。又曰两火合并。
故为阳明。是阳明主气金之气。而又有悍热之火气也。胃气上注于肺者。胃腑所生之营气宗气。上注于肺。而行于
经脉之外内。以应呼吸漏下。其悍热之气。上冲头者。循咽上走空窍。循眼系。入络脑。出 。下客
主人。循牙车。此阳明之悍气。上走空窍。行于皮肤之气分。而下合于阳明之脉中。并下人迎。此胃
腑所生之悍气。别走于阳明者也。故阴阳上下。其动也若一。盖身半以上为阳。身半以下为阴。谓在
上之人迎。在下之冲阳。其动之相应也。故阳病而阳脉小。阴脉大者为逆。阴病而阴脉大。阳脉小者
为逆。故阴阳上下。静则俱静。动则俱动。若引绳墨。如相倾而不相应者。则为病矣。按上章曰胸
气有街。腹气有街。头气有街。胫气有街。气在腹者。止之背俞。与冲脉于脐左右之动脉间。夫足阳明
之脉。其支者下人迎。入缺盆。从缺盆下乳内廉。挟脐入气街中。其支者。下循腹里。至气街中而合。
以下髀关。循股外廉。至足跗上。夫胃之悍气。合阳明之脉而下人迎。挟脐入气街中。则与冲脉相合。
而出于腹气之街矣。其下行而出于足跗者。动于冲阳而上。与人迎之相应也。
黄帝曰。足少阴何因而动。岐伯曰。冲脉者。十二经之海也。与少阴之大络。起于肾。下出于气
街。循阴股内廉。邪入 中。循胫骨内廉。并少阴之经。下入内踝之后。入足下。其别者。邪入踝。出属
跗上。入大趾之间。注诸络。以温足胫。此脉之常动者也。(邪斜同)
此言流溢于中之血气。一从冲脉与足少阴之大络。而下出于足胫之气街。循阴股内廉者。血气出于
皮肤。仍循少阴之经而行也。斜入 中者。与太阳之承山踝上以下也。其别者。乃少阴之支络。别走于
踝跗。上入大趾之间。而散于十趾之络。是以阳气起于足五趾之表。阴气起于足五趾之里。盖阴阳二气。
本于先天之水火。藏于肾脏。出于下而升于上也。夫卫气者。阳明所生之气也。上节论卫气之别走阳明。合于人
迎。是从膺胸脐腹。而下至跗上。如左右之动脉。与冲脉会于脐间。则阳明之血气。随冲脉而出于腹
气之街矣。此节论冲脉与少阴出于胫气之街。盖手足十二经之本标。只出于头气之街。胸气之街。
营卫之行。从本而入。从标而出。上下相贯。如环无端。其腹气之街。胫气之街。乃别出阳明少阴之
血气。不在十二经脉本标之内。故别提出阳明少阴之动输焉。
黄帝曰。营卫之行也。上下相贯。如环之无端。今有其卒然遇邪气。及逢大寒。手足懈惰。其脉
阴阳之道。相输之会。行相失也。气何由还。岐伯曰。夫四末阴阳之会者。此气之大络也。四街者。气
之径路也。故络绝则径通。四末解。则气从合。相输如环。黄帝曰善。此所谓如环无端。莫知其纪。
此之谓也。
此申明经脉之血气。从四街而出行于脉外。皮肤分肉之气血。从四末而入行于脉中。上下相贯。
环转之无端也。四末者。四肢之杪末。手足之指井也。其脉者。谓手足三阴三阳之经输。阴阳之道者。
血气从此所行之道路也。相输之会气从合者。谓皮肤之气血。从四末而溜于脉中。输行于经。而与脉中
之血气相会。入于肘膝之间。而与脉中之血气相合。故曰四末解。则气从合。盖假风寒之邪。以明四末
乃阴阳之会。气从此而所入之大络也。如因邪气所阻。则手足懈惰。而道路不通。气何由而环转。如四
末和解。则气血输会于脉中。而还转于气街矣。夫经脉者。内连于脏腑。外络于形身。外内出入。常营
无已。络脉者。乃经脉之支别。如江河之支流。至梢杪而有尽也。四街者。气之径路也。故络绝则径通。
手足十二经之本标。出于头气之街。胸气之街。
阳明所生之血气。复出于腹气之街。少阴所藏之血气。复出于胫气之街。此经脉中之血气。复从络
脉之尽处。出于气街。而行于皮肤分肉之外也。此营卫之行于皮肤经脉之外内。上下相贯。如环无
端。莫知其纪也。王子方曰。本经云。营行脉中。卫行脉外。又曰。浮气之不循经者为卫气。精气
之营于经者为营气。今复言营卫之行环转于经脉之外内。岂经义自相矛盾与。曰。卫气昼行于阳。
夜行于阴。应天气之晦明。天道右旋。地道左转。天运于地之外。交相逆顺而行。应营气行于脉中。
卫气行于脉外。外内清浊之不相干也。然天气营运于地之外。而复通贯于地中。有四时之寒暑往来。
生长收藏。此天地阴阳之气。上下升降。外内出入有分有合。环转无端。是以营卫之行。环转于皮
肤经脉之外内者。应天地之气交也。夫所谓营行脉中者。始于手太阴肺。终于足厥阴肝。腹走手而手
走头。头走足而足走腹。一脉流通。终而复始。此营血之行于脉中也。又别出两行营卫之道。清者为
营。浊者为卫。营行脉中。卫行脉外。营于脉中者。循手足之十二经脉。及阴跷阳跷任脉督脉。合十
六丈二尺为一周。昼行二十五度。夜行二十五度。应呼吸漏下者。此营气之行于脉中也。卫气昼行阳
二十五度。夜行阴二十五度。此营气卫气各走其道。清浊外内之不相干也。若夫手足之三阴三阳。十
二经脉。皆从指井所出。而营于五脏之二十五输。六腑之三十六输。夫指井离爪甲如韭许。乃血
肉筋骨之尽处。血气皆从何来。而曰所出为井耶。盖受皮肤之气血。从此而溜注于脉中。十二经脉之
血气。始从此而生出。故曰所出为井。所溜为荥。所注为输。所行为经也。充肤热肉之气血。妇随夫唱
。相将而行。同溜于经脉之中。故曰营卫之行也。上下相贯。四末阴阳之会者。此气之大络也。夫宗气
半行于脉中。半行于
脉外。营血半营于经隧。半营于皮肤。营气行于脉中。卫气行于脉外。阴中有阳。阳中有阴。犹两
仪四象之定体。血气贯通于外内。应天地之气交。一息不运则生化灭矣。夫皮肤气分为阳。经脉血
分为阴。阳走阳而阴走阴。此阴阳之相离也。阴出于阳。阳入于阴。此阴阳之相合也。阴阳之道。
有离而有合也。若行于阳者。只行于阳。行于阴者。只行于阴。无外内出入之神机。而生化亦灭矣。
阴阳之奥。会心者明之。余伯荣曰。五乱胀论。言卫气乱脉。是谓大 。卫气逆为脉胀。卫气并脉
循分为肤胀。若卫气行于脉内。岂非乱脉乎。曰。卫气之在路也。常然并脉循分肉。行有逆顺。阴阳
相随。乃得天和。谓脉内之血气顺行。而脉外之气血逆转。行有逆顺。乃得天地之和。卫气乱脉者。
谓卫气顺脉而行也。若夫环转于皮肤经脉之外内。正所谓交相逆顺而行。又何乱之有。
黄帝说:人体有十二条经脉,但手太阴肺经和足少阴肾经、足阳明胃经的脉搏唯独跳动不停,这是为什么呢?
岐伯回答说:这是因为它们是反映胃气的脉象。胃是五脏六腑营养物质的海洋,其中清轻的精气上注于肺,肺气随着手太阴肺经的气机运行。这种运行伴随着呼吸而往来不息,所以人每呼一次脉跳两次,每吸一次脉也跳两次。只要呼吸不止,脉搏也就不会停止。
黄帝说:当气经过寸口(手腕桡动脉处)时,向上行十寸,向下伏藏八寸,它是通过什么路径返回的呢?我不明白其中的极限所在。
岐伯回答说:气离开脏腑时,突然爆发就像弓弩发射箭矢一样迅猛;又像水从高岸冲下。气流上行至鱼际部位时,气势逐渐衰退,其余的气分散并逆向上行,所以脉动变得微弱。
这一章论述了营气、卫气和宗气,它们沿着一定的度数在经脉的内侧和外侧运行。冲脉在足少阴肾经和足阳明胃经之间运行,并从腹气街和胫气街发出,以此说明血气在经脉和皮肤之间运行,相互协调平衡。黄帝问为什么手太阴、足少阴、足阳明三经唯独跳动不停,指的是手太阴经的太渊穴、经渠穴,足阳明经的人迎穴、冲阳穴,以及足少阴经的太溪穴这些部位的动脉搏动。岐伯说“这是明胃脉”,意思是胃为五脏六腑之海,其中的营气、卫气和宗气,都是由胃腑消化谷物产生的精微物质所化生。所谓“清气上注于肺”,指的是营气和宗气。所谓“肺气从太阴而行”,是指脉气随着三阴三阳之气而运行。所谓“其行也以息往来”,是指人一呼一吸之间,脉气运行六寸,一天一夜一万三千五百次呼吸,脉气运行八百一十丈,完成一个循环。
黄帝问“气之过于寸口,上十焉息”,指的是营气、卫气、宗气都汇聚于息道(呼吸道),并在寸口显现出来。“下八焉伏”,指的是流溢于体内的营血,潜伏在下焦胞宫之中,所以像水从高岸落下一样。按照《内经》本经营气篇所说:“营气的运行之道,以内谷为宝。”谷物进入胃中,进而传送给肺,流溢于体内,布散于体表。其中精纯专一的部分运行于经络隧道之中,常年循环无已,周而复始。黄帝所说的“下伏”的营血有八分,这指的是精纯而运行于经络隧道中的营气只占二分。营气运行在脉管内部,卫气运行在脉管外部,宗气则兼行于营卫之道。这就是经脉内外之气相互协调平衡,而有形的营血分别运行于内外,也是均匀相等的。
冲脉起于胞中,向上沿脊柱内侧行走,是经络之海。其中浮行于体表的分支,沿腹部右侧上行,至胸部后散开,充盈肌肤,温暖肌肉,渗透皮毛。这部分潜伏在胞中的血液,一半随冲脉运行于脉内,一半随冲脉散行于皮肤。另外,足阳明胃经的脉气,与冲脉在脐部左右的动脉汇合,从腹气街发出。冲脉与足少阴肾经的大络,沿大腿内侧下行,从胫气街发出。那精纯专一的营气,二分运行于经络隧道;随冲脉运行的气血,二分出于气街。这样,经脉内外的气血就保持均匀相等了。皮肤的气血,从井穴流入注于荥穴、输穴;脉中的血气,从本标向外达于肤表,往返循环,无穷无尽。
岐伯说“气之离脏,卒然如弓弩之发”,是指五脏之气到达手太阴肺经并在寸口变显时,应手而动,就像弓弩发射弦声一样。气流上行至鱼际,则搏动之气减弱,不再明显。所谓“其余气衰散以逆上”,是指剩余的气分散,并上行注入手阳明大肠经,所以脉气上行至鱼际,且运行缓慢微弱。这说明五脏之气,依靠胃气才能到达手太阴肺经。气由腹走手,由手走头,由头走足,由足走腹,常年循环无已,周而复始,环转无端。
岐伯回答说:胃气上注于肺,其中剽悍滑疾之气上冲头部,沿着咽喉向上走向空窍,沿着眼系,进入脑络,出于颃颡,下行至客主人穴,沿着牙车(下颌角),与阳明经汇合,并下行至人迎穴。这是胃气别行于阳明经的缘故。所以阴阳上下部的脉动是一致的。因此,阳病而阳脉小的是逆证,阴病而阴脉大的是逆证。如果阴阳两部脉象要么都静止,要么都剧烈跳动,像拉紧的绳子一样倾斜失衡,那就是病态。(“坎”音同“堪”)。
这一段论述阳明之气旺盛,所以独自跳动不停。《阴阳系日月论》说:“两阳合并于前,故称阳明。”又说“两火合并”,所以称为阳明。这意味着阳明主司金气,同时又具有剽悍热盛的火气。胃气上注于肺,是指胃腑所生的营气和宗气,上注于肺,运行于经脉内外,以配合呼吸节律。而那剽悍热盛之气,上冲头部,沿着咽喉走向空窍,沿着眼系,进入脑络,出于颃颡,下行至客主人穴,沿着牙车。这是阳明经的剽悍之气,上行走向空窍,运行于皮肤的气分,而下合于阳明经脉中,并下行至人迎穴。这是胃腑所生的剽悍之气,别行于阳明经的缘故。所以阴阳上下部的脉动是一致的。大概身体上半身为阳,下半身为阴。指上部的人迎脉和下部的冲阳脉,其搏动是相应的。所以阳病而阳脉小、阴脉大的是逆证;阴病而阴脉大、阳脉小的是逆证。因此,阴阳上下部,静止时都静止,跳动时都跳动。如果像墨线一样笔直却不相呼应,那就是病了。
按上一章所说,胸气有气街,腹气有气街,头气有气街,胫气有气街。气在腹部者,止于背俞穴,以及与冲脉在脐部左右的动脉之间。足阳明胃经的支脉,下行至人迎,进入缺盆,从缺盆下行至乳内侧,挟脐进入气街中。其另一支脉,下行沿腹腔内部,至气街中汇合,然后下行经过髀关,沿大腿外侧,至足背。胃的剽悍之气,合入阳明经脉下行至人迎,挟脐进入气街中,这就与冲脉相合,并从腹气街发出。其下行而出于足背的脉气,在冲阳穴处搏动向上,与人迎脉相应。
岐伯回答说:冲脉,是十二经脉之海。它与足少阴肾经的大络,起于肾,向下出于气街,沿大腿内侧下行,斜入腘窝中,沿胫骨内侧下行,并足少阴经下行,进入内踝之后,入足底。其分支,斜入踝部,出于足背,进入大趾之间,注入各络脉,以温养足胫。这是该脉常动的表现。(“邪”通“斜”)。
这一段论述流溢于体内的血气,一部分从冲脉和足少阴肾经的大络,向下出于足胫的气街。所谓“循阴股内廉”,是指血气出于皮肤,仍沿少阴经而行。所谓“斜入腘中”,是与太阳经的承山穴及踝上部位相关。其分支,乃是少阴经的支络,别行至踝部和足背,上行进入大趾之间,并散在于十个脚趾的络脉中。因此,阳气起于足五趾的表面,阴气起于足五趾的里面。大概阴阳二气,源于先天的水火,藏于肾脏,出于下部而升于上部。卫气,是由阳明经所生的气。上一节论述卫气别行于阳明经,汇合于人迎,是从膺胸、脐腹,向下至足背。如果左右动脉与冲脉会合于脐间,那么阳明经的血气就会随冲脉出于腹气街。这一节论述冲脉与足少阴经出于胫气街。大概手足十二经脉的本标,只出于头气街、胸气街。营卫的运行,从本而入,从标而出,上下贯通,如环无端。至于腹气街、胫气街,乃是别出阳明、少阴的血气,不在十二经脉本标的常规范围内,所以特别提出阳明、少阴的动输现象。
黄帝说:营卫的运行,上下贯通,如环无端。现在如果遇到突然遭受邪气,或遭遇大寒,导致手足懈怠无力,此时脉象阴阳之道,相互输送交会的地方,运行失去协调,气是如何返回的呢?
岐伯回答说:四肢末端是阴阳之气交会的地方,这是气的大络。四街(头、胸、腹、胫的气街)是气通行的径路。所以如果络脉闭塞,径路就会通畅;四肢调和,气就能从交会处汇合,相互输送如环无端。
黄帝说:好。这就是所谓的如环无端,不知其终结,说的就是这种情况。
这一段申明经脉的血气,从四街外出运行于脉外;皮肤分肉间的血气,从四末进入运行于脉中。上下贯通,环转无端。四末,指四肢的末端,手足的井穴。其脉,指手足三阴三阳经的腧穴。阴阳之道,指血气从此通行的道路。所谓“相输之会,气从合”,是指皮肤的气血,从四末流入脉中,输注运行于经脉,并与脉中的血气相会,进入肘膝之间,与脉中血气相合。所以说“四末解,则气从合”。假如假借风寒之邪,来说明四末乃是阴阳交会之处,气由此进入的大络。如果因邪气阻滞,则手足懈怠,道路不通,气如何能环转?如果四末调和,则气血输注会合于脉中,并回转于气街。
夫经脉,内连脏腑,外络形体,内外出入,常年循环无已。络脉,是经脉的分支,如同江河的支流,到了梢末就有尽头。四街,是气通行的径路。所以络脉闭塞则径路通畅。手足十二经脉的本标,出于头气街、胸气街。阳明经所生的血气,复出出于腹气街;少阴经所藏的血气,复出出于胫气街。这是经脉中的血气,又从络脉的尽头处,出于气街,而运行于皮肤分肉之外。这就是营卫运行于皮肤经脉的内外,上下贯通,如环无端,不知其终结。
王子方说:本经云:“营行脉中,卫行脉外。”又说:“浮气之不循经者为卫气,精气之营于经者为营气。”现在又说营卫的运行环转于经脉的内外,难道经文义理自相矛盾吗?回答说:卫气昼行于阳,夜行于阴,顺应天气的晦明变化。天道右旋,地道左转,天运于地之外,交相逆顺而行,应合营气行于脉中,卫气行于脉外,内外清浊互不干扰。然而天气营运于地之外,又贯通于地中,有四时寒暑往来,生长收藏。这是天地阴阳之气,上下升降,内外出入,有分有合,环转无端。因此营卫的运行,环转于皮肤经脉的内外,是顺应天地之气的交感。所谓“营行脉中”,始于手太阴肺经,终于足厥阴肝经,腹走手,手走头,头走足,足走腹,一脉流通,终而复始。这是营血运行于脉中。另外还有两行营卫之道,清者为营,浊者为卫,营行脉中,卫行脉外。营于脉中者,循行手足十二经脉,及阴跷、阳跷、任脉、督脉,合计十六丈二尺为一周,昼行二十五度,夜行二十五度,应合呼吸节律。这是营气运行于脉中。卫气昼行阳二十五度,夜行阴二十五度。这是营气、卫气各走其道,清浊内外互不干扰。至于手足三阴三阳十二经脉,皆从指井穴所出,而营于五脏的二十五个腧穴,六腑的三十六个腧穴。指井穴距离指甲如韭菜叶宽,乃是血肉筋骨的尽头处,血气从何而来,却说“所出为井”呢?大概是接受了皮肤的气血,从此流入注于脉中,十二经脉的血气,才从此生出。所以说“所出为井,所溜为荥,所注为输,所行为经”。充盈肌肤、温暖肌肉的气血,如妇随夫唱,相伴而行,同流入经脉之中,所以说“营卫之行也,上下相贯”。所谓“四末阴阳之会者,此气之大络也”。宗气一半行于脉中,一半行于脉外;营血一半营于经隧,一半营于皮肤;营气行于脉中,卫气行于脉外。阴中有阳,阳中有阴,犹如两仪四象的定体。血气贯通于内外,应合天地之气的交感。一息不运,则生化灭绝。皮肤气分为阳,经脉血分为阴,阳走阳而阴走阴,这是阴阳的分离。阴出于阳,阳入于阴,这是阴阳的结合。阴阳之道,有离而有合。如果行于阳的只行于阳,行于阴的只行于阴,没有内外出入的神妙机制,那么生化也就灭绝了。阴阳的奥妙,用心体会的人自然明白。
余伯荣说:《五乱胀论》中说,卫气乱脉,称为大胀。卫气逆乱导致脉胀,卫气并入脉中循行分肉导致肤胀。如果卫气行于脉内,岂不是乱脉吗?回答说:卫气在运行路上,常常并脉循行分肉,运行有逆有顺,阴阳相随,这才符合天和。谓脉内的血气顺行,而脉外的气血逆转,运行有逆有顺,才得天地之和。所谓“卫气乱脉”,是指卫气顺着脉道而行。至于环转于皮肤经脉的内外,正所谓交相逆顺而行,又有什么乱的呢?
Huangdi said: There are twelve meridian channels in the human body, yet the pulses of the Hand-Taiyin Lung Meridian and the Foot-Shaoyin Kidney Meridian and Foot-Yangming Stomach Meridian alone beat ceaselessly. Why is this?
Qibo replied: This is because they reflect the Stomach Pulse (Wei Mai). The Stomach is the sea of nutrients for the five zang organs and six fu organs. Its clear essence ascends to the Lungs. The Lung Qi travels along the Hand-Taiyin channel. This travel occurs with the rhythm of respiration. Therefore, when a person exhales, the pulse beats twice; when a person inhales, the pulse also beats twice. As long as respiration does not cease, the pulse movement will not stop.
Huangdi said: When Qi passes through the Cun Kou (inch position at the radial artery), it travels ten cun upwards and hides eight cun downwards. Through what path does it return? I do not understand its limits.
Qibo replied: When Qi leaves the zang organs, it erupts suddenly like an arrow released from a crossbow, or like water rushing down from a high bank. As the Qi flows upward to the Yu Ji area, its momentum declines. The remaining Qi scatters and moves upward against the flow, so its movement becomes subtle.
This chapter discusses Ying Qi (Nutritive Qi), Wei Qi (Defensive Qi), and Zong Qi (Gathering Qi), which travel along specific degrees inside and outside the meridian channels. Chong Mai (Penetrating Vessel) travels between the Foot-Shaoyin Kidney Meridian and Foot-Yangming Stomach Meridian, emerging from the Fu Qi Jie (Abdominal Qi Street) and Jing Qi Jie (Calf Qi Street), thereby illustrating that blood and Qi circulate between the meridians and the skin, maintaining mutual harmony. Huangdi asked why the Hand-Taiyin, Foot-Shaoyin, and Foot-Yangming meridians alone beat ceaselessly. This refers to the arterial pulsations at Tai Yuan and Jing Qu points on the Hand-Taiyin Meridian, Ren Ying and Chong Yang points on the Foot-Yangming Meridian, and Tai Xi point on the Foot-Shaoyin Meridian. Qibo stated "these are clear Stomach Pulses," meaning the Stomach is the sea of the five zang and six fu organs. The Ying Qi, Wei Qi, and Zong Qi within it are all generated from the refined essence of grain digested by the Stomach. "Clear essence ascending to the Lungs" refers to Ying Qi and Zong Qi. "Lung Qi traveling along Taiyin" means pulse Qi travels with the Qi of the Three Yin and Three Yang meridians. "Its travel occurs with respiration" means that during one exhalation and one inhalation, pulse Qi travels six cun. In one day and night, with 13,500 breaths, pulse Qi travels 810 zhang to complete one cycle.
When Huangdi asked about "Qi passing over Cun Kou, where does it rest after going up ten cun?" he referred to Ying Qi, Wei Qi, and Zong Qi gathering at the respiratory pathway and manifesting at Cun Kou. "Hiding eight cun downwards" refers to Ying Blood flowing into the interior and hiding in the Bao Zhong (uterus/lower jiao), thus resembling water falling from a high bank. According to the Ying Qi Chapter of this classic: "The way of Ying Qi treasures internal grain." Grain enters the Stomach, is transmitted to the Lungs, flows into the interior, and spreads to the exterior. The purest and most concentrated part travels within the meridian tunnels, circulating endlessly and restarting cyclically. The "hiding" Ying Blood mentioned by Huangdi accounts for eight parts, whereas the purest Ying Qi traveling within the meridian tunnels accounts for only two parts. Ying Qi travels inside the vessels, while Wei Qi travels outside the vessels. Zong Qi travels both paths of Ying and Wei. This represents the harmonious balance of Qi inside and outside the meridians.有形 Ying Blood also distributes evenly between the interior and exterior.
Chong Mai originates in Bao Zhong, ascends along the spine's interior, and serves as the Sea of the Meridians. Its branch floating outward follows the right side of the abdomen upward, dispersing in the chest, filling the skin, warming the flesh, and渗着 the hair follicles. Half of this blood hiding in Bao Zhong travels within the vessels following Chong Mai, and half disperses into the skin following Chong Mai. Furthermore, the Foot-Yangming Stomach Meridian merges with Chong Mai at the arteries left and right of the navel, emerging from the Fu Qi Jie. Chong Mai and the large collateral of the Foot-Shaoyin Kidney Meridian descend along the inner thigh, emerging from the Jing Qi Jie. The purest Ying Qi, two parts, travels within the meridian tunnels; the Qi and Blood following Chong Mai, two parts, emerge from the Qi Streets. Thus, Qi and Blood inside and outside the meridians remain balanced. Qi and Blood in the skin flow from the Jing-Well points to the Ying-Spring and Shu-Stream points. Qi and Blood in the vessels emerge outward to the skin surface from their roots and terminals, returning via various paths, without end.
Qibo stated "Qi leaving the zang organs, suddenly erupting like a crossbow release," referring to the Qi of the five zang organs reaching the Hand-Taiyin Lung Meridian and manifesting at Cun Kou, moving upon touch, like the string of a bow being released. As Qi ascends to Yu Ji, the pulsating Qi weakens and becomes imperceptible. "The remaining Qi scatters and moves upward" refers to residual Qi dispersing and ascending into the Foot-Yangming Large Intestine Meridian. Hence, the pulse rises to Yu Ji, but its movement is slow and subtle. This indicates that the Qi of the five zang organs relies on Stomach Qi to reach the Hand-Taiyin Lung Meridian. Qi moves from the abdomen to the hand, from the hand to the head, from the head to the foot, and from the foot to the abdomen, circulating endlessly and cyclically without beginning or end.
Huangdi said: What causes the Foot-Yangming Stomach Meridian to pulse?
Qibo replied: Stomach Qi ascends to the Lungs. Its fierce and rapid Qi rushes upward to the head, following the throat to the orifices, along the eye system, entering the brain network, emerging from the pharynx, descending to the Ke Zhu Ren point, following the jaw angle, merging with the Yangming Meridian, and descending together to the Ren Ying point. This is Stomach Qi taking a separate route to the Yangming Meridian. Therefore, the pulsations above and below, yin and yang, are consistent. Thus, if yang disease presents with a small yang pulse, it is adverse; if yin disease presents with a large yin pulse, it is adverse. If both yin and yang pulses are either still or agitated, tilting like a taut rope, it indicates disease.
This section discusses how Yangming Qi is abundant, causing it to pulse independently. The *Yin Yang Xi Ri Yue Lun* states: "Two Yangs combine anteriorly, hence called Yangming." It also says: "Two Fires merge, hence Yangming." This implies Yangming governs Metal Qi but also possesses fierce, hot Fire Qi. Stomach Qi ascending to the Lungs refers to the Ying Qi and Zong Qi generated by the Stomach, which ascend to the Lungs and travel inside and outside the meridians to correspond with respiration. The fierce and hot Qi rushing upward to the head follows the throat to the orifices, along the eye system, into the brain, emerging from the pharynx, descending to Ke Zhu Ren, and following the jaw angle. This is the fierce Qi of the Yangming Meridian, ascending to the orifices, traveling in the qi aspect of the skin, and merging downward into the Yangming vessel, descending to Ren Ying. This is the fierce Qi generated by the Stomach, taking a separate route to Yangming. Thus, the pulsations of yin and yang above and below are consistent. Generally, the upper half of the body is Yang, and the lower half is Yin. This refers to the corresponding pulsations of Ren Ying above and Chong Yang below. Therefore, if yang disease has a small yang pulse and large yin pulse, it is adverse; if yin disease has a large yin pulse and small yang pulse, it is adverse. Thus, yin and yang above and below are still together or move together. If they are straight like a plumb line but do not correspond, it is disease.
As stated in the previous chapter, there are Qi Streets in the chest, abdomen, head, and calves. Qi in the abdomen stops at the Back-Shu points and the arteries left and right of the navel associated with Chong Mai. The branch of the Foot-Yangming Stomach Meridian descends to Ren Ying, enters Que Pen, descends from Que Pen to the medial side of the breast, accompanies the navel into the Qi Street. Another branch descends along the abdominal interior, merging at the Qi Street, then descends through Bi Guan, along the lateral thigh, to the dorsum of the foot. The fierce Qi of the Stomach merges with the Yangming vessel, descends to Ren Ying, accompanies the navel into the Qi Street, thus merging with Chong Mai and emerging from the Fu Qi Jie. The Qi descending to the dorsum of the foot pulses at Chong Yang upward, corresponding with Ren Ying.
Huangdi said: What causes the Foot-Shaoyin Kidney Meridian to pulse?
Qibo replied: Chong Mai is the Sea of the Twelve Meridians. It connects with the large collateral of the Foot-Shaoyin Kidney Meridian, originating from the Kidney, descending to emerge from the Qi Street, following the medial thigh, obliquely entering the popliteal fossa, following the medial tibia, running parallel to the Shaoyin Meridian, descending behind the medial malleolus, entering the sole of the foot. Its branch obliquely enters the ankle, emerges on the dorsum of the foot, enters between the big toe, injects into the collaterals, to warm the calf and foot. This is the normal pulsation of this vessel.
This section discusses how blood and Qi flowing into the interior exit downward from Chong Mai and the large collateral of the Foot-Shaoyin Kidney Meridian at the Jing Qi Jie of the calf. "Following the medial thigh" means blood and Qi emerge from the skin and still follow the Shaoyin Meridian. "Obliquely entering the popliteal fossa" relates to Cheng Shan of the Taiyang Meridian and areas above the ankle. Its branch is the collateral of Shaoyin, diverging to the ankle and dorsum, ascending between the big toe, and scattering into the collaterals of the ten toes. Thus, Yang Qi originates from the dorsal aspect of the five toes, and Yin Qi originates from the plantar aspect of the five toes. Generally, Yin and Yang Qi originate from innate Water and Fire, stored in the Kidneys, emerging from the lower body and ascending. Wei Qi is generated by Yangming. The previous section discussed Wei Qi diverging to Yangming and merging at Ren Ying, traveling from the chest, navel, and abdomen down to the dorsum of the foot. If the left and right arteries meet Chong Mai at the navel, then the blood and Qi of Yangming emerge from the Fu Qi Jie with Chong Mai. This section discusses Chong Mai and Foot-Shaoyin emerging from the Jing Qi Jie. Generally, the root and terminal of the twelve meridians of the hands and feet emerge only from the Head Qi Street and Chest Qi Street. The travel of Ying and Wei enters from the root and exits from the terminal, connecting上下 like a ring without end. The Fu Qi Jie and Jing Qi Jie are special outlets for the blood and Qi of Yangming and Shaoyin, not within the standard root-terminal framework of the twelve meridians. Hence, the pulsations of Yangming and Shaoyin are specifically highlighted.
Huangdi said: The travel of Ying and Wei connects上下 like a ring without end. Now, if one suddenly encounters pathogenic Qi or severe cold, causing limbs to become flaccid and weak, and the pathways of yin and yang pulses lose their coordinated transmission, how does Qi return?
Qibo replied: The four extremities are the meeting places of Yin and Yang Qi, which are the great collaterals of Qi. The Four Streets are the direct routes of Qi. Therefore, if collaterals are blocked, the direct routes become patent; if the four extremities are harmonized, Qi converges at the junctions, transmitting circularly like a ring.
Huangdi said: Excellent. This is what is meant by "like a ring without end, knowing no limit."
This clarifies that the blood and Qi of the meridians travel outward from the Four Streets to the exterior of the vessels, while the blood and Qi of the skin and muscles enter from the four extremities into the vessels. They connect上下, circling endlessly. The four extremities refer to the tips of the limbs, the Jing-Well points of the hands and feet. Their vessels refer to the Shu points of the three Yin and three Yang meridians of the hands and feet. The "way of yin and yang" refers to the pathways traveled by blood and Qi. "The meeting of mutual transmission, Qi converging" means that Qi and Blood from the skin flow from the four extremities into the vessels, transmit through the meridians, and converge with the blood and Qi in the vessels, entering the elbows and knees to merge with the blood and Qi in the vessels. Hence, "when the four extremities are harmonized, Qi converges." Using wind-cold pathogens as an example, the four extremities are the meeting place of Yin and Yang, the great collaterals where Qi enters. If blocked by pathogens, limbs become flaccid, pathways are obstructed, and Qi cannot circle. If the four extremities are harmonized, Qi and Blood transmit and converge in the vessels, returning to the Qi Streets.
Meridians connect internally with the zang-fu organs and externally with the body form, entering and exiting continuously, circulating endlessly. Collaterals are branches of the meridians, like tributaries of rivers, ending at the tips. The Four Streets are the direct routes of Qi. Thus, if collaterals are blocked, the direct routes open. The roots and terminals of the twelve meridians of the hands and feet emerge from the Head Qi Street and Chest Qi Street. The blood and Qi generated by Yangming re-emerge from the Fu Qi Jie. The blood and Qi stored by Shaoyin re-emerge from the Jing Qi Jie. This is how blood and Qi in the meridians emerge from the ends of the collaterals, exit the Qi Streets, and travel outside the skin and muscles. This is how Ying and Wei travel inside and outside the skin and meridians, connecting上下, circling endlessly, without limit.
Wang Zifang said: The classic states: "Ying travels inside the vessels, Wei travels outside the vessels." It also says: "Floating Qi not following the meridians is Wei Qi; Essence Qi nourishing the meridians is Ying Qi." Now it again states that Ying and Wei travel circularly inside and outside the meridians. Is this contradictory? The answer is: Wei Qi travels in Yang during the day and in Yin at night, responding to the brightness and darkness of Heaven. The Way of Heaven rotates right, the Way of Earth rotates left. Heaven operates outside Earth, moving in contrary and顺顺 directions, corresponding to Ying Qi traveling inside the vessels and Wei Qi traveling outside, where clear and turbid, inside and outside do not interfere. However, Heaven's Qi operates outside Earth yet penetrates into Earth, with seasonal changes of cold and heat, growth, and storage. This is the Qi of Heaven and Earth Yin and Yang, ascending and descending, entering and exiting, dividing and combining, circling endlessly. Therefore, the travel of Ying and Wei circling inside and outside the skin and meridians responds to the interaction of Heaven and Earth Qi. "Ying travels inside the vessels" begins at Hand-Taiyin Lung and ends at Foot-Jueyin Liver, moving from abdomen to hand, hand to head, head to foot, foot to abdomen, flowing through one vessel, finishing and restarting. This is Ying Blood traveling inside the vessels. There are also two distinct paths for Ying and Wei: Clear is Ying, Turbid is Wei; Ying travels inside, Wei travels outside. Ying inside the vessels follows the twelve meridians of hands and feet, plus Yin Qiao, Yang Qiao, Ren Mai, and Du Mai, totaling 16 zhang 2 chi for one cycle, traveling 25 degrees by day and 25 degrees by night, responding to respiration. This is Ying Qi traveling inside the vessels. Wei Qi travels 25 degrees in Yang by day and 25 degrees in Yin by night. Thus, Ying and Wei each follow their own paths, with clear/turbid and inside/outside not interfering. As for the twelve meridians of the three Yin and three Yang of hands and feet, they all emerge from the Jing-Well points and nourish the twenty-five Shu points of the five zang and thirty-six Shu points of the six fu. The Jing-Well points are located near the nails, the ends of flesh, blood, sinew, and bone. Where does the Qi and Blood come from to be called "emerging from Well"? It is that Qi and Blood from the skin flow into the vessels here, and the Qi and Blood of the twelve meridians begin to generate from here. Hence, "Emerging is Well, Flowing is Ying, Pouring is Shu, Passing is Jing." Qi and Blood filling the skin and warming the flesh travel together like husband and wife, flowing into the vessels together. Hence, "The travel of Ying and Wei connects上下." "The four extremities are the meeting of Yin and Yang, these are the great collaterals of Qi." Zong Qi travels half inside the vessels and half outside. Ying Blood nourishes half in the meridian tunnels and half in the skin. Ying Qi travels inside the vessels, Wei Qi travels outside. Yin contains Yang, Yang contains Yin, like the fixed forms of Two Modes and Four Images. Qi and Blood penetrate inside and outside, responding to the interaction of Heaven and Earth Qi. If one breath ceases, generation and transformation perish. Skin Qi aspect is Yang, Meridian Blood aspect is Yin. Yang goes to Yang, Yin goes to Yin; this is the separation of Yin and Yang. Yin emerges from Yang, Yang enters Yin; this is the combination of Yin and Yang. The Way of Yin and Yang involves separation and combination. If those traveling in Yang only travel in Yang, and those in Yin only travel in Yin, lacking the divine mechanism of inside-outside exchange, generation and transformation would perish. The profundity of Yin and Yang is understood by those who grasp it with heart.
Yu Borong said: In the *Wu Luan Zhang Lun*, it is said that Wei Qi disrupting the vessels is called Da Zhang. Rebellious Wei Qi causes Mai Zhang (pulse distension); Wei Qi merging with vessels and following muscle spaces causes Fu Zhang (skin distension). If Wei Qi travels inside the vessels, is this not disrupting the vessels? The answer is: Wei Qi, while on its path, often runs alongside the vessels following the muscle spaces. Travel has reverse and顺顺 directions, with Yin and Yang following each other, achieving Heavenly Harmony. This means blood and Qi inside the vessels move forward, while Qi and Blood outside the vessels move in reverse. Having reverse and顺顺 movements achieves the harmony of Heaven and Earth. "Wei Qi disrupting the vessels" refers to Wei Qi moving along the vessel path. Regarding the circulation inside and outside the skin and meridians, this is precisely moving in contrary and顺顺 directions. How could this be considered disruption?