皮寒热者。不可附席。毛发焦。鼻槁腊。不得汗。取三阳之络。以补手太阴。(腊思亦切)
上二章论五脏六腑。以及外合之皮肉筋骨为病。此章论病三阴三阳之经气。而为寒为热也。病
在皮。故不可附席。皮肤之血气以滋毛发。皮气伤。故毛发焦也。腊、干也。肺主皮毛。开窍在鼻。
故鼻为之干槁。此邪在表。而病太阴太阳之气。当从汗解。如不得汗。宜取太阳之络以发汗。补手
太阴以资其津液焉。按以上三章。经旨相连。故无君臣问答之辞。其病在腑脏经气之不同。故分为
三章。此章通论阴阳之经气为病。故篇名寒热。寒热者。阴阳之气也。
肌寒热者。肌痛。毛发焦而唇槁腊。不得汗。取三阳于下。以去其血者。补足太阴。以出其汗。
脉外之血气。充肤热肉。生毫毛。故病在肌。则肌肉痛而毛发焦也。脾主肌肉。开窍于口。故
唇口槁腊。如不得汗。当取三阳于下。以去其血。补足太阴以资水谷之汗。三阳。太阳也。盖寒热虽
在肌。而汗从表
出也。莫云从曰。肺之鼻窍。脾之口窍。皆在气分上看。
骨寒热者。病无所安。汗注不休。齿未槁。取其少阴于阴股之络。齿已槁。死不治。骨厥亦然。
骨寒热者。病少阴之气也。病无所安者。阴躁也。少阴为生气之原。汗注不休者。生气外脱也。
齿未槁者。根气尚存。取足少阴于阴股之络以去其邪。齿已槁。死不治矣。此邪病少阴之气。邪正
相搏。故为寒热。邪去则愈。正脱则死矣。骨厥者。谓肾脏为病。而肾气厥逆也。夫圣人南面而立。
前曰广明。后曰太冲。太冲之地。名曰少阴。少阴之上。名曰太阳。是少阴为生阳之本。然肾脏亦
为生气之原。故曰骨厥亦然。盖以分别骨寒热者。病少阴之气也。沈亮宸曰。以上三节。病在三阴
之气。故曰取三阳之络。曰取少阴于阴股之络。而不言经穴。
上章之病在五脏。则曰行间三里。昆仑。涌泉。而不言三阴三阳。
骨痹。举节不用而痛。汗注烦心。取三阳之经补之。
骨痹举节不用而痛。汗注烦心。病在少阴之气而入深也。故当取太阳之经补之。以去其邪。夫
经脉为里。浮见于皮部者为络。上节论三阴之气而为寒热者。病在于肤表。故取之络。此病气入深。
故取之经。此篇论三阴三阳之经气为病。有病在气而不及于经者。有病在气。而转入于经者。有经
气之兼病者。盖阴阳六气。合手足之六经也。沈亮宸曰。冬者肾脏。血气在中。内着骨髓。通于五
脏。骨痹。冬痹者。汗注烦心。病通于脏也。
邪气者。常随四时之气血而入客也。故下文曰。冬取经输。经输者。治骨髓。故取三阳之经。
以发越阴脏之痹。
莫云从曰。以本经之法。施于治道。如鼓应桴。马氏退理以先针。致使后学咸视为针刺而忽之。不
知针刺之中。有至道存焉。
身有所伤。血出多。及中风寒。若有所堕坠。四肢懈惰不收。名曰体惰。取其小腹脐下三结交。
三结交者。阳明太阴也。脐下三寸关元也。
此言皮肤之血气有伤。当取之阳明太阴也。夫首言皮腠之寒热者。病三阴之气也。此言皮腠
之血气受伤。亦取之太阴阳明。阴阳血气之相关也。身有所伤。血出多。伤其血矣。及中风寒。伤
其营卫矣。夫人之形体。藉气 而血濡。血气受伤。故若有所堕坠。四肢懈惰不收。名曰体惰。夫
充肤热肉之血气。生于阳明水谷之精。流溢于中。由冲任而布散于皮腠。故当取小腹脐下之阳明太
阴。任脉之关元。以助血气之生原。三结交者。足太阴阳明与任脉交结于小腹脐下也。沈亮宸曰。
首言三阴之气。本于里阴。而外主于皮毛肌骨。下节论三阳之气。从下而生。而上出于颈项头面。
此言肤表之血气。亦由下而上充于皮肤。盖阴阳血气。皆从下而上也。
厥痹者。厥气上及腹。取阴阳之络。视主病也。泻阳补阴经也。颈侧之动脉人迎。人迎。足阳
明也。在婴筋之前。婴筋之后。手阳明也。名曰扶突。次脉。手少阳也。名曰天牖。次脉足太阳也。
名曰天柱。腋下动脉。臂太阴也。名曰天府。
此言阳气生于阴中。由下而上也。厥痹者。痹闭于下。以致三阳之气厥逆。只及于腹。而不能
上行于头项也。
取阴阳之络。视主病者。视厥痹之在何经也。泻阳者。泻其厥逆而使之上也。补阴者。阳气生于阴
中也。次脉者。从喉旁而次序于项后。即本输篇之所谓一次脉二次脉也。盖三阳之经气。皆循颈项
而上充于头面也。腋下动脉。手太阴也。太阴统主阴阳之气者也。
阳明头痛。胸满不得息。取之人迎。
此下五节。承上文而分论厥逆之气。各有所见之证。各随所逆之经以取之。阳明头痛。阳明之
气。厥逆于腹。不得循人迎。而上充于头。是以头痛。逆于中焦。故胸满不得息。当取之人迎。以
通其气。
暴喑气 。取扶突与舌本出血。( 梗同)
夫金主声。心主言。手阳明主气而主金。故阳明气逆于下。则暴喑。而气梗矣。取扶突与舌本
出血。则气通而音声出矣。
暴聋气蒙。耳目不明。取天牖。
手少阳之脉入耳中。至目锐 。少阳之气厥于下。则上之经脉不通。是以暴聋气蒙。耳目不明。
当取之天牖。
暴挛痫眩。足不任身。取天柱。
足太阳主筋。故气厥则暴挛而足不任身矣。太阳之脉。起于目内 之睛明。气不上通。故痫眩
也。当取之天柱。
暴瘅。内逆。肝肺相搏。血溢鼻口。取天府。
瘅、消瘅。暴瘅、暴渴也。肝脉贯肺。故手太阴之气逆。则肝肺相搏。肺主气而肝主血。气逆于中。
则血亦留聚而上溢矣。肺乃水之生原。搏则津液不生而暴瘅矣。皆当取手太阴之天府。以疏其搏逆。
夫暴疾。一时之厥证也。此因于气厥。故用数暴字。
此为大牖五部。
牖、窗也。头面之穴窍。如楼阁之大牖。所以通气者也。气厥于下。以致在上之经脉不通。而
为耳目不明。暴喑痫眩诸证。盖言三阳之气。由下而生。从上而出。故总结曰。此为大牖五部。以
下复论其经络焉。沈亮宸曰。人迎扶突。天牖天柱。头气之街也。腋下动脉。胸气之街也。莫云从
问曰。本输篇论次脉。乃手足三阳之六经。此节只言手阳明少阳。足阳明太阳为大牖何也。曰。太
阳之气。生于膀胱水中。少阳之气。本于命门相火。阳明之气。生于中焦胃腑。在经脉有手足之六经。
在二气只论三阴三阳也。其手阳明与太阴为表里。主行周身之气。故合为五大牖焉。
臂阳明有入 遍齿者。名曰大迎。下齿龋。取之臂。恶寒补之。不恶寒泻之。足太阳有入 遍
齿者。名曰角孙。上齿龋。取之在鼻 与前。方病之时。其脉盛。盛则泻之。虚则补之。一曰。取
之出鼻外。( 音仇龋邱禹切)
上节论三阳之气循次而上出于大牖。此复论气从络脉以相通。所谓络绝则径通。如环无端。莫
知其纪也。盖气之出于大牖者。从气街而出于脉外。气之行于脉中者。从络脉而贯于脉中。外内环
转之无端。故莫知其纪也。颧鼻交处为 。龋、齿痛也。臂阳明有入 遍络于齿者。名曰大迎。大
迎乃足阳明之经穴。此手阳明之气。从络而贯于足阳明之经。故下齿痛。当取之臂阳明。恶寒饮者。虚也
。当补之。不恶寒饮者。
实也。当泻之。足太阳有入 遍络于齿者。名曰角孙。角孙乃手少阳之经穴。此足太阳之气。贯于
手少阳之经。故上齿痛者。当取之鼻与 前。乃太阳之络脉也。按营血宗气之所营行者。经脉也。
足太阳之络。不入于齿中。此非经脉。亦非支别。乃微细之系。以通二阳之气者也。故方病之时。
其脉盛。乃气之太过也。太过则泻之。不及则补之。莫云从曰。三阳之气。分则有三。合则为一。
一阳之气。下通于泉。绕地环转。而复通贯于地中。故遍历于齿。属口对入。齿者。水脏之所生。
口者。土之外候也。
足阳明有挟鼻入于面者。名曰悬颅。属口对入。系目本。视有过者取之。损有余。益不足。反
者益。(足阳明当作手太阳)
此总结三阳之六次脉也。盖三阳之气。上出于大牖者。循手之阳明少阳。足之阳明太阳。而
经脉之贯通。则有手足六脉之相交矣。故手太阳有挟鼻入于面者。名曰悬颅。悬颅乃足少阳之经穴。
此手太阳之气。从络脉而通于足少阳之经也。属口对入上系目本。视有过者取之。过、病也。如病
在太阳。而太阳之络有余。少阳之经不足。则当损大阳之有余。益少阳之不足。反是者。又当益太
阳也。沈亮宸曰。反者当从有过上看。推此二句。当知太阳之气。从络脉而贯于少阳之经。少阳
之气。从络脉而通于太阳之经也。以上四脉亦然。
莫云从问曰。阳明手足相交。自然之道也。太阳之与少阳相合。其义何居。曰。太少之气。本
于先天之水火。犹两钱所分之四象。是以正月二月。主于太少。五月六月。主于太少。太少之相合也。
阳明者。两阳合明。故曰阳明主于三月四月。此阳明之自相交合也。夫阴阳之道。推变无穷。明乎
经常变易之理。始可与言阴阳矣。
朱济公问曰。太阳之气主皮毛。阳明之气主肌腠。少阳之气主枢胁。今论三阳之气。又皆循
经而上出于头面焉。曰。此升降出入之道也。阴阳之气。出入于外内。故皮寒热者。取之太阳太阴。
肌寒热者。取三阳于下。升降于上下。故邪中于面。则下阳明。中于项则下太阳。中于颊则下少阳。
二阳之气。营运于肌表。故中于阳。则溜于经。经气外内之相通也。此升降出入之无息者也。一息
不运。则失其机矣。
其足太阳有通项入于脑者。正属目本。名曰眼系。头目苦痛。取之在项中两筋间入脑。乃别
阴跷阳跷。阴阳相交。阳入阴。阴出阳。交于目锐 。阳气盛则 目。阴气盛则瞑目。
此言足太阳之气。贯通于阳跷阴跷也。其者。承上文而言。言其足太阳又有通项入于脑者。正
属目本。名曰眼系。在项中两筋间入脑。乃别络于阴跷阳跷。而阴阳相交于目锐 。阳跷之气入于
阴跷。阴跷之气出于阳跷。如阳跷之气盛则张目。阴跷之气盛则瞑目。此太阳之气。又从眼系而贯
通于阴阳之跷脉也。按、脉度篇曰。跷脉者。太阴之别。起于然谷之后。循胸上行。属目内 。合
于太阳阳跷而上行。气并相还。则为濡目。此言阴跷之脉。起于足少阴。而上通于太阳阳跷。此节
论太阳之气。通于阳跷阴跷。故曰男子数其阳。女子数其阴。盖阴跷之脉。通少阴之精水于阳跷。
阳跷之脉。通太阳之气于阴跷。男子以气为主。故男子数其阳。女子以精血为主。故女子数其阴。
气为阳而血为阴也。莫云从曰。举足行高曰跷。足少阴太阳。乃阴阳血气之生原。阴跷阳跷。主
通阴阳血气。从下而上交于目。目者。生命之门也。
热厥。取足太阴少阳皆留之。寒厥。取足阳明少阴于足皆留之。
此论阴阳之气不和。而为寒厥热厥也。盖在表之阴阳不和。则为肌皮之寒热。发原之阴阳不和。
则为寒厥热厥矣。马元台曰。少阳当作少阴。少阴当作少阳。按、素问厥论曰。阳气衰于下。则为
寒厥。阴气衰于下。则为热厥。盖以热厥为足三阳气胜。则所补在阴。故当取足太阴少阳皆留之。
以使针下寒也。寒厥为足三阴气胜。则所补在阳。故当取足阳明少阳于足者留之。以俟针下热也。
余伯荣曰。取之于足者。谓阳气生于下也。
舌纵涎下烦 。取足少阴。
此言上下之阴阳不和也。少阴之上。君火主之。而下为水脏。水火之气。上下时交。舌纵涎下
烦者。肾气不上资于心火也。故当取足少阴。以通少阴之气。
振寒洒洒。鼓颔不得汗出。腹胀烦 。取手太阴。
此言表里之阴阳不和也。内经云。阳加于阴谓之汗。肤表为阳。腹内为阴。在内之阴液。藉表
阳之气。宣发而为汗。振寒洒洒。鼓颔不得汗出。腹胀烦 者。表里之阴阳不和也。故当取手太阴。以
疏皮毛之气。以行其汗液焉。手太阴主通调水液。四布于皮毛者也。莫云从曰。上节论上下。此节
论表里。乃阴阳之升降出入。篇名寒热者。皆阴阳之不调也。
刺虚者。刺其去也。刺实者。刺其来也。
此总论阴阳寒热之不调。因邪正虚实之有碍也。虚者。正气之不足。实者。邪气之有余。盖邪气
实则正气虚矣。故刺虚者。刺其气之方去。所谓追而济之也。刺实者。刺其气之方来。所谓迎而夺之也。迎之
随之。以意和之。可使气调。可使病已也。
春取络脉。夏取分腠。秋取气口。冬取经输。凡此四时。各以时为齐。络脉治皮肤。分腠治肌
肉。气口治筋脉。经输治骨髓。
此以人之形层深浅。与四时之气为齐也。盖人之血气。应天地之阴阳出入。故春取络脉。夏取
分腠。春夏之气。从内而外也。秋取气口。冬取经输。秋冬之气。复从外而内也。此人之气血。随
天地四时之气。而外内出入者也。齐者。所以一之也。凡此四时。以应人之阴阳出入。故各以时为
齐。故取络脉者。以治皮肤。取分腠以治肌肉。取气口以治筋脉。取经输以治骨髓。此又以四时之
皮寒热:患者身体发热,无法贴近席子躺卧。毛发焦枯,鼻孔干燥萎缩,无汗。治疗应取足三阳经的络穴,并补益手太阴肺经。(“腊”音同“思亦”,意为干枯。)
以上两章论述了五脏六腑以及外合于皮、肉、筋、骨的病变。本章论述病在三阴、三阳经气,表现为寒或热的证候。病在皮肤,所以不能贴席而卧。皮肤的血液和精气滋养毛发,皮气受损,所以毛发焦枯。“腊”即干枯之意。肺主皮毛,开窍于鼻,所以鼻子因此变得干枯萎缩。这是邪气在体表,病及太阴、太阳之气,应当通过发汗来解除。如果不出汗,适宜取太阳经的络穴以发汗,补益手太阴肺经以资助津液。按:以上三章,经文旨意相连,所以没有君臣问答的辞句。因为病在脏腑经气的不同,所以分为三章。本章通论阴阳经气致病,所以篇名《寒热》。寒热,就是阴阳之气。
肌寒热:肌肉疼痛,毛发焦枯,嘴唇干枯萎缩,无汗。治疗应在下部取足三阳经,放血以去除瘀血;补益足太阴脾经,以促使出汗。脉外的血气充盈皮肤,温热肌肉,生长毫毛,所以病在肌肉,则肌肉疼痛而毛发焦枯。脾主肌肉,开窍于口,所以嘴唇和口腔干枯萎缩。如果不出汗,应当在下部取足三阳经(指足太阳经),以去除瘀血,补益足太阴脾经以资生水谷之汗。所谓“三阳”,指足太阳经。因为寒热虽在肌肉,但汗液是从体表排出的。莫云从说:肺的鼻窍、脾的口窍,都应当从气分的角度来理解。
骨寒热:病人坐卧不安,大汗淋漓不止。如果牙齿尚未干枯,可取足少阴肾经在大腿内侧的络穴进行治疗。如果牙齿已经干枯,则属死证,无法治愈。骨厥证也是如此。骨寒热,是少阴肾经之气受病。坐卧不安,是因为阴躁动。少阴肾经是生气的根源,大汗淋漓不止,说明生气向外脱失。牙齿未干枯,说明根基之气尚存,取足少阴肾经在大腿内侧的络穴以祛除邪气。牙齿已干枯,说明根基之气已绝,属于死证无法治愈。这是邪气侵犯少阴之气,邪正相搏,所以出现寒热。邪气去除则痊愈,正气脱失则死亡。骨厥,是指肾脏发病,肾气厥逆。圣人面南而坐,前方称为广明,后方称为太冲。太冲之地,名为少阴。少阴之上,名为太阳。这说明少阴是生阳之本。然而肾脏也是生气的根源,所以说骨厥证也是如此。这主要是为了区分骨寒热是病在少阴之气。沈亮宸说:以上三节,病在三阴之气,所以说取三阳的络穴,取少阴在大腿内侧的络穴,而不提及具体的经穴。上一章病在五脏,则提到行间、三里、昆仑、涌泉等穴位,而不提三阴三阳。
骨痹:关节活动受限且疼痛,大汗淋漓,心烦意乱。治疗应取足三阳经的经穴进行补法。骨痹导致关节活动受限且疼痛,大汗淋漓,心烦意乱,这是病在少阴之气且深入体内。所以应当取足太阳膀胱经进行补法,以祛除邪气。经脉位于深层,浮现在皮部的是络脉。上一节论述三阴之气导致的寒热,病在肤表,所以取络穴。此病气入深,所以取经穴。本篇论述三阴三阳经气致病,有仅病在气而未波及经的,有病在气而转入经的,有经气兼病的。大概阴阳六气,结合手足六经而言。沈亮宸说:冬季对应肾脏,血气在中,内着骨髓,通达五脏。骨痹,即冬季痹症,大汗淋漓,心烦意乱,病气通达于脏。
邪气,常随着四季气血的变化而入客体内。所以下文说:冬季取经输穴。经输穴,主治骨髓病变,所以取足三阳经的经穴,以发散阴脏的痹阻。莫云从说:用本经的方法施用于治疗之道,如同击鼓应槌一样迅速准确。马氏退理主张先针刺,致使后学者都将其视为单纯的针刺技术而忽视它,不知道针刺之中蕴含着至高的大道。
身体有所损伤,出血过多,以及感受风寒,或者有坠落伤,四肢懈怠无力,不能收持,称为“体惰”。治疗应取小腹脐下三结交穴。三结交,指足阳明胃经与足太阴脾经相交之处,即脐下三寸的关元穴。
这里说的是皮肤的血气受到损伤,应当取足阳明、足太阴经。开头所说的皮腠寒热,是三阴之气受病。这里说皮腠的血气受伤,也取太阴、阳明经,体现了阴阳血气的相关性。身体受伤,出血过多,伤了血;又感受风寒,伤了营卫。人的形体,依靠气推动而血濡养。血气受伤,所以感觉像是有坠落伤,四肢懈怠无力,不能收持,称为体惰。充盈皮肤、温热肌肉的血气,产生于阳明水谷的精微,流溢于中,由冲脉、任脉布散于皮腠。所以应当取小腹脐下的足阳明、足太阴经,以及任脉的关元穴,以助血气的生成之源。三结交,是足太阴、足阳明与任脉在小腹脐下相交结的地方。沈亮宸说:首段论述三阴之气,源于里阴,而外主皮毛肌骨。下节论述三阳之气,从下而生,而上出于颈项头面。这里说肤表的血气,也是由下而上充于皮肤。大概阴阳血气,都是从下而上的。
厥痹:厥气上达腹部,治疗应取阴阳经的络穴,观察主要病在哪一经。泻阳经,补阴经。颈侧的动脉是人迎穴。人迎穴,属足阳明胃经,在喉结旁婴筋之前。婴筋之后,是手阳明大肠经,名为扶突穴。再往后的脉,是手少阳三焦经,名为天牖穴。再往后的脉,是足太阳膀胱经,名为天柱穴。腋下的动脉,是手太阴肺经,名为天府穴。
这里说阳气生于阴中,由下而上运行。厥痹,是痹闭于下部,导致三阳之气厥逆,只到达腹部,而不能上行至头项。取阴阳经的络穴,观察厥痹在哪一经。泻阳经,是为了泻其厥逆之气使其上行。补阴经,是因为阳气生于阴中。次脉,是从喉旁依次排列到项后,即《本输》篇所说的一次脉、二次脉。大概三阳经气,都循行颈项而上充于头面。腋下动脉,属手太阴肺经。太阴统管阴阳之气。
以下五节,承接上文分别论述厥逆之气,各自有不同的见证,各随其逆乱的经脉来选取穴位。阳明头痛,是阳明之气厥逆于腹部,不能循行人迎穴而上充于头部,所以头痛。气逆于中焦,所以胸满呼吸不畅。应当取人迎穴,以通畅其气。
突然失音,气息梗塞,取扶突穴与舌根部出血。(“梗”同“梗”)
金主声音,心主言语。手阳明大肠经主气而主金,所以阳明之气逆乱于下,就会突然失音,气息梗塞。取扶突穴与舌根部出血,则气机通畅,声音发出。
手少阳三焦经的脉入耳中,至目外眦。少阳之气厥逆于下,则上部经脉不通,所以突然耳聋,气机蒙蔽,耳目不明。应当取天牖穴。
足太阳膀胱经主筋,所以气厥则突然痉挛,双脚不能支撑身体。太阳经脉起于目内眦的睛明穴,气不上通,所以发生癫痫、眩晕。应当取天柱穴。
瘅,指消瘅。暴瘅,指突然口渴。肝脉贯注肺部,所以手太阴肺气逆乱,则肝肺相搏。肺主气,肝主血,气逆于中,则血也留聚而上溢。肺是水液的生成之源,相搏则津液不生而突发暴渴。这些都应当取手太阴肺经的天府穴,以疏解其搏逆之气。突然发生的疾病,是一时的厥证。这是因为气厥所致,所以用多个“暴”字。
这被称为“大牖五部”。
牖,即窗户。头面的穴位孔窍,如同楼阁的大窗,是用来通气的地方。气厥逆于下,导致在上部的经脉不通,而出现耳目不明、突然失音、癫痫眩晕等症状。大概是说三阳之气,由下而生,从上而出。所以总结说:这称为大牖五部。以下重新论述经络。沈亮宸说:人迎、扶突、天牖、天柱,是头气之街。腋下动脉,是胸气之街。莫云从问:《本输》篇论述次脉,是手足三阳的六条经,这一节只说手阳明、手少阳、足阳明、足太阳为大牖,为什么呢?回答说:太阳之气,生于膀胱水中;少阳之气,本于命门相火;阳明之气,生于中焦胃腑。在经脉上有手足六经,在二气上只论三阴三阳。手阳明与手太阴为表里,主运行周身之气,所以合为五大牖。
手阳明经有进入面部遍络于牙齿的分支,名为大迎穴。下齿龋痛,取手臂上的穴位。恶寒者补之,不恶寒者泻之。足太阳经有进入面部遍络于牙齿的分支,名为角孙穴。上齿龋痛,取鼻翼前与颧骨交接处的穴位。刚患病时,该处脉搏盛大,盛大则泻之,虚弱则补之。另一种说法是:取鼻外侧的穴位。(“仇”音“邱禹切”,指颧骨与鼻翼交接处,“龋”指龋齿疼痛)
上一节论述三阳之气依次向上出于大牖,这里重新论述气从络脉相通。所谓络脉断绝则径脉相通,如环无端,不知其纪绪。大概气出于大牖,是从气街出于脉外;气行于脉中,是从络脉贯穿于脉中。外内环转无端,所以不知其纪绪。颧骨与鼻翼交接处为“仇”。龋,指齿痛。手阳明经有进入“仇”处遍络于牙齿的分支,名为大迎。大迎本是足阳明胃经的经穴,这里是手阳明之气,从络脉贯穿到足阳明经,所以下齿痛,应当取手阳明经。恶寒饮水的,是虚证,应当补之。不恶寒饮水的,是实证,应当泻之。足太阳经有进入“仇”处遍络于牙齿的分支,名为角孙。角孙本是手少阳三焦经的经穴,这里是足太阳之气,贯穿到手少阳经,所以上齿痛,应当取鼻翼与“仇”之前的穴位,那是太阳的络脉。按:营血宗气所运行的,是经脉。足太阳的络脉,并不进入牙齿中。这不是经脉,也不是支别,而是微细的联系,用来沟通二阳之气。所以在刚患病时,脉搏盛大,这是气太过。太过则泻之,不及则补之。莫云从说:三阳之气,分开有三条,合起来是一条。一阳之气,下通于泉,绕地环转,又贯通于地中,所以遍历于牙齿。齿属口对入,齿是水脏所生,口是土之外候。
足阳明胃经有挟鼻入面的分支,名为悬颅穴。属口对入,系于目本。观察有过盛的部位取之。损有余,益不足。反之则益。(此处“足阳明”当作“手太阳”)
这里总结三阳的六次脉。大概三阳之气,上出于大牖,循行手的阳明、少阳,足的阳明、太阳,而经脉的贯通,则有手足六脉的相交。所以手太阳经有挟鼻入面的分支,名为悬颅。悬颅本是足少阳胆经的经穴,这里是手太阳之气,从络脉通于足少阳经。属口对入,上系目本。观察有过盛的部位取之。“过”即病。如病在太阳,而太阳之络有余,少阳之经不足,则应当损太阳之有余,益少阳之不足。反之,则当益太阳。沈亮宸说:“反者”应当从“有过”的角度看。推究这两句,应当知道太阳之气,从络脉贯穿于少阳经;少阳之气,从络脉通于太阳经。以上四脉也是如此。莫云从问:阳明手足相交,是自然之道。太阳与少阳相合,其中的道理何在?回答说:太少之气,本于先天之水火,犹如两钱所分出的四象。所以正月二月,主于太少;五月六月,主于太少。太少相合。阳明者,两阳合明,所以阳明主于三月四月。这是阳明自身的相交合。阴阳之道,推变无穷,明白经常与变易的道理,才可以谈论阴阳。朱济公问:太阳之气主皮毛,阳明之气主肌腠,少阳之气主枢胁。现在论述三阳之气,又都循经而上出于头面,为什么呢?回答说:这是升降出入的道理。阴阳之气,出入于内外。所以皮寒热,取太阳、太阴;肌寒热,取三阳于下,升降于上下。所以邪中于面,则下取阳明;中于项,则下取太阳;中于颊,则下取少阳。二阳之气,营运于肌表,所以中于阳,则流入于经。这是经气外内相通。这是升降出入无休止的。一息不运,就失去了时机。
足太阳经有通项入脑的分支,正属目本,名为眼系。头目苦痛,取在项中两筋间入脑的部位,乃别络阴跷、阳跷。阴阳相交,阳入阴,阴出阳,交于目外眦。阳气盛则张目,阴气盛则瞑目。
这里说足太阳之气,贯通于阳跷、阴跷。“其”字承上文而言,说足太阳又有通项入脑的分支,正属目本,名为眼系。在项中两筋间入脑,乃别络于阴跷、阳跷,而阴阳相交于目外眦。阳跷之气入于阴跷,阴跷之气出于阳跷。如阳跷之气盛则张目,阴跷之气盛则瞑目。这是太阳之气,又从眼系而贯通于阴阳跷脉。按:《脉度》篇说:跷脉,是太阴之别,起于然谷之后,循胸上行,属目内眦,合于太阳阳跷而上行。气并相还,则为濡目。这里说阴跷之脉,起于足少阴,而上通于太阳阳跷。这一节论太阳之气,通于阳跷、阴跷,所以说男子数其阳,女子数其阴。大概阴跷之脉,通少阴之精水于阳跷;阳跷之脉,通太阳之气于阴跷。男子以气为主,所以男子数其阳;女子以精血为主,所以女子数其阴。气为阳,血为阴。莫云从说:举足行高曰跷。足少阴、足太阳,是阴阳血气的生原。阴跷、阳跷,主通阴阳血气,从下而上交于目。目,是生命之门。
热厥,取足太阴、足少阳经,均留针。寒厥,取足阳明、足少阴经于足部,均留针。
这里论述阴阳之气不和,而为寒厥、热厥。大概在表的阴阳不和,则为肌皮之寒热;发源的阴阳不和,则为寒厥、热厥。马元台说:原文“少阳”当作“少阴”,“少阴”当作“少阳”。按:《素问·厥论》说:阳气衰于下,则为寒厥;阴气衰于下,则为热厥。大概热厥是足三阳之气胜,所以所补在阴,故当取足太阴、足少阳均留针,以使针下感到寒凉。寒厥是足三阴之气胜,所以所补在阳,故当取足阳明、足少阴于足部留针,以等待针下感到温热。余伯荣说:取之于足,是说阳气生于下。
这里说上下阴阳不和。少阴之上,君火主之,而下为水脏。水火之气,上下时常交泰。舌纵涎下,心烦,是肾气不上资于心火。所以应当取足少阴经,以通少阴之气。
这里说表里阴阳不和。《内经》说:阳加于阴谓之汗。肤表为阳,腹内为阴。在内之阴液,藉表阳之气,宣发而为汗。战栗怕冷,下巴抖动,无汗,腹胀,心烦,是表里阴阳不和。所以应当取手太阴经,以疏皮毛之气,以行其汗液。手太阴肺经主通调水液,四布于皮毛。莫云从说:上一节论上下,这一节论表里,乃是阴阳的升降出入。篇名《寒热》,都是阴阳不调。
刺虚证,刺其气之去(追而济之)。刺实证,刺其气之来(迎而夺之)。
这里总论阴阳寒热不调,因邪正虚实有碍。虚,是正气不足;实,是邪气有余。邪气实则正气虚。所以刺虚证,刺其气之方去,所谓追而济之。刺实证,刺其气之方来,所谓迎而夺之。迎之随之,以意和之,可使气调,可使病愈。
春取络脉,夏取分腠,秋取气口,冬取经输。凡此四时,各以时为齐。络脉治皮肤,分腠治肌肉,气口治筋脉,经输治骨髓。
这里以人体形层的深浅,与四时之气相应。大概人的血气,应天地阴阳的出入。所以春取络脉,夏取分腠,春夏之气,从内而外。秋取气口,冬取经输,秋冬之气,复从外而内。这是人的气血,随天地四时之气,而外内出入。齐,是统一的意思。凡此四时,以应人的阴阳出入,所以各以时为齐。所以取络脉,以治皮肤;取分腠,以治肌肉;取气口,以治筋脉;取经输,以治骨髓。这也是以四时之...
Pi Han Re (Cold and Heat in the Skin): The patient experiences fever and cannot lie close to the mat. Hair becomes scorched, the nose dries and shrivels, and there is no sweating. Treatment should involve selecting the Luo-connecting vessels of the Foot Triple-Yang meridians and supplementing the Hand Taiyin Lung Meridian. ("La" sounds like "Si Yi", meaning dry and withered.)
The preceding two chapters discussed diseases of the Zang-Fu organs and their external manifestations in the skin, flesh, sinews, and bones. This chapter discusses diseases involving the Qi of the Three Yin and Three Yang meridians, manifesting as cold or heat. Since the disease is in the skin, the patient cannot lie close to the mat. The blood and essence-Qi of the skin nourish the hair; when Pi-Qi is damaged, the hair becomes scorched. "La" means dry. The Lungs govern the skin and hair and open into the nose; thus, the nose becomes dry and shriveled. This indicates pathogenic factors at the exterior, affecting the Qi of the Taiyin and Yangming meridians. Resolution should be achieved through sweating. If sweating does not occur, it is appropriate to select the Luo-connecting vessel of the Taiyang meridian to induce sweating, and supplement the Hand Taiyin Lung Meridian to aid fluid production. Note: The intent of the above three chapters is continuous, hence there are no dialogues between ruler and minister. Because the diseases differ in the Zang-Fu and meridian Qi, they are divided into three chapters. This chapter generally discusses diseases caused by Yin and Yang meridian Qi, hence the chapter title "Han Re" (Cold and Heat). Cold and heat refer to Yin and Yang Qi.
Ji Han Re (Cold and Heat in the Muscle): Muscle pain, scorched hair, dry and shriveled lips, and no sweating. Treatment involves selecting the Foot Triple-Yang meridians below to remove blood stasis, and supplementing the Foot Taiyin Spleen Meridian to induce sweating. Blood and Qi outside the vessels fill the skin, warm the muscles, and generate body hair. Thus, when disease is in the muscle, there is muscle pain and scorched hair. The Spleen governs the muscles and opens into the mouth; therefore, the lips and oral cavity become dry and shriveled. If sweating does not occur, one should select the Foot Triple-Yang meridians (referring to the Foot Taiyang Bladder Meridian) below to remove blood stasis, and supplement the Foot Taiyin Spleen Meridian to generate sweat from grain and water. "Triple-Yang" refers to the Foot Taiyang Meridian. Although cold and heat are in the muscle, sweat is expelled from the exterior. Mo Yuncong stated: The nasal orifice of the Lung and the oral orifice of the Spleen should be understood from the perspective of Qi.
Gu Han Re (Cold and Heat in the Bone): The patient is restless and unable to find a comfortable position, with continuous profuse sweating. If the teeth have not yet withered, treat by selecting the Luo-connecting vessel of the Foot Shaoyin Kidney Meridian on the inner thigh. If the teeth have already withered, it is a death case and cannot be treated. Gu Jue (Bone Jue) is similar. Gu Han Re is a disease of the Shaoyin Kidney Qi. Restlessness is due to Yin agitation. Shaoyin is the root of generating Qi; continuous profuse sweating indicates the outward depletion of generating Qi. Teeth not withered indicate that root Qi still exists; selecting the Luo-connecting vessel of the Foot Shaoyin Kidney Meridian on the inner thigh expels pathogenic factors. Teeth withered indicate the extinction of root Qi, constituting a fatal condition. This is pathogenic factors invading Shaoyin Qi, with evil and righteous Qi clashing, resulting in cold and heat. When pathogens are expelled, recovery occurs; when righteous Qi depletes, death ensues. Gu Jue refers to kidney disease where Kidney Qi rebels. The sage faces south; the front is called Guangming, the back is called Taichong. The place of Taichong is named Shaoyin. Above Shaoyin is named Taiyang. This shows Shaoyin is the root of Sheng-Yang. However, the Kidney is also the source of generating Qi, hence Gu Jue is similar. This distinguishes Gu Han Re as a disease of Shaoyin Qi. Shen Liangchen said: In the above three sections, the disease is in the Three Yin Qi, hence it says "select the Luo of Triple-Yang" and "select the Luo of Shaoyin on the inner thigh," without mentioning specific acupoints. In the previous chapter, diseases in the Five Zang mentioned acupoints like Xingjian, Zusanli, Kunlun, and Yongquan, without mentioning Three Yin and Three Yang.
Gu Bi (Bone Bi): Joint immobility with pain, profuse sweating, and vexation. Treatment involves selecting the Jing-River points of the Foot Triple-Yang meridians and applying the tonification method. Gu Bi causing joint immobility and pain, with profuse sweating and vexation, indicates disease in Shaoyin Qi having penetrated deeply. Therefore, one should select the Foot Taiyang Bladder Meridian and apply tonification to expel pathogens. Meridians are deep, while those floating on the skin surface are Luo-connecting vessels. The previous section discussed cold and heat caused by Three Yin Qi, which were at the superficial level, hence Luo vessels were selected. Here, the Qi has penetrated deeply, hence meridians are selected. This article discusses diseases of Three Yin and Three Yang meridian Qi. Some diseases affect only Qi without involving meridians; some start in Qi and transfer to meridians; some involve both Qi and meridians. Generally, Yin-Yang Six Qi combine with the Six Meridions of the Hand and Foot. Shen Liangchen said: Winter corresponds to the Kidney; blood and Qi are central, penetrating marrow and connecting to the Five Zang. Gu Bi is winter Bi, with profuse sweating and vexation, indicating the disease connects to the Zang.
Pathogenic Qi often enters and lodges following the changes of Qi and Blood in the four seasons. Hence, the text later states: In winter, select Jing-Shu points. Jing-Shu points treat bone marrow diseases; thus, select Jing points of the Foot Triple-Yang meridians to disperse Bi obstruction in Yin Zang organs. Mo Yuncong said: Applying the methods of this classic to treatment is as immediate as striking a drum with a mallet. Ma Shi Tui Li advocated needling first, causing later students to view it merely as acupuncture technique and neglect it, unaware that profound Dao resides within needling.
If the body suffers injury, with excessive bleeding, or contracts wind-cold, or suffers a fall, leading to flaccidity and inability to control the limbs, it is called Ti Duo (Body Flaccidity). Treatment should select the San Jie Jiao (Three Connections Intersection) below the umbilicus. San Jie Jiao refers to the intersection of the Foot Yangming Stomach Meridian and Foot Taiyin Spleen Meridian, specifically Guan Yuan (CV4), three cun below the umbilicus.
This describes injury to the blood and Qi of the skin and pores, requiring selection of the Foot Yangming and Foot Taiyin meridians. The initial discussion of cold and heat in skin pores involved Three Yin Qi. Here, injury to blood and Qi in skin pores also selects Taiyin and Yangming, demonstrating the interconnection of Yin-Yang blood and Qi. Body injury with excessive bleeding damages blood; contracting wind-cold damages Ying and Wei. The human form relies on Qi for movement and Blood for nourishment. Damage to blood and Qi makes one feel as if fallen, with flaccid limbs unable to hold themselves, termed Ti Duo. The blood and Qi that fill the skin and warm the muscles originate from the essence of Grain-Water in Yangming, overflow centrally, and distribute to the skin pores via the Chong and Ren vessels. Thus, one should select the Foot Yangming and Foot Taiyin meridians below the umbilicus, and Guan Yuan of the Ren Vessel, to assist the source of blood and Qi generation. San Jie Jiao is where the Foot Taiyin, Foot Yangming, and Ren Vessel intersect below the umbilicus. Shen Liangchen said: The first part discusses Three Yin Qi, originating from interior Yin and governing exterior skin, muscle, and bone. The next section discusses Three Yang Qi, arising from below and emerging above to the neck, head, and face. Here, superficial blood and Qi also rise from below to fill the skin. Generally, Yin-Yang blood and Qi rise from below.
Jue Bi (Jue Bi Syndrome): Jue Qi rises to the abdomen. Treatment involves selecting the Luo-connecting vessels of Yin and Yang meridians, observing which meridian is primarily affected. Drain the Yang meridians, tonify the Yin meridians. The arterial pulse on the side of the neck is Ren Ying (ST9). Ren Ying belongs to the Foot Yangming Stomach Meridian, located anterior to the carotid artery (Ying Jin). Posterior to the carotid artery is the Hand Yangming Large Intestine Meridian, named Fu Tu (LI16). The next pulse posteriorly is the Hand Shaoyang Sanjiao Meridian, named Tian You (TE16). The next pulse is the Foot Taiyang Bladder Meridian, named Tian Zhu (BL10). The arterial pulse in the axilla is the Hand Taiyin Lung Meridian, named Tian Fu (LU3).
This states that Yang Qi is born within Yin and rises from below. Jue Bi is obstruction in the lower body, causing rebellion of Three Yang Qi, reaching only the abdomen but failing to ascend to the head and neck. Selecting Luo-connecting vessels of Yin and Yang meridians allows observation of which meridian is affected by Jue Bi. Draining Yang meridians reverses the rebellious Qi, allowing it to ascend. Tonifying Yin meridians acknowledges that Yang Qi originates from Yin. "Ci Mai" (Secondary Pulses) are arranged from the side of the throat sequentially to the back of the neck, corresponding to the First and Second Pulses mentioned in the *Ben Shu* chapter. Generally, the Qi of the Three Yang meridians circulates along the neck and head to fill the face. The axillary pulse belongs to the Hand Taiyin Lung Meridian. Taiyin governs the Qi of Yin and Yang.
Yangming Headache, chest fullness, and dyspnea: Select Ren Ying (ST9).
The following five sections continue the previous text, separately discussing Jue Qi (Rebellious Qi) presenting with specific symptoms, selecting points according to the affected meridian. Yangming headache occurs because Yangming Qi rebels in the abdomen and fails to ascend via Ren Ying to fill the head, causing headache. Rebellion in the middle jiao causes chest fullness and dyspnea. One should select Ren Ying to unblock the Qi.
Sudden Aphonia with Qi Obstruction: Select Fu Tu (LI16) and bleed the base of the tongue. ("Geng" is identical to "Geng").
Metal governs sound; the Heart governs speech. The Hand Yangming Large Intestine Meridian governs Qi and corresponds to Metal. Thus, when Yangming Qi rebels below, sudden aphonia and Qi obstruction occur. Bleeding Fu Tu and the base of the tongue unblocks the Qi and restores voice.
Sudden Deafness with Qi Confusion, unclear vision and hearing: Select Tian You (TE16).
The Hand Shaoyang Sanjiao Meridian enters the ear and reaches the outer canthus. When Shaoyang Qi rebels below, the upper meridians become blocked, causing sudden deafness, Qi confusion, and unclear vision/hearing. One should select Tian You.
Sudden Spasm, Epilepsy, Vertigo, with feet unable to support the body: Select Tian Zhu (BL10).
The Foot Taiyang Bladder Meridian governs sinews; thus, Qi rebellion causes sudden spasm and inability of the feet to support the body. The Taiyang meridian originates at Jing Ming (BL1) in the inner canthus. Failure of Qi to ascend causes epilepsy and vertigo. One should select Tian Zhu.
Sudden Dan (Jaundice/Heat Disease), internal rebellion, Liver-Lung conflict, bleeding from nose and mouth: Select Tian Fu (LU3).
Dan refers to Xiao Dan (Consumption-Dan). Bao Dan refers to sudden thirst. The Liver meridian penetrates the Lung; thus, when Hand Taiyin Lung Qi rebels, Liver and Lung conflict. The Lung governs Qi, the Liver governs Blood. Qi rebellion in the center causes Blood stagnation and upward溢 (overflow). The Lung is the source of Water; conflict prevents fluid generation, causing sudden thirst. All these cases require selecting Tian Fu of the Hand Taiyin Lung Meridian to relieve the conflicting rebellion. Sudden diseases are acute Jue syndromes caused by Qi rebellion, hence the repeated use of "Bao" (Sudden).
These are called the "Da You Wu Bu" (Five Great Windows).
You means window. Acupoints and orifices of the head and face are like the great windows of a pavilion, used to ventilate Qi. Qi rebellion below causes blockage of upper meridians, leading to unclear vision/hearing, sudden aphonia, epilepsy, and vertigo. This illustrates that Three Yang Qi arises from below and exits from above. Thus, it concludes: These are the Five Great Windows. The following re-discusses meridians. Shen Liangchen said: Ren Ying, Fu Tu, Tian You, and Tian Zhu are the Street of Head Qi. The axillary arterial pulse is the Street of Chest Qi. Mo Yuncong asked: The *Ben Shu* chapter discusses Ci Mai as the six meridians of Hand and Foot Yang. Why does this section list only Hand Yangming, Hand Shaoyang, Foot Yangming, and Foot Taiyang as the Great Windows? Answer: Taiyang Qi originates from Bladder Water; Shaoyang Qi is rooted in Ministerial Fire; Yangming Qi originates from the Middle Jiao Stomach. In meridians, there are six Hand and Foot meridians; in the Two Qi, only Three Yin and Three Yang are discussed. Hand Yangming and Hand Taiyin are exterior-interior pairs, governing the circulation of Qi throughout the body, hence combined into the Five Great Windows.
Hand Yangming has a branch entering the face and encircling the teeth, named Da Ying (LI17 - note: text says Da Ying but describes LI17 location/function, though traditionally Da Ying is ST5. The commentary clarifies it relates to Hand Yangming Qi connecting to Foot Yangming). For lower toothache, select points on the arm. If aversion to cold, tonify; if no aversion to cold, drain. Foot Taiyang has a branch entering the face and encircling the teeth, named Jiao Sun (TE18). For upper toothache, select points anterior to the nose and cheekbone. At the onset of illness, the pulse is vigorous; if vigorous, drain; if deficient, tonify. Another method says: select points outside the nose. ("Qiu" sounds like "Qiu Yu Qie", referring to the junction of cheekbone and nose; "Qu" refers to toothache).
The previous section discussed Three Yang Qi ascending sequentially to the Great Windows. This section re-discusses Qi communicating through Luo vessels. It is said that when Luo vessels are cut, Jing meridians connect, forming a circle without end, unknown in origin. Qi exiting the Great Windows comes out from the Qi Streets outside the vessels. Qi moving within vessels passes through Luo vessels into the vessels. External and internal circulation is endless, hence its origin is unknown. The junction of the cheekbone and nose is "Qiu". Qu is toothache. Hand Yangming has a branch entering "Qiu" and encircling the teeth, named Da Ying. Da Ying is originally an acupoint of the Foot Yangming Stomach Meridian; here, Hand Yangming Qi penetrates from the Luo vessel into the Foot Yangming Meridian. Thus, lower toothache requires selecting the Hand Yangming Meridian. Aversion to cold and drinking indicates deficiency; tonify. No aversion to cold and drinking indicates excess; drain. Foot Taiyang has a branch entering "Qiu" and encircling the teeth, named Jiao Sun. Jiao Sun is originally an acupoint of the Hand Shaoyang Sanjiao Meridian; here, Foot Taiyang Qi penetrates into the Hand Shaoyang Meridian. Thus, upper toothache requires selecting points anterior to the nose and "Qiu", which are Taiyang Luo vessels. Note: Ying Blood and Zong Qi circulate in the meridians. The Foot Taiyang Luo vessel does not enter the teeth. This is neither a main meridian nor a collateral branch, but a fine connection transmitting Qi between the Two Yangs. Hence, at onset, the pulse is vigorous, indicating Qi excess. Excess is drained; deficiency is tonified. Mo Yuncong said: Three Yang Qi, when separated, are three; when united, is one. One Yang Qi descends to the spring, circles the earth, and reconnects underground, traversing the teeth. Teeth belong to the mouth opening inward; teeth are generated by the Water Organ (Kidney); the mouth is the external manifestation of Earth.
Foot Yangming has a branch挟 (flanking) the nose entering the face, named Xuan Lu (GB21 - note: text says Xuan Lu but attributes it to Hand Taiyang in commentary, likely a textual variant or error in original commentary logic, but follows text: "Zu Yangming dang zuo Shou Taiyang" i.e., Foot Yangming should be Hand Taiyang). It connects to the mouth, opens inward, and ties to the root of the eye. Select based on excess. Reduce excess, tonify deficiency. Reverse this, and tonify instead. (Note: "Foot Yangming" should be "Hand Taiyang").
This summarizes the six Ci Mai of the Three Yang. Generally, Three Yang Qi ascending to the Great Windows follows Hand Yangming, Hand Shaoyang, Foot Yangming, and Foot Taiyang. Meridian connectivity involves intersections of Hand and Foot six meridians. Thus, Hand Taiyang has a branch flanking the nose entering the face, named Xuan Lu. Xuan Lu is originally an acupoint of the Foot Shaoyang Gallbladder Meridian; here, Hand Taiyang Qi communicates from the Luo vessel to the Foot Shaoyang Meridian. Connecting to the mouth, opening inward, and tying to the root of the eye. Select where there is excess. "Excess" means disease. If the disease is in Taiyang, and Taiyang Luo is in excess while Shaoyang Meridian is deficient, reduce Taiyang excess and tonify Shaoyang deficiency. Conversely, tonify Taiyang. Shen Liangchen said: "Reverse this" should be viewed from the perspective of "excess". Deduce from these two sentences: Taiyang Qi penetrates from the Luo vessel into the Shaoyang Meridian; Shaoyang Qi communicates from the Luo vessel into the Taiyang Meridian. The same applies to the above four pulses. Mo Yuncong asked: Hand and Foot Yangming intersect naturally. What is the rationale for Taiyang and Shaoyang combining? Answer: Shaoshao Qi originates from primordial Water and Fire, like the four images divided from two coins. Thus, January and February are governed by Shao and Tai; May and June are governed by Shao and Tai. Shao and Tai combine. Yangming means Two Yangs combined brightness, hence Yangming governs March and April. This is Yangming's self-intersection. The Way of Yin and Yang changes infinitely; understanding constant and variable principles allows discussion of Yin and Yang. Zhu Jigong asked: Taiyang Qi governs skin and hair; Yangming Qi governs muscle and pores; Shaoyang Qi governs pivot and hypochondrium. Now discussing Three Yang Qi, why do they all ascend along meridians to the head and face? Answer: This is the way of ascending, descending, entering, and exiting. Yin-Yang Qi enters and exits internally and externally. Thus, for Pi Han Re, select Taiyang and Taiyin; for Ji Han Re, select Triple-Yang below, ascending and descending. Pathogens striking the face descend to Yangming; striking the neck descend to Taiyang; striking the cheek descend to Shaoyang. Er-Yang Qi circulates on the muscle surface; thus, striking Yang flows into the meridians. This is the mutual communication of meridian Qi inside and out. This is the ceaseless ascending, descending, entering, and exiting. If one breath ceases to move, the mechanism is lost.
The Foot Taiyang Meridian has a branch passing through the neck into the brain, directly connecting to the root of the eye, named Yan Xi (Eye System). For severe head and eye pain, select the point between the two tendons in the neck entering the brain. This branches to Yin Qiao and Yang Qiao. Yin and Yang intersect; Yang enters Yin, Yin exits Yang, intersecting at the outer canthus. When Yang Qi is abundant, eyes open; when Yin Qi is abundant, eyes close.
This states that Foot Taiyang Qi connects to Yang Qiao and Yin Qiao. "Qi" continues from the previous text, stating Foot Taiyang has another branch passing through the neck into the brain, directly connecting to the root of the eye, named Yan Xi. Entering the brain between the two tendons in the neck, it branches to Yin Qiao and Yang Qiao, with Yin and Yang intersecting at the outer canthus. Yang Qiao Qi enters Yin Qiao; Yin Qiao Qi exits Yang Qiao. If Yang Qiao Qi is abundant, eyes open; if Yin Qiao Qi is abundant, eyes close. This shows Taiyang Qi connects through the Eye System to the Yin-Yang Qiao vessels. Note: The *Mai Du* chapter states: Qiao vessels are branches of Taiyin, originating after Ran Gu, ascending along the chest, connecting to the inner canthus, merging with Taiyang Yang Qiao and ascending. Qi returning together moistens the eyes. This states Yin Qiao originates from Foot Shaoyin and ascends to connect with Taiyang Yang Qiao. This section discusses Taiyang Qi connecting to Yang Qiao and Yin Qiao, hence "Men count their Yang, women count their Yin." Generally, Yin Qiao connects Shaoyin Essence-Water to Yang Qiao; Yang Qiao connects Taiyang Qi to Yin Qiao. Men prioritize Qi, hence men count Yang; women prioritize Essence-Blood, hence women count Yin. Qi is Yang, Blood is Yin. Mo Yuncong said: Raising the foot high is called Qiao. Foot Shaoyin and Foot Taiyang are the sources of Yin-Yang blood and Qi. Yin Qiao and Yang Qiao govern the passage of Yin-Yang blood and Qi, ascending from below to intersect at the eyes. The eyes are the gate of life.
Re Jue (Heat Jue): Select Foot Taiyin and Foot Shaoyang, retaining the needle. Cold Jue: Select Foot Yangming and Foot Shaoyin on the feet, retaining the needle.
This discusses disharmony of Yin and Yang Qi causing Cold Jue and Heat Jue. Disharmony of Yin and Yang at the exterior causes cold and heat in muscle and skin; disharmony at the source causes Cold Jue and Heat Jue. Ma Yuantai said: "Shaoyang" should be "Shaoyin", and "Shaoyin" should be "Shaoyang". Note: *Su Wen · Jue Lun* states: Yang Qi deficiency below causes Cold Jue; Yin Qi deficiency below causes Heat Jue. Generally, Heat Jue is due to excess of Foot Three Yang Qi, so tonification targets Yin; thus, select Foot Taiyin and Foot Shaoyang, retaining the needle, to induce a cold sensation under the needle. Cold Jue is due to excess of Foot Three Yin Qi, so tonification targets Yang; thus, select Foot Yangming and Foot Shaoyin on the feet, retaining the needle, to await a warm sensation under the needle. Yu Borong said: Selecting points on the feet indicates Yang Qi originates from below.
Tongue protrusion with drooling and vexation: Select Foot Shaoyin.
This discusses disharmony of upper and lower Yin and Yang. Above Shaoyin, Lord Fire governs; below is the Water Organ. Water and Fire Qi interact上下 (up and down). Tongue protrusion, drooling, and vexation indicate Kidney Qi failing to nourish Heart Fire. Thus, select Foot Shaoyin to unblock Shaoyin Qi.
Chills, shivering, jaw quivering, no sweating, abdominal distension, and vexation: Select Hand Taiyin.
This discusses disharmony of interior and exterior Yin and Yang. *Nei Jing* states: Yang added to Yin is called sweat. Exterior is Yang, interior is Yin. Interior Yin fluids rely on exterior Yang Qi to diffuse and become sweat. Chills, shivering, jaw quivering, no sweating, abdominal distension, and vexation indicate disharmony of interior and exterior Yin and Yang. Thus, select Hand Taiyin to vent Qi of the skin and pores and promote sweat flow. Hand Taiyin Lung Meridian governs the regulation of water fluids, distributing them to the skin and pores. Mo Yuncong said: The previous section discussed upper and lower; this section discusses interior and exterior, representing the ascending, descending, entering, and exiting of Yin and Yang. The chapter title "Han Re" refers to Yin-Yang disharmony.
Tonifying deficiency involves needling where Qi is departing (chasing and assisting). Reducing excess involves needling where Qi is arriving (meeting and seizing).
This summarizes disharmony of Yin-Yang and cold-heat due to obstacles from pathogenic and righteous Qi and deficiency/excess. Deficiency is insufficient righteous Qi; excess is surplus pathogenic Qi. When pathogenic Qi is excess, righteous Qi is deficient. Thus, tonifying deficiency involves needling where Qi is departing, known as "chasing and assisting." Reducing excess involves needling where Qi is arriving, known as "meeting and seizing." Meeting and following, harmonizing with intention, can regulate Qi and cure disease.
In Spring, select Luo vessels; in Summer, select Fen Cou (interstices); in Autumn, select Qi Kou (Radial Pulse); in Winter, select Jing-Shu points. For these four seasons, each uses the season as the standard. Luo vessels treat the skin; Fen Cou treats the muscles; Qi Kou treats sinews and vessels; Jing-Shu points treat bone marrow.
This aligns the depth of human tissue layers with the Qi of the four seasons. Human blood and Qi respond to the entering and exiting of Heaven and Earth Yin and Yang. Thus, Spring selects Luo vessels, Summer selects Fen Cou, as Spring and Summer Qi moves from inside to outside. Autumn selects Qi Kou, Winter selects Jing-Shu points, as Autumn and Winter Qi returns from outside to inside. This is human Qi and Blood moving in and out with the Qi of Heaven, Earth, and the four seasons. "Qi" (Standard) means unity. These four seasons correspond to human Yin-Yang entering and exiting, hence each uses the season as the standard. Thus, selecting Luo vessels treats the skin; selecting Fen Cou treats the muscles; selecting Qi Kou treats sinews and vessels; selecting Jing-Shu points treats bone marrow. This also uses the four seasons'...