（出灵枢第十篇）
〔小肠〕手太阳之脉。起于小指之端。循手外侧。上腕出踝中。直上循臂骨下廉。出肘内侧两筋之间。上循 外后
廉。出肩
解。绕肩胛。交肩上。入缺盆。络心。循咽。下膈。抵胃。属小肠。（按筋字。发挥中作骨。极是。试以手按其处。实系
两骨而无筋也。臂骨尽处为腕。腕下兑骨为踝。即手腕外侧高起圆骨是也。肘手臂中节也。肘之上下。皆名为臂。 音
儒。肩 下内侧对腋处。高起 白肉也。膂上两角为肩解。肩胛。即肩 。注见前。此言手太阳之脉。起于小指端。循
手外侧。上腕。出手踝中。直上循臂骨下。出肘内侧两骨间。上循 肉外之后廉。出肩解。绕肩胛。此系后肩。会督脉
之大椎穴。左右相交于两肩之上。此系前肩。入缺盆。向腋下。内行。当膻中之分。络心。复从络心处。还出循胃系。
盖胃系。即咽也。按此当在咽之下。下膈。行任脉之外。过上中下三脘。皆任脉穴名。抵胃。言至胃尽处。正当脐上二
寸之分。而属于小肠也。）其支者。从缺盆。循颈。上颊。至目锐 。却入耳中。（此言其支脉之行。从缺盆上行。循颈
颊等处。至目外角。却行入耳中。抵听宫而终也。）其支者。别颊。上 。抵鼻。至目内 。斜络于颧。（此言交经之支。
别从前支脉上颊之处。复上 。抵鼻。至目内 之睛明穴。以交于足太阳经也。发挥中无斜络于颧四字。滑氏不知交经
之后。其支脉之余气。复斜行络于两颧。而后止也。）
\r手太阳经脉之图\pt68a7.bmp\r
（琥）按手太阳之脉。上下左右分行。共六道。其脉之起。自手小指外侧端。上行腕踝臂肘 肉等处。上肩。会大
椎。复交肩。入缺盆。络心。属小肠者。二道。此其正经之脉也。其支者。即从前入缺盆处。上行循颈与颊。至目外角。
却行入耳中者。又二道。此其接正经而上行之。二大支脉也。又其支者。从前支脉上颊之处。别行上 。抵鼻。至目内
。其余气。则左右斜络于颧者。二道。此其交经之二小支脉也。前热论中云。项痛脊强。虽不言手太阳经病。然手太
阳之脉。绕肩胛。会大椎。盖大椎上连于项。下通乎脊。又肩胛。即肩 。足太阳之脉。下项循肩 。可见太阳一经。
有手足兼病者。今医多昧而不及察也。
东垣云。仲景用五苓散。以泻湿热。乃治太阳病。从标入本之药。小肠火为本。膀胱水为本。寒毒之气。从标入本。
邪与手经相合。而下至膀胱。难知中以五苓散主之。
（琥）据上东垣之说。则是伤寒有手太阳经病。可无疑矣。
〔大肠〕手阳明之脉。起于大指次指之端。循指上廉。出合谷两骨之间。上入两筋之中。循臂上廉。入肘外廉。上
外前廉。
上肩。出 骨之前廉。上出于柱骨之会上。下入缺盆。络肺。下膈。属大肠。（上廉外廉。前廉义同。总臂外之上侧也。
人垂两手。则阳明之经向前。故又云外前廉。会上二字。疑有脱误。大指次指。谓手之第二指。名食指也。合谷。本经
穴名。 。音鱼。肩端骨也。柱骨。肩胛上际颈骨之根也。此言手阳明之脉。起于食指端。循次指上廉。出合谷两骨之
间。俗名虎口是也。复上入两筋之中。此即本经之阳溪穴也。复上循臂骨之上廉。又入肘外廉。及 之外前廉。复上肩。
出肩端两骨间之前廉。更上出柱骨之上。会于大椎。复下前肩而入缺盆。内络肺脏。还出循足阳明经脉。下膈。当天枢
之分。天枢。足阳明经穴名。挟脐旁二寸。以属于大肠腑也。）其支者。从缺盆。上颈。贯颊。入下齿中。还出挟口。交
人中。左之右。右之左。上挟鼻孔。（此言其支脉之行。从前入。缺盆处。上行于颈。贯于颊。入下齿缝中。还出挟两口
吻。相交于人中之分。人中。督脉穴名。在鼻柱下。左脉往右。右脉往左。上挟鼻孔两旁。以交于足阳明经也。）
\r手阳明经脉之图\pt68a8.bmp\r
（琥）按手阳明之脉。上下左右分行。共四道。其脉之起。自手第二指内侧端。上行循指出虎口。复上行。循臂入
肘。上 。及肩。出 骨。复上出天柱骨。会于大椎。下前肩而入缺盆。络肺。循足阳明经。下膈。挟脐旁二寸。而属
大肠者。二道。此其正经之脉也。其支者。即从前入。缺盆处。别上颈。贯颊。入下齿缝中。复出挟口吻。左右相交于
人中。复上挟鼻孔之外而终者。二道。此其交经之支脉也。前热论中云。身热鼻干。不得卧。身热者。身以前热也。虽
不言手阳明经病。然手阳明下入缺盆。络肺。下膈。属大肠者。其脉循足阳明经。亦行于身之前。又其支者。上挟鼻孔。
则是身热。鼻干。不得卧。谓非手足阳明二经兼病邪。今医但执足经以求治。是亦昧而不及察也。
东垣答海藏问云。谓如手阳明。流入足阳明。是上流下也。本非足经病。当于手经中求之。是知治足经者非也。
（琥）据上东垣之说。则是伤寒有手阳明经病。可无疑矣。
三焦手少阳之脉起于小指次指之端。上出两指之间。循手表腕。出臂外两骨之间。上贯肘循 外。上肩而交出足少
阳之后。入缺盆。布膻中。散络心包。下膈。循属三焦（两指之两当作次。三焦者滑氏发挥云。上焦在心下。下膈。当
胃上口。其治在膻中。中焦在胃中腕。当脐上四寸。不上不下。其治在脐旁。下焦当膀胱上口。其治在脐下一寸。乃水
谷之道路。气之所终始也。马氏注以三焦。为有形之物。云右肾之下。有脂膜如手大。正与膀胱相对者。非孙东宿着三
焦。评已明证其误。详医旨绪余中。小指次指。手之第四指也。手表。手之外也。膻中。任脉穴名。当两乳之间。循历
也。循属。犹言历。属也。此言手少阳之脉。起于手第四指端。上出次指间。循手外腕。出臂外两骨之间。上贯肘。循
外。上肩。过两肩井。足少阳经穴名。故云出足少阳之后。入缺盆。横布于膻中之分。散绕心包。乃下膈。当胃上口。
以属上焦。于中脘。以属中焦。于阴交。以属下焦也。阴交。任脉穴名。在脐下一寸。考胃上口。当在膈之上。滑氏云
下膈者。误也。）其支者。从膻中。上出缺盆。上项。挟耳后。直上出耳上角。以屈下颊至 （此言支脉之行。从前布膻
中之处。上出缺盆之外。上项。过大椎。复上。挟耳后。直上至耳上角。折行至两眉头。及目内 之分。屈曲下颊。还
上而至于 也。）其支者。从耳后。入耳中。出走耳前。过客主人前。交颊。至目锐 （此言交经之一小支脉。即从前支
脉。挟耳后处。入耳中。却出走耳前。过足少阳经客主人穴之前。下交两颊。还上而至目锐 。以交于足少阳经也。）
\r手少阳经脉之图\pt68a9.bmp\r
（琥）按手少阳之脉。上下左右分行。共六道。其脉之起。自手第四指端。循手腕臂肘 肉之外。上肩。入缺盆。
布膻中之分。散络心包。下膈而历属上中下三焦者。二道。此其正经之脉也。其支者即从前布膻中之处。上出缺盆。上
项。挟耳而行。出耳上角。屈行下颊。还上而至 者。二道。此接正经。而上行之支脉也。又其支者。从耳后。入耳中。
出走耳前。交颊还上。而至目锐 者。二道。此其交经之支脉也。前热论中云。胸胁痛而耳聋。世医但知为足少阳经之
病。殊不知手少阳之脉。亦入耳中。又其正经之脉。布膻中。下膈。非胸之分而何。则是少阳一证。除胁痛之外。凡耳
聋胸痛等候。每多手经受邪者。今医皆昧而不之察也。
深师疗伤寒。已八九日。三焦热。其脉滑数。昏愦。身体壮热。沉重拘挛。或时呼。呻。毒已攻内。表犹未解。今
直用解毒汤。则挛急不瘥。直用汗药。则毒因加剧。而方无表里。疗者意思以三黄汤救其内。有所增加以解其外。因用
三黄石膏栀子香豉麻黄汤。（方详外台秘要中。按上证。系手少阳三焦受病。故无汗下之禁）
王叔和撰次伤寒脉法云。阴阳相搏。名曰动。阳动。则汗出。阴动。则发热。形冷恶寒者。此三焦伤也。（成氏注云
三焦者。原气之别使。主行气于阳。三焦既伤。则阳气不通。而致身冷恶寒。夫身冷恶寒明系表证。由是而知。叔和所
云三焦伤者。乃手少阳经病也。）
（琥）据上二家之说。则是伤寒有手少阳经病。可无疑矣。
肺手太阴之脉。起于中焦。下络大肠。还循胃口。上膈。属肺。从肺系。横出腋下。下循 内。行少阴心主之前。
下肘中。循臂内上骨下廉。入寸口。上鱼。循鱼际。出大指之端。（中焦者。在胃中脘。当脐上四寸之分。胃口。胃下口
也。即小肠上口。名曰幽门。马氏注以胃口。为胃之上脘。大误。夫肺经之脉。既下络于大肠矣。则是还上而过小肠。
循胃口者。非胃下口而何。且也。既循胃口。复上膈。岂有胃之上口。反在膈下之理。肺系喉咙也。手掌后高骨旁动脉
为关。关前动脉为寸口。曰上鱼者。谓掌骨之前。大指本节之后。其肥肉隆起处。形如鱼者。统谓之鱼。鱼际。即其间
之穴名也。此言手太阴之脉起于中焦。下行而络于大肠。还上而循胃下口。上膈。连属于肺。即从肺系出外。横行循胸。
以出腋下。下循 内。行少阴心主二经之前。盖人垂两手。则肘臂贴身。大指居前。小指居后。手少阴心经。循小指之
内。手厥阴心主。循小指次指出其端。此经之行。循大指内侧。故云行少阴心主之前也。再下而行肘中。循臂内上骨之
下廉。今人臂皆两骨相合。垂手则上骨居前。曰下廉者。上骨之内侧也。入寸口。上鱼。循本经之鱼际穴。复循大指内
侧。而出其端也。）其支者。从腕后。直出次指内廉出其端。（此言其支脉之行。从本经手腕后之列缺穴。直达次指内廉
出其端。以交于手阳明经也。马注云从列缺穴。已交于手阳明经之合谷穴。即循手阳明经。以达于次指端之商阳穴。又
随商阳穴而上行者非。盖此道支脉。行于次指之内。自出指端。交经之后。方行于次指之内侧也。）
\r手太阴经脉之图\pt68a10.bmp\r
（琥）按手太阴之脉。上下左右分行。共四道。其脉之本。起于中焦。下络大肠。上属于肺。从肺系外行。横出腋
下。下循 肘与臂。入寸口。上鱼。出大指之端者。二道。此其正经之脉也。其支者从正经所行手腕之后。别行而出次
指之端者。二道。此其交经之脉也。前热论中云。腹满嗌干。此实系足太阴经受病。殊不知手太阴之脉。下络大肠。还
循胃口。肠胃实热。腹必作满。又太阴脉从肺系。肺之系。即喉咙也。喉咙之口。名为嗌。肺气热。则嗌必干。由是而
知。腹满嗌干者。每多手太阴经病热之证。今医亦昧而不及察也。
许学士叔微治一舟子病伤寒。发黄。鼻内酸痛。身与目如金。小便赤而数。大便如经。或欲行茵陈五苓。许曰非其
治也。小便和。大便如常。则知病不在脏腑。今眼睛疼。鼻颇痛。是病在清道中。清道者。华盖。肺之经也。若下大黄。
则必腹胀为逆。因用瓜蒂散。先食水。次搐之。鼻中黄水尽。乃愈。
（琥）据上许学士案。则是伤寒有手太阴经证。可无疑矣。
心手少阴之脉。起于心中。出属心系。下膈。络小肠。（心系。滑氏注云有二。一则由肺叶而下。曲折向后。并脊膂。
贯脊髓。与肾相通者。愚以此是肾之系。凡四脏皆系于心也。一则与肺相通。上入肺两大叶间者。此方为心之系。盖心
与肺同一系。而肺之系。实上接于喉也。此言手少阴之脉起于心中。上出属心之系。外行循任脉之外。下膈。当脐上二
寸之分。以络于小肠也。）其支者。从心系。上挟咽。系口系。（此言其支脉之行。即从心系而上。由喉之后。挟咽两旁。
再上而系于目之内系也。）其直者。复从心系。却上肺。下出腋下。循 内后廉。行手太阴心主之后。下肘内。循臂内后
廉。抵掌后锐骨之端。入掌内后廉。循小指之内出其端（锐骨之锐。省文作兑。即手踝骨也。此言其直行之经脉。复从
心系。直上至肺之分。出循腋下。由本经之极泉穴。下行循 内后廉。行手太阴心主二经之后。下肘臂内之后廉。至掌
后兑骨之端。入掌内廉。循小指内出其端。以交于手太阳经也）
\r手少阴经脉之图\pt68a11.bmp\r
（琥）按手少阴之脉。上下左右分行。共六道。其脉之起。自心中。出属心系。下膈。络小肠者。二道。此为脉之
根也。其支者。即从前属心系处。上挟咽系目系者。二道。此为脉之枝也。其直者。复从心系。却上肺。出腋下。下循
肘臂掌之内。循小指内出其端者。二道。此为脉之本也。前热论中云。口燥舌干而渴。世医只知。此为足少阴经之病。
殊不知舌乃心之苗。舌干者。手少阴经。必为热所乘。医人亦昧而不知察也。
王海藏治一人患伤寒。得汗数日忽身热。自汗脉弦数。心不得宁。真劳复也。王诊之曰劳心之所致神之所舍未复其初。
而又劳伤其神。营卫失度。当补其子。益其脾。解发其劳。庶几得愈。授以补脾汤。佐以小柴胡汤而解。或者曰。虚则
(From Chapter 10 of *Ling Shu*)
[Small Intestine] The Hand-Taiyang meridian originates at the tip of the little finger. It follows the lateral aspect of the hand, ascends to the wrist, emerges from between the malleolus-like prominence (ankle bone) of the wrist. It goes straight up along the lower border of the forearm bone, emerges between the two tendons on the medial side of the elbow. It ascends along the posterior-lateral border of the upper arm, emerges from the shoulder joint (Jianjie), winds around the scapula, and intersects at the shoulder. It enters the supraclavicular fossa (Quepen), connects with the Heart, follows the pharynx, descends through the diaphragm, reaches the Stomach, and belongs to the Small Intestine. (Note: The character "tendon" in the original text is written as "bone" in *Fa Hui*, which is extremely correct. Try touching this area with your hand; it is actually two bones without tendons. The end of the forearm bone is the wrist; the protruding bone below the wrist is called the ankle, i.e., the round bony prominence on the lateral side of the wrist. The middle section of the arm and elbow are referred to as the arm. Both above and below the elbow are named arm. "Ru" is pronounced as 'ru'. The place under the shoulder, medially opposite the axilla, is the raised white flesh. The two angles above the spinal muscles are called Jianjie. Scapula refers to the area near Jianyu acupoint; see previous notes. This describes the Hand-Taiyang meridian originating at the tip of the little finger, following the lateral side of the hand, ascending to the wrist, emerging from the ankle bone, going straight up along the lower side of the forearm bone, emerging between the two bones on the medial side of the elbow, ascending along the posterior-lateral border of the humeral muscle, emerging from Jianjie, and winding around the scapula. This is the posterior shoulder, intersecting with the Dazhui acupoint of the Du Meridian, crossing left and right above both shoulders. This is the anterior shoulder, entering the Quepen, heading towards the axilla, moving internally, corresponding to the Danzhong region, connecting with the Heart. Then returning from the connection with the Heart, it ascends along the gastric system. The so-called gastric system is the pharynx. Note that this should be below the pharynx, descending through the diaphragm, running outside the Ren Meridian, passing through the Upper, Middle, and Lower Wan (names of acupoints on the Ren Meridian), reaching the Stomach, meaning arriving at the end of the Stomach, precisely at the location 2 cun above the umbilicus, and belonging to the Small Intestine.) Its branch arises from the Quepen, follows the neck upwards, reaches the cheek, arrives at the outer canthus of the eye, then turns back into the ear. (This describes the course of its branch: ascending from the Quepen, following the neck and cheek, reaching the outer canthus, turning back into the ear, ending at the Tinggong acupoint.) Another branch diverges from the cheek, ascends to the infraorbital region, reaches the nose, arrives at the inner canthus of the eye, and obliquely connects with the zygomatic arch. (This describes the branch for meridian intersection: diverging from the point where the previous branch ascends to the cheek, ascending again to the infraorbital region, reaching the nose, arriving at the Jingming acupoint at the inner canthus, to intersect with the Foot-Taiyang meridian. *Fa Hui* lacks the four characters "obliquely connects with the zygomatic arch". Hua Shi did not know that after intersecting meridians, the residual qi of the branch obliquely connects with both zygomatic arches before stopping.)
Hand-Taiyang Meridian Diagram \pt68a7.bmp
(Hu) According to my observation, the Hand-Taiyang meridian divides into six paths上下左右 (up, down, left, right). Its origin starts from the lateral tip of the little finger of the hand, ascends to the wrist, ankle, forearm, elbow, and humeral muscle areas, goes up to the shoulder, meets the Dazhui, crosses the shoulder again, enters the Quepen, connects with the Heart, and belongs to the Small Intestine; these are two paths. These are the main meridians. Its branches, arising from the point where it enters the Quepen, ascend along the neck and cheek to the outer canthus, then turn back into the ear; these are another two paths. These are the two major branches connecting to the main meridian and ascending. Furthermore, its branches, diverging from the point where the previous branch ascends to the cheek, go up to the infraorbital region, reach the nose, arrive at the inner canthus, and their residual qi obliquely connects to the zygomatic arch on both sides; these are two paths. These are the two small branches for meridian intersection. The earlier *Re Lun* states: "Neck pain and stiff spine." Although it does not mention Hand-Taiyang meridian disease, the Hand-Taiyang meridian winds around the scapula and meets the Dazhui. Since Dazhui connects upwards to the neck and downwards to the spine, and the scapula corresponds to Jianyu, while the Foot-Taiyang meridian descends from the neck along Jianyu, it is evident that the Taiyang category involves diseases affecting both Hand and Foot meridians. However, many modern physicians are ignorant and fail to observe this.
Dong Yuan stated: Zhang Zhongjing used Wuling San (Five-Ling Decoction) to drain damp-heat; this is a medicine for treating Taiyang disease, entering from the manifest level to the root level. Fire of the Small Intestine is the root; Water of the Bladder is the root. Cold-toxic qi enters from the manifest to the root. Pathogenic factors combine with the Hand meridian and descend to the Bladder. *Nan Zhi Zhong* uses Wuling San as the primary treatment.
(Hu) Based on Dong Yuan's statement above, there is undoubtedly Hand-Taiyang meridian disease in Shanghan (Cold Damage).
[Large Intestine] The Hand-Yangming meridian originates at the tip of the index finger. It follows the upper border of the finger, emerges between the two bones at Hegu, ascends into the space between the two tendons. It follows the upper border of the forearm, enters the lateral border of the elbow, ascends along the anterior-lateral border of the upper arm. It goes up to the shoulder, emerges from the anterior border of the acromion bone, ascends out to the meeting point of the vertebral column bones, descends into the Quepen, connects with the Lung, descends through the diaphragm, and belongs to the Large Intestine. (Upper border, lateral border, and anterior border have similar meanings, generally referring to the upper lateral side of the arm. When a person hangs their hands down, the Yangming meridian faces forward, hence also called the anterior-lateral border. The term "meeting at the top" is suspected to have missing characters. Index finger refers to the second finger of the hand, named the index finger. Hegu is an acupoint of this meridian. "Nao" is pronounced 'yu', referring to the shoulder-end bone. Zhu Gu refers to the root of the cervical bone at the upper edge of the scapula. This describes the Hand-Yangming meridian originating at the tip of the index finger, following the upper border of the index finger, emerging between the two bones at Hegu, commonly known as the tiger's mouth. It then ascends into the space between the two tendons, which is the Yangxi acupoint of this meridian. It continues up along the upper border of the forearm bone, enters the lateral border of the elbow, and the anterior-lateral border of the upper arm. It goes up to the shoulder, emerges from the anterior border between the two bones at the shoulder end, goes further up out of the Zhu Gu, meets at Dazhui, descends from the anterior shoulder into the Quepen, internally connects with the Lung, returns to follow the Foot-Yangming meridian, descends through the diaphragm, at the Tianshu region. Tianshu is an acupoint of the Foot-Yangming meridian, located 2 cun lateral to the umbilicus, belonging to the Large Intestine fu organ.) Its branch arises from the Quepen, ascends to the neck, passes through the cheek, enters the lower teeth, returns to flank the mouth, intersects at the Renzhong, with the left vessel going to the right and the right vessel going to the left, ascending to flank the nostrils. (This describes the course of its branch: ascending from the Quepen, passing through the neck and cheek, entering the lower dental gap, returning to flank the corners of the mouth, intersecting at the Renzhong region. Renzhong is an acupoint of the Du Meridian, located below the nasal columella. The left vessel goes to the right, the right vessel goes to the left, ascending to flank the sides of the nostrils, to intersect with the Foot-Yangming meridian.)
Hand-Yangming Meridian Diagram \pt68a8.bmp
(Hu) According to my observation, the Hand-Yangming meridian divides into four paths. Its origin starts from the medial tip of the second finger of the hand, ascends along the finger out of the tiger's mouth, continues up, follows the arm into the elbow, ascends to the upper arm and shoulder, emerges from the acromion bone, goes further up out of the Tianzhu bone, meets at Dazhui, descends from the anterior shoulder into the Quepen, connects with the Lung, follows the Foot-Yangming meridian, descends through the diaphragm, flanks 2 cun lateral to the umbilicus, and belongs to the Large Intestine; these are two paths. These are the main meridians. Its branch, diverging from the point where it enters the Quepen, ascends separately to the neck, passes through the cheek, enters the lower dental gap, returns to flank the corners of the mouth, intersects left and right at Renzhong, and ascends to flank the outside of the nostrils to terminate; these are two paths. These are the branches for meridian intersection. The earlier *Re Lun* states: "Body heat, dry nose, inability to lie down." Body heat refers to heat in the anterior body. Although it does not mention Hand-Yangming meridian disease, the Hand-Yangming descends into the Quepen, connects with the Lung, descends through the diaphragm, and belongs to the Large Intestine. Its meridian follows the Foot-Yangming meridian, also running along the anterior body. Moreover, its branch ascends to flank the nostrils. Thus, body heat, dry nose, and inability to lie down refer to pathogens affecting both Hand and Foot Yangming meridians. However, current physicians only focus on the Foot meridian for treatment, which is also ignorance and failure to observe.
Dong Yuan answered Hai Cang's question: For example, when Hand-Yangming flows into Foot-Yangming, it is flowing downwards. It is originally not a Foot meridian disease; one should seek treatment within the Hand meridian. From this, we know that treating the Foot meridian is incorrect.
(Hu) Based on Dong Yuan's statement above, there is undoubtedly Hand-Yangming meridian disease in Shanghan.
The Sanjiao (Triple Burner) Hand-Shaoyang meridian originates at the tip of the ring finger. It ascends out between the two fingers, follows the dorsal aspect of the wrist, emerges between the two bones on the lateral aspect of the forearm, ascends through the elbow, follows the lateral aspect of the upper arm, goes up to the shoulder, and exits behind the Foot-Shaoyang meridian. It enters the Quepen, spreads in the Danzhong region, disperses to connect with the Pericardium, descends through the diaphragm, follows and belongs to the Sanjiao. ("Two fingers" should be "next finger". Regarding Sanjiao, Hua Shi in *Fa Hui* says: The Upper Jiao is below the heart, below the diaphragm, at the upper opening of the stomach, treated at Danzhong; the Middle Jiao is in the middle of the stomach, 4 cun above the umbilicus, neither up nor down, treated beside the umbilicus; the Lower Jiao is at the upper opening of the bladder, treated 1 cun below the umbilicus. It is the pathway for food and water, where qi begins and ends. Ma Shi annotated Sanjiao as a tangible object, saying there is a membrane like a palm below the right kidney, directly opposite the bladder. This error was clearly refuted by Sun Yisu in his critique of Sanjiao, detailed in *Yi Zhi Xu Yu*. The ring finger is the fourth finger of the hand. "Shou Biao" means the exterior of the hand. Danzhong is an acupoint of the Ren Meridian, located between the nipples. "Xun Li Ye, Xun Shu" means to pass through and belong. This describes the Hand-Shaoyang meridian originating at the tip of the fourth finger of the hand, ascending out between the next finger, following the dorsal wrist, emerging between the two bones on the lateral forearm, ascending through the elbow, following the lateral upper arm, going up to the shoulder, passing through the two Jianjing acupoints (Foot-Shaoyang meridian points), hence said to exit behind the Foot-Shaoyang meridian. Entering the Quepen, spreading horizontally at the Danzhong region, dispersing to surround the Pericardium, then descending through the diaphragm, at the upper opening of the stomach, belonging to the Upper Jiao; at Zhongwan, belonging to the Middle Jiao; at Yinjiao, belonging to the Lower Jiao. Yinjiao is an acupoint of the Ren Meridian, 1 cun below the umbilicus. Examining the upper opening of the stomach, it should be above the diaphragm; Hua Shi's statement "descends through the diaphragm" is erroneous.) Its branch arises from the Danzhong, ascends out of the Quepen, goes up to the neck, flanks the posterior ear, goes straight up out of the superior angle of the ear, bends down to the cheek to reach the chin. (This describes the course of the branch: ascending from the Danzhong region, exiting the Quepen, going up to the neck, passing Dazhui, ascending again, flanking the posterior ear, going straight up to the superior angle of the ear, bending to the glabella and inner canthus, curving down the cheek, returning up to the chin.) Another branch arises from behind the ear, enters the ear, exits the front of the ear, passes anterior to the Keyuren acupoint, intersects the cheek, and arrives at the outer canthus. (This describes a small branch for meridian intersection: from the point where the previous branch flanks the posterior ear, entering the ear, exiting the front of the ear, passing anterior to the Foot-Shaoyang meridian's Keyuren acupoint, descending to intersect both cheeks, returning up to the outer canthus, to intersect with the Foot-Shaoyang meridian.)
Hand-Shaoyang Meridian Diagram \pt68a9.bmp
(Hu) According to my observation, the Hand-Shaoyang meridian divides into six paths. Its origin starts from the tip of the fourth finger of the hand, follows the exterior of the wrist, forearm, elbow, and upper arm muscles, goes up to the shoulder, enters the Quepen, spreads at the Danzhong region, disperses to connect with the Pericardium, descends through the diaphragm and successively belongs to the Upper, Middle, and Lower Sanjiao; these are two paths. These are the main meridians. Its branch, arising from the Danzhong region, ascends out of the Quepen, goes up to the neck, flanks the ear, exits the superior angle of the ear, bends down the cheek, returns up to the chin; these are two paths. These are the branches connecting to the main meridian and ascending. Another branch, from behind the ear, enters the ear, exits the front of the ear, intersects the cheek, returns up to the outer canthus; these are two paths. These are the branches for meridian intersection. The earlier *Re Lun* states: "Hypochondriac pain and deafness." Physicians of the world only know this as a Foot-Shaoyang meridian disease, unaware that the Hand-Shaoyang meridian also enters the ear. Furthermore, its main meridian spreads at Danzhong and descends through the diaphragm; is this not the chest region? Therefore, for Shaoyang syndromes, besides hypochondriac pain, symptoms such as deafness and chest pain are often due to pathogenic invasion of the Hand meridian. Current physicians are ignorant and do not observe this.
Shen Shi treated Shanghan that had persisted for eight or nine days, with heat in the Sanjiao, slippery and rapid pulse, confusion, severe body heat, heaviness, and spasms. Sometimes shouting or groaning, toxins have attacked internally, yet the exterior remains unresolved. If one directly uses detoxifying decoctions, spasms will not improve; if one directly uses diaphoretic medicines, toxins will worsen. Moreover, the formula lacks distinction between interior and exterior. The practitioner's idea is to use Sanhuang Tang to save the interior, with additions to resolve the exterior. Therefore, use Sanhuang Shigao Zhizi Xiangchi Mahuang Tang. (Formula details in *Waitai Miyao*. According to the above symptoms, it is Hand-Shaoyang Sanjiao disease, hence no contraindications for sweating or purging.)
Wang Shuhe compiled *Shanghan Pulse Methods*: "When Yin and Yang struggle, it is called Movement. Yang movement causes sweating; Yin movement causes fever. Cold form and aversion to cold indicate injury to the Sanjiao." (Cheng Wuji commented: Sanjiao is the special envoy of Original Qi, governing the circulation of Qi in Yang. If Sanjiao is injured, Yang Qi cannot circulate, leading to cold form and aversion to cold. Since cold form and aversion to cold are clearly exterior syndromes, we know that Wang Shuhe's "injury to Sanjiao" refers to Hand-Shaoyang meridian disease.)
(Hu) Based on the statements of these two experts, there is undoubtedly Hand-Shaoyang meridian disease in Shanghan.
The Lung Hand-Taiyin meridian originates in the Middle Jiao, descends to connect with the Large Intestine, returns to follow the stomach opening, ascends through the diaphragm, and belongs to the Lung. From the lung system (trachea/pharynx), it emerges horizontally to the axilla, descends along the medial aspect of the upper arm, running anterior to the Hand-Shaoyin Heart meridian and Hand-Jueyin Pericardium meridian, descends to the elbow center, follows the medial aspect of the forearm along the lower border of the ulna, enters the Cun Kou, ascends to the大鱼际 (Thenar eminence), follows the Yu Ji acupoint, and emerges at the tip of the thumb. (Middle Jiao is in the middle of the stomach, at the region 4 cun above the umbilicus. Stomach opening refers to the lower opening of the stomach, i.e., the upper opening of the Small Intestine, named Youmen. Ma Shi annotated stomach opening as the upper wan of the stomach, which is a major error. Since the Lung meridian has already descended to connect with the Large Intestine, returning up and passing the Small Intestine, following the stomach opening must refer to the lower opening of the stomach. Moreover, since it follows the stomach opening and then ascends through the diaphragm, how could the upper opening of the stomach be below the diaphragm? Lung system refers to the throat. The arterial pulse beside the high bone behind the palm is Guan; the pulse anterior to Guan is Cun Kou. "Ascending to Yu" refers to the fleshy prominence resembling a fish anterior to the metacarpal bone and posterior to the proximal phalanx of the thumb, collectively called Yu. Yu Ji is the name of the acupoint in this area. This describes the Hand-Taiyin meridian originating in the Middle Jiao, descending to connect with the Large Intestine, returning up to follow the lower opening of the stomach, ascending through the diaphragm, connecting to the Lung, exiting externally from the lung system, traversing the chest horizontally to emerge from the axilla, descending along the medial upper arm, running anterior to the Hand-Shaoyin Heart and Hand-Jueyin Pericardium meridians. When a person hangs their hands down, the elbows and arms are close to the body, the thumb is anterior, and the little finger is posterior. The Hand-Shaoyin Heart meridian follows the medial little finger; the Hand-Jueyin Pericardium meridian follows the tip of the ring finger. This meridian follows the medial thumb, hence said to run anterior to the Shaoyin Heart and Jueyin Pericardium meridians. Descending further to the elbow center, following the lower border of the medial bone of the forearm. In modern humans, the forearm consists of two bones combined; when hanging down, the radius is anterior. "Lower border" refers to the medial side of the radius. Entering Cun Kou, ascending to Yu, following the Yu Ji acupoint of this meridian, continuing along the medial thumb, and emerging at its tip.) Its branch arises from behind the wrist, goes straight out to the medial border of the index finger and emerges at its tip. (This describes the course of its branch: from Lieque acupoint behind the wrist of this meridian, reaching directly to the medial border of the index finger and emerging at its tip, to intersect with the Hand-Yangming meridian. Ma's annotation says from Lieque, it has already intersected with Hegu of the Hand-Yangming meridian, i.e., following the Hand-Yangming meridian to reach Shangyang acupoint at the tip of the index finger, and ascending with Shangyang is incorrect. This branch runs on the medial side of the index finger; only after emerging from the tip and intersecting meridians does it run on the medial side of the index finger.)
Hand-Taiyin Meridian Diagram \pt68a10.bmp
(Hu) According to my observation, the Hand-Taiyin meridian divides into four paths. Its root originates in the Middle Jiao, descends to connect with the Large Intestine, ascends to belong to the Lung, emerges externally from the lung system, horizontally exits the axilla, descends along the medial upper arm, elbow, and forearm, enters Cun Kou, ascends to Yu, and emerges at the tip of the thumb; these are two paths. These are the main meridians. Its branch, diverging from behind the wrist where the main meridian runs, goes out to the tip of the index finger; these are two paths. These are the branches for meridian intersection. The earlier *Re Lun* states: "Abdominal fullness and dry throat." This actually indicates Foot-Taiyin meridian disease. However, one should not ignore that the Hand-Taiyin meridian descends to connect with the Large Intestine and returns to follow the stomach opening. Excess-heat in the intestines and stomach必然 causes abdominal fullness. Furthermore, the Taiyin meridian comes from the lung system; the lung system is the throat. The opening of the throat is called Yi. If Lung Qi is hot, Yi必然 becomes dry. From this, we know that abdominal fullness and dry throat are often signs of heat syndrome in the Hand-Taiyin meridian. Current physicians are also ignorant and fail to observe this.
Xu Shuwei Xueshi treated a boatman suffering from Shanghan, yellow jaundice, soreness and pain inside the nose, body and eyes golden-yellow, red and frequent urination, but normal bowel movements. Someone suggested using Yinchen Wuling San. Xu said this is not the correct treatment. With harmonious urination and normal bowels, the disease is not in the Zang-Fu organs. Now, with eye pain and significant nasal pain, the disease is in the Clear Passages. The Clear Passage is Huagai, the Lung meridian. If Da Huang were used, abdominal distension would result as a counter-effect. Therefore, he used Goudi San, first administering water, then insufflating the powder into the nose. When all yellow fluid drained from the nose, the patient recovered.
(Hu) Based on Xu Xueshi's medical case above, there is undoubtedly Hand-Taiyin meridian syndrome in Shanghan.
The Heart Hand-Shaoyin meridian originates in the Heart, emerges to belong to the Heart System, descends through the diaphragm, and connects with the Small Intestine. (Heart System: Hua Shi noted there are two types. One descends from the lung lobes, curves backward, runs along the spinal muscles, penetrates the spinal cord, and connects with the Kidney; I consider this the Kidney system, as all four Zang organs connect to the Heart. The other connects with the Lung, entering between the two large lobes of the Lung; this is truly the Heart System. The Heart and Lung share the same system, and the Lung system actually connects upwards to the throat. This describes the Hand-Shaoyin meridian originating in the Heart, emerging upwards to belong to the Heart System, running externally outside the Ren Meridian, descending through the diaphragm, at the region 2 cun above the umbilicus, to connect with the Small Intestine.) Its branch arises from the Heart System, ascends to flank the pharynx, and connects to the Eye System. (This describes the course of its branch: ascending from the Heart System, passing behind the throat, flanking both sides of the pharynx, ascending again to connect to the internal connection of the eye.) Its direct branch re-emerges from the Heart System, goes up to the Lung, descends out of the axilla, follows the posterior-medial border of the upper arm, runs posterior to the Hand-Taiyin and Heart-Jueyin meridians, descends to the medial elbow, follows the posterior-medial border of the forearm, reaches the end of the sharp bone behind the palm, enters the posterior-medial aspect of the palm, follows the medial little finger, and emerges at its tip. (The sharpness of the sharp bone is abbreviated as Dui, i.e., the wrist ankle bone. This describes the direct meridian: re-emerging from the Heart System, going straight up to the Lung region, exiting to follow the axilla, descending from the Jiquan acupoint of this meridian, following the posterior-medial border of the upper arm, running posterior to the Hand-Taiyin and Heart-Jueyin meridians, descending the posterior-medial border of the elbow and forearm, reaching the end of the Dui bone behind the palm, entering the medial palm, following the medial little finger, and emerging at its tip, to intersect with the Hand-Taiyang meridian.)
Hand-Shaoyin Meridian Diagram \pt68a11.bmp
(Hu) According to my observation, the Hand-Shaoyin meridian divides into six paths. Its origin starts from the Heart, emerges to belong to the Heart System, descends through the diaphragm, and connects with the Small Intestine; these are two paths. These are the roots of the meridian. Its branch, arising from the point where it belongs to the Heart System, ascends to flank the pharynx and connect to the Eye System; these are two paths. These are the branches of the meridian. Its direct branch, re-emerging from the Heart System, goes up to the Lung, exits the axilla, descends along the medial elbow, arm, and palm, follows the medial little finger and emerges at its tip; these are two paths. These are the main body of the meridian. The earlier *Re Lun* states: "Dry mouth, dry tongue, and thirst." Physicians of the world only know this as a Foot-Shaoyin meridian disease, unaware that the tongue is the sprout of the Heart. If the tongue is dry, the Hand-Shaoyin meridian must be invaded by heat. Physicians are also ignorant and fail to observe this.
Wang Haizang treated a person suffering from Shanghan. After sweating for several days, sudden body heat, spontaneous sweating, string-taut and rapid pulse, and mental restlessness occurred. This was truly a relapse due to overexertion. Wang diagnosed: Caused by overworking the Heart, the abode of Spirit has not returned to its original state, and the Spirit is further injured by overexertion. Ying and Wei are out of balance. One should tonify the Son, benefit the Spleen, and relieve the fatigue, hoping for recovery. He prescribed Bupi Tang, assisted with Xiaochaihu Tang, resulting in resolution. Some said: Deficiency implies...