经云∶大肠者,传道之官,变化出焉。又云∶回肠当脐左回十六曲,大四寸,径一寸
寸之少半,长二丈一尺,受谷一斗,水七升半。又云∶广肠附脊以受回肠,乃出滓秽之
路。大八寸,径二寸,寸之大半,长二尺八寸,受谷九升三合八分合之一。是经多气少血。
《难经》曰∶大肠重二斤十二两,肛门重
十二两。
张介宾曰∶按回肠者,以其回叠也;广肠者,即回肠之更大者;直肠者,又广肠之
末节,下连肛门也。
\r手阳明大肠腑图\p06-d43a50.bmp\r
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,上出于柱骨之上会,下入缺盆,络
肺下膈属大肠。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。
\r大肠经循行图\p06-d43a51.bmp\r
阳明之脉手大肠,次指内侧起商阳,循指上廉出合谷,岐骨两筋循臂肪,入肘外廉
循外,肩端前廉柱骨旁,从肩下入缺盆内,络肺下膈属大肠。支从缺盆直上颈,斜贯颊
前下齿当,环出人中交左右,上侠鼻孔注迎香。
【注】手阳明大肠经之脉,起于大指次指内廉之端。出于大指者,谓出于大指少商穴
也,本经之络。其支者,直出于次指之端,以交于手阳明大肠经之商阳穴,故曰∶起于大
指次指之端也。从商阳穴循食指上廉,二间、三间穴也。从三间穴循出两骨之间,合谷穴
也。从合谷上两筋之间,阳溪穴也。从阳溪穴循臂上廉至偏历、温溜、下廉、上廉、三
里穴也。从三里穴入肘外廉,曲池穴也。从曲池穴上 外前廉,肘 、五里、臂 穴也。
从臂 穴上肩,肩 穴也。从肩 穴出 骨之前廉,巨骨穴也。从巨骨穴上出于柱骨之会
上,言会于督脉之大椎穴也;自督脉大椎穴入交足阳明胃经之缺盆穴。络肺下膈属大肠
者,谓其支从缺盆上颈,复循本经之天鼎穴,贯颊至扶突穴也。从扶突穴入下齿中禾 穴,
从禾 穴还出挟口交人中──左之右,右之左──上挟鼻孔迎香穴而终,以交于足阳明胃经也。
The classic texts state: The Large Intestine is the official responsible for transmission, where changes and transformations occur. It is further stated that the Hui Chang (Revolving Intestine) is located to the left of the umbilicus, revolving sixteen times, with a width of four cun, a diameter of one cun and one-third cun, and a length of two zhang and one chi, capable of holding one dou of grain and seven sheng and half a sheng of water. It is also stated that the Guang Chang (Broad Intestine) attaches to the spine to receive the Revolving Intestine; this is the pathway for expelling waste and filth. The Broad Intestine is eight cun wide, two cun and two-thirds cun in diameter, and two chi and eight cun long, capable of holding nine sheng, three he, and one-eighth he of grain. This meridian is characterized by abundant Qi and scarce Blood. The Nan Jing states: The Large Intestine weighs two jin and twelve liang, and the An Men (Anus) weighs twelve liang.
Zhang Jiebin stated: Regarding the Hui Chang, its name derives from its revolved and folded structure; the Guang Chang is the larger portion of the Hui Chang; the Zhi Chang (Straight Intestine) is the terminal segment of the Guang Chang, connecting downwards to the Anus.
The Hand-Yangming Large Intestine Fu Meridian originates at the tip of the radial side of the index finger, follows the upper medial border of the finger, emerges between the two bones at Hegu (LI4), ascends into the space between the two tendons, follows the upper lateral border of the forearm, enters the lateral aspect of the elbow, ascends along the anterior lateral border of the upper arm, reaches the shoulder emerging before the anterior border of the acromion, ascends above the meeting point of the vertebral column, descends into the Supraclavicular Fossa (Quepen), connects with the Lung, passes downward through the diaphragm, and belongs to the Large Intestine. Its branch arises from the Supraclavicular Fossa, ascends to the neck, penetrates the cheek, enters the lower teeth, returns to emerge flanking the mouth, crosses at Renzhong (GV26)—left crossing right, right crossing left—and ascends to flank both sides of the nostrils.
The Yangming Hand-Large Intestine meridian starts at Shangyang (LI1) on the inner side of the index finger, follows the upper border of the finger out to Hegu (LI4), traverses the gap between the bones and tendons along the forearm, enters the lateral elbow, follows the lateral upper arm, passes the anterior border of the shoulder and beside the vertebral column, descends from the shoulder into the Supraclavicular Fossa, connects with the Lung, passes downward through the diaphragm, and belongs to the Large Intestine. The branch rises straight from the Supraclavicular Fossa to the neck, obliquely penetrates the anterior cheek to the lower teeth, circles out to cross Renzhong (GV26) left and right, and ascends to flank the nostrils, entering Yingxiang (LI20).
[Annotation] The meridians of the Hand-Yangming Large Intestine originate at the end of the medial border of the index finger. The phrase "emerges from the thumb" refers to Shaoshang (LU11) of the thumb, which is the collateral branch of this meridian. Its branch directly emerges from the tip of the index finger to connect with Shangyang (LI1) of the Hand-Yangming Large Intestine Meridian; hence it is said to "originate at the ends of the index and thumb fingers." From Shangyang (LI1), following the upper border of the index finger, are Erjian (LI2) and Sanjian (LI3). From Sanjian (LI3), emerging between the two bones, is Hegu (LI4). From Hegu (LI4) ascending between the two tendons is Yangxi (LI5). From Yangxi (LI5), following the upper lateral border of the forearm to Pianli (LI6), Wenliu (LI7), Xia Lian (LI8), Shang Lian (LI9), and Sanli (ST36/LI10 context implies ST36 but text says Sanli which usually refers to Zusanli ST36, however in LI channel context often refers to specific points or is a textual variation, here strictly translating as Sanli), are the points. From Sanli entering the lateral aspect of the elbow is Quchi (LI11). From Quchi (LI11) ascending to the anterior lateral border of the upper arm are Zhou Liao (LI12), Wuli (LI13), and Bi Nao (LI14). From Bi Nao ascending to the shoulder is Jianyu (LI15). From Jianyu (LI15) emerging before the anterior border of the acromial bone is Gugu (LI16). From Gugu (LI16) ascending above the meeting of the vertebral column, it meets Dazhui (GV14) of the Du Mai; from Dazhui (GV14) of the Du Mai, it enters and intersects with Quepen (ST12) of the Foot-Yangming Stomach Meridian. Connecting with the Lung, passing downward through the diaphragm, and belonging to the Large Intestine refers to the branch arising from Quepen, ascending to the neck, again following Tianding (LI17) of this meridian, penetrating the cheek to Futu (LI18). From Futu (LI18) entering the lower teeth is Heliao (LI19); from Heliao (LI19) returning to emerge flanking the mouth and crossing at Renzhong (GV26)—left crossing right, right crossing left—ascending to flank the nostrils to Yingxiang (LI20) to conclude, thereby connecting with the Foot-Yangming Stomach Meridian.