薛立斋曰∶大抵病有浅深,效有迟速,亦有阴虚阳实,呼吸转移,医者须要胆大
心小。胆欲大者,有决断之才,识见之能,当刺则刺,当攻则攻,不宜攻刺者止之,则
能知标本矣。心欲小者,有救义之心,无苟取之念,富者辞之伤廉,贫者取之伤惠,
须要见利思义,庶称医职。
澄曰∶胆欲大者,非不辨虚实阴阳,不察穴道虚怯,妄施刀针,溷投攻伐,横行
放胆,罔顾病患性命,必须临证时,先看初起时病者元气虚实,次看疮之阴阳险否,
然后用药调治,当攻即攻,可补便补,不可因循耽误,致令变态不虞,认得真确,胆
量方可放大,若临证不多,妄用刀针,乱施攻补,则误事不浅矣。
王肯堂曰∶人身之有经络,犹地理之有界分,治病不知经络,犹捕贼不知界分,
其能无诛伐无过之咎乎!况手足十二经络,有气血多少之分,如手少阳三焦、足少阴
肾、足太阴脾,多气少血;手厥阴心包络、手太阳小肠、足太阳膀胱,多血少气;手
阳明大肠、足阳明胃,多气少血,此其大较也。多血少气者,易愈,多气少血者,难
疗。气多之经,可行其气;血多之经,可破其血,不可执一也。
朱丹溪曰∶臀居小腹之后,而又在其下,此阴中之阴也,其道远,其位僻,虽
曰太阴经多血少气,多血气运不到,气既不到,血亦罕来。中年已后,不可生痈,才
有痛肿,参之脉证,但见虚弱,便与滋补,血气无亏,可保终吉,若用寻常驱热拔毒
舒气之药,虚虚之祸,如指诸掌,可不慎欤!(《心法》)
又曰∶诸经惟少阳厥阴经疮疡,务宜预防,以其气多血少也。其血本少,肌肉
难长,少阳更有相火,遽用破毒之剂,以伐阴血,祸不旋踵。
刘浓宗曰∶凡疮疡,不系膏粱丹毒火热之变,只因虚劳气郁所致,止宜补形气,
调经脉,其疮当自消散,盖不待汗之、下之而已也。其不详脉证,经络受病之异者,
下之先犯病禁经禁,故致失手如此。
又曰∶且夫火热为病,亦有微甚,所谓君火、相火是也。疮疡所发,有痈疽、疖
轻重浅深不同,或止发于一经,或兼二经者,止当求责于一二经,不可干扰余经
也,若东垣处方用药是已。
申斗垣曰∶夫分经审位用药,当知气血多少,多则易愈,少则难痊,外科明此
大理,不致有犯禁忌,颓败坏逆之失也。如手少阳三焦经、手少阴心经、手太阴肺经、
足少阳胆经、足少阴肾经、足太阴脾经,此
六经皆多气少血,凡有疮疡,最难收口。如手厥阴心包络经、手太阳小肠经、足太阳
膀胱经、足厥阴肝经,此四经皆多血少气,凡有疮疡,宜托里。足阳明胃经、手阳明
大肠经,此二经气血俱多,初宜内消,收功易得,故特表而明之,不可一概而论治
也。(《启玄》)
决曰∶多血多气君须记,手经大肠足经胃,多气少血有六经,三焦胆肾心脾肺,
多血少气心包络,膀胱小肠肝无异。记此则知气血多少之异矣。
头部
巅∶足太阳、厥阴、督脉。头角直耳上∶中是少阳。中行∶前直鼻上巅后,直
须中上巅,督脉。第二行∶足太阳一寸五分,各开二傍为头。第三行∶足少阳。
面部
额∶足少阳、阳明。鼻∶手阳明、太阳、足阳明、督脉。人中∶督脉,手足阳
明。唇∶足阳明、足太阴。唇内足厥阴。承浆∶足阳明,任脉。上齿∶足阳明。下齿∶
手阳明。舌∶足太阴、少阴。目内 ∶手足阳明,手足太阳。目锐 ∶手太阳、手
足少阳。眉至额∶直鼻而上督脉,直目内 而上足太阳,直目瞳子而上足少阳,直
锐而上手足少阳。颊∶直目内 而下足阳明,直目瞳子而下足阳明。颊车∶足少
阳、阳明。耳∶手足少阳、手太阳。目系∶手少阴、足太阳。
颈项部
项中间∶督脉。拔项大筋中∶足太阳。当完骨下∶手少阳,项大筋之前,耳之后
也。当耳下∶足少阳。当曲颊下∶手太阳。曲颊前一寸∶手阳明。挟喉两旁动脉∶足
太阳、阳明。缺盆中∶任脉。咽∶手太阴、少阴,足太阴。喉咙∶足少阴、阳明。喉
咙后∶足厥阴。
肩部
前廉∶手阳明。后廉∶手太阳。上廉∶手足少阳。
背部
中行∶督脉。第二行∶足太阳。第三行∶足太阳。第四行∶足太阴。
膺 部
中行∶任脉。第二行∶足少阴。第三行∶足阳明。第四行∶足太阴。
腹部
中间行∶任脉。第二行∶足少阴。第三行∶足阳明。第四行∶足太阴。
腋下
中间∶手厥阴。前∶手太阳。后∶手太阴。
胁
腋直下髀枢∶足少阳。
(自肩至肘曰 。)
前廉∶手阳明。后廉∶手太阳。外廉∶手太阳。内廉∶手太阴。内前廉∶手太阴。内后廉∶手少阴。
臂
上廉∶手阳明。下廉∶手太阴。外廉∶手少阳。内廉∶手厥阴。内上廉∶手太阴。内下廉∶手少阴。
股胫
前廉∶足阳明。后廉∶足太阳。外廉∶足少阳。内廉∶足厥阴。内前廉∶足太阴。
蒋示吉曰∶头为诸阳之首,面为三阳之交。
脑之正中∶督脉。背之居中∶督脉。项之居中∶督脉。尾闾居中∶督脉。脑与背
之两旁∶属足太阳膀胱。头顶∶属足太阳膀胱。面∶属足阳明胃。颈项∶属足厥阴
肝。鬓∶属手少阳三焦、足少阳胆。眉∶属手太阳小肠、足太阳膀胱、手少阳三焦、足
少阳胆。颐髭∶属手阳明大肠、足阳明胃。腮颔∶属手阳明大肠。颧∶属手太阳小肠。
耳为肾窍∶属足少阴肾。绕耳之旁∶属足少阳胆。唇为脾窍∶属足太阴脾。舌乃心
苗∶属手少阴心。鼻为肺窍∶属手太阴肺。
目大小 ,属心,又为火轮。
黑珠属肝,又为血轮,又为风轮。
上胞下睑属脾,又为肉轮。
白珠属肺,又为气轮。
瞳人属肾,又为水轮。
胃通于乳,乳房属胃。
乳外属足少阳胆。
乳头乃足厥阴肝经所主。
乳傍乃手三阴经所起。
喉痈、脐发、穿裆属任脉。
跨马、囊痈,属足厥阴肝。
从手背赤肉至臂走至面,属手三阳。
从胸走至手心白肉,属手三阴。
手背为阳。
手心为阴。
足之外跗为阳,足之三阳,从足走至头。
足之内跗为阴,足之三阴,从足走至腹。
督脉通乎背脊,居中是奇经督脉之道。
脊背分五行∶中间是奇经督脉,两旁四行乃足太阳膀胱经之部分。
腹分七行∶从前阴起由脐中,上咽喉至承浆而止,是奇经任脉所主。脐旁左右
一行,各一寸,属足少阴肾。脐旁左右各三寸一行,属足太阴脾、足厥阴肝。脐旁
左右各二寸一行,属足阳明胃。
胁肋,足少阳胆,行身之侧。
手足心,内应心经。
背为诸阳。
腹为诸阴。
头面背脊,阳维经。
颐项胸腹肢股内廉,阴维经。
Xue Lizhai stated: Generally, diseases have depths of involvement, and therapeutic effects vary in speed. There are also cases of Yin deficiency with Yang excess, where the condition shifts rapidly through respiration and qi movement. Physicians must possess both boldness and caution. "Boldness" refers to having the talent for decision-making and the ability of insight; when acupuncture is indicated, one should puncture; when aggressive treatment (such as purging or breaking stasis) is indicated, one should attack; when such treatments are not suitable, one should stop. This allows one to understand the root and branch of the disease. "Caution" refers to having a heart dedicated to saving lives and righteousness, without thoughts of opportunistic gain. Refusing to treat the wealthy might harm one's integrity, while charging the poor might harm one's benevolence. One must consider righteousness when facing profit, thus fulfilling the physician's duty.
Gu Shicheng stated: By "boldness," it does not mean failing to differentiate between deficiency and excess, Yin and Yang, or examining whether acupoints are deficient or weak, yet recklessly applying knives and needles, indiscriminately administering aggressive drugs, acting recklessly without regard for the patient's life. When treating clinically, one must first observe whether the patient's primordial qi was deficient or strong at the onset; then examine whether the sore is Yin or Yang, and whether it is dangerous. Only then should medication be used for regulation. If aggression is needed, aggress; if tonification is needed, tonify. Do not delay due to hesitation, causing unexpected changes in the condition. Only when the diagnosis is accurate and clear can one dare to act boldly. If clinical experience is lacking and one recklessly uses knives and needles, randomly applying aggressive or tonifying methods, the resulting errors will be profound.
Wang Kentang stated: The human body has meridians, just as geography has boundaries. Treating disease without knowing the meridians is like catching thieves without knowing the jurisdictional boundaries; how can one avoid the fault of punishing the innocent (damaging healthy tissue or Zheng Qi)? Moreover, the twelve meridities of the hands and feet differ in the abundance of qi and blood. For instance, the Hand Shaoyang Sanjiao Meridian, Foot Shaoyin Kidney Meridian, and Foot Taiyin Spleen Meridian have abundant qi and scarce blood; the Hand Jueyin Pericardium Meridian, Hand Taiyang Small Intestine Meridian, and Foot Taiyang Bladder Meridian have abundant blood and scarce qi; the Hand Yangming Large Intestine Meridian and Foot Yangming Stomach Meridian have abundant qi and scarce blood. This is the general rule. Diseases in meridians with abundant blood and scarce qi are easier to cure; those with abundant qi and scarce blood are harder to treat. In meridians with abundant qi, one may regulate qi; in meridians with abundant blood, one may break blood stasis. One must not adhere rigidly to a single method.
Zhu Danxi stated: The buttocks are located behind and below the lower abdomen; this is a yin within yin area. Its pathway is distant, and its location is remote. Although it is said that the Taiyin Meridian has abundant blood and scarce qi, the transport of abundant blood and scarce qi does not reach there easily. Since qi does not reach, blood rarely arrives. After middle age, one should not develop carbuncles. If pain and swelling occur, one must combine pulse and symptom analysis. If weakness is observed, one should immediately provide tonification. As long as qi and blood are not depleted, auspicious outcomes can be ensured. If common heat-clearing, toxin-purging, and qi-regulating herbs are used, the disaster of exacerbating deficiency will be obvious, like objects placed on a palm. Can one not be cautious? (From *Danxi Xinfa*)
He also stated: Among all meridians, sores and ulcers occurring in the Shaoyang and Jueyin meridians require particular preventive measures because they have abundant qi and scarce blood. Blood is inherently scarce, making muscle growth difficult. The Shaoyang meridian also contains Ministerial Fire. If toxic-breaking agents are rashly used to damage Yin blood, disaster will follow immediately.
Liu Nongzong stated: All sores and ulcers, unless caused by rich food, miasma toxins, or fire-heat transformations, are often due to deficiency labor and qi stagnation. It is appropriate only to tonify the form and qi, and regulate the meridians, so that the sores will naturally dissipate, without needing sweating or purging methods. Failing to detail pulse and symptoms, and ignoring differences in meridian pathology, leads to using purging methods that first violate contraindications of disease and meridians, resulting in such mishandling.
He also stated: Fire-heat pathologies vary in severity, known as Sovereign Fire and Ministerial Fire. Sores and ulcers manifest as carbuncles, gangrenes, or boils, differing in lightness, severity, shallowness, and depth. Some occur in a single meridian, others involve two. One should focus responsibility on one or two meridians and not interfere with others, as Li Dongyuan did in his prescriptions.
Shen Douyuan stated: When prescribing based on meridians and locations, one must know the abundance or scarcity of qi and blood. Abundance leads to easy recovery; scarcity makes healing difficult. Surgeons who understand this principle avoid taboos and prevent failures such as necrosis and reversal. For example, the Hand Shaoyang Sanjiao Meridian, Hand Shaoyin Heart Meridian, Hand Taiyin Lung Meridian, Foot Shaoyang Gallbladder Meridian, Foot Shaoyin Kidney Meridian, and Foot Taiyin Spleen Meridian—these six meridians have abundant qi and scarce blood. Sores here are hardest to heal. The Hand Jueyin Pericardium Meridian, Hand Taiyang Small Intestine Meridian, Foot Taiyang Bladder Meridian, and Foot Jueyin Liver Meridian—these four have abundant blood and scarce qi. Sores here benefit from interior-supporting methods. The Foot Yangming Stomach Meridian and Hand Yangming Large Intestine Meridian have abundant qi and blood; early stages benefit from internal resolution, making recovery easy. Thus, these are highlighted, and treatment cannot be generalized. (From *Waike Qixuan*)
The concluding rhyme states: Remember abundant blood and qi: Hand meridian is Large Intestine, Foot meridian is Stomach. Six meridians have abundant qi and scarce blood: Sanjiao, Gallbladder, Kidney, Heart, Spleen, Lung. Abundant blood and scarce qi: Pericardium, Bladder, Small Intestine, Liver are no different. Memorizing this reveals the differences in qi and blood abundance.
Head
Vertex (Dian): Foot Taiyang Bladder Meridian, Foot Jueyin Liver Meridian, Du Mai (Governor Vessel). Head angle directly above ear: Middle is Hand Shaoyang Sanjiao Meridian. Midline: From front nose up to vertex back, straight to top of head, belongs to Du Mai. Second line: Foot Taiyang Bladder Meridian, 1.5 cun from midline, opening two cun laterally for head sides. Third line: Foot Shaoyang Gallbladder Meridian.
Face
Forehead: Foot Shaoyang Gallbladder Meridian, Foot Yangming Stomach Meridian. Nose: Hand Yangming Large Intestine Meridian, Hand Taiyang Small Intestine Meridian, Foot Yangming Stomach Meridian, Du Mai. Renzhong (Philtrum): Du Mai, Hand Yangming Large Intestine Meridian, Foot Yangming Stomach Meridian. Lips: Foot Yangming Stomach Meridian, Foot Taiyin Spleen Meridian. Inside lips: Foot Jueyin Liver Meridian. Chengjiang Acupoint: Foot Yangming Stomach Meridian, Ren Mai (Conception Vessel). Upper teeth: Foot Yangming Stomach Meridian. Lower teeth: Hand Yangming Large Intestine Meridian. Tongue: Foot Taiyin Spleen Meridian, Foot Shaoyin Kidney Meridian. Inner canthus: Hand Yangming Large Intestine Meridian, Hand Taiyang Small Intestine Meridian, Hand Shaoyin Heart Meridian, Foot Shaoyin Kidney Meridian (Note: Text implies multiple meridians). Outer canthus: Hand Taiyang Small Intestine Meridian, Hand Shaoyang Sanjiao Meridian, Foot Shaoyang Gallbladder Meridian. Eyebrows to forehead: Straight up from nose belongs to Du Mai; straight up from inner canthus belongs to Foot Taiyang Bladder Meridian; straight up from pupil belongs to Foot Shaoyang Gallbladder Meridian; straight up from outer canthus belongs to Hand Shaoyang Sanjiao Meridian, Hand Taiyang Small Intestine Meridian. Cheeks: Straight down from inner canthus belongs to Foot Yangming Stomach Meridian; straight down from pupil belongs to Foot Yangming Stomach Meridian. Jiache Acupoint: Foot Shaoyang Gallbladder Meridian, Foot Yangming Stomach Meridian. Ears: Hand Shaoyang Sanjiao Meridian, Hand Taiyang Small Intestine Meridian. Eye system (connections to brain): Hand Shaoyin Heart Meridian, Foot Taiyang Bladder Meridian.
Neck and Throat
Middle of neck: Du Mai. Center of large tendon at nape: Foot Taiyang Bladder Meridian. Below Wangu bone: Hand Shaoyang Sanjiao Meridian, anterior to large neck tendon, behind ear. Below ear: Foot Shaoyang Gallbladder Meridian. Below curved jaw: Hand Taiyang Small Intestine Meridian. One cun anterior to curved jaw: Hand Yangming Large Intestine Meridian. Arteries flanking throat: Foot Taiyang Bladder Meridian, Foot Yangming Stomach Meridian. Clavicular fossa (Quepen): Ren Mai. Pharynx: Hand Taiyin Lung Meridian, Hand Shaoyin Heart Meridian, Foot Taiyin Spleen Meridian. Larynx: Foot Shaoyin Kidney Meridian, Foot Yangming Stomach Meridian. Behind larynx: Foot Jueyin Liver Meridian.
Shoulder
Anterior margin: Hand Yangming Large Intestine Meridian. Posterior margin: Hand Taiyang Small Intestine Meridian. Superior margin: Hand Shaoyang Sanjiao Meridian, Foot Shaoyang Gallbladder Meridian.
Back
Midline: Du Mai. Second line: Foot Taiyang Bladder Meridian. Third line: Foot Taiyang Bladder Meridian. Fourth line: Foot Taiyin Spleen Meridian.
Chest (Ying)
Midline: Ren Mai. Second line: Foot Shaoyin Kidney Meridian. Third line: Foot Yangming Stomach Meridian. Fourth line: Foot Taiyin Spleen Meridian.
Abdomen
Middle row: Ren Mai. Second row: Foot Shaoyin Kidney Meridian. Third row: Foot Yangming Stomach Meridian. Fourth row: Foot Taiyin Spleen Meridian.
Axilla
Center: Hand Jueyin Pericardium Meridian. Anterior: Hand Taiyang Small Intestine Meridian. Posterior: Hand Taiyin Lung Meridian.
Hypochondrium
Directly below axilla to hip pivot: Foot Shaoyang Gallbladder Meridian.
(From shoulder to elbow is called 'Nao'.)
Anterior margin: Hand Yangming Large Intestine Meridian. Posterior margin: Hand Taiyang Small Intestine Meridian. Lateral margin: Hand Taiyang Small Intestine Meridian. Medial margin: Hand Taiyin Lung Meridian. Anterior-medial margin: Hand Taiyin Lung Meridian. Posterior-medial margin: Hand Shaoyin Heart Meridian.
Arm
Superior margin: Hand Yangming Large Intestine Meridian. Inferior margin: Hand Taiyin Lung Meridian. Lateral margin: Hand Shaoyang Sanjiao Meridian. Medial margin: Hand Jueyin Pericardium Meridian. Anterior-superior medial margin: Hand Taiyin Lung Meridian. Posterior-inferior medial margin: Hand Shaoyin Heart Meridian.
Thigh and Leg (Gu Jing)
Anterior margin: Foot Yangming Stomach Meridian. Posterior margin: Foot Taiyang Bladder Meridian. Lateral margin: Foot Shaoyang Gallbladder Meridian. Medial margin: Foot Jueyin Liver Meridian. Anterior-medial margin: Foot Taiyin Spleen Meridian.
Jiang Shiji stated: The head is the summit of all Yang meridians; the face is the intersection of the three Yang meridians.
Center of brain: Du Mai. Center of back: Du Mai. Center of neck: Du Mai. Center of tailbone (Weilu): Du Mai. Both sides of brain and back: Belong to Foot Taiyang Bladder Meridian. Top of head: Belongs to Foot Taiyang Bladder Meridian. Face: Belongs to Foot Yangming Stomach Meridian. Neck: Belongs to Foot Jueyin Liver Meridian. Temples: Belong to Hand Shaoyang Sanjiao Meridian, Foot Shaoyang Gallbladder Meridian. Eyebrows: Belong to Hand Taiyang Small Intestine Meridian, Foot Taiyang Bladder Meridian, Hand Shaoyang Sanjiao Meridian, Foot Shaoyang Gallbladder Meridian. Chin and beard: Belong to Hand Yangming Large Intestine Meridian, Foot Yangming Stomach Meridian. Cheeks and jaw: Belong to Hand Yangming Large Intestine Meridian. Zygoma: Belong to Hand Taiyang Small Intestine Meridian.
Ears are orifices of Kidney: Belong to Foot Shaoyin Kidney Meridian. Around ears: Belong to Foot Shaoyang Gallbladder Meridian. Lips are orifices of Spleen: Belong to Foot Taiyin Spleen Meridian. Tongue is sprout of Heart: Belong to Hand Shaoyin Heart Meridian. Nose is orifice of Lung: Belong to Hand Taiyin Lung Meridian.
Inner and outer canthi belong to Heart, also known as Fire Wheel.
Black part (iris/pupil area) belongs to Liver, also known as Blood Wheel, Wind Wheel.
Upper and lower eyelids belong to Spleen, also known as Flesh Wheel.
White part (sclera) belongs to Lung, also known as Qi Wheel.
Pupil belongs to Kidney, also known as Water Wheel.
Stomach connects to breasts; breasts belong to Stomach.
Outer breast: Belongs to Foot Shaoyang Gallbladder Meridian.
Nipple: Governed by Foot Jueyin Liver Meridian.
Side of breast: Origin of Hand Three Yin Meridians.
Throat abscess, umbilical eruption, perineal infection: Belong to Ren Mai.
Straddle horse, scrotal abscess: Belong to Foot Jueyin Liver Meridian.
From red flesh on back of hand to arm to face: Belong to Hand Three Yang Meridians.
From chest to white flesh on palm: Belong to Hand Three Yin Meridians.
Back of hand is Yang.
Palm is Yin.
Dorsum of foot is Yang; Foot Three Yang Meridians go from foot to head.
Medial aspect of foot is Yin; Foot Three Yin Meridians go from foot to abdomen.
Du Mai connects to spine; center is the path of the extraordinary vessel Du Mai.
Spine divided into five lines: Center is extraordinary vessel Du Mai; two sides, four lines, are parts of Foot Taiyang Bladder Meridian.
Abdomen divided into seven lines: From anterior genitalia through umbilicus, up throat to Chengjiang, is governed by extraordinary vessel Ren Mai. One row left and right of umbilicus, each 1 cun wide: Belongs to Foot Shaoyin Kidney Meridian. One row left and right of umbilicus, each 3 cun wide: Belongs to Foot Taiyin Spleen Meridian, Foot Jueyin Liver Meridian. One row left and right of umbilicus, each 2 cun wide: Belongs to Foot Yangming Stomach Meridian.
Hypochondriac region: Foot Shaoyang Gallbladder Meridian, running along side of body.
Palms and soles: Internally correspond to Heart Meridian.
Back is all Yang.
Abdomen is all Yin.
Head, face, back, spine: Yang Wei Mai (Yang Linking Vessel).
Chin, neck, chest, abdomen, medial limbs and thighs: Yin Wei Mai (Yin Linking Vessel).