肝象木(肝于五行象木),与胆合为腑(胆为清净之腑)。其经足厥阴(厥阴肝脉),与足少阳为表里(少阳,胆脉也,
脏阴腑阳,故为表里)。其脉弦(弦,肝脉之大形也)其相冬三月(冬水王木相),王春三月,废夏三月(夏火王木废),
囚季夏六月(季夏土王木囚),死秋三月(秋金王木死)。其王日甲乙,王时平旦、日出(并木也)。其困日戊己,困时食
时、日 (并土也),其死日庚辛,死时晡时、日入(并金也)。其神魂(肝之所藏者魂),其主色,其养筋(肝气所养
者筋),其候目(肝候出目,故肝实则目赤),其声呼,其色青,其臭臊(《月令》云∶其臭膻)。其液泣(泣出肝),其味
酸,其宜苦(苦,火味也),其恶辛(辛,金味)。肝俞在背第九椎,募在期门(直两乳下二肋端);胆俞在背第十椎,募
在日月。(穴在期门下五分)上新撰。(并出《素问》诸经。昔人撰集,或混杂相涉,烦而难了,今抄事要分别五脏各为
一部)
冬至之后得甲子。少阳起于夜半,肝家王(冬至者,岁终之节。甲子日者,阴阳更始之数也。少阳,胆也,胆者,
木也,生于水,故起夜半;其气常微少,故言少阳。云夜半子者,水也)。肝者,东方木(肝与胆为脏腑,故王东方,应
木行也)。万物始生,其气来软而弱,宽而虚(春少阳气,温和软弱,故万物日生焉)。故脉为弦(肝气养于筋。故其脉
弦,强亦法木体强也)。软即不可发汗,弱即不可下。宽者开,开者通,通者利,故名曰宽而虚(言少阳始起尚软弱,入
荣卫腠理开通,发即汗出不止;不可下,下之而泄利不禁。故言宽虚、通利也)。春以胃气为本,不可犯也。(胃者,土
也,万物禀土而生,胃亦养五脏,故肝王以胃气为本也。不可犯者,不可伤也)上四时经。
黄帝问曰∶春脉如弦,何如而弦?岐伯曰∶春脉肝也,东方木也,万物之所以始生也,故其气来濡弱轻虚而滑,端
直以长,故曰弦。反此者病。黄帝曰∶何如而反?岐伯曰∶其气来实而强,此谓太过,病在外;其气来不实而微,此谓
不及,病在中。黄帝曰∶春脉太过与不及,其病皆何如?岐伯曰∶太过则令人善忘(忘当作怒)。忽忽眩冒而癫疾;不及
则令人胸胁痛引背,下则两胁 满。黄帝曰∶善。
肝脉来濡弱招招,如揭竿末梢,曰平(《巢源》云∶绰绰如按琴瑟之弦,如揭长竿曰平)。春以胃气为本。肝脉来盈
实而滑,如循长竿,曰肝病,肝脉来急而益劲,如新张弓弦,曰肝死。真肝脉至,中外急,如循刀刃,责责然(《巢源》
云∶赜赜然),如按琴瑟弦,色青白不泽,毛折,乃死。春胃微弦曰平,弦多胃少曰肝病;但弦无胃曰死。有胃而毛,曰
秋病;毛甚,曰今病。肝藏血,血舍魂。悲哀动中则伤魂,魂伤则狂妄不精,不敢正当人(不精不敢正当人,一作其精
不守,令人阴缩),阴缩而筋挛,两胁骨不举,毛悴色夭,死于秋。春肝木王,其脉弦细而长,名曰平脉也。反得浮涩而
短者(《千金》云∶微涩而短),是肺之乘肝,金之克木,为贼邪,大逆,十死不治(一本云∶日、月、年数至三,忌庚
辛)。反得洪大而散者(《千金》云∶浮大而洪),是心之乘肝,子之扶母,为实邪,虽病自愈。反得沉濡而滑者,是肾之
乘肝,母之归子,为虚邪,虽病易治。反得大而缓者,是脾之乘肝,土之陵木,为微邪,虽病即瘥。
肝脉来濯濯如倚竿,如琴瑟之弦,再至,曰平;三至,曰离经,病;四至,脱精;五至,死;六至,命尽。足厥阴
脉也。
肝脉急甚,为恶言;微急,为肥气,在胁下若覆杯,缓甚为善呕;微缓为水瘕痹;大甚为内痈,善呕衄;微大,为
肝痹,缩,咳引少腹;小甚为多饮;微小为消瘅;滑甚为颓疝;微滑为遗溺;涩甚为淡饮;微涩为螈 挛筋。
足厥阴气绝则筋缩,引卵与舌。厥阴者,肝脉也。肝者,筋之合也。筋者,聚于阴器而脉络于舌本。故脉弗营则筋
缩急,筋缩急则引舌与卵。故唇青、舌卷、卵缩,则筋先死。庚笃辛死,金胜木也。
肝死脏,浮之脉弱,按之中如索不来,或曲如蛇行者,死。上《素问》《针经》、张仲景。
The Liver corresponds to Wood in the Five Elements (the Liver symbolizes Wood), and combines with the Gallbladder to form a Fu organ (the Gallbladder is referred to as the "Clear and Pure" Fu). Its meridian is the Foot Jueyin Meridian (i.e., the Jueyin Liver Meridian), which stands in exterior-interior relationship with the Foot Shaoyang Meridian (Shaoyang refers to the Gallbladder meridian; Zang organs are Yin and Fu organs are Yang, hence they are exterior-interior pairs). Its pulse characteristic is Xian (Cord-like) pulse (Xian is the primary morphology of the Liver pulse). Its Qi prospers during the three months of Winter (Water rules in Winter, so Wood is in the "Xiang" or secondary prosperous state), prospers during the three months of Spring, becomes "Fei" (abandoned/weak) during the three months of Summer (Fire rules in Summer, so Wood is abandoned), becomes "Qiu" (imprisoned/restrained) during the sixth month of late Summer (Earth rules in late Summer, so Wood is restrained), and dies during the three months of Autumn (Metal rules in Autumn, so Wood dies). It rules on Jia and Yi days, and at Pingdan (daybreak) and Richu (sunrise) times (all corresponding to the attribute of Wood). It is constrained on Wu and Ji days, and at Shishi (meal time) and Ri Die (solar noon decline) times (all corresponding to the attribute of Earth); it dies on Geng and Xin days, and at Bushi (afternoon, 3-5 PM) and Riru (sunset) times (all corresponding to the attribute of Metal). The Liver stores Hun (Soul/Hun Spirit, a spiritual activity stored by the Liver), governs complexion, and nourishes Sinew (tendons) (Sinews are nourished by Liver Qi). It manifests externally in the Eyes (the Liver opens into the eyes, so Liver excess presents as red eyes). Its vocalization is shouting, its color is Green, its odor is Fishy (Shao) (as stated in *Yueling*: its odor is Muttony/Shan). Its fluid is Tears (Tears are produced from the Liver). Its taste preference is Sour, it benefits from Bitter (Bitter is the taste of Fire), and it dislikes Pungent (Pungent is the taste of Metal). The Back-Shu point of the Liver is located beside the ninth thoracic vertebra, and its Front-Mu point is Qimen (located two rib lengths below the nipples, at the end of the second rib); the Back-Shu point of the Gallbladder is beside the tenth thoracic vertebra, and its Front-Mu point is Riyue (located five fen below Qimen). The above content is newly compiled (all derived from *Suwen* and other classics. Previous compilations were mixed and confusingly complex; now, essential points are extracted, and each Zang organ is treated in a separate section).
After the Winter Solstice, upon encountering the first Jiazi day, the Qi of Shaoyang begins at midnight, and Liver Qi becomes prosperous (Winter Solstice is the terminal solar term of the year. The Jiazi day marks the numerical beginning of the alternation of Yin and Yang. Shaoyang refers to the Gallbladder, which belongs to Wood. Wood is born from Water, thus it begins at midnight; its Qi is often slight, hence it is called Shaoyang [Lesser Yang]. Midnight Zi hour corresponds to Water). The Liver belongs to Eastern Wood (As Zang-Fu organs, the Liver and Gallbladder rule the East and correspond to the Wood element). When all things begin to grow, their Qi arrives soft and weak, broad and empty (The Spring Shaoyang Qi is gentle and weak, causing all things to grow daily). Therefore, the pulse appears Xian (Cord-like) (Liver Qi nourishes the Sinews, so its pulse is Xian; its strength also mimics the rigid nature of Wood). If the pulse is soft, sweating therapy should not be used; if it is weak, purgative therapy should not be used. "Broad" implies opening; "opening" implies unblocking; "unblocking" implies promoting flow; hence it is described as broad and empty (This means that when Shaoyang initially arises, it is still weak and soft. As it enters the Ying-Wei and interstices, it becomes open. If sweating is induced, sweat will not stop; if purgatives are used, diarrhea will become uncontrollable. Hence, it is described as broad, empty, open, and flowing). In Spring, Stomach Qi is the root and must not be violated (Stomach belongs to Earth; all things rely on Earth to be born, and the Stomach nourishes the Zang organs. Thus, when Liver Qi is prosperous, it relies on Stomach Qi as its root. "Must not be violated" means it must not be damaged). The above discusses the Four Seasons meridians.
The Yellow Emperor asked: The Spring pulse resembles a string. What constitutes a string-like pulse? Bo Zi replied: The Spring pulse corresponds to the Liver and Eastern Wood, the cause of the beginning of all things. Thus, its Qi arrives soft, weak, light, void, slippery, straight, and long; therefore, it is called Xian (Cord-like). Deviation from this indicates disease. The Yellow Emperor asked: How does it deviate? Bo Zi said: If its Qi arrives solid and strong, this is termed "Excess" (Tai Guo), indicating disease in the Exterior; if its Qi arrives unsolid and faint, this is termed "Deficiency" (Bu Ji), indicating disease in the Interior. The Yellow Emperor asked: Regarding Excess and Deficiency of the Spring pulse, what are their respective symptoms? Bo Zi said: Excess causes irritability (note: "Wang" should be "Nu" anger), sudden dizziness, vertigo, and epilepsy; Deficiency causes chest and hypochondriac pain radiating to the back, and downward, fullness in both hypochondria. The Yellow Emperor said: Excellent.
A Liver pulse that arrives soft, weak, and swaying, like the tip of a raised bamboo pole, is called a Normal Pulse (Ping Mai) (*Zhubing Yuanhou Lun* states: "Chuo chuo" like pressing a zither string, or like holding a long pole upright is Normal). In Spring, Stomach Qi is the root. A Liver pulse that arrives full, solid, and slippery, like feeling along a long pole, indicates Liver Disease. A Liver pulse that arrives rapid and increasingly tense, like a newly strung bowstring, indicates Liver Death. When the True Liver Pulse appears, it is tense inside and out, like feeling a knife edge, "Ze ze" (or "Ze ze" per *Zhubing Yuanhou Lun*), like pressing a zither string. With greenish-white complexion lacking luster and brittle hair, death ensues. A Spring pulse with slight Xian quality and Stomach Qi is Normal; Xian quality exceeding Stomach Qi indicates Liver Disease; only Xian quality without Stomach Qi indicates Death. Presence of Stomach Qi combined with Mao (Feather/Lung) pulse predicts illness in Autumn; excessive Mao pulse predicts immediate illness. The Liver stores Blood, and Blood houses the Hun. Sorrow disturbing the interior damages the Hun; damaged Hun leads to madness and lack of clarity, inability to face others normally (alternative text: "Essence fails to guard, causing genital retraction"), resulting in genital retraction and sinew spasm, inability to lift the hypochondriac bones, with withered hair and sallow complexion, leading to death in Autumn. In Spring, when Liver Wood is prosperous, the pulse is Xian, thin, and long, known as the Normal Pulse. If instead a Floating, Choppy, and Short pulse is obtained (*Qianjin Fang* notes: slightly choppy and short), this is Lung overacting on Liver, Metal overcoming Wood, representing a "Thief Evil" (Zei Xie), a great reversal, ten deaths incurable (another version notes: counting days, months, or years up to three, avoid Geng/Xin days). If instead a Surging, Large, and Scattered pulse is obtained (*Qianjin Fang* notes: floating, large, and surging), this is Heart overacting on Liver, Son supporting Mother, representing an "Excess Evil" (Shi Xie); although ill, recovery will occur spontaneously. If instead a Deep, Soft, and Slippery pulse is obtained, this is Kidney overacting on Liver, Mother returning to Son, representing a "Deficiency Evil" (Xu Xie); although ill, it is easy to treat. If instead a Large and Slow pulse is obtained, this is Spleen overacting on Liver, Earth insulting Wood, representing a "Minor Evil" (Wei Xie); although ill, it will heal quickly.
A Liver pulse that sounds "zhuo zhuo", like leaning against a pole, like a zither string, beating twice per respiration, is Normal; beating three times is Li Jing (Departing from the Meridian standard), indicating disease; four times indicates Essence depletion; five times indicates Death; six times indicates Life's end. This refers to the Foot Jueyin Meridian.
If the Liver pulse is extremely tense (Ji Shen), it manifests as abusive speech; mildly tense (Wei Ji), it manifests as Fei Qi (Fatty Mass) under the hypochondrium resembling an inverted cup; extremely slack (Huan Shen), it manifests as frequent vomiting; mildly slack, it manifests as Shui Jia Bi (Water Mass Obstruction); extremely large, it manifests as Internal Abscess with frequent vomiting and epistaxis; mildly large, it manifests as Gan Bi (Liver Obstruction) with curling, coughing pulling the lower abdomen; extremely small, it manifests as polydipsia; minimally small, it manifests as Xiao Dan (Consumption Fever); extremely slippery, it manifests as Tui Shan (Descending Hernia); mildly slippery, it manifests as enuresis; extremely choppy, it manifests as Dan Yin (Pale Fluid Retention); mildly choppy, it manifests as convulsions and sinew spasm.
When the Qi of the Foot Jueyin Meridian ceases, sinews contract, pulling the testicles and tongue. Jueyin is the Liver Meridian. The Liver is the convergence of sinews. Sinews gather at the genitalia and connect to the root of the tongue. Therefore, if pulse Qi fails to nourish sinews, they contract and tighten; tightened sinews pull the tongue and testicles. Thus, cyanotic lips, curled tongue, and retracted testicles indicate that sinews die first. Condition worsens on Geng days and dies on Xin days, because Metal conquers Wood.
The Dead Organ Pulse of the Liver: superficially weak, deep pressure feels like a broken cord that does not return, or curved like a snake moving, indicates Death. Content sourced from *Suwen*, *Zhenjing*, and Zhang Zhongjing.