黄帝问于岐伯曰。经脉十二者。外合于十二经水。而内属于五脏六腑。夫十二经水者。其有大
小深浅广狭远近各不同。五脏六腑之高下小大。受谷之多少亦不等。相应奈何。夫经水者。受水而
行之。五脏者。合神气魂魄而藏之。六腑者。受谷而行之。受气而扬之。经脉者。受血而荣之。合
而以治奈何。刺之浅深。灸之壮数。可得闻乎。岐伯答曰。善哉问也。天至高不可度。地至广不
可量。此之谓也。且夫人生于天地之间。六合之内。此天之高。地之广也。非人力之所能度量而
至也。若夫八尺之士。皮肉在此。外可度量切循而得之。其死可解剖而视之。其脏之坚脆。腑之
大小。谷之多少。脉之长短。血之清浊。气之多少。十二经之多血少气。与其少血多气。与其皆
多血气。与其皆少血气。皆有大数。其治以针灸。各调其经气。固其常有合乎。
此篇以十二经脉。内属于五脏六腑。外合于十二经水。经水有大小浅深广狭远近之不同。脏腑
有高下大小受谷多少之不等。五脏主藏五脏之神志。六腑主行水谷之精气。经脉受荣血以荣行。帝
问可以合一而为灸刺之治法乎。伯曰。天之高。地之广。不可度量者也。人生于天地六合之内。
亦犹此天之高。地之广。非人力之所能度量。若夫有形之皮肉筋骨。外可度量切循。内可解剖而视。
其于脏之坚脆。腑之大小。谷之多少。脉之长短。血之清浊。气之多少。十二经之多血少气。多气
少血。血气皆多。血气皆少。皆有大数。大数者。即本脏篇之五脏坚脆。肠胃篇腑之大小。绝谷篇
谷之多少。脉度篇脉之长短。九针篇之多血少气。多气少血。皆
有数推之。其治以针艾。调其经气。固其常有合于数者。即下文之六分五分。十呼七呼。以至于二
呼一呼。此手足阴阳。皆有合于数也。按、前二章。论十二经脉。应天之六气。五脏六腑。应五
音六律。五色五时。此复论脏腑经脉。应地之十二经水。是人合天地之道。而不可度量者也。
黄帝曰。余闻之快于耳。不解于心。愿卒闻之。岐伯答曰。此人之所以参天地而应阴阳也。不
可不察。足太阳外合于清水。内属于膀胱而通水道焉。足少阳外合于渭水。内属于胆。足阳明外
合于海水。内属于胃。足太阴外合于湖水。内属于脾。足少阴外合于汝水。内属于肾。足厥阴外
合于渑水。内属于肝。手太阳外合于淮水。内属于小肠而水道出焉。手少阳外合于漯水。内属于三
焦。手阳明外合于江水。内属于大肠。手太阴外合于河水。内属于肺。手少阴外合于济水。内属于心。
手心主外合于漳水。内属于心包。（渑音成漯 合切音沓）
夫三阴三阳。合天之六气。手足经脉。应地之经水。十二经脉。外合于六气。内属于脏腑。
是以手足之三阴三阳。外合于十二经水。而经水又内属于脏腑。此人之所以参天地而应阴阳也。清
水乃黄河合淮处。分流为清河。肺属天而主气。膀胱为津液之府。受气化而出。六腑皆浊。而膀胱
之水独清。故足太阳外合于清水。内属于膀胱而通水道焉。渭水出于雍州。合泾 漆沮沔水。而
渭水独清。诸阳皆浊。而胆为中精之府。独受其清。故足少阳外合于渭水。内属于胆。海水汪洋
于地之外。而地居海之中。阳明居中土。为万物之所归。又为水谷之海。故足阳明外合于海水。而
内属于胃。湖水有五湖。即洞庭彭泽震泽之类。脾位中央而灌溉于四旁。故足太阴外合于湖水。而
内属于脾。汝水发源于河南天息山。河南居天地之中。夫天居地上。
见者一百八十二度半强。地下亦然。北极出地上三十六度。南极入地下亦三十六度。而嵩正当天之
中极。盖天气包于地之外。又从中而通贯于地中。故名天息。肾主天一之水。而为生气之原。上应
于喉以司呼吸。故足少阴外合于汝水。而内属于肾。渑水出于清州之临淄。而西入于淮。天下之水。
皆从东去。渑水自东而来。故应足厥阴东方之肝木。淮水自海水而入于淮泗。小肠受盛胃之水液。
而济泌于膀胱。故手太阳外合于淮水。内属于小肠。漯济乃西北之大水。漯合济而入于 豫诸州。
少阳为君主之相。阴阳相合。故手少阳合于漯水。而内属于三焦。江水自西属之岷山发源。曲折
万里。而东入于海。大肠传道水谷。济泌别汁。回肠十六折而渗入膀胱。故手阳明外合于江水。内
属于大肠。河源发于星宿海。自干位而来。千里一曲。故曰黄河之水天上来。肺属干金而主天。为
水之生源。故手太阴外合于河水。而内属于肺。济水发源于王屋山。截河而流水不混其清。故名曰
清济。潜流屡绝。状虽微而独尊。故居四渎之一。心为君主之官而独尊。故手少阴外合济水。内属
于心。漳水有二。一出于上党沾悬大黾谷。名为清漳。一出上党长子悬鹿谷山。名为浊漳。二漳异
源而下流相合。夫血者神气。阴中之清。心所主也。合厥阴包络。而流行于经脉之中。犹二水之合流。
故手心主外合于漳水。内属于心包。此人之所以参天地而应阴阳也。愚按、膀胱为水府。主受藏
津液。津液随三焦出气。以温肌肉。三焦下俞。出于委阳。并太阳之正。入络膀胱。约下焦。是中
焦所生之津液。即随中焦之气而出。膀胱所藏之津液。即随下焦之气而出。营运于肤表。以温肌肉。
充皮肤。故示从容论曰。怯然少气者。是水道不行。形气消索也。曰通水道者。谓水道之上通于天。
非独下出之溲便也。
凡此五脏六腑。十二经水者。外有源泉。而内有所禀。此皆内外相贯。如环无端。人经亦然。
故天为阳。地为阴。腰以上为天。腰以下为地。故海以北者为阴。湖以北者为阴中之阴。漳以南者
为阳。河以北至漳者。为阳中之阴。漯以南至江者。为阳中之太阳。此一隅之阴阳也。所以人与天
地相参也。
夫泉在地之下。地居天之中。水随天气上下环转于地之外。而复通贯于地中。故曰外有源泉。
而内有所禀。盖地禀在泉之水。而外为十二经水之源流。内外相贯。如环无端。而人亦应之。水热穴
论曰。肾者。至阴也。至阴者。盛水也。肺者。太阴也。少阴者。冬脉也。故其本在肾。其末在肺。
皆积水也。是肾脏之精水。膀胱之津水。皆随肺主之气。而营运于肤表。故腰以上为天。腰以下为
地。天地上下之皆有水也。海以北者。谓胃居中央。以中胃之下为阴。肝肾之所居也。湖以北者。乃脾
土所居之分。故为阴中之阴。脾为阴中之至阴也。漳以南者为阳。乃心主包络之上。心肺之所居也。
盖以上为天为阳为南。下为地为阴为北也。河以北至漳者。谓从上焦而后行于背也。漯以南至江者。
谓从中焦而前行于腹也。此以人之面南而背北也。盖人生于天地之间。六合之内。以此身一隅之阴
阳。应天地之上下四旁。所以与天地参也。
黄帝曰。夫经水之应经脉也。其远近浅深。水血之多少。各不同合。而以刺之奈何。岐伯答曰。
足阳明。五脏六腑之海也。其脉大血多。气盛热壮。刺此者不深勿散。不留不泻也。足阳明刺深六分。
留十呼。足太阳深五分。留七呼。足少阳深四分留五呼。足太阴深三分。留四呼。足少阴深二分。
留三呼。足厥阴深一分。留二呼。手之阴阳。其受气之道近。其气之来疾。其刺深者。皆无过二分。
其留皆无过一呼。其少长大小肥瘦。以心撩之。命曰法天之
常。灸之亦然。灸而过此者。得恶火则骨枯脉涩。刺而过此者则脱气。（撩料同）
此论灸刺之法。以手足之阴阳。血气之多少。合经水之浅深。以应天之常数。夫数出河图。始
于一而终于十。二乃阴之始。十乃阴之终。海水者。至阴也。故从阳明以至于厥阴。厥阴者。两阴
交尽。阴极而阳生也。天一生水。地六成之。从六分而至一分者。法天之常也。腰以上为天。故手
之阴阳。受气之道近。其气之来疾。故宜浅刺而疾出也。终始篇曰。刺肥人者。以秋冬之齐。刺瘦
人者。以春夏之齐。是以少长大小肥瘦。以心撩之。量其浅深疾徐。所以法天时之常也。灸法亦然。
若灸而过此法。命曰恶火。则骨为之枯。脉为之涩。刺而过此法。则脱气矣。
黄帝曰。夫经脉之大小。血之多少。肤之浓薄。肉之坚脆。及 之大小。可为度量乎。岐伯答
曰。其不为度量者。取其中度也。不甚脱肉。而血气不衰也。若夫度之人。消瘦而形肉脱者。恶可
以度量刺乎。审切循扪按。视其寒温盛衰而调之。是谓因适而为之真也。
尚御公曰。适、从也。真、正也。夫天阙西北。地陷东南。至高之地。冬气常在。至下之地。秋
气常在。而人亦应之。是以五方之民。有疏理致理。肥脂瘦消之不同。故可为度量者。取其中度也。
中度者。即瘦而不甚脱肉。虽弱而血气不衰。是谓适其中而为度之正也。莫云从曰。上节法天之常。
此因地之理。以适人之浓薄坚脆。所以人与天地参也。
Huangdi asked Qibo: The twelve meridians correspond externally to the twelve rivers of the earth and internally belong to the five zang organs and six fu organs. These twelve rivers vary in size, depth, width, narrowness, distance, and proximity. Similarly, the five zang organs and six fu organs differ in position (high or low), size, and capacity for receiving food and fluids. How do they correspond? The rivers receive water and flow; the five zang organs store spirit, qi, hun, and po; the six fu organs receive food and fluids and circulate, receiving qi and disseminating it; the meridians receive blood and nourish the body. How should these be integrated for treatment? May I ask about the depth of acupuncture and the number of moxibustion cones?
Qibo replied: Excellent question! Heaven is so high it cannot be measured; Earth is so vast it cannot be quantified. This is what is meant. Humans live between heaven and earth, within the six directions. The height of heaven and the breadth of earth are beyond human measurement. However, an adult of eight chi tall has skin and flesh on the surface, which can be measured, palpated, and traced externally; after death, anatomy can reveal internal structures. The hardness or fragility of the zang organs, the size of the fu organs, the amount of food received, the length of vessels, the clarity or turbidity of blood, the quantity of qi, and the conditions of the twelve meridians—whether rich in blood and deficient in qi, rich in qi and deficient in blood, abundant in both, or deficient in both—all follow fixed numerical laws (Da Shu). When treating with acupuncture and moxibustion, one regulates the meridian qi accordingly, which naturally aligns with these constant principles.
This chapter discusses how the twelve meridians internally belong to the five zang and six fu organs and externally correspond to the twelve rivers. Rivers vary in size, depth, width, and distance; organs vary in position, size, and digestive capacity. The five zang store spiritual aspects; the six fu transport essence from food and fluids; meridians circulate Ying (nutritive) blood. Huangdi asks if a unified method for moxibustion and acupuncture exists. Qibo states that just as heaven and earth are immeasurable, human existence within them follows similar unmeasurable principles. Yet, tangible structures like skin, flesh, bones, and tendons can be measured externally or viewed via dissection. Internal characteristics such as organ texture, vessel length, blood quality, and qi quantity also follow fixed numbers. These "fixed numbers" refer to data found in chapters like *Ben Zang*, *Chang Wei*, *Jue Gu*, *Mai Du*, and *Jiu Zhen*. Treatment with needles and moxa aims to regulate meridian qi, adhering to these measurable constants, such as depths of 6 fen, 5 fen, etc., and retention times of 10 hu, 7 hu, down to 2 hu or 1 hu. Both hand and foot yin and yang meridians conform to these numbers. Previously, we discussed meridians corresponding to the Six Qi of heaven and organs to musical tones and seasons. Now, we discuss organs and meridians corresponding to the twelve rivers of earth. Humans embody the way of heaven and earth, which is immeasurable.
Huangdi said: I heard this clearly but do not fully understand it in my heart; please explain thoroughly. Qibo replied: This is how humans participate in heaven and earth and respond to yin and yang; it must be carefully observed.
The Foot Taiyang Meridian corresponds externally to the Qing Shui (Clear Water) and internally to the Bladder, governing water passages. The Foot Shaoyang Meridian corresponds externally to the Wei Shui and internally to the Gallbladder. The Foot Yangming Meridian corresponds externally to the Hai Shui (Sea Water) and internally to the Stomach. The Foot Taiyin Meridian corresponds externally to the Hu Shui (Lake Water) and internally to the Spleen. The Foot Shaoyin Meridian corresponds externally to the Ru Shui and internally to the Kidney. The Foot Jueyin Meridian corresponds externally to the Mian Shui and internally to the Liver. The Hand Taiyang Meridian corresponds externally to the Huai Shui and internally to the Small Intestine, where water passages emerge. The Hand Shaoyang Meridian corresponds externally to the Ta Shui and internally to the Sanjiao (Triple Burner). The Hand Yangming Meridian corresponds externally to the Jiang Shui (Yangtze River) and internally to the Large Intestine. The Hand Taiyin Meridian corresponds externally to the He Shui (Yellow River) and internally to the Lung. The Hand Shaoyin Meridian corresponds externally to the Ji Shui and internally to the Heart. The Hand Jueyin Pericardium Meridian corresponds externally to the Zhang Shui and internally to the Pericardium.
The Three Yin and Three Yang correspond to the Six Qi of heaven; the hand and foot meridians correspond to the rivers of earth. Thus, the twelve meridians correspond externally to the Six Qi and internally to the zang-fu organs. This is how humans participate in heaven and earth and respond to yin and yang.
Qing Shui is formed where the Yellow River and Huai River converge and diverge. The Lung belongs to Metal/Heaven and governs Qi; the Bladder is the mansion of Body Fluids, transforming Qi to excrete fluids. While all Fu organs are turbid, the water in the Bladder is uniquely clear; thus, Foot Taiyang corresponds to Qing Shui and the Bladder. Wei Shui originates in Yongzhou, merging with other rivers yet remaining uniquely clear. While all Yang meridians are associated with turbidity, the Gallbladder is the mansion of pure essence, receiving clarity; thus, Foot Shaoyang corresponds to Wei Shui and the Gallbladder. The Sea surrounds the earth; Yangming occupies the central Earth element, returning all things and serving as the Sea of Food and Fluids; thus, Foot Yangming corresponds to the Sea and the Stomach. Lake Water includes lakes like Dongting and Pengze; the Spleen resides centrally and irrigates the four directions; thus, Foot Taiyin corresponds to Lake Water and the Spleen. Ru Shui originates from Tianxi Mountain in Henan, located at the center of heaven and earth. Heaven covers the earth and penetrates through it; thus, Kidney, which governs the water of Tiant Yi (First Heaven) and is the source of vital energy, corresponds to Ru Shui and the Kidney. Mian Shui flows eastward against the general flow of Chinese rivers; thus, it corresponds to the Liver Wood of the East and Foot Jueyin. Huai Shui enters from the sea into the Huai-Si region; the Small Intestine receives fluids from the Stomach and filters them to the Bladder; thus, Hand Taiyang corresponds to Huai Shui and the Small Intestine. Ta and Ji are major northwestern rivers; Shaoyang acts as the minister of the monarch, combining yin and yang; thus, Hand Shaoyang corresponds to Ta Shui and the Sanjiao. Jiang Shui originates from Minshan in the west, winding thousands of miles to the sea; the Large Intestine transmits waste and separates juices; thus, Hand Yangming corresponds to Jiang Shui and the Large Intestine. He Shui (Yellow River) originates from Xingxiu Hai in the northwest (Qian direction); the Lung belongs to Metal/Heaven and is the source of water; thus, Hand Taiyin corresponds to He Shui and the Lung. Ji Shui originates from Wangwu Mountain, cutting through the Yellow River with clear, unmixed water; it is unique and respected among the Four Great Rivers. The Heart is the sovereign organ, unique and respected; thus, Hand Shaoyin corresponds to Ji Shui and the Heart. Zhang Shui consists of Clear Zhang and Turbid Zhang, merging downstream. Blood is the clear aspect of Shen-Qi, governed by the Heart and circulating via the Jueyin Pericardium, like merging waters; thus, Hand Jueyin corresponds to Zhang Shui and the Pericardium. This illustrates how humans participate in heaven and earth and respond to yin and yang.
Note: The Bladder stores fluids. Fluids exit via Sanjiao Qi to warm muscles. The lower shu point of Sanjiao, Weiyang, connects to the Taiyang channel and enters the Bladder, regulating the Lower Burner. Fluids generated in the Middle Burner exit with Middle Burner Qi; stored fluids in the Bladder exit with Lower Burner Qi, circulating on the skin surface to warm muscles and fill the skin. As stated in *Shi Cong Rong Lun*, "timidity and shortness of breath indicate blocked water passages and depleted form-qi." "Unblocking water passages" refers to their connection to heaven, not just urination.
All five zang, six fu, and twelve rivers have external sources and internal origins. They interpenetrate like a circle without end. Human meridians are the same. Heaven is Yang, Earth is Yin; above the waist is Heaven, below is Earth. North of the Sea is Yin; north of the Lake is Yin within Yin; south of Zhang is Yang; north of the River to Zhang is Yang within Yin; south of Ta to Jiang is Yang within Yang. This partial yin-yang relationship shows how humans correspond to heaven and earth.
Springs are underground; Earth is within Heaven. Water circles outside and penetrates inside. Hence, external sources and internal origins. Earth receives subterranean water, forming the twelve rivers. Humans correspond to this. *Shui Re Xue Lun* states: "Kidney is Supreme Yin, storing water. Lung is Taiyin. Shaoyin is Winter pulse. Root in Kidney, branch in Lung, both accumulate water." Kidney essence-water and Bladder fluid-circulate with Lung Qi on the skin. Above waist is Heaven, below is Earth; water exists in both. "North of Sea" refers to the Lower Burner (Liver/Kidney). "North of Lake" refers to Spleen Earth (Yin within Yin). "South of Zhang" refers to Upper Burner (Heart/Lung). "River to Zhang" refers to back circulation from Upper Burner. "Ta to Jiang" refers to front abdominal circulation from Middle Burner. Facing South and Backing North, humans use their local yin-yang to correspond to heaven and earth's four directions.
Huangdi asked: Since rivers and meridians differ in distance, depth, and blood/qi volume, how should acupuncture be applied? Qibo replied: Foot Yangming is the Sea of Five Zang and Six Fu. Its vessel is large, blood abundant, qi vigorous, and heat strong. Acupuncture here should not be too deep to avoid dispersing qi, nor retained too long to avoid draining qi. Depth: Foot Yangming 6 fen, retain 10 hu; Foot Taiyang 5 fen, retain 7 hu; Foot Shaoyang 4 fen, retain 5 hu; Foot Taiyin 3 fen, retain 4 hu; Foot Shaoyin 2 fen, retain 3 hu; Foot Jueyin 1 fen, retain 2 hu. For hand yin/yang meridians, qi pathways are near and arrival is swift. Depth should not exceed 2 fen, retention no more than 1 hu. For variations in age, size, fatness, and thinness, adjust mentally according to heavenly norms. Moxibustion follows the same rules. Exceeding these limits causes "evil fire" (bone dryness, vessel stagnation) or "qi depletion."
This section discusses acupuncture/moxibustion methods based on yin/yang, blood/qi volume, and river depths, aligning with heavenly numbers (Hetu). Two is the start of Yin, Ten is the end. Sea water is Supreme Yin. From Yangming to Jueyin, Jueyin represents the convergence of two Yins, where Yin reaches its limit and Yang generates. Heaven generates One Water, Earth completes it with Six. Depths from 6 fen to 1 fen follow heavenly norms. Above waist is Heaven; hand meridians have near qi pathways and swift arrival, requiring shallow insertion and quick withdrawal. *Zhong Shi* states: "Acupuncture for fat people follows Autumn/Winter standards; for thin people, Spring/Summer standards." Adjust depth/speed based on body type to follow heavenly time norms. Moxibustion exceeding limits causes bone dryness and vessel stagnation; acupuncture exceeding limits causes qi depletion.
Huangdi asked: Can vessel size, blood volume, skin thickness, muscle firmness, and collateral size be measured? Qibo replied: Those not fixed by standard measure take the "medium" person as the standard—one who is not emaciated and has robust blood and qi. For severely emaciated individuals, fixed measures do not apply. One must examine, palpate, press, and observe cold/heat/excess/deficiency to regulate treatment. This is called true treatment adapted to suitability.
Shang Yugong commented: "Shi" means adaptation; "Zhen" means correctness. Heaven opens in the Northwest, Earth sinks in the Southeast. High lands retain winter Qi; low lands retain autumn Qi. Humans adapt. People of five regions differ in pore density and fat/thinness. Therefore, the "medium" person serves as the standard for measurement. The medium person is lean but not emaciated, weak but with robust qi/blood. Mo Yuncong added: The previous section followed heavenly norms; this section uses earthly principles to adapt to human constitution, showing human correspondence to heaven and earth.