雷公问于黄帝曰。禁服之言。凡刺之理。经脉为始。营其所行。制其度量。内次五脏。外别六
腑。愿尽闻其道。黄帝曰。人始生。先成精。精成而脑髓生。骨为干。脉为营。筋为刚。肉为墙。
皮肤坚而毛发长。谷入于胃。脉道以通。血气乃行。雷公曰。愿卒闻经脉之始生。黄帝曰。经脉者。
所以能决死生。处百病。调虚实。不可不通。
此篇论脏腑十二经脉之生始出入。营血营行脉中。六气合于脉外。始于手太阴肺。终于足厥
阴肝。周而复始。循度环转之无端也。人始生先成精者。本于先天水火之精气而先生两肾。脑为
精髓之海。肾精上注于脑而脑髓生。骨为干者。骨生于水脏。如木之干也。营者。犹营舍之所以
藏血气也。筋为刚者。言筋之强劲也。肉为墙者。肉生于土。犹城墙之外卫也。皮肤坚而毛发长。
血气之充盛也。此言皮肤脉肉筋骨。乃五脏之外合。本于先天之精气也。谷入于胃。脉道以通。血
气乃行。言荣卫气血。生于后天水谷之精也。愚按、血气之生始出入。阴阳之离合盛衰。非神灵
睿圣。焉能洞鉴隔垣。灵素二经。叙君臣咨访。盖欲证明斯道。永垂金石。然
隐微之中。惟帝所洞察。故复指示于臣僚云。西铭曰。营气篇论营血之生始循行。亦出于帝论。
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。其支者。从腕后直出次指内
廉出其端。是动则病肺胀满膨膨而喘咳。缺盆中痛。甚则交两手而瞀。此为臂厥。是主肺所生病者。
咳上气喘。渴烦心。胸满。 臂内前廉痛。厥掌中热。气盛有余。则肩背痛。风寒汗出中风。小便
数而欠。气虚则肩背痛寒。少气不足以息。溺色变。为此诸病。盛则泻之。虚则补之。热则疾之。
寒则留之。陷下则灸之。不盛不虚。以经取之。盛者寸口大三倍于人迎。虚者则寸口反小于人迎也。
曰肺曰脉者。乃有形之脏腑经脉。曰太阴者。无形之六气也。血脉内生于脏腑。外合于六气。
以脉气分而论之。病在六气者。见于人迎气口。病在气而不在脉也。病在脏腑者。病在内而外见于
脏腑所主之尺寸也。合而论之。脏腑经脉。内合五行。外合六气。五六相得而各有合也。故曰肺手
太阴之脉。概脏腑经脉阴阳之气而言也。此篇论荣血荣行脉中。始于手太阴肺。终于足厥阴肝。腹走
手而手走头。头走足而足走腹。环转无端。终而复始。六脏之脉。属脏络腑。六腑之脉。属腑络脏。
脏腑相连。阴阳相贯。先为是动。后及所生。是动者。病在三阴三阳之气。而动见于人迎气口。病
在气而不在经。故曰盛则泻之。虚则补之。不盛不虚。以经取之。谓阴阳之气偏盛。浅刺绝皮。益
深绝皮。以泻阴阳之盛。致谷气以补阴阳之虚。此取皮腠之气分。而不及于经也。如阴阳之气。不
盛不虚。而经脉不和者。则当取之于经也。所生者。谓十二经脉。乃脏腑之所生。脏腑之病。
外见于经证也。夫是动者。病因于外。所生者。病因于内。凡病有因于外者。有因于内者。有因于
外而及于内者。有因于内而及于外者。有外内之兼病者。本篇统论脏腑经气。故曰肺手太阴之脉。
曰是动。曰所生。治病者当随其所见之证。以别外内之因。又不必先为是动。后及所生。而病证之
毕具也。膈者。胸内之膈肉。前连鸠尾。后连脊之十一椎。胸旁肋下谓之腋。膊内肱处谓之 。
尽处为肘。肘以下为臂廉侧也。寸口。两寸尺之动脉处。鱼际。掌中大指下高起之白肉。有如鱼腹。
因以为名。荣气之道。内谷为实。谷入于胃。乃传之肺。故肺脉起于中焦之胃脘。下络大肠。还循
胃口。而复上膈属肺。横出腋下之中府云门。下循 内。历天府侠白。行于少阴心主之前。下肘中。
抵尺泽。循臂骨之下廉。历孔最列缺。入寸口之经渠太渊。以上鱼。出大指端之少商。其旁而支行
者。从列缺分行于腕后。循合谷上行于食指之端。以交于手阳明大肠经之商阳。是动则病肺胀膨膨
而喘咳。缺盆中痛。瞀、目垂貌。甚则交两手而瞀。此为臂气厥逆之所致。盖三阴三阳之气。各循
于手足之经。气逆于外。而病见于内也。所生者。肺脏所生之病。而外见于经证。夫五行之气。五
脏所主。而六腑为之合。故在脏。则曰主肺主脾主心主肾主肝。在腑。则曰主津主液主气主血主骨
主筋。此皆脏腑所生之病。而外见于经证也。是主肺所生之病。故咳嗽上气。渴而烦心。肺主气而
为水之生原。肺乃心之盖也。胸满。 臂痛。掌中热。皆经脉所循之部而为病也。气之盛虚者。谓
太阴之气也。肺俞在肩背。因气而痛于俞。所谓气伤痛也。溺色变者。气虚而不化也。夫三阴三阳
之气。本于阳明胃腑所生。从手阳明之五里。而散行于肤表。肺主气而外主皮毛。是以手太阴与手
足阳明。论气之盛虚。其余诸经略而不论也。夫三阴三阳之气。
有因于本气之盛虚。有因于外感风寒。以致气之盛者。故提于十二经之首曰。风寒汗出中风。盖以
申明三阴三阳之气在表。而合于天之六气也。为此是动所生诸病。盛则泻之。虚则补之。热则疾出
其针以泻其热。寒则留之以俟针下热也。艾名冰台。举冰向日。能于冰中取火。故气陷下者灸之。
谓能起生阳之气于阴中也。如阴阳之气。无有盛虚。而所生之经脉不调者。则当取之于经矣。经者。
肺手太阴之脉也。所谓气之盛者。寸口大三倍于人迎。虚者。寸口反小于人迎也。尚御公曰。脏腑
之气。候见于手太阴之寸关尺。人迎气口。左右之寸口也。候法不同。各有分别。故首提曰肺手太
阴之脉。复曰气有盛虚。曰人迎气口。书不尽言。义已 括。读者当怿思之。金西铭曰。终始篇云。
少气者。脉口人迎俱少而不称尺寸也。言人迎气口。转应于尺寸。是尺寸与人迎气口。各有分别。
张玉师曰。人迎气口。以左右分阴阳。脏腑之脉。以尺寸分阴阳。
Lei Gong asked Huang Di, "Regarding the principles mentioned in the *Jin Fu* (Forbidden Regulations) chapter: the rationale of acupuncture begins with the meridians. One must investigate their courses and determine their measurements, connecting internally to the Five Zang organs and distinguishing externally from the Six Fu organs. I wish to hear the complete explanation of this path."
Huang Di said, "When human life begins, essence is formed first. Once essence is formed, brain marrow develops. Bones serve as the structural framework, meridians circulate Qi and Blood, tendons provide strength, and muscles act as protective walls. The skin is firm, and hair grows long. When food enters the stomach, the meridian pathways become unobstructed, and Qi and Blood begin to flow."
Lei Gong said, "I wish to hear completely how the meridians originate."
Huang Di said, "The meridians are capable of determining life and death, managing all diseases, and regulating deficiency and excess; therefore, they must not be left unexamined."
This chapter discusses the origin, entry, exit, circulation of Ying Blood within the vessels, and the coordination of the Six Qi outside the vessels for the twelve meridians of the Zang and Fu organs. The cycle begins with the Hand Taiyin Lung Meridian and ends with the Foot Jueyin Liver Meridian, repeating endlessly in a continuous loop according to specific pathways. Human generation starts with the formation of essence, which originates from the primordial Essence of Water and Fire, initially forming the two Kidneys. The Brain is the sea of essence and marrow; Kidney Essence ascends to the Brain, generating Brain Marrow. Bones, serving as the trunk, are born from the Water Organ (Kidney), akin to the trunk of a tree. 'Ying' refers to the storage of Qi and Blood within the vessels, like a camp storing supplies. 'Tendons are strong' indicates the robust nature of tendons. 'Muscles are walls' signifies that muscles, born from Earth (Spleen), act as external defenses like city walls. Firm skin and long hair result from abundant Qi and Blood. The skin, vessels, muscles, tendons, and bones described here are external correspondences of the Five Zang organs, rooted in primordial essence. Food entering the stomach unblocks the meridian pathways, allowing Qi and Blood to flow, indicating that Ying, Wei, Qi, and Blood are generated from the refined essence of postnatal food and water. In my opinion, the origin, entry, exit of Qi and Blood, and the separation, union, waxing, and waning of Yin and Yang are insights so profound that only a divine sage could perceive them through walls. The *Ling Shu* and *Su Wen* narrate consultations between ruler and ministers to prove this Great Dao, ensuring it lasts forever. Yet, only the Emperor could perceive these subtle truths, thus instructing his officials again. Xi Ming states: The *Ying Qi* chapter discusses the origin and circulation of Ying Blood, also derived from the Emperor's discourse.
The Lung Meridian of Hand-Taiyin originates in the Middle Jiao, descends to connect with the Large Intestine, returns along the stomach opening, pierces the diaphragm, and belongs to the Lung. From the lung system (trachea and throat), it emerges horizontally under the axilla, descends along the anterior aspect of the upper arm, running anterior to the Heart Meridian of Hand-Shaoyin and Pericardium Meridian of Hand-Jueyin, reaches the elbow, follows the medial border of the forearm bone, enters the Cun Kou (radial pulse), ascends to the Yu Ji (Thenar eminence), follows the margin of the thenar eminence, and exits at the tip of the thumb. Its branch arises from the wrist, goes straight to the medial side of the index finger, and exits at its tip. When this meridian undergoes pathological changes, it causes lung distension, fullness, wheezing, and coughing; pain in the supraclavicular fossa (Que Pen); and severely, crossing both hands over the chest with blurred vision, known as Bi Jue (Arm Jue). This meridian governs diseases generated by the Lung, including cough, asthma, thirst, mental restlessness, chest fullness, pain along the anterior medial aspect of the arm, and heat in the palm. If Qi is excessive and surplus, there is shoulder and back pain, aversion to wind, sweating, and wind-stroke; frequent urination with scanty volume. If Qi is deficient, there is cold pain in the shoulder and back, shortness of breath insufficient for respiration, and changes in urine color. For these conditions, excess is drained, deficiency is tonified, heat is treated with rapid needle withdrawal, cold is treated with retained needles, sinking Qi is treated with moxibustion, and neither excess nor deficiency is treated by selecting points on the affected meridian. In cases of excess, the Cun Kou pulse is three times larger than the Ren Ying pulse; in deficiency, the Cun Kou pulse is smaller than the Ren Ying pulse.
'Lung' and 'Meridian' refer to the有形 (formative) Zang organs and meridians; 'Taiyin' refers to the无形 (formless) Qi of the Six Qi. Blood vessels are generated internally by the Zang organs and harmonize externally with the Six Qi. Analyzing separately by meridian Qi: diseases in the Six Qi manifest in the Ren Ying and Qi Kou pulses, indicating disease in Qi rather than the vessel itself; diseases in the Zang organs manifest internally but appear externally on the Cun, Guan, and Chi positions corresponding to the Zang organs. Synthesizing these, Zang and Fu organs internally harmonize with the Five Elements and externally with the Six Qi; five and six match and have their respective unions. Thus, 'Hand-Taiyin Lung Meridian' speaks generally of the Yin-Yang Qi of Zang, Fu, and meridians. This chapter discusses Ying Blood circulating within the vessels, starting from the Hand-Taiyin Lung Meridian and ending at the Foot-Jueyin Liver Meridian. Abdomen connects to Hand, Hand to Head, Head to Foot, Foot to Abdomen, rotating endlessly, finishing and restarting. The meridians of the Six Zang belong to the Zang and link to the Fu; the meridians of the Six Fu belong to the Fu and link to the Zang. Zang and Fu are connected, Yin and Yang are interwoven. First come 'Shi Dong' (Is Moving) diseases, followed by 'Suo Sheng' (Generated) diseases. 'Shi Dong' diseases involve the Qi of the Three Yin and Three Yang, manifesting in Ren Ying and Qi Kou, indicating disease in Qi rather than the meridian itself. Hence, 'Excess is drained, deficiency is tonified, neither excess nor deficiency is treated by selecting the meridian.' This means if Yin-Yang Qi is biased towards excess, shallow needling penetrates the skin to drain excess Yin-Yang Qi, guiding Grain Qi to tonify deficiency. This targets the Qi of the skin and pores, not the meridian itself. If Yin-Yang Qi is neither excess nor deficiency, but the meridian is disharmonious, one should select points on the meridian. 'Suo Sheng' refers to the Twelve Meridians being generated by the Zang and Fu; diseases of the Zang and Fu manifest externally as meridian symptoms. 'Shi Dong' implies the cause is external; 'Suo Sheng' implies the cause is internal. Diseases may arise from external factors, internal factors, external affecting internal, internal affecting external, or both. This chapter comprehensively discusses Zang-Fu meridian Qi, hence mentioning 'Hand-Taiyin Lung Meridian,' 'Shi Dong,' and 'Suo Sheng.' Practitioners should distinguish external and internal causes based on observed symptoms. It is not necessarily true that 'Shi Dong' always precedes 'Suo Sheng'; rather, all symptom patterns are present. The Diaphragm is the muscle within the chest, connecting anteriorly to Jiū Wěi and posteriorly to the 11th thoracic vertebra. The area below the ribs on the sides of the chest is called the Axilla. The inner arm near the humerus is called Nao. The end point is the Elbow. Below the elbow is the lateral side of the Arm. Cun Kou is the arterial pulse site of the Cun and Chi positions. Yu Ji is the raised white flesh below the thumb in the palm, resembling a fish belly, hence the name. The path of Ying Qi relies on internal Grain for substance. Food enters the Stomach, transmits to the Lung. Thus, the Lung Meridian originates in the Middle Jiao at the Stomach, descends to connect with the Large Intestine, returns along the stomach opening, ascends through the diaphragm to belong to the Lung, emerges horizontally through Zhong Fu and Yun Men in the axilla, descends through Nao, passing Tian Fu and Xia Bai, runs anterior to the Heart and Pericardium meridians, reaches the elbow at Chi Ze, follows the lower border of the arm bone, passes Kong Zui and Lie Que, enters Cun Kou at Jing Qu and Tai Yuan, ascends to Yu Ji, and exits at Shao Shang at the thumb tip. The collateral branch diverges from Lie Que at the wrist, ascends along He Gu to the tip of the index finger, intersecting with Shang Yang of the Hand-Yangming Large Intestine Meridian. Pathological changes in this meridian cause lung distension, wheezing, coughing, pain in the supraclavicular fossa, blurred vision (Mu, drooping eyes), and severely, crossing hands over the chest with blurred vision, caused by reversal of Arm Qi. Generally, the Qi of the Three Yin and Three Yang circulates in the hand and foot meridians; Qi reverses externally, and disease manifests internally. 'Suo Sheng' refers to diseases generated by the Lung organ, manifesting externally as meridian symptoms. The Qi of the Five Elements is governed by the Five Zang, with the Six Fu acting as their partners. Thus, for Zang organs, we say governing Lung, Spleen, Heart, Kidney, Liver; for Fu organs, we say governing Fluids, Fluids, Qi, Blood, Bones, Tendons. These are diseases generated by Zang and Fu, manifesting externally as meridian symptoms. Since it governs diseases generated by the Lung, there is cough and asthma, thirst with mental restlessness. The Lung governs Qi and is the source of Water; the Lung is the cover of the Heart. Chest fullness, arm pain, and heat in the palm are diseases occurring in the parts where the meridian circulates. Excess and deficiency of Qi refer to Taiyin Qi. Lung Shu is on the shoulder and back; pain occurs at the Shu point due to Qi, known as 'Qi causes pain.' Changes in urine color occur because Qi is deficient and cannot transform. The Qi of the Three Yin and Three Yang originates from the Yangming Stomach Fu, dispersing from Wu Li of the Hand-Yangming meridian to the skin surface. The Lung governs Qi and externally governs skin and hair; thus, the Hand-Taiyin and Hand/Foot-Yangming meridians specifically discuss Qi excess and deficiency, while other meridians are briefly mentioned without detailed discussion. The Qi of the Three Yin and Three Yang may be due to intrinsic excess/deficiency or external contraction of Wind-Cold causing Qi excess. Therefore, at the beginning of the twelve meridians, it mentions 'Wind-Cold, sweating, wind-stroke,' to clarify that the Qi of the Three Yin and Three Yang is on the exterior and combines with the Heaven's Six Qi. For these Shi Dong and Suo Sheng diseases, excess is drained, deficiency is tonified, heat is treated with rapid needle withdrawal to drain heat, and cold is treated with retained needles until warmth is felt. Moxa is also called Bing Tai (Ice Platform); holding ice towards the sun can extract fire from ice. Thus, sinking Qi is treated with moxibustion, meaning to raise the generating Yang Qi from within Yin. If Yin-Yang Qi has no excess or deficiency, but the generated meridian is unregulated, one should select points on the meridian. The 'Meridian' refers to the Hand-Taiyin Lung Meridian. Qi excess is when Cun Kou is three times larger than Ren Ying; Qi deficiency is when Cun Kou is smaller than Ren Ying. Shang Yu Gong said: The Qi of Zang and Fu is reflected in the Cun, Guan, and Chi of the Hand-Taiyin. Ren Ying and Qi Kou are the Cun Kou of the left and right hands. The methods of pulse diagnosis differ and are distinct. Hence, it first mentions 'Hand-Taiyin Lung Meridian,' then states Qi has excess and deficiency, mentioning Ren Ying and Qi Kou. Words cannot fully express speech; the meaning is contained herein. Readers should ponder joyfully. Jin Xi Ming said: The *Zhong Shi* chapter states, 'Those with shortness of breath have both Pulse Kou and Ren Ying weak, not matching the Cun and Chi positions.' This indicates Ren Ying and Qi Kou correspond to Cun and Chi, showing that Cun/Chi and Ren Ying/Qi Kou are distinct. Zhang Yu Shi said: Ren Ying and Qi Kou distinguish Yin and Yang by left and right; Zang and Fu meridians distinguish Yin and Yang by Cun and Chi positions.