黄帝问曰。余闻皮有分部。脉有经纪。筋有结络。骨有度量。其所主病各异。别其分部左右上下。阴阳所在。病之
始终。愿闻其道。(此章论十二经之络脉。分络于皮肤之间。病之始生。必先于皮毛。入客于络脉。随皮部所循之脉。而
传入于经。入舍于所主之脏腑。如不入于络。则留于筋骨之间。而为筋挛骨痛也。分部分属之部署也。经、径也。纪、
维也。言脉络有径之经。横之维也。结、绑定也。络、联系也。言筋之系于分肉。连于骨节也。度量、大小长短也。邪
在皮肉筋骨络脉脏腑。各有浅深。或为筋挛骨痛。肉铄破 。或入舍于脏腑。而为脏腑之病也。别其络脉所分之上下左
右。十二经脉之阴阳所在。而知病之始终也。)岐伯对曰。欲知皮部。以经脉为纪者。诸经皆然。(夫径而深者为经。浮
而见于皮者为络。纪、记也。欲知皮之分部。当以所见之络脉分之。然又当以经脉为纪。盖络乃经脉之支别。如肺之经
脉。循于鱼际尺泽 腋之间。即其间所见之络脉。乃肺之络。而络外之皮。即肺主之部矣。视其色多青则寒。黄赤则热。
络盛则入客于经。经满则入舍于肺脏。十二经皆然。)阳明之阳。名曰害蜚。(阳明之阳络。名曰害蜚。蜚、飞动也。阳
明者午也。为盛阳之时。如万物之飞动。阳盛而阴气加之。有害于飞。故名曰害蜚。)上下同法。视其部中有浮络者。皆
阳明之络也。(上下同法。谓手足二经皆同此法。部中、皮之分部中也。)其色多青则痛。多黑则痹。黄赤则热。多白则
寒。五色皆见。则寒热也。络盛则入客于经。(夫邪之中人。始于皮肤。次于络脉。留而不去。则传舍于经。故视其皮部
之浮络。多青则痛。多黑则痹。黄赤则热。多白则寒。五色皆见。则为寒热。络盛而不泻其邪。则入客于经矣。在阳明
之部分。则为阳明之病。在少阳之部分。则为少阳之病。在三阴之部分。则为三阴之病。故列于首节。而六经皆然。)阳
主外。阴主内。(此言经络之分阴阳外内也。经云。内有阴阳。外有阴阳。在外者皮肤为阳。筋骨为阴。故见于皮肤间者。
为络为阳而主外。络于筋骨间者。为经为阴而主内。盖在阳者可从外解。在阴者则内入而舍于脏腑矣。按通评虚实论曰。
络满经虚。灸阴刺阳。经满络虚。刺阴灸阳。盖以络为阳而经为阴也。)少阳之阳。名曰枢持。(枢、枢机也。持、主
持也。少阳主枢。故名枢持。)上下同法。视其部中有浮络者。皆少阳之络也。络盛则入客于经。故在阳者主内。在阴者
主出。以渗于内。诸经皆然。(此复论经气之从内而外出也。夫五脏内合五行。地之阴阳也。六经外合六气。天之阴阳
也。天之六气。下合地之五行。地之五行。上呈天之六气。是以在外六经之气。从阳而内。在内经脉之气。从阴而外出
于皮肤。复从皮肤而入于肌肉筋骨。以渗于脏腑募原之间。而内通于五脏。此论经脉之气。环转无端。盖从内而外也。
详本经四时刺逆从论。)太阳之阳。名曰关枢。(关、卫固也。太阳主诸阳之气而主表。阳气生于阴中。枢转而外出。
太阳之气。从内而出。卫固于外。故曰关枢。)上下同法。视其部中有浮络者。皆太阳之络也。络盛则入客于经。(上下
谓手足二经。六气止合六经。足之六经。上合于手。故止曰上下同法。而不言手之小肠。足之膀胱也。六经皆然。)少
阴之阴。名曰枢儒。(儒、说文。柔也。王氏曰。顺也。少阴为三阴开阖之枢。而阴气柔顺。故名枢儒。)上下同法。视
其部中有浮络者。皆少阴之络也。络盛则入客于经。其入经也。从阳部注于经。其出者。从阴内注于骨。(四时刺逆从论
曰。春者天气始开。地气始泄。冻解冰释。水行经通。故人气在脉。夏者经满气溢。入孙络受血。皮肤充实。长夏者。
经络皆盛。内溢肌中。秋者天气始收。腠理闭塞。皮肤引急。冬者盖藏。血气在中。内着骨髓。通于五脏。此言经脉之
气。从经脉而出于孙络。从孙络而溢于皮肤。复从皮肤而入于肌肉筋骨。故曰。其出者。从阴内注于骨。阴、谓经脉也。
言脉气之环转。从经而出。复从外而内注于骨。诸经皆然。此论三阴。而少阴又主冬主骨。故复申明之。王芳侯曰。其
入经也。从阳部注于经。论邪气之从外而入。其出者。从阴内注于骨。论正气之从内而出。)心主之阴。名害肩。(阴、
谓厥阴之络也。两阴交尽。故曰厥阴。肩、任也。谓任一身之阴。阴极而一阳加之。故曰害肩。)上下同法。视其部中曰。
有浮络者。皆心主之络也。络盛则入客于经。(上谓手厥阴心主。下谓足厥阴肝经。此篇论络脉经脉。而手厥阴心主主脉。
故提手厥阴焉。)太阴之阴。名曰关蛰。(蛰者。阴藏蛰动之虫。盖气藏于阴。而欲动蛰于外。乃太阴关之。故名关蛰。
夫内为阴。外为阳也。荣卫篇曰。太阴主内。太阳主外。枢转外出之阳。而太阳关之。故名关枢。阴藏动蛰之气。而太
阴关之。故名关蛰。两阳合明。故曰阳明。两阴交尽。故曰厥阴。以阳盛而一阴加之。故曰害蜚。阴极而一阳加之。故
曰害肩。少阳主三阳之枢。故曰枢持。少阴主三阴之枢。故曰枢儒。以三阴三阳对待论之。命名之义自得矣。)上下同法。
视其部中有浮络者。皆太阴之络也。络盛则入客于经。凡十二经络脉者。皮之部也。(六脏六腑。所合十二经之络脉。各
分属于皮之部署。)是故百病之始生也。必先于皮毛。邪中之。则腠理开。开则入客于络脉。留而不去。传入于经。留而
不去。传入于腑。廪于肠胃。(此言邪入于经。有不动脏而溜于腑者。传入于腑。谓入于大肠小肠胃腑也。廪、积也。夫
经络受邪。则内干脏腑。其脏气实者。不必动脏。则溜于腑矣。盖阳明居中土。为万物之所归。邪入于胃。则积于肠胃
之间。为贲响腹胀诸证。)邪之始入于皮也。 然起毫毛。开腠理。其入于络也。则络脉盛。色变。其入客于经也。则感
虚乃陷下。其留于筋骨之间。寒多则筋挛骨痛。热多则筋弛骨消。肉铄 破。毛直而败。(此论邪之有入于经络。而虚陷
于内者。有留于筋骨之间。而为筋挛骨痛者。盖皮肉筋骨。皆属气分。络脉经俞。皆属血分。经络内连脏腑。是以经络
受邪。入脏腑为内所因。如不入于络。则留于皮肉筋骨之间。为外皮肤所中也。 然、寒栗逆起之貌。邪盛于络。则变
见青黄赤黑之色于皮部。转入于经。则感脏腑之气虚而陷下也。如留于筋骨之间。则为筋挛骨痛。铄肉破 。毛直夭焦
之败证。)帝曰。夫子言皮之十二部。其生病皆何如。岐伯曰。皮者。脉之部也。邪客于皮则腠理开。开则邪入。客于络
脉。络脉满则注于经脉。经脉满则入舍于腑脏也。故皮者有分部。不与。而生大病也。帝曰。善。(此言邪入于经。而内
干脏腑也。不与、不及也。言皮毛之表气微虚。以致邪入于经。而为干脏之危病也。)
Yellow Emperor asked: I have heard that the skin has its divisions, the meridians have their guidelines, the sinews have their knots and networks, and the bones have their measurements. The diseases they govern are different. By distinguishing their divisions, left and right, upper and lower, and the locations of Yin and Yang, one can understand the beginning and end of diseases. I wish to hear the principle behind this. (This chapter discusses the collateral vessels of the twelve meridians, which branch out into the skin. The onset of disease always begins at the hair follicles and skin. Pathogenic factors invade the collateral vessels, follow the meridians circulating within the skin regions, enter the main meridians, and lodge in the governing Zang-Fu organs. If they do not enter the collaterals, they remain between the sinews and bones, causing tendon spasms and bone pain. "Division" refers to the distribution areas. "Jing" (Meridian) refers to the path; "Ji" (Guideline) refers to the connection. This means the vascular system has longitudinal paths and transverse connections. "Jie" (Knot) refers to binding; "Luo" (Collateral) refers to connecting. This means sinews are tied to the muscle intervals and connected to the bone joints. "Measurement" refers to size and length. Pathogenic factors at different depths in the skin, flesh, sinews, bones, collaterals, and Zang-Fu organs cause varying symptoms, such as tendon spasms, bone pain, muscle wasting, or internal organ diseases. By distinguishing the upper, lower, left, and right distributions of the collateral vessels and the Yin-Yang locations of the twelve main meridians, one can know the progression of diseases.)
Qi Bo replied: To understand the skin regions, one should use the main meridians as guidelines; this applies to all meridians. (The deep and straight pathways are the main meridians (Jing-Mai), while the superficial ones visible on the skin are the collateral vessels (Luo-Mai). "Ji" means record. To know the divisions of the skin, one should distinguish them based on the observed collateral vessels. However, one must use the main meridians as the guideline because collaterals are branches of the main meridians. For example, the Lung meridian circulates between Yuji, Chize, and the axilla. The collateral vessels seen there are Lung collaterals, and the skin outside these collaterals is the Lung's skin region. Observing color: bluish indicates Cold, yellowish-red indicates Heat. If the collateral vessels are full, pathogens enter the main meridian; if the main meridian is full, pathogens lodge in the Lung organ. This applies to all twelve meridians.)
The Yang collateral of the Yangming meridian is called Haifei. (The Yang collateral of the Yangming meridian is named Haifei. "Fei" implies flying/movement. Yangming corresponds to the Wu hour, a time of extreme Yang, like things in motion. When extreme Yang is subjected to Yin, it harms the movement, hence the name Haifei.) The same method applies to the upper and lower limbs. Observe any floating collaterals in the region; they are all Yangming collaterals. (Applying the same method to upper and lower limbs means both Hand and Foot Yangming meridians follow this rule. "In the region" refers to the skin division area.) If the color is mostly blue, there is pain; mostly black, Bi syndrome (obstruction); yellowish-red, Heat; mostly white, Cold; if all five colors appear, it indicates mixed Cold and Heat. If the collaterals are full, pathogens enter the main meridian. (Pathogens attacking humans start at the skin, then move to the collaterals. If they linger, they transmit to the main meridians. Thus, observing floating collaterals in the skin region: blue indicates pain, black indicates obstruction, yellowish-red indicates Heat, white indicates Cold, and all five colors indicate mixed Cold and Heat. If collaterals are full and pathogens are not drained, they enter the main meridian. In the Yangming skin region, it is a Yangming disease; in the Shaoyang region, a Shaoyang disease; in the Three Yin regions, a Three Yin disease. Hence listed first, applying to all six meridians.)
Yang governs the exterior, Yin governs the interior. (This discusses the Yin-Yang distinction between exterior and interior of meridians. The classic states: There is Yin and Yang inside, and Yin and Yang outside. Externally, skin is Yang, sinews and bones are Yin. Those visible in the skin are collaterals, belonging to Yang and governing the exterior; those connecting sinews and bones are meridians, belonging to Yin and governing the interior. What is in the Yang aspect can be resolved from the exterior; what is in the Yin aspect enters internally and lodges in the Zang-Fu organs. According to the *Tong Ping Xu Shi Lun*: If collaterals are full and meridians empty, moisten Yin and puncture Yang; if meridians are full and collaterals empty, puncture Yin and moisten Yang. This treats collaterals as Yang and meridians as Yin.)
The Yang collateral of the Shaoyang meridian is called Shuchi. (Shu means pivot; Chi means to hold/govern. Shaoyang governs the pivot, hence named Shuchi.) The same method applies to the upper and lower limbs. Observe any floating collaterals in the region; they are all Shaoyang collaterals. If the collaterals are full, pathogens enter the main meridian. Therefore, for those in the Yang aspect, Qi moves inward to outward; for those in the Yin aspect, Qi moves outward to infiltrate internally. All meridians function this way. (This re-discusses the process of Meridian Qi moving from interior to exterior. The Five Zang organs internally correspond to the Five Elements, representing Earth's Yin-Yang. The Six Meridians externally correspond to the Six Qi, representing Heaven's Yin-Yang. Heaven's Six Qi combines with Earth's Five Elements; Earth's Five Elements presents to Heaven's Six Qi. Thus, the Qi of the external Six Meridians moves from Yang inward; the Qi of the internal meridians moves from Yin outward to the skin, then into muscles/sinews/bones, infiltrating the Zang-Fu organs and Yuan Mu points, connecting internally to the Five Zang. This describes the endless circulation of Meridian Qi from interior to exterior. See *Si Shi Ci Ni Cong Lun* in this classic.)
The Yang collateral of the Taiyang meridian is called Guanshu. (Guan means guard/secure. Taiyang governs the Qi of all Yangs and the exterior. Yang Qi is born from Yin, pivots, and moves outward. Taiyang Qi moves from interior to exterior, guarding the outside, hence named Guanshu.) The same method applies to the upper and lower limbs. Observe any floating collaterals in the region; they are all Taiyang collaterals. If the collaterals are full, pathogens enter the main meridian. (Upper and lower refer to Hand and Foot meridians. The Six Qi combine only with the Six Meridians; the Foot Six Meridians connect upward to the Hand, so we say "upper and lower apply the same method" without separately mentioning Hand Small Intestine or Foot Bladder. This applies to all six meridians.)
The Yin collateral of the Shaoyin meridian is called Shuru. (Ru means soft/gentle according to Shuowen. Master Wang says: compliant/submissive. Shaoyin is the pivot of the opening and closing of the Three Yins, and its Qi is soft and compliant, hence named Shuru.) The same method applies to the upper and lower limbs. Observe any floating collaterals in the region; they are all Shaoyin collaterals. If the collaterals are full, pathogens enter the main meridian. When entering the meridian, it flows from the Yang aspect into the meridian; when exiting, it flows from the Yin interior into the bones. (*Si Shi Ci Ni Cong Lun* states: In Spring, Heaven's Qi opens, Earth's Qi leaks, ice melts, water flows, and human Qi is in the vessels. In Summer, vessel Qi is full and overflows into Sun-Luo vessels, filling the blood and skin. In Late Summer, both meridians and collaterals are full, overflowing into muscles. In Autumn, Heaven's Qi收 (gathers), pores close, skin tightens. In Winter, storage occurs, Qi/Blood stay inside, penetrating marrow and connecting to Five Zang. This describes Meridian Qi exiting vessels to Sun-Luo, overflowing to skin, then entering muscles/sinews/bones. Thus: "Exiting, it flows from Yin interior into bones." Yin here refers to the main meridian. It means pulse Qi circulates, exiting the meridian and flowing back inward to the bones. This applies to all meridians. Here discussing Three Yins, and since Shaoyin governs Winter and bones, it is reiterated. Wang Fanghou said: "Entering the meridian from Yang aspect" discusses pathogenic factors entering from outside; "Exiting from Yin interior into bones" discusses healthy Qi exiting from inside.)
The Yin collateral of the Heart Master (Pericardium) is called Haijian. (Yin here refers to the Jueyin collateral. Two Yins meeting their end is called Jueyin. Jian means to bear/carry. It bears the Yin of the whole body. At the extremity of Yin, a touch of Yang is added, hence named Haijian.) The same method applies to the upper and lower limbs. Observe any floating collaterals in the region; they are all Heart Master collaterals. If the collaterals are full, pathogens enter the main meridian. (Upper refers to Hand Jueyin Pericardium Meridian, lower to Foot Jueyin Liver Meridian. This chapter discusses collateral and main meridians, and since Hand Jueyin Pericardium governs the vessels, it is highlighted.)
The Yin collateral of the Taiyin meridian is called GuanZhe. (Zhe refers to insects hiding/dormant in Yin. Qi hides in Yin but desires to move/dorm externally, being closed by Taiyin, hence named GuanZhe. Interior is Yin, exterior is Yang. The *Ying Wei Pian* states: Taiyin governs interior, Taiyang governs exterior. The pivot turning outward Yang is closed by Taiyang, hence named Guanshu. The Qi of Yin dormancy/movement is closed by Taiyin, hence named GuanZhe. Two Yangs combined and bright is Yangming; two Yins meeting their end is Jueyin. With extreme Yang touched by one Yin, it is Haifei; with extreme Yin touched by one Yang, it is Haijian. Shaoyang governs the pivot of Three Yangs, hence Shuchi; Shaoyin governs the pivot of Three Yins, hence Shuru. Discussing the correspondence of Three Yin and Three Yang, the meaning of naming becomes clear.) The same method applies to the upper and lower limbs. Observe any floating collaterals in the region; they are all Taiyin collaterals. If the collaterals are full, pathogens enter the main meridian.
All twelve meridian collateral vessels belong to the skin regions. (The collateral vessels of the twelve meridians corresponding to the six Zang and six Fu organs each distribute to specific skin areas.)
Therefore, the onset of all hundred diseases begins at the hair follicles and skin. When pathogens attack, the interstices (Couli) open, allowing entry into the collateral vessels. If they linger, they transmit to the main meridians; if they still linger, they transmit to the Fu organs, accumulating in the intestines and stomach. (This explains that pathogens entering meridians may not affect Zang organs directly but flow into Fu organs. Transmitting to Fu organs means entering large intestine, small intestine, stomach, etc. "Lin" means accumulation. When meridians/collaterals receive pathogens, they internally affect Zang-Fu. If Zang Qi is solid, it need not disturb the Zang, but flows into the Fu. Because Yangming resides in the center (Earth element) and is the destination of all things, pathogens entering the stomach accumulate in the intestines/stomach, causing symptoms like borborygmus and abdominal distension.)
When pathogens first enter the skin, chills arise at the hair follicles, and interstices open. Upon entering collaterals, the collaterals become full and color changes occur. Upon invading meridians, deficiency allows sinking. If remaining between sinews and bones, excessive Cold causes tendon spasms and bone pain; excessive Heat causes flaccid sinews, bone destruction, muscle wasting, and brittle/hair loss. (This discusses pathogens entering meridians/collaterals and sinking due to deficiency, or remaining in sinews/bones causing spasms/pain. Skin/flesh/sinews/bones belong to Qi aspect; collaterals/acupoints belong to Blood aspect. Meridians connect internally to Zang-Fu; thus, meridian pathology entering Zang-Fu is an internal cause. If not entering collaterals, remaining in skin/flesh/sinews/bones is an external cutaneous cause. "Li Ran" describes the appearance of chills/shivering. Pathogen excess in collaterals shows blue/yellow/red/black colors in skin regions. Transitioning to meridians involves deficiency of Zang-Fu Qi leading to sinking. Remaining in sinews/bones causes spasms/pain, wasting, and brittle hair/death signs.)
Yellow Emperor said: You spoke of the twelve divisions of the skin. How do diseases manifest? Qi Bo said: Skin is the domain of the vessels. Pathogens lodging in skin open the interstices; opened interstices allow entry into collaterals; full collaterals inject into main meridians; full main meridials lodge in Zang-Fu organs. Therefore, skin has divisions. If defensive Qi is insufficient ("Bu Yu"), serious diseases arise. Yellow Emperor said: Excellent. (This discusses pathogens entering meridians and internally affecting Zang-Fu. "Bu Yu" means insufficiency. It means slight deficiency of exterior Qi in skin/hair allows pathogens to enter meridians, becoming critical diseases affecting Zang organs.)