皮部，皮之十二部也。手足三阳三阴。十二经络之脉，皆在于皮，各有分部。故曰十二经络脉者，
皮之部也。部有左右上下，复有外内浅深。百病之生，先于皮毛，由皮毛而腠理，腠理而络脉，
络脉而经脉，经脉而腑脏。腑脏之气，亦通于皮，亦有分部，其腑脏之气，不与于皮，而生大病矣。
黄帝问曰∶余闻皮有分部，脉有经纪，筋有结络，骨有度量，
其所生病各异。别其分部，左右上下，阴阳所在，病之始终，愿闻其道。
量，平声。别，音逼。皮主通体，分属经脉，各有其部，故皮有分部。周身脉道，有径直之经，横
络之纪，故脉有经纪。《灵枢·经筋》十三，各有所结，间有所络，故筋有结络。骨度长短不同，不可以度而
量之，故骨有度量。皮脉筋骨，生病不同，故生病各异。凡此，当别其分部，左右上下，阴阳所在，
而知病之始终，故举以问。
岐伯对曰∶欲知皮部，以经脉为纪者，诸经皆然。
皮有分部，乃以经脉而分其部，故欲知皮部，以经脉为纪者，
十二经皆然。诸，十二也。
阳明之阳，名曰害蜚，上下同法，视其部中有浮络者，皆阳明
之络也，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，阳主外，阴主内。
蜚，飞同。经脉之气，从内达外，由阖而枢，枢而开。故首论阳明之阖，次论少阳之枢，终论太阳
之开。阳明之阳，行身之前而主阖。阖则不开，有害于飞，故名曰害蜚。蜚，犹开也。上下，犹
手足也。无分手足，皆为害蜚，故上下同法。但视其阳明部中，皮内有浮络者，皆手足阳明之络也。其浮
络之色，多青则痛，多黑则痹，黄赤则热，多白则寒。若青黑黄赤白，五色皆见，则寒热互呈
也。皮络之邪过盛，则入客于经。盖络为阳，主外，经为阴，主内也。
少阳之阳，名曰枢持。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。
少阳之阳，行身之侧，而主枢，故名曰枢持。持犹主也。无分手足，皆为枢持，故上下同法。但
视其少阳部中，皮内有浮络者，皆手足少阳之络也。皮部之邪过盛，则入客于经。络为阳，主外，
络盛客经，则阳气内入，故在阳者主内。经为阴，主内，阳气内入，则阴气外出，故在阴者主出。出而复
入，以渗于内。此阴阳经络，外内出入，不独手足少阳为然，而诸经皆然。
太阳之阳，名曰关枢。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。
太阳之阳，行身之背，而主开，故名曰关枢。关，犹系也。枢转始开，开之系于枢也。无分手足，
皆为关枢，故上下同法。但视其太阳部中，皮内有浮络者，皆手足太阳之络也。皮络之邪过盛，则入客于经。
少阴之阴，名曰枢儒。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。
经脉之气，有阳有阴，枢为之主。故先论少阴之枢，次论厥阴之阖，终论太阴之开。少阴之阴，从
而上，注胸中而止，枢转神机，区别水火，故名曰枢儒。儒，犹区也。手足少阴，皆为枢
儒，故上下同法，但视其少阴部中，皮内有浮络者，皆手足少阴之络也。皮络之邪过盛，则入客于经。
其入经也，从浮络之阳部而注于经，有入则有出。其出者，少阴在内，从至阴之内，注于骨中而始出也。
心主之阴，名曰害肩。上下同法，视其部中有浮络者，皆心主之络也，络盛则入客于经。
心主手厥阴心主包络也。手足无分、上下同法，故举手之厥阴以明之。心主之阴，起于胸中，而主阖，
阖则不能外任，故名曰害肩。肩，犹任也。手足厥阴，皆为害肩，故上下同法，但视其心主
部中，皮内有浮络者，皆心主之络。是足之厥阴，亦同于手之厥阴也，皮络之邪过盛，则入客于经。
太阴之阴，名曰关蛰。上下同法，视其部中浮络者，皆太阴之络也，络盛则入客于经。
太阴之阴，循足胫，交出厥阴之前，而主开，故名曰关蛰。蛰，犹藏也。藏而后开，开之关于蛰也。
手足太阴，皆为关蛰，故上下同法。但视其太阴部中，皮内有浮络者，皆手足太阴之络也。
皮络之邪过盛，则入客于经，凡络盛客经，言从络脉而至于经脉，以明络脉之部，即经脉之部也。
凡十二经络脉者，皮之部也。
通承上文而言手足三阳三阴。凡十二经络脉者，在于通体，而为皮之部也。此一节，言手足三阳
三阴，十二经络之脉，皆在于皮，以皮部而知经络，即以经络而分皮部也。
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。
中，去声。部有左右上下、复有外内浅深。是故百病之始生也，必先于皮毛。由皮毛而入于腠理。
故邪中之，则腠理开。由腠理而入于络脉，故开则入客于络脉。由络脉而入于经脉，故留而不
去，传入于经。由经脉而入于腑，故留而不去，传入于腑。肠胃为
土腑，万物之所归，故廪于肠胃。廪，仓廪，言聚藏也。
邪之入于皮也，溯然起毫毛，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，则筋施骨消，闪烁 破，毛直而败。
复从上文之意而推论之，又言邪之始入于皮也。溯然起毫毛，由毫毛而入于腠理，故开腠理。其从腠
理而入于络也，则络脉盛而色变。其从络脉而入客于经也，则感经脉之虚，而邪乃陷下。其从
经脉而不入于腑则伤脏气。留于筋骨之间，寒多则筋挛骨痛，热多则筋施骨消，甚至虚于内而绝于外，闪烁
破，腠理绝矣，毛直而败，皮毛绝矣。毛内筋骨，脏气主之，此言从皮毛而入脏也。
帝曰∶夫子言皮之十二部，其生病，皆何如？
伯言十二经络脉者，皮之部也，故问皮之十二部，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。
经脉络脉之部，皆在于皮。故皮者，脉之部也。邪客于皮，则腠理开，腠理开，则邪入客于络脉。络脉
满，则邪注于经脉。经脉满，则邪入舍于腑脏也。是知病之生也，始于皮毛，各从其部由浅入深，而舍于腑脏也。
故皮者有分部，不与，而生大病也。
与，去声。此后申明生病之意。腑脏之气，通于皮中，故皮者各有分部。若腑脏之气，不与
于皮，而生大病也。
帝曰∶善。
部有左右上下，复有外内浅深，而皮部之邪，入腑入脏。腑脏之气，出于皮中，帝故
善之。此一节，言皮部有皮毛腠理络脉经脉
之浅深，而腑脏之气，皆当于皮部也。
The Pi-Part (Skin Regions) refers to the twelve divisions of the skin. The meridians of the Hand and Foot Three-Yang and Three-Yin channels all reside within the skin, each having its specific division. Therefore, it is said that the meridians of the twelve channels are the divisions of the skin. These divisions have distinctions of left and right, upper and lower, as well as exterior and interior, superficial and deep. The onset of various diseases first occurs in the hair and skin, then passes from the skin into the Couli (interstices of the skin and muscles), from the Couli into the Luo-Collaterals, from the Luo-Collaterals into the Jing-Meridians, and from the Jing-Meridians into the Zang-Fu organs. The Qi of the Zang-Fu organs also communicates with the skin and has corresponding divisions; if the Qi of the Zang-Fu organs does not communicate with the skin, severe diseases will arise.
Yellow Emperor asked: I have heard that the skin has divisions, the pulse has a system, the sinews have knots and connections, and the bones have measurements. The diseases they produce are different. I wish to know how to distinguish these divisions, their locations on the left, right, upper, and lower, their Yin and Yang positions, and the beginning and end of diseases. Please explain the principles involved.
Gao Shizong commented: "Liang" (measure) is pronounced with the level tone. "Bie" (distinguish) is pronounced like "bi". The skin governs the whole body and is divided among the meridians, each having its own region, hence the skin has divisions. The vascular pathways of the body have straight-running Jing-Meridians and horizontally running Luo-Collaterals as their framework, hence the pulse has a system. As stated in *Ling Shu: Jing Jin* (Meridian Sinews), sinews have knots at certain points and connections in between, hence sinews have knots and connections. Bones vary in length and cannot be measured by standard rulers alone, hence bones have measurements. Since the diseases arising from the skin, pulse, sinews, and bones differ, the resulting pathologies are distinct. All these require distinguishing their divisions, left/right, upper/lower, and Yin/Yang locations to understand the progression of disease, which is why this question was raised.
Qi Bo replied: To understand the Pi-Part, one should take the Jing-Meridians as the framework; this applies to all channels.
Since the skin has divisions, it is divided according to the meridians. Thus, to understand the Pi-Part, taking the Jing-Meridians as the framework applies to all twelve channels. "Zhu" here refers to the twelve channels.
The Yang aspect of the Yangming channel is named "Hai Fei" (Harmful Flight/Openness). The methods for the hand and foot are the same. Observe any floating Luo-Collaterals within the Yangming region; these are all collaterals of the Yangming channel. If the color is predominantly blue/green, there is pain; if black, Bi syndrome (obstruction); if yellow/red, heat; if white, cold. If all five colors appear, it indicates alternating cold and heat. When the collateral Qi is excessive, it invades and resides in the Jing-Meridian. Yang governs the exterior, and Yin governs the interior.
Gao Shizong commented: "Fei" is identical to "Fei" (fly/fly away). The Qi of the Jing-Meridian moves from the interior to the exterior, passing through He (closing) to Shu (pivot), and finally to Kai (opening). Thus, the discussion begins with Yangming's He, followed by Shaoyang's Shu, and concludes with Taiyang's Kai. The Yang of Yangming travels along the anterior aspect of the body and governs He (closing). He means not opening; if it harms openness (Fei), it is named Hai Fei. "Fei" implies opening. There is no distinction between hand and foot; both are called Hai Fei, so the method is the same for both. One need only observe the floating Luo-Collaterals within the skin of the Yangming region; these are the collaterals of the Hand and Foot Yangming channels. Regarding the color of these floating collaterals: predominantly blue/green indicates pain; black indicates obstruction; yellow/red indicates heat; white indicates cold. If all five colors are present, cold and heat coexist. When the pathogenic factor in the skin collaterals becomes excessive, it invades the Jing-Meridian. This is because collaterals belong to Yang and govern the exterior, while meridians belong to Yin and govern the interior.
The Yang aspect of the Shaoyang channel is named "Shu Chi" (Pivot Holding). The methods for the hand and foot are the same. Observe any floating Luo-Collaterals within the Shaoyang region; these are all collaterals of the Shaoyang channel. When the collateral Qi is excessive, it invades and resides in the Jing-Meridian. Therefore, what is in the Yang aspect governs entry inward, and what is in the Yin aspect governs exit outward, allowing penetration into the interior. This applies to all channels.
Gao Shizong commented: The Yang of Shaoyang travels along the lateral aspect of the body and governs Shu (pivot), hence it is named Shu Chi. "Chi" means to hold or govern. There is no distinction between hand and foot; both are called Shu Chi, so the method is the same for both. One need only observe the floating Luo-Collaterals within the skin of the Shaoyang region; these are the collaterals of the Hand and Foot Shaoyang channels. When the pathogenic factor in the skin region becomes excessive, it invades the Jing-Meridian. Collaterals belong to Yang and govern the exterior. When excessive collateral Qi invades the meridian, Yang Qi enters inward; thus, what is in the Yang aspect governs inward movement. Meridians belong to Yin and govern the interior. When Yang Qi enters inward, Yin Qi moves outward; thus, what is in the Yin aspect governs outward movement. Exiting and re-entering allows penetration into the interior. This dynamic of Yin and Yang meridians moving in and out applies not only to the Hand and Foot Shaoyang but to all channels.
The Yang aspect of the Taiyang channel is named "Guan Shu" (Gate Pivot). The methods for the hand and foot are the same. Observe any floating Luo-Collaterals within the Taiyang region; these are all collaterals of the Taiyang channel. When the collateral Qi is excessive, it invades and resides in the Jing-Meridian.
Gao Shizong commented: The Yang of Taiyang travels along the posterior aspect of the body and governs Kai (opening), hence it is named Guan Shu. "Guan" means to tie or connect. The pivot turns to open, and the opening is connected to the pivot. There is no distinction between hand and foot; both are called Guan Shu, so the method is the same for both. One need only observe the floating Luo-Collaterals within the skin of the Taiyang region; these are the collaterals of the Hand and Foot Taiyang channels. When the pathogenic factor in the skin collaterals becomes excessive, it invades the Jing-Meridian.
The Yin aspect of the Shaoyin channel is named "Shu Ru" (Pivot Separation). The methods for the hand and foot are the same. Observe any floating Luo-Collaterals within the Shaoyin region; these are all collaterals of the Shaoyin channel. When the collateral Qi is excessive, it invades and resides in the Jing-Meridian. Upon entering the meridian, it flows from the Yang aspect into the meridian; upon exiting, it flows from the Yin interior into the bones.
Gao Shizong commented: The Qi of the Jing-Meridians has both Yin and Yang aspects, governed by the Shu (pivot). Thus, the discussion addresses Shaoyin's Shu first, then Jueyin's He, and finally Taiyin's Kai. The Yin of Shaoyin ascends and stops in the chest, pivoting the Shen-Ji (spiritual mechanism) to distinguish water and fire, hence it is named Shu Ru. "Ru" means separation or distinction. Both Hand and Foot Shaoyin are called Shu Ru, so the method is the same for both. One need only observe the floating Luo-Collaterals within the skin of the Shaoyin region; these are the collaterals of the Hand and Foot Shaoyin channels. When the pathogenic factor in the skin collaterals becomes excessive, it invades the Jing-Meridian. Upon entering the meridian, it flows from the Yang aspect of the floating collaterals into the meridian; where there is entry, there is exit. Upon exiting, since Shaoyin is internal, it flows from the interior of Zhiyin (Supreme Yin) into the bones before emerging.
The Yin aspect of the Xin-Zhu (Heart Master/Pericardium) is named "Hai Jian" (Harmful Shoulder/Burden). The methods for the hand and foot are the same. Observe any floating Luo-Collaterals within the Xin-Zhu region; these are all collaterals of the Xin-Zhu. When the collateral Qi is excessive, it invades and resides in the Jing-Meridian.
Gao Shizong commented: Xin-Zhu refers to the Hand Jueyin Pericardium. There is no distinction between hand and foot; the method is the same for both, so the Hand Jueyin is cited for illustration. The Yin of the Heart Master originates in the chest and governs He (closing). Because He prevents external bearing, it is named Hai Jian. "Jian" means to bear or carry. Both Hand and Foot Jueyin are called Hai Jian, so the method is the same for both. One need only observe the floating Luo-Collaterals within the skin of the Xin-Zhu region; these are the collaterals of the Xin-Zhu. This shows that Foot Jueyin is consistent with Hand Jueyin. When the pathogenic factor in the skin collaterals becomes excessive, it invades the Jing-Meridian.
The Yin aspect of the Taiyin channel is named "Guan Zhe" (Gate Hibernation/Storage). The methods for the hand and foot are the same. Observe any floating Luo-Collaterals within the Taiyin region; these are all collaterals of the Taiyin channel. When the collateral Qi is excessive, it invades and resides in the Jing-Meridian.
Gao Shizong commented: The Yin of Taiyin follows the leg and calf, crosses anterior to Jueyin, and governs Kai (opening), hence it is named Guan Zhe. "Zhe" means storage or hibernation. Storage precedes opening, and the opening is connected to storage. Both Hand and Foot Taiyin are called Guan Zhe, so the method is the same for both. One need only observe the floating Luo-Collaterals within the skin of the Taiyin region; these are the collaterals of the Hand and Foot Taiyin channels. When the pathogenic factor in the skin collaterals becomes excessive, it invades the Jing-Meridian. Whenever excessive collateral Qi invades the meridian, it signifies movement from the Luo-Collateral to the Jing-Meridian, clarifying that the division of the Luo-Collateral is the same as that of the Jing-Meridian.
In summary, the meridians of the twelve channels are the divisions of the skin.
Gao Shizong commented: This continues the discussion of the Hand and Foot Three-Yang and Three-Yin. The meridians of the twelve channels are distributed throughout the body and serve as the divisions of the skin. This section explains that the meridians of the Hand and Foot Three-Yang and Three-Yin reside in the skin; one can know the meridians through the skin regions and divide the skin regions through the meridians.
Therefore, when various diseases begin, they must first affect the hair and skin. When pathogenic factors attack, the Couli open; once open, the pathogens invade and reside in the Luo-Collaterals. If they remain without departing, they transmit into the Jing-Meridians. If they remain in the meridians without departing, they transmit into the Fu organs, eventually accumulating in the intestines and stomach.
Gao Shizong commented: "Zhong" (attack/infect) is pronounced with the falling tone. Divisions have left/right, upper/lower, and exterior/interior, superficial/deep distinctions. Therefore, when diseases begin, they first affect the hair and skin. From the skin, they enter the Couli. Thus, when pathogens attack, the Couli open. From the Couli, they enter the Luo-Collaterals; hence, when the Couli open, pathogens invade the collaterals. From the collaterals, they enter the Jing-Meridians; hence, if they remain, they transmit to the meridians. From the meridians, they enter the Fu organs; hence, if they remain, they transmit to the Fu organs. The intestines and stomach are Earth Fu organs, the gathering place of all things, so pathogens accumulate there. "Lin" means granary, indicating accumulation and storage.
When pathogenic factors enter the skin, the lanugo rises, and the Couli open; when they enter the collaterals, the collaterals become full and the color changes; when they invade the Jing-Meridians, they encounter deficiency and sink downward; when they remain between the sinews and bones, excess cold causes sinew spasms and bone pain, while excess heat causes sinew flaccidity and bone wasting, even leading to muscle ulceration and breakdown, with lanugo becoming stiff and failing.
Gao Shizong commented: Further deducing from the previous text, when pathogens initially enter the skin, the lanugo rises, leading to the opening of the Couli. Entering from the Couli into the collaterals causes the collaterals to become full and change color. Entering from the collaterals into the Jing-Meridians involves encountering meridian deficiency, causing the pathogens to sink. If they do not enter the Fu organs from the meridians, they damage Zang Qi. Remaining between sinews and bones, excess cold causes spasms and pain, while excess heat causes flaccidity and wasting. Eventually, internal deficiency leads to external severance, muscle ulceration, severance of the Couli, and failure of the lanugo, indicating the severance of hair and skin. Lanugo, interior, sinews, bones, and Zang Qi are governed by the Zang organs; this describes the transmission of pathogens from the skin/hair to the Zang organs.
The Yellow Emperor said: You spoke of the twelve divisions of the skin. What kind of diseases do they produce?
Qi Bo stated that the meridians of the twelve channels are the divisions of the skin, so the question asks about the diseases produced by the twelve divisions of the skin.
Qi Bo answered: The skin is the division of the pulses. When pathogens reside in the skin, the Couli open; once open, the pathogens invade and reside in the Luo-Collaterals. When the collaterals are full, the pathogens flow into the Jing-Meridians. When the meridians are full, the pathogens enter and reside in the Zang-Fu organs.
Gao Shizong commented: The divisions of the Jing-Meridians and Luo-Collaterals are all within the skin. Hence, the skin is the division of the pulses. When pathogens reside in the skin, the Couli open; once open, pathogens invade the collaterals. When collaterals are full, pathogens flow into the meridians. When meridians are full, pathogens enter and reside in the Zang-Fu organs. Thus, we know that disease onset begins in the hair and skin, progressing from superficial to deep according to their divisions, until residing in the Zang-Fu organs.
Therefore, the skin has divisions. If [the Zang-Fu Qi] does not interact with them, severe diseases will arise.
Gao Shizong commented: "Yu" (interact/participate) is pronounced with the falling tone. This further explains the pathology. The Qi of the Zang-Fu organs communicates with the skin, so the skin has specific divisions. If the Qi of the Zang-Fu organs does not communicate with the skin, severe diseases will arise.
The Yellow Emperor said: Excellent.
Gao Shizong commented: Divisions have left/right, upper/lower, and exterior/interior, superficial/deep distinctions, and pathogens in the skin region can enter the Fu and Zang organs. The Qi of the Zang-Fu organs emerges from the skin. Therefore, the Yellow Emperor approved. This section explains that the skin region has layers of depth including hair/skin, Couli, Luo-Collaterals, and Jing-Meridians, and the Qi of the Zang-Fu organs should be reflected in the skin region.