条文:
张介宾曰:心包一脏,「难经」言其无形。
滑寿曰:心包一名手心主,以脏象校之,在心下横膜之上,竖膜之下,
其与横膜相粘,而黄脂裹者心也,脂_之外,有细筋膜如丝,
与心肺相连者,心包也,
此说为是,凡言无形者非。
「灵兰秘典论」有:十二官,独少心包一官,而有膻中者,臣使之官,
喜乐出焉二句。
今考心包,脏居膈上,经始胸中,正值膻中之所,位居相火,代君行事,
实臣使也,此一官即此经之谓欤(图五十九)。
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条文:
手厥阴心主包络之脉,起于胸中,出属心包络,下膈历络三焦;
其支者,循胸中出胁下腋三寸,上抵腋下,循臑内,行太阴少阴之间,
入肘中,下臂行两筋之间,入掌中,循中指出其端;
其支者,别掌中循小指次指出其端(见图六○)。
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条文:
手厥阴心主起胸,属包下膈三焦宫,支者循胸出胁下,胁下连腋三寸同,
仍上抵腋循臑内,太阴少阴两经中,指透中冲支者别,小指次指终相通。
注:[1]手厥阴心包络之脉,起于胸中,出而外行天池穴,属心包络之经也。
[2]内行下膈,历络三焦者,散布于腹之上、中、下也。
[3]其支者,循胸中出腋下三寸,即天池穴处也。
[4]从天池循臑内至天泉,从天泉穴行手太阴、手少阴两脉之间,
入肘内曲泽穴,下臂行两筋之间,□门、间使、内关、大陵四穴,
入掌中劳宫穴,从劳宫循中指出其端,中冲穴也。
[5]其本支之别支,别行掌中,循小指次指之端,
以交于手少阳三焦经也。
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滑寿说:心包又名手心主,根据脏象理论来考察,它位于心脏下方横膈膜之上、竖膈膜之下,与横膈膜粘连并被黄色脂肪包裹的是心脏;而在脂肪之外,有像丝一样的细筋膜,与心肺相连的,就是心包。这种说法是正确的,凡是说心包无形的人是不对的。《灵枢·灵兰秘典论》中提到:“十二官”中唯独缺少心包这一官职,却有一句关于“膻中者,臣使之官,喜乐出焉”的描述。现在考证心包,其脏器居于膈肌之上,经脉起始于胸中,正好位于膻中所在的位置,位居相火(寄居在命门之火中的少阳之火),代替君主(心脏)行使职权,确实是臣使之官,这一官职指的就是这条经脉吧(见图五十九)。
手厥阴心主包络的经脉,起始于胸中,向外归属于心包络,向下穿过膈肌,依次联络上、中、下三焦;它的分支,沿着胸中走出胁部,下行至腋下三寸处,向上到达腋下,沿着上臂内侧行走,行走在手太阴肺经和手少阴心经之间,进入肘窝中,向下沿前臂行走于两条肌腱之间,进入手掌心中,沿着中指直达其末端;另一分支,从掌中分出,沿着无名指直达其末端(见图六〇)。
手厥阴心主经脉起始于胸部,归属心包,下行通过膈肌联系三焦宫府;分支沿着胸中走出胁部,胁下连接腋下三寸处相同位置,仍然向上到达腋下,沿着上臂内侧行走,处于手太阴和手少阴两条经脉中间,手指透出中冲穴为分支所别,小指次指(无名指)端最终相通。
注:[1] 手厥阴心包络的经脉,起始于胸中,外出而外行经过天池穴,属于心包络的经脉。
[2] 内行部分向下穿过膈肌,依次联络三焦,是散布于腹部的上、中、下三个部位。
[3] 它的分支,沿着胸中走出腋下三寸处,即天池穴的位置。
[4] 从天池穴沿着上臂内侧行至天泉穴,从天泉穴行走在手太阴、手少阴两脉之间,进入肘内曲泽穴,向下沿前臂行走于两条肌腱之间,经过郄门、间使、内关、大陵四穴,进入手掌中劳宫穴,从劳宫穴沿着中指直达其末端,即中冲穴。
[5] 其主干分支的另一支,另起于掌中,沿着无名指的末端行走,以交接手少阳三焦经。
Zhang Jiebin stated: Regarding the Pericardium (Xinbao), a zang organ, the *Nan Jing* (Classic of Difficult Issues) describes it as formless.
Hua Shou stated: The Pericardium is also known as the Hand-Shaoyin Master of the Heart (Shouxin Zhu). Based on Zang-Xiang (visceral manifestation) theory, it is located above the horizontal diaphragm and below the vertical diaphragm. The organ adhering to the horizontal diaphragm and wrapped in yellow fat is the Heart; outside this fat, there are fine fibrous membranes like silk connecting with the Heart and Lungs, which constitute the Pericardium. This explanation is correct, whereas those claiming it is formless are incorrect. In the *Ling Lan Mi Dian Lun* (Secret Canon of the Spiritual Orchid), among the "Twelve Officials," the Pericardium official is missing, yet there is a description regarding the Danzhong (Chest Center): "The Danzhong is the Official of the Envoy, from whom joy and pleasure emanate." Upon examination, the Pericardium organ resides above the diaphragm, and its meridian begins in the chest, precisely at the location of the Danzhong. Occupying the position of Ministerial Fire (Xiang Huo), it acts on behalf of the Sovereign (the Heart), truly serving as an envoy. Does this official refer to this meridian? (See Figure 59).
The meridian of the Hand-Jueyin Heart-Master Pericardium originates in the chest, emerges to connect with the Pericardium, descends through the diaphragm, and successively links with the Triple Burner (Sanjiao); its branch follows the chest, emerges to the hypochondrium, descends three cun below the axilla, ascends to reach the axilla, runs along the medial aspect of the upper arm, traveling between the Taiyin and Shaoyin meridians, enters the elbow, descends along the forearm between two tendons, enters the palm, and follows the middle finger to its tip; another branch diverges from the palm, follows the ring finger to its tip (see Figure 60).
The Hand-Jueyin Heart-Master meridian originates in the chest, connects to the Pericardium, and descends through the diaphragm to the Triple Burner palace; its branch follows the chest, emerges to the hypochondrium, connecting to the same position three cun below the axilla; still ascending to the axilla, it runs along the medial upper arm, situated between the Taiyin and Shaoyin meridians; the finger penetrates Zhongchong (PC9) where the branch diverges, and the ring finger's end ultimately connects.
Note: [1] The meridian of the Hand-Jueyin Pericardium originates in the chest, emerges externally passing through Tianchi (TE16), belonging to the Pericardium meridian.
[2] The internal path descends through the diaphragm, successively linking the Triple Burner, distributing throughout the upper, middle, and lower abdomen.
[3] Its branch follows the chest, emerging three cun below the axilla, which is the location of Tianchi (TE16).
[4] From Tianchi, following the medial upper arm to Tianquan (PC10), then running between the Hand-Taiyin and Hand-Shaoyin meridians, entering Quze (PC3) within the elbow, descending along the forearm between two tendons, passing through Ximen (PC4), Jianshi (PC5), Neiguan (PC6), and Daling (PC7), entering the palm at Laogong (PC8), following the middle finger to its tip, which is Zhongchong (PC9).
[5] A separate branch from the main trunk diverges in the palm, follows the tip of the ring finger, and connects with the Hand-Shaoyang Triple Burner meridian.