奇经八脉，其诊又别。直上直下，浮则为督，
牢则为冲，紧则任脉。寸左右弹，阳跷可决。
尺左右弹，阴跷可别。关左右弹，带脉当诀。
尺外斜上，至寸阴维。尺内斜上，至寸阳维。
督脉为病，脊强癫痫。任脉为病，七疝瘕坚。
冲脉为病，逆气里急。带主带下，脐痛精失。
阳维寒热，目眩僵仆。阴维心痛，胸胁刺筑。
阳跷为病，阴缓阳急。阴跷为病，阳缓阴急。
癫痫螈 ，寒热恍惚。八脉脉证，各有所属。
奇经八脉者，在十二经脉之外，无脏腑与之配偶，故曰奇。夫脏腑之脉，寸、
关、尺有定位；（左寸心、小肠，右寸肺、大肠，左关肝、胆，右关脾、胃，左尺肾、膀胱，右尺命
门、三焦。）浮、中、沉有定体；（《难经》以三菽、六菽、九菽、十二菽按之至骨，分肺、心、脾、
肝、肾。）弦、钩、毛、石有定形。（春弦肝木，夏钩心火，秋毛肺金，冬石肾水。）此则另为一脉，形
状固异，而隧道亦殊。病证不同，而延医自别。盖督、任、冲三脉皆起于胞中，一源而三派。督行于背，
总督诸阳。任行于腹，总督诸阴。冲则后行于背，前行于腹，上行于头，下行于足，以
至溪谷肌肉，无处不到，诚十二经内外上下之要冲也。故《灵枢》顺逆肥瘦篇曰∶
冲脉者，五脏六腑之海也，五脏六腑皆禀焉。二脉直行上下，发源最中，故见于脉，
亦皆直上直下也。直上直下者，即三部俱长透之义。若直上下而浮，则气张扬，阳
象也，故属督。若直上下而紧，则势敛束，阴象也，故属任。若直上下而牢，则体
坚实，有余之象也，故属冲。阳跷、阴跷者，皆起于足跟。人身之超越矫捷者，亦
莫过于足跟，故曰跷。一则为足太阳之别，循外踝上行，入风池，合于太阳，故名
阳跷。一则为足少阴之别，循内踝上行，至咽喉，交贯冲脉，故名阴跷。寸以候阳，
寸左右弹者，言在寸左右，皆有弹石搏手之势，是阳跷脉也。尺以候阴，尺左右
弹者，言在尺左右，皆有弹石搏手之势，是阴跷脉也。二经之起，以踝之内外分阴
阳者，外踝属太阳，而内踝属少阴也。二经之脉，以尺寸分阴阳者，以阳跷入风池，
合太阳至头，故以寸候之。阴跷合少阴而不至头，故以尺候之也。带脉者，围身一
周，不上不下，如束带然。故弹搏之脉，惟见于左、右中关耳。阳维、阴维者，维
持一身。阳维维阳，起于诸阳之会。阴维维阴，起于诸阴之交。夫人身经脉繁密，
二脉能于阴交阳会处，加一扎缚，举纲齐目，而阴阳斯得维持之力矣。其见于脉，
自尺至寸，皆刺斜而上。阴则自外入内，阳则自内出外。盖其经亦皆自下而起，阳
自外踝，出肩至脑，阴自内踝，入腹至喉故也。此八经之脉状，病则见，不病则不
见。《难经》二十八难曰∶人脉隆盛，入于八脉而不环周，故十二经亦不能拘之。不
能拘之者，谓十二经不能拘此八脉在环周之内。然而八脉之元元，已寓于十二经中
矣。故平和不病，则不见也。其脉曰浮、曰牢、曰紧、曰左右弹、曰斜上，虽皆各
因其阴阳道路呈象，而脉状则俱似有邪而实者。本难云∶蓄则砭射，良有以哉。其
病督脉脊强癫痫者，盖督脉起于少腹以下骨中央。女子入系庭孔之端，终阴器，绕
篡，绕臀，至少阴，与太阳、少阴合，入股内，贯脊，属肾，与太阳起目内 ，上
额交巅，上入络脑，还出，别下项，循肩膊内，夹脊，抵腰中，入循膂，络肾。（自
目内 上额，下循膂络肾，皆合太阳而并行者也。）其男子循茎下至篡，与女子等。其少腹直上者，
贯脐中央，上贯心，入喉，上颐，环唇，上系两目之下中央。其脉之别，名曰长强，
挟脊上项，散上头，下当肩胛，左右别走太阳，入贯臀。二十八难亦曰∶督脉者，
起于下极之俞，并于脊里，上至风府，入属于脑。由是观之，则督脉与太阳合行者
十九，故邪客则脊强，以其贯脊也。督与太阳皆主表，而督为诸阳之总。太阳为诸
阳之长，又曰巨阳。风邪从类伤阳，表必先受，故留则为癫痫疾也。癫痫时发时止，
或筋脉牵引，或项背反张，虽云风伤督脉，亦太阳主筋故耳。（宜羌活胜湿汤、生铁落饮、泻
青丸之类。）任脉为病，七疝瘕坚者。盖任脉总诸阴之会，其脉起于胞中，循腹里，为
经络之海。其浮而外者，循腹里，上行于咽喉，别而络唇口。《难经》亦云∶起于中
极之下，以上毛际，循腹里，上关元，至咽喉。七疝者，在巢氏则曰厥疝、 疝、
寒疝、气疝、盘疝、 疝、野狼疝。张子和非之，另立七名。曰∶寒疝、水疝、筋疝、
血疝、气疝、狐疝、 疝。而诸经之载，如《素问》四时刺逆从论所云狐疝风、肺
风疝、脾风疝、心风疝、肾风疝、肝风疝。骨空论所云冲疝。脉解篇所云 疝。玉
机真藏论所云疝瘕，少腹冤热而痛，出白，一名曰蛊。《灵枢》邪气脏腑病形篇所
云∶小肠病者，小腹痛，腰脊控睾而痛，时窘之后。此亦疝类也。名虽多种，总不
能出于七疝之外。盖七疝之发，必在前阴、少腹之间，任脉所经之地。虽属他经，
未有不以任为原者。瘕者，假也。气聚则坚，气散则平。亦似疝之时作时止，发则
亦在任脉界分，多属血凝经滞，女子之病也。（宜东垣丁香楝实丸、三因散聚汤、化气汤之类。）冲
脉为病，逆气里急者。冲之与任皆起胞中，上循背里，为经络之海，亦名血海。其
浮而外者，亦循腹上行，会于咽喉，别而络唇口，强半与任脉同。《素问》骨空论曰∶
冲脉者，起于气街，并足少阴之经，挟脐上行，至胸中而散。二十八难则曰∶起
于气冲，并足阳明之经，挟脐上行，至胸中而散。痿论亦曰∶冲脉者，经脉之海，
主渗灌溪谷，与阳明合于宗筋。二论所并，虽有少阴、阳明之不同，要知自脐至胸，
与阳明则并于前，与少阴则并于后也，故与阳明皆得称为五脏六腑之海。其气不顺，
血不和，则胸腹之气循经壅逆而里急矣。（宜苏子降气汤、黑锡丹、震灵丹之类。）带脉为病，带
下脐痛精失者，以带脉起于季胁，回身如带，脏腑十二经络皆过于此。若饮食不节，
劳欲纵伤，致令湿热下流，邪火内郁。外或风入胞宫；邪凝脐腹。带脉不任，与邪
俱陷。或赤或白，如涕如脓。或青黄杂色，或浊黑异形。溢漏不时，淋沥不净。其
兼证，则腰腹 疼，足膝痿软，头目晕眩，经脉参差。甚或寒热往来，容颜枯瘁。
然而发源于冲、任、脾胃者多，以冲为血海，任总诸阴，脾胃司水谷故耳。是以骨
空论曰∶任脉为病，女子带下瘕聚。又痿论曰∶冲脉与阳明合于宗筋之会，而阳明
为之长，皆属于带脉。带脉起于季胁章门，前则当脐上，故又或为脐痛。《灵枢》经
别篇曰∶肾足少阴，当十四椎，出属带脉。盖肾主藏精，带固腰膂，虚则一不能藏，
一不能固，而精有自失者矣。（宜金匮桂枝龙骨牡蛎汤、和剂威喜丸之类。）阳维为病，寒热、目眩、
僵仆者，以阳维维络一身之阳，阳主卫，主气、主表，病则不能维阳，是阳无护持，
而卫气亦因之不固，故在表则生寒热。其脉气所发，别于金门，（在足太阳外踝下）以阳交为
，（足少阳外踝上。）与手、足太阳及跷脉会于 俞，（手太阳肩后。）与手、足少阳会于天 ，
（手少阳缺盆上。）又会于肩井（足少阳肩上。）其在头也，与足少阳会于阳白（足少阳眉上，）
上于本神及临泣，（俱在足少阳眉上。）上至正营（足少阳目窗上。）及脑空，（足少阳枕骨下。）
下至风池，（足少阳颞 后。）与督脉会于风府、（督脉后发际。）哑门。（督脉风府后。）观此，
则知本脉之维于头目手足
颈项肩背诸阳，无一不到。其脉不荣，则不能维。在头目，无维则眩。在颈项肩背，
无维则僵。在手足，无维则仆矣。（宜东垣柴胡升阳汤、东垣退热汤之类。）阴维为病，心痛、胸
腹刺筑者，以阴维维络一身之阴。阴主荣、主里，不能维阴则阴无约束，而荣气因
之不和，故在里则心痛。又荣主血，血合心，故心痛也。其脉气所发，阴维之 名
曰筑宾，（足少阴内踝上）与足太阴会于腹哀、（足太阴乳下。）大横，（足太阴腹哀下。）又与足太阴会
于府舍、（足太阴少腹下、）期门，（足厥阴乳下。）与任脉会于天突、（任脉喉下。）廉泉。（任
脉舌本下。）观此，则知本脉之维于胸腹诸阴，亦无一不到。其脉不荣，则不能维。在胸胁失所
维，则动筑而刺痛矣。（宜本事枳实散、奇效拈痛丸、四七汤之类。）阳跷为病，阴缓阳急。阴跷为
病，阳缓阴急，及癫痫螈 ，寒热恍惚者，盖二跷之脉，同发一源。《难经》二十八
难曰∶阳跷脉起于跟中，阴跷脉亦起于跟中，不唯同起于根，而又同终于目。《灵
枢》脉度篇曰∶跷脉者，少阴之别。起于然谷之后，上内踝之上，直上循阴股，
入阴，上循胸里，入缺盆，上出人迎之前，入 ，属目内 ，合于太阳、阳跷而上
行。气并相还，则为濡目。（濡润荣养于目。）又曰∶男子数其阳，女子数其阴。当数者为
经，不当数者为络。观此，则知二跷之脉，虽以男女分阴阳，而实则迭为经络，是
一本也。故其为病，亦不似前六脉，逐经分属。本文以癫痫螈 ，寒热恍惚，总系
二经之下，以二经均可病此。证虽云四，而病机可分为八。阴阳缓急之义，自是显
然。夫人之身，背为阳，腹为阴。开为阳，阖为阴。外为阳，内为阴。热为阳，寒
为阴。癫则目闭俯首，阴急而阳缓也。痫则目直僵仆，阳急而阴缓也。大惑论所谓
卫气不得入于阴，常留于阳。留于阳则阳气满。阳气满则阳跷盛。不得入于阴则阴
气虚，故目不瞑。卫气留于阴，不得行于阳。留于阴则阴气盛，阴气盛则阴跷满。
不得入于阳则阳气虚，故目闭。脉度篇亦云∶跷之阴脉荣其脏，阳脉荣其腑。又云∶
内溉五脏，外濡腠理。又阴出阳，则交于足太阳。阳入阴，则交于足少阴。虽一为
太阳之别，一为少阴之别，而实则随卫气相终始者。故卫气之行留，即可征二跷之
虚盛。 者，挈也。筋脉挈向里拘，阴急而阳缓也。 者，纵也。筋脉纵从外弛，
阳急而阴缓也。寒则气收敛，从里从阴，阴急而阳缓也。热则气散漫，从表从阳，
阳急而阴缓也。恍者，目前恍然，若有所见。缪刺论曰∶邪客于足阳跷之脉，令人
目痛从内 始，且合太阳上行而并濡于目，病属目而从外。阳跷之病，阳急而阴缓
也。惚者，胸中 惚，若有所失。脉度篇曰∶跷脉者，少阴之别，起于然谷之后，
循阴股，入阴，上循胸里，入缺盆。二十八难曰∶阴跷脉者，亦起于跟中，循内踝
上行至咽喉，交贯冲脉，病属胸腹而从内。阴跷之病，阴急而阳缓也。二脉一为经，
一为络。病在经，则经急络缓。病在络，则经缓络急。总之，皆可言经，皆可言络，
但以男女分阴阳之所属，缓急证病邪之所在，而正文以诸证为二经所共，义良深矣。
（宜胃风汤、交加散、海藏愈风汤、加味逍遥散、十全大补汤之类。）
奇经八脉的诊察方法又有所不同。脉象直上直下，浮取为督脉（总督诸阳之脉），沉取坚实为冲脉（血海，十二经之海），紧束为任脉（总任诸阴之脉）。寸口脉左右弹指，可决断阳跷脉（主一身左右之阳）；尺部脉左右弹指，可辨别阴跷脉（主一身左右之阴）；关部脉左右弹指，可判断带脉（约束纵行诸脉）。脉象从尺部外侧斜向上行至寸部，为阴维脉（维系诸阴之脉）；从尺部内侧斜向上行至寸部，为阳维脉（维系诸阳之脉）。
督脉发病，表现为脊柱强直、癫痫。任脉发病，表现为七种疝气及腹内结块坚硬。冲脉发病，表现为气逆和腹部拘急。带脉发病，表现为带下病、脐痛和遗精失精。阳维脉发病，表现为寒热往来、目眩和突然僵倒。阴维脉发病，表现为心痛和胸胁刺痛筑痛。阳跷脉发病，表现为内侧肌肉松弛而外侧肌肉拘急。阴跷脉发病，表现为外侧肌肉松弛而内侧肌肉拘急。以及癫痫抽搐、寒热交替、神志恍惚等症状。奇经八脉的病证，各有其特定的归属。
所谓奇经八脉，是在十二经脉之外，没有脏腑与之配偶，所以称为“奇”。脏腑的经脉，在寸、关、尺三部有固定的定位：（左寸对应心与小肠，右寸对应肺与大肠，左关对应肝与胆，右关对应脾与胃，左尺对应肾与膀胱，右尺对应命门与三焦。）浮、中、沉三种按法有固定的体象：（《难经》以三菽、六菽、九菽、十二菽的重量按压至骨，分别对应肺、心、脾、肝、肾。）弦、钩、毛、石四种脉形有固定的形态。（春季脉弦属肝木，夏季脉钩属心火，秋季脉毛属肺金，冬季脉石属肾水。）而奇经八脉则是另一类脉，形状固然不同，经络隧道也殊异。病证不同，就医诊治自然有别。大概督、任、冲三脉都起于胞宫（子宫/精室），同源而三支分流。督脉行于背部，总督全身阳气。任脉行于腹部，总督全身阴气。冲脉则后行于背，前行于腹，上行于头，下行于足，直至溪谷肌肉，无处不到，确实是十二经脉内外上下的重要通道。所以《灵枢·顺逆肥瘦篇》说：冲脉是五脏六腑的海，五脏六腑都禀受于此。这两条脉（指督、任，或泛指直行之脉）直行上下，发源最深处，所以在脉象上也表现为直上直下。直上直下，即是指寸、关、尺三部都长而透达的意思。如果直上直下且浮，则气势张扬，属于阳象，所以归属于督脉。如果直上直下且紧，则气势收敛，属于阴象，所以归属于任脉。如果直上直下且牢（沉实有力），则形体坚实，属于有余之象，所以归属于冲脉。
阳跷脉和阴跷脉，都起于足跟。人体超越矫捷的动作，莫过于足跟，所以称为“跷”。其中一条是足太阳膀胱经的别支，循外踝上行，进入风池穴，合于太阳经，所以名叫阳跷。另一条是足少阴肾经的别支，循内踝上行，至咽喉，交贯冲脉，所以名叫阴跷。寸口候阳，寸口脉左右弹指的，是说在寸部左右，都有如弹石搏手之势，这是阳跷脉的征象。尺部候阴，尺部脉左右弹指的，是说在尺部左右，都有如弹石搏手之势，这是阴跷脉的征象。这两条经脉的起始，以外踝和内踝来分阴阳，是因为外踝属太阳经，内踝属少阴经。这两条经脉的脉象，以寸部和尺部来分阴阳，是因为阳跷脉入风池，合太阳经至头部，所以用寸部来候察它。阴跷脉合少阴经而不直达头部，所以用尺部来候察它。
带脉环绕身体一周，不上不下，像束带一样。所以弹搏有力的脉象，只见于左、右中部的关脉处。阳维脉和阴维脉，维持一身之气。阳维脉维系阳气，起于诸阳经交会之处。阴维脉维系阴气，起于诸阴经交会之处。人身经脉繁密，这两条脉能在阴交阳会的地方，加以扎缚，举纲齐目，从而使阴阳得到维持的力量。它们反映在脉象上，从尺部到寸部，都是刺斜而上行。阴维脉是从外入内斜上，阳维脉是从内出外斜上。大概它们的经脉也都是自下而起，阳维脉自外踝出发，经过肩部至脑部；阴维脉自内踝出发，进入腹部至喉部。这八条经脉的脉状，有病时出现，无病时不出现。《难经·二十八难》说：人脉气隆盛，进入八脉而不环周运行，所以十二经脉也不能拘束它们。不能拘束它们，是说十二经脉不能将八脉拘束在环周运行的范围内。然而八脉的元气，已经蕴含在十二经中了。所以平和无病时，就不显现出来。它们的脉象叫做浮、牢、紧、左右弹、斜上，虽然都各自因其阴阳道路呈现形象，但脉状看起来都像是有邪气而实证。本难经说：蓄积则可砭射，确实是有道理的。
督脉发病，脊柱强直、癫痫，大概是因为督脉起于小腹以下骨中央。女子进入廷孔（尿道口/阴道口）之端，终止于阴器，环绕篡部（肛门），环绕臀部，至少阴经，与太阳经、少阴经汇合，入股内，贯穿脊柱，属肾，与太阳经起于目内眦，上额交巅顶，上入络脑，复出，别向下项，循肩膊内，夹脊，抵腰中，入循膂（脊旁肌肉），络肾。（自目内眦上额，下循膂络肾，都是合太阳经并行。）男子则循茎部下至篡部，与女子相同。其少腹直上的分支，贯穿脐中央，上贯心，入喉，上颐，环唇，上系两目之下中央。其脉的别支，名叫长强，挟脊上项，散上头，下当肩胛，左右别走太阳经，入贯臀。《难经·二十八难》也说：督脉起于下极之俞（长强穴），并于脊里，上至风府，入属于脑。由此看来，督脉与太阳经并行的部分占十九，所以邪气客居则脊柱强直，因为它贯穿脊柱。督脉与太阳经都主表，而督脉是诸阳之总。太阳经是诸阳之长，又叫巨阳。风邪同类相伤阳气，表必先受邪，所以停留则为癫痫疾。癫痫时发时止，或筋脉牵引，或项背反张，虽然说风伤督脉，也是由于太阳经主筋的缘故。（适宜用羌活胜湿汤、生铁落饮、泻青丸之类。）
任脉发病，七种疝气和瘕坚，大概是因为任脉总汇诸阴之会，其脉起于胞中，循腹里，为经络之海。其浮而外的部分，循腹里，上行于咽喉，别而络唇口。《难经》也说：起于中极之下，以上毛际，循腹里，上关元，至咽喉。七疝，在巢元方的书中说是厥疝、睪疝、寒疝、气疝、盘疝、附疝、野狼疝。张子和对此非议，另立七个名字。说是：寒疝、水疝、筋疝、血疝、气疝、狐疝、㿗疝。而各经记载，如《素问·四时刺逆从论》所说狐疝风、肺风疝、脾风疝、心风疝、肾风疝、肝风疝。《骨空论》所说冲疝。《脉解篇》所说㿗疝。《玉机真藏论》所说疝瘕，小腹胀痛冤热而出白浊，一名蛊。《灵枢·邪气脏腑病形篇》所说：小肠病者，小腹痛，腰脊控睾而痛，时窘之后。这也属于疝类。名称虽多，总不能超出七疝的范围。大概七疝发作，必在前阴、少腹之间，这是任脉所经过的地方。虽然属于其他经脉，没有不以任脉为原发的。瘕，是假的意思。气聚则坚硬，气散则平复。也像疝气那样时作时止，发作时也在任脉界分，多属于血凝经滞，是女子的病。（适宜用东垣丁香楝实丸、三因散聚汤、化气汤之类。）
冲脉发病，气逆里急。冲脉与任脉都起于胞中，上循背里，为经络之海，也叫血海。其浮而外的部分，也循腹上行，会于咽喉，别而络唇口，大半与任脉相同。《素问·骨空论》说：冲脉起于气街，并足少阴之经，挟脐上行，至胸中而散。《难经·二十八难》则说：起于气冲，并足阳明之经，挟脐上行，至胸中而散。《痿论》也说：冲脉是经脉之海，主渗灌溪谷，与阳明经合于宗筋。两论所述并行之经，虽有少阴、阳明之不同，要知道自脐至胸，与阳明经则并于前，与少阴经则并于后，所以与阳明经都得以称为五脏六腑之海。其气不顺，血不和，则胸腹之气循经壅逆而里急。（适宜用苏子降气汤、黑锡丹、震灵丹之类。）
带脉发病，带下、脐痛、精失，因为带脉起于季胁，回身如带，脏腑十二经络都经过此处。如果饮食不节，劳欲纵伤，致使湿热下流，邪火内郁。外感风邪侵入胞宫；邪气凝结脐腹。带脉不能胜任，与邪气俱陷。或赤或白，如涕如脓。或青黄杂色，或浊黑异形。溢漏不时，淋沥不净。其兼证，则腰腹疼痛，足膝痿软，头目晕眩，经脉参差。甚至寒热往来，容颜枯槁。然而发源于冲脉、任脉、脾胃的多，因为冲为血海，任总诸阴，脾胃司水谷的缘故。所以《骨空论》说：任脉为病，女子带下瘕聚。《痿论》说：冲脉与阳明经合于宗筋之会，而阳明经为之长，皆属于带脉。带脉起于季胁章门，前则当脐上，所以又可能引起脐痛。《灵枢·经别篇》说：肾足少阴经，当第十四椎，出属带脉。大概肾主藏精，带脉固摄腰膂，虚则一方面不能藏精，一方面不能固摄，而精液就会自行流失。（适宜用金匮桂枝龙骨牡蛎汤、和剂威喜丸之类。）
阳维脉发病，寒热、目眩、僵仆，因为阳维脉维系络属一身之阳，阳主卫、主气、主表，发病则不能维阳，是阳无护持，而卫气也因此不固，所以在表则生寒热。其脉气所发出的穴位，别于金门穴（在足太阳外踝下），以阳交穴（足少阳外踝上）为郄穴，与手、足太阳经及跷脉会于腧俞穴（手太阳肩后），与手、足少阳经会于天牖穴（手少阳缺盆上），又会于肩井穴（足少阳肩上）。其在头部，与足少阳经会于阳白穴（足少阳眉上），上至本神及临泣穴（俱在足少阳眉上），上至正营穴（足少阳目窗上）及脑空穴（足少阳枕骨下），下至风池穴（足少阳颞后），与督脉会于风府穴（督脉后发际）、哑门穴（督脉风府后）。看这些，就知道本脉维系于头目手足颈项肩背诸阳部位，无一不到。其脉不荣养，则不能维系。在头目，无维系则眩晕。在颈项肩背，无维系则僵硬。在手足，无维系则僵仆。（适宜用东垣柴胡升阳汤、东垣退热汤之类。）
阴维脉发病，心痛、胸腹刺筑，因为阴维脉维系络属一身之阴。阴主荣、主里，不能维阴则阴无约束，而荣气因此不和，所以在里则心痛。又荣主血，血合于心，所以心痛。其脉气所发出的穴位，阴维脉的郄名叫筑宾穴（足少阴内踝上），与足太阴经会于腹哀穴（足太阴乳下）、大横穴（足太阴腹哀下），又与足太阴经会于府舍穴（足太阴少腹下）、期门穴（足厥阴乳下），与任脉会于天突穴（任脉喉下）、廉泉穴（任脉舌本下）。看这些，就知道本脉维系于胸腹诸阴部位，也无一不到。其脉不荣养，则不能维系。在胸胁失去维系，则动则筑痛而刺痛。（适宜用本事枳实散、奇效拈痛丸、四七汤之类。）
阳跷脉发病，阴缓阳急。阴跷脉发病，阳缓阴急，以及癫痫抽搐、寒热恍惚，大概因为这两条跷脉同发一源。《难经·二十八难》说：阳跷脉起于跟中，阴跷脉也起于跟中，不仅同起于根，而且同终于目。《灵枢·脉度篇》说：跷脉，是少阴经的别支。起于然谷之后，上内踝之上，直上循阴股，入阴，上循胸里，入缺盆，上出人迎之前，入颧，属目内眦，合于太阳、阳跷而上行。气并相还，则为濡目（濡润荣养于目）。又说：男子数其阳，女子数其阴。当数为经，不当数为络。看这些，就知道二跷脉，虽然以男女分阴阳，而实则迭为经络，是一本源。所以它们的发病，也不像前六脉那样逐经分属。本文以癫痫抽搐、寒热恍惚，总系于二经之下，因为二经均可病此。证候虽说是四种，而病机可分为八种。阴阳缓急的意义，自然是显然的。人的身体，背为阳，腹为阴。开为阳，阖为阴。外为阳，内为阴。热为阳，寒为阴。癫症则目闭俯首，是阴急而阳缓。痫症则目直僵仆，是阳急而阴缓。《大惑论》所谓卫气不得入于阴，常留于阳。留于阳则阳气满。阳气满则阳跷盛。不得入于阴则阴气虚，所以目不瞑（失眠）。卫气留于阴，不得行于阳。留于阴则阴气盛，阴气盛则阴跷满。不得入于阳则阳气虚，所以目闭（嗜睡）。《脉度篇》也说：跷之阴脉荣养其脏，阳脉荣养其腑。又说：内溉五脏，外濡腠理。又阴出阳，则交于足太阳。阳入阴，则交于足少阴。虽然一个是太阳之别，一个是少阴之别，而实则随卫气相终始的。所以卫气的行留，即可推知二跷的虚盛。螈（yǒng），是挈的意思。筋脉挈向里拘挛，是阴急而阳缓。瘛（chì），是纵的意思。筋脉纵从外弛缓，是阳急而阴缓。寒则气收敛，从里从阴，阴急而阳缓。热则气散漫，从表从阳，阳急而阴缓。恍者，目前恍然，若有所见。《缪刺论》说：邪客于足阳跷之脉，令人目痛从内眦始，且合太阳上行而并濡于目，病属目而从外。阳跷之病，阳急而阴缓也。惚者，胸中惚惚，若有所失。《脉度篇》说：跷脉者，少阴之别，起于然谷之后，循阴股，入阴，上循胸里，入缺盆。《难经·二十八难》说：阴跷脉者，亦起于跟中，循内踝上行至咽喉，交贯冲脉，病属胸腹而从内。阴跷之病，阴急而阳缓也。二脉一为经，一为络。病在经，则经急络缓。病在络，则经缓络急。总之，皆可言经，皆可言络，但以男女分阴阳之所属，缓急证病邪之所在，而正文以诸证为二经所共，义良深矣。（适宜用胃风汤、交加散、海藏愈风汤、加味逍遥散、十全大补汤之类。）
The diagnosis of the Eight Extraordinary Vessels (Qi Jing Ba Mai) is distinct. A pulse moving straight up and down, when superficial (Fu), indicates the Du Meridian (Governor Vessel); when firm and deep (Lao), it indicates the Chong Meridian (Penetrating Vessel); when tight (Jin), it indicates the Ren Meridian (Conception Vessel). A pulsation to the left and right at the Cun position (distal wrist crease) allows for the determination of the Yang Qiao Meridian (Yang Heel Vessel); a pulsation to the left and right at the Chi position (proximal wrist crease) distinguishes the Yin Qiao Meridian (Yin Heel Vessel); a pulsation to the left and right at the Guan position (mid-wrist) resolves the Dai Meridian (Girdle Vessel). A pulse slanting from the outer Chi to the Cun indicates the Yin Wei Meridian (Yin Linking Vessel); a pulse slanting from the inner Chi to the Cun indicates the Yang Wei Meridian (Yang Linking Vessel).
Disease of the Du Meridian manifests as stiffness of the spine and epilepsy. Disease of the Ren Meridian manifests as seven types of Hernia Qi (Qi Ju) and hard masses in the abdomen. Disease of the Chong Meridian manifests as rebellious Qi and abdominal urgency. Disease of the Dai Meridian manifests as leukorrhea, umbilical pain, and loss of essence. Disease of the Yang Wei Meridian manifests as alternating chills and fever, vertigo, and sudden stiff collapse. Disease of the Yin Wei Meridian manifests as heart pain and stabbing/battering pain in the chest and hypochondrium. Disease of the Yang Qiao Meridian manifests as flaccidity on the medial side and spasticity on the lateral side. Disease of the Yin Qiao Meridian manifests as spasticity on the medial side and flaccidity on the lateral side. Additionally, there are symptoms of epilepsy with convulsions, alternating chills and fever, and mental confusion. The syndromes of the Eight Extraordinary Vessels each have their specific affiliations.
The term "Extraordinary" refers to the fact that these vessels exist outside the Twelve Regular Meridians and have no Zang-Fu organs paired with them. For the meridians associated with Zang-Fu organs, the Cun, Guan, and Chi positions have fixed locations: (Left Cun corresponds to the Heart and Small Intestine; Right Cun to the Lung and Large Intestine; Left Guan to the Liver and Gallbladder; Right Guan to the Spleen and Stomach; Left Chi to the Kidney and Bladder; Right Chi to the Mingmen and San Jiao.) The three depths of pressure—superficial (Fu), moderate (Zhong), and deep (Chen)—have fixed correspondences: (The *Nan Jing* uses weights equivalent to three, six, nine, and twelve beans pressing to the bone to correspond to the Lung, Heart, Spleen, Liver, and Kidney.) The four pulse shapes—string-like (Xian), hook-shaped (Gou), hair-like (Mao), and stone-like (Shi)—have fixed forms: (Spring string-like corresponds to Liver Wood; Summer hook-like to Heart Fire; Autumn hair-like to Lung Metal; Winter stone-like to Kidney Water.) In contrast, the Eight Extraordinary Vessels constitute a separate category; their shapes are inherently different, and their pathways are distinct. Their disease manifestations differ, necessitating distinct diagnostic approaches. Generally, the Du, Ren, and Chong meridians all originate from the Bao Zhong (Uterus/Essence Chamber), sharing one source but branching into three. The Du Meridian runs along the back and governs all Yang meridians. The Ren Meridian runs along the abdomen and governs all Yin meridians. The Chong Meridian runs posteriorly along the back, anteriorly along the abdomen, upward to the head, and downward to the feet, reaching even the muscle valleys, serving as the crucial thoroughfare for the interior, exterior, upper, and lower aspects of the Twelve Regular Meridians. Thus, the *Ling Shu: Shun Ni Fei Shu Pian* states: "The Chong Meridian is the Sea of the Five Zang and Six Fu organs; all Zang and Fu organs receive its influence." These meridians run straight up and down, originating from the deepest center, hence appearing in the pulse as straight up and down. "Straight up and down" implies that all three positions (Cun, Guan, Chi) are long and penetrating. If straight up and down and superficial, the Qi is expansive, representing a Yang image, thus belonging to the Du Meridian. If straight up and down and tight, the Qi is constricted, representing a Yin image, thus belonging to the Ren Meridian. If straight up and down and firm/deep, the form is solid, representing an excess image, thus belonging to the Chong Meridian.
The Yang Qiao and Yin Qiao meridians both originate from the heel. The agility and leaping ability of the human body are most evident in the heels, hence the name "Qiao" (Heel). One branch is a collateral of the Foot-Taiyang Bladder Meridian, running up along the lateral malleolus, entering the Fengchi point, and joining the Taiyang Meridian, hence named Yang Qiao. The other is a collateral of the Foot-Shaoyin Kidney Meridian, running up along the medial malleolus, reaching the throat, and intersecting the Chong Meridian, hence named Yin Qiao. The Cun position reflects Yang; a pulsation to the left and right at the Cun indicates a force like stones striking the fingers, characterizing the Yang Qiao Meridian. The Chi position reflects Yin; a pulsation to the left and right at the Chi indicates a similar force, characterizing the Yin Qiao Meridian. The distinction between Yin and Yang at the origin of these two meridians lies in the lateral and medial malleoli, as the lateral malleolus belongs to the Taiyang Meridian and the medial malleolus to the Shaoyin Meridian. The distinction by Cun and Chi positions arises because the Yang Qiao enters Fengchi, joins the Taiyang to reach the head, so it is reflected at the Cun. The Yin Qiao joins the Shaoyin but does not reach the head, so it is reflected at the Chi.
The Dai Meridian encircles the body once, neither ascending nor descending, like a belt. Therefore, a pulsating pulse is only seen at the middle Guan position on both sides. The Yang Wei and Yin Wei meridians maintain the whole body. Yang Wei maintains Yang, originating from the meeting of all Yang meridians. Yin Wei maintains Yin, originating from the meeting of all Yin meridians. Given the complexity of the body's meridians, these two vessels bind together at the intersections of Yin and Yang, acting as the net's cord to organize the mesh, thereby maintaining Yin and Yang. In the pulse, they appear slanting upward from Chi to Cun. Yin Wei slants from outside to inside; Yang Wei slants from inside to outside. This is because their pathways rise from below: Yang Wei starts from the lateral malleolus, passes through the shoulder to the brain; Yin Wei starts from the medial malleolus, enters the abdomen to the throat. The pulse patterns of these eight vessels appear when diseased and disappear when healthy. The *Nan Jing: Chapter 28* states: "When vessel Qi is abundant, it enters the Eight Extraordinary Vessels but does not circulate continuously, so the Twelve Regular Meridians cannot constrain them." To say they cannot be constrained means the Twelve Regular Meridians cannot confine the Eight Extraordinary Vessels within their continuous circulation. However, the primal Qi of the Eight Extraordinary Vessels is already embedded within the Twelve Regular Meridians. Thus, in a state of health without disease, they do not manifest. Their pulse characteristics—superficial, firm, tight, pulsating laterally, and slanting upward—each present images according to their Yin-Yang pathways, yet generally resemble excess conditions with pathogenic factors. As the *Nan Jing* says: "Accumulation can be treated with bloodletting," which is indeed justified.
Disease of the Du Meridian involves spinal stiffness and epilepsy. The Du Meridian originates from the central part below the lower abdomen. In women, it enters the end of the Ting Kong (urethral/vaginal opening), terminates at the genitalia, circles the anus and buttocks, reaches the Shaoyin Meridian, combines with the Taiyang and Shaoyin, enters the thigh, penetrates the spine, connects to the Kidney, and meets the Taiyang at the inner canthus of the eye, ascends the forehead to the vertex, enters the brain, emerges, descends the nape, follows the shoulder blades, runs alongside the spine, reaches the waist, enters the paraspinal muscles, and connects to the Kidney. (From the inner canthus up the forehead, down the paraspinal muscles to connect to the Kidney, all parallel to the Taiyang.) In men, it follows the penis to the anus, identical to women. Its branch rising straight from the lower abdomen penetrates the center of the umbilicus, ascends through the heart, enters the throat, rises to the chin, circles the lips, and connects to the center below the eyes. Its collateral is named Changqiang, running alongside the spine to the nape, scattering over the head, descending to the scapulae, diverging to the Taiyang on both sides, and penetrating the buttocks. *Nan Jing: Chapter 28* also states: "The Du Meridian originates from the Shu point at the lower extreme, runs parallel in the spinal canal, ascends to the Fengfu point, and enters the Brain." From this, we see that the Du Meridian runs parallel with the Taiyang for nineteen segments; thus, when pathogens invade, spinal stiffness occurs due to its penetration of the spine. Both Du and Taiyang govern the exterior, but Du is the chief of all Yang. Taiyang is the leader of all Yang, also called Ju Yang. Wind pathogens injure Yang by affinity, affecting the exterior first; if retained, it causes epilepsy. Epilepsy comes and goes, with tendon pulling or opisthotonos. Although attributed to wind injuring the Du Meridian, it is also because the Taiyang governs the tendons. (Suitable formulas include Qiang Huo Sheng Shi Tang, Sheng Tie Luo Yin, Xie Qing Wan.)
Disease of the Ren Meridian involves seven types of Hernia Qi and hard masses. The Ren Meridian gathers all Yin meridians, originating from the Bao Zhong, running along the abdomen, and serving as the Sea of the Meridians. Its superficial branch runs along the abdomen, ascends to the throat, diverges to network the lips and mouth. *Nan Jing* also states: It originates below Zhongji, ascends past the pubic hair, runs along the abdomen, passes Guanyuan, to the throat. The seven types of Hernia Qi, according to Chao Yuanfang, are Jue Hernia, Zi Hernia, Cold Hernia, Qi Hernia, Pan Hernia, Fu Hernia, and Ye Lang Hernia. Zhang Zihe criticized this and proposed seven new names: Cold Hernia, Water Hernia, Tendon Hernia, Blood Hernia, Qi Hernia, Fox Hernia, and Tui Hernia. Other classics mention various types, such as Fox Hernia Wind, Lung Wind Hernia, etc., in *Su Wen*, and Chong Hernia in *Gu Kong Lun*. *Yu Ji Zhen Cang Lun* mentions Shan Jia, characterized by lower abdominal heat and pain with white discharge, also called Gu. *Ling Shu: Xie Qi Zang Fu Bing Xing Pian* describes Small Intestine disease as lower abdominal pain, lumbar/spinal pain radiating to the testicles, and frequent urgency, which is also a type of Hernia. Despite many names, they all fall under the seven types. Hernias always occur in the anterior genitalia and lower abdomen, areas traversed by the Ren Meridian. Even if involving other meridians, the Ren Meridian is the root. "Shan" (mass) means false; Qi accumulation makes it hard, Qi dispersion makes it soft. Like Hernia, it comes and goes, occurring in the Ren Meridian's domain, often due to blood stasis and meridian obstruction, primarily affecting women. (Suitable formulas include Ding Xiang Lian Shi Wan, San Yin San Ju Tang, Hua Qi Tang.)
Disease of the Chong Meridian involves rebellious Qi and abdominal urgency. The Chong and Ren meridians both originate from the Bao Zhong, ascend along the back interior, serve as the Sea of Meridians, and are also called the Sea of Blood. Its superficial branch ascends along the abdomen, meets at the throat, networks the lips and mouth, largely overlapping with the Ren Meridian. *Su Wen: Gu Kong Lun* states: The Chong Meridian originates at Qi Chuan, runs parallel with the Foot-Shaoyin Meridian, flanks the umbilicus upward to the chest where it disperses. *Nan Jing: Chapter 28* says: It originates at Qi Chong, runs parallel with the Foot-Yangming Meridian, flanks the umbilicus upward to the chest where it disperses. *Wei Lun* also states: The Chong Meridian is the Sea of Meridians, mainly moistening the muscle valleys, combining with the Yangming at the Zong Jin. Although the parallel meridians differ (Shaoyin vs. Yangming), from the umbilicus to the chest, it runs anteriorly with Yangming and posteriorly with Shaoyin, thus being called the Sea of Five Zang and Six Fu organs with Yangming. When Qi is unsmooth and Blood is disordered, Chest and Abdominal Qi rebels along the meridians causing abdominal urgency. (Suitable formulas include Su Zi Jiang Qi Tang, Hei Xi Dan, Zhen Ling Dan.)
Disease of the Dai Meridian involves leukorrhea, umbilical pain, and loss of essence. The Dai Meridian originates from the costal region, encircles the body like a belt, and all Twelve Zang-Fu meridians pass through it. Irregular diet and excessive labor/lust cause Damp-Heat to flow downward and Evil Fire to stagnate internally. External Wind may enter the Bao Gong; Evil condenses in the umbilical/abdominal region. The Dai Meridian cannot bear it, sinking with the Evil. Discharge may be red or white, like mucus or pus, or mixed green/yellow, or turbid black. Leakage is irregular and persistent. Accompanying symptoms include lower back/abdominal pain, weak knees/feet, dizziness, and irregular menstruation. Severe cases involve alternating chills/fever and emaciation. Most originate from the Chong, Ren, Spleen, and Stomach, as Chong is the Sea of Blood, Ren gathers Yin, and Spleen/Stomach manage Grain and Water. *Gu Kong Lun* states: Ren Meridian disease in women includes leukorrhea and masses. *Wei Lun* states: Chong and Yangming combine at the Zong Jin, led by Yangming, all belonging to the Dai Meridian. The Dai Meridian originates at Zhangmen in the costal region, anterior to the umbilicus, hence causing umbilical pain. *Ling Shu: Jing Bie Pian* states: Foot-Shaoyin Kidney Meridian, at the 14th thoracic vertebra, exits to belong to the Dai Meridian. The Kidney stores Essence; the Dai Meridian secures the lower back. Deficiency leads to inability to store and secure, resulting in spontaneous loss of essence. (Suitable formulas include Gui Zhi Long Gu Mu Li Tang, Wei Xi Wan.)
Disease of the Yang Wei Meridian involves alternating chills/fever, vertigo, and stiff collapse. Yang Wei networks all Yang, governing Wei Qi, Qi, and the Exterior. When diseased, it fails to maintain Yang, leaving Wei Qi insecure, causing exterior chills/fever. Its acupoints include Jinmen (lateral to Foot-Taiyang lateral malleolus), Yangjiao (lateral to Foot-Shaoyang lateral malleolus), meeting Taiyang and Qiao at Shu Yu (posterior to Hand-Taiyang shoulder), meeting Hand/Foot-Shaoyang at Tianyou (above Hand-Shaoyang clavicle), meeting at Jianjing (shoulder of Foot-Shaoyang). In the head, it meets Foot-Shaoyang at Yangbai (above eyebrow), Benshen and Linqi (above eyebrow), Zhengying (above Mingguan), Naokong (below occipital bone), and Fengchi (temporal region), meeting Du at Fengfu (nape) and Yamen (behind Fengfu). This shows Yang Wei maintains all Yang points on the head, eyes, limbs, neck, shoulders, and back. If not nourished, it cannot maintain. Lack of maintenance in head/eyes causes vertigo; in neck/shoulders/back causes stiffness; in limbs causes collapse. (Suitable formulas include Chai Hu Sheng Yang Tang, Tui Re Tang.)
Disease of the Yin Wei Meridian involves heart pain and stabbing/battering pain in the chest/abdomen. Yin Wei networks all Yin, governing Ying Qi and the Interior. Failure to maintain Yin leaves Ying Qi disordered, causing interior heart pain. Ying relates to Blood, and Blood harmonizes with the Heart, hence heart pain. Its acupoints include Zubin (above Foot-Shaoyin medial malleolus), meeting Foot-Taiyin at Fuai (below breast), Daheng (below Fuai), Fushe (lower abdomen), Qimen (below breast), meeting Ren at Tiantu (below throat) and Lianquan (below tongue base). This shows Yin Wei maintains all Yin points in the chest and abdomen. If not nourished, it cannot maintain. Lack of maintenance in chest/hypochondrium causes stabbing/battering pain. (Suitable formulas include Zhi Shi San, Qi Xiao Nian Tong Wan, Si Qi Tang.)
Disease of the Yang Qiao Meridian manifests as medial flaccidity and lateral spasticity. Disease of the Yin Qiao Meridian manifests as lateral flaccidity and medial spasticity, along with epilepsy with convulsions, alternating chills/fever, and mental confusion. These two Qiao meridians share a common source. *Nan Jing: Chapter 28* states: Both originate from the heel and terminate at the eyes. *Ling Shu: Mai Du Pian* states: Qiao meridians are collaterals of Shaoyin, originating behind Ran Gu, ascending the medial malleolus, up the inner thigh, into the yin, up the chest interior, to the supraclavicular fossa, anterior to Ying Chuan, entering the cheekbone, attaching to the inner canthus, combining with Taiyang and Yang Qiao to ascend. Qi returns together to moisten the eyes. It also states: Count Yang for men, Yin for women. Those counted are Jing (Regular), those not counted are Luo (Collateral). Thus, although divided by gender, they are essentially one source, alternating as Jing and Luo. Their diseases are not strictly separated by vessel as with the previous six. The text groups epilepsy, convulsions, chills/fever, and confusion under both, as both can cause these. Four symptoms, eight mechanisms. Back is Yang, Front is Yin; Opening is Yang, Closing is Yin; Exterior is Yang, Interior is Yin; Heat is Yang, Cold is Yin. Dian (Epilepsy) involves closed eyes and bowed head, indicating Yin spasticity and Yang flaccidity. Xian (Seizure) involves staring eyes and stiff collapse, indicating Yang spasticity and Yin flaccidity. *Da Huo Lun* states: If Wei Qi cannot enter Yin, it stays in Yang, making Yang full and Yang Qiao strong. If it cannot enter Yin, Yin Qi is deficient, causing insomnia. If Wei Qi stays in Yin, Yin Qi becomes full and Yin Qiao full. If it cannot enter Yang, Yang Qi is deficient, causing sleepiness. *Mai Du Pian* states: Yin Qiao nourishes Zang, Yang Qiao nourishes Fu. Internal irrigation of Five Zang, external moistening of Cou Li. Yin exits to Yang at Foot-Taiyang; Yang enters Yin at Foot-Shaoyin. Though one is a Taiyang collateral and the other a Shaoyin collateral, they follow Wei Qi throughout. Thus, the movement/stasis of Wei Qi reveals the deficiency/excess of the two Qiao meridians. Yong (Convulsion) means drawing inward, tendon contraction, Yin spasticity/Yang flaccidity. Chi (Flaccidity) means relaxing outward, tendon laxity, Yang spasticity/Yin flaccidity. Cold causes Qi convergence (Interior/Yin, Yin spasticity/Yang flaccidity). Heat causes Qi dispersion (Exterior/Yang, Yang spasticity/Yin flaccidity). Huang (Confusion/Vision) is seeing things before the eyes. *Miao Ci Lun* states: Pathogen in Foot-Yang Qiao causes eye pain starting from the inner canthus, combining with Taiyang to moisten the eye, disease in the eye from the exterior. Yang Qiao disease is Yang spasticity/Yin flaccidity. Hu (Mental Fog/Loss) is feeling lost in the chest. *Mai Du Pian* states: Qiao is Shaoyin collateral, from Ran Gu up inner thigh to chest/supraclavicular fossa. *Nan Jing: Chapter 28* states: Yin Qiao from heel up medial malleolus to throat, intersecting Chong, disease in chest/abdomen from interior. Yin Qiao disease is Yin spasticity/Yang flaccidity. One is Jing, one is Luo. Disease in Jing means Jing spastic/Luo flaccid. Disease in Luo means Jing flaccid/Luo spastic. Ultimately, both can be referred to as Jing or Luo, distinguished by gender-based Yin/Yang attribution and the location of pathogenic spasticity/flaccidity. The text grouping these symptoms under both meridians has profound meaning. (Suitable formulas include Wei Feng Tang, Jiao Jia San, Hai Zang Yu Feng Tang, Jia Wei Xiao Yao San, Shi Quan Da Bu Tang.)