指受血而能摄。（指得之则神在指，故摄指强矣。血气者，人之神也。但言血而不言气，何也？盖气属阳而
无形，血属阴而有形，而人之形体，以阴而成，人之所以生成者，血脉也。血者，神气也，血脉和则精神乃
居。故此皆言血者，谓神根据形生，用自体出也。）卧出而风吹之，血凝于肤者为痹，（卧出之际，若玄府未
闭，魄汗未藏者，为风所吹则血凝于肤，或致麻木，或生疼痛，而病为痹。）凝于脉者为泣，（风寒外袭，
血凝于脉，则脉道泣滞而为病也。）凝于足者为厥。（四肢为阳诸之本，风寒客之而血凝于足，则阳衰阴胜
而气逆为厥也。）此三者，血行而不得反其空，故为痹厥也。（血得热则行，得寒则凝，凡风寒所客，则
血脉凝涩不能营运而反其空，故为痹厥之病也。空、孔同，谓血行之道。）
五脏常内阅于上七窍也。（阅，历也。五脏位次于内，而气达于外，故阅于上之七窍。人身共有九窍，
上者七，下者二是也。）故肺气通于鼻，肺和则鼻能知臭香矣；心气通于舌，心和则舌能知五
味矣；肝气通于目，肝和则目能辨五色矣；脾气通于口，脾和则口能知五谷矣；肾气通于耳，肾和则耳能闻
五音矣。（其气各有所通，亦各有所用，然必五脏气和，而后各称其职，否则脏有所
病，则窍有所应矣。）五脏不和则七窍不通，六腑不和则留为痈。（五脏属阴主里，故其不和则七窍为之不
利；六腑属阳主表，故其不利则肌腠留为痈疡矣。）邪在腑则阳脉不和，阳脉不和则气留之，气留
之则阳气盛矣；阳气太盛则阴不利，阴脉不利则血留之，血留之则阴气盛矣。阴气太盛则阳气不能荣也，
故曰“关”；阳气太盛则阴气不能荣也，故曰“格”；阴阳俱盛不得相荣，故曰“关格”。关格者，不得尽
期而死也。（阴阳之气，贵乎和平。邪气居之，不在于阴，必在于阳。故邪气在腑则气留之而阳胜，阳胜
则阴病矣；阴病则血留之而阴胜，阴胜则阳病矣。故阴气太盛则阳气不荣而为“关”，阳气太盛则阴气不荣
而为“格”，阴阳俱胜不得相荣，故阴自阴，阳自阳，不相浃洽而为“关格”，故不得尽天年而死矣。人迎盛
者为格阳，寸口盛者为关阴。）
人受气于谷，谷入于胃，以传于肺，五脏六腑，皆以受气。（人之生，由乎气。气者所受于天，与谷
气并而充身者也。故谷食入胃，化而为气，是为“谷气”，亦曰“胃气”。此气出自中焦，传化于脾，上
归于肺，积于胸中气海之间，乃为宗气。宗气之行，以息往来，通达三焦，而五脏六腑皆以受气。是以胃
为水谷血气之海，而人所受气者，亦唯谷而已。故谷不入半日则气衰，一日则气少矣。）其清者为营，浊者为
卫。（谷气出于胃，而气有清浊之分。清者，水谷之精气也；浊者，水谷之悍气也。清者属阴，其性精专，
故化生血脉而周行于经隧之中，是为“营气”；浊者属阳，其性 疾滑利，故不循经络而直达肌表，充实于
皮毛分肉之间，是为“卫气”。然营气、卫气，无非资藉于宗气，故宗气盛则荣卫和，宗气衰则营卫弱矣。）
营在脉中，卫在脉外。（营，营运于中也；卫，护卫于外也。脉者，非气非血，其犹气血之橐 也。营属
阴而主里，卫属阳而主表，故营在脉中，卫在脉外，其浮气之不循经者为卫气，其精
气之行于经者为营气。）营周不休，五十而复大会，阴阳相贯，如
环无端。（营气之行，周流不休，凡一昼一夜，五十周于身而复为大会。其十二经脉之次，则一阴一阳，一表
一里，迭行相贯，终而复始，故曰“如环无端”也。）卫气行于阴二十五度，行于阳二十五度，分为昼
夜，故气至阳而起，至阴而止。（卫气之行，夜则行阴分二十五度，昼则行阳分二十五度，凡一昼一夜，亦
五十周于身。气至阳而起，至阴而止，昼兴夜息之义。）故曰日中而阳陇为重阳，夜半而阴陇为重
阴。（此分昼夜之阴阳，以明营卫之行也。陇，盛也。昼为阳，日中为阳中之阳，故曰“重阳”；夜为阴，
夜半为阴中之阴，故曰”重阴”。陇，音笼。）故太阴主内，太阳主外，各行二十五度，分为昼夜。（太阴，
手太阴也。太阳，足太阳也。内言营气，外言卫气。营气始于手太阴，而复会于太阴，故太阴主内；卫气始于
足太阳，而复会于太阳，故太阳主外。营气周流十二经，昼夜各二十五度；卫气昼则行阳，夜则行阴，亦各二十
五度。营、卫各为五十度，以分昼夜也。）夜半为阴陇，夜半后而为阴衰，平旦阴尽而阳受气矣；日中为阳
陇，日西而阳衰，日入阳尽而阴受气矣。（夜半后为阴衰，阳生于子也；日西而阳衰，阴生于午也。平旦至
日中，天之阳，阳中之阳也；日中至黄昏，天之阳，阳中之阴也；合夜至鸡鸣，天之阴，阴中之阴也；鸡鸣至
平旦，天之阴，阴中之阳也。故人亦应之。）夜半而大会，万民皆卧，命曰“合阴”；平旦阴尽而阳受气。如
是无已，与天地同纪。（大会，言营卫阴阳之会也。营卫之行，表里异度，故常不相值，惟于夜半子时，阴气
已极，阳气将生，营气在阴，卫气亦在阴，故万民皆瞑而卧，命曰“合阴”。合阴者，营卫皆归于脏，而会
于天一之中也。平旦阴尽而阳受气，故民皆张目而起，此阴阳消息之道，常如是无已，而与天地同其纪。所
谓天地之纪者，如天地日月，各有所会之纪也。天以二十八舍为纪，地以十二辰次为纪，日月以行之迟速
为纪。故天与地一岁一会，如玄枵加于子宫是也；天与日亦一岁一会，如冬至日躔星纪是也；日与月则一月
一会，如晦
朔之同宫是也。人之营卫以昼夜为纪，故一日凡行五十周而复为大会焉。）老人不夜瞑，少壮之人不昼瞑。
壮者之血气盛，其肌肉滑，气道通，营卫之行不失其常，故昼精而夜瞑；老者之气血衰，其肌肉枯，气道
涩，五脏之气相抟，其营气衰少而卫气内伐，故昼不精，夜不瞑。（老者之气血衰，故肌肉枯，气道涩，
五脏之气抟聚不行而营气衰少矣。营气衰少，故卫气乘虚内伐。卫失其常，故昼不精；营失其常，故夜不
瞑也。）营出于中焦，卫出于下焦。（营气者，由谷入于胃，中焦受气取汁，化其精微，而上注于肺，乃
自手太阴始，周行于经隧之中，故营气出于中焦。卫气者，出其悍气之 疾，而先行于四末、分肉、皮
肤之间，不入于脉，故于平旦阴尽，阳气出于目，循头项下行，始于足太阳膀胱经而行于阳分，日西阳尽，
则始于足少阴肾经而行于阴分，其气自膀胱与肾，由下而出，故卫气出于下焦。按，人身不过表里，表里不过
阴阳，阴阳即营卫，营卫即血气。脏腑筋骨居于内，必赖营气以资之，经脉以疏之；皮毛分肉居于外，经之所
不通，营之所不及，故赖卫气以 之，孙络以濡之。而后内而精髓，外而发肤，无勿得其养者，皆营卫之化
也。卫气属阳，乃出于下焦，下者必升，故其气自下而上，亦犹地气上为云也；营本属阴，乃自中焦而出于
上焦，上者必降，故营气自上而下，亦犹天气降为雨也。虽卫主气而在外，然亦何尝无血；营主血而在内，
然亦何尝无气？故营中未必无卫，卫中未必无营，但行于内者谓之营，行于外者谓之卫。此人身阴阳交感之
道，分之则二，合之则一而已。）上焦出于胃上口，并咽以上，贯膈而布胸中，走腋，循太阴之分而行，还
至阳明，上至舌，下足阳明，（胃上口，即上脘也。咽为胃系，水谷之道路也。膈上曰胸中，即膻中也。其旁
行者走两腋，出天池之次，循手太阴肺经之分而还于手阳明。其上行者至于舌，其下行者交于足阳明以行于
中、下二焦，皆上焦之部分也。）常与营俱行于阳二十五度，行于阴亦二十五度，一周也，故五十
度而复大会于手太阴矣。（上焦者，肺之所居，宗气之所聚。营气者，随宗气以行于十四经脉之中。故上焦
之气常与营气俱行于阳二十五度，阴亦二十五度，言昼夜周行五十度，至次日寅时复会于手太阴肺经，是为一
周。然则营气虽出于中焦，而施化则由于上焦也。）中焦亦并胃中，出上焦之后，此所受气者，泌糟粕，蒸
津液，化其精微，上注于肺脉，乃化而为血，以奉生身，莫贵于此，故独得行于经隧，命曰“营气”。（后，
下也。受气者，五谷入胃，其糟粕、津液、宗气分为三隧，以注于三焦。而中焦者，泌糟粕，蒸津液，受气
取汁，变化而赤，是谓血，以奉生身，而行于经隧，是为“营气”，故曰“营出中焦”。下焦别回肠，注
膀胱，则自膈膜之下至脐上一寸水分穴之上，皆中焦之部分也。泌，音秘。）营卫者，精气也；血者，神气
也。故血之与气，异名同类焉。故夺血者无汗，夺汗者无血，人生有两死而无两生。（营卫之气，虽厘清浊，
然皆水谷之精华，故曰“精气”。血由化而赤，莫测其妙，故曰“神气”。然血化于液，液化于气，是血之于
气本为同类，而血之与汗亦非两种。但血主营，为阴为里，汗属卫，为阳为表，一表一里，无可并攻，故夺
血者无取其汗，夺汗者无取其血。若表里俱夺，则不脱于阴，必脱于阳，脱则死矣，故曰“人生有两死”；
然而人之生也，阴阳之气，皆不可少，未有孤阳能生，亦未有孤阴能生者，故曰“无两生”也。）下焦者，别
回肠，注于膀胱而渗入焉。故水谷者，常并居于胃中，成糟粕而俱下于大肠，而成下焦，渗而俱
下，济泌别汁，循下焦而渗入膀胱焉。（回肠，大肠也。济、 同，犹酾滤也。泌，如狭流也。别汁，分别
清浊也。别回肠者，谓水谷并居于胃中，传化于小肠，当脐上一寸水分穴处，糟粕由此别行回肠，从后
而出，津液由此别渗膀胱，从前而出，膀胱无上口，故云渗入。凡自水分穴而下，皆下焦之部分也。下焦者，
当膀胱上口，主分别清浊。其言上口者，以渗入之处为言，非真谓有口也。如果有口则不言渗入矣。酾，音筛。）
人饮酒，酒亦入胃，谷未熟而小便独先下。酒者，熟谷之液也，其气悍以清，故后谷而入，先谷而液出焉。（
酒之气悍则直连下焦，酒之质清则速行无滞，故后谷而入，先谷而出也。）上焦如雾，
中焦如沤，下焦如渎，此之谓也。（如雾者，气浮于上也。言宗气积于胸中，司呼吸而布 于经隧之间，
如天之雾，故曰“上焦如雾”也。沤者，水上之泡，水得气而不沉者也。言营血化于中焦，随气流行，以奉生
身，如沤处浮沉之间，故曰“中焦如沤”也。渎者，水所注泄，言下焦主出而不纳，逝而不及，故曰“下
焦如渎”也。然则肺司雾，脾司沤，大肠、膀胱司川渎之化也。三焦者，本全体之大脏，统上、中、下而言
也。发明之处，不啻再四，《难经》谓三焦有名无形，遂起后世之疑，莫能辨正，观此则明且悉矣。）
任脉者，起于中极之下，以上毛际，循腹里，上关元，至咽喉，上颐，循面入目。（以下任、冲、督
脉，皆奇经也。中极，任脉穴名，在曲骨上一寸。中极之下，即胞宫之所。任、冲、督三脉，皆
起于胞宫，而出于会阴之间。任由会阴而行于腹，督由会阴而行于背，冲由会阴出，并少阴而散于胸中。故此
自毛际，行腹里关元，上至咽喉面目者，皆任脉之道也。）冲脉者，起于气街，并少阴之经，挟脐上
行，至胸中而散。（起，言外脉之所起，非发源之谓也。下仿此。气街，即气冲，足阳明经穴，在毛际两旁。
冲脉起于气街，并足少阴之经，合于横骨、大赫等十一穴。挟脐上行，至胸中而散，此言冲脉之前行
者也。然少阴之脉，上股内后廉，贯脊属肾，冲脉亦入脊内，为伏冲之脉。然则冲脉之后行者，当亦并少阴
无疑也。所谓伏冲者，以其最深也。故凡十二经之气血，此皆受之，荣养周身，所以为五脏六腑经脉之海也。）
任脉为病，男子内结七疝，女子带下瘕聚。（任脉自前阴上毛际，行腹里，故男女之为病如此。带下，赤白
带下也。瘕， 瘕也。聚，积聚也。）冲脉为病，逆气里急。冲脉挟脐上行，至于胸中，故其气不顺
则膈塞逆，气血不和则胸腹里急也。督脉为病，脊强反折。（督脉贯于脊中，故令脊强反折而屈伸不利。）
督脉者，起于少腹，以下骨中央，女子入系廷孔，（此下皆言督脉也。少腹，小腹也，胞宫之所居。
骨中央，横骨下近外之中央也。廷，正也，直也，言正中之直孔，即溺孔也。）其孔，溺孔之端也。（女人溺
孔，在前阴中横骨之下。孔之上际谓之端，乃督脉外起之所。此虽以女子为言，然男子溺孔亦在横骨下中央，
第为宗筋所函，故不见耳。溺，娘吊切。）其络循阴器，合篡间，绕篡后，（督脉别络，自溺孔之端循阴器，
分行向后，复合于篡间，乃又自篡间分而为二，绕行于篡之后。篡，交篡之义，谓两便争行之所，即前后
二阴之间也。篡，初患切。）别绕臀，至少阴，与巨阳中络者，合少阴，上股内后廉，贯脊属肾。（足少阴之
手指得到血液的滋养才能进行抓握。（手指有了血，神志就依附于手指，所以手指的摄持功能就强了。血和气，是人的精神活动的物质基础。这里只说血而不说气，为什么呢？因为气属于阳，没有固定的形态；血属于阴，有具体的形体。而人的形体是由阴（血）构成的，人之所以能生成，依靠的是血脉。血，就是神气的载体，血脉调和，精神才能安居其中。所以这里都讲血，意思是神志依附于形体而产生，作用从本体中发出。）睡觉时外出被风吹，血液凝滞在皮肤里的叫做痹证，（睡觉外出时，如果汗孔没有闭合，汗液没有收藏好，被风吹袭就会导致血液凝滞在皮肤，或者导致麻木，或者产生疼痛，从而形成痹证。）凝滞在脉管中的叫做涩滞，（风寒外邪侵袭，血液凝滞在脉管中，那么脉道就会涩滞不通从而致病。）凝滞在足部的叫做厥证。（四肢是阳气根本所在，风寒客邪侵入导致血液凝滞在足部，那么阳气衰微、阴气偏胜，气机逆乱就形成厥证。）这三种情况，都是血液运行而不能返回其空窍（血管），所以形成痹证和厥证。（血液遇热则运行，遇寒则凝滞，凡是风寒邪气客居体内，血脉就会凝涩不能正常运行并返回其空窍，所以形成痹厥病。空、孔同义，指血液运行的通道。）
五脏的气经常上行通达上部的七窍。（阅，经过的意思。五脏位置在体内，但气能通达体外，所以经过上部的七窍。人身共有九窍，上面七个，下面两个，就是这样。）所以肺气通于鼻，肺气调和则鼻子能辨别气味；心气通于舌，心气调和则舌头能辨别五味；肝气通于目，肝气调和则眼睛能分辨五色；脾气通于口，脾气调和则嘴巴能辨别五谷的味道；肾气通于耳，肾气调和则耳朵能听到五音。（它们的气各有所通，也各有所用，但必须五脏之气调和，然后才能各自胜任其职，否则脏腑有病，窍道就会有反应。）五脏不和则七窍不通，六腑不和则停留成为痈肿。（五脏属阴主里，所以它们不和则七窍就不利；六腑属阳主表，所以它们不利则肌肉腠理间停留成为痈疡。）邪气在腑则阳脉不和，阳脉不和则气停留，气停留则阳气盛了；阳气太盛则阴气不利，阴脉不利则血停留，血停留则阴气盛了。阴气太盛则阳气不能荣养，所以叫“关”；阳气太盛则阴气不能荣养，所以叫“格”；阴阳都盛而不能相互荣养，所以叫“关格”。关格病，是不能活到自然寿命而死。（阴阳之气，贵在平和。邪气占据它，不在阴分，必在阳分。所以邪气在腑则气停留而阳胜，阳胜则阴病了；阴病则血停留而阴胜，阴胜则阳病了。所以阴气太盛则阳气不荣养而为“关”，阳气太盛则阴气不荣养而为“格”，阴阳俱盛不能相互荣养，所以阴自阴，阳自阳，不相交融而为“关格”，所以不能尽天年而死。人迎脉盛的是格阳，寸口脉盛的是关阴。）
人通过饮食获得气，食物进入胃，传导给肺，五脏六腑都以此受气。（人的生存，依赖于气。气是禀受于先天，与谷气结合而充满全身。所以谷物进入胃，化生为气，这叫“谷气”，也叫“胃气”。此气出自中焦，传化于脾，上归于肺，积聚在胸中气海之间，就成为宗气。宗气的运行，随着呼吸往来，通达三焦，而五脏六腑都因此受气。所以胃是水谷气血的大海，人所获得的气，也只在于谷物。所以谷物不吃半天气就衰弱，一天不吃气就少了。）其中清的部分成为营气，浊的部分成为卫气。（谷气出于胃，气有清浊之分。清的，是水谷的精气；浊的，是水谷的悍气。清的属阴，性质精专，所以化生血脉而在经络隧道中周行，这叫“营气”；浊的属阳，性质剽疾滑利，所以不循行经络而直达肌表，充实于皮毛分肉之间，这叫“卫气”。然而营气、卫气，无非依托于宗气，所以宗气盛则营卫调和，宗气衰则营卫虚弱。）营气在脉管中，卫气在脉管外。（营，营运于内部；卫，护卫于外部。脉，不是气也不是血，它就像气血的风箱一样。营属阴主里，卫属阳主表，所以营在脉中，卫在脉外，那些浮散不循经的气叫卫气，那些精气行于经的叫营气。）营气周流不停，五十周后再次大会，阴阳互相贯穿，像圆环一样没有端点。（营气的运行，周流不休，凡是一昼一夜，五十周于身体而再次大会。其十二经脉的顺序，则是一阴一阳，一表一里，交替运行贯穿，终而复始，所以说“如环无端”。）卫气行于阴分二十五周，行于阳分二十五周，分为昼夜，所以气至阳分人就醒来，至阴分人就停止（睡眠）。（卫气的运行，夜间行阴分二十五周，白天行阳分二十五周，凡是一昼一夜，也是五十周于身体。气至阳分而起，至阴分而止，这是昼兴夜息的意义。）所以说中午时阳气隆盛称为重阳，半夜时阴气隆盛称为重阴。（这是区分昼夜的阴阳，来说明营卫的运行。陇，盛的意思。昼为阳，日中为阳中之阳，所以叫“重阳”；夜为阴，夜半为阴中之阴，所以叫“重阴”。陇，读音笼。）所以太阴主内（营气），太阳主外（卫气），各行二十五周，分为昼夜。（太阴，指手太阴肺经。太阳，指足太阳膀胱经。内言营气，外言卫气。营气始于手太阴，而又会合于太阴，所以太阴主内；卫气始于足太阳，而又会合于太阳，所以太阳主外。营气周流十二经，昼夜各二十五周；卫气白天行阳，夜晚行阴，也各二十五周。营、卫各为五十周，以分昼夜。）半夜是阴气隆盛，半夜过后阴气衰退，天亮时阴气尽而阳气受气了；中午是阳气隆盛，日落时阳气衰退，太阳落山阳气尽而阴气受气了。（半夜过后阴气衰退，阳气生于子时；日落时阳气衰退，阴气生于午时。天亮到中午，是天的阳，阳中之阳；中午到黄昏，是天的阳，阳中之阴；入夜到鸡鸣，是天的阴，阴中之阴；鸡鸣到天亮，是天的阴，阴中之阳。所以人也顺应这个规律。）半夜时大会，百姓都睡觉，名叫“合阴”；天亮时阴气尽而阳气受气。像这样没有休止，与天地同规律。（大会，指营卫阴阳的会合。营卫的运行，表里度数不同，所以常不相值，只有在半夜子时，阴气已极，阳气将生，营气在阴，卫气也在阴，所以百姓都闭眼睡觉，名叫“合阴”。合阴，是指营卫都归于脏，而会合于天一之中。天亮阴尽而阳受气，所以百姓都睁眼起床，这是阴阳消长的道理，常常像这样没有休止，而与天地同其规律。所谓天地的规律，比如天地日月，各有会合的规律。天以二十八宿为规律，地以十二辰次为规律，日月以运行的快慢为规律。所以天与地一年会合一次，比如玄枵加临于子宫；天与日也是一年会合一次，比如冬至日躔星纪；日与月则一月会合一次，比如晦朔同宫。人的营卫以昼夜为规律，所以一天凡运行五十周而再次大会。）老人晚上不闭眼睡觉，少壮的人白天不闭眼睡觉。壮年人气血旺盛，肌肉滑润，气道通畅，营卫的运行不失常态，所以白天精神饱满而晚上能睡好；老年人气血衰弱，肌肉枯槁，气道涩滞，五脏之气相搏结，他的营气衰少而卫气向内侵伐，所以白天不精神，晚上睡不着。（老年人气血衰弱，所以肌肉枯槁，气道涩滞，五脏之气聚结不行而营气衰少。营气衰少，所以卫气乘虚向内侵伐。卫气失去常态，所以白天不精神；营气失去常态，所以晚上睡不着。）营气出于中焦，卫气出于下焦。（营气，由谷物进入胃，中焦接受气化取汁，化生其精微，而上注于肺，于是自手太阴开始，周行于经络隧道中，所以营气出于中焦。卫气，出其悍气之剽疾，而先行于四肢末端、分肉、皮肤之间，不入于脉，所以在天亮阴尽，阳气出于目，循头项下行，始于足太阳膀胱经而行于阳分，日落阳气尽，则始于足少阴肾经而行于阴分，其气自膀胱与肾，由下而出，所以卫气出于下焦。按，人身不过表里，表里不过阴阳，阴阳即营卫，营卫即血气。脏腑筋骨居于内，必赖营气来资助它，经脉来疏通它；皮毛分肉居于外，经所不通，营所不及，所以赖卫气来护卫它，孙络来濡养它。这样而后内而精髓，外而发肤，无不得到滋养的，都是营卫的化育。卫气属阳，乃出于下焦，下者必升，所以其气自下而上，也像地气上升为云；营本属阴，乃自中焦而出于上焦，上者必降，所以营气自上而下，也像天气下降为雨。虽然卫主气而在外，然而又何尝没有血；营主血而在内，然而又何尝没有气？所以营中未必无卫，卫中未必无营，只是行于内的叫营，行于外的叫卫。这是人身阴阳交感的道理，分开则是二，合起来则是一而已。）上焦出于胃上口，并咽以上，穿过膈膜而布散于胸中，走向腋下，循行太阴经的分野而运行，还至阳明，上至舌，下至足阳明，（胃上口，就是上脘。咽是胃的系带，是水谷的道路。膈上叫胸中，就是膻中。其旁行者走两腋，出天池穴附近，循手太阴肺经的分野而还于手阳明。其上行者至于舌，其下行者交于足阳明以行于中、下二焦，这都是上焦的部分。）常与营气一起行于阳分二十五周，行于阴分也是二十五周，这是一周，所以五十周后再次在手太阴肺经大会。（上焦，是肺所居住的地方，宗气所聚集之处。营气，随宗气而行于十四经脉之中。所以上焦之气常与营气一起行于阳分二十五周，阴分也是二十五周，说的是昼夜周行五十周，到次日寅时再次会合于手太阴肺经，这是一周。既然这样，营气虽然出于中焦，而施化则由于上焦。）中焦也在胃中，出在上焦之后，这里所接受的气，泌别糟粕，蒸腾津液，化生其精微，上注于肺脉，于是化而为血，以奉养身体，没有比这更珍贵的了，所以独得行于经络隧道，名叫“营气”。（后，下的意思。受气，指五谷入胃，其糟粕、津液、宗气分为三条通道，以注入三焦。而中焦，泌别糟粕，蒸腾津液，受气取汁，变化而赤，这就是血，以奉养身体，而行于经络隧道，这叫“营气”，所以说“营出中焦”。下焦别行回肠，注入膀胱，则自膈膜之下至脐上一寸水分穴之上，都是中焦的部分。泌，读音秘。）营卫，是精气；血，是神气。所以血与气，名称不同但同类。所以失血的人不要发汗，夺汗的人不要放血，人生有两死而无两生。（营卫之气，虽然分清浊，然都是水谷的精华，所以叫“精气”。血由化而生赤，莫测其妙，所以叫“神气”。然而血化于液，液化于气，是血之于气本为同类，而血之与汗亦非两种。但血主营，为阴为里，汗属卫，为阳为表，一表一里，无可并攻，所以失血者不要取其汗，夺汗者不要取其血。如果表里俱夺，则不脱于阴，必脱于阳，脱则死矣，所以说“人生有两死”；然而人之生，阴阳之气，都不可少，未有孤阳能生，亦未有孤阴能生者，所以说“无两生”。）下焦，别行回肠，注入膀胱而渗入其中。所以水谷，常并居于胃中，变成糟粕而俱下于大肠，而成下焦，渗而俱下，济泌别汁，循下焦而渗入膀胱焉。（回肠，是大肠。济、同，犹酾滤也。泌，如狭流也。别汁，分别清浊也。别回肠者，谓水谷并居于胃中，传化于小肠，当脐上一寸水分穴处，糟粕由此别行回肠，从后而出，津液由此别渗膀胱，从前而出，膀胱无上口，故云渗入。凡自水分穴而下，皆下焦之部分也。下焦者，当膀胱上口，主分别清浊。其言上口者，以渗入之处为言，非真谓有口也。如果有口则不言渗入矣。酾，读音筛。）人饮酒，酒也进入胃，谷未熟而小便独先下。酒，是熟谷的液体，其气悍而清，所以后谷而入，先谷而液出焉。（酒之气悍则直连下焦，酒之质清则速行无滞，故后谷而入，先谷而出也。）上焦如雾，中焦如沤，下焦如渎，说的就是这个。（如雾者，气浮于上也。言宗气积于胸中，司呼吸而布于经隧之间，如天之雾，故曰“上焦如雾”也。沤者，水上之泡，水得气而不沉者也。言营血化于中焦，随气流行，以奉生身，如沤处浮沉之间，故曰“中焦如沤”也。渎者，水所注泄，言下焦主出而不纳，逝而不及，故曰“下焦如渎”也。然则肺司雾，脾司沤，大肠、膀胱司川渎之化也。三焦者，本全体之大脏，统上、中、下而言也。发明之处，不啻再四，《难经》谓三焦有名无形，遂起后世之疑，莫能辨正，观此则明且悉矣。）
任脉，起于中极之下，向上至毛际，循腹里，上至关元，至咽喉，上颐，循面入目。（以下任、冲、督脉，都是奇经。中极，任脉穴名，在曲骨上一寸。中极之下，即胞宫之所。任、冲、督三脉，皆起于胞宫，而出于会阴之间。任由会阴而行于腹，督由会阴而行于背，冲由会阴出，并少阴而散于胸中。故此自毛际，行腹里关元，上至咽喉面目者，皆任脉之道也。）冲脉，起于气街，并少阴之经，挟脐上行，至胸中而散。（起，言外脉之所起，非发源之谓也。下仿此。气街，即气冲，足阳明经穴，在毛际两旁。冲脉起于气街，并足少阴之经，合于横骨、大赫等十一穴。挟脐上行，至胸中而散，此言冲脉之前行者也。然少阴之脉，上股内后廉，贯脊属肾，冲脉亦入脊内，为伏冲之脉。然则冲脉之后行者，当亦并少阴无疑也。所谓伏冲者，以其最深也。故凡十二经之气血，此皆受之，荣养周身，所以为五脏六腑经脉之海也。）任脉为病，男子内结七疝，女子带下瘕聚。（任脉自前阴上毛际，行腹里，故男女之为病如此。带下，赤白带下也。瘕，假瘕也。聚，积聚也。）冲脉为病，逆气里急。冲脉挟脐上行，至于胸中，故其气不顺则膈塞逆，气血不和则胸腹里急也。督脉为病，脊强反折。（督脉贯于脊中，故令脊强反折而屈伸不利。）督脉，起于少腹，以下骨中央，女子入系廷孔，（此下皆言督脉也。少腹，小腹也，胞宫之所居。骨中央，横骨下近外之中央也。廷，正也，直也，言正中之直孔，即溺孔也。）其孔，溺孔之端也。（女人溺孔，在前阴中横骨之下。孔之上际谓之端，乃督脉外起之所。此虽以女子为言，然男子溺孔亦在横骨下中央，第为宗筋所函，故不见耳。溺，娘吊切。）其络循阴器，合篡间，绕篡后，（督脉别络，自溺孔之端循阴器，分行向后，复合于篡间，乃又自篡间分而为二，绕行于篡之后。篡，交篡之义，谓两便争行之所，即前后二阴之间也。篡，初患切。）别绕臀，至少阴，与巨阳中络者，合少阴，上股内后廉，贯脊属肾。（足少阴之
Fingers are able to grasp when they receive blood nourishment. (When fingers receive blood, the spirit attaches to them, thus strengthening their grasping function. Blood and Qi are the material basis for human spiritual activities. Here only blood is mentioned, not Qi; why? Because Qi belongs to Yang and has no fixed form, while Blood belongs to Yin and has a concrete shape. The human body is formed by Yin (Blood), and human generation relies on blood vessels. Blood is the carrier of the spirit; when blood vessels are harmonious, the spirit can reside peacefully. Therefore, all these discussions focus on blood, meaning that the spirit arises from reliance on the physical form, and its functions emerge from the body itself.) When going out during sleep and being exposed to wind, if blood stagnates in the skin, it is called Bi syndrome (Obstruction Syndrome). (During sleep or upon exiting, if the sweat pores are not closed and sweat is not retained, wind exposure causes blood to stagnate in the skin, leading to numbness or pain, thereby forming Bi syndrome.) If blood stagnates within the vessels, it is called sluggish flow. (External invasion by Wind-Cold causes blood to stagnate in the vessels, leading to obstruction and disease.) If blood stagnates in the feet, it is called Jue syndrome (Reversal Syndrome). (The four limbs are the root of Yang Qi. When Wind-Cold pathogens invade and cause blood stagnation in the feet, Yang Qi declines and Yin Qi prevails, causing Qi rebellion and forming Jue syndrome.) These three conditions occur because blood circulation fails to return to its empty apertures (vessels), resulting in Bi and Jue syndromes. (Blood flows when heated and coagulates when cold. When Wind-Cold pathogens reside in the body, blood vessels become stagnant and cannot circulate normally or return to their apertures, hence forming Bi-Jue diseases. "Kong" and "Kong" [hole] are synonymous, referring to the channels of blood circulation.)
The Qi of the Five Zang Organs frequently ascends to communicate with the seven orifices above. ("Yue" means to pass through. The Five Zang organs are located internally, but their Qi reaches the exterior, thus passing through the seven upper orifices. The human body has nine orifices in total: seven above and two below.) Thus, Lung Qi communicates with the nose; when Lung Qi is harmonious, the nose can distinguish odors. Heart Qi communicates with the tongue; when Heart Qi is harmonious, the tongue can distinguish the five flavors. Liver Qi communicates with the eyes; when Liver Qi is harmonious, the eyes can distinguish the five colors. Spleen Qi communicates with the mouth; when Spleen Qi is harmonious, the mouth can taste the flavors of grains. Kidney Qi communicates with the ears; when Kidney Qi is harmonious, the ears can hear the five tones. (Their Qi has specific pathways and functions, but must be harmonious among the Five Zang organs to perform their duties properly; otherwise, organ pathology manifests in the orifices.) Disharmony of the Five Zang organs leads to blockage of the seven orifices; disharmony of the Six Fu organs leads to retention and formation of carbuncles. (The Five Zang belong to Yin and govern the interior, so their disharmony causes orifice dysfunction; the Six Fu belong to Yang and govern the exterior, so their dysfunction leads to retention in the muscle interstices forming carbuncles.) Pathogens in the Fu organs cause disharmony of Yang pulses; disharmony of Yang pulses causes Qi stagnation; Qi stagnation leads to excess Yang; excessive Yang impedes Yin; impediment of Yin causes blood stagnation; blood stagnation leads to excess Yin. Excessive Yin prevents Yang from nourishing, termed "Guan" (Closed); excessive Yang prevents Yin from nourishing, termed "Ge" (Blocked); when both Yin and Yang are excessive and cannot mutually nourish, it is termed "Guan-Ge" (Closed and Blocked). Guan-Ge patients die before reaching their natural lifespan. (Yin and Yang Qi should be peaceful. Pathogens occupy either Yin or Yang. Pathogens in Fu organs cause Qi stagnation and Yang excess, harming Yin; Yin harm causes blood stagnation and Yin excess, harming Yang. Thus, excessive Yin leads to Yang non-nourishment ("Guan"), excessive Yang leads to Yin non-nourishment ("Ge"), and mutual non-nourishment due to dual excess forms "Guan-Ge," preventing longevity. Prominent Renying pulse indicates Ge-Yang; prominent Cunkou pulse indicates Guan-Yin.)
Humans obtain Qi from food. Food enters the stomach, transmits to the Lungs, and nourishes the Five Zang and Six Fu organs. (Human life depends on Qi. This Qi is inherited from Heaven and combined with Grain Qi to fill the body. Food entering the stomach transforms into Qi, called "Grain Qi" or "Stomach Qi." Originating in the Middle Jiao, transmitted via the Spleen, and returning to the Lungs, it accumulates in the Chest Sea as Zong Qi (Pectoral Qi). Zong Qi moves with respiration, penetrating the Triple Burner, nourishing all organs. Thus, the Stomach is the sea of water and grain and blood/Qi; humans rely solely on grain for Qi. Without grain for half a day, Qi weakens; without it for a day, Qi diminishes.) The clear part becomes Ying Qi (Nutrient Qi); the turbid part becomes Wei Qi (Defensive Qi). (Qi from the stomach has clear and turbid aspects. Clear Qi is the essence of water and grain; turbid Qi is its fierce/rapid aspect. Clear Qi belongs to Yin, is refined and dedicated, transforms into blood vessels, and circulates through meridians, becoming Ying Qi. Turbid Qi belongs to Yang, is rapid and slippery, does not follow meridians but reaches the surface directly, filling the skin and muscle spaces, becoming Wei Qi. However, both Ying and Wei Qi rely on Zong Qi; thus, robust Zong Qi ensures harmonious Ying-Wei, while weak Zong Qi leads to deficient Ying-Wei.) Ying Qi resides within the vessels; Wei Qi resides outside the vessels. (Ying circulates internally; Wei guards externally. Vessels are neither Qi nor Blood alone but act like bellows for them. Ying belongs to Yin and governs the interior; Wei belongs to Yang and governs the exterior. Hence, Ying is inside vessels, Wei outside. Floating Qi not following meridians is Wei Qi; refined Qi circulating in meridians is Ying Qi.) Ying Qi circulates continuously, meeting again after fifty cycles, with Yin and Yang interconnecting like a circle without end. (Ying Qi circulates ceaselessly, completing fifty cycles in one day and night. The twelve meridians alternate Yin-Yang and Interior-Exterior, connecting endlessly, hence "like a circle without end.") Wei Qi travels twenty-five cycles in Yin and twenty-five in Yang, dividing day and night; thus, Qi reaching Yang awakens the person, while reaching Yin induces sleep/rest. (Wei Qi travels Yin divisions twenty-five times at night and Yang divisions twenty-five times during the day, totaling fifty cycles. Reaching Yang causes waking; reaching Yin causes rest, reflecting the rhythm of activity and repose.) Thus, midday sees peak Yang, called "Double Yang"; midnight sees peak Yin, called "Double Yin." ("Long" means abundance. Day is Yang; midday is Yang within Yang, hence Double Yang. Night is Yin; midnight is Yin within Yin, hence Double Yin. "Long" sounds like 'long'.) Taiyin governs the interior (Ying Qi), Taichu governs the exterior (Wei Qi), each traveling twenty-five cycles, divided by day and night. (Taiyin refers to Hand-Taiyin Lung Meridian; Taichu refers to Foot-Taichu Bladder Meridian. Interior refers to Ying Qi, which starts at Hand-Taiyin and returns there, hence Taiyin governs interior. Exterior refers to Wei Qi, starting at Foot-Taichu and returning there, hence Taichu governs exterior. Ying Qi circulates the twelve meridians, twenty-five cycles each for day and night; Wei Qi travels Yang by day and Yin by night, also twenty-five cycles each. Ying and Wei each complete fifty cycles to divide day and night.) Midnight is peak Yin; after midnight, Yin declines. At dawn, Yin ends and Yang receives Qi. Midday is peak Yang; at sunset, Yang declines. At dusk, Yang ends and Yin receives Qi. (After midnight, Yin declines as Yang generates at Zi hour; at sunset, Yang declines as Yin generates at Wu hour. Dawn to midday is Heaven's Yang, Yang within Yang; midday to dusk is Heaven's Yang, Yin within Yang. Dusk to rooster crow is Heaven's Yin, Yin within Yin; rooster crow to dawn is Heaven's Yin, Yang within Yin. Humans mirror this.) Midnight is the great meeting; people sleep, called "He Yin" (Combined Yin). At dawn, Yin ends and Yang receives Qi. This cycle continues endlessly, aligning with Heaven and Earth. (Great meeting refers to the convergence of Ying, Wei, Yin, and Yang. Due to different paths, they rarely meet except at midnight Zi hour, when Yin is extreme and Yang is about to generate. Both Ying and Wei Qi are in Yin, so people sleep, called "He Yin." He Yin means Ying and Wei return to the Zang organs and converge in Tian Yi. At dawn, Yin ends and Yang rises, so people wake. This follows the law of Yin-Yang waxing and waning, aligning with cosmic rhythms. Heaven uses 28 Mansions, Earth uses 12 Earthly Branches, Sun/Moon use speed. Heaven/Earth meet yearly; Heaven/Sun meet yearly; Sun/Moon meet monthly. Human Ying-Wei uses day/night as rhythm, meeting every fifty cycles.) Elderly do not sleep soundly at night; young and strong do not sleep during the day. In the vigorous, Qi and Blood are abundant, muscles are smooth, Qi channels are open, and Ying-Wei flow is normal, resulting in alert days and sound nights. In the elderly, Qi and Blood decline, muscles wither, Qi channels become obstructed, and Zang Qi knots. Ying Qi becomes deficient, and Wei Qi invades inward, causing daytime fatigue and nighttime insomnia. (Elderly have declining Qi/Blood, withering muscles, and obstructed channels. Zang Qi stagnates, reducing Ying Qi. Deficient Ying allows Wei Qi to invade inward. Disordered Wei causes daytime lethargy; disordered Ying causes nighttime insomnia.) Ying Qi originates from the Middle Jiao; Wei Qi originates from the Lower Jiao. (Ying Qi comes from food in the stomach. The Middle Jiao extracts essence, sends it up to the Lungs, starting at Hand-Taiyin, circulating meridians; thus, Ying originates from Middle Jiao. Wei Qi, being fierce and rapid, moves first to extremities, muscles, and skin, not entering vessels. At dawn, Yang Qi exits the eye, descends head/neck, starts at Foot-Taichu Bladder Meridian for Yang phase. At sunset, it starts at Foot-Shaoyin Kidney Meridian for Yin phase. Its Qi emerges from Bladder/Kidney from below; thus, Wei originates from Lower Jiao. Note: The body is Interior/Exterior, which is Yin/Yang, which is Ying/Wei, which is Blood/Qi. Internal organs/bones/tendons rely on Ying for nourishment and meridians for smoothing; external skin/muscles rely on Wei for protection and collateral vessels for moistening. Thus, internal marrow and external hair/skin are all nourished by Ying-Wei transformation. Wei is Yang, originating from Lower Jiao; lower things rise, like earth vapor becoming clouds. Ying is Yin, originating from Middle Jiao to Upper Jiao; upper things descend, like heaven rain falling. Though Wei governs Qi externally, it contains Blood; though Ying governs Blood internally, it contains Qi. Thus, Ying may contain Wei, and Wei may contain Ying. Those moving internally are Ying; those moving externally are Wei. This is the way of Yin-Yang interaction: separated as two, united as one.) Upper Jiao exits the upper opening of the stomach, ascends with the pharynx, pierces the diaphragm, spreads in the chest, goes to the axilla, follows the Taiyin division, returns to Yangming, ascends to the tongue, and descends to Foot-Yangming. (Upper stomach opening is Shangwan. Pharynx is the stomach's connection and food pathway. Above diaphragm is chest/Shanzhong. Side paths go to axillae/Tianchi, follow Hand-Taiyin Lung Meridian to Hand-Yangming. Upward path reaches tongue; downward path crosses Foot-Yangming to Middle/Lower Jiao. All are parts of Upper Jiao.) It often travels with Ying Qi twenty-five cycles in Yang and twenty-five in Yin, completing one cycle; thus, after fifty cycles, it meets again at Hand-Taiyin. (Upper Jiao is where the Lungs reside and Zong Qi gathers. Ying Qi follows Zong Qi through fourteen meridians. Thus, Upper Jiao Qi travels with Ying Qi twenty-five cycles in Yang and Yin, totaling fifty daily, meeting Hand-Taiyin Lung Meridian at Yin hour next day, completing one cycle. Although Ying originates from Middle Jiao, its distribution depends on Upper Jiao.) Middle Jiao is also in the stomach, behind the Upper Jiao. The Qi received here separates dregs, steams fluids, transforms essence, sends it up to Lung vessels, transforming into Blood to nourish the body. Nothing is more precious; thus, it alone travels in meridians, named "Ying Qi." ("Hou" means below. Receiving Qi means grain in stomach separates into dregs, fluids, and Zong Qi into three tunnels for Triple Burner. Middle Jiao separates dregs, steams fluids, extracts essence, transforms to red, creating Blood to nourish the body in meridians, called Ying Qi. Hence "Ying from Middle Jiao." Lower Jiao separates Hui Chang, injects Bladder. From below diaphragm to one cun above umbilicus Shuifen point is Middle Jiao. "Mi" sounds like 'mi'.) Ying and Wei are Essence-Qi; Blood is Spirit-Qi. Thus, Blood and Qi are different names but same category. Therefore, those who lose Blood should not sweat; those who lose Sweat should not bleed. Life has two deaths but no two lives. (Although Ying-Wei are clear/turbid, both are grain essence, called "Essence-Qi." Blood turns red mysteriously, called "Spirit-Qi." Blood derives from fluids, fluids from Qi; thus Blood and Qi are same category, and Blood and Sweat are not distinct. But Blood governs Ying (Yin/Interior), Sweat belongs to Wei (Yang/Exterior). One interior, one exterior, cannot be attacked simultaneously. Thus, losing Blood requires avoiding sweat; losing Sweat requires avoiding blood. If both interior/exterior are depleted, one departs Yin, the other Yang; departure means death, hence "two deaths." However, life requires both Yin and Yang; isolated Yang or Yin cannot generate life, hence "no two lives".) Lower Jiao separates Hui Chang, injects into Bladder, and seeps in. Thus, water and grain reside in stomach, become dregs, descend to Large Intestine, forming Lower Jiao, seeping down, filtering juices, following Lower Jiao to seep into Bladder. (Hui Chang is Large Intestine. Ji/Tong means straining. Mi means narrow flow. Bie Zhi means separating clear/turbid. Separating Hui Chang means water/grain in stomach transmit to Small Intestine. At Shuifen point one cun above umbilicus, dregs go separately to Hui Chang, exiting posteriorly; fluids seep separately to Bladder, exiting anteriorly. Bladder has no upper opening, hence "seeps." Below Shuifen point is Lower Jiao. Lower Jiao is at Bladder upper opening, governing separation of clear/turbid. "Upper opening" refers to seepage site, not a literal mouth. If literal, it wouldn't say "seep." "Shai" sounds like 'shai'.) When humans drink wine, it enters the stomach. Before grain digests, urine excretes first. Wine is liquid of cooked grain, its Qi is fierce and clear, so it enters after grain but exits as liquid before grain. (Wine's fierce Qi connects directly to Lower Jiao; its clear quality moves fast without stagnation, hence entering after grain but exiting before.) Upper Jiao is like mist; Middle Jiao like foam; Lower Jiao like a ditch. This is what is meant. (Like mist: Qi floats upward. Zong Qi accumulates in chest, governs respiration, spreads in meridians like sky mist, hence "Upper Jiao like mist." Like foam: bubbles on water, water buoyant with Qi. Ying/Blood transform in Middle Jiao, circulate with Qi to nourish body, floating between sinking/rising like foam, hence "Middle Jiao like foam." Like ditch: water drains. Lower Jiao governs exit not intake, flowing away quickly, hence "Lower Jiao like ditch." Thus, Lungs govern mist, Spleen governs foam, Large Intestine/Bladder govern drainage. Triple Burner is the great organ of the whole body, encompassing Upper/Middle/Lower. Elaborations are numerous. *Nan Jing* says Triple Burner has name but no form, causing later doubts. Observing this clarifies it fully.)
Ren Mai (Conception Vessel) starts below Zhongji, ascends to pubic hair line, follows abdominal interior, passes Guanyuan, reaches throat, chin, face, and eyes. (Ren, Chong, Du are extraordinary vessels. Zhongji is a Ren Mai acupoint, one cun above Qugu. Below Zhongji is Uterus. Ren, Chong, Du all originate in Uterus, exiting Huiyin. Ren runs abdomen from Huiyin; Du runs back from Huiyin; Chong exits Huiyin, joins Shaoyin, scatters in chest. Thus, from pubic hair, abdominal interior, Guanyuan, to throat/face/eyes are Ren Mai pathways.) Chong Mai (Penetrating Vessel) starts at Qichong, runs alongside Shaoyin Meridian, flanks navel upward, scatters in chest. ("Start" refers to external vessel origin, not source. Similar below. Qichong is Foot-Yangming acupoint, beside pubic hair. Chong starts at Qichong, joins Foot-Shaoyin, converges at Henggu, Dahe, etc. Flanking navel to chest describes anterior path. Shaoyin ascends inner thigh, pierces spine, connects Kidney. Chong also enters spine as Fuchong (Hidden Penetrating) Vessel. Posterior Chong likely joins Shaoyin too. "Hidden" implies deepest depth. Thus, Chong receives Qi/Blood of all twelve meridians, nourishing body, hence "Sea of Twelve Meridians.") Ren Mai pathology: Men develop seven types of Hernia internally; Women develop leukorrhea and masses. (Ren Mai runs from genitalia to pubic hair, abdominal interior, causing these symptoms. Leukorrhea is white/red discharge. Xia refers to false masses; Ju refers to accumulations.) Chong Mai pathology: Counterflow Qi and internal urgency. (Chong flanks navel to chest. Disharmonious Qi causes chest oppression/rebellion; disharmonious Qi/Blood causes chest/abdominal urgency.) Du Mai (Governor Vessel) pathology: Stiff spine and backward bending. (Du pierces spine, causing stiffness and limited movement.) Du Mai starts in lower abdomen, below central bone. In women, it enters the Ting Kong (Urethral Orifice). (Below describes Du Mai. Lower abdomen is小腹/Uterus area. Central bone is center below transverse bone. Ting means straight/upright, referring to the central straight hole, i.e., urethra.) This hole is the end of the urethral orifice. (Women's urethra is below transverse bone in genitalia. Upper edge of hole is "Duan," where Du Mai externally starts. Though described for women, men's urethra is also centrally below transverse bone, but hidden by Zongjin, thus invisible. "Ni" sounds like 'niang diao'.) Its collaterals follow the genitalia, merge at Cu Jian (Perineum), and circle behind Cu. (Du collateral starts at urethral end, follows genitalia backward, merges at Cu Jian, then splits to circle behind. "Cu" means crossing, place of two openings, i.e., between front and rear yins. "Cu" sounds like 'chu huan'.) It branches around buttocks, reaches Shaoyin, combines with Juyang middle collaterals, merges with Shaoyin, ascends inner thigh posterior edge, pierces spine, connects Kidney. (Foot-Shaoyin...)