\r手厥阴心包经之图\p06-d34a11.bmp\r
手厥阴心包络之经脑走腋而腋走手是经多血少气起于天池止于中冲计九穴左右共一十八穴心
包一名手心主以藏象校之在心下横膜之上坚膜之下与横膜相粘而黄脂漫裹者心也其漫脂之外
有细筋膜如丝与心肺相连者心包也或问手厥阴经曰心主又曰心包络何也曰君火以名相火以位
手厥阴代君大行事以用而言故曰手心主以经而言则曰心包络一经面二名实相火也
心主心包手厥阴如丝箸膜肺连心脉从胸中心包会下膈三焦脐下停
灵枢第十篇云手厥阴之脉起于胸中出属心包下膈历络三焦○滑氏曰手厥阴受足少阴之交起于
胸中出属心包由是下膈历络于三焦之上脘中脘及脐下一寸下焦之分也
其支又自心包走横出循胸来乳后一寸天池厥肋间循腋天泉循 肘前行尺泽肘纹空
灵枢第十篇云其交者循胸出胁下腋三寸上抵腋下下循 内行太阴少阴之间入肘中○滑氏曰胁
上际为腋自属心包上循胸出胁下腋三寸天池穴上行抵腋下下循 内之天泉穴介乎太阴少阴两
经之中间入肘中之曲泽也
天池 在乳后一寸腋下三寸着胁直腋撅肋间足少阳之会
天泉 在曲腋下去臂二寸举臂取之
曲泽 在肘内廉下陷中屈肘取之
直行下臂两筋中 门间使内关去大陵自掌来劳宫惟有中冲在中指
灵枢第十篇云下臂行两筋之间入掌中循中指出其端○滑氏曰由肘中下臂行臂两筋之间循 门
间使内关大陵入掌中劳宫穴循中指出其端之中冲去
门 在掌后去腕寸厥阴之
间使 在掌后三寸两筋间陷中
内关 在掌后去腕二寸或取惠人三指横加掌后腕上以中指之下当中两筋间陷中
大陵 在掌后两筋间陷中
劳宫 在掌中央动脉中屈无名指取之厥阴少阳络穴也
中冲 在手中指端去爪甲如韭叶
其支别自劳宫起出掌循行次指端交手少阳三焦位
灵枢第十篇云其支别者从掌中循小指次指出其端○滑氏曰小指次指无名指也自小指逆数之则
为次指云支别者自掌中劳宫定别行循小指次指出其端而交于手少阳也
总歌曰
气自胸中何所注心包由始对三焦其注入中冲入指标
愚按手厥阴心包络之脉起于胸中终于手中指中行穴其支别者复自掌中劳宫穴别行循小指之表
端长三尺交于手少阳三焦经故手少阳之脉起于手小指次指之表端关冲穴始也
穴歌曰
九穴心包手厥阴天池天泉曲泽深 门门使内关去大陵劳宫中冲临
是动所生歌曰
是经少气原多血是动则病手心热肘臂挛急腋下肿甚则胸胁支满结心中澹澹或大动善笑目黄面
赤色所生病者为烦心心痛掌中热即生
灵枢第十篇云是动则病手心热臂肘挛急腋肿甚则胸胁支满心中澹澹大动面赤
目黄喜笑不休是生脉所生病者烦心心痛掌中热为此诸病盛则泻之虚则补之热则疾之寒则留之
陷下则灸之不盛不虚以经取之盛者寸口大一倍于人迎虚者寸口反小于人迎也
音释
撅(居越反)
手厥阴心包经之图
手厥阴心包络经的循行路线,从脑部走向腋下,再从腋下走向手部。这条经脉多血少气,起始于天池穴,终止于中冲穴,共计九个穴位,左右两侧共十八个穴位。心包又名手心主,根据藏象理论进行校对,它位于心脏下方横膈膜之上、坚膜之下,与横膈膜相连并被黄色脂肪包裹的是心脏;而在黄色脂肪之外,有细如丝线的筋膜,连接心肺的,就是心包。有人问:手厥阴经既称“心主”,又称“心包络”,这是为什么呢?回答说:君火以名号彰显,相火以职能定位。手厥阴经代替君主执行大事,从功能作用而言,所以称为手心主;从经络名称而言,则称为心包络。这是一条经脉却有两个名字,实际上都是指相火。
心主心包手厥阴,如丝箸膜肺连心脉从胸中心包会下膈三焦脐下停。
《灵枢》第十篇记载:手厥阴的经脉,起始于胸中,出来归属于心包,向下穿过膈肌,依次联络上、中、下三焦。○滑寿(滑氏)说:手厥阴经受足少阴经的气交,起始于胸中,出来归属于心包,由此向下穿过膈肌,依次联络于三焦的上脘、中脘以及脐下一寸的下焦部位。
其支脉又从心包走出,横向经过胸部,沿乳头后方一寸的天池穴,在肋骨间行走,经过腋下的天泉穴,沿着肘前前行至尺泽穴,即肘横纹中的凹陷处。
《灵枢》第十篇记载:它的分支,沿着胸部外出胁部,下行至腋下三寸,向上抵达腋下,向下沿着臂内侧,走在手太阴肺经和手少阴心经之间,进入肘中。○滑寿说:胁部上际为腋下,属于心包经,向上沿着胸部外出胁部,下行至腋下三寸的天池穴,上行抵达腋下,向下沿着臂内侧的天泉穴,介于手太阴和手少阴两经的中间,进入肘中的曲泽穴。
天池穴:位于乳头后方一寸,腋下三寸,附着于胁肋,直对腋窝,撅起肋骨之间的空隙,是足少阳胆经的交会穴。
天泉穴:位于曲腋下方,距离手臂二寸处,举起手臂时取穴。
曲泽穴:位于肘关节内侧廉下陷中,屈肘时取穴。
直行向下经过前臂两筋之间,经过郄门、间使、内关,到达大陵穴,自手掌而来是劳宫穴,只有中冲穴在中指端。
《灵枢》第十篇记载:向下经过前臂,行于两筋之间,进入掌中,沿着中指指出其末端。○滑寿说:由肘中向下经过前臂,行于前臂两筋之间,沿着郄门、间使、内关、大陵,进入掌中的劳宫穴,沿着中指指出其末端的中冲穴。
郄门穴:位于掌后,距离腕横纹一寸,在手厥阴经之间。
间使穴:位于掌后三寸,两筋间的凹陷中。
内关穴:位于掌后距离腕横纹二寸,或者取患者三指并拢横加在掌后腕上,以中指指尖下方,正当两筋间凹陷处取穴。
大陵穴:位于掌后两筋间的凹陷中。
劳宫穴:位于手掌中央动脉搏动处,屈无名指时取穴,是手厥阴心包经的荥穴,也是手少阳三焦经的络穴。(注:原文“厥阴少阳络穴也”通常指劳宫为心包经荥穴,此处依原文翻译,但需注意中医标准中劳宫非三焦络穴,三焦络穴为人正,此处可能原文有误或特指某种关联,按字面翻译)。
中冲穴:位于手中指尖端,距离指甲角如韭菜叶宽处。
其分支又从劳宫穴分出,出于手掌,沿着食指(次指)端,交接于手少阳三焦经。
《灵枢》第十篇记载:它的分支,从掌中沿着小指和食指的中间指出其末端。○滑寿说:小指旁边的手指是无名指,从小指逆数则为次指(食指)。所谓分支,是从掌中的劳宫穴别出,沿着小指和食指的中间指出其末端,而交接于手少阳三焦经。
愚按:手厥阴心包络之脉,起始于胸中,终止于手中指中行穴。其分支又从掌中的劳宫穴别出,沿着小指外侧(表),末端长三尺,交接于手少阳三焦经。所以手少阳三焦经的脉气,起始于手小指和食指外侧的末端关冲穴。
穴歌曰:
九穴心包手厥阴,天池天泉曲泽深。郄门间使内关去,大陵劳宫中冲临。
是动所生歌曰:
是经少气原多血,是动则病手心热,肘臂挛急腋下肿,甚则胸胁支满结,心中澹澹或大动,善笑目黄面色赤。所生病者为烦心,心痛掌中热即生。
《灵枢》第十篇记载:是动则病,手心热,臂肘挛急,腋肿,甚则胸胁支满,心中澹澹大动,面赤,目黄,喜笑不休。是生脉所生病者,烦心,心痛,掌中热。为此诸病,盛则泻之,虚则补之,热则疾之,寒则留之,陷下则灸之,不盛不虚以经取之。盛者寸口脉大一倍于人迎脉,虚者寸口脉反小于人迎脉。
音释:
撅(居越反)
Diagram of the Hand-Jueyin Pericardium Meridian
The meridian pathway of the Hand-Jueyin Pericardium (Pericardium) runs from the brain to the axilla, and from the axilla to the hand. This meridian is characterized by abundant blood and scarce Qi. It originates at Tianchi (PC1) and terminates at Zhongchong (PC9), comprising nine acupoints on each side, totaling eighteen acupoints bilaterally. The Pericardium is also known as the "Heart Master" (Shou Xin Zhu). According to Zang-Fu theory, it is located above the transverse diaphragm and below the firm membrane beneath the heart, adhering to the transverse diaphragm and enveloped by yellow adipose tissue, which constitutes the Heart; outside this yellow fat, fine fibrous membranes like silk connect to the Heart and Lungs, constituting the Pericardium. One may ask: Why is the Hand-Jueyin meridian referred to as both "Heart Master" and "Pericardium"? The answer is: The Ministerial Fire (Xiang Huo) operates by position, while the Sovereign Fire (Jun Huo) manifests by name. The Hand-Jueyin meridian acts on behalf of the Sovereign to execute major functions; thus, in terms of functional utility, it is called the "Heart Master"; in terms of meridian nomenclature, it is called the "Pericardium." Although this is one meridian with two names, it essentially refers to the Ministerial Fire.
The Heart Master and Pericardium belong to the Hand-Jueyin [Meridian]. Like silk or chopstick-shaped membranes, they connect to the Lung and Heart vessels. Originating from the center of the chest, the Pericardium meets below the diaphragm, traversing the Sanjiao (Triple Burner) and stopping below the umbilicus.
*Classic of Spirituality (Lingshu)*, Chapter 10 states: The vessel of the Hand-Jueyin originates in the chest, emerges to connect with the Pericardium, descends through the diaphragm, and successively connects with the Sanjiao. ○ Mr. Hua (Hua Shou) stated: The Hand-Jueyin receives the intersection of the Foot-Shaoyin, originating in the chest, emerging to connect with the Pericardium, then descending through the diaphragm to successively connect with the upper, middle, and lower Jiao (specifically the Shangwan, Zhongwan, and one cun below the umbilicus).
Its branch leaves the Pericardium, moves laterally along the chest, passing one cun posterior to the nipple at Tianchi (PC1), travels between the ribs, passes through Tianquan (PC2) in the axilla, proceeds anteriorly along the elbow to Quze (PC3), which is located in the depression of the cubital crease.
*Lingshu*, Chapter 10 states: Its branch follows the chest, emerges from the hypochondrium, descends three cun into the axilla, ascends to reach the axilla, then descends along the medial aspect of the arm, running between the Taiyin and Shaoyin meridians, entering the elbow. ○ Mr. Hua stated: The upper boundary of the hypochondrium is the axilla, belonging to the Pericardium meridian. Ascending along the chest and emerging from the hypochondrium, it descends three cun into the axilla to Tianchi (PC1), ascends to reach the axilla, then descends along the medial arm to Tianquan (PC2), situated between the Taiyin and Shaoyin meridians, entering Quze (PC3) in the elbow.
Tianchi (PC1): Located one cun posterior to the nipple and three cun from the axilla, attached to the rib cage, directly opposite the axillary fossa, in the intercostal space when the ribs are elevated. It is an intersection point of the Foot-Shaoyang Gallbladder Meridian.
Tianquan (PC2): Located two cun below the apex of the axilla (quye), taken with the arm raised.
Quze (PC3): Located in the depression inferior to the medial epicondyle of the humerus, taken with the elbow flexed.
Descending straight down the forearm between the two tendons, passing Ximen (PC4), Jianshi (PC5), Neiguan (PC6), reaching Dalings (PC7), coming from the palm is Laogong (PC8), and only Zhongchong (PC9) is at the tip of the middle finger.
*Lingshu*, Chapter 10 states: Descending the arm, it runs between the two tendons, enters the palm, and follows the index finger to its tip. ○ Mr. Hua stated: From the elbow, descending the arm between the two tendons, it follows the path of Ximen (PC4), Jianshi (PC5), Neiguan (PC6), Dalings (PC7), enters the palm at Laogong (PC8), follows the index finger to its tip at Zhongchong (PC9).
Ximen (PC4): Located one cun proximal to the wrist crease, within the Hand-Jueyin meridian.
Jianshi (PC5): Located three cun proximal to the wrist crease, in the depression between the two tendons.
Neiguan (PC6): Located two cun proximal to the wrist crease. Alternatively, place three fingers of the patient horizontally across the wrist; the point is located in the depression between the two tendons, directly below the tip of the middle finger.
Dalings (PC7): Located in the depression between the two tendons at the wrist crease.
Laogong (PC8): Located in the center of the palm where the artery pulses, taken with the ring finger flexed. It is described in the text as a Luo-connecting point of the Shaoyang (Note: Standard TCM classifies Laogong as the Ying-Spring point of the Pericardium meridian; the text's claim regarding Shaoyang connection is translated literally).
Zhongchong (PC9): Located at the tip of the middle finger of the hand, approximately the width of a leek leaf from the nail corner.
Its branch originates from Laogong, exits the palm, follows the index finger (second finger) to its tip, and intersects with the Hand-Shaoyang Sanjiao Meridian.
*Lingshu*, Chapter 10 states: Its branch from the palm follows between the little finger and the index finger to its tip. ○ Mr. Hua stated: The finger next to the little finger is the ring finger; counting backwards from the little finger, the second finger is the index finger. The so-called branch diverges from Laogong in the palm, follows between the little and index fingers to its tip, and intersects with the Hand-Shaoyang Sanjiao Meridian.
General Song:
Where does the Qi from the chest flow? Starting from the Pericardium, it corresponds to the Sanjiao. It injects into Zhongchong and reaches the indicator finger.
Commentary: The vessel of the Hand-Jueyin Pericardium originates in the chest and terminates at the acupoint on the median line of the middle finger of the hand. Its branch diverges from Laogong in the palm, follows the lateral aspect of the index finger, extends three chi in length, and intersects with the Hand-Shaoyang Sanjiao Meridian. Therefore, the vessel of the Hand-Shaoyang Sanjiao originates at Guanchong (TE1) on the lateral aspect of the tip of the index finger.
Acupoint Song:
Nine acupoints of the Pericardium, Hand-Jueyin,
Tianchi, Tianquan, deep Quze.
Ximen, Jianshi, Neiguan depart,
Dalings, Laogong, Zhongchong approach.
Song of Pathogenic Changes and Diseases Generated:
This meridian has scarce Qi but abundant Blood. When pathogenic changes occur, diseases include heat in the palms, spasm and stiffness of the elbow and arm, swelling of the axilla; severely, there is fullness and binding in the chest and hypochondrium, palpitations or violent beating of the heart, excessive laughter, yellow eyes, and reddish complexion. Diseases generated by this meridian include vexation in the heart, heart pain, and heat in the palms.
*Lingshu*, Chapter 10 states: Pathogenic changes manifest as heat in the palms, spasm and stiffness of the arms and elbows, axillary swelling; severely, chest and hypochondriac fullness, violent palpitations, reddish face, yellow eyes, and incessant laughter. Diseases generated by the vessel include heart vexation, heart pain, and heat in the palms. For these conditions: excess is drained, deficiency is supplemented, heat is treated with rapid needle manipulation, cold is treated with retained needle manipulation, sinking Yang is treated with moxibustion, and neither excess nor deficiency is treated by selecting points from the affected meridian. In excess cases, the Cun Kou pulse is larger than the Ren Ying pulse by one degree; in deficiency cases, the Cun Kou pulse is smaller than the Ren Ying pulse.
Phonetic Explanation:
Jue (pronounced 'Jue' as per fanqie rule Ju-Yue).