经曰∶包络者,护卫心主,不使浊气干之,正犹君主有宫城也。
又曰∶心包络一经,《难经》言其无形。
\r心包络图\p04-a41a21.bmp\r
滑伯仁曰∶心包络,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KT 之外,有细筋膜如丝,与心肺相连者,心包也。此说为是,言无形者非。
又按《灵兰秘典论》十二官,独少心包一官,而多“膻中者,臣使之官,喜乐出焉”一段,今考心包藏居
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,即心包无疑矣。
又曰∶手厥阴经心包络。
又曰∶是经多血少气。
又曰∶戌时血注于心包络。
补∶地黄。
泻∶枳壳、乌药。
温∶肉桂。
凉∶栀子。
引经报使∶柴胡、青皮、川芎。
《灵枢》曰∶十二原,以心包经大陵穴为心之原,明真心不受邪,故知手心主代君火也。
又曰∶是动病则手心热,臂肘挛急,腋肿甚则胸胁支满,心中澹澹大动,面赤喜笑不休,目黄,是主心包。
手厥阴心包络引药歌∶
戌包败酱柴胡(白)术,(牡)丹皮熟地与沙参,更有下行经络药,青(皮)柴(胡)熟地可相亲。
经曰∶三焦者,决渎之官,水道出焉。
《中藏经》曰∶三焦者,人之三元之气也,主升降出入,总领五脏六腑,营卫经络,内外左右上下之气。
三焦通,则内外左右上下皆通,其于周身灌体,和内调外,营左养右,导上宣下,号曰中清之府,莫大于此
也。形色最赤,总护诸阳,非无状空有名者也。
经曰∶手少阳经三焦。
又曰∶是经少血多气。
又曰∶亥时气血注于三焦。
《灵枢》曰∶上焦如雾,中焦如沤,下焦如渎。
《入门》曰∶上焦主出阳气,温于皮肤分肉之间,若雾露之溉焉,故曰上焦如雾。中焦主变化水谷之味,
其精微上注于肺,化而为血,行于经隧,以荣五脏周身,故曰中焦如沤。下焦主通利溲便,以时传下,出而不
纳,开通秘塞,故曰下焦如渎。
又曰∶心肺若无上焦,何以宗主营卫,脾胃若无中焦,何以腐熟水谷,肝肾若无下焦,何以疏决津液,无
形而有用,主持诸气。三焦者,水谷之道路,气之所终始也。
\r三焦图\p04-a41a22.bmp\r
《正传》曰∶三焦,指腔子而言,包含乎肠胃之总司也。胸中肓膜之上曰上焦,肓膜之下,脐之上曰中焦,
脐之下曰下焦,总名曰三焦。
东垣曰∶上中下三焦,通为一气,卫于身也。三焦,非正腑也,无形而有用。
《入门》曰∶三焦为丙火之腑,故其发也,为无根之相火。
经曰∶下焦溢为水。
经曰∶手少阳三焦经,与手厥阴为表里。三焦者,水谷之道路,气之所终始也,上焦者,在心下,下膈,
主内而不出;其治在膻中,直两乳陷者是。中焦者,在胃中脘,当脐上四寸,不上不下,主腐熟水谷;其治在
脐旁。下焦者,在脐下当膀胱际也,主分别清浊,出而不内,以传道也;
其治在脐下一寸焦原也。三焦者,三原之气也。(内,音纳。上焦主出阳气,温于皮肤分肉之间,若雾露之溉
焉。中焦主变化水谷之味,为血以荣五脏六腑。下焦主通利,溲以时传下,故日出而不内。溲,音搜。)
《九墟》云∶中焦亦并于胃中,出上焦之后,此肾受气,以别糟粕,蒸津液,化其精微上注于肺脉,乃化
而为血,以奉生身,故得独行于经隧,命曰荣气。故言中焦如沤也。仲景曰∶下焦不和,清便重下,大便数难,
脐腹筑痛,故曰∶三焦者,寄于胸中。
《脉诀》云∶三焦无状,空有名。愚谓三焦者,三原之气也,实非无形,但不专主一脏耳。既为原气别使,
又为传化之腑,由十二经始于中焦,常与卫气俱行,故扁鹊指为水谷之道路,气之所终始也。上焦出于胃上口,
并咽以上贯膈布胸,走腋而至太阴之分;中焦亦并胃中,出上焦之后;下焦别回肠,注于膀胱,而渗入焉。手
厥阴心包,乃其合也。布络三焦,而三焦之经则又散络心包,苟无其形,将何所凭,而包络从何所附以传化焉。
《三元参赞》云∶其体有一脂膜如掌状,与膀胱相对,有白脉自其中出,夹脊而上贯脑,窃谓如雾如沤,喻其
明之薄处,如渎云者,则又指夫渗入膀胱处也。一名外府,一名虚脏,信然。 范曰∶此三焦有名无形,正脏
腑有余不尽之义,苟止心肝脾肺肾,而无三焦所寄之腑,是人身与天地为二矣。
又曰∶脏腑俱五者,谓手心主非脏,三焦非腑也,以脏腑俱六者,合手心主与三焦也。
《难经》曰∶脏惟有五,腑独有六者,何也?所谓腑有六者,谓三焦也。有原气之别焉,主持诸气,有名
而无形,其经属手少阳,此外腑也,故言腑有六。
又云∶十二经,五脏六腑十一耳,其一经者,何等经也。然一经者,手少阴与心主别脉也,心主与三焦为
表里,俱有名
而无形,故言经有十二也。缘不专主一脏,故言有名无形。
《正理论》云∶三焦者,有名无形,上合于手心主,下合于右肾,遂有命门三焦表里之说。殊不知包络相
火,附名右肾。夫人之脏腑,一阴一阳,自有定偶,岂得一经而两配之理,所谓上合于心主,正言其为表里,
下合右肾者,正言其与包络相火相合,又以三焦为原气之别使也,知此则知命门与肾,通三焦无两配矣。
《脉诀》曰∶右尺脉浮,则风邪客于下焦,大便热秘,浮而虚,元气不足。沉则水病,腰脚痛;沉细下痢
脐寒痛逼。迟则寒泻,小腹冷,腰脚重。数则小便赤,大便秘。浮数表热,沉数里热。滑则相火炎盛,梦泄阴
虚。妇人和滑,则为有孕。涩则大便涩,津液衰,其余诊法与肾脉同。
又曰∶是动病则耳聋浑浑 ,嗌肿喉痹。是主气。
手少阳三焦引经药歌∶
亥焦地骨(皮川)芎(黄) (白)术,附子青(皮)柴(胡)熟地逢,白虎细辛皆在内,青柴下走共川芎。
又曰∶一切治法仿心经用。
海藏曰∶上焦如雾,雾不散则为喘满,此出而不纳也。中焦如沤,沤不利则为留饮,留饮不散,久为中满,
此上不能纳,下不能出也。下焦如渎,渎不利则为肿满,此上纳而下不出也。
《灵枢》曰∶鼻柱中央起三焦,乃约。
又曰∶三焦病者,腹气满,小腹尤坚,不得小便,窘急溢则水留即为胀。
又曰∶小腹痛肿,不得小便,邪在三焦约也。
经曰∶三焦,为上中下水谷之道路,其病通利,大小便为主。
补∶黄 、甘草、益智。
泻∶泽泻。
温∶附子。
凉∶石膏。
引经报使∶柴胡、青皮、川芎。
经文说:心包络的功能是护卫心主,防止浊气侵犯它,这正如同君主拥有宫城作为防护一样。
滑伯仁说:心包络,又名手心主。从脏腑的象位来考察,心脏位于横膈膜之上、竖膈膜之下,那些与横膈膜粘连并被黄色脂肪包裹的组织,就是心脏。在黄色脂肪之外,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,说心包络无形体的观点是不对的。
另外考证《灵兰秘典论》中关于十二官的描述,唯独缺少“心包”这一官职,却多出了一段“膻中,是臣使之官,主管喜乐”的内容。现在考证发现,心包藏居于膈肌上方,经脉起始于胸中,正好位于膻所在的位置,位居相火之位,代替君主行事,确实是臣使之官。这一个官职,就是心包无疑了。
又说:这条经脉多血少气。
补法用药:地黄。
泻法用药:枳壳、乌药。
温法用药:肉桂。
凉法用药:栀子。
引经报使药(引导药物到达病所):柴胡、青皮、川芎。
《灵枢》说:十二原穴中,以心包经的大陵穴作为心的原穴,说明真心不受邪气侵袭,因此知道手心主代替君火受邪。
又说:本经发生变动产生的病症,会出现手心发热,手臂和肘部拘挛僵硬,腋下肿胀,严重时胸胁支撑胀满,心中悸动不安,面色发红,喜欢笑个不停,眼睛发黄,这些症状主要反映心包的病变。
手厥阴心包络引经药歌诀:
戌时对应的心包络,败酱草、柴胡、白术,牡丹皮、熟地黄与沙参,还有下行经络的药物,青皮、柴胡、熟地可以亲近配合使用。
《中藏经》说:三焦,是人体的三元之气,主管气的升降出入,总领五脏六腑、营卫经络以及内外左右上下所有的气机。
三焦通畅,则内外左右上下都通畅,它在周身灌注形体,调和内部与外部,滋养左侧并养护右侧,疏导上部并宣通下部,被称为中清之府,没有比这更重要的了。它的颜色最红,总护诸阳,并不是没有形状只徒有虚名的东西。
又说:这条经脉少血多气。
《灵枢》说:上焦像雾露弥漫,中焦像沤渍发酵,下焦像沟渠排水。
《入门》说:上焦主要输出阳气,温煦于皮肤和肌肉纹理之间,就像雾露灌溉一样,所以说上焦如雾。中焦主要变化水谷的味道,其精微物质向上注于肺,化生为血液,运行于经脉隧道中,以营养五脏和周身,所以说中焦如沤。下焦主要通利大小便,按时传导下去,排出而不收纳,开通闭塞,所以说下焦如渎。
又说:心肺如果没有上焦,如何宗主营卫?脾胃如果没有中焦,如何腐熟水谷?肝肾如果没有下焦,如何疏泄津液?三焦虽然无形体却有功用,主持各种气机。三焦是水谷运行的道路,也是气机终结和开始的地方。
《正传》说:三焦,是指胸腔腹腔而言,是包含肠胃在内的总管司。胸中肓膜之上称为上焦,肓膜之下、肚脐之上称为中焦,肚脐之下称为下焦,总名称为三焦。
李东垣说:上、中、下三焦,贯通为一气,护卫身体。三焦不是正统的腑,虽然无形体却有功用。
《入门》说:三焦是丙火的腑,所以它发作时,表现为无根的相火。
经文说:手少阳三焦经,与手厥阴心包经互为表里。三焦是水谷的道路,气机终始的地方。上焦在心下,穿过膈肌,主管摄入而不外出;其治疗部位在膻中,即两乳之间的凹陷处。中焦在胃的中脘部,当脐上四寸处,不上不下,主管腐熟水谷;其治疗部位在脐旁。下焦在脐下,接近膀胱的位置,主管分别清浊,排出而不纳入,以传导为主;其治疗部位在脐下一寸的关元穴处。三焦,就是三元之气。(内,读音同纳。上焦主管输出阳气,温煦于皮肤肌肉之间,如雾露灌溉。中焦主管变化水谷味道,化为血液以荣养五脏六腑。下焦主管通利,小便按时传导下去,所以日出而不出入体内。溲,读音同搜。)
《九墟》说:中焦也合并于胃中,位于上焦之后,这里肾接受气,以分别糟粕,蒸腾津液,将其精微物质上注于肺脉,进而化生为血液,以奉养生命,所以能独自行于经脉隧道中,命名为营气。所以说中焦如沤。张仲景说:下焦不和,会导致大小便异常,大便次数多且困难,脐腹剧烈疼痛,所以说:三焦寄居在胸中。
《脉诀》说:三焦没有具体形状,徒有虚名。我认为三焦是三元之气,实际上并非无形,只是不专门主宰某一个脏器罢了。既然作为原气的别使,又作为传化的腑,由于十二经起源于中焦,常与卫气一起运行,所以扁鹊称它为水谷的道路,气机终始的地方。上焦出于胃的上口,沿着咽喉向上穿过膈肌分布于胸部,走向腋下而至太阴经的分野;中焦也合并于胃中,位于上焦之后;下焦别出回肠,注入膀胱,并渗入其中。手厥阴心包经,是与三焦相合的经脉。三焦经散布联络心包,而心包络的经脉又散络三焦,如果三焦没有形体,凭借什么存在?心包络又从何处附着以进行传化呢?
《三元参赞》说:三焦的形体有一片手掌状的脂膜,与膀胱相对,有白色的脉络从中发出,夹着脊柱向上贯穿脑部。我私下认为,“如雾如沤”是比喻其明澈稀薄的地方,“如渎”则是指出渗入膀胱的部位。三焦又名外府,又名虚脏,确实如此。范氏说:所谓三焦有名无形,正是指脏腑有余不尽的含义。如果只有心肝脾肺肾,而没有三焦所寄居的腑,那么人身就与天地分离了。
又说:说脏腑都是五个的,是指手心主不是脏,三焦不是腑;说脏腑都是六个的,是将手心主和三焦合在一起计算。
《难经》说:脏只有五个,为什么腑独有六个呢?所谓腑有六个,是指包括三焦在内。三焦有原气的区别,主持诸气,有名而无形,其经脉属于手少阳,这是外腑,所以说腑有六个。
又说:十二经脉,五脏六腑加起来只有十一个,那多出来的一经是什么经呢?然而多出来的这一经,是手少阴与手心主的别脉。手心主与三焦互为表里,都有名而无形,所以说经有十二条。因为不专门主宰某一脏,所以说有名无形。
《正理论》说:三焦有名无形,上合于心包主,下合于右肾,于是有了命门与三焦表里的说法。殊不知心包络的相火,依附于右肾之名。人的脏腑,一阴一阳,自有固定的配对,岂有一经配两脏的道理?所谓上合于心主,正是说它们互为表里;下合右肾,正是说它与心包络的相火相合,又以三焦作为原气的别使。懂得这一点,就知道命门与肾相通,三焦并没有双重配对的问题。
《脉诀》说:右尺脉浮,表示风邪客居于下焦,导致大便热秘;脉浮而虚,表示元气不足。脉沉则为水病,腰脚疼痛;脉沉细则下痢,脐寒痛急迫。脉迟则为寒泻,小腹冷,腰脚沉重。脉数则小便赤黄,大便秘结。脉浮数表示表热,脉沉数表示里热。脉滑表示相火炎盛,梦遗,阴虚。妇女脉滑,则表示怀孕。脉涩表示大便涩滞,津液衰少,其余诊法与肾脉相同。
又说:本经发生变动产生的病症,会出现耳聋,声音浑浊,咽喉肿痛,喉痹。这些症状主要反映气的病变。
手少阳三焦引经药歌诀:
亥时对应的三焦,地骨皮、川芎、白术,附子、青皮、柴胡、熟地相逢,白虎汤、细辛都在其中,青皮、柴胡下行共同配合川芎。
又说:一切治疗方法仿照心经的方法使用。
张元素(海藏)说:上焦如雾,雾气不散就会喘满,这是只出不进。中焦如沤,沤渍不利就会留饮,留饮不散,久了就会形成中满,这是上不能纳,下不能出。下焦如渎,沟渠不利就会肿满,这是上能纳而下不出。
又说:三焦患病,腹部气机胀满,小腹部尤其坚硬,不能小便,窘迫急迫,水液停留就会形成胀病。
The Classic states: The Pericardium (Xin Bao Luo) serves to protect the Heart Master, preventing turbid Qi from invading it, just as a monarch has a palace city for protection.
It is also stated that regarding the Hand-Jueyin Pericardium Meridian, the *Nan Jing* (Classic of Difficult Issues) describes it as formless.
Hua Boren said: The Pericardium, also known as the Hand-Center Master, can be verified by the visceral manifestations. The Heart is located above the horizontal diaphragm and below the vertical diaphragm; the tissue adhering to the horizontal diaphragm and wrapped in yellow fat is the Heart. Outside this yellow fat, there are fine fibrous membranes like silk connecting to the Heart and Lungs; this is the Pericardium. This view is correct, and the claim that the Pericardium is formless is incorrect.
Furthermore, examining the "Treatise on the Secret Canon of the Twelve Officials" in the *Ling Shu*, the office of the Pericardium is missing, while an extra section appears: "The Danzhong (Chest Center) is the official of the minister, where joy and laughter originate." Upon examination, the Pericardium resides above the diaphragm, with its meridian starting in the chest, precisely at the location of the Danzhong. Occupying the position of Ministerial Fire, it acts on behalf of the Sovereign, truly serving as a ministerial official. This office is undoubtedly the Pericardium.
It is also stated: The Hand-Jueyin Meridian is the Pericardium Meridian.
It is also stated: This meridian has abundant Blood but scarce Qi.
It is also stated: At Xu hour (7-9 PM), blood flows into the Pericardium.
Tonification herbs: Di Huang (Rehmanniae Radix).
Purgation herbs: Zhi Qiao (Aurantii Fructus), Wu Yao (Linderae Radix).
Warming herbs: Rou Gui (Cinnamomi Cortex).
Cooling herbs: Zhi Zi (Gardeniae Fructus).
Guiding herbs (Yin Jing Bao Shi): Chai Hu (Bupleuri Radix), Qing Pi (Citri Reticulatae Pericarpium Viride), Chuan Xiong (Chuanxiong Rhizoma).
The *Ling Shu* states: Among the Twelve Yuan-Source points, Da Ling (PC7) of the Pericardium Meridian serves as the Yuan-Source point of the Heart, indicating that the True Heart does not accept pathogenic factors, thus confirming that the Hand-Center Master substitutes for the Sovereign Fire.
It is also stated: When this meridian is disturbed, symptoms include heat in the palm, spasm and stiffness of the arm and elbow, swelling of the axilla, and if severe, distension and fullness in the chest and hypochondrium, palpitations (heart beating heavily), red face, excessive laughing, and yellow eyes. These are the primary manifestations of the Pericardium.
Song of Guiding Herbs for the Hand-Jueyin Pericardium Meridian:
At Xu hour, for the Pericardium, use Bai Jiang Cao, Chai Hu, and Bai Zhu; Mu Dan Pi, Shu Di Huang, and Sha Shen; along with herbs descending the meridians, Qing Pi, Chai Hu, and Shu Di Huang are compatible.
The Classic states: The San Jiao (Triple Burner) is the official of drainage, through which water passages flow.
The *Zhong Zang Jing* states: The San Jiao is the Qi of the Three Primes (San Yuan) in the human body, governing ascending, descending, exiting, and entering, and commanding all Five Zang and Six Fu organs, Ying and Wei, meridians, and the Qi of the interior, exterior, left, right, upper, and lower.
When the San Jiao is unobstructed, the interior, exterior, left, right, upper, and lower are all unobstructed. It irrigates the entire body, harmonizes the interior and exterior, nourishes the left and protects the right, guides the upper and vents the lower. It is called the Mansion of Middle Clarity, and nothing surpasses it. Its color is the reddest, protecting all Yang aspects; it is not something without form or mere empty name.
The Classic states: The Hand-Shaoyang Meridian is the San Jiao Meridian.
It is also stated: This meridian has scarce Blood but abundant Qi.
It is also stated: At Hai hour (9-11 PM), Qi and Blood flow into the San Jiao.
The *Ling Shu* states: The Upper Burner is like mist, the Middle Burner like fermentation, and the Lower Burner like a ditch.
The *Ru Men* states: The Upper Burner primarily outputs Yang Qi, warming the skin and muscle interstices like mist and dew, hence "Upper Burner like mist." The Middle Burner primarily transforms the flavors of food and drink; its essence ascends to the Lung, transforms into Blood, travels through the vessel tunnels, and nourishes the Five Zang organs and the whole body, hence "Middle Burner like fermentation." The Lower Burner primarily facilitates urination and defecation, transmitting downward in due time, expelling without retaining, opening blockages, hence "Lower Burner like a ditch."
It is also stated: Without the Upper Burner, how could the Heart and Lungs command Ying and Wei? Without the Middle Burner, how could the Spleen and Stomach rot and ripen food and drink? Without the Lower Burner, how could the Liver and Kidneys drain fluids? Though formless, it has function and governs all Qi. The San Jiao is the pathway of food and drink and the beginning and end of Qi.
The *Zheng Zhuan* states: The San Jiao refers to the body cavity, acting as the general manager containing the intestines and stomach. Above the hui membrane in the chest is the Upper Burner; below the hui membrane and above the navel is the Middle Burner; below the navel is the Lower Burner. Collectively named the San Jiao.
Li Dongyuan said: The Upper, Middle, and Lower Burners constitute one Qi, guarding the body. The San Jiao is not a proper Fu organ; it is formless yet functional.
The *Ru Men* states: The San Jiao is the Fu organ of Bing Fire, so when it manifests, it appears as rootless Ministerial Fire.
The Classic states: Overflow from the Lower Burner leads to edema.
The Classic states: The Hand-Shaoyang San Jiao Meridian is interior-exterior paired with the Hand-Jueyin Pericardium Meridian. The San Jiao is the pathway of food and drink and the beginning and end of Qi. The Upper Burner is below the heart, piercing the diaphragm, governing intake without output; its treatment site is the Danzhong, directly between the breasts. The Middle Burner is in the middle of the stomach, four cun above the navel, neither high nor low, governing the rotting and ripening of food and drink; its treatment site is beside the navel. The Lower Burner is below the navel, near the bladder, governing the separation of clear and turbid, expelling without retaining, for transmission; its treatment site is one cun below the navel, at Guanyuan. The San Jiao is the Qi of the Three Origins. (Nei sounds like Na. The Upper Burner outputs Yang Qi, warming the skin and muscles like mist and dew. The Middle Burner transforms food flavors into Blood to nourish the Five Zang and Six Fu. The Lower Burner facilitates passage, urine transmits downward in time, so it exits but does not enter. Sou sounds like Sou.)
The *Jiu Xu* says: The Middle Burner also merges with the stomach, emerging after the Upper Burner. Here the Kidney receives Qi, separates dregs, steams fluids, transforms their essence, and sends it up to the Lung meridian, where it becomes Blood to sustain life, thus traveling alone in the vessel tunnels, named Ying Qi. Hence, "Middle Burner like fermentation." Zhang Zhongjing said: If the Lower Burner is disharmonious, there will be heavy stool and difficult defecation, and pounding pain in the umbilical and abdominal region. Thus, it is said: The San Jiao resides in the chest.
The *Mai Jue* says: The San Jiao has no form, only an empty name. I believe the San Jiao is the Qi of the Three Origins; it is actually not formless, but merely does not exclusively govern one Zang organ. Since it is the special envoy of Original Qi and a transforming Fu organ, and since the Twelve Meridians begin at the Middle Burner, often traveling with Wei Qi, Bian Que pointed to it as the pathway of food and drink and the beginning and end of Qi. The Upper Burner emerges from the upper orifice of the stomach, goes up the throat, pierces the diaphragm, distributes in the chest, travels to the axilla, and reaches the Taiyin division. The Middle Burner also merges with the stomach, emerging after the Upper Burner. The Lower Burner branches from the ileum, pours into the bladder, and渗 (seeps) therein. The Hand-Jueyin Pericardium is its union. The Pericardium network spreads to the San Jiao, and the San Jiao meridian scatters to network the Pericardium. If there were no form, what would it rely on? From where would the Pericardium attach to transmit and transform?
The *San Yuan Can Zan* says: Its body is a palm-shaped fatty membrane, opposite the bladder, with white vessels emerging from it, flanking the spine and penetrating the brain. I privately hold that "like mist and fermentation" metaphorically describes its thin and clear areas, while "like a ditch" refers to the area seeping into the bladder. It is also named Outer Mansion and Empty Viscus, which is true. Fan said: That the San Jiao is named but formless correctly reflects the meaning of excess in Zang and Fu. If there were only Heart, Liver, Spleen, Lung, and Kidney, without the Fu organ where the San Jiao resides, the human body would be separate from Heaven and Earth.
It is also stated: Those who say there are five Zang and Fu mean that the Hand-Center Master is not a Zang, and the San Jiao is not a Fu. Those who say there are six Zang and Fu combine the Hand-Center Master and the San Jiao.
The *Nan Jing* asks: Why are there only five Zang but six Fu? The six Fu include the San Jiao. It has distinctions of Original Qi, governs all Qi, is named but formless, its meridian belongs to the Hand-Shaoyang, and it is an external Fu, hence "six Fu."
It also says: There are Twelve Meridians, Five Zang and Six Fu, totaling eleven. What is the extra meridian? The extra meridian is the distinct pulse of the Hand-Shaoyin and the Hand-Center Master. The Hand-Center Master and the San Jiao are interior-exterior paired, both named but formless, hence "Twelve Meridians." Because they do not exclusively govern one Zang, they are described as named but formless.
The *Zheng Li Lun* says: The San Jiao is named but formless, joining the Hand-Center Master above and the Right Kidney below, leading to theories of Mingmen and San Jiao interior-exterior pairing. Little do they know that the Ministerial Fire of the Pericardium attaches to the name of the Right Kidney. Human Zang and Fu have fixed Yin-Yang pairs; how can one meridian pair with two? Saying it joins the Hand-Center Master means they are interior-exterior; saying it joins the Right Kidney means it combines with the Pericardium's Ministerial Fire, and since the San Jiao is the special envoy of Original Qi, understanding this reveals that Mingmen and Kidney connect, and the San Jiao has no dual pairing.
The *Mai Jue* says: A floating pulse at the Right Chi indicates Wind-Evil lodging in the Lower Burner, causing hot constipation. Floating and deficient indicates insufficient Original Qi. Deep indicates Water disease, waist and leg pain. Deep and fine indicates dysentery, cold pain pressing at the navel. Slow indicates cold diarrhea, cold lower abdomen, heavy waist and legs. Rapid indicates red urine, dry stool. Floating-rapid indicates Exterior Heat, Deep-rapid indicates Interior Heat. Slippery indicates flourishing Ministerial Fire, nocturnal emission, Yin deficiency. In women, a slippery pulse indicates pregnancy. Choppy indicates dry stool, decline of Body Fluids; other diagnostic methods are the same as the Kidney pulse.
It is also stated: When this meridian is disturbed, symptoms include deafness with muffled hearing, swollen throat, and throat obstruction. These primarily reflect Qi disorders.
Song of Guiding Herbs for the Hand-Shaoyang San Jiao Meridian:
At Hai hour, for the San Jiao, use Di Gu Pi, Chuan Xiong, Bai Zhu; Fu Zi, Qing Pi, Chai Hu, and Shu Di meet; Bai Hu Tang and Xi Xin are included; Qing Pi and Chai Hu descend together with Chuan Xiong.
It is also stated: All treatment methods imitate those used for the Heart Meridian.
Zhang Congzheng (Hai Zang) said: The Upper Burner is like mist; if the mist does not disperse, there is wheezing and fullness, which is exit without entry. The Middle Burner is like fermentation; if fermentation is unfavorable, there is retained fluid. If retained fluid does not dissipate, it becomes long-term fullness in the middle, which is inability to enter above and exit below. The Lower Burner is like a ditch; if the ditch is unfavorable, there is swelling and fullness, which is ability to enter above but not exit below.
The *Ling Shu* states: Rising from the center of the nasal bridge is the San Jiao, representing restraint.
It is also stated: In San Jiao disease, there is abdominal Qi fullness, especially hardness in the lower abdomen, inability to urinate, urgency, and if water remains, it becomes distension.
It is also stated: Pain and swelling in the lower abdomen, inability to urinate, is evil constrained in the San Jiao.
The Classic states: The San Jiao is the pathway of food and drink for the Upper, Middle, and Lower Burners. Its diseases primarily concern the patency of urination and defecation.
Tonification herbs: Huang Qi, Gan Cao, Yi Zhi Ren.
Purgation herbs: Ze Xie.
Warming herbs: Fu Zi.
Cooling herbs: Shi Gao.
Guiding herbs: Chai Hu, Qing Pi, Chuan Xiong.