(素问血气形志篇)
夫人之常数,太阳常多血少气,少阳常少血多气,阳明常多气多血,少阴常少血多气,厥阴常多血少气,太阴常多
气少血,此天之常数。(十二经血气各有多少不同,乃天禀之常数,故凡用针者,但可泻其多,不可泻其少,当详察血气
而为之补泻也。按∶两经言血气之数者凡三,各有不同。如五音五味篇三阳经与此皆相同,三阴经与此皆相反,详见藏
象类十七。又如九针论诸经与此皆同,惟太阴一经云多血少气,与此相反。须知灵枢多误,当以此篇为正,观末节出气
出血之文,与此正合,无差可知矣。外灵枢九针论文与此同者,俱不重载。)足太阳与少阴为表里,少阳与厥阴为表里,
阳明与太阴为表里,是为足阴阳也。(足太阳膀胱也,足少阴肾也,是为一合。足少阳胆也,足厥阴肝也,是为二合。足
阳明胃也,足太阴脾也,是为三合。阳为腑,经行于足之外侧。阴为脏,经行于足之内侧。此足之表里也。)手太阳与少
阴为表里,少阳与心主为表里,阳明与太阴为表里,是为手之阴阳也。(手太阳小肠也,手少阴心也,是为四合。手少阳
三焦也,手心主厥阴也,是为五合。手阳明大肠也,手太阴肺也,是为六合。阳为腑,经行于手之外侧。阴为脏,经行
于手之内侧。此手之表里也。)今知手足阴阳所苦,凡治病必先去其血,乃去其所苦,伺之所欲,然后泻有余,补不足。
(知手足之阴阳,则病在何经,其苦可知。治之者,于血脉壅盛、为病异常之处,先去其血,血去则去其所苦矣,非谓
凡刺者必先去血也。滞血既去,然后伺察脏气之所欲,如肝欲散、心欲 、肺欲收、脾欲燥、肾欲坚之类,以泻有余补
不足而调治之也。)刺阳明出血气,刺太阳出血恶气,刺少阳出气恶血,刺太阴出气恶血,刺少阴出气恶血,刺厥阴出血
恶气也。(此明三阴三阳血气各有多少,而刺者之出血出气当知其约也。手足阳明多血多气,故刺之者出其血气。手足太
阳多血少气,故刺之者但可出其血而恶出其气。总而计之,则太阳厥阴均当出血恶气,少阳少阴太阴均当出气恶血,唯
阳明可出气出血,正与首节义相合。恶,去声。)
(《素问·血气形志篇》)
人的生理常数,太阳经通常多血少气,少阳经通常少血多气,阳明经通常多气多血,少阴经通常少血多气,厥阴经通常多血少气,太阴经通常多气少血,这是天生的恒定规律。(十二经脉的血气含量各有不同,这是先天禀赋的固定常数,所以凡是使用针刺的人,只能泻其有余,不可泻其不足,应当详细考察血气的状况来进行补泻操作。按:文中提到两经血气数量的说法共有三处,各不相同。如《五音五味》篇中三阳经与此相同,三阴经则与此相反,详见《藏象类》第十七节。又如《九针论》中各经与此相同,只有太阴经说是多血少气,与此相反。需要知道《灵枢》多有错误,应以本篇为准,看末尾关于出气出血的论述,与此完全吻合,没有差错可知。《灵枢·九针论》中与本文相同的段落,此处不再重复记载。)足太阳膀胱经与足少阴肾经互为表里,足少阳胆经与足厥阴肝经互为表里,足阳明胃经与足太阴脾经互为表里,这称为足部的阴阳表里关系。(足太阳是膀胱经,足少阴是肾经,这是一合。足少阳是胆经,足厥阴是肝经,这是二合。足阳明是胃经,足太阴是脾经,这是三合。阳经属于腑,经络行走在足部的外侧。阴经属于脏,经络行走在足部的内侧。这就是足部的表里关系。)手太阳小肠经与手少阴心经互为表里,手少阳三焦经与手厥阴心包经互为表里,手阳明大肠经与手太阴肺经互为表里,这称为手部的阴阳表里关系。(手太阳是小肠经,手少阴是心经,这是四合。手少阳是三焦经,手心主即手厥阴心包经,这是五合。手阳明是大肠经,手太阴是肺经,这是六合。阳经属于腑,经络行走在手部的外侧。阴经属于脏,经络行走在手部的内侧。这就是手部的表里关系。)现在如果知道了手足阴阳经脉所患的疾病,凡治病必须先去除瘀血,然后才能消除病痛,观察脏腑之气所喜好的状态,然后泻其有余,补其不足。(了解手足阴阳经脉,就知道病在何经,其痛苦所在也就知道了。治疗时,对于血脉壅盛、病情异常之处,先去除瘀血,血去除了,病痛也就消除了,这并不是说凡是针刺都必须先去血。瘀滞之血去除后,然后观察脏气所喜好,如肝喜疏散、心喜柔润、肺喜收敛、脾喜燥湿、肾喜坚固等情况,通过泻其有余、补其不足来调理治疗。)针刺阳明经可放出血液和邪气,针刺太阳经可放出血液而避免放出邪气,针刺少阳经可放出邪气而避免放出血液,针刺太阴经可放出邪气而避免放出血液,针刺少阴经可放出邪气而避免放出血液,针刺厥阴经可放出血液而避免放出邪气。(这里阐明三阴三阳经脉血气各有多少,以及施针者放血或泄气应当遵循的原则。手足阳明经多血多气,所以针刺时可以放出血液和邪气。手足太阳经多血少气,所以针刺时只可放出血液而应避免放出邪气。总起来计算,太阳经和厥阴经都应当放血而避免泄气,少阳经、少阴经和太阴经都应当泄气而避免放血,只有阳明经可以既泄气又放血,这与开头的义理完全相符。恶,读作去声,意为厌恶、避免。)
(Su Wen, Chapter on Blood, Qi, Form and Will)
The constant physiological parameters of the human body are as follows: the Taiyang (Greater Yang) channel typically has abundant blood but deficient qi; the Shaoyang (Lesser Yang) channel typically has deficient blood but abundant qi; the Yangming (Bright Yang) channel typically has abundant qi and abundant blood; the Shaoyin (Lesser Yin) channel typically has deficient blood but abundant qi; the Jueyin (Terminal Yin) channel typically has abundant blood but deficient qi; and the Taiyin (Greater Yin) channel typically has abundant qi but deficient blood. These are the innate constants. (The amounts of blood and qi in the twelve channels vary, which constitutes the innate constant endowment. Therefore, when using acupuncture, one should only reduce excesses and never deplete deficiencies. One must carefully examine the state of blood and qi to apply tonification or reduction accordingly. Note: There are three different statements regarding the quantities of blood and qi in two-channel pairs throughout the texts. For instance, in the chapter "Five Tones and Five Flavors," the three Yang channels match this text, while the three Yin channels are opposite; see details in Zangxiang Category, Section 17. Furthermore, in the "Nine Needles" chapter, all channels match this text except for the Taiyin channel, which states abundant blood and deficient qi, contradicting this text. It must be understood that the Ling Shu contains many errors, and this chapter should be regarded as authoritative. The concluding section discussing the release of qi and blood aligns perfectly with this text, leaving no room for doubt. Passages in the Ling Shu's "Nine Needles" chapter that agree with this text are not repeated here.) The Foot-Taiyang Bladder Channel and the Foot-Shaoyin Kidney Channel form an exterior-interior relationship; the Foot-Shaoyang Gallbladder Channel and the Foot-Jueyin Liver Channel form an exterior-interior relationship; the Foot-Yangming Stomach Channel and the Foot-Taiyin Spleen Channel form an exterior-interior relationship. This constitutes the yin-yang relationships of the foot channels. (Foot-Taiyang is the Bladder Channel, and Foot-Shaoyin is the Kidney Channel; this is the first pair. Foot-Shaoyang is the Gallbladder Channel, and Foot-Jueyin is the Liver Channel; this is the second pair. Foot-Yangming is the Stomach Channel, and Foot-Taiyin is the Spleen Channel; this is the third pair. Yang channels belong to Fu organs, and their meridians run along the lateral aspect of the foot. Yin channels belong to Zang organs, and their meridians run along the medial aspect of the foot. This describes the exterior-interior relationship of the foot.) The Hand-Taiyang Small Intestine Channel and the Hand-Shaoyin Heart Channel form an exterior-interior relationship; the Hand-Shaoyang Sanjiao Channel and the Hand-Jueyin Pericardium Channel form an exterior-interior relationship; the Hand-Yangming Large Intestine Channel and the Hand-Taiyin Lung Channel form an exterior-interior relationship. This constitutes the yin-yang relationships of the hand channels. (Hand-Taiyang is the Small Intestine Channel, and Hand-Shaoyin is the Heart Channel; this is the fourth pair. Hand-Shaoyang is the Sanjiao Channel, and Hand-Jueyin [Pericardium] is the Hand Master; this is the fifth pair. Hand-Yangming is the Large Intestine Channel, and Hand-Taiyin is the Lung Channel; this is the sixth pair. Yang channels belong to Fu organs, and their meridians run along the lateral aspect of the hand. Yin channels belong to Zang organs, and their meridians run along the medial aspect of the hand. This describes the exterior-interior relationship of the hand.) Now, knowing the ailments of the hand and foot yin-yang channels, in treating any disease, one must first remove blood stasis, thereby eliminating the source of suffering. Then, observe the preferences of the Zang organ qi, and subsequently reduce excess and tonify deficiency. (Understanding the hand and foot yin-yang channels reveals which meridian is affected and what the specific suffering is. In treatment, at sites where blood vessels are congested and pathology is abnormal, blood stasis should be removed first; once the blood stasis is gone, the suffering is alleviated. This does not mean that every acupuncture session requires bloodletting. After removing stagnant blood, one should then observe the preferences of the Zang organ qi—for example, the Liver desires dispersion, the Heart desires softness/moisture, the Lung desires astringency, the Spleen desires dryness, and the Kidney desires firmness—and regulate them by reducing excess and tonifying deficiency.) Acupuncture at the Yangming channel may release both blood and qi; acupuncture at the Taiyang channel may release blood but should avoid releasing qi; acupuncture at the Shaoyang channel may release qi but should avoid releasing blood; acupuncture at the Taiyin channel may release qi but should avoid releasing blood; acupuncture at the Shaoyin channel may release qi but should avoid releasing blood; and acupuncture at the Jueyin channel may release blood but should avoid releasing qi. (This clarifies the varying amounts of blood and qi in the Three Yin and Three Yang channels and establishes the principles for practitioners regarding whether to release blood or qi. The Hand and Foot Yangming channels have abundant blood and qi, so needling may release both blood and qi. The Hand and Foot Taiyang channels have abundant blood but deficient qi, so needling should release blood but avoid releasing qi. Generally speaking, both Taiyang and Jueyin channels should release blood but avoid releasing qi; Shaoyang, Shaoyin, and Taiyin channels should release qi but avoid releasing blood; only the Yangming channel can release both qi and blood. This aligns perfectly with the principle stated in the opening section. 'E' (avoid/dislike) is pronounced as 'qu' sheng.)