(素问五脏生成篇)
诸脉者皆属于目,(大惑论曰∶五脏六腑之精气,皆上注于目而为之精。口问篇曰∶目者,宗脉之所聚也。故诸脉者
皆属于目。)诸髓者皆属于脑,(脑为髓海,故诸髓皆属之。)诸筋者皆属于节,(筋力坚强,所以连属骨节。如宣明五气
篇曰∶久行伤筋。以诸筋皆属于节故也。)诸血者皆属于心,(阴阳应象大论曰∶心生血。痿论曰∶心主身之血脉。故诸
血皆属于心。)诸气者皆属于肺,(调经论、本神篇皆曰∶肺藏气。五味篇曰∶其大气之搏而不行者,积于胸中,命曰气
海,出于肺,循喉咽,故呼则出,吸则入。此诸气之皆属于肺也。)此四肢八溪之朝夕也。(四肢者,两手两足也。八溪
者,手有肘与腋,足有 与 也,此四肢之关节,故称为溪。朝夕者,言人之诸脉髓筋血气。无不由此出入,而朝夕运
行不离也。邪客篇曰∶人有八虚,皆机关之室,真气之所过,血络之所游。即此之谓。一曰∶朝夕即潮汐之义,言人身
气血往来,如海潮之消长,早曰潮,晚曰汐者,亦通。)故人卧血归于肝,(人寤则动,动则血随气行阳分而运于诸经,
人卧则静,静则血随气行阴分而归于肝,以肝为藏血之脏也。故人凡寐者,其面色多白,以血藏故耳。)肝受血而能视,
(肝开窍于目,肝得血则神聚于目,故能视。)足受血而能步,(足得之则神在足,故步履健矣。)掌受血而能握,(掌得
之则神在手,故把握固矣。)指受血而能摄。(指得之则神在指,故摄持强矣。愚按∶血气者,人之神也,而此数节皆但
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。如九针篇曰∶人之所以生成者,血脉也。
营卫生会篇曰∶血者神气也。平人绝谷篇曰∶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,则脉道泣滞而为病矣。泣,涩同。)凝于足者为厥,(四肢为诸阳之本,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。凡此上
文三节者,以风寒所客,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。)人有大谷十二分,
(大谷者,言关节之最大者也。节之大者无如四肢,在手者肩肘腕,在足者髁膝腕,四肢各有三节,是为十二分。分,
处也。按∶此即上文八溪之义,夫既曰溪,何又曰谷?如气穴论曰∶肉之大会为谷,小会为溪,肉分之间,溪谷之会,
以行荣卫,以会大气。是溪谷虽以小大言,而为气血之会则一,故可以互言也。上文单言之,故止云八溪;此节与下文
小溪三百五十四名相对为言,故云大谷也。诸注以大谷十二分为十二经脉之部分者,皆非。)小溪三百五十四名,少十二
俞,(小溪者,言通身骨节之交也。小针解曰∶节之交三百六十五会者,络脉之渗灌诸节者也。十二俞,谓十二脏之俞,
如肺俞、心俞之类是也。此除十二俞皆通于脏气者,不在小溪之列,则当为三百五十三名,兹云五十四者,传写之误也。)
此皆卫气之所留止,邪气之所客也,针石缘而去之。(凡此溪谷之会,本皆卫气留止之所,若其为病,则亦邪气所客之处
也。邪客于经,治以针石,必缘其所在,取而去之。缘,因也。)
(《素问·五脏生成篇》)
所有的脉都归属于目。(《大惑论》说:五脏六腑的精气,都上注于目而形成视觉。《口问篇》说:目是宗脉汇聚的地方。所以所有的脉都归属于目。)所有的髓都归属于脑,(脑是髓海,所以所有的髓都归属于它。)所有的筋都归属于节,(筋力坚强,用来连接骨节。如《宣明五气篇》说:久行伤筋。因为所有的筋都归属于节的原因。)所有的血都归属于心,(《阴阳应象大论》说:心主生血。《痿论》说:心主管身体的血脉。所以所有的血都归属于心。)所有的气都归属于肺,(《调经论》、《本神篇》都说:肺藏气。《五味篇》说:那盛大之气搏动而不运行的,积聚在胸中,称为气海,出于肺,沿着喉咽,所以呼气时排出,吸气时进入。这就是所有的气都归属于肺的道理。)这是四肢八溪的朝夕运行规律。(四肢,就是两手两足。八溪,手有肘和腋,足有[缺字]与[缺字],这是四肢的关节,所以称为溪。朝夕,是说人的各种脉、髓、筋、血、气,无不由此出入,并且日夜运行不停息。《邪客篇》说:人有八虚,都是机关的所在,真气经过的地方,血络游行的地方。说的就是这个意思。另一种说法:朝夕即潮汐的意思,说人身气血往来,像海潮的消长,早叫潮,晚叫汐,也讲得通。)所以人躺下睡觉时,血归于肝,(人醒着就活动,活动则血随气行于阳分而运行于各条经脉;人躺下睡觉就安静,安静则血随气行于阴分而归于肝,因为肝是藏血的脏器。所以人凡是睡眠的时候,面色多苍白,是因为血归藏的缘故。)肝得到血滋养就能视物,(肝开窍于目,肝得到血则神聚于目,所以能看见。)脚得到血滋养就能行走,(脚得到血则神在脚,所以步履稳健。)手掌得到血滋养就能握持,(手掌得到血则神在手,所以把握牢固。)手指得到血滋养就能摄取,(手指得到血则神在指,所以抓取有力。我按语:血气,是人的神志基础,但这几段话只谈血不谈气为什么呢?大概气属阳而无形状,血属阴而有形体,而人的形体,由阴构成。如《九针篇》说:人之所以生成的,是血脉。《营卫生会篇》说:血就是神气。《平人绝谷篇》说:血脉调和则精神才能安居。所以这里都谈血,是说神根据形产生,作用从体发出。)睡醒后外出被风吹袭,血凝滞于皮肤的就成为痹证,(睡醒外出的时候,如果玄府未闭、汗液未收敛,被风所吹,则血凝滞于皮肤,或者导致麻木,或者产生疼痛而病为痹证。)凝滞于脉中的就成为泣(涩),(风寒外袭,血凝滞于脉中,则脉道涩滞而生病。泣,同涩字。)凝滞于足的就成为厥,(四肢是诸阳的根本,风寒侵袭而血凝滞于足,则阳衰阴盛而气逆成为厥证。)这三种情况,血运行而不能返回其孔窍,所以成为痹证和厥证。(血得热则运行,得寒则凝滞。以上三段文字,因风寒所客,则血脉凝涩,不能营运而返回其空窍,所以成为痹厥之病。空,同孔,指血运行的通道。)人体有大谷十二处,(大谷,指最大的关节。大的节没有比得上四肢的,在手的是肩、肘、腕,在足的是踝、膝、跗,四肢各有三节,这就是十二处。分,就是处。按:这也就是上文八溪的意义,既然叫溪,为什么又叫谷?如《气穴论》说:肌肉的大聚会叫谷,小聚会叫溪,肌肉分界之间,溪谷交会之处,用以运行营卫,汇聚大气。这样看来,溪谷虽然以大小区分,但作为气血交会之处则是一样的,所以可以互换称呼。上文单独提及,所以只说八溪;这一节与下文小溪三百五十四名相对而言,所以说大谷。许多注释将大谷十二分解释为十二经脉的部分,都不对。)小溪三百五十四处,减去十二俞穴,(小溪,指全身骨节的交会处。《灵枢·小针解》说:骨节交会处的三百六十五个穴位,是络脉渗灌各个骨节的地方。十二俞,指十二脏的背俞穴,如肺俞、心俞之类。这里除了十二俞都与脏气相通,不在小溪之列,那么应当是三百五十三处,这里说三百五十四处,是传写错误。)这些都是卫气停留止聚的地方,也是邪气客居的地方,针刺砭石顺着这些部位而去除邪气。(凡是溪谷交会之处,本来都是卫气停留的地方,如果发生病变,也是邪气客居的地方。邪气客居于经,用针石治疗,必须顺着邪气所在的部位,取穴而去除它。缘,顺着、依据的意思。)
(Su Wen, Chapter 5: Generation of the Five Zang Organs)
All vessels (Mai, blood vessels and meridians) are connected to the eyes. (The Da Huo Lun states: The essence of the five zang organs and six fu organs all ascend to the eyes to form vision. The Kou Wen Pian states: The eyes are the gathering place of the Zong Mai [Major Vessels]. Therefore, all vessels are connected to the eyes.) All marrow (Sui) is connected to the brain, (The brain is the Sea of Marrow, therefore all marrow belongs to it.) All sinews (Jin) are connected to the joints, (Sinews provide strength and connect the bones and joints. As stated in the Xuan Ming Wu Qi Pian: Prolonged walking injures the sinews. This is because all sinews are connected to the joints.) All blood (Xue) is connected to the Heart, (The Yin Yang Ying Xiang Da Lun states: The Heart generates blood. The Wei Lun states: The Heart governs the blood vessels of the body. Therefore, all blood is connected to the Heart.) All qi (Qi) is connected to the Lungs, (Both the Tiao Jing Lun and Ben Shen Pian state: The Lungs store qi. The Wu Wei Pian states: The great qi that moves but does not circulate accumulates in the chest, called the Sea of Qi, emerging from the Lungs, following the throat and pharynx, so it exits during exhalation and enters during inhalation. This is why all qi is connected to the Lungs.) This describes the daily circulation of the four limbs and eight xi [valleys/creeks]. (The four limbs refer to the two hands and two feet. The eight xi refer to the elbows and axillae in the upper limbs, and the knees and ankles in the lower limbs; these are the joints of the four limbs, hence called xi. "Zhao Xi" [morning and evening] means that the various vessels, marrow, sinews, blood, and qi of the human body all enter and exit through these points, circulating day and night without cessation. The Xie Ke Pian states: Humans have eight xu [deficient spots], which are the chambers of the joints, where true qi passes and blood collaterals travel. This refers to this concept. Another interpretation: "Zhao Xi" implies tides, meaning the flow of qi and blood in the body is like the ebb and flow of sea tides; morning is called chao [tide in], evening is called xi [tide out], which is also a valid explanation.) Therefore, when a person lies down to sleep, blood returns to the Liver. (When awake, one moves; movement causes blood to follow qi into the yang aspects and circulate through the various meridians. When sleeping, one is still; stillness causes blood to follow qi into the yin aspects and return to the Liver, as the Liver is the organ that stores blood. Thus, people who are sleeping often have pale complexions because the blood is stored away.) The Liver receives blood and thus enables vision. (The Liver opens into the eyes; when the Liver receives blood, the spirit gathers in the eyes, enabling sight.) The feet receive blood and thus enable walking. (When the feet receive blood, the spirit resides in the feet, making steps steady.) The palms receive blood and thus enable grasping. (When the palms receive blood, the spirit resides in the hands, making grips firm.) The fingers receive blood and thus enable holding/picking up. (When the fingers receive blood, the spirit resides in the fingers, making grasping strong. Note: Qi and blood are the basis of human spirit/shen. Why do these sections only mention blood and not qi? Generally, qi belongs to yang and is formless, while blood belongs to yin and has form. Human physical form is constituted by yin. As the Jiu Zhen Pian states: What generates humans is blood vessels. The Ying Wei Sheng Hui Pian states: Blood is shen qi. The Ping Ren Jue Gu Pian states: When blood vessels are harmonious, spirit resides. Therefore, speaking of blood here implies that spirit is generated based on form, and function emerges from the body.) If, after waking and going out, one is exposed to wind, blood coagulating in the skin becomes Bi syndrome [obstruction]. (During the time of waking and going out, if the xuan fu [pores] are not closed and sweat is not retained, exposure to wind causes blood to coagulate in the skin, leading to numbness or pain, resulting in Bi syndrome.) Coagulation in the vessels becomes Qi [stagnation/roughness]. (External invasion of wind-cold causes blood to coagulate in the vessels, leading to vessel stagnation and disease. Qi is synonymous with Se [astringent/stagnant].) Coagulation in the feet becomes Jue [cold extremities/reversal]. (The four limbs are the root of all yang. Wind-cold invading and causing blood to coagulate in the feet leads to yang deficiency and yin excess, causing qi reversal and Jue syndrome.) In these three cases, blood circulates but cannot return to its empty spaces [orifices/channels], thus becoming Bi and Jue syndromes. (Blood flows when warm and coagulates when cold. Regarding the previous three sections, due to wind-cold invasion, blood vessels become stagnant and unable to circulate and return to their orifices, thus causing Bi and Jue diseases. Kong is the same as Kong [hole/orifice], referring to the channels of blood flow.) The human body has twelve major gu [valleys]. (Major gu refers to the largest joints. There are no larger joints than those in the four limbs: in the hands, the shoulders, elbows, and wrists; in the feet, the ankles, knees, and tarsus. Each limb has three joints, totaling twelve places. Fen means place. Note: This corresponds to the meaning of the eight xi mentioned earlier. Since they are called xi, why are they also called gu? As the Qi Ke Lun states: Large gatherings of muscle are called gu, small gatherings are called xi. Between muscle divisions, the convergence of xi and gu serves to circulate ying and wei qi and gather great qi. Thus, although xi and gu differ in size, they are both convergences of qi and blood, so the terms can be used interchangeably. The previous text mentioned them singly, hence only eight xi; this section contrasts with the 354 minor xi mentioned below, hence called major gu. Annotations interpreting the twelve major gu as parts of the twelve meridians are incorrect.) There are 354 minor xi [valleys], excluding the twelve Shu [transporting] points. (Minor xi refers to the intersections of bones throughout the body. The Xiao Zhen Jie states: The 365 intersections of joints are where collateral vessels seep into and irrigate the joints. The twelve Shu points refer to the back-Shu points of the twelve zang organs, such as Fei Shu and Xin Shu. Excluding the twelve Shu points which communicate with zang qi and are not part of the minor xi category, there should be 353 points; the text saying 354 is a transcription error.) These are all places where Wei Qi [Defensive Qi] stays and stops, and where pathogenic qi lodges. Acupuncture and stone therapy remove pathogens along these pathways. (All convergence points of xi and gu are originally places where Wei Qi stays. If disease occurs, these are also places where pathogenic qi lodges. When pathogenic qi lodges in the meridians, treatment with acupuncture and stone must follow the location of the pathogen to remove it. Yuan means to follow or base upon.)