（督之为言都也，行背部之中行，为阳脉之都纲。以其督领诸脉故名。其脉从 至头长四尺五
寸）《难经》曰∶督脉起于下极之 （两阴两筋之间为篡，篡内深处为下极，其 会阴穴也，一名屏翳），并
于脊里，上至风府（指穴在项后，入发际一寸，大筋宛宛中），入属于脑，上巅，循额，至鼻柱（附足太阳膀
胱之脉，行抵龈交穴而终）。属阳脉之海（自上巅至此十二字，滑伯仁所增）。为病脊强而厥。《素问》曰∶
起于少腹（起，非初起，亦犹任脉、冲脉，起于胞中），以下骨中央（下行于腰之横骨围之中央也），女子入
系廷孔，其孔，溺孔之端也，其络循阴器，合篡间，绕篡后，别绕臀（别络也），至少阴与巨阳中络者，合少阴
上股内后廉，贯脊属肾（足少阴之络者，自股内后廉，贯脊属肾。足太阳络之外行者，循髀枢，络股阳而下，
其中行者，下贯臀，至 中，与外行络合）；与太阳起于目内 ，上额交巅上，入络脑，还出别下项，循肩膊
内，挟脊抵腰中，入循膂络肾（接绕臀而上行）；其男子循茎下至篡，与女子等（自与太阳至此，皆督脉之别
络也）；其少腹直上者，贯脐中央，上贯心入喉，上颐环唇，上系两目之下中央（自其少腹至此，并任脉之行
而云，是督脉所系，则知任脉、冲脉、督脉名异而同体也）。
按∶《难经》滑氏言直行者，《素问》言别络，所以不
同，任脉仿此。为病脊强反折（脊强者，五痉之总名，其症卒口噤，背反张而 。诸药不已，可灸身柱穴）。
《灵枢》曰∶督脉之别，名曰长强（按∶张世贤注《难经》以下极之 为长强穴，则此云别，名曰长强者，何也？
考之《图经》，下极在篡中，为会阴之穴，长强，在脊 端，居会阴之后，而东垣亦云，督脉出于会阴，根于长
强，则其为两穴明矣。张氏之说非也），扶膂上项，散头上，下当肩胛左右，别走太阳，入贯膂。实则脊强，
虚则头重，有过者，取之所别也。
（督脉的“督”字意为总汇，它行于背部的正中线上，是阳经经脉的总纲。因为它总督统领所有经脉，所以得名。它的脉道从会阴穴起至头部，全长四尺五寸）《难经》说：督脉起始于下极穴（两阴器与两筋之间的部位称为篡，篡内深处为下极，此处是会阴穴，又名屏翳），并行于脊柱内部，向上到达风府穴（该穴位在项后，入发际一寸处，大筋凹陷中），进入并归属于脑，上行至头顶，沿前额下行，至鼻梁柱（伴随足太阳膀胱经，行走至龈交穴而终止）。属于阳脉之海（从“自上巅至此”这十二个字，是滑伯仁所添加的内容）。作为病症表现为脊背强直且厥逆。《素问》说：（督脉）起始于少腹（这里的“起”，并非指初生起点，也如同任脉、冲脉，起始于胞宫），向下行至骨中央（下行于腰部横骨围成的中央位置），女子进入并联系廷孔，这个孔，就是尿道口的末端，其络脉循行经过阴器，汇聚于篡间，环绕篡后，另外分支环绕臀部（这是别络），到达足少阴肾经和足太阳膀胱经的中部络脉处，与足少阴肾经汇合后上行至大腿内侧后缘，贯穿脊柱并归属于肾（足少阴肾经的络脉，从大腿内侧后缘，贯穿脊柱归属于肾。足太阳膀胱经络的外行者，循行髀枢，联络股阳而下，其中行者，下行贯穿臀部，至骶骨端，与外行络脉汇合）；与足太阳膀胱经起始于目内眦，上行至额头，交汇于头顶，进入联络脑部，复出后分别下行至项部，沿肩膊内侧，夹持脊柱抵达腰中，进入并循行于膂肉，联络肾脏（接续环绕臀部而上行）；男子则循阴茎下行至篡，与女子相同（从“与太阳”到这里，都是督脉的别络）；其直行向上的部分，贯穿脐中央，向上穿过心脏进入喉咙，上行至面颊环绕嘴唇，向上系连两眼之下的中央（从“其少腹”到这里，都叙述的是任脉的行径，既然说这是督脉所关联的，就知道任脉、冲脉、督脉名称不同但本源同一）。
按语：《难经》中滑氏所言为直行者，《素问》所言为别络，因此说法不同，任脉的情况仿照此理。作为病症表现为脊背强直且身体反折（脊强，是五种痉病的总称，其症状突然牙关紧闭，背部向后反张如弓。若诸药无效，可灸身柱穴）。《灵枢》说：督脉的别络，名叫长强（按语：张世贤注释《难经》时将下极的篡视为长强穴，那么这里说别络名叫长强，又是为什么呢？考证《图经》，下极位于篡中，是会阴穴，长强穴在脊柱末端，位于会阴穴之后，而李东垣也说，督脉出于会阴，根于长强，那么这两个穴位显然是不同的。张氏的说法是错误的），扶持膂肉上行至项部，散布于头部，向下当肩胛左右，别走足太阳膀胱经，进入并贯穿膂肉。实证表现为脊背强直，虚证表现为头重，若有病邪，取用其别络处的穴位进行治疗。
(The character "Du" in Du Mai (Governor Vessel) means "capital" or "gathering point." It runs along the midline of the back and serves as the chief commander of all Yang meridians. It is named so because it supervises and leads all other meridians. Its channel extends from [Huiyin] to the head, measuring four chi and five cun in length.) The *Nan Jing* (Classic of Difficult Issues) states: The Du Mai (Governor Vessel) originates at Xiaji (The area between the two yin organs and two tendons is called Cuan; the deep part within Cuan is Xiaji, which corresponds to the Huiyin acupoint, also known as Pingyi). It runs parallel within the spinal column, ascends to Fengfu (Located behind the neck, one cun inside the hairline, in the depression of the large tendon), enters and connects with the brain, ascends to the vertex, follows the forehead, and reaches the nasal bridge (It accompanies the Foot-Taiyang Bladder Meridian, running until Yinjiao acupoint where it terminates). It belongs to the Sea of Yang Meridians (The twelve characters from "from the vertex above to here" were added by Hua Boren). As a disease manifestation, it presents with rigidity of the spine and cold extremities (Jue). The *Su Wen* (Basic Questions) states: It originates in the lower abdomen (Here, "originates" does not mean the initial starting point; similarly to the Ren Mai (Conception Vessel) and Chong Mai (Penetrating Vessel), it originates from the Baozhong/Uterus). It descends to the center of the bone (Descending to the center surrounded by the transverse bones of the waist). In women, it enters and connects with Tingkong (This opening is the end of the urethral meatus). Its collateral network circulates through the external genitalia, converges at Cuanjian, circles around the posterior aspect of Cuan, and separately circles the buttocks (This is a Luo-connecting vessel). It reaches the middle collaterals of the Foot-Shaoyin Kidney Meridian and the Foot-Taiyang Bladder Meridian, merges with the Foot-Shaoyin Kidney Meridian, and ascends along the posterior medial aspect of the thigh, piercing the spine and connecting with the Kidneys (The collateral of the Foot-Shaoyin Kidney Meridian travels from the posterior medial aspect of the thigh, pierces the spine, and connects with the Kidneys. The external branch of the Foot-Taiyang Bladder Meridian's collateral circulates through the hip pivot, connects with the lateral thigh, and descends; its internal branch descends through the buttocks, reaches the sacral tip, and merges with the external branch). It starts together with the Foot-Taiyang Bladder Meridian at the inner canthus of the eye, ascends to the forehead, crosses at the vertex, enters to connect with the brain, re-emerges, descends separately to the nape, follows the medial aspect of the shoulder blades, flanks the spine to reach the middle of the waist, enters to circulate through the paraspinal muscles, and connects with the Kidneys (Continuing upward after circling the buttocks); in men, it circulates down the penis to Cuan, identical to women (From "with the Taiyang" to here, these are all the collateral branches of the Du Mai (Governor Vessel)). The straight ascending portion penetrates the center of the umbilicus, ascends through the heart into the throat, rises to the chin, circles the lips, and ascends to tie into the center below both eyes (From "its lower abdomen" to here, it describes the pathway of the Ren Mai (Conception Vessel). Since it is stated that this is connected to the Du Mai (Governor Vessel), it is known that the Ren Mai (Conception Vessel), Chong Mai (Penetrating Vessel), and Du Mai (Governor Vessel) have different names but share the same origin/body).
Commentary: The difference between Hua Shi's statement in the *Nan Jing* (Classic of Difficult Issues) regarding the direct pathway and the *Su Wen* (Basic Questions) regarding the collateral pathways explains the discrepancy; the Ren Mai (Conception Vessel) follows this pattern. As a disease manifestation, it presents with rigidity of the spine and opisthotonos (Rigidity of the spine is the general term for the five types of tetanus/spasm disorders; symptoms include sudden lockjaw, backward arching of the back. If various medicines fail, Shen Zhu acupoint may be moxa-ed). The *Ling Shu* (Spiritual Pivot) states: The collateral branch of the Du Mai (Governor Vessel) is named Changqiang (Commentary: Zhang Shixian, in his annotation of the *Nan Jing*, identified the Cuan at Xiaji as the Changqiang acupoint. Then why is the collateral branch named Changqiang here? Consulting the *Tu Jing* (Illustrated Classic), Xiaji is located in the center of Cuan and is the Huiyin acupoint. Changqiang is located at the tip of the coccyx, posterior to Huiyin. Li Dongyuan also stated that the Du Mai (Governor Vessel) emerges from Huiyin and roots at Changqiang. Thus, they are clearly two distinct acupoints. Zhang's theory is incorrect). It supports the paraspinal muscles, ascends to the nape, scatters over the head, descends to the area opposite the left and right scapulae, diverges to the Foot-Taiyang Bladder Meridian, and enters to pierce the paraspinal muscles. Excess conditions manifest as rigidity of the spine; deficiency conditions manifest as heaviness of the head. For pathological changes, treat the acupoint where it diverges.