(肝之为脏,左三叶,右四叶,凡七叶。其治在左,其脏在右胁右肾之前,并胃着脊之第九
椎)《灵枢》曰∶足厥阴之脉,起于大趾丛毛之际(大敦穴也),上循足跗上廉(大趾间陷中,行间穴也。大
趾本节后陷中,太冲穴也),去内踝一寸,上踝八寸,交出太阴之后(内踝前一寸,中封穴也),上 内廉(曲
泉穴也),循股阴,入毛中,过阴器,抵小腹,挟胃属肝络胆(股阴,内侧也,循股内之阴包、五里、阴廉,
上会于足太阴之冲门、府舍,入阴毛中之急脉,遂左右相交,环绕阴器,而会于任脉之曲骨,自阴上入小腹,
会于任脉之中极、关元,循章门至期门之所,挟胃属肝,下足少阳日月之所络胆,而肝胆相为表里也),上贯
膈,布胁肋(自期门上贯膈,行足太阴食窦之外,大包之里,散布胁肋,上足少阳渊腋、手太阴云门之下,足
厥阴经穴止于此),循喉咙之后,上入顽颡,连目系,上出额,与督脉会于巅(颃颡,咽颡也。目内深处为目
系。其内行而上者,自胁肋间,由足阳明人迎之外,循喉咙之后入颃颡,行足阳明大迎、地仓、四白之外,内
连目系,上出足少阳阳白之外,临泣之里,与督脉相会于巅顶之百会穴);其支者,从目系,下颊里,环唇内(此
支者,从前目系之分,下行任脉之外,本经之里,下颊里,交环于口唇之内);其支者,复从肝别贯膈,上注
肺(又其支者,从前期门属肝所,行足太阴食窦之外,本经之里,别贯膈,上注于肺,下行至中焦,挟中脘之
分,复接于手太阴肺经,以尽十二经之一周,终而复始也)。其别,名曰蠡沟,去内踝五寸,别走少阳;其别
者,循胫上睾,结于茎。其病气逆则睾肿卒疝;实则挺长,虚则暴痒,取之所别也(足厥阴之络,名蠡沟,在
足内踝上五寸,别走足少阳者也。本经络阴器,上睾结于茎,故其所病如此。而治此者,当取所别之蠡沟)。
其正,别跗上,上至毛际,合于少阳,与别俱行,此为二合也(足厥阴之正,别足跗上内行,上至阴毛之际,
合于足少阳,与别者俱行,上布胁肋,是为六合之二也)。其筋起于大趾之上,上结于内踝之前(大趾上三毛
际,大敦之次,行跗上与足太阴之筋并行,结于内踝前中封之次也),上循胫,上结内辅之下,上循阴股,结
于阴器,络诸筋(由内踝上足胫,循三阴交之分,上行并足少阴之筋,上结于内辅骨下曲泉之次,复并太阴之
筋,上循阴股中五里、阴廉之分,上急脉,结于阴器。阴器者,合太阴、厥阴、阳明、少阴之筋,以及冲、任、
督三脉皆聚于此,故曰宗筋。厥阴属肝,肝主筋,故络诸筋,而一之以成健运之用)。是动则病腰痛不可以俯
仰,丈夫颓疝,妇人小腹肿,甚则嗌干,面尘脱色。是主肝所生病者,胸满呕逆,洞泄狐疝,遗溺闭癃。盛
者寸口大一倍于人迎,虚者寸口反小于人迎也(篇内是
动、所生病皆谓经脉病也,若筋病则与此不同,散见前编各条,此不详录。又凡十二经脉,病盛则泄之,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,虽亦散见于前。而此复重录者,以其大体所。
欲从一关类,故不厌其详也)。
肝脏作为脏器,左边有三叶,右边有四叶,总共七叶。它的功能调节部位在左侧,而脏器本体位于右侧胁下、右肾的前方,并与胃相连,附着于脊柱第九椎骨处。《灵枢》说:足厥阴肝经,起始于大趾丛毛之处(即大敦穴),向上沿足背内侧上行(经过大趾间的陷中,即行间穴;大趾本节后方的陷中,即太冲穴),在内踝前一寸处上行,至内踝上八寸处,交叉到足太阴脾经的后面(此处为内踝前一寸的中封穴),沿大腿内侧上行(曲泉穴所在),沿股部内侧进入阴毛中,经过生殖器,抵达小腹,夹行于胃旁,归属于肝,联络胆(股阴指大腿内侧,沿股内侧的阴包、五里、阴廉等穴,向上汇合于足太阴脾经的冲门、府舍穴,进入阴毛中的急脉,左右相交,环绕生殖器,并汇合于任脉的曲骨穴,从阴部向上进入小腹,汇合于任脉的中极、关元穴,沿章门穴行至期门穴处,夹胃归属于肝,向下联络足少阳胆经的日月穴,肝胆互为表里),向上穿过膈肌,散布于胁肋部(自期门穴向上穿过膈肌,行于足太阴脾经食窦穴之外、大包穴之内,散布于胁肋,上行至足少阳胆经渊腋穴、手太阴肺经云门穴之下,足厥阴肝经的穴位至此为止),沿喉咙后方,向上进入鼻咽部(颃颡),连接目系(眼球后连脑的脉络),向上出于额部,与督脉会合于头顶(颃颡即咽部上方软腭处。目内深处为目系。其内行向上的分支,从胁肋间,由足阳明胃经人迎穴外侧,沿喉咙后方进入颃颡,行于足阳明胃经大迎、地仓、四白穴外侧,向内连接目系,向上出于足少阳胆经阳白穴外侧、临泣穴内侧,与督脉会合于头顶的百会穴);其分支,从目系下行至颊里,环绕口唇内侧(此分支,从前目系处分出,下行于任脉外侧、本经内侧,下行至颊里,交环于口唇之内);另一分支,又从肝分出,贯穿膈肌,向上注入肺(又一支脉,从前期门属肝处,行于足太阴脾经食窦穴外侧、本经内侧,别出贯穿膈肌,向上注入肺经,下行至中焦,夹行于中脘穴部分,重新接入手太阴肺经,以完成十二经脉的一周循环,终而复始)。其络脉,名叫蠡沟,在内踝上五寸处,别走足少阳胆经;其别出的络脉,沿胫骨上行至睾丸,结聚于阴茎。其病证表现为气逆则睾丸肿胀突发疝气;实证则阴茎挺长,虚证则突然瘙痒,治疗应取该络穴蠡沟(足厥阴之络名为蠡沟,位于足内踝上五寸,别行走向足少阳胆经。本经络循阴器,上行睾丸结于阴茎,所以其病症如此。治疗这些病症,应当取用所别出的蠡沟穴)。其正脉,别行于足背上方,上行至阴毛际,与足少阳胆经相合,与别出的络脉同行,这称为二合(足厥阴的正脉,别行于足跗上向内,上行至阴毛之际,与足少阳胆经相合,与别出的络脉一同上行,散布于胁肋,这是六合中的第二合)。其筋起于大趾之上,向上结聚于内踝之前(大趾上三毛际,大敦穴旁边,行于足背与足太阴脾经之筋并行,结聚于内踝前中封穴旁边),沿胫骨上行,向上结聚于膝内辅骨之下,沿大腿内侧上行,结聚于生殖器,联络诸筋(由内踝上行足胫,沿三阴交穴部分,上行并合足少阴肾经之筋,向上结聚于内辅骨下方曲泉穴旁边,再并合足太阴脾经之筋,沿大腿内侧上行经过五里、阴廉穴部分,上行至急脉穴,结聚于生殖器。生殖器处,汇聚了太阴、厥阴、阳明、少阴之筋,以及冲、任、督三脉,故称为宗筋。厥阴属肝,肝主筋,故联络诸筋,从而统摄形成健运的功能)。经脉变动则出现腰痛不能俯仰,男子颓疝,女子小腹肿胀,严重时咽喉干燥,面色如尘且脱色。肝经主治肝脏所生的疾病,包括胸满呕逆、洞泄、狐疝、遗尿或小便闭塞不通。脉象方面,盛实时寸口脉搏比人迎脉搏大一倍,虚弱时寸口脉搏反而小于人迎脉搏(篇内的“是动”、“所生病”均指经脉病,若为筋病则与此不同,散见于前编各条,此处不详录。另外,凡十二经脉,病盛则用泻法,虚则用补法,热证则速刺,寒证则留针,脉陷下则用灸法,不盛不虚则取本经治疗,这些原则虽也散见于前文,但此处再次重录,是因为大体想要归类清晰,所以不厌其烦地详细记录)。
The liver, as an organ, has three lobes on the left and four on the right, totaling seven lobes. Its functional regulation is located on the left, while the organ itself is situated in the right hypochondrium, anterior to the right kidney, connected with the stomach, and attached to the ninth thoracic vertebra of the spine. The *Ling Shu* states: The Foot-Jueyin (Liver) Meridian originates at the pubic hair on the big toe (Dadun, LR1), ascends along the medial aspect of the dorsum of the foot (passing through the depression between the big toes, Xingjian, LR2; and the depression behind the first metatarsophalangeal joint, Taichong, LR3). It passes one cun anterior to the medial malleolus, ascends eight cun above the ankle, crosses posterior to the Foot-Taiyin (Spleen) Meridian (Zhongfeng, LR4, one cun anterior to the medial malleolus), ascends along the medial aspect of the thigh (Ququan, LR8), enters the pubic region, passes around the external genitalia, reaches the lower abdomen, flanks the stomach, connects with the Liver, and links with the Gallbladder (The "thigh yin" refers to the medial thigh. Following Yinbao, Wuli, and Yinlian on the medial thigh, it converges with Chongmen and Fushhe of the Foot-Taiyin Spleen Meridian, enters Jimai in the pubic hair, intersects left and right, surrounds the genitalia, and converges with Qugu of the Ren Mai. Ascending from the genitalia into the lower abdomen, it converges with Zhongji and Guanyuan of the Ren Mai, follows Zhangmen to Qimen, flanks the stomach, connects with Riyue of the Foot-Shaoyang Gallbladder Meridian, and the Liver and Gallbladder are exterior-interior partners). It pierces the diaphragm and spreads into the hypochondrium and ribs (From Qimen, it pierces the diaphragm, runs lateral to Shidou of the Foot-Taiyin Spleen Meridian and medial to Dabao, spreading into the hypochondrium. It ascends below Yuan Ye of the Foot-Shaoyang Gallbladder Meridian and Yunmen of the Hand-Taiyin Lung Meridian; the acupoints of the Foot-Jueyin Liver Meridian end here). It follows the posterior aspect of the throat, ascends into the nasopharynx (Hangsang), connects with the optic nerve system (Muxi), emerges onto the forehead, and meets the Du Mai at the vertex (Hangsang refers to the soft palate/pharyngeal area. Muxi is the deep interior connection of the eye. The internal ascending branch travels from the hypochondrium, lateral to Renying of the Foot-Yangming Stomach Meridian, follows the posterior throat into Hangsang, runs lateral to Daying, Dicang, and Sibai of the Foot-Yangming Stomach Meridian, internally connects with Muxi, emerges lateral to Yangbai of the Foot-Shaoyang Gallbladder Meridian and medial to Linqi, and meets the Du Mai at Baihui on the vertex). A branch descends from the optic nerve system into the cheek interior, encircling the inner lips (This branch diverges from the previous optic nerve system point, descends lateral to the Ren Mai and medial to this meridian, goes down to the cheek interior, and interlocks within the lips). Another branch diverges from the Liver, pierces the diaphragm, and ascends to pour into the Lungs (Another branch, from Qimen where it connects to the Liver, runs lateral to Shidou of the Foot-Taiyin Spleen Meridian and medial to this meridian, diverges to pierce the diaphragm, and ascends to pour into the Lung Meridian. Descending to the Middle Jiao, it flanks Zhongwan, reconnects with the Hand-Taiyin Lung Meridian, completing one cycle of the twelve meridians, ending and restarting). Its collateral is named Ligou, five cun above the medial malleolus, diverging to the Foot-Shaoyang Gallbladder Meridian; its divergent branch follows the tibia upward to the testis, knotting at the penis. Pathological changes involving qi reversal result in testicular swelling and sudden hernia; excess conditions manifest as priapism, while deficiency conditions manifest as sudden pruritus; treatment should target the collateral point Ligou (The collateral of the Foot-Jueyin is named Ligou, located five cun above the medial malleolus, diverging to the Foot-Shaoyang Gallbladder Meridian. This meridian collaterals the genitalia, ascends to the testis, and knots at the penis, hence these symptoms. Treatment for these conditions should target the divergent point Ligou). The main channel diverges on the dorsum of the foot, ascends to the pubic hair, merges with the Foot-Shaoyang, and travels together with the collateral; this is called the second convergence (The proper channel of the Foot-Jueyin diverges medially on the dorsum, ascends to the pubic hair, merges with the Foot-Shaoyang Gallbladder Meridian, travels with the collateral, and spreads into the hypochondrium; this is the second of the six convergences). Its sinews originate above the big toe, ascending to knot anterior to the medial malleolus (At the pubic hair above the big toe, next to Dadun, running on the dorsum parallel to the sinews of the Foot-Taiyin Spleen Meridian, knotting near Zhongfeng anterior to the medial malleolus), following the tibia upward, knotting below the medial condyle of the tibia, ascending along the medial thigh, knotting at the genitalia, and connecting with all sinews (Ascending from the medial malleolus along the leg, following Sanyinjiao, traveling parallel to the sinews of the Foot-Shaoyin Kidney Meridian, knotting below the medial condyle near Ququan, then merging with the sinews of the Foot-Taiyin Spleen Meridian, ascending along the medial thigh through Wuli and Yinlian, reaching Jimai, and knotting at the genitalia. The genitalia gather the sinews of the Taiyin, Jueyin, Yangming, and Shaoyin, as well as the Chong, Ren, and Du meridians, thus called the Zongjin (Master Sinew). Jueyin belongs to the Liver, and the Liver governs the sinews, thus connecting all sinews to facilitate movement and function). When the meridian is disturbed, it causes low back pain preventing flexion and extension, hernia in men, lower abdominal swelling in women, and in severe cases, dryness of the throat and a dusty, pale complexion. The Liver Meridian governs diseases generated by the Liver, including chest fullness, vomiting and reflux, loose diarrhea, fox hernia, enuresis, and urinary retention or difficulty. In terms of pulse diagnosis, when the condition is excess, the Cun Kou pulse is larger than the Ren Ying pulse by one degree; when deficient, the Cun Kou pulse is smaller than the Ren Ying pulse (The "Is-Disturbed" and "Generated Diseases" in this chapter refer to meridian diseases. Sinew diseases differ and are detailed elsewhere. Regarding the twelve meridians, excess is treated with draining, deficiency with tonifying, heat with rapid needling, cold with retained needling, sinking with moxibustion, and neither excess nor deficiency by selecting from the meridian itself. These principles are scattered in previous texts but repeated here for clarity and detail).