(广三寸,长五寸,掩乎太仓,附着于脊之第十一椎)《灵枢》曰∶足太阴之脉,起于大趾之
端(隐白穴也),循趾内侧白肉际(大都穴也),过核骨后(太白穴也,核骨在足大趾本节后约二寸,内踝骨
前约三寸,如枣核,横于足内侧,赤白肉际者是也,窦太师指为孤拐骨者非),上内踝前廉(商丘穴也)。上
内循胫骨后,交出厥阴之前( ,足肚也,亦名腓肠。本经自漏谷上行,交出厥阴之前,即地机、阴陵泉也),
上膝股内前廉(股,大腿也。一曰髀内为股。前廉,上侧也,当血海、箕门之次),入腹,属脾络胃(自冲门
穴入腹内行,脾与胃为表里,故于中、下二脘之分,属脾络胃也),上膈,挟咽、连舌本,散舌下(咽以咽物,
居喉之后,自胃脘上行至此,连舌本,散舌下而终。本,犹根也);其支者,复从胃别上膈,注心中(足
太阴外行者,由腹之四行。上府舍、腹结等穴,散于胸中,而止于大包。其内行而支者,自胃脘别上膈,注心
中,而接乎手少阴经也)。其别,名曰公孙,去本节之后一寸,别走阳明;其别者,入络肠胃。厥气上逆则霍
乱,实则肠中切痛,虚则鼓胀,取之所别也(足太阴之络,名公孙,在足大趾本节后一寸,别走足阳明者也。
厥气者,脾气失调而或寒或热,皆为厥气逆而上行,则为霍乱,本经入腹属脾络胃,故其病如此。治此者,当
取所别之公孙也)。其正者上至髀,合于阳明,与别俱行,上结于咽,贯舌中,此为三合(此足太阴之正上股,
内合于足阳明,与别者俱行上咽贯舌。是为六合之三者也)。其大络者,名曰大包,出渊腋下三寸,布胸胁。
实则身尽痛,虚则百节尽皆纵,此脉若罗络之血者,皆取脾之大络脉也(脾之大络,名大包,在渊腋下三寸,
布胸胁,出九肋间,总统阴阳诸络,由脾灌溉五脏者也,故其为病如此。罗络之血者,言此大络,包罗诸络之
血,故皆取脾之大络以去之。大络,即大包)。其筋起于大趾之端内侧,上结于内踝(大趾之端内侧,隐白穴
也,循核骨而上结于内踝,下商丘之次);其直者,络于膝内辅骨,上循阴股,结于髀,聚于阴器(络,当作
结,此自内踝直上,结于膝内辅骨阴陵泉之次。股之内侧曰阴股,结于髀,箕门之次也。乃上横骨两端,与足
厥阴会于冲门,横绕曲骨,并足少阴、阳明之筋,而聚于阴器,皆刚筋也),上腹,结于脐,循腹里,结于肋,
散于胸中;其内者着于脊(其前行者,自阴器上腹,会手少阴之筋,结于脐,循腹里,由大横、腹哀之次,结
于肋,乃散为柔细之筋,上行布于胸乡、大包之次。其内行者,由阴器宗筋之间,并阳明、少阴之筋,而上着
于脊之命门)。是动则病舌本强,食则呕,胃脘
痛,腹胀善噫,得后与气则快然如衰(如衰,脾气通也),身体皆重。是主脾所生病者,舌本强,体不能动摇,
食不下,烦心,心下急痛,溏、瘕、泄,水闭,黄胆,不能卧,强立,股膝内肿,厥,足大趾不用。盛者,寸
口大三倍于人迎;虚者,寸口反小于人迎也。
(脾脏位于广三寸,长五寸处,覆盖在太仓即胃之上,附着于脊柱第十一椎旁。)《灵枢》记载:足太阴脾经,起始于大趾末端(隐白穴),沿趾内侧白肉边缘行走(经过大都穴),越过核骨后方(太白穴;核骨位于足大趾本节后约二寸,内踝前约三寸,形状如枣核,横置于足内侧赤白肉际处,窦太师将其指认为孤拐骨是错误的),上行至内踝前缘(商丘穴)。再沿小腿内侧上行,经过胫骨后缘,交叉至足厥阴肝经之前(腓肠肌部位,亦称腓肠。本经从漏谷穴上行,交叉至厥阴经之前,即地机、阴陵泉穴所在),上行至膝大腿内侧前缘(股即大腿。一说髀内为股。前廉指上侧,位于血海、箕门穴之间),进入腹部,属脾络胃(自冲门穴入腹内行,脾与胃互为表里,故在中脘、下脘部位,属脾而络胃),向上穿过膈肌,夹持咽喉,连接舌根,散布于舌下(咽用于吞咽食物,位于喉之后,自胃脘上行至此,连接舌根,散布于舌下而终止。本,即根的意思);其分支,又从胃分出上行穿过膈肌,注入心中(足太阴脾经外行者,由腹部有四条线路。上行经过府舍、腹结等穴,散布于胸中,止于大包穴。其内行而分出的支脉,自胃脘别出上行穿过膈肌,注入心中,从而接手少阴心经)。其别络,名为公孙,距离本节后方一寸,别走足阳明胃经;其另一别络,进入并联络肠胃。厥气上逆则发生霍乱,实证则肠中剧烈疼痛,虚证则腹部鼓胀,治疗应取该别络的穴位(足太阴脾经的别络名为公孙,位于足大趾本节后一寸,别走足阳明经。厥气是指脾气失调,或寒或热,都称为厥气逆而上行,从而导致霍乱,本经入腹属脾络胃,所以病症如此。治疗此病,应当取用别出的公孙穴)。其正脉上行至大腿,与足阳明胃经相合,与别络共同上行,向上结于咽喉,贯穿舌中,这称为三合(这是足太阴脾经的正脉上行至大腿,向内合于足阳明经,与别络一同上行至咽喉贯穿舌中。这是六合中的第三合)。其大络,名为大包,出于渊腋下三寸,布散于胸胁。实证则全身疼痛,虚证则所有关节松弛无力,这种脉络如同罗网般联络血液的,都应取脾之大络脉(脾的大络名为大包,位于渊腋下三寸,布散于胸胁,出于第九肋间,统率阴阳诸络,由脾灌溉五脏,所以其病症如此。罗络之血,意指此大络包罗诸络之血,因此都取脾之大络以去除病邪。大络即大包)。其筋起于大趾末端内侧,向上结于内踝(大趾末端内侧即隐白穴,沿核骨上行结于内踝,位于商丘穴之下);其直行者,联络于膝内辅骨,向上沿阴股内侧行走,结于髀部,聚于阴器(“络”字此处应作“结”,此自内踝直上,结于膝内辅骨阴陵泉穴附近。股的内侧称为阴股,结于髀部,位于箕门穴附近。乃上行至横骨两端,与足厥阴肝经会合于冲门穴,横向环绕曲骨,并与足少阴肾经、足阳明胃经的筋汇聚于阴器,这些都是刚筋),向上至腹部,结于脐部,沿腹里行走,结于肋骨,散布于胸中;其内部者附着于脊柱(前行者,自阴器上行至腹部,与会手少阴心经之筋,结于脐部,沿腹里行走,经过大横、腹哀穴附近,结于肋骨,然后分散为柔细之筋,上行布散于胸乡、大包穴附近。内行者,由阴器宗筋之间,并行阳明、少阴之筋,而上行附着于脊柱的命门)。经脉变动则出现以下病症:舌根僵硬,进食则呕吐,胃脘痛,腹胀且喜欢嗳气,大小便通畅或排气后感觉轻松缓解(如衰,指脾气通畅),身体沉重。本经主治脾所生的疾病:舌根僵硬,身体不能动摇,饮食不下,心烦,心下部急痛,大便溏泄、瘕积、泄泻,小便闭塞,黄疸,不能平卧,强立时头晕,大腿膝盖内侧肿胀,厥逆,足大趾不能活动。脉象盛大时,寸口脉搏比人迎大三倍;脉象虚弱时,寸口脉搏反而小于人迎。
(The spleen is three cun wide and five cun long, covering the Tai Cang [Stomach], and attached to the eleventh thoracic vertebra of the spine.] The *Ling Shu* states: The Foot-Taiyin Spleen Meridian originates at the tip of the great toe (Yinbai SP-1), follows the medial border of the white flesh of the toe (Dadu SP-2), passes behind the nuclear bone (Taibai SP-3; the nuclear bone is located approximately two cun posterior to the metatarsophalangeal joint of the great toe, about three cun anterior to the medial malleolus, shaped like a jujube pit, lying transversely on the medial side of the foot at the junction of red and white skin; Master Dou's identification of it as the "lone ankle bone" is incorrect), ascends along the anterior margin of the medial malleolus (Shangqiu SP-5). It then ascends along the posterior aspect of the tibia, crossing anterior to the Foot-Jueyin Liver Meridian (the calf muscle, also known as the gastrocnemius. Ascending from Lougu SP-7 along this meridian to cross anterior to the Jueyin Meridian refers to the locations of Diji SP-8 and Yinlingquan SP-9), ascends to the anterior margin of the medial knee and thigh (Thigh refers to the upper leg. Alternatively, the inner part of the thigh is called Gu. Anterior margin refers to the upper lateral side, located between Xuehai SP-10 and Jimen SP-8), enters the abdomen, connects with the Spleen and links with the Stomach (Entering the abdomen from Chongmen SP-12, as the Spleen and Stomach are interior-exteriorly related, it connects with the Spleen and links with the Stomach in the regions of the Middle and Lower Epigastrium), ascends through the diaphragm, flanks the pharynx, connects with the root of the tongue, and scatters under the tongue (The pharynx is used for swallowing food, located posterior to the larynx. Ascending from the gastric region to here, it connects with the root of the tongue and scatters under the tongue to terminate. Ben, meaning root); its branch separates from the stomach, ascends through the diaphragm, and pours into the Heart (The external pathway of the Foot-Taiyin Meridian consists of four rows in the abdomen. Ascending past Fushhe SP-13, Fujie SP-14, etc., it scatters in the chest and terminates at Dabao SP-21. Its internal branch separates from the gastric region, ascends through the diaphragm, pours into the Heart, and connects with the Hand-Shaoyin Pericardium/Heart Meridian). Its collateral is named Gongsun (SP-4), one cun posterior to the proximal interphalangeal joint, diverging to the Foot-Yangming Stomach Meridian; its branch enters and links with the Intestines and Stomach. If rebellious Qi rebels upward, Huoluan [Cholera-like disorder] occurs; excess manifests as cutting pain in the intestines, deficiency manifests as abdominal distension and drum-like swelling; treatment should target the collateral point (The collateral of the Foot-Taiyin Spleen Meridian is named Gongsun, located one cun posterior to the proximal joint of the great toe, diverging to the Foot-Yangming Stomach Meridian. Jue Qi refers to the imbalance of Spleen Qi, whether cold or heat, causing Qi to rebel and ascend, leading to Huoluan. Since this meridian enters the abdomen, connects with the Spleen, and links with the Stomach, the pathology is thus. To treat this, one should select the divergent Gongsun point). The main vessel ascends to the thigh, merges with the Yangming Meridian, travels together with the collateral, knots at the pharynx, penetrates the middle of the tongue; this is called the Triple Combination (This main vessel of the Foot-Taiyin ascends to the thigh, internally merges with the Foot-Yangming, traveling with the collateral to the pharynx and penetrating the tongue. This constitutes one of the six combinations). Its major collateral is named Dabao (SP-21), emerging three cun below Yuanxi (likely referring to a specific landmark or typo for another point, but text says Yuanxia) and distributing across the chest and hypochondrium. Excess manifests as generalized body pain; deficiency manifests as laxity of all joints. For these vessels that resemble a net linking blood, one should treat the Major Collateral of the Spleen (The Major Collateral of the Spleen is named Dabao, located three cun below the axillary region, distributing across the chest and hypochondrium, emerging from between the ninth ribs, commanding the collaterals of Yin and Yang, irrigating the Five Zang Organs via the Spleen, hence the pathology described. Luo Luo Zhi Xue refers to this major collateral encompassing the blood of various collaterals; thus, the Major Collateral of the Spleen is selected for treatment. Major Collateral refers to Dabao). The Spleen tendons originate at the medial tip of the great toe, ascending to knot at the medial malleolus (Medial tip of the great toe is Yinbai SP-1; following the nuclear bone upward to knot at the medial malleolus, inferior to Shangqiu SP-5); its straight portion links with the medial condyle of the tibia, ascends along the medial thigh, knots at the hip, and gathers at the genitalia ("Link" here should be interpreted as "knot"; ascending straight from the medial malleolus, it knots near Yinlingquan SP-9. The medial aspect of the thigh is called Yin Gu. Knotting at the hip is near Jimen SP-8. Then ascending to both ends of Henggu, meeting the Foot-Jueyin at Chongmen SP-12, wrapping horizontally around Qugu, and joining the tendons of the Foot-Shaoyin Kidney and Foot-Yangming Stomach to gather at the genitalia, these are all rigid tendons), ascending to the abdomen, knotting at the umbilicus, running along the interior of the abdomen, knotting at the ribs, and scattering in the chest; its internal portion attaches to the spine (The anterior path ascends from the genitalia to the abdomen, meeting the tendons of the Hand-Shaoyin Heart Meridian, knotting at the umbilicus, running along the abdominal interior, passing through Daheng SP-15 and Fu'ai SP-16, knotting at the ribs, then dispersing into fine, soft tendons ascending to distribute near Xiongxiang (local point) and Dabao SP-21. The internal path runs between the Zongjin of the genitalia, alongside the tendons of the Yangming and Shaoyin meridians, and ascends to attach to the Mingmen of the spine). When the meridian is disturbed, it causes stiffness of the tongue root, vomiting after eating, epigastric pain, abdominal fullness with frequent belching, and a feeling of relief after defecation or passage of gas (Ru Shuai indicates the smooth flow of Spleen Qi), and heaviness of the entire body. Diseases governed by the Spleen include: stiffness of the tongue root, inability to move the body, difficulty in eating, vexation, urgency and pain in the epigastrium, loose stools, masses, diarrhea, urinary retention, jaundice, inability to lie flat, weakness upon standing, swelling of the medial thigh and knee, reversal [cold limbs], and immobility of the great toe. In cases of excess, the pulse at Cun Kou is three times larger than Ren Ying; in cases of deficiency, the pulse at Cun Kou is smaller than Ren Ying.