脉有奇经八脉者,何谓也?然∶有阳维、阴维,有阳跷、阴跷,有冲、有督、有任、有带之脉,凡此八脉者,皆不
拘于经,故曰奇经八脉也。经有十二,络有十五,凡二十七气,相随上下,何独不拘于经也?然∶圣人图设沟渠,通利
水道,以备不虞。天雨降下,沟渠溢满, 霈妄行,当此之时,圣人不能复图也。此络脉流溢,诸经不能复拘也。
奇经八脉者,既不拘于十二经,皆何起何系也?然∶阳维者,起于诸阳之会;阴维者,起于诸阴之交。阳维、阴维
者,维络于身,溢畜不能环流溉灌诸经者也。阳跷者,起于跟中,循外踝而上行,入风池。阴跷者,亦起于跟中,循内
踝而上行,至咽喉,交贯冲脉。冲脉者,起于关元,循腹里直上,至咽喉中(一云∶冲脉者,起于气冲,并阳明之经,
夹脐上行,至胸中而散也)。督脉者,起于下极之输,并于脊里,循背上,至风府。冲脉者,
阴脉之海也;督脉者,阳脉之海也。任脉者,起于胞门、子户、夹脐上行,至胸中(一云∶任脉者,起于中极之下,
以上毛际,循腹里,上关元,至喉咽)。带脉者,起于季肋,(《难经》作季胁)回身一周。此八者,皆不系于十二经,故
曰奇经八脉者也。
奇经之为病何如?然∶阳维维于阳,阴维维于阴。阴阳不能相维,怅然失志,容容(《难经》作溶溶)不能自收持(怅
然者,其人惊,即维脉缓,缓即令身不能自收持,即失志善忘恍惚也)。阳维为病,苦寒热;阴维为病,苦心痛(阳维为
卫,卫为寒热。阴维为荣,荣为血,血者主心,故心痛也)。阴跷为病,阳缓而阴急(阴跷在内踝,病即其脉急,当从内
踝以上急,外踝以上缓);阳跷为病,阴缓而阳急(阳跷在外踝,病即其脉急,其人当从外踝以上急,内踝以上缓)。冲
之为病,逆气而里急(冲脉从关元至喉咽,故其为病逆气而里急)。督之为病,脊强而厥(督脉在背,病即其脉急,故令
脊强也)。任之为病,其内苦结,男子为七疝,女子为瘕聚(任脉起于胞门、子户、故其病结为七疝、瘕聚)。带之为病,
苦腹满,腰容容(《难经》作溶溶)若坐水中状(带脉者,回带人之身体,病即其脉缓,故令腰容容也)。此奇经八脉之
为病也。
诊得阳维脉浮者,暂起目眩,阳盛实,苦肩息,洒洒如寒。
诊得阴维脉沉大而实者,苦胸中痛,胁下支满,心痛。
诊得阴维如贯珠者,男子两胁实,腰中痛;女子阴中痛,如有疮状。
诊得带脉,左右绕脐腹腰脊痛,冲阴股也。两手脉浮之俱有阳,沉之俱有阴,阴阳皆实盛者,此为冲、督之脉也。
冲、督之脉者,十二经之道路也。冲、督用事则十二经不复朝于寸口,其人皆苦恍惚狂痴,不者,必当犹豫,有两心也。
两手阳脉浮而细微,绵绵不可知,俱有阴脉,亦复细绵绵,此为阴跷,阳跷之脉也。此家曾有病鬼魅风死,苦恍惚,亡
人为祸也。
诊得阳跷,病拘急;阴跷病缓。
尺寸俱浮,直上直下,此为督脉。腰背强痛,不得俯仰,大人癫病,小人风痫疾。
脉来中央浮,直上下痛者,督脉也。动苦腰背膝寒,大人癫,小儿痫也,灸顶上三丸。正当顶上。
尺寸脉俱牢(一作芤),直上直下,此为冲脉。胸中有寒疝也。
脉来中央坚实,径至关者,冲脉也。动苦少腹痛,上抢心,有瘕疝,绝孕,遗矢、溺,胁支满烦也。
横寸口边丸丸,此为任脉。苦腹中有气如指,上抢心,不得俯仰,拘急。
脉来紧细实长至关者,任脉也。动苦少腹绕脐,下引横骨、阴中切痛。取脐下三寸。
奇经八脉的脉象是怎样的呢?回答说:有阳维脉、阴维脉,有阳跷脉、阴跷脉,有冲脉、督脉、任脉、带脉,这八条脉,都不受十二正经的约束,所以称为奇经八脉。
十二正经有十二条,十五络脉有十五条,总共二十七气,上下相随运行,为什么唯独这八条脉不受正经约束呢?回答说:圣人挖掘沟渠,疏通水道,以预防意外情况的发生。当天下大雨时,沟渠溢满,雨水泛滥妄行,在这个时候,即使是圣人也不能再重新规划了。这就好比络脉中的气血流溢出来,诸条正经就无法再约束它们了。
奇经八脉既然不受十二正经的约束,它们都是从哪里起始、联系到哪里呢?回答说:阳维脉起于诸阳经交会之处;阴维脉起于诸阴经交汇之处。阳维脉和阴维脉,维系联络全身,当气血溢出蓄积而不能环绕流动灌溉诸经时,便汇聚于此。阳跷脉起于足跟中部,沿外踝向上行走,进入风池穴。阴跷脉也起于足跟中部,沿内踝向上行走,到达咽喉部,与冲脉相交贯通。冲脉起于关元穴,沿腹部内侧直上,到达咽喉中(另一种说法是:冲脉起于气冲穴,并合阳明经,夹脐上行,至胸中而散开)。督脉起于下极之输穴(长强穴),并行于脊柱内部,沿背部上行,至风府穴。冲脉是阴脉之海;督脉是阳脉之海。任脉起于胞门、子户,夹脐上行,至胸中(另一种说法是:任脉起于中极穴之下,向上经过毛际,沿腹部内侧,上至关元穴,至喉咽)。带脉起于季肋部,环绕身体一周。这八条脉,都不隶属于十二正经,所以称为奇经八脉。
奇经八脉发生病变会怎样呢?回答说:阳维脉维系阳经,阴维脉维系阴经。如果阴阳不能相互维系,患者就会神情恍惚、失志,面容呆滞(《难经》作“溶溶”),不能自我控制(所谓怅然,是指其人惊恐,导致维脉缓弱,脉缓则使身体不能自我收持,即表现为失志、健忘、恍惚)。阳维脉发病,苦于寒热往来;阴维脉发病,苦于心痛(阳维脉主卫气,卫气病则见寒热;阴维脉主营血,营血病则涉及心脏,故见心痛)。阴跷脉发病,表现为外侧弛缓而内侧拘急(阴跷脉位于内踝,发病时其脉急,应当是从内踝以上拘急,外踝以上弛缓);阳跷脉发病,表现为内侧弛缓而外侧拘急(阳跷脉位于外踝,发病时其脉急,其人应当是从外踝以上拘急,内踝以上弛缓)。冲脉发病,表现为气逆且腹部拘急(冲脉从关元穴上行至咽喉,所以它的病症是气逆且腹部拘急)。督脉发病,表现为脊背强直且厥冷(督脉在背部,发病时其脉急,所以导致脊背强直)。任脉发病,其内部苦于结聚,男子发为七疝,女子发为瘕聚(任脉起于胞门、子户,所以它的病症结聚为七疝、瘕聚)。带脉发病,苦于腹部胀满,腰部松软无力(《难经》作“溶溶”),像坐在冷水中的样子(带脉环绕人体身体,发病时其脉缓弱,所以导致腰部松软无力)。这就是奇经八脉的病变表现。
诊察发现阳维脉浮的,突然起身时会头晕目眩,阳气盛实,苦于肩部呼吸急促,感觉洒洒如寒冷。
诊察发现阴维脉沉大而实的,苦于胸部疼痛,胁下支撑胀满,心痛。
诊察发现阴维脉如贯珠状的,男子两胁实痛,腰部疼痛;女子阴中疼痛,好像有疮疡的样子。
诊察发现带脉病的,左右绕脐腹及腰脊疼痛,气冲犯阴股。两手脉象轻取都有阳脉,重取都有阴脉,阴阳都实盛的,这是冲脉、督脉的脉象。
冲脉、督脉,是十二经运行的道路。当冲脉、督脉主事时,十二经的气血不再朝注于寸口,患者都苦于恍惚、狂痴,如果不这样,必定犹豫不决,有二心。
两手阳脉浮而细微,绵绵不绝难以感知,同时也有阴脉,也是细绵绵的,这是阴跷、阳跷的脉象。这类人曾经有过被鬼魅风邪致死或患病的历史,苦于恍惚,认为是亡人为祸。
尺寸两部脉俱浮,直上直下,这是督脉的脉象。腰背强痛,不能俯仰,大人患癫病,小儿患风痫疾。
脉来中央浮,直上下痛的,是督脉。动则苦于腰背膝部寒冷,大人患癫病,小儿患痫病,可灸头顶正中三丸。正当头顶正中线。
尺寸两部脉俱牢(一作芤),直上直下,这是冲脉的脉象。胸中有寒疝。
脉来中央坚实,直达关部的,是冲脉。动则苦于小腹痛,气上抢心,有瘕疝,绝育,遗矢、溺,胁下支撑胀满烦闷。
What are the pulses of the Eight Extraordinary Vessels (Qi Jing Ba Mai)? The answer is: There are the Yang Linking Vessel (Yang Wei), Yin Linking Vessel (Yin Wei), Yang Heel Vessel (Yang Qiao), Yin Heel Vessel (Yin Qiao), Chong Vessel (Chong Mai), Du Vessel (Du Mai), Ren Vessel (Ren Mai), and Dai Vessel (Dai Mai). These eight vessels are not constrained by the regular meridians, hence they are called the Eight Extraordinary Vessels.
There are twelve regular meridians and fifteen collaterals, totaling twenty-seven qi pathways that follow each other up and down. Why are these eight specifically not constrained by the regular meridians? The answer is: Sages dug ditches and cleared waterways to prepare for unforeseen circumstances. When heavy rain falls and the ditches overflow, causing waters to flood wildly, even a sage cannot re-plan at that moment. Similarly, when the qi and blood in the collaterals overflow, the regular meridians can no longer constrain them.
Since the Eight Extraordinary Vessels are not constrained by the twelve regular meridians, where do they originate and connect? The answer is: The Yang Linking Vessel originates from the convergence of all yang meridians; the Yin Linking Vessel originates from the intersection of all yin meridians. The Yang and Yin Linking Vessels link and network the body, storing excess qi and blood that cannot circulate freely to irrigate the regular meridians. The Yang Heel Vessel originates in the middle of the heel, travels along the lateral malleolus upwards, and enters Fengchi (GB20). The Yin Heel Vessel also originates in the middle of the heel, travels along the medial malleolus upwards, reaches the throat, and intersects with the Chong Vessel. The Chong Vessel originates at Guanyuan (CV4), travels straight up inside the abdomen to the throat (another version states: it originates at Qichong (ST30), runs alongside the Stomach Meridian, flanking the navel upwards, and disperses in the chest). The Du Vessel originates at Xiaji's transport point (Changqiang, GV1), runs parallel within the spinal column, travels up the back to Fengfu (GV16). The Chong Vessel is the Sea of Yin Vessels; the Du Vessel is the Sea of Yang Vessels. The Ren Vessel originates at Baomen and Zihu, travels up flanking the navel to the chest (another version states: it originates below Zhongji (CV3), goes up to the pubic hairline, travels inside the abdomen, passes Guanyuan, and reaches the throat). The Dai Vessel originates at the costal region, encircles the body once. These eight vessels do not attach to the twelve regular meridians, hence they are called the Eight Extraordinary Vessels.
How do diseases manifest in the Eight Extraordinary Vessels? The answer is: The Yang Linking Vessel links yang, and the Yin Linking Vessel links yin. If yin and yang cannot link each other, the patient experiences mental confusion and loss of will, appearing lethargic (Rannan describes this as "rong rong") and unable to control themselves (Confusion implies fright, leading to a slow linking pulse; a slow pulse causes the body to lose self-control, manifesting as loss of will, forgetfulness, and trance). Disease of the Yang Linking Vessel involves suffering from chills and fever; disease of the Yin Linking Vessel involves suffering from heart pain (The Yang Linking Vessel governs Wei Qi, so its disease presents with chills and fever; the Yin Linking Vessel governs Ying Blood, which relates to the Heart, hence heart pain). Disease of the Yin Heel Vessel presents with laxity on the exterior and tension on the interior (The Yin Heel Vessel is at the medial malleolus; when diseased, its pulse is tense, meaning tension above the medial malleolus and laxity above the lateral malleolus); disease of the Yang Heel Vessel presents with laxity on the interior and tension on the exterior (The Yang Heel Vessel is at the lateral malleolus; when diseased, its pulse is tense, meaning tension above the lateral malleolus and laxity above the medial malleolus). Disease of the Chong Vessel presents with rebellious qi and abdominal urgency (The Chong Vessel runs from Guanyuan to the throat, so its disease involves rebellious qi and abdominal urgency). Disease of the Du Vessel presents with stiffness of the spine and cold extremities (The Du Vessel is on the back; when diseased, its pulse is tense, causing spinal stiffness). Disease of the Ren Vessel involves internal knotting; in men, it manifests as seven types of hernia (Qishen); in women, it manifests as masses (Jiaju) (The Ren Vessel originates at Baomen and Zihu, so its disease knots into hernias and masses). Disease of the Dai Vessel involves suffering from abdominal fullness and a sensation of the waist being limp (Rannan describes this as "rong rong"), as if sitting in water (The Dai Vessel encircles the body; when diseased, its pulse is weak/lax, causing the waist to feel limp). These are the diseases of the Eight Extraordinary Vessels.
If the Yang Linking Vessel pulse is floating, there is temporary dizziness upon rising, excess and solid yang, suffering from shoulder breathing (dyspnea involving shoulders), and feeling chilly like having chills.
If the Yin Linking Vessel pulse is deep, large, and solid, there is suffering from chest pain, distending fullness under the hypochondrium, and heart pain.
If the Yin Linking Vessel pulse resembles beads strung together, men suffer from fullness and pain in both hypochondria and lower back pain; women suffer from pain in the vagina, resembling an ulceration.
If the Dai Vessel is diagnosed, there is pain around the umbilicus, abdomen, lower back, and spine, with qi rushing to the inner thighs. If both hands' pulses show yang upon superficial palpation and yin upon deep palpation, both being excess and strong, this indicates the Chong and Du Vessels.
The Chong and Du Vessels are the pathways of the twelve regular meridians. When the Chong and Du Vessels are active, the twelve meridians no longer flow to the Cun Kou pulse site. Patients suffer from trance, mania, or dementia; otherwise, they are indecisive and have divided minds.
If both hands' yang pulses are floating, fine, and minute, continuous yet indistinct, and both hands' yin pulses are also fine and continuous, this indicates the Yin Heel and Yang Heel Vessels. Such individuals may have previously suffered from ghost-possessing wind diseases or death, suffering from trance, believing it to be harm from the deceased.
Diagnosing the Yang Heel Vessel disease results in spasticity; Yin Heel Vessel disease results in laxity.
If Cun and Chi pulses are both floating, moving straight up and down, this is the Du Vessel. Symptoms include stiff and painful lower back, inability to bend or extend, epilepsy in adults, and convulsive seizures in children.
If the pulse comes from the center, floating, with pain moving straight up and down, this is the Du Vessel. Movement causes suffering from cold in the lower back, back, and knees, epilepsy in adults, and infantile convulsions in children. Moxibustion should be applied to three spots on the vertex, directly on the midline.
If Cun and Chi pulses are both firm (or hollow), moving straight up and down, this is the Chong Vessel. There is cold hernia in the chest.
If the pulse comes from the center, solid and firm, reaching the Guan position, this is the Chong Vessel. Movement causes suffering from lower abdominal pain, qi rushing upward to the heart, masses/hernias, infertility, involuntary defecation/urination, and distending fullness and irritability in the hypochondrium.
If there is a pulsating mass at the side of the Cun Kou, this is the Ren Vessel. There is suffering from gas in the abdomen feeling like a finger, rushing upward to the heart, inability to bend or extend, and spasticity.
If the pulse is tight, fine, solid, and long, reaching the Guan position, this is the Ren Vessel. Movement causes suffering from lower abdominal pain winding around the umbilicus, radiating downward to Henggu and the genitals with cutting pain. Treatment involves points three cun below the umbilicus.