足厥阴肝经。名曰将军。居左手关上。与足少阳胆经为表里。肝脏胆腑。言其体属东方乙木。言其用。心主血。肝
藏之故。肝为血海。其候在目。肝和则目辨五色。其华在爪。其充在筋。爪与筋。皆血所养也。肝又藏魂。从神往来
谓之魂。精气之辅弼也。谋虑于是乎出。言其性情之杂着。肝主色。自入为青。其传于五脏者。亦各自有色。其为各脏
所传者。肺主声。入肝为呼。心主臭。入肝为臊。脾主味。入肝为酸。肾主液。入肝为泪。其为六淫所中。诸风病皆始
于肝。故肝所发病。必头目眩。胁痛肢满。手足青。其为七情所害。肝气虚则恐。实则怒。怒则魂门弛张。木气奋激。
肺金乘之。故曰怒气伤肝。其有不内外因而病者。疲剧筋痛。肝气不调也。肝脉受胆脉之交。胆脉终于足大指三毛。肝
脉即起足大指丛毛之际。上循足跗。去内踝一寸。即螺蛳骨。上踝八寸。上 内廉。即曲膝腕中。循股入阴毛中。过阴
器。
抵小腹。故肝病为 疝狐疝。少腹痛遗溺闭隆诸病。从小腹挟胃。属肝络胆。上贯膈。布胁肋。故肝病肋胁腰痛不可俯
仰。从胁肋循喉咙之后。上入颃颡。颃。胫也。颡。额也。连目系。目内廉深处为目系。上出额与督脉会于巅。其支者。
从目系下颊里。环唇内。其支者。复从肝别贯膈上注肺。故肺脉从中焦起。诊脉如十二菽之重浮于十二菽者。胆脉也。
重按至筋脉。如筝弦相似曰弦。次稍加力。脉道迨递为长。此其平脉也。少见筋急。其脉必紧。若见肺脉。金来克木为
贼邪。然二者皆阳。阳之性热。金畏热。金反虚而木反盛。木来乘金。则为空虚。浮而数。风热入肝经。目昏眼泪。筋
。浮而促。心腹胀满。涩则肝虚不能藏血。肋胀身痛目昏。缓大则微邪。不治自退。沉濡而滑。肾邪相干。是为虚邪。
沉则引寒入胃。主血冷痞满。沉而坚实。致 癖之疾。沉而虚弱。肝家虚乏。濡至受湿冷雾露之气。精枯筋 。滑则肝
家有热。头旋目暗筋急。洪大属火为实邪。风热侵胃。中焦烦闷。目赤左瘫。盗汗呕吐。芤则血不归宗。主吐血。血不
养筋。主瘫缓。不能含血养目。主眼暗。又木火相合。木挟火而侮金。主肠痈。又有正邪。弦为本脉。亦不可过。如新
上弓弦而急者为太过。病邪在外。令人常怒。忽忽眩冒癫疾。如筝弦解落为不及。胸胁痛引背。下则两胁 满。弦脉
见于三部。乃肝气有余。主目痛。又主恚逆满胸。若溢关上涌出寸口。乃木盛生风。主目弦头重筋疼。肝之积名曰肥气。
状如覆杯。在左胁下。突出如肉肥盛之状。以季夏戊己日得之。盖肺邪传肝。肝当传脾。脾旺不受传。肝复欲还肺。肺
不受。故留结为积。肝气实梦山林树木。虚则梦细草。若肝绝而真藏脉见。中外急。如循刀刃。责责然。见于外者。睹
物而不能转睛曰直视。又手足爪甲皆青黑。卵筋缩。舌卷。盖筋聚于阴器。而脉络于舌本故也。庚日笃。辛日死。死于
申酉时。肝之大略如此。
足厥阴肝经,被称为“将军”,脉象位于左手关部。它与足少阳胆经互为表里。肝脏与胆腑,从形体属性上讲属于东方的乙木。从其功能作用来看,心主血,而肝负责贮藏血液,因此肝被称为“血海”。肝的功能状态反映在眼睛上:肝气调和则眼睛能辨别五色;肝的精气荣华表现在指甲上;肝充养筋脉。指甲和筋脉,都是由血液滋养的。肝还贮藏“魂”,随着神气往来出入的称为魂,它是精气的辅佐力量。人的谋略思虑由此产生。关于其性情杂糅的表现:肝对应青色,自身呈现为青色;它传变到其他五脏时,各脏也有对应的颜色。至于其他脏腑传给肝的情况:肺主声音,传入肝表现为呼;心主气味,传入肝表现为臊味;脾主味道,传入肝表现为酸味;肾主津液,传入肝表现为泪液。当受到六淫邪气侵袭时,各种风病都起始于肝。所以肝病发作,必然出现头晕目眩、胁肋疼痛、肢体胀满、手足发青等症状。如果是被七情(喜怒忧思悲恐惊)所伤害,肝气虚则会恐惧,肝气实则易怒。发怒会导致魂门开合失常,木气奋起激荡,此时肺金会乘虚克制肝木,所以说怒气伤肝。如果是由不内外因导致的疾病,如极度疲劳、筋脉疼痛,则是肝气不调所致。
肝脉接受胆脉的气交,胆脉终止于足大趾的丛毛处,肝脉即起于足大趾丛毛之际,向上沿足背而行,在内踝前一寸处,即螺蛳骨位置;再向上至内踝八寸处,交叉到小腿内侧前缘,即膝盖弯曲处的腕中;接着沿大腿内侧进入阴毛区域,经过生殖器,抵达小腹。因此肝病会出现疝气、狐疝、小腹痛、遗尿或小便闭塞不通等病症。经脉从小腹挟胃上行,属肝络胆,穿过膈肌,散布于胁肋部。因此肝病会出现胁肋腰痛,身体不能俯仰。经脉从胁肋部沿喉咙后方上行,进入颃颡(咽喉上部)。颃指胫骨部位(此处指咽喉深部),颡指额部(此处指鼻咽部)。经脉连接目系(眼球深处连脑的组织),向上出于额头,与督脉交会于头顶。其分支,从目系下行至脸颊内部,环绕嘴唇内侧。另一分支,再从肝脏分出,贯穿膈肌,向上注入肺脏。因此肺脉从中焦开始。
诊察脉象时,像十二颗豆粒那样重的力度浮取,是胆脉。重按至筋脉层面,脉象像筝弦一样紧绷,称为“弦”脉。稍微再加一点力,脉道显得长而通畅,这是正常的平脉。如果稍微见到筋脉拘急,脉象必定紧。如果出现肺脉的特征,金来克木,称为贼邪。但二者皆属阳,阳的性质热,金畏热,金反而虚弱而木反而旺盛,木来乘金,脉象就会空虚。若脉浮而数,是风热侵入肝经,症状为眼睛昏花、流泪、筋脉拘急。若脉浮而促,症状为心腹胀满。若脉涩,则是肝虚不能藏血,症状为胁肋胀满、身体疼痛、眼睛昏花。若脉缓大,则是微邪,不治也能自行消退。若脉沉濡而滑,是肾邪干扰,称为虚邪。若脉沉,寒邪引入胃中,主血冷痞满。若脉沉而坚实,会导致积聚癖块之疾。若脉沉而虚弱,是肝家虚乏。若脉濡,是受湿冷雾露之气侵袭,导致精气枯竭、筋脉拘急。若脉滑,是肝家有热,症状为头晕、眼睛昏暗、筋脉拘急。若脉洪大,属火,为实邪,风热侵胃,中焦烦闷,眼睛发红、左侧偏瘫、盗汗呕吐。若脉芤,是血不归经,主吐血;血不能养筋,主瘫痪弛缓;不能含血养目,主眼睛昏暗。另外,木火相合,木挟带火势侮害肺金,主肠痈。还有正邪之分,弦脉是肝的本脉,也不可以太过。如果像新张开的弓弦那样紧急,称为太过,病邪在外,使人经常发怒,恍惚眩晕冒昧,甚至癫疾。如果像筝弦解落那样松弛无力,称为不及,症状为胸胁痛牵引背部,下部两胁胀满。弦脉出现在寸关尺三部,乃是肝气有余,主眼睛疼痛,也主愤怒逆气充满胸中。如果脉气溢出关上涌向寸口,乃是木盛生风,主眼睛昏眩、头重、筋脉疼痛。
肝脏的积病名叫“肥气”,形状像倒扣的杯子,位于左胁下,突出如肉般肥盛的样子。如果在季夏戊己日得此病,是因为肺邪传肝,肝应当传脾,但脾旺不受传,肝又想返还给肺,肺不接受,所以停留结聚成为积病。肝气实的人做梦梦见山林树木,肝气虚的人做梦梦见细草。如果肝气绝绝而真脏脉出现,脉象中外紧急,像触摸刀刃一样锋利,责责作响。表现在外的症状是,看东西但不能转动眼珠,称为直视。还有手足爪甲都呈青黑色,睾丸筋脉收缩,舌头卷曲。这是因为筋汇聚于阴器,而脉络连系于舌本的缘故。病情在庚日加重,辛日死亡,死于申时或酉时。肝脏的大致情况就是这样。
The Foot-Jueyin Liver Meridian is named "General" (Jiangjun). Its pulse position is at the Guan (Gate) position on the left hand. It forms an interior-exterior relationship with the Foot-Shaoyang Gallbladder Meridian. The Liver and Gallbladder, in terms of their physical nature, belong to the Wood element of the East (Yi Wood). In terms of their function, the Heart governs Blood, and since the Liver stores it, the Liver is referred to as the "Sea of Blood." Its manifestation is in the eyes: when the Liver Qi is harmonious, the eyes can distinguish the five colors. Its brilliance manifests in the nails, and its nourishment extends to the sinews. The nails and sinews are both nourished by blood. The Liver also stores the Hun (Ethereal Soul), which is defined as that which travels back and forth with the Shen (Spirit); it serves as an assistant to the Jing (Essence). Strategic planning arises from here. Regarding its mixed characteristics: the Liver corresponds to the color Green; internally it appears green. When transmitted to the Five Zang Organs, each has its own corresponding color. Regarding transmissions from other organs to the Liver: the Lung governs sound, transmitted to the Liver it manifests as exhalation (Hu); the Heart governs odor, transmitted to the Liver it manifests as a fishy smell (Sao); the Spleen governs taste, transmitted to the Liver it manifests as sourness; the Kidney governs fluids, transmitted to the Liver it manifests as tears. When attacked by the Six Excesses (Liu Yin), all wind diseases originate in the Liver. Therefore, liver diseases inevitably present with dizziness and vertigo, hypochondriac pain, limb fullness, and cyanosis of the hands and feet. If harmed by the Seven Emotions (Qi Qing), deficiency of Liver Qi leads to fear, while excess leads to anger. Anger causes the Hun Gate to dilate and contract abnormally, causing Wood Qi to surge and excite; consequently, Metal (Lung) overacts upon it. Thus, it is said that anger injures the Liver. Diseases caused by non-external or internal factors, such as severe fatigue and tendon pain, result from disharmony of Liver Qi.
The Liver Meridian receives qi exchange from the Gallbladder Meridian. The Gallbladder Meridian terminates at the hair tuft on the big toe, and the Liver Meridian originates at this hair tuft. It ascends along the dorsum of the foot, one cun anterior to the medial malleolus, at the site of the snail-shell bone (peroneal tubercle area). Ascending eight cun above the ankle, it crosses to the medial aspect of the leg, at the wrist of the knee joint. It follows the thigh into the pubic region, passes through the genitalia, and reaches the lower abdomen. Therefore, liver diseases manifest as hernias (Shan), wandering hernias (Huxian), lower abdominal pain, enuresis, or urinary retention. The meridian ascends from the lower abdomen alongside the stomach, belongs to the Liver and connects with the Gallbladder, pierces the diaphragm, and spreads across the hypochondrium. Therefore, liver diseases cause pain in the hypochondrium and lower back, with inability to bend or extend the body. From the hypochondrium, it follows the posterior aspect of the throat, enters the pharynx (Hangsang). Hang refers to the deep throat/pharyngeal cavity, Sang refers to the forehead/nasal cavity area. It connects with the Eye System (Muxi, the tissue connecting the eye to the brain), emerges above the forehead, and meets the Du Meridian at the vertex (Dian). A branch descends from the Eye System to the inner cheek, encircling the inside of the lips. Another branch diverges from the Liver, pierces the diaphragm, and flows upward into the Lungs. Hence, the Lung Meridian begins from the Middle Jiao.
When diagnosing the pulse, applying pressure equivalent to twelve beans (shu) for superficial palpation reveals the Gallbladder pulse. Pressing heavily to the level of the sinews, where the pulse feels taut like a zither string, is called a String-like Pulse (Xian Mai). Applying slightly more force, making the pulse channel appear long and continuous, represents the Normal Pulse (Ping Mai). If slight tension in the sinews is observed, the pulse will be Tight (Jin). If Lung pulse characteristics appear, Metal overcoming Wood constitutes a Robber Pathogen (Ze Xie). However, both are Yang; Yang nature is hot. Metal fears heat, so Metal becomes deficient while Wood becomes excessive, leading Wood to overact upon Metal, resulting in an Empty pulse. A Floating and Rapid (Shuo) pulse indicates Wind-Heat invading the Liver Meridian, presenting with blurred vision, tearing, and sinew stiffness. A Floating and Rushing (Cu) pulse presents with chest and abdominal distension. a Choppy (Se) pulse indicates Liver deficiency failing to store blood, presenting with hypochondriac distension, body pain, and blurred vision. a Slow and Large (Huan Da) pulse indicates minor pathogens, which may resolve spontaneously without treatment. a Deep, Soft, and Slippery (Chen Ru Hua) pulse indicates interference by Kidney pathogens, termed Deficient Pathogen (Xu Xie). a Deep pulse indicates Cold entering the Stomach, governing cold-blood stagnation and fullness. a Deep and Firm pulse leads to accumulation disorders (Pi Ji). a Deep and Weak pulse indicates Liver deficiency. a Soft (Ru) pulse indicates invasion by damp-cold fog and dew, leading to essence depletion and sinew stiffness. a Slippery (Hua) pulse indicates Heat in the Liver, presenting with dizziness, dim vision, and sinew stiffness. a Surging and Large (Hong Da) pulse belongs to Fire and is an Excess Pathogen; Wind-Heat invades the Stomach, causing middle jiao restlessness, red eyes, left-sided hemiplegia, night sweats, and vomiting. a Hollow (Kou) pulse indicates blood failing to return to its source, governing hematemesis; blood failing to nourish sinews governs flaccid paralysis; blood failing to nourish the eyes governs dim vision. Furthermore, Wood and Fire combine; Wood carries Fire to insult Metal, governing intestinal abscesses. There is also the concept of Correct Pathogen (Zheng Xie): the String-like pulse is the root pulse of the Liver, but it should not be excessive. If it is tight like a newly strung bowstring, it is termed Excessive (Tai Guo), indicating pathogenic factors outside, causing frequent anger,恍惚 dizziness, and epilepsy. If it is loose like a released zither string, it is termed Insufficient (Bu Ji), presenting with chest and hypochondriac pain radiating to the back, and lower bilateral hypochondriac fullness. A String-like pulse appearing in all three positions (Cun, Guan, Chi) indicates excess Liver Qi, governing eye pain and angry resentment filling the chest. If the pulse overflows from the Guan position towards the Cun position, it indicates Wood excess generating Wind, governing dizzy vision, heavy head, and sinew pain.
The accumulation disease of the Liver is named Feiqi (Fatty Qi), shaped like an inverted cup, located under the left hypochondrium, protruding like fleshy growth. If contracted during the late summer days of Wu and Ji, it is because Lung pathogen transmits to the Liver. The Liver should transmit to the Spleen, but the Spleen is prosperous and does not accept transmission. The Liver attempts to return the pathogen to the Lung, but the Lung refuses. Thus, it remains and knots to form an accumulation. Excess Liver Qi dreams of mountains, forests, and trees; deficiency dreams of fine grass. If Liver Qi is exhausted and the True Zang Pulse appears, the pulse is tense inside and out, feeling sharp like touching a blade, sounding "ze ze." Externally manifested symptoms include inability to turn the eyes while looking at objects, termed fixed gaze (Zhi Shi). Additionally, the fingernails and toenails become cyanotic and black, the spermatic cord contracts, and the tongue curls. This is because sinews gather at the genitalia and meridians connect to the base of the tongue. The condition worsens on Geng days and dies on Xin days, dying during the Shen or You hours. Such is the general overview of the Liver.