雷公问曰∶禁脉之言,凡刺之理,经脉为始,愿闻其道?黄帝答曰∶经脉者,所以决死
生,处百病,调虚实,不可不通也。
肺手太阴之脉,起于中焦,下络大肠,还循胃口,上膈属肺,从肺系横出腋下,下
循内,行少阴心主之前,下肘中,循臂内廉上骨下廉,入寸口,上鱼,循鱼际,出大指
之端。其支者,从腕后直出次指内廉,出其端。是动则病肺胀满,膨膨然而喘咳,缺盆中
痛,甚则交两手而瞀(音务,又音茂),是谓臂厥。是主肺所生病者,咳,上气,喘喝,烦心
,胸满, (音如)臂内前廉痛,厥,掌中热。气盛有余则肩背痛,风寒汗出中风,小便
数而欠。气虚则肩背痛寒,少气不足以息,溺色变(一云卒遗矢无度)。为此诸病。凡十
二经之病,盛则泻之,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
。盛者则寸口大三倍于人迎,虚者则寸口反小于人迎也。
大肠手阳明之脉,起于大指次指之端外侧,循指上廉,出合谷两骨之间,上入两筋之
中,循臂上廉,入肘外廉,上循 外廉上肩,出 (音隅)骨之前廉,上出柱骨之会
上,下入缺盆,络肺下鬲,属大肠。其支者,从缺盆直上至颈,贯颊,下入齿中,还出侠
口,交人中,左之右,右之左,上侠鼻孔。是动则病齿痛,颊肿。是主津液所生病者,目
黄,口干,鼽(音求)衄,喉痹,肩前 痛者,大指次指痛不用。气盛有余则当脉过
者热肿,虚则寒栗不复。为此诸病。盛者则人迎大三倍于寸口;虚者则人迎反小于寸口
也。
胃足阳明之脉,起于鼻交 中,傍约大肠之脉,下循鼻外,上入齿中,还出侠口
环唇,下交承浆,却循颐后下廉,出大迎,循颊车,上耳前,过客主人,循发际至额
颅。其支者,从大迎前下人迎,循喉咙入缺盆,下鬲属胃络脾。其直者,从缺盆下乳内
廉,下侠脐,入气街中。其支者,起于胃口,下循腹里,下至气街中而合,以下髀关,抵伏
兔,下入膝膑中,下循 外廉,下足跗,入中指内间。其支者,下膝三寸而别,以下
入中指外间。其支者,别跗上入大指间,出其端。是动则病凄凄然振寒,善伸数欠,颜黑。
病至则恶人与火,闻木音则惕然惊,心欲动,独闭户塞牖而处,甚则欲上高而歌,弃衣而走
,贲响腹胀,是为臂(一作 )厥。是主血所生病者,狂 (一作疟)温淫汗出,鼽衄
,口 唇紧,颈肿喉痹,大腹水肿,膝膑肿痛,循膺、乳、气街、股、伏兔、
外廉、足跗上皆痛,中指不用。气盛则身以前皆热,其有余于胃,则消谷善饥,溺色黄。
气不足则身以前皆寒栗,胃中寒则胀满。为此诸病。盛者人迎大三倍于寸口,虚者人迎反
小于寸口也。
脾足太阴之脉,起于大指之端,循指内侧白肉际,过核骨后,上内踝前廉,上
内,循 骨后,交出厥阴之前,上循膝股内前廉,入腹属脾络胃,上鬲侠咽,连舌本
,散舌下。其支者,复从胃别上鬲注心中。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,身体皆重。是主脾所生病者,舌本痛,体不能动摇,食不下,
烦心心下急,寒疟、溏,瘕(音加)泄、水闭、黄胆,不能食,唇青,强立股膝内肿痛
,厥,足大指不用。为此诸病。盛者则寸口大三倍于人迎,虚者则寸口反小于人迎也。
心手少阴之脉,起于心中,出属心系,下鬲络小肠。其支者,从心系,上侠咽,系目
系(一本作循胸出胁)。其直者,复从心系却上肺,上出腋下,下循 内后廉,循太阴
心主之后,下肘中内廉,循臂内后廉,抵掌后锐骨之端,入掌内后廉,循小指内出其端。是
动则病嗌干心痛,渴而欲饮,是为臂厥。是主心所生病者,目黄胁满痛, 臂内后廉痛
,厥,掌中热痛。为此诸病。盛者则寸口大再倍于人迎,虚者则寸口反小于人迎也。
小肠手太阳之脉,起于小指之端,循手外侧上腕,出踝中,直上循臂骨下廉,出肘
内侧两骨之间,上循 外后廉,出肩解,绕肩胛,交肩上,入缺盆,向腋下,络心,循
咽下鬲抵胃,属小肠。其支者,从缺盆循颈上颊,至目锐 ,却入耳中。其支者,别颊上
(音拙)抵鼻,至目内 ,斜络于颧。是动则病嗌痛颔肿,不可以顾,肩似拔,
似折。是主腋所生病者,耳聋目黄,颊肿,颈颔肩 肘臂外后廉痛。为
此诸病。盛者则人迎大再倍于寸口,虚者则人迎反小于寸口也。
膀胱足太阳之脉,起于目内 ,上额交巅。其支者,从巅至耳上角。其直者,从巅入
络脑,还出别下项,循肩膊内,挟脊抵腰中,入循膂,络肾属膀胱。其支者,从腰中下会
于后阴,贯臀入 中。其支者,从膊内左右别下贯胛(一作髋)挟脊内,过髀枢,循髀
外后廉,下合 中,以下贯 (足踉也)内,出外踝之后,循京骨,至小指外侧。是动
则病冲头痛,目似脱,项似拔,脊腰似折不可以曲, 如结, 如裂,是谓踝厥
。是主筋所生病者,痔疟狂颠疾,头囟(音信)项颈间痛,目黄泪出,鼽衄,项背
腰尻 脚皆痛,小指不用。为此诸病。盛者则人迎大再倍于寸口。虚者
则人迎反小于寸口也。
肾足少阴之脉,起于小指之下,斜趣足心,出然谷之下,循内踝之后,别入跟中,以
上内,出 中内廉,上股内后廉,贯脊属肾络膀胱。其直者,从肾上贯肝膈,入肺
中,循喉咙,侠舌本(一本云从横骨中挟脐循腹里上行而入肺)。其支者,从肺出络心
,注胸中。是动则病饥不欲食,面黑如炭色,咳唾则有血,喝喝(一作喉鸣)而喘,坐而欲起
,目KT KT 无所见,心如悬饥状,是为骨厥。是主肾所生病者,口热舌干,咽肿
上气,嗌干及痛,烦心,心痛,黄胆,肠 ,脊股内后廉痛,痿厥,嗜卧,足下热而痛
。灸则强食生肉,缓带被发,大杖重履而步。为此诸病。盛者则寸口大再倍于人迎,虚者
则寸口反小于人迎也。
心主手厥阴之脉,起于胸中,出属心包络,下鬲,历络三焦。其支者,循胸出胁下
腋三寸,上抵腋下,循 内行太阴、少阴之间,入肘中,下循臂行两筋之间,循中
指出其端。其支者,别掌中,循小指次指出其端。是动则病手心热,臂肘挛急,腋肿,甚则
胸胁支满,心中 大动,面赤目黄,喜笑不休。是主脉(一作心包络)所生病者,烦
心心痛,掌中热。为此诸病。盛者则寸口大一倍于人迎,虚者则寸口反小
于人迎也。
三焦手少阳之脉,起于小指次指之端,上出两指之间,循手表腕出臂外两骨之间,
上贯肘,循 外上肩,而交出足少阳之后,入缺盆,布膻中,散络心包,下鬲,遍属
三焦。其支者,从膻中,上出缺盆,上项侠耳后,直上出耳上角,以屈下额(一作颊),至
。其支者,从耳后入耳中,出走耳前,过客主人前,交颊,至目锐 。是动则病
耳聋,浑浑 ,嗌肿喉痹。是主气所生病者,汗出,目锐 痛,颊耳后肩
肘臂外皆痛,小指次指不为用。为此诸病。盛者则人迎大一倍于寸口,虚者则人迎
反小于寸口也。
胆足少阳之脉,起于目锐 ,上抵头角,下耳后,循颈行手少阳之前,至肩上,却交
出手少阳之后,入缺盆。其支者,从耳后,入耳中,出走耳前,至目锐 后。其支者,别目
锐,下大迎,合手少阳抵于 下(一本云别目锐 上迎手少阳于额),加颊车,下颈,合
缺盆,以下胸中,贯膈络肝属胆,循胁里,出气街,绕毛际,横入髀厌中。其直者,
从缺盆下腋,循胸中,过季胁,下合髀厌中,以下循髀阳,出膝外廉,下外辅骨之前,直下
抵绝骨之端,下出外踝之前,循足跗上,入小指次指之端。其支者,别跗上,入大指之间,
循大指歧骨内出其端,还贯入爪甲,出三毛。是动则病口苦,善太息,心胁痛不能反侧
,甚则面微尘,体无膏泽,足外反热,是为阳厥。是主骨所生病者,头面颔痛,目锐 痛,
缺盆中肿痛,腋下肿痛,马刀挟瘿,汗出振寒,疟,胸中胁肋髀膝外至
绝骨外踝前及诸节皆痛,小指次指不用。为此诸病。盛者则人迎大一倍于寸口,虚者人
迎反小于寸口也。
肝足厥阴之脉,起于大指丛毛之际,上循足跗上廉,去内踝一寸,上外踝八寸,交出
太阴之后,上 内廉,循股阴入毛中,环阴器,抵小腹,侠胃属肝络胆,上贯膈,布
胁肋,循喉咙之后,上入颃颡,连目系,上出额,与督脉会于巅。(一云∶其支者,从小腹
与太阴、少阳结于腰髁夹脊下第三第四骨孔中)。其支者,从目系下颊里,环唇内。其支者,复
从
,面尘脱色。是主肝所生病者,胸满呕逆,洞泄,狐疝,遗精癃闭。为此诸病。盛者
则寸口大一倍于人迎,虚者则寸口反小于人迎也。
足少阴气绝则骨枯,少阴者冬脉也,伏行而濡骨髓者也,故骨不濡(一作软)则肉不
能着骨也,骨肉不相亲则肉濡而却,肉濡而却故齿长而垢,发无润泽,无润泽者骨先死
,戊笃己死,土胜水也。
手少阴气绝则脉不通,脉不通则血不流,血不流则发色不泽,故面色如黧(一作
漆柴)者血先死,壬笃癸死,水胜火也。《灵枢》云∶少阴终者,面黑齿长而垢,腹胀闭
,上下不通而终矣。
足太阴气绝则脉不营其口唇,口唇者肌肉之本也,脉弗营则肌肉濡,肌肉濡则
人中满(一作舌痿),人中满则唇反,唇反者肉先死,甲笃乙死,木胜土也。
手太阴气绝则皮毛焦,太阴者行气温于皮毛者也,气弗营则皮毛焦,皮毛焦则
津液去,津液去则皮节着,皮节着则爪枯毛折,毛折者毛先死,丙笃丁死,火胜金也
。《九卷》云∶腹胀闭不得息,善噫,善呕,呕则逆,逆则面赤,不逆上下不通,上下不通
则面黑皮毛焦而终矣。
足厥阴气绝则筋弛,厥阴者肝脉也,肝者筋之合也,筋者聚于阴器,而脉络于
舌本,故脉弗营则筋缩急,筋缩急则引卵与舌,故唇青舌卷卵缩则筋先死,庚笃
辛死,金胜木也。《九卷》云∶中热嗌干,喜溺烦心,甚则舌卷卵上缩而终矣。
五阴俱绝则目系转,转则目运,运为志先死,故志先死则远一日半而死矣。
太阳脉绝,其终也,戴眼,反折螈 ,其色白,绝汗乃出,则终矣。
少阳脉绝,其终也,耳聋,百节尽纵,目橐(一作HT ,一本无此字)系绝,系绝一日半死
,其死也,目白(一作色青白)乃死。
阳明脉绝,其绝也,口目动作,善惊妄言,色黄,其上下经盛而不行(一作不仁),则终
矣。
六阳俱绝则阴阳相离,阴阳相离则腠理发泄,绝汗乃出,大如贯珠,转出不流,则
气先死矣。故旦占夕死,夕占旦死。此十二经之败也。
雷公问道:关于禁刺脉气的言论,大凡针刺的原理,以经脉为起点,希望听听其中的道理?黄帝回答说:经脉,是用来决断生死、处理百病、调节虚实的关键,不能不通晓。
手太阴肺经的经脉,起始于中焦,向下联络大肠,回过来沿着胃的上口,穿过膈肌,属于肺脏;从肺系(气管喉咙部)横出腋下,沿上臂内侧下行,走在手少阴心经和手厥阴心包经的前面,下至肘窝中,沿前臂内侧桡骨边缘,进入寸口(桡动脉搏动处),上行至大鱼际,沿鱼际边缘,出于大拇指尖端。它的支脉,从腕后直出食指内侧边缘,到达其尖端。这条经脉发生变动,就会生病:肺部胀满,膨膨胀胀地喘咳,缺盆中疼痛,严重时两手交叉按在胸前而视物昏花,这叫做臂厥。这条经脉主治肺所发生的疾病:咳嗽,气逆,喘息有声,心烦,胸满,以及沿着手臂内侧前缘疼痛,厥冷,掌心发热。如果肺气盛有余,则肩背疼痛,容易出汗,患中风,小便频数且量少。如果肺气虚,则肩背怕冷,气短不足以呼吸,尿液颜色改变(一说为突然失禁无度)。对于这些疾病,凡是十二经的病,实证用泻法,虚证用补法,热证用疾刺法,寒证用留针法,脉气下陷的用灸法,不虚不实的,直接取本经治疗。实证时,寸口脉比人迎脉大三倍;虚证时,寸口脉反而小于人迎脉。
手阳明大肠经的经脉,起始于食指外侧尖端,沿食指上侧边缘,出于合谷穴两骨之间,向上进入两筋之中,沿前臂上侧边缘,进入肘外侧边缘,沿上臂外侧边缘上行至肩部,出于肩峰前缘,上行至柱骨(第七颈椎棘突)的会合处,向下进入缺盆,联络肺脏,穿过膈肌,属于大肠。它的支脉,从缺盆直上至颈部,贯穿面颊,进入下齿中,回出来夹着口唇,在人中穴交叉,左侧走向右侧,右侧走向左侧,上行夹着鼻孔。这条经脉发生变动,就会生病:牙齿痛,脸颊肿。这条经脉主治津液所发生的疾病:眼睛发黄,口干,鼻塞流涕或鼻出血,咽喉肿痛,肩前部疼痛,食指疼痛且不能使用。如果经气盛有余,则经脉经过的部位发热肿胀;如果经气虚,则畏寒战栗不能恢复。对于这些疾病,实证时人迎脉比寸口脉大三倍;虚证时人迎脉反而小于寸口脉。
足阳明胃经的经脉,起始于鼻翼旁,交会在鼻根中,旁边约束大肠经的脉气,向下沿鼻外,上行进入下齿中,回出来夹着口唇,环绕嘴唇,在下部与人中穴相交,然后顺着腮后下方下行,出于大迎穴,沿颊车穴,上行至耳前,经过客主人穴(上关穴),沿发际直到额颅。它的支脉,从大迎穴前向下到人迎穴,沿喉咙进入缺盆,向下穿过膈肌,属于胃,联络脾脏。它的直行脉,从缺盆下行至乳内廉,向下夹脐两旁,进入气街(腹股沟动脉处)。它的支脉,起于胃的下口,向下沿腹腔内部,下行至气街中与直行脉会合,然后下行至髀关穴,抵伏兔穴,下行进入膝盖髌骨中,沿胫骨外侧边缘,下行至足背,进入中趾内侧间隙。它的支脉,从膝下三寸处分出,向下进入中趾外侧间隙。它的支脉,从足背分出,进入大趾间,出其尖端。这条经脉发生变动,就会生病:凄凄然怕冷,喜欢伸展,频繁打哈欠,面色发黑。病发作时则厌恶人和火,听到木器的声音就惊恐跳动,心中悸动不安,独自关上门窗居住,严重时想登上高处唱歌,脱掉衣服奔跑,腹部肠鸣胀满,这叫做骭(音干,指小腿胫骨)厥。这条经脉主治血所发生的疾病:狂乱,温病淫热汗出,鼻塞流涕或鼻出血,口角唇紧,颈部肿胀咽喉肿痛,大腹水肿,膝盖髌骨肿痛,沿着胸部、乳房、气街、大腿、伏兔、小腿外侧、足背都疼痛,中趾不能使用。如果经气盛,则身体前面都发热,如果在胃方面有余,则消化食物快容易饥饿,尿液颜色黄。如果经气不足,则身体前面都寒冷战栗,胃中有寒则胀满。对于这些疾病,实证时人迎脉比寸口脉大三倍,虚证时人迎脉反而小于寸口脉。
足太阴脾经的经脉,起始于大趾尖端,沿脚趾内侧白肉际,经过核骨(第一跖骨基底)后方,上行至内踝前缘,上行至小腿内侧,沿胫骨后方,交出足厥阴肝经的前面,上行沿膝盖大腿内侧前缘,进入腹部属于脾,联络胃,向上穿过膈肌,夹着咽喉,连系舌根,散布在舌下。它的支脉,又从胃别出,向上穿过膈肌注入心中。这条经脉发生变动,就会生病:舌根强硬,吃东西呕吐,胃脘痛,腹胀喜欢嗳气,大小便通畅后,感觉轻松好像病势减轻,身体沉重。这条经脉主治脾所发生的疾病:舌根痛,身体不能动摇,吃不下东西,心烦,心下部急迫,寒疟,大便溏泄,瘕积泄泻,小便闭塞,黄疸,吃不下东西,嘴唇青紫,强行站立则大腿膝盖内侧肿痛,厥冷,足大趾不能使用。对于这些疾病,实证时寸口脉比人迎脉大三倍,虚证时寸口脉反而小于人迎脉。
手少阴心经的经脉,起始于心中,出来属于心系(心脏与其他组织联系的脉络),向下穿过膈肌,联络小肠。它的支脉,从心系向上夹着咽喉,连系目系(眼球与脑相连的脉络)。它的直行脉,又从心系退回向上到肺,向上出于腋下,沿上臂内侧后缘,走在手太阴肺经和手厥阴心包经的后面,下至肘窝内侧,沿前臂内侧后缘,抵掌后高骨(豌豆骨)的尖端,进入掌内后侧,沿小指内侧出其尖端。这条经脉发生变动,就会生病:咽喉干燥,心痛,口渴想喝水,这叫做臂厥。这条经脉主治心所发生的疾病:眼睛发黄,胁肋满痛,手臂内侧后缘疼痛,厥冷,掌心发热疼痛。对于这些疾病,实证时寸口脉比人迎脉大二倍,虚证时寸口脉反而小于人迎脉。
手太阳小肠经的经脉,起始于小指尖端,沿手外侧上行至腕,出于踝中(尺骨茎突),直上沿前臂骨下侧边缘,出于肘内侧两骨之间,沿上臂外侧后缘,出于肩关节解(肩关节后下方凹陷处),绕肩胛,交于肩上,进入缺盆,向腋下,联络心脏,沿咽喉向下穿过膈肌抵胃,属于小肠。它的支脉,从缺盆沿颈上至面颊,至目外眦,却进入耳中。它的支脉,从面颊部分出,上行至颧骨抵鼻旁,至目内眦,斜络于颧骨。这条经脉发生变动,就会生病:咽喉痛,下颌肿,不能回顾,肩膀像被拔除一样,肘部像折断一样。这条经脉主治腋窝所发生的疾病:耳聋,眼睛发黄,脸颊肿,颈部、下颌、肩、肘、臂外侧后缘疼痛。对于这些疾病,实证时人迎脉比寸口脉大二倍,虚证时人迎脉反而小于寸口脉。
足太阳膀胱经的经脉,起始于目内眦,上行至额头,交会于头顶。它的支脉,从头顶至耳上角。它的直行脉,从头顶入里联络脑部,回出来分别下行项部,沿肩膊内,挟脊柱抵腰中,进入循行于脊内肌肉,联络肾脏,属于膀胱。它的支脉,从腰中下行会合于后阴(肛门),贯穿臀部进入腘中(膝窝)。它的支脉,从肩膊内左右分别下行贯穿肩胛(一说髋部),挟脊柱内,过髀枢(髋关节),沿大腿外侧后缘,下行合于腘中,然后向下贯穿小腿肚(腓肠肌)内,出于外踝之后,沿京骨穴,至小指外侧。这条经脉发生变动,就会生病:冲头痛,眼睛像要脱出,项部像被拔除,脊腰像折断不能弯曲,腘中像结聚一样,小腿肚像撕裂一样,这叫做踝厥。这条经脉主治筋所发生的疾病:痔疮,疟疾,狂癫疾,头囟、项、颈间疼痛,眼睛发黄流泪,鼻塞流涕或鼻出血,项背腰尻脚皆痛,小趾不能使用。对于这些疾病,实证时人迎脉比寸口脉大二倍,虚证时人迎脉反而小于寸口脉。
足少阴肾经的经脉,起始于小趾之下,斜向足心,出于然谷穴下方,沿内踝后方,分支进入跟中,向上沿小腿内侧,出于腘窝内侧边缘,上行大腿内侧后缘,贯穿脊柱属于肾,联络膀胱。它的直行脉,从肾向上贯穿肝和膈肌,进入肺中,沿喉咙,夹着舌根(另一版本说从横骨中挟脐沿腹腔内部上行进入肺)。它的支脉,从肺出来联络心脏,注入胸中。这条经脉发生变动,就会生病:饥饿但不想吃东西,面色黑如炭色,咳嗽吐痰带血,喉间有声响而喘,坐着想站起来,两眼昏花视物不清,心中悬空似饥饿状,这叫做骨厥。这条经脉主治肾所发生的疾病:口热舌干,咽喉肿痛气逆,咽喉干燥及疼痛,心烦,心痛,黄疸,肠澼(痢疾),脊股内侧后缘疼痛,痿厥,嗜睡,足下发热而痛。如果用灸法治疗,应鼓励多吃食物以生肌肉,松开腰带披散头发,拄大杖穿厚鞋行走。对于这些疾病,实证时寸口脉比人迎脉大二倍,虚证时寸口脉反而小于人迎脉。
手厥阴心包经的经脉,起始于胸中,出来属于心包络,向下穿过膈肌,依次联络上、中、下三焦。它的支脉,沿胸中出于胁部,下行至腋下三寸,向上抵腋下,沿上臂内侧走在手太阴肺经和手少阴心经之间,进入肘中,向下沿前臂走在两筋之间,沿掌中出于中指尖端。它的支脉,从掌中分出,沿无名指出其尖端。这条经脉发生变动,就会生病:手心发热,臂肘挛急,腋肿,严重时胸胁支撑满闷,心中悸动剧烈,面色红赤,眼睛发黄,喜欢笑个不停。这条经脉主治脉(一说心包络)所发生的疾病:心烦心痛,掌心发热。对于这些疾病,实证时寸口脉比人迎脉大一倍,虚证时寸口脉反而小于人迎脉。
手少阳三焦经的经脉,起始于无名指尖端,向上出于两指之间,沿手腕背面,出于前臂外侧两骨之间,向上贯穿肘部,沿上臂外侧上行至肩部,而交出足少阳胆经的后面,进入缺盆,分布于膻中,散络心包,向下穿过膈肌,遍属上、中、下三焦。它的支脉,从膻中上行出于缺盆,上项部夹耳后,直上出于耳上角,以屈折向下至下颌(一说面颊),至目眶下。它的支脉,从耳后进入耳中,出走耳前,经过客主人穴前,交于面颊,至目外眦。这条经脉发生变动,就会生病:耳聋,耳鸣嗡嗡作响,咽喉肿痛咽喉痹阻。这条经脉主治气所发生的疾病:汗出,目外眦痛,脸颊、耳后、肩、肘、臂外侧都疼痛,无名指不能使用。对于这些疾病,实证时人迎脉比寸口脉大一倍,虚证时人迎脉反而小于寸口脉。
足少阳胆经的经脉,起始于目外眦,上行抵头角,下行至耳后,沿颈部行于手少阳三焦经之前,至肩上,却交出手少阳三焦经的后面,进入缺盆。它的支脉,从耳后,进入耳中,出走耳前,至目外眦后方。它的支脉,从目外眦分出,下行至大迎穴,合于手少阳三焦经抵于眼眶下(另一版本说从目外眦上方迎面颊于额部合于手少阳),加于颊车穴,下行颈部,合于缺盆,下行至胸中,贯穿膈肌联络肝脏,属于胆,沿胁肋内部,出于气街,绕阴毛际,横向进入髋关节中。它的直行脉,从缺盆下行至腋窝,沿胸中,过季胁,下行合于髋关节中,然后下行沿大腿外侧,出于膝盖外侧边缘,下行至外辅骨(腓骨)前方,直下抵绝骨(腓骨下端)尖端,下行出于外踝之前,沿足背,入小趾次趾(第四趾)尖端。它的支脉,从足背分出,入大趾之间,沿大趾歧骨内出其尖端,还贯入爪甲,出于丛毛。这条经脉发生变动,就会生病:口苦,喜欢叹气,心胁痛不能翻身侧卧,严重时面色如蒙尘,身体无光泽,足外侧反热,这叫做阳厥。这条经脉主治骨所发生的疾病:头面下颌痛,目外眦痛,缺盆中肿痛,腋下肿痛,马刀侠瘿(淋巴结结核),汗出恶寒战栗,疟疾,胸中胁肋髀膝外至绝骨外踝前及诸节皆痛,小趾次趾不能使用。对于这些疾病,实证时人迎脉比寸口脉大一倍,虚证时人迎脉反而小于寸口脉。
足厥阴肝经的经脉,起始于大趾丛毛处,上行沿足背外侧边缘,距内踝一寸,上行至外踝八寸,交出足太阴脾经的后面,上行沿小腿内侧边缘,沿大腿内侧进入阴毛中,环绕生殖器,抵小腹,夹胃属于肝,联络胆,向上贯穿膈肌,分布于胁肋,沿喉咙后面,上行入颃颡(鼻咽部),连系目系,上行出于额头,与督脉会于头顶。(另一版本说:它的支脉,从小腹与足太阴、足少阳结于腰髁夹脊下第三第四骨孔中)。它的支脉,从目系下行至面颊内部,环绕嘴唇内部。它的支脉,又从肝分出,上行出于额头,与督脉会于头顶。这条经脉发生变动,就会生病:面色如蒙尘,脱色。这条经脉主治肝所发生的疾病:胸满呕吐逆气,洞泄(水样腹泻),狐疝,遗精癃闭。对于这些疾病,实证时寸口脉比人迎脉大一倍,虚证时寸口脉反而小于人迎脉。
足少阴经气竭绝,则骨骼枯槁。少阴是冬季的脉象,潜行而濡养骨髓。所以骨头得不到濡养,则肌肉不能附着于骨。骨肉不相亲附,则肌肉萎缩松弛而退缩。肌肉萎缩退缩,所以牙齿显得长且垢秽,头发没有润泽。没有润泽是因为骨先死,戊日病重己日死亡,这是土克水的结果。
手少阴经气竭绝,则脉道不通。脉道不通则血液不流动。血液不流动则发色不润泽。所以面色如黑漆柴草般晦暗的是血先死,壬日病重癸日死亡,这是水克火的结果。《灵枢》说:少阴终者,面色黑,牙齿长且垢秽,腹胀闭塞,上下不通而死。
足太阴经气竭绝,则脉气不能营养口唇。口唇是肌肉的根本。脉气不能营养,则肌肉松弛。肌肉松弛则人中部位饱满(一说舌体痿软)。人中饱满则嘴唇翻卷。嘴唇翻卷是肉先死,甲日病重乙日死亡,这是木克土的结果。
手太阴经气竭绝,则皮毛焦枯。太阴是运行气温煦皮毛的经脉。气不能营养,则皮毛焦枯。皮毛焦枯则津液耗去。津液耗去则皮节干枯着骨。皮节着骨则指甲枯槁毛发折断。毛发折断是毛先死,丙日病重丁日死亡,这是火克金的结果。《九卷》说:腹胀闭塞不得呼吸,喜欢嗳气,喜欢呕吐,呕吐则气逆,气逆则面红,不逆则上下不通,上下不通则面色黑皮毛焦而死。
足厥阴经气竭绝,则筋弛缓。厥阴是肝的经脉,肝是筋的汇合处。筋聚于生殖器,脉络于舌根。所以脉气不能营养,则筋缩急。筋缩急则牵引睾丸和舌头。所以嘴唇青紫、舌卷、睾丸上缩是筋先死,庚日病重辛日死亡,这是金克木的结果。《九卷》说:体内热咽喉干,喜欢小便,心烦,严重时舌卷睾丸上缩而死。
五脏阴气全部竭绝,则目系扭转。目系扭转则头晕眼花。头晕眼花是志先死。所以志先死则在一日半后死亡。
太阳经脉气竭绝,是死亡的征兆。表现为瞪眼直视,身体反张抽搐,面色苍白,绝汗流出,则死亡。
少阳经脉气竭绝,是死亡的征兆。表现为耳聋,全身关节松弛纵缓,目系断绝。目系断绝一日半后死亡,死亡时眼睛变白(一说色青白)。
阳明经脉气竭绝,是死亡的征兆。表现为口眼歪斜抽动,容易惊恐胡言乱语,面色黄,上下经脉盛大而不仁(或不运行),则死亡。
六条阳经经脉气全部竭绝,则阴阳分离。阴阳分离则腠理开泄,绝汗流出,汗珠大如串联的珠子,转动流出不再回流,则气先死。所以早上占测晚上死,晚上占测早上死。这是十二经败绝的表现。
Lei Gong asked: Regarding the teachings on prohibited pulse points, the principle of acupuncture generally begins with the meridians. I wish to hear the rationale behind this? The Yellow Emperor replied: The meridians are essential for determining life and death, managing all diseases, and regulating deficiency and excess; they must not be left ununderstood.
The Lung Meridian of Hand-Taiyin originates in the middle jiao (middle burner), descends to connect with the Large Intestine, returns along the upper opening of the stomach, passes through the diaphragm, and enters into the Lung. From the lung system (trachea and larynx), it emerges horizontally at the axilla, descends along the medial aspect of the upper arm, running anterior to the Heart Meridian of Hand-Shaoyin and Pericardium Meridian of Hand-Jueyin, reaches the elbow crease, follows the medial border of the forearm to the cun kou (radial artery pulse point), ascends to the thenar eminence, follows the radial border of the thenar, and exits at the tip of the thumb. Its branch arises from the wrist, goes straight to the medial side of the index finger, and exits at its tip. When this meridian is disturbed, disease occurs: lung distension, bloating with wheezing and coughing, pain in the supraclavicular fossa, and in severe cases, crossing both hands over the chest with visual confusion, known as Arm Jue syndrome. This meridian governs diseases generated by the Lung: cough, qi rebellion, wheezing with sound, vexation, chest fullness, pain along the anterior medial border of the arm, cold limbs, and heat in the palm. If lung qi is excessive, there is shoulder and back pain, sweating upon wind-stroke, frequent urination with small volume. If lung qi is deficient, there is cold shoulder and back pain, shortness of breath insufficient for respiration, and change in urine color (or sudden incontinence). For these diseases of the twelve meridians, excess is treated by draining, deficiency by tonifying, heat by rapid needling, cold by retaining the needle, sinking qi by moxibustion, and neither excess nor deficiency by treating the affected meridian directly. In excess, the cun kou pulse is three times larger than the ren ying pulse; in deficiency, the cun kou pulse is smaller than the ren ying pulse.
The Large Intestine Meridian of Hand-Yangming originates at the lateral tip of the index finger, follows the radial border of the finger, emerges between the two bones at He Gu, ascends between the two tendons, follows the radial border of the forearm, enters the lateral aspect of the elbow, ascends along the lateral border of the upper arm to the shoulder, emerges anterior to the acromion, ascends to the meeting point of the vertebral column, descends into the supraclavicular fossa, connects with the Lung, passes through the diaphragm, and enters into the Large Intestine. Its branch rises from the supraclavicular fossa to the neck, penetrates the cheek, enters the lower teeth, returns to encircle the lips, crosses at Ren Zhong, going left to right and right to left, ascending to flank the nostrils. When disturbed, disease occurs: toothache, cheek swelling. This meridian governs diseases generated by fluids: yellow eyes, dry mouth, nasal congestion or epistaxis, throat obstruction, pain in the anterior shoulder, and pain with dysfunction of the index finger. If qi is excessive, heat and swelling occur along the meridian pathway; if deficient, chills that do not resolve. In excess, the ren ying pulse is three times larger than the cun kou pulse; in deficiency, the ren ying pulse is smaller than the cun kou pulse.
The Stomach Meridian of Foot-Yangming originates at the side of the nose, crossing at the root of the nose, adjacent to the Large Intestine meridian, descends along the lateral nose, enters the upper teeth, returns to encircle the lips, crosses below the chin at Cheng Jiang, follows the posterior mandible down to Da Ying, along Jia Che, ascends anterior to the ear, passes through Ke Zhu Ren, follows the hairline to the forehead. Its branch descends from anterior to Da Ying to Ren Ying, follows the throat into the supraclavicular fossa, passes through the diaphragm, enters the Stomach, and connects with the Spleen. Its main vessel descends from the supraclavicular fossa along the medial mammary line, descends flanking the umbilicus, and enters the Qi Chong region. Its branch originates from the stomach outlet, descends along the abdominal interior to meet the main vessel at Qi Chong, then descends to Bi Guan, reaches Fu Tu, enters the knee patella, follows the lateral tibial border, descends to the dorsum of the foot, and enters the space between the middle toes. Another branch diverges three cun below the knee, entering the lateral space of the middle toe. Another branch diverges from the dorsum, enters the big toe, and exits at its tip. When disturbed, disease occurs: aversion to cold, desire to stretch, frequent yawning, dark complexion. Upon onset, aversion to people and fire, startle at wooden sounds, palpitations, preferring to stay alone behind closed doors; in severe cases, climbing high to sing, discarding clothes and running, abdominal rumbling and distension, known as Gai Jue syndrome. This meridian governs diseases generated by blood: mania, warm pathogen heat with sweating, nasal congestion or epistaxis, tight lips, neck swelling and throat obstruction, abdominal edema, knee pain, pain along the chest, breast, Qi Chong, thigh, Fu Tu, lateral calf, and dorsum of the foot, with dysfunction of the middle toe. If qi is excessive, the anterior body is hot; if stomach qi is excessive, digestion is rapid with hunger and yellow urine. If qi is deficient, the anterior body is cold and shivering; stomach cold causes distension. In excess, the ren ying pulse is three times larger than the cun kou pulse; in deficiency, the ren ying pulse is smaller than the cun kou pulse.
The Spleen Meridian of Foot-Taiyin originates at the tip of the big toe, follows the medial white flesh margin, passes posterior to the nuclear bone, ascends anterior to the medial malleolus, ascends the medial calf, follows the posterior tibia, crosses anterior to the Liver Meridian of Foot-Jueyin, ascends along the anterior medial knee and thigh, enters the abdomen, enters the Spleen, and connects with the Stomach. It ascends through the diaphragm, flanks the pharynx, connects to the root of the tongue, and scatters under the tongue. Its branch diverges from the stomach, ascends through the diaphragm, and pours into the Heart. When disturbed, disease occurs: stiff tongue root, vomiting after eating, epigastric pain, abdominal distension with belching, relief after defecation or passing gas, heavy body. This meridian governs diseases generated by the Spleen: tongue root pain, immobility, inability to eat, vexation, urgency in the heart region, cold malaria, loose stools, mass diarrhea, urinary retention, jaundice, anorexia, blue lips, swelling and pain in the inner thigh and knee when standing forcibly, cold limbs, and dysfunction of the big toe. In excess, the cun kou pulse is three times larger than the ren ying pulse; in deficiency, the cun kou pulse is smaller than the ren ying pulse.
The Heart Meridian of Hand-Shaoyin originates in the Heart, emerges to belong to the Heart System, descends through the diaphragm, and connects with the Small Intestine. Its branch rises from the Heart System, flanks the pharynx, and connects to the Eye System. Its main vessel returns from the Heart System to ascend to the Lung, emerges at the axilla, descends along the posterior medial aspect of the upper arm, runs posterior to the Lung and Pericardium meridians, reaches the medial elbow, follows the posterior medial forearm, reaches the end of the ulnar styloid process, enters the posterior medial palm, and exits at the tip of the little finger. When disturbed, disease occurs: dry throat, heart pain, thirst with desire to drink, known as Arm Jue syndrome. This meridian governs diseases generated by the Heart: yellow eyes, flank fullness and pain, pain along the posterior medial arm, cold limbs, and heat and pain in the palm. In excess, the cun kou pulse is twice as large as the ren ying pulse; in deficiency, the cun kou pulse is smaller than the ren ying pulse.
The Small Intestine Meridian of Hand-Taiyang originates at the tip of the little finger, follows the lateral hand up to the wrist, emerges at the ankle, goes straight up along the lateral border of the forearm bone, emerges between the two bones at the medial elbow, ascends along the posterior lateral border of the upper arm, emerges at the shoulder joint, winds around the scapula, crosses the shoulders, enters the supraclavicular fossa, heads to the axilla, connects with the Heart, follows the pharynx down through the diaphragm to the Stomach, and enters the Small Intestine. Its branch rises from the supraclavicular fossa along the neck to the cheek, to the outer canthus, and enters the ear. Another branch diverges from the cheek, ascends to the cheekbone, reaches the nose, to the inner canthus, and obliquely connects to the zygoma. When disturbed, disease occurs: sore throat, submandibular swelling, inability to look back, shoulder feeling like being pulled, elbow feeling like being broken. This meridian governs diseases generated by the axilla: deafness, yellow eyes, cheek swelling, pain in the neck, jaw, shoulder, elbow, and posterior lateral arm. In excess, the ren ying pulse is twice as large as the cun kou pulse; in deficiency, the ren ying pulse is smaller than the cun kou pulse.
The Bladder Meridian of Foot-Taiyang originates at the inner canthus, ascends to the forehead, and crosses at the vertex. Its branch goes from the vertex to the upper angle of the ear. Its main vessel enters from the vertex to connect with the brain, returns to descend separately along the nape, follows the medial shoulder blade, flanks the spine to the waist, enters the paraspinal muscles, connects with the Kidney, and enters the Bladder. Its branch descends from the waist to meet at the posterior orifice, penetrates the buttocks into the popliteal fossa. Another branch diverges from the medial shoulder blade, descends flanking the spine, passes the hip pivot, follows the posterior lateral thigh, merges into the popliteal fossa, descends through the gastrocnemius, emerges posterior to the lateral malleolus, follows Jing Gu, to the lateral tip of the little toe. When disturbed, disease occurs: headache striking upward, eyes feeling like popping out, neck feeling like being pulled, spine and waist feeling like broken unable to bend, popliteal fossa feeling knotted, calf feeling torn, known as Ankle Jue syndrome. This meridian governs diseases generated by sinews: hemorrhoids, malaria, mania, epilepsy, pain in the head, fontanelle, neck, yellow eyes with tearing, nasal congestion or epistaxis, pain in the neck, back, waist, sacrum, and feet, with dysfunction of the little toe. In excess, the ren ying pulse is twice as large as the cun kou pulse; in deficiency, the ren ying pulse is smaller than the cun kou pulse.
The Kidney Meridian of Foot-Shaoyin originates below the little toe,斜趣slopes toward the sole, emerges below Ran Gu, follows posterior to the medial malleolus, branches into the heel, ascends the medial calf, emerges at the medial popliteal border, ascends the posterior medial thigh, penetrates the spine, enters the Kidney, and connects with the Bladder. Its main vessel ascends from the Kidney, penetrates the Liver and diaphragm, enters the Lung, follows the throat, flanks the tongue root. Its branch emerges from the Lung, connects with the Heart, and pours into the chest. When disturbed, disease occurs: hunger without desire to eat, face black as charcoal, hemoptysis, wheezing with throat sounds, desire to rise from sitting, blurred vision, heart hanging with hunger sensation, known as Bone Jue syndrome. This meridian governs diseases generated by the Kidney: oral heat, dry tongue, throat swelling and qi rebellion, dry and painful throat, vexation, heart pain, jaundice, dysentery, pain in the posterior medial spine and thigh, weakness and cold limbs, lethargy, heat and pain in the soles. With moxibustion, encourage eating to generate flesh, loosen belt, wear heavy shoes, and walk with a staff. In excess, the cun kou pulse is twice as large as the ren ying pulse; in deficiency, the cun kou pulse is smaller than the ren ying pulse.
The Pericardium Meridian of Hand-Jueyin originates in the chest, emerges to belong to the Pericardium Collateral, descends through the diaphragm, and sequentially connects with the Triple Energizer. Its branch follows the chest, emerges at the hypochondrium, descends three cun below the axilla, ascends to the axilla, runs along the medial upper arm between the Taiyin and Shaoyin meridians, enters the elbow, descends along the forearm between two tendons, follows the center of the palm, and exits at the tip of the middle finger. Its branch diverges from the palm, follows the ring finger, and exits at its tip. When disturbed, disease occurs: heat in the palm, spasm and stiffness of the arm and elbow, axillary swelling, chest and flank fullness, violent palpitations, red face, yellow eyes, uncontrollable laughter. This meridian governs diseases generated by the vessels (or Pericardium): vexation, heart pain, heat in the palm. In excess, the cun kou pulse is one time larger than the ren ying pulse; in deficiency, the cun kou pulse is smaller than the ren ying pulse.
The Triple Energizer Meridian of Hand-Shaoyang originates at the tip of the ring finger, ascends between the two fingers, follows the dorsal wrist, emerges between the two forearm bones, ascends through the elbow, follows the lateral upper arm to the shoulder, crosses posterior to the Foot-Shaoyang, enters the supraclavicular fossa, distributes in the Tan Zhong, scatters and connects with the Pericardium, descends through the diaphragm, and belongs to the Triple Energizer. Its branch rises from Tan Zhong, emerges at the supraclavicular fossa, ascends the neck, flanks the ear, goes straight up to the upper ear angle, curves down to the mandible/cheek, to the infraorbital region. Its branch enters the ear from behind, exits anterior to the ear, passes anterior to Ke Zhu Ren, crosses the cheek, to the outer canthus. When disturbed, disease occurs: deafness, roaring tinnitus, throat swelling and obstruction. This meridian governs diseases generated by qi: sweating, pain in the outer canthus, pain in the cheek, ear, shoulder, elbow, and lateral arm, with dysfunction of the ring finger. In excess, the ren ying pulse is one time larger than the cun kou pulse; in deficiency, the ren ying pulse is smaller than the cun kou pulse.
The Gallbladder Meridian of Foot-Shaoyang originates at the outer canthus, ascends to the head corner, descends behind the ear, follows the neck anterior to the Hand-Shaoyang, to the shoulder, crosses posterior to the Hand-Shaoyang, enters the supraclavicular fossa. Its branch enters the ear from behind, exits anterior to the ear, to the posterior outer canthus. Its branch diverges from the outer canthus, descends to Da Ying, meets the Hand-Shaoyang at the orbital floor, adds to Jia Che, descends the neck, meets the supraclavicular fossa, descends to the chest, penetrates the diaphragm, connects with the Liver, enters the Gallbladder, follows the interior of the costal arch, emerges at Qi Chong, surrounds the pubic hair, transversely enters the hip groove. Its main vessel descends from the supraclavicular fossa to the axilla, follows the chest, passes the hypochondrium, meets the hip groove, descends along the lateral thigh, emerges at the lateral knee, descends anterior to the fibula, reaches the end of Jue Gu, emerges anterior to the lateral malleolus, follows the dorsum of the foot, enters the tip of the fourth toe. Its branch diverges from the dorsum, enters between the big toe, follows the interosseous space, exits at the tip, returns through the nail bed, exits at the hair tuft. When disturbed, disease occurs: bitter taste, frequent sighing, heart and flank pain preventing turning, dust-like complexion, lack of luster, heat on the lateral foot, known as Yang Jue syndrome. This meridian governs diseases generated by bones: head, face, jaw pain, outer canthus pain, supraclavicular swelling, axillary swelling, scrofula, sweating with chills, malaria, pain in the chest, flank, thigh, knee, lateral leg, lateral malleolus, and joints, with dysfunction of the fourth toe. In excess, the ren ying pulse is one time larger than the cun kou pulse; in deficiency, the ren ying pulse is smaller than the cun kou pulse.
The Liver Meridian of Foot-Jueyin originates at the hair tuft of the big toe, ascends along the lateral dorsum of the foot, one cun from the medial malleolus, eight cun from the lateral malleolus, crosses posterior to the Taiyin, ascends the medial calf, follows the medial thigh into the pubic region, circles the genitalia, reaches the lower abdomen, flanks the Stomach, enters the Liver, and connects with the Gallbladder. It ascends through the diaphragm, distributes in the hypochondrium, follows the posterior throat, enters the nasopharynx, connects to the eye system, ascends to the forehead, and meets the Du Meridian at the vertex. Its branch descends from the eye system to the cheek interior, circles the lips internally. Its branch diverges from the liver, ascends to the forehead, meets the Du Meridian at the vertex. When disturbed, disease occurs: dust-like complexion, loss of color. This meridian governs diseases generated by the Liver: chest fullness, vomiting and rebellion, profuse diarrhea, fox hernia, spermatorrhea, and stranguria. In excess, the cun kou pulse is one time larger than the ren ying pulse; in deficiency, the cun kou pulse is smaller than the ren ying pulse.
When the Qi of the Foot-Shaoyin meridian perishes, the bones become withered. Shaoyin is the winter pulse, hidden and nourishing the marrow. Thus, if bones are not nourished, flesh cannot adhere. If flesh and bone are not intimate, flesh shrinks and recedes. Receding flesh makes teeth appear long and dirty, and hair loses luster. Loss of luster indicates bone death first. Disease worsens on Wu days and dies on Ji days, as Earth overcomes Water.
When the Qi of the Hand-Shaoyin meridian perishes, the vessels become blocked. Blocked vessels mean blood does not flow. Unflowing blood means hair loses luster. Thus, a face like dark charcoal indicates blood death first. Disease worsens on Ren days and dies on Gui days, as Water overcomes Fire. The Ling Shu states: At the end of Shaoyin, the face is black, teeth are long and dirty, abdomen is distended and closed, upper and lower passages are blocked, and death ensues.
When the Qi of the Foot-Taiyin meridian perishes, the vessels fail to nourish the lips. Lips are the root of muscle. Without nourishment, muscle becomes flaccid. Flaccid muscle leads to fullness in the philtrum (or tongue atrophy). Fullness in the philtrum causes lip retraction. Retraction indicates muscle death first. Disease worsens on Jia days and dies on Yi days, as Wood overcomes Earth.
When the Qi of the Hand-Taiyin meridian perishes, skin and hair become scorched. Taiyin circulates qi to warm the skin and hair. Without qi, skin and hair scorch. Scorched skin and hair lose fluids. Lost fluids cause skin joints to adhere to bone. Adhesion causes nails to wither and hair to break. Breaking hair indicates hair death first. Disease worsens on Bing days and dies on Ding days, as Fire overcomes Metal. The Jiu Juan states: Abdominal distension and closure, inability to breathe, frequent belching and vomiting, vomiting leads to rebellion, rebellion leads to red face. If no rebellion, upper and lower passages are blocked. Blocked passages lead to black face, scorched skin and hair, and death.
When the Qi of the Foot-Jueyin meridian perishes, sinews become flaccid. Jueyin is the Liver meridian; the Liver is the convergence of sinews. Sinews gather at the genitalia and connect to the tongue root. Without nourishment, sinews contract and tighten. Tightening pulls the testicles and tongue. Blue lips, curled tongue, and retracted testicles indicate sinew death first. Disease worsens on Geng days and dies on Xin days, as Metal overcomes Wood. The Jiu Juan states: Internal heat, dry throat, frequent urination, vexation, severe cases have curled tongue and retracted testicles, leading to death.
When the Yin of the five Zang organs perishes, the eye system twists. Twisting causes dizziness. Dizziness indicates Zhi (will) death first. Thus, if Zhi dies first, death occurs in one and a half days.
When the Taiyang meridian perishes, it is the end. Signs include staring upward, opisthotonos, convulsions, pale face, and absolute sweat, leading to death.
When the Shaoyang meridian perishes, it is the end. Signs include deafness, relaxation of all joints, and severance of the eye system. Severance leads to death in one and a half days; death occurs when the whites of the eyes turn white (or cyan-white).
When the Yangming meridian perishes, it is the end. Signs include facial twitching, fright, delirium, yellow face, and excessive but non-flowing upper and lower meridians (or insensitivity), leading to death.
When the six Yang meridians perish, Yin and Yang separate. Separation causes pores to open, absolute sweat flows out in beads like strings, rolling out without flowing back, indicating Qi death first. Thus, morning prediction means evening death, evening prediction means morning death. This is the failure of the twelve meridians.