黄帝问曰∶经脉十二,而手太阴之脉独动不休何也?岐伯对曰∶足阳明胃脉也,胃者
五脏六腑之海,其清气上注于肺,肺气从太阴而行之,其行也以息往来,故人脉一呼再
动,一吸脉亦再动,呼吸不已,故动而不止。曰∶气口何以独为五脏主?曰∶胃者水谷之
海,六腑之大源也。五味入于口,藏于胃,以养五脏气,气口亦太阴也,是以五脏六腑之气
味皆出于胃,变见于气口。故五气入于鼻,藏于心肺,肺有病而鼻为之不利也。(《九卷
》言其动,《素问》论其气,此言其为五脏之所主,相发明也)。曰∶气之过于寸口也,上出
焉息,下出焉伏,何道从还,不知其极也?曰∶气之离于脏也,卒然如弓弩之发,如水岸之
下,上于鱼以反衰,其余气衰散以逆上,故其行微也。
曰∶足阳明因何而动?曰∶胃气上注于胃,其悍气上冲头者,循喉上走空窍,循眼系入
络脑,出颔下客主人,循牙车,合阳
明,并下人迎,此胃气走于阳明者也。故阴阳上下,其动也若一。故阳病而阳脉小者为逆,
阴病而阴脉大者为逆,阴阳俱盛,与其俱动,若引绳相倾者病。曰∶足少阴因何而动?曰
∶冲脉者十二经脉之海也,与少阴之大络起于肾下,出于气街,循阴股内廉,斜入 中
,循 骨内廉,并少阴之经,下入内踝之后足下。其别者,斜入踝内,出属跗上,入大
指之间,以注诸络,以温足跗,此脉之常动者也。
曰∶卫气之行也,上下相贯,如环无端,今有卒遇邪气,及逢大寒,手足不随,其脉
阴阳
之
无端,莫知其纪,终而复始,此之谓也。
十二经脉伏行于分肉之间,深而不见。其常见者,足太阴脉过于外踝之上,无所隐。
故诸脉之浮而常见者,皆络脉也。六经络,手阳明少阴之大络起五指间,上合肘中。饮酒
者,卫气先行皮肤,先充络脉,络脉先盛,则卫气以平,营气乃满,而经脉大盛也。脉之卒
然动者,皆邪气居之,留于本末,不动则热,不坚则陷且空,不与众同,是以知其何脉之动
也。
雷公问曰∶何以知经脉之与络脉异也?黄帝答曰∶经脉者,常不可见也。其虚实也,以
气口知之。脉之见者,皆络脉也。诸络脉皆不能经大节之间,必行绝道而出入复合于皮
中,其会皆见于外。故诸刺络脉者,必刺其结上,甚血者虽无血结,急取之以泻其邪而出
其血,留之发为痹也。
凡诊络脉,脉色青则寒且痛,赤则有热。胃中有寒,则手鱼际之络多青。胃中有热,则
鱼际之络赤。其暴黑者,久留痹也。其有赤有青有黑者,寒热也。其青而小短者,少气也。
凡刺寒热者,皆多血络,必间日而一取之,血尽乃止,调其虚实。其小而短者少气,甚者
泻之则闷,闷甚则仆不能言,闷则急坐之也。
手太阴之别,名曰列缺,起于腕上分间,并太阴之经直入掌中,散入于鱼际。其病实则
手兑骨掌热,虚则欠KT (音掐开口也),小便遗数,取之去腕一寸半,别走阳明。
手少阴之别,名曰通里,在腕一寸半,别而上行,循经入于心中,系舌本,属目系。实
则支膈,虚则不能言,取之腕后一寸,别走太阳。
手心主之别,名曰内关,去腕二寸,出于两筋之间,循经以上,系于心包络,心系实
则心痛,虚则为烦心,取之两筋间。
手太阳之别,名曰支正,上腕五寸,内注少阴,其别者上走肘,络肩 。实则
筋弛肘废,虚则生疣,小者如指痂疥,取之所别。
手阳明之别,名曰偏历,去腕三寸,别走太阴,其别者上循臂,乘肩 ,上曲颊遍
齿。其别者入耳,会于宗脉。实则龋(音禹)齿耳聋,虚则齿寒痹鬲,取之所别。
手少阳之别,名曰外关,去腕二寸,外绕臂,注胸中,合心主。实则肘挛,虚则不收,
取之所别。
足太阳之别,名曰飞扬,去踝七寸,别走少阴,实则窒鼻(一云鼽窒)头背痛,虚则鼽
衄,取之所别。
足少阳之别,名曰光明,去踝上五寸,别走厥阴,并经下络足跗。实则厥,虚则痿
,坐不能起,取之所别。
足阳明之别,名曰丰隆,去踝八寸,别走太阴。其别者,循胫骨外廉上络头项,合诸经
之气,下络喉嗌。其病气逆则喉痹瘁喑。实则颠狂,虚则足不收,胫枯,取之所别。
足太阴之别,名曰公孙,去本节后一寸,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。
足少阴之别,名曰大钟,当踝后绕跟,别走太阳。其别者,并经上走于心包下,外贯腰
脊。其病气逆则烦闷,实则癃闭,虚则腰痛,取之所别。
足厥阴之别,名曰蠡沟,去内踝上五寸,别走少阳。其别者,循经上睾,结于茎。其病
气逆则睾肿卒疝,实则挺长热,虚则暴痒,取之所别。
任脉之别,名曰尾翳,下鸠尾,散于腹。实则腹皮痛,虚则瘙痒,取之所别。
督脉之别,名曰长强。侠脊上项散头,上下当肩胛左右,别走太阳,入贯膂。实则脊
强,虚则头重,高摇之,挟脊之有过者(《九墟》无此九字),取之所别。
脾之大络名曰大包,出渊腋下三寸,布胸胁。实则一身尽痛,虚则百脉皆纵,此脉若罗
络之血者,皆取之。凡此十五络者,实则必见,虚则必下,视之不见,求之上下,人经
不同,络脉异所别也
黄帝问曰∶皮有分部,脉有经纪,愿闻其道?岐伯对曰∶欲知皮部以经脉为纪者,诸经
皆然。阳明之阳,名曰害蜚,十二经上下同法,视其部中有浮络者,皆阳明之络也。其色多
青则痛,多黑则痹,黄赤则热,多白则寒,五色皆见,则寒热也。络盛则入客于经,阳主外
,阴主内。
少阳之阳,名曰枢杼(一作持),视其部中有浮络者,皆少阳之络也。络盛则入客于经。
故在阳者主内,在阴者主外,以渗于内也。诸经皆然。
太阳之阳,名曰关枢,视其部中有浮络者,皆太阳之络也。络盛则入客于经。
少阴之阴,名曰枢儒,视其部中有浮络者,皆少阴之络也。络盛则入客于经,其入于
经也,从阳部注于经,其出者,从阴部内注于骨。
心主之阴,名曰害肩,视其部中有浮络者,皆心主之络也。络盛则入客于经。
太阴之阴,名曰关蛰,视其部中有浮络者,皆太阴之络也。络盛则入客于经。凡此十二
经络脉者。皮之部也,是故百病之始生也,必先客于皮毛,邪中之则腠理开,开则入客于
络脉,留而不去,传入于经,留而不去,传入于腑,禀于肠胃。邪之始入于皮也,淅然起
毫
间,寒多则筋挛骨痛,热多则筋弛骨消,肉烁 破,毛直而败也。曰∶十二部,其生病何
如?曰∶皮者,脉之部也。邪客于皮则腠理开,开则邪入客于络脉,络脉满则注于经脉,经
脉满则入舍于腑脏。故皮有分部,不愈而生大病也。
曰∶夫络脉之见,其五色各异,其故何也?曰∶经有常色,而络无常变。曰∶经之常色
何如?曰∶心赤肺白肝青脾黄肾黑,皆亦应其经脉之色也。曰∶其络之阴阳亦应其经乎?曰
∶阴络之色应其经,阳络之色变无常,随四时而行。寒多则凝泣,凝泣则青黑;热多则淖
(音皋),淖 则黄赤。此其常色者,谓之无病。五色俱见,谓之寒热。
曰∶余闻人之合于天地也,内有五脏,以应五音、五色、五味、五时、五位。外有六腑
,以合六律。主持阴阳诸经,而合之十二月、十二辰、十二节、十二时、十二经水、十二经
脉,此五脏六腑所以应天道也。夫十二经脉者,人之所以生,病之所以成,人之所以治,病
之所以起,学之所始,工之所止,粗之所易,上之所难也。其离合出入奈何?曰∶此粗之
所过,上之所悉也,请悉言之∶
足太阳之正,别入于 中,其一道下尻五寸,别入于肛,属于膀胱,散之肾,循膂当
心入散。直者,从膂上出于项,复属于太阳,此为一经也。
足少阴之正,至 中,别走太阳而合,上至肾,当十四椎,出属带脉。直者,系舌本
,复出于项,合于太阳,此为一合。(《九墟》云∶或以诸阴之别者皆为正也)。
足少阳之正,或以诸经别者为正(一本云绕髀入毛际,合于厥阴)。别者入季胁之间,
循胸里,属胆,散之上肝贯心,以上侠咽,出颐颔中,散于面,系目系,合少阳于外 。
足厥阴之正,别跗上,上至毛际,合于少阳,与别俱行,此为二合。
足阳明之正,上至髀,入于腹里,属于胃,散之脾,上通于心,上循咽,出于口,上
,还系目,合于阳明。
足太阴之正,则别上至髀,合于阳明,与别俱行,上络于咽,贯舌本,此为三合。
手太阳之正,指地,别入于肩解,入腋走心,系小肠。
手少阴之正,别下于渊腋两筋之间,属心主,上走喉咙,出于面,合目内 ,此为四合
。
手少阳之正,指天,别于巅,入于缺盆,下走三焦,散于胸中。
手心主之正,别下渊腋三寸,入胸中,别属三焦,出循喉咙,出耳后,合少阳完骨之下
,此为五合。
手阳明之正,从手循膺乳,别于肩 ,入柱骨下,走大肠,属于肺,上循喉咙,出
缺盆,合于阳明。
手太阴之正,别入渊腋少阴之前,入走肺,散之太阳,上出缺盆,循喉咙,复合阳明,
此为六合。
黄帝问道:十二经脉中,为什么手太阴肺经的脉搏唯独跳动不停呢?岐伯回答说:这是因为足阳明胃经的缘故。胃是五脏六腑营养的来源(五脏六腑之海),其中清轻的精微之气上注于肺,肺气随着手太阴肺经运行,其运行伴随呼吸一呼一吸而往来,所以人的脉搏在每一次呼气时跳动两次,每一次吸气时也跳动两次,呼吸不止,脉搏也就跳动不停。
黄帝又问:为什么手腕部的寸口脉能够单独作为诊断五脏六腑状况的依据呢?岐伯回答说:胃是水谷汇聚的地方,也是六腑功能的根本来源。各种味道进入口中,储藏于胃,用来滋养五脏之气。寸口脉属于手太阴肺经,因此五脏六腑的气和味都源于胃,并反映在寸口脉上。所以,五种气味从鼻子吸入,储藏在心肺之中,如果肺有病,鼻子就会感到不通畅。(《九卷》论述了脉搏的跳动,《素问》论述了气的运行,这里论述了寸口为五脏之主,三者相互发明印证。)
黄帝问:气经过寸口时,向上出于鱼际穴附近的动脉,向下伏行于尺泽穴附近,它通过什么道路返回体内,我不明白它的极致道理是什么?岐伯回答说:气离开脏腑时,突然像弓弩发射一样迅猛,又像水从岸边倾泻而下,向上到达鱼际部位后反而衰减,其余的气衰散并逆向上行,所以它的运行显得微弱。
黄帝问:足阳明胃经为什么独自跳动?岐伯回答说:胃气上注于胃,其中剽悍滑疾之气上行冲击头部,沿着喉咙上行至头面空窍,沿着眼系进入络属脑部,出于下颌客主人穴,沿着牙车穴,汇合于阳明经,并下行至人迎穴,这是胃气运行于阳明经的表现。所以,无论阴阳上下,其脉动是一致的。因此,阳病而阳脉反小的是逆证,阴病而阴脉反大的是逆证;如果阴阳脉都盛大,且一起跳动,就像拉紧的绳子互相倾斜一样,这就是病态。
黄帝问:足少阴肾经为什么独自跳动?岐伯回答说:冲脉是十二经脉的海,它与足少阴肾经的大络起于肾下,出于气街穴,沿着大腿内侧下行,斜入腘窝中,沿着胫骨内侧,并行于足少阴经,下行进入内踝后方直至足底。其分支者,斜入踝内,出于足背,进入大脚趾之间,以灌注各络脉,以温养足背,这是该脉常动的表现。
黄帝说:卫气的运行,上下贯穿,如圆环没有端点。现在突然遇到邪气,以及遭遇大寒,导致手足不能随意运动,其脉象阴阳失去端点规律,不知道它的纪纲,最终又重新开始,说的就是这个道理。
十二经脉伏行于肌肉间隙之间,深藏而不见。其中常见的,只有足太阴脾经在外踝上方显露,无处隐藏。所以,所有浮露而常见的脉,都是络脉。六条阳经的络脉中,手阳明大肠经和手少阴心经的大络起于五指间,上行汇合于肘中。饮酒的人,卫气先行于皮肤,先充盈络脉,络脉先盛满,然后卫气趋于平和,营气才充满,此时经脉就盛大显现。脉搏突然跳动的,都是邪气停留所致,邪气留滞于本末,如果不跳动则发热,如果不坚实则下陷且空虚,不与正常脉象相同,因此可以知道是哪条脉在跳动。
雷公问道:如何知道经脉与络脉的区别呢?黄帝回答说:经脉通常是看不见的。其虚实状况,可以通过寸口脉来知晓。看得见的脉,都是络脉。所有的络脉都不能经过大的关节之间,必定行走于特殊的通道而出入,再复合于皮肤之中,它们的交会点都显露在外面。所以,凡是刺络脉的,必须刺其结聚之处,如果有瘀血即使没有明显的结块,也要急取之以泻除邪气并放出血液,否则留滞会发为痹症。
凡是诊察络脉,脉色青表示有寒且痛,赤表示有热。胃中有寒,则手掌大鱼际处的络脉多呈青色。胃中有热,则大鱼际处的络脉呈红色。如果突然变黑,说明久留成为痹症。如果颜色有赤、有青、有黑,说明有寒热错杂。如果脉青而细小短促,说明气少。
凡是针刺治疗寒热病症的,都要选取多血的络脉,必须隔日取一次,直到血色排尽才停止,以调治其虚实。对于细小短促的气虚络脉,如果严重的话,用泻法会导致胸闷,胸闷严重则会昏倒不能说话,出现胸闷时要急忙让其坐下。
手太阴肺经的别络,名叫列缺,起于腕上分肉之间,并着手太阴经直入掌中,散布于大鱼际。其病实证表现为手兑骨处掌中发热,虚证表现为呵欠(欠KT)、小便频数遗溺,治疗取去腕上一寸半处,此络别走手阳明大肠经。
手少阴心经的别络,名叫通里,在腕后一寸半处,别行而上行,沿经进入心中,联系舌根,属目系。实证表现为胸膈支撑胀满,虚证表现为不能说话,治疗取腕后一寸处,此络别走手太阳小肠经。
手厥阴心包经的别络,名叫内关,去腕二寸,出于两筋之间,沿经上行,系于心包络。心系实证表现为心痛,虚证表现为心烦,治疗取两筋之间。
手太阳小肠经的别络,名叫支正,上腕五寸处,向内注入足少阴经,其分支上行至肘部,络属肩髃穴。实证表现为筋弛缓、肘部废用,虚证表现为生疣,小的如手指上的痂疥,治疗取此别络处。
手阳明大肠经的别络,名叫偏历,去腕三寸,别走手太阴肺经,其分支沿臂上行,乘越肩部,上至曲颊遍齿。其另一分支进入耳中,会合于宗脉。实证表现为龋齿、耳聋,虚证表现为牙齿寒冷、痹阻胸膈,治疗取此别络处。
手少阳三焦经的别络,名叫外关,去腕二寸,向外绕过手臂,注入胸中,合于心主(心包)。实证表现为肘部挛缩,虚证表现为手臂不能收持,治疗取此别络处。
足太阳膀胱经的别络,名叫飞扬,去踝七寸,别走足少阴肾经,实证表现为鼻塞(一说鼻流清涕鼻塞)、头背痛,虚证表现为鼻流清涕或衄血,治疗取此别络处。
足少阳胆经的别络,名叫光明,去踝上五寸,别走足厥阴肝经,并经行下行络属足背。实证表现为厥逆,虚证表现为痿软无力,坐起困难,治疗取此别络处。
足阳明胃经的别络,名叫丰隆,去踝八寸,别走足太阴脾经。其分支,沿胫骨外侧上行络属头项,汇合诸经之气,下行络属喉嗌。其病气逆则导致喉痹失音。实证表现为癫狂,虚证表现为足部不能收持、胫部枯瘦,治疗取此别络处。
足太阴脾经的别络,名叫公孙,去本节下一寸,别走足阳明胃经。其分支,入内络属肠胃。厥气上逆则导致霍乱,实证表现为肠中剧烈疼痛,虚证表现为鼓胀,治疗取此别络处。
足少阴肾经的别络,名叫大钟,当踝后绕跟,别走足太阳膀胱经。其分支,并经上行至心包之下,外贯腰脊。其病气逆则烦闷,实证表现为癃闭,虚证表现为腰痛,治疗取此别络处。
足厥阴肝经的别络,名叫蠡沟,去内踝上五寸,别走足少阳胆经。其分支,沿经上行至睾丸,结于阴茎。其病气逆则睾丸肿胀突发疝气,实证表现为阴茎挺长发热,虚证表现为突发瘙痒,治疗取此别络处。
任脉的别络,名叫尾翳(鸠尾),下至鸠尾穴,散布于腹部。实证表现为腹皮痛,虚证表现为瘙痒,治疗取此别络处。
督脉的别络,名叫长强。夹脊上行至项部散布于头部,上下位于肩胛左右,别走足太阳膀胱经,入内贯注于骶部肌肉。实证表现为脊柱强直,虚证表现为头重,高摇头部时,挟脊有过错之处(《九墟》无此九字),治疗取此别络处。
脾的大络,名叫大包,出渊腋下三寸,布散于胸胁。实证表现为全身尽痛,虚证表现为百脉皆松弛,这些脉络如同罗网般的血络,都要取治。凡这十五络脉,实证必然显露,虚证必然下陷,视而不见时,需上下求索,因为人的经络不同,络脉别出的部位也各异。
黄帝问道:皮肤有分部,脉有经纪,希望听听其中的道理?岐伯回答说:想要了解皮部以经脉为纲领的,所有经脉都是这样。阳明经的阳气,名叫害蜚,十二经上下同理,观察其部中有浮络的,都是阳明经的络脉。其色多青则痛,多黑则痹,黄赤则热,多白则寒,五色都见到,则是寒热错杂。络脉盛满则邪气侵入经脉,阳主外,阴主内。
少阳经的阳气,名叫枢杼(一作持),观察其部中有浮络的,都是少阳经的络脉。络脉盛满则邪气侵入经脉。所以在阳分的邪气主内入,在阴分的邪气主外达,以渗入内部。所有经脉都是这样。
太阳经的阳气,名叫关枢,观察其部中有浮络的,都是太阳经的络脉。络脉盛满则邪气侵入经脉。
少阴经的阴气,名叫枢儒,观察其部中有浮络的,都是少阴经的络脉。络脉盛满则邪气侵入经脉。其进入经脉的,从阳部注入经脉,其出来的,从阴部内注于骨。
心主(心包)的阴气,名叫害肩,观察其部中有浮络的,都是心主经的络脉。络脉盛满则邪气侵入经脉。
太阴经的阴气,名叫关蛰,观察其部中有浮络的,都是太阴经的络脉。络脉盛满则邪气侵入经脉。凡这十二经络脉,是皮肤的分区。所以百病初生时,必先客居皮毛,邪气中伤则腠理开,开则邪入客居络脉,停留不去,传入经脉,停留不去,传入腑脏,禀受于肠胃。邪气初入皮时,淅然毫毛竖起,寒多则筋挛骨痛,热多则筋弛骨消,肉削破,毛发直立败坏。
黄帝问:十二部生病情况如何?岐伯答:皮是脉的分区。邪气客于皮则腠理开,开则邪入客于络脉,络脉满则注于经脉,经脉满则入舍于腑脏。所以皮有分部,不愈而生大病。
黄帝问:络脉的显现,其五色各异,原因是什么?岐伯答:经脉有常色,而络脉无常变。黄帝问:经脉的常色是怎样的?岐伯答:心赤、肺白、肝青、脾黄、肾黑,也都对应其经脉的颜色。黄帝问:络脉的阴阳也对应经脉吗?岐伯答:阴络的颜色对应其经脉,阳络的颜色变化无常,随四季而变化。寒多则凝涩,凝涩则青黑;热多则淖泽,淖泽则黄赤。这是常色,称为无病。五色俱见,称为寒热。
黄帝说:我听说人合于天地,内有五脏,以应五音、五色、五味、五时、五位。外有六腑,以合六律。主持阴阳诸经,而合之十二月、十二辰、十二节、十二时、十二经水、十二经脉,这是五脏六腑所以顺应天道的道理。那十二经脉,是人之所以生存,病之所以形成,人之所以治疗,病之所以兴起,学问的起始,工匠的终止,粗工所容易忽略,上工所难以精通的。它们的离合出入是怎样的?黄帝说:这是粗工所经过的,上工所详尽了解的,请让我详细说说:
足太阳膀胱经的正经,别入于腘中,其中一道下行至尻骨五寸处,别入于肛门,属于膀胱,散布于肾,沿骶部当心上行至心而散布。直行者,从骶部上行出于项部,重新属于太阳经,这是一经。
足少阴肾经的正经,至腘中,别走太阳经而相合,上行至肾,当第十四椎处,出而属带脉。直行者,系于舌根,复出项部,合于太阳经,这是一合。(《九墟》说:或者将诸阴经的别络都称为正经)。
足少阳胆经的正经,有的将诸经别络称为正(一本说绕过大腿进入毛际,合于厥阴)。别行者入季胁之间,循胸里,属于胆,散布至上肝,贯心,以上侠咽,出于颐颔中,散布于面部,系目系,合少阳于外眼角。
足厥阴肝经的正经,别行于足背上方,上行至毛际,合于少阳经,与别络俱行,此为二合。
足阳明胃经的正经,上行至髀部,入于腹里,属于胃,散布于脾,上通于心,上循咽,出于口,上至目眶下,还系目系,合于阳明经。
足太阴脾经的正经,则别行上行至髀部,合于阳明经,与别络俱行,上络于咽,贯舌根,此为三合。
手少阴心经的正经,别行下于渊腋两筋之间,属心主,上走喉咙,出于面部,合目内眦,此为四合。
手少阳三焦经的正经,指天,别于巅顶,入于缺盆,下走三焦,散布于胸中。
手厥阴心包经的正经,别行下渊腋三寸,入胸中,别属三焦,出循喉咙,出耳后,合少阳于完骨之下,此为五合。
Huangdi asked: Among the twelve meridians, why does the pulse of the Hand-Taiyin Lung Meridian alone beat continuously? Qibo replied: It is due to the Foot-Yangming Stomach Meridian. The Stomach is the sea of the five zang and six fu organs (the source of nourishment for all internal organs). Its clear qi ascends and pours into the Lungs. The Lung qi travels along the Hand-Taiyin Lung Meridian. Its movement is linked to respiration, coming and going with each breath. Therefore, in a person's pulse, it beats twice during one exhalation and twice during one inhalation. Since breathing never ceases, the pulse beats without stopping.
Huangdi asked: Why can the cunkou pulse at the wrist alone serve as the master indicator for the five zang organs? Qibo answered: The Stomach is the sea of water and grain, and the great source of the six fu organs. Flavors enter the mouth, are stored in the Stomach, and nourish the qi of the five zang organs. The cunkou pulse belongs to the Hand-Taiyin Lung Meridian. Thus, the qi and flavors of the five zang and six fu organs all originate from the Stomach and manifest at the cunkou. Therefore, the five aromas enter through the nose and are stored in the Heart and Lungs; if the Lung is diseased, the nose becomes obstructed. (The *Jiu Juan* discusses the pulsation, the *Su Wen* discusses the qi, and this text discusses its role as the master of the five zang; they elucidate each other.)
Huangdi asked: When qi passes through the cunkou, it emerges above at the Yuji point area and descends below at the Chize point area. Through what path does it return? I do not understand its ultimate principle. Qibo answered: When qi leaves the zang organs, it suddenly rushes forth like an arrow from a crossbow or water cascading from a bank. It ascends to the fish border (Yuji) and then declines; the remaining qi dissipates and rises counter-flowingly, so its movement appears subtle and weak.
Huangdi asked: Why does the Foot-Yangming Stomach Meridian pulse independently? Qibo answered: Stomach qi ascends to the Stomach. Its fierce, rapid qi ascends to strike the head, follows the throat up to the empty orifices of the head, follows the eye system into the brain, emerges below the jaw at the Keyrenman point, follows the Yache point, merges with the Yangming Meridian, and descends together to the Renying point. This is how Stomach qi travels along the Yangming Meridian. Therefore, whether above or below, yin or yang, their pulsations are uniform. Thus, if a yang disease presents with a small yang pulse, it is a contrary sign; if a yin disease presents with a large yin pulse, it is a contrary sign. If both yin and yang pulses are excessive and beat together, tilting towards each other like a pulled rope, this indicates disease.
Huangdi asked: Why does the Foot-Shaoyin Kidney Meridian pulse independently? Qibo answered: The Chong Mai (Penetrating Vessel) is the sea of the twelve meridians. It originates from the lower kidney along with the large collateral of the Foot-Shaoyin Meridian, emerges at the Qichong point, follows the inner aspect of the thigh, slants into the popliteal fossa, follows the inner aspect of the tibia, runs parallel to the Foot-Shaoyin Meridian, and descends behind the medial malleolus to the sole of the foot. Its branch slants into the ankle, emerges on the dorsum of the foot, enters between the big toe, and pours into the various collaterals to warm the foot dorsum. This is the normal pulsation of this vessel.
Huangdi said: The Wei Qi (Defensive Qi) circulates up and down, interweaving like a circle without end. Now, if one suddenly encounters pathogenic qi or severe cold, causing the hands and feet to become immobile, the yin and yang pulses lose their rhythmic order, and one cannot discern its pattern, yet it eventually restarts. This is what is meant.
The twelve main meridians run hidden within the muscle intervals, deep and invisible. The only ones commonly visible are those of the Foot-Taiyin Spleen Meridian over the lateral malleolus, where there is no concealment. Therefore, all floating and commonly visible vessels are collaterals. Among the six yang meridians' collaterals, the large collaterals of the Hand-Yangming Large Intestine and Hand-Shaoyin Heart meridians originate between the five fingers and ascend to merge in the elbow region. After drinking wine, the Wei Qi first travels in the skin and first fills the collaterals. When the collaterals are full, the Wei Qi becomes calm, the Ying Qi (Nutritive Qi) becomes full, and the main meridians become excessively prominent. Sudden pulsations in the vessels are caused by pathogenic qi residing there, lingering at the root or extremities. If it does not pulse, heat arises; if it is not firm, it sinks and becomes hollow. Since it differs from the normal state, one can identify which meridian is pulsating.
Leigong asked: How can one distinguish between the main meridians and the collaterals? Huangdi answered: The main meridians are usually invisible. Their deficiency or excess is known through the cunkou pulse. The vessels that are visible are all collaterals. All collaterals cannot pass through major joints; they must travel through unique pathways to emerge and re-enter, merging within the skin. Their intersections are all visible externally. Therefore, when needling collaterals, one must needle at the site of congestion. Even if there is no obvious blood clot but there is abundant blood, one should urgently drain it to expel the pathogen and release the blood; otherwise, retention will lead to Bi syndrome (obstruction).
In general, diagnosing collaterals: if the vessel color is green, it indicates cold and pain; if red, it indicates heat. Cold in the Stomach causes many green vessels in the thenar eminence (fish border). Heat in the Stomach causes red vessels in the thenar eminence. Sudden blackness indicates long-standing Bi syndrome. Red, green, and black colors indicate mixed cold and heat. Green and small/short vessels indicate deficient qi.
When needling for cold and heat conditions, one should select vessels with abundant blood and treat them every other day until the blood is exhausted, adjusting for deficiency and excess. For small and short vessels indicating deficient qi, excessive draining may cause chest oppression. Severe oppression leads to collapse and inability to speak; in such cases, one should urgently have the patient sit down.
The collateral of the Hand-Taiyin Lung Meridian is named Lieque (LU-7). It originates between the muscles above the wrist, runs parallel to the Lung Meridian straight into the palm, and disperses into the thenar eminence. In excess conditions, there is heat in the palm at the radial styloid process; in deficiency conditions, there is yawning and frequent urination or incontinence. Treatment involves needling 1.5 cun from the wrist, where it diverges to connect with the Hand-Yangming Large Intestine Meridian.
The collateral of the Hand-Shaoyin Heart Meridian is named Tongli (HT-5). It is located 1.5 cun above the wrist, diverges and ascends, follows the meridian into the heart, connects to the root of the tongue, and attaches to the eye system. In excess conditions, there is a sensation of fullness supporting the diaphragm; in deficiency conditions, there is inability to speak. Treatment involves needling 1 cun behind the wrist, where it diverges to connect with the Hand-Taiyang Small Intestine Meridian.
The collateral of the Hand-Jueyin Pericardium Meridian is named Neiguan (PC-6). It is located 2 cun from the wrist, emerges between the two tendons, follows the meridian upward, and attaches to the Pericardium. In excess conditions of the Heart system, there is heart pain; in deficiency conditions, there is vexation. Treatment involves needling between the two tendons.
The collateral of the Hand-Taiyang Small Intestine Meridian is named Zhizheng (SI-7). It is 5 cun above the wrist, internally injects into the Foot-Shaoyin Meridian. Its branch ascends to the elbow and connects to the Jianliao point. In excess conditions, there is flaccidity of the tendons and elbow dysfunction; in deficiency conditions, warts grow, small ones resembling scabies or crusts on the finger. Treatment involves needling at the divergence point.
The collateral of the Hand-Yangming Large Intestine Meridian is named Pianli (LI-6). It is 3 cun from the wrist, diverges to connect with the Hand-Taiyin Lung Meridian. Its branch follows the arm upward, crosses the shoulder, ascends to the temporo-mandibular joint, and covers the teeth. Another branch enters the ear and meets the Zong Mai (Gathering Vessels). In excess conditions, there are toothaches and deafness; in deficiency conditions, there is cold in the teeth and obstruction in the diaphragm. Treatment involves needling at the divergence point.
The collateral of the Hand-Shaoyang Sanjiao Meridian is named Waiguan (TE-5). It is 2 cun from the wrist, winds around the arm externally, pours into the chest, and merges with the Pericardium. In excess conditions, there is elbow contracture; in deficiency conditions, there is inability to hold the arm. Treatment involves needling at the divergence point.
The collateral of the Foot-Taiyang Bladder Meridian is named Feiyang (BL-58). It is 7 cun from the ankle, diverges to connect with the Foot-Shaoyin Kidney Meridian. In excess conditions, there is nasal obstruction (or rhinorrhea), headache, and back pain; in deficiency conditions, there is rhinorrhea or epistaxis. Treatment involves needling at the divergence point.
The collateral of the Foot-Shaoyang Gallbladder Meridian is named Guangming (GB-37). It is 5 cun above the ankle, diverges to connect with the Foot-Jueyin Liver Meridian, and descends to connect with the foot dorsum. In excess conditions, there is cold limbs (Jue); in deficiency conditions, there is flaccidity (Wei), making it difficult to sit up. Treatment involves needling at the divergence point.
The collateral of the Foot-Yangming Stomach Meridian is named Fenglong (ST-40). It is 8 cun from the ankle, diverges to connect with the Foot-Taiyin Spleen Meridian. Its branch follows the outer aspect of the tibia upward to connect with the head and neck, gathers the qi of various meridians, and descends to connect with the throat. Disease involving qi rebellion causes sore throat and loss of voice. In excess conditions, there is mania; in deficiency conditions, there is inability to hold the foot and withering of the shin. Treatment involves needling at the divergence point.
The collateral of the Foot-Taiyin Spleen Meridian is named Gongsun (SP-4). It is 1 cun distal to the metatarsophalangeal joint, diverges to connect with the Foot-Yangming Stomach Meridian. Its branch enters and connects with the intestines and stomach. Rebellion of jue qi causes Huoluan (cholera-like vomiting and diarrhea). In excess conditions, there is cutting pain in the intestines; in deficiency conditions, there is abdominal distension. Treatment involves needling at the divergence point.
The collateral of the Foot-Shaoyin Kidney Meridian is named Dazhong (KI-4). It is located behind the ankle, winding around the heel, and diverges to connect with the Foot-Taiyang Bladder Meridian. Its branch runs parallel upward to the lower Pericardium, piercing the waist and spine. Disease involving qi rebellion causes irritability and oppression. In excess conditions, there is strangury and retention; in deficiency conditions, there is lower back pain. Treatment involves needling at the divergence point.
The collateral of the Foot-Jueyin Liver Meridian is named Ligou (LR-5). It is 5 cun above the medial malleolus, diverges to connect with the Foot-Shaoyang Gallbladder Meridian. Its branch follows the meridian upward to the testis, knotting at the penis. Disease involving qi rebellion causes testicular swelling and sudden hernia. In excess conditions, there is priapism and heat; in deficiency conditions, there is sudden itching. Treatment involves needling at the divergence point.
The collateral of the Ren Mai (Conception Vessel) is named Wei Yi (Jiuwei, CV-15). It descends from the Jiuwei point and disperses in the abdomen. In excess conditions, there is pain in the abdominal skin; in deficiency conditions, there is itching. Treatment involves needling at the divergence point.
The collateral of the Du Mai (Governing Vessel) is named Changqiang (GV-1). It runs alongside the spine up to the neck and disperses in the head, extending left and right below the shoulder blades, diverging to connect with the Foot-Taiyang Bladder Meridian, and entering to pierce the sacral muscles. In excess conditions, there is spinal rigidity; in deficiency conditions, there is heaviness of the head. When shaking the head high, look for abnormalities along the spine. Treatment involves needling at the divergence point.
The large collateral of the Spleen is named Dabao (SP-21). It emerges 3 cun below the Yuanxi point and spreads over the chest and hypochondrium. In excess conditions, there is pain throughout the body; in deficiency conditions, all vessels become lax. These vessels, resembling a net of blood, should all be treated. Of these fifteen collaterals, excess conditions are always visible, while deficiency conditions always sink. If not seen visually, seek them above and below, as human meridians vary, and the divergence points of collaterals differ.
Huangdi asked: The skin has divisions, and the vessels have a network structure. I wish to hear the principle behind this? Qibo answered: To understand the skin regions using the meridians as the guide, this applies to all meridians. The yang of the Yangming Meridian is called Haifei. Following the same method for all twelve meridians, observe any floating collaterals in the region; these are all collaterals of the Yangming Meridian. If the color is mostly green, there is pain; mostly black, Bi syndrome; yellow and red, heat; mostly white, cold. If all five colors appear, it indicates mixed cold and heat. When collaterals are full, pathogens enter the main meridians. Yang governs the exterior, Yin governs the interior.
The yang of the Shaoyang Meridian is called Shuzhu. Observe any floating collaterals in the region; these are all collaterals of the Shaoyang Meridian. When collaterals are full, pathogens enter the main meridians. Thus, pathogens in the yang aspect move inward, and those in the yin aspect move outward, seeping into the interior. This applies to all meridians.
The yang of the Taiyang Meridian is called Guanshu. Observe any floating collaterals in the region; these are all collaterals of the Taiyang Meridian. When collaterals are full, pathogens enter the main meridians.
The yin of the Shaoyin Meridian is called Shuru. Observe any floating collaterals in the region; these are all collaterals of the Shaoyin Meridian. When collaterals are full, pathogens enter the main meridians. Upon entering the meridians, they flow from the yang aspect into the meridians; upon exiting, they flow from the yin aspect inward to the bones.
The yin of the Heart Master (Pericardium) is called Haijian. Observe any floating collaterals in the region; these are all collaterals of the Heart Master Meridian. When collaterals are full, pathogens enter the main meridians.
The yin of the Taiyin Meridian is called Guanxie. Observe any floating collaterals in the region; these are all collaterals of the Taiyin Meridian. When collaterals are full, pathogens enter the main meridians. These twelve meridian-collateral systems constitute the skin regions. Therefore, when diseases begin, they first lodge in the skin and hair. Pathogens attacking cause the cou li (pores) to open; once open, pathogens enter the collaterals. If they remain, they transmit to the meridians; if they remain there, they transmit to the fu organs, ultimately affecting the intestines and stomach. When pathogens first enter the skin, the hair stands erect. If cold predominates, tendons contract and bones ache; if heat predominates, tendons relax and bones waste away, flesh shrinks and breaks, and hair becomes stiff and deteriorates.
Huangdi asked: What are the diseases arising from the twelve regions? Qibo answered: The skin is the domain of the vessels. Pathogens lodging in the skin cause the cou li to open; once open, pathogens enter the collaterals. When collaterals are full, they pour into the meridians; when meridians are full, they lodge in the zang-fu organs. Thus, the skin has divisions; if not healed, major diseases arise.
Huangdi asked: The visible collaterals display different colors. What is the reason? Qibo answered: The main meridians have constant colors, while collaterals do not have constant changes. Huangdi asked: What are the constant colors of the meridians? Qibo answered: The Heart is red, the Lung is white, the Liver is green, the Spleen is yellow, and the Kidney is black. These correspond to the colors of their respective meridians. Huangdi asked: Do the yin and yang collaterals also correspond to the meridians? Qibo answered: The color of the yin collaterals corresponds to their meridian. The color of the yang collaterals varies constantly, following the four seasons. With much cold, the blood coagulates and flows slowly, appearing green or black; with much heat, the blood becomes fluid and moist, appearing yellow or red. These are considered normal colors, indicating no disease. If all five colors appear, it indicates mixed cold and heat.
Huangdi said: I have heard that humans harmonize with Heaven and Earth. Internally, there are five zang organs corresponding to the five tones, five colors, five flavors, five seasons, and five directions. Externally, there are six fu organs corresponding to the six pitches. They govern the yin and yang meridians, harmonizing with the twelve months, twelve earthly branches, twelve solar terms, twelve double-hours, twelve rivers, and twelve meridians. This is how the five zang and six fu correspond to the Way of Heaven. The twelve meridians are the basis of life, the formation of disease, the method of treatment, the origin of illness, the beginning of learning, and the limit of skill. They are easily overlooked by crude practitioners but thoroughly understood by superior physicians. How do they separate, combine, enter, and exit? Huangdi said: This is passed over by crude practitioners but fully comprehended by superior physicians. Let me explain in detail:
The Zheng Qi (Regular Branch) of the Foot-Taiyang Bladder Meridian diverges into the popliteal fossa. One branch descends five cun below the coccyx, diverges into the anus, connects to the Bladder, and disperses to the Kidney, following the sacral muscles up to the heart to disperse. The straight branch ascends from the sacral muscles, emerges at the nape, and reconnects with the Taiyang Meridian. This constitutes one meridian pathway.
The Zheng Qi of the Foot-Shaoyin Kidney Meridian reaches the popliteal fossa, diverges to connect with the Taiyang Meridian and merges, ascends to the Kidney, exits at the level of the fourteenth vertebra, and connects to the Dai Mai (Girdle Vessel). The straight branch connects to the root of the tongue, re-emerges at the nape, and merges with the Taiyang Meridian. This constitutes one combination. (*Jiu Xu* states: Alternatively, the divergences of all yin meridians are considered Zheng Qi).
The Zheng Qi of the Foot-Shaoyang Gallbladder Meridian: some consider the divergences of various meridians as Zheng Qi (one version says it wraps around the thigh, enters the pubic region, and merges with Jueyin). The divergent branch enters the space between the costal cartilages, follows the interior of the chest, connects to the Gallbladder, disperses to the upper Liver, pierces the Heart, ascends alongside the pharynx, emerges in the jaw/chin area, disperses in the face, connects to the eye system, and merges with Shaoyang at the outer canthus.
The Zheng Qi of the Foot-Jueyin Liver Meridian diverges from the dorsum of the foot, ascends to the pubic region, merges with Shaoyang, and travels together with the divergent branch. This constitutes the second combination.
The Zheng Qi of the Foot-Yangming Stomach Meridian ascends to the thigh, enters the abdominal cavity, connects to the Stomach, disperses to the Spleen, ascends to connect with the Heart, follows the pharynx, emerges at the mouth, ascends to the orbit, returns to connect to the eye system, and merges with Yangming.
The Zheng Qi of the Foot-Taiyin Spleen Meridian diverges and ascends to the thigh, merges with Yangming, travels together with the divergent branch, connects to the pharynx, pierces the root of the tongue. This constitutes the third combination.
The Zheng Qi of the Hand-Taiyang Small Intestine Meridian points downward, diverges into the shoulder joint, enters the axilla, travels to the Heart, and connects to the Small Intestine.
The Zheng Qi of the Hand-Shaoyin Heart Meridian diverges downward between the two tendons of the Yuanxi region, connects to the Pericardium, ascends to the throat, emerges in the face, and merges at the inner canthus. This constitutes the fourth combination.
The Zheng Qi of the Hand-Shaoyang Sanjiao Meridian points upward, diverges at the vertex, enters the Supraclavicular Fossa, descends to the Sanjiao, and disperses in the chest.
The Zheng Qi of the Hand-Jueyin Pericardium Meridian diverges downward 3 cun from Yuanxi, enters the chest, diverges to connect to the Sanjiao, emerges following the throat, emerges behind the ear, and merges with Shaoyang below the Wangu point. This constitutes the fifth combination.
The Zheng Qi of the Hand-Yangming Large Intestine Meridian follows the chest and breast from the hand, diverges at Jianliao, enters below the vertebral column, travels to the Large Intestine, connects to the Lung, follows the throat, emerges from the Supraclavicular Fossa, and merges with Yangming.
The Zheng Qi of the Hand-Taiyin Lung Meridian diverges into the anterior aspect of the Yuanxi region near the Shaoyin Meridian, travels to the Lung, disperses to the Taiyang Meridian, emerges from the Supraclavicular Fossa, follows the throat, and merges with Yangming. This constitutes the sixth combination.