平按∶此篇自篇首至因天之序，见《灵枢》卷十第七十一《邪客》篇。自手太阴之脉至逆数
之曲折也，见《甲乙经》卷三第二十四。又自心主之脉至内络心肺，见《甲乙经》卷三第二十五。
自黄帝曰手少阴至因天之叙，见《甲乙经》卷三第二十六。自黄帝曰经脉十二至末，见《灵枢》
卷九第六十二《动 》篇，又见《甲乙经》卷二第一下编。
黄帝问于岐伯曰∶脉之屈折，出入之处，焉至而出，焉至而止，焉至而徐，焉至而疾，焉至
而入？六腑之输于身者，余愿尽闻其序。（举其五义，问五脏脉行处，并问身之六腑之输。平按∶
其序《灵枢》作少序。）别离之处，离而入阴，别而行阳，皆何道从行？愿闻其方。岐伯对曰∶
窘乎哉问，明乎哉道。（问阴阳二脉离合之处也。平按∶《灵枢》别而行阳作别而入阳，皆何道从
行作此何道而从
行，“窘乎哉问，……”二句作“帝之所问，针道毕矣”二句。）黄帝曰∶愿卒闻之。岐伯曰∶
手太阴之脉，出于大指之端，内屈循白肉，至本节之后太泉，留以澹，以外屈上于本节，（手太
阴脉，从脏行至腕后，一支上大指次指之端，变为手阳明脉；其本从腕后上鱼，循鱼际出大指之
端，即指端内屈回，循大指白肉至本节后太泉穴处，停留成澹而动，然后外出上于本节也。澹，
从滥反。平按∶内屈《甲乙经》作内侧。循白肉《灵枢》、《甲乙经》均作循白肉际，太泉均作
太渊，唐人讳渊作泉，说见前。留《甲乙经》作溜。上于本节《甲乙》作本指以下。注一支袁刻
误作一丈。本节后，袁刻脱后字。）以下内屈，与手少阴心主诸络会于鱼际，数脉并注，（上本
节已，方从本节以下内屈，与手少阴心主诸络会于鱼际，然后则与数络共为流注也。平按∶与手
少阴心主诸络《灵枢》、《甲乙经》作与诸阴络。又注与手少阴，与字袁刻误作于。）其气滑利，
伏行壅骨之下，外屈出于寸口而行，上至于肘内廉，入于大筋之下，内屈上行 阴，入掖下，内
屈走肺，（壅骨，谓手鱼骨也。 阴，谓手三阴脉行于 中，故曰 阴。其脉元出中焦，以是肺
脉，上属于肺，令从外还，俱至于肺，故手太阴经，上下常通，是动所生之病，疗此一经也。平
按∶外屈下《甲乙经》无出字，注云∶一本下有出字。）此顺行逆数之屈折也。（手太阴一经之
中，上下常行，名之为顺。数其屈折，从手向身，故曰逆数也。）心主之脉，出于中指之
端，内屈循中指内廉，以上留于掌中，伏行两骨之间，外屈其两筋之间，骨肉之际，其气滑利，
上行三寸，外屈行两筋之间，上至肘内廉，入于小筋之下，两骨之会，上入于胸中，内络心肺。
（心主之脉，从心包起，出于中指之端，即中指端内屈回，循中指内廉，上入胸中，内络心肺。
心主一经，上下恒通，是动所生，但疗此经。举手太阴、心主二经，余之十经顺行逆数例皆同也。
营卫之气，一日一夜行二十八脉五十周，如环无端，与正经异也。平按∶心主上《甲乙经》有手
字。外屈其，《灵枢》其作出，《甲乙经》无其字。上行三寸《灵枢》、《甲乙经》作上二寸。外
屈行《灵枢》作外屈出行，《甲乙经》注云∶一本有出字。两骨之会《灵枢》作留两骨之会，
《甲乙经》注云∶一本有留字。内络心肺《灵枢》作内络于心脉，《甲乙经》作内络心包。又注
与正经异，袁刻与作于，正作五。）黄帝曰∶手少阴之脉独无输何也？岐伯曰∶少阴，心脉也。
心者，五脏六腑之大主也，精神之舍也，其脏坚固，邪弗能客也，客之则心伤，心伤则神去，神
去则死矣。故诸邪之在于心者，皆在于心之包络，包络者，心主之脉也，故独无输焉。黄帝曰∶
少阴独无输者，不病乎？岐伯曰∶其外经病而脏不病，故独取其经于掌后兑骨之端。（其脏坚固
者，如五脏中心有坚脆。心脆者则善病消瘅，以不坚故善病消瘅，即是受邪。故知不受邪者，不
得多受外邪，至于饮食资心以致病者，不得无邪，所以少阴心之主所生病皆有疗也。又《明堂》
手少阴亦有五输主病，不得无输，即其信也。兑骨之端，手少阴输也。平按∶输《灵枢》作 ，
《甲乙经》作俞。大主也下《甲乙经》有为帝主三字。客《灵枢》、《甲乙经》作容，正统本
《甲乙经》作客。少阴独无输《甲乙经》作少阴脉独无俞。不病乎《甲乙经》作心不
病乎。兑骨《灵枢》作锐骨。）其余脉出入屈折，其行之徐疾，皆如手太阴、心主之脉行也。（余
谓十种经脉者也。平按∶屈折《甲乙经》作曲折。其行之徐疾《甲乙经》无此句。手太阴《灵枢》
作手少阴，《甲乙经》同，注云∶少阴，少字宜作太字。《铜人经》作厥字，正统本《甲乙经》
亦作厥。）故本输者，皆因其气之实虚疾徐以取之，是谓因冲而泻，因衰而补，如是者，邪气得
去，真气坚固，是谓因天之序。（因冲，冲，盛也。真气，和气也。是谓因天四时之序，得邪去
真存也。）
黄帝曰∶经脉十二，而手太阴、足少阴、阳明独动不休何也？（总问三脉常动之由。平按∶太
阴下《甲乙经》有之脉二字，无足少阴阳明五字。）岐伯曰∶足阳明，胃脉也。胃者，五脏六腑
之海也。（谷入于胃，变为糟粕、津液、宗气，分为三隧，泌津液注之于脉，化而为血，以营四
末，内注五脏六腑，以应刻数，名为营气。其出悍气 疾，先行四末分肉皮肤之间，昼夜不休者，
名为卫气。营出中焦，卫出上焦也。大气搏而不行，名为宗气，积于胸中，命曰气海，出于肺，循
喉咙，呼则出，吸则入也。故胃为五脏六腑之海也。平按∶足阳明《灵枢》作是明二字。）其清
气上注于肺，气从太阴而行之，（胃之清气，上注于肺，从手太阴一经之脉上下而行。平按∶肺
下《灵枢》、《甲乙经》重肺字。）其行也，以息往来。（其手太阴脉上下行也，要由胸中气海
之气，出肺循喉咙，呼出吸入，以息往来，故手太阴脉得上下行。）故人一呼脉再动，一吸脉亦
再动，呼吸不已，故动而不止。（脉，手太阴脉也。人受谷气，积于胸中，呼则推于手太阴，以
为二动，吸则引于手太阴，复为二动，命为气海，呼吸不已，故手太阴动不止也。）黄帝曰∶气
之过于寸口也，上焉息，下焉伏，何道从还？不知其极。（气
谓手太阴脉气，从手寸口上入肺而息，从肺下至手指而屈。伏，屈也。肺气循手太阴脉道下手至手
指端，还肺之时，为从本脉而还？为别有脉道还也？吾不知端极之也。平按∶“上焉息，下焉伏”
《灵枢》作“上十焉息，下八焉伏”，《甲乙经》作“上出焉息，下出焉伏”。）岐伯曰∶气之
离于脏也，卒如弓弩之发，如水之下崖，上于鱼以反衰，其余衰散以逆上，故其行微。（气，手
太阴脉气也。手太阴脉气，从胃中焦，上入于肺，下腋向手上鱼至少商之时，以乘脏腑盛气，如
弓弩之发机，比湍流之下岸，言其盛也。从少商返回，逆上向肺，虽从本脉而还，以去脏腑渐远，
其脏腑余气衰散，故其行迟微也。平按∶卒如《灵枢》、《甲乙经》作卒然如三字，袁刻作卒然
于三字。崖《灵枢》作岸，如水之下崖《甲乙经》作如水岸之下。其余衰散《灵枢》《甲乙经》
作其余气衰散。）黄帝曰∶足之阳明，何因而动？（十二经脉此皆有动，余之九经动有休时，唯
此三经常动不息，太阴常动已具前章，故次问阳明常动之义，故曰何因动也。平按∶何因《甲乙经》
作因何。）岐伯曰∶胃气上注于肺，（问曰∶十二经脉别走，皆从脏之阴络，别走之阳；亦从腑
之阳络，别走之阴。此之别走，乃别胃腑盛气，还走胃脉阳明经者何也？答曰∶胃者水谷之海，
五脏六腑皆悉禀之，别起一道之气合于阳明，故阳明得在经脉中长动，在结喉两箱，名曰人迎，
五脏六腑脉气并出其中，所以别走与余不同。平按∶肺《甲乙经》作胃。）其悍气上冲头者，循
咽上走空窍，（悍气冲时，循咽上走七窍，使七窍通明也。悍音汗。）循眼系入络脑，出颔下客
主人，循牙车合阳明，（复循眼系，络脑两箱，出于颔下。颔，谓牙车骨，属颅骨之下也。平按∶
颔《灵枢》作 。）并下人迎，此胃气别走于阳明者也。（足阳明经及别走气二脉并下以为人迎
也，故胃别气走阳明也。平按∶《甲乙经》无别字。）故
阴阳上下，其动也若一。（阴谓寸口，手太阴也；阳谓人迎，足阳明也。上谓人迎，下谓寸口，
有其二义∶人迎是阳，所以居上也；寸口是阴，所以居下也。又人迎在颈，所以为上；寸口在手，
所以为下。人迎寸口之动，上下相应俱来，譬之引绳，故若一也。所论人迎寸口，唯出黄帝正经，
计此之外，不可更有异端。近相传者，直以两手左右为人迎寸口，是则两手相望以为上下，竟无
正经可凭，恐误物深也。）故阳病而阳脉小者为逆，阴病而阴脉大者为逆。（阳大阴小，乃是阴
阳之性。阳病，人迎大小俱病，而大者为顺，小者为逆；阴病，寸口大小俱病，而小者为顺，大
者为逆。顺则易疗，逆则为难也。）故阴阳俱静与其动，若引绳相顿者，病也。（谓人迎寸口之
脉乍静乍躁，若引绳相顿乍动乍静者，病也。平按∶阴阳俱静与其动《灵枢》作阴阳俱静俱动，
《甲乙经》作阴阳俱盛与其俱动。又《灵枢》、《甲乙经》顿均作倾。）黄帝曰∶足少阴何因而动？
（已言阳明常动于前，次论足少阴脉动不休也。平按∶何因《甲乙经》作因何。）岐伯曰∶冲脉
者，十二经之海也，与少阴之大络，起于肾下，出于气街，循阴股内廉，邪入 中，循胫骨内廉，
并少阴之经，下入内踝之后，入足下；其别者，邪入踝，出属、跗上，入大指之间，注诸络以温
足胫，此脉之常动者也。（少阴正经，从足心上内踝之后，上行循胫向肾。冲脉起于肾下，与少
阴大络下行出气街，循胫入内踝，后下入足下。按《逆顺肥瘦》少阴独下中云∶注少阴大络。若
尔，则冲脉共少阴常动也。若取与少阴大络俱下，则是冲脉常动，少阴不能动也。平按∶《甲乙经》
邪作斜，胫骨作 骨，足胫作足跗。注少阴正经，袁刻经作阴。）黄帝曰∶营卫之行也，上下相贯，
如环之毋端。今有其卒然遇邪气，及逢大寒，手足懈惰，其脉阴阳之道，相输之会，行
相失也，气何由得还？（营行手太阴，下至手大指次指之端，回为手阳明，上行至头，下足阳明，
如此十二经脉，阴阳相贯，如环无端也。卒有邪气及寒，客于四肢，阴阳相输之道不通，何由还
也？平按∶营卫《甲乙经》作卫气，懈惰作不随。得还，得字《灵枢》、《甲乙经》均无。）岐
伯曰∶夫四末阴阳之会者，此气之大络也。四街者，气之径也。故络绝则经通，四末解则气从合，
相输如环。（四末，谓四肢，身之末也。四街，谓胸腹头 脉气道也。邪气大寒客于四末，先客络
脉，络脉虽壅，内经尚通，故气相输如环，寒邪解已，复得通也。平按∶气之径《灵枢》作气之
径路，《甲乙》作气之经，注∶经一作径。正统本《甲乙经》作径。相输袁刻作相辅，注同。）
黄帝曰∶善。此所谓如环之毋端，莫知其纪，终而复始之谓也。（述其所解。）
【平按】：本篇从开头至“因天之序”，见于《灵枢》卷十第七十一《邪客》篇。从“手太阴之脉”至“逆数之曲折也”，见于《甲乙经》卷三第二十四。又从“心主之脉”至“内络心肺”，见于《甲乙经》卷三第二十五。从“黄帝曰手少阴”至“因天之叙”，见于《甲乙经》卷三第二十六。从“黄帝曰经脉十二”至末尾，见于《灵枢》卷九第六十二《动输》篇，又见于《甲乙经》卷二第一下编。
黄帝问岐伯说：脉道的弯曲转折，出入的部位，从哪里出来，到哪里停止，哪里运行缓慢，哪里运行迅速，从哪里进入？六腑在体表的腧穴，我希望详尽地听闻它们的次序。（提出五个方面的问题，询问五脏脉道运行的部位，并询问身体六腑的腧穴。平按：其中的次序，《灵枢》作“少序”。）分离的地方，离而进入阴分，别而行于阳分，都遵循什么道路行走？希望听闻其方法。岐伯回答说：问得多么深奥啊，道理多么明白啊。（询问阴阳二脉离合的地方。平按：《灵枢》中“别而行阳”作“别而入阳”，“皆何道从行”作“此何道而从行”，“窘乎哉问……”这两句作“帝之所问，针道毕矣”两句。）黄帝说：我希望彻底地听闻它。岐伯说：手太阴肺经的脉气，出于大拇指的末端，向内弯曲循行于白肉际，到达本节之后的太渊穴，停留以形成滑利之气，向外弯曲上行至本节，（手太阴脉，从内脏行至腕后，一支向上到大指和次指的末端，变为手阳明脉；其本源从腕后上行至鱼际，循鱼际出大拇指的末端，即指端向内弯曲回返，循大指白肉至本节后太渊穴处，停留成为滑利而动，然后外出上行至本节。澹，音同滥。平按：“内屈”，《甲乙经》作“内侧”。“循白肉”，《灵枢》、《甲乙经》均作“循白肉际”，“太泉”均作“太渊”，唐人避讳“渊”字写作“泉”，说法见前文。“留”，《甲乙经》作“溜”。“上于本节”，《甲乙经》作“本指以下”。注中“一支”袁刻误作“一丈”。“本节后”，袁刻脱漏“后”字。）向下向内弯曲，与手少阴心包经及诸络脉会合于鱼际，多条脉气并注，（到达本节以上后，才从本节以下向内弯曲，与手少阴心包经及诸络脉会合于鱼际，然后才与多条络脉共同流注。平按：“与手少阴心主诸络”，《灵枢》、《甲乙经》作“与诸阴络”。又注中“与手少阴”，“与”字袁刻误作“于”。）脉气滑利，伏行于手鱼骨之下，向外弯曲出于寸口而运行，上行至于肘内廉，进入大筋之下，向内弯曲上行于阴分，进入腋下，向内弯曲走向肺脏，（壅骨，指的是手鱼骨。阴分，指的是手三阴脉行于其中，所以叫阴分。其脉原本出自中焦，因为是肺脉，上属于肺，让它从外部返回，都至于肺，所以手太阴经，上下常通，是动所生的病，治疗这一条经即可。平按：“外屈”下《甲乙经》无“出”字，注云：一本下有“出”字。）这就是顺行逆数的屈折。（手太阴一经之中，上下常行，叫做顺。数它的屈折，从手向身，所以叫逆数。）心包经的脉气，出于中指末端，向内弯曲循行于中指内廉，向上停留于掌中，伏行于两骨之间，向外弯曲于两筋之间，骨肉之际，脉气滑利，上行三寸，向外弯曲行于两筋之间，上行至肘内廉，进入小筋之下，两骨交会之处，向上进入胸中，向内联络心肺。（心包经的脉气，从心包起始，出于中指末端，即中指端向内弯曲回返，循中指内廉，上行入胸中，向内联络心肺。心包一经，上下恒通，是动所生，只治疗这条经。举出手太阴、心主二经为例，其余十经顺行逆数的规律都相同。营卫之气，一天一夜运行二十八脉五十周，如环无端，与正经不同。平按：“心主上”，《甲乙经》有“手”字。“外屈其”，《灵枢》“其”作“出”，《甲乙经》无“其”字。“上行三寸”，《灵枢》、《甲乙经》作“上二寸”。“外屈行”，《灵枢》作“外屈出行”，《甲乙经》注云：一本有“出”字。“两骨之会”，《灵枢》作“留两骨之会”，《甲乙经》注云：一本有“留”字。“内络心肺”，《灵枢》作“内络于心脉”，《甲乙经》作“内络心包”。又注中“与正经异”，袁刻“与”作“于”，“正”作“五”。）
黄帝说：手少阴心经唯独没有腧穴，为什么呢？岐伯说：少阴，是心脉。心，是五脏六腑的大主，是精神的居所，它的脏器坚固，邪气不能侵入，如果侵入就会伤心，心伤则神去，神去就会死亡。所以各种邪气在心部的，都在心包络，心包络，就是心主之脉，所以唯独没有腧穴。黄帝说：少阴唯独没有腧穴，是不生病吗？岐伯说：它的外经有病而内脏不病，所以唯独取用手掌后方兑骨端的腧穴。（它的脏器坚固，就像五脏中心脏有坚脆之分。心脏脆弱的人就容易患消瘅病，因为不坚固所以容易患消瘅病，这就是受邪。所以知道不受邪的，不会多受外邪，至于饮食滋养心脏导致疾病的，也不是没有邪气，所以少阴心之主所生的病都有治疗的方法。又《明堂》中手少阴也有五输穴主治疾病，不能说没有腧穴，这是确凿的证据。兑骨之端，是手少阴的输穴。平按：“输”，《灵枢》作“腧”，《甲乙经》作“俞”。“大主也”下《甲乙经》有“为帝主”三字。“客”，《灵枢》、《甲乙经》作“容”，正统本《甲乙经》作“客”。“少阴独无输”，《甲乙经》作“少阴脉独无俞”。“不病乎”，《甲乙经》作“心不病乎”。“兑骨”，《灵枢》作“锐骨”。）其余脉道的出入屈折，它们运行的快慢，都像手太阴、心主之脉的运行一样。（余，指的是十种经脉。平按：“屈折”，《甲乙经》作“曲折”。“其行之徐疾”，《甲乙经》无此句。“手太阴”，《灵枢》作“手少阴”，《甲乙经》同，注云：少阴，“少”字宜作“太”字。《铜人经》作“厥”字，正统本《甲乙经》也作“厥”。）所以本输穴，都是根据气的虚实快慢来选取的，这叫做因势而泻，因衰而补，像这样，邪气得以去除，真气坚固，这叫做顺应自然的次序。（因冲，冲，盛也。真气，和气也。这叫做顺应天四时的次序，使邪去真存。）
黄帝说：经脉十二条，为什么手太阴、足少阴、足阳明唯独跳动不停止呢？（总问三条脉常动的原因。平按：“太阴”下《甲乙经》有“之脉”二字，无“足少阴阳明”五字。）岐伯说：足阳明，是胃脉。胃，是五脏六腑的海。（谷食进入胃中，变为糟粕、津液、宗气，分为三条通道，泌出津液注入脉中，化而为血，以营养四肢末端，向内注入五脏六腑，以应合刻漏之数，叫做营气。其中悍气急疾，先行于四肢分肉皮肤之间，昼夜不停止的，叫做卫气。营气出于中焦，卫气出于上焦。大气搏结而不行，叫做宗气，积聚于胸中，名叫气海，出于肺，循喉咙，呼则出，吸则入。所以胃是五脏六腑的海。平按：“足阳明”，《灵枢》作“是明”二字。）胃中的清气上注于肺，气从太阴脉运行，（胃的清气，上注于肺，从手太阴一经的脉上下而行。平按：“肺”下《灵枢》、《甲乙经》重“肺”字。）它的运行，随着呼吸往来。（手太阴脉上下行，要靠胸中气海之气，出肺循喉咙，呼出吸入，随着呼吸往来，所以手太阴脉得以上下行。）所以人每呼一次脉跳两次，每吸一次脉也跳两次，呼吸不停，所以脉动不止。（脉，指手太阴脉。人受谷气，积聚于胸中，呼则推于手太阴，作为两次跳动，吸则引于手太阴，又作为两次跳动，命名为气海，呼吸不停，所以手太阴动不止。）黄帝说：气经过寸口的时候，向上到哪里息止，向下在哪里潜伏，从什么道路返回？不知道它的极致。（气指手太阴脉气，从手寸口上入肺而息，从肺下至手指而屈。伏，即屈。肺气循手太阴脉道下手至手指端，还肺之时，是从本脉返回？还是有别的脉道返回？我不知道它的端极所在。平按：“上焉息，下焉伏”，《灵枢》作“上十焉息，下八焉伏”，《甲乙经》作“上出焉息，下出焉伏”。）岐伯说：气离开脏的时候，突然像弓弩发射，像水从悬崖落下，上行至鱼际后反而衰减，其余的衰减散乱而逆向上行，所以运行微弱。（气，指手太阴脉气。手太阴脉气，从胃中焦，上入于肺，下腋向手上鱼至少商穴时，凭借脏腑盛气，像弓弩发射机关，比湍流下岸，形容其盛。从少商返回，逆向上行向肺，虽然从本脉而还，但因为远离脏腑，脏腑余气衰散，所以运行迟微。平按：“卒如”，《灵枢》、《甲乙经》作“卒然如”三字，袁刻作“卒然于”三字。“崖”，《灵枢》作“岸”，“如水之下崖”，《甲乙经》作“如水岸之下”。“其余衰散”，《灵枢》《甲乙经》作“其余气衰散”。）
黄帝说：足阳明，是什么原因而动？（十二经脉此处都有动，其余九经动有休止之时，唯独这三经常动不息，太阴常动已在前面章节具备，所以接着问阳明常动的意义，所以说何因动。平按：“何因”，《甲乙经》作“因何”。）岐伯说：胃气上注于肺，（问：十二经脉别走，都从脏的阴络，别走之阳；也从腑的阳络，别走之阴。这里的别走，乃是别胃腑盛气，还走胃脉阳明经的是什么原因？答：胃是水谷之海，五脏六腑都禀受它，别起一道的气合于阳明，所以阳明能在经脉中长动，在结喉两侧，名叫人迎，五脏六腑脉气并出其中，所以别走与其他不同。平按：“肺”，《甲乙经》作“胃”。）它的悍气上冲头部，循咽向上走入空窍，（悍气冲时，循咽向上走入七窍，使七窍通明。悍音汗。）循眼系进入联络脑部，出于颔下客主人穴，循牙车合于阳明，（又循眼系，络脑两侧，出于颔下。颔，指牙车骨，属颅骨之下。平按：“颔”，《灵枢》作“𦟌”。）并下行人迎，这是胃气别走于阳明的。（足阳明经及别走气二脉并下以为人迎，所以胃别气走阳明。平按：《甲乙经》无“别”字。）所以阴阳上下，它们的跳动是一致的。（阴指寸口，手太阴；阳指人迎，足阳明。上指人迎，下指寸口，有两层含义：人迎是阳，所以居上；寸口是阴，所以居下。又人迎在颈，所以上；寸口在手，所以下。人迎寸口的动，上下相应俱来，像拉绳子一样，所以一致。所论人迎寸口，只出自黄帝正经，估计除此之外，不可能再有异端。近世相传者，直接把两手左右作为人迎寸口，这是两手相望以为上下，最终没有正经可凭，恐怕误导人很深。）所以阳病而阳脉小的是逆证，阴病而阴脉大的是逆证。（阳大阴小，是阴阳的本性。阳病，人迎大小俱病，而大者为顺，小者为逆；阴病，寸口大小俱病，而小者为顺，大为逆。顺则易治，逆则难治。）所以阴阳都静或都动，像拉绳子相顿挫一样，是病。（指人迎寸口的脉乍静乍躁，像拉绳子相顿挫乍动乍静的，是病。平按：“阴阳俱静与其动”，《灵枢》作“阴阳俱静俱动”，《甲乙经》作“阴阳俱盛与其俱动”。又《灵枢》、《甲乙经》“顿”均作“倾”。）
黄帝说：足少阴是什么原因而动？（已说阳明常动在前，接着论足少阴脉动不休。平按：“何因”，《甲乙经》作“因何”。）岐伯说：冲脉，是十二经的海，与少阴的大络，起于肾下，出于气街，循大腿内侧，斜入腘中，循胫骨内廉，并少阴之经，下入内踝之后，入足底；它的别支，斜入踝部，出属跗上，入大指之间，注入诸络以温暖足胫，这是脉常动的。（少阴正经，从足心上内踝之后，上行循胫向肾。冲脉起于肾下，与少阴大络下行出气街，循胫入内踝，后下入足底。按《逆顺肥瘦》少阴独下中说：注少阴大络。如果是这样，那么冲脉共少阴常动。如果取与少阴大络俱下，则是冲脉常动，少阴不能动。平按：《甲乙经》“邪”作“斜”，“胫骨”作“䯒骨”，“足胫”作“足跗”。注少阴正经，袁刻“经”作“阴”。）
黄帝说：营卫的运行，上下贯穿，如环无端。现在如果遇到邪气，以及遇到大寒，手足懈怠懒惰，它们的脉阴阳之道，相互输送的会合处，运行失去联系，气如何能返回？（营行手太阴，下至手大指次指的末端，回为手阳明，上行至头，下足阳明，如此十二经脉，阴阳相贯，如环无端。突然有邪气及寒，客于四肢，阴阳相输之道不通，如何返回？平按：“营卫”，《甲乙经》作“卫气”，“懈惰”作“不随”。“得还”，“得”字《灵枢》、《甲乙经》均无。）岐伯说：四肢是阴阳交会的地方，这是气的大络。四街，是气的径路。所以络脉绝则经气通，四肢舒缓则气从合，相互输送如环。（四末，指四肢，身体的末端。四街，指胸腹头颈脉气道。邪气大寒客于四末，先客络脉，络脉虽壅塞，内经尚通，所以气相输如环，寒邪解除后，重新通畅。平按：“气之径”，《灵枢》作“气之径路”，《甲乙》作“气之经”，注：经一作径。正统本《甲乙经》作“径”。相输，袁刻作“相辅”，注同。）
黄帝说：好。这就是所说的如环无端，不知道它的纪纲，终而复始的意思。（陈述其解释。）
[Ping An]: This section from the beginning to "following the order of Heaven" is found in *Ling Shu* (Spiritual Pivot), Volume 10, Chapter 71, "Xie Ke" (Evil Guests). From "The meridian of Hand-Taiyin" to "the tortuous turns counted inversely," it is found in *Jia Yi Jing* (Classified Classic of Acupuncture and Moxibustion), Volume 3, Section 24. Also, from "The meridian of Heart-Master" to "internally connecting to the Heart and Lungs," it is found in *Jia Yi Jing*, Volume 3, Section 25. From "Huang Di said: The meridian of Hand-Shaoyin" to "following the order of Heaven," it is found in *Jia Yi Jing*, Volume 3, Section 26. From "Huang Di said: There are twelve meridians" to the end, it is found in *Ling Shu*, Volume 9, Chapter 62, "Dong Shu" (Moving and Transmitting), and also in *Jia Yi Jing*, Volume 2, Part 1, Lower Compilation.
Huang Di asked Qi Bo: Regarding the tortuous turns of the meridians and their points of entry and exit, where do they emerge, where do they stop, where do they move slowly, where do they move quickly, and where do they enter? I wish to hear in detail the sequence of the acupoints of the Six Fu organs on the body. (This raises five questions, asking about the locations where the meridians of the Five Zang organs travel, and also asking about the acupoints of the Six Fu organs on the body. Ping An: The term "sequence" in *Ling Shu* is written as "shao xu".) At the points of separation, some branches enter Yin, while others travel along Yang. Through which pathways do they proceed? I wish to hear the method. Qi Bo replied: How profound your question is! How clear is this principle! (Asking about the places where the Yin and Yang meridians separate and merge. Ping An: In *Ling Shu*, "travel along Yang" is written as "enter into Yang"; "through which pathways do they proceed" is written as "through which pathway does one proceed"; the two sentences "How profound your question... " are written as "What the Emperor asks, the Dao of needle therapy completes".) Huang Di said: I wish to hear it completely. Qi Bo said: The meridian of Hand-Taiyin Lung emerges from the tip of the thumb, curves inward along the white flesh margin, reaches Taiyuan (LU-9) behind the proximal interphalangeal joint, stays there to generate a smooth flow, curves outward and ascends to the proximal joint, (The Hand-Taiyin meridian travels from the interior organs to the wrist; one branch goes up to the tips of the thumb and index finger, transforming into the Hand-Yangming meridian; its root travels from the wrist up to the thenar eminence, follows the fish border, and exits at the tip of the thumb. That is, at the tip of the finger, it curves inward, follows the white flesh of the thumb to Taiyuan behind the proximal joint, stays to become smooth and moving, then exits and ascends to the proximal joint. Dan, pronounced like lan. Ping An: "Curves inward" in *Jia Yi Jing* is written as "inner side". "Follows white flesh" in *Ling Shu* and *Jia Yi Jing* is written as "follows the white flesh margin". "Tai Quan" is written as "Tai Yuan" in both; Tang dynasty people avoided the character Yuan by writing Quan, see previous notes. "Stays" in *Jia Yi Jing* is written as "liu". "Ascends to the proximal joint" in *Jia Yi Jing* is written as "below the proximal finger". Note: "One branch" in Yuan edition is mistakenly written as "one zhang". "Behind the proximal joint", Yuan edition omits "behind".) It curves downward and inward, meeting the meridians and collateral vessels of Hand-Shaoyin Pericardium and others at the thenar eminence, with multiple pulses merging together, (After reaching above the proximal joint, it then curves downward and inward from the proximal joint, meeting the meridians and collateral vessels of Hand-Shaoyin Pericardium and others at the thenar eminence, and then flows together with multiple collaterals. Ping An: "With the meridians and collateral vessels of Hand-Shaoyin Pericardium" in *Ling Shu* and *Jia Yi Jing* is written as "with the Yin collateral vessels". Also in the note, "With Hand-Shaoyin", the character "Yu" is mistakenly written as "Yu" in Yuan edition.) The qi is smooth and slippery, running deep below the carpometacarpal bone of the thumb, curving outward to emerge at the Cun Kou pulse point and traveling, ascending to the medial aspect of the elbow, entering below the large tendon, curving inward and ascending through the Yin regions, entering the axilla, curving inward to travel to the Lung, (Yong Gu refers to the carpometacarpal bone of the thumb. Yin region refers to where the three Yin meridians of the hand travel, hence called Yin region. The meridian originally originates from the Middle Jiao; since it is the Lung meridian, it connects upward to the Lung, allowing it to return from the exterior. All reach the Lung, so the Hand-Taiyin meridian is constantly connected above and below. Diseases arising from movement or generation are treated by focusing on this single meridian. Ping An: Below "curves outward", *Jia Yi Jing* lacks the character "chu"; the note says: another version has the character "chu".) This is the tortuous turning described as forward movement and inverse counting. (Within the single meridian of Hand-Taiyin, constant movement above and below is called forward. Counting its tortuous turns from hand towards body is called inverse counting.) The meridian of Heart-Master (Pericardium) emerges from the tip of the middle finger, curves inward along the medial aspect of the middle finger, ascends and stays in the palm, runs deep between two bones, curves outward between two tendons at the junction of bone and flesh, the qi is smooth and slippery, ascends three cun, curves outward between two tendons, ascends to the medial aspect of the elbow, enters below the small tendon at the meeting of two bones, ascends into the chest, and internally connects to the Heart and Lungs. (The meridian of Heart-Master starts from the Pericardium, emerges from the tip of the middle finger, i.e., at the tip of the middle finger it curves inward, follows the medial aspect of the middle finger, ascends into the chest, and internally connects to the Heart and Lungs. The single meridian of Heart-Master is constantly connected above and below; diseases arising from movement or generation are treated by focusing on this meridian. Taking Hand-Taiyin and Heart-Master as examples, the principles of forward movement and inverse counting for the other ten meridians are the same. Ying and Wei qi circulate through twenty-eight meridians fifty times in one day and night, like a ring without end, differing from the regular meridians. Ping An: "Heart-Master ascends" in *Jia Yi Jing* has the character "Shou". "Outwardly curves its" in *Ling Shu* "Qi" is written as "Chu", *Jia Yi Jing* lacks "Qi". "Ascends three cun" in *Ling Shu* and *Jia Yi Jing* is written as "ascends two cun". "Outwardly curves travel" in *Ling Shu* is written as "outwardly curves out travel", *Jia Yi Jing* note says: another version has the character "Chu". "Meeting of two bones" in *Ling Shu* is written as "stays at the meeting of two bones", *Jia Yi Jing* note says: another version has the character "Liu". "Internally connects to Heart and Lungs" in *Ling Shu* is written as "internally connects to Heart vessels", *Jia Yi Jing* is written as "internally connects to Pericardium". Also in the note, "Differs from regular meridians", Yuan edition "Yu" is written as "Yu", "Zheng" is written as "Wu".)
Huang Di said: Why does the meridian of Hand-Shaoyin Heart alone lack acupoints? Qi Bo said: Shaoyin is the Heart meridian. The Heart is the great master of the Five Zang and Six Fu organs, the residence of the Spirit. Its organ is solid, so evil qi cannot invade it. If it invades, it injures the Heart; if the Heart is injured, the Spirit departs; if the Spirit departs, death occurs. Therefore, any evil qi located in the Heart is actually in the Pericardium Luo. The Pericardium Luo is the meridian of the Heart-Master, so it alone lacks acupoints. Huang Di said: Since Shaoyin alone lacks acupoints, does it not get sick? Qi Bo said: Its external meridian may be diseased while the internal organ remains healthy, so one should exclusively select the acupoint at the end of the Rui Gu (sharp bone) behind the palm. (Its organ is solid, just as among the Five Zang organs, the Heart has variations in firmness and fragility. Those with a fragile Heart easily suffer from Xiao Shan (wasting-thirst), because fragility leads to susceptibility to disease, which means receiving evil. Thus, knowing that it does not receive evil means it does not easily receive external evil. As for diseases caused by diet nourishing the Heart, there is still evil involved, so the diseases generated by the master of Shaoyin Heart all have treatments. Also, in *Ming Tang*, Hand-Shaoyin has five Shu points governing diseases, so one cannot say there are no acupoints; this confirms it. The end of Rui Gu is the Shu point of Hand-Shaoyin. Ping An: "Shu" in *Ling Shu* is written as "Shu", *Jia Yi Jing* is written as "Yu". After "Great Master", *Jia Yi Jing* has the characters "Wei Di Zhu". "Ke" in *Ling Shu* and *Jia Yi Jing* is written as "Rong", orthodox edition of *Jia Yi Jing* is written as "Ke". "Shaoyin alone lacks Shu" in *Jia Yi Jing* is written as "Shaoyin meridian alone lacks Yu". "Bu Bing Hu" in *Jia Yi Jing* is written as "Xin Bu Bing Hu". "Rui Gu" in *Ling Shu* is written as "Rui Gu".) The entry, exit, and tortuous turns of the remaining meridians, and their speed of movement, are all like the movement of the Hand-Taiyin and Heart-Master meridians. (Remaining refers to the ten types of meridians. Ping An: "Qu Zhe" in *Jia Yi Jing* is written as "Qu Zhe". "Its movement's slowness and speed" is absent in *Jia Yi Jing*. "Hand-Taiyin" in *Ling Shu* is written as "Hand-Shaoyin", same in *Jia Yi Jing*, note says: for Shaoyin, the character "Shao" should be "Tai". *Tong Ren Jing* writes "Jue", orthodox edition of *Jia Yi Jing* also writes "Jue".) Therefore, the Ben Shu (Original Acupoints) are selected based on the excess or deficiency and speed of the qi, which is called draining according to fullness and tonifying according to deficiency. In this way, evil qi is expelled, and true qi becomes solid. This is called following the order of Heaven. (Following Chong, Chong means abundance. Zhen Qi means harmonious qi. This is called following the order of the four seasons of Heaven, causing evil to leave and truth to remain.)
Huang Di said: There are twelve meridians, but why do only Hand-Taiyin, Foot-Shaoyin, and Foot-Yangming move continuously without rest? (Generally asking the reason for the constant movement of these three meridians. Ping An: After "Taiyin", *Jia Yi Jing* has the characters "Zhi Mai", lacking the five characters "Zu Shao Yin Yang Ming".) Qi Bo said: Foot-Yangming is the Stomach meridian. The Stomach is the sea of the Five Zang and Six Fu organs. (Grain enters the Stomach, transforms into dregs, fluids, and Zong Qi, dividing into three tunnels. Secreted fluids are injected into the vessels, transforming into blood to nourish the four extremities, and internally inject into the Five Zang and Six Fu organs to correspond to the clepsydra time, named Ying Qi. Among them, Han Qi is fierce and rapid, first traveling between the muscles and skin of the four extremities, ceaselessly day and night, named Wei Qi. Ying Qi originates from the Middle Jiao, Wei Qi originates from the Upper Jiao. Great Qi gathers and does not move, named Zong Qi, accumulating in the chest, called Qi Sea, emerging from the Lung, following the throat, exiting on exhalation, entering on inhalation. Thus, the Stomach is the sea of the Five Zang and Six Fu organs. Ping An: "Foot-Yangming" in *Ling Shu* is written as "Shi Ming" two characters.) The clear qi of the Stomach ascends and pours into the Lung, and the qi travels via the Taiyin meridian, (The clear qi of the Stomach ascends and pours into the Lung, traveling up and down via the single meridian of Hand-Taiyin. Ping An: After "Lung", *Ling Shu* and *Jia Yi Jing* repeat the character "Lung".) Its movement depends on the coming and going of respiration. (The movement of the Hand-Taiyin meridian up and down relies on the qi of the Qi Sea in the chest, emerging from the Lung, following the throat, exiting on exhalation and entering on inhalation, moving with respiration, thus allowing the Hand-Taiyin meridian to travel up and down.) Therefore, when a person exhales once, the pulse moves twice; when inhaling once, the pulse also moves twice. Since respiration never ceases, the pulse movement never stops. (Pulse refers to the Hand-Taiyin pulse. Humans receive grain qi, accumulating in the chest. Exhalation pushes it to Hand-Taiyin, resulting in two movements; inhalation draws it to Hand-Taiyin, resulting in two more movements, named Qi Sea. Since respiration never ceases, the Hand-Taiyin pulse never stops moving.) Huang Di said: When the qi passes over Cun Kou, where does it go up to rest, and where does it hide below? Through what path does it return? I do not know its ultimate limit. (Qi refers to Hand-Taiyin meridian qi, rising from Cun Kou of the hand into the Lung to rest, descending from the Lung to the fingers to curve. Fu means curve. Lung qi follows the Hand-Taiyin meridian path down to the fingertips, and when returning to the Lung, is it returning via the original meridian or via another meridian path? I do not know the ultimate origin. Ping An: "Shang Yan Xi, Xia Yan Fu" in *Ling Shu* is written as "Shang Shi Yan Xi, Xia Ba Yan Fu", in *Jia Yi Jing* is written as "Shang Chu Yan Xi, Xia Chu Yan Fu".) Qi Bo said: When qi leaves the Zang organs, it suddenly acts like the release of a crossbow or water falling from a cliff. It rises to the thenar eminence and then weakens; the remaining weakened and scattered qi moves inversely upward, so its movement is slight. (Qi refers to Hand-Taiyin meridian qi. Hand-Taiyin meridian qi, from the Middle Jiao of the Stomach, ascends into the Lung, descends under the armpit to the hand's thenar eminence and reaches Shaoshang. At this time, relying on the abundant qi of the Zang organs, it is like the release of a crossbow trigger, compared to rapids flowing down a bank, describing its abundance. Returning from Shaoshang, moving inversely upward toward the Lung, although returning via the original meridian, because it gradually moves away from the Zang organs, the residual qi of the Zang organs scatters and weakens, so its movement is slow and slight. Ping An: "Ru Ru" in *Ling Shu* and *Jia Yi Jing* is written as "Ru Ran Ru" three characters, Yuan edition writes "Ru Ran Yu" three characters. "Ya" in *Ling Shu* is written as "An", "Like water falling from Ya" in *Jia Yi Jing* is written as "Like water bank falling down". "Its remaining weakening and scattering" in *Ling Shu* and *Jia Yi Jing* is written as "Its remaining qi weakening and scattering".)
Huang Di said: What causes Foot-Yangming to move? (All twelve meridians here have movement; the other nine meridians have periods of rest, but these three are constantly active without stopping. Taiyin's constant movement was already detailed in the previous chapter, so next we ask about the meaning of Yangming's constant movement, hence saying "What causes movement". Ping An: "He Yin" in *Jia Yi Jing* is written as "Yin He".) Qi Bo said: Stomach qi ascends and pours into the Lung, (Question: The twelve meridians branch off, all going from the Yin collaterals of the Zang to the Yang; also from the Yang collaterals of the Fu to the Yin. This branching off is specifically taking the abundant qi of the Stomach Fu and returning to travel the Stomach meridian Foot-Yangming. Why? Answer: The Stomach is the sea of water and grain; the Five Zang and Six Fu all rely on it. A separate channel of qi arises and combines with Yangming, so Yangming can move continuously within the meridians. Located on both sides of the larynx, it is named Ren Ying. The pulse qi of the Five Zang and Six Fu all emerge from it, so its branching differs from the rest. Ping An: "Fei" in *Jia Yi Jing* is written as "Wei".) Its Han Qi rushes upward to the head, following the pharynx and ascending to enter the orifices, (When Han Qi rushes, it follows the pharynx and ascends to enter the seven orifices, making them clear. Han sounds like Han.) Following the eye system to connect to the brain, emerging below the jaw at the Keyrenman acupoint, following the masseter muscle to combine with Yangming, (Again following the eye system, connecting to both sides of the brain, emerging below the jaw. Han refers to the masseter bone, belonging below the skull. Ping An: "Han" in *Ling Shu* is written as "𦟌".) descending together to Ren Ying, this is Stomach qi branching off to travel to Yangming. (Foot-Yangming meridian and the two channels of branching-off qi descend together to form Ren Ying, thus Stomach's separate qi travels to Yangming. Ping An: *Jia Yi Jing* lacks the character "Bie".) Therefore, Yin and Yang above and below, their movement is consistent. (Yin refers to Cun Kou, Hand-Taiyin; Yang refers to Ren Ying, Foot-Yangming. Up refers to Ren Ying, Down refers to Cun Kou. There are two meanings: Ren Ying is Yang, so it resides above; Cun Kou is Yin, so it resides below. Also, Ren Ying is in the neck, so it is up; Cun Kou is in the hand, so it is down. The movement of Ren Ying and Cun Kou corresponds above and below simultaneously, like pulling a rope, thus consistent. The discussion of Ren Ying and Cun Kou comes only from the orthodox Yellow Emperor classics; estimating beyond this, there cannot be other heterodoxies. Recent transmissions directly take the left and right hands as Ren Ying and Cun Kou, which regards the two hands as looking at each other for up and down, ultimately having no orthodox classic to rely on, likely misleading people deeply.) Therefore, if Yang disease presents with a small Yang pulse, it is a reversal (Ni); if Yin disease presents with a large Yin pulse, it is a reversal. (Yang large and Yin small are the nature of Yin and Yang. For Yang disease, if both Ren Ying sizes are diseased, large is Shun (smooth/favorable), small is Ni (reversal/unfavorable); for Yin disease, if both Cun Kou sizes are diseased, small is Shun, large is Ni. Shun is easy to treat, Ni is difficult.) Therefore, if Yin and Yang are both quiet or both active, like a rope being pulled taut and jerking, it is disease. (Refers to the pulses of Ren Ying and Cun Kou alternating between quiet and agitated, like a rope being pulled taut and jerking, alternating between movement and stillness, indicating disease. Ping An: "Yin Yang Ju Jing Yu Qi Dong" in *Ling Shu* is written as "Yin Yang Ju Jing Ju Dong", in *Jia Yi Jing* is written as "Yin Yang Ju Sheng Yu Qi Ju Dong". Also, "Dun" in *Ling Shu* and *Jia Yi Jing* is written as "Qing".)
Huang Di said: What causes Foot-Shaoyin to move? (Having spoken of Yangming's constant movement previously, now discussing Foot-Shaoyin meridian's ceaseless movement. Ping An: "He Yin" in *Jia Yi Jing* is written as "Yin He".) Qi Bo said: Chong Mai (Penetrating Vessel) is the sea of the twelve meridians. It originates from below the Kidney with the large Luo vessel of Shaoyin, emerges from Qichong, follows the medial aspect of the inner thigh, obliquely enters the popliteal fossa, follows the medial aspect of the tibia, runs parallel with the Shaoyin meridian, descends behind the medial malleolus, and enters the sole of the foot; its branch obliquely enters the ankle, emerges on the dorsum of the foot, enters between the big toe, and pours into the various collaterals to warm the lower leg and shin. This is the meridian that constantly moves. (The regular Shaoyin meridian ascends from the sole of the foot, behind the medial malleolus, following the tibia towards the Kidney. Chong Mai originates from below the Kidney, descends with the large Luo vessel of Shaoyin, emerges from Qichong, follows the tibia, enters the medial malleolus, and descends into the sole. According to "Ni Shun Fei Shou" regarding Shaoyin descending alone: "Injects into the large Luo of Shaoyin." If so, then Chong Mai and Shaoyin move constantly together. If taken as descending together with the large Luo of Shaoyin, then Chong Mai moves constantly, and Shaoyin cannot move. Ping An: In *Jia Yi Jing*, "Xie" is written as "Xie", "Tibia" is written as "Ci Gu", "Lower leg" is written as "Zu Fu". Note: Regular Shaoyin meridian, Yuan edition "Jing" is written as "Yin".)
Huang Di said: The circulation of Ying and Wei qi penetrates up and down like a ring without end. Now, if suddenly encountering evil qi, or meeting severe cold, causing the limbs to become flaccid and lazy, their Yin and Yang meridian pathways, the intersections of mutual transmission, lose their connection. How can the qi return? (Ying travels Hand-Taiyin, descending to the tip of the index finger, returning as Hand-Yangming, ascending to the head, descending to Foot-Yangming. Thus, the twelve meridians, Yin and Yang interpenetrating, form a ring without end. Suddenly having evil qi and cold, lodging in the four limbs, the pathway of Yin-Yang mutual transmission is blocked, how can it return? Ping An: "Ying Wei" in *Jia Yi Jing* is written as "Wei Qi", "Xie Duo" is written as "Bu Sui". "De Huan", the character "De" is absent in *Ling Shu* and *Jia Yi Jing*.) Qi Bo said: The four extremities are the meeting place of Yin and Yang, this is the great Luo of qi. Si Jie (Four Streets) are the pathways of qi. Therefore, if the Luo vessels are severed, the Jing meridians remain open; if the four extremities relax, the qi converges, transmitting mutually like a ring. (Si Mo refers to the four limbs, the ends of the body. Si Jie refers to the meridian pathways of the chest, abdomen, head, and neck. Evil qi and severe cold lodge in the four extremities, first lodging in the Luo vessels. Although the Luo vessels are congested, the interior meridians remain open, so qi transmits mutually like a ring. Once the cold evil resolves, it reconnects. Ping An: "Qi Zhi Jing" in *Ling Shu* is written as "Qi Zhi Jing Lu", *Jia Yi* is written as "Qi Zhi Jing", note: Jing is one as Jing. Orthodox edition of *Jia Yi Jing* writes "Jing". Xiang Shu, Yuan edition writes "Xiang Fu", note same.)
Huang Di said: Excellent. This is what is meant by like a ring without end, unknown its chronology, ending and starting again. (Describing the explanation.)