(照马氏补辑)
手太阴。十一穴。中府云门天府列。侠白下尺泽。孔最见列缺。经渠太渊下鱼际。抵指少商如
韭叶。(古离爪甲如韭今如米许)
太阴肺兮出中府。云门之下一寸许。云门璇玑旁六寸。巨骨之下二骨数。天府腋下三寸求。侠
白肘上五寸主。尺泽肘中约横文。孔最腕上七寸取。列缺腕侧一寸半。经渠寸口陷中主。太渊掌后横
纹头。鱼际节后散脉举。少商大指端内侧。相去爪甲韭叶许。(云门巨骨下、挟气户旁二寸陷中、
去中行任脉六寸、气户巨骨下、俞府两旁各二寸陷中、去中行任脉四寸、去膺窗四寸八分。俞府巨骨
下、璇玑旁二寸陷中、璇玑天突下一寸、天突结喉下四寸宛宛中、右挨穴之法自天突起至璇玑、自璇玑
至云门、其法甚简后仿此)
大肠手阳明之脉。起于大指次指之端。循指上廉。出合谷两骨之间。上入两筋之间。循臂上廉。
入肘外廉。上 外前廉上肩。出 骨之前廉。上出于柱骨之会上。下入缺盆络肺。下膈属大肠。
其支者。从缺盆上颈贯颊。入下齿中。还出挟口。交人中。左之右。右之左。上挟鼻孔。是动则病
齿痛颈肿。是主津液所生病者。目黄口干。鼽衄喉痹。肩前 痛。大指次指痛不用。气有余。则当
脉所过者热肿。虚则寒栗不复。为此诸病。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。盛者人迎大三倍于寸口。虚者人迎反小于寸口也。( 牛口反鼽音求)
大指次指者。手大指之次指。名食指也。合谷。本经穴名。俗名虎口。肩端两骨间为 骨。肩
HT上处为天柱骨。缺盆在结喉两旁之高骨。形圆而踝。如缺盆然。大肠手阳明之脉。受手太阴之
交。起于次指之商阳井穴。循二间三间之上廉。出两骨间之合谷穴。上入两筋间之阳溪。循臂上廉
之偏历温溜。下廉上廉三里。入肘外廉之曲池。上循 外之前廉。历肘 五里。以上肩之肩 穴。
出骨之前廉。循巨骨上行。出于柱骨之会上。下入缺盆络肺。下膈属于大肠。其支行者。从缺盆
上颈。循天鼎扶突上贯于颊。入下齿缝中。还出挟口。交人中之内。左脉往右。右脉往左。上挟鼻
孔。循禾 迎香而终以交于足阳明胃经也。是动则病齿痛颈肿。盖气伤痛。形伤肿。因气以及形也。
大肠传导水谷。变化精微。故主所生津液病。则津液竭而火热盛。故为目黄口干鼽衄喉痹诸证。
肩及大指之次指。皆大肠经脉所循之部分。如腑气有余。则当脉所过之处热肿。腑气
虚。则寒栗不复。手阳明之主气也。为此是动所生诸病。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。盛者人迎大三倍于寸口。虚者人迎反小于寸口也。盖申明盛虚者。
乃三阴三阳之气。如气不盛虚。则当取之于经。
(根据马氏补辑的内容)
手太阴肺经,共有十一个穴位:中府、云门、天府、侠白、尺泽、孔最、列缺、经渠、太渊、鱼际、少商。(古法测量指甲宽度如韭菜叶宽,今法约为米粒大小)。
手太阴肺经起于中府穴。在云门穴下方约一寸处。云门穴位于璇玑穴旁开六寸处,巨骨穴下方两骨之间。天府穴在腋下三寸处寻求。侠白穴在肘上五寸处主治。尺泽穴在肘横纹中央。孔最穴在腕上七寸处取穴。列缺穴在手腕侧方一寸半处。经渠穴在寸口脉搏跳动处的凹陷中主治。太渊穴在掌后横纹头处。鱼际穴在节后散脉处可触及。少商穴在大拇指内侧端,距离指甲边缘约韭菜叶宽。(注释:云门和巨骨下方、挟气户旁开二寸的凹陷中,距人体正中线任脉六寸;气户和巨骨下方、俞府两旁各二寸的凹陷中,距人体正中线任脉四寸,距膺窗穴四寸八分。俞府在巨骨下方、璇玑旁开二寸的凹陷中,璇玑在天突穴下一寸,天突在结喉下四寸的凹陷中。右侧挨次取穴的方法从天突开始至璇玑,从璇玑至云门,其方法甚为简便,后续仿照此例)。
大肠手阳明经的脉气,起始于食指末端。沿手指上缘上行,出于合谷穴两骨之间,向上进入两筋之间。沿手臂上缘上行,入肘外侧,上臂外侧前缘,上肩,出肩峰前缘,向上出于柱骨(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。
其分支,从缺盆上行至颈部,贯穿面颊,进入下齿中,再出来夹口唇交叉于人中穴,左侧经脉走向右侧,右侧经脉走向左侧,上行夹鼻孔两侧。
本经发生变动所生的病症,包括牙齿疼痛、颈部肿胀。本经主要主管津液所生的疾病,表现为眼睛发黄、口干、鼻塞流涕或鼻出血、咽喉肿痛闭塞。肩前部疼痛,食指疼痛且活动不便。邪气有余(实证),则经脉经过的部位出现热肿;正气不足(虚证),则出现寒战且不能恢复。针对这些病症,实证用泻法,虚证用补法,热证用疾刺法(快进快出),寒证用留针法,脉陷下者用灸法,不虚不实者取本经穴位治疗。实证的表现是人迎脉大三倍于寸口脉,虚证的表现是人迎脉反而小于寸口脉。(注:“鼽”音求,指鼻塞流涕)。
“大指次指”,即大拇指旁边的第二个手指,名为食指。“合谷”,是本经的穴位名称,俗称虎口。“肩端两骨间”称为肩髃骨。“HT上处”(此处原文可能有误,结合上下文应指肩部高处)为天柱骨(第七颈椎棘突)。“缺盆”在结喉两旁的高骨,形状圆而有棱角,如同缺口的盆状。
大肠手阳明经,接受手太阴肺经的交接,起始于食商的井穴(商阳穴)。沿二间、三间穴的上缘上行,出于两骨间的合谷穴,向上进入两筋间的阳溪穴,沿手臂上缘的偏历、温溜穴,下廉、上廉、三里穴,入肘外侧的曲池穴。向上沿臂外侧前缘,经过肘部的五里穴,以上行至肩髃穴。出肩峰前缘,沿巨骨穴上行,出于柱骨的会合处。向下进入缺盆,联络肺脏,穿过膈肌属于大肠。其支脉,从缺盆上行至颈部,循天鼎、扶突穴上行贯穿面颊,进入下齿缝中,再出来夹口唇,交于人中的内侧。左侧脉气往右行,右侧脉气往左行,上行夹鼻孔,循禾髎、迎香穴而终,以交于足阳明胃经。
本经发生变动所生的病症,包括牙齿疼痛、颈部肿胀。这是因为气伤痛,形伤肿,因气及形的缘故。
大肠传导水谷,变化精微,所以主管所生津液的疾病。如果津液枯竭而火热盛,就会出现眼睛发黄、口干、鼻塞流涕或鼻出血、咽喉肿痛闭塞等各种证候。
肩部和食指,都是大肠经脉循行的部位。如果腑气有余(实证),则经脉经过的地方出现热肿;腑气虚(虚证),则出现寒战且不能恢复。手阳明经主司气。针对这些是动、所生诸病,实证用泻法,虚证用补法,热证用疾刺法,寒证用留针法,脉陷下者用灸法,不虚不实者取本经穴位治疗。实证的表现是人迎脉大三倍于寸口脉,虚证的表现是人迎脉反而小于寸口脉。这里是为了申明盛虚的概念,乃指三阴三阳之气的盛衰。如果气不盛不虚,则应当取之于本经。
(According to the supplementary compilation by Ma)
The Hand-Taiyin Lung Meridian has eleven acupoints: Zhongfu (LU-1), Yunmen (LU-2), Tianfu (LU-3), Xiabai (LU-4), Chize (LU-5), Kongzui (LU-6), Lieque (LU-7), Jingqu (LU-8), Taiyuan (LU-9), Yuji (LU-10), and Shaoshang (LU-11). (Ancient method measured nail width as wide as a leek leaf, modern method is approximately the size of a grain of rice).
The Hand-Taiyin Lung Meridian originates from Zhongfu (LU-1). It is located approximately one cun below Yunmen (LU-2). Yunmen (LU-2) is six cun lateral to Xuanji (CV-21), between two bones below Jugu (SI-11/Tianzong area context implies shoulder bone structure). Tianfu (LU-3) is sought three cun below the axilla. Xiabai (LU-4) governs at five cun above the elbow crease. Chize (LU-5) is in the center of the transverse cubital crease. Kongzui (LU-6) is taken seven cun above the wrist. Lieque (LU-7) is one and a half cun on the radial side of the wrist. Jingqu (LU-8) governs in the depression at the radial pulse (Cunkou). Taiyuan (LU-9) is at the head of the transverse wrist crease. Yuji (LU-10) can be palpated at the scattered vessels after the joint. Shaoshang (LU-11) is at the medial tip of the thumb, about a leek-leaf width away from the nail edge. (Annotations: Yunmen and Jugu are below, two cun lateral to Qihu (ST-15) in the depression, six cun from the midline Ren Mai; Qihu and Jugu are below, two cun lateral to Shufu (KI-27) in the depression, four cun from the midline Ren Mai, four cun eight fen from Yingchuang (ST-16). Shufu is below Jugu, two cun lateral to Xuanji (CV-21) in the depression; Xuanji is one cun below Tiantu (CV-22); Tiantu is in the depression four cun below the laryngeal prominence. The method for locating points on the right side starts from Tiantu to Xuanji, and from Xuanji to Yunmen; this method is very simple and subsequent points follow this example).
The meridian of the Large Intestine Hand-Yangming originates at the end of the second finger (index finger). It follows the upper border of the finger, emerges between the two bones at Hegu (LI-4), enters between the two tendons above. It follows the upper border of the forearm, enters the lateral aspect of the elbow, ascends along the anterior border of the lateral aspect of the arm, reaches the shoulder, emerges from the anterior border of the acromion, ascends to emerge at the meeting point of the vertebral column (C7). It descends into the Supraclavicular Fossa (Quepen), connects with the Lung, passes through the diaphragm, and belongs to the Large Intestine.
Its branch ascends from the Supraclavicular Fossa to the neck, penetrates the cheek, enters the lower teeth, re-emerges to flank the mouth, crosses at the Philtrum (Renzhong/GV-26), left meridian goes to the right, right meridian goes to the left, and ascends to flank both nostrils.
Diseases caused by movement/disorder of this meridian include toothache and neck swelling. This meridian primarily governs diseases related to body fluids (Jinye), manifesting as yellow eyes, dry mouth, nasal congestion/epistaxis, and sore throat with obstruction. Pain in the anterior shoulder, pain and immobility of the index finger. If Qi is in excess (Excess pattern), heat and swelling occur at the sites traversed by the meridian; if Qi is deficient (Deficiency pattern), chills occur that do not resolve. For these conditions, Excess is treated with draining (Xie), Deficiency with tonifying (Bu), Heat with rapid needling (Ji), Cold with retained needle (Liu), sinking/depressed pulses with moxibustion (Jiu), and neither excess nor deficiency by selecting points from the meridian itself. In Excess patterns, the Renying (ST-9) pulse is three times larger than the Cunkou (Radial) pulse; in Deficiency patterns, the Renying pulse is smaller than the Cunkou pulse. (Note: "Qiu" [nasal congestion] sounds like "qiu").
"The second finger of the hand" refers to the finger next to the thumb, named the Index Finger. "Hegu" is the name of an acupoint in this meridian, commonly known as the Tiger's Mouth. "Between the two bones at the shoulder end" refers to the Jianyu bone. The high point above HT is the Tianzhu bone (C7 spinous process). "Quepen" (Supraclavicular Fossa) is the high bone on both sides of the larynx, round with angles, resembling a broken basin.
The Large Intestine Hand-Yangming meridian receives the connection from the Hand-Taiyin Lung meridian, originating at the Well point Shangyang (LI-1) of the index finger. It follows the upper borders of Erjian (LI-2) and Sanjian (LI-3), emerges from Hegu (LI-4) between the two bones, enters Yangxi (LI-5) between the two tendons above, follows Pianli (LI-6) and Wenliu (LI-7) on the upper border of the forearm, Xiaolian (LI-8), Shanglian (LI-9), Sanli (LI-10), enters Quchi (LI-11) at the lateral elbow. It ascends along the anterior border of the lateral arm, passes through Wuli (LI-13) at the elbow, ascends to Jianyu (LI-15). It emerges from the anterior border of the acromion, follows Gugu (SI-11) upward, emerges at the meeting point of the vertebral column. It descends into Quepen, connects with the Lung, passes through the diaphragm, and belongs to the Large Intestine. Its branch ascends from Quepen to the neck, follows Tianding (LI-16) and Futu (LI-18) upward to penetrate the cheek, enters the lower teeth gap, re-emerges to flank the mouth, crosses inside the Philtrum. Left meridian qi moves right, right meridian qi moves left, ascends to flank the nostrils, follows Heliao (LI-18) and Yingxiang (LI-20) to terminate, connecting with the Foot-Yangming Stomach Meridian.
Diseases caused by movement/disorder include toothache and neck swelling. This is because Qi disorder causes pain, Shape (tissue) disorder causes swelling, and Qi affects Shape.
The Large Intestine conducts food residue and transforms essence and fine nutrients, thus governing diseases of generated body fluids. If body fluids are exhausted and fire-heat is excessive, symptoms such as yellow eyes, dry mouth, nasal congestion/epistaxis, and sore throat obstruction occur.
The shoulder and the index finger are parts traversed by the Large Intestine meridian. If Fu-organ Qi is in excess, heat and swelling occur at the meridian's path; if Fu-organ Qi is deficient, chills occur that do not resolve. The Hand-Yangming meridian governs Qi. For these disorders and generated diseases, Excess is drained, Deficiency is tonified, Heat is rapidly needled, Cold retains the needle, sinking pulses use moxibustion, and neither excess nor deficiency uses the meridian itself. Excess is indicated when Renying is three times larger than Cunkou; Deficiency is indicated when Renying is smaller than Cunkou. This clarifies that excess and deficiency refer to the Qi of the Three Yin and Three Yang. If Qi is neither excess nor deficient, points should be selected from the meridian.