第1章　古典经络

Chapter 1　The Classical Meridian

1.1　人体经络的发现与针具的发明

The discovery of the meridian of the human body and the invention of needling tools

早在我国4 000多年前的新石器时代，人们就已掌握了磨制技术，能够制作出一些比较精致的、适合于刺入身体来治疗疾病的石器，称之为“砭石”，这是最古老的医疗工具。《山海经》中说：“有石如玉，可以为针。”用它治疗疾病即为砭石疗法。我国在考古中曾发现过砭石实物，如图1-1-1所示[1]。

Early since more than 4 000 years of the New Stone Age, mankind had grasped the polishing technologies, and was possible to make some delicate stone utensils, suitable to pinch into the human body in order to treat diseases. This kind of stones was named as“bian”stone. This was the oldest therapeutic tool.In a Chinese ancient book Classics of Mountain and Sea, one sentence“there are stones as jade, being able to be as needles”, which was just the“bian”stone for therapeutic use. In our country, the real object“bian”stone was discovered in Chinese archaeological activities shown as Fig. 1-1-1[1].

随着古人智慧和社会生产力的不断发展，由石针逐步演变成骨针、竹针，最后产生了金属针。如图1-1-2所示。由于金属的韧性及制针技术工艺的提高，使针刺穴位时取穴更加准确，针刺穴位时出现的循经感传现象使人们逐渐发现了遍布全身的经络系统。成书于春秋战国时期的《黄帝内经》及成书于公元前2世纪的《难经》把前人对人体经络现象的认识进行了系统的总结，提出了完整的经络学说：经络遍布于人体全身各个部位，担负运送全身气血、沟通内外上下的功能；经络不仅分布于体表，而且进入体内和脏腑相互联结；循环往复，周而复始，运行不息。由于每条阴经属于一脏，并与一腑相连络；每条阳经属于一腑，又联结一脏，这就使全身四肢和脏腑紧密地联系起来，每条经脉所指的疾病，都和它的循行走向及所连属的脏腑直接相关。这样，经络学说对于阐释人体的生理功能和病理变化，从而进一步指导疾病的诊断和治疗都具有极其重要的意义。

Associated with the continuous development of human wisdom and social productive forces, the stone needle gradually evolved to bony and bamboo needles, and finally to metal needle, shown as Fig. 1-1-2.Because more tenacity or roughness of the metal needles and the improvement of making needle techniques caused to more precise location for needle to be punctured in. The accompanied propagated sensation by meridian (PSM) led to people step by step to discover the meridian system throughout the whole human body. In the classic book The Yellow Emperor’s Canon of Internal Medicine (Huangdi’s Internal Classic)written early in the period of the“Spring-Autumn and War State”and in the later book Difficult Classic(Classic on Difficult Problems), the understanding of the former experiences for the meridian phenomena of the human body had been generally reviewed and a perfect theory was proposed. Those main points are:The meridian are distributed throughout the whole body, undertaking the functions of communicating the“qi”(vitality) and blood, getting through upper side and lower side of the human body; the meridian not only is distributed on the superficial part of the body but also is deep in the body interconnected with all the viscera (internal organs); the meridian circulates back and forth without stopping as long as the body lives. Owing to every Yin (negative) meridians connected with every Zang viscera (interior solid) and Yang(positive) meridians with every Fu viscera (interior empty), the symptoms or treatment of diseases with the definite meridian could be directly associated with Zang or Fu respectively. This makes four limbs being very tightly connected with meridian courses and inner viscera (Zang and Fu). The disease associated with every meridian is connected with its related viscera. Thus, the theory of the meridian has very important significance for explaining the physiological and pathological variations, then further to guide the treatment and therapy.

1.2　针灸理论——经络学说的创立

The theory of acupuncture and moxibustion—the creation of the meridian theory

现存的有关“经络”的文献以《黄帝内经》（简称《内经》）为最早，根据近代发现汉墓出土的古帛书和竹简记载，在《内经》之前有“十一脉”，“十一脉”是后人称为《脉书》的主要内容。《脉书》流传有不同的文本，在1983年长沙马王堆汉墓出土的帛书中主要有两个文本：一种内容简洁，按先“足三阳三阴脉”后“臂二阴三阳脉”排列，称之为《足臂十一脉灸经》；另一种内容较详，按先六阳脉后五阴脉次序排列，称之为《阴阳十一脉灸经》。两书均论述人体11条脉的循行、主病和灸法，与《黄帝内经》论十二经脉相当接近，只是缺少一条手厥阴脉。

The earliest existed documents for describing the meridian up to now is The Yellow Emperor’s Canon of Internal Medicine (Huangdi’s Internal Classic). According to the records about the meridian on the“ancient book copied on silk”(gu bo shu) and bamboo slips (zhu jian, used for writing) digged out recently from the tomb of Han dynasty before The Yellow Emperor’s Canon, there already existed“Eleven Pulses”also named as The Pulse Book by descendants (here pulse means meridian’s passage channel or vessel). There were different texts in the ancient times. Two kinds of texts from the ancient“book”copied on silk (gu bo shu) of Ma Wang Dui tomb of Han dynasty dug out in 1983. One edition is brief and simple, with the name of the Classic of Foot-arm Eleven Pulses and Moxibustion, ranking with the series of first“foot three Yang three Yin pulses”, then“arm two Yin three Yang pulses”. Another edition is detailed, named as the Classic of Yin-Yang Eleven Pulses and Moxibustion, ranking with the series of first“six Yang pulses, then five Yin pulses”. In these two“books”, the running along courses or routes, treatment objects and moxibustion method for these eleven meridians of the human body are similar to that described in the Huangdi’s Internal Classic except one meridian named Hand Jueyin Pulse (i. e.Hand Pericardium meridian).

1.2.1　第一部针灸经络专著——《黄帝内经》

The first treatise on acupuncture- moxibustion and meridian- collateral—The Yellow Emperor’s Canon of Internal Medicine

《黄帝内经》是现存的中医文献中最早而且完整的中医经典著作，已经形成了完整的经络系统，即有十二经脉、十五络脉、十二经筋、十二经别，以及与经脉系统相关的标本、根结、气街、四海等，并对腧穴、针灸方法、针刺适应证和禁忌证等也做了详细的论述，尤其是其中的《灵枢经》所记载的针灸理论更为丰富而系统，所以《灵枢经》是经络学说和针灸技术的第一次总结，其主要内容至今仍是针灸的核心，故《灵枢经》也称为《针经》，见图1-2-1、图1-2-2[2]。

The book—The Yellow Emperor’s Canon of Internal Medicine is the earliest complete and extanded classic treatise or monograph, in which the complete system of meridians-collateral, including twelve meridians, fifteen (main) collaterals, muscles along the twelve meridians (jing jin), twelve branches of the twelve meridians (jing bie), and those related to the meridians- collaterals system including incidentalfundamental (biao ben), root-node (gen jie),“qi”pathway (qi jie), four seas (si hai), etc. In addition, the detailed description on Shu points (here shu means transportation), methods of acupuncture and moxibustion, indication and contraindication with needling puncture etc. In particular, the theory on acupuncture and moxibustion recorded in the the Miraculous Pivot also named Lingshu Jing as part of that book were more abundant and systematic, so that it is known as the first time significant review on the theory and techniques of the meridian, the main content of which is still the kernel of the meridiancollateral. So that, The Miraculous Pivot is also called as The Needling Classic (zhen jing), see Fig. 1-2-1 and Fig. 1-2-2[2].

1.2.2　针灸经络专著——《难经》与《针灸甲乙经》

Two treatises on meridian- collateral—Difficult Classic and A Classic of Acupuncture and Moxibustion

继《内经》之后，战国时代的神医扁鹊所著《难经》对针灸学说进行了补充和完善。 《难经》原称《八十一难》，对经络学说理论有了进一步发展，特别是关于奇经八脉和原气的论述。东汉末，张仲景著成《伤寒论》，以六经辨证为主线指导临床用药，这是对《内经》和《难经》经络理论的继承和发展。到魏晋时期，皇甫谧编集了《针灸甲乙经》，这是现存的最早的经穴专著，此书全面论述了脏腑经络学说，发展并确定了349个穴位，对其位置、主治、操作进行了论述，同时介绍了针灸方法及常见病的治疗，是经络学说和针灸技术的第二次总结，见图1-2-3[2]。

After the book The Yellow Emperor’s Canon of Internal Medicine, the distinguished and miraculous doctor BIAN Que wrote Difficult Classic (Nan Jing), in which the theory of Acupuncture and Moxibustion was replenished and completed. The original name of Difficult Classic was The Yellow Emperor’s Eighty One Difficult Classics,in which the meridian theory had new development, especially consisting in the exposition on“eight extra vessels”(qi jing ba mai) and original“qi”. By the end of East Han dynasty, ZHANG Zhongjing completed the book Treatise on Febrile and Miscellaneous Diseases (Shang Han Za Bing Lun), in which the clinical treatment and the selection for the herbs or drugs should be mainly in accordance with the differentiation of syndromes by six meridians. This was the inherit and development of the meridian theory from The Yellow Emperor’s Canon of Internal Medicine and The Difficult Classic. Later on, in the period of Wei-Jing, The doctor HUANGFU Mi compiled the treatise A Classic of Acupuncture and Moxibustion (Zhen Jiu Jia Yi Jing), which, up to now, is a very detailed treatise on meridian and points. In this book, the theory on the relationship between Zang-Fu viscera and the meridian was developed, and 349 points were determined as well as their location, manipulation and main diseases to be treated. Also in this book, the methods of acupuncture and moxibustion and treatment for common diseases were introduced, which could be known as the second general review of the meridian theory and techniques. See Fig. 1-2-3[2].

1.2.3　明堂孔穴图与铜人

“The Hole-points Illustrations of Mingtang”and the Bronze Figure

唐宋时期，经络学说和针灸技术有了很大的发展。医家们开始编制经络穴位图，当时称为“明堂孔穴图”或“明堂图”。宋代医学家王惟一编成《铜人腧穴针灸图经》三卷，共载354经穴；次年铸成“铜人”经穴模型两座（图1-2-4），并以图经刻石，对统一经穴定位影响甚广；后期又组织编写了《圣济总录》（约1112年），在其中将经穴依所在经脉排列，为以后各代著书立说所继承。关于奇经八脉的穴位他提出了四肢的“八脉交会穴”，这些穴位的治疗作用通向头面躯干的一定部位（奇经八脉所属），特指这些经穴与八脉相通[2]。

In Tang and Song dynasties, the meridian theory and techniques had developed a lot, some doctors and experts began to compile the a Illustrations or graphs to display meridian and points. At that time it was called as“The Hole-points Illustrations of Mingtang”or“Mingtang Classic”. In Song dynasty, the doctor and expert WANG Weiyi compiled the graph and text Illustrated Manual on the points for the Bronze Figure (Tong Ren Shu Xue Zhen Jiu Tu Jing) in total and 354 points within three volumes; and in next year, two models of“bronze figure”were cast, see Fig. 1-2-4, which has immense influence through very long period, in particular for determining the precise location of points. Later on around the year of 1112, a new book General Collections of Holy Relief (Sheng Ji Zong Lu) was organized to compile.In this book, all the points were arranged according to various meridian-lines, following which all descendants inherited in their writing and edition. In addition, he proposed the new points named“eight confluent points”on the four limbs in the system of“eight extra vessels”. These confluent points have the specific function for therapy, which plays the role for getting through to the definite locations of head and trunk (belong to eight extra vessels) [2].

1.2.4　顺时而刺——子午流注

Puncturing corresponding to the time—Midnight-noon ebb-flow

唐宋时期还将古代“候气而刺”“顺时而刺”的思想发展作为具体的子午流注针法。金代何若愚写成《流注指微赋》，他把经、络与脉做了区分，而且认为经与络是有深有浅的。阎明广加以注解，并收集有关资料扩展成为《子午流注针经》（1153年），这是子午流注法的初期著作。

In this period, the“needling following the climate and needling following the time”was developed to a method named as“Midnight-noon ebb-flow”. In the dynasty Jin, HE Ruoyu wrote a verse named as Verses for Detailed Ebb-flow, in which the meridian-collaterals and“pulse”were differentiated, and the meridian and collaterals are deep and flood respectively. For this prose, YAN Mingguang noted and explained, then expanded as a book named The Real Classic of Midnight-noon Ebb-Flow in which some others were also involved and collected (1153). This treatise was the book in the preliminary period concerning the“Midnight-noon ebb-flow”.

1.2.5　十四经发挥与针灸大成

“Exposition of fourteen meridians”and“Compendium of Acupuncture and Moxibustion”(shi si jing fa hui) and (zhen jiu da cheng).

元代滑伯仁在忽必烈《金兰循经取穴图解》（1303年）的基础上编著成《十四经发挥》（1341年），首次将十二经脉与任、督二脉合称为十四经脉，以后经络的研究和发展多以此书为主要参考。明代高武《针灸聚英》（1529年）也依照此书流注次序排列绘图。徐风的《针灸大全》又将其改编成《子午流注逐日按时走穴歌》十首，为后人多方加以转载。此法的特点就是按时选用十二经的“井、荥、输、原、经、合”穴。其后，又有将八脉交会穴也结合时辰来选用，称为“飞腾八法”或“灵龟八法”。同时期，李时珍作《奇经八脉考》（1578年），就奇经八脉文献进行了汇集和考证；杨继洲著《针灸大成》，汇集了明代以前的针灸著作，总结了临床经验，内容丰富，是后世学习针灸的重要参考书，是经络学说和针灸技术的第三次总结。

In Yuan dynasty, Based on Kublai Khan’s (Hubilie)“Jin-Lan Graphs for Taking Points Along Meridians”(1303), HUA Boren compiled a book titled as Exposition of Fourteen Meridians (1341), in which the 12 meridians and two vessels (Conception and Governor) firstly were combined together to for 14 meridian-pulses. Later on, the research and development mostly followed this version and as the main reference book. In Ming dynasty, GAO Wu (1529) edited the graphs according to the order of“Midnight-noon ebb-flow”in the book Essentials of Acupuncture and Moxibustion (Zhen Jiu Ju Ying).XU Feng revised that book named as“A Complete Manual of Acupuncture and Moxibustion”(Zhen Jiu Da Quan), in which ten verses were edited in order to taking acu-points according to the time order of“Midnight-noon ebb-flow”. Later on, these verses have been quoted by many persons. The specific points of these ten verses consist in selecting acu-points according to“Jing, xing, shu, yuan, jing, he”of 12 meridians (Note: at 6 different locations from limb terminals to elbows or knees) along every meridians. Afterwards, some doctors selected the confluent points of extra meridians (Note: strange vessels and eight pulses) associated with the time in day, which was also called“flying eight methods”or“eight methods of spiritual turtle”. At the same period, LI Shizhen collected and verified the related books, then wrote On the Extra Meridians (1578). YANG Jizhou wrote the book named as Compendium of Acupuncture and Moxibustion (Zhen Jiu Da Cheng), in which the treatises before Ming dynasty were collected together, and the clinical experiences were summarized and reviewed with abundant contents, as an important reference book for later study. This is the third review of meridian theory and acupuncture techniques.

1.2.6　药物归经运用与发展

Application and development of the drugs or herbs belonging to associated meridian lines

药物归经和运用方面有所发展，将经络学说与药物结合起来，认为“何经之病，宜用何经之药”，是掌握药物性能的要领。温病学派叶天士等注重分经辨证用药，于十二经之外更重视奇经，为经络理论在方药方面的运用做出了贡献。

The theory of the drugs or herbs belonging to or enter their associated meridian lines connects the meridians and drugs. With that theory, it is considered that“The drugs belonging to what meridian should be used for the disease of the corresponding meridians”, which is the key point to grasp the characteristics of drugs. YE Tianshi et al. belonging to the school of thought of epidemic febrile diseases emphasized using drugs in accordance with differentiating meridians. Among twelve regular meridians, he paid more attention to the“extra”meridians beyond the twelve meridians. Hence, he contributed to the theory of the meridian on the application for using drugs and prescriptions.

1.3　古典经络运行图及穴位定位图

The modern anatomic graphs of point locations for the classic meridian

经穴解剖定位图

近六十年来，为了让大家详尽地了解经络与人体实体解剖结构的相互关系，我国多个机构绘制了古典经络的现代解剖定位图来普及经络知识，如图1-3-1～1-3-3所示[2]。

In recent 60 years, for popularization of meridian knowledge to common people detailed understanding the relationship between the meridian and the real anatomic locations of human body, many institutions in our country have edited the anatomic graphs of modern point locations for the classic meridian, shown as Fig. 1-3-1 to Fig. 1-3-3[2].

李丁教授根据古典经络循行路线绘制了十四经脉和相关穴位解剖定位的英文辨识图，如图1-3-2（a）到图1-3-3（n）所示[3]。

Professor LI Ding has plotted the anatomic locations of 14 meridians-vessels and the related points according to the courses of classic meridians (in English), shown as Fig. 1-3-2(a) to Fig. 1-3-3(n)[3].

参考文献

References

［1］张立剑．针灸图说[M]．青岛：青岛出版社，2010.ZHANG Lijian. Illustrated Acupuncture. Qingdao: Qingdao Press, 2010.

［2］靳士英，张彤云．针灸穴位挂图[M]．北京：人民卫生出版社，1971.JIN Shiying, ZHANG Tongyun. Chart of lleridians and Potnts Illustration. Beijing: People’s Medical Publishing House, 1971.

［3］李丁．健美经络图[M]．太原：山西人民出版社，1984.LI Ding. Illustratiue Plates of Merdians and Collaterals in Human Body—An Aid to Body Building.Taiyuan: Shanxi People’s Publishing Press, 1984.