心與包絡辨

Distinguish Between the Heart and Xin Bao Luo Meridians

近世西醫日益發展，不論是影像學、生理學、解剖學等皆有可觀的進步，然而對於中國傳統醫學，尤其是在經絡理論、經絡實質的方面仍然是一知半解。有鑒於此，本文將從古典文獻、解剖學兩觀點切入探討，試圖尋找對應中醫經絡學說中的「心」與「心包絡」之實質，並在古典與現代醫學文獻中找出證據，釐清心與心包絡的實質與特性。在「心經」方面，我們發現《靈樞．經脉》中關於心經體內循行的部分經文與解剖學的「大動脈系統」有關。而在「心包絡」實質方面，我們共進行三方面的探討：首先，一般認為的心包絡等同心包膜（pericardium）之觀點稍嫌侷限，未能解釋臨床上內關治療冠心病的原理，故此乃一個需釐清之點；接著，我們透過心包絡、三焦相表裏的關係與三焦的膜理論，推論心包絡應為人體內各種膜類上之中小動脉系統；最後，我們認為「心主手厥陰心包絡之脈」的「心主」應理解成「由心所主宰」之意，故「心主心包絡」之意是：心包絡是聽命於心，而既然「包」是指一切膜類，而「絡」是細小血管，因此「心主心包絡」便是「由心所主宰的一切膜類上的中小血管系統」。綜合心經、心包絡經兩方面的討論可知：心與心主手厥陰心包絡兩條經脈，就包含了大動脈系統與各種膜上的中小動脈系統！ With the growing development of western medicine in recent decades, considerable progress has been made in medical imageology, physiology, anatomy and etc. However, the limited knowledge on especially meridian theory and its intrinsic features still remain in Traditional Chinese Medicine. In view of this, this study reviews and investigates the intrinsic features of “Heart” and “Xin Bao Luo” in the Meridian theory based on classical literature and anatomical perspectives. Through the classical and modern medical literature, we attempt to clarify the intrinsic features as well as the characteristics of the Heart and “Xin Bao Luo” from the evidence found. For the Heart meridian, we discover that part of the description of the meridian pathway in the body is related to the aortic system in anatomy through the ‘Magic Pivot, Chapter 10-Meridians’. As for the intrinsic features of “Xin Bao Luo”, the following three discussions are included: Firstly, the limitation in the general perception of “Xin Bao Luo is equivalent to Pericardium” has failed to explain the principle of clinical treatment of Coronary Heart Disease by Neiguan (PC6). Hence, it remains as one of the key points required to be clarified. Secondly, through the exterior-interior relationship of “Xin Bao Luo” and San Jiao (Triple membrane) and its membrane theory, “Xin Bao Luo” is inferred as the middle and small arterial system of various membrane types. Finally, we believe that “Heart governs the “Xin Bao Luo” meridian of Hand Jue Yin” is being comprehended as “The heart is the dominating organ”. Hence “Heart governs “Xin Bao Luo” ” is referred as ‘The Heart is governing all the middle and small artery system on the membranes within the body’ since “Bao” is defined as all the membranes while “Luo” is defined as the arterioles. Integrating the discussion on the “Heart” and “Xin Bao Luo”, it is learnt that the two meridians-Heart meridian and “Heart governs the “Xin Bao Luo” meridian of Hand Jue Yin” include the aortic system and the middle and small artery system on the various membranes.

With the growing development of western medicine in recent decades, considerable progress has been made in medical imageology, physiology, anatomy and etc. However, the limited knowledge on especially meridian theory and its intrinsic features still remain in Traditional Chinese Medicine. In view of this, this study reviews and investigates the intrinsic features of “Heart” and “Xin Bao Luo” in the Meridian theory based on classical literature and anatomical perspectives. Through the classical and modern medical literature, we attempt to clarify the intrinsic features as well as the characteristics of the Heart and “Xin Bao Luo” from the evidence found. For the Heart meridian, we discover that part of the description of the meridian pathway in the body is related to the aortic system in anatomy through the ‘Magic Pivot, Chapter 10-Meridians’. As for the intrinsic features of “Xin Bao Luo”, the following three discussions are included: Firstly, the limitation in the general perception of “Xin Bao Luo is equivalent to Pericardium” has failed to explain the principle of clinical treatment of Coronary Heart Disease by Neiguan (PC6). Hence, it remains as one of the key points required to be clarified. Secondly, through the exterior-interior relationship of “Xin Bao Luo” and San Jiao (Triple membrane) and its membrane theory, “Xin Bao Luo” is inferred as the middle and small arterial system of various membrane types. Finally, we believe that “Heart governs the “Xin Bao Luo” meridian of Hand Jue Yin” is being comprehended as “The heart is the dominating organ”. Hence “Heart governs “Xin Bao Luo” ” is referred as ‘The Heart is governing all the middle and small artery system on the membranes within the body’ since “Bao” is defined as all the membranes while “Luo” is defined as the arterioles. Integrating the discussion on the “Heart” and “Xin Bao Luo”, it is learnt that the two meridians-Heart meridian and “Heart governs the “Xin Bao Luo” meridian of Hand Jue Yin” include the aortic system and the middle and small artery system on the various membranes.