足太阳之筋。起于足小趾。上结于踝。邪上。结于膝。其下。循足外侧。结于踵。上循跟。结于 。其别者。结于
外。上 中内廉。与 中并。上结于臀。上挟脊。上项。其支者。别入结于舌本。其直者。结于枕骨。上头。下颜。
结于鼻。其支者。为目上纲。（纲或作网误此谓目上胞内开阖之筋也）下结于 。（ 音求即颧也）其支者。从腋后外廉。
结于肩 。其支者。入腋下。上出缺盆。上结于完骨。其支者。出缺盆。邪上。出于 。其病。小指支。（支撑拄不便也）
跟肿痛。 挛。脊反折。项筋急。肩不举。腋支缺盆中纽痛。不可左右摇。治在燔针劫刺。以知为数。以痛为输。名曰
仲春痹也。足少阳之筋。起于小趾次趾。上结外踝。上循胫外廉。结于膝外廉。其支者。别起外辅骨。上走髀。前者结
于伏兔之上。后者结于尻。其直者。上乘 季胁。（季胁二字乃 之注也经文每多如此）上走腋前廉。系于膺乳。结于缺
盆。直者。上出腋。贯缺盆。出太阳之前。循耳后。上额角。交巅上。下走颔。（篇中颔字皆与常说不同乃指眉后陷中开
口合口其处即为之振撼也一作 ）上结于 。支者。结于目 。为外维。其病。小指次指支。转筋。引膝外转筋。膝不
可屈伸。 筋急。前引髀。后引尻。即上乘 。季胁痛。上引缺盆膺乳。颈维筋急。从左之右。右目不开。上过右角。
并跷脉而行左。络于右故伤左角。右足不用命曰。维筋相交。治在燔针劫刺。以知为数。以痛为输。名曰孟春痹也。足
阳明之筋。起于中三趾。结于跗上。邪外上。加于辅骨。上结于膝外廉。直上。结于髀枢。上循胁。属脊。其直者。上
循。结于（缺此缺谓缺其文也马注作缺盆误以上下文部位推之当在伏兔之下）其支者。结于外辅骨。合少阳。其直者。
上循伏兔。上结于髀。聚于阴器。上腹而布。至缺盆而结。上颈。上挟口。合于 。下结于鼻。上合于太阳。太阳为目
上纲。阳明为目下纲。其支者。从颊结于耳前。其病。足中趾支。胫转筋。脚跳坚。伏兔转筋。髀前肿。 疝。腹筋急。
引缺盆及颊。卒口僻急者。目不合。热则筋纵。目不开。颊筋有寒。则急引颊。移口有热。则筋弛纵缓。不胜收故僻。
治之以马膏。膏其急者。以白酒和桂以涂。其缓者。以桑钩钩之。即以生桑灰置之坎中。高下以坐等。以膏熨急颊。且
饮美酒。啖美炙肉。不饮酒者。自强也。为之三拊而已。治在燔针劫刺。以知为数。以痛为输。名曰季春痹也。足太阴
之筋。起于大趾之端。内侧。上结于内踝。其直者。络于膝内辅骨。上循阴股。结于髀。聚于阴器。上腹。结于脐。循
腹里。结于肋散于胸中。其内者。着于脊。其病。足大趾支。内踝痛。转筋痛。膝内辅骨痛。阴股引髀而痛。阴器纽痛。
上引脐。两胁痛。引膺中。脊内痛。治在燔针劫刺。以知为数。以痛为输。命曰孟秋痹也。足少阴之筋。起于小趾之下。
并足太阴之筋。邪走内踝之下。结于踵。与太阳之筋合而上结于内辅之下。并太阴之筋。而上循阴股。结于阴器。循脊
内挟膂。上至项。结于枕骨。与足太阳之筋合其病。足下转筋。及所过而结者。皆痛及转筋。病在此者。主痫螈及痉。
在外者。不能俯。在内者。不能仰。故阳病者。腰反折不能俯。阴病者不能仰。治在燔针劫刺。以知为数。以痛为输。
在内者熨引饮药。此筋折纽。纽发数甚者。死不治。名曰仲秋痹也。足厥阴之筋。起于大趾之上。上结于内踝之前。上
循胫。上结内辅之下。上循阴股。结于阴器。络诸筋。（厥阴主筋为诸筋之所系属也）其病。足大趾支。内踝之前痛。内
辅痛。阴股痛。转筋。阴器不用。伤于内则不起。伤于寒。则阴缩入。伤于热。则纵挺不收。治在行水清阴气。其病转
筋者。治在燔针劫刺。以知为数。以痛为输。命曰季秋痹也。手太阳之筋起于小指之上。结于腕。上循臂内廉。结于肘
内锐骨之后。弹之应小指之上。入结于腋下。其支者。后走腋后廉。上绕肩胛。循颈。出足太阳之前。结于耳后完骨。
其支者。入耳中。直者。出耳上。下结于颔。上属目外 。其病。小指支。肘内锐骨后廉痛。循臂阴。入腋下。腋下痛。
腋后廉痛。绕肩胛引颈而痛。应耳中鸣。痛引颔。目瞑良久乃得视。（篇中独此句是气化之病）颈筋急。则为筋 颈肿。
寒热在颈者。（似当作寒热在颈者则为筋 颈肿）治在燔针劫刺。以知为数。以痛为输。其为肿者。复而锐之。本支者上
曲牙。循耳前。属目外 。上颔结于角。其病当所过者支。转筋。治在燔针劫刺。以知为数。以痛为输。（此四十一字与
手少阳之筋文重复且支者上本字即舌本之本字错衍之迹显然）名曰仲夏痹也。手少阳之筋。起于小指次指之端。结于腕。
上循臂结于肘。上绕 外廉。上肩。走颈。合手太阳。其支者。当曲颊入系舌本。其支者。上曲牙。循耳前。属目外 。
上乘颔。结于角。其病。当所过者即支。转筋。舌卷。治在燔针劫刺。以知为数。以痛为输。名曰季夏痹也。手阳明之
筋。起于大指次指之端。结于腕。上循臂。上结于肘外。上 。结于 。其支者。绕肩胛。挟脊。直者。从肩 上颈。
其支者。上颊。结于 。直者。上出手少阳之前。上左角。络头。下右颔。其病。当所过者支痛及转筋。肩不举。颈不
可左右视。治在燔针劫刺。以知为数。以痛为输。名曰孟夏痹也。手太阴之筋。起于大指之上。循指上行。结于鱼后。
行寸口外侧。上循臂。结肘中。上 内廉。入腋下。出缺盆。结肩前 。上结缺盆。下结胸里。散贯贲。合贲下。（甲乙
经作胁下当是贲膈也其下无可合也抑或言合于贲下之胁处也）抵季胁。其病。当所过者支。转筋。痛甚。成息贲。胁急。
吐血。治在燔针劫刺。以知为数。以痛为输。名曰仲冬痹也。手心主之。筋起于中指。与太阴之筋并行。结于肘内廉。
上臂阴。结腋下。下散前后。（前后胁前后也故下云挟胁下文前及胸痛前似当训膺）挟胁。其支者。入腋。散胸中。结于
臂。（臂字可疑详见下条足太阴条有结于脐循腹里结于肋散于胸中之文臂或肋之讹也）其病。当所过者支。转筋。前及胸
痛。息贲。治在燔针劫刺。以知为数。以痛为输。名曰孟冬痹也。手少阴之筋起于小指之内侧。结于锐骨。上结肘内廉。
上入腋。交太阴。挟乳里。结于胸中。循臂。（胸之下脐之上无臂也臂字必误）下系于脐。其病。内急。心承伏梁。（此
挟乳里结胸中之病也）下为肘纲。其病。当所过者支。转筋。筋痛。治在燔针劫刺。以知为数。以痛为输。（下为肘纲句
是遥承上结肘内廉来随即接叙其证治也下文又遥承伏梁说叙事组织断续有趣。又按循臂下为肘纲是一串事疑本条有脱文
错简）其成伏梁。唾血脓者。死不治。经筋之病。寒则反折筋。急热则筋弛纵不收。阴痿不用。阳急则反折。阴急。则
俯不伸。 刺者刺寒急也。热则筋纵不收。无用燔针。名曰季冬痹也。足之阳明手之太阳。筋急则口目为 。 急不能
卒视。治皆如上方也。
十二排直起直落。不提不束。此种文格内经独多。其摩绘曲折之妙。与经脉同。而彼以雄阔胜此以坚朴胜。筋病起
于寒热。成于燥湿。其见证则拘急缓纵支。转痿痛。俯仰屈伸而以痫痉。偏废口 。 急为重也。篇中多有错脱处。宜
细考之。
The sinew channel of Foot-Taiyang originates at the little toe, ascends and binds at the ankle. If pathogenic factors ascend, they bind at the knee. Its descending branch follows the lateral aspect of the foot, binding at the heel; it ascends along the Achilles tendon, binding at the popliteal fossa (original text missing character, supplemented from *Ling Shu: Jing Jin*). Its collateral branch binds at the lateral malleolus. Ascending along the medial, lateral, and middle aspects of the thigh, it runs parallel with the sinew channel of Foot-Shaoyang, ascending to bind at the buttock. It ascends flanking the spine, reaching the neck. Its branch enters internally and binds at the root of the tongue. The main trunk binds at the occiput, ascends to the head, descends to the face, and binds at the nose. Its branch forms the constraint of the upper eyelid (Gang, or mistakenly written as Wang, referring to the sinews opening and closing the upper eyelid), descending to bind at the zygomatic bone (Qiu, i.e., cheekbone). Another branch arises from the posterior-lateral axillary margin, binding at the Jianyu acupoint (original text missing character, supplemented). Another branch enters the axilla, ascends out of the supraclavicular fossa, and binds at the Wangu point. Another branch exits the supraclavicular fossa, obliquely ascends, and emerges at the temporal angle (original text missing character, supplemented). Symptoms include discomfort and support issues in the little toe, swelling and pain in the heel, spasm in the popliteal fossa, opisthotonos, stiffness in the neck, inability to raise the shoulder, pulling pain in the axilla and supraclavicular fossa, and inability to rotate the body left or right. Treatment involves burning needle puncture (Fanzhen Jiesi), using the improvement of symptoms as a guide and the painful point as the Shu point. This condition is named Zhongchun Bi.
The sinew channel of Foot-Shaoyang originates at the fourth toe, ascends and binds at the lateral malleolus, following the lateral aspect of the lower leg, binding at the lateral knee. Its branch arises separately from the lateral fibula, ascending towards the thigh. The anterior branch binds above the Futu point, and the posterior branch binds at the sacrum. The main trunk ascends to cover the hypochondrium (the characters "Ji Xie" are notes for "Ji", common in this text), ascends to the anterior axillary margin, ties to the chest and breast, and binds at the supraclavicular fossa. The straight branch ascends out of the axilla, penetrates the supraclavicular fossa, emerges anterior to the Foot-Taiyang channel, follows behind the ear, ascends to the frontal angle, intersects at the vertex, and descends to the mandible (in this chapter, "Han" refers to the depression behind the eyebrow, where movement causes vibration, also written as "Qiu"). It ascends to bind at the outer canthus (original text missing character, supplemented). Its branch binds at the outer canthus, serving as the maintaining sinew of the eye. Symptoms include discomfort in the fourth toe, spasms, pulling spasms to the lateral knee, inability to flex or extend the knee, stiffness in the popliteal fossa, pulling forward to the thigh, backward to the sacrum, pain in the hypochondrium, and upward pulling to the supraclavicular fossa and chest/breast. Stiffness in the cervical maintaining sinews: if injured on the left and affecting the right, the right eye cannot open; the pathogen travels up the right angle, merges with the Yangming vessel running left, and connects to the right. Thus, injury to the left angle results in dysfunction of the right foot, named Weijin Xiangjiao. Treatment involves burning needle puncture, using symptom improvement as a guide and painful points as Shu points. This condition is named Mengchun Bi.
The sinew channel of Foot-Yangming originates at the middle three toes, binds at the dorsum of the foot, obliquely ascends laterally to the fibula, and binds at the lateral knee. The straight branch ascends to bind at the hip pivot, follows the costal region upwards, and attaches to the spine. Another straight branch ascends along (original text missing character, supplemented as "Futu"), binding at (original text missing, Ma's annotation suggests Supraclavicular Fossa, but context implies below Futu). Its branch binds at the lateral fibula, merging with the Foot-Shaoyang sinew channel. The straight branch ascends along the Futu, binds at the thigh, gathers at the genitalia, spreads over the abdomen, binds at the supraclavicular fossa, ascends to the neck, flanks the mouth, merges at the nose (original text missing character, supplemented), binds downward at the nose, and merges upward with Foot-Taiyang. Foot-Taiyang is the upper constraint of the eye; Foot-Yangming is the lower constraint. Its branch binds at the ear from the cheek. Symptoms include discomfort in the middle toe, calf spasms, jumping hardness in the foot, spasms in the Futu area, swelling of the anterior thigh, hernia, abdominal muscle stiffness, pulling to the supraclavicular fossa and cheek. Sudden deviation of the mouth and eyes: if stiff, the eye cannot close; if hot, the sinew relaxes, and the eye cannot open. Cold in the cheek sinews causes stiffness and pulling, shifting the mouth; heat causes relaxation and inability to control, leading to deviation. Treatment uses horse fat plaster applied to the stiff side; white wine mixed with cinnamon powder applied to the relaxed side. Use a mulberry hook to pull the relaxed side, placing raw mulberry ash in a pit at sitting height, and apply horse fat plaster to the stiff cheek while drinking good wine and eating roasted meat. Those who do not drink alcohol should force themselves. Perform three manipulations. Treatment also includes burning needle puncture, using symptom improvement as a guide and painful points as Shu points. This condition is named Jichun Bi.
The sinew channel of Foot-Taiyin originates at the medial end of the big toe, ascending to bind at the medial malleolus. The straight branch connects to the medial condyle of the tibia, ascends along the medial thigh, binds at the thigh, gathers at the genitalia, ascends to the abdomen, binds at the umbilicus, follows the interior of the abdomen, binds at the ribs, and scatters in the chest. The internal branch attaches to the spine. Symptoms include discomfort in the big toe, pain at the medial malleolus, painful spasms, pain at the medial tibial condyle, pulling pain from the medial thigh to the thigh, pulling pain at the genitalia, upward pulling to the umbilicus, bilateral hypochondriac pain, pulling to the center of the chest, and pain inside the spine. Treatment involves burning needle puncture, using symptom improvement as a guide and painful points as Shu points. This condition is named Mengqiu Bi.
The sinew channel of Foot-Shaoyin originates below the little toe, running with the Foot-Taiyin sinew channel, obliquely walking to the lower medial malleolus, binding at the heel, merging with the Foot-Taiyang sinew channel and ascending to bind below the medial condyle. Running with the Foot-Taiyin sinew channel, it ascends along the medial thigh, binds at the genitalia, follows the interior of the spine flanking the paraspinal muscles, ascends to the neck, binds at the occiput, and merges with the Foot-Taiyang sinew channel. Symptoms include plantar spasms, and pain and spasms at all passing and binding sites. Disease here primarily manifests as epilepsy, convulsions, and tetany. External involvement prevents bending forward; internal involvement prevents extending backward. Thus, Yang disease causes opisthotonos preventing bending; Yin disease prevents extending. Treatment involves burning needle puncture, using symptom improvement as a guide and painful points as Shu points. For internal cases, use moxibustion, guidance exercises, and herbal medicine. If this sinew disease breaks and twists frequently and severely, it is fatal and untreatable. This condition is named Zhongqiu Bi.
The sinew channel of Foot-Jueyin originates above the big toe, ascending to bind anterior to the medial malleolus, following the lower leg, binding below the medial condyle, ascending along the medial thigh, binding at the genitalia, and connecting to all sinews (Jueyin governs sinews and is the connection point for all sinews). Symptoms include discomfort in the big toe, pain anterior to the medial malleolus, pain in the medial condyle, pain in the medial thigh, spasms, dysfunction of the genitalia. Injury internally leads to impotence; injury by cold leads to retraction; injury by heat leads to flaccidity and inability to retract. Treatment involves promoting water metabolism and clearing Yin qi. For spasms, treatment involves burning needle puncture, using symptom improvement as a guide and painful points as Shu points. This condition is named Jiqiu Bi.
The sinew channel of Hand-Taiyang originates above the little finger, binding at the wrist, ascending along the medial arm, binding posterior to the sharp bone of the elbow, where palpation elicits pain in the little finger, entering and binding in the axilla. Its branch goes posteriorly along the axillary margin, winds around the scapula, follows the neck, emerges anterior to Foot-Taiyang, and binds at the Wangu point behind the ear. Its branch enters the ear; the straight branch emerges above the ear, descends to bind at the mandible, and ascends to connect to the outer canthus. Symptoms include discomfort in the little finger, pain at the posterior edge of the medial elbow, pain along the medial arm into the axilla, axillary pain, posterior axillary pain, scapular pain pulling to the neck, ringing in the ears, pain pulling to the mandible, and temporary blindness (this sentence uniquely reflects Qi transformation pathology). Neck sinew stiffness causes Jinbi and neck swelling. Cold-heat in the neck (likely meaning cold-heat in the neck causes Jinbi and neck swelling). Treatment involves burning needle puncture, using symptom improvement as a guide and painful points as Shu points. For swelling, use sharp needles again. The branch at Quya follows the ear anteriorly, connects to the outer canthus, ascends to the mandible, and binds at the frontal angle. Symptoms include support pain and spasms at passing sites. Treatment involves burning needle puncture, using symptom improvement as a guide and painful points as Shu points. (These 41 characters repeat the Hand-Shaoyang sinew channel text, and "Zhi Zhe Shang Ben" is clearly a corruption of "She Ben"). This condition is named Zhongxia Bi.
The sinew channel of Hand-Shaoyang originates at the end of the ring finger, binding at the wrist, ascending along the arm, binding at the elbow, winding around the lateral ulna, ascending to the shoulder, walking to the neck, merging with Hand-Taiyang. Its branch enters at the corner of the jaw and ties to the root of the tongue. Its branch ascends to Quya, follows the ear anteriorly, connects to the outer canthus, covers the mandible, and binds at the frontal angle. Symptoms include support discomfort, spasms, and tongue retraction at passing sites. Treatment involves burning needle puncture, using symptom improvement as a guide and painful points as Shu points. This condition is named Jixia Bi.
The sinew channel of Hand-Yangming originates at the index finger, binding at the wrist, ascending along the arm, binding at the lateral elbow, ascending to (original text missing, supplemented as "Nao"), binding at (original text missing, supplemented as "Jianfeng"). Its branch winds around the scapula, flanks the spine. The straight branch goes from the shoulder peak to the neck. Its branch ascends to the cheek, binds at the side of the nose (original text missing, supplemented as "Qiu"). The straight branch ascends anterior to Hand-Shaoyang, to the left frontal angle, connects to the head, and descends to the right mandible. Symptoms include support pain and spasms at passing sites, inability to raise the shoulder, and inability to rotate the neck left or right. Treatment involves burning needle puncture, using symptom improvement as a guide and painful points as Shu points. This condition is named Mengxia Bi.
The sinew channel of Hand-Taiyin originates above the thumb, ascending along the finger, binding posterior to the Thenar eminence, running along the lateral Cun Kou, ascending along the arm, binding at the elbow, ascending to (original text missing, supplemented as "Axilla") medial margin, entering the axilla, emerging from the supraclavicular fossa, binding at the anterior shoulder (original text missing, supplemented as "Jianyu"), ascending to bind at the supraclavicular fossa, descending to bind in the chest interior, scattering through the diaphragm, and merging below the Gen (Jia Yi Jing reads Hypochondrium, likely referring to the diaphragm/hypochondrium area). It reaches the hypochondrium. Symptoms include support discomfort, spasms, severe pain, formation of Xiben, rib stiffness, and hematemesis. Treatment involves burning needle puncture, using symptom improvement as a guide and painful points as Shu points. This condition is named Zhongdong Bi.
The sinew channel of Hand-Jueyin Pericardium originates at the middle finger, running parallel with Hand-Taiyin, binding at the medial elbow, ascending along the medial arm, binding in the axilla, descending to scatter anteriorly and posteriorly (anterior/posterior refer to the hypochondrium, hence "flanking the hypochondrium"; "front" in chest pain likely refers to the chest). It flanks the hypochondrium. Its branch enters the axilla, scatters in the chest, and binds at the arm ("Arm" is questionable, see Foot-Taiyin note regarding "Rib"). Symptoms include support discomfort, spasms, anterior and chest pain, and Xiben. Treatment involves burning needle puncture, using symptom improvement as a guide and painful points as Shu points. This condition is named Mengdong Bi.
The sinew channel of Hand-Shaoyin originates at the medial little finger, binding at the sharp bone, ascending to bind at the medial elbow, entering the axilla, intersecting Hand-Taiyin, flanking the breast interior, binding in the chest, and descending (the character "Arm" here is erroneous) to tie to the umbilicus. Symptoms include internal stiffness and Fuliang under the heart (disease of binding in the chest after flanking the breast interior), becoming the Elbow Gang downwards. Symptoms include support discomfort, spasms, and sinew pain at passing sites. Treatment involves burning needle puncture, using symptom improvement as a guide and painful points as Shu points. (The phrase "becoming Elbow Gang downwards" echoes the previous binding at the medial elbow; the narrative structure is disjointed yet interesting. Also, "descending Arm then becoming Elbow Gang" seems like a continuous event, suggesting missing text or disordered slips in this section). If it forms Fuliang with expectoration of blood and pus, it is fatal and untreatable.
Diseases of the sinew channels: Cold causes reverse bending and sinew stiffness; Heat causes sinew flaccidity and inability to contract, leading to impotence and dysfunction. Yang stiffness causes opisthotonos; Yin stiffness causes inability to extend while bending. Burning needles treat cold-induced stiffness. Heat causes flaccidity and should not be treated with burning needles. This condition is named Jidong Bi.
Stiffness of the sinews of Foot-Yangming and Hand-Taiyang causes deviation of the mouth and eyes, making sudden vision difficult. Treatment follows the methods described above.
The twelve sinew channels rise and fall directly, without lifting or bundling. This style is unique to the Neijing. Its skillful depiction of twists and turns is similar to the meridians, but while meridians excel in grandeur, sinew channels excel in solidity and simplicity. Sinew diseases arise from cold and heat, solidify due to dryness and dampness. Manifestations include stiffness, flaccidity, support, spasms, atrophy, and pain, affecting flexion, extension, bending, and stretching, with epilepsy, tetany, hemiplegia, facial deviation, and sinew stiffness being the most severe. There are many errors and omissions in this chapter, which require careful examination.