〔溪〕妇人阴肿，肾痛。枳实半斤切碎，炒热布裹包熨之，冷即易。（《秘录》）交接劳复，阴卵痛。（是
劳复阴阳易。）
〔仲〕胃气下泄，阴吹而正喧，此谷气之实也，膏发煎导之。（方见黄胆。）
〔洁〕男子阴头痛，女子阴中痛∶大敦
〔《集》〕阴茎虚痛∶中极 太溪 三阴交 复溜 不已，取血 阴陵泉 关元 海底
〔《甲》〕妇人阴中痛，少腹坚急痛，阴陵泉主之。女子阴中寒，归来主之。
〔《灵》〕足太阳之筋，起于足小指，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，为目上网，下结于 。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。（以知为数，以痛为输者，言经筋病
用燔针之法，但以知觉所针之病应效为度数，非如取经脉法有几呼几吸几度之定数也。但随筋之痛处为输穴，亦非
如取经脉法有荥俞经合之定穴也。）
足少阳之筋，起于小指次指，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，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，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，起于中三指，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 ，结于膝。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。太阳为目上网，阳明为目下网。其支者，
从颊结于耳前，其病足中指支胫转筋，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。（治在燔针之上当有
“其病转筋者”五字，如足厥阴筋行水清阴气之下所言也。盖燔针但宜施于筋寒转筋之病，其筋热缓纵者则不宜也。
搏，击也，指也。盖治口 僻之法，以火烘马之脂膏熨其半边急者，以白酒调和桂末涂其半边缓者，又以桑钩钩其
口吻之僻偏复于故处，使高下相等，复以水调生桑灰于钩柄之坎缝处，连颊涂之，以收其缓，其桑钩柄别
用线系缚于肩后，使勿走作也。复饮酒啖肉使筋脉柔和以助外之涂熨。不饮酒者，则自强其筋骨，使正以手相拍
其熨处也。张子和云∶左寒右热则左急而右缓，右寒左热则右急而左缓，故偏于左者，左寒右热，偏于右者，右
寒左热。夫寒不可轻用辛热之剂，盖左中寒则逼热于右，右中寒则逼热于左，阳气不得宣行故也。）
足太阴之筋，起于大指之端内侧，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，其病足大指支内踝痛，转筋痛，膝内辅骨痛，阴
股引髀而痛，阴器纽痛，下引脐两胁痛，引膺中脊内痛。治在燔针劫刺，以知为数，以痛为输，名曰孟秋痹也。
足少阴之筋，起于小指之下，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，
并太阳之筋，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 及 ，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，起于大指之上，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。
其病足大指支内踝之前痛，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，名曰季秋痹也。
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，出走太阳之前，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，颈筋急则为筋 颈肿。寒热在颈者，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，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，上出手太阳之前，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，散前后挟胁。其支者，入腋，
散胸中，结于臂。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，下
系于脐。（臂当作胸。）其病内急，心承伏梁，下为肘网。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；其成伏梁唾血脓者，死不治，名曰季冬痹也。（“名曰季冬痹也”六字符误在后“无用
燔针”之下，今移在此。）
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。淬刺者，刺寒急也。
热则筋纵不收，无用燔针。（艾灸亦然，今世不分寒急热纵，皆用艾灸者，未知此理也。）
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。（俱见《灵枢》经筋篇。）
形乐志苦，病生于筋，治之以熨引。（全文见治法。）
诸筋病皆属于节。经云∶诸筋者，皆属于节。又云∶手屈而不伸者，病在筋是也。肝主诸筋。经云∶肝主
筋。又云∶在脏为肝，在体为筋。又云∶酸生肝，肝生筋，筋生心是也。筋病忌风，忌食酸辛，忌久行。经云∶
风伤筋，燥胜风，酸伤筋，辛胜酸。又云∶酸走筋，筋病无多食酸。又云∶多食辛则筋急而爪枯。又云∶久行
伤筋是也。
[Xu] Women with vulvar swelling accompanied by kidney region pain. Take Zhi Shi (Immature Bitter Orange) half a jin, chop it finely, stir-fry until hot, wrap in cloth, and apply as a hot compress to the affected area. Replace immediately when it cools down. (From *Mi Lu*) Pain in the scrotum due to relapse after sexual intercourse caused by overexertion. (This is the condition of Lao Fu Yin Yang Yi.)
[Zhang Zhongjing] Stomach Qi leaking downward, resulting in flatulence from the vagina with continuous sound; this is due to excess Grain Qi. Treat with Gao Fa Jian (Ox Hair Decoction). (Formula see Jaundice chapter.)
[Li Dongyuan] Men with headache in the genital region, women with pain inside the vagina: Da Dun (LR1).
[*Zhenjiu Jicheng*] Dull pain in the penis: Zhong Ji (CV3), Tai Xi (KI3), San Yin Jiao (SP6), Fu Liu (KI7). If ineffective, additionally take Xue Hai (SP10), Yin Ling Quan (SP9), Guan Yuan (CV4), Hai Di (EX-LE5).
[*Jia Yi Jing*] Women with pain inside the vagina and hardness/urgency in the lower abdomen: Yin Ling Quan (SP9) governs this. Women with cold sensation inside the vagina: Gui Lai (ST29) governs this.
[*Ling Shu*] The Sinew-Meridian of Foot-Taiyang begins at the little toe, ascends to knot at the ankle, and pathogenic factors ascend to knot at the knee. Its descending branch follows the lateral aspect of the foot, knots at the heel, ascends along the Achilles tendon, and knots at the popliteal fossa. Another branch knots at the lateral aspect of the popliteal fossa, ascends along the medial aspect of the thigh and middle of the popliteal fossa, joins and ascends to knot at the buttock, ascends flanking the spine to the nape. Its collateral branch enters and knots at the root of the tongue. Its straight course knots at the occiput, goes up the head to the face, and knots at the nose. Its branch forms the upper eyelid network, descending to knot at the inner canthus. Its branch, from the posterior-lateral axilla, knots at Jian Yu (LI15). Its branch enters the axilla, ascends out of the supraclavicular fossa, and ascends to knot at Wan Gu (GB12). Its branch exits the supraclavicular fossa, obliquely ascends out of the vertex. Symptoms include pain and swelling supporting the little toe and heel, spasm of the popliteal fossa, opisthotonos, stiffness of neck sinews, inability to raise the shoulder, pulling pain in the axilla and supraclavicular fossa, inability to shake left or right. Treatment involves burning needle rapid puncture (Fan Zhen Ji Ci), using efficacy as the measure, and pain points as Shu points. This is named Zhong Chun Bi (Mid-Spring Obstruction). ("Using efficacy as the measure" means for sinew-meridian diseases treated with burning needles, the number of treatments is determined by when the patient feels relief, unlike meridian acupuncture which has fixed breath counts. "Pain points as Shu points" means selecting acupoints based on tender spots along the sinew, unlike the fixed Five Shu points of meridians.)
The Sinew-Meridian of Foot-Shaoyang begins at the second toe, ascends to knot at the lateral malleolus, ascends along the lateral aspect of the shin, and knots at the lateral aspect of the knee. Its branch arises separately from the lateral fibular bone, ascends to the thigh; the anterior part knots above Fu Tu (ST32), the posterior part knots at the sacrum. Its straight course ascends to the costal margin, moves to the anterior-lateral axilla, ties to the chest/breast, and knots at the supraclavicular fossa. The straight course ascends out of the axilla, penetrates the supraclavicular fossa, emerges anterior to Foot-Taiyang, follows behind the ear, ascends to the frontal angle. It crosses the vertex, descends to the mandible, and ascends to knot at the outer canthus. A branch knots at the outer canthus to form the external dimension. Symptoms include spasms supporting the second toe, pulling spasms to the lateral knee, inability to flex/extend the knee, stiff sinews, anterior pulling to the thigh, posterior pulling to the sacrum, pain at the costal margin, upward pulling to the supraclavicular fossa, chest/breast, and neck. External dimension sinew stiffness causes the left eye to be unable to open if injured on the right, moving up the right corner, running with the Qiao vessels, crossing left to right. Injury to the left corner renders the right foot useless. This is named Wei Jin Xiang Jiao (Crossed Dimension Sinew Interaction). Treatment involves burning needle rapid puncture, using efficacy as the measure, and pain points as Shu points. This is named Meng Chun Bi (Early Spring Obstruction).
The Sinew-Meridian of Foot-Yangming begins at the middle three toes, knots at the dorsum of the foot, pathogenic factors add externally to the fibula, ascend to knot at the lateral aspect of the knee, straightly ascend to knot at the hip joint, ascend along the hypochondrium, attach to the spine. Its straight course ascends along Fu Tu (ST32), knots at the knee. Its branch knots at the lateral fibular bone, merging with Foot-Shaoyang. Its straight course ascends along Fu Tu (ST32), knots at the thigh, gathers at the genitalia, spreads upward on the abdomen, knots at the supraclavicular fossa, ascends to the neck, ascends flanking the mouth, merges at the inner canthus, descends to knot at the nose, and ascends to merge with Foot-Taiyang. Foot-Taiyang forms the upper eyelid network, Foot-Yangming forms the lower eyelid network. Its branch knots from the cheek at the anterior aspect of the ear. Symptoms include spasms supporting the middle toe and shin, jumping/hardness of the foot, spasms at Fu Tu (ST32), swelling of the anterior thigh, hernia/abdominal sinew stiffness pulling to the supraclavicular fossa and cheek, sudden facial deviation. In stiff cases, eyes cannot close; in heat cases, sinews relax, eyes cannot open. Cold in cheek sinews causes stiffness pulling the mouth; heat causes relaxation/inability to control, leading to deviation. Treatment uses Ma Zi (Horse Fat) to plaster the stiff side, Bai Jiu (White Wine) mixed with Gui Mu (Cinnamon Bark Powder) to apply to the relaxed side, use a mulberry hook to pull the mouth back to center, place raw mulberry ash in a pit level with sitting height. Plaster the stiff cheek with horse fat, drink good wine, eat roasted meat. Non-drinkers should self-stimulate by patting three times. Treatment involves burning needle rapid puncture, using efficacy as the measure, and pain points as Shu points. This is named Ji Chun Bi (Late Spring Obstruction). (Note: "If symptoms involve spasms" should precede burning needle treatment. Burning needles are only suitable for cold/spasm conditions, not heat/relaxation. Zhang Zihe stated: Left cold/right heat causes left stiffness/right relaxation; right cold/left heat causes right stiffness/left relaxation. Cold should not be lightly treated with pungent-hot agents as it forces heat to the opposite side, blocking Yang Qi circulation.)
The Sinew-Meridian of Foot-Taiyin begins at the medial end of the big toe, ascends to knot at the medial malleolus. Its straight course connects to the medial condyle of the tibia, ascends along the medial thigh, knots at the thigh, gathers at the genitalia, ascends to the abdomen and knots at the umbilicus, runs inside the abdomen, knots at the ribs, scatters in the chest. Its internal branch attaches to the spine. Symptoms include pain supporting the big toe and medial malleolus, spasmodic pain, medial tibial condyle pain, medial thigh pulling to thigh pain, twisting pain in genitalia, downward pulling to umbilicus and hypochondrium, pulling to chest and spine. Treatment involves burning needle rapid puncture, using efficacy as the measure, and pain points as Shu points. This is named Meng Qiu Bi (Early Autumn Obstruction).
The Sinew-Meridian of Foot-Shaoyin begins below the little toe, runs parallel to Foot-Taiyin, obliquely walks below the medial malleolus, knots at the heel, combines with Foot-Taiyang to ascend and knot below the medial tibial condyle, runs with Foot-Taiyang, ascends along the medial thigh, knots at the genitalia, follows inside the spine flanking the erector muscles, ascends to the nape, knots at the occiput, combining with Foot-Taiyang. Symptoms include plantar spasms, and pain/spasms at all passing/knotting sites. Diseases here primarily involve epilepsy and clonic spasms. External involvement prevents bending forward; internal involvement prevents bending backward. Yang disease causes opisthotonos preventing bending forward; Yin disease prevents bending backward. Treatment involves burning needle rapid puncture, using efficacy as the measure, and pain points as Shu points. For internal cases, use warming compresses and herbal drinks. If sinews break/twist frequently and severely, death is inevitable. This is named Zhong Qiu Bi (Mid-Autumn Obstruction).
The Sinew-Meridian of Foot-Jueyin begins above the big toe, ascends to knot anterior to the medial malleolus, ascends along the shin, knots below the medial tibial condyle, ascends along the medial thigh, knots at the genitalia, links all sinews. Symptoms include pain supporting the big toe and anterior medial malleolus, medial condyle pain, medial thigh pain/spasms, dysfunction of genitalia. Injury internally leads to impotence; injury to cold leads to retraction; injury to heat leads to flaccidity/protrusion without retraction. Treatment involves regulating water and clearing Yin Qi. For spasms, treatment involves burning needle rapid puncture, using efficacy as the measure, and pain points as Shu points. This is named Ji Qiu Bi (Late Autumn Obstruction).
The Sinew-Meridian of Hand-Taiyang begins above the little finger, knots at the wrist, ascends along the medial arm, knots posterior to the medial epicondyle, eliciting sensation at the little finger, entering and knotting in the axilla. Its branch goes posteriorly along the lateral axilla, circles the scapula, follows the neck, emerges anterior to Foot-Taiyang, knots at Wan Gu (GB12) behind the ear. Its branch enters the ear. The straight course exits above/below the ear, knots at the mandible, attaches to the outer canthus. Symptoms include pain supporting the little finger and posterior medial epicondyle, following the medial arm into the axilla causing axillary pain, lateral axillary pain, scapular pain pulling to the neck, tinnitus/pain pulling to the mandible, prolonged eye closure before vision returns, neck sinew stiffness causing goiter/swelling. For cold-heat in the neck, treatment involves burning needle rapid puncture, using efficacy as the measure, and pain points as Shu points. For swelling, repeat sharp pricking. The main branch ascends to Qu Ya (ST7), follows anterior to the ear, attaches to the outer canthus, ascends to the mandible, knots at the frontal angle. Symptoms include spasms at passing sites. Treatment involves burning needle rapid puncture, using efficacy as the measure, and pain points as Shu points. This is named Zhong Xia Bi (Mid-Summer Obstruction).
The Sinew-Meridian of Hand-Shaoyang begins at the tip of the second finger, knots at the wrist, ascends along the arm, knots at the elbow, circles the lateral elbow, ascends to the shoulder, walks to the neck, merges with Hand-Taiyang. Its branch enters the jaw to tie to the root of the tongue. Its branch ascends to Qu Ya (ST7), follows anterior to the ear, attaches to the outer canthus, ascends to the mandible, knots at the frontal angle. Symptoms include spasms and tongue rolling at passing sites. Treatment involves burning needle rapid puncture, using efficacy as the measure, and pain points as Shu points. This is named Ji Xia Bi (Late Summer Obstruction).
The Sinew-Meridian of Hand-Yangming begins at the tips of the index and middle fingers, knots at the wrist, ascends along the arm, knots at the lateral elbow, ascends to knot at Jian Liao (TE14). Its branch circles the scapula, flanks the spine. The straight course goes from Jian Yu (LI15) to the neck. Its branch ascends to the cheek, knots at the zygoma. The straight course emerges anterior to Hand-Taiyang, ascends to the left frontal angle, networks the head, descends to the right mandible. Symptoms include pain and spasms at passing sites, inability to raise the shoulder, inability to turn the head left/right. Treatment involves burning needle rapid puncture, using efficacy as the measure, and pain points as Shu points. This is named Meng Xia Bi (Early Summer Obstruction).
The Sinew-Meridian of Hand-Taiyin begins above the thumb, follows the finger up, knots posterior to the Thenar eminence, runs along the lateral Cun Kou, ascends along the arm, knots at the elbow, ascends along the medial arm, enters the axilla, emerges from the supraclavicular fossa, knots at the anterior shoulder, ascends to knot at the supraclavicular fossa, descends to knot in the chest interior, scatters through the diaphragm, merges below the diaphragm to reach the costal margin. Symptoms include pain and spasms at passing sites, severe cases develop Xi Ben (Breathful Accumulation), rib urgency, hematemesis. Treatment involves burning needle rapid puncture, using efficacy as the measure, and pain points as Shu points. This is named Zhong Dong Bi (Mid-Winter Obstruction).
The Sinew-Meridian of Hand-Zhongying (Pericardium) begins at the middle finger, runs parallel to Hand-Taiyin, knots at the medial elbow, ascends the medial arm, knots at the axilla, scatters anterior/posterior flanking the ribs. Its branch enters the axilla, scatters in the chest, knots at the sternum. Symptoms include spasms/pain anteriorly and chest pain/Xi Ben at passing sites. Treatment involves burning needle rapid puncture, using efficacy as the measure, and pain points as Shu points. This is named Meng Dong Bi (Early Winter Obstruction).
The Sinew-Meridian of Hand-Shaoyin begins at the medial little finger, knots at the styloid process, ascends to knot at the medial elbow, ascends into the axilla, crosses Hand-Taiyin, flanks the breast interior, knots in the chest, follows the arm, descends to tie to the umbilicus. ("Arm" should be "Chest"). Symptoms include internal urgency, Xin Cheng Fu Liang (Heart bearing a beam), lower elbow net. Symptoms include spasms/pain at passing sites. Treatment involves burning needle rapid puncture, using efficacy as the measure, and pain points as Shu points; if Fu Liang with hemoptysis/purulent sputum develops, death is inevitable. This is named Ji Dong Bi (Late Winter Obstruction).
Diseases of the Sinew-Meridians: Cold causes opisthotonos and sinew stiffness; Heat causes sinew flaccidity and inability to retract, leading to impotence. Yang stiffness causes opisthotonos; Yin stiffness causes inability to extend after bending. Cui Ci (Quenching puncture) treats cold stiffness. Heat causes flaccidity; do not use Fan Zhen (Burning needles). (Moxibustion is similar; modern practitioners use moxa indiscriminately for both cold and heat, lacking this understanding.)
Foot-Yangming and Hand-Taiyang sinew stiffness causes facial deviation and inability to see suddenly. Treatment follows the above methods. (All seen in *Ling Shu* Sinew-Meridian Chapter.)
Form comfort but mental suffering, disease arises in sinews, treat with warming compresses and Dao Yin (guiding and pulling exercises). (Full text see Treatment Methods chapter.)
All sinew diseases belong to the joints. Classic says: All sinews belong to the joints. Also: Flexion without extension indicates sinew disease. The Liver governs all sinews. Classic says: Liver governs sinews. Also: In organs it is the Liver, in tissues it is sinews. Also: Sour generates Liver, Liver generates sinews, sinews generate Heart. Sinew diseases avoid wind, avoid sour/pungent foods, avoid prolonged walking. Classic says: Wind injures sinews, Dryness overcomes Wind, Sour injures sinews, Pungent overcomes Sour. Also: Sour travels to sinews, sinew diseases should not consume much sour. Also: Excess pungent causes sinew stiffness and brittle nails. Also: Prolonged walking injures sinews.