马云。终始本古经篇名。而伯乃述之。故前根结篇有云。九针之玄。要在终始。此又曰。毕于终始。故知
其为古经篇名也。按首无起句。当同前篇。俱为岐伯言也。
毕于终始 张云。终始本篇名。详载阴阳针刺之道。今散类各章。志云。终始者始于五脏。次于经脉。
终于六气。盖五脏内生六络。六经外合六气。盖五脏又本于六气之所生。故曰人生于地。悬命于天。简案、终
始。其义未详。姑仍马张。
阳受气于四末（止）可令和 马云。阳在外。受气于四肢。阴在内。受气于五脏。故因其气之来而
迎之者。泻之法也。因其气之往而随之者。补之法也。知迎随为补泻。则阴阳诸经之气可和调矣。
和气之方 论语。雍也。集解引孔注云。方、道也。
无道行私 张云。不明至道。而强不知以为知。即无
道行私也。伐人长命。殃必及之。天道不爽。当知所畏。
谨奉天道（止）经脉为纪 张云。天道阴阳。有十二辰次为之纪。人身血气。有十二经脉为之纪。
循环无端。终而复始。故曰终始。
持其脉口人迎 张云。脉口在手。太阴脉也。可候五脏之阴。人迎在颈。阳明脉也。可候六腑之
阳。人之血气经脉。所以应天地阴阳之盛衰者。毕露于此。故曰天道毕矣。
应四时也 张云。春夏人迎微大。秋冬寸口微大。（简案出禁服篇）应四时也。上谓人迎。下谓
脉口。相应往来。即如下编所谓俱往俱来。若引绳大小齐等也。简案、马以上为寸口。以下为尺。恐非。
不结动也 张云。结涩则不足。动疾则有余。皆非平脉也。
本末之寒温之相守司也 甲乙作本末相遇。寒温相守司。似是。禁服篇曰。察其本末之寒温。以
验其脏腑之病。张云。脏气为本。肌体为末。表里寒温司守。不致相失。故必外之形肉。内之血气。皆相称者。
谓之平人。志。本末之寒温之两之字下句。注云。本末者。有本标之出入。寒温者。应寒暑之往来。各相守司
也。简案、志注。义未明晰。
少气者（止）不称尺寸 张云。少气者。元气虚也。兼阴阳而言。故上之人迎。下之脉口。必皆
衰少无力。而两手之尺寸。亦不相称也。简案、尺寸。诸家为寸关尺之尺寸。然内经无此义。今言不称尺寸者。
其脉短少。不称常时之尺寸。
可将以甘药 不可饮以至剂 张云。但可将以甘药。甘药之谓。最有深意。盖欲补虚羸。非甘纯
不可也。至剂。刚毒之剂也。正气衰者不可攻。故不宜用也。志云。甘药者调胃之药。谓三阴三阳之气。本于
中焦胃腑所生。宣补其生
气之原。道之流行。故不可饮以至剂。谓甘味太过。反留中也。简案、以至剂为至甘之剂。殆乖经旨。
弗灸 张云。以火能伤阴也。志云。谓阴阳之气不足于外。非经脉之陷下也。
人迎一盛（止）病在手阳明 张云。人迎。足阳明脉也。一盛二盛。谓大于气口一倍二倍也。阳
明主表。而行气于三阳。故人迎一盛。病在足经之少阳。若大一倍而加以躁动。则为阳中之阳。而上在手经之
少阳矣。凡二盛三盛。病皆在足。而躁则皆在手也。下仿此。简案、禁服篇曰。人迎大一倍于寸口。病在足少
阳。以下文例同。故张以一盛为一倍也。马志以人迎气口。为左右寸口而释之。此王叔和以降之说。非古之义。
不可从。
人迎四盛（止）为外格 张云。人迎盛至四倍。且大且数者。乃六阳偏盛之极。盈溢于腑。格拒
六阴。是为外格。按、下文曰。溢阴为内关。内关不通。死不治。则此外格者。亦死无疑。简案、禁服篇云。
溢阳为外格。死不治。志云。阳可盛而阴不可盛也。故溢阳不曰死。盖不考耳。
脉口一盛（止）在手太阴 张云。脉口。手太阴脉也。太阴主里。而行气于三阴。故脉口一盛。
病在足经之厥阴。若加以躁。则为阴中之阳。而上在手厥阴心主矣。凡二盛三盛皆在足。而躁则皆在手也。志
本厥阴之下。更多厥阴二字。误。
脉口四盛（止）死不治 张云。脉口四盛。且大且数者。乃六阴偏盛。盈溢于脏。表里隔绝。是
为内关。主死不治。
命曰关格 张云。人迎主阳。脉口主阴。若俱盛至四倍以上。则各盛其盛。阴阳不交。故曰关格。
可与言死期也。马云。后世医籍。皆以饮食不下为关格。视此节大义。可深
惭云。（关格义详于素问识六节藏象论当互阅）
人迎一盛泻足少阳（止）上气和乃止 张云。人迎主腑。故其一盛。病在胆经。肝胆相为表
里。阳实而阴虚。故当泻足少阳之腑。补足厥阴之脏也。泻者二。补者一。泻倍于补也。疏取之者。欲其从容。
不宜急也。上气。言气之至也。气至而和。谷气至矣。故可止针。下仿此。马云。必切其脉而验其病之退否。
疏而取穴于胆肝二经之上。盖彼此之穴相间之谓疏也。候至气和乃止针。由此推之。则一盛而躁。病在手少阳。
当泻手少阳三焦经。而补手厥阴心包络经矣。志云。疏、当作躁。谓一盛而躁。二盛而躁。当取手之阴阳也。
简案、据马志。上气之上。接上句。且志改疏作躁。并不允。
太阳主胃 甲乙。阳、作阴。马云。太阳作阳明。张云。太言太阴。阳言阳明。脾与胃为表里。
故曰太阳主胃。简案、甲乙为是。此盖该上文足阳明日二取之而言。张云。上文人迎之治。治三阳也。皆日二
泻一补。气口之治。治三阴也。皆日二补一泻。盖以三阳主表。病在表者。宜泻倍于补也。三阴在里。病在里
者。宜补倍于泻也。皆以脏气为重。惟恐其或伤耳。又如厥阴少阳。肝胆木脏也。东方多实。故可日二取之。
太阴阳明。脾与胃也。脾胃大富于谷气。故可日二取之。惟少阴太阳。则二日一取之。盖肾与膀胱。为天一之
脏。真阴之原。故宜保重如此。圣人之顾根本。岂惟针刺为然哉。
三倍以上（止）为他病矣 甲乙。三、作四。张云。俱盛三倍以上。即四盛也。阴阳俱溢。即
溢阴溢阳也。不开。即外关内格也。如此者。血气闭塞无所行。五盛真阴伤于内。刺之已不可。灸之则愈亡其
阴。而变生他病。必至不能治也。志云。若不以针开之。则血脉闭塞。气无所行。流溢于中。
则内伤五脏矣。夫盛则泻之。虚则补之。陷下则灸之。此阴阳之气。偏盛不和。非陷下也。故灸之则生他病矣。
凡刺之道（止）血气不行 志云。谓阴阳之气偏盛。刺之和调则止矣。然又当补阴泻阳。补阴者。
补五脏之衰阴。泻阳者。导六气之外出。六节脏象论曰。五气入鼻。藏于心肺。上使五色修明。音声能彰。顺
气篇曰。五者音也。音主长夏。是补其藏阴。则心、肺、脾、藏之气和。而音声益彰矣。肝开窍于目。肾开窍
于耳。肝肾之气盛。则耳目聪明矣。甲乙。音气、作音声。
适虽言故 马云。苟坚如其初。则适才虽言病去复旧。其病未去也。张云。脉坚如旧者。虽欲文饰
其故。而病实未除也。简案、据下文言。快而推之。故乃病去而复其故之谓。马注为是。
夫如其故 甲乙。夫、作大。是。
痛虽不随针 甲乙。痛、作病。下同。针下有减字。下文同。马云。虽不随针而即去。然亦必以渐而衰矣。
十二经脉之所生病 马云。欲通十二经脉之所生病。及虚实补泻。必明于本经经脉第十篇而后可。
可得传于终始矣 张云。终始、本篇名。即本末之谓。
故阴阳不相移（止）取之其经 张云。移、移易也。倾、相伤也。或阴或阳。无所改易。不相移也。
虚者自虚。实者自实。不相倾也。此则无所从生。而各病其病。但求其经而取之。
邪辟妄合 辟、甲乙作 。马志作 。张云。邪辟妄合等六句。详言病变也。凡此者皆须用针。治
以三刺之法。则诸病可去也。
沉浮异处 四时不得 马云。脉气浮沉。似所处各异。
志云。浮沉异处者。阴阳之气与经脉不相合也。四时不得者。不得其升降浮沉也。
故一刺（止）谷气至也 张云。初刺之在于浅近。故可出阳分之邪。再刺之在于深远。故可出阴分
之邪。三刺之在候谷气。谷气者。元气也。止、出针也。盖邪气来也紧而疾。谷气来也徐而和。必邪气去而后
谷气至。故已补而实则虚者坚。已泻而虚则坚者软。是以知谷气之至也。马云。此节大意。见前官针篇。
阴盛而阳虚（止）和之 张云。此以脉口、人迎、言阴阳也。脉口盛者。阴经盛而阳经虚也。当先
补其阴。后泻其阳而和之。人迎盛者。阳经盛而阴经虚也。当先补其阴。后泻其阳而和之。何也。以治病者。
皆宜先顾正气。后治邪气。盖攻实无难。伐虚当畏。于此节之义。可见用针用药。其道皆然。
三脉动于足大趾之间 马云。阳明动于大趾次趾之间。凡厉兑、陷谷、冲阳、解溪、皆在足跗上也。厥
阴动于大趾次趾之间。正以大敦、行间、太冲、中封、在足跗内也。少阴则动于足心。其穴涌泉。乃足跗之下也。
其动也 甲乙作三脉动于大指者八字。
阳明止少阴在下 楼氏纲目曰。阳明在上。冲阳脉也。厥阴在中。太冲脉也。少阴在下。太溪脉也。
马云。阳明则在手足之上。厥阴则在于二经之中。少阴则在于足之下耳。
膺 中膺（止）取之上 马云。此言凡取穴者。必当各中其所也。胸之两旁谓之膺。故膺内有 。
如胃经气户、库房、屋翳、膺窗。肾经 中、神藏、灵墟、神封、之类。凡刺膺 者。当中其膺可也。背内有
。如督脉经诸穴。居脊之中。膀胱经诸穴。居脊之四行之类。凡刺背 者。当中其背与肩
膊可也。凡按分肉虚。虚则取之耳。张云。凡肩膊之虚软而痛者。病有阴经阳经之异。阴经在膺。故治阴病者。
当取膺 而必中其膺。阳经在背。故治阳病者。当取背 而必中其背。病在手经故取之上。上者手也。如手太
阴之中府、云门。手厥阴之天池。皆膺 也。手少阳之肩 、天 。手太阳之天宗、曲垣、肩外 。皆背 也。
咸主肩膊虚痛等病。简案、二家所取义各异。未审孰是。然张添痛字释之。似于原文未允当。但马以肩膊二字
接上句。以上字接次节重字上。非。
重舌刺舌柱 以铍针也 张云。舌下生小舌。谓之重舌。舌柱即舌下之节如柱者也。当用第五
针曰铍针者刺之。九针论曰。铍针主大痈脓两热争者。官针篇曰。病为大脓者。取以铍针。简案、刺出恶血也。
手屈（止）守筋 张云。屈而不伸者。筋之拘挛也。故治当守筋。不可误求于骨。伸而不屈者。
骨之废弛也。故治当守骨。不可误求于筋也。
补须一方实（止）无使邪气得入 张云。补、当作刺。刺法虽多。其要惟二。则补泻而已。一者
因其方实。故当深取之。勿按其 。欲以出其邪气。此泻法也。一者因其方虚。故当浅刺之。以养其血脉。疾
按其穴。以拒其邪气。此补法也。马云。方、犹俗云才方也。
邪气来也（止）徐而和 马云。邪气之来。其针下必紧而疾。谷气之来。其针下必徐而和。可
得而验也。
刺诸痛者 其脉皆实 甲乙者下有深刺之诸痛者六字。张云。此言痛而可刺者。脉必皆实者也。然
则脉虚者。其不宜刺可知矣。
从腰以上（止）足太阴阳明皆主之 张云。此近取之法也。腰以上者。天之气也。故当取肺与
大肠二经。盖肺经自胸行
手。大肠经自手上头也。腰以下者。地之气也。故当取脾胃二经。盖脾经自足入腹。胃经自头下足也。病之在
阴在阳。各察其所主而刺之。
病在上者（止）取之 张云。此远取之法也。有病在上而脉通于下者。当取于下。病在下而脉
通于上者。当取于上。故在头者取之足。在腰者取之 。盖疏其源而流自通。故诸经皆有井、荥、俞、原、经、
合之辨。
春气在毛（止）以春夏之齐 甲乙。毛、上有毫字。马云。齐、剂同。素问有刺齐论。张云。
此言病气之中人。随时气而为深浅也。春夏阳气在上。故取毫毛皮肤。则浅其针。秋冬阳气在下。故取分肉筋
骨。则深其针。是以时为齐也。按、四时刺逆从论曰。春气在经脉。夏气在孙络。长夏气在肌肉。秋气在皮肤。
冬气在骨髓。中与本篇若异者何也。盖本篇言病邪之应时令。有表有里。四时刺逆从论。言人气之合天地。有
升有降。义本不同。非矛盾也。肥人肉浓。浅之则不及。故宜秋冬之齐。瘦人肉薄。深之则太过。故宜春夏之
齐。志云。齐者与时一之也。简案、志注非是。七十难与本篇之义合。
病痛者阴也（止）深刺之 张云。凡病痛者。多由寒邪滞逆于经。及深居筋骨之间。凝聚不散。
故病痛者为阴也。按之不得者。隐藏深处也。是为阴邪。故刺亦宜深。然则痛在浮浅者。由属阳邪可知也。但
诸痛属阴者多耳。
病在上者阳也（止）浅刺之 张云。阳主升。故在上者为阳。阴主降。故在下者为阴。痒者散
动于肤腠故为阳。凡病在阳者。皆宜浅刺之。其在下者。自当深刺无疑也。志云。此论表里上下之阴阳。夫表
为阳。里为阴。身半以上为阳。身半以下为阴。病在阳者名曰风。故痒者阳也。病在皮肤之
Ma Yun's commentary: "Zhongshi" (Ends and Beginnings) is originally the title of an ancient classic chapter, which Bo Gao (or possibly refers to Qibo) elaborated upon. Therefore, in the previous chapter "Genjie" (Roots and Ends), it states: "The profound mystery of the nine needles lies in Zhongshi." Here it again says "concluded in Zhongshi," thus confirming it as the title of an ancient classic chapter. Since the beginning of this text lacks an opening sentence, it should be consistent with the preceding chapter, both being statements by Qibo.
"Concluded in Zhongshi": Zhang Jingyue's commentary: "Zhongshi" is the title of this chapter, detailing the principles of yin-yang acupuncture. It is now scattered across various chapters. Zhang Zhicong's commentary: The so-called "ends and beginnings" refers to starting with the five zang organs, proceeding to the meridians, and concluding with the six qi. Generally, the five zang organs internally generate six collaterals, and the six meridians externally harmonize with the six qi. The five zang organs are fundamentally derived from the generation of the six qi; hence it is said, "Humans are born of the earth, and their life is suspended from heaven." Brief note: The meaning of "Zhongshi" remains unclear; for now, we follow the interpretations of Ma and Zhang.
"Yang receives qi at the four extremities": Ma Yun's commentary: Yang qi is external and receives qi from the four limbs; Yin qi is internal and receives qi from the five zang organs. Therefore, meeting the qi as it arrives constitutes the reducing method; following the qi as it departs constitutes the tonifying method. Understanding that Ying-Sui (meeting and following) corresponds to reducing and tonifying allows the qi of all yin and yang meridians to be harmonized.
"The method to harmonize qi": From *Analects*, "Yong Ye," collected commentary citing Kong Anguo's note: "Fang" means the Way (Dao).
"No Dao, acting selfishly": Zhang Jingyue's commentary: Not understanding the supreme Dao yet pretending to know it is acting without Dao and selfishly. Damaging others' long life will surely bring disaster upon oneself. Heaven's Dao is impartial; one ought to have reverence.
"Respectfully following Heaven's Dao" to "Meridians as the Chronicle": Zhang Jingyue's commentary: In Heaven's Dao, yin and yang have the twelve earthly branches as their chronicle; in the human body, blood and qi have the twelve meridians as their chronicle. They circulate endlessly, ending and beginning anew, hence called "Zhongshi."
"Holding the Mai Kou and Ren Ying": Zhang Jingyue's commentary: Mai Kou is on the hand, belonging to the Hand Taiyin Lung Meridian, capable of observing the yin of the five zang organs. Ren Ying is on the neck, belonging to the Foot Yangming Stomach Meridian, capable of observing the yang of the six fu organs. The fluctuations of human blood, qi, and meridians reflecting the rise and fall of heaven and earth's yin and yang are fully revealed here, hence it is said, "Heaven's Dao is complete."
"Corresponding to the Four Seasons": Zhang Jingyue's commentary: In spring and summer, Ren Ying is slightly larger; in autumn and winter, Cun Kou is slightly larger. (Brief note: This phrase appears in the "Jinfu" chapter.) This corresponds to the four seasons. The "upper" mentioned above refers to Ren Ying, and the "lower" below refers to Mai Kou. Their corresponding movement is like what is described later as moving together, equal in size like a taut rope. Brief note: Ma Yun's interpretation of the upper as Cun Kou and lower as Chi section is likely incorrect.
"Not knotted or agitated": Zhang Jingyue's commentary: A knotted or choppy pulse indicates deficiency; an agitated or rapid pulse indicates excess. Neither is a normal pulse.
"The cold and warmth of the root and branch guarding each other": *Jia Yi Jing* reads "root and branch meet, cold and warmth guard each other," which seems more plausible. The "Jinfu" chapter states: "Observe the cold and warmth of the root and branch to verify zang-fu diseases." Zhang Jingyue's commentary: Zang qi is the root, somatic tissue is the branch. Interior-exterior and cold-warmth mutually guard against deviation. Thus, when external flesh and internal blood/qi are proportional, it is called a healthy person. Zhang Zhicong's commentary: The character "liang" (two) under "cold and warmth of root and branch" belongs to the next sentence. The annotation explains: Root and branch refer to the entry and exit of Biao-Biao (root and mark); cold and warmth correspond to the coming and going of cold and heat, each guarding its own domain. Brief note: Zhang Zhicong's annotation is not clear enough.
"Qi deficiency" to "Not proportional to Cun-Chi": Zhang Jingyue's commentary: Qi deficiency implies weak primordial qi. Speaking of both yin and yang, both the upper Ren Ying and lower Mai Kou pulses will be weak and powerless, and the Cun and Chi sections of both hands will also be disproportionate. Brief note: "Cun-Chi" usually refers to the Cun, Guan, and Chi positions, but this meaning does not exist in *Neijing*. Here, "not proportional to Cun-Chi" means the pulse is short and does not match the standard dimensions.
"Can be treated with sweet medicines" and "Cannot drink potent formulations": Zhang Jingyue's commentary: Only sweet medicines can be used for regulation. The term "sweet medicine" holds deep significance. To tonify emaciation and weakness, purely sweet substances are essential. "Potent formulation" refers to harsh or toxic drugs. Those with deficient righteous qi cannot undergo attack, so such drugs are unsuitable. Zhang Zhicong's commentary: Sweet medicines regulate stomach qi because the qi of the three yin and three yang originates from the middle jiao stomach. Tonifying the source of generating qi promotes the flow of Dao. Therefore, one should not drink potent formulations, as excessive sweetness causes stagnation in the middle jiao. Brief note: Interpreting "potent formulation" as extremely sweet contradicts the original intent.
"Do not moxa": Zhang Jingyue's commentary: Because fire damages yin. Zhang Zhicong's commentary: This refers to insufficient yin and yang qi externally, not sunken meridians.
"Ren Ying one-fold excess" to "Disease in Hand Yangming": Zhang Jingyue's commentary: Ren Ying is the Foot Yangming Stomach Meridian pulse. One-fold and two-fold excess mean it is one or two times larger than Qi Kou. Yangming governs the exterior and circulates qi through the three yang meridians. Thus, if Ren Ying is one-fold excess, the disease is in the Foot Shaoyang. If it is one-fold excess plus agitation, it becomes yang within yang, and the disease moves up to the Hand Shaoyang. For two-fold and three-fold excess, the disease is always in the foot meridians; if agitated, it is in the hand meridians. The rest follows this pattern. Brief note: The "Jinfu" chapter states: "Ren Ying one time larger than Cun Kou, disease in Foot Shaoyang." Following this example, Zhang interprets one-fold as one time. Ma Yun and Zhang Zhicong interpret Ren Ying and Qi Kou as left and right Cun Kou, which is a post-Wang Shuhe view, not the ancient meaning, and should not be followed.
"Ren Ying four-fold excess" to "External Ge": Zhang Jingyue's commentary: When Ren Ying is four-fold excess, large and rapid, it represents the extreme excess of the six yang, overflowing into the fu organs and rejecting the six yin, termed "External Ge." Note: The text later says: "Overflowing yin creates Internal Guan; if Internal Guan is blocked, death is inevitable." Thus, External Ge is also undoubtedly fatal. Brief note: The "Jinfu" chapter says: "Overflowing yang creates External Ge, death is inevitable." Zhang Zhicong comments: Yang can overflow, but yin cannot; hence overflowing yang is not called fatal, likely due to lack of verification.
"Mai Kou one-fold excess" to "In Hand Taiyin": Zhang Jingyue's commentary: Mai Kou is the Hand Taiyin Lung Meridian pulse. Taiyin governs the interior and circulates qi through the three yin meridians. Thus, if Mai Kou is one-fold excess, the disease is in the Foot Jueyin. If accompanied by agitation, it becomes yin within yin, moving up to the Hand Jueyin Pericardium. For two-fold and three-fold excess, the disease is in the foot meridians; if agitated, it is in the hand meridians. Zhang Zhicong's edition erroneously adds "Jueyin" twice after Jueyin.
"Mai Kou four-fold excess" to "Death is uncurable": Zhang Jingyue's commentary: When Mai Kou is four-fold excess, large and rapid, it represents the extreme excess of the six yin, overflowing into the zang organs, isolating interior and exterior, termed "Internal Guan," leading to death.
"Called Guan Ge": Zhang Jingyue's commentary: Ren Ying governs yang, Mai Kou governs yin. If both exceed four-fold, they各自盛 their excess, and yin and yang do not interact, hence called "Guan Ge." One may predict the time of death. Ma Yun's commentary: Later medical texts define Guan Ge as inability to swallow food/drink. Comparing this with the main meaning of this section brings deep shame. (For details on Guan Ge, see *Suwen Shi*, Six Jie Zang Xiang Lun, cross-reference.)
"Ren Ying one-fold excess, reduce Foot Shaoyang" to "Upper qi harmonized then stop": Zhang Jingyue's commentary: Ren Ying governs fu organs; thus, one-fold excess indicates disease in the Gallbladder Meridian. Liver and Gallbladder are interior-exterior pairs; yang is excess and yin is deficient. Therefore, reduce the Foot Shaoyang Fu organ and tonify the Jueyin Zang organ. Reduce twice, tonify once; reduction is double the tonification. "Shu qu zhi" (selecting distantly/sparsely) implies a leisurely approach, not urgent. "Shang qi" (upper qi) refers to the arrival of qi. When qi arrives and harmonizes, Gu Qi (grain qi) has arrived, so needling can stop. Ma Yun's commentary: One must palpate the pulse to verify if the pathogen recedes, selecting acupoints sparsely between the Gallbladder and Liver meridians. Wait until qi harmonizes before stopping. By inference, if one-fold excess with agitation, disease is in Hand Shaoyang; reduce Hand Shaoyang Sanjiao and tonify Hand Jueyin Pericardium. Zhang Zhicong's commentary: "Shu" should be "Zao" (agitated). One-fold agitated, two-fold agitated, select hand yin-yang meridians. Brief note: Based on Ma and Zhang, connecting "Shang" to the previous sentence and changing "Shu" to "Zao" is inappropriate.
"Taiyang governs Stomach": *Jia Yi Jing* reads "Yang" as "Yin." Ma Yun notes: Taiyang should be Taiyang (Yangming). Zhang Jingyue notes: "Tai" refers to Taiyin, "Yang" refers to Yangming. Spleen and Stomach are interior-exterior, hence Taiyang governs Stomach. Brief note: *Jia Yi Jing* is correct. This likely summarizes the earlier "Foot Yangming daily two treatments." Zhang Jingyue further explains: Treating Ren Ying treats the three yang meridians (2 reduce, 1 tonify). Treating Qi Kou treats the three yin meridians (2 tonify, 1 reduce). Exterior diseases favor reduction over tonification; interior diseases favor tonification over reduction, prioritizing zang qi. Wood organs (Liver/Gallbladder) often have excess, allowing two treatments daily. Earth organs (Spleen/Stomach) are rich in grain qi, allowing two treatments daily. Water organs (Kidney/Bladder) are the source of true yin, requiring caution (treatment every two days). Sages protect the root, not just in acupuncture.
"Three times or more" to "Other diseases arise": *Jia Yi Jing* reads "three" as "four." Zhang Jingyue's commentary: Excess of three times or more is equivalent to four-fold. Yin-yang both overflowing is Yiyin/Yiyang. Lack of opening is Waiguan/Neige. In such cases, blood and qi are blocked. Five-fold excess injures true yin internally. Needling is ineffective; moxibustion destroys yin and causes other diseases, becoming untreatable. Zhang Zhicong's commentary: Without needle intervention, blood vessels block, qi stagnates, damaging zang organs. Excess requires reducing, deficiency tonifying, sunken moxa-ing. This is yin-yang imbalance, not sinking, so moxa causes other diseases.
"All acupuncture methods" to "Blood and qi do not flow": Zhang Zhicong's commentary: Yin-yang imbalance is resolved by harmonizing acupuncture. However, one must tonify yin and reduce yang. Tonifying yin supplements the declining yin of the five zang; reducing yang guides the outward flow of the six qi. *Six Jie Zang Xiang Lun* states: "Five qi enter via nose, stored in Heart/Lung, brightening complexion and voice." *Shun Qi* chapter states: "Sound relates to late summer." Tonifying zang yin harmonizes Heart/Lung/Spleen qi, enhancing voice. Liver opens to eyes, Kidney to ears; strong Liver/Kidney qi ensures sharp hearing and vision. *Jia Yi Jing* reads "sound qi" as "voice sound."
"Although he says it is as before": Ma Yun's commentary: If the pulse remains hard as initially, although he claims the disease has returned to normal, the disease persists. Zhang Jingyue's commentary: If the pulse is hard as before, despite verbal claims, the disease remains. Brief note: Based on the following text "fast and push," "returning to former state" means disease removal. Ma's note is correct.
"As if it were the former": *Jia Yi Jing* reads "Fu" as "Da," which is correct.
"Pain does not immediately follow the needle": *Jia Yi Jing* reads "Tong" (pain) as "Bing" (disease). Ma Yun's commentary: Although pain does not vanish instantly with needling, it gradually subsides.
"Diseases generated by the twelve meridians": Ma Yun's commentary: To understand diseases of the twelve meridians and deficiency/excess reduction/tonification, one must study Chapter 10 "Benjing Jingmai."
"Can be transmitted to Zhongshi": Zhang Jingyue's commentary: "Zhongshi" is this chapter's title, synonymous with "root and branch."
"Therefore yin and yang do not shift" to "Select from their meridians": Zhang Jingyue's commentary: "Shift" means change; "Qing" means mutual harm. Yin or yang remains unchanged. Deficiency stays deficient, excess stays excess, without mutual harm. Disease arises independently; simply select the affected meridian.
"Evil deviations combine falsely": Zhang Jingyue's commentary: These six sentences detail pathological changes. All require acupuncture using the three-stab method to resolve diseases.
"Floating and sinking differ in location" and "Do not conform to seasons": Ma Yun's commentary: Pulse floating/sinking seem to occupy different locations. Zhang Zhicong's commentary: Floating/sinking differences indicate yin-yang qi mismatch with meridians. Not conforming to seasons means failing to achieve proper ascending-descending-floating-sinking dynamics.
"Therefore one stab" to "Gu Qi arrives": Zhang Jingyue's commentary: First stab is shallow, expelling yang-pathogens. Second stab is deep, expelling yin-pathogens. Third stab waits for Gu Qi (primordial qi). Stop means withdrawing the needle. Pathogenic qi arrives tight and fast; Gu Qi arrives slow and harmonious. Only after pathogens leave does Gu Qi arrive. Thus, after tonification, excess becomes soft; after reduction, hardness becomes soft, indicating Gu Qi arrival. Ma Yun's commentary: See *Guan Zhen* chapter for main ideas.
"Yin excess and yang deficiency" to "Harmonize them": Zhang Jingyue's commentary: Using Mai Kou/Ren Ying to discuss yin/yang: Mai Kou excess means yin meridian excess and yang meridian deficiency. Tonify yin first, then reduce yang to harmonize. Ren Ying excess means yang meridian excess and yin meridian deficiency. Tonify yin first, then reduce yang to harmonize. Why? Treaters must prioritize righteous qi over pathogens. Attacking excess is easy; attacking deficiency is dangerous. This principle applies to both acupuncture and herbal medicine.
"Three pulses move between the big toes": Ma Yun's commentary: Yangming moves between the big and second toes (Lidui, XianGu, ChongYang, Jiexi on dorsum). Jueyin moves there too (Dadun, Xingjian, Taichong, Zhongfeng on medial dorsum). Shaoyin moves at the sole (Yongquan).
"Its movement": *Jia Yi Jing* reads "Three pulses move at big toe" as eight characters.
"Yangming stops, Shaoyin below": Lou's *Gangmu* states: Yangming is above (Chongyang pulse). Jueyin is middle (Taichong pulse). Shaoyin is below (Taixi pulse). Ma Yun's commentary: Yangming is upper/lower extremities; Jueyin is middle; Shaoyin is lowest foot.
"Ying chest Ying" to "Select above": Ma Yun's commentary: Acupoint selection must hit the target. Sides of chest are Ying. Points include Stomach Meridian (Qihu, Kufang, Wuyi, Yingchuang) and Kidney Meridian (Shen Cang, Ling Xu, Shen Feng). Puncturing Ying points should center on the chest. Back points include Du Meridian (spine center) and Bladder Meridian (four rows along spine). Puncturing back points should center on back/shoulders. Empty muscle areas require treatment. Zhang Jingyue's commentary: Shoulder/arm emptiness/pain differs by meridian. Yin meridians are in Ying; treat yin diseases by centering on Ying. Yang meridians are in Back; treat yang diseases by centering on Back. Hand meridian diseases select "above" (hands). Examples: Hand Taiyin (Zhongfu, Yunmen), Hand Jueyin (Tianchi) are Ying points. Hand Shaoyang (Jianliao, Tianliao), Hand Taiyang (Tianzong, Qu Yuan, Jianwaishu) are Back points. All treat shoulder/arm emptiness-pain. Brief note: Two interpretations differ. Zhang adding "pain" is imprecise. Ma connecting "shoulder/arm" to previous sentence and "above" to next section is incorrect.
"Tongue swelling puncture tongue pillar with Pi Needle": Zhang Jingyue's commentary: Small tongue under tongue is Tongue Swelling. Tongue pillar is the column-like structure underneath. Use the fifth needle, Pi Needle. *Nine Needles Theory*: Pi Needle treats large abscesses with competing heat. *Official Needles*: Large pus requires Pi Needle. Brief note: Puncture to release bad blood.
"Hand flexion" to "Guard tendons": Zhang Jingyue's commentary: Flexed but unable to extend indicates tendon spasm; treat tendons, not bones. Extended but unable to flex indicates bone laxity; treat bones, not tendons.
"Tonification requires one side solid" to "Prevent evil qi entry": Zhang Jingyue's commentary: "Tonify" should be "Puncture." Key techniques are reducing and tonifying. Solid condition: Deep puncture, do not press hole, expel evil (Reducing). Deficient condition: Shallow puncture, nourish blood/qi, quickly press hole to repel evil (Tonifying). Ma Yun's commentary: "Fang" means "just now."
"Pathogenic qi arrives" to "Slow and harmonious": Ma Yun's commentary: Pathogenic qi feels tight/fast under needle. Gu Qi feels slow/harmonious. This can be verified.
"Puncture all pains, their pulses are all solid": Zhang Jingyue's commentary: Painful conditions suitable for needling have solid pulses. Thus, deficient pulses are unsuitable for needling.
"From waist up" to "Foot Taiyin and Yangming both govern": Zhang Jingyue's commentary: Proximal selection. Waist up is Heaven Qi; select Lung and Large Intestine meridians (Lung chest-to-hand, LI hand-to-head). Waist down is Earth Qi; select Spleen and Stomach meridians (Spleen foot-to-abdomen, Stomach head-to-foot). Treat yin/yang diseases by observing their governance.
"Diseases above" to "Select from": Zhang Jingyue's commentary: Distal selection. Disease above with pulse connection below selects below. Disease below with pulse connection above selects above. Head diseases select feet; waist diseases select... Clear source, flow connects. All meridians have Jing-River-Stream-Source-Channel-Combine distinctions.
"Spring qi in hair" to "Use spring-summer standards": *Jia Yi Jing* adds "Hao" before "Mao." Ma Yun's commentary: Qi equals Ji. *Suwen* has *Ci Qi Lun*. Zhang Jingyue's commentary: Pathogens penetrate according to seasonal depth. Spring/summer yang is high; shallow needling (skin/hair). Autumn/winter yang is low; deep needling (muscle/bone). Season dictates standard. Note: *Si Shi Ci Ni Cong Lun* says: Spring qi in channels, Summer in collaterals, Late Summer in muscles, Autumn in skin, Winter in marrow. Difference? This chapter discusses pathogen-season correspondence (exterior-interior); *Ni Cong Lun* discusses human qi-earth-heaven correspondence (ascending-descending). Different meanings, not contradictory. Fleshy people need deeper needling (autumn/winter standard); thin people need shallower needling (spring/summer standard). Zhang Zhicong's commentary: Qi aligns with season. Brief note: Incorrect. Matches *Seventy Nan Jing*.
"Painful diseases are yin" to "Deep puncture": Zhang Jingyue's commentary: Pain often stems from cold pathogen stagnation in meridines or deep bone/muscle accumulation, making it yin. Unpressable pain hides deep (yin pathogen), requiring deep puncture. Superficial pain is yang pathogen, though most pains are yin.
"Diseases above are yang" to "Shallow puncture": Zhang Jingyue's commentary: Yang ascends (above is yang); Yin descends (below is yin). Itchiness scatters in skin/collaterals (yang). Yang diseases require shallow puncture; yin diseases deep puncture. Zhang Zhicong's commentary: Discusses exterior-interior/upper-lower yin-yang. Exterior is yang, interior is yin. Upper half is yang, lower half is yin. Wind diseases are yang; itchiness is yang. Disease in skin...