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(Lingshu, Chapter "Jingmai" and Chapter "Maidu")

Huangdi said: The twelve Jing-mai (Primary Meridians) run deep within the intervals between muscles, hidden from view. Those that are commonly visible are those of the Foot-Taiyin Spleen Channel passing over the lateral malleolus, because there is no concealment there. All vessels that float superficially and are commonly visible are Luo-connecting vessels (Collaterals). [Note: The original text "Foot-Taiyin" should be "Hand-Taiyin". Jing-mai run deep and straight, so the twelve primary meridians of the hand and foot all lie hidden within the muscle intervals and cannot be seen. Among them, only the Hand-Taiyin Lung Channel is visible, passing over the wrist's outer aspect; because the bone is exposed and the skin is shallow, it cannot be concealed. As stated later, "Jing-mai are usually invisible; their deficiency or excess is known via the Qi-kou pulse," this refers precisely to this point. Furthermore, any vessel floating on the surface and visible belongs to the Luo-connecting vessels. Fen-rou refers to the texture between muscles.] The six Luo-vessels of the Hand-Yangming Large Intestine Channel and Hand-Shaoyang Sanjiao Channel originate between the five fingers and ascend to converge in the middle of the elbow. [This cites the largest hand Luo-vessels to illustrate the method of observing collaterals. There are six channels for both hands and feet, but among the hand six channels' collaterals, only those of the Yangming and Shaoyang are the largest. The Luo-vessel of the Hand-Yangming Large Intestine Channel is named Pianli, located three cun distal to the left wrist on the radial side, diverging to connect with the Taiyin channel. The Luo-vessel of the Hand-Shaoyang Sanjiao Channel is named Waiguan, located two cun proximal to the wrist between the two tendons on the dorsal aspect of the forearm, running obliquely inward, passing through the Yangming and Taiyin, and diverging to connect with the Jueyin channel. Descending branches of these two vessels: the Yangming emerges near the Hegu acupoint, distributing to the index and middle fingers; the Shaoyang emerges near the Yangchi acupoint, scattering to the middle, ring, and little fingers. Hence, they originate between the five fingers. Ascending branches converge at the medial aspect of the elbow, near the Quze acupoint of the Hand-Jueyin Pericardium Channel. Any blue veins visible on the back of the human hand are clearly observable, commonly called "blue veins"; these are neither sinews nor primary meridians, but large collaterals where blood accumulates. Superficial collaterals on the exterior can be understood by analogy.] In individuals who drink alcohol, Wei-Qi (Defensive Qi) first reaches the skin and fills the Luo-connecting vessels, causing the collaterals to become prominent first. Thus, after the Wei-Qi becomes full, Ying-Qi (Nutritive Qi) then fills, and the Jing-mai (Primary Meridians) become highly prominent. [Wei-Qi is the fierce and slippery essence derived from food and grain; its nature is rapid and smooth, and it does not enter the meridians. Wine is also a fierce qi derived from food and grain, sharing this rapid nature. Therefore, when one drinks wine, its qi follows the Wei-Qi to reach the skin first and fill the collaterals. Once the collaterals are full, the Wei-Qi becomes saturated (like a tide reaching high water), followed by the filling of Ying-Qi, and finally the prominence of the Jing-mai. Ping implies fullness. Commentary: Vessels have Jing and Luo divisions; Jing is internal, Luo is external. Qi has Ying and Wei divisions; Ying is internal, Wei is external. One might expect that since wine's qi moves from inside out, it should affect Jing before Luo. Why does it affect Luo first? This is because Ying-Qi is like a spring bubbling underground, circulating endlessly, hence "Ying circulates within the vessels." Wei-Qi is like mist and rain vaporizing, penetrating up and down and pervading all things, hence "Wei circulates outside the vessels." Just as rainwater from the earth must first enter streams before reaching rivers and seas, Wei-Qi from the stomach must first fill the collaterals before reaching the primary meridians. Thus, the Lingshu chapter "Jing Shui" maps the twelve meridians to twelve rivers. In this analogy, Jing-mai are like great rivers, and Luo-vessels are like tributaries across the plains. This distinguishes Jing-Luo from Ying-Wei.] Sudden pulsations of the vessels indicate the presence of pathogenic factors residing there, lingering at the root and extremities of the meridians. If there is no pulsation, there may be heat; if not firm, it indicates sinking and emptiness. Deviating from normal patterns allows identification of which meridian is affected. [The preceding text states that drinking wine causes meridian prominence. Therefore, sudden pulsations in vessels that are usually quiet are caused by pathogens lingering at the root and end of the meridians. Here, "pathogen" refers to the toxic effects of alcohol. Alcohol-pathogen in the vessels causes even non-pulsating superficial collaterals to feel hot; although enlarged, they lack firmness, leading to a sensation of sinking and emptiness. This distinction between superficial collaterals and primary meridians allows differentiation based on movement and emptiness. The example of drinking wine is used specifically to highlight these differences to distinguish Jing and Luo vessels.] Leigong asked: How do we know the difference between Jing-mai and Luo-connecting vessels? Huangdi replied: Jing-mai are usually invisible; their deficiency or excess is assessed via the Qi-kou pulse. What is visible are all Luo-connecting vessels. [Qi-kou refers to the Hand-Taiyin Lung Channel. The Lung governs all vessels, and Qi-kou is the great convergence of pulses. Since the twelve primary meridians are deep and invisible, their status is discerned only at Qi-kou due to its accessibility. Other vessels visible on the surface are Luo-connecting vessels, not primary meridians.] Leigong said: I do not understand why. Huangdi said: All Luo-connecting vessels do not pass through major joints; they must travel through alternate pathways to enter and exit, rejoining beneath the skin, with their intersections visible externally. [Major joints refer to large articulations. Alternate pathways refer to interstitial routes. Primary meridians pass through muscle fissures and major joints. Luo-vessels bypass major joints, connecting areas inaccessible to primary meridians to facilitate circulation. Collaterals vary in size: large ones are called Da-luo (Great Collaterals), small ones are Sun-luo (Grandchild Collaterals). Da-luo are like tree trunks with entry and exit points; Sun-luo are like branches scattered in the skin and interstices, so their intersections are visible externally.] Therefore, when needling Luo-connecting vessels, one must needle at the site of congestion. If blood stasis is severe, even without visible knots, urgent bloodletting is required to drain the pathogen and expel stagnant blood; otherwise, retention may lead to Bi-syndrome (obstruction syndrome). [When needling collaterals, one targets the site of congestion where blood gathers, appearing thicker and more protruding than usual. If blood stasis is severe, even without distinct knots, urgent bloodletting is necessary to remove pathogenic blood; otherwise, it develops into painful obstruction. In northwestern customs, for wind-cold painful obstruction, an arm is tightly bound to engorge the blue veins at the elbow. Then, using a stone lancet at Quze and collateral knots, blood is released, termed "releasing cold." This is a remnant technique of this section, not without basis.] In diagnosing Luo-connecting vessels, cyan color indicates cold and pain; red indicates heat. Cold in the Stomach manifests as cyan vessels on the大鱼际 (Thenar eminence); heat in the Stomach manifests as red vessels at Yuji. Sudden blackening indicates long-standing Bi-syndrome. Mixed red, black, and cyan colors indicate alternating cold and heat. Cyan and short vessels indicate Qi deficiency. [Diagnosis involves observation. Color changes reveal disease; the Thenar vessels are particularly superficial. Cold causes Qi and Blood to coagulate and stagnate, turning cyan/black, indicating cold and pain. Heat causes Qi and Blood to become fluid and red/yellow, indicating heat. The Thenar area belongs to the Hand-Taiyin Lung Channel, but Stomach Qi extends here, allowing assessment of Stomach condition. Black is the most severe color; sudden blackening results from prolonged Bi. Alternating colors indicate fluctuating cold/heat. Cyan and shortness imply Yin excess and Yang deficiency, hence Qi deficiency.] When treating cold and heat syndromes involving multiple blood collaterals, needling should occur every other day until the blood is exhausted, after which deficiency or excess is regulated. [When pathogens lodge in the skin and hair without entering the meridians, causing cold and heat, the pathology lies in the blood collaterals. Thus, bloodletting every other day removes the pathogen. Once blood (and thus pathogen) is cleared, needling stops, and regulation follows based on deficiency or excess. Pathogens enter from the skin/hair and penetrate to the Zang organs; see Lingshu "Needling Class" item 30.] Small and short collaterals indicate Qi deficiency. Severe deficiency treated with draining methods leads to dizziness and fainting; severe cases result in collapse and inability to speak. In such cases, urgently sit the patient up. [Small, short collaterals reflect low Qi and should not be needled. Draining severe deficiency causes double depletion, leading to dizziness or syncope. Urgently seating the patient aids Qi recovery. Supine positioning may stagnate Qi, risking fatality.]
Jing-mai are internal; branching transversely are Luo-connecting vessels; further branching from Luo are Sun-collaterals. Prominent vessels with blood stasis must be rapidly purged. Excess is drained; deficiency is tonified with herbal decoctions. [Lingshu, Chapter "Maidu". Primary meridians run deep and straight, thus internal and hard to see. Collaterals branch transversely and are superficial, thus external and easy to see. Further branching yields Sun-collaterals ("Sun" means small; smaller ones are more numerous. Fine vessels throughout the body are Sun-collaterals in the skin and interstices. Collaterals with prominent blood stasis must be removed promptly to prevent obstruction. Zhu means to eliminate. However, draining is only for excess; deficiency contraindicates needling. As stated in Lingshu "Xieqi Zangfu Bingxing": "If Yin-Yang, form, and Qi are all deficient, do not use needles but regulate with sweet herbs." This refers to tonifying deficiency with herbal medicine.]