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[Lingshu] When a person is first born, essence (Jing) forms first. Once essence is formed, brain and marrow are generated. Bones serve as the structural framework. Vessels (Mai) circulate Ying-Qi. Tendons provide firmness. Flesh acts as a protective wall. The skin is firm and hair grows. When food enters the stomach, the vessel pathways become unobstructed. Blood and Qi then begin to circulate. The meridians (Jingluo) are capable of determining life and death, managing various diseases, and regulating deficiency and excess; they must not be obstructed.

The Hand-Taiyin Lung Meridian originates from the Middle Jiao (Zhongjiao). It descends to connect with the Large Intestine (the Lung and Large Intestine are exterior-interior pairs). It returns along the upper opening of the stomach (Shangwan of the Stomach), ascends through the diaphragm (located below the heart, separating turbid Qi from ascending to warm the Heart and Lung), and belongs to the Lung. From the lung system (i.e., the trachea/throat), it emerges horizontally into the axilla (the area below the shoulder and above the ribs). It descends along the medial aspect of the arm (the area between shoulder and elbow, pronounced 'rou'). It runs anterior to the Hand-Shaoyin Pericardium Meridian (Heart. Pericardium). It descends to the cubital fossa (the end of the arm is the elbow). It follows the medial aspect of the forearm along the lower border of the bone (the forearm is below the elbow). It enters the Cun Kou (the radial artery pulse point proximal to the wrist crease). It ascends to the Thenar eminence (Yu Ji), following the Yu Ji (the area anterior to the metacarpal bone, posterior to the thumb, where the muscle bulges; collectively called 'Yu'. 'Yu Ji' refers to the acupoint within this area). It exits at the tip of the thumb (ending at Shaoshang LI11. The Jingbie chapter also states: it emerges superiorly at the Supraclavicular Fossa (Quepen), following the throat). Its branch arises from behind the wrist (the end of the forearm bone is the wrist), goes straight out to the medial side of the index finger, and exits at its tip (from Lieque LU7 behind the wrist, it crosses over to the Hand-Yangming Meridian, reaching Shangyang LI1).

When this meridian is affected, it causes Lung distension and fullness, bloating with wheezing and coughing, and pain in the Quepen (depression lateral to the clavicle, an ST acupoint). In severe cases, the patient may cross their arms over the chest and experience confusion (Mao, meaning disorientation). This is termed Arm Jue. This meridian governs diseases produced by the Lung: cough with rebellious Qi, wheezing (primary disease of this meridian), thirst (Metal fails to generate Water), vexation in the heart (Heart vessel connects to Lung), chest fullness (vessel passes through diaphragm and distributes in the chest), pain along the anterior medial aspect of the arm (vessel follows the arm), Jue syndrome (Arm Jue), and heat in the palm (Pericardium region; vessel runs anterior to Hand-Shaoyin). If Qi is excessive, there is shoulder and back pain (Back is the domain of Hand-Taiyin; alternatively, arm pain). Wind-cold with sweating and stroke-like symptoms, frequent urination with scanty output (Lung heat causes frequent short urination; mother disease affecting child). If Qi is deficient, there is shoulder/back pain (alternatively arm pain), aversion to cold (fear of cold), shortness of breath insufficient for respiration (primary disease of this meridian), and change in urine color (mother pathogen affecting child).

The Hand-Yangming Large Intestine Meridian originates at the tip of the index finger (the second finger of the hand, i.e., index finger). It follows the radial border of the finger, emerges between the two bones at Hegu (Hegu, also known as Tiger's Mouth, an acupoint of this meridian). It ascends between the two tendons (Yangxi acupoint). It follows the radial border of the forearm, enters the lateral aspect of the elbow, ascends along the anterior-lateral aspect of the arm to the shoulder, emerges anterior to the Scapula (Yugu, pronunciation 'yu'; Scapula, also an acupoint name located between the two bones at the shoulder tip). It ascends to emerge at the meeting of the vertebral column (Tianzhu bone, Bladder Meridian, meets here at Dazhui). It descends into the Quepen (Supraclavicular fossa, an ST acupoint in the depression lateral to the clavicle). It connects with the Lung (Large Intestine and Lung are exterior-interior pairs). It descends through the diaphragm and belongs to the Large Intestine. Its branch arises from Quepen, ascends the neck, penetrates the cheek, enters the lower teeth, returns to exit crossing the mouth at the philtrum, crossing left to right and right to left, ascending to flank the nostrils (ending at Yingxiang LI20. The Jingbie chapter also states: it follows the throat. This chapter later states: its branch enters the ear, combining with the Zong Mai).

When this meridian is affected, it causes toothache (vessel enters tooth gaps) and neck swelling (vessel ascends neck). This meridian governs diseases produced by fluids (Large Intestine governs Jin-Ye): yellow eyes (internal heat of Large Intestine), dry mouth (lack of fluids), rhinorrhea (Qiu, clear nasal discharge), epistaxis (Nü, nosebleed), and throat obstruction (Bi, due to Metal dryness). Pain in the anterior shoulder and index finger pain with dysfunction (inability to lift/use, all due to vessel passage). If Qi is excessive, there is heat and swelling along the vessel pathway. If deficient, there is cold shivering that does not resolve.

The Foot-Yangming Stomach Meridian originates at the bridge of the nose (Shangen). It approaches (or enters) the Foot-Taiyin Spleen Meridian near Jingming. It descends along the lateral nose, ascends into the teeth (upper teeth). It returns to exit flanking the mouth and encircling the lips. It descends to intersect Chengjiang (depression below the lower lip, meeting of Foot-Yangming vessels). It then follows the post-mental groove (cheek below is Han, below Han is Yi). It emerges at Daying (an acupoint of this meridian anterior to the jaw). It follows Jiache (end of the curved jaw below the ear). It ascends anterior to the ear, passing Guochurenzhu (Foot-Shaoyang acupoint, arising bone anterior to ear). It follows the hairline to the forehead and skull (forehead and skull are below the hairline). Its branch arises anterior to Daying, descends to Renying (also named Wuhui, an arterial pulse 1.5 cun lateral to the laryngeal prominence, used to inspect Qi of the five Zang organs). It follows the throat (this chapter also states: it connects to head and nape, descends to connect to throat/esophagus). It enters the Quepen (Supraclavicular fossa). It descends through the diaphragm, belongs to the Stomach, and connects with the Spleen (exterior-interior pair. Wang Ang notes: this is the main channel, why is it classified as a branch?). The direct branch descends from Quepen along the medial inferior breast, descends flanking the umbilicus, and enters the Qichong (also known as Qichong, an acupoint of this meridian, one cun below Guilai, arterial pulse. Weiqi chapter states: Chest Qi has streets, Abdominal Qi has streets, Head Qi has streets, Shin Qi has streets. 'Street' means road/way). Another branch arises from the stomach opening, descends along the interior of the abdomen, and meets the main branch at Qichong (merging with the previous vessel). It descends to Bituan, reaches Futu (Thigh interior is Bi. The fleshy elevation 6 cun above the knee on the anterior thigh is Futu. Behind Futu is Bituan). It descends to the patella (between the knee tendons is Bin). It descends along the lateral border of the tibia, down to the dorsum of the foot (foot surface). It enters the space between the toes of the middle finger. A branch descends 3 cun below the knee, diverges, and enters the lateral space of the middle finger. Another branch diverges from the dorsum of the foot, enters the big toe, and exits at its tip (reaching Lidui ST45 to terminate, connecting to Hand-Taiyin. Wang Ang notes: this is also a main channel, why is it a branch? Jingbie chapter also states: it connects upward to the Heart, follows the pharynx, exits the intestinal gate, ascends, and reconnects to the eye system).

When this meridian is affected, it causes chills and trembling (Nuè Lun states: Yangming deficiency causes cold shivering and jaw quivering). Frequent groaning and yawning, dark complexion (Earth controls Water). Upon onset, aversion to people and fire (Yangming Maijie chapter: Yangming Qi and Blood are abundant; extreme heat causes aversion to people and fire). Hearing wood sounds causes sudden fright. Heart palpitations (Yangming is Earth, fears Wood). Desire to close doors and windows and stay alone (Suwen Maijie chapter: Yin and Yang contend. Yang exhausts, Yin becomes excessive, hence desire to close doors/windows). In severe cases, climbing high to sing, discarding clothes and running (Yangming Maijie chapter: Limbs are the root of all Yang. Yang excess makes limbs solid; solidity allows climbing high. Heat excessive in body, hence discarding clothes and running). Borborygmus and abdominal distension (vessel follows abdomen; Water and Fire clash, causing sound and distension). This is referred to as Tui Jue (Tibia is Tui). This meridian governs diseases produced by Blood (Blood level): manic malaria, warm disorders with sweating (Yangming naturally sweats more), rhinorrhea and epistaxis (Stomach heat rising), ulcers/rash on lips (Zhen same as Zhen, lip ulcer; vessel flanks mouth and circles lips), neck swelling (vessel follows jaw to Daying), throat obstruction (vessel follows throat), massive abdominal edema (Stomach decline, Earth fails to control Water), knee-patella swelling and pain (vessel descends to knee-patella), pain along Yingchuan (Yingchuang acupoint), breast (Ruzhong, Rugen, both this meridian acupoints), Qichong, thigh, Futu, lateral border, and dorsum of foot. Middle finger dysfunction (all due to vessel passage). If Qi is excessive, the anterior body is hot (Yangming travels anterior body). Excess in Stomach leads to rapid digestion and hunger (Fire excess, Middle Jiao consumption). Urine is yellow (Stomach heat descends to Bladder). If Qi is deficient, the anterior body is cold and shivering. Cold in Stomach leads to distension (Cold distension).

The Foot-Taiyin Spleen Meridian originates at the tip of the great toe (Yinbai acupoint of Foot Great Toe). It follows the medial white flesh margin of the toe. It passes posterior to the nuclear bone (commonly known as the malleolus, bone rising on both sides posterior to the heel). It ascends to the anterior border of the medial malleolus (Ankle has inner and outer sides on both sides of tibia). It ascends to the medial aspect of the leg (Duan, pronounced 'duan', Yupian says: heel. Alternatively Shan, pronounced 'shan', also named Fei, calf muscle). It follows the posterior border of the tibia, crosses anterior to the Foot-Jueyin (Foot Jueyin Meridian). It ascends to the anterior-medial border of the knee and thigh. It enters the abdomen, belongs to the Spleen, and connects with the Stomach (exterior-interior pair). It ascends through the diaphragm, flanks the pharynx, connects to the root of the tongue, and scatters under the tongue. Its branch diverges from the Stomach, ascends through the diaphragm, and pours into the Heart (All Five Zang enter the Heart).

When this meridian is affected, it causes stiffness of the tongue root (connects to tongue root). Vomiting after eating (connects to Stomach). Epigastric pain. Abdominal distension and frequent belching (Yi, same as burping. Kouwen chapter: Cold Qi lodges in Stomach, Jue reverses and rises from below, scattering, then re-emerges from Stomach, hence belching). Relief after defecation or passing gas (obtaining Hou and Qi). Feeling relaxed as if symptoms have subsided (Bing Shuai). Heaviness of the body (Spleen governs flesh). This meridian governs diseases produced by the Spleen: tongue root pain, inability to move the body (severe weight mentioned above), inability to eat (Spleen governs food processing), vexation in the heart (vessel pours into Heart), acute pain in the epigastrium (same as epigastric pain), loose stools (Tang), accumulation diarrhea (Jia Xie, diarrhea due to accumulation), water retention and jaundice (Damp-Heat cannot drain; Yellow is Spleen color). Inability to lie down (Stomach disharmony leads to sleeplessness). Swelling of inner thigh and knee upon standing forcibly (Spleen governs four limbs, vessel travels thigh/knee). Jue syndrome. Dysfunction of the great toe (origin of the vessel).

The Hand-Shaoyin Heart Meridian originates in the Heart, emerges to belong to the Heart System (Heart System connects upward to Lung, descends from lung lobes, curves backward, pierces spinal cord, connects to Kidney. All Five Zang connect to Heart, and Heart connects to Five Zang). It descends through the diaphragm to connect with the Small Intestine (Small Intestine and Heart are exterior-interior pairs). Its branch arises from the Heart System, ascends to flank the pharynx and connect to the Eye System (Jingbie chapter also states: travels throat, emerges on face, combines at inner canthus. This chapter also states: branch vessel connects to tongue root). The direct branch returns from the Heart System, ascends to the Lung, and emerges from the axilla (Jiquan acupoint). It descends along the posterior medial aspect of the arm, running posterior to the Hand-Taiyin (Lung) and Hand-Shaoyin (Pericardium). It descends to the medial elbow, follows the posterior medial aspect of the forearm, reaches the end of the styloid process of the ulna (sharp bone at wrist end). It enters the posterior medial palm, follows the medial side of the little finger, and exits at its tip (ending at Shaochong HT9 to connect to Hand-Taiyang. Hua Bolin said: Heart is the Monarch, honored above other Zang, thus its transmission between meridians does not require branches).

When this meridian is affected, it causes dry throat (flanks pharynx), heart pain, thirst with desire to drink (Heart Fire). This is Arm Jue (vessel follows arm). This meridian governs diseases produced by the Heart: yellow eyes (connects to Eye System, combines at inner canthus), hypochondriac pain (vessel emerges from hypochondrium), pain along the posterior medial aspect of the arm (vessel follows posterior medial arm), Jue, and heat/pain in the palm (belonging to Heart Master Pericardium, disease is similar).

The Hand-Taiyang Small Intestine Meridian originates at the tip of the little finger (Shaose HT1 of Hand Little Finger, connecting to Shaoyin Heart Meridian). It follows the lateral aspect of the hand up to the wrist (end of forearm bone is wrist). It emerges at the ankle (radial/ulnar bone below wrist is ankle). It goes straight up, follows the lower border of the arm bone, emerges between the two tendons at the medial elbow. It ascends along the posterior-lateral aspect of the arm, emerges at the shoulder joint (Lu are muscles beside spine, two angles above Lu are shoulder joint). It winds around the scapula (scapula is flat bone below shoulder joint). It crosses the shoulders (meets Dazhui above, crossing left and right on shoulders). It enters the Quepen. It connects with the Heart. It follows the pharynx, descends through the diaphragm, reaches the Stomach, and belongs to the Small Intestine (Small Intestine and Heart are exterior-interior pairs). Its branch arises from Quepen, follows the neck to the cheek, reaches the outer canthus (outer corner of eye is Ruizi). It enters the ear (ending at Tinggong SI19 of this meridian). Another branch diverges from the cheek, ascends to the infraorbital area (area below eye is Xia). It reaches the nose, arrives at the inner canthus (inner corner). It obliquely connects to the zygoma (crossing Foot-Taiyang Meridian).

When this meridian is affected, it causes sore throat and submandibular swelling, inability to look back (flanks pharynx and neck). Shoulder feels like being pulled, arm feels like being broken (emerges from shoulder, follows arm). This meridian governs diseases produced by fluids (Small Intestine governs Ye): deafness (vessel enters Tinggong), yellow eyes (vessel reaches outer canthus), cheek swelling (ascends cheek), pain along neck, collarbone, shoulder, arm, elbow, and lateral-posterior border of arm.

The Foot-Taiyang Bladder Meridian originates at the inner canthus (Jingming acupoint, meeting point of Hand/Foot Taiyang, Shaoyang, Yangming). It ascends the forehead and crosses the vertex (Baihui acupoint at top). Its branch arises from the vertex to the upper angle of the ear. The direct branch enters from the vertex, connects to the Brain, returns to exit separately and descends the nape (back of neck is Xiang, sides are Jing, front is Hou). It follows the interior of the shoulder blades (lower part of posterior shoulder is Bo). It flanks the spine (runs along the first row beside spinal vertebrae, 1.5 cun apart). It reaches the waist (horizontal bone above sacrum is Yao). It enters and follows the Paraspinal muscles (muscles flanking spine are Lü. Jingbie chapter also states: follows Lü, enters heart center). It passes through the Kidney and belongs to the Bladder (exterior-interior pair). Its branch arises from the waist, descends flanking the spine, penetrates the buttocks, and enters the popliteal fossa (areas Cishu, Zhongshu, Xiashu along midline of spine; popliteal crease is Bi). Another branch arises from the shoulder blade, diverges left and right, penetrates the scapula, and flanks the spine internally (second row beside spine, 3 cun apart, from Tianzhu downward, diverging left/right from shoulder, penetrating scapula/Lü, traversing sacrum/buttocks to Bitu). It passes Bitu (lateral thigh is Bi, Bitu is below Jiegut bone). It follows the lateral thigh, descends from the posterior border, and merges at the popliteal fossa (combining with the branch entering Bi). It descends through the calf muscle (Fei). It emerges posterior to the lateral malleolus. It follows Jinggu (an acupoint of this meridian, red-white flesh boundary on lateral foot). It reaches the lateral side of the little finger (Zhiyin BL67 to connect to Foot-Shaoyin Kidney Meridian).

When this meridian is affected, it causes headache striking upward (ascends forehead, crosses vertex, connects to brain). Eyes feel like popping out, nape feels like being pulled (vessel starts below eye, descends nape). Spine pain, waist feels like breaking (flanks spine, reaches waist). Thigh cannot bend (vessel passes Bitu). Leg feels knotted, leg feels torn (enters Bi, penetrates Bi). This is Huai Jue (vessel travels lateral malleolus). This meridian governs diseases produced by tendons (meaning of governing tendons is unclear. Note: Taiyang diseases often involve spasms/stiffness; above symptoms are all wind damaging tendons). Hemorrhoids (vessel enters anus), malaria (Taiyang malaria), mania and epilepsy (Epilepsy chapter also mentions needling Taiyang meridian). Head, fontanelle, and nape pain, yellow eyes with tearing (all due to vessel passage). Rhinorrhea and epistaxis (clear discharge is Qiu, blood is Nü. Taiyang Qi cannot follow the meridian, rushes upward to brain, downward causes Qiu/Nü). Pain in nape, back, waist, sacrum, legs, and feet. Little finger dysfunction (all foot little fingers are vessel passages).

The Foot-Shaoyin Kidney Meridian originates below the little toe, slanting towards the sole (Yongquan KI1). It emerges below RanGu (an acupoint of this meridian, depression anterior to large bone of ankle). It follows posterior to the medial malleolus, diverges to enter the heel (posterior heel). It ascends along the medial calf. It emerges at the medial border (popliteal crease). It ascends the posterior-medial border of the thigh. It pierces the spine (meeting Changqiang GV1 of Du Meridian). It belongs to the Kidney and connects with the Bladder (exterior-interior pair. Jingbie chapter also states: at 14th thoracic vertebra, emerges to belong to Dai Meridian). The direct branch ascends from the Kidney, pierces the Liver and Diaphragm, enters the Lung. It follows the throat, flanks the tongue root (connects to Henggu, ends at Huiyan). Its branch arises from the Lung, connects to the Heart, and pours into the Chest (Tanzhong in chest, connecting to Hand-Jueyin Pericardium Meridian).

When this meridian is affected, it causes hunger without desire to eat (Deficient Fire excess causes hunger, Spleen weakness causes no desire to eat). Complexion like lacquer and firewood (Kidney color is black; Cha means thin/emaciated). Coughing and spitting blood (vessel enters Lung, hence blood in sputum, indicating Kidney damage). Panting with "he-he" sound (Kidney Qi rushes upward). Desire to rise when sitting (Yin deficiency causes restlessness). Vision blurred as if seeing nothing (Pupil belongs to Kidney; Water deficiency causes this). Heart feels suspended, like hunger (vessel connects to Heart). Qi deficiency leads to fear (Fear is the emotion of Kidney). Heart palpitations as if someone is about to capture. This is Gu Jue (Kidney governs Bone). This meridian governs diseases produced by the Kidney: oral heat, dry tongue, swollen throat (all Kidney Fire). Rebellious Qi (Kidney Water overflows into skin causing edema). Dry and painful throat (follows throat, flanks tongue root). Vexation and heart pain (vessel connects to Heart). Jaundice (Kidney Water counter-attacks Spleen Earth, or Female Labor Jaundice). Intestinal dysentery (Suwen Daqi Lun: Kidney pulse small, deep, and forceful indicates intestinal dysentery with blood). Pain along posterior-medial border of spine and thigh (vessel travels foot). Wei syndrome (Bone Wei). Jue (Insufficiency below leads to Jue rising above). Lethargy/desire to sleep (Shaoyin disease, only desires to sleep). Heat and pain in soles (vessel originates at Yongquan KI1 in sole).

The Hand-Jueyin Pericardium Meridian originates in the Chest, emerges to belong to the Pericardium (located below Heart). It descends through the diaphragm, sequentially connects with the Triple Burner (Sanjiao and Pericardium are exterior-interior. Xieke chapter states: enters Chest, internally connects to Heart and Lung). Its branch arises from the Chest, exits the hypochondrium, descends 3 cun below the axilla (Tianchi acupoint. From here to Zhongchong, all are this meridian acupoints). It ascends to the axilla. It descends along the medial arm (Tianquan acupoint). It runs between the Hand-Taiyin (Lung) and Hand-Shaoyin (Heart) (between these two meridians). It enters the elbow (Quze acupoint, depression medial to elbow). It descends the arm, runs between the two tendons (Daling acupoint, between two tendons posterior to wrist, in transverse crease depression). It enters the palm (Laogong acupoint). It follows the middle finger to its tip (Zhongchong acupoint). Its branch diverges from the palm, follows the ring finger to its tip (ring finger is the fourth digit. Here it connects to Hand-Shaoyang Sanjiao Meridian. Jingbie chapter also states: follows throat, emerges posterior to ear).

When this meridian is affected, it causes heat in the palm, spasms/stiffness of arm and elbow, axillary swelling. In severe cases, chest and hypochondriac fullness/support (all due to vessel passage). Palpitations in the Heart (Heart Master supports Heart Monarch, so disease is similar). Red face (Red is Heart color). Yellow eyes (Eye is envoy of Heart). Uncontrollable laughter (Heart excess causes continuous laughter). This meridian governs diseases produced by the Vessels (Heart governs Vessels). Vexation and heart pain, heat in palm (primary disease of this meridian).

The Hand-Shaoyang Sanjiao Meridian originates at the tip of the ring finger (Guanchong LI1 of Ring Finger). It emerges between the two fingers. It follows the dorsal wrist (end of forearm is wrist, following Yangchi acupoint of this meridian). It emerges between the two bones of the forearm (Tianjing acupoint). It ascends through the elbow (end is elbow). It follows the lateral aspect of the arm to the shoulder (area opposite axilla below shoulder is Bo). It crosses posterior to the Foot-Shaoyang (Gallbladder Meridian). It enters the Quepen (Supraclavicular fossa). It distributes at Tanzhong (middle between two breasts in Upper Jiao). It scatters and connects with the Pericardium. It descends through the diaphragm, follows and belongs to the Sanjiao (exterior-interior with Pericardium). Its branch arises from Tanzhong, ascends to exit Quepen, ascends the neck, connects posterior to the ear, goes straight up, emerges at the upper angle of the ear, bends down to the cheek, reaching the infraorbital area (Xia, below eye). Another branch arises from posterior to the ear, enters the ear, exits anterior to the ear, passes anterior to Guochurenzhu (Foot-Shaoyang acupoint, arising bone anterior-superior to ear). It crosses the cheek.