马云。内言经脉合于宿度经水。及末有真气邪气等义。故名篇。吴云。外邪入于正气。名曰合。刺之泻
去其邪。名曰离。高同。
经水 简按王解经字。恐非。盖经。是经纬之经。王注泾水。灵经水篇。甲乙。并作清水。新校正引
甲乙。亦作泾
水者。何。
陇起 马吴张并云。陇。隆同。简按陇。垄同。刘向传。丘陇。项羽纪。陇亩。俱可证。通雅云。
内经言。夜半阴陇。而日中阳陇。而脉应之。犹言拥起为陇。而过此渐平迤也。
经之动脉 志云。虚风。虚乡之邪风也。经之动脉。谓经血之动于脉也。言虚风之邪。因而入客于
经。亦如经水之得风。其至于所在之处。亦波涌而陇起。循循。次序貌。言邪在于经。虽有时陇起。而次序循
行。无有常处。
其行于脉中循循然 甲乙。无其行二字。高云。其不因于邪。则血气之行于脉中循循然。简按此虚
邪入而客者。高为不因于邪。恐非。循循。吴从王所引一本作 。马云。似有次序之意。不必 。（音椿。
考字书。义难叶。）论语。循循然善诱人。何注。次序貌。
时大时小 张云。邪气随脉。必至寸口。有邪则陇起而大。无邪则平和而小。随其所在。而为形见。
故行无常处。
在阴与阳不可为度 马云。或在阳经。或在阴经。吴改与作在。志云。止可分其在阴与阳。而不可
为度数。
从而察之 从。甲乙作循。
转针 张云。搓转其针。如搓线之状。慢慢转之。勿令太紧。泻左则左转。泻右则右转。故曰捻针。
为故 吴云。故。常法也。高云。欲以得气。为复其故。今从吴义。
大气皆出 高云。大气。针下所聚之气也。简按王注。大邪之气。注下文则云。大经之气。何其言
之不一。当从高注。
扪而循之 通雅云。扪摸一字。古无摸字。即扪也。
切而散之 马云。谓以指切扪其穴。使气之布散也。
推而按之 张云。再以指揉按其肌肤。欲针道之流利也。高云。分擘其穴。不使倾移。
弹而怒之 马云。以指屡屡弹之。使病者觉有怒意。使之脉气填满也。张云。以指弹其穴。欲其意有
所注。则气必随之。故脉络 满如怒起也。简按七十八难。怒。作努。怒努通用。庄子逍遥游。怒而飞。外物
篇。草木怒生。后汉第五伦传。鲜车怒马。皆努同。
抓而下之 马云。谓以左手之爪甲。 其正穴。而右手方下针也。七十八难。抓。作爪。张云。抓。
爪同。简按后后赵壹传。针石运乎手爪。太子贤注云。古者以砭石为针。凡针之法。右手象天。左手法地。弹
而怒之。搔而下之。此运手爪也。盖取此篇。但抓作搔。高云。抓。犹引也。未知何据。
通而取之 甲乙。取。作散。吴云。通达其处。然后取定其穴。张云。下针之后。必候气以取其疾。
外引其门 简按王引调经论文。乃灵官能篇文。
其气以至 甲乙。以。作已。马云。以。已同。
令神气存 甲乙。神。作真。
其寒温未相得 马云。舍于经脉之中。寒则血凝泣。与血之温。尚未相得。暑则气淖泽。与血之寒。
尚未相得。张云。邪气寒正气温。故不相得。高云。未为寒病。未为温病。其寒温未相得。时如涌波之初起也。
志云。寒温欲相得者。真邪未合也。故邪气波陇而起。来去于经脉之中。而无有常处。徐永时云。真邪已合。
如真气虚寒。则化而为寒。真气盛热。则化而为热。邪随正气所化。故曰寒温未相得。
逢其冲 志云。逢。迎也。冲者。邪盛而隆起之时也。高云。邪气冲突。宜避其锐。逢。甲乙。作迎。
邪气复至 复。甲乙。作益。
其来不可逢 吴云。其邪之来不可逢。其虚而取之。盖恐更伤其经气也。正此云无逢其冲之谓。张
云。真气不实。迎而泻之。邪气虽去。真气必太虚矣。故曰。其来不可逢也。按小针解曰。其来不可逢者。气
盛不可补也。彼言补。此言泻。文若相反。各有深义。当两察之。
大气已过 吴云。大气。人气也。人气应乎水刻。异在灵枢。志云。大气。风邪之气也。高云。针
下所聚之大气已过。而复泻之。则真气外脱。简按上文云。大气皆出。又云。大气留止。高注为是。
其往不可追 张云。小针解曰。其往不可追者。气虚不可泻也。
不可挂以发 小针解云。不可挂以发者。言气有易失也。吴云。此上必有阙文。此两释其义耳。取
邪之时。不可毫发间差。张云。欲泻其邪。在气至之顷。不可挂以发者。言丝毫之不可失也。志云。挂。 同。
发针 吴云。施针也。
若先若后 吴云。若先之则邪未至。后之则虚其真。
病不可下 张云。下者。降服之谓。高云。下。犹退也。
如扣椎 吴云。椎。木瘤也。张云。椎。木椎也。顽钝难入。如扣椎之难也。简按木瘤。未有所考。
溶溶 释音。溶。音容。张云。流动貌。简按说文。水盛也。
逆而刺之温血也 吴云。温血。毒血也。张云。凡取络者。必取其血。刺出温血。邪必随之而去矣。
故病可立已。温血。热血也。简按王注。刺之下句。恐非也。志云。若逆而刺之。是谓内温。血不得散。气不
得出。（三句。出十二原篇。）高
云。温。通调也。略同王义。不可从。
中腑 吴云。中腑。胃也。土主中宫。故曰中腑。调之中腑者。言三部九候。皆以冲和胃气调息之。
张云。中腑。脏气也。凡三部九候脉证。皆以脏气为主。气顺则吉。气逆则凶。故调之中腑。志高仍吴注。
大过且至 吴云。大邪为过也。高云。大过。死期也。今从吴。
大经 举痛论云。血泣不得注大经。
内着 马云。着。着同。
不能久长 张云。杀人冥冥之中。莫此为甚。欲遗阴德于子孙者。当以此为切戒。高云。不能使人
久长于人世也。
因不知 因。甲乙。作固。
因加相胜 志云。不知六气之加临。五运之相胜。高同。简按盖谓不知五胜之理反补之。此则加相
胜者。乃释邪攻正也。与运气之义迥别。
Ma Yun stated that the text internally discusses the relationship between meridians, stellar mansions (Su Du), and river waters, as well as the concepts of True Qi (Zhen Qi) and Pathogenic Qi (Xie Qi) mentioned at the end; hence the chapter title. Wu Yun explained that when external pathogens enter into the healthy Qi, it is called "He" (Combination/Union); needling to drain them out is called "Li" (Separation). Gao agreed with this view.
Jing Shui (River Waters): Jian An commented on Wang Bing's interpretation of the character "Jing", suggesting it might be incorrect. Here, "Jing" refers to the warp/weft (longitudinal lines). Wang Bing annotated it as "Jing Water". The *Ling Shu: Jing Shui* chapter and the *Jia Yi Jing* both write it as "Qing Water". Why does the New Correction cite the *Jia Yi Jing* as writing "Jing Water"?
Long Qi (Rising like a mound): Ma, Wu, and Zhang all stated that "Long" is identical to "Long" (Mound/Rise). Jian An noted that "Long" is identical to "Long" (Field ridge). This can be evidenced by Liu Xiang's biography using "Qiu Long" and the *Records of the Grand Historian: Xiang Yu* using "Long Mu". *Tong Ya* states that in the *Nei Jing*, "At midnight Yin rises (Long), and at noon Yang rises (Long)", corresponding to the pulse, similar to saying it piles up like a mound, and after this point gradually flattens and meanders.
Jing Zhi Dong Mai (The pulsating artery of the meridian): Zhi Yun explained that Xu Feng (Deficient Wind) refers to pathogenic winds coming from deficient directions. "Jing Zhi Dong Mai" refers to the movement of Jing Blood within the vessels. It means that the pathogenic wind of Xu Feng takes the opportunity to invade and lodge in the meridians, just as river waters react to wind; when it reaches a specific location, it surges and rises like waves. "Xun Xun" describes an orderly sequence. It means that although pathogens in the meridians may cause rising swellings, they follow an orderly circulation without a fixed location.
Qi Xing Yu Mai Zhong Xun Xun Ran (Moving orderly within the vessels): The *Jia Yi Jing* omits the characters "Qi Xing". Gao Yun stated that if not due to pathogens, the flow of Blood and Qi within the vessels is orderly. Jian An countered that this passage refers to the invasion of Deficient Pathogens, so Gao's claim that it is not due to pathogens is likely incorrect. "Xun Xun": Wu cited a version from Wang Bing where the character was different. Ma Yun suggested it implies orderliness, and one need not overanalyze the variant character (pronounced Chun, difficult to rhyme according to dictionaries). The *Analects* says, "Xun Xun Ran Shan You Ren" (Orderly and effectively guiding people). He Yan's commentary defines it as "in order".
Shi Da Shi Xiao (Sometimes large, sometimes small): Zhang Yun explained that pathogens follow the meridians to the Cunkou pulse site. With pathogens, the pulse rises and becomes large; without pathogens, it is peaceful and small. Manifestations appear depending on the location, hence there is no fixed place of movement.
Zai Yin Yu Yang Bu Ke Wei Du (In Yin and Yang, cannot be measured by degrees): Ma Yun stated it could be in Yang meridians or Yin meridians. Wu changed "Yu" to "Zai". Zhi Yun argued that one can only distinguish whether it is in Yin or Yang, but cannot establish a fixed degree or measure.
Cong Er Cha Zhi (Follow and examine it): In the *Jia Yi Jing*, "Cong" is written as "Xun".
Zhuan Zhen (Rotating the needle): Zhang Yun described twisting the needle like twisting thread, rotating slowly without tightening too much. To drain on the left, rotate left; to drain on the right, rotate right. Hence it is called Nián Zhen (Twisting needle).
Wei Gu (As the constant method): Wu Yun defined "Gu" as the standard method. Gao Yun stated the goal is to obtain Deqi (arrival of Qi) to restore the original state. We follow Wu's interpretation here.
Da Qi Jie Chu (All major Qi exits): Gao Yun defined "Da Qi" as the Qi gathered under the needle. Jian An noted that Wang Bing's commentary referred to it as "Da Xie Zhi Qi" (Major Pathogenic Qi), while his commentary on the following text called it "Da Jing Zhi Qi" (Major Meridian Qi), showing inconsistency. Therefore, Gao's annotation should be followed.
Men Er Xun Zhi (Palpate and stroke it): *Tong Ya* states that "Men Mo" was originally one character; the character "Mo" did not exist in ancient times, so "Men" served this purpose.
Qie Er San Zhi (Press and disperse it): Ma Yun explained this as pressing the acupoint with fingers to disperse the Qi.
Tui Er An Zhi (Push and press it): Zhang Yun described rubbing and pressing the skin and muscle with fingers to ensure smooth needle insertion. Gao Yun suggested separating the acupoint area to prevent displacement.
Dan Er Nu Zhi (Tap and enrage it): Ma Yun described repeatedly tapping the acupoint with fingers to create a sensation of "anger" (tension/fullness) in the patient, filling the vessel with Qi. Zhang Yun added that tapping focuses the mind, causing Qi to follow, making the meridians full as if enraged. Jian An noted that in *Nan Jing Chapter 78*, "Nu" is written as "Nu" (Strain/Effort); they are interchangeable. Examples include *Zhuangzi*'s "Nu Er Fei" (Soaring with effort) and *Han Shu*'s "Xian Che Nu Ma" (Fresh carriages and spirited horses).
Zhua Er Xia Zhi (Scratch and insert the needle): Ma Yun described using the fingernails of the left hand to locate the correct acupoint before inserting the needle with the right hand. *Nan Jing Chapter 78* writes "Zhua" as "Zhao" (Claw). Zhang Yun confirmed "Zhua" and "Zhao" are identical. Jian An cited *Hou Zhao Yi Zhuan*: "Needles and stones operate through hand claws." Prince Tai Xian's commentary noted that ancient needles were bi-shi (stone needles). In acupuncture, the right hand represents Heaven, the left Earth; tapping creates tension, scratching inserts the needle—this utilizes the hand claws, likely derived from this chapter, though this chapter uses "Zhua" where others use "Sao". Gao Yun interpreted "Zhua" as "pulling," but the basis is unknown.
Tong Er Qu Zhi (Unblock and select it): The *Jia Yi Jing* writes "Qu" as "San". Wu Yun explained that one must unblock the area first, then select the acupoint. Zhang Yun stated that after needle insertion, one must wait for Deqi to treat the disease.
Wai Yin Qi Men (Externally draw open the gate): Jian An noted that Wang Bing's citation from *Tiao Jing Lun* actually originates from the *Ling Shu: Guan Neng* chapter.
Qi Qi Yi Zhi (When the Qi arrives): The *Jia Yi Jing* writes "Yi" as "Yi". Ma Yun stated "Yi" and "Yi" are interchangeable.
Ling Shen Qi Cun (Let the Spirit Qi remain): The *Jia Yi Jing* writes "Shen" as "Zhen".
Qi Han Wen Wei Xiang De (Its cold and warmth have not yet harmonized): Ma Yun explained that when pathogens lodge in the meridians, cold causes blood to coagulate and stagnate, conflicting with the warmth of the blood; heat makes Qi fluid, conflicting with the coldness of the blood. Zhang Yun stated that pathogenic Qi is cold while Healthy Qi is warm, hence they do not harmonize. Gao Yun suggested this means neither a Cold syndrome nor a Warm syndrome has fully formed; it resembles the initial surge of waves. Zhi Yun stated that when cold and warmth desire to harmonize, it means True Qi and Pathogen have not yet combined, so the pathogen surges and moves without a fixed location. Xu Yongshi stated that once True Qi and Pathogen combine, if True Qi is deficient and cold, it transforms into cold; if True Qi is abundant and hot, it transforms into heat. Since the pathogen follows the transformation of True Qi, it is said that cold and warmth have not yet harmonized.
Feng Qi Chong (Encounter its surge): Zhi Yun defined "Feng" as "Ying" (to meet/encounter head-on) and "Chong" as the time when pathogenic Qi is abundant and surging. Gao Yun advised avoiding the sharpness of the conflict. The *Jia Yi Jing* writes "Feng" as "Ying".
Xie Qi Fu Zhi (Pathogenic Qi returns): The *Jia Yi Jing* writes "Fu" as "Yi".
Qi Lai Bu Ke Feng (Its arrival cannot be met/head-on encountered): Wu Yun warned against meeting the arriving pathogen head-on. Treating during deficiency risks further damaging the Jing Qi, which aligns with the instruction not to encounter the surge. Zhang Yun explained that if Healthy Qi is not solid, treating it head-on (draining) may remove the pathogen but leave the Healthy Qi severely depleted. Thus, "Qi Lai Bu Ke Feng". Referencing *Xiao Zhen Jie*: "Qi Lai Bu Ke Feng" means when Qi is abundant, do not tonify. That text refers to tonification, whereas this text refers to draining; although the texts seem contradictory, each holds deep meaning and should be examined together.
Da Qi Yi Guo (The major Qi has passed): Wu Yun defined "Da Qi" as Human Qi (Healthy Qi), which corresponds to water clock measurements, differing in *Ling Shu*. Zhi Yun defined "Da Qi" as Wind Pathogen Qi. Gao Yun stated that if the major Qi gathered under the needle has passed, draining again will cause Healthy Qi to escape externally. Jian An agreed with Gao, citing previous texts stating "Da Qi Jie Chu" (All major Qi exits) and "Da Qi Liu Zhi" (Major Qi remains).
Qi Wang Bu Ke Zhui (Its departure cannot be pursued): Zhang Yun cited *Xiao Zhen Jie*: "Qi Wang Bu Ke Zhui" means when Qi is deficient, do not drain.
Bu Ke Gua Yi Fa (Cannot be delayed by a hair): *Xiao Zhen Jie* states this means Qi is easily lost. Wu Yun suggested missing text above, interpreting these sentences as explaining the principle: timing the extraction of pathogens allows no hair's breadth of error. Zhang Yun emphasized that seizing the moment of Qi arrival for draining allows no slightest delay. Zhi Yun noted "Gua" is identical to "Gua" (Hang/Delay).
Fa Zhen (Release the needle): Wu Yun defined this as administering the needle treatment.
Ruo Xian Ruo Hou (If early or if late): Wu Yun explained that treating too early means the pathogen has not arrived; treating too late depletes the True Qi.
Bing Bu Ke Xia (The disease cannot be treated with descending methods): Zhang Yun defined "Xia" as subduing/descending. Gao Yun defined "Xia" as retreating/withdrawing.
Ru Kou Zhui (Like striking a wooden pestle): Wu Yun defined "Zhui" as a wooden tumor/growth. Zhang Yun defined "Zhui" as a wooden pestle, hard and blunt, difficult to penetrate, like striking wood. Jian An noted "Mu Liu" (Wood Tumor) lacks verification.
Rong Rong (Flowing/Melting): Pronunciation: "Rong" sounds like "Rong". Zhang Yun described it as flowing. Jian An cited *Shuo Wen*: "Water abundance."
Ni Er Ci Zhi Wen Xue Ye (Piercing against it yields warm blood): Wu Yun defined "Wen Xue" as toxic blood. Zhang Yun stated that when treating collaterals, one must extract blood; piercing out warm/toxic blood ensures pathogens depart, curing the illness immediately. "Wen Xue" means hot blood. Jian An doubted Wang Bing's commentary on the subsequent sentence. Zhi Yun cited: "Piercing against it is called internal warming; blood cannot disperse, Qi cannot exit" (from *Shi Er Yuan* chapter). Gao Yun defined "Wen" as regulating/unblocking, similar to Wang's view, but deemed it incorrect to follow.
Zhong Fu (Centered in the Fu organs): Wu Yun identified "Zhong Fu" as the Stomach. Earth governs the Central Palace, hence called Zhong Fu. Regulating Zhong Fu means adjusting the Three Regions and Nine Holdings based on the harmonious Stomach Qi. Zhang Yun identified "Zhong Fu" as Zang Qi. All pulse signs in the Three Regions and Nine Holdings are primarily governed by Zang Qi; smooth Qi brings auspiciousness, reversed Qi brings misfortune. Hence, regulating Zhong Fu. Zhi Gao retained Wu's note.
Da Guo Qie Zhi (Great excess is about to arrive): Wu Yun defined "Da Guo" as excessive major pathogens. Gao Yun defined "Da Guo" as the time of death. We follow Wu's interpretation.
Da Jing (Major Meridian): *Ju Tong Lun* states: "Blood stagnates and cannot flow into the Major Meridian."
Nei Zhuo (Internally adheres): Ma Yun stated "Zhuo" is identical to "Zhuo" (Adhere/Settle).
Bu Neng Jiu Chang (Cannot last long): Zhang Yun warned that killing silently in this manner is severe; those wishing to accumulate merit for descendants should take this as a stern warning. Gao Yun stated it prevents people from living long in the human world.
Yin Bu Zhi (Because [one] does not know): The *Jia Yi Jing* writes "Yin" as "Gu" (Indeed/Surely).
Yin Jia Xiang Sheng (Due to adding mutual overcoming): Zhi Yun explained this as ignorance of the six Qi additions and the mutual overcoming of the Five Movements. Gao agreed. Jian An suggested this refers to not understanding the principle of Five Overcomings and mistakenly tonifying, which constitutes "adding mutual overcoming"—releasing pathogens to attack healthy Qi, distinct from the theory of Five Movements and Six Qi.