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Yang governs the four limbs. The Classics state: "The four limbs are the root of all Yang meridians." It is also stated: "Yang Qi receives its nourishment in the four limbs." When Yang is excessive, the limbs swell. The Classics state: "When Yang Qi knots, swelling occurs in the four limbs." When Yang is deficient, the limbs feel full or distended. The Classics state: "In winter, Qi fills the four limbs." The Spleen governs the four limbs. The Classics state: "The four limbs receive Qi from the Stomach, but this Qi cannot reach the meridians directly; it must be transmitted by the Spleen to be distributed." When the Spleen is excessive, the limbs cannot move. The Classics state: "If the Spleen pulse is excessive, it causes disease, manifesting externally as an inability to move the limbs." When the Spleen is deficient, the limbs cannot function. The Classics state: "The Spleen corresponds to muscle; if the physical form is deficient, the limbs cannot function." It is also stated: "Lassitude and inertia of the four limbs indicate that Spleen Jing (Essence) is not circulating." Treatment is discussed under Wei Syndrome (Flaccidity Syndrome) and Stroke. Pathogenic factors in the five Zang organs remain in the collateral joints. The Classics state: "If the Lung and Heart have pathogenic factors, their Qi remains in the two elbows; if the Liver has pathogenic factors, their Qi remains in the two thighs; if the Spleen has pathogenic factors, their Qi remains in the two hips; if the Kidney has pathogenic factors, their Qi remains in the two knees." Treatment is discussed under Painful Bi Syndrome. According to the Theory of Six Qi, inability to move the limbs belongs to Dampness. The Classics state: "Excessive Earth is called Dunfu (Piled High). In the era of Dunfu, diseases manifest as abdominal fullness and inability to move the limbs."

The *Lingshu* chapter on Jing-Jin (Sinew Meridians) states: The Foot-Taiyang Sinew Meridian originates at the little toe, ascends to knot at the ankle, slants upward to knot at the knee. Its descending branch follows the lateral aspect of the foot to knot at the heel, ascends along the Achilles tendon, and knots at the popliteal fossa. Another branch knots at the lateral side of the popliteal fossa, ascends along the medial aspect of the popliteal fossa, runs parallel with the main trunk, and knots at the buttock, ascending along the spine to the nape. A collateral branch enters and knots at the base of the tongue. The straight branch knots at the occiput, goes up the head, descends to the face, and knots at the nose. Another branch serves as the upper eyelid retractor, descending to knot at the infraorbital region. Another branch arises from the posterior-lateral axilla, knots at the shoulder joint. Another branch enters the axilla, emerges at the supraclavicular fossa, and knots at the mastoid process. Another branch emerges from the supraclavicular fossa, slants upward to the temporal region. Symptoms include pain and swelling supporting the little toe and heel, spasm of the popliteal fossa, opisthotonos, neck stiffness, inability to raise the shoulder, pulling pain in the axilla and supraclavicular fossa preventing left-right rotation. Treatment involves burning needle puncture (Cao Ci), using clinical response as the indicator and pain points as Shu points. This is named Zhongchun Bi (Mid-Spring Bi Syndrome). The Foot-Shaoyang Sinew Meridian originates at the second toe, ascends to knot at the lateral malleolus, follows the lateral aspect of the lower leg, and knots at the lateral aspect of the knee. A branch arises separately from the fibula, ascends to the thigh, anteriorly knotting above the Rectus Femoris, and posteriorly knotting at the sacrum. The straight branch ascends to the costal margin, moves to the anterior axillary line, ties to the chest and breast, and knots at the supraclavicular fossa. The straight branch emerges from the axilla, passes through the supraclavicular fossa, emerges anterior to the Foot-Taiyang meridian, follows behind the ear, ascends to the frontal angle, crosses the vertex, descends to the mandible, and knots at the lateral canthus. A branch knots at the lateral canthus as the outer维系 (Wei). Symptoms include pain and spasmodic contraction supporting the second toe,牵引 (pulling) to lateral knee spasms, inability to flex or extend the knee, popliteal stiffness, anterior pulling to the thigh, posterior pulling to the sacrum, pain at the costal margin, and upward pulling to the supraclavicular fossa, chest, breast, and neck. If the lesion moves from left to right, the right eye cannot open; it passes over the right corner, travels with the Qiao vessels, and connects left to right. Thus, injury to the left corner renders the right foot non-functional. This is named Weijin Xiangjiao (Cross-Connection of Wei Jin). Treatment involves burning needle puncture, using clinical response as the indicator and pain points as Shu points. This is named Mengchun Bi (Early Spring Bi Syndrome). The Foot-Yangming Sinew Meridian originates at the middle three toes, knots at the dorsum of the foot, slants outward to add to the fibular head, ascends to knot at the lateral aspect of the knee, and straightly ascends to knot at the hip joint, following the ribs to attach to the spine. The straight branch ascends along the Rectus Femoris and knots at the knee. A branch knots at the lateral fibular head, merging with the Foot-Shaoyang. The straight branch ascends along the Rectus Femoris, knots at the thigh, gathers at the genitalia, distributes over the abdomen, knots at the supraclavicular fossa, ascends to the neck, flanks the mouth, and merges with the Foot-Taiyang meridian (which governs the upper eyelid); the Yangming meridian governs the lower eyelid. A branch knots at the preauricular area from the cheek. Symptoms include pain and spasmodic contraction supporting the middle toe and shin, jumping hardness of the foot, spasms in the Rectus Femoris, swelling of the anterior thigh, hernia, abdominal muscle tension pulling to the supraclavicular fossa and cheek, sudden facial deviation. In acute cases, eyes cannot close; in heat cases, muscles relax and eyes cannot open. Cold in the cheek muscles causes tightness pulling the mouth; heat causes relaxation and inability to control deviation. Treatment uses horse fat plaster applied to the tight side, and white wine mixed with Cinnamon Twig applied to the relaxed side. Use a mulberry wood hook for the relaxed side, place raw mulberry ash in a pit level with the sitting height, and apply hot compresses with the plaster to the tight cheek. Drink fine wine and eat roasted meat. Do this three times while massaging. Treatment also involves burning needle puncture, using clinical response as the indicator and pain points as Shu points. This is named Jichun Bi (Late Spring Bi Syndrome). The Foot-Taiyin Sinew Meridian originates at the medial end of the great toe, ascends to knot at the medial malleolus. The straight branch 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, follows the interior of the abdomen to knot at the ribs, and scatters in the chest. The internal branch attaches to the spine. Symptoms include pain supporting the great toe and medial malleolus, spasmodic pain, pain at the medial tibial condyle, pain pulling from the medial thigh to the hip, pulling pain at the genitalia, upward pulling to the umbilicus and hypochondrium, and pain in the chest and spine. Treatment involves burning needle puncture, using clinical response as the indicator and pain points as Shu points. This is named Mengqiu Bi (Early Autumn Bi Syndrome). The Foot-Shaoyin Sinew Meridian originates below the little toe, running with the Foot-Taiyin sinew, slanting to the inferior medial malleolus, knotting at the heel, combining with the Foot-Taiyang sinew, and ascending to knot below the medial tibial condyle. Running with the Foot-Taiyang sinew, it ascends along the medial thigh, knots at the genitalia, follows the interior of the spine alongside the erector spinae, ascends to the nape, knots at the occiput, and combines with the Foot-Taiyang sinew. Symptoms include plantar spasms, pain and spasms at all sites of origin and knotting. Disease here primarily manifests as epilepsy, convulsions, and tetany. External involvement prevents bending forward; internal involvement prevents leaning back. Yang disease causes opisthotonos preventing bending; Yin disease prevents extending backward. Treatment involves burning needle puncture, using clinical response as the indicator and pain points as Shu points. For internal involvement, use moxibustion/heat therapy, guidance exercises, and herbal medicine. If the sinew undergoes severe twisting and frequent attacks, death is inevitable. This is named Zhongqiu Bi (Mid-Autumn Bi Syndrome). The Foot-Jueyin Sinew Meridian originates above the great toe, ascends to knot anterior to the medial malleolus, follows the lower leg, knots below the medial tibial condyle, ascends along the medial thigh, knots at the genitalia, and links all sinews. Symptoms include pain supporting the great toe and anterior medial malleolus, pain at the medial condyle, thigh pain with spasms, genital dysfunction. Injury internally leads to impotence; injury to cold causes retraction; injury to heat causes flaccidity and protrusion without retraction. Treatment involves draining water and clearing Yin Qi. For spasms, treatment involves burning needle puncture, using clinical response as the indicator and pain points as Shu points. This is named Jiqiu Bi (Late Autumn Bi Syndrome). The Hand-Taiyang Sinew Meridian originates above the little finger, knots at the wrist, follows the medial arm, knots posterior to the medial epicondyle (where tapping elicits sensation in the little finger), and enters to knot in the axilla. A branch goes posteriorly along the axillary border, winds around the scapula, follows the neck to emerge anterior to the Foot-Taiyang meridian, and knots at the mastoid process behind the ear. A branch enters the ear. The straight branch emerges above the ear, descends to knot at the mandible, and ascends to connect to the lateral canthus. Symptoms include pain supporting the little finger and posterior medial elbow border, pain entering the axilla, pain in the axilla and posterior axillary border, pain winding around the scapula and pulling to the neck, tinnitus and pain pulling to the mandible, temporary blindness, and neck stiffness causing neck swelling. For cold-heat in the neck, treatment involves burning needle puncture, using clinical response as the indicator and pain points as Shu points. For swelling, use sharp needles repeatedly. The main branch ascends to the zygomatic arch, follows the ear anteriorly, connects to the lateral canthus, ascends to the mandible, and knots at the frontal angle. Pain at these sites causes spasmodic contraction. Treatment involves burning needle puncture, using clinical response as the indicator and pain points as Shu points. This is named Zhongxia Bi (Mid-Summer Bi Syndrome). The Hand-Shaoyang Sinew Meridian originates at the tip of the second finger, knots at the wrist, follows the arm to knot at the elbow, winds around the lateral elbow, ascends to the shoulder and neck, merging with the Hand-Taiyang. A branch enters the tongue base at the angle of the jaw. Another branch ascends to the zygomatic arch, follows the ear anteriorly, connects to the lateral canthus, and ascends to the mandible to knot at the frontal angle. Symptoms include spasmodic contraction at sites of passage and tongue retraction. Treatment involves burning needle puncture, using clinical response as the indicator and pain points as Shu points. This is named Jixia Bi (Late Summer Bi Syndrome). The Hand-Yangming Sinew Meridian originates at the index finger, knots at the wrist, follows the arm, knots at the lateral elbow, ascends to knot at the acromion. A branch winds around the scapula and flanks the spine; the straight branch goes from the shoulder well to the neck. A branch ascends to the cheek and knots at the zygoma. The straight branch emerges anterior to the Hand-Taiyang meridian, ascends to the left corner, networks the head, and descends to the right mandible. Symptoms include pain and spasmodic contraction at sites of passage, inability to raise the shoulder, and inability to rotate the head left or right. Treatment involves burning needle puncture, using clinical response as the indicator and pain points as Shu points. This is named Mengxia Bi (Early Summer Bi Syndrome). The Hand-Taiyin Sinew Meridian originates above the great finger, follows the finger upward, knots posterior to the thenar eminence, runs along the lateral aspect of the Cun Kou pulse, ascends the arm, knots at the elbow, follows the medial arm, enters the axilla, emerges at the supraclavicular fossa, knots at the anterior shoulder, ascends to knot at the supraclavicular fossa, descends to knot in the chest interior, scatters across the diaphragm, merges below the diaphragm, and reaches the costal margin. Symptoms include spasmodic contraction and pain at sites of passage; severe pain leads to Xi Ben (Breath-Restless Accumulation), rib stiffness, and hemoptysis. Treatment involves burning needle puncture, using clinical response as the indicator and pain points as Shu points. This is named Zhongdong Bi (Mid-Winter Bi Syndrome). The Hand-Jueyin (Pericardium) Sinew Meridian originates at the middle finger, runs parallel with the Hand-Taiyin, knots at the medial elbow, ascends the medial arm, knots in the axilla, and scatters anteriorly and posteriorly flanking the ribs. A branch enters the axilla, scatters in the chest, and knots at the Danzhong (Conception Vessel 17). Symptoms include spasmodic contraction and pain at sites of passage, anterior chest pain, and Xi Ben. Treatment involves burning needle puncture, using clinical response as the indicator and pain points as Shu points. This is named Mengdong Bi (Early Winter Bi Syndrome). The Hand-Shaoyin Sinew Meridian originates at the medial little finger, knots at the pisiform, ascends to knot at the medial elbow, enters the axilla, crosses the Hand-Taiyin, flanks the inner breast, knots in the chest, follows the arm, and descends to tie at the umbilicus. Symptoms include internal urgency, Fu Liang (Hidden Beam) beneath the heart, and "Elbow Net" below. Spasmodic contraction and pain occur at sites of passage. Treatment involves burning needle puncture, using clinical response as the indicator and pain points as Shu points. If Fu Liang with hematemesis and pus forms, death is inevitable. Diseases of the Sinew Meridians: Cold causes opisthotonos and tendon stiffness; Heat causes flaccidity and inability to retract, impotence, and limb paralysis. Yang stiffness causes opisthotonos; Yin stiffness prevents bending forward. Burning needles treat cold-induced stiffness. Heat causes flaccidity and should not be treated with burning needles. This is named Jidong Bi (Late Winter Bi Syndrome). For the Foot-Yangming and Hand-Taiyang, tendon stiffness causes facial deviation and inability to look suddenly. Treatment is as described above. Those whose bodies are comfortable but minds are distressed suffer from tendon diseases, treated with heat therapy and Dao Yin (guiding and pulling). All tendon diseases belong to the joints. The Classics state: "All tendons belong to the joints." It is also stated: "Flexion without extension of the hand indicates disease in the tendons." The Liver governs all tendons. The Classics state: "The Liver governs the tendons." It is also stated: "In the Zang organs it is the Liver; in the body tissues it is the tendons." It is also stated: "Sour flavor generates the Liver; the Liver generates the tendons; the tendrons generate the Heart." Tendon diseases contraindicate wind, sour and pungent foods, and prolonged walking. The Classics state: "Wind injures tendons; Dryness overcomes Wind; Sour injures tendons; Pungent overcomes Sour." It is also stated: "Sour enters the tendons; those with tendon diseases should not consume much sour." It is also stated: "Excessive consumption of pungent flavors causes tendon stiffness and brittle nails." It is also stated: "Prolonged walking injures the tendons."