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Huangdi asked: Among the twelve meridians, why does the pulse of the Hand-Taiyin Lung Meridian alone beat continuously? Qibo replied: It is due to the Foot-Yangming Stomach Meridian. The Stomach is the sea of the five zang and six fu organs (the source of nourishment for all internal organs). Its clear qi ascends and pours into the Lungs. The Lung qi travels along the Hand-Taiyin Lung Meridian. Its movement is linked to respiration, coming and going with each breath. Therefore, in a person's pulse, it beats twice during one exhalation and twice during one inhalation. Since breathing never ceases, the pulse beats without stopping.

Huangdi asked: Why can the cunkou pulse at the wrist alone serve as the master indicator for the five zang organs? Qibo answered: The Stomach is the sea of water and grain, and the great source of the six fu organs. Flavors enter the mouth, are stored in the Stomach, and nourish the qi of the five zang organs. The cunkou pulse belongs to the Hand-Taiyin Lung Meridian. Thus, the qi and flavors of the five zang and six fu organs all originate from the Stomach and manifest at the cunkou. Therefore, the five aromas enter through the nose and are stored in the Heart and Lungs; if the Lung is diseased, the nose becomes obstructed. (The *Jiu Juan* discusses the pulsation, the *Su Wen* discusses the qi, and this text discusses its role as the master of the five zang; they elucidate each other.)

Huangdi asked: When qi passes through the cunkou, it emerges above at the Yuji point area and descends below at the Chize point area. Through what path does it return? I do not understand its ultimate principle. Qibo answered: When qi leaves the zang organs, it suddenly rushes forth like an arrow from a crossbow or water cascading from a bank. It ascends to the fish border (Yuji) and then declines; the remaining qi dissipates and rises counter-flowingly, so its movement appears subtle and weak.

Huangdi asked: Why does the Foot-Yangming Stomach Meridian pulse independently? Qibo answered: Stomach qi ascends to the Stomach. Its fierce, rapid qi ascends to strike the head, follows the throat up to the empty orifices of the head, follows the eye system into the brain, emerges below the jaw at the Keyrenman point, follows the Yache point, merges with the Yangming Meridian, and descends together to the Renying point. This is how Stomach qi travels along the Yangming Meridian. Therefore, whether above or below, yin or yang, their pulsations are uniform. Thus, if a yang disease presents with a small yang pulse, it is a contrary sign; if a yin disease presents with a large yin pulse, it is a contrary sign. If both yin and yang pulses are excessive and beat together, tilting towards each other like a pulled rope, this indicates disease.

Huangdi asked: Why does the Foot-Shaoyin Kidney Meridian pulse independently? Qibo answered: The Chong Mai (Penetrating Vessel) is the sea of the twelve meridians. It originates from the lower kidney along with the large collateral of the Foot-Shaoyin Meridian, emerges at the Qichong point, follows the inner aspect of the thigh, slants into the popliteal fossa, follows the inner aspect of the tibia, runs parallel to the Foot-Shaoyin Meridian, and descends behind the medial malleolus to the sole of the foot. Its branch slants into the ankle, emerges on the dorsum of the foot, enters between the big toe, and pours into the various collaterals to warm the foot dorsum. This is the normal pulsation of this vessel.

Huangdi said: The Wei Qi (Defensive Qi) circulates up and down, interweaving like a circle without end. Now, if one suddenly encounters pathogenic qi or severe cold, causing the hands and feet to become immobile, the yin and yang pulses lose their rhythmic order, and one cannot discern its pattern, yet it eventually restarts. This is what is meant.

The twelve main meridians run hidden within the muscle intervals, deep and invisible. The only ones commonly visible are those of the Foot-Taiyin Spleen Meridian over the lateral malleolus, where there is no concealment. Therefore, all floating and commonly visible vessels are collaterals. Among the six yang meridians' collaterals, the large collaterals of the Hand-Yangming Large Intestine and Hand-Shaoyin Heart meridians originate between the five fingers and ascend to merge in the elbow region. After drinking wine, the Wei Qi first travels in the skin and first fills the collaterals. When the collaterals are full, the Wei Qi becomes calm, the Ying Qi (Nutritive Qi) becomes full, and the main meridians become excessively prominent. Sudden pulsations in the vessels are caused by pathogenic qi residing there, lingering at the root or extremities. If it does not pulse, heat arises; if it is not firm, it sinks and becomes hollow. Since it differs from the normal state, one can identify which meridian is pulsating.

Leigong asked: How can one distinguish between the main meridians and the collaterals? Huangdi answered: The main meridians are usually invisible. Their deficiency or excess is known through the cunkou pulse. The vessels that are visible are all collaterals. All collaterals cannot pass through major joints; they must travel through unique pathways to emerge and re-enter, merging within the skin. Their intersections are all visible externally. Therefore, when needling collaterals, one must needle at the site of congestion. Even if there is no obvious blood clot but there is abundant blood, one should urgently drain it to expel the pathogen and release the blood; otherwise, retention will lead to Bi syndrome (obstruction).

In general, diagnosing collaterals: if the vessel color is green, it indicates cold and pain; if red, it indicates heat. Cold in the Stomach causes many green vessels in the thenar eminence (fish border). Heat in the Stomach causes red vessels in the thenar eminence. Sudden blackness indicates long-standing Bi syndrome. Red, green, and black colors indicate mixed cold and heat. Green and small/short vessels indicate deficient qi.

When needling for cold and heat conditions, one should select vessels with abundant blood and treat them every other day until the blood is exhausted, adjusting for deficiency and excess. For small and short vessels indicating deficient qi, excessive draining may cause chest oppression. Severe oppression leads to collapse and inability to speak; in such cases, one should urgently have the patient sit down.

The collateral of the Hand-Taiyin Lung Meridian is named Lieque (LU-7). It originates between the muscles above the wrist, runs parallel to the Lung Meridian straight into the palm, and disperses into the thenar eminence. In excess conditions, there is heat in the palm at the radial styloid process; in deficiency conditions, there is yawning and frequent urination or incontinence. Treatment involves needling 1.5 cun from the wrist, where it diverges to connect with the Hand-Yangming Large Intestine Meridian.

The collateral of the Hand-Shaoyin Heart Meridian is named Tongli (HT-5). It is located 1.5 cun above the wrist, diverges and ascends, follows the meridian into the heart, connects to the root of the tongue, and attaches to the eye system. In excess conditions, there is a sensation of fullness supporting the diaphragm; in deficiency conditions, there is inability to speak. Treatment involves needling 1 cun behind the wrist, where it diverges to connect with the Hand-Taiyang Small Intestine Meridian.

The collateral of the Hand-Jueyin Pericardium Meridian is named Neiguan (PC-6). It is located 2 cun from the wrist, emerges between the two tendons, follows the meridian upward, and attaches to the Pericardium. In excess conditions of the Heart system, there is heart pain; in deficiency conditions, there is vexation. Treatment involves needling between the two tendons.

The collateral of the Hand-Taiyang Small Intestine Meridian is named Zhizheng (SI-7). It is 5 cun above the wrist, internally injects into the Foot-Shaoyin Meridian. Its branch ascends to the elbow and connects to the Jianliao point. In excess conditions, there is flaccidity of the tendons and elbow dysfunction; in deficiency conditions, warts grow, small ones resembling scabies or crusts on the finger. Treatment involves needling at the divergence point.

The collateral of the Hand-Yangming Large Intestine Meridian is named Pianli (LI-6). It is 3 cun from the wrist, diverges to connect with the Hand-Taiyin Lung Meridian. Its branch follows the arm upward, crosses the shoulder, ascends to the temporo-mandibular joint, and covers the teeth. Another branch enters the ear and meets the Zong Mai (Gathering Vessels). In excess conditions, there are toothaches and deafness; in deficiency conditions, there is cold in the teeth and obstruction in the diaphragm. Treatment involves needling at the divergence point.

The collateral of the Hand-Shaoyang Sanjiao Meridian is named Waiguan (TE-5). It is 2 cun from the wrist, winds around the arm externally, pours into the chest, and merges with the Pericardium. In excess conditions, there is elbow contracture; in deficiency conditions, there is inability to hold the arm. Treatment involves needling at the divergence point.

The collateral of the Foot-Taiyang Bladder Meridian is named Feiyang (BL-58). It is 7 cun from the ankle, diverges to connect with the Foot-Shaoyin Kidney Meridian. In excess conditions, there is nasal obstruction (or rhinorrhea), headache, and back pain; in deficiency conditions, there is rhinorrhea or epistaxis. Treatment involves needling at the divergence point.

The collateral of the Foot-Shaoyang Gallbladder Meridian is named Guangming (GB-37). It is 5 cun above the ankle, diverges to connect with the Foot-Jueyin Liver Meridian, and descends to connect with the foot dorsum. In excess conditions, there is cold limbs (Jue); in deficiency conditions, there is flaccidity (Wei), making it difficult to sit up. Treatment involves needling at the divergence point.

The collateral of the Foot-Yangming Stomach Meridian is named Fenglong (ST-40). It is 8 cun from the ankle, diverges to connect with the Foot-Taiyin Spleen Meridian. Its branch follows the outer aspect of the tibia upward to connect with the head and neck, gathers the qi of various meridians, and descends to connect with the throat. Disease involving qi rebellion causes sore throat and loss of voice. In excess conditions, there is mania; in deficiency conditions, there is inability to hold the foot and withering of the shin. Treatment involves needling at the divergence point.

The collateral of the Foot-Taiyin Spleen Meridian is named Gongsun (SP-4). It is 1 cun distal to the metatarsophalangeal joint, diverges to connect with the Foot-Yangming Stomach Meridian. Its branch enters and connects with the intestines and stomach. Rebellion of jue qi causes Huoluan (cholera-like vomiting and diarrhea). In excess conditions, there is cutting pain in the intestines; in deficiency conditions, there is abdominal distension. Treatment involves needling at the divergence point.

The collateral of the Foot-Shaoyin Kidney Meridian is named Dazhong (KI-4). It is located behind the ankle, winding around the heel, and diverges to connect with the Foot-Taiyang Bladder Meridian. Its branch runs parallel upward to the lower Pericardium, piercing the waist and spine. Disease involving qi rebellion causes irritability and oppression. In excess conditions, there is strangury and retention; in deficiency conditions, there is lower back pain. Treatment involves needling at the divergence point.

The collateral of the Foot-Jueyin Liver Meridian is named Ligou (LR-5). It is 5 cun above the medial malleolus, diverges to connect with the Foot-Shaoyang Gallbladder Meridian. Its branch follows the meridian upward to the testis, knotting at the penis. Disease involving qi rebellion causes testicular swelling and sudden hernia. In excess conditions, there is priapism and heat; in deficiency conditions, there is sudden itching. Treatment involves needling at the divergence point.

The collateral of the Ren Mai (Conception Vessel) is named Wei Yi (Jiuwei, CV-15). It descends from the Jiuwei point and disperses in the abdomen. In excess conditions, there is pain in the abdominal skin; in deficiency conditions, there is itching. Treatment involves needling at the divergence point.

The collateral of the Du Mai (Governing Vessel) is named Changqiang (GV-1). It runs alongside the spine up to the neck and disperses in the head, extending left and right below the shoulder blades, diverging to connect with the Foot-Taiyang Bladder Meridian, and entering to pierce the sacral muscles. In excess conditions, there is spinal rigidity; in deficiency conditions, there is heaviness of the head. When shaking the head high, look for abnormalities along the spine. Treatment involves needling at the divergence point.

The large collateral of the Spleen is named Dabao (SP-21). It emerges 3 cun below the Yuanxi point and spreads over the chest and hypochondrium. In excess conditions, there is pain throughout the body; in deficiency conditions, all vessels become lax. These vessels, resembling a net of blood, should all be treated. Of these fifteen collaterals, excess conditions are always visible, while deficiency conditions always sink. If not seen visually, seek them above and below, as human meridians vary, and the divergence points of collaterals differ.

Huangdi asked: The skin has divisions, and the vessels have a network structure. I wish to hear the principle behind this? Qibo answered: To understand the skin regions using the meridians as the guide, this applies to all meridians. The yang of the Yangming Meridian is called Haifei. Following the same method for all twelve meridians, observe any floating collaterals in the region; these are all collaterals of the Yangming Meridian. If the color is mostly green, there is pain; mostly black, Bi syndrome; yellow and red, heat; mostly white, cold. If all five colors appear, it indicates mixed cold and heat. When collaterals are full, pathogens enter the main meridians. Yang governs the exterior, Yin governs the interior.

The yang of the Shaoyang Meridian is called Shuzhu. Observe any floating collaterals in the region; these are all collaterals of the Shaoyang Meridian. When collaterals are full, pathogens enter the main meridians. Thus, pathogens in the yang aspect move inward, and those in the yin aspect move outward, seeping into the interior. This applies to all meridians.

The yang of the Taiyang Meridian is called Guanshu. Observe any floating collaterals in the region; these are all collaterals of the Taiyang Meridian. When collaterals are full, pathogens enter the main meridians.

The yin of the Shaoyin Meridian is called Shuru. Observe any floating collaterals in the region; these are all collaterals of the Shaoyin Meridian. When collaterals are full, pathogens enter the main meridians. Upon entering the meridians, they flow from the yang aspect into the meridians; upon exiting, they flow from the yin aspect inward to the bones.

The yin of the Heart Master (Pericardium) is called Haijian. Observe any floating collaterals in the region; these are all collaterals of the Heart Master Meridian. When collaterals are full, pathogens enter the main meridians.

The yin of the Taiyin Meridian is called Guanxie. Observe any floating collaterals in the region; these are all collaterals of the Taiyin Meridian. When collaterals are full, pathogens enter the main meridians. These twelve meridian-collateral systems constitute the skin regions. Therefore, when diseases begin, they first lodge in the skin and hair. Pathogens attacking cause the cou li (pores) to open; once open, pathogens enter the collaterals. If they remain, they transmit to the meridians; if they remain there, they transmit to the fu organs, ultimately affecting the intestines and stomach. When pathogens first enter the skin, the hair stands erect. If cold predominates, tendons contract and bones ache; if heat predominates, tendons relax and bones waste away, flesh shrinks and breaks, and hair becomes stiff and deteriorates.

Huangdi asked: What are the diseases arising from the twelve regions? Qibo answered: The skin is the domain of the vessels. Pathogens lodging in the skin cause the cou li to open; once open, pathogens enter the collaterals. When collaterals are full, they pour into the meridians; when meridians are full, they lodge in the zang-fu organs. Thus, the skin has divisions; if not healed, major diseases arise.

Huangdi asked: The visible collaterals display different colors. What is the reason? Qibo answered: The main meridians have constant colors, while collaterals do not have constant changes. Huangdi asked: What are the constant colors of the meridians? Qibo answered: The Heart is red, the Lung is white, the Liver is green, the Spleen is yellow, and the Kidney is black. These correspond to the colors of their respective meridians. Huangdi asked: Do the yin and yang collaterals also correspond to the meridians? Qibo answered: The color of the yin collaterals corresponds to their meridian. The color of the yang collaterals varies constantly, following the four seasons. With much cold, the blood coagulates and flows slowly, appearing green or black; with much heat, the blood becomes fluid and moist, appearing yellow or red. These are considered normal colors, indicating no disease. If all five colors appear, it indicates mixed cold and heat.

Huangdi said: I have heard that humans harmonize with Heaven and Earth. Internally, there are five zang organs corresponding to the five tones, five colors, five flavors, five seasons, and five directions. Externally, there are six fu organs corresponding to the six pitches. They govern the yin and yang meridians, harmonizing with the twelve months, twelve earthly branches, twelve solar terms, twelve double-hours, twelve rivers, and twelve meridians. This is how the five zang and six fu correspond to the Way of Heaven. The twelve meridians are the basis of life, the formation of disease, the method of treatment, the origin of illness, the beginning of learning, and the limit of skill. They are easily overlooked by crude practitioners but thoroughly understood by superior physicians. How do they separate, combine, enter, and exit? Huangdi said: This is passed over by crude practitioners but fully comprehended by superior physicians. Let me explain in detail:

The Zheng Qi (Regular Branch) of the Foot-Taiyang Bladder Meridian diverges into the popliteal fossa. One branch descends five cun below the coccyx, diverges into the anus, connects to the Bladder, and disperses to the Kidney, following the sacral muscles up to the heart to disperse. The straight branch ascends from the sacral muscles, emerges at the nape, and reconnects with the Taiyang Meridian. This constitutes one meridian pathway.

The Zheng Qi of the Foot-Shaoyin Kidney Meridian reaches the popliteal fossa, diverges to connect with the Taiyang Meridian and merges, ascends to the Kidney, exits at the level of the fourteenth vertebra, and connects to the Dai Mai (Girdle Vessel). The straight branch connects to the root of the tongue, re-emerges at the nape, and merges with the Taiyang Meridian. This constitutes one combination. (*Jiu Xu* states: Alternatively, the divergences of all yin meridians are considered Zheng Qi).

The Zheng Qi of the Foot-Shaoyang Gallbladder Meridian: some consider the divergences of various meridians as Zheng Qi (one version says it wraps around the thigh, enters the pubic region, and merges with Jueyin). The divergent branch enters the space between the costal cartilages, follows the interior of the chest, connects to the Gallbladder, disperses to the upper Liver, pierces the Heart, ascends alongside the pharynx, emerges in the jaw/chin area, disperses in the face, connects to the eye system, and merges with Shaoyang at the outer canthus.

The Zheng Qi of the Foot-Jueyin Liver Meridian diverges from the dorsum of the foot, ascends to the pubic region, merges with Shaoyang, and travels together with the divergent branch. This constitutes the second combination.

The Zheng Qi of the Foot-Yangming Stomach Meridian ascends to the thigh, enters the abdominal cavity, connects to the Stomach, disperses to the Spleen, ascends to connect with the Heart, follows the pharynx, emerges at the mouth, ascends to the orbit, returns to connect to the eye system, and merges with Yangming.

The Zheng Qi of the Foot-Taiyin Spleen Meridian diverges and ascends to the thigh, merges with Yangming, travels together with the divergent branch, connects to the pharynx, pierces the root of the tongue. This constitutes the third combination.

The Zheng Qi of the Hand-Taiyang Small Intestine Meridian points downward, diverges into the shoulder joint, enters the axilla, travels to the Heart, and connects to the Small Intestine.

The Zheng Qi of the Hand-Shaoyin Heart Meridian diverges downward between the two tendons of the Yuanxi region, connects to the Pericardium, ascends to the throat, emerges in the face, and merges at the inner canthus. This constitutes the fourth combination.

The Zheng Qi of the Hand-Shaoyang Sanjiao Meridian points upward, diverges at the vertex, enters the Supraclavicular Fossa, descends to the Sanjiao, and disperses in the chest.

The Zheng Qi of the Hand-Jueyin Pericardium Meridian diverges downward 3 cun from Yuanxi, enters the chest, diverges to connect to the Sanjiao, emerges following the throat, emerges behind the ear, and merges with Shaoyang below the Wangu point. This constitutes the fifth combination.

The Zheng Qi of the Hand-Yangming Large Intestine Meridian follows the chest and breast from the hand, diverges at Jianliao, enters below the vertebral column, travels to the Large Intestine, connects to the Lung, follows the throat, emerges from the Supraclavicular Fossa, and merges with Yangming.

The Zheng Qi of the Hand-Taiyin Lung Meridian diverges into the anterior aspect of the Yuanxi region near the Shaoyin Meridian, travels to the Lung, disperses to the Taiyang Meridian, emerges from the Supraclavicular Fossa, follows the throat, and merges with Yangming. This constitutes the sixth combination.