任脉二十四。穴行腹与胸。会阴始兮曲骨从。中极关元石门通。气海阴交会。神关水分逢。下
脘建里兮。中脘上脘。巨阙鸠尾兮。中庭膻中。玉堂上紫宫华盖。璇玑上天突之宫。饮彼廉泉。
承浆味融。
任脉会阴两阴间。曲骨毛际陷中安。中极脐下四寸取。关元脐下三寸连。脐下二寸石门穴。
脐下寸半气海全。脐下一寸阴交穴。脐之中央号神阙。脐上一寸为水分。脐上二寸下脘列。脐上
三寸名建里。中脘脐上四寸许。脐上五寸上脘在。巨阙脐上六寸五。鸠尾蔽骨下五分。中庭膻中
寸六取。膻中却在两乳间。膻上寸六玉堂主。膻上紫宫三寸二。膻上华盖四八举。（四寸八分）膻
上璇玑五寸八。玑上一寸天突起。天突喉下约四寸。廉泉颔下骨尖已。承浆颐前唇棱下。任脉中
央行腹里。（行腹中央共二十七穴）
手太阴气绝。则皮毛焦。太阴者行气温于皮毛者也。故气不荣则皮毛焦。皮毛焦则津液去皮
节。津液去皮节者。则爪枯毛折。毛折者。则毛先死。丙笃丁死。火胜金也。
此论三阴三阳之气终也。皮脉肉筋骨。脏腑之外应也。脏腑者。雌雄之内合也。阴阳六气。本
于脏腑之五行所生。气先死于外。而后脏腑绝于内也。手太阴之气。主于皮毛。是以太阴气绝。则皮毛焦。手太阴
主气。气主熏肤泽毛。故太阴者。行气温于皮毛者也。是以气不荣则皮毛焦。津液者。随三焦出气
以温肌肉。淖泽于骨节。润泽于皮肤。气不荣。则津液去皮节矣。津液去皮节。则爪枯毛折矣。毛
先死者。手太阴之气。先绝于外也。丙笃丁死。肺藏之气。死于内也。尚御公曰。按上古天元
册文。丹 苍素元之天气。经于五方分野。合化地之五行。而地之五行。上呈天之六气。五营运
论曰。神在天为风。风生木。木生酸。酸生肝。肝生筋。筋生心。是人之立形定气。本于五行所
生。故曰其生五。其数三。谓生于五行。而终于三阴三阳之数。是以所生病者。脏腑五行之病生于
内也。是动者。六气之运动于外而为病也。然是动所生之病。皆终于三阴三阳之气者。脏腑五行
之气。本于天之所化。故天气先绝。而后脏腑之气终也。朱济公曰。夫人生于地。悬命于天。天
地合气。命之曰人。本经论人秉天地之气所生。配合天地阴阳。五运六气。能明乎造化死生之道。一
点灵明。与太虚同体。万劫常存。本未尝有生。未尝有死也。张玉师曰。形谓之器。故曰无形无
患。盖既成形器。未有不损坏者也。然此一灵真性。虽千磨百炼。愈究愈精。故佛老以真空见性。
灵素二经。谓空中有真。
手少阴气绝。则脉不通。脉不通则血不流。血不流则髦色不泽。故其面黑如漆柴者。血先死。
壬笃癸死。水胜火也。
心主血脉。故手少阴气绝。则脉不通。脉随气行者也。脉不通则血不流。血随脉气流行者也。
夫心之合脉也。其荣色也。髦者。血气之所生也。故血脉不流。则髦色不泽。面如漆柴。少阴气绝。
则血先死。壬笃癸死。心脏之火气灭也。
足太阴气绝者。则脉不荣肌肉。唇舌者。肌肉之本也。脉不荣则肌肉软。肌肉软则肉萎人中满。
人中满则唇反。唇反者肉先死。甲笃乙死。木胜土也。
足太阴之气生于脾。脾脏荣而外主肌肉。是以太阴气绝。则脉不荣于肌肉矣。脾开窍于口。主
为卫。使之迎粮。故唇舌为肌肉之本。脉不荣则肉萎唇反。太阴之生气绝于外也。甲笃乙死。脾脏
之气死于内也。
足少阴气绝。则骨枯。少阴者。冬脉也。伏行而濡骨髓者也。故骨不濡。则肉不能着也。骨肉
不相亲。则肉软却。肉软却。故齿长而垢。发无泽。发无泽者骨先死。戊笃己死。土胜水也。
足少阴之气主骨。故气绝则骨枯。冬脉者。谓五脏之脉气。合四时而外濡于皮肉筋骨者也。夫
溪骨属骨。肉本于骨也。故骨不濡。则肉不能着于骨。而骨肉不相亲矣。骨肉不相亲。则骨气外
脱而齿长矣。夫肾主藏精而化血。发者。血之余也。发无泽者。肾脏之精气绝而骨先死矣。
足厥阴气绝则筋绝。厥阴者。肝脉也。肝者。筋之合也。筋者聚于阴气而脉络于舌本也。故
脉弗荣则筋急。筋急则引舌与卵。故唇青舌卷卵缩。则筋先死。庚笃辛死。金胜木也。
足厥阴之气主筋。故气绝则筋绝矣。厥阴者肝脉。肝者筋之合。谓厥阴之气。合于肝脉。肝
脏之气。合于筋也。聚于阴气者。筋气之会于宗筋也。筋聚于阴器而络于舌本。故脉不荣于筋。
则筋急而舌卷卵缩矣。厥阴气绝。则筋先死。庚笃辛死。金胜木而肝脏之木气绝也。
五阴气俱绝。则目系转。转则目运。目运者为志先死。志先死。则一日半死矣。
此总结五脏五行之气。本于先天之水火也。心系上系于目系。目系转者。心气将绝也。火之精
为神。水之精为志。神生于精。火生于水。故志死而神先绝。所谓生则俱生。急则俱死也。天一
生水。地二生火。一日半者。一二日之间。阴阳水火之气。终于天地始生之数也。
六阳气绝。则阴与阳相离。离则腠理发泄。绝汗乃出。故旦占夕死。夕占旦死。
此言六腑三阳之气终也。阴阳离合论曰。未出地者。命曰阴中之阴。已出地者。名曰阴中之
阳。盖三阳之气。根于阴而出于阳。是以六阳将绝。则阴与阳相离矣。离则阳气外脱。腠理发泄。
绝汗乃出。而阳气终也。三阳者。应天之气。是以旦占夕死。夕占旦死。不能终天运之一周。尚御
公曰。此章与本经终始篇。素问诊要经终篇。大义相同。
经脉十二者。伏行分肉之间。深而不见。其常见者。足太阴过于外踝之上。无所隐故也。诸脉
之浮而常见者。皆络脉也。六经络。手阳明少阳之大络。起于五指间。上合肘中。饮酒者。卫气
先行皮肤。先充络脉。络脉先盛。故卫气已平。荣气乃满。而经络大盛。脉之卒然盛者。皆邪气
居之。留于本末。不动则热。不坚则陷且空。不与众同。是以知其何脉之动也。雷公曰。何以知
经脉之与络脉异也。黄帝曰。经脉者。常不可见也。其虚实也。以气口知之。脉之见者。皆络脉也。
此申明十二经脉之血气。与脉外皮肤之气血。皆生于胃腑水谷之精。而各走其道。经脉十二
者。六脏六腑手足三阴三阳之脉。乃荣血之荣行。伏行于分肉之内。深而不见者也。诸脉之浮而常见者。皆络脉
也。支而横者为络。络之别者为孙。盖胃腑所生之血气。精专者独行于经隧。荣行于十二经脉之中。
其出于孙络皮肤者。别走于经别。经别者。脏腑之大络也。盖从大络而出于络脉皮肤。下行者。从
足太阴之络。而出于足 之街。故其常见者。足太阴过于外踝之上。无所隐故也。上行者。从手阳
明少阳之络。注于尺肤以上鱼。而散于五指。故曰手阳明少阳之大络。起于五指间。上合肘中。谓
行于皮肤之气血。从手阳明少阳之大络。散于五指间。复从五指之井。溜于脉中。而与脉中之血气。
上合于肘中也。夫阴阳六气。主于肤表。经云。太阴为之行气于三阴。阳明者。表也。亦为之行
气于三阳。盖手太阴主气而外主皮毛。手阳明为太阴之合。故亦为之行气于肤表也。手少阳主气。
为厥阴包络之腑。心主包络。主行血于脉中。少阳主行血于脉外。是以手阳明少阳之大络。主行胃
腑所出之血气。而注于络脉皮肤之间。玉版篇曰。胃者。水谷血气之海也。海之所行云气者。天下也。
胃之所出血气者。经隧也。经隧者。五脏六腑之大络也。缪刺篇曰。邪客于皮毛。入舍于孙络。留
而不去。闭塞不通。不得入于经。流溢于大络。而生奇病也。是血气之行于脉外者。外内出入。
各有其道。故复引饮酒者以证明之。夫酒者。水谷之悍液。卫者。水谷之悍气。故饮酒者。液随卫气而
先行皮肤。是以面先赤。而小便独先下。盖先通调四布于外也。津液随卫气先行皮肤。先充络脉。络
脉先盛。卫气已平。荣气乃满。而经脉大盛。此血气之从皮肤而络。络而脉。脉而经。盖从外而
内也。如十二经脉之卒然盛者。皆邪气居于脉中也。本末者。谓十二经脉之有本标也。如留于脉
而不动则热。不留于脉。则脉不坚而外陷于肤空矣。此十
二经脉之流行出入。不与络脉大络之众同也。是以知何脉之动也。以气口知之。气口者。手太阴之两
脉口也。此言荣血之行于十二经脉中者。乃伏行之经脉。以手太阴之气口知之。血气之行于皮肤而
见于络脉者。候见于人迎气口也。此节凡四转。盖以申明十二经脉之血气。与皮肤之气血。各有出
入之道路。再按、十二经脉之始于手太阴肺。终于足厥阴肝。周而复始者。乃荣血之行于脉中也。
十二经脉之皆出于井。溜于荥。行于经。入于合者。乃皮肤之气血。溜于脉中。而与经脉之血气。
合于肘膝之间。本篇之所谓六经脉。手阳明少阳之大络起于五指间。上合肘中者是也。本经痈疽篇
曰。余闻肠胃受谷。上焦出气。以温分肉而养骨节。通腠理。中焦出气如露。上注 谷。而渗孙
脉。津液和调。变化而赤为血。血和则孙脉先满溢。乃注于络脉皆盈。乃注二经脉。阴阳已张。因
息乃行。行有经纪。周有道理。与天协议。不得休止。此水谷所生之津液。随三焦出气。以温肌肉。
渗于孙络。化赤为血。而溢于经脉。本篇之所谓饮酒者。卫气先行皮肤。先充络脉。络脉先盛。卫
气已平。荣血乃满。而经脉大盛是也。是脉外之气血。一从经隧而出于孙络皮肤。一随三焦出气以
温肌肉。变化而赤。是所出之道路有两歧也。其入于经也。一从指井而溜于经荥。一从皮肤而入
于络脉。是所入之道路有两歧也。其经脉之血气。行于脉外。从本标而出于气街。本篇之所谓留于
本末。不动则热。不坚则陷且空。不与众同是也。此血气出入之道路。合于天地阴阳。五运六气。
乃本经之大关目。故不厌烦赘而详言之。学人亦不可不用心参究者也。夫血气之从经隧而出于孙
络皮肤者。海之所以行云气于天下也。随三焦出气以温肌肉者。应司天在泉。水随气而营运于肤
表也。肤表之气血。入于脉中。应天运于
地之外。而复通贯于地中。经脉之血气。行于皮肤之外。犹地之百川。流注于泉下。而复营运于
天表也。此天地上下升降外内出入之相通也。人合天地阴阳之道。营运不息。可以与天地相参。如
升降息。则气立狐危。出入废。则神机化灭矣。
雷公曰。细子无以明其然也。黄帝曰。诸络脉皆不能经大节之间。必行绝道而出入。复合于
皮中。其会皆见于外。故诸刺络脉者。必刺其结上甚血者。虽无结急取之。以泻其邪。而出其血。
留之发为痹也。凡诊络脉。脉色青则寒且痛。赤则有热。胃中寒。手鱼之络多青矣。胃中有热。鱼
际络赤。其暴黑者。留久痹也。其有赤有黑有青者。寒热气也。其青短者。少气也。凡刺寒热者。
皆多血络。必间日而一取之。血尽乃止。乃调其虚实。其青而短者少气。甚者泻之则闷。闷甚则
仆。不得言。闷则急坐之也。
此复申明上文之义。盖假病刺以证血气之生始出入。下经曰。先度其骨节大小广狭。而脉度
定矣。盖十二经脉。皆循于骨节间而为长短之度。其络脉皆不能经大节之间。必行绝道而出入。绝
道者。别道也。盖胃腑所出之血气。行于经别者。从经别而出于络脉。复合于皮中。其血气色脉
之会合。皆见于外。故刺诸络脉者。必刺其结上。甚血者。虽无结急取之。以泻其邪。而出其血。
留之发为痹也。经云。病在阴者名为痹。盖皮肤络脉之邪。留而不泻。则入于分肉筋骨之间而为痹。
与邪居经脉之中。留于本末。不动则热之不同也。诊、视也。凡诊络脉。脉色青则寒。赤则有热。
盖浮络之血气。皆见于皮之部也。胃中寒。手鱼之络多青。胃中热。鱼际络赤。盖皮络之气血。本
于胃腑所生。从手阳明少阳。注于尺肤而上鱼也。气者。三阴三阳之气。胃腑之所生也
少气甚者。泻之则闷。气益虚而不能行于外也。闷甚则仆不能言者。谓阴阳六气。生于胃腑水谷之
精。而本于先天之水火也。少阴之气厥于下。则仆而不得言。故闷则急坐之。以启少阴之气。即如上
文之缓带被发。大杖重履而步之一法也。高士宗曰。上节以十二经脉。分别卫气血气之行于皮
肤络脉。此节单论皮肤络脉。以复申明上文之义。黄载华曰。冲脉任脉。皆起于胞中。上循背
里。为经络之海。其浮而外者。循腹右上行。会于咽喉。别而络唇口。血气盛。则充肤热肉。血独
盛。则淡渗皮肤。生毫毛。是脉外之气血。又从冲脉而散于皮毛。故曰复合于皮中。其会皆见于
外。谓经别所出之血气。与冲脉所出之血气。会合于皮中。当知皮肤血气所出之道有三径也。
手太阴之别。名曰列缺。起于腕上分间。并太阴之经。直入掌中。散入于鱼际。其病实则手
锐掌热。虚则欠KT 。小便遗数。取之去腕半寸。别走阳明也。（KT 同数叶朔）
The Ren Mai (Conception Vessel) has twenty-four acupoints, distributed along the abdomen and chest. It begins at Huiyin (CV1), followed by Qugu (CV2). Zhongji (CV3), Guanyuan (CV4), and Shimen (CV5) are connected. Qihai (CV6), Yinjiao (CV7), Shenque (CV8), and Shuifen (CV9) follow in sequence. Xiawan (CV10) and Jianli (CV11), along with Zhongwan (CV12) and Shangwan (CV13). Juque (CV14) and Jiutui (CV15), along with Zhongting (CV16) and Danzhong (CV17). Yutang (CV18), Zigong (CV19), Huagai (CV20), Xuanji (CV21), up to Tiantu (CV22). Drinking from Lianquan (CV23), and the taste merges at Chengjiang (CV24).
Huiyin of the Ren Mai is located between the two yin organs. Qugu is secured in the depression at the pubic hairline. Zhongji is taken four cun below the umbilicus. Guanyuan connects three cun below the umbilicus. Shimen is two cun below the umbilicus. Qihai is fully established one and a half cun below the umbilicus. Yinjiao is one cun below the umbilicus. The center of the umbilicus is called Shenque. One cun above the umbilicus is Shuifen. Xiawan is arranged two cun above the umbilicus. Jianli is named three cun above the umbilicus. Zhongwan is approximately four cun above the umbilicus. Shangwan is five cun above the umbilicus. Juque is six and a half cun above the umbilicus. Jiutui is five fen below the xiphoid process. Zhongting and Danzhong are taken at one and six-tenths cun. Danzhong is actually between the two breasts. Yutang is governed one and six-tenths cun above Danzhong. Zigong is three and two-tenths cun above Danzhong. Huagai is four and eight-tenths cun above Danzhong. Xuanji is five and eight-tenths cun above Danzhong. Tiantu protrudes one cun above Xuanji. Tiantu is approximately four cun below the larynx. Lianquan is at the tip of the hyoid bone under the chin. Chengjiang is below the lip ridge in front of the chin. The Ren Mai travels along the central line, circulating within the abdomen.
When the Qi of the Hand-Taiyin Lung Meridian (Shou Taiyin Fei Jing) ceases, the skin and hair become dry and scorched. The Taiyin meridian is responsible for circulating Qi to warm the skin and hair. Therefore, if Qi fails to nourish, the skin and hair become dry. If the skin and hair become dry, body fluids detach from the joints. If body fluids detach from the joints, the nails wither and hair breaks. If hair breaks, it indicates that hair dies first. The condition worsens on Bing days and leads to death on Ding days, due to Fire overcoming Metal.
This passage discusses the termination of the Qi of the Three Yin and Three Yang meridians. Skin, vessels, flesh, sinews, and bones are external manifestations of the Zang-Fu organs. The Zang-Fu organs represent the internal coordination of Yin and Yang. The Six Qi of Yin and Yang originate from the generation of the Five Elements within the Zang-Fu organs. Qi dies externally first, and then the Zang-Fu organs cease internally. The Qi of the Hand-Taiyin governs the skin and hair; thus, when Taiyin Qi ceases, the skin and hair wither. The Hand-Taiyin governs Qi, which primarily steams the skin and moistens the hair. Therefore, the Taiyin meridian circulates Qi to warm the skin and hair. Consequently, if Qi does not nourish, the skin and hair wither. Body fluids, following the Qi of the San Jiao (Triple Burner), warm the muscles, moisten the joints, and lubricate the skin. If Qi does not nourish, body fluids detach from the joints. If body fluids detach from the joints, the nails wither and hair breaks. Hair dying first indicates that the Qi of the Hand-Taiyin ceases externally first. Worsening on Bing days and death on Ding days signifies the death of Lung Qi internally. Master Shang Yu stated: According to ancient texts like the Tian Yuan Ce, the Heavenly Qi of Dan, Cang, Su, and Yuan passes through the five directional divisions, coordinating with the Earthly Five Elements. The Earthly Five Elements present the Heavenly Six Qi upwards. The "Treatise on the Five Movements and Six Qi" states: Spirit in Heaven is Wind; Wind generates Wood; Wood generates Sour; Sour generates Liver; Liver generates Sinews; Sinews generate Heart. This establishes that human form and Qi originate from the Five Elements. Hence it is said, "Its generation is five, its number is three," meaning born of the Five Elements and ending with the numbers of the Three Yin and Three Yang. Thus, diseases generated are those of the Zang-Fu Five Elements arising internally; diseases moved are those of the Six Qi moving externally causing pathology. However, all diseases arising from movement ultimately relate to the Qi of the Three Yin and Three Yang. The Qi of the Zang-Fu Five Elements originates from Heavenly transformation; therefore, Heavenly Qi ceases first, followed by Zang-Fu Qi. Master Zhu Jigong stated: Humans are born of Earth, but their destiny hangs from Heaven. Heaven and Earth combine Qi, termed Human. The Classic discusses humans inheriting Heaven and Earth Qi, coordinating with Heaven and Earth Yin-Yang, Five Movements, and Six Qi. Understanding the Dao of creation and death, a spark of spirituality unites with the Great Void, existing eternally through countless kalpas, originally neither born nor dying. Master Zhang Yushi stated: Form is termed vessel; hence, without form, there is no harm. Once formed into a vessel, none escapes damage. Yet this true spiritual nature, though tested a thousand times, becomes more refined. Thus, Buddhism and Daoism see nature through emptiness; the Ling Shu and Su Wen assert truth exists within emptiness.
When the Qi of the Hand-Shaoyin Heart Meridian (Shou Shaoyin Xin Jing) ceases, the vessels become obstructed. Obstruction leads to stagnant blood. Stagnant blood results in lackluster hair and complexion. Thus, the face turns black like lacquered firewood, indicating blood dies first. The condition worsens on Ren days and leads to death on Gui days, due to Water overcoming Fire.
The Heart governs blood vessels; thus, when Hand-Shaoyin Qi ceases, vessels obstruct. Vessels follow Qi circulation. Obstruction leads to blood stasis. Blood flows with vessel Qi. The Heart harmonizes with vessels, and its flourishing manifests in complexion. Hair is generated by blood and Qi. Therefore, if blood and vessels do not flow, hair lacks luster, and the face resembles lacquered firewood. Shaoyin Qi cessation means blood dies first. Worsening on Ren days and death on Gui days signifies the extinguishing of Heart Fire Qi.
When the Qi of the Foot-Taiyin Spleen Meridian (Zu Taiyin Pi Jing) ceases, vessels fail to nourish the muscles. Lips and tongue are the root of muscles. Lack of nourishment causes muscle flaccidity. Flaccid muscles lead to atrophy and fullness in the philtrum. Fullness in the philtrum causes lip retraction. Lip retraction indicates flesh dies first. The condition worsens on Jia days and leads to death on Yi days, due to Wood overcoming Earth.
Foot-Taiyin Qi originates in the Spleen, which nourishes and externally governs muscles. Thus, Taiyin Qi cessation prevents vessel nourishment of muscles. The Spleen opens into the mouth and governs Wei Qi to receive food. Hence, lips and tongue are the root of muscles. Lack of nourishment causes muscle atrophy and lip retraction. Taiyin vital Qi ceases externally. Worsening on Jia days and death on Yi days signifies Spleen Qi death internally.
When the Qi of the Foot-Shaoyin Kidney Meridian (Zu Shaoyin Shen Jing) ceases, bones become withered. Shaoyin is the Winter Pulse,潜伏 (hidden) and nourishing the marrow. Without marrow nourishment, flesh cannot adhere. Disconnection of flesh and bone causes muscle retraction. Muscle retraction makes teeth appear long and dirty, and hair loses luster. Loss of hair luster indicates bone dies first. The condition worsens on Wu days and leads to death on Ji days, due to Earth overcoming Water.
Foot-Shaoyin Qi governs bones; cessation causes bone withering. The Winter Pulse refers to the Qi of the Five Zang organs coordinating with the four seasons to nourish skin, flesh, sinews, and bones externally. Acupoints belong to bones; flesh originates from bones. Without bone nourishment, flesh cannot adhere, leading to disconnection. Disconnection causes bone Qi to escape externally, making teeth appear long. The Kidney stores essence and transforms blood; hair is the surplus of blood. Lack of hair luster signifies Kidney essence depletion and bone death first.
When the Qi of the Foot-Jueyin Liver Meridian (Zu Jueyin Gan Jing) ceases, sinews sever. Jueyin is the Liver Meridian. The Liver harmonizes with sinews. Sinews gather at the genitalia and connect to the base of the tongue. Lack of vessel nourishment causes spasticity. Spasticity pulls the tongue and testicles. Cyanotic lips, curled tongue, and retracted testicles indicate sinews die first. The condition worsens on Geng days and leads to death on Xin days, due to Metal overcoming Wood.
Foot-Jueyin Qi governs sinews; cessation causes sinew severance. Jueyin is the Liver Meridian; the Liver harmonizes with sinews, meaning Jueyin Qi harmonizes with Liver Meridian, and Liver Qi harmonizes with sinews. Gathering at Yin Qi refers to sinew Qi meeting at the Zong Jin (major sinews). Sinews gather at the genitalia and connect to the tongue base. Lack of vessel nourishment causes spasticity, curled tongue, and retracted testicles. Jueyin Qi cessation means sinews die first. Worsening on Geng days and death on Xin days signifies Metal overcoming Wood and Liver Wood Qi cessation.
When the Qi of all Five Yin organs ceases, the eye connections twist. Twisting causes dizziness. Dizziness indicates Zhi (Will) dies first. Death of Zhi leads to death in one and a half days.
This summarizes the Qi of the Five Zang organs and Five Elements, originating from primordial Water and Fire. The Heart connection links to the eye connection. Eye twisting indicates impending Heart Qi cessation. The essence of Fire is Shen (Spirit); the essence of Water is Zhi (Will). Shen is born from Essence; Fire is born from Water. Thus, death of Zhi precedes Shen. As life comes together, death comes together. One generates Water; Two generates Fire. One and a half days represents the interval where Yin-Yang and Water-Fire Qi end according to the numbers of Heaven and Earth's initial generation.
When the Qi of the Six Yang organs ceases, Yin and Yang separate. Separation causes pores to open and sweat to leak out as "Jue Han" (extreme sweat). Thus, morning prediction implies evening death, and evening prediction implies morning death.
This describes the termination of the Qi of the Six Fu organs and Three Yang meridians. The "Treatise on Yin-Yang Separation and Combination" states: Not yet emerging from the earth is Yin within Yin; emerging from the earth is Yang within Yin. Essentially, Three Yang Qi roots in Yin and emerges from Yang. Thus, impending Six Yang cessation causes Yin-Yang separation. Separation leads to external escape of Yang Qi, pore opening, extreme sweat, and Yang Qi termination. Three Yang corresponds to Heavenly Qi; hence, morning prediction implies evening death, and evening prediction implies morning death, unable to complete a full cycle of Heavenly movement. Master Shang Yu stated: This chapter shares the same core meaning with the "Zhong Shi" chapter of this Classic and the "Zhen Yao Jing Zhong" chapter of the Su Wen.
The Twelve Primary Meridians run deep within the intermuscular spaces, invisible. The only commonly visible part is the Foot-Taiyin Spleen Meridian passing over the lateral malleolus, due to lack of concealment there. All visibly floating vessels are Luo Collaterals. The large Luo Collaterals of the Hand-Yangming and Hand-Shaoyang meridians originate between the fingers and ascend to join at the elbows. In drinkers, Wei Qi (Defensive Qi) moves first into the skin, filling the Luo Collaterals. The Luo Collaterals become full first; once Wei Qi stabilizes, Ying Qi (Nutritive Qi) fills, and the meridians become greatly prominent. Sudden prominence of vessels indicates pathogenic Qi occupation. Retention at the root or branch causes heat if immobile; collapse if not firm, differing from others, allowing identification of the affected vessel. Lei Gong asked how to distinguish Primary Meridians from Luo Collaterals. Huang Di replied: Primary Meridians are usually invisible; their deficiency or excess is known via the Qi Kou pulse. Visible vessels are Luo Collaterals.
This clarifies that the blood and Qi of the Twelve Primary Meridians, and the Qi and blood of the skin, all originate from the essence of water and grain in the Stomach, each taking its own path. The Twelve Primary Meridians, corresponding to the Six Zang and Six Fu organs and the Three Yin and Three Yang of the hands and feet, are the pathways of Ying Blood, running deep within the muscles, invisible. Floating visible vessels are Luo Collaterals. Branching horizontally are Luo Collaterals; branching further are Sun Collaterals. The refined essence of Stomach Qi and blood runs alone in the Jing Tubes, circulating within the Twelve Primary Meridians. Those exiting to the Sun Collaterals and skin take different paths via Jing-Bie (Extraordinary Collaterals), which are the large collaterals of the Zang-Fu organs. Descending ones exit via the Foot-Taiyin collateral to the foot street. Hence, the visible part is the Foot-Taiyin over the ankle. Ascending ones, from the Hand-Yangming and Hand-Shaoyang collaterals, pour into the skin above the大鱼际 (thenar eminence) and scatter among the fingers. Thus, the large collaterals of Hand-Yangming and Hand-Shaoyang start between fingers and join at the elbows. This means Qi and blood on the skin scatter from these large collaterals among fingers, then flow from the Jing (Well) points into the vessels, joining vessel Qi at the elbows. The Six Qi of Yin and Yang govern the surface. The Classic states: Taiyin circulates Qi to the Three Yin; Yangming is the exterior, also circulating Qi to the Three Yang. Hand-Taiyin governs Qi and externally the skin/hair; Hand-Yangming is the interior-exterior pair of Taiyin, thus also circulating Qi to the surface. Hand-Shaoyang governs Qi and is the Fu organ of the Pericardium (Jueyin). The Heart governs the Pericardium, circulating blood within vessels; Shaoyang circulates blood outside vessels. Thus, the large collaterals of Hand-Yangming and Hand-Shaoyang circulate Stomach Qi and blood into the skin and Luo Collaterals. The "Yu Ban" chapter states: The Stomach is the sea of water, grain, Qi, and blood. The clouds and Qi of the sea are the world. The Qi and blood emitted by the Stomach are the Jing Tubes. Jing Tubes are the large collaterals of the Five Zang and Six Fu organs. The "Miu Ci" chapter states: Pathogens enter skin, lodge in Sun Collaterals, remain blocking flow, cannot enter meridians, overflow into large collaterals, causing strange diseases. Thus, Qi and blood outside vessels have specific entry/exit paths. This is proven by drinking alcohol. Alcohol is the fierce fluid of water/grain; Wei Qi is the fierce Qi of water/grain. Drinkers' fluids follow Wei Qi into the skin first, reddening the face and causing early urination, spreading outward. Body fluids follow Wei Qi into skin, filling Luo Collaterals first. When Wei Qi stabilizes, Ying Qi fills, and meridians become prominent. This shows Qi and blood moving from skin to Luo, Luo to Mai, Mai to Jing, from outside to inside. Sudden prominence of Twelve Primary Meridians indicates pathogenic Qi in vessels. "Root and branch" refer to the origins and endpoints of the Twelve Primary Meridians. Retention in vessels without movement causes heat; non-retention causes vessels to be soft and sunken into the skin. This circulation differs from the numerous Luo and Large Collaterals. Identification is made via Qi Kou. Qi Kou is the radial artery of the Hand-Taiyin. Ying Blood in Twelve Primary Meridians is identified via Hand-Taiyin Qi Kou. Qi and blood on skin/Luo Collaterals are observed at Ren Ying and Qi Kou. This section has four turns, clarifying distinct paths for Primary Meridian Qi/blood and Skin Qi/blood. The Twelve Primary Meridians begin at Hand-Taiyin Lung and end at Foot-Jueyin Liver, cycling continuously, representing Ying Blood in vessels. Exiting Jing points, flowing to Ying points, traveling Jing points, entering He points, represents skin Qi/blood flowing into vessels, joining Primary Meridian Qi/blood at elbows/knees. The "Six Primary Meridians" mentioned, large collaterals of Hand-Yangming/Shao-yang starting between fingers and joining at elbows, exemplify this. The "Yong Ju" chapter states: Intestines and stomach receive grain; Upper Jiao emits Qi to warm muscles, nourish joints, and open pores. Middle Jiao emits Qi like dew, pouring into grain, seeping into Sun Collaterals. Harmonized body fluids transform into red blood. Balanced blood fills Sun Collaterals first, then Luo Collaterals, then Primary Meridians. Yin-Yang expand, move with breath, follow order, match Heaven, never resting. This body fluid, following San Jiao Qi, warms muscles, seeps into Sun Collaterals, transforms to blood, overflows into meridians. This matches the "drinker" description: Wei Qi enters skin, fills Luo Collaterals, stabilizes, Ying Blood fills, meridians promote. Thus, extra-vascular Qi/blood has two exit paths: one via Jing Tubes to Sun Collaterals/skin, one via San Jiao Qi to warm muscles and transform to blood. Entry into vessels also has two paths: one from Jing to Ying points, one from skin to Luo Collaterals. Extra-vascular Primary Meridian Qi/blood exits from root/branch to Qi Street. Retention at root/branch causes heat if static, collapse if soft, differing from others. These paths align with Heaven-Earth Yin-Yang and Five Movements/Six Qi, a key theme detailed extensively for study. Qi/blood from Jing Tubes to Sun Collaterals/skin is like the sea emitting Qi globally. Following San Jiao Qi to warm muscles corresponds to Si Tian/Zai Quan, water moving with Qi on the surface. Surface Qi/blood entering vessels corresponds to Heaven operating outside Earth and penetrating within. Primary Meridian Qi/blood on skin is like rivers flowing to springs and operating on the sky. This is the mutual connection of Heaven-Earth ascent/descent and inside/outside entry/exit. Humans coordinate with Heaven-Earth Yin-Yang, operating endlessly, comparable to Heaven and Earth. If ascent/descent stops, Qi establishment is perilous. If entry/exit ceases, Spirit mechanism perishes.
Lei Gong asked for clarification. Huang Di said: Luo Collaterals cannot pass through major joints; they must take alternate routes in and out, rejoining in the skin, where their convergence is visible. Therefore, treating Luo Collaterals requires puncturing prominent, blood-filled nodes. Even without nodes, urgent treatment is needed to drain pathogens and blood; retention causes Bi Syndrome (Obstruction). Diagnosing Luo Collaterals: Blue color indicates cold and pain; red indicates heat. Cold in Stomach causes blue vessels on the大鱼际 (thenar); heat causes red vessels. Sudden black indicates long-standing Bi. Mixed colors indicate mixed cold/heat. Short blue vessels indicate Qi deficiency. Treating cold/heat involves many blood vessels, treated every other day until blood clears, then adjusting deficiency/excess. Short blue vessels indicate Qi deficiency; excessive draining causes fainting, prostration, and inability to speak. Fainting requires sitting immediately.
This reiterates the previous meaning, using disease treatment to demonstrate Qi/blood origin and movement. The "Xia Jing" states: Measure bone joint size to determine vessel length. Twelve Primary Meridians follow joints for length. Luo Collaterals avoid major joints, taking alternate routes, rejoining in skin, visible at convergence. Treating them requires puncturing nodes or urgent drainage to prevent Bi. Pathogens in Yin are Bi. Skin/Luo pathogens retained enter muscles/bones/joints causing Bi, differing from pathogens in Primary Meridians causing heat. Diagnosis is observation. Blue indicates cold; red indicates heat. Floating Luo Qi is visible on skin. Stomach cold causes blue大鱼际 vessels; heat causes red. Skin Luo Qi originates from Stomach, flowing from Hand-Yangming/Shao-yang to尺肤 (forearm skin) and大鱼际. Qi refers to Three Yin/Yang Qi generated by Stomach. Qi deficiency with excessive draining causes fainting due to further Qi depletion. Prostration and speechlessness result from lower Jue Yin Qi reversal. Sitting helps revive Shaoyin Qi, similar to loosening belts and walking with a staff described earlier. Master Gao Shizong stated: The previous section distinguished Wei/Qi/Blood movement in skin/Luo via Twelve Primary Meridians; this section focuses on skin/Luo to reiterate. Master Huang Zaihua stated: Chong and Ren Mai originate in the uterus, ascend the back, serving as the Sea of Meridians. Their superficial parts ascend the abdomen to the throat, connecting lips/mouth. Abundant Qi/blood fills skin/warms flesh; abundant blood渗 (seeps) into skin, growing hair. Thus, extra-vascular Qi/blood scatters from Chong Mai to skin/hair, rejoining in skin, visible externally. This means Qi/blood from Jing-Bie and Chong Mai converge in skin, showing three paths for skin Qi/blood.
The Branch of Hand-Taiyin is named Lieque (LU7), originating above the wrist, running parallel to the Taiyin channel into the palm, scattering at the大鱼际. Excess causes heat in the hand and palm; deficiency causes yawning and frequent urination. Treat by needling half a cun from the wrist, diverting to the Yangming channel.