马云。内有阴阳诸经。根于某穴。结于某穴。故名篇。
岐伯曰 甲乙作黄帝曰。
阴道偶 阳道奇 张云。奇者数之单。如一三五七九是也。偶者数之拆。如二四六八十是也。
发于春夏 马云。凡病发于春夏者。则阴气少而阳气多。是谓阴阳不调也。志云。发者谓人之阴阳
开阖。简案、今从马义。
故茎叶枯槁 湿雨下归 简案、此二句盖谓上茎叶枯槁。则湿雨归其下根而养之。乃秋冬之时候也。
然与上文之例不同。或恐是衍文。
阴阳相移 甲乙移作离。
奇邪离经 马云。奇邪、不正之邪也。感此入彼谓之离经。张云。奇邪、弗常之邪也。离经、流传
无定也。志云。奇邪离经者。邪不入于经。流于大络而生奇病。言邪之变易。不可胜数也。
折关败枢 马云。素问离合真邪论曰。太阳为开。阳明为阖。少阳为枢。太阴为开。厥阴为阖。少
阴为枢。正与下文相同。今曰关者。是有关乃所以开阖也。
开阖而走 阴阳大失 马云。关折枢败。门阖误走其气。阴阳大失。气难复取。张云。败折其关枢。
走失其阴阳。简案、据张注八字为一句。今仍马注。
九针之玄。要在终始 甲乙作九针之要。在于终始。马云。九针玄妙之法。其要在终始篇中。张云。
终始本末也。即下文根结开阖之义。又本经有终始篇。所载者皆针道。故不知终始。针道咸绝。
命门者目也 张云。足太阳下者根于至阴穴。上者结于睛明穴。故曰命门者目也。王氏曰。命门者
藏精。光照之所。则两目也。志云。命门者太阳为水火生命之原。目窍乃经气所出之门也。（王氏说见阴阳离
合论注）
颡大者钳耳也 马云。谓头维穴也。张云。足阳明下者根于厉兑。上者结于承泣。今曰颡大者。意
谓项颡之上大迎穴也。大迎在颊下两耳之旁。故曰钳耳。志云。颡大者颃颡也。在上 之中。两耳之间。故曰
钳耳。简案、楼氏云。颡大谓额角入发际。头维二穴也。以其钳束于耳上。故名钳耳也。知马根据楼说。今从之。
甲乙作结于颃颡。颃颡者钳大。钳大者耳也。义未详。
窗笼者耳中也 马云。谓听宫穴也。按手太阳小肠经。有天窗穴。一名窗笼。（出甲乙）去颈大筋
前曲颊下扶突后。动脉应手陷中。观下文肾经结于任脉经之廉泉。肝经结任脉经之玉英。则本经有结之他经者。
疑天窗为足少阳经之所结欤。张云。乃手太阳听宫穴也。为手足少阳手太阳之会。故足少阳结于此。志云。窗
笼者耳中也。如窗之通气于上也。简案、窗笼者耳也。亦出卫气篇。
太阳为开（止）为枢 张云。所谓开、阖、枢者。不过欲明内外而分其辨治之法也。志云。开阖如
户扉。枢犹转牡。
舍枢则不能开阖。舍开阖则无从运枢。此三阳之气。互相出入于经脉皮肤形身脏腑之外内者也。（开阖枢义具
阴阳离合论）
渎而暴病起矣 甲乙渎作溃缓。张云。太阳为阳中之表。故气在肌肉。为肉节渎也。表主在外。
邪易入之。故多新暴病也。简案、渎、 也。 、扰也。
渎者皮肉宛 而弱也 甲乙作溃缓者。皮肉缓 而弱也。张云。即消瘦干枯之谓。简案、淮南
子天文训高注。 、肉不满也。
痿疾 张云。阳明主润宗筋。束骨而利机关。故为痿疾。
骨徭 马云。正以其节缓而不能收。即骨之摇动故也。素问气交变大论。有筋骨徭复。王注亦以
为筋骨摇动。简案、至真要大论。又有筋骨徭并。文亦同义。
当穷其本 甲乙穷作窍。张云。窍此三阳所在之本。或开或阖或枢以治之也。
太仓 马云。即中脘。系任脉经。甲乙云。中脘一名太仓。胃募也。志云。太仓者舌本也。脾为
仓廪之官。其脉连舌本。散舌下。使之迎根。故结于舌本。名曰太仓。简案、以太仓为舌本无所考。
廉泉 简案、诸家为任脉经穴非也。气腑论。足少阴舌下各一。王注舌本左右二穴也。刺疟论。
舌下两脉者。廉泉也。并谓肾经穴。
玉英 马云。即玉堂穴。系任脉经。甲乙云。玉堂一名玉英。张兆璜云。谓唇内之龈交英HT 也。
谓齿白如玉HT 也。简案、以玉英为龈交。亦未见所据。
络于膻中 志云。肝脉贯膈也。简案、厥阴特多此一句。
膈洞 马云。开折则脾不运化。仓廪无所转输。其病
为膈证。为洞泄。张云。膈、隔塞也。洞、如邪气脏腑病形篇曰。洞者食不化。下嗌还出也。志云。膈者上不
开而不受纳。洞者下关折而飧泄也。
气绝面喜悲 甲乙绝作弛。马云。肝气绝而喜悲。简案、绝、谓阻绝也。
脉有所结而不通 马云。肾脉有所结。而下焦不通。
取之不足 甲乙无不足二字。张云。脉有结者。皆不足之所致。简案、不足二字衍。甲乙为是。
足太阳（止）飞扬也 张云。此下言手足三阳之盛络。凡治病者所当取也。足太阳之至阴井也。京
骨、原也。昆仑、经也。天柱、在头。飞扬、在足。皆本经之当取者。后效此。
天容 甲乙注云疑误。马云。当作天冲。张同。（天容手太阳经穴）
下陵 马云。当作解溪经也。张同。
小海 简案、他经举原穴。此独举合穴者何。
一日一夜（止）曰狂生 张云。营运也。人之经脉。营运于身者。一日一夜。凡五十周。以营五脏
之精气。如五十营篇者即此之义。其数则周身上下左右前后。凡二十八脉。共长十六丈二尺。人之宗气。积于
胸中。主呼吸而行经隧。一呼气行三寸。一吸气行三寸。呼吸定息。脉行六寸。以一息六寸推之。则一昼一夜。
凡一万三千五百息。通计五十周于身。则脉行八百一十丈。其有大过不及。而不应此数者。名曰狂生。狂犹妄
也。言虽生未可必也。简案、马云。狂生犹云侥幸而生也非。
不一代者 十一难代作止。脉轻作投。并文略不同。张云。代、更代之义。谓于平脉之中。而忽见
软弱。或乍数乍疏。或断而复起。盖其脏有所损。则气有所亏。故变易若此。均名为代。若五十动而不一代者。
五脏受气皆足。乃为
和平之脉。简案、脉要精微论云。代则气衰。张守节史记正义云。候脉动不定曰代。即此义也。杨玄操云。代
者还尺中。停久方来。名曰代也。此本于伤寒论。不可从。
予之短期 张云。予、与同。短期死期也。李中梓云。短、近也。死期近矣。
终始 马云。其要法在本经终始篇中。其义甚详。
乍数乍疏 张云。此其时相变代。乃与常代者不同。盖以脏气衰败。无所主持。而失常如此。故
三部九候等论。皆云乍疏乍数者死。简案、张圈外注甚详。不复繁引。
逆顺五体 马云。五体者即阴阳二十五人篇。有五形之人也。张云。骨、节、皮、肉、血、气、
经、脉。禀有不齐。刺治亦异。所以有逆顺之变。
悍 史上、比昭切。下、候岸切。勇健貌。张云。 音飘。急也。
膏粱菽藿 张云。膏、脂肥也。粱、粟类。谷之良者也。菽、豆也。藿、豆叶也。贵者之用膏粱。
贱者之用菽藿。食味有浓薄。禀质所以不同也。
微以徐之 简案、据上文疾迟留疾推之。似徐是疾之误。此岂徐出而不留之谓欤。
形气不足（止）急泻之 张云。貌虽不足。而神气病气皆有余。此外似虚而内则实。邪气胜也。
当急泻之。东垣李氏云。气谓口鼻中气息也。形谓皮肉筋骨血脉也。（出辨惑论）简案、张带说神气。却觉不允。
形气有余（止）急补之 张云。形虽壮伟。而病气神气则不足。此外似实而内则虚。正气衰也。当
急补之。志云。形气谓皮肉筋骨之形气。病气者阴阳血气之为病也。此虽分别形气病气。然重在病气之有余不足。
阴阳气俱不足 张云。阳主外。阴主内。若形气病气俱不足。此表里阴阳俱虚也。
满而补之 甲乙。满、作实。
充郭 素汤液醪醴论。津液充郭。王注云。郭、皮也。
内 甲乙。 、作胀。
HT 辟 甲乙。HT 、作慑。马云。僻积之意。张云。HT 、畏怯也。HT 、邪僻不正也。简案、素调经
论。虚者聂辟气不足。王注。聂、谓聂皱。辟、谓辟叠也。玉篇。HT 、尺涉切。与慑通。根据王注聂皱与辟貂通。
类篇。 、谓衣襞积。马意盖亦同。
薄着 张云。瘦而涩也。
夭 张云。夭、短折也。 、焦同。（ 义见前）
乃光 甲乙。光、作充。
乱脉 甲乙。脉、作经。
五脏变化之病 甲乙作五脏之变化。无之病二字。
五脉 张云。五脏之脉应也。
皮之柔粗 甲乙皮下有肤字。
马云说：人体内部有阴经和阳经，它们分别根源于某个穴位，结止于另一个穴位，因此这篇名为《根结》。
岐伯说（《甲乙经》中作黄帝说）：阴经的数目是偶数，阳经的数目是奇数。张云解释说：所谓“奇”，是指单数的数字，如一、三、五、七、九；所谓“偶”，是指双数的数字，如二、四、六、八、十。
疾病发生在春夏季节，马云说：凡是疾病发生在春夏季节的，是因为阴气少而阳气多，这叫做阴阳不调。志云解释说：“发”指的是人的阴阳的开阖机制。简案认为：现在遵从马云的解释。
所以茎叶枯槁，湿雨向下归流。简案认为：这两句大概是说，如果上面的茎叶枯槁，那么湿雨就会流向下面的根部来滋养它，这是秋冬季节的情形。然而这与上文的体例不同，恐怕是衍文（多余的文字）。
阴阳相互移易，《甲乙经》中“移”字作“离”。
奇邪离开经脉，马云说：奇邪，是不正常的邪气。感受这种邪气并传入其他部位叫做“离经”。张云说：奇邪，是非常规的邪气；离经，指邪气流传没有定所。志云说：奇邪离经，是指邪气不进入正经，而是流注到大络而产生奇特的病症。这说明邪气的变化不可胜数。
折损关隘，败坏枢纽。马云引用《素问·离合真邪论》说：太阳为开，阳明为阖，少阳为枢；太阴为开，厥阴为阖，少阴为枢。这与下文的内容相同。现在所说的“关”，是指有关隘才能进行开阖。
开阖失常而气机走泄，导致阴阳大失。马云说：关折枢败，门阖误走其气，导致阴阳大失，气难以恢复。张云说：败折其关枢，走失其阴阳。简案认为：根据张注，这八个字应作为一句。现在仍遵从马注。
九针的玄妙之处，关键在于《终始》篇。《甲乙经》作“九针的要旨，在于终始”。马云说：九针玄妙之法，其要点在《终始》篇中。张云说：终始指本末，即下文根结、开阖的含义。另外，《灵枢》本经中有《终始》篇，所载内容都是针刺之道，所以如果不了解终始，针刺之道就会断绝。
命门就是眼睛。张云说：足太阳膀胱经下部的根穴在至阴穴，上部的结穴在睛明穴，所以说命门就是眼睛。王氏说：命门藏精，是光照的来源，即两目。志云说：命门是太阳经水火生命的本源，目窍是经气发出的门户。（王氏的说法见《阴阳离合论》注）
颃颡宽大者，像钳子一样夹住耳朵。马云说：指的是头维穴。张云说：足阳明胃经下部的根穴在厉兑穴，上部的结穴在承泣穴。现在说的“颃颡宽大者”，意谓项颡之上的大迎穴。大迎穴位于脸颊下方、两耳旁边，所以说像钳子夹住耳朵。志云说：颃颡者，即颃颡部位，在上部中间，两耳之间，所以说像钳子夹住耳朵。简案认为：楼氏说，“颃颡”指额角入发际处的头维二穴。因为它们夹束在耳朵上方，所以名叫“钳耳”。知道马云依据楼氏之说，现在遵从这一说法。《甲乙经》作“结于颃颡。颃颡者钳大。钳大者耳也。”含义不详。
窗笼就是耳朵内部。马云说：指的是听宫穴。按手太阳小肠经，有天窗穴，又名窗笼（出自《甲乙经》），位于颈部大筋前，曲颊下扶突穴后，动脉应手的凹陷处。观下文肾经结于任脉经的廉泉穴，肝经结于任脉经的玉英穴，则本经也有结于他经的情况。怀疑天窗穴是足少阳胆经所结之处吗？张云说：乃是手太阳经的听宫穴，它是手足少阳经与手太阳经的交会穴，所以足少阳经结于此。志云说：窗笼就是耳朵内部，像窗户一样让气息通达于上。简案认为：窗笼就是耳朵，也见于《卫气》篇。
太阳主开（止）……主枢。张云说：所谓的开、阖、枢，不过是为了阐明内外之分，从而区分治疗方法。志云说：开阖就像门户，枢犹转动门轴。舍弃枢就不能开阖，舍弃开阖就无法运转枢。这三阳之气，互相出入于经脉、皮肤、形体、脏腑之外内。（开阖枢的含义详见《阴阳离合论》）
水道壅滞而暴病发生。《甲乙经》中“渎”字作“溃缓”。张云说：太阳是阳中之表，所以气在肌肉，成为肉节的渎滞。表主在外，邪气容易侵入，所以多有新发的暴病。简案认为：渎，通“窦”，孔穴之意；扰，扰乱之意。
渎滞者，皮肉松弛软弱。《甲乙经》作“溃缓者，皮肉缓弱”。张云说：即消瘦干枯的意思。简案认为：《淮南子·天文训》高诱注说：“，肉不满也。”
骨摇。马云说：正因为关节松弛而不能收敛，即骨骼摇动的缘故。《素问·气交变大论》中有“筋骨徭复”，王冰注也认为是筋骨摇动。简案认为：《至真要大论》中又有“筋骨徭并”，文字相同，意义也同。
应当穷究其根本。《甲乙经》中“穷”字作“窍”。张云说：窍指此三阳所在之本，或从开、或从阖、或从枢来治疗。
太仓。马云说：即中脘穴，属于任脉经。《甲乙经》说：中脘又名太仓，是胃的募穴。志云说：太仓指舌本。脾为仓廪之官，其经脉连接舌本，散布于舌下，使之迎根，所以结于舌本，名叫太仓。简案认为：以太仓为舌本，无所考证。
廉泉。简案认为：各家说是任脉经穴，这是错误的。《气腑论》说：足少阴肾经在舌下各有一穴。王冰注说是舌本左右两个穴位。《刺疟论》说：舌下两脉者，就是廉泉穴。都说是肾经穴。
玉英。马云说：即玉堂穴，属于任脉经。《甲乙经》说：玉堂一名玉英。张兆璜说：指唇内的龈交穴。说牙齿白如玉。简案认为：以玉英为龈交，也未见依据。
络于膻中。志云说：肝脉贯穿膈膜。简案认为：厥阴经特别多了这一句。
膈证与洞泄。马云说：开折则脾不运化，仓廪无所转输，其病为膈证，为洞泄。张云说：膈，指隔塞。洞，如《邪气脏腑病形》篇所说：洞者，食不化，下咽后又吐出。志云说：膈者，上部不开而不受纳；洞者，下部关折而飧泄。
气绝面喜悲。《甲乙经》中“绝”字作“弛”。马云说：肝气绝而喜悲。简案认为：绝，谓阻绝。
取之不足。《甲乙经》无“不足”二字。张云说：脉有结者，皆因不足所致。简案认为：“不足”二字是衍文，《甲乙经》是正确的。
足太阳（止）……飞扬穴。张云说：以下讲的是手足三阳经的盛络，凡是治病时应当选取的穴位。足太阳经的井穴是至阴，原穴是京骨，经穴是昆仑，天柱在头部，飞扬在足部，都是本经应当选取的穴位。后世效法此例。
天容。《甲乙经》注云疑似错误。马云说：当作天冲穴。张云同意。（天容穴在手太阳经）
小海。简案认为：其他经列举原穴，唯独这里列举合穴，为什么呢？
一日一夜（止）……曰狂生。张云说：营运。人的经脉，在身体中营运，一日一夜共五十周，以营养五脏的精气，如《五十营》篇所述即是此义。其数值则是周身上下左右前后，共二十八脉，总长十六丈二尺。人的宗气，积聚于胸中，主管呼吸而行于经隧。一呼气行三寸，一吸气行三寸，呼吸定息，脉行六寸。以一息六寸推算，则一昼一夜，共一万三千五百息。通计五十周于身，则脉行八百一十丈。如果有过大或不及，而不符合这个数值的，名叫“狂生”。狂，犹妄也。意思是虽然活着，但未必能长久。简案认为：马云说“狂生”犹言侥幸而生，是不对的。
不一代者。《难经·十一难》中“代”字作“止”，“脉轻”作“投”，文字略有不同。张云说：代，更代之义。谓在平脉之中，忽然见到软弱，或乍数乍疏，或断而复起。大概因为脏有所损，则气有所亏，所以变易如此。均名为代。如果五十动而不一代者，说明五脏受气皆足，这才是和平之脉。简案认为：《脉要精微论》说：代则气衰。张守节《史记正义》说：候脉动不定曰代，即此义。杨玄操说：代者还尺中，停久方来，名叫代。这源于《伤寒论》，不可从。
予之短期。张云说：予，与同。短期即死期。李中梓说：短，近也。死期近了。
乍数乍疏。张云说：此时相变代，乃与常代者不同。大概因为脏气衰败，无所主持，而失常如此。所以《三部九候》等论，都说乍疏乍数者死。简案认为：张圈外注非常详细，不再繁引。
逆顺五体。马云说：五体者即《阴阳二十五人》篇，有五形之人。张云说：骨、节、皮、肉、血、气、经、脉，禀赋不齐，刺治也不同，所以有逆顺的变化。
悍。史上音比昭切，下音候岸切。勇健貌。张云说：音飘。急也。
膏粱菽藿。张云说：膏，脂肥也。粱，粟类，谷之良者也。菽，豆也。藿，豆叶也。贵人用膏粱，贱人用菽藿，食味有浓薄，禀质所以不同。
微以徐之。简案认为：据上文疾迟留疾推之，似“徐”是“疾”之误。这难道是徐出而不留的意思吗？
形气不足（止）急泻之。张云说：貌虽不足，而神气病气皆有余，这是外似虚而内则实，邪气胜也，应当急泻之。东垣李氏说：气谓口鼻中气息也。形谓皮肉筋骨血脉也。（出自《辨惑论》）简案认为：张带说神气，却觉不妥。
形气有余（止）急补之。张云说：形虽壮伟，而病气神气则不足，这是外似实而内则虚，正气衰也，应当急补之。志云说：形气谓皮肉筋骨之形气，病气者阴阳血气之为病也。此处虽分别形气病气，然重在病气之有余不足。
阴阳气俱不足。张云说：阳主外，阴主内。若形气病气俱不足，这是表里阴阳俱虚也。
满而补之。《甲乙经》中“满”字作“实”。
充郭。《素问·汤液醪醴论》说：津液充郭。王冰注说：郭，皮也。
内胀。《甲乙经》中“”字作“胀”。
HT辟。《甲乙经》中“HT”字作“慑”。马云说：僻积之意。张云说：HT，畏怯也。HT，邪僻不正也。简案认为：《素问·调经论》说：虚者聂辟气不足。王冰注：聂，谓聂皱。辟，谓辟叠也。《玉篇》：HT，尺涉切。与慑通。根据王注聂皱与辟貂通。《类篇》：，谓衣襞积。马意盖亦同。
薄着。张云说：瘦而涩也。
夭。张云说：夭，短折也。、焦同。（义见前）
乃光。《甲乙经》中“光”字作“充”。
乱脉。《甲乙经》中“脉”字作“经”。
五脏变化之病。《甲乙经》作“五脏之变化”，无“之病”二字。
五脉。张云说：五脏之脉应也。
皮之柔粗。《甲乙经》皮下有“肤”字。
Ma Yun stated: Within the human body, there are Yin and Yang meridians. Each originates at a specific acupoint and terminates at another, hence the chapter is named "Roots and Knots" (Genjie).
Qibo said (in *Jia Yi Jing*, it is attributed to Huangdi): The pathways of Yin are even in number, while those of Yang are odd. Zhang Yun explained: "Odd" refers to single numbers, such as one, three, five, seven, and nine. "Even" refers to double numbers, such as two, four, six, eight, and ten.
When diseases manifest in spring and summer, Ma Yun stated: For any disease occurring in spring and summer, it indicates that Yin Qi is scanty and Yang Qi is abundant, which is termed "disharmony of Yin and Yang." Zhi Yun explained: "Manifestation" refers to the opening and closing mechanisms of human Yin and Yang. The editorial note states: We follow Ma Yun's interpretation here.
Consequently, the stems and leaves wither, and moist rain flows downward. The editorial note suggests: These two sentences likely mean that if the upper stems and leaves wither, the moist rain will flow down to nourish the lower roots, representing the season of autumn and winter. However, this differs from the style of the preceding text and may be an interpolated passage.
Yin and Yang shift mutually; in *Jia Yi Jing*, "shift" is written as "depart".
Anomalous pathogens depart from the meridians. Ma Yun stated: Anomalous pathogens refer to abnormal evil influences. Contracting these and having them enter other pathways is called "departing from the meridians." Zhang Yun stated: Anomalous pathogens are irregular evils; departing from the meridians means their transmission has no fixed course. Zhi Yun stated: When anomalous pathogens depart from the meridians, the evil does not enter the regular meridians but flows into the great collaterals, generating peculiar diseases. This illustrates the countless variations of pathogens.
The gates are broken, and the pivots are ruined. Ma Yun cited *Su Wen: Li He Zhen Xie Lun*: Taiyang serves as the opening, Yangming as the closing, Shaoyang as the pivot; Taiyin as the opening, Jueyin as the closing, Shaoyin as the pivot. This aligns with the following text. The term "gate" now implies that gates exist to facilitate opening and closing.
If opening and closing fail, Qi escapes, leading to a major loss of Yin and Yang. Ma Yun stated: When gates break and pivots fail, the doors close improperly, causing Qi to escape, resulting in a major loss of Yin and Yang, making Qi difficult to recover. Zhang Yun stated: Ruining the gates and pivots causes the loss of Yin and Yang. The editorial note suggests: Based on Zhang's commentary, these eight characters should form a single sentence. We currently adhere to Ma Yun's annotation.
The profound nature of the Nine Needles lies in the chapter "Zhong Shi" (Ends and Beginnings). In *Jia Yi Jing*, it reads: "The essence of the Nine Needles lies in Zhong Shi." Ma Yun stated: The profound methods of the Nine Needles are centered in the "Zhong Shi" chapter. Zhang Yun stated: "Zhong Shi" refers to ends and beginnings, i.e., the meanings of Roots and Knots, Opening and Closing, and Pivots mentioned below. Furthermore, the *Ling Shu* itself contains a chapter titled "Zhong Shi," which details acupuncture methods. Therefore, without understanding Zhong Shi, the art of acupuncture is severed.
The Mingmen (Gate of Life) is the eyes. Zhang Yun stated: The lower root of the Foot-Taiyang Bladder Meridian is at Zhiyin (BL-67), and its upper knot is at Jingming (BL-1); thus, it is said that the Mingmen is the eyes. Wang Shi stated: The Mingmen stores Essence and is the source of light, referring to the two eyes. Zhi Yun stated: The Mingmen is the origin of water and fire for life in the Taiyang meridian, and the eye apertures are the gates where meridian Qi emerges. (Wang Shi's view is seen in the commentary on *Yin Yang Li He Lun*).
A large Hangsang (nasopharynx) clamps the ears. Ma Yun stated: This refers to Touwei (ST-8). Zhang Yun stated: The lower root of the Foot-Yangming Stomach Meridian is at Lidui (ST-45), and its upper knot is at Chengqi (ST-1). The phrase "large Hangsang" here likely refers to Daying (ST-5) above the neck and nasopharynx. Daying is located beside the cheeks and below the ears, hence described as "clamping the ears." Zhi Yun stated: Hangsang refers to the region between the upper middle part and the ears, hence "clamping the ears." The editorial note states: Lou Shi said that "Hangsang" refers to the Touwei acupoints (ST-8) at the hairline of the forehead angles. Because they clamp the upper ears, they are named "clamping the ears." Knowing Ma Yun followed Lou Shi, we adopt this view. *Jia Yi Jing* reads: "Knots at Hangsang. Hangsang is large-clamping. Large-clamping is the ear." The meaning is unclear.
Chuanglong (Window Cage) is inside the ear. Ma Yun stated: This refers to Tinggong (SI-19). According to the Hand-Taiyang Small Intestine Meridian, there is a Tianchuang acupoint, also known as Chuanglong (from *Jia Yi Jing*), located anterior to the great tendon of the neck, below the angle of the jaw, posterior to Futu (LI-18), in the depression where the arterial pulse is felt. Observing that the Kidney Meridian knots at Lianquan (CV-23) of the Ren Mai, and the Liver Meridian knots at Yuying (CV-22) of the Ren Mai, it appears this meridian also knots at points on other meridians. Could Tianchuang be the knot point of the Foot-Shaoyang Gallbladder Meridian? Zhang Yun stated: It is actually Tinggong (SI-19) of the Hand-Taiyang meridian, which is the intersection of the Hand-Shaoyang, Foot-Shaoyang, and Hand-Taiyang meridians; thus, the Foot-Shaoyang meridian knots here. Zhi Yun stated: Chuanglong is inside the ear, allowing Qi to ventilate upwards like a window. The editorial note states: Chuanglong refers to the ear, also mentioned in the *Wei Qi* chapter.
Taiyang governs Opening... [and] Shaoyang governs Pivot. Zhang Yun stated: The terms Opening, Closing, and Pivot merely clarify the distinction between interior and exterior to differentiate treatment methods. Zhi Yun stated: Opening and Closing are like door leaves; the Pivot is like the door hinge. Abandoning the Pivot makes Opening and Closing impossible; abandoning Opening and Closing leaves no way to operate the Pivot. These three Yang energies mutually enter and exit within and outside the meridians, skin, body, and organs. (The meaning of Opening, Closing, and Pivot is detailed in *Yin Yang Li He Lun*).
If the channels are obstructed, acute illnesses arise. In *Jia Yi Jing*, "Du" (obstructed) is written as "Kui Huan" (ulcerated/relaxed). Zhang Yun stated: Taiyang is the exterior of Yang, so Qi resides in the muscles, becoming obstructed in the muscle joints. The exterior governs the outer surface, making it easy for pathogens to invade, hence prone to new acute illnesses. The editorial note states: "Du" is synonymous with "Dou" (cavity/pore); "Rao" means disturbance.
Obstruction leads to flaccid and weak skin and flesh. In *Jia Yi Jing*, it reads: "Ulcerated relaxation leads to flaccid and weak skin and flesh." Zhang Yun stated: This refers to emaciation and dryness. The editorial note cites Gao You's commentary on *Huainanzi: Tianwen Xun*: "Manrou" means insufficient flesh.
Wei Ji (Flaccidity Disease). Zhang Yun stated: Yangming moistens the Zongjin (major tendons), binds the bones, and facilitates joint movement; thus, it gives rise to Wei Ji.
Yao (Bone Tremor). Ma Yun stated: Precisely because the joints are lax and cannot retract, causing bone tremors. *Su Wen: Qi Jiao Bian Da Lun* mentions "Gu Jin Yao Fu," and Wang Bing's commentary also interprets this as bone and joint tremors. The editorial note adds: *Zhi Zhen Yao Da Lun* also mentions "Gu Jin Yao Bing," with identical text and meaning.
One must thoroughly investigate the root cause. In *Jia Yi Jing*, "Qiong" (thoroughly investigate) is written as "Qiao" (aperture). Zhang Yun stated: Qiao refers to the root of these three Yang meridians; treat them according to whether they function as Opening, Closing, or Pivot.
Tai Cang (Grand Granary). Ma Yun stated: This is Zhongwan (CV-12), belonging to the Ren Mai. *Jia Yi Jing* states: Zhongwan is also named Tai Cang, and is the Front-Mu point of the Stomach. Zhi Yun stated: Tai Cang refers to the base of the tongue. The Spleen is the official of the granaries; its meridian connects to the base of the tongue and spreads under it, reaching the root, hence it knots at the base of the tongue, named Tai Cang. The editorial note states: Identifying Tai Cang as the base of the tongue lacks verification.
Lianquan (Spring Under the Chin). The editorial note states: Various scholars consider it a Ren Mai acupoint, which is incorrect. *Qi Fu Lun* states: There is one acupoint on each side of the tongue for the Foot-Shaoyin Kidney Meridian. Wang Bing's commentary identifies these as the left and right acupoints at the base of the tongue. *Ci Nu Lun* states: The two vessels under the tongue are Lianquan (CV-23). All refer to Kidney Meridian acupoints.
Yuying (Jade Hero). Ma Yun stated: This is Yutang (CV-19), belonging to the Ren Mai. *Jia Yi Jing* states: Yutang is also named Yuying. Zhang Zhaohuang stated: It refers to the Yinjiao acupoint inside the lips. It describes teeth white as jade. The editorial note states: Identifying Yuying as Yinjiao also lacks evidence.
Connects to Danzhong (Chest Center). Zhi Yun stated: The Liver meridian penetrates the diaphragm. The editorial note states: The Jueyin meridian uniquely includes this sentence.
Ge (Diaphragmatic Obstruction) and Dong (Sinking Hole/Diarrhea). Ma Yun stated: If the opening fails, the Spleen cannot transport and transform, and the granaries cannot distribute nutrients. The disease manifests as Ge syndrome and Dong diarrhea. Zhang Yun stated: Ge means obstruction/blockage. Dong, as described in *Xie Qi Zang Fu Bing Xing Pian*, means food is not digested and regurgitates after swallowing. Zhi Yun stated: Ge refers to the upper part failing to open and accept intake; Dong refers to the lower gate failing and causing undigested stool discharge.
Qi exhaustion leads to a tendency toward sorrow. In *Jia Yi Jing*, "Jue" (exhaustion) is written as "Chi" (laxity). Ma Yun stated: Exhaustion of Liver Qi leads to a tendency toward sorrow. The editorial note states: Jue means blockage/interruption.
Meridians have knots and become blocked. Ma Yun stated: Knots in the Kidney meridian lead to blockage in the Lower Jiao.
Treat deficiency. *Jia Yi Jing* omits the words "Bu Zu" (deficiency). Zhang Yun stated: Knots in the meridians are caused by deficiency. The editorial note states: The words "Bu Zu" are interpolations; *Jia Yi Jing* is correct.
Foot-Taiyang... Feiyang. Zhang Yun stated: The following discusses the abundant collaterals of the Hand and Foot Three Yang meridians, which should be selected when treating diseases. The Jing-Well point of the Foot-Taiyang meridian is Zhiyin (BL-67); the Yuan-Source point is Jinggu (BL-64); the Jing-River point is Kunlun (BL-60); Tianzhu (BL-10) is in the head; Feiyang (BL-58) is on the foot. These are all points to be selected from this meridian. Later generations followed this example.
Tianrong. *Jia Yi Jing* notes suspect error. Ma Yun stated: It should be Tianchong (GB-17). Zhang Yun agrees. (Tianrong is a Hand-Taiyang acupoint).
Xialing. Ma Yun stated: It should be Jiexi (ST-41). Zhang Yun agrees.
Xiaohai. The editorial note asks: Why do other meridians list Yuan-Source points, while this one lists He-Sea points?
One day and night... is called Kuang Sheng (Mad Birth/Abnormal Survival). Zhang Yun stated: Circulation and operation. Human meridians circulate through the body fifty times in one day and night to nourish the Essence and Qi of the Five Zang organs, as described in the *Wu Shi Ying* chapter. The measurement involves twenty-eight meridians throughout the body, totaling sixteen zhang and two chi. The Zong Qi (Gathering Qi) accumulates in the chest, governing respiration and moving through the vessel tunnels. One exhalation moves three cun, one inhalation moves three cun; during the pause between breaths, the pulse moves six cun. Calculating from six cun per breath, there are thirteen thousand five hundred breaths in a day and night. Counting fifty cycles through the body, the pulse travels eight hundred and ten zhang. If the movement exceeds or falls short of this number, it is called "Kuang Sheng." Kuang means delusion/falsehood. It implies that although alive, longevity is not guaranteed. The editorial note states: Ma Yun's interpretation that Kuang Sheng means "surviving by luck" is incorrect.
Without a Dai (Intermittent) Pulse. In *Nan Jing: Chapter 11*, "Dai" is written as "Zhi" (stop), and "Mai Qing" as "Tou," with slight textual differences. Zhang Yun stated: Dai means alternation. It refers to suddenly appearing weakness in a normal pulse, or alternating rapid and slow rhythms, or interruptions followed by resumption. This occurs because organ damage leads to Qi deficiency, causing such changes. All are termed Dai. If there are fifty beats without a Dai pulse, it indicates sufficient Qi in all Five Zang organs, representing a harmonious pulse. The editorial note cites *Mai Yao Jing Wei Lun*: "Dai indicates Qi decline." Zhang Shoujie's commentary on *Shiji Zhengyi* states: "Monitoring uncertain pulse movements is called Dai," which aligns with this meaning. Yang Xuancuo stated: Dai returns to the Chi position, pausing for a long time before returning, named Dai. This originates from *Shang Han Lun* and should not be followed.
Granting a Short Term. Zhang Yun stated: Yu means "give." Short term refers to the time of death. Li Zhongzi stated: Duan means near. The time of death is near.
Zhong Shi (Ends and Beginnings). Ma Yun stated: Its essential methods are in the *Zhong Shi* chapter of this classic, with very detailed meanings.
Suddenly Rapid, Suddenly Slow. Zhang Yun stated: This temporal alternation differs from ordinary Dai pulses. It occurs because organ Qi is exhausted and lacks control, leading to such失常 (abnormality). Therefore, chapters like *San Bu Jiu Hou* state that sudden rapidity and slowness indicate death. The editorial note states: Zhang's marginal annotations are very detailed, so further citation is omitted.
Ni Shun Wu Ti (Reverse and Smooth Five Bodies). Ma Yun stated: The Five Bodies refer to the five body types in the *Yin Yang Er Shi Wu Ren* chapter. Zhang Yun stated: Bone, joints, skin, flesh, blood, Qi, meridians, and vessels have uneven endowments, requiring different acupuncture treatments, hence variations in Ni (reverse) and Shun (smooth).
Han (Fierce/Vigorous). Pronounced bi-zhao-qie on top, hou-an-qie on bottom. Describes a brave and vigorous appearance. Zhang Yun stated: Pronounced piao. Means urgent/fast.
Gao Liang Shu Huo (Rich Fats and Grains vs. Beans and Leaves). Zhang Yun stated: Gao refers to fat/lard. Liang refers to millet-like grains, the finest cereals. Shu refers to beans. Huo refers to bean leaves. Nobles consume Gao Liang, while commoners consume Shu Huo. Dietary flavors vary in richness, leading to different constitutions.
Subtly and slowly regulate it. The editorial note suggests: Based on the preceding discussion of speed and retention, "Xu" (slow) might be a typo for "Ji" (fast). Does this imply withdrawing slowly without retention?
Xing Qi Bu Zu (Form and Qi Deficiency)... urgently drain it. Zhang Yun stated: Although appearance shows deficiency, Shen Qi (Spirit Qi) and Bing Qi (Pathogenic Qi) are both excessive. This is external deficiency but internal excess, with pathogenic dominance. Urgent draining is required. Li Dongyuan stated: Qi refers to breath from nose and mouth. Xing refers to skin, flesh, bones, sinews, and blood vessels. (From *Bian Huo Lun*) The editorial note comments: Zhang's inclusion of Shen Qi seems inappropriate.
Xing Qi You Yu (Form and Qi Excess)... urgently tonify it. Zhang Yun stated: Although Form is robust, Bing Qi and Shen Qi are deficient. This is external excess but internal deficiency, with healthy Qi decline. Urgent tonification is required. Zhi Yun stated: Xing Qi refers to the Form-Qi of skin, flesh, bones, and sinews; Bing Qi refers to pathological Yin-Yang, Blood, and Qi. Although distinguishing Form-Qi and Pathogenic Qi, the emphasis is on the excess or deficiency of Pathogenic Qi.
Yin and Yang Qi are both insufficient. Zhang Yun stated: Yang governs the exterior, Yin governs the interior. If Form-Qi and Pathogenic Qi are both insufficient, this indicates deficiency of both interior and exterior Yin and Yang.
Tonify fullness. In *Jia Yi Jing*, "Man" (full) is written as "Shi" (solid/excess).
Chong Guo (Fill the Outer Wall). *Su Wen: Tang Ye Lao Li Lun* states: Jin Ye fills the Guo. Wang Bing's commentary: Guo refers to the skin.
Internal Distension. In *Jia Yi Jing*, "Man" is written as "Zhang" (distension).
HT Pi (Fearful/Deviant). In *Jia Yi Jing*, "HT" is written as "She" (fear). Ma Yun stated: Meaning accumulation of deviation. Zhang Yun stated: HT means timidity/fear; HT means deviant/abnormal. The editorial note cites *Su Wen: Tiao Jing Lun*: "Deficiency causes Nie Pi Qi insufficiency." Wang Bing's commentary: Nie means wrinkling/collapsing; Pi means folding/layering. *Yu Pian*: HT, pronounced chi-she-qie. Interchangeable with She. Based on Wang Bing's note, Nie-collapsing and Pi-folding are related. *Lei Pian*: Refers to clothing folds. Ma Yun's intent is likely similar.
Bo Zhuo (Thin and Adherent). Zhang Yun stated: Emaciated and rough/stagnant.
Yao (Premature Aging/Break). Zhang Yun stated: Yao means premature shortening/breaking. "Man" is synonymous with "Jiao" (scorched/dry). (Meaning seen previously).
Nai Guang (Then Bright/Filled). In *Jia Yi Jing*, "Guang" is written as "Chong" (fill).
Luan Mai (Disordered Pulse). In *Jia Yi Jing*, "Mai" is written as "Jing" (meridian).
Diseases of the Five Zang Transformations. In *Jia Yi Jing*, it reads "Transformations of the Five Zang," omitting "Zhi Bing" (of disease).
Wu Mai (Five Pulses). Zhang Yun stated: Corresponding pulses of the Five Zang organs.
Softness and Roughness of the Skin. In *Jia Yi Jing*, the character "Fu" (skin/subcutaneous) appears below "Pi" (skin).