针道备矣 甲乙。备。作毕。
马云。邪客于各经之络。则左痛取右。右痛取左。与经病异处。故以缪刺名篇。据灵枢官针篇第三节。
则巨刺。亦左取右。右取左。特有经穴络穴不同耳。张云。缪。异也。简案缪。广韵。靡幼切。礼大传注。纰
缪。犹错也。王注从之。盖左病刺右。右病刺左。交错其处。故曰缪刺。
极于五脏 简按极。至也。见诗周颂注。
如此则治其经焉 张云。邪气自浅入深。而极于五脏之次者。当治其经。治经者。十二经穴之正刺
也。尚非缪刺之谓。
入舍于孙络 甲乙。络。作脉。据上文。当从甲乙。
大络 吴云。十二经支注之大络。难经所谓络脉十五络。是也。高云。流溢。传注也。气穴论云。
孙络之脉别经者。并注于络。传注十四络脉者。是也。
奇病 张云。病在支络。行不由经。故曰奇病。志云。奇病者。谓病气在左。而证见于右。病气在
右。而证见于左。盖大络乃经脉之别。阳走阴。阴走阳者也。
与经相干 马云。其邪客大络。左注于右。右注于左。上下左右。与经相干。其实不得入于经。而
止布于四末。志云。经脉篇曰。手太阴之别。并太阴之经。直入掌中。手少阴之别。循经入于心中。盖大络俱
并经附行。故曰与经相干。高云。经。经隧也。经隧者。五脏六腑之大络也。故与经相
干。而输布于手足之四末。其气左右流行。无有常处。经隧相干。故不入于经俞。不入于经俞。刺其络脉。故
命曰缪刺。简案据诸家之义。干。预也。即干涉之干。
必巨刺之 吴云。巨刺。大经之刺也。志云。巨。大也。谓当以长针取之。亦左取右。而右取左也。
简案官针篇。无长针取之之说。今从吴注。
缪处 马云。缪者。异也。王注。以所刺之穴。如纰缪纲纪者。非岐伯自有明旨。吴云。与经脉常行
之处差缪也。高云。脉度篇云。经脉为里。支而横者为络。故络病者。其痛与经脉缪处。缪处。异处也。谓经
脉之痛。深而在里。络脉之痛。支而横居。病在于络。左右纰缪。故命曰缪刺。
邪客于足少阴之络 马云。肾经络穴大钟也。简按张吴诸家。不指言其穴。盖络泛言一经之络也。
马。每络注某穴。恐非。
无积者 高云。胀满有积。当刺其胸胁。若无积者病。少阴之络。上走心包。故当刺然骨之前。简
按吴云。积。五脏积也。五脏真气不足。而后病积。若复刺出其血。是重虚矣。故在禁。志云。无积者。无盛
血之结也。并误。
然骨之前 高。骨。作谷。注云。谷。旧本讹骨。今改。下二然谷之谷仿此。简按本输篇云。肾溜
于然谷。然骨之下者也。不必改字。
如食顷 张云。食顷。一饭顷也。后仿此。简按王立饥之解。不通。
不已左取右 甲乙。无不已二字。简按此已系于络病。何待其不已而缪刺之。甲乙为是。
取五日已 甲乙。无取字。张云。病新发者。邪未深也。虽不即愈。亦不过五日而已。
邪客于手少阳之络 甲乙。作少阴之络。注云。一作少阳。
刺手中指次指 马云。中指之次指。即第四指也。去爪甲上如韭叶者。即关冲穴也。高云。中指次指。
即小指次指。手少阳关冲井穴也。志云。当刺中指心包络之中冲。次指手少阳之关冲。简按甲乙注。中指。当
小指。张吴亦据新校正。作小指。本输篇。关冲者。手小指次指之端也。气府论。肘以下至手小指次指本。各
六俞。热病篇。取手小指次指爪甲下。去端如韭叶。厥病篇。取手小指次指爪甲上。与肉交者。诸篇言关冲穴
者如是。当从新校正。
如韭叶 志注本输篇云。上古如韭叶。今时如大米许。简按甲乙。少泽。手小指之端。去爪甲一分。
以此推之。凡云如韭叶者。当以一分为准。
卒疝 高云。经脉篇曰。足厥阴之别。其病气逆。则睾肿卒疝。故邪客于足厥阴之络。令人卒疝暴痛。
与肉交者 志云。即去端如韭许。
男子立已女子有顷已 吴云。男子以阳用事。故已速。女子以阴用事。故已稍迟。志云。女子之生。
不足于血。故有顷。男子之血盛。故立已。
刺外踝下 甲乙。下。作上。吴云。金门京骨通谷。三 也。高云。三 者。通谷为荥。束骨为输。
京骨为原也。简按据甲乙。盖谓跗阳穴。跗阳。在踝上三寸。
邪客于臂掌之间 高云。经脉篇曰。心主手厥阴心包络之脉。下臂入掌中。病则臂肘挛急。掌中热。
故邪客于臂掌之间。不可得屈。
刺其踝后 马云。当刺心经之通里穴也。张云。手厥阴经也。踝后者。以两踝言。踝中之后。则内关
也。内关为手
厥阴之络。故当取之。志同。高云。先以指按之。按之而痛。乃刺之。简按考文义。不宜定为某穴。故王不注。
高为得矣。
以月死生为数 吴云。望前为月生。望后为月死。此以应痛为 。不拘穴法。张云。月之死生。随日
盈缩。以为数也。故自初一至十五。月日以盈。为之生数。当一日一 。一 。即一刺也。至十五日渐增。至
十五 矣。自十六至三十日。月日以缩。为之死数。当日减一刺。故十六日止十四 。减至月终。唯一刺矣。
盖每日一刺。以朔望为进止也。志云。手厥阴心主主血脉。是谓待时而调之也。高云。由微而盛。如月之生。
故渐多之。由盛而微。如月之衰。故渐减之。月郭空则无治也。
邪客于足阳跷之脉 马本。无足字。高云。脉度篇云。跷脉。从足至目。属目内 。故邪客于足阳跷
之脉。令人目痛。从内 始。
外踝之下半寸所 高云。仆参穴也。简按甲乙云。申脉。阳跷所生也。在足外踝下陷者中。容爪甲
许。又云。仆参。在跟骨下陷者中。则知旧注为是。
如行十里顷而已 志云。跷健善行。如行十里。则跷脉之气已周。高云。跷脉属奇经。其行最疾。
故如人行十里之顷。而痛病可已。简按据汉书贾捐之传。吉行五十里之数。而度之。即得一时三刻有奇。
人有所堕坠 马云。此言恶血为病。当有缪刺之法。
利药 吴云。先宜饮利瘀血药也。
上伤厥阴之脉 张云。凡堕坠者。必病在筋骨。故上伤厥阴之脉。肝主筋也。下伤少阴之络。肾主
骨也。刺然骨之前出血。即少阴络也。
然骨之前血脉 简按诸注仍原文而注之。不必从新校正。
刺足跗上动脉 张云。足厥阴之输。太冲穴也。王氏谓为阳明之冲阳。似与此无涉。志高不注穴名。
善悲惊不乐 吴云。厥阴之病。连于肝则惊。少阴之病。逆于 中。则不乐。故刺法相侔也。张云。
堕跌伤阴。神气散失。故善悲惊不乐。志高与张同。简按吴注近是。
中指爪甲上 吴仍王注。改作小指。注云。关冲穴也。为手少阳井。手少阳之络。从耳后入耳中。故
刺之。简按马张高并从新校正。为是。
其不时闻者 吴云。绝无所闻者为实。不时闻者为虚。虚而刺之。是重虚也。张云。时或有闻者。尚
为可治。其不闻者。络气已绝。刺亦无益。故不可刺也。简按若吴注所言。则当云其时不闻者。疏甚。
耳中生风 吴云。生风。如风之号也。志云。加耳鸣之风生也。简按千金方。耳中飕飕。是也。
凡痹往来 高云。此言往来行痹。不涉经脉。但当缪刺其络脉。不必刺其 穴也。凡痹往来。谓之行
痹。其行无常处者。邪在分肉之间。不涉经脉也。简按千金方。风痹。游走无定处。名曰血痹。此亦邪在于血
络者。
痛而刺之 张云。谓随痛所在。求其络而缪刺之也。志同。高云。凡痹必痛。痛而刺之。简按今从张注。
用针者随气盛衰以为 数 吴本。十一字为注文。云。旧作大文。僭改为细注。
月生一日一 甲乙。月上。有以月死生为数六字。高云。上文手厥阴心包主血脉。故以月死生为
数。此言痹痛。则冲任之血。不能热肉充肤。澹渗皮毛。故亦以月死生为 数。篇中缪刺无 数。皆以月死生。
为数也。
邪客于足阳明之经 马吴张并根据新校正。经。作络。志
仍原文。云。此言经脉之互交者。亦当以缪取也。经。谓阳明之经脉也。高同。简按据王注及志高。则刺大经
之病也。似与巨刺无别。今亦仍新校正。
足中指次指 马从王注。吴云。足阳明之脉。有入中指内间者。有入中指外间者。有入大指间者。此
言刺足中指次指。乃中指及次指也。次指是厉兑穴。中指则不必穴也。张云。中指次指。皆足阳明所出之经。
即厉兑穴次也。志云。足阳明之脉。下入中指外间。其支者。别跗上。入大指间出其端。故当取中指间之内庭。
大指次指间之厉兑。高云。中指次指。即大指次指也。爪甲上与肉交者。足阳明厉兑井穴也。简按高以自大指
当第三指者。为中指。则与王注异。而考本输篇。胃出于厉兑。厉兑者。足大指内次指之端也。本篇下文则云。
足阳明中指爪甲上一 。明是足以第二指为中指。而与手之中指不同。当以甲乙为是。
温衣饮食 志云。咳者。邪干肺也。故宜温衣。及温暖饮食。若形寒饮冷。是为重伤矣。
气上走贲上 简按新校正。引杨玄操。是也。丁德用云。胃言若虎贲之士。围达之象。故曰贲门也。
况胃者围也。主仓廪。故别名太仓。今考诗注。贲。大也。胃已名太仓。贲门盖取于此。若以虎贲之贲。则义
不叶。马以下诸注。仍新校正。唯高本于王。
六刺立已左刺右右刺左 高云。左刺右右刺左六字。衍文。简按下文嗌中肿云云。亦邪客于足少阴
者。故以此六字为衍文。然嗌中肿二十八字。王所移于此。未可果为衍文。
不能内唾 高云。内。犹咽也。
腰痛引少腹控 吴云。足太阴湿土也。湿病者。先注于腰。故腰痛。太阴之筋。聚于阴器。循腹
里结胁。故引少
腹控 。张云。足太阴之络。上入布胸胁。而筋着于脊。故为病加此。控。引也。高云。经脉论云。脾之大络。
名曰大包。出渊液。布胁胸。实则身尽痛。虚则百节尽皆纵。令人腰痛引少腹。身尽痛之意也。控 不可以仰
息。布胸胁。百节尽皆纵之意也。
腰尻之解两胂之上是腰俞 吴据新校正。删是腰俞三字。注云。腰尻之解。腰俞一穴也。两胂上。脾
俞二穴也。马云。腰俞。在中行二十一椎之下。则无左右。断是白环俞也。张云。腰俞止一穴居中。本无左右。
此言左取右。右取左者。必腰俞左右。即足太阳之下 穴也。高云。解骨缝也。胂上。髁胂之上。即髀股也。
申明腰尻之解。两胂之上。腰俞是也。盖腰尻之解。属于腰俞。两腰之上。即腰俞两旁之下也。简按刺腰痛论
云。腰痛。引少腹控 。不可仰。刺腰尻交者。两髁胂上。以月生死为 数。王注。腰尻交者。谓髁下尻骨两
旁四骨空。左右八穴。俗呼此骨。为八 骨也。今由此攻之。是腰俞三字衍。而其义则张注为得矣。
邪客于足太阳之络 张云。足太阳经。挟脊抵腰中。故拘挛脊急。其筋从腋后入腋下。故引胁而痛。
应手如痛 如。甲乙。作而。吴云。此不拘穴俞而刺。谓之应痛穴。
治诸经刺之所过者不病 过。王。平声。马云。盖经旨以病为有过也。高。之下。病下。并句。注云。治
诸经刺之。谓治诸经之病。则正刺其经也。所过者不病。谓诸经所过之道。不为邪客。而不病也。简按旧注义长。
刺其通脉 甲乙。作过脉。马云。刺其听宫穴也。耳聋以下十六字。高。移上文邪客于手阳明之络后。
注云。刺之病不已。更刺中指之中冲。中指中冲。主通脉出于耳前。故
曰耳聋云云。盖手阳明之脉。上颈贯颊。在于耳前。通脉出耳前。通心主包络之脉。而出于耳前之手阳明也。
简按据上文刺之所过者。通字作过。似是。
齿龋刺手阳明 熊音。龋。丘禹反。齿病也。高云。齿龋。齿腐痛也。说文。齿蠹也。释名。龋。朽
也。虫啮之齿缺朽也。高本。此以下十七字。连下文缪传引上齿以下四十八字。移前节邪客于足阳明之经。令
人鼽衄云云条之后。甲乙。阳明下。有立已二字。
邪客于五脏之间 吴云。五脏之间。谓五脏络也。张云。邪客于五脏之间。必各引其经而痛。但见
病处。各取其井。而缪刺之。高云。邪客于五脏之间。其病也。经脉络脉。相引而痛。有时来出于络脉。有时
但止于经脉。故时来时止。
五刺已 志云。五脏之气平也。
缪传引上齿 吴云。病本在下齿。今缪传于上齿也。志云。谓手阳明之邪。缪传于足阳明之脉也。
足阳明之脉。入上齿中。此邪客于手阳明之经别。而缪传于足阳明之脉。致引入上齿。
齿唇寒痛 甲乙。无痛字。
视其手背脉 马云。盖指手阳明之络穴偏历也。简按诸家不注某穴。此泛言手背。不必指一穴也。
足阳明中指爪甲上一 足上。甲乙。有刺字。高本。一上。有各字。云。旧本无各字。今臆补。
此五络皆会于耳中 志云。耳者。宗脉之所聚也。张兆璜云。宗脉者。宗气所出之脉也。即胃之大
络。出于乳下。聚于耳中。
上络左角 马云。络于左耳之额角。志云。肝主血。而居左。其气直上于巅顶也。
针刺的道理已经完备了。
马云认为：邪气侵犯各条经络的络脉，就会出现左侧疼痛取右侧穴位，右侧疼痛取左侧穴位的治法。这与治疗经脉病的部位不同，所以用“缪刺”作为篇名。根据《灵枢·官针》篇第三节的内容，巨刺也是左病取右、右病取左，只不过选取的是经穴和络穴有所不同罢了。张景岳说：“缪”，就是“异”的意思。简按：“缪”，《广韵》注音为“靡幼切”。《礼记·大传》注解说：“纰缪”，就像“错乱”一样。王冰的注释采纳了这个说法。大概是因为左边的病刺右边的穴位，右边的病刺左边的穴位，左右交错其位置，所以称为“缪刺”。
（邪气）深入至五脏。简按：“极”，意为“至”、“到达”。见于《诗经·周颂》注。
像这样就要治疗其经脉。张景岳说：邪气由浅入深，进而深入至五脏的顺序时，应当治疗其经脉。所谓治经，是指对十二正经穴位进行直刺。这还谈不上是缪刺。
（邪气）进入并停留于孙络。《甲乙经》中，“络”字作“脉”。根据上文语境，应当遵从《甲乙经》的版本。
（邪气）进入大络。吴崑说：十二经分支注入的大络，就是《难经》所说的十五络脉。高世栻说：流溢、传注。《素问·气穴论》说：从经脉别出的孙络，都注入络脉，再传注于十四络脉，说的就是这个道理。
（这种病称为）奇病。张景岳说：病在支络，不经过经脉运行，所以称为奇病。张志聪说：奇病，是指病气在左边，而症状表现在右边；病气在右边，而症状表现在左边。大概大络是经脉的别支，阳气走向阴分，阴气走向阳分。
与经脉相互干扰。马云说：邪气客居在大络，向左注入右侧，向右注入左侧，上下左右，与经脉相互干扰。其实邪气并不能进入经脉，只是散布在四肢末端。张志聪说：《素问·经脉篇》说：手太阴肺经的别络，并入手太阴经脉，直接入掌中；手少阴心经的别络，循经脉进入心中。大概大络都是伴随经脉并行运行的，所以说“与经脉相干”。高世栻说：经，指经隧。经隧，就是五脏六腑的大络。所以与经脉相干，而输布于手足的四肢末端。其气血左右流行，没有固定位置。因为经隧相互干扰，所以不入于经俞。既然不入于经俞，就刺其络脉，所以命名为缪刺。简按：根据各家解释，“干”意为“预”，即干涉之“干”。
必须采用巨刺法。吴崑说：巨刺，是刺大经的方法。张志聪说：巨，就是大。意思是应当用长针来取穴。也是左病取右、右病取左。简按：《灵枢·官针》篇中没有使用长针的说法，现在遵从吴崑的注释。
（在）缪处（异侧部位）。马云说：缪，就是异。王冰注解说：所刺的穴位，如同纲纪错乱的位置，这不是岐伯本来的明确旨意。吴崑说：与经脉常行的位置有差异错位。高世栻说：《素问·脉度篇》说：经脉在里，分支横出的叫络。所以络脉的病，其疼痛部位与经脉不同。“缪处”，就是异处。意思是经脉的痛，深沉而在里；络脉的痛，分支横出而在表。病在络脉，左右交错错位，所以命名为缪刺。
邪气侵犯足少阴肾经的络脉。马云说：肾经络穴是大钟穴。简按：张景岳、吴崑等各家，没有明确指出具体穴位，大概是泛指一经的络脉。马云每提到络就注明某穴，恐怕不对。
（如果）没有积聚。高世栻说：如果有胀满且有积聚，应当刺胸胁。如果没有积聚，病在少阴之络，向上走连心包，所以应当刺然骨之前。简按：吴崑说：积，指五脏积。五脏真气不足，然后才产生积证。如果再刺出其血，就是使虚者更虚，所以在禁忌之列。张志聪说：无积，是指没有盛血的结聚。以上两种解释都有误。
然骨之前。高世栻认为：“骨”字应作“谷”。注解说：“谷”字是旧本讹误为“骨”，现在改正。下文两个“然谷”的“谷”字仿照此例。简按：《灵枢·本输》篇说：肾气溜注于然谷，然谷在然骨之下。不必改字。
像吃一顿饭的时间。张景岳说：食顷，就是一顿饭的功夫。后文仿照此例。简按：王冰解释为“饥”，讲不通。
如果不愈，则左病取右。《甲乙经》中没有“不已”二字。简按：这里已经是络病了，何必等到不愈才用缪刺呢？《甲乙经》的版本是对的。
取五日可愈。《甲乙经》中没有“取”字。张景岳说：病是新发的，邪气未深。虽然不能立即痊愈，也不过五日就好了。
邪气侵犯手少阳三焦经的络脉。《甲乙经》作“少阴之络”。注解说：一作“少阳”。
刺手中指次指。马云说：中指的次指，就是第四指。距离指甲上如韭菜叶宽的地方，就是关冲穴。高世栻说：中指次指，就是小指次指。是手少阳三焦经的关冲井穴。张志聪说：应当刺中指的心包络之中冲穴，以及次指手少阳的关冲穴。简按：《甲乙经》注解说：“中指”应当是“小指”。张景岳、吴崑也依据新校正，作“小指”。《灵枢·本输》篇说：关冲穴，在手小指次指的末端。《素问·气府论》说：肘以下至手小指次指根部，各有六个腧穴。《素问·热病篇》说：取手小指次指爪甲下，距离端头如韭菜叶宽。《素问·厥病篇》说：取手小指次指爪甲上，与肉交接处。诸篇关于关冲穴的描述都是如此，应当遵从新校正。
如韭菜叶宽。张志聪注《本输》篇说：上古时期如韭菜叶宽，现代如大米粒大小。简按：《甲乙经》说：少泽穴，在手小指端，距离指甲一分。以此推断，凡是说“如韭菜叶宽”的，都应当以一分为准。
卒疝。高世栻说：《素问·经脉篇》说：足厥阴肝经的别络，如果病气上逆，就会导致睾丸肿胀、卒疝。所以邪气侵犯足厥阴肝经的络脉，使人突发疝气暴痛。
与肉交接处。张志聪说：就是距离端头如韭菜叶宽的地方。
男子立即痊愈，女子过一会儿痊愈。吴崑说：男子以阳气为主，所以痊愈得快。女子以阴气为主，所以痊愈得稍慢。张志聪说：女子生成时，血气不足，所以需要过一会儿。男子血气旺盛，所以立即痊愈。
刺外踝下方。《甲乙经》中，“下”字作“上”。吴崑说：金门、京骨、通谷这三个穴。高世栻说：这三个穴中，通谷是荥穴，束骨是输穴，京骨是原穴。简按：根据《甲乙经》，大概是指跗阳穴。跗阳穴，在外踝上三寸。
邪气侵犯臂掌之间。高世栻说：《素问·经脉篇》说：手厥阴心包络之脉，下行手臂进入掌中。生病时手臂肘部拘挛紧急，掌中发热。所以邪气侵犯臂掌之间，导致手臂无法屈伸。
刺其踝后方。马云说：应当刺心经的通里穴。张景岳说：是手厥阴经。所谓的“踝后”，是以两个踝关节而言，踝中的后方，就是内关穴。内关是手厥阴心包经的络穴，所以应当取这个穴。张志聪观点相同。高世栻说：先用手指按压，按压感到疼痛的地方，再刺它。简按：考察文义，不宜定为某个特定穴位，所以王冰没有注释。高世栻的解释更为恰当。
根据月亮盈亏变化来决定针刺次数。吴崑说：望日之前为月生，望日之后为月死。这是以疼痛程度为依据，不拘泥于固定的穴位法则。张景岳说：月的生死，随着日月的盈亏而变化，以此决定针刺次数。所以从初一到十五，月亮日渐圆满，为生数。应当一天增加一次针刺，一次针刺即为一刺。到十五日逐渐增多，达到十五次。从十六日到三十日，月亮日渐亏缺，为死数。当天减少一次针刺，所以十六日只止于十四次，减少到月底，只剩下一刺。大概每天针刺一次，以朔望（初一、十五）为进退的标准。张志聪说：手厥阴心主统辖血脉，这就是等待时机来调治。高世栻说：由微而盛，像月亮的生长，所以逐渐增多。由盛而微，像月亮的衰退，所以逐渐减少。月郭空（新月）时不进行医治。
邪气侵犯足阳跷脉。马莳版本没有“足”字。高世栻说：《素问·脉度篇》说：跷脉，从足至目，属于目内眦。所以邪气侵犯足阳跷脉，使人目痛，从目内眦开始。
外踝下半寸处。高世栻说：是仆参穴。简按：《甲乙经》说：申脉穴，是阳跷脉所生之处，在足外踝下方的凹陷中，容纳指甲盖大小的地方。又说：仆参穴，在跟骨下的凹陷中。由此可知旧注是正确的。
像人行走十里路的功夫就能痊愈。张志聪说：跷脉健善于行走，像人行走十里路，那么跷脉的气机就已经周遍全身。高世栻说：跷脉属于奇经，其运行速度最快，所以像人行走十里路的功夫，疼痛疾病就可以痊愈。简按：根据《汉书·贾捐之传》，吉行五十里的数量，推算一下，即得到一时三刻多一点。
人有所坠落。马云说：这是说恶血致病，应当有缪刺的方法。
服用利药。吴崑说：先宜饮用促进瘀血排出的药物。
上部损伤厥阴之脉。张景岳说：凡是坠落伤，必然病在筋骨，所以上部损伤厥阴之脉。肝主筋。下部损伤少阴之络，肾主骨。刺然骨之前出血，就是刺少阴络。
然骨之前的血脉。简按：各家注释仍然顺着原文注解，不必遵从新校正。
刺足背上的动脉。张景岳说：足厥阴经的输穴，是太冲穴。王冰认为是阳明经的冲阳穴，似乎与此无关。张志聪、高世栻不注穴位名称。
容易悲伤、惊恐、不快乐。吴崑说：厥阴的病，牵连肝脏就会惊恐；少阴的病，逆乱于胸中，就会不快乐。所以刺法相似。张景岳说：坠落跌打损伤阴分，神气散失，所以容易悲伤、惊恐、不快乐。张志聪、高世栻观点与张景岳相同。简按：吴崑的注释接近真理。
中指爪甲上。吴崑仍沿用王冰的注释，改为“小指”。注解说：是关冲穴，为手少阳井穴。手少阳之络，从耳后入耳中，所以刺这里。简按：马莳、张景岳、高世栻都遵从新校正，改为小指，这是正确的。
那些不时能听到声音的。吴崑说：完全听不到是实证，不时能听到是虚证。虚证而刺之，就是使虚者更虚。张景岳说：时或有听到的，还可以治疗。那些完全听不到的，络气已绝，刺也没有益处，所以不可刺。简按：如果按照吴崑的注释，应该说“其时不闻者”，这就太疏漏了。
耳中生风。吴崑说：生风，像风声呼啸一样。张志聪说：加上耳鸣的风声。简按：《千金方》中描述的“耳中飕飕”的声音，就是这个意思。
凡是痹症往来游走。高世栻说：这是说行痹，不涉及经脉，只应当缪刺其络脉，不必刺其经穴。凡痹症往来游走，称为行痹。其行走没有固定位置，邪气在分肉之间，不涉及经脉。简按：《千金方》说，风痹游走无定处，名叫血痹。这也是邪气在于血络的情况。
疼痛就刺它。张景岳说：意思是随着疼痛所在之处，寻找其络脉进行缪刺。张志聪观点相同。高世栻说：凡是痹症必然疼痛，疼痛就刺它。简按：现在遵从张景岳的注释。
用针的人随着气血的盛衰来决定针刺次数。吴崑版本中，这十一个字是注文。云：旧本作大字，僭改为细注。
月生一日一刺。《甲乙经》中，“月上”有“以月死生为数”六个字。高世栻说：上文说手厥阴心包主血脉，所以以月亮的生死来决定次数。这里说痹痛，则是冲任之血，不能温热肌肉充实皮肤，澹渗皮毛，所以也以月亮的生死来决定针刺次数。篇中缪刺没有针刺次数，都是以月亮的生死来决定次数。
邪气侵犯足阳明胃经。马莳、吴崑、张景岳都依据新校正，将“经”改为“络”。张志聪仍保留原文，说：这是说经脉的互交者，也应当以缪刺法取穴。“经”，指阳明之经脉。高世栻观点相同。简按：根据王冰注及张志聪的观点，这是刺大经的病，似乎与巨刺没有区别。现在也遵从新校正，改为“络”。
足中指次指。马莳遵从王冰注。吴崑说：足阳明之脉，有进入中指中间的，有进入中指外侧的，有进入大指间的。这里说刺足中指次指，是指中指及次指。次指是厉兑穴，中指则不必指定穴位。张景岳说：中指次指，都是足阳明经发出的经脉，即厉兑穴的次序。张志聪说：足阳明之脉，向下进入中指外侧，其支脉，别出于足背，进入大指间出其端。所以应当取中指间之内庭穴，大指次指间的厉兑穴。高世栻说：中指次指，就是大指次指。爪甲上与肉交接处，是足阳明厉兑井穴。简按：高世栻把自大指算起的第三指当作中指，这与王冰注不同。但考证《灵枢·本输》篇，胃经出于厉兑，厉兑穴是在足大指内次指的末端。本篇下文则说：足阳明中指爪甲上一刺。明显是以第二指为中指，而与手的中指不同。应当以《甲乙经》为准。
穿暖衣服，吃温暖饮食。张志聪说：咳嗽，是邪气干扰肺脏。所以适宜穿暖衣服，以及食用温暖饮食。如果形体受寒、饮食生冷，就是严重的重伤了。
气向上走到贲门之上。简按：新校正引用杨玄操的说法，是正确的。丁德用说：胃被称为虎贲之士，有围达的形象，所以叫贲门。况且胃是围裹的意思，主管仓廪，所以别名太仓。现在考证《诗经》注，贲，就是大的意思。胃已经名为太仓，贲门大概取意于此。如果用虎贲的贲，则意义不协。马莳以下的各家注释，仍遵从新校正，只有高世栻基于王冰注。
六刺确立后，左刺右，右刺左。高世栻说：“左刺右右刺左”这六个字是衍文。简按：下文“嗌中肿”等内容，也是邪气侵犯足少阴经的情况，所以把这六个字视为衍文。然而“嗌中肿”二十八字，是王冰移置于此的，不能断定一定是衍文。
不能吞咽唾液。高世栻说：内，通“咽”。
腰痛牵引少腹，牵控睾丸。吴崑说：足太阴脾属湿土。湿病者，湿气先注于腰部，所以腰痛。太阴之筋，聚集于阴器，循行腹部内部结于胁肋，所以牵引少腹牵控睾丸。张景岳说：足太阴之络，向上进入布散于胸胁，而筋附着于脊，所以生病出现这种情况。控，就是牵引。高世栻说：《素问·经脉论》说：脾之大络，名叫大包，出于渊液穴，布散于胁胸。实证则全身疼痛，虚证则百节尽皆松弛纵缓，令人腰痛牵引少腹，全身疼痛的意思。控引睾丸不可以仰面呼吸，布散于胁胸，百节尽皆松弛纵缓的意思。
腰尻的结合部，两胂的上方，是腰俞穴。吴崑依据新校正，删除了“是腰俞”三个字。注解说：腰尻之解，是腰俞一穴。两胂上，是脾俞二穴。马云说：腰俞穴，在中行二十一椎之下，则没有左右之分，断定为白环俞穴。张景岳说：腰俞只有一个穴位居中，本来没有左右之分。这里说左取右、右取左的，一定是腰俞左右的穴位，即足太阳经的下髎穴。高世栻说：解，指骨缝。胂上，指髁胂的上方，即大腿股部。申明腰尻之解，两胂的上方，就是腰俞。大概腰尻之解，属于腰俞，两腰的上方，即腰俞两旁之下。简按：《素问·刺腰痛篇》说：腰痛，牵引少腹牵控睾丸，不可以仰面，刺腰尻交者，在两髁胂上，以月亮的生死来决定针刺次数。王冰注解说：腰尻交者，是指髁下尻骨两旁四骨空，左右八穴。俗呼此骨为八髎骨。现在由此攻之，说明“腰俞”三字是衍文，而其含义张景岳的注释更为恰当。
邪气侵犯足太阳膀胱经的络脉。张景岳说：足太阳经，挟脊柱抵腰部中间，所以拘挛脊背紧急。其筋从腋后进入腋下，所以牵引胁肋而痛。
按压时感到疼痛。如，《甲乙经》作“而”。吴崑说：这不拘泥于特定的穴位，叫做应痛穴。
治疗各经针刺所经过的部位不生病。过，王冰读平声。马云说：大概经旨以病为有过失。高世栻认为：“之下”和“病下”并句。注解说：治诸经刺之，意思是治疗各经的病，就是正刺其经脉。所过者不病，意思是各经所经过的道路，不被邪气侵犯，所以不生病。简按：旧注的意义更长。
刺其通脉。《甲乙经》作“过脉”。马云说：刺其听宫穴。耳聋以下十六个字，高世栻移到上文“邪客于手阳明之络”之后。注解说：刺之病不愈，再刺中指的中冲穴。中指中冲，主通脉出于耳前，所以说“耳聋”等等。大概手阳明之脉，上行颈部贯穿脸颊，位于耳前。通脉出于耳前，通心主包络之脉，而出于耳前的手阳明经。简按：根据上文“刺之所过者”，“通”字作“过”字，似乎是正确的。
齿龋刺手阳明经。熊音：龋，丘禹反，齿病。高世栻说：齿龋，牙齿腐烂疼痛。《说文》：齿蠹。《释名》：龋，朽也，虫啮之齿缺朽也。高世栻版本中，从此以下十七字，连下文“缪传引上齿”以下四十八字，移到前节“邪客于足阳明之经，令人鼽衄”等内容条之后。《甲乙经》中，“阳明”下有“立已”二字。
邪气侵犯五脏之间。吴崑说：五脏之间，指五脏的络脉。张景岳说：邪气侵犯五脏之间，必然各自牵引其经脉而痛。只要看到病处，各取其井穴，进行缪刺。高世栻说：邪气侵犯五脏之间，其病症，经脉络脉相互牵引而痛。有时来自络脉，有时只止于经脉，所以时来时止。
五刺完毕。张志聪说：五脏之气平和了。
缪传牵引上齿。吴崑说：病本在下齿，现在缪传于上齿。张志聪说：谓手阳明之邪，缪传于足阳明之脉。足阳明之脉，进入上齿中。这是邪气侵犯手阳明之经别，而缪传于足阳明之脉，导致牵引引入上齿。
牙齿嘴唇寒冷疼痛。《甲乙经》中没有“痛”字。
观察手背的脉象。马云说：大概是指手阳明之络穴偏历穴。简按：各家没有注明某穴，这里是泛指手背，不必指某一个穴位。
足阳明中指爪甲上一刺。足上，《甲乙经》有“刺”字。高世栻版本中，“一上”有“各”字。云：旧本无“各”字，现在臆补。
这五条络脉都汇聚于耳中。张志聪说：耳，是宗脉汇聚的地方。张兆璜说：宗脉，是宗气所出的脉，即胃的大络，出于乳下，汇聚于耳中。
上行联络左角。马云说：络于左耳的额角。张志聪说：肝主血，而居于左，其气直上于头顶。
The principles of acupuncture are now complete. (Jia Yi: "Bei" should be read as "Bi", meaning finished.)
Ma Yun stated: When pathogenic factors invade the collaterals of various meridians, pain on the left side is treated by selecting points on the right, and pain on the right side is treated by selecting points on the left. This differs from the treatment location for meridian diseases. Therefore, this chapter is named "Miao Ci" (Counter-Needling). According to Section 3 of the *Guan Zhen* chapter in *Ling Shu*, Ju Ci (Great Counter-Needling) also involves treating the left for right-sided symptoms and vice versa; the only difference lies in the selection of Jing-Points versus Luo-Points. Zhang Jingyue explained: "Miao" means "different." Commentary notes: In *Guang Yun*, "Miao" is pronounced "mi you qie." The commentary on *Li Ji: Da Zhuan* states that "pi miao" is akin to "disorder." Wang Bing adopted this view. Essentially, because disease on the left is needled on the right, and disease on the right is needled on the left, crossing over their positions, it is called Miao Ci.
(The pathogen) reaches the Five Zang organs. Commentary notes: "Ji" means "to reach" or "arrive," as seen in the commentary on *Shi Jing: Zhou Song*.
In such cases, one should treat the Meridians. Zhang Jingyue stated: When pathogenic factors move from shallow to deep, eventually reaching the level of the Five Zang organs, one should treat the Meridians. Treating the meridians refers to direct needling of the regular points of the Twelve Primary Meridians. This does not yet constitute Miao Ci.
(Entering) into the Sun-Luo (Fine Collaterals). *Jia Yi* reads "mai" instead of "luo." Based on the preceding context, the *Jia Yi* version should be followed.
(The pathogen enters) the Da-Luo (Large Collaterals). Wu Kun stated: These are the large collaterals branching off the Twelve Primary Meridians, which correspond to the Fifteen Luo-Vessels mentioned in *Nan Jing*. Gao Shishi stated: Flowing overflow and transmission. The *Su Wen: Qi Xue Lun* states: "The Sun-Luo vessels that branch off the meridians all pour into the Luo-vessels, transmitting to the fourteen Luo-vessels." This refers to that process.
(Called) Qi Bing (Odd/Strange Disease). Zhang Jingyue stated: When the disease is in the collateral branches and does not follow the main meridians, it is called a Qi Bing. Zhang Zhicong stated: A Qi Bing refers to a condition where the pathogenic qi is on the left, but symptoms appear on the right, or vice versa. Generally, the Da-Luo are branches of the main meridians; Yang moves to Yin, and Yin moves to Yang.
(Interspersed with) the Meridians. Ma Yun stated: When pathogenic factors lodge in the Da-Luo, they flow from left to right and right to left, interacting with the meridians up, down, left, and right. However, the pathogen actually cannot enter the meridians and merely distributes to the four extremities. Zhang Zhicong cited the *Jing Mai* chapter: "The collateral of Hand-Taiyin lung merges with the Hand-Taiyin meridian and enters the palm directly; the collateral of Hand-Shaoyin heart follows the meridian into the heart." Generally, the Da-Luo run alongside the meridians, hence the phrase "interspersed with the meridians." Gao Shishi stated: "Jing" refers to Jing-Sui (Meridian Tunnels). Jing-Suis are the large collaterals of the Five Zang and Six Fu organs. Thus, they interact with the meridians and distribute to the four extremities of the hands and feet. Their Qi flows left and right without fixed locations. Because the Jing-Suis interact, they do not enter the Jing-Shu points. Since they do not enter the Jing-Shu points, one needles the Luo-collaterals, hence the name Miao Ci. Commentary notes: Based on various explanations, "Gan" means "interfere" or "involve."
One must use Ju Ci (Great Counter-Needling). Wu Kun stated: Ju Ci is the needling of the Great Meridians. Zhang Zhicong stated: "Ju" means great. It implies using long needles. It also involves treating the left for right-sided symptoms and vice versa. Commentary notes: The *Guan Zhen* chapter in *Ling Shu* does not mention using long needles; we follow Wu Kun's annotation here.
(In the) Miao Chu (Different/Opposite Location). Ma Yun stated: "Miao" means different. Wang Bing’s commentary suggested that the needled points are like disordered guidelines, which is not Qibo’s original clear intent. Wu Kun stated: It differs from the normal course of the meridians. Gao Shishi cited the *Mai Du* chapter: "Meridians are internal; branches running horizontally are collaterals." Therefore, for collateral diseases, the pain location differs from the meridians. "Miao Chu" means a different location. It means meridian pain is deep and internal, while collateral pain is branched, horizontal, and superficial. Since the disease is in the collaterals, with left-right disorder, it is named Miao Ci.
Pathogenic factors invade the collateral of Foot-Shaoyin Kidney. Ma Yun stated: The Luo-point of the Kidney meridian is Dazhong (KI4). Commentary notes: Various commentators like Zhang, Wu, etc., did not specify the point, likely referring generally to the collateral of a meridian. Ma’s practice of assigning a specific point to every collateral is likely incorrect.
(If there is) No Accumulation. Gao Shishi stated: If there is distension and accumulation, one should needle the chest and hypochondrium. If there is no accumulation, and the disease is in the Foot-Shaoyin collateral ascending to the Pericardium, one should needle the area anterior to Ran Gu. Commentary notes: Wu Kun stated: "Ji" refers to Five Zang accumulations. Accumulations arise after the True Qi of the Five Zang is deficient. If one then needles to bleed, it further depletes the deficiency, so it is contraindicated. Zhang Zhicong stated: "No accumulation" means no knot of excessive blood. Both interpretations are erroneous.
Anterior to Ran Gu. Gao Shishi argued that "Gu" should be "Gu" (Valley). The note says "Gu" was an error for "Gu" in old editions and has been corrected. The two instances of "Ran Gu" below follow this example. Commentary notes: The *Ben Shu* chapter states: "Kidney Qi flows into Ran Gu, which is below Ran Gu bone." There is no need to change the character.
Like the time it takes to eat a meal. Zhang Jingyue stated: "Shi Qing" means the duration of one meal. Subsequent texts follow this pattern. Commentary notes: Wang Bing’s interpretation of "hunger" is illogical.
If not cured, take the opposite side. *Jia Yi* omits the words "bu yi" (not cured). Commentary notes: Here the disease is already in the collateral; why wait until it is not cured to apply Miao Ci? The *Jia Yi* version is correct.
Cured within five days. *Jia Yi* omits the character "qu" (take). Zhang Jingyue stated: For newly onset diseases, the pathogen is not deep. Even if not immediately cured, it will resolve within five days.
Pathogenic factors invade the collateral of Hand-Shaoyang Sanjiao. *Jia Yi* reads "collateral of Foot-Shaoyin." Note: One version reads "Shaoyang."
Needle the second digit of the middle finger. Ma Yun stated: The second digit of the middle finger is the fourth finger. The spot about the width of a leek leaf above the nail bed is Guan Chong (TE1). Gao Shishi stated: The second digit of the middle finger is the second digit of the little finger, which is Guan Chong (TE1), the Jing-Well point of Hand-Shaoyang Sanjiao. Zhang Zhicong stated: One should needle Zhong Chong (PC9) in the middle finger (Pericardium collateral) and Guan Chong (TE1) in the second digit (Hand-Shaoyang). Commentary notes: *Jia Yi* notes that "middle finger" should be "little finger." Zhang Jingyue and Wu Kun also follow the New Correction to read "little finger." The *Ben Shu* chapter states: Guan Chong is at the end of the second digit of the little hand. The *Qi Fu Lun* states: From elbow to the base of the second digit of the little hand, there are six acupoints each. The *Re Bing* chapter states: Take the spot under the nail of the second digit of the little hand, distance from the tip like a leek leaf. The *Jue Bing* chapter states: Take the spot above the nail of the second digit of the little hand, where it meets the flesh. All chapters describe Guan Chong thus; we should follow the New Correction.
Width of a leek leaf. Zhang Zhicong annotated the *Ben Shu* chapter: Ancient times it was the width of a leek leaf; modern times it is the size of a rice grain. Commentary notes: *Jia Yi* states: Xiao Ze (SI1) is at the end of the little finger, one fen away from the nail. By inference, whenever it says "width of a leek leaf," it should be standardized as one fen.
Acute Hernia. Gao Shishi stated: The *Jing Mai* chapter says: "The collateral of Foot-Jueyin Liver, if pathogenic Qi rebels, causes testicular swelling and acute hernia." Thus, when pathogenic factors invade the collateral of Foot-Jueyin Liver, it causes sudden hernia and violent pain.
Where it meets the flesh. Zhang Zhicong stated: This refers to the spot distance from the tip like a leek leaf.
Men recover immediately; women recover after a short while. Wu Kun stated: Men rely on Yang Qi, so recovery is fast. Women rely on Yin Qi, so recovery is slightly slower. Zhang Zhicong stated: Women are born with insufficient Blood, hence the delay. Men have abundant Blood, hence immediate recovery.
Needle below the lateral malleolus. *Jia Yi* reads "above" instead of "below." Wu Kun stated: Jinmen (BL63), Jinggu (BL64), Tonggu (BL65). Gao Shishi stated: Among these three, Tonggu is the Ying-Spring point, Shugu (BL60) is the Shu-Stream point, and Jinggu is the Yuan-Source point. Commentary notes: Based on *Jia Yi*, this likely refers to Fuyang (BL59). Fuyang is located three cun above the ankle.
Pathogenic factors invade the arm and palm. Gao Shishi stated: The *Jing Mai* chapter says: "The meridian of Hand-Jueyin Pericardium descends the arm and enters the palm. Disease manifests as stiffness and spasm of the arm and elbow, and heat in the palm." Thus, when pathogenic factors invade the arm and palm, flexion becomes difficult.
Needle behind the ankle. Ma Yun stated: One should needle Tongli (HT5) of the Heart Meridian. Zhang Jingyue stated: It is the Hand-Jueyin Meridian. "Behind the ankle" refers to both ankles; behind the midpoint of the ankle is Neiguan (PC6). Neiguan is the Luo-Point of Hand-Jueyin Pericardium, so it should be selected. Zhang Zhicong agrees. Gao Shishi stated: Press with fingers first; needle where tenderness is found. Commentary notes: Examining the text, it is inappropriate to fixate on a specific acupoint, which is why Wang Bing did not annotate it. Gao Shishi’s explanation is more appropriate.
Determine the number based on the waxing and waning of the moon. Wu Kun stated: Before the full moon is waxing; after the full moon is waning. This corresponds to pain intensity, not fixed point methods. Zhang Jingyue stated: The waxing and waning of the moon follows the sun's expansion and contraction to determine the count. From the 1st to the 15th, the moon expands daily, constituting the "waxing count." One should add one needle per day. One needle equals one puncture. By the 15th, it increases to fifteen punctures. From the 16th to the 30th, the moon contracts daily, constituting the "waning count." One should reduce one needle per day. Thus, on the 16th, stop at fourteen punctures, reducing until the end of the month to only one puncture. Basically, one puncture per day, advancing and retreating according to the new and full moons. Zhang Zhicong stated: Hand-Jueyin Xin-Zhu governs blood vessels; this is waiting for the right time to regulate. Gao Shishi stated: From slight to strong, like the moon growing, so gradually increase. From strong to slight, like the moon declining, so gradually decrease. When the moon is empty (new moon), do not treat.
Pathogenic factors invade the Foot-Yangqiao Vessel. Ma Shi’s edition lacks the character "Foot." Gao Shishi stated: The *Mai Du* chapter says: "Qiao vessels run from foot to eye, belonging to the inner canthus." Thus, when pathogenic factors invade the Foot-Yangqiao vessel, it causes eye pain starting from the inner canthus.
Half a cun below the lateral malleolus. Gao Shishi stated: This is Pugen (BL61). Commentary notes: *Jia Yi* states: Shenmai (BL62) is where the Yangqiao is born, in the depression below the lateral malleolus, space for a fingernail. It also states: Pugen is in the depression below the calcaneus. Thus, the old annotation is correct.
Recovered in the time it takes to walk ten li. Zhang Zhicong stated: Qiao vessels are agile and good at walking. Like walking ten li, the Qi of the Qiao vessel has circulated fully. Gao Shishi stated: Qiao vessels belong to the Extraordinary Vessels and move fastest. Thus, in the time it takes to walk ten li, the pain disease can cease. Commentary notes: According to the *Book of Han: Biography of Jia Juanzhi*, traveling fifty li is considered auspicious travel. Calculating from this, it amounts to one hour and forty-five minutes plus.
When a person falls or is dropped. Ma Yun stated: This describes illness caused by evil blood, requiring the method of Miao Ci.
Administer purgative medicine. Wu Kun stated: First, administer medicine to promote the discharge of stagnant blood.
Upper injury to the Jueyin Meridian. Zhang Jingyue stated: Falls invariably injure bones and sinews, thus upper injury affects the Jueyin Meridian. The Liver governs sinews. Lower injury affects the Shaoyin Collateral; the Kidney governs bones. Bleeding from the area anterior to Ran Gu constitutes needling the Shaoyin Collateral.
Blood vessels anterior to Ran Gu. Commentary notes: Various annotations follow the original text; there is no need to follow the New Correction.
Needle the artery on the dorsum of the foot. Zhang Jingyue stated: The Shu-Stream point of Foot-Jueyin is Taichong (LR3). Wang Bing identified it as Chongyang (ST42) of the Yangming Meridian, which seems irrelevant. Zhang Zhicong and Gao Shishi did not annotate the acupoint name.
Prone to sadness, fright, and unhappiness. Wu Kun stated: Jueyin disease connects to the Liver, causing fright. Shaoyin disease rebels in the chest, causing unhappiness. Hence the needling methods are similar. Zhang Jingyue stated: Falling and bruising injures Yin, scattering the Spirit and Qi, leading to sadness, fright, and unhappiness. Zhang Zhicong and Gao Shishi agree with Zhang Jingyue. Commentary notes: Wu Kun’s annotation is closer to the truth.
Above the nail of the middle finger. Wu Kun followed Wang Bing’s note, changing it to "little finger." Note: This is Guan Chong (TE1), the Jing-Well point of Hand-Shaoyang. The collateral of Hand-Shaoyang enters the ear from behind the ear, so needling here is indicated. Commentary notes: Ma Shi, Zhang Jingyue, and Gao Shishi all follow the New Correction, which is correct.
Those who occasionally hear sounds. Wu Kun stated: Complete deafness is Excess; occasional hearing is Deficiency. Needling a Deficiency case exacerbates the deficiency. Zhang Jingyue stated: Occasional hearing indicates treatability. Those who hear nothing have exhausted Luo-Qi; needling is futile and contraindicated. Commentary notes: If following Wu Kun’s logic, it should say "those who do not hear occasionally," which is very sloppy.
Wind generated in the ear. Wu Kun stated: Generating wind sounds like whistling wind. Zhang Zhicong stated: Accompanied by tinnitus-like wind noise. Commentary notes: *Qian Jin Fang* describes this as "su su" sound in the ear.
Whenever Bi syndrome wanders. Gao Shishi stated: This refers to Xing Bi (Wandering Bi), which does not involve the meridians. One should only Miao Ci the collaterals, not the Jing points. Whenever Bi syndrome wanders, it is called Xing Bi. Its movement has no fixed location; the pathogen is between the muscle divisions and does not involve the meridians. Commentary notes: *Qian Jin Fang* states that Wind-Bi wandering without fixed location is named Xue Bi (Blood Bi). This is also pathogen in the blood collaterals.
Needle where it hurts. Zhang Jingyue stated: Follow the pain location, find its collateral, and apply Miao Ci. Zhang Zhicong agrees. Gao Shishi stated: All Bi syndromes hurt; needle where it hurts. Commentary notes: We follow Zhang Jingyue’s annotation here.
The practitioner determines the number of punctures according to the flourishing and declining state of Qi. Wu Kun’s edition places these eleven characters as a footnote, stating: Old edition had them as main text; arrogantly changed to small print.
Waxing moon, one puncture on the first day. *Jia Yi* includes the six characters "determine number by moon waxing/waning" after "moon rises." Gao Shishi stated: The previous section mentions Hand-Jueyin Pericardium governing blood vessels, hence determining numbers by moon phases. This section discusses Bi pain, where Chong-Ren blood fails to warm muscles and fill skin, seeping into hair follicles, so it also uses moon phases to determine puncture counts. In the Miao Ci section, there are no puncture counts; all are determined by moon waxing/waning.
Pathogenic factors invade the Foot-Yangming Stomach Meridian. Ma Shi, Wu Kun, and Zhang Jingyue follow the New Correction, changing "Meridian" to "Collateral." Zhang Zhicong retains the original text, stating: This refers to intersecting meridians, which also require Miao Ci. "Jing" refers to the Yangming Meridian. Gao Shishi agrees. Commentary notes: Based on Wang Bing’s note and Zhang Zhicong, this treats diseases of the Great Meridian, seemingly indistinguishable from Ju Ci. We also follow the New Correction here.
Second digit of the middle toe of the foot. Ma Shi follows Wang Bing’s note. Wu Kun stated: The Foot-Yangming meridian has branches entering between the middle toes, outside the middle toes, and between the big toes. Here, "second digit of the middle toe" refers to the middle toe and its adjacent digit. The adjacent digit is Lidui (ST45); the middle toe need not be a specific point. Zhang Jingyue stated: The middle toe and adjacent digit are where Foot-Yangming meridians emerge, specifically Lidui. Zhang Zhicong stated: Foot-Yangming meridian descends between the outer middle toes; its branch diverges on the dorsum, entering the big toe gap. Thus, one should take Neiting (ST44) between the middle toes and Lidui (ST45) between the big toe and adjacent digit. Gao Shishi stated: The middle toe and adjacent digit refer to the big toe and its adjacent digit. The spot above the nail where it meets the flesh is Lidui (ST45), the Jing-Well point of Foot-Yangming. Commentary notes: Gao Shishi considers the third digit from the big toe as the "middle toe," differing from Wang Bing. However, verifying the *Ben Shu* chapter: Stomach emerges at Lidui, which is at the end of the second digit of the big foot. The lower text of this chapter says: "One puncture above the nail of the middle toe of the foot." Clearly, the second digit is considered the middle toe, distinct from the hand’s middle toe. The *Jia Yi* version is correct.
Warm clothing and diet. Zhang Zhicong stated: Coughing results from pathogen interfering with the Lungs. Thus, warm clothing and warm food/drink are suitable. Cold exposure and cold drinks cause severe secondary injury.
Qi ascends to above Ben (贲). Commentary notes: The New Correction cites Yang Xuancao, which is correct. Ding De Yong stated: The stomach is likened to Hu Ben warriors, having a surrounding image, hence called Ben Gate. Moreover, Wei (Stomach) means surrounding, governing granaries, hence alias Tai Cang. Verifying *Shi Jing* commentary: Ben means large. Since the stomach is already named Tai Cang, Ben Gate likely derives from this meaning. Using "Hu Ben" (warrior) makes the meaning inconsistent. Ma Shi and subsequent commentators follow the New Correction; only Gao Shishi bases his on Wang Bing.
Six needling methods established: Left needle right, right needle left. Gao Shishi stated: The six characters "Left needle right, right needle left" are interpolations. Commentary notes: The following text regarding "swelling in the throat" also concerns Foot-Shaoyin invasion, so these six characters are likely interpolations. However, the twenty-eight characters "swelling in the throat" were moved here by Wang Bing and cannot be definitively ruled as interpolations.
Unable to swallow saliva. Gao Shishi stated: "Nei" is synonymous with "yan" (swallow).
Lower back pain radiating to the lower abdomen and pulling the scrotum/testicles. Wu Kun stated: Foot-Taiyin Spleen belongs to damp earth. Damp diseases first accumulate in the waist, causing lower back pain. Taiyin sinews gather at the genitalia,循行 the abdominal interior, and knot at the hypochondrium, thus radiating to the lower abdomen and pulling the scrotum. Zhang Jingyue stated: Foot-Taiyin collateral ascends to distribute in the chest and hypochondrium, and sinews attach to the spine, causing these symptoms. "Kong" means pulling/radiating. Gao Shishi cited the *Jing Mai Lun*: "The Great Collateral of the Spleen is named Da Bao, emerging from Yuan Ye, distributing to the chest and hypochondrium. Excess causes whole-body pain; deficiency causes all joints to relax, leading to lower back pain radiating to the lower abdomen and whole-body pain." Pulling the scrotum prevents supine breathing; distributing to the chest hypochondrium reflects the relaxation of all joints.
The junction of the sacrum and buttocks, above the two shen muscles, is Yaoshu (DU2). Wu Kun deleted the three characters "is Yaoshu" based on the New Correction. Note: "Junction of sacrum and buttocks" is Yaoshu (DU2). "Above the two shen" refers to Pishu (BL20). Ma Yun stated: Yaoshu is below the 21st vertebra in the midline, having no left/right distinction; it must be Baihuanshu (BL30). Zhang Jingyue stated: Yaoshu is a single midline point, originally without left/right. The instruction to treat left with right and right with left must refer to points flanking Yaoshu, i.e., Xiagiao (BL32) of Foot-Taiyang. Gao Shishi stated: "Jie" means bone gap. "Shen Shang" refers to above the Hou Shen, i.e., the thigh. Clarifying: The junction of sacrum and buttocks, above the two shen muscles, is Yaoshu. The junction of sacrum and buttocks belongs to Yaoshu; above the two waists is below the sides of Yaoshu. Commentary notes: The *Ci Yao Tong Lun* states: "Lower back pain radiating to lower abdomen and pulling scrotum, unable to lie supine, needle the intersection of sacrum and buttocks, above the two Hou Shen, determining puncture count by moon phases." Wang Bing noted: Intersection of sacrum and buttocks refers to the four bony spaces on both sides of the coccyx below the femoral condyles, eight acupoints total. Commonly called the Ba Liao bones. Investigating this, the three characters "Yaoshu" are interpolations, but Zhang Jingyue’s interpretation of the meaning is superior.
Pathogenic factors invade the collateral of Foot-Taiyang Bladder. Zhang Jingyue stated: Foot-Taiyang meridian flanks the spine and reaches the waist center, causing spinal stiffness. Its sinews enter the axilla from the posterior axillary fold, causing rib pain.
Tender upon palpation. "Ru" in *Jia Yi* is read as "Er" (and). Wu Kun stated: This does not adhere to specific acupoints but is needled where tender, called Ying Tong Xue (Responsive Pain Point).
Treating diseases in areas passed by needling other meridians. "Guo" is read as level tone by Wang Bing. Ma Yun stated: The classic implies disease arises from excess/pathology. Gao Shishi punctuated "Zhi Xia" and "Bing Xia" together. Note: "Treating needling of various meridians" means treating diseases of various meridians via direct needling. "Areas passed do not become diseased" means the pathways traversed by various meridians are not invaded by pathogens and thus remain healthy. Commentary notes: The old annotation has greater merit.
Needle its Tong Mai (Passing Vessel). *Jia Yi* reads "Guo Mai." Ma Yun stated: Needle Ting Gong (SI19). The sixteen characters "deafness..." were moved by Gao Shishi to follow "Pathogenic factors invade the collateral of Hand-Yangming." Note: If needling fails to cure, needle Zhong Chong (PC9) in the middle finger. Zhong Chong governs Tong Mai emerging before the ear, hence "deafness..." Hand-Yangming meridian ascends the neck, passes through the cheek, and is located before the ear. Tong Mai emerges before the ear, connecting to the Xin Bao vessel and emerging at Hand-Yangming before the ear. Commentary notes: Based on the previous text "areas passed by needling," reading "Tong" as "Guo" seems plausible.
For dental caries, needle Hand-Yangming. Xiong Yin: Qu, pronounced qiu yu fan, refers to tooth disease. Gao Shishi stated: Chi Qu is rotting and painful teeth. *Shuo Wen*: Tooth decay. *Shi Ming*: Qu means rotten, teeth missing due to worm erosion. Gao Shishi’s edition combines the following seventeen characters with the next forty-eight characters ("Miao Chuan pulls upper teeth...") and moves them after the section "Pathogenic factors invade Foot-Yangming Meridian, causing nasal congestion and epistaxis." *Jia Yi* adds "Li Yi" (immediately cured) after "Yangming."
Pathogenic factors invade the space between the Five Zang organs. Wu Kun stated: Space between Five Zang refers to their collaterals. Zhang Jingyue stated: Pathogen invading the space between Five Zang organs inevitably pulls their meridians causing pain. Observe the disease site and select its Jing-Well points for Miao Ci. Gao Shishi stated: Pathogen invading the space between Five Zang organs causes pain via mutual pulling of Jing and Luo vessels. Sometimes it emerges from collaterals, sometimes stops at meridians, hence intermittent appearance.
Five needlings completed. Zhang Zhicong stated: The Qi of the Five Zang organs is balanced.
Miao Chuan pulls the upper teeth. Wu Kun stated: The root disease is in the lower teeth, now Miao Chuan transfers to the upper teeth. Zhang Zhicong stated: Pathogen of Hand-Yangming Miao Chuan transfers to Foot-Yangming meridian. Foot-Yangming meridian enters the upper teeth. This is pathogen invading the Jing-Bie of Hand-Yangming and Miao Chuan transferring to Foot-Yangming, causing referral to the upper teeth.
Cold pain in teeth and lips. *Jia Yi* omits the character "tong" (pain).
Observe the vessels on the back of the hand. Ma Yun stated: Likely referring to Pianli (LI6), the Luo-Point of Hand-Yangming. Commentary notes: Commentators do not specify a point; this generally refers to the back of the hand, not necessarily a single point.
One puncture above the nail of the middle toe of Foot-Yangming. *Jia Yi* adds the character "ci" (needle) after "foot." Gao Shishi’s edition adds "ge" (each) after "yi shang." Note: Old editions lacked "ge"; added conjecturally.
These five collaterals all converge in the ear. Zhang Zhicong stated: The ear is the gathering place of Zong Mai (Ancestral Vessels). Zhang Zhaohuang stated: Zong Mai refers to vessels issuing from Zong Qi, i.e., the Great Collateral of the Stomach, emerging below the breast and converging in the ear.
Ascends to connect with the left corner. Ma Yun stated: Connects to the frontal angle of the left ear. Zhang Zhicong stated: The Liver governs Blood and resides on the left; its Qi ascends directly to the vertex.