平按∶此篇见《灵枢》卷三第十《经脉》篇，又见《甲乙经》卷二第一下编。
黄帝曰∶经脉十二经脉者，伏行分肉之间，深而不见，其常见者，足太阴过于内踝之上，毋
所隐故见也。诸脉之浮而常见者，皆络脉也。（十二经脉及诸络脉∶其不见者，谓十一经也；其
可见者，谓足太阴经，上行至于踝上，以其皮薄故见也；诸余络脉，皆见者也。平按∶足太阴下
《甲乙经》有脉字。内踝《灵枢》、《甲乙经》均作外踝，正统本《甲乙经》作内踝。查阴脉行
内，阳脉行外，足太阴为阴脉，应内联踝。再检本书脾足太阴之脉，上内踝前廉。杨注云∶十二
经脉，皆行筋肉骨间；唯此足太阴经，上于内踝薄肉之处，脉得见
者也。与此处正相发明。作外踝者，恐误。）六经络手阳明少阳之大络也，起于五指间，上合肘
中。（六阳络中∶手阳明络，肺腑之络也；手少阳络，三焦之络也。手阳明大肠之经，起大指次
指之间，即大指次指及中指内间，手阳明络起也。手少阳经，起小指次指间，即小指次指及中指
外间，手少阳脉起也。故二脉络起五指间也。平按∶少阳《甲乙经》作少阴。注手少阳，手字袁
刻脱。）饮酒者，卫气先行皮肤，先充络脉，络脉先盛，故卫气已平，营气乃满，而经脉大盛也。
（酒是熟谷之液，入胃先行皮肤，故卫气盛。卫气注入脉中故平，营气满也。营气满于所入之经，
则所入经，脉络大盛动也。平按∶故卫气已平《甲乙经》作则卫气以平。）脉之卒然动者，皆邪
气居之，留于本末，（十二经脉有卒然动者，皆是营卫之气将邪气入此脉中，故此脉动也。本末，
即是此经本末也。络脉将邪入于卫气，卫气将邪入于此脉本末之中，留而不出，故为动也。酒即
邪也。）不动则热，（若邪在脉中，盛而不动，则当邪居处，蒸而热也。）不坚则陷且空，不与
众同，是以知其何脉之病。（当邪居处，热邪盛也，必为坚硬。若寒邪盛多，脉陷肉空，与平人不
同。以此候之，知十二经中何经之病。平按∶病《灵枢》、《甲乙经》作动也二字。注必为坚硬，
硬字右旁有五孟反三字小注，袁刻作“必为坚，坚，孟硬反”，与原抄不合。）雷公曰∶何以知
经脉之与络脉异耶？黄帝曰∶经脉者常不可见，其虚实也以气口知之，脉之见者皆络脉也。（经
脉不见，若候其虚实，当诊寸口可知之也。络脉横居，五色可见，即目观之，以知虚实也。）雷
公曰∶细子无以明其然。（细子，谦称也。经脉诊气口可知虚实，犹未明其络脉见之然也。）黄
帝曰∶诸络脉皆不能经大节之间，必行绝而道出，入复合于皮中，其会皆见于外。（大节，谓四肢十二大节等也。
凡络脉之行，至大节间止，缘于络道出节至外，入于皮中，与余络合，见于皮。绝，止也。平按∶
自雷公曰至黄帝曰，《甲乙经》无此十三字。而道《灵枢》、《甲乙经》作道而。）故诸刺络脉
者，必刺其结上，甚血者虽毋结，急取之以泻其邪而出其血，留之发为痹。（此言疗络所在也。结，
谓聚也。邪客于络，有血聚处，可刺去之。虽无聚处，观于络脉血盛之处，即有邪居，可刺去之，
恐其邪气停留，发为痹病也。平按∶诸刺道藏本《灵枢》作刺诸。《甲乙经》虽毋结作虽无血结。）
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，鱼络亦赤；鱼黑
者，留久痹也；其有赤有青有黑者，寒热；（此言诊络虚实法也。络色有三，青、赤、黑也。但
青有寒，但赤有热，但黑有痹，三色具者即有寒热也。色之候者，青赤二色候胃中也。皆候鱼络胃
者，手阳明脉与太阴合，太阴之脉循胃口至鱼，故候太阴之络，知胃寒热。胃中有痹，亦可候鱼，
若邪客处久留成痹，即便诊之。平按∶《甲乙经》胃中寒作胃中有寒。鱼络亦赤《灵枢》作鱼际
络赤，《甲乙经》作则鱼际之络赤。鱼黑者《灵枢》、《甲乙经》均作其暴黑者。寒热下《灵枢》
有气也二字。）其青而小短者，少气也。（青色主寒，而短小者，即寒气少也。平按∶《灵枢》
无而小二字。）凡刺寒热者皆多血络，必间日而一取之，血尽而止，乃调其虚实。（此言刺络脉
法也。寒热，胃中寒热也，以胃气故青赤，络脉血乃多者也。欲为多日刺之，故间日取，得平乃
止也。）其小而短者少气，甚泻之则 ， 甚则仆、不能言， 则急坐之。（阴络小而短者，则
阴气少，故甚泻□踣倒；坐而屈之即脉满，故醒而能言也。亦可阴阳络皆短小，即二气俱少，泻之仆也。仆，踣也。平
按∶两甚字原抄本均作其，谨根据《灵枢》、《甲乙经》作甚。 《灵枢》、《甲乙经》均作闷。注踣上原缺一字，袁刻作则。）
【平按】：此篇见于《灵枢》卷三第十《经脉》篇，又见于《甲乙经》卷二第一下编。
黄帝说：十二经脉在体内伏行于肌肉间隙之间，位置深而通常看不见；那些能够看见的，是足太阴脾经经过内踝上方，因为此处没有遮挡所以显露出来。所有浮浅且能看见的脉，都是络脉。（注释：十二经脉及诸络脉中：看不见的，指十一经；看得见的，指足太阴经，上行至踝上，因其皮肤薄故可见；其余络脉，皆可见。平按：足太阴下，《甲乙经》有“脉”字。内踝，《灵枢》、《甲乙经》均作外踝，正统本《甲乙经》作内踝。查阴脉行于内侧，阳脉行于外侧，足太阴为阴脉，应内联内踝。再检本书脾足太阴之脉，上行至内踝前廉。杨注云：十二经脉，都运行在筋肉骨节之间；唯独这条足太阴经，上行于内踝处皮肉薄弱的地方，脉得以显现。与此处正相印证。作外踝者，恐怕是误写。）六条阳经的大络，即手阳明大肠经和手少阳三焦经的大络，起于五指之间，向上汇合于肘中。（注释：六阳络中：手阳明络，是肺脏的络脉（注：此处原文逻辑似有混淆，通常手阳明络属肺，但手阳明经属大肠，需结合上下文理解，此处依原文直译）；手少阳络，是三焦的络脉。手阳明大肠经，起于食指与拇指之间，即食指与中指内侧，手阳明络由此发起。手少阳经，起于无名指与小指之间，即无名指与小指外侧，手少阳脉由此发起。因此这两条络脉起于五指之间。平按：少阳，《甲乙经》作少阴。注中手少阳，“手”字袁刻本脱漏。）饮酒的人，卫气先行于皮肤，先充盈络脉，络脉先盛满，所以卫气已经平和后，营气才充满，而经脉盛大充盈。
（注释：酒是熟谷的液体，入胃后先行于皮肤，所以卫气盛。卫气注入脉中所以平和，营气充满。营气充满于所入之经，则所入之经，脉络盛大跳动。平按：故卫气已平，《甲乙经》作则卫气以平。）脉突然跳动的，都是邪气停留所致，留滞于经脉的本末（注释：十二经脉中有突然跳动的，都是营卫之气将邪气引入此脉中，所以此脉跳动。本末，即是此经的本末。络脉将邪气引入卫气，卫气将邪气引入此脉本末之中，停留而出不来，所以表现为跳动。酒也是邪气的一种）。如果不跳动则有热感（注释：若邪气在脉中，盛大而不跳动，则在邪气居处，蒸腾发热），如果不坚实则下陷且空虚，与常人不同，因此可以知道是哪条经脉生病。（注释：当邪气居处，热邪盛大，必然坚硬。若寒邪盛大，脉陷肉空，与普通人不同。以此观察，可知十二经中哪条经有病。平按：病，《灵枢》、《甲乙经》作动也二字。注中必为坚硬，硬字右旁有五孟反三字小注，袁刻作“必为坚，坚，孟硬反”，与原抄不合。）
雷公问：如何知道经脉与络脉的区别呢？黄帝说：经脉通常不可见，其虚实通过气口（寸口脉）来知晓；那些看得见的脉，都是络脉。（注释：经脉不见，若要候察其虚实，应当诊察寸口可知。络脉横居体表，五色可见，即用肉眼观察，以知虚实。）雷公说：学生无法明白其中的道理。（细子，谦称。经脉诊气口可知虚实，但仍不明白络脉可见的道理。）黄帝说：所有络脉都不能经过大的关节之间，必定行走于断绝之处而道出，进入皮下后又复合，其交会点都显露于体表。（大节，指四肢十二个大关节等。凡络脉的运行，到大关节间停止，因为络道出于关节至外部，进入皮中，与其他络脉会合，显露于皮表。绝，止也。平按：自雷公曰至黄帝曰，《甲乙经》无此十三字。而道，《灵枢》、《甲乙经》作道而。）
所以凡是刺络脉的，必须刺其结聚之上，如果血盛即使没有结聚，也要急取放血以泻除邪气并排出瘀血，否则停留日久会发为痹病。（注释：此言治疗络脉所在的方法。结，谓聚也。邪气客于络脉，有血聚之处，可刺去之。即使没有聚处，观察络脉血盛之处，即有邪气居住，可刺去之，恐其邪气停留，发为痹病。平按：诸刺，道藏本《灵枢》作刺诸。《甲乙经》虽毋结作虽无血结。）
凡是诊察络脉，脉色青则寒且痛，赤则有热。胃中寒，手鱼际部的络脉多青色；胃中有热，鱼际络脉也呈红色；鱼际部色黑者，是久留的痹病；其有红有青有黑的，是寒热错杂（注释：此言诊络虚实之法。络色有三：青、赤、黑。但青主寒，但赤主热，但黑主痹，三色具备者即有寒热。色的候察，青赤二色候胃中状况。皆候鱼际络，因胃者，手阳明脉与太阴合，太阴之脉循胃口至鱼际，故候太阴之络，知胃之寒热。胃中有痹，亦可候鱼际，若邪气客处久留成痹，即便诊察。平按：《甲乙经》胃中寒作胃中有寒。鱼络亦赤，《灵枢》作鱼际络赤，《甲乙经》作则鱼际之络赤。鱼黑者，《灵枢》、《甲乙经》均作其暴黑者。寒热下，《灵枢》有气也二字。）其青而细小短促的，是少气（注释：青色主寒，而短小者，即寒气少也。平按：《灵枢》无而小二字。）
凡是刺治寒热证，都要多刺血络，必须隔日取一次，血尽而止，然后调治其虚实。（注释：此言刺络脉之法。寒热，指胃中寒热，因胃气故现青赤，络脉血乃多者也。欲为多日刺之，故间日取，得平乃止也。）其小而短的少气，若过度泻之则会跌倒，甚则仆倒、不能言语，此时应让其急坐休息。（注释：阴络小而短者，则阴气少，故甚泻则踣倒；坐而屈之即脉满，故醒而能言也。亦可阴阳络皆短小，即二气俱少，泻之则仆倒。仆，踣也。平按：两甚字原抄本均作其，谨根据《灵枢》、《甲乙经》作甚。《灵枢》、《甲乙经》均作闷。注踣上原缺一字，袁刻本作则。）
[Ping An]: This chapter appears in *Ling Shu* (Spiritual Pivot), Volume 3, Chapter 10 "Jing Mai" (Meridians), and also in *Jia Yi Jing* (The Classic of A-Bian Acupuncture and Moxibustion), Volume 2, Part 1, Lower Section.
Huang Di said: The twelve Jing Mai (Primary Meridians) run deep within the intermuscular spaces, are profound and usually invisible. Those that are commonly visible are those of the Foot Taiyin Spleen Channel, which passes above the medial malleolus; because there is no concealment there, they are seen. All vessels that float superficially and are commonly visible are Luo Mai (Collaterals). (Annotation: Among the twelve Jing Mai and various Luo Mai: the invisible ones refer to eleven channels; the visible one refers to the Foot Taiyin Channel, ascending to above the ankle, and because the skin is thin, it is visible; all other Luo Mai are visible. Ping An: Below "Foot Taiyin", *Jia Yi Jing* has the character "Mai". "Nei Huai" (Medial Malleolus): both *Ling Shu* and *Jia Yi Jing* make it "Wai Huai" (Lateral Malleolus), while the orthodox edition of *Jia Yi Jing* makes it "Nei Huai". Checking Yin channels run on the inside, Yang channels run on the outside; Foot Taiyin is a Yin channel and should connect internally to the medial malleolus. Re-examining the text of this book regarding the Spleen Foot Taiyin Channel, it ascends to the anterior margin of the medial malleolus. Yang's annotation states: The twelve Jing Mai all run between muscles, bones, and joints; only this Foot Taiyin Channel ascends to the place with thin flesh at the medial malleolus, where the vessel can be seen. This perfectly elucidates the current passage. Writing "lateral malleolus" is likely an error.) The six large Luo Mai of the Yang channels are the large collaterals of the Hand Yangming Large Intestine Channel and the Hand Shaoyang Sanjiao Channel; they originate between the five fingers and ascend to converge in the elbow region. (Annotation: Among the six Yang Luo: the Hand Yangming Luo is the collateral of the Lung organ; the Hand Shaoyang Luo is the collateral of the Sanjiao. The Hand Yangming Large Intestine Channel originates between the index finger and thumb, specifically between the index and middle fingers on the inner side, where the Hand Yangming Luo arises. The Hand Shaoyang Channel originates between the ring finger and little finger, specifically on the outer side of these two fingers, where the Hand Shaoyang Mai arises. Thus, these two Luo Mai arise from between the five fingers. Ping An: "Shaoyang" in *Jia Yi Jing* is written as "Shaoyin". In the note for Hand Shaoyang, the character "Shou" (Hand) is omitted in the Yuan edition.) For those who drink wine, Wei Qi (Defensive Qi) moves first into the skin, filling the Luo Mai initially; thus, when the Wei Qi has become balanced, Ying Qi (Nutritive Qi) then fills, and the Jing Mai become greatly full.
(Annotation: Wine is the liquid of cooked grains; entering the Stomach, it moves first into the skin, so Wei Qi becomes abundant. When Wei Qi injects into the vessels, it becomes balanced, and Ying Qi fills. When Ying Qi fills the channel it enters, the Luo Mai of that channel become greatly full and pulsating. Ping An: "Gu Wei Qi Yi Ping" in *Jia Yi Jing* is written as "Ze Wei Qi Yi Ping".) Sudden movements or pulsations of the vessels indicate that pathogenic factors reside there, remaining at the root and extremities of the channel. (Annotation: If there are sudden movements in the twelve Jing Mai, it is because Ying and Wei Qi have introduced pathogenic factors into these vessels, causing them to pulse. "Ben Mo" (Root and Extremities) refers to the proximal and distal ends of this channel. The Luo Mai introduces pathogens into Wei Qi, and Wei Qi introduces pathogens into the root and extremities of this vessel, where they remain without exiting, thus causing movement. Wine is also considered a pathogen.) If there is no movement but heat, (Annotation: If pathogens are in the vessel, abundant yet not moving, heat will steam and accumulate at the site of the pathogen.) if it is not firm, it sinks and becomes empty, differing from others; therefore, one can know which channel is diseased. (Annotation: At the site where pathogens reside, if heat pathogens are abundant, it must be hard. If cold pathogens are abundant, the vessel sinks and flesh becomes empty, differing from normal people. By observing this, one knows which of the twelve channels is diseased. Ping An: "Bing" (Disease) in *Ling Shu* and *Jia Yi Jing* is written as "Dong Ye" (Movement/Acting). In the note "Bi Wei Jian Ying", the right side of the character "Ying" has a small annotation "You Wu Meng Fan"; the Yuan edition writes "Bi Wei Jian, Jian, Meng Ying Fan", which does not match the original manuscript.)
Lei Gong asked: How do we know the difference between Jing Mai and Luo Mai? Huang Di said: Jing Mai are usually invisible; their deficiency and excess are known through the Qikou (Cunkou/Radial artery). Those that are visible are all Luo Mai. (Annotation: Since Jing Mai are not visible, if one wishes to observe their deficiency or excess, one should diagnose the Cunkou to know. Luo Mai lie transversely on the surface, and their five colors are visible; by visual observation, one knows their deficiency or excess.) Lei Gong said: Your student cannot understand why this is so. ("Xi Zi" is a humble self-reference. Although diagnosing the Cunkou reveals the deficiency/excess of Jing Mai, the reason for the visibility of Luo Mai remains unclear.) Huang Di said: All Luo Mai cannot pass through major joints; they must travel through discontinuous paths and emerge, entering beneath the skin again and recombining, with their intersections all visible externally. ("Da Jie" refers to the twelve major joints of the four limbs. Generally, the movement of Luo Mai stops at the major joints; because the Luo pathways exit the joint to the exterior, enter the skin, and merge with other Luo Mai, they appear on the skin surface. "Jue" means stop. Ping An: From "Lei Gong Yue" to "Huang Di Yue", *Jia Yi Jing* lacks these thirteen characters. "Er Dao" in *Ling Shu* and *Jia Yi Jing* is written as "Dao Er".)
Therefore, whenever needling Luo Mai, one must needle above the knots (accumulations). If blood is abundant, even if there are no knots, one should urgently extract blood to drain the pathogens and expel the blood; otherwise, retention will lead to Bi Syndrome (Obstruction). (Annotation: This discusses treating the location of Luo Mai. "Jie" means accumulation. When pathogens lodge in the Luo Mai, there may be areas of blood accumulation, which can be needled away. Even without accumulation, observing places where Luo Mai blood is abundant indicates pathogen residence, which can be needled away, fearing that pathogen retention will cause Bi disease. Ping An: "Zhu Ci" in the Daozang edition of *Ling Shu* is written as "Ci Zhu". *Jia Yi Jing* writes "Sui Wu Jie" as "Sui Wu Xue Jie".)
Generally, diagnosing Luo Mai: if the vessel color is blue/green, there is cold and pain; if red, there is heat. If the Stomach has cold, the Luo Mai on the Thenar eminence (Yu Ji) are mostly blue/green; if the Stomach has heat, the Yu Ji Luo Mai are also red; if the Yu Ji is black, it is long-standing Bi syndrome; if it has red, blue/green, and black colors, it indicates mixed cold and heat. (Annotation: This discusses the method of diagnosing Luo Mai deficiency and excess. There are three Luo Mai colors: blue/green, red, and black. Blue/green indicates cold, red indicates heat, black indicates Bi; having all three colors indicates mixed cold and heat. Regarding color diagnosis, blue/green and red indicate conditions in the Stomach. Diagnosing the Yu Ji Luo Mai relates to the Stomach because the Hand Yangming channel combines with the Taiyin, and the Taiyin channel follows the stomach opening to the Yu Ji; thus, diagnosing the Taiyin Luo Mai reveals Stomach cold or heat. Stomach Bi can also be diagnosed at the Yu Ji; if pathogens lodge and remain long-term forming Bi, it can be diagnosed. Ping An: *Jia Yi Jing* writes "Wei Zhong Han" as "Wei Zhong You Han". "Yu Luo Yi Chi" in *Ling Shu* is written as "Yu Ji Luo Chi", and in *Jia Yi Jing* as "Ze Yu Ji Zhi Luo Chi". "Yu Hei Zhe" in *Ling Shu* and *Jia Yi Jing* is written as "Qi Bao Hei Zhe". Below "Han Re", *Ling Shu* has the characters "Qi Ye".) If the vessels are blue/green and small/short, it indicates Qi deficiency. (Annotation: Blue/green indicates cold, and being small/short indicates that the cold qi is slight. Ping An: *Ling Shu* lacks the characters "Er Xiao".)
Whenever needling to treat cold and heat syndromes, one should use many blood vessels (Luo Mai); treatment must be taken every other day until the blood is exhausted, then regulate the deficiency and excess. (Annotation: This discusses the method of needling Luo Mai. Cold and heat refer to Stomach cold and heat; due to Stomach Qi, the colors are blue/green and red, and the Luo Mai blood is abundant. To treat over multiple days, one takes treatment every other day, stopping when balance is achieved.) If the vessels are small and short, indicating Qi deficiency, excessive draining will cause fainting/collapse; if severe, the patient may fall, be unable to speak, and should be made to sit urgently. (Annotation: If Yin Luo Mai are small and short, Yin Qi is deficient, so excessive draining causes collapse; sitting with bent knees allows the vessels to fill, so the patient wakes and can speak. Alternatively, if both Yin and Yang Luo Mai are short and small, both Qi types are deficient, and draining causes collapse. "Pu" means collapse/fall. Ping An: Both instances of "Shen" in the original manuscript were written as "Qi"; corrected to "Shen" based on *Ling Shu* and *Jia Yi Jing*. *Ling Shu* and *Jia Yi Jing* both write "Men" (Oppressed/Stifled). The character above "Bo" in the note was originally missing; the Yuan edition writes "Ze".)