四末。不入于经俞。与经脉缪处者是也。玉版论之所谓胃者。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。盖胃腑所生之血气。其精专者
独行于经隧。从手太阴肺脉。而终于足厥阴肝经。此荣血之循行于十二经脉之中。一脉流通。环转
不息者也。其血气之四布于皮肤者。从脏腑之别络而出。虽与经相干。与经并行。而各走其道。出
于孙络。散于皮肤。故手太阴之经。别曰列缺。手少阴之经。别曰通里。足太阳
曰飞扬。足少阳曰光明。与手足之井荥输经合穴不相干也。曰太阴少阴。曰太阳少阳。与脏腑之
经脉各缪处也。此胃腑之血气。四布于肤表之阳分者。从大络而出于孙络皮肤。从络脉而阴走于阳。
阳走于阴。如江河之外。别有江河。江可通于河。河可通于江。与经脉之荣血。一以贯通者不相同
也。故手太阴之别。名曰列缺。起于腕上分间。分间者。谓手太阴之经脉。与经别之于此间而相
分也。并太阴之经者。并太阴之经脉而行也。散入于鱼际。谓入鱼际而散于皮肤。即上文之所谓诸
络脉必行绝道而出入。复合于皮中。其会见于外也。实则手锐掌热。气盛于外也。虚则欠KT 。
小便遗数。气虚于内也。盖肤表之血气。由脏腑经隧之所生也。当取之去腕半寸。即列缺穴间。别
走阳明者。阴络之从此而别走于阳也。尚御公曰。此篇病证。与缪刺篇之不同。缪刺篇论邪客于
皮肤孙络。溜于大络而生奇病。病从外而内也。此篇论本气之虚实。病从内而外也。故曰诸络脉
必行绝道而出入。朱济公曰。如手太阴之列缺。手阳明之偏历。虽非井荥输经。然亦系经脉之穴。
盖经别之各走其道。布于四末。与经相干。于列缺通里诸经之间。复别而上行。并经而入掌。散于
络脉。而合于皮中者也。张玉师曰。皮部论云。欲知皮部。以经脉为纪。阳明之阳。名曰害蜚。
视其上下有浮络者。皆阳明之络也。少阳之阳。名曰枢持。少阴之阴。名曰枢儒。凡十二经络脉者。
皮之部也。是皮部之络脉。虽以经脉为纪。并循于十二经脉之部。然从大络而出。别走其道。与经
脉缪处。故有害蜚枢持之别名。同学之士。当于灵素二经。细心合参。其义始得。
手少阴之别。名曰通里。去腕一寸半。别而上行。循经入于心中。系舌本。属目系。其实则
支膈。虚则不能言。取之掌后一寸。别走太阳也。
手少阴之别络。与经相干。名曰通里之间。去腕一寸半。别经而上行。循经入于心中。系舌本。
属目系。其气实。膈间若有所支而不畅。虚则不能言。盖心主言。而经别络舌本也。掌后一寸。乃
别走于太阳之络脉处。故取阴阳分行之处而刺之。按心脉上挟咽。系目系。经别系舌本。属目系。
盖经别并经而行也。
手心主之别。名曰内关。去腕二寸。出于两筋之间。循经以上系于心包络。心系实则心痛。虚
则为头强。取之两筋间也。
手心主之别络。与经相干于内关之间。去腕二寸。别经脉而出于两筋之内。循经并行。上系于
心包络。心系实则心痛。心系与包络之相通也。虚则为头强。盖包络主行血脉。脉气虚。故头强也。
按十二经别。皆阳走阴而阴走阳。此不曰别走少阳。或简脱也。
手太阳之别。名曰支正。上腕五寸。内注少阴。其别者上走肘。络肩 。实则节弛肘废。虚则
生疣。小者如指痂疥。取之所别也。（ 音偶疣音尤）
上腕五寸。乃手太阳经之支正。太阳之经别。布于四末。与经相干。名曰支正之间。内注于
手少阴之别络。其别行者上走肘。络肩 。手太阳小肠主液。实则津液留滞。不能淖泽于骨。是以
节弛肘废。三因曰。气虚不行则生疣。小者如指上之痂疥。即 痤之类。气郁之所生也。
手阳明之别。名曰偏历。去腕三寸。别入太阴。其别者。上循臂。乘肩 。上曲颊偏历。其别
者。入耳合于宗脉。实则龋聋。虚则齿寒痹隔。取之所别也。
去腕三寸。乃手阳明经之偏历。手阳明之别络。布于四末。与经相干于偏历之间。而别入于太
阴之经别。其别行者。上循臂。乘肩 。上曲颊。遍络于齿。又其别者。入耳中。合于宗脉。实则
气滞而为齿痛耳聋。虚则齿痹隔。盖手阳明主行血气于皮肤。以温肌肉。虚则不行于外。故为齿
寒而痹闭阻隔也。尚御公曰。取之别者。为偏齿入耳之别络。非偏历也。十二络皆同。
手少阳之别。名曰外关。去腕二寸。外绕臂。注胸中。合心主。病实则肘挛。虚则不收。取之
所别也。
去腕二寸。乃手少阳经之外关。少阳之别络。布于四末。与经相干于外关之间。外行绕臂。注胸
中。合心主之大络。病实则肘挛。虚则不收。少阳厥阴之主筋也。
足太阳之别。名曰飞扬。去踝七寸。别走少阴。实则鼽窒头背痛。虚则鼽衄。取之所别也。
踝上七寸。乃足太阳经之飞扬穴。足太阳之别络。与经相干于飞扬之间。不入于经俞。别走于
足少阴之络。实则鼽窒背痛。虚则鼽衄。盖别络并经而循于头背也。
足少阳之别。名曰光明。去踝五寸。别走厥阴。下络足跗。实则厥。虚则痿 。坐不能起。取
之所别也。
踝上五寸。乃足少阳经之光明。少阳之大络。与经相会于光明之间。别走于厥阴之别络。下络
足跗。少阳主初阳之气。实则胆气不升。而逆于下则为厥。气虚则为痿 。坐不能起。
足阳明之别。名曰丰隆。去踝八寸。别走太阴。其别者。循胫骨外廉。上络头项。合诸经之气。
下络喉嗌。其病气逆。则喉痹卒喑。实则狂癫。虚则足不收。胫枯。取之所别也。
去足踝八寸。乃足阳明经之丰隆。阳明之别络。与经相会于丰隆之间。而别走于足太阴之别
络。其别行者。并经脉而循于胫骨外廉。上络头项。十五大络之气血。皆本于胃腑水谷之所生。是
以足阳明之络。与诸经之气相合。其病气逆。则喉痹卒喑。经别之络于喉嗌也。实则气厥于下而
为癫狂。血气虚则足不收。胫枯。取之所别也。
足太阴之别。名曰公孙。去本节之后一寸。别走阳明。其别者。入络肠胃。厥气上逆则霍乱。实
则肠中切痛。虚则鼓胀。取之所别也。
去足大趾本节之后一寸。乃足太阴之公孙穴。太阴之别络。分布于足。与经相干于公孙之间。
而别走于阳明之络。其别行者。入络肠胃。厥气上逆。则为霍乱。气有余而实。则为肠中切痛。不
足而虚。则为鼓胀。当取之所别也。
足少阴之别。名曰大钟。当踝后绕跟。别走太阳。其别者。并经上走于心包下。外贯腰脊。其
病气逆则烦闷。实则闭癃。虚则腰痛。取之所别也。
当踝后绕跟处。乃足少阴经之大钟。少阴之别络。与经相会于大钟之间。而别走于太阳。其别
行者。并经而行。上走于心包络之下。外贯腰脊。其病气逆则烦闷。水气上乘于心故烦闷。实则
闭癃。别走太阳。而膀胱之气不化也。虚则腰痛。腰者肾之府也。按手少阳三焦。手厥阴包络之
气。皆本于肾脏之所生。故并经上走于心包下。盖包络之气。生于肾脏。注于络中。并经而上也。
足厥阴之别。名曰蠡沟。去内踝五寸。别走少阳。其别者。经胫上睾。结于茎。其病气逆。则
睾肿卒疝。实则挺长。虚则暴痒。取之所别也。
去内踝五寸。乃是厥阴经之蠡沟。厥阴之别络。分布于足。与经相干于蠡沟之间。而别走于
少阳之络。胫、足 。睾、睾丸。即阴子也。茎、阴茎。乃前之宗筋。挺、即阴茎也。取之所别
者。取别走少阳之络。所谓阳取阴而阴取阳。左取右而右取左也。
任脉之别。名曰尾翳。下鸠尾。散于腹。实则腹皮痛。虚则痒瘙。取之所别也。
按任脉起于中极之下。以上毛际。循腹里。上关元。至咽喉。上颐循面入目。所谓尾翳者。即
鸠尾之上。盖任脉之别络。出于下极。并经而上。复下于鸠尾。以散于腹。络气实则腹皮急。虚则
痒瘙。当取之所别络也。
督脉之别。名曰长强。挟脊上项。散头上下。当肩胛左右。别走太阳。入贯膂。实则脊强。虚
则头重高摇之。挟脊之有过者。取之所别也。
按、督脉起于少腹以下骨中央。女子入系庭孔。其孔。溺孔之端也。其络循阴器。合篡间。绕
篡后。别绕臀。至少阴与巨阳中络者合少阴。上股内后廉。贯脊属肾。与太阳起于目内 。上额交
巅。上入络脑。还出别下项。循肩膊内。挟脊抵腰中。上循膂络肾。其男子循茎下至篡。与女子
等。其少腹直上者。贯脐中央。上贯心入喉。上颐环唇。上系两目之下中央。盖督脉总督一身之
阳。应天道之绕地环转。是以下行而上者。循茎至篡。从少
腹贯脐中央。入喉上颐。环唇系目。其上行而下者。起于目内 。上额交巅。下项挟脊抵腰中。而
环转于周身之前后也。其督脉之别络。出于长强之分。挟脊上行。散于头上。是督脉之行于脊膂者。
从头项而下行。别络之从下而上行于头项也。虚实者本气之实虚。有过者。有过之脉。邪气之所
客也。尚御公曰。以有过之脉。总结于督脉之后。盖申明虚实者。乃本气之实虚。非邪实也。朱
永年曰。按任督之大络。与经脉交相逆顺而行。当知十二别络。虽循经并行。亦往来逆顺者也。
脾之大络。名曰大包。出渊液下三寸。布胸胁。实则身尽痛。虚则百节尽皆纵。此脉若罗络
之血者。皆取之。脾之大络脉也。
大包乃脾经之穴名。在足少阳胆经渊液之下三寸。脾之大络。循脾经之大包。而四布于胸胁。
实则身尽痛。虚则百节尽皆纵。罗络之血者。谓大络之血气。散于周身之孙络皮肤。若罗纹之纵横
而络于身也。夫脾之有大络者。脾主为胃行其津液。灌溉于五脏四旁。从大络而布于周身。是以病
则一身尽痛。百节皆纵。而血络之若罗纹。以络于周身。足太阴之大络者。只并经而行。散血气于
本经之部分。是以足太阴脾脏之有二络也。如曰脾足太阴之脉。兼是动所生而言也。曰足太阴之
大络。曰脾之大络。分脾脏经气而言也。
凡此十五络者。实则必见。虚则必下。视之不见。求之上下。人经不同。络脉异所别也。
凡此十五大络之血气充实。则外溢于孙络皮肤。故实则必见。虚则下陷于内之大络。故视之
不见也。求之上下者。谓络脉之相交于上下阴阳之间。病在上者求之下。病在下者求之上。病在
阴者取之阳。病在阳者
取之阴也。夫十五大络。虽与经相干。而布于四末。其气无常处。不入于经俞。与经脉缪处。故与
人之经脉不同。而络脉异所别也。尚御公曰。经脉有经脉之络脉。经别有经别之络脉。故曰络脉异所也。
四肢末端。不进入经脉的腧穴。与经脉交错分布的就是这些络脉。《玉版论要》所说的“胃”，是水谷化生的血气的海洋。海洋中运行的云气，就像天下的云气一样。胃所化生并输布血气的通道，就是经隧。所谓经隧，就是五脏六腑的大络。大概胃腑所化生的血气，其中精纯专一的部分，独自行走于经隧之中，从手太阴肺经开始，一直运行到足厥阴肝经结束。这就是营血在十二经脉中的循环运行，一脉贯通，环转不息。而那些散布于皮肤的血气，则是从脏腑的别络中流出。虽然它们与经脉相互关联、并行，但各自走自己的道路，出于孙络，散播于皮肤。所以手太阴肺经的别络名叫列缺，手少阴心经的别络名叫通里，足太阳膀胱经的别络名叫飞扬，足少阳胆经的别络名叫光明。这些别络与手足三阴三阳的井、荥、输、经、合五腧穴没有直接关系。之所以称为太阴、少阴、太阳、少阳，是因为它们与脏腑的主经脉各自行走，交错分布。这是胃腑化生的血气，散布于体表的阳分部分，从大络出发，经过孙络到达皮肤。从络脉走向阴分，又从阴分走向阳分，就像江河之外另有江河，江可以连通河，河也可以连通江，这与经脉中营血单一贯通的情况是不相同的。
所以手太阴肺经的别络，名叫列缺，起始于手腕上方的分肉间隙。“分间”是指手太阴肺经的经脉与它的别络在此处分开。它并行于手太阴经脉，散布进入鱼际穴区域，意思是进入鱼际而散布于皮肤。这就是上文所说的所有络脉必然行走在特殊的通道（绝道）上出入，最终复合于皮中，其交会点显露于体表。如果实证，则手腕锐骨处和手掌发热，这是因为气盛于外；如果虚证，则呵欠连天，小便频数或失禁，这是因为气虚于内。大概体表的血气，是由脏腑经隧所化生的。应当取腕横纹上半寸处的列缺穴。这条别络另走阳明经，是阴络从此处分出走向阳经。尚御公说：本篇论述的病证，与《缪刺论》篇不同。《缪刺论》篇论述的是邪气客居于皮肤孙络，流入大络而产生奇病，病势是从外向内发展的。本篇论述的是本气的虚实，病势是从内向外出发的。所以说所有的络脉必然行走在特殊的通道上出入。朱济公说：如手太阴肺经的列缺，手阳明大肠经的偏历，虽然不是井、荥、输、经、合五腧穴，但也属于经脉上的穴位。大概经别各自走自己的道路，散布于四肢末端，与经脉相互关联，在列缺、通里等经别之间，又别行而上行，经过经脉进入手掌，散布于络脉，并与皮部相合。张玉师说：《皮部论》中说：“要了解皮部，以经脉为纲纪。”阳明之阳，名叫害蜚，观察其上下有浮络出现的，都是阳明的络脉。少阳之阳，名叫枢持。少阴之阴，名叫枢儒。凡是十二经络脉，都是皮部的表现。因此皮部的络脉，虽然以经脉为纲纪，并循行于十二经脉的部位，但它们从大络分出，另走其道，与经脉交错分布，所以有“害蜚”、“枢持”等别名。同学们应当在《灵枢》和《素问》二经中细心综合参详，其中的义理才能明白。
手少阴心经的别络，名叫通里，距离腕后一寸半，别行而上行，沿着经脉进入心中，联系舌根，归属于目系。实证则胸膈支撑胀满，虚证则不能说话。取穴在掌后一寸处，此络别走太阳经。手少阴心经的别络，与经脉相互关联，名叫通里，距离腕后一寸半，别经脉而上行，沿着经脉进入心中，联系舌根，归属于目系。其气实，则胸膈间好像有东西支撑而不通畅；其气虚，则不能说话。大概心主言语，而经别联络舌根。腕后一寸处，是别走于太阳经的络脉所在之处，所以选取阴阳分行之处进行针刺。按：心脉上行挟咽喉，联系目系；经别联系舌根，归属于目系。大概经别是与经脉并行而行的。
手心主心包经的别络，名叫内关，距离腕后二寸，出于两筋之间，沿着经脉上行，联系于心包络。心系实证则心痛，虚证则头项强直。取穴在两筋之间。手心主心包经的别络，在内关处与经脉相互关联，距离腕后二寸，别经脉而出于两筋之内，沿着经脉并行，上行联系于心包络。心系与心包络相通。虚证则头项强直，大概心包络主行血脉，脉气虚弱，所以头项强直。按：十二经别，都是阳走向阴，阴走向阳，这里不说别走少阳，可能是简略或脱漏。
手太阳小肠经的别络，名叫支正，距离腕后五寸，向内注入手少阴心经。其别行者向上走到肘部，联络肩髃。实证则关节弛缓、肘部废用，虚证则生疣赘，小的像手指上的痂疥。取穴在其别行之处。（“ ”音偶，“疣”音尤）。距离腕后五寸，是手太阳经的支正穴。太阳经的经别，散布于四肢末端，与经脉相互关联，名叫支正，向内注入手少阴心经的别络。其别行者向上走到肘部，联络肩髃。手太阳小肠经主液，实证则津液留滞，不能滋润骨骼，所以关节弛缓、肘部废用。《三因方》说：气虚不行则生疣，小的像手指上的痂疥，即痤之类，是气郁所产生的。
手阳明大肠经的别络，名叫偏历，距离腕后三寸，别入太阴经。其别行者，向上循行手臂，经过肩髃，上至曲颊偏历。其别行者，进入耳中，合于宗脉。实证则龋齿耳聋，虚证则牙齿寒冷痹痛阻隔。取穴在其别行之处。距离腕后三寸，是手阳明经的偏历穴。手阳明大肠经的别络，散布于四肢末端，在偏历处与经脉相互关联，而别入于太阴经的经别。其别行者，向上循行手臂，经过肩髃，上至曲颊，遍络于牙齿。又有其别行者，进入耳中，合于宗脉。实证则气滞导致齿痛耳聋，虚证则牙齿痹痛阻隔。大概手阳明大肠经主行血气于皮肤，以温养肌肉，虚证则血气不能行于外部，所以出现牙齿寒冷而痹闭阻隔。尚御公说：取别行者，是指偏齿入耳的别络，不是偏历穴本身。十二络都是这样。
手少阳三焦经的别络，名叫外关，距离腕后二寸，向外绕过手臂，注入胸中，合于心主。病实证则肘部挛急，虚证则不能收持。取穴在其别行之处。距离腕后二寸，是手少阳经的外关穴。少阳经的别络，散布于四肢末端，在外关处与经脉相互关联，外行绕过手臂，注入胸中，合于心主的大络。病实证则肘部挛急，虚证则不能收持。少阳和厥阴主筋。
足太阳膀胱经的别络，名叫飞扬，距离踝后七寸，别走少阴经。实证则鼻塞流涕、头背痛，虚证则鼻塞流清涕或鼻出血。取穴在其别行之处。踝上七寸，是足太阳经的飞扬穴。足太阳经的别络，在飞扬处与经脉相互关联，不进入经俞，别走于足少阴肾经的络脉。实证则鼻塞背痛，虚证则鼻塞流涕或鼻出血。大概别络与经脉并行而循行于头背部。
足少阳胆经的别络，名叫光明，距离踝后五寸，别走厥阴经，向下联络足背。实证则四肢厥冷，虚证则痿软无力，坐起困难。取穴在其别行之处。踝上五寸，是足少阳经的光明穴。少阳经的大络，在光明处与经脉相会，别走于厥阴经的别络，向下联络足背。少阳主初生之阳气，实证则胆气不升，逆于下则为厥；气虚则为痿软无力，坐起困难。
足阳明胃经的别络，名叫丰隆，距离踝后八寸，别走太阴经。其别行者，沿着胫骨外缘，向上联络头项，合于诸经之气，向下联络喉咽。其病若气逆，则喉痹突然失音。实证则狂癫，虚证则足部不收持，小腿枯瘦。取穴在其别行之处。距足踝八寸，是足阳明经的丰隆穴。阳明经的别络，在丰隆处与经脉相会，而别走于足太阴脾经的别络。其别行者，与经脉并行而循行于胫骨外缘，向上联络头项。十五大络的气血，都本源于胃腑水谷所化生，因此足阳明胃经的络脉，与诸经之气相合。其病若气逆，则喉痹突然失音，这是经别联络于喉咽所致。实证则气厥于下而为癫狂，血气虚则足部不收持，小腿枯瘦。取穴在其别行之处。
足太阴脾经的别络，名叫公孙，距离足大趾本节之后一寸，别走阳明经。其别行者，进入联络肠胃。厥气上逆则霍乱。实证则肠中剧烈疼痛，虚证则腹胀鼓胀。取穴在其别行之处。距足大趾本节之后一寸，是足太阴脾经的公孙穴。太阴经的别络，分布于足部，在公孙处与经脉相互关联，而别走于阳明经的络脉。其别行者，进入联络肠胃。厥气上逆，则为霍乱。气有余而实，则为肠中剧烈疼痛。不足而虚，则为腹胀鼓胀。应当取其在别行之处。
足少阴肾经的别络，名叫大钟，位于踝后绕跟处，别走太阳经。其别行者，与经脉并行上走于心包之下，外贯腰脊。其病若气逆则烦闷，实证则小便闭塞不通，虚证则腰痛。取穴在其别行之处。当踝后绕跟处，是足少阴经的大钟穴。少阴经的别络，在大钟处与经脉相会，而别走于太阳经。其别行者，与经脉并行，上走于心包络之下，外贯腰脊。其病若气逆则烦闷，这是水气上乘于心故烦闷。实证则小便闭塞不通，因为别走太阳，膀胱之气不化。虚证则腰痛，腰是肾之府。按：手少阳三焦经、手厥阴心包络的气，都本源于肾脏所化生，所以与经脉并行上走于心包之下。大概包络之气，生于肾脏，注入络中，并与经脉并行而上。
足厥阴肝经的别络，名叫蠡沟，距离内踝五寸，别走少阳经。其别行者，沿胫骨上至睾丸，结于阴茎。其病若气逆，则睾丸肿胀突发疝气。实证则阴茎挺长，虚证则突然瘙痒。取穴在其别行之处。距内踝五寸，是厥阴经的蠡沟穴。厥阴经的别络，分布于足部，在蠡沟处与经脉相互关联，而别走于少阳经的络脉。胫、足，睾、睾丸，即阴子也。茎、阴茎，乃前阴的宗筋。挺、即阴茎也。取其所别者，是取别走少阳的络脉，所谓阳取阴而阴取阳，左取右而右取左。
任脉的别络，名叫尾翳，向下至鸠尾，散布于腹部。实证则腹皮疼痛，虚证则瘙痒。取穴在其别行之处。按：任脉起于中极之下，以上至毛际，循腹里，上至关元，至咽喉，上颐循面入目。所谓尾翳，即鸠尾之上。大概任脉的别络，出于下极，与经脉并行而上，复下于鸠尾，以散布于腹部。络气实则腹皮紧急，虚则瘙痒，应当取其别络。
督脉的别络，名叫长强，挟脊柱上行至项部，散布于头部上下，当肩胛左右，别走太阳经，进入贯穿夹脊肌肉。实证则脊柱强直，虚证则头重摇晃不定。挟脊有过错之处，取穴在其别行之处。按：督脉起于少腹以下骨中央，女子入系廷孔，其孔即溺孔之端。其络循阴器，合于篡间，绕篡后，别绕臀部，至少阴与巨阳中络者合于少阴，上股内后廉，贯脊属肾。与太阳经起于目内眦，上额交巅，上入络脑，还出别下项，循肩膊内，挟脊抵腰中，上循夹脊络肾。男子循阴茎下至篡，与女子相同。其少腹直上者，贯脐中央，上贯心入喉，上颐环唇，上系两目之下中央。大概督脉总督一身之阳，应天道之绕地环转，所以下行而上者，循阴茎至篡，从少腹贯脐中央，入喉上颐，环唇系目。其上行而下者，起于目内眦，上额交巅，下项挟脊抵腰中，而环转于周身之前后。其督脉的别络，出于长强之分，挟脊上行，散布于头上。是督脉之行于脊夹脊者，从头项而下行，别络之从下而上行于头项也。虚实者是本气的虚实，有过者，是有过错的脉，是邪气所客居之处。尚御公说：以“有过之脉”总结于督脉之后，大概是申明虚实者，乃是本气的虚实，而非邪气之实。朱永年说：按任督的大络，与经脉交相逆顺而行，应当知道十二别络，虽然循经并行，也是往来逆顺的。
脾的大络，名叫大包，出于渊液穴下三寸，布散于胸胁。实证则全身尽痛，虚证则百节皆松弛纵缓。这种脉象如同罗网般的络脉之血，都要取治。这是脾的大络脉。大包是脾经的穴名，在足少阳胆经渊液穴下三寸。脾的大络，循脾经的大包穴，而四布于胸胁。实证则全身尽痛，虚证则百节皆松弛纵缓。罗络之血，是指大络的血气，散布于周身之孙络皮肤，像罗纹一样纵横而络于身体。夫脾有大络者，因为脾主为胃行其津液，灌溉于五脏四旁，从大络而布于周身，所以生病则一身尽痛，百节皆纵，而血络像罗纹一样络于周身。足太阴的大络，只与经脉并行，散布血气于本经的部分，所以足太阴脾脏有两个络脉。如果说“脾足太阴之脉”，是兼指是动病和所生病而言。如果说“足太阴之大络”、“脾之大络”，是区分脾脏经气而言。
凡这十五条络脉，实证必然显现于外，虚证必然下陷于内。视而不见时，要在上下寻找。人的经脉不同，络脉别出的部位也各异。凡这十五条大络的血气充实，则外溢于孙络皮肤，所以实证必然显现。虚证则下陷于内的大络，所以视而不见。所谓“求之上下”，是指络脉相交于上下阴阳之间，病在上者求之于下，病在下者求之于上，病在阴者取之于阳，病在阳者取之于阴。夫十五条大络，虽然与经脉相互关联，但散布于四肢末端，其气无常处，不进入经俞，与经脉交错分布，所以与人的经脉不同，而络脉别出的部位也各异。尚御公说：经脉有经脉的络脉，经别有经别的络脉，所以说络脉别出的部位各异。
The four extremities do not enter the Shu points of the meridians. Those that are distributed in a crisscross manner relative to the main meridians are these collateral vessels (Luo Mai). As stated in the *Yu Ban Lun Yao*, the "Stomach" is the sea of blood and qi generated from water and grain. The clouds and qi circulating within this sea are like the clouds and qi in the world. The channels through which the Stomach distributes the generated blood and qi are the "Jing Sui" (Meridian Tunnels/Vessels). These Jing Sui are the great collaterals of the Zang and Fu organs. Generally, the blood and qi generated by the Stomach, among which the pure and concentrated portion travels exclusively within the Jing Sui, begins from the Lung Meridian of Hand-Taiyin and ends at the Liver Meridian of Foot-Jueyin. This describes the circulation of Ying (Nutrient) Blood within the Twelve Primary Meridians, flowing continuously in an unceasing cycle. The blood and qi that spread to the skin originate from the branch collaterals of the Zang and Fu organs. Although they interact with and run parallel to the main meridians, they follow their own distinct paths, emerging from the Sun Luo (Fine Collaterals) and dispersing into the skin. Therefore, the branch collateral of the Lung Meridian of Hand-Taiyin is named Lieque (LU7); that of the Heart Meridian of Hand-Shaoyin is Tongli (HT5); that of the Bladder Meridian of Foot-Taiyang is Feiyang (BL58); and that of the Gallbladder Meridian of Foot-Shaoyang is Guangming (GB37). These branch collaterals are unrelated to the Jing-Well, Ying-Spring, Shu-Stream, Jing-River, and He-Sea acupoints of the hand and foot yin and yang meridians. They are referred to as Taiyin, Shaoyin, Taiyang, and Shaoyang because they run separately and intersect with the main meridians of the Zang and Fu organs. This refers to the blood and qi generated by the Stomach, which spreads to the Yang aspect of the body surface, exiting from the Great Collaterals, passing through the Fine Collaterals to the skin. From the collaterals, it moves Yinward to Yang, and Yangward to Yin, much like rivers having separate branches outside the main river; the Jiang can connect to the He, and the He to the Jiang. This differs from the single, continuous flow of Ying Blood within the primary meridians.
Thus, the branch collateral of the Lung Meridian of Hand-Taiyin is named Lieque (LU7), originating in the intermuscular space above the wrist. "Intermuscular space" refers to the point where the main meridian of Hand-Taiyin separates from its branch collateral. It runs parallel to the Lung Meridian and disperses into the region of Yuji (LU10), meaning it enters Yuji and spreads into the skin. This corresponds to the earlier statement that all collateral vessels must travel through unique pathways to enter and exit, eventually converging within the skin, with their intersections visible externally. In excess conditions, there is heat in the sharp bone of the wrist and the palm, indicating Qi abundance on the exterior. In deficiency conditions, there is yawning and frequent or incontinent urination, indicating Qi deficiency internally. Generally, the blood and qi on the body surface are generated by the Jing Sui of the Zang and Fu organs. Treatment should target Lieque (LU7), located half a cun above the wrist crease. This branch collateral diverges to the Yangming Meridian, representing the divergence of a Yin collateral to a Yang channel. Shang Yugong stated: The pathological conditions discussed in this chapter differ from those in the *Miao Ci* (Miraculous Puncture) chapter. The *Miao Ci* chapter discusses pathogens lodging in the skin and fine collaterals, sliding into the great collaterals to produce strange diseases, progressing from the exterior to the interior. This chapter discusses the deficiency and excess of the Root Qi, progressing from the interior to the exterior. Hence, it states that all collateral vessels must travel through unique pathways to enter and exit. Zhu Jigong said: For example, Lieque (LU7) of the Lung Meridian of Hand-Taiyin and Pianli (LI6) of the Large Intestine Meridian of Hand-Yangming, although not Jing-Well, Ying-Spring, Shu-Stream, Jing-River, or He-Sea points, are still acupoints on the meridians. Essentially, the Jing Bie (Branch Divergences) each follow their own paths, distributing to the four extremities and interacting with the main meridians. Between the branch collaterals such as Lieque and Tongli, they further diverge and ascend, passing through the meridians into the palm, dispersing into the collaterals, and merging with the skin layer. Zhang Yushi said: The *Pi Bu Lun* (Treatise on Skin Regions) states, "To know the skin regions, take the meridians as the guideline." The Yang of Yangming is named Haifei; observing floating collaterals above and below indicates they are collaterals of Yangming. The Yang of Shaoyang is named Chuchi; the Yin of Shaoyin is named Shuru. All twelve meridian collaterals belong to the skin regions. Thus, although the collaterals of the skin regions use the meridians as guidelines and follow the twelve meridian regions, they emerge from the great collaterals, follow distinct paths, and intersect with the main meridians, hence having alternative names like Haifei and Chuchi. Students should carefully cross-reference the *Ling Shu* and *Su Wen* to fully understand these principles.
The branch collateral of the Heart Meridian of Hand-Shaoyin is named Tongli (HT5), located 1.5 cun distal to the wrist. It diverges and ascends, following the meridian into the heart, connecting to the root of the tongue, and attaching to the eye system. In excess conditions, there is a sensation of obstruction in the chest and diaphragm; in deficiency conditions, speech is impaired. The point is taken one cun behind the palm, where it diverges to the Taiyang Meridian. The branch collateral of the Hand-Shaoyin Heart Meridian interacts with the main meridian at Tongli (HT5), 1.5 cun distal to the wrist. It diverges from the meridian and ascends, following the pathway into the heart, connecting to the root of the tongue, and attaching to the eye system. When Qi is in excess, there is a feeling of support or obstruction in the diaphragm; when deficient, speech is lost. The Heart governs speech, and the branch collateral connects to the root of the tongue. One cun behind the palm is where it diverges to the Taiyang collateral. Therefore, acupuncture targets the site where Yin and Yang pathways diverge. Note: The Heart pulse ascends along the throat and connects to the eye system; the Jing Bie connects to the root of the tongue and attaches to the eye system. The Jing Bie runs parallel to the main meridian.
The branch collateral of the Pericardium Meridian of Hand-Jueyin is named Neiguan (PC6), located 2 cun distal to the wrist, emerging between the two tendons. It follows the meridian upward to connect with the Pericardium Luo. In excess conditions, there is heart pain; in deficiency conditions, there is stiffness of the head and neck. The point is taken between the two tendons. The branch collateral of the Hand-Jueyin Pericardium Meridian interacts with the main meridian at Neiguan (PC6), 2 cun distal to the wrist. It diverges from the meridian and emerges between the two tendons, running parallel upward to connect with the Pericardium Luo. The connection between the Heart System and the Pericardium Luo is key. In deficiency conditions, there is stiffness of the head and neck, as the Pericardium governs the movement of blood vessels; vessel Qi deficiency leads to head stiffness. Note: The Twelve Jing Bie generally move from Yang to Yin and Yin to Yang. The omission here of "diverging to Shaoyang" may be due to textual abbreviation or loss.
The branch collateral of the Small Intestine Meridian of Hand-Taiyang is named Zhizheng (SI7), located 5 cun distal to the wrist, injecting inwardly into the Hand-Shaoyin. Its branch goes up to the elbow and connects to Jianliao (SI14). In excess conditions, there is flaccidity of the joints and uselessness of the elbow; in deficiency conditions, warts grow, small ones resembling scabs or ringworm on the fingers. The point is taken at its divergence. Five cun distal to the wrist is Zhizheng (SI7) of the Hand-Taiyang Meridian. The Jing Bie of Taiyang distributes to the four extremities, interacting with the main meridian at Zhizheng, and injects inwardly into the branch collateral of Hand-Shaoyin. Its branch goes up to the elbow and connects to Jianliao (SI14). The Hand-Taiyang Small Intestine governs fluids. In excess conditions, fluid retention prevents nourishment of the bones, leading to joint flaccidity and elbow uselessness. The *San Yin Fang* states: Qi deficiency and stagnation cause warts, small ones resembling scabs on fingers, which are types of acne caused by Qi stagnation.
The branch collateral of the Large Intestine Meridian of Hand-Yangming is named Pianli (LI6), located 3 cun distal to the wrist, diverging into the Taiyin Meridian. Its branch ascends along the arm, passes over Jianliao (LI15), and reaches Qujia (LI17) at Pianli. Another branch enters the ear and merges with the Zong Mai (Major Vessel). In excess conditions, there is toothache and deafness; in deficiency conditions, there is coldness and bi-syndrome obstruction in the teeth. The point is taken at its divergence. Three cun distal to the wrist is Pianli (LI6) of the Hand-Yangming Meridian. The branch collateral of Hand-Yangming distributes to the four extremities, interacting with the main meridian at Pianli, and diverges into the Jing Bie of Taiyin. Its branch ascends along the arm, passes over Jianliao (LI15), and reaches Qujia (LI17), covering the teeth. Another branch enters the ear and merges with the Zong Mai. In excess conditions, Qi stagnation causes toothache and deafness; in deficiency conditions, there is tooth bi-syndrome and obstruction. The Hand-Yangming governs the distribution of blood and qi to the skin to warm the muscles. In deficiency, it fails to reach the exterior, causing cold teeth and bi-obstruction. Shang Yugong stated: Taking the "branch" refers to the branch collateral entering the teeth and ear, not necessarily the Pianli acupoint itself. This applies to all twelve collaterals.
The branch collateral of the Sanjiao Meridian of Hand-Shaoyang is named Waiguan (TE5), located 2 cun distal to the wrist, winding outward around the arm, injecting into the chest, and merging with the Hand-Jueyin. In excess conditions, there is elbow spasm; in deficiency conditions, there is inability to grasp. The point is taken at its divergence. Two cun distal to the wrist is Waiguan (TE5) of the Hand-Shaoyang Meridian. The branch collateral of Shaoyang distributes to the four extremities, interacting with the main meridian at Waiguan, moving outward around the arm, injecting into the chest, and merging with the great collateral of the Hand-Jueyin. In excess conditions, there is elbow spasm; in deficiency conditions, there is inability to grasp. Shaoyang and Jueyin govern the sinews.
The branch collateral of the Bladder Meridian of Foot-Taiyang is named Feiyang (BL58), located 7 cun distal to the ankle, diverging to the Shaoyin Meridian. In excess conditions, there is nasal congestion, headache, and back pain; in deficiency conditions, there is nasal discharge or epistaxis. The point is taken at its divergence. Seven cun above the ankle is Feiyang (BL58) of the Foot-Taiyang Meridian. The branch collateral of Foot-Taiyang interacts with the main meridian at Feiyang, does not enter the Shu points, but diverges to the collateral of the Foot-Shaoyin Kidney Meridian. In excess conditions, there is nasal congestion and back pain; in deficiency conditions, there is nasal discharge or epistaxis. The branch collateral runs parallel to the meridian along the head and back.
The branch collateral of the Gallbladder Meridian of Foot-Shaoyang is named Guangming (GB37), located 5 cun distal to the ankle, diverging to the Jueyin Meridian, and descending to connect with the dorsum of the foot. In excess conditions, there is cold limbs (Jue); in deficiency conditions, there is flaccidity (Wei), making it difficult to sit up. The point is taken at its divergence. Five cun above the ankle is Guangming (GB37) of the Foot-Shaoyang Meridian. The great collateral of Shaoyang meets the main meridian at Guangming, diverging to the branch collateral of Jueyin, and descends to connect with the dorsum of the foot. Shaoyang governs the initial Yang Qi. In excess conditions, Gallbladder Qi fails to ascend and reverses downward, causing Jue; in deficiency conditions, there is Wei syndrome, making it difficult to sit up.
The branch collateral of the Stomach Meridian of Foot-Yangming is named Fenglong (ST40), located 8 cun distal to the ankle, diverging to the Taiyin Meridian. Its branch follows the lateral border of the tibia, ascends to connect with the head and neck, merging with the Qi of various meridians, and descends to connect with the throat. If Qi rebels, there is throat obstruction and sudden aphonia. In excess conditions, there is mania and epilepsy; in deficiency conditions, there is foot weakness and emaciation of the shins. The point is taken at its divergence. Eight cun above the ankle is Fenglong (ST40) of the Foot-Yangming Meridian. The branch collateral of Yangming meets the main meridian at Fenglong, diverging to the branch collateral of Foot-Taiyin Spleen. Its branch runs parallel to the meridian along the lateral tibia, ascends to connect with the head and neck. The Qi and Blood of the fifteen great collaterals originate from the water and grain generated by the Stomach. Thus, the collateral of Foot-Yangming merges with the Qi of other meridians. If Qi rebels, there is throat obstruction and sudden aphonia due to the Jing Bie connecting to the throat. In excess conditions, Qi rebellion causes mania and epilepsy; in deficiency conditions, foot weakness and shin emaciation occur. The point is taken at its divergence.
The branch collateral of the Spleen Meridian of Foot-Taiyin is named Gongsun (SP4), located one cun posterior to the base of the big toe, diverging to the Yangming Meridian. Its branch enters and connects with the intestines and stomach. If rebellious Qi ascends, there is Huoluan (cholera-like disorder). In excess conditions, there is severe abdominal pain; in deficiency conditions, there is abdominal distension. The point is taken at its divergence. One cun posterior to the base of the big toe is Gongsun (SP4) of the Foot-Taiyin Meridian. The branch collateral of Taiyin distributes to the foot, interacting with the main meridian at Gongsun, and diverges to the Yangming collateral. Its branch enters and connects with the intestines and stomach. Rebellious Qi ascending causes Huoluan. Excess Qi causes severe abdominal pain; deficiency Qi causes abdominal distension. Treatment should target its divergence.
The branch collateral of the Kidney Meridian of Foot-Shaoyin is named Dazhong (KI4), located behind the ankle, winding around the heel, diverging to the Taiyang Meridian. Its branch runs parallel to the meridian, ascending to below the Pericardium, and piercing through the waist and spine. If Qi rebels, there is irritability and oppression. In excess conditions, there is urinary retention; in deficiency conditions, there is lower back pain. The point is taken at its divergence. Behind the ankle, winding around the heel, is Dazhong (KI4) of the Foot-Shaoyin Meridian. The branch collateral of Shaoyin meets the main meridian at Dazhong, diverging to the Taiyang. Its branch runs parallel, ascending to below the Pericardium Luo, and piercing through the waist and spine. Rebellious Qi causes irritability and oppression due to Water Qi attacking the Heart. Excess conditions cause urinary retention because the branch diverges to Taiyang, and Bladder Qi fails to transform. Deficiency causes lower back pain, as the waist is the mansion of the Kidney. Note: The Qi of the Hand-Sanjiao and Hand-Jueyin Pericardium originates from the Kidney. Thus, the branch runs parallel, ascending to below the Pericardium. The Pericardium Qi is born in the Kidney, injected into the collaterals, and ascends with the meridian.
The branch collateral of the Liver Meridian of Foot-Jueyin is named Ligou (LR5), located 5 cun distal to the medial malleolus, diverging to the Shaoyang Meridian. Its branch ascends along the tibia to the testis, knotting at the penis. If Qi rebels, there is testicular swelling and sudden hernia. In excess conditions, there is priapism; in deficiency conditions, there is sudden itching. The point is taken at its divergence. Five cun distal to the medial malleolus is Ligou (LR5) of the Jueyin Meridian. The branch collateral of Jueyin distributes to the foot, interacting with the main meridian at Ligou, and diverges to the Shaoyang collateral. "Tibia/Foot," "Testis," i.e., Yin Zi. "Penis," i.e., the Zong Jin of the anterior. "Ting," i.e., the penis. Taking the divergence refers to taking the branch collateral diverging to Shaoyang, embodying the principle of "Yang takes Yin and Yin takes Yang, left takes right and right takes left."
The branch collateral of the Ren Mai (Conception Vessel) is named Wei Yi, descending to Jiutui (CV15), and dispersing into the abdomen. In excess conditions, there is pain in the abdominal skin; in deficiency conditions, there is itching. The point is taken at its divergence. Note: The Ren Mai originates below Zhongji (CV3), ascends to the pubic hair line, follows the interior of the abdomen, passes through Guanyuan (CV4), reaches the throat, ascends to the chin, follows the face, and enters the eyes. "Wei Yi" refers to above Jiutui (CV15). The branch collateral of the Ren Mai emerges from the lower extreme, runs parallel upward, then descends to Jiutui (CV15) to disperse into the abdomen. Excess collateral Qi causes tight abdominal skin; deficiency causes itching. Treatment should target the branch collateral.
The branch collateral of the Du Mai (Governing Vessel) is named Changqiang (GV1), flanking the spine to the nape, dispersing above and below the head, located at the left and right of the shoulder blades, diverging to the Taiyang Meridian, entering and piercing the paraspinal muscles. In excess conditions, there is spinal rigidity; in deficiency conditions, there is heavy head and trembling. Points with abnormalities along the spine are treated at its divergence. Note: The Du Mai originates below the lower abdomen at the central bone. In women, it enters and connects to the Ting Kong (urethral opening), which is the end of the urine hole. Its collateral circulates the genitalia, merges at the perineum, winds around the anus, diverges to wind around the buttocks, meets the Foot-Shaoyin and Foot-Taiyang middle collaterals, ascends along the inner posterior thigh, pierces the spine, and belongs to the Kidney. It joins the Taiyang Meridian starting at the inner canthus, ascends the forehead, crosses the vertex, enters the brain, emerges, diverges down the nape, follows the shoulder blades, flanks the spine to the middle of the waist, ascends along the paraspinal muscles to connect with the Kidney. In men, it follows the penis to the perineum, same as women. The part rising straight from the lower abdomen pierces the umbilicus, ascends through the heart, enters the throat, reaches the chin, circles the lips, and connects to the center below both eyes. The Du Mai governs all Yang in the body, corresponding to the heavenly way circling the earth. Thus, the downward-flowing part rises: following the penis to the perineum, piercing the umbilicus, entering the throat, reaching the chin, circling the lips, and connecting to the eyes. The upward-flowing part starts at the inner canthus, ascends the forehead, crosses the vertex, descends the nape, flanks the spine to the waist, and circles the front and back of the body. The branch collateral of the Du Mai emerges at Changqiang (GV1), flanks the spine upward, and disperses on the head. Thus, the Du Mai flows down the spine from the head/neck, while its branch collateral flows up from the lower body to the head/neck. "Excess and Deficiency" refer to the Root Qi's state; "Abnormalities" refer to meridians with pathogenic invasion. Shang Yugong stated: Summarizing "abnormal meridians" after the Du Mai clarifies that excess and deficiency refer to Root Qi, not pathogenic excess. Zhu Yongnian stated: The great collaterals of Ren and Du Mai run counter-current and reverse to the meridians. It should be known that the twelve branch collaterals, although running parallel to the meridians, also move in reverse and counter directions.
The great collateral of the Spleen is named Dabao (SP21), emerging three cun below Yuan Ye (GB24), and spreading across the chest and hypochondrium. In excess conditions, there is pain throughout the body; in deficiency conditions, all joints become flaccid. This vessel, resembling a net of blood collaterals, should be treated. This is the great collateral of the Spleen. Dabao (SP21) is an acupoint name, located three cun below Yuan Ye (GB24) of the Foot-Shaoyang Gallbladder Meridian. The great collateral of the Spleen follows Dabao (SP21) of the Spleen Meridian and spreads to the chest and hypochondrium. Excess causes whole-body pain; deficiency causes joint flaccidity. "Net-like blood" refers to the Qi and Blood of the great collaterals dispersing into the Sun Luo and skin of the entire body,纵横 like a mesh network. Since the Spleen has a great collateral, it is because the Spleen governs transporting fluids for the Stomach, irrigating the five Zang and four margins, spreading via the great collateral to the whole body. Thus, disease causes whole-body pain and joint flaccidity, with blood collaterals resembling a mesh network. The great collateral of Foot-Taiyin only runs parallel to the meridian, distributing Qi and Blood to its own region. Therefore, the Foot-Taiyin Spleen has two collaterals. Saying "Meridian of Foot-Taiyin Spleen" includes both the Moving and Generating diseases. Saying "Great Collateral of Foot-Taiyin" or "Great Collateral of Spleen" distinguishes the Qi of the Spleen Zang.
Regarding these fifteen collaterals: In excess conditions, they must be visible externally; in deficiency conditions, they must sink internally. If not seen, seek them above and below. Human meridians vary, and collateral divergence sites differ. When the Qi and Blood of these fifteen great collaterals are full, they overflow into the Sun Luo and skin, so excess conditions are visible. In deficiency, they sink into the internal great collaterals, so they are invisible. "Seeking above and below" means seeking collaterals that intersect between upper and lower Yin and Yang. Disease above seeks below; disease below seeks above; disease in Yin treats Yang; disease in Yang treats Yin. Although the fifteen great collaterals interact with the meridians, they distribute to the four extremities, have no fixed location, do not enter the Shu points, and intersect with the main meridians. Thus, they differ from human meridians, and collateral divergence sites vary. Shang Yugong stated: Meridians have meridian collaterals, and Jing Bie have Jing Bie collaterals. Hence, collateral divergence sites differ.