《黃帝素問靈樞集註》Vol. 5

Lei Gong inquired of the Yellow Emperor about the channels and vessels: "The fundamental principle of acupuncture treatment begins with understanding the channels. I beg you to explain in detail how the channels circulate, how to measure their length, and their correspondences with the five zang organs internally and the six fu organs externally."

The Yellow Emperor replied: "When a human is conceived, the first thing formed is the prenatal Jing (essence). When this essence condenses, it produces the brain and marrow. The bones serve as the body's supporting pillars, the channels transport nourishment, the tendons provide strength, the muscles form protective walls, the skin gradually toughens, and the hair begins to grow. When food enters the stomach, the channel pathways become unobstructed, allowing Qi and blood to circulate properly."

Lei Gong requested a detailed explanation of how the channels are generated. The Yellow Emperor expounded: "The channel system can determine life and death, diagnose various diseases, and regulate excess and deficiency in the body—it is essential knowledge that physicians must master."

He specifically described two main channels:

The first is the Hand Taiyin Lung Channel (the channel corresponding to the lungs). It originates at the middle burner (the junction of chest and abdomen), descends to connect with the large intestine, then returns to encircle the stomach before ascending through the diaphragm to enter the lungs. From the trachea system, it extends laterally to the armpit, descending along the inner side of the upper arm, passing in front of the Heart and Pericardium channels, reaching the cubital fossa. It then follows the radial side of the inner forearm, enters the cunkou pulse point at the wrist, passes through the thenar eminence, and finally terminates at the tip of the thumb. A branch extends from behind the wrist directly to the radial side of the index finger.

When this channel is disordered, symptoms include lung distension, coughing with wheezing, pain in the supraclavicular fossa, and in severe cases, crossing the arms over the chest with dizziness (called "arm reversal"). It governs lung diseases, manifesting as cough with rebellious Qi, thirst, heart vexation, chest fullness, pain along the anterior border of the inner upper arm, and heat in the palms. In excess patterns (Qi and blood excess), there is shoulder and back pain, fear of wind, sweating, frequent urination, and shortness of breath. In deficiency patterns (Qi and blood insufficiency), there is cold in the shoulder and back, faint breathing, and abnormal urine color. The treatment principle is: drain for excess patterns, supplement for deficiency patterns; use swift needling for heat patterns and retained needles for cold patterns; use moxibustion for sunken points; for neither deficiency nor excess, regulate using the channel's own points. In excess patterns, the cunkou pulse is three times larger than the renying pulse; in deficiency patterns, the cunkou pulse is conversely smaller than the renying pulse.

The second is the Hand Yangming Large Intestine Channel, which begins at the tip of the index finger. It ascends along the radial side of the index finger, passes through the Hegu point (between the first and second metacarpal bones), enters the depression between the two tendons, and ascends along the outer forearm to the outer elbow. From there, it travels along the anterior border of the outer upper arm to the shoulder, passes the anterior border of the acromion, ascends to the seventh cervical vertebra, then descends to enter the supraclavicular fossa where it connects with the lungs. It then descends through the diaphragm to connect with the large intestine. A branch ascends from the supraclavicular fossa to the neck, penetrates the cheek, and enters the lower gums.

This passage describes the pathway of the Stomach Channel of Foot-Yangming (足阳明胃经) in the human body, along with its associated disorders and treatment principles.

The Stomach Channel originates from both sides of the nose, descending to enter the upper gums, encircling the lips, and converging at the center of the chin. It then follows the mandible's edge to the throat, passes through the collarbone into the thoracic cavity, connects with the stomach and links to the spleen. One branch descends from the collarbone through the inner side of the breasts, running along both sides of the navel into the groin, then continuing down the front of the thigh, knee, and outer side of the lower leg, finally reaching the instep and middle toe. Another branch separates three inches below the knee, extending to the outer side of the middle toe, while a further branch diverges from the instep to terminate at the tip of the big toe.

When this channel malfunctions, the following symptoms may appear: chills with shivering, frequent yawning, dark facial complexion, aversion to people and firelight, being startled by the sound of wood (五行-Wuxing/ Five Phases element), preference for solitude with doors and windows closed. In severe cases, patients may climb to high places singing, strip off clothes and run wildly, or experience abdominal distension (called "Gan Jue"). This channel governs blood-related disorders, potentially manifesting as mania, malaria, abnormal sweating, nosebleeds, facial paralysis, lip rashes, neck swelling and pain, sore throat, abdominal edema, knee swelling and pain. Pain may occur along the channel's pathway including the chest, breasts, groin, thighs, outer lower legs, and instep, with impaired movement of the middle toe.

Treatment principles are: for excess patterns (Qi surplus) showing heat and swelling along the channel, use draining techniques; for deficiency patterns (Qi insufficiency) presenting with chills and shivering, apply tonifying methods; heat syndromes require swift needling, while cold syndromes need retained needles; channel collapse calls for moxibustion; for neither deficient nor excess conditions, select points from this channel. To assess deficiency/excess, compare the pulse strength at Renying (ST-9, carotid artery) and Cunkou (wrist pulse): in excess patterns, the Renying pulse is three times stronger than Cunkou; in deficiency, Renying becomes weaker than Cunkou.

This scripture primarily discusses the meridian pathways of the Spleen, Heart, and Small Intestine channels along with their corresponding treatment principles for related disorders.

The Spleen Channel (Foot Taiyin meridian) originates from the inner side of the big toe, follows the white fleshy border along the inner foot, passes behind the ankle bone, ascends along the inner calf, traverses the knee and inner thigh, enters the abdominal cavity to connect with the spleen, then continues upward through the stomach and diaphragm, distributing along the throat to reach the root of the tongue. When this meridian malfunctions, symptoms may include tongue stiffness, vomiting, stomach pain, abdominal distension, and belching. Patients often find relief after bowel movements or passing gas, though they may experience general bodily heaviness. The treatment principles are: draining method for excess patterns, tonifying method for deficiency patterns, swift needling for heat patterns, retained needles for cold patterns, moxibustion for sunken pulses, and selecting points along the meridian for balanced conditions without evident deficiency or excess.

The Heart Channel (Hand Shaoyin meridian) emerges from the heart, descending to connect with the small intestine while a separate branch ascends through the throat to link with the eyes. Disorders of this channel may manifest as throat dryness, heart pain, thirst with desire to drink, and can also cause yellowing of the eyes, hypochondriac pain, inner arm pain, and burning pain in the palms. The treatment principles mirror those of the Spleen Channel: draining excess, tonifying deficiency, swift needling for heat, retained needles for cold, moxibustion for sunken pulses, and meridian-based point selection for balanced conditions.

While the complete pathway of the Small Intestine Channel isn't fully detailed in this passage, contextual clues suggest its treatment principles align with other meridians. These contents embody the fundamental TCM concept of "pattern differentiation and treatment determination" (辨证论治), where practitioners assess pulse variations (such as comparing the Renying and Cunkou pulses) to diagnose deficiency or excess conditions before applying appropriate acupuncture therapies.

The pathway of the Hand Taiyang Small Intestine Meridian (one of the twelve primary meridians) runs as follows: Beginning at the tip of the little finger, it ascends along the outer side of the hand's dorsum to the wrist, emerging between the wrist's bony prominences. It continues along the lower border of the forearm bone, passing between two tendons at the inner elbow joint, then ascends along the posterior outer edge of the upper arm. After traversing behind the shoulder joint and circling the scapula, it intersects with the Foot Taiyang meridian at the shoulder before entering the supraclavicular fossa (Quepen point). From there it descends to connect with the heart, follows the esophagus through the diaphragm, and finally reaches the stomach, belonging to the small intestine. A branch ascends from the supraclavicular fossa along the neck, passes the cheek to the outer canthus, then turns inward to enter the ear. Another branch separates at the cheek, ascending to the bridge of the nose and connecting diagonally with the zygomatic region.

Abnormalities in this meridian manifest as: sore throat, jaw swelling restricting head movement, shoulder pain as if being pulled, and upper arm pain resembling a fracture. It primarily governs fluid metabolism, with related disorders including deafness, yellowed eyes, swollen cheeks, and pain along the neck, jaw, shoulder, elbow, and posterior outer arm. Treatment varies by presentation: draining method for excess patterns, tonifying for deficiency, swift needling for heat, retained needles for cold, moxibustion for sunken pulses, and standard point selection for balanced conditions. Excess manifests as the Renying pulse (carotid) being twice as strong as the Cunkou (radial), while deficiency shows the reverse.

The Foot Taiyang Bladder Meridian pathway originates at the inner canthus, ascending across the forehead to converge at the vertex. A branch reaches the upper ear region, while the main channel enters to connect with the brain before descending along the neck. It passes the inner scapula region, running parallel to the spine to the lumbar region where it connects deeply with the kidneys before terminating at the bladder. A lumbar branch descends through the buttocks to the popliteal fossa; another diverges bilaterally from the inner scapula, descending along the posterior thigh and lateral femur to reunite at the popliteal fossa, then continuing through the calf muscle to emerge behind the external malleolus and follow the fifth metatarsal to the little toe's outer side.

Meridian dysfunction causes: severe headache, eye distension, neck rigidity, spinal pain, lumbar pain like breaking, stiff thighs, tight popliteal fossae, and calf pain resembling splitting (termed "ankle reversal"). It primarily governs tendon functions, with pathologies including hemorrhoids, malaria, manic-depressive disorders, vertex headache, yellow eyes with tearing, nosebleeds, and pain along the neck, back, lumbar, buttock, popliteal, calf and foot regions, plus little toe immobility. Treatment follows the same principles as the Hand Taiyang meridian, applying supplementation, drainage, needling or moxibustion according to deficiency/excess and heat/cold patterns.

The Foot Shaoyin Kidney Meridian pathway begins below the small toe... (subsequent content not fully provided in original text)

This passage describes the circulation pathways of the Kidney and Pericardium meridians in the human body along with their associated disorders.

The Kidney meridian originates at the Yongquan (Gushing Spring) point on the sole of the foot, passes behind the inner ankle, ascends along the inner side of the lower leg, moves behind the knee, and continues upward along the posterior inner thigh. It penetrates the spine to connect with the kidneys, with a branch linking to the bladder. The main pathway proceeds upward through the liver and diaphragm into the lungs, following the throat to reach the root of the tongue. When this meridian is imbalanced, symptoms may include hunger without desire to eat, dark facial complexion, coughing blood, panting, restlessness, blurred vision, palpitations, and heart fluttering. Kidney meridian deficiency often manifests as fearful anxiety, as if being pursued—a condition called "bone reversal." Other related disorders encompass dry mouth and throat, sore throat, heart vexation and pain, jaundice with diarrhea, inner thigh and leg pain, excessive sleepiness, and burning pain in the soles. Treatment principles involve draining excess conditions, supplementing deficiencies, swift needling for heat patterns, retained needles for cold patterns, and moxibustion for sinking Qi.

The Pericardium meridian (Hand Jueyin) begins in the chest cavity, descending through the diaphragm to connect with the triple burner (Sanjiao). Its main branch runs along the chest to the armpit at three cun below, then descends along the inner upper arm to the elbow, passing between two tendons in the forearm into the palm, following the middle finger to its tip. Another branch separates at the palm, running along the ring finger to its extremity. Meridian dysfunction manifests as hot palms, arm spasms, swollen armpits, chest and rib-side distension, violent heartbeat, red face with yellow eyes, and uncontrollable laughter. The Pericardium meridian governs blood vessel-related disorders, commonly presenting as heart vexation, heart pain, and palm heat. Treatment follows the same principles as the Kidney meridian, employing different needling techniques according to excess/deficiency and heat/cold conditions.

The Triple Burner meridian (Hand Shaoyang) originates at the tip of the ring finger, ascending between the fourth and fifth metacarpal bones—this briefly outlines its initial pathway.

This meridian originates between the two bones on the outer side of the wrist, ascends along the outer aspect of the arm past the elbow, continues upward along the outer upper arm to the shoulder, where it intersects with the Foot Shaoyang meridian before entering the supraclavicular fossa (quepen). It distributes in the chest center (danzhong), connects with the pericardium, descends through the diaphragm, and sequentially belongs to the upper, middle, and lower Sanjiao (Triple Burner).

A branch diverges from the chest upward to emerge at the supraclavicular fossa, ascends along the neck to connect behind the ear, rises directly to the superior auricular angle, then curves downward to reach the cheek. Another branch enters the ear from behind, emerges in front of the ear, passes through the cheek region, and reunites with the previous branch at the outer canthus (outer eye corner).

Pathological manifestations of this meridian include deafness, tinnitus, and sore swollen throat. It governs disorders caused by Qi (vital energy) imbalance, presenting as sweating, pain in the outer eye corner, cheek pain, and pain along the posterior ear, shoulder, upper arm, elbow, and outer forearm, with stiffness in the ring finger. Treatment principles: draining method for excess patterns, tonifying method for deficiency patterns, swift needling for heat patterns, retained needles for cold patterns, moxibustion for sunken pulses, and selecting points along this meridian for balanced conditions. Excess manifests as the renying pulse being twice as strong as the cunkou pulse, while deficiency shows the renying pulse weaker than cunkou.

The Foot Shaoyang Gallbladder Meridian begins at the outer canthus, ascends to the head's corner, descends behind the ear, runs along the neck anterior to the Hand Shaoyang meridian, reaches the shoulder where it crosses posterior to Hand Shaoyang to enter the supraclavicular fossa. A branch enters the ear from behind, emerges anteriorly, then returns posterior to the outer canthus. Another branch separates at the outer canthus, descends to the mandible (daying), meets Hand Shaoyang at the lower cheek, continues past the mandibular angle (jiache), descends along the neck to reunite with the supraclavicular branch, enters the chest, penetrates the diaphragm to connect with the liver, belongs to the gallbladder, descends along the rib interior, passes through the groin (qijie), circles the pubic hairline, and enters the hip joint (bixi) laterally.

The main meridian descends from the supraclavicular fossa to the armpit, runs along the thoracic side past the hypochondrium, descends to meet at the hip joint, continues downward along the outer thigh, emerges at the knee's outer side, descends to the anterior border of the fibula (outer supporting bone), reaches the fibula's lower end (juegu), continues to the outer ankle's front, and follows the foot dorsum between the fourth and fifth toes. A subsidiary branch separates at the foot dorsum, enters the web between the big toe and second toe, follows the big toe's medial border to its tip, then curves back through the nail to emerge at the toe's hairy region.

Pathological manifestations include bitter taste, sighing, chest and hypochondriac pain preventing turning, severe cases showing dust-like gray complexion with dull skin, and heat in the foot's outer side—this constitutes "yang reversal" disorder. It governs bone-related conditions: headache, mandibular pain, outer canthus pain, swollen painful supraclavicular fossa, armpit swelling, scrofula (madao xiaying), sweating with chills, malaria, and pain in the chest, ribs, outer thigh, outer knee, outer calf, front of outer ankle and all joints, with stiffness in the fourth toe.

This scripture primarily discusses the pathological manifestations of human meridian disorders, their treatment methods, and the symptoms of Qi exhaustion in specific meridians. I will explain it in several sections:

Regarding disorders of the Foot Shaoyang Gallbladder Meridian, the following symptoms may appear: sweating in the armpits, chills and shivering, malaria-like conditions, pain along the chest, ribs, and the outer thigh down to the lower leg and front of the ankle, as well as impaired movement of the little toe and fourth toe. Treatment methods should be adapted to the condition: draining techniques for excess patterns, tonifying techniques for deficiency patterns, swift needling for heat patterns, retained needles for cold patterns, moxibustion for sinking Qi, and selecting points along the meridian itself for balanced conditions without clear deficiency or excess. In excess patterns, the Renying pulse (carotid artery) will be twice as strong as the Cunkou pulse (wrist pulse), while in deficiency patterns, the Renying pulse will be weaker than the Cunkou pulse.

The Foot Jueyin Liver Meridian pathway begins at the big toe, traverses the instep and inner ankle, ascends along the inner thigh to enter the genital region, encircles the reproductive organs, reaches the lower abdomen, connects with the liver and gallbladder, then passes upward through the diaphragm to distribute along the ribcage, continues behind the throat to connect with the eyes, and finally meets the Governor Vessel (Du Mai) at the crown of the head. Liver Meridian disorders can cause back pain preventing bending or stretching, hernias in men, abdominal distension in women, and in severe cases, dry throat and dull facial complexion. The treatment approach resembles that for the Gallbladder Meridian, but with opposite pulse diagnosis: in excess patterns, the Cunkou pulse will be twice as strong as the Renying pulse, while in deficiency patterns, the Cunkou pulse will be weaker than the Renying pulse.

When Qi exhaustion occurs in the Hand Taiyin Lung Meridian, the skin and body hair become dry and withered, as the lungs govern the skin and body hair. When body fluids fail to nourish properly, it leads to parched nails and hair loss - these are signs of impending Lung Qi collapse. The condition worsens on Bing days (associated with Fire) and death may occur on Ding days (also Fire), because Fire overcomes Metal (the Lung's elemental association).

With Qi exhaustion in the Hand Shaoyang Heart Meridian, blood vessels become obstructed. When blood ceases to flow, the complexion turns dark like lacquered firewood - this indicates impending Heart Qi collapse. The condition worsens on Ren days (associated with Water) and death may occur on Gui days (also Water), because Water overcomes Fire (the Heart's elemental association).

During Qi exhaustion of the Foot Taiyin Spleen Meridian, muscles lose their nourishment, as the spleen governs the muscles. Since lips and tongue are the roots of muscular tissue, muscle atrophy causes tongue flaccidity and swelling of the philtrum (the groove above the upper lip) - these are signs of impending Spleen Qi collapse.

This scripture primarily discusses the manifestations of meridian Qi-blood depletion and corresponding signs of impending death, as well as the distinction between main meridians and collateral vessels.

When the Qi-blood of the Foot Shaoyin Kidney Meridian (which governs bones) becomes exhausted, the bones will wither. The Kidney Meridian resembles winter's pulse quality, deeply nourishing the bone marrow. Without this nourishment, muscles will atrophy and slough off. After the separation of bone from flesh, teeth appear elongated and yellowish, while hair loses its luster. This condition worsens on Wu days (Earth element days) and leads to death on Ji days (Earth element days), as Earth overcomes Water in the Five Phases cycle.

When the Qi-blood of the Foot Jueyin Liver Meridian (which governs tendons) becomes exhausted, the tendons lose their function. The Liver governs tendons, which gather in the genital region and connect to the tongue root. Meridian depletion causes tendon constriction, manifesting as bluish lips, curled tongue, and scrotal retraction. This condition worsens on Geng days (Metal element days) and leads to death on Xin days (Metal element days), as Metal overcomes Wood.

If the Yin Qi of all five zang organs becomes exhausted, the eyeballs will rotate incessantly - a sign of imminent Shen (spirit) dissipation, with death occurring within a day and a half. When the Yang Qi of the six fu organs becomes severed, causing Yin-Yang separation, cold sweats appear. Morning-onset cases lead to evening death, while evening-onset cases lead to morning death.

Main meridians typically lie deep between muscles and remain invisible. The visible portion near the ankle belongs to the Foot Taiyin Spleen Meridian. All superficial visible vessels are collateral vessels. Major collaterals like the Hand Yangming and Hand Shaoyang emerge between fingers and converge at the elbows. When drinking alcohol, defensive Qi first circulates to the skin, filling the collateral vessels before the meridians become vigorous.

The Yellow Emperor explains: Meridians are generally invisible - their deficiency or excess must be assessed at the Qi pulse (diagnostic location). Visible vessels are always collaterals. Collateral vessels don't pass through major joints but traverse special pathways, ultimately converging beneath the skin. Therefore, when needling collaterals, one should target nodular blood stasis sites.

(Note: References like "worsens on Jia day, death on Yi day" reflect ancient calendrical prognosis using heavenly stems and earthly branches, demonstrating the Five Phases mutual conquest theory's medical application.)

This scripture primarily discusses the diagnostic examination of human meridians and their corresponding acupuncture treatments.

The text first explains methods for examining collateral vessels: A bluish hue in the collaterals indicates cold stagnation with pain, while redness signifies heat syndrome. When cold accumulates in the stomach, the thenar eminence collateral typically appears bluish; when stomach heat is present, it turns red. Sudden darkening suggests longstanding obstruction syndrome. Multicolored collaterals (red, black, blue) indicate alternating cold and heat patterns. Thin and short collaterals reveal Qi and blood deficiency.

For treating cold-heat disorders, practitioners should select engorged blood collaterals for needling, administering treatment every other day until bleeding ceases before rebalancing excess/deficiency conditions. Exceptionally thin and short collaterals indicate severe Qi-blood depletion – bloodletting in such cases may cause chest oppression, with severe instances leading to syncope and aphasia; immediate seated rest is required if chest distress occurs.

The text then details several major meridians:

1. The collateral of the Hand Taiyin (Lung) meridian, named Lieque, branches from above the wrist, follows the Taiyin pathway into the palm, dispersing to the thenar eminence. Excess manifests as palm heat; deficiency as yawning and frequent urination. The acupuncture point lies half a cun above the wrist, with this collateral connecting to the Yangming meridian.

2. The Hand Shaoyin (Heart) collateral Tongli, located 1.5 cun above the wrist, ascends to connect with the heart, linking the tongue root and eyes. Excess presents as substernal distension; deficiency as speech difficulties. Needle 1 cun behind the palm, with the collateral extending to the Taiyang meridian.

3. The Hand Jueyin (Pericardium) collateral Neiguan emerges 2 cun above the wrist between tendons, connecting upward to the pericardium. Excess causes heart pain; deficiency manifests as neck stiffness. The treatment point lies between the tendons.

4. The Hand Taiyang (Small Intestine) collateral Zhizheng, 5 cun above the wrist, connects internally to Shaoyin. Excess shows as joint laxity and elbow weakness; deficiency may produce warts or small rashes. Needle at the branching point.

5. The Hand Yangming (Large Intestine) collateral Pianli, 3 cun above the wrist, connects to Taiyin. Excess manifests as dental caries and deafness; deficiency as tooth coldness and obstruction. Treat at the branching site.

6. The Hand Shaoyang (Triple Burner) collateral Waiguan circles the arm 2 cun above the wrist before entering the chest. Excess causes elbow spasms; deficiency results in grasping inability. Needle at the branching location.

7. The Foot Taiyang (Bladder) collateral Feiyang lies 7 cun above the ankle. These passages meticulously document each meridian's pathway, pathological manifestations, and corresponding acupuncture therapies, forming essential foundations for TCM meridian diagnosis and treatment.

This passage describes the distribution, pathways, and corresponding treatments for the fifteen collateral vessels (important branches of the meridian system) in the human body. Each collateral vessel has a specific name, a defined pathway, and treats particular conditions, categorized into excess (shi) and deficiency (xu) syndromes.

The collateral vessel of the Foot Shaoyang (Gallbladder) Meridian is called Guangming (Bright Light), located five cun above the external malleolus, with a branch connecting to the Foot Jueyin (Liver) Meridian. In excess conditions, it manifests as cold limbs; in deficiency, as weak legs unable to stand. Both are treated at this point.

The collateral vessel of the Foot Yangming (Stomach) Meridian is called Fenglong (Abundant Bulge), located eight cun above the external malleolus, with a branch connecting to the Foot Taiyin (Spleen) Meridian. Its ascending branch runs along the outer leg to the head and neck, regulating Qi and blood in all meridians. Excess conditions cause manic or epileptic behavior; deficiency results in weak feet and atrophied calves. Treatment is applied here.

The collateral vessel of the Foot Taiyin (Spleen) Meridian is called Gongsun (Yellow Emperor), one cun behind the big toe’s base, with a branch connecting to the Foot Yangming (Stomach) Meridian. Excess causes severe abdominal pain; deficiency leads to abdominal distension. Treatment is applied here.

The collateral vessel of the Foot Shaoyin (Kidney) Meridian is called Dazhong (Great Bell), circling the heel with a branch connecting to the Foot Taiyang (Bladder) Meridian. Excess causes urinary retention; deficiency results in lower back pain. Treatment is applied here.

The collateral vessel of the Foot Jueyin (Liver) Meridian is called Ligou (Woodworm Canal), five cun above the internal malleolus, with a branch connecting to the Foot Shaoyang (Gallbladder) Meridian. Excess causes sudden scrotal swelling or hernia; deficiency leads to intense genital itching. Treatment is applied here.

The collateral vessel of the Conception Vessel (Ren Mai) is called Weiyi (Tail Screen), spreading across the abdomen. Excess causes skin pain; deficiency results in itching. Treatment is applied here.

The collateral vessel of the Governing Vessel (Du Mai) is called Changqiang (Long Strong), ascending along the spine to the crown of the head. Excess causes spinal rigidity; deficiency leads to heavy, unsteady head movements. Treatment is applied here.

The major collateral of the Spleen Meridian is called Dabao (Great Embracement), located three cun below the armpit. Excess causes full-body pain; deficiency results in loose joints. Treatment is applied here.

The passage concludes by noting that these fifteen collaterals are visibly prominent in excess conditions and sunken in deficiency. If not visible, one should search nearby, as meridian distributions vary among individuals.

This passage provides phonetic annotations and lexical explanations for rare characters in the Yellow Emperor's Inner Classic: Spiritual Pivot (Huangdi Neijing: Lingshu), specifically focusing on pronunciation guides and terminological definitions.

The character "瞀" is pronounced as "wù"; the character "順" follows the "Lieqie" pronunciation (an ancient fanqie phonetic notation system); "髀" is read as "bì," referring to the thigh region; and "骭" is pronounced "hàn," indicating the shinbone.

The reduplicated term "憺憺" is pronounced "dàn dàn," describing a state of mental tranquility. Here, the character "邪" carries the same meaning as "斜" (oblique). The character "焞" employs the "Tuhunqie" fanqie method (an ancient Chinese phonetic system using two common characters to indicate the pronunciation of an uncommon character).

"肬" is pronounced "yóu," referring to skin excrescences. The annotation concludes by specifying that this content appears in the fifth volume of the Collected Commentaries on the Spiritual Pivot of the Yellow Emperor's Inner Classic (Huangdi Neijing Lingshu Jizhu).

These phonetic and lexical annotations assisted ancient physicians in accurately interpreting specialized terminology within classical medical texts, reflecting traditional medicine's precise descriptions of anatomical structures and pathological changes. Terms such as "髀" (thigh) and "骭" (shinbone) remain standard anatomical terminology in Chinese medicine to this day.