马云。服事也。诗大雅板篇。有我言维服。内论脉有关格。宜用灸刺药法。故名篇。志云。篇名禁服者。
诫其佩服而禁其轻泄也。又云。首篇有禁服二字。因以名篇。简案、篇首云。旦暮勒服之。又云。此先师之所
禁。志后说为是。
近者编绝久者简垢 张云。六十篇古经数也。今失其传。编绝简垢。即韦编三绝之谓。垢、尘污也。
盖古时无纸。书于竹简。以熟皮编之。故曰韦编。简案、说文。编、次简也。史孔子世家。读易韦编三绝。前
儒林传注。编、所以联次简也。尔雅疏。简、竹简也。古未有纸。载文于简。谓之简札。
褊浅 史记礼书。褊陋之说。入焉而 。注。褊狭也。
自强于学若细子 简案、强、勉也。勒也。谓自勉强若细子然。未能浑束为一也。
坐私传之也 简案、坐字未详。盖谓于其坐私传之也。
割臂歃血 曲礼疏。割牲左耳。盛以珠盘。又取血盛以玉敦。用血为盟书。书成乃歃血。读书说
文。盟者以血涂口旁曰歃血。淮南齐俗训。胡人弹骨。越人啮骨。中国歃血。所由各异。其于信一也。
斋宿 简案、宿、与肃通。礼。祭统先期。旬有一日。宫宰宿夫人。注。宿、读为肃。戒也。
正阳 简案、正午也。礼祭义。殷人祭其阳。注。阳
谓日中时也。
凡刺之理（止）血尽不殆矣 马云。凡刺之理六句。见前经脉篇。张云。经脉为始。必先明经络也。
营其所行。营行有终始也。知其度量。脉度有短长也。内刺五脏。外刺六腑。分表里出入也。卫气者阳气也。
卫外而为固者也。阳气不固。则卫气失常。而邪从卫入。乃生疾病。故为百病母。泻实则虚。补虚则实。故虚
实乃止。病在血者调之络。邪血去尽。则不殆矣。
夫约方者（止）则神与弗俱 张云。约者要也。约方、约囊。其道同也。囊满弗约。则输泄而倾。
方成弗约。则不切于用。盖杂则不精也。易曰。精义入神。以致用也。不得其精。焉能入神。有方无约。即无
神也。故曰神与弗俱。所谓约者。即前外揣篇。浑束为一之义。
弗满而约之 张云。满言欲博。约言欲精。弗满而约之。谓亦有不由博学而可得其快捷方式者否也。故
曰愿为下村。
寸口主中（止）名曰平人 张云。太阴行气于脏。故寸口主中。阳明行气于腑。故人迎主外。人迎
寸口。一表一里也。故往来相应。欲其大小齐等。若引绳之匀者。是为和调之脉。然人迎主阳。故必于春夏微
大。寸口主阴。故必于秋冬微大。乃谓之平人也。简案、马志。并以左右寸口。为人迎气口释之。失古义矣。
代则乍甚乍间 张云。此言人迎脉也。乍甚乍间。即下文乍痛乍止之谓。志云。乍痛乍止者。病
在血气之交。或在气或在脉。有交相更代之义。故脉代也。
紧痛（止）名曰经刺 按、甲乙张马忘作旦。是。张云。紧则为痛痹。故当取分肉。代因血气不调。
故当取血络。且饮调和之药。脉陷下不起者有寒滞。故宜灸之。若不因血气
之盛虚。而病有留于经络者。则当随经所在。或饮药。或灸刺。以取之也。
人迎四倍者（止）以验其脏腑之病 张云。脉之偏盛至于四倍者。乃为关格不治之证。若一倍、二
倍、三倍。不过为病。而但有轻重之分耳。故当审其致病之本末。察其寒热脏腑而施之治也。
病在足厥阴（止）在手心主 张云。人迎寸口。相为表里。故上文云。人迎一倍。病在足少阳。此云
寸口一倍。病在足厥阴。胆与肝为表里也。一倍而躁。为人迎。在手少阳。寸口在手心。主三焦包络。人表里
也。凡后二倍三倍。表里皆然。
盛则胀满（止）出糜、少气、溺色变 张云。此言寸口脉也。盛则外实中虚。故为胀满、寒中、食不化。
虚则真阴不足。故为热中、出糜、少气、溺色变。糜、谓泄泻糜烂之物。
紧则先刺（止）以经取之 甲乙。徒、作从。马志本取之下。有名曰经刺四字。张云。紧则为寒。故
宜先刺后灸。欲其经易通。寒易去也。脉陷下者。以寒着于血。而血结为滞。故宜灸之也。代则取血络。及不
盛不虚。义见上文。马云。徒灸之徒。但也。志云。夫痛痹在于分腠之气。分腠者。皮肤脏腑之肉理。故病在
阳者。取之分肉。病在阴者。先刺而后灸之。盖灸者。所以启在内在下之气也。代则气分之邪交于脉络。故先
取血络。而后饮药以调之。
可传于大数 马云。大数大义。具本经络始篇。张云。营、经脉也。输、荥输也。大数、大法也。即
经脉、本输、终始、禁服等篇之义。
大数曰（止）无劳也 甲乙作大曰盛则从泻。小曰虚则从补。紧则从灸刺之。且饮药。陷下则从灸之。
亦曰作亦用。
大以弱作代一字。简案、根据甲乙改字。义太明晰。与上文相贯串。马云。以经取之。则取阳经者。不取阴经。
取阴经者。不取阳经。此之谓经治。其饮药灸刺三者。亦可兼行也。且其脉急者。可加导引之功。或脉大而弱
者。则当主于安静。虽有用力。不至大劳也。此乃大法之所在。即约方之要者。而外揣浑束为一之义尽矣。张
云。经取之。即所谓经治者。或饮药。或灸刺。皆可随经所宜而治也。脉急者。邪盛也。宜设法引去之。脉大
以弱者。阴不足也。宜安静以养阴。用力无劳也。
马云说：“服”，指侍奉、顺从。《诗经·大雅·板》篇中说：“有我言维服。”《内经》中论述脉象有“关格”之证，适宜用灸法、刺法和药物疗法，因此以“禁服”命名篇章。王冰注解说：篇名“禁服”，是告诫医者不要随意佩戴（指轻视医道）而禁止其轻率泄密。又说：因为首篇中有“禁服”二字，所以以此命名。简案认为：篇首说“旦暮勒服之”，又说“这是先师所禁止的”，王冰后来的说法是正确的。
“近者编绝，久者简垢”。张景岳注解说：六十篇古经的数量。如今已失传。“编绝简垢”，就是所谓“韦编三绝”的意思。“垢”，指尘污。大概古代没有纸，文字写在竹简上，用熟牛皮绳编连，所以叫“韦编”。简案认为：《说文解字》说，“编”，是编排竹简。《史记·孔子世家》记载孔子读《易》时“韦编三绝”。前《儒林传》注解说：“编”，是用来连接编排竹简的工具。《尔雅疏》说：“简”，是竹简。古代还没有纸，将文字载于简上，称为简札。
“褊浅”。《史记·礼书》中有“褊陋之说，入焉而……”的记载。注解说：“褊”，意为狭小、狭隘。
“自强于学若细子”。简案认为：“强”，意为勉力。“勒”，意为约束。意思是自我勉力学习，像幼童一样，未能将知识融会贯通为一整体。
“坐私传之也”。简案认为：“坐”字的含义不详。大概是说在座席间私下传授医术。
“割臂歃血”。《曲礼疏》记载：割下牲品的左耳，盛放在珠盘中；又取血盛放在玉敦中，用血订立盟书。书成之后才歃血。《说文解字》解释“盟”字时说：用血涂在口旁叫做歃血。《淮南子·齐俗训》说：胡人弹骨，越人啮骨，中原地区歃血，虽然方式各异，但在守信这一点上是相同的。
“斋宿”。简案认为：“宿”，通“肃”。《礼记》祭统篇说：祭祀前十一天，宫宰通知夫人准备。注解说：“宿”，读作“肃”，意为警戒、严肃。
“正阳”。简案认为：指正午时分。《礼记·祭义》说：殷人在阳气旺盛时祭祀。注解说：“阳”，指日中之时。
“凡刺之理……血尽不殆矣”。马云说：关于针刺原理的这六句话，见前文《经脉》篇。张景岳注解说：以经脉为起点，必须首先明了经络。营气所运行的路径，营气的运行有始有终。知道脉度的长短，脉度有短有长。内可刺五脏，外可刺六腑，区分表里出入的关系。卫气就是阳气，护卫体表而固守正气。如果阳气不固，则卫气失常，邪气从卫分侵入，从而产生疾病，所以卫气是百病之母。泻实则使虚，补虚则使实，虚实调理得当即可停止施治。病在血分的，调理络脉；邪气随血液去尽，就不会有危险了。
“夫约方者……则神与弗俱”。张景岳注解说：“约”，意为简要、约束。“约方”与“约囊”道理相同。口袋满了如果不扎紧，就会泄漏倾覆。方剂形成了如果不加精简，就不切合实用。杂乱就不精纯。《易经》说：“精义入神，以致用也。”得不到精粹，怎么能进入神妙境界？有方剂而无精简，就没有神妙之处。所以说“神与弗俱”。所谓的“约”，就是前文《外揣》篇中“浑束为一”的意义。
“弗满而约之”。张景岳注解说：“满”意指想要广博，“约”意指想要精粹。“弗满而约之”，是说是否有不通过博学就能获得捷径的方法呢？所以说“愿为下村”（此处原文可能有误或特指某种谦辞/术语，依原文直译）。
“寸口主中……名曰平人”。张景岳注解说：太阴经行气于脏，所以寸口主内脏病变。阳明经行气于腑，所以人迎穴主体表病变。人迎和寸口，一表一里。所以两者的脉动应当相应，大小相等，就像拉直的绳子一样均匀，这叫调和之脉。然而人迎主阳，所以在春夏季节应当略微盛大；寸口主阴，所以在秋冬季节应当略微盛大，这才叫平人（健康人）。简案认为：马莳和王冰的注释，都以左右寸口来解释为人迎和气口，失去了古义。
“代则乍甚乍间”。张景岳注解说：这里说的是人迎脉。“乍甚乍间”，即下文所说的“乍痛乍止”。王冰注解说：乍痛乍止，是因为病在气血交接之处，或者在气分，或者在脉分，有交替更替的意义，所以脉象表现为代脉。
“紧痛……名曰经刺”。按语：《甲乙经》、张景岳、马莳本均作“旦”，是正确的。张景岳注解说：紧脉则为痛痹，所以应当取分肉部位。代脉因气血不调，所以应当取血络。并且饮用调和的药物。脉象陷下不起的，有寒邪停滞，所以适宜灸法。如果不是因为气血的盛虚，而是病邪留滞于经络，就应当根据经络所在，或者服药，或者灸刺，来进行治疗。
“人迎四倍者……以验其脏腑之病”。张景岳注解说：脉象偏盛达到四倍的，是关格不治之证。如果是一倍、两倍、三倍，不过是有病，只是轻重不同罢了。所以应当审察致病的根本和末节，观察寒热和脏腑情况来实施治疗。
“病在足厥阴……在手心主”。张景岳注解说：人迎和寸口，互为表里。所以上文说人迎一倍，病在足少阳；这里说寸口一倍，病在足厥阴。胆与肝互为表里。一倍且躁动，人迎脉对应手少阳，寸口脉对应手心主（心包），三焦与心包互为表里。凡是后文提到的两倍、三倍，表里关系都是如此。
“盛则胀满……出糜、少气、溺色变”。张景岳注解说：这里说的是寸口脉。盛则外实中虚，所以出现胀满、寒中、食物不消化。虚则真阴不足，所以出现热中、排泄糜烂之物、气短、尿液颜色改变。“糜”，指泄泻时糜烂浑浊的物质。
“紧则先刺……以经取之”。《甲乙经》中“徒”作“从”。马莳本将“取之”放在下面，并有“名曰经刺”四字。张景岳注解说：紧脉则为寒邪，所以适宜先刺后灸，希望经络容易通畅，寒邪容易去除。脉象陷下的，是因为寒邪附着于血，导致血结阻滞，所以适宜灸法。代脉则取血络，以及不盛不虚的情况，意义见上文。马云说：“徒灸之”的“徒”，只是的意思。王冰注解说：痛痹在于分腠之气。分腠，是指皮肤和脏腑之间的肌肉纹理。所以病在阳分的，取分肉部位；病在阴分的，先刺而后灸。大概灸法的作用是激发内在和下部的阳气。代脉则是气分之邪交结于脉络，所以先取血络，然后服药以调和它。
“可传于大数”。马云说：大数的含义，详见本经《经络始》篇。张景岳注解说：营，指经脉；输，指荥输。大数，指大法。即《经脉》、《本输》、《终始》、《禁服》等篇的含义。
“大数曰……无劳也”。《甲乙经》作：大脉盛则从泻，小脉虚则从补，紧脉从灸刺，并且服药。陷下脉从灸法。“亦曰”作“亦用”。
简案认为：根据《甲乙经》改字，义理非常清晰，与上文连贯。马云说：以经取之，就是取阳经不取阴经，取阴经不取阳经，这叫经治。服药、灸、刺三种方法也可以兼用。而且脉急的，可以加用导引之功；或者脉大而弱的，则应当以安静为主。即使用力，也不会过度劳累。这是大法所在，也就是“约方”的要旨，而《外揣》篇“浑束为一”的意义也就完备了。张景岳注解说：经取之，就是所谓的经治。或者服药，或者灸刺，都可以依据经络的适宜情况进行治疗。脉急，说明邪气盛，应当设法引导去除。脉大而弱，说明阴不足，应当安静以养阴，用力不可过劳。
Ma Yun stated: "Fu" refers to serving or obedience. In the "Da Ya" chapter of the *Book of Songs* (Shi Jing), it says, "My words are for obedience." The *Neijing* discusses the pulse condition of "Guan Ge" (關格, obstruction and rejection), which is suitable for treatment with moxibustion, acupuncture, and herbal medicine; hence the chapter is named "Jin Fu" (Forbidden Administration). Wang Bing annotated: The chapter title "Jin Fu" warns against casual adherence (to superficial knowledge) and prohibits reckless disclosure. He further stated that since the first chapter contains the phrase "Jin Fu," the chapter was named accordingly. Jian An's commentary notes: The beginning of the chapter says, "Restrict and administer morning and evening," and also states, "This is what the former masters forbade." Wang Bing's later explanation is considered correct.
"Near ones have broken bindings, long-standing ones have dusty slips." Zhang Jingyue annotated: This refers to the sixty chapters of the ancient classics, which are now lost. "Broken bindings and dusty slips" refers to the idiom "the leather binding of the book broke three times" (Wei Bian San Jue). "Gou" means dust and dirt. Generally, in ancient times when paper did not exist, texts were written on bamboo slips, which were bound together with cured leather strips, hence called "Wei Bian" (Leather Binding). Jian An's commentary cites the *Shuowen Jiezi*: "Bian" means arranging slips. The *Records of the Grand Historian: Hereditary House of Confucius* records that Confucius read the *I Ching* until the "leather binding broke three times." The annotation in the earlier *Biographies of Scholars* states: "Bian" is used to link and arrange slips. The commentary on the *Erya* states: "Jian" refers to bamboo slips. Before the invention of paper, writing on slips was called "Jian Zha" (Slip Notes).
"Bian Qian" (Narrow and shallow). The *Records of the Grand Historian: Book of Rites* mentions "narrow and crude theories." The annotation states: "Bian" means narrow or limited.
"Strengthen oneself in learning like a young child." Jian An's commentary explains: "Qiang" means to strive or exert effort. "Le" means to constrain. It means to strive in learning like a young child, unable to integrate knowledge into a unified whole.
"Sitting and privately transmitting it." Jian An's commentary states: The meaning of the character "Zuo" (sitting/offense) is unclear. It likely implies transmitting medical knowledge privately while seated.
"Cutting the arm and smearing blood with oath." The commentary on the *Qu Li* states: Cut the left ear of the sacrificial animal, place it in a pearl dish; take blood and place it in a jade vessel. Use the blood to write the covenant. After the text is written, smear blood on the lips. The *Shuowen Jiezi* explains "Meng" (oath): Smearing blood on the sides of the mouth is called "Sha Xue" (smearing blood). The *Huainanzi: Qi Su Xun* states: Hu people snap bones, Yue people bite bones, and Chinese people smear blood. Although the methods differ, their commitment to trust is the same.
"Fasting and Solemn Preparation." Jian An's commentary notes: "Su" is interchangeable with "Su" (solemn/respectful). The *Liji: Ji Tong* states: Eleven days before the sacrifice, the palace official notifies the madam. The annotation says: "Su" is read as "Su," meaning to warn or be solemn.
"Zheng Yang" (Correct Sun/Midday). Jian An's commentary states: It refers to midday. The *Liji: Ji Yi* states: The Yin people sacrificed during the Yang time. The annotation says: "Yang" refers to the time when the sun is at its zenith.
"The principles of all acupuncture... until the blood is exhausted, there will be no danger." Ma Yun stated: These six sentences regarding the principles of acupuncture are found in the previous chapter, "Jing Mai" (Meridians). Zhang Jingyue annotated: Starting with meridians, one must first understand the meridian system. Ying Qi (Nutrient Qi) has specific pathways and beginnings/endings in its circulation. One must know the measurements, as pulse lengths vary. Internally, one can puncture the Five Zang organs; externally, one can puncture the Six Fu organs, distinguishing between interior and exterior entry and exit. Wei Qi (Defensive Qi) is Yang Qi, which protects the exterior and consolidates the body. If Yang Qi is not consolidated, Wei Qi becomes abnormal, allowing pathogens to enter from the Wei level, causing disease; thus, Wei Qi is the mother of all diseases. Draining excess makes it deficient; tonifying deficiency makes it sufficient. Therefore, treatment stops when deficiency and excess are balanced. For diseases in the Blood level, regulate the Collaterals; once pathogenic blood is exhausted, there will be no danger.
"To restrict prescriptions... then Spirit does not accompany." Zhang Jingyue annotated: "Yue" means concise or restrictive. Restricting prescriptions is like tying a bag; the principle is the same. If a bag is full but not tied, it leaks and overturns. If a prescription is formed but not refined, it is not practical. Clutter leads to lack of precision. The *I Ching* says: "Essence enters the spirit to achieve utility." Without essence, how can one enter the spiritual realm? Having a prescription without refinement lacks spirit. Hence, "Spirit does not accompany." The so-called "restriction" refers to the meaning of "integrating into one" (Hun Shu Wei Yi) from the previous chapter, "Wai Chuai."
"Not full but restricted." Zhang Jingyue annotated: "Man" (full) implies wanting breadth; "Yue" (restricted) implies wanting precision. "Not full but restricted" asks if there is a shortcut to mastery without extensive study. Hence, "wishing to be [like] Xia Cun" (textual ambiguity retained).
"Cunkou governs the interior... named Ping Ren (Normal Person)." Zhang Jingyue annotated: The Taiyin channel circulates Qi within the Zang organs, so Cunkou governs interior conditions. The Yangming channel circulates Qi within the Fu organs, so the Renying point governs exterior conditions. Renying and Cunkou are exterior and interior, respectively. Their pulses should correspond, being equal in size, like a taut string; this is a harmonious pulse. However, Renying governs Yang, so it should be slightly fuller in Spring and Summer; Cunkou governs Yin, so it should be slightly fuller in Autumn and Winter. This is called a Ping Ren (healthy person). Jian An's commentary notes: Ma Shi and Wang Bing interpreted both left and right Cunkou as Renying and Qikou, losing the ancient meaning.
"Dai pulse indicates alternating severity and remission." Zhang Jingyue annotated: This refers to the Renying pulse. "Alternating severity and remission" corresponds to the later text "alternating pain and cessation." Wang Bing annotated: Alternating pain and cessation occur because the disease is at the intersection of Qi and Blood, or in Qi or in the vessels, having a meaning of mutual substitution; thus, the pulse is Dai (intermittent).
"Tightness causes pain... named Jing Ci (Meridian Puncture)." Note: The *Jia Yi Jing*, Zhang Jingyue, and Ma Shi versions read "Dan" (morning/dawn), which is correct. Zhang Jingyue annotated: Tightness indicates Pain Bi syndrome, so one should select the muscle spaces. Dai pulse indicates irregular Qi and Blood, so one should select blood collaterals. Additionally, drink harmonizing medicines. Pulses that sink and do not rise indicate cold stagnation, so moxibustion is appropriate. If the disease remains in the meridians not due to Qi and Blood excess or deficiency, treat according to the meridian location, using either herbs or moxibustion/acupuncture.
"If Renying is four times stronger... to verify Zang-Fu disease." Zhang Jingyue annotated: A pulse intensity four times greater than normal indicates Guan Ge (Obstruction and Rejection), an untreatable condition. If it is one, two, or three times stronger, it merely indicates disease with varying degrees of severity. Therefore, one must examine the root and branch of the pathology, observe Cold/Heat and Zang-Fu status, and apply treatment accordingly.
"Disease in Foot Jueyin... in Hand Jueyin Xin Bao." Zhang Jingyue annotated: Renying and Cunkou are exterior-interior pairs. Thus, the earlier text states Renying one-time strength indicates Foot Shaoyang disease; here, Cunkou one-time strength indicates Foot Jueyin disease. Gallbladder and Liver are exterior-interior. One-time strength with restlessness in Renying corresponds to Hand Shaoyang; Cunkou corresponds to Hand Jueyin Xin Bao (Pericardium). San Jiao and Pericardium are exterior-interior. This relationship holds for two-times and three-times strengths mentioned later.
"Excess causes distension and fullness... discharge of pus, shortness of breath, change in urine color." Zhang Jingyue annotated: This refers to the Cunkou pulse. Excess indicates exterior excess and interior deficiency, causing distension, interior cold, and indigestion. Deficiency indicates insufficient True Yin, causing interior heat, discharge of purulent material, shortness of breath, and changes in urine color. "Mi" refers to purulent or rotten substances in diarrhea.
"Tightness requires first puncturing... obtain via Meridian." The *Jia Yi Jing* reads "Cong" instead of "Tu." Ma Shi's version places "Qu Zhi" below and adds "Named Jing Ci." Zhang Jingyue annotated: Tightness indicates Cold, so one should puncture first and then moxa, hoping to unblock the meridians and dispel cold. Sinking pulses indicate cold adhering to Blood, causing stasis, so moxibustion is appropriate. Dai pulse requires selecting blood collaterals. The case of neither excess nor deficiency is explained above. Ma Yun stated: "Tu Jiu Zhi Tu" – the second "Tu" means "merely." Wang Bing annotated: Pain Bi resides in the Qi of Fen Cou (muscle intervals). Fen Cou refers to the texture of skin and muscle between organs. Disease in Yang levels selects muscle spaces; disease in Yin levels requires puncturing first, then moxa. Moxibustion activates internal and lower Qi. Dai pulse indicates Qi-level pathogens intersecting with collaterals, so select blood collaterals first, then drink medicine to harmonize.
"Can be transmitted to the General Principles." Ma Yun stated: The general principles are detailed in the opening chapter of the Meridians. Zhang Jingyue annotated: Ying refers to Meridians; Shu refers to Ying-Shu points. Da Shu (General Principles) refers to Great Laws, encompassing the meanings of chapters such as "Jing Mai," "Ben Shu," "Zhong Shi," and "Jin Fu."
"The General Principles state... no labor." The *Jia Yi Jing* reads: Full pulse excess follows draining; small pulse deficiency follows tonifying; tight pulse follows moxa/acupuncture and drinking medicine; sinking pulse follows moxa. "Yi Yue" is read as "Yi Yong." Jian An's commentary notes: Amending characters based on the *Jia Yi Jing* makes the meaning clear and coherent with the preceding text. Ma Yun stated: Obtaining via Meridian means treating Yang meridians without treating Yin, and vice versa; this is called Jing Zhi (Meridian Treatment). Drinking medicine, moxa, and acupuncture can be combined. For urgent pulses, add Dao Yin exercises; for large and weak pulses, prioritize tranquility. Even with effort, avoid excessive fatigue. This is the core of the Great Law, the essence of "Restricting Prescriptions," and fully embodies the "Integrating into One" meaning of "Wai Chuai." Zhang Jingyue annotated: Obtaining via Meridian is Jing Zhi. Whether using medicine, moxa, or acupuncture, treatment follows the meridian's suitability. Urgent pulses indicate strong pathogens, requiring guidance to remove them. Large and weak pulses indicate Yin deficiency, requiring tranquility to nourish Yin; effort should not cause fatigue.