太阴之筋。上结于肘中廉、曲泽之次。
上臂阴(止)挟胁 张云。上臂阴天泉之次。由曲腋间并太阴之筋。结于腋下。当天池之次。下行
前后。布散挟胁。联于手太阴足少阳之筋。
结于臂 张云。臂、当作贲。盖此支并太阴之筋。入散胸中。故同结于贲也。志云。臂当作贲。贲
叶臂。散于胸中。结于贲门。故成息奔也。
支转筋 甲乙。筋、下有痛手心主四字。
孟冬痹 张云。手厥阴以两阴交尽之经。故应十月之气。
手少阴之筋(止)结肘内廉 张云。小指内侧。少冲次也。
结于锐骨、神门次也。肘内廉。少海次也。
循臂 张云。臂字亦当作贲。盖心主少阴之筋。皆与太阴合于贲而下行也。楼氏云。臂、当作胸。
心承伏梁 下为肘网 张云。承、承于下也。伏梁坚伏之积也。网、如罗网之牵急也。手少阴之筋。
起于小指内侧。结于锐骨上结肘内廉。上入腋挟乳里。结于胸中。下系于脐。故在内则为内急。为伏梁。在外
则为肘网。及当其所过之处。则为转筋等病。
经筋之病(止)无用燔针 张云。此以下皆结上文经筋为病而总言之也。马云。寒急有阴阳之分。背
为阳。阳急则反折。腹为阴。阴急则俯不伸。故制为 刺者。正为寒也。( 刺即燔针)简案、张以阳急阴急
为足太阳少阴。非。
名曰季冬痹 楼氏以此五字。移前段唾血脓者死不治下。张同。云手少阴之经。应十二月之气也。
此节旧在后无用燔针之下。盖误次也。今移正于此。
足之阳明(止)皆如上方也 甲乙。 、作僻。马云。 、僻同。口僻之义。此申言胃与小肠二经之
筋。其有病当治法如前也。足之阳明胃经。手之太阳小肠经。其筋若急。则口与目皆为 。其目 亦急。不
能猝然视物。治之者。用燔针以劫刺之。以知病为刺数。以痛处为输穴。故曰治法如右方也。前俱详言。而又
申言之。叮咛之意也。简案、志以上方为右 之方。误甚。
足太阴脾经的筋脉,向上结聚于肘关节内侧及曲泽穴部位。
在上臂内侧(此处“止”字为衍文或误植),挟持胁肋部。张云指出:上臂阴天泉穴部位。从腋窝中间与手太阴肺经的筋脉并行,结聚于腋下,对应天池穴部位。向下行于身体前后,散布并挟持胁肋,联络着手太阴肺经和足少阳胆经的筋脉。
结聚于手臂(张云认为:“臂”字应当作“贲”。因为这一分支并入太阴经的筋脉,进入并散布于胸中,所以共同结聚于贲门)。志云认为:“臂”应当作“贲”,“贲”音同“臂”,散布于胸中,结聚于贲门,因此形成喘息奔迫的症状。
支转筋(《甲乙经》记载:在“筋”字下还有“痛手心主”四个字)。
孟冬痹证(张云指出:手厥阴心包经是两阴交尽的经脉,所以应合十月的气候之气)。
手少阴心经的筋脉(此处“止”字为衍文或误植)结聚于肘关节内侧。
张云指出:小指内侧,少冲穴部位。
结聚于锐骨(神门穴部位)。肘关节内侧,少海穴部位。
循行于手臂(张云指出:“臂”字也应当作“贲”。因为心主包络和手少阴心经的筋脉,都与太阴经会合于贲门然后下行)。楼氏说:“臂”字应当作“胸”。
心脏承受伏梁病(下部形成肘网)(张云解释:“承”意为承受于下方。“伏梁”是指坚硬潜伏的积块。“网”如同罗网的牵拉拘急一样。手少阴心经的筋脉,起于小指内侧,结聚于锐骨上,进而结聚于肘关节内侧,向上进入腋窝,挟持乳房内部,结聚于胸中,向下系连于肚脐。所以在体内则表现为内部拘急、伏梁病;在体表则表现为肘部的网状拘急,以及经过之处出现的转筋等疾病)。
经筋的疾病(此处“止”字为衍文或误植)不要使用燔针(火针)(张云指出:以下文字都是总结上文关于经筋疾病的论述。马云说:寒邪导致的拘急有阴阳之分。背部属阳,阳侧拘急则身体向后反折;腹部属阴,阴侧拘急则身体向前弯曲不能伸直。所以制定用燔针刺法,正是为了治疗寒邪。(燔针即火针)简案评论:张云将阳急阴急理解为足太阳和足少阴经是错误的)。
名称叫做季冬痹证(楼氏将这五个字移到前一段“唾血脓者死不治”之下,张云赞同。张云说:手少阴心经应合十二月的气候之气。这一节原文旧时在“无用燔针”之下,大概是次序错误。现在将其移正到此处)。
足阳明胃经(此处“止”字为衍文或误植)治疗方法都如上方所述(《甲乙经》记载:“ ”字写作“僻”。马云说:“ ”与“僻”同义,指口眼歪斜的意思。这里进一步说明胃经和小肠经的筋脉,如果有疾病,其治疗方法如同前文所述。足阳明胃经和手太阳小肠经的筋脉如果发生拘急,则口部和眼部都会出现歪斜。眼部歪斜也会拘急,不能突然视物。治疗时,使用燔针进行劫刺,以病情好转为停止针刺的标准,以疼痛处作为输穴。所以说治疗方法如右方所述。前面已经详细言说,这里又再次申述,表达了叮咛告诫之意。简案评论:志云将“上方”理解为右侧的方法,错误很大)。
The sinews of the Foot-Taiyin (Spleen) channel ascend and knot at the medial aspect of the elbow joint and the region of Quze (PC3).
On the medial aspect of the upper arm (the character "Zhi" here is likely a scribal error or interpolation), they flank the hypochondrium. Zhang Yun notes: the region of Tianquan (PC15) in the upper arm. From the axillary space, running parallel with the sinews of the Hand-Taiyin (Lung) channel, they knot at the axilla, corresponding to the region of Tianchi (PC17). Descending anteriorly and posteriorly, they spread out flanking the hypochondrium, connecting with the sinews of the Hand-Taiyin (Lung) and Foot-Shaoyang (Gallbladder) channels.
They knot at the arm (Zhang Yun states that "Bi" [arm] should be read as "Ben" [diaphragm/epigastrium]. This branch merges with the Taiyin sinews, entering and spreading within the chest, thus knotting together at Ben). Zhi Yun also states that "Bi" should be "Ben"; "Ben" sounds like "Bi", spreads within the chest, and knots at the贲门 (cardia/pylorus region), thereby causing panting and rushing sensations (Xiben).
Branches with spasms (The *Jiayi Jing* records four additional characters under "sinew": "pain, hand-shao-yin zhu" [Heart Pericardium]).
Mengdong Bi syndrome (Zhang Yun notes: The Hand-Jueyin (Pericardium) channel is where two Yin channels converge, thus it corresponds to the Qi of the tenth month).
The sinews of the Hand-Shaoyin (Heart) channel (the character "Zhi" here is likely a scribal error or interpolation) knot at the medial aspect of the elbow.
Zhang Yun notes: the medial side of the little finger, the region of Shaochong (HT9).
They knot at Ruigu (the styloid process of the ulna, region of Shenmen HT7). At the medial aspect of the elbow, the region of Shaohai (HT3).
Running along the arm (Zhang Yun notes that "Bi" should also be "Ben". Because the sinews of the Heart Pericardium and Hand-Shaoyin (Heart) all merge with the Taiyin at Ben before descending). Lou Shi says that "Bi" should be "Xiong" [chest].
The heart bears the Fuliang disease (lower formation of Zhouwang) (Zhang Yun explains: "Cheng" means bearing from below. "Fuliang" refers to a hard, latent accumulation mass. "Wang" resembles the tension of a net. The sinews of the Hand-Shaoyin (Heart) channel originate from the medial side of the little finger, knot at Ruigu, then ascend to knot at the medial aspect of the elbow, enter the axilla, flank the interior of the breast, knot in the chest, and descend to tie to the umbilicus. Therefore, internally it manifests as internal tightness and Fuliang; externally it manifests as Zhouwang at the elbow, and conditions such as spasms at the sites they traverse.)
Diseases of the sinews (the character "Zhi" here is likely a scribal error or interpolation) do not use Fanthen (burning needle/fire needle) (Zhang Yun states: The following text summarizes the discussion on diseases of the sinews mentioned above. Ma Yun says: Tightness caused by cold has Yin and Yang distinctions. The back is Yang; Yang tightness causes opisthotonos (backward bending). The abdomen is Yin; Yin tightness causes flexion inability to extend. Thus, the method of Fanthen acupuncture was formulated specifically for cold pathogens. (Fanthen is synonymous with fire needle)). Jian An comments: Zhang Yun's interpretation of Yang tightness and Yin tightness as referring to the Foot-Taiyang and Foot-Shaoyin channels is incorrect.
It is named Jidong Bi syndrome (Lou Shi moved these five characters to follow the previous paragraph's "death due to hemoptysis and purulent sputum," which Zhang Yun agrees with. Zhang Yun says: The Hand-Shaoyin (Heart) channel corresponds to the Qi of the twelfth month. This section was originally placed after "do not use Fanthen," likely due to a textual ordering error. It is now corrected and placed here.)
The Foot-Yangming (Stomach) channel (the character "Zhi" here is likely a scribal error or interpolation); treatments are as described above (The *Jiayi Jing* writes the character as "Pi". Ma Yun says "Pi" and "Pi" [crooked/deviated] are synonymous, meaning facial deviation. This further elaborates that if the sinews of the Stomach and Small Intestine channels are diseased, their treatment follows the aforementioned methods. If the sinews of the Foot-Yangming Stomach channel and Hand-Taiyang Small Intestine channel become tight, both the mouth and eyes will deviate. Eye deviation also involves tightness, preventing sudden visual focus. Treatment uses Fanthen for Ji Ci (robbing/stabbing technique), stopping when the patient reports improvement ("zhi"), using painful spots as acupoints. Hence, it is said that the treatment method is as described above/right. The details were previously stated, and this restatement conveys an admonitory tone. Jian An comments: Zhi Yun's interpretation of "above method" as referring to the right side is a significant error.).