灵台一而不桎）居左之上者曰桎之为人。而属于左足太阳之上也。安安、定静貌。诸不言桎。而此独言者。盖以
水性虽流而为器所局。则安然不动。故云桎也。凡此颊颊之类者。皆所以表水形之象也。志云。桎之为人者。
谓居岗
陵山谷之民众。如山之在上。安然而不动也。盖水性动而不静。故水形之人动手足发行摇身。如居于高陵山谷
之中。受加宫之所胜制。则手足如桎梏而安然不动矣。倪仲宣云。不曰左羽右羽。而曰众之为人。桎之为人。
此即以众桎而为左右也。倪仲玉云。水形之人。岂应桎梏而戮死耶。经义渊微。圣辞古朴。非覃思精粹。岂易
疏也。简案、众羽桎羽。见五音五味篇。
五形之人（止）相欺者是也 马云。此总结上文五行之人。有二十五等之异者。乃众人之难辨而易欺者也。
张云。形分为五。而又分为二十五。禀赋既偏。则不免强弱胜负之相欺。故惟不偏不易。而钟天地之正气者。
斯为阴阳和平之人。是以有圣跖贤愚之别也。杨慎云。相法出于黄帝。虽不能通其详。其大旨可知矣。乃知此
术不始于左传荀子所载。唐举管辂之所师。当出于此。（出升庵外集五十一卷）
形胜色（止）富贵大乐 甲乙。惑、作害。马云。人有形胜色者。如木形人而黄色现也。有色胜形者。如
本形人而白色现也。但此等之人。不以本形之本色相见。而有他色来见。至其形色相胜之时。值有年忌相加。
则感之而病。倘有疏失。则甚可忧矣。如得本形本色相得者。其年当富贵大乐也。张云。胜时年者。如木王土
衰。而又逢丁壬之木运。或东方之干支。或厥阴气候之类。值其王气相加而感之。则病矣。既病而再有疏失。
乃可忧也。简案、张以运气释之。恐非经旨。至其胜时下句。
凡年忌（止）是谓年忌 甲乙凡年忌下上之人大忌。作凡人之大忌五字。似是。张云。此言年忌。始于七
岁以至六十一岁。皆递加九年者。盖以七为阳之少。九为阳之老。阳数极于九而极必变。故自七岁以后。凡遇
九年。皆为年忌。马
云。凡所谓年忌者。乃各经下上之人。大忌其常加也。如太角之人。比是于左足少阳之上。判角之人。比于左
足少阳之下。属木之人也。简案、相胜之时下句。
足阳明之上（止）两吻多画 甲乙髯美髯短髯少及无髯之髯。俱作须。（汉书高祖纪师古注在颐曰须在
颊曰髯）血少气多。作血多气少。气少血多。作气多血少。张云。此下言手足三阳之外候也。足阳明胃经之脉。
行于上体者。循鼻外挟口环唇。故此经气血之盛衰。皆形见于口旁之髯也。吻、口角也。画、纹也。阳明血气
不充两吻。故多纹画。简案、汉周亚夫从理入口而饿死。其理略同。
足阳明之下（止）足痹 甲乙足趾作足大趾。马云。KT 、音祝。释文云。手足中寒疮也。张云。足阳
明之脉。行于下体者。由归来至气街。阴阳总宗筋之会。会于气街。而阳明为之长。故形见于下毛。而或有至
胸至脐也。行则善高举足者。因其血多。盖四肢皆禀气于胃。足受血而能步也。足趾少肉。足善寒者。因其气
少。盖四肢者诸阳之本。阳气不足。则指少肉而善寒也。血少气多。则浮见于外。故下体肉分。多为寒肿也。
悴、憔悴也。足阳明为五脏六腑之海。主润宗筋。束骨而利机关也。今气血俱少于下。故为痿厥足痹等病。楼
云。下毛、阴毛也。简案、KT 、音 。说文。中寒肿核。玉篇。手足中寒疮也。前赵充国传。手足皲KT 。
足少阳之上（止）无须 张云。足少阳胆经之脉。行于上体者。抵于 下颊车。故其气血之盛衰。必形见
于须髯也。在颐曰须。在颊曰髯。志云。通髯美者。俗名连鬓胡也。
善痹骨痛爪枯也 张云。此皆筋骨之病。以少阳厥阴为表里而肝主筋也。
足少阳之下（止）无肉 张云。足少阳之脉。行于下体者。
出膝外廉下外转骨外辅之前。故其形见者。皆在足之外侧。
足太阳之上（止）美色 甲乙面多少理。作面多小理。张云。足太阳膀胱之脉。行于上体者。起于目内 。
其筋之支者。下颜结于鼻。故其气血之盛衰。皆形见于眉面之间也。志云。毫毛者。眉中之长毛。因血气盛而
生长。恶眉者。无华彩而枯瘁也。少理当作小理。而多小理者。多细小之纹理。盖气少而不能充润皮肤也。
足太阳之下（止）踵下痛 张云。足太阳经之行于下体者。从后廉下合 中。贯 内。出外踝之后。结于
踵。故其形见为病。皆在足之跟踵也。
手阳明之上（止）无髭 甲乙。无髭上有善转筋三字。张云。手阳明大肠之脉行于上体者。挟口交人中。
上挟鼻孔。故其气血之盛衰。必形见于髭也。在口上曰髭。在口下曰须。
手阳明之下（止）以寒 张云。手阳明之行于下体者。上 外前廉。下近于腋。且阳明太阴为表里。而太
阴之脉出腋下。故腋下毛美。手鱼肉者。大指本节后浓肉也。本经之脉起次指。出合谷。故形见于此。
手少阳之上（止）恶色 张云。手少阳三焦之脉行于上体者。出耳前后。至目锐 。故其血气之盛衰。皆
见于眉耳之间。
手少阳之下（止）多脉 甲乙。卷、作拳。张云。手少阳之脉行于下体者。起名指端。循手腕。出臂外上
肘。故其形见若此。志云。盖手少阳之血气。循手表腕。盛则皮缓肉淖。故善于卷握也。多脉者。皮肉瘦而脉
络多外见也。
手太阳之上（止）恶色 甲乙。有多须无有字。须、作髯。恶色、作黑色。张云。手太阳小肠之脉行于上
体者。循颊上 。斜络于颧。故其血气之盛衰。皆形见于须面之间也。
手太阳之下（止）以寒 张云。手太阳之脉行于下体者。循手外侧上腕。故其形见者如此。按本篇首
言五形者。以脏为主而言其禀。此言六阳者。以腑为表而言其形。禀质相合。象变斯具矣。此所以有左右上下
之分也。
有约乎（止）可以知逆顺矣 张云。约、度也。此言足太阳一经之盛衰。而他经之有余不足。亦由是
也。审察既明。而后调之。则不失其逆顺矣。马云。审察其形气之有余不足。而盛则泻之。虚则补之。可以知
当补而补。当泻而泻之为顺。而反此则为逆矣。志云。逆顺者。皮肤经脉之血气。交相逆顺而行者也。知逆顺
之有余不足。则知所以调之矣。仇汝霖云。脉字其字宜玩。盖用脉字。以知足太阳之脉之气血多少。加其字。
以分别肥而泽者。乃诸阳之脉之血气有余也。
按其寸口（止）决之乃行 甲乙。涩、作泣。张云。寸口在手。太阴脉也。人迎在头阳明脉也。太阴
行气于三阴。阳明行气于三阳。故按其寸口人迎。而可以调阴阳也。禁服终始经脉等篇。所谓人迎脉口。一盛、
二盛、三盛等义皆是也。切、深也。循、察也。经络为病身必痛。痹甚则血气不行。故脉道凝涩也。血脉凝涩。
气不至也。故当留针以补。而致其气以温之。致、使之至也。决者开泄之谓。简案、王注脉要精微论云。切、
谓以指切近于脉也。张训深兆。马注。甚则不行。云甚则不能起而行也。似是。
故曰（止）则而予之 甲乙。休、作往。则而予之、作即而取之。马云。大凡病之气有余于上者。则
病在上求之下。当针其穴之在下者。以导而下之。气不足于上者。则仍刺其上穴。乃推其针而久留以休息之。
候其气至可也。如针已稽留。而气尚未至。必因而迎之。随即有以推之耳。凡此者。必先明于各经。经脉之隧。
然后可持针以刺之。其间有寒热
相争者。则导而行之。有气郁陈。（宛陈素问汤液醪醴论有去宛陈 自水积言本经首篇有宛陈则除之自结血言
本篇此节有宛陈而不结者指积气言）而血未结者。必侧其针以刺之。（则侧同侧针即卧针予与同）张云。休者
留针以待气也。稽留不至。言气至之迟滞者。接之引之。而使其必来也。迎、去声。凡物来而接之则平声。物
未来而迓之使来则去声。隧、道也。必明经脉之道路。而后能执持之也。其有寒热不和者。因其偏而导去之。
脉道虽有郁陈。而血不结者。则其势而予治之。则、度也。
必先明知二十五人（止）刺约毕也 甲乙。则、作别。刺上有则字。也、作矣。张云。凡刺之道。须明血
气。故必知此二十五人之脉理而刺之。大约可以尽矣。
【灵台一而不桎】位于左侧上方的部位称为“桎”。它归属于左足太阳经的上部。安安、定静，是形容安定的样子。文中其他处没有提到“桎”，唯独这里提到，大概是因为水的本性虽然流动，但受到容器的局限，就安然不动了，所以称之为“桎”。大凡像这种颊部特征之类的，都是用来表征水形人的形象。《志》说：“所谓‘桎’这种人，是指居住在岗陵山谷中的百姓，就像山在上方一样，安然不动。”大概水的性质是动而不静的，所以水形之人动手脚行走时会摇动身体。如果处于高陵山谷之中，受到加宫（土）的克制，那么手脚就像被枷锁束缚一样安然不动。倪仲宣说：不说左羽右羽，而说众之为人、桎之为人，这就是以众和桎来对应左右。倪仲玉说：水形之人，难道应该被枷锁束缚而处死吗？经文的意义深远微妙，圣人的言辞古朴，不深入思考精粹之处，怎么能轻易疏解呢？简案：众羽、桎羽，见于《五音五味篇》。
【五形之人】……互相欺骗的就是这样的人。马云说：这是总结上文五行之人，有二十五种差异，是众人难以辨别且容易受欺的。张云说：形体分为五类，又细分为二十五类，禀赋既然偏颇，就免不了强弱胜负的相互欺凌。所以只有不偏不倚、秉承天地正气的人，才是阴阳和平之人。因此才有圣人与盗跖、贤者与愚者的区别。杨慎说：相法出于黄帝，虽然不能通晓其详细，但大致主旨可以知晓。由此可知这门技术不是始于《左传》《荀子》所载，也不是唐举、管辂所师承的，应当出自于此。（出自《升庵外集》第五十一卷）
【形胜色】……富贵大乐。《甲乙经》中，“惑”写作“害”。马云说：人有形胜色的，比如木形人却显现黄色。有色胜形的，比如本为木形人却显现白色。只是这些人不以本形本色相见，而是有其他颜色显现。到了形色相胜的时候，又遇到年忌相加，就会感邪而病。如果有疏忽失误，那就很令人担忧了。如果能得到本形本色相得的，那年应当富贵安乐。张云说：胜时年者，比如木旺土衰，又逢丁壬之木运，或东方之干支，或厥阴气候之类，值其王气相加而感邪，就会生病。既已生病再有疏忽，才令人担忧。简案：张景岳用运气来解释，恐怕不符合经文原意。至于胜时下句。
【凡年忌】……是谓年忌。《甲乙经》中，“凡年忌下上之人大忌”作“凡人之大忌”五字，似乎是对的。张云说：这里说的年忌，从七岁到六十一岁，都是递加九年。因为七是阳之少，九是阳之老，阳数极于九，极则必变，所以自七岁以后，凡是遇到九年，都称为年忌。马云说：所谓的年忌，是各经上下之人，非常忌讳常态的叠加。比如太角之人，比附于左足少阳之上；判角之人，比附于左足少阳之下，属于木形人。简案：相胜之时下句。
【足阳明之上】……两吻多画。《甲乙经》中，“髯美髯短髯少及无髯之髯”俱作“须”。（《汉书·高祖纪》颜师古注：在下巴叫须，在脸颊叫髯）。“血少气多”作“血多气少”，“气少血多”作“气多血少”。张云说：下面讲的是手足三阳经的外在表现。足阳明胃经的脉，行于上体的，循鼻外侧挟口环唇，所以这条经气血的盛衰，都表现在口旁的胡须上。吻，是口角。画，是纹路。阳明气血不充盈两吻，所以多有皱纹。简案：汉代周亚夫从理入口而被饿死，其道理大致相同。
【足阳明之下】……足痹。《甲乙经》中，“足趾”作“足大趾”。马云说：KT，音祝。《释文》说：手足中间的寒疮。张云说：足阳明经的行于下体的，由归来穴至气街，是阴阳诸筋的会合处，会于气街，而阳明经为之长，所以表现于下部的阴毛，有的甚至长至胸脐。走路喜欢高抬脚的，是因为血多。大概四肢都禀受胃气，足得到血才能行走。足趾肉少，脚容易冷的，是因为气少。大概四肢是诸阳之本，阳气不足，则指头肉少而容易冷。血少气多，则浮越于外，所以下体肌肉部分，多为寒肿。悴，是憔悴。足阳明是五脏六腑的海，主润宗筋，束骨而利关节。现在气血都少于下部，所以发生痿、厥、足痹等疾病。楼全善说：下毛，即阴毛。简案：KT，音...《说文》：中寒肿核。《玉篇》：手足中寒疮也。前赵充国传：手足皲KT。
【足少阳之上】……无须。张云说：足少阳胆经的脉，行于上体的，抵于下颌下方颊车穴，所以其气血的盛衰，必然表现在胡须上。在下巴叫须，在脸颊叫髯。《志》说：通髯美者，俗名连鬓胡。
【善痹骨痛爪枯也】张云说：这些都是筋骨方面的病，因为少阳与厥阴互为表里，而肝主筋。
【足少阳之下】……无肉。张云说：足少阳经的行于下体的，出膝外廉，下外踝转骨外辅骨之前，所以其形体表现，都在足的外侧。
【足太阳之上】……美色。《甲乙经》中，“面多少理”作“面多小理”。张云说：足太阳膀胱经的脉，行于上体的，起于目内眦，其筋的分支，下行至下巴结于鼻，所以其气血的盛衰，都表现在眉面之间。《志》说：毫毛，是眉毛中长出的毛，因血气旺盛而生长。恶眉，是没有光彩而枯槁的眉毛。少理当作小理，而多小理者，是有很多细小的纹理，大概是气少而不能充润皮肤。
【足太阳之下】……踵下痛。张云说：足太阳经的行于下体的，从后廉下行合于腘中，贯入腨内，出外踝之后，结于踵，所以其形体表现为病，都在足的脚跟处。
【手阳明之上】……无髭。《甲乙经》中，“无髭”上有“善转筋”三字。张云说：手阳明大肠经的行于上体的，挟口交于人中，上挟鼻孔，所以其气血的盛衰，必然表现在髭上。在口上叫髭，在口下叫须。
【手阳明之下】……以寒。张云说：手阳明经的行于下体的，上肩外前廉，下近于腋。而且阳明与太阴互为表里，而太阴经出腋下，所以腋下毛发美。手鱼肉，是大拇指本节后的厚肉。本经的脉起于次指，出合谷，所以表现于此。
【手少阳之上】……恶色。张云说：手少阳三焦经的行于上体的，出耳前后，至目锐眦，所以其血气的盛衰，都表现在眉耳之间。
【手少阳之下】……多脉。《甲乙经》中，“卷”作“拳”。张云说：手少阳经的行于下体的，起名指端，循手腕，出臂外上肘，所以其形体表现如此。《志》说：大概手少阳的血气，循手表腕，旺盛则皮缓肉淖，所以善于卷握。多脉，是皮肉瘦而脉络多外露。
【手太阳之上】……恶色。《甲乙经》中，有多须无有字。须，作髯。恶色，作黑色。张云说：手太阳小肠经的行于上体的，循颊上颧，斜络于颧，所以其血气的盛衰，都表现在须面之间。
【手太阳之下】……以寒。张云说：手太阳经的行于下体的，循手外侧上腕，所以其形体表现如此。按本篇开头说五形，是以脏为主而言其禀赋；这里说六阳，是以腑为表而言其形体。禀质相合，象变就具备了。这就是为什么有左右上下的区分。
【有约乎】……可以知逆顺矣。张云说：约，是度量的意思。这里说的是足太阳一经的盛衰，而其他经的有余不足，也是由此类推。审察清楚之后，然后调理，就不会违背逆顺的原则了。马云说：审察其形气的有余不足，盛则泻之，虚则补之，可以知道当补而补、当泻而泻为顺，反之则为逆。志云说：逆顺，是皮肤经脉的血气交互逆顺运行的意思。知道逆顺的有余不足，就知道如何调治了。仇汝霖说：“脉”这个字值得玩味。大概用“脉”字，是为了知足太阳之脉的气血多少；加“其”字，是为了分别肥而润泽者，那是诸阳之脉的血气有余。
【按其寸口】……决之乃行。《甲乙经》中，“涩”作“泣”。张云说：寸口在手，是太阴脉。人迎在头，是阳明脉。太阴行气于三阴，阳明行气于三阳，所以按诊寸口和人迎，就可以调理阴阳。《禁服》《终始》《经脉》等篇所说的“人迎脉口”，一盛、二盛、三盛等含义都是这样的。切，是深的意思。循，是察的意思。经络有病身体必痛，痹甚则血气不行，所以脉道凝涩。血脉凝涩，气就不至。所以应当留针以补，并引导气来温煦它。致，是使之至的意思。决，是开泄的意思。简案：王冰注《脉要精微论》说：切，是指用手指切近于脉。张景岳训“切”为深兆，马莳注：“甚则不行”，云甚则不能起而行，似乎是对的。
【故曰】……则而予之。《甲乙经》中，“休”作“往”。“则而予之”作“即而取之”。马云说：大凡病之气有余于上的，则病在上求之下，应当针刺下方的穴位，以导引而下。气不足于上的，则仍刺其上穴，乃推针久留以休息之，等待气至即可。如果针已稽留，而气尚未至，必须顺势迎之，随即加以推按引导。大凡这些，必须先明各经经脉的隧道，然后才能持针针刺。其中有寒热相争的，则导引而行。有气郁积（《素问·汤液醪醴论》有“去宛陈”，是从水积言；本经首篇有“宛陈则除之”，是从结血言；本篇此节有“宛陈而不结者”，指积气言），而血未凝结的，必须侧针以刺之（“则”同“侧”，侧针即卧针；“予”同“与”）。张云说：休，是留针以待气。稽留不至，是说气至迟滞，接引它使其必来。迎，读去声。凡物来而接之则读平声，物未来而迓之使来则读去声。隧，是道路。必明经脉的道路，然后能执持它。其有寒热不和的，因其偏而导去之。脉道虽有郁积陈旧，而血不凝结的，则顺着其势给予治疗。则，是度量。
【必先明知二十五人】……刺约毕也。《甲乙经》中，“则”作“别”。刺上有“则”字。“也”作“矣”。张云说：凡刺之道，须明血气，所以必须知道这二十五人的脉理然后针刺，大约可以穷尽了。
[Lingtai Yi Er Bu Zhi] The location above on the left is called "Zhi" (shackle). It belongs to the upper part of the Left Foot Taiyang Bladder Channel. "An'an" refers to a calm and still appearance. Other parts of the text do not mention "Zhi," but this one does, likely because although water naturally flows, it becomes still and unmoving when confined by a vessel; thus it is called "Zhi." All such features on the cheeks are used to represent the image of the Water-type person. The *Zhi* states: "The so-called 'Zhi' type person refers to the common people living in hills, ridges, and valleys, who are like mountains standing high, calm and unmoving." Generally, the nature of water is moving and not static, so Water-type persons move their hands and feet and sway their bodies when walking. If they reside in high hills and valleys and are controlled by Jia Gong (Earth element), their hands and feet become like shackled, remaining calm and unmoving. Ni Zhongxuan said: Instead of saying Left Yu and Right Yu, it says Zhong's person and Zhi's person; this uses Zhong and Zhi to correspond to the left and right. Ni Zhongyu said: Shouldn't a Water-type person be shackled and executed? The meaning of the classic is profound and subtle, and the sage's words are ancient and simple; without deep and refined contemplation, how could it be easily elucidated? Brief note: Zhong Yu and Zhi Yu appear in the *Wu Yin Wu Wei* chapter.
[Five Shape Types] ...those who deceive each other are such people. Ma Yun said: This summarizes the preceding text on the Five Element types, noting that there are twenty-five variations, which are difficult for the masses to distinguish and easy to deceive. Zhang Jingyue said: Shapes are divided into five, further subdivided into twenty-five. Since constitutions are biased, they inevitably suffer from mutual bullying due to strength and weakness, victory and defeat. Therefore, only those who are unbiased and unchanging, inheriting the upright Qi of Heaven and Earth, are the Yin-Yang Peaceful types. Hence, there are distinctions between sages and bandits, the virtuous and the foolish. Yang Shen said: Physiognomy originates from the Yellow Emperor. Although I cannot understand its details, the general purport is clear. Thus, I know this art did not start with what is recorded in the *Zuo Zhuan* or *Xunzi*, nor was it taught by Tang Ju or Guan Lu, but should originate from here. (From *Sheng'an Waiji*, Vol. 51)
[Xing Sheng Se] ...wealth, honor, and great joy. In the *Jia Yi Jing*, "Huo" is written as "Hai." Ma Yun said: There are people whose shape dominates their color, such as a Wood-type person manifesting yellow color. There are also those whose color dominates their shape, such as a person originally of Wood type manifesting white color. However, these people do not meet others with their original shape's true color, but with another color appearing. When the time comes for shape and color to clash, and if the "Nian Ji" (annual taboos) coincide, they will contract disease upon exposure to pathogens. If there is negligence, it is very worrying. If one obtains the harmony of original shape and true color, that year should bring wealth, honor, and great joy. Zhang Jingyue said: "Sheng Shi Nian" refers to times when, for example, Wood is prosperous and Earth is weak, combined with Ding-Ren Wood cycles, or East sector stems/branches, or Jueyin climatic conditions. When the prosperous Qi adds up and causes infection, disease occurs. Only after becoming ill and then being negligent is it truly worrying. Brief note: Zhang's interpretation using Yunqi (Five Movements and Six Qi) may not align with the original intent of the classic. Regarding the sentence following "Sheng Shi."
[Fan Nian Ji] ...this is called Nian Ji. In the *Jia Yi Jing*, "Fan Nian Ji Xia Shang Zhi Ren Da Ji" is written as "Fan Ren Zhi Da Ji" (five characters), which seems correct. Zhang Jingyue said: The "Nian Ji" mentioned here starts at age seven and goes up to sixty-one, increasing by nine years each time. This is because seven is the young Yang number, and nine is the old Yang number. Yang numbers reach their limit at nine, and where there is an extreme, change must occur. Therefore, after age seven, every ninth year is considered a Nian Ji. Ma Yun said: What is called Nian Ji is that people of various channels' upper and lower regions greatly fear the constant addition. For example, the Tai Jiao type corresponds to the upper part of the Left Foot Shaoyang Gallbladder Channel; the Pan Jiao type corresponds to the lower part of the Left Foot Shaoyang Gallbladder Channel, belonging to the Wood type. Brief note: The sentence following "Xiang Sheng Zhi Shi."
[Zu Yang Ming Zhi Shang] ...many lines on both corners of the mouth. In the *Jia Yi Jing*, "Ran Mei Ran Duan Ran Shao Ji Wu Ran Zhi Ran" is all written as "Xu" (beard on chin). (*Han Shu: Gaozu Ji*, Yan Shigu's annotation: Xu is on the chin, Ran is on the cheek). "Xue Shao Qi Duo" is written as "Xue Duo Qi Shao," and "Qi Shao Xue Duo" is written as "Qi Duo Xue Shao." Zhang Jingyue said: The following discusses the external manifestations of the Hand and Foot Three Yang channels. The Foot Yangming Stomach Channel, when traveling through the upper body, follows the outside of the nose, flanks the mouth, and circles the lips. Therefore, the prosperity or decline of Qi and Blood in this channel are manifested in the beard around the mouth. "Kun" refers to the corner of the mouth. "Hua" refers to wrinkles. Because Yangming Qi and Blood do not fully fill the two corners of the mouth, many wrinkles appear. Brief note: The story of Zhou Yafu of the Han Dynasty, who starved himself by swallowing a stone, shares a similar principle.
[Zu Yang Ming Zhi Xia] ...foot bi (numbness/pain). In the *Jia Yi Jing*, "Zu Zhi" is written as "Zu Da Zhi" (big toe). Ma Yun said: KT, pronounced Zhu. The *Shi Wen* explains it as cold sores in the hands and feet. Zhang Jingyue said: The Foot Yangming Channel, when traveling through the lower body, goes from Guilai to Qicheng, which is the meeting point of Yin and Yang tendons, converging at Qicheng, with the Yangming acting as the leader. Thus, it manifests in the pubic hair below, sometimes extending to the chest or navel. Those who walk with high-stepping feet do so because they have abundant blood. Generally, the four limbs receive Qi from the Stomach; the feet can walk only when nourished by blood. Toes with little flesh and feet prone to coldness indicate deficient Qi. Generally, the four limbs are the root of all Yang; insufficient Yang Qi results in toes with little flesh and a tendency toward coldness. Deficient blood and excessive Qi float outward, causing the flesh of the lower body to often present with cold swelling. "Cui" means haggard. The Foot Yangming is the sea of the five zang and six fu organs, responsible for moistening the Zongjin (major tendons), binding the bones, and facilitating joint movement. Now, since Qi and Blood are both deficient in the lower part, diseases such as Wei (atrophy), Jue (cold extremities), and Zu Bi (foot numbness/pain) occur. Lou Quanshan said: Xia Mao refers to pubic hair. Brief note: KT, pronounced... *Shuo Wen*: Cold swelling nodules. *Yu Pian*: Cold sores in hands and feet. *Qian Zhao Chongguo Zhuan*: Hands and feet cracked and KT.
[Zu Shao Yang Zhi Shang] ...no beard. Zhang Jingyue said: The Foot Shaoyang Gallbladder Channel, when traveling through the upper body, reaches below the mandible at Jiache. Therefore, its Qi and Blood prosperity or decline must manifest in the beard. Beard on the chin is called Xu; beard on the cheek is called Ran. The *Zhi* states: Beautiful full beard is commonly known as sideburns connected to the beard.
[Shan Bi Gu Tong Zhao Ku Ye] Zhang Jingyue said: These are all disorders of sinews and bones. Since Shaoyang and Jueyin are interior-exterior pairs, and the Liver governs the sinews...
[Zu Shao Yang Zhi Xia] ...no flesh. Zhang Jingyue said: The Foot Shaoyang Channel, when traveling through the lower body, exits the lateral edge of the knee, descends past the lateral malleolus, and precedes the fibula. Therefore, its physical manifestations are all located on the lateral side of the foot.
[Zu Tai Yang Zhi Shang] ...beautiful complexion. In the *Jia Yi Jing*, "Mian Duo Shao Li" is written as "Mian Duo Xiao Li." Zhang Jingyue said: The Foot Taiyang Bladder Channel, when traveling through the upper body, originates from the inner canthus of the eye. Its tendon branches descend to the chin and knot at the nose. Therefore, its Qi and Blood prosperity or decline are manifested between the eyebrows and face. The *Zhi* states: Hao Mao refers to the long hairs in the eyebrows, which grow due to abundant Qi and Blood. E Mei refers to eyebrows lacking luster and appearing withered. "Shao Li" should be read as "Xiao Li." Having many small lines indicates many fine textures, likely due to insufficient Qi failing to moisten the skin.
[Zu Tai Yang Zhi Xia] ...pain under the heel. Zhang Jingyue said: The Foot Taiyang Channel, when traveling through the lower body, descends from the posterior margin, joins the popliteal fossa, penetrates the calf muscle, emerges behind the lateral malleolus, and knots at the calcaneus. Therefore, its pathological manifestations are all located at the heel of the foot.
[Shou Yang Ming Zhi Shang] ...no mustache. In the *Jia Yi Jing*, the three characters "Shan Zhuan Jin" (prone to cramping) appear before "Wu Zi." Zhang Jingyue said: The Hand Yangming Large Intestine Channel, when traveling through the upper body, flanks the mouth, crosses the philtrum, and ascends to flank the nostrils. Therefore, its Qi and Blood prosperity or decline must manifest in the mustache. Mustache above the mouth is called Zi; beard below the mouth is called Xu.
[Shou Yang Ming Zhi Xia] ...prone to cold. Zhang Jingyue said: The Hand Yangming Channel, when traveling through the lower body, ascends the anterior-lateral shoulder border and descends near the axilla. Moreover, Yangming and Taiyin are interior-exterior pairs, and the Taiyin Channel emerges from the axilla; therefore, the axillary hair is beautiful. "Shou Rou Yu" refers to the thick flesh at the base of the thumb. The primary channel originates from the index finger, emerges at Hegu, and thus manifests here.
[Shou Shao Yang Zhi Shang] ...dull complexion. Zhang Jingyue said: The Hand Shaoyang Sanjiao Channel, when traveling through the upper body, emerges before and behind the ear and reaches the outer canthus of the eye. Therefore, its Qi and Blood prosperity or decline are all seen between the eyebrows and ears.
[Shou Shao Yang Zhi Xia] ...many visible vessels. In the *Jia Yi Jing*, "Juan" is written as "Quan" (fist). Zhang Jingyue said: The Hand Shaoyang Channel, when traveling through the lower body, originates at the tip of the index finger, follows the wrist, and emerges on the lateral arm above the elbow. Thus, its physical manifestation is as described. The *Zhi* states: Generally, the Qi and Blood of the Hand Shaoyang follow the hand and wrist; when abundant, the skin is loose and flesh soft, making one good at grasping/fisting. "Duo Mai" means the skin and flesh are thin while the collaterals are numerous and externally visible.
[Shou Tai Yang Zhi Shang] ...dull/blackish complexion. In the *Jia Yi Jing*, there are extra characters for "You Xu" (has beard). "Xu" is written as "Ran." "E Se" is written as "Hei Se." Zhang Jingyue said: The Hand Taiyang Small Intestine Channel, when traveling through the upper body, follows the cheek, ascends to the orbital bone, and obliquely connects to the zygomatic arch. Therefore, its Qi and Blood prosperity or decline are manifested between the beard and face.
[Shou Tai Yang Zhi Xia] ...prone to cold. Zhang Jingyue said: The Hand Taiyang Channel, when traveling through the lower body, follows the lateral aspect of the hand and ascends the wrist. Thus, its physical manifestation is as such. According to the beginning of this chapter, speaking of the Five Shapes focuses on the Zang organs to discuss constitution; here, speaking of the Six Yang focuses on the Fu organs as the exterior to discuss form. Constitution and form harmonize, and images/variations are complete. This is why there are distinctions of left/right and upper/lower.
[You Yue Hu] ...can know Ni and Shun. Zhang Jingyue said: Yue means to measure. This discusses the prosperity and decline of the Foot Taiyang channel alone, while the excess and deficiency of other channels are inferred similarly. Once examination is clear, subsequent regulation will not violate the principles of Ni (counterflow) and Shun (smooth flow). Ma Yun said: Examine the excess or deficiency of form and Qi. If excessive, drain it; if deficient, tonify it. One can know when to tonify and when to drain as Shun (correct), and reversing this is Ni (incorrect). The *Zhi* states: Ni and Shun refer to the alternating counterflow and smooth flow of Qi and Blood in the skin and meridians. Knowing the excess or deficiency of Ni and Shun allows one to know how to regulate. Qiu Rulin said: The character "Mai" (vessel) deserves careful study. Using "Mai" indicates knowing the amount of Qi and Blood in the Foot Taiyang vessel. Adding "Qi" distinguishes those who are fat and lustrous, indicating excess Qi and Blood in the Yang vessels.
[An Qi Cun Kou] ...decide and then proceed. In the *Jia Yi Jing*, "Se" is written as "Qi." Zhang Jingyue said: Cun Kou is on the hand, the Taiyin vessel. Ren Ying is on the head, the Yangming vessel. Taiyin circulates Qi among the Three Yin, and Yangming circulates Qi among the Three Yang. Therefore, palpating Cun Kou and Ren Ying allows for regulating Yin and Yang. The concepts of "Ren Ying Mai Kou," "One Prosperity," "Two Prosperities," etc., found in chapters like *Jin Fu*, *Zhong Shi*, and *Jing Mai* are all of this meaning. Qie means deep. Xun means examine. Meridian diseases cause body pain; severe Bi leads to stagnation of Qi and Blood, causing the pulse pathway to become congealed and sluggish. Congealed blood vessels mean Qi does not arrive. Therefore, one should retain the needle to tonify and guide Qi to warm it. Zhi means to make it arrive. Jue means to open and drain. Brief note: Wang Bing's commentary on *Mai Yao Jing Wei Lun* states: Qie means pressing the finger close to the pulse. Zhang Jingyue interprets Qie as deep probing. Ma Shi's annotation: "Shen Ze Bu Xing" means unable to rise and walk due to severity, which seems plausible.
[Guyue] ...ze er yu zhi. In the *Jia Yi Jing*, "Xiu" is written as "Wang." "Ze Er Yu Zhi" is written as "Ji Er Qu Zhi." Ma Yun said: Generally, if pathogenic Qi is excessive in the upper part, treat the disease in the upper by seeking the lower; needle the acupoints below to guide the Qi downward. If Qi is deficient in the upper, still needle the upper acupoints, push the needle and retain it for rest, waiting for Qi arrival. If the needle has been retained but Qi has not yet arrived, one must intercept it and immediately apply pushing techniques. All these require prior understanding of the pathways of each meridian before holding the needle to puncture. Where there is conflict between Cold and Heat, guide and circulate it. Where there is Qi stagnation accumulation (*Suwen: Tangye Laoli Lun* mentions "remove Wan Chen" referring to water accumulation; the first chapter of this classic mentions "Wan Chen Ze Chu Zhi" referring to blood clotting; this section mentions "Wan Chen Er Bu Jie," referring to accumulated Qi), and blood has not coagulated, one must angle the needle to puncture ("Ze" is same as "Ce," angled needle implies lying flat; "Yu" is same as "Yu"). Zhang Jingyue said: Xiu means retaining the needle to await Qi. "Ji Liu Bu Zhi" refers to delayed Qi arrival; connect and guide it to ensure it arrives. "Ying" is pronounced with a falling tone. When receiving something coming, it is level tone; when welcoming something not yet come to make it arrive, it is falling tone. Sui means path. One must understand the meridian pathways to wield the needle correctly. For those with disharmony of Cold and Heat, guide away the bias. For meridians with stagnant, old Qi but non-coagulated blood, treat according to the momentum. Ze means to measure.
[Bixian Mingzhi Er Shiwu Ren] ...ci yue bi ye. In the *Jia Yi Jing*, "Ze" is written as "Bie." There is a "Ze" character before "Ci." "Ye" is written as "Yi." Zhang Jingyue said: The way of needling requires understanding Qi and Blood; thus, one must know the meridian principles of these twenty-five types before needling. Approximately, this covers everything.