（灵枢经脉篇 脉度篇）
黄帝曰∶经脉十二者，伏行分肉之间，深而不见；其常见者，足太阴过于外踝之上，无所隐故也。诸脉之浮而常见
者，皆络脉也。（灵枢经脉篇。足太阴当作手太阴。经脉深而直行，故手足十二经脉，皆伏行分肉之间，不可得见。其有
见者，惟手太阴一经，过于手外踝之上，因其骨露皮浅，故不能隐。下文云经脉者常不可见也，其虚实也以气口知之，
正谓此耳。此外诸脉，凡浮露于外而可见者，皆络脉也。分肉，言肉中之分理也。）六经络，手阳明少阳之大络，起于五
指间，上合肘中。（此举手络之最大者，以明视络之法也。手足各有六经，而手六经之络，则惟阳明少阳之络为最大。手
阳明之络名偏历，左腕后三寸上侧间，别走太阴；手少阳之络名外关，在臂表腕后二寸两筋间，邪行向内，历阳明、太
阴别走厥阴。二络之下行者，阳明出合谷之次，分络于大食二指；少阳出阳池之次，散络于中名小三指，故起于五指间。
其上行者，总合于肘中内廉厥阴曲泽之次。凡人手背之露筋者，皆显然可察，俗谓之青筋，此本非筋非脉，即蓄血之大
络也。凡浮络之在外者，皆可推此而知耳。）饮酒者，卫气先行皮肤、先充络脉，络脉先盛，故卫气已平，营气乃满，而
经脉大盛。（卫气者，水谷之悍气也，其气 疾滑利，不入于经。酒亦水谷之悍气，其 疾之性亦然。故饮酒者，必随卫
气先达皮肤，先充络脉，络脉先盛，则卫气已平，而后营气满，经脉乃盛矣。平，犹潮平也，即盛满之谓。愚按∶脉有
经络，经在内，络在外；气有营卫，营在内，卫在外。今饮酒者，其气自内达外，似宜先经而后络，兹乃先络而后经者
何也？盖营气者，犹原泉之混混，循行地中，周流不息者也，故曰营行脉中。卫气者，犹雨雾之郁蒸，透彻上下，遍及
万物者也，故曰卫行脉外。是以雨雾之出于地，必先入百川而后归河海；卫气之出于胃，必先充络脉而后达诸经，故经
水篇以十二经分发十二水。然则经即大地之江河，络犹原野之百川也。此经络营卫之辨。）脉之卒然动者，皆邪气居之，
留于本末；不动则热，不坚则陷且空，不与众同，是以知其何脉之动也。（上文言饮酒者能致经脉之盛，故脉之平素不甚
动而卒然动者，皆邪气居之，留于经脉之本末而然耳。邪气者，即指酒气为言。酒邪在脉，则浮络者虽不动，亦必热也；
虽大而不坚，故陷且空也。此浮络与经脉之不同，故可因之以知其动者为何经之脉也。此特举饮酒为言者，正欲见其动
与不动，空与不空，而经脉络脉为可辨矣。）雷公曰∶何以知经脉之与络脉异也？黄帝曰∶经脉者常不可见也，其虚实也
以气口知之，脉之见者皆络脉也。（气口者，手太阴肺经也。肺朝百脉，气口为脉之大会，凡十二经脉，深不可见，而其
虚实，惟于气口可知之，因其无所隐也。若其他浮露在外而可见者，皆络脉而非经也。）雷公曰∶细子无以明其然也。黄
帝曰∶诸络脉皆不能经大节之间，必行绝道而出入，复合于皮中，其会皆见于外。（大节，大关节也。绝道，间道也。凡
经脉所行，必由 谷大节之间。络脉所行，乃不经大节，而于经脉不到之处，出入联系以为流通之用。然络有大小，大
者曰大络、小者曰孙络。大络犹木之干，行有出入；孙络犹木之枝，散于肤腠，故其会皆见于外。）故诸刺络脉者，必刺
其结上，甚血者虽无结，急取之以泻其邪而出其血，留之发为痹也。（凡刺络脉者，必刺其结上，此以血之所聚，其结粗
突倍常，是为结上，即当刺处也。苦血聚已甚，虽无结络，亦必急取之以去其邪血，否则发为痹痛之病。今西北之俗，
但遇风寒痛痹等疾，即以绳带紧束上臂，令手肘青筋胀突，乃用磁锋于肘中曲泽穴次，合络结上，砭取其血，谓之放寒，
即此节之遗法，勿谓其无所据也。）凡诊络脉，脉色青则寒且痛，赤则有热。胃中寒，手鱼之络多青矣；胃中有热，鱼际
络赤；其暴黑者，留久痹也；其有赤有黑有青者，寒热气也；其青短者，少气也。（诊，视也。此诊络脉之色可以察病，
而手鱼之络尤为显浅易见也。寒则气血凝涩，凝涩则青黑，故青则寒且痛。热则气血淖泽，淖泽则黄赤，故赤则有热。
手鱼者，大指本节间之丰肉也。鱼虽手太阴之部，而胃气至于手太阴，故可以候胃气。五色之病，惟黑为甚，其暴黑者，
以痹之留久而致也。其赤黑青色不常者，寒热气之往来也。其青而短者，青为阴胜，短为阳不足，故为少气也。）凡刺寒
热者皆多血络，必间日而一取之，血尽而止，乃调其虚实。（凡邪气客于皮毛，未入于经而为寒热者，其病在血络，故当
间日一取以去其血。血尽则邪尽，邪尽则止针，而后因其虚实以调治之也。邪自皮毛而入，极于五脏之次，义详针刺类
三十。）其小而短者少气，甚者泻之则闷，闷甚则仆不得言，闷则急坐之也。（视其络脉之小而短者，气少故也，不可刺
之。虚甚而泻，其气重虚，必致昏闷，甚则运仆暴脱不能出言，急扶坐之，使得气转以渐而苏。若偃卧则气滞，恐致不
救也。）
经脉为里，支而横者为络，络之别者为孙，盛而血者疾诛之，盛者泻之，虚者饮药以补之。（灵枢脉度篇。经脉直行
深伏，故为里而难见。络脉支横而浅，故在表而易见。络之别者为孙，孙者言其小也，愈小愈多矣。凡人遍体细脉，即
皆肤腠之孙络也。络脉有血而盛者，不去之则壅而为患，故当疾诛之。诛，除也。然必盛者而后可泻，虚则不宜用针。
故邪气脏腑病形篇曰∶阴阳形气俱不足，勿取以针而调以甘药。即虚者饮药以补之之谓。）
（《灵枢·经脉》篇、《灵枢·脉度》篇）
黄帝说：十二经脉，潜伏运行在肌肉间隙之间，深藏而不可见；那些经常可以看见的，是足太阴脾经经过外踝上方的一段，因为此处没有遮蔽的缘故。所有浮露于体表且经常可见的脉络，都是络脉。（注：原文“足太阴”应为“手太阴”。经脉深直而行，所以手足十二经脉都潜伏在肌肉间隙中，无法看见。其中能看见的，只有手太阴肺经这一条，经过手腕外侧上方，因为骨骼显露、皮肤浅薄，所以无法隐藏。下文说“经脉通常不可见，其虚实通过气口来知晓”，正是说的这个意思。此外其他浮露在外可见的脉络，都是络脉。分肉，指肌肉中的纹理。）六经之络，手阳明大肠经和手少阳三焦经的大络，起始于五指之间，向上汇合于肘部中间。（这里列举手络中最显著的，来说明观察络脉的方法。手足各有六经，但手六经的络脉中，只有阳明经和少阳经的络脉最大。手阳明大肠经的络脉名叫偏历，位于左手腕后三寸的上侧，别行走向太阴经；手少阳三焦经的络脉名叫外关，在前臂背面腕后二寸两筋之间，斜行向内，经过阳明、太阴，别行走向厥阴经。这两条络脉向下行的部分，阳明经出于合谷穴附近，分别联络食指和中指；少阳经出于阳池穴附近，散布联络中指、无名指和小指，所以说起始于五指之间。它们向上行的部分，总汇于肘部内侧厥阴心包经曲泽穴附近。凡是人手背显露的青色筋脉，都明显可察，俗称青筋，这本来不是筋也不是经脉，而是蓄积血液的大络。凡是在体表的浮络，都可以由此类推而知晓。）饮酒的人，卫气先到达皮肤、先充盈络脉，络脉先变得盛大，所以卫气已经平盛（充满），营气才满溢，而经脉才盛大。（卫气，是水谷中剽悍滑利的精气，它的性质疾速滑利，不进入经脉。酒也是水谷产生的剽悍之气，其疾速的性质也是如此。所以饮酒的人，其气必然跟随卫气先到达皮肤，先充盈络脉，络脉先盛大，然后卫气才平盛，接着营气满溢，经脉才盛大。平，就像潮水平满一样，即盛满的意思。我按语：脉有经络之分，经在内，络在外；气有营卫之分，营在内，卫在外。现在饮酒的人，其气从内达外，似乎应该先经过经再到达络，为什么反而是先络后经呢？这是因为营气，就像地下涌出的泉水，在地下循环流动，周流不息，所以说“营行脉中”。卫气，就像雨雾的郁蒸，透彻上下，遍及万物，所以说“卫行脉外”。因此雨雾从地而出，必须先流入百川然后汇入河海；卫气从胃而出，必须先充盈络脉然后到达各条经脉，所以《灵枢·经水》篇将十二经脉对应分发为十二条河流。既然这样，经脉就像大地上的江河，络脉就像原野上的百川。这是经络与营卫的区别。）脉搏突然跳动的，都是邪气停留所致，邪气停留在经脉的根本和末端；如果不跳动则会有热感，如果不坚实则会下陷且空虚，不与正常情况相同，因此可以知道是哪条经脉在跳动。（上文说饮酒会导致经脉盛大，所以平时不怎么跳动的脉搏如果突然跳动，都是邪气停留，滞留在经脉的本末造成的。邪气，这里指酒气。酒邪在脉中，那么浮络即使不跳动，也必定发热；虽然大但不坚实，所以下陷且空虚。这是浮络与经脉的不同，因此可以通过这一点来辨别跳动的究竟是哪条经的脉。这里特意举饮酒为例，正是想让人看出动与不动、空与不空的区别，从而分辨经脉络脉。）雷公说：怎么知道经脉和络脉不同呢？黄帝说：经脉通常不可见，其虚实通过气口来知晓，那些显现出来的都是络脉。（气口，即手太阴肺经。肺朝会百脉，气口是脉的大会合之处，凡十二经脉都深藏不可见，而其虚实，只有通过气口才能知晓，因为它无所隐藏。至于其他浮露在外可见的，都是络脉而不是经脉。）雷公说：我不明白其中的道理。黄帝说：所有的络脉都不经过大的关节之间，必定行走于特殊的通道出入，又复合于皮肤之中，它们的交会点都显露在外面。（大节，指大关节。绝道，指旁路。凡是经脉所行的路径，必须经过肌肉缝隙和大关节之间。络脉所行的路径，不经过大关节，而是在经脉不到的地方，出入联系以起到流通作用。然而络脉有大有小，大的叫大络，小的叫孙络。大络就像树木的主干，有进有出；孙络就像树木的枝条，散布在皮肤腠理之间，所以它们的交会点都显露在外面。）所以凡是刺络脉的，必须刺其结聚之处，瘀血严重的即使没有结聚，也要急取放血以泻除邪气并排出瘀血，否则留滞日久会发展为痹证。（凡是刺络脉，必须刺其结聚之处，这是因为血液聚集的地方，其结块粗突比平常加倍，这就是所谓的“结上”，也就是应当针刺的地方。如果瘀血积聚已经很严重，即使没有明显的结块，也必须急取放血以去除邪血，否则就会发展为痹痛病。如今西北地区的习俗，只要遇到风寒痛痹等疾病，就用绳带紧紧束住上臂，使手肘部的青筋胀突，然后用磁锋在肘部曲泽穴附近及络脉结聚处，砭石放血，称为“放寒”，就是这一节的遗留方法，不要说它没有依据。）凡是诊察络脉，脉色发青则表示寒且痛，发红则表示有热。胃中有寒，手掌大鱼际处的络脉多呈青色；胃中有热，鱼际络脉发红；如果突然变黑，说明是久留的痹证；如果有红、有黑、有青色的，表示寒热错杂；如果青色且短小，表示气虚。（诊，即视诊。诊察络脉的颜色可以察知病情，而手掌大鱼际处的络脉尤其浅显易见。寒则气血凝涩，凝涩则呈现青黑色，所以青色表示寒且痛。热则气血淖泽，淖泽则呈现黄红色，所以红色表示有热。手鱼，即大拇指本节间的丰隆肌肉处。手鱼虽属手太阴肺经部位，但胃气通达于手太阴经，所以可以候察胃气。五色病变中，黑色最为严重，突然变黑是因为痹证久留所致。红黑青色交替出现，是寒热气机往来。青色且短小，青为阴胜，短为阳不足，所以是气虚。）凡是治疗寒热病的，往往涉及多条血络，必须隔日针刺一次，直到瘀血排尽为止，然后再调理其虚实。（凡是邪气客居在皮毛，尚未进入经脉而引起寒热的，病位在血络，所以应当隔日取血以祛除邪气。血排尽则邪气尽，邪气尽则停止针刺，然后根据虚实进行调理。邪气从皮毛而入，极于五脏的顺序，详见《针刺类》第三十条。）络脉细小且短小的属于气虚，如果严重虚弱却用泻法，患者会出现昏闷，昏闷严重则会跌倒不能说话，昏闷时要急忙让患者坐下。（观察络脉细小短小的，是因为气少，不可针刺。极度虚弱却用泻法，会导致正气双重亏损，必然引起昏闷，严重时甚至晕倒暴脱不能言语，此时应急忙扶起患者使其坐立，以便气息逐渐恢复。如果让其仰卧，则气机阻滞，恐怕导致无法救治。）
经脉在里，分支横出的为络脉，络脉再分出的为孙络，盛大且有瘀血的要迅速清除，盛的用泻法，虚的用药物补益。（《灵枢·脉度》篇。经脉直行深伏，所以在里且难见。络脉分支横行且浅表，所以在表且易见。络脉再分出的叫孙络，孙的意思是微小，越小越多。凡人遍体的细脉，都是皮肤腠理间的孙络。络脉中有血且盛大的，如果不除去则会壅塞成为病患，所以要迅速清除。诛，即除去。但必须是实证才可以泻，虚证不宜用针。所以《灵枢·邪气脏腑病形》篇说：“阴阳形气俱不足，勿取以针而调以甘药。”这就是虚者饮药以补之的意思。）
(Lingshu, Chapter "Jingmai" and Chapter "Maidu")
Huangdi said: The twelve Jing-mai (Primary Meridians) run deep within the intervals between muscles, hidden from view. Those that are commonly visible are those of the Foot-Taiyin Spleen Channel passing over the lateral malleolus, because there is no concealment there. All vessels that float superficially and are commonly visible are Luo-connecting vessels (Collaterals). [Note: The original text "Foot-Taiyin" should be "Hand-Taiyin". Jing-mai run deep and straight, so the twelve primary meridians of the hand and foot all lie hidden within the muscle intervals and cannot be seen. Among them, only the Hand-Taiyin Lung Channel is visible, passing over the wrist's outer aspect; because the bone is exposed and the skin is shallow, it cannot be concealed. As stated later, "Jing-mai are usually invisible; their deficiency or excess is known via the Qi-kou pulse," this refers precisely to this point. Furthermore, any vessel floating on the surface and visible belongs to the Luo-connecting vessels. Fen-rou refers to the texture between muscles.] The six Luo-vessels of the Hand-Yangming Large Intestine Channel and Hand-Shaoyang Sanjiao Channel originate between the five fingers and ascend to converge in the middle of the elbow. [This cites the largest hand Luo-vessels to illustrate the method of observing collaterals. There are six channels for both hands and feet, but among the hand six channels' collaterals, only those of the Yangming and Shaoyang are the largest. The Luo-vessel of the Hand-Yangming Large Intestine Channel is named Pianli, located three cun distal to the left wrist on the radial side, diverging to connect with the Taiyin channel. The Luo-vessel of the Hand-Shaoyang Sanjiao Channel is named Waiguan, located two cun proximal to the wrist between the two tendons on the dorsal aspect of the forearm, running obliquely inward, passing through the Yangming and Taiyin, and diverging to connect with the Jueyin channel. Descending branches of these two vessels: the Yangming emerges near the Hegu acupoint, distributing to the index and middle fingers; the Shaoyang emerges near the Yangchi acupoint, scattering to the middle, ring, and little fingers. Hence, they originate between the five fingers. Ascending branches converge at the medial aspect of the elbow, near the Quze acupoint of the Hand-Jueyin Pericardium Channel. Any blue veins visible on the back of the human hand are clearly observable, commonly called "blue veins"; these are neither sinews nor primary meridians, but large collaterals where blood accumulates. Superficial collaterals on the exterior can be understood by analogy.] In individuals who drink alcohol, Wei-Qi (Defensive Qi) first reaches the skin and fills the Luo-connecting vessels, causing the collaterals to become prominent first. Thus, after the Wei-Qi becomes full, Ying-Qi (Nutritive Qi) then fills, and the Jing-mai (Primary Meridians) become highly prominent. [Wei-Qi is the fierce and slippery essence derived from food and grain; its nature is rapid and smooth, and it does not enter the meridians. Wine is also a fierce qi derived from food and grain, sharing this rapid nature. Therefore, when one drinks wine, its qi follows the Wei-Qi to reach the skin first and fill the collaterals. Once the collaterals are full, the Wei-Qi becomes saturated (like a tide reaching high water), followed by the filling of Ying-Qi, and finally the prominence of the Jing-mai. Ping implies fullness. Commentary: Vessels have Jing and Luo divisions; Jing is internal, Luo is external. Qi has Ying and Wei divisions; Ying is internal, Wei is external. One might expect that since wine's qi moves from inside out, it should affect Jing before Luo. Why does it affect Luo first? This is because Ying-Qi is like a spring bubbling underground, circulating endlessly, hence "Ying circulates within the vessels." Wei-Qi is like mist and rain vaporizing, penetrating up and down and pervading all things, hence "Wei circulates outside the vessels." Just as rainwater from the earth must first enter streams before reaching rivers and seas, Wei-Qi from the stomach must first fill the collaterals before reaching the primary meridians. Thus, the Lingshu chapter "Jing Shui" maps the twelve meridians to twelve rivers. In this analogy, Jing-mai are like great rivers, and Luo-vessels are like tributaries across the plains. This distinguishes Jing-Luo from Ying-Wei.] Sudden pulsations of the vessels indicate the presence of pathogenic factors residing there, lingering at the root and extremities of the meridians. If there is no pulsation, there may be heat; if not firm, it indicates sinking and emptiness. Deviating from normal patterns allows identification of which meridian is affected. [The preceding text states that drinking wine causes meridian prominence. Therefore, sudden pulsations in vessels that are usually quiet are caused by pathogens lingering at the root and end of the meridians. Here, "pathogen" refers to the toxic effects of alcohol. Alcohol-pathogen in the vessels causes even non-pulsating superficial collaterals to feel hot; although enlarged, they lack firmness, leading to a sensation of sinking and emptiness. This distinction between superficial collaterals and primary meridians allows differentiation based on movement and emptiness. The example of drinking wine is used specifically to highlight these differences to distinguish Jing and Luo vessels.] Leigong asked: How do we know the difference between Jing-mai and Luo-connecting vessels? Huangdi replied: Jing-mai are usually invisible; their deficiency or excess is assessed via the Qi-kou pulse. What is visible are all Luo-connecting vessels. [Qi-kou refers to the Hand-Taiyin Lung Channel. The Lung governs all vessels, and Qi-kou is the great convergence of pulses. Since the twelve primary meridians are deep and invisible, their status is discerned only at Qi-kou due to its accessibility. Other vessels visible on the surface are Luo-connecting vessels, not primary meridians.] Leigong said: I do not understand why. Huangdi said: All Luo-connecting vessels do not pass through major joints; they must travel through alternate pathways to enter and exit, rejoining beneath the skin, with their intersections visible externally. [Major joints refer to large articulations. Alternate pathways refer to interstitial routes. Primary meridians pass through muscle fissures and major joints. Luo-vessels bypass major joints, connecting areas inaccessible to primary meridians to facilitate circulation. Collaterals vary in size: large ones are called Da-luo (Great Collaterals), small ones are Sun-luo (Grandchild Collaterals). Da-luo are like tree trunks with entry and exit points; Sun-luo are like branches scattered in the skin and interstices, so their intersections are visible externally.] Therefore, when needling Luo-connecting vessels, one must needle at the site of congestion. If blood stasis is severe, even without visible knots, urgent bloodletting is required to drain the pathogen and expel stagnant blood; otherwise, retention may lead to Bi-syndrome (obstruction syndrome). [When needling collaterals, one targets the site of congestion where blood gathers, appearing thicker and more protruding than usual. If blood stasis is severe, even without distinct knots, urgent bloodletting is necessary to remove pathogenic blood; otherwise, it develops into painful obstruction. In northwestern customs, for wind-cold painful obstruction, an arm is tightly bound to engorge the blue veins at the elbow. Then, using a stone lancet at Quze and collateral knots, blood is released, termed "releasing cold." This is a remnant technique of this section, not without basis.] In diagnosing Luo-connecting vessels, cyan color indicates cold and pain; red indicates heat. Cold in the Stomach manifests as cyan vessels on the大鱼际 (Thenar eminence); heat in the Stomach manifests as red vessels at Yuji. Sudden blackening indicates long-standing Bi-syndrome. Mixed red, black, and cyan colors indicate alternating cold and heat. Cyan and short vessels indicate Qi deficiency. [Diagnosis involves observation. Color changes reveal disease; the Thenar vessels are particularly superficial. Cold causes Qi and Blood to coagulate and stagnate, turning cyan/black, indicating cold and pain. Heat causes Qi and Blood to become fluid and red/yellow, indicating heat. The Thenar area belongs to the Hand-Taiyin Lung Channel, but Stomach Qi extends here, allowing assessment of Stomach condition. Black is the most severe color; sudden blackening results from prolonged Bi. Alternating colors indicate fluctuating cold/heat. Cyan and shortness imply Yin excess and Yang deficiency, hence Qi deficiency.] When treating cold and heat syndromes involving multiple blood collaterals, needling should occur every other day until the blood is exhausted, after which deficiency or excess is regulated. [When pathogens lodge in the skin and hair without entering the meridians, causing cold and heat, the pathology lies in the blood collaterals. Thus, bloodletting every other day removes the pathogen. Once blood (and thus pathogen) is cleared, needling stops, and regulation follows based on deficiency or excess. Pathogens enter from the skin/hair and penetrate to the Zang organs; see Lingshu "Needling Class" item 30.] Small and short collaterals indicate Qi deficiency. Severe deficiency treated with draining methods leads to dizziness and fainting; severe cases result in collapse and inability to speak. In such cases, urgently sit the patient up. [Small, short collaterals reflect low Qi and should not be needled. Draining severe deficiency causes double depletion, leading to dizziness or syncope. Urgently seating the patient aids Qi recovery. Supine positioning may stagnate Qi, risking fatality.]
Jing-mai are internal; branching transversely are Luo-connecting vessels; further branching from Luo are Sun-collaterals. Prominent vessels with blood stasis must be rapidly purged. Excess is drained; deficiency is tonified with herbal decoctions. [Lingshu, Chapter "Maidu". Primary meridians run deep and straight, thus internal and hard to see. Collaterals branch transversely and are superficial, thus external and easy to see. Further branching yields Sun-collaterals ("Sun" means small; smaller ones are more numerous. Fine vessels throughout the body are Sun-collaterals in the skin and interstices. Collaterals with prominent blood stasis must be removed promptly to prevent obstruction. Zhu means to eliminate. However, draining is only for excess; deficiency contraindicates needling. As stated in Lingshu "Xieqi Zangfu Bingxing": "If Yin-Yang, form, and Qi are all deficient, do not use needles but regulate with sweet herbs." This refers to tonifying deficiency with herbal medicine.]