灵枢经·经脉 Channels

Leigong asked Huangdi, saying: "Regarding the teaching handed down in the Jin Mai ('On the Forbidden Vessels') — that in all the principles of needling, the channel vessels are the starting point: one must trace the courses along which they travel, establish their proper measurements, correlate them internally with the five viscera, and distinguish them externally from the six bowels. I wish to hear the whole of this doctrine."

Huangdi said: "When a person is first brought into being, the essence is formed first; once the essence is formed, the brain and marrow are generated. The bones serve as the trunk, the vessels as the enclosing network, the sinews as the binding strength, and the flesh as the wall. Once the skin is firm and the body hair has grown, grain enters the stomach, the pathways of the vessels become open, and qi and blood are thereby set in motion."

Leigong said: "I wish to hear in full how the channel vessels first arise." Huangdi said: "The channel vessels are that by which one determines death and life, addresses the hundred diseases, and regulates deficiency and excess — one must not fail to master them."

The Hand Taiyin Lung channel arises in the middle burner, descends to network with the large intestine, turns back to follow the opening of the stomach, ascends through the diaphragm, and belongs to the lung. From the lung system it emerges transversely to below the axilla, descends along the inner aspect of the upper arm, running in front of the Hand Shaoyin Heart channel and the Xin Zhu ("heart ruler," i.e. the Pericardium) channel, descends to the middle of the elbow, follows the inner border of the forearm along the radial bone, enters the cunkou, ascends over the thenar eminence, follows the border of the thenar eminence, and emerges at the tip of the thumb. Its branch separates from behind the wrist and runs straight out to the inner border of the index finger, emerging at its tip.

When this channel is disturbed, the resulting disease is fullness and distension of the lung, a bloated, panting cough, pain within the supraclavicular fossa, and in severe cases the two hands are crossed over the chest with a feeling of blurred, clouded vision — this is called "arm reversal." Among the diseases governed by the lung, there is coughing with qi rising, panting, thirst, vexation of the heart, fullness of the chest, pain and reversal-cold along the anterior inner border of the upper arm and forearm, and heat in the palm. When the qi is in excess, there is pain in the shoulder and back; if wind and cold bring on sweating, one is struck by wind, with frequent, scanty urination. When the qi is deficient, there is pain in the shoulder and back, cold, shortness of breath insufficient to sustain respiration, and change in the color of the urine. For all these diseases: if excess, drain it; if deficient, supplement it; if hot, needle it swiftly; if cold, retain the needle; if the vessel is sunken and collapsed, apply moxibustion; if neither excess nor deficient, take it by way of the channel itself. In cases of excess, the cunkou pulse (felt at the wrist) is three-fold larger than the renying pulse (felt at the neck); in cases of deficiency, the cunkou is instead smaller than the renying.

The Hand Yangming Large Intestine channel arises at the tip of the index finger, follows the upper border of the finger, emerges between the two bones at hegu (the web between thumb and index finger), ascends into the depression between the two tendons, follows the upper border of the forearm, enters the outer border of the elbow, ascends along the anterior outer border of the upper arm, ascends to the shoulder, emerges in front of the acromion, ascends further to the meeting point above the great pillar bone at the base of the neck, descends into the supraclavicular fossa, networks with the lung, descends through the diaphragm, and belongs to the large intestine. Its branch ascends from the supraclavicular fossa to the neck, passes through the cheek, enters the lower gums, then turns back out to flank the mouth, crosses at renzhong (the philtrum) — the left channel crossing to the right, the right to the left — and ascends to flank the nostril.

When this channel is disturbed, the resulting disease is toothache and swelling of the neck. Among the diseases governed by the body fluids, there is yellowing of the eyes, dryness of the mouth, nosebleed, throat impediment, pain in the anterior shoulder and upper arm, and pain and disuse of the index finger. When the qi is in excess, the region through which the channel passes becomes hot and swollen; when deficient, there is chill and shivering that does not recover. For all these diseases: if excess, drain it; if deficient, supplement it; if hot, needle it swiftly; if cold, retain the needle; if sunken and collapsed, apply moxibustion; if neither excess nor deficient, take it by way of the channel itself. In cases of excess, the renying pulse is three-fold larger than the cunkou; in cases of deficiency, the renying is instead smaller than the cunkou.

The Foot Yangming Stomach channel arises where the nose meets the bridge between the eyes, joins laterally with the Taiyang channel, descends along the outer side of the nose, enters the upper gums, turns back out to flank the mouth and encircle the lips, descends to cross at chengjiang below the lower lip, then withdraws to follow the lower border behind the jaw, emerges at daying, follows jiache along the jaw, ascends in front of the ear, passes kezhuren, follows the hairline, and reaches the forehead. Its branch descends from in front of daying to renying, follows the throat, enters the supraclavicular fossa, descends through the diaphragm, belongs to the stomach, and networks with the spleen. Its direct branch descends from the supraclavicular fossa along the inner border of the breast, descends to flank the navel, and enters qichong. Another branch arises at the lower opening of the stomach, descends inside the abdomen, and reaches down to qichong, where it joins with the direct branch; from there it descends past biguan, reaches futu, descends to the kneecap, descends along the outer border of the shin, descends to the instep, and enters between the toes at the middle toe. A further branch separates three cun below the knee and descends to enter between the outer side of the middle toe. Yet another branch separates from the instep and enters between the big toe and its neighbor, emerging at its tip.

When this channel is disturbed, the resulting disease is shivering with cold as though drenched in cold water, frequent groaning, repeated yawning, a darkened forehead, and when the illness arrives the person dislikes other people and fire; on hearing the sound of wood, he is startled with fright, his heart wants to race, and he wishes only to shut the doors and windows and stay alone. In severe cases he wishes to climb to a high place and sing, to cast off his clothes and run about, with rumbling and distension in the abdomen — this is called "shin reversal." Among the diseases governed by the blood, there is mania, malaria, excess of warm-disease, sweating, nosebleed, deviation of the mouth, eruptions on the lips, swelling of the neck, throat impediment, swelling and water accumulation in the great abdomen, swollen and painful kneecaps, and pain running along the chest, breast, qichong, thigh, futu, the outer border of the shin, and the instep, with disuse of the middle toe. When the qi is in excess, the entire front of the body feels hot; if there is a surplus of qi in the stomach, this causes rapid digestion and easy hunger, with yellow urine. When the qi is deficient, the entire front of the body feels chilled and shivering, and cold in the stomach brings distension and fullness. For all these diseases: if excess, drain it; if deficient, supplement it; if hot, needle it swiftly; if cold, retain the needle; if sunken and collapsed, apply moxibustion; if neither excess nor deficient, take it by way of the channel itself. In cases of excess, the renying pulse is three-fold larger than the cunkou; in cases of deficiency, the renying is instead smaller than the cunkou.

The Foot Taiyin Spleen channel arises at the tip of the big toe, follows the border between the red and white flesh along the inner side of the toe, passes behind the core bone, ascends along the anterior border of the inner ankle, ascends the inner aspect of the calf, follows behind the shinbone, crosses to emerge in front of the Jueyin channel, ascends the anterior inner border of the knee and thigh, enters the abdomen, belongs to the spleen, and networks with the stomach; it ascends through the diaphragm, flanks the throat, connects with the root of the tongue, and disperses beneath the tongue. Its branch again separates from the stomach, ascends through the diaphragm, and pours into the heart.

When this channel is disturbed, the resulting disease is stiffness at the root of the tongue, vomiting after eating, pain in the stomach duct, abdominal distension, frequent belching; upon defecation or the passing of gas one feels relieved as though the illness had eased, yet the whole body feels heavy. Among the diseases governed by the spleen, there is pain at the root of the tongue, inability to move the body, inability to swallow food, vexation of the heart, acute pain below the heart, sloppy diarrhea and abdominal masses, water retention, jaundice, inability to lie down, an inability to remain still though standing, swelling and reversal-cold in the inner thigh and knee, and disuse of the big toe. For all these diseases: if excess, drain it; if deficient, supplement it; if hot, needle it swiftly; if cold, retain the needle; if sunken and collapsed, apply moxibustion; if neither excess nor deficient, take it by way of the channel itself. In cases of excess, the cunkou pulse is three-fold larger than the renying; in cases of deficiency, the cunkou is instead smaller than the renying.

The Hand Shaoyin Heart channel arises within the heart, emerges to belong to the heart system, descends through the diaphragm, and networks with the small intestine. Its branch ascends from the heart system to flank the throat and connect with the eye system. Its direct branch again ascends from the heart system to the lung, descends and emerges below the axilla, descends along the posterior inner border of the upper arm, running behind the Taiyin and Xin Zhu channels, descends inside the elbow, follows the posterior inner border of the forearm, reaches the tip of the small bone behind the palm, enters the posterior inner border of the palm, follows the inner side of the little finger, and emerges at its tip.

When this channel is disturbed, the resulting disease is dryness of the throat, pain in the heart, and thirst with a desire to drink — this is called "arm reversal." Among the diseases governed by the heart, there is yellowing of the eyes, pain in the rib-side, pain and reversal-cold along the posterior inner border of the upper arm and forearm, and heat and pain in the palm. For all these diseases: if excess, drain it; if deficient, supplement it; if hot, needle it swiftly; if cold, retain the needle; if sunken and collapsed, apply moxibustion; if neither excess nor deficient, take it by way of the channel itself. In cases of excess, the cunkou pulse is two-fold larger than the renying; in cases of deficiency, the cunkou is instead smaller than the renying.

The Hand Taiyang Small Intestine channel arises at the tip of the little finger, follows the outer side of the hand, ascends the wrist, emerges at the bony prominence of the wrist, ascends straight along the lower border of the forearm bone, emerges between the two tendons on the inner side of the elbow, ascends along the posterior outer border of the upper arm, emerges at the shoulder joint, encircles the shoulder blade, crosses at the top of the shoulder, enters the supraclavicular fossa, networks with the heart, follows the throat, descends through the diaphragm, reaches the stomach, and belongs to the small intestine. Its branch ascends from the supraclavicular fossa along the neck to the cheek, reaches the outer canthus of the eye, and then enters the ear. Another branch separates at the cheek, ascends to zhuo (the region below the eye), reaches the nose, arrives at the inner canthus of the eye, and slants to network with the cheekbone.

When this channel is disturbed, the resulting disease is pain in the throat, swelling of the jaw, inability to turn the head to look back, a shoulder that feels as if wrenched out, and an upper arm that feels as if broken. Among the diseases governed by the body fluids, there is deafness, yellowing of the eyes, swelling of the cheek, and pain in the neck, jaw, shoulder, upper arm, elbow, and the posterior outer border of the forearm. For all these diseases: if excess, drain it; if deficient, supplement it; if hot, needle it swiftly; if cold, retain the needle; if sunken and collapsed, apply moxibustion; if neither excess nor deficient, take it by way of the channel itself. In cases of excess, the renying pulse is two-fold larger than the cunkou; in cases of deficiency, the renying is instead smaller than the cunkou.

The Foot Taiyang Bladder channel arises at the inner canthus of the eye, ascends the forehead, and crosses at the vertex. Its branch runs from the vertex to the upper corner of the ear. Its direct branch enters from the vertex to network with the brain, then returns and emerges to descend the nape, following the inner border of the shoulder blade, flanking the spine, reaching the lower back, entering to follow the paraspinal muscles, networking with the kidney, and belonging to the bladder. Its branch descends from the lower back, flanks the spine, pierces the buttock, and enters the popliteal fossa. Another branch, from within the shoulder blades on both sides, separates and descends, pierces the scapula, flanks the inside of the spine, passes the hip joint, follows the outer side of the thigh along its posterior border, descends to join at the popliteal fossa, and from there descends to pierce the inner aspect of the calf, emerges behind the outer ankle, follows jinggu, and reaches the outer side of the little toe.

When this channel is disturbed, the resulting disease is a surging headache, eyes that feel as if bulging outward, a nape that feels as if wrenched, pain in the spine, a lower back that feels as if broken, inability to bend the hip, a popliteal fossa that feels bound up, and a calf that feels as if splitting apart — this is called "ankle reversal." Among the diseases governed by the sinews, there is hemorrhoids, malaria, mania, epilepsy-like disorders, pain at the crown of the head and nape, yellowing of the eyes, tearing, nosebleed, and pain throughout the nape, back, lower back, sacrum, popliteal fossa, calf, and foot, with disuse of the little toe. For all these diseases: if excess, drain it; if deficient, supplement it; if hot, needle it swiftly; if cold, retain the needle; if sunken and collapsed, apply moxibustion; if neither excess nor deficient, take it by way of the channel itself. In cases of excess, the renying pulse is two-fold larger than the cunkou; in cases of deficiency, the renying is instead smaller than the cunkou.

The Foot Shaoyin Kidney channel arises beneath the little toe, runs obliquely to the sole of the foot, emerges below rangu, follows behind the inner ankle, separates to enter the heel, ascends the inner calf, emerges at the inner border of the popliteal fossa, ascends the posterior inner border of the thigh, pierces the spine, belongs to the kidney, and networks with the bladder. Its direct branch ascends from the kidney, pierces the liver and diaphragm, enters the lung, follows the throat, and flanks the root of the tongue. Its branch emerges from the lung, networks with the heart, and pours into the chest.

When this channel is disturbed, the resulting disease is hunger without any desire to eat, a face as dark and withered as lacquered wood, coughing with blood in the spittle, wheezing and panting, wanting to rise the moment one sits, dim and blurred vision as though seeing nothing, and a heart that feels suspended as if in hunger. When the qi is deficient, one is prone to fear, the heart pounds anxiously as though someone were about to seize him — this is called "bone reversal." Among the diseases governed by the kidney, there is heat in the mouth, dryness of the tongue, swelling of the throat, qi rising upward, dryness and pain of the throat, vexation of the heart, pain in the heart, jaundice, dysenteric diarrhea, pain along the posterior inner border of the spine and thigh, wilting weakness and reversal-cold, excessive drowsiness, and heat and pain in the soles of the feet. For all these diseases: if excess, drain it; if deficient, supplement it; if hot, needle it swiftly; if cold, retain the needle; if sunken and collapsed, apply moxibustion. When treated with moxibustion, the patient should be made to eat well so as to generate flesh, to loosen the belt and let the hair hang free, and to walk with a stout staff and heavy shoes. In cases of excess, the cunkou pulse is two-fold larger than the renying; in cases of deficiency, the cunkou is instead smaller than the renying.

The Xin Zhu, the Hand Jueyin Pericardium channel, arises within the chest, emerges to belong to the pericardium, descends through the diaphragm, and successively networks with the triple burner. Its branch follows the chest and emerges at the rib-side, descends three cun below the axilla, ascends back up to the axilla, follows the inner aspect of the upper arm, running between the Taiyin and Shaoyin channels, enters the elbow, descends the forearm, runs between the two tendons, enters the palm, follows the middle finger, and emerges at its tip. Another branch separates within the palm, follows the ring finger, and emerges at its tip.

When this channel is disturbed, the resulting disease is heat in the center of the palm, spasm and tension of the forearm and elbow, swelling of the axilla, and in severe cases fullness and distension of the chest and rib-sides, violent throbbing within the heart, redness of the face, yellowing of the eyes, and incessant laughter. Among the diseases governed by the vessels, there is vexation of the heart, pain in the heart, and heat in the palm. For all these diseases: if excess, drain it; if deficient, supplement it; if hot, needle it swiftly; if cold, retain the needle; if sunken and collapsed, apply moxibustion; if neither excess nor deficient, take it by way of the channel itself. In cases of excess, the cunkou pulse is one-fold larger than the renying; in cases of deficiency, the cunkou is instead smaller than the renying.

The Hand Shaoyang Triple Burner channel arises at the tip of the ring finger, ascends between the two fingers, follows the back of the wrist, emerges between the two bones on the outer forearm, ascends to pierce the elbow, follows the outer upper arm, ascends to the shoulder, and crosses to emerge behind the Foot Shaoyang channel, enters the supraclavicular fossa, spreads through danzhong at the center of the chest, disperses to network with the pericardium, descends through the diaphragm, and follows down to belong to the triple burner. Its branch ascends from danzhong, emerges at the supraclavicular fossa, ascends the nape, connects behind the ear, ascends straight up to emerge at the upper corner of the ear, then bends downward to the cheek, reaching zhuo. Another branch enters the ear from behind it, emerges to run in front of the ear, passes in front of kezhuren, crosses the cheek, and reaches the outer canthus of the eye.

When this channel is disturbed, the resulting disease is deafness with a dull, muffled roaring in the ears, swelling of the throat, and throat impediment. Among the diseases governed by the qi, there is sweating, pain at the outer canthus of the eye, pain in the cheek, and pain behind the ear and in the shoulder, upper arm, elbow, and outer forearm, with disuse of the ring finger. For all these diseases: if excess, drain it; if deficient, supplement it; if hot, needle it swiftly; if cold, retain the needle; if sunken and collapsed, apply moxibustion; if neither excess nor deficient, take it by way of the channel itself. In cases of excess, the renying pulse is one-fold larger than the cunkou; in cases of deficiency, the renying is instead smaller than the cunkou.

The Foot Shaoyang Gallbladder channel arises at the outer canthus of the eye, ascends to the corner of the head, descends behind the ear, follows the neck in front of the Hand Shaoyang channel, reaches the top of the shoulder, then crosses back out behind the Hand Shaoyang channel, and enters the supraclavicular fossa. Its branch enters the ear from behind it, emerges to run in front of the ear, and reaches behind the outer canthus of the eye. Another branch separates at the outer canthus, descends to daying, joins with the Hand Shaoyang channel, reaches below zhuo, adds on at jiache, descends the neck, joins at the supraclavicular fossa, and from there descends into the chest, pierces the diaphragm, networks with the liver, belongs to the gallbladder, follows the inside of the rib-side, emerges at qichong, encircles the margin of the pubic hair, and enters transversely into the hip joint. Its direct branch descends from the supraclavicular fossa to the axilla, follows the chest, passes the free ribs, descends to join at the hip joint, and from there descends along the outer side of the thigh, emerges at the outer border of the knee, descends in front of the fibula, continues straight down to reach juegu at the end of the fibula, descends to emerge in front of the outer ankle, follows the top of the instep, and enters between the fourth toe and the little toe. Another branch separates from the instep, enters between the big toe and its neighbor, follows the inner side of the cleft bone of the big toe, emerges at its tip, turns back to pierce the nail, and emerges at the tuft of three hairs.

When this channel is disturbed, the resulting disease is bitterness in the mouth, frequent sighing, pain in the heart and rib-side, inability to turn the body from side to side, and in severe cases the face appears as though covered with fine dust, the body lacks its usual luster, and the outer side of the foot becomes abnormally hot — this is called "yang reversal." Among the diseases governed by the bones, there is headache, pain in the jaw, pain at the outer canthus of the eye, swelling and pain within the supraclavicular fossa, swelling below the axilla, scrofulous swellings resembling a saber-clam shell strung along the neck, sweating with shivering, malaria, and pain throughout the chest, rib-side, flank, thigh, and from the outer knee down to the shin, juegu, and the region in front of the outer ankle, and pain in all the joints, with disuse of the fourth toe. For all these diseases: if excess, drain it; if deficient, supplement it; if hot, needle it swiftly; if cold, retain the needle; if sunken and collapsed, apply moxibustion; if neither excess nor deficient, take it by way of the channel itself. In cases of excess, the renying pulse is one-fold larger than the cunkou; in cases of deficiency, the renying is instead smaller than the cunkou.

The Foot Jueyin Liver channel arises at the tuft of hair on the big toe, ascends along the upper border of the instep, one cun from the inner ankle, ascends eight cun above the ankle, crosses to emerge behind the Taiyin channel, ascends the inner border of the popliteal fossa, follows the inner side of the thigh, enters the pubic hair, passes around the genitals, reaches the lower abdomen, flanks the stomach, belongs to the liver, and networks with the gallbladder; it ascends to pierce the diaphragm, spreads through the rib-side, follows behind the throat, ascends into the nasopharynx, connects with the eye system, emerges at the forehead, and meets the Governing Vessel at the vertex. Its branch descends from the eye system into the cheek, and encircles the inside of the lips. Another branch again separates from the liver, pierces the diaphragm, and ascends to pour into the lung.

When this channel is disturbed, the resulting disease is lower back pain such that one cannot bend forward or backward, scrotal hernia swelling in men and swelling of the lower abdomen in women, and in severe cases dryness of the throat, a dust-covered face, and loss of complexion. Among the diseases governed by the liver, there is fullness in the chest, retching and vomiting, diarrhea with undigested food, fox hernia, incontinence of urine, and urinary blockage. For all these diseases: if excess, drain it; if deficient, supplement it; if hot, needle it swiftly; if cold, retain the needle; if sunken and collapsed, apply moxibustion; if neither excess nor deficient, take it by way of the channel itself. In cases of excess, the cunkou pulse is one-fold larger than the renying; in cases of deficiency, the cunkou is instead smaller than the renying.

When the qi of the Hand Taiyin is exhausted, the skin and body hair wither. The Taiyin is that which circulates qi to warm the skin and body hair. Hence when the qi fails to nourish, the skin and hair wither; when the skin and hair wither, the body fluids depart from the skin and joints; when the body fluids depart from the skin and joints, the nails become dry and brittle and the hair breaks off; when the hair breaks off, this means the hair dies first. Such a person will worsen on a bing day and die on a ding day, for fire overcomes metal.

When the qi of the Hand Shaoyin is exhausted, the vessels no longer flow freely; when the vessels no longer flow freely, the blood no longer circulates; when the blood no longer circulates, the hair and complexion lose their luster. Hence when the face turns black like withered lacquer wood, this means the blood dies first. Such a person will worsen on a ren day and die on a gui day, for water overcomes fire.

When the qi of the Foot Taiyin is exhausted, the vessels no longer nourish the flesh and muscles. The lips and tongue are the root of the flesh and muscles. When the vessels fail to nourish, the flesh and muscles become flaccid; when the flesh and muscles become flaccid, the tongue withers and the philtrum becomes full; when the philtrum becomes full, the lips turn outward; when the lips turn outward, this means the flesh dies first. Such a person will worsen on a jia day and die on a yi day, for wood overcomes earth.

When the qi of the Foot Shaoyin is exhausted, the bones wither. The Shaoyin is the vessel of winter; it travels hidden within and moistens the bones and marrow. Hence when the bones are not moistened, the flesh cannot adhere to them; when the bones and flesh no longer cling to one another, the flesh becomes flaccid and recedes; when the flesh becomes flaccid and recedes, the teeth appear to lengthen and grow coated with grime, and the hair loses its luster; when the hair loses its luster, this means the bone dies first. Such a person will worsen on a wu day and die on a ji day, for earth overcomes water.

When the qi of the Foot Jueyin is exhausted, the sinews give out. The Jueyin is the vessel of the liver; the liver corresponds with the sinews, and the sinews gather at the genital region, with the vessel networking at the root of the tongue. Hence when the vessel fails to nourish, the sinews become tense; when the sinews become tense, they pull upon the tongue and the genitals, so that the lips turn blue, the tongue curls up, and the genitals contract — this means the sinews die first. Such a person will worsen on a geng day and die on a xin day, for metal overcomes wood.

When the qi of all five yin channels is exhausted together, the eye system rotates; when it rotates, the eyes become disoriented and everything appears to spin — this means the will dies first; when the will dies first, death follows within a day and a half at most. When the qi of the six yang channels is exhausted, yin and yang separate from each other; when they separate, the interstices of the skin open and leak, and "severance sweat" pours out. Hence if this is observed in the morning, death will come by evening; if observed in the evening, death will come by the following morning.

The twelve channel vessels travel hidden between the layers of flesh, running deep and thus invisible. The one that is normally visible is the Foot Taiyin, where it passes above the outer ankle, for there it has no place to hide. All the vessels that float near the surface and are habitually visible are network vessels. Among the network vessels of the six channels, the great network vessels of the Hand Yangming and Hand Shaoyang arise between the five fingers and ascend to join within the elbow. In a person who has been drinking wine, the defensive qi travels first through the skin, first fills the network vessels, and the network vessels become replete first. Hence once the defensive qi has become level and calm, the nutritive qi then becomes full, and the channel vessels become greatly replete. Whenever a vessel suddenly throbs and stirs, this is invariably because evil qi has lodged within it, lingering at its root or its tip; if it does not throb, there is heat; if it is not firm, there is sinking and hollowness — and where it does not resemble the vessels around it, one can thereby know which particular vessel is stirring.

Leigong said: "How can one know the difference between the channel vessels and the network vessels?" Huangdi said: "The channel vessels are ordinarily invisible; their deficiency and excess are known through the qikou (the pulse felt at the wrist, equivalent to the cunkou). Vessels that are visible are, in every case, network vessels."

Leigong said: "This lowly disciple is still unable to grasp the reason for this." Huangdi said: "None of the network vessels are able to pass directly through the large joints; they must instead travel by cut-off pathways, emerging and entering, and then rejoin within the skin, so that their confluences are all visible on the surface. Hence, whenever one needles a network vessel, one must needle the place where it knots and where the blood is most abundant. Even where there is no knot, one should still take it up promptly, so as to drain the evil qi and let out its blood; if it is allowed to linger, it will develop into impediment (bi) disease. In examining the network vessels generally: if the color of the vessel is green-blue, there is cold and pain; if red, there is heat. When there is cold in the stomach, the network vessels at the thenar eminence of the hand are mostly green-blue; when there is heat in the stomach, the network vessel at the thenar border is red. Where it has suddenly turned black, this is impediment disease that has lingered long. Where there is a mixture of red, black, and green-blue, this indicates alternating cold and heat qi. Where it is green-blue and short, this indicates scanty qi. In all cases of needling for cold and heat disorders, when the blood-filled network vessels are numerous, one must take them up once every other day, stopping only once the blood is exhausted, and then regulate the deficiency and excess. Where the vessel is small and short, this indicates scanty qi; in severe cases, if one drains it, the patient will feel oppressed and stifled, and if the oppression is severe he will collapse and be unable to speak — when this oppression occurs, one must promptly sit the patient upright."

The connecting vessel of the Hand Taiyin is called Lieque. It arises above the wrist, in the cleft between the tendons, runs alongside the Taiyin channel, enters directly into the palm, and disperses into the thenar eminence. When this vessel is in excess, the disease is heat in the wrist and palm; when deficient, the disease is yawning and stretching, with frequent involuntary urination. It is needled one and a half cun above the wrist. It branches off to communicate with the Yangming channel.

The connecting vessel of the Hand Shaoyin is called Tongli. It lies one and a half cun above the wrist, branches off and ascends, follows the channel to enter the heart, connects with the root of the tongue, and belongs to the eye system. When in excess, the disease is a propped-up, obstructed feeling in the diaphragm; when deficient, the disease is inability to speak. It is needled one cun behind the palm. It branches off to communicate with the Taiyang channel.

The connecting vessel of the Hand Xin Zhu is called Neiguan. It lies two cun above the wrist, emerges between the two tendons, follows the channel upward, and connects with the pericardium. When the heart system is in excess, the disease is pain in the heart; when deficient, the disease is stiffness of the head. It is needled between the two tendons.

The connecting vessel of the Hand Taiyang is called Zhizheng. It lies five cun above the wrist, and pours inward into the Shaoyin channel; its branch ascends to the elbow and networks with jianyu at the shoulder. When in excess, the disease is slackness of the joints and disuse of the elbow; when deficient, the disease is warts, small ones resembling scabby, itchy skin lesions. It is needled at the point where it branches off.

The connecting vessel of the Hand Yangming is called Pianli. It lies three cun above the wrist, and branches off to enter the Taiyin channel; another branch ascends along the forearm, mounts jianyu, ascends to the curve of the cheek, and reaches the teeth; yet another branch enters the ear and joins with the ancestral vessels. When in excess, the disease is dental caries and deafness; when deficient, the disease is cold in the teeth and a blocked, obstructed feeling in the chest. It is needled at the point where it branches off.

The connecting vessel of the Hand Shaoyang is called Waiguan. It lies two cun above the wrist, encircles the outer forearm, pours into the chest, and joins with the Xin Zhu channel. When the disease is one of excess, there is spasm of the elbow; when deficient, there is inability to draw it in. It is needled at the point where it branches off.

The connecting vessel of the Foot Taiyang is called Feiyang. It lies seven cun above the ankle, and branches off to communicate with the Shaoyin channel. When in excess, the disease is nasal congestion, with pain in the head and back; when deficient, the disease is nosebleed. It is needled at the point where it branches off.

The connecting vessel of the Foot Shaoyang is called Guangming. It lies five cun above the ankle, branches off to communicate with the Jueyin channel, and descends to network with the instep of the foot. When in excess, the disease is reversal-cold; when deficient, the disease is wilting weakness and lameness, so that one cannot rise once seated. It is needled at the point where it branches off.

The connecting vessel of the Foot Yangming is called Fenglong. It lies eight cun above the ankle, and branches off to communicate with the Taiyin channel; another branch follows the outer border of the shinbone, ascends to network with the head and nape, joins with the qi of the various channels, and descends to network with the throat. When its qi rebels, the disease is throat impediment with sudden loss of voice. When in excess, the disease is mania and epilepsy; when deficient, the disease is inability to draw up the foot, with withering of the shin. It is needled at the point where it branches off.

The connecting vessel of the Foot Taiyin is called Gongsun. It lies one cun behind the base joint of the big toe, and branches off to communicate with the Yangming channel; another branch enters to network with the intestines and stomach. When reversal qi surges upward, the disease is sudden turmoil disorder, an acute affliction of vomiting and diarrhea; when in excess, the disease is cutting pain within the intestines; when deficient, the disease is drum-like distension. It is needled at the point where it branches off.

The connecting vessel of the Foot Shaoyin is called Dazhong. It lies behind the ankle, encircling the heel, and branches off to communicate with the Taiyang channel; another branch runs alongside the channel, ascending to below the pericardium, and pierces outward through the lower back and spine. When its qi rebels, the disease is vexation and oppression; when in excess, the disease is urinary blockage; when deficient, the disease is lower back pain. It is needled at the point where it branches off.

The connecting vessel of the Foot Jueyin is called Ligou. It lies five cun above the inner ankle, and branches off to communicate with the Shaoyang channel; another branch follows the shin, ascends to the testicles, and knots at the penis. When its qi rebels, the disease is swelling of the testicles and sudden hernia; when in excess, the disease is prolonged erection; when deficient, the disease is sudden itching. It is needled at the point where it branches off.

The connecting vessel of the Conception Vessel is called Weiyi. It descends from jiuwei and disperses through the abdomen. When in excess, the disease is pain in the skin of the abdomen; when deficient, the disease is itching. It is needled at the point where it branches off.

The connecting vessel of the Governing Vessel is called Changqiang. It flanks the paraspinal muscles, ascends the nape, disperses over the top of the head, and descends to correspond with the shoulder blades on both sides, branching off to communicate with the Taiyang channel and entering to pierce the paraspinal muscles. When in excess, the disease is stiffness of the spine; when deficient, the disease is heaviness of the head, and shaking it produces dizziness — in this case the fault lies where the vessel flanks the spine. It is needled at the point where it branches off.

The great connecting vessel of the spleen is called Dabao. It emerges three cun below yuanye and spreads through the chest and rib-side. When in excess, the disease is pain throughout the entire body; when deficient, the disease is slackness in all the joints. Whenever this vessel is engorged and stagnant with blood as though exhausted, one should needle it at the great connecting vessel of the spleen.

In all of these fifteen connecting vessels, when there is excess the vessel will necessarily become visible, and when there is deficiency it will necessarily sink and become depressed. If on inspection it is not visible, one should search for it above and below. Since people's channels are not uniform, the network vessels likewise differ from person to person in where they branch off.