灵枢经·经筋 Sinew Channels
足太阳之筋，起于足小趾，上结于踝，邪上结于膝，其下循足外侧，结于踵，上循跟，结于膕；其别者，结于腨外，上膕中内廉，与膕中并上结于臀，上挟脊上项；其支者，别入结于舌本；其直者，结于枕骨，上头，下颜，结于鼻；其支者，为目上网，下结于頄；其支者，从腋后外廉结于肩髃；其支者，入腋下，上出缺盆，上结于完骨；其支者，出缺盆，邪上出于頄。其病小趾支跟肿痛，膕挛，脊反折，项筋急，肩不举，腋支缺盆中纽痛，不可左右摇。治在燔针劫刺，以知为数，以痛为输，名曰仲春痹也1。1. 也 : 旧脱。
足少阳之筋，起于小指次指，上结外踝，上循胫外廉，结于膝外廉；其支者，别起外辅骨，上走髀，前者结于伏兔之上，后者，结于尻；其直者，上乘䏚季胁，上走腋前廉，系于膺乳，结于缺盆；直者，上出腋，贯缺盆，出太阳之前，循耳后，上额角，交巅上，下走颔，上结于頄；支者，结于目眦为外维。其病小指次指支转筋，引膝外转筋，膝不可屈伸，膕筋急，前引髀，后引尻，即上乘䏚季胁痛，上引缺盆、膺乳、颈维筋急。从左之右，右目不开，上过右角，并蹻脉而行，左络于右，故伤左角，右足不用，命曰维筋相交。治在燔针劫刺，以知为数，以痛为输，名曰孟春痹也。
足阳明之筋，起于中三指，结于跗上，邪外上加于辅骨，上结于膝外廉，直上结于髀枢，上循胁属脊；其直者，上循骭，结于膝；其支者，结于外辅骨，合少阳；其直者，上循伏兔，上结于髀，聚于阴器，上腹而布，至缺盆而结，上颈，上挟口，合于頄，下结于鼻，上合于太阳。太阳为目上网，阳明为目下网；其支者，从颊结于耳前。其病足中指支胫转筋，脚跳坚，伏兔转筋，髀前踵，㿉疝，腹筋急，引缺盆及颊，卒口僻；急者，目不合，热则筋纵，目不开，颊筋有寒，则急，引颊移口，有热则筋弛纵，缓不胜收，故僻。治之以马膏，膏其急者；以白酒和桂，以涂其缓者，以桑钩钩之，即以生桑炭置之坎中，高下以坐等。以膏熨急颊，且饮美酒，敢美炙肉，不饮酒者，自强也，为之三拊而已。治在燔针劫刺，以知为数，以痛为输，名曰季春痹也。
足太阴之筋，起于大指之端内侧，上结于内踝；其直者，络于膝内辅骨，上循阴股，结于髀，聚于阴器，上腹结于脐，循腹里，结于肋，散于胸中；其内者，著于脊。其病足大指支内踝痛，转筋痛，膝内辅骨痛，阴股引髀而痛，阴器纽痛，上引脐两胁痛，引膺中脊内痛。治在燔针劫刺，以知为数，以痛为输，命曰孟秋痹也。
足少阴之筋，起于小指之下，并足太阴之筋，邪走内踝之下，结于踵，与太阳之筋合，而上结于内辅之下，并太阴之筋，而上循阴股，结于阴器，循脊内挟膂上至项，结于枕骨，与足太阳之筋合。其病足下转筋，及所过而结者皆痛及转筋。病在此者，主癎瘈及痉，在外者不能挽，在内者不能仰。故阳病者，腰反折不能俛，阴病者，不能仰。治在燔针劫刺，以知为数，以痛为输。在内者熨引饮药，此筋折纽，纽发数甚者死不治，名曰仲秋痹也。
足厥阴之筋，起于大指之上，上结于内踝之前，上循胫，上结内辅之下，上循阴股，结于阴器，络诸筋。其病足大指支内踝之前痛，内辅痛，阴股痛转筋，阴器不用，伤于内则不起，伤于寒则阴缩入，伤于热则纵挺不收，治在行水清阴气；其病转筋者，治在燔针劫刺，以知为数，以痛为输，命曰季秋痹也。
手太阳之筋，起于小指之上，结于腕，上循臂内廉，结于肘内锐骨之后，弹之应小指之上，入结于腋下；其支者，后走腋后廉，上绕肩胛，循颈出走太阳之前，结于耳后完骨；其支者，入耳中；直者，出耳上，下结于颔，上属目外眦。其病小指支肘内锐骨后廉痛，循臂阴，入腋下，腋下痛，腋后廉痛，绕肩胛引颈而痛，应耳中鸣痛引颔，目瞑良久乃得视，颈筋急，则为筋瘻颈肿，寒热在颈者。治在燔针劫刺之，以知为数，以痛为输。其为肿者，复而锐之。本支者，上曲牙，循耳前属目外眦，上颔结于角，其痛当所过者支转筋。治在燔针劫刺，以知为数，以痛为输，名曰仲夏痹也。
手少阳之筋，起于小指次指之端，结于腕，中循臂，结于肘，上绕臑外廉、上肩、走颈，合手太阳；其支者，当曲颊入系舌本；其支者，上曲牙，循耳前，属目外眦，上乘颔，结于角。其病当所过者，即支转筋，舌卷。治在燔针劫刺，以知为数，以痛为输，名曰季夏痹也。
手阳明之筋，起于大指次指之端，结于腕，上循臂，上结于肘外，上臑，结于髃；其支者，绕肩胛，挟脊；直者，从肩髃上颈；其支者，上颊，结于頄；直者，上出手太阳之前，上左角，络头，下右颔。其病当所过者，支痛及转筋，肩不举，颈不可左右视。治在燔针劫刺，以知为数，以痛为输，名曰孟夏痹也。
手太阴之筋，起于大指之上，循指上行，结于鱼后，行寸口外侧，上循臂，结肘中，上臑内廉，入腋下，出缺盆，结肩前髃，上结缺盆，下结胸里，散贯贲，合贲下抵季胁。其病当所过者，支转筋，痛甚成息贲，胁急吐血。治在燔针劫刺，以知为数，以痛为输。名曰仲冬痹也。
手心主之筋，起于中指，与太阴之筋并行，结于肘内廉，上臂阴，结腋下，下散前后挟胁；其支者，入腋，散胸中，结于臂。其病当所过者，支转筋前及胸痛息贲。治在燔针劫刺，以知为数，以痛为输，名曰孟冬痹也。
手少阴之筋，起于小指之内侧，结于锐骨，上结肘内廉，上入腋，交太阴，挟乳里，结于胸中，循臂下系于脐。其病内急心承伏梁，下为肘网。其病当所过者，支转筋，筋痛,治在燔针劫刺，以知为数，以痛为输。其成伏梁唾血脓者，死不治。经筋之病，寒则反折筋急，热则筋弛纵不收，阴痿不用。阳急则反折，阴急则俛不伸。焠刺者，刺寒急也，热则筋纵不收，无用燔针，名曰季冬痹也。
足之阳明，手之太阳，筋急则口目为僻，眦急不能卒视，治皆如右方也。
The sinew channel of Foot Taiyang originates at the little toe, ascends and knots at the ankle, then slants upward to knot at the knee; its lower portion follows the outer side of the foot and knots at the heel, ascends along the heel-cord and knots in the popliteal fossa. A branch knots on the outer side of the calf, ascends the inner border of the popliteal region, and together with the popliteal branch ascends to knot at the buttock, then rises alongside the spine to the nape of the neck. One offshoot branches off and enters to knot at the root of the tongue. The straight-running portion knots at the occipital bone, ascends over the head, descends over the forehead, and knots at the nose. One branch forms the upper network of the eye and descends to knot beside the cheekbone. Another branch runs from behind the axilla along its outer border to knot at the shoulder. Another branch enters below the axilla, ascends and emerges at the supraclavicular fossa, and ascends to knot at the mastoid bone. Yet another branch emerges from the supraclavicular fossa and slants upward to emerge beside the cheekbone. Its disorders include swelling and pain radiating from the little toe to the heel, spasm of the popliteal region, opisthotonos of the spine, tension of the sinews at the nape, inability to raise the shoulder, and twisting pain radiating from the axilla to the supraclavicular fossa, such that one cannot turn from side to side. Treatment lies in the swift piercing with a heated needle, taking as the count of treatments the point at which relief is felt, and taking the site of pain as the transport point. This is called the impediment of mid-spring.
The sinew channel of Foot Shaoyang originates at the fourth toe, ascends to knot at the outer ankle, then rises along the outer border of the shin to knot at the outer side of the knee. A branch arises separately from the fibula, ascends to run to the thigh; its anterior portion knots above the 'crouching hare,' and its posterior portion knots at the sacrum. The straight-running portion ascends over the flank and free ribs, rises to run along the front border of the axilla, connects with the chest and breast, and knots at the supraclavicular fossa. The straight-running branch ascends and emerges at the axilla, penetrates the supraclavicular fossa, emerges in front of the Taiyang sinew channel, follows behind the ear, ascends to the corner of the forehead, crosses at the vertex, descends to run to the jaw, and ascends to knot beside the cheekbone. A branch knots at the outer canthus of the eye, forming the 'outer maintaining' network. Its disorders include cramping that radiates from the fourth toe, cramping that draws upon the outer knee such that the knee cannot bend or extend, tension of the sinews in the popliteal region drawing forward on the thigh and backward on the sacrum, pain radiating upward over the flank and free ribs, and tension radiating up to the supraclavicular fossa, chest, breast, and neck-maintaining sinews. When the disorder passes from left to right, the right eye cannot open; because the sinew channel passes above the right corner of the forehead and travels together with the Yangqiao vessel — the yang stepping vessel — with the left connecting to the right, an injury to the left corner of the forehead causes the right foot to lose its function — this is called 'the crossing of the maintaining sinews.' Treatment lies in the swift piercing with a heated needle, taking as the count the point at which relief is felt, and taking the site of pain as the transport point. This is called the impediment of early spring.
The sinew channel of Foot Yangming originates at the three middle toes, knots on the instep, slants outward and upward to add onto the fibula, ascends to knot at the outer side of the knee, and rises straight up to knot at the hip joint; it then ascends along the flank and connects with the spine. The straight-running portion ascends along the shin and knots at the knee. A branch knots at the fibula and joins with Shaoyang. Another straight-running portion ascends along the 'crouching hare,' rises to knot at the thigh, gathers at the genitals, spreads upward over the abdomen, and knots at the supraclavicular fossa; it then ascends the neck, rises alongside the mouth, joins beside the cheekbone, descends to knot at the nose, and ascends to join with Taiyang. Taiyang forms the upper network of the eye, and Yangming forms the lower network of the eye. A branch runs from the cheek to knot in front of the ear. Its disorders include cramping radiating from the middle toe to the shin, hardness with jumping of the foot, cramping of the 'crouching hare,' swelling at the front of the thigh, hernial swelling, tension of the abdominal sinews drawing on the supraclavicular fossa and the cheek, and sudden deviation of the mouth. When the affected side is in spasm, the eye on that side cannot close; when there is heat, the sinews become slack and the eye cannot open. When the cheek sinews are affected by cold, they contract, drawing the cheek and shifting the mouth; when affected by heat, the sinews become loose and slack, too relaxed to draw back, and so the mouth deviates. Treatment is by applying horse fat as an ointment to the contracted side, and by anointing the slack side with white wine mixed with cinnamon; one then hooks the area with a mulberry hook, placing fresh mulberry charcoal in a pit, its height matched to the level of the patient when seated. One applies hot compresses of the ointment to the contracted cheek, and has the patient drink fine wine and eat richly roasted meat; if the patient does not drink wine, he should force himself to do so all the same. This treatment is applied with three gentle pattings, and that suffices. Treatment lies in the swift piercing with a heated needle, taking as the count the point at which relief is felt, and taking the site of pain as the transport point. This is called the impediment of late spring.
The sinew channel of Foot Taiyin originates at the medial tip of the great toe, ascends and knots at the inner ankle. Its straight-running portion connects with the inner aspect of the knee, ascends along the medial thigh, knots at the thigh, gathers at the genitals, ascends over the abdomen and knots at the navel, follows the interior of the abdomen, knots at the ribs, and disperses within the chest; its inner portion attaches to the spine. Its disorders include pain radiating from the great toe to the inner ankle, cramping pain, pain at the inner aspect of the knee, pain radiating along the medial thigh to the hip, twisting pain in the genitals, pain radiating upward to the navel and both flanks, and pain radiating to the chest and the interior of the spine. Treatment lies in the swift piercing with a heated needle, taking as the count the point at which relief is felt, and taking the site of pain as the transport point. This is called the impediment of early autumn.
The sinew channel of Foot Shaoyin originates beneath the little toe, runs together with the sinew channel of Foot Taiyin, slants toward the area beneath the inner ankle, and knots at the heel, joining with the sinew channel of Taiyang; it ascends to knot beneath the inner side of the knee, runs together with the Taiyin sinew channel, ascends along the medial thigh, and knots at the genitals; it then follows the interior of the spine, flanks the muscles of the back, ascends to the nape, and knots at the occipital bone, joining with the sinew channel of Foot Taiyang. Its disorders include cramping in the sole of the foot, and pain and cramping at every point where the channel knots along its course. When disease lies in this channel, it governs epilepsy, convulsions, and tetany; when the disorder is on the outside, the body cannot be drawn forward, and when on the inside, it cannot be extended backward. Thus in yang disease, the lower back becomes rigidly arched and cannot bend forward; in yin disease, the body cannot be extended backward. Treatment lies in the swift piercing with a heated needle, taking as the count the point at which relief is felt, and taking the site of pain as the transport point. When the disorder is on the inside, one applies hot compresses, guided stretching exercises, and medicinal decoctions. When the sinews become twisted and knotted in this way, and the twisting recurs frequently and severely, it is fatal and cannot be treated. This is called the impediment of mid-autumn.
The sinew channel of Foot Jueyin originates above the great toe, ascends and knots in front of the inner ankle, ascends along the shin, ascends to knot beneath the inner side of the knee, ascends along the medial thigh, and knots at the genitals, where it connects with all the other sinew channels. Its disorders include pain radiating from the great toe to the area in front of the inner ankle, pain at the inner knee, pain and cramping along the medial thigh, and impotence of the genitals; if injured internally, the member cannot rise; if injured by cold, it retracts inward; if injured by heat, it becomes flaccid and extended, unable to draw back. Treatment lies in draining the water and clearing the yin qi; when the disorder involves cramping, treatment lies in the swift piercing with a heated needle, taking as the count the point at which relief is felt, and taking the site of pain as the transport point. This is called the impediment of late autumn.
The sinew channel of Hand Taiyang originates above the little finger, knots at the wrist, ascends along the inner border of the forearm, and knots behind the bony prominence on the inner side of the elbow — striking this point produces a sensation felt above the little finger — then enters and knots below the axilla. A branch runs backward along the posterior border of the axilla, ascends and winds around the scapula, follows the neck, and emerges to run in front of the Taiyang sinew channel of the foot, knotting behind the ear at the mastoid bone. Another branch enters the ear. The straight-running portion emerges above the ear, descends to knot at the jaw, and ascends to connect with the outer canthus of the eye. Its disorders include pain radiating from the little finger to the posterior border of the bony prominence at the inner elbow, following the inner side of the forearm and entering below the axilla, with pain below the axilla, pain at the posterior border of the axilla, and pain winding around the scapula and radiating to the neck, accompanied by ringing and pain in the ear radiating to the jaw, and blurred vision that clears only after a long while. When the sinews of the neck become tense, this produces sinew fistula and swelling of the neck, with cold and heat lodged there. Treatment lies in the swift piercing with a heated needle, taking as the count the point at which relief is felt, and taking the site of pain as the transport point. Where there is swelling, one repeats the piercing with a sharp needle. As for the original branch that ascends to the bent tooth at the angle of the jaw, follows in front of the ear, connects with the outer canthus, ascends to the jaw and knots at the corner of the forehead — pain occurring anywhere along its course produces radiating cramping. Treatment lies in the swift piercing with a heated needle, taking as the count the point at which relief is felt, and taking the site of pain as the transport point. This is called the impediment of midsummer.
The sinew channel of Hand Shaoyang originates at the tip of the fourth finger, knots at the wrist, runs centrally along the forearm, knots at the elbow, ascends around the outer border of the upper arm, rises over the shoulder, and runs to the neck, joining with Hand Taiyang. A branch, at the bend of the jaw, enters and connects with the root of the tongue. Another branch ascends to the bent tooth, follows in front of the ear, connects with the outer canthus of the eye, rises over the jaw, and knots at the corner of the forehead. Its disorders, wherever the channel passes, produce radiating cramping and curling of the tongue. Treatment lies in the swift piercing with a heated needle, taking as the count the point at which relief is felt, and taking the site of pain as the transport point. This is called the impediment of late summer.
The sinew channel of Hand Yangming originates at the tip of the index finger, knots at the wrist, ascends along the forearm, ascends to knot at the outer elbow, rises up the upper arm, and knots at the shoulder. A branch winds around the scapula and flanks the spine. The straight-running portion goes from the shoulder up to the neck. Another branch ascends to the cheek and knots beside the cheekbone. The straight-running portion ascends and emerges in front of Hand Taiyang, ascends to the left corner of the forehead, connects with the head, and descends to the right jaw. Its disorders, wherever the channel passes, produce radiating pain and cramping, inability to raise the shoulder, and inability to turn the neck from side to side. Treatment lies in the swift piercing with a heated needle, taking as the count the point at which relief is felt, and taking the site of pain as the transport point. This is called the impediment of early summer.
The sinew channel of Hand Taiyin originates above the thumb, follows the digit upward, and knots behind the thenar eminence; it travels along the outer side of the radial pulse position, ascends along the forearm, knots at the elbow, ascends along the inner border of the upper arm, enters below the axilla, emerges at the supraclavicular fossa, and knots in front of the shoulder; it ascends to knot at the supraclavicular fossa, and descends to knot within the chest, dispersing to penetrate the diaphragm, and joining below the diaphragm to reach the free ribs. Its disorders, wherever the channel passes, produce radiating cramping; when severe, this becomes 'panting mass' — a mass of rebellious qi lodged in the chest — with tension of the rib-sides and vomiting of blood. Treatment lies in the swift piercing with a heated needle, taking as the count the point at which relief is felt, and taking the site of pain as the transport point. This is called the impediment of midwinter.
The sinew channel of Hand Jueyin, the Pericardium, originates at the middle finger, runs alongside the sinew channel of Taiyin, and knots at the inner side of the elbow; it ascends the inner side of the upper arm and knots below the axilla, then descends and disperses forward and backward, flanking the rib-sides. A branch enters the axilla, disperses within the chest, and knots at the arm. Its disorders, wherever the channel passes, produce radiating cramping in front and chest pain with 'panting mass.' Treatment lies in the swift piercing with a heated needle, taking as the count the point at which relief is felt, and taking the site of pain as the transport point. This is called the impediment of early winter.
The sinew channel of Hand Shaoyin originates at the inner side of the little finger, knots at the bony prominence of the wrist, ascends to knot at the inner elbow, ascends further to enter the axilla, crosses with Taiyin, flanks the interior of the breast, and knots within the chest; it follows the forearm downward and connects with the navel. Its disorders include internal tension, with the heart harboring 'hidden beam' — an abdominal mass — and below this, contracture of the elbow. Its disorders, wherever the channel passes, produce radiating cramping and sinew pain. Treatment lies in the swift piercing with a heated needle, taking as the count the point at which relief is felt, and taking the site of pain as the transport point. When 'hidden beam' develops to the point of spitting blood and pus, it is fatal and cannot be treated. In disorders of the sinew channels generally: when caused by cold, the body arches backward and the sinews grow tense; when caused by heat, the sinews become slack and cannot contract, and yin atrophy renders the member useless. When the yang sinews are tense, the body arches backward; when the yin sinews are tense, the body bends forward and cannot straighten. 'Quenched needling' is used to treat cold tension; when heat causes the sinews to be slack and unable to contract, one should not use the heated needle. This is called the impediment of late winter.
When the sinew channels of Foot Yangming and Hand Taiyang become tense, the mouth and eyes become deviated; when the canthus becomes tense, one cannot suddenly see clearly. Treatment in all these cases follows the methods described above.