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Chapter 10 of 81
黄帝内经·灵枢
Lei Gong asked the Yellow Emperor for instruction: The fundamental principle of acupuncture treatment must begin with the channels (the main pathways in the human body through which qi and blood circulate, connecting the viscera and bowels with the limbs and joints). One must understand how they operate, how they are measured, how they connect internally to the five viscera, and how they distinguish externally the six bowels.
The Yellow Emperor replied: When a person is first formed, essence is produced first; after essence is produced, the brain and spinal cord come into being. The bones serve as the body's pillars, the channels as pathways for transporting qi and blood, the sinews as ropes binding the body, the muscles as city walls, the skin dense and protective, and hair grows forth. When food and drink enter the stomach, the vessel pathways become unobstructed, and only then can qi and blood circulate throughout the body.
Lei Gong wished to hear clearly the principles of the channels from beginning to end. The Yellow Emperor emphasized: The channels can determine life and death, manage all diseases, and regulate deficiency and excess—therefore one must thoroughly understand them.
The following twelve channels all follow the same format in the original text: first describing the starting point, connections with viscera and bowels, and pathway course, then distinguishing between "diseases when activated" (symptoms appearing when the channel qi undergoes abnormal movement) and "diseases it governs" (related disorders controlled by that channel and treatable through it), finally appending treatment principles.
Originates in the middle burner, descends to connect with the Large Intestine, then curves back around the upper opening of the Stomach, ascends through the diaphragm, and belongs to the Lungs. From the lung system it emerges transversely at the axilla, descends along the anterior border of the medial upper arm, enters the elbow crease, follows the anterior border of the medial forearm, reaches the radial pulse area, ascends to the thenar eminence, and emerges at the tip of the thumb. A branch from the wrist goes to the medial tip of the index finger.
Disorders: Lung fullness and distension, cough, pain in the supraclavicular fossa; in severe cases, arms crossed over the chest with blurred vision—called Arm Jue. Disorders governed by this channel include cough, wheezing, vexation in the heart, chest fullness, pain along the anterior border of the medial upper arm, and heat in the palms. When qi is excessive: shoulder and back pain, sweating, frequent urination; when qi is deficient: cold pain in shoulders and back, shortness of breath, changes in urine color.
Originates at the tip of the index finger, follows the upper border of the index finger, passes between the two bones at Hegu, enters between the two tendons, follows the upper border of the forearm, enters the lateral elbow, ascends to the shoulder, meets at Dazhui, descends into the supraclavicular fossa, connects with the Lung, descends through the diaphragm, and belongs to the Large Intestine. A branch from the supraclavicular fossa ascends to the neck, enters the lower teeth, curves around the lips, crosses at Renzhong, and terminates beside the opposite nostril.
Disorders: Tooth pain, neck swelling. This channel governs fluids-related disorders: yellow eyes, dry mouth, nosebleed, throat obstruction, pain along the shoulder and forearm, inability to move the index finger. When qi is excessive: heat and swelling along the channel pathway; when qi is deficient: cold chills and shivering, difficulty recovering.
Originates beside the nose, enters the upper teeth, encircles the lips, descends and crosses at Chengjiang, follows the cheek, in front of the ear, the hairline, and up to the forehead. A branch from Daying descends into the supraclavicular fossa, through the diaphragm, belongs to the Stomach, and connects with the Spleen. The direct branch descends from the supraclavicular fossa along the medial breast, flanks the umbilicus, and enters Qi Street. Another branch from the lower opening of the stomach descends to join at Qi Street, then follows the anterior thigh, knee, lateral tibia, down the dorsum of the foot, entering the medial and lateral sides of the middle toe and the tip of the great toe.
Disorders: Aversion to cold with shivering, frequent yawning, dark complexion; in severe cases, aversion to people and fire, fright at the sound of wood, preference for closing doors and staying alone; in extreme cases, climbing high and singing, discarding clothes and running, abdominal distension with intestinal rumbling—called Gan Jue. This channel governs blood-related disorders: fever, malaria, sweating, nosebleed, mouth and lip sores, neck swelling with throat obstruction, great abdominal edema, knee swelling and pain, as well as pain in the chest, breast, Qi Street, thigh, lateral tibia, dorsum of the foot, and inability to move the middle toe. When qi is excessive: heat in the front of the body, rapid digestion with constant hunger, yellow urine; when qi is deficient: cold chills in the front of the body, stomach cold with fullness.
Originates at the tip of the great toe, follows the medial white flesh border of the foot, passes the navicular bone, ascends the anterior border of the medial malleolus, follows the medial lower leg, crosses in front of the Foot-Jueyin Liver Channel, ascends the medial knee and thigh, enters the abdomen, belongs to the Spleen and connects with the Stomach, ascends through the diaphragm, flanks the throat, connects with the root of the tongue, and disperses beneath the tongue. A branch from the Stomach ascends through the diaphragm and empties into the Heart.
Disorders: Stiff tongue root, vomiting after eating, stomach pain, abdominal distension with belching, slight relief after passing gas or stool, but with heavy body sensation. Disorders governed by this channel include tongue root pain, inability to turn the body, inability to eat, heart vexation, acute pain below the heart, diarrhea, edema, jaundice, insomnia, swelling of the medial thigh and knee, and inability to move the great toe.
Originates in the Heart, emerges and belongs to the Heart System, descends through the diaphragm, and connects with the Small Intestine. A branch from the Heart System ascends flanking the throat and connects with the eye system. The direct branch from the Heart System ascends to the Lung, descends and emerges beneath the axilla, follows the posterior border of the medial upper arm, descends into the medial elbow, follows the posterior border of the medial forearm, reaches the pisiform bone at the wrist, enters the posterior medial palm, and emerges at the tip of the little finger.
Disorders: Dry throat, heart pain, thirst with desire to drink—called Arm Jue. Disorders governed by this channel include yellow eyes, hypochondriac pain, pain and coldness along the posterior border of the medial upper arm, and heat and pain in the palms.
Originates at the tip of the little finger, follows the lateral hand ascending to the wrist, emerges at the ulnar styloid process, ascends along the lower border of the forearm bone, emerges at the medial elbow between the two tendons, ascends along the posterior border of the lateral upper arm, emerges at the shoulder joint, circles the scapula, crosses at the shoulder, enters the supraclavicular fossa, connects with the Heart, descends through the diaphragm, reaches the Stomach, and belongs to the Small Intestine. A branch from the supraclavicular fossa ascends to the neck and cheek, reaches the outer canthus, and enters the ear; another branch from the cheek ascends to the cheekbone, reaches beside the nose, and ends at the inner canthus.
Disorders: Sore throat, jaw swelling, inability to turn the head, shoulder pain as if pulled or wrenched, lateral upper arm pain as if broken. This channel governs fluids-related disorders: deafness, yellow eyes, cheek swelling, as well as pain in the neck, jaw, shoulder, upper arm, elbow, and posterior lateral border of the forearm.
Originates at the inner canthus, ascends the forehead and meets at the vertex. A branch from the vertex goes to the upper corner of the ear. The direct branch from the vertex enters and connects with the brain, emerges again descending the nape, follows the medial shoulder blade, flanks the spine reaching the lumbar region, enters and follows the spine, connects with the Kidney, and belongs to the Bladder. Another branch from the lumbar region descends flanking the spine, passes through the buttocks, and enters the popliteal fossa; another branch from the medial shoulder blade separates bilaterally descending, passes through the scapula, flanks the spine, crosses the hip joint, follows the posterior lateral thigh, descends and joins in the popliteal fossa, then descends through the posterior lower leg, emerges behind the lateral malleolus, follows the fifth metatarsal bone, and ends at the lateral tip of the little toe.
Disorders: Severe headache, eyes feeling as if they will pop out, neck as if pulled, spine pain, lower back as if broken, hip joint unable to flex, popliteal fossa as if bound, lower leg as if torn—called Ankle Jue. This channel governs sinew-related disorders: hemorrhoids, malaria, mania, epilepsy, head and neck pain, yellow eyes with tearing, as well as pain in the nape, back, lumbar region, sacrum, popliteal fossa, lower leg, and foot, and inability to move the little toe.
Originates beneath the little toe, obliquely traverses the sole of the foot, emerges below Rangu, follows behind the medial malleolus, enters the heel, ascends the medial lower leg, emerges at the medial popliteal fossa, ascends the posterior medial thigh, passes through the spine, belongs to the Kidney, and connects with the Bladder. The direct branch from the Kidney ascends through the liver and diaphragm, enters the Lung, follows the throat, and flanks the root of the tongue; a branch from the Lung emerges connecting with the Heart and empties into the chest.
Disorders: Hunger without desire to eat, dull complexion like lacquered charcoal, coughing and spitting blood, wheezing and shortness of breath, restlessness in sitting and lying, blurred vision, empty feeling in the heart like hunger; when qi is deficient, prone to fear, palpitations as if being pursued—called Bone Jue. Disorders governed by this channel include dry mouth with hot tongue, throat swelling, qi counterflow, dry sore throat, heart vexation with heart pain, jaundice, diarrhea, pain along the spine and posterior medial thigh, weakness and cold reversal, somnolence, and heat and pain in the soles.
Originates in the chest, emerges and belongs to the Pericardium Network, descends through the diaphragm, and connects with the Triple Burner. A branch follows the chest emerging at the hypochondrium, descends three cun below the axilla, ascends to the axilla, follows the medial aspect of the upper arm in the middle, enters the elbow crease, descends between the two tendons of the forearm, enters the palm, and follows along the middle finger tip; another branch from the palm separates and follows the ring finger tip.
Disorders: Heat in the palms, cramping of the arm and elbow, swelling beneath the axilla; in severe cases, chest and hypochondriac fullness and oppression, restless heart palpitations, red face with yellow eyes, and incessant laughter. This channel governs vessels-related disorders: heart vexation, heart pain, and heat in the palms.
Originates at the tip of the ring finger, ascends between the two fingers, follows the dorsum of the hand, emerges between the two bones of the lateral forearm, ascends through the elbow, follows the lateral upper arm ascending to the shoulder, crosses behind the Foot-Shaoyang channel, enters the supraclavicular fossa, spreads into the chest center (Danzhong), disperses connecting with the Pericardium, descends through the diaphragm, and belongs to the Triple Burner. A branch from Danzhong ascends emerging from the supraclavicular fossa, ascends the neck, attaches behind the ear, emerges at the upper corner of the ear, curves down to the cheek; another branch from behind the ear enters the ear, emerges in front of the ear, and reaches the outer canthus.
Disorders: Deafness, muffled sounds in the ears, throat swelling and pain, throat obstruction. This channel governs qi-related disorders: sweating, pain at the outer canthus, cheek pain, pain along the posterior ear and lateral shoulder, arm, and elbow, and inability to move the ring finger.
Originates at the outer canthus, ascends to the corner of the head, descends behind the ear, follows the neck, reaches the shoulder, and enters the supraclavicular fossa. A branch from behind the ear enters the ear, emerges in front of the ear, and reaches behind the outer canthus; another branch from the outer canthus descends to Daying, joins the Hand-Shaoyang, descends below Jiache, enters the supraclavicular fossa, descends into the chest, passes through the diaphragm, connects with the Liver, belongs to the Gallbladder, follows the interior of the hypochondrium, emerges at Qi Street, circles the pubic hair region, and transversely enters the hip joint. The direct branch from the supraclavicular fossa descends beneath the axilla, follows the chest passing the floating ribs, descends joining the hip joint, then follows the lateral thigh, emerges at the lateral knee, descends in front of the fibula, reaches the tip of the fibula, descends emerging in front of the lateral malleolus, follows the dorsum of the foot, and enters the fourth toe tip; a branch from the dorsum of the foot separates and enters the great toe tip, curving back through the nail.
Disorders: Bitter taste in the mouth, frequent sighing, chest and hypochondriac pain with inability to turn the body; in severe cases, dull complexion as if covered with dust, dry skin without luster, and heat on the lateral foot—called Yang Jue. This channel governs bone-related disorders: headache, jaw pain, pain at the outer canthus, swelling and pain in the supraclavicular fossa, swelling beneath the axilla, scrofula, sweating with chills, malaria, as well as joint pain in the chest, hypochondrium, thigh, knee, lateral lower leg, fibula tip, and anterior lateral malleolus, and inability to move the fourth toe.
Originates at the hairy region of the great toe, ascends along the dorsum of the foot, one cun from the medial malleolus, ascends eight cun above the malleolus, crosses behind the Foot-Taiyin channel, ascends the medial popliteal fossa, follows the medial thigh, enters the pubic hair region, encircles the genitalia, reaches the lower abdomen, flanks the Stomach, belongs to the Liver, and connects with the Gallbladder, ascends through the diaphragm, spreads over the hypochondria and ribs, follows behind the throat, ascends into the nasopharynx, connects with the eye system, ascends emerging at the forehead, and meets the Governing Vessel at the vertex. A branch from the eye system descends into the cheek, encircling the inside of the lips; another branch from the Liver separates, ascends through the diaphragm, and empties into the Lung.
Disorders: Lower back pain with inability to bend or extend, hernia in men, swelling of the lower abdomen in women; in severe cases, dry throat and dull complexion without luster. Disorders governed by this channel include chest fullness, vomiting with counterflow, diarrhea, hernia, urinary incontinence, and difficult urination.
Following the disorders of the twelve channels, the original text repeatedly states the same treatment principle:
Excess conditions use draining methods; deficient conditions use tonifying methods; heat conditions use rapid needling; cold conditions use retained needles; sunken pulses use moxibustion; when neither excessive nor deficient, treat the channel itself.
Additionally, the original text uses the relative pulse strength ratio between Renying and Cunkou to determine the deficiency or excess predominance of the channel.
This represents the ancients' fundamental approach to acupuncture intervention for channel disorders—today it should be studied as academic theory and principle, not regarded as specific operational guidance.
The original text then discusses the manifestations when the qi of the five viscera channels becomes exhausted:
This section represents the ancients' observational summary of critical conditions, colored by Five Phase and Heavenly Stem/Earthly Branch calculations of their time, and should be regarded as historical understanding—not directly applicable to modern prognostic assessment.
The twelve channels run deep between the muscles and flesh, and are not easily visible from the body surface under normal conditions; the superficial vessels visible on the body surface mostly belong to the collaterals (branches that separate from the channels and form a network throughout the body).
When examining collaterals, the ancients emphasized color:
After drinking alcohol, defensive qi first fills the skin and collaterals, then nutritive qi becomes abundant, and only then do the channels become visibly full. If a vessel suddenly pulsates prominently at some location, it indicates pathogenic qi residing in the channels or collaterals. The ancients also proposed: when needling collaterals, one should needle at the site of stasis and congestion to drain pathogenic blood; if blood stasis remains unremoved, it will develop into bi disease.
Finally, the original text lists the fifteen major collaterals:
Lieque (Hand-Taiyin), Tongli (Hand-Shaoyin), Neiguan (Hand-Jueyin), Zhizheng (Hand-Taiyang), Pianli (Hand-Yangming), Waiguan (Hand-Shaoyang), Feiyang (Foot-Taiyang), Guangming (Foot-Shaoyang), Fenglong (Foot-Yangming), Gongsun (Foot-Taiyin), Dazhong (Foot-Shaoyin), Ligou (Foot-Jueyin), Weiyi (Conception Vessel), Changqiang (Governing Vessel), Dabao (Major collateral of the Spleen).
Each major collateral has its own deficiency and excess disorders: for example, Lieque in excess causes heat in the wrist and palm area; in deficiency causes yawning and frequent urination; Tongli in excess causes uncomfortable distension in the chest and diaphragm; in deficiency causes inability to speak; Neiguan in excess causes heart pain; in deficiency causes stiffness in the head and neck; and so on.
The original text concludes: these collaterals are mostly visible in excess conditions and sunken in deficient conditions; when not visible on the body surface, one should search above and below the area, because human constitutions differ and collateral distribution varies.
The channels are the core system for "determining life and death, managing all diseases, and regulating deficiency and excess"
This chapter views the channels as a network connecting the viscera, circulating qi and blood, and communicating between the internal and external. It is not a concept of a single blood vessel or nerve, but rather an ancient functional connectivity model of the human body.
"Diseases when activated" versus "diseases it governs"
This is the most distinctive feature of this chapter's disorder classification. It can be understood as:
Deficiency/excess supplementing and draining combined with pulse assessment
This chapter repeatedly emphasizes "excess drains, deficiency supplements, heat uses rapid needling, cold uses retained needles, sunken uses moxibustion, neither excess nor deficiency—treat the channel." This is the fundamental principle of acupuncture supplementing and draining.
Simultaneously, the pulse strength comparison between Renying and Cunkou is used to determine channel deficiency or excess. This embodies the ancient holistic approach of "pulse diagnosis—pattern differentiation—channel selection."
The hierarchical view of channels and collaterals
"Channels are deep and invisible; collaterals are superficial and commonly visible" reflects the ancients' direct observation of the depth differences in the human vascular system. Collateral color diagnosis connects superficial small vessel coloration with cold, heat, deficiency, and excess states.
Exhaustion of the five yin channels and viscera—tissue correspondences
Lung governs skin and body hair, Heart governs blood and vessels, Spleen governs muscles, Kidney governs bones, Liver governs sinews—these correspondences are concentratedly expressed in this chapter through the "qi exhaustion" patterns and form an important foundation of the visceral manifestation theory in Chinese medicine.
Associated Concepts:
Further Reading:
📖 Bugua · Classical Study
This content is based on classical Chinese medicine texts and is provided solely for traditional cultural learning and study. It does not constitute any medical diagnosis, medication, or treatment advice; please consult a physician promptly if you feel unwell.