十六难曰∶脉有三部九候，有阴阳，有轻重，有六十首，一脉变为四时，离圣久远，各
自是其法，何以别之？
然∶是其病，有内外证。
其病为之奈何？
然∶假令得肝脉，其外证∶善洁，面青，善怒；其内证∶脐左有动气，按之牢若痛；其病∶四肢满，
闭淋、溲便难，转筋。有是者肝也，无是者非也。
假令得心脉，其外证∶面赤，口干，喜笑；其内证∶齐上有动气，按之牢若痛；其病∶烦心，心痛，
掌中热而 。有是者心也，无是者非也。
假令得脾脉，其外证∶面黄，善噫，善思，善味；其内证∶当脐有动气，按之牢若痛；其病∶腹胀
满，食不消，体重节痛，怠堕嗜卧，四肢不收。有是者脾也，无是者非也。
假令得肺脉，其外证∶面白，善嚏，悲愁不乐，欲哭；其内证∶脐右有动气，按之牢若痛；其病∶
喘咳，洒淅寒热。有是者肺也，无是者非也。
假令得肾脉，其外证∶面黑，善恐欠；其内证∶脐下有动气，按之牢若痛；其病∶逆气，小腹急痛，
泄如下重，足胫寒而逆。有是者肾也，无是者非也。
十七难曰；经言病或有死，或有不治自愈，或连年月不已，其死生存亡，可切脉而知之耶？然∶可
尽知也。
诊病若闭目不欲见人者，脉当得肝脉强急而长。而反得肺脉浮短而涩者，死也。
病若开目而渴，心下牢者，脉当得紧实而数，反得沉涩而微者。死也。
病若吐血，复鼽衄血者，脉当沉细。反浮大而牢者，死也。
病若谵言妄语，身当有热，脉当洪大，而反手足厥逆，脉沉细而微者，死也。
病若大腹而泄者，脉当微细而涩，反紧大而滑者，死也。
第十六难说：脉诊有三部九候，有阴阳之分，有轻重之别，有六十首（指脉象分类），一脉随四季变化而改变。由于距离圣人时代久远，各家各自坚持自己的方法，如何辨别其正误呢？
回答说：这要看疾病是否有外在和内在的证候表现。
疾病的内外证候是如何表现的？
回答说：假如诊得肝脉，其外在证候表现为：爱清洁，面色发青，容易发怒；其内在证候表现为：肚脐左侧有搏动感，按压时感觉坚硬且疼痛；其病症表现为：四肢胀满，小便闭塞不通、排尿困难，大便艰难，筋脉拘挛抽搐。具备这些症状的是肝病，不具备这些症状的就不是肝病。
假如诊得心脉，其外在证候表现为：面色发红，口干燥，喜欢笑；其内在证候表现为：心窝上方有搏动感，按压时感觉坚硬且疼痛；其病症表现为：心烦意乱，心痛，手掌心发热且伴有轻微寒战感（注：原文“热而 ”此处疑为脱字，通常作“热而烦”或类似描述，依文意译为掌心热并伴不适）。具备这些症状的是心病，不具备这些症状的就不是心病。
假如诊得脾脉，其外在证候表现为：面色发黄，经常嗳气，思虑过多，味觉敏感；其内在证候表现为：肚脐正中有搏动感，按压时感觉坚硬且疼痛；其病症表现为：腹部胀满，食物不消化，身体沉重且关节疼痛，倦怠乏力嗜睡，四肢无力收摄。具备这些症状的是脾病，不具备这些症状的就不是脾病。
假如诊得肺脉，其外在证候表现为：面色苍白，经常打喷嚏，悲伤忧愁不快乐，想哭；其内在证候表现为：肚脐右侧有搏动感，按压时感觉坚硬且疼痛；其病症表现为：气喘咳嗽，忽冷忽热如洒冷水般战栗。具备这些症状的是肺病，不具备这些症状的就不是肺病。
假如诊得肾脉，其外在证候表现为：面色发黑，容易恐惧呵欠；其内在证候表现为：肚脐下方有搏动感，按压时感觉坚硬且疼痛；其病症表现为：气逆上冲，小腹部急迫疼痛，腹泻且有肛门重坠感，足胫寒冷且逆冷。具备这些症状的是肾病，不具备这些症状的就不是肾病。
第十七难说：医经中说，有的病会致死，有的病不治疗也能自愈，有的病长年累月不好。关于病人的生死存亡，可以通过切脉来知晓吗？
回答说：可以完全知晓。
如果病人闭着眼睛不想见人，脉象应当对应肝脉，表现为强急而长。如果反而得到肺脉，表现为浮短而涩，这是死证。
如果病人睁着眼睛且口渴，心下部痞硬牢固，脉象应当表现为紧实而数。如果反而得到沉涩而微的脉象，这是死证。
如果病人吐血，又兼有鼻出血，脉象应当表现为沉细。如果反而得到浮大而坚牢的脉象，这是死证。
Chapter 16 states: Pulse diagnosis involves three positions and nine palpation sites, distinctions of Yin and Yang, variations in pressure (light and heavy), sixty pulse categories, and a single pulse type transforming according to the four seasons. Since much time has passed since the Sages, each school adheres to its own methods. How can one distinguish the correct from the incorrect?
The answer is: One must examine whether there are external and internal clinical manifestations (Zheng) of the disease.
How are these external and internal manifestations manifested?
The answer is: Suppose a Liver pulse (Gan Mai) is obtained. Its external manifestations include: a preference for cleanliness, a bluish complexion, and irritability. Its internal manifestations include: pulsation at the left side of the umbilicus, which feels firm and painful upon pressure. The pathological symptoms include: fullness in the four limbs, urinary obstruction or difficult urination, difficulty in defecation, and tendon spasms. If these signs are present, it is a Liver disease; if absent, it is not.
Suppose a Heart pulse (Xin Mai) is obtained. Its external manifestations include: a reddish complexion, dry mouth, and excessive laughter. Its internal manifestations include: pulsation above the epigastrium, which feels firm and painful upon pressure. The pathological symptoms include: mental restlessness, heart pain, and heat in the palms accompanied by discomfort. If these signs are present, it is a Heart disease; if absent, it is not.
Suppose a Spleen pulse (Pi Mai) is obtained. Its external manifestations include: a yellowish complexion, frequent belching, excessive thinking, and heightened sensitivity to taste. Its internal manifestations include: pulsation at the center of the umbilicus, which feels firm and painful upon pressure. The pathological symptoms include: abdominal distension, indigestion, heaviness of the body with joint pain, lethargy and drowsiness, and weakness of the four limbs. If these signs are present, it is a Spleen disease; if absent, it is not.
Suppose a Lung pulse (Fei Mai) is obtained. Its external manifestations include: a pale complexion, frequent sneezing, sadness and sorrow, and a desire to cry. Its internal manifestations include: pulsation at the right side of the umbilicus, which feels firm and painful upon pressure. The pathological symptoms include: wheezing and coughing, and alternating chills and fever resembling the sensation of cold water being sprinkled on the skin. If these signs are present, it is a Lung disease; if absent, it is not.
Suppose a Kidney pulse (Shen Mai) is obtained. Its external manifestations include: a dark complexion, fearfulness, and yawning. Its internal manifestations include: pulsation below the umbilicus, which feels firm and painful upon pressure. The pathological symptoms include: rebellious Qi ascending, acute pain in the lower abdomen, diarrhea with a sensation of rectal heaviness/tenesmus, and coldness with reversal in the feet and shins. If these signs are present, it is a Kidney disease; if absent, it is not.
Chapter 17 states: The Classics say that some diseases lead to death, some heal spontaneously without treatment, and some persist for years. Can the life and death of patients be known through pulse diagnosis?
The answer is: It can be fully determined.
If a patient keeps their eyes closed and does not wish to see people, the pulse should correspond to the Liver pulse, appearing strong, tense, long, and stretched. If instead, a Lung pulse (Fei Mai) is obtained, appearing floating, short, and choppy, this indicates a fatal condition.
If a patient keeps their eyes open, feels thirsty, and has a firm hardness in the epigastrium, the pulse should appear tight, solid, and rapid. If instead, a deep, choppy, and faint pulse is obtained, this indicates a fatal condition.
If a patient suffers from hematemesis (vomiting blood) combined with epistaxis (nosebleed), the pulse should be deep and fine. If instead, a floating, large, and firm pulse is obtained, this indicates a fatal condition.
If a patient speaks deliriously and妄语 (makes nonsensical statements), the body should be hot, and the pulse should be surging and large. If instead, the hands and feet are cold (Jue Ni), and the pulse is deep, fine, and faint, this indicates a fatal condition.
If a patient has a distended abdomen and diarrhea, the pulse should be faint, fine, and choppy. If instead, a tight, large, and slippery pulse is obtained, this indicates a fatal condition.