十四难曰∶脉者损至，何谓也？然∶至之脉，一呼再至曰平，三至曰离经，四至曰夺精，五至曰死，六
至曰命绝，此至之脉也。何谓损？一呼一至曰离经，再呼一至曰夺精，三呼一至曰死，四呼一至曰命绝，
此损之脉也。至脉从下上，损脉从上下也。
损脉之为病奈何？然∶一损损于皮毛，皮聚而毛落；二损损于血脉，血脉虚少，不能荣于五脏六腑；三
损损于肌肉，肌肉消瘦，饮食不能为肌肤；四损损于筋，筋缓不能自收持；五损损于骨，骨痿不能起于床。
反此者，至于收病也。从上下者，骨痿不能起于床者死；从下上者，皮聚而毛落者死。
治损之法奈何？然∶损其肺者，益其气；损其心者，调其荣卫；损其脾者，调其饮食，适其
寒温；损其肝者，缓其中；损其肾者，益其精。此治损之法也。
脉有一呼再至，一吸再至；有一呼三至，一吸三至；有一呼四至，一吸四至；有一呼五至，一吸五至；
有一呼六至，一吸六至；有一呼一至，一吸一至；有再呼一至，再吸一至；有呼吸再至。脉来如此，何以
别知其病也。
然∶脉来一呼再至，一吸再至，不大不小曰平。一呼三至，一吸三至，为适得病，前大后小，即头痛、
目眩。前小后大，即胸满、短气。一呼四至，一吸四至，病欲甚，脉洪大者，苦烦满；沉细者，腹中痛；滑
者伤热，涩者中雾露。一呼五至，一吸五至，其人当困，沉细夜加，浮大昼加，不大不小，虽困可治，其有
大小者为难治。一呼六至，一吸六至，为死脉也，沉细夜死，浮大昼死。一呼一至，一吸一至，名曰损，人
虽能行，犹当着床，所以然者，血气皆不足故也。再呼一至，再吸一至，呼吸再至，名曰无魂，无魂者，当
死也，人虽能行，名曰行尸。
上部有脉，下部无脉，其人当吐，不吐者死。上部无脉，下部有脉，虽困无能为害。所以然者，譬
如人之有尺，树之有根，枝叶虽枯槁，根本将自生，脉有根本，人有元气，故知不死。
第十四难问道：脉象有“损”和“至”的区别，这是什么意思呢？回答说：“至”脉，一次呼吸脉搏跳动两次称为平脉（正常脉象），三次称为离经（偏离常道），四次称为夺精（精气耗损），五次称为死脉，六次称为命绝（生命终结），这就是“至”脉。什么是“损”脉呢？一次呼吸脉搏跳动一次称为离经，两次呼吸才跳动一次称为夺精，三次呼吸才跳动一次称为死脉，四次呼吸才跳动一次称为命绝，这就是“损”脉。“至”脉的病势是从下往上发展，“损”脉的病势是从上往下发展。
“损”脉引起的病症是怎样的呢？回答说：一损损伤皮毛，表现为皮肤聚缩而毛发脱落；二损损伤血脉，血脉虚少，不能滋养五脏六腑；三损损伤肌肉，肌肉消瘦，饮食无法转化为肌肤营养；四损损伤筋脉，筋脉弛缓不能自我约束控制；五损损伤骨骼，骨痿软弱不能起床。如果反过来发展，就会发展到收敛病气的阶段。从上往下发展的，如果是骨痿不能起床的就会死亡；从下往上发展的，如果是皮肤聚缩毛发脱落的就会死亡。
治疗“损”证的方法是怎样的呢？回答说：肺受损的，要补益其气；心受损的，要调和其营卫（营气和卫气）；脾受损的，要调节饮食，适应寒温变化；肝受损的，要舒缓其情志；肾受损的，要补益其精。这就是治疗“损”证的方法。
脉象有一次呼吸跳动两次，一次吸气也跳动两次；有一次呼吸跳动三次，一次吸气也跳动三次；有一次呼吸跳动四次，一次吸气也跳动四次；有一次呼吸跳动五次，一次吸气也跳动五次；有一次呼吸跳动六次，一次吸气也跳动六次；有一次呼吸跳动一次，一次吸气也跳动一次；有两次呼吸才跳动一次，两次吸气才跳动一次；还有呼吸之间只跳动两次的。脉象出现这些情况，如何辨别它们对应的疾病呢？
回答说：脉象一次呼吸跳动两次，一次吸气也跳动两次，脉势不大不小，称为平脉。一次呼吸跳动三次，一次吸气也跳动三次，这是刚得病，如果前部脉大后部脉小，就会出现头痛、目眩；如果前部脉小后部脉大，就会出现胸满、短气。一次呼吸跳动四次，一次吸气也跳动四次，病情想要加重，如果脉象洪大，就会苦于烦闷胀满；如果脉象沉细，就会腹中疼痛；如果脉象滑利，就是伤于热邪；如果脉象涩滞，就是伤于雾露湿气。一次呼吸跳动五次，一次吸气也跳动五次，病人应当感到困倦，如果脉象沉细，夜间症状加重；如果脉象浮大，白天症状加重；如果脉势不大不小，虽然困倦但可治愈，如果脉势有大有小，就难以治愈。一次呼吸跳动六次，一次吸气也跳动六次，这是死脉，如果脉象沉细，夜间死亡；如果脉象浮大，白天死亡。一次呼吸跳动一次，一次吸气也跳动一次，名叫“损”，人虽然能行走，但也应当卧床，之所以这样，是因为气血都不充足。两次呼吸才跳动一次，两次吸气才跳动一次，呼吸之间只跳动两次，名叫“无魂”，无魂的人将会死亡，人虽然能行走，名叫“行尸”。
上部有脉，下部无脉，病人应当呕吐，如果不呕吐的就会死亡。上部无脉，下部有脉，虽然困倦但不会造成危害。之所以这样，比如人有尺脉，就像树木有树根，枝叶虽然枯槁，树根自会再生，脉有根本，人有元气，所以知道不会死亡。
Chapter 14 asks: What is meant by the distinction between "Sun" (Loss) and "Zhi" (Excess/Increase) pulses? The response states: Regarding the "Zhi" pulse, two beats per exhalation are considered a normal pulse (Ping Mai). Three beats indicate deviation from the normal course (Li Jing), four beats indicate depletion of essence (Duo Jing), five beats indicate a death pulse, and six beats indicate the end of life. These constitute the "Zhi" pulses. What constitutes the "Sun" pulse? One beat per exhalation indicates deviation from the normal course; one beat per two exhalations indicates depletion of essence; one beat per three exhalations indicates a death pulse; and one beat per four exhalations indicates the end of life. These constitute the "Sun" pulses. The pathology of the "Zhi" pulse progresses from below upwards, whereas the pathology of the "Sun" pulse progresses from above downwards.
What are the diseases caused by the "Sun" pulse? The response states: First-degree loss affects the skin and hair, manifesting as contracted skin and falling hair. Second-degree loss affects the blood vessels, resulting in deficient and scanty blood that fails to nourish the Zang and Fu organs. Third-degree loss affects the muscles, leading to emaciation where food intake cannot be transformed into muscle tissue. Fourth-degree loss affects the sinews, causing flaccidity and an inability to maintain self-control. Fifth-degree loss affects the bones, resulting in bone atrophy and the inability to rise from bed. If the progression reverses, it leads to the stage of collecting pathological factors. In cases progressing from above downwards, bone atrophy preventing rising from bed signifies death. In cases progressing from below upwards, contracted skin and falling hair signify death.
What is the method for treating loss syndromes? The response states: For lung loss, tonify its Qi; for heart loss, regulate Ying Wei (Nutritive and Defensive Qi); for spleen loss, regulate diet and adapt to cold and warmth; for liver loss, soothe its interior (emotions/Qi stagnation); and for kidney loss, tonify its Essence. This is the method for treating loss syndromes.
Pulses may present with two beats per exhalation and two per inhalation; three beats per exhalation and three per inhalation; four beats per exhalation and four per inhalation; five beats per exhalation and five per inhalation; six beats per exhalation and six per inhalation; one beat per exhalation and one per inhalation; one beat per two exhalations and one per two inhalations; or two beats per full respiration cycle. Given these variations, how can one distinguish the corresponding diseases?
The response states: Two beats per exhalation and two per inhalation, with neither large nor small force, is a normal pulse. Three beats per exhalation and three per inhalation indicates recent onset of disease; if the proximal pulse is large and the distal pulse is small, headache and dizziness occur; if the proximal pulse is small and the distal pulse is large, chest fullness and shortness of breath occur. Four beats per exhalation and four per inhalation indicates worsening disease; if the pulse is洪大 (Hong Da, Vast/Surging), the patient suffers from irritability and fullness; if the pulse is沉细 (Chen Xi, Deep and Fine), abdominal pain occurs; if the pulse is滑 (Hua, Slippery), it indicates injury by heat pathogens; if the pulse is涩 (Se, Choppy), it indicates injury by fog and dew dampness. Five beats per exhalation and five per inhalation indicates the patient should feel fatigued; if the pulse is deep and fine, symptoms worsen at night; if the pulse is floating and large, symptoms worsen during the day; if the pulse is neither large nor small, recovery is possible despite fatigue; if the pulse varies in size, treatment is difficult. Six beats per exhalation and six per inhalation is a death pulse; if deep and fine, death occurs at night; if floating and large, death occurs during the day. One beat per exhalation and one per inhalation is named "Sun" (Loss); although the person can walk, they must lie in bed because both Blood and Qi are insufficient. One beat per two exhalations and one per two inhalations, or two beats per full respiration cycle, is named "Wu Hun" (Soulless); those without soul will die. Although such persons can walk, they are called "walking corpses."
If there is a pulse in the upper position but none in the lower position, the patient should vomit; if they do not vomit, they will die. If there is no pulse in the upper position but there is one in the lower position, although the patient is weak, it poses no fatal threat. This is analogous to a tree having roots; even if branches and leaves wither, the root system remains vital. Since the pulse has a root and humans have Yuan Qi (Original Qi), death is avoided.