革脉之至，如皮革之坚急也，涌泉，状其盛满也。见此脉者，病渐增进而色夭不泽也。绵绵弦绝，则胃气绝无，
真脏脉见，故死）。
《大奇论》曰∶脉至浮合，浮合如数，一息十至以上，是经气予不足也，微见九十日死（此以下皆定死期
也。浮合者，如浮波之合，后浪催前，泛泛无纪，如数者，似数而非数也。数太过为血热也。如数者血败也，浮
合者气败也。一息十至以上，死期大迫。此云九十日者，误也，十字直衍。微见者，初见也。初见此脉，九日当
死）。脉至如火薪然，是心精之予夺也，草干而死（脉如火然，是火旺过极之脉，心经之精气夺尽矣。夏令火旺，尚可强
支，水令草干，阳尽而死矣）。脉至如散叶，是肝气予虚也，木叶落而死（散
叶者，浮泛无根，肝气虚极也。木叶落则金旺而木绝，其死宜也）。脉至如省客，省客者，脉塞而鼓，是肾气予
不足也，悬去枣华而死（省客，省问之客，时来时去者也。塞者，涩而代也。鼓者，坚且搏也。涩代为精败，
坚搏为胃少，至于枣华吐，则土旺水衰立尽矣）。脉至如泥丸，是胃精予不足也，榆荚落而死（泥丸者，泥弹之
状，动短之脉也。主胃中精气不足。榆荚至春深而落，木旺之时，土必败矣）。脉至如横格，是胆予不足也，禾
熟而死（横格者，长大坚劲，木之真脏脉也，胆之衰败也。禾熟于秋，金王而木乃绝矣）。脉至如弦缕，是胞精
予不足也。病善言，下霜而死，不言，可治（弦者，喻其劲急。缕者，喻其细小。胞者，心胞络也。舌为心苗，
火动则善言。冬月飞霜，水来克火而死矣。不言则所伤犹浅，故可救也）。脉至如交漆，交漆者，左右傍至也，
微见三十日死（交漆者，模糊而大，即泻漆之义也。左右傍至，大可知也。微者，初也，月令易而死期至矣）。
脉至如涌泉，浮鼓肌中，太阳气予不足也，少气，味韭英而死（涌泉者，如泉之涌，有升无降，而浮鼓于肌表
之间，是足太阳膀胱气不足也。膀胱为三阳而主表也，今表实里虚，故为少气。韭英，韭花也。发于长夏，土克
水，故死）。脉至如颓土之状，按之不得，是肌气予不足也。五色先见黑，白垒发死（上下虚则颓。脉来虚大，
按之不可得，正下虚之象也。脾主肌肉，肌气即脾气也。黑为水色，土败而木反侮之。垒 同，即莲 也。 有
五，而白者发于春，木旺之时，土其绝矣）。脉至如悬雍，悬雍者，浮揣切之益大，是十二俞之予不足也，水凝而死（悬
雍者，喉间下垂肉乳也，俗名喉咙花。浮揣之而大，是有阳无阴，孤阳亢上之象。十二俞者，脏腑
十二经所输也，水凝而死者，阴气盛而孤阳绝也）。脉至如偃刀，偃刀者，浮之小急，按之坚大急，五脏菀热，
寒热独并于肾也。如此其人不得坐，立春而死（偃刀。卧刀也。浮之小急，如刀口也。按之坚大急，如刀背也。
重按之肾之应也，肾虚则阴消，而五脏咸热，虽五脏有郁菀之热而发为寒热，其原则独归并于肾也。肾因亏损，
腰脊 疼，不能起坐。冬令水旺，未即败绝，遇春乃死也）。脉至如丸滑不直手，不直手者，按之不可得也，
是大肠气予不足也。枣叶生而死（如丸者，流利之状，正滑脉也。不直手者，滑而不应手，按之则无也。大肠
与肺金相为表里，枣叶生于初夏，火盛则金绝，故当死）。脉至如华者，令人善恐，不欲坐卧，行立常听，是小
肠气予不足也，季秋而死（如华者，盛满而轻浮也。小肠与心相为表里，小肠虚则心亦虚，故善恐、不得坐卧
也。行立常听，恐惧多而狐疑也。丙火墓于戌，故当季秋死）。
《三部九候论》曰∶形盛脉细，少气不足以息者死（形盛者。脉亦盛，其常也。形盛脉细，脉不应形矣，甚
而少气难以布息，死不旋踵）。形瘦脉大，胸中多气者死（形小脉小，其常也。形瘦脉大，既不相应，甚而
胸中多逆上之气，阴败阳孤，不死安待），形气相得者生（身形与脉气相得，如形小脉小、形大脉大是也），
参伍不调者病（三以相参，伍以相类。谓之不调者，或大或小，或迟或疾，或滑或涩，不合常度，皆病脉也），
三部九候皆相失者死（三部者，上中下三部，分天地人，分胸膈腹也。九候者，每部有浮中沉三候，三部各三，合
而为九候也。或应浮大而反沉细，应沉细而反浮大，谓之相失，而不合于揆度也）。
形肉已脱，九候虽调犹死（脾主肌肉，为脏之本。若肌肉脱则脾绝矣，九候虽调无益也）。七诊虽见，九候
皆从者不死（七诊者，独大、独小、独疾、独迟、独热、独寒、独陷下也。从，顺也，合也。脉顺四时之令
及合诸经之体者，虽见七诊之脉，不至于死）。
《阴阳别论》曰∶凡持真脏之脉者，肝至悬绝，十八日死（悬绝者，真脏脉见，胃气已无，悬悬欲绝也，
十八日者，为木金成数之余，金胜木而死也）。心至悬绝，九日死（九日者，为火水生成数之余，水胜也）。肺
至悬绝，十二日死（十二日，为金火生成数之余，火胜金也）。肾至悬绝，七日死（七日者，为水土生数之余，
土胜水也）。脾至悬绝，四日死（四日者，为木生数之余，木胜土也）。
《平人气象论》曰∶妇人手少阴脉动甚者，妊子也（手少阴，心脉也。动甚者，流利滑动，血旺而然也，故当妊子）。
《阴阳别论》曰∶阴搏阳别，谓之有子（阴搏阳别，言阴脉搏动，与阳脉迥别也。阴阳二字所包者广，以左
右言，则左为阳、右为阴；以部位言，则寸为阳、尺为阴；以九候言，则浮为阳、沉为阴。旧说以尺脉洪实为
阴，与阳脉迥别似矣，然则手少阴脉动甚亦在寸也，何取于阳别之旨乎，故因会通诸阴阳而后可决也）。
《征四失论》曰∶诊病不问其始，忧患饮食之失节，起居之过度，或伤于毒，不先言此，卒持寸口，何病
能中，妄言作名，为粗所穷（此言临脉者，必先察致病之因，而后参之以脉，则阴阳虚实不致淆讹。若不问其始
，是不求其生也。如忧患饮食，内因也；起居过度，外因也；伤于毒者，不内外因也。不先察其因而卒持寸口，
自谓脉神，无假于问，岂知真假逆从？脉病原有不合者，仓卒一诊，安能尽中病情？妄言作名，欺世卖俗，误治
伤生，损德不小矣）。
愚按∶脉者，血气之征兆也。病态万殊，尽欲以三指测其变化，非天下之至巧者，孰能与于斯？许叔微云∶脉之
理幽而难明，吾意所解，口莫能宣也，可以笔墨传、口耳授者，皆粗迹也。
虽然，粗者未谙，精者从何而出？析而言之，二十四字犹嫌其略；约而归之，浮沉迟数已握其纲，所以脉不辨阴
阳，愈索而愈惑也。阴阳之义已见于前阴搏阳别之条。又。滑伯仁曰∶察脉须辨上、下、来、去、至、止，不明此
六字，则阴阳不别也。上者为阳，来者为阳，至者为阳，下者为阴，去者为阴，止者为阴。上者，自尺上于寸，
阳生于阴也。下者，自寸下于尺，阴生于阳也。来者，自骨肉而出于皮肤，气之升也。去者，自皮肤而还于骨肉，
气之降也。应曰至，息曰止。此义至浅而至要，行远自迩，登高自卑；请事斯语矣。
革脉到来时，脉搏感觉像皮革一样坚硬紧急，涌泉形容其气势盛大充盈。出现这种脉象的人，病情逐渐加重且面色枯槁无光泽。（如果脉象绵绵无力随后突然断绝，说明胃气完全丧失，真脏脉显现，所以会死亡）。
《素问·大奇论》说：脉象到来如浮波相合（浮合脉），看起来像数脉，一呼一吸之间跳动十次以上，这是经气严重不足的表现，初次见到这种脉象，九十日内会死亡（以下所述皆为确定的死期。所谓“浮合”，就像漂浮的波浪汇聚，后浪推前浪，泛泛无序；所谓“似数而非数”，是血气败坏的表现；所谓“浮合”，是气机败坏的表现。一息十至以上，死期迫近。这里说九十日是错误的，“十”字是直接衍生的多余文字。所谓“微见”，是指初次见到。初次见到此脉，九日当死）。脉象到来像燃烧的柴火一样猛烈，这是心之精气被剥夺的表现，等到草木干枯的季节就会死亡（脉象如火燃烧，是火旺至极的脉象，心经的精气已经耗尽。夏令火旺时，尚可勉强支撑，到了水令季节草木干枯，阳气耗尽而死）。脉象到来像飘散的叶子，这是肝气虚弱的表现，等到树叶落下的季节就会死亡（散叶，指浮泛无根，是肝气极度虚弱。木叶落下时金气旺盛而木气断绝，此时死亡是适宜的）。脉象到来像访客忽来忽去（省客脉），所谓“省客”，即询问之客，时而来时而去。脉道涩滞且代偿性停顿（塞者，涩而代也），脉搏坚实且搏动有力（鼓者，坚且搏也）。涩代表示精血败坏，坚搏表示胃气稀少，到了枣花盛开的时节，土旺水衰，生命立刻终结。脉象到来像泥丸（泥丸脉），这是胃中精气不足的表现，等到榆荚落下的季节就会死亡（泥丸，像泥弹的形状，是短促的脉象。主胃中精气不足。榆荚在春深时节落下，正值木气旺盛之时，土气必然败坏）。脉象到来像横亘的木条（横格脉），这是胆气不足的表现，等到禾苗成熟的季节就会死亡（横格，指脉长、大、坚、劲，是木的真脏脉，表示胆气衰败。禾苗在秋季成熟，金气旺盛而木气断绝）。脉象到来像弦线交织（弦缕脉），这是胞宫精气不足的表现。病人喜欢多言，在下霜的季节会死亡；如果不善言辞，还可以治疗（弦，比喻脉劲急；缕，比喻脉细小。胞，指心包络。舌为心之苗窍，火动则多言。冬月飞霜，水来克火而死。如果不善言辞，说明受损尚浅，所以可以救治）。脉象到来像漆液交混（交漆脉），所谓“交漆”，指左右旁侧同时到达，初次见到这种脉象，三十日后会死亡（交漆，模糊而大，即泻漆的意思。左右旁至，规模之大可想而知。微，指初起。月令改变而死期便至）。脉象到来像涌泉，浮取鼓动于肌肉之中，这是太阳经气不足的表现，气息微弱，食用韭花时会死亡（涌泉，像泉水涌出，只升不降，浮鼓于肌表之间，是足太阳膀胱经气不足。膀胱属三阳而主表，现在表实里虚，所以气少。韭英，即韭花。发于长夏，土克水，所以死亡）。脉象到来像倒塌的土堆，按压却摸不到，这是肌气不足的表现。五色先现黑色，若白色出现在春季则会死亡（上下虚则颓。脉来虚大，按之不可得，正是下虚的征象。脾主肌肉，肌气即脾气。黑为水色，土败而木反侮之。垒同“蕾”，即莲蕾。莲蕾有五种颜色，而白色发于春季，木旺之时，土气已绝）。脉象到来像悬雍（悬雍脉），所谓“悬雍”，指喉间下垂的肉垂，俗名喉咙花。浮取切按时反而更大，这是十二俞经气不足的表现，在水凝结冰的季节会死亡（悬雍，喉间下垂肉乳，俗名喉咙花。浮揣之而大，是有阳无阴，孤阳亢盛于上的征象。十二俞，是脏腑十二经所输注的部位。水凝而死，是阴气盛而孤阳绝灭）。脉象到来像倒置的刀（偃刀脉），所谓“偃刀”，指轻取小且急，重按坚大且急，这是五脏郁热，寒热邪气独并于肾的表现。这样的人不能坐立，到立春时会死亡（偃刀，卧刀也。轻取小急，如刀口；重按坚大急，如刀背。重按对应肾脏，肾虚则阴消，五脏皆热。虽然五脏有郁热而发为寒热，但其根本原则独归于肾。肾因亏损，腰脊疼痛，不能起坐。冬令水旺时尚未立即败绝，遇到春天才死）。脉象到来像圆滑的珠子但不应手，所谓“不直手”，指按压时摸不到，这是大肠经气不足的表现，等到枣叶生长时会死亡（如珠，流利之状，正是滑脉。不直手，滑而不应手，按之则无。大肠与肺金相为表里，枣叶生于初夏，火盛则金绝，所以应当死亡）。脉象到来像花朵（华脉），使人容易恐惧，不想坐卧，行走站立时常倾听，这是小肠经气不足的表现，在季秋时会死亡（如华，盛满而轻浮。小肠与心相为表里，小肠虚则心亦虚，所以善恐、不得坐卧。行立常听，是恐惧多而狐疑。丙火墓于戌，所以在季秋死）。
《素问·三部九候论》说：形体壮盛但脉象细弱，气短不足以呼吸的，会死亡（形盛者，脉也应盛，这是常态。形盛脉细，脉不应形，甚至气短难以布息，死期就在眼前）。形体消瘦但脉象洪大，胸中气逆多的，会死亡（形小脉小，这是常态。形瘦脉大，既不相称，甚至胸中多有逆上之气，阴败阳孤，不死还能等待什么）。形体与脉气相协调的，能生存（身形与脉气相得，如形小脉小、形大脉大等）。参伍不调的，有病（三以相参，伍以相类。称为不调，指或大或小，或迟或疾，或滑或涩，不合常度，都是病脉）。三部九候都失常的，会死亡（三部，指上中下三部，分天地人，分胸膈腹。九候，每部有浮中沉三候，三部各三，合而为九候。或应浮大而反沉细，应沉细而反浮大，称为相失，不符合揆度）。
形体肌肉已经脱失，即使九候脉象调和，也会死亡（脾主肌肉，为脏之本。若肌肉脱失则脾绝，九候虽调也无益）。七诊脉象虽然出现，但九候脉象顺应四时的，不会死亡（七诊，指独大、独小、独疾、独迟、独热、独寒、独陷下。从，顺也，合也。脉顺四时之令及合诸经之体者，虽见七诊之脉，不至于死）。
《素问·阴阳别论》说：凡是持守真脏脉的，肝脉悬绝，十八日死（悬绝，真脏脉见，胃气已无，悬悬欲绝。十八日，为木金成数之余，金胜木而死）。心脉悬绝，九日死（九日，为火水生成数之余，水胜也）。肺脉悬绝，十二日死（十二日，为金火生成数之余，火胜金也）。肾脉悬绝，七日死（七日，为水土生数之余，土胜水也）。脾脉悬绝，四日死（四日，为木生数之余，木胜土也）。
《素问·平人气象论》说：妇人手少阴脉动势明显的，是怀孕（手少阴，心脉也。动甚，流利滑动，血旺而然，所以应当怀孕）。
《素问·阴阳别论》说：阴脉搏动与阳脉迥别，叫做怀孕（阴搏阳别，言阴脉搏动，与阳脉迥别。阴阳二字涵盖广泛，以左右言，左为阳、右为阴；以部位言，寸为阳、尺为阴；以九候言，浮为阳、沉为阴。旧说以尺脉洪实为阴，与阳脉迥别似乎有理，然而手少阴脉动甚也在寸部，何取于阳别之意呢？所以要融会贯通各种阴阳理论才能决断）。
《素问·征四失论》说：诊病不问其起因，忧患、饮食失节、起居过度，或伤于毒物，不先了解这些，仓促切按寸口，怎么能准确诊断病情？妄言定名，是被粗疏所困（此言临证者，必先察致病之因，而后参之以脉，则阴阳虚实不致混淆错误。若不问其始，是不求其本源。如忧患饮食，内因也；起居过度，外因也；伤于毒者，不内外因也。不先察其因而仓促持寸口，自谓脉神，无需问诊，岂知真假逆从？脉病原有不合者，仓促一诊，安能尽中病情？妄言定名，欺世卖俗，误治伤生，损德不小矣）。
我按语：脉，是气血的外在征兆。病态千变万化，都想用三指测知其变化，不是天下最灵巧的人，谁能做到这样？许叔微说：脉理幽深难明，我心意所解，口中无法宣达。可以用笔墨传达、口耳授受的，都是粗浅的痕迹。
虽然如此，粗浅者尚未精通，精深者从何而出？分析而言，二十四字犹嫌简略；概括而言，浮沉迟数已掌握其纲领，所以脉不辨阴阳，越探究越困惑。阴阳之义已见于前文“阴搏阳别”条。又，滑伯仁说：察脉须辨别上、下、来、去、至、止，不明白这六个字，就无法辨别阴阳。上者为阳，来者为阳，至者为阳，下者为阴，去者为阴，止者为阴。上，指自尺部上行至寸部，阳生于阴。下，指自寸部下行至尺部，阴生于阳。来，指自骨肉出于皮肤，气之升也。去，指自皮肤还于骨肉，气之降也。应曰至，息曰止。此义至浅而至要，行远自迩，登高自卑；请践行此语。
When the Ge pulse (Leather Pulse) arrives, it feels hard and urgent like leather; Yongquan describes its abundant and full momentum. Those presenting this pulse suffer from progressively worsening disease with a sallow and lusterless complexion. (If the pulse becomes threadlike and weak then suddenly cuts off, it indicates the complete loss of Stomach Qi, the appearance of the Zang-Fu True Pulses, hence death ensues).
The *Da Qi Lun* states: When the pulse arrives resembling floating waves merging (Fuhe Pulse), appearing rapid, beating more than ten times per respiration, this indicates severe insufficiency of Jing-Qi. If seen even slightly for the first time, death will occur within ninety days (The following all specify fixed periods until death. "Fuhe" resembles floating waves converging, with rear waves urging front waves, chaotic and unmeasured. "Appearing rapid but not truly rapid" indicates blood corruption; "Fuhe" indicates Qi corruption. More than ten beats per respiration implies imminent death. The mention of ninety days here is erroneous; the character "ten" is a superfluous duplication. "Wei jian" means first seen. Upon first seeing this pulse, death occurs in nine days). When the pulse arrives as fierce as burning firewood, this indicates the depletion of Heart Essence and Qi; death will occur when grass and trees dry up (A pulse like burning fire indicates extreme excess of Fire, signifying that the Essence and Qi of the Heart Meridian are exhausted. In summer when Fire is prosperous, one may barely sustain life; in the Water season when grass dries, Yang is exhausted and death follows). When the pulse arrives like scattered leaves, this indicates deficiency of Liver Qi; death will occur when tree leaves fall (Scattered leaves refer to floating and rootless qualities, indicating extreme deficiency of Liver Qi. When wood leaves fall, Metal is prosperous and Wood is cut off, making death appropriate at that time). When the pulse arrives like a visitor coming and going (Shengke Pulse), meaning a guest who asks questions, appearing and disappearing intermittently. "Se" refers to roughness and intermittent pauses (Dai pulse); "Gu" refers to firmness and forceful beating. Roughness and Dai indicate corruption of Essence and Blood; firmness and force indicate scanty Stomach Qi. By the time dates flowers bloom, Earth is prosperous and Water declines, leading to immediate demise. When the pulse arrives like a clay pellet (Niwan Pulse), this indicates insufficiency of Stomach Essence and Qi; death will occur when elm seeds fall (Niwan resembles a clay pellet, a short pulse. It signifies insufficiency of Stomach Essence and Qi. Elm seeds fall in late spring when Wood is prosperous, causing Earth to fail). When the pulse arrives like a horizontal grid (Hengge Pulse), this indicates insufficiency of Gallbladder Qi; death will occur when grain ripens (Hengge refers to a long, large, firm, and strong pulse, which is the True Pulse of Wood, indicating failure of the Gallbladder. Grain ripens in autumn when Metal is prosperous and Wood is cut off). When the pulse arrives like intertwined strings (Xianlv Pulse), this indicates insufficiency of Baojing (Uterine/Pericardium Essence). The patient speaks excessively; death will occur when frost falls; if they do not speak excessively, the condition is treatable ("Xian"喻劲急, "Lv"喻细小. "Bao" refers to the Pericardium Meridian. The tongue is the sprout of the Heart; Fire moving causes excessive speech. Frost in winter represents Water overcoming Fire, leading to death. Lack of excessive speech implies lesser injury, thus salvageable). When the pulse arrives like mixing lacquer (Jiaoqi Pulse), meaning reaching from both sides laterally, death will occur thirty days after first being seen (Jiaoqi is blurred and large, akin to pouring lacquer. Lateral reach indicates vastness. "Wei" means initial. As the monthly order changes, the period of death arrives). When the pulse arrives like a gushing spring, floating and beating within the muscles, this indicates insufficiency of Taiyang Qi, shortness of breath, and death upon consuming leek flowers (Yongquan resembles a gushing spring, rising only without descending, floating and beating between muscle surfaces, indicating insufficiency of Foot-Taiyang Bladder Qi. The Bladder belongs to Three-Yang and governs the exterior; now exterior is excess and interior is deficient, hence shortness of breath. Jiu Ying is leek flower. Emerging in Long Summer, Earth overcomes Water, leading to death). When the pulse arrives like a collapsing earth mound, undetectable upon pressure, this indicates insufficiency of Muscle Qi. If black color appears on the face first, death will occur if white appears in spring (Deficiency above and below leads to collapse. A pulse that is empty and large, undetectable upon pressure, is a sign of lower deficiency. Spleen governs muscles; Muscle Qi is Spleen Qi. Black is the color of Water; when Earth fails, Wood insults it. Lei is similar to "Lei" (bud). Lotus buds have five colors; white appears in spring when Wood is prosperous, leaving Earth extinct). When the pulse arrives like the uvula (Xuanyong Pulse), where palpating lightly makes it larger, this indicates insufficiency of the Twelve Shu points' Qi; death will occur when water freezes (Xuanyong is the fleshy projection in the throat, commonly called throat flower. Palpating lightly yields a larger pulse, indicating Yang without Yin, isolated Yang hyperactive upwards. The Twelve Shu are the transport points of the twelve Zang-Fu meridians. Death by water freezing indicates盛 Yin and extinction of isolated Yang). When the pulse arrives like an inverted knife (Yandao Pulse), where superficial palpation is small and urgent, deep palpation is firm, large, and urgent, this indicates heat stagnation in the Five Zang organs, with cold-heat pathogens exclusively combining in the Kidney. Such a person cannot sit upright; death will occur at Lichun (Inverted knife lies flat. Superficial small/urgent resembles the blade edge; deep firm/large/urgent resembles the blade back. Deep pressure corresponds to the Kidney. Kidney deficiency leads to Yin consumption and heat in all Five Zang. Although there is stagnant heat causing cold-heat symptoms, the root lies in the Kidney. Due to Kidney deficiency, waist and spine ache, preventing sitting or standing. In winter when Water is prosperous, collapse is delayed until spring). When the pulse arrives like a slippery bead but does not respond to the hand, meaning it is undetectable upon pressure, this indicates insufficiency of Large Intestine Qi; death will occur when jujube leaves grow (Resembling beads indicates smoothness, a Slippery Pulse. Not responding to the hand means slipping away upon pressure. The Large Intestine and Lung Metal are exterior-interior partners. Jujube leaves grow in early summer; excessive Fire cuts off Metal, leading to death). When the pulse arrives like a flower, causing fearfulness, reluctance to sit or lie down, and constant listening while walking or standing, this indicates insufficiency of Small Intestine Qi; death will occur in late autumn (Like a flower indicates fullness and lightness. The Small Intestine and Heart are exterior-interior partners; Small Intestine deficiency leads to Heart deficiency, causing fear and restlessness. Constant listening reflects fear and suspicion. Bing Fire enters the tomb at Xu, hence death in late autumn).
The *San Bu Jiu Hou Lun* states: If the body is robust but the pulse is thin, with insufficient Qi to breathe, death ensues (Robust body should have a robust pulse. Thin pulse mismatching the body, especially with shortness of breath, indicates imminent death). If the body is emaciated but the pulse is large, with much Qi in the chest, death ensues (Emaciated body should have a small pulse. Large pulse mismatching the body, especially with rebellious Qi in the chest, indicates Yin failure and isolated Yang; death is inevitable). If form and Qi are harmonious, life is sustained (Form and pulse match, e.g., small form/small pulse, large form/large pulse). If pulses are irregular and discordant (Can Wu), disease exists (Comparing three and classifying five. Discordance refers to variations in size, speed, or texture not conforming to norms, all indicating pathological pulses). If all Nine Hounds are lost/disordered, death ensues (Three Parts refer to Upper, Middle, Lower, corresponding to Heaven, Earth, Human, and Chest/Abdomen. Nine Hounds refer to Floating, Middle, Deep at each part. Loss refers to mismatches, e.g., expected large/superficial but found small/deep, violating measurement standards).
If flesh and muscles are already depleted, even if the Nine Hounds are harmonious, death ensues (Spleen governs muscles and is the root of Zang organs. Muscle depletion signifies Spleen extinction; harmonious pulses are useless). If the Seven Diagnoses are present but the Nine Hounds follow [seasonal norms], death does not ensue (Seven Diagnoses refer to exclusively large, small, rapid, slow, hot, cold, or sunken. "Follow" means compliant. Pulses complying with seasonal orders and meridian structures, despite showing Seven Diagnosis signs, do not lead to death).
The *Yin Yang Bie Lun* states: Regarding True Zang Pulses, if the Liver pulse hangs isolated (Xuanjue), death occurs in eighteen days (Xuanjue indicates True Zang pulse appearance, no Stomach Qi, hanging and about to sever. Eighteen days relates to the remainder of Wood/Metal completion numbers; Metal overcomes Wood leading to death). If the Heart pulse hangs isolated, death occurs in nine days (Nine days relates to Fire/Water generation numbers; Water overcomes). If the Lung pulse hangs isolated, death occurs in twelve days (Twelve days relates to Metal/Fire generation numbers; Fire overcomes Metal). If the Kidney pulse hangs isolated, death occurs in seven days (Seven days relates to Water/Earth generation numbers; Earth overcomes Water). If the Spleen pulse hangs isolated, death occurs in four days (Four days relates to Wood generation number; Wood overcomes Earth).
The *Ping Ren Qi Xiang Lun* states: If the Hand-Shaoyin pulse moves vigorously in women, it indicates pregnancy (Hand-Shaoyin is the Heart pulse. Vigorous movement, smooth and slippery, indicates abundant blood, hence pregnancy).
The *Yin Yang Bie Lun* states: Yin pulsing distinctly different from Yang is called having a child (Yin pulsing distinct from Yang. Yin/Yang covers broad concepts: Left is Yang, Right is Yin; Cun is Yang, Chi is Yin; Floating is Yang, Deep is Yin. Old theories consider full Chi pulse as Yin distinct from Yang, yet Hand-Shaoyin vigor is also at Cun. Thus, integrating various Yin/Yang theories is necessary for judgment).
The *Zheng Si Shi Lun* states: Diagnosing illness without asking about its onset, worries, dietary irregularities, excessive lifestyle, or toxic injuries, and immediately palpating the Cun Kou without prior inquiry, how can one accurately diagnose? Making arbitrary names results in being trapped by coarseness (Physicians must first investigate etiology before correlating with pulses to avoid confusion of Yin/Yang and Deficiency/Excess. Ignoring onset ignores the source. Worries/diet are internal causes; lifestyle excesses are external; toxins are neither-internal-nor-external. Rushing to pulse diagnosis without inquiry claims pulse divinity but misses truth/reversal. Accurate diagnosis requires thorough inquiry; otherwise, errors harm life and virtue).
My commentary: Pulses are omens of Qi and Blood. With myriad pathological states, measuring changes with three fingers requires supreme skill. Xu Shuwei said: Pulse principles are profound and hard to clarify; what I understand internally cannot be fully expressed verbally. What can be transmitted via writing or speech are merely coarse traces.
Nevertheless, without mastering the coarse, how can the refined emerge? Analytically, twenty-four characters seem brief; summarily, Floating, Deep, Slow, and Rapid grasp the outline. Without distinguishing Yin and Yang, investigation leads only to confusion. Yin-Yang principles were discussed under "Yin Pulsing Distinct from Yang." Additionally, Hua Bo-ren stated: Examining pulses requires distinguishing Up, Down, Coming, Going, Arriving, and Stopping. Without understanding these six characters, Yin and Yang cannot be distinguished. Up is Yang, Coming is Yang, Arriving is Yang; Down is Yin, Going is Yin, Stopping is Yin. Up moves from Chi to Cun, Yang born from Yin. Down moves from Cun to Chi, Yin born from Yang. Coming emerges from bone/flesh to skin, Qi ascending. Going returns from skin to bone/flesh, Qi descending. Response is Arriving, Breath is Stopping. This principle is simple yet vital; travel far starting near, climb high starting low; please practice these words.