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\r六气分合六部时日诊候之图二\ps98a20.bmp\r
时令者；四时之变脉与之应也。十二月大寒，至二月春分，为初之气，厥阴风木主
令，《经》云∶厥阴之至，其脉弦。春分至小满为二之气，少阴君火主令，《经》云∶
少阴之至，其脉钧。小满至六月大暑，为三之气，少阳相火主令，《经》曰∶少阳之至，
大而浮。大暑至八月秋分，为四之气，太阴湿土主令，《经》曰∶太阴之至，其脉沉。
秋分至十月小雪，为五之气，阳明燥金主令，《经》曰∶阳明之至，短而涩。小雪至
十二月，大寒为六之气，太阳寒水主令，《经》曰∶太阳之至大而长。
以平治之纪为例，若太过之纪，其气未至，而至从节前十二日为度，不及之纪其气
至而未至，从节后十三日为度。太过之岁，从左尺浮分起立春，不及之岁，从左关中分
起立春，根据次而推之，此六气至理，而方书所未发者，必于平旦，阴气未散，阳气未
动，饮食未进，言语未吐之时，清心调息，逐部细究，则时令之病，可以前知。诊得六
部俱平则已，若有独大、独小、独浮、独沉、独长、独短，与各部不同，根据图断之，
无不验者。假如左关中候，脉独弦大，已知雨水后，惊蛰边，有风热之病，盖弦主风，
而大主热也。且左关又为风木之令故也。如右尺沉分，脉独缓滞而实大，已知芒种后，
夏至边，有湿热之病，盖缓滞主湿，实大主热也。若缓滞虚大，乃湿热相火为患，盖缓
滞为湿，而虚大为相火也。且在沉分，沉亦主湿，又在相火之位故也。久病之人，六脉
俱浊滞，惟右寸中候，脉得从容和缓，清净无滞，已知霜降后，立冬边必愈，其余仿此
而推之，百不一失也。
夫按政运者，所以明不应之脉，盖不应者，沉细也，有其诊则见矣。凡值此不应，
乃岁运合宜，不必求治，误治之，反伐天和。
土运为南政，土位居中，面南行令故也。其余四达以盖事之，北面受令，故为北政。
甲已二年，为土运南政，如运少阴司天，则两寸不应，厥阴司天，则右寸不应，
太阴司天，则左寸不应。少阴在泉，则两尺不应，厥阴在泉，则右尺不应，太阴有泉，
则左尺不应。
乙丙丁戊庚辛壬发八年，皆为北政，如遇少阴司天，则两尺不应，厥阴司天，则右
尺不应，太阴司天，则左尺不应。少阴在泉，则两寸不应，厥阴在泉，则右寸不应，
太阴在泉，则左寸不应。
如尺当不应，而反浮大，寸当浮大，而反沉细，寸当不应，而反浮大，尺当浮大，
而反沉细，是谓尺寸反，《经》曰∶尺寸反者，死。如右当不应而反浮大，左当浮大而
反沉细，左当不应而反浮大，右当浮大而反沉细，是谓左右反，《经》曰∶左右反者，
死。
真脏者，所以明不治之脉，盖人以胃气为本，胃气脉者，应手中和，意思忻忻，悠
悠扬扬，难以名状是也。太过不及者，病。但得真脏脉，不得胃气者，死。
《经》曰∶脉气有余，形气不足生，是重以脉也。又曰∶形肉已脱，九候虽调犹
死，是重以形肉也。何经言之，相反若是？此二者，均不可偏废也。夫脉气有余，里无
大病也。形气不足，未至肉脱也，何死之虞？若至形肉俱脱者，必久病也。此时客病
虽无所苦，然气血亏竭，依稀一线之气，留连未绝，所以九候如丝，似乎和缓之象，然
形如柴立，大肉已败，脾主肌肉，土崩脾绝矣。难无风雨之侵，油干灯自尽耳。
一以尺中为根，人之有尺，犹树之有根，水为天一之元，先天命根也。王叔和
曰∶寸关虽无，尺犹不绝，如此之流，何忧殒灭，谓其有根也。若肾脉独败，是无根
矣。一以沉候为根，《经》曰∶诸浮脉无根者，皆死。是谓有表无里，谓之孤阳不生。
夫造化所以亘万古而不息者，一阴一阳，互为其根也。阴既绝矣，孤阳岂能独存乎？二
说似乎不同，实则一致。两尺为肾部，沉候之六脉皆肾也。然则两尺之无根，与沉取之
无根，总属肾水绝矣。故曰∶脉贵有神。有神者，即重按有根之谓，譬如树木根本一
坏，虽猛力培植，终无发生之理。
寸脉浮太阳也。又兼疾脉，此阳中之阳也，名曰重阳。尺内沉细，阴也。又兼迟
脉，此阴中之阴也，名曰重阴。上部重阳，下部重阴，阳亢阴隔，癫狂乃成，六脉有表
无里，如濡脉之类，此名脱阴。六脉有里无表，谓之陷下，如弱脉之类，此名脱阳。六
脉暴脱，此阴阳俱脱也。《经》曰∶脱阴者目盲，脱阳者见鬼，阴阳俱脱者危。
《经》曰∶持脉有道，虚静为保，春日浮，如鱼之游在波。夏日在肤，泛泛乎万物
有余。秋日下肤，虫蛰将去。冬日在骨，蛰虫周密，君子居室。故曰∶知内者，按而纪
之；知外者，终而始之。此六者，持脉之大法。
冲阳者，胃脉也，在足跗上（即脚面也）五寸，骨间动脉，上去陷谷三寸，盖土
者，万物之母，冲阳脉不衰，胃气犹在，病虽危，尚可生也。太溪者，肾脉也。在足内
踝，后跟骨上（即足跗后两面圆骨，俗名孤拐骨），动脉陷中，盖水者，天一之元，太
溪不衰，肾犹未绝，病虽危，尚可生也。太冲者，肝脉也。在足大指本节后，二寸陷
中，盖肝者，东方木也。生物之始，此脉不衰，则生生之机尚可望也，故名生死之门。
女人尤以此为主，盖以妇人主血，而肝为血海，且东方生物之始也。气海穴，在脐下一
寸半，气海者，男子生气之海也。丹田穴在脐下三寸，即关元穴，乃足少阴任脉之会及
阴阳之门户，人身之根本，为精神藏聚之所，二处之动气，即脉之根源也。
《经》曰∶荣行脉中，卫行脉外，是言荣卫所行之道路，岂足以尽脉之变化哉！故
《经》曰∶根于中者，命曰∶神机脉之所以神其用者，皆元神上钟，而主宰其机脏腑精
华，而变现其体，若以脉中惟以气血为用，则尺寸之肤，莫非血气也。皆可以按脉验病矣。
上鱼者，脉上于鱼际也。世人常有此脉，脉同病异，不可以一例论也。有两手上
鱼者，有一手上鱼者，若平人神色充实，而有此脉者，此天禀之浓，元神充满，上溢于
鱼也，其人必寿。若人素无此脉，一若上鱼者，此病脉也。《难经》曰∶关之前者，阳
之动也。脉当九分而浮，减者，法曰不及，过者，法曰太过，遂上鱼为溢，为外关内
格，此阴乘阳之脉也。
阳实者，人知其脉之洪大矣。至其极也，而脉反匿伏焉。此干之上九，亢龙有悔
也。阴虚者，人知其脉之微细矣。至其极也，而脉反躁疾焉。此坤之上六，龙战于野
也。是皆阴阳亢制之理，惟明者知之。
脉有乘侮，假令肺病而见心脉，虽云克我者为贼邪，然本脏实有以致之。《经》曰∶
邪之所凑，其气必虚，犹国无君子故奸人得乘之。又如肺病而见肝脉，我克者为微邪，
然本脏之衰可占也。故《经》曰∶气不足则已所胜者，轻而侮之，惟君子道消，故小人
道长也。余脏可推。
男子以阳为主，两寸之脉，常旺于尺，若两寸反弱，尺反盛者，肾不足也。女子以
阴为主，两尺之脉常旺于寸。若尺反弱，而寸反盛者，上焦有余也。不足固病，有余亦
病，所为过犹不及也。
老弱之人，脉宜缓弱，若脉过旺者，病也。少壮之人，脉宜充实，若脉过弱者，病
也。然犹有说焉。老者脉旺而不躁，此天禀之浓引年之叟也，名曰寿脉。若脉躁疾，有
表无里，此孤阳也。其死迅矣。壮者脉细而和缓，三部同等，此天禀之静清逸之土也，
名曰阴脉，若脉来细而劲直，前后不等，可与之决死期矣。
病之阴脉，有沉有紧有数，而仲景统以微细言之，盖沉必重按始得，紧数亦在沉细
中见，不似阳症浮大而紧数也。
薛氏曰∶人知数为热，不知沉细中见数为寒甚，真阴寒症，脉尝有七八至者，但按
之无力而数耳，宜深察之。
脉法倡自岐黄，不过测病情，决生死而已，安得有所谓太素也？自杨上善主《太素
脉法》，征休征咎，比于神灵，皆风鉴者之流托名《太素》，以神其说耳。然亦有可采
之句，如曰∶脉形圆净，至数分明，谓之清。脉形散涩，至数模糊之谓浊。质清，脉
清，富贵而多喜，质浊脉浊，贫贱而多忧，质清脉浊，外富贵而内贫贱，失意处多，得
意处少也。质浊脉清，外贫贱而内富贵，得意处多，失意处少也，富贵而寿，脉清而
长，贫贱而夭，脉浊而促，清而长者，富贵而夭，浊而促者，贫贱而寿，此皆可采之
句，实为穷通休咎之征，然亦不能外乎风鉴也。
六气分合六部时日诊候之图一\ps98a19.bmp\
六气分合六部时日诊候之图二\ps98a20.bmp\
时令（季节气候）的变化，与四时（春、夏、秋、冬）变化的脉象是相应的。从十二月大寒到二月春分，称为初之气，由厥阴风木（足厥阴肝经与足少阳胆经，主风气与木气）主令，《内经》说：厥阴之气到来时，脉象呈弦象（端直以长，如按琴弦）。从春分到小满为二之气，由少阴君火（手少阴心经与足少阴肾经，主热气与火气）主令，《内经》说：少阴之气到来时，脉象钧（均，指脉来和缓均匀）。从小满到六月大暑为三之气，由少阳相火（手少阳三焦经与足少阳胆经，主火气）主令，《内经》说：少阳之气到来时，脉象大而浮（脉体宽大且位置表浅）。从大暑到八月秋分为四之气，由太阴湿土（足太阴脾经与手太阴肺经，主湿气与土气）主令，《内经》说：太阴之气到来时，脉象沉（位置深在，重按始得）。从秋分到十月小雪为五之气，由阳明燥金（手阳明大肠经与足阳明胃经，主燥气与金气）主令，《内经》说：阳明之气到来时，脉象短而涩（脉来不充，往来艰涩）。从小雪到十二月大寒为六之气，由太阳寒水（足太阳膀胱经与手太阳小肠经，主寒气与水气）主令，《内经》说：太阳之气到来时，脉象大而长（脉体宽大且搏动范围长）。
以平治之纪（正常平衡的年份）为例，如果是太过之纪（运气偏盛），其气未至，但脉象变化会提前，以节前十二天为限度；不及之纪（运气偏衰），其气虽至但脉象反应滞后，以节后十三天为限度。太过之年，脉象从左尺浮分（左手尺部轻取）起于立春开始变化；不及之年，脉象从左关中分（左手关部中取）起于立春开始变化，依此类推进行推算。这是六气运行的精微道理，是方书未曾阐发的。必须在平旦（清晨日出前后），阴气未散，阳气未动，饮食未进，言语未吐之时，清心调息，逐部仔细探究，那么时令之病，就可以预先知晓。诊察发现六部脉象都平和则已，如果有独大、独小、独浮、独沉、独长、独短，与其他各部不同的，根据图表判断，没有不灵验的。假如左关部（对应肝胆）候诊时，脉象独见弦大，已知雨水后、惊蛰左右，会有风热之病，因为弦脉主风，大脉主热。而且左关又属于风木主令的部位。如果右尺部（对应肾与命门）沉分（重取），脉象独见缓滞而实大，已知芒种后、夏至左右，会有湿热之病，因为缓滞主湿，实大主热。若是缓滞虚大，则是湿热与相火为患，因为缓滞为湿，虚大为相火。且在沉分，沉脉亦主湿，又在相火的部位，所以如此。久病之人，六脉俱浊滞，唯独右寸部（对应肺）中候（中取），脉象从容和缓，清净无滞，已知霜降后、立冬左右必定痊愈，其余情况仿此推演，百无一失。
所谓“不应”之脉，是为了说明不合时令的脉象。所谓不应，是指脉象沉细。有这种诊象就表现为不应。凡是遇到这种不应，乃是岁运适宜，不必求治，误治反而伤害天和（自然生机）。
土运为南政（南方君主之政），土位居中央，面南行令的缘故。其余四运（木、火、金、水）以盖事之（辅佐者），北面受令，故为北政（北方臣子之政）。甲己二年，为土运南政，如果运少阴司天（主管上半年气候），则两寸脉不应（沉细不见）；厥阴司天，则右寸不应；太阴司天，则左寸不应。少阴在泉（主管下半年气候），则两尺脉不应；厥阴在泉，则右尺不应；太阴在泉，则左尺不应。
乙丙丁戊庚辛壬癸八年，皆为北政，如果遇到少阴司天，则两尺脉不应；厥阴司天，则右尺不应；太阴司天，则左尺不应。少阴在泉，则两寸脉不应；厥阴在泉，则右寸不应；太阴在泉，则左寸不应。
如果尺部应当不应（沉细），反而浮大；寸部应当浮大，反而沉细；寸部应当不应，反而浮大；尺部应当浮大，反而沉细，这叫做尺寸反，《内经》说：尺寸反者，死。如果右部应当不应而反浮大，左部应当浮大而反沉细；左部应当不应而反浮大，右部应当浮大而反沉细，这叫做左右反，《内经》说：左右反者，死。
真脏脉，是用来说明不可治愈的脉象。大概人以胃气为本，胃气脉的特点，是应手中和，意思忻忻（愉快舒适），悠悠扬扬，难以名状。太过或不及，都是病。只要得到真脏脉，得不到胃气，就会死亡。
《内经》说：脉气有余，形气不足，生，这是重视脉象。又说：形肉已脱，九候虽调犹死，这是重视形体肌肉。为什么经文说得相反如此？这两者，都不可偏废。夫脉气有余，里无大病也。形气不足，未至肉脱也，何死之虞？若至形肉俱脱者，必久病也。此时客病虽无所苦，然气血亏竭，依稀一线之气，留连未绝，所以九候如丝，似乎和缓之象，然形如柴立，大肉已败，脾主肌肉，土崩脾绝矣。难无风雨之侵，油干灯自尽耳。
一以尺中为根，人之有尺，犹树之有根，水为天一之元，先天命根也。王叔和曰：寸关虽无，尺犹不绝，如此之流，何忧殒灭，谓其有根也。若肾脉独败，是无根矣。一以沉候为根，《经》曰：诸浮脉无根者，皆死。是谓有表无里，谓之孤阳不生。夫造化所以亘万古而不息者，一阴一阳，互为其根也。阴既绝矣，孤阳岂能独存乎？二说似乎不同，实则一致。两尺为肾部，沉候之六脉皆肾也。然则两尺之无根，与沉取之无根，总属肾水绝矣。故曰：脉贵有神。有神者，即重按有根之谓，譬如树木根本一坏，虽猛力培植，终无发生之理。
寸脉浮太阳也。又兼疾脉，此阳中之阳也，名曰重阳。尺内沉细，阴也。又兼迟脉，此阴中之阴也，名曰重阴。上部重阳，下部重阴，阳亢阴隔，癫狂乃成，六脉有表无里，如濡脉之类，此名脱阴。六脉有里无表，谓之陷下，如弱脉之类，此名脱阳。六脉暴脱，此阴阳俱脱也。《经》曰：脱阴者目盲，脱阳者见鬼，阴阳俱脱者危。
《经》曰：持脉有道，虚静为保，春日浮，如鱼之游在波。夏日在肤，泛泛乎万物有余。秋日下肤，虫蛰将去。冬日在骨，蛰虫周密，君子居室。故曰：知内者，按而纪之；知外者，终而始之。此六者，持脉之大法。
冲阳穴（Chongyang, ST42），胃脉也，在足跗上（即脚面也）五寸，骨间动脉，上去陷谷三寸，盖土者，万物之母，冲阳脉不衰，胃气犹在，病虽危，尚可生也。太溪穴（Taixi, KI3），肾脉也。在足内踝，后跟骨上（即足跗后两面圆骨，俗名孤拐骨），动脉陷中，盖水者，天一之元，太溪不衰，肾犹未绝，病虽危，尚可生也。太冲穴（Taichong, LR3），肝脉也。在足大指本节后，二寸陷中，盖肝者，东方木也。生物之始，此脉不衰，则生生之机尚可望也，故名生死之门。女人尤以此为主，盖以妇人主血，而肝为血海，且东方生物之始也。气海穴（Qihai, CV6），在脐下一寸半，气海者，男子生气之海也。丹田穴（Dantian）在脐下三寸，即关元穴（Guanyuan, CV4），乃足少阴任脉之会及阴阳之门户，人身之根本，为精神藏聚之所，二处之动气，即脉之根源也。
《经》曰：荣行脉中，卫行脉外，是言荣卫所行之道路，岂足以尽脉之变化哉！故《经》曰：根于中者，命曰：神机脉之所以神其用者，皆元神上钟，而主宰其机脏腑精华，而变现其体，若以脉中惟以气血为用，则尺寸之肤，莫非血气也。皆可以按脉验病矣。
上鱼者，脉上于鱼际也。世人常有此脉，脉同病异，不可以一例论也。有两手上鱼者，有一手上鱼者，若平人神色充实，而有此脉者，此天禀之浓，元神充满，上溢于鱼也，其人必寿。若人素无此脉，一若上鱼者，此病脉也。《难经》曰：关之前者，阳之动也。脉当九分而浮，减者，法曰不及，过者，法曰太过，遂上鱼为溢，为外关内格，此阴乘阳之脉也。
阳实者，人知其脉之洪大矣。至其极也，而脉反匿伏焉。此干之上九，亢龙有悔也。阴虚者，人知其脉之微细矣。至其极也，而脉反躁疾焉。此坤之上六，龙战于野也。是皆阴阳亢制之理，惟明者知之。
脉有乘侮，假令肺病而见心脉，虽云克我者为贼邪，然本脏实有以致之。《经》曰：邪之所凑，其气必虚，犹国无君子故奸人得乘之。又如肺病而见肝脉，我克者为微邪，然本脏之衰可占也。故《经》曰：气不足则已所胜者，轻而侮之，惟君子道消，故小人道长也。余脏可推。
男子以阳为主，两寸之脉，常旺于尺，若两寸反弱，尺反盛者，肾不足也。女子以阴为主，两尺之脉常旺于寸。若尺反弱，而寸反盛者，上焦有余也。不足固病，有余亦病，所为过犹不及也。
老弱之人，脉宜缓弱，若脉过旺者，病也。少壮之人，脉宜充实，若脉过弱者，病也。然犹有说焉。老者脉旺而不躁，此天禀之浓引年之叟也，名曰寿脉。若脉躁疾，有表无里，此孤阳也。其死迅矣。壮者脉细而和缓，三部同等，此天禀之静清逸之土也，名曰阴脉，若脉来细而劲直，前后不等，可与之决死期矣。
病之阴脉，有沉有紧有数，而仲景统以微细言之，盖沉必重按始得，紧数亦在沉细中见，不似阳症浮大而紧数也。
薛氏曰：人知数为热，不知沉细中见数为寒甚，真阴寒症，脉尝有七八至者，但按之无力而数耳，宜深察之。
脉法倡自岐黄，不过测病情，决生死而已，安得有所谓太素也？自杨上善主《太素脉法》，征休征咎，比于神灵，皆风鉴者之流托名《太素》，以神其说耳。然亦有可采之句，如曰：脉形圆净，至数分明，谓之清。脉形散涩，至数模糊之谓浊。质清，脉清，富贵而多喜，质浊脉浊，贫贱而多忧，质清脉浊，外富贵而内贫贱，失意处多，得意处少也。质浊脉清，外贫贱而内富贵，得意处多，失意处少也，富贵而寿，脉清而长，贫贱而夭，脉浊而促，清而长者，富贵而夭，浊而促者，贫贱而寿，此皆可采之句，实为穷通休咎之征，然亦不能外乎风鉴也。
Diagram of Diagnosis of Six Qi Divided and Combined in Six Parts According to Time and Days 1 \ps98a19.bmp\
Diagram of Diagnosis of Six Qi Divided and Combined in Six Parts According to Time and Days 2 \ps98a20.bmp\
Seasonal climates (Shiling) correspond to the pulse changes of the four seasons. From Great Cold in the twelfth month to Spring Equinox in the second month is the First Qi, governed by Jueyin Wind-Wood (Jueyin Fengmu). The Classic states: "When Jueyin arrives, its pulse is Xian (String-like)." From Spring Equinox to Grain Full is the Second Qi, governed by Shaoyin Sovereign Fire (Shaoyin Junhuo). The Classic states: "When Shaoyin arrives, its pulse is Jun (Uniform/Harmonious)." From Grain Full to Great Heat in the sixth month is the Third Qi, governed by Shaoyang Ministerial Fire (Shaoyang Xianghuo). The Classic states: "When Shaoyang arrives, its pulse is Da (Large) and Fu (Floating)." From Great Heat to Autumn Equinox in the eighth month is the Fourth Qi, governed by Taiyin Damp-Earth (Taiyin Shitu). The Classic states: "When Taiyin arrives, its pulse is Chen (Deep)." From Autumn Equinox to Minor Snow in the tenth month is the Fifth Qi, governed by Yangming Dry-Metal (Yangming Zaojin). The Classic states: "When Yangming arrives, its pulse is Duan (Short) and Se (Choppy)." From Minor Snow to Great Cold in the twelfth month is the Sixth Qi, governed by Taiyang Cold-Water (Taiyang Han shui). The Classic states: "When Taiyang arrives, its pulse is Da (Large) and Chang (Long)."
Taking a balanced year (Pingzhi Zhi Ji) as an example: In years of Excess (Taiguo), if the Qi has not yet arrived, the pulse change precedes the solar term by twelve days as the limit. In years of Deficiency (Bují), if the Qi has arrived but the pulse does not reflect it, the pulse change lags behind the solar term by thirteen days as the limit. In Excess years, the pulse begins to change from the Floating position of the Left Chi (Left Cun-Guan-Chi) starting at Start of Spring. In Deficiency years, the pulse begins to change from the Middle position of the Left Guan starting at Start of Spring. Deduce accordingly. This is the profound principle of the Six Qi, unexplored in medical formularies. One must examine the pulse at dawn (Pingdan), when Yin Qi has not dispersed, Yang Qi has not stirred, food and drink have not been taken, and speech has not been uttered. With a clear mind and regulated breath, investigate each part carefully, and seasonal diseases can be predicted in advance. If the six parts of the pulse are all peaceful, so be it. If there is one that is exclusively Large, Small, Floating, Deep, Long, or Short, differing from other parts, judgment based on the chart will invariably be accurate. For instance, if the Left Guan (Liver/Gallbladder) pulse is exclusively Xian (String-like) and Da (Large), one knows that after Rain Water and around Jingzhe (Awakening of Insects), there will be Wind-Heat disease. Xian indicates Wind, and Da indicates Heat. Moreover, the Left Guan corresponds to the domain of Wind-Wood. If the Right Chi (Kidney/Mingmen) Chen (Deep) position shows an exclusively Huan (Slow/Lax) and Zhi (Stagnant) pulse that is Shi (Solid) and Da (Large), one knows that after Mangzhong (Grain in Ear) and around Summer Solstice, there will be Damp-Heat disease. Huan-Zhi indicates Dampness, and Shi-Da indicates Heat. If the pulse is Huan-Zhi Xu (Deficient) and Da (Large), it is caused by Damp-Heat and Ministerial Fire. Huan-Zhi represents Dampness, and Xu-Da represents Ministerial Fire. Furthermore, being in the Chen (Deep) position, Deep also indicates Dampness, and it is located in the position of Ministerial Fire. In chronic illness, if all six pulses are turbid and stagnant, but only the Right Cun (Lung) Zhong (Middle) position pulse is Congrong (Leisurely) and Hehuan (Harmonious), pure and unstagnated, one knows that after Frost Descent and around Start of Winter, recovery will occur. Other cases can be deduced similarly, with high accuracy.
The concept of "Bu Ying" (Non-responsive) pulse explains pulses that do not match the season. "Bu Ying" refers to a Chen (Deep) and Xi (Fine) pulse. Its presence indicates non-responsiveness. When encountering such non-responsiveness, it signifies that the annual运气 (Yunqi) is appropriate; no treatment is needed. Mis-treatment would harm Tianhe (Heavenly Harmony/Natural Vitality).
Earth Yun (Movement) is Nan Zheng (Southern Governance). Earth resides in the center and governs facing South. The other four Yun (Wood, Fire, Metal, Water) assist it, governing facing North, hence Bei Zheng (Northern Governance). In Jia and Ji years, it is Earth Yun Nan Zheng. If Shaoyin Si Tian (Governs Heaven/First Half of Year), both Cun (Inch) pulses are Bu Ying. If Jueyin Si Tian, the Right Cun is Bu Ying. If Taiyin Si Tian, the Left Cun is Bu Ying. If Shaoyin Zai Quan (Governs泉水/Second Half of Year), both Chi (Cubit) pulses are Bu Ying. If Jueyin Zai Quan, the Right Chi is Bu Ying. If Taiyin Zai Quan, the Left Chi is Bu Ying.
In Yi, Bing, Ding, Wu, Geng, Xin, Ren, Gui years (eight years total), it is Bei Zheng. If Shaoyin Si Tian, both Chi pulses are Bu Ying. If Jueyin Si Tian, the Right Chi is Bu Ying. If Taiyin Si Tian, the Left Chi is Bu Ying. If Shaoyin Zai Quan, both Cun pulses are Bu Ying. If Jueyin Zai Quan, the Right Cun is Bu Ying. If Taiyin Zai Quan, the Left Cun is Bu Ying.
If the Chi should be Bu Ying (Deep/Fine) but is instead Fu (Floating) and Da (Large), and the Cun should be Fu and Da but is instead Chen and Xi; if the Cun should be Bu Ying but is Fu and Da, and the Chi should be Fu and Da but is Chen and Xi, this is called Chicun Fan (Reversal of Inch and Cubit). The Classic states: "Chicun Fan leads to death." If the Right should be Bu Ying but is Fu and Da, and the Left should be Fu and Da but is Chen and Xi; if the Left should be Bu Ying but is Fu and Da, and the Right should be Fu and Da but is Chen and Xi, this is called Zuoyou Fan (Reversal of Left and Right). The Classic states: "Zuoyou Fan leads to death."
Zhen Zang Mai (True Organ Pulse) indicates incurable conditions. Humans rely on Wei Qi (Stomach Qi) as the root. The Wei Qi pulse feels harmonious and moderate, pleasant and relaxed, difficult to describe. Excess or Deficiency constitutes disease. Obtaining the Zhen Zang Mai without Wei Qi indicates death.
The Classic states: "Pulse Qi is in excess, Form Qi is deficient; survival depends on prioritizing the pulse." It also states: "Form and flesh are depleted; even if the Nine Probes are harmonious, death occurs; this prioritizes form and flesh." Why does the Classic seem contradictory? Both aspects must not be neglected. Pulse Qi in excess implies no severe internal disease. Form Qi deficiency implies flesh has not yet wasted away; why fear death? If both form and flesh are depleted, it must be a chronic illness. Although the patient may feel no discomfort from the external pathogen, Qi and Blood are exhausted, leaving only a faint thread of Qi lingering. Thus, the Nine Probes appear like silk threads, seemingly harmonious. However, the body stands like firewood, major muscles have failed. Spleen governs muscles; Earth collapses, Spleen perishes. Without shelter from wind and rain, it is like oil running out of a lamp; the light extinguishes itself.
One considers the Chi (Cubit) position as the root. Human Chi is like tree roots. Water is the origin of Tianyi (Heavenly One), the congenital root of life. Wang Shuhe said: "Even if Cun and Guan are absent, if Chi is not cut off, why worry about demise?" This means there is still a root. If only the Kidney pulse fails, there is no root. Another view considers the Chen (Deep) probing as the root. The Classic states: "All Floating pulses without a root lead to death." This is having exterior without interior, called Gu Yang (Lone Yang) which cannot generate life. Creation sustains itself through Yin and Yang,互为根 (mutually rooting). If Yin is extinct, how can Lone Yang survive alone? These two views seem different but are essentially consistent. Both Chi positions belong to the Kidneys; all six pulses probed deeply relate to the Kidneys. Therefore, lack of root in both Chi positions and lack of root upon deep probing both indicate exhaustion of Kidney Water. Hence, "Pulse values Shen (Spirit)." Shen means having a root upon heavy pressure. Like a tree, if the root is destroyed, no amount of cultivation will bring forth new growth.
Cun pulse Floating indicates Taiyang. If combined with Ji (Rapid) pulse, this is Yang within Yang, named Chong Yang (Double Yang). Chi inside is Chen (Deep) and Xi (Fine), Yin. If combined with Chi (Slow) pulse, this is Yin within Yin, named Chong Yin (Double Yin). Upper body Chong Yang, lower body Chong Yin, Yang hyperactivity and Yin blockage lead to Dian Kuang (Mania/Psychosis). Six pulses having exterior without interior, such as Ru (Soggy) pulse, is named Tuo Yin (Collapse of Yin). Six pulses having interior without exterior, called Xian Xia (Sinking/Collapse), such as Ruo (Weak) pulse, is named Tuo Yang (Collapse of Yang). Sudden collapse of six pulses indicates simultaneous collapse of Yin and Yang. The Classic states: "Tuo Yin results in blindness; Tuo Yang results in hallucinations; simultaneous collapse of Yin and Yang is critical."
The Classic states: "There is a method for holding the pulse; emptiness and tranquility are preserved. Spring pulses float, like fish swimming in waves. Summer pulses are in the skin, abundant like all things in summer. Autumn pulses descend below the skin, like insects preparing to hibernate. Winter pulses are in the bone, like insects tightly sealed, and gentlemen stay indoors." Thus: "Those who know the interior press and record them; those who know the exterior conclude and begin anew." These six points are the great methods of pulse diagnosis.
Chongyang (ST42) is the Stomach pulse, located five cun above the foot dorsum (instep), between the bones where the artery throbs, three cun above Xangu. Earth is the mother of all things. If Chongyang pulse does not decline, Stomach Qi remains. Even if the disease is critical, life is possible. Taixi (KI3) is the Kidney pulse. Located behind the medial malleolus, above the heel bone (the round bones on the back two sides of the foot dorsum, commonly known as 'lone turn bone'), in the depression where the artery throbs. Water is the origin of Tianyi. If Taixi does not decline, Kidney Qi is not exhausted. Even if critical, life is possible. Taichong (LR3) is the Liver pulse. Located two cun posterior to the base of the big toe, in the depression. Liver is Wood of the East, the beginning of biological generation. If this pulse does not decline, the mechanism of life is hopeful, hence named the Gate of Life and Death. This is especially important for women, as women govern Blood, Liver is the Sea of Blood, and it is the beginning of Eastern generation. Qihai (CV6) is located one and a half cun below the umbilicus. Qihai is the sea of generating Qi for men. Dantian is three cun below the umbilicus, which is Guanyuan (CV4), the meeting point of Foot Shaoyin and Ren Mai, and the gate of Yin and Yang. It is the root of the human body, the storage place of Spirit. The moving Qi in these two places is the root of the pulse.
The Classic states: "Ying (Nutritive) flows within the vessels, Wei (Defensive) flows outside the vessels." This describes the paths of Ying and Wei, but is it enough to exhaust the changes of the pulse? Thus, the Classic states: "Rooted in the middle, it is called Shen Ji (Spirit Mechanism)." The reason the pulse manifests its spiritual function is because Yuan Shen (Primordial Spirit) concentrates above, commanding the mechanism, and the essence of the Zang-Fu transforms its form. If we consider only Qi and Blood functioning within the pulse, then the skin of Cun and Chi is nothing but Qi and Blood. All could be verified by palpating the pulse.
"Shang Yu" (Ascending to the Fish) means the pulse extends to the Yuji (LU10) area. People often have this pulse, but diseases differ; it cannot be generalized. Some have it on both hands, some on one hand. If a healthy person with full spirit and color has this pulse, it indicates strong congenital endowment, full Yuan Shen overflowing to the Yu area; such a person will live long. If a person usually lacks this pulse and suddenly develops it, it is a pathological pulse. The Nan Jing states: "Anterior to the Guan is the movement of Yang. The pulse should be nine fen and floating. If reduced, it is legally termed Deficiency; if excessive, it is legally termed Excess. Thus ascending to Yu is called Yi (Overflow), representing Wai Guan Nei Ge (External Blockade, Internal Obstruction), which is a pulse of Yin invading Yang."
In Yang Excess, people know the pulse is Hong (Surging) and Da (Large). At its extreme, the pulse hides and vanishes. This is like the Top Nine of Qian (Heaven): "Arrogant dragon will have cause to repent." In Yin Deficiency, people know the pulse is Wei (Micro) and Xi (Fine). At its extreme, the pulse becomes Zao (Restless) and Ji (Rapid). This is like the Top Six of Kun (Earth): "Dragon fights in the field." These are principles of Yin-Yang hyper-restriction, known only to the wise.
Pulses have Cheng (Overacting) and Wu (Counter-acting). Suppose Lung disease presents Heart pulse. Although "what overcomes me is Thief Evil," the organ itself is solid, causing this. The Classic states: "Where evil gathers, Qi must be deficient," like a state without virtuous men allows villains to take advantage. Again, Lung disease presenting Liver pulse: "What I overcome is Minor Evil," but this indicates the decline of the primary organ. Thus, the Classic states: "When Qi is insufficient, what I normally overcome lightly counter-acts me." Only when the Way of the Gentleman declines does the Way of the Petty Man grow. The same applies to other organs.
Men prioritize Yang; the two Cun pulses are usually stronger than the Chi. If Cun is weak and Chi is strong, Kidney is deficient. Women prioritize Yin; the two Chi pulses are usually stronger than the Cun. If Chi is weak and Cun is strong, the Upper Jiao is in excess. Deficiency is definitely disease; excess is also disease. Excess is no different from Deficiency.
For the elderly and weak, the pulse should be Huan (Slow) and Ruo (Weak). If the pulse is overly vigorous, it is disease. For the young and strong, the pulse should be Chongshi (Full and Solid). If the pulse is overly weak, it is disease. However, there is more to say. An elderly person with a vigorous but not restless pulse indicates strong congenital endowment and longevity; this is called Shou Mai (Longevity Pulse). If the pulse is restless and rapid, having exterior without interior, it is Gu Yang (Lone Yang). Death will be swift. A strong person with a fine, harmonious, and slow pulse, equal in all three positions, indicates quiet, pure, and elegant congenital endowment; this is called Yin Mai. If the pulse comes fine and stiff/straight, unequal front and back, one can determine the time of death.
Pathological Yin pulses include Chen (Deep), Jin (Tight), and Shu (Rapid). Zhang Zhongjing generally describes them as Wei (Micro) and Xi (Fine). Chen requires heavy pressure to detect; Jin and Shu are also seen within Chen-Xi, unlike Yang syndromes which are Fu (Floating), Da (Large), Jin (Tight), and Shu (Rapid).
Xue Shi said: "People know Shu (Rapid) indicates Heat, but do not know that Shu seen within Chen-Xi indicates severe Cold. True Yin-Cold syndromes sometimes have pulses of seven or eight beats per breath, but they are powerless upon pressure despite being rapid. One must examine deeply."
Pulse methodology originated from Qi Bo and Huang Di, merely to assess disease condition and decide life or death. How could there be such a thing as Taisu? Since Yang Shangshan promoted "Taisu Pulse Method," predicting fortune and misfortune, comparing it to spirits, these are all physiognomists claiming the name "Taisu" to mystify their theory. However, there are valuable sentences, such as: "Pulse shape is round and clean, beat count distinct, called Qing (Clear). Pulse shape is scattered and choppy, beat count vague, called Zhuo (Turbid). Clear constitution, clear pulse: wealth and honor, much joy. Turbid constitution, turbid pulse: poverty and low status, much worry. Clear constitution, turbid pulse: outwardly wealthy/inwardly poor, many disappointments, few satisfactions. Turbid constitution, clear pulse: outwardly poor/inwardly wealthy, many satisfactions, few disappointments. Wealthy and long-lived: pulse is Qing and Chang (Long). Poor and short-lived: pulse is Zhuo and Cu (Hasty). Qing and Chang: wealthy but short-lived. Zhuo and Cu: poor but long-lived." These are all valuable insights, truly signs of fortune and misfortune, yet they cannot escape physiognomy.