病，藏于中者也。证，形于外者也。工于问者，非徒问其证，殆欲即其证见，以求其病
因耳！法当先问其人之平昔有无宿疾？有无恚怒忧思？饮食喜淡喜浓、喜燥喜润？嗜茶嗜酒？大
便为燥为溏？妇人问其有无胎产？月事先期后期？有无胀痛？再问其病初起何因？前见何证？后变
何证？恶寒恶热孰重孰轻？有汗无汗？汗多汗少？汗起何处？汗止何处？口淡口苦？渴与不渴？思饮
不思饮？饮多饮少？喜热喜凉？（喜热饮不皆属寒，尝有郁遏不通者，亦喜热饮，以热则流通故
也）。思食不思食？能食不能食？食多食少？化速化迟？胸心胁腹有无胀痛？二便通涩？大便为燥为
溏？小便为清为浊？色黄色淡？（二便最为紧要，乃病之外见者也）。种种详诘，就其见证，审其
病因，方得轩岐治病求本之旨。岂徒见痰治痰，见血治血而已哉！
经曰∶营行脉中。又曰∶脉者，血之府也。又曰∶十二经皆有动脉。（按∶十二经动脉，
上部动脉在头，中部动脉在手，下部动脉在足，是为三部。一部三候，是为九候。上部天，
两额之动脉，足少阳之颔厌也；上部地，两颊之动脉，足阳明之地仓、大迎也；上部人，耳
前之动脉，手少阳之和 也。中部天，手太阴之太渊、经渠也；中部地，手阳明之合谷
也；中部人，手少阴之神门也。下部天，足厥阴之五里也；下部地，足少阴之太溪也；下部
人，足太阴之箕门也。下部之天以候肝，地以候肾，人以候脾胃之气；中部天以候肺，地以
候胸中之气，人以候心；上部天以候头角之气，地以候口齿之气，人以候耳目之气。下部天
，女子则取太冲；下部人，胃气则候于阳明之冲阳，仲景谓之趺阳。《难经》三部者，寸、
关、尺也。九候者，浮、中、沉也。又是一法。）《内经》诊法三部九候，就十二经之动脉
诊之，以决死生，以处百病，以调虚实，而除邪疾，部位分明，毫厘不爽。迨扁鹊兴，着《
八十一难经》，将十二经脉均诊于两手，以图简便，其法亦自《内经》得来。经曰∶尺内两
傍，则季胁也（季胁包藏脏腑）。尺外以候肾，尺内以候腹中；（内外者，一部中之内外也。浮
为外，沉为内，非两条脉也，辨见《金鉴》。柯韵伯云∶凡脏腑近背者，皆候于外，近腹中
者，皆候于内。《金鉴》谓五脏皆当候于内，六腑皆当候于外。《内经》内外字，是传写之
误）。中附上（关部），左外以候肝，内以候膈，（按∶心、肺居膈上，肝、脾、肾居膈下。五脏
俱注于膈，肝、脾、肾、胆之脉，俱贯膈而上；心、心包络、肾、三焦、肠、胃之脉，俱从
膈而下。是膈为十一经必由之道）。右外以候胃，内以候脾。上附上，（寸部）。右外以候肺
内以候胸中，左外以候心，内以候膻中。前以候前，后以候后。（关前以候前，关后以候后）。
上竟上者，胸、喉中事也；下竟下者，少腹、腰、股、膝、胫、足中事也。
或曰∶十二经脉，手六经脉走手，足六经脉走足不走手，今皆诊于手者何也？曰∶崇其
原也。十二经脉根心而生，而上通于肺，以回于下。心主血，肺主气。气为血帅，故肺主藏
气而朝百脉。十二经之气，皆受之于肺。平旦寅初，肺气流布，起于寸口（寸口又曰脉口、
曰气口，乃寸、关、尺三部之总名，非但指寸之一部已也），营运十二经中，周而复始，一
日一夜，五十度毕。（按∶人经脉，上下左右前后，二十有八，周身十六丈二尺。人一呼脉行
三寸，一吸脉行三寸，一呼一吸，合为一息，一息脉行六寸，二百七十息，气行十六丈二尺
，一周于身。人一日一夜，凡一万三千五百息，气行五十度周于身，漏水下百刻，凡行八百
一十丈，即十六丈二尺而积之也）。次日平旦寅初，复会于寸口。寸口者，脉之大会，故十
二经之盛衰，悉见于此。经曰∶经脉者，常不可见也（经脉近筋骨走，故肉浓处按之不觉跳
动，肉消处按之方见）。其虚实也，以气口知之，此气口所以独为五脏主也。人生不过气血
两端，万病亦不过病气血两端。心为主血之脏，肺为藏气以运血之脏，心肺二经之脉，皆走
气口，探其源不可知其流乎！
曰∶脉有尺寸何说？曰∶人身上下两焦，中有膈膜一层，以分阴阳之界。《难经》分寸
为尺，分尺为寸，（关上分去一寸，余者为尺。关下分去一尺，余者为寸）。阴得尺中一寸，阳
得寸内九分。盖象乎此。（关以下至尺泽，皆谓之尺，而诊脉则止候关下一寸。关以下至鱼际
，皆谓之寸，而诊脉则止候关上九分。曰九分者，其下一分为关耳！关仅一分，象膈膜故也）
。曰∶关以前者，阳之动也（诊心肺）脉尝见九分而浮，过者法曰太过，减者法曰不及，若
上
者
，阴气不能营，谓之格；阴气太盛，阳气不能营，谓之关；（按∶《三难》及《三十七难》
关
得尽其命而死矣。（此数句出《难经》。）
或又曰∶既以尺寸分阴阳，又云脉有轻重者，何谓也？曰∶此亦诊阴阳之法也。曰∶初
持脉如三菽之重，与皮毛相得者，肺部也；如六菽之重，与血脉相得者，心部也；如九菽之
重，与肌肉相得者，脾部也；如十二菽之重，与筋平者，肝部也；按之至骨，举指来实者，
肾部也。夫人呼出心与肺，吸入肾与肝，呼吸之间，脾受谷味，故浮者阳也，沉者阴也，脾
在中州，故其脉在中。《灵枢·九针篇》曰∶肺主皮，心主脉，脾主肌，肝主筋，肾主骨。
扁鹊从此悟出，分轻重五等，诊候五脏本象之脉，以别太过不及之为病，实足辅翼经文，而
为诊候之大法。
曰∶诊法如此，《内经》又以寸、关、尺分发脏腑者，何谓也？曰∶人正南面而立，心
属南离，故候于寸；人之有心，犹天之有日，日出于东，故心候于左寸。肺主天气，故亦候
于寸；肺属西方金，故候于右寸。肝、胆属震巽木，故候于左关；脾、胃属中央土，故候于
右关。肾与膀胱属坎水，故候于两尺；三焦生右肾傍，故候于右尺。二肠为至浊至下之腑，
当候之于尺∶小肠与心相表里，候于左尺；大肠与肺相表里，候于右尺（按∶扁鹊《十难》
据脏腑表里之说，将大、小肠候于两寸。西晋王叔和遵之。元、明诸家，力辨其非，谓二肠
为至浊至下之腑，断不能候于至上之寸部。近代黄坤载又谓二肠腑虽至浊，经行头上则至清
。徐灵胎亦以为然。喻嘉言、罗东逸仍从元明诸公驳正之说。御纂《金鉴》配二肠于尺部。
按∶《内经》尺内以候腹中一句，当谨遵《金鉴》。又按∶叔和谓左尺候肾水与膀胱，右尺
候命门相火，盖误以三焦为命门也。考命门之说，《内经》不载。《内经》所谓之命门，指
眼目而言，后人以肾为人身之根蒂，故谓两肾中央为命门，其实命门即两肾之称，诊肾即是
诊命门。叔和右尺诊命门之说，其误可知。膀胱与肾相表里，肾候之两尺，膀胱亦当候之两
尺，惟三焦在右肾傍，当候之右尺）。再以三焦言之。肺为华盖，居于至高，故候于寸；右
肺大于左（左肺二叶，右肺三叶），故经谓肺藏于右，肺气由右而降，故候于右寸。心象日，
故候于寸。心居肺下而位乎中，肺稍偏于右，是心稍居肺左矣。心血从心左下窍而生，故曰
候于左寸。肝、胆、脾、胃同居膈膜之下，故候于关。肝生于左，故候于左关；脾虽居胃之
左，而与胃相连，胃之下口由右而降，故候于右关。肾居腰脊，故候于两尺。大小肠、膀胱
、三焦同位于下焦，故亦候于尺。《内经》三部分发脏腑，盖象乎此。虽然，古人亦据常理
言之耳！人身气血，一气贯通，区区一寸之地，不必拘分，亦不能尽验。
他如男女左右及奇脉斜行之说，更难尽凭。东垣左手人迎主外感（人迎，穴名，在结喉
两旁，与肺脉同诊），右手气口主内积之说（六脉均谓气口），尤属不经。学人不可不知，亦
不可尽拘，但能得其提纲，则权衡在握矣。
曰∶诊法何如？曰∶诊法之精，无过《内经》。经以浮、沉、缓、急、大、小、滑、涩
八脉，辨表、里、寒、热、虚、实、顺、逆。曰诸浮者，病在阳；诸沉者，病在阴；诸急者
，多寒；缓者，多热；（寒主收引，故脉紧急；热主蒸散，故脉缓数）。大者，多气少血；小
者
甚（如微浮、甚浮、微沉、甚沉之类）。悬绝（如太过至三倍、四倍，不及止一至、二至、绝
无之类）之三等，以察病之进退、顺逆、死生，何其精且约乎！及仲景以阴阳着脉为十，以浮
、数、动、滑、大为阳；沉、涩、弱、弦、微为阴。诊阴阳之法，又莫过于此。迨叔和兴，
繁脉象为二十四，且撰出七表、八里、九道之名（九道更不可解），愈多愈乱，皆由于未审夫
脉之有大原也。夫脉之大原，缘于胃气。经曰∶五脏皆禀气于胃，脏气不能自至于手太阴，
必因胃气，乃至于手太阴。若邪气胜，精气衰，胃气不能与之俱至于手太阴，故真脏之气独
见。独见者病胜脏也，病胜脏曰死。又曰∶四时百病，胃气为本，人无胃气曰逆，逆者死。
若是者，胃气顾不重哉？然推胃气之原，又生于谷气。经曰∶食气入胃，浊气（即谷气）归心
，淫精于脉，脉气流经（十二经），经气归于肺，肺朝百脉，输精于皮毛，毛脉（即肺脉）合精
，行气于腑（六腑），府精神明（六腑精气神明），留于四脏。气归于权衡，权衡以平（肺主治
节，分布气化，以得其平），气口成寸，以决死生。又曰∶得谷者昌，绝谷者亡。审是，谷
气不又为胃气之本乎？
曰∶胃气脉何如？曰∶胃气脉和柔轻缓，匀净分明，三部九候，皆要如此，中候尤重，
非仅诊于右关一部已也。经曰∶春胃微弦曰平。胃而微弦者，轻虚而滑，端直以长，如循嫩
竹竿梢之象。弦多胃少曰肝病。弦多胃少者，滑硬弹指，如循长竿者然。其气来实而长，此
谓太过，病在外；其气来不实而微，此谓不及，病在中。太过则令人善怒，忽忽眩冒巅疾；
不及则令人胸痛引背，两胁 满。但弦无胃曰死。但弦无胃者，中外急劲，如按弓弦，
如循刀刃，此真肝脉见也，色青白不泽，毛折乃死。夏胃微钩曰平。胃而微钩者，圆满滑利
，来盛去衰，如连珠，如循琅 （美玉）。钩多胃少曰心病。钩多胃少者，喘喘连属，其中微
曲，有急促相仍之象。其气来盛去亦盛，此谓太过，病在外；其气来不盛，去反盛，此谓不
及，病在中。太过则令人身热肤痛为浸淫（蒸热）。不及则令人烦心，上见咳唾，下见气泄。
但钩无胃曰死。但钩无胃者，前曲后居。前曲者，轻取则坚，强而不柔。后居者，重取则牢
，实而不动（坚而且滞），如操革带之钩，全失冲和之气，此真心脉见也，色赤黑不泽，毛折
乃死。长夏胃微软弱曰平。胃而微软弱者，和柔轻缓，匀净分明，如鸡践地，从容不迫。弱
多胃少曰脾病。弱多胃少者，轻疾不缓，如鸡举足者然。太过则令人四肢不举（湿胜）；不及
则令人九窍不通，（经曰∶脾脏者土也，孤脏以灌四傍者也。今不能灌溉，故不通），名曰重
强
中止，如屋之漏，点滴不匀，又或如水之流，去而不返，此真脾脉见也，色黄青不泽，毛折
乃死。秋胃微毛曰平。胃而微毛者，厌厌聂聂，如众苗齐秀者然，轻浮和缓，如落榆荚者然
。毛多胃少曰肺病，毛多胃少者，不上不下，往来涩滞，或如循鸡羽，轻浮而虚。其气来毛
而中央坚，两旁虚，此谓太过，病在外；其气来毛而微，此谓不及，病在中。太过则令人气
逆而背痛；不及则令人喘，呼吸少气，而咳，上气见血，下（指气下）闻病因（呻吟）。但毛
无
不泽，毛折乃死。冬胃微石曰平。胃而微石者，喘喘累累，沉而圆实流利，乃阴中藏阳之象
。石多胃少曰肾病。石多胃少者，坚搏牵连如引葛然，其气来如弹石，此谓太过，病在外；
其去如数者（如数者，动止急促，有似紧数，愈虚则愈数，乃真阴亏损之象，原非阳强实热
之数），此谓不及，病在中。太过则令人解 （寒不寒、热不热、弱不弱、壮不壮），脊
脉痛而少气，不欲言；不及则令人心悬如病饥， 中清（侠脊两傍空软处名 。清
，冷也），脊中痛，少腹满，小便变。但石无胃曰死。但石无胃者，散乱而劲，如夺索，如
弹石，此真肾脉见也，色黑黄不泽，毛折乃死。凡此皆面兼二色者，五行相克之道也；皆曰
不泽者，阴液销亡，色由无光而无体也；皆曰毛折乃死者，肺之化源绝也，草木之枯萎也，
先本实而后枝叶，其即毛折不泽之义也。夫观《内经》诊法，四时百病，一以胃气为本，即
以五脏本脉之微甚，诊病之太过不及，以微甚之相去悬绝，知胃气已亡，决之曰死。理何其
精，法何其约乎！
且夫诊法有以约为贵者，亦有以博为贵者，盖以一脉能兼数病，一病能兼数脉，真伪固
当辨认，常变尤贵圆通。试取景岳十六脉而详辨之。浮在皮毛，主阳，主表，主风，固也，
疾病，是潜藏于体内的病理状态。证候，是显露于体外的症状表现。善于问诊的医生，不仅仅询问表面的证候，更是希望通过这些证候的表现，来探求疾病的根本原因！诊法应当先询问患者平时是否有旧疾？是否有愤怒、忧愁、思虑等情绪波动？饮食口味偏好清淡还是浓重？偏好干燥还是湿润的食物？是否嗜好喝茶或饮酒？大便性状是干结还是稀溏？女性患者需询问是否有怀孕或生产史？月经周期是提前还是推后？是否有胀痛感？接着再询问此次发病的起因是什么？最初出现了什么证候？后来发生了怎样的变化？恶寒与发热哪个更严重？有汗还是无汗？汗量多还是少？汗从哪里发出？汗在哪里停止？口淡还是口苦？口渴还是不渴？想喝水还是不想喝水？喝水量多还是少？喜欢热饮还是冷饮？（喜欢热饮并不一定都属寒证，曾有因气机郁遏不通的患者，也喜欢热饮，因为热能使气机流通的缘故）。想吃东西还是不想吃东西？能吃还是不能吃？食量多还是少？消化速度快还是慢？胸、心、胁、腹是否有胀痛？二便通畅还是涩滞？大便是干结还是稀溏？小便颜色是清亮还是浑浊？色泽是黄还是淡？（二便最为紧要，这是疾病在体外的表现）。通过这样种种详细的追问，结合患者的证候表现，审察病因，才能领会黄帝、岐伯“治病求本”的宗旨。难道仅仅是见到痰就治痰，见到血就治血而已吗！
经文说：营气运行在脉管之中。又说：脉，是血液汇聚的府库。又说：十二经脉都有动脉。（按：十二经的动脉，上部的动脉在头部，中部的动脉在手部，下部的动脉在足部，这称为三部。每一部又有浮、中、沉三种候法，合起来称为九候。上部天，指两额头的动脉，属于足少阳胆经的颔厌穴；上部地，指两颊的动脉，属于足阳明胃经的地仓穴和大迎穴；上部人，指耳前的动脉，属于手少阳三焦经的和髎穴。中部天，属于手太阴肺经的太渊穴和经渠穴；中部地，属于手阳明大肠经的合谷穴；中部人，属于手少阴心经的神门穴。下部天，属于足厥阴肝经的五里穴；下部地，属于足少阴肾经的太溪穴；下部人，属于足太阴脾经的箕门穴。下部天用来候察肝脏之气，地用来候察肾脏之气，人用来候察脾胃之气；中部天用来候察肺脏之气，地用来候察胸中之气，人用来候察心脏之气；上部天用来候察头角之气，地用来候察口齿之气，人用来候察耳目之气。对于女性，下部天取足厥阴肝经的太冲穴；下部人，胃气则候察于足阳明胃经的冲阳穴，张仲景称之为趺阳穴。《难经》所说的三部，是指寸、关、尺三部。九候，是指浮、中、沉三种指力。这是另一种方法。）《内经》的诊法采用三部九候，诊察十二经的动脉，以此决断生死，诊治各种疾病，调节虚实，祛除邪气，部位分明，毫厘不差。等到扁鹊兴起，撰写《八十一难经》，将十二经脉的诊察都集中在双手上，以求简便，这种方法也是源自《内经》。经文说：尺部内侧两旁，对应季胁（季胁包裹着脏腑）。尺部外侧用来候察肾脏，尺部内侧用来候察腹中。（内外，是指一部脉中的内外侧。浮取为外，沉取为内，并不是两条脉，辨析见《医宗金鉴》。柯韵伯说：凡是靠近背部的脏腑，都候察于外侧，靠近腹中的脏腑，都候察于内侧。《医宗金鉴》认为五脏都应当候察于内，六腑都应当候察于外。《内经》中的“内外”二字，可能是传抄之误）。中部附上（即关部），左手外侧用来候察肝脏，内侧用来候察膈膜。（按：心、肺位于膈膜之上，肝、脾、肾位于膈膜之下。五脏的气都注于膈膜，肝、脾、肾、胆的经脉，都贯穿膈膜向上；心、心包络、肾、三焦、肠、胃的经脉，都从膈膜向下。所以膈膜是十一条经脉必经的道路）。右手外侧用来候察胃，内侧用来候察脾。上部附上（即寸部），右手外侧用来候察肺，内侧用来候察胸中；左手外侧用来候察心，内侧用来候察膻中。前部候察身体前侧，后部候察身体后侧。（关前候察前，关后候察后）。寸部脉象延伸到尽头以上，对应胸、喉中的病变；尺部脉象延伸到尽头以下，对应少腹、腰、大腿、膝、小腿、足部的病变。
有人问：十二经脉，手六条经脉走向手部，足六条经脉走向足部而不走向手部，现在为什么都在手上诊脉呢？回答说：这是尊崇其本源。十二经脉根源于心而生发，向上通达于肺，然后回返向下。心主血，肺主气。气是血的统帅，所以肺主藏气而朝会百脉。十二经的气，都受之于肺。清晨寅时初刻，肺气开始流布，起于寸口（寸口又称脉口、气口，是寸、关、尺三部的总称，不仅仅指寸这一部），在十二经中运行，周而复始，一天一夜，循环五十周完毕。（按：人的经脉，上下左右前后，共有二十八条，周身长十六丈二尺。人每呼气一次，脉行三寸，每吸气一次，脉行三寸，一呼一吸合为一息，一息脉行六寸，二百七十息，气行十六丈二尺，一周于身。人一天一夜，共一万三千五百息，气行五十周于身，漏壶滴水一百刻，共行八百一十丈，即十六丈二尺累积而成）。第二天清晨寅时初刻，气血再次会聚于寸口。寸口，是脉的大会合处，所以十二经的盛衰，全都显现于此。经文说：经脉，通常是看不见的（经脉贴近筋骨行走，所以在肌肉丰厚处按压感觉不到跳动，在肌肉消瘦处按压才能看到跳动）。经脉的虚实，通过气口可以知晓，这就是气口之所以单独作为五脏主宰的原因。人生不过只有气和血两端，万病也不过是病在气和血两端。心是主血的脏器，肺是藏气以运血的脏器，心肺二经的脉，都走于气口，探究了源头，难道不能知道支流的情况吗！
又问：脉有寸和尺，这是什么说法？回答说：人身上下两焦，中间有一层膈膜，以此区分阴阳界限。《难经》把关以上分为尺，关以下分为寸，（关上分去一寸，剩下的部分称为尺。关下分去一尺，剩下的部分称为寸）。阴气得到尺中的一寸，阳气得到寸内的九分。大概是象征这种格局。（关以下至尺泽穴，都称为尺，但诊脉时只候察关下一寸。关以下至鱼际，都称为寸，但诊脉时只候察关上九分。说九分，是因为下面一分是关！关仅占一分，象征膈膜）。又问：关以前的脉，是阳气的变动（诊察心肺）脉象常现于九分且浮取明显，超过这个限度叫作太过，不足这个限度叫作不及，如果脉气上越，阴气不能营运，称为格；阴气太盛，阳气不能营运，称为关；（按：《难经·三难》及《第三十七难》说：关脉得尽命而死。（这几句出自《难经》。）
又有人问：既然用寸尺来分阴阳，又说脉有轻重之分，这是什么意思？回答说：这也是诊察阴阳的方法。问：初持脉时，力度如同三颗豆子的重量，与皮毛相得的，是肺部的脉；如同六颗豆子的重量，与血脉相得的，是心部的脉；如同九颗豆子的重量，与肌肉相得的，是脾部的脉；如同十二颗豆子的重量，与筋平齐的，是肝部的脉；按至骨部，抬起手指感觉坚实的，是肾部的脉。人呼气时心与肺的气外出，吸气时肾与肝的气内入，呼吸之间，脾接受水谷精微，所以浮取的脉属阳，沉取的脉属阴，脾位于中州，所以它的脉象在中部。《灵枢·九针篇》说：肺主皮，心主脉，脾主肌，肝主筋，肾主骨。扁鹊从此领悟，分出轻重的五等，诊察五脏本象的脉，以辨别太过和不及导致的疾病，确实足以辅助经文，成为诊察的大法。
问：诊法如此，《内经》又将寸、关、尺分别分配给脏腑，这是什么意思？回答说：人正面向南站立，心属南方离卦，所以候察于寸部；人有心脏，就像天有太阳，太阳从东方升起，所以心候察于左寸。肺主天气，所以也候察于寸部；肺属西方金，所以候察于右寸。肝、胆属震巽木，所以候察于左关；脾、胃属中央土，所以候察于右关。肾与膀胱属坎水，所以候察于两尺；三焦生于右肾旁边，所以候察于右尺。大小肠是至浊至下的腑，应当候察于尺部：小肠与心相表里，候察于左尺；大肠与肺相表里，候察于右尺（按：扁鹊《第十难》依据脏腑表里的说法，将大肠、小肠候察于两寸。西晋王叔和遵循此说。元、明各家的学者，极力辩驳其错误，认为大小肠是至浊至下的腑，绝对不能候察于至上的寸部。近代黄坤载又说大小肠腑虽然至浊，但经络上行到头面则至清。徐灵胎也认为如此。喻嘉言、罗东逸仍遵从元明诸公驳正的说法。御纂《医宗金鉴》将大小肠配属于尺部。按：《内经》中“尺内以候腹中”一句，应当谨遵《医宗金鉴》。又按：王叔和说左尺候肾水与膀胱，右尺候命门相火，大概是错误地将三焦当作命门。考证命门的说法，《内经》没有记载。《内经》所说的命门，指的是眼目。后人认为肾是人身的根本，所以谓两肾中央为命门，其实命门就是两肾的称呼，诊肾即是诊命门。王叔和右尺诊命门的说法，其错误可想而知。膀胱与肾相表里，肾候察于两尺，膀胱也应当候察于两尺，只有三焦在右肾旁边，应当候察于右尺）。再从三焦来说。肺为华盖，居于最高处，所以候察于寸部；右肺大于左肺（左肺两叶，右肺三叶），所以经文说肺藏于右侧，肺气由右而降，所以候察于右寸。心像太阳，所以候察于寸部。心位于肺下而处于中间，肺稍偏于右，所以心稍居肺之左。心血从心左下窍而生发，所以说候察于左寸。肝、胆、脾、胃同居于膈膜之下，所以候察于关部。肝生于左侧，所以候察于左关；脾虽然位于胃的左侧，但与胃相连，胃的下口由右侧下降，所以候察于右关。肾位于腰脊，所以候察于两尺。大小肠、膀胱、三焦同位于下焦，所以也候察于尺部。《内经》三部分发脏腑，大概是象征这种情况。虽然如此，古人也是依据常理而言的！人身气血，一气贯通，区区一寸之地，不必拘泥于分割，也不能完全验证。
其他如男女左右及奇经斜行的说法，更难完全凭借。李东垣认为左手人迎主外感（人迎，穴位名，在结喉两旁，与肺脉同时诊察），右手气口主内积的说法（六脉都称为气口），尤其属于不经之谈。学习者不可不知道，也不可完全拘泥，只要能掌握其提纲，就能把握权衡了。
问：诊法如何？回答说：诊法的精妙，没有超过《内经》的。经文以浮、沉、缓、急、大、小、滑、涩八种脉象，辨别表、里、寒、热、虚、实、顺、逆。说：凡是浮脉，病在阳；凡是沉脉，病在阴；凡是急脉，多寒；缓脉，多热；（寒主收引，所以脉紧急；热主蒸散，所以脉缓数）。大脉，多气少血；小脉，甚（如微浮、甚浮、微沉、甚沉之类）。悬绝（如太过至三倍、四倍，不及仅一至、二至、绝无之类）这三种等级，用来察看病情的进退、顺逆、死生，何其精妙且简约啊！等到张仲景以阴阳确立脉象为十种，以浮、数、动、滑、大为阳；沉、涩、弱、弦、微为阴。诊察阴阳的方法，没有超过这个的了。等到王叔和兴起，繁杂的脉象达到二十四种，并且撰出七表、八里、九道的名称（九道更难以理解），越多越乱，都是因为没有审察脉的大原。脉的大原，源于胃气。经文说：五脏都禀受胃气，脏气不能自己到达手太阴肺经，必须依靠胃气，才能到达手太阴。如果邪气胜，精气衰，胃气不能与之俱至于手太阴，所以真脏之气单独显现。单独显现的是病胜脏，病胜脏曰死。又说：四时百病，胃气为本，人无胃气曰逆，逆者死。像这样，胃气难道不重要吗？然而推究胃气的来源，又生于谷气。经文说：食物进入胃，浊气（即谷气）归于心，淫溢精华于脉，脉气流经（十二经），经气归于肺，肺朝会百脉，输精于皮毛，毛脉（即肺脉）合精，行气于腑（六腑），腑精神明（六腑精气神明），留于四脏。气归于权衡，权衡以平（肺主治节，分布气化，以得其平），气口成寸，以决死生。又说：得谷者昌，绝谷者亡。审视这一点，谷气不又是胃气的根本吗？
问：胃气脉是什么样子的？回答说：胃气脉和柔轻缓，匀净分明，三部九候，都要如此，中候尤其重要，不仅仅是在右关一部诊察而已。经文说：春季脉象带有微弱的弦意称为平脉。胃而微弦者，轻虚而滑，端直以长，像抚摸嫩竹竿梢的意象。弦多胃少称为肝病。弦多胃少者，滑硬弹指，像抚摸长竿一样。其气来实而长，这叫作太过，病在外；其气来不实而微，这叫作不及，病在内。太过则使人容易发怒，恍惚眩晕冒昧头顶疾病；不及则使人胸痛牵引背部，两胁胀满。只有弦象而没有胃气称为死脉。只有弦象没有胃气者，中外急劲，像按弓弦，像抚摸刀刃，这是真肝脉出现，面色青白无光泽，毛发枯折乃死。夏季脉象带有微弱的钩意称为平脉。胃而微钩者，圆满滑利，来势盛而去势衰，像连珠，像抚摸美玉。钩多胃少称为心病。钩多胃少者，喘喘连属，其中微曲，有急促相仍的意象。其气来盛去也盛，这叫作太过，病在外；其气来不盛，去反而盛，这叫作不及，病在内。太过则使人身体发热皮肤疼痛为浸淫（蒸热）。不及则使人烦心，上见咳唾，下见气泄。只有钩象而没有胃气称为死脉。只有钩象没有胃气者，前曲后居。前曲者，轻取则坚硬，强而不柔。后居者，重取则牢固，实而不动（坚而且滞），像握住革带的钩，完全失去冲和之气，这是真心脉出现，面色赤黑无光泽，毛发枯折乃死。长夏脉象带有微弱软弱的意态称为平脉。胃而微软弱者，和柔轻缓，匀净分明，像鸡踩地，从容不迫。弱多胃少称为脾病。弱多胃少者，轻疾不缓，像鸡举足一样。太过则使人四肢不能举动（湿胜）；不及则使人九窍不通，（经文说：脾脏者是土也，孤脏以灌四傍者也。现在不能灌溉，所以不通），名为重强。中止，像屋顶漏水，点滴不均匀，又像水流，去而不返，这是真脾脉出现，面色黄青无光泽，毛发枯折乃死。秋季脉象带有微弱的毛意称为平脉。胃而微毛者，厌厌聂聂，像众苗一齐秀发一样，轻浮和缓，像榆荚落下一样。毛多胃少称为肺病，毛多胃少者，不上不下，往来涩滞，或者像抚摸鸡羽，轻浮而虚。其气来毛而中央坚实，两旁虚弱，这叫作太过，病在外；其气来毛而微，这叫作不及，病在内。太过则使人气逆而背痛；不及则使人气喘，呼吸少气，而咳嗽，上气见血，下（指气下）闻病因（呻吟）。只有毛象而没有胃气称为死脉。只有毛象没有胃气者，面色不泽，毛发枯折乃死。冬季脉象带有微弱的石意称为平脉。胃而微石者，喘喘累累，沉而圆实流利，是阴中藏阳的意象。石多胃少称为肾病。石多胃少者，坚搏牵连像牵引葛藤一样，其气来像弹石，这叫作太过，病在外；其去像数脉者（如数者，动止急促，有似紧数，愈虚则愈数，是真阴亏损的意象，原本不是阳强实热的数脉），这叫作不及，病在内。太过则使人懈惰（寒不寒、热不热、弱不弱、壮不壮），脊脉痛而少气，不想说话；不及则使人心中悬空像生病饥饿， 中清（侠脊两旁空软处名 。清，冷也），脊中痛，少腹满，小便变。只有石象而没有胃气称为死脉。只有石象没有胃气者，散乱而劲，像夺索，像弹石，这是真肾脉出现，面色黑黄无光泽，毛发枯折乃死。凡此皆兼见两种颜色，这是五行相克的道理；都说无光泽，是阴液销亡，色由无光而无体；都说毛发枯折乃死，是肺的化源绝也，草木枯萎，先本实而后枝叶，这就是毛折不泽的含义。观察《内经》诊法，四时百病，一以胃气为本，即以五脏本脉的微甚，诊察病情的太过不及，以微甚相差悬殊，知道胃气已亡，决断曰死。道理何其精妙，方法何其简约啊！
况且诊法有以简约为贵的，也有以广博为贵的，因为一脉能兼数病，一病能兼数脉，真伪固然应当辨认，常变尤其贵在圆通。试取景岳十六脉而详细辨别的。浮脉在皮毛，主阳，主表，主风，固然是这样，
Disease (Bing) is the pathological state hidden within the body. Syndrome (Zheng) is the manifestation of symptoms appearing on the exterior. A skilled physician in inquiry does not merely ask about the surface syndromes, but aims to investigate the root cause of the disease based on these manifestations! The method should first inquire whether the patient has a history of chronic diseases? Whether there have been emotional fluctuations such as anger, sorrow, or overthinking? Dietary preferences for light or heavy flavors? Preference for dry or moist foods? Habits of tea or alcohol consumption? Stool consistency: dry or loose? For female patients, inquire about pregnancy or childbirth history? Menstrual cycle: early or late? Presence of distending pain? Then ask what was the initial cause of this illness? What were the initial symptoms? How did the symptoms change later? Which is more severe, aversion to cold (Ehan) or fever (Re)? Sweating present or absent? Large or small amount of sweat? Where does the sweat originate? Where does it stop? Tasteless or bitter taste in mouth? Thirsty or not? Desire to drink or not? Large or small volume of drinking? Preference for hot or cold drinks? (Preference for hot drinks does not necessarily indicate Cold syndrome; there are cases where Qi stagnation and obstruction occur, and patients also prefer hot drinks because heat promotes circulation). Desire to eat or not? Ability to eat or not? Large or small appetite? Fast or slow digestion? Distending pain in chest, heart, hypochondrium, or abdomen? Urination and defecation: unobstructed or obstructed? Stool: dry or loose? Urine: clear or turbid? Color: yellow or pale? (Urination and defecation are most critical, as they are external manifestations of the disease). Through such detailed questioning, combining the observed syndromes, and examining the etiology, one can grasp the essence of Huangdi and Qibo's principle of "seeking the root in treating disease." Is it merely treating phlegm when phlegm is seen, and treating blood when blood is seen!
The Classic says: Ying (Nutrient) Qi circulates within the vessels. It also says: Vessels are the residence of Blood. It also says: All twelve meridians have arterial pulses. (Note: The arterial pulses of the twelve meridians, those in the upper part are in the head, those in the middle part are in the hands, and those in the lower part are in the feet, which are called the Three Regions. Each region has three positions (Fu, Zhong, Chen), totaling Nine Positions. Upper Region Heaven refers to the arterial pulse at both temples, belonging to the Han Yan point of Foot Shaoyang Gallbladder Meridian; Upper Region Earth refers to the arterial pulse at both cheeks, belonging to the Di Cang and Da Ying points of Foot Yangming Stomach Meridian; Upper Region Human refers to the arterial pulse in front of the ears, belonging to the He Liao point of Hand Shaoyang Sanjiao Meridian. Middle Region Heaven belongs to the Tai Yuan and Jing Qu points of Hand Taiyin Lung Meridian; Middle Region Earth belongs to the He Gu point of Hand Yangming Large Intestine Meridian; Middle Region Human belongs to the Shen Men point of Hand Shaoyin Heart Meridian. Lower Region Heaven belongs to the Wu Li point of Foot Jueyin Liver Meridian; Lower Region Earth belongs to the Tai Xi point of Foot Shaoyin Kidney Meridian; Lower Region Human belongs to the Ji Men point of Foot Taiyin Spleen Meridian. Lower Region Heaven is used to observe Liver Qi, Earth to observe Kidney Qi, and Human to observe Spleen and Stomach Qi; Middle Region Heaven observes Lung Qi, Earth observes Chest Qi, and Human observes Heart Qi; Upper Region Heaven observes Head and Horn Qi, Earth observes Mouth and Teeth Qi, and Human observes Eyes and Ears Qi. For women, the Lower Region Heaven takes the Tai Chong point of Foot Jueyin Liver Meridian; for Lower Region Human, Stomach Qi is observed at the Chong Yang point of Foot Yangming Stomach Meridian, which Zhang Zhongjing calls Fu Yang. The "Three Regions" mentioned in the Nan Jing refer to Cun, Guan, and Chi. The "Nine Positions" refer to Floating, Middle, and Deep pressure. This is another method.) The diagnostic method of Nei Jing uses the Three Regions and Nine Positions, diagnosing the arterial pulses of the twelve meridians, to determine life and death, treat various diseases, regulate deficiency and excess, and eliminate pathogenic factors, with distinct locations and precise accuracy. When Bian Que arose, he wrote the Eighty-One Difficult Issues (Nan Jing), consolidating the diagnosis of the twelve meridians into both hands for simplicity, a method derived from Nei Jing. The Classic says: The inner sides of the Chi position correspond to the Hypochondrium (Hypochondrium encloses the Zang-Fu organs). The outer side of Chi observes the Kidneys, and the inner side observes the Abdominal cavity. (Inner and outer refer to the inner and outer sides of one pulse position. Floating is outer, Deep is inner, not two separate pulses; see Jin Jian for distinction. Ke Yunbo said: Organs closer to the back are observed on the outer side, and those closer to the abdominal cavity are observed on the inner side. Jin Jian states that all Zang organs should be observed internally and all Fu organs externally. The terms "inner" and "outer" in Nei Jing may be transcription errors.) The Middle section attached above (i.e., Guan position), the left outer side observes the Liver, and the inner side observes the Diaphragm. (Note: Heart and Lung are above the diaphragm, while Liver, Spleen, and Kidney are below. Qi of all five Zang organs flows through the diaphragm; meridians of Liver, Spleen, Kidney, and Gallbladder pass through the diaphragm upwards; meridians of Heart, Pericardium, Kidney, Sanjiao, Intestines, and Stomach pass downwards through the diaphragm. Thus, the diaphragm is the必经 path for eleven meridians.) The right outer side observes the Stomach, and the inner side observes the Spleen. The Upper section attached above (i.e., Cun position), the right outer side observes the Lung, and the inner side observes the Chest center; the left outer side observes the Heart, and the inner side observes the Dan Zhong. The anterior part observes the anterior body, and the posterior part observes the posterior body. (Anterior to Guan observes anterior, Posterior to Guan observes posterior). Pulses extending beyond the end upwards correspond to matters of the Chest and Throat; pulses extending beyond the end downwards correspond to matters of the Lower Abdomen, Waist, Thighs, Knees, Shins, and Feet.
One might ask: The twelve meridians, six hand meridians go to the hands, and six foot meridians go to the feet and not the hands. Why are they all diagnosed at the hands now? The answer is: To honor the source. The twelve meridians originate from the Heart and connect upwards to the Lung, then return downwards. The Heart governs Blood, and the Lung governs Qi. Qi is the commander of Blood, so the Lung stores Qi and oversees all vessels. The Qi of the twelve meridians is received from the Lung. At dawn during the Yin hour, Lung Qi begins to circulate, starting from Cun Kou (Cun Kou is also known as Mai Kou or Qi Kou, the general term for the three regions of Cun, Guan, and Chi, not just the Cun region alone), circulating through the twelve meridians, completing fifty cycles in one day and night. (Note: Human meridians, up, down, left, right, front, and back, total twenty-eight, spanning sixteen zhang and two chi around the body. With each exhalation, the pulse moves three cun; with each inhalation, it moves three cun. One breath constitutes one Xi, moving the pulse six cun. In two hundred and seventy Xis, Qi travels sixteen zhang and two chi, completing one circuit around the body. In one day and night, there are thirteen thousand five hundred Xis, allowing Qi to travel fifty circuits around the body, corresponding to one hundred marks on the clepsydra, totaling eight hundred and ten zhang, which accumulates to sixteen zhang and two chi.) At dawn on the next day during the Yin hour, Qi and Blood converge again at Cun Kou. Cun Kou is the great assembly of pulses, so the prosperity and decline of all twelve meridians are manifested here. The Classic says: Meridians are usually invisible (Meridians run close to bones and tendons, so pressing in thick muscle areas does not reveal pulsation, while pressing in thin muscle areas reveals it). The deficiency and excess of meridians are known through Qi Kou, which is why Qi Kou alone serves as the master of the five Zang organs. Human life consists only of Qi and Blood, and all diseases involve only Qi and Blood. The Heart is the organ governing Blood, and the Lung is the organ storing Qi to move Blood. The meridians of the Heart and Lung both travel to Qi Kou; having explored the source, how could one not know the flow?
Another question: What is the explanation for pulses having Cun and Chi? The answer is: In the human body, the upper and lower Jiao are separated by a layer of Diaphragm membrane, marking the boundary of Yin and Yang. The Nan Jing divides the area above Guan as Chi and below Guan as Cun, (One cun is divided off above Guan, and the remainder is called Chi. One chi is divided off below Guan, and the remainder is called Cun). Yin obtains one cun in Chi, and Yang obtains nine fen inside Cun. This symbolizes this structure. (From Guan down to Chi Ze, it is all called Chi, but pulse diagnosis only observes one cun below Guan. From Guan down to Yu Ji, it is all called Cun, but pulse diagnosis only observes nine fen above Guan. Saying nine fen, because the lower one fen is Guan! Guan occupies only one fen, symbolizing the diaphragm membrane). Another question: Before Guan, the movement is Yang (diagnosing Heart and Lung). The pulse often appears at nine fen and floats. Exceeding this limit is called Excess (Tai Guo), and falling short is called Deficiency (Bu Ji). If the pulse rises excessively, Yin Qi cannot nourish, called Ge (Gridlock); if Yin Qi is too excessive, Yang Qi cannot nourish, called Guan (Obstruction); (Note: Nan Jing Chapter 3 and Chapter 37 state: If Guan pulse reaches its limit, death ensues. (These sentences are from Nan Jing.)
Another question: Since Cun and Chi divide Yin and Yang, and it is said that pulses have varying degrees of pressure, what does this mean? The answer is: This is also a method of diagnosing Yin and Yang. Question: Initially holding the pulse with the weight of three beans, touching the skin and hair, this is the Lung pulse; with the weight of six beans, touching the blood vessels, this is the Heart pulse; with the weight of nine beans, touching the muscles, this is the Spleen pulse; with the weight of twelve beans, level with the tendons, this is the Liver pulse; pressing to the bone, and feeling firm upon lifting the finger, this is the Kidney pulse. When humans exhale, Heart and Lung Qi exit; when inhaling, Kidney and Liver Qi enter. Between breathing, the Spleen receives grain essence. Therefore, floating pulses are Yang, and deep pulses are Yin. The Spleen resides in the Central Province, so its pulse is in the middle. Ling Shu · Nine Needles Chapter says: Lung governs skin, Heart governs vessels, Spleen governs muscles, Liver governs tendons, Kidney governs bones. Bian Que realized this and divided the pressure into five levels, diagnosing the native pulses of the five Zang organs to distinguish between Excess and Deficiency diseases, truly assisting the Classics and becoming a major diagnostic method.
Question: With diagnostics like this, why does Nei Jing distribute Zang-Fu organs to Cun, Guan, and Chi? The answer is: When a person stands facing south, the Heart belongs to the South Li Trigram, so it is observed at Cun; having a Heart is like having the Sun in the sky, the Sun rises in the East, so the Heart is observed at Left Cun. The Lung governs Heavenly Qi, so it is also observed at Cun; the Lung belongs to Western Metal, so it is observed at Right Cun. Liver and Gallbladder belong to Zhen and Xun Wood, so they are observed at Left Guan; Spleen and Stomach belong to Central Earth, so they are observed at Right Guan. Kidney and Bladder belong to Kan Water, so they are observed at both Chis; Sanjiao is born beside the right Kidney, so it is observed at Right Chi. Large and Small Intestines are the most turbid and lowest Fu organs, so they should be observed at Chi: Small Intestine is interior-exterior related to Heart, observed at Left Chi; Large Intestine is interior-exterior related to Lung, observed at Right Chi. (Note: Bian Que's Tenth Difficulty, based on interior-exterior relationships of Zang-Fu, placed Large and Small Intestines at both Cuns. Wang Shuhe of Western Jin followed this. Scholars of Yuan and Ming dynasties strongly refuted this, arguing that Large and Small Intestines are the most turbid and lowest Fu organs and absolutely cannot be observed at the highest Cun region. Modern Huang Kunzai argued that although these Fu organs are turbid, their meridians ascend to the head and become pure. Xu Lingtai agreed. Yu Jiayan and Luo Dongyi still followed the refutations of Yuan and Ming scholars. The Imperial Compilation Jin Jian paired Large and Small Intestines with the Chi region. Note: The sentence "Chi inner observes abdominal cavity" in Nei Jing should strictly follow Jin Jian. Also note: Wang Shuhe stated Left Chi observes Kidney Water and Bladder, Right Chi observes Mingmen Fire, likely mistakenly equating Sanjiao with Mingmen. Research shows Mingmen theory is not recorded in Nei Jing. The Mingmen mentioned in Nei Jing refers to the eyes. Later generations considered the Kidney the root of the body, so they called the center of the two kidneys Mingmen. Actually, Mingmen is synonymous with the two kidneys; diagnosing Kidney is diagnosing Mingmen. Wang Shuhe's theory of Right Chi diagnosing Mingmen is clearly erroneous. Bladder is interior-exterior related to Kidney; since Kidney is observed at both Chis, Bladder should also be observed at both Chis. Only Sanjiao is beside the right Kidney and should be observed at Right Chi). Speaking further of Sanjiao: Lung is the Canopy, residing at the highest point, so it is observed at Cun; the right lung is larger than the left (left lung has two lobes, right lung has three), so the Classic says Lung resides on the right, and Lung Qi descends from the right, hence observed at Right Cun. Heart resembles the Sun, so it is observed at Cun. Heart is located below the Lung and in the middle; since Lung is slightly to the right, Heart is slightly to the left of Lung. Heart Blood originates from the lower orifice on the left of the Heart, hence observed at Left Cun. Liver, Gallbladder, Spleen, and Stomach reside together below the diaphragm, so they are observed at Guan. Liver grows on the left, so it is observed at Left Guan; although Spleen is to the left of Stomach, it is connected to Stomach, and the lower opening of Stomach descends from the right, so it is observed at Right Guan. Kidney resides in the lumbar spine, so it is observed at both Chis. Large and Small Intestines, Bladder, and Sanjiao are all located in the Lower Jiao, so they are also observed at Chi. The distribution of Zang-Fu organs in the three regions of Nei Jing symbolizes this. Nevertheless, the ancients spoke according to general principles! Human Qi and Blood are connected as one, covering just an inch of space; one need not rigidly divide it, nor can it be fully verified.
Other theories regarding left/right differences for men/women and oblique paths of extraordinary vessels are even less reliable. Li Dongyuan believed Left Hand Ren Ying indicates external contraction (Ren Ying is an acupoint name, located on both sides of the larynx, diagnosed simultaneously with Lung pulse), and Right Hand Qi Kou indicates internal accumulation (all six pulses are called Qi Kou), which is particularly unfounded. Learners must know this but not adhere to it completely; grasping the outline allows one to hold the balance.
Question: How is the diagnostic method? Answer: The precision of diagnostic methods surpasses none compared to Nei Jing. The Classic uses Floating, Deep, Slow, Urgent, Large, Small, Slippery, and Choppy pulses to differentiate Exterior, Interior, Cold, Heat, Deficiency, Excess, Smooth, and Adverse conditions. It says: All floating pulses indicate disease in Yang; all deep pulses indicate disease in Yin; all urgent pulses indicate much Cold; slow pulses indicate much Heat. (Cold causes contraction and pulling, hence urgent pulses; Heat causes steaming and dispersion, hence slow and rapid pulses). Large pulses indicate much Qi and little Blood; Small pulses indicate extreme [conditions] (such as slight floating, severe floating, slight deep, severe deep, etc.). Suspended and Absolute (such as Excess reaching three or four times, Deficiency limited to one or two beats, or absent) are three levels to observe disease progression, smoothness/adversity, and life/death. How precise and concise! Later, Zhang Zhongjing established ten pulses based on Yin and Yang: Floating, Rapid, Agitated, Slippery, and Large are Yang; Deep, Choppy, Weak, Wiry, and Micro are Yin. No method of diagnosing Yin and Yang surpasses this. When Wang Shuhe arose, pulse images became complicated with twenty-four types, and names like Seven Tables, Eight Mansions, and Nine Paths were created (Nine Paths are incomprehensible), leading to more confusion due to failing to examine the Great Origin of pulses. The Great Origin of pulses stems from Stomach Qi. The Classic says: All five Zang organs receive Qi from the Stomach. Zang Qi cannot reach Hand Taiyin on its own; it must rely on Stomach Qi to reach Hand Taiyin. If pathogens prevail and essence declines, Stomach Qi cannot accompany it to Hand Taiyin, so True Zang Qi appears alone. Appearing alone means disease conquers the Zang; disease conquering the Zang leads to death. It also says: For all diseases in the four seasons, Stomach Qi is the root. Humans without Stomach Qi are termed Rebellious, and Rebellious leads to death. Are Stomach Qi not important? However, tracing the origin of Stomach Qi, it is generated from Grain Qi. The Classic says: Food entering the Stomach, Turbid Qi (i.e., Grain Qi) returns to the Heart, overflowing essence into vessels, vessel Qi flows through meridians (twelve meridians), meridian Qi returns to the Lung, Lung oversees all vessels, transmitting essence to skin and hair, Hair Pulse (i.e., Lung pulse) combines essence, moving Qi to Fu organs (six Fu organs), Fu organ essence becomes bright and spiritual, remaining in the four Zang organs. Qi returns to the balance scale, balanced by equilibrium (Lung governs regulation, distributing Qi transformation to achieve balance), Qi Kou forms Cun, determining life and death. It also says: Those who obtain Grain prosper; those who lose Grain perish. Examining this, is Grain Qi not the root of Stomach Qi?
Question: What is the Stomach Qi pulse like? Answer: The Stomach Qi pulse is soft, gentle, light, and slow, uniform and clear. All three regions and nine positions must be like this, with the Middle position being especially important, not just diagnosing at the Right Guan. The Classic says: Spring Stomach slightly Wiry is Ping (Normal). Stomach with slight Wiry means light, void, slippery, straight and long, resembling touching the tip of a tender bamboo shoot. More Wiry and less Stomach Qi indicates Liver disease. More Wiry and less Stomach Qi feels slippery and hard against the finger, like touching a long pole. Qi coming solid and long is called Excess, disease in Exterior; Qi coming insubstantial and micro is called Deficiency, disease in Interior. Excess causes irritability, dizziness, and head disorders; Deficiency causes chest pain radiating to the back and fullness in both hypochondria. Only Wiry without Stomach Qi indicates death. Only Wiry without Stomach Qi feels tense and hard inside and out, like pressing a bowstring or touching a blade, indicating True Liver Pulse. Complexion is cyan-white without luster, hair breaks and dies. Summer Stomach slightly Hooked is Ping. Stomach with slight Hooked means round, slippery, and smooth, arriving vigorously and departing weakly, like linked pearls or touching jade. More Hooked and less Stomach Qi indicates Heart disease. More Hooked and less Stomach Qi feels continuous and hurried, slightly curved in the middle, with a sense of urgency. Qi arriving vigorously and departing vigorously is Excess, disease in Exterior; Qi arriving weakly but departing vigorously is Deficiency, disease in Interior. Excess causes body heat and skin pain (steaming heat); Deficiency causes vexation, coughing and spitting above, and Qi leakage below. Only Hooked without Stomach Qi indicates death. Only Hooked without Stomach Qi bends forward and stays backward. Forward bending means firm upon light touch, strong but not soft. Backward staying means secure upon heavy touch, solid and immobile (firm and stagnant), like handling a hook on a leather belt, completely losing harmonious Qi, indicating True Heart Pulse. Complexion is red-black without luster, hair breaks and dies. Late Summer Stomach slightly Soft and Weak is Ping. Stomach with slight Soft and Weak means soft, gentle, light, slow, uniform and clear, like a chicken stepping on ground, unhurried. More Weak and less Stomach Qi indicates Spleen disease. More Weak and less Stomach Qi feels light and fast, not slow, like a chicken lifting its foot. Excess causes inability to lift limbs (dampness prevailing); Deficiency causes obstruction of the nine orifices. (Classic says: Spleen is Earth, the solitary organ irrigating the four directions. Now unable to irrigate, hence obstruction), named Heavy Strength. Interrupted, like a leaking roof, uneven drops, or like flowing water, going and not returning, indicating True Spleen Pulse. Complexion is yellow-cyan without luster, hair breaks and dies. Autumn Stomach slightly Hairy is Ping. Stomach with slight Hairy means subtle and fluttering, like seedlings sprouting together, light, floating, gentle, and slow, like falling elm seeds. More Hairy and less Stomach Qi indicates Lung disease. More Hairy and less Stomach Qi feels neither up nor down, sluggish in movement, or like touching chicken feathers, light, floating, and empty. Qi coming Hairy with a solid center and empty sides is Excess, disease in Exterior; Qi coming Hairy and micro is Deficiency, disease in Interior. Excess causes Qi rebellion and back pain; Deficiency causes panting, shortness of breath, coughing, hemoptysis above, and groaning below. Only Hairy without Stomach Qi indicates death. Only Hairy without Stomach Qi lacks luster, hair breaks and dies. Winter Stomach slightly Stony is Ping. Stomach with slight Stony feels continuous and piled up, deep, round, solid, and slippery, representing Yang hidden in Yin. More Stony and less Stomach Qi indicates Kidney disease. More Stony and less Stomach Qi feels hard and gripping like pulling vines. Qi coming like throwing stones is Excess, disease in Exterior; Qi departing like Rapid pulses (Rapid here means quick stops and starts, similar to Tight and Rapid, becoming more rapid as deficiency increases, representing True Yin depletion, originally not Yang excess heat Rapid) is Deficiency, disease in Interior. Excess causes lethargy (not cold, not hot, not weak, not strong), spinal pain, shortness of breath, and reluctance to speak; Deficiency causes a hanging sensation in the heart like hunger, coldness in the paravertebral hollows, spinal pain, lower abdominal fullness, and changes in urination. Only Stony without Stomach Qi indicates death. Only Stony without Stomach Qi feels scattered and stiff, like pulling ropes or throwing stones, indicating True Kidney Pulse. Complexion is black-yellow without luster, hair breaks and dies. All these involve mixed colors, following the way of Five Elements overcoming each other; all lacking luster indicates destruction of Yin fluids, color losing light and substance; all stating hair breaks and dies indicates the extinction of Lung's transformation source, like withered grass and trees, where roots die before branches, embodying the meaning of broken hair and lack of luster. Observing Nei Jing diagnostics, all diseases in four seasons take Stomach Qi as the root. By observing the slightness or severity of native Zang pulses, diagnosing Excess or Deficiency of disease, and noting the vast difference in slightness/severity, knowing Stomach Qi is exhausted, one determines death. How profound the principle, how concise the method!
Moreover, some diagnostic methods value conciseness, while others value comprehensiveness, because one pulse can correspond to multiple diseases, and one disease can manifest multiple pulses. Distinguishing true from false is essential, and flexibility in understanding normal and abnormal variations is highly valued. Let us examine Jing Yue's Sixteen Pulses in detail. Floating pulse is at the skin and hair, governing Yang, Exterior, and Wind, which is indeed correct,