此即上古诊法其三也。决虚实，断死生，全在总看。故融会经意为歌，且引证什之。业者并小字读之，可也。
脉会太阴决死生，寸关尺具阴阳情。
《难》曰∶寸口者，脉之大会，手太阴之动脉也。寸口，即寸关尺，五脏六腑之所始终也。他如冲阳，
专应乎胃，太冲专应乎肝，太溪专应乎肾，岂能通乎十二经哉？故法取寸口也。脉本生于阴阳，但阳生于尺而
动于寸，阴生于寸而动于尺，关则阴阳相半，界二者之中。阳脉常浮而数，病在头目胸膈；阴脉常沉而迟，病在
脐腹腰脚；中脉随时浮沉，病在腹胁胃脘。阴阳恒宜相济，不宜偏胜。若阳一于上而高过鱼际，名曰溢；阴一于
下而深入尺泽，名曰覆。寸脉下不至关为阳绝，尺脉上不至关为阴绝，乃真脏之脉而无中气往来以和之也。学人
于此而喜悟焉，则始终一寸九分之间，周身阴阳太过不及之情见矣。叔和云∶阳弦头痛定无疑，阴弦腹痛何方
走。阳数即吐兼
头痛，阴微即泻脐中吼。阳实应知面赤风，阴微盗汗劳兼有。阳实大滑应舌强，阴数脾热并口臭。阳微浮弱定
心寒，阴滑食注脾家咎。关前关后辨阴阳，察病根源应不朽。诸浮躁脉皆为阳，诸沉细脉皆为阴。凡脉从阴阳
易已，脉逆阴阳难已。
浮中沉法知迟数，逆顺虚实应五行。
初持脉见于皮肤之间者曰浮。浮而大散者心，浮而短涩者肺。见于肌肉之下者曰沉。沉而弦长者肝，沉
而濡滑者肾。不轻不重与肌肉相得者脾。多有兼乎四脏之邪，则和缓之中，亦必兼乎浮沉滑涩长短弦大，各脉
皆然。如沉滑则顺于左尺逆于左寸，如浮涩则顺于右寸逆于左半。寸口宜浮而反损小，阳虚而阴入乘之也。或
时浮滑而长，谓之阴中伏阳。尺部宜沉而反实大，阴虚而阳入乘之也。或时沉濡而短，谓之阳中伏阴。如尺本
沉而又沉，谓之重阴；寸本浮而又浮，谓之重阳；寸尺俱微甚谓之脱阳脱阴。无非五行生克偏全，四时五脏，
各部应得与否，以为逆顺虚实，浮沉迟数（歌见前）。
极烦九候并十变，无非脏腑合流形。
九候∶上部天，足少阳胆以候头角；上部人，手少阳相火三焦以候耳目；上部地，足阳明胃以候口齿。
中部天，以候肺；中部人，以候心；中部地，以候胸中之气。下部天，以候肝；下部人，以候脾胃之气；下部
地，以候肾。左尺外以候肾，内以候腹中；左关外以候肝，内以候膈中；右关外以候脾，内心候胃脘；右寸外
以候肺，内以候胸中；左关外以候心，内以候膻中。前以候前，后以候后。上竟上者，胸喉中事也；下竟下者，
小腹腰股膝胫足中事也。三部九候皆相失者死；九候虽调，肌肉已脱者死。是阴阳交错之妙，而虚实微贼正之
五邪，因以分焉。十变∶心脉急甚者，肝邪干心也；微急者，胆邪干小肠也，为从后来者为虚邪；心脉大甚
者，心邪自干心也；微大者，小肠邪自干小肠也，为正邪；心脉缓甚者，脾邪干心也；微缓者，胃邪干小肠也，
为从前来者为实邪；心脉涩甚者，肺邪干心也；微涩者，大肠邪干小肠也，从其所胜者为微邪；心脉沉甚者，
肾邪干心也；微沉者，膀胱邪干小肠也，是从所不胜者为贼邪。五脏各有刚柔邪，故令一脉辄变为十也。曰九曰
十，似繁而简，不外乎浮中沉而自然得之也。故曰数者，腑也；迟者，脏也，以是别知脏腑之病。后世分析太
甚，不知阴阳交错、脏腑同气故耳。
三部脉全容易识，
三部通度，六脉俱全，浮沉迟数相等者，脉易识而病易愈也。歌云∶三部俱浮肺脏风，恶风发热鼻流涕；
三部沉迟冷积成，皮肤枯槁真元惫；三关俱缓脾家热，口臭齿肿时反胃；三部俱弦肝好怒，目翳泪疼多 癖；
三部俱数心热狂，口舌生疮唇破碎；三部虚濡微涩伏，久病必死卒病生；三部浮滑芤弦数，卒病相宜久病倾。
又有六部同脉者，古云∶双弦之脉土易亏，双浮之脉水易亏。余以类推。凡三部脉滑而微者，病在肺；下紧上虚
者，病在脾；长而弦者，病在肝；脉小血少者，病在心，实者为心劳；大而紧者，病在肾；缓滑者，热在胃
中；迟缓而涩者，胃中有寒有 结；脉实紧者，胃中有寒，苦不能食，时时自利者难治。脉来累累如贯珠，不
前至寸者，有风寒在大肠，伏留不去；脉来累累而止，不至寸口濡者，结热在小肠，伏留不去；脉代而钩者，
病在络脉，钩即夏脉。经络皆实者，寸脉急而尺缓；络气不足，经气有余者，脉寸热而尺寒；经虚络满者，尺
热满而寸寒涩。
或至不至更难凭。
寸口壮大而尺中无者，此为阴盛于阳，苦腰背痛足胫寒，尺脉浮大而寸口无者，此为阳盛于阴，其人虚
而损多汗，或小腹满痛不能溺，溺即阴中痛，大便亦然。尺寸脉牢而长关中无者，此为阴阳相干。尺寸俱无而
关中有者，此为阴阳气归于中。左关以验风寒，或风与火之盛衰；右关以验七情，或劳与饮食之内
伤。三部或至或不至者，冷气在脾，故令脉不通也。上部有脉，下部无脉，宿食填胸也，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，譬如树有根本，故寸口平而死者，肾气先绝于内故也。
上下来去存消息，
上者，自尺部上于寸口，阳生于阴也，为表；下者，自寸口下于尺部，阴生于阳也，为里。来者，自骨肉
之分，出皮肤之际，气之升也，为表；去者，自皮肤之际，还于骨肉之分，气之降也，为里。上下来去，乃阴
阳消长之消息也。以上下言之；上盛则气高，下盛则气胀。短而急者，病在上；长而缓者，病在下。太过多
上溢，不及多下落。以来去言之∶脉来疾去徐，上实下虚，为厥癫病；来徐去疾，上虚下实，为恶风。脉虽失
而有一线往来者，可治；脉虽全而无往来者，死。上下左右之脉相应而参差者，病甚；上下左右之脉相失而不
可数者，死。
又，左脉不和，病在表，主四肢；右脉不和，病在里，主腹脏。有有表无里者，有有里无表者。
推法应须竖且横。
脉隐伏者，乃用推法。经曰∶推而外之，属腑，内而不外，有心腹积也；推而内之，属脏，外而不内，身
有热也；推而上之关前，上而不下，腰足清也；推而下之关后，下而不上，头顶病也。按之至骨，脉气少者，
腰脊痛而身有痹也。盖脉有隐显，皆阴阳变化错综，须横看竖看，乃可以尽其变也。
惟有天和脉不应，
歌曰∶天和脉只论三阴，南天高兮北泉深；太阴专主右尺寸，厥阴尺寸左边沉；少阴尺寸两不应，相交相反
死将临。天和，乃平脉也，诸阳为浮，诸阴为沉，故不言三阳司天、在泉。南政以天道言∶甲己二岁论脉，则寸
在南而尺在北。三阴司天，则两寸不应；太阴司天，右寸不应；少阴司天，两寸不应；厥阴司天，左寸不应；
三阴在泉，则两尺不应；太阴在泉，右尺不应；少阴在泉，两尺不应；厥阴在泉，左尺不应。北政以地道言∶
乙丙丁戊庚辛壬癸之岁论脉，则寸在北而尺在南。三阴司天，则两尺不应；太阴司天，右尺不应；少阴司天，
两尺不应；厥阴司天，左尺不应。三阴在泉，则两寸不应；太阴在泉，右寸不应；少阴在泉，两寸不应；厥阴
在泉，左寸不应。不应者，皆为沉脉也。《绀珠经》曰∶五行君火不用事，故南政少阴司天，君火在上，则两寸
不应；司泉，君火在下，则两尺不应。厥阴司天，君火在左，故左寸不应；司泉，则左尺不应。太阴司天，君
火在右，故右寸不应；司泉，则右尺不应。北政少阴司天，君火在上，则两尺不应；司泉，君火在下，则两寸
不应。厥阴司天，君火在左，故左尺不应；司泉，则左寸不应。太阴司天，君火在右，故右尺不应；司泉，则右
寸不应。凡不应者，谓脉沉而细，不应于手也。反之则沉为浮，细为大也。岁当君火在寸，而沉响应于尺；岁
当君火在尺，而沉响应于寸，经曰∶尺寸反者死。岁当君火在左，而沉响应于右；岁当君火在右，而沉响应于
左，经曰∶阴阳易者死。又曰∶学诊之士，必先岁气，良有以哉！此与仲景、丹溪所说不同，然所论深得《素问》
君火以退之旨，故从之。
急弹靡常是奇经。
歌曰∶督冲犹豫若狂痴，两手坚实浮沉齐，尺寸俱浮俱牢者，直上直下亦如之；任紧细长至关止，阴中
切痛引腹脐。前部左右脉弹手，阳跷癫痫痹皮肌；后部弹手阴跷脉，里急阴疝崩漏危；中部弹手带脉病，走精经
绝恐无儿。从少阴斜至太阳，阳维巅仆声如羊；从少阳斜至厥阴，阴维痒痹恶风侵。来大时小是阴络，肉痹应
时还自觉；来小时大阳络病，皮肤不仁汗滴落。按《脉经》，两手脉浮沉实盛一般者，冲督脉也。主凡事犹豫
有两心，甚则癫狂痴迷不省，尺寸俱浮直上直下，或只关浮，直上直下者，督脉也。主腰背强，大人癫，小儿
痫。尺寸俱牢，直上直下，或只关实者，冲脉也。主胸中有寒，妇人瘕疝绝产。脉来紧细实长者，任脉也。苦
小腹痛引脐，阴中切痛。前部
左右弹手者，阳跷脉也。苦癫痫恶风，偏枯僵仆羊鸣身体强痹，后部左右弹手者，阴跷脉也。苦小腹痛，里急，
引阴中痛，男子为疝，女子崩漏。中部左右弹手者，带脉也。苦小腹痛引腰，男子失精，女子绝经，令人无子。
从少阴斜至太阳者，阳维也。巅仆羊鸣，或失音不能言。从少阳斜至厥阴者，阴维也。苦癫痫，肌肉淫痒痹。
汗出恶风。阴络来大时小，苦肉痹应时自发，身洗洗也；阳络来小时大，皮肤不仁且痛，汗出而寒。凡见奇经
之病，而后有奇经之脉，病证详前经络。
一脉二变尤堪怪，
动脉，阴阳气相搏耳。阴阳和则脉不动，今气先中于邪，则气为之是动。气既受邪，则血亦不行，而病所
由生。故一脉之动，变为气血两病，岂特左为血而右为气哉？又，洪大一脉，有力而实者为热甚，无力而虚
者为虚甚。微涩一脉，无力而短者固为虚，然伏热痰气凝滞，亦可概以虚视之乎？是知脉之变化不拘如此，故有
舍证而从脉者，有舍脉而从证者。有从一分脉、二分证者；有从一分证、二分脉者；有清高贵人，两手俱无脉
者；有左小右大，左大右小者；有反关脉者；又有折一手及疮伤脉道者，可不从其证乎？善诊者，尚其悟之。
男女寅申莫浪惊。
天之阳在南而阴在北，男子面南而生于寅，则两寸在南而得其阳，寸脉洪而尺脉弱者，常也；地之阳在北而
阴在南，女子面北而生于申，则两尺在北而得其阴，寸脉弱而尺脉洪者，常也。阳强则阴弱，天之道也，反之
者病。男得女脉为不足，女得男脉为太过。左得之病在左，右得之病在右。男左女右者，地之定位也。盖人立形
于地，故从地化。楚人尚左者，夷道也。故男子左脉强而右脉弱，女子则右脉强而左脉弱。天以阴为用，故人之
左耳目明于右耳目。地以阳为用，故人之右手足强于左手足。阴阳互用也，非反也。凡男子诊脉必先伸左手，女
子诊脉必先伸右手。男子得阳气多，故左脉盛；女子得阴气多，故右脉盛，男子以左尺为精府，女子以右尺为血
海，此天地之神化也，所以别男女，决死生。叔和云，女人反此背看之，尺脉第三同断病是也。或不知此阴阳，
五脏倒装者，非。
大衍五十为至数，主位先天见圣灵。
脉以息数为主，血为脉，气为息，应曰至，息曰止。呼吸者，气之橐 ；动应者，血之波澜。人一呼脉行
三寸，一吸脉行三寸，呼吸定，脉行六寸。人一日一夜，凡一万三千五百息，脉行五十度，周于身，漏水下
百刻。荣卫行阳二十五度，行阴亦二十五度，为一周也，故五十度复会于手太阴。法以一呼一吸为一息。一
息之间，脉来四至五至，和缓舒畅者为平。六数七极，热之甚也。三迟二慢，冷危证也。两息一至与八九
十余，则不成息矣。凡至数多者为至，至数少者为损。损脉从上损肺起，而下及于肾，至脉从下损肾起，而上
及于肺。《快捷方式》曰∶从上损下死犹迟，至脉多从下损上，然此小衍之数也。大衍以五十数为极至，三部平均，
满五十数而一止，或不止者无病。若觉肾脉忽沉，就肾部数起，不满五十动而止者，一脏无气。呼出心与肺，
一动肺，一动心；吸入肾与肝，一动肝，一动肾；呼吸之间，一动脾。今吸不能至肝至肾而还，复动肺脉，则四
十动后一止者，是肾先绝，肝脏代至，期四年春草生时死。就肝部数起，三十动一止者，肝肾两脏无气，心脏
代至，期三年谷雨时死。就心部数起，二十动一止者，肾肝心三脏无气，脾脏代至，期二年桑柘赤时死。就脾
部数起，十五动一止者，肾肝心脾四脏无气，肺脉代至，期一年草枯时死。至于两动一止，或三四动一止者，
死以日断矣。是知脉之虚实死生，皆在息数之间。奈何今之诊者，或专究析诸般脉形，而不暇察夫至数。又有
虽知察夫至数，而无得手应心之妙，数之愈繁而愈失其真。噫！折一
臂、瞽一目而不夭，脉少有变，则病患随之。今人问病，每曰脉息何如？医者于此未达奈何？学人要在平时对
这就是上古诊脉法的第三种。判断虚证与实证，决断死生预后，全在于整体观察。因此我将《内经》的要义融会贯通编成歌诀，并引用了十分之一的经典作为佐证。从业者连同小字注释一起阅读即可。
脉象汇聚于太阴经以决断死生，寸、关、尺三部兼备阴阳的情状。
《难经》说：寸口，是脉气的大会合处，是手太阴肺经的动脉。寸口，即包括寸、关、尺三部，是五脏六腑气血运行的起始和终结之处。其他如冲阳穴（足阳明胃经原穴），专门对应胃；太冲穴（足厥阴肝经原穴），专门对应肝；太溪穴（足少阴肾经原穴），专门对应肾，怎么能通晓十二经脉的情况呢？所以诊脉取法于寸口。脉气本源于阴阳，但阳气生于尺部而显动于寸部，阴气生于寸部而显动于尺部，关部则是阴阳各半，处于二者之间。阳脉通常浮而数，病位在头目胸膈；阴脉通常沉而迟，病位在脐腹腰脚；中部的脉象随时间变化而浮沉，病位在腹胁胃脘。阴阳应当相互协调，不宜偏盛。如果阳气独盛于上且高过鱼际（手掌大鱼际边缘），称为“溢”；阴气独盛于下且深入尺泽（肘窝横纹中），称为“覆”。寸脉向下不到关部为“阳绝”，尺脉向上不到关部为“阴绝”，这是真脏脉，没有中气往来调和。学者若能于此领悟，那么在寸口一寸九分的范围内，周身阴阳太过或不及的情况就显现出来了。王叔和说：阳脉弦紧头痛确定无疑，阴脉弦紧腹痛去向何方。阳脉数则呕吐兼头痛，阴脉微细则腹泻脐中作响。阳实应知面赤风动，阴虚盗汗劳损兼有。阳实大滑应舌强语謇，阴数脾热并口臭。阳微浮弱定有心寒，阴滑食积脾家之过。关前关后辨别阴阳，察知病根永不朽坏。所有浮躁的脉象都属于阳，所有沉细的脉象都属于阴。凡是脉象顺应阴阳规律的容易治愈，违背阴阳规律的难以治愈。
通过浮、中、沉三候法可知迟脉与数脉，逆顺虚实应合五行。
初按脉时感觉在皮肤之间的叫浮脉。浮而大散的属心，浮而短涩的属肺。按至肌肉之下的叫沉脉。沉而弦长的属肝，沉而濡滑的属肾。不轻不重刚好与肌肉相得的属脾。脉象多兼有四脏的病邪，所以在和缓之中，也必然兼有浮沉滑涩长短弦大等特征，各种脉象都是如此。如沉滑脉，在左尺部为顺，在左寸部为逆；如浮涩脉，在右寸部为顺，在左半部为逆。寸口脉宜浮反而出现损小脉，是阳虚而阴气乘袭所致。有时浮滑而长，称为“阴中伏阳”。尺部脉宜沉反而出现实大脉，是阴虚而阳气乘袭所致。有时沉濡而短，称为“阳中伏阴”。如尺部本应沉而又沉，称为“重阴”；寸部本应浮而又浮，称为“重阳”；寸部和尺部都微弱至极称为“脱阳脱阴”。这无非是五行生克偏全、四时五脏各部脉象是否相应，以此来判断逆顺虚实。浮沉迟数（歌诀见前文）。
极度烦乱需参详九候及十变，无非是脏腑气血合流成形。
九候：上部天，足少阳胆经以候头角；上部人，手少阳三焦经以候耳目；上部地，足阳明胃经以候口齿。中部天，以候肺；中部人，以候心；中部地，以候胸中之气。下部天，以候肝；下部人，以候脾胃之气；下部地，以候肾。左尺外侧以候肾，内侧以候腹中；左关外侧以候肝，内侧以候膈中；右关外侧以候脾，内侧以候胃脘；右寸外侧以候肺，内侧以候胸中；左关外侧以候心，内侧以候膻中。前侧以候身体前部，后侧以候身体后部。脉气上达尽处，主胸喉中的病变；脉气下达尽处，主小腹腰股膝胫足中的病变。如果三部九候脉象都失常者死；九候脉象虽然调和，但肌肉已脱陷者死。这是阴阳交错的奥妙，以及虚实微贼五种正邪的区别，由此得以分辨。十变：心脉急甚者，是肝邪侵犯心；微急者，是胆邪侵犯小肠，属于从后来者为虚邪；心脉大甚者，是心邪自犯心；微大者，是小肠邪自犯小肠，为正邪；心脉缓甚者，是脾邪侵犯心；微缓者，是胃邪侵犯小肠，属于从前来者为实邪；心脉涩甚者，是肺邪侵犯心；微涩者，是大肠邪侵犯小肠，从其所胜者为微邪；心脉沉甚者，是肾邪侵犯心；微沉者，是膀胱邪侵犯小肠，是从所不胜者为贼邪。五脏各有刚柔之邪，所以使得一脉辄变为十种情况。说九说十，看似繁杂实则简单，不外乎浮中沉自然得出。所以说数脉属腑，迟脉属脏，以此区别知晓脏腑之病。后世分析过于琐碎，不知阴阳交错、脏腑同气的缘故罢了。
三部脉象全面掌握便容易识别，
三部脉通畅，六脉俱全，浮沉迟数相等者，脉象容易识别，疾病也容易痊愈。歌诀说：三部俱浮为肺脏受风，恶风发热鼻流涕；三部沉迟为冷积形成，皮肤枯槁真元疲惫；三关俱缓为脾家热，口臭齿肿时常反胃；三部俱弦为肝好怒，目翳流泪疼痛多积聚；三部俱数为心热狂躁，口舌生疮嘴唇破碎；三部虚濡微涩伏匿，久病必死新病突发；三部浮滑芤弦数，新病适宜久病危倾。
又有六部脉象相同的情况，古语说：双弦脉土易亏，双浮脉水易亏。其余以此类推。凡三部脉滑而微弱的，病在肺；下紧上虚的，病在脾；长而弦的，病在肝；脉小血少的，病在心，实者为心劳；大而紧的，病在肾；缓滑的，热在胃中；迟缓而涩的，胃中有寒有结聚；脉实紧的，胃中有寒，痛苦不能进食，时时自利的难治。脉来累累如贯珠，不到达寸口的，有大肠风寒，伏留不去；脉来累累而止，不到达寸口且濡弱的，有小肠结热，伏留不去；脉代而钩的，病在络脉，钩即夏脉。经络皆实的，寸脉急而尺缓；络气不足，经气有余的，脉寸热而尺寒；经虚络满的，尺热满而寸寒涩。
或者至脉或者不至脉更难凭据。
寸口脉壮大而尺中无脉的，此为阴盛于阳，痛苦于腰背痛足胫寒；尺脉浮大而寸口无脉的，此为阳盛于阴，其人虚弱且多汗，或小腹满痛不能排尿，排尿即阴中痛，大便亦然。尺寸脉牢而长关中无脉的，此为阴阳相干。尺寸俱无而关中有脉的，此为阴阳气归于中。左关以验风寒，或风与火的盛衰；右关以验七情，或劳倦与饮食的内伤。三部脉或至或不至的，冷气在脾，故令脉不通也。上部有脉，下部无脉，宿食填塞胸中，其人应当呕吐，不吐者死。上部无脉，下部有脉，虽困顿也无害。之所以这样，譬如树有根本，所以寸口平而死者，是肾气先在内部衰竭的缘故。
上下左右来去存消息，
上，指自尺部上行于寸口，阳气生于阴，为表；下，指自寸口下行于尺部，阴气生于阳，为里。来，指自骨肉之分出皮肤之际，气之升，为表；去，指自皮肤之际还于骨肉之分，气之降，为里。上下来去，乃阴阳消长的消息。以上下来言：上盛则气高，下盛则气胀。短而急的，病在上；长而缓的，病在下。太过者多上溢，不及者多下落。以来去言：脉来疾去徐，上实下虚，为厥癫病；来徐去疾，上虚下实，为恶风。脉虽失但有一线往来的，可治；脉虽全但无往来的，死。上下左右之脉相应而参差的，病重；上下左右之脉相失而不可数的，死。
另外，左脉不和，病在表，主四肢；右脉不和，病在里，主腹脏。有有表无里的，有有里无表的。
推法应当竖看且横看。
脉隐伏者，需用推法。经文说：推而外之，属腑，内而不外的，有心腹积块；推而内之，属脏，外而不内的，身有热；推而上至关前，上而不下行的，腰足清冷；推而下至关后，下而不上行的，头顶有病。按之至骨，脉气少的，腰脊痛且身有痹症。盖脉有隐显，皆是阴阳变化错综，必须横看竖看，才能穷尽其变化。
只有天和之脉不应，
歌诀说：天和脉只论三阴，南天高兮北泉深；太阴专主右尺寸，厥阴尺寸左边沉；少阴尺寸两不应，相交相反死将临。天和，即平脉，诸阳为浮，诸阴为沉，所以不言三阳司天、在泉。南政以天道言：甲己二岁论脉，则寸在南而尺在北。三阴司天，则两寸不应；太阴司天，右寸不应；少阴司天，两寸不应；厥阴司天，左寸不应；三阴在泉，则两尺不应；太阴在泉，右尺不应；少阴在泉，两尺不应；厥阴在泉，左尺不应。北政以地道言：乙丙丁戊庚辛壬癸之岁论脉，则寸在北而尺在南。三阴司天，则两尺不应；太阴司天，右尺不应；少阴司天，两尺不应；厥阴司天，左尺不应。三阴在泉，则两寸不应；太阴在泉，右寸不应；少阴在泉，两寸不应；厥阴在泉，左寸不应。不应者，皆为沉脉。《绀珠经》说：五行君火不用事，故南政少阴司天，君火在上，则两寸不应；司泉，君火在下，则两尺不应。厥阴司天，君火在左，故左寸不应；司泉，则左尺不应。太阴司天，君火在右，故右寸不应；司泉，则右尺不应。北政少阴司天，君火在上，则两尺不应；司泉，君火在下，则两寸不应。厥阴司天，君火在左，故左尺不应；司泉，则左寸不应。太阴司天，君火在右，故右尺不应；司泉，则右寸不应。凡不应者，谓脉沉而细，不应于手也。反之则沉为浮，细为大也。岁当君火在寸，而沉响应于尺；岁当君火在尺，而沉响应于寸，经文说：尺寸反者死。岁当君火在左，而沉响应于右；岁当君火在右，而沉响应于左，经文说：阴阳易者死。又说：学诊之士，必先岁气，良有以哉！这与仲景、丹溪所说不同，然而所论深得《素问》君火以退之旨，故从之。
急弹靡常是奇经。
歌诀说：督冲犹豫若狂痴，两手坚实浮沉齐，尺寸俱浮俱牢者，直上直下亦如之；任紧细长至关止，阴中切痛引腹脐。前部左右脉弹手，阳跷癫痫痹皮肌；后部弹手阴跷脉，里急阴疝崩漏危；中部弹手带脉病，走精经绝恐无儿。从少阴斜至太阳，阳维巅仆声如羊；从少阳斜至厥阴，阴维痒痹恶风侵。来大时小是阴络，肉痹应时还自觉；来小时大阳络病，皮肤不仁汗滴落。按《脉经》，两手脉浮沉实盛一般者，冲督脉也。主凡事犹豫有两心，甚则癫狂痴迷不省，尺寸俱浮直上直下，或只关浮，直上直下者，督脉也。主腰背强，大人癫，小儿痫。尺寸俱牢，直上直下，或只关实者，冲脉也。主胸中有寒，妇人瘕疝绝产。脉来紧细实长者，任脉也。苦小腹痛引脐，阴中切痛。前部左右弹手者，阳跷脉也。苦癫痫恶风，偏枯僵仆羊鸣身体强痹，后部左右弹手者，阴跷脉也。苦小腹痛，里急，引阴中痛，男子为疝，女子崩漏。中部左右弹手者，带脉也。苦小腹痛引腰，男子失精，女子绝经，令人无子。从少阴斜至太阳者，阳维也。巅仆羊鸣，或失音不能言。从少阳斜至厥阴者，阴维也。苦癫痫，肌肉淫痒痹。汗出恶风。阴络来大时小，苦肉痹应时自发，身洗洗也；阳络来小时大，皮肤不仁且痛，汗出而寒。凡见奇经之病，而后有奇经之脉，病证详前经络。
一脉二变尤堪怪，
动脉，是阴阳气相搏耳。阴阳和则脉不动，今气先中于邪，则气为之是动。气既受邪，则血亦不行，而病所由生。故一脉之动，变为气血两病，岂特左为血而右为气哉？另外，洪大一脉，有力而实者为热甚，无力而虚者为虚甚。微涩一脉，无力而短者固为虚，然伏热痰气凝滞，亦可概以虚视之乎？是知脉之变化不拘如此，故有舍证而从脉者，有舍脉而从证者。有从一分脉、二分证者；有从一分证、二分脉者；有清高贵人，两手俱无脉者；有左小右大，左大右小者；有反关脉者；又有折一手及疮伤脉道者，可不从其证乎？善诊者，尚其悟之。
男女寅申莫浪惊。
天之阳在南而阴在北，男子面南而生于寅，则两寸在南而得其阳，寸脉洪而尺脉弱者，常也；地之阳在北而阴在南，女子面北而生于申，则两尺在北而得其阴，寸脉弱而尺脉洪者，常也。阳强则阴弱，天之道也，反之者病。男得女脉为不足，女得男脉为太过。左得之病在左，右得之病在右。男左女右者，地之定位也。盖人立形于地，故从地化。楚人尚左者，夷道也。故男子左脉强而右脉弱，女子则右脉强而左脉弱。天以阴为用，故人之左耳目明于右耳目。地以阳为用，故人之右手足强于左手足。阴阳互用也，非反也。凡男子诊脉必先伸左手，女子诊脉必先伸右手。男子得阳气多，故左脉盛；女子得阴气多，故右脉盛，男子以左尺为精府，女子以右尺为血海，此天地之神化也，所以别男女，决死生。叔和云，女人反此背看之，尺脉第三同断病是也。或不知此阴阳，五脏倒装者，非。
大衍五十为至数，主位先天见圣灵。
脉以息数为主，血为脉，气为息，应曰至，息曰止。呼吸者，气之橐籥；动应者，血之波澜。人一呼脉行三寸，一吸脉行三寸，呼吸定，脉行六寸。人一日一夜，凡一万三千五百息，脉行五十度，周于身，漏水下百刻。荣卫行阳二十五度，行阴亦二十五度，为一周也，故五十度复会于手太阴。法以一呼一吸为一息。一息之间，脉来四至五至，和缓舒畅者为平。六数七极，热之甚也。三迟二慢，冷危证也。两息一至与八九十余，则不成息矣。凡至数多者为至，至数少者为损。损脉从上损肺起，而下及于肾，至脉从下损肾起，而上及于肺。《快捷方式》说：从上损下死犹迟，至脉多从下损上，然此小衍之数也。大衍以五十数为极至，三部平均，满五十数而一止，或不止者无病。若觉肾脉忽沉，就肾部数起，不满五十动而止者，一脏无气。呼出心与肺，一动肺，一动心；吸入肾与肝，一动肝，一动肾；呼吸之间，一动脾。今吸不能至肝至肾而还，复动肺脉，则四十动后一止者，是肾先绝，肝脏代至，期四年春草生时死。就肝部数起，三十动一止者，肝肾两脏无气，心脏代至，期三年谷雨时死。就心部数起，二十动一止者，肾肝心三脏无气，脾脏代至，期二年桑柘赤时死。就脾部数起，十五动一止者，肾肝心脾四脏无气，肺脉代至，期一年草枯时死。至于两动一止，或三四动一止者，死以日断矣。是知脉之虚实死生，皆在息数之间。奈何今之诊者，或专究析诸般脉形，而不暇察夫至数。又有虽知察夫至数，而无得手应心之妙，数之愈繁而愈失其真。噫！折一臂、瞽一目而不夭，脉少有变，则病患随之。今人问病，每曰脉息何如？医者于此未达奈何？学人要在平时对
This is the third method of pulse diagnosis from ancient times. Determining deficiency and excess, and judging life and death, all depend on an overall observation. Therefore, I have integrated the essential meanings of the classics into a song, citing one-tenth of them as evidence. Practitioners may read it together with the smaller text annotations.
The pulse gathers at the Taiyin meridian to determine life and death; the Cun, Guan, and Chi positions contain the conditions of Yin and Yang.
The *Nan Jing* (Classic of Difficult Issues) states: "Cunkou is the great assembly of pulses, the moving artery of the Hand-Taiyin Lung Meridian." Cunkou refers to the Cun, Guan, and Chi positions, which are the beginning and end of the Qi and Blood of the Zang and Fu organs. Others, such as Chongyang (Yuan-Source point of Foot-Yangming Stomach Meridian), specifically correspond to the Stomach; Taichong (Yuan-Source point of Foot-Jueyin Liver Meridian), specifically corresponds to the Liver; Taixi (Yuan-Source point of Foot-Shaoyin Kidney Meridian), specifically corresponds to the Kidney. How can they comprehensively reflect the twelve meridians? Therefore, the method selects Cunkou. Pulse originates from Yin and Yang, but Yang Qi arises from the Chi position and manifests at the Cun position, while Yin Qi arises from the Cun position and manifests at the Chi position. The Guan position represents half Yin and half Yang, situated between the two. Yang pulses are typically floating and rapid, indicating disease in the head, eyes, chest, and diaphragm; Yin pulses are typically deep and slow, indicating disease in the umbilical region, abdomen, waist, and legs; the middle pulse floats and sinks with time, indicating disease in the abdomen, hypochondrium, and epigastrium. Yin and Yang should harmonize with each other and not prevail excessively. If Yang Qi alone prevails upwards and exceeds the Yuji boundary (edge of the thenar eminence), it is called "Overflow" (Yi); if Yin Qi alone prevails downwards and penetrates deeply into the Chize area (cubital fossa), it is called "Inversion" (Fu). If the Cun pulse does not reach down to the Guan position, it is "Yang Extinction"; if the Chi pulse does not reach up to the Guan position, it is "Yin Extinction." These are True Zang pulses without the moderating presence of Middle Qi. If students can comprehend this, within the span of one inch and nine fen of the Cunkou, the conditions of excessive or insufficient Yin and Yang throughout the body will be revealed. Shuhe said: "A wiry Yang pulse definitely indicates headache; where does a wiry Yin pulse go? It indicates abdominal pain." A rapid Yang pulse indicates vomiting accompanied by headache; a minute Yin pulse indicates diarrhea with roaring in the umbilicus. Yang excess indicates facial redness and wind; Yin deficiency indicates night sweats and consumptive disease. Yang excess, large and slippery indicates stiff tongue; Yin rapid indicates Spleen heat and bad breath. Yang minute, floating, and weak indicates Heart cold; Yin slippery indicates food stagnation and Spleen fault. Distinguishing Yin and Yang before and after the Guan allows one to inspect the root of the disease imperishably. All floating and restless pulses belong to Yang; all deep and fine pulses belong to Yin. Generally, pulses conforming to Yin and Yang are easy to cure; those opposing Yin and Yang are difficult to cure.
Using the Floating, Middle, and Deep methods, one knows Slow and Rapid pulses; Reverse/Smooth and Deficient/Excess correspond to the Five Elements.
When initially palpating, feeling the pulse between the skin is called Floating. Floating and large/scattered belongs to the Heart; Floating and short/astringent belongs to the Lung. Pressing to below the muscle layer is called Deep. Deep and wiry/long belongs to the Liver; Deep and soft/slipping belongs to the Kidney. Neither light nor heavy, just touching the muscle, belongs to the Spleen. There are often combinations of pathogens from the four Zang organs, so within the harmonious and moderate quality, there must also be combined features of floating, deep, slipping, astringent, long, short, wiry, and large. Each pulse type has its characteristics. For example, a Deep-Slippery pulse is favorable at the Left Chi but unfavorable at the Left Cun; a Floating-Astringent pulse is favorable at the Right Cun but unfavorable at the left half. The Cunkou pulse should be floating; if it appears diminished and small instead, it indicates Yang deficiency with Yin invasion. Sometimes it is floating, slippery, and long, called "Yang Hidden within Yin." The Chi position pulse should be deep; if it appears solid and large instead, it indicates Yin deficiency with Yang invasion. Sometimes it is deep, soft, and short, called "Yin Hidden within Yang." If the Chi position is originally deep and becomes even deeper, it is called "Double Yin"; if the Cun position is originally floating and becomes even more floating, it is called "Double Yang"; if both Cun and Chi are extremely minute, it is called "Extinction of Yang and Yin." This is nothing but the partiality or completeness of the generation and restriction of the Five Elements, and whether the pulses of the four seasons and five Zang organs correspond to their respective positions, used to determine reverse/smooth and deficient/excess. Floating, deep, slow, and rapid (see song above).
Extreme confusion requires consulting the Nine Palpations and Ten Transformations, which are none other than the flowing forms of Zang and Fu organs.
Nine Palpations: Upper Heaven, Foot-Shaoyang Gallbladder Meridian, observes the temples; Upper Human, Hand-Shaoyang Sanjiao Meridian, observes the ears and eyes; Upper Earth, Foot-Yangming Stomach Meridian, observes the mouth and teeth. Middle Heaven, observes the Lung; Middle Human, observes the Heart; Middle Earth, observes the Qi in the chest. Lower Heaven, observes the Liver; Lower Human, observes the Qi of the Spleen and Stomach; Lower Earth, observes the Kidney. Outer Left Chi observes the Kidney; Inner Left Chi observes the abdomen. Outer Left Guan observes the Liver; Inner Left Guan observes the diaphragm. Outer Right Guan observes the Spleen; Inner Right Guan observes the epigastrium. Outer Right Cun observes the Lung; Inner Right Cun observes the chest. Outer Left Guan observes the Heart; Inner Left Guan observes the Danzhong. Anterior observes the anterior body; Posterior observes the posterior body. Reaching the upper extreme concerns the chest and throat; reaching the lower extreme concerns the lower abdomen, waist, thighs, knees, shins, and feet. If the pulses of the three positions and nine palpations are all discordant, death ensues; if the nine palpations are harmonious but the muscles are wasted, death ensues. This is the wonder of Yin-Yang interlacing, and the five correct evils of deficiency, excess, subtle, and treacherous are distinguished thereby. Ten Transformations: If the Heart pulse is extremely wiry, it is Liver pathogen invading the Heart; slightly wiry, it is Gallbladder pathogen invading the Small Intestine, known as Empty Evil from behind; if the Heart pulse is extremely large, it is Heart pathogen self-invading the Heart; slightly large, it is Small Intestine pathogen self-invading the Small Intestine, known as Correct Evil; if the Heart pulse is extremely slack, it is Spleen pathogen invading the Heart; slightly slack, it is Stomach pathogen invading the Small Intestine, known as Full Evil from ahead; if the Heart pulse is extremely choppy, it is Lung pathogen invading the Heart; slightly choppy, it is Large Intestine pathogen invading the Small Intestine, known as Subtle Evil from the conquered; if the Heart pulse is extremely deep, it is Kidney pathogen invading the Heart; slightly deep, it is Bladder pathogen invading the Small Intestine, known as Treacherous Evil from the unconquered. Each Zang organ has rigid and soft pathogens, causing one pulse to transform into ten types. Saying nine or ten seems complex but is simple, derived naturally from floating, middle, and deep. Thus, rapid pulses belong to Fu organs; slow pulses belong to Zang organs, allowing differentiation of Zang and Fu diseases. Later generations analyzed too much, forgetting the interlacing of Yin and Yang and the shared Qi of Zang and Fu.
The three-position pulse is fully understood and easily recognized.
If the three positions are unobstructed, the six pulses are complete, and floating, deep, slow, and rapid are equal, the pulse is easy to recognize and the disease easy to cure. The song says: Three positions all floating indicate Wind in the Lung organ, aversion to wind, fever, and runny nose; three positions deep and slow indicate Cold accumulation, withered skin, and exhausted Yuan Qi; three Guan positions all slack indicate Heat in the Spleen, bad breath, swollen gums, and frequent regurgitation; three positions all wiry indicate Liver anger, eye cataracts, tearing, pain, and many accumulations; three positions all rapid indicate Heart heat and mania, mouth/tongue ulcers, and broken lips; three positions deficient, soft, minute, choppy, and hidden indicate inevitable death in chronic disease or sudden onset in acute disease; three positions floating, slippery, knotted, wiry, and rapid are suitable for acute disease but disastrous for chronic disease.
There are also cases where all six positions have the same pulse. Ancient saying: Double wiry pulse indicates Earth deficiency; double floating pulse indicates Water deficiency. One can infer the rest. Generally, if the three positions are slippery but minute, the disease is in the Lung; tight below and empty above, the disease is in the Spleen; long and wiry, the disease is in the Liver; small pulse with little blood, the disease is in the Heart, and solid indicates Heart labor; large and tight, the disease is in the Kidney; slack and slippery, heat is in the Stomach; slow, slack, and choppy, there is Cold and knotting in the Stomach; solid and tight pulse, there is Cold in the Stomach, suffering inability to eat, and frequent spontaneous diarrhea is difficult to treat. Pulses coming like beads strung together, not reaching the Cun, indicate Wind-Cold in the Large Intestine, lingering and not departing; pulses coming like beads but stopping, not reaching the Cun and being soft, indicate Knotting Heat in the Small Intestine, lingering and not departing; pulsus alternans (Dai) and hooked indicates disease in the collaterals, Hooked is the Summer pulse. If both channels and collaterals are solid, the Cun pulse is urgent and the Chi pulse is slack; if collateral Qi is insufficient and channel Qi is excessive, the Cun pulse is hot and the Chi pulse is cold; if channel is deficient and collateral is full, the Chi is hot and full while the Cun is cold and choppy.
Or pulses arriving or not arriving are harder to rely upon.
If the Cun pulse is large and strong but the Chi is absent, this is Yin prevailing over Yang, suffering from backache, leg pain, and cold shins. If the Chi pulse is floating and large but the Cun is absent, this is Yang prevailing over Yin, the person is deficient, loses much sweat, or has lower abdominal fullness/pain and inability to urinate, with pain in the yin during urination, and similarly in defecation. If both Cun and Chi pulses are firm and long but the Guan is absent, this is Yin and Yang interfering with each other. If both Cun and Chi are absent but the Guan is present, this is Yin and Yang Qi returning to the center. The Left Guan tests Wind-Cold, or the rise and fall of Wind and Fire; the Right Guan tests the Seven Emotions, or internal injury from fatigue and diet. If the three positions have pulses arriving or not arriving, Cold Qi is in the Spleen, causing blocked pulses. If there is pulse above but none below, Food Retention fills the chest; the person should vomit, and if not, death ensues. If there is no pulse above but pulse below, although distressed, it causes no harm. Why? Like a tree having roots. Thus, if the Cunkou is flat and death occurs, it is because Kidney Qi first failed internally.
Observing Up/Down and Come/Go preserves the message.
Up refers to rising from the Chi to the Cun, Yang born from Yin, representing Exterior; Down refers to descending from the Cun to the Chi, Yin born from Yang, representing Interior. Come refers to emerging from the bone/muscle division to the skin surface, Qi ascending, representing Exterior; Go refers to returning from the skin surface to the bone/muscle division, Qi descending, representing Interior. Up/Down and Come/Go are the messages of Yin-Yang waxing and waning. Speaking of Up/Down: Excess above leads to high Qi (shortness of breath); excess below leads to distension. Short and urgent indicates disease above; long and slack indicates disease below. Excess tends to overflow upward; insufficiency tends to fall downward. Speaking of Come/Go: Rapid come and slow go indicates Excess above and Deficiency below, leading to Jue or Epilepsy; slow come and rapid go indicates Deficiency above and Excess below, leading to aversion to wind. If the pulse is lost but has a thread-like continuity, it is treatable; if the pulse is complete but lacks continuity, death ensues. If pulses up/down/left/right correspond but are irregular, the disease is severe; if they are discordant and cannot be counted, death ensues.
Furthermore, Disharmony of the Left pulse indicates disease in the Exterior, governing the limbs; Disharmony of the Right pulse indicates disease in the Interior, governing the abdominal organs. There are cases with Exterior but no Interior, and cases with Interior but no Exterior.
Pushing method requires vertical and horizontal examination.
For hidden pulses, the pushing method is used. The Classics say: Push outward, it belongs to Fu organs; if inward but not outward, there are abdominal masses. Push inward, it belongs to Zang organs; if outward but not inward, the body has heat. Push up to before the Guan, if going up but not down, the waist and feet are cold. Push down to after the Guan, if going down but not up, there is disease in the head. Pressing to the bone with little pulse Qi indicates backache and Bi syndrome. Since pulses have hidden and manifest aspects, all due to intricate changes of Yin and Yang, one must view them horizontally and vertically to exhaust their variations.
Only the Tianhe pulse does not respond.
The song says: Tianhe pulse only discusses the Three Yin; Southern Heaven is high, Northern Spring is deep; Taiyin specifically governs the Right Cun/Chi; Jueyin is sunken at the Left Cun/Chi; Shaoyin at both Cun/Chi does not respond; intersection and opposition signal impending death. Tianhe refers to the Normal Pulse. All Yang pulses are floating; all Yin pulses are deep, hence the Three Yang Si Tian/Zai Quan are not mentioned. Nan Zheng (Southern Administration) speaks of Heavenly Dao: In years of Jia and Ji, Cun is South and Chi is North. When Three Yin Si Tian, both Cun do not respond; Taiyin Si Tian, Right Cun does not respond; Shaoyin Si Tian, both Cun do not respond; Jueyin Si Tian, Left Cun does not respond. When Three Yin Zai Quan, both Chi do not respond; Taiyin Zai Quan, Right Chi does not respond; Shaoyin Zai Quan, both Chi do not respond; Jueyin Zai Quan, Left Chi does not respond. Bei Zheng (Northern Administration) speaks of Earthly Dao: In years of Yi, Bing, Ding, Wu, Geng, Xin, Ren, Gui, Cun is North and Chi is South. When Three Yin Si Tian, both Chi do not respond; Taiyin Si Tian, Right Chi does not respond; Shaoyin Si Tian, both Chi do not respond; Jueyin Si Tian, Left Chi does not respond. When Three Yin Zai Quan, both Cun do not respond; Taiyin Zai Quan, Right Cun does not respond; Shaoyin Zai Quan, both Cun do not respond; Jueyin Zai Quan, Left Cun does not respond. "Not responding" means the pulse is deep and fine, not felt by the hand. The *Ganzhu Jing* says: The Minister Fire of the Five Elements does not take command. Thus, in Nan Zheng, when Shaoyin Si Tian, Minister Fire is above, so both Cun do not respond; when Zai Quan, Minister Fire is below, so both Chi do not respond. When Jueyin Si Tian, Minister Fire is on the left, so Left Cun does not respond; when Zai Quan, Left Chi does not respond. When Taiyin Si Tian, Minister Fire is on the right, so Right Cun does not respond; when Zai Quan, Right Chi does not respond. In Bei Zheng, when Shaoyin Si Tian, Minister Fire is above, so both Chi do not respond; when Zai Quan, Minister Fire is below, so both Cun do not respond. When Jueyin Si Tian, Minister Fire is on the left, so Left Chi does not respond; when Zai Quan, Left Cun does not respond. When Taiyin Si Tian, Minister Fire is on the right, so Right Chi does not respond; when Zai Quan, Right Cun does not respond. All "not responding" pulses are deep and fine, failing to resonate to the touch. Conversely, deep becomes floating, and fine becomes large. If the year dictates Minister Fire at the Cun, but the deep response resonates at the Chi; if the year dictates Minister Fire at the Chi, but the deep response resonates at the Cun, the Classics say: "Reverse Cun and Chi leads to death." If the year dictates Minister Fire on the left, but the deep response resonates on the right; if the year dictates Minister Fire on the right, but the deep response resonates on the left, the Classics say: "Exchange of Yin and Yang leads to death." It is also said: "Those who learn diagnosis must first know the annual Qi, for good reason!" This differs from Zhang Zhongjing and Danxi, but the discussion deeply captures the intent of the *Su Wen* regarding Minister Fire retreating, so we follow it.
Sudden plucking and irregularity characterize the Extraordinary Vessels.
The song says: Du and Chong vessels show hesitation, madness, or foolishness; both hands are solid, floating, and deep equally; if both Cun and Chi are floating and firm, they go straight up and straight down similarly; Ren vessel is tight, thin, and long, stopping at the Guan, with cutting pain in the yin radiating to the abdomen and umbilicus. Pulsating at the anterior left and right indicates Yang Qiao vessel, epilepsy, Bi, skin/muscle issues; pulsating at the posterior indicates Yin Qiao vessel, interior urgency, Yin hernia, and metrorrhagia are critical; pulsating at the middle indicates Dai vessel, spermatorrhea, amenorrhea, fear of infertility. Slanting from Shaoyin to Taiyang indicates Yang Wei, falling from height, baa-ing like a sheep; slanting from Shaoyang to Jueyin indicates Yin Wei, itching, Bi, aversion to wind. Coming large then small indicates Yin Collateral, flesh Bi spontaneously occurring; coming small then large indicates Yang Collateral, skin insensitivity and dripping sweat. According to the *Mai Jing*, if both hands' pulses are equally floating, deep, solid, and vigorous, it is the Chong and Du vessels. It indicates hesitation and dual-mindedness, or severe madness/confusion. If both Cun and Chi are floating, going straight up and down, or only Guan is floating, going straight up and down, it is the Du vessel. It indicates stiff back/waist, adult epilepsy, pediatric seizures. If both Cun and Chi are firm, going straight up and down, or only Guan is solid, it is the Chong vessel. It indicates Cold in the chest, uterine masses, sterility in women. Tight, thin, solid, and long pulse indicates the Ren vessel. Suffering lower abdominal pain radiating to the umbilicus, cutting pain in the yin. Pulsating at the anterior left and right indicates Yang Qiao vessel. Suffering epilepsy, aversion to wind, hemiplegia, falling stiffly, baa-ing, body stiffness/Bi. Pulsating at the posterior left and right indicates Yin Qiao vessel. Suffering lower abdominal pain, interior urgency, radiating pain in the yin; men have hernias, women have metrorrhagia. Pulsating at the middle left and right indicates Dai vessel. Suffering lower abdominal pain radiating to the waist; men have spermatorrhea, women have amenorrhea, causing infertility. Slanting from Shaoyin to Taiyang is Yang Wei. Falling from height, baa-ing, or loss of voice. Slanting from Shaoyang to Jueyin is Yin Wei. Suffering epilepsy, muscle itching/Bi, sweating, aversion to wind. Yin Collateral coming large then small suffers flesh Bi spontaneously arising, body shivering; Yang Collateral coming small then large has skin insensitivity and pain, sweating and cold. Whenever extraordinary vessel diseases appear, followed by extraordinary vessel pulses, see the preceding meridian chapters for detailed symptoms.
One pulse transforming twice is particularly strange.
The Dong (Pulsating) pulse is the struggle of Yin and Yang Qi. When Yin and Yang are harmonious, the pulse does not move. Now, if Qi is first invaded by pathogens, Qi becomes active. Once Qi is affected, Blood also fails to flow, giving rise to disease. Thus, the movement of one pulse transforms into both Qi and Blood diseases, not just Left for Blood and Right for Qi. Furthermore, the Hong (Surging) pulse: forceful and solid indicates severe Heat; weak and empty indicates severe Deficiency. The Wei Se (Minute and Choppy) pulse: weak and short is indeed Deficiency, but can latent Heat, Phlegm, and Qi stagnation be generally viewed as Deficiency? Thus, we know pulse changes are not restricted thus. Hence, some discard symptoms to follow the pulse, some discard the pulse to follow symptoms. Some follow one part pulse and two parts symptoms; some follow one part symptom and two parts pulse. There are noble people with no pulse in both hands; there are Left small/Right large or Left large/Right small; there are Fan Guan (Reversed Gate) pulses; there are those with broken arms or damaged pulse channels. Can one not follow the symptoms? Those skilled in diagnosis should realize this.
Do not be surprised by Men/Yin and Women/Shen.
Heaven's Yang is South and Yin is North. Men face South and are born in Yin, so both Cun are South and obtain Yang; Cun pulse surging and Chi pulse weak is normal. Earth's Yang is North and Yin is South. Women face North and are born in Shen, so both Chi are North and obtain Yin; Cun pulse weak and Chi pulse surging is normal. Yang strong means Yin weak, this is the Way of Heaven; reversing this causes disease. Man obtaining Woman's pulse indicates insufficiency; Woman obtaining Man's pulse indicates excess. Obtaining on the left indicates disease on the left; obtaining on the right indicates disease on the right. Man Left/Woman Right is the fixed position of Earth. Since humans stand on Earth, they transform according to Earth. Chu people value Left, which is the way of barbarians. Thus, Men have strong Left pulse and weak Right pulse; Women have strong Right pulse and weak Left pulse. Heaven uses Yin, so human left ears/eyes are sharper than right. Earth uses Yang, so human right hands/feet are stronger than left. Yin and Yang use each other, this is not reversal. Generally, when diagnosing men, extend the Left hand first; when diagnosing women, extend the Right hand first. Men obtain more Yang Qi, so Left pulse is vigorous; Women obtain more Yin Qi, so Right pulse is vigorous. Men regard Left Chi as the House of Essence; Women regard Right Chi as the Sea of Blood. This is the divine transformation of Heaven and Earth, distinguishing men and women, judging life and death. Shuhe said: "Women reverse this, look backwards; the third Chi pulse diagnoses disease similarly." Or those who do not know this Yin-Yang, with inverted Zang organs, are incorrect.
Da Yan Fifty is the Ultimate Number, Master Position reveals Spirit from Pre-Heaven.
Pulse is primarily determined by breath count. Blood is the pulse, Qi is the breath. Response is called "Zhi", Breath is called "Zhi". Breathing is the bellows of Qi; movement/response is the waves of Blood. In one exhalation, pulse moves 3 cun; in one inhalation, pulse moves 3 cun. At the pause of breathing, pulse moves 6 cun. In one day and night, there are 13,500 breaths. Pulse moves 50 cycles around the body, water clock drops 100 marks. Ying and Wei travel Yang 25 cycles, travel Yin 25 cycles, making one cycle. Thus, after 50 cycles, they meet again at the Hand-Taiyin. The method counts one exhalation and one inhalation as one breath. Between one breath, if the pulse comes 4-5 times, harmonious and smooth, it is Normal. 6 rapid, 7 extreme, indicates severe Heat. 3 slow, 2 sluggish, indicates Cold critical condition. One beat per two breaths, or 80-90+ beats per breath, does not constitute a proper breath. Generally, many beats is "Zhi" (Arrival), few beats is "Sun" (Damage). Sun pulse starts from top damaging Lung and goes down to Kidney; Zhi pulse starts from bottom damaging Kidney and goes up to Lung. *Kuaijie Fangshi* says: Damage from top down dies later; Zhi pulse mostly from bottom damage up, but this is the number of Xiao Yan. Da Yan takes 50 as the ultimate. If three positions are average, reaching 50 beats before one stop, or no stop, there is no disease. If one feels the Kidney pulse suddenly sink, counting from the Kidney position, stopping before 50 beats, one Zang has no Qi. Exhaling reaches Heart and Lung, one beat Lung, one beat Heart; Inhaling reaches Kidney and Liver, one beat Liver, one beat Kidney; Between breaths, one beat Spleen. Now, if inhalation cannot reach Liver and Kidney and returns, activating Lung pulse again, then stopping after 40 beats, Kidney failed first, Liver compensates, expected death in spring when grass grows. Counting from Liver position, stopping after 30 beats, Liver and Kidney have no Qi, Heart compensates, expected death at Grain Rain three years later. Counting from Heart position, stopping after 20 beats, Kidney, Liver, Heart have no Qi, Spleen compensates, expected death in two years when mulberry leaves turn red. Counting from Spleen position, stopping after 15 beats, Kidney, Liver, Heart, Spleen have no Qi, Lung compensates, expected death in one year when grass withers. As for stopping after two beats, or three/four beats, death is judged by days. Thus, we know pulse deficiency/excess and life/death are all within the breath count. Why do current diagnosticians only study various pulse shapes and neglect the count? And those who know to check the count but lack the skill of hand-heart correspondence, counting more intricately loses the truth. Alas! Breaking an arm or blinding one eye does not cause premature death, but slight pulse variation follows the patient. When people ask about illness, they always ask "How is the pulse?" Doctors fail to understand this. Students must practice regularly...