先天图静坐调息，观气往来。临时又有屏气不息之敬，则是以吾心之太极，而验彼身之太极，不离乎气血，不
杂乎气血，乃先天之灵也，岂泥象数者之可语哉！断病之法，四时四季，以其当旺者为主。五脏六腑，候其盛
衰之极者为病，本位太过不足之极者亦死。《素问》云∶人之居处动静而脉亦能为之改。则凡不幸而脉稍有变
者，可不调养之以尽其天年乎？叔和云∶五十不止身无病，数内有止皆知定；四十一止一脏绝，却后四年多没
命；三十一止即三年，二十一止二年应；十五一止一年殂，以下有止看暴病。又云∶两动一止、或三四五动一
止，六七死，四动一止即八朝，仿此推排但根据次。不问内因外因，久病暴病，见代止必死。凡诸般死脉，皆十
动以下之变名也。
四时胃气为之本，
人之气血，春升夏浮，秋降冬沉，应周天之常度，配四时之定序。以各部言之∶肝弦、心洪、肺涩、肾
沉、脾缓者，本脏脉也；以时令言之∶春时六部中俱带弦，夏俱带洪，秋俱带涩，冬俱带沉，长夏四季俱带和
缓。凡人得应时之脉者，无病也。然必微弦，微洪，微毛，微石，为有胃气。若纯见弦洪毛石，谓之真脏之脉。
无胃气以和之者必死。故曰∶四时以胃气为本。此脉之常体也。然消息盈亏，理化不住，运动密移，春行冬令，
夏行春令，秋行夏令，冬行春令，四变之动，脉与之应者，乃气候之至脉也。亦必脉有胃气无害，胃气者，中
气也。不大不细，不长不短，不浮不沉，不滑不涩，应手中和，意思欣欣难以名状者是也。有胃气则脉有力
有神，无胃气则脉无力无神，神即胃气也。男子左手重而气口脉和，女子右手重而人迎脉和，亦为有胃气。今
人泥以浮取腑，沉取脏，中取胃气，而不知中固中也，浮之中亦有中也，沉之中亦有中也。不当泥其形，而当
求其神也。神即有力也。或疑七诊之法，亦以中为胃气，且如六脉俱沉，可断其无中气耶！其九候指法轻重，
经论详矣，已采入心部脉注。
六甲循环若弟兄。
气候阴阳，更迭四时。冬至阴极阳生，夏至阳极阴生。冬至后得甲子，少阳旺六十日，其气尚微，故脉来
乍大乍小，乍短乍长。第二甲子，阳明旺六十日。其气始萌，故脉浮大而短。第三甲子，太阳旺六十日，其气
大盛，故脉来洪大而长。夏至后第四甲子，太阴旺六十日，阴气初生，故脉紧大而长。第五甲子，少阴旺六十日，
阴气渐盛，故脉紧细而微。第六甲子，厥阴旺六十日，阴气极盛，故脉沉短而敦重。六六三百六十日以成一岁，
此三阴三阳之旺，时日之大要也。又大寒至春分，厥阴风木之至，其脉弦。春分至小满，少阴君火之至，其脉
洪而钩。小满至大暑，少阳相火之至，其脉大而浮。大暑至秋分，太阴湿土之至，其脉沉。秋分至小雪，阳明燥
金之至，其脉短而涩。小雪至大寒，太阳寒水之至，其脉大而长。或问∶六甲六气，主脉皆本《内经》，而脉
形有不同者，何耶？盖人禀气盛，则脉应时而盛，禀气弱或有病邪凝滞，则脉不能应时，而不失其真气，则亦
随阴阳微盛而变化略不同耳，非相反也。此言人身气候有一日一应周天者，有一年一应周天者。丹溪曰∶脉，
神也，阳也。其行速，犹太阳一日一周。息，气也，阴也。其行迟，犹太阴一月一周是也。歌云∶春弦夏洪秋
似毛，冬沉如石应天地；阿阿缓若春杨柳，此是脾家居四季；气候变动或不同，生死总诀在胃气。
约哉四脉千古诀！
博之二十七种，约之则为浮沉迟数滑涩缓大八要，又约之则为浮沉迟数，又至约则为浮中沉。盖浮兼数，
沉兼迟，中则浮沉之间，故所集六部脉诀，每以浮沉二字贯之。虽曰浮者阳也，沉者阴也，阴阳辨而脉无余蕴
矣。是知浮沉迟数四脉，真千古要诀也。彭用光曰∶浮阳曰金，轻清于上；芤实洪长，在心取象。沉阴
曰水，润滑在下；微弱伏虚，由沉化生。迟寒曰土，三至一息；内涵四脉，濡缓涩结。数热曰火，一息六至；
弦紧仿佛，滑大为异。盖浮乃轻手取之，而芤实洪长之类，皆轻手而得之也。沉乃重手取之，而微弱伏虚之类，
皆重手而得之也。迟者不急，一息三至，而濡缓涩结之类也。数者频急，一息六七至，而弦紧滑大之类也。学
者能以四脉为祖，先看五脏之中何脏得之？后看三部之中何部得之？庶乎据脉可以识证，因证亦可以识脉，随人
人之脉与证而立方，庶乎不致误人也。
动静玄机太简明。
脉理繁洁，治法多端。若不凭浮沉迟数，则指下茫然。且脉有单看浮而总看沉者，有总看浮而单看沉者，
迟数亦然。要之，审决经络，惟总看可凭。凡脉以得中为静，太过而为盛之极，不及而为衰之极，俱谓之动。
只取其动者治之，则经络不杂，何其简且明哉！
不问在经并脏腑，有力无力要叮咛。
四脉不问何部得之，有力则为风积痛热，无力则为虚气寒疮。百病无不包括。
欲识根源无别巧，只要临时心气清。
根源，即手太阴也，胃气也。先天之灵，非心清气定者不能察识。七诊法云∶一静其心，存其神也；二
忘外意，无私虑也；三匀呼吸，定其气也；四轻指于皮肤之间，探其腑脉，浮也；五微重指于肌肉之间，取其
胃气，中也；六沉指于筋骨之上，取其脏脉，沉也；七察病患脉息数来也。
通过静坐调息来观察先天之气的往来。临证时又需保持屏气凝神的恭敬态度，这是以我们心中的“太极”去验证身体上的“太极”，既不脱离气血，也不杂乱于气血，这才是先天的灵性，难道是那些拘泥于象数推演的人所能理解的吗？
诊断疾病的方法，以四时四季中当令旺盛的脉象为主。五脏六腑，以其盛衰达到极点时的表现为病，本位脉象太过或不足达到极点者也会死亡。《素问》说：人的居处和动静状态不同，脉象也会随之改变。那么，凡是偶然出现脉象稍有变化的，难道不应该调养以尽其天年吗？
王叔和说：脉搏五十次以上无间歇，身体无病；脉数中有间歇，都知道是定数（预后）；四十一次一止，一脏气绝，四年后多死亡；三十一次一止，三年后死；二十一次一止，两年后死；十五次一止，一年后死；以下有间歇的要看是暴病还是久病。又说：跳动两下出现一次间歇，或者三四五下出现一次间歇，六七下出现一次间歇则死；四下出现一次间歇，八天后死，依此类推。不问内因外因，久病暴病，见到代脉（规律性间歇）必死。各种死脉，都是十动以下的变化名称。
四时的胃气是脉象的根本。人的气血，春天升发，夏天浮越，秋天肃降，冬天沉潜，顺应周天运行的常规度数，配合四时固定的次序。从各部脉象来说：肝脉弦、心脉洪、肺脉涩、肾脉沉、脾脉缓，这是本脏的正常脉象；从时令来说：春季六部脉都带弦象，夏季都带洪象，秋季都带涩象，冬季都带沉象，长夏及四季都带和缓之象。凡人得到应时的脉象，就没有病。但是必须微弦、微洪、微毛（轻虚而浮）、微石（沉实如石），才是有胃气。如果纯见弦、洪、毛、石脉，称为真脏脉。没有胃气来调和的必然死亡。所以说：四时以胃气为本。这是脉象的常态。然而消息盈亏，理化不停，运动密移，有时春行冬令，夏行春令，秋行夏令，冬行春令（此处原文可能有误，通常指气候反常），四时变化的动态，脉象与之相应的，就是气候至时的脉象。也必须有胃气才无害。所谓胃气，就是中气。不大不小，不长不短，不浮不沉，不滑不涩，应手中和，意态欣欣难以名状的就是胃气。有胃气则脉有力有神，无胃气则脉无力无神，神就是胃气。男子左手重按而气口脉和缓，女子右手重按而人迎脉和缓，也是有胃气的表现。现在的人拘泥于浮取候腑、沉取候脏、中取候胃气，却不知道中就在其中，浮之中也有中，沉之中也有中。不应当拘泥于形体，而应当探求其神。神就是有力。有人怀疑七诊法也以中为胃气，况且如果六脉俱沉，能断定其中气已无吗！关于九候指法的轻重，经典论述很详细，已采入心部脉注中。
六甲循环如同兄弟。气候阴阳，更迭四时。冬至阴极阳生，夏至阳极阴生。冬至后遇到第一个甲子日，少阳旺六十日，其气尚微弱，所以脉来乍大乍小，乍短乍长。第二个甲子日，阳明旺六十日，其气开始萌芽，所以脉浮大而短。第三个甲子日，太阳旺六十日，其气大盛，所以脉来洪大而长。夏至后第四个甲子日，太阴旺六十日，阴气初生，所以脉紧大而长。第五个甲子日，少阴旺六十日，阴气渐盛，所以脉紧细而微。第六个甲子日，厥阴旺六十日，阴气极盛，所以脉沉短而敦重。六六三百六十日成一岁，这是三阴三阳旺盛的时间大要。另外，大寒到春分，厥阴风木之气到来，其脉弦。春分到小满，少阴君火之气到来，其脉洪而钩。小满到大暑，少阳相火之气到来，其脉大而浮。大暑到秋分，太阴湿土之气到来，其脉沉。秋分到小雪，阳明燥金之气到来，其脉短而涩。小雪到大寒，太阳寒水之气到来，其脉大而长。有人问：六甲六气的主脉都基于《内经》，但脉形有不同，为什么呢？大概人气盛，则脉应时而盛，人气弱或有病邪凝滞，则脉不能应时，但不失其真气，则也随阴阳微盛而变化略有不同罢了，并非相反。这里说的是人身气候有一日应一周天的，有一年应一周天的。朱丹溪说：脉，是神，属阳。其运行速度快，犹如太阳一日一周天。息，是气，属阴。其运行速度慢，犹如太阴一月一周天。歌诀说：春弦夏洪秋似毛，冬沉如石应天地；柔和缓若春杨柳，这是脾家居于四季；气候变动或不同，生死总诀在胃气。
简约的四脉是千古秘诀！博大的有二十七种，简约则为浮、沉、迟、数、滑、涩、缓、大八要，再简约则为浮、沉、迟、数，最简约则为浮、中、沉。盖浮兼数，沉兼迟，中则是浮沉之间，所以所集的六部脉诀，每以浮沉二字贯穿。虽然说是浮者为阳，沉者为阴，阴阳辨别清楚则脉理无余蕴了。因此知道浮、沉、迟、数四脉，真是千古要诀。彭用光说：浮为阳曰金，轻清在上；芤、实、洪、长，在心取象。沉为阴曰水，润滑在下；微、弱、伏、虚，由沉化生。迟为寒曰土，一息三至；内涵四脉，濡、缓、涩、结。数为热曰火，一息六至；弦、紧仿佛，滑、大为异。盖浮是轻手取之，而芤、实、洪、长之类，都是轻手而得的。沉是重手取之，而微、弱、伏、虚之类，都是重手而得的。迟是不急，一息三至，是濡、缓、涩、结之类。数是频急，一息六七至，是弦、紧、滑、大之类。学者能以四脉为根本，先看五脏之中何脏得此脉？后看三部之中何部得此脉？这样依据脉可以识证，因证也可以识脉，随每个人的脉与证而立方，庶乎不致误人。
动静玄机太简明。脉理繁洁，治法多端。如果不凭浮沉迟数，则指下茫然。且脉有单看浮而总看沉的，有总看浮而单看沉的，迟数也是如此。总之，审决经络，只有总看才可凭借。凡脉以得中为静，太过而为盛之极，不及而为衰之极，都称为动。只取其动者治疗，则经络不杂，何其简单明了啊！
不问在经并脏腑，有力无力要叮咛。四脉不问从何部得来，有力则为风积痛热，无力则为虚气寒疮。百病无不包括。
欲识根源无别巧，只要临时心气清。根源，即手太阴肺经，也是胃气。先天的灵性，不是心清气定的人不能察识。七诊法说：一静其心，存其神；二忘外意，无私虑；三匀呼吸，定其气；四轻指于皮肤之间，探其腑脉，此为浮；五微重指于肌肉之间，取其胃气，此为中也；六沉指于筋骨之上，取其脏脉，此为沉；七察病患脉息数来也。
Meditate in stillness and regulate breathing to observe the coming and going of Qi. When treating patients, one must also maintain reverence by holding breath and focusing the mind; this is using the Taiji (Supreme Ultimate) within our heart to verify the Taiji within the body. It neither departs from Blood and Qi nor becomes entangled with them; this is the spiritual essence of the Pre-Heaven (Xiantian). How could those who are stuck on image and number (numerology/divination) understand this!
The method for diagnosing disease takes the pulse corresponding to the season as the primary indicator. For the Zang and Fu organs, illness is determined when their flourishing or declining states reach an extreme. If the pulse at its original position is either excessively strong or deficient to the extreme, death will occur. The *Suwen* (Basic Questions) states: "A person's living environment and activity level can cause changes in the pulse." Therefore, if one unfortunately experiences even slight variations in the pulse, should they not nourish themselves to fulfill their natural lifespan?
Shuhe (Wang Shuhe) said: "If the pulse beats fifty times without interruption, the body is healthy; interruptions within the count indicate a fixed prognosis. An interruption after forty-one beats indicates the failure of one Zang organ, leading to death after four years; an interruption after thirty-one beats leads to death in three years; after twenty-one beats, two years; after fifteen beats, one year. For interruptions below fifteen beats, distinguish between acute and chronic conditions." He further stated: "An interruption after two beats, or after three, four, or five beats, indicates death if it occurs after six or seven beats; an interruption after four beats leads to death in eight days. Deduce similarly based on sequence. Regardless of internal or external causes, whether chronic or acute, the appearance of a Dai pulse (intermittent pulse) signifies death. All kinds of fatal pulses are variations of fewer than ten beats."
Stomach Qi (Wei Qi) of the four seasons is the root of the pulse. Human Blood and Qi rise in Spring, float in Summer, descend in Autumn, and sink in Winter, following the constant measure of the celestial cycle and matching the fixed order of the four seasons. Speaking of individual positions: Liver pulse is Wiry (Xian), Heart pulse is Surging (Hong), Lung pulse is Rough (Se), Kidney pulse is Deep (Chen), and Spleen pulse is Moderate (Huan); these are the pulses of the respective Zang organs. Speaking of seasons: In Spring, all six positions carry a Wiry quality; in Summer, all carry a Surging quality; in Autumn, all carry a Rough quality; in Winter, all carry a Deep quality; during Late Summer and the transition seasons, all carry a Moderate and harmonious quality. A person who obtains a pulse corresponding to the season has no disease. However, it must be slightly Wiry, slightly Surging, slightly Feathery (Mao - light and floating), or slightly Stone-like (Shi - deep and firm) to indicate the presence of Stomach Qi. If only Wiry, Surging, Feathery, or Stone-like pulses appear purely, they are called True Zang Pulses. Without Stomach Qi to harmonize them, death is certain. Thus it is said: "In the four seasons, Stomach Qi is the foundation." This is the normal state of the pulse. However, waxing and waning, transformation and generation never cease; movement shifts rapidly. Sometimes Spring follows Winter's command, Summer follows Spring's, Autumn follows Summer's, and Winter follows Spring's (note: text likely implies climatic anomalies). The dynamic changes of the four seasons correspond in the pulse; these are pulses arriving with the climate. They must also possess Stomach Qi to be harmless. Stomach Qi is Middle Qi (Zhong Qi): neither large nor small, neither long nor short, neither floating nor deep, neither slippery nor rough, responding with harmony, appearing vibrant yet indescribable. With Stomach Qi, the pulse has strength and Spirit (Shen); without it, the pulse lacks strength and Spirit. Spirit is Stomach Qi. In men, heavy pressure on the left hand yields a harmonious Qi Kou pulse; in women, heavy pressure on the right hand yields a harmonious Ying Chang pulse; both indicate Stomach Qi. Modern practitioners stick to floating to inspect Fu organs, deep to inspect Zang organs, and middle to inspect Stomach Qi, not realizing that 'middle' exists within the middle, but also within the floating and the deep. One should not stick to form but seek the Spirit. Spirit is strength. Some doubt the Seven Diagnostics method which also considers 'middle' as Stomach Qi; if all six pulses are deep, can one conclude there is no Middle Qi? The techniques for nine positions regarding finger pressure are detailed in the classics and have been included in the notes on the Heart pulse section.
The Six Jia cycles resemble brothers. Climate and Yin-Yang alternate through the four seasons. At Winter Solstice, Yin reaches its peak and Yang begins to grow; at Summer Solstice, Yang reaches its peak and Yin begins to grow. After Winter Solstice, upon reaching the first Jia Zi day, Shaoyang (Lesser Yang) prospers for sixty days. Its Qi is still subtle, so the pulse comes varying in size and length. On the second Jia Zi day, Yangming (Bright Yang) prospers for sixty days. Its Qi begins to sprout, so the pulse is floating, large, and short. On the third Jia Zi day, Taiyang (Greater Yang) prospers for sixty days. Its Qi is abundant, so the pulse is surging, large, and long. After Summer Solstice, on the fourth Jia Zi day, Taiyin (Greater Yin) prospers for sixty days. Yin Qi initially grows, so the pulse is tight, large, and long. On the fifth Jia Zi day, Shaoyin (Lesser Yin) prospers for sixty days. Yin Qi gradually strengthens, so the pulse is tight, fine, and subtle. On the sixth Jia Zi day, Jueyin (Terminal Yin) prospers for sixty days. Yin Qi is at its peak, so the pulse is deep, short, and heavy. Six cycles of sixty days make 360 days, completing a year. This is the major outline of the prosperity of the Three Yin and Three Yang. Additionally: From Great Cold to Spring Equinox, Jueyin Wind-Wood arrives, its pulse is Wiry. From Spring Equinox to Grain Full, Shaoyin Sovereign Fire arrives, its pulse is Surging and Hooked. From Grain Full to Great Heat, Shaoyang Ministerial Fire arrives, its pulse is large and floating. From Great Heat to Autumn Equinox, Taiyin Damp-Earth arrives, its pulse is deep. From Autumn Equinox to Light Snow, Yangming Dry-Metal arrives, its pulse is short and rough. From Light Snow to Great Cold, Taiyang Cold-Water arrives, its pulse is large and long. One might ask: The main pulses of the Six Jia and Six Qi are based on the *Neijing*, yet the pulse forms differ. Why? Generally, if human Qi is robust, the pulse flourishes with the season; if human Qi is weak or pathogenic factors stagnate, the pulse cannot respond to the season. However, as long as the True Qi is not lost, it will change slightly with the minor fluctuations of Yin and Yang, not oppositely. This refers to the human body's climate responding to the celestial cycle daily or annually. Danxi (Zhu Zhenheng) said: "Pulse is Spirit, belonging to Yang. Its movement is fast, like the Sun circling once a day. Breath is Qi, belonging to Yin. Its movement is slow, like the Moon circling once a month." The song says: "Spring Wiry, Summer Surging, Autumn like Feather, Winter Deep like Stone responds to Heaven and Earth; Gentle and slow like spring willows, this is the Spleen dwelling in the four seasons; Climate changes may differ, the general principle of life and death lies in Stomach Qi."
The concise Four Pulses are the eternal secret! Broadly speaking, there are twenty-seven types; concisely, they reduce to the Eight Essentials: Floating, Deep, Slow, Rapid, Slippery, Rough, Moderate, Large. Further condensed, they become Floating, Deep, Slow, Rapid. Most concisely, they become Floating, Middle, Deep. Floating combines with Rapid, Deep combines with Slow, and Middle is between Floating and Deep. Thus, in the collected pulse formulas for the six positions, Floating and Deep are always emphasized. Although Floating is Yang and Deep is Yin, distinguishing Yin and Yang leaves no hidden aspects of the pulse. Therefore, knowing that Floating, Deep, Slow, and Rapid are truly the eternal secrets. Peng Yongguang said: "Floating is Yang, called Metal, light and clear above; Kun, Shi, Hong, and Chang take imagery from the Heart. Deep is Yin, called Water, smooth and lubricating below; Wei, Ruo, Fu, and Xu arise from Deep. Slow is Cold, called Earth, three beats per respiration; containing four pulses, Ru, Huan, Se, and Jie. Rapid is Heat, called Fire, six to seven beats per respiration; Xian and Jin are similar, Hua and Da are distinct." Floating is obtained with light pressure, so Kun, Shi, Hong, Chang, etc., are obtained lightly. Deep is obtained with heavy pressure, so Wei, Ruo, Fu, Xu, etc., are obtained heavily. Slow is unhurried, three beats per respiration, including Ru, Huan, Se, Jie. Rapid is frequent and urgent, six to seven beats per respiration, including Xian, Jin, Hua, Da. Scholars should take these four pulses as the ancestor: first see which Zang organ in the Five Zangs obtains it? Then see which position in the Three Positions obtains it? Thus, relying on the pulse to identify the syndrome, and due to the syndrome to identify the pulse, prescribing formulas according to each person's pulse and syndrome, one will hardly err.
The mystery of movement and stillness is too simple. Pulse theory is complex yet clear, treatment methods are numerous. Without relying on Floating, Deep, Slow, and Rapid, the fingers feel bewildered. Some pulses require looking singly at Floating and collectively at Deep, or collectively at Floating and singly at Deep; the same applies to Slow and Rapid. Ultimately, to examine and decide upon meridians, only the collective view is reliable. Any pulse that attains the Middle is Still (Jing); excessive is the extreme of Flourishing, insufficient is the extreme of Declining; both are called Moving (Dong). Treating only the Moving aspect ensures the meridians are not mixed, how simple and clear!
Regardless of whether it is in the Meridians or Zang-Fu Organs, one must heed Strength and Weakness. For the four pulses, regardless of where they are obtained, Strength indicates Wind, Accumulation, Pain, or Heat; Weakness indicates Deficient Qi, Cold, or Ulcers. This covers all hundred diseases.
To know the root requires no other trick, only a clear mind and Qi at the moment. The root is the Hand-Taiyin Lung Meridian and Stomach Qi. The Pre-Heaven spirit cannot be perceived unless the mind is clear and calm. The Seven Diagnostics method states: First, quiet the mind and preserve the Spirit; second, forget external distractions and selfish thoughts; third, equalize breathing to stabilize Qi; fourth, place fingers lightly on the skin to explore Fu organ pulses (Floating); fifth, press slightly deeper into the muscles to obtain Stomach Qi (Middle); sixth, press deeply to the bones to obtain Zang organ pulses (Deep); seventh, observe the patient's pulse rate.