人身十二经脉,交通有道,循行有次,气统于先,血附于内,流行还转,昼夜不停。而医家诊脉,以左右
两手,分寸、关、尺三部,医以三指候之,以医之一呼一吸,候病者之脉。其脉应指而动,一动谓之一至,一呼一吸
之间,其脉若四至以上,或五至以下,不数不迟,谓之平脉。若一呼一吸,其脉三至,或三至有余,则为迟脉;
一呼一吸,其脉六至,或六至有余,则为数脉。经云∶迟为虚寒,数为虚热。此识病之法,非脉法也。
然脉之形象,又有浮、沉、滑、涩、弦、紧、大、小之分。浮者,泛泛于上,轻指即得,如水漂木,故曰
浮。沉者,沉伏于下,重指始得,如石下沉,故曰沉。滑则往来流利,如珠走盘而圆转。涩则往来艰涩,如刀
刮竹而阻滞。弦如弓弦,按之不移也。紧如转索,按之劲急也。大乃脉体洪大,过于本位也。小乃脉体收敛,
不及本位也。此脉之外,又有微、细、芤、革。微者,虚微,似有似无也。细者,细小,如发如丝也。芤者,
上有中无,如按葱管也。革者,外劲而坚,如按鼓皮也。脉之形象不一,须于指下辨明,合证参考,自有定见。
然尤当审其脉之圆缓,并脉之胃气。圆缓者,脉来应指,至数均调,三部同等也,胃气者,轻举应指,重按柔
和也。若脉不圆缓,及无胃气,轻病必重,重病必死。
又病脉之外,兼有死脉。方书有虾游、鱼翔、屋漏、雀啄、弹石诸说。虾游者,如虾之游,鱼翔者,如鱼
之摆鳞。屋漏者,至不伦次,点滴稀疏。雀啄者,如雀啄物,急疾涣散。弹石者,坚硬牢实,如指弹石。虾游、
鱼翔、屋漏,乃散漫不伦之脉也∶雀啄、弹石,乃坚强不和之脉也。方书之言,摹拟亦似,此皆脉无胃气,应
指无神也,
见则必死。
又两手三部之脉,地脉也,可以指诊;面容之色,天脉也,用以目察。六气调和,五行不偏,自有正色,
若面无正色,神气不扬,夭色外呈,其寿不久。
诸脉之外,又有动脉。动脉有二∶一则三部之脉,厥厥动摇,圆疾如豆也;一则头额喉旁,胸腹胫足,
跃跃而动,此经脉循行环转于空隙之处,微露其端,所谓流中溢外也。
又高阳生《脉诀》云∶左心、小肠、肝、胆、肾、膀胱,右肺、大肠、脾、胃、包、三焦。此一脏一腑相
为配合,合《灵枢》之脉法也。而《素问》脉法,又以两手寸脉候上,关脉候中,尺脉候下。约而言之,右寸
候肺,左寸候心,而膻中、上焦,附于两寸;右关候脾,左关候肝,而鬲中、中焦、胃、大小肠,附于两关;
尺中候肾与膀胱,无分左右,而季胁、血海、下焦,附于两尺。此上以候上,中以候中,下以候下,《素问》之
脉法为然也。
又仲师《伤寒论·平脉篇》,更有诊法,以三菽、六菽、九菽、十二菽之由轻而重,自举而按,以候五脏之
气。故曰如三菽之重者,肺气也,如六菽之重者,心气也;如九菽之重者,脾气也;如十二菽之重者,肝气也;
按之至骨者,肾气也。此又以浮、中、沉诊五脏之气。《伤寒论》之脉法为然也。
经论脉法,平素俱熟于胸中,则论病诊视,无往不
宜矣。然有三部无脉,移于外络,名为反关脉者,此又不可不知也。总之,脉者,五脏六腑之大原,有脉则生,
无脉则死;三部脉平,病虽剧亦生,三部不平,病虽轻亦危。
又脉分左右,左主血,右主气。男为阳,阳者气也,故男子之脉,宜于右旺;女为阴,阴者血也,故女子
之脉,宜于左旺。男子右脉和平,虽困无害,女子左脉和平,虽困亦无害。盖五脏所居之位,男居于左者,女则
居于右,男居于右者,女则居于左。《素问》云∶男子左为逆,右为从;女子右为逆,左为从,所从不同,则两手
左右所属脏腑,亦当不同矣。
至诊脉论病,如云某脉系某病,某病得某脉,不但蛇足,且诊视之下,亦难为据。不若但论脉之有神无神、
和缓与不和缓之为得也。
至如小儿之脉,亦如此法。但小儿啼哭不驯,不能细诊,只以一二指按之,脉来四五至,亦为和平;若按之
而似有似无,或急疾无神,兼之病剧,亦不能生。其视虎口而别以色,云小儿脉有六七至者,皆妄谈也。诊小
儿之脉,须知小儿呼吸急疾,约以急疾应之可耳!
由此推之,无论大小男女,凡病内虚者脉弱为宜,洪大则忌;初病外感者,阳脉为宜,阴脉则忌。其
他《脉诀》之言,多属不经,不可为信。欲求诊脉之法者,考于《灵枢》,详于《素问》,更合本论辨脉平脉,
而会通之,则
得其要矣。
人身十二经脉,交通有道,循行有次,气统于先,血附于内,流行还转,昼夜不停。
人体内的十二经脉(运行气血的通道),其交会通行有固定的规律,循行路径有先后次序,气机统领于前,血液依附于内,气血循环往复,昼夜不息。
而医家诊脉,以左右两手,分寸、关、尺三部,医以三指候之,以医之一呼一吸,候病者之脉。
医生在诊察脉搏时,用左手和右手的寸部、关部、尺部这三个部位,医生用食指、中指、无名指三根手指来感应,并以医生自己的一次呼气与一次吸气的时间,来测定病人的脉搏次数。
其脉应指而动,一动谓之一至,一呼一吸之间,其脉若四至以上,或五至以下,不数不迟,谓之平脉。
脉搏随着手指的按压而跳动,一次跳动称为“一至”。在一次呼吸之间,脉搏跳动四次以上,或者五次以下,不快也不慢,这叫做平脉(正常脉象)。
若一呼一吸,其脉三至,或三至有余,则为迟脉;一呼一吸,其脉六至,或六至有余,则为数脉。
如果一次呼吸之间,脉搏只有三次跳动,或者三次多一点,这就叫迟脉(脉率缓慢);如果一次呼吸之间,脉搏达到六次跳动,或者六次以上,这就叫数脉(脉率快速)。
经云∶迟为虚寒,数为虚热。此识病之法,非脉法也。
经典著作中说:迟脉主虚寒证,数脉主虚热证。这是识别疾病性质的方法,而不是单纯的脉象形态分类法。
然脉之形象,又有浮、沉、滑、涩、弦、紧、大、小之分。
然而脉象的形象,还有浮脉、沉脉、滑脉、涩脉、弦脉、紧脉、大脉、小脉的区别。
浮者,泛泛于上,轻指即得,如水漂木,故曰浮。
浮脉,脉位表浅,轻轻按摸就能感觉到,就像木头漂浮在水面上,所以叫浮脉。
沉者,沉伏于下,重指始得,如石下沉,故曰沉。
沉脉,脉位深沉,用力按压才能感觉到,就像石头沉入水底,所以叫沉脉。
滑则往来流利,如珠走盘而圆转。
滑脉,血流往来流畅,像珠子在盘子里滚动一样圆润顺滑。
涩则往来艰涩,如刀刮竹而阻滞。
涩脉,血流往来艰难滞涩,像用刀刮竹子一样阻碍不通。
弦如弓弦,按之不移也。
弦脉,感觉像拉紧的弓弦,按压时感觉挺直且位置固定不移。
紧如转索,按之劲急也。
紧脉,感觉像旋转的绳索,按压时感觉强劲紧急。
大乃脉体洪大,过于本位也。
大脉,脉体宽大洪盛,超过正常的范围。
小乃脉体收敛,不及本位也。
小脉,脉体细小收敛,达不到正常的宽度。
此脉之外,又有微、细、芤、革。
除了上述脉象外,还有微脉、细脉、芤脉、革脉。
微者,虚微,似有似无也。
微脉,极其微弱,好像有又好像没有。
细者,细小,如发如丝也。
细脉,脉形细小,像头发丝一样。
芤者,上有中无,如按葱管也。
芤脉,浮取有力但中空,像按压葱管的感觉。
革者,外劲而坚,如按鼓皮也。
革脉,外壁坚硬紧绷,像按压鼓皮的感觉。
脉之形象不一,须于指下辨明,合证参考,自有定见。
脉象的形象各不相同,必须在手指下仔细辨别清楚,结合临床症状进行参考,自然会有明确的判断。
然尤当审其脉之圆缓,并脉之胃气。
然而尤其应当审察脉象是否圆滑缓和,以及是否有“胃气”(脾胃之气在脉象上的反映,代表生机)。
圆缓者,脉来应指,至数均调,三部同等也,胃气者,轻举应指,重按柔和也。
所谓圆缓,是指脉搏来去应指,节律均匀调和,寸、关、尺三部力度相当;所谓胃气,是指轻取时脉搏应指,重按时感觉柔和有力。
若脉不圆缓,及无胃气,轻病必重,重病必死。
如果脉象不圆滑缓和,并且没有胃气,即使是轻病也会加重,重病则会导致死亡。
又病脉之外,兼有死脉。方书有虾游、鱼翔、屋漏、雀啄、弹石诸说。
除了病脉之外,还有死脉(预示死亡的脉象)。医书中有关于虾游脉、鱼翔脉、屋漏脉、雀啄脉、弹石脉的说法。
虾游者,如虾之游,鱼翔者,如鱼之摆鳞。
虾游脉,像虾在水中游动(忽隐忽现);鱼翔脉,像鱼摆动鳞片(头定尾摇)。
屋漏者,至不伦次,点滴稀疏。
屋漏脉,脉搏跳动毫无规律,间隔很久才跳一下,像屋顶漏水点滴稀疏。
雀啄者,如雀啄物,急疾涣散。
雀啄脉,像麻雀啄食一样,急促而杂乱涣散。
弹石者,坚硬牢实,如指弹石。
弹石脉,脉象坚硬牢固,像手指敲击石头。
虾游、鱼翔、屋漏,乃散漫不伦之脉也∶雀啄、弹石,乃坚强不和之脉也。
虾游、鱼翔、屋漏这三种脉象,是散乱无序的脉象;雀啄、弹石这两种脉象,是僵硬不和的脉象。
方书之言,摹拟亦似,此皆脉无胃气,应指无神也,见则必死。
医书中的描述,模拟得非常相似,这些脉象都是因为脉中没有胃气,手指下感觉没有神气,出现这种脉象必然导致死亡。
又两手三部之脉,地脉也,可以指诊;面容之色,天脉也,用以目察。
另外,双手寸关尺三部脉属于“地脉”,可以用手指诊察;面部的色泽属于“天脉”,可以用眼睛观察。
六气调和,五行不偏,自有正色,若面无正色,神气不扬,夭色外呈,其寿不久。
如果人体六淫之气调和,五行平衡不偏颇,面部自然会有正常的色泽;如果面部没有正常色泽,神采不扬,呈现出早衰夭折的气色,那么寿命不会长久。
诸脉之外,又有动脉。动脉有二∶一则三部之脉,厥厥动摇,圆疾如豆也;一则头额喉旁,胸腹胫足,跃跃而动,此经脉循行环转于空隙之处,微露其端,所谓流中溢外也。
在各种脉象之外,还有动脉。动脉有两种情况:一种是寸关尺三部脉搏,跳动剧烈动摇,圆滑快捷像豆子一样;另一种是在头部、额头、喉咙旁边、胸部、腹部、小腿、脚部,血管跃跃欲动,这是因为经脉循行环绕经过骨骼肌肉的空隙处,微微显露出搏动,这就是所谓的“流中溢外”。
又高阳生《脉诀》云∶左心、小肠、肝、胆、肾、膀胱,右肺、大肠、脾、胃、包、三焦。此一脏一腑相为配合,合《灵枢》之脉法也。
另外,高阳生的《脉诀》中说:左手对应心、小肠、肝、胆、肾、膀胱,右手对应肺、大肠、脾、胃、心包、三焦。这是一脏一腑相互配合,符合《灵枢》的脉法理论。
而《素问》脉法,又以两手寸脉候上,关脉候中,尺脉候下。
而《素问》的脉法,则是用两手的寸脉候察上部病变,关脉候察中部病变,尺脉候察下部病变。
约而言之,右寸候肺,左寸候心,而膻中、上焦,附于两寸;右关候脾,左关候肝,而鬲中、中焦、胃、大小肠,附于两关;尺中候肾与膀胱,无分左右,而季胁、血海、下焦,附于两尺。
概括来说,右寸脉候察肺,左寸脉候察心,而膻中、上焦的病变附着于两寸脉;右关脉候察脾,左关脉候察肝,而膈中、中焦、胃、大小肠的病变附着于两关脉;尺脉候察肾与膀胱,不分左右,而季胁、血海、下焦的病变附着于两尺脉。
此上以候上,中以候中,下以候下,《素问》之脉法为然也。
这就是上以候上、中以候中、下以候下,《素问》的脉法就是这样规定的。
又仲师《伤寒论·平脉篇》,更有诊法,以三菽、六菽、九菽、十二菽之由轻而重,自举而按,以候五脏之气。
另外,张仲景在《伤寒论·平脉篇》中,还有另一种诊法,通过从轻到重的力度,分别用相当于三颗豆子、六颗豆子、九颗豆子、十二颗豆子的重量,从轻取到重按,来候察五脏之气。
故曰如三菽之重者,肺气也,如六菽之重者,心气也;如九菽之重者,脾气也;如十二菽之重者,肝气也;按之至骨者,肾气也。
所以说,像三颗豆子那样轻的重量,候的是肺气;像六颗豆子那样稍重的重量,候的是心气;像九颗豆子那样更重的重量,候的是脾气;像十二颗豆子那样更重的重量,候的是肝气;按压到骨头层面,候的是肾气。
此又以浮、中、沉诊五脏之气。《伤寒论》之脉法为然也。
这也是通过浮取、中取、沉取来诊察五脏之气。《伤寒论》的脉法就是这样的。
经论脉法,平素俱熟于胸中,则论病诊视,无往不宜矣。
如果平时将经典论述的脉法都熟记于心,那么在讨论疾病和诊察病情时,就没有不适宜的地方了。
然有三部无脉,移于外络,名为反关脉者,此又不可不知也。
但是,有的人寸关尺三部摸不到脉搏,脉搏移动到了手背的外侧络脉,这叫作反关脉,这一点又是不能不知道的。
总之,脉者,五脏六腑之大原,有脉则生,无脉则死;三部脉平,病虽剧亦生,三部不平,病虽轻亦危。
总之,脉象是五脏六腑的根本源泉,有脉就有生机,无脉就会死亡;如果三部脉象平和,即使病情严重也能存活;如果三部脉象不平,即使病情轻微也有危险。
又脉分左右,左主血,右主气。
另外,脉象分属左右,左手主血,右手主气。
男为阳,阳者气也,故男子之脉,宜于右旺;女为阴,阴者血也,故女子之脉,宜于左旺。
男性属阳,阳指的是气,所以男子的脉象,右侧旺盛为宜;女性属阴,阴指的是血,所以女子的脉象,左侧旺盛为宜。
男子右脉和平,虽困无害,女子左脉和平,虽困亦无害。
如果男子右脉平和,即使生病也没有大碍;如果女子左脉平和,即使生病也没有大碍。
盖五脏所居之位,男居于左者,女则居于右,男居于右者,女则居于左。
这是因为五脏所在的位置,男性位于左边的脏器,女性则位于右边;男性位于右边的脏器,女性则位于左边。
《素问》云∶男子左为逆,右为从;女子右为逆,左为从,所从不同,则两手左右所属脏腑,亦当不同矣。
《素问》中说:对于男子,左侧脉象异常为逆(凶),右侧为从(顺);对于女子,右侧脉象异常为逆,左侧为从。因为顺逆的标准不同,所以两手左右所属的脏腑定位也应当有所不同。
至诊脉论病,如云某脉系某病,某病得某脉,不但蛇足,且诊视之下,亦难为据。
至于诊脉论病,如果说某种脉象一定对应某种疾病,某种疾病一定出现某种脉象,这不仅是画蛇添足,而且在临床诊视中,也难以作为依据。
不若但论脉之有神无神、和缓与不和缓之为得也。
不如只论述脉象是有神还是无神、是和缓还是不和缓,这样才是正确的做法。
至如小儿之脉,亦如此法。但小儿啼哭不驯,不能细诊,只以一二指按之,脉来四五至,亦为和平;若按之而似有似无,或急疾无神,兼之病剧,亦不能生。
至于小儿的脉象,也是用这种方法。但是小儿哭闹不听话,不能细致诊察,只用一两个手指按压,脉搏跳动四五次(在一呼一吸间),也算和平;如果按压时感觉似有似无,或者急促快而没有神气,再加上病情严重,也就不能存活了。
其视虎口而别以色,云小儿脉有六七至者,皆妄谈也。诊小儿之脉,须知小儿呼吸急疾,约以急疾应之可耳!
那些通过观察虎口颜色来判断,或者说小儿脉搏一息六七次的说法,都是荒谬的言论。诊断小儿脉象,必须知道小儿呼吸急促,大约以急促的节奏来应对即可!
由此推之,无论大小男女,凡病内虚者脉弱为宜,洪大则忌;初病外感者,阳脉为宜,阴脉则忌。
由此推断,无论老少男女,凡是体内虚损的疾病,脉象微弱为宜,洪大则忌讳;初患外感病的,阳脉(浮数等)为宜,阴脉(沉迟等)则忌讳。
其他《脉诀》之言,多属不经,不可为信。
其他《脉诀》中的言论,大多属于荒诞不经的内容,不可以相信。
欲求诊脉之法者,考于《灵枢》,详于《素问》,更合本论辨脉平脉,而会通之,则得其要矣。
想要探求诊脉的方法,应当在《灵枢》中考证,在《素问》中详查,再结合本篇关于辨脉和平脉的论述,融会贯通,就能掌握其中的要领了。
The twelve meridians of the human body have established pathways for communication and a specific order of circulation. Qi leads the way, while Blood follows within; they circulate and turn continuously without stopping day or night. When physicians palpate the pulse, they use the three positions—Cun (Inch), Guan (Bar), and Chi (Cubit)—on both the left and right wrists. The physician uses three fingers to sense the pulse, measuring the patient's pulse beats against the physician's own single exhalation and inhalation.
The pulse moves in response to the finger pressure; one beat is called one "Zhi" (beat). Within one exhalation and inhalation, if the pulse beats four times or more, but five times or less, neither rapid nor slow, it is called a Ping Mai (Normal Pulse). If within one exhalation and inhalation the pulse beats three times or slightly more than three, it is called a Chi Mai (Slow Pulse); if it beats six times or slightly more than six, it is called a Shu Mai (Rapid Pulse). The classics state: "Chi indicates deficiency-cold, Shu indicates deficiency-heat." This is a method for identifying disease nature, not merely pulse morphology classification.
However, pulse images also vary into Fu (Floating), Chen (Sinking), Hua (Slippery), Se (Choppy), Xian (Wiry), Jin (Tight), Da (Large), and Xiao (Small). Fu pulse floats superficially, detectable with light pressure, like wood floating on water, hence named Fu. Chen pulse sinks deep, detectable only with heavy pressure, like a stone sinking, hence named Chen. Hua pulse flows smoothly back and forth, like pearls rolling on a plate. Se pulse flows roughly and obstructedly, like a knife scraping bamboo. Xian pulse feels like a bowstring, firm and unyielding upon pressure. Jin pulse feels like a twisting rope, tense and urgent upon pressure. Da pulse has a voluminous body, exceeding the normal position. Xiao pulse has a constricted body, falling short of the normal width.
Beyond these, there are Wei (Micro), Xi (Fine), Kou (Hollow), and Ge (Leather) pulses. Wei pulse is extremely weak, seeming present yet absent. Xi pulse is thin and small, like a hair or silk thread. Kou pulse feels firm on the surface but hollow in the middle, like pressing an onion stalk. Ge pulse is hard and taut on the outside, like pressing a drumhead. Since pulse images are diverse, one must distinguish them clearly under the fingers and correlate them with symptoms to form a definite judgment.
However, it is crucial to examine whether the pulse is round and relaxed, and whether it possesses "Wei Qi" (Stomach Qi, representing digestive vitality). A "round and relaxed" pulse responds to the finger with uniform rhythm and equal strength across the Cun, Guan, and Chi positions. "Wei Qi" means the pulse responds to light pressure and feels soft and harmonious upon heavy pressure. If the pulse lacks roundness and relaxation, and has no Wei Qi, mild illness will become severe, and severe illness will lead to death.
Besides pathological pulses, there are also "Death Pulses." Medical texts describe Xia You (Shrimp Swimming), Yu Xiang (Fish Gliding), Wu Lou (House Leaking), Que Zhuo (Sparrow Pecking), and Dan Shi (Finger Striking Stone). Xia You resembles a shrimp swimming (erratic and faint); Yu Xiang resembles a fish gliding (head still, tail trembling). Wu Lou beats irregularly, sparse and intermittent like dripping water. Que Zhuo resembles a sparrow pecking food, rapid and scattered. Dan Shi is hard and solid, like a finger striking a stone. Xia You, Yu Xiang, and Wu Lou are scattered and disordered pulses; Que Zhuo and Dan Shi are rigid and discordant pulses. These descriptions in medical texts are apt simulations; all indicate a lack of Wei Qi and Shen (Spirit) in the pulse, appearing inevitably fatal.
Furthermore, the pulses at the three positions of both hands constitute the "Earth Pulse," palpable by fingers; facial complexion constitutes the "Heaven Pulse," observable by eyes. When the Six Qi are harmonious and the Five Elements are balanced, a normal complexion appears naturally. If the face lacks normal color, spirit is dim, and signs of premature aging appear externally, longevity will be short.
Besides various pulses, there is also Dong Mai (Moving Pulse). There are two types of Dong Mai: First, the pulses at the three positions tremble vigorously, round and rapid like a bean. Second, vessels in the head, forehead, beside the throat, chest, abdomen, shins, and feet jump visibly. This occurs because meridians circulate through gaps between tissues, slightly revealing their ends, known as "overflowing from the flow."
Gao Yangsheng's *Mai Jue* (Pulse Classic) states: Left side corresponds to Heart, Small Intestine, Liver, Gallbladder, Kidney, Bladder; Right side corresponds to Lung, Large Intestine, Spleen, Stomach, Pericardium, San Jiao (Triple Burner). This pairing of Zang and Fu organs aligns with the pulse methods in the *Ling Shu* (Spiritual Pivot). However, the pulse method in the *Su Wen* (Basic Questions) uses the Cun position to inspect the Upper Jiao, Guan for the Middle Jiao, and Chi for the Lower Jiao. Briefly, Right Cun inspects the Lung, Left Cun inspects the Heart, while Dan Zhong and Upper Jiao attach to both Cun positions; Right Guan inspects the Spleen, Left Guan inspects the Liver, while Diaphragm, Middle Jiao, Stomach, and Large/Small Intestines attach to both Guan positions; Chi inspects Kidney and Bladder,不分左右 (without distinguishing left/right), while Hypochondrium, Blood Sea, and Lower Jiao attach to both Chi positions. This "upper inspects upper, middle inspects middle, lower inspects lower" approach is characteristic of the *Su Wen* pulse method.
Additionally, Zhang Zhongjing’s *Shang Han Lun* (Treatise on Cold Damage), Chapter on Leveling Pulses, offers another diagnostic method using increasing weight equivalent to three, six, nine, and twelve beans, moving from light lifting to pressing, to inspect the Qi of the five Zang organs. Thus, light pressure like three beans inspects Lung Qi; six beans inspects Heart Qi; nine beans inspects Spleen Qi; twelve beans inspects Liver Qi; pressing to the bone inspects Kidney Qi. This utilizes Floating, Middle, and Deep techniques to diagnose Zang Qi, consistent with the *Shang Han Lun* pulse method.
If one masters the classic discussions on pulse methods mentally, then diagnosing and discussing diseases will be appropriate in all aspects. However, some individuals have no pulse at the three standard positions, with the pulse shifting to external collaterals, known as Fan Guan Mai (Reverse Passage Pulse); this must also be known. In summary, the pulse is the great root of the five Zang and six Fu organs. Presence of pulse means life, absence means death. If the three positions are balanced, even severe illness may survive; if unbalanced, even mild illness may be critical.
Furthermore, pulses are divided left and right: Left governs Blood, Right governs Qi. Men are Yang, and Yang refers to Qi, so men's pulses should be stronger on the right. Women are Yin, and Yin refers to Blood, so women's pulses should be stronger on the left. If a man's right pulse is harmonious, he is safe even if ill; if a woman's left pulse is harmonious, she is safe even if ill. This is because the positions of the five Zang organs differ: what is on the left in men is on the right in women, and vice versa. The *Su Wen* states: "For men, left is Ni (adverse/unfavorable), right is Cong (favorable); for women, right is Ni, left is Cong." Since the favorable sides differ, the organ associations for the left and right hands must also differ accordingly.
Regarding diagnosing disease via pulse, stating that "a certain pulse belongs to a certain disease" or "a certain disease yields a certain pulse" is superfluous and difficult to rely upon clinically. It is better to simply discuss whether the pulse has Shen (Spirit) or lacks it, and whether it is harmonious/relaxed or not.
For children's pulses, the same method applies. However, children cry and resist, making detailed diagnosis difficult. Using one or two fingers, if the pulse beats four or five times per breath cycle, it is considered harmonious. If it feels faint or rapid and spiritless, combined with severe illness, survival is unlikely. Observing the Tiger's Mouth (web between thumb and index finger) for color changes, or claiming children's pulses beat six or seven times per breath, are all absurd theories. When diagnosing children's pulses, one must know that children breathe rapidly and adjust expectations accordingly.
From this deduction, regardless of age or gender, internal deficiency diseases suit weak pulses, while large/voluminous pulses are contraindicated. Initial exterior contraction diseases suit Yang pulses (floating/rapid), while Yin pulses (deep/slow) are contrainddicated. Other statements in the *Mai Jue* are mostly baseless and unreliable. Those seeking pulse diagnosis methods should verify them in the *Ling Shu*, study them in detail in the *Su Wen*, and integrate them with the differentiation and leveling of pulses discussed herein to grasp the essentials.