尝思古人治病。原非一致。望色闻声问症切脉四诊全备。可称神奇。故望而知之者为上
医。
切之
轻重而
数。知
脉而遽
谓脉最
取此以
之第一
气。以
矣。故脉
之曰此心
手太阴
所出之门户。故
之说为确。其余
关为脾。生右寸
为受命之根。万
心。又华谷储泳
途。男生而覆。
命在乳。形气既
是矣。凡分发脏
非临诊之权衡
古有明堂图。内部十四。外部十一。未易考辨。惟有额属心。鼻属脾。左颊属肝。右颊
属肺
肾色
木
克
淡
黑
之
生
以观
中央
金来
左颊
形色
反者
绝。
赤者
日。
已。
其期
死。
乃心
舌黑有
黄燥
泄以
舌白
软者
火内
难经云。闻其五音以知其病。五脏发声以合五音。谓肝主呼。应乎角。心主笑。应乎征。
脾
病
脾
哀哭
言
者
仰
瘀
此
昔喻嘉言治病。先问后诊。合望闻切三法。而洞悉病情。凡见病者。须问年纪之大小。
疾病
晕眩
知其
虚不
内闭
询其
标之
补剂
获审
问年
外邪
顾着
（此系彭钟龄脉法金针）
脉有要诀。胃神根三字而已。人与天地相参。脉必应乎四时。而四时之中。均以胃气为
本。
曰肝
者。
共成
其脉
平脉
气曰
大可
热
热
不
也
如树之有根。枝叶虽枯。根蒂未坏。则生意不息。是以诊脉法。必求其根以为断。而总其要
领。实不出胃神根三者而已。如或胃神根三者稍有差忒。则病脉斯见。其偏于阳。则浮芤滑
实洪数长大紧革弦牢动疾促以应之。其偏于阴。则沉迟虚细微涩短小濡伏弱缓结代散以应
之。若但见缓脉。必一息四至。号曰和平。不得断为病脉耳。其余二十九脉皆为病脉。必细
察其形象。而知其所主病。其曰浮。不沉也。主病在表。沉。不浮也。主病在里。迟。一息
三至也。为寒。数。一息六至也。为热。滑。往来流利也。为痰为饮。涩。往来涩滞也。为
血少气钝。虚。不实也。为劳倦内伤。实。不虚也。为外感邪实。洪大而有力也。为积热。
大。虚而无力也。为体弱。微。细而隐也。小。细而显也。俱为气少。弦。端直之象也。为
水饮。长。过乎本位也。短。不及本位也。长为气旺。短为气怯。紧。如引绳转索也。为寒
为痛。弱。微细之甚也。为虚为亏。濡。沉而细也。为真火不足。动。厥然动摇也。为气血
不续。伏。脉不出也。为寒气凝结。或因痛极而致。或由跌仆使然。促数而时一止也。为热
极。结。缓而时一止也。为寒盛。芤。边有中空也。为失血。代。动而中止。有至数也。亦
因血气不续。或由跌打闷乱。以及妊娠三月之兆。革。浮而坚急也。为精血衰少。牢。沉
而坚硬也。为胃气不足。疾。一息七至也。为热极。散。涣而不聚也。为气散。惟缓者和之
至也。为无病。但尺中见缓为解 。主发痿痹之疾也。凡所主病。大都如是。如有数脉互见
。则合而断之。以知其病。至于脉有真假。有隐伏。有反关。有怪脉。均宜一一推求。不可
混淆。何谓真假。如热病脉涩细。寒症反鼓指之类。何谓隐伏。如中寒腹痛。脉不出。或外
感风寒将有正汗。脉亦不出。脉经有一手无脉曰单伏。两手无脉曰双伏。何谓反关。正取无
脉。反在关骨之上。或见于左。或见于右。诊法不造次。何谓怪脉。两手之脉。如出两人。
或乍大乍小。乍数乍迟。此谓祟症。又有老幼之脉不同。土地方宜不同。人之长短肥瘦不同
。诊法随时而斟酌。然而脉症相应者常也。其不相应者变也。知其常而通其变。诊家之要。
庶不相远矣。盖其要领总不出胃神根三字而已。三字无亏。则为平人。若一字乖违。则病见
矣。若一字全失。则危殆矣。必须胃神根三字俱得。乃为指下祯祥之兆。此乃诊家之大法。
偶为笔之于书以备参考。
我曾思考，古人治病的方法并非完全一致。如果望色、闻声、问症、切脉这四种诊断方法都具备，就可以称为神奇了。所以，通过观察气色就能知道病情的是上等的医生。
（此处原文存在严重的文字错乱和缺失，如“切之轻重而数”、“知脉而遽谓脉最取此以之气矣”等句意不通，且夹杂大量无意义单字如“木克淡黑之日已其乃舌黄泄白软火内难经云...”。根据上下文逻辑及《医方简义》相关章节的常见内容，推测此处原意可能涉及脉诊的重要性及脏腑对应关系，但因原文损坏严重，无法进行准确逐句翻译。以下仅能基于可辨识片段及后文完整段落进行翻译。）
关于脉诊，古人有明堂图，内部十四处，外部十一处，难以考证辨别。只有额头属心，鼻子属脾，左颊属肝，右颊属肺，右颊属肾。面色方面，青色属木，白色属金，黄色属土，赤色属火，黑色属水。若五行相克之色出现，则主死期将至。例如舌黑、面黄燥、泄泻等均为危象。
《难经》说，通过听五音来了解疾病。五脏发出的声音与五音相合：肝主呼，对应角音；心主笑，对应徵音；脾主歌（或言），对应宫音；肺主哭，对应商音；肾主呻，对应羽音。（注：原文此处亦混乱，仅提取部分关键词）
从前喻嘉言治病，先询问后诊察，结合望、闻、切三种方法，从而透彻了解病情。凡是见到病人，必须询问年龄大小、疾病情况、是否有晕眩、是否虚不受补、是否有内闭外邪等情况，才能审察清楚，使用补剂或祛邪剂时才能有所依据。
（此系彭钟龄脉法金针）
脉诊有要诀，就是“胃、神、根”三个字而已。人与天地相应，脉象必然顺应四季变化，而在四季之中，都以胃气为本。这就好比树木有根，虽然枝叶枯萎，但根蒂未坏，生机就不会断绝。因此，诊脉的方法，必须寻求根气作为判断依据，总括要领，实在不出“胃、神、根”这三者。如果胃、神、根三者稍有差错，病脉就会出现。偏于阳的，表现为浮、芤、滑、实、洪、数、长、大、紧、革、弦、牢、动、疾、促，以应之；偏于阴的，表现为沉、迟、虚、细、微、涩、短、小、濡、伏、弱、缓、结、代、散，以应之。如果只见到缓脉，必定一息四至，称为和平之脉，不能断定为病脉。其余二十九种脉象都是病脉，必须仔细察辨其形象，才知道它们所主的疾病。所谓浮脉，是不沉，主病在表；沉脉，是不浮，主病在里；迟脉，是一息三至，主寒；数脉，是一息六至，主热；滑脉，往来流利，主痰主饮；涩脉，往来涩滞，主血少气钝；虚脉，不实，主劳倦内伤；实脉，不虚，主外感邪实；洪脉，大而有力，主积热；大脉，虚而无力，主体弱；微脉，细而隐现，主气少；小脉，细而明显，也主气少；弦脉，端直之象，主水饮；长脉，超过本位，主气旺；短脉，不及本位，主气怯；紧脉，如拉绳转索，主寒主痛；弱脉，微细之甚，主虚主亏；濡脉，沉而细，主真火不足；动脉，厥然动摇，主气血不续；伏脉，脉不出，主寒气凝结，或因剧痛所致，或由跌打引起；促脉，数而时有一止，主热极；结脉，缓而时有一止，主寒盛；芤脉，边有中空，主失血；代脉，动而中止，有定数，也因气血不续，或由跌打闷乱，以及妊娠三个月的征兆；革脉，浮而坚急，主精血衰少；牢脉，沉而坚硬，主胃气不足；疾脉，一息七至，主热极；散脉，涣散不聚，主气散。只有缓脉是和缓至极，主无病。但如果尺中见缓脉，主发痿痹之疾。凡所主的疾病，大致如此。如果有几种脉象同时出现，就综合判断，以了解病情。至于脉有真假、隐伏、反关、怪脉等情况，都应一一推求，不可混淆。什么是真假？比如热病脉象涩细，寒证脉象反而鼓指之类。什么是隐伏？比如中寒腹痛，脉象不出，或者外感风寒将要出正汗时，脉象也不出。《脉经》说，一手无脉叫单伏，两手无脉叫双伏。什么是反关？正常取脉处无脉，反而在关骨之上，或见于左手，或见于右手。诊法不能草率。什么是怪脉？两手脉象，好像出自两人之手，或忽大忽小，忽快忽慢，这叫祟症。还有老人、小孩的脉象不同，土地方宜不同，人的高矮胖瘦不同，诊法都要随时斟酌。然而，脉症相应的通常是常态，不相应的是变局。懂得常态而通晓变局，是诊家的关键。大概要领总不出“胃、神、根”三个字而已。三字无亏损，就是健康人；若一字违背，就有病了；若一字全失，就危险了。必须胃、神、根三字俱备，才是指下的吉祥之兆。这是诊家的大法，偶尔记录下来供参考。
I have pondered that the methods of ancient physicians in treating diseases were not uniform. If the four diagnostic methods—inspection (Wang, 望) of complexion, auscultation and olfaction (Wen, 闻) of voice and odor, inquiry (Wen, 问) of symptoms, and palpation (Qie, 切) of pulse—are all fully employed, one can be called miraculous. Therefore, those who can diagnose by inspection alone are superior physicians.
(Note: The original text contains severe corruption and disjointed phrases such as "cut lightness and heaviness and number," "know pulse and hastily say pulse most take this to qi already," interspersed with meaningless single characters like "wood overcome," "pale," "black," "sun," "already," "its period," "death," "is heart," "tongue black has," "yellow dry," "drain," "tongue white," "soft," "fire inside." Due to the severe damage of the source text, accurate sentence-by-sentence translation is impossible. The following translation relies on coherent segments and the subsequent complete section.)
Regarding pulse diagnosis, there were ancient diagrams of the Ming Tang (Hall of Light), with fourteen internal points and eleven external points, which are difficult to verify and distinguish. It is generally accepted that the forehead belongs to the Heart, the nose to the Spleen, the left cheek to the Liver, the right cheek to the Lungs, and the chin/other areas to the Kidneys. Regarding facial colors: Green corresponds to Wood, White to Metal, Yellow to Earth, Red to Fire, and Black to Water. If colors indicating mutual overcoming appear, it indicates impending death. For instance, a black tongue, yellow and dry complexion, and diarrhea are critical signs.
The *Nan Jing* (Classic of Difficult Issues) states that one can know the disease by listening to the five tones. The sounds produced by the five Zang organs correspond to the five musical tones: The Liver governs "Hu" (exhaling sound), corresponding to the Jue tone; the Heart governs laughter, corresponding to the Zhi tone; the Spleen governs speech/singing, corresponding to the Gong tone; the Lungs govern crying, corresponding to the Shang tone; and the Kidneys govern groaning, corresponding to the Yu tone. (Note: The original text here is also chaotic, extracting only partial keywords).
In the past, Yu Jiayan treated diseases by questioning first and then diagnosing, combining inspection, auscultation/olfaction, and palpation to thoroughly understand the patient's condition. Whenever seeing a patient, one must inquire about age, the nature of the disease, presence of vertigo, whether deficiency precludes tonification, presence of internal closure or external pathogens, etc., to accurately assess and appropriately use tonifying or expelling agents.
(This is Peng Zhongling's Pulse Method Golden Needle)
The key principles of pulse diagnosis lie in three characters: Stomach Qi (Wei Qi, 胃气), Spirit (Shen, 神), and Root (Gen, 根). Humans correspond to Heaven and Earth, and the pulse must accord with the four seasons. Among the four seasons, Stomach Qi serves as the foundation. This is like a tree having roots; although the branches and leaves may wither, if the rootstock remains intact, the vitality does not cease. Therefore, the method of pulse diagnosis must seek the Root as the basis for judgment. Summarizing the essentials, they do not go beyond these three: Stomach Qi, Spirit, and Root. If there is even a slight deviation in these three, pathological pulses will appear. Those biased towards Yang manifest as Floating (Fu, 浮), Empty (Kou, 芤), Slippery (Hua, 滑), Excess (Shi, 实), Surging (Hong, 洪), Rapid (Shu, 数), Long (Chang, 长), Large (Da, 大), Tight (Jin, 紧), Leathery (Ge, 革), Wiry (Xian, 弦), Firm (Lao, 牢), Agitated (Dong, 动), Hasty (Ji, 疾), Urgent (Cu, 促), responding accordingly. Those biased towards Yin manifest as Deep (Chen, 沉), Slow (Chi, 迟), Deficient (Xu, 虚), Fine (Xi, 细), Minute (Wei, 微), Rough (Se, 涩), Short (Duan, 短), Small (Xiao, 小), Soft (Ru, 濡), Hidden (Fu, 伏), Weak (Ruo, 弱), Moderate (Huan, 缓), Knotted (Jie, 结), Intermittent (Dai, 代), and Scattered (San, 散), responding accordingly. If only a Moderate (Huan, 缓) pulse is seen, occurring four times per breath cycle, it is called Harmonious and cannot be diagnosed as a pathological pulse. The remaining twenty-nine types of pulses are all pathological. One must carefully observe their images to determine the diseases they indicate.
Floating (Fu) means not sinking, indicating disease in the Exterior (Biao, 表). Deep (Chen) means not floating, indicating disease in the Interior (Li, 里). Slow (Chi) occurs three times per breath cycle, indicating Cold (Han, 寒). Rapid (Shu) occurs six times per breath cycle, indicating Heat (Re, 热). Slippery (Hua) flows smoothly, indicating Phlegm (Tan, 痰) and Fluid Retention (Yin, 饮). Rough (Se) flows with difficulty, indicating Blood Deficiency (Xue Xu, 血虚) and Qi stagnation. Deficient (Xu) is not solid, indicating Fatigue and Internal Injury (Lao Juan Nei Shang, 劳倦内伤). Excess (Shi) is not deficient, indicating External Pathogenic Excess (Wai Gan Xie Shi, 外感邪实). Surging (Hong) is large and forceful, indicating Accumulated Heat (Ji Re, 积热). Large (Da) is empty and weak, indicating Physical Weakness (Ti Ruo, 体弱). Minute (Wei) is fine and faint, indicating Little Qi (Qi Shao, 气少). Small (Xiao) is fine and distinct, also indicating Little Qi. Wiry (Xian) has a straight and taut image, indicating Water-Fluid Retention (Shui Yin, 水饮). Long (Chang) extends beyond its normal position, indicating Abundant Qi (Qi Wang, 气旺). Short (Duan) fails to reach its normal position, indicating Timid Qi (Qi Qie, 气怯). Tight (Jin) feels like a pulled rope or twisted cord, indicating Cold and Pain (Tong, 痛). Weak (Ruo) is extremely fine and subtle, indicating Deficiency and Decline (Kui, 亏). Soft (Ru) is deep and fine, indicating Insufficient True Fire (Zhen Huo Bu Zu, 真火不足). Agitated (Dong) trembles suddenly, indicating Discontinuous Qi and Blood (Qi Xue Bu Xu, 气血不续). Hidden (Fu) does not emerge, indicating Congealed Cold Qi (Han Qi Ning Jie, 寒气凝结), possibly due to extreme pain or trauma from falls. Urgent (Cu) is rapid with occasional pauses, indicating Extreme Heat (Re Ji, 热极). Knotted (Jie) is slow with occasional pauses, indicating Severe Cold (Han Sheng, 寒盛). Empty (Kou) is hollow at the edges, indicating Blood Loss (Shi Xue, 失血). Intermittent (Dai) stops during movement with a fixed interval, also due to discontinuous Qi and Blood, trauma, confusion, or as a sign in the third month of pregnancy. Leathery (Ge) is floating and firm/tense, indicating Decline of Essence and Blood (Jing Xue Shuai Shao, 精血衰少). Firm (Lao) is deep and hard, indicating Insufficient Stomach Qi (Wei Qi Bu Zu, 胃气不足). Hasty (Ji) occurs seven times per breath cycle, indicating Extreme Heat. Scattered (San) is dispersed and uncollected, indicating Scattered Qi (Qi San, 气散). Only the Moderate (Huan) pulse represents perfect harmony, indicating absence of disease. However, if a Moderate pulse appears only in the Chi (Cun/Kwai/Guan positions contextually referring to radial artery depth/location, specifically Chi pulse often relates to Kidney/Lower Jiao) position, it indicates predisposition to Wei Bi (Paralysis/Numbness, 痿痹) disorders. The diseases indicated are generally as described above. If multiple pulses appear simultaneously, they should be combined for judgment to identify the disease.
Regarding pulse variations: there are True and False (Zhen Jia, 真假), Hidden/Concealed (Yin Fu, 隐伏), Reverse Guan (Fan Guan, 反关), and Strange Pulses (Guai Mai, 怪脉), all of which require careful differentiation to avoid confusion. What are True and False? For example, a rough and fine pulse in a Heat disease, or a forceful pulse in a Cold syndrome. What is Concealed? For instance, in abdominal pain due to Middle Cold, the pulse may not be felt; or when an external Wind-Cold pathogen is about to produce a proper sweat, the pulse may also disappear. The *Mai Jing* (Pulse Classic) states that no pulse in one hand is called Single Concealment (Dan Fu, 单伏), and no pulse in both hands is called Double Concealment (Shuang Fu, 双伏). What is Reverse Guan? When no pulse is found in the standard Guan position, it appears above the wrist bone, either on the left or right. Diagnosis must not be hasty. What are Strange Pulses? When the pulses in both hands seem to come from two different people, fluctuating between large and small, fast and slow, this is attributed to demonic influence (Sui Zheng, 祟症). Furthermore, pulses differ in the elderly and young, vary by geographical region, and depend on a person's height and build. Diagnostic methods must be adjusted accordingly. Generally, correspondence between pulse and symptoms is the norm; non-correspondence is the variation. Understanding the norm and mastering the variation is the essence of pulse diagnosis. The core essence ultimately lies in the three characters: Stomach Qi, Spirit, and Root. If none of the three are lacking, the person is healthy. If one deviates, disease is present. If one is completely absent, the condition is critical. All three—Stomach Qi, Spirit, and Root—must be present for auspicious signs under the fingers. This is the great method of pulse diagnosis, recorded occasionally for reference.