者、独小者、独疾者、独迟者、独寒者、独热者、独陷下者，皆病之所在也。独寒、独热，谓其或在上，或
在下，或在表，或在里也。陷下，沉伏不起也。此难以三部九候为言，而于气口部位类推为用。）
诊有十度∶度人脉度，脏度，肉度，筋度，俞度。（十度，谓脉、脏、肉、筋、俞五度，左右各一，二五为
十也。度人之度，音铎。）阴阳气尽，人病自具。（凡此十度者，人身阴阳之理尽之矣。故人之
疾病，亦无不具见于此。）脉动无常，散阴颇阳，脉脱不具，诊无常行。（脉动无常，言脉无常体也。散
阴颇阳，言阴气散失者脉颇类阳也。浮大者，气实血虚也。脉浮无根者死，有表无里者死。真阴散而孤阳在，
脉颇似阳而无根者，非真阳之脉也，此其脉有所脉而阴阳不全具矣。诊此者，有不可以阴阳之常法行也。）诊
必上下，度民君卿。（贵贱、尊卑，劳逸有异；膏粱、藜藿，气质不同，故当度民君卿，分别上下以为诊。）
受师卒术不察逆从，弃阴附阳，诊故不明。（卒，尽也。阴阳离决，精神乃绝。故凡善诊者，见其阴必察
其阳，见其阳必察其阴，使不知阴阳逆从之理，诊焉得明？）至阴虚，天气绝，至阳盛，地气不足。
（至阴、至阳，即天地之道也。至阴虚者，地气衰而不升，不升则无以降，故天气绝。至阳盛者，天气亢而不
降，不降则无以升，故地气不足。盖阴阳二气，互藏其根，更相为用，不可偏废。此借天地自然之道，以喻
人之阴阳贵和也。）阴阳并交，至人之所行。（并交者，阴阳不相失而得其和平也。此其调摄之妙，惟至
人者乃能行之。）阴阳并交者，阳气先至，阴气后至，是以持诊之道，先后阴阳而持之。（凡阴阳之道，阳
动阴静，阳刚阴柔，阳倡阴随，阳施阴受，阳升阴降，阳前阴后，阳上阴下，阳左阴右，数者为阳，迟
者为阴，表者为阳，里者为阴，至者为阳，
去者为阴，进者为阳，退者为阴，发生者为阳，收藏者为阴，阳之行速，阴之行迟，故阴阳并交者，必阳先至
而阴后至，是以持诊者在察阴阳先后，以测其精要也。）奇恒之势，乃六十首。诊合微之事，追阴
阳之变，章五中之情，取虚实之要，定五度之事，知此乃足以诊。（奇，异也。恒，常也。六十首，即所谓《九
针》六十篇之义，今失其传矣。诊合微之事者，参诸诊之法而合其精微也。追阴阳之变者，求阴
阳盛衰之变也。章，明也。五中，五脏也。五度，即前十度也。会此数者，参伍其妙，斯足以言诊矣。）
是以切阴不得阳，诊消亡，得阳不得阴，守学不湛，知左不知右，知右不知左，知上不知下，
知先不知后，故治不久。（切阴不得阳，诊消亡者，言但知有阴阳而不知阴阳互根、互用之义，及阴平阳秘之
道者也。湛，明也。偏守其学，终属不明。左右、上下、先后，皆阴阳之道也。使不知左右，则不明升降
之理；不知上下，则不明清浊之宜；不知先后，则不知缓急之用，安望能治，治而能久哉？）知丑知善，知
病知不病，知高知下，知坐知起，知行知止，用之有纪，诊道乃具，万世不殆。（凡此数者，皆有对待之理，
若差之毫厘，则谬以千里。故凡病之善恶，形之动静，皆所当辨。能明此义，而用之有纪，诊道斯备，故可
万世无殆矣。纪，条理也。殆，危也。）起所有余，知所不足。（起，兴起也。言将治其有余，
当察其不足。盖邪气多有余，正气多不足。若只知有余而忘其不足，则取败之道也。此示人以根本当慎之意。）
度事上下，脉事因格。（能度形情之高下，则脉事因之可格致而知也。）是以形弱气虚死；（中外俱败
也。）形气有余、脉气不足死；（外貌无恙，脏气已坏也。）脉气有余、形气不足生。（脏气未伤者形衰无
害，盖以根本为主也，形肉已脱九候虽调犹死，盖脱与不足本自不同，而形肉既脱，脾元绝矣，故脉气虽调亦
所不治。与此互求，其义更明。）是以诊有大方，坐起有常。（大方者，大法也。坐起有常则举动不苟，
而先正其身，身正于外，心必随之，故诊
之大方必先乎此。）出入有行，以转神明。（行，德行也。医以活人为心，其于出入之时，念念皆真，无一不
敬，则德能动天，诚能格心，故可以转运周旋而无往弗神矣。行，去声。）必清必净，上观下观。（必清必
净则心专志一而神明见，然后上观之以察其神、色、声、音，下观之以察其形、体、逆、顺。）司八正邪，别
五中部。（司，候也。别，审也。候八节、八风之正邪以察其表，审五脏、五形之部位以察其里。）按脉动
静，循尺滑涩寒温之意。（按脉动静，可别阴阳，滑涩寒温，可知虚实。凡脉滑则尺之皮肤亦滑，脉涩则尺
之皮肤亦涩，脉寒则尺之皮肤亦寒，脉温则尺之皮肤亦温，故循尺即可以知之。循，揣摩也。）视其大
小，合之病能。（大小，二便也。二便为约束之门户，门户不要则仓廪不藏，得守者生，失守者死，故视
其大小以合病能。能，情状之谓。）逆从以得，复知病名。（反者为逆，顺者为从。必得逆从，必知病名，
庶有定见而无差谬。）诊可十全，不失人情。（诊如上法，庶可十全，其于人情尤不可失也。）视息视意，
不失调理。（视息者，察呼吸以观其气，视意者，察形色以观其情，故能不失调理。）不知此道，失经绝理。
亡言妄期，此谓失道。（不知此道则亡言妄期，未有不殆者矣。）万物之外，六合之内，天地之变，阴阳
之应。彼春之暖，为夏之暑，彼秋之忿，为冬之怒。四变之动，脉与之上下。（物在天中，天包物外，天地
万物，本同一气。凡天地之变，即阴阳之应，故春之暖为夏暑之渐也，秋之忿为冬怒之渐也。春生夏长，秋
收冬藏，是即阴阳四变之动，而脉亦随之以上下也。）以春应中规，（规者，所以为圆之器。
春气发生，圆活而动，故应中规，而人脉应之，所以圆活也。）夏应中矩，（矩者，所以为方之器。夏气茂
盛，盛极而止，故应中矩，而人脉应之，所以洪大方正也。）秋应中衡，（衡，平也。秋气万宝俱成平于地
面，故应中衡，而人脉应之，所以浮毛而见于外也。）冬应中权。（权，秤锤也。冬气闭藏，故应中权，
而人脉应之，所以沉石而伏于内也。凡兹规矩权衡
者，皆发明阴阳升降之理，以合乎四时脉气之变象也。）是故冬至四十五日，阳气微上，阴气微下；夏至四十
五日，阴气微上，阳气微下。阴阳有时，与脉为期。期而相失，如脉所分。分之有期，故知死时。（冬至一
阳生，故冬至后四十五日以至立春，阳气以渐而微上，阳微上则阴微下矣。夏至一阴生，故夏至后四十五日以
至立秋，阴气以渐而微上，阴微上则阳微下矣。此所谓阴阳有时也。与脉为期者，脉随时而变迁也。期而相
失者，谓春规、夏矩、秋衡、冬权不合于度也。如脉所分者，谓五脏之脉各有所属也。分之有期者，谓衰王
各有其时也。知此者，则必知死生之时矣。）微妙在脉，不可不察。察之有纪，从阴阳始。始之有经，从五
行生。生之有度，四时为宜。（脉之微妙，亦惟阴阳五行为之经纪，而阴阳五行之生各有其度∶如阳生于
冬至，阴生于夏至，木生于亥，火生于寅，金生于巳，水土生于申，此四时生王各有其宜也。纪，纲纪也。
经，经常也。即大纲、小纪之义。）补泻勿失，与天地如一。（天地之道，损有余而补不足。补泻不失其宜，
则与天地之道如一矣。）得一之精，以知死生。（一之精者，天人一理之精微也。天地之道，阳主乎动，阴
主乎静，阳来则生，阳去则死，知天道之所以不息者，则知人之所以死生矣。）所以声合五音，色合五
行，脉合阴阳。（声合宫商角征羽，色合金木水火土，脉合四时阴阳，虽三者若乎有分，而理则一也。）
持脉有道，虚静为保。（凡持脉之道，一念精诚，最嫌扰乱。虚心静志，纤微无间，诊道全矣。保，不失也。）
春日浮，如鱼之游在波。（脉得春气，虽浮动而未全出，故如鱼之游在波也。）夏日在肤，泛泛乎万物有余。（
脉得夏气，则洪盛于外，故泛泛乎如万物之有余也。）秋日下肤，蛰虫将去。（脉得秋气，则洪盛
渐敛，故如欲蛰之虫将去也。）冬日在骨，蛰虫周密，君子居室。（脉得冬气，沉伏在骨，故如蛰虫之周密，
君子之于斯时，亦当体天地闭藏之道，而居于室也。）故知内者按而纪之，知外者终而始之。此
六者，持脉之大法。（“内”言脏气，脏象有位，故可按而纪之；“外”言经气，经脉有序，故可终而始之。
此四时、内外六者之法。）春脉如弦。春脉者肝也，东方木也，万物之所以始生也。故其气来 弱
轻虚而滑，端直以长，故曰弦。反此者病。（弦者，端直以长，状如弓弦有力也，然 弱轻虚而滑，则弦中
自有和意，肝脏主之。）何如而反？其气来实而强，此谓太过，病在外；其气来不实而微，
此谓不及，病在中。（其气来实而强，弦之过也；其气来不实而微，弦之不及也。皆谓弦脉之反。太过者病
在外，不及者病在中。盖外病多有余，内病多不足也。）太过则令人善忘，忽忽眩冒而巅疾；其不
及，则令人胸痛引背，下则两胁 满。（忘，当作怒。肝气虚则恐，实则怒。忽忽，恍忽不爽也。冒，闷昧
也。巅疾，疾在巅顶也。足厥阴之脉，会于巅上，贯膈，布胁肋，故其为病如此。 ，音区，腋下胁也。）
夏脉钩。夏脉者心也，南方火也，万物之所以盛长也。故其气来盛去衰，故曰钩。反此者病。（钩者，举指来
盛，去势似衰，盖脉盛于外，而去则无力，阳之盛也，心脏主之。）何如而反？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。（其气来盛去亦盛，钩之过也；其来不盛去反盛，钩之不
及也，皆为钩脉之反。去反盛者，非强盛之谓。凡脉自骨肉之分，出于皮肤之际谓之来；自皮肤之际还于骨
肉之分，谓之去。来不盛去反盛者，言来则不足，去则有余，即消多长少之意。故扁鹊于春肝、夏心、秋肺、
冬肾，皆以实强为太过，病在外，虚微为不及，病在内。辞虽异而意则同也。）太过则令人身热而肤痛，为
浸淫；其不及则令人烦心，上见咳唾，下为气泄。（夏脉太过，则阳有余而病在外，故令人身热肤痛而
浸淫流布于形体；不及则君火衰而病在内，故上为心气不足而烦心，虚阳侵肺而咳唾，下为不固而气泄，
以本经脉起心中，出属心系，下膈，络小肠，又从心系却上肺故也。）秋脉如浮。秋脉者肺也，西方金也，
万物之所以收成也。故其气来轻虚以浮，来急去散，故曰浮。反此者病。（浮者，轻虚之谓。来急去散者，
以秋时阳气尚在皮毛也。肺脏主之。）何如而反？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。（中央坚，浮而中坚也。凡浮而太过，浮而不及，皆浮之反，
而病之在外在内，义与前同。）太过则令人逆气，而背痛愠愠然；其不及则令人喘，呼吸少
气而咳，上气见血，下闻病音。（肺脉起中焦，下络大肠，还循胃口，上膈属肺，其脏附背，故太过则逆气
为壅而背痛见于外。愠愠，悲郁貌。其不及则喘咳短气；气不归原，所以上气；阴虚内损，所以见血。下
闻病音，谓喘息则喉下有声也。）冬脉如营。冬脉者肾也，北方水也，万物之所以合藏也。故其气来沉以搏，
故曰营。反此者病。（营者，营垒之谓，如士卒之团聚不散，亦沉石之义也，肾脏主之。）
何如而反？其气来如弹石者，此谓太过，病在外；其去如数者，此谓不及，病在中。（来如弹石者，其志
至强，营之太过也；其去如数者，动止疾促，营之不及也。盖数本属热，而此真阴亏损之脉，亦
必紧数，然愈虚则愈数，原非阳强实热之数，故云“如数”，则辨析之意深矣。此而一差，祸如反掌也。太
过，病在外；不及，病在中。）太过则令人解 ，脊脉痛而少气，不欲言，其不及则令人心悬如病饥，
中清，脊中痛，少腹满、小便变。（冬脉太过，阴邪胜也。阴邪胜则肾气伤，真阳虚，故令人四体懈怠，
举动不精，是谓解 。脊痛者，肾脉之所至也。肾藏精，精伤则无气，故少气不欲言，皆病之在外也。其
不及则真阴虚，虚则心肾不交，故令人心悬而怯，如病饥也。季胁下空软之处曰 中，肾之旁也。肾脉
贯脊属肾，络膀胱，故为脊痛、腹满、小便变等病。变者，谓或黄，或赤，或为遗淋，或为癃闭之类，由
肾水不足而然，是皆病之在中也。 ，音迹。）脾脉者土也，孤脏以灌四旁者也。（脾属土，土为万物
之本，故营运水谷，化津液，以灌溉于肝、心、
肺、肾之四脏者也。土无定位，分王四季，故称为孤脏。）善者不可得见，恶者可见。（脾无病则灌溉周而
四脏安，不知脾力之何有，故善者不可得见；脾病则四脏亦随而病，故恶候见矣。）其来如水之流者，此谓
那些脉象独小、独大、独快、独慢、独寒、独热、独陷下（沉伏不起）的，都是疾病所在的地方。所谓独寒、独热，是指病气或在上部，或在下部，或在体表，或在体内。陷下，指脉搏沉伏不起。这种情况难以用三部九候来阐述，而应在气口部位进行类推应用。）
诊法有十度：度量人的脉度、脏度、肉度、筋度、俞度。（十度，是指脉、脏、肉、筋、俞这五度，左右各一，二五相乘为十。度人的“度”，读音同“铎”。）阴阳之气耗尽，人的病症自然显现。（凡是这十度，涵盖了人身阴阳的道理。所以人的疾病，无不在此中体现。）脉动没有常规，阴气散失则脉象颇似阳脉，脉气脱失则无法具备正常的脉象特征，诊法也就没有固定的行径。（脉动无常，是说脉象没有固定的形态。散阴颇阳，是说阴气散失时脉象颇类似阳脉。浮大的脉象，是气实血虚的表现。脉浮无根者死，有表无里者死。真阴散失而孤阳独存，脉象颇似阳脉却无根，这不是真正的阳脉，这是脉象有所偏颇而阴阳不全。诊断这种情况，不能按照阴阳的常规方法来进行。）
诊察必须上下兼顾，衡量百姓与贵贱的不同。（地位贵贱、尊卑不同，劳逸各异；饮食膏粱厚味或藜藿淡食不同，体质气质也不同，因此应当衡量民众与君卿的差异，分别上下以进行诊察。）如果师从老师学习医术却不考察逆从之理，抛弃阴而依附阳，诊察自然就不明白。（卒，意为尽。阴阳离决，精神就会断绝。所以善于诊察的人，见到阴必察其阳，见到阳必察其阴，如果不了解阴阳逆从的道理，诊察怎么能明辨呢？）至阴虚弱，天气就断绝；至阳亢盛，地气就不足。（至阴、至阳，即天地的道理。至阴虚，是指地气衰败而不能上升，不升则无法下降，所以天气断绝。至阳盛，是指天气亢奋而不能下降，不降则无法上升，所以地气不足。大概阴阳二气，互藏其根，互相为用，不可偏废。这是借用天地自然的道理，来比喻人的阴阳贵在和谐。）阴阳并交，是至人（修养极高的人）所践行的。（并交，是指阴阳不相失而获得和平。这种调摄的妙处，只有至人才能实行。）
阴阳并交，阳气先至，阴气后至，因此掌握诊察之道，要先后阴阳来把握它。（凡阴阳之道，阳动阴静，阳刚阴柔，阳倡阴随，阳施阴受，阳升阴降，阳前阴后，阳上阴下，阳左阴右，数为阳，迟为阴，表为阳，里为阴，至为阳，去为阴，进为阳，退为阴，发生者为阳，收藏者为阴，阳的行进速度快，阴的行进速度慢，所以阴阳并交时，必定是阳先到而阴后到，因此掌握诊察的人在观察阴阳的先后，以推测其精要。）奇恒之势，共有六十首（篇）。诊察结合细微之事，追踪阴阳的变化，彰显五脏的情状，取虚实的关键，确定五度的事务，懂得这些就足以进行诊察了。（奇，异也。恒，常也。六十首，即《九针》六十篇的含义，现在已失传。诊合微之事，是参合诊法而结合其精微之处。追阴阳之变，是求索阴阳盛衰的变化。章，明也。五中，指五脏。五度，即前十度。领会这些数者，参伍其妙，才足以谈论诊察。）
因此，切按阴脉却不得阳脉，诊察就会消亡；得到阳脉却不得阴脉，守持学问就不深湛；知左不知右，知右不知左，知上不知下，知先不知后，所以治疗就不能持久。（切阴不得阳，诊消亡，是说只知道有阴阳而不知道阴阳互根、互用的意义，以及阴平阳秘的道理。湛，明也。偏守其学，终究属于不明。左右、上下、先后，都是阴阳的道理。如果不了解左右，就不明白升降的道理；不了解上下，就不明白清浊的适宜；不了解先后，就不知道缓急的用处，怎能指望能治疗，治疗又能持久呢？）知道丑与善，知道病与不病，知道高与下，知道坐与起，知道行与止，运用有条理，诊道才算完备，万世不危。（凡这些数者，都有对待的道理，如果差之毫厘，就会谬以千里。所以凡是病的善恶，形的动静，都应当辨别。能明白这个道理，并且运用有条理，诊道就具备了，所以可以万世无危。纪，条理也。殆，危也。）兴起有余，知道所不足。（起，兴起也。说要治疗其有余，应当察知其不足。大概邪气多有余，正气多不足。如果只知道有余而忘记其不足，就是导致失败的道路。这是提示人们根本应当谨慎的意思。）
衡量事情上下，脉事因此可以格致。（能衡量形情的高下，那么脉事就可以通过格物致知来了解了。）因此，形弱气虚者死；（内外俱败。）形气有余、脉气不足者死；（外貌无恙，脏气已坏。）脉气有余、形气不足者生。（脏气未伤者，形衰无害，因为以根本为主。形肉已脱，即使九候脉象调和也死，因为脱与不足本来不同，而形肉既脱，脾元绝矣，所以脉气虽调也不治。与此互求，其义更明。）
因此诊察有大法，坐起有常规。（大方，是大法。坐起有常规则举动不苟，先端正自身，身正于外，心必随之，所以诊察的大法必先于此。）出入有德行，以转运神明。（行，德行也。医生以活人为心，其在出入之时，念念皆真，无一不敬，则德能动天，诚能格心，所以可以转运周旋而无往不神。行，去声。）必须清静，上观下观。（必须清静则心专志一而神明显现，然后上观以察其神、色、声、音，下观以察其形、体、逆、顺。）司察八正邪，辨别五中部。（司，候也。别，审也。候八节、八风之正邪以察其表，审五脏、五形之部位以察其里。）按脉动静，循尺滑涩寒温之意。（按脉动静，可别阴阳，滑涩寒温，可知虚实。凡脉滑则尺肤亦滑，脉涩则尺肤亦涩，脉寒则尺肤亦寒，脉温则尺肤亦温，所以循尺即可知之。循，揣摩也。）视其大小，合之病能。（大小，指二便。二便是约束的门户，门户不固则仓廪不藏，得守者生，失守者死，所以视其大小以合病能。能，情状之谓。）逆从得以明确，再知道病名。（反者为逆，顺者为从。必得逆从，必知病名，才有定见而无差谬。）诊察可十全，不失人情。（诊察如上法，庶可十全，对于人情尤其不可失。）视息视意，不失调理。（视息，是察呼吸以观其气；视意，是察形色以观其情，所以能不失调理。）
不知此道，失经绝理。亡言妄期，此谓失道。（不知此道则亡言妄期，未有不危的。）万物之外，六合之内，天地之变，阴阳之应。那春天的暖，成为夏天的暑；那秋天的忿，成为冬天的怒。四时的变动，脉象随之上下。（物在天中，天包物外，天地万物，本同一气。凡天地之变，即阴阳之应，所以春之暖为夏暑之渐，秋之忿为冬怒之渐。春生夏长，秋收冬藏，这就是阴阳四变之动，而脉象也随之上下。）以春应中规，（规，是画圆的器具。春气发生，圆活而动，所以应中规，人脉应之，所以圆活。）夏应中矩，（矩，是画方的器具。夏气茂盛，盛极而止，所以应中矩，人脉应之，所以洪大方正。）秋应中衡，（衡，平也。秋气万宝俱成平于地面，所以应中衡，人脉应之，所以浮毛而见于外。）冬应中权。（权，秤锤也。冬气闭藏，所以应中权，人脉应之，所以沉石而伏于内。凡此规矩权衡，都是发明阴阳升降的道理，以合乎四时脉气之变象。）
因此冬至后四十五日，阳气微上，阴气微下；夏至后四十五日，阴气微上，阳气微下。阴阳有时，与脉为期。期而相失，如脉所分。分之有期，故知死时。（冬至一阳生，所以冬至后四十五日至立春，阳气以渐而微上，阳微上则阴微下。夏至一阴生，所以夏至后四十五日至立秋，阴气以渐而微上，阴微上则阳微下。这就是所谓的阴阳有时。与脉为期，是脉随时而变迁。期而相失，是说春规、夏矩、秋衡、冬权不合于度。如脉所分，是说五脏之脉各有所属。分之有期，是说衰王各有其时。懂这些，就知道死生之时了。）
微妙在脉，不可不察。察之有纪，从阴阳始。始之有经，从五行生。生之有度，四时为宜。（脉之微妙，亦惟阴阳五行为之经纪，而阴阳五行之生各有其度：如阳生于冬至，阴生于夏至，木生于亥，火生于寅，金生于巳，水土生于申，这四时生王各有其宜。纪，纲纪也。经，经常也。即大纲、小纪之义。）补泻勿失，与天地如一。（天地之道，损有余而补不足。补泻不失其宜，则与天地之道如一矣。）得一之精，以知死生。（一之精者，天人一理之精微也。天地之道，阳主乎动，阴主乎静，阳来则生，阳去则死，知天道之所以不息者，则知人之所以死生矣。）所以声合五音，色合五行，脉合阴阳。（声合宫商角征羽，色合金木水火土，脉合四时阴阳，虽三者若乎有分，而理则一也。）
持脉有道，虚静为保。（凡持脉之道，一念精诚，最嫌扰乱。虚心静志，纤微无间，诊道全矣。保，不失也。）春日浮，如鱼之游在波。（脉得春气，虽浮动而未全出，故如鱼之游在波也。）夏日在肤，泛泛乎万物有余。（脉得夏气，则洪盛于外，故泛泛乎如万物之有余也。）秋日下肤，蛰虫将去。（脉得秋气，则洪盛渐敛，故如欲蛰之虫将去也。）冬日在骨，蛰虫周密，君子居室。（脉得冬气，沉伏在骨，故如蛰虫之周密，君子之于斯时，亦当体天地闭藏之道，而居于室也。）故知内者按而纪之，知外者终而始之。此六者，持脉之大法。（“内”言脏气，脏象有位，故可按而纪之；“外”言经气，经脉有序，故可终而始之。此四时、内外六者之法。）
春脉如弦。春脉者肝也，东方木也，万物之所以始生也。故其气来弱轻虚而滑，端直以长，故曰弦。反此者病。（弦者，端直以长，状如弓弦有力也，然弱轻虚而滑，则弦中自有和意，肝脏主之。）何如而反？其气来实而强，此谓太过，病在外；其气来不实而微，此谓不及，病在中。（其气来实而强，弦之过也；其气来不实而微，弦之不及也。皆谓弦脉之反。太过者病在外，不及者病在中。盖外病多有余，内病多不足也。）太过则令人善忘，忽忽眩冒而巅疾；其不及，则令人胸痛引背，下则两胁满。（忘，当作怒。肝气虚则恐，实则怒。忽忽，恍忽不爽也。冒，闷昧也。巅疾，疾在巅顶也。足厥阴之脉，会于巅上，贯膈，布胁肋，故其为病如此。 ，音区，腋下胁也。）
夏脉钩。夏脉者心也，南方火也，万物之所以盛长也。故其气来盛去衰，故曰钩。反此者病。（钩者，举指来盛，去势似衰，盖脉盛于外，而去则无力，阳之盛也，心脏主之。）何如而反？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。（其气来盛去亦盛，钩之过也；其来不盛去反盛，钩之不及也，皆为钩脉之反。去反盛者，非强盛之谓。凡脉自骨肉之分，出于皮肤之际谓之来；自皮肤之际还于骨肉之分，谓之去。来不盛去反盛者，言来则不足，去则有余，即消多长少之意。故扁鹊于春肝、夏心、秋肺、冬肾，皆以实强为太过，病在外，虚微为不及，病在内。辞虽异而意则同也。）太过则令人身热而肤痛，为浸淫；其不及则令人烦心，上见咳唾，下为气泄。（夏脉太过，则阳有余而病在外，故令人身热肤痛而浸淫流布于形体；不及则君火衰而病在内，故上为心气不足而烦心，虚阳侵肺而咳唾，下为不固而气泄，以本经脉起心中，出属心系，下膈，络小肠，又从心系却上肺故也。）
秋脉如浮。秋脉者肺也，西方金也，万物之所以收成也。故其气来轻虚以浮，来急去散，故曰浮。反此者病。（浮者，轻虚之谓。来急去散者，以秋时阳气尚在皮毛也。肺脏主之。）何如而反？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。（中央坚，浮而中坚也。凡浮而太过，浮而不及，皆浮之反，而病之在外在内，义与前同。）太过则令人逆气，而背痛愠愠然；其不及则令人喘，呼吸少气而咳，上气见血，下闻病音。（肺脉起中焦，下络大肠，还循胃口，上膈属肺，其脏附背，故太过则逆气为壅而背痛见于外。愠愠，悲郁貌。其不及则喘咳短气；气不归原，所以上气；阴虚内损，所以见血。下闻病音，谓喘息则喉下有声也。）
冬脉如营。冬脉者肾也，北方水也，万物之所以合藏也。故其气来沉以搏，故曰营。反此者病。（营者，营垒之谓，如士卒之团聚不散，亦沉石之义也，肾脏主之。）何如而反？其气来如弹石者，此谓太过，病在外；其去如数者，此谓不及，病在中。（来如弹石者，其志至强，营之太过也；其去如数者，动止疾促，营之不及也。盖数本属热，而此真阴亏损之脉，亦必紧数，然愈虚则愈数，原非阳强实热之数，故云“如数”，则辨析之意深矣。此而一差，祸如反掌也。太过，病在外；不及，病在中。）太过则令人解 ，脊脉痛而少气，不欲言，其不及则令人心悬如病饥，中清，脊中痛，少腹满、小便变。（冬脉太过，阴邪胜也。阴邪胜则肾气伤，真阳虚，故令人四体懈怠，举动不精，是谓解 。脊痛者，肾脉之所至也。肾藏精，精伤则无气，故少气不欲言，皆病之在外也。其不及则真阴虚，虚则心肾不交，故令人心悬而怯，如病饥也。季胁下空软之处曰 中，肾之旁也。肾脉贯脊属肾，络膀胱，故为脊痛、腹满、小便变等病。变者，谓或黄，或赤，或为遗淋，或为癃闭之类，由肾水不足而然，是皆病之在中也。 ，音迹。）
脾脉者土也，孤脏以灌四旁者也。（脾属土，土为万物之本，故营运水谷，化津液，以灌溉于肝、心、肺、肾之四脏者也。土无定位，分王四季，故称为孤脏。）善者不可得见，恶者可见。（脾无病则灌溉周而四脏安，不知脾力之何有，故善者不可得见；脾病则四脏亦随而病，故恶候见矣。）其来如水之流者，此谓
Those pulse qualities that are exclusively small, exclusively rapid, exclusively slow, exclusively cold, exclusively hot, or exclusively sunken (sinking and unrising), all indicate the location of disease. "Exclusively cold" and "exclusively hot" refer to pathogenic qi being either in the upper part, lower part, exterior, or interior. "Sunken" refers to the pulse sinking and failing to rise. This situation is difficult to explain using the Three Regions and Nine Locations method, so it should be applied by analogy at the Qi Kou (radial artery) position.)
There are ten measures for diagnosis: measuring the pulse measure, organ measure, flesh measure, tendon measure, and acupoint measure. (The ten measures refer to the five measures of pulse, organs, flesh, tendons, and acupoints, one on each side, two times five equals ten. The character "duo" in "measuring people" is pronounced like "duo".) When Yin and Yang qi are exhausted, the person's diseases will naturally manifest. (All these ten measures encompass the principles of Yin and Yang in the human body. Therefore, human diseases are all reflected herein.) Pulse movement has no constant form; when Yin qi scatters, the pulse resembles Yang; when pulse qi escapes, normal pulse characteristics cannot be maintained, and diagnostic methods lose their fixed course. ("Pulse movement has no constant form" means the pulse has no fixed morphology. "Scattering Yin resembles Yang" means when Yin qi scatters, the pulse resembles Yang. A floating and large pulse indicates excess Qi and deficient Blood. A floating pulse without root indicates death; having exterior but lacking interior indicates death. When True Yin scatters and solitary Yang remains, the pulse resembles Yang but lacks root; this is not a true Yang pulse. This indicates the pulse is biased and Yin-Yang are incomplete. Diagnosing this requires deviating from the standard methods of Yin and Yang.")
Diagnosis must consider both upper and lower, and assess the differences between commoners and nobles. (Status, seniority, work-rest patterns differ; diets of rich foods versus coarse grains differ in constitution and temperament. Therefore, one must assess the differences between people and rulers, distinguishing upper and lower levels for diagnosis.) If one learns medicine from a teacher but fails to investigate the principles of reversal and compliance, abandoning Yin to follow Yang, diagnosis will inevitably remain unclear. ("Zu" means complete. When Yin and Yang separate and resolve, spirit perishes. Thus, a skilled diagnostician, upon observing Yin, must examine Yang, and upon observing Yang, must examine Yin. Without understanding the principles of Yin-Yang reversal and compliance, how can diagnosis be clear?) Extreme Yin deficiency leads to the severance of Heaven Qi; extreme Yang excess leads to insufficiency of Earth Qi. ("Extreme Yin" and "Extreme Yang" refer to the Dao of Heaven and Earth. Extreme Yin deficiency means Earth Qi declines and fails to ascend; without ascending, it cannot descend, thus Heaven Qi is severed. Extreme Yang excess means Heaven Qi becomes hyperactive and fails to descend; without descending, it cannot ascend, thus Earth Qi is insufficient. Yin and Yang Qi hide roots within each other and utilize each other; neither can be neglected. This borrows the natural Dao of Heaven and Earth to illustrate that human Yin and Yang value harmony.) Yin and Yang interacting together is practiced by the Perfect Person. ("Interacting together" means Yin and Yang do not lose each other and achieve peace. This subtle regulation can only be practiced by the Perfect Person.)
When Yin and Yang interact together, Yang arrives first, and Yin arrives later. Therefore, mastering the Dao of diagnosis involves holding to Yin and Yang in their sequence. (In the Dao of Yin and Yang: Yang moves, Yin is still; Yang is firm, Yin is soft; Yang initiates, Yin follows; Yang acts, Yin receives; Yang ascends, Yin descends; Yang precedes, Yin follows; Yang is above, Yin is below; Yang is left, Yin is right; number is Yang, slowness is Yin; exterior is Yang, interior is Yin; arrival is Yang, departure is Yin; advancement is Yang, retreat is Yin; generation is Yang, storage is Yin. Yang moves fast, Yin moves slow. Thus, when Yin and Yang interact, Yang arrives first and Yin later. The diagnostician observes the sequence of Yin and Yang to deduce their essence.) The patterns of the extraordinary and the ordinary consist of sixty chapters. Diagnosis combines subtle matters, traces changes in Yin and Yang, clarifies the conditions of the Five Zang, grasps the essentials of deficiency and excess, determines the affairs of the five measures, and understanding these is sufficient for diagnosis. ("Qi" means extraordinary. "Heng" means ordinary. Sixty chapters refer to the meaning of the sixty chapters of *Nine Needles*, which are now lost. "Combining subtle matters in diagnosis" means integrating the subtleties of diagnostic methods. "Tracing changes in Yin and Yang" means seeking variations in Yin-Yang prosperity and decline. "Zhang" means clarify. "Wu Zhong" refers to the Five Zang. "Five measures" refer to the aforementioned ten measures. Mastering these allows one to discuss diagnosis.)
Therefore, palpating Yin without obtaining Yang leads to the disappearance of diagnosis; obtaining Yang without Yin results in shallow learning; knowing the left but not the right, knowing the right but not the left, knowing the upper but not the lower, knowing the prior but not the posterior—thus treatment cannot be sustained. ("Palpating Yin without obtaining Yang, diagnosis disappears" means knowing only of Yin and Yang but not their mutual rooting and mutual use, nor the way of Yin-Ping and Yang-Mi. "Zhan" means clear. Partially adhering to learning ultimately remains unclear. Left-right, upper-lower, prior-posterior are all principles of Yin and Yang. Not knowing left-right means not understanding ascending-descending; not knowing upper-lower means not understanding clearing-turbid; not knowing prior-posterior means not knowing urgency-slowness. How can one expect to treat effectively and sustainably?)" Knowing ugliness and beauty, knowing disease and health, knowing high and low, knowing sitting and rising, knowing walking and stopping—if applied with order, the Dao of diagnosis is complete, enduring for ten thousand generations without peril. (All these have reciprocal principles. A difference of a hair's breadth leads to an error of a thousand miles. Thus, the good and evil of disease, the movement and stillness of form, must be distinguished. Understanding this and applying it with order makes the Dao of diagnosis complete, ensuring safety for ten thousand generations. "Ji" means order. "Dai" means peril.) Rising implies excess; knowing what is lacking. ("Qi" means rising. To treat excess, one must observe deficiency. Pathogenic Qi is often in excess, while Healthy Qi is often deficient. Knowing only excess and forgetting deficiency is the path to failure. This warns people to be cautious of the root.) Assessing matters of upper and lower, pulse matters are thereby comprehended. (If one can assess the height and depth of physical conditions, pulse matters can be understood through investigation.)
Therefore, weak form and deficient Qi lead to death; (Both interior and exterior are ruined.) Excess form and Qi but deficient pulse Qi lead to death; (Externally normal, but internal organ Qi is damaged.) Excess pulse Qi but deficient form and Qi lead to survival. (If organ Qi is undamaged, weak form is harmless because the root is primary. If flesh and muscles are wasted, even if the nine pulses are harmonious, death occurs. Wasting differs from deficiency; once flesh is wasted, Spleen Yuan is severed, so even harmonious pulse Qi cannot be treated. Comparing this clarifies the meaning.)
Thus, diagnosis has great principles, and sitting/standing have constants. ("Da Fang" means great law. Constant sitting/standing ensures proper conduct, rectifying the self first. Rectifying the body externally aligns the mind. Thus, the great principle of diagnosis begins here.) Entry and exit involve virtue, transforming spirit. ("Xing" means virtue. The physician's heart is to save lives. In entry and exit, thoughts are true and respectful. Virtue moves Heaven, sincerity penetrates the heart, allowing divine transformation in all actions. "Xing" is pronounced with the departing tone.) Must be clear and pure, observing above and below. (Clarity and purity focus the mind and reveal spirit. Observe above to inspect spirit, color, voice, and sound; observe below to inspect form, body, reversal, and compliance.) Monitor the eight correct evils, distinguish the five central regions. ("Si" means monitor. "Bie" means examine. Monitor the correctness and evil of the eight solar terms and winds to inspect the exterior; examine the locations of the five Zang and five forms to inspect the interior.) Press pulse movement and stillness, follow the meanings of sliding, rough, cold, and warm. (Pressing pulse movement/stillness distinguishes Yin/Yang; sliding/rough/cold/warm reveals deficiency/excess. If the pulse is sliding, the skin of the Chi position is also sliding; if rough, then rough; if cold, then cold; if warm, then warm. Thus, following the Chi reveals this. "Xun" means to feel out.) Observe size, combining with disease conditions. ("Size" refers to urination and defecation. These are the gates of constraint. If gates are loose, granaries leak. Retention brings life, loss brings death. Observing size helps understand disease conditions. "Neng" means condition/state.) Reversal and compliance are obtained, then disease names are known. (Reversal is contrary, compliance is smooth. Obtaining reversal/compliance and knowing disease names ensures certainty without error.) Diagnosis can be perfect, not losing human circumstances. (Following the above methods, diagnosis can be perfect, especially regarding human circumstances.) Observe breath and intent, not losing regulation. ("Shi Xi" is observing breath to view Qi; "Shi Yi" is observing form/color to view emotion, thus maintaining regulation.) Not knowing this Dao loses classics and severs principles. Speaking without basis and making false predictions is called losing the Dao. (Not knowing this Dao leads to baseless speech and false predictions, inevitably perilous.) Outside all things, within the six directions, changes of Heaven and Earth, responses of Yin and Yang. The warmth of spring becomes the heat of summer; the anger of autumn becomes the rage of winter. Movements of the four seasons cause pulses to rise and fall. (Things are within Heaven, Heaven envelops things outside. Heaven, Earth, and all things share one Qi. Changes of Heaven and Earth are responses of Yin and Yang. Spring warmth gradually becomes Summer heat; Autumn anger gradually becomes Winter rage. Spring generation, Summer growth, Autumn harvest, Winter storage are the movements of Yin-Yang four changes, and pulses follow accordingly.) Spring corresponds to the compass. (The compass draws circles. Spring Qi generates, round and active, corresponding to the compass; human pulse responds, becoming round and active.) Summer corresponds to the square. (The square draws rectangles. Summer Qi flourishes, reaching peak and stopping, corresponding to the square; human pulse responds, becoming grand, large, upright, and方正.) Autumn corresponds to the balance. (Balance means level. Autumn Qi completes all treasures level on the ground, corresponding to the balance; human pulse responds, appearing floating and fine on the surface.) Winter corresponds to the weight. (Weight is a plumb bob. Winter Qi stores and hides, corresponding to the weight; human pulse responds, sinking heavy and hiding inside. All these compass, square, balance, and weight elucidate the principles of Yin-Yang ascending/descending, conforming to seasonal pulse changes.)
Therefore, forty-five days after Winter Solstice, Yang Qi slightly ascends, Yin Qi slightly descends; forty-five days after Summer Solstice, Yin Qi slightly ascends, Yang Qi slightly descends. Yin and Yang have their times, setting periods for pulses. If periods are missed, it matches pulse divisions. Divisions have timing, thus knowing the time of death. (Winter Solstice generates one Yang. Forty-five days after WS to Start of Spring, Yang Qi gradually ascends slightly; as Yang ascends, Yin descends. Summer Solstice generates one Yin. Forty-five days after SS to Start of Autumn, Yin Qi gradually ascends slightly; as Yin ascends, Yang descends. This is "Yin and Yang have their times." Setting periods for pulses means pulses change with time. Missing periods means Spring Compass, Summer Square, Autumn Balance, Winter Weight do not match degrees. Matching pulse divisions means each Zang pulse has its domain. Divisions have timing means decline/prosperity have their times. Knowing this knows the time of life and death.)
Subtlety lies in the pulse, must not fail to observe. Observation has order, starting from Yin and Yang. Starting has classics, born from Five Elements. Birth has limits, suitable for four seasons. (Pulse subtlety relies on Yin-Yang and Five Elements as order. Yin-Yang and Five Elements birth have limits: Yang births at Winter Solstice, Yin at Summer Solstice, Wood at Hai, Fire at Yin, Metal at Si, Earth/Water at Shen. Four seasons birth/prosperity have suitability. "Ji" means discipline. "Jing" means constant. i.e., major outline and minor discipline.) Tonification and drainage must not be lost, matching Heaven and Earth as one. (Heaven and Earth's Dao reduces excess and supplements deficiency. Correct tonification/drainage matches Heaven and Earth's Dao.) Grasping the essence of One, knowing life and death. (Essence of One is the subtlety of Heaven-Human unity. Heaven-Earth Dao: Yang governs movement, Yin governs stillness. Yang coming brings life, Yang going brings death. Knowing Heaven's non-stop Dao knows human life/death.) Thus sound matches Five Tones, color matches Five Elements, pulse matches Yin and Yang. (Sound matches Gong-Shang-Jue-Zhi-Yu, color matches Wood-Fire-Water-Metal-Earth, pulse matches Four Seasons Yin-Yang. Though three seem divided, principle is one.) Holding pulse has Dao, emptiness and stillness are guarantee. (Holding pulse requires sincere thought, avoiding disturbance. Empty heart and quiet will, without gap, complete the diagnostic Dao. "Bao" means not losing.) Spring pulse floats, like fish swimming in waves. (Spring pulse gets Spring Qi, floating but not fully out, like fish in waves.) Summer pulse at skin, abundant like all things. (Summer pulse gets Summer Qi, grand and external, abundant like all things.) Autumn pulse below skin, hibernating insects about to leave. (Autumn pulse gets Autumn Qi, grandness gathers, like insects preparing to hibernate.) Winter pulse in bone, hibernating insects secure, gentleman in room. (Winter pulse gets Winter Qi, sinking in bone, like secure hibernating insects. Gentleman at this time should embody Heaven-Earth storage and stay indoors.) Thus, knowing interior presses and records; knowing exterior ends and begins. These six are the great methods of holding pulse. ("Interior" refers to Organ Qi, with positions, so can be pressed and recorded; "Exterior" refers to Meridian Qi, with order, so can be ended and begun. These are the methods of four seasons and interior/exterior.)
Spring pulse is like a bowstring. Spring pulse is Liver, Eastern Wood, where all things begin. Its Qi comes weak, light, empty, and slippery, straight and long, thus called Bowstring. Opposite of this is disease. (Bowstring is straight and long, strong like a bowstring, but weak/light/empty/slippery contains harmony. Liver governs this.) How is it opposite? Qi comes solid and strong, called Excess, disease in Exterior; Qi comes not solid and slight, called Deficiency, disease in Interior. (Solid/strong is excess of Bowstring; not solid/slight is deficiency of Bowstring. Both are opposites of Bowstring. Excess disease is in Exterior, Deficiency disease is in Interior. Exterior diseases often have excess, Interior diseases often have deficiency.) Excess causes forgetfulness, dizziness, and vertex disease; Deficiency causes chest pain radiating to back, and fullness in both hypochondria. ("Wang" should be "Nu" (anger). Liver Qi deficiency causes fear, excess causes anger. "Hu Hu" means confused/unpleasant. "Mao" means stifled. "Dian Ji" is disease at the vertex. Foot Jueyin Meridian meets at vertex, passes diaphragm, spreads to hypochondria, hence these symptoms. , pronunciation qu, armpit/hypochondrium.)
Summer pulse is like a hook. Summer pulse is Heart, Southern Fire, where all things flourish and grow. Its Qi comes vigorous and departs declining, thus called Hook. Opposite of this is disease. (Hook: lifting finger comes vigorous, departing seems declining. Pulse vigorous externally, departing powerless, Yang prosperity. Heart governs this.) How is it opposite? Qi comes vigorous and departs vigorous, called Excess, disease in Exterior; Qi comes not vigorous and departs vigorously, called Deficiency, disease in Interior. (Vigorous-come/vigorous-depart is excess of Hook; Not-vigorous-come/vigorous-depart is deficiency of Hook. Both are opposites of Hook. "Departing vigorously" does not mean strong. Pulse coming from bone/flesh to skin is "Come"; returning from skin to bone/flesh is "Depart". Not-vigorous-come/vigorous-depart means Come is deficient, Depart is excessive, i.e., consuming more than growing. Thus Bian Que considered Spring Liver, Summer Heart, Autumn Lung, Winter Kidney: solid/strong is Excess, disease in Exterior; weak/slight is Deficiency, disease in Interior. Words differ, meaning same.) Excess causes body heat and skin pain, spreading erosion; Deficiency causes vexation, coughing/spitting above, and Qi leakage below. (Summer pulse Excess: Yang excess, disease in Exterior, causing body heat, skin pain, spreading erosion. Deficiency: Ministerial Fire decline, disease in Interior, causing Heart Qi deficiency/vexation, Deficient Yang invading Lung/coughing, instability/Qi leakage. Meridian starts in Heart, connects Heart system, passes diaphragm, connects Small Intestine, returns to Lung.)
Autumn pulse is like floating. Autumn pulse is Lung, Western Metal, where all things harvest. Its Qi comes light, empty, and floating, urgent come and scattered depart, thus called Floating. Opposite of this is disease. (Floating means light/empty. Urgent come/scattered depart: Autumn Yang Qi still in skin/hair. Lung governs this.) How is it opposite? Qi comes hairy with center firm and sides empty, called Excess, disease in Exterior; Qi comes hairy and slight, called Deficiency, disease in Interior. (Center firm means floating with firm center. Floating Excess/Floating Deficiency are opposites of Floating, disease in Exterior/Interior same as before.) Excess causes reverse Qi and back pain with sorrowful feeling; Deficiency causes panting, shortness of breath, cough, upper Qi with blood, lower hearing disease sounds. (Lung Meridian starts Middle Jiao, connects Large Intestine, returns to stomach, passes diaphragm, belongs to Lung, attaches to back. Excess causes reverse Qi obstruction/back pain. "Yun Yun" is sorrowful appearance. Deficiency causes panting/cough/shortness of breath; Qi not returning origin causes upper Qi; Yin deficiency/internal damage causes blood. Lower hearing disease sound means throat sound during panting.)
Winter pulse is like Ying (camp). Winter pulse is Kidney, Northern Water, where all things store. Its Qi comes sinking and firm, thus called Ying. Opposite of this is disease. (Ying means camp, like soldiers gathering, not scattering, also meaning sinking stone. Kidney governs this.) How is it opposite? Qi comes like flicking stones, called Excess, disease in Exterior; Qi departs like rapid count, called Deficiency, disease in Interior. (Coming like flicking stones: will is very strong, Ying Excess. Departing like rapid count: movement stops quickly, Ying Deficiency. Rapid count usually belongs to Heat, but this True Yin deficiency pulse must also be tight/rapid. The more deficient, the more rapid, originally not Yang-strong real heat rapid count, hence "like rapid", deep analysis. One mistake here, disaster is easy. Excess disease in Exterior, Deficiency disease in Interior.) Excess causes relaxation of sinews, spine pain, shortness of breath, unwilling to speak; Deficiency causes heart hanging like hungry illness, middle cold, spine pain, lower abdomen fullness, urine changes. (Winter pulse Excess: Yin Evil wins. Yin Evil wins damages Kidney Qi, True Yang deficiency, causing limb relaxation, poor movement, called Relaxation. Spine pain: Kidney Meridian reaches there. Kidney stores Essence, Essence damage means no Qi, hence shortness of breath/unwilling to speak, all Exterior disease. Deficiency: True Yin deficiency, Heart-Kidney not communicating, heart hanging/fear like hunger. "Zhong" is soft area under lateral ribs, beside Kidney. Kidney Meridian passes spine, belongs to Kidney, connects Bladder, hence spine pain, abdominal fullness, urine changes. Changes: yellow, red, enuresis, strangury, due to Kidney Water deficiency, all Interior disease. , pronunciation ji.)
Spleen pulse is Earth, the solitary Organ irrigating the four sides. (Spleen belongs to Earth, Earth is root of all things, transporting water/grain, transforming fluids, irrigating Liver, Heart, Lung, Kidney. Earth has no fixed position, rules four seasons, thus called Solitary Organ.) Good state cannot be seen, bad state can be seen. (When Spleen healthy, irrigation complete, four Zang safe, unaware of Spleen power, thus good state unseen; Spleen diseased, four Zang follow disease, thus bad signs seen.) Coming like flowing water, this is...