脉要精微篇 黄帝问曰∶诊法何如？岐伯对曰∶诊法常以平旦，阴气未动，阳气未散，
饮食未进，经脉未盛，络脉调匀，血气未乱，故乃可诊有过之脉。
平旦未劳于事，阴气未扰，阳气未耗，故可以候有过之病脉也。
切脉动静而视精明，神气也。察五色，观五脏有余不足，六腑强弱，形之盛衰，以此参伍，
决死生之分。
参伍，视察五色等事，与所切脉参合比伍，而其决死生之分也。
夫脉者，血之府也，长则气治，安也。短则气病，数则烦心，大则病进，上盛则气高，下盛
则气胀，上盛，谓寸口；下盛，谓尺中。代则气衰，细则气少，涩则心痛，浑浑革至如涌泉，病
进而色弊，绵绵其去如弦绝者，死。
浑浑，脉混乱也。革至，谓脉弦实。如涌泉，脉迫迫而出不反也。绵锦其去，脉来绵绵，
相续不见其去，如弦之数绝，主病色而死矣。
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。
察脉在手阴阳升降之妙，故曰纪纲。始之有经，言知其经常之大概，次从五行之生旺，次
从四时之所宜，所谓有度也。如此，微妙皆可察而知也。
是故声合五音，色合五行，脉合阴阳。
此申上文微妙不可不察，而各有合之之理是也。
持脉有道，虚静为宝。（虚心静性。）春日浮，如鱼之游在波；（不甚浮也。）夏日在肤，
泛泛乎万物有余；盛大充足。秋日下肤，蛰虫将去，（随气而降，故曰下肤，观蛰虫可见。）冬
日在骨，蛰虫周密，君子居室。（深沉之义。）
此言四时之常脉，所谓始之有经是也。
尺内两旁则季胁，（季，末也，极下也。）尺外以候肾，尺里以候腹，中附上，（关上也。）
左外以候肝，内以候鬲；右外以候胃，内以候脾。上附上，寸上也。右外以候肺，内以候胸中；
左外以候心，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，少腹腰股
膝足中事也。
自尺内至于上附上，六部之分位，以诊十二候也。上竟上者之四句，总结上文诊候之各得其宜也。
平人气象篇 帝曰∶平人何如？岐伯对曰∶人一呼脉再动，一吸脉再动，呼吸定息脉
五动，闰以定息，命曰平人。
一呼一吸，脉各再动，定息脉又一动，为五动也，曰平。
人一呼脉一动，一吸脉一动，曰少气。
呼吸定息五动曰平。今呼吸各一息，脉为迟，以减平人之半，少气可知矣。
人一呼脉三动，一吸脉三动而躁，尺热曰病温，尺不热脉滑曰病风，脉涩曰痹。
躁，烦躁也。尺热，尺分皮肤热，是为病瘟。尺不热而滑为风，涩为血少，故病痿痹。
是为数脉也。
人一呼脉四动以上曰死，脉绝不至曰死，乍疏乍数曰死。
一呼四动，一吸亦四动，是倍平人之半，此数而又甚者也。脉绝不至，乍疏乍数，皆其谷
气绝亡，故皆主死。
平人之常气禀于胃，胃者，平人之常气也。人无胃气曰逆，逆者死。
无胃气，四时之脉不得其本脏和气也。观下文，可以知之。
春胃微弦曰平，弦多胃少曰肝病，但弦无胃曰死，胃而有毛曰秋病，毛甚曰今病。
春胃气则弦而软是也。弦多，谓弦甚。五注如始张弓弦。胃气少者，乃本气自病。纯弦绝
无胃气者死，胃而毛秋病，毛甚者金克木，故即病。
夏胃微钩曰平，钩多胃少曰心病，但钩无胃曰死，胃而有石曰冬病，石甚曰今病。
夏胃气则弦而滑是也。但钩谓洪大而坚，有石谓沉伏得冬脉，故冬病石甚，水克火，故即病也。
长夏胃微 弱曰平，弱多胃少曰脾病，但代无胃曰死， 弱有石曰冬病，弱甚曰今病。
长夏胃气软弱是也。弱多，无力也，代，不能还也，主死。弱而沉为冬病，弱甚曰即病。
秋胃微毛曰平，毛多胃少曰肺病，但毛无胃曰死，毛而有弦曰春病，弦甚曰今病。
秋胃气浮是也。毛多，浮微也，为肺气不足而病也。浮微而欲绝者死，浮而弦为春病，弦
甚曰为即病。
年胃微石曰平，石多胃少曰肾病，但石无胃曰死，石而有钩曰夏病，钩甚曰今病。
冬胃气沉是也。石多，沉伏也，为肾气不充也。但石沉而坚也，石而有钩，沉滑也，而病于
夏。石甚为即病也。
玉机真藏篇 曰∶春以胃气为本。病肝脉来，盈实而滑，如循长竿，（长而紧也。）
曰肝病。死肝脉至，急益劲，如新张弓弦，曰肝死。真肝脉至，中外急，如循刀刃责责然，如按
琴瑟弦，色青白不泽，毛折，乃死。
夏以胃气为本。病心脉来，喘喘连属，其中微曲，曰心病。死心脉来，前曲后居，如操带钩，
曰心死。
带钩，陷下不动也。真心脉至坚而搏，如循薏苡子累累然，色赤黑不泽，毛折，乃死。
长夏以胃气为本。病脾脉来，实而盈数，如鸡举足，曰脾病。死脾脉来，锐坚如鸟之啄，如
鸟之距，如屋之漏，如水之流，曰脾死。真脾脉至，弱而乍疏乍数，色黄青不泽，毛折，乃死。
秋以胃气为本。病肺脉来，不上不下，如循鸡羽，曰肺病。死肺脉来，如物之浮，如风吹毛，
曰肺死。（浮而散也。）真肺脉至，大而虚，如以毛羽中人肤，色赤白不泽，毛折，乃死。
冬以胃气为本。病肾脉来，如引葛，按之益坚，曰肾病。死肾脉来，发如夺索，辟辟然如弹
石，曰肾死。（促而肾也。）真肾脉至，搏而绝，如指弹石辟辟然，色黑黄不泽，毛折，乃死。
玉机真藏论 岐伯曰∶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，曰弦，反此者病。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。
太过为阳居表，故在外；不及为阴居中，故在内。
太过令人善怒，忽忽眩冒而颠疾；其不及则令人胸痛引背，下则两胁 满。
太过肝气实则怒，视眩冒闷，气上为颠疾；不及肝气不流，故胁痛 满也。
夏脉者心也，南方火也，万物之所以盛长也。故其气来盛去衰，曰钩，（即前曲后居，来疾
去迟也。）反此者病。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。太过则令人身热而肤痛，为浸淫；不及则令人烦心，上见咳唾，下为气泄。
心脉太过，则身热而肤痛，浸淫流布而痛；不及为心烦咳唾，下则气泄。
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。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。太过则令人逆气背痛，愠愠然；不及则令人喘，呼吸少气而咳，上气见血，下闻病音。
上见血，喘而咯血；下闻病音，复又咳嗽也。
冬脉者肾也，北方水也，万物之所以合藏也。故其气来沉以搏，曰营，反此者病。其气来如
弹石，此谓太过，病在外；其去如数，此谓不及，病在中。太过则令人懈 ，（懈，倦也，似热
不热，似寒不寒，似弱不弱，似强不强，无可名状，谓之懈 病也。）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。
中，季胁之下，侠脊两旁空软处也，肾外当 ，故曰 。清，清冷也。脊中，两肾之中。
少腹， 之前。小腹满，肾气不行也，故小便变，或赤或涩也。
帝曰∶脾脉独何主？曰∶脾脉者土也，孤藏以灌四旁者也。善者不得见，恶者可见。（脾寄
旺于四季，故善不可见，恶可见。）其来如水之流，此为太过，病在外；如鸟之啄，此谓不及，
病在中。太过则令人四肢不举，不及则令人九窍不通。
中气不足，不能灌溉于四旁，则五脏不和，故九窍不通也。
平人气象篇 曰∶欲知太过与不及，寸口之脉中手短者，曰头痛。寸口脉中手长者，
曰足胫痛。寸口脉中手促上击者，曰肩背痛。寸口脉沉而坚者，曰病在中。寸口脉浮而盛者，曰
病在外。寸口脉沉而弱，曰寒热及疝瘕少腹痛。寸口脉沉而横，曰胁下有积，腹中有横积痛。寸
口脉沉而喘，曰寒热。脉盛滑坚者，曰病在外。脉小实而坚者，病在内。脉小弱以涩，谓之久病。
脉滑浮而疾者，谓之新病。脉急者，曰疝瘕少腹
痛。脉滑曰风。脉涩曰痹。缓而滑曰热中。盛而紧曰胀。尺脉缓涩，谓之解 。安卧脉盛，谓之
脱血。尺涩脉滑，谓之多汗。尺寒脉细，谓之后泄。脉尺粗常热谓之热中。妇人手少阴脉动甚者，孕子也。
少阴在掌后陷中，当小指而应手者也。动谓动也，经脉别论曰∶阴搏阳别，谓之有子。
经脉别论篇曰∶食入于胃，浊气归心，淫精于脉，脉气流经，精气归肺，肺朝百脉，输精于
皮毛。毛脉合精，行气于腑，腑精神明，留于四脏，气归于权衡。权衡以平，气口成寸，以决死生。
气口乃手太阴肺脉，为脉之大会，百脉尽朝，故以其分决死生，是成寸口脉法，寸关尺三部是也。
饮入于胃，游溢精气，上输于脾，脾气散精，上归于肺，通调水道，下输膀胱，水精四布，
五经并行，合于四时五脏阴阳，揆度以为常也。
水精布经，五脏四时俱以常度，不相失也。
平人气象篇 曰∶人以水谷为本，故人绝水谷则死，脉无胃气亦死。所谓无胃气者，
但得真藏脉不得胃气也。所谓脉不得胃气者，肝不弦肾不石也。
石弦而曰不，谓不似微弦微石之和也。五脏仿此。
玉机真藏论 曰∶见真藏曰死，何也？岐伯曰∶五脏者皆禀气于胃，胃者五脏之本也。
藏气者，不能自致于手太阴，必因于胃气，乃至于手太阴也，故五脏各以其时，自为（自为其状而
至太阴。）而至于手太阴也。故邪气胜者，精气衰也，故病甚者，胃气不能与之俱至于手太阴，
故真藏之气独见者，病胜藏也，故曰死。
高保衡《新校正》云∶真藏脉者，无余物和杂，故名真也。如弦是肝脉，若微弦则和，而
有胃气微弦，二分胃气，一分弦气，故曰微弦。若三分俱弦，则
为真藏脉矣。
脉要精微篇 曰∶心脉搏坚而长，当病舌卷不能言；其 而散者，当消环自已。肺脉
搏坚而长，当病唾血；其 而散者，当病灌汗，至令不复发散也。肝脉搏坚而长，色不青，当病
坠若搏，（若搏，或坠，或击伤而搏也。）因血在胁下，令人喘逆；其 而散者色泽，当病溢饮。
溢饮者渴暴多饮，而溢入肌皮肠胃之外也。胃脉搏坚而长，其色赤，当病折髀；（髀抵伏兔，故病
如折也。）其 而散者，当病食痹。脾脉搏坚而长，其色黄，当病少气；其 而散色不泽者，当
病足 肿，若水状也。肾脉搏坚而长，其色黄而赤者，当病折腰；其 而散者，当病少血，至令不复也。
搏坚，皆为太过；软而散，皆为不及。五脏各因太过不及而病也。
阴阳别论篇 曰∶脉有阴阳，知阳者知阴，知阴者知阳。凡阳有五，五五二十五阳。
所谓阴者，真藏也，见则为败，败必死也。所谓阳者，胃脘之阳也。别于阳者，知病处也；别于
阴者，知死生之期。三阳在头，三阴在手，所谓一也。
汪心谷云∶阴者五脏之阴也，阳者胃之阳气也。二十五阳一岁，五脏脉变，各经阳气有五，
合为二十五也。三阳三阴，手足三阳三阴经也。一，同也。夫经脉者，由于胃气冲灌，而行贯乎
四时，曰春弦夏钩秋毛冬石，兼微曰平，如胃之阳气少者曰病，以寸尺候其病处，或在肾在腹在
膻中之类。若胃之阳气已绝，不能与脉俱至于手之太阴，而五脏之阴气独见，见则为败，败必死
也。其死必于所不胜之期，如肝见庚辛，心见壬癸，脾见甲乙，肺见丙丁，肾见戊己，故曰知死
生之期。王氏及《素问钞》，皆以人迎气口牵强注释，于理益晦，知者审之。
凡持真脉之藏脉者，肝至悬绝急，十八日死。
汪氏∶真脉之脏脉者，谓真脏脉之至数，以分五脏之属也。至，脉之应也。悬绝，止绝也。
急，劲也。十八，肝脏之得数也。日，日干庚辛是也，脉绝死于所不胜之期。凡脉至流行，内应
五脏肝心脾肺肾之气，外应先天五行水一火二木三金四土五之数，故脉五至为小息，五十至为一
大息。若五十至之中，有胃气无止绝曰平。无胃气兼止绝有常数者曰死。凡脉止绝，法以至绝至
复数起，周五脏而得其余数，则应所属之脏气已绝，至于所不胜之期日而死。肝至十八日死者，
除五脏三五一十五余三，属木内应于肝，故知肝气已绝，庚辛日干为死之期也。
心至悬绝，九日死。
肝至十八加心至九数，共二十七数，除五脏五周，五五二十五余二，属火内应于心，故知
心气已绝，壬癸日干为死之期也。
肺至悬绝，十二日死。
肝心已共二十七数，加肺十二数，共合三十九数，除五脏七周，五七三十五数余四，属金
内应于肺，故知肺气已绝，丙丁日干死之期也。
肾至悬绝，七日死。
肝心肺已共三十九数，加肾七数，共合四十六数，除五脏九周，五九四十五数余一，属水
内应于肾，故知肾气已绝，戊己日干死之期也。
脾至悬绝，四日死。
脉要精微篇：黄帝问道：诊脉的方法是怎样的？岐伯回答说：诊脉通常在清晨进行，此时阴气尚未扰动，阳气尚未耗散，饮食尚未摄入，经脉之气尚未充盛，络脉气血调和均匀，血气运行未受干扰，因此可以诊察出有异常的脉象。
清晨时人未从事劳作，阴气未被扰乱，阳气未被消耗，所以可以候察到病态的脉象。
切按脉搏的动静，同时观察患者眼睛的神采（精明），这是神气的表现。审视面部的五色，以观察五脏的有余或不足，六腑的强或弱，以及形体的盛衰，将这些情况相互参照比较，从而判断死生的界限。
所谓“参伍”，是指视察五色等情况，与所切得的脉象相互参照、比对，从而决断死生的界限。
脉，是血液汇聚的府库。脉长说明气机调畅，身体安和；脉短说明气机有病；脉数（快）说明心中烦闷；脉大说明病情正在进展；寸口脉上部盛实说明气机上逆，尺中脉下部盛实说明腹部胀满。“上盛”指寸口脉，“下盛”指尺中脉。脉代（间歇）说明气机衰弱；脉细说明气虚量少；脉涩说明心痛；脉象浑浊急迫如涌泉般冲出而不回返，说明病情加重且面色败坏；脉象绵绵而去，像弓弦断裂一样突然消失，主死亡。
“浑浑”指脉象混乱。“革至”指脉象弦而坚实。“如涌泉”指脉气迫促而出，一去不返。“绵绵其去”指脉来连绵不断，相续不绝却看不到它离去的样子，像弓弦之数突然断绝，主病色俱败而死。
脉理的微妙之处，不可不仔细考察。考察脉理有纲纪，从阴阳开始。起始有常规，从五行相生而来。生化的规律，以顺应四时为适宜。考察脉象在于把握手部阴阳升降的奥妙，所以称为纲纪。起始有常规，是说知晓其经常的大概规律，其次依据五行的生旺变化，再次依据四时的适宜性，这就是所谓的“有度”。如此，脉理的微妙之处都可以被察觉并知晓。
这是在重申上文所说的微妙之处不可不察，以及它们各自相应的道理。
持脉有一定的法则，虚心静气最为宝贵。（即保持内心虚空，性情宁静。）春季的脉象浮在表面，像鱼在水中游动；（这种浮并不明显。）夏季的脉象在皮肤表层，泛泛然像万物生长茂盛、盛大充足；秋季的脉象下沉至皮肤之下，像冬眠的昆虫准备离开洞穴；（随气机下降，所以说在下肤，观察冬眠昆虫的状态可见。）冬季的脉象深沉在骨，像冬眠的昆虫严密包裹，君子居于室内。（体现深沉的含义。）
尺部内侧两旁对应季胁（季，指末端，极下的位置）。尺部外侧候察肾脏，尺部内侧候察腹部。从中部向上附连处（即关部），左手外侧候察肝脏，内侧候察膈膜；右手外侧候察胃，内侧候察脾。再向上附连处（即寸部），右手外侧候察肺脏，内侧候察胸中；左手外侧候察心脏，内侧候察膻中。脉的前方候察身体前部的病症，后方候察身体后部的病症。脉象上至于尽头的，对应胸喉中的疾病；脉象下至于尽头的，对应少腹、腰、股、膝、足中的疾病。
自尺部内侧直到上附上，这六部分位，用来诊察十二种候症。关于“上竟上者”的四句话，是对上文各部位诊候得其适宜的总结。
平人气象篇：皇帝问：正常人的脉象是怎样的？岐伯回答说：正常人一呼脉搏跳动两次，一吸脉搏跳动两次，呼吸之间停顿的一息脉搏跳动五次，闰余的计算基于定息，这就叫做正常人。
一呼一吸，脉搏各跳动两次，定息时脉搏又跳动一次，共五次跳动，称为平脉。
呼吸定息时脉搏跳动五次为平脉。现在呼吸各一息，脉搏仅跳动一次，属于迟脉，比正常人的次数减半，可知是少气。
如果一呼脉搏跳动三次，一吸脉搏跳动三次且躁动，尺部皮肤发热的是温病，尺部不发热但脉滑的是风病，脉涩的是痹证。
“躁”指烦躁。尺部皮肤发热，是瘟病。尺部不发热而脉滑为风病，脉涩为血少，所以病痿痹。
这属于数脉。
如果一呼脉搏跳动四次以上叫死脉，脉搏久不复来叫死脉，忽快忽慢叫死脉。
一呼四次，一吸也是四次，是正常人数目的两倍多，这是数脉中更严重的情况。脉搏久不复来，忽快忽慢，都是谷气绝亡的表现，所以都主死亡。
正常人的常气禀受于胃，胃就是正常人的常气。人如果没有胃气就叫逆，逆则死。
没有胃气，意味着四时的脉象失去了本脏的和缓之气。看下文就可以知道。
春季脉象带有微弱的胃气且微弦，称为平脉；弦象多而胃气少，称为肝病；只有弦象而没有胃气，称为死脉；如果有胃气且兼见毛（浮）象，预示秋季发病；毛象甚重，预示当下发病。
春季胃气表现为弦而柔和。弦象多，指弦象严重。如同刚拉开的弓弦。胃气少，是本脏自身生病。纯弦而无胃气者死，有胃气而见毛象则秋病，毛象甚重则是金克木，所以立即发病。
夏季脉象带有微弱的胃气且微钩（洪），称为平脉；钩象多而胃气少，称为心病；只有钩象而没有胃气，称为死脉；如果有胃气且兼见石（沉）象，预示冬季发病；石象甚重，预示当下发病。
夏季胃气表现为弦而滑。只有钩象指洪大而坚，有石象指沉伏得冬脉，所以冬病石甚，是水克火，所以立即发病。
长夏脉象带有微弱的胃气且微弱，称为平脉；弱象多而胃气少，称为脾病；只有代脉而没有胃气，称为死脉；如果有胃气且兼见石（沉）象，预示冬季发病；弱象甚重，预示当下发病。
长夏胃气表现为软弱。弱象多，指无力。代脉，指脉来中止不能立即恢复，主死。弱而沉为冬病，弱象甚重指立即发病。
秋季脉象带有微弱的胃气且微毛（浮），称为平脉；毛象多而胃气少，称为肺病；只有毛象而没有胃气，称为死脉；如果有毛象且兼见弦象，预示春季发病；弦象甚重，预示当下发病。
秋季胃气表现为浮。毛象多，指浮而微，为肺气不足而病。浮微而欲绝者死，浮而弦为春病，弦象甚重指立即发病。
冬季脉象带有微弱的胃气且微石（沉），称为平脉；石象多而胃气少，称为肾病；只有石象而没有胃气，称为死脉；如果有胃气且兼见钩（洪）象，预示夏季发病；钩象甚重，预示当下发病。
冬季胃气表现为沉。石象多，指沉伏，为肾气不充。只有石象沉而坚。石而有钩，指沉滑，而在夏季发病。石象甚重指立即发病。
玉机真藏篇：说：春季以胃气为本。肝病脉象来时，盈实而滑，像抚摸长竿（长而紧），称为肝病。死肝脉象到来，紧急且强劲，像新拉开的弓弦，称为肝死。真肝脉象到来，内外紧急，像抚摸刀刃责责作响，像按压琴瑟弦，面色青白无光泽，毫毛枯折，乃死。
夏季以胃气为本。心病脉象来时，喘喘相连属，其中微曲，称为心病。死心脉象来时，前曲后居，像拿着带钩，称为心死。
带钩，指陷下不动。真心脉象到来坚硬搏指，像抚摸薏苡子累累相连，面色赤黑无光泽，毫毛枯折，乃死。
长夏以胃气为本。脾病脉象来时，实而盈数，像鸡举足，称为脾病。死脾脉象来时，锐坚像鸟啄食，像鸟爪距，像屋顶漏雨，像水流不止，称为脾死。真脾脉象到来，弱而忽疏忽数，面色黄青无光泽，毫毛枯折，乃死。
秋季以胃气为本。肺病脉象来时，不上不下，像抚摸鸡羽，称为肺病。死肺脉象来时，像物体漂浮，像风吹毛发，称为肺死。（浮而散。）真肺脉象到来，大而虚，像羽毛中人皮肤，面色赤白无光泽，毫毛枯折，乃死。
冬季以胃气为本。肾病脉象来时，像牵引葛藤，按之更加坚实，称为肾病。死肾脉象来时，发如夺索，辟辟然像弹石，称为肾死。（促而劲也。）真肾脉象到来，搏动而绝，像手指弹石辟辟然，面色黑黄无光泽，毫毛枯折，乃死。
玉机真藏论：岐伯说：春脉对应肝脏，属东方木，是万物开始生长的原因。所以它的脉气来时，柔弱轻虚而滑，端直而长，称为弦脉，与此相反的就是病脉。脉气来时实而强，这叫太过，病在外；脉气来时不实而微，这叫不及，病在内。
太过使人容易发怒，恍惚眩晕冒昧而患颠疾；不及使人胸痛牵引背部，向下则两胁胀满。
太过肝气实则怒，视物眩晕冒闷，气上逆为颠疾；不及肝气不流通，所以胁痛胀满。
夏脉对应心脏，属南方火，是万物盛大生长的原因。所以它的脉气来时盛而去时衰，称为钩脉（即前曲后居，来疾去迟），与此相反的就是病脉。脉气来时盛去时也盛，这叫太过，病在外；脉气来时不盛去时反而盛，这叫不及，病在内。太过使人身体发热而皮肤疼痛，形成浸淫疮；不及使人心中烦闷，向上见咳唾，向下见气泄。
心脉太过，则身热而肤痛，浸淫流布而痛；不及为心烦咳唾，向下则气泄。
秋脉对应肺脏，属西方金，是万物收成原因。所以它的脉气来时，轻虚而浮，来急去散，所以称为浮脉，与此相反的就是病脉。脉气来时，毛而中央坚，两旁虚，这叫太过，病在外；脉气来时，毛而微，这叫不及，病在内。太过使人气逆背痛，郁郁不乐；不及使人气喘，呼吸短少而咳嗽，向上见咯血，向下闻咳嗽声。
冬脉对应肾脏，属北方水，是万物闭藏的原因。所以它的脉气来时沉而搏指，称为营脉，与此相反的就是病脉。脉气来时像弹石，这叫太过，病在外；脉气去时像数脉，这叫不及，病在内。太过使人懈惰（懈惰，疲倦也，似热不热，似寒不寒，似弱不弱，似强不强，无可名状，称为懈惰病），脊脉痛而少气不想说话。不及使人心里悬空像得了饥饿病，季胁下清冷，脊中痛，少腹胀满，小便异常。
季胁下，侠脊两旁空软处，肾外当此，所以叫季胁下。清，指清冷。脊中，两肾之中。少腹，季胁之前。小腹满，肾气不行，所以小便变，或赤或涩。
皇帝问：脾脉单独主什么？回答说：脾脉属土，是孤脏灌溉四旁的脏器。好的脾脉看不见，坏的脾脉才看得见。（脾寄旺于四季，所以好脉不可见，坏脉可见。）脉气来时像水流，这叫太过，病在外；像鸟啄食，这叫不及，病在内。太过使人四肢不能抬起，不及使人九窍不通。
平人气象篇说：想知道太过与不及，寸口脉按之短的，叫头痛。寸口脉按之长的，叫足胫痛。寸口脉按之促而上击的，叫肩背痛。寸口脉沉而坚的，叫病在中。寸口脉浮而盛的，叫病在外。寸口脉沉而弱的，叫寒热及疝瘕少腹痛。寸口脉沉而横的，叫胁下有积，腹中有横积痛。寸口脉沉而喘（急促）的，叫寒热。脉盛滑坚的，叫病在外。脉小实而坚的，病在内。脉小弱而涩的，叫久病。脉滑浮而疾的，叫新病。脉急的，叫疝瘕少腹痛。脉滑的叫风。脉涩的叫痹。缓而滑的叫热中。盛而紧的叫胀。尺脉缓涩，叫解惰。安卧而脉盛的，叫脱血。尺涩脉滑的，叫多汗。尺寒脉细的，叫后泄。脉尺部粗常热的，叫热中。妇人手少阴脉动甚的，是怀孕。
少阴在掌后陷中，当小指而应手。动谓动也，《经脉别论》说：阴搏阳别，谓之有子。
《经脉别论篇》说：食物进入胃，浊气归于心，精气渗入脉中，脉气流经，精气归肺，肺朝百脉，输精于皮毛。毛脉合精，行气于腑，腑精神明，留于四脏，气归于权衡。权衡以平，气口成寸，以此决断死生。
气口乃手太阴肺脉，为脉之大会，百脉尽朝，所以以其分部决断死生，这就是成寸口脉法，即寸、关、尺三部。
饮水进入胃，游溢精气，上输于脾，脾气散精，上归于肺，通调水道，下输膀胱，水精四布，五经并行，合于四时五脏阴阳，揆度以为常。
平人气象篇说：人以水谷为本，所以人断绝水谷就会死，脉无胃气也会死。所谓无胃气，就是只得到真藏脉而没有胃气。所谓脉不得胃气，就是肝不弦、肾不石。
玉机真藏论说：见到真藏脉就死，为什么呢？岐伯说：五脏都禀受气于胃，胃是五脏的根本。脏气不能自己到达手太阴肺经，必须凭借胃气，才能到达手太阴肺经。所以五脏各自在其对应的时令，呈现其状态而至手太阴肺经。所以邪气胜则精气衰，病重时，胃气不能与之俱至于手太阴肺经，所以真藏之气独见的，是病胜脏，所以死。
高保衡《新校正》说：真藏脉者，没有其他杂物混杂，所以叫真。比如弦是肝脉，若微弦则和，而有胃气，微弦脉中二分胃气，一分弦气，所以叫微弦。若三分全是弦，则为真藏脉了。
脉要精微篇说：心脉搏坚而长，应当病舌卷不能言；其软而散的，应当消环自愈。肺脉搏坚而长，应当病唾血；其软而散的，应当病灌汗，至今不再复发散发。肝脉搏坚而长，面色不青，应当病坠伤或搏击伤（若搏，或坠，或击伤而搏也），因血在胁下，令人喘逆；其软而散的，面色润泽，应当病溢饮。溢饮者口渴暴多饮，水溢入肌皮肠胃之外。胃脉搏坚而长，面色赤，应当病折髀（髀抵伏兔，故病如折也）；其软而散的，应当病食痹。脾脉搏坚而长，面色黄，应当病少气；其软而散、色不泽的，应当病足肿，像水状。肾脉搏坚而长，面色黄而赤的，应当病折腰；其软而散的，应当病少血，至今不能恢复。
阴阳别论篇说：脉有阴阳，知阳者知阴，知阴者知阳。凡阳有五，五五二十五阳。
所谓阴，指真藏脉，见了就是败象，败必死。所谓阳，指胃脘之阳（胃气）。别于阳的，知病处；别于阴的，知死生之期。三阳在头，三阴在手，说的是一样道理。
汪心谷说：阴者五脏之阴也，阳者胃之阳气也。二十五阳一岁，五脏脉变，各经阳气有五，合为二十五也。三阳三阴，手足三阳三阴经也。一，同也。夫经脉者，由于胃气冲灌，而行贯乎四时，曰春弦夏钩秋毛冬石，兼微曰平，如胃之阳气少者曰病，以寸尺候其病处，或在肾在腹在膻中之类。若胃之阳气已绝，不能与脉俱至于手之太阴，而五脏之阴气独见，见则为败，败必死也。其死必于所不胜之期，如肝见庚辛，心见壬癸，脾见甲乙，肺见丙丁，肾见戊己，故曰知死生之期。王氏及《素问钞》，皆以人迎气口牵强注释，于理益晦，知者审之。
汪氏说：真脉之脏脉者，谓真脏脉之至数，以分五脏之属也。至，脉之应也。悬绝，止绝也。急，劲也。十八，肝脏之得数也。日，日干庚辛是也，脉绝死于所不胜之期。凡脉至流行，内应五脏肝心脾肺肾之气，外应先天五行水一火二木三金四土五之数，故脉五至为小息，五十至为一一大息。若五十至之中，有胃气无止绝曰平。无胃气兼止绝有常数者曰死。凡脉止绝，法以至绝至复数起，周五脏而得其余数，则应所属之脏气已绝，至于所不胜之期日而死。肝至十八日死者，除五脏三五一十五余三，属木内应于肝，故知肝气已绝，庚辛日干为死之期也。
肝至十八加心至九数，共二十七数，除五脏五周，五五二十五余二，属火内应于心，故知心气已绝，壬癸日干为死之期也。
肝心已共二十七数，加肺十二数，共合三十九数，除五脏七周，五七三十五数余四，属金内应于肺，故知肺气已绝，丙丁日干死之期也。
肝心肺已共三十九数，加肾七数，共合四十六数，除五脏九周，五九四十五数余一，属水内应于肾，故知肾气已绝，戊己日干死之期也。
Chapter on the Essential and Subtle Aspects of Pulse Diagnosis: The Yellow Emperor asked, "What is the method of pulse diagnosis?" Qibo replied, "Pulse diagnosis is usually performed at dawn. At this time, Yin Qi has not yet moved, Yang Qi has not yet dispersed, food and drink have not been taken in, the Jing Mai (Primary Meridians) are not yet full, the Luo Mai (Collateral Vessels) are harmonious and even, and Blood and Qi are not yet disturbed. Therefore, only then can abnormal pulses be diagnosed."
At dawn, before laboring, Yin Qi is undisturbed, and Yang Qi is unexhausted; thus, pathological pulses can be observed.
By palpating the movement and stillness of the pulse while observing the clarity of the eyes (Jing Ming), which reflects Shen Qi (Spiritual Energy), and by examining the five colors of the face to observe the excess or deficiency of the Zang Organs (Solid Organs), the strength or weakness of the Fu Organs (Hollow Organs), and the flourishing or declining state of the body, these factors are cross-referenced (Can Wu) to determine the division between life and death.
"Can Wu" refers to inspecting the five colors and other signs, combining and comparing them with the palpated pulse to decide the boundary of life and death.
The pulse is the residence of Blood. A long pulse indicates regulated Qi and peace; a short pulse indicates diseased Qi; a rapid pulse (Shu) indicates mental restlessness; a large pulse indicates advancing disease; excess at the upper part (Cunkou / Inch Position) indicates Qi rebellion, while excess at the lower part (Chizhong / Foot Position) indicates abdominal distension. "Upper excess" refers to the Cunkou; "lower excess" refers to the Chizhong. A intermittent pulse (Dai) indicates Qi decline; a fine pulse indicates Qi deficiency; a choppy pulse (Se) indicates heart pain; a chaotic and urgent pulse like a gushing spring that does not return indicates worsening disease and deteriorated complexion; a pulse that goes away continuously like a breaking string indicates death.
"Hun Hun" means chaotic pulse. "Ge Zhi" means a wiry and solid pulse. "Like a gushing spring" means the pulse rushes out urgently and does not return. "Mian Mian its departure" means the pulse comes continuously without seeing it depart, like the sudden break of a string's tension, indicating fatal disease and complexion.
The subtlety of the pulse must not be neglected. Its inspection has principles, starting from Yin and Yang. Its beginning has classics, arising from the Five Elements (Wu Xing). Its generation has limits, suitable for the Four Seasons. Inspecting the pulse involves the wonder of Yin and Yang rising and falling in the hand, hence called principles. Starting with classics means knowing the general regularity, then following the growth and prosperity of the Five Elements, then following what is suitable for the Four Seasons; this is having limits. Thus, all subtleties can be observed and known.
Therefore, sounds correspond to the Five Tones, complexions correspond to the Five Elements, and pulses correspond to Yin and Yang.
This reiterates the necessity of observing the subtleties mentioned above and their respective correspondences.
There is a way to hold the pulse, where emptiness and tranquility are precious. (Maintain an empty mind and tranquil nature.) Spring pulses float, like fish swimming in waves; (not very floating.) Summer pulses are at the skin level, abundant like all things growing vigorously; Autumn pulses descend to the skin, like hibernating insects preparing to leave; (descending with Qi, hence 'descend to skin', observable from hibernating insects.) Winter pulses are deep in the bone, like hibernating insects tightly wrapped, and gentlemen staying indoors; (meaning of depth.)
This describes the normal pulses of the four seasons, referred to as "starting with classics."
The inner side of both sides of the Chi position corresponds to the hypochondrium (Ji, meaning end, extremely low). The outer side of Chi observes the Kidney; the inner side of Chi observes the abdomen. From the middle attaching up (Guan position), the left outer side observes the Liver, the inner side observes the Diaphragm; the right outer side observes the Stomach, the inner side observes the Spleen. From the top attaching up (Cun position), the right outer side observes the Lung, the inner side observes the chest; the left outer side observes the Heart, the inner side observes the Shanzhong (Pericardium). The front observes the anterior, the back observes the posterior. Pulses reaching the extreme upper correspond to matters of the chest and throat; pulses reaching the extreme lower correspond to matters of the lower abdomen, waist, thigh, knee, and foot.
From the inner Chi to the top attaching up, the six positions diagnose twelve observations. The four sentences about "extreme upper" summarize the appropriateness of each diagnostic observation mentioned above.
Chapter on the Phenomena of Normal People: The Emperor asked, "What is a normal person?" Qibo replied, "In a normal person, the pulse beats twice per exhalation and twice per inhalation. During the pause between breaths, it beats five times. This is calculated based on the pause, and is called a normal person."
One exhalation and one inhalation, the pulse beats twice each, plus one beat during the pause, totaling five beats, called Ping (Normal).
If the pulse beats once per exhalation and once per inhalation, it is called Sha Qi (Deficient Qi).
Five beats per respiratory cycle is normal. Now, with one beat per respiration, the pulse is slow, half the normal count, indicating deficient Qi.
If the pulse beats three times per exhalation and three times per inhalation, and is restless, with heat in the Chi position, it is a Warm Disease (Wen Bing); if the Chi is not hot but the pulse is slippery, it is a Wind Disease; if the pulse is choppy, it is Bi Syndrome (Obstruction).
"Restless" means irritability. Heat in the Chi position (skin over the Chi) indicates epidemic disease. No heat in Chi but slippery pulse indicates Wind; choppy pulse indicates blood deficiency, hence Wei Bi (Flaccidity and Obstruction).
This is a Rapid Pulse (Shu Mai).
If the pulse beats four times or more per exhalation, it is a Death Pulse; if the pulse stops and does not return, it is a Death Pulse; if it is occasionally slow and occasionally rapid, it is a Death Pulse.
Four beats per exhalation and four per inhalation is double the normal, even more severe than rapid. Pulse cessation and irregular rhythm indicate the extinction of Grain Qi, hence all indicate death.
The normal Qi of a healthy person is derived from the Stomach; the Stomach is the source of normal Qi. Without Stomach Qi, it is Ni (Rebellious/Contrary), and Ni leads to death.
No Stomach Qi means the seasonal pulses lack the harmonious Qi of the root organ. This can be understood from the following text.
Spring pulse with slight Stomach Qi and slight Wiry (Xian) character is Normal; excessive Wiry with little Stomach Qi indicates Liver Disease; purely Wiry without Stomach Qi indicates Death; Stomach Qi present with Floating (Mao) character indicates Autumn illness; excessive Floating indicates current illness.
Spring Stomach Qi is Wiry yet soft. Excessive Wiry means severe Wiry. Like a newly drawn bowstring. Little Stomach Qi means the root organ is diseased itself. Purely Wiry without Stomach Qi is death. Stomach Qi with Mao (Floating) indicates Autumn illness; excessive Mao means Metal overcomes Wood, so immediate illness.
Summer pulse with slight Stomach Qi and slight Hook (Gou/Hong) character is Normal; excessive Hook with little Stomach Qi indicates Heart Disease; purely Hook without Stomach Qi indicates Death; Stomach Qi present with Stone (Shen/Chen) character indicates Winter illness; excessive Stone indicates current illness.
Summer Stomach Qi is Wiry and Slippery. Purely Hook means Large and Firm. Having Stone character means Deep pulse of Winter, hence Winter illness; excessive Stone means Water overcomes Fire, so immediate illness.
Long Summer pulse with slight Stomach Qi and slight Weak character is Normal; excessive Weak with little Stomach Qi indicates Spleen Disease; purely Dai (Intermittent) without Stomach Qi indicates Death; Stomach Qi present with Stone character indicates Winter illness; excessive Weak indicates current illness.
Long Summer Stomach Qi is Weak. Excessive Weak means powerless. Dai means unable to return, indicating death. Weak and Deep indicates Winter illness; excessive Weak means immediate illness.
Autumn pulse with slight Stomach Qi and slight Mao (Floating) character is Normal; excessive Mao with little Stomach Qi indicates Lung Disease; purely Mao without Stomach Qi indicates Death; Mao character with Wiry character indicates Spring illness; excessive Wiry indicates current illness.
Autumn Stomach Qi is Floating. Excessive Mao means slightly floating, indicating Lung Qi deficiency and disease. Floating and faint approaching extinction is death; Floating with Wiry is Spring illness; excessive Wiry means immediate illness.
Winter pulse with slight Stomach Qi and slight Shi (Deep) character is Normal; excessive Shi with little Stomach Qi indicates Kidney Disease; purely Shi without Stomach Qi indicates Death; Stomach Qi present with Hook character indicates Summer illness; excessive Hook indicates current illness.
Winter Stomach Qi is Deep. Excessive Shi means Deep, indicating Kidney Qi insufficiency. Purely Shi is Deep and Firm. Shi with Hook means Deep and Slippery, causing illness in Summer. Excessive Shi means immediate illness.
Chapter on the Jade Machine and True Hidden: It says: Spring takes Stomach Qi as the root. When the Liver pulse comes, full, solid, and slippery, like feeling a long pole (long and tight), it is Liver Disease. The dying Liver pulse comes urgent and strong, like a newly drawn bowstring, indicating Liver Death. The True Liver pulse comes tense inside and out, like feeling a knife edge rasping, like pressing a zither string, with greenish-white lusterless complexion and brittle hair, indicating death.
Summer takes Stomach Qi as the root. When the Heart pulse comes, panting and connected, slightly curved within, it is Heart Disease. The dying Heart pulse comes curved forward and stationary backward, like holding a belt hook, indicating Heart Death.
Belt hook means sinking and immobile. The True Heart pulse comes firm and beating, like feeling Coix seeds (Yiyi Zi) clustered, with reddish-black lusterless complexion and brittle hair, indicating death.
Long Summer takes Stomach Qi as the root. When the Spleen pulse comes, solid, full, and rapid, like a chicken lifting its foot, it is Spleen Disease. The dying Spleen pulse comes sharp and firm like a bird pecking, like a bird's spur, like a leaking roof, like flowing water, indicating Spleen Death. The True Spleen pulse comes weak and occasionally sparse and occasional rapid, with yellowish-green lusterless complexion and brittle hair, indicating death.
Autumn takes Stomach Qi as the root. When the Lung pulse comes, neither ascending nor descending, like feeling a chicken feather, it is Lung Disease. The dying Lung pulse comes like a floating object, like wind blowing feathers, indicating Lung Death. (Floating and scattered.) The True Lung pulse comes large and empty, like a feather touching human skin, with reddish-white lusterless complexion and brittle hair, indicating death.
Winter takes Stomach Qi as the root. When the Kidney pulse comes, like pulling a vine, becoming harder upon pressure, it is Kidney Disease. The dying Kidney pulse comes like pulling a rope, crackling like striking stones, indicating Kidney Death. (Rapid and firm.) The True Kidney pulse comes beating and abrupt, like fingers striking stones crackling, with blackish-yellow lusterless complexion and brittle hair, indicating death.
Chapter on the Jade Machine and True Hidden Discourse: Qibo said: The Spring pulse belongs to the Liver, Eastern Wood, the cause of all things beginning to grow. Thus, its Qi comes weak, light, empty, and slippery, straight and long, called Wiry (Xian); contrary to this is disease. If its Qi comes solid and strong, this is Excess (Tai Guo), disease in the Exterior; if its Qi comes not solid and faint, this is Deficiency (Bu Ji), disease in the Interior.
Excess is Yang residing in the exterior, hence disease in the exterior; Deficiency is Yin residing in the interior, hence disease in the interior.
Excess causes anger, dizziness, vertigo, and epilepsy; Deficiency causes chest pain radiating to the back, and below, fullness in both hypochondria.
Excess Liver Qi excess leads to anger, visual dizziness and vertigo, Qi rebelling upwards causing epilepsy; Deficiency Liver Qi stagnation leads to hypochondriac pain and fullness.
The Summer pulse belongs to the Heart, Southern Fire, the cause of all things flourishing and growing. Thus, its Qi comes vigorous and departs declining, called Hook (Gou) (i.e., curved forward and stationary backward, coming fast and departing slow); contrary to this is disease. If its Qi comes vigorous and departs vigorous, this is Excess, disease in the Exterior; if its Qi comes not vigorous but departs vigorous, this is Deficiency, disease in the Interior. Excess causes body heat and skin pain, forming spreading sores (Jin Yin); Deficiency causes mental vexation, coughing and spitting upwards, and Qi leakage downwards.
Heart pulse Excess causes body heat and skin pain, spreading sores; Deficiency causes heart vexation, coughing/spitting, and Qi leakage downwards.
The Autumn pulse belongs to the Lung, Western Metal, the cause of all things harvesting. Thus, its Qi comes light, empty, and floating, coming urgent and departing scattered, called Floating (Fu); contrary to this is disease. If its Qi comes, hairy (Mao/Floating) with center firm and sides empty, this is Excess, disease in the Exterior; if its Qi comes, hairy and faint, this is Deficiency, disease in the Interior. Excess causes rebellious Qi, back pain, and depression; Deficiency causes asthma, shortness of breath, cough, hemoptysis upwards, and noisy breathing downwards.
Hemoptysis upwards means asthma and coughing blood; noisy breathing downwards means further coughing.
The Winter pulse belongs to the Kidney, Northern Water, the cause of all things storing. Thus, its Qi comes deep and beating, called Ying (Camp/Nourishing); contrary to this is disease. If its Qi comes like striking stones, this is Excess, disease in the Exterior; if its Qi departs like a rapid pulse, this is Deficiency, disease in the Interior. Excess causes lassitude (Xie Dai), spine pain, shortness of breath, and unwillingness to speak. Deficiency causes a hanging heart like hunger, coldness in the hypochondrium, spine pain, lower abdominal fullness, and urinary changes.
Hypochondrium refers to the soft area beside the spine below the ribs. Cold means chilling. Spine center is between the two kidneys. Lower abdomen is anterior to the hypochondrium. Lower abdominal fullness indicates Kidney Qi stagnation, hence urinary changes, either red or difficult.
The Emperor asked: What does the Spleen pulse primarily govern? He answered: The Spleen pulse belongs to Earth, the solitary organ irrigating the four directions. Good Spleen pulses are not seen; bad ones are visible. (Spleen thrives in the four seasons, so good pulses are invisible, bad ones visible.) If its Qi comes like flowing water, this is Excess, disease in the Exterior; like a bird pecking, this is Deficiency, disease in the Interior. Excess causes inability to lift the limbs; Deficiency causes obstruction of the nine orifices.
Insufficient Middle Qi cannot irrigate the four directions, leading to disharmony of the five Zang organs, hence obstruction of the nine orifices.
Chapter on the Phenomena of Normal People says: To know Excess and Deficiency, if the Cun Kou pulse feels short upon pressing, it is Headache. If the Cun Kou pulse feels long upon pressing, it is Pain in the Legs/Shins. If the Cun Kou pulse feels hurried and strikes upward, it is Shoulder and Back Pain. If the Cun Kou pulse is deep and firm, it is Disease in the Interior. If the Cun Kou pulse is floating and vigorous, it is Disease in the Exterior. If the Cun Kou pulse is deep and weak, it is Cold-Heat and Hernia/Masses with lower abdominal pain. If the Cun Kou pulse is deep and horizontal, it is Accumulation under the hypochondrium and transverse accumulation pain in the abdomen. If the Cun Kou pulse is deep and rapid, it is Cold-Heat. Vigorous, slippery, and firm pulses indicate Disease in the Exterior. Small, solid, and firm pulses indicate Disease in the Interior. Small, weak, and choppy pulses indicate Chronic Disease. Slippery, floating, and rapid pulses indicate New Disease. Urgent pulses indicate Hernia/Masses and lower abdominal pain. Slippery pulses indicate Wind. Choppy pulses indicate Bi Syndrome. Slow and slippery pulses indicate Heat in the Middle. Vigorous and tight pulses indicate Distension. Slow and choppy Chi pulses indicate Lassitude. Sleeping with vigorous pulses indicates Blood Loss. Choppy Chi and slippery pulses indicate Profuse Sweating. Cold Chi and fine pulses indicate Posterior Discharge (Diarrhea). Rough and constantly hot Chi pulses indicate Heat in the Middle. In women, if the Hand Sha Yin pulse moves strongly, it indicates Pregnancy.
Sha Yin is located in the depression behind the wrist, responding when pressing towards the little finger. "Move" refers to pulsation. Chapter on Divergent Channels says: Yin pulsation distinct from Yang indicates pregnancy.
Chapter on Divergent Channels says: Food enters the Stomach, turbid Qi returns to the Heart, essence permeates the vessels, vessel Qi flows through the meridians, essence returns to the Lungs, the Lungs direct all vessels, transmitting essence to the skin and hair. Skin and vessel essence combine, Qi flows into the Fu organs, Fu organ spirit becomes bright, remaining in the four Zang organs, Qi returns to balance. Balance achieved, the Qi Kou forms the Cun inch, deciding life and death.
Qi Kou is the Hand Taiyin Lung pulse, the great assembly of pulses, where all vessels converge; thus, its divisions decide life and death. This forms the Cun Kou pulse method, consisting of Cun, Guan, and Chi positions.
Water enters the Stomach, overflowing essence ascends to the Spleen, Spleen Qi scatters essence, ascending to return to the Lungs, regulating water passages, descending to transport to the Bladder, water essence distributes in four directions, five meridians run together, conforming to the Four Seasons and Yin-Yang of the Five Zang organs, measured as constant norms.
Water essence distributed in meridians, Five Zang and Four Seasons follow constant measures, not deviating.
Chapter on the Phenomena of Normal People says: Humans rely on water and grain; thus, humans die without water and grain, and pulses die without Stomach Qi.所谓无胃气者，就是只得到真藏脉而没有胃气。所谓脉不得胃气，就是肝不弦、肾不石。
"Stone/Wiry but saying not" means not resembling the mild Wiry or mild Stone harmony. The five Zang organs follow this pattern.
Chapter on the Jade Machine and True Hidden says: Seeing the True Hidden pulse indicates death. Why? Qibo said: All five Zang organs receive Qi from the Stomach; the Stomach is the root of the five Zang organs. Organ Qi cannot reach the Hand Taiyin independently but must rely on Stomach Qi to reach the Hand Taiyin. Thus, each Zang organ, in its own season, presents its condition to reach the Hand Taiyin. Therefore, when pathogenic Qi prevails, essential Qi declines. In severe illness, Stomach Qi cannot accompany it to the Hand Taiyin. Thus, when the True Hidden Qi appears alone, the disease overwhelms the organ, hence death.
Gao Baoheng's "New Correction" states: The True Hidden pulse has no other elements mixed, hence called True. For example, Wiry is the Liver pulse; if slightly Wiry, it is harmonious with Stomach Qi. In a slightly Wiry pulse, two parts are Stomach Qi, one part is Wiry Qi, hence "slightly Wiry." If all three parts are Wiry, it is the True Hidden pulse.
Chapter on the Essential and Subtle Aspects of Pulse Diagnosis says: If the Heart pulse is firm and long, it should cause tongue curling and inability to speak; if soft and scattered, it should resolve spontaneously in the Huanyuan area. If the Lung pulse is firm and long, it should cause spitting blood; if soft and scattered, it should cause profuse sweating (Guan Han), which will not recur. If the Liver pulse is firm and long, but the complexion is not green, it should be due to a fall or blow; because blood is under the hypochondrium, causing wheezing and rebellion; if soft and scattered, with lustrous complexion, it should cause Overflowing Drink (Yi Yin). Overflowing Drink involves sudden thirst and excessive drinking, with fluid overflowing into muscles, skin, and outside the stomach/intestines. If the Stomach pulse is firm and long, and the complexion is red, it should cause hip fracture-like pain (Bi reaches Futu, so pain feels like a break); if soft and scattered, it should cause Food Bi (obstruction). If the Spleen pulse is firm and long, and the complexion is yellow, it should cause shortness of Qi; if soft, scattered, and lusterless, it should cause leg swelling, resembling edema. If the Kidney pulse is firm and long, and the complexion is yellow-red, it should cause lower back fracture-like pain; if soft and scattered, it should cause blood deficiency, never recovering.
Firm and long indicate Excess; soft and scattered indicate Deficiency. Each Zang organ suffers disease due to Excess or Deficiency.
Chapter on Yin-Yang Distinctions says: Pulses have Yin and Yang. Knowing Yang means knowing Yin; knowing Yin means knowing Yang. There are five Yangs, making twenty-five Yangs.
What is called Yin is the True Hidden pulse; appearing means decay, and decay means death. What is called Yang is the Yang of the Stomach cavity (Stomach Qi). Distinguishing from Yang reveals the disease location; distinguishing from Yin reveals the timing of death. Three Yangs are at the head, Three Yins are at the hand; this is unity.
Wang Xingu says: Yin is the Yin of the five Zang organs; Yang is the Yang Qi of the Stomach. Twenty-five Yangs correspond to one year; the five Zang pulses change, each meridian's Yang Qi has five, totaling twenty-five. Three Yangs and Three Yins refer to the Hand and Foot Three Yang and Three Yin meridians. One means same. Meridians are irrigated by Stomach Qi and circulate through the four seasons: Spring Wiry, Summer Hook, Autumn Hairy, Winter Stone. Combined with slightness, it is Normal. If Stomach Yang Qi is scant, it is Disease. Using Cun and Chi to locate the disease, whether in the Kidney, abdomen, or Shanzhong. If Stomach Yang Qi is exhausted, it cannot accompany the pulse to the Hand Taiyin, and the Yin Qi of the five Zang organs appears alone. Appearing means decay, decay means death. Death must occur during the period of the overcoming element: e.g., Liver sees Geng/Xin, Heart sees Ren/Gui, Spleen sees Jia/Yi, Lung sees Bing/Ding, Kidney sees Wu/Ji. Hence, knowing the timing of life and death. Wang Shi and "Suwen Synopsis" force interpretations using Renying and Qikou, making the logic obscure; let the wise examine this.
For those holding the True Pulse of the Zang organs: If the Liver pulse hangs isolated and urgent, death occurs in eighteen days.
Wang says: True Pulse of Zang organs refers to the frequency of the True Hidden pulse, categorizing the five Zang organs. "Zhi" means pulse response. "Xuan Jue" means isolated cessation. "Ji" means firm. Eighteen is the number belonging to the Liver. Days refer to the Heavenly Stems Geng and Xin. Pulse cessation dies during the overcoming period. All pulse movements internally correspond to the Qi of the five Zang organs (Liver, Heart, Spleen, Lung, Kidney) and externally correspond to the numbers of innate Five Elements: Water 1, Fire 2, Wood 3, Metal 4, Earth 5. Thus, five beats constitute a small breath, fifty beats constitute a large breath. If within fifty beats, there is Stomach Qi without cessation, it is Normal. Without Stomach Qi combined with cessation having a constant number, it is Death. For pulse cessation, counting from cessation to recovery, cycling through the five Zang organs to get the remainder, indicates the corresponding Zang Qi is exhausted, leading to death on the overcoming day. Liver dying in eighteen days: Subtracting five cycles of three (fifteen) from eighteen leaves three, belonging to Wood, internally corresponding to the Liver. Thus, Liver Qi is exhausted, and Geng/Xin stems are the death period.
If the Heart pulse hangs isolated, death occurs in nine days.
Liver's eighteen plus Heart's nine equals twenty-seven. Subtracting five cycles of five (twenty-five) leaves two, belonging to Fire, internally corresponding to the Heart. Thus, Heart Qi is exhausted, and Ren/Gui stems are the death period.
If the Lung pulse hangs isolated, death occurs in twelve days.
Liver and Heart total twenty-seven, plus Lung's twelve equals thirty-nine. Subtracting seven cycles of five (thirty-five) leaves four, belonging to Metal, internally corresponding to the Lung. Thus, Lung Qi is exhausted, and Bing/Ding stems are the death period.
If the Kidney pulse hangs isolated, death occurs in seven days.
Liver, Heart, and Lung total thirty-nine, plus Kidney's seven equals forty-six. Subtracting nine cycles of five (forty-five) leaves one, belonging to Water, internally corresponding to the Kidney. Thus, Kidney Qi is exhausted, and Wu/Ji stems are the death period.
If the Spleen pulse hangs isolated, death occurs in four days.