人有胃脘痈者，诊当何如？曰∶诊此者当候胃脉，其脉当沉细，沉细者气逆，逆者人迎甚盛，则热。
人迎者胃脉也，逆而盛，则热聚于胃口而不行，故胃脘为痈也。
此下六条，皆《内经》脉案，教人以诊之法也。诊者无
失色脉，而于脉尤当从容比类，循上及下以求索之，而得其病情。若此条胃脘有痈，当候胃脉。今胃
脉即沉细，则胃气不升。人迎在上而盛，则热聚于上而不行。此以本经上下推求而得之也。
有病厥者，诊右脉沉而紧，左脉浮而迟，病主安在？歧伯曰∶冬诊之，右脉固当沉紧，此应四时；
左脉浮而迟，此逆四时。在左当主病在肾，颇关在肺，当腰痛也，少阴脉贯肾络肺，今得肺脉，肾为之病
，故肾为腰痛之病也。
病厥者左右脉既不伦，则以逆四时者推之。在左则当主肾，以冬令肾为主也，况当腰痛，则诚肾厥矣。
此以时令逆从而推得之者也。
有癃者，一日数十溲，此不足也。身热如炭，颈膺如格，人迎躁盛，喘息气逆，此有余也。太阴脉细
微如发者，此不足也。其病安在？曰∶病在太阴，其盛在胃，颇在肺，病名曰厥，死不治，此所谓五有余
二不足也。五有余者，五病之气有余也；二不足者，亦病气之不足也。今外得五有余，内得二不足，此其
身不表不里，亦正死明矣。
癃者气化不及州都，而外证如炭如格，躁盛，喘息气逆，皆以阳盛。或人独太阴脉细如发，则知太阴
肺气不得下输膀胱，是中虚已极，已从脉细微见之。而外五有余，此格阳之诊也，故病名厥。日死不治，此从
脉细与病癃二不足者决之也。
有人头痛筋挛骨重，怯然少气，哕噫腹满，时惊不嗜卧，此何脏之发也？脉浮而弦，切之石坚，所以三
脏者何也？曰∶夫从容之谓也。年长则求之于腑，年少则求之于经，年壮则求之于脏。今子所言皆失，八风
菀热，五脏消铄，传邪相染。夫浮而弦者，是肾不足也。沉而实者，是肾气内着也。怯然
少气者，水道不行，形气消索也。咳嗽烦冤者，是肾气之逆也。一人之气，病在一脏也。若言三脏，
不在法也。
此条为证多端，头痛筋挛可入太阳，哕噫腹满可入太阴，时惊不嗜卧可入阳明。而脉则浮弦石坚
，又可疑浮为太阴，弦为厥阴，石坚为少阴。只以骨重、怯然少气为的属少阴，故
诸证皆决于肾也。其浮为有表无里，弦为肾不养肝，石坚则肾之内着，可知是诸证皆不归元之诊也。此从
其病根所在而断之也。
有人四肢解惰，喘咳血泄，而诊以为伤肺，切脉浮大而紧，粗工下砭石多出血，血止身轻，何也？曰∶
子治与此病失矢。夫圣人之治，循守法度，援物比类，化之宣之，循上及下，何必守经。今夫脉浮大虚者，
是脾气之外绝，去胃外归阳明也。夫二火不胜三水，是以脉乱而无常也。四肢懈惰，此脾精之不行也。喘
咳者，是水气并阳明也。血泄者，脉急血无所行也。以为伤肺，不引比类。夫伤肺者，脾气不守，胃
气不清，经气不为使，真脏坏决，经脉旁绝，五脏漏泄，不衄则呕，此二者不相类也。
病见四肢懈惰，喘咳血泄。切脉浮大而紧，大为脾脉，带浮而紧，则脾伤气不内归，故喘咳血泄，如
所指言者。若以为肺伤，不惟无此脉证，亦无此诊矣。经脉傍绝，五脏漏泄，不衄则呕，盖其证已与伤
脾殊，此从其比类以知之也。
诊得心脉而急，此为何病？曰∶病名心疝。少腹当有形也。心为牡脏，小肠为之使，故曰，少腹当有形也
。
诸急者多寒，心脉独急，宜结寒于心。然心牡脏，卒不得结，必结于小肠，以小肠为其使，故当移之于此
也。此得之以心不受病，而知病之移于使也。诊家之治法，不可概列枚举，就《内经》脉案而悟之，斯过
半矣。
有人患有胃脘痈（胃部化脓性炎症），诊断应当如何进行？回答说：诊断此病应当观察胃脉，其脉象应当沉细。脉象沉细表示气机逆乱，气机逆乱则人迎脉（颈部两侧动脉，反映胃经气血状况）非常盛大，从而产生热邪。
人迎脉属于胃脉，气机逆乱且盛大，则热邪聚集在胃口而不能运行，所以导致胃脘形成痈肿。
以下六条内容，都是《黄帝内经》中的脉案，用来教导人们诊断的方法。诊病时不能忽视色诊和脉诊，而在脉诊上更应当从容不迫地进行类比比较，顺着经络从上到下寻求索证，从而掌握病情。像这一条所说的胃脘有痈，应当候察胃脉。现在胃脉呈现沉细，说明胃气不能上升。人迎脉在上部且盛大，说明热邪聚集在上部而不能下行。这是通过本经上下推求而得出的结论。
有人患厥病（四肢逆冷的病症），诊察右脉沉而紧，左脉浮而迟，疾病主要在哪里？岐伯说：冬季诊察时，右脉本来应当沉紧，这符合四季变化的规律；左脉浮而迟，这违背了四季变化的规律。左脉异常通常主肾病，但也与肺有关，应当出现腰痛症状。足少阴肾经贯穿肾脏并联络肺部，现在出现了肺的脉象（浮迟），说明肾脏生病，所以肾脏是腰痛疾病的根源。
患厥病的人左右脉象都不伦不类，就根据违背四季规律的脉象来推断。左脉异常则主要责之于肾，因为冬季以肾气为主，况且伴有腰痛，这确实是肾厥病。这是通过时令逆从关系推求出来的。
有人患癃闭（小便不通利），一天排尿几十次，这是正气不足的表现。身体发热像火炭一样，颈胸部感觉像被格拒阻隔，人迎脉搏动躁动盛大，喘息气逆，这是邪气有余的表现。太阴脉细微得像头发一样，这也是正气不足的表现。疾病在哪里呢？回答说：病位在太阴脾，邪气盛在阳明胃，也与肺有关，病名叫做厥，预后不良难以治愈，这就是所谓的“五有余二不足”。五有余，是指五种病邪之气有余；二不足，也是指病气之不足。现在外部表现出五有余，内部表现出二不足，这种病人身处表里之间，死亡是明显的了。
癃闭是因为气化功能无法到达膀胱（州都之官），而外在症状像火炭、像格拒，脉搏躁动盛大，喘息气逆，这些都是阳气亢盛所致。唯独太阴脉细微如发，就知道太阴肺气不能向下输布到膀胱，这是中焦虚损到了极点，已经从脉象细微看出来。而外部表现为五有余，这是格阳（真寒假热）的诊断，所以病名叫做厥。说会死亡且难以治愈，这是从脉象细微和小便癃闭这两个不足方面判断的。
有人头痛、筋脉拘挛、骨骼沉重、畏缩乏力、气短、呃逆嗳气、腹部胀满、时常惊恐、不喜欢睡觉，这是什么脏腑发出的病变？脉象浮而弦，重按坚硬如石，为什么说涉及三个脏腑呢？回答说：这就是所谓从容比类的道理。年长的人求病于腑，年少的人求病于经脉，年壮的人求病于脏。现在你所说的都错了，这是八风（八方之风邪）郁积化热，五脏精气消减耗损，病邪相互传染。脉象浮而弦，是肾气不足的表现。脉象沉而实，是肾气内结滞留的表现。畏缩乏力、气短，是因为水道不通行，形体和气都消耗枯竭。咳嗽烦闷冤屈感，是肾气上逆的表现。一个人的气，病在一脏。如果说涉及三脏，就不符合诊法了。
这一条症状表现多样，头痛筋挛可以归入太阳经，呃逆嗳气腹满可以归入太阴经，时常惊恐不喜欢睡觉可以归入阳明经。而脉象浮弦石坚，又让人怀疑浮脉属太阴，弦脉属厥阴，石坚脉属少阴。只以骨重、畏缩乏力、气短为确切的少阴病特征，所以所有症状都归结于肾脏。浮脉表示有表无里，弦脉表示肾不能滋养肝，石坚脉表示肾气内结，可知这些症状都是元气不归根本的诊断。这是从其病根所在而做出的判断。
有人四肢懈怠无力，喘咳吐血泄泻，医生诊断为肺伤，切脉浮大而紧，粗劣的医生使用砭石放血，血止后身体轻松，为什么呢？回答说：你的治疗与此病不符。圣人治病，遵循法规制度，援引事物进行类比，灵活变通宣导，顺着经络从上到下推求，何必死守经文。现在的脉象浮大虚，是脾气向外断绝，离开胃部回归阳明经的表现。二火（心火、命门之火）不能胜过三水（寒水、湿水等），所以脉象紊乱无常。四肢懈怠无力，这是脾精不能运行的表现。喘咳，是水气并入阳明经的表现。吐血泄泻，是因为脉急迫血液无法正常运行的表现。如果认为是肺伤，没有运用类比推理。如果是肺伤，脾气不守，胃气不清，经气不能发挥作用，真脏脉败坏决裂，经脉旁绝，五脏精气漏泄，不是鼻衄就是呕吐，这两种情况是不相似的。
病见四肢懈怠无力，喘咳吐血泄泻。切脉浮大而紧，大为脾脉，带有浮而紧，说明脾受伤气不能内归，所以出现喘咳吐血泄泻，正如所指出的那样。如果认为是肺伤，不仅没有这样的脉证，也没有这样的诊断了。经脉旁绝，五脏精气漏泄，不是鼻衄就是呕吐，大概这些症状已经与伤脾不同，这是通过类比推理得知的。
诊察到心脉紧急，这是什么病？回答说：病名叫心疝。小腹应当有肿块或硬物。心为阳脏（牡脏），小肠为其使（配合者），所以说，小腹应当有有形之物。
各种紧急的脉象多主寒证，唯独心脉紧急，应该是寒邪凝结于心。然而心为阳脏，突然之间不容易凝结，必然凝结在小肠，因为小肠是心的使，所以病邪会转移到这里。这是通过心脏不受病，而知病邪转移到其使者的方法。诊家的治疗方法，不能一概列举枚举，只要从《黄帝内经》的脉案中领悟，就超过一半了。
A person suffering from a carbuncle in the stomach region (Wei Wan Yong, an abscess or suppurative inflammation of the stomach), how should it be diagnosed? It is said: When diagnosing this condition, one must observe the Stomach pulse. The pulse should be deep and fine (Chen Xi). A deep and fine pulse indicates rebellious Qi (Qi Ni). Rebellious Qi causes the Renying pulse (Renying, the carotid artery reflecting the state of the Stomach meridian) to become extremely full and vigorous, generating heat.
The Renying pulse belongs to the Stomach meridian. When Qi is rebellious and the pulse is full, heat gathers at the gastric opening but cannot circulate, thus causing a carbuncle in the stomach region.
The following six entries are all pulse cases from the *Neijing* (Yellow Emperor's Inner Canon), intended to teach diagnostic methods. In diagnosis, one must not neglect both complexion and pulse observation; particularly with pulse diagnosis, one should calmly employ analogical comparison, tracing along the meridians from top to bottom to seek evidence and thereby ascertain the disease condition. For instance, in the case of a carbuncle in the stomach region, one should inspect the Stomach pulse. Since the Stomach pulse is now deep and fine, it indicates that Stomach Qi fails to ascend. The Renying pulse being upper and full indicates that heat gathers above and fails to descend. This conclusion is reached by deducing through the upper and lower aspects of the same meridian.
In a patient with Jue disease (Jue Bing, characterized by cold extremities), if the right pulse is deep and tight, and the left pulse is floating and slow, where is the primary pathology? Qibo stated: During winter diagnosis, the right pulse should naturally be deep and tight, conforming to the four seasons; however, the left pulse being floating and slow violates the seasonal pattern. An abnormality in the left pulse primarily indicates kidney disease, closely involving the lungs, and should manifest as lower back pain. The Foot-Shaoyin Kidney meridian passes through the kidneys and connects with the lungs. Now, having obtained a lung pulse (floating and slow), it indicates kidney pathology, hence the kidney is the source of the lower back pain.
For patients with Jue disease whose left and right pulses are inconsistent, one deduces based on the pulse violating the seasonal norms. Abnormality in the left pulse points primarily to the kidney, as the kidney governs during winter, especially when accompanied by lower back pain, confirming it as Kidney Jue. This deduction is made by analyzing the reversal of seasonal correspondences.
A patient suffers from Long (Long Bi, difficulty in urination), voiding urine dozens of times a day, indicating deficiency. The body feels hot like a charcoal fire, the neck and chest feel obstructed or blocked, the Renying pulse is restless and vigorous, with wheezing and rebellious Qi, indicating excess. The Taiyin pulse is minute and hair-thin, also indicating deficiency. Where is the disease located? It is answered: The disease lies in the Taiyin (Spleen), its excess is in the Yangming (Stomach), and it somewhat involves the Lung. The disease name is Jue, which is incurable and fatal. This is referred to as "Five Excesses and Two Deficiencies." The five excesses refer to the excess of five pathogenic qi factors; the two deficiencies refer to the insufficiency of pathological qi. Currently, there are five excesses externally and two deficiencies internally. Such a patient stands between exterior and interior, making death evident.
Long (urinary retention) occurs because Qi transformation fails to reach the Bladder (Zhou Du, the storehouse of fluids), while external signs like heat resembling charcoal and obstruction indicate Yang excess. Only the Taiyin pulse being minute like hair reveals that Taiyin Lung Qi cannot descend to transport fluids to the Bladder, indicating extreme middle-jiao deficiency, visible from the minute pulse. With five excesses externally, this is a diagnosis of Ge Yang (Ge Yang, true cold false heat syndrome), hence named Jue. The prognosis of death and incurability is determined by the two deficiencies: the minute pulse and urinary Long.
A patient presents with headache, tendon cramping, heavy bones, timidity with shortness of breath, belching, abdominal fullness, frequent fright, and insomnia. Which zang organ is the source? The pulse is floating and wiry, and firm/hard upon pressure (Shi Jian). Why are three organs implicated? It is answered: This refers to the principle of calm analogical reasoning. For the elderly, seek disease in the fu organs; for the young, in the meridians; for the prime-aged, in the zang organs. What you say is incorrect. This results from the stagnation of Eight Winds (Ba Feng, pathogenic winds from eight directions) transforming into heat, consuming and wasting the five zang organs, with pathogens transmitting and infecting each other. A floating and wiry pulse indicates Kidney deficiency. A deep and solid pulse indicates Kidney Qi internal stagnation. Timidity and shortness of breath occur because water pathways do not flow, leading to the exhaustion of form and Qi. Coughing and vexation result from rebellious Kidney Qi. One person's Qi has pathology in one zang organ. To speak of three organs contradicts diagnostic principles.
This entry presents diverse symptoms: headache and tendon cramping may enter the Taiyang channel; belching, belching, and abdominal fullness may enter the Taiyin channel; frequent fright and insomnia may enter the Yangming channel. However, the pulse being floating, wiry, and stone-hard raises doubts: floating might suggest Taiyin, wiry might suggest Jueyin, and stone-hard might suggest Shaoyin. Only by taking heavy bones, timidity, and shortness of breath as definitive indicators of Shaoyin can all symptoms be attributed to the Kidney. Floating indicates exterior without interior; wiry indicates the Kidney failing to nourish the Liver; stone-hard indicates Kidney Qi internal stagnation. Thus, these symptoms represent a diagnosis of Yuan Qi (Original Qi) failing to return to its root. This judgment is made based on the location of the disease root.
A patient presents with flaccidity of the four limbs, wheezing, coughing, hematochezia, and bleeding. The physician diagnoses Lung injury. The pulse is floating, large, and tight. Crude practitioners use bian stones (stone lancets) to bleed, and after bleeding stops, the body feels light. Why? It is answered: Your treatment deviates from the disease. The Sage treats according to laws and regulations, uses analogical reasoning, transforms and disseminates Qi, tracing from top to bottom, rather than rigidly adhering to scriptures. A floating, large, and empty pulse indicates Spleen Qi externally severed, departing from the Stomach to return to Yangming. When the Two Fires (Heart Fire and Mingmen Fire) cannot overcome the Three Waters (Cold/Water elements), the pulse becomes chaotic and irregular. Flaccidity of the four limbs indicates Spleen Jing (Essence) failing to circulate. Wheezing and coughing indicate Water Qi merging with Yangming. Hematochezia and bleeding occur because the pulse is urgent, leaving blood nowhere to go. Diagnosing Lung injury without employing analogical reasoning is flawed. If it were Lung injury, Spleen Qi would not guard, Stomach Qi would not clear, Jing Qi would not function, the True Zang pulse would break, meridians would sever peripherally, and the five zang organs would leak. Symptoms would be epistaxis or vomiting. These two scenarios are dissimilar.
The disease presents with flaccidity, wheezing, coughing, and bleeding. The pulse is floating, large, and tight. Large is the Spleen pulse; combined with floating and tight, it indicates Spleen injury with Qi failing to return inward, causing wheezing, coughing, and bleeding, as described. If diagnosed as Lung injury, neither the pulse nor the symptoms match, nor does the diagnostic logic hold. Peripheral meridian severance and zang leakage leading to epistaxis or vomiting differ significantly from Spleen injury. This is known through analogical reasoning.
Upon diagnosing a heart pulse that is urgent/tight, what is the disease? It is answered: The disease is named Xin Shan (Heart Hernia). There should be a palpable mass in the lower abdomen. The Heart is a Yang (Mu) organ, and the Small Intestine is its Shi (envoy/assistant). Therefore, it is said that there should be a palpable mass in the lower abdomen.
Urgent pulses generally indicate Cold. If only the Heart pulse is urgent, it suggests Cold knotting in the Heart. However, since the Heart is a Yang organ, it rarely knots directly; instead, the Cold knots in the Small Intestine, as the Small Intestine is the Heart's envoy. Thus, the pathology shifts there. This method allows one to know that if the Heart itself is not diseased, the pathology has shifted to its envoy. The therapeutic methods of diagnosticians cannot be exhaustively listed; by comprehending the pulse cases in the *Neijing*, one grasps more than half of them.