（添加）
此篇总揭天地阴阳，人身造化，脉病治法，昭然可考，为初学之一鉴云。
三才，天地人也。天者，轻清而上浮也。地者，重浊而下凝也。阳之精为日，东升而西坠也。阴之精为
月，夜见而昼隐也。天不足西北，故西北方阴也，而人右耳目不如左明也。地不满东南，故东南方阳也，而人
左手足不如右强也。天气下降，地气上升也。阴中有阳，阳中有阴也。平旦至日中，天之阳，阳中之阳也。日
中至黄昏，天之阳，阳中之阴也。合夜至鸡鸣，天之阴，阴中之阴也。鸡鸣至平旦，天之阴，阴中之阳也。故
人亦应之。
天地者，万物之上、下也。阴阳者，血气之男、女也。左右者，阴阳之道路也。水火者，阴阳之征兆也。
金木者，生成之始终也。玄气凝空，水始生也。赤气炫空，火始生也。苍气浮空，木始生也。素气横空，金始
生也。黄气际空，土始生也。
天地氤氲，万物化醇。男女媾精，万物化生。人者，得天地之正气，灵于万物者也。命者，天之赋也。精
者，身之本也。形者，生之舍也。气者，生之元也。神者，生之制也。
心者，君主之官，神明出焉。肺者，相傅之官，治节出焉。胆者，中正之官，决断出焉。膻中者，臣使之
官，喜乐出焉。肝者，将军之官，谋虑出焉。脾胃者，仓廪之官，五味出焉。大肠者，传导之官，变化出焉。
小肠者，受盛之官，化物出焉。肾者，作强之官，伎巧出焉。三焦者，决渎
之官，水道出焉。膀胱者，州都之官，津液藏焉，气化则能出矣。命门者，精神之所舍也，男子以藏精，女子以系胞。
三阳者，太阳、阳明、少阳也。三阴者，太阴、少阴、厥阴也。阳明者，两阳合明也。厥阴者，两阴交尽
也。手太阳，小肠经也。手阳明，大肠经也。手少阳，三焦经也。手太阴，肺经也，手少阴，心经也。手厥阴，
心包络也。足太阳，膀胱经也。足阳明，胃经也。足少阳，胆经也。足太阴，脾经也。足少阴，肾经也。足厥
阴，肝经也。
头者，诸阳之所会。面者，五脏六腑之荣。鼻属肺，肺和则鼻知香臭矣。目属肝，肝和则目辨黑白矣。
口属脾，脾和则口知五谷矣。舌属心，心和则舌知五味矣。耳属肾，肾和则耳闻五音矣。
头者，精神之府，头倾视深，精神将脱矣。背者，胸中心府，背曲肩垂，府将坏矣。腰者，肾之府，转摇
不能，肾将惫矣。骨者，髓之府，不能久立，立则振掉，骨将惫矣。膝者，筋之府，屈伸不能，行则偻俯，筋
将惫矣。
九窍者∶肝补之于目，心开窍于耳，肺开窍于鼻，脾开窍于口，肾开窍于二阴也。
发者，属心，禀火气也。眉者，属肝，禀木气也。须者，属肾，禀水气也。咽者，咽物，纳水谷，接三脘，
以通胃也。喉者，喉气，有九节，通五脏，以系肺也。发者，血之余也。神者，气之余也。爪者，筋之余也。
齿者，骨之余也。魂者，神明之辅弼也。魄者，精气之匡佐也。血为荣，荣者，水谷之精气也。气为卫，卫者，
水谷之悍气也。直行者，谓之经。旁行者，谓之络也。
脉者，天真委和之气也。三部，寸、关、尺也。九候，浮、中、沉也。五脏，心、肝、脾、肺、肾也。六腑，胆、
胃、大肠、小肠、膀胱、三焦也。
左手寸口，心与小肠之脉所出，君火也。左手关部，肝与胆之脉所出，风木也。左手尺部，肾与膀胱之脉
所出，寒水也。右手寸口，肺与大肠之脉所出，燥金也。右手关部，脾与胃之脉所出，湿土也。右手尺部，命
门与三焦之脉所出，相火也。
每部中客有浮、中、沉三候，三而三之，为九候也。浮者，主皮肤，候表及腑也。中者，主肌肉，以候胃
气也。沉者，主筋骨，候里及脏也。寸为阳，为上部，法天，主心胸以上至头之有疾也。关为阴阳之中，为中
部，法人，主膈以下至脐之有疾也。尺为阴，为下部，法地，主脐以下至足之有疾也。
四时之脉者，弦、钩、毛、石也。春脉弦，肝，东方木也。夏脉钩，心，南方火也。秋脉毛，肺，西方金
也。冬脉石，肾，北方水也。四季脉迟缓，脾，中央土也。四时平脉，六脉俱带和缓也，谓有胃气，有胃气曰
生，无胃气曰死。
五行者，金、木、水、火、土也。相生者，谓金生水，水生木，木生火，火生土，土生金也。相克者，谓
金克木，木克土，土克水，水克火，火克金也。相生者吉，相克者凶。（如心见沉细，肝见短涩，肾见迟缓，
肺见洪大，脾见弦长，皆遇克也。心见缓，肝见洪，肺见沉，脾见涩，肾见弦，皆遇我之所生也。）
左手属阳，右手属阴也。关前为阳，关后为阴也。男子左手脉常大于右手者，为顺也。女子右手脉常大于
左手者，为顺也。男子尺脉常弱，寸脉常盛，是其常也。女子尺脉常盛，寸脉常弱，是其常也。反者，女得男
脉，男得女脉。男得女脉为不及，女得男脉为太过。不及固病，太过亦病，所谓过犹不及也。
人迎者，左手关前一分是也。气口者，右手关前一分是也。人迎以候天之六气∶风、寒、暑、湿、燥、火
之外感也。气口以候人之七情∶喜、怒、忧、思、悲、恐、惊之内伤也。人迎脉紧盛，大于气口一倍，属表，
为阳，为腑也。气口脉紧盛，大于人迎一倍，属里，为阴，为脏也。属表为外感风寒，属里为内伤饮食。人迎、
气口俱紧盛，为挟食伤寒，为内伤挟外感也。男子久病，气口充于人迎者，有胃气也。女子久病，人迎充于气
口者，有胃气也。病虽重，可治，反此者逆也。
外因者，六淫之邪也。内因者，七情之气也。不内外因者，饮食劳倦跌扑也。
六脉者，浮、沉、迟、数、滑、涩也。浮者为阳，在表，为风、为虚也；沉者为阴，在里，为湿、为实也。
迟者，为阴寒在脏也；数者，为阳热在腑也。滑者，血多气少也；涩者，气滞血枯也。
八要者，表、里、虚、实、寒、热、邪、正也。表者，病不在里也；里者，病不在表也。虚者，五虚也；
实者，五实也。寒者，脏腑积冷也；热者，脏腑积热也。邪者，外邪相干也；正者，脏腑自病也。
七表者，浮、芤、滑、实、弦、紧、洪也。
八里者，微、沉、缓、涩、迟、伏、濡、弱也。
九道者，长、短、虚、促、结、代、牢、动、细也。
七死者，雀啄、屋漏、弹石、解索、鱼翔、虾游、釜沸也。
奇经八脉者，阳维、阴维、阳跷、阴跷、冲脉、任脉、督脉、带脉也。
人病脉不病，名曰内虚；脉病患不病，名曰行尸也。
五运主病者，谓∶诸风掉眩，皆属于肝木；诸痛痒疮疡，皆属于心火；诸湿肿满，皆属于脾土；诸气
郁，皆属于肺金；诸寒收引，皆属于肾水也。
六气为病者，谓∶诸暴强直，支痛 戾，里急筋缩，皆属于风。厥阴风木，乃肝、胆之气也。诸病喘呕吐
酸，暴注下迫，转筋，小便混浊，腹胀大，鼓之如鼓，痈疽疡疹，瘤气结核，吐下霍乱，瞀郁肿胀，鼻塞鼽衄，
血溢血泄，淋闭，身热，恶寒，战栗，惊惑，悲笑，谵妄，衄蔑血污，皆属于热。少阴君火之热，乃真心、小
肠之气也。诸痉强直，积饮痞膈中满，霍乱吐下，体重 肿，肉如泥，按之不起，皆属于湿。太阴湿土，乃脾、
胃之气也。诸热瞀 ，暴喑冒昧，躁扰狂越，骂詈惊骇， 肿酸疼，气逆冲上，禁栗如丧神守，嚏呕疮疡喉痹，
耳鸣及聋，呕涌溢，食不下，目昧不明，暴注 ，暴病暴死，皆属于火。少阳相火之热，乃心包络、三焦之
气也。诸涩枯涸，干劲皴揭，皆属于燥。阳明燥金，乃肺与大肠之气也。诸病上下所出水液澄澈清冷， 瘕
疝，坚痞，腹满急痛，下痢清白，食已不饥，吐利腥秽，屈伸不便，厥逆禁固，皆属于寒。乃肾与膀胱之气也。
亢则害，承乃制者，寒极则生热，热极则生寒，木极而似金，火极而似水，土极而似木，金极而似火，水
极而似土也。
五虚者，脉细，皮寒，气少，泄利前后，饮食不入也。粥浆入胃，泻止则生。
五实者，脉盛，皮热，腹胀，前后不通，瞀闷也。大、小便通利而得汗者生。
五胜者，风胜则动，热胜则肿，燥胜则干，寒胜则浮，湿胜则濡泄。
五恶者，心恶热，肺恶寒，肝恶风，脾恶湿，肾恶燥。
六脱者，脱气，脱血，脱津，脱液，脱精，脱神也。
五劳者，久视伤血，劳于心也。久卧伤气，劳于肺也。久坐伤肉，劳于脾也。久立伤骨，劳于肾也。久行
伤筋，劳于肝也。心劳神损，肺劳气损，脾劳食损，肝劳血损，肾劳精损。
六极者，尽力谋虑，劳伤乎肝，应乎筋极。曲运神机，劳伤乎心，应乎脉极。意外过思，劳伤乎脾，应乎
肉极。预事而忧，劳伤乎肺，应乎气极。矜持志节，劳伤乎肾，应乎骨极。此五劳应乎五极者也。然精极者，
五脏六腑之气衰，形体皆极，眼视无明，齿焦发落，体重耳聋，行履不正，邪气逆于六腑，厥于五脏，故成精极。
五脏受病者，忧愁思虑则伤心，形寒饮冷则伤肺，恚怒气逆则伤肝，饮食劳倦则伤脾，坐湿入水则伤肾也。
五损者，一损损于皮毛，皮聚而毛落。二损损于血脉，血脉虚少，不能荣于五脏六腑。三损损于肌肉，肌
肉消瘦，饮食不能为肌肤。四损损于筋，筋缓不能自收持。五损损于骨，骨痿不能起于床。从上下者，骨痿不
能起于床者死。从下上者，皮聚而毛落者死。然损其肺者，益其气。损其心者，调其荣卫。损其脾者，调其饮
食，适其寒温。损其肝者，缓其中。损其肾者，益其精也。
四时发病者，春伤于风，夏必飧泄。夏伤于暑，秋必 疟。秋伤于湿，冬必咳嗽。冬伤于寒，春必温病。
凡病之始起也，可刺而已。其盛，可待衰而已。故因其轻而扬之，因其重而减之。形不足者，温之以气。精不
足者，补之以味。在表者，汗而发之。在里者，下而夺之。高者，因而越之。剽悍者，按而收之。脏寒虚脱者，
治以灸炳。脉病，挛痹
者，治以针刺。血实，蓄结肿热者，治以砭石。气滞，痿厥寒热者，治以导引。经络不通，病生于不仁者，治
以醪醴。血气凝涩，病生于筋脉者，治以熨药。然又必先岁气，无伐天和，能合色、脉，可以万全。化而裁之
存乎变，神而明之存乎人，此先圣作之于前，诸贤述之于后，诚入门之阶梯，乃医家之总领也。
（按语）
这一篇总括了天地阴阳、人体造化、脉象疾病及治疗方法，清晰可考，作为初学者的借鉴。
三才，指的是天、地、人。天，是轻清之气而向上漂浮的。地，是重浊之气而向下凝结的。阳的精粹化为太阳，从东方升起而在西方落下。阴的精粹化为月亮，夜间出现而白天隐没。天的西北方不足，所以西北方属阴，因此人的右耳目不如左耳目灵敏。地的东南方不满，所以东南方属阳，因此人的左手足不如右手足强壮。天气下降，地气上升。阴中有阳，阳中有阴。从黎明到中午，是天的阳气，属于阳中之阳。从中午到黄昏，是天的阳气，属于阳中之阴。从日落合夜到鸡鸣，是天的阴气，属于阴中之阴。从鸡鸣到黎明，是天的阴气，属于阴中之阳。人也顺应这种规律。
天和地，是万物的上和下。阴和阳，是血和气的男和女（比喻对立统一）。左和右，是阴阳运行的道路。水和火，是阴阳的征兆。金和木，是生成过程的始终。玄色之气凝聚于空中，水开始产生。赤色之气炫耀于空中，火开始产生。苍色之气浮游于空中，木开始产生。白色之气横亘于空中，金开始产生。黄色之气际连于空中，土开始产生。
天地元气交融，万物化育醇厚。男女交媾精气，万物化生繁衍。人，是禀受天地正气，比万物更有灵性的生物。命，是天所赋予的。精，是身体的根本。形，是生命的居所。气，是生命的本源。神，是生命的主宰。
心，是君主之官，神明由此发出。肺，是相傅之官，治节由此产生。胆，是中正之官，决断由此产生。膻中，是臣使之官，喜乐由此产生。肝，是将军之官，谋虑由此产生。脾胃，是仓廪之官，五味由此产生。大肠，是传导之官，变化由此产生。小肠，是受盛之官，化物由此产生。肾，是作强之官，伎巧由此产生。三焦，是决渎之官，水道由此产生。膀胱，是州都之官，津液藏于此，经过气化作用才能排出。命门，是精神寄居的地方，男子用它来藏精，女子用它来系胞宫。
三阳经，指太阳、阳明、少阳。三阴经，指太阴、少阴、厥阴。阳明，是两阳合明。厥阴，是两阴交尽。手太阳经是小肠经。手阳明经是大肠经。手少阳经是三焦经。手太阴经是肺经。手少阴经是心经。手厥阴经是心包络。足太阳经是膀胱经。足阳明经是胃经。足少阳经是胆经。足太阴经是脾经。足少阴经是肾经。足厥阴经是肝经。
头，是诸阳经汇聚的地方。面，是五脏六腑荣华的外现。鼻属肺，肺气调和则鼻能辨别香臭。目属肝，肝气调和则眼能分辨黑白。口属脾，脾气调和则口能知晓五谷滋味。舌属心，心气调和则舌能辨别五味。耳属肾，肾气调和则耳能听到五音。
头，是精神所在的府库，如果头低垂、眼神深陷，说明精神即将耗脱。背，是胸中心脏所在的府库，如果背部弯曲、肩膀下垂，说明府库将毁坏。腰，是肾脏所在的府库，如果转动摇晃困难，说明肾将衰惫。骨，是骨髓所在的府库，如果不能久站，站立时身体颤抖，说明骨将衰惫。膝，是筋所在的府库，如果屈伸困难，行走时弯腰驼背，说明筋将衰惫。
九窍：肝补益于目，心开窍于耳，肺开窍于鼻，脾开窍于口，肾开窍于前后二阴。
头发，属心，禀受火气。眉毛，属肝，禀受木气。胡须，属肾，禀受水气。咽，是吞咽食物，接纳水谷，连接三脘，以通胃腑。喉，是呼吸气息，有九节，连通五脏，以系肺脏。头发，是血的余绪。神，是气的余绪。爪甲，是筋的余绪。牙齿，是骨的余绪。魂，是神明的辅佐。魄，是精气的匡助。血为营，营，是水谷的精微之气。气为卫，卫，是水谷的剽悍之气。直行的称为经。旁行的称为络。
脉，是天真柔和之气。三部，指寸、关、尺。九候，指浮、中、沉三种取脉力度。五脏，指心、肝、脾、肺、肾。六腑，指胆、胃、大肠、小肠、膀胱、三焦。
左手寸口，是心与小肠经脉气血发出的部位，对应君火。左手关部，是肝与胆经脉气血发出的部位，对应风木。左手尺部，是肾与膀胱经脉气血发出的部位，对应寒水。右手寸口，是肺与大肠经脉气血发出的部位，对应燥金。右手关部，是脾与胃经脉气血发出的部位，对应湿土。右手尺部，是命门与三焦经脉气血发出的部位，对应相火。
每部脉中又有浮、中、沉三种候法，三部各三候，共为九候。浮取，主要候皮肤，以察表证及腑病。中取，主要候肌肉，以察胃气。沉取，主要候筋骨，以察里证及脏病。寸部属阳，为上部的脉，法天，主心胸以上至头部的疾病。关部为阴阳之中，为中部的脉，法人，主膈以下至脐部的疾病。尺部属阴，为下部的脉，法地，主脐以下至足部的疾病。
四时的脉象，分别是弦、钩、毛、石。春脉弦，对应肝，属东方木。夏脉钩，对应心，属南方火。秋脉毛，对应肺，属西方金。冬脉石，对应肾，属北方水。四季末月（长夏）脉迟缓，对应脾，属中央土。四时的平脉，六脉都带有和缓之象，这叫有胃气，有胃气则生，无胃气则死。
五行，指金、木、水、火、土。相生，指金生水，水生木，木生火，火生土，土生金。相克，指金克木，木克土，土克水，水克火，火克金。相生为吉，相克为凶。（例如：心脉见沉细，肝脉见短涩，肾脉见迟缓，肺脉见洪大，脾脉见弦长，都是遇到了克制它的脉象。心脉见缓，肝脉见洪，肺脉见沉，脾脉见涩，肾脉见弦，都是遇到了它所生的脉象。）
左手属阳，右手属阴。关前为阳，关后为阴。男子左手脉常大于右手，这是顺证。女子右手脉常大于左手，这是顺证。男子尺脉常弱，寸脉常盛，这是常态。女子尺脉常盛，寸脉常弱，这是常态。反之，女子得男脉，男子得女脉，即为逆。男子得女脉为不及，女子得男脉为太过。不及固然生病，太过也生病，所谓过犹不及。
人迎穴，在左手关前一分处。气口脉，在右手关前一分处。人迎脉用来候测天之六气：风、寒、暑、湿、燥、火等外感邪气。气口脉用来候测人之七情：喜、怒、忧、思、悲、恐、惊等内伤因素。人迎脉紧盛，比气口大一倍，属表，为阳，为腑病。气口脉紧盛，比人迎大一倍，属里，为阴，为脏病。属表为外感风寒，属里为内伤饮食。人迎和气口都紧盛，为挟食伤寒，即内伤兼外感。男子久病，气口脉充盛于人迎脉，说明还有胃气。女子久病，人迎脉充盛于气口脉，说明还有胃气。病情虽重，还可治疗；反之则为逆证。
外因，指六淫邪气。内因，指七情之气。不内外因，指饮食、劳倦、跌打损伤等。
六脉，指浮、沉、迟、数、滑、涩。浮脉属阳，主表，主风、主虚；沉脉属阴，主里，主湿、主实。迟脉，主阴寒在脏；数脉，主阳热在腑。滑脉，主血多气少；涩脉，主气滞血枯。
八要，指表、里、虚、实、寒、热、邪、正。表，指病不在里；里，指病不在表。虚，指五虚；实，指五实。寒，指脏腑积冷；热，指脏腑积热。邪，指外邪干扰；正，指脏腑自病。
七表脉，指浮、芤、滑、实、弦、紧、洪。
八里脉，指微、沉、缓、涩、迟、伏、濡、弱。
九道脉，指长、短、虚、促、结、代、牢、动、细。
七死脉，指雀啄、屋漏、弹石、解索、鱼翔、虾游、釜沸。
奇经八脉，指阳维脉、阴维脉、阳跷脉、阴跷脉、冲脉、任脉、督脉、带脉。
五运主病，指：各种风病引起的动摇眩晕，都归属于肝木；各种痛痒疮疡，都归属于心火；各种湿病引起的肿胀胀满，都归属于脾土；各种气机郁滞，都归属于肺金；各种寒病引起的收缩牵引，都归属于肾水。
六气为病，指：各种突然发生的强直、支痛、挛急、筋缩，都归属于风。厥阴风木，即肝、胆之气。各种喘咳呕吐酸水、急性腹泻里急后重、转筋、小便浑浊、腹胀大如鼓、痈疽疹子、瘤气结核、吐泻霍乱、昏闷郁结肿胀、鼻塞流涕鼻出血、吐血便血、淋证闭尿、身热恶寒、战栗、惊恐疑惑、悲笑无常、胡言乱语、鼻出血污血，都归属于热。少阴君火之热，即真心、小肠之气。各种痉病强直、停饮痞膈中满、霍乱吐下、身体沉重浮肿、肉如泥按之不起，都归属于湿。太阴湿土，即脾、胃之气。各种热病昏闷、突然失音昏昧、烦躁狂越、骂詈惊骇、肿痛酸痛、气逆冲上、战栗如失神守、喷嚏呕吐疮疡喉痹、耳鸣耳聋、呕吐溢出、饮食不下、视物不明、急性腹泻、突发重病猝死，都归属于火。少阳相火之热，即心包络、三焦之气。各种干涩枯涸、皮肤干燥皲裂，都归属于燥。阳明燥金，即肺与大肠之气。各种上下排出的水液清澈寒冷、瘕疝、坚硬痞块、腹部胀满急痛、下痢清白、吃完不觉得饿、吐利腥秽、屈伸不便、四肢厥冷拘禁，都归属于寒。这是肾与膀胱之气。
亢盛就会造成危害，有所承制才能平衡，意思是寒极则生热，热极则生寒，木极而似金，火极而似水，土极而似木，金极而似火，水极而似土。
五虚，指脉细、皮寒、气少、大小便泄利、饮食不入。如果喝进粥浆，泻止，就能生还。
五实，指脉盛、皮热、腹胀、大小便不通、昏闷。如果大小便通利并能出汗，就能生还。
五胜，指风胜则动摇，热胜则肿胀，燥胜则干枯，寒胜则浮肿，湿胜则濡泄。
五劳，指久视伤血，劳于心；久卧伤气，劳于肺；久坐伤肉，劳于脾；久立伤骨，劳于肾；久行伤筋，劳于肝。心劳则神损，肺劳则气损，脾劳则食损，肝劳则血损，肾劳则精损。
六极，指尽力谋虑，劳伤肝脏，应验于筋极。曲运神机，劳伤心脏，应验于脉极。意外过思，劳伤脾脏，应验于肉极。预事而忧，劳伤肺脏，应验于气极。矜持志节，劳伤肾脏，应验于骨极。这五劳对应五极。至于精极，是五脏六腑之气衰竭，形体极度虚弱，眼花不明，齿焦发落，体重耳聋，行走不正，邪气逆于六腑，厥逆于五脏，从而形成精极。
五脏受病，忧愁思虑则伤心，形体受寒或饮冷则伤肺，愤怒气逆则伤肝，饮食不节或劳倦则伤脾，坐湿地或入水则伤肾。
五损，一损损于皮毛，表现为皮肤聚拢、毛发脱落。二损损于血脉，表现为血脉虚少，不能滋养五脏六腑。三损损于肌肉，表现为肌肉消瘦，饮食不能转化为肌肤。四损损于筋，表现为筋缓无力，不能自主收持。五损损于骨，表现为骨痿无力，不能起床。从上往下损的，骨痿不能起床者死。从下往上损的，皮聚毛落者死。然而，损其肺者，要益其气。损其心者，要调其营卫。损其脾者，要调其饮食，适应寒温。损其肝者，要舒缓其中气。损其肾者，要益其精。
四时发病，春伤于风，夏天必然发生飧泄。夏伤于暑，秋天必然发生疟疾。秋伤于湿，冬天必然咳嗽。冬伤于寒，春天必然发生温病。
凡病刚开始起时，可以用针刺治愈。如果病势正盛，可以等待其衰退后再治。所以病轻扬散的，用发散法；病重的，用削减法。形体不足的，用气药温补。精不足的，用味厚药滋补。病在表的，用汗法发汗。病在里的，用下法攻逐。病位高的，用涌吐法。病势剽悍的，用按压收敛法。脏腑寒凉虚脱的，用艾灸治疗。脉病、挛痹的，用针刺治疗。血实、蓄结肿热的，用砭石放血治疗。气滞、痿厥寒热的，用导引治疗。经络不通、病生于麻木不仁的，用酒剂治疗。血气凝涩、病生于筋脉的，用热敷药熨治疗。然而必须先考虑岁气，不要破坏天和之气，能结合面色和脉象，就可以万无一失。变化裁断在于变通，神妙明了在于人为，这是先圣在前创立，众贤在后阐述，确实是入门的阶梯，也是医家的总领。
[Note]
This chapter summarizes Heaven and Earth Yin-Yang, human creation, pulse patterns, diseases, and treatment methods, which are clear and verifiable, serving as a reference for beginners.
The Three Powers (San Cai) refer to Heaven, Earth, and Humanity. Heaven is light and clear, floating upward. Earth is heavy and turbid, condensing downward. The essence of Yang becomes the Sun, rising in the East and setting in the West. The essence of Yin becomes the Moon, visible at night and hidden by day. Heaven is deficient in the Northwest; therefore, the Northwest belongs to Yin, and thus a person's right ear and eye are not as acute as the left. Earth is incomplete in the Southeast; therefore, the Southeast belongs to Yang, and thus a person's left hand and foot are not as strong as the right. Heavenly Qi descends, Earthly Qi ascends. There is Yin within Yang, and Yang within Yin. From dawn to noon, it is Heavenly Yang, specifically Yang within Yang. From noon to dusk, it is Heavenly Yang, specifically Yin within Yang. From sunset to cockcrow, it is Heavenly Yin, specifically Yin within Yin. From cockcrow to dawn, it is Heavenly Yin, specifically Yang within Yin. Humans also correspond to these rhythms.
Heaven and Earth are the upper and lower bounds of all things. Yin and Yang are the male and female aspects of Blood and Qi. Left and Right are the pathways of Yin and Yang. Water and Fire are the manifestations of Yin and Yang. Metal and Wood are the beginning and end of generation and completion. Dark Qi condenses in the sky, marking the birth of Water. Red Qi shines in the sky, marking the birth of Fire. Green/Cyan Qi floats in the sky, marking the birth of Wood. White Qi spreads across the sky, marking the birth of Metal. Yellow Qi connects the sky, marking the birth of Earth.
When Heaven and Earth interact harmoniously, all things are nurtured profoundly. When males and females unite their essences, all things are generated. Humans receive the upright Qi of Heaven and Earth and are more spiritual than other creatures. Life (Ming) is endowed by Heaven. Essence (Jing) is the root of the body. Form (Xing) is the residence of life. Qi is the origin of life. Spirit (Shen) is the master of life.
The Heart is the Official of the Sovereign, from whom Shen Ming (Spiritual Consciousness) emerges. The Lung is the Official of the Chancellor, from whom Zhi Jie (Regulation) arises. The Gallbladder is the Official of Integrity, from whom Decision arises. The Dan Zhong (Chest Center) is the Official of the Envoy, from whom Joy and Delight arise. The Liver is the Official of the General, from whom Strategy and Consideration arise. The Spleen and Stomach are the Officials of the Granary, from whom the Five Flavors arise. The Large Intestine is the Official of Transmission, from whom Transformation arises. The Small Intestine is the Official of Reception, from whom Differentiation arises. The Kidney is the Official of Strength, from whom Skill and Dexterity arise. The San Jiao (Triple Burner) is the Official of Irrigation, from whom Water Channels arise. The Bladder is the Official of the Capital, storing Jin Ye (Body Fluids), which can be excreted only through Qi transformation. the Ming Men (Gate of Life) is the dwelling place of Spirit and Essence; in men, it stores Essence; in women, it anchors the Bao Gong (Uterus).
The Three Yang meridians are Taiyang, Yangming, and Shaoyang. The Three Yin meridians are Taiyin, Shaoyin, and Jueyin. Yangming represents the convergence of two Yangs. Jueyin represents the exhaustion of two Yins. The Hand-Taiyang Meridian is the Small Intestine Meridian. The Hand-Yangming Meridian is the Large Intestine Meridian. The Hand-Shaoyang Meridian is the San Jiao Meridian. The Hand-Taiyin Meridian is the Lung Meridian. The Hand-Shaoyin Meridian is the Heart Meridian. The Hand-Jueyin Meridian is the Pericardium. The Foot-Taiyang Meridian is the Bladder Meridian. The Foot-Yangming Meridian is the Stomach Meridian. The Foot-Shaoyang Meridian is the Gallbladder Meridian. The Foot-Taiyin Meridian is the Spleen Meridian. The Foot-Shaoyin Meridian is the Kidney Meridian. The Foot-Jueyin Meridian is the Liver Meridian.
The Head is the assembly point of all Yang meridians. The Face is the manifestation of the prosperity of the Zang and Fu organs. The Nose belongs to the Lung; when Lung Qi is harmonious, the nose discerns odors. The Eyes belong to the Liver; when Liver Qi is harmonious, the eyes distinguish black and white. The Mouth belongs to the Spleen; when Spleen Qi is harmonious, the mouth knows the taste of grains. The Tongue belongs to the Heart; when Heart Qi is harmonious, the tongue distinguishes the five flavors. The Ears belong to the Kidney; when Kidney Qi is harmonious, the ears hear the five tones.
The Head is the mansion of Spirit. If the head droops and the eyes are sunken, Spirit is about to escape. The Back is the mansion of the Chest and Heart. If the back is curved and shoulders droop, the mansion is about to collapse. The Waist is the mansion of the Kidneys. If turning and shaking are difficult, the Kidneys are failing. Bones are the mansion of Marrow. If one cannot stand for long, or trembles when standing, bones are failing. Knees are the mansion of Sinews. If flexion and extension are difficult, and one walks stooped, sinews are failing.
The Nine Orifices: The Liver benefits the Eyes; the Heart opens into the Ears; the Lung opens into the Nose; the Spleen opens into the Mouth; the Kidney opens into the two Yin orifices (urethra and anus).
Hair belongs to the Heart, inheriting Fire Qi. Eyebrows belong to the Liver, inheriting Wood Qi. Beard belongs to the Kidney, inheriting Water Qi. The Pharynx (Yan) swallows food, receives water and grain, connects the three Jiaos, and communicates with the Stomach. The Larynx (Hou) conducts Qi, has nine segments, connects the five Zang organs, and attaches to the Lung. Hair is the surplus of Blood. Spirit is the surplus of Qi. Nails are the surplus of Sinews. Teeth are the surplus of Bones. Hun (Ethereal Soul) is the assistant of Shen Ming. Po (Corporeal Soul) is the helper of Jing Qi. Blood is Ying (Nutritive) Qi; Ying Qi is the refined essence of water and grain. Qi is Wei (Defensive) Qi; Wei Qi is the vigorous essence of water and grain. Those that run straight are called Jing (Main) Meridians. Those that branch off are called Luo (Collateral) Meridians.
Pulse is the Qi of Heavenly Truth and Harmony. The Three Positions are Cun (Inch), Guan (Bar), and Chi (Cubit). The Nine Examinations are Floating, Middle, and Deep pressure. The Five Zang organs are Heart, Liver, Spleen, Lung, Kidney. The Six Fu organs are Gallbladder, Stomach, Large Intestine, Small Intestine, Bladder, San Jiao.
The Cun position on the Left Hand is where the Qi and Blood of the Heart and Small Intestine meridians emerge, corresponding to Ministerial Fire. The Guan position on the Left Hand is where the Qi and Blood of the Liver and Gallbladder meridians emerge, corresponding to Wind-Wood. The Chi position on the Left Hand is where the Qi and Blood of the Kidney and Bladder meridians emerge, corresponding to Cold-Water. The Cun position on the Right Hand is where the Qi and Blood of the Lung and Large Intestine meridians emerge, corresponding to Dry-Metal. The Guan position on the Right Hand is where the Qi and Blood of the Spleen and Stomach meridians emerge, corresponding to Wet-Earth. The Chi position on the Right Hand is where the Qi and Blood of the Ming Men and San Jiao meridians emerge, corresponding to Assistant Fire.
Each position has three examinations: Floating, Middle, and Deep. Three times three makes nine examinations. Floating palpation primarily examines the skin, indicating exterior conditions and Fu organ diseases. Middle palpation primarily examines the muscles, indicating Stomach Qi. Deep palpation primarily examines the tendons and bones, indicating interior conditions and Zang organ diseases. Cun is Yang, representing the Upper Section, modeling Heaven, governing diseases from the chest/heart up to the head. Guan is the midpoint of Yin and Yang, representing the Middle Section, modeling Humanity, governing diseases from below the diaphragm to the navel. Chi is Yin, representing the Lower Section, modeling Earth, governing diseases from below the navel to the feet.
The pulses of the four seasons are Xian (Wiry), Gou (Hook), Mao (Feather), and Shi (Stone). Spring pulse is Wiry, corresponding to the Liver and Eastern Wood. Summer pulse is Hook-like, corresponding to the Heart and Southern Fire. Autumn pulse is Feather-light, corresponding to the Lung and Western Metal. Winter pulse is Stone-deep, corresponding to the Kidney and Northern Water. Pulses during the transition months (Late Summer) are Slow and Moderate, corresponding to the Spleen and Central Earth. A normal pulse in all seasons shows a moderate and harmonious quality in all six positions, known as having "Stomach Qi." Having Stomach Qi means life; lacking it means death.
The Five Elements are Metal, Wood, Water, Fire, and Earth. Mutual Generation: Metal generates Water, Water generates Wood, Wood generates Fire, Fire generates Earth, Earth generates Metal. Mutual Restriction: Metal restricts Wood, Wood restricts Earth, Earth restricts Water, Water restricts Fire, Fire restricts Metal. Generation is auspicious; restriction is ominous. (For example: if the Heart pulse appears Deep and Fine, the Liver pulse Short and Choppy, the Kidney pulse Slow and Moderate, the Lung pulse Surging and Large, and the Spleen pulse Wiry and Long, these represent encountering restrictive pulses. If the Heart pulse appears Moderate, the Liver pulse Surging, the Lung pulse Deep, the Spleen pulse Choppy, and the Kidney pulse Wiry, these represent encountering pulses of what they generate.)
The Left Hand belongs to Yang, the Right Hand to Yin. Before the Guan position is Yang, behind it is Yin. In men, the Left Hand pulse is often larger than the Right; this is favorable. In women, the Right Hand pulse is often larger than the Left; this is favorable. In men, the Chi pulse is often weak, and the Cun pulse strong; this is normal. In women, the Chi pulse is often strong, and the Cun pulse weak; this is normal. Reversals occur when women have a man's pulse or men have a woman's pulse. A man having a woman's pulse indicates deficiency; a woman having a man's pulse indicates excess. Deficiency causes disease; excess also causes disease. Excess is no different from deficiency.
Ren Ying (Human Welcome) refers to one-fen anterior to the Guan position on the Left Hand. Qi Kou (Qi Gate) refers to one-fen anterior to the Guan position on the Right Hand. Ren Ying pulse monitors the Six Qi of Heaven: external pathogens of Wind, Cold, Summer-heat, Dampness, Dryness, and Fire. Qi Kou pulse monitors the Seven Emotions of Humanity: internal injuries of Joy, Anger, Worry, Thought, Sorrow, Fear, and Fright. If Ren Ying pulse is tight and full, exceeding Qi Kou by double, it indicates Exterior, Yang, and Fu disease. If Qi Kou pulse is tight and full, exceeding Ren Ying by double, it indicates Interior, Yin, and Zang disease. Exterior indicates external Wind-Cold; Interior indicates internal dietary injury. If both Ren Ying and Qi Kou are tight and full, it indicates cold damage complicated by food stagnation (internal injury with external contraction). In chronic illness of men, if Qi Kou is fuller than Ren Ying, Stomach Qi remains. In chronic illness of women, if Ren Ying is fuller than Qi Kou, Stomach Qi remains. Even if the disease is severe, it is treatable; the reverse is unfavorable.
External Causes refer to the Six Evils (pathogens). Internal Causes refer to the Qi of the Seven Emotions. Non-external/internal causes refer to diet, fatigue, and falls/injuries.
The Six Pulse Qualities are Floating, Deep, Slow, Rapid, Slippery, and Choppy. Floating is Yang, exterior, indicating Wind or Deficiency. Deep is Yin, interior, indicating Dampness or Excess. Slow indicates Cold in the Zang. Rapid indicates Heat in the Fu. Slippery indicates abundant Blood and deficient Qi. Choppy indicates stagnant Qi and depleted Blood.
The Eight Essentials are Exterior, Interior, Deficiency, Excess, Cold, Heat, Evil (Pathogen), and Zheng (Healthy Qi). Exterior means disease is not in the Interior. Interior means disease is not in the Exterior. Deficiency refers to the Five Deficiencies. Excess refers to the Five Excesses. Cold refers to accumulated cold in Zang/Fu. Heat refers to accumulated heat in Zang/Fu. Evil refers to interference by external pathogens. Zheng refers to self-disease of Zang/Fu.
Seven Exterior Pulses: Floating, Knotted (Kou), Slippery, Full, Wiry, Tight, Surging.
Eight Interior Pulses: Micro, Deep, Moderate, Choppy, Slow, Hidden, Soft, Weak.
Nine Pathological Pulses: Long, Short, Deficient, Urgent, Knotted, Interrupted, Firm, Moving, Fine.
Seven Death Pulses: Sparrow Pecking, Leaking Roof, Striking Stone, Untying Knot, Fish Swimming, Shrimp Swimming, Boiling Cauldron.
The Eight Extraordinary Vessels are Yang Wei, Yin Wei, Yang Qiao, Yin Qiao, Chong Mai, Ren Mai, Du Mai, Dai Mai.
If a person is ill but the pulse is normal, it is called Internal Deficiency. If the pulse is abnormal but the person has no symptoms, it is called a Walking Corpse.
Diseases governed by the Five Movements: All wind diseases causing trembling and dizziness belong to Liver Wood. All pain, itching, sores, and ulcers belong to Heart Fire. All damp diseases causing swelling and fullness belong to Spleen Earth. All Qi stagnation belongs to Lung Metal. All cold diseases causing contraction and pulling belong to Kidney Water.
Diseases governed by the Six Qi: All sudden stiffness, painful obstruction, twisting, and tendon contraction belong to Wind. Jueyin Wind-Wood corresponds to Liver and Gallbladder Qi. All wheezing, vomiting, acid regurgitation, acute diarrhea with tenesmus, tendon spasms, turbid urine, abdominal distension like a drum, carbuncles, sores, rashes, tumors, lymphatic masses, vomiting/diarrhea cholera, mental confusion, swelling, nasal congestion, epistaxis, hematemesis, hematochezia, stranguria, retention, fever, aversion to cold, shivering, fright, confusion, inappropriate laughter/crying, delirium, bloody sputum, all belong to Heat. Shaoyin Ruler Fire Heat corresponds to True Heart and Small Intestine Qi. All spasms, stiffness, fluid retention, epigastric blockage, fullness, cholera vomiting/diarrhea, heavy body, edema, flesh that does not rebound upon pressure, all belong to Dampness. Taiyin Wet-Earth corresponds to Spleen and Stomach Qi. All heat diseases with mental confusion, sudden aphonia, stupor, restlessness, mania, cursing, fright, swelling, soreness/pain, counterflow Qi, trembling as if losing spirit, sneezing, vomiting, sores, throat obstruction, tinnitus, deafness, violent vomiting, inability to eat, blurred vision, acute diarrhea, sudden severe illness, sudden death, all belong to Fire. Shaoyang Assistant Fire Heat corresponds to Pericardium and San Jiao Qi. All dryness, witheredness, aridity, rough and cracked skin, all belong to Dryness. Yangming Dry-Metal corresponds to Lung and Large Intestine Qi. All fluids discharged from above and below that are clear and cold, hernias, hard masses, abdominal fullness and acute pain, clear dysentery, lack of hunger after eating, foul vomiting/diarrhea, inability to flex/extend, cold limbs and rigidity, all belong to Cold. This corresponds to Kidney and Bladder Qi.
When something is in extreme excess, it causes harm; control comes from what succeeds it. Extreme cold generates heat; extreme heat generates cold. Extreme Wood resembles Metal; extreme Fire resembles Water; extreme Earth resembles Wood; extreme Metal resembles Fire; extreme Water resembles Earth.
Five Deficiencies: Fine pulse, cold skin, shortness of breath, diarrhea/incontinence of urine and stool, inability to eat. If porridge enters the stomach and diarrhea stops, life is preserved.
Five Excesses: Surging pulse, hot skin, abdominal distension, obstruction of urination and defecation, mental confusion/oppression. If urination/defecation become free and sweating occurs, life is preserved.
Five Dominances: Wind dominance causes movement/trembling. Heat dominance causes swelling. Dryness dominance causes dryness. Cold dominance causes edema/fluid retention. Dampness dominance causes loose stools.
Five Dislikes: Heart dislikes Heat. Lung dislikes Cold. Liver dislikes Wind. Spleen dislikes Dampness. Kidney dislikes Dryness.
Six Depletions: Depletion of Qi, Blood, Jin Ye, Body Fluids, Essence, and Spirit.
Five Labors: Prolonged viewing damages Blood, laboring the Heart. Prolonged lying down damages Qi, laboring the Lung. Prolonged sitting damages Flesh, laboring the Spleen. Prolonged standing damages Bones, laboring the Kidney. Prolonged walking damages Sinews, laboring the Liver. Heart labor damages Shen. Lung labor damages Qi. Spleen labor damages Food intake. Liver labor damages Blood. Kidney labor damages Essence.
Six Extremes: Exhaustive planning injures the Liver, manifesting as Sinew Extremity. Mental exertion injures the Heart, manifesting as Pulse Extremity. Unexpected excessive thinking injures the Spleen, manifesting as Flesh Extremity. Worrying about future events injures the Lung, manifesting as Qi Extremity. Maintaining rigid will injures the Kidney, manifesting as Bone Extremity. These five labors correspond to the five extremities. Regarding Essence Extremity: when Qi of all Zang and Fu organs declines, the form becomes extremely weak, vision blurs, teeth wither, hair falls, body feels heavy, hearing diminishes, gait is unsteady, evil Qi rebels in the Six Fu, and reverses in the Five Zang, resulting in Essence Extremity.
Causes of Zang Disease: Worry and thought injure the Heart. Cold exposure and cold drinks injure the Lung. Anger and Qi rebellion injure the Liver. Diet irregularity and fatigue injure the Spleen. Sitting in dampness or entering water injures the Kidney.
Five Damages: First damage affects Skin and Hair; skin gathers, hair falls. Second damage affects Blood Vessels; vessels become deficient, unable to nourish Zang and Fu. Third damage affects Muscle; muscles emaciate, food cannot transform into flesh. Fourth damage affects Sinews; sinews relax, unable to hold themselves. Fifth damage affects Bone; bone atrophy prevents rising from bed. Damage from top to bottom: bone atrophy preventing rising from bed leads to death. Damage from bottom to top: skin gathering and hair falling leads to death. However, for Lung damage, benefit Qi. For Heart damage, regulate Ying and Wei. For Spleen damage, regulate diet and adapt to cold/warmth. For Liver damage, soothe the middle. For Kidney damage, benefit Essence.
Seasonal Disease Onset: Injury to Wind in Spring leads to undigested food diarrhea in Summer. Injury to Summer-heat in Summer leads to Malaria in Autumn. Injury to Dampness in Autumn leads to Cough in Winter. Injury to Cold in Winter leads to Warm Diseases in Spring.
At the onset of any disease, acupuncture may suffice. If the pathogen is strong, wait for it to weaken before treating. Therefore, for mild/light conditions, use dispersing methods. For heavy/severe conditions, use reducing methods. For deficiency of Form, warm with Qi tonics. For deficiency of Essence, tonify with Flavor-rich substances. For exterior conditions, induce sweating. For interior conditions, purge downwards. For high-positioned pathogens, use emesis. For fierce/aggressive pathogens, press and contain them. For cold deficiency collapse of Zang organs, use moxibustion. For pulse diseases, spasms, and bi-syndrome, use acupuncture. For blood excess, accumulation, and swelling/heat, use bian stone (bloodletting). For Qi stagnation, flaccidity, cold/heat alternation, use Daoyin (guiding and pulling exercises). For meridian blockage and numbness, use medicinal wine. For coagulated Qi and Blood affecting sinews and vessels, use hot compresses/herbal applications. However, one must first consider the annual Qi and not violate the harmony of Heaven. Combining color observation with pulse diagnosis ensures perfection. Adaptation lies in change; enlightenment lies in the practitioner. This was established by ancient sages and elaborated by later worthies, truly a ladder for entry and the master key for physicians.