春弦夏洪秋毛冬石四季和缓是为平脉太过实强病生于外不及虚微病生于内春得秋脉死在
金日五脏准此推之不失四时百病胃气为本脉贵有神不可不审此言四时正脉百病皆以胃气为本
天地之气东升属木于时为春万物始生其气从伏藏中透出在人肝应之而见弦脉气转而南属火于
时为夏万物盛长其气从升后散大于外在人则心应之而见钩脉气转而西属金于时为秋万物收成
其气从散大之极自表初收在人则肺应之而见毛脉气转而北属水于时为冬万物合藏其气从收降
而敛实在人则肾应之而见石脉以上（内经）论四时正脉形状然因时变易其中总不外和柔平缓
气
象盖和缓为土即是胃气有胃气而合时便为平脉所谓太过不及者言弦钩毛石之脉与时相应俱宜
和缓而适中欲其微似不欲其太显欲其微见不欲其不见如春脉当微弦为平若太弦是为太过则气
实强而病生于外矣若不弦是为不及则气虚微而病生于内矣其弦钩毛石之太过不及病亦犹是不
但不见春弦之太过不及而反见浮毛之秋脉当升而反降当生而反杀气机大逆是谓克贼未有不病
而死者春木既为金克金日邪旺故死五脏皆以此理推之自无差失四时有四时之脉四时有四时之
病但土灌溉四旁虽病变百出必以之为本况胃气乃水谷之精诸脉有神乃水谷之力也岂不闻得谷
者昌乎诚不可不审也
春季脉象弦，夏季脉象洪大，秋季脉象轻浮如毛，冬季脉象沉实如石，四季之中脉象和缓从容，这称为平脉（正常脉象）。脉象太过、坚实强劲，病邪生于体表外部；脉象不及、虚弱细微，病邪生于体内内部。春季出现秋季的毛脉，患者会在庚辛金日死亡，五脏的脉象均可依此类推，不会有所差错。
四时百病，都以胃气为根本。脉象贵在有神采，不可不仔细审察。这里论述的是四时的正脉，各种疾病都以胃气为根本。
天地的阳气东升，归属于木，对应季节为春，万物开始生长，其气从伏藏中透出，在人体肝脏应之而显现为弦脉。阳气转而向南，归属于火，对应季节为夏，万物盛大生长，其气从升发后散大于外在，在人体心脏应之而显现为钩脉（来盛去衰之脉）。阳气转而向西，归属于金，对应季节为秋，万物收成，其气从散大的极点开始从体表向内收敛，在人体肺脏应之而显现为毛脉（轻虚以浮之脉）。阳气转而向北，归属于水，对应季节为冬，万物闭藏，其气从收降而敛实在内，在人体肾脏应之而显现为石脉（沉潜有力之脉）。以上引自《内经》论述四时正脉的形状，然而因时节变化，其中总不外乎柔和平缓的气象。
盖“和缓”属土，即是胃气。有胃气并符合时令，便称为平脉。所谓“太过”与“不及”，是指弦、钩、毛、石之脉与时令相应，都应当兼有和缓之意且适中。希望其微弱隐约，不希望其过于显露；希望其微微可见，不希望其完全不见。例如春季脉象应当微弦才是平脉，如果太弦，就是太过，那么气实强而病生于外。如果不弦，就是不及，那么气虚微而病生于内。其弦、钩、毛、石的太过与不及，病情也与此类似。
不仅是不见春季弦脉的太过或不及，反而出现浮毛的秋季脉象，应当升发反而下降，应当生发反而杀气，气机大逆，这称为克贼（相克太过），没有不生病死亡的。春季木气既被金气所克，在金日邪气旺盛，所以死亡。五脏都可以以此理类推，自然没有差错。
四时有四时的脉象，四时有四时的疾病。但土气灌溉四方，虽然病变百出，必须以胃气为根本。况且胃气是水谷的精微，诸脉有神是水谷的力量。岂不听说“得谷者昌”吗？确实不可不仔细审察。
The pulse in spring is *Xian* (String-like), in summer *Hong* (Surging), in autumn *Mao* (Feather-like/Light), and in winter *Shi* (Stone-like/Deep). In the four seasons, a pulse that is harmonious and mild is called a *Ping Mai* (Normal Pulse). A pulse that is excessive, solid, and strong indicates disease originating from the exterior; a pulse that is deficient, weak, and minute indicates disease originating from the interior. If the Autumn *Mao* pulse appears in Spring, death occurs on Metal days (Geng/Xin days). The pulses of the Five Zang Organs can be deduced by this method without error.
All diseases across the four seasons are rooted in the *Wei Qi* (Stomach Qi). The pulse values spiritual vitality (*Shen*), which must be carefully examined. This passage discusses the correct pulses of the four seasons, emphasizing that all diseases take *Wei Qi* as their foundation.
Heaven and Earth's Qi rises to the East, belonging to Wood, corresponding to Spring. When all things begin to grow, their Qi emerges from dormancy. In humans, the Liver corresponds to this, manifesting as the *Xian* pulse. The Qi turns South, belonging to Fire, corresponding to Summer. When all things flourish and grow, their Qi expands outward after rising. In humans, the Heart corresponds to this, manifesting as the *Gou* pulse (Hook-like, vigorous coming and gentle going). The Qi turns West, belonging to Metal, corresponding to Autumn. When all things are harvested, their Qi, having reached maximum expansion, begins to contract inward from the exterior. In humans, the Lung corresponds to this, manifesting as the *Mao* pulse (Feather-like, light and floating). The Qi turns North, belonging to Water, corresponding to Winter. When all things store and hide, their Qi condenses and becomes substantial within. In humans, the Kidney corresponds to this, manifesting as the *Shi* pulse (Stone-like, deep and firm). The above references the *Neijing* discussing the shapes of the correct pulses of the four seasons. However, due to seasonal changes, they always embody a soft, gentle, and mild Qi image.
"Gentle and mild" belongs to Earth, which is precisely *Wei Qi*. With *Wei Qi* present and aligned with the season, it constitutes a normal pulse. The terms "excessive" and "deficient" refer to the *Xian*, *Gou*, *Mao*, and *Shi* pulses corresponding to their respective seasons; they should all include an element of gentleness and moderation. They should be subtle and not too prominent; they should be slightly visible but not absent. For instance, the Spring pulse should be slightly *Xian* to be normal. If it is excessively *Xian*, it is "excessive," leading to excess Qi and disease from the exterior. If there is no *Xian* quality, it is "deficient," leading to deficient Qi and disease from the interior. The pathology of excess or deficiency in the *Xian*, *Gou*, *Mao*, and *Shi* pulses follows similar logic.
Not only does the absence of the expected Spring *Xian* pulse (whether excessive or deficient) indicate illness, but appearing with the Floating and Feather-like Autumn pulse when one should be ascending and generating life, yet instead descending and exhibiting killing energy, represents a great reversal of Qi mechanism. This is called "Ke Ze" (Overcoming/Clashing). Such cases inevitably result in disease and death. Since Spring Wood is overcome by Metal, and Evil Qi is prosperous on Metal days, death ensues. The Five Zang Organs can be deduced using this principle without error.
The four seasons have their respective pulses and their respective diseases. Although Earth Qi irrigates the four directions and diseases may manifest in myriad ways, *Wei Qi* must remain the foundation. After all, *Wei Qi* is the essence of water and grain, and the spiritual vitality of the various pulses is the power derived from water and grain. Is it not said that "those who obtain grain prosper"? Indeed, this must be carefully examined.