脉乃命脉，气血统宗；气能率血，气行血从。
《内经》亦言血脉，而气在血先之义自见，并无语病。后人着《脉经》，遂谓脉为血脉，气往应之。其下文
又云，脉不自行，气动脉应。先说气应脉，后复言脉应气。尺幅之中，自相悖戾，今特正之。
右寸为肺，所以主气；百脉上通，呼吸所系。
左寸为心，血生之经；一气一血，赖以养形。
天地之大用，莫先于水火；人身之至宝，不外乎气血。阴以抱阳，阳以摄阴，阴阳生长，互相为根，故两寸
又为诸经之统领。胸中附右寸，膻中附左寸，此上以候上之义也。
其在右关，脾胃属土；仓廪之官，水谷之府。
右外以候胃，内以候脾。土为万物之母，脾胃不败，则正气犹存，病家所以重胃气也。
其在左关，肝胆之部；风阳易动，不宜暴怒。
左外以候肝，内以候胆。肝胆应春，所以生长，然风阳易动，亢则为害，最宜善调。
右尺命门，釜下之火；日用必需，是可补助。
经谓尺外以候肾，尺里以候腹。五脏惟肾有两枚，故两尺不分左右，皆属于肾。腹中则统命门，大小肠
、膀胱皆在其中。究竟不分发，则混淆无主，后人无所持循。今将命门归于右尺，大肠隶之。命门火衰，便
不能熏蒸脾土，百病从此而生，但宜善为温养，不可过燥。
左尺肾水，性命之根；与右尺火，并号神门。
肾归左尺，膀胱小肠隶之。天一生水，性命之源。尺脉有神，纵有重恙，犹能转吉；若两尺败坏，决无生理。
部位既明，当知脉象；切脉之时不宜孟浪；以我中指，先按关上；前后两指，寸尺相向。
掌后高骨，是名曰关。先将中指正按关上，再将前后二指，平放寸尺之上。人长，排指宜疏；人短，排指宜密。
脉有七诊，浮中及沉；左右判别，上阳下阴。
寸脉浮取，关脉中取，尺脉沉取。左与右，即左右手分属之脏腑；上与下，即寸以候上，尺以候下也。
九候之法，即浮中沉；三而三之，分部推寻。
浮以候寸，中以候关，沉以候尺，是合寸关尺为三候也。每部之中，又各有浮中沉三候，是分寸关尺为九候也。
别有一种名曰斜飞；尺则犹是，寸关相违。
斜飞之脉，尺部如常，关寸之脉斜行通过高骨。一手如此者甚多。浮沉之间，与常脉稍异。
更有一种，正位全无；反出关后，大象模糊。
反关之脉，正位全无，反出关后，形如血管。大象至数，不甚分明，毕竟反常之事，不足为训，诊时尤宜善会。
男脉左大女脉右盛；男子寸强，女子尺胜。
男为阳，女为阴，故男脉左大，女脉右大。男子寸盛尺虚，阳盛于阴也；女子尺盛寸虚，阴盛于阳也。
脉应四时，递相判别；春弦夏洪，秋毛冬石。
春初发生，有枝无叶，故脉弦以象之。夏令繁盛，枝叶畅茂，故脉洪以象之。秋令整肃，草木黄落，故脉毛
以象之。冬令闭藏，水土坚凝，故脉石以象之。长夏属土，则脉更宜于和缓。
五脏之脉，各部分见；先能知常，方能知变。
五脏之脉，各有本象，反常则为病。
心脉浮大；肺脉浮涩；肝脉沉弦；肾脉沉实；脾胃之脉，和缓得中；右尺命火，与心脉同。
旧说心脉之浮，浮大而散；肺脉之浮，浮涩而短；肝脉之沉，沉弦而长；肾脉之沉，沉实而濡等语，予窃有
所未安。夫心为君火，火性炎上，故脉宜浮。君火柔和，故浮大而不洪数。但用浮大二字，状心脉最佳；若
兼散象，则气血虚脱，疾不可为矣。散字宜节去。肺主气，故脉亦浮；其兼涩者，气多血少故也；若兼短，则
气病而为肺害。短字宜节去。肝脉沉弦，固也。若长脉，当候于寸尺，不当候于关上。长字宜节去。又云肾
脉之沉，沉实而濡。濡脉之象，浮而且小，与沉实相反，断不能相兼。濡字更宜节去。
临诊脉时，虚心静气；虚则能精，静则能细。以心之灵，通于指端；指到心到，会悟参观。
切脉之道，全贵心灵手敏，活泼泼地一片化机，方能因应。此在平日讲求精切，阅历既多，指下之妙，得
之于心，不能宣之于口，实有此种境界。即如六阳之脉，偏于浮大；其沉候，即在常脉之中候，不得谓之
沉候全无也。六阴之脉，偏于沉细；其浮候，即在常脉之中候，不得谓之浮候全无也。又况病有新久，体
有强弱，年有壮老，见症虽同，施治不一，化裁通变，则泛应各当矣。
脉来太过，外感为病；脉来不及，内伤之症。
外感六淫，风寒暑湿燥火也，其脉必有洪数弦紧滑大等象。内伤七情，喜怒忧思悲恐惊也，其脉必有
细涩濡微弱小芤散等象。
人之大气积于胸中；呼吸出入，上下流通。呼出之气，由心达肺；吸入之气，肝肾相济。
大气积于胸中，所以统摄一身，呼出则由心达肺，吸入则由肝纳肾。故论根气，则归本于肾，而枢纽实
在中州。
呼吸定息，迟数可别；一息四至，和平之极。五至为常，亦无差忒。三至为迟，迟乃寒结；二损一败，不可复活。
六至为数，数即病热；七至为疾，热甚危极；若八九至，阳竭阴绝。
一息四至，脉极和平。其谓五至无 ，闰以太息者，是言四至中时多一至，乃人之息长，如三年一闰，五
年再闰，非论一息五至之本脉也。其实一息五至，常人甚多，亦非病脉。惟三迟、六数、七疾，乃为寒病、热
病。其一二至与八九至，则为阴绝、阳绝，无从施治。
浮脉在上，轻按即得；肌肤之间，百不失一。沉脉在下，主里主阴；按至筋骨，受病最深。
浮脉属阳主表，沉脉属阴主里。
浮沉迟数，脉之大端；四者既明。余脉详看。
浮迟表寒，浮数表热；沉迟里寒，沉数里热。余可类推。
大纲秩然，条目宜审；滑涩虚实，亦为要领。
浮沉以辨表里，迟数以辨寒热，是为脉之大纲。滑与涩，所以验气血之通塞；虚与实，所以分邪正之盛
衰；是为脉之条件。脉症虽多，不外乎此，故以下分为八门以总括之。
浮脉上泛，如水漂木；轻取即得，重按不足。芤脉如葱，轻手而空；浮沉俱有，但虚其中。如按鼓皮，其名曰革；
中沉俱空阳亢阴竭。
浮脉为阳，主一切表病，故脉在肌肤之间。芤主失血，中空者气不能摄血故也。革脉弦大而浮，故谓虚
寒相搏，其实乃阴不抱阳，孤阳上浮，真阴下脱之象。
肌肉之下，其脉为沉；重按乃得，病发于阴。弦大而沉，厥名曰牢；气凝血结，浊阴混淆。沉极为伏，三候如无；
气机闭塞，真阳已孤。
沉脉属阴，主一切里症。牢则多主蓄血积聚。伏则气分闭塞，清阳不能发舒。
迟脉为寒，气凝血滞；若损与败，不可复治。迟而一止，其名曰结；气血错乱，兼主冷积。结虽时止，至数无常；
代则有定，气血消亡。
迟为阴寒，气不宣通，故至数艰缓。迟而时有一止，旋止旋还，并无定数，谓之结脉，乃气血错乱，寒气积
聚所致。若止不能还，兼有定数，便是代脉。四动一止，五六日死；两动一止，三四日死也。
数脉为热，其阴必虚；若因风火，则为有余。热甚则疾。一息七至；八九为极，烦冤而死。数而一止，其脉为促；
多主肺痈，郁热阳毒。
数脉为热，不外虚实两端。疾则热甚而危，极则必无生理。促乃数而一止，亦无定数。热郁于中，故多肺胃之病。
滑脉主痰，亦主诸气；气盛痰多，往来流利。动脉如豆，多见于关；若在寸尺，阴阳两悭。
滑亦阳脉，痰气盛，故往来流利。动脉多见关部，若在寸为阳动，主亡阳汗多；在尺为阴动，乃阴虚热极。
女子寸关脉动，即为孕娠。
涩为血少，往来涩滞；血不养气，艰难而至。
血少不润，故往来艰涩。轻刀刮竹，如雨沾沙，俱极形似。
虚脉如何，往来无力；浮中如常，沉候亏缺。濡脉浮小，如水漂棉；轻取无力，重按豁然。微脉更虚，有无之间；
气血亏损，病势颠连。散脉无定，涣而不收；元气将败，如水浮沤。弱脉在下，似弦非弦；沉细而
软，不宜壮年。细则更沉，如发如丝；行于筋骨，虚寒可知。短脉气病，见于寸尺；不能满部，真阳遏抑。
虚脉往来无力，三候俱有，而沉候实空。濡脉小而且浮，浮中俱有，沉候如无。微则但有浮中，并无沉候。
散则涣散无定，气血皆脱之象。弱脉但有中沉两候，浮候如无。细脉则更沉而且小，如一丝在筋骨之
间。短则气弱，真阳不能通畅。以上各脉，皆由气血虚弱，故汇在虚字门中，不附于浮沉两部。
实脉之来，三候有力；更大于牢，邪滞郁结。洪脉上涌，与洪水同；泛泛不已，热盛于中。大脉较润，来刚去柔；
正虚邪盛，病进可忧。弦脉劲直，如张弓弦；木旺克土，痰饮连绵。弦而弹转，其脉为紧；为寒为痛，沉浮宜审。
寸尺之脉，有时而长；过于本位，毗阴毗阳。
实脉三候有力，更大于牢，为邪滞郁结。洪则如涌如沸，邪热炽盛。大则正虚病进，久病更危。弦为肝之
本象，木旺克土，故主气，又主痰饮。浮紧为寒，沉紧为痛，并为气病。长过于寸，则毗阳而亡阴；长过于尺，
则毗阴而亡阳；又为关格之征。以上各种，皆是实病，故导入实字门中，不附别部。
惟有缓脉，悠悠扬扬；是为胃气，见之吉祥。别有一种，怠缓近迟；血虚气弱，积湿可知。
缓者从容和缓，所谓胃气也。悠悠扬扬，意思欣欣，此八字最能传缓字之神。病家得此，定可无害。若怠
缓无神，乃是湿病，不可不知。
一切病症，不外三因；何症何脉，辨之贵真。不能殚述，自可引伸；神而明之，存乎其人。
脉是生命之根本，气血的总汇；气能统率血，气行则血随之而行。
《黄帝内经》中也提到血脉，但其中“气在血先”的道理自然显现，并没有语病。后人编撰《脉经》，却说脉就是血脉，气去应和它。它的下文又说，脉不能自行，气推动脉而脉相应。前面说气应和脉，后面又说脉应和气。篇幅之中，自相矛盾，现在特意纠正这一点。
右寸部对应肺，所以主管气；百脉向上通达，与呼吸密切相关。
左寸部对应心，是生血的经脉；一阴一阳、一气一血，依靠它来滋养形体。
天地之间最大的作用，没有比水火更重要的；人体中最宝贵的东西，不外乎气血。阴以抱持阳，阳以固摄阴，阴阳相互生长，互为根本，所以左右两寸部又是各条经脉的统领。胸中依附于右寸部，膻中依附于左寸部，这是上部诊察上部的道理。
至于右关部，脾胃属土；它是掌管仓储的官员，是水谷汇聚的府库。
右侧外部候察胃，内部候察脾。土是万物的母亲，脾胃不败坏，正气就还存在，所以病人重视胃气。
至于左关部，是肝胆的部位；风阳容易妄动，不宜暴怒。
左侧外部候察肝，内部候察胆。肝胆对应春季，主生长，然而风阳容易妄动，亢盛就会为害，最适宜善于调摄。
右尺部是命门，如同锅灶下的火；日常必需，是可以补助的。
医经说尺部外部候察肾，尺部内部候察腹部。五脏中只有肾有两个，所以左右两尺部不分左右，都归属于肾。腹部则统辖命门，大小肠、膀胱都在其中。究竟如果不加以区分，就会混淆无主，后人无所遵循。现在将命门归于右尺部，大肠隶属于它。命门火衰，就不能熏蒸脾土，各种疾病从此产生，只宜善于温养，不可过于燥烈。
左尺部是肾水，是性命的根本；与右尺部的火，并称为神门。
肾归属于左尺部，膀胱和小肠隶属于它。天一生水，是性命的源头。尺脉有神，即使有重病，也能转危为安；如果两尺部败坏，绝对没有生机。
部位既然明确了，应当知道脉象；切脉的时候不应该草率；用我的中指，先按在关上；前后的两个手指，寸部和尺部相对。
掌后高骨，名叫关。先将中指正对着按在关上，再将前后两个手指，平放在寸部和尺部之上。人高，手指排列宜疏；人矮，手指排列宜密。
脉有七种诊法，浮取、中取及沉取；左右进行判别，上部属阳下部属阴。
寸脉轻取，关脉中取，尺脉重取。左与右，即左右手分别所属的脏腑；上与下，即寸部候察上部，尺部候察下部。
九候的方法，就是浮、中、沉；三乘以三，分部推寻。
轻取候察寸部，中取候察关部，重取候察尺部，这是合寸、关、尺为三候。每部之中，又各有浮、中、沉三候，这是分寸、关、尺为九候。
另外有一种名叫斜飞；尺部还是正常的，寸部和关部却相反。
斜飞的脉，尺部如常，关部和寸部的脉斜行通过高骨。一只手如此的人很多。在浮取和沉取之间，与常脉稍有不同。
更有一种，正位完全没有；反而出现在关后，形象模糊。
反关的脉，正位完全没有，反而出现在关后，形状像血管。形象和至数，不是很分明，毕竟是反常的事情，不足以作为准则，诊察时尤其应该善于领会。
男脉左边大女脉右边盛；男子寸脉强，女子尺脉胜。
男属阳，女属阴，所以男脉左边大，女脉右边大。男子寸盛尺虚，是阳盛于阴；女子尺盛寸虚，是阴盛于阳。
脉象顺应四季，依次判别；春弦夏洪，秋毛冬石。
初春发生，有枝无叶，所以脉弦以象征它。夏季繁盛，枝叶畅茂，所以脉洪以象征它。秋季整肃，草木黄落，所以脉毛以象征它。冬季闭藏，水土坚凝，所以脉石以象征它。长夏属土，则脉更宜于和缓。
五脏的脉，各自部分显现；先能知道常态，方能知道变化。
五脏的脉，各有本来的形象，反常就是病。
心脉浮大；肺脉浮涩；肝脉沉弦；肾脉沉实；脾胃的脉，和缓适中；右尺命火，与心脉相同。
旧的说法中心脉的浮，浮大而散；肺脉的浮，浮涩而短；肝脉的沉，沉弦而长；肾脉的沉，沉实而濡等话，我私下感到不安。心为君火，火性炎上，所以脉宜浮。君火柔和，所以浮大而不洪数。只用浮大两个字，形容心脉最佳；如果兼有散象，则是气血虚脱，病不可治了。散字应该删去。肺主气，所以脉也浮；它兼涩的，是气多血少的原因；如果兼短，则是气病而为肺害。短字应该删去。肝脉沉弦，固然正确。若长脉，应当在寸尺候察，不应当在关上候察。长字应该删去。又说肾脉的沉，沉实而濡。濡脉的形象，浮而且小，与沉实相反，绝对不能相兼。濡字更应该删去。
临诊切脉时，虚心静气；虚心就能精细，安静就能细致。用心之灵明，通达于指端；指到心到，会悟参详观察。
切脉之道，全贵心灵手敏，活泼泼地一片化机，才能因应。这在于平日讲求精切，阅历既多，指下的妙处，得之于心，不能宣之于口，确实有这种境界。就像六阳之脉，偏于浮大；它的沉候，就在常脉的中候之中，不能说沉候全无。六阴之脉，偏于沉细；它的浮候，就在常脉的中候之中，不能说浮候全无。更何况病有新久，体质有强弱，年龄有壮老，见症虽然相同，施治不一样，灵活变通，就能泛应各当。
脉来太过，是外感病；脉来不及，是内伤病。
外感六淫，是风寒暑湿燥火，其脉必有洪数弦紧滑大等形象。内伤七情，是喜怒忧思悲恐惊，其脉必有细涩濡微弱小芤散等形象。
人的大气积聚于胸中；呼吸出入，上下流通。呼出的气，由心达肺；吸入的气，肝肾相济。
大气积聚于胸中，所以统摄一身，呼出则由心达肺，吸入则由肝纳肾。所以论根气，则归本于肾，而枢纽实在中州（脾胃）。
呼吸定息，迟数和数可以辨别；一息四至，是和平的极致。五至为正常，也没有差错。三至为迟，迟乃是寒结；二损一败，不可复活。
六至为数，数即是病热；七至为疾，热甚危极；如果八九至，阳竭阴绝。
一息四至，脉极和平。所谓五至无差，闰以太息者，是说四至中有时多一至，乃人之息长，如三年一闰，五年再闰，不是论述一息五至的本脉。其实一息五至，常人很多，也不是病脉。只有三迟、六数、七疾，才是寒病、热病。其一二至与八九至，则是阴绝、阳绝，无从施治。
浮脉在上，轻按即得；肌肤之间，百不失一。沉脉在下，主里主阴；按至筋骨，受病最深。
浮脉属阳主表，沉脉属阴主里。
浮沉迟数，脉的大纲；这四者既然明了。其余脉详细看。
浮迟表寒，浮数表热；沉迟里寒，沉数里热。其余可类推。
大纲井然有序，条目应当审慎；滑涩虚实，也是要领。
浮沉用以辨别表里，迟数以辨别寒热，这是脉的大纲。滑与涩，用来验查气血的通塞；虚与实，用来分辨邪正的盛衰；这是脉的条件。脉症虽多，不外乎此，所以下面分为八门以总括之。
浮脉上浮，如水漂木；轻取即得，重按不足。芤脉如葱，轻手而空；浮沉俱有，但虚其中。如按鼓皮，其名曰革；中沉俱空阳亢阴竭。
浮脉为阳，主一切表病，所以脉在肌肤之间。芤主失血，中空是因为气不能摄血。革脉弦大而浮，所以谓虚寒相搏，其实是阴不抱阳，孤阳上浮，真阴下脱的形象。
肌肉之下，其脉为沉；重按乃得，病发于阴。弦大而沉，厥名曰牢；气凝血结，浊阴混淆。沉极为伏，三候如无；气机闭塞，真阳已孤。
沉脉属阴，主一切里症。牢则多主蓄血积聚。伏则气分闭塞，清阳不能发舒。
迟脉为寒，气凝血滞；若损与败，不可复治。迟而一止，其名曰结；气血错乱，兼主冷积。结虽时止，至数无常；代则有定，气血消亡。
迟为阴寒，气不宣通，所以至数艰缓。迟而时有一止，旋止旋还，并无定数，谓之结脉，乃气血错乱，寒气积聚所致。若止不能还，兼有定数，便是代脉。四动一止，五六日死；两动一止，三四日死也。
数脉为热，其阴必虚；若因风火，则为有余。热甚则疾。一息七至；八九为极，烦冤而死。数而一止，其脉为促；多主肺痈，郁热阳毒。
数脉为热，不外虚实两端。疾则热甚而危，极则必无生理。促乃数而一止，亦无定数。热郁于中，故多肺胃之病。
滑脉主痰，亦主诸气；气盛痰多，往来流利。动脉如豆，多见于关；若在寸尺，阴阳两悭。
滑亦阳脉，痰气盛，所以往来流利。动脉多见关部，若在寸为阳动，主亡阳汗多；在尺为阴动，乃阴虚热极。
女子寸关脉动，即为孕娠。
涩为血少，往来涩滞；血不养气，艰难而至。
血少不润，所以往来艰涩。轻刀刮竹，如雨沾沙，俱极形似。
虚脉如何，往来无力；浮中如常，沉候亏缺。濡脉浮小，如水漂棉；轻取无力，重按豁然。微脉更虚，有无之间；气血亏损，病势颠连。散脉无定，涣而不收；元气将败，如水浮沤。弱脉在下，似弦非弦；沉细而软，不宜壮年。细则更沉，如发如丝；行于筋骨，虚寒可知。短脉气病，见于寸尺；不能满部，真阳遏抑。
虚脉往来无力，三候俱有，而沉候实空。濡脉小而且浮，浮中俱有，沉候如无。微则但有浮中，并无沉候。散则涣散无定，气血皆脱之象。弱脉但有中沉两候，浮候如无。细脉则更沉而且小，如一丝在筋骨之间。短则气弱，真阳不能通畅。以上各脉，皆由气血虚弱，所以汇在虚字门中，不附于浮沉两部。
实脉之来，三候有力；更大于牢，邪滞郁结。洪脉上涌，与洪水同；泛泛不已，热盛于中。大脉较润，来刚去柔；正虚邪盛，病进可忧。弦脉劲直，如张弓弦；木旺克土，痰饮连绵。弦而弹转，其脉为紧；为寒为痛，沉浮宜审。
寸尺之脉，有时而长；过于本位，毗阴毗阳。
实脉三候有力，更大于牢，为邪滞郁结。洪则如涌如沸，邪热炽盛。大则正虚病进，久病更危。弦为肝之本象，木旺克土，故主气，又主痰饮。浮紧为寒，沉紧为痛，并为气病。长过于寸，则毗阳而亡阴；长过于尺，则毗阴而亡阳；又为关格之征。以上各种，皆是实病，故导入实字门中，不附别部。
惟有缓脉，悠悠扬扬；是为胃气，见之吉祥。别有一种，怠缓近迟；血虚气弱，积湿可知。
缓者从容和缓，所谓胃气也。悠悠扬扬，意思欣欣，这八个字最能传缓字之神。病家得此，定可无害。若怠缓无神，乃是湿病，不可不知。
一切病症，不外三因；何症何脉，辨之贵真。不能殚述，自可引伸；神而明之，存乎其人。
Pulse is the vital pulse, the general source of Qi and Blood; Qi can lead Blood, when Qi moves, Blood follows.
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) also mentions blood vessels, but the meaning that "Qi precedes Blood" naturally becomes clear, with no linguistic error. Later authors compiled the *Maijing* (Classic of Pulse), claiming that pulse is merely blood vessel, and Qi responds to it. Its subsequent text states, "Pulse does not move on its own; Qi moves the pulse, and the pulse responds." First it says Qi responds to pulse, then again says pulse responds to Qi. Within this short space, there is self-contradiction, which is now specifically corrected.
The right Cun position corresponds to the Lung, thus governing Qi; all vessels connect upwards, related to respiration.
The left Cun position corresponds to the Heart, the meridian generating Blood; one Qi and one Blood rely on it to nourish the form.
The greatest function of Heaven and Earth is nothing prior to Water and Fire; the supreme treasure of the human body is nothing beyond Qi and Blood. Yin embraces Yang, Yang secures Yin, Yin and Yang grow mutually, rooting in each other, therefore the two Cun positions are the commanders of all meridians. The chest attaches to the right Cun, the Danzhong (Conception Vessel point CV17) attaches to the left Cun; this is the principle of inspecting the upper via the upper.
As for the Guan position on the right, the Spleen and Stomach belong to Earth; they are the officials managing granaries, the mansions of water and grain.
The exterior of the right side inspects the Stomach, the interior inspects the Spleen. Earth is the mother of all things; if the Spleen and Stomach do not fail, Righteous Qi still exists, which is why patients value Stomach Qi.
As for the Guan position on the left, it is the region of the Liver and Gallbladder; Wind-Yang easily stirs, violent anger should be avoided.
The exterior of the left side inspects the Liver, the interior inspects the Gallbladder. Liver and Gallbladder correspond to Spring, governing growth, yet Wind-Yang easily stirs; if hyperactive, it causes harm, so it is best to regulate well.
The Chi position on the right is the Mingmen (Gate of Life); it is the fire under the cauldron; essential for daily use, it can be supplemented.
The classics state that the exterior of Chi inspects the Kidney, the interior of Chi inspects the abdomen. Among the Zang organs, only the Kidneys are two, therefore the left and right Chi positions are not distinguished by left or right, both belonging to the Kidney. The abdomen governs the Mingmen, including the Large Intestine, Small Intestine, and Bladder. Ultimately, without distinction, confusion arises without a master, leaving later generations without standards. Now, the Mingmen is assigned to the right Chi, and the Large Intestine is subordinate to it. If Mingmen Fire declines, it cannot steam the Spleen Earth, and various diseases arise from this; it is suitable only for gentle warming and nourishing, not for excessive dryness.
The Chi position on the left is Kidney Water, the root of life; together with the Fire of the right Chi, they are jointly called Shenmen (Spirit Gate).
The Kidney returns to the left Chi, with the Bladder and Small Intestine subordinate to it. Heaven generates Water as number one, the source of life. If the Chi pulse has Spirit, even with severe illness, recovery is possible; if both Chi positions fail, there is absolutely no hope of life.
Once the positions are clear, one must know the pulse images; during palpation, one should not be rash; using my middle finger, first press at Guan; the front and back fingers face the Cun and Chi respectively.
The high bone behind the palm is named Guan. First, place the middle finger directly pressing on Guan, then place the front and back two fingers flat upon Cun and Chi. For tall people, finger spacing should be sparse; for short people, finger spacing should be dense.
There are seven diagnostic methods: superficial (Fu), moderate (Zhong), and deep (Chen); distinguish left and right, upper is Yang and lower is Yin.
Cun pulse is taken superficially, Guan pulse moderately, Chi pulse deeply. Left and Right refer to the Zang-Fu organs attributed to the left and right hands; Upper and Lower refer to Cun inspecting the upper and Chi inspecting the lower.
The method of Nine Inspections is exactly Fu, Zhong, and Chen; three times three, searching by section.
Superficial inspection inspects Cun, moderate inspection inspects Guan, deep inspection inspects Chi; this combines Cun, Guan, and Chi into three inspections. Within each section, there are again three inspections of Fu, Zhong, and Chen; this divides Cun, Guan, and Chi into nine inspections.
Another type is called Xiefei (Slanting Flight); the Chi section is normal, but Cun and Guan are contrary.
In the Xiefei pulse, the Chi section is like normal, but the pulses at Guan and Cun slant across the high bone. Many people have this in one hand. Between superficial and deep, it differs slightly from normal pulse.
Even another type has no normal position at all; instead appearing after Guan, the image is vague.
In the Fanguan (Reverse Guan) pulse, the normal position is completely absent, appearing instead after Guan, shaped like a blood vessel. The image and rate are not very distinct; ultimately, it is an abnormal matter, not worthy of being a standard, so during diagnosis, one must understand it well.
Male pulses are larger on the left, female pulses are fuller on the right; men have strong Cun, women have superior Chi.
Men are Yang, women are Yin, so male pulses are larger on the left, female pulses are larger on the right. Men have excess Cun and deficiency Chi, meaning Yang exceeds Yin; women have excess Chi and deficiency Cun, meaning Yin exceeds Yang.
Pulses respond to the four seasons, discriminated sequentially; Spring is Wiry (Xian), Summer is Surging (Hong), Autumn is Hairy (Mao), Winter is Stone-like (Shi).
Early spring emergence has branches but no leaves, so the pulse is Wiry to symbolize it. Summer abundance has lush branches and leaves, so the pulse is Surging to symbolize it. Autumn solemnity has yellowing and falling vegetation, so the pulse is Hairy to symbolize it. Winter storage has solidified water and earth, so the pulse is Stone-like to symbolize it. Late Summer belongs to Earth, so the pulse should be more harmonious and slow.
The pulses of the Five Zang organs appear in their respective sections; knowing the normal allows one to know the abnormal.
The pulses of the Five Zang organs each have their original image; deviation indicates disease.
Heart pulse is Floating and Large; Lung pulse is Floating and Choppy; Liver pulse is Deep and Wiry; Kidney pulse is Deep and Solid; Spleen and Stomach pulse is Harmonious and Moderate; Right Chi Ming Fire is the same as the Heart pulse.
Old theories say Heart pulse is Floating, Large, and Scattered; Lung pulse is Floating, Choppy, and Short; Liver pulse is Deep, Wiry, and Long; Kidney pulse is Deep, Solid, and Soft. I privately feel uneasy about these statements. The Heart is Minister Fire, Fire nature flares upward, so the pulse should be Floating. Minister Fire is gentle, so it is Floating and Large but not Surging and Rapid. Using only "Floating and Large" best describes the Heart pulse; if combined with Scattered image, it indicates Qi and Blood depletion, incurable disease. The character "Scattered" should be removed. The Lung governs Qi, so the pulse is also Floating; its combination with Choppy is due to much Qi and little Blood; if combined with Short, it is Qi disease harming the Lung. The character "Short" should be removed. Liver pulse being Deep and Wiry is correct. However, the Long pulse should be inspected at Cun and Chi, not at Guan. The character "Long" should be removed. It also says Kidney pulse is Deep, Solid, and Soft. The image of Soft pulse is Floating and Small, opposite to Deep and Solid, absolutely incompatible. The character "Soft" should be removed.
When diagnosing, maintain a vacant mind and quiet spirit; vacancy allows precision, quietness allows detail. With the spirit of the heart, connect to the fingertips; where the finger goes, the heart goes, comprehend and observe.
The way of palpation relies entirely on a nimble mind and skilled hands, a lively transformative mechanism, to respond appropriately. This requires daily refinement of skill; with much experience, the subtlety under the fingers is obtained in the heart, cannot be expressed in words, truly reaching such a realm. Just as Six Yang pulses tend to be Floating and Large; their deep inspection lies within the moderate inspection of normal pulse, one cannot say deep inspection is nonexistent. Six Yin pulses tend to be Deep and Fine; their superficial inspection lies within the moderate inspection of normal pulse, one cannot say superficial inspection is nonexistent. Furthermore, diseases have new and old stages, constitutions have strength and weakness, ages have youth and old age; although symptoms may be the same, treatments differ; flexible adaptation ensures appropriate response to each case.
Excessive pulse indicates Exogenous disease; insufficient pulse indicates Endogenous injury.
Exogenous Six Evils are Wind, Cold, Summerheat, Dampness, Dryness, and Fire; their pulses must have images like Surging, Rapid, Wiry, Tight, Slippery, or Large. Endogenous Seven Emotions are Joy, Anger, Worry, Thought, Grief, Fear, and Fright; their pulses must have images like Fine, Choppy, Soft, Weak, Minute, Small, Knotted, or Scattered.
The Great Qi of humans accumulates in the chest; respiration enters and exits, circulating up and down. Exhaled air travels from Heart to Lung; inhaled air is assisted by Liver and Kidney.
Great Qi accumulates in the chest, thus commanding the whole body; exhalation goes from Heart to Lung, inhalation is received by Liver and Kidney. Therefore, discussing Root Qi, it returns to the Kidney, while the pivot is actually in the Middle Jiao (Spleen/Stomach).
Respiration determines the rate; four beats per breath is the extreme of peace. Five beats is normal, without error. Three beats is Slow, indicating Cold stagnation; two or one beat is damage or failure, irrecoverable.
Six beats is Numbered (Rapid), indicating pathological Heat; seven beats is疾 (Fast), extreme Heat danger; if eight or nine beats, Yang exhausts and Yin perishes.
Four beats per breath is extremely peaceful. The saying "five beats without error, intercalated by long sigh" means sometimes one extra beat occurs among four, due to long breath, like leap years every three or five years, not referring to the fundamental pulse of five beats per breath. In fact, many normal people have five beats per breath, which is not a disease pulse. Only three Slow, six Rapid, and seven Fast indicate Cold and Heat diseases. One or two beats, and eight or nine beats indicate Yin extinction and Yang extinction, untreatable.
Floating pulse is above, obtained with light pressure; between skin and muscle, rarely missed. Deep pulse is below, governing Interior and Yin; pressing to sinews and bones, disease is deepest.
Floating pulse belongs to Yang, governing Exterior; Deep pulse belongs to Yin, governing Interior.
Floating, Deep, Slow, and Rapid are the major outlines of pulse; once these four are clear, examine other pulses in detail.
Floating-Slow indicates Exterior Cold, Floating-Rapid indicates Exterior Heat; Deep-Slow indicates Interior Cold, Deep-Rapid indicates Interior Heat. Others can be inferred.
The outline is orderly, items should be examined carefully; Slippery, Choppy, Deficient, and Excess are also key points.
Floating and Deep differentiate Exterior and Interior; Slow and Rapid differentiate Cold and Heat; these are the major outlines of pulse. Slippery and Choppy verify the blockage or flow of Qi and Blood; Deficient and Excess distinguish the prosperity or decline of Pathogenic and Righteous factors; these are the conditions of pulse. Although pulse and symptoms are numerous, they do not exceed this, hence divided into eight categories below to summarize them.
Floating pulse rises like wood floating on water; obtained lightly, insufficient heavily. Kous (Hollow) pulse is like a scallion, empty with light touch; present in both floating and deep, but hollow in the middle. Like pressing a drum skin, named Ge (Leather); middle and deep are empty, Yang hyperactivity and Yin exhaustion.
Floating pulse is Yang, governing all Exterior diseases, so pulse is between skin and muscle. Kou governs blood loss, hollowness is because Qi cannot control Blood. Ge pulse is Wiry, Large, and Floating, so said to be struggle between Deficiency and Cold, but actually it is Yin not embracing Yang, solitary Yang floating up, true Yin descending and escaping.
Below muscle, the pulse is Deep; obtained with heavy pressure, disease originates in Yin. Wiry, Large, and Deep is named Lao (Firm); Qi stagnation and Blood coagulation, turbid Yin confusion. Extreme Deep is Fu (Hidden), three inspections seem non-existent; Qi mechanism blocked, True Yang isolated.
Deep pulse belongs to Yin, governing all Interior syndromes. Lao mostly governs accumulated Blood and masses. Fu indicates Qi blockage, Clear Yang cannot expand.
Slow pulse is Cold, Qi stagnation and Blood stasis; if damaged or failed, irrecoverable. Slow with one stop is named Jie (Knotted); Qi and Blood disorder, also governs Cold accumulation. Jie stops occasionally, rate irregular; Dai (Intermittent) has fixed intervals, Qi and Blood consumption.
Slow is Yin-Cold, Qi not unblocking, so rate is difficult and slow. Slow with occasional stop, stopping and returning, no fixed number, called Jie pulse, caused by Qi and Blood disorder and Cold accumulation. If stop does not return, with fixed number, it is Dai pulse. Four beats one stop, death in 5-6 days; two beats one stop, death in 3-4 days.
Rapid pulse is Heat, Yin must be deficient; if due to Wind-Fire, it is Excess. Extreme heat leads to Fast. Seven beats per breath; eight or nine is extreme, death from vexation. Rapid with one stop is Cu (Surging); mostly governs Lung Abscess, stagnant Heat and Yang Toxin.
Rapid pulse is Heat, not exceeding Deficiency and Excess extremes. Fast means extreme Heat and danger, extreme means no hope. Cu is Rapid with one stop, also no fixed number. Heat stagnates in the middle, so mostly Lung and Stomach diseases.
Slippery pulse governs Phlegm, also governs all Qi; Qi excess and Phlegm abundance, flowing smoothly. Dong (Moving) pulse is like a bean, mostly seen at Guan; if at Cun or Chi, both Yin and Yang are deficient.
Slippery is also Yang pulse, Phlegm-Qi excess, so flowing smoothly. Moving pulse mostly seen at Guan section; if at Cun is Yang Moving, governs Yang collapse and sweating; if at Chi is Yin Moving, indicates Yin deficiency and extreme Heat.
If a woman's Cun and Guan pulses are Moving, it indicates pregnancy.
Choppy pulse is Blood deficiency, flow is obstructed; Blood not nourishing Qi, arriving with difficulty.
Blood deficiency lacks lubrication, so flow is difficult. Like scraping bamboo with a light knife, or rain soaking sand, both are very similar.
How is the Deficient pulse? Flow is powerless; Floating and Moderate are normal, Deep inspection is lacking. Ru (Soft) pulse is Floating and Small, like cotton floating on water; powerless with light touch, vanishes with heavy pressure. Wei (Minute) pulse is more deficient, between existence and non-existence; Qi and Blood loss, disease trend is unstable. San (Scattered) pulse has no fixity, dissipated and unrestrained; Yuan Qi about to fail, like bubbles floating on water. Ruo (Weak) pulse is below, resembling Wiry but not Wiry; Deep, Fine, and Soft, unsuitable for young adults. Xi (Fine) pulse is even deeper, like hair or silk; moving along sinews and bones, Deficiency-Cold known. Duan (Short) pulse is Qi disease, seen at Cun and Chi; cannot fill the section, True Yang suppressed.
Deficient pulse flows powerlessly, all three inspections present, but Deep inspection is truly empty. Ru pulse is Small and Floating, present in Floating and Moderate, Deep inspection seems non-existent. Wei has only Floating and Moderate, no Deep inspection. San is dissipated and unfixed, image of Qi and Blood depletion. Ruo has only Moderate and Deep inspections, Floating inspection seems non-existent. Xi is even deeper and Small, like a thread between sinews and bones. Duan is Qi weak, True Yang cannot flow smoothly. All above pulses are due to Qi and Blood deficiency, so gathered in the Deficient category, not attached to Floating or Deep sections.
Excess pulse comes with power in all three inspections; even larger than Firm, Pathogen stagnation and depression. Hong (Surging) pulse surges upward, like floodwater; endless flooding, Heat excess in the middle. Da (Large) pulse is moister, coming firm and going soft; Righteous deficiency and Pathogen excess, disease progression worrying. Xian (Wiry) pulse is stiff and straight, like a drawn bowstring; Wood excess overcoming Earth, Phlegm-fluid continuous. Xian and snapping is Jin (Tight); for Cold and Pain, Floating and Deep should be examined.
Cun and Chi pulses are sometimes Long; exceeding original position, touching Yin and Yang.
Excess pulse has power in three inspections, larger than Firm, for Pathogen stagnation and depression. Hong is like surging and boiling, Evil Heat blazing. Da is Righteous deficiency and disease progression, chronic disease more critical. Xian is the original image of Liver, Wood excess overcoming Earth, so governs Qi and Phlegm-fluid. Floating-Tight is Cold, Deep-Tight is Pain, both are Qi diseases. Long exceeding Cun touches Yang and loses Yin; Long exceeding Chi touches Yin and loses Yang; also sign of Guan-Ge (Obstruction and Reversal). All above are Excess diseases, so introduced into Excess category, not attached to other sections.
Only Huan (Moderate) pulse, leisurely and graceful; this is Stomach Qi, auspicious to see. Another type, sluggish and near Slow; Blood deficiency and Qi weakness, Dampness accumulation known.
Huan is calm and moderate, what is called Stomach Qi. Leisurely and graceful, meaning joyful, these eight characters best convey the spirit of Huan. Patients having this will surely be harmless. If sluggish and spiritless, it is Damp disease, must not be unknown.
All diseases do not exceed Three Causes; which symptom matches which pulse, discrimination values truth. Cannot enumerate all, can extend naturally; divine understanding depends on the person.