《素问·六节脏象论》岐伯曰∶人迎一盛，病在少阳；二盛，病在太阳，三盛，病在阳明；四盛以上为
格阳。寸口一盛，病在厥阴；二盛，病在少阴，三盛，病在太阴；四盛以上为关阴。人迎与寸口，俱盛四倍以
上为关格，关格之脉赢，不能极于天地之精气，则死矣。
人迎主六腑之阳，寸口主五脏之阴，故二脉统一身之阴阳也。而分三阴三阳者，明二气流行，皆有生旺之
序也。然偏旺则偏胜而病，偏甚则偏绝矣。人迎一盛者，少阳偏旺，故病在少阳；二盛偏甚，病在太阳；三
盛偏极，病在阳明也。寸口阴盛亦然。其言盛者，偏邪之气，非阴阳气旺之谓也。故至四盛以上，则邪气盛极，
而成关格之病。阴阳不相交通，故关者，不得小便；格者，格拒吐逆，食不下。关格之脉赢满四盛以上，不能
尽其所禀天地之精气而死也。《灵枢·终始篇》曰∶人迎一盛，病在足少阳，一盛而躁，病在手少阳，以至二
盛、三盛，及寸口一盛、二盛、三盛，皆兼足手，大抵盛在足经，病或可治，兼躁而及手经，则病深不可治也。
惟《难经》以尺寸之脉下覆上溢名
关格，为真脏脉，其人不病而死，与《内经》互明其理也。
《素问·腹中论》帝曰∶病热而有所痛，何也？岐伯曰∶病热者，阳脉也，以三阳之动也，人迎一盛少
阳，二盛太阳，三盛阳明，入阴也。夫阳入于阴，故病在头与腹，乃 胀而头痛也。
人迎主阳，热病阳邪，故人迎脉盛，盛甚则阳邪入阴。盖太阳主开，犹可外泄，阳明主阖，则邪必入阴，
以阳明与太阴为表里也。未离阳明，邪热上冲而头痛，已入太阴，故腹胀。上节言兼躁是足传手，此节言从阳
入阴，皆谓病邪深重，当急治之，勿使成关格死证也。
《素问·六节脏象论》中，岐伯说：人迎脉（位于颈部两侧颈动脉搏动处，主候六腑阳气）比寸口脉（位于手腕桡动脉搏动处，主候五脏阴气）大一倍，病在少阳经；大两倍，病在太阳经；大三倍，病在阳明经；大四倍以上称为格阳（阳气亢盛于上，拒阴于下）。寸口脉比人迎脉大一倍，病在厥阴经；大两倍，病在少阴经；大三倍，病在太阴经；大四倍以上称为关阴（阴气闭塞于内，格阳于外）。如果人迎脉和寸口脉都盛大四倍以上，称为关格（阴阳离决之危候），这种脉象表现为气血极度虚弱，无法承受天地精气的滋养，患者就会死亡。
人迎脉主要反映六腑的阳气，寸口脉主要反映五脏的阴气，所以这两条脉共同统摄全身的阴阳平衡。之所以区分三阴和三阳，是为了说明阴阳二气的流行运行，都有生长旺盛的顺序规律。然而，如果偏旺就会导致偏胜而发病，偏盛至极就会导致偏绝。人迎脉大一倍，是少阳之气偏旺，所以病在少阳；大两倍是偏盛，病在太阳；大三倍是偏极，病在阳明。寸口脉阴气盛大的情况也是如此。这里所说的“盛”，指的是偏邪之气盛，并不是指正常的阴阳之气旺盛。所以到了大四倍以上，就是邪气盛极，从而形成关格的病症。阴阳之气不能相互交通，所谓“关”，是指小便不通；所谓“格”，是指格拒导致呕吐逆乱，饮食难进。关格的脉象虽然盛大满溢至四倍以上，但人体正气已极度亏损，无法耗尽其所禀受的天地精气，最终导致死亡。
《灵枢·终始篇》说：人迎脉大一倍，病在足少阳经；如果一倍且伴有躁动不安，病在手少阳经；以此类推到两倍、三倍，以及寸口脉的一倍、两倍、三倍，都是既涉及足经也涉及手经。大致来说，邪气仅在足经时，病情或许还可以治疗；如果兼有躁动并波及手经，则病情深重难以治愈。
只有《难经》将尺寸脉象的下覆上溢命名为关格，认为这是真脏脉（脏腑真气败露之脉），病人虽未表现出明显病症却会死亡，这与《内经》的道理互相印证阐明。
《素问·腹中论》中，黄帝问：患热病却伴有疼痛，是什么原因呢？岐伯回答：患热病的，属于阳脉病变，因为三阳经的气机发动所致。人迎脉大一倍对应少阳，大两倍对应太阳，大三倍对应阳明，这是阳气进入阴分的表现。阳气进入阴分，所以病位在头部和腹部，出现腹胀和头痛的症状。
人迎脉主阳气，热病由阳邪引起，所以人迎脉盛大，盛大至极则阳邪侵入阴分。大概太阳经主司开泄，邪气尚可通过体表向外发散；阳明经主司闭合，邪气必然侵入阴分，因为阳明与太阴互为表里。邪热尚未离开阳明经时，向上冲逆导致头痛；一旦进入太阴经，就会出现腹胀。上一段提到的兼有躁动是指病邪从足经传入手经，这一段讲的是病邪从阳分进入阴分，都是指病邪深重，应当紧急治疗，不要使其发展成关格这样的死证。
In the *Suwen: Chapter 6 - Six Sections and Viscera Manifestations*, Qibo stated: When the Renying pulse (located at the neck, reflecting Yang of the Fu organs) is one-fold stronger than the Cunkou pulse (located at the wrist, reflecting Yin of the Zang organs), the disease is in Shaoyang; two-fold stronger, it is in Taiyang; three-fold stronger, it is in Yangming; four-fold or more stronger is termed Ge Yang (Yang rebellion). When the Cunkou pulse is one-fold stronger than the Renying pulse, the disease is in Jueyin; two-fold stronger, it is in Shaoyin; three-fold stronger, it is in Taiyin; four-fold or more stronger is termed Guan Yin (Yin obstruction). If both the Renying and Cunkou pulses are four-fold or more stronger, it is termed Guan Ge (Obstruction and Rebellion, a critical condition of Yin-Yang separation). The Guan Ge pulse indicates extreme depletion; unable to sustain the essence and Qi of Heaven and Earth, death ensues.
The Renying pulse governs the Yang of the six Fu organs, while the Cunkou pulse governs the Yin of the five Zang organs; thus, these two pulses collectively regulate the Yin and Yang of the whole body. The differentiation into Three Yin and Three Yang clarifies that the circulation of these two Qi has an order of growth and prosperity. However, excessive prosperity leads to dominance and disease, and extreme excess leads to extinction. A Renying pulse one-fold stronger indicates Shaoyang excess, hence disease in Shaoyang; two-fold stronger indicates greater excess, disease in Taiyang; three-fold stronger indicates extreme excess, disease in Yangming. The same logic applies to Cunkou Yin excess. The term "excess" here refers to the predominance of pathogenic factors, not the vigorous state of normal Yin and Yang Qi. Therefore, when it reaches four-fold or more, pathogenic Qi becomes extremely abundant, resulting in Guan Ge disease. Due to the lack of communication between Yin and Yang, "Guan" refers to urinary retention, and "Ge" refers to vomiting and regurgitation with inability to ingest food. Although the Guan Ge pulse appears full and strong (four-fold or more), the body's righteous Qi is depleted and cannot exhaust its endowment of Heaven and Earth's essence, leading to death.
The *Lingshu: Chapter on End and Beginning* states: A Renying pulse one-fold stronger indicates disease in the Foot-Shaoyang channel; if one-fold and restless, the disease involves the Hand-Shaoyang channel. This extends to two-fold and three-fold strengths for both Renying and Cunkou, involving both foot and hand channels generally. Roughly speaking, if the excess is confined to the foot channels, the disease may be treatable; if accompanied by restlessness and involving the hand channels, the disease is deep and incurable.
Only the *Nanjing* defines Guan Ge as the overflowing and sinking of the Cun and Chi pulses, identifying it as a True Zang pulse (pulse of exposed organ essence), where the patient dies without apparent illness. This elucidates the principle mutually with the *Neijing*.
In the *Suwen: Chapter on Abdominal Disorders*, the Yellow Emperor asked: Why does heat disease present with pain? Qibo replied: Heat disease involves Yang pulses due to the movement of the Three Yang channels. A Renying pulse one-fold stronger corresponds to Shaoyang, two-fold to Taiyang, and three-fold to Yangming, indicating Yang entering Yin. Since Yang enters Yin, the disease manifests in the head and abdomen, causing distension and headache.
The Renying pulse governs Yang. As heat disease is caused by Yang pathogens, the Renying pulse becomes strong; when excessively strong, Yang pathogens enter Yin. Taiyang governs opening, allowing pathogens to be released externally; Yangming governs closing, so pathogens must enter Yin, as Yangming and Taiyin are exterior-interior pairs. Before leaving Yangming, pathogenic heat rushes upward causing headache; upon entering Taiyin, abdominal distension occurs. The previous section discussed transmission from foot to hand channels via restlessness; this section discusses transmission from Yang to Yin. Both indicate severe pathogenic depth, requiring urgent treatment to prevent progression to fatal Guan Ge syndrome.