凡黄家日晡多发热者，以阳明旺时也。（晡，《说文》作 ，云日加申时食也。仲景云
阳明
旺申酉戌时，）疸热随之而发，故以此为黄胆之常。以其病在中上而下无病，则散而不至逆
也。凡气在中则可上可下，在上必陷，在下必逆。若女劳疸热固结于下，不得下泄，则时时
上逆，特与脾近，与肺远，止得逆乘于中，不能逆乘于上。至日晡则中实脾旺，疸热之逆乘
于中者，得以乘势逆乘于上，上至肺而极，故以肺虚恶寒之例而为此病。恶寒仍肺病，非肾
病，辨症之诀如此。其额上黑之义同。盖女劳疸之热之逆行于脏者，借迳于脾胃而及肺；其
逆行于经者，借迳于大腹而及额上。额上为心之部。肾病者，颧与颜黑，此之谓也。此义三
十年来，屡思不得，至癸巳夏偶得之。
《脉经》第一篇释脉名，两言隐指。尝以问之老医，举无应者。及历症有年，始知其的
。盖
隐者，扬之反。经文皆于按之下言隐指者，谓脉气之鼓，被指按住，则不能发扬，似乎隐匿
，故曰隐指。其独系之虚实二脉何也？实脉初持时，止见长大，不得谓之实；及按之而长象
不减，又不得发扬，则其气横充指下而见满象，始成实脉矣。故曰隐指 然。《广雅》∶
“，满也”是也。虚脉初持时，止见软大，不得谓之虚；及按之而大象不减，又不得发扬
，则其气旁流指下而见芤象，始成为虚脉矣。故曰隐指豁豁然空。《玉篇》∶“豁，空也”
是也。虚实二脉之真际，皆待按之而见，故惟此二脉言隐指。古人立言之妙，非浅学所能领
会矣。
凡是黄疸病患者在傍晚时分多出现发热症状的，是因为阳明经气在此时旺盛的缘故。（“晡”，《说文解字》写作“哺”，意思是太阳到达申位时的进餐时间。张仲景说阳明经气在申、酉、戌三个时辰旺盛，）黄疸的热邪随之发作，所以把这作为黄疸病的常规表现。因为病邪位于中上焦而下部没有病变，所以病势发散而不会逆乱上行。凡是气机位于中部，就可以向上或向下运行；位于上部必然下陷，位于下部必然上逆。如果是女劳疸，热邪固结在下部，不能向下排泄，就会时时向上逆乱，由于距离脾脏较近，距离肺脏较远，只能逆乱侵犯中部（脾胃），而不能逆乱侵犯上部（心肺）。到了傍晚时分，中焦充实，脾气旺盛，原本逆乱侵犯中部的黄疸热邪，得以乘着这股势头进一步向上逆乱侵犯，向上到达肺脏达到极点，所以借用肺气虚导致恶寒的例子来解释这种病症。恶寒仍然是肺脏的疾病，而不是肾脏的疾病，辨别症状的关键就在于此。其额头发黑的含义与此相同。大概女劳疸的热邪逆行侵犯脏腑，是借道于脾胃而波及肺脏；热邪逆行侵犯经络，是借道于大腹而波及额头。额头是心所主的部位。肾脏有病的人，颧骨和颜面发黑，说的就是这种情况。这个道理我思考了三十年，多次思索不得其解，直到癸巳年夏天偶然领悟了它。
《脉经》第一篇解释脉象名称时，两次提到“隐指”。我曾经拿这个问题询问老医生，举出没有能回答上来的。等到经历临床病例多年后，才知道了它的真谛。大概“隐”是“扬”的反义词。经文都在重按之下提到“隐指”，意思是脉气的鼓动，被手指按住后，就不能发扬光大，似乎隐匿起来，所以叫作“隐指”。为什么唯独把它与虚、实两种脉象联系起来呢？实脉在初按时，只见到脉形长大，还不能称之为实脉；等到重按时，长形的脉象不减少，又不能发扬，那么脉气就横充于指下而出现满实的形象，这才成为实脉。所以说“隐指然”。《广雅》中说：“，满也”，就是这个意思。虚脉在初按时，只见到脉形软大，还不能称之为虚脉；等到重按时，大的脉象不减少，又不能发扬，那么脉气就在指下旁流而出现中空（芤）的形象，这才成为虚脉。所以说“隐指豁豁然空”。《玉篇》中说：“豁，空也”，就是这个意思。虚、实两种脉象的真谛，都要等到重按之后才能显现，所以只有这两种脉象提到“隐指”。古人立言的精妙之处，不是浅薄学识的人所能领会的啊。
In cases of jaundice, fever often occurs in the late afternoon because the Yangming channel is at its peak. ("Bu" is written as "bu" in *Shuowen Jiezi*, meaning mealtime when the sun reaches the Shen hour. Zhang Zhongjing stated that Yangming qi is prosperous during the Shen, You, and Xu hours.) The heat of jaundice follows this rhythm to manifest, thus making it a common pattern for jaundice. Since the pathology is located in the middle and upper jiao with no disease in the lower part, the pathogenic factor disperses without rebelling upward. Generally, qi located in the middle can move up or down; if located in the upper part, it must sink; if located in the lower part, it must rebel upward. In female labor jaundice (Nulao Dan), heat is firmly consolidated in the lower part and cannot drain downward, causing frequent upward rebellion. Being closer to the Spleen and farther from the Lung, it only rebels against the middle (Spleen/Stomach) and cannot rebel against the upper (Lungs/Heart). By late afternoon, the middle is full and Spleen qi is prosperous; the jaundice heat rebelling against the middle takes advantage of this momentum to rebel further upward, reaching the Lungs where it peaks. Therefore, this condition is explained by analogy to lung deficiency causing aversion to cold. Aversion to cold is still a Lung disease, not a Kidney disease; this is the key to differentiating symptoms. The meaning of blackness on the forehead is similar. Essentially, the heat of female labor jaundice rebelling into the Zang organs borrows the pathway through the Spleen and Stomach to reach the Lungs; when rebelling into the channels, it borrows the pathway through the large abdomen to reach the forehead. The forehead is the area governed by the Heart. When the Kidneys are diseased, the cheekbones and face turn black; this is what is meant. I pondered this principle for thirty years without success until I accidentally understood it in the summer of the Guisi year.
The first chapter of *Mai Jing* (Pulse Classic) explains pulse names, mentioning "Yin Zhi" (Hidden Finger/Pulse) twice. I once asked old physicians about this, but none could answer. After years of clinical experience, I finally grasped its true meaning. "Yin" is the opposite of "Yang". Wherever the text mentions "Yin Zhi" under deep pressure, it means that the pulsation of the pulse qi, when pressed by the finger, cannot expand or manifest vigorously, appearing hidden; hence it is called "Yin Zhi". Why is it specifically associated with the Excess (Shi) and Deficiency (Xu) pulses? When initially holding an Excess pulse, one only perceives length and largeness, which does not yet constitute Excess; only upon deep pressure, when the long shape remains unchanged and cannot expand, causing the qi to fill the fingers horizontally and present a full sensation, does it become an Excess pulse. Thus, it is described as "Yin Zhi Ran" (hidden yet full). *Guangya* states: "Man, full," which corresponds to this. When initially holding a Deficiency pulse, one only perceives softness and largeness, which does not yet constitute Deficiency; only upon deep pressure, when the large shape remains unchanged and cannot expand, causing the qi to flow sideways beneath the fingers and present a hollow (Kou) sensation, does it become a Deficiency pulse. Thus, it is described as "Yin Zhi Huo Huo Ran Kong" (hidden yet hollowly empty). *Yupian* states: "Huo, empty," which corresponds to this. The true nature of both Excess and Deficiency pulses is revealed only upon deep pressure; therefore, only these two pulses mention "Yin Zhi." The subtlety of the ancients' language is beyond the comprehension of those with shallow learning.