(素问脉要精微论）
帝曰∶脉其四时动奈何？知病之所在奈何？知病之所变奈何？知病乍在内奈何？知病乍在外奈何？请问此五者，可
得闻乎？岐伯曰∶请言其与天运转大也。（凡此五者，即阴阳五行之理，而阴阳五行，即天地之道，故伯以天运转大为对，
则五者之变动，尽乎其中矣。）万物之外，六合之内，天地之变，阴阳之应，彼春之暖，为夏之暑，彼秋之忿，为冬之怒，
四变之动，脉与之上下。（物在天中，天包物外，天地万物，本同一气，凡天地之变，即阴阳之应。故春之暖者，为夏暑
之渐也；秋之忿者，为冬怒之渐也。春生夏长，秋收冬藏，是即阴阳四变之动，而脉亦随之以上下也。）以春应中规，（规
者，所以为圆之器。春气发生，圆活而动，故应中规，而人脉应之，所以圆滑也。）夏应中矩，（矩者，所以为方之器。
夏气茂盛，盛极而止，故应中矩，而人脉应之，所以洪大方正也。）秋应中衡，（衡，平也，秤横也。秋气万宝俱成，平
于地面，故应中衡，而人脉应之，所以浮毛而见于外也。）冬应中权。（权，秤锤也。冬气闭藏，故应中权，而人脉应之，
所以沉石而伏于内也。凡兹规矩权衡者，皆发明阴阳升降之理，以合乎四时脉气之变象也。）是故冬至四十五日，阳气微
上，阴气微下；夏至四十五日，阴气微上，阳气微下。阴阳有时，与脉为期，期而相失，如脉所分，分之有期，故知死
时。（冬至一阳生，故冬至后四十五日以至立春，阳气以渐而微上，阳微上则阴微下矣。夏至一阴生，故夏至后四十五日
以至立秋，阴气以渐而微上，阴微上则阳微下矣。此所谓阴阳有时也。与脉为期者，脉随时而变迁也。期而相失者，谓
春规夏矩秋衡冬权不合于度也。如脉所分者，谓五脏之脉，各有所属也。分之有期者，谓衰王各有其时也。知此者，则
知死生之时矣。）微妙在脉，不可不察，察之有纪，从阴阳始，始之有经，从五行生，生之有度，四时为宜，（脉之微妙，
亦惟阴阳五行为之经纪，而阴阳五行之生，各有其度。如阳生于冬至，阴生于夏至，木生于亥，火生于寅，金生于巳，
水土生于申，此四时生王各有其宜也。纪，纲纪也。经，经常也。即大纲小纪之义。）补泻勿失，与天地如一，（天地之
道，损有余而补不足。易曰天道亏盈而益谦，地道变盈而流谦。故不足则当补，有余则当泻，补泻不失其宜，则与天地
之道如一矣。）得一之精，以知死生。（一之精者，天人一理之精微也。天地之道，阳主乎动，阴主乎静，阳来则生，阳
去则死。知天道之所以不息者，则知人之所以死生矣。）是故声合五音，色合五行，脉合阴阳。（声合宫商角征羽，色合
金木水火土，脉合四时阴阳，虽三者若乎有分，而理则一也。）是故持脉有道，虚静为保。（凡持脉之道，一念精诚，最
嫌扰乱，故必虚其心，静其志，纤微无间，而诊道斯为全矣。保，不失也。）春日浮，如鱼之游在波。（脉得春气，虽浮
动而未全出，故如鱼之游在波也。）夏日在肤，泛泛乎万物有余。（脉得夏气，则洪盛于外，故泛泛乎如万物之有余也。）
秋日下肤，蛰虫将去。（脉得秋气，则洪盛渐敛，故如欲蛰之虫将去也。）冬日在骨，蛰虫周密，君子居室。（脉得冬气，
沉伏在骨，故如蛰虫之周密。君子之于斯时，亦当体天地闭藏之道，而居于室也。）故曰∶知内者按而纪之，知外者终而
始之。此六者持脉之大法。（内言脏气，藏象有位，故可按而纪之。外言经气，经脉有序，故可终而始之。然必知此四时
内外六者之法，则脉之时动，病之所在，及病变之或内或外，皆可得而知也，故为持脉之大法。）
《素问·脉要精微论》
黄帝问道：脉搏随四季的变化如何？怎样知道疾病所在的部位？怎样知道疾病的演变情况？怎样知道病邪忽然在体内？怎样知道病邪忽然在体表？请问这五种情况，可以讲给我听吗？岐伯回答说：请允许我谈谈它与天体运转宏大规律的关系。（以上五种情况，就是阴阳五行（构成宇宙万物的基本元素及相互关系）的道理，而阴阳五行，也就是天地运行的法则，所以岐伯以天体运转的宏大规律来回答，那么这五种情况的变动，就完全包含在其中了。）万物之外，六合（指上下和东西南北四方，泛指天下或宇宙）之内，天地的变化，阴阳的感应，那春天的温暖，成为夏天的暑热；那秋天的肃杀，成为冬天的严寒。四季气候的变动，脉搏也随之上下起伏。（物体在天地之中，天包裹着物体在外，天地万物，本源于同一气，凡是天地的变化，就是阴阳的感应。所以春天的温暖，是夏天暑热的渐进；秋天的肃杀，是冬天严寒的渐进。春生、夏长、秋收、冬藏，这就是阴阳四季的变动，而脉搏也随着它而上下变化。）春天脉搏应合规（古代画圆的工具）的圆活之象，（规，是用来画圆的器具。春气发生，圆活而动，所以应合规，而人的脉搏随之，所以显得圆滑。）夏天应合矩（古代画方的工具）的方正之象，（矩，是用来画方的器具。夏气茂盛，盛极而止，所以应合矩，而人的脉搏随之，所以显得洪大、方正。）秋天应合衡（秤杆）的平衡之象，（衡，即平，指横着的秤杆。秋气使万物成熟，平齐于地面，所以应合衡，而人的脉搏随之，所以呈现浮取如毛的感觉，显现于外。）冬天应合权（秤锤）的沉潜之象。（权，即秤锤。冬气闭藏，所以应合权，而人的脉搏随之，所以呈现沉取如石的感觉，潜伏在内。这些规矩权衡，都是为了阐明阴阳升降的道理，以符合四季脉气的变化形象。）因此，冬至后四十五日，阳气微微上升，阴气微微下降；夏至后四十五日，阴气微微上升，阳气微微下降。阴阳各有其时，与脉搏相应，如果到了相应的时节脉搏却不相符，根据脉象所分的脏腑归属，以及衰旺各有其时，就能知道死亡的时间。（冬至一阳生，所以冬至后四十五日直到立春，阳气逐渐微微上升，阳气微升则阴气微降。夏至一阴生，所以夏至后四十五日直到立秋，阴气逐渐微微上升，阴气微升则阳气微降。这就是所说的阴阳各有其时。与脉为期，是指脉搏随季节变迁。期而相失，是指春规、夏矩、秋衡、冬权不合乎法度。如脉所分，是指五脏的脉象，各自有所归属。分之有期，是指衰旺各有其时。懂得这些，就知道死生的时间了。）脉搏的精妙微妙之处，不可不仔细考察，考察它有纲纪，从阴阳开始，开始它有常规，从五行（木、火、土、金、水及其生克关系）产生，产生它有法度，以顺应四季为宜，（脉搏的精妙微妙，也只由阴阳五行作为纲纪，而阴阳五行的产生，各有其法度。如阳生于冬至，阴生于夏至，木生于亥月，火生于寅月，金生于巳月，水土生于申月，这四季的生旺各有其适宜的时候。纪，是纲纪。经，是经常。即大纲和小纪的含义。）补泻不要失误，与天地之道一致，（天地的法则，是减损有余而补充不足。《易经》说天道亏损盈满而增益谦虚，地道改变盈满而流向谦虚。所以不足就当补，有余就当泻，补泻不失其宜，就与天地之道一致了。）得到“一”的精微，从而知道死生。（“一”的精微，是天人合一之理的精微处。天地的法则，阳主导动，阴主导静，阳来则生，阳去则死。知道天道之所以不息的原因，就知道人之所以有死生了。）因此，声音对应五音（宫、商、角、徵、羽），面色对应五行，脉搏对应阴阳。（声音对应宫商角徵羽，面色对应金木水火土，脉搏对应四时阴阳，虽然这三者似乎有所区分，但道理是一致的。）因此，诊脉有法则，虚静（心境虚空宁静）是保证。（大凡诊脉的道理，一念精诚，最忌讳扰乱，所以必须使心虚空，使志意宁静，细致入微没有间隙，那么诊脉之道才算完备了。保，是不失的意思。）春天的脉象浮，像鱼在水波中游动。（脉搏得到春气，虽然浮动但未完全出露，所以像鱼在水波中游动。）夏天的脉象在皮肤表面，泛泛然像万物丰盛有余。（脉搏得到夏气，则洪盛于外，所以泛泛然像万物丰盛有余的样子。）秋天的脉象下沉至皮肤之下，像冬眠的虫子将要离去。（脉搏得到秋气，则洪盛逐渐收敛，所以像将要冬眠的虫子将要离开一样。）冬天的脉象沉伏在骨间，像冬眠的虫子严密隐蔽，君子在此时也应当体察天地闭藏的法则，而居于室内。（脉搏得到冬气，沉伏在骨间，所以像冬眠的虫子严密隐蔽。君子在这个时候，也应当体察天地闭藏的法则，而居住在室内。）所以说：了解内脏的情况，按压脉搏以记录其规律；了解外在经络的情况，从头到尾地推究其始末。这六点（指春浮、夏洪、秋毛、冬石，以及知内、知外）是诊脉的大法。（内指脏气，藏象有固定位置，所以可以按压并记录其规律。外指经气，经脉有次序，所以可以从头到尾推究。然而必须懂得这四季内外六种方法，那么脉搏随季节的变动、疾病所在的部位，以及病变有时在体内有时在体外的情况，都可以知道了，所以称为诊脉的大法。）
<Suwen: Pulse Essentials and Subtleties>
The Yellow Emperor asked: How do the pulses move in accordance with the four seasons? How can one know the location of the disease? How can one know the transformation of the disease? How can one know when the pathogen is suddenly inside? How can one know when the pathogen is suddenly outside? I ask if these five points can be explained to me. Qibo replied: Please allow me to speak of their correspondence with the great movement of the heavens. (These five points are essentially the principles of Yin-Yang and Wu Xing (Five Elements), which constitute the fundamental elements and their interactions, and Yin-Yang and Wu Xing are the way of Heaven and Earth. Thus, Qibo responds with the grand movement of the heavens, so that the changes of these five points are fully contained within it.) Outside all things, within the Six Directions (referring to up, down, east, west, south, north, generally meaning the universe or world), the changes of Heaven and Earth, and the responses of Yin and Yang, the warmth of spring becomes the heat of summer; the severity of autumn becomes the cold of winter. The movements of the four seasonal changes cause the pulses to rise and fall accordingly. (Things exist within Heaven and Earth, and Heaven envelops things from without. Heaven, Earth, and all things originate from the same Qi. Therefore, any change in Heaven and Earth is a response of Yin and Yang. Thus, the warmth of spring is the gradual onset of summer's heat; the severity of autumn is the gradual onset of winter's cold. Spring generates, Summer grows, Autumn harvests, Winter stores; this is the movement of Yin-Yang through the four seasons, and the pulse also rises and falls with it.) In spring, the pulse corresponds to the Gui (compass for drawing circles), [indicating roundness]. (The Gui is an instrument for drawing circles. The Qi of Spring arises, moving in a round and lively manner, thus corresponding to the Gui. Human pulses correspond to this, appearing smooth and round.) In summer, the pulse corresponds to the Ju (square ruler), [indicating squareness]. (The Ju is an instrument for drawing squares. The Qi of Summer flourishes, reaching its peak and then stopping, thus corresponding to the Ju. Human pulses correspond to this, appearing surging, large, and upright.) In autumn, the pulse corresponds to the Heng (balance beam), [indicating balance]. (Heng means level, referring to the horizontal beam of a scale. In autumn, all treasures mature, becoming level with the ground, thus corresponding to the Heng. Human pulses correspond to this, appearing floating like hair on the surface.) In winter, the pulse corresponds to the Quan (steelyard weight), [indicating sinking]. (Quan refers to the weight of a steelyard. The Qi of Winter closes and stores, thus corresponding to the Quan. Human pulses correspond to this, appearing deep and heavy like stone, hidden within.) All these rules of Gui, Ju, Heng, and Quan serve to elucidate the principles of Yin-Yang ascending and descending, aligning with the changing images of pulse Qi in the four seasons.) Therefore, forty-five days after the Winter Solstice, Yang Qi slightly ascends, and Yin Qi slightly descends; forty-five days after the Summer Solstice, Yin Qi slightly ascends, and Yang Qi slightly descends. Yin and Yang have their specific times, matching the pulses. If they miss their timing, according to the division of the pulse [to organs], and knowing that decline and flourishing each have their periods, one can know the time of death. (At the Winter Solstice, one Yang is born. Thus, from 45 days after the Winter Solstice until Li Chun (Start of Spring), Yang Qi gradually and slightly ascends; as Yang slightly ascends, Yin slightly descends. At the Summer Solstice, one Yin is born. Thus, from 45 days after the Summer Solstice until Li Qiu (Start of Autumn), Yin Qi gradually and slightly ascends; as Yin slightly ascends, Yang slightly descends. This is what is meant by Yin and Yang having their specific times. "Matching the pulse" means the pulse changes with the seasons. "Missing the timing" means the Spring-Gui, Summer-Ju, Autumn-Heng, and Winter-Quan do not conform to the standard. "According to the division of the pulse" means the pulses of the Five Zang Organs each have their respective affiliations. "Having periods for decline and flourishing" means they each have their proper times. Understanding this allows one to know the times of life and death.) The subtlety and profundity of the pulse must not go unexamined. Examination has its discipline, starting with Yin-Yang. Discipline has its classics, arising from Wu Xing (Wood, Fire, Earth, Metal, Water and their generating/controlling relationships). Generation has its measure, suited to the four seasons. (The subtlety of the pulse is governed by Yin-Yang and Wu Xing. The generation of Yin-Yang and Wu Xing has its own measures. For example, Yang is born at the Winter Solstice, Yin at the Summer Solstice, Wood in the Hai month, Fire in the Yin month, Metal in the Si month, and Earth/Water in the Shen month. The generation and flourishing in the four seasons each have their appropriateness. Ji refers to discipline/guidelines. Jing refers to constants/classics. This implies the meaning of major outlines and minor guidelines.) Tonification and reduction should not be missed, aligning with the Way of Heaven and Earth. (The Way of Heaven and Earth reduces the excess and supplements the deficient. The I Ching states: The Way of Heaven diminishes the full and benefits the humble; the Way of Earth transforms the full and flows to the humble. Thus, deficiency requires tonification, and excess requires reduction. If tonification and reduction are applied appropriately, they align with the Way of Heaven and Earth.) Grasping the essence of "One" allows one to know life and death. (The essence of "One" is the subtlety of the unity of Heaven and Humanity. The Way of Heaven and Earth: Yang governs movement, Yin governs stillness. When Yang comes, there is life; when Yang goes, there is death. Knowing why the Way of Heaven does not cease allows one to understand human life and death.) Therefore, sounds correspond to the Five Tones (Gong, Shang, Jue, Zhi, Yu); complexions correspond to Wu Xing; pulses correspond to Yin and Yang. (Sounds correspond to Gong, Shang, Jue, Zhi, Yu; complexions correspond to Metal, Wood, Water, Fire, Earth; pulses correspond to the Yin and Yang of the four seasons. Although these three seem distinct, their principle is one.) Therefore, holding the pulse follows a Dao, where Xu Jing (Empty Mind and Quiet Will) serves as the guarantee. (In the art of pulse diagnosis, sincere focus is paramount, and disturbance is most to be avoided. Thus, one must empty the mind and quiet the will, attending to every minute detail without gap, so that the Dao of diagnosis is complete. Bao means not losing or failing.) In spring, the pulse floats, like a fish swimming in waves. (The pulse receives Spring Qi; although floating, it is not fully exposed, thus resembling a fish swimming in waves.) In summer, the pulse is at the skin level, abundant and overflowing like all things in plenty. (The pulse receives Summer Qi, becoming surging and external, thus appearing abundant like the plenitude of all things.) In autumn, the pulse sinks below the skin, like hibernating insects about to depart. (The pulse receives Autumn Qi, and its surging nature gradually收敛 [converges/restrains], thus resembling insects about to hibernate.) In winter, the pulse is in the bones, like hibernating insects tightly concealed, and gentlemen reside indoors. (The pulse receives Winter Qi, sinking and hidden in the bones, thus resembling hibernating insects tightly concealed. Gentlemen at this time should also embody the Way of Heaven and Earth's closure and storage, residing indoors.) Thus it is said: To know the interior, press the pulse and record its patterns; to know the exterior, trace it from end to beginning. These six points are the great methods of holding the pulse. (Interior refers to Zang Qi; Zang Xiang [Visceral Manifestations] have fixed positions, so they can be pressed and recorded. Exterior refers to Jing Qi [Meridian Qi]; Meridians have order, so they can be traced from start to finish. However, one must understand these six methods of the four seasons' interior and exterior. Then, the pulse's seasonal movements, the location of diseases, and whether pathological changes are internal or external can all be known. Hence, they are called the great methods of pulse diagnosis.)