（素问大奇论 全）
肝满肾满肺满，皆实即为肿。（满，邪气壅滞而为胀满也。此言肝肾肺经，皆能为满，若其脉实，当为浮肿，而辨如
下文也。）肺之雍，喘而两 满。（肺居膈上，其系横出腋下，故肺雍则喘而两 满。雍，壅同。 音区，腋下胁也。）肝
雍，两 满，卧则惊，不得小便。（肝经之脉环阴器，布胁肋，故肝雍则两 满而不得小便。肝主惊骇，卧则气愈雍，故
多惊也。）肾雍， 下至少腹满，胫有大小，髀 大跛易偏枯。（肾脉循内踝之后上 ，出 内廉，上股内属肾络膀胱而
上行，故肾经雍则 下至少腹胀满也。足胫或肿或消，是谓大小。自髀至 ，或为大，或为跛，或掉易无力，或偏枯不
用，是皆肾经雍滞、不能营运所致。 下，诸本皆作脚下，甲乙经作 下者是，今从之。髀音皮。 音杭。）心脉满大，
痫螈筋挛。（心脉满大，火有余也。心主血脉，火盛则血涸，故痫螈而筋挛。痫音闲，癫痫也。螈音炽，抽搐也。挛音恋，
拘挛也。下同。）肝脉小急，痫螈筋挛。肝藏血，小为血不足，急为邪有余，故为是病。夫痫螈筋挛，病一也，而心肝二
经皆有之，一以内热，一以风寒，寒热不同，血衰一也，故同有是病。）肝脉骛暴，有所惊骇，脉不至若喑，不治自已。
（骛，驰骤也。暴，急疾也。惊骇者肝之病，故肝脉急乱者，因惊骇而然。甚有脉不至而声喑者，以猝惊则气逆，逆则
脉不通，而肝经之脉循喉咙，故声喑而不出也。然此特一时之气逆耳，气通则愈矣，故不治自已。骛音务。喑音音，声
不出也。）肾脉小急，肝脉小急，心脉小急，不鼓皆为瘕。（三脉细小而急，阴邪聚于阴分也，故当随三经之位而为瘕。
瘕音加，又去声， 瘕也。）肾肝并沉为石水，并浮为风水，（此言水病之有阴阳也。肾肝在下，肝主风，肾主水，肝肾
俱沉者，阴中阴病也，当病石水。石水者，凝结少腹，沉坚在下也。肝肾俱浮者，阴中阳病也，当病风水。风水者，游
行四体，浮泛于上也。诸篇水证详义，当考会通类水胀证。）并虚为死，（肾为五脏之根，肝为发生之主，根本空虚，有
表无里也，故当死。）并小弦欲惊。（肝肾并小，真阴虚也。小而兼弦，木邪胜也。气虚胆怯，故为欲惊。）肾脉大急沉，
肝脉大急沉，皆为疝。（疝者，寒气结聚所为。脉急者挟肝邪，脉沉者在阴分，沉急而大，阴邪盛也。肝肾之脉络小腹，
结于阴器，寒邪居之，故当病疝。愚按∶疝病乃寒挟肝邪之证，或结于少腹，或结于睾丸，或结于睾丸之左右上下，而
筋急绞痛、脉必急搏者，多以寒邪结聚阴分，而挟风木之气也。如四时刺逆从论曰肺风疝、脾风风疝之类，皆兼一风字，
其必挟肝邪可知。疝音讪。睾音高，阴丸也。）心脉搏滑急为心疝，肺脉沉搏为肺疝，（病疝而心脉搏滑急者，寒挟肝邪
乘心也。肺脉沉搏者，寒挟肝邪乘肺也。）三阳急为瘕，三阴急为疝。（三阳，手足太阳经也。三阴，手足太阴经也。邪
聚三阳为瘕聚，邪聚三阴为疝气，凡脉急者，皆邪盛也。前言肝肾心肺而此言脾经，所以五脏皆有疝。）二阴急为痫厥，
二阳急为惊。（二阴，少阴也。二阳，阳明也。脉急者为风寒，邪乘心肾，故为痫为厥。木邪乘胃，故发为惊。阳明脉解
篇曰∶胃者土也，故闻木音而惊者，土恶木也。是亦此义。）脾脉外鼓沉为肠 ，久自已。（沉为在里而兼外鼓者，邪不
甚深，虽为肠 ，久当自已。肠 ，下痢也。凡心肝脾肾，皆主阴分，或寒湿，或热，各有所伤，乃自大肠下血，均谓
为肠 。 音劈。）肝脉小缓为肠 ，易治。（肝脉急大则邪盛难愈，今脉小缓，为邪轻易治也。）肾脉小搏沉为肠 下血，
血温身热者死。（肾居下部，其脉本沉，若小而搏，为阴气不足而阳邪乘之，故为阳 下血。若其血温身热者，邪火有余，
真阴丧败也，故当死。）心肝 亦下血，二脏同病者可治，（心生血，肝藏血，故二脏之 亦下血，而不独肾也。然心肝
二脏，木火同气，故同病者为顺而可治。若肝脾同病，是为土败木贼，其难治也明矣。）其脉小沉涩为肠 ，其身热者死，
热见七日死。（心肝之脉，小沉而涩，以阴不足而血伤也，故为肠 。然脉沉细者不当热，今脉小身热是为逆，故当死。
而死于热见七日者，六阴败尽也。）胃脉沉鼓涩，胃外鼓大，心脉小坚急，皆膈偏枯，（沉鼓涩，阳不足也。外鼓大，阴
受伤也。小坚而急，阴邪胜也。胃为水谷之海，心为血脉之主，胃气既伤，血脉又病，故致上下痞隔，半身偏枯也。）男
子发左，女子发右，不喑舌转可治，三十日起；（男子左为逆，右为从；女子右为逆，左为从。今以偏枯而男子发左，女
子发右，是逆证也。若声不喑，舌可转，则虽逆于经，未甚于脏，乃为可治，而一月当起。若偏枯而喑者，肾气内竭而
然，其病必甚。如脉解篇曰∶内夺而厥，则为喑俳，此肾虚也。正以肾脉循喉咙挟舌本故耳。左右逆从义，见论治类十
四。）其从者喑，三岁起；（若男发于右而不发于左，女发于左而不发于右，皆谓之从。从，顺也。然证虽从而声则喑，
是外轻而内重也，故必三岁而后起。）年不满二十者，三岁死。（以气血方刚之年，辄见偏枯废疾，此禀赋不足，早雕之
兆也，不出三年死矣。）脉至而搏，血衄身热者死，脉来悬钩浮为常脉。（搏脉弦强，阴虚者最忌之。凡诸失血鼻衄之疾，
其脉搏而身热，真阴脱败也，故当死。然失血之证多阴虚，阴虚之脉多浮大，故悬钩而浮，乃其常脉，无足虑也。悬者
不高不下，不浮不沉，如物悬空之义。谓脉虽浮钩，而未失中和之气也。）脉至如喘，名曰暴厥，暴厥者不知与人言。（喘
者，如气之喘，言急促也。暴厥，谓猝然厥逆而不知人也。）脉至如数，使人暴惊，三四日自已。（数脉主热，而如数者，
实非真数之脉。盖以猝动肝心之火，故令人暴惊。然脉非真数，故俟三四日而气衰自愈矣。）
脉至浮合，浮合如数，一息十至以上，是经气予不足也，微见九十日死。（此下皆言死期也。浮合，如浮波之合，后
以催前，泛泛无常也。一息十至以上，其状如数，而实非数热之脉，是经气之衰极也。微见，始见也。言初见此脉，便
可期九十日而死；若见之已久，则不必九十日矣。所以在九十日者，以时更季易，天道变而人气从之也。予，与同，党
与之义。下同。）脉至如火薪然，是心精之予夺也，草干而死。（如火薪然者，来如焰之锐，去如灭之速。此火脏无根之
脉，而心经之精气与夺也。夏令火王，犹为可支，草干而死，阳尽时也。）脉至如散叶，是肝气予虚也，木叶落而死。（如
散叶者，浮泛无根也。此以肝气大虚，全无收敛。木叶落者，金胜木败，肝死时也。）脉至如省客，省客者脉塞而鼓，是
肾气予不足也，悬去枣华而死。（省客，如省问之客，或去或来也。塞者，或无而止。鼓者，或有而搏。是肾原不固，而
无所主持也。枣华之候，初夏时也。悬者，华之开。去者，华之落。言于枣华开落之时，火王而水败，肾虚者死也。）脉
至如丸泥，是胃精予不足也，榆荚落而死。（丸泥者，泥弹之状，坚强短涩之谓，此胃精中气之不足也。榆荚，榆钱也，
春深而落。木旺之时，土败者死。）脉至如横格，是胆气予不足也，禾熟而死。（横格，如横木之格于指下，长而且坚，
是为木之真脏，而胆气之不足也。禾熟于秋，金令王也，故木败而死。）脉至如弦缕，是胞精予不足也，病善言，下霜而
死；不言，可治。（弦缕者，如弦之急，如缕之细，真元亏损之脉也。胞，子宫也，命门元阳之所聚也。胞之脉系于肾，
肾之脉系舌本，胞气不足，当静而无言；今反善言，是阴气不藏，而虚阳外见，时及下霜，虚阳消败而死矣。故与其善
言者，不若无言者为肾气犹静，而尚可治也。）脉至如交漆，交漆者左右旁至也，微见三十日死。（交漆者，如泻漆之交，
左右旁至，缠绵不清也。微见，初见也。三十日为月建之易，而阴阳偏败者，不过一月之期也。）脉至如涌泉，浮鼓肌中，
太阳气予不足也，少气，味韭英而死。（涌泉者，如泉之涌，有升无降，而浮鼓于肌肉之中，是足太阳膀胱之气不足也。
膀胱为三阳而主外，今其外实内虚，阴精不足，故为少气。当至味韭英之时而死者，以冬尽春初，水渐衰也。）脉至如颓
土之状，按之不得，是肌气予不足也，五色先见黑，白垒发死。（颓土之状，虚大无力，而按之即不可得。肌气即脾气，
脾主肌肉也。黑为水之色，土败极而水反乘之，故当死。垒， 同，即蓬 之属。 有五种，而白者发于春，木王之时，
土当败也。）脉至如悬雍，悬雍者浮揣切之益大，是十二俞之予不足也，水凝而死。（悬雍，喉间下垂肉乳也。如悬雍浮
揣切之益大者，浮短孤悬，有上无下也。俞皆在背，为十二经脏气之所系。水凝而死，阴气盛而孤阳绝也。揣，杵水切。
俞，输同。）脉至如偃刀，偃刀者浮之小急，按之坚大急，五脏菀热寒热，独并于肾也，如此其人不得坐，立春而死。（偃
刀，卧刀也。浮之小急，如刀口也。按之坚大急，如刀背也。此以五脏菀热而发为寒热，阳旺则阴消，故独并于肾也。
腰者肾之府，肾阴既亏，则不能起坐。立春阳盛，阴日以衰，所以当死。菀，郁同。）脉至如丸，滑不直手，不直手者按
之不可得也，是大肠气予不足也，枣叶生而死。（如丸，短而小也。直，当也。言滑小无根而不胜按也。大肠应庚金，枣
叶生初夏，火旺则金衰，故死。）脉至如华者，令人善恐，不欲坐卧，行立常听，是小肠气予不足也，季秋而死。（如华，
如草木之华而轻浮柔弱也。小肠属丙火，与心为表里，小肠不足则气通于心。善恐不欲坐卧者，心气怯而不宁也。行立
常听者，恐惧多而生疑也。丙火墓于戌，故当季秋死。）
（《素问·大奇论》全篇）
肝脏脉象满实，肾脏脉象满实，肺脏脉象满实，只要脉象坚实，就会发生浮肿。（“满”，是指邪气壅滞导致胀满。这里说肝、肾、肺三经都能出现满证，如果脉象坚实，应当出现浮肿，具体辨别方法如下文所述。）肺脏气机壅滞，会出现喘息且两侧胁肋部胀满。（肺位于膈肌之上，其经脉横出腋下，所以肺气壅滞则喘息且两侧胁肋胀满。“雍”与“壅”同义。“䐜”音区，指腋下胁肋部位。）肝脏气机壅滞，两侧胁肋胀满，睡眠时易受惊骇，小便不通。（肝经的经脉环绕阴器，散布于胁肋，所以肝气壅滞则两侧胁肋胀满且小便不通。肝主惊骇，睡眠时气机更加壅滞，所以容易受惊。）肾脏气机壅滞，从足跟到小腹部胀满，小腿粗细不一，大腿肿胀或跛行，容易患偏枯症。（肾脉沿着内踝后方上行，出于内廉，沿大腿内侧属肾络膀胱而上行，所以肾经气机壅滞则从足跟到小腹胀满。足胫部有的肿、有的消，这就叫大小不一。从大腿到足跟，有的肿大，有的跛行，有的颤抖无力，有的半身不遂，这些都是肾经气机壅滞、不能营运气血所致。“䐜下”，各版本多作“脚下”，《甲乙经》作“䐜下”是正确的，现在依从它。“髀”音皮。“䐜”音杭。）心脉满大，会出现癫痫抽搐和筋脉拘挛。（心脉满大，是火气有余。心主血脉，火盛则血液枯竭，所以出现癫痫抽搐和筋脉拘挛。“痫”音闲，即癫痫。“螈”音炽，即抽搐。“挛”音恋，即拘挛，以下相同。）肝脉细小而急，也会出现癫痫抽搐和筋脉拘挛。肝藏血，脉小表示血不足，脉急表示邪气有余，所以出现这些病证。癫痫抽搐和筋脉拘挛，病名虽然一样，但心和肝两经都会出现，一个是由于内热，一个是由于风寒，寒热不同，但血衰是一样的，所以都可能出现这种病证。）肝脉疾速暴乱，是因为受到惊骇，脉象不至或声音嘶哑，不需要治疗也会自行痊愈。（“骛”，是驰骤的意思。“暴”，是急疾的意思。惊骇是肝的病证，所以肝脉急乱，是因为惊骇引起的。严重的会出现脉象不至且声音嘶哑，因为突然受惊导致气逆，气逆则脉道不通，而肝经的经脉循行经过喉咙，所以声音嘶哑发不出来。然而这只是一时的气逆罢了，气通就会痊愈，所以不需要治疗也会自行痊愈。“骛”音务。“喑”音音，指声音发不出来。）肾脉细小而急，肝脉细小而急，心脉细小而急，按之不鼓指的，都是瘕病。（三脉细小而急，是阴邪聚集在阴分，所以应当根据三经的部位形成瘕病。“瘕”音加，又读去声，指积聚类疾病。）肾脉和肝脉都沉，是石水；都浮，是风水。（这里说的是水病的阴阳属性。肾和肝都在下部，肝主风，肾主水，肝肾脉俱沉，是阴中之阴病，应当得石水。石水，是凝结在少腹，沉重坚硬在下部。肝肾脉俱浮，是阴中之阳病，应当得风水。风水，是游行四肢，浮泛在上部。各篇中关于水证的详细含义，应当参考《会通类·水胀证》。）肾脉和肝脉都虚，是死证。（肾是五脏的根本，肝是生发的主体，根本空虚，有表无里，所以会死亡。）肾脉和肝脉都小而弦，想要惊恐。（肝肾脉都小，是真阴虚损。小而且兼弦，是木邪亢盛。气虚胆怯，所以想要惊恐。）肾脉大、急、沉，肝脉大、急、沉，都是疝病。（疝病，是由寒气结聚造成的。脉急表示挟有肝邪，脉沉表示在阴分，沉急而大，是阴邪亢盛。肝肾的经脉联络小腹，结于阴器，寒邪居留其中，所以应当得疝病。我认为：疝病是寒邪挟带肝邪的病证，有的结在少腹，有的结在睾丸，有的结在睾丸的左右上下，并且筋脉紧急绞痛、脉象必定急搏的，多是寒邪结聚阴分，而挟带风木之气。如《四时刺逆从论》所说肺风疝、脾风风疝之类，都带一个“风”字，它们必定挟带肝邪是可以知道的。“疝”音讪。“睾”音高，指阴丸。）心脉搏动滑利而急，是心疝；肺脉沉而搏指，是肺疝。（患疝病而心脉搏滑急的，是寒邪挟带肝邪乘袭心脏。肺脉沉搏的，是寒邪挟带肝邪乘袭肺脏。）太阳、阳明、少阳脉急，是瘕病；太阴、少阴、厥阴脉急，是疝病。（三阳，指手足太阳经。三阴，指手足太阴经。邪气聚集在三阳经形成瘕聚，邪气聚集在三阴经形成疝气，凡是脉急的，都是邪气亢盛。前面提到肝肾心肺，这里提到脾经，所以五脏都有疝病。）少阴脉急，是痫厥；阳明脉急，是惊。（二阴，指少阴。二阳，指阳明。脉急是风寒，邪气乘袭心肾，所以出现痫和厥。木邪乘袭胃，所以发作惊。《脉解篇》说：胃属土，所以听到木音就惊恐的，是土厌恶木。这也是这个意思。）脾脉外部鼓动而内部沉，是肠澼，时间久了会自行痊愈。（沉表示病在里而兼有外部鼓动，说明邪气不深，虽然是肠澼，久了应当自行痊愈。“肠澼”，指下痢。凡是心、肝、脾、肾，都主阴分，或因寒湿，或因热，各自有所损伤，于是从大肠下血，都称为肠澼。“澼”音劈。）肝脉小缓，是肠澼，容易治疗。（肝脉急大则邪气盛难愈，现在脉小缓，是邪气轻浅容易治疗。）肾脉小、搏指、沉，是肠澼下血，如果血色温热身体发热的是死证。（肾居下部，其脉本应沉，如果小而搏指，是阴气不足而阳邪乘袭，所以为阳邪下血。如果血色温热身体发热，是邪火有余，真阴丧败，所以会死亡。）心和肝脉也见下血，这两脏同时发病的可以治疗，（心生成血，肝贮藏血，所以心和肝的下血，不仅限于肾。然而心和肝两脏，木火同气，所以同病的是顺证而可治。如果肝脾同病，这是土败木贼，其难治是明显的。）脉象小、沉、涩是肠澼，如果身体发热的是死证，发热持续七天死亡。（心和肝的脉，小沉而涩，是因为阴不足而血受伤，所以为肠澼。然而脉沉细的不应当发热，现在脉小身体发热是逆证，所以会死亡。而在发热七天死亡，是因为六阴败尽。）胃脉沉而鼓涩，胃脉外部鼓大而有力，心脉小坚急，都是膈塞和偏枯，（沉鼓涩，是阳气不足。外部鼓大，是阴液受伤。小坚而急，是阴邪亢盛。胃是水谷之海，心是血脉之主，胃气既已受伤，血脉又有病，所以导致上下痞隔，半身偏枯。）男子发病在左侧，女子发病在右侧，如果不失语且舌体转动灵活可以治疗，三十天可以起床；（男子左侧为逆，右侧为从；女子右侧为逆，左侧为从。现在以偏枯而言，男子发病在左，女子发病在右，这是逆证。如果声音不嘶哑，舌头可以转动，那么虽然在经络上逆，但未至于脏腑严重受损，是为可治，一个月应当起身。如果偏枯且失语的，是肾气内竭造成的，病情一定很重。如《脉解篇》说：内夺而厥，则为喑俳，这是肾虚。正因为肾脉循行喉咙夹舌本的原因。左右逆从的含义，见《论治类》十四。）如果是顺证却失语，三年才能起床；（如果男子发病在右而不发在左，女子发病在左而不发在右，都叫做从。从，就是顺。然而证候虽顺但声音嘶哑，这是外轻内重，所以必须三年后才能起身。）年龄不满二十岁的，三年内死亡。（在气血正旺盛的年纪，却出现偏枯废疾，这是禀赋不足，早衰的迹象，不出三年就会死亡。）脉象来势搏击有力，鼻出血且身体发热的是死证，脉来悬钩而浮是常脉。（搏脉弦强，阴虚的人最忌讳。凡是各种失血鼻衄的疾病，如果脉搏搏击有力且身体发热，是真阴脱败，所以会死亡。然而失血的病证多阴虚，阴虚的脉多浮大，所以悬钩而浮，是它的常脉，不值得忧虑。“悬”是不高不下，不浮不沉，像物体悬挂在空中的意思。是说脉虽然浮钩，但未失去中和之气。）脉象急促如喘，名叫暴厥，暴厥的人会神志不清不能与人交谈。（“喘”，是像气之喘，指急促。暴厥，指猝然厥逆而神志不清。）脉象数，使人突然惊恐，三四天会自行痊愈。（数脉主热，但像数的脉，实际上不是真正的数脉。大概是因为猝然触动肝心之火，所以令人暴惊。然而脉不是真正的数，所以等到三四天气衰自愈。）
脉象浮合，浮合像数脉，一呼吸十次以上，是经气给予不足，轻微见到这种情况九十天后死亡。（以下都是说死期。浮合，像浮波相合，后浪催前浪，泛泛无常。一呼吸十次以上，其状像数脉，但实际上不是数热之脉，是经气极度衰败。微见，是刚开始见到。说刚见到此脉，就可以预期九十天后死亡；如果见到已久，则不必等九十天了。之所以在九十天，是因为时节更替，天道变化而人气随之改变。予，与同，党与之义。以下相同。）脉象像燃烧的柴火，这是心精被剥夺，草干枯时死亡。（像燃烧的柴火，来时像火焰锐利，去时像熄灭迅速。这是火脏无根的脉，是心经精气被剥夺。夏令火旺，还可以支撑，草干枯时死亡，是阳气耗尽的时候。）脉象像飘散的叶子，这是肝气给予虚损，树叶落下时死亡。（像飘散的叶子，浮泛无根。这是因为肝气大虚，完全没有收敛。木叶落，是金胜木败，肝气死亡的时候。）脉象像省客，省客的脉象堵塞而鼓动，这是肾气给予不足，枣花盛开凋落时死亡。（省客，像探视问候的客人，有时离去有时来。塞，是或无而止。鼓，是或有而搏。这是肾原不固，而没有主持。枣花的时节，是初夏。悬，是花开。去，是花落。说在枣花开放凋落的时候，火旺而水败，肾虚者死亡。）脉象像丸泥，这是胃精给予不足，榆荚落下时死亡。（丸泥，是泥弹的形状，坚强短涩的意思，这是胃精中气不足。榆荚，是榆钱，春深而落。木旺之时，土败者死亡。）脉象像横格，这是胆气给予不足，禾苗成熟时死亡。（横格，像横木格在指下，长而且坚，这是木的真脏脉，是胆气不足。禾苗在秋天成熟，金令当旺，所以木败而死。）脉象像弦缕，这是胞精给予不足，病人喜欢说话，下霜时死亡；不喜欢说话，可以治疗。（弦缕，像弦的紧急，像线的细，是真元亏损的脉。胞，是子宫，是命门元阳聚集的地方。胞的脉系于肾，肾的脉系舌本，胞气不足，应当安静不说话；现在反而喜欢说话，是阴气不藏，而虚阳外现，等到下霜时，虚阳消败而死。所以与其喜欢说话的，不如不说话的好，因为不说话表明肾气尚静，还可以治疗。）脉象像交漆，交漆是左右旁至，轻微见到三十天后死亡。（交漆，像泻漆的交错，左右旁至，缠绵不清。微见，是初见。三十天是月建的变化，阴阳偏败的，不超过一个月的期限。）脉象像涌泉，浮鼓于肌肉之中，是太阳气给予不足，气短，吃韭菜花时死亡。（涌泉，像泉水涌出，只有升没有降，而浮鼓在肌肉之中，是足太阳膀胱之气不足。膀胱是三阳而主外，现在它外实内虚，阴精不足，所以气短。应当到吃韭菜花时死亡的，是因为冬尽春初，水气渐衰。）脉象像倒塌的土，按之不得，这是肌气给予不足，五色先见黑色，白痱发作时死亡。（倒塌土的样子，虚大无力，而按之立即不可得。肌气就是脾气，脾主肌肉。黑是水之色，土败极而水反乘之，所以会死亡。垒，同“癗”，即蓬癗之类。癗有五种，而白者发于春季，木旺之时，土应当败。）脉象像悬雍，悬雍是浮揣切之益大，这是十二俞给予不足，水凝时死亡。（悬雍，喉间下垂的肉乳。像悬雍浮揣切之益大，是浮短孤悬，有上无下。俞都在背部，是十二经脏气所系。水凝而死，是阴气盛而孤阳绝。揣，杵水切。俞，输同。）脉象像偃刀，偃刀是浮取小急，重按坚大急，五脏郁热寒热，独并于肾，这样的人不能坐，立春时死亡。（偃刀，卧刀。浮取小急，像刀口。重按坚大急，像刀背。这是因为五脏郁热而发为寒热，阳旺则阴消，所以独并于肾。腰是肾之府，肾阴既亏，则不能起坐。立春阳气盛，阴气日益衰，所以应当死亡。菀，郁同。）脉象像丸，滑利不直手，不直手是按之不可得，这是大肠气给予不足，枣叶生长时死亡。（像丸，短而小。直，当。说滑小无根而不能承受按压。大肠应庚金，枣叶生在初夏，火旺则金衰，所以死亡。）脉象像花，使人容易恐惧，不想坐卧，行走站立时常听，这是小肠气给予不足，季秋时死亡。（像花，像草木之花而轻浮柔弱。小肠属丙火，与心为表里，小肠不足则气通于心。善恐不欲坐卧，是心气怯而不宁。行立常听，是恐惧多而生疑。丙火墓于戌，所以应当在季秋死亡。）
(Full text from *Suwen: Daqi Lun*)
When the Liver, Kidney, and Lung pulses are "full" (Man, indicating pathogenic qi stagnation causing distension), if they are solid, edema will occur. (This states that the Liver, Kidney, and Lung meridians can all present with fullness; if the pulse is solid, swelling should be expected, to be differentiated as described below.) Lung qi obstruction leads to panting and fullness in both hypochondriac regions. (The Lung resides above the diaphragm, its system extends horizontally to the axilla; thus, Lung obstruction causes panting and hypochondriac fullness. "Yong" is synonymous with "Yong" [obstruction]. "Dan" [pronounced qu] refers to the axillary hypochondriac region.) Liver qi obstruction causes hypochondriac fullness, fright during sleep, and inability to urinate. (The Liver meridian circles the genitalia and spreads over the hypochondrium; thus, Liver obstruction causes hypochondriac fullness and urinary retention. The Liver governs fright; during sleep, qi becomes more obstructed, leading to frequent fright.) Kidney qi obstruction causes fullness from the heel to the lower abdomen, varying sizes of the calves, swelling or lameness of the thighs, and predisposition to hemiplegia. (The Kidney meridian follows behind the medial malleolus, ascends, emerges at the medial aspect, runs along the inner thigh, connects with the Kidney and bladders, and ascends; thus, Kidney obstruction causes fullness from the heel to the lower abdomen. When calves are swollen or emaciated, it is called "varying sizes." From thigh to heel, there may be swelling, lameness, tremors/weakness, or hemiplegia; these are all caused by Kidney qi obstruction failing to circulate qi and blood. "Dan xia" is written as "jiao xia" in most texts, but *Jiayi Jing* writes "Dan xia," which is correct and adopted here. "Bi" is pronounced pi. "Dan" is pronounced hang.) Heart pulse full and large indicates epilepsy, convulsions, and tendon cramps. (Heart pulse full and large indicates excess fire. The Heart governs blood vessels; excessive fire depletes blood, causing epilepsy, convulsions, and tendon cramps. "Xian" is pronounced xian, meaning epilepsy. "Yuan" is chi, meaning convulsion. "Luan" is luan, meaning cramp, same below.) Liver pulse small and rapid also indicates epilepsy, convulsions, and tendon cramps. The Liver stores blood; a small pulse indicates blood deficiency, and a rapid/tight pulse indicates excess pathogen, hence these diseases. Although epilepsy, convulsions, and tendon cramps share the same name, they appear in both Heart and Liver meridians: one due to internal heat, the other due to wind-cold. Though cold and heat differ, blood deficiency is the same, so both may present this disease.) Liver pulse rushing and chaotic, accompanied by fright, where the pulse is absent or voice is lost, will resolve spontaneously without treatment. ("Wu" means galloping/rushing. "Bao" means sudden/rapid. Fright is a Liver disease; thus, a rapid and chaotic Liver pulse results from fright. In severe cases, the pulse may be absent and voice hoarse because sudden fright causes qi rebellion, blocking the pulse; since the Liver meridian passes through the throat, voice is lost. However, this is merely temporary qi rebellion; once qi flows freely, health returns, so no treatment is needed. "Wu" is pronounced wu. "Yin" is pronounced yin, meaning loss of voice.) Kidney, Liver, and Heart pulses that are small, rapid, and do not beat against the finger indicate Jia masses. (Three pulses small and rapid indicate Yin pathogens gathering in the Yin divisions; thus, Jia masses form according to the locations of these three meridians. "Jia" is pronounced jia, referring to mass-like accumulations.) If Kidney and Liver pulses are both deep, it is Shishi water (Stone Water); if both are floating, it is Fengshui (Wind Water). (This discusses the Yin-Yang nature of water diseases. Kidney and Liver are in the lower body; Liver governs Wind, Kidney governs Water. Both deep indicates Yin within Yin disease, resulting in Stone Water. Stone Water coagulates in the lower abdomen, heavy and hard below. Both floating indicates Yang within Yin disease, resulting in Wind Water. Wind Water wanders the four limbs, floating above. For detailed meanings of water syndromes in other chapters, refer to *Huitong Lei: Shuizhang Zheng*.) If Kidney and Liver pulses are both deficient, it is a death sign. (Kidney is the root of the five Zang organs; Liver is the master of growth/generation. Root emptiness, having exterior without interior, leads to death.) If Kidney and Liver pulses are both small and wiry, there is impending fright. (Both small indicates True Yin deficiency. Small and wiry indicates Wood pathogen dominance. Qi deficiency and gallbladder timidity cause impending fright.) If Kidney pulse is large, rapid, and deep, and Liver pulse is large, rapid, and deep, both indicate Shan (Hernia). (Shan is caused by cold qi aggregation. Rapid pulse indicates accompanying Liver pathogen; deep pulse indicates location in Yin division. Large, rapid, and deep indicates excess Yin pathogen. Kidney and Liver meridians connect to the lower abdomen and genitalia; cold pathogen residing there causes Shan. Note: Shan disease is cold accompanying Liver pathogen, aggregating in lower abdomen, testicles, or surrounding areas, with tight tendons, severe pain, and rapid/pounding pulse. This is mostly cold pathogen aggregating in Yin division, accompanying Wood/Wind qi. As stated in *Sishi Ni Cong Lun*, terms like Fei Feng Shan and Pi Feng Feng Shan include "Wind," indicating they must accompany Liver pathogen. "Shan" is pronounced shan. "Gao" is pronounced gao, meaning testicle.) Heart pulse slippery, rapid, and pounding indicates Xin Shan (Heart Hernia); Lung pulse deep and pounding indicates Fei Shan (Lung Hernia). (In Shan disease, Heart pulse slippery/rapid/pounding indicates cold accompanying Liver pathogen attacking the Heart. Lung pulse deep/pounding indicates cold accompanying Liver pathogen attacking the Lung.) San Yang (Three Yang) rapid pulse indicates Jia mass; San Yin (Three Yin) rapid pulse indicates Shan. (San Yang refers to Hand-Foot Taiyang meridians. San Yin refers to Hand-Foot Taiyin meridians. Pathogen gathering in San Yang forms Jia mass; gathering in San Yin forms Shan qi. All rapid pulses indicate excess pathogen. Previous sections mentioned Kidney, Liver, Heart, Lung; this mentions Spleen, showing all five Zang can have Shan.) Er Yin (Lesser Yin) rapid pulse indicates Epileptic Syncope; Er Yang (Lesser Yang) rapid pulse indicates Fright. (Er Yin refers to Shaoyin. Er Yang refers to Yangming. Rapid pulse indicates wind-cold; pathogen attacking Heart/Kidney causes Epilepsy/Syncope. Wood pathogen attacking Stomach causes Fright. *Maijie Pian* states: Stomach is Earth; fear of Wood sound occurs because Earth dislikes Wood. This aligns with this principle.) Spleen pulse external beating and internal deep indicates Changpi (Intestinal Dysentery), which resolves spontaneously after a long time. (Deep indicates interior; combined with external beating, pathogen is not deep. Though Changpi, it resolves spontaneously. "Changpi" refers to bloody diarrhea. Heart, Liver, Spleen, and Kidney all govern Yin divisions; whether injured by cold-damp or heat, bleeding from large intestine is called Changpi. "Pi" is pronounced pi.) Liver pulse small and slow indicates Changpi, easy to treat. (Liver pulse rapid/large indicates excess pathogen, difficult to cure. Small/slow indicates mild pathogen, easy to treat.) Kidney pulse small, pounding, and deep indicates Changpi with bloody stool. If blood is warm and body feverish, it is a death sign. (Kidney is lower body, pulse naturally deep. Small and pounding indicates Yin deficiency allowing Yang pathogen to attack, causing Yang-related bloody stool. Warm blood and fever indicate excess evil fire and loss of True Yin, leading to death.) Heart and Liver pulses also show bloody stool; simultaneous disease of these two Zang is treatable. (Heart generates blood, Liver stores blood; thus, bloody stool occurs in Heart/Liver, not just Kidney. Heart and Liver share Wood/Fire qi; simultaneous disease is favorable and treatable. If Liver and Spleen are simultaneously diseased, it is Earth failure and Wood encroachment, clearly difficult to treat.) Pulse small, deep, and choppy indicates Changpi; if body is feverish, it is a death sign, dying when fever persists for seven days. (Heart/Liver pulse small/deep/choppy indicates Yin deficiency and blood injury, causing Changpi. Deep/thin pulse should not have fever; now small pulse with fever is adverse, leading to death. Death after seven days of fever indicates exhaustion of Six Yin.) Stomach pulse deep, beating, and choppy; Stomach pulse externally beating and large; Heart pulse small, firm, and rapid: all indicate Ge (Diaphragmatic Obstruction) and Pianku (Hemiplegia). (Deep/beating/choppy indicates Yang deficiency. Externally beating/large indicates Yin injury. Small/firm/rapid indicates Yin pathogen excess. Stomach is Sea of Grain and Water; Heart is Master of Blood Vessels. Stomach Qi injured and Blood Vessels diseased lead to upper/lower obstruction and hemiplegia.) In men, onset on the left; in women, onset on the right. If voice is not lost and tongue moves, it is treatable, recovering in thirty days. (Left is adverse for men, right is favorable; Right is adverse for women, left is favorable. Hemiplegia starting on left in men/right in women is adverse. If voice is clear and tongue mobile, though meridian-adverse, organ damage is not severe, so treatable, recovery in one month. If hemiplegic and aphasic, Kidney Qi is internally exhausted, condition is severe. *Maijie Pian* says: Internal depletion and syncope cause aphasia/paralysis, indicating Kidney deficiency. This is because Kidney meridian passes through throat and ties to tongue base. See *Lunzhi Lei* 14 for Left/Right Adverse/Favorable principles.) If favorable onset but aphasic, recovery takes three years. (If man starts on right/not left, woman on left/not right, it is "Cong" [Favorable]. Cong means smooth. But if syndrome is smooth yet voice is lost, exterior is light, interior is heavy, so recovery takes three years.) Those under twenty years old die within three years. (At prime age of vigorous Qi and Blood, hemiplegia/disability indicates insufficient constitution and premature decline, dying within three years.) Pulse striking forcefully, with nasal hemorrhage and fever, is a death sign. Pulse hanging hook and floating is normal. (Striking pulse is wiry/strong, taboo for Yin deficiency. In hemorrhage/nasal bleed, striking pulse with fever indicates True Yin collapse, leading to death. Hemorrhage often involves Yin deficiency; Yin deficiency pulse is often floating/large. Thus, hanging-hook floating is normal for this context, not worrying. "Xuan" means neither high nor low, neither floating nor sunken, like object suspended. It means although floating/hooked, neutral Qi is preserved.) Pulse like panting is named Baojue (Sudden Syncope); Baojue patients cannot speak or interact. ("Chuan" means like gasping, indicating urgency. Baojue is sudden syncope with unconsciousness.) Pulse like rapid number makes person suddenly frightened, resolving in three to four days. (Rapid pulse governs heat; "like rapid" is not true rapid pulse. Sudden stirring of Liver/Heart fire causes sudden fright. Since pulse is not truly rapid, Qi subsides and self-heals in 3-4 days.)
Pulse like Fuhe (Floating Convergence), resembling rapid pulse, exceeding ten beats per breath, indicates Jing Qi insufficiency; slight appearance predicts death in ninety days. (Below discusses death periods. "Fuhe" is like converging waves, endless and irregular. >10 beats/breath resembles rapid pulse but is not heat-rapid; it indicates extreme Jing Qi decline. "Wei jian" means first appearance. Seeing this pulse initially predicts death in 90 days; if seen long, death comes sooner. 90 days corresponds to seasonal change, Heavenly Dao variation, and human Qi adaptation. "Yu" is same as "Yu" [alliance/support], same below.) Pulse like burning firewood indicates Heart Essence deprivation; death occurs when grass dries. (Like burning firewood: sharp arrival, quick disappearance. Rootless pulse of Fire Organ, Heart Essence deprived. Summer Fire prosperity supports it; death when grass dries is when Yang exhausts.) Pulse like scattered leaves indicates Liver Qi deficiency; death occurs when tree leaves fall. (Scattered leaves: floating, rootless. Severe Liver Qi deficiency, no convergence. Leaf fall: Metal dominates Wood failure, Liver death time.) Pulse like Xingke (Visiting Guest), Xingke pulse is blocked yet beating, indicates Kidney Qi insufficiency; death occurs when jujube flowers bloom and fall. (Xingke: guest visiting, coming and going. Blocked: stops intermittently. Beating: appears intermittently. Kidney origin unstable, no governance. Jujube flower time: early summer. Xuan: bloom. Qu: fall. At bloom/fall, Fire prosperous, Water fails; Kidney deficiency dies.) Pulse like pill mud indicates Stomach Essence insufficiency; death occurs when elm pods fall. (Pill mud: shape of mud pellet, firm, short, choppy. Insufficiency of Stomach Essence/Middle Qi. Elm pods fall in late spring. Wood prosperity, Earth failure, death.) Pulse like Hengge (Horizontal Grid) indicates Gallbladder Qi insufficiency; death occurs when grain ripens. (Hengge: horizontal wood across fingers, long and firm. True Zang pulse of Wood, Gallbladder Qi insufficiency. Grain ripens in Autumn, Metal command prosperous, Wood fails, death.) Pulse like Xianlv (String and Thread) indicates Bao (Uterus) Essence insufficiency. Patient speaks excessively, dies at frost; if silent, treatable. (Xianlv: urgent like string, thin like thread. True Yuan depletion pulse. Bao is uterus, gathering point of Mingmen Original Yang. Bao meridian ties to Kidney; Kidney meridian ties to tongue base. Bao Qi deficiency should be silent/still; excessive speech indicates Yin not storing, Deficient Yang revealing. At frost, Deficient Yang collapses, death. Better to be silent than speak, as silence shows Kidney Qi still quiet, treatable.) Pulse like Jiaoqi (Intersecting Lacquer), Jiaoqi is lateral intersection, slight appearance predicts death in thirty days. (Jiaoqi: like pouring lacquer intersecting, lateral, tangled. Wei jian: first appearance. 30 days is lunar cycle change; Yin/Yang partial failure does not exceed one month.) Pulse like Yongquan (Surging Spring), floating and beating in muscle, indicates Taiyang Qi insufficiency, shortness of breath; death occurs when eating leek flowers. (Yongquan: surging spring, ascending only, descending never, floating/beating in muscle. Foot Taiyang Bladder Qi insufficiency. Bladder is San Yang, governing exterior. Now exterior excess, interior deficiency, Yin essence insufficient, hence shortness of breath. Death at leek flower time: end of winter/start of spring, Water Qi declining.) Pulse like Tui Tu (Collapsed Earth), unpressable, indicates Ji Qi (Muscle Qi) insufficiency. Black color appears first in Five Colors; death when Baifei (White Paralysis) erupts. (Collapsed earth: hollow, large, weak, unpressable. Ji Qi is Spleen Qi, Spleen governs muscle. Black is Water color; Earth failure extreme, Water counter-attacks, death. "Lei" same as "Lei", type of pustule/mass. Five types exist; White type erupts in Spring, Wood prosperous, Earth should fail.) Pulse like Xuanyong (Tonsil), Xuanyong feels larger when floated, pressed, cut, indicates Twelve Shu points insufficiency; death occurs when water freezes. (Xuanyong: fleshy protuberance in throat. Floating/pressing/cutting makes it larger: floating, short, isolated, upper without lower. Shu points on back, connected to Twelve Meridian/Zang Qi. Water freeze death: Yin excess, isolated Yang severed. "Chuai" pronunciation chu shui qie. "Yu" same as "Shu".) Pulse like Yandao (Reclining Knife), Yandao is small/rapid on float, firm/large/rapid on press. Five Zang郁热 (Stagnant Heat) with alternating cold/heat, concentrating solely in Kidney. Such patient cannot sit; dies at Start of Spring. (Yandao: reclining knife. Float small/rapid like blade edge. Press firm/large/rapid like blade back. Five Zang stagnant heat causing cold/heat. Yang prosperity consumes Yin, concentrating in Kidney. Waist is Kidney mansion; Kidney Yin亏, cannot rise/sit. Start of Spring Yang prosperous, Yin declines daily, death. "Yun" same as "Yu".) Pulse like Wan (Pill), slippery, not straight to hand (unpressable), indicates Large Intestine Qi insufficiency; death occurs when jujube leaves grow. (Like pill: short/small. "Zhi" means appropriate/direct. Slippery/small/rootless, cannot bear pressure. Large Intestine corresponds to Geng Metal. Jujube leaves grow early summer, Fire prosperous, Metal declines, death.) Pulse like Hua (Flower) causes fear, unwillingness to sit/lie, listening while walking/standing, indicates Small Intestine Qi insufficiency; death occurs in Late Autumn. (Like flower: light, floating, soft like plant flower. Small Intestine is Bing Fire, paired with Heart. SI deficiency connects Qi to Heart. Fear/unwillingness to sit: Heart Qi timid/restless. Listening while moving: fear breeds suspicion. Bing Fire tomb in Xu, death in Late Autumn.)