（素问玉机真藏论）
黄帝问曰∶春脉如弦，何如而弦？岐伯曰∶春脉者肝也，东方木也，万物之所以始生也，故其气来 弱轻虚而滑，
端直以长，故曰弦，反此者病。（弦者，端直以长，状如弓弦有力也。然 弱轻虚而滑，则弦中自有和意，肝脏主之。扁
鹊曰∶春脉弦者，肝东方木也，万物始生，未有枝叶，故其脉之来，濡弱而长，故曰弦。 ，软同。）帝曰∶何如而反？
岐伯曰∶其气来实而强，此谓太过，病在外；其气来不实而微，此谓不及，病在中。（其气来实而强，弦之过也。其气来
不实而微，弦之不及也。皆为弦脉之反。太过者病在外，不及者病在中，盖外病多有余，内病多不足，此其常也。下准
此。）帝曰∶春脉太过与不及，其病皆何如？岐伯曰∶太过则令人善忘，忽忽眩冒而巅疾；其不及则令人胸痛引背，下则
两胁 满。（忘，当作怒。本神篇曰∶肝气虚则恐，实则怒。气交变大论曰∶岁木太过，甚则忽忽善怒，眩冒巅疾。皆同
此义。忽忽，恍忽不爽也。冒，闷昧也。巅疾，疾在顶巅也。足厥阴之脉会于巅上，贯膈布胁肋，故其为病如此。 音
区，腋下胁也。）
帝曰∶善。夏脉如钩，何如而钩？岐伯曰∶夏脉者心也，南方火也，万物之有以盛长也，故其气来盛去衰，故曰钩，
反此者病。（钩者，举指来盛，去势似衰。盖脉盛于外而去则无力，阳之盛也，心脏主之。扁鹊曰∶夏脉钩者，心南方火
也，万物之所茂，垂枝布叶，皆下曲如钩，故其脉之来疾去迟，故曰钩。长，上声。）帝曰∶何如而反？岐伯曰∶其气来
盛去亦盛，此谓太过，病在外；其气来不盛去反盛，此谓不及，病在中。（其气来盛去亦盛，钩之过也。其来不盛去反盛，
钩之不及也。皆为钩脉之反。去反盛者，非强盛之谓。凡脉自骨肉之分，出于皮肤之际，谓之来；自皮肤之际，还于骨
肉之分，谓之去。来不盛、去反盛者，言来则不足，去则有余，即消多长少之意。故扁鹊于春肝夏心秋肺冬肾，皆以实
强为太过，病在外；虚微为不及，病在内。辞虽异而意则同也。）帝曰∶夏脉太过与不及，其病皆何如？岐伯曰∶太过则
令人身热而肤痛，为浸淫；其不及则令人烦心，上见咳唾，下为气泄。（夏脉太过，则阳有余而病在外，故令人身热肤痛，
而浸淫流布于形体。不及则君火衰而病在内，故上为心气不足而烦心，虚阳侵肺而咳唾，下为不固而气泄。以本经脉起
心中，出属心系，下膈络小肠，又从心系却上肺故也。）
帝曰∶善。秋脉如浮，何如而浮？歧伯曰∶秋脉者肺也，西方金也，万物之所以收成也，故其气来轻虚以浮，来急
去散故曰浮，反此者病。（浮者，轻虚之谓。来急去散者，以秋时阳气尚在皮毛也，肺脏主之。扁鹊曰∶秋脉毛者，肺西
方金也，万物之所终，草木华叶，皆秋而落，其枝独在，若毫毛也，故其脉之来，轻虚以浮，故曰毛。）帝曰∶何如而反？
岐伯曰∶其气来毛而中央坚、两旁虚，此谓太过，病在外；其气来毛而微，此谓不及，病在中。（中央坚，浮而中坚也。
凡浮而太过，浮而不及，皆浮之反，而病之在内在外，义与前同。）帝曰∶秋脉太过与不及，其病皆何如？岐伯曰∶太过
则令人逆而背痛，愠愠然；其不及则令人喘，呼吸少气而咳，上气见血，下闻病音。（肺脉起中焦，下络大肠，还循胃口，
上膈属肺，其脏附背，故太过则逆气为壅而背痛见于外。愠愠，悲郁貌。其不及则喘咳短气，气不归原，所以上气。阴
虚内损，所以见血。下闻病音，谓喘息则喉下有声也。）
帝曰∶善。冬脉如营，何如而营？岐伯曰∶冬脉者肾也，北方水也，万物之所以合藏也，故其气来沉以搏，故曰营，
反此者病。（营者，营叠之谓，如士卒之团聚不散，亦沉石之义也，肾脏主之。扁鹊曰∶冬脉石者，肾北方水也，万物之
所藏也，盛冬之时，水凝如石，故其脉之来，沉濡而滑，故曰石。甲乙经亦作沉以濡。）帝曰∶何如而反？岐伯曰∶其气
来如弹石者，此谓太过病在外；其去如数者，此谓不及，病在中。（来如弹石者，其至坚强，营之太过也。其去如数者，
动止疾促，营之不及也。盖数本属热，而此真阴亏损之脉，亦必紧数。然愈虚则愈数，原非阳强实热之数，故云如数，
则辨析之意深矣。此而一差，祸如反掌也。太过病在外，不及病在中，义俱同前。数音朔。）帝曰∶冬脉太过与不及，其
病皆何如？岐伯曰∶太过则令人解 ，脊脉痛而少气不欲言；其不及则令人心悬如病饥，眇中清，脊中痛，少腹满，小
便变。帝曰∶善。（冬脉太过，阴邪胜也。阴邪胜，则肾气伤，真阳虚，故令人四体懈怠，举动不精，是谓解 。脊痛者，
肾脉之所至也。肾藏精，精伤则无气，故少气不欲言。皆病之在外也。其不及则真阴虚，虚则心肾不交，故令人心悬而
怯如病饥也。季胁下空软之处曰眇中，肾之旁也。肾脉贯脊属肾络膀胱，故为脊痛腹满小便变等证。变者，谓或黄或赤、
或为遗淋、或为癃闭之类，由肾水不足而然。是皆病之在中也。解 义详疾病类五十。 音迹。眇音秒。）
帝曰∶四时之序，逆从之变异也，然脾脉独何主？（上文言肝心肺肾之脉，既分四时，而逆从之变，自皆有异，然
脾亦一脏，当有所主也。）歧伯曰∶脾脉者土也，孤脏以灌四旁者也。（脾属土，土为万物之本，故营运水谷，化津液以
灌溉于肝心肺肾之四脏者也。土无定位，分王四季，故称为孤脏。详见藏象类七。）帝曰∶然则脾善恶可得见之乎？岐伯
曰∶善者不可得见，恶者可见。（脾无病则灌溉周而四脏安，不知脾力之何有，故善者不可得见。脾病则四脏亦随而病，
故恶候见矣。）帝曰∶恶者何如可见？歧伯曰∶其来如水之流者，此谓太过，病在外；如鸟之喙者，此谓不及，病在中。
（如水之流者，滑而动也。如鸟之喙者，锐而短也。太过病在外，不及病在中，义俱同前。喙，一本作啄。喙音诲，
也。）帝曰∶夫子言脾为孤脏，中央土以灌四旁，其太过与不及，其病皆何如？岐伯曰∶太过则令人四肢不举；其不及则
令人九窍不通，名曰重强。（脾土太过病在外，故令人四肢不举，以脾主四肢而湿胜之也。不及病在中，故令人九窍不通，
以脾气弱则四脏皆弱而气不行也。重强，不柔和貌，沉重拘强也。愚按∶本篇脾脉一条云∶其来如水之流者，此为太过。
平人气象论曰∶如水之流曰脾死。此其一言太过，一言危亡，词同意异，岂无所辨？盖水流之状，滔滔洪盛者，其太过
也。溅溅不返者，其将竭也。凡此均谓之流，而一盛一危，迥然有异，故当详别其状，而勿因词害意也。又如太过则令
人四肢不举，此以在外之标而概言之，故曰太过。若脾虚不能胜湿者，岂亦同太过之谓耶？溅音笺，浅而疾也。）帝瞿然
而起，再拜而稽首曰∶善。吾得脉之大要，天下至数，五色脉变，揆度奇恒，道在于一。（瞿然，敬肃貌。道在于一，言
至数脉变虽多，而理则一而已矣。）神转不回，回则不转，乃失其机。（神即生化之理，不息之机也。五气循环，不愆其
序，是为神转不回。若却而回返，则逆其常候而不能运转，乃失生气之机矣。）至数之要，迫近以微。（至数之要，即道
在于一，是诚切近人身而最称精微者也。）着之玉版，藏之脏腑，每旦读之，名曰玉机。（着之玉版以传不朽。藏之脏腑
以志不忘。名曰玉机，以璇玑玉衡可窥天道，而此篇神理可窥人道，故以并言，而实则珍重之辞也。上文自至数以至玉
机，又见玉版论要篇，详论治类十四。）
【《素问·玉机真藏论》】
黄帝问道：春季的脉象像弓弦一样，什么样的脉象才称为弦脉？岐伯回答说：春季的脉象对应肝脏，位于东方，五行属木，是万物开始生长的季节，所以它的脉气来时柔弱、轻虚而滑利，形态端正且长，所以称为弦脉；如果与此相反，就是病脉。（弦脉的特征是形态端正且长，形状像弓弦一样有力。但是脉来柔弱轻虚而滑利，说明弦脉中自带有柔和之意，这是肝脏所主。扁鹊说：春季脉象呈弦状，是因为肝属东方木，万物刚开始生长，还没有枝叶，所以脉气来时濡弱而长，因此称为弦。濡，同软。）黄帝问：什么样的脉象算是相反（异常）呢？
岐伯回答说：如果脉气来时充实而强劲，这叫做“太过”，病在体表；如果脉气来时不充实而微弱，这叫做“不及”，病在体内。（脉气来时充实而强劲，是弦脉的过度表现。脉气来时不充实而微弱，是弦脉的不足表现。这都是弦脉的反常现象。太过则病在体表，不及则病在体内，大概体表的病多属于有余，体内的病多属于不足，这是一般的规律。下面的章节都依此类推。）黄帝问：春季脉象的太过和不及，它们引起的病症分别是什么样的？岐伯回答说：太过就会使人容易发怒，恍惚眩晕甚至头顶发病；不及就会使人胸痛牵引背部，向下则两胁胀满。（“忘”字，应当作“怒”。《本神篇》说：肝气虚则恐惧，肝气实则易怒。《气交变大论》说：岁运木气太过，严重时就会使人恍惚易怒、眩晕、头顶发病。意思都与这里相同。“忽忽”，指恍惚不爽快。“冒”，指昏闷不明。“巅疾”，指发生在头顶的疾病。足厥阴肝经的脉气会合于头顶，贯穿膈肌，散布于胁肋，所以它的病变如此。“ 音区”，指腋下胁部。）
黄帝说：好。夏季的脉象像钩子一样，什么样的脉象才称为钩脉？岐伯回答说：夏季的脉象对应心脏，位于南方，五行属火，是万物茂盛生长的季节，所以它的脉气来时旺盛而去时衰弱，所以称为钩脉；如果与此相反，就是病脉。（钩脉的特征是指下感觉来时盛大，去势似乎衰弱。因为脉气盛于外，去时则无力，这是阳气旺盛的表现，由心脏所主。扁鹊说：夏季脉象呈钩状，是因为心属南方火，万物茂盛，垂下的枝条展开的叶子，都向下弯曲像钩子一样，所以脉气来时快而去时慢，因此称为钩。长，读上声。）黄帝问：什么样的脉象算是相反（异常）呢？
岐伯回答说：如果脉气来时旺盛，去时也旺盛，这叫做“太过”，病在体表；如果脉气来时不旺盛，去时反而旺盛，这叫做“不及”，病在体内。（脉气来时旺盛，去时也旺盛，是钩脉的过度表现。脉气来时不旺盛，去时反而旺盛，是钩脉的不足表现。这都是钩脉的反常现象。所谓“去反盛”，并不是指强劲旺盛的意思。凡是脉气从骨肉深处到达皮肤表面，叫做“来”；从皮肤表面回到骨肉深处，叫做“去”。来不盛、去反盛，意思是来时无力，去时有余，即消耗多而生长少的意思。所以扁鹊对于春之肝、夏之心、秋之肺、冬之肾，都以实强为太过，病在体表；以虚微为不及，病在体内。言辞虽然不同，但意义是一样的。）黄帝问：夏季脉象的太过和不及，它们引起的病症分别是什么样的？岐伯回答说：太过就会使人身体发热而且皮肤疼痛，形成浸淫疮；不及就会使人心中烦闷，向上表现为咳嗽吐痰，向下表现为气泄。（夏季脉象太过，则阳气有余而病在体表，所以使人身体发热皮肤疼痛，并且浸淫流布于形体。不及则君火衰微而病在体内，所以上面因心气不足而心烦，虚阳侵犯肺部而咳嗽吐痰，下面因固摄无力而气泄。因为手少阴心经起于心中，出来归属于心系，向下穿过膈肌联络小肠，又从心系返回上行至肺的缘故。）
黄帝说：好。秋季的脉象像浮毛一样，什么样的脉象才称为浮脉？岐伯回答说：秋季的脉象对应肺脏，位于西方，五行属金，是万物收获的季节，所以它的脉气来时轻虚而浮，来势急而去势散，所以称为浮脉；如果与此相反，就是病脉。（浮脉，就是轻虚的意思。来势急而去势散，是因为秋季阳气还在皮毛部位，由肺脏所主。扁鹊说：秋季脉象如毛，是因为肺属西方金，万物终结，草木的花叶，都在秋天落下，只剩下树枝，像毫毛一样，所以脉气来时轻虚而浮，因此称为毛。）黄帝问：什么样的脉象算是相反（异常）呢？
岐伯回答说：如果脉气来时有毛的感觉，中间坚实、两边虚弱，这叫做“太过”，病在体表；如果脉气来时有毛的感觉而且微弱，这叫做“不及”，病在体内。（中央坚实，是指浮取时中间感觉坚实。凡是浮脉太过或浮脉不及，都是浮脉的反常现象，至于病在体内还是体表，意义与前面相同。）黄帝问：秋季脉象的太过和不及，它们引起的病症分别是什么样的？岐伯回答说：太过就会使人气逆而且背痛，心情抑郁不快；不及就会使人气喘，呼吸短促而且咳嗽，气逆吐血，下部能听到病理性声音。（肺脉起于中焦，向下联络大肠，回转沿着胃的上口，向上穿过膈肌属于肺脏，其脏器附于背部，所以太过则逆气壅滞而背痛表现在外。“愠愠”，是悲郁的样子。不及则气喘咳嗽、短气，气不能归根，所以上逆。阴虚内损，所以出现吐血。下部听到病理性声音，是指喘息时喉下有声音。）
黄帝说：好。冬季的脉象像营垒（沉石）一样，什么样的脉象才称为营脉？岐伯回答说：冬季的脉象对应肾脏，位于北方，五行属水，是万物闭藏的季节，所以它的脉气来时沉而搏指，所以称为营脉；如果与此相反，就是病脉。（营脉，是指聚集重叠的意思，像士卒团聚不散，也有沉石的含义，由肾脏所主。扁鹊说：冬季脉象如石，是因为肾属北方水，万物闭藏，严冬时节，水凝结像石头一样，所以脉气来时沉濡而滑，因此称为石。《甲乙经》也写作沉而濡。）黄帝问：什么样的脉象算是相反（异常）呢？
岐伯回答说：如果脉气来时像弹石一样坚硬，这叫做“太过”，病在体表；如果脉气去时像数脉（快速）一样，这叫做“不及”，病在体内。（脉气来时像弹石一样，是脉气到达时非常坚强，是营脉的太过表现。脉气去时像数脉，是脉搏跳动停止急促，是营脉的不及表现。一般来说，“数”脉本属热证，但这里是真阴亏损的脉象，也必然紧数。然而越是虚损则脉越数，原本不是阳气强盛的实热之数，所以说“像数”，其中的辨析意味很深。这一旦出错，灾祸就在顷刻之间。太过则病在体表，不及则病在体内，意义都同前文。数，读朔音。）黄帝问：冬季脉象的太过和不及，它们引起的病症分别是什么样的？岐伯回答说：太过就会使人肢体懈怠松弛，脊背经脉疼痛而且少气不想说话；不及就会使人心里空虚像得了饥病一样，季胁下空软处清冷，脊中疼痛，小腹胀满，小便异常。黄帝说：好。（冬季脉象太过，是阴邪胜盛。阴邪胜盛，则肾气受伤，真阳虚衰，所以使人四肢懈怠，动作不精明，这叫做解 。脊痛，是因为肾脉经过的地方。肾藏精，精伤则无气，所以少气不想说话。这些都是病在体表的证候。不及则是真阴虚损，虚则心肾不交，所以使人心里空虚怯懦像得了饥病一样。季胁下空软之处叫做眇中，是肾脏旁边。肾脉贯穿脊柱，属于肾脏，联络膀胱，所以出现脊痛、腹满、小便异常等证候。变，是指小便颜色或黄或赤，或者是遗尿淋沥，或者是癃闭之类，这是由于肾水不足造成的。这些都是病在体内的证候。解 的意义详见疾病类第五十节。 音迹。眇，读秒音。）
黄帝问：四季的顺序，有顺逆变化的差异，然而脾脉单独由什么主导？（上文讲了肝、心、肺、肾的脉象，既然分属四季，那么顺逆的变化自然各有不同，然而脾也是一脏，应当有所主事吧。）岐伯回答说：脾脉对应土，是孤独的脏腑，用来灌溉其他四脏。（脾属土，土是万物的根本，所以运化水谷，化生津液以灌溉肝、心、肺、肾这四脏。土没有固定的位置，分旺于四季，所以称为孤脏。详见藏象类第七节。）黄帝问：那么脾脉的好坏可以看出来吗？岐伯回答说：好的脾脉看不出来，坏的脾脉可以看出来。（脾没有病时，灌溉周全，四脏安宁，人们不知道脾的力量有多大，所以好的脾脉看不出来。脾有病时，四脏也随之生病，所以坏的症状就显现出来了。）黄帝问：坏的脾脉什么样可以看出来？岐伯回答说：脉气来时像水流一样滑利而动荡，这叫做“太过”，病在体表；像鸟嘴一样锐而短促，这叫做“不及”，病在体内。（像水流一样，是滑利而动的样子。像鸟嘴一样，是尖锐而短促的样子。太过则病在体表，不及则病在体内，意义都同前文。喙，另一版本作啄。喙，读诲音，解释见前。）黄帝问：先生您说脾是孤脏，居中央属土以灌溉四旁，它的太过和不及，引起的病症分别是什么样的？岐伯回答说：太过就会使人四肢不能抬举；不及就会使人九窍不通，名叫重强。（脾土太过病在体表，所以使人四肢不能抬举，因为脾主四肢而湿气胜的缘故。不及病在体内，所以使人九窍不通，因为脾气弱则四脏皆弱而气机不行。重强，是不柔和的样子，沉重拘谨僵硬。我按语：本篇关于脾脉的一条说：脉气来时像水流一样，这叫太过。《平人气象论》说：像水流一样叫脾死。这里一个说过太，一个说危亡，词意相同但含义不同，难道没有区别吗？大概水流的状态，滔滔洪盛的是太过；溅溅不停即将枯竭的是将死。凡此都称为流，但一盛一危，截然不同，所以应当详细辨别其形态，不要因为文字而误解了意思。又如太过使人四肢不能抬举，这是从体表的标症概括来说的，所以说过太。如果是脾虚不能胜湿的情况，难道也是过太的意思吗？溅，读笺音，浅而疾速的意思。）黄帝惊讶地站起来，拜了两拜并叩头说：好。我得到了诊脉的大要，天下最精妙的道理，观察五色脉象的变化，衡量正常与异常，道理在于统一。（瞿然，是恭敬严肃的样子。道在于一，是说虽然脉象变化繁多，但原理只有一个而已。）神机运转不息，如果回转就不运转，那就失去了生机。（神就是生化的道理，不息的机制。五气循环，不差次序，这叫神转不回。如果却而回返，就违背了常态而不能运转，就失去了生气的机制。）最精妙的道理，切近人身而且极其精微。（最精妙的道理，就是道在于一，确实贴近人身而且最为精微。）把它写在玉版上，藏在脏腑之中，每天早晨诵读，名叫《玉机》。（写在玉版上传播不朽。藏在脏腑中以志不忘。名叫《玉机》，因为璇玑玉衡可以窥探天道，而本篇的神理可以窥探人道，所以并提，实际上是珍重的言辞。上文从“至数”到“玉机”，又见于《玉版论要》篇，详见治类第十四节。）
[Su Wen: Yu Ji Zhen Zang Lun]
The Yellow Emperor asked, "The spring pulse is like a bowstring. What kind of pulse is called 'Xian' (String-like)?" Qi Bo replied, "The spring pulse corresponds to the Liver (Gan), which is in the East and belongs to Wood (Mu). It is the season when all things begin to grow. Therefore, its Qi comes weak, light, void, and slippery; it is straight and long. Hence it is called 'Xian'. If it is contrary to this, it indicates disease." (The characteristic of Xian is being straight and long, resembling the strong tension of a bowstring. However, if it is weak, light, void, and slippery, it contains an element of harmony within the string-like quality, governed by the Liver. Bian Que said: The spring pulse is Xian because the Liver belongs to Eastern Wood, and all things are just beginning to grow without branches or leaves. Thus, the pulse comes soft, weak, and long, hence called Xian. 'Ru' is synonymous with 'Ruan' [soft].) The Yellow Emperor asked, "What constitutes the contrary state?"
Qi Bo replied, "If the Qi comes solid and strong, this is called 'Tai Guo' (Excess), and the disease is external; if the Qi comes insubstantial and faint, this is called 'Bu Ji' (Deficiency), and the disease is internal." (Solid and strong coming Qi is an excess of Xian. Insufficient and faint coming Qi is a deficiency of Xian. Both are contraries of the Xian pulse. Excess leads to external disease, deficiency to internal disease; generally, external diseases are often due to excess, while internal diseases are often due to deficiency. This is the general rule, applied similarly below.) The Yellow Emperor asked, "Regarding the excess and deficiency of the spring pulse, what are their respective symptoms?" Qi Bo replied, "Excess causes one to be prone to anger, sudden dizziness, and vertigo, leading to disorders of the vertex; deficiency causes chest pain radiating to the back, and downward distension in both hypochondriac regions." ('Wang' should be read as 'Nu' [anger]. The Ben Shen Pian states: When Liver Qi is deficient, there is fear; when excessive, there is anger. The Qi Jiao Bian Da Lun states: When the annual Wood Qi is excessive, severe cases involve sudden anger, dizziness, and vertex disorders. The meaning is identical here. 'Hu Hu' refers to a state of confusion or lack of clarity. 'Mao' refers to mental cloudiness. 'Dian Ji' refers to disease located at the vertex. The Foot Jueyin Liver Meridian converges at the vertex, passes through the diaphragm, and spreads over the hypochondrium, thus causing these symptoms. 'Qu' sounds like 'Qu', referring to the axillary hypochondrium.)
The Yellow Emperor said, "Good. The summer pulse is like a hook. What kind of pulse is called 'Gou' (Hook-like)?" Qi Bo replied, "The summer pulse corresponds to the Heart (Xin), which is in the South and belongs to Fire. It is the season when all things flourish and grow abundantly. Therefore, its Qi comes vigorous and goes declining. Hence it is called 'Gou'. If it is contrary to this, it indicates disease." (The Gou pulse feels vigorous upon pressing and seems weaker upon release. The pulse is strong externally but weak upon return, indicating abundant Yang, governed by the Heart. Bian Que said: The summer pulse is Gou because the Heart belongs to Southern Fire, and all things are lush. Hanging branches and spreading leaves curve downwards like hooks. Thus, the pulse comes fast and goes slow, hence called Gou. 'Chang' is pronounced with the rising tone.) The Yellow Emperor asked, "What constitutes the contrary state?"
Qi Bo replied, "If the Qi comes vigorous and also goes vigorous, this is called 'Tai Guo' (Excess), and the disease is external; if the Qi comes not vigorous but goes vigorous, this is called 'Bu Ji' (Deficiency), and the disease is internal." (Vigorous coming and going is an excess of Gou. Not vigorous coming but vigorous going is a deficiency of Gou. Both are contraries of the Gou pulse. 'Going vigorous' does not mean strong and robust. Generally, pulse moving from deep muscle/bone to the skin surface is called 'Coming'; returning from the skin surface to deep muscle/bone is called 'Going'. 'Not vigorous coming, vigorous going' means the arrival is insufficient and the departure is excessive, implying consumption exceeds growth. Thus, Bian Que stated for Spring/Liver, Summer/Heart, Autumn/Lung, and Winter/Kidney that solid/strong is Excess (external disease), and void/faint is Deficiency (internal disease). Although the wording differs, the meaning is the same.) The Yellow Emperor asked, "Regarding the excess and deficiency of the summer pulse, what are their respective symptoms?" Qi Bo replied, "Excess causes body heat and skin pain, manifesting as impetigo; deficiency causes vexation in the heart, upward coughing and expectoration, and downward leakage of Qi." (Summer pulse excess implies Yang surplus and external disease, causing body heat, skin pain, and spreading impetigo. Deficiency implies decline of Ministerial Fire and internal disease, causing upper Heart Qi deficiency with vexation, deficiency-Yang invading the Lung with cough/expectoration, and lower failure of consolidation with Qi leakage. This is because the Heart Meridian originates in the heart, connects to the heart system, descends through the diaphragm to connect with the Small Intestine, and returns from the heart system to ascend to the Lung.)
The Yellow Emperor said, "Good. The autumn pulse is like floating hair. What kind of pulse is called 'Fu' (Floating)?" Qi Bo replied, "The autumn pulse corresponds to the Lung (Fei), which is in the West and belongs to Metal. It is the season when all things are harvested. Therefore, its Qi comes light, void, and floating; it arrives urgently and scatters upon departure. Hence it is called 'Fu'. If it is contrary to this, it indicates disease." (Fu means light and void. Urgent arrival and scattered departure occur because Yang Qi remains in the skin/hair during autumn, governed by the Lung. Bian Que said: The autumn pulse is Mao [Hair] because the Lung belongs to Western Metal, and all things conclude. Grass and tree flowers/leaves fall in autumn, leaving only branches like hairs. Thus, the pulse comes light, void, and floating, hence called Mao.) The Yellow Emperor asked, "What constitutes the contrary state?"
Qi Bo replied, "If the Qi comes like hair but is firm in the center and empty on the sides, this is called 'Tai Guo' (Excess), and the disease is external; if the Qi comes like hair but is faint, this is called 'Bu Ji' (Deficiency), and the disease is internal." (Firm in the center means firm upon superficial palpation. Any Fu pulse that is excessive or deficient is a contrary Fu pulse; the implications for internal/external disease are the same as before.) The Yellow Emperor asked, "Regarding the excess and deficiency of the autumn pulse, what are their respective symptoms?" Qi Bo replied, "Excess causes reverse flow of Qi and back pain, accompanied by a feeling of depression; deficiency causes asthma, shortness of breath, cough, upward reversal of Qi with blood, and pathological sounds heard below." (The Lung Meridian originates in the middle Jiao, descends to connect with the Large Intestine, returns along the stomach opening, ascends through the diaphragm to belong to the Lung. The organ attaches to the back. Thus, excess causes Qi stagnation and external back pain. 'Yun Yun' describes a sorrowful/depressed appearance. Deficiency causes asthma, cough, shortness of breath, and Qi failing to root, leading to upward reversal. Yin deficiency and internal damage lead to blood manifestation. Pathological sounds below refer to wheezing sounds in the throat during respiration.)
The Yellow Emperor said, "Good. The winter pulse is like Ying (Camp/Sunken Stone). What kind of pulse is called 'Ying'?" Qi Bo replied, "The winter pulse corresponds to the Kidney (Shen), which is in the North and belongs to Water. It is the season when all things hide and store. Therefore, its Qi comes sunken and beating. Hence it is called 'Ying'. If it is contrary to this, it indicates disease." (Ying means gathering and overlapping, like soldiers assembled tightly, also implying the meaning of sunken stone, governed by the Kidney. Bian Que said: The winter pulse is Shi [Stone] because the Kidney belongs to Northern Water, and all things are stored. In mid-winter, water freezes like stone. Thus, the pulse comes sunken, soft, and slippery, hence called Shi. The Jia Yi Jing also writes it as sunken and soft.) The Yellow Emperor asked, "What constitutes the contrary state?"
Qi Bo replied, "If the Qi comes like bouncing stones, this is called 'Tai Guo' (Excess), and the disease is external; if it goes like Shu (Rapid) pulse, this is called 'Bu Ji' (Deficiency), and the disease is internal." (Coming like bouncing stones indicates extreme hardness upon arrival, an excess of Ying. Going like Shu indicates rapid cessation, a deficiency of Ying. Generally, Shu belongs to Heat, but here it reflects True Yin deficiency, necessarily tight and rapid. The more deficient, the more rapid; originally, this is not the rapidity of Yang excess/heat, hence 'like Shu', showing deep analytical distinction. A mistake here brings disaster instantly. Excess is external, deficiency is internal, meanings consistent with before. 'Shu' is pronounced 'Shuo'.) The Yellow Emperor asked, "Regarding the excess and deficiency of the winter pulse, what are their respective symptoms?" Qi Bo replied, "Excess causes flaccidity of the limbs, pain in the spinal meridians, shortness of breath, and reluctance to speak; deficiency causes a sensation of emptiness in the heart as if hungry, coldness in the Miao region, pain in the spine, fullness of the lower abdomen, and changes in urination." The Yellow Emperor said, "Good." (Winter pulse excess indicates Yin pathogen dominance. Yin dominance injures Kidney Qi and True Yang, causing limb flaccidity and lack of vigor, called 'Jie Dai'. Spinal pain occurs where the Kidney Meridian travels. Kidney stores Essence; Essence injury leads to Qi deficiency, causing shortness of breath and reluctance to speak. These are external diseases. Deficiency involves True Yin loss, leading to Heart-Kidney non-interaction, causing heart emptiness and fear akin to hunger. 'Miao Zhong' is the hollow area under the lateral costal margin, beside the Kidney. The Kidney Meridian penetrates the spine, belongs to the Kidney, and connects with the Bladder, causing spinal pain, abdominal fullness, and urinary changes. 'Bian' refers to yellow or red urine, enuresis/dysuria, or retention, caused by Kidney Water insufficiency. These are internal diseases. See Disease Category 50 for 'Jie Dai'. 'Ji' sounds like 'Ji'. 'Miao' sounds like 'Miao'.)
The Yellow Emperor asked, "The sequence of four seasons involves variations of compliance and deviation. However, what governs the Spleen pulse alone?" (The preceding text discussed Liver, Heart, Lung, and Kidney pulses divided by seasons, with distinct variations in compliance/deviation. Yet the Spleen is also a Zang organ and should have its own governance.) Qi Bo replied, "The Spleen pulse corresponds to Earth. It is the solitary Zang organ that irrigates the other four." (Spleen belongs to Earth, the root of all things. It transports food/grain and transforms fluids to irrigate the Liver, Heart, Lung, and Kidney. Earth has no fixed position but rules each of the four seasons, hence called the Solitary Zang. See Zang-Xiang Category 7.) The Yellow Emperor asked, "Can the good and bad states of the Spleen pulse be seen?" Qi Bo replied, "The good state cannot be seen; the bad state can be seen." (When the Spleen is healthy, irrigation is complete and the four Zang organs are peaceful; people do not perceive the Spleen's power, so the good state is unseen. When the Spleen is diseased, the four Zang organs follow suit into disease, so bad signs appear.) The Yellow Emperor asked, "How can the bad state be identified?" Qi Bo replied, "If it comes like flowing water, this is 'Tai Guo' (Excess), and the disease is external; if it comes like a bird's beak, this is 'Bu Ji' (Deficiency), and the disease is internal." (Like flowing water means slippery and moving. Like a bird's beak means sharp and short. Excess is external, deficiency is internal, meanings consistent with before. 'Hui' is written as 'Zhuo' in some texts. 'Hui' is pronounced 'Hui'.) The Yellow Emperor asked, "You stated the Spleen is the solitary Zang, Central Earth irrigating the four directions. Regarding its excess and deficiency, what are their respective symptoms?" Qi Bo replied, "Excess causes inability to lift the limbs; deficiency causes obstruction of the nine orifices, named 'Zhong Qiang'." (Spleen Earth excess is external, causing inability to lift limbs, as Spleen governs limbs and Dampness prevails. Deficiency is internal, causing obstruction of nine orifices, as weak Spleen Qi leads to weakness in all four Zang organs and stagnant Qi. 'Zhong Qiang' means lack of flexibility, heavy and stiff. Note: This chapter states 'coming like flowing water' is Excess. Ping Ren Qi Xiang Lun states 'like flowing water' is Spleen Death. One speaks of excess, the other of critical death; words similar, meanings different. Flowing water surging is excess; splashing without return is depletion. Both are called 'flow', but one is prosperity, the other peril. One must distinguish the form carefully. Also, 'excess causing inability to lift limbs' refers to external manifestations. If Spleen deficiency fails to overcome Dampness, is it also called excess? 'Jian' is pronounced 'Jian', meaning shallow and rapid.) The Yellow Emperor rose startled, bowed twice, and kowtowed, saying, "Excellent. I have grasped the essentials of pulse diagnosis, the supreme numbers of the world, the changes of five colors and pulses, measuring normal and abnormal. The Dao lies in One." (Ju Ran means respectful and solemn. 'Dao lies in One' means although pulse changes are many, the principle is one.) "Shen turns and does not return; if it returns, it does not turn, thus losing its opportunity." (Shen is the principle of bio-transformation, the mechanism of ceaseless activity. Five Qi circulate without order error, called Shen turning without return. If it reverses, it violates normalcy and cannot rotate, losing the mechanism of vital Qi.) "The essence of supreme numbers is close and subtle." (The essence of supreme numbers is 'Dao lies in One', truly close to the human body and most refined.) "Write it on jade tablets, store it in the Zang-Fu, read it every morning, named 'Yu Ji'." (Written on jade tablets to transmit immortality. Stored in Zang-Fu to remember. Named 'Yu Ji' because the Xuanji Yuheng reveals Heavenly Dao, while this chapter's spirit reveals Human Dao, spoken together as words of great value. The section from 'Zhi Shu' to 'Yu Ji' appears again in Yu Ban Lun Yao Pian; see Treatment Category 14 for details.)