（灵枢论疾诊尺篇）
黄帝问于岐伯曰∶余欲无视色持脉，独调其尺以言其病，从外知内，为之奈何？（欲诊尺以知脏腑，故曰从外知内。）
岐伯曰∶审其尺之缓急小大滑涩，肉之坚脆，而病形定矣。（寸口之脉，由尺达寸，故但诊尺部之脉，其内可知。通身形
体，难以尽见，然肉之盛衰，必形于腕后，故但察尺部之肉，其外可知。是以独调其尺而病形定矣。）视人之目窠上微痈，
如新卧起状，其颈脉动，时咳，按其手足上 而不起者，风水肤胀也。（目窠，目下卧蚕处也。痈，壅也，即新起微肿状。
颈脉，人迎脉也。 而不起，按之有窝也。是即风水肤胀之外候。风水义见疾病类三十一。肤胀义见疾病类五十七。窠
音科。痈，去声。 音夭。）尺肤滑，其淖泽者，风也。（阳受风气，故病风者，尺肤滑而淖泽也。尺肉弱者，解 安卧，
脱肉者寒热不治。（尺肉弱者，肌必消瘦，肉瘦阴虚，当为解 。解 者，身体困倦，故欲安卧。无邪而脱肉寒热者，真
阴败也，故不治。）尺肤滑而泽脂者，风也。（泽脂，即前淖泽之谓。风者阳气，阳在肌肤，故滑而泽脂。）尺肤涩者，风
痹也。（尺肤涩者血少，血不能营，故为风痹。）尺肤粗如枯鱼之鳞者，水 饮也。（如枯鱼之鳞，干涩甚也。以脾土衰而
肌肉消，水得乘之，是为 饮。又下编肝脉涩甚为溢饮。 ，溢同。）尺肤热甚，脉盛躁者，病温也；其脉盛而滑者，病
且出也。（尺肤热者其身必热，脉盛躁者阳邪有余，故当为温病。若脉虽盛而兼滑者，是脉已不躁而正气将复，故不久当
愈。出，渐愈之谓。）尺肤寒，其脉小者，泄、少气。（肤寒脉小，阳气衰也，故为泄为少气。）尺肤炬然先热后寒者，寒
热也；尺肤先寒，久大之而热者，亦寒热也。（炬然，火热貌。或先热而后寒，或先寒而后热，皆寒热往来之候。）肘所
独热者，腰以上热；手所独热者，腰以下热。（肘，臂 之节也。一曰曲池以上为肘。肘在上，手在下，故肘应腰上，手
应腰下也。）肘前独热者，膺前热；肘后独热者，肩背热。（肘前，内廉也，手三阴之所行，故应于膺前。肘后，外廉也，
手太阳之所行，故应于肩背。）臂中独热者，腰腹热。（肘下为臂，臂在下，故应腰腹。）肘后粗以下三四寸热者，肠中有
虫。（肘后粗以下三四寸，谓三里以下，内关以上之所，此阴分也。阴分有热，故应肠中有虫。）掌中热者，腹中热；掌
中寒者，腹中寒。（掌中者，三阴之所聚，故或热或寒，皆应于腹中。）鱼上白肉有青血脉者，胃中有寒。（鱼上脉青，胃
之寒也。经脉篇亦曰∶胃中寒，手鱼之脉多青矣。鱼义见经络类二。）尺炬然热，人迎大者，当夺血；尺坚大，脉小甚，
少气， 有加，立死。（尺炬然热，火在阴也。人迎大者，阳之胜也。故当失血。若尺肤坚大而脉则小甚，形有余而气衰
少也。阴虚既极，而烦 再加，故当立死。 ，美本切。）
《灵枢·论疾诊尺篇》
黄帝向岐伯问道：我想不通过观察面色和切按脉象，仅通过调察尺部（前臂内侧皮肤）来推断疾病，从外部表现了解内部脏腑状况，该怎么做呢？（想要通过诊察尺部来知晓脏腑情况，所以称为从外部了解内部。）
岐伯回答说：仔细审察尺部皮肤的缓急、大小、滑涩，以及肌肉的坚硬或脆弱，那么疾病的形态就可以确定了。（寸口脉由尺部延伸至寸部，所以只诊察尺部的脉象，内部的状况就可以知晓。全身形体难以完全见到，然而肌肉的盛衰必然表现在手腕后方，所以只观察尺部的肌肉，外部的状况就可以知晓。因此，仅通过调察尺部，疾病的形态就确定了。）
如果看到人的眼睑上方微微浮肿，像刚睡醒的样子，颈部动脉搏动明显，时常咳嗽，按压其手足背部凹陷不能立即恢复的，这是风水肤胀病。（目窠，指眼下卧蚕部位。痈，意为壅滞，即新起的轻微肿胀状。颈脉，即人迎脉。按之有窝且不起，指按压后出现凹陷。这就是风水肤胀的外部征候。风水的含义见疾病类第三十一篇。肤胀的含义见疾病类第五十七篇。窠音科。痈，去声。 音夭。）
尺部皮肤滑润，且湿润光泽的，是风病。（阳经受风气侵袭，所以患风病的人，尺部皮肤滑润且湿润光泽。）
尺部肌肉瘦弱的，表现为懈怠嗜卧；肌肉极度消瘦脱落的，伴有寒热症状，属于难治之症。（尺部肌肉瘦弱，肌肉必然消瘦，肉瘦则阴虚，应当出现懈怠。懈怠者，身体困倦，所以想安静躺卧。如果没有邪气却出现肌肉脱落和寒热症状，是真阴败坏的表现，所以难治。）
尺部皮肤滑润且有油脂光泽的，是风病。（泽脂，就是前面所说的淖泽。风属阳气，阳气在肌肤之间，所以皮肤滑润且有油脂光泽。）
尺部皮肤粗糙的，是风痹病。（尺部皮肤粗糙是因为血少，血液不能濡养肌肤，所以形成风痹。）
尺部皮肤粗糙得像枯鱼的鳞片一样的，是水饮病。（像枯鱼的鳞片，说明干燥涩滞非常严重。因为脾土衰弱而肌肉消减，水湿得以乘虚侵入，这就形成了水饮。另外在下编中提到肝脉涩甚也是溢饮。 ，与溢同义。）
尺部皮肤灼热，脉象盛大躁动的，是温病；如果脉象盛大而滑利的，病情即将好转。（尺部皮肤热，身体必然发热，脉象盛大躁动说明阳邪有余，所以应当是温病。如果脉象虽然盛大但兼有滑利，说明脉已不再躁动，正气将要恢复，所以不久就会痊愈。出，指逐渐痊愈的意思。）
尺部皮肤寒冷，脉象细小的，是泄泻、气短。（皮肤寒冷脉象细小，说明阳气衰微，所以出现泄泻和气短。）
尺部皮肤先灼热而后寒冷的，是寒热往来；尺部皮肤先寒冷，久按之后变热的，也是寒热往来。（炬然，形容火热貌。或者先热后寒，或者先寒后热，都是寒热往来的征候。）
肘部单独发热的，腰部以上发热；手部单独发热的，腰部以下发热。（肘，是手臂的关节处。另一种说法认为曲池穴以上为肘。肘在上，手在下，所以肘对应腰以上，手对应腰以下。）
肘前部单独发热的，胸膺前部发热；肘后部单独发热的，肩背部发热。（肘前，指内侧，是手三阴经所经过的地方，所以对应胸膺前部。肘后，指外侧，是手太阳经所经过的地方，所以对应肩背部。）
手臂中部单独发热的，腰腹部发热。（肘下为臂，臂在下，所以对应腰腹部。）
肘后粗隆处向下三四寸处发热的，肠中有虫。（肘后粗隆处向下三四寸，指足三里穴以下，内关穴以上的区域，这是阴分所在。阴分有热，所以对应肠中有虫。）
手掌中心发热的，腹中发热；手掌中心发冷的，腹中寒冷。（手掌中心是三阴经汇聚的地方，所以无论热还是冷，都对应腹中的状况。）
手掌大鱼际上方白肉处有青色血脉的，胃中有寒。（鱼际上脉络青紫，是胃寒的表现。经脉篇中也说：胃中寒，手鱼部的脉络多呈青色。鱼的含义见经络类第二篇。）
尺部皮肤灼热，人迎脉大的，应当发生失血；尺部皮肤坚硬大，脉象极细小，气短，如果出现烦闷，将会立即死亡。（尺部灼热，说明火在阴分。人迎脉大，说明阳胜。所以应当失血。如果尺部皮肤坚硬大而脉象极细小，是形有余而气衰少。阴虚已经极度严重，如果再出现烦闷，所以会立即死亡。 ，美本切。）
*Huangdi Neijing Lingshu: Chapter on Diagnosing Diseases by Observing the Cheek and Forearm Skin (Lingshu Lunji Zhichi Pian)*
The Yellow Emperor asked Qibo: I wish to diagnose without observing facial complexion or holding the pulse, but solely by examining the forearm skin (Chifu) to predict the disease, knowing the interior from the exterior. How should this be done? (By diagnosing the forearm skin to understand the Zang-Fu organs, it is called knowing the interior from the exterior.)
Qibo replied: Carefully examine the tension (slow/tight), size, smoothness, and roughness of the forearm skin, as well as the firmness or fragility of the flesh, and the pathological manifestations will be determined. (The Cunkou pulse extends from the Chi position to the Cun position; thus, by examining only the pulse at the Chi position, the internal condition can be known. The entire body is difficult to observe completely, but the flourishing or decline of muscle mass must manifest behind the wrist. Therefore, by observing only the flesh at the Chi position, the external condition can be known. Hence, by solely examining the forearm skin, the pathological form is established.)
If one observes slight swelling above the eye sockets (Muke, the area under the eyes resembling a silkworm), resembling the state after just waking up, with palpable pulsation in the neck vessels (Renying pulse), frequent coughing, and pitting edema upon pressing the hands and feet that does not immediately recover, this indicates Fengshui Fuzhang (Wind-water distension). (Muke refers to the area under the eyes. Yong here means obstruction/swelling, indicating recent mild swelling. Renying refers to the carotid artery. Pitting edema indicates depression upon pressure. These are external signs of Wind-water Fuzhang. See Disease Category 31 for Fengshui and Category 57 for Fuzhang.)
If the forearm skin is smooth and glossy (Naozhe), it indicates Wind disease. (Yang channels receive wind pathogens; thus, patients with wind disease have smooth and glossy forearm skin.)
If the forearm flesh is weak, it manifests as lethargy and desire to lie down; if the flesh is emaciated and there are alternating chills and fever, it is incurable. (Weak forearm flesh implies muscle wasting and Yin deficiency, leading to lethargy. Without pathogenic factors, emaciation with chills and fever indicates failure of True Yin, hence incurable.)
If the forearm skin is smooth and oily, it indicates Wind disease. (Oily glossiness refers to the aforementioned smoothness. Wind is Yang Qi; when present in the skin and muscles, it causes smoothness and oiliness.)
If the forearm skin is rough, it indicates Fengbi (Wind Bi syndrome). (Rough forearm skin indicates blood deficiency, where blood fails to nourish the tissues, resulting in Wind Bi.)
If the forearm skin is rough like the scales of a dried fish, it indicates Shuiyin (Water retention). (Dryness and roughness like dried fish scales indicate severe dryness. Due to Spleen Earth deficiency and muscle wasting, Water invades, forming Shuiyin. Also, see Lower Volume regarding Liver pulse being very choppy indicating Yi Yin. "Yi" and "Shui" are synonymous here.)
If the forearm skin is intensely hot and the pulse is vigorous and restless, it indicates Wenbing (Warm disease); if the pulse is vigorous yet slippery, the disease is about to resolve. (Hot forearm skin implies body heat; vigorous and restless pulse indicates excess Yang pathogen, pointing to Warm disease. If the pulse is vigorous but slippery, it suggests the restlessness has subsided and healthy Qi is recovering, so recovery will occur soon. "Chu" means gradual recovery.)
If the forearm skin is cold and the pulse is small, it indicates diarrhea and Qi deficiency. (Cold skin and small pulse indicate Yang Qi decline, leading to diarrhea and shortness of breath.)
If the forearm skin is initially hot then becomes cold, or initially cold then becomes hot after prolonged handling, it indicates alternating chills and fever. ("Juran" describes intense heat. Whether hot then cold or cold then hot, these are signs of alternating chills and fever.)
Heat isolated to the elbow indicates heat in the upper half of the waist; heat isolated to the hand indicates heat in the lower half of the waist. (The elbow is the joint of the arm. Some say the area above Quchi is the elbow. Since the elbow is superior and the hand is inferior, the elbow corresponds to the upper waist and the hand to the lower waist.)
Heat isolated to the anterior aspect of the elbow indicates heat in the anterior chest; heat isolated to the posterior aspect of the elbow indicates heat in the shoulder and back. (The anterior elbow is the medial side, traversed by the Three Yin Hand meridians, corresponding to the anterior chest. The posterior elbow is the lateral side, traversed by the Hand Taiyang meridian, corresponding to the shoulder and back.)
Heat isolated to the middle of the arm indicates heat in the waist and abdomen. (Below the elbow is the arm; since the arm is inferior, it corresponds to the waist and abdomen.)
Heat three to cun below the prominent bone at the posterior elbow indicates intestinal parasites. (This area, between Zusanli and Neiguan, belongs to the Yin division. Heat in the Yin division corresponds to intestinal parasites.)
Heat in the center of the palm indicates heat in the abdomen; cold in the center of the palm indicates cold in the abdomen. (The center of the palm is where the Three Yin meridians converge; thus, heat or cold here corresponds to abdominal conditions.)
Blue veins visible on the white flesh above the Thenar eminence (Yu) indicate Cold in the Stomach. (Blue veins on the Yu indicate Stomach Cold. The Meridian Chapter also states: Cold in the Stomach results in many blue veins on the hand Yu. See Meridian Category 2 for the meaning of Yu.)
If the forearm skin is intensely hot and the Renying pulse is large, blood loss should be expected; if the forearm skin is hard and large while the pulse is extremely small, accompanied by Qi deficiency, and if irritability arises, death will ensue immediately. (Intense heat in the forearm indicates Fire in the Yin. A large Renying pulse indicates Yang excess, leading to blood loss. If the forearm skin is hard and large but the pulse is extremely small, it signifies Excess of Form but Deficiency of Qi. With extreme Yin deficiency, if irritability is added, immediate death occurs.)