（灵枢根结篇）
一日一夜五十营，以营五脏之精，不应数者，名曰狂生。（营，运也。人之经脉营运于身者，一日一夜凡五十周，以
营五脏之精气，如五十营篇者即此之义。其数则周身上下左右前后凡二十八脉，共长十六丈二尺。人之宗气积于胸中，
主呼吸而行经隧，一呼气行三寸，一吸气行三寸，呼吸定息，脉行六寸。以一息六寸推之，则一昼一夜，凡一万三千五
百息，通行五十周于身，则脉行八百一十丈。其有太过不及而不应此数者，名曰狂生。狂犹妄也，言虽生未可必也。）所
谓五十营者，五脏皆受气。持其脉口，数其至也。（凡此五十营者，即五脏所受之气也。但诊持脉口而数其至，则脏气之
衰王可知矣。脉口义详藏象类十一。数，上声。）五十动而不一代者，五脏皆受气；（代，更代之义，谓于平脉之中，而
忽见 弱，或乍数乍疏，或断而复起。盖其脏有所损则气有所亏，故变易若此，均名为代。若五十动而不一代者，五脏
受气皆足，乃为和平之脉。）四十动一代者，一脏无气；（四十动一代者，是五脏中一脏亏损也。愚按∶十一难曰∶经言
脉不满五十动而一止，一脏无气者，何脏也？然。人吸者随阴入，呼者因阳出，今吸不能至肾，至肝而还，故知一脏无
气者，肾气先尽也。然则五脏和者气脉长，五脏病者气脉短。观此一脏无气必先乎肾，如下文所谓二脏三脏四脏五脏者，
当自远而近，以次而短，则由肾及肝，由肝及脾，由脾及心，由心及肺。故凡病将危者，必气促似喘，仅呼吸于胸中数
寸之间。盖其真阴绝于下，孤阳浮于上，此气短之极也。医于此际而尚欲平之散之，未有不随扑而灭者，良可哀也。夫
人之生死由乎气，气之聚散由乎阴，而残喘得以尚延者，赖一线之气未绝耳，此脏气之不可不察也。）三十动一代者，二
脏无气；二十动一代者，三脏无气；十动一代者，四脏无气；不满十动一代者，五脏无气，予之短期，要在终始。（予，
与同。短期，死期也。言五脏无气，可与之定死期矣。终始，本经篇名，具十二经终之义。）所谓五十动而不一代者，以
为常也，以知五脏之期。予之短期者，乍数乍疏也。（以为常者，言人之常脉当如是也，故可因此以察五脏之气。若欲知
其短期，则在乎乍疏乍数，此其时相变代，乃与常代者不同，盖以脏气衰败，无所主持而失常如此，故三部九候等论皆
云乍疏乍数者死。愚按∶代脉之义，自仲景叔和俱云∶动而中止，不能自还，因而复动，脉代者死。又曰∶脉五来一止，
不复增减者死，经名曰代。脉七来，是人一息半时，不复增减，亦名曰代，正死不疑。故王太仆之释代脉，亦云动而中
止，不能自还也。自后滑伯仁因而述之曰∶动而中止，不能自还，因而复动，由是复止，寻之良久，乃复强起，为代。
故后世以结促代并言，均目之为止脉，岂足以尽其义哉？夫缓而一止为结，数而一止为促，其至则或三或五或七八至不
等，然皆至数分明，起止有力。所主之病，有因气逆痰壅而为间阻者，有因血气虚脱而为断续者，有因生平禀赋多滞而
脉道不流利者，此自结促之谓也。至于代脉之辨，则有不同。如宣明五气篇曰脾脉代，邪气脏腑病形篇曰黄者其脉代，
皆言脏气之常候，非谓代为止也。又平人气象论曰，长夏胃微 弱曰平，但代无胃曰死者，乃言胃气去而真脏见者死，
亦非谓代为止也。由此观之，则代本不一，各有深义。如五十动而不一代者，乃至数之代，即本篇之所云者是也。若脉
本平匀而忽强忽弱者，乃形体之代，即平人气象论所云者也。又若脾主四季而随时更代者，乃气候之代，即宣明五气等
篇所云者是也。凡脉无定候，更变不常，则均谓之代。但当各因其变而察其情，庶得其妙。设不明此，非惟失经旨之大
义，即于脉象之吉凶，皆茫然莫知所辨矣，又乌足以言诊哉？二篇详义，见后十一及疾病类二十五。又按∶本篇但言动
止之数，以诊五脏无气之候，未尝凿言死期，而王氏脉经乃添出死期岁数，曰∶脉来四十投而一止者，一脏无气，却后
四岁春草生而死。脉来三十投而一止者，二脏无气，却后三岁麦熟而死。脉来二十投而一止者，三脏无气，却后二岁桑
椹赤而死。脉来十投而一止者，四脏无气，岁中死。脉来五动而一止者，五脏无气，却后五日而死。自后诸家言脉者皆
宗此说，恐未有一脏无气而尚活四岁、二脏无气而尚活三岁之理，诊者辨之。）
（《灵枢·根结》篇）
人的一日一夜，经脉在全身运行五十周，以此来滋养五脏的精气。如果脉动次数不符合这个规律，就称为“狂生”（指虽然活着，但生命状态妄乱，难以预测吉凶）。（注：“营”意为运行。人的经脉在体内运行，一天一夜共循环五十周，用以营运五脏的精气，这与《灵枢·五十营》篇中的含义一致。其具体数据是：周身上下左右前后共有二十八条经脉，总长度为十六丈二尺。人体的宗气积聚在胸中，主管呼吸并推动血液在经络中运行。一次呼气脉行三寸，一次吸气脉行三寸，一呼一吸之间（定息），脉行六寸。按每次呼吸脉行六寸推算，一天一夜共有万三千五百次呼吸，经脉在全身通行五十周，总共运行八百一十丈。如果脉动次数过多或过少而不符合这一规律，就称为“狂生”。所谓“狂”，就是妄乱的意思，意指虽然还活着，但生死未卜。）
所谓的“五十营”，是指五脏都接受了经气的滋养。诊察时，持住患者的脉口，计数脉搏跳动的次数。（以上所说的五十营，即五脏所接受的经气。只要诊察脉口并计数其跳动次数，就可以知道脏气的盛衰情况。“脉口”的含义详见《藏象类》第十一节。“数”字读上声。）
脉搏跳动五十次而没有一次歇止的，说明五脏都接受了充足的经气；（“代”是更替、替代的意思，指在正常的脉象中，突然出现微弱，或者忽快忽慢，或者中断后又重新跳动。这是因为某个脏器受损导致经气亏损，所以脉象发生这种变化，统称为“代”。如果五十次跳动中没有一次歇止，说明五脏受气充足，这是和平正常的脉象。）
脉搏跳动四十次出现一次歇止的，说明有一脏没有经气；（四十次跳动出现一次歇止，意味着五脏中有一脏亏损。我按语道：《难经·十一难》说：经文讲脉搏不满五十次就出现一次停跳，是一脏无气，是哪一脏呢？回答是：人吸气时气随阴入里，呼气时气随阳出。现在吸气不能到达肾脏，只到肝脏就返回了，所以知道是一脏无气，且首先是肾气耗尽。既然这样，那么五脏调和则气脉长，五脏有病则气脉短。观察这一点可知，一脏无气必先影响肾，如下文所说的二脏、三脏、四脏、五脏无气的情况，应当是由远及近，依次缩短，即由肾及肝，由肝及脾，由脾及心，由心及肺。所以凡是病情危重的人，必然气息急促类似喘息，仅在胸中几寸之间呼吸。这是因为真阴在下枯竭，孤阳在上浮越，这是气短到了极点。医生在这个时候如果还想用平散的方法治疗，没有不随之灭亡的，实在令人悲哀。人的生死取决于气，气的聚散取决于阴，而残存的喘息得以延续，全靠一线之气未绝罢了，这就是脏气不可不仔细考察的原因。）
脉搏跳动三十次出现一次歇止的，说明有两脏没有经气；
脉搏跳动二十次出现一次歇止的，说明有三脏没有经气；
脉搏跳动十次出现一次歇止的，说明有四脏没有经气；
脉搏跳动不满十次就出现一次歇止的，说明五脏都没有经气，可以给予预定的死期，关键在于参考《终始》篇的原则。（“予”通“与”。短期，即死期。意思是五脏无气，可以与之确定死期了。“终始”是本经的一篇名，包含十二经脉终始的意义。）
所谓“五十动而不一代”，将其作为常态，用来判断五脏的期限。给予预定的死期的情况，是脉象忽快忽慢。（作为常态，是说人的正常脉象应当如此，因此可以通过它来观察五脏之气。如果想要知道死期，则在于脉象忽疏忽数，这是时机相应变代，与平常的“代”不同，这是因为脏气衰败，无所主持而失常如此，所以《三部九候论》等篇章都说“乍疏乍数者死”。我按语道：关于“代脉”的含义，自张仲景、王叔和以来都认为：脉搏跳动中途停止，不能自行恢复，因而再次跳动，脉象为代者主死。又说：脉搏五次跳动后停止一次，不再增减的，主死，经文称之为代。脉搏七次跳动（相当于一人半次呼吸的时间），不再增减的，也称为代，确凿无疑地主死。所以王冰注释代脉也说：跳动中途停止，不能自行恢复。后来滑伯仁沿袭并阐述说：跳动中途停止，不能自行恢复，因而再次跳动，由此再次停止，仔细寻按很久，才勉强再起，这叫代。因此后世将结脉、促脉、代脉并提，都称之为止脉，这哪里足以穷尽它们的含义呢？脉缓而一止为结脉，脉数而一止为促脉，其至数可能是三次、五次或七八次不等，但都至数分明，起止有力。其所主的病症，有因气逆痰壅造成间阻的，有因气血虚脱造成断续的，有因生平禀赋多滞涩导致脉道不流畅的，这些属于结脉和促脉的范畴。至于代脉的辨别，则有不同。如《宣明五气》篇说“脾脉代”，《邪气脏腑病形》篇说“黄色者的脉代”，都是指脏气的正常征候，并非指代为止脉。又《平人气象论》说，长夏季节胃气微弱的脉象为平脉，但如果只有代脉而没有胃气，则是死脉，这是指胃气离去而真脏脉显现者死，也并非指代为止脉。由此看来，代脉本不止一种含义，各有深意。如“五十动而不一代”，是指至数上的代，即本篇所说的内容。如果脉象本来平稳均匀，却突然忽强忽弱，这是形体上的代，即《平人气象论》所说的内容。又如脾主四季而随时更替，这是气候上的代，即《宣明五气》等篇所说的内容。凡是脉象没有固定征候，变化无常的，都称为代。但应当根据每种变化来察知其情状，这样才能得其妙处。如果不明白这一点，不仅会失去经文的大义，就连对脉象的吉凶也茫然不知如何辨别，又怎么能谈论诊法呢？这两篇的详细含义，见后文《十一难》及《疾病类》第二十五节。另外我按语道：本篇只讲了动止的次数，用以诊察五脏无气的征候，并没有明确说出死期的年岁，而王叔和的《脉经》却添加了死期的岁数，说：脉搏来四十次而停一次，是一脏无气，四年后春草生时死亡。脉搏来三十次而停一次，是二脏无气，三年后麦熟时死亡。脉搏来二十次而停一次，是三脏无气，两年后桑椹变红时死亡。脉搏来十次而停一次，是四脏无气，当年内死亡。脉搏来五次而停一次，是五脏无气，五天后死亡。此后各家论述脉象的都尊崇这一说法，恐怕没有一脏无气还能活四年、二脏无气还能活三年的道理，诊察者应当辨析这一点。）
(Lingshu, Genjie Chapter)
In one day and night, the meridians circulate fifty times to nourish the essence and qi of the five zang organs. If the pulse movements do not conform to this number, it is called "kuang sheng" (wild generation, referring to a life state that is chaotic and whose outcome is uncertain). (Note: "Ying" means to circulate or operate. The human meridians circulate in the body fifty times in a day and night to operate and nourish the essence and qi of the five zang organs, which is consistent with the meaning in the Lingshu, Wushi Ying Chapter. The specific data are as follows: there are twenty-eight meridians in total above and below, left and right, front and back, with a combined length of sixteen zhang and two chi. The Zong Qi (Gathering Qi) of the human body accumulates in the chest, governing respiration and driving blood through the collaterals. In one exhalation, the pulse moves three cun; in one inhalation, it moves three cun. In one complete breath cycle (ding xi), the pulse moves six cun. Based on six cun per breath, there are thirteen thousand five hundred breaths in a day and night. The meridians circulate fifty times in the body, covering a total distance of eight hundred ten zhang. If the pulse frequency is excessive or insufficient and does not match this standard, it is called "kuang sheng." "Kuang" implies chaos or delusion, meaning that although the person is alive, their fate is unpredictable.)
The so-called "Wushi Ying" (Fifty Circulations) refers to the fact that the five zang organs all receive qi. During examination, hold the pulse at the Cun Kou (Pulse Gate) and count the beats. (The aforementioned fifty circulations refer to the qi received by the five zang organs. By examining the Cun Kou and counting its beats, one can determine the decline or prosperity of the zang qi. The meaning of "Cun Kou" is detailed in Zangxiang Class, Section 11. "Shu" is pronounced with the rising tone.)
If the pulse beats fifty times without any intermission, the five zang organs are all receiving qi; ("Dai" means replacement or substitution. It refers to an abnormality within a normal pulse, such as suddenly appearing weak, alternating between rapid and slow, or stopping and then restarting. This occurs because damage to a zang organ leads to a deficiency of qi, causing such changes in the pulse, all of which are termed "Dai." If there are fifty beats without any intermission, it indicates that the five zang organs are sufficiently nourished by qi, representing a harmonious and healthy pulse.)
If the pulse beats forty times before showing one intermission, it indicates that one zang organ lacks qi; (An intermission after forty beats signifies a deficiency in one of the five zang organs. Commentary: Nan Jing, Chapter 11 states: The classic says if the pulse stops once before reaching fifty beats, it indicates one zang lacks qi. Which zang is it? The answer is: Inhalation follows Yin inward, and exhalation follows Yang outward. Now, if inhalation cannot reach the Kidney but returns at the Liver, we know that one zang lacks qi, specifically that Kidney Qi has been exhausted first. Thus, when the five zang are harmonious, the qi and pulse are long; when diseased, they are short. Observing this, the lack of qi in one zang must begin with the Kidney. Following the logic for two, three, four, and five zangs lacking qi mentioned later, the progression should be from distant to near, shortening sequentially: from Kidney to Liver, Liver to Spleen, Spleen to Heart, and Heart to Lung. Therefore, in critical conditions, patients inevitably exhibit rapid breathing resembling asthma, confined only to a few cun in the chest. This is due to the exhaustion of True Yin below and the floating of solitary Yang above, representing the extreme of shortness of breath. At this juncture, if a physician attempts to treat with dispersing methods, death will inevitably follow, which is truly lamentable. Human life and death depend on Qi; the gathering and scattering of Qi depend on Yin. The continuation of labored breathing relies solely on a thread of unextinguished Qi. Hence, the importance of carefully observing zang qi cannot be overstated.)
If the pulse beats thirty times before showing one intermission, it indicates that two zang organs lack qi;
If the pulse beats twenty times before showing one intermission, it indicates that three zang organs lack qi;
If the pulse beats ten times before showing one intermission, it indicates that four zang organs lack qi;
If the pulse shows an intermission in fewer than ten beats, it indicates that the five zang organs all lack qi. A prognosis of death may be given, based on the principles of the Zhongshi Chapter. ("Yu" is synonymous with "give." "Duanqi" refers to the time of death. This means that when the five zang lack qi, a definite time of death can be assigned. "Zhongshi" is the title of a chapter in the original text, detailing the termination and beginning of the twelve meridians.)
The statement "fifty beats without intermission" serves as the norm, allowing one to ascertain the condition of the five zang. The indication of imminent death is characterized by irregularities in speed and rhythm. (Considering it the norm means that a normal human pulse should be like this, thus allowing observation of the qi of the five zang. To identify the time of death, one looks for pulses that are intermittently rapid and slow. This represents a change in timing, differing from the regular "Dai" pulse. It results from the deterioration of zang qi, leading to a loss of control and deviation from normalcy. Hence, chapters like Sanbu Jiuhou Lun state that "intermittently rapid and slow" pulses indicate death. Commentary: Regarding the meaning of "Dai Mai" (Intermittent Pulse), Zhang Zhongjing and Wang Shuhe both stated: "Beats stop midway, cannot return spontaneously, and then resume; a Dai pulse indicates death." They also said: "Five beats followed by one stop, without further increase or decrease, indicates death, termed Dai in the classics." Seven beats (equivalent to half a breath cycle) without increase or decrease are also termed Dai, unequivocally indicating death. Wang Bing’s commentary on the Dai pulse similarly states: "Beats stop midway and cannot return." Later, Hua Borén elaborated: "Beats stop midway, cannot return, resume, stop again; after searching for a long time, they rise forcibly. This is Dai." Consequently, later generations grouped Jie (Knotted), Cu (Rapid-intermittent), and Dai together as "stopping pulses," which fails to capture their full meaning. A slow pulse with intermittent stops is Jie; a rapid pulse with intermittent stops is Cu. Their frequencies may vary (three, five, seven, or eight beats per interval), but the rhythm is distinct, and the starts and stops are forceful. These are caused by Qi rebellion and phlegm obstruction, Qi and Blood depletion, or congenital stagnation affecting vessel flow. However, the differentiation of Dai Mai differs. For instance, Xuanming Wuqi Pian states "Spleen pulse is Dai," and Xieqi Zangfu Bingxing Pian states "Yellow complexion corresponds to a Dai pulse." Both refer to the normal manifestation of zang qi, not a stopping pulse. Furthermore, Pingren Qixiang Lun states: "In late summer, a slight weakness in the Stomach pulse is normal; but a Dai pulse without Stomach Qi indicates death." This refers to the departure of Stomach Qi and the appearance of the True Zang pulse, signifying death, not merely a stopping pulse. From this, we see that "Dai" has multiple meanings. "Fifty beats without intermission" refers to the numerical aspect of Dai, as described in this chapter. If a normally uniform pulse suddenly becomes strong or weak, it refers to physical variation, as mentioned in Pingren Qixiang Lun. If the Spleen governs the four seasons and changes accordingly, it refers to climatic variation, as noted in Xuanming Wuqi Pian. Any pulse without a fixed pattern that changes frequently is termed Dai. One must observe the specific variations to understand their significance. Failure to comprehend this leads to misunderstanding the classics and inability to distinguish auspicious from inauspicious pulse signs, rendering diagnostic discussion futile. Detailed explanations are found in Nan Jing Chapter 11 and Disease Class, Section 25. Additional Commentary: This chapter only discusses the number of beats and stops to diagnose the lack of qi in the five zang, without explicitly predicting years of survival. However, Wang Shuhe’s Mai Jing added specific timelines: Forty beats with one stop indicates one zang lacks qi, death in four years when spring grass grows. Thirty beats with one stop indicates two zangs lack qi, death in three years when wheat ripens. Twenty beats with one stop indicates three zangs lack qi, death in two years when mulberries turn red. Ten beats with one stop indicates four zangs lack qi, death within the year. Five beats with one stop indicates five zangs lack qi, death in five days. Subsequent authorities have adhered to this view, yet it is unlikely that one could survive four years with one zang lacking qi or three years with two zangs lacking qi. Practitioners should critically evaluate this claim.)