三部谓上中下，九候谓上中下各三候也，经旨如是。后世则以寸关尺为三部，而分浮中沉取之，就脉辨
证，
能决死，
黄帝问曰∶……愿闻天地之至数，合于人形血气，通决死生，为之奈何？岐伯曰∶天地之至数，始于一，
终于九焉。（按∶九为奇数之终。）一者天，二者地，三者人，因而三之，三三者九，以应九野。故人有三部，
部有三候，以决死生，以处百病，以调虚实而除邪疾。（按∶九野注见前。）帝曰∶何谓三部？岐伯曰∶有下
部，有中部，有上部，部各有三候。三候者，有天，有地，有人也。必指而导之，乃以为真。（言必当谘受于
师也。）上部天，两额之动脉；（在额两旁，动应于手，足少阳脉气所行也。）上部地，两颊之动脉；在鼻孔下两旁，近
于巨 之分，动应于手，（足阳明脉气之所行。）上部人，耳前之动脉。（在耳前陷者中，动应于手，手少阳
脉气之所行也。）中部天，手太阴也；（谓肺脉也，在掌后寸口中，是谓经渠，动应于手。）中部地，手阳明
也；（谓大肠脉也，在手大指次指岐骨间，合谷之分，动应于手也。）中部人，手少阴也。（谓心脉也，在掌
后锐骨之端，神门之分，动应于手也。）下部天，足厥阴也；（谓肝脉也，在毛际外，羊矢下一寸半陷中，五里
之分，卧而取之，动应于手也。女子取太冲，在足大趾本节后二寸陷中是。）下部地，足少阴也，（谓肾脉也，
在足内踝后跟骨上陷中，太溪之分，动应手。）下部人，足太阴也。（谓脾脉也，在鱼腹上趋筋间，直五里下
箕门之分，宽巩足单衣沉取乃得之，而动应于手也。候胃气者，当取足跗之上，冲阳之分，动应手也。按∶本
经所指，盖合经脉穴道，二者并言，不徒专取寸关尺也，宜分别观之。）故下部之天以候肝，地以候肾，人以
候脾胃之气。（脾脏与胃以膜相连，故以候脾兼候胃也。）帝曰∶中部之候奈何？岐伯曰∶亦有天，亦有地，
亦有人。天以候肺，地以候胸中之气，（经云肠胃同候，故以候胸中也。）人以候心。帝曰∶上部何以候之？
岐伯曰∶亦有天，亦有地，亦有人。天以候头角之气，地以候口齿之气，人以候耳目之气。（按∶后三段不过复解
前文，无深义也。）三部者，各有天，各有地，各有人。三而成天，三而成地，三而成人。三而三之，合则
为九，九分为九野，九野为九脏。故神脏五，形脏四，合为九脏。（……神脏五者，肝藏魂，心藏神，脾藏意，
肺藏魄，肾藏志，以其皆神气居之故也。形脏四者，一头角，二耳目，三
口齿，四胸中也。按∶此一节是上文三部九候之总结也。为犹应也，九野为九脏，犹言九脏应九野也。谨按
上部三候，形脏居其三；中部三候，神脏居其二，形脏居其一；下部三候，则尽神脏也。然其中有可疑者，
前言中部地，手阳明也，注云大肠脉也。乃岐伯复解，则又云地以候胸中之气，注云手阳明脉当其处，按手阳
明脉，自肩 前廉，上出柱骨之会，下入缺盆，络肺下膈，属大肠。虽有下膈二字，不可直言胸中，一疑也。
若言大肠所盘折之地，乃是当脐，又非胸中，二疑也。后既总言形脏四，则胸中二字，必非差误。前言手阳明
三字，三部中止言脏脉，并不及腑，而手阳明为腑脉，或者错误，亦未可知，三疑也。前后不合，存之以俟
后之识者。）帝曰∶以候奈何？岐伯曰∶必先度其形之肥瘦，以调其气之虚实，实则泻之，虚则补之。……帝曰∶
决死生奈何？岐伯曰∶形盛脉细，少气不足以息者危；（形气相反，故生气至危。危者言其近死，犹有生者也。）
形瘦脉大，胸中多气者死。（凡如是类皆形气不相得也。按∶形盛谓肌肉未消，脉细谓小弱无力。惟脉细故
少气，惟少气故不足以息也。此等脉证，多见于初病之人。盖由天禀素弱，故脉来无力。苟能峻补，犹可以生，
故但云危也。若夫肌肉既脱而脉反浮大，为真原枯竭。胸中多气，为元气脱根。此等脉证，久病之人见之，死
不旋踵矣。然则新起之病，独无之乎？曰∶有之，脉大气浮，甚且喘促者，则为阴竭阳浮之证。切忌补气，急
用敛阴。如或不应，更加桂附，庶使气纳丹田。俗医不知此理，误用利气，速其死矣。新病之与久病，其死皆
同，惟形瘦与不瘦为异耳。）形气相得者生，参伍不调者病，（参谓参校，伍谓类伍。按∶谓脉来至数不等也。）
三部九候皆相失者死。（按∶相失谓大小迟疾悬殊也。）三部之脉，半得半失，犹可以治。若皆相失，则死也。
上下左右之脉相应如参舂者病甚，上下左右相失不可数者死。（按∶上下谓寸尺，左右谓两手，盖言两手三部
也。每部三候，三六一十八，注以为
十八诊是也。参舂谓频动击手，加杵米也。脉法曰∶“人一呼脉再至，一吸脉亦再至曰平。”今所谓一呼一吸
脉四至也。三至曰离经，四至曰脱精，五至曰死，六至曰命尽，是一呼一吸脉十二至矣。若两手三部之脉至干
不可数，是亦脉来十至以外之类，欲不死得乎。）中部之候虽独调，与众脏相失者死；中部之候相减者死。（按∶
中部谓两关也，言尺寸之脉既失其常，即使关脉无病，犹之三部九候相失之类也，故亦曰死。若两关独病，脉
日减少，即使尺寸无病，是亦三部九候相失之类也。上下一意，特互言之以畅其说，非有二也。）目内陷者死。
（按∶内陷谓眼珠深 。五脏之精皆上会于目，内陷则真精枯竭，故死。注单指太阳，偏矣。）帝曰∶何以知病
之所在？岐伯曰∶察九候，独小者病，独大者病，独疾者病，独迟者病，独热者病，独寒者病，独陷下者病。（……
脉见七诊，谓参伍不调，随其独异，以言其病尔。）九候之相应也，上下若一，不得相失。（上下若一，言迟
速大小等也。）一候后则病，二候后则病甚，三候后则病危。所谓后者，应不俱也。（……俱犹同也，一也。
按∶此就一部而言也。不俱谓脉来之数，后不应前也。）真脏脉见者胜死。（按∶真脏脉见，死无疑矣。然其
死也，又必于胜已之日。）足太阳气绝者，其足不可屈伸，死必戴眼。（足太阳脉起于目内 ，上额交巅，上
从巅入络脑，还出别下项，循肩 内，挟脊抵腰中。其支者，复从肩 ，别下贯胂，过髀枢，下合 中，贯
循踵，至足外侧。太阳气绝，死如是矣。按∶新校正云∶“按诊要经终论载三阳三阴脉终之证，此独纪足太阳气
绝一证，余应阙文也。”）帝曰∶冬阴夏阳奈何？（言死时也。）岐伯曰∶九候之脉皆沉细悬绝者为阴，主
冬，故以夜半死；盛躁喘数者为阳，主夏，故以日中死。（位无常居，物极则反也。乾坤之义，阴极则龙战于
野，阳极则亢龙有
悔，是以阴阳极脉，死于夜半日中也。）是故寒热病者以平旦死。（平晓木王，木气为风，故木王之时，寒热
病死。）热中及热病者以日中死。（阳之极也。）病风者以日夕死。（卯酉冲也。）病水者以夜半死。（水王
故也。）其脉乍疏乍数，乍迟乍疾者，日乘四季死。（辰戌丑未，土寄王之，脾气内绝，故日乘四季而死。）
形肉已脱，九候虽调犹死。（亦谓形气不相得也。按∶人之所以为人者，内而精神，外而形肉而已。形肉消脱，
则精神亦且涣散而无根据。当此之时，九候岂有尚调之理，经特甚言之耳。）七诊虽见，九候皆从者不死。所言
不死者，风气之病及经月之病，似七诊之病而非也，故言不死。（按∶皆从者，脉至前后相合也。脉见七诊，
前后不移，为病而已，必不至死。然其所以不死者，惟风病脉多疾大，久病脉必迟小，非真如七诊之脉与死为
邻也。经，久也，谓病至逾月之久也，注作月经，误矣。）若有七诊之病，其脉候亦败者死矣，必发哕噫。
（……按∶既犯七诊，而九候错乱，无有不死。必发哕噫者，病剧气乱故也。哕，胃疾，吃忒也。噫，心疾，气
厄于下，欲上出而取气也。）其脉疾者不病，（气强盛故。）其脉迟者病，（气不足故。）脉不往来者死，（按∶
气血凝涩故也。）皮肤着者死。（按∶着谓着骨，血肉干实故也。着，直略切。）帝曰∶其可治者奈何？岐伯
曰∶经病者治其经，络病者治其络，（求有过者。按∶王本孙络病者治其孙络血，甲乙经无孙血二字，今从之。）
身有痛者治其经络。（按∶王本血病身有痛，甲乙无血病二字，今从之。）其病者在奇邪，奇邪之脉，则缪
刺之。（缪刺者，刺络脉，左取右，右取左也。）留瘦不移，节而刺之。（……病气淹留，形容减瘦，证不移易，
则消息节级，养而刺之。）瞳子高者太阳不足，戴眼者太阳已
绝，此决生死之要，不可不察也。（……此复明前太阳气欲绝及已绝之候也。）
“三部”指的是上、中、下三个部位，“九候”指的是上、中、下各部位又分别分为天、地、人三候，经文的旨意就是这样。后世医家则将寸口脉的寸、关、尺三部作为“三部”，并分别采用浮取、中取、沉取的方法来诊察脉象，以此来辨别证候，判断生死。
黄帝问道：……我想了解天地至高的数理，如何与人的形体血气相合，从而通晓并决断生死，该怎么做呢？岐伯回答说：天地至高之理，起始于一，终结于九。（按语：九是奇数的终极。）一代表天，二代表地，三代表人，由此推演三倍，三乘以三得九，以对应九州之地。所以人有三部，每部有三候，用来决断生死，诊治百病，调理虚实以祛除邪疾。（按语：“九野”的注释见前文。）黄帝说：什么叫三部？岐伯说：有下部，有中部，有上部，每部各有三候。这三候，分别对应天、地、人。必须通过手指切按来导引感知，才能掌握其真谛。（意指必须向老师请教学习才是真知。）上部之天，指两额旁的动脉；（位于额头两旁，搏动应手，是足少阳胆经脉气所行的部位。）上部之地，指两颊部的动脉；位于鼻孔下方两旁，靠近巨髎穴的分界处，搏动应手，（是足阳明胃经脉气所行的部位。）上部之人，指耳前的动脉。（在耳前凹陷处，搏动应手，是手少阳三焦经脉气所行的部位。）中部之天，是手太阴肺经；（即肺脉，位于手腕后寸口处，名为经渠穴，搏动应手。）中部之地，是手阳明大肠经；（即大肠脉，位于手大拇指和食指叉骨间的高骨处，即合谷穴的分界处，搏动应手。）中部之人，是手少阴心经。（即心脉，位于手腕后锐骨端的凹陷处，即神门穴的分界处，搏动应手。）下部之天，是足厥阴肝经；（即肝脉，位于阴毛边缘外侧，羊矢穴下一寸半的凹陷处，即五里穴的分界处，需卧位取穴，搏动应手。女子则取太冲穴，位于足大趾本节后二寸的凹陷处。）下部之地，是足少阴肾经，（即肾脉，位于足内踝后方跟骨上方的凹陷处，即太溪穴的分界处，搏动应手。）下部之人，是足太阴脾经。（即脾脉，位于鱼腹上方趋筋之间，直对五里穴下方的箕门穴分界处，需用宽巩足单衣等重物压迫沉取方能触及，且搏动应手。若要诊察胃气，应当取足背上的冲阳穴分界处，搏动应手。按语：本经所指的内容，大概是结合经脉和穴位两者来说的，不仅仅局限于寸关尺三部，应当分别观察理解。）因此，下部之天用以诊察肝脏，下部之地用以诊察肾脏，下部之人用以诊察脾胃之气。（因为脾脏与胃通过膜相连，所以诊察脾时也兼及胃气。）黄帝问：中部的脉候情况怎样？岐伯说：也有天、地、人。天用以诊察肺，地用以诊察胸中之气，（经文说肠胃同候，所以此处用以诊察胸中。）人用以诊察心。黄帝问：上部如何诊察？岐伯说：也有天、地、人。天用以诊察头角之气，地用以诊察口齿之气，人用以诊察耳目之气。（按语：后面三段不过是对前文的重复解释，没有深奥的含义。）所谓三部，每部都有天、地、人。三数合成天，三数合成地，三数合成人。三再乘以三，合起来就是九，九分为九野，九野对应九脏。所以神脏有五，形脏有四，合起来共九脏。（……神脏五者，肝藏魂，心藏神，脾藏意，肺藏魄，肾藏志，因为它们都是神气居住的地方。形脏四者，一头角，二耳目，三口齿，四胸中。按语：这一段是上文三部九候理论的总结。“为”意为“应”，九野对应九脏，就是说九脏对应九野。谨按：上部三候中，形脏占其三；中部三候中，神脏占其二，形脏占其一；下部三候中，则全是神脏。然而其中有所怀疑之处，前文说中部之地是手阳明经，注解说这是大肠脉。但岐伯在重新解释时，又说地用以诊察胸中之气，注解说手阳明脉经过该处。按手阳明大肠经，从肩部前廉上行，出于柱骨之会，下行进入缺盆，联络肺，下行穿过膈肌，属于大肠。虽然文中提到“下膈”二字，但不能直接说是胸中，这是一疑。如果说是指大肠盘曲折叠的部位，那应该是在脐部，又不是胸中，这是二疑。后文总述形脏四者时，提到“胸中”二字，必定不是笔误。前文讲手阳明经，在三部中只言脏脉，并未涉及腑脉，而手阳明是腑脉，或许是错误所致，也未可知，这是三疑。前后文义不合，暂且保留以供后世有识之士考证。）黄帝问：如何根据脉候来判断病情？岐伯说：必须先度量患者形体的肥瘦，以调治其气的虚实，实证用泻法，虚证用补法。……黄帝问：如何决断生死？岐伯说：形体壮盛但脉象细弱，气息短少不足以呼吸的，危险；（形与气相反，所以生机极其危险。说“危”是指接近死亡，但还有生存的可能。）形体消瘦但脉象洪大，胸中气多胀满的，死。（凡是这类情况都是形气不相匹配。按语：形盛指肌肉未消减，脉细指脉搏细小软弱无力。正因为脉细所以少气，正因为少气所以呼吸不足。这种脉证多见于初病之人。大概是由于先天禀赋素来虚弱，所以脉来无力。如果能峻猛进补，还可以生还，所以说只是“危”。如果肌肉已经脱失而脉反见浮大，是真元枯竭的表现。胸中多气，是元气脱离根本的表现。这种脉证如果在久病之人身上出现，死亡就在眨眼之间了。那么新起的病就没有这种情况吗？回答说：有的，如果脉大气浮，甚至出现喘促症状的，就是阴竭阳浮的证候。切忌使用补气药，急用收敛阴液的药物。如果无效，再加用桂枝、附子，以使气收纳于丹田。庸医不懂这个道理，误用利气药物，加速了病人的死亡。新病与久病，其死亡结局相同，只是形体瘦削与否有所不同罢了。）形与气相协调的能生，脉象参差错乱不调和的有病，（“参”意为参校比较，“伍”意为类伍排列。按语：指脉来的至数不均匀。）如果三部九候的脉象都失常错乱的，死。（按语：相失指脉象大小、迟疾悬殊很大。）三部脉象，一半正常一半失常的，还可以治疗。如果全部失常，就会死亡。上下左右脉象相应如舂米般频繁冲击手掌的，病重；上下左右脉象失常且无法计数的，死。（按语：上下指寸脉和尺脉，左右指两手，这里说的是两手三部脉。每部三候，三乘六得一十八，注家认为是十八诊。参舂指频繁跳动击打手掌，如同加杵捣米一样。脉法说：“人一呼脉跳两次，一吸脉跳两次叫平脉。”现在所说的一呼一吸脉跳四次。跳三次叫离经，跳四次叫脱精，跳五次叫死，跳六次叫命尽，这样一呼一吸脉就跳十二次了。如果两手三部脉跳动次数多到无法计数，这也是脉来十次以上之类，想不死可能吗？）中部的脉候即使单独调和，但如果与其他脏腑脉象不相匹配的，死；中部的脉候如果减弱减少的，死。（按语：中部指两手的关脉，意思是寸脉和尺脉既然失去了常态，即使关脉没有疾病，也属于三部九候相失的情况，所以也说死。如果只有两关独病，脉象日渐减少，即使寸尺无病，也属于三部九候相失的情况。上下文意思一致，只是互文见义以畅达其说，并非有两层含义。）眼睛向内凹陷的，死。（按语：内陷指眼珠深陷。五脏的精气都上汇于目，内陷说明真精枯竭，所以死。注家仅指太阳经，偏颇了。）黄帝问：如何知道疾病所在的具体部位？岐伯说：诊察九候，发现某一部脉象特别小的有病，特别大的有病，特别快的有病，特别慢的有病，特别热的有病，特别寒的有病，特别下陷的有病。（……脉现七诊中的异常，指脉象参差错乱，随着其独特差异，来指出病变所在。）九候的脉象应当相互呼应，上下如一，不能失常。（上下如一，指迟速、大小等保持一致。）某一候脉来迟缓落后于其他候的，有病；两候落后的，病重；三候落后的，病危。所谓的“落后”，指脉来不应期不一致。（……俱意为相同、一致。按语：这是就一部而言。不俱指脉来的频率，后面的不应和前面对应。）出现真脏脉的，死于克己之日。（按语：见到真脏脉，死亡无疑了。但其死亡时间，必然是在克制该脏气的那一天。）足太阳经气绝的，双脚不能屈伸，死时眼睛向上翻视。（足太阳膀胱经起于目内眦，上行至额部交会于巅顶，从巅顶入络脑，复出别向下项部，沿肩胛内侧，夹脊柱抵于腰中。其支脉，又从肩胛部分出，别行向下贯穿臀部，过髀枢，下行合于腘窝中，贯穿小腿肚，至足外侧。太阳经气绝，死亡时呈现上述症状。按语：新校正说：“《诊要经终论》记载了三阳三阴经脉终绝的症状，这里唯独记录足太阳经气绝一证，其余应当是缺文。”）黄帝问：冬季属阴、夏季属阳，在死亡时间上有什么表现？（指死亡的时间特征。）岐伯说：九候脉象都沉细悬绝的是阴脉，主冬，所以常在夜半死亡；脉象盛大躁动、气喘急促的是阳脉，主夏，所以常在日中死亡。（位置没有固定不变的规律，事物发展到极端就会反过来。乾坤的道理，阴气极盛则龙战于野，阳气极盛则亢龙有悔，所以阴阳极盛的脉象，分别死于夜半和日中。）因此，寒热病患者常在平旦（清晨）死亡。（平晓时木气旺盛，木气化为风，所以在木气旺盛的时候，寒热病死。）热中证及热病患者常在日中死亡。（这是阳气的极点。）患风病的常在日夕（傍晚）死亡。（卯酉对冲之时。）患水病的常在夜半死亡。（水气王相的缘故。）脉象忽快忽慢、忽疏忽数的，常在四季末的时辰（辰、戌、丑、未时）死亡。（辰戌丑未时，土气寄旺，脾气内部绝灭，所以在四季末的时辰死亡。）形体肌肉已经脱失，即使九候脉象调和也会死亡。（也是指形气不相匹配。按语：人之所以为人，内在是精神，外在是形体肌肉而已。形体肌肉消脱，精神也就涣散而无依托。在这个时候，九候脉象怎么还会有调和的道理呢？经文特意用极端的说法来强调罢了。）如果出现七诊的脉象，但九候脉象都顺从常理的，不死。所说的不死，是指风气引起的疾病以及病程长达一个月的疾病，看似符合七诊的病状但实际上不是，所以说不会死。（按语：皆从指脉象前后相合。脉现七诊，前后不变，只是生病而已，不至于死。然而其之所以不死，是因为风病脉多疾大，久病脉必迟小，并不真正像七诊脉那样与死亡相邻。经，意为久，指病超过一个月之久，注家解释为月经，是错误的。）如果有七诊的病状，其脉候也败坏的，就会死亡，一定会发生呃逆和嗳气。（……按语：既犯七诊，而九候错乱，没有不死的。一定发生呃逆和嗳气，是因为病势剧烈导致气机紊乱。哕，是胃的疾病，即打嗝。噫，是心的疾病，气郁结在下，想要向上排出而索取气息。）脉象疾速的没有病，（因为气强盛。）脉象迟缓的有病，（因为气不足。）脉象停止不往来的，死，（按语：气血凝滞涩阻的缘故。）皮肤紧贴骨骼的，死。（按语：着指附着于骨，血肉干枯坚实。着，读音为直略切。）黄帝问：可以治疗的怎么办？岐伯说：经病治疗其经，络病治疗其络，（寻找有过错的部位。按语：王冰本孙络病者治其孙络血，《甲乙经》无“孙血”二字，现在依从它。）身体有疼痛的，治疗其经络。（按语：王冰本血病身有痛，《甲乙经》无“血病”二字，现在依从它。）病位在奇邪的，奇邪的脉象，就用缪刺法治疗。（缪刺，是刺络脉，左病取右，右病取左。）形体消瘦且病邪留滞不移的，节制针刺。（……病气淹留，形容减瘦，证候不移易，则斟酌节级，调养后针刺。）瞳孔上视的是太阳经气不足，眼睛向上翻视定睛不动的是太阳经气已绝，这是决断生死的关键，不可不仔细考察。（……这是再次阐明前文太阳经气欲绝及已绝的征候。）
"Three Parts" refers to the Upper, Middle, and Lower sections. "Nine Probes" (Jiu Hou) refers to the three probes—Heaven, Earth, and Man—within each of the three sections. This is the intent of the classic text. Later generations interpreted "Three Parts" as the Cun, Guan, and Chi positions of the radial artery, employing Floating, Middle, and Sinking palpation techniques to differentiate syndromes and determine life and death.
The Yellow Emperor asked: ... I wish to hear about the supreme numbers of Heaven and Earth, how they correspond to human form and blood qi, and how to use them to distinguish life from death. What should be done?
Qibo replied: The supreme numbers of Heaven and Earth begin with One and end with Nine. (Note: Nine is the ultimate odd number.) One represents Heaven, Two represents Earth, Three represents Man. Multiplying by three yields nine, corresponding to the Nine Regions (Jiu Ye). Thus, humans have Three Parts, each with three probes, used to determine life and death, treat the hundred diseases, regulate deficiency and excess, and eliminate pathogenic disorders. (Note: See previous annotations for "Nine Regions".)
The Emperor asked: What are the Three Parts? Qibo said: There is a Lower Part, a Middle Part, and an Upper Part; each part has three probes. These three probes correspond to Heaven, Earth, and Man. One must guide the fingers to perceive them to grasp the truth. (Meaning: One must learn from a teacher.)
The Upper Part's Heaven probe is the arterial pulse on both sides of the forehead. (Located on both sides of the forehead, pulsating at the touch, where the Qi of the Foot-Shaoyang Gallbladder Meridian travels.) The Upper Part's Earth probe is the arterial pulse on both cheeks. (Located on both sides below the nostrils, near the boundary of the Juliao point, pulsating at the touch, where the Qi of the Foot-Yangming Stomach Meridian travels.) The Upper Part's Man probe is the arterial pulse in front of the ears. (Located in the depression in front of the ear, pulsating at the touch, where the Qi of the Hand-Shaoyang Sanjiao Meridian travels.)
The Middle Part's Heaven probe is the Hand-Taiyin Lung Meridian. (Referring to the Lung pulse, located at the Cun Kou in the wrist crease, known as Jingquan, pulsating at the touch.) The Middle Part's Earth probe is the Hand-Yangming Large Intestine Meridian. (Referring to the Large Intestine pulse, located between the metacarpal bones of the thumb and index finger, at the boundary of the Hegu point, pulsating at the touch.) The Middle Part's Man probe is the Hand-Shaoyin Heart Meridian. (Referring to the Heart pulse, located at the end of the styloid process of the ulna, at the boundary of the Shenmen point, pulsating at the touch.)
The Lower Part's Heaven probe is the Foot-Jueyin Liver Meridian. (Referring to the Liver pulse, located outside the pubic hairline, one and a half cun below the Yangshi point, in a depression, at the boundary of the Wuli point; taken while lying down, pulsating at the touch. For women, take Taichong, located two cun behind the root of the big toe in a depression.) The Lower Part's Earth probe is the Foot-Shaoyin Kidney Meridian. (Referring to the Kidney pulse, located in the depression behind the medial malleolus and above the calcaneus, at the boundary of the Taixi point, pulsating at the touch.) The Lower Part's Man probe is the Foot-Taiyin Spleen Meridian. (Referring to the Spleen pulse, located between the tendons on the upper calf, directly below Wuli at the boundary of the Jimen point; requires heavy compression to feel, pulsating at the touch. To observe Stomach Qi, take the Chongyang point on the dorsum of the foot, pulsating at the touch. Note: The Classic refers to both meridians and acupoints, not just the Cun-Guan-Chi positions; they should be observed separately.)
Therefore, the Lower Part's Heaven probe observes the Liver, its Earth probe observes the Kidney, and its Man probe observes the Qi of the Spleen and Stomach. (Since the Spleen and Stomach are connected by membranes, observing the Spleen also observes the Stomach.)
The Emperor asked: How are the Middle Part probes? Qibo said: They also have Heaven, Earth, and Man. Heaven observes the Lung, Earth observes the Qi of the Chest Center, (The Classic states the Intestines and Stomach share observation, so this observes the chest center), and Man observes the Heart.
The Emperor asked: How does one observe the Upper Part? Qibo said: It also has Heaven, Earth, and Man. Heaven observes the Qi of the Head and Horns, Earth observes the Qi of the Mouth and Teeth, and Man observes the Qi of the Ears and Eyes. (Note: The following paragraphs merely re-explain the preceding text without deep meaning.)
The Three Parts each have Heaven, Earth, and Man. Three constitute Heaven, three constitute Earth, three constitute Man. Three times three equals nine. Nine divides into Nine Regions, which correspond to Nine Viscera. Thus, there are five Spirit Viscera (Shen Zang) and four Form Viscera (Xing Zang), totaling nine. (The five Spirit Viscera are: Liver stores Hun, Heart stores Shen, Spleen stores Yi, Lung stores Po, Kidney stores Zhi, because they house spiritual energy. The four Form Viscera are: 1. Head and Horns, 2. Ears and Eyes, 3. Mouth and Teeth, 4. Chest Center. Note: This section summarizes the preceding theory of Three Parts and Nine Probes. "Wei" means "corresponds to"; Nine Regions correspond to Nine Viscera. Carefully noted: Among the Upper Part's three probes, four Form Viscera occupy three; among the Middle Part's three probes, two Spirit Viscera and one Form Viscera occupy them; among the Lower Part's three probes, all are Spirit Viscera. However, doubts remain: Previously, the Middle Part's Earth was identified as the Hand-Yangming Meridian, annotated as the Large Intestine pulse. But when Qibo re-explained, he said Earth observes the Qi of the Chest Center, annotated as the Hand-Yangming meridian passing that area. The Hand-Yangming Large Intestine Meridian starts from the anterior shoulder, ascends to the vertebral junction, descends into the Clavicular Fossa, connects to the Lung, passes through the Diaphragm, and belongs to the Large Intestine. Although it mentions "passing through the diaphragm," it cannot be directly called the "Chest Center," which is doubt one. If referring to the coiled location of the Large Intestine, it is at the umbilicus, not the chest center, which is doubt two. Later, the summary of four Form Viscera includes "Chest Center," implying it is not an error. Previously, only Zang pulses were mentioned in the Three Parts, not Fu pulses, yet Hand-Yangming is a Fu pulse; perhaps this is an error, which is doubt three. Due to inconsistencies, this is preserved for future scholars.)
The Emperor asked: How does one observe [the condition]? Qibo said: First, measure the fatness or thinness of the body to adjust the deficiency or excess of Qi. Excess is drained; deficiency is tonified. ...
The Emperor asked: How does one determine life and death? Qibo said: A robust body with fine pulses, shortness of breath insufficient for respiration indicates danger. (Body and Qi are contradictory, so vital energy is extremely critical. "Danger" implies near-death but with potential for survival.) A emaciated body with large pulses and excessive Qi in the chest indicates death. (Such cases represent a mismatch between body and Qi. Note: "Robust body" means muscles are not wasted; "fine pulse" means weak and powerless. Because the pulse is fine, there is little Qi; because there is little Qi, respiration is insufficient. Such pulse-symptom patterns often appear in early-stage illnesses, likely due to innate weakness resulting in weak pulses. With aggressive tonification, survival is possible, hence "danger." If muscles are wasted and the pulse floats and becomes large, it indicates exhaustion of the True Origin. Excessive Qi in the chest indicates Yuan Qi detaching from its root. Such patterns in chronic patients lead to immediate death. Do new illnesses never present this way? Answer: Yes, if the pulse is large and floating, even with panting, it indicates Yin exhaustion and Yang floating. Avoid tonifying Qi; urgently use Yin-astringing herbs. If ineffective, add Guizhi Tang (Cinnamon Twig Decoction) and Fuzi (Aconite Root) to guide Qi to the Dantian. Unskilled physicians, unaware of this principle, mistakenly use Qi-moving herbs, hastening death. New and chronic illnesses share the same fatal outcome, differing only in whether the body is emaciated.)
When Body and Qi are harmonious, life prevails. When pulses are irregular and uncoordinated, disease exists. (Can refers to comparison; Wu refers to grouping. Note: Pulse rates are uneven.) If all Nine Probes are discordant, death occurs. (Note: Discordance means significant disparity in size and speed.) If half of the Three Parts' pulses are normal and half abnormal, treatment is still possible. If all are discordant, death ensues. If the pulses of Up, Down, Left, and Right respond like a pestle pounding rice, the disease is severe. If they are discordant and uncountable, death ensues. (Note: Up/Down refer to Cun/Chi; Left/Right refer to both hands, i.e., the Three Parts of both hands. Each part has three probes, totaling eighteen diagnoses. "Pestle pounding" means frequent beating against the hand, like adding a pestle to grain. Pulse methodology states: "Two beats per exhalation and two per inhalation is normal." Here, four beats per cycle are described. Three beats indicate deviation from the classic, four indicate depletion of essence, five indicate death, six indicate end of life, totaling twelve beats per cycle. If pulses are too fast to count, death is inevitable.) Even if the Middle Part's pulse is harmonious alone, if it mismatches other viscera, death occurs. If the Middle Part's pulse diminishes, death occurs. (Note: Middle Part refers to the Guan pulses. If Cun and Chi lose their norm, even if Guan is healthy, it constitutes discordance among the Nine Probes, leading to death. If only Guan is diseased and diminishing, even if Cun and Chi are healthy, it is also discordance. The text uses mutual explanation for clarity, not distinct meanings.) Sunken eyes indicate death. (Note: Sunken means deeply recessed. Essence of all five viscera converges in the eyes; sunken eyes indicate exhaustion of true essence, hence death. The annotation focusing solely on Taiyang is biased.)
The Emperor asked: How does one know the location of the disease? Qibo said: Observe the Nine Probes. The one that is uniquely small is diseased; uniquely large is diseased; uniquely rapid is diseased; uniquely slow is diseased; uniquely hot is diseased; uniquely cold is diseased; uniquely depressed is diseased. (...Pulse manifestations of the Seven Diagnoses indicate irregularity; based on unique differences, one identifies the disease.)
The Nine Probes should correspond, being uniform up and down, without discordance. (Uniformity means consistency in speed and size.) If one probe lags, there is disease; if two lag, the disease is severe; if three lag, the disease is critical. "Lagging" means the responses are not simultaneous. (...Simultaneous means identical. Note: This applies to a single part. Non-simultaneous means the frequency of the later pulse does not match the earlier one.) Appearance of True Zang Pulses indicates death on the day of overcoming [the organ]. (Note: True Zang Pulses signify certain death. Death occurs on the day that overcomes the specific organ's element.)
When the Qi of the Foot-Taiyang Bladder Meridian ceases, the feet cannot flex or extend, and death involves upward staring of the eyes. (The Foot-Taiyang Bladder Meridian originates at the inner canthus, ascends to the vertex, enters the brain, exits to the nape, runs along the scapula,夹 spine to the loins. Branches descend through the buttocks, pass the hip joint, enter the popliteal fossa, run along the calf, to the lateral foot. When Taiyang Qi ceases, death presents thus. Note: Xin Zhengxiao states: "Zhenyao Jingzhong Lun records termination signs for all three Yang and Yin meridians; here only Foot-Taiyang is recorded, implying missing text.")
The Emperor asked: What about Winter Yin and Summer Yang? (Referring to time of death.) Qibo said: If all Nine Probes are sinking, fine, and suspended/extreme, it is Yin, ruling Winter, so death occurs at midnight. If pulses are full, rapid, panting, and numerous, it is Yang, ruling Summer, so death occurs at noon. (Positions are not fixed; extremes reverse. The principle of Qian and Kun: extreme Yin leads to dragon battle in the wild; extreme Yang leads to regret of the soaring dragon. Thus, extreme Yin/Yang pulses die at midnight/noon.) Therefore, Cold-Heat diseases cause death at dawn. (Wood is prosperous at dawn; Wood Qi transforms into Wind, so Cold-Heat diseases die during Wood's prosperity.) Heat-in-the-Middle and Heat diseases cause death at noon. (Extreme Yang.) Wind diseases cause death at dusk. (Mao-You opposition.) Water diseases cause death at midnight. (Water is prosperous.) Pulses that are suddenly sparse/slow or sudden/fast/diseased cause death during the Four Seasons' transition periods (Chen, Xu, Chou, Wei hours). (Earth Qi is dominant in these hours; Spleen Qi internally fails, causing death.) If flesh and muscle are exhausted, even if Nine Probes are harmonious, death occurs. (Also indicates body-Qi mismatch. Note: Humans consist of internal spirit and external flesh/muscle. When flesh/muscle waste away, spirit scatters without foundation. At this time, how could Nine Probes be harmonious? The Classic uses extreme language for emphasis.)
If the Seven Diagnoses appear, but the Nine Probes follow the norm, death does not occur. The "non-death" refers to Wind diseases and menstrual diseases (or long-term illnesses lasting over a month), which resemble Seven Diagnosis symptoms but are not truly so, hence no death. (Note: "Following norm" means pulse continuity. Pulse manifestations of Seven Diagnoses without change indicate illness but not necessarily death. Why no death? Wind disease pulses are typically rapid/large; chronic disease pulses are typically slow/small; they do not truly border death like the Seven Diagnoses imply. "Jing" means long-lasting, referring to illness exceeding a month; annotating it as menstruation is incorrect.) If Seven Diagnosis symptoms exist and pulse conditions also fail, death occurs, accompanied by hiccups and belching. (...Note: Violating Seven Diagnoses with chaotic Nine Probes guarantees death. Hiccups and belching occur due to severe disease disrupting Qi mechanism. Hiccups (Yue) are stomach disorders; Belching (Yi) are heart disorders, where Qi stagnates below and seeks to ascend.)
Rapid pulses indicate no disease (Qi is strong). Slow pulses indicate disease (Qi is insufficient). Pulses that do not flow indicate death (Qi and Blood are stagnant). Skin adhering tightly to bone indicates death (Flesh and blood are dry and solid).
The Emperor asked: How are treatable cases managed? Qibo said: Treat Jing diseases by treating the Jing; treat Luo diseases by treating the Luo (seeking pathological sites). (Note: Wang Bing's edition mentions Sun Luo blood; Jia Yi Jing omits "Sun Blood"; we follow Jia Yi Jing.) For body pain, treat the Jing and Luo. (Note: Wang Bing's edition mentions blood disease causing pain; Jia Yi Jing omits "blood disease"; we follow Jia Yi Jing.) For diseases caused by Odd Pathogens (Qi Xie), whose pulses differ, use Miao Ci (Needling opposite sides). (Miao Ci involves needling collateral vessels, treating left with right and right with left.) For emaciation with persistent pathogens, puncture with regulation/moderation. (...Pathogen Qi lingers, appearance wastes, symptoms do not shift; then adjust dosage and level, nourish, and puncture.) High pupils indicate Taiyang deficiency; upward staring indicates Taiyang exhaustion. This is key to determining life and death and must be carefully observed. (...This reiterates the signs of Taiyang Qi impending exhaustion and actual exhaustion.)