脉居气血之先，切为四诊之一，凡欲治病，惟脉为要矣。然其道至精至微，苟非手快心灵，鲜不毫厘千里。
所载脉法，虽不甚详，然大略已尽于此矣。
黄帝问曰∶诊法何如？岐伯对曰∶诊法常以平旦，阴气未动，阳气未散，饮食未进，经脉未盛，络脉调
匀，气血未乱，故乃可诊有过之脉。切脉动静，而视精明，察五色，观五脏有余不足，六腑强弱，形之盛衰，
以此参伍，决死生之分。（过谓异于常候也，切谓以指切近于脉也。按∶动，注谓动而降卑，降卑之义殊不
可解。平旦之时，阳初用事，人气清明，气血未乱，故可以审脉之得失，平旦六句正言气血之所以未乱也。精
明注作穴名，误矣。盖人一身之精神，皆上注于目。视精明者，谓视目精之明暗，而知人之精气也，观下文“夫
精明者”一段可见矣。参伍谓较其多寡之数，易曰“参伍以变”是也。）
夫脉者，血之府也。（府，聚也，言血之多少皆聚见于经脉之中也。故刺志论曰∶“脉实血实，脉虚血虚，
此其常也，反此者病。”由是故也。）长则气治，短则气病，数则烦心，大则病进，（夫长为气和故治，短为不
足故病，数急为热故烦心，大为邪盛故病进也。）上盛则气高，下盛则气胀，代则气衰，细则气少，涩则心痛。
（上谓寸口，下谓尺中，盛谓盛满。代脉者，动而中止，不能自还。细脉者，动如莠蓬。涩脉者，往来时不利而
蹇涩也。）浑浑革至如涌泉，病进而色弊，绵绵其去如弦绝，死。（浑浑，
言脉气浊乱也。革至者，谓脉来弦而大，实而长也。如涌泉者，言脉 但出而不返也。绵绵，言微微似有而
不甚应手也。如弦绝者，言脉卒断如弦之绝去也。若病日进面色弊恶，如此之脉皆必死也。按∶王注明确可遵，
新校正更引甲乙、脉经，非也。）
夫精明五色者，气之华也。（按∶精明以目言，五色以面言，言目之光采精明，面之五色各正，乃元气充
足，故精华发见于外也。）赤欲如白裹朱，不欲如赭；白欲如鹅羽，不欲如盐；青欲如苍璧之泽，不欲如蓝，
黄欲如罗裹雄黄，不欲黄土；黑欲如重漆色，不欲如地苍。（……按∶色贵润泽而有神也，此言五色。）夫精
明者，所以视万物，别白黑，审短长。以长为短，以白为黑，如是则精衰矣。（按∶精衰则目不精明，此盖
解精明。）
五脏者，中之守也。（按∶腑为阳，属表；脏为阴，属里。惟属里故曰中。守者，注云“五神安守之所”，
是矣。）中盛脏满，气胜伤恐者，声如从室中言，是中气之湿也。（按∶声如从室中言者，谓气闭而声不外达也。）
言而微，终日乃复言者，此夺气也。衣被不敛，言语善恶，不避亲疏者，此神明之乱也。仓廪不藏者，是门
户不要也。（要谓禁要。）水泉不止者，是膀胱不藏也。（按∶恶谓诟詈。元气削夺，则言语断续，神明昏乱，
则凡事错妄，此易明也。若仓廪不藏，世以责之脾胃，而不知胃有病则不受，脾有病则不运，今非不能受，
不能运，乃藏之不固，其责在肾。何则？肾开窍于二阴，肾虚则不能禁固，即如水泉不止，虽是膀胱不能收藏，
然其所以不能收藏者，则皆肾虚气不能摄之故也。水热穴论曰∶“肾者胃之关也。”即门户之义。）得守者生，
失守者死。（按∶神以脏藏，脏以神守，故生死因之而判焉。）
夫五脏者，身之强也。（脏安则神守，神守则身强。）头者
精明之府，头倾视深，精神将夺矣。背者胸中之府，背曲肩随，府将坏矣。腰者肾之府，转摇不能，肾将惫矣。
膝者筋之府，屈伸不能，行则偻附，筋将惫矣。骨者髓之府，不能久立，行则振掉，骨将惫矣。（按∶此皆身
之不强也。倾，侧垂也。视深，眼胞内陷也。随，谓与背俱曲也。附，别本作俯，太素作跗，俱非，盖身既伛
偻，不能独行，必倚附于物而行也。振掉，战动也。偻音楼，不能仰伸也。）得强则生，失强则死。（……按∶
常强则疾病不起，一弱则疾病随之，有不可知者矣。）
帝曰∶脉其四时动奈何？知病之所在奈何？知病之所变奈何？知病乍在内奈何？知病乍在外奈何？请问此
五者，可得闻乎？岐伯曰∶请言其与天运转大也。（按∶天之转运无穷，五者之变化亦若是也。）万物之外，六
合之内，天地之变，阴阳之应，彼春之暖，为夏之暑，彼秋之忿，为冬之怒，四变之动，脉与之上下。（六合
谓四方上下也。按∶春气融和为暖，夏气酷烈为暑，全元起以暖为缓，非也。注以忿为急解，言秋气劲急也，
良是。秋气劲急，有似于忿，冬气肃杀，则似于怒矣。气因时变，脉则与之相应如是也。）以春应中规，（春
脉弱而滑，如规之象，中外皆然，故以春应中规。）夏应中矩，（夏脉洪大，兼之滑数，如矩之象，可正平
之，故以夏应中矩也。）秋应中衡，（秋脉浮毛，轻涩而散，如秤衡之象，高下必平，故以秋应中衡。）冬应
中权，（冬脉如石，兼沉而滑，如秤权之象，下远于衡，故以冬应中权也。按∶四时迭换，脉象应之，若规
矩衡权之有不同也。四字不得太泥。）是故冬至四十五日，阳气微上，阴气微下；夏至四十五日，阴气微上，
阳气微下。阴阳有时，与脉为期，期而相失，知脉所分，分之有期，故知
死时。（察阴阳升降之准，则知经脉递迁之象，审气候递迁之失，则知气血分合之期，分期不差，故知人死
之时节。）微妙在脉，不可不察，察之有纪，从阴阳始，始之有经，从五行生，生之有度，四时为宜。（按∶
宜太素作数，非是。盖脉与四时合宜，则为无病之生脉也。）补泻勿失，与天地如一。（……按∶言治法也。）
是故阴盛则梦涉大水恐惧，阳盛则梦大火燔灼，阴阳俱盛则梦相杀毁伤。上盛则梦飞，下盛则梦堕。甚饱
则梦与，甚饥则梦取。肝气盛则梦怒，肺气盛则梦哭。短虫多则梦聚众，长虫多则梦相击毁伤。（按∶新校正
云∶“详是知阴盛则梦涉至梦哭，乃灵枢之文，误置于此，仍少心脾肾气盛则梦，今具甲乙经中。短虫多二句，
亦不当出此，应他经脱简文也。”）
是故持脉有道，虚静为宝。（前明脉应，此举持脉所由也。然持脉之道，必虚其心，静其志，乃保定盈虚而
不失。按∶王本作保，颇觉辞费。甲乙作宝，于义较通，从之，宝犹贵也。）春日浮，如鱼之游在波；
（虽出犹未全浮。按∶亦有和缓之象。）夏日在肤，泛泛乎万物有余；（泛泛，平貌。阳气大盛，脉气亦象万物
之有余，易取而洪大也。）秋日下肤，蛰虫将去；（随阳气之渐降，故曰下肤。何以明阳气之渐降？蛰虫将欲
藏去故也。）冬日在骨，蛰虫周密，君子居室。（……在骨，言脉深沉也。蛰虫周密，言阳气伏藏。君子居室，
此人事也。按∶新校正云∶详此前对帝问脉其四时动之事。）
心脉搏坚而长，当病舌卷不能言；（搏谓搏击于手也。诸脉搏坚而长者，皆为劳心而脏脉气虚极也。心手
少阴脉，从心系上挟咽喉，故令舌卷短而不能言也。按∶心脉坚长，搏击指下，火盛气
浮。舌为心苗，故卷而不能言也。注谓劳心而脏气虚极，恐坚长之脉不可概以虚断也。）其 而散者，当消环
自已。（诸脉 散，皆为气实血虚也。消谓消散，环谓环周，言其经气如环之周，当其火王自消散也。按∶
消环义殊不可解，甲乙经作消渴，王注作消散环周，俱不明确，缺疑可也。 音软。谨按心、肺、肝、胃、脾、
肾五脏一腑凡六经，其脉并以搏坚而长， 而散，分发病证。王氏俱作虚解，窃尝疑之。夫六经之脉，为象不
同，主病自异，奈何一概以坚长 散立说∶经岂无意乎？用是思之，所谓搏坚而长者，以邪实而言也；其 而
散者，以正虚而言也。一经之内，有实有虚，脉病自各相应。王注惟不明乎虚实之分，宜其言之蒙混不确也。
虽然，六经之义亦有可议者，即如心脉坚长，搏击指下，是为火盛气浮，其证甚多，岂止舌卷不能言。凡此之
类，盖亦约略言之，或止举其病之尤者言之，未可据以为实也。善读内经者，亦惟会其大意而已。）
肺脉搏坚而长，当病唾血；（按∶肺脉浮涩而短，此其常也。今反搏击坚长，是为火邪犯肺，病必唾血。唾
血者，痰涎之中见血也。）其 而散者，当病灌汗，至令不复散发也。按∶汗出于玄府，玄府者肺之合，今肺
脉散，是肺虚而邪从其合也，故当灌汗。灌汗者，汗出浸淫，有如浇灌，如是不可更为发散，令肺益虚也。
按新校正云∶“详下文诸脏各言色，而心肺二脏不言者，疑缺文也。”
肝脉搏坚而长，色不青，当病坠若搏，因血在胁下，令人喘逆（诸脉见本经之气而色不应者，皆非病从
内生，是外病来胜也。肝厥阴脉布胁肋，循喉咙之后。其支别者，复从肝贯膈，上注肺。今血在胁下，血气上
熏于肺，故令人喘逆也。按∶注解是矣，惟解坠搏处尚欠明确，今删而补之。青者肝色也，肝内病则色必外
见。今脉病而色不见，是病从外来，坠与搏者外来之病也。肝主两胁而藏血，坠若搏，因而血逆于胁下矣。血
离经则败而气秽，故上熏肺而喘逆也。）其 而散，色泽者，当病溢饮，溢饮者，渴暴多饮而易入肌皮肠胃之外
也。（面色浮泽，是为中湿。血虚中湿，水
液不消，故言当病溢饮也。水饮既满，故渗溢易而入肌皮肠胃之外也。按∶注解易字义确，甲乙经作溢，非
也。）
胃脉搏坚而长，其色赤，当病折髀；（按∶胃脉宜缓，今见坚长而搏击，是胃气有余，其色赤，是胃中有
火，宜见敦阜热渴，四肢热痛等证，而云当病折髀，真不可解。王注既不明确，欲更求其义，亦终不能，阙疑
可也。髀，股骨也。）其 而散者，当病食痹。（按∶痹注以为痛，误矣。胃主受纳，胃脉 散，则虚而水谷
为之壅闭矣，故云食痹。）
脾脉搏坚而长，其色黄，当病少气；（按∶脾脉本宜平缓，反见坚长而搏击，是失其和平之性而脾自病。
脾病则色外见，故色黄。脾胃者元气之母也，脾病则气不运，故少气。）其 而散，色不泽者，当病足 肿若
水状也。（按∶泽，润泽∶水之气也。脾者，土也，制水者也。脾脉 散，是虚不制水，水反得而侮土矣。然
水若上行，则润泽之气必见于颜面。今乃不见，是水病下行，故云当病足 肿若水状也。治此之法，实土利水
为要矣。）
肾脉搏坚而长，其色黄而赤者，当病折腰；（色气黄赤，是心脾干肾，肾受客伤，故腰如折也。腰为肾府，
故病发于中。）其 而散者，当病少血，至令不复也。（按∶肾脉宜沉实，今反 散，是精血内亏，真元何由得
复。）
帝曰∶诊得心脉而急，此为何病？病形何如？岐伯曰∶病名心疝，少腹当有形也。帝曰∶何以言之？
岐伯曰∶心为牡脏，小肠为之使，故曰少腹当有形也。（诸脉劲急者皆为寒，心为牡脏，其气应阳，今脉反寒，
故为疝也。按∶少腹注为小肠，误矣。少腹，脐下，下半腹是也。寒气聚于中，故有形。心为阳中之太阳，
故为牡脏。小肠其腑也，故云为之使。然心为牡脏二句，伯对帝问，似是发语之辞，其所以当有形意，全未说
出，故曰二字，承接不上，此处必有阙文，王氏亦竟忽略，真缺憾也。余特会其大意
而补缀之曰∶心与小肠为表里，并属火。今寒邪犯心，心为火脏，寒无所容，邪气以从其合也，寒欲犯心，
不得停留，转入小肠。小肠部分外当少腹，故少腹有形。然病本原于心，故曰心疝也。）
帝曰∶诊得胃脉，病形何如？岐伯曰∶胃脉实则胀，虚则泄。（脉实者气有余，故胀满；脉虚者气不足，
故泄利。按∶新校正云∶“详此对前帝问知病之所在。”）
帝曰∶病成而变何谓？岐伯曰∶风成为寒热，（按∶风邪中人，必为寒热。）瘅成为消中，（瘅谓湿热也，
积热于内，故变为消中也。按∶新校正云∶“详王注以善食而瘦为消中，按本经多食而数溲为消中，善食而瘦，
乃是食 之证，当云善食而溲数。”）厥成为巅疾，（厥谓气逆也，气逆上而不已，则变为上巅之疾也。）
久风为飧泄，（肝气内合而乘脾，故为是病焉。按∶风者木之化，久风不去，则木盛凌脾，故为飧泄。夕食为
飧，飧泄者夜泄利也。）脉风成为疠。风论曰∶“风寒客于脉而不去，名曰疠风。”又曰∶“疠者，有荣气
热附，其气不清，故使其鼻柱坏而色败，皮肤疡溃。”然此则癞也。按∶疠，原读作癞。病之变化，不可胜
数。（按∶新校正云∶“详此前对帝问知病之所变奈何。”）
帝曰∶诸痈肿筋挛骨痛，此皆安生？岐伯曰∶此寒气之肿，八风之变也。（八风，八方之风也。）帝曰∶治之
奈何？岐伯曰∶此四时之病，以其胜治之愈也。（胜谓胜克，如金胜木，木胜土之类。）
帝曰∶有故病五脏发动，因伤脉色，各何以知其久暴至之病乎？岐伯对曰∶悉乎哉问也！征其脉小色不夺
者，新病也；（气乏而神犹强也。）征其脉不夺其色夺者，此久病也；（神持而邪凌其气也。）征其脉与五色
脉象位于气血运行之前，切脉是四诊（望、闻、问、切）之一，凡是想要治病，只有脉诊是最为关键的。然而脉道的道理极其精微，如果不是手法熟练、心思灵敏，很少有不出现毫厘之差而谬以千里的。
所载的脉法，虽然不够详尽，但大概的内容都已经包含在这里了。
黄帝问道：诊脉的方法是怎样的？岐伯回答说：诊脉通常在平旦（清晨日出前后）进行，此时阴气尚未扰动，阳气尚未耗散，饮食尚未摄入，经脉之气尚未旺盛，络脉之气调和均匀，气血尚未紊乱，所以才能诊察出有异常的脉象。切按脉搏的动静，观察眼睛的神采，审视面部的五色，考察五脏的有余和不足、六腑的强与弱、形体的盛与衰，将这些情况相互参照比较，从而判断死生的界限。（“过”是指异于常态的征候，“切”是指用手指切近脉位。按语：动，注解说指脉动而降卑，降卑的含义很难解释。平旦之时，阳气刚开始发挥作用，人气清明，气血未乱，所以可以审察脉气的得失，平旦六句正是说明气血之所以未乱的原因。精明注作穴位名，是错误的。因为人一身的精神，都上注于目。视精明，是指观察眼睛精光的明暗，从而知道人的精气状况，看下文“夫精明者”一段就可以明白了。参伍是指比较其多寡的数量，《易经》说“参伍以变”就是这个意思。）
脉，是血液汇聚的地方。（府，就是聚的意思，是说血的多少都汇聚显现于经脉之中。所以《刺志论》说：“脉实血实，脉虚血虚，这是常理，与此相反的就是病。”由此可知。）脉长则气机调畅，脉短则气机有病，脉数则心烦，脉大则病势进展，（长为气和所以调畅，短为不足所以有病，数急为热所以心烦，大为邪盛所以病势进展。）寸口上部脉盛则气逆，尺部下部脉盛则气胀，代脉则气衰，细脉则气少，涩脉则心痛。（上指寸口，下指尺中，盛指盛满。代脉，指脉动中止，不能自行恢复。细脉，指脉动像莠蓬草一样微弱。涩脉，指脉往来时不利落而蹇涩。）脉象浑浑乱如涌泉般急促，病势进展且面色败坏；脉象绵绵似有若无如弦断绝，主死。（浑浑，是说脉气浊乱。革至，是说脉来弦大而实长。如涌泉，是说脉气只出不返。绵绵，是说微微似有而不甚应手。如弦绝，是说脉突然断绝像弦之断裂。如果病日进且面色败恶，出现这样的脉象都必死无疑。按语：王冰的注解明确可遵，新校正引用《甲乙经》、《脉经》，是不对的。）
眼睛的精明和面部的五色，是脏腑精气的外在荣华。（按语：精明指目，五色指面，说目光神采精明，面部五色端正，乃是元气充足，所以精华发见于外。）赤色想要像白布裹着朱砂，不想要像赭石；白色想要像鹅毛，不想要像盐；青色想要像青玉那样润泽，不想要像蓝草；黄色想要像罗纱裹着雄黄，不想要像黄土；黑色想要像重漆的颜色，不想要像地苍。（……按语：颜色贵在润泽而有神，这里说的是五色。）眼睛的精明，是用来观看万物，辨别黑白，审察长短。如果把长看作短，把白看作黑，这样就是精气衰败了。（按语：精衰则目不精明，这大概是解释精明。）
五脏，是体内精神守舍的地方。（按语：腑属阳，主表；脏属阴，主里。因为属里所以叫中。守，注解说“五神安守之所”，是对的。）中焦气盛、脏腑胀满，气逆伤及惊恐，声音好像从屋子里传出来似的，这是中气湿阻。（按语：声如从室中言，是说气闭阻而声音不能外达。）说话声音低微，整天才说几句话，这是夺气。衣服被子不整理，言语善恶不分，不避亲疏，这是神明混乱。仓廪（脾胃）不能藏纳，是因为门户（幽门、阑门等）没有约束。（要谓禁要。）水泉（尿液）不止，是膀胱不能藏纳。（按语：恶谓诟骂。元气削夺，则言语断续，神明昏乱，则凡事错妄，这容易明白。至于仓廪不藏，世人归咎于脾胃，却不知胃有病则不受纳，脾有病则不运化，现在不是不能受纳、不能运化，而是藏纳不固，责任在肾。为什么呢？肾开窍于二阴，肾虚则不能禁固，就像水泉不止，虽然是膀胱不能收藏，然而之所以不能收藏，都是因为肾虚气不能摄持的缘故。《水热穴论》说：“肾者胃之关也。”这就是门户的意思。）得到守舍的就生，失去守舍的就死。（按语：神由脏所藏，脏由神所守，所以生死因此判定。）
五脏，是身体强健的根本。（脏安则神守，神守则身强。）头，是精明之府，头低垂、眼窝深陷，精神将要耗夺了。背，是胸中之府，背部弯曲、肩膀下垂，府将坏了。腰，是肾之府，转动摇晃不能，肾将要疲惫了。膝，是筋之府，屈伸不能，行走则弯腰依附，筋将要疲惫了。骨，是髓之府，不能久立，行走则颤抖摇晃，骨将要疲惫了。（按语：这都是身体不强健的表现。倾，侧垂。视深，眼睑内陷。随，指与背一起弯曲。附，别本作俯，《太素》作跗，都不对，大概是身体既已伛偻，不能独行，必须倚附于物而行。振掉，战动。偻音楼，不能仰伸。）得到强健的就生，失去强健的就死。（……按语：常强则疾病不起，一旦虚弱则疾病随之而来，其中有不可预知的了。）
黄帝说：脉象随四季变动是怎样的？如何知道病在哪里？如何知道病的变化？如何知道病忽然在内？如何知道病忽然在外？请问这五点，可以听您讲讲吗？岐伯说：请允许我谈谈它与天体运转的大致规律。（按语：天体的运转无穷无尽，这五点的变化也是如此。）万物之外，六合之内（四方上下），天地的变化，阴阳的应合，那春天的温暖，变成夏天的暑热；那秋天的肃杀（忿怒），变成冬天的严寒（愤怒），四季的变化运动，脉象也随之升降。（六合指四方上下。按语：春气融和为暖，夏气酷烈为暑，全元起把暖解释为缓，不对。注解说忿为急，说秋气劲急，很好。秋气劲急，有点像忿怒，冬气肃杀，则像愤怒了。气因时而变，脉则相应如此。）春脉应合乎规（圆规）的形象，（春脉弱而滑，像规的形状，内外皆然，所以春应中规。）夏脉应合乎矩（曲尺）的形象，（夏脉洪大，兼之滑数，像矩的形状，可以正平之，所以夏应中矩。）秋脉应合乎衡（秤杆）的形象，（秋脉浮毛，轻涩而散，像秤衡的形状，高下必平，所以秋应中衡。）冬脉应合乎权（秤锤）的形象，（冬脉如石，兼沉而滑，像秤权的形状，下远于衡，所以冬应中权。按语：四季更迭变换，脉象相应，若规矩衡权有所不同。这四个字不要过于拘泥。）所以冬至后四十五日，阳气微微上升，阴气微微下降；夏至后四十五日，阴气微微上升，阳气微微下降。阴阳有时限，与脉象有约定，到了期限而脉象不符，知道脉象的分野，分野有定期，所以知道死亡的时间。（察考阴阳升降的准则，就知道经脉递迁的现象，审察气候递迁的失误，就知道气血分合的时期，分期不差，所以知道人死的时节。）脉理的微妙在于脉象，不可不仔细考察，考察它有纲纪，从阴阳开始，开始它有常规，从五行产生，产生它有法度，以顺应四时为适宜。（按语：宜，《太素》作数，不对。盖脉与四时合宜，就是无病的生脉。）补泻不要失误，与天地自然规律一致。（……按语：说的是治法。）
所以阴气盛则梦见渡大水而恐惧，阳气盛则梦见大火燃烧灼热，阴阳俱盛则梦见互相杀戮毁伤。上部盛则梦见飞翔，下部盛则梦见坠落。吃得很饱则梦见送东西给别人，饥饿得厉害则梦见向别人索取。肝气盛则梦见发怒，肺气盛则梦见哭泣。短虫多则梦见聚集众人，长虫多则梦见互相击打毁伤。（按语：新校正说：“详细考证这段从阴盛梦涉水到梦哭，是《灵枢》的文章，误置于此，还缺少心脾肾气盛则梦的内容，现在具备在《甲乙经》中。短虫多两句，也不应当出现在这里，应该是其他篇章脱落的简文。”）
所以持脉有道，虚静最为宝贵。（前面阐明脉应四时，这里提出持脉的原则。然而持脉之道，必须虚心，静志，才能保定盈虚而不失。按语：王本作保，觉得辞费。《甲乙经》作宝，于义较通，遵从它，宝犹贵也。）春脉浮，像鱼在波中游动；（虽出但未完全浮起。按语：也有和缓的意象。）夏脉在肤，泛泛乎万物有余；（泛泛，平貌。阳气大盛，脉气也象万物之有余，易取而洪大。）秋脉下肤，像蛰虫将要离去；（随着阳气逐渐下降，所以说下肤。怎么证明阳气渐降？因为蛰虫将要藏去。）冬脉在骨，像蛰虫周密，君子居室。（……在骨，说脉深沉。蛰虫周密，说阳气伏藏。君子居室，这是人事。按语：新校正说：详细考证此前回答帝问脉其四时动的事情。）
心脉搏击坚实而长，应当病舌卷缩不能说话；（搏谓搏击于手下。诸脉搏坚而长的，都是劳心导致脏脉气虚极。心手少阴脉，从心系上挟咽喉，所以令舌卷短而不能言。按语：心脉坚长，搏击指下，火盛气浮。舌为心苗，所以卷而不能言。注解说劳心而脏气虚极，恐怕坚长之脉不可以一概以虚断。）脉软而散的，应当患消渴病，等到环周之气自会消散。（诸脉软散，都是气实血虚。消谓消散，环谓环周，说其经气如环之周，当其火旺时自消散。按语：消环含义很难解释，《甲乙经》作消渴，王注作消散环周，都不明确，存疑即可。软音软。谨按心、肺、肝、胃、脾、肾五脏一腑凡六经，其脉并以搏坚而长，软而散，分别发病证。王氏都作虚解，我曾怀疑。夫六经之脉，形象不同，主病各异，怎么能一概以坚长软散立论：经文难道没有深意吗？于是思考，所谓搏坚而长，是从邪实而言；其软而散，是从正虚而言。一经之内，有实有虚，脉病自然各相应。王注只不明虚实之分，所以言之蒙混不确。虽然，六经之义也有可议之处，就如心脉坚长，搏击指下，是为火盛气浮，其证很多，岂止舌卷不能言。凡此类，大概也是约略而言，或者只举其病之最甚者言，不可据以为实。善于读《内经》的人，也只领会其大意而已。）
肺脉搏击坚实而长，应当病唾血；（按语：肺脉浮涩而短，这是常理。现在反见搏击坚长，是为火邪犯肺，病必唾血。唾血，是痰涎之中见血。）脉软而散的，应当病灌汗，至今不能再散发（治疗）。按语：汗出于玄府，玄府是肺之合，现在肺脉散，是肺虚而邪从其合，所以当灌汗。灌汗，是汗出浸淫，有如浇灌，像这样不可再发散，令肺更虚。按新校正说：“详细考证下文诸脏各言色，而心肺二脏不言者，疑缺文也。”
肝脉搏击坚实而长，面色不青，应当病坠堕或被打搏，因而血在胁下，令人喘逆（诸脉见本经之气而色不应者，皆非病从内生，是外病来胜也。肝厥阴脉布胁肋，循喉咙之后。其支别者，复从肝贯膈，上注肺。今血在胁下，血气上熏于肺，故令人喘逆也。按语：注解是对的，惟解坠搏处尚欠明确，今删而补之。青者肝色也，肝内病则色必外见。今脉病而色不见，是病从外来，坠与搏者外来之病也。肝主两胁而藏血，坠若搏，因而血逆于胁下矣。血离经则败而气秽，故上熏肺而喘逆也。）脉软而散，面色润泽的，应当病溢饮，溢饮，是口渴暴多饮而易入肌皮肠胃之外也。（面色浮泽，是为中湿。血虚中湿，水液不消，故言当病溢饮也。水饮既满，故渗溢易而入肌皮肠胃之外也。按语：注解易字义确，《甲乙经》作溢，不对。）
胃脉搏击坚实而长，其色赤，应当病折髀（大腿骨折痛）；（按语：胃脉宜缓，现在见坚长而搏击，是胃气有余，其色赤，是胃中有火，宜见敦阜热渴，四肢热痛等证，而云当病折髀，真不可解。王注既不明确，欲更求其义，亦终不能，阙疑可也。髀，股骨也。）脉软而散的，应当病食痹。（按语：痹注以为痛，误矣。胃主受纳，胃脉软散，则虚而水谷为之壅闭矣，故云食痹。）
脾脉搏击坚实而长，其色黄，应当病少气；（按语：脾脉本宜平缓，反见坚长而搏击，是失其和平之性而脾自病。脾病则色外见，故色黄。脾胃者元气之母也，脾病则气不运，故少气。）脉软而散，色不泽的，应当病足肿若水状也。（按语：泽，润泽∶水之气也。脾者，土也，制水者也。脾脉软散，是虚不制水，水反得而侮土矣。然水若上行，则润泽之气必见于颜面。今乃不见，是水病下行，故云当病足肿若水状也。治此之法，实土利水为要矣。）
肾脉搏击坚实而长，其色黄而赤者，应当病折腰；（色气黄赤，是心脾干肾，肾受客伤，故腰如折也。腰为肾府，故病发于中。）脉软而散的，应当病少血，至今不能恢复也。（按语：肾脉宜沉实，现在反软散，是精血内亏，真元何由得复。）
黄帝说：诊得心脉而急，这是什么病？病形怎样？岐伯说：病名心疝，少腹应当有形块。黄帝说：为什么这样说？岐伯说：心为牡脏，小肠为之使，所以说少腹应当有形块。（诸脉劲急者皆为寒，心为牡脏，其气应阳，现在脉反寒，故为疝也。按语：少腹注为小肠，误矣。少腹，脐下，下半腹是也。寒气聚于中，故有形。心为阳中之太阳，故为牡脏。小肠其腑也，故云为之使。然心为牡脏二句，伯对帝问，似是发语之辞，其所以当有形意，全未说出，故曰二字，承接不上，此处必有阙文，王氏亦竟忽略，真缺憾也。余特会其大意而补缀之曰∶心与小肠为表里，并属火。今寒邪犯心，心为火脏，寒无所容，邪气以从其合也，寒欲犯心，不得停留，转入小肠。小肠部分外当少腹，故少腹有形。然病本原于心，故曰心疝也。）
黄帝说：诊得胃脉，病形怎样？岐伯说：胃脉实则胀，虚则泄。（脉实者气有余，故胀满；脉虚者气不足，故泄利。按语：新校正说：“详细考证此对前帝问知病之所在。”）
黄帝说：病成而变是什么意思？岐伯说：风成为寒热，（按语：风邪中人，必为寒热。）瘅成为消中，（瘅谓湿热也，积热于内，故变为消中也。按语：新校正说：“详细考证王注以善食而瘦为消中，按本经多食而数溲为消中，善食而瘦，乃是食之证，当云善食而溲数。”）厥成为巅疾，（厥谓气逆也，气逆上而不已，则变为上巅之疾也。）久风为飧泄，（肝气内合而乘脾，故为是病焉。按语：风者木之化，久风不去，则木盛凌脾，故为飧泄。夕食为飧，飧泄者夜泄利也。）脉风成为疠。《风论》说：“风寒客于脉而不去，名曰疠风。”又说：“疠者，有荣气热附，其气不清，故使其鼻柱坏而色败，皮肤疡溃。”然此则癞也。按语：疠，原读作癞。病之变化，不可胜数。（按语：新校正说：“详细考证此前对帝问知病之所变奈何。”）
黄帝说：各种痈肿筋挛骨痛，这些是怎么产生的？岐伯说：这是寒气之肿，八风之变也。（八风，八方之风也。）黄帝说：怎么治疗？岐伯说：这是四时之病，以其胜治之愈也。（胜谓胜克，如金胜木，木胜土之类。）
黄帝说：有旧病五脏发动，因伤脉色，各怎样知道是新病还是久病？岐伯回答说：问得真详细啊！征验其脉小色不夺的，是新病；（气乏而神犹强也。）征验其脉不夺其色夺的，是久病也；（神持而邪凌其气也。）征验其脉与五色
Pulse is located prior to the movement of Qi and Blood. Palpation (Qie Zhen) is one of the Four Diagnostic Methods (Wang, Wen, Wen, Qie). In order to treat diseases, pulse diagnosis is paramount. However, the principles of pulse are extremely subtle. Unless one possesses skilled hands and a quick mind, it is rare not to make errors that lead to significant deviations from the truth.
Although the recorded pulse methods are not very detailed, the general outline is fully contained here.
The Yellow Emperor asked: "What is the method of diagnosis?"
Qi Bo replied: "Diagnosis is usually performed at dawn (Ping Dan). At this time, Yin Qi has not yet moved, Yang Qi has not yet dispersed, food and drink have not been taken in, the Jing Luo (Primary and Secondary Channels) are not yet vigorous, the collateral vessels are harmonious and uniform, and Qi and Blood are not yet chaotic. Therefore, only then can abnormal pulses be diagnosed." By palpating the movement and stillness of the pulse, observing the clarity of the eyes (Jing Ming), examining the five colors of the face, and assessing the excess or deficiency of the Five Zang Organs (Liver, Heart, Spleen, Lung, Kidney), the strength or weakness of the Six Fu Organs (Gallbladder, Small Intestine, Stomach, Large Intestine, Bladder, San Jiao), and the flourishing or decline of the physical form, these factors are compared and cross-referenced (Can Wu) to determine the boundary between life and death. ("Guo" refers to signs different from the normal state; "Qie" refers to pressing the finger close to the pulse. Note: 'Dong' is interpreted by some as pulse movement descending, but this meaning is hard to explain. At dawn, Yang Qi begins to function, human Qi is clear and bright, and Qi and Blood are not yet chaotic, so the gain or loss of pulse Qi can be examined. The six sentences about dawn explain why Qi and Blood are not yet chaotic. Interpreting 'Jing Ming' as an acupoint name is incorrect. The spirit of the whole body ascends to the eyes. Observing 'Jing Ming' means observing the brightness or dimness of the eye's spirit to know the person's essence and Qi, as seen in the following passage on 'Fu Jing Ming Zhe'. 'Can Wu' means comparing numbers of excess or deficiency, as stated in the I Ching: 'Can Wu Yi Bian'.)
The pulse is the residence (Fu) of Blood. (Fu means gathering; it means that the quantity of blood gathers and manifests in the Jing Luo.) Thus, the *Treatise on Acupuncture and Qi* says: "When the pulse is full, Blood is full; when the pulse is empty, Blood is empty. This is the norm; deviation from this indicates disease."
A long pulse indicates regulated Qi; a short pulse indicates diseased Qi; a rapid pulse indicates vexation of the heart; a large pulse indicates advancing disease. (Long indicates harmonious Qi and thus regulation; short indicates insufficiency and thus disease; rapid and urgent indicates Heat causing vexation; large indicates abundant pathogenic factors and thus advancing disease.) Excess in the upper part (Cun Kou / Inch position) indicates rebellious Qi; excess in the lower part (Chi position) indicates abdominal distension; a choppy/intermittent pulse (Dai Mai) indicates declining Qi; a thin pulse indicates deficient Qi; a choppy pulse (Se Mai) indicates heart pain. (Upper refers to Cun Kou, Lower refers to Chi Zhong, Excess refers to fullness. Dai Mai is characterized by pauses in the beat that do not self-correct. Xi Mai beats faintly like weeds. Se Mai is unsmooth and hesitant in its flow.) If the pulse is turbid and rushing like a gushing spring, the disease advances and the complexion deteriorates; if the pulse is faint and disappearing like a broken string, death ensues. (Hun Hun describes turbid and chaotic pulse Qi. Ge Zhi describes a pulse that is wiry, large, solid, and long. Like a gushing spring means the pulse flows out but does not return. Mian Mian describes a pulse that is faintly present but not easily felt. Like a broken string means the pulse suddenly cuts off like a severed string. If the disease progresses daily and the complexion becomes sallow, such pulses indicate certain death. Note: Wang Bing's commentary is clear and should be followed; the New Correction citing *Jia Yi Jing* and *Mai Jing* is incorrect.)
The clarity of the eyes and the five colors of the face are the blossoms (Hua) of Qi. (Note: Jing Ming refers to the eyes, Wu Se refers to the face. Clear eyes and correct facial colors indicate sufficient Yuan Qi, whose essence manifests externally.) Red should resemble white silk wrapping cinnabar, not hematite; White should resemble goose feathers, not salt; Green should resemble the luster of green jade, not indigo; Yellow should resemble raw yellow earth wrapped in silk, not plain yellow earth; Black should resemble heavy lacquer, not dark soil. (...Note: Colors should be moist and spirited; this discusses the five colors.) The clarity of the eyes is used to see all things, distinguish black from white, and judge length and shortness. If one mistakes long for short and white for black, the Essence is depleted. (Note: Depletion of Essence leads to lack of clarity in the eyes; this explains 'Jing Ming'.)
The Five Zang Organs are the guardians within. (Note: Fu organs are Yang and exterior; Zang organs are Yin and interior. Because they are interior, they are called 'Zhong' (Middle/Inside). Guardian refers to the place where the Five Spirits reside securely.) If there is excess in the Middle with organ fullness, and Qi rebellion injuring fear, the voice sounds as if coming from inside a room; this is dampness in the Middle Qi. (Note: Voice sounding like it comes from a room indicates Qi blockage preventing sound from reaching outside.) Speaking in a low voice and only speaking again after a whole day indicates depletion of Qi. Wearing clothes and blankets disheveled, speaking without regard for good or bad, and not avoiding intimacy or distance with relatives and strangers indicates chaos of the Spirit (Shen). Failure of the Granary (Spleen/Stomach) to store indicates failure of the gates to control. (Yao means restriction/control.) Unceasing urine indicates failure of the Bladder to store. (Note: E stands for abuse. When Yuan Qi is depleted, speech is intermittent; when Shen is confused, actions are erroneous, which is easy to understand. Regarding failure of the Granary to store, people blame the Spleen and Stomach, not realizing that if the Stomach is diseased it cannot receive, and if the Spleen is diseased it cannot transport. Here, it is not inability to receive or transport, but inability to store firmly, which is the responsibility of the Kidney. Why? The Kidney opens into the two yin openings. Kidney deficiency leads to inability to secure, just as unceasing urine, although it is the Bladder's failure to store, is ultimately due to Kidney Qi failing to hold. *Water Heat Acupoint Treatise* says: "The Kidney is the gate of the Stomach." This implies the meaning of the gate.) Those who retain their guardians live; those who lose them die. (Note: Spirit is stored by the Zang, and the Zang is guarded by the Spirit, so life and death are judged by this.)
The Five Zang Organs are the strength of the body. (When Zang are peaceful, Shen is guarded; when Shen is guarded, the body is strong.) The head is the residence of Jing Ming. If the head droops and the eyes are sunken, the Spirit is about to be depleted. The back is the residence of the Chest. If the back is curved and shoulders sag, the residence is about to fail. The waist is the residence of the Kidney. If turning and shaking is impossible, the Kidney is about to be exhausted. The knees are the residence of the Sinews. If flexion and extension are impossible, and walking requires stooping and leaning, the Sinews are about to be exhausted. The bones are the residence of Marrow. If standing for long periods is impossible, and walking causes trembling, the Bones are about to be exhausted. (Note: These are all signs of bodily weakness. Qing means tilting down. Shi Shen means sunken eye sockets. Sui means bending along with the back. Fu means leaning on objects because the body is too stooped to walk alone. Zhen Diao means trembling. Lou means inability to extend upright.) Those who retain strength live; those who lose strength die. (...Note: Constant strength prevents disease; once weak, disease follows, with unpredictable consequences.)
The Emperor said: "How does the pulse move with the four seasons? How do we know the location of the disease? How do we know the changes of the disease? How do we know when the disease is suddenly internal? How do we know when the disease is suddenly external? Please tell me about these five points."
Qi Bo said: "Let me speak of how they correspond to the great rotation of Heaven." (Note: The rotation of Heaven is endless, and the changes of these five points are similar.) Outside all things, within the Six Directions (Si He - North, South, East, West, Up, Down), the changes of Heaven and Earth, the response of Yin and Yang: the warmth of spring becomes the heat of summer; the severity (fen) of autumn becomes the anger (nu) of winter. The movement of the four changes corresponds to the rising and falling of the pulse. (Six Directions refer to the four cardinal directions plus up and down. Note: Spring Qi is harmonious and warm; Summer Qi is intense and hot. Quan Quanyi interpreted 'warm' as slow, which is incorrect. The commentary interprets 'fen' as urgent, describing Autumn Qi as sharp and urgent, which is good. Autumn Qi is sharp like anger; Winter Qi is肃杀 (solemn and killing) like rage. Qi changes with the times, and the pulse responds accordingly.) Spring pulse corresponds to the Circle (Gui); (Spring pulse is weak and slippery, resembling the shape of a circle, so Spring corresponds to Gui.) Summer pulse corresponds to the Square (Ju); (Summer pulse is洪大 (vast/large), combined with slippery and rapid, resembling the shape of a square, so Summer corresponds to Ju.) Autumn pulse corresponds to the Balance (Heng); (Autumn pulse is floating and fine, light, choppy, and scattered, resembling the balance of a scale, so Autumn corresponds to Heng.) Winter pulse corresponds to the Weight (Quan); (Winter pulse is like stone, combined with deep and slippery, resembling the weight of a scale, so Winter corresponds to Quan. Note: As the four seasons change, the pulse images respond differently, like the circle, square, balance, and weight. Do not interpret these four characters too rigidly.) Therefore, forty-five days after the Winter Solstice, Yang Qi slightly rises, and Yin Qi slightly descends; forty-five days after the Summer Solstice, Yin Qi slightly rises, and Yang Qi slightly descends. Yin and Yang have their times, and the pulse has its period. If the period passes and the pulse deviates, knowing the division of the pulse, and knowing that divisions have periods, one can know the time of death. (By observing the standard of Yin and Yang ascent and descent, one knows the image of meridian transition; by examining the loss of climatic transition, one knows the period of Qi and Blood combination and separation. If the division is accurate, one knows the time of death.) The subtlety lies in the pulse, which must not be neglected. Examination has a discipline, starting from Yin and Yang. Starting has classics, generated from the Five Elements. Generation has limits, appropriate for the four seasons. (Note: 'Yi' (appropriate) is written as 'Shu' (number) in *Tai Su*, which is incorrect. Pulse harmonizing with the four seasons indicates a healthy pulse.) Do not miss tonification or sedation; align with Heaven and Earth. (...Note: This refers to treatment methods.)
Therefore, when Yin is excessive, one dreams of crossing large waters and feeling fear; when Yang is excessive, one dreams of large fires burning; when both Yin and Yang are excessive, one dreams of killing and destruction. Excess in the upper part leads to dreams of flying; excess in the lower part leads to dreams of falling. Being very full leads to dreams of giving; being very hungry leads to dreams of taking. Liver Qi excess leads to dreams of anger; Lung Qi excess leads to dreams of crying. Many short parasites lead to dreams of gathering crowds; many long parasites lead to dreams of fighting and destruction. (Note: New Correction states: "Detailed examination shows that from 'Yin excess dreams of crossing water' to 'dreams of crying', this is text from *Ling Shu* misplaced here. It also lacks content regarding Heart, Spleen, and Kidney Qi excess, which is found in *Jia Yi Jing*. The lines about short and long parasites should not appear here and are likely lost slips from other chapters.")
Therefore, holding the pulse has a way: emptiness and stillness are precious. (Previously explained pulse response to seasons; now stating the principle of holding the pulse. The way of holding the pulse requires an empty mind and quiet will, to preserve surplus and deficit without error. Note: Wang's version uses 'Bao' (protect), which seems verbose. *Jia Yi Jing* uses 'Bao' (treasure), which makes more sense. We follow it; Bao means precious.) Spring pulse floats, like fish swimming in waves; (Though emerging, not fully floating. Note: Also has a gentle and slow image.) Summer pulse is in the skin, abundant like all things in summer; (Fan Fan means flat/surplus. Yang Qi is abundant, pulse Qi also resembles the abundance of all things, easy to take and vast/large.) Autumn pulse is below the skin, like hibernating insects preparing to leave; (Following the gradual descent of Yang Qi, hence 'below skin'. How do we know Yang Qi is descending? Because hibernating insects are about to hide.) Winter pulse is in the bone, like hibernating insects tightly packed, and gentlemen staying indoors. (...In bone means pulse is deep. Hibernating insects tightly packed means Yang Qi is hidden. Gentlemen staying indoors is human affairs. Note: New Correction states: "Detailed examination shows this previously answered the Emperor's question about pulse movement with the four seasons.")
If the Heart pulse beats firm and long, one should suffer from tongue retraction and inability to speak; (Bo means beating against the hand. All pulses that are firm and long indicate Heart labor leading to extreme deficiency of Zang pulse Qi. The Heart Hand-Shaoyin Meridian ascends from the Heart connection alongside the throat, causing tongue retraction and inability to speak. Note: Heart pulse firm and long, beating against fingers, indicates Fire excess and Qi floating. The tongue is the sprout of the Heart, hence retraction and inability to speak. The commentary attributes it to Heart labor and extreme Zang Qi deficiency, but it is doubtful that a firm and long pulse can be generally diagnosed as deficiency.) If the pulse is soft and scattered, one should suffer from Xiao Ke (Wasting-Thirst), which will resolve itself when the cycle completes. (All soft and scattered pulses indicate Qi excess and Blood deficiency. Xiao means dissipate, Huan means cycle, indicating its Jing Qi circulates like a ring, and when Fire is king, it dissipates naturally. Note: The meaning of 'Xiao Huan' is hard to explain. *Jia Yi Jing* reads 'Xiao Ke', Wang Bing reads 'dissipate around the cycle', neither is clear. Leave as doubt. Ruan sounds like ruan. Carefully: The Heart, Lung, Liver, Stomach, Spleen, and Kidney (Five Zang and one Fu, six meridians) all have pulses that are firm/long or soft/scattered, corresponding to different diseases. Wang Bing interprets all as deficiency. I have doubted this. The six meridians have different images and govern different diseases; how can they all be explained by firm/long and soft/scattered? Does the scripture have no intent? Upon reflection, 'firm and long' refers to Pathogenic Excess; 'soft and scattered' refers to Healthy Deficiency. Within one meridian, there is both excess and deficiency, and pulse and disease correspond respectively. Wang Bing failed to clarify the distinction between excess and deficiency, hence his vague and inaccurate statements. Although, the meaning of the six meridians is also debatable. For example, Heart pulse firm and long, beating against fingers, indicates Fire excess and Qi floating, which has many symptoms, not just tongue retraction. Such cases are likely generalizations or examples of the most severe symptoms, and should not be taken as absolute facts. Those who read *Nei Jing* well only grasp the general idea.)
If the Lung pulse beats firm and long, one should suffer from spitting blood; (Note: Lung pulse is normally floating, choppy, and short. Now it beats firm and long, indicating Fire pathogen attacking the Lung, causing spitting blood. Spitting blood means blood in saliva/phlegm.) If the pulse is soft and scattered, one should suffer from Guan Han (Pouring Sweat), which cannot be treated with diaphoresis anymore. Note: Sweat comes from Xuan Fu (pores), which is the union of the Lung. Now the Lung pulse is scattered, indicating Lung deficiency and pathogens entering through its union, hence Pouring Sweat. Guan Han means sweat oozes like pouring water; in such cases, further diaphoresis should not be used, as it would further weaken the Lung. Note New Correction: "Detailed examination shows that while other Zang discuss colors, Heart and Lung do not, suggesting missing text."
If the Liver pulse beats firm and long, and the color is not green, one should suffer from falling or beating injuries, with blood trapped under the ribs, causing wheezing and counterflow qi. (When pulses show the Qi of the respective meridian but the color does not match, the disease does not originate internally but comes from outside to overcome. The Liver Jueyin Meridian distributes to the hypochondrium and follows behind the throat. Its branch passes through the Liver, crosses the diaphragm, and enters the Lung. Now blood is under the ribs, and blood Qi steams upward to the Lung, causing wheezing and counterflow qi. Note: The commentary is correct, but the explanation of 'falling/beating' is unclear. Supplementing: Green is the color of the Liver. Internal Liver disease must manifest externally in color. Now the pulse indicates disease but the color does not, meaning the disease comes from outside. Falling and beating are external injuries. The Liver governs the hypochondrium and stores Blood. Falling or beating causes blood to rebel under the ribs. Blood leaving the vessels becomes stale and foul, steaming upward to the Lung and causing wheezing.) If the pulse is soft and scattered, and the complexion is lustrous, one should suffer from Yi Yin (Overflowing Drink). Yi Yin means sudden thirst and excessive drinking, with fluid easily entering outside the muscle, skin, stomach, and intestines. (Floating and lustrous complexion indicates internal Dampness. Blood deficiency with internal Dampness leads to failure of fluid metabolism, hence Yi Yin. Once fluid fills up, it overflows easily into muscle, skin, stomach, and intestines. Note: The commentary on 'Yi' is correct; *Jia Yi Jing* reads 'Yi', which is incorrect.)
If the Stomach pulse beats firm and long, and the color is red, one should suffer from She Bi (fractured thigh pain). (Note: Stomach pulse should be slow. Now it is firm, long, and beating, indicating Stomach Qi excess. Red color indicates Fire in the Stomach. Symptoms should include abundant food intake, heat, thirst, and limb pain, but the text says 'She Bi', which is inexplicable. Wang Bing's commentary is unclear, and seeking further meaning is futile. Leave as doubt. Bi refers to the femur.) If the pulse is soft and scattered, one should suffer from Shi Bi (Food Bi). (Note: Bi interpreted as pain by commentators is incorrect. The Stomach governs reception. Soft and scattered Stomach pulse indicates deficiency, causing water and grain to become blocked, hence Food Bi.)
If the Spleen pulse beats firm and long, and the color is yellow, one should suffer from Shao Qi (deficient Qi). (Note: Spleen pulse should be smooth and slow. Firm, long, and beating indicates loss of peaceful nature and Spleen disease. Spleen disease manifests externally in color, hence yellow. Spleen and Stomach are the mother of Yuan Qi. Spleen disease leads to non-transportation of Qi, hence deficient Qi.) If the pulse is soft and scattered, and the color is not lustrous, one should suffer from foot swelling resembling water. (Note: Ze means moist/lustrous, the Qi of Water. Spleen is Earth, controlling Water. Soft and scattered Spleen pulse indicates deficiency failing to control Water, allowing Water to insult Earth. If Water ascends, moist Qi would appear on the face. Since it does not, Water disease descends, hence foot swelling. Treatment involves strengthening Earth and promoting water drainage.)
If the Kidney pulse beats firm and long, and the color is yellow and red, one should suffer from Zhe Yao (broken waist pain). (Yellow and red colors indicate Heart and Earth insulting the Kidney, causing the Kidney to suffer from guest pathogens, hence waist pain like breaking. Waist is the residence of the Kidney, hence disease originates internally.) If the pulse is soft and scattered, one should suffer from Shao Xue (deficient Blood), unable to recover. (Note: Kidney pulse should be deep and solid. Now it is soft and scattered, indicating internal deficiency of Essence and Blood. How can True Yuan recover?)
The Emperor said: "Palpating the Heart pulse, it is urgent. What disease is this? What are the symptoms?"
Qi Bo said: "The disease name is Xin Shan (Heart Hernia), and there should be a mass in the lower abdomen."
The Emperor said: "Why do you say so?"
Qi Bo said: "The Heart is a Mu (Yang) Zang, and the Small Intestine is its envoy, therefore there should be a mass in the lower abdomen." (Urgent pulses all indicate Cold. The Heart is a Mu Zang, its Qi corresponds to Yang. Now the pulse indicates Cold, hence Hernia. Note: Interpreting 'lower abdomen' as Small Intestine is incorrect. Lower abdomen is below the navel, the lower half of the abdomen. Cold Qi gathers in the middle, hence a mass. The Heart is Tai Yang within Yang, hence a Mu Zang. The Small Intestine is its Fu, hence 'envoy'. However, the two sentences 'Heart is Mu Zang...' seem like introductory remarks in Qi Bo's answer to the Emperor. The reason for the mass is not explained, so the word 'Gu' (therefore) does not connect properly. There must be missing text here, which Wang Bing ignored, a true regret. I summarize the general idea and supplement: Heart and Small Intestine are interior-exterior pairs, both belonging to Fire. Now Cold pathogen attacks the Heart. The Heart is a Fire Zang, having no place for Cold, so the pathogen follows its union. Cold wanting to attack the Heart cannot stay, and transfers to the Small Intestine. The Small Intestine region corresponds externally to the lower abdomen, hence a mass in the lower abdomen. However, the disease originates in the Heart, hence 'Heart Hernia'.)
The Emperor said: "Palpating the Stomach pulse, what are the symptoms?"
Qi Bo said: "Stomach pulse excess indicates distension; deficiency indicates diarrhea." (Excess pulse means Qi surplus, hence distension; deficiency pulse means Qi insufficiency, hence diarrhea. Note: New Correction states: "Detailed examination shows this answers the Emperor's previous question about knowing the location of disease.")
The Emperor said: "What is meant by disease formation and transformation?"
Qi Bo said: "Wind becomes Cold-Heat; (Note: Wind pathogen invading humans always causes Cold-Heat.) Dan becomes Xiao Zhong; (Dan means Damp-Heat. Accumulated Heat internally transforms into Xiao Zhong. Note: New Correction states: "Wang Bing interprets Xiao Zhong as eating much and losing weight. According to this classic, Xiao Zhong is eating much and urinating frequently. Eating much and losing weight is actually Shi Gu disease; it should be said 'eating much and frequent urination'.") Jue becomes Dian Ji; (Jue means Qi rebellion. Qi rebelling upward without stopping transforms into disease at the vertex.) Long-term Wind becomes Sun Xie; (Liver Qi internally combines and overacts on Spleen, causing this disease. Note: Wind is the transformation of Wood. Long-term Wind not departing leads to Wood excess insulting Spleen, hence Sun Xie. 'Sun' means evening meal; Sun Xie is night diarrhea.) Pulse Wind becomes Li. *Feng Lun* says: 'Cold and Wind lodge in the pulse and do not depart, named Li Feng.' It also says: 'Li means Ying Qi has Heat attachment, its Qi is not clear, hence causing the nasal pillar to collapse and complexion to fail, skin ulcers and溃烂.' However, this is Leprosy (Lei). Note: Li originally reads Lei. Transformations of disease are countless. (Note: New Correction states: "Detailed examination shows this answers the Emperor's previous question about knowing disease transformations.")
The Emperor said: "Various abscesses, sinew spasms, and bone pain, how are these generated?"
Qi Bo said: "These are swellings of Cold Qi and changes of the Eight Winds." (Eight Winds refer to winds from the eight directions.)
The Emperor said: "How to treat them?"
Qi Bo said: "These are diseases of the four seasons; treat them with their overcoming [element] to cure." (Sheng means overcoming, e.g., Metal overcomes Wood, Wood overcomes Earth.)
The Emperor said: "If there is an old disease where the Five Zang activate, damaging the pulse and color, how can one distinguish whether it is a new or old disease?"
Qi Bo replied: "You ask thoroughly! If the pulse is small but the color is not depleted, it is a new disease; (Qi is lacking but Shen is still strong.) If the pulse is not depleted but the color is depleted, it is an old disease; (Shen holds but Evil insults Qi.) If the pulse and five colors..."