经中论阴阳之类多矣，而此篇所言，乃取手足三阴三阳之脉，形见于寸口者，为之比类而较论之，以补从
前之所未备，虽言证不详，然亦有可采之句焉。
孟春始至，黄帝燕坐，临观八极，正八风之气而问雷公曰∶阴阳之类，经脉之道，五中所主，何脏最贵？
（孟春始至，谓立春之日也。燕，安也。观八极，谓视八方远际之色。正八风，谓候八方之风，朝会于太一者
也。五中谓五脏。按∶杨上善云∶“夫天为阳，地为阴，人为和。阴无其阳，衰杀无已；阳无其阴，生长不止。
生长不止则伤于阴，阴伤则阴灾起；衰杀不已则伤于阳，阳伤则阳祸生矣。故须圣人在天地间，和阴阳气，
令万物生也。和气之道，谓先修身为德则阴阳气和，阴阳气和则八节风调，八虚风止，于是疵疠不起，嘉祥日
集，此亦不知所以然而然也。故黄帝问身之经脉贵贱，根据之调摄，修德于身，以正八风之气。”）雷公对曰∶
春、甲乙、青，
中主肝，治七十二日，是脉之主时，臣以其脏最贵。（东方甲乙，春气主之。金匮真言论曰∶“东方青色，入
通于肝。”故曰青中主肝也。然五行之气，各王七十二日，五积而乘之，则终一岁之数三百六十日，故云治七十
二日也。夫四时之气，以春为始，五脏之应，肝脏合之，公故以其脏为最贵也。）
帝曰∶却念上下经，阴阳从容，子所言贵，最其下也。雷公致斋七日，旦复侍坐。（悟非，故斋以洗心。
愿益，故坐而复请。）帝曰∶三阳为经，二阳为维，一阳为游部。（……经谓经纶，所以济成务。维谓维持，
所以系天真。游谓游行，部谓身形部分也。故主气者济成务，化谷者系天真，主色者散布精微，游行诸部也。
按∶新校正云∶“杨上善云∶三阳，足太阳脉也，从目内 上头，分为四道，下项并正别脉上下六道以行于背，
与身为经。二阳，足阳明脉也，从鼻而起，下咽，分为四道，并正别脉六道，上下行腹，网维于身。一阳，
足少阳脉也，起目外 ，络头，分为四道，下缺盆，并正别脉六道上下，主经营百节，流气三部，故曰游部。”）
三阳为表，二阴为里，（少阴与太阳为表里故云。按∶太阳，膀胱；少阴，肾也。）一阴至绝作朔晦，却具合
以正其理。（一阴，厥阴也，厥犹尽也。灵枢经曰∶“亥为左足之厥阴，戌为右足之厥阴，两阴俱尽，故曰厥阴。”
夫阴尽为晦，阴生为朔，厥阴者，以阴尽为义也。征其气王则朔，适言其气尽则晦，既见其朔，又当其晦，
故曰一阴至绝作朔晦也。然征彼俱尽之阴，合此发生之木，以正应五行之理而无替循环，故云却具合以正其理
也。按∶新校正云∶“注言阴生为朔，疑是阳生为朔。”是也，宜改从之。又按此节文义，殊难解释，注虽曲
为之辞，亦似未确，其中必有脱误，阙疑可也。）雷公曰∶受业未能明。帝曰∶所谓三阳者，太阳为经，（阳
气盛大，故曰太阳。按∶大者为经，小者为脉，太阳主表，为诸脉之大经也。）三阳脉至手太阴，弦浮而不
沉，决以度，察以心，合之阴阳之论。（太阴为寸口也，寸口
者手太阴也，脉气之所行，故脉皆至于寸口也。太阳之脉，洪大以长，今弦浮不沉，则当约以四时高下之度而
决断之，察以五脏异同之候而参合之，以应阴阳之论，知其臧否耳。按∶诸脉至手太阴俱有得失，而太阳独无，
疑此处必有脱简也。）所谓二阳者，阳明也。（灵枢经曰∶“辰为左足之阳明，巳为右足之阳明。”两阳合明，
故曰二阳者，阳明也。）至手太阴，弦而沉急不鼓，炅至以病，皆死。（鼓谓鼓动。炅，热也。阳明之脉，浮大
而短，今弦而沉急不鼓者，是阴气胜阳，木来乘土也。而反热病至者，是阳气之衰败，犹灯之焰，欲灭反明，
故皆死也。）一阳者，少阳也，（阳气未大，故曰少阳。）至手太阴，上连人迎，弦急悬不绝，此少阳之病也，
（人迎谓结喉两旁一寸五分脉动应手者也。弦为少阳之脉，今急悬不绝，是经气不足，故曰少阳之病也。悬者，
谓如悬物之动摇也。）专阴则死。（专，独也，言其独有阴气而无阳气则死。）三阴者，六经之所主也，（三阴，
太阴也。言所以诸脉皆至手太阴者何？以是六经之主故也。六经谓三阴三阳之经脉，所以至手太阴者何？以肺
朝百脉之气，皆交会于气口也。故下文曰∶）交于太阴，（此正发明肺朝百脉之义也。经脉别论曰∶“肺朝百
脉。”）伏鼓不浮，上空志心。（按∶杨上善云∶“肺脉浮涩，此为平也，今见伏鼓，是肾脉也。足少阴脉，
贯脊属肾，上入肺中，从肺出络心。肺气下入肾志，上入心神也。”王氏谓志心为小心，义未通。杨说较注似
胜，但以伏鼓为肾脉，谓肺气下入肾志，上入心神，亦属牵强。愚谓肺脉宜浮而反见沉伏，且于伏中鼓动，
是气闭而火动也。空犹控也，志心犹言心志也，心之志为神。肺位本在心上，今肺脉既见伏鼓不浮，是气反抑
于心之下，气闭火动上控心，而心神亦为之动也。此伏鼓的是手太阴本经自至之脉，非若余五脉之至手太阴者
比，杨氏盖惑于此也。）二阴至肺，其气归膀胱，外连脾胃。（二阴谓足少阴肾之脉。少阴之脉，别行者，入
跟中，以上至股内后廉，贯脊属肾络膀胱。其直行者，从肾上贯肝膈，入肺中。故上至于肺，其气归于膀胱，
外连于脾胃。
按∶肾与膀胱为表里，其气本相通，肾又为胃关，脾胃之气实原于命门，故肾脉之见于寸口者，其气内归于
膀胱，外连于脾胃，盖以经脉相通之气言也。）一阴独至，经绝气浮不鼓，钩而滑。（若一阴独至肺，经气内
绝，则气浮不鼓于手；若经不内绝，则钩而滑。按∶一阴，厥阴肝木也。独至者，不兼他脉也。肝脉来见于肺，
木性畏金，故其气欲绝而不能鼓动。然木中有火，火能凌金，故又有浮滑之象也。）此六脉者，乍阴乍阳，交
属相并，缪通五脏，合于阴阳，（按∶六经之脉各有阴阳，其互见于寸口也，或阴中见阳，或阳中见阴，或
一脉而兼数病，或一病而见数脉，交属缪通，而总于寸口决之，以知五脏之阴阳，合与不合，从一可知也。）
先至为主，后至为客。（脉气乍阴见阳，乍阳见阴，何以别之？当以先至为主，后至为客也。至谓至寸口也。）
雷公曰∶臣悉尽意，受传经脉，颂得从容之道，以合从容，不知阴阳，不知雌雄。（按∶帝所言从容之道，脉
有阴阳之分，证有雌雄之别，虽尽心讲颂，欲知之而不能，必如何而可也。）帝曰∶三阳为父，（父所以督济
群小，言高尊也。）二阳为卫，（卫所以却御诸邪，言扶生也。）一阳为纪；（纪所以纲纪形气，言其平也。）
三阴为母，（母所以育养诸子，言滋生也。）二阴为雌，（雌者，阴之目也。）一阴为独使。（一阴之脏，外合
三焦，三焦主谒导诸气，名为使者，故云独使也。）二阳一阴，阳明主病，不胜一阴， 而动，九窍皆沉。（一
阴，厥阴肝木气也。二阳，阳明胃土气也。木土相薄，故阳明主病也。木伐其土，土不胜木，故云不胜一阴。
脉而动者， 为胃气，动谓木形，木土相持，则胃气不转，故九窍沉滞而不通利也。按∶自此以下，言阴阳
各经参错为病，即前所谓交属缪通也。）三阳一阴，太阳脉胜，一阴不能止，内乱五脏，外为惊骇。（三阳，足太
阳之气，故曰太阳胜也。木生火，今盛阳燔木，木复受之，阳气洪盛，内为狂热，故内乱五脏也。肝主惊骇，
故外形惊骇
之状也。）二阴二阳，病在肺，少阴脉沉，胜肺伤脾，外伤四肢。（二阴谓手少阴心之脉。二阳亦胃脉也。心
胃合病，邪上下并，故外伤脾，内胜肺也。所以然者，胃为脾府，心火胜金故尔。脾主四肢，故脾伤则外伤于
四肢矣。少阴脉谓手掌后五分当小指，神门之脉也。按∶新校正云∶“详此二阳，乃手阳明大肠，肺之腑也。
少阴心火胜金之腑，故云病在肺。王氏以二阳为胃，义未甚通，况又以见胃病肾之说，此乃是心病肺也。”）
二阴二阳皆交至，病在肾，骂詈妄行，巅疾为狂。（二阴为肾，水之脏也；二阳为胃，土之府也。土气刑水，
故交至而病在肾也。以肾水不胜，故胃盛而巅为狂。按∶巅当作癫，癫属二阴，狂属二阳。）二阴一阳，病出
于肾，阴气客游于心，脘下空窍，堤闭塞不通，四肢别离。（一阳，谓手少阳三焦，心主火之腑也。水上干火，
故病出于肾，阴气客游于心也。何者？肾之脉，从肾上贯肝膈，入肺中。其支别者，从肺中出络心，注胸中。
故如是也。然空窍阴客上游，胃不能制，胃不能制是土气衰，故脘下空窍皆不通也。言堤者，谓如堤堰不容泄
漏。胃脉循足，心脉络手，故四肢如别离而不用也。按∶病出于肾，谓病由肾出也，与前病在肺肾者不同。
肾为阴脏，故其气亦阴。三焦为火腑，内贯三停，外通九窍。故肾水为病，阴气充斥，上自心腕，下及诸窍，
而令闭塞如堤也。四肢本属胃土，水盛则反侮土，故亦令别离也。注言土衰近是，而新校正非之，误矣。）
一阴一阳代绝，此阴气至心，上下无常，出入不知，咽喉干燥，病在土脾。（一阴，厥阴肝脉，一阳，少阳胆脉，
并木之气也。代绝者，动而中止也，以其代绝，故为病也。木气生火，故病生而阴气至心也。夫肝胆之气，
上至头首，下至腰足，中主腹胁，故病发上下无常处也。若受纳不知其味，窍泻不知其度，而咽喉干燥者，喉
咙之后属咽，为胆之使，故病则咽喉干燥，虽病在脾土之中，盖由肝胆之所为尔。）二阳三阴，至阴皆在，阴
不过阳，阳气不能止阴，阴阳并绝，浮为血瘕，沉为脓 。（二阳，阳明；三阴，手太阴；至阴，
脾也。按∶此节中有脱误，阙疑可也。）阴阳皆壮，下至阴阳。（若阴阳皆壮而相薄不已者，渐下至于阴阳之
内，为大病矣。阴阳者，男子为阳道，女子为阴器，以其能盛受故而也。）上合昭昭，下合冥冥，诊决死生之
期，遂合岁首。
雷公曰∶请问短期。（……按∶短期，死期也，死因于病，不能终命而短也。新校正云∶“全元起本，自
雷公以下别为一篇，名四时病类。”）黄帝曰∶冬三月之病，合于阳者，至春正月，脉有死征，皆归出春。
（病合于阳，谓前阴合阳而为病者也。虽正月脉有死征，阳已发生，至王不死，故出春三月而至夏初也。）
冬三月之病，在理已尽，草与柳叶皆杀，（里谓二阴，肾之气也。然肾病而正月脉有死征者，以枯草尽青，柳叶生
出而皆死也。理，里也。已，以也。古用同。）春阴阳皆绝，期在孟春。（立春之后，而脉阴阳皆悬绝者，期死
不出正月。）春三月之病，曰阳杀，（阳病不谓伤寒温热之病，谓非时病热，脉洪盛数也。然春三月中，阳气
尚少，未当全盛，而反病热，脉应夏气者，经云脉不再见，夏脉当洪数，无阳外应，故必死于夏至也。以死于
夏至阳气杀物之时，故云阳杀也。）阴阳皆绝，期在草干。（若不阳病，但阴阳之脉皆悬绝者，死在于霜降草
干之时也。）夏三月之病，至阴不过十日，（谓热病也，脾热病则五脏危，土成数十，故不过十日也。）
阴阳交，期在 水。（详热论曰∶“温病而汗出，辄复热而脉躁疾，不为汗衰，狂言不能食者死，名曰阴阳交。”
六月病暑，阴阳复交，二气相搏，故乃死于立秋之候也。按∶新校正云∶“ 水者，七月建申，水生于申，阴
阳逆也。杨上善云∶ ，廉检反，水静也，七月水生时也。”）秋三月之病，三阳俱起，不治自已。（秋阳气
衰，阴气渐出，阳不胜阴，故自已也。）阴阳交合者，立不能坐，坐不能起。（以气不由其正用故尔。）三阳
独至，期
在石水。（有阳无阴，故云独至也。着至教论曰∶“三阳独至者，是三阳并至。”由此则但有阳而无阴也。石
水者，谓冬月水冰如石之时，故云石水也。火墓于戌，冬阳气微，故石水而死也。）二阴独至，期在盛水。（亦
所谓并至而无阳也。盛水谓雨雪皆解为水之时，则正谓正月中气也。按∶全元起本二阴作三阴。）
《内经》中论述阴阳类别的文字很多，但本篇所讲的，是选取手足三阴三阳经脉在寸口处显现的脉象，进行类比和比较论述，以补充前文所未详尽之处。虽然对证候的描述不够详细，但也有值得采纳的句子。
孟春（春季的第一个月）刚开始时，黄帝安坐，观察八方极远之处的景象，校正八方之风的气机，问雷公说：“关于阴阳的类别、经脉的道理，五脏各自的主属，哪一脏最为尊贵？”
（注：孟春始至，指立春这一天。燕，通“宴”，意为安适。观八极，指观察八方遥远边际的天色。正八风，指观测来自八个方向的风，看它们是否朝会于太一星。五中，指五脏。按：杨上善说：“天为阳，地为阴，人为中和之气。阴如果没有阳，衰杀就会没完没了；阳如果没有阴，生长就会不止。生长不止就会损伤阴，阴受损则阴灾兴起；衰杀不已就会损伤阳，阳受损则阳祸产生。所以需要圣人在天地之间调和阴阳二气，让万物生长。调和之气的道理在于，先修养自身品德，那么阴阳之气就会和谐；阴阳之气和谐，那么四季之风就会调顺，八方虚邪之风就会停止，于是疾病不起，吉祥之事日日聚集，这也是不知其所以然而然的结果。所以黄帝询问人体经脉的贵贱，以此为依据来调养身体，修养自身品德，以端正八方之风的气机。”）雷公回答说：“春季、天干甲乙、颜色青，中间主要主管肝脏，治理七十二天，这是经脉主时的规律，我认为肝脏最尊贵。”
（注：东方甲乙，由春气主导。《金匮真言论》说：“东方青色，内通于肝。”所以说青色中间主要主管肝脏。然而五行之气，各自主王七十二天，五者累积并乘序，正好是一年三百六十天的数目，所以说治理七十二天。四时之气，以春季为开始，五脏的对应关系，肝脏与之相合，所以我才认为肝脏最尊贵。）
黄帝说：“回想上下经书中关于阴阳从容之道的论述，你所说的‘最贵’，其实是最下等的。”雷公斋戒七日，第二天早晨再次侍奉在座。（领悟到错误，所以斋戒以洗涤心灵。希望得到更多教诲，所以坐下再次请教。）黄帝说：“三阳作为经，二阳作为维，一阳作为游部。”
（……经，指经纶，用来济助成就事务。维，指维持，用来维系天真之气。游，指游行，部指身体的各个部分。所以主气者济助成就事务，化谷者维系天真，主色者散布精微，游行于各个部位。按：新校正说：“杨上善说：三阳，指足太阳脉，从目内眦上行头部，分为四道，下行颈部并正别脉共六道行于背部，与身体构成经。二阳，指足阳明脉，从鼻起，下行咽喉，分为四道，并正别脉六道，上下行于腹部，网维于身体。一阳，指足少阳脉，起于目外眦，络头，分为四道，下行缺盆，并正别脉六道上下，主经营百节，流气三部，所以叫游部。”）三阳为表，二阴为里，（少阴与太阳互为表里，所以这样说。按：太阳，膀胱；少阴，肾。）一阴至绝如同朔晦（初一和三十），回过头来结合发生之理以端正其法则。（一阴，即厥阴，厥有尽的意思。《灵枢经》说：“亥为左足之厥阴，戌为右足之厥阴，两阴俱尽，所以叫厥阴。”阴尽为晦，阴生为朔，厥阴是以阴尽为含义的。征验其气旺则为朔，刚才说其气尽则为晦，既见其朔，又当其晦，所以说一阴至绝作朔晦。然而征验那俱尽之阴，结合此发生之木，以端正应合五行之理而无替循环，所以说回过头来结合发生以端正其理。按：新校正说：“注中说阴生为朔，怀疑是阳生为朔。”这是对的，应该改正遵从。又按这一节的文义，很难解释，注释虽然曲意为之，也似乎不确切，其中必有脱漏错误，存疑即可。）雷公说：“受业未能明白。”黄帝说：“所谓三阳，太阳为经，”（阳气盛大，所以叫太阳。按：大者为经，小者为脉，太阳主表，是诸脉的大经。）三阳脉至手太阴（寸口），弦浮而不沉，用度数决断，用心察审，合于阴阳之论。（太阴即寸口，寸口即手太阴，是脉气运行的地方，所以脉都至于寸口。太阳之脉，洪大且长，现在弦浮不沉，就应当以四时高下之度来约束决断它，以五脏异同之候来察审参合它，以应合阴阳之论，知道其好坏罢了。按：诸脉至手太阴都有得失，而太阳独无，怀疑此处必有脱简。）所谓二阳，就是阳明。（《灵枢经》说：“辰为左足之阳明，巳为右足之阳明。”两阳合明，所以叫二阳，即阳明。）至手太阴，弦而沉急不鼓动，热病至者，皆死。（鼓，指鼓动。炅，热也。阳明之脉，浮大而短，现在弦而沉急不鼓动，是阴气胜阳，木来乘土。反而热病至者，是阳气衰败，像灯的火焰，欲灭反明，所以都死。）一阳，就是少阳，（阳气未大，所以叫少阳。）至手太阴，上连人迎，弦急悬绝不断，这是少阳的病，（人迎指结喉两旁一寸五分脉动应手的地方。弦为少阳之脉，现在急悬不绝，是经气不足，所以叫少阳的病。悬，指像悬挂之物动摇。）专阴则死。（专，独也，说它独有阴气而无阳气则死。）三阴，是六经的主宰，（三阴，即太阴。说为什么诸脉都至手太阴？因为它是六经之主。六经指三阴三阳的经脉，为什么至手太阴？因为肺朝百脉之气，都交会于气口。所以下文说：）交于太阴，（这正是阐明肺朝百脉的意义。《经脉别论》说：“肺朝百脉。”）伏鼓不浮，上空志心。（按：杨上善说：“肺脉浮涩，这是平脉，现在见伏鼓，是肾脉。足少阴脉，贯脊属肾，上入肺中，从肺出络心。肺气下入肾志，上入心神。”王氏说志心为小心，义不通。杨说较注似胜，但以伏鼓为肾脉，谓肺气下入肾志，上入心神，也属牵强。我认为肺脉宜浮而反见沉伏，且在伏中鼓动，是气闭而火动。空犹控也，志心犹言心志，心之志为神。肺位本在心上，现在肺脉既见伏鼓不浮，是气反抑于心之下，气闭火动上控心，而心神亦为之动。这伏鼓的是手太阴本经自至之脉，不像其余五脉之至手太阴那样，杨氏大概被迷惑于此。）二阴至肺，其气归膀胱，外连脾胃。（二阴指足少阴肾之脉。少阴之脉，别行者，入跟中，以上至股内后廉，贯脊属肾络膀胱。其直行者，从肾上贯肝膈，入肺中。所以上至于肺，其气归于膀胱，外连于脾胃。按：肾与膀胱为表里，其气本相通，肾又为胃关，脾胃之气实原于命门，所以肾脉见于寸口者，其气内归于膀胱，外连于脾胃，这是以经脉相通之气而言。）一阴独至，经绝气浮不鼓，钩而滑。（如果一阴独至肺，经气内绝，则气浮不鼓于手；如果经不内绝，则钩而滑。按：一阴，厥阴肝木也。独至者，不兼他脉也。肝脉来见于肺，木性畏金，故其气欲绝而不能鼓动。然木中有火，火能凌金，故又有浮滑之象也。）这六脉，乍阴乍阳，交属相并，缪通五脏，合于阴阳，（按：六经之脉各有阴阳，其互见于寸口也，或阴中见阳，或阳中见阴，或一脉而兼数病，或一病而见数脉，交属缪通，而总于寸口决之，以知五脏之阴阳，合与不合，从一可知也。）先至为主，后至为客。（脉气乍阴见阳，乍阳见阴，怎么区别？应当以先至为主，后至为客。至，指至寸口。）
雷公说：“臣已尽心意，接受传授的经脉，诵读得到从容之道，以合从容，但不知阴阳，不知雌雄。”（按：帝所言从容之道，脉有阴阳之分，证有雌雄之别，虽尽心讲颂，欲知之而不能，必如何而可也。）黄帝说：“三阳为父，”（父所以督济群小，言高尊也。）二阳为卫，”（卫所以却御诸邪，言扶生也。）一阳为纪；”（纪所以纲纪形气，言其平也。）三阴为母，”（母所以育养诸子，言滋生也。）二阴为雌，”（雌者，阴之目也。）一阴为独使。”（一阴之脏，外合三焦，三焦主谒导诸气，名为使者，所以叫独使。）二阳一阴，阳明主病，不胜一阴， 而动，九窍皆沉。（一阴，厥阴肝木气也。二阳，阳明胃土气也。木土相薄，故阳明主病也。木伐其土，土不胜木，所以说不胜一阴。脉而动者， 为胃气，动谓木形，木土相持，则胃气不转，所以九窍沉滞而不通利也。按：自此以下，言阴阳各经参错为病，即前所谓交属缪通也。）三阳一阴，太阳脉胜，一阴不能止，内乱五脏，外为惊骇。（三阳，足太阳之气，所以曰太阳胜也。木生火，今盛阳燔木，木复受之，阳气洪盛，内为狂热，所以内乱五脏也。肝主惊骇，所以外形惊骇之状也。）二阴二阳，病在肺，少阴脉沉，胜肺伤脾，外伤四肢。（二阴谓手少阴心之脉。二阳亦胃脉也。心胃合病，邪上下并，故外伤脾，内胜肺也。所以然者，胃为脾府，心火胜金故尔。脾主四肢，所以脾伤则外伤于四肢矣。少阴脉谓手掌后五分当小指，神门之脉也。按：新校正说：“详此二阳，乃手阳明大肠，肺之腑也。少阴心火胜金之腑，所以云病在肺。王氏以二阳为胃，义未甚通，况又以见胃病肾之说，此乃是心病肺也。”）二阴二阳皆交至，病在肾，骂詈妄行，巅疾为狂。（二阴为肾，水之脏也；二阳为胃，土之府也。土气刑水，所以交至而病在肾也。以肾水不胜，所以胃盛而巅为狂。按：巅当作癫，癫属二阴，狂属二阳。）二阴一阳，病出于肾，阴气客游于心，脘下空窍，堤闭塞不通，四肢别离。（一阳，谓手少阳三焦，心主火之腑也。水上干火，所以病出于肾，阴气客游于心也。何者？肾之脉，从肾上贯肝膈，入肺中。其支别者，从肺中出络心，注胸中。所以如是也。然空窍阴客上游，胃不能制，胃不能制是土气衰，所以脘下空窍皆不通也。言堤者，谓如堤堰不容泄漏。胃脉循足，心脉络手，所以四肢如别离而不用也。按：病出于肾，谓病由肾出也，与前病在肺肾者不同。肾为阴脏，所以其气亦阴。三焦为火腑，内贯三停，外通九窍。所以肾水为病，阴气充斥，上自心腕，下及诸窍，而令闭塞如堤也。四肢本属胃土，水盛则反侮土，所以亦令别离也。注言土衰近是，而新校正非之，误矣。）一阴一阳代绝，此阴气至心，上下无常，出入不知，咽喉干燥，病在土脾。（一阴，厥阴肝脉，一阳，少阳胆脉，并木之气也。代绝者，动而中止也，以其代绝，所以为病也。木气生火，所以病生而阴气至心也。夫肝胆之气，上至头首，下至腰足，中主腹胁，所以病发上下无常处也。若受纳不知其味，窍泻不知其度，而咽喉干燥者，喉咙之后属咽，为胆之使，所以病则咽喉干燥，虽病在脾土之中，盖由肝胆之所为尔。）二阳三阴，至阴皆在，阴不过阳，阳气不能止阴，阴阳并绝，浮为血瘕，沉为脓 。（二阳，阳明；三阴，手太阴；至阴，脾也。按：此节中有脱误，阙疑可也。）阴阳皆壮，下至阴阳。（如果阴阳皆壮而相薄不已者，渐下至于阴阳之内，为大病矣。阴阳者，男子为阳道，女子为阴器，以其能盛受故而也。）上合昭昭，下合冥冥，诊决死生之期，遂合岁首。
雷公说：“请问短期。”（……按：短期，死期也，死因于病，不能终命而短也。新校正说：“全元起本，自雷公以下别为一篇，名四时病类。”）黄帝说：“冬三月之病，合于阳者，至春正月，脉有死征，皆归出春。”（病合于阳，谓前阴合阳而为病者也。虽正月脉有死征，阳已发生，至王不死，所以出春三月而至夏初也。）冬三月之病，在理已尽，草与柳叶皆杀，（里谓二阴，肾之气也。然肾病而正月脉有死征者，以枯草尽青，柳叶生出而皆死也。理，里也。已，以也。古用同。）春阴阳皆绝，期在孟春。（立春之后，而脉阴阳皆悬绝者，期死不出正月。）春三月之病，曰阳杀，（阳病不谓伤寒温热之病，谓非时病热，脉洪盛数也。然春三月中，阳气尚少，未当全盛，而反病热，脉应夏气者，经云脉不再见，夏脉当洪数，无阳外应，所以必死于夏至也。以死于夏至阳气杀物之时，所以云阳杀也。）阴阳皆绝，期在草干。（如果不阳病，但阴阳之脉皆悬绝者，死在于霜降草干之时也。）夏三月之病，至阴不过十日，（谓热病也，脾热病则五脏危，土成数十，所以不过十日也。）阴阳交，期在 水。（详热论说：“温病而汗出，辄复热而脉躁疾，不为汗衰，狂言不能食者死，名曰阴阳交。”六月病暑，阴阳复交，二气相搏，所以乃死于立秋之候也。按：新校正说：“ 水者，七月建申，水生于申，阴阳逆也。杨上善说： ，廉检反，水静也，七月水生时也。”）秋三月之病，三阳俱起，不治自已。（秋阳气衰，阴气渐出，阳不胜阴，所以自已也。）阴阳交合者，立不能坐，坐不能起。（以气不由其正用故尔。）三阳独至，期在石水。（有阳无阴，所以云独至也。着至教论说：“三阳独至者，是三阳并至。”由此则但有阳而无阴也。石水者，谓冬月水冰如石之时，所以云石水也。火墓于戌，冬阳气微，所以石水而死也。）二阴独至，期在盛水。（亦所谓并至而无阳也。盛水谓雨雪皆解为水之时，则正谓正月中气也。按：全元起本二阴作三阴。）
There are many discussions in the *Neijing* regarding the categories of Yin and Yang, but this chapter focuses on comparing and analyzing the pulse manifestations of the three Yin and three Yang meridians of the hands and feet at the Cun Kou (Inch Gate) position, to supplement what was previously incomplete. Although the description of symptoms is not detailed, there are still valuable insights to be gleaned.
At the beginning of Meng Chun (the first month of spring), when Huang Di (Yellow Emperor) was seated in tranquility, observing the eight extreme directions and regulating the Qi of the Eight Winds, he asked Lei Gong: "Regarding the categories of Yin and Yang, the principles of meridians, and the mastership of the five Zang organs, which organ is the most noble?"
(Note: Meng Chun Shi Zhi refers to the day of Li Chun (Start of Spring). Yan means tranquil. Guan Ba Ji refers to observing the colors at the far reaches of the eight directions. Zheng Ba Feng refers to monitoring the winds from the eight directions as they converge on Tai Yi. Wu Zhong refers to the Five Zang organs. According to Yang Shangshan: "Heaven is Yang, Earth is Yin, and Man is Harmony. Without Yang, Yin would decay endlessly; without Yin, Yang would grow endlessly. Endless growth injures Yin, leading to Yin disasters; endless decay injures Yang, leading to Yang calamities. Thus, a Sage is needed between Heaven and Earth to harmonize Yin and Yang Qi, allowing all things to grow. The way of harmony lies in cultivating one's virtue first, so that Yin and Yang Qi become harmonious. When Yin and Yang are harmonious, the seasonal winds are balanced, and evil winds cease, preventing disease and gathering auspiciousness. This happens naturally. Therefore, Huang Di inquired about the hierarchy of meridians to guide self-cultivation and regulate the Eight Winds.") Lei Gong replied: "Spring, Heavenly Stems Jia and Yi, and color Qing (Green) are primarily associated with the Liver, governing seventy-two days. This is the timing of meridian dominance, so I consider the Liver the most noble."
(Note: East corresponds to Jia and Yi, dominated by Spring Qi. The *Jin Gui Zhen Lun* states: 'The green color of the East communicates with the Liver.' Hence, Green primarily governs the Liver. Each of the Five Elements dominates for seventy-two days, totaling 360 days in a year. Since Spring marks the beginning of the seasons and corresponds to the Liver among the Five Zang, I deem it the most noble.)
Huang Di said: "Reflecting on the discussions of Yin and Yang in the Upper and Lower Classics, your statement of 'most noble' is actually the lowest." Lei Gong fasted for seven days and sat in attendance again the next morning. (Realizing his error, he fasted to purify his mind. Seeking further instruction, he sat to ask again.) Huang Di said: "San Yang (Three Yang) serves as the Jing (Meridian/Vessel), Er Yang (Two Yang) serves as the Wei (Net/Vein), and Yi Yang (One Yang) serves as You Bu (Wandering Part)."
(...Jing refers to organizing principles that facilitate affairs. Wei refers to maintaining and connecting to innate nature. You refers to wandering/moving, and Bu refers to body regions. Thus, the master of Qi facilitates affairs, the transformer of Grain maintains innate nature, the master of Color distributes essence, and [Qi] moves through various parts. According to the New Correction citing Yang Shangshan: 'San Yang refers to the Foot-Taiyang Meridian... Er Yang refers to the Foot-Yangming Meridian... Yi Yang refers to the Foot-Shaoyang Meridian... hence called You Bu.') San Yang represents the Exterior, Er Yin represents the Interior. (Shao Yin and Tai Yang are exterior-interior pairs. Note: Tai Yang is Bladder; Shao Yin is Kidney.) Yi Yin reaching extremity is like the New Moon (Shuo) and Last Day (Hui). Returning to combine with generation principles rectifies the logic. (Yi Yin is Jue Yin, meaning 'extremity/end'. The *Lingshu* says: 'Hai is Left Foot Jue Yin, Xu is Right Foot Jue Yin; two Yins end together, hence Jue Yin.' Yin ending is Hui, Yin generating is Shuo. Jue Yin signifies the end of Yin. Validating its peak is Shuo, validating its end is Hui. Thus, Yi Yin reaching extremity acts as Shuo and Hui. Combining this ending Yin with generating Wood rectifies the Five Elements cycle. Note: The New Correction suggests 'Yin generating is Shuo' might be a typo for 'Yang generating is Shuo', which should be adopted. The text here is difficult; notes are speculative; leave doubts as unknown.) Lei Gong said: "I do not understand." Huang Di said: "When we say San Yang, Tai Yang is the Jing." (Yang Qi is abundant, hence Tai Yang. Note: Large is Jing, small is Mai. Tai Yang governs the exterior and is the great Jing of all pulses.) When San Yang pulses reach Hand-Taiyin (Cun Kou), they are Xian (Wiry) and Fu (Floating) but not Chen (Sinking). Judge by measure, observe with heart, align with Yin-Yang theory. (Taiyin is Cun Kou, where pulse Qi travels. Taiyang pulse is typically Hong Da Chang (Vast, Large, Long). If it is Xian Fu Chen-less, judge by seasonal degrees, observe by Zang differences, and align with Yin-Yang theory to determine good or bad. Note: All pulses reach Hand-Taiyin, but Taiyang alone lacks specific mention here, suggesting a textual loss.) When we say Er Yang, it is Yangming. (*Lingshu*: 'Chen is Left Foot Yangming, Si is Right Foot Yangming.' Two Yangs combined brightness, hence Er Yang, i.e., Yangming.) Reaching Hand-Taiyin, if it is Xian, Chen, Ji (Rapid), and does not drum (Gu), and heat illness arrives, death ensues. (Gu means drumming/pulsation. Jiong means heat. Yangming pulse is typically Fu Da Duan (Floating, Large, Short). If Xian Chen Ji without drumming, Yin overcomes Yang, Wood attacks Earth. Heat illness indicates Yang collapse, like a flickering flame before extinction; thus, death.) Yi Yang is Shaoyang. (Yang Qi is not yet great, hence Shaoyang.) Reaching Hand-Taiyin, if it connects upward to Ren Ying (Human Well) and is Xian, Ji, Xuan (Suspenseful/Hanging), and unceasing, this is Shaoyang disease. (Ren Ying is the pulse at 1.5 cun lateral to the Adam's apple. Xian is Shaoyang pulse. Ji Xuan Bu Jue indicates insufficient Jing Qi, hence Shaoyang disease. Xuan means swaying like a hanging object.) Zhuan Yin (Exclusive Yin) leads to death. (Zhuan means exclusive/alone; having only Yin Qi without Yang Qi causes death.) San Yin is the master of the Six Meridians. (San Yin is Taiyin. Why do all pulses reach Hand-Taiyin? Because it masters the Six Meridians. Six Meridians refer to Three Yin and Three Yang. Pulses reach Hand-Taiyin because Lung governs all meridians, converging at Qi Kou. Hence:) They intersect at Taiyin. (Elucidates Lung governing all meridians. *Jingmai Bie Lun*: 'Lung governs all meridians.') If Fu (Hidden) and Gu (Beating) without Fu (Floating), it empties/control Zhi Xin (Will-Mind). (Note: Yang Shangshan says Lung pulse should be Fu Se (Floating, Choppy); Fu Gu indicates Kidney pulse. Kidney channel enters Lung and connects to Heart. Lung Qi descends to Kidney Will and ascends to Heart Spirit. Wang Shi's interpretation of Zhi Xin as Xiao Xin (Lesser Heart) is unclear. Yang's view is better but still forced. I believe Lung pulse should be Floating; seeing Hidden/Beating indicates Qi closure and Fire movement. Kong means control/direct; Zhi Xin means Heart Will/Spirit. Lung sits above Heart; Hidden/Beating pulse suppresses Qi below Heart, Fire moves up controlling Heart, agitating Spirit. This Fu Gu is intrinsic to Hand-Taiyin, unlike other pulses. Yang was confused here.) Er Yin reaches Lung, its Qi returns to Bladder, externally connecting to Spleen and Stomach. (Er Yin refers to Foot-Shaoyin Kidney Meridian. Branches enter heel, ascend thigh, pierce spine, connect to Kidney and Bladder. Main line ascends from Kidney, pierces Liver/Diaphragm, enters Lung. Thus reaching Lung, Qi returns to Bladder, externally connects to Spleen/Stomach. Note: Kidney/Bladder are exterior-interior. Kidney is Gate of Stomach; Spleen/Stomach Qi originates from Ming Men. Thus, Kidney pulse at Cun Kou reflects Qi returning internally to Bladder and externally to Spleen/Stomach via meridian connections.) Yi Yin arriving alone, Jing Qi severed, Qi floats but does not drum, Gou (Hook) and Hua (Slippery). (If Yi Yin alone reaches Lung and Jing Qi is internally severed, Qi floats without drumming. If not severed, it is Gou Hua. Note: Yi Yin is Jue Yin Liver Wood. Alone arrival means no other pulses. Liver pulse appearing at Lung (Metal) shows Wood fearing Metal, so Qi wants to sever and cannot drum. However, Wood contains Fire, which can overcome Metal, hence Floating/Slippery signs.) These six pulses are alternately Yin and Yang, intersecting and merging, intricately connecting the Five Zang, aligning with Yin-Yang. (Note: Six Meridian pulses have Yin/Yang aspects. At Cun Kou, Yin may show Yang, Yang may show Yin, one pulse may indicate multiple diseases, or one disease shows multiple pulses. Intersecting and intricately connecting, all decided at Cun Kou to know Zang Yin-Yang harmony.) First arrival is Zhu (Host/Master), later arrival is Ke (Guest). (How to distinguish alternating Yin/Yang? By order of arrival at Cun Kou. First is Host, later is Guest.)
Lei Gong said: "I have exerted my mind fully, received transmission of meridians, studied the Cong Rong (Leisurely/Comprehensive) method, aligning with Cong Rong, yet I do not understand Yin-Yang, nor Yin-Yang (Male-Female/Gender) distinctions." (Note: Emperor spoke of Cong Rong method, where pulses have Yin/Yang divisions and symptoms have Male/Female distinctions. Despite study, understanding eludes him.) Huang Di said: "San Yang is Father," (Father directs and supports the young, implying high respect.) "Er Yang is Guard," (Guard repels evils, implying supporting life.) "Yi Yang is Discipline;" (Discipline regulates Form-Qi, implying balance.) "San Yin is Mother," (Mother nourishes children, implying generation.) "Er Yin is Female," (Female is a category of Yin.) "Yi Yang is Sole Envoy." (Yi Yang organ connects externally to San Jiao. San Jiao guides Qi, named Envoy, hence Sole Envoy.) In Er Yang and Yi Yin, Yangming dominates disease, unable to withstand Yi Yin, pulsation occurs, Nine Orifices sink/stagnate. (Yi Yin is Jue Yin Liver Wood. Er Yang is Yangming Stomach Earth. Wood-Earth conflict makes Yangming diseased. Wood attacks Earth, Earth cannot withstand Wood. Pulsation indicates Stomach Qi disturbance, Wood shape. Wood-Earth stalemate stops Stomach Qi rotation, causing Nine Orifices stagnation. Note: Below describes mixed meridian diseases, as mentioned earlier as intersecting/intricate connection.) In San Yang and Yi Yin, Taiyang pulse wins, Yi Yin cannot stop it, internally disturbing Five Zang, externally manifesting as fright/terror. (San Yang is Foot-Taiyang Qi, hence Taiyang wins. Wood generates Fire; excessive Yang burns Wood, Wood receives it, Yang becomes excessive, causing internal fever, disturbing Five Zang. Liver governs fright, hence external fright symptoms.) In Er Yin and Er Yang, disease is in Lung, Shao Yin pulse is Chen (Sinking), overcoming Lung injuring Spleen, externally injuring Four Limbs. (Er Yin refers to Hand-Shaoxin Heart Pulse. Er Yang is also Stomach Pulse. Heart-Stomach combined disease, pathogens attack up/down, thus externally injuring Spleen, internally overcoming Lung. Stomach is Spleen's Fu, Heart Fire overcomes Metal. Spleen governs limbs, so Spleen injury affects limbs. Shao Yin pulse refers to Shenmen pulse behind palm, 5 cun from little finger. Note: New Correction says Er Yang here is Hand-Yangming Large Intestine, Lung's Fu. Heart Fire overcomes Metal's Fu, hence Lung disease. Wang Shi's view of Er Yang as Stomach is weak; this is Heart affecting Lung.) In Er Yin and Er Yang both arriving, disease is in Kidney, cursing/wandering behavior, Dian Ji (Manic Disorder) becomes Kuang (Madness). (Er Yin is Kidney Water; Er Yang is Stomach Earth. Earth controls Water, so disease in Kidney. Kidney Water fails, Stomach Earth prevails, leading to Mania. Note: Dian should be Epilepsy/Mania, belonging to Er Yin; Kuang belongs to Er Yang.) In Er Yin and Yi Yang, disease originates from Kidney, Yin Qi wanders into Heart, epigastric empty orifices, dam-like blockage prevents flow, Four Limbs feel separated. (Yi Yang is Hand-Shaoyang San Jiao, Fire Fu of Heart Master. Water attacks Fire, disease from Kidney, Yin Qi wanders to Heart. Kidney channel ascends to Lung, branches connect to Heart/Chest. Empty orifices blocked by Yin guest upstream, Stomach cannot control it (Earth Qi weak), so epigastric/orifice blockage. Dam metaphor implies no leakage. Stomach channel follows legs, Heart channel connects to hands, so limbs feel useless/separated. Note: Disease from Kidney differs from Lung/Kidney disease above. Kidney is Yin Zang, San Jiao is Fire Fu. Kidney Water disease fills with Yin Qi, blocking upper/lower orifices like a dam. Limbs belong to Stomach Earth; Water excess insults Earth, causing separation. Note's Earth weakness is close; New Correction refuting it is wrong.) Yi Yin and Yi Yang Dai Jue (Intermittent Stop), this Yin Qi reaches Heart, up/down unpredictable, entering/exiting unknown, throat dry, disease in Earth-Spleen. (Yi Yin is Jue Yin Liver Pulse, Yi Yang is Shaoyang Gallbladder Pulse, both Wood Qi. Dai Jue means pulse stops intermittently. Wood generates Fire, so Yin Qi reaches Heart. Liver/Gallbladder Qi goes head-to-foot, mid-abdomen, so disease varies. If swallowing/tasting unknown, excretion uncontrolled, throat dry: Throat is Gallbladder Envoy, so disease causes dryness. Though disease in Spleen Earth, it stems from Liver/Gallbladder.) Er Yang and San Yin, Zhi Yin (Spleen) is present, Yin does not overcome Yang, Yang Qi cannot stop Yin, Yin-Yang both severed, Floating indicates Blood Mass (Xia Jia), Sinking indicates Pus/Abscess. (Er Yang is Yangming; San Yin is Hand-Taiyin; Zhi Yin is Spleen. Note: Textual errors suspected; leave as unknown.) If Yin-Yang both strong, descending to Yin-Yang. (If Yin-Yang strong and clashing continuously, descends into Yin-Yang interior, becoming severe disease. Yin-Yang here refers to Male Genitals/Female Organs due to their capacity to receive/generate.) Upward combines with Brightness (Zhao Zhao), downward combines with Darkness (Ming Ming), diagnosing determining life/death timing, aligning with Year Start.
Lei Gong said: "Please ask about Short Term (Short Life Expectancy)." (Note: Short Term means time of death, dying from illness before natural end. New Correction: Quan Yuanqi version separates this section as 'Four Seasons Disease Category'.) Huang Di said: "Diseases in Winter Three Months combining with Yang, by Spring First Month, pulses show death signs, all return to exiting Spring." (Disease combining with Yang refers to prior Yin combining with Yang to cause disease. Even if death signs appear in First Month, Yang has generated; if it peaks without death, it exits Spring into Early Summer.) Diseases in Winter Three Months, in Li (Interior) exhausted, grass and Willow leaves perish. (Li refers to Er Yin, Kidney Qi. Kidney disease with death signs in First Month: grass dries, willow sprouts, yet death occurs. Li is Interior. Yi is Yi. Ancient usage same.) Spring Yin-Yang both severed, period in Meng Chun. (After Li Chun, if Yin-Yang pulses are Xuan Jue (Hanging/Extreme), death expected within First Month.) Spring Three Months disease, called Yang Sha (Yang Killing). (Yang disease here does not mean Cold/Warmth disease, but non-seasonal heat, pulse Hong Sheng Shu (Vast, Full, Rapid). In Spring, Yang Qi is scarce, not yet peak, yet heat disease appears, pulse matching Summer Qi. Classic says pulse does not reappear; Summer pulse should be Hong Shu, lacking external Yang response, so death at Summer Solstice. Dying at Summer Solstice when Yang kills things, hence Yang Sha.) Yin-Yang both severed, period in Grass Dry. (If not Yang disease, but Yin-Yang pulses Xuan Jue, death at Frost Descent when grass dries.) Summer Three Months disease, Zhi Yin does not exceed ten days. (Refers to Heat disease. Spleen Heat disease endangers Five Zang. Earth completes tens, so not exceeding ten days.) Yin-Yang Jiao (Intersection), period in [Water]. (*Re Lun* details: Warm disease sweating, then recurring heat, rapid/restless pulse, not subsiding with sweat, delirium, inability to eat = Yin-Yang Jiao, death. June heatstroke, Yin-Yang re-intersect, Qi clash, death at Start of Autumn. Note: New Correction: [Water] is Seventh Month Shen, Water born in Shen, Yin-Yang reversal. Yang Shangshan: [Character] pronounced Lian Jian, water still, Seventh Month Water birth time.) Autumn Three Months disease, San Yang all rise, untreated recovers itself. (Autumn Yang declines, Yin emerges, Yang cannot overcome Yin, hence self-recovery.) Yin-Yang Jiao He (Intersection/Union), standing cannot sit, sitting cannot rise. (Qi does not function correctly.) San Yang Du Zhi (Alone Arrives), period in Shi Shui (Stone Water). (Yang without Yin, hence Alone Arrives. *Zhi Jiao Lun*: 'San Yang Alone Arrives is Three Yang Combined.' Thus only Yang, no Yin. Shi Shui refers to Winter when water freezes like stone, hence Stone Water. Fire tomb in Xu, Winter Yang微弱, hence death in Stone Water.) Er Yin Du Zhi, period in Sheng Shui. (Also called Combined Arrival without Yang. Sheng Shui refers to time when snow/rain melt to water, i.e., Middle Qi of First Month. Note: Quan Yuanqi version reads Er Yin as San Yin.)