吴云。平人。气血平调之人。气。脉气。象。脉形也。
平人 调经论云。阴阳匀平。以充其形。九候若一。命曰平人。终始篇云。形肉血气。必相称也。
是谓平人。
一吸脉亦再动 高本删亦字。医统同。简按灵动输篇。一呼脉再动。一吸脉亦再动。甲乙引。作一
呼脉亦再动。一吸脉亦再动。
闰以大息 张云。常人之脉。一呼两至。一吸亦两至。呼吸定息。谓一息既尽。而换息未起之际也。
脉又一至。故曰五动。闰。余也。犹闰月之谓。言平人常息之外。间有一息甚长者。是为闰以太息。而又不止
五至也。简按张注详备。与难经符。但难经以一呼再动。一吸再动。呼吸之间又一动。为定息五动。张则以一
息四动。两息之间又一动。为五动。此为少异焉。李云。一息四至。呼吸定息脉五动者。当其闰以大息之时也。
马及志高并同。此说不可从。果如其言。则宜云闰以大息。呼吸脉五动。噫。何倒置经文。而释之也。
常以不病 甲乙。病下。有之人二字。
以调之为法 甲乙。无为法二字。
曰少气 马云。难经以为离经脉。由正气衰少。故脉如是也。吴云。是为虚寒。
三动而躁 马云。难经亦以为离经脉。是六至而躁。躁者。动之甚也。王注以躁为烦躁。灵枢终始
禁服等篇。有一倍而躁。二倍而躁等语。则躁本言脉。不言病也。张云。躁者。急疾之谓。
尺热曰病温 张云。言尺中近臂之处有热者。必其通身皆热也。脉数躁而身有热。故知为病温。高云。
脉躁疾而尺肤热。则曰病温。简按王注。以尺为寸关尺之尺。马亦从之。非。
脉滑曰病风 张云。数滑而尺不热者。阳邪盛也。故当病风。然风之伤人。其变不一。不独在于肌表。
故尺不热者。脉法曰。滑。不涩也。往来流利。为血实气壅。简按寿夭刚柔篇云。病在阳者。命曰风。病在阴
者。命曰痹。此章与痹对言。亦谓偏风之属。
脉四动以上曰死 张云。一呼四动。则一息八至矣。况以上乎。难经谓之夺精。四至曰脱精。五至曰
死。六至曰命尽。是皆一呼四至以上也。故死。
乍疏乍数 高云。一呼脉四动以上。则大过之极。脉绝不至则不及之极。乍疏乍数。则错乱之极。
故皆曰死。
人无胃气曰逆 张云。如玉机真脏论曰。脉弱以滑。是有胃气。终始篇曰。邪气来也。紧而疾。谷气
来也。徐而和。是皆胃气之谓。大都脉代时宜。无太过无不及。自有一种雍容和缓之状者。便是胃气之脉。
胃而有毛 脉经。作有胃而毛。下并同。张云。是为贼邪。以胃气尚存。故至秋而后病。后皆仿此。
脏真散于肝 吴云。肝气喜散。春时肝木用事。故五脏天真之气。皆散于肝。
但代无胃曰死 张云。长夏属土。虽主建未之六月。然实兼辰戌丑未四季之月为言也。代。更代也。
脾主四季。脉当随时而更。然必欲皆兼和软。方得脾脉之平。若四季相代。而但弦但钩。但毛但石。是但代无
胃。见真脏也。故曰死。简按吴马并仍王注。以代为止。恐与经旨左矣。
软弱有石曰冬病 张云。石为冬脉。属水。长夏阳气正盛。而见沉石之脉。以火土气衰。而水反乘也。
故至冬而病。简按推前文例。石当是弦。冬病当是春病。
弱甚曰今病 马云。弱。当作石。张同。云。长夏石甚者。火土大衰。故不必至冬。今即病矣。新校
正云。按甲乙经。弱。作石。简按今甲乙。弱。作软。脉经。作石。推前文例。弱当是弦。志高从王义。
脏真濡于脾 吴云。濡。泽也。脾气喜濡泽。长夏之时。脾土用事。故五脏真气。皆濡泽于脾。
毛而有弦曰春病 吴本。毛。作胃。张云。弦为春脉。属木。秋时得之。以金气衰。而木反乘也。故
至春木王时而病。简按推前文例。当是胃而有钩。曰夏病。
弦甚曰今病 张云。秋脉弦甚。是金气大衰。而木寡于畏。故不必至夏。今即病矣。简按推前文例。
当是钩甚。
以行营卫 甲乙。以。作肺。
石而有钩曰夏病 张云。钩为夏脉。属火。冬时得之。以水气衰。而火反侮也。故至夏火王时而病。
汪昂云。钩。当作软弱。简按推上文例。当是胃而有弱。曰长夏病。
钩甚曰今病 张云。冬脉钩甚。是水气大衰。而火寡于畏。故不必至夏。今即病矣。简按推上文例。
当是弱甚曰今病。而软弱有石曰冬病以下。与春夏其例不同。盖错综其意。欲人彼此互推。知其由也。必不文
字讹误焉。
其动应衣脉宗气也 甲乙。衣。作手。脉下。有之字。沈氏经络全书曰。虚里。乳根穴分也。俗谓
之气眼。顾英白曰。乳根二穴。左右皆有动气。经何独言左乳下。盖举其动之甚者耳。非左动而右不动也。其
动应手。脉宗气也。素问本无二义。马玄台因坊刻之误。而谓应衣者。言病患肌肉瘦
弱。其脉动甚而应衣也。亦通。始读素问。则心窃疑之。至读甲乙经。而疑遂释然。简按五味篇曰。大气积于
胸中。命曰气海。邪客篇曰。宗气积于胸中。皆此义也。通雅云。宗尊一字。孝经。宗祀。注。尊祀。王云。
宗。尊也。此乃古训。应衣。当从甲乙。而作应手。若应衣则与下文何别。张云。前言应衣者。言其微动似乎
应衣。可验虚里之胃气。此言应衣者。言其大动。真有若与衣俱振者。此臆度之见。不考甲乙之失耳。
盛喘数绝 张云。若虚里动甚而如喘。或数急而兼断绝者。由中气不守而然。故曰病在中。简按马
吴志。以喘为病证。非。
结而横有积矣 张云。胃气之出。必由左乳之下。若有停阻。则结横为积。故凡患 者。多在左肋
之下。因胃气积滞而然。如五十六难。曰肝之积名曰肥气。在左胁下者。盖以左右上下。分发五行而言耳。而
此实胃气所主也。吴云。脉来迟。时一止。曰结。横。横格于指下也。言虚里之脉结而横。是胃中有积。简按
横。盖谓其动横及于右边。张注以结横不为脉象。恐非。
绝不至曰死 志云。胃腑之生气绝于内也。
宗气泄也 吴云。宗气宜藏不宜泄。乳下虚里之脉。其动应衣。是宗气失藏。而外泄也。马云。乳
下之动应衣者。予曾见其人病终不治。张云。虚里跳动。最为虚损病本。故凡患阴虚劳怯。则心下多有跳动。
及为惊悸慌张者。是即此证。人止知其心跳。而不知为虚里之动也。但动之微者。病尚微。动之甚者。病则甚。
亦可因此以察病之轻重。凡患此者。当以纯甘壮水之剂。填补真阴。夫谷入于胃。以传于肺。五脏六腑。皆以
受气。是由胃气。而上为宗气也。气为水母。
气聚则水生。是由肺气而下生肾水也。今胃气传之肺。而肾虚不能纳。故宗气泄于上。则肾水竭于下。肾愈虚。
则气愈无所归。气不归则阴愈虚矣。气水同类。当求相济。故凡欲纳气归原者。惟有补阴以配阳一法。简按许
氏本事方云。王思和曰。今心怯非心松也。胃之大络。名曰虚里。络胸膈及两乳间。虚而有痰则动。此张注所
未论及。故表而出之。
中手促上击者 马云。寸口之脉。中医人之指。而促上来击者。是肩背在上。故其脉促上也。名曰
肩背痛。简按据马注。促上。谓促于鱼上而搏击。吴以为结促之促。志以为浮而搏击。并乖经旨。
寒热及疝瘕少腹痛 马云。下文脉急者。曰疝瘕少腹痛。据理此处及疝瘕少腹痛六字为衍。简按当
从新校正。
沉而横曰胁下有积 甲乙。横下。有坚字。无有积二字。张云。横。急数也。志云。横。横逆。言
脉之形象。非谓病也。简按横。谓寸口脉位。横斜于筋骨间。张志恐非。
沉而喘 甲乙。沉。作浮。
脉滑浮而疾者 甲乙。作脉浮滑实大。
脉急者 吴云。急。弦急也。是为厥阴病脉。张云。弦急者。阴邪盛。故为疝瘕少腹痛。
疝瘕 甲乙。作疝 。
曰病无他 张云。虽曰有病。无他虞也。高云。无他变也。
不间脏 张云。五十三难曰。七传者死。间脏者生。七传者。传其所胜也。间脏者。传其所生也。
皆此之谓。考之吕氏注。曰。间脏者。间其所胜之脏。而相传也。心胜肺。脾间之。脾胜肾。肺间之。肺胜肝。
肾间之。肾胜心。肝间之。肝胜脾。心间之。此谓传其所生也。今不间脏。而传其
所克。故曰死。间。去声。
臂多青脉 张云。血脱则气去。气去则寒凝。凝泣则青黑。故臂见青色。言臂则他可知矣。即诊尺
之义。志云。诊。视也。论诊尺必先视臂之脉色。
解 释音。 。音亦。熊同。高云。解。懈同。 。音亦。余篇解 同。犹懈怠。志云。懈惰也。
杭世骏道古堂集云。解 二字。不见他书。解。即懈。 。音亦。倦而支节不能振耸。惫而精气不能检摄。筋
不束骨。脉不从理。解解 。不可指名。非百病中有此一症也。内经言此者凡五。平人气象论云。尺脉缓涩。
谓之解 。王氏注。伫不可名。伫。困弱也。（按宋书明恭王皇后传。后在家。为伫弱妇人。）玉机真脏论云。
冬脉太过。则令人解 。此从脉起见也。刺疟论云。足少阳之疟。令人身体解 。寒不甚。热不甚。恶见人。
见人心惕惕然。热多汗出甚。此从疟起见也。刺要论云。刺骨无伤髓。髓伤则销铄 酸。体解 然不去矣。四
时刺逆从论云。夏刺经脉。血气乃竭。令人解 。此从刺而究其极也。要皆从四末以起见。如经所言堕怠。小
变其辞。而意较微眇尔。宋景濂送葛医师序。不得其解。篁南江氏。辑名医类案。引叶氏录验方。以为俗名发
痧之证。别列一门。武断极矣。余尝见有此病。发必神思躁扰。少腹痛。灵素未尝言及。与解 之义。毫不干
涉。殆大缪矣。简按王注据刺疟论解之。然此少阳疟之状。而非解 之义。马吴张并仍王注。皆不可从。但志
高及杭氏之说为稳贴。解 字。亦见论疾诊尺篇。云。尺肉弱者。解 也。盖解 。即懈惰懈倦之谓。四时刺
逆从论解 。诊要经终论作解惰。刺疟论解 。巢源作解倦。此可以证也。 。即亦字从人者。与易通。王注
气厥论云。食亦者。谓食入移易而过。不生肌肤。亦。易也。甲乙引气厥论。
作食 。骨空论。易髓无孔。王注云。易。亦也。此可以证 亦同。而与易通也。而易。谓变易其平常。神农
本草蜣螂条。狂易。（证类。音羊。误。汉书外戚传云。素有狂易病。师古注。狂易者。狂而变易常性也。）
阴阳别论。偏枯痿易。王注。易。谓变易常用。而痿弱无力也。大奇论。跛易偏枯。王注。血气变易。为偏枯
也。知是解易即解惰。变易平常之义矣。滑云。一说作解极。谓懈倦之极也。未知何据。虞氏正传云。解者。
肌肉解散。 者。筋不束。俗呼为砂病。内经名解 。实非真砂病也。此说亦太误。
安卧脉盛曰脱血 马云。安卧者。不能起也。脉盛者。火愈炽也。火热则血妄行。故谓之脱血。高
云。安卧。犹嗜卧。
尺涩脉滑谓之多汗 吴云。尺部肌肤涩。是皮毛失其津液也。脉来滑。阴火盛也。阳盛阴虚。故为
多汗。阴阳别论曰。阳加于阴。谓之汗。简按王以脉为尺脉。张同。并误。
脉尺粗 熊本。无脉字。吴同。当删。
谓之热中 简按王注。谓下焦中也。非。马云。热气在腹。谓之热中也。
目裹微肿 宋本。裹。作里。吴同。志高作内。并非。
胃疸 简按疸。瘅同。即前篇所谓消中。后世所称中消渴也。马云。谷疸。志云。黄胆。并非。
面肿曰风 马云。水证有兼风者。其面发肿。盖面为诸阳之会。风属阳。上先受之。故感于风者。
面必先肿。不可误以为止于水也。评热论。水热穴论。论疾诊尺篇。皆名曰风水。王注以为胃风者非。及考风
论。胃风之状。并无面肿之说。简按金匮要略云。面目肿大有热。名曰风水。又云。腰以上肿。当发汗。
足胫肿曰水 吴云。脾胃主湿。肾与膀胱主水。其脉皆行于足胫。故足胫肿者为水。简按金匮要略云。
腰以下肿。当利小便。
妇人手少阴脉动甚者妊子也 赵府本。妊。作任。熊吴张并同。张云。心脉动甚者。血王而然。王
启玄云云。盖指心经之脉。即神门穴也。其说甚善。任。妊同。孕也。简按论疾诊尺亦曰。女子手少阴脉动甚
者妊子。知是全本作足少阴者。未为得。王以动为厥厥动摇之动脉。马以妊子为男子。皆误。
未有脏形 马云。未有正脏之脉相形。而他脏之脉反见。春夏脉宜浮大。今反沉细而瘦。秋冬脉宜
沉细。今反浮大而肥。此即所谓逆四时也。玉机真脏论云。未有脏形于春夏。而脉沉涩。秋冬脉浮大。名曰逆
四时。与此义同。志云。未有春弦夏钩秋毛冬石之脏形。简按吴张为真脏之脉形。非。
命曰反四时也 吴删四时二字。马云。是皆难治之证。犹脉之反四时也。王注为衍文。殊不知古人
以彼形此。则未必非取譬之意。（王注。当是新校正。）简按马注似傅会。
肝不弦肾不石也 张云。人生所赖者水谷。故胃气以水谷为本。而五脏又以胃气为本。若脉无胃气。
吴云：所谓“平人”，是指气血平和调匀的人。“气”指脉气，“象”指脉形。
《调经论》说：“阴阳匀平，以充其形，九候若一，命曰平人。”《终始篇》说：“形肉血气，必相称也，是谓平人。”
一呼一吸之间，脉搏跳动四次（一呼脉跳两次，一吸脉跳两次）。高世栻删去了“亦”字，《医统正脉》本与此相同。丹波简按：《灵枢·灵动输篇》记载：“一呼脉再动，一吸脉亦再动。”《甲乙经》引用时，作“一呼脉亦再动，一吸脉亦再动”。
偶尔因深长呼吸而多跳一次（闰以大息）。张景岳注：“常人的脉搏，一呼两至，一吸也是两至。‘呼吸定息’，是指一次呼吸结束，而下一次呼吸尚未开始的间隙。此时脉搏又多跳一次，所以说五动。‘闰’，就是余数，就像闰月一样。意思是说，在常人正常的呼吸次数之外，偶尔会有一次特别长的呼吸（太息），导致脉搏多跳一次，这就是‘闰以大息’，而且不止五至。丹波简按：张景岳的注解详细完备，与《难经》相符。但《难经》认为一呼两动、一吸两动，加上呼吸之间的定息一动，共为五动；张景岳则认为一息四动，在两息之间多出一动，共为五动。这是细微的差异。李中梓说：一息四至，呼吸定息时脉动五下，这发生在‘闰以大息’的时候。马莳和高世栻都持此观点。这种说法不可采纳。如果真像他们所说，应该说‘闰以大息时，呼吸间脉动五下’。唉，为什么颠倒经文来解释呢？
平时没有疾病（常以不病）。《甲乙经》在“病”字下有“之人”二字。
以调和身体为原则（以调之为法）。《甲乙经》无“无为”二字，应为“以调之为法”。
称为少气（曰少气）。马云：“《难经》认为这是离经脉，因为正气衰少，所以脉象如此。”吴崑说：“这是虚寒证。”
脉搏急促且快（三动而躁）。马云：“《难经》也认为这是离经脉，六至且躁。‘躁’，是跳动非常剧烈的意思。王冰注将‘躁’解释为烦躁，《灵枢·终始》、《禁服》等篇有‘一倍而躁’、‘二倍而躁’等语句，那么‘躁’本来是指脉象，而不是指病症。”张景岳说：“躁，就是急疾的意思。”
尺部皮肤发热称为温病（尺热曰病温）。张景岳说：“意思是尺部靠近手臂的地方发热，必定全身都发热。脉数且躁，身体发热，所以知道是温病。”高世栻说：“脉躁疾且尺肤热，就称为温病。”丹波简按：王冰注将“尺”解释为寸关尺中的尺部，马莳也遵从这一说法，这是错误的。
脉滑称为风病（脉滑曰病风）。张景岳说：“脉数滑且尺部不发热，是阳邪盛，所以应当患风病。然而风邪伤人，变化不一，不仅在于肌表。所以尺部不发热。脉法说：‘滑，就是不涩。’往来流利，是血实气壅的表现。”丹波简按：《素问·寿夭刚柔篇》说：“病在阳的，叫做风；病在阴的，叫做痹。”本章与“痹”相对而言，也是指偏风之类。
脉搏每息跳动四次以上称为死证（脉四动以上曰死）。张景岳说：“一呼四动，那么一息就是八至了，何况超过这个数目呢？《难经》称之为夺精。四至叫脱精，五至叫死，六至叫命尽。这些都是指一呼四至以上的情况，所以主死。”
忽慢忽快（乍疏乍数）。高世栻说：“一呼脉四动以上，则是太过之极；脉绝不至，则是不及之极。忽慢忽快，则是错乱之极。所以都称为死证。”
人如果没有胃气就叫逆证（人无胃气曰逆）。张景岳说：“如《玉机真脏论》说：‘脉弱以滑，是有胃气。’《终始篇》说：‘邪气来也，紧而疾；谷气来也，徐而和。’这都是指胃气。大抵脉象随季节变化，没有太过也没有不及，自有一种雍容和缓的状态，这就是胃气之脉。”
胃气尚存但出现毛脉（胃而有毛）。《脉经》作“有胃而毛”，下文都一样。张景岳说：“这是贼邪。因为胃气尚存，所以到秋天后才发病。后文都仿照这个逻辑。”
脏真之气散布于肝（脏真散于肝）。吴崑说：“肝气喜欢疏散，春季肝木当令，所以五脏的天真之气，都散布于肝。”
只有代脉而没有胃气称为死证（但代无胃曰死）。张景岳说：“长夏属土，虽然主要掌管建未之六月，但实际上兼论辰、戌、丑、未四季之月。‘代’，是更代的意思。脾主四季，脉象应当随季节更替，但必须兼有柔和软弱的特征，才算是脾脉平和。如果在四季更替之时，只见到弦、钩、毛、石的真脏脉，而没有柔和的胃气，这就是‘但代无胃’，出现了真脏脉，所以称为死证。”丹波简按：吴崑和马莳仍然沿用王冰的注释，将“代”解释为停止，恐怕与经文原意不符。
脉软弱但带有石脉称为冬季发病（软弱有石曰冬病）。张景岳说：“石脉是冬脉，属水。长夏阳气正盛，却出现沉石的脉象，是因为火土气衰，而水气反乘。所以到冬天才会发病。”丹波简按：推究前文的体例，“石”应当是“弦”，“冬病”应当是“春病”。
脉象极弱称为当前发病（弱甚曰今病）。马云：“弱”当作“石”。张景岳同此说。他说：“长夏石脉极盛，是火土大衰，所以不必等到冬天，现在就会发病。”新校正说：“按《甲乙经》，‘弱’作‘石’。”丹波简按：现在的《甲乙经》中，“弱”作“软”。《脉经》作“石”。推究前文体例，“弱”应当是“弦”。高世栻遵从王冰的意见。
脏真之气濡润于脾（脏真濡于脾）。吴崑说：“濡，就是润泽。脾气喜欢濡泽。长夏之时，脾土当令，所以五脏的真气，都濡泽于脾。”
脉毛中带弦称为春季发病（毛而有弦曰春病）。吴本中，“毛”作“胃”。张景岳说：“弦脉是春脉，属木。秋季得到这种脉象，是因为金气衰，而木气反乘。所以到春季木旺时才发病。”丹波简按：推究前文体例，应当是“胃而有钩，曰夏病”。
弦脉极盛称为当前发病（弦甚曰今病）。张景岳说：“秋脉弦甚，是金气大衰，而木气无所畏惧。所以不必等到夏季，现在就会发病。”丹波简按：推究前文体例，应当是“钩甚”。
以此运行营卫之气（以行营卫）。《甲乙经》中，“以”作“肺”。
脉石中带钩称为夏季发病（石而有钩曰夏病）。张景岳说：“钩脉是夏脉，属火。冬季得到这种脉象，是因为水气衰，而火气反侮。所以到夏季火旺时才发病。”汪昂说：“钩”当作“软弱”。丹波简按：推究上文体例，应当是“胃而有弱，曰长夏病”。
钩脉极盛称为当前发病（钩甚曰今病）。张景岳说：“冬脉钩甚，是水气大衰，而火气无所畏惧。所以不必等到夏季，现在就会发病。”丹波简按：推究上文体例，应当是“弱甚曰今病”。而“软弱有石曰冬病”以下的内容，与春夏的体例不同，大概是错综其意，让人彼此互推，从而明白其中的道理。必定不是文字讹误。
脉搏跳动剧烈甚至带动衣服，这是宗气外泄（其动应衣脉宗气也）。《甲乙经》中，“衣”作“手”，“脉”下有“之”字。沈氏《经络全书》说：“虚里穴，位于乳根穴处。俗称气眼。”顾英白说：“乳根二穴，左右都有动气，经文为何独言左乳下？大概是举出跳动最明显的一侧罢了，并非左边动而右边不动。其动应手，是宗气的表现。《素问》原本没有两种含义。马莳因为坊刻本的错误，认为‘应衣’是指病人肌肉瘦弱，脉搏跳动剧烈以至于带动衣服。这也讲得通。我初读《素问》时心里暗自怀疑，直到读到《甲乙经》，疑虑才消除。”丹波简按：《五味篇》说：“大气积于胸中，命曰气海。”《邪客篇》说：“宗气积于胸中。”都是这个意思。《通雅》说：“宗”即“尊”。《孝经》注：“宗祀”即“尊祀”。王冰说：“宗，尊也。”这是古训。“应衣”应当从《甲乙经》作“应手”。如果作“应衣”，与下文有何区别？张景岳说：“前面说的‘应衣’，是指微动似乎应衣，可以验证虚里的胃气；这里说的‘应衣’，是指大动，真有好像与衣服一起振动的样子。这是臆测之见，没有考证《甲乙经》的错误。”
脉搏急促且时有断绝（盛喘数绝）。张景岳说：“如果虚里跳动剧烈如同喘息，或者急促且兼有断绝，这是因为中气不守所致，所以称为病在中焦。”丹波简按：马莳、吴崑、高世栻都将“喘”解释为病症，这是不对的。
脉结且横溢，说明有积滞（结而横有积矣）。张景岳说：“胃气出于左乳之下，如果有停阻，则脉结且横溢形成积滞。所以凡是患积聚病的人，多在左肋之下，这是由于胃气积滞所致。如《难经·五十六难》说：‘肝之积名曰肥气，在左胁下。’这是以左右上下分发五行来说的，而实际上是由胃气所主。”吴崑说：“脉来迟，时时一止，称为结。‘横’，是横格于指下。意思是虚里的脉结且横，说明胃中有积滞。”丹波简按：“横”，大概是指跳动横及于右边。张景岳认为“结横”不是脉象，恐怕不对。
脉绝不至称为死证（绝不至曰死）。高世栻说：“胃腑的生气在内绝灭。”
宗气外泄（宗气泄也）。吴崑说：“宗气宜藏不宜泄。乳下虚里的脉搏跳动剧烈甚至带动衣服，这是宗气失藏而外泄。”马云：“我曾见过乳下跳动应衣的人，最终病重不治。”张景岳说：“虚里跳动，是最严重的虚损病的根本。所以凡是患阴虚劳怯的人，心下多有跳动，以及惊悸慌张的，就是这种证候。人们只知道是心跳，而不知道是虚里在动。但跳动轻微的，病还轻；跳动剧烈的，病就重。也可以借此观察病情的轻重。凡患此病者，应当用纯甘壮水的药剂，填补真阴。谷物进入胃中，传送给肺，五脏六腑都由此受气，这是由胃气而上成为宗气。气为水之母，气聚则水生，这是由肺气而下生肾水。现在胃气传给肺，而肾虚不能纳气，所以宗气泄于上，肾水竭于下。肾越虚，气就越无所归。气不归元，阴就越虚。气和水是同类，应当寻求相互济助。所以凡想纳气归原的，只有补阴以配阳这一种方法。”丹波简按：许叔微《本事方》说：王思和说：“现在的心怯，不是心松。胃的大络，名叫虚里，联络胸膈及两乳之间，虚而有痰则动。这是张景岳注释中未涉及到的，所以列举出来。”
脉搏急促向上搏击（中手促上击者）。马云：“寸口脉，中医者的手指，感到急促上来搏击，是因为肩背在上，所以脉促上。称为肩背痛。”丹波简按：根据马云的注释，“促上”是指在鱼际处急促而搏击。吴崑认为是结促之促，高世栻认为是浮而搏击，都违背了经文原意。
恶寒发热以及疝瘕少腹痛（寒热及疝瘕少腹痛）。马云：“下文‘脉急者，曰疝瘕少腹痛’。据理推断，此处‘及疝瘕少腹痛’六字为衍文。”丹波简按：应当遵从新校正的意见。
脉沉且横，称为胁下有积（沉而横曰胁下有积）。《甲乙经》中，“横”下有“坚”字，无“有积”二字。张景岳说：“横，是急数。”高世栻说：“横，是横逆，指脉的形象，不是说病。”丹波简按：“横”，是指寸口脉位，横斜于筋骨之间。张志聪的说法恐怕不对。
脉沉且喘（沉而喘）。《甲乙经》中，“沉”作“浮”。
脉急（脉急者）。吴崑说：“急，是弦急。这是厥阴病的脉象。”张景岳说：“弦急，是阴邪盛，所以为疝瘕少腹痛。”
称为病无他虞（曰病无他）。张景岳说：“虽说是病了，没有其他忧虑。”高世栻说：“没有其他变证。”
不间脏（不间脏）。张景岳说：“《难经·五十三难》说：‘七传者死，间脏者生。’七传，是传其所胜（克）；间脏，是传其所生（母子关系）。都是这个意思。考察吕广的注释说：‘间脏者，间其所胜之脏而相传也。’心克肺，脾间之；脾克肾，肺间之；肺克肝，肾间之；肾克心，肝间之；肝克脾，心间之。这叫传其所生。现在不间脏，而是传其所克，所以称为死证。‘间’，读去声。”
臂部有很多青筋（臂多青脉）。张景岳说：“血脱则气去，气去则寒凝，凝泣则青黑。所以臂部见青色。说臂部，其他部位也就知道了。这就是诊察尺肤的意义。”高世栻说：“诊，就是视。论述诊尺必须先看臂部的脉色。”
解㑊（解 释音...）。解，音懈。㑊，音亦。熊宗立同此。高世栻说：“解，同懈。㑊，音亦。余篇‘解㑊’同。犹懈怠。”高世栻说：“懈惰。”杭世骏《道古堂集》说：“‘解㑊’二字，不见于其他书籍。‘解’即‘懈’。‘㑊’，音亦。疲倦而肢节不能振耸，疲惫而精气不能检摄，筋不束骨，脉不从理，解解㑊㑊，不可指名。这不是百病中的一种症状。《内经》提到这种情况共有五次：《平人气象论》说：‘尺脉缓涩，谓之解㑊。’王冰注：‘伫不可名。伫，困弱也。’（按《宋书·明恭王皇后传》，皇后在家时，是伫弱妇人。）《玉机真脏论》说：‘冬脉太过，则令人解㑊。’这是从脉象说起。《刺疟论》说：‘足少阳之疟，令人身体解㑊。寒不甚，热不甚，恶见人，见人心惕惕然，热多汗出甚。’这是从疟疾说起。《刺要论》说：‘刺骨无伤髓。髓伤则销铄酸，体解㑊然不去矣。’《四时刺逆从论》说：‘夏刺经脉，血气乃竭，令人解㑊。’这是从针刺过度探究其极端情况。总之都是从四肢末端说起，如经文所说的堕怠，只是稍微变换了辞藻，而意义较为微妙。宋濂《送葛医师序》未能理解。篁南江氏辑录《名医类案》，引用叶氏《录验方》，认为是俗名发痧的证候，另列一门，武断极了。我曾经见过这种病，发作时必定神思躁扰，少腹痛，《灵枢》、《素问》未曾提及，与‘解㑊’的含义毫不相关，这大概是极大的谬误。”丹波简按：王冰注依据《刺疟论》解释，然而那是少阳疟的症状，而非‘解㑊’的含义。马莳、吴崑、张景岳都沿袭王冰的注释，都不对。只有高世栻和杭世骏的说法比较稳妥。“解㑊”一词，也见于《论疾诊尺篇》，说：“尺肉弱者，解㑊也。”大概“解㑊”，就是懈惰、懈倦的意思。《四时刺逆从论》作“解㑊”，《诊要经终论》作“解惰”，《刺疟论》作“解㑊”，巢元方《诸病源候论》作“解倦”，这可以证明。“㑊”即“亦”字从人，与“易”相通。王冰注《气厥论》说：“食亦者，谓食入移易而过，不生肌肤。亦，易也。”《甲乙经》引《气厥论》作“食㑊”。《骨空论》“易髓无孔”，王冰注说：“易，亦也。”这可以证明“㑊”、“亦”同，而与“易”相通。而“易”，谓变易其平常。《神农本草经》蜣螂条：“狂易。”（《证类本草》音羊，误。《汉书·外戚传》云：“素有狂易病。”师古注：“狂易者，狂而变易常性也。”）《阴阳别论》：“偏枯痿易。”王冰注：“易，谓变易常用，而痿弱无力也。”《大奇论》：“跛易偏枯。”王冰注：“血气变易，为偏枯也。”可知“解易”即“解惰”，是变易平常的意思。滑寿说：“一说作‘解极’，谓懈倦之极也。”不知何据。虞抟《正传》说：“解者，肌肉解散。㑊者，筋不束。俗呼为砂病。《内经》名为解㑊，实非真砂病也。”这种说法也太错误。
安静卧床但脉盛大，称为脱血（安卧脉盛曰脱血）。马云：“安卧，是不能起身。脉盛，是火愈炽。火热则血妄行，所以称为脱血。”高世栻说：“安卧，犹嗜卧。”
尺部肌肤涩而脉滑，称为多汗（尺涩脉滑谓之多汗）。吴崑说：“尺部肌肤涩，是皮毛失去津液。脉来滑，是阴火盛。阳盛阴虚，所以为多汗。《阴阳别论》说：‘阳加于阴，谓之汗。’”丹波简按：王冰将“尺”解释为尺脉，张景岳同此，都错了。
尺部脉粗（脉尺粗）。熊本无“脉”字，吴崑同，应当删去。
称为热中（谓之热中）。丹波简按：王冰注，谓下焦中也。不对。马云：“热气在腹，谓之热中也。”
眼睑微肿（目裹微肿）。宋本作“里”，吴崑同，高世栻作“内”，都不对。
胃疸（胃疸）。丹波简按：“疸”同“瘅”，即前篇所说的“消中”，后世所称的中消渴。马云说是谷疸，高世栻说是黄胆，都不对。
面部浮肿称为风病（面肿曰风）。马云：“水证有兼风的，其面部浮肿。盖面部是诸阳之会，风属阳，上部先受之，所以感受风邪，面部必先肿。不可误以为只是水病。《评热论》、《水热穴论》、《论疾诊尺篇》都称为风水。王冰注认为是胃风，不对。及考《风论》，胃风的症状，并没有面部浮肿的说法。”丹波简按：《金匮要略》说：“面目肿大有热，名曰风水。”又说：“腰以上肿，当发汗。”
足胫浮肿称为水病（足胫肿曰水）。吴崑说：“脾胃主湿，肾与膀胱主水。它们的脉都行于足胫，所以足胫肿的是水病。”丹波简按：《金匮要略》说：“腰以下肿，当利小便。”
妇女手少阴脉动甚，是怀孕（妇人手少阴脉动甚者妊子也）。赵府本作“任”，熊宗立、吴崑、张景岳都同此。张景岳说：“心脉动甚，是血旺所致。王启玄说……大概指心经之脉，即神门穴。这种说法很好。‘任’、‘妊’同，孕也。”丹波简按：《论疾诊尺》也说：“女子手少阴脉动甚者妊子。”知道全本作“足少阴”是不对的。王冰将“动”解释为厥厥动摇的动脉，马莳将“妊子”解释为男子，都错了。
还没有出现真脏脉的形态（未有脏形）。马云：“还没有正脏的脉象显现，而其他脏的脉反而出现。春夏脉宜浮大，现在反沉细而瘦；秋冬脉宜沉细，现在反浮大而肥。这就是所谓的逆四时。《玉机真脏论》说：‘未有脏形于春夏，而脉沉涩；秋冬脉浮大，名曰逆四时。’与此义相同。”高世栻说：“没有春弦、夏钩、秋毛、冬石的脏形。”丹波简按：吴崑、张景岳认为是真脏之脉形，不对。
称为反四时（命曰反四时也）。吴崑删去“四时”二字。马云：“这些都是难治的证候，犹如脉之反四时。”王冰注认为是衍文，殊不知古人以彼形此，未必不是取譬之意。（王注，应当是新校正。）丹波简按：马云的注释似有牵强附会。
肝脉不弦，肾脉不石（肝不弦肾不石也）。张景岳说：“人生所赖者是水谷，所以胃气以水谷为本，而五脏又以胃气为本。如果脉无胃气……”
Wu Yun: The term "Ping Ren" (Normal Person) refers to an individual whose Qi and Blood are balanced and harmonious. "Qi" denotes the Qi of the pulse, and "Xiang" (Image/Symbol) refers to the form or shape of the pulse.
The *Tiao Jing Lun* (Treatise on Regulating the Channels) states: "When Yin and Yang are evenly balanced, filling the body, and the nine palpations are uniform, it is called a Normal Person." The *Zhong Shi Pian* (Chapter on Beginning and End) states: "Form, flesh, blood, and Qi must be proportionate; this is called a Normal Person."
During one respiration cycle (one inhalation and one exhalation), the pulse beats four times (twice during exhalation and twice during inhalation). Gao Shixi deleted the character "Yi" (also/even). The *Yi Tong Zheng Mai* edition agrees with this deletion. Danbo Jian'an notes: The *Ling Shu: Ling Dong Shu Pian* records: "With one exhalation, the pulse moves twice; with one inhalation, the pulse also moves twice." The *Jia Yi Jing* cites it as: "With one exhalation, the pulse also moves twice; with one inhalation, the pulse also moves twice."
Occasionally, due to a deep sigh (Run Yi Da Xi - intercalated by a great breath), there is an extra beat. Zhang Jingyue's commentary explains: "In normal people, the pulse beats twice per exhalation and twice per inhalation. 'Respiration fixed rest' (Hu Xi Ding Xi) refers to the interval after one respiration cycle ends and before the next begins. During this interval, the pulse beats once more, hence the total of five beats. 'Run' means surplus, similar to an intercalary month in the calendar. It implies that outside the normal breathing count, there is occasionally a very long breath (Da Xi), causing an extra pulse beat. This is called 'Run Yi Da Xi,' and it may exceed five beats. Danbo Jian'an notes: Zhang's commentary is detailed and consistent with the *Nan Jing*. However, the *Nan Jing* considers two beats per exhalation, two per inhalation, and one during the rest interval as the standard five beats. Zhang considers four beats per respiration cycle plus one extra beat between cycles as five beats. This is a minor difference. Li Zhongzi states: Four beats per respiration cycle, with five beats at the fixed rest interval, occurs during the 'Run Yi Da Xi.' Ma Shi and Gao Shixi agree with this view. This interpretation should not be followed. If true, it should be stated as 'during Run Yi Da Xi, the pulse beats five times within respiration.' Alas, why invert the classic text to explain it?
Normally without disease (Chang Yi Bu Bing). The *Jia Yi Jing* adds the characters "Zhi Ren" (of person) after "Bing".
To regulate as the method (Yi Tiao Zhi Wei Fa). The *Jia Yi Jing* lacks the characters "Wu Wei", reading instead "Yi Tiao Zhi Wei Fa".
Called Shao Qi (Deficient Qi). Ma Yin states: "The *Nan Jing* regards this as a Li Jing Mai (Departing Pulse), caused by the deficiency of righteous Qi, thus the pulse appears so." Wu Kun states: "This indicates Deficiency-Cold."
Three beats and rapid/restless (San Dong Er Zao). Ma Yin states: "The *Nan Jing* also regards this as a Li Jing Mai, six beats and restless. 'Zao' means extremely vigorous movement. Wang Bing注释 interprets 'Zao' as irritability. Chapters like *Ling Shu: Zhong Shi* and *Jin Fu* mention phrases like 'one fold restless' and 'two folds restless,' indicating that 'Zao' originally referred to the pulse, not the disease." Zhang Jingyue states: "'Zao' means hurried and rapid."
Heat in the Chi position indicates Warm Disease (Chi Re Yue Bing Wen). Zhang Jingyue states: "This means if the Chi area near the arm is hot, the whole body must be hot. With a rapid, restless pulse and body heat, we know it is a Warm Disease." Gao Shixi states: "If the pulse is rapid/restless and the Chi skin is hot, it is called Warm Disease." Danbo Jian'an notes: Wang Bing注释 interpreted 'Chi' as the Chi position in Cun-Guan-Chi, and Ma Shi followed this, which is incorrect.
Slippery pulse indicates Wind Disease (Mai Hua Yue Bing Feng). Zhang Jingyue states: "A rapid, slippery pulse without heat in the Chi position indicates excess Yang pathogen, thus one should suffer from Wind Disease. However, wind pathogens cause varied changes, not just in the muscle surface. Therefore, the Chi is not hot. Pulse theory states: 'Hua (Slippery) means not Se (Choppy).' It flows smoothly, indicating excess Blood and congested Qi." Danbo Jian'an notes: The *Su Wen: Shou Yao Gang Rou Pian* states: "Disease in Yang is called Feng; disease in Yin is called Bi." This chapter contrasts with Bi, referring also to types of partial Wind.
Four beats or more per respiration indicate Death (Mai Si Dong Yi Shang Yue Si). Zhang Jingyue states: "Four beats per exhalation means eight beats per respiration cycle. How much more if above this? The *Nan Jing* calls this Duo Jing (Depletion of Essence). Four beats is Tuo Jing, five beats is Si (Death), six beats is Ming Jin (End of Life). All refer to four beats or more per exhalation. Hence, death."
Intermittently slow and rapid (Zha Shu Zha Shu). Gao Shixi states: "Four beats or more per exhalation is the extreme of excess. Absence of pulse is the extreme of deficiency. Intermittently slow and rapid is the extreme of chaos. Thus, all are called death."
Absence of Stomach Qi is called Ni (Rebellious/Adverse) (Ren Wu Wei Qi Yue Ni). Zhang Jingyue states: "As the *Yu Ji Zhen Zang Lun* says: 'Weak and slippery pulse indicates presence of Stomach Qi.' The *Zhong Shi Pian* says: 'When Evil Qi comes, it is tight and rapid; when Grain Qi comes, it is slow and harmonious.' These all refer to Stomach Qi. Generally, pulses change with seasons, neither excessive nor deficient, possessing a natural leisurely and harmonious quality; this is the pulse of Stomach Qi."
Stomach Qi present but with Mao (Metal/Lung) pulse characteristics (Wei Er You Mao). The *Mai Jing* reads "You Wei Er Mao", same for subsequent instances. Zhang Jingyue states: "This is Zei Xie (Robber Pathogen). Because Stomach Qi still exists, illness manifests only in Autumn. Subsequent texts follow this logic."
Zhen Zhen (True Visceral Qi) scatters to the Liver (Zang Zhen San Yu Gan). Wu Kun states: "Liver Qi likes to scatter. In Spring, Liver Wood dominates, so the True Qi of the Five Zang organs scatters to the Liver."
Only Dai (Intermittent) pulse without Stomach Qi indicates Death (Dan Dai Wu Wei Yue Si). Zhang Jingyue states: "Late Summer belongs to Earth. Although it governs the sixth month (Jian Wei), it actually encompasses the months of Chen, Xu, Chou, and Wei (the four seasons). 'Dai' means alternating. Spleen governs the four seasons, so the pulse should alternate with time. However, it must always include softness and harmony to be considered a balanced Spleen pulse. If during seasonal alternation, one sees only Xian (String-like), Gou (Hook), Mao (Feather), or Shi (Stone) pulses without the soft Stomach Qi, this is 'Dan Dai Wu Wei' (Only Alternating without Stomach Qi), revealing the True Zang pulse. Hence, death." Danbo Jian'an notes: Wu Kun and Ma Shi followed Wang Bing注释, interpreting 'Dai' as stopping, which likely contradicts the original intent.
Soft and weak with Shi (Stone/Kidney) pulse indicates Winter illness (Ruan Ruo You Shi Yue Dong Bing). Zhang Jingyue states: "Shi pulse is the Winter pulse, belonging to Water. Late Summer has abundant Yang Qi, yet a sinking Shi pulse appears because Fire and Earth Qi are weak, allowing Water to overact. Thus, illness occurs in Winter." Danbo Jian'an notes: Following previous patterns, 'Shi' should be 'Xian', and 'Dong Bing' should be 'Chun Bing' (Spring illness).
Extremely weak pulse indicates current illness (Ruo Shen Yue Jin Bing). Ma Yin states: "'Ruo' should be 'Shi'. Zhang Jingyue agrees. He says: "Extreme Shi pulse in Late Summer indicates severe decline of Fire and Earth, so illness occurs immediately, not waiting for Winter." New Correction states: "According to *Jia Yi Jing*, 'Ruo' is written as 'Shi'." Danbo Jian'an notes: Current *Jia Yi Jing* writes 'Ruo' as 'Ruan'. *Mai Jing* writes 'Shi'. Following previous patterns, 'Ruo' should be 'Xian'. Gao Shixi follows Wang Bing注释.
Zhen Zhen moistens the Spleen (Zang Zhen Ru Yu Pi). Wu Kun states: "'Ru' means moistening. Spleen Qi likes moisture. In Late Summer, Spleen Earth dominates, so the True Qi of the Five Zang organs moistens the Spleen."
Mao (Metal/Lung) pulse with Xian (Wood/Liver) characteristics indicates Spring illness (Mao Er You Xian Yue Chun Bing). Wu Ben edition writes 'Mao' as 'Wei'. Zhang Jingyue states: "Xian pulse is the Spring pulse, belonging to Wood. Obtaining this in Autumn indicates Metal Qi is weak and Wood Qi overacts. Thus, illness occurs when Wood dominates in Spring." Danbo Jian'an notes: Following previous patterns, it should be "Wei Er You Gou, Yue Xia Bing" (Stomach Qi with Hook characteristics indicates Summer illness).
Extreme Xian pulse indicates current illness (Xian Shen Yue Jin Bing). Zhang Jingyue states: "Extreme Xian pulse in Autumn indicates severe decline of Metal Qi and lack of restraint on Wood. Thus, illness occurs immediately, not waiting for Summer." Danbo Jian'an notes: Following previous patterns, it should be "Gou Shen" (Extreme Hook).
Thereby circulating Ying and Wei (Yi Xing Ying Wei). The *Jia Yi Jing* writes 'Yi' as 'Fei' (Lung).
Shi (Stone/Kidney) pulse with Gou (Fire/Heart) characteristics indicates Summer illness (Shi Er You Gou Yue Xia Bing). Zhang Jingyue states: "Gou pulse is the Summer pulse, belonging to Fire. Obtaining this in Winter indicates Water Qi is weak and Fire Qi counter-rebels. Thus, illness occurs when Fire dominates in Summer." Wang Ang states: "'Gou' should be 'Ruan Ruo' (Soft and Weak)." Danbo Jian'an notes: Following previous patterns, it should be "Wei Er You Ruo, Yue Chang Xia Bing" (Stomach Qi with Soft characteristics indicates Late Summer illness).
Extreme Gou pulse indicates current illness (Gou Shen Yue Jin Bing). Zhang Jingyue states: "Extreme Gou pulse in Winter indicates severe decline of Water Qi and lack of restraint on Fire. Thus, illness occurs immediately, not waiting for Summer." Danbo Jian'an notes: Following previous patterns, it should be "Ruo Shen Yue Jin Bing". The section below "Ruan Ruo You Shi Yue Dong Bing" differs from the Spring/Summer patterns, likely intertwining meanings for mutual deduction, rather than textual errors.
Movement affecting clothes indicates Zong Qi (Ancestral Qi) (Qi Dong Ying Yi Mai Zong Qi Ye). The *Jia Yi Jing* writes 'Yi' (Clothes) as 'Shou' (Hand), and adds 'Zhi' after 'Mai'. Shen Shi's *Jing Luo Quan Shu* states: "Xu Li point is at Ru Gen. Commonly called Qi Yan." Gu Yingbai states: "Both left and right Ru Gen points have movement; why does the classic mention only left lower chest? It highlights the most prominent side, not that left moves while right does not. Movement responding to hand indicates Zong Qi. *Su Wen* has no dual meaning here. Ma Shi, due to printing errors, thought 'Ying Yi' meant patients with emaciated muscles having strong pulse movements affecting clothes. This is also plausible. I doubted this initially until reading *Jia Yi Jing*, resolving my doubts." Danbo Jian'an notes: *Wu Wei Pian* states: "Great Qi accumulates in the chest, named Qi Hai." *Xie Ke Pian* states: "Zong Qi accumulates in the chest." Both mean this. *Tong Ya* states: 'Zong' means 'Zun' (Venerable). *Xiao Jing* commentary: 'Zong Si' means 'Zun Si'. Wang Bing states: "'Zong' means 'Zun'. This is ancient teaching. 'Ying Yi' should be 'Ying Shou' (Responding to Hand) per *Jia Yi Jing*. If 'Ying Yi', what distinguishes it from the following text? Zhang Jingyue states: "Previous 'Ying Yi' refers to slight movement seeming to affect clothes, verifying Xu Li Stomach Qi. This 'Ying Yi' refers to strong movement truly vibrating clothes. This is speculation, failing to check *Jia Yi Jing* errors."
Pulse rapid, panting, and frequently interrupted (Sheng Chuan Shu Jue). Zhang Jingyue states: "If Xu Li movement is severe like panting, or rapid and interrupted, it is due to Middle Qi failing to hold. Hence, disease in the Middle." Danbo Jian'an notes: Ma, Wu, and Gao interpret 'Chuan' as a symptom, which is incorrect.
Knotted and transverse pulse indicates accumulation (Jie Er Heng You Ji Yi). Zhang Jingyue states: "Stomach Qi exits from below the left breast. If blocked, it knots and spreads transversely, forming accumulation. Thus, accumulation diseases often occur below the left ribs, due to Stomach Qi stagnation. As *Nan Jing 56* states: 'Liver accumulation named Fei Qi, located under left rib.' This divides Five Elements spatially, but is actually governed by Stomach Qi." Wu Kun states: "Slow pulse with occasional stop is 'Jie' (Knotted). 'Heng' is transverse resistance under fingers. Knotted and transverse Xu Li pulse indicates Stomach accumulation." Danbo Jian'an notes: 'Heng' likely means movement spreading to the right. Zhang's view that 'Jie Heng' is not a pulse image is likely incorrect.
Absence of pulse indicates death (Jue Bu Zhi Yue Si). Gao Shixi states: "Life-generating Qi of the Stomach organ is cut off internally."
Zong Qi leaks (Zong Qi Xie Ye). Wu Kun states: "Zong Qi should be stored, not leaked. Strong movement at Xu Li below the breast indicates Zong Qi loss and external leakage." Ma Yin states: "I have seen people with strong movement below the breast who ultimately died untreatable." Zhang Jingyue states: "Xu Li movement is the root of severe deficiency diseases. Patients with Yin deficiency and consumption often have heart area movement and palpitations. People know it as heartbeat but not Xu Li movement. Slight movement means mild disease; severe movement means severe disease. One can judge severity by this. Treatment requires pure sweet and water-nourishing agents to fill True Yin. Grain enters Stomach, transmits to Lung, nourishing all Zang-Fu. This becomes Zong Qi ascending from Stomach Qi. Qi is mother of Water; Qi gathering generates Water. This is Kidney Water generated descending from Lung Qi. Now Stomach Qi transmits to Lung, but Kidney deficiency fails to grasp Qi. Thus Zong Qi leaks upward, Kidney Water exhausts downward. More Kidney deficiency leads to Qi having no return. Qi not returning makes Yin more deficient. Qi and Water are similar; seek mutual assistance. To gather Qi to origin, only tonifying Yin to match Yang works." Danbo Jian'an notes: Xu Shimwei's *Ben Shi Fang* quotes Wang Sihe: "Current heart timidity is not heart looseness. Great collateral of Stomach is named Xu Li, connecting chest/diaphragm and breasts. Deficiency with phlegm causes movement. Zhang missed this."
Pulse feels rapid, striking upwards (Zhong Shou Cu Shang Ji Zhe). Ma Yin states: "Cunkou pulse, feeling rapid and striking up with fingers, indicates shoulder/back pain above. Named Shoulder Back Pain." Danbo Jian'an notes: Per Ma, 'Cu Shang' means rapid striking at the fish margin. Wu interprets 'Cu' as knotted-rapid; Gao as floating-striking. Both miss the original intent.
Chills, fever, hernia, mass, and lower abdominal pain (Han Re Ji Shan Jia Shao Fu Tong). Ma Yin states: "Later text says: 'Rapid pulse indicates hernia, mass, lower abdominal pain.' Logically, these six characters here are superfluous." Danbo Jian'an notes: Should follow New Correction.
Sinking and transverse pulse indicates hypochondriac accumulation (Chen Er Heng Yue Xie Xia You Ji). *Jia Yi Jing* adds 'Jian' (Hard) after 'Heng', removes 'You Ji'. Zhang Jingyue states: "'Heng' means rapid and frequent." Gao Shixi states: "'Heng' means transverse rebellion, describing pulse image, not disease." Danbo Jian'an notes: 'Heng' refers to Cunkou pulse position slanting between sinews and bone. Zhang Zhicong's view is likely incorrect.
Sinking and panting (Chen Er Chuan). *Jia Yi Jing* writes 'Chen' as 'Fu' (Floating).
Slippery, floating, and rapid pulse (Mai Hua Fu Er Ji Zhe). *Jia Yi Jing* reads "Mai Fu Hua Shi Da".
Rapid pulse (Mai Ji Zhe). Wu Kun states: "'Ji' is String-Rapid. This is Jue Yin disease pulse." Zhang Jingyue states: "String-Rapid indicates excess Yin pathogen, thus hernia, mass, lower abdominal pain."
Hernia and Mass (Shan Jia). *Jia Yi Jing* writes "Shan Yuan".
Indicates no other worry (Yue Bing Wu Ta). Zhang Jingyue states: "Though diseased, no other concern." Gao Shixi states: "No other transformation."
Not passing through intervening Zang (Bu Jian Zang). Zhang Jingyue states: "*Nan Jing 53* says: 'Seven transmissions die; intervening Zang lives.' Seven transmission passes to what it conquers; intervening Zang passes to what it generates. This applies. Lu Guang's commentary: 'Intervening Zang passes to what it conquers via intervening Zang.' Heart conquers Lung, Spleen intervenes; Spleen conquers Kidney, Lung intervenes; Lung conquers Liver, Kidney intervenes; Kidney conquers Heart, Liver intervenes; Liver conquers Spleen, Heart intervenes. This is passing to what it generates. Now, not intervening, but passing to what it conquers, hence death. 'Jian' is read as departing tone."
Many blue veins on arms (Bi Duo Qing Mai). Zhang Jingyue states: "Blood depletion leads to Qi departure; Qi departure leads to cold coagulation; coagulation turns blue-black. Arms show blue color. Arm implies others. This is diagnosing Chi skin." Gao Shixi states: "Diagnose means observe. Discussing Chi diagnosis requires observing arm vein color first."
Xie Jie (Exhaustion/Lethargy). Xie sounds like Xie (Slack). Jie sounds like Yi. Xiong Tongli agrees. Gao Shixi states: "Xie is same as Xie (Slack). Jie sounds like Yi. Other chapters use 'Xie Jie'. Like slackness." Gao Shixi states: "Sluggishness." Hang Shijun's *Dao Gu Tang Ji* states: "'Xie Jie' appears nowhere else. 'Xie' is 'Xie'. 'Jie' sounds like Yi. Weary with limbs unable to lift, exhausted with essence unable to control, sinews not binding bones, pulses not following logic. 'Xie Xie Jie Jie' cannot be named specifically. Not one of hundred diseases. *Nei Jing* mentions this five times: *Ping Ren Qi Xiang Lun*: 'Chi pulse slow and choppy, called Xie Jie.' Wang Bing注释: 'Cannot name. Zhu, weakness.' (*Song Shu*: Empress was Zhu Ruo woman). *Yu Ji Zhen Zang Lun*: 'Winter pulse excessive, causes Xie Jie.' From pulse. *Ci Mie Lun*: "Shaoyang Malaria causes body Xie Jie. Mild chills/fever, aversion to people, fearful heart, heavy sweating." From malaria. *Ci Yao Lun*: "Needle bone without injuring marrow. Marrow injury causes melting acid, body Xie Jie remains." From needling extremity. *Si Shi Ci Ni Cong Lun*: "Summer needle meridians, blood/qi exhaust, causes Xie Jie." From needling extreme. All start from four extremities, like 'Duo Dai' in classics, slightly varied wording, subtle meaning. Song Lian failed to understand. Huang Nan Jiang's *Ming Yi Lei An* cited Ye's *Lu Yan Fang* as vulgar 'Fa Sha', creating a new category, arbitrarily. I have seen this disease: onset with mental agitation, lower abdominal pain. *Ling Su* never mentioned it. Irrelevant to 'Xie Jie'. Likely major error." Danbo Jian'an notes: Wang Bing注释 based on *Ci Mie Lun*, but that is Shaoyang Malaria symptom, not 'Xie Jie' meaning. Ma, Wu, Zhang followed Wang, all incorrect. Only Gao and Hang are steady. 'Xie Jie' also in *Lun Ji Zhen Chi Lun*: "Weak Chi flesh, Xie Jie." Basically means sluggishness/lethargy. *Si Shi Ci Ni Cong Lun* writes 'Xie Jie'; *Zhen Yao Jing Zhong Lun* writes 'Xie Duo'; *Ci Mie Lun* writes 'Xie Jie'; Chao Yuanfang writes 'Xie Juan'. This proves it. 'Jie' is 'Yi' with person radical, connects to 'Yi' (Change). Wang Bing注释 on *Qi Jue Lun*: "Shi Yi: Food passes through quickly, not generating flesh. Yi means Change." *Jia Yi Jing* cites *Qi Jue Lun* as 'Shi Jie'. *Gu Kong Lun*: "Yi Sui Wu Kong", Wang注释: "Yi is Yi (Also)". Proves 'Jie'/'Yi' same, connects to 'Yi'. 'Yi' means changing normalcy. *Shen Nong Ben Cao Jing* Scat Beetle: "Kuang Yi" (*Zheng Lei*: sound Yang, error. *Han Shu*: "Suffer Kuang Yi". Shigu注释: "Kuang Yi is madness changing normal nature"). *Yin Yang Bie Lun*: "Pian Ku Wei Yi", Wang注释: "Yi is changing usual, leading to flaccid weakness". *Da Qi Lun*: "Bo Yi Pian Ku", Wang注释: "Blood/qi change, leading to hemiplegia". Thus 'Xie Yi' is 'Xie Duo', meaning changing normalcy. Hua Shou says: "One theory writes 'Xie Ji', extreme exhaustion. Unknown basis." Yu Tun's *Zheng Chuan*: "Xie is muscle dissolution. Jie is sinew not binding. Vulgarly Sand Disease. *Nei Jing* names Xie Jie, not real Sand Disease." This is too wrong.
Resting but pulse full indicates Blood Depletion (An Wo Mai Sheng Yue Tuo Xue). Ma Yin states: "An Wo means inability to rise. Mai Sheng means fire blazing. Heat causes blood reckless flow, hence Tuo Xue." Gao Shixi states: "An Wo is like嗜卧 (loving to lie down)."
Chi roughness and Slippery pulse indicate profuse sweating (Chi Se Mai Hua Wei Duo Han). Wu Kun states: "Chi skin rough means skin/hair lost fluids. Slippery pulse means Yin Fire excess. Yang excess Yin deficiency causes profuse sweat. *Yin Yang Bie Lun*: 'Yang added to Yin is sweat.'" Danbo Jian'an notes: Wang Bing interpreted 'Chi' as Chi pulse, Zhang agreed, both wrong.
Chi pulse coarse (Mai Chi Cu). Xiong Ben lacks 'Mai', Wu agrees, should delete.
Called Re Zhong (Internal Heat) (Wei Zhi Re Zhong). Danbo Jian'an notes: Wang注释 says Lower Jiao Zhong. Incorrect. Ma Yin states: "Heat Qi in abdomen is Re Zhong."
Eyelids slightly swollen (Mu Guo Wei Zhong). Song Ben writes 'Li', Wu agrees, Gao writes 'Nei', all incorrect.
Wei Dan (Stomach Jaundice) (Wei Dan). Danbo Jian'an notes: 'Dan' same as 'Dan', previously Xiao Zhong, later Zhong Xiao Ke. Ma Yin says Gu Dan; Gao says Huang Dan, both incorrect.
Facial swelling indicates Wind (Mian Zhong Yue Feng). Ma Yin states: "Water diseases with Wind cause facial swelling. Face is meeting of Yang channels; Wind is Yang, affects upper first. Wind sensation causes facial swelling first. Do not mistake for only Water disease. *Ping Re Lun*, *Shui Re Xue Lun*, *Lun Ji Zhen Chi Lun* call it Feng Shui. Wang注释 thinks Wei Feng is wrong. Checking *Feng Lun*, Wei Feng symptoms do not include facial swelling." Danbo Jian'an notes: *Jin Gui Yao Lue* says: "Face/eyes swollen with heat named Feng Shui." Also: "Swelling above waist, induce sweat."
Lower leg swelling indicates Water (Zu Jing Zhong Yue Shui). Wu Kun states: "Spleen/Stomach govern Damp; Kidney/Bladder govern Water. Their pulses run to legs. Leg swelling is Water disease." Danbo Jian'an notes: *Jin Gui Yao Lue* says: "Swelling below waist, promote urination."
Woman's Hand Shaoyin pulse moving strongly indicates pregnancy (Fu Ren Shou Shao Yin Mai Dong Shen Zhe Ren Zi Ye). Zhao Fu Ben writes 'Ren' as 'Ren' (Bear/Carry), Xiong/Wu/Zhang agree. Zhang states: "Heart pulse moving strongly is due to Blood dominance. Wang Qixuan... refers to Heart Meridian pulse, Shenmen point. Good theory. 'Ren'/'Ren' same, pregnancy." Danbo Jian'an notes: *Lun Ji Zhen Chi* also says: "Woman Hand Shaoyin pulse moving strongly indicates pregnancy." Knowing full text uses 'Foot Shaoyin' is incorrect. Wang Bing interpreted 'Dong' as jumping pulse; Ma Shi interpreted 'Ren Zi' as man, both wrong.
No Zang Form yet (Wei You Zang Xing). Ma Yin states: "No correct Zang pulse form appears, but other Zang pulses appear. Spring/Summer pulses should be Floating/Large, now Sunken/Fine/Thin; Autumn/Winter pulses should be Sunken/Fine, now Floating/Large/Full. This is Reverse Four Seasons. *Yu Ji Zhen Zang Lun*: 'No Zang form in Spring/Summer but Sunken/Choppy pulse; Autumn/Winter Floating/Large pulse, named Reverse Four Seasons.' Same meaning." Gao Shixi states: "No Spring Xian, Summer Gou, Autumn Mao, Winter Shi Zang forms." Danbo Jian'an notes: Wu/Zhang think True Zang pulse form, incorrect.
Named Reverse Four Seasons (Ming Yue Fan Si Shi Ye). Wu deletes 'Si Shi'. Ma Yin states: "All difficult treatments, like pulse reverse four seasons." Wang注释 thinks superfluous, unaware ancients used analogy. (Wang注释 likely New Correction.) Danbo Jian'an notes: Ma's comment seems forced.
Liver not Xian, Kidney not Shi (Gan Bu Xian Shen Bu Shi). Zhang Jingyue states: "Humans rely on Grain/Water. Stomach Qi based on Grain/Water. Five Zang based on Stomach Qi. If pulse lacks Stomach Qi..."