但持脉之道，既在下指灵活，令其脉脊与手指目相对。（卢氏曰∶诊法多端，全凭指法捷取。
盖人
之中指上两节长，无名食指上两节短，参差不齐。若按举排指疏，则移越一寸九分之定位；排指密，又不及寸
关尺之界分。齐截三指，斯中指翘出，而节节相对，节无不转，转无不活，以别左右，分表里，推内外，悉五
脏，候浮中沉，此三指定位法也。及其位定，专指举按，固得其真，不若独指之无牵带，别有低昂也。第惟食
指肉薄而灵，中指则浓，无名指更浓且木。是必指端棱起如线者名曰指目，以按脉中之脊。无论洪大弦
革，即小细丝微，咸有脊焉。真如目之视物，妍丑毕具，故古人称诊脉曰看脉，可想见其取用矣。每见惜指甲
之修长，用指浓肉分，或指节之下，以凭诊视者，真不啻目生颈腋胸胁间矣。）尤须得要以求病根。
在未诊时，谁不自认精明，谓其何部何脉，何脉何象。及至临症就诊，则既以浮为风，而又若浮非浮而非风
也。以紧为寒，而又若紧非紧而非寒也。以洪为火，而又若洪非洪而非火也。以数为燥，而又若数非数而
非燥也。以虚为暑，以濡为湿，而又若虚非虚，若濡非濡，而不可以暑湿名也。诸如此类，既莫能分，复以六
部六脉，分断考求，毫不相贯。（分断考求，最为诊家大弊，窃叹今时犯此甚多。如张璐谓人诊脉，大似向泥
人祈祷，有时灵应，有时不灵应。）讵知病属一理，脉自无二，得其一而脉斯可断矣。得其脉之独有所见，而
脉又可断矣。（从独字洗出脉要精义。）盖独之义不一。如有以诸部无乖，或以一部稍乖者，是其受病在此，
而可以独名也。有以五脏五脉各应互见，而六部六脉偏见一脏之脉者，是其病根伏是，
而更可以独名也。独义无过如斯。故内经三部九候论，则有独大独小独疾独迟独热独寒之谓耳。如独而
强者，则为病属有余；独而弱者，即为病属不足。独而有力有神，其脉虽强而不为过。（有力尤须有神。李东垣
曰∶脉病当求其神之有与无，如六数七极热也，脉中有力即有神也；三迟二败寒也，脉中有力即有神也。热而
有神，当泄其热，则神在焉；寒而有神，当去其寒，则神在矣。寒热之脉，无力无神，将何恃而泄热去寒乎。
林之翰曰∶按东垣此论，深达至理。但以有力二字言有神，恐不足尽有神之妙。王执中曰∶有力中带光泽润滑
也。于解进矣。萧子 歌云∶轻清稳浓肌肉里，不离中部象自然。则又有进焉。）独而和缓柔弱，其脉虽弱，而
不为害。盖假独者易知，而真独者难明。得其要以求其独，则独无不在；失其要以求其独，则独其莫得矣。
（又从要字一层，剥出精义。）故善言独者，早以阴阳之原，（肾水为阴之原，肾火为阳之原。）气血之本，
（肾水为血之本，肾火为气之本，脾胃仓廪又为生气生血之本。）以求独之根。（知其根，则知其要；知其要，
则知其独。）继以顺逆之理，（约注云∶春夏洪大为顺，沉细为逆；秋冬沉细为顺，洪大为逆。男子左大为顺
，女子右大为顺。凡外感症∶阳病见阳脉为顺，见阴脉为逆；阴病见阳脉亦为顺。内伤症，阳病见阳脉为顺，
见阴脉为逆；阴病见阴脉为顺，见阳脉为逆也。）取舍之道，（顺之则取，如有根有神有胃之类；逆之则舍，
如残贼败脱离绝之类。）并脉上下来去至止，晓然于胸，以识独之宜。（滑氏曰∶上者为阳，来者为阳，至者
为阳；下者为阴，去者为阴，止者为阴也。上者，自尺部上于寸口，阳生于阴也。下者，自寸口下于尺部，阴
生于阴也。来者，自骨肉之分而出于皮肤之际，气之升也。去者，自皮肤之际而还于骨肉之分，气之降也。应
曰至，息曰止也。）然后临症施诊，以求独之所在（独在取舍明，轻重晓），则独存；以明独之所至（独至根
蒂知，真假识），则独出矣。故有见上为独，而其独偏在下也；见左为独，而其独偏在右也；见腑为独，而其
独偏在脏也；见表为独，而其独偏在里也。此其独可以意会（独有左右逢源之趣），而不可以言传；（独有难以
尽言之妙。）此其独可以独知（独有化裁尽变之义），
而不可以共觉矣（独有独觉难与时师共言之理）。苟无独知之明，（仅读医方快捷方式、叔和脉诀，何能独知。）
独见之真，（仅见一时之病，一方之病，何能独见。）独守之固，（仅守时师耳听之说，蔓衍汤方
之书，何能独守。）而曰惟我为独，（又从独字推进一层，妙义旋生。）独固是也，而恐则为独夫之独矣；独
亦是也，而恐则为毒人之独矣。（绣尝谓医有四失∶一曰字句不晓，二曰涉猎汤方，三曰株守一书，四曰剿袭
糟粕。凡此四失，必能毒人。）其尚得谓真正之独，与因应化裁之独哉。故曰持脉之道，贵乎活泼（一语括尽）
。若局守不变，则所向辄迷，又安能审独求真，而得病之所归者乎。
诊脉的方法，关键在于下指灵活，使脉管的搏动轨迹（脉脊）与手指的指尖部位（指目）相对。卢氏说：诊脉的方法多种多样，完全依靠指法敏捷地捕捉脉象。人的中指上两节较长，无名指和小指的上两节较短，参差不齐。如果按、举时排开手指疏朗，则位置会偏离一寸九分的标准定位；如果排指紧密，又达不到寸、关、尺的界限划分。将三指截齐，这样中指就会翘起，各关节相对，关节没有不转动的，转动没有不灵活的，以此辨别左右，区分表里，推究内外，对应五脏，候察浮、中、沉三种脉位，这就是三指定位法。等到位置确定后，专门用手指进行举按，固然能得到真脉，但不如单指操作没有牵绊，能更好地体现脉象的高低起伏。只是食指肉质薄而灵敏，中指较厚，无名指更厚且木钝。必须是指端棱起如线状的部分，称为“指目”，用来按压脉中的搏动轨迹。无论脉象是洪大、弦硬、革脉，还是细小、丝微，都有搏动轨迹。真的就像眼睛看东西一样，美丑毕现，所以古人称诊脉为“看脉”，可以想见其取用之妙了。我常看到爱惜指甲修长的人，用指腹浓肉部分，或者指节下方来诊察脉象，这简直就像眼睛长在脖子、腋下、胸部和胁肋间一样了。）尤其需要掌握要领以探求病根。
在未诊脉之前，谁不自认为精明，声称知道哪一部是什么脉，什么脉有什么象。等到临症就诊时，却既觉得浮脉是风邪，但又觉得浮非浮而非风邪；觉得紧脉是寒邪，但又觉得紧非紧而非寒邪；觉得洪脉是火邪，但又觉得洪非洪而非火邪；觉得数脉是燥邪，但又觉得数非数而非燥邪；觉得虚脉是暑邪，濡脉是湿邪，但又觉得虚非虚、濡非濡，不能简单用暑湿来命名。诸如此类，既然无法分辨，又用六部六脉分别断章取义地考求，毫不贯通。（分断考求，是诊脉的大弊病，我私下感叹现在犯此错误的人很多。如张璐说人诊脉，大似向泥人祈祷，有时灵验，有时不灵验。）哪里知道病属于一个道理，脉自然没有两种，得到其一而脉就可以判断了。得到脉象中独特的表现，而脉又可以判断了。（从“独”字引申出脉要的精义。）大概“独”的含义不止一种。如有以各部无乖违，或有一部稍乖违的，这是受病在此，可以称为“独”。有以五脏五脉各自相应互见，而六部六脉中偏见一脏之脉的，这是病根潜伏于此，更可以称为“独”。独的含义不过如此。所以《内经·三部九候论》中，就有独大、独小、独疾、独迟、独热、独寒的说法。如独而强的，则为病属有余；独而弱的，即为病属不足。独而有力有神，其脉虽然强盛但不为过。（有力尤其须要有神。李东垣说：诊脉应当求其神的有无，如六数七极是热证，脉中有力即是有神；三迟二败是寒证，脉中有力即是有神。热而有神，当清泄其热，则神在焉；寒而有神，当去除其寒，则神在矣。寒热之脉，无力无神，凭借什么去泄热去寒呢？林之翰说：按照东垣的这个论述，深达至理。但仅以“有力”二字来说明有神，恐怕不足以尽尽有神的奥妙。王执中说：有力中带光泽润滑。这就进了一步。萧子歌云：轻清稳浓肌肉里，不离中部象自然。这就又进了一步。）独而和缓柔弱，其脉虽然微弱，但不为害。大概假借的“独”容易知晓，而真正的“独”难以明了。得其要领以求其独，则无处不是独；失其要领以求其独，则根本得不到独。（又从“要”字层层剥茧，引出精义。）所以善于谈论“独”的人，早以阴阳的本原，（肾水为阴之本原，肾火为阳之本原。）气血的根本，（肾水为血之本源，肾火为气之本源，脾胃仓廪又是生气生血之本源。）来探求独的根源。（知道其根，就知道其要；知道其要，就知道其独。）继以顺逆的道理，（约注说：春夏洪大为顺，沉细为逆；秋冬沉细为顺，洪大为逆。男子左脉大为顺，女子右脉大为顺。凡外感症：阳病见阳脉为顺，见阴脉为逆；阴病见阳脉亦为顺。内伤症，阳病见阳脉为顺，见阴脉为逆；阴病见阴脉为顺，见阳脉为逆也。）取舍的原则，（顺之则取，如有根、有神、有胃气之类；逆之则舍，如残贼、败离、绝脱之类。）以及脉象的上下来去至止，在心中了然清楚，以识别独的适宜之处。（滑氏说：上者为阳，来者为阳，至者为阳；下者为阴，去者为阴，止者为阴也。上者，自尺部上于寸口，阳生于阴也。下者，自寸口下于尺部，阴生于阳也。来者，自骨肉之分而出于皮肤之际，气之升也。去者，自皮肤之际而还于骨肉之分，气之降也。应曰至，息曰止也。）然后临症施诊，以求独的所在（独在取舍明确，轻重知晓），则独存；以明独的所至（独至根蒂知晓，真假识别），则独出了。所以有见上部为独，而其独偏在下部；见左部为独，而其独偏在右部；见腑为独，而其独偏在脏；见表为独，而其独偏在里。这种独可以意会（独有左右逢源之趣），而不可以言传；（独有难以尽言之妙。）这种独可以独知（独有化裁尽变之义），而不可以共觉（独有独觉难与时师共言之理）。如果没有独知的明智，（仅读医方快捷方式、叔和脉诀，何能独知。）独见的真实，（仅见一时之病，一方之病，何能独见。）独守的坚固，（仅守时师耳听之说，蔓衍汤方之书，何能独守。）而说只有我是独，（又从独字推进一层，妙义旋生。）独固然是对的，但恐怕就成了孤陋寡闻的独了；独也是对的，但恐怕就成了害人害己的独了。（绣曾谓医有四失：一曰字句不晓，二曰涉猎汤方，三曰株守一书，四曰剿袭糟粕。凡此四失，必能毒人。）这还能称为真正的独，与因应化裁之独吗？所以说持脉之道，贵在活泼（一语括尽）。如果拘泥不变，则所向皆迷，又怎能审察独求真，而得到病的归宿呢？
The method of pulse-taking lies in the flexibility of the fingers, aligning the "pulse ridge" (the trajectory of the arterial pulsation) with the "finger tip" (the sensitive distal end of the finger). Lu stated: There are various diagnostic methods, all relying on the agility of finger techniques to capture the pulse. The middle finger's upper two segments are longer, while those of the ring and little fingers are shorter, leading to unevenness. If the fingers are spread apart during pressing or lifting, the position may deviate by one inch and nine fen from the standard location; if pressed too closely, it fails to distinguish the Cun, Guan, and Chi positions. By aligning the three fingers evenly, the middle finger rises slightly, ensuring each joint is opposed, turning freely and flexibly. This allows for distinguishing left and right, exterior and interior, internal and external, corresponding to the Five Zang organs, and sensing floating, moderate, and deep pulses. This is the method of positioning the three fingers. Once positioned, using a single finger for pressing and lifting can indeed capture the true pulse, but it is superior to use a single finger without interference, allowing better perception of the pulse's elevation and depression. However, the index finger is thin and agile, the middle finger is thicker, and the ring finger is even thicker and duller. One must use the part of the fingertip that protrudes like a line, called the "finger tip" (Zhi Mu), to press against the pulse ridge. Whether the pulse is surging, large, wiry, or leathery, or fine, thread-like, or minute, there is always a ridge. It is truly like the eye seeing objects, revealing beauty and ugliness clearly. Hence, ancients referred to pulse diagnosis as "looking at the pulse," illustrating its utility. I often see practitioners who cherish long fingernails using the fleshy part of the finger or below the joints to diagnose, which is akin to having eyes on the neck, armpits, chest, or flanks. It is essential to grasp the key principles to seek the root of the disease.
Before diagnosis, everyone claims to be sharp, asserting knowledge of which position corresponds to which pulse and what image each pulse presents. Yet, upon clinical examination, one might perceive a floating pulse as wind, yet feel it is not truly floating nor wind; a tight pulse as cold, yet feeling it is not truly tight nor cold; a surging pulse as fire, yet feeling it is not truly surging nor fire; a rapid pulse as dryness, yet feeling it is not truly rapid nor dry; a deficient pulse as summerheat, a soggy pulse as dampness, yet feeling they are not truly deficient or soggy, and cannot be simply named summerheat or dampness. Such ambiguities make differentiation impossible. Subsequently, analyzing the six positions and six pulses in isolation leads to disjointed reasoning. (Isolated analysis is a major flaw in pulse diagnosis; I sigh that many today commit this error. Zhang Lu said diagnosing pulse is like praying to a clay idol—sometimes effective, sometimes not.) How can one know that disease follows a single principle, and the pulse has no duality? Grasping one aspect allows the pulse to be judged. Grasping the unique manifestation within the pulse allows it to be judged further. (This extracts the essence of pulse theory from the concept of "uniqueness".) The meaning of "unique" (Du) is multifaceted. For instance, if most positions are normal but one shows slight deviation, the disease resides there, justifying the term "unique." Or, if the five pulses corresponding to the five Zang organs appear mutually, but one specific pulse dominates in the six positions, indicating the disease root is hidden there, further justifying "unique." The meaning of uniqueness is limited to these aspects. Thus, the *Neijing*’s *Tribune Nine Views* mentions unique enlargement, shrinkage, speed, slowness, heat, and cold. A unique and strong pulse indicates excess; a unique and weak pulse indicates deficiency. A unique pulse that is forceful and possesses "Shen" (Spirit/Vitality) is strong but not excessive. (Forcefulness must include Shen. Li Dongyuan stated: In pulse diagnosis, seek the presence or absence of Shen. Six beats per respiration or extreme rapidity indicate heat; forcefulness in the pulse implies Shen. Three beats or sluggishness indicate cold; forcefulness implies Shen. With heat and Shen, clear the heat, and Shen remains; with cold and Shen, dispel the cold, and Shen remains. Cold and heat pulses without force or Shen have no basis for clearing heat or dispelling cold. Lin Zhihan commented: Li’s argument reaches profound truth. However, defining Shen merely as "forcefulness" may not fully capture its subtleties. Wang Zhizhong added: Forcefulness accompanied by luster and smoothness. This is an advancement. Xiao Zi Ge wrote: Light, clear, steady, and thick within the muscles, naturally reflecting the central image. This represents further progress.) A unique pulse that is harmonious, slow, soft, and weak is weak but not harmful. Fake uniqueness is easy to identify, but true uniqueness is difficult to comprehend. Grasping the key to find uniqueness reveals it everywhere; losing the key makes it unattainable. (This peels back layers from the concept of "key" to reveal refined meaning.) Therefore, those skilled in discussing uniqueness first understand the origin of Yin and Yang (Kidney Water is the origin of Yin, Kidney Fire is the origin of Yang), the root of Qi and Blood (Kidney Water is the root of Blood, Kidney Fire is the root of Qi, and the Spleen and Stomach are the sources of generating Qi and Blood) to seek the root of uniqueness. (Knowing the root leads to knowing the key; knowing the key leads to knowing uniqueness.) Then, understanding the principles of compliance and opposition (Annotations note: Surging and large in Spring/Summer is compliant; deep and fine is opposing. Deep and fine in Autumn/Winter is compliant; surging and large is opposing. In men, left dominance is compliant; in women, right dominance is compliant. For external contraction: Yang disease with Yang pulse is compliant, Yin pulse is opposing; Yin disease with Yang pulse is also compliant. For internal injury: Yang disease with Yang pulse is compliant, Yin pulse is opposing; Yin disease with Yin pulse is compliant, Yang pulse is opposing.), the way of selection and rejection (Compliant pulses like those with Root, Shen, and Stomach Qi are selected; opposing pulses like those being destroyed, separated, or exhausted are rejected.), and the up/down, coming/going, arrival/stopping of the pulse, clearly understood in the mind, allows one to recognize the appropriate manifestation of uniqueness. (Hua Shi stated: Up is Yang, Coming is Yang, Arrival is Yang; Down is Yin, Going is Yin, Stopping is Yin. Up refers to movement from Chi to Cun, where Yang arises from Yin. Down refers to movement from Cun to Chi, where Yin arises from Yang. Coming refers to Qi rising from the bone/flesh level to the skin surface. Going refers to Qi descending from the skin surface back to the bone/flesh level. "Arrival" marks the beat, "Stopping" marks the breath pause.) Only then, when clinically diagnosing, seeking the location of uniqueness (where uniqueness lies in clear selection/rejection and awareness of weight/importance), does uniqueness exist; clarifying the extent of uniqueness (where uniqueness reaches through knowing roots/tubers and recognizing truth/falsehood), does uniqueness emerge. Thus, one may perceive uniqueness in the upper region, but it actually lies lower; perceive it in the left, but it lies in the right; perceive it in the Fu organs, but it lies in the Zang organs; perceive it in the Exterior, but it lies in the Interior. This uniqueness can be intuitively grasped (uniqueness offers the joy of resourcefulness) but cannot be fully conveyed verbally (uniqueness contains ineffable subtleties); it can be known individually (uniqueness implies adaptive transformation) but not shared collectively (uniqueness involves solitary insight difficult to share with contemporaries). Without the clarity of individual knowledge (merely reading quick medical guides or He Huanshu’s Pulse Classic, how can one know uniquely?), without the authenticity of individual vision (merely seeing transient or localized diseases, how can one see uniquely?), without the firmness of individual adherence (merely following contemporary hearsay or proliferating prescription books, how can one adhere uniquely?), and claiming "I alone am unique," (advancing the concept of uniqueness layer by layer, generating subtle meanings,) although uniqueness is correct, it risks becoming the uniqueness of an isolated ignoramus; although uniqueness is correct, it risks becoming the uniqueness that harms others. (Xiu once stated four medical errors: 1. Ignorance of terminology, 2. Superficial engagement with prescriptions, 3. Rigid adherence to a single book, 4. Plagiarizing dross. These four errors inevitably harm people.) Can such behavior be called true uniqueness or adaptive uniqueness? Therefore, the art of pulse-taking values flexibility (a phrase summarizing everything). If rigid and unchanging, one becomes lost in every direction, unable to examine uniqueness, seek truth, and determine the destination of the disease.