石阳黄韫兮。着脉确一书。或从而叩其义。韫兮曰。医凭乎脉。而脉衰乎理。从来医家论脉。不患其言之无理。而
患其言之于理甚精。以之测病。而所谓精者。终未确也。夫脉以测病。不确岂能无误。浮游沉塞。起伏传变。全寄之乎
三指。轻辄重按。反复呼吸。实有毫厘千里之判。微乎渺乎。确诚未易言矣。 于脉学。究心已久。尝以轩岐之经为主。
而于诸贤论脉之书。采其理之的然可信者。而据以为确。间有未的。则证之于经。复出己意。以旁探博求。其所谓确者。
第识见有限。窃恐自以为确。而终未必其能确也。倘高明于其未确者。更加校正。则幸甚矣。韫兮之言若此。岁壬戌余
以母病。延之来淮。出视是书。山阳医士李铸九见之。深为折服。晚年其学益进。余复携其帙至真洲。以示李乔年。乔
年亦世医也。谓余曰。是书实足发蒙启 。先生既刊行伤寒论翼矣。曷极付剞劂。附之于后俾得表里印证。厥功岂不伟
哉。余曰诺。因次述其语。以弁简端。
乾隆丙寅小春歙州程 识
气口者。手太阴肺经之动脉。而五脏六腑之气。于此候之也。盖人以气生。营卫之气。先天也。水谷之气。后天也。
先天后天之气。脉皆主之。故饮入于胃。其精气。自脾归肺。食入于肾。其精气。自心归肺。肺布饮食之精气于诸脏腑。
而后血气充。营卫调。诸脏腑之气。各随其经。同营卫之气。而呼吸朝之于肺。故手太阴肺经。乃诸脏腑之气所聚也。
圣人于气口。候其盛衰。泄天地化育莫测之秘。岂不神乎。
石阳的黄韫兮撰写了《脉确》这本书。有人于是向他请教书中的义理。黄韫兮说：医生依靠脉诊，但脉学衰微在于医理不明。自古以来医家论述脉象，不担心他们的言论没有道理，而担心他们的道理过于精微。用这种所谓的“精”来推测病情，最终未必准确。既然用脉象来推测疾病，如果不准确，怎么能不出错呢？浮、沉、迟、数（注：原文为“浮游沉塞”，结合语境及后文“起伏传变”，此处指脉象的浮沉变化及可能的迟数或涩滞等，暂译为浮、沉等脉象特征）、起伏、传变，全凭三指（食指、中指、无名指）感知。轻按即重按，反复体会呼吸节律，这确实有毫厘之差千里之谬的区别。脉象微妙渺茫，要确切地把握它实在不容易。
我对脉学钻研已久，曾以黄帝内经和岐伯的经文为主要依据，对于各位贤者论述脉学的书籍，选取其中道理明确可信的内容作为确定的标准。间或有不够明确的，就参照经典验证，再发表自己的见解，以此旁征博引、广泛探求。我所说的“确”，只是受限于见识，私下担心自以为确定，但最终未必真的确定。如果高明之士对其中不确定的地方加以校正，那就太好了。黄韫兮的话大致如此。壬戌年，我因母亲生病，邀请他来到淮安。他拿出这本书给我看。山阳的医士李铸九见到这本书，深深折服。晚年他的学问更加精进，我又带着书稿到真州，给李乔年看。李乔年也是世医，他对我说：“这本书确实足以启发蒙昧。先生既然已经刊行了《伤寒论翼》，为什么不把它付梓刻印，附在后面，以便相互印证，其功德难道不大吗？”我答应了。因此记录并陈述他的话，放在书的开头。
乾隆丙寅年小春月，歙州的程某识记。
气口，是手太阴肺经的动脉，五脏六腑的气都在这裡候察。大概人靠气生存，营卫之气源于先天，水谷之气源于后天。先天和后天的气，脉象都能反映。所以饮食进入胃中，其精气由脾输送到肺；食物进入肾（注：此处原文逻辑可能有误或特指某种生理过程，通常食入于胃，但依原文翻译），其精气由心输送到肺。肺将饮食的精气布散到各个脏腑，然后气血充盈，营卫调和。各脏腑的气，各自随着经脉，与营卫之气一起，在呼吸时朝会于肺。所以手太阴肺经，是各脏腑气汇聚的地方。圣人通过气口候察气的盛衰，泄露天地化育不可测度的秘密，难道不神奇吗？
Huang Yunxi of Shiyang authored the book *Mai Que* (Pulse Certainty). Someone subsequently inquired about its principles. Yunxi replied: Physicians rely on pulse diagnosis, yet pulse studies have declined due to a lack of sound reasoning. Historically, physicians discussing pulses do not worry that their statements lack logic, but rather worry that their reasoning is overly subtle. When using such so-called "subtlety" to predict diseases, it ultimately fails to be certain. Since pulses are used to predict diseases, if they are not accurate, how can errors be avoided? Floating, sinking, rising, falling, and transmission/variation are all perceived through three fingers. Pressing lightly then heavily, repeatedly observing respiration, there is indeed a distinction as vast as a hair's breadth versus a thousand miles. Pulses are subtle and elusive; certifying them is certainly not easy.
I have devoted myself to pulse studies for a long time. I took the classics of Huangdi (Yellow Emperor) and Qibo (Grand Duke Qi) as the main basis, and from books on pulse theory by various sages, I selected those with clear and credible principles as my standard for certainty. Where things were not entirely clear, I verified them against the classics and added my own insights, exploring broadly and seeking widely. What I call "certainty" is limited by my knowledge; I fear that what I consider certain may not ultimately be so. If scholars of superior insight could correct the uncertain parts, it would be most fortunate. Such was Yunxi's statement. In the Renxu year, owing to my mother's illness, I invited him to Huai'an. He presented this book to me. Li Zhujiu, a medical practitioner from Shanyang, saw it and was deeply convinced. In his later years, his learning advanced further. I again brought the manuscript to Zhenzhou and showed it to Li Qiaonian. Qiaonian was also a hereditary physician. He said to me: "This book is truly sufficient to enlighten the ignorant. Since you have already published *Shanghan Lun Yi* (Wings to the Treatise on Cold Damage), why not have it printed and attached afterwards, so that internal and external aspects can verify each other? Would not the merit be great?" I agreed. Therefore, I recorded and stated his words, placing them at the beginning of the volume.
Recorded by Cheng of Shézōu in the early winter of the Bingyin year of the Qianlong reign.
The Qi Kou (Vital Gate), which is the arterial point of the Hand-Taiyin Lung Meridian, is where the Qi of the five zang and six fu organs is observed. Generally, humans live by Qi. The Ying and Wei (Defensive) Qi originate from the congenital (pre-heavenly), while the Qi of water and grain originates from the acquired (post-heavenly). Both congenital and acquired Qi are governed by the pulse. Thus, when drink enters the stomach, its essence travels from the Spleen to the Lung; when food enters the Kidney (Note: Text says Kidney, though physiologically usually Stomach/Spleen context applies, translating literally here), its essence travels from the Heart to the Lung. The Lung distributes the essence of food and drink to all organs, after which Blood and Qi become abundant, and Ying and Wei Qi are harmonized. The Qi of all organs follows its respective meridian, joining with Ying and Wei Qi to converge upon the Lung during respiration. Therefore, the Hand-Taiyin Lung Meridian is the gathering place of the Qi of all organs. The Sages observe the excess or deficiency of Qi at the Qi Kou, revealing the unfathomable secrets of Heaven and Earth's nurturing power. Is this not miraculous?