五十不止身无病。数内有止皆知定。
前诀以四十五动为准。而此诀又以五十动为准者。何也盖前诀以左
右手各部中。见其有止。即于止之数。准洪范五九之数。以断死生。即洁
古论中所谓相胜者死也。此诀以脉之大概言。但取五脏之气。全与不
全。以定死生。故用大衍之数五十也。大抵人身之脉。昼夜循环。无有巳
时。脉见一动。乃循一脏。五动乃循五脏。遍五十动。是十次五脏。而犹循
环不已。则五脏皆受气。而大衍之数足矣。即洁古论中所谓得相生者
愈也。故曰。身无病。若于五十动之中。忽有一代。及至再动。每代皆如前
数。即可根据其代数之远近。而定其死期也。熊宗立释中。谓四十动一止
为肾脏先绝者。非也。夫人之死。岂必从肾先死耶。凡诊他人脉者。须澄
心静气。如七诊之法。然后以指探病患。一手之脉数过五十动。不见有
止。再探病患。一手之脉亦数过五十动。不见有止。然后以指当部推求。
每部须数。过四十五动。不见有止方无大故。若或一手或两手。或一部
或几部中。有歇指处。即从此歇指后。第一动数起。看是几动一止。谓有
常数。谓无常数。以断其吉凶。要知一手候过五十动。两手则百动矣。又
于一部候过四十五动。六部共计二百七十动矣。并前百动。计共三百
七十动。更欲候其表里阴阳。虚实寒热。其间工夫。正自不少。何以今之
诊脉者。将手探脉。未一茶顷。便曰。我已得其情矣。且自 其纯熟。以欺
愚蒙。不知脉之形状。即可纯熟。而知脉之至数。不可以纯熟而促。以此
欺人。实自欺也。后之君子。其勉之哉。
四十一止一脏绝。却后四年多没命。三十一止即三年。二十一止二年应。
十五一止一年殂。以下有止看暴病。
脉经云。脉来五十动而不止者。五脏皆受气即无病。四十动而一止者。
一脏无气。却后四年死。以至十动一止者。四脏无气岁中死。此王氏脉
经也。正与此诀相为表里。奈何戴起宗复引经文而疑之曰。肾绝六日
死。肝绝八日死。心绝一日死。果此藏气绝。又安能待四岁三岁乎。斯言
一开。至使后人并脉经而疑之矣。不知五脏之中。有精。有气。有神。有先
天元阴。后天元阴。先天元阳。后天元阳。非止于血肉之形质已也。脉诀
与脉经所言。乃五脏无形之精气。不能流动充满。年月日久。渐次损坏。
以至有形而后死。故于数岁之前。脉上而即见止也。故经曰。四十动一
止。一脏无气。以至十动一止。为四脏无气。戴起宗不善读书。而以一脏
无气之气字。误认为有形之败坏。则误矣。至于内经所言肾绝六日死。
肝绝八日死。心绝一日死者。乃五脏之精气神。或为七情。或为六欲。或
为六淫。一时暴伤而绝。故又曰。以下有止看暴病。非所论于此也。
五十次搏动中无间歇，身体就没有疾病。如果在脉搏计数中出现间歇，都可以据此判断生死。
之前的脉诀以四十五次搏动为基准。而此处的脉诀又以五十次搏动为基准，为什么呢？大概是因为之前的脉诀是在左手和右手各部脉象中，发现其中有间歇，就根据间歇的次数，参照《尚书·洪范》中“五”与“九”的数理关系，来推断死生。这就是洁古（张元素）论述中所说的“相克者死”。此处的脉诀是从脉象的大概情况而言，只取五脏之气是否完整，以此来定生死。所以采用大衍之数五十。大体上，人体的脉象昼夜循环，没有停止的时候。脉搏每跳动一次，就循行经过一个脏腑；跳动五次，就循行经过五脏；循环五十次，就是十次经过五脏，而且仍然循环不止，这说明五脏都受到了气的滋养，大衍之数的要求就满足了。这就是洁古论述中所说的“相生者愈”。所以说，如果身体没有病，在五十次搏动之中，忽然出现一次代脉（指脉搏节律不齐，有规律的间歇），等到再次搏动时，每次代脉的间歇次数都和之前一样，就可以根据这个间歇次数的多少，来断定其死亡的时间。熊宗立在解释中说，四十次搏动出现一次间歇是肾脏气先绝的表现，这是不对的。人的死亡，难道一定是从肾脏先死吗？
凡是诊察他人的脉象，必须澄澈心神，平静气息，像“七诊”的方法那样，然后用手指探查病患的脉象。一只手脉搏数过五十次，不见有间歇；再探查另一只手，脉搏也数过五十次，不见有间歇。然后用手指按部推求，每一部脉象都必须数过四十五次，不见有间歇，这才没有大碍。如果在一手或两手，或者一部或几部脉中，出现手指感觉停顿的地方，就从这次停顿后的第一次搏动开始数，看是几次搏动出现一次间歇。是有固定的规律，还是没有固定的规律，以此来断吉凶。要知道，一只手候脉超过五十次，两只手就是一百次了。又在一部脉候脉超过四十五次，六部脉共计二百七十次了。加上前面的一百次，总共三百七十次。还要进一步候察表里、阴阳、虚实、寒热，其中的功夫实在不少。为什么现在的诊脉者，把手搭在脉上，不到喝一盏茶的时间，就说：“我已经掌握病情了。”并且凭借自己的纯熟技巧，来欺骗愚昧无知的人。不知道脉的形状可以靠纯熟来掌握，但脉的至数（频率和节律）不能因为纯熟而缩短候诊时间。用这种方法欺骗别人，实际上是自欺欺人。后来的君子们，应当努力改正这一点。
四十一动出现一次间歇，表示一脏之气已绝，此后四年多就会死亡。三十一动出现一次间歇，三年后应验。二十一动出现一次间歇，两年后应验。十五动出现一次间歇，一年后死亡。如果是十五动以下的间歇，要看是否是暴病（突然发生的急病）。
《脉经》说：脉搏来去五十次而不出现间歇的，说明五脏都接受了气，即没有疾病。四十次搏动出现一次间歇的，说明有一脏没有气，此后四年会死亡。直到十次搏动出现一次间歇的，说明有四脏没有气，一年内会死亡。这是王叔和《脉经》中的说法，正与此处的脉诀互为表里。奈何戴起宗又引用经文来质疑它说：肾绝则六日死，肝绝则八日死，心绝则一日死。如果真的这些脏腑之气绝了，怎么能等待四年、三年呢？这种言论一开，致使后人连《脉经》也产生了怀疑。他们不知道在五脏之中，有精、有气、有神、有先天元阴、后天元阴、先天元阳、后天元阳，并不仅仅局限于血肉形成的形体质料。脉诀与脉经所说的，乃是五脏无形之精气，如果不能流动充满，年月久了，会逐渐损坏，以至于形体败坏后才死亡。所以在数年之前，脉象上就已经出现间歇了。所以经文说：四十动一止，是一脏无气；直到十动一止，是四脏无气。戴起宗不善于读书，把“一脏无气”中的“气”字，错误地理解为有形体的败坏，这就错了。至于《内经》所说的肾绝六日死、肝绝八日死、心绝一日死的情况，乃是五脏的精气神，因为七情、六欲或六淫等因素，一时之间受到剧烈伤害而导致气绝。所以又说：“十五动以下的间歇，要看是否是暴病。”这不属于此处讨论的范畴。
If there are no pauses in fifty beats, the body is free of disease. If pauses occur within the count, life and death can be determined accordingly.
The previous pulse formula takes forty-five beats as the standard. Why does this formula take fifty beats as the standard? Generally speaking, the previous formula examines the left and right hands for pauses; upon finding a pause, it uses the number of pauses to reference the numerology of "five" and "nine" from the *Book of Documents* (*Hongfan*) to judge life and death. This corresponds to Jiegu's (Zhang Yuansu) discussion stating that "those who overcome each other die." This formula speaks generally of the pulse, focusing solely on whether the Qi of the Five Zang organs is complete or incomplete to determine life and death. Therefore, it employs the Great Expansion Number of fifty. Broadly speaking, human pulse circulation continues day and night without cessation. Each beat circulates through one Zang organ; five beats circulate through the Five Zang organs. After fifty beats, the cycle has passed through the Five Zang organs ten times and continues without end, indicating that all Five Zang organs have received Qi, fulfilling the requirement of the Great Expansion Number. This corresponds to Jiegu's statement that "those who generate each other recover." Thus, it is said: if the body is healthy, but within fifty beats a Dai pulse (a regular intermittent pulse) suddenly appears, and subsequent beats show the same interval pattern, the time of death can be estimated based on the frequency of these intervals. Xiong Zongli's interpretation that a pause after forty beats indicates the premature exhaustion of Kidney Qi is incorrect. Does death necessarily begin with the failure of the Kidneys?
When examining another person's pulse, one must clear the mind and calm the spirit, following methods such as the "Seven Diagnoses," before palpating the patient. The pulse of one hand should be counted for over fifty beats without observing any pause; then the other hand should also be counted for over fifty beats without pause. Only then should specific positions be palpated. Each position must be counted for over forty-five beats without pause to ensure there is no major pathology. If a pause is felt in one or both hands, or in one or several positions, counting should restart from the first beat after the pause to determine the interval (whether constant or variable) to judge auspiciousness or inauspiciousness. Note that examining one hand for over fifty beats amounts to one hundred beats for both hands. Examining one position for over forty-five beats totals two hundred seventy beats for all six positions. Adding the previous one hundred beats, the total reaches three hundred seventy beats. Furthermore, assessing exterior-interior, Yin-Yang, deficiency-excess, and cold-heat requires considerable effort. Why do contemporary practitioners, after placing their fingers on the pulse for less than the time it takes to drink a cup of tea, claim, "I already understand the condition"? They rely on superficial familiarity to deceive the ignorant. While the shape of the pulse can be mastered through practice, the rate and rhythm cannot be rushed by mere familiarity. Deceiving others in this manner is essentially self-deception. Future scholars should strive to avoid this.
A pause after forty-one beats indicates the exhaustion of one Zang organ, leading to death after approximately four years. A pause after thirty-one beats indicates death within three years. A pause after twenty-one beats indicates death within two years. A pause after fifteen beats indicates death within one year. Pauses occurring fewer than fifteen beats should be evaluated in the context of sudden acute diseases.
The *Mai Jing* (Pulse Classic) states: If the pulse completes fifty beats without interruption, it means the Five Zang organs have received Qi, indicating no disease. A pause after forty beats indicates one Zang organ lacks Qi, leading to death after four years. Down to a pause after ten beats indicates four Zang organs lack Qi, leading to death within the year. This aligns perfectly with the current verse. However, Dai Qizong cited this text to question it, arguing: "Kidney exhaustion leads to death in six days, Liver exhaustion in eight days, Heart exhaustion in one day. If these Zang organs are truly exhausted, how can they wait four or three years?" This argument caused later generations to doubt the *Mai Jing*. They failed to realize that within the Five Zang organs exist Essence, Qi, Spirit, Pre-heaven Primordial Yin, Post-heaven Primordial Yin, Pre-heaven Primordial Yang, and Post-heaven Primordial Yang; these are not merely physical flesh structures. The verses and the *Mai Jing* refer to the formless Essence and Qi of the Five Zang organs. When these cannot flow and fill the body, over months and years, they gradually deteriorate until physical decay occurs, leading to death. Hence, pauses appear on the pulse years before death. The scripture says: "Forty beats with one pause indicates one Zang lacks Qi; down to ten beats with one pause indicates four Zangs lack Qi." Dai Qizong misread the character "Qi" in "one Zang lacks Qi" as referring to physical decay, which was an error. Regarding the *Neijing* statements that Kidney exhaustion causes death in six days, Liver in eight days, and Heart in one day: these refer to the sudden exhaustion of the Essence, Qi, and Spirit due to emotional trauma, desires, or pathogenic factors. Hence, it is stated: "Pauses below fifteen beats should be viewed as acute conditions." This is distinct from the chronic depletion discussed here.