绝于外也，而医反补其肾肝。（肾肝主内，心肺主外。补，谓以针补之也。）阳绝补阴，阴绝补阳，（心肺为阳，肾肝为阴。）
是谓实实虚虚，损不足而益有余。（绝者，虚也，不足也。不绝者，实也，有余也。补其所不当补，则绝者益殆矣。）如
此死者，医杀之耳。（言病不必死，而医者误治以致其死也。）
十三难曰∶经言见其色而不得其脉，反得相胜之脉者，即死，得相生之脉者，病即自已。色之与脉，当参相应，为
之奈何？（经文见《灵·邪气脏腑病形论》。相胜、相生，义见下文。）
然∶五脏有五色，皆见于面，亦当与寸口尺内相
应。（五色见下，言何脏病则现何色也。寸口指脉言，尺内指尺之皮肤言，下文自明。）
假令色青，其脉当弦而急；色赤，其脉浮大而散；色黄，其脉中缓而大；色白，其脉浮涩而短；色黑，其脉沉濡而
滑。此所谓五色之与脉，当参相应也。（《灵·五色篇》云∶“青为肝，赤为心，白为肺，黄为脾，黑为肾。”弦急浮大五
者，皆五脏之本脉也。《灵·邪气脏腑病形篇》云∶“色青者，其脉弦也；赤者，其脉钩也；黄者，其脉代也；白者，其
脉毛；黑者，其脉石。”与此可以参观。）脉数，尺之皮肤亦数；脉急，尺之皮肤亦急；脉缓，尺之皮肤亦缓；脉涩，尺
之皮肤亦涩；脉滑，尺之皮肤亦滑。（此所谓与尺内相应者也。）
五脏各有声、色、臭、味，当与寸口尺内相应，其不（一本有相字）应者，病也。
假令色青，其脉浮涩而短，若大而缓，为相胜；浮大而散，若小而滑，为相生也。（色青属肝，浮涩而短是肺脉，脉
胜色也；大而缓为脾脉，色胜脉也，故曰相胜。浮大而散是心脉，色生脉也；小而滑为肾脉，脉生色也，故曰相生。）
经言知一为下工，知二为中工，知三为上工。上工十全九，中工十全八，下工十全六，此之谓也。（知一，谓色、脉、
尺三者之中能明其一也。全，谓不误治，能愈其病也。）
十四难曰∶脉有损至，何谓也？（少曰损，多曰至。）
然∶至之脉，一呼再至曰平，三至曰离经，四至曰夺精，五至
曰死，六至曰命绝，此至之脉也。何谓损？一呼一至曰离经，再（一作二）呼一至曰夺精，三呼一至曰死，四呼一至曰
命绝，此损之脉也。（平者，适得其常之谓。离经，离其常经也。夺精，精气已夺也。死者，言其必至于死。命绝，则其
生气已绝，仅存脉之动而已，亦随息也。）
至脉从下上，损脉从上下也。（心肺为上，肾肝为下。）损脉之为病奈何？
然∶一损损于皮毛，皮聚而毛落；二损损
于血脉，血脉虚少，不能荣于五脏六腑；三损损于肌肉，肌肉消瘦，饮食不能为肌肤；四损损于筋，筋缓不能自收持；
五损损于骨，骨痿不能起于床。反此者，至于收病也。（按于收二字，滑氏云疑作“脉之”是也。《灵·九针篇》肺主皮，
心主脉，脾主肌，肝主筋，肾主骨。皮聚者，枯而缩也。五脏肺居最上，肾居最下，由肺以至肾，此所谓从上下也。反
此谓至脉之病，则由肾以至肺，所谓从下上也。）从上下者，骨痿不能起于床者死；从下上者，皮聚而毛落者死。（此以
断至损脉之死期也。盖损即为迟，迟属寒，故先中于表。至即为数，数为热，故先中于里。相传既久，至内外表里俱病，
则不复可治矣。）治损之法奈何？
然∶损其肺者，益其气；损其心者，调其营卫；损其脾者。调其饮食，适其寒温；损其
肝者，缓其中；损其肾者，益其精。此治损之法也。（肺主气，故益其气。营卫者，血之所充。饮食寒温，肌肉之所由生。
缓中者，即经所谓“肝苦急，急食甘以缓之”之义。精者，肾之所藏。盖病在何脏，则各随其所在而治之也。）
然∶脉来一呼再至，一吸再至，不大不小曰平。一呼三至，一吸三至，为适
得病，（适得病，即上文离经之义，言仅为有病之脉也。）前大后小，即头痛、目眩，前小后大，即胸满、短气。（前指寸，
后指尺。前大后小，病气在阳，故头痛、目眩。前小后大，病气在阴，故胸满、短气。）一呼四至，一吸四至，病欲甚，
（病欲甚，即夺精之义，言其病将深也。）脉洪大者，苦烦满，沉细者，腹中痛，滑者伤热，涩者中雾露。（洪大为阳邪
外越，故烦满。沉细为阴邪内陷，故腹痛。滑为血实，故为热。涩为伤湿，故中雾露，此又于一息四至之病，分别言之，
亦举此为例言，仍当取所现脉象以别其病，欲令读者推展其义也。）一呼五至，一吸五至，其人当困，沉细夜加，浮大昼
加，不大不小，虽困可治，其有大小者，为难治。（困者，近于死也。沉细属阴，故加于夜。浮大属阳，故加于昼。大，
即浮大。小，即沉细。若不大不小，则昼夜不至于有加，故可治。有大小，则历昼夜而病益进，为难治也。不大不小，
即《灵·禁服篇》所谓“若引绳大小齐等”之义，若更参差不伦，则难治矣。）一呼六至，一吸六至，为死脉也，沉细夜
死，浮大昼死。（死脉，即命绝之谓。）一呼一至，一吸一至，名曰损，人虽能行，犹当着床，所以然者，血气皆不足故
也。（言虽能行步，久当不起于床也。血气不足，明所以得损脉之故。）再呼一至，再吸一至，名曰无魂，无魂者当死也，
人虽能行，名曰行尸。（无魂，言魂气已离也。行尸，言其人生道已绝，如尸之行也。）上部有脉，下部无脉，其人当吐，
不吐者死。（吐则气逆于上，故脉亦从而上，则下部之无脉，乃因吐而然，非真离其根也。若不吐而无脉，则脉为真无，
而非气逆之故矣，故曰死。）上部无脉，下部有脉，虽困无能为害。所以然者，譬如人之有尺，树之有根，枝叶虽枯槁，
根本将自生。脉有根本，人有元气，故知不死。
十五难曰∶经言春脉弦，夏脉钩，秋脉毛，冬脉石，是王脉耶？将病脉也？（经文见《素·平人气象论》及《玉机
真脏论》。）
然∶弦、钩、毛、石者，四时之脉也。（四时之脉，谓脉之应乎四时，即王脉也。）春脉弦者，肝东方木也，万
物始生，未有枝叶，故其脉之来，濡弱而长，故曰弦。（濡弱而长，是弦之正象，否则即为太过、不及之脉也。）夏脉钩
者，心南方火也，万物之所茂，垂枝布叶，皆下曲如钩，故其脉之来疾去迟，故曰钩。（来疾者，其来少急而劲；去迟者，
其去少缓而弱，此所谓下曲如钩也。）秋脉毛者，肺西方金也，万物之所终，草木华叶，皆秋而落，其枝独在，若毫毛也，
故其脉之来，轻虚以浮，故曰毛。（其枝独在、若毫毛，言其四面无所辅，而体又甚轻也。）冬脉石者，肾北方水也，万
物之所藏也，盛冬之时，水凝如石，故其脉之来，沉濡而滑，故曰石。此四时之脉也。（冬气敛聚，故沉而濡滑，水之象
也。按脏腑之与五行，各有所属，而春夏秋脉皆以木为喻者，盖惟木为因时迁变也。）如有变奈何？（变，谓失常也。）
然∶春脉弦，反者为病。何谓反？
然∶其气来实强，是谓太过，病在外；气来虚微，是谓不及，病在内。（太过属阳，而
发于表，故病在外。不及属阴，而怯于中，故病在内。）气来厌厌聂聂，如循榆叶曰平；（厌厌，《素问》王冰注以为浮薄
而虚也。）
益实而滑，如循长竿曰病；（此皆弦而太过之象。）急而劲益强，如新张弓弦曰死。（此则弦之至，即所谓真脏脉也。）
春脉微弦曰平，弦多胃气少曰病，但弦无胃气曰死，胃气，（冲和之气也。微弦、胃气少、但弦无胃气，即上文三者之象
也。下文仿此。）春以胃气为本。夏脉钩，反者为病。何谓反？
然∶其气来实强，是谓太过，病在外；气来虚微，是谓不
及，病在内。其脉来累累如环，如循琅 曰平；（如环，《素问》作“如连珠”，言其满盛也。琅 ，石似珠者。）来而益
数，如鸡举足者曰病；（谓实而劲也。）
前曲后居，如操带钩曰死。（居，《素问》王冰注曰∶“不动也”。带钩，曲而坚者也。）夏脉微钩曰平，钩多胃气少曰
病，但钩无胃气曰死，夏以胃气为本。秋脉毛，反者为病。何谓反？
然∶其气来实强，是谓太过，病在外；气来虚微，
是谓不及，病在内。其脉来蔼蔼如车盖，按之益大曰平；（车盖，言其浮大而虚也。）
不上不下，如循鸡羽曰病；（《素问》王冰注谓“中央坚而两旁虚”。）按之萧索，如风吹毛曰死。（《素问》云∶如物
之浮，如风吹毛，曰肺死。“王冰谓”如物之浮，瞥瞥然；如风吹毛，纷纷然也。“盖皆轻虚飘乱之义”。）秋脉微毛曰平，
毛多胃气少曰病，但毛无胃气曰死，秋以胃气为本。冬脉石，反者为病。何谓反？
然∶其气来实强，是谓太过，病在外；
气来虚微，是谓不及，病在内。脉来上大下兑，濡滑如雀之啄曰平；（雀啄，上大而末锐也。）啄啄连属，其中微曲曰病，
（啄啄连属，言搏手而数。其中微曲，言其象似钩也。）
来如解索，去如弹石曰死。（解索，紧而散；弹石，促而坚也。《素问》云∶“发如夺索，辟辟如弹石，曰肾死。”）
冬脉微石曰平，石多胃气少曰病，但石无胃气曰死，冬以胃气为本。胃者，水谷之海，（水谷皆聚于胃，如海为众水所聚
也。）主禀四时，（胃属土，土分王四季，故曰主禀四时。）皆以胃气为本，是谓四时之变病，死生之要会也。脾者，中州
也，其平和不可得见，（中州，言在四脏之中，四脏平和，则脾脉在其中，故不可得见。）衰
乃见耳。来如雀之啄，如水之下漏，是脾衰之（一本无之字）见也。（雀啄，言其坚锐。水下漏，言其断续无常。）
十六难曰∶脉有三部九候，有阴阳，有轻重，有六十首，一脉变为四时，（三部九候，详《素·三部九候论》。阴阳，
详第四难。轻重，详第五难。六十首，见《素·方盛衰论》，王冰注谓其义不存，或谓即各王六十日之义。一脉变为四
时，详十五难。但诸设难下文俱无发明，疑有脱误。）离圣久远，各自是其法，何以别之？
然∶是其病有内外证。（凡人
所受伤为病，所以验其病者为证，盖病合而证分也。）其病为之奈何？
然∶假令得肝脉，（五脏脉体详十三难。）其外证∶
善洁，（肝与胆合，胆为清净之腑，故善洁。）面青，善怒；（《素·阴阳应象大论》∶肝“在色为苍”，“在志为怒”。）其内
证∶脐左有动气，按之牢若痛；（《素·刺禁论》∶“肝生于左”，脐左，肝之位也。动气，真气不能藏而发现于外也。牢者，
气结而坚。痛者，气郁而滞。）其病∶四肢满，（满，闭塞也。盖肢节皆属于肝，左氏传云∶“风淫末疾”。）闭淋，溲便难，
（《灵·经脉篇》云，足厥阴循阴股，结于阴器，故病见于溲便也。）转筋。（《灵·九针篇》云∶“肝主筋”，故病筋也。）
有是者肝也，无是者非也。（是，指上文病证而言。如无此病证，则虽见肝脉，而受病实不在肝也。）假令得心脉，其外
证∶面赤，（《素》心“在色为赤”。）口干，（心气通于舌，火上炎则干也。）喜笑；（《素》心“在声为笑”。）其内证∶脐
上有动气，（脐上，心之位也。）按之牢若痛；其病∶烦心，心痛，（病在本脏也。）掌中热而 。（《灵·经脉篇》手少阴
之脉“入掌内”，故掌中热。 ，干呕也。《素·至真要大论》∶“诸逆冲上，皆属于火。”）有是者心也，无是者非也。假
令得脾脉，其外证∶面黄，（《素》脾“在色为黄”。）善噫，（噫，即嗳气。《灵·口问篇》云∶“寒气客于胃，厥逆从下上
散，复出于胃，故为噫。”脾与胃合，故病同也。）善思，（《素》脾“在志为思。”）善味；（《素》脾“在窍为口”，故主味。）
其内证∶当脐有动气，按之牢若痛；（当脐，脾位乎中也。）其病∶腹胀满，（《素·金匮真言论》∶“腹为阴，阴中之至阴
脾也。”故病在腹。）食不消，（脾主磨食。）体重，（脾主肌肉。）节痛，（《素·痿论》）∶阳明“主束骨而利机关，”脾与胃
合，故亦主节。）怠惰嗜卧，（劳倦亦属脾也。）四肢不收。（脾主四肢。）有是者脾也，无是者非也。假令得肺脉，其外证∶
面白，（《素》肺“在色为白”。）善嚏，（《灵·口问篇》∶“阳气和利，满于心，出于鼻。故嚏。肺气通于鼻，故善嚏也。”）
悲愁不乐，欲哭；（《素》肺“在志为忧”，“在声为哭。”）其内证∶脐右有动气，按之牢若痛；（《素，刺禁论》∶“肺藏于
右”，脐右，肺之位也。）其病∶喘咳，（肺主气，气逆则喘咳。）洒淅寒热。（肺主皮毛。）有是者肺也，无是者非也。假
令得肾脉，其外证∶面黑，（《素》肾“在色为黑。”）（善恐《素》“在志为恐”。）欠；（《灵·口问篇》∶“阴气积于下，阳
气未尽，阳引而上，阴引而下，阴阳相引，故数欠。”又云∶“肾主为欠。”）其内证∶脐下有动气，按之牢若痛；（肾居最
（如果邪气）在体表绝灭，而医生反而用补法治疗肾和肝。（肾和肝主守内，心和肺主卫外。这里的“补”，指的是用针刺的补法。）阳气衰竭却去补阴，阴气衰竭却去补阳，（心与肺属阳，肾与肝属阴。）这叫做使实证更实，虚证更虚，损害不足的正气而增加有余的邪气。（所谓“绝”，就是虚，就是不足；所谓“不绝”，就是实，就是有余。补了不该补的地方，那么已经衰竭的就更加危险了。）像这样导致死亡的，是医生杀死了病人。（意思是病不一定死，而是医生误治导致了死亡。）
第十三难说：经文说看到面色却得不到相应的脉象，反而得到相克（相胜）的脉象，就会死亡；得到相生脉象的，病就会自然痊愈。面色与脉象，应当相互参验对应，该怎么做呢？（这段经文见于《灵枢·邪气脏腑病形论》。相胜、相生的含义见下文。）
回答说：五脏有五种颜色，都表现在面部，也应当与寸口脉及尺部皮肤相应。（五色表现见下，指哪一脏有病就显现哪种颜色。寸口指脉象而言，尺内指尺部的皮肤而言，下文自明。）
假如面色青，脉象应当弦而急；面色赤，脉象浮大而散；面色黄，脉象中缓而大；面色白，脉象浮涩而短；面色黑，脉象沉濡而滑。这就是所说的五色与脉象应当相互参验对应。（《灵枢·五色篇》说：“青色属肝，赤色属心，白色属肺，黄色属脾，黑色属肾。”弦、急、浮、大、散等，都是五脏的本脉。《灵枢·邪气脏腑病形篇》说：“面色青的，脉象弦；面色赤的，脉象钩；面色黄的，脉象代；面色白的，脉象毛；面色黑的，脉象石。”这与上文可以参照印证。）脉数，尺部的皮肤也感觉热（数）；脉急，尺部的皮肤也紧张（急）；脉缓，尺部的皮肤也松弛（缓）；脉涩，尺部的皮肤也粗糙（涩）；脉滑，尺部的皮肤也光滑（滑）。（这就是所说的与尺部皮肤相应。）
五脏各有声音、颜色、气味、味道，应当与寸口脉及尺部皮肤相应，如果不相应的，就是病了。
假如面色青，脉象应当弦而急，如果见到浮涩而短的脉，或者大而缓的脉，这是相克（相胜）的关系；如果见到浮大而散的脉，或者小而滑的脉，这是相生的关系。（面色青属肝，浮涩而短是肺脉，脉克色，所以叫相胜；大而缓是脾脉，色克脉，所以也叫相胜。浮大而散是心脉，色生脉；小而滑是肾脉，脉生色，所以叫相生。）
经文说懂得一种（色、脉、尺）的是下工，懂得两种的是中工，懂得三种的是上工。上工治愈率十分之九，中工治愈率十分之八，下工治愈率十分之六，说的就是这个道理。（懂得一种，是指在色、脉、尺三者中能明白其一。全，指不误治，能治愈疾病。）
第十四难说：脉象有损脉和至脉，是什么意思呢？（少称为损，多称为至。）
回答说：至脉，一呼脉跳两次为平脉，三次为离经脉，四次为夺精脉，五次为死脉，六次为命绝脉，这就是至脉。什么是损脉？一呼脉跳一次为离经脉，两呼脉跳一次为夺精脉，三呼脉跳一次为死脉，四呼脉跳一次为命绝脉，这就是损脉。（平，指适得其常。离经，脱离其正常的经脉规律。夺精，精气已被耗夺。死，指必然导致死亡。命绝，则生机已绝，仅存脉搏跳动而已，也会随着呼吸停止。）
至脉的病势由下向上发展，损脉的病势由上向下发展。（心肺在上，肾肝在下。）损脉导致的病症是怎样的呢？
回答说：一损损伤皮毛，皮肤聚缩而毛发脱落；二损损伤血脉，血脉虚少，不能滋养五脏六腑；三损损伤肌肉，肌肉消瘦，饮食不能化为肌肤；四损损伤筋，筋脉弛缓不能自我约束；五损损伤骨，骨痿不能起床。与此相反的（即至脉），则是病势由下向上收敛。 （按“于收”二字，滑寿先生认为疑作“脉之”是对的。《灵枢·九针篇》说肺主皮，心主脉，脾主肌，肝主筋，肾主骨。皮聚，是指枯槁收缩。五脏中肺居最上，肾居最下，由肺到肾，这就是所谓的由上向下。相反的情况称为至脉的病，则由肾到肺，这就是所谓的由下向上。）由上向下的（损脉），出现骨痿不能起床的会死；由下向上的（至脉），出现皮肤聚缩毛发脱落的会死。（这是判断至脉和损脉的死期。大概损脉即为迟脉，迟属寒，所以先伤于表。至脉即为数脉，数为热，所以先伤于里。传变既久，导致内外表里都生病，就不可以再治疗了。）治疗损病的方法是怎样的呢？
回答说：损伤肺的，补益其气；损伤心的，调和其营卫；损伤脾的，调节饮食，适应寒温；损伤肝的，舒缓其中气；损伤肾的，补益其精。这就是治疗损病的方法。（肺主气，所以补益其气。营卫是由血液充盛的。饮食寒温，是肌肉生成的来源。缓中，即经文所说的“肝苦急，急食甘以缓之”的意思。精，是肾所藏的。大概病在哪个脏，就各自随其所在而治疗。）
回答说：脉来一呼两次，一吸两次，不大不小，称为平脉。一呼三次，一吸三次，为刚刚得病，（适得病，即上文离经的含义，指仅仅是有病的脉象。）前部（寸）大后部（尺）小，就会出现头痛、目眩；前部小后部大，就会出现胸满、短气。（前指寸口，后指尺部。前大后小，病气在阳，所以头痛、目眩。前小后大，病气在阴，所以胸满、短气。）一呼四次，一吸四次，病情将要加重，（病欲甚，即夺精的含义，指病情将深入。）脉象洪大的，苦于烦闷胀满；脉象沉细的，腹中疼痛；脉象滑的，伤于热邪；脉象涩的，中受雾露湿气。（洪大为阳邪外越，所以烦满。沉细为阴邪内陷，所以腹痛。滑为血实，所以为热。涩为伤湿，所以中受雾露。这里又对一息四至的不同病状分别说明，也是举例而言，仍应当根据现存的脉象来辨别疾病，希望读者推展其义。）一呼五次，一吸五次，其人应当困顿，（困者，近于死也。）脉沉细的夜间加重，脉浮大的白天加重，脉不大不小，虽然困顿也可治疗，如果有大小不一的，为难治。（沉细属阴，所以在夜间加重。浮大属阳，所以在白天加重。大，即浮大。小，即沉细。若不大不小，则昼夜不至于加重，所以可治。若有大小不一，则历经昼夜病情日益进展，为难治。不大不小，即《灵枢·禁服篇》所说的“如引绳大小齐等”的意思，如果参差不齐，则难治。）一呼六次，一吸六次，是死脉，脉沉细的夜间死，脉浮大的白天死。（死脉，即命绝的意思。）一呼一次，一吸一次，名叫损脉，人虽然能行走，终究应当卧床，之所以这样，是因为气血都不足。（意思是虽然能步行，长久以后必将不起床。气血不足，说明了得损脉的原因。）两呼一次，两吸一次，名叫无魂，无魂的人将会死亡，人虽然能行走，名叫行尸。（无魂，指魂气已离开。行尸，指其人生路已绝，如同尸体行走一样。）上部有脉，下部无脉，其人应当呕吐，不呕吐的会死。（呕吐则气逆于上，所以脉也随之上行，那么下部的无脉，是因为呕吐所致，并非真正断根。如果不呕吐而无脉，则脉是真的没有，而不是气逆的缘故，所以说死。）上部无脉，下部有脉，虽然困顿也无害处。之所以这样，比如人有尺肤，树有树根，枝叶虽然枯槁，根本还会自己生长。脉有根本，人有元气，所以知道不死。
第十五难说：经文说春脉弦，夏脉钩，秋脉毛，冬脉石，这是旺脉呢？还是病脉呢？（经文见于《素问·平人气象论》及《玉机真脏论》。）
回答说：弦、钩、毛、石，是四季的脉象。（四季之脉，指脉应合四季，即旺脉。）春脉弦，因为肝属东方木，万物开始生长，还没有枝叶，所以它的脉象来势濡弱而长，所以叫弦。（濡弱而长，是弦脉的正常形象，否则就是太过或不及的脉象。）夏脉钩，因为心属南方火，万物茂盛，垂枝布叶，都向下弯曲如钩，所以它的脉象来势疾而去势迟，所以叫钩。（来疾，指来势稍急而劲；去迟，指去势稍缓而弱，这就是所谓的向下弯曲如钩。）秋脉毛，因为肺属西方金，万物终结，草木花叶，都在秋天落下，只剩下枝条，像毫毛一样，所以它的脉象来势轻虚而浮，所以叫毛。（其枝独在、像毫毛，指四面没有辅助，而且体非常轻。）冬脉石，因为肾属北方水，万物收藏，盛冬之时，水凝结如石头，所以它的脉象来势沉濡而滑，所以叫石。这就是四季的脉象。（冬气敛聚，所以沉而濡滑，这是水的象。按脏腑与五行，各有所属，而春夏秋脉都以木为比喻，大概只有木是因时变迁变化的。）如果有变化怎么办？（变，指失常。）
回答说：春脉弦，反常的就是病。什么叫反常？
回答说：脉气来势实强，这叫太过，病在体表；脉气来势虚微，这叫不及，病在体内。（太过属阳，发于表，所以病在外。不及属阴，怯于中，所以病在内。）脉气来势厌厌聂聂，像抚摸榆叶那样，叫平脉；（厌厌，《素问》王冰注认为是浮薄而虚。）更加实而滑，像抚摸长竿那样，叫病脉；（这都是弦而太过的形象。）急而劲益强，像新张开的弓弦那样，叫死脉。（这就是弦脉的极致，即所谓的真脏脉。）春脉微弦叫平脉，弦多胃气少叫病脉，但弦无胃气叫死脉，春以胃气为本。夏脉钩，反常的就是病。什么叫反常？
回答说：脉气来势实强，这叫太过，病在体表；脉气来势虚微，这叫不及，病在体内。脉来累累如环，像抚摸琅玕（美石）那样，叫平脉；（如环，《素问》作“如连珠”，指满盛。琅玕，似珠的美石。）来势更加急促，像鸡举足那样，叫病脉；（指实而劲。）前曲后直，像拿着带钩那样，叫死脉。（居，《素问》王冰注说：“不动”。带钩，曲而坚硬的。）夏脉微钩叫平脉，钩多胃气少叫病脉，但钩无胃气叫死脉，夏以胃气为本。秋脉毛，反常的就是病。什么叫反常？
回答说：脉气来势实强，这叫太过，病在体表；脉气来势虚微，这叫不及，病在体内。脉来蔼蔼如车盖，按之更大叫平脉；（车盖，指浮大而虚。）不上不下，像抚摸鸡羽那样，叫病脉；（《素问》王冰注谓“中央坚而两旁虚”。）按之萧索，像风吹毛那样，叫死脉。（《素问》说：像物体漂浮，像风吹毛，叫肺死。“王冰说”像物体漂浮，瞥瞥然；像风吹毛，纷纷然。“大概都是轻虚飘乱的意义”。）秋脉微毛叫平脉，毛多胃气少叫病脉，但毛无胃气叫死脉，秋以胃气为本。冬脉石，反常的就是病。什么叫反常？
回答说：脉气来势实强，这叫太过，病在体表；脉气来势虚微，这叫不及，病在体内。脉来上大下尖，濡滑像雀啄那样，叫平脉；（雀啄，上大而末锐。）啄啄相连，其中微曲，叫病脉，（啄啄相连，指搏手而数。其中微曲，指其象似钩。）来势像解开的绳索，去势像弹石那样，叫死脉。（解索，紧而散；弹石，促而坚。《素问》说：“发如夺索，辟辟如弹石，叫肾死”。）冬脉微石叫平脉，石多胃气少叫病脉，但石无胃气叫死脉，冬以胃气为本。胃，是水谷的海，（水谷都汇聚于胃，像海汇聚众水一样。）主宰禀受四时，（胃属土，土分旺于四季，所以叫主宰禀受四时。）都以胃气为本，这就叫四季的变化病，死生的关键。脾，是中州，其平和的状态不可得见，（中州，指在四脏之中，四脏平和，则脾脉在其中，所以不可得见。）衰败时才显现。脉来像雀啄，像水往下漏，这是脾衰败的表现。（雀啄，指其坚锐。水下漏，指其断续无常。）
第十六难说：脉有三部九候，有阴阳，有轻重，有六十首，一脉变为四时，（三部九候，详见《素问·三部九候论》。阴阳，详见第四难。轻重，详见第五难。六十首，见于《素问·方盛衰论》，王冰注谓其义已失传，或谓即各旺六十日的意义。一脉变为四时，详见第十五难。但诸设难下文都没有阐明，怀疑有脱漏错误。）距离圣人久远，各自坚持自己的方法，怎么辨别呢？
回答说：是因为病症有外证和内证。（凡人所受伤成为病，用来验证病的是证，大概病合而证分。）病症是怎么回事呢？
回答说：假如得到肝脉，（五脏脉体详见第十三难。）其外证：爱干净，（肝与胆相合，胆为清净之腑，所以爱干净。）面色青，易怒；（《素问·阴阳应象大论》：肝“在色为苍”，“在志为怒”。）其内证：脐左有动气，按压坚实且痛；（《素问·刺禁论》：“肝生于左”，脐左，是肝的位置。动气，真气不能藏而表现于外。牢，指气结而坚。痛，指气郁而滞。）其病：四肢胀满，（满，闭塞。肢节皆属于肝，左氏传云：“风淫末疾”。）小便闭淋，排尿困难，（《灵枢·经脉篇》说，足厥阴肝经循行阴股，结于阴器，所以病见于小便方面。）转筋。（《灵枢·九针篇》说：“肝主筋”，所以病在筋。）有这些表现的是肝病，没有这些表现的就不是。（是，指上文病证。如果没有这些病证，即使见到肝脉，实际受病的也不在肝。）假如得到心脉，其外证：面色赤，（《素问》心“在色为赤”。）口干，（心气通于舌，火上炎则干。）喜笑；（《素问》心“在声为笑”。）其内证：脐上有动气，（脐上，是心的位置。）按压坚实且痛；其病：心烦，心痛，（病在本脏。）手掌发热且干呕。（《灵枢·经脉篇》手少阴心经“入掌内”，所以掌中热。哕，干呕。《素问·至真要大论》：“诸逆冲上，皆属于火”。）有这些表现的是心病，没有这些表现的就不是。假如得到脾脉，其外证：面色黄，（《素问》脾“在色为黄”。）爱嗳气，（噫，即嗳气。《灵枢·口问篇》说：“寒气客于胃，厥逆从下上散，复出于胃，故为噫。”脾与胃相合，所以病相同。）爱思考，（《素问》脾“在志为思”。）味觉灵敏；（《素问》脾“在窍为口”，所以主味。）其内证：当脐有动气，按压坚实且痛；（当脐，脾位乎中。）其病：腹胀满，（《素问·金匮真言论》：“腹为阴，阴中之至阴脾也。”所以病在腹。）食物不消化，（脾主磨食。）身体沉重，（脾主肌肉。）关节疼痛，（《素问·痿论》：阳明“主束骨而利机关”，脾与胃相合，所以也主关节。）怠惰嗜卧，（劳倦也属脾。）四肢无力不收。（脾主四肢。）有这些表现的是脾病，没有这些表现的就不是。假如得到肺脉，其外证：面色白，（《素问》肺“在色为白”。）爱打喷嚏，（《灵枢·口问篇》：“阳气和利，满于心，出于鼻。故嚏。肺气通于鼻，所以爱打喷嚏。”）悲伤愁苦不乐，想哭；（《素问》肺“在志为忧”，“在声为哭”。）其内证：脐右有动气，按压坚实且痛；（《素问·刺禁论》：“肺藏于右”，脐右，是肺的位置。）其病：喘咳，（肺主气，气逆则喘咳。）洒淅寒热。（肺主皮毛。）有这些表现的是肺病，没有这些表现的就不是。假如得到肾脉，其外证：面色黑，（《素问》肾“在色为黑”。）（易恐《素问》“在志为恐”。）呵欠；（《灵枢·口问篇》：“阴气积于下，阳气未尽，阳引而上，阴引而下，阴阳相引，所以数欠。”又说：“肾主为欠”。）其内证：脐下有动气，按压坚实且痛；（肾居最下）
(If the pathogenic factor) is extinguished in the exterior, yet the physician instead tonifies the Kidney and Liver. (The Kidney and Liver govern the interior; the Heart and Lung govern the exterior. "Tonify" here refers to the tonification method of acupuncture.) To tonify Yin when Yang is exhausted, or to tonify Yang when Yin is exhausted, (The Heart and Lung belong to Yang; the Kidney and Liver belong to Yin,) this is called making the excess more excessive and the deficiency more deficient, damaging what is insufficient and benefiting what is already in surplus. (What is termed "exhausted" is deficiency, i.e., insufficiency; what is termed "not exhausted" is excess, i.e., surplus. Tonifying what should not be tonified will make the exhausted state even more perilous.) Death resulting from such circumstances is caused by the physician killing the patient. (This means the disease does not necessarily lead to death, but the physician's mismanagement causes it.)
Chapter 13 states: The classic says that if one observes the facial color but fails to obtain the corresponding pulse, and instead obtains a pulse that overcomes (Sheng) the color, death will ensue; if a pulse that generates (Sheng) the color is obtained, the disease will resolve spontaneously. Facial color and pulse should correspond with each other; how should this be done? (This passage appears in *Ling Shu: Pathogenic Factors and Zang-Fu Manifestations*. The meanings of overcoming and generating are explained below.)
The response is: The Five Zang organs have five colors, all manifested on the face, which should also correspond with the Cun Kou pulse and the skin of the Chi area. (The manifestation of the five colors is described below, indicating that whichever Zang organ is diseased will manifest its corresponding color. "Cun Kou" refers to the pulse, while "Chi Nei" refers to the skin of the Chi area, as clarified in the subsequent text.)
For example, if the facial color is green (Qing), the pulse should be Wiry (Xian) and rapid (Ji); if red (Chi), the pulse should be Floating (Fu), Large (Da), and Scattered (San); if yellow (Huang), the pulse should be Moderate (Zhong), Slow (Huan), and Large (Da); if white (Bai), the pulse should be Floating (Fu), Choppy (Se), and Short (Duan); if black (Hei), the pulse should be Deep (Chen), Soft (Ru), and Slippery (Hua). This is what is meant by the correspondence between the five colors and the pulses. (*Ling Shu: Five Colors* states: "Green belongs to the Liver, Red to the Heart, White to the Lung, Yellow to the Spleen, Black to the Kidney." Wiry, rapid, floating, large, and scattered are the fundamental pulses of the Five Zang organs. *Ling Shu: Pathogenic Factors and Zang-Fu Manifestations* states: "Those with green faces have wiry pulses; those with red faces have hook-like pulses; those with yellow faces have intermittent pulses; those with white faces have hair-like pulses; those with black faces have stone-like pulses." This can be cross-referenced with the above.) If the pulse is Rapid (Shu), the skin of the Chi area also feels hot (Shu); if the pulse is Urgent (Ji), the skin of the Chi area is also tense (Ji); if the pulse is Slow (Huan), the skin of the Chi area is also relaxed (Huan); if the pulse is Choppy (Se), the skin of the Chi area is also rough (Se); if the pulse is Slippery (Hua), the skin of the Chi area is also smooth (Hua). (This is what is meant by correspondence with the Chi area skin.)
The Five Zang organs each have associated sounds, colors, odors, and tastes, which should correspond with the Cun Kou pulse and the Chi area skin. If there is no correspondence, it indicates disease.
For example, if the facial color is green, the pulse should be Wiry and rapid. If a Floating, Choppy, and Short pulse is seen, or a Large and Slow pulse, this indicates an Overcoming (Xiang Sheng/Ke) relationship. If a Floating, Large, and Scattered pulse is seen, or a Small and Slippery pulse, this indicates a Generating (Xiang Sheng) relationship. (Green color belongs to the Liver; a Floating, Choppy, and Short pulse is a Lung pulse, where the pulse overcomes the color, hence "Overcoming"; a Large and Slow pulse is a Spleen pulse, where the color overcomes the pulse, hence also "Overcoming". A Floating, Large, and Scattered pulse is a Heart pulse, where the color generates the pulse; a Small and Slippery pulse is a Kidney pulse, where the pulse generates the color, hence "Generating".)
The classic states that knowing one aspect makes one a Lower-grade practitioner (Xia Gong), knowing two makes one a Middle-grade practitioner (Zhong Gong), and knowing three makes one an Upper-grade practitioner (Shang Gong). An Upper-grade practitioner cures nine out of ten cases, a Middle-grade practitioner eight out of ten, and a Lower-grade practitioner six out of ten. This is what is meant. (Knowing one refers to being able to clarify one among color, pulse, and Chi skin. "Quan" refers to avoiding mismanagement and curing the disease.)
Chapter 14 states: Pulses include Sun (Damaging) and Zhi (Increasing) types. What does this mean? (Few beats are termed Sun; many beats are termed Zhi.)
The response is: In Zhi pulses, two beats per exhalation indicate a Normal Pulse (Ping); three beats per exhalation indicate Li Jing (Departing from the Standard); four beats per exhalation indicate Duo Jing (Depletion of Essence); five beats per exhalation indicate Si (Death); six beats per exhalation indicate Ming Jue (Extinction of Life). These are Zhi pulses. What are Sun pulses? One beat per exhalation indicates Li Jing; two breaths for one beat indicate Duo Jing; three breaths for one beat indicate Si; four breaths for one beat indicate Ming Jue. These are Sun pulses. (Normal refers to adhering to regularity. Li Jing means departing from normal physiological patterns. Duo Jing means essence has been depleted. Si indicates inevitable death. Ming Jue means vital energy is extinct, leaving only pulse movement, which will soon cease with respiration.)
Zhi pulses progress from bottom to top; Sun pulses progress from top to bottom. (Heart and Lung are upper; Kidney and Liver are lower.) How do diseases caused by Sun pulses manifest?
The response is: First-degree Sun damages the skin and hair, causing skin contraction and hair loss; Second-degree Sun damages the blood vessels, causing vessel deficiency and inability to nourish the Five Zang and Six Fu organs; Third-degree Sun damages the muscles, causing muscle emaciation and inability of food to transform into flesh; Fourth-degree Sun damages the sinews, causing flaccidity and inability to self-control; Fifth-degree Sun damages the bones, causing bone atrophy and inability to rise from bed. The reverse of this applies to Zhi pulses. (Regarding the characters "Yu Shou", Master Hua noted they likely should be "Mai Zhi". *Ling Shu: Nine Needles* states the Lung governs skin, Heart governs vessels, Spleen governs muscles, Liver governs sinews, and Kidney governs bones. Skin contraction refers to withering and shrinking. Among the Zang organs, the Lung is highest and the Kidney lowest; moving from Lung to Kidney is what is meant by "from top to bottom". The reverse describes Zhi pulse diseases, moving from Kidney to Lung, i.e., "from bottom to top".) For those progressing from top to bottom (Sun pulses), bone atrophy preventing rising from bed indicates death; for those progressing from bottom to top (Zhi pulses), skin contraction and hair loss indicate death. (This judges the time of death for Zhi and Sun pulses. Generally, Sun corresponds to Slow (Chi) pulses, which belong to Cold, thus affecting the exterior first. Zhi corresponds to Rapid (Shuo) pulses, which belong to Heat, thus affecting the interior first. After prolonged transmission, both interior/exterior and surface/deep levels become diseased, rendering treatment impossible.) How should Sun diseases be treated?
The response is: For Lung damage, benefit its Qi; for Heart damage, regulate Ying and Wei; for Spleen damage, adjust diet and adapt to cold/warmth; for Liver damage, soothe its center; for Kidney damage, benefit its Essence. This is the method for treating Sun diseases. (The Lung governs Qi, so benefit its Qi. Ying and Wei are filled by blood. Diet and temperature regulation are the sources of muscle formation. "Soothing the center" follows the classic principle: "The Liver dislikes constraint; eat sweet foods to soothe it." Essence is stored by the Kidney. Generally, treat according to the affected Zang organ.)
The response continues: Two beats per exhalation and two per inhalation, neither large nor small, is a Normal Pulse. Three beats per exhalation and three per inhalation indicate recent onset of disease (Shi De Bing, meaning Li Jing, merely having a disease pulse). If the front (Cun) is large and the back (Chi) is small, headache and dizziness occur; if the front is small and the back is large, chest fullness and shortness of breath occur. (Front refers to Cun, back to Chi. Front large/back small indicates pathogenic Qi in Yang, causing headache/dizziness. Front small/back large indicates pathogenic Qi in Yin, causing chest fullness/shortness of breath.) Four beats per exhalation and four per inhalation indicate worsening disease (Bing Yu Shen, meaning Duo Jing, disease deepening). If the pulse is Surging (Hong) and Large (Da), there is vexation and fullness; if Deep (Chen) and Fine (Xi), there is abdominal pain; if Slippery (Hua), heat injury occurs; if Choppy (Se), mist/dew dampness invades. (Surging/Large indicates Yang pathogen escaping outward, causing vexation/fullness. Deep/Fine indicates Yin pathogen sinking inward, causing abdominal pain. Slippery indicates blood excess, hence heat. Choppy indicates dampness injury, hence mist/dew invasion. This distinguishes diseases within four beats per breath, serving as an example; readers should deduce further based on observed pulse qualities.) Five beats per exhalation and five per inhalation indicate the person is distressed (Kun, near death). If Deep/Fine, symptoms worsen at night; if Floating/Large, symptoms worsen during the day. If neither large nor small, though distressed, it is treatable; if varying in size, it is difficult to treat. (Deep/Fine belongs to Yin, worsening at night. Floating/Large belongs to Yang, worsening during the day. Large refers to Floating/Large; Small refers to Deep/Fine. If neither large nor small, symptoms do not worsen diurnally/nocturnally, hence treatable. If varying, symptoms progress throughout day and night, hence difficult. "Neither large nor small" corresponds to *Ling Shu: Forbidden Regulations*: "like a rope of equal thickness"; if uneven, it is difficult to treat.) Six beats per exhalation and six per inhalation are Death Pulses (Si Mai). If Deep/Fine, death occurs at night; if Floating/Large, death occurs during the day. (Death pulse is synonymous with Ming Jue.) One beat per exhalation and one per inhalation is named Sun Pulse. Though the person can walk, they will eventually need to stay in bed, because Qi and Blood are both insufficient. (Though able to walk, they will ultimately not rise. Insufficient Qi/Blood explains the cause of the Sun pulse.) Two breaths for one beat is named Wu Hun (No Soul). Those with No Soul will die. Though able to walk, they are called "Walking Corpses". (No Soul means the soul qi has departed. Walking Corpse means life is extinguished, like a corpse walking.) If there is pulse in the upper part but none in the lower part, the person should vomit. If they do not vomit, they will die. (Vomiting causes Qi rebellion upward, so the pulse rises accordingly; lower pulse absence is due to vomiting, not true root loss. If no vomiting and no lower pulse, the pulse is truly absent, not due to Qi rebellion, hence death.) If there is no pulse in the upper part but pulse in the lower part, though distressed, it is harmless. Why? It is like a tree having roots; even if branches and leaves wither, the root survives. Pulses have roots; humans have Yuan Qi (Primal Qi), so death is avoided.
Chapter 15 states: The classic says Spring pulse is Wiry (Xian), Summer is Hook-like (Gou), Autumn is Hair-like (Mao), Winter is Stone-like (Shi). Are these Wang (Prosperous) pulses or Bing (Disease) pulses? (Passage found in *Su Wen: Plain Person Meteorological Theory* and *Jade Machine True Viscera Theory*.)
The response is: Wiry, Hook, Hair, and Stone are the pulses of the Four Seasons. (Four Season pulses refer to pulses responding to the seasons, i.e., Prosperous pulses.) Spring pulse is Wiry because the Liver belongs to East Wood. When things begin to grow, without branches or leaves, the pulse comes soft-weak and long, hence Wiry. (Soft-weak and long is the correct image of Wiry; otherwise, it is Excess or Deficient.) Summer pulse is Hook-like because the Heart belongs to South Fire. When things flourish, branches hang down like hooks, so the pulse comes rapidly and departs slowly, hence Hook-like. (Coming rapidly means slightly urgent and strong; departing slowly means slightly slow and weak, i.e., bending down like a hook.) Autumn pulse is Hair-like because the Lung belongs to West Metal. When things end, flowers and leaves fall in autumn, leaving only branches like hairs, so the pulse comes light, empty, and floating, hence Hair-like. (Only branches remaining, like hairs, means no support on four sides and very light body.) Winter pulse is Stone-like because the Kidney belongs to North Water. When things are stored, in deep winter water freezes like stone, so the pulse comes deep, soft, and slippery, hence Stone-like. These are the Four Season pulses. (Winter Qi gathers, so it is deep and slippery, the image of water. Regarding Zang organs and Five Elements, each has specific associations, but Spring/Summer/Autumn pulses use Wood as metaphor because Wood changes with seasons.) What if there are abnormalities? (Abnormality means deviation from norm.)
The response is: Spring pulse is Wiry; reversal indicates disease. What is reversal?
The response is: If Qi comes solid and strong, it is called Excess (Tai Guo), disease in the Exterior; if Qi comes empty and slight, it is called Deficiency (Bu Ji), disease in the Interior. (Excess belongs to Yang, manifesting in the exterior. Deficiency belongs to Yin, timid in the interior.) If Qi comes faintly and softly, like touching elm leaves, it is Normal; (Faintly, Wang Bing's commentary on *Su Wen* considers it floating, thin, and empty.) if more solid and slippery, like touching a long bamboo pole, it is Disease; (These are images of Wiry Excess.) if urgent, strong, and rigid, like a newly strung bowstring, it is Death. (This is the extreme of Wiry, i.e., True Viscera Pulse.) Spring pulse slightly Wiry is Normal; much Wiry with little Stomach Qi is Disease; purely Wiry without Stomach Qi is Death. Spring takes Stomach Qi as the root. Summer pulse is Hook-like; reversal indicates disease. What is reversal?
The response is: If Qi comes solid and strong, it is Excess, disease in Exterior; if Qi comes empty and slight, it is Deficiency, disease in Interior. If pulse comes continuously like a ring, like touching Lang Gan (jade-like stone), it is Normal; (Like a ring, *Su Wen* says "like linked pearls," indicating fullness. Lang Gan is a jade-like stone.) if coming more rapidly, like a chicken lifting its foot, it is Disease; (Indicates solid and strong.) if front curved and back straight, like holding a belt hook, it is Death. (Straight/Zhu, Wang Bing notes: "immovable". Belt hook is curved and hard.) Summer pulse slightly Hook-like is Normal; much Hook-like with little Stomach Qi is Disease; purely Hook-like without Stomach Qi is Death. Summer takes Stomach Qi as the root. Autumn pulse is Hair-like; reversal indicates disease. What is reversal?
The response is: If Qi comes solid and strong, it is Excess, disease in Exterior; if Qi comes empty and slight, it is Deficiency, disease in Interior. If pulse comes abundant like a chariot canopy, pressing makes it larger, it is Normal; (Chariot canopy, indicating floating, large, and empty.) neither up nor down, like touching chicken feathers, it is Disease; (Wang Bing notes: "firm in center, empty on sides.") pressing reveals desolation, like wind blowing feathers, it is Death. (*Su Wen* says: like floating object, like wind blowing feathers, is Lung Death. "Wang Bing says: like floating object, flickering; like wind blowing feathers, chaotic. 'Generally implies light, empty, and chaotic meaning'.") Autumn pulse slightly Hair-like is Normal; much Hair-like with little Stomach Qi is Disease; purely Hair-like without Stomach Qi is Death. Autumn takes Stomach Qi as the root. Winter pulse is Stone-like; reversal indicates disease. What is reversal?
The response is: If Qi comes solid and strong, it is Excess, disease in Exterior; if Qi comes empty and slight, it is Deficiency, disease in Interior. If pulse comes large above and sharp below, soft and slippery like a sparrow pecking, it is Normal; (Sparrow pecking, large above and sharp tip.) pecking continuously, slightly curved in middle, it is Disease, (Pecking continuously, beating hand and frequent. Slightly curved in middle, resembling Hook.) coming like untying a rope, departing like flicking stone, it is Death. (Untying rope, tight and scattered; flicking stone, rapid and hard. *Su Wen* says: "Hair like seizing rope, crackling like flicking stone, is Kidney Death".) Winter pulse slightly Stone-like is Normal; much Stone-like with little Stomach Qi is Disease; purely Stone-like without Stomach Qi is Death. Winter takes Stomach Qi as the root. The Stomach is the Sea of Water and Grain, (Water and grain gather in Stomach, like sea gathering waters.) governing provision for the Four Seasons, (Stomach belongs to Earth, Earth prospers in four seasons, hence governing provision for four seasons.) all taking Stomach Qi as the root. This is called the variable diseases of the Four Seasons, the key to life and death. The Spleen is the Central Region (Zhong Zhou). Its peaceful state cannot be seen; (Central Region means among the four Zang organs; when four Zang are peaceful, Spleen pulse is included, hence unseen.) it is seen only when declining. Coming like sparrow pecking, like water leaking down, is the manifestation of Spleen decline. (Sparrow pecking, firm and sharp. Water leaking, intermittent and irregular.)
Chapter 16 states: Pulses have Three Parts and Nine Locations, Yin and Yang, Light and Heavy, Sixty Heads, one pulse changing into Four Seasons. (Three Parts/Nine Locations detailed in *Su Wen: Three Parts Nine Locations*. Yin/Yang in Chapter 4. Light/Heavy in Chapter 5. Sixty Heads in *Su Wen: Abundance and Decline*, Wang Bing notes meaning lost, or refers to sixty days prosperity. One pulse changing into Four Seasons in Chapter 15. But subsequent questions lack explanation, suspecting omission/error.) Distance from Sages is long, each insists on their methods, how to distinguish?
The response is: Because diseases have Exterior and Interior manifestations. (Injuries causing disease are verified by manifestations; disease combines while manifestations differentiate.) What are the diseases?
The response is: For example, obtaining Liver pulse (Five Zang pulse bodies detailed in Chapter 13). Exterior manifestations: Love cleanliness, (Liver pairs with Gallbladder, Gallbladder is clear/pure fu, hence love cleanliness.) Green face, prone to anger; (*Su Wen: Yin-Yang Ying Xiang Da Lun*: Liver "color is blue/green", "emotion is anger".) Interior manifestations: Moving Qi at left of umbilicus, firm and painful upon pressure; (*Su Wen: Acupuncture Taboos*: "Liver born on left", left of umbilicus is Liver position. Moving Qi is true Qi failing to store and manifest externally. Firm means Qi knotting and hard. Pain means Qi stagnating.) Disease: Limb fullness/blockage, (Fullness means blockage. Limbs belong to Liver, *Zuo Zhuan*: "Wind induces terminal diseases".) Urinary obstruction/dysuria, difficult urination, (*Ling Shu: Meridians*: Foot Jueyin Liver meridian runs along inner thigh, knots at genitalia, hence urinary issues.) Tendon cramping. (*Ling Shu: Nine Needles*: "Liver governs tendons", hence tendon disease.) Having these indicates Liver disease; lacking them indicates non-Liver disease. (These refer to above symptoms. Without these, even with Liver pulse, disease is not in Liver.) For example, obtaining Heart pulse. Exterior manifestations: Red face, (*Su Wen*: Heart "color is red".) Dry mouth, (Heart Qi connects to tongue, Fire flaming upward causes dryness.) Laughter; (*Su Wen*: Heart "sound is laughter".) Interior manifestations: Moving Qi above umbilicus, (Above umbilicus is Heart position.) firm and painful upon pressure; Disease: Vexed heart, Heart pain, (Disease in the Zang itself.) Hot palms and hiccups/vomiting. (*Ling Shu: Meridians*: Hand Shaoyin Heart meridian "enters palm", hence hot palms. Hiccups/vomiting. *Su Wen: Supreme Essentials*: "All rebellious upward movements belong to Fire".) Having these indicates Heart disease; lacking them indicates non-Heart disease. For example, obtaining Spleen pulse. Exterior manifestations: Yellow face, (*Su Wen*: Spleen "color is yellow".) Frequent belching, (Yi is belching. *Ling Shu: Mouth Questions*: "Cold qi lodges in Stomach, Rebellious Qi scatters upward from below, exits Stomach again, hence belching." Spleen pairs with Stomach, hence same disease.) Frequent thinking, (*Su Wen*: Spleen "emotion is thought".) Keen taste; (*Su Wen*: Spleen "orifice is mouth", hence governs taste.) Interior manifestations: Moving Qi at umbilicus, firm and painful upon pressure; (At umbilicus, Spleen is central.) Disease: Abdominal fullness, (*Su Wen: Golden Cabinet True Meanings*: "Abdomen is Yin, Yin among Yin is Spleen." Hence disease in abdomen.) Food indigestion, (Spleen grinds food.) Heavy body, (Spleen governs muscles.) Joint pain, (*Su Wen: Flaccidity Syndrome*: Yangming "binds bones and facilitates joints", Spleen pairs with Stomach, hence also governs joints.) Lethargy and desire to sleep, (Fatigue also belongs to Spleen.) Limbs unable to hold/restrain. (Spleen governs limbs.) Having these indicates Spleen disease; lacking them indicates non-Spleen disease. For example, obtaining Lung pulse. Exterior manifestations: White face, (*Su Wen*: Lung "color is white".) Frequent sneezing, (*Ling Shu: Mouth Questions*: "Yang Qi harmonious and beneficial, fills Heart, exits Nose. Hence sneezing. Lung Qi connects to Nose, hence sneezing.") Sadness, sorrow, unhappiness, desire to cry; (*Su Wen*: Lung "emotion is grief", "sound is crying".) Interior manifestations: Moving Qi at right of umbilicus, firm and painful upon pressure; (*Su Wen: Acupuncture Taboos*: "Lung stored on right", right of umbilicus is Lung position.) Disease: Asthma and cough, (Lung governs Qi, Qi rebellion causes asthma/cough.) Chills and fever. (Lung governs skin/hair.) Having these indicates Lung disease; lacking them indicates non-Lung disease. For example, obtaining Kidney pulse. Exterior manifestations: Black face, (*Su Wen*: Kidney "color is black".) (Fear. *Su Wen*: "Emotion is fear".) Yawning; (*Ling Shu: Mouth Questions*: "Yin Qi accumulates below, Yang Qi not exhausted, Yang pulls upward, Yin pulls downward, Yin-Yang pull each other, hence frequent yawning." Also: "Kidney governs yawning".) Interior manifestations: Moving Qi below umbilicus, firm and painful upon pressure; (Kidney resides lowest)