凡诊脉于掌后约文。密排三指。头指半指之前为寸外。阳中之阳。半指之后为寸内。阳中之阴。第二指半指前。为
关上阳。半指后。关下阴。（按原本此下有半指之前尺外阳半指之后尺内阴十四字。乃因下文而误衍也。今删之。）第三
指半指之前。为尺外阳。半指之后。为尺内阴。寸外阳浮散。寸内阴浮大。关上阳弦长。关下阴弦紧。尺外阳沉滑。尺
内阴沉涩。此左手脉之阴阳。察其脉状。明其覆溢。
夫夏至之后。阴出二分。故曰天关。冬至之后。阳入三分。故曰地轴。所以人之脉阴出阳入。名曰关也。其立夏阴
气乃终。名曰地户。立冬阳气乃终。名曰天门。其关格门户。是阴阳始终之要。其过于本位。应见而不见。名曰不及。
不应见处而见。名曰覆溢。其关格覆溢。是阴阳相胜。皆当不病而死也。
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立秋处暑否卦所主为阴始生
小满芒种乾卦所主故阴至立夏而终
小雪大雪坤卦所主故阳至立冬而终
立春雨水泰卦所主为阳所生
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此寸外主头寸内主胸中关上主膈中
关下主腹中尺外主脐下尺内主至足
四难曰。脉有阴阳之法。何谓也。然。呼出心与肺。吸入肾与肝。呼吸之间。脾受谷味也。其脉在中。
吕曰。心肺在膈上。脏中之阳。故呼其气出。肾肝在膈下。脏中之阴。故吸其气入。脾者。中州主养四脏。故曰呼
吸以受谷气。丁曰。经言呼出者。非气自心肺而出也。为肾肝在膈下。主内。因呼而出至心至肺。故呼出心与肺也。又
心肺者在膈上。主外。故吸即随阴而入至肾至肝。故经曰。呼者因阳出。吸者随阴入。其呼吸阴阳相随上下。经历五脏
之间。乃脾受谷味也。又脾者主中州。故言其脉在中也。
浮者、阳也。
丁曰。谓脉循行皮肤血脉之间。在肌肉之上。则名曰浮也。杨曰。按之不足。举之有余。故曰浮。虞曰。阳象火而
炎上、故曰浮也。
沉者、阴也。
丁曰。谓脉循行帖节辅骨。名曰沉。杨曰。按之有余。举之不足。故曰沉。虞曰。阴象水而润下。故曰沉。
故曰阴阳也。心肺俱浮。何以别之。然。浮而大散者。心也。浮而短涩者。肺也。
丁曰。心者、南方火也。故脉来浮而大散。其大者是脏。散者是腑也。肺者、西方金也。金主燥。其脉浮涩而短。
短者、脏也。涩者、腑也。杨曰。细而迟。来往难且散。或一止。名曰涩也。虞曰。心象火。明烛于外。故浮大而散。
肺属金。其位居高。故浮短而涩。故曰心肺俱浮也。
肾肝俱沉。何以别之。然。牢而长者。肝也。
丁曰。肝者、东方木也。其脉牢而长。牢者、脏也。长者。腑也。杨曰。按之但觉坚极。故曰牢。虞曰。肝属木。
根本生于地。牢义可知。枝叶长于天。长理出此也。
按之濡。举指来实者。肾也。
丁曰。肾者、北方水也。主寒。其性濡沉。濡者、脏也。沉滑者、腑也。杨曰。按之不足。举之有余。谓之濡也。
大而长。微强。按之应指 然者。谓之实。虞曰。火性外柔。按之乃濡。水性内刚。举指来实。则其义也。
脾者中州。故其脉在中。
丁曰。脾者、中央土也。能成养四旁。故随四时而见。所以经不言脉之象也。杨曰。脾王于季夏。主养四脏。其脉
来大小浮沉。故根据四时。王脉俱至四季一十八日。即变宽缓。是脾之王气也。上有心肺。下有肾肝。故曰在中也。虞曰。
上文言呼吸之间。脾受谷味。此言脾者中州。其脉在中。 者、谷也。谷、空也。谓人之呼吸之气。自谷而有。脾土属
土。位居中央。土者、五方物始终以之。故受谷味。乃处中州。故曰其脉在中也。
是阴阳之法也。脉有一阴一阳。一阴二阳。一阴三阳。有一阳一阴。一阳二阴。一阳三阴。如此之言。寸口有六脉
俱动耶。然此言者。非有六脉俱动也。谓浮沉长短滑涩也。
丁曰。经前引五脏之脉。以应五行。今引此三阴三阳之脉。以应六气。其浮滑长。三阳也。其沉短涩。三阴也。凡
持三部中。察此六脉。即可知阴阳伏匿之法也。若皮肤之下。是脉之下为阳部也。若有此三阴之脉见。是阴上乘于阳也。
若肌肉之下。是脉之下为阴部也。若有此三阳脉见。即是阳气下乘于阴也。此乃是上下察阴阳之法也。杨曰。过于本位
谓之长。不及本位谓之短也。
浮者、阳也。滑者、阳也。长者、阳也。
杨曰。按之往来流利展转替替然。谓之滑。
沉者、阴也。短者、阴也。涩者、阴也。所谓一阴一阳者。谓脉来沉而滑也。
丁曰。其脉若在左尺而见。此是肾与膀胱表里。顺也。若在左寸口。即为病脉。逆也。
一阴二阳者。谓脉来沉滑而长也。
此脉见于阴部。即是阳下乘于阴也。
一阴三阳者。谓脉来浮滑而长。时一沉也。
此者是阳伏于阴也。
所言一阳一阴者。谓脉来浮而涩也。
丁曰。浮涩者肺脉。当见右手寸口。即是本部之阴阳。即顺也。若在左关。病。即是逆也。
一阳二阴者。谓脉来长而沉涩也。
丁曰。即乏血气。皆涩也。
一阳三阴者、谓脉来沉涩而短。时一浮也。
丁曰。若有阳部见之。此谓阴伏阳也。
各以其经所在。名病逆顺也。
杨曰。随春夏秋冬。观其六脉之变。则知病之逆顺也。
五难曰。脉有轻重。何谓也。然。初持脉如三菽之重。与皮毛相得者。肺部也。如六菽之重。与血脉相得者。心部
也。
吕曰。菽者、豆也。言脉之轻重。如三豆之重。在皮毛之间。皮毛者、肺气所行也。言肺部也。心主血脉。次于肺。
如六豆重。
如九菽之重。与肌肉相得者。脾部也。
吕曰。脾在中央。主肌肉。故次心。如九豆之重也。
如十二菽之重。与筋平者、肝部也。
吕曰。肝主筋。又在脾下。故次之。
按之至骨。举指来疾者、肾也。
吕曰。肾主骨。其脉沉至骨。故曰肾也。
故曰轻重也。
丁曰。经言菽者、豆也。此是诊脉举按之法也。此篇当在四难之前。以等阴阳高下。虞曰。脉之轻重。经中所载甚
详。若根据经逐位寻之。义且浅矣。今举一例为式。假令左手寸口如三菽得之。乃知肺气之至。如六菽之重得之。知本经
之至。如九菽得之。知脾气之至。如十二菽得之。知肝气之至。按之至骨得之。知肾气之至。夫如是。乃知五脏之气。
更相溉灌。六脉因兹亦有准绳。可以定吉凶。可以言疾病。余皆仿之。故曰轻重也。
六难曰。脉有阴盛阳虚。阳盛阴虚。何谓也。然。浮之损小。沉之实大。故曰阴盛阳虚。沉之损小。浮之实大。故
曰阳盛阴虚。是阴阳虚实意也。
吕曰。阳脉是寸口。本浮而实。今轻手浮而得之。更损减而小。故曰阳虚。重手按之。沉、反更实大。沉者阴。故
言阴实也。丁曰。阳脉本浮。轻手而按其脉。损至而小。此是阳虚不足也。阴脉本沉而濡。今重手而按之。损至而小。
是阴不足也。阳脉本浮。更加实大。此是阳盛阴虚也。素问曰。诸浮者。肾不足也。虞曰。人之所禀者。阴阳也。阴阳
平。权衡等。则无更虚更实之证。今言盛与虚。则为病之脉。脉要精微论曰。阴盛则梦涉大水恐惧。阳盛则梦大火燔灼。
阴阳俱盛。则梦相杀毁伤。夫如是。可验阴阳虚实之意也。
七难曰。经言少阳之至。乍小乍大。乍短乍长。阳明之至。浮大而短。太阳之至。洪大而长。太阴之至。紧大而长。
少阴之至。紧细而微。厥阴之至。沉短而敦。此六者。是平脉邪。将病脉邪。然。皆王脉也。其气以何月。各王几日。
然冬至之后得甲子。少阳王。复得甲子。阳明王。复得甲子。太阳王。复得甲子。太阴王。复得甲子。少阴王。复得甲
子。厥阴王。王各六十日。六六三百六十日。以成一岁。此三阳三阴之王时日大要也。
吕曰。少阳王正月二月。其气尚微少。故其脉来进退无常。阳明王三月四月。其气始萌未盛。故其脉来浮大而短也。
太阳王五月六月。其气太盛。故其脉来洪大而长。太阴王七月八月。乘夏余阳。阴气未盛。故其脉来紧大而长。少阴王
九月十月。阳气衰而阴气盛。故其脉来紧细而微也。厥阴王十一月十二月。阴气盛极。故言厥阴。其脉来沉短以敦。敦
者、沉重也。四时经一阴一阳八王。此难经三阳在前。三阴在后。其王所以不同者。其移各异也。难经谓从正月至六月。
春夏半岁。浮阳用事。故言三阳王在前。从七月至十二月。秋冬半岁。沉阴用事。故言三阴在后。谓四时阴阳夫妇之王
也。丁曰。夫三阴三阳之气王。随六甲以言之。此法是按黄帝六节脏象论云。天以六六之节成一岁。其自冬至之后。得
甲子。即是盛年初之气分也。（按盛字疑衍。）其甲子或在小寒之初。或在大寒之后，所以少阳之气。未出阴分。故其脉
乍大乍小。乍短乍长也。复得甲子。阳明王。其阳明之至。浮大而短。为二之气。其后始暄。其气未盛。是故阳明之至。
浮大而短。太阳之至。洪大而长。复得甲子。为三之气。盛阳之分。故太阳之至。洪大而长也。太阴之至。紧大而长。
复得甲子。为四之气。暑湿之分。秋气始生。乘夏余阳。故太阴之至。紧大而长也。少阴之至。紧细而微。复得甲子。
为五之气。清切之分。故少阴之至。紧细而微也。（按此而字。原本误在下文水凝二字下。今移正。）厥阴之至。沉短而
敦。复得甲子。为终之气。盛阴之分。水凝如石。故厥阴之至。沉短而敦也。此三阴三阳之脉王。随六甲之日数。故有
此六脉之状。是谓平脉也。
八难曰。寸口脉平而死者。何谓也。然。诸十二经脉者。皆系于生气之原。所谓生气之原者。谓十二经之根本也。
谓肾间动气也。此五脏六腑之本。十二经脉之根。呼吸之门。三焦之原。一名守邪之神。故气者、人之根本也。根绝则
茎叶枯矣。寸口脉平而死者。生气独绝于内也。
吕曰。寸口脉平而死者。非应四时脉。其脉状若平和也。又曰。十二经皆系于生气之原。所谓生气之原者。为十二
经本原也。夫气冲之脉者。起于两肾之间。主气。故言肾间动气。挟任脉上至喉咽。通喘息。故云呼吸之门。上系手三
阴三阳为支。下系足三阴三阳为根。故圣人引树以设喻也。其三焦之原者。是三焦之府。宣行荣冲。（按冲字疑当作卫。）
邪不妄入。故曰守邪之神也。人以尺脉为根本。寸脉为茎叶。寸脉虽平。尺脉绝。上部有脉。下部无脉者。死也。
寸口脉平者。应四时也。所云死者。尺中无脉也。尺脉者、人之根本。根本既绝。则茎叶枯焉。然则以尺脉为根本。寸
脉为茎叶。故引树以为譬也。丁曰。肾间动气者。谓左为肾。右为命门。命门者、精神之所舍。元气之所系也。一名守
邪之神者。以命门之神固守。邪气不得妄入。入则死矣。此肾气先绝于内。其人不病。病即死矣。虞曰。经言十二经。
皆系于生气之原。谓肾间动气也。何以言之。谓两肾之间动气者。乃人之所受父母之原气也。肾者。北方子之正位。故
圣人云。元气起于子。子者、坎之方位。坎者、即父母之元气也。谓干为天为父。坤为地为母。今坎之初六六三。乃坤
之初六六三也。坎之九二。干之九二也。谓乾坤交于六三。九二而成坎卦。坎主子位。所以元气起于子也。肾者、水也。
黄庭经云。是水之精。坎之气。今言两肾之间。即人之原气也。术士云。肾间曰丹田。亦曰隐海。中有神龟。呼吸原气。
故曰呼吸之门也。人之三焦。法天地三元之气。故曰三焦之原。十二经脉凭此而生。乃曰十二经之根也。今寸口传受谷
气。其脉但平和。奈人之生气之原。已绝于两肾之间。则十二经无所相根据。虽寸脉平和。人当死矣。所以喻木之无根
本也。肾者、足少阴之经也。左为肾。右曰命门。命门有穴。在背十四椎节下。又有志室二穴。在十四椎节下两旁各三
寸。有神守于命门。不令邪入志室。邪入志室。人则死矣。
九难曰。何以别知脏腑之病耶。然。数者、腑也。迟者、脏也。
杨曰。去来急促。一息过五至。名数也。呼吸三至。去来极迟。故曰迟也。
数则为热。迟则为寒。诸阳为热。诸阴为寒。故以别知脏腑之病也。
吕曰。病者阳，故其脉数。脏者阴。故其脉来迟。杨曰。阳脉行疾。故病乃数。阴脉行迟。故病乃迟。此直云病在
脏腑。不显其名。则病莫知准的。若数而弦者。病在胆。迟而弦者。病在肝。除脏腑悉根据本状。而迟数皆仿此也。虞曰。
阳气乱则数。阴气虚则迟。则知脏腑有寒热之证也。丁曰。脉者、计于漏刻。其春秋二分。昼夜五十刻。则阴阳俱等。
故得平和。冬夏二至。昼夜不等。夏至之前。昼六十刻。故六十为数（按六十疑当作六至。）故数则为热。冬至之前。夜
加六十刻。故阴多阳少。是为寒。夫阴阳漏刻可定。人自有损益。故迟数有加。所以经云。诸阳为热。诸阴为寒。
十难曰。一脉为十变者。何谓也。然。五邪、刚柔相逢之意也。假令心脉急甚者。肝邪干心也。
凡是在手掌后横纹处诊脉，将三根手指紧密排列。食指指尖前半个指宽的位置为寸部外侧，属于阳中之阳；半个指宽后的位置为寸部内侧，属于阳中之阴。中指指尖前半个指宽的位置为关部外侧阳，半个指宽后的位置为关部内侧阴。（按原本此处有“半指之前尺外阳，半指之后尺内阴”十四字，是因下文而误衍生的，现在删去。）无名指指尖前半个指宽的位置为尺部外侧阳，半个指宽后的位置为尺部内侧阴。寸部外侧阳脉浮散，寸部内侧阴脉浮大；关部外侧阳脉弦长，关部内侧阴脉弦紧；尺部外侧阳脉沉滑，尺部内侧阴脉沉涩。这是左手脉象的阴阳变化，通过观察脉状，明确其覆脉和溢脉的特征。
夏至之后，阴气外出二分，所以称为天关。冬至之后，阳气入内三分，所以称为地轴。因此人的脉象中阴出阳入，称为关。立夏时阴气终结，称为地户。立冬时阳气终结，称为天门。这些关格门户，是阴阳始终的关键。如果脉象超过本位，该出现的时候没出现，称为不及。不该出现的地方却出现了，称为覆溢。这种关格、覆溢的现象，是阴阳相互偏胜的表现，都应当在不生病的情况下死亡。
立秋、处暑时节，否卦所主为阴气开始生成。
小满、芒种时节，乾卦所主，所以阴气到立夏终结。
小雪、大雪时节，坤卦所主，所以阳气到立冬终结。
立春、雨水时节，泰卦所主，为阳气开始生成。
此寸部外侧主头部，寸部内侧主胸中，关部外侧主膈中，关部内侧主腹中，尺部外侧主脐下，尺部内侧主至足。
第四难说：脉象有阴阳的方法，是什么意思呢？回答说：呼气时心与肺参与，吸气时肾与肝参与，在呼吸之间，脾受纳水谷精微之气。脾的脉象位于中部。
吕广说：心肺在膈上，是脏中的阳，所以呼气时气出。肾肝在膈下，是脏中的阴，所以吸气时气入。脾是中州，主养四脏，所以说呼吸之间受纳谷气。
丁德用说：经文说呼出，并非气直接从心肺而出。因为肾肝在膈下，主内，因呼气而气上升至心至肺，所以说呼出心与肺。另外心肺在膈上，主外，所以吸气时随阴气进入至肾至肝，所以经文说：呼者因阳出，吸者随阴入。呼吸的阴阳相随上下，经历五脏之间，这时脾才受纳水谷精微。另外脾主中州，所以说它的脉在中部。
浮脉，属阳。
丁德用说：谓脉行于皮肤血脉之间，在肌肉之上，就称为浮。
杨玄操说：重按感觉不足，轻举感觉有余，所以称为浮。
虞庶说：阳象火而炎上，所以称为浮。
沉脉，属阴。
丁德用说：谓脉行贴附节辅骨，称为沉。
杨玄操说：重按感觉有余，轻举感觉不足，所以称为沉。
虞庶说：阴象水而润下，所以称为沉。
所以说这是阴阳。心肺的脉都浮，如何区别它们呢？回答说：浮而大散的，是心脉；浮而短涩的，是肺脉。
丁德用说：心属南方火，所以脉来浮而大散。其大者是脏，散者是腑。肺属西方金，金主燥，其脉浮涩而短。短者是脏，涩者是腑。
杨玄操说：细而迟，往来困难且散，或有一止，称为涩。
虞庶说：心象火，光明烛照于外，所以脉浮大而散。肺属金，其位居高，所以脉浮短而涩。所以说心肺脉俱浮。
肾肝的脉都沉，如何区别它们呢？回答说：牢而长的，是肝脉。
丁德用说：肝属东方木，其脉牢而长。牢者是脏，长者是腑。
杨玄操说：重按只觉坚极，所以称为牢。
虞庶说：肝属木，根本生于地，牢的意义可知。枝叶长于天，长的道理出于此。
重按柔软，轻举指来感觉坚实的，是肾脉。
丁德用说：肾属北方水，主寒，其性濡沉。濡者是脏，沉滑者是腑。
杨玄操说：重按感觉不足，轻举感觉有余，称为濡。
虞庶说：大而长，微微强劲，重按应指坚实有力的，称为实。火性外柔，重按乃濡；水性内刚，轻举指来实，这就是其中的道理。
脾属中州，所以其脉在中。
丁德用说：脾属中央土，能成养四旁，所以随四季而变化显现。因此经文不言脉的具体形象。
杨玄操说：脾旺于季夏，主养四脏，其脉来大小浮沉，所以根据四时。王脉俱至四季各十八日，即变得宽缓，这是脾的王气。上有心肺，下有肾肝，所以说在中。
虞庶说：上文讲呼吸之间，脾受谷味，这里讲脾者中州，其脉在中。“谷”者，空也。谓人之呼吸之气，自谷而有。脾土属土，位居中央，土是五方万物始终依赖的，所以受纳谷味，处于中州，所以说其脉在中。
这就是阴阳的方法。脉有一阴一阳、一阴二阳、一阴三阳，有一阳一阴、一阳二阴、一阳三阴。像这样的话，寸口有六条脉同时跳动吗？回答说：这里说的，不是有六条脉同时跳动，而是指浮、沉、长、短、滑、涩这六种脉象。
丁德用说：经文前引五脏之脉以应五行，现在引此三阴三阳之脉以应六气。其浮滑长为三阳，其沉短涩为三阴。凡是持三部脉，观察这六脉，就可以知道阴阳伏匿的方法了。如果在皮肤之下，是脉的下部为阳部，如果有此三阴之脉出现，是阴上乘于阳。如果在肌肉之下，是脉的下部为阴部，如果有此三阳脉出现，即是阳气下乘于阴。这是上下察阴阳的方法。
杨玄操说：超过本位称为长，不及本位称为短。
浮脉，属阳。滑脉，属阳。长脉，属阳。
杨玄操说：重按往来流利展转替替然，称为滑。
沉脉，属阴。短脉，属阴。涩脉，属阴。所谓一阴一阳，是指脉来沉而滑。
丁德用说：如果脉在左尺出现，这是肾与膀胱表里关系，顺证。如果在左寸口出现，即为病脉，逆证。
所言一阳一阴，是指脉来浮而涩。
丁德用说：浮涩是肺脉，应当见右手寸口，即是本部之阴阳，即顺证。如果在左关出现，有病，即是逆证。
一阳三阴，是指脉来沉涩而短，时而一浮。
丁德用说：如果有阳部出现，这叫阴伏阳。
各自以其经脉所在，名为病之逆顺。
杨玄操说：随春夏秋冬，观察其六脉的变化，就知道病的逆顺了。
第五难说：脉有轻重，是什么意思呢？回答说：初持脉如三颗豆子的重量，与皮毛相得的，是肺的部位。如六颗豆子的重量，与血脉相得的，是心的部位。
吕广说：菽就是豆。言脉的轻重，如三豆的重量，在皮毛之间。皮毛是肺气所行，言肺的部位。心主血脉，次于肺，如六豆重。
如九颗豆子的重量，与肌肉相得的，是脾的部位。
吕广说：脾在中央，主肌肉，故次心，如九豆重。
如十二颗豆子的重量，与筋平的，是肝的部位。
吕广说：肝主筋，又在脾下，故次之。
按之至骨，举指来疾的，是肾。
吕广说：肾主骨，其脉沉至骨，所以说肾。
所以说轻重。
丁德用说：经文说菽是豆，这是诊脉举按的方法。此篇应当在第四难之前，以等阴阳高下。
虞庶说：脉的轻重，经书中记载很详细。如果根据经文逐位寻找，义理就浅了。现在举一例作为格式。假如左手寸口如三豆得之，就知道肺气至；如六豆重得之，知本经气至；如九豆得之，知脾气至；如十二豆得之，知肝气至；按之至骨得之，知肾气至。像这样，就知道五脏之气更相灌溉，六脉因此也有准绳，可以定吉凶，可以言疾病。其余都仿照这个例子。所以说轻重。
第六难说：脉有阴盛阳虚、阳盛阴虚，是什么意思呢？回答说：轻取（浮）损小，重取（沉）实大，所以叫阴盛阳虚。重取（沉）损小，轻取（浮）实大，所以叫阳盛阴虚。这是阴阳虚实的意思。
吕广说：阳脉是寸口，本浮而实。现在轻手浮取而得，更损减而小，所以叫阳虚。重手按之，沉反更实大。沉者阴，所以说阴实。
丁德用说：阳脉本浮，轻手按其脉，损至而小，这是阳虚不足。阴脉本沉而濡，现在重手按之，损至而小，是阴不足。阳脉本浮，更加实大，这是阳盛阴虚。《素问》说：诸浮者，肾不足也。
虞庶说：人所禀赋的是阴阳。阴阳平，权衡等，就没有更虚更实的证候。现在说盛与虚，就是病的脉象。《脉要精微论》说：阴盛则梦涉大水恐惧，阳盛则梦大火燔灼，阴阳俱盛，则梦相杀毁伤。像这样，可以验证阴阳虚实的意思。
第七难说：经文说少阳之至，乍小乍大，乍短乍长；阳明之至，浮大而短；太阳之至，洪大而长；太阴之至，紧大而长；少阴之至，紧细而微；厥阴之至，沉短而敦。这六个，是平脉呢，还是病脉呢？回答说：都是王脉（旺脉）。它们的气在什么月，各王几日呢？回答说：冬至之后得甲子日，少阳王。再得甲子日，阳明王。再得甲子日，太阳王。再得甲子日，太阴王。再得甲子日，少阴王。再得甲子日，厥阴王。各王六十日，六六三百六十日，以成一岁。这是三阳三阴王时日的大概。
吕广说：少阳王正月二月，其气尚微少，所以其脉来进退无常。阳明王三月四月，其气始萌未盛，所以其脉来浮大而短。太阳王五月六月，其气太盛，所以其脉来洪大而长。太阴王七月八月，乘夏余阳，阴气未盛，所以其脉来紧大而长。少阴王九月十月，阳气衰而阴气盛，所以其脉来紧细而微。厥阴王十一月十二月，阴气盛极，所以说厥阴。其脉来沉短以敦。敦者，沉重也。四时经一阴一阳八王，此《难经》三阳在前，三阴在后。其王所以不同者，其移各异也。《难经》谓从正月至六月，春夏半岁，浮阳用事，所以说三阳王在前。从七月至十二月，秋冬半岁，沉阴用事，所以说三阴在后。谓四时阴阳夫妇之王。
丁德用说：夫三阴三阳之气王，随六甲而言。此法是按《黄帝六节脏象论》云：天以六六之节成一岁。其自冬至之后，得甲子，即是盛年初之气分。（按“盛”字疑衍。）其甲子或在小寒之初，或在大寒之后，所以少阳之气，未出阴分，故其脉乍大乍小，乍短乍长。复得甲子，阳明王，其阳明之至，浮大而短，为二之气。其后始暄，其气未盛，是故阳明之至，浮大而短。太阳之至，洪大而长，复得甲子，为三之气。盛阳之分，故太阳之至，洪大而长。太阴之至，紧大而长，复得甲子，为四之气。暑湿之分，秋气始生，乘夏余阳，故太阴之至，紧大而长。少阴之至，紧细而微，复得甲子，为五之气。清切之分，故少阴之至，紧细而微。（按此“而”字，原本误在下文“水凝”二字下，今移正。）厥阴之至，沉短而敦，复得甲子，为终之气。盛阴之分，水凝如石，故厥阴之至，沉短而敦。此三阴三阳之脉王，随六甲之日数，故有此六脉之状。是谓平脉。
第八难说：寸口脉平而死者，是什么意思呢？回答说：所有的十二经脉，都系于生气之原。所谓生气之原，就是十二经的根本。称为肾间动气。这是五脏六腑之本，十二经脉之根，呼吸之门，三焦之原。一名守邪之神。所以气，是人的根本。根绝则茎叶枯矣。寸口脉平而死者，是因为生气独绝于内。
吕广说：寸口脉平而死者，不是应四时的脉，其脉状若平和。又说：十二经皆系于生气之原。所谓生气之原，为十二经本原。夫气冲之脉，起于两肾之间，主气，所以说肾间动气。挟任脉上至喉咽，通喘息，所以说呼吸之门。上系手三阴三阳为支，下系足三阴三阳为根。所以圣人引树以设喻。其三焦之原者，是三焦之府，宣行荣卫。（按“冲”字疑当作“卫”。）邪不妄入，所以说守邪之神。人以尺脉为根本，寸脉为茎叶。寸脉虽平，尺脉绝。上部有脉，下部无脉者，死也。寸口脉平者，应四时也。所说的死者，尺中无脉也。尺脉者，人之根本。根本既绝，则茎叶枯焉。然而以尺脉为根本，寸脉为茎叶，所以引树以为譬。
丁德用说：肾间动气者，谓左为肾，右为命门。命门者，精神之所舍，元气之所系也。一名守邪之神者，以命门之神固守，邪气不得妄入。入则死矣。此肾气先绝于内，其人不病，病即死矣。
虞庶说：经文说十二经，皆系于生气之原，谓肾间动气也。何以言之？谓两肾之间动气者，乃人之所受父母之原气也。肾者，北方子之正位，所以圣人云：元气起于子。子者，坎之方位。坎者，即父母之元气也。谓干为天为父，坤为地为母。今坎之初六六三，乃坤之初六六三也。坎之九二，干之九二也。谓乾坤交于六三、九二而成坎卦。坎主子位，所以元气起于子也。肾者，水也。《黄庭经》云：是水之精，坎之气。今言两肾之间，即人之原气也。术士云：肾间曰丹田，亦曰隐海，中有神龟，呼吸原气，所以说呼吸之门。人之三焦，法天地三元之气，所以说三焦之原。十二经脉凭此而生，乃曰十二经之根也。今寸口传受谷气，其脉但平和，奈人之生气之原，已绝于两肾之间，则十二经无所相根据。虽寸脉平和，人当死矣。所以喻木之无根本。肾者，足少阴之经也。左为肾，右曰命门。命门有穴，在背十四椎节下。又有志室二穴，在十四椎节下两旁各三寸。有神守于命门，不令邪入志室。邪入志室，人则死矣。
第九难说：如何分别知道脏腑的病呢？回答说：数脉，属腑。迟脉，属脏。
杨玄操说：去来急促，一息过五至，称为数。呼吸三至，去来极迟，所以说迟。
数则为热，迟则为寒。诸阳为热，诸阴为寒。所以以此分别知道脏腑的病。
吕广说：病者阳，所以其脉数。脏者阴，所以其脉来迟。
杨玄操说：阳脉行疾，所以病乃数。阴脉行迟，所以病乃迟。这里只说病在脏腑，不显其名，则病莫知准的。若数而弦者，病在胆。迟而弦者，病在肝。除脏腑悉根据本状，而迟数皆仿照此例。
虞庶说：阳气乱则数，阴气虚则迟，则知脏腑有寒热之证。
丁德用说：脉者，计于漏刻。其春秋二分，昼夜五十刻，则阴阳俱等，故得平和。冬夏二至，昼夜不等。夏至之前，昼六十刻，故六十为数（按“六十”疑当作“六至”），故数则为热。冬至之前，夜加六十刻，故阴多阳少，是为寒。夫阴阳漏刻可定，人自有损益，故迟数有加。所以经文云：诸阳为热，诸阴为寒。
When palpating the pulse at the wrist crease, place three fingers closely together. The position half a finger-width anterior to the tip of the index finger is the exterior Yang of the Cun (Inch) position, which is Yang within Yang. The position half a finger-width posterior to that is the interior Yin of the Cun position, which is Yin within Yang. The position half a finger-width anterior to the tip of the middle finger is the exterior Yang of the Guan (Bar) position. The position half a finger-width posterior to that is the interior Yin of the Guan position. (Note: The original text contains fourteen characters here—"half a finger-width anterior is exterior Yang of Chi, half a finger-width posterior is interior Yin of Chi"—which are erroneous interpolations due to the following text and have been deleted.) The position half a finger-width anterior to the tip of the ring finger is the exterior Yang of the Chi (Cubit) position. The position half a finger-width posterior to that is the interior Yin of the Chi position. The exterior Yang of Cun is floating and scattered; the interior Yin of Cun is floating and large. The exterior Yang of Guan is wiry and long; the interior Yin of Guan is wiry and tight. The exterior Yang of Chi is deep and slippery; the interior Yin of Chi is deep and choppy. These describe the Yin and Yang of the left hand pulse. By observing the pulse condition, one clarifies the characteristics of Fu (Reversal) and Yi (Overflow) pulses.
After the Summer Solstice, Yin Qi exits by two parts, hence it is called Tian Guan (Heavenly Gate). After the Winter Solstice, Yang Qi enters by three parts, hence it is called Di Zhou (Earth Axis). Therefore, in human pulses, the exit of Yin and entry of Yang is named Guan (Barrier). When Yin Qi ends at Li Xia (Start of Summer), it is called Di Hu (Earth Door). When Yang Qi ends at Li Dong (Start of Winter), it is called Tian Men (Heavenly Gate). These Guan barriers and doors are the key to the beginning and end of Yin and Yang. If the pulse exceeds its proper position but fails to appear when it should, it is called Bu Ji (Insufficiency). If it appears where it should not, it is called Fu Yi (Reversal and Overflow). Such Guan Ge (Barrier and Grid), Fu, and Yi phenomena indicate that Yin and Yang are overcoming each other; death will occur even without apparent illness.
At Li Qiu (Start of Autumn) and Chu Shu (Limit of Heat), the Pi Hexagram governs, indicating the beginning of Yin generation.
At Xiao Man (Grain Buds) and Mang Zhong (Grain in Ear), the Qian Hexagram governs, so Yin ends at Li Xia.
At Xiao Xue (Minor Snow) and Da Xue (Major Snow), the Kun Hexagram governs, so Yang ends at Li Dong.
At Li Chun (Start of Spring) and Yu Shui (Rain Water), the Tai Hexagram governs, indicating the beginning of Yang generation.
The exterior of Cun governs the head; the interior of Cun governs the chest. The exterior of Guan governs the diaphragm; the interior of Guan governs the abdomen. The exterior of Chi governs below the navel; the interior of Chi governs down to the feet.
Difficulty 4 states: There is a method of Yin and Yang in pulse diagnosis. What does this mean? It is answered: Exhalation involves the Heart and Lungs; inhalation involves the Kidneys and Liver. Between breaths, the Spleen receives grain essence. Its pulse is located in the middle.
Lu Guang says: The Heart and Lungs are above the diaphragm, representing Yang within Zang organs, so exhalation causes Qi to exit. The Kidneys and Liver are below the diaphragm, representing Yin within Zang organs, so inhalation causes Qi to enter. The Spleen is the Central Region, nourishing the four Zang organs, thus it is said that between breaths, it receives grain Qi.
Ding Deyong says: When the classic says "exhalation," it does not mean Qi exits directly from the Heart and Lungs. Because the Kidneys and Liver are below the diaphragm and govern internalization, upon exhalation, Qi rises to the Heart and Lungs; hence it is said "exhalation involves Heart and Lungs." Furthermore, the Heart and Lungs are above the diaphragm and govern externalization, so upon inhalation, Qi follows Yin into the Kidneys and Liver. Thus the classic says: "Exhalation follows Yang out; inhalation follows Yin in." The Yin and Yang of respiration follow each other up and down, passing through the five Zang organs, during which the Spleen receives grain essence. Since the Spleen governs the Central Region, its pulse is said to be in the middle.
Floating pulse belongs to Yang.
Ding Deyong says: When the pulse runs between the skin and blood vessels, above the muscle, it is called Floating.
Yang Xuance says: When pressed deeply, it feels insufficient; when lifted lightly, it feels abundant. Hence it is called Floating.
Yu Shu says: Yang resembles fire, which flares upward; hence it is called Floating.
Deep pulse belongs to Yin.
Ding Deyong says: When the pulse runs adhering to the joints and accessory bones, it is called Deep.
Yang Xuance says: When pressed deeply, it feels abundant; when lifted lightly, it feels insufficient. Hence it is called Deep.
Yu Shu says: Yin resembles water, which moistens downward; hence it is called Deep.
Thus, these are Yin and Yang. Both Heart and Lung pulses are floating; how to distinguish them? It is answered: Floating, large, and scattered indicates the Heart; floating, short, and choppy indicates the Lung.
Ding Deyong says: The Heart belongs to Fire in the South, so the pulse comes floating, large, and scattered. The "large" aspect represents the Zang organ; the "scattered" aspect represents the Fu organ. The Lung belongs to Metal in the West; Metal governs dryness, so its pulse is floating, choppy, and short. The "short" aspect represents the Zang organ; the "choppy" aspect represents the Fu organ.
Yang Xuance says: Fine and slow, difficult to move, and scattered, or with occasional pauses, is called Choppy.
Yu Shu says: The Heart resembles fire, shining brightly outward, so the pulse is floating, large, and scattered. The Lung belongs to Metal, residing high, so the pulse is floating, short, and choppy. Thus, both Heart and Lung pulses are floating.
Both Kidney and Liver pulses are deep; how to distinguish them? It is answered: Firm and long indicates the Liver.
Ding Deyong says: The Liver belongs to Wood in the East; its pulse is firm and long. The "firm" aspect represents the Zang organ; the "long" aspect represents the Fu organ.
Yang Xuance says: When pressed deeply, only extreme hardness is felt; hence it is called Firm.
Yu Shu says: The Liver belongs to Wood; its root grows in the earth, explaining the meaning of "firm." Its branches grow toward heaven, explaining the meaning of "long."
Soft upon deep pressure, but becoming solid upon lifting the finger, indicates the Kidney.
Ding Deyong says: The Kidney belongs to Water in the North, governing cold; its nature is soft and deep. The "soft" aspect represents the Zang organ; the "deep and slippery" aspect represents the Fu organ.
Yang Xuance says: Insufficient upon deep pressure, abundant upon light lifting is called Soft.
Yu Shu says: Large and long, slightly strong, and solid upon deep pressure is called Solid. Fire nature is externally soft, becoming soft upon pressure; Water nature is internally rigid, becoming solid upon light lifting. This is the principle.
The Spleen belongs to the Central Region, so its pulse is in the middle.
Ding Deyong says: The Spleen belongs to Earth in the Center, nourishing the four peripheries, so it manifests according to the four seasons. Therefore, the classic does not specify a single pulse image for it.
Yang Xuance says: The Spleen prospers in late summer, nourishing the four Zang organs. Its pulse varies in size, depth, and floatiness, corresponding to the four seasons. The Prosperous Pulse arrives for eighteen days in each of the four seasons, becoming broad and slow; this is the Prosperous Qi of the Spleen. Above are Heart and Lung; below are Kidney and Liver; hence it is said to be in the middle.
Yu Shu says: The previous text mentioned the Spleen receiving grain essence between breaths; this text states the Spleen is the Central Region and its pulse is in the middle. "Gu" (Valley/Empty) means empty. Human respiratory Qi originates from emptiness. The Spleen belongs to Earth, positioned centrally. Earth is relied upon by all things in the five directions to receive grain essence, thus residing in the Central Region, so its pulse is in the middle.
This is the method of Yin and Yang. Pulses can be one Yin one Yang, one Yin two Yang, one Yin three Yang; one Yang one Yin, one Yang two Yin, one Yang three Yin. Does this mean six pulses beat simultaneously at the Cun Kou? It is answered: This refers not to six pulses beating simultaneously, but to the six pulse qualities: Floating, Deep, Long, Short, Slippery, and Choppy.
Ding Deyong says: The classic previously cited five Zang pulses to correspond to the Five Elements; now it cites these Three Yin and Three Yang pulses to correspond to the Six Qi. Floating, Slippery, and Long are Three Yang; Deep, Short, and Choppy are Three Yin. By holding the three positions and observing these six pulses, one can understand the methods of Yin and Yang hiding. If below the skin, the lower part of the pulse is the Yang region; if Three Yin pulses appear here, Yin is overriding Yang. If below the muscle, the lower part of the pulse is the Yin region; if Three Yang pulses appear here, Yang is overriding Yin. This is the method of inspecting Yin and Yang from above and below.
Yang Xuance says: Exceeding the proper position is called Long; falling short of the proper position is called Short.
Floating pulse is Yang. Slippery pulse is Yang. Long pulse is Yang.
Yang Xuance says: Smooth, flowing, and rolling upon pressure is called Slippery.
Deep pulse is Yin. Short pulse is Yin. Choppy pulse is Yin. "One Yin One Yang" refers to a pulse that is Deep and Slippery.
Ding Deyong says: If this pulse appears at the Left Chi, it indicates the interior-exterior relationship between Kidney and Bladder, which is favorable. If it appears at the Left Cun Kou, it is a pathological pulse, unfavorable.
"One Yin Two Yang" refers to a pulse that is Deep, Slippery, and Long.
If this pulse appears in the Yin region, it indicates Yang overriding Yin.
"One Yin Three Yang" refers to a pulse that is Floating, Slippery, and Long, occasionally Deep.
This indicates Yang hidden within Yin.
"One Yang One Yin" refers to a pulse that is Floating and Choppy.
Ding Deyong says: Floating and Choppy is the Lung pulse, which should appear at the Right Cun Kou, representing the Yin and Yang of its own region, which is favorable. If it appears at the Left Guan, there is disease, which is unfavorable.
"One Yang Two Yin" refers to a pulse that is Long, Deep, and Choppy.
Ding Deyong says: This indicates a lack of Qi and Blood, all Choppy.
"One Yang Three Yin" refers to a pulse that is Deep, Choppy, and Short, occasionally Floating.
Ding Deyong says: If seen in the Yang region, this is called Yin hiding Yang.
Based on the location of the respective meridians, one names the disease as favorable or unfavorable.
Yang Xuance says: Observing the changes of the six pulses according to spring, summer, autumn, and winter reveals whether the disease is favorable or unfavorable.
Difficulty 5 states: Pulses have degrees of weight. What does this mean? It is answered: Applying light pressure equivalent to the weight of three beans, feeling the pulse at the level of the skin and hair, indicates the Lung region. Applying pressure equivalent to six beans, feeling the pulse at the level of the blood vessels, indicates the Heart region.
Lu Guang says: "Shu" means bean. The weight of the pulse is like three beans, between the skin and hair. Skin and hair are where Lung Qi travels, indicating the Lung region. The Heart governs blood vessels, secondary to the Lung, like six beans.
Applying pressure equivalent to nine beans, feeling the pulse at the level of the muscle, indicates the Spleen region.
Lu Guang says: The Spleen is in the center, governing muscles, thus secondary to the Heart, like nine beans.
Applying pressure equivalent to twelve beans, feeling the pulse at the level of the tendons, indicates the Liver region.
Lu Guang says: The Liver governs tendons and is below the Spleen, thus secondary.
Pressing to the bone, with the pulse returning swiftly upon lifting the finger, indicates the Kidney.
Lu Guang says: The Kidney governs bones; its pulse is deep to the bone, hence the Kidney.
Thus, these are the degrees of weight.
Ding Deyong says: The classic mentions "shu" as beans; this is the method of lifting and pressing in pulse diagnosis. This chapter should precede Difficulty 4 to equalize Yin and Yang heights.
Yu Shu says: The weights of pulses are detailed in the classics. Following the classics position by position makes the meaning shallow. Now taking one example as a model: If the Left Cun Kou requires three beans' weight, one knows Lung Qi has arrived; if six beans, the meridian Qi has arrived; if nine beans, Spleen Qi has arrived; if twelve beans, Liver Qi has arrived; pressing to the bone, Kidney Qi has arrived. In this way, one knows the five Zang Qi irrigate each other, and the six pulses have standards to determine fortune/misfortune and discuss disease. Others follow this pattern. Thus, they are called weights.
Difficulty 6 states: Pulses exhibit Yin Excess and Yang Deficiency, or Yang Excess and Yin Deficiency. What does this mean? It is answered: Light pressure (Floating) yields a diminished/small pulse; heavy pressure (Deep) yields a solid/large pulse. This is called Yin Excess and Yang Deficiency. Heavy pressure (Deep) yields a diminished/small pulse; light pressure (Floating) yields a solid/large pulse. This is called Yang Excess and Yin Deficiency. This is the meaning of Yin/Yang Deficiency/Excess.
Lu Guang says: Yang pulses are at Cun Kou, originally floating and solid. Now, light floating pressure yields a diminished/small pulse, hence Yang Deficiency. Heavy pressing yields a Deep pulse that is surprisingly solid/large. Deep is Yin, hence Yin Excess.
Ding Deyong says: Yang pulses are originally floating; light pressure yields a diminished/small pulse, indicating Yang Deficiency. Yin pulses are originally deep and soft; heavy pressure yields a diminished/small pulse, indicating Yin Deficiency. Yang pulses are originally floating; if they become solid/large, this is Yang Excess and Yin Deficiency. *Su Wen* says: All floating pulses indicate Kidney deficiency.
Yu Shu says: Humans are endowed with Yin and Yang. If Yin and Yang are balanced, there are no alternating deficiency/excess syndromes. Speaking of excess and deficiency refers to pathological pulses. *Mai Yao Jing Wei Lun* says: Yin excess dreams of wading in water and fear; Yang excess dreams of fire burning; both Yin and Yang excess dream of killing and injury. Thus, one can verify the meaning of Yin/Yang deficiency/excess.
Difficulty 7 states: The classic says: At the time of Shaoyang, the pulse is alternately small and large, short and long. At the time of Yangming, it is floating, large, and short. At the time of Taiyang, it is surging, large, and long. At the time of Taiyin, it is tight, large, and long. At the time of Shaoyin, it is tight, fine, and faint. At the time of Jueyin, it is deep, short, and dull. Are these six normal pulses or pathological pulses? It is answered: They are all Prosperous Pulses (Wang Mai). In which months do their Qi prosper, and for how many days? It is answered: After the Winter Solstice, upon obtaining a Jia-Zi day, Shaoyang prospers. Upon obtaining another Jia-Zi day, Yangming prospers. Upon obtaining another Jia-Zi day, Taiyang prospers. Upon obtaining another Jia-Zi day, Taiyin prospers. Upon obtaining another Jia-Zi day, Shaoyin prospers. Upon obtaining another Jia-Zi day, Jueyin prospers. Each prospers for sixty days. Six times sixty equals three hundred and sixty days, completing one year. This is the general rule for the days of prosperity of the Three Yang and Three Yin.
Lu Guang says: Shaoyang prospers in the first and second months; its Qi is still slight, so the pulse comes irregularly. Yangming prospers in the third and fourth months; its Qi is just sprouting and not yet strong, so the pulse is floating, large, and short. Taiyang prospers in the fifth and sixth months; its Qi is very strong, so the pulse is surging, large, and long. Taiyin prospers in the seventh and eighth months, riding on the residual Yang of summer while Yin Qi is not yet strong, so the pulse is tight, large, and long. Shaoyin prospers in the ninth and tenth months; Yang Qi declines and Yin Qi becomes strong, so the pulse is tight, fine, and faint. Jueyin prospers in the eleventh and twelfth months; Yin Qi reaches extremity, hence Jueyin. The pulse is deep, short, and dull. "Dun" means heavy. The four seasons undergo eight periods of Yin and Yang prosperity. Here in *Nan Jing*, Three Yang are before Three Yin. The difference lies in their shifting. *Nan Jing* states that from the first to the sixth month (spring and summer half-year), floating Yang is active, so Three Yang are stated first. From the seventh to the twelfth month (autumn and winter half-year), sinking Yin is active, so Three Yin are stated last. This refers to the prosperity of Yin and Yang couples in the four seasons.
Ding Deyong says: The prosperity of Three Yin and Three Yang Qi follows the Six Jia cycles. This method aligns with *Huangdi Liu Jie Zang Xiang Lun*: Heaven completes a year with six-six segments. After the Winter Solstice, obtaining a Jia-Zi day marks the beginning of the year's Qi. (Note: "Sheng" character may be superfluous.) The Jia-Zi day may be at the start of Minor Cold or after Major Cold. Thus, Shaoyang Qi has not yet exited the Yin division, so the pulse is alternately large/small and short/long. Obtaining another Jia-Zi day, Yangming prospers; its pulse is floating, large, and short, marking the second Qi period. Afterwards warmth begins, but Qi is not yet strong, hence Yangming pulse is floating, large, and short. Taiyang pulse is surging, large, and long; obtaining another Jia-Zi day, it marks the third Qi period. In the peak Yang division, Taiyang pulse is surging, large, and long. Taiyin pulse is tight, large, and long; obtaining another Jia-Zi day, it marks the fourth Qi period. In the heat-damp division, autumn Qi begins, riding on residual summer Yang, hence Taiyin pulse is tight, large, and long. Shaoyin pulse is tight, fine, and faint; obtaining another Jia-Zi day, it marks the fifth Qi period. In the clear-cold division, Shaoyin pulse is tight, fine, and faint. (Note: The character "er" was originally misplaced under "shui ning" and has been corrected.) Jueyin pulse is deep, short, and dull; obtaining another Jia-Zi day, it marks the final Qi period. In the peak Yin division, water freezes like stone, hence Jueyin pulse is deep, short, and dull. The prosperity of these Three Yin and Three Yang pulses follows the days of the Six Jia, resulting in these six pulse conditions. These are called Normal Pulses.
Difficulty 8 states: Cun Kou pulse is normal, yet the patient dies. What does this mean? It is answered: All twelve meridians are connected to the Source of Vital Qi. The Source of Vital Qi is the root of the twelve meridians, known as the Moving Qi between the Kidneys. This is the root of the five Zang and six Fu organs, the root of the twelve meridians, the gate of respiration, and the source of the San Jiao. It is also called the Spirit Guarding against Evil. Thus, Qi is the root of humans. If the root perishes, the stems and leaves wither. Cun Kou pulse is normal, yet the patient dies, because the Source of Vital Qi alone has perished internally.
Lu Guang says: Cun Kou pulse is normal, yet the patient dies; this is not the pulse corresponding to the four seasons, but appears peaceful. Also, the twelve meridians connect to the Source of Vital Qi, which is the origin of the twelve meridians. The Chong Mai arises between the two Kidneys, governing Qi, hence "Moving Qi between the Kidneys." It accompanies the Ren Mai up to the throat, facilitating breathing, hence "Gate of Respiration." It connects superiorly to the Hand Three Yin and Yang as branches, and inferiorly to the Foot Three Yin and Yang as roots. Thus the sage uses trees as metaphors. The source of the San Jiao is the mansion of the San Jiao, disseminating Ying and Wei Qi. (Note: "Chong" may be a typo for "Wei".) Evil does not enter randomly, hence "Spirit Guarding Against Evil." Humans take Chi pulse as the root and Cun pulse as the stem and leaves. Even if Cun pulse is normal, if Chi pulse perishes, having pulse above but none below indicates death. Cun Kou pulse being normal corresponds to the four seasons. The "death" mentioned refers to the absence of pulse at Chi. Chi pulse is the root of humans. Once the root perishes, the stems and leaves wither. Thus, using Chi as root and Cun as stem, the tree metaphor is used.
Ding Deyong says: Moving Qi between the Kidneys refers to the Left as Kidney and Right as Mingmen (Gate of Life). Mingmen is where Spirit resides and Yuan Qi is attached. Called "Spirit Guarding Against Evil," the spirit of Mingmen firmly guards, preventing evil from entering randomly. If evil enters, death occurs. If Kidney Qi perishes internally first, the person is not ill, but once ill, they die.
Yu Shu says: The classic states the twelve meridians connect to the Source of Vital Qi, i.e., Moving Qi between the Kidneys. Why? The Moving Qi between the two Kidneys is the Original Qi received from parents. The Kidney is the correct position of Zi in the North. Thus the sage says: Yuan Qi originates at Zi. Zi is the direction of Kan. Kan is the Original Qi of parents. Qian is Heaven/Father, Kun is Earth/Mother. The initial six lines of Kan correspond to the initial six lines of Kun. The nine-two of Kan corresponds to the nine-two of Qian. Qian and Kun intersect at six-three and nine-two to form the Kan hexagram. Kan governs the Zi position, so Yuan Qi originates at Zi. The Kidney is Water. *Huang Ting Jing* says: It is the essence of water, the Qi of Kan. Thus, the space between the two Kidneys is the Original Qi of humans. Taoists say: The space between Kidneys is called Dantian or Hidden Sea, containing a divine turtle that breathes Original Qi, hence "Gate of Respiration." Human San Jiao models the Three Primordial Qi of Heaven and Earth, hence "Source of San Jiao." The twelve meridians rely on this to generate, hence "Root of Twelve Meridians." Now, Cun Kou transmits Grain Qi, and its pulse is merely peaceful. However, if the Source of Vital Qi has perished between the two Kidneys, the twelve meridians have no foundation. Even if Cun pulse is peaceful, the person will die. Thus, it is compared to a tree without roots. The Kidney is the Foot Shaoyin Meridian. Left is Kidney, Right is Mingmen. There is an acupoint at Mingmen, below the fourteenth thoracic vertebra. There are also two Zhishi acupoints, three cun lateral to the fourteenth thoracic vertebra. A spirit guards Mingmen, preventing evil from entering Zhishi. If evil enters Zhishi, the person dies.
Difficulty 9 states: How to distinguish diseases of Zang and Fu? It is answered: Rapid pulse belongs to Fu. Slow pulse belongs to Zang.
Yang Xuance says: Coming and going rapidly, exceeding five beats per respiration cycle, is called Rapid. Three beats per respiration cycle, coming and going extremely slowly, is called Slow.
Rapid indicates Heat; Slow indicates Cold. All Yang indicates Heat; all Yin indicates Cold. Thus, one distinguishes Zang and Fu diseases by this.
Lu Guang says: Disease is Yang, so its pulse is rapid. Zang is Yin, so its pulse is slow.
Yang Xuance says: Yang pulses move quickly, so disease presents as rapid. Yin pulses move slowly, so disease presents as slow. Simply stating disease is in Zang or Fu without naming it makes the target unknown. If Rapid and Wiry, disease is in Gallbladder. If Slow and Wiry, disease is in Liver. Except for Zang/Fu specifics based on original conditions, Slow and Rapid follow this pattern.
Yu Shu says: Chaotic Yang Qi leads to Rapid; deficient Yin Qi leads to Slow. Thus, one knows Zang and Fu have Cold or Heat syndromes.
Ding Deyong says: Pulse measurement relies on clepsydra (water clock). During Spring and Autumn equinoxes, day and night are fifty ke, so Yin and Yang are equal, yielding peace. During Winter and Summer solstices, day and night are unequal. Before Summer Solstice, day is sixty ke, so sixty is considered Rapid (Note: "Sixty" likely means "six beats"). Thus Rapid indicates Heat. Before Winter Solstice, night adds sixty ke, so Yin is more than Yang, indicating Cold. Although Yin/Yang clepsydra times are fixed, humans have gains and losses, so Slow/Rapid vary. Hence the classic says: All Yang is Heat, all Yin is Cold.
Difficulty 10 states: What does "one pulse transforms ten times" mean? It is answered: It refers to the interaction of Five Evils and the meeting of Gang and Rou. For example, if the Heart pulse is extremely wiry/tight, it is Liver Evil invading the Heart.