虞曰。肝木脾土。脾主四肢。木病则土无所畏。故四肢闭满。玉机真脏论曰。脾太过。令人四肢不举。癃溲便难转
筋。有是者肝也。无是者非也。
丁曰。肝者、东方木也。其治在左应震。齐左有动气。按之牢若痛。其病四肢满闭者。谓肢节挛 也。淋溲便难者、
足厥阴上系舌本。下环于阴器。故淋溲便难也。其转筋者、谓肝含血以养筋。故病即转筋也。有此内外证。即肝也。无
是者。非也。虞曰。癃溲、谓小府涩也。便难。大府所注难也。谓肝脉循于阴器。故癃溲也。肝肾主下部。肝病则气逆
不行于下。故便难也。肝属木也。木曰曲直。筋乃象之。今肝病。故转筋也。吕曰。外证者。腑之候。胆者清净之腑。
故面青善洁。若衣被饮食不洁者。其人便欲怒。胆色青。故面青怒也。（按此怒字疑衍。）其内证者、肝之证。肝者、东
方为青龙。在左方。故肝之证在齐左。
假令得心脉。其外证。面赤。口干。喜笑。
丁曰。外证者、手太阳之脉为外经。故有病即见于外。其应火。故病即外热、口干、喜笑。是其外证也。虞曰。心
脉浮大而散。心属火。火性炎上。故面亦口干也。心在声为笑也。
其内证。齐上有动气。按之牢若痛。其病烦心。心痛。掌中热而 。有是者。心也。无是者。非也。
丁曰。心者、南方火也。其位在离。故齐上有动气。其病烦心、心痛、掌中热而 者。心病即烦痛、故 。臂内掌
中热而 者。是其内证也。有其证者。心之病。无其证者。即非也。虞曰。心之积名曰伏梁。在齐上。火之生热。心为
五脏之君。四脏有病。心主知之。尚有痛状。何况本经自病耶。常痛、乃心包脉也。正心不受病。病则旦占夕死。夕占
旦死。重明受病。则心包络。乃手厥阴之脉。出两手中指之端。不入掌心。屈名指取之。 名劳宫 。心包病。则掌中
热而 心。吕曰。外证者。小肠手太阳脉为热。故令口干。阳主躁。故喜笑也。其内证者心。心在前为朱雀。故证在齐
上也。
假令得脾脉。
虞曰。脾脉中缓而大。
其外证面黄善噫。
丁曰。其外证面黄。阳明为胃之经。故见色黄。外之证也。虞曰。脾、土也。在变动为噫。
善思。
虞曰。脾者在志为思也。
善味。
虞曰。脾主甘受味。故善味。
其内证。当齐有动气。按之牢若痛。
虞曰。脾之积。名曰痞气。当齐之中。
其病。腹胀满。食不消。体重。节痛。怠堕嗜卧。四肢不收。有是者。脾也。无是者。非也。
丁曰。内证者、足太阴脾也。当齐有动气者。脾主中州也。其病腹满。食不消。体重节痛。怠堕嗜卧。四肢不收。
皆为土。土静、故有此证。前注言外证面黄而不解余说者。为善噫。善味者、是脾也。今腹胀满。食不消。即是胃也。
胃为水谷之海。病即食不消。体重节痛。怠堕嗜卧。四肢不收。皆是见外证也。今却言内证也。此经所说。文至不明。
未敢尽注其说。以俟后贤。虞曰。湿气胜则令人彭胀。阳气在下。食乃不消。得主内。病则如是。脾属土。土性安静。
故知是土主四肢。病乃四肢不收。吕曰。外证、足阳明胃脉之证。胃气实。谷气消。即多所思。欲饮食。胃气虚。食不
消。气力虚羸。其人感思虑。内证者、脾也。脾在中央。故证当齐。齐者、又阴阳之中。故其脉在脾也。
假令得肺脉。其外证。面白善嚏。悲愁不乐。欲哭。
丁曰。其外证者、手阳明之经。大肠为肺之腑也。故善嚏。悲愁不乐。欲哭。此外之证也。虞曰。肺脉浮短而涩。
面白。乃金之色也。肺主皮毛。皮毛外感寒。内合于肺。故嚏也。悲者、肺之志也。脾土肺金。脾为肺母。脾主歌。子
病母忧。故不乐。在声为哭。
其内证。齐右有动气。按之牢若痛。其病。喘嗽、洒淅寒热。有是者。肺也。无是者。非也。
丁曰。其言内证者。手太阴之经。应西方金在兑。故言齐右有动气也。其为喘嗽洒淅寒热者。故知内证也。虞曰。
肺之积。名曰息贲。在右胁下。肺主皮毛。今寒气外感于皮毛。内合于肺。则气道涩。故喘而咳。肺主气。外候于皮毛。
肺虚则洒淅寒。肺实则热而闷。故云寒热也。吕曰。外证者、大肠脉也。乃手阳明之脉。为肺之腑。气通于鼻。故善嚏。
肺主秋。秋、愁也。故其病悲哭。内证者。肺之证。肺主皮毛。有寒则洒淅咳嚏。肺在西方。为白虎。主右方。故证在
齐右。
假令得肾脉。其外证。面黑、喜恐欠。
丁曰。其外证者。太阳膀胱之经。故为外经也。故有病则色黑。面黑喜恐欠也。虞曰。沉濡面滑。肾之脉也。黑色、
肾之色也。在志曰恐。巨阳虚则欠。
其内证。齐下有动气。按之牢若痛。
虞曰。肾之积。名曰贲豚。在齐下。故云在齐下。（按以前四条例之。此五字疑衍。）
其病逆气。少腹急痛。泄如下重。足胫寒而逆。有是者。肾也。无是者。非也。
丁曰。其内证者、肾王于冬。应北方。故在齐之下也。其病。逆气。少腹急痛。泄如下重。其泄者为大瘕。泄而里
急后重也。此内之证也。虞曰。肾气不足。伤于冲脉。故气逆肾者。足少阴之脉。循少腹与足厥阴足太阴三阴交于齐下。
今病。故少腹急痛也。五泄之候。肾为后重泄。肾者、胃之关。今气虚。故为下重泄。谓食毕思急圊。足内踝上五寸间。
乃足少阴之动脉。故足胫寒而逆。通评虚实论曰。气逆者、足寒也。吕曰。外证、足太阳膀胱脉也。其人善欠者。其人
善恶寒。若胫寒。身体洒洒而寒。故其善欠。（按此其字疑衍。）肾与手少阳。俱主候心。故善恐。其内证者。肾王于冬。
主北方玄武。故证在齐下。虞曰。经言是其病有内外证。推寻至此。惟肝脉平证。善洁二字是表证。心脉不见手太阳外
证。脾脉中有善噫。是外证。肺脉亦无手阳明之证。肾脉中只有欠一字。是足太阳不足之证。五脏推之。黄帝素问并言
皆只足脏之证也。越人言其外证者、取其形见于外也。吕氏所注。多不该经旨。
十七难曰。经言病或有死。或有不治自愈。或连年月不已。其死生存亡。可切脉而知之耶。然。可尽知也。诊病若
闭目不欲见人者。脉当得。肝脉强急而长。
丁曰。此是肝之病证。故脉强急而长。杨曰。强急犹弦急。虞曰。肝木之脉。弦软而长。今见强急。病乃如是。
而反得肺脉浮短而涩者。死也。
丁曰。浮短涩者。是肺脉。此者金当胜木。故知死也。杨曰。肝为木。肺为金。肝病得肺脉。真鬼来克。金胜木。
故必死也。
病若开目而渴。心下牢者。脉当得紧实而数。反得沉濡而微者。死也。
丁曰。心之病证。今反见肾脉。心火肾水。水来克火。故知死也。杨曰。心病得肾脉。水胜火。故死也。按之短实
而数。有似切绳。谓之紧也。按之短小不动摇。若有若无。轻手乃得。重手不得。谓之微也。虞曰。病开目而渴。心下
牢。脉又紧实而数。此曰阳病得阳脉。脉不相反。今见沉濡而微。谓阳病得阴脉。故曰死也。
病若吐血。复鼽衄血者。脉当沉细而反。浮大而牢者。死也。
丁曰。此者肺脉之病证。今反见心脉。心火肺金。火来胜金。故知死也。虞曰。血属阴。吐血衄血。脉得沉细。此
谓脉与病相应。今反浮大而牢。与病相反。故死也。
病若谵言妄语。身当有热。脉当洪大。而手足厥逆。脉沉细而微者。死也。
丁曰。此病是心病之证。今反手足厥。脉沉细而微者。是水胜火。即知死也。杨曰。按之迟但小谓之细。
虞曰。肺主声。心主言。今脉洪大。是知热乘于心。肺邪受之。故谵言妄语。肺主皮毛。今邪客于卫气。不得宣通。
乃身热。夫如是。病与脉相应。今手足厥逆。脉沉细而微。阳病得阴脉。故云必死也。
病若大腹而泄者。脉当微细而涩。反紧大而滑者。死也。
丁曰。此病脾土之证候。紧大滑者是肝。木来胜土。故知死也。此经不言肾。水之证。阙此一脏也。杨曰。凡此五
者。病脉相反。故为必死。经云。五逆者死。此之谓也。虞曰。湿气胜则胀。脾不禁故泄。脉微细涩。病脉相承。紧大
而滑。此曰相反。如此之候。其死明矣。
十八难曰。脉有三部。部有四经。手有太阴阳明。足有太阳少阴。为上下部。何谓也。然。手太阴。阳明金也。足
少阴。太阳水也。金生水。水流下行而不能上。故在下部也。
丁曰。夫脉有三部者。寸关尺也。若合两手言之。即六部也。每部之内。各有二经。六部之内。合为十二经。今此
云四经者。是谓手太阳阳明。与足太阳少阴。此四经者。法水火之性。各有纲纪。而不能变通上下。余八经在手生足。
在足生手。所以经言部有四也。是右手寸口。肺与大肠应金生左尺水也。足太阳少阴水。其性润下。故不能上生于手。
而生左足厥阴少阳木。此二部皆是足之经纪。所以言在下部也。是左尺水。生左关木。杨曰。手太阴、肺脉也。肺为诸
脏上盖。其治在右方。故在右手上部也。手阳明。大肠脉。是肺之府。故随肺居上部焉。足少阴肾脉。肾为水。肺之子。
水流趣于肾。又最居于下。故为左手下部也。足太阳膀胱。为肾之府。故随肾居下部焉。经言脉有三部。部有四经者。
谓总两手而言之也。两手各有三部。部各有二经。两手上部合四也。中下二部亦复如此。三四十二。则十二经也。肺金
居上而下生肾水。故肺肾在左右手上下部也。
足厥阴少阳木也。生手太阳少阴火。火炎上行而不能下。故为上部。
丁曰。手太阳少阴。应左寸君火。火上（按此上字疑当作性。）炎上。不能下生足。而生手心主少阳火。是生右尺相
火也。杨曰。足厥阴。肝脉也。肝治在左方。故为左手之下部。足少阳胆者。为肝之府。故随肝居下部也。手太阳。小
肠脉。为心之府。故随心居上部焉。
手心主少阳火。生足太阴阳明土。土主中宫。故在中部也。
丁曰。是相火应其灰火也。中部者、右关也。生右寸。金也。杨曰。手心主心包络脉也。手少阳。三焦脉也。故合
为左手中部。足太阴。脾脉也。足阳明。胃脉也。故合为右手中部。此经作如此分别。若根据脉经配二部。又与此不同也。
虞曰。经言手心主少阳火。生足太阴阳明土。土主中宫。故在右手中部。惟只言火生土之意。不言手心主少阳。在左手
中部。惟只取其相生言之也。今明三部相生之意如此。右手尺中少阳火。生关上阳明土。关上阳明土。却生寸口太阴金。
寸口太阴金。却生左手尺中少阴水。左手尺中少阴水。却生左手关上厥阴木。关上厥阴木。却生左手寸口少阴火。却又
别心主火。故心主生足太阴阳明土也。此乃五行相生之意耳。又足厥阴与足太阴。何以居于左右两手关部中。胃脾太阴。
脾脉居于中州。乃在右手关上也。又足厥阴木。木者根生于地。枝叶长于天。亦阴阳共焉。故亦在左中部也。
此皆五行子母更相生养者也。
丁曰。言此皆五行更相生养者。是谓右寸金生左尺水。水生左关木。木生左寸君火。君火生右尺相火。相火生右关
土。而后生右寸金。故言子母更相生养者也。
脉有三部九候。各何所主之。然。三部者、寸关尺也。九候者。浮中沉也。
丁曰。前顺五行而言之生养。即逆三部而反到。所以经别问各何所主也。杨曰。寸口、阳也。关中、部也。尺中、
阴也。此三部各有浮中沉三候。三三九候也。故曰。九浮为阳。沉为阴。中者胃气也。虞曰。一部之中有三候。浮者为
腑。沉者为脏。中者、乃是中焦之脉也。假令寸口浮为腑。沉为脏。中为中焦。皆仿此用之。
上部法天。主胸以上至头之有疾也。
丁曰。两手寸口。皆为上部。即寸外主头。寸内主胸中。是头皆一指下。前后言病。左右同法也。杨曰。所谓自膈
以上为上焦也。
中部法人。主膈以下至齐之有疾也。
丁曰。言左右两关也。第二指半指以前。言膈下。半指之后。主齐上。左右同。杨曰。所谓自膈以下为中焦也。
下部法地。主齐以下至足之有疾也。
丁曰。下部左右两尺。第三指半指之前。主齐下有疾。半指之后。以候至足之有疾。杨曰。所谓自齐以下至足为下
焦也。
审而刺之者也。
丁曰。刺字当作次第之次。此是审三部各有内外。主从头至足之有疾也。故知刺字传文误也。杨曰。用针者。必当
审详三部九候病之所在。然后各根据其源而刺之也。
人病有沉滞久积聚。可切脉而知之耶。然。诊在右胁有积气。得肺脉结。脉结甚则积甚。结微则气微。诊不得肺脉。
而右胁有积气者何也。然。肺脉虽不见。右手脉当沉伏。
丁曰。病久积聚。可切脉而知之者。五脏六腑。皆有积聚。今云右胁有积气。当肺脉见。如是脉不见。亦沉伏。详
经之意。脉浮、行于肉上（按原本于误肾。又误在下句首。今改正。）脉沉、行于筋下。其浮行于肉上而无常数而止者。
名曰结也。其沉行于筋下时上。名曰伏也。伏者脏病积也。浮结者。腑病聚也。两手三部。各有浮沉结伏而言病也。今
虞氏说：肝属木，脾属土。脾主司四肢。若肝木有病，则无法制约脾土（注：此处原文逻辑似有倒置或特指相乘关系，直译为：木病则土无所畏），所以出现四肢闭塞胀满的症状。《玉机真脏论》说：脾气太过，会导致四肢不能抬举、小便不利、大便困难、筋脉拘挛抽搐。具备这些症状的，是肝病；不具备这些症状的，就不是肝病。
丁氏说：肝位于东方，属木。其气机调理在左侧，对应八卦中的震卦。肚脐左侧如果有搏动感，按压时感觉坚硬且疼痛。所谓四肢胀满闭塞，是指肢体关节拘挛。淋证、小便困难，是因为足厥阴肝经上行连接舌根，下行环绕生殖器，所以会出现淋证和小便困难。所谓筋脉拘挛抽搐，是因为肝藏血以滋养筋脉，所以生病时就会出现筋脉拘挛抽搐。具备这些内外症状的，就是肝病；不具备这些症状的，就不是肝病。
虞氏说：癃闭和小便不利，是指膀胱（小府）排尿涩滞。大便困难，是大肠（大府）传导艰难。因为肝脉循行经过生殖器，所以会出现小便不利。肝肾主管人体下部，肝病导致气机逆乱，不能下行于下焦，所以出现大便困难。肝属木，木的特性是曲直，筋脉正是这种特性的体现。现在肝生病了，所以出现筋脉拘挛抽搐。
吕氏说：外证，是腑病的征候。胆是清净之腑，所以面色发青，爱干净。如果衣服、被子、饮食不洁净，病人就会发怒。胆色为青，所以面青易怒。（按语：此处的“怒”字可能是衍文。）内证，是肝的病证。肝位于东方，称为青龙，在左侧，所以肝的病证表现在肚脐左侧。
丁氏说：外证，是因为手太阳小肠经循行于体表，所以有病就会表现在外部。它对应火，所以生病时会出现外部发热、口干、喜欢笑。这就是它的外证。
虞氏说：心脉浮大而散。心属火，火性炎上，所以面色赤红、口干。心在声音方面表现为笑。
其内证表现为：肚脐上方有搏动感，按压时感觉坚硬且疼痛。病症表现为心烦、心痛、手掌中心发热且空虚感。具备这些症状的，是心病；不具备这些症状的，就不是心病。
丁氏说：心位于南方，属火。其方位在离卦，所以肚脐上方有搏动感。其病症表现为心烦、心痛、手掌中心发热且空虚感的，是因为心病导致烦痛，所以出现空虚感。手臂内侧手掌中心发热且空虚感的，就是它的内证。有这些症状的，是心的病；没有这些症状的，就不是。
虞氏说：心的积病名叫伏梁，位于肚脐上方。火产生热，心是五脏的君主，其他四脏有病，心主知（感知）。尚且有疼痛的症状，何况本经自病呢？经常疼痛，那是心包络脉的病。正心是不受病的，如果正心受病，早上发现晚上死，晚上发现早上死。双重说明受病的是心包络，即手厥阴心包经，出于两手中间指的末端，不入掌心。弯曲无名指取穴名为劳宫。心包生病，则手掌中心发热且空虚感。
吕氏说：外证，是小肠手太阳经脉的热象，所以导致口干。阳主动躁，所以喜欢笑。内证，是心的病证。心在前，称为朱雀，所以症状在肚脐上方。
假如诊得脾脉，
其外证表现为：面色发黄，容易嗳气。
丁氏说：其外证面色发黄，是因为阳明胃经，所以显现黄色。这是外在的症状。
多思虑。
喜好味道。
其内证表现为：正当肚脐处有搏动感，按压时感觉坚硬且疼痛。
其病症表现为：腹部胀满，食物不消化，身体沉重，关节疼痛，倦怠嗜卧，四肢无力收持。具备这些症状的，是脾病；不具备这些症状的，就不是脾病。
丁氏说：内证，是足太阴脾经。正当肚脐处有搏动感的，是因为脾主中州。其病症腹部胀满，食物不消化，身体沉重关节疼痛，倦怠嗜卧，四肢无力收持，都是因为土的原因。土性静，所以有此症状。前注说外证面色黄而不解释其余说法的，是为了说明嗳气和喜好味道，这是脾的特征。现在腹部胀满，食物不消化，这其实是胃病。胃是水谷之海，生病就食物不消化，身体沉重关节疼痛，倦怠嗜卧，四肢无力收持，这些都是见到外证。现在却说内证。这部经典所说的文字非常不明确，不敢完全注释其说法，以此等待后来的贤者。
虞氏说：湿气胜则让人膨胀，阳气在下，食物才能不消化。得到主的内部，生病就会这样。脾属土，土性安静，所以知道是土主司四肢，生病就是四肢无力收持。
吕氏说：外证，是足阳明胃脉的病证。胃气实，谷气消，就多思虑，想要饮食。胃气虚，食物不消化，气力虚弱消瘦。那人感到思虑。内证，是脾。脾在中央，所以症状在肚脐。肚脐，又是阴阳的中部，所以脉在脾。
假如诊得肺脉，其外证表现为：面色白，容易打喷嚏，悲伤忧愁不快乐，想哭。
丁氏说：其外证，是手阳明大肠经。大肠是肺的腑，所以容易打喷嚏。悲伤忧愁不快乐，想哭，这是外在的症状。
虞氏说：肺脉浮短而涩。面白，是金的颜色。肺主皮毛，皮毛外感寒邪，内合于肺，所以打喷嚏。悲，是肺的情志。脾土是肺金之母，脾主歌，子病母忧，所以不快乐。在声音方面表现为哭。
其内证表现为：肚脐右侧有搏动感，按压时感觉坚硬且疼痛。其病症表现为：气喘咳嗽、怕冷发热。具备这些症状的，是肺病；不具备这些症状的，就不是肺病。
丁氏说：其说内证，是手太阴肺经，对应西方金，在兑卦，所以说肚脐右侧有搏动感。其为气喘咳嗽、怕冷发热的，所以知道是内证。
虞氏说：肺的积病，名叫息贲，位于右胁下。肺主皮毛，现在寒气外感于皮毛，内合于肺，则气道涩滞，所以喘而咳。肺主气，外候于皮毛。肺虚则怕冷，肺实则热而闷，所以说寒热。
吕氏说：外证，是大肠脉，即手阳明脉，是肺的腑，气通于鼻，所以容易打喷嚏。肺主秋，秋，愁也，所以其病悲伤哭泣。内证，是肺的病证。肺主皮毛，有寒则怕冷咳嗽打喷嚏。肺在西方，为白虎，主右方，所以症状在肚脐右侧。
假如诊得肾脉，其外证表现为：面色黑，喜欢恐惧、呵欠。
丁氏说：其外证，是太阳膀胱经，所以为外经。所以有病则面色黑，面色黑、喜欢恐惧、呵欠。
虞氏说：沉濡面滑，是肾的脉象。黑色，是肾的颜色。在情志方面曰恐。巨阳虚则呵欠。
其内证表现为：肚脐下方有搏动感，按压时感觉坚硬且疼痛。
虞氏说：肾的积病，名叫奔豚，位于肚脐下方。所以说在肚脐下方。（按语：参照前四个条例，这五个字可能是衍文。）
其病症表现为：气逆，小腹急痛，泄泻伴有肛门重坠感，足胫寒冷且逆冷。具备这些症状的，是肾病；不具备这些症状的，就不是肾病。
丁氏说：其内证，是肾旺于冬季，对应北方，所以在肚脐下方。其病症气逆，小腹急痛，泄泻伴有肛门重坠感。其泄泻属于大瘕泄，泄泻且里急后重。这是内证。
虞氏说：肾气不足，伤于冲脉，所以气逆。肾，是足少阴脉，循行经过小腹与足厥阴、足太阴三阴经交汇于肚脐下。现在生病，所以小腹急痛。五泄的征候，肾为后重泄。肾，是胃的关口，现在气虚，所以为下重泄。谓吃完饭后急着去厕所。足内踝上五寸间，乃是足少阴的动脉，所以足胫寒冷且逆冷。《通评虚实论》说：气逆的，脚冷。
吕氏说：外证，是足太阳膀胱脉。那人喜欢呵欠的，那人善恶寒。如果小腿冷，身体洒洒然寒冷，所以他喜欢呵欠。（按语：此“其”字可能是衍文。）肾与手少阳，都主候心，所以喜欢恐惧。内证，是肾旺于冬季，主北方玄武，所以症状在肚脐下方。
虞氏说：经文说这个病有内外证，推寻至此，只有肝脉平证，“善洁”二字是表证。心脉不见手太阳外证。脾脉中有“善噫”，是外证。肺脉也没有手阳明之证。肾脉中只有“欠”一字，是足太阳不足之证。推究五脏，黄帝《素问》并言都只讲足脏的病证。越人（扁鹊）说其外证，是取其形见于外部。吕氏所注，大多不符合经旨。
第十七难说：经文说病有的会死，有的不治自愈，有的连年月不好。其死生存亡，可以通过切脉知道吗？回答说：可以全部知道。诊断病人如果闭眼不想见人的，脉应当得肝脉强急而长。
杨氏说：强急就像弦急。
虞氏说：肝木的脉，弦软而长。现在见到强急，病就是这样。反而得肺脉浮短而涩的，会死。
杨氏说：肝为木，肺为金。肝病得肺脉，是真鬼来克，金胜木，所以必死。
病如果睁眼口渴，心下坚硬的，脉应当得紧实而数。反而得沉濡而微的，会死。
丁氏说：心的病证，现在反见肾脉。心火肾水，水来克火，所以知道会死。
杨氏说：心病得肾脉，水胜火，所以死。按之短实而数，有点像切绳子，叫做紧。按之短小不动摇，若有若无，轻手可得，重手不得，叫做微。
虞氏说：病睁眼口渴，心下坚硬，脉又紧实而数，这叫阳病得阳脉，脉不相反。现在见到沉濡而微，叫阳病得阴脉，所以说死。
病如果吐血，又流鼻血的，脉应当沉细而反见浮大而牢的，会死。
丁氏说：这是肺脉的病证，现在反见心脉。心火肺金，火来胜金，所以知道会死。
虞氏说：血属阴，吐血衄血，脉得沉细，这叫脉与病相应。现在反见浮大而牢，与病相反，所以死。
病如果胡言乱语，身体应当有热，脉应当洪大。而手足厥逆，脉沉细而微的，会死。
丁氏说：这个病是心病的证候，现在反见手足厥冷，脉沉细而微的，是水胜火，就知道会死。
杨氏说：按之迟但小叫做细。
虞氏说：肺主声，心主言。现在脉洪大，是知道热乘于心，肺邪受之，所以胡言乱语。肺主皮毛，现在邪客于卫气，不得宣通，乃身热。像这样，病与脉相应。现在手足厥逆，脉沉细而微，阳病得阴脉，所以说必死。
病如果大腹泄泻的，脉应当微细而涩。反见紧大而滑的，会死。
丁氏说：这个病是脾土证的征候，紧大滑是肝脉，木来胜土，所以知道会死。这部经文不说肾、水的证候，缺了这一脏。
杨氏说：凡是这五种情况，病脉相反，所以为必死。经文说：五逆者死，说的就是这个。
虞氏说：湿气胜则胀，脾不禁故泄。脉微细涩，病脉相承。紧大而滑，这叫相反。这样的征候，其死很明显了。
第十八难说：脉有三部，每部有四经。手有太阴、阳明，足有太阳、少阴，为上部和下部，这是什么意思？回答说：手太阴、阳明属金，足少阴、太阳属水。金生水，水流向下而不能向上，所以在下部。
丁氏说：所谓脉有三部，是寸、关、尺。如果合两手来说，就是六部。每部之内，各有二经。六部之内，合为十二经。现在这里说四经，是说手太阳、阳明与足太阳、少阴。这四经，效法水火之性，各有纲纪，而不能变通上下。其余八经在手生足，在足生手，所以经文说部有四。右手寸口，肺与大肠应金，生左尺水。足太阳、少阴水，其性润下，所以不能上生于手，而生左足厥阴、少阳木。这两部都是足的经纪，所以说在下部。左尺水生左关木。
杨氏说：手太阴，肺脉。肺为诸脏上盖，其治在右方，所以在右手上部。手阳明，大肠脉，是肺之府，所以随肺居上部。足少阴肾脉，肾为水，肺之子，水流趋向于肾，又最居于下，所以为左手下部。足太阳膀胱，为肾之府，所以随肾居下部。经文说脉有三部，部有四经，是说总括两手而言。两手各有三部，每部各有二经。两手上部合四。中、下两部也是如此，三乘以四等于十二，就是十二经。肺金居上而下生肾水，所以肺肾在左右手上下部。
足厥阴、少阳属木，生手太阳、少阴火。火炎上而不能下，所以为上部。
丁氏说：手太阳、少阴，应左寸君火，火上（按：此“上”字疑当作“性”）炎上，不能下生足，而生手心主、少阳火，是生右尺相火。
杨氏说：足厥阴，肝脉。肝治在左方，所以为左手之下部。足少阳胆，为肝之府，所以随肝居下部。手太阳，小肠脉，为心之府，所以随心居上部。
杨氏说：手心主心包络脉，手少阳三焦脉，所以合为左手中部。足太阴，脾脉，足阳明，胃脉，所以合为右手中部。这部经作如此分别，如果根据《脉经》配二部，又与此不同。
虞氏说：经文说手心主、少阳火，生足太阴、阳明土，土主中宫，所以在右手中部。只说了火生土的意思，没说手心主、少阳在左手中部，只取其相生而言。现在阐明三部相生之意如此：右手尺中少阳火，生关上阳明土；关上阳明土，却生寸口太阴金；寸口太阴金，却生左手尺中少阴水；左手尺中少阴水，却生左手关上厥阴木；关上厥阴木，却生左手寸口少阴火。却又别有心主火，所以心主生足太阴、阳明土。这是五行相生之意罢了。另外足厥阴与足太阴，何以居于左右两手关部中？胃脾太阴，脾脉居于中州，乃在右手关上也。另外足厥阴木，木者根生于地，枝叶长于天，也是阴阳共有的，所以也在左中部。
这都是五行子母更相生养的关系。
丁氏说：说这都是五行更相生养的，是指右寸金生左尺水，水生左关木，木生左寸君火，君火生右尺相火，相火生右关土，而后生右寸金。所以说子母更相生养。
脉有三部九候，各有什么主治？回答说：三部，是寸、关、尺。九候，是浮、中、沉。
丁氏说：前面顺五行而言之生养，即逆三部而反到，所以经文另问各何所主。
杨氏说：寸口，阳也；关中，部也；尺中，阴也。这三部各有浮、中、沉三候，三三得九候。所以说：九浮为阳，沉为阴，中者是胃气。
虞氏说：一部之中有三候，浮者为腑，沉者为脏，中者，乃是中焦之脉。假如寸口浮为腑，沉为脏，中为中焦，都仿照此用法。
上部法天，主胸以上至头部的疾病。
丁氏说：两手寸口，皆为上部。即寸外主头，寸内主胸中。头部都是一指之下，前后言病，左右同法。
杨氏说：所谓自膈以上为上焦。
中部法人，主膈以下至肚脐的疾病。
丁氏说：言左右两关。第二指半指以前，言膈下；半指之后，主肚脐上。左右同。
杨氏说：所谓自膈以下为中焦。
下部法地，主肚脐以下至足部的疾病。
丁氏说：下部左右两尺，第三指半指之前，主肚脐下有疾；半指之后，以候至足之有疾。
杨氏说：所谓自肚脐以下至足为下焦。
审而刺之者也。
丁氏说：“刺”字当作“次第”之“次”。这是审察三部各有内外，主从头至足之有疾。所以知道“刺”字是传文误。
杨氏说：用针者，必须审详三部九候病之所在，然后各根据其源而刺之。
人病有沉滞久积聚，可切脉而知之吗？回答说：诊察在右胁有积气，得肺脉结。脉结甚则积甚，结微则气微。诊不得肺脉，而右胁有积气的，为什么呢？回答说：肺脉虽不见，右手脉当沉伏。
丁氏说：病久积聚，可切脉而知之者，五脏六腑，皆有积聚。今云右胁有积气，当肺脉见。如是脉不见，亦沉伏。详经之意，脉浮，行于肉上（按原本“于”误“肾”，又误在下句首，今改正）。脉沉，行于筋下。其浮行于肉上而无常数而止者，名曰结也。其沉行于筋下时上，名曰伏也。伏者脏病积也。浮结者，腑病聚也。两手三部，各有浮沉结伏而言病也。今
Yu stated: The Liver belongs to Wood, and the Spleen belongs to Earth. The Spleen governs the four limbs. If Liver-Wood is diseased, it fails to restrain Spleen-Earth (Note: The original text logic implies a specific interaction where Wood disease affects Earth's stability), resulting in obstruction and fullness in the four limbs. The *Yu Ji Zhen Zang Lun* states: "Excessive Spleen-Qi causes the limbs to be unable to move, urinary retention, difficult defecation, and tendon cramping. Those with these signs have Liver disease; those without do not."
Ding stated: The Liver is located in the East and belongs to Wood. Its regulatory qi is on the left, corresponding to the Zhen trigram of the Bagua. If there is pulsating Qi at the left side of the umbilicus, which feels firm and painful upon palpation, this indicates Liver pathology. The term "fullness and obstruction of the four limbs" refers to joint contracture. Strangury and difficult urination occur because the Foot Jueyin Liver Meridian ascends to connect with the root of the tongue and descends to circle the external genitalia. Tendon cramping occurs because the Liver stores Blood to nourish the tendons; thus, when diseased, tendons cramp. The presence of these internal and external signs confirms Liver disease; their absence rules it out.
Yu stated: "Longzhou" (urinary retention) refers to涩 (astringency/difficulty) in the Bladder (Small Fu). Difficult defecation refers to difficulty in the Large Intestine (Large Fu). Since the Liver Meridian passes through the genitalia, urinary difficulties arise. The Kidney and Liver govern the lower body. Liver disease causes Qi rebellion, preventing it from descending to the lower jiao, leading to difficult defecation. The Liver belongs to Wood; Wood is characterized by bending and straightening, and tendons reflect this nature. Therefore, Liver disease results in tendon cramping.
Lü stated: External signs are indicators of Fu organ pathology. The Gallbladder is a clear and pure Fu organ; thus, the complexion is green, and the person values cleanliness. If clothes, bedding, or food are unclean, the person becomes angry. Since the Gallbladder color is green, the face appears green and anger ensues. (Note: The character "anger" here may be an interpolation.) Internal signs are symptoms of the Liver itself. The Liver is the Azure Dragon of the East, located on the left; hence, Liver signs manifest at the left side of the umbilicus.
Suppose the Liver pulse is obtained. Its external signs include: red complexion, dry mouth, and a tendency to laugh.
Ding stated: External signs arise because the Hand-Taiyang Small Intestine Meridian runs superficially; thus, pathology manifests externally. Corresponding to Fire, disease presents as external heat, dry mouth, and laughter. These are its external signs.
Yu stated: The Heart pulse is floating, large, and scattered. The Heart belongs to Fire; Fire flares upward, causing a red complexion and dry mouth. The Heart manifests in sound as laughter.
Its internal signs include: pulsating Qi above the umbilicus, feeling firm and painful upon palpation. Symptoms include vexation, heart pain, and heat in the palms with a sensation of emptiness. Presence of these signs indicates Heart disease; absence rules it out.
Ding stated: The Heart is located in the South and belongs to Fire, corresponding to the Li trigram, hence pulsating Qi above the umbilicus. Vexation, heart pain, and palm heat/emptiness result from Heart pathology causing pain and emptiness. Heat and emptiness in the inner arm and palm constitute internal signs. Presence confirms Heart disease; absence denies it.
Yu stated: The accumulation of the Heart is named Fuliang, located above the umbilicus. Fire generates heat. The Heart is the Sovereign of the Five Zang organs; if other Zangs are diseased, the Heart perceives it. Even so, there are pain symptoms, let alone primary meridian disease. Chronic pain belongs to the Pericardium Meridian. The true Heart does not accept disease; if it does, death follows quickly (morning diagnosis leads to evening death, and vice versa). The double explanation indicates the Pericardium (Hand-Jueyin Pericardium Meridian) is affected, emerging at the tips of the middle fingers, not entering the palm. Bending the ring finger locates Laogong (PC8). Pericardium disease causes palm heat and emptiness.
Lü stated: External signs involve heat in the Hand-Taiyang Small Intestine Meridian, causing dry mouth. Yang is active and restless, causing laughter. Internal signs are Heart pathology. The Heart is the Vermilion Bird in the front; thus, signs appear above the umbilicus.
Suppose the Spleen pulse is obtained.
Yu stated: The Spleen pulse is moderate, slow, and large.
Its external signs include: yellow complexion and frequent belching.
Ding stated: The yellow complexion arises because the Yangming Stomach Meridian is involved, manifesting yellow. This is an external sign.
Yu stated: The Spleen belongs to Earth; in terms of movement/change, it manifests as belching.
Excessive thinking.
Yu stated: The Spleen governs thought in the emotions.
Appetite for flavors.
Yu stated: The Spleen governs sweet taste and accepts all flavors, hence an appetite for flavors.
Its internal signs include: pulsating Qi directly at the umbilicus, feeling firm and painful upon palpation.
Yu stated: The accumulation of the Spleen is named Piqi, located in the center of the umbilicus.
Symptoms include: abdominal distension, indigestion, heaviness of the body, joint pain, lethargy and desire to sleep, and inability to hold the four limbs. Presence of these signs indicates Spleen disease; absence rules it out.
Ding stated: Internal signs belong to the Foot-Taiyin Spleen Meridian. Pulsating Qi at the umbilicus occurs because the Spleen governs the Central Region. Abdominal distension, indigestion, heaviness, joint pain, lethargy, and limb weakness are due to Earth. Earth is quiet, hence these signs. The previous note mentioned external yellow complexion but did not explain others to highlight belching and flavor preference as Spleen traits. Current symptoms of distension and indigestion actually point to the Stomach. The Stomach is the Sea of Water and Grain; disease causes indigestion, heaviness, joint pain, lethargy, and limb weakness, which are external signs. Yet this text calls them internal. The wording here is unclear; I dare not fully annotate it, waiting for future scholars.
Yu stated: Excess Dampness causes bloating. Yang Qi being below prevents proper digestion. When the dominant factor is internal, disease manifests thus. The Spleen belongs to Earth; Earth is quiet, governing the limbs. Disease results in limb weakness.
Lü stated: External signs are Foot-Yangming Stomach Meridian pathology. Excess Stomach Qi digests grain, leading to excessive thought and desire to eat. Deficient Stomach Qi causes indigestion, weakness, and mental fatigue. Internal signs are Spleen pathology. The Spleen is central, so signs are at the umbilicus, the midpoint of Yin and Yang, hence the pulse relates to the Spleen.
Suppose the Lung pulse is obtained. External signs include: white complexion, frequent sneezing, sadness, sorrow, unhappiness, and desire to cry.
Ding stated: External signs involve the Hand-Yangming Large Intestine Meridian. The Large Intestine is the Fu of the Lung, hence sneezing. Sadness, sorrow, and crying are external signs.
Yu stated: The Lung pulse is floating, short, and choppy. White is the color of Metal. The Lung governs skin and hair; external cold affecting skin/hair internally combines with the Lung, causing sneezing. Sadness is the emotion of the Lung. Spleen-Earth is the mother of Lung-Metal. Mother worries when child is sick, hence unhappiness. In sound, it manifests as crying.
Internal signs include: pulsating Qi at the right side of the umbilicus, feeling firm and painful upon palpation. Symptoms include wheezing, coughing, and alternating chills and fever. Presence indicates Lung disease; absence rules it out.
Ding stated: Internal signs refer to the Hand-Taiyin Lung Meridian, corresponding to West Metal and the Dui trigram, hence pulsating Qi at the right umbilicus. Wheezing, coughing, and chills/fever confirm internal signs.
Yu stated: The accumulation of the Lung is named Xiben, located under the right hypochondrium. The Lung governs skin and hair; external cold invading skin/hair internally combines with the Lung, obstructing airways, causing wheezing and coughing. The Lung governs Qi and manifests externally on skin/hair. Lung deficiency causes chills; excess causes heat and oppression, hence chills and fever.
Lü stated: External signs are Large Intestine (Hand-Yangming) Meridian pathology, the Fu of the Lung, connecting Qi to the nose, hence sneezing. The Lung governs Autumn; Autumn is associated with sorrow, hence sadness and crying. Internal signs are Lung pathology. The Lung governs skin/hair; cold causes chills, cough, and sneezing. The Lung is in the West, the White Tiger, governing the right side, hence signs at the right umbilicus.
Suppose the Kidney pulse is obtained. External signs include: black complexion, fearfulness, and yawning.
Ding stated: External signs involve the Taiyang Bladder Meridian, an exterior meridian. Disease manifests as black complexion, fear, and yawning.
Yu stated: Deep, soft, and slippery pulse is the Kidney pulse. Black is the color of the Kidney. Fear is the emotion of the Kidney. Deficiency of the Great Yang (Taiyang) causes yawning.
Internal signs include: pulsating Qi below the umbilicus, feeling firm and painful upon palpation.
Yu stated: The accumulation of the Kidney is named Bentun, located below the umbilicus. Hence "below the umbilicus." (Note: Referencing previous examples, these five characters may be interpolated.)
Symptoms include: rebellious Qi, acute pain in the lower abdomen, diarrhea with a sensation of rectal tenesmus, and coldness/reversal in the calves. Presence indicates Kidney disease; absence rules it out.
Ding stated: Internal signs relate to the Kidney flourishing in Winter, corresponding to the North, hence below the umbilicus. Rebellious Qi, lower abdominal pain, and diarrhea with tenesmus constitute internal signs.
Yu stated: Insufficient Kidney Qi injures the Chong Mai, causing rebellious Qi. The Kidney is the Foot-Shaoyin Meridian, passing through the lower abdomen and intersecting with Foot-Jueyin and Foot-Taiyin meridians below the umbilicus. Disease causes lower abdominal pain. Among the five types of diarrhea, the Kidney is associated with tenesmus. The Kidney is the gate of the Stomach; Qi deficiency causes heavy diarrhea (urgency after eating). At 5 cun above the medial malleolus lies the Foot-Shaoyin arterial pulse, causing calf coldness and reversal. The *Tong Ping Xu Shi Lun* states: "Rebellious Qi leads to cold feet."
Lü stated: External signs are Foot-Taiyang Bladder Meridian pathology. Yawning indicates sensitivity to cold. If calves are cold, the body feels chilly, hence yawning. (Note: "Qi" may be interpolated.) The Kidney and Hand-Shaoyang both monitor the Heart, hence fear. Internal signs relate to the Kidney in Winter, governing North Xuanwu, hence signs below the umbilicus.
Yu stated: Analyzing the text regarding internal/external signs: only the Liver ping pulse has "values cleanliness" as an external sign. The Heart pulse lacks Hand-Taiyang external signs. The Spleen pulse has "frequent belching" as an external sign. The Lung pulse lacks Hand-Yangming signs. The Kidney pulse has only "yawning," indicating Foot-Taiyang deficiency. Comparing the Five Zangs, the *Huangdi Sùwèn* mentions only Foot-Zang signs. Yue Ren (Bian Que) stated external signs are those manifesting outwardly. Lü’s annotations often miss the essence of the classic.
Chapter 17 states: The classic says some diseases cause death, some heal spontaneously, and some persist for years. Can pulse diagnosis determine life and death? Reply: It can be fully known. If a patient closes their eyes and avoids people, the pulse should be strong, tense, and long (Liver pulse).
Ding stated: This is a Liver disease sign, hence the strong, tense, long pulse.
Yang stated: Strong and tense resembles string-tightness.
Yu stated: The Liver-Wood pulse should be soft, string-like, and long. Seeing strong and tense indicates such pathology. If instead a floating, short, and choppy Lung pulse is found, death ensues.
Ding stated: Floating, short, and choppy is the Lung pulse. Metal overcomes Wood, hence death.
Yang stated: Liver is Wood, Lung is Metal. Liver disease with Lung pulse indicates "True Ghost" overcoming; Metal overcomes Wood, hence certain death.
If a patient opens their eyes, feels thirsty, and has hardness below the heart, the pulse should be tight, solid, and rapid. If instead a deep, soft, and faint pulse is found, death ensues.
Ding stated: Heart disease presenting with Kidney pulse (Water overcoming Fire) indicates death.
Yang stated: Heart disease with Kidney pulse means Water overcomes Fire, hence death. Tightness is felt as short, solid, and rapid like pressing a rope. Faintness is short, small, unshakable, present with light pressure but absent with heavy pressure.
Yu stated: Thirst, eye-opening, and subcardiac hardness with a tight, solid, rapid pulse indicate Yang disease with Yang pulse (no contradiction). A deep, soft, faint pulse indicates Yang disease with Yin pulse, hence death.
If a patient vomits blood and suffers epistaxis, the pulse should be deep and fine. If instead a floating, large, and firm pulse is found, death ensues.
Ding stated: Lung disease presenting with Heart pulse (Fire overcoming Metal) indicates death.
Yu stated: Blood belongs to Yin. Hematemesis and epistaxis with a deep, fine pulse indicate correspondence between pulse and disease. A floating, large, firm pulse contradicts the disease, hence death.
If a patient speaks deliriously and妄语 (nonsense), the body should be hot, and the pulse洪大 (surging/large). If instead hands and feet are cold and the pulse is deep, fine, and faint, death ensues.
Ding stated: Heart disease presenting with cold extremities and deep, fine, faint pulse indicates Water overcoming Fire, hence death.
Yang stated: Slow and small upon palpation is defined as fine.
Yu stated: The Lung governs sound, the Heart governs speech. A surging pulse indicates heat attacking the Heart, with Lung pathogen involvement, causing delirium. The Lung governs skin/hair; pathogen lodging in Wei Qi prevents circulation, causing fever. Here, disease and pulse correspond. Cold extremities with deep, fine, faint pulse indicate Yang disease with Yin pulse, hence certain death.
If a patient has abdominal distension and diarrhea, the pulse should be micro, fine, and choppy. If instead tight, large, and slippery, death ensues.
Ding stated: Spleen-Earth pathology with tight, large, slippery pulse (Liver/Wood overcoming Earth) indicates death. The text omits Kidney/Water pathology, missing one Zang.
Yang stated: In all five cases, disease and pulse contradict, ensuring death. The classic states: "Five reversals lead to death."
Yu stated: Excess Dampness causes distension; Spleen failure causes diarrhea. Micro, fine, choppy pulses match the disease. Tight, large, slippery pulses contradict. Such signs clearly indicate death.
Chapter 18 states: Pulses have three positions, each with four meridians. Hands have Taiyin and Yangming; Feet have Taiyang and Shaoyin, constituting upper and lower parts. What does this mean? Reply: Hand-Taiyin and Yangming belong to Metal; Foot-Shaoyin and Taiyang belong to Water. Metal generates Water; water flows down and cannot rise, hence they are in the lower part.
Ding stated: Three positions are Cun, Guan, Chi. Considering both hands, there are six positions. Each position contains two meridians, totaling twelve. "Four meridians" refers to Hand-Taiyang/Yangming and Foot-Taiyang/Shaoyin. These four follow Water/Fire natures and cannot interchange upper/lower. The other eight meridians generate from hand to foot and foot to hand, hence "four per position." Right Cun/Kou corresponds to Lung/Large Intestine (Metal), generating Left Chi Water. Foot-Taiyang/Shaoyin Water is moist and downward, unable to rise to the hand, but generates Left Foot Jueyin/Shaoyang Wood. These two positions are foot-related, hence "lower part." Left Chi Water generates Left Guan Wood.
Yang stated: Hand-Taiyin is Lung pulse. Lung is the canopy of Zangs, regulated on the right, hence right hand upper part. Hand-Yangming is Large Intestine pulse, Fu of Lung, hence upper part. Foot-Shaoyin is Kidney pulse; Kidney is Water, child of Lung. Water flows to Kidney, situated lowest, hence left hand lower part. Foot-Taiyang Bladder is Fu of Kidney, hence lower part. "Three positions, four meridians" refers to both hands. Two hands × three positions × two meridians = twelve meridians. Lung Metal resides upper and generates Kidney Water below, hence Lung/Kidney in upper/lower parts of both hands.
Foot-Jueyin/Shaoyang belong to Wood, generating Hand-Taiyang/Shaoyin Fire. Fire flares up and cannot descend, hence upper part.
Ding stated: Hand-Taiyang/Shaoyin correspond to Left Cun Jun Fire. Fire (note: "up" likely "nature") flares up, cannot generate foot meridians, but generates Hand-Shaoyin Master/Pericardium and Shaoyang Fire, generating Right Chi Minister Fire.
Yang stated: Foot-Jueyin is Liver pulse, regulated left, hence left lower part. Foot-Shaoyang Gallbladder is Fu of Liver, hence lower part. Hand-Taiyang Small Intestine is Fu of Heart, hence upper part.
Hand-Shaoyin Master/Shaoyang belong to Fire, generating Foot-Taiyin/Yangming Earth. Earth governs Central Palace, hence middle part.
Ding stated: This is Minister Fire corresponding to ash fire. Middle part is Right Guan. Generates Right Cun Metal.
Yang stated: Hand-Shaoyin Master is Pericardium pulse; Hand-Shaoyang is Sanjiao pulse, combining for left middle part. Foot-Taiyin is Spleen pulse; Foot-Yangming is Stomach pulse, combining for right middle part. This classification differs from *Mai Jing*.
Yu stated: The text says Hand-Shaoyin Master/Shaoyang Fire generates Foot-Taiyin/Yangming Earth, residing in right middle part, focusing only on Fire generating Earth, omitting Hand-Shaoyin Master in left middle part, using only generation logic. Clarifying three-part generation: Right Chi Minister Fire generates Right Guan Yangming Earth; Right Guan Earth generates Cun Taiyin Metal; Cun Metal generates Left Chi Shaoyin Water; Left Chi Water generates Left Guan Jueyin Wood; Left Guan Wood generates Left Cun Shaoyin Fire. Distinctly, Heart Master generates Foot-Taiyin/Yangming Earth. This is Five Elements generation. Why are Foot-Jueyin and Foot-Taiyin in both hands' Guan positions? Spleen pulse governs Central Earth, residing in Right Guan. Foot-Jueyin Wood takes root in earth and grows to heaven, sharing Yin/Yang, hence also in left middle part.
These are mutual generation and nourishment among Five Elements parents and children.
Ding stated: Mutual generation refers to Right Cun Metal generating Left Chi Water, Water generating Left Guan Wood, Wood generating Left Cun Jun Fire, Jun Fire generating Right Chi Minister Fire, Minister Fire generating Right Guan Earth, then returning to Right Cun Metal. Hence "parent-child mutual generation."
Pulses have three positions and nine inspections. What do they govern? Reply: Three positions are Cun, Guan, Chi. Nine inspections are Floating, Middle, Deep.
Ding stated: Following Five Elements generation inversely returns to three positions, hence the question.
Yang stated: Cun is Yang; Guan is Position; Chi is Yin. Each has Floating, Middle, Deep inspections (3x3=9). Nine floats are Yang; deep is Yin; middle is Stomach Qi.
Yu stated: One position has three inspections: Floating is Fu, Deep is Zang, Middle is Middle Jiao pulse. E.g., Cun floating is Fu, deep is Zang, middle is Middle Jiao. Apply similarly elsewhere.
Upper part models Heaven, governing diseases from chest to head.
Ding stated: Both hands' Cun are upper part. Cun outer governs head; Cun inner governs chest. Head is within one finger's width. Diagnosis methods are same for left/right/front/back.
Yang stated: Above diaphragm is Upper Jiao.
Middle part models Humanity, governing diseases from diaphragm to umbilicus.
Ding stated: Refers to left/right Guan. Half-finger anterior to second finger governs below diaphragm; posterior half governs above umbilicus. Same for left/right.
Yang stated: Below diaphragm is Middle Jiao.
Lower part models Earth, governing diseases from umbilicus to feet.
Ding stated: Lower part left/right Chi. Third finger half-position anterior governs below umbilicus; posterior half governs to feet.
Yang stated: Below umbilicus to feet is Lower Jiao.
Examine and puncture accordingly.
Ding stated: "Ci" (puncture) should be "Ci" (sequence/order). This examines internal/external aspects of three positions, governing diseases from head to feet. Thus, "ci" is a textual error.
Yang stated: Acupuncturists must examine three positions and nine inspections to locate disease, then puncture according to origin.
Can chronic stagnation and accumulations be diagnosed by pulse? Reply: Accumulated Qi in right hypochondrium yields Knotted Lung pulse. Severe knotting indicates severe accumulation; slight knotting indicates slight Qi. If Lung pulse is not found but right hypochondrium has accumulated Qi, why? Reply: Though Lung pulse is absent, right hand pulse should be deep and hidden.
Ding stated: Chronic accumulations in Zang-Fu can be diagnosed by pulse. Right hypochondrium accumulation should show Lung pulse. If absent, it is still deep/hidden. Examining the text: Floating pulse runs above flesh; Deep pulse runs below sinews. Floating pulse stopping irregularly above flesh is called Knotted. Deep pulse rising intermittently below sinews is called Hidden. Hidden indicates Zang accumulation; Floating-Knotted indicates Fu aggregation. Both hands/three positions have floating/deep/knotted/hidden variations indicating disease. Now