平按∶此篇自篇首至末，见《素问》卷六第十九《玉机真脏论》篇，又见《甲乙经》卷四《经
脉》第一上编。
黄帝问岐伯曰∶春脉如弦，何如而弦？岐伯曰∶春脉者肝脉也，东方木也，万物所以始生也，
故其气来，濡弱软虚而滑，端直以长，故曰弦，反此者病。（凡人之身，与天地阴阳四时之气皆
同，故内身外物虽殊，春气俱发。肝气春王，故春脉来，比草木初出。其若琴弦之调品者，不大缓，
不大急，不大虚，不大实，不涩不曲。肝气亦然，濡润、柔弱、软小、浮虚、轻滑、端直，而尺
部之上，长至一寸，故比之弦。软，如遄反。平按∶《素问》、《甲乙》濡弱作 弱，软虚作轻
虚。注调品袁刻作调和。）黄帝曰∶何如而反？岐伯曰∶其
气来实而强，此谓大过，病在外；其气来不实而微，此谓不及，病在中。（其春脉坚实劲直，名为
来实而强，此为春脉少阳有余，邪在胆腑少阳，故曰在外。一曰而弦，疑非也。其春脉厥阴脉来，
虽然不实而更微弱，此为不足，邪在肝脏厥阴，故曰在中也。）黄帝曰∶春脉大过与不及，其病皆
何如？岐伯曰∶大过则令人喜忘，忽忽眩冒而癫疾；（春脉大过，以邪在胆少阳，少阳之脉循胸
里属胆，散之上肝贯心，又抵角上头，故喜忘、忽忽眩冒而癫也。平按∶喜忘《素问》、《甲乙》
作善忘，新校正云∶按《气交变大论》云∶“木大过，甚则忽忽善怒。忘当作怒。”其不及则令人
胸痛引背，下则两胁 满。黄帝曰∶善哉。肝虚则胸痛引背，两胁 满，皆肝脏病也。 ，去居反。
腋下三寸以下，胁也；胁不至八间之外， 也。平按∶胸痛《甲乙》作胸满，注云∶“一作痛。”
注胸痛，胸字袁刻误作胃。）
黄帝问岐伯曰∶夏脉如钩，何如而钩？岐伯对曰∶夏脉者心脉也，南方火也，万物所以盛长
也，故其气来盛去衰，故曰钩，反此者病。（夏阳气盛，万物不胜盛长，遂复垂下，故曰钩也。
夏脉从内起，上至于手，不胜其盛，回而衰迟，故比之钩也。）黄帝曰∶何如而反？岐伯曰∶其
气来盛去亦盛，此谓大过，病在外；其气来不盛，去反盛，此谓不及，病在中。（来去俱盛，太
阳气盛也，邪在少阳太阳，故曰在外也。其来不盛，阳气有衰，脉行衰迟，去反盛者，阴气盛实，
病在心脏也，故曰病在中。平按∶《素问》新校正云∶详越人肝心肺肾四脏脉，俱以强实为太过，
虚微为不及，与《素问》不同。）黄帝曰∶夏脉大过与不及，其病皆何如？岐伯曰∶大过则令人
身热而骨痛，为浸淫；（肾主骨，水也。今太阳大盛，身热乘
肾，以为微邪，故为骨痛。浸淫者，滋长也。平按∶骨痛《素问》作肤痛。）其不及则令人烦心，
上见噬唾，下为气。黄帝曰∶善哉。（阳虚阴盛，故心烦也。心脉入心中，系舌本，故上见噬唾。
噬，市滞反，谓嚼唾也。气，谓广肠泄气也。平按∶《素问》噬作咳，气下有泄字，《甲乙》同。）
黄帝问于岐伯曰∶秋脉如浮，何如而浮？岐伯对曰∶秋脉者肺脉也，西方金也，万物所以收
也，故其气来轻虚以浮，其气来急去皆散，故曰浮，反此者病。（秋时阳气已衰，阴气未大，其
气轻虚，其来以急，其去浮散，故曰如浮也。平按∶《素问》、《甲乙》收下有成字，其气来急
去皆散作来急去散。）黄帝曰∶何如而反？岐伯曰∶其气来毛而中央坚，两旁虚，此谓大过，病
在外；其气来毛而微，此谓不及，病在中。（其脉来如以手按毛，毛中央坚，此为阳盛，病在大
肠手阳明，故曰在外。如手按毛，毛中央微，肺气衰微，故曰在中也。）黄帝曰∶秋脉大过与不
及，其病皆何如？岐伯曰∶大过则令人气逆而背痛温温然；（府阳气盛，则气逆连背痛。温温然，
热不甚也。平按∶《素问》、《甲乙》气逆作逆气，温温作愠愠。）其不及，则令人喘呼而咳，
上气见血，下闻病音。黄帝曰∶善哉。（肺气不足，喘呼咳而上气，唾而有血，下闻胸中喘呼气
声也。平按∶呼下《素问》有吸少气三字，《甲乙》有少气二字。）
黄帝问于岐伯曰∶冬脉如营，何如而营？岐伯对曰∶冬脉肾脉也，万物所以藏也，故其气来
沉以搏，故曰营，反此者病。（营，聚也。谓万物收藏归根，气亦得深搏骨，沉聚内营，故曰如
营也。平按∶万物上应脱北方水也四字，根据前春夏秋三段经文，均有东方木、南方火、西方金等
句，宜据《素问》、《甲乙》补
入。沉以搏《甲乙》作沉以濡，按《素问》新校正云∶搏当从《甲乙经》作濡，以脉沉而濡，濡
古软字，乃冬脉之平调脉；若沉而搏击于手，则冬脉之太过脉。又引越人云∶冬脉石者，北方水
也，万物之所藏，盛冬之时，水凝如石，故其脉来沉濡而滑，故曰石也。）黄帝曰∶何如而反？
岐伯曰∶其气来如弹石者，此谓大过，病在外；（其脉如石，以为平也。弹石，谓令石脉上来弹
手，如石击手，如弹之以石，谓肾太阳气有余，病在膀胱太阳，故曰在外也。）其气去如毛者，
此谓不及，病在中。（肾气不足，故其气去，按之如按于毛，病在于肾，故曰在中。一曰如数也。
平按∶如毛《素问》、《甲乙》作如数。）黄帝曰∶冬脉大过与不及，其病皆何如？岐伯曰∶大过
则令人解 、腹痛而少气不欲言；（大过，足太阳盛，太阳之脉行头背脚，故气盛身解 也。解
音懈， 相传音亦，谓怠惰运动难也。太阳既盛，肾阴气少，气少故不欲言也。平按∶腹痛《素问》、
《甲乙》作脊脉痛。）不及则令人心如悬病饥，脊中痛，少腹满，小便变。黄帝曰∶善哉。（肾
脉上入于心，故肾虚心如悬状，如病于饥。当脊中肾气不足，故痛也。又小腹虚满，小便变色也。
平按∶心如悬病饥《素问》、《甲乙》作心悬如病饥。饥下《素问》有 中清三字。《甲乙》无脊
中痛以下三句。）
黄帝曰∶四时之序，逆顺之变异矣，然脾脉独何主乎？（四时四脏气，候脉之逆顺、弦钩浮
营、大过不及等，变异多端，已闻之矣。然四脏之脉于四时而王，未知脾脉独主何时也。平按∶
《素问》顺作从。）岐伯曰∶脾者土也，孤脏以灌四旁者也。（孤，尊独也。五行之中，土独为
尊，以王四季。脾为土也，其味甘淡，为酸苦辛
咸味液，滋灌四旁之脏，其脉在关中宫，独四时不见，故不主时也。）黄帝曰∶然则脾之善恶，
亦可得见乎？岐伯曰∶善者不可见，恶者可见。（善，谓平和不病之脉也。弦钩浮营四脉见时，皆
为脾胃之气滋灌俱见，故四脏脉常得和平。然则脾脉以他为善，自更无善也，故曰善者不可见也。
恶者病脉也，脾受邪气，脉见关中，诊之得知，故曰可见也。平按∶注“恶者病脉也”五字，袁
刻脱。）黄帝曰∶恶者何如可见也？岐伯曰∶其来如水流者，此谓大过，病在外；其来如鸟之啄者，
此谓不及，病在中。（当关指下有脉，如水之流动，即脾气大过也，此阳气病在胃足阳明，故曰
在外。其脉来时如鸟啄指，此为脾虚受病，故曰在中。一曰鸟距，如鸟距隐人指也。平按∶《素问》、
《甲乙》在外下无其来二字，啄均作喙。）黄帝曰∶夫子之言脾之孤脏也，中央土也，以灌四旁，
其大过与不及，其病皆何如？岐伯曰∶大过则令人四肢不举，（胃气虽盛，脾病不为行气四肢，
故曰四肢不举也。）其不及则令人九窍不通，名曰重强。（脾虚受病，不得行气于九窍，故不通
也。不行气于身，故身重而强也。巨两反。）黄帝惧然起，再拜稽首，（惧，敬起也。道大于天，
故受道拜而稽首也。平按∶惧《素问》作瞿。注受道二字袁刻误作再。）曰∶吾得脉之大要，天下
至数，（弦钩浮营等脉，大过不及之理，名曰脉之大要。至数，至理也。平按∶《素问》曰下有善
字。）脉变，揆度奇恒，道在于一数，神转而不回，回则不转，乃失其机，至数之要，迫近以微，
（唯是血气一脉，随四时而变，故曰脉变。方欲切脉以求，谓之揆也。以四时度之，得其病变，谓
之度也。有病不得以四时死者，曰奇也。得以四时死者，曰恒也。虽有此二种不同，道在一数。言一
数者，谓之神转，神转谓是神动而营，神而营者不可动，曲而不动则失神藏机。机，微也。故
脉诊至理，近机微也。平按∶脉上《素问》有五色二字，神转上《素问》无数字。注谓是，是字袁
刻作动。）着之玉版，藏之于腑，每旦读之，名曰生机。（书而藏之，日日读之，以为摄生机要，
故曰生机也。平按∶《素问》于腑作脏腑，生机作玉机。）
【平按】：本篇从开头到结尾，见于《素问》卷六第十九篇《玉机真脏论》，也见于《甲乙经》卷四《经脉》第一上编。
黄帝问岐伯说：春脉像琴弦一样，什么样的脉象才叫作弦？岐伯回答说：春脉是肝脉，对应东方木行，是万物开始生长的季节，所以它的脉气来时，濡弱、软虚而滑利，端直且长，所以叫作弦；与此相反的则是病脉。（凡人的身体，与天地阴阳四时的气息都相同，所以体内脏腑与体外万物虽然不同，但春气都会生发。肝气在春季当令，所以春脉到来，就像草木刚刚长出。如果像琴弦的调品那样，不太缓、不太急、不太虚、不太实、不涩不曲。肝气也是如此，濡润、柔弱、软小、浮虚、轻滑、端直，而在尺部之上，长达一寸，所以比作弦。软，读音同“遄”。【平按】：《素问》和《甲乙经》中“濡弱”写作“弱”，“软虚”写作“轻虚”。注：调品，袁刻本写作“调和”。）
黄帝说：什么样的脉象算是反常（病脉）？岐伯回答说：脉气来时坚实强劲，这叫做“大过”，病邪在外；脉气来时不实且微弱，这叫做“不及”，病邪在内。（其春脉坚实劲直，名为来实而强，这是春脉少阳有余，邪气在胆腑少阳，所以叫作在外。另一种说法认为“而弦”二字可能是衍文，疑非原文。其春脉厥阴脉来，虽然不实反而更微弱，这是不足，邪气在肝脏厥阴，所以叫作在中。）
黄帝说：春脉的大过和不及，它们引起的病症分别是什么样的？岐伯回答说：大过则让人容易遗忘，恍惚眩晕甚至患癫疾；（春脉大过，是因为邪气在胆少阳，少阳之脉循行于胸里属胆，散布于上肝贯心，又抵角上头，所以会出现喜忘、忽忽眩冒而癫的症状。【平按】：《素问》和《甲乙经》中“喜忘”写作“善忘”，新校正云：按《气交变大论》云：“木大过，甚则忽忽善怒。”这里的“忘”字应当是“怒”字的误写。）其不及则让人胸痛牵引背部，下部则两胁胀满。黄帝说：说得好。肝虚则胸痛引背，两胁胀满，都是肝脏的病证。“ ，去居反。腋下三寸以下为胁；胁不至八间之外， 也。【平按】：《甲乙经》中“胸痛”写作“胸满”，注云：“一作痛。”注中指出“胸痛”的“胸”字，袁刻本误作“胃”。）
黄帝问岐伯说：夏脉像钩子一样，什么样的脉象才叫作钩？岐伯回答说：夏脉是心脉，对应南方火行，是万物盛大生长的季节，所以它的脉气来时旺盛，去时衰弱，所以叫作钩；与此相反的则是病脉。（夏季阳气盛，万物不能承受这种盛大的生长，于是枝叶下垂，所以叫作钩。夏脉从内起，上行至于手，不能承受其盛势，回返而衰迟，所以比作钩。）
黄帝说：什么样的脉象算是反常？岐伯回答说：脉气来时旺盛，去时也旺盛，这叫做“大过”，病邪在外；脉气来时不旺盛，去时反而旺盛，这叫做“不及”，病邪在内。（来去俱盛，是太阳阳气盛，邪气在少阳太阳，所以叫作在外。其来不盛，说明阳气有衰，脉行衰迟，去时反而盛，是阴气盛实，病在心脏，所以叫作病在中。【平按】：《素问》新校正云：详察越人关于肝心肺肾四脏脉，都以强实为太过，虚微为不及，这与《素问》不同。）
黄帝说：夏脉的大过和不及，它们引起的病症分别是什么样的？岐伯回答说：大过则让人身热且骨痛，表现为浸淫疮；（肾主骨，属水。现在太阳大盛，身热乘袭肾脏，成为微邪，所以导致骨痛。浸淫，指滋长蔓延。【平按】：《素问》中“骨痛”写作“肤痛”。）其不及则让人心烦，上部可见吞咽困难或唾沫，下部出现气泄（腹泻）。黄帝说：说得好。（阳虚阴盛，所以心烦。心脉入心中，系舌本，所以上部可见噬唾。噬，市滞反，指嚼唾。气，指广肠泄气。【平按】：《素问》中“噬”写作“咳”，“气”下有“泄”字，《甲乙经》同。）
黄帝问岐伯说：秋脉像浮毛一样，什么样的脉象才叫作浮？岐伯回答说：秋脉是肺脉，对应西方金行，是万物收敛的季节，所以它的脉气来时轻虚而浮，其气来急去皆散，所以叫作浮；与此相反的则是病脉。（秋季阳气已衰，阴气未大盛，其气轻虚，其来以急，其去浮散，所以叫作如浮。【平按】：《素问》和《甲乙经》中“收”下有“成”字，“其气来急去皆散”写作“来急去散”。）
黄帝说：什么样的脉象算是反常？岐伯回答说：脉气来时像羽毛，中间坚实，两旁虚弱，这叫做“大过”，病邪在外；脉气来时像羽毛且微弱，这叫做“不及”，病邪在内。（其脉来如用手按毛，毛中央坚，这是阳盛，病在大肠手阳明，所以叫作在外。如手按毛，毛中央微，肺气衰微，所以叫作在中。）
黄帝说：秋脉的大过和不及，它们引起的病症分别是什么样的？岐伯回答说：大过则让人气逆且背痛，伴有温温然不适感；（府阳气盛，则气逆连及背痛。温温然，指热不甚烈。【平按】：《素问》和《甲乙经》中“气逆”写作“逆气”，“温温”写作“愠愠”。）其不及，则让人喘呼且咳嗽，上部见血，下部听到病音（喘息声）。黄帝说：说得好。（肺气不足，喘呼咳而上气，唾而有血，下部听到胸中喘呼气声。【平按】：《素问》中“呼”下有“吸少气”三字，《甲乙经》有“少气”二字。）
黄帝问岐伯说：冬脉像营聚一样，什么样的脉象才叫作营？岐伯回答说：冬脉是肾脉，是万物收藏的季节，所以它的脉气来时沉而搏指，所以叫作营；与此相反的则是病脉。（营，即聚。谓万物收藏归根，气亦得深搏于骨，沉聚内营，所以叫作如营。【平按】：万物上应脱漏“北方水也”四字，根据前春夏秋三段经文，均有东方木、南方火、西方金等句，宜据《素问》、《甲乙》补入。沉以搏，《甲乙经》作“沉以濡”，按《素问》新校正云：搏当从《甲乙经》作濡，因为脉沉而濡，濡古通软字，乃是冬脉之平调脉；若沉而搏击于手，则是冬脉之太过脉。又引越人云：冬脉石者，北方水也，万物之所藏，盛冬之时，水凝如石，故其脉来沉濡而滑，故曰石也。）
黄帝说：什么样的脉象算是反常？岐伯回答说：脉气来时像弹石一样坚硬，这叫做“大过”，病邪在外；（其脉如石，以为平也。弹石，谓令石脉上来弹手，如石击手，如弹之以石，谓肾太阳气有余，病在膀胱太阳，所以叫作在外。）脉气去时像羽毛一样轻浮，这叫做“不及”，病邪在内。（肾气不足，所以其气去，按之如按于毛，病在于肾，所以叫作在中。另一种说法认为是“如数”。【平按】：《素问》和《甲乙经》中“如毛”写作“如数”。）
黄帝说：冬脉的大过和不及，它们引起的病症分别是什么样的？岐伯回答说：大过则让人懈惰、腹痛且少气不想说话；（大过，足太阳盛，太阳之脉行头背脚，所以气盛身解怠。解音懈， 相传音亦，谓怠惰运动难也。太阳既盛，肾阴气少，气少故不欲言也。【平按】：《素问》和《甲乙经》中“腹痛”写作“脊脉痛”。）其不及则让人心如悬挂般饥饿感，脊中痛，少腹满，小便异常。黄帝说：说得好。（肾脉上入于心，所以肾虚心如悬状，如病于饥。当脊中肾气不足，所以痛也。又小腹虚满，小便变色也。【平按】：《素问》和《甲乙经》中“心如悬病饥”写作“心悬如病饥”。饥下《素问》有“中清”三字。《甲乙经》无“脊中痛以下三句”。）
黄帝说：四时的顺序，逆顺的变化已经知道了，然而脾脉独自主什么时令呢？（四时四脏气，候脉之逆顺、弦钩浮营、大过不及等，变异多端，已闻之矣。然四脏之脉于四时而王，未知脾脉独主何时也。【平按】：《素问》中“顺”写作“从”。）
岐伯回答说：脾属土，是孤脏，用来灌溉四方其他脏腑。（孤，尊独也。五行之中，土独为尊，以王四季。脾为土也，其味甘淡，为酸苦辛咸味液，滋灌四旁之脏，其脉在关中宫，独四时不见，故不主时也。）
黄帝说：那么脾脉的善恶，也可以看出来吗？岐伯回答说：善（正常）的看不出来，恶（病态）的才能看出来。（善，谓平和不病之脉也。弦钩浮营四脉见时，皆为脾胃之气滋灌俱见，故四脏脉常得和平。然则脾脉以他为善，自更无善也，故曰善者不可见也。恶者病脉也，脾受邪气，脉见关中，诊之得知，故曰可见也。【平按】：注“恶者病脉也”五字，袁刻本脱漏。）
黄帝说：恶脉如何看出来？岐伯回答说：脉来时像水流一样滑利，这叫做“大过”，病邪在外；脉来时像鸟啄食一样短促，这叫做“不及”，病邪在内。（当关指下有脉，如水之流动，即脾气大过也，此阳气病在胃足阳明，所以叫作在外。其脉来时如鸟啄指，此为脾虚受病，所以叫作在中。另一种说法认为是“鸟距”，如鸟距隐人指也。【平按】：《素问》和《甲乙经》中“在外”下无“其来”二字，“啄”均写作“喙”。）
黄帝说：先生您说脾是孤脏，属中央土，用来灌溉四方，它的大过和不及，引起的病症分别是什么样的？岐伯回答说：大过则让人四肢不能举动，（胃气虽盛，脾病不为行气四肢，所以叫作四肢不举。）其不及则让人九窍不通，名叫重强。（脾虚受病，不得行气于九窍，所以不通也。不行气于身，故身重而强也。巨两反。）
黄帝敬畏地起身，再拜稽首，（惧，敬起也。道大于天，故受道拜而稽首也。【平按】：《素问》中“惧”写作“瞿”。注中“受道”二字袁刻本误作“再”。）说：我得到了脉的大要，天下的至理，（弦钩浮营等脉，大过不及之理，名曰脉之大要。至数，至理也。【平按】：《素问》中“曰”下有“善”字。）脉变，揆度奇恒，道在于一数，神转而不回，回则不转，乃失其机，至数之要，迫近以微，（唯是血气一脉，随四时而变，故曰脉变。方欲切脉以求，谓之揆也。以四时度之，得其病变，谓之度也。有病不得以四时死者，曰奇也。得以四时死者，曰恒也。虽有此二种不同，道在一数。言一数者，谓之神转，神转谓是神动而营，神而营者不可动，曲而不动则失神藏机。机，微也。故脉诊至理，近机微也。【平按】：《素问》中“脉”上有“五色”二字，“神转”上《素问》无数字。注中“谓是”，是字袁刻本作“动”。）着之玉版，藏之于腑，每旦读之，名曰生机。（书而藏之，日日读之，以为摄生机要，故曰生机也。【平按】：《素问》中“于腑”写作“脏腑”，“生机”写作“玉机”。）
[Ping An]: This chapter, from beginning to end, is found in *Suwen* (Basic Questions), Volume 6, Chapter 19 "Yu Ji Zhen Zang Lun" (Treatise on the True Viscera and Pulse Mechanisms), and also in *Jiayi Jing* (A-B Classic), Volume 4, "Jing Mai" (Meridians) Part 1, Upper Section.
The Yellow Emperor asked Qibo: The spring pulse resembles a string; what constitutes a string-like pulse? Qibo replied: The spring pulse corresponds to the Liver Meridian, associated with the East and the Wood element, marking the time when all things begin to grow. Therefore, its qi arrives soft, weak, gentle, empty yet smooth, straight and long; thus it is called "string." If it deviates from this, it indicates disease. (The human body shares the same yin-yang and four-seasonal qi as heaven and earth. Although internal organs and external objects differ, spring qi arises universally. When Liver qi governs in spring, the pulse arrives like grass and trees just sprouting. It should be like the tuning of a zither string: neither too slow nor too fast, neither too empty nor too full, neither rough nor curved. Liver qi is similar: moist, weak, soft, small, floating, empty, light, smooth, straight, extending one cun above the chi position, hence compared to a string. "Soft" is pronounced like "chuan". [Ping An]: In *Suwen* and *Jiayi Jing*, "ru ruo" is written as "ruo", and "ruan xu" as "qing xu". Note: "Tiao pin" in Yuan edition is written as "tiao he".)
The Yellow Emperor asked: What constitutes a deviation (abnormal pulse)? Qibo replied: When the qi arrives solid and strong, this is called "Excess" (Da Guo), indicating disease outside; when the qi arrives not solid but faint, this is called "Deficiency" (Bu Ji), indicating disease inside. (When the spring pulse is solid, firm, and straight, named arriving solid and strong, this indicates Spring Shaoyang excess, with pathogen in the Gallbladder Fu organ of Shaoyang, hence called "outside." Another view suggests "er xian" might be an interpolation. When the spring Jueyin pulse arrives, though not solid, it is even weaker, indicating insufficiency, with pathogen in the Liver Zang organ of Jueyin, hence called "inside.")
The Yellow Emperor asked: Regarding the Excess and Deficiency of the spring pulse, what are their respective symptoms? Qibo replied: Excess causes forgetfulness, sudden dizziness, and epilepsy. (Spring pulse Excess implies pathogen in Shaoyang Gallbladder. The Shaoymai meridian runs through the chest, connects to the gallbladder, spreads upward to the liver and heart, reaches the vertex and head; thus forgetfulness, sudden dizziness, and epilepsy occur. [Ping An]: In *Suwen* and *Jiayi Jing*, "xi wang" is written as "shan wang". Xin Zhengjiao notes: According to *Qi Jiao Bian Da Lun*: "Wood excess leads to sudden anger." 'Wang' should be a typo for 'Nu'.) Deficiency causes chest pain radiating to the back, and distension in both hypochondriac regions below. The Yellow Emperor said: Excellent. Liver deficiency causes chest pain radiating to the back and hypochondriac distension, all being Liver diseases. " , pronounced 'qu ju fan'. Below three cun under the armpit is the hypochondrium; beyond eight intercostal spaces is . [Ping An]: In *Jiayi Jing*, "xiong tong" is written as "xiong man", note says: "Another version reads 'tong'." Note points out that in "xiong tong", the character "xiong" in Yuan edition is erroneously printed as "wei".)
The Yellow Emperor asked Qibo: The summer pulse resembles a hook; what constitutes a hook-like pulse? Qibo replied: The summer pulse corresponds to the Heart Meridian, associated with the South and the Fire element, marking the time when all things flourish and grow. Therefore, its qi arrives vigorous and depenes declining; thus it is called "hook." If it deviates from this, it indicates disease. (Summer yang qi is vigorous; all things cannot withstand such vigorous growth and droop downwards, hence called "hook." Summer pulse rises from within, reaches the hand, cannot sustain its vigor, returns and declines slowly, hence compared to a hook.)
The Yellow Emperor asked: What constitutes a deviation? Qibo replied: When the qi arrives vigorous and depens vigorous, this is called "Excess," disease outside; when the qi arrives not vigorous, but depens vigorous, this is called "Deficiency," disease inside. (Arriving and departing both vigorous indicates Taiyang yang excess, pathogen in Shaoyang/Taiyang, hence "outside." Arriving not vigorous indicates yang decline, pulse movement slow; departing vigorous indicates yin excess/fullness, disease in the Heart, hence "disease inside." [Ping An]: *Suwen* Xin Zhengjiao notes: Examining Yue Ren's descriptions of Liver, Heart, Lung, Kidney pulses, he defines Strong/Solid as Excess and Empty/Faint as Deficiency, which differs from *Suwen*.)
The Yellow Emperor asked: Regarding the Excess and Deficiency of the summer pulse, what are their respective symptoms? Qibo replied: Excess causes fever and bone pain, manifesting as浸淫 (oozing sores). (Kidney governs bones and belongs to Water. Now Taiyang is excessively strong; fever attacks the Kidney, becoming a minor pathogen, causing bone pain. Jin Yin means spreading/growing. [Ping An]: In *Suwen*, "gu tong" is written as "fu tong".) Deficiency causes vexation, upper manifestations of swallowing difficulty or saliva, and lower manifestations of gas discharge (diarrhea). The Yellow Emperor said: Excellent. (Yang deficiency and Yin excess cause mental restlessness. Heart meridian enters the heart and ties to the tongue root, hence upper manifestations of Shi Tuo. 'Shi', pronounced 'shi zhi fan', refers to chewing saliva. 'Qi' refers to rectal gas discharge. [Ping An]: In *Suwen*, 'Shi' is written as 'Ke'; 'Qi' has 'Xie' after it; *Jiayi Jing* is the same.)
The Yellow Emperor asked Qibo: The autumn pulse resembles floating; what constitutes a floating pulse? Qibo replied: The autumn pulse corresponds to the Lung Meridian, associated with the West and the Metal element, marking the time when all things gather and harvest. Therefore, its qi arrives light, empty, and floating; its arrival is rapid, departure scattered; thus it is called "floating." If it deviates from this, it indicates disease. (In autumn, yang qi has declined, yin qi is not yet dominant; its qi is light and empty, arrival rapid, departure scattered, hence called "like floating." [Ping An]: In *Suwen* and *Jiayi Jing*, 'Shou' has 'Cheng' after it; "qi lai ji qu jie san" is written as "lai ji qu san".)
The Yellow Emperor asked: What constitutes a deviation? Qibo replied: When the qi arrives like hair, firm in the center and empty on both sides, this is called "Excess," disease outside; when the qi arrives like hair and is faint, this is called "Deficiency," disease inside. (Pulse arrival feels like pressing on hair; hair center is firm, indicating Yang excess, disease in Large Intestine Hand-Yangming, hence "outside." Like pressing on hair, hair center is faint, Lung qi is weak, hence "inside.")
The Yellow Emperor asked: Regarding the Excess and Deficiency of the autumn pulse, what are their respective symptoms? Qibo replied: Excess causes reverse flow of qi and back pain, with a warm sensation. (Fu organ yang qi is excessive, causing qi reversal connecting to back pain. Wen Wen Ran indicates mild heat. [Ping An]: In *Suwen* and *Jiayi Jing*, "qi ni" is written as "ni qi", "wen wen" as "yun yun".) Deficiency causes panting, coughing, upper blood expectoration, and audible pathological sounds below. The Yellow Emperor said: Excellent. (Lung qi insufficient, panting/coughing with reverse qi, spitting blood, audible wheezing from chest below. [Ping An]: In *Suwen*, after 'Hu' there are 'Xi Shao Qi' three characters; *Jiayi Jing* has 'Shao Qi' two characters.)
The Yellow Emperor asked Qibo: The winter pulse resembles Ying (gathering); what constitutes a Ying-like pulse? Qibo replied: The winter pulse corresponds to the Kidney Meridian, marking the time when all things store and hide. Therefore, its qi arrives deep and pounding, thus called "Ying." If it deviates from this, it indicates disease. (Ying means gathering. All things store and return to roots; qi also deeply pounds into bone, sinking and gathering internally, hence called "like Ying." [Ping An]: Four characters "Bei Fang Shui Ye" are missing after "Wan Wu"; based on previous Spring/Summer/Autumn sections having "Dong Fang Mu", "Nan Fang Huo", "Xi Fang Jin", etc., they should be added according to *Suwen*/*Jiayi Jing*. "Chen Yi Bo" in *Jiayi Jing* is "Chen Yi Ru". *Suwen* Xin Zhengjiao notes: 'Bo' should be 'Ru' per *Jiayi Jing*, because deep and soft pulse is the harmonious winter pulse; if deep and pounding against the hand, it is the Excess winter pulse. Also cites Yue Ren: Winter pulse Stone, North Water, storage of all things, mid-winter water freezes like stone, so pulse comes deep, soft, and slippery, hence called Stone.)
The Yellow Emperor asked: What constitutes a deviation? Qibo replied: When the qi arrives like bouncing stones, this is called "Excess," disease outside; (Pulse like stone is considered normal. Bouncing stone means the pulse comes up hitting the hand like a stone striking or being bounced by stone, indicating Kidney/Taiyang qi excess, disease in Bladder Taiyang, hence "outside.") When the qi depens like hair, this is called "Deficiency," disease inside. (Kidney qi insufficient, so upon departure, pressing feels like pressing on hair, disease in Kidney, hence "inside." Another reading is "like rapid." [Ping An]: In *Suwen* and *Jiayi Jing*, "ru mao" is written as "ru shu".)
The Yellow Emperor asked: Regarding the Excess and Deficiency of the winter pulse, what are their respective symptoms? Qibo replied: Excess causes lethargy, abdominal pain, shortness of breath, and reluctance to speak. (Excess, Foot-Taiyang is strong; Taiyang meridian runs head, back, legs, so qi excess causes body relaxation/lethargy. 'Jie' sounds like 'Xie', meaning sluggish/difficult movement. Since Taiyang is strong, Kidney yin qi is scant, leading to shortness of breath and reluctance to speak. [Ping An]: In *Suwen* and *Jiayi Jing*, "fu tong" is written as "ji mai tong".) Deficiency causes a feeling of hunger with heart hanging suspended, middle back pain, lower abdominal fullness, and abnormal urination. The Yellow Emperor said: Excellent. (Kidney meridian enters Heart, so Kidney deficiency makes heart feel suspended like hunger. Middle back Kidney qi insufficient causes pain. Lower abdomen vacuous fullness, urine color changes. [Ping An]: In *Suwen* and *Jiayi Jing*, "xin ru xuan bing ji" is written as "xin xuan ru bing ji". After 'Ji', *Suwen* has 'Zhong Qing' three characters. *Jiayi Jing* lacks the last three sentences starting from 'Ji Zhong Tong'.)
The Yellow Emperor said: The sequence of four seasons and variations of reversal/harmony have been heard. However, what does the Spleen pulse alone govern? (Four seasons/four viscera qi, observing pulse reversal/harmony, string/hook/floating/Ying, Excess/Deficiency, etc., vary greatly, already heard. But four viscera pulses govern in four seasons; unknown when Spleen pulse alone governs. [Ping An]: In *Suwen*, 'Shun' is written as 'Cong'.)
Qibo replied: Spleen belongs to Earth, the solitary Zang, irrigating the four directions. (Solitary means unique/respected. Among Five Elements, Earth is uniquely respected, governing four seasons. Spleen is Earth, flavor sweet/bland, nourishing fluids of sour/bitter/pungent/salty, irrigating four surrounding viscera. Its pulse is at Guan-Zhong Palace, unseen in four seasons, hence does not govern a specific season.)
The Yellow Emperor asked: Then can the good or bad of the Spleen pulse be seen? Qibo replied: The good cannot be seen; the bad can be seen. (Good means harmonious and non-diseased pulse. When String/Hook/Floating/Ying four pulses appear, they all show Spleen-Stomach qi irrigation, so four viscera pulses remain harmonious. Thus Spleen pulse takes others as good, having no independent good sign, hence "good cannot be seen." Bad means diseased pulse; Spleen receives pathogen, pulse appears at Guan-Zhong, diagnosed to know, hence "can be seen." [Ping An]: Note "E Zhe Bing Mai Ye" five characters are missing in Yuan edition.)
The Yellow Emperor asked: How can the bad pulse be seen? Qibo replied: When it arrives like flowing water, this is "Excess," disease outside; when it arrives like a bird pecking, this is "Deficiency," disease inside. (At Guan finger, pulse flows like water, indicating Spleen qi Excess, this Yang disease in Stomach Foot-Yangming, hence "outside." Pulse arrival like bird pecking finger indicates Spleen deficiency receiving disease, hence "inside." Another reading is "bird spur," like bird spur hiding in person's finger. [Ping An]: In *Suwen* and *Jiayi Jing*, no "Qi Lai" after "Zai Wai"; "Zhuo" written as "Hui".)
The Yellow Emperor said: You said Spleen is solitary Zang, Central Earth, irrigating four directions. What are the symptoms of its Excess and Deficiency? Qibo replied: Excess causes inability to move limbs. (Stomach qi may be strong, but Spleen disease fails to transport qi to limbs, hence "unable to move limbs".) Deficiency causes obstruction of the nine orifices, named "Zhong Qiang" (heavy stiffness). (Spleen deficiency fails to transport qi to nine orifices, hence obstructed. Fails to transport qi to body, hence body heavy and stiff. Ju Liang fan.)
The Yellow Emperor rose respectfully, bowed twice and kowtowed. (Ju means respectful rising. Dao is greater than heaven, thus receiving Dao, bowing and kowtowing. [Ping An]: In *Suwen*, 'Ju' is written as 'Qu'. Note "Shou Dao" two characters erroneously printed as "Zai" in Yuan edition.) He said: I have obtained the major essence of pulses, the supreme principles of the world. (String/Hook/Floating/Ying pulses, Excess/Deficiency principles, named Major Essence of Pulses. Zhi Shu means supreme principle. [Ping An]: In *Suwen*, 'Yue' has 'Shan' after it.) Pulse variations, measuring odd and constant, the Dao lies in One Number. Shen turns without returning; if it returns, it does not turn, thus losing its mechanism. The essence of supreme principles is close and subtle. (Only blood-qi one pulse varies with four seasons, hence "pulse variation". Cutting pulse to seek is called Kui. Measuring with four seasons to get disease change is called Du. Disease not dying by four seasons is Qi (Odd). Disease dying by four seasons is Heng (Constant). Though two types differ, Dao is in One Number. Saying One Number means Shen Zhuan (Spirit Turning). Shen Zhuan means Spirit moves and nourishes. Spirit-nourishing cannot move; curving without moving loses Spirit-Zang mechanism. Ji means subtle. Thus pulse diagnosis supreme principle is near subtlety. [Ping An]: In *Suwen*, 'Se Wu' two characters before 'Mai'; no characters before 'Shen Zhuan'. Note 'Wei Shi', 'Shi' character printed as 'Dong' in Yuan edition.) Written on Jade Tablet, stored in Fu organs, read every morning, named Sheng Ji (Vitality/Mechanism of Life). (Written and stored, read daily, regarded as capturing vital mechanism essence, hence named Sheng Ji. [Ping An]: In *Suwen*, 'Yu Fu' written as 'Zang Fu', 'Sheng Ji' written as 'Yu Ji'.)