问曰。伤寒有五。其脉何如。难经五十八难曰。中风之脉。阳浮
而滑。阴濡而弱。湿温之脉。阳濡而弱。阴小而急。伤寒之脉。阴阳俱
盛而紧涩。热病之脉。阴阳俱浮。浮之而滑。沉之散涩。温病之脉。行在诸经。不知何经之动。各随其经之所在而
取之。
问曰。脉之辨寒暑何如。仲景曰。脉盛身寒。得之伤寒。脉虚身热。得之伤暑。
问曰。欲愈之脉何如。仲景曰。凡得病厥脉动数。服汤药更迟。脉浮大减小。初躁后静者。此皆愈证也。
问曰。病有损脉何如。雍曰。伤寒至脉多。损脉少。故仲景曰。四
损三日死。五损一日死。六损一时死。凡四息而一至。曰四损。五息一至。曰五损。六息一至。曰六损也。
问曰。死生之脉何如。仲景曰。脉阴阳俱盛。大汗出不解者死。
脉阴阳俱虚。热不止者死。脉至乍数乍疏者死。脉至如转索者死。谵言妄语。身微热。脉浮大。手足温者生。逆冷。
脉
沉细者。不过一日
死。此以前。是皆伤寒证候也。
问曰。温病刺五十九穴。何穴也。素问三十二篇曰。病甚者为五
十九刺是也。灵枢二十三篇曰。所谓五十九刺者。两手外内侧各三。
凡十二 。五指间各一。凡八 。足亦如是。亦八 。头入发一寸旁
三分。各三 。凡六 。更入发三寸边五。凡十 。耳前后口下（一作
目下）各一。项中一。凡六 。巅上一。囟会一。发际一。廉泉一。风池
二。天柱二。此五十九穴也。
右伤寒脉法针术。不止于此。此则论其叙论所载。其余各见逐经逐证之下。
Q: Shanghan (Cold Damage) is divided into five types. What are their pulse characteristics? The *Nan Jing* (Classic of Difficult Issues), Chapter 58, states: For Zhongfeng (Wind Strike), the Yang position (Cun/Kou) is floating and slippery, while the Yin position (Chi/Middle) is soggy and weak; for Shiwen (Damp-Warmth), the Yang position is soggy and weak, and the Yin position is small and rapid; for Shanghan (Cold Damage), both Yin and Yang positions are full and tight-choppy; for Rebing (Heat Disease), both Yin and Yang positions are floating; superficial palpation reveals a slippery quality, while deep palpation reveals a scattered and choppy quality; for Wenbing (Warm Disease), the pulse circulates through the various meridians, and it is unknown which meridian is affected; diagnosis should be made by following the location of the affected meridian.
Q: How to distinguish between Cold and Summerheat in pulse diagnosis? Zhang Zhongjing stated: A full pulse accompanied by cold body temperature indicates Shanghan (Cold Damage); a deficient pulse accompanied by high body temperature indicates Shangshu (Summerheat Injury).
Q: What are the pulse signs indicating recovery? Zhang Zhongjing stated: In cases where Jue Mai (Pulse of Reversal/Cold Extremities) is present with rapid and frequent beats, if after administering herbal decoctions the pulse becomes slower, changes from floating-large to smaller, and shifts from initial restlessness to subsequent calmness, these are all signs of recovery.
Q: What constitutes the "Sun Mai" (Damaged/Deficient Pulse)? Guo Yong stated: In Shanghan (Cold Damage), pulses with increased frequency (Zhi Mai) are common, whereas pulses with decreased frequency (Sun Mai) are rare. Thus, Zhang Zhongjing stated: Four Sun leads to death in three days; Five Sun leads to death in one day; Six Sun leads to death within half a watch (approx. 1-2 hours). If the pulse beats once every four breaths, it is called Four Sun; once every five breaths, it is called Five Sun; once every six breaths, it is called Six Sun.
Q: What are the pulse signs for determining life and death prognosis? Zhang Zhongjing stated: If both Yin and Yang pulses are full, yet profuse sweating fails to resolve the condition, death ensues. If both Yin and Yang pulses are deficient, yet fever persists without stopping, death ensues. If the pulse is irregular, alternating between rapid and slow, death ensues. If the pulse feels like a turning rope (tight and unyielding), death ensues. However, if the patient mutters deliriously, has slight body heat, a floating-large pulse, and warm hands and feet, survival is possible. Conversely, if there is cold extremities and a deep-thin pulse, death will occur within one day. All the above constitute the syndromic manifestations of Shanghan (Cold Damage).
Q: Regarding the fifty-nine acupuncture points for treating Warm Disease, which points are they? *Su Wen* (Plain Questions), Chapter 32, states that for severe conditions, the method of Fifty-Nine Stabs is used. *Ling Shu* (Spiritual Pivot), Chapter 23, explains that the so-called Fifty-Nine Stabs include: three points on each side of the lateral and medial aspects of both hands, totaling twelve; one point between each of the five fingers, totaling eight; the same applies to the feet, totaling eight; at the head, one cun inside the hairline, three points on each side of the midline, totaling six; three cun inside the hairline, five points along the lateral border, totaling ten; one point each in front of the ear, behind the ear, and below the mouth (or below the eye in some versions), plus one point in the middle of the neck, totaling six; one point at the vertex (Baihui), one at Xinhui, one at the anterior hairline midpoint (Yintang/Lianquan area context implies specific points like Lianquan), one at Lianquan, two at Fengchi, and two at Tianzhu. These sum up to fifty-nine points.
The aforementioned pulse methods and acupuncture techniques for Shanghan (Cold Damage) are not limited to this text; this section only discusses what is recorded in the introductory treatise. The remaining details are found under the respective chapters on meridians and syndromes.