凡诊脉,当视其人大小短长,及性气缓急,脉之迟速大小长短,皆如其人形性者吉,反
之者凶。 诊伤寒热盛,脉浮大者生,沉小者死。 伤寒己得汗,脉沉小者生,浮大者死。
温病三四日以下不得汗,脉大疾者生,脉细小难得者死,不治。 温病时行大热,其脉细
小者死。(《脉经》云∶时行作穣穣。) 温病下利,腹中痛甚者死,不治。 温病汗不出,
出不至足者死。 厥逆汗出,脉坚强急者生,虚缓者死。 热病二三日,身体热,腹满头痛,
食饮如故,脉直而疾者,八日死。 四五日头痛腹痛而吐,脉来细强,十二日死。 八九日
头不疼,身不痛,目不赤,色不变,而反利,脉来牒牒,按之不弹手时大,心下坚,十七日
死。 热病七八日,脉不软(一作喘)不散(一作数者),当喑,喑后三日汗不出者死。 热
病
七八日,其脉微细,小便不利,加暴口燥、脉代、舌焦枯黑者死。 热病未得汗,脉盛躁疾,
得汗者生,不得汗者难瘥。热病已得汗,脉静安者生,脉躁者难治。热病脉躁盛而不得汗者,
此阳气之极也,十死不治。 热病已得汗,脉常躁盛,此阴气之极也,亦死。(《太素》作
阳极。) 热病已得汗,常大热不去者,亦死。(大,一作专。) 热病已得汗,热未去,脉
微躁者,慎不得刺治也。 热病发热甚者,其脉阴阳皆竭,慎勿刺,不汗出,必下利。 诊
人被风不仁痿蹶,其脉虚者生。(《巢氏病源》云∶虚数者生。)坚急疾者死。 诊癫病,虚
则可治,实则死。又云∶脉实坚者生,脉沉细小者死。 癫病脉搏大滑者,久久自已,其脉
沉小急实,不可治,小坚急亦不可疗。 诊头痛目痛,久视(一作卒视)无所见者死。 诊
人
心腹积聚,其脉坚强急者生,虚弱者死。又实强者生,沉者死。 其脉大,腹大胀,四肢逆
冷,其人脉形长者死。 腹胀满便血,脉大时绝极下血,脉小疾者死。 心腹痛,痛不得息,
脉细小迟者生,坚大疾者死。 肠 便血,身热则死,寒则生。 肠 下白沫,脉沉则生,
浮则死。 肠 下脓血,脉悬绝则死,滑大则生。 肠 之属身热,脉不悬绝滑大者生,弦
涩者死,以脏期之。 肠 下脓血,脉沉小流连者生,数疾且大有热者死。 肠 筋挛,脉
小细安静者生,脉浮大紧者死。 洞泄,食不化,下脓血,脉微小者生,紧急者死。泄注,
脉缓时小结者生,浮大数者死。 蚀阴疰,其脉虚小者生,紧急者死。 咳嗽脉沉紧者死,
浮直者生。浮软者生,小沉伏匿者死。 咳嗽羸瘦,脉形坚大者死。 咳脱形发热,脉小坚
急者死。 肌瘦下脱形,热不去者死。 咳而呕,腹胀且泄,脉弦急欲绝者死。 吐血、衄
血,脉滑小弱者生,实大者死。汗出若衄,脉小滑者生,大躁者死。 唾血,脉紧强者死,
滑者生。 吐血而咳上气,其脉数有热,不得卧者死。 伤寒家咳而上气,脉数散者死。谓
其人形损故也。 上气喘息低昂,脉滑,手足温者生,脉涩,四肢寒者死。 上气面浮肿肩
息,其脉大不可治,加利必死。(一作又甚。) 上气注液,其脉虚宁宁伏匿者生,坚强者死。
寒气上攻,脉实而顺滑则生,实而逆涩则死。(《太素》云∶寒气暴上,脉满实,何如?曰∶
实而滑则生,实而逆则死。其形尽满何如?曰∶举形尽满者,脉急大坚,尺满而不应,如是
者,顺则生,逆则死。何为顺则生,逆则死?曰∶所谓顺者,手足温也。所谓逆者,手足寒
也。) 消渴脉数大者生,细小浮短者死。 瘅,脉实大,病久可治,弦小坚急,病久不
可治
病胀闭,其脉浮大软者生,沉细虚小者死。 水病腹大如鼓,脉实者生,虚者死。 卒中恶
,吐血数升,脉浮大疾快者生,沉细数者死。 卒中恶,腹大四肢满,脉大而缓者生,浮
而紧者死,紧细而微者亦生。 病疮,腰脊强急螈 者,皆不可治。 寒热螈 ,其
者死。 金疮血出太多,其脉虚细者生,数实大者死。 金疮出血,脉沉小者生,浮大者死。
斫疮出血一二石,脉来大者,二十日死。 斫刺俱有病多少血出不自止断者,脉止脉来大者,
七日死。 从高顿仆,内有血,腹胀满,其脉坚强者生,小弱者死。 人为百药所中伤,脉
洪大而速(《脉经》作迟)者生,微细者死。 人病甚而脉不调者,难瘥。 人病甚而脉洪
者,
易瘥。 人阴阳俱结者,见其上齿如熟小豆,其脉躁者死。(结一作竭。) 人内外俱虚,身
体冷而汗出,微呕烦扰,手足厥逆,体不得安静者死。 脉实满,手足寒头热,春秋生,冬
夏死。 老人脉微,阳羸阴强者生,脉焱大加息者死。阴弱阳强,脉至而代,奇月而死。 尺
脉涩而坚,为血实气虚,其病腹痛逆满,气上行,此为妇人胞中绝伤,有恶血,久成结瘕,
得病以冬时,黍 赤而死。 尺脉细而微者,血气俱不足,细而有力者,是谷气不足,病得
节辄动,枣叶生而死,此病秋时得之。 左手寸口脉偏动,乍大乍小不齐,从寸口至关,关
至尺三部之位,处处动摇,各异不同,其人病在仲夏得之,此脉桃花落而死。(花一作叶。) 右
手寸口脉偏沉伏,乍小乍大,朝来浮大,暮夜沉伏。浮大即太过,上出鱼际。沉伏即下不至
关中,往来无常,时时复来者,榆叶(一作荚)落而死。 右手尺部脉三十动一止,有顷更
还,
二
十动而一止,止而复来,来逆如循直木,如循张弓弦, 然如两人共引一索者,至立春而
死。(《脉经》作立冬死。)
In general, when palpating the pulse, one should observe the patient's body size, height and length, as well as their temperament, whether slow or urgent. If the slowness, speed, magnitude, and length of the pulse correspond to the patient's physique and temperament, the prognosis is auspicious; conversely, it is inauspicious.
When diagnosing Shanghan (Cold Damage) with intense heat, a floating and large pulse indicates survival, while a deep and small pulse indicates death.
After sweating has occurred in Shanghan, a deep and small pulse indicates survival, while a floating and large pulse indicates death.
In Wenbing (Warm Disease), if no sweat occurs within three to four days, a large and rapid pulse indicates survival, while a fine and difficult-to-feel pulse indicates death and untreatability.
During an epidemic of Wenbing with high fever, a fine pulse indicates death. (The *Mai Jing* states: "When epidemic diseases occur, the pulse is full.")
If Wenbing presents with diarrhea and severe abdominal pain, it indicates death and untreatability.
If Wenbing presents with no sweat, or sweat that does not reach the feet, it indicates death.
In Jue-ni (Cold Reversal) with sweating, a firm, strong, and urgent pulse indicates survival, while a weak and slow pulse indicates death.
In Rebing (Heat Disease) on the second or third day, with body heat, abdominal fullness, headache, but normal appetite, a straight and rapid pulse indicates death on the eighth day.
On the fourth or fifth day, with headache, abdominal pain, and vomiting, a pulse that comes forth fine and strong indicates death on the twelfth day.
On the eighth or ninth day, without headache or body pain, with red eyes or changed complexion absent, but instead presenting with diarrhea, a pulsation that is hurried, non-elastic upon pressure, and occasionally enlarged, accompanied by hardness below the heart, indicates death on the seventeenth day.
In Rebing on the seventh or eighth day, if the pulse is not soft (alternatively described as panting) and not scattered (alternatively described as rapid), aphonia should occur; if no sweat follows after three days of aphonia, it indicates death.
In Rebing on the seventh or eighth day, with a micro-fine pulse, difficulty in urination, sudden dry mouth, intermitted pulse, and a scorched, blackened tongue, it indicates death.
In Rebing without sweat, a盛大 (grand) and restless pulse indicates difficulty in recovery; if sweat occurs, it indicates survival.
In Rebing after sweat has occurred, a quiet and calm pulse indicates survival, while a restless pulse indicates difficulty in treatment.
In Rebing, if the pulse is restless and excessive without sweat, this represents the extreme of Yang Qi; it is ten deaths with no cure.
In Rebing after sweat has occurred, if the pulse remains constantly restless, this represents the extreme of Yin Qi, and also indicates death. (*Tai Su* reads "extreme of Yang").
In Rebing after sweat has occurred, if high fever persists, it also indicates death. ("Large" alternatively reads "special").
In Rebing after sweat has occurred, if heat has not subsided and the pulse is slightly restless, acupuncture treatment must be approached with caution.
In Rebing with severe fever, if both Yin and Yang pulses are exhausted, do not use acupuncture; otherwise, no sweat will occur, and diarrhea will inevitably follow.
When diagnosing wind-induced numbness and flaccidity, a weak pulse indicates survival. (*Chao Shi Bing Yuan* states: "A weak and rapid pulse indicates survival.") A firm, urgent, and rapid pulse indicates death.
When diagn Dian disease (epilepsy/mental disorder), a weak pulse indicates treatability, while a solid pulse indicates death. It is also stated that a solid and firm pulse indicates survival, while a deep and fine pulse indicates death.
If the pulse in Dian disease is large and slippery, it will naturally resolve over time; if the pulse is deep, small, urgent, and solid, it is untreatable; if small, firm, and urgent, it is also uncurable.
When diagnosing headache and eye pain, inability to see even after prolonged (or sudden) viewing indicates death.
When diagnosing accumulation masses in the heart and abdomen, a firm, strong, and urgent pulse indicates survival, while a weak pulse indicates death. It is also stated that a solid and strong pulse indicates survival, while a deep pulse indicates death.
If the pulse is large, the abdomen is distended, and the limbs are cold, a long pulse form indicates death.
With abdominal fullness and bloody stool, if the pulse is large and frequently intermittent with massive bleeding, a small and rapid pulse indicates death.
With heart and abdominal pain, where pain is so severe that breathing is interrupted, a fine, small, and slow pulse indicates survival, while a firm, large, and rapid pulse indicates death.
In Changpi (intestinal dysentery) with bloody stool, body heat indicates death, while cold indicates survival.
In Changpi with white mucus discharge, a deep pulse indicates survival, while a floating pulse indicates death.
In Changpi with pus and blood discharge, a suspended and extreme pulse indicates death, while a slippery and large pulse indicates survival.
For conditions belonging to Changpi, if there is body heat, a pulse that is not suspended/extreme but is slippery and large indicates survival; a wiry and choppy pulse indicates death; the time of death can be predicted based on the Zang organs.
In Changpi with pus and blood discharge, a deep, small, and lingering pulse indicates survival; a rapid, frequent, and large pulse with heat indicates death.
In Changpi with muscle cramps, a small, fine, and quiet pulse indicates survival; a floating, large, and tight pulse indicates death.
In Dongxie (profuse watery diarrhea) with undigested food and pus/blood discharge, a micro-pulse indicates survival, while an urgent pulse indicates death.
In Xiezhù (diarrhea with urgency), a slow pulse with occasional small knots indicates survival, while a floating, large, and rapid pulse indicates death.
In Shiyin Zhu (corrosive yin pestilence), a weak and small pulse indicates survival, while an urgent pulse indicates death.
In coughing, a deep and tight pulse indicates death, while a floating and straight pulse indicates survival. A floating and soft pulse indicates survival, while a small, deep, and hidden pulse indicates death.
In coughing with emaciation, a firm and large pulse indicates death.
In coughing with physical depletion and fever, a small, firm, and urgent pulse indicates death.
With muscle wasting and physical depletion, if fever persists, it indicates death.
In coughing with vomiting, abdominal distension, and diarrhea, a wiry and urgent pulse nearing extinction indicates death.
In hematemesis (vomiting blood) and epistaxis (nosebleed), a slippery, small, and weak pulse indicates survival, while a solid and large pulse indicates death. With sweating or nosebleed, a small and slippery pulse indicates survival, while a large and restless pulse indicates death.
In spitting blood, a tight and strong pulse indicates death, while a slippery pulse indicates survival.
In hematemesis with coughing and rebellious Qi, a rapid pulse with heat and inability to lie down indicates death.
In Shanghan patients with coughing and rebellious Qi, a rapid and scattered pulse indicates death, due to the damage of the person's physique.
In rebellious Qi with wheezing and loud breathing sounds, a slippery pulse with warm hands and feet indicates survival, while a choppy pulse with cold limbs indicates death.
In rebellious Qi with facial edema and shoulder breathing (accessory muscle respiration), a large pulse is untreatable; if accompanied by diarrhea, it is fatal. (Alternatively: "even more severe").
In rebellious Qi with fluid secretion, a void, quiet, and hidden pulse indicates survival, while a firm pulse indicates death.
When Cold Qi attacks upward, a solid and smooth pulse indicates survival, while a solid and reverse/choppy pulse indicates death. (*Tai Su* states: "When Cold Qi suddenly ascends and the pulse is full and solid, how is it judged? Answer: Solid and smooth indicates survival; solid and reverse indicates death. How is it judged when the entire form is full? Answer: When the whole body is full, the pulse is urgent, large, and firm, with the Chi position being full but unresponsive. In such cases, smooth indicates survival, reverse indicates death. What constitutes smooth survival and reverse death? Answer: Smooth refers to warm hands and feet. Reverse refers to cold hands and feet.")
In Xiaoke (wasting-thirst), a rapid and large pulse indicates survival, while a fine, floating, and short pulse indicates death.
In Dan disease, a solid and large pulse allows for treatment even if the disease is chronic; a wiry, small, firm, and urgent pulse makes chronic disease untreatable.
In Zhangbi (distension and closure), a floating, large, and soft pulse indicates survival, while a deep, fine, void, and small pulse indicates death.
In Shuibing (water disease) with a drum-like distended abdomen, a solid pulse indicates survival, while a void pulse indicates death.
In Zhongfeng E (sudden evil stroke) with several sheng of vomited blood, a floating, large, and rapid pulse indicates survival, while a deep, fine, and rapid pulse indicates death.
In Zhongfeng E with abdominal distension and limb fullness, a large and slow pulse indicates survival, while a floating and tight pulse indicates death; a tight, fine, and minute pulse also indicates survival.
In Chuangbing (wound disease) with stiffness and spasms of the waist and spine, all are untreatable.
In Hanre Chouye (cold-heat spasms), the [missing term] indicates death.
In Jinchuang (metal wound) with excessive bleeding, a void and fine pulse indicates survival, while a rapid, solid, and large pulse indicates death.
In Jinchuang with bleeding, a deep and small pulse indicates survival, while a floating and large pulse indicates death.
In chopping wounds with loss of one or two sheng of blood, a large incoming pulse indicates death in twenty days.
In combined chopping and stabbing injuries with varying degrees of blood loss that does not stop, a large incoming pulse indicates death in seven days.
From a fall from height with internal blood stasis and abdominal distension, a firm pulse indicates survival, while a small and weak pulse indicates death.
If poisoned by various medicines, a洪大 (grand-large) and fast pulse indicates survival (Mai Jing reads "slow"), while a micro and fine pulse indicates death.
If the disease is severe but the pulse is irregular, recovery is difficult.
If the disease is severe but the pulse is grand, recovery is easy.
If Yin and Yang are both knotted, and the upper teeth appear like cooked small beans, a restless pulse indicates death. ("Knot" alternatively reads "exhaustion").
If both interior and exterior are void, with a cold body and sweating, slight vomiting and restlessness, cold reversal of hands and feet, and bodily unrest, it indicates death.
With a solid and full pulse, cold hands and feet, and head heat, survival in Spring/Autumn, death in Winter/Summer.
In the elderly with a micro pulse, Yang deficiency and Yin excess indicate survival; a blazing, large pulse with added breath indicates death. Yin deficiency and Yang excess, with an intermitted pulse, indicates death in one month.
A Chi pulse that is choppy and firm indicates Blood excess and Qi deficiency. The disease involves abdominal pain, rebellious fullness, and Qi ascending. This is due to injury in the uterus of women, with bad blood, eventually forming a mass. If contracted in winter, death occurs when millet turns red.
A Chi pulse that is fine and micro indicates deficiency of both Blood and Qi. If fine yet forceful, it indicates deficiency of Grain Qi. The disease fluctuates with solar terms; death occurs when jujube leaves sprout, as the disease was contracted in autumn.
If the Cun Kou pulse on the left hand moves unevenly, alternating between large and small and irregular, shaking everywhere from Cun to Guan to Chi, each position differing, and the disease was contracted in mid-summer, death occurs when peach blossoms fall. ("Flower" alternatively reads "leaf").
If the Cun Kou pulse on the right hand is predominantly deep and hidden, alternating between small and large, floating and large in the morning, deep and hidden at night. Floating and large means excess, extending above the Yu Ji point. Deep and hidden means not reaching the Guan position, coming and going unpredictably, returning occasionally; death occurs when elm leaves (alternatively pods) fall.
If the Chi pulse on the right hand stops every thirty beats, recovering after a moment, or stops every twenty beats, returning with a reverse flow like touching a straight piece of wood, or a drawn bowstring, or gurgling like two people pulling a rope together, death occurs at Lichun (Start of Spring). (*Mai Jing* reads Lidong, Start of Winter.)