（灵枢论疾诊尺篇）
黄帝问于岐伯曰∶余欲无视色持脉，独调其尺以言其病，从外知内，为之奈何？（欲诊尺以知脏腑，故曰从外知内。）
岐伯曰∶审其尺之缓急小大滑涩，肉之坚脆，而病形定矣。（寸口之脉，由尺达寸，故但诊尺部之脉，其内可知。通身形
体，难以尽见，然肉之盛衰，必形于腕后，故但察尺部之肉，其外可知。是以独调其尺而病形定矣。）视人之目窠上微痈，
如新卧起状，其颈脉动，时咳，按其手足上 而不起者，风水肤胀也。（目窠，目下卧蚕处也。痈，壅也，即新起微肿状。
颈脉，人迎脉也。 而不起，按之有窝也。是即风水肤胀之外候。风水义见疾病类三十一。肤胀义见疾病类五十七。窠
音科。痈，去声。 音夭。）尺肤滑，其淖泽者，风也。（阳受风气，故病风者，尺肤滑而淖泽也。尺肉弱者，解 安卧，
脱肉者寒热不治。（尺肉弱者，肌必消瘦，肉瘦阴虚，当为解 。解 者，身体困倦，故欲安卧。无邪而脱肉寒热者，真
阴败也，故不治。）尺肤滑而泽脂者，风也。（泽脂，即前淖泽之谓。风者阳气，阳在肌肤，故滑而泽脂。）尺肤涩者，风
痹也。（尺肤涩者血少，血不能营，故为风痹。）尺肤粗如枯鱼之鳞者，水 饮也。（如枯鱼之鳞，干涩甚也。以脾土衰而
肌肉消，水得乘之，是为 饮。又下编肝脉涩甚为溢饮。 ，溢同。）尺肤热甚，脉盛躁者，病温也；其脉盛而滑者，病
且出也。（尺肤热者其身必热，脉盛躁者阳邪有余，故当为温病。若脉虽盛而兼滑者，是脉已不躁而正气将复，故不久当
愈。出，渐愈之谓。）尺肤寒，其脉小者，泄、少气。（肤寒脉小，阳气衰也，故为泄为少气。）尺肤炬然先热后寒者，寒
热也；尺肤先寒，久大之而热者，亦寒热也。（炬然，火热貌。或先热而后寒，或先寒而后热，皆寒热往来之候。）肘所
独热者，腰以上热；手所独热者，腰以下热。（肘，臂 之节也。一曰曲池以上为肘。肘在上，手在下，故肘应腰上，手
应腰下也。）肘前独热者，膺前热；肘后独热者，肩背热。（肘前，内廉也，手三阴之所行，故应于膺前。肘后，外廉也，
手太阳之所行，故应于肩背。）臂中独热者，腰腹热。（肘下为臂，臂在下，故应腰腹。）肘后粗以下三四寸热者，肠中有
虫。（肘后粗以下三四寸，谓三里以下，内关以上之所，此阴分也。阴分有热，故应肠中有虫。）掌中热者，腹中热；掌
中寒者，腹中寒。（掌中者，三阴之所聚，故或热或寒，皆应于腹中。）鱼上白肉有青血脉者，胃中有寒。（鱼上脉青，胃
之寒也。经脉篇亦曰∶胃中寒，手鱼之脉多青矣。鱼义见经络类二。）尺炬然热，人迎大者，当夺血；尺坚大，脉小甚，
少气， 有加，立死。（尺炬然热，火在阴也。人迎大者，阳之胜也。故当失血。若尺肤坚大而脉则小甚，形有余而气衰
少也。阴虚既极，而烦 再加，故当立死。 ，美本切。）
*Huangdi Neijing Lingshu: Chapter on Diagnosing Diseases by Observing the Cheek and Forearm Skin (Lingshu Lunji Zhichi Pian)*
The Yellow Emperor asked Qibo: I wish to diagnose without observing facial complexion or holding the pulse, but solely by examining the forearm skin (Chifu) to predict the disease, knowing the interior from the exterior. How should this be done? (By diagnosing the forearm skin to understand the Zang-Fu organs, it is called knowing the interior from the exterior.)
Qibo replied: Carefully examine the tension (slow/tight), size, smoothness, and roughness of the forearm skin, as well as the firmness or fragility of the flesh, and the pathological manifestations will be determined. (The Cunkou pulse extends from the Chi position to the Cun position; thus, by examining only the pulse at the Chi position, the internal condition can be known. The entire body is difficult to observe completely, but the flourishing or decline of muscle mass must manifest behind the wrist. Therefore, by observing only the flesh at the Chi position, the external condition can be known. Hence, by solely examining the forearm skin, the pathological form is established.)
If one observes slight swelling above the eye sockets (Muke, the area under the eyes resembling a silkworm), resembling the state after just waking up, with palpable pulsation in the neck vessels (Renying pulse), frequent coughing, and pitting edema upon pressing the hands and feet that does not immediately recover, this indicates Fengshui Fuzhang (Wind-water distension). (Muke refers to the area under the eyes. Yong here means obstruction/swelling, indicating recent mild swelling. Renying refers to the carotid artery. Pitting edema indicates depression upon pressure. These are external signs of Wind-water Fuzhang. See Disease Category 31 for Fengshui and Category 57 for Fuzhang.)
If the forearm skin is smooth and glossy (Naozhe), it indicates Wind disease. (Yang channels receive wind pathogens; thus, patients with wind disease have smooth and glossy forearm skin.)
If the forearm flesh is weak, it manifests as lethargy and desire to lie down; if the flesh is emaciated and there are alternating chills and fever, it is incurable. (Weak forearm flesh implies muscle wasting and Yin deficiency, leading to lethargy. Without pathogenic factors, emaciation with chills and fever indicates failure of True Yin, hence incurable.)
If the forearm skin is smooth and oily, it indicates Wind disease. (Oily glossiness refers to the aforementioned smoothness. Wind is Yang Qi; when present in the skin and muscles, it causes smoothness and oiliness.)
If the forearm skin is rough, it indicates Fengbi (Wind Bi syndrome). (Rough forearm skin indicates blood deficiency, where blood fails to nourish the tissues, resulting in Wind Bi.)
If the forearm skin is rough like the scales of a dried fish, it indicates Shuiyin (Water retention). (Dryness and roughness like dried fish scales indicate severe dryness. Due to Spleen Earth deficiency and muscle wasting, Water invades, forming Shuiyin. Also, see Lower Volume regarding Liver pulse being very choppy indicating Yi Yin. "Yi" and "Shui" are synonymous here.)
If the forearm skin is intensely hot and the pulse is vigorous and restless, it indicates Wenbing (Warm disease); if the pulse is vigorous yet slippery, the disease is about to resolve. (Hot forearm skin implies body heat; vigorous and restless pulse indicates excess Yang pathogen, pointing to Warm disease. If the pulse is vigorous but slippery, it suggests the restlessness has subsided and healthy Qi is recovering, so recovery will occur soon. "Chu" means gradual recovery.)
If the forearm skin is cold and the pulse is small, it indicates diarrhea and Qi deficiency. (Cold skin and small pulse indicate Yang Qi decline, leading to diarrhea and shortness of breath.)
If the forearm skin is initially hot then becomes cold, or initially cold then becomes hot after prolonged handling, it indicates alternating chills and fever. ("Juran" describes intense heat. Whether hot then cold or cold then hot, these are signs of alternating chills and fever.)
Heat isolated to the elbow indicates heat in the upper half of the waist; heat isolated to the hand indicates heat in the lower half of the waist. (The elbow is the joint of the arm. Some say the area above Quchi is the elbow. Since the elbow is superior and the hand is inferior, the elbow corresponds to the upper waist and the hand to the lower waist.)
Heat isolated to the anterior aspect of the elbow indicates heat in the anterior chest; heat isolated to the posterior aspect of the elbow indicates heat in the shoulder and back. (The anterior elbow is the medial side, traversed by the Three Yin Hand meridians, corresponding to the anterior chest. The posterior elbow is the lateral side, traversed by the Hand Taiyang meridian, corresponding to the shoulder and back.)
Heat isolated to the middle of the arm indicates heat in the waist and abdomen. (Below the elbow is the arm; since the arm is inferior, it corresponds to the waist and abdomen.)
Heat three to cun below the prominent bone at the posterior elbow indicates intestinal parasites. (This area, between Zusanli and Neiguan, belongs to the Yin division. Heat in the Yin division corresponds to intestinal parasites.)
Heat in the center of the palm indicates heat in the abdomen; cold in the center of the palm indicates cold in the abdomen. (The center of the palm is where the Three Yin meridians converge; thus, heat or cold here corresponds to abdominal conditions.)
Blue veins visible on the white flesh above the Thenar eminence (Yu) indicate Cold in the Stomach. (Blue veins on the Yu indicate Stomach Cold. The Meridian Chapter also states: Cold in the Stomach results in many blue veins on the hand Yu. See Meridian Category 2 for the meaning of Yu.)
If the forearm skin is intensely hot and the Renying pulse is large, blood loss should be expected; if the forearm skin is hard and large while the pulse is extremely small, accompanied by Qi deficiency, and if irritability arises, death will ensue immediately. (Intense heat in the forearm indicates Fire in the Yin. A large Renying pulse indicates Yang excess, leading to blood loss. If the forearm skin is hard and large but the pulse is extremely small, it signifies Excess of Form but Deficiency of Qi. With extreme Yin deficiency, if irritability is added, immediate death occurs.)