【素】人一呼脉再动。一吸脉亦再动。呼吸定息。脉五动。闰以太息。命曰平人。（灵枢脉度。五十营等篇。人身脉
长一十六丈二尺。一呼脉行三寸。一吸脉行三寸。昼夜一万三千五百息。气行五十营。漏水下百刻。凡行八百一十丈。
即一十六丈二尺。而积之也。难经曰。呼出心与肺。吸入肾与肝。呼吸之间。脾受谷味也。其脉在中。是五动亦以应五
脏也。）平人者。不病也。常以不病调病患。医不病。故为病患平息以调之为法。人一呼脉一动。一吸脉一动。曰少气。
（脉诀以为败脉。难经以为离经脉。正气衰也。）人一呼脉三动。一吸脉三动而躁。（躁动。脉诀为数脉。）尺热曰病温。
（尺为阴位。寸为阳位。阴阳俱热。故为病温。）尺不热。脉滑曰病风。脉涩曰痹。（滑为阳盛。涩为血少。）人一呼。脉
四动以上曰死。（一息八至。脉诀以为脱脉。难经以为夺精脉。四动以上。则九至矣。为死脉。）脉绝不至曰死。乍疏乍
数曰死。平人之常气禀于胃。胃者。平人之常气也。人无胃气曰逆。逆者死。春胃微弦曰平。弦多胃少曰肝病。但弦无
胃曰死。胃而有毛曰秋病。（毛为肺脉。为金克木。）毛甚曰今病。（即病。）藏真散于肝。肝藏筋膜之气也。夏胃微钩曰
平。钩多胃少曰心病。但钩无胃曰死。胃而有石曰冬病。（水克火。）石甚曰今病。藏真通于心。心藏血脉之气也。长夏
胃微 （音软。）弱曰平。弱多胃少曰脾病。但代无胃曰死。（动而中止曰代。） 弱有石曰冬病。（为水反侮土。次其胜
克。当作弦脉。）弱甚曰今病。藏真濡于脾。脾藏肌肉之气也。秋胃微毛曰平。毛多胃少曰肺病。但毛无胃曰死。毛而有
弦曰春病。（为木反侮金。吴注。虽曰我克者为微邪。然木气泄。至春无以生荣。故病。次其胜克。当为钩脉。）弦甚曰
今病。藏真高于肺。以行营卫阴阳也。（肺为傅相。营卫阴阳。皆赖之以分布。）冬胃微石曰平。石多胃少曰肾病。但石
无胃曰死。石而有钩曰夏病。（为火反侮水。次其胜克。钩当云 弱。）钩甚曰今病。藏真下于肾。肾藏骨髓之气也。夫
平心脉来。累累如连珠。如循琅 。（美玉。）曰心平。夏以胃气为本。病心脉来。喘喘连属。（喘喘。则有不足之意。）
其中微曲。曰心病。死心脉来。前曲后居。（停滞。）如操带钩。曰心死。平肺脉来。厌厌聂聂。如落榆荚。曰肺平。秋
以胃气为本。病肺脉来。不上不下。如循鸡羽。曰肺病。（王注。中坚旁虚。吴注。涩难。）死肺脉来。如物之浮。如风
吹毛。曰肺死。平肝脉来。 弱招招。如揭长竿末梢。曰肝平。（长而 。）春以胃气为本。病肝脉来。盈实而滑。如循
长竿。曰肝病。（长而不 。）死肝脉来。急益劲。如张新弓弦。曰肝死。平脾脉来。和柔相离。如鸡践地。曰脾平。长
夏以胃气为本。病脾脉来。实而盈数。如鸡举足。曰脾病。（践地形。其轻缓。举足形。其拳实。）死脾脉来。锐坚如乌
之喙。如鸟之距。如屋之漏。如水之流。曰脾死。平肾脉来。喘喘累累如钩。按之而坚。曰肾平。（冬为石脉。坚亦石意
也。钩为心脉。坚中带钩。为水火阴阳相济。）冬以胃气为本。病肾脉来如引葛。按之益坚。曰肾病。死肾脉来。发如夺
索。辟辟如弹石。曰肾死。（平人气象论）
【素】春脉如弦。春脉者肝也。东方木也。万物之所以始生也。故其气来 弱。轻虚而滑。端直以长。故曰弦。反
此者病。其气来实而强。此谓太过。病在外。其气来不实而微。此谓不及。病在中。（有余为外感。不足为内伤。）太过
则令人善忘。（当作善怒。气交变大论。木太过则忽忽善怒。）忽忽眩冒而巅疾。（眩。目转也。冒。瞀闷也。厥阴与督脉
会于巅。）其不及则令人胸痛引背。（金匮曰。胸痛引背。阳虚而阴弦也。）下则两胁 满。（肝脉贯膈。布胁肋。）夏脉如
钩。夏脉者心也。南方火也。万物之所以盛长也。故其气来盛去衰。故曰钩。反此者病。其气来盛去亦盛。此谓太过。
病在外。其气来不盛。去反盛。此谓不及。病在中。太过则令人身热而肤痛。为浸淫。（阳有余。故身热。热不得越。故
肤痛。浸淫。蒸热不已也。）其不及。则令人烦心。（不足故内烦。）上见咳唾。下为气泄。（心脉上肺。故咳唾。络小肠。
故气泄。）秋脉如浮。秋脉者肺也。西方金也。万物之所以收成也。故其气来轻虚以浮。来急去散。故曰浮。反此者病。
其气来毛。而中央坚。两旁虚。此谓太过。病在外。其气来毛而微。此谓不及。病在中。太过则令人逆气而背痛。（肺系
属背。）愠愠然。其不及。则令人喘。呼吸少气而咳。上气见血。（咳血。）下闻病音。（呻吟。）冬脉如营。（有营守乎中
之象。）冬脉者肾也。北方水也。万物之所以合藏也。故其气来沉以搏。故曰营。反此者病。其气来如弹石者。此谓太过。
病在外。其去如数者。（数疾。）此谓不及。病在中。太过则令人解 。（寒不寒。热不热。弱不弱。壮不壮。）脊脉痛。
（肾
脉贯脊。）而少气不欲言。（吴注。人之声音。修长为出于肾。）其不及。则令人心悬如病饥。（肾水不能济心火。） 中清。
（挟脊两旁空软处名 。清。冷也。肾外当 。）脊中痛。少腹满。小便变。（络膀胱。）脾脉者土也。孤脏以灌四旁者也。
（不主四时。故云孤脏。脾位中央。故灌四脏。）善者不可得见。恶者可见。（脾有功于四脏。善则四脏之善。脾病则四
脏亦病矣。）其来如水之流者。此谓太过。病在外。如乌之喙者。此谓不及。病在中。太过则令人四肢不举。（脾主四肢。
湿胜故不举。）其不及。则令人九窍不通。（不能灌溉五脏。故九窍不通。）名曰重强。（藏气皆不和顺。）真肝脉至。（即
真藏脉。）中外急如循刀刃。责责然如按琴瑟弦。色青白不泽。毛折乃死。（卫气败绝。）真心脉至。坚而搏。如循薏苡子。
累累然。色赤黑不泽。毛折乃死。真肺脉至。大而虚。如以毛羽中人肤。色白赤不泽。毛折乃死。真肾脉至。搏而绝。
如指弹石。辟辟然。色黑黄不泽。毛折乃死。真脾脉至。弱而乍数乍疏。色黄青不泽。毛折乃死。见真藏曰死。何也。
五脏者。皆禀气于胃。胃者五脏之本也。脏气者。不能自致于手太阴。（肺。）必因于胃气。乃至于手太阴也。（脉必先会
于手太阴。而后能行于诸经。）故五脏各以其时自为。而至于手太阴也。（弦钩毛石等。因时各为其状。而至于手太阴寸
部。所谓肺朝百脉也。）故邪气胜者。精气衰也。故病甚者。胃气不能与之俱至于手太阴。故真藏之气独见。独见者。病
胜藏也。故曰死。（玉机真藏论。）
【素】脉有阴阳。知阳者知阴。知阴者知阳。（王注。深知则备议其变易。）凡阳有五。五五二十五阳。（阳。阳和之
脉也。五脏心肝脾肺肾。形为弦钩 毛石五脉。当旺之时。各形本脉。一脉之中。又各兼五脉。无过不及者。皆为阳脉
也。）所谓阴者。真藏也。见则为败。败必死也。（真藏。即前真肝脉至之类。藏者。藏也。藏真。见而不藏。全失阳和
之气。为阴脉也。）所谓阳者。胃脘之阳也。（有胃气。则脉和缓。为阳脉。无胃气。则为阴脉。王注。解作人迎胃脉。
在结喉旁动脉应手处。左小常以候藏。右大常以候府。于经文似觉欠贯。）别于阳者。（脉虽病而有胃气者。）知病处也。
（某脉不和。则知病在某处。）别于阴者。（真藏阴脉。）知死生之期。（阴阳生克。推而知之。）（阴阳别论）
【素】脉从阴阳。病易已。脉逆阴阳。病难已。（左人迎为阳。春夏洪大为顺。沉细为逆。右气口为阴。秋冬沉细为
顺。洪大为逆。男子左大为顺。女子右大为顺。凡外感症。阳病见阳脉为顺。阳病见阴脉为逆。阴病见阳脉亦为顺。内
伤症阳病见阳脉为顺。阳病见阴脉为逆。阴病见阴脉为顺。阴病见阳脉亦为逆也。）脉得四时之顺。曰病无他。（如春弦
夏钩等是也。）脉反四时。及不间藏。曰难已。（春得肺脉。夏得肾脉。为反四时。间藏。如肝病乘土。当传脾。乃不传
脾而传心。则间其所胜之藏。而传于所生之藏矣。难经所谓间藏者生是也。）脉有逆从。四时未有藏形。（当旺之时。本
脏之脉未至。）春夏而脉瘦。（玉机真藏论作沉涩。）秋冬而脉浮大。命曰逆四时也。风热而脉静。（伤风热者。脉宜浮大。）
泄而脱血。脉实。（脉宜沉细。而反实大。）病在中。脉虚。（内伤病而脉无力。）病在外。脉涩坚者。（外感病。脉宜浮滑。
而反涩坚。）皆难治。（按玉机真藏论。病在中脉实坚。病在外。脉不实坚者。皆难治与此相反。新校正云。此得而彼误。）
命曰反四时也。（与反四时者相类。）（平人气象论）
【素】五邪所见。春得秋脉。夏得冬脉。长夏得春脉。秋得夏脉。冬得长夏脉。（皆五行相克。）名曰阴出之阳。病
善怒。不治。（新校正。阴出之阳。病善怒。疑错简。吴注云。谓真藏阴脉。出于阳和脉之上。再加善怒。则东方生生之
本亡矣。）（宣明五气论）
【素】春不沉。夏不弦。冬不涩。秋不数。是谓四塞。（吴注。言脉虽待时而至。亦不可绝类而至。若春至而全无冬
脉。夏至而全无春脉。已虽专旺。而早绝其母气。是五脏不相贯通也。）参见曰病。复见曰病。未去而去曰病。去而不去
曰病。（吴注。一部而参见诸部。此乘侮交至也。既见于本部。复见于他部。此淫气太过也。未去而去。为本气不足。来
气有余。去而不去。为本气有余。来气不足。王注。复见谓再见。已衰。已死之气也。）（至真要大论）
【灵】经脉为里。（如手太阴肺经。自中府至少商。乃直行于经隧之里者也。）支而横者为络。（如肺经之列缺穴。横
行于手阳明大肠经者。为络脉也。）络之别者为孙。（络之歧者。犹子又生孙也。）（脉度）
【灵】经脉者。常不可见也。其虚实也。以气口知之。（十二经脉伏行分肉之间。深而不见。必诊气口寸脉。然后知
其虚实。故诊脉者。必以气口为主也。）脉之见者。皆络脉也。（络脉如肺列缺。大肠偏历之类。其脉常动。不必于气口
知之。）凡诊络脉。脉色青。则寒且痛。赤则有热。胃中寒。手鱼之络多青矣。（手大指下。肉高起者为鱼。）胃中有热。
鱼际络赤。（鱼际亦肺经穴。）其暴黑者。留久痹也。其有赤有黑有青者。寒热气也。其青短者。少气也。（经脉）
【素】气口何以独为五脏主。（气口即寸脉。亦曰脉口。可以候气之盛衰。故名气口。若分言之。今以左为人迎。右
为气口。）曰。胃者。水谷之海。六腑之大源也。（言脉虽见于气口。而实本之于脾胃。）五味入口藏于胃。以养五脏气。
气口亦太阴也。（脾为足太阴。为胃行其津液。以传于肺。而肺气口。亦手太阴也。）是以五脏六腑之气味。皆出于胃。
变见于气口。（气味由胃传肺。肺为转输于诸经。故诸经之脉。皆变见于此。）故五气入鼻。藏于心肺。（五味入口入于府。
五气入鼻入于藏。惟心肺居膈上。故先受之。）心肺有病。而鼻为之不利也。（五脏别论）
【素】食气入胃。（此段专言食。）散精于肝。淫气于筋。（肝主筋。其精淫溢入肝以养筋。）食气入胃。浊气归心。
淫精于脉。（谷肉皆粗浊之物。其气上归于心。其精微者。则淫入于脉。心主脉即血。）脉气流经。经气归于肺。肺朝百
脉。输精于皮毛。（脉气流行于十二经。十二经之气。皆归于肺。肺居高而受百脉之朝会。乃转输精气。布散于皮毛。如
木之行津。必由于皮也。）毛脉合精。行气于府。（府。王注作膻中。谓宗气之所聚也。张注作六腑。）府精神明。留于四
脏。（六腑之精气神明。上输于肺。以养心肝脾肾四脏。）气归于权衡。权衡以平。（肺主治节。分布气化。使四脏安定。
三焦均平。上下中外。各得其所也。）气口成寸。以决死生。（此脉之所由来也。气口亦名寸口。百脉之大要会也。马注。
与鱼际相去一寸。故名成寸。张注。分尺为寸也。按脉前为寸。后为尺。中为关。此云成寸。盖兼关尺而言之也。医者
由此察脉。知病以决人之死生也。）饮入于胃。（此段专言饮。与上文食入相对。故此下有通调水道。水精四布之文。东
垣丹溪改作饮食入胃。后人宗之。失经旨矣。）游溢精气。上输于脾。脾气散精。上归于肺。（脾主为胃行其津液。所谓
上焦如雾。中焦如沤也。）通调水道。下输膀胱。（肺行下降之令。转输而入膀胱。所谓下焦如渎也。）水精四布。五经并
行。合于四时。（脉道之行。因时而呈其状。）五脏阴阳。（礼记饮以养阳。食以养阴。此合饮食而言之也。）揆度以为常
也。（病能论。揆者。言切求其脉理也。度者。得其病处。以四时度之也。医者因此揆而度之。以知病情。为常法也。）
（经
脉别论）
[Suwen] In a healthy person (Pingren, an individual free from disease), the pulse beats twice during each exhalation and twice during each inhalation. At the pause between breaths (Dingxi), the pulse beats five times in total; if occasionally accompanied by a deep sigh-like breath (Taixi), it is still considered normal. (According to *Lingshu: Maidu* and *Wushi Ying*, the total length of the meridians in the human body is 16 zhang 2 chi. With each exhalation, Qi moves three cun; with each inhalation, Qi moves three cun. Over day and night, there are 13,500 breaths, during which Qi circulates fifty times through the body. The water clock drips for one hundred ke, and the pulse travels a total of 810 zhang, accumulating to 16 zhang 2 chi. *Nanjing* states: Exhalation involves the Heart and Lung; inhalation involves the Kidney and Liver. Between breaths, the Spleen receives grain essence. Its pulse is located in the middle. These five beats correspond to the Five Zang Organs.) A "Pingren" refers to someone who is not ill. Typically, one compares the patient's pulse with that of a healthy person. Since the physician is healthy, they regulate their own breathing to a calm rhythm to serve as a standard for diagnosing the patient. If the pulse beats only once per exhalation and once per inhalation, it is called Shaqi (deficiency of Qi, indicating decline of righteous Qi). (*Maijue* calls this a Bai Mai (decaying pulse); *Nanjing* calls it a Li Mai (departed pulse), signifying the decline of righteous Qi.) If the pulse beats three times per exhalation and three times per inhalation, and is rapid/agitated (Zao), it indicates Wenbing (warm disease) if the Chi (cubital) position is hot. (The Chi position belongs to Yin, while the Cun (radial) position belongs to Yang. Heat in both Yin and Yang positions indicates warm disease.) If the Chi position is not hot, a slippery (Hua) pulse indicates Fengbing (wind disease), while a choppy (Se) pulse indicates Bi syndrome (obstruction). (Slippery pulse indicates excess Yang; choppy pulse indicates blood deficiency.) If the pulse beats four or more times per exhalation, it indicates death. (Eight beats or more per respiration cycle. *Maijue* calls this Tuo Mai (escaping pulse); *Nanjing* calls it Duo Jing Mai (pulse of depleted essence). Four beats or more implies nine beats, which is a dying pulse.) If the pulse ceases completely, it indicates death. If the pulse is irregular, alternating between slow and rapid, it indicates death. The normal Qi of a healthy person is derived from the Stomach; the Stomach is the source of normal Qi. Absence of Stomach Qi is termed Ni (rebellion/contrary), and those with Ni die. In Spring, a pulse that is slightly Xian (wiry) but retains Wei Qi (Stomach Qi) is normal. If Xian exceeds Wei Qi, it indicates Liver disease. If there is only Xian without Wei Qi, it indicates death. If Wei Qi contains Mao (floating) characteristics, illness will occur in Autumn. (Mao corresponds to the Lung pulse; Metal overcomes Wood.) If Mao is pronounced, illness occurs immediately. Zhen Qi (True Qi) disperses into the Liver, which stores the Qi of the sinews. In Summer, a pulse that is slightly Gou (hook-like/hooked) but retains Wei Qi is normal. If Gou exceeds Wei Qi, it indicates Heart disease. If there is only Gou without Wei Qi, it indicates death. If Wei Qi contains Shi (stone/deep) characteristics, illness will occur in Winter. (Water overcomes Fire.) If Shi is pronounced, illness occurs immediately. Zhen Qi connects to the Heart, which stores the Qi of the blood vessels. In Late Summer, a pulse that is slightly Ruo (weak/soft) but retains Wei Qi is normal. If Ruo exceeds Wei Qi, it indicates Spleen disease. If there is only Dai (intermittent) without Wei Qi, it indicates death. (A pulse that stops intermittently is called Dai.) If Ruo contains Shi characteristics, illness will occur in Winter. (Water insults Earth; following the order of overcoming, it should be Xian.) If Ruo is pronounced, illness occurs immediately. Zhen Qi moistens the Spleen, which stores the Qi of the muscles. In Autumn, a pulse that is slightly Mao (floating) but retains Wei Qi is normal. If Mao exceeds Wei Qi, it indicates Lung disease. If there is only Mao without Wei Qi, it indicates death. If Mao contains Xian characteristics, illness will occur in Spring. (Wood insults Metal. Note by Wu: Although what I overcome is considered minor evil, if Wood Qi leaks, it cannot generate prosperity in Spring, leading to illness. Following the order of overcoming, it should be Gou.) If Xian is pronounced, illness occurs immediately. Zhen Qi rises above the Lung to distribute Ying (Nutrient) and Wei (Defensive) Qi and Yin-Yang. (The Lung acts as an assistant; Ying, Wei, Yin, and Yang all rely on it for distribution.) In Winter, a pulse that is slightly Shi (deep) but retains Wei Qi is normal. If Shi exceeds Wei Qi, it indicates Kidney disease. If there is only Shi without Wei Qi, it indicates death. If Shi contains Gou characteristics, illness will occur in Summer. (Fire insults Water; following the order of overcoming, Gou should be Ruo.) If Gou is pronounced, illness occurs immediately. Zhen Qi descends to the Kidney, which stores the Qi of the bone marrow. A normal Heart pulse comes continuously like linked pearls, feeling like smooth jade; this is the normal Heart pulse, rooted in Wei Qi during Summer. A pathological Heart pulse comes rapidly connected, with slight curvature; this is Heart disease. A dying Heart pulse feels rigid at the end and stiff, like holding a belt hook; this is heart death. A normal Lung pulse comes gently and softly, like falling elm seeds; this is the normal Lung pulse, rooted in Wei Qi during Autumn. A pathological Lung pulse does not rise or fall properly, feeling like tracing a chicken feather; this is Lung disease. (Wang’s note: Firm in the center, empty on sides. Wu’s note: Choppy and difficult.) A dying Lung pulse floats like an object or blows like wind through hair; this is lung death. A normal Liver pulse comes soft and swaying, like the tip of a long pole held high; this is the normal Liver pulse, rooted in Wei Qi during Spring. A pathological Liver pulse is full, solid, and slippery, like tracing a long pole; this is Liver disease. A dying Liver pulse is urgent and strong, like a newly tightened bowstring; this is liver death. A normal Spleen pulse is harmonious and soft, like a chicken treading on the ground; this is the normal Spleen pulse, rooted in Wei Qi during Late Summer. A pathological Spleen pulse is solid, full, and rapid, like a chicken lifting its foot; this is Spleen disease. A dying Spleen pulse is sharp and hard like a crow’s beak or bird’s claw, or like dripping roof water or flowing water; this is spleen death. A normal Kidney pulse comes steadily like a hook, firm upon pressure; this is the normal Kidney pulse, rooted in Wei Qi during Winter. (Winter pulse is Shi; firmness also implies Shi. Gou is Heart pulse; firmness with Gou implies harmony of Water and Fire, Yin and Yang.) A pathological Kidney pulse feels like pulling a vine, becoming harder upon pressure; this is Kidney disease. A dying Kidney pulse feels like ropes being pulled apart, crackling like stones; this is kidney death. (From *Pingren Qixiang Lun*)
[Suwen] Spring pulses resemble Xian (wiry). Spring corresponds to the Liver and East/Wood, the time when all things begin to grow. Thus, its Qi comes soft, light, void, and slippery, straight and long, hence called Xian. Deviation from this indicates disease. If the Qi comes solid and strong, it is called Taiguo (excess), indicating disease in the exterior. If the Qi comes insubstantial and weak, it is called Bují (deficiency), indicating disease in the interior. (Excess is external contraction; deficiency is internal injury.) Excess causes irritability (should be anger; *Qijiao Bian Dalun*: Excess Wood leads to sudden anger), dizziness, vertigo, and diseases of the vertex. (Xuan means spinning vision; Mao means confusion/darkness. Jueyin and Du meridian meet at the vertex.) Deficiency causes chest pain radiating to the back (*Jin Gui Yao Lue*: Chest pain radiating to back indicates Yang deficiency and Yin wiriness), and distension in the hypochondrium below (Liver meridian passes through the diaphragm and spreads along the costal region). Summer pulses resemble Gou (hook). Summer corresponds to the Heart and South/Fire, the time when all things flourish. Thus, its Qi comes vigorous and recedes weakly, hence called Gou. Deviation indicates disease. If the Qi comes vigorous and recedes vigorously, it is Taiguo (excess), disease in the exterior. If the Qi comes weak but recedes vigorously, it is Bují (deficiency), disease in the interior. Excess causes fever and skin pain, forming spreading sores (Jinyin). (Yang excess causes fever; heat cannot vent, causing skin pain; Jinyin means lingering heat.) Deficiency causes vexation. (Deficiency leads to internal vexation.) Upper symptoms include cough and spitting; lower symptoms include Qi leakage. (Heart meridian connects to Lung, causing cough/spit. Collaterals connect to Small Intestine, causing Qi leakage.) Autumn pulses resemble Fu (floating). Autumn corresponds to the Lung and West/Metal, the time of harvest. Thus, its Qi comes light, void, and floating, urgent in arrival and scattered in departure, hence called Fu. Deviation indicates disease. If the Qi comes like Mao (floating) but is firm in the center and empty on sides, it is Taiguo (excess), disease in the exterior. If the Qi comes like Mao but is weak, it is Bují (deficiency), disease in the interior. Excess causes rebellious Qi and back pain (Lung system relates to back), and a feeling of oppression. Deficiency causes panting, shortness of breath, cough, hemoptysis, and groaning sounds. Winter pulses resemble Ying (camp/guarding). Winter corresponds to the Kidney and North/Water, the time of storage. Thus, its Qi comes deep and pounding, hence called Ying. Deviation indicates disease. If the Qi comes like striking stones, it is Taiguo (excess), disease in the exterior. If the departure resembles Shu (rapid), it is Bují (deficiency), disease in the interior. Excess causes lethargy (neither cold nor hot, neither weak nor strong), spinal pain (Kidney meridian penetrates spine), and reluctance to speak. (Wu’s note: Voice longevity originates from Kidney.) Deficiency causes a sensation of hunger with an empty heart (Kidney Water fails to nourish Heart Fire), coldness in the paravertebral area, spinal pain, abdominal fullness, and urinary changes. (Connects to Bladder.) The Spleen pulse belongs to Earth, a solitary organ that irrigates the four directions. (Does not govern a specific season, hence solitary. Located centrally, it nourishes the other four Zang organs.) A healthy Spleen pulse is imperceptible; a diseased one is visible. (Spleen benefits the four Zang; if healthy, all are healthy; if diseased, all suffer.) If the pulse flows like water, it is Taiguo (excess), disease in the exterior. If it feels like a crow’s beak, it is Bují (deficiency), disease in the interior. Excess causes inability to move the limbs (Spleen governs limbs; dampness prevents movement). Deficiency causes obstruction of the nine orifices (failure to irrigate Zang organs). This is called Zhongqiang (heavy rigidity, disharmony of Zang Qi). When the True Liver Pulse arrives, it is tense inside and out like touching a blade, sounding like plucking a lute string, with cyan-white complexion lacking luster; death follows when lanugo falls out (collapse of Defensive Qi). When the True Heart Pulse arrives, it is hard and pounding like rolling Coicis Semen, with red-black complexion lacking luster; death follows when lanugo falls out. When the True Lung Pulse arrives, it is large and void like feathers piercing skin, with white-red complexion lacking luster; death follows when lanugo falls out. When the True Kidney Pulse arrives, it is pounding and intermittent like fingers striking stones, with black-yellow complexion lacking luster; death follows when lanugo falls out. When the True Spleen Pulse arrives, it is weak and alternating rapid/slow, with yellow-cyan complexion lacking luster; death follows when lanugo falls out. Seeing the True Zang pulse indicates death. Why? All five Zang organs derive Qi from the Stomach; the Stomach is the root of the five Zang. Zang Qi cannot reach the Hand-Taiyin Lung meridian on its own; it must rely on Stomach Qi. Therefore, the five Zang manifest their seasonal pulses at the Hand-Taiyin (Cun Kou). Thus, when pathogenic Qi prevails, essential Qi declines. In severe illness, Stomach Qi cannot accompany the pathogen to the Hand-Taiyin, so only the True Zang Qi appears alone. Appearing alone means disease overwhelms the Zang. Hence, death. (From *Yuji Zhenzang Lun*)
[Suwen] Pulses have Yin and Yang. Knowing Yang allows knowing Yin, and knowing Yin allows knowing Yang. (Wang’s note: Deep understanding prepares for discussing variations.) There are five types of Yang pulses, making twenty-five Yang combinations. (Yang refers to harmonious pulses. The five Zang—Heart, Liver, Spleen, Lung, Kidney—manifest as Xian, Gou, Ruo, Mao, Shi pulses. During their respective seasons, they show their native pulse. Within each pulse, five variations exist. Those without excess or deficiency are Yang pulses.) What is called Yin is the True Zang pulse. Its appearance signifies collapse and inevitable death. (True Zang refers to the pulses described earlier. 'Zang' means hidden. True Qi appearing without being hidden, losing all Yang harmony, constitutes a Yin pulse.) What is called Yang is the Yang of the Stomach cavity. (Presence of Stomach Qi makes the pulse harmonious, which is Yang. Absence makes it Yin. Wang’s note interprets this as Renying/Stomach pulse at the neck; left small for Zang, right large for Fu. This seems inconsistent with the text.) Distinguishing Yang (pathological pulse with Stomach Qi) reveals the location of disease. (If a specific pulse is discordant, the disease is located there.) Distinguishing Yin (True Zang Yin pulse) predicts the time of death. (Derived from Yin-Yang generation and overcoming cycles.) (From *Yinyang Bie Lun*)
[Suwen] If the pulse conforms to Yin-Yang principles, the disease is easy to cure; if it contradicts them, it is difficult. (Left Renying is Yang:洪大 (voluminous/large) is favorable in Spring/Summer, Chen Xi (deep/thin) is unfavorable. Right Qikou is Yin: Chen Xi is favorable in Autumn/Winter, Hong Da is unfavorable. For men, Left > Right is favorable; for women, Right > Left is favorable. For external contractions: Yang disease with Yang pulse is favorable; Yang disease with Yin pulse is unfavorable. Yin disease with Yang pulse is favorable. For internal injuries: Yang disease with Yang pulse is favorable; Yang disease with Yin pulse is unfavorable. Yin disease with Yin pulse is favorable; Yin disease with Yang pulse is unfavorable.) If the pulse follows the four seasons, there is no other danger. (e.g., Spring Xian, Summer Gou). If the pulse opposes the four seasons or violates the sequence of Zang transmission, it is difficult to cure. (Spring getting Lung pulse, Summer getting Kidney pulse opposes the seasons. 'Jianzang' transmission: e.g., Liver disease attacking Earth should transmit to Spleen; if it transmits to Heart instead, skipping the overcome organ, it is Jianzang. *Nanjing* says Jianzang implies survival.) Reversal and conformity in pulses: If the native Zang pulse has not yet appeared during its season... (See detailed analysis in original). Wind-heat with a quiet pulse, diarrhea/blood loss with a solid pulse, interior disease with a deficient pulse, exterior disease with a choppy/firm pulse—all are difficult to treat. (Note: Contradicts *Yuji Zhenzang Lun*. New correction suggests error here.) This is called opposing the four seasons. (From *Pingren Qixiang Lun*)
[Suwen] Manifestations of the five evils: Spring getting Autumn pulse, Summer getting Winter pulse, Late Summer getting Spring pulse, Autumn getting Summer pulse, Winter getting Late Summer pulse (all involve Five Element overcoming). This is called Yin emerging into Yang. The patient becomes irritable and untreatable. (New correction suspects textual error. Wu’s note: True Yin Zang pulse emerges above Yang-Harmonious pulse; added irritability destroys the generative root of East/Wood.) (From *Xuanming Wuqi Lun*)
[Suwen] Spring lacks Chen (deep), Summer lacks Xian (wiry), Winter lacks Se (choppy), Autumn lacks Shu (rapid)—this is called Si Sai (four obstructions). (Wu’s note: Pulses await their season but should not appear abruptly. If Spring arrives without any trace of Winter pulse, etc., the mother Qi is cut off early, disrupting Zang connection.) Simultaneous appearance indicates disease; reappearance indicates disease; disappearance before due time indicates disease; persistence beyond due time indicates disease. (Wu’s note: Simultaneous appearance across regions indicates乘侮 (overcoming/insulting) interactions. Appearance in non-native region indicates excessive pathogenic Qi. Early disappearance indicates deficiency of native Qi and excess of incoming Qi. Persistence indicates excess of native Qi and deficiency of incoming Qi. Wang’s note: Reappearance refers to decayed/dead Qi.) (From *Zhiyao Dayao Lun*)
[Lingshu] Jing-Meridians run deeply within. (e.g., Hand-Taiyin Lung Meridian from Zhongfu to Shaoguang runs straight within the channels). Branching horizontally are Luo-Collaterals. (e.g., Lieque of Lung meridian crossing Hand-Yangming Large Intestine meridian is a Luo collateral). Divisions of Luo are Sun-Collaterals. (Branches of Luo, like grandchildren of children.) (From *Maidu*)
[Lingshu] Jing-Meridians are usually invisible. Their deficiency or excess is known via the Qikou (Cun Kou). (Twelve Jing-Meridians run deep between muscles. One must diagnose the Qikou Cun pulse to know deficiency/excess. Thus, Qikou is primary.) Visible pulses are all Luo-Collaterals. (e.g., Lieque, Pianli. These pulses often move and do not require Qikou diagnosis.) Generally, diagnosing Luo-Collaterals: Blue color indicates cold and pain. Red indicates heat. Cold in Stomach causes blue veins on the hand fish (Thenar eminence). Heat in Stomach causes redness at Yuji (acupoint). Sudden black indicates chronic Bi. Mixed colors indicate mixed cold/heat. Short/blue indicates Shaqi (Qi deficiency). (From *Jingmai*)
[Suwen] Why does Qikou alone govern the five Zang? (Qikou/Cun Kou reflects Qi abundance/deficiency. Left is Renying, Right is Qikou.) Answer: The Stomach is the sea of water and grain, the great source of the six Fu organs. (Pulse appears at Qikou but originates in Spleen/Stomach.) Flavors enter the Stomach to nourish Zang Qi. Qikou is also Taiyin. (Spleen is Foot-Taiyin, transports fluids to Lung. Lung Qikou is Hand-Taiyin.) Thus, Qi/flavor of all Zang/Fu originate in Stomach and manifest at Qikou. (Flavors pass Stomach to Lung; Lung distributes to meridians. Hence, all pulses manifest here.) Five aromas enter the nose and store in Heart/Lung. (Flavors enter Fu; aromas enter Zang. Heart/Lung are superior, receiving first.) Disease in Heart/Lung causes nasal obstruction. (From *Wuzang Bie Lun*)
[Suwen] Food enters the Stomach, disperses essence to Liver, flooding sinews. (Liver governs sinews; essence nourishes them.) Food enters Stomach, turbid Qi returns to Heart, flooding essence into vessels. (Grain/meat are coarse/turbid; Qi goes to Heart; fine essence floods into vessels. Heart governs vessels/blood.) Vessel Qi flows through meridians, meridian Qi returns to Lung. Lung receives all vessels, transmits essence to skin/hair. (Meridian Qi flows through twelve meridians, returning to Lung. Lung is high, receiving all vessels, distributing essence to skin/hair like sap in wood.) Skin/Vessel essence combines, moving Qi to the Fu (Chest/Danzhong or Six Fu). Fu essence/ming stays in four Zang. (Six Fu essence goes to Lung to nourish Heart, Liver, Spleen, Kidney.) Qi returns to balance, achieving equilibrium. (Lung regulates distribution, stabilizing four Zang and Sanjiao.) Qikou forms Cun, deciding life and death. (Origin of pulse. Cun Kou is meeting of all vessels. Ma’s note: One cun from Yuji. Zhang’s note: Dividing Chi into Cun. Pulse front is Cun, back is Chi, middle is Guan. 'Cheng Cun' includes Guan/Chi. Physicians use this to decide life/death.) Drinks enter Stomach. (This section focuses on drinks, contrasting with food. Dong Yuan/Dan Xi changed to 'food/drink', losing original intent.) Floating Qi/Essence goes up to Spleen. Spleen scatters essence, sending it up to Lung. (Spleen transports fluids for Stomach. Upper Jiao like mist, Middle Jiao like fermenting vat.) Regulates water pathways, transmitting down to Bladder. (Lung directs downward flow to Bladder. Lower Jiao like ditch.) Water essence distributes everywhere, five meridians run together, conforming to four seasons. (Pulse flow varies by season.) Five Zang Yin-Yang. (Li Ji: Drinks nourish Yang, food nourishes Yin. Combined meaning.) Measure and estimate as constant practice. (Kui = measuring pulse logic; Du = locating disease by season. Physicians use this method.) (From *Jingmai Bie Lun*)