手中之少阴。乃肾脉。非心脉也。）（平人气象论）
【灵】经脉十二。而手太阴足少阴阳明。独动不休何也。（肺之太渊。肾之太溪。胃之人迎。皆动不休。按胃之动脉。
马注作足之冲阳。然下文并未说到足上。惟云上冲头。并下人迎。别走阳明。似当以人迎为是。）曰。是明胃脉也。（先
明胃脉。方知肺脉。故脉中有胃气者生。）胃为五脏六腑之海。其清气上注于肺。（受水谷而化精微之气。以上注于肺。）
肺气从太阴而行之。（此营气也。营行脉中。从手太阴始。而遍行于五脏六腑。）其行也。以息往来。故人一呼脉再动。
一吸脉亦再动。呼吸不已。故动而不止。（十二经脉。皆会于寸口。故动而不休。即手太阴肺之太渊穴也。在掌后陷中。
九针篇曰。阳中之少阴肺也。其原出于太渊。）足之阳明。何因而动。曰。胃气上注于肺。（此前段行于肺之营气。）其悍
气上冲头者。（此言胃中 悍之卫气。）循咽。上走空窍。循眼系。入络脑。（循足太阳膀胱经睛明穴。上络于脑。）出 。
（同颔。）下客主人。（足少阳胆经穴。耳前起骨上廉。）循牙车。（即颊车。胃经。）合阳明。（阳明胃经。）并下人迎。（胃
经穴。侠结喉两旁一寸五分动脉。）此胃气别走于阳明者也。（胃腑之气。循三阳而别走阳明之经。此虽为卫气。实本胃
内之气而行。）故阴阳上下。其动也若一。（或行于阴。或行于阳。或升于上。或降于下。而形为弦钩毛石等脉。虽各不
同。然其合于时。应于藏。其动也则若一矣。）故阳病而阳脉小者为逆。（阳症脉宜浮大。小为阳症见阴脉。）阴病而阴脉
大者为逆。（阴症脉宜沉细大为阴症见阳脉。）故阴阳俱静俱动若引绳。相倾者病。（言阴阳动静。当如引绳平等。所谓脉
有胃气者生也。若相倾则病矣。马注。作引绳以相倾。谬。）足少阴何因而动。曰。冲脉者。十二经之海也。与少阴之大
络（足少阴肾。）起于肾下。出于气街。（即阳明胃经气冲穴。侠脐相去四寸。动脉应手。）循阴股内廉。邪入 中。（膝
后曲处。）循胫骨内廉。并少阴之经。（肾经。）下入内踝之后。入足下。（涌泉穴。）其别者邪入踝。（胫两旁。）出属跗上。
（足面。）入大指之间。（据与肾脉并行。当作小趾。）注诸络。以温足胫。此脉之常动者也。（按诸篇俱言冲脉上冲。惟
此篇及顺逆肥瘦论。言冲脉并肾脉下行。马注云。由此观之。肺脉之动不休者。以营气随肺气而行诸经。诸经之脉。朝
于肺也。胃脉之动不休者。以卫气由胃循三阳。而行不已也。肾脉之动不休者。以与冲脉并行。灌诸络而行不已也。）（动
输）
【素】论言人迎与寸口相应若引绳。小大齐等。命曰平。（见灵枢禁服篇。）阴之所在。寸口如何。（王注。阴之所在。
脉沉不应。引绳齐等。其候颇乖。张注。阴。手足少阴也。）曰。视岁南北。可知之矣。（甲己二岁为南政。余八岁为北
政。五运以甲己土运为尊。六气以少阴君火为尊。张注。五运之中。惟少阴不司气化。）北政之岁。少阴在泉。则寸口不
应。（北政。面北以定其上下。则尺主司天。寸主在泉。少阴在泉。则寸口不应。不以尺为主。而以寸为主者。从君而不
从臣也。）厥阴在泉。则右不应。（少阴间气在右故。）太阴在泉。则左不应。（少阴间气在左故。）南政之岁。少阴司天。
则寸口不应。（南政。面南以定其上下。则寸主司天。尺主在泉。少阴司天。则寸口不应。）厥阴司天。则右不应。太阴
司天。则左不应。（左右与前义同。）诸不应者。反其诊则见矣。（王注。不应皆为脉沉。仰手而沉。覆其手。则沉为浮。
细为大也。马注。诸不应者。即南北二政。而相反以诊之。则南政主在寸者。北政主在尺。南政主在尺者。北政主在寸。
其脉自明矣。凡左右二间。其相反与尺寸同。吴注。反。变也。诊。候也。诸不应者。岁运经候之常也。今乃见者。其
候变也。变则不应者。斯应矣。）尺候何如。曰。北政之岁。三阴在下。则寸不应。三阴在上。则尺不应。（司天曰上。
在泉曰下。）南政之岁。三阴在天。则寸不应。三阴在泉。则尺不应。左右同。（吴注。惟少阴所在则不应。以少阴君也。
有端拱无为之象。然善则不见。恶者可见。犹无道而失君象也。）（至真要大论）
【素】脉至浮合。浮合如数。一息十至以上。是经气予不足也。微见九十日死。脉至如火薪然。（瞥瞥不定。）是心
精之予夺也。草干而死。脉至如散叶。是肝气予虚也。木叶落而死。脉至如省客。（省问之客。倏去倏来。）省客者。脉
塞而鼓。是肾气予不足也。悬去枣华而死。（枣华于夏。）脉至如丸泥。是胃精予不足也。榆荚落而死。（秋深。）脉至如
横格。是胆气予不足也。禾熟而死。脉至如弦缕。是胞精予不足也。病善言下霜而死。不言可治。（王注。胞脉系于肾。
肾脉挟舌本。胞气不足。当不能言。今反善言。是真气内绝而外出也。）脉至如交漆。（交当作绞。）交漆者。左右旁至也。
微见三十日死。脉至如涌泉。（有出无入。）浮鼓肌中。太阳气予不足也。少气味。韭英而死。（气不足而口无味。长夏韭
英。马注。以少气为句。味韭英而死为句。谬。）脉至如颓土之状。按之不得。是肌气予不足也。五色先见黑白垒发死。
（瘾疹见于肌上。）脉至如悬雍。（人上 。名悬雍。）悬雍者。浮揣切之益大。是十二俞之予不足也。（背有十二经之俞
穴。）水凝而死。脉至如偃刀。偃刀者。浮之小急。按之坚大急。五脏菀（郁热。）热。寒热独并于肾也。如此其人不得
坐。立春而死。脉至如丸。滑不直手。不直手者。按之不可得也。是大肠气予不足也。枣叶生而死。（初夏。）脉至如华
者。（虚弱之意。）令人善恐。不欲坐卧。行立常听。（小肠脉入耳中。）是小肠气予不足也。季秋而死。（此篇脉名脉状。
不必强解。以意会之可也。）（大奇论）
The Shaoyin pulse at the hand is the Kidney pulse, not the Heart pulse. (From *Suwen: Pingren Qixiang Lun*)
[Lingshu] Among the twelve meridians, why do only the Hand Taiyin, Foot Shaoyin, and Foot Yangming meridians have pulses that beat continuously? (Commentary: The Yuan-source point of the Lung meridian, Taiyuan; the Yuan-source point of the Kidney meridian, Taixi; and the Renying point of the Stomach meridian all exhibit continuous pulsation. Regarding the location of the Stomach meridian's arterial pulse, Ma Shi's commentary suggests it is at Chongyang on the foot. However, the subsequent text does not mention the foot, but rather states it ascends to the head and descends through Renying, separately entering the Yangming meridian. Therefore, Renying should be considered correct.) The answer is: This clearly refers to the Stomach pulse. (By first clarifying the Stomach pulse, one can understand the Lung pulse; thus, a pulse containing Stomach Qi indicates life.) The Stomach is the sea of nutrients for the five zang and six fu organs. Its clear and subtle qi ascends and pours into the Lung. (Referring to the subtle qi transformed from food and drink, which ascends to the Lung.) Lung Qi travels along the Hand Taiyin meridian. (This is Ying Qi. Ying Qi circulates within the vessels, starting from the Hand Taiyin meridian, and then pervades the five zang and six fu organs.) Its movement comes and goes with respiration. Therefore, in one exhalation, the pulse beats twice; in one inhalation, the pulse also beats twice. As long as breathing continues, the pulse beats without stopping. (The qi of the twelve meridians converges at the Cun Kou, hence the continuous beating. This refers specifically to Taiyuan of the Hand Taiyin Lung meridian, located in the depression behind the wrist. The *Jiu Zhen* chapter states: "Shaoyin among Yang is the Lung, its source emerges at Taiyuan.") What causes the Foot Yangming Stomach meridian to beat? The answer is: Stomach Qi ascends and pours into the Lung. (This refers to the Ying Qi circulating in the Lung mentioned in the previous section.) Among this, the fierce and rapid Wei Qi ascends to the head. (This refers to the fierce Wei Qi of the Stomach.) It follows the throat, ascends to enter the orifices, follows the eye system, and enters to connect with the brain. (Following the Jingming point of the Foot Taiyang Bladder meridian, ascending to connect with the brain.) It emerges from the mandible, descends to the Kechzhuoren point, (a point of the Foot Shaoyall Gallbladder meridian, on the upper margin of the bone rising before the ear,) follows the Jiache point, (also known as Jiache, belonging to the Stomach meridian,) merges with the Yangming meridian, (the Yangming Stomach meridian,) and descends together to the Renying point. (A point of the Stomach meridian, an arterial pulse located 1.5 cun lateral to both sides of the laryngeal prominence.) This is how Stomach Qi takes a separate path to travel along the Yangming meridian. (The qi of the Stomach fu organ travels along the three Yang meridians and separately enters the Yangming meridian. Although this is Wei Qi, it essentially originates from the qi within the Stomach.) Thus, the movement of Yin and Yang above and below is uniform. (Whether traveling in Yin, traveling in Yang, ascending above, or descending below, manifesting as string-like, hook-like, hair-like, or stone-like pulses, although different, they conform to the seasons and correspond to the zang organs, yet their movement remains consistent.) Therefore, if a Yang disease presents with a small Yang pulse, it is a counter-indication. (Yang diseases typically present with floating and large pulses; a small pulse indicates a Yin pulse appearing in a Yang disease.) If a Yin disease presents with a large Yin pulse, it is a counter-indication. (Yin diseases typically present with deep and fine pulses; a large pulse indicates a Yang pulse appearing in a Yin disease.) Therefore, if both Yin and Yang pulses are still or both are agitated, like a taut rope leaning against each other, it indicates disease. (This means the dynamics of Yin and Yang should be balanced like a taut rope. Such a pulse contains Stomach Qi and indicates life. If they lean against each other unevenly, it indicates disease. Ma Shi's commentary interpreting it as "leaning against each other like a taut rope" is incorrect.) What causes the Foot Shaoyin Kidney meridian to beat? The answer is: The Chong Mai (Penetrating Vessel) is the sea of the twelve meridians. It arises from below the Kidney along with the large collateral of the Shaoyin meridian (Foot Shaoyin Kidney), emerges from the Qichong point, (the Qichong point of the Yangming Stomach meridian, four cun lateral to the umbilicus, where the arterial pulse is palpable,) descends along the medial aspect of the thigh, obliquely enters the popliteal fossa, (the bend behind the knee,) descends along the medial aspect of the tibia, running parallel with the Shaoyin meridian, (Kidney meridian,) descends into the posterior aspect of the medial malleolus, and enters the sole of the foot, (Yongquan point.) Its branch obliquely enters the ankle, (sides of the tibia,) emerges on the dorsum of the foot, (foot surface,) and enters between the big toe. (Based on its parallel course with the Kidney pulse, it should likely be the little toe.) It pours into the various collaterals to warm the lower legs and shins. This is the normal site of continuous pulsation in the meridians. (Most chapters state that the Chong Mai ascends, but only this chapter and the *Shunyi Feishou Lun* chapter state that the Chong Mai descends parallel to the Kidney pulse. Ma Shi notes: From this, we see that the Lung pulse beats continuously because Ying Qi follows Lung Qi to circulate through the meridians, and the meridians converge at the Lung; the Stomach pulse beats continuously because Wei Qi circulates from the Stomach through the three Yang meridians without ceasing; the Kidney pulse beats continuously because it runs parallel with the Chong Mai, irrigating the collaterals without ceasing.) (From *Lingshu: Dongshu*)
[Suwen] The classic states that the Renying and Cun Kou pulses correspond to each other like a taut rope, equal in size, which is called a Normal Pulse. (See *Lingshu: Jinfu Pian*.) How does the pulse at Cun Kou present when Yin is dominant? (Wang Bing's commentary: Where Yin resides, the pulse is deep and not prominent. If it is equal like a taut rope, the sign is quite abnormal. Zhang Jingyue's commentary: Yin refers to the Hand and Foot Shaoyin meridians.) The answer is: By observing whether the year is Nan Zheng (Southern Administration) or Bei Zheng (Northern Administration), one can know this. (Years of Jia and Ji are Nan Zheng; the remaining eight years are Bei Zheng. Among the Five Movements, Jia and Ji Earth movements are supreme; among the Six Qi, Shaoyin Sovereign Fire is supreme. Zhang Jingyue notes: Among the Five Movements, only Shaoyin does not govern Qi transformation.) In a Bei Zheng year, if Shaoyin is at the Quan (Earthly Position), then the Cun Kou pulse will not respond (be weak or absent). (Bei Zheng involves facing North to determine upper and lower positions; thus, the Chi position governs Si Tian (Heavenly Position), and the Cun position governs Quan. If Shaoyin is at Quan, the Cun Kou pulse does not respond. Not prioritizing Chi over Cun, but prioritizing Cun over Chi, follows the principle of respecting the Sovereign over the Minister.) If Jueyin is at Quan, then the right Cun will not respond. (Because the inter-qi of Shaoyin is on the right.) If Taiyin is at Quan, then the left Cun will not respond. (Because the inter-qi of Shaoyin is on the left.) In a Nan Zheng year, if Shaoyin is at Si Tian (Heavenly Position), then the Cun Kou pulse will not respond. (Nan Zheng involves facing South to determine upper and lower positions; thus, the Cun position governs Si Tian, and the Chi position governs Quan. If Shaoyin is at Si Tian, the Cun Kou pulse does not respond.) If Jueyin is at Si Tian, then the right Cun will not respond. If Taiyin is at Si Tian, then the left Cun will not respond. (The meaning of left and right is the same as before.) For all cases of non-response, reversing the diagnostic method (e.g., turning the hand over) will reveal them. (Wang Bing's commentary: Non-response is due to deep pulses. With the palm up, the pulse is deep; flipping the hand makes deep appear as superficial, and thin appear as large. Ma Shi's commentary: The so-called non-response refers to the opposite diagnostic approaches for Nan and Bei Zheng. For Nan Zheng, what is governed by Cun is governed by Chi in Bei Zheng, and vice versa, making the pulse clear. The principles for the left and right inter-qi are the same as for Cun and Chi. Wu Kun's commentary: "Fan" means change; "Zhen" means sign. The phenomenon of non-response is the normal pattern of annual movements and meridians. If it appears now, it indicates a change in signs. When there is change, the normally non-responsive becomes responsive.) How does the Chi position present? The answer is: In a Bei Zheng year, if the Three Yin are below (at Quan), then the Cun Kou pulse will not respond; if the Three Yin are above (at Si Tian), then the Chi pulse will not respond. (Si Tian is called Upper, Quan is called Lower.) In a Nan Zheng year, if the Three Yin are at Si Tian, then the Cun Kou pulse will not respond; if the Three Yin are at Quan, then the Chi pulse will not respond. The left and right are the same. (Wu Kun's commentary: Only where Shaoyin resides does the pulse not respond, because Shaoyin is the Sovereign Fire, having the image of sitting upright and doing nothing. However, goodness is unseen, while evil is visible, resembling a ruler who has lost his sovereign demeanor due to lack of virtue.) (From *Suwen: Zhi Zhen Yao Da Lun*)
[Suwen] A pulse that is Fu He (floating and combined), resembling a Shu (rapid) pulse, beating more than ten times per breath cycle, indicates insufficiency of Jing Qi bestowed by the meridians. If this sign appears mildly, death occurs in ninety days. A pulse that burns like firewood (flickering and unstable) indicates deprivation of Heart Jing essence; death occurs when grass dries up. A pulse like scattered leaves indicates deficiency of Liver Qi bestowed; death occurs when tree leaves fall. A pulse like a "Sheng Ke" (visiting guest asking questions), coming and going suddenly, indicates insufficiency of Kidney Qi bestowed; death occurs when jujube flowers bloom (summer). A pulse like a mud pellet indicates insufficiency of Stomach Jing essence; death occurs when elm pods fall (late autumn). A pulse like a horizontal grid indicates insufficiency of Gallbladder Qi bestowed; death occurs when grain ripens. A pulse like a silk thread indicates insufficiency of Bao (Uterus/Bladder) Jing essence bestowed; if the patient speaks excessively, death occurs during frost; if they do not speak excessively, it is treatable. (Wang Bing's commentary: The Bao vessels connect to the Kidney, and the Kidney vessels flank the root of the tongue. Insufficiency of Bao Qi should result in inability to speak. Speaking excessively now indicates internal exhaustion of True Qi and its external escape.) A pulse like Jiao Qi (twisted lacquer), arriving from both sides laterally, indicates severe insufficiency; death occurs in thirty days. A pulse like a gushing spring (outflow without inflow), floating and beating within the muscles, indicates insufficiency of Taiyang Qi bestowed; with diminished smell/taste, death occurs when leek flowers bloom. (Diminished Qi leads to loss of taste/smell, occurring in late summer when leeks flower. Ma Shi's commentary incorrectly segments the sentence as "Shao Qi" [little Qi] and "Wei Jiu Ying Er Si" [tastes leek flowers and dies].) A pulse like crumbling earth, unpalpable upon pressure, indicates insufficiency of Muscle Qi bestowed; death occurs when black and white colors appear on the face in patches. (Erythema appears on the skin.) A pulse like Xuan Yong (uvula), becoming larger upon light palpation and pressing, indicates insufficiency of the Twelve Shu points' Qi bestowed. (There are Twelve Shu points on the back corresponding to the twelve meridians.) Death occurs when water freezes. A pulse like an inverted knife, where light palpation feels small and urgent, and heavy palpation feels hard, large, and urgent, indicates heat stagnation in the five Zang organs, with cold and heat combining exclusively in the Kidney. Such a person cannot sit; death occurs at the beginning of Spring. A pulse like a pill, slippery and not straight under the finger, meaning ungraspable upon pressure, indicates insufficiency of Large Intestine Qi bestowed; death occurs when jujube leaves sprout (early summer). A pulse like a flower (indicating weakness) causes fearfulness, aversion to sitting or lying down, and constant listening while walking or standing. (The Small Intestine meridian enters the ear.) This indicates insufficiency of Small Intestine Qi bestowed; death occurs in late autumn. (The pulse names and descriptions in this chapter need not be forced into literal interpretations; understanding their intent is sufficient.) (From *Suwen: Da Qi Lun*)