出于外。其势不能入于阴也。主少气。正以脉涌则气乏也。韭有英时。冬尽春初也。水已亏极。安能至于盛春
耶。张同。吴云。少气。气不足也。少味。液不足也。韭至长夏而英。长夏属土。太阳壬水之所畏也。故死。
高云。气为阳。味为阴。太阳有寒热阴阳之气。太阳虚故少气味。英盛也。韭英。乃季春土王之时。韭英而死。
土克水也。简按少气味。未详。姑从马说。韭英。吴高似是。
如颓土之状 志云。颓土。倾颓之土也。脾主肌肉。如颓土而按之不得者。无来去上下之象。高同。
五色先见黑 志云。土位中央。而分主于四季。当五色俱见而先见黄。若五色之中。而先见黑。是土
败而水气乘之矣。
白垒 甲乙。作白累。马云。垒。当作 。诗云绵绵葛 。 。亦葛之属。吴云垒者。瘾疹之高起
者。北方黑色。主收藏。西方白色。主杀物故死。张云垒。 同。即蓬 之属。 有五种。而白者发于春。木
王之时。土当败也。简按垒。 通。不必改。尔雅。诸虑。山 。郭注云。今江东呼 为藤。似葛而粗大。广
雅云。 。藤也。一切经音义。引集训云。藤。 也。 。谓草之有枝条。蔓延。如葛之属也。吴越间谓之藤。
本草。马志云。 者。藤也。则蓬 。明是藤蔓矣。据此则 所指不一。未知白垒是何物。张说难信。吴读为
之 。亦恐非。○志云。玉师曰。以经水如浮波。心脉如火薪。肝脉如散叶。胃脉如泥丸。太阳如涌泉。肌脉
如颓土。皆以五行之气。效象形容。盖此乃五脏虚败之气。变见于脉。非五脏之病脉也。
悬雍 高云。雍。作 。虚肿之KT 。上浮本大也。简按诸注并不允。盖雍。瓮通。山海经。悬瓮之
山。晋水出焉。郭璞注云。山腹有巨石。如 形。因以为名。 。亦作瓮。说文。罂也。广雅。瓶也。盖取其
大腹小口。而形容浮揣切之益大之象也。甲乙。雍作痈。非。
浮揣切之益大 马云。悬雍。本浮也。揣切之际。其脉益大。而全无沉意。张云。浮短孤悬。有上无
下也。志云。揣。度也。先轻浮而度之。再重按而切之。其本益大。简按志注与经旨相反。不可从。吴。揣下。
补无力二字。赘。
十二俞之予不足也 甲乙。予上。有气字。张云。俞皆在背。为十二经脏气之所系。水凝而死。阴气
盛。而孤阳绝也。
水凝而死 甲乙。凝。作冻。
如偃刀 张云。卧刀也。浮之小急。如刀口也。按之坚大急。如刀背也。高云。偃。息也。刀。金器
也。简按高说未知何谓。
菀熟 甲乙。作寒热。诸本。熟。作热。张云。此以五脏菀热。而发为寒热。阳王则阴消。故独并于
肾也。腰者肾之府。肾阴既亏。则不能起坐。立春阳盛。阴日以衰。所以当死。菀。郁同。简按吴云。熟。热
之深。谬甚。
如丸滑不直手 张云。如丸。短而小也。直。当也。言滑小无根。而不胜按也。马吴并云。直。值同。
甲乙作着。
枣叶生而死 张云。大肠应庚金。枣叶生初夏。火王则金衰。故死。马云。枣叶之时。则先枣华之候矣。
如华 甲乙。作如春。马云。是似草木之华。虚弱而按
之无本也。
善恐不欲坐卧 马云。令人善恐。以心气不足也。不欲坐卧。以心气不宁也。张云。小肠不足。则气
通于心。善恐不欲坐卧者。心气怯而不宁也。
行立常听 志云。如耳作蝉鸣。或如钟磬声。皆虚证也。
季秋而死 马云。小肠属火。火王犹可生。至季秋。则衰极而死矣。志云。遇金水生旺之时而死。
The pulse qi emerges from the exterior. Its momentum cannot enter the Yin aspect. It indicates Sha Qi (deficiency of vital energy). This is precisely because a surging pulse indicates a lack of Zheng Qi (upright energy). The time when Chinese chives flower is at the end of winter and the beginning of spring. At this time, Kidney Water has been depleted to the extreme; how can it reach the peak of late spring? Zhang Tong and Wu Kun state: "Sha Qi" means insufficiency of Qi; "Shao Wei" means insufficiency of body fluids. Chinese chives flower in Long Xia (late summer). Long Xia belongs to Earth, which is feared by Tai Yang Ren Water (the water element associated with the Tai Yang channel). Therefore, death ensues. Gao Shishi states: Qi belongs to Yang, and Wei (flavor/substance) belongs to Yin. The Tai Yang channel possesses cold-heat and Yin-Yang Qi. Due to Tai Yang deficiency, there is a shortage of Qi and Wei. The flowering of Chinese chives occurs during Ji Chun (spring), when Earth is dominant. Death upon the flowering of Chinese chives is due to Earth overcoming Water. Jian An [the author's commentary]: The meaning of "shortage of Qi and Wei" is unclear. For now, we follow Ma Shi's explanation. Regarding "Jiu Ying" (flowering of Chinese chives), the interpretations of Wu Kun and Gao Shishi seem plausible but are not entirely accurate.
The pulse resembles collapsed earth. Su Wen Ji Zhu notes: "Tui Tu" refers to collapsing or ruined earth. The Spleen governs the muscles. A pulse like collapsed earth, which feels weak and rootless upon palpation, lacks the dynamic imagery of coming and going, ascending and descending. Gao Shishi holds the same view.
Among the five colors, black appears first. Su Wen Ji Zhu notes: Earth resides in the center and governs the four seasons. When all five colors appear, yellow should be seen first. If among the five colors, black appears first, this indicates that Earth Qi is failing and Water Qi is taking advantage of the weakness.
Bai Lei (a plant or pathological manifestation). Jia Yi Jing writes it as "Bai Lei". Ma Shi says: "Lei" should be written as "Lei" (liana). The Book of Songs states: "Lush are the grapevines." "Lei" is also a type of vine. Wu Kun says: "Lei" refers to the raised portions of urticaria (wind hives). The North corresponds to Black, governing storage; the West corresponds to White, governing killing. Therefore, death occurs. Zhang Jingyue says: "Lei" is interchangeable with "Lei", referring to plants like Peng Lei. There are five types of Lei, and the white one emerges in Spring, when Wood Qi is dominant and Earth Qi should fail. Jian An comments: "Lei" and "Lei" are interchangeable; there is no need to change the character. Er Ya states: Zhu Lu, Shan Lei. Guo Pu's annotation says: In Jiangdong today, "Lei" is called Teng (vine), resembling Ge (creeper) but thicker. Guang Ya states: Lei is a vine. Yi Qie Jing Yin Yi cites Ji Xun saying: Teng is Lei. Lei refers to herbs with branches that spread and creep, similar to Ge. In the Wu-Yue region, it is called Teng. Ben Cao records that Ma Zhi said: Lei is a vine. Thus, Peng Lei is clearly a creeping vine. Based on this, the reference of "Lei" is inconsistent, and it is unknown what specific substance "Bai Lei" refers to. Zhang Jingyue's theory is difficult to accept. Wu Kun's reading of it as "Lei" (piles/stacks) is also likely incorrect. ○ Su Wen Ji Zhu notes: Master Yu said: The pulse of Jing Shui (water vessels) resembles floating waves; the Heart pulse resembles firewood burning; the Liver pulse resembles scattered leaves; the Stomach pulse resembles clay pills; the Tai Yang pulse resembles a gushing spring; the muscle pulse resembles collapsed earth. All these use the Qi of the Five Elements to simulate shapes and descriptions. These represent the Qi of deficiency and failure of the Five Zang organs manifesting in the pulse, not the disease pulses of the Five Zang organs themselves.
Xuan Yong (referring to a pulse characteristic, metaphorically describing a pulse that is large at the root/proximal end). Gao Shishi says: "Yong" is written as "Yong" (swollen). It describes a swollen appearance, floating upward with a large proximal end. Jian An comments: Various annotations are unsatisfactory. Probably "Yong" is interchangeable with "Weng" (urn). Shan Hai Jing states: Mount Xuan Weng, from which the Jin River flows. Guo Pu's annotation says: There is a huge rock in the mountain belly, shaped like a weng (urn). Hence the name. "Weng" is also written as "Ying". Shuo Wen Jie Zi says: It is a ying (jar). Guang Ya says: It is a bottle. It likely takes its shape of a large belly and small mouth to describe the image of the pulse becoming larger upon superficial and deep palpation. In Jia Yi Jing, "Yong" is written as "Yong" (carbuncle), which is incorrect.
Fu Chuai Qie Zhi Yi Da (the pulse becomes even larger upon light and heavy palpation). Ma Shi says: The Xuan Yong pulse is originally floating. During the Chuai (palpating/measuring) phase, the pulse becomes even larger, completely lacking any sinking quality. Zhang Jingyue says: The pulse is floating, short, and isolated, existing only above without below. Su Wen Ji Zhu notes: Chuai means to measure. First, measure it lightly and superficially; then press heavily to feel it. The proximal part becomes even larger. Jian An comments: The annotation in Su Wen Ji Zhu contradicts the intent of the classic and cannot be accepted. Wu Kun added the words "wu li" (powerless) after "Chuai", which is superfluous.
Insufficiency of Qi in the Twelve Shu Points. Jia Yi Jing adds the character "Qi" before "Yu". Zhang Jingyue says: The Shu points are all located on the back and are connected to the Qi of the twelve meridians and zang organs. Death from "Water Congealing" occurs because Yin Qi is excessive and solitary Yang is cut off.
Water Congealing Leads to Death. In Jia Yi Jing, "Ning" (congeal) is written as "Dong" (freeze).
Pulse Resembles an Inverted Knife (Yan Dao). Zhang Jingyue says: It is like a lying knife. Light palpation reveals a small and rapid pulse, like the edge of a knife; heavy palpation reveals a firm, large, and rapid pulse, like the back of a knife. Gao Shishi says: Yan means to lie down or rest. Dao is a metal instrument. Jian An comments: Gao Shishi's explanation is obscure and its meaning is unknown.
Wen Re (Stagnant Heat/Deep Heat). Jia Yi Jing writes it as "Han Re" (cold and heat). In various editions, "Shu" (cooked/mature) is written as "Re" (heat). Zhang Jingyue says: This refers to stagnant heat in the five zang organs manifesting as alternating cold and heat. When Yang Qi is dominant, Yin Qi declines, so the pathogen concentrates solely in the Kidney. The waist is the mansion of the Kidney. Since Kidney Yin is deficient, the patient cannot rise or sit. After Lichun (Start of Spring), Yang Qi is strong and Yin Qi declines daily; thus, death occurs at this time. "Wen" is synonymous with "Yu" (stagnation/depression). Jian An comments: Wu Kun's claim that "Shu" implies the depth of heat is highly erroneous.
Pulse Resembles a Smooth Pill Not Straight to the Hand (round, slippery, short, and unable to withstand pressure). Zhang Jingyue says: Like a pill, it is short and small. "Zhi" means "zhi" (to match/value). It means the pulse is slippery and small without a root, and cannot bear pressure. Ma Shi and Wu Kun both say: "Zhi" is interchangeable with "Zhi" (value). Jia Yi Jing writes it as "Zhuo" (touch/contact).
Death When Jujube Leaves Emerge. Zhang Jingyue says: The Large Intestine corresponds to Geng Metal. Jujube leaves emerge in early summer; when Fire Qi is dominant, Metal Qi declines, leading to death. Ma Shi says: The time when jujube leaves emerge is the period following the blooming of jujube flowers.
Pulse Resembles Flowers (floating and rootless). Jia Yi Jing writes it as "Ru Chun" (like spring). Ma Shi says: This resembles the flowers of grass and trees; it is weak and has no root upon palpation.
Prone to Fear, Unwilling to Sit or Lie Down. Ma Shi says: Being prone to fear is due to insufficiency of Heart Qi. Unwillingness to sit or lie down is due to unsettled Heart Qi. Zhang Jingyue says: Insufficiency of the Small Intestine allows Qi to connect to the Heart. Prone to fear and unwillingness to sit or lie down indicate timid and unsettled Heart Qi.
Hearing Sounds While Walking and Standing. Su Wen Ji Zhu notes: Such as cicada-like buzzing in the ears, or bell/chime sounds, all are manifestations of deficiency syndromes.
Death in Late Autumn. Ma Shi says: The Small Intestine belongs to Fire. When Fire Qi is dominant, survival is possible. By Late Autumn, Fire Qi reaches extreme decline, leading to death. Su Wen Ji Zhu notes: Death occurs when encountering the times when Metal and Water Qi are prosperous.