吴云。平人。气血平调之人。气。脉气。象。脉形也。
平人 调经论云。阴阳匀平。以充其形。九候若一。命曰平人。终始篇云。形肉血气。必相称也。
是谓平人。
一吸脉亦再动 高本删亦字。医统同。简按灵动输篇。一呼脉再动。一吸脉亦再动。甲乙引。作一
呼脉亦再动。一吸脉亦再动。
闰以大息 张云。常人之脉。一呼两至。一吸亦两至。呼吸定息。谓一息既尽。而换息未起之际也。
脉又一至。故曰五动。闰。余也。犹闰月之谓。言平人常息之外。间有一息甚长者。是为闰以太息。而又不止
五至也。简按张注详备。与难经符。但难经以一呼再动。一吸再动。呼吸之间又一动。为定息五动。张则以一
息四动。两息之间又一动。为五动。此为少异焉。李云。一息四至。呼吸定息脉五动者。当其闰以大息之时也。
马及志高并同。此说不可从。果如其言。则宜云闰以大息。呼吸脉五动。噫。何倒置经文。而释之也。
常以不病 甲乙。病下。有之人二字。
以调之为法 甲乙。无为法二字。
曰少气 马云。难经以为离经脉。由正气衰少。故脉如是也。吴云。是为虚寒。
三动而躁 马云。难经亦以为离经脉。是六至而躁。躁者。动之甚也。王注以躁为烦躁。灵枢终始
禁服等篇。有一倍而躁。二倍而躁等语。则躁本言脉。不言病也。张云。躁者。急疾之谓。
尺热曰病温 张云。言尺中近臂之处有热者。必其通身皆热也。脉数躁而身有热。故知为病温。高云。
脉躁疾而尺肤热。则曰病温。简按王注。以尺为寸关尺之尺。马亦从之。非。
脉滑曰病风 张云。数滑而尺不热者。阳邪盛也。故当病风。然风之伤人。其变不一。不独在于肌表。
故尺不热者。脉法曰。滑。不涩也。往来流利。为血实气壅。简按寿夭刚柔篇云。病在阳者。命曰风。病在阴
者。命曰痹。此章与痹对言。亦谓偏风之属。
脉四动以上曰死 张云。一呼四动。则一息八至矣。况以上乎。难经谓之夺精。四至曰脱精。五至曰
死。六至曰命尽。是皆一呼四至以上也。故死。
乍疏乍数 高云。一呼脉四动以上。则大过之极。脉绝不至则不及之极。乍疏乍数。则错乱之极。
故皆曰死。
人无胃气曰逆 张云。如玉机真脏论曰。脉弱以滑。是有胃气。终始篇曰。邪气来也。紧而疾。谷气
来也。徐而和。是皆胃气之谓。大都脉代时宜。无太过无不及。自有一种雍容和缓之状者。便是胃气之脉。
胃而有毛 脉经。作有胃而毛。下并同。张云。是为贼邪。以胃气尚存。故至秋而后病。后皆仿此。
脏真散于肝 吴云。肝气喜散。春时肝木用事。故五脏天真之气。皆散于肝。
但代无胃曰死 张云。长夏属土。虽主建未之六月。然实兼辰戌丑未四季之月为言也。代。更代也。
脾主四季。脉当随时而更。然必欲皆兼和软。方得脾脉之平。若四季相代。而但弦但钩。但毛但石。是但代无
胃。见真脏也。故曰死。简按吴马并仍王注。以代为止。恐与经旨左矣。
软弱有石曰冬病 张云。石为冬脉。属水。长夏阳气正盛。而见沉石之脉。以火土气衰。而水反乘也。
故至冬而病。简按推前文例。石当是弦。冬病当是春病。
弱甚曰今病 马云。弱。当作石。张同。云。长夏石甚者。火土大衰。故不必至冬。今即病矣。新校
正云。按甲乙经。弱。作石。简按今甲乙。弱。作软。脉经。作石。推前文例。弱当是弦。志高从王义。
脏真濡于脾 吴云。濡。泽也。脾气喜濡泽。长夏之时。脾土用事。故五脏真气。皆濡泽于脾。
毛而有弦曰春病 吴本。毛。作胃。张云。弦为春脉。属木。秋时得之。以金气衰。而木反乘也。故
至春木王时而病。简按推前文例。当是胃而有钩。曰夏病。
弦甚曰今病 张云。秋脉弦甚。是金气大衰。而木寡于畏。故不必至夏。今即病矣。简按推前文例。
当是钩甚。
以行营卫 甲乙。以。作肺。
石而有钩曰夏病 张云。钩为夏脉。属火。冬时得之。以水气衰。而火反侮也。故至夏火王时而病。
汪昂云。钩。当作软弱。简按推上文例。当是胃而有弱。曰长夏病。
钩甚曰今病 张云。冬脉钩甚。是水气大衰。而火寡于畏。故不必至夏。今即病矣。简按推上文例。
当是弱甚曰今病。而软弱有石曰冬病以下。与春夏其例不同。盖错综其意。欲人彼此互推。知其由也。必不文
字讹误焉。
其动应衣脉宗气也 甲乙。衣。作手。脉下。有之字。沈氏经络全书曰。虚里。乳根穴分也。俗谓
之气眼。顾英白曰。乳根二穴。左右皆有动气。经何独言左乳下。盖举其动之甚者耳。非左动而右不动也。其
动应手。脉宗气也。素问本无二义。马玄台因坊刻之误。而谓应衣者。言病患肌肉瘦
弱。其脉动甚而应衣也。亦通。始读素问。则心窃疑之。至读甲乙经。而疑遂释然。简按五味篇曰。大气积于
胸中。命曰气海。邪客篇曰。宗气积于胸中。皆此义也。通雅云。宗尊一字。孝经。宗祀。注。尊祀。王云。
宗。尊也。此乃古训。应衣。当从甲乙。而作应手。若应衣则与下文何别。张云。前言应衣者。言其微动似乎
应衣。可验虚里之胃气。此言应衣者。言其大动。真有若与衣俱振者。此臆度之见。不考甲乙之失耳。
盛喘数绝 张云。若虚里动甚而如喘。或数急而兼断绝者。由中气不守而然。故曰病在中。简按马
吴志。以喘为病证。非。
结而横有积矣 张云。胃气之出。必由左乳之下。若有停阻。则结横为积。故凡患 者。多在左肋
之下。因胃气积滞而然。如五十六难。曰肝之积名曰肥气。在左胁下者。盖以左右上下。分发五行而言耳。而
此实胃气所主也。吴云。脉来迟。时一止。曰结。横。横格于指下也。言虚里之脉结而横。是胃中有积。简按
横。盖谓其动横及于右边。张注以结横不为脉象。恐非。
绝不至曰死 志云。胃腑之生气绝于内也。
宗气泄也 吴云。宗气宜藏不宜泄。乳下虚里之脉。其动应衣。是宗气失藏。而外泄也。马云。乳
下之动应衣者。予曾见其人病终不治。张云。虚里跳动。最为虚损病本。故凡患阴虚劳怯。则心下多有跳动。
及为惊悸慌张者。是即此证。人止知其心跳。而不知为虚里之动也。但动之微者。病尚微。动之甚者。病则甚。
亦可因此以察病之轻重。凡患此者。当以纯甘壮水之剂。填补真阴。夫谷入于胃。以传于肺。五脏六腑。皆以
受气。是由胃气。而上为宗气也。气为水母。
气聚则水生。是由肺气而下生肾水也。今胃气传之肺。而肾虚不能纳。故宗气泄于上。则肾水竭于下。肾愈虚。
则气愈无所归。气不归则阴愈虚矣。气水同类。当求相济。故凡欲纳气归原者。惟有补阴以配阳一法。简按许
氏本事方云。王思和曰。今心怯非心松也。胃之大络。名曰虚里。络胸膈及两乳间。虚而有痰则动。此张注所
未论及。故表而出之。
中手促上击者 马云。寸口之脉。中医人之指。而促上来击者。是肩背在上。故其脉促上也。名曰
肩背痛。简按据马注。促上。谓促于鱼上而搏击。吴以为结促之促。志以为浮而搏击。并乖经旨。
寒热及疝瘕少腹痛 马云。下文脉急者。曰疝瘕少腹痛。据理此处及疝瘕少腹痛六字为衍。简按当
从新校正。
沉而横曰胁下有积 甲乙。横下。有坚字。无有积二字。张云。横。急数也。志云。横。横逆。言
脉之形象。非谓病也。简按横。谓寸口脉位。横斜于筋骨间。张志恐非。
沉而喘 甲乙。沉。作浮。
脉滑浮而疾者 甲乙。作脉浮滑实大。
脉急者 吴云。急。弦急也。是为厥阴病脉。张云。弦急者。阴邪盛。故为疝瘕少腹痛。
疝瘕 甲乙。作疝 。
曰病无他 张云。虽曰有病。无他虞也。高云。无他变也。
不间脏 张云。五十三难曰。七传者死。间脏者生。七传者。传其所胜也。间脏者。传其所生也。
皆此之谓。考之吕氏注。曰。间脏者。间其所胜之脏。而相传也。心胜肺。脾间之。脾胜肾。肺间之。肺胜肝。
肾间之。肾胜心。肝间之。肝胜脾。心间之。此谓传其所生也。今不间脏。而传其
所克。故曰死。间。去声。
臂多青脉 张云。血脱则气去。气去则寒凝。凝泣则青黑。故臂见青色。言臂则他可知矣。即诊尺
之义。志云。诊。视也。论诊尺必先视臂之脉色。
解 释音。 。音亦。熊同。高云。解。懈同。 。音亦。余篇解 同。犹懈怠。志云。懈惰也。
杭世骏道古堂集云。解 二字。不见他书。解。即懈。 。音亦。倦而支节不能振耸。惫而精气不能检摄。筋
不束骨。脉不从理。解解 。不可指名。非百病中有此一症也。内经言此者凡五。平人气象论云。尺脉缓涩。
谓之解 。王氏注。伫不可名。伫。困弱也。（按宋书明恭王皇后传。后在家。为伫弱妇人。）玉机真脏论云。
冬脉太过。则令人解 。此从脉起见也。刺疟论云。足少阳之疟。令人身体解 。寒不甚。热不甚。恶见人。
见人心惕惕然。热多汗出甚。此从疟起见也。刺要论云。刺骨无伤髓。髓伤则销铄 酸。体解 然不去矣。四
时刺逆从论云。夏刺经脉。血气乃竭。令人解 。此从刺而究其极也。要皆从四末以起见。如经所言堕怠。小
变其辞。而意较微眇尔。宋景濂送葛医师序。不得其解。篁南江氏。辑名医类案。引叶氏录验方。以为俗名发
痧之证。别列一门。武断极矣。余尝见有此病。发必神思躁扰。少腹痛。灵素未尝言及。与解 之义。毫不干
涉。殆大缪矣。简按王注据刺疟论解之。然此少阳疟之状。而非解 之义。马吴张并仍王注。皆不可从。但志
高及杭氏之说为稳贴。解 字。亦见论疾诊尺篇。云。尺肉弱者。解 也。盖解 。即懈惰懈倦之谓。四时刺
逆从论解 。诊要经终论作解惰。刺疟论解 。巢源作解倦。此可以证也。 。即亦字从人者。与易通。王注
气厥论云。食亦者。谓食入移易而过。不生肌肤。亦。易也。甲乙引气厥论。
作食 。骨空论。易髓无孔。王注云。易。亦也。此可以证 亦同。而与易通也。而易。谓变易其平常。神农
本草蜣螂条。狂易。（证类。音羊。误。汉书外戚传云。素有狂易病。师古注。狂易者。狂而变易常性也。）
阴阳别论。偏枯痿易。王注。易。谓变易常用。而痿弱无力也。大奇论。跛易偏枯。王注。血气变易。为偏枯
也。知是解易即解惰。变易平常之义矣。滑云。一说作解极。谓懈倦之极也。未知何据。虞氏正传云。解者。
肌肉解散。 者。筋不束。俗呼为砂病。内经名解 。实非真砂病也。此说亦太误。
安卧脉盛曰脱血 马云。安卧者。不能起也。脉盛者。火愈炽也。火热则血妄行。故谓之脱血。高
云。安卧。犹嗜卧。
尺涩脉滑谓之多汗 吴云。尺部肌肤涩。是皮毛失其津液也。脉来滑。阴火盛也。阳盛阴虚。故为
多汗。阴阳别论曰。阳加于阴。谓之汗。简按王以脉为尺脉。张同。并误。
脉尺粗 熊本。无脉字。吴同。当删。
谓之热中 简按王注。谓下焦中也。非。马云。热气在腹。谓之热中也。
目裹微肿 宋本。裹。作里。吴同。志高作内。并非。
胃疸 简按疸。瘅同。即前篇所谓消中。后世所称中消渴也。马云。谷疸。志云。黄胆。并非。
面肿曰风 马云。水证有兼风者。其面发肿。盖面为诸阳之会。风属阳。上先受之。故感于风者。
面必先肿。不可误以为止于水也。评热论。水热穴论。论疾诊尺篇。皆名曰风水。王注以为胃风者非。及考风
论。胃风之状。并无面肿之说。简按金匮要略云。面目肿大有热。名曰风水。又云。腰以上肿。当发汗。
足胫肿曰水 吴云。脾胃主湿。肾与膀胱主水。其脉皆行于足胫。故足胫肿者为水。简按金匮要略云。
腰以下肿。当利小便。
妇人手少阴脉动甚者妊子也 赵府本。妊。作任。熊吴张并同。张云。心脉动甚者。血王而然。王
启玄云云。盖指心经之脉。即神门穴也。其说甚善。任。妊同。孕也。简按论疾诊尺亦曰。女子手少阴脉动甚
者妊子。知是全本作足少阴者。未为得。王以动为厥厥动摇之动脉。马以妊子为男子。皆误。
未有脏形 马云。未有正脏之脉相形。而他脏之脉反见。春夏脉宜浮大。今反沉细而瘦。秋冬脉宜
沉细。今反浮大而肥。此即所谓逆四时也。玉机真脏论云。未有脏形于春夏。而脉沉涩。秋冬脉浮大。名曰逆
四时。与此义同。志云。未有春弦夏钩秋毛冬石之脏形。简按吴张为真脏之脉形。非。
命曰反四时也 吴删四时二字。马云。是皆难治之证。犹脉之反四时也。王注为衍文。殊不知古人
以彼形此。则未必非取譬之意。（王注。当是新校正。）简按马注似傅会。
肝不弦肾不石也 张云。人生所赖者水谷。故胃气以水谷为本。而五脏又以胃气为本。若脉无胃气。
Wu Yun: The term "Ping Ren" (Normal Person) refers to an individual whose Qi and Blood are balanced and harmonious. "Qi" denotes the Qi of the pulse, and "Xiang" (Image/Symbol) refers to the form or shape of the pulse.
The *Tiao Jing Lun* (Treatise on Regulating the Channels) states: "When Yin and Yang are evenly balanced, filling the body, and the nine palpations are uniform, it is called a Normal Person." The *Zhong Shi Pian* (Chapter on Beginning and End) states: "Form, flesh, blood, and Qi must be proportionate; this is called a Normal Person."
During one respiration cycle (one inhalation and one exhalation), the pulse beats four times (twice during exhalation and twice during inhalation). Gao Shixi deleted the character "Yi" (also/even). The *Yi Tong Zheng Mai* edition agrees with this deletion. Danbo Jian'an notes: The *Ling Shu: Ling Dong Shu Pian* records: "With one exhalation, the pulse moves twice; with one inhalation, the pulse also moves twice." The *Jia Yi Jing* cites it as: "With one exhalation, the pulse also moves twice; with one inhalation, the pulse also moves twice."
Occasionally, due to a deep sigh (Run Yi Da Xi - intercalated by a great breath), there is an extra beat. Zhang Jingyue's commentary explains: "In normal people, the pulse beats twice per exhalation and twice per inhalation. 'Respiration fixed rest' (Hu Xi Ding Xi) refers to the interval after one respiration cycle ends and before the next begins. During this interval, the pulse beats once more, hence the total of five beats. 'Run' means surplus, similar to an intercalary month in the calendar. It implies that outside the normal breathing count, there is occasionally a very long breath (Da Xi), causing an extra pulse beat. This is called 'Run Yi Da Xi,' and it may exceed five beats. Danbo Jian'an notes: Zhang's commentary is detailed and consistent with the *Nan Jing*. However, the *Nan Jing* considers two beats per exhalation, two per inhalation, and one during the rest interval as the standard five beats. Zhang considers four beats per respiration cycle plus one extra beat between cycles as five beats. This is a minor difference. Li Zhongzi states: Four beats per respiration cycle, with five beats at the fixed rest interval, occurs during the 'Run Yi Da Xi.' Ma Shi and Gao Shixi agree with this view. This interpretation should not be followed. If true, it should be stated as 'during Run Yi Da Xi, the pulse beats five times within respiration.' Alas, why invert the classic text to explain it?
Normally without disease (Chang Yi Bu Bing). The *Jia Yi Jing* adds the characters "Zhi Ren" (of person) after "Bing".
To regulate as the method (Yi Tiao Zhi Wei Fa). The *Jia Yi Jing* lacks the characters "Wu Wei", reading instead "Yi Tiao Zhi Wei Fa".
Called Shao Qi (Deficient Qi). Ma Yin states: "The *Nan Jing* regards this as a Li Jing Mai (Departing Pulse), caused by the deficiency of righteous Qi, thus the pulse appears so." Wu Kun states: "This indicates Deficiency-Cold."
Three beats and rapid/restless (San Dong Er Zao). Ma Yin states: "The *Nan Jing* also regards this as a Li Jing Mai, six beats and restless. 'Zao' means extremely vigorous movement. Wang Bing注释 interprets 'Zao' as irritability. Chapters like *Ling Shu: Zhong Shi* and *Jin Fu* mention phrases like 'one fold restless' and 'two folds restless,' indicating that 'Zao' originally referred to the pulse, not the disease." Zhang Jingyue states: "'Zao' means hurried and rapid."
Heat in the Chi position indicates Warm Disease (Chi Re Yue Bing Wen). Zhang Jingyue states: "This means if the Chi area near the arm is hot, the whole body must be hot. With a rapid, restless pulse and body heat, we know it is a Warm Disease." Gao Shixi states: "If the pulse is rapid/restless and the Chi skin is hot, it is called Warm Disease." Danbo Jian'an notes: Wang Bing注释 interpreted 'Chi' as the Chi position in Cun-Guan-Chi, and Ma Shi followed this, which is incorrect.
Slippery pulse indicates Wind Disease (Mai Hua Yue Bing Feng). Zhang Jingyue states: "A rapid, slippery pulse without heat in the Chi position indicates excess Yang pathogen, thus one should suffer from Wind Disease. However, wind pathogens cause varied changes, not just in the muscle surface. Therefore, the Chi is not hot. Pulse theory states: 'Hua (Slippery) means not Se (Choppy).' It flows smoothly, indicating excess Blood and congested Qi." Danbo Jian'an notes: The *Su Wen: Shou Yao Gang Rou Pian* states: "Disease in Yang is called Feng; disease in Yin is called Bi." This chapter contrasts with Bi, referring also to types of partial Wind.
Four beats or more per respiration indicate Death (Mai Si Dong Yi Shang Yue Si). Zhang Jingyue states: "Four beats per exhalation means eight beats per respiration cycle. How much more if above this? The *Nan Jing* calls this Duo Jing (Depletion of Essence). Four beats is Tuo Jing, five beats is Si (Death), six beats is Ming Jin (End of Life). All refer to four beats or more per exhalation. Hence, death."
Intermittently slow and rapid (Zha Shu Zha Shu). Gao Shixi states: "Four beats or more per exhalation is the extreme of excess. Absence of pulse is the extreme of deficiency. Intermittently slow and rapid is the extreme of chaos. Thus, all are called death."
Absence of Stomach Qi is called Ni (Rebellious/Adverse) (Ren Wu Wei Qi Yue Ni). Zhang Jingyue states: "As the *Yu Ji Zhen Zang Lun* says: 'Weak and slippery pulse indicates presence of Stomach Qi.' The *Zhong Shi Pian* says: 'When Evil Qi comes, it is tight and rapid; when Grain Qi comes, it is slow and harmonious.' These all refer to Stomach Qi. Generally, pulses change with seasons, neither excessive nor deficient, possessing a natural leisurely and harmonious quality; this is the pulse of Stomach Qi."
Stomach Qi present but with Mao (Metal/Lung) pulse characteristics (Wei Er You Mao). The *Mai Jing* reads "You Wei Er Mao", same for subsequent instances. Zhang Jingyue states: "This is Zei Xie (Robber Pathogen). Because Stomach Qi still exists, illness manifests only in Autumn. Subsequent texts follow this logic."
Zhen Zhen (True Visceral Qi) scatters to the Liver (Zang Zhen San Yu Gan). Wu Kun states: "Liver Qi likes to scatter. In Spring, Liver Wood dominates, so the True Qi of the Five Zang organs scatters to the Liver."
Only Dai (Intermittent) pulse without Stomach Qi indicates Death (Dan Dai Wu Wei Yue Si). Zhang Jingyue states: "Late Summer belongs to Earth. Although it governs the sixth month (Jian Wei), it actually encompasses the months of Chen, Xu, Chou, and Wei (the four seasons). 'Dai' means alternating. Spleen governs the four seasons, so the pulse should alternate with time. However, it must always include softness and harmony to be considered a balanced Spleen pulse. If during seasonal alternation, one sees only Xian (String-like), Gou (Hook), Mao (Feather), or Shi (Stone) pulses without the soft Stomach Qi, this is 'Dan Dai Wu Wei' (Only Alternating without Stomach Qi), revealing the True Zang pulse. Hence, death." Danbo Jian'an notes: Wu Kun and Ma Shi followed Wang Bing注释, interpreting 'Dai' as stopping, which likely contradicts the original intent.
Soft and weak with Shi (Stone/Kidney) pulse indicates Winter illness (Ruan Ruo You Shi Yue Dong Bing). Zhang Jingyue states: "Shi pulse is the Winter pulse, belonging to Water. Late Summer has abundant Yang Qi, yet a sinking Shi pulse appears because Fire and Earth Qi are weak, allowing Water to overact. Thus, illness occurs in Winter." Danbo Jian'an notes: Following previous patterns, 'Shi' should be 'Xian', and 'Dong Bing' should be 'Chun Bing' (Spring illness).
Extremely weak pulse indicates current illness (Ruo Shen Yue Jin Bing). Ma Yin states: "'Ruo' should be 'Shi'. Zhang Jingyue agrees. He says: "Extreme Shi pulse in Late Summer indicates severe decline of Fire and Earth, so illness occurs immediately, not waiting for Winter." New Correction states: "According to *Jia Yi Jing*, 'Ruo' is written as 'Shi'." Danbo Jian'an notes: Current *Jia Yi Jing* writes 'Ruo' as 'Ruan'. *Mai Jing* writes 'Shi'. Following previous patterns, 'Ruo' should be 'Xian'. Gao Shixi follows Wang Bing注释.
Zhen Zhen moistens the Spleen (Zang Zhen Ru Yu Pi). Wu Kun states: "'Ru' means moistening. Spleen Qi likes moisture. In Late Summer, Spleen Earth dominates, so the True Qi of the Five Zang organs moistens the Spleen."
Mao (Metal/Lung) pulse with Xian (Wood/Liver) characteristics indicates Spring illness (Mao Er You Xian Yue Chun Bing). Wu Ben edition writes 'Mao' as 'Wei'. Zhang Jingyue states: "Xian pulse is the Spring pulse, belonging to Wood. Obtaining this in Autumn indicates Metal Qi is weak and Wood Qi overacts. Thus, illness occurs when Wood dominates in Spring." Danbo Jian'an notes: Following previous patterns, it should be "Wei Er You Gou, Yue Xia Bing" (Stomach Qi with Hook characteristics indicates Summer illness).
Extreme Xian pulse indicates current illness (Xian Shen Yue Jin Bing). Zhang Jingyue states: "Extreme Xian pulse in Autumn indicates severe decline of Metal Qi and lack of restraint on Wood. Thus, illness occurs immediately, not waiting for Summer." Danbo Jian'an notes: Following previous patterns, it should be "Gou Shen" (Extreme Hook).
Thereby circulating Ying and Wei (Yi Xing Ying Wei). The *Jia Yi Jing* writes 'Yi' as 'Fei' (Lung).
Shi (Stone/Kidney) pulse with Gou (Fire/Heart) characteristics indicates Summer illness (Shi Er You Gou Yue Xia Bing). Zhang Jingyue states: "Gou pulse is the Summer pulse, belonging to Fire. Obtaining this in Winter indicates Water Qi is weak and Fire Qi counter-rebels. Thus, illness occurs when Fire dominates in Summer." Wang Ang states: "'Gou' should be 'Ruan Ruo' (Soft and Weak)." Danbo Jian'an notes: Following previous patterns, it should be "Wei Er You Ruo, Yue Chang Xia Bing" (Stomach Qi with Soft characteristics indicates Late Summer illness).
Extreme Gou pulse indicates current illness (Gou Shen Yue Jin Bing). Zhang Jingyue states: "Extreme Gou pulse in Winter indicates severe decline of Water Qi and lack of restraint on Fire. Thus, illness occurs immediately, not waiting for Summer." Danbo Jian'an notes: Following previous patterns, it should be "Ruo Shen Yue Jin Bing". The section below "Ruan Ruo You Shi Yue Dong Bing" differs from the Spring/Summer patterns, likely intertwining meanings for mutual deduction, rather than textual errors.
Movement affecting clothes indicates Zong Qi (Ancestral Qi) (Qi Dong Ying Yi Mai Zong Qi Ye). The *Jia Yi Jing* writes 'Yi' (Clothes) as 'Shou' (Hand), and adds 'Zhi' after 'Mai'. Shen Shi's *Jing Luo Quan Shu* states: "Xu Li point is at Ru Gen. Commonly called Qi Yan." Gu Yingbai states: "Both left and right Ru Gen points have movement; why does the classic mention only left lower chest? It highlights the most prominent side, not that left moves while right does not. Movement responding to hand indicates Zong Qi. *Su Wen* has no dual meaning here. Ma Shi, due to printing errors, thought 'Ying Yi' meant patients with emaciated muscles having strong pulse movements affecting clothes. This is also plausible. I doubted this initially until reading *Jia Yi Jing*, resolving my doubts." Danbo Jian'an notes: *Wu Wei Pian* states: "Great Qi accumulates in the chest, named Qi Hai." *Xie Ke Pian* states: "Zong Qi accumulates in the chest." Both mean this. *Tong Ya* states: 'Zong' means 'Zun' (Venerable). *Xiao Jing* commentary: 'Zong Si' means 'Zun Si'. Wang Bing states: "'Zong' means 'Zun'. This is ancient teaching. 'Ying Yi' should be 'Ying Shou' (Responding to Hand) per *Jia Yi Jing*. If 'Ying Yi', what distinguishes it from the following text? Zhang Jingyue states: "Previous 'Ying Yi' refers to slight movement seeming to affect clothes, verifying Xu Li Stomach Qi. This 'Ying Yi' refers to strong movement truly vibrating clothes. This is speculation, failing to check *Jia Yi Jing* errors."
Pulse rapid, panting, and frequently interrupted (Sheng Chuan Shu Jue). Zhang Jingyue states: "If Xu Li movement is severe like panting, or rapid and interrupted, it is due to Middle Qi failing to hold. Hence, disease in the Middle." Danbo Jian'an notes: Ma, Wu, and Gao interpret 'Chuan' as a symptom, which is incorrect.
Knotted and transverse pulse indicates accumulation (Jie Er Heng You Ji Yi). Zhang Jingyue states: "Stomach Qi exits from below the left breast. If blocked, it knots and spreads transversely, forming accumulation. Thus, accumulation diseases often occur below the left ribs, due to Stomach Qi stagnation. As *Nan Jing 56* states: 'Liver accumulation named Fei Qi, located under left rib.' This divides Five Elements spatially, but is actually governed by Stomach Qi." Wu Kun states: "Slow pulse with occasional stop is 'Jie' (Knotted). 'Heng' is transverse resistance under fingers. Knotted and transverse Xu Li pulse indicates Stomach accumulation." Danbo Jian'an notes: 'Heng' likely means movement spreading to the right. Zhang's view that 'Jie Heng' is not a pulse image is likely incorrect.
Absence of pulse indicates death (Jue Bu Zhi Yue Si). Gao Shixi states: "Life-generating Qi of the Stomach organ is cut off internally."
Zong Qi leaks (Zong Qi Xie Ye). Wu Kun states: "Zong Qi should be stored, not leaked. Strong movement at Xu Li below the breast indicates Zong Qi loss and external leakage." Ma Yin states: "I have seen people with strong movement below the breast who ultimately died untreatable." Zhang Jingyue states: "Xu Li movement is the root of severe deficiency diseases. Patients with Yin deficiency and consumption often have heart area movement and palpitations. People know it as heartbeat but not Xu Li movement. Slight movement means mild disease; severe movement means severe disease. One can judge severity by this. Treatment requires pure sweet and water-nourishing agents to fill True Yin. Grain enters Stomach, transmits to Lung, nourishing all Zang-Fu. This becomes Zong Qi ascending from Stomach Qi. Qi is mother of Water; Qi gathering generates Water. This is Kidney Water generated descending from Lung Qi. Now Stomach Qi transmits to Lung, but Kidney deficiency fails to grasp Qi. Thus Zong Qi leaks upward, Kidney Water exhausts downward. More Kidney deficiency leads to Qi having no return. Qi not returning makes Yin more deficient. Qi and Water are similar; seek mutual assistance. To gather Qi to origin, only tonifying Yin to match Yang works." Danbo Jian'an notes: Xu Shimwei's *Ben Shi Fang* quotes Wang Sihe: "Current heart timidity is not heart looseness. Great collateral of Stomach is named Xu Li, connecting chest/diaphragm and breasts. Deficiency with phlegm causes movement. Zhang missed this."
Pulse feels rapid, striking upwards (Zhong Shou Cu Shang Ji Zhe). Ma Yin states: "Cunkou pulse, feeling rapid and striking up with fingers, indicates shoulder/back pain above. Named Shoulder Back Pain." Danbo Jian'an notes: Per Ma, 'Cu Shang' means rapid striking at the fish margin. Wu interprets 'Cu' as knotted-rapid; Gao as floating-striking. Both miss the original intent.
Chills, fever, hernia, mass, and lower abdominal pain (Han Re Ji Shan Jia Shao Fu Tong). Ma Yin states: "Later text says: 'Rapid pulse indicates hernia, mass, lower abdominal pain.' Logically, these six characters here are superfluous." Danbo Jian'an notes: Should follow New Correction.
Sinking and transverse pulse indicates hypochondriac accumulation (Chen Er Heng Yue Xie Xia You Ji). *Jia Yi Jing* adds 'Jian' (Hard) after 'Heng', removes 'You Ji'. Zhang Jingyue states: "'Heng' means rapid and frequent." Gao Shixi states: "'Heng' means transverse rebellion, describing pulse image, not disease." Danbo Jian'an notes: 'Heng' refers to Cunkou pulse position slanting between sinews and bone. Zhang Zhicong's view is likely incorrect.
Sinking and panting (Chen Er Chuan). *Jia Yi Jing* writes 'Chen' as 'Fu' (Floating).
Slippery, floating, and rapid pulse (Mai Hua Fu Er Ji Zhe). *Jia Yi Jing* reads "Mai Fu Hua Shi Da".
Rapid pulse (Mai Ji Zhe). Wu Kun states: "'Ji' is String-Rapid. This is Jue Yin disease pulse." Zhang Jingyue states: "String-Rapid indicates excess Yin pathogen, thus hernia, mass, lower abdominal pain."
Hernia and Mass (Shan Jia). *Jia Yi Jing* writes "Shan Yuan".
Indicates no other worry (Yue Bing Wu Ta). Zhang Jingyue states: "Though diseased, no other concern." Gao Shixi states: "No other transformation."
Not passing through intervening Zang (Bu Jian Zang). Zhang Jingyue states: "*Nan Jing 53* says: 'Seven transmissions die; intervening Zang lives.' Seven transmission passes to what it conquers; intervening Zang passes to what it generates. This applies. Lu Guang's commentary: 'Intervening Zang passes to what it conquers via intervening Zang.' Heart conquers Lung, Spleen intervenes; Spleen conquers Kidney, Lung intervenes; Lung conquers Liver, Kidney intervenes; Kidney conquers Heart, Liver intervenes; Liver conquers Spleen, Heart intervenes. This is passing to what it generates. Now, not intervening, but passing to what it conquers, hence death. 'Jian' is read as departing tone."
Many blue veins on arms (Bi Duo Qing Mai). Zhang Jingyue states: "Blood depletion leads to Qi departure; Qi departure leads to cold coagulation; coagulation turns blue-black. Arms show blue color. Arm implies others. This is diagnosing Chi skin." Gao Shixi states: "Diagnose means observe. Discussing Chi diagnosis requires observing arm vein color first."
Xie Jie (Exhaustion/Lethargy). Xie sounds like Xie (Slack). Jie sounds like Yi. Xiong Tongli agrees. Gao Shixi states: "Xie is same as Xie (Slack). Jie sounds like Yi. Other chapters use 'Xie Jie'. Like slackness." Gao Shixi states: "Sluggishness." Hang Shijun's *Dao Gu Tang Ji* states: "'Xie Jie' appears nowhere else. 'Xie' is 'Xie'. 'Jie' sounds like Yi. Weary with limbs unable to lift, exhausted with essence unable to control, sinews not binding bones, pulses not following logic. 'Xie Xie Jie Jie' cannot be named specifically. Not one of hundred diseases. *Nei Jing* mentions this five times: *Ping Ren Qi Xiang Lun*: 'Chi pulse slow and choppy, called Xie Jie.' Wang Bing注释: 'Cannot name. Zhu, weakness.' (*Song Shu*: Empress was Zhu Ruo woman). *Yu Ji Zhen Zang Lun*: 'Winter pulse excessive, causes Xie Jie.' From pulse. *Ci Mie Lun*: "Shaoyang Malaria causes body Xie Jie. Mild chills/fever, aversion to people, fearful heart, heavy sweating." From malaria. *Ci Yao Lun*: "Needle bone without injuring marrow. Marrow injury causes melting acid, body Xie Jie remains." From needling extremity. *Si Shi Ci Ni Cong Lun*: "Summer needle meridians, blood/qi exhaust, causes Xie Jie." From needling extreme. All start from four extremities, like 'Duo Dai' in classics, slightly varied wording, subtle meaning. Song Lian failed to understand. Huang Nan Jiang's *Ming Yi Lei An* cited Ye's *Lu Yan Fang* as vulgar 'Fa Sha', creating a new category, arbitrarily. I have seen this disease: onset with mental agitation, lower abdominal pain. *Ling Su* never mentioned it. Irrelevant to 'Xie Jie'. Likely major error." Danbo Jian'an notes: Wang Bing注释 based on *Ci Mie Lun*, but that is Shaoyang Malaria symptom, not 'Xie Jie' meaning. Ma, Wu, Zhang followed Wang, all incorrect. Only Gao and Hang are steady. 'Xie Jie' also in *Lun Ji Zhen Chi Lun*: "Weak Chi flesh, Xie Jie." Basically means sluggishness/lethargy. *Si Shi Ci Ni Cong Lun* writes 'Xie Jie'; *Zhen Yao Jing Zhong Lun* writes 'Xie Duo'; *Ci Mie Lun* writes 'Xie Jie'; Chao Yuanfang writes 'Xie Juan'. This proves it. 'Jie' is 'Yi' with person radical, connects to 'Yi' (Change). Wang Bing注释 on *Qi Jue Lun*: "Shi Yi: Food passes through quickly, not generating flesh. Yi means Change." *Jia Yi Jing* cites *Qi Jue Lun* as 'Shi Jie'. *Gu Kong Lun*: "Yi Sui Wu Kong", Wang注释: "Yi is Yi (Also)". Proves 'Jie'/'Yi' same, connects to 'Yi'. 'Yi' means changing normalcy. *Shen Nong Ben Cao Jing* Scat Beetle: "Kuang Yi" (*Zheng Lei*: sound Yang, error. *Han Shu*: "Suffer Kuang Yi". Shigu注释: "Kuang Yi is madness changing normal nature"). *Yin Yang Bie Lun*: "Pian Ku Wei Yi", Wang注释: "Yi is changing usual, leading to flaccid weakness". *Da Qi Lun*: "Bo Yi Pian Ku", Wang注释: "Blood/qi change, leading to hemiplegia". Thus 'Xie Yi' is 'Xie Duo', meaning changing normalcy. Hua Shou says: "One theory writes 'Xie Ji', extreme exhaustion. Unknown basis." Yu Tun's *Zheng Chuan*: "Xie is muscle dissolution. Jie is sinew not binding. Vulgarly Sand Disease. *Nei Jing* names Xie Jie, not real Sand Disease." This is too wrong.
Resting but pulse full indicates Blood Depletion (An Wo Mai Sheng Yue Tuo Xue). Ma Yin states: "An Wo means inability to rise. Mai Sheng means fire blazing. Heat causes blood reckless flow, hence Tuo Xue." Gao Shixi states: "An Wo is like嗜卧 (loving to lie down)."
Chi roughness and Slippery pulse indicate profuse sweating (Chi Se Mai Hua Wei Duo Han). Wu Kun states: "Chi skin rough means skin/hair lost fluids. Slippery pulse means Yin Fire excess. Yang excess Yin deficiency causes profuse sweat. *Yin Yang Bie Lun*: 'Yang added to Yin is sweat.'" Danbo Jian'an notes: Wang Bing interpreted 'Chi' as Chi pulse, Zhang agreed, both wrong.
Chi pulse coarse (Mai Chi Cu). Xiong Ben lacks 'Mai', Wu agrees, should delete.
Called Re Zhong (Internal Heat) (Wei Zhi Re Zhong). Danbo Jian'an notes: Wang注释 says Lower Jiao Zhong. Incorrect. Ma Yin states: "Heat Qi in abdomen is Re Zhong."
Eyelids slightly swollen (Mu Guo Wei Zhong). Song Ben writes 'Li', Wu agrees, Gao writes 'Nei', all incorrect.
Wei Dan (Stomach Jaundice) (Wei Dan). Danbo Jian'an notes: 'Dan' same as 'Dan', previously Xiao Zhong, later Zhong Xiao Ke. Ma Yin says Gu Dan; Gao says Huang Dan, both incorrect.
Facial swelling indicates Wind (Mian Zhong Yue Feng). Ma Yin states: "Water diseases with Wind cause facial swelling. Face is meeting of Yang channels; Wind is Yang, affects upper first. Wind sensation causes facial swelling first. Do not mistake for only Water disease. *Ping Re Lun*, *Shui Re Xue Lun*, *Lun Ji Zhen Chi Lun* call it Feng Shui. Wang注释 thinks Wei Feng is wrong. Checking *Feng Lun*, Wei Feng symptoms do not include facial swelling." Danbo Jian'an notes: *Jin Gui Yao Lue* says: "Face/eyes swollen with heat named Feng Shui." Also: "Swelling above waist, induce sweat."
Lower leg swelling indicates Water (Zu Jing Zhong Yue Shui). Wu Kun states: "Spleen/Stomach govern Damp; Kidney/Bladder govern Water. Their pulses run to legs. Leg swelling is Water disease." Danbo Jian'an notes: *Jin Gui Yao Lue* says: "Swelling below waist, promote urination."
Woman's Hand Shaoyin pulse moving strongly indicates pregnancy (Fu Ren Shou Shao Yin Mai Dong Shen Zhe Ren Zi Ye). Zhao Fu Ben writes 'Ren' as 'Ren' (Bear/Carry), Xiong/Wu/Zhang agree. Zhang states: "Heart pulse moving strongly is due to Blood dominance. Wang Qixuan... refers to Heart Meridian pulse, Shenmen point. Good theory. 'Ren'/'Ren' same, pregnancy." Danbo Jian'an notes: *Lun Ji Zhen Chi* also says: "Woman Hand Shaoyin pulse moving strongly indicates pregnancy." Knowing full text uses 'Foot Shaoyin' is incorrect. Wang Bing interpreted 'Dong' as jumping pulse; Ma Shi interpreted 'Ren Zi' as man, both wrong.
No Zang Form yet (Wei You Zang Xing). Ma Yin states: "No correct Zang pulse form appears, but other Zang pulses appear. Spring/Summer pulses should be Floating/Large, now Sunken/Fine/Thin; Autumn/Winter pulses should be Sunken/Fine, now Floating/Large/Full. This is Reverse Four Seasons. *Yu Ji Zhen Zang Lun*: 'No Zang form in Spring/Summer but Sunken/Choppy pulse; Autumn/Winter Floating/Large pulse, named Reverse Four Seasons.' Same meaning." Gao Shixi states: "No Spring Xian, Summer Gou, Autumn Mao, Winter Shi Zang forms." Danbo Jian'an notes: Wu/Zhang think True Zang pulse form, incorrect.
Named Reverse Four Seasons (Ming Yue Fan Si Shi Ye). Wu deletes 'Si Shi'. Ma Yin states: "All difficult treatments, like pulse reverse four seasons." Wang注释 thinks superfluous, unaware ancients used analogy. (Wang注释 likely New Correction.) Danbo Jian'an notes: Ma's comment seems forced.
Liver not Xian, Kidney not Shi (Gan Bu Xian Shen Bu Shi). Zhang Jingyue states: "Humans rely on Grain/Water. Stomach Qi based on Grain/Water. Five Zang based on Stomach Qi. If pulse lacks Stomach Qi..."