左手中指木相连脉候须还来一息。
此言医者。以中指探病患之左手关脉。乃肝木也。其脉亦须还准前五
九之数为一大息。则无病。
二十六动沉却来。肝脏有风兼热极。
若诊得二十六动上。而见一沉。则为肝脏有风兼热极矣。何也二十六
动。以五五除之。则余其一。一为水之生数。以四五除之。则余其六。六为
水之成数。合生成之数。皆水。是母来抑子。肝为风木。子挟母势。而风热
愈炽。故曰肝脏有风兼热极矣。
二十九动涩匿匿。本脏及筋终绝塞。
匿匿涩貌。涩为金脉。肝脉见涩。为金来克木。况二十九动上见之。以五
五除之。则余其四。四为金之生数。以四五除之。则余其九。九为金之成
数。合生成之数俱金。洁古曰。木得金而伐矣。夫肝主筋。故曰本脏及筋
终绝塞也。
一十九动便沉沉肝绝未闻人救得。
夫肝为木。今见一十九动。而沉以二五除之。则余其九。九为金之成数。
以三五除之。则余其四。四为金之生数。合生成之数俱金。洁古曰木得
金而伐矣。
左手肾脉指第三。四十五动无疾咎。
言病患左手尺部。医者以第三无名指探之。亦须准前五九四十五动
而不歇。是无疾咎之脉也。
按经云。左手尺部脉。四十动而一止。止而复来。来逆如循直木。如循张
弓弦。 然如两人共引一索。至立冬死。（千金方作至立春死。）
指下急急动弦时。便是热风之脉候。
弦为风木。急急动弦为风而兼热。是母挟子势。而为风热之候也。然此
病易治。为子扶母兮瘥速。有余之证也。
忽然来往慢慢极。肾脏败时须且救。此病多从冷变来。疗之开破千金口。
倘诊得肾脉。忽然来往。慢慢而极。言迟而又迟也。迟则为寒。肾为寒水。
当有既济之功。今肾部而见极迟之脉。是纯阴无阳。其肾脏之败可知
矣。然犹有可救之理。应知此病多从虚极变而为寒。谓之不足。其病难
已。必须大剂温补。未可轻言治疗也。
二十五动沉却来。肾绝医人无好手。努力黄泉在眼前。纵活也应终不久。
夫肾者水也。今见二十五动。而况以四五除之。尚余其五。五乃土之生
数。以三五除之。尚余其十。十乃土之成数。合生成之数皆土。洁古曰。水
得土而绝矣。其能久乎哉。
The middle finger on the left hand corresponds to the Liver pulse; pulse diagnosis requires counting based on "one breath" (a complete respiratory cycle).
This refers to the physician using the middle finger to palpate the Guan position of the patient's left wrist, which represents the Wood element of the Liver. The number of pulsations should also conform to multiples of nine mentioned previously; if the pulsations within one major breath adhere to this count, there is no disease.
If there are twenty-six pulsations accompanied by a Deep pulse (Chen Mai), it indicates extreme Wind and Heat in the Liver.
If upon examination, twenty-six pulsations are counted and a Deep pulse is observed, it signifies that the Liver has Wind pathogen combined with extreme Heat. Why? Twenty-six pulsations, when divided by five times five, leaves a remainder of one; one is the generating number of Water. When divided by four times five, the remainder is six; six is the completion number of Water. Combining these generating and completion numbers, they all belong to Water. This represents the Mother (Kidney Water) suppressing the Child (Liver Wood). Since the Liver belongs to Wind-Wood, the Child borrows the momentum of the Mother, causing the Wind-Heat to become even more intense. Therefore, it is said that the Liver has Wind combined with extreme Heat.
If there are twenty-nine pulsations with a Choppy (Se) quality, it indicates the terminal closure of the Zang organ itself and the sinews.
"Nini" describes the appearance of a Choppy pulse. A Choppy pulse belongs to Metal. If the Liver pulse exhibits a Choppy quality, it signifies Metal overcoming Wood. Furthermore, observing this at twenty-nine pulsations: dividing by five times five leaves a remainder of four; four is the generating number of Metal. Dividing by four times five leaves a remainder of nine; nine is the completion number of Metal. Combining these generating and completion numbers, they all belong to Metal. Jiegu (Zhang Yuansu) stated: "Wood is felled when it meets Metal." Since the Liver governs the sinews, it is said that the Zang organ and sinews face terminal closure.
If there are nineteen pulsations that are Deep and sinking, the Liver Qi is exhausted; it is unheard of for anyone to be saved.
The Liver belongs to Wood. Now, observing nineteen pulsations: dividing by two times five leaves a remainder of nine; nine is the completion number of Metal. Dividing by three times five leaves a remainder of four; four is the generating number of Metal. Combining these generating and completion numbers, they all belong to Metal. Jiegu stated: "Wood is felled when it meets Metal."
The third finger on the left hand corresponds to the Kidney pulse. Forty-five pulsations without pause indicate no disease.
This refers to the patient's Chi position on the left wrist, where the physician uses the third finger (ring finger) to palpate. It must also conform to the forty-five pulsations mentioned previously without interruption; this is the pulse of health without fault.
According to classics: For the left Chi pulse, if there is one stop every forty pulsations, and after stopping it returns, coming back in a rebellious manner like touching a straight piece of wood, or like touching a taut bowstring, or as if two people are pulling a single rope together, death will occur at the Start of Winter. (The *Qianjin Fang* records death at the Beginning of Spring.)
When the pulse feels urgent and wiry under the fingers, it is the pulse sign of Wind-Heat.
The Wiry (Xian) pulse belongs to Wind-Wood. An urgent, wiry movement indicates Wind combined with Heat. This is the Mother borrowing the momentum of the Child, resulting in a Wind-Heat pattern. However, this disease is easy to treat because the Child supports the Mother, leading to rapid recovery; it is a syndrome of Excess.
Suddenly, if the pulse comes and goes extremely slowly, the Kidneys are failing and must be urgently rescued. This disease often arises from Cold transformation; treatment requires drastic measures, worth a thousand gold.
If the Kidney pulse is suddenly found to be extremely slow in its rhythm, meaning slow beyond measure. Slow pulses indicate Cold. The Kidney is the organ of Cold Water and should possess the function of Water-Fire intersection. Now, seeing an extremely slow pulse in the Kidney region indicates Pure Yin without Yang, revealing the failure of the Kidneys. Nevertheless, there is still hope for rescue. One should know that this disease often transforms from extreme deficiency into Cold, termed a Deficiency syndrome. The illness is difficult to cure. Large doses of warming and tonifying herbs are necessary; routine treatments should not be lightly prescribed.
If there are twenty-five pulsations accompanied by a Deep pulse, the Kidney essence is exhausted; no skilled physician can save. Strive hard, for the Yellow Springs (death) are before your eyes. Even if alive, life will be short.
The Kidney belongs to Water. Now, observing twenty-five pulsations: dividing by four times five leaves a remainder of five; five is the generating number of Earth. Dividing by three times five leaves a remainder of ten; ten is the completion number of Earth. Combining these generating and completion numbers, they all belong to Earth. Jiegu stated: "Water is cut off when it meets Earth." How can it last long?