面肿苍黑舌卷青。四肢乏力眼如盲。泣出不止是肝绝。〔八日应当〕（日遇庚辛）命必倾。
此云八日从甲数至庚为八日。此言则胶柱矣。从直改为庚辛。
面黧肩息直视看。又兼掌肿没文斑。狂言乱语心闷热。一日之内到冥间。脐趺肿满面浮黄。
泄利不觉污衣裳。肌肉粗涩兼唇反。一十二日内灾殃。
口鼻气出不复回。唇反无文〔黑〕（鼻）似煤。皮毛焦干爪枯折。途程二日定知灾。
面黑齿痛目如盲。自汗如水腰折频。皮肉濡〔结〕（却）发无泽。四日应当命不存。
改结为却。本难经。
（旧文不伦。今移从各类。）
肝为血兮肺为气。血为营兮气为卫。阴阳配偶不参差。两脏通和皆类例。血衰气旺定无妊。血旺
气衰应有体。
以上论成妊之原。
〔尺〕（寸）微关滑尺带数。流利往来并雀啄。小儿之脉已形见。数月怀胎犹未觉。
上云尺微。下云尺数。可见上尺为误。女脉在关下。尺脉常盛。若尺微则无阴为病矣。脉经云妊
娠初时寸微小。呼吸五至。三月而尺数也。内经曰手少阴脉动甚者。妊子也。又云阴搏阳别。谓之
有子。阴谓尺中。搏谓搏击于手。尺脉搏击。与寸口殊别。则阴气挺然。为妊之兆。此即所谓寸微尺
数也。脉指南云脉动入产门者有胎也。谓出尺脉外。名曰产门。又云尺中脉数而旺者。胎脉也。为血
盛也。关滑。雀啄。脉经并不载。素问曰滑为多血少气。故有子。此脉诀所自增也。流利往来。滑
脉之形。雀啄者。脉指南云。关上。一动一止者一月。二动一止者二月。余仿此。推之万不失一。此
所谓雀啄。雀啄在他病为死形。
三部〔沉正等无疑〕（浮沉按无绝。）尺内不止真胎妇。
脉经曰。三部浮沉正等。按之无绝者。有妊也。今脉诀去浮。以疑易绝。云沉正等无疑。误甚。
今改之。夫正等者。即仲景所谓寸关尺三处。大小浮沉迟数同等也。仲景以同等为阴阳平和之脉。
虽剧当愈。叔和以正等又按无绝。为有妊之兆。真吉征也。内经腹中论曰何以知怀子之且生也。岐
伯曰身有病而无邪脉也。所谓身有病。谓经闭也。尺脉来而断绝者。经闭月水不利。今病经闭。
而脉反如常不断绝者。妊娠也。
滑疾〔不散〕（按微）胎三月。但疾不散五月母。
脉经曰。脉滑疾。重手按之微者。胎已三月也。重手按之不散。但疾不滑者。五月也。今改上句
从脉经。
以上论三月内有胎之兆。然未知男女之兆也。四月方可以别。故此以下乃分男女之诊。分作两
类乃明。
左疾为男右为女。流利相通速来去。两手关脉大相应。已形亦在前通语。
脉经曰。妊娠四月欲知男女法。左尺偏大为男。右尺偏大为女。左右尺俱大。生二子。大者如实状。
左疾为男。右疾为女。俱疾生二子。既分左右脉疾。又云流利相通。又云两手关脉大相应。乃是左右
尺脉疾大。上与关大相应。又流利相应。与寸通应。但分左右尺以别男女。左阳右阴以位定也。池氏以
左疾为左寸心部属太阳经。以右疾为右寸肺部属太阴经。盖惑于脉赋太阴洪而女孕。太阳大而男孕。不知
脉赋惑于脉诀之差。盖脉赋脉诀。皆窃叔和之名以行世。所述之脉。醇疵相半。声律之赋。晋代
未有。而世鲜知其非。明于医者。间亦改之一二。而未能尽正云。
左手〔太阳浮大〕（沉实诊为）男。右手〔太阴沉细〕（浮大诊为）女。
脉经曰。得太阴脉为男。得太阳脉为女。太阴脉沉。太阳脉浮。又云左手沉实为男。右手浮大为女。
左右手俱沉实。猥生二男。左右手俱浮大。猥生二女。李氏虽改脉诀沉细为沉大。犹未知太阳脉浮非男。
脉经作女诊也。太阴脉沉非女。脉经作男诊也。又以太阳为左手心部。太阴为右手肺部。是又惑于
脉诀脉赋之差。徇池氏以舛注舛之非也。脉经虽曰太阳脉沉为男。太阴脉浮为女。亦不明言以何经
为太阳太阴。当于何部诊之。不若脉经后条浮大为女。沉实为男为明白。故根据后条改之。
诸阳为男诸阴女。指下分明长记取。
脉经曰。左右尺俱浮为产二男。不尔则男作女生。左右尺俱沉为产二女。不尔则女作男生。前云
右浮大为女。左沉实为男。是独以左右脉各异立言。今左右俱浮为二男。俱沉为二女。是并左右两
尺脉一同以立言。其于诸阳男。诸阴女。未尝差也。左沉实左疾。左偏大。与俱浮。或以脉。或以位。
皆阳也。右浮大。右疾。右偏大。与俱沉。或以脉。或以位。皆阴也。此二句总结男女分诊定法也。
以上辨四月之后。妊娠男女之诊。
〔母乘子〕（夫乘妻）兮纵气雾。妻乘夫兮横气助。子乘母兮逆气参。〔夫乘妻〕（母乘子）兮顺气护。
仲景谓脉有相乘。水行乘火。金行乘木。曰纵。谓其气直恣。乘其所胜也。火行乘水。木行乘金。
曰横。谓其气横逆。反乘所不胜也。水行乘金。火行乘木。曰逆。谓子加于母而气逆也。金行乘水。
木行乘火。为顺。谓由母至子。其气顺也。李 范不知此论相乘。脉中夫妻母子。却作人身形之夫妻
母子解之。理不能通。然脉诀引此以诊别男女妊形。据脉经别载于前。不载在诊妊娠之条。本只是
取仲景所论相乘之脉。脉诀不能甄别。混引以歌妊娠。今姑根据仲景解之。此四句元在后。今移在此。
与纵横逆顺从类。其纵顺二脉。改根据仲景元文。
左手带纵两个儿。右手带横一双女。左手脉逆生三男。右手脉顺生三女。寸关尺部皆相应。一男
一女分形证。
以上十句。皆脉诀自撰之辞。恐难以诊妊娠男女之别也。且相乘之脉。乃五脏之邪。发为病证。
见之于脉。妊娠乃阴阳和平。阳施阴化以成形。岂有逆于理。乘于脏。现于脉。用为男女之诊。又寸
关尺皆应。即是左右手前后如一也。即脉经所谓三部浮沉正等之脉。何以应一男一女乎。以上系脉
诀差取仲景所论相乘之脉。以论妊娠。今条其非如前。
往来三部通流利。滑数相参皆替替。阳盛阴虚脉得明。遍满胸堂皆逆气。
此言恶阻之证之脉。
小儿足日胎成聚。身热脉乱无所苦。汗出不食吐逆时。精神架构其中住。
此亦谓恶阻证也。脉乱。盖谓滑数而躁疾也。非谓恶乱无次序者。此八句。皆谓妊娠病脉。
有时子死母身存。或即母亡存子命。牢紧强弦滑者安。沉细而微归泉〔路〕（瞑。改以协韵）
沉细而微。谓三部俱如此。凶兆也。此四句论妊妇生死脉证之别。
Facial edema, dark and cyanotic complexion, tongue rolling up with a cyan color. Weakness in the four limbs, vision blurred as if blind. Uncontrollable weeping indicates Liver Qi exhaustion. (Eight days should be) (days encountering Geng-Xin), life will inevitably end.
The "eight days" mentioned here counts from Jia to Geng as eight days. This statement is rigid and inflexible. Changed "Zhi" to "Geng-Xin".
Darkened complexion, shoulder breathing (shoulder shrugging during respiration), fixed staring gaze. Accompanied by swollen palms with disappearance of palm lines and appearance of spots. Delirious speech, mental heat and stifling sensation. Death within one day.
Swelling of the umbilicus and dorsum of the foot, yellowish facial edema.
Diarrhea or dysentery, uncontrollable soiling of clothes. Rough and dry muscles, accompanied by eversion of lips. Disaster within twelve days.
Exhalation from mouth and nose does not return. Lip eversion without lines, (nose) color black like coal. Dry and brittle skin and hair, withered and broken nails. Within two days, disaster is certain.
Black complexion, toothache, blindness. Spontaneous sweating like water, frequent sensation of waist breaking. Soft and flaccid flesh and skin, lusterless hair. Death within four days.
Changed "Jie" (knot) to "Que" (return). From *Nan Jing* (Classic of Difficult Issues).
(Old text was disordered. Now moved to respective categories.)
Liver governs Blood, Lung governs Qi. Blood is Ying (Nutritive) Qi, Qi is Wei (Defensive) Qi. Yin and Yang are paired without discrepancy. The harmonious interaction of these two organs follows similar patterns. If Blood is deficient and Qi is hyperactive, pregnancy is definitely absent. If Blood is abundant and Qi is relatively weak, pregnancy should be present.
The above discusses the origin of conception and pregnancy.
(Cun) pulse is faint, Guan pulse is slippery, Chi pulse carries rapidity. Smooth flow and movement, along with Sparrow-pecking pulse manifestation. The pulse of an infant has already appeared. Months of pregnancy remain undetected.
Previously it stated Chi pulse is faint; later it states Chi pulse is rapid. Thus, the "Chi" in the former is an error. In women, the pulse is located below Guan. The Chi pulse is usually vigorous. If the Chi pulse is faint, it indicates Yin deficiency leading to disease. *Mai Jing* (Pulse Classic) states: At the beginning of pregnancy, the Cun pulse is minute and small, with five breaths per pulse beat. At three months, the Chi pulse becomes rapid. *Nei Jing* (Inner Canon) states: When the Hand-Shaoyin pulse beats vigorously, pregnancy exists. It also says: "Yin bo Yang bie" (Yin pulses beat strongly while Yang pulses are distinct), called having a child. "Yin" refers to the Chi position. "Bo" refers to beating against the fingers. The Chi pulse beats distinctly different from the Cun-Kuan position, indicating prominent Yin Qi, a sign of pregnancy. This is what is meant by "Cun faint, Chi rapid". *Mai Zhi Nan* (Guide to Pulse Diagnosis) states: Pulses moving into the "Chan Men" (Birth Gate) indicate fetus. This refers to outside the Chi pulse, named Chan Men. It also states: Rapid and vigorous Chi pulse indicates fetal pulse, due to abundant Blood. Guan slippery, Sparrow-pecking pulse are not recorded in *Mai Jing*. *Su Wen* (Basic Questions) states: Slippery indicates abundant Blood and deficient Qi. Hence pregnancy. This addition comes from *Mai Jue* (Pulse Rhymes). Smooth flow represents the shape of the Slippery pulse. Regarding Sparrow-pecking, *Mai Zhi Nan* states: At Guan, one beat followed by a pause is one month; two beats followed by a pause is two months, and so on. Deduction yields high accuracy. This is the so-called Sparrow-pecking. In other diseases, Sparrow-pecking is a death sign.
Three positions (Sink equally without doubt) (Floating and Sinking, pressing reveals no interruption). Continuous pulsation within Chi, truly a pregnant woman.
*Mai Jing* states: Floating and Sinking equal in all three positions, with no interruption upon deep pressure, indicates pregnancy. *Mai Jue* omits "Floating", replaces "Interruption" with "Doubt", stating "Sinking equally without doubt". This is a significant error. Corrected now. "Equal" refers to Zhang Zhongjing's description where Cun, Guan, and Chi are equal in size, floating/sinking, slow/rapid. Zhongjing considered equality as a pulse of Yin-Yang harmony; even with severe illness, recovery is expected. He Shuhe considered equality plus no interruption upon pressure as a sign of pregnancy, a truly auspicious omen. *Nei Jing · Fu Zhong Lun* asks: How to know when a pregnant woman is about to give birth? Qibo answers: The body has symptoms but the pulse lacks pathogenic signs. "Body has symptoms" refers to amenorrhea. If the Chi pulse interrupts, it indicates amenorrhea or irregular menstruation. Now, if amenorrhea occurs but the pulse remains normal and uninterrupted, it is pregnancy.
Slippery and rapid (not scattered) (pressing slightly) indicates three-month fetus. Only rapid without scattering indicates five-month mother.
*Mai Jing* states: Slippery and rapid pulse, faint upon heavy pressure, indicates three-month fetus. Not scattered upon heavy pressure, only rapid without slipperiness, indicates five months. The first sentence is corrected here according to *Mai Jing*.
The above discusses signs of pregnancy within three months. However, gender cannot yet be determined. Differentiation begins at four months. Therefore, the following section divides male and female diagnosis into two categories for clarity.
Rapid left pulse indicates male, rapid right pulse indicates female. Smooth connection, fast coming and going. Enlarged Guan pulses in both hands correspond. Formation is also mentioned in previous general statements.
*Mai Jing* states: To determine gender at four months of pregnancy: Left Chi biased large indicates male; Right Chi biased large indicates female. Both Chis large indicate twins. Large means feeling full. Rapid left indicates male, rapid right indicates female. Both rapid indicates twins. Since it distinguishes left/right rapid pulses, and mentions smooth connection, and enlarged Guan pulses corresponding, it implies that the rapid and large Left/Right Chi pulses correspond upwards to the enlarged Guan, and smoothly connect with the Cun. Gender is distinguished solely by Left/Right Chi, based on Left-Yang/Right-Yin positional theory. Chi Shi believed Left rapid corresponds to Left Cun Heart channel (Taiyang), and Right rapid to Right Cun Lung channel (Taiyin). This confusion stems from *Mai Fu* (Pulse Ode) which states Taiyang large indicates male pregnancy, Taiyin full indicates female pregnancy. They did not realize *Mai Fu* was misled by errors in *Mai Jue*. Both *Mai Fu* and *Mai Jue* borrowed He Shuhe's name for circulation. Their described pulses contain both accurate and flawed elements. Rhythmic odes did not exist in the Jin Dynasty, and few realized their inauthenticity. Knowledgeable physicians occasionally corrected minor points but failed to fully rectify them.
Left hand (Taiyang Floating Large) (Sink Solid diagnose as) Male. Right hand (Taiyin Sink Fine) (Floating Large diagnose as) Female.
*Mai Jing* states: Obtaining Taiyin pulse indicates male; obtaining Taiyang pulse indicates female. Taiyin pulse is sinking; Taiyang pulse is floating. It also states: Left hand sink-solid indicates male; Right hand float-large indicates female. Both hands sink-solid indicate multiple males; both hands float-large indicate multiple females. Li Shi changed *Mai Jue*'s "sink-fine" to "sink-large", yet still failed to recognize that Taiyang floating does not indicate male (*Mai Jing* diagnoses female for this). Taiyin sinking does not indicate female (*Mai Jing* diagnoses male for this). Identifying Taiyang as Left Heart and Taiyin as Right Lung further confuses matters, following Chi Shi's erroneous annotations. Although *Mai Jing* mentions Taiyang sink for male and Taiyin float for female, it does not specify which channels or positions constitute Taiyang/Taiyin. It is clearer to follow *Mai Jing*'s later statement: Floating-large for female, Sink-solid for male. Thus, correction is made based on that statement.
All Yang pulses indicate male, All Yin pulses indicate female. Clearly distinguish under fingers, remember long.
*Mai Jing* states: Both Left and Right Chi floating indicates delivery of two males; otherwise, a male may be born as female. Both Left and Right Chi sinking indicates delivery of two females; otherwise, a female may be born as male. Previously, Right floating-large for female and Left sink-solid for male were discussed separately regarding left/right differences. Now, both sides floating for two males and both sides sinking for two females discuss the combined Left/Right Chi pulses. There is no discrepancy with "All Yang male, All Yin female". Left sink-solid, left rapid, left biased-large, and both floating—whether by pulse quality or position—are Yang. Right floating-large, right rapid, right biased-large, and both sinking—whether by pulse quality or position—are Yin. These two sentences summarize the definitive rules for gender differentiation in pregnancy diagnosis.
The above differentiates pregnancy gender diagnosis after four months.
(Mother overcomes Son) (Husband overcomes Wife) implies Vertical (Zong) Qi mist. Wife overcomes Husband implies Horizontal (Heng) Qi assistance. Son overcomes Mother implies Reverse (Ni) Qi interference. (Husband overcomes Wife) (Mother overcomes Son) implies Smooth (Shun) Qi protection.
Zhongjing stated that pulses have mutual overcoming: Water overcoming Fire, Metal overcoming Wood is called Vertical (Zong), meaning Qi acts directly, overcoming what it controls. Fire overcoming Water, Wood overcoming Metal is called Horizontal (Heng), meaning Qi acts transversely, counter-overcoming what it cannot control. Water overcoming Metal, Fire overcoming Wood is called Reverse (Ni), meaning Son adds to Mother causing reverse Qi. Metal overcoming Water, Wood overcoming Fire is called Smooth (Shun), meaning Mother to Son, Qi flows smoothly. Li Fan did not understand this discussion on mutual overcoming; interpreting pulse Husband/Wife/Mother/Son as physical human relationships makes no logical sense. However, *Mai Jue* cites this to diagnose fetal gender. According to *Mai Jing*, this is recorded earlier, not in the pregnancy diagnosis section. It originally just took Zhongjing's discussion on overcoming pulses. *Mai Jue* failed to discriminate, mixing it into pregnancy rhymes. For now, we interpret it according to Zhongjing. These four sentences were originally at the end, now moved here to align with Vertical/Horizontal/Reverse/Smooth categories. The Vertical and Smooth pulses are corrected according to Zhongjing's original text.
Left hand with Vertical generates two sons. Right hand with Horizontal generates twin daughters. Left hand Reverse pulse generates three sons. Right hand Smooth pulse generates three daughters. Cun, Guan, Chi positions all correspond. One son and one daughter show distinct forms.
The above ten sentences are self-composed by *Mai Jue*, likely unreliable for diagnosing pregnancy gender. Moreover, overcoming pulses represent pathogenic Qi of the Five Viscera manifesting as disease symptoms in the pulse. Pregnancy is a state of Yin-Yang harmony, where Yang imparts and Yin transforms to form the fetus. How can there be reversal of principle, overcoming of viscera, and manifestation in the pulse used for gender diagnosis? Furthermore, if Cun, Guan, Chi all correspond, it means Left and Right hands are identical front-to-back, i.e., the *Mai Jing* concept of "Three positions floating and sinking equal". How does this correspond to one son and one daughter? The above details how *Mai Jue* erroneously selected Zhongjing's overcoming pulse theory to discuss pregnancy. Its errors are listed above.
Flowing through all three positions smoothly. Slippery and rapid intermixed, all rhythmic. Yang excess and Yin deficiency make the pulse clear. Fullness in the chest hall indicates rebellious Qi.
This describes the pulse of Morning Sickness (E Zu).
At full term, the fetus gathers. Body heat, chaotic pulse, no suffering. Sweating, anorexia, intermittent vomiting. Spirit resides within.
This also refers to Morning Sickness. "Chaotic pulse" refers to slippery, rapid, and restless qualities, not disorderly sequence. These eight lines describe pathological pulses in pregnancy.
Sometimes the fetus dies while the mother lives. Or the mother dies while the fetus survives. Firm, tight, strong, wiry, or slippery pulses indicate safety. Sink, fine, and faint pulses lead to the underworld (death).
Sink, fine, and faint refer to all three positions being like this. An ominous sign. These four lines discuss the distinction between life and death pulse signs in pregnant women.