小见尺左，水耗无多；小见尺右，火衰不旺；虚见尺左，心肾不交；虚见尺右，水火皆乏；微见尺左，冷入关元；微见尺右，寒通腹里；细见尺左，髓冷胫枯；细见尺右，命寒精泄；数见尺左，水少而火沸为痰；数见尺右，火炎而水随作喘；急见尺左，痛入阴丸；急见尺右，疼添小腹；短见尺左，自无延龄之福；短见尺右，定含怯战之羞；代见尺左，精败欲绝；代见尺右，火息将亡；结见尺左，邪袭水而不散；结见尺右，邪袭火而不离；促见尺左，髓耗而足不行步；促见尺右，火衰而气不通心；革见尺左，玉关不闭；革见尺右，河车俱焚；动见尺左，定然魂梦多遗；动见尺右，定然阳强不倒；毛见尺左，精耗而龙火将兴；毛见尺右，焰腾而命门自热；耎见尺左，肾弱相宜；耎见尺右，火衰当助；钩见尺左，阴平之士；钩见尺右，守真无疑；石见尺左，精无倾失之慨；石见尺右，阳有退藏之庆；坚见尺左，邪入于骨髓；坚见尺右，邪居于腰膝；躁见尺左，肾难上交于心；躁见尺右，阳且高越于膈；搏见尺左，膀胱有热闭之淋；搏见尺右，咽喉长疮蛾之肿；散见尺左，肾水欲绝于须臾；散见尺右，元阳将逃于顷刻。
陈士铎曰：脉有兼见以观其变，必有独现以显其常，常变之道不可不分观之也。鬼真君先言其变，示变之宜知也，再言其常，示常之宜谙也。知常而后达变，又宁至有治常之失哉。
又曰：脉不分观部位，则病情不可得而知，此寸关尺必须分观其脉也。
又曰：脉有寸关尺无脉，而脉见于列缺之间者。世人以为反关脉也，此乃经脉虚而络脉盛也，经脉虚故不现于寸关尺三部，络脉盛故现于列缺之间。盖直行为经，而旁行为络，列缺正络脉之穴也，在两手交叉食指尽处，两筋骨罅中，属肺经之络，别走阳明之络也。此中原有动脉，宜细动不宜大动，今寸关尺三部无脉，而此处之脉大动，亦现三部之象，是阳胜于阴也，千金翼谓阳脉逆反大于寸口三倍，正言反关脉也。亦当分观其动，以别疾病耳。
又曰：寸关尺分上中下也，心肺居上而以寸观之，象天也；肝脾居中而以关观之，象人也；肾居下而以尺观之，象地也。医道必须统天地人以论医，则医无剩义，脉诀亦必合天地人以示法，则法无遁情。非好作广大之语也，实有不如此则其法不为备耳。
又曰：寸关尺分上中下切之，是矣。然其中有上而兼中者，有中而兼下者，有中而兼上下者，又不可不知之也。如寸脉浮而连于关，关脉数而连于尺，如关脉大而连于寸尺者是也。此又当合寸关尺而同观，又不可专主于寸而不及于关，专主于关而不及于尺，又在临症切脉而变通之也。
又曰：脉宜分观以别虚实，然亦有合寸关尺以分虚实者，大约左之寸关尺齐旺者，乃外感居多，右之寸关尺齐旺者，乃内伤居多，非但左寸旺为外感，右寸旺为内伤也。
又曰：寸关尺分观之后，又宜合观，不分观不知其细，不合观不得其合。故分观之时，当以一指切其脉，合观之时，又当以三指切其脉也。
又曰：看寸关尺三部之脉，当先切关脉，而后看寸脉，而后看尺脉，左右相同。
又曰：今人看脉，男先看左，女先看右，男女之脉何尝有异，正不必如此拘拘也。
又曰：凡人之脉，贵有胃气。胃气者，平气也，毋论寸关尺，下指之时觉有平和之象，即是有胃气也，非独右关平和始有胃气耳。
又曰：脾与胃为表里，胃病则脾必病，脾病则胃亦病，病则安有胃气哉。故脾脉与胃脉同观，所以脾胃之脉皆在右关切之耳。
又曰：胃旺而脉愈微，胃衰而脉愈盛。故右关太旺，反是胃气之虚也。然而右关之旺，又由左关之旺也，左关旺而右关不能衰，此木来克土之象，又不可不知也。
又曰：三部之脉，前人以尺脉为根，似乎切脉重在尺也，不知本实先拔，固然枝叶难荣，然而过于摧残，如狂风大雨拔木折枝，根亦随竭，此脉必统三部而观之也。
又曰：寸关尺各有内外之分，尺外尺里、关外关里、寸外寸里皆从左右以分内外，而非上下以分内外也。余注内经，已详哉言之矣。而鬼真君不言及此者，盖举要以示人耳。
又曰：脉分三部，上寸也，中关也，下尺也。寸之内又分左右左，寸候心而包络膻中统其内，右寸候肺而胸脘咽喉统其内；关之内又分左右，左关候肝而胆胁膈则统其内，右关候脾而胃则统其内；尺之内又分左右，左尺候肾中之水，而小肠膀胱小腹股膝统其内，右尺候肾中之火，而大肠腰胫胻统其内；三焦有上焦中焦下焦之异，上焦属于寸，中焦属于关，下焦属于尺，不可于右肾候之也，命门为十二经之主，不属于右肾而不得不候之于右肾也，部位既明切脉自无疑。
又曰：鬼真君所分部位，一皆准于内经，与王叔和所定大相悬殊，世人见之未有不惊异者也。然而鬼真君正恐人惊异，单言五脏而不言七腑，铎虑部位不明，又将何以诊脉，故于前条细列以问世，第推鬼真君之意，但知五脏之脉，正不必又及七腑之脉也，铎重言之，似乎饶舌矣。
又曰：五脏各有表里，心则与小肠为表里也，肝则与胆为表里也，肺则与大肠为表里也，脾则与胃为表里也，肾则与膀胱为表里也，表病则里病，原相关切，故治里正所以治表也，何必分表是表，而不属之脏，里是里，而不属于腑也。
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第四篇
鬼真君曰：诊脉宜分生死，决日当定时辰。伤寒热病，洪大生而沉细死；产后热病，缓滑吉而弦急凶；头痛之疴，生于浮滑而死于短涩；腹胀之症，死于虚小而生于大浮；下痢活于微小，浮洪反有难疗之叹；癫狂全于实大，沉细转兴莫救之忧；消渴数大有生机，虚小愁其阴尽；霍乱浮洪无死法，微迟虑彼阳亡；中风最喜迟浮，急实者何能起死；中恶偏宜紧细，浮大者不易回生；心疼沉细非比浮大之难医，水气大浮不似沉细之莫疗；吐血鼻衄沉弱沉细者生，实大浮大俱为亡兆；中毒肠癖洪大滑大者吉，微细滑细各是危征；喘急宜浮滑，短涩云亡；咳嗽尚浮濡，沉伏决毙；久泻反宜微细，浮洪者多致归阴；新产切忌大弦，缓滑者宁忧辞世；呕吐虚细者吉，实大则艰于奏功；痨瘵浮滑者佳，细数则难以取效；盗汗惟嫌紧数，虚小无愁；失血止虑浮洪，细弱可喜；内实者吉在浮洪，沉细有变迁之祸；内虚者吉在沉细，浮大无存活之祥；痹症尤嫌浮大，细涩长延；厥病更忌紧弦，洪数即解；癥瘕见细微而可喜，弦滑者危；眩冒见浮滑而相宜，沉涩者危；黄疸不宜急数，迟滑易于分消；白淋偏贵濡迟，涩弱艰于止遏；便闭生于细微，洪大有阴尽之伤；发汗生于虚小，弦洪有阳亡之失；腹痛沉伏，多入泉台；胁痛芤大，定趋死路；脱症结代，难留人世；喘症促革，易走冥途；关格涩浮，常登鬼录；痈疽滑大，转庆生缘；结胸现沉紧，半寄于死亡；脏结现浮滑，速痊于淹滞；直中阴经，丧沦代结；忽成热病，全活浮洪；发斑洪大未是死征，噎膈数细实非生气；偏枯之症，弦滑何愁；歪斜之疴，数大可治；噤口之痢，结涩不易疗；中暑之症，沉浮不须惊；循衣摸床，细小尤堪救援；遗尿撒手，促革必至丧捐；筋青囊缩，微短陨没；舌黑发直，数大焦枯；脐突唇裂，结代应殁，口张足肿；短促何延；呃逆不止，短散就木；懊(忄农)无休，微弱加餐；血晕散促，顷刻归阴；肠结搏坚，旦夕歌露。
更有代钩之象，心死可定九日；弹石之状，肾死必绝于七朝；弓弦之张，肝死定亡于十八；釜沸之乱，脾死可绝于四三；浮水之景，肺死应丧于十二也。尚有秘法，可以罄传于万年。如见前形，不必问现于何脏，见虾游而断八日之必死，见雀啄而决七日之必亡，见吹毛而言四日之必危，见夺索而许一日之必逝，见屋漏而定五日之必陨，其余死亡可据推断。
陈士铎曰：死亡之脉不尽于此，然而得此正易决存亡也。
又曰：《素问》、《灵枢》载死亡之脉甚备，二书参观更无差错。
又曰：死亡之脉，全在看脉之有神无神，有神者有胃气也，无神者无胃气也，故有胃气，虽现死脉而可生，无胃气即现生脉而必死，又在临症而消息之也。
又曰：脉现死亡，不可轻断死期，往往有用药得宜，虽不能起死为生，然延留数日亦其常也，诀中篇末有决日之法，愚以为终非定论，但断其必死，而不必先定其日期，当与高明共商之。
又曰：死亡之脉，现之于骤者易救，以脏腑初绝，尚有根可续也，倘时日已久，虽有人参又何以生之于无何有之乡哉，有无可如何者矣。
又曰：脉有细微欲绝者，多是死亡之脉，然脉有伏而不出，似细微欲绝，其实绝而未绝也。一出脉而细微之象如失，此等之脉最难辨别，又当合症而参之，未可全恃夫切脉也。
又曰：脉有生死之各别，如鱼游雀啄之类，弹石解索屋漏水流吹毛之状，自是死脉无疑，见此等之脉即可决其必亡。苟无此等之脉现，似乎不宜遽言其死，不知脉贵有神，倘浮沉迟数之间，涩滑大小之际，初按若有，再按若无，或散或乱或来或去全无神气，虽非旦夕之云亡，必至岁月之难久，何尝非死脉哉。倘代结之脉，按之有神，不过痰涎之壅塞，寒痛之遏抑，暂时之病，未尝非生也，故决人生死，全要看脉之有神无神为贵耳。
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第五篇
妇人小儿之脉
鬼真君曰：阴阳原无二道，男女何有殊形，五脏相同，不必两分彼此，三部亦一，宁须各论参差。唯受妊成胎独殊男子，故辨妊论孕更别妇人。尺中脉滑，女经不调且有带淋之病；关中脉涩，天癸已断宁非郁塞之疴；左寸滑而左尺大，怀子之兆；左尺数而左关微，有儿之征；左寸带纵，两男之祥；右寸带纵，两女之喜；左关左尺脉皆大，心脉流利必三男；右关右尺脉皆大，心脉流利必三女；然三部有一部之滞，未宜遽许为胎；各脉无一脉之顺，何敢轻言是孕；子死母存，尺浮而寸沉；母亡而子活，尺涩而寸伏；盖子系于肾，尺浮则子无生气；母系于肺，寸沉则母有生机；子系于尺，尺涩而子之气不散；母系于寸，寸浮而母之根已离；沉细之脉，胎欲离经；浮滑之脉，胞将即产；腹疼腰痛，定然即降；浆来胞破，未可言生；身重体寒，面目又青，脉无可畏；心烦血燥，舌兼黑脉断堪忧；子母难留，唇口沫出；娘儿全活，面鼻颜黄；新产脉缓，自存胃气；新产脉滑，未损脾阴；实大既形，定非佳信；弦急兼现，岂是庥祥；沉小实为顺候，涩促半作逆观；脉微何足害，尚可回阳；脉洪反宜愁，最嫌逆冷；妇人之脉若此，小儿之诊若何？三部不妨俱数，只虑沉迟；六经各喜均长，翻嫌细小；惟弦紧不可骤扬，恐来风邪之祟；更虚濡不宜常见，虞多水气之殃；急脉形于指下，呕吐而腹痛难痊；大脉浮于关前，泻痢而心惊不救；见此已可通彼，知偏何难悟全哉。
陈士铎曰：男女之病，彼此相同，原无反背，故有病而可同断也。唯胎产前后少异男子，故鬼真君又传此篇，而于论孕娠独详也。至于小儿，原不必切脉，以气血未全，各脉不十分准。鬼真君之论小儿，亦约略之辞，然而小儿纯阳，所生之病多是饮食之伤，惊疳吐泻之症。得此数言，以括其全，所谓要言不烦也。
又曰：妇人之脉少异于男子者，左尺多旺耳。男子左尺旺，实非佳兆。女子左尺旺，此阴血有余，转是佳祥，盖易于受胎也。
又曰：妇人之病最难治者，以其性情多郁耳，郁则气血即不流通，经辄闭塞，而左关随现涩脉矣。故看妇人之脉，贵切肝脉，辨其涩与不涩，是第一秘法。虽各经皆有涩脉，而左关不涩是其郁未甚也。
又曰：小儿之脉，弦紧急俱是外邪，除此之外，皆内伤也。治内伤之法，补脾健胃为先，即治外邪，亦当顾正，虽纯脉现弦紧弦急，未可单为祛邪也。
《脉学阐微》
邢锡波
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中医瑰宝苑
前言
The pulse appearing small at the left Chi (Kidney Yin) indicates severe depletion of Kidney Water; the pulse appearing small at the right Chi (Kidney Yang) indicates deficiency and weakness of Mingmen Fire. The pulse appearing deficient (Xu) at the left Chi indicates a lack of communication between the Heart and Kidneys; the pulse appearing deficient at the right Chi indicates a dual deficiency of Water and Fire. The pulse appearing minute (Wei) at the left Chi indicates cold invading the Guanyuan point; the pulse appearing minute at the right Chi indicates cold penetrating the abdominal interior. The pulse appearing thin (Xi) at the left Chi indicates cold in the marrow and withering of the shins; the pulse appearing thin at the right Chi indicates cold in the Mingmen and leakage of essence. The pulse appearing rapid (Shu) at the left Chi indicates that scanty Kidney Water leads to boiling deficiency fire transforming into phlegm; the pulse appearing rapid at the right Chi indicates blazing fire causing Kidney Water to rise, resulting in wheezing. The pulse appearing urgent (Ji) at the left Chi indicates pain penetrating the scrotum; the pulse appearing urgent at the right Chi indicates intensified pain in the lower abdomen. The pulse appearing short (Duan) at the left Chi indicates an inherent lack of longevity; the pulse appearing short at the right Chi indicates inevitable timidity and shame. The pulse appearing intermittent (Dai) at the left Chi indicates essence decay nearing extinction; the pulse appearing intermittent at the right Chi indicates extinguishing fire nearing death. The pulse appearing knotted (Jie) at the left Chi indicates pathogenic factors attacking Kidney Water without dispersing; the pulse appearing knotted at the right Chi indicates pathogenic factors attacking Mingmen Fire without departing. The pulse appearing hurried (Cu) at the left Chi indicates marrow depletion leading to inability to walk; the pulse appearing hurried at the right Chi indicates deficient fire leading to Qi failing to reach the Heart. The pulse appearing leathery (Ge) at the left Chi indicates failure of the Jade Gate (urethral orifice) to close; the pulse appearing leathery at the right Chi indicates consumption of the River Cart (innate Qi). The pulse appearing moving (Dong) at the left Chi indicates frequent seminal emissions in dreams; the pulse appearing moving at the right Chi indicates persistent erectile dysfunction. The pulse appearing feathery (Mao) at the left Chi indicates essence depletion with impending rising of Dragon Fire; the pulse appearing feathery at the right Chi indicates blazing flames with self-heating of the Mingmen. The pulse appearing soft (Ruan) at the left Chi is suitable for weak Kidneys; the pulse appearing soft at the right Chi requires warming assistance for deficient fire. The pulse appearing hook-like (Gou) at the left Chi indicates a person with balanced Yin and Yang; the pulse appearing hook-like at the right Chi indicates adherence to truth without doubt. The pulse appearing stone-hard (Shi) at the left Chi indicates no loss of essence; the pulse appearing stone-hard at the right Chi indicates auspicious retreat of Yang. The pulse appearing firm (Jian) at the left Chi indicates pathogens entering the bone marrow; the pulse appearing firm at the right Chi indicates pathogens residing in the waist and knees. The pulse appearing restless (Zao) at the left Chi indicates difficulty in Kidney Water ascending to the Heart; the pulse appearing restless at the right Chi indicates Yang Qi soaring above the diaphragm. The pulse appearing pounding (Bo) at the left Chi indicates heat-closure dysuria in the Bladder; the pulse appearing pounding at the right Chi indicates swelling of sores in the throat. The pulse appearing scattered (San) at the left Chi indicates imminent exhaustion of Kidney Water; the pulse appearing scattered at the right Chi indicates imminent escape of Primordial Yang.
Chen Shiduo stated: Pulses may appear combined to observe changes, but must also appear uniquely to reveal normalcy; the principles of normality and change must be observed separately. Gui Zhenjun first discusses changes to show their importance, then discusses normalcy to show its familiarity. Knowing the normal allows one to understand changes, preventing errors in treating standard conditions.
Furthermore, if pulses are not observed by location, the condition cannot be known; thus, the Cun, Guan, and Chi positions must be observed separately.
Furthermore, if there is no pulse at the Cun, Guan, and Chi positions, but it appears at the Lieque acupoint, people consider this a reversed-guan pulse. This is actually due to deficiency in the main meridians and excess in the collateral vessels. Because the main meridians are deficient, the pulse does not appear at the three positions; because the collaterals are excessive, it appears at Lieque. Straight flow constitutes meridians, while lateral flow constitutes collaterals. Lieque is a collateral acupoint, located where the index fingers meet when hands cross, in the gap between bones and tendons, belonging to the Lung meridian's collateral, diverging to the Yangming collateral. There is normally a pulsation here, which should be fine rather than large. Now, with no pulse at the three positions but a large pulsation here reflecting all three, it indicates Yang exceeding Yin. *Qianjin Yi* states that reversed Yang pulses are larger than the Cun Kou by three times, referring to reversed-guan pulses. One must observe the pulsation separately to distinguish diseases.
Furthermore, Cun, Guan, and Chi correspond to Upper, Middle, and Lower respectively. Heart and Lung reside in the Upper and are observed via Cun, resembling Heaven; Liver and Spleen reside in the Middle and are observed via Guan, resembling Humanity; Kidney resides in the Lower and is observed via Chi, resembling Earth. Medicine must integrate Heaven, Earth, and Humanity. If the pulse classification integrates these three, the method leaves nothing hidden. This is not merely grand rhetoric but necessary for completeness.
Furthermore, while observing Cun, Guan, and Chi separately is correct, one must know that sometimes Upper combines with Middle, Middle with Lower, or Middle with both Upper and Lower. For example, a floating Cun pulse connecting to Guan, a rapid Guan pulse connecting to Chi, or a large Guan pulse connecting to both Cun and Chi. In such cases, they must be observed together. One should not focus solely on Cun ignoring Guan, or Guan ignoring Chi. Adaptability during clinical palpation is essential.
Furthermore, while separate observation distinguishes Deficiency and Excess, combining Cun, Guan, and Chi can also distinguish them. Generally, simultaneous fullness at Left Cun, Guan, and Chi indicates mostly external contraction; simultaneous fullness at Right Cun, Guan, and Chi indicates mostly internal injury. It is not just Left Cun fullness for external contraction and Right Cun fullness for internal injury.
Furthermore, after separate observation, combined observation is necessary. Separate observation reveals details; combined observation reveals the whole. Thus, use one finger for separate observation and three fingers for combined observation.
Furthermore, when examining the three positions, start with Guan, then Cun, then Chi, for both sides.
Furthermore, modern practitioners examine men's Left pulse first and women's Right pulse first. There is no fundamental difference between male and female pulses; such rigidity is unnecessary.
Furthermore, all human pulses value Stomach Qi. Stomach Qi is harmonious Qi. Regardless of position, if the pulse feels harmonious upon pressing, it possesses Stomach Qi. It is not limited to the Right Guan being harmonious.
Furthermore, Spleen and Stomach are exterior-interior pairs. Stomach disease affects Spleen, and Spleen disease affects Stomach. When diseased, how can Stomach Qi exist? Therefore, Spleen and Stomach pulses are observed together, which is why both are palpated at the Right Guan.
Furthermore, when Stomach Qi is strong, the pulse becomes more minute; when Stomach Qi is weak, the pulse becomes more excessive. Thus, excessive fullness at Right Guan indicates deficiency of Stomach Qi. However, Right Guan fullness often stems from Left Guan fullness. If Left Guan is full, Right Guan cannot be weak; this reflects Wood overcoming Earth, a phenomenon one must recognize.
Furthermore, predecessors considered Chi pulse as the root, suggesting emphasis on Chi. While a uprooted tree has few branches, excessive destruction (like storms breaking trees) exhausts the root too. Thus, the three positions must be observed collectively.
Furthermore, Cun, Guan, and Chi have Inner/Outer distinctions based on Left/Right, not Up/Down. I detailed this in my commentary on *Neijing*. Gui Zhenjun omitted this for brevity.
Furthermore, regarding positioning: Cun corresponds to Heart (and Pericardium/Shanzhong) on the Left, and Lung (and chest/throat) on the Right. Guan corresponds to Liver (and Gallbladder/flanks/diaphragm) on the Left, and Spleen (and Stomach) on the Right. Chi corresponds to Kidney Water (Small Intestine/Bladder/lower abdomen/thighs/knees) on the Left, and Kidney Fire (Large Intestine/waist/calves) on the Right. The San Jiao (Triple Burner) has Upper, Middle, and Lower aspects corresponding to Cun, Guan, and Chi respectively, not specifically the Right Kidney. Although Mingmen is the master of twelve meridians and technically not the Right Kidney, it is observed at the Right Chi. Once locations are clear, palpation is unambiguous.
Furthermore, Gui Zhenjun’s positioning aligns with *Neijing*, differing significantly from Wang Shuhe’s. People are surprised. Gui Zhenjun likely focused on Five Zang organs to avoid confusion, omitting Six Fu organs. Chen Shiduo elaborates to clarify diagnosis, though perhaps redundantly.
Furthermore, Five Zang organs have exterior-interior relationships: Heart-Small Intestine, Liver-Gallbladder, Lung-Large Intestine, Spleen-Stomach, Kidney-Bladder. Exterior disease affects Interior. Treating Interior treats Exterior. One need not rigidly separate Zang (Interior) from Fu (Exterior).
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Chapter Four
Gui Zhenjun stated: Pulse diagnosis determines life and death; timing predicts duration. In Cold Damage and Heat Diseases, Full-Rapid (Hong Da) indicates survival, Deep-Fine (Chen Xi) indicates death. In postpartum heat diseases, Slow-Smooth (Huan Hua) is auspicious, Wiry-Urgent (Xian Ji) is ominous. For headaches, Floating-Smooth (Fu Hua) indicates survival, Short-Rough (Duan Se) indicates death. For abdominal distension, Empty-Small (Xu Xiao) indicates death, Large-Floating (Da Fu) indicates survival. For dysentery, Minute-Small (Wei Xiao) indicates survival, Floating-Hong (Fu Hong) indicates difficult treatment. For mania, Full-Large (Shi Da) indicates recovery, Deep-Fine (Chen Xi) indicates untreatable decline. For diabetes (Xiao Ke), Rapid-Large (Shu Da) indicates vitality, Empty-Small (Xu Xiao) indicates Yin exhaustion. For cholera, Floating-Hong (Fu Hong) has no fixed death rule, Minute-Slow (Wei Chi) fears Yang collapse. For stroke, Slow-Floating (Chi Fu) is favorable, Urgent-Full (Ji Shi) is incurable. For sudden evil, Tight-Fine (Jin Xi) is suitable, Floating-Large (Fu Da) is hard to recover. For heart pain, Deep-Fine (Chen Xi) is easier to treat than Floating-Large (Fu Da); for edema, Large-Floating (Da Fu) is harder to treat than Deep-Fine (Chen Xi). For hematemesis and epistaxis, Deep-Weak/Fine (Chen Ruo/Xi) indicates survival, Full/Large/Floating (Shi Da/Fu Da) indicates death omen. For poisoning and intestinal abscesses, Full-Hong/Smooth (Hong Da/Hua Da) is auspicious, Minute-Fine/Smooth (Wei Xi/Hua Xi) is critical. For wheezing, Floating-Smooth (Fu Hua) is suitable, Short-Rough (Duan Se) indicates death. For cough, Floating-Soft (Fu Ru) is acceptable, Deep-Hidden (Chen Fu) indicates certain death. For chronic diarrhea, Minute-Fine (Wei Xi) is suitable, Floating-Hong (Fu Hong) leads to death. For new postpartum, Large-Wiry (Da Xian) is taboo, Slow-Smooth (Huan Hua) is safe. For vomiting, Empty-Fine (Xu Xi) is auspicious, Full-Large (Shi Da) is ineffective. For consumption (Lao Zhai), Floating-Smooth (Fu Hua) is good, Fine-Rapid (Xi Shu) is ineffective. For night sweats, Tight-Rapid (Jin Shu) is disliked, Empty-Small (Xu Xiao) is safe. For blood loss, Floating-Hong (Fu Hong) is feared, Fine-Weak (Xi Ruo) is pleasing. For internal excess, Floating-Hong (Fu Hong) is auspicious, Deep-Fine (Chen Xi) risks change. For internal deficiency, Deep-Fine (Chen Xi) is auspicious, Floating-Large (Fu Da) lacks survival signs. For bi syndrome, Floating-Large (Fu Da) is disliked, Fine-Rough (Xi Se) prolongs illness. For jue disease, Tight-Wiry (Jin Xian) is taboo, Full-Rapid (Hong Shu) resolves it. For masses (Zheng Jia), Fine-Minute (Xi Wei) is pleasing, Wiry-Smooth (Xian Hua) is dangerous. For dizziness, Floating-Smooth (Fu Hua) is suitable, Deep-Rough (Chen Se) is dangerous. For jaundice, Urgent-Rapid (Ji Shu) is unsuitable, Slow-Smooth (Chi Hua) facilitates resolution. For white strangury, Soft-Slow (Ru Chi) is valued, Rough-Weak (Se Ruo) is hard to stop. For constipation, arising from Fine-Minute (Xi Wei), Full-Hong (Hong Da) indicates Yin exhaustion. For sweating therapy, arising from Empty-Small (Xu Xiao), Wiry-Hong (Xian Hong) indicates Yang collapse. For abdominal pain, Deep-Hidden (Chen Fu) often leads to death. For hypochondriac pain, Hollow-Large (Kou Da) leads to death. For collapse, Knotted-Intermittent (Jie Dai) is hard to survive. For wheezing, Hurried-Leathery (Cu Ge) leads to death. For guan-ge, Rough-Floating (Se Fu) enters the underworld. For carbuncles, Smooth-Large (Hua Da) indicates survival. For chest binding, Deep-Tight (Chen Jin) implies half-death. For organ knotting, Floating-Smooth (Fu Hua) indicates quick recovery. For direct invasion of Yin meridians, death involves intermittent pulses. For sudden heat disease, survival involves Floating-Hong pulses. For macules, Full-Hong (Hong Da) is not necessarily fatal; for dysphagia, Fine-Rapid (Xi Shu) is not vital. For hemiplegia, Wiry-Smooth (Xian Hua) is manageable. For facial deviation, Rapid-Large (Shu Da) is treatable. For locked-jaw dysentery, Knotted-Rough (Jie Se) is hard to treat. For summerheat, Floating-Deep (Fu Chen) need not alarm. For clutching clothes, Fine-Small (Xi Xiao) offers hope. For enuresis/open hands, Hurried-Leathery (Cu Ge) leads to death. For blue veins/shrunken scrotum, Minute-Short (Wei Duan) leads to death. For black tongue/stiffness, Rapid-Large (Shu Da) with scorched appearance indicates death. For protruding navel/cracked lips, Knotted-Intermittent (Jie Dai) indicates death; open mouth/swollen feet with Short-Urgent (Duan Cu) pulses delay nothing. For hiccups, Short-Scattered (Duan San) leads to death. For restlessness, Weak (Wei Ruo) with appetite suggests survival. For blood晕, Scattered-Hurried (San Cu) leads to immediate death. For intestinal obstruction, Pounding-Firm (Bo Jian) indicates imminent death.
Additionally, Intermittent-Hook (Dai Gou) images indicate Heart death within nine days; Stone-tapping (Dan Shi) indicates Kidney death within seven days; Bow-string (Gong Xian) indicates Liver death within eighteen days; Cauldron-boiling (Fu Fei) indicates Spleen death within four or three days; Floating-water (Fu Shui) indicates Lung death within twelve days. There are secret methods passed down. Seeing shrimp-swimming (Xia You) predicts death in eight days; seeing sparrow-pecking (Que Zhuo) predicts death in seven days; seeing blowing-feather (Chui Mao) predicts critical danger in four days; seeing pulling-rope (Duo Suo) predicts death in one day; seeing house-leak (Wu Lou) predicts death in five days. Other deaths can be inferred similarly.
Chen Shiduo stated: Death pulses are not limited to these, but recognizing them aids in determining survival.
Furthermore, *Suwen* and *Lingshu* detail death pulses comprehensively; consulting both ensures accuracy.
Furthermore, death pulses depend on Shen (Spirit). Shen indicates Stomach Qi. With Stomach Qi, even death pulses may survive; without Stomach Qi, even life pulses will die. Clinical judgment is key.
Furthermore, do not lightly predict death dates. Proper medication may extend life even if cure is impossible. The text's date predictions are not absolute; stating inevitability without specific dates is preferable.
Furthermore, sudden death pulses are easier to save as organ connection is recent and roots remain. Long-standing death pulses are hopeless even with Ginseng.
Furthermore, minute-almost-extinct pulses often indicate death, but hidden (Fu) pulses mimicking this may not be truly extinct. Once the pulse emerges losing its minute quality, it is distinct. These are hard to distinguish; combine with symptoms, do not rely solely on palpation.
Furthermore, pulses like fish-swimming, sparrow-pecking, stone-tapping, rope-untying, house-leaking, blowing-feather are definitely death pulses. Absence of these does not guarantee life. Value Shen. If pulses feel present initially but vanish upon repressing, or are scattered/disordered/lacking spirit, they are death pulses even if not immediate. Intermittent/Knotted pulses with Shen may be temporary phlegm or cold-pain blockages, indicating life. Determining life/death relies entirely on the presence or absence of Shen.
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Chapter Five
Pulses of Women and Children
Gui Zhenjun stated: Yin and Yang follow one path; men and women share similar forms. Five Zang are identical; no need to separate. Three positions are one; no need for disparate discussion. Only pregnancy differs from men, requiring specific analysis for women. Slippery pulse at Chi indicates irregular menstruation and leukorrhea/dysuria. Rough pulse at Guan indicates cessation of Tian Gui (menstruation) and stagnation. Slippery Left Cun and Large Left Chi indicate pregnancy. Rapid Left Chi and Micro Left Guan indicate conception. Left Cun with longitudinal flow indicates two males; Right Cun with longitudinal flow indicates two females. Large Left Guan and Left Chi with smooth Heart pulse indicate three males; Large Right Guan and Right Chi with smooth Heart pulse indicate three females. However, stagnation in any position casts doubt on pregnancy; lack of smoothness in all pulses precludes claiming pregnancy. Fetus dead/mother alive: Chi Floating, Cun Deep. Mother dead/fetus alive: Chi Rough, Cun Hidden. Fetus relates to Kidney (Chi); Chi Floating means fetus lacks vitality. Mother relates to Lung (Cun); Cun Deep means mother has vitality. Fetus at Chi; Chi Rough means fetus Qi remains. Mother at Cun; Cun Floating means mother's root is severed. Deep-Fine pulse indicates impending miscarriage; Floating-Smooth pulse indicates imminent delivery. Abdominal/back pain indicates immediate birth. Fluid rupture does not guarantee survival. Heavy body/cold/extremities/blue face/pulse: not fearful. Heart vexation/blood dryness/black tongue/cut pulse: worrying. Mother/fetus hard to save: foam at lips. Both survive: yellowish complexion. New postpartum Slow pulse retains Stomach Qi; Smooth pulse preserves Spleen Yin. Full-Large pulse is bad; Wiry-Urgent pulse is ominous. Deep-Small is favorable; Rough-Hurried is adverse. Micro pulse allows Yang recovery; Hong pulse worries due to cold extremities. Such are women's pulses. How about children? All three positions may be Rapid, fearing only Deep-Slow. Six channels prefer uniform length, dislike Small-Fine. Wiry-Tight should not surge suddenly, fearing wind evil. Empty-Soft should not be common, fearing water qi. Urgent pulse under fingers indicates vomiting/abdominal pain. Large pulse floating before Guan indicates diarrhea/dysentery with heart fright. Understanding this allows understanding others.
Chen Shiduo stated: Men's and women's diseases are similar, allowing shared diagnosis. Pregnancy/postpartum differs slightly, hence the detailed chapter. Children need not have pulses taken as Qi/Blood are incomplete and pulses inaccurate. Gui Zhenjun's comments on children are generalizations. Children are Pure Yang; diseases are mostly dietary, fright, malnutrition, vomiting, diarrhea. These words summarize well.
Furthermore, women's pulses differ mainly in Left Chi being fuller. In men, Left Chi fullness is bad; in women, it indicates abundant Yin-Blood, auspicious for conception.
Furthermore, women's diseases are hardest to treat due to emotional depression. Depression blocks Qi/Blood, closing menses, showing Rough pulse at Left Guan. Observing women's pulses values palpating Liver pulse to check for Roughness. This is the primary secret. Roughness elsewhere indicates less severe depression if Left Guan is not rough.
Furthermore, children's Wiry/Urgent/Tight pulses indicate external evil; otherwise, internal injury. Treat internal injury by tonifying Spleen/Stomach first. Even for external evil, protect Zheng Qi. Do not solely dispel evil if pulses are purely Wiry/Tight/Urgent.
*Maixue Chanwei*
Xing Xibo
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Chinese Medical Treasures Pavilion
Preface