凡脉数脉迟者。数为热。迟为寒。诸阳为热。诸阴为寒。浮之损小。沉之实大。名曰阳虚阴盛。阳虚者。轻手按之
浮而损小。阴盛者。重手按之。沉而实大。名曰阳虚阴盛也。沉之损小。浮之实大。名曰阳盛阴虚也。阳盛者。轻手按
之实大。阴虚者。重手按之而反损小。故曰阳盛阴虚也。
闻而知之者。谓之圣。盖五脏各有正声。声者。脏之音。中之守也。中盛则气腾。中虚则气弱。故脾应宫。其声慢
而缓大。肺应商。其声促而清冷。肝应角。其声悲而和杂。心应征。其声雄而清明。肾应羽。其声长而细。此五脏之正
声。得守者生也。其声促。是肺病。声雄。是心病。声慢。是脾病。声悲。是肝病。声沉。是肾病。声长。是大肠病。
声短。是小肠病。声迟。是胃病。声清。是胆病。声微。是膀胱病。声悲。是肝脾二脏相克声速微细。是胃膀胱相克声
轻。是虚声细。是痢。声粗。是风。声短。是气战声实。是秘泻。涩声灼。是内病。声短迟是泄脱。声如从实。中言者。
气之涩也。宫乃复言者。气之夺。谵妄不避善恶。神之乱也。欲声言意相续者。阴阳失守也。故失守者死。
望而知之谓之神。盖五脏之色。视之则知其病之有无。五色者。气之先也。其色赤。如绵裹朱砂者生。如 者死。
其色白。如白璧之泽者生。如垩者死。其色青。如苍泽者生。如蓝者死。其色黄。如绵裹雄黄者生。色如土者死。其色
黑。如鸦羽者生。色如炭者死。五色昏欲先光彩荣润者寿。皆不欲枯燥也其面色青者。冷气作痛。青黑皆痛也。面色黄。
是劳。赤是热。白是脱血。黑是风。青白皆为寒。目若赤为热。眼眯红湿者。下虚上热。睛黄是劳。目白是冷。病患心
绝者。则面 赤者。死在一日。肝绝则面如蓝青色。眼眶陷入。死在三日。脾绝者。面黄如土。四肢肿起。九日死肺绝
者。则面如白垩土。鼻入输。三日死。肾绝者。则面色黧黑。痿黄兼卒。呻吟四日死。筋绝者。爪甲黑。八日死。脉绝
四体张。唇青毛发干。五日死。骨绝者。齿如热豆。一日死。凡脚跗肿。身体沉重。卒失尿溺。妄言错乱。怒问屎臭。
阴囊肿。口反张。爪甲黑。目直视。如此者皆死也。形之盛衰。得强者生失强者死。头乃精明之府。头倾视深。精神夺
矣。背者。脑之府。背肿肩垂。形将坏矣。腰乃肾之府。转摇不能。肾将惫矣。仓廪不藏者。胃气不固也。水泉不禁者。
膀胱不闭也。无非失强之不可疗者。以表其形之衰惫矣。审形盛衰。诊妇人杂病。与男子同。
In cases where the pulse is rapid (Shu, fast) or slow (Chi, slow), a rapid pulse indicates Heat, while a slow pulse indicates Cold. All Yang conditions manifest as Heat, and all Yin conditions manifest as Cold. If the pulse feels weak and small upon superficial palpation (Fu, floating) but solid and large upon deep palpation (Chen, sinking), it is named "Yang Deficiency and Yin Excess." In Yang Deficiency, light pressure reveals a floating, weak, and small pulse; in Yin Excess, heavy pressure reveals a deep, solid, and large pulse; this is also termed "Yang Deficiency and Yin Excess." Conversely, if the pulse feels weak and small upon deep palpation but solid and large upon superficial palpation, it is named "Yang Excess and Yin Deficiency." In Yang Excess, light pressure reveals a solid and large pulse; in Yin Deficiency, heavy pressure reveals a pulse that is surprisingly weak and small; thus, it is called "Yang Excess and Yin Deficiency."
Diagnosis through hearing is referred to as "Sage" (the highest level of diagnostic skill). Each of the Five Zang Organs has its proper sound; the sound is the tone of the organ and the manifestation of its internal essence. When the interior Qi is abundant, the Qi surges; when the interior Qi is deficient, the Qi is weak. Therefore, the Spleen corresponds to the Gong note, with a sound that is slow, gentle, and expansive; the Lung corresponds to the Shang note, with a sound that is urgent, clear, and cold; the Liver corresponds to the Jue note, with a sound that is sorrowful yet harmonious; the Heart corresponds to the Zhi note, with a sound that is majestic and clear; the Kidney corresponds to the Yu note, with a sound that is long and fine. These are the proper sounds of the Five Zang Organs. Retaining these sounds indicates life. A hurried sound indicates Lung disease; a majestic sound indicates Heart disease; a slow sound indicates Spleen disease; a sorrowful sound indicates Liver disease; a deep sound indicates Kidney disease; a long sound indicates Large Intestine disease; a short sound indicates Small Intestine disease; a delayed sound indicates Stomach disease; a clear sound indicates Gallbladder disease; a faint sound indicates Bladder disease.
A sorrowful sound indicates the mutual overcoming between the Liver and Spleen; a rapid and fine sound indicates the mutual overcoming between the Stomach and Bladder; a light sound indicates Deficiency; a thin sound indicates Dysentery; a coarse sound indicates Wind pathogen; a short sound indicates Qi tremor; a solid sound indicates constipation or diarrhea; a rough sound accompanied by a burning sensation indicates an internal disease; a short and delayed sound indicates collapse from leakage; a sound seeming to come from solidity with interrupted speech indicates Qi stagnation; repeated Gong notes indicate the loss of Zheng Qi (Upright Qi); delirium regardless of good or evil indicates confusion of Shen (Spirit); the desire to speak but with discontinuous intent indicates the loss of Yin-Yang balance. Thus, those who lose this balance will die.
Diagnosis through observation is referred to as "Divine" (an extremely high level of diagnostic skill). Each of the Five Zang Organs has a corresponding color; observing the color reveals the presence or absence of disease. The five colors are the precursors of Qi luster. A red complexion like silk wrapping cinnabar indicates life; like raw cinnabar without processing indicates death. A white complexion like the luster of white jade indicates life; like white chalk indicates death. A green complexion like fresh verdigris indicates life; like indigo dye indicates death. A yellow complexion like silk wrapping realgar indicates life; like earth indicates death. A black complexion like crow feathers indicates life; like charcoal indicates death. If the five colors appear dull and lose their luster and moisture first, longevity is shortened; dryness and lack of luster are undesirable in all cases. A green face indicates pain caused by Cold Qi; green and black together indicate pain. A yellow face indicates exhaustion (Lao); red indicates Heat; white indicates blood loss; black indicates Wind; green and white both indicate Cold. Red eyes indicate Heat; swollen, red, and moist eyelids indicate lower deficiency and upper Heat; yellow sclera indicates exhaustion; cold white eyes indicate Cold.
If a patient's Heart Qi is exhausted, the malar region appears red like makeup, and death occurs within one day. If Liver Qi is exhausted, the face turns blue-green with sunken eye sockets, and death occurs within three days. If Spleen Qi is exhausted, the face is yellow like earth with swollen limbs, and death occurs within nine days. If Lung Qi is exhausted, the face is like white chalk with retracted nostrils, and death occurs within three days. If Kidney Qi is exhausted, the face is dark black, the body is emaciated and suddenly fails, accompanied by groaning, and death occurs within four days. If Sinew Qi is exhausted, the nails turn black, and death occurs within eight days. If Pulse Qi is exhausted, the four limbs spread open, lips turn cyan, and hair dries up, leading to death within five days. If Bone Qi is exhausted, teeth become dry and hot like beans, and death occurs within one day.
Cases involving edema of the dorsum pedis, heaviness of the body, sudden incontinence of urine and feces, delirious and confused speech, angry questioning about fecal odor, scrotal swelling, opisthotonos (retractions of the mouth/jaw), black nails, and fixed staring eyes are all fatal signs. Regarding the flourishing or declining state of the form, those retaining strength live, and those losing strength die. The head is the residence of Jing Ming (clear and bright spirit); a drooping head and deep-set eyes indicate the depletion of Spirit. The back is the residence of the Brain; swelling of the back and drooping shoulders indicate the impending ruin of the form. The waist is the residence of the Kidney; inability to twist or rotate indicates the impending exhaustion of the Kidneys. Failure of the Granary (Stomach/Spleen) to store indicates insecure Stomach Qi; incontinence of water springs (urine) indicates unsecured Bladder closure. These are all cases of lost strength that cannot be treated, demonstrating the decline and exhaustion of the form. Examining the flourishing or declining state of the form for diagnosing miscellaneous diseases in women is the same as for men.