肺朝百脉，〔难经曰∶寸口者，脉之大会。肺居至高，脏腑各经之气，无不上熏故也。〕气
口寸成，以决死生。〔气口、即寸口，六部皆统于肺脉。〕尺外以候肾，〔尺脉前半部也。背为阳，肾
附于背也。〕尺里以候腹。〔尺脉后半部也。腹为阴，小肠、膀胱在腹也。余仿此。〕中附上，
〔言附尺之上而居乎中者，即关脉也，掌后高骨之分。〕左外以候肝，内以候鬲；〔举鬲而言，则中
焦之鬲膜、胆腑在其中矣。〕右外以候肾，内以候脾。上附上，〔言上而又上，即寸脉也。〕右外以
候肺，内以候胸中；〔鬲膜之上皆是，即寸主上焦，关主中焦，尺主下焦之义。〕左外以候心，内以
候膻中。《脉诀云∶包络与心，左寸之应；惟胆与肝，左关所认；膀胱小肠肾，左尺为定；胸中及肺
，右寸昭
彰；胃与脾，属在右关，大肠并肾，右尺班班。〕人一呼，脉再动，一吸，脉亦再动，呼吸定息，脉五动
，闰以太
息，命曰平人。〔一呼一吸为一息，四至为平和，而五至亦为平脉者，人之气息，时长时短，凡鼓三息
，必有一息之长，鼓
五息，又有一息之长，名为太息，如岁一闰，五岁再三象历
闰也。〕一呼脉一动，一吸脉一动，曰少气。〔一息三至为迟、迟则为寒，二至转寒，而阳气衰少
可知。〕一呼脉三动，一吸脉三动而躁，尺热，曰病温；尺不热，脉滑，曰病风。〔一息六至为数
。躁者，急病也。尺热，言尺后近臂有热，则必通身皆热，脉数躁而身发热，故知病温；数滑而身不
热，当病内风，以外风身必热也。〕一呼脉四动以上曰死，脉绝不至曰死，〔荣卫已绝也。〕乍疏乍
数曰死。〔气血溃乱也。〕持脉有道，虚静为保。〔言贵虚其心，静其志，保不失也。〕切脉动静，
〔脉诊也。〕而视精明，〔视目之精明，神诊也。〕察五色，〔色诊也。〕观五脏，有余不足，
六腑强弱，〔证诊也。〕形之盛衰，〔形诊也。〕以此参伍，决死生之分。〔以此数者、与脉参伍推
求，则阴阳表里虚实寒热，自无遁状。可以决生死之分。不齐之谓参，剖其异而分之也。相类之谓伍
，比其同而合之也。〕诊病不问其始，〔是不求其本也。〕忧患饮食之失节，〔内因也。〕起
居之过度，〔外因也。〕或系于毒，〔不内外因也。〕不先言此，卒持寸口，何病能中，妄言作名，
为粗所穷。一日一夜五十营，以荣五脏之精，不应数者，名曰狂生。〔营者运也，经脉营运于身，昼
夜凡五十周，以运五脏之精。其有太过不及，则不应此数矣。狂者妄也，犹言幸而生也。〕所谓
五十营者，五脏皆受气，持其寸口，数其至也。五十动而不一代者，五脏皆受气；四十动一代者，
一脏无气；三十动一代者，二脏无气；二十动一代者，三脏无气；十动一代者，四脏无气；不满十动一
代者，五脏无气。予之短期，要在终始。〔短期，死期也。终始，本经篇名。〕所谓五十动而不一代
有，以为常也，以知五脏之气。予之短期者，乍数乍疏也。
日春胃微弦平，〔春弦夏洪，秋毛冬石，四季之末，和缓不忒，此时令之平脉也。故宜微弦微
毛微石，而不至太过，是谓胃气之冲和也。〕弦多胃少曰肝病，〔弦多者，过于弦也。胃少者，少
和缓也。〕但弦无胃曰死。〔但弦急而无冲和之气，是胃气已绝，而肝之真脏脉见。〕胃而有毛曰
秋病，〔春得秋脉是贼邪，以胃气尚存，故至秋病。〕毛甚！曰今病。
夏胃微钩曰平，〔钩即洪脉也，万物畅茂，垂枝布叶，下而如钩也。〕钩多胃少曰心病，但钩无
胃曰死。胃而有石曰冬病，石甚曰今病。
长夏胃微软弱曰平，弱多胃少曰脾病，但弱无胃曰死。软弱有石曰冬病，石甚曰今病。
秋胃微毛曰平，〔浮涩而和缓，类羽毛之轻虚也。〕毛多胃少曰肺病，但毛无胃曰死。毛而有弦
曰春病，弦甚曰今病。
冬胃微石曰平，〔即沉也，如石沉水之谓。〕石多胃少曰肾病，但石无胃曰死。石而有钩曰夏
病，钩甚曰今病。
人以水谷为本，故人绝水谷则死，脉无胃气亦死。所谓无胃气者，但得真脏脉，不得胃气也。〔
即但弦但石之类。〕所谓脉不得胃气者，肝不弦，肾不石也。〔肝无气则不弦，亦由不得胃气而然，
与真脏无胃者等耳。〕察九候，〔三部各浮中沉三候，共得九候。〕独小者病，独大者病，独疾者
病，独迟者病，独热者病，独寒者病，〔独者言三部之中察其独异于他部者，推其病之所在也。独热，
阳部得阳脉也，独寒，阴部得阴脉也。〕独陷下者病。〔沉伏而不起也。〕夫脉者血之腑也，〔营行脉
中，故为血腑，然血随气行，实兼而言也。〕长则气治，〔气足则脉长。〕短则气
病，〔气虚则脉短。〕数则烦心，〔火热盛也。〕大则病进。〔邪方张也。〕上盛则气高，〔寸盛则火
亢气逆。〕下盛则气胀，〔关尺盛则邪实胀满。〕代则气衰，〔气将绝也。〕细则气少，〔气不充也。
〕涩则心痛。〔血少气滞。〕浑浑革至如涌泉，病进而色弊，绵绵其去如弦绝，死。〔浑浑者，汹涌
之貌。革脉之至，如皮革之坚急也。涌泉，状其盛满也，见此脉者，病渐增进，而色夭不泽也。绵绵弦绝，
则胃气绝而真脏脉见，故死。〕形气相得者生，〔如形盛脉大，形瘦脉细，是也。〕形盛脉细，少气不
足以息者危。〔外有余而中不足也。〕形瘦脉大，胸中多气者死。〔阴不足而阳有余也，阴形既败，孤阳
无附矣。〕脉气有余，形气不足生。〔若形虽衰，脉未败，根本犹存，与形脱之大肉去尽不同。〕形气
有余，脉气不足，死。〔外貌无恙，脏气已坏也。〕
形肉已脱九候虽调，犹死。〔脾主肌肉，为脏之本，肉脱则脾绝，脉虽调无益也。〕三部九候皆相
失者，死。〔应大反小，应小反大也。〕夫精明五色者，气之华也，〔精明见于目，五色显于面，皆五气之
精华，言气而血在其中也。〕青欲如苍璧之泽，不欲如蓝；赤欲如白裹朱，不欲如赭；黄欲如罗裹雄黄，
不欲如黄土；白欲如鹅羽，不欲如盐；黑欲如重漆，不欲如地苍。〔地之苍黑色。五色之欲者，皆取其
润，五色之不欲者，皆恶其枯槁也。〕五色精微象见矣，其寿不久也。〔此皆五色精微之象，凶兆既见
，寿不远矣。〕得神者昌，失神者亡。能合色脉，可以万全。色青者其脉弦，赤者其脉钩，黄者其脉代，
白者其脉毛，黑者其脉石。〔色脉相应者顺。〕见其色而不得其脉，〔色脉相悖者逆。〕
反得其相胜之脉则生矣，〔色脉相克者凶。〕得其相生之脉，则病已矣。〔色脉相生者吉。〕面青
目赤，面青目黑，面赤目青，面赤目白，面黑目白，皆死。〔色中无黄，胃气已绝，〕赤色出两颧，
〔两颧亦为肺部。〕大如母指者，〔成块成条，聚而不散也。〕病虽小愈，必卒死。黑色出于庭，〔
天庭，处于至高，黑干之，是肾绝也。〕大如拇指，必不病而卒死。
The Lung governs all the vessels. (Nan Jing states: The Cun Kou is the great assembly of the pulses. Because the Lung resides at the highest position, the Qi of all Zang-Fu organs and meridions ascends to it.) By examining the Qi Kou (Cun Kou), one can determine life and death. (Qi Kou is identical to Cun Kou; the six positions are all governed by the Lung pulse.) The outer part of the Chi position observes the Kidney. (This refers to the anterior half of the Chi pulse. The back belongs to Yang, and the Kidneys attach to the dorsal spine.) The inner part of the Chi position observes the abdomen. (This refers to the posterior half of the Chi pulse. The abdomen belongs to Yin, where the Small Intestine and Bladder reside. Others follow this pattern.) The Guan position attaches above the Chi and resides in the middle. (Referring to the position attaching above the Chi and situated centrally, i.e., the Guan pulse, located at the prominence of the wrist bone.) On the left side, the outer Guan observes the Liver, and the inner Guan observes the Diaphragm. (Mentioning the Diaphragm implies that the diaphragmatic membrane and Gallbladder in the Middle Jiao are included.) On the right side, the outer Guan observes the Kidney, and the inner Guan observes the Spleen. The Cun position attaches above the Guan and is higher still. (Referring to the position even higher up, i.e., the Cun pulse.) On the right side, the outer Cun observes the Lung, and the inner Cun observes the Chest Center. (This covers the area above the diaphragm, illustrating the principle that Cun governs the Upper Jiao, Guan governs the Middle Jiao, and Chi governs the Lower Jiao.) On the left side, the outer Cun observes the Heart, and the inner Cun observes the Dan Zhong (Pericardium). *Mai Jue* says: The Pericardium and Heart correspond to the Left Cun; only the Gallbladder and Liver are recognized by the Left Guan; the Bladder, Small Intestine, and Kidney are fixed by the Left Chi; the Chest Center and Lung are clearly shown by the Right Cun; the Stomach and Spleen belong to the Right Guan; the Large Intestine and Kidney are distinct in the Right Chi. When a person exhales, the pulse beats twice; when inhaling, the pulse also beats twice. Between breaths, the pulse beats five times, occasionally supplemented by a deep sigh (Tai Xi), which is called a "Ping Ren" (healthy person). (One exhalation and one inhalation constitute one breath. Four beats are peaceful, and five beats are also considered normal because human respiration varies in length. Every three breaths, there is often one longer breath; every five breaths, there is one longer breath, called Tai Xi, similar to having leap months in a calendar cycle.) If the pulse beats once per exhalation and once per inhalation, it is called "Shao Qi" (deficient Qi). (Three beats per breath indicate a Slow pulse, which indicates Cold. Two beats indicate severe Cold, revealing the deficiency of Yang Qi.) If the pulse beats three times per exhalation and three times per inhalation, and is rapid, with heat in the Chi region, it is a Warm disease. If the Chi region is not hot but the pulse is slippery, it is a Wind disease. (Six beats per breath constitute a Rapid pulse. "Rapid/agitated" indicates an acute condition. Heat in the Chi region means heat near the forearm on the Chi side, implying whole-body heat. A rapid, agitated pulse with body heat indicates a Warm disease. A rapid, slippery pulse without body heat suggests internal Wind, as external Wind would cause body heat.) If the pulse beats more than four times per exhalation, it indicates death. If the pulse ceases completely, it indicates death (the Wei Qi and Ying Qi have severed). If the pulse is irregularly slow and rapid, it indicates death (the Qi and Blood are chaotic). There is a way to hold the pulse: emptiness and tranquility serve as the guarantee. (Meaning one must keep the mind empty and the will quiet to ensure accuracy.) Palpating the movement and stillness of the pulse (Pulse diagnosis), while observing the clarity of the eyes (Spirit diagnosis), inspecting the five colors of the face (Color diagnosis), observing the excess or deficiency of the Zang organs and the strength or weakness of the Fu organs (Symptom diagnosis), and assessing the flourishing or declining state of the body form (Form diagnosis)—by cross-referencing these factors, one can decide the division between life and death. (By cross-referencing these aspects with the pulse, the conditions of Yin/Yang, Interior/Exterior, Excess/Deficiency, and Cold/Heat will be revealed without hiding. One can then determine life or death. "Can" refers to disparity and differentiation; "Wu" refers to similarity and integration.) If one diagnoses a disease without asking about its onset, (failing to seek the root), including emotional distress, dietary irregularities (Internal causes), excessive daily activities (External causes), or poisoning (Neither-internal-nor-external causes), and suddenly palpates the Cun Kou without this information, how can one accurately identify the disease? Making wild guesses leads to being confounded by the crude. In one day and night, the Qi circulates fifty rounds to nourish the essence of the five Zang organs. If it does not conform to this number, it is called "Kuang Sheng" (abnormal survival). (Ying refers to circulation; the meridional Qi circulates fifty times daily to transport the essence of the five Zang organs. Deviations from this count indicate abnormality.) The so-called fifty rounds mean that the five Zang organs all receive Qi. Holding the Cun Kou and counting the beats: if there are fifty beats without any interruption, the five Zang organs all receive Qi; if there is one interruption in forty beats, one Zang lacks Qi; in thirty beats, two Zang lack Qi; in twenty beats, three Zang lack Qi; in ten beats, four Zang lack Qi; if there is an interruption in fewer than ten beats, all five Zang lack Qi. Predicting the short term (death date) depends on the beginning and end (Zhi Shi chapter). The so-called fifty beats without interruption is the norm, used to know the Qi of the five Zang. The indication for predicting death is an irregularly rapid or slow pulse.
In Spring, a pulse with slight Stomach Qi and a wiry quality is normal. (Spring is wiry, Summer is surging, Autumn is floating/hairy, Winter is sunken/stony; the end of each season shows a harmonious and moderate pulse. Thus, slight wiry, slight hairy, and slight stony pulses are normal, provided they are not excessive, indicating the harmony of Stomach Qi.) If the wiry quality is strong and Stomach Qi is weak, it is Liver disease. (Strong wiry means excessive tension; weak Stomach Qi means lack of moderation.) If there is only wiry without Stomach Qi, it indicates death. (Only tense wiry without harmony indicates the exhaustion of Stomach Qi and the appearance of the true organ pulse of the Liver.) If Stomach Qi is present but accompanied by a hairy (floating) pulse, illness will occur in Autumn. (Seeing the Autumn pulse in Spring is a hostile pathogen; because Stomach Qi remains, illness manifests in Autumn.) If the hairy pulse is very strong, illness occurs now.
In Summer, a pulse with slight Stomach Qi and a hook (surging) quality is normal. (Hook is synonymous with Surging pulse; like abundant vegetation with drooping branches.) If the hook quality is strong and Stomach Qi is weak, it is Heart disease. If there is only hook without Stomach Qi, it indicates death. If Stomach Qi is present but accompanied by a stony (sunken) pulse, illness will occur in Winter. If the stony pulse is very strong, illness occurs now.
In Late Summer, a pulse with slight Stomach Qi and a soft/weak quality is normal. If the weak quality is strong and Stomach Qi is weak, it is Spleen disease. If there is only weak without Stomach Qi, it indicates death. If the weak pulse is accompanied by a stony pulse, illness will occur in Winter. If the stony pulse is very strong, illness occurs now.
In Autumn, a pulse with slight Stomach Qi and a hairy (floating) quality is normal. (Floating, slightly choppy, yet harmonious, resembling the lightness of feathers.) If the hairy quality is strong and Stomach Qi is weak, it is Lung disease. If there is only hairy without Stomach Qi, it indicates death. If the hairy pulse is accompanied by a wiry pulse, illness will occur in Spring. If the wiry pulse is very strong, illness occurs now.
In Winter, a pulse with slight Stomach Qi and a stony (sunken) quality is normal. (Sunken, like a stone sinking in water.) If the stony quality is strong and Stomach Qi is weak, it is Kidney disease. If there is only stony without Stomach Qi, it indicates death. If the stony pulse is accompanied by a hook (surging) pulse, illness will occur in Summer. If the hook pulse is very strong, illness occurs now.
Humans rely on water and grain as their foundation; thus, humans die when deprived of water and grain, and the pulse dies when devoid of Stomach Qi. So-called "devoid of Stomach Qi" means obtaining only the true organ pulse without Stomach Qi. (Such as purely wiry or purely stony pulses.) So-called "pulse lacking Stomach Qi" means the Liver pulse is not wiry, and the Kidney pulse is not stony. (When the Liver lacks Qi, the pulse is not wiry; this is also due to the lack of Stomach Qi, equivalent to the true organ pulse without Stomach Qi.) Inspecting the Nine Positions (three positions—Cun, Guan, Chi—each assessed at superficial, middle, and deep levels, totaling nine positions): if one is uniquely small, it is disease; uniquely large, disease; uniquely rapid, disease; uniquely slow, disease; uniquely hot, disease; uniquely cold, disease; (Unique refers to anomalies found in one position compared to others, locating the pathology. Unique heat indicates Yang position receiving Yang pulse; unique cold indicates Yin position receiving Yin pulse.) uniquely depressed/sunken, disease. (Deep and hidden, failing to rise.) The pulse is the residence of blood. (Ying Qi flows within the vessels, hence it is the residence of blood; however, since blood follows Qi, it is discussed jointly.) A long pulse indicates regulated Qi. (Sufficient Qi results in a long pulse.) A short pulse indicates diseased Qi. (Deficient Qi results in a short pulse.) A rapid pulse indicates vexation in the heart. (Excessive fire/heat.) A large pulse indicates advancing disease. (Pathogenic factors are rampant.) Excess in the upper part indicates high Qi (asthma/reversal). (Excess in Cun indicates hyperactive fire and reversed Qi.) Excess in the lower part indicates abdominal distension. (Excess in Guan/Chi indicates pathogenic fullness and distension.) An intermittent pulse indicates Qi decline. (Qi is about to sever.) A fine pulse indicates deficient Qi. (Qi is insufficient.) A choppy pulse indicates heart pain. (Blood deficiency and Qi stagnation.) A pulse that is turbulent and rushing like a gushing spring, with disease progressing and complexion deteriorating; or a pulse that fades away slowly like a breaking string, indicates death. (Turbulent describes a surging appearance. The Ge pulse feels hard and urgent like leather. Gushing spring describes fullness. Seeing this pulse means disease progresses and complexion becomes dull. Fading like a broken string indicates the severance of Stomach Qi and the appearance of the true organ pulse, hence death.) If body form and Qi are compatible, life prevails. (e.g., robust form with large pulse, thin form with fine pulse.) If the body form is robust but the pulse is fine, and there is insufficient Qi to breathe, it is critical. (Excess externally, deficiency internally.) If the body form is thin but the pulse is large, with excessive Qi in the chest, it indicates death. (Yin deficiency and Yang excess; with Yin form destroyed, lone Yang has no attachment.) If pulse Qi is excessive but body Qi is deficient, life prevails. (If the form is weak but the pulse is not exhausted, the root remains, unlike total emaciation.) If body Qi is excessive but pulse Qi is deficient, it indicates death. (Appearance seems normal, but visceral Qi is ruined.)
If flesh and muscles are already depleted, even if the nine positions are harmonious, death ensues. (Spleen governs muscles and is the root of the Zang; muscle depletion means Spleen failure, rendering harmonic pulses useless.) If all three parts and nine positions are discordant, death ensues. (Expected large but actually small, expected small but actually large.) The clarity of the eyes and the five colors are the splendor of Qi. (Clarity appears in the eyes, five colors manifest on the face; these are the essences of the five Qi, implying blood is included within Qi.) Green should resemble the luster of dark jade, not blue grass; Red should resemble cinnabar wrapped in white silk, not hematite; Yellow should resemble realgar wrapped in gauze, not yellow earth; White should resemble goose feathers, not salt; Black should resemble heavy lacquer, not dark earth. (Desired colors seek moisture/luster; undesired colors fear dryness/withered appearance.) If the subtle images of the five colors appear [as ominous signs], lifespan is not long. (These are ominous signs of the five colors' essence; once seen, life is short.) Those who possess Shen (Spirit) prosper; those who lose Shen perish. Integrating color and pulse ensures complete success. Green complexion corresponds to a wiry pulse; red to a hook pulse; yellow to an intermittent pulse; white to a hairy pulse; black to a stony pulse. (Matching color and pulse is favorable.) Seeing the color but not finding the corresponding pulse is unfavorable. (Color and pulse contradict.) If instead, a controlling (clashing) pulse is found, life may prevail. (Color and pulse clash is ominous.) If a generating pulse is found, the disease will resolve. (Color and pulse generate is auspicious.) Green face with red eyes, green face with black eyes, red face with green eyes, red face with white eyes, black face with white eyes—all indicate death. (Absence of yellow in the face indicates exhaustion of Stomach Qi.) Red color appearing on both cheekbones (cheekbones also relate to the Lung), size like a thumb (clumped and不散), although the disease may seem mild, sudden death will occur. Black color appearing on the Tian Ting (forehead, the highest point), size like a thumb, indicates Kidney exhaustion; even without obvious symptoms, sudden death will occur.