平按∶此篇自篇首至末，见《素问》卷五第十八《平人气象论》篇，又见《甲乙经》卷四第一，惟编次小异。
黄帝问岐伯曰∶平人何如？对曰∶人一呼脉再动，人一吸脉亦再动，命曰平人。平人者，不
病也。医不病，故为病患平息以论法也。（平人病法，先医人自平，一呼脉再动，一吸脉再动，
是医不病调和脉也。然后数人之息，一呼脉再动，一吸脉再动，即是彼人不病者也。若彼人一呼
脉一动，一吸脉一动等，名曰不及，皆有病也。故曰∶医不病，为病患平息者也。平按∶《素问》、
《甲乙》一吸上无人字，命曰上有“呼吸定息脉五动，闰以太息”十一字。医不病上《素问》有
“常以不病调病患”七字，《甲乙》有“常以不病之人，以调病患”十字。以论法也《素问》作
“以调之为法”五字，《甲乙》作“以调之”三字。）人一呼脉一动，人一吸脉一动
者，曰少气。（呼吸皆一动，名曰不及，故知少气。平按∶一吸上《素问》、《甲乙》无人字。）
人一呼脉三动，一吸脉三动而躁及尺热，曰病温；尺不热，脉滑曰风，涩曰痹。（脉之三动，以是
气之有余，又加躁疾，尺之皮肤复热，即阳气盛，故为病温。病温，先夏至日前发也；若后夏至日
发者，病暑也。一呼三动而躁，尺皮不热，脉滑曰风，脉涩曰痹也。平按∶《甲乙》无“一吸脉
三动”五字。躁下《素问》、《甲乙》无及字，风上有病字。《素问》涩上有脉字。《甲乙》无
涩曰痹三字。）人一呼脉四至曰死，（四至阳气独盛，阴气绝衰，故死。平按∶四至《素问》作
四动以上，《甲乙》同。）脉绝不至曰死，（以手按脉，一来即绝，更不复来，故死。）乍疏乍
数曰死。（乍疏曰阴，乍数曰阳，阴阳动乱不次，故曰死也。）平人之常气禀于胃，胃者平人之
常气也，人无胃气曰逆，逆曰死。（和平之人，五脏气之常者，其气各各禀承胃气；一一之脏若
无胃气，其脉独见为逆，故致死。平按∶无胃气上《甲乙》作“人常廪气于胃脉，以胃气为本”
十二字。）春胃微弦曰平，（胃者，人迎胃脉也。五脏之脉，弦钩代浮石，皆见于人迎胃脉之中。
胃脉即足阳明脉，主于水谷，为五脏六腑十二经脉之长，所以五脏之脉欲见之时，皆以胃气将至
人迎也。胃气之状，柔弱是也。故人迎五脉见时，但弦钩代毛石各各自见，无柔弱者，即五脏各
失胃气，故脉独见，独见当死。春脉胃多弦少曰微，微曰平人。）弦多胃少曰肝病，（弦多胃少，
即肝少谷气，故曰肝病也。）但弦无胃曰死，（肝无谷气，致令肝脉独见，故死也。）胃而有毛
曰秋病，（春胃见时，但得柔弱之气，竟无有弦，然胃中有毛，即是肝时有肺气来乘，以胃气弦，
故至秋有病。平按∶注故至秋，故字袁刻误作欲。）毛甚
曰金病，（春得毛脉甚于胃气，以金克火，故曰金病也。平按∶金《素问》、《甲乙》作今。注
火字，恐系木字传写之讹。）脏真散于肝，肝脏筋之气。（脏真者，真弦脉也。弦无胃气曰散，
弦脉不能自散，以其肝脏散无胃气，所以真脏散于肝也。故肝藏神，藏于魂也；肝藏气者，藏筋
气也。平按∶《素问》、《甲乙》筋下有膜字。）夏胃微钩曰平，夏脉人迎胃多钩少曰微钩，微
钩曰平也。钩多胃少曰心病，（心病食少谷气少，令脉至人迎钩多胃少，故知心病也。平按∶
注令字袁刻作今。）但钩无胃曰死，（心病害食，心无谷气，致令钩无胃气，故死。）胃而有石
曰冬病，（心，火也。夏心王时遂得肾脉，虽有胃气，唯得石，冬时当病，以水克火。）石甚曰
今病，（夏有胃气，虽得石脉，至秋致病；今夏得石脉甚，少胃气，贼邪来克，故曰今病。）藏
真痛于心，心藏血脉之气。（心无胃气，即心有痛病，致令藏真脉见人迎，故曰脏真痛于心也。
故心藏神，藏于神气也；心藏气，藏血脉之气也。平按∶痛《素问》、《甲乙》作通。）长夏胃微
弱曰平，胃少弱多曰脾病，（ ，而免反，柔也。长夏，六月也。脾行胃气以灌四脏，故四脏脉
至于人迎皆有胃气，即四脏平和也；若脾病，不得为胃行气至于人迎，即四脏之脉各无胃气，故
四脏有病也。问曰∶长夏是脾用事，此言胃气，不言脾者，何也？答曰∶脾为其君，不可自见，
是以于长夏时得胃气者，即得脾气。故于长夏胃气见时微有不足，名曰平好。若更胃少复虚弱者，
即是脾病，致使胃气少而虚弱也。平按∶胃少弱多《素问》作弱多胃少《甲乙》作 弱。注为胃行
气，袁刻作气行。若更胃少复虚弱者，袁刻胃作至，复作腹。）但代无胃曰死，（人之一呼出心
与肺，脉有二动；一吸入肝与肾，脉有二动。人呼吸已定息之时，脾受气于胃，输与四脏以为呼吸，
故当定息。脾受气时，其脉不动，称之曰代。代，息也。当代之时，胃气当见；若脉代时无胃气，
则脾无谷
气，所以致死也。） 弱有石曰冬病，（长夏脾胃见时，中有肾脉，是为微邪来乘不已，至秋当
病也。平按∶注至秋，秋字根据经文应作冬。）弱甚曰今病，（脾胃之脉虚弱，其谷气微少，故即
今病也。平按∶弱《甲乙》作 ，注云∶《素》作弱。）脏真传于脾，脾藏肌肉之气。（脾脏真
脉谓之唯代，之无胃气，唯代之脉，从脾传来，至于人迎也。故脾脏藏神，藏于意也；脾脏藏气，
藏肌肉气也。平按∶传《素问》、《甲乙》作濡。注之无胃气，之字袁刻作若。）秋胃微毛曰平，
（秋时人迎胃多毛少，曰平人也。）胃少毛多曰肺病，（谷气少也。平按；胃少毛多《素问》、
《甲乙》作毛多胃少。）但毛无胃曰死，（真脏见脉。）毛而有弦曰春病，（肝来乘肺，是邪来
乘不已，至春木王之时当病。平按∶注是邪，根据上下注应作微邪。）弦甚曰今病，（有胃无毛，
但有弦者，是木反克金，故曰今病。）脏真高于肺，以行营卫阴泄曰死。（脏真之脉见时，高于
肺藏和平之气。高，过也。肺为阴也。无胃之气，既过肺之和气，即是肺伤。肺主行营卫，肺既伤
已，即是阴气泄漏，故致死也。平按∶阴泄曰死《素问》、《甲乙》作阴阳也三字。）冬胃微石
曰平，（冬人迎脉，胃 弱气多，石脉微者，名曰平人。）胃少石多曰肾病，（肾少谷气，故令
弱气少，坚石脉多，故知肾病。平按∶胃少石多《素问》作石多胃少。）但石无胃曰死，（脏真
脉见，故致死也。）石而有钩曰夏病，（石脉，水也。钩脉，火也。石脉见时，有钩见者，微邪来
乘不已，至夏当病也。）钩甚曰今病，（虽有胃气，钩甚，所以今病也。）脏真下于肾，肾藏骨髓
之气。（肾为五脏和气之下，今肾无胃气，乃过下于肾也。故肾脏藏神，藏于志也；肾脏藏气，
骨髓气也。自此以上，即是人迎胃脉候五脏气也。）胃之大络，名曰虚里，贯鬲络肺，出于左乳
下，其动应衣。（下诊胃络之脉。虚音墟。虚里，城邑居处也。此胃大络，乃是五脏
六腑所禀居处，故曰虚里。其脉出左乳下，常有动以应衣也。平按∶应衣《甲乙》作应手。注胃络
之脉，脉字原缺右方，左方有月字，当是脉字，袁刻作法。）脉宗气盛喘数绝者，则病在中；（宗，
尊也。此之大络，一身之中血气所尊，故曰宗气。其脉动如人喘数而绝者，病在脏中也。平按∶脉
宗气《素问》作脉宗气也，《甲乙》作脉之宗气也。）结而横，有积矣；（此脉结者，腹中有积
居也。积，阴病也。）绝不至曰死。（此虚里脉，来已更不复来，是胃气绝，所以致死。平按∶曰
死下《素问》有“乳之下其动应衣，宗气泄也”十一字，新校正云∶“按全元起本无此十一字，
《甲乙经》亦无。”本书在后。）欲知寸口脉太过与不及，寸口之脉中手短者，曰头痛；（上来诊
人迎法，以下诊寸口法，故曰欲知诊寸口之脉有病，唯有太过与不及也。口者，气行处也。从关至
鱼一寸之处，有九分之位，是手太阴气所行之处，故曰寸口。其脉之动，不满九分，故曰短也。短
者阳气不足，故头痛也。平按∶《甲乙》无“欲知寸口脉太过与不及”十字。）乳之下，其动应
于衣，宗气泄。（乳下虚里之脉，若阳气盛溢，其脉动以应衣，是为宗气泄溢者也。）寸口之脉
中手长者，足胫痛；（寸口之脉过九分以上，曰长。长者阳气有余，阴气不足，故胫痛也。）喘
数绝不至，曰死。（长而喘，所以致死。平按∶《素问》无此句。）寸口脉中手如从下上击者，
曰肩背痛。（脉从下向上击人手，如从下有物上击人手，是阳气盛，阳脉行于肩背，故知肩背痛
也。平按∶如从下上击者《素问》作促上击者，《甲乙》作促上数者，注云∶《素问》作击。又
按从下，下字袁刻作物。）寸口脉中手沉而紧者，曰病在中；（沉紧者，阴脉也。病在于脏，故
沉紧也。平按∶《素问》无中手二字，紧作坚。）寸口脉浮而盛者，病在外。（浮盛，阳也。病
在于腑，故浮盛也。）寸口脉沉而弱，曰寒热及疝瘕、
少腹痛；（沉，阴气盛也。弱，阳气虚也。阴盛阳虚，故有寒热，疝瘕病、少腹痛也。）寸口之
脉沉而横坚，曰 下有积，腹中有横积痛。（其脉沉横而坚者，阴盛，故知 下有积。积，阴病
也。横，指下脉横也。 侧箱，即下穴处也。又其阴病，少腹中有横积也。平按∶《素问》无坚
字。 下《素问》、《甲乙》作胁下。《甲乙》沉作紧，注云∶《素问》作沉而横。腹中上《甲乙》
无有积二字。注即下穴处也，别本作腋下 处也。）寸口脉盛滑坚者，病曰甚，在外；（寸口阳
也，滑亦阳也，坚为阴也，阳盛阴少，故病曰甚，在六腑也。平按∶寸口下《素问》有脉沉而喘
曰寒热七字，本书在后。）脉小实而坚者，病曰甚，在内；（小实为阴，坚亦为阴，故病曰甚，
在五脏也。平按∶《素问》无曰甚二字。）有胃气而和者，病曰无他。（寸口之脉虽小实坚，若
有胃气和之，虽病不至于困也。平按∶《素问》无此条。《甲乙》有胃气上有病甚二字。）脉小
弱以涩者，谓之久病；（小弱以涩，是阴阳虚弱，故是久病。）脉涩浮而大疾者，谓之新病。（涩
为阴也，浮大阳也，其脉虽涩，而浮流利，即知新病。平按∶涩浮而大疾《素问》作滑浮而疾，
《甲乙》作浮滑而实大，注云∶《素问》作浮而疾。）脉滑曰风，（气虚而行利，即是风府之候
也。平按∶《素问》脉滑上有脉急者曰疝瘕少腹痛九字，本书在后。注风府别本作风病。）脉缓
而滑曰热中，（缓滑，阳也。指下如按缓绳，而去来流利，是热中候者。）脉涩曰痹，（涩，阴
也。按之指下涩而不利，是寒湿之气聚为痹也。）脉盛而紧曰胀。（寸口脉盛紧实者，是阴气内
积，故为胀也。）脉顺阴阳，病易已；（人迎脉口大小顺四时者，虽病易愈也。平按∶顺《素问》
作从。）脉逆阴阳脱者，病难已；（人迎寸口大小不顺四时，既逆阴阳，故病难已也。平按∶《素
问》无脱者二字。）脉逆四时，病难已。（春夏人迎小于寸口，秋冬寸
口小于是人迎，即知是脉反四时，故病难已也。平按∶此条《素问》作“脉得四时之顺，曰病无他，
脉反四时及不间藏，曰难已”，《甲乙》同，惟脉字作按寸口三字，难已作死。）脉急者曰疝瘕、
少腹痛，（按其脉如按弓弦，是阴气积，故知疝瘕少腹痛也。）寸口脉沉而喘曰寒热，（沉，阴
气也。脉动如人喘者，是为阳也。即知寒热也。平按∶《素问》此条在前有横积痛下。）臂多青
脉曰脱血。（臂，尺地也。尺地络脉青黑为寒，即知脱血，以其阳虚，阴盛乘阳，故脉青。）尺
脉缓涩者，谓之解 安卧；（缓为阳也，涩为阴，以从关至尺取一寸以为尺部，尺部又阴，以阴
气多，懈惰安卧也。平按∶注以从关，以字袁刻脱。）尺脉盛，谓之脱血。（尺脉盛，谓阴气盛，
阳气虚，故脱血也。平按∶上安卧二字《素问》王注作属下尺脉盛解释。）尺涩脉滑，谓之多汗；
（尺之皮肤粗涩，尺之脉滑，是谓阳盛阴虚，数故泄汗也。）尺寒脉细，谓之后泄；（尺之皮肤
冷，尺脉沉细，是为内寒，故后泄也。）脉尺粗常热者，谓之热中。（脉之尺地皮肤粗，又常热，
是其热中也。）肝见庚辛死，心见壬癸死，脾见甲乙死，肺见丙丁死，肾见戊己死，是谓真脏见，
皆死。（真脏各见被克之时，故皆死也。）颈脉动疾喘咳曰水，（颈脉，是胃脉人迎也。人迎常动，
今有水病，故动疾可见喘咳也。有本为肾脉动也。）目果微肿如卧起之状曰水，（目果，目上下
睑也。睑之微肿，水之候。平按。《素问》果作裹，卧下有蚕字，）足胫肿曰水。（寒湿气盛，故
足胫肿，水之候也。）目黄者，曰黄胆也；（三阳脉在目，故黄胆热病，目为黄也。疸，多但反。
平按∶足胫二句《素问》在面肿曰风之下。）溺黄安卧者，曰黄胆；（肾及膀胱中热，安卧不劳
者，黄胆病候也。平按∶《素问》黄
Ping An (Commentary): This chapter, from the beginning to the end, is found in Volume 5, Chapter 18 "Ping Ren Qi Xiang Lun" (Discussion on the Pulse Signs of Healthy People) of the *Su Wen* (Basic Questions), and also in Volume 4, Chapter 1 of the *Jia Yi Jing* (Classic of Fixed and Certain Points), with only slight differences in arrangement.
Huang Di asked Qi Bo: What constitutes a Ping Ren (healthy person)? Qi Bo replied: When a person exhales, the pulse beats twice; when they inhale, the pulse also beats twice. This is called a Ping Ren. A Ping Ren is one who is not diseased. The physician, being free from disease, uses their own calm breathing and pulse rhythm as a standard to evaluate the patient's condition. (The method for distinguishing between healthy and sick individuals requires the physician to first be in a state of balance: two pulse beats per exhalation and two per inhalation reflect the physician's harmonious pulse. Then, by counting the patient's breaths, if the patient also exhibits two beats per exhalation and two per inhalation, they are considered healthy. If the patient has only one beat per exhalation or inhalation, it is termed "Bu Ji" (insufficiency), indicating disease. Thus, it is said: the healthy physician uses their own balanced respiration to assess the patient.) Ping An Commentary: In the *Su Wen* and *Jia Yi Jing*, the character "Ren" (person) is omitted after "Yi Xi" (one inhalation). Before "Ming Yue" (is called), there are eleven characters: "Hu Xi Ding Xi Mai Wu Dong, Run Yi Tai Xi" (At the pause between breaths, the pulse moves five times, supplemented by a deep sigh). Above "Yi Bing Bing" (the healthy physician), the *Su Wen* has seven characters: "Chang Yi Bu Bing Tiao Bing Huan" (Always use the non-diseased to regulate the diseased), while the *Jia Yi Jing* has ten characters: "Chang Yi Bu Bing Zhi Ren, Yi Tiao Bing Huan" (Always use a healthy person to regulate the patient). "Yi Lun Fa Ye" is written as "Yi Tiao Zhi Wei Fa" (five characters) in the *Su Wen* and "Yi Tiao Zhi" (three characters) in the *Jia Yi Jing*.
If one exhalation corresponds to one pulse beat, and one inhalation to one pulse beat, it is called Shao Qi (deficiency of vital energy). (Both exhalation and inhalation correspond to only one beat, which is termed insufficiency, thus indicating Shao Qi.) Ping An Commentary: The character "Ren" is absent above "Yi Xi" in both the *Su Wen* and *Jia Yi Jing*.
If one exhalation corresponds to three pulse beats, and one inhalation to three beats, accompanied by restlessness and heat in the Chi region (wrist area below the styloid process), it indicates Wen Bing (warm disease); if the Chi region is not hot, a slippery pulse indicates Feng Bing (wind disease), and a choppy pulse indicates Bi Syndrome (obstruction syndrome). (Three beats per breath indicate an excess of Qi. With added restlessness and heat in the Chi skin, it signifies excessive Yang, hence Warm Disease. Warm diseases manifest before the Summer Solstice; those manifesting after are Shu Bing (summerheat disease). Three beats with restlessness but no Chi heat, with a slippery pulse, is Wind Disease; a choppy pulse is Bi Syndrome.) Ping An Commentary: The *Jia Yi Jing* lacks the five characters "Yi Xi Mai San Dong". The character "Ji" (and) is missing after "Zao" (restless) in the *Su Wen* and *Jia Yi Jing*; "Bing" (disease) appears before "Feng". The *Su Wen* adds "Mai" (pulse) before "Se" (choppy). The *Jia Yi Jing* omits "Se Yue Bi" (choppy indicates Bi).
Four beats per exhalation indicate death. (Four beats signify exclusive excess of Yang and exhaustion of Yin, leading to death.) Pulse absence indicates death. (When pressing the pulse, it comes once and then ceases, never returning, indicating death.) Irregular intervals (alternating slow and fast) indicate death. (Slow indicates Yin, fast indicates Yang; chaotic Yin-Yang movement without order leads to death.)
The normal Qi of a healthy person is derived from the Stomach; the Stomach is the source of normal Qi. Absence of Stomach Qi is termed Ni (rebellion/contrary), which leads to death. (In healthy individuals, the Qi of the Five Zang organs relies on Stomach Qi. If any Zang lacks Stomach Qi, its pulse appears alone, which is contrary and fatal.) Ping An Commentary: Above "Wu Wei Qi" (no Stomach Qi), the *Jia Yi Jing* reads "Ren Chang Lin Qi Yu Mai, Yi Wei Qi Wei Ben" (People constantly receive Qi from the Stomach pulse, taking Stomach Qi as the root) – twelve characters.
In Spring, a pulse with slight Stomach Qi and minor Xian (string-like/taut) quality is Ping (normal). (The Stomach pulse is the Ren Ying pulse. The pulses of the Five Zang—Xian, Gou, Dai, Fu, Shi—all appear within the Ren Ying Stomach pulse. The Stomach pulse is the Foot Yangming pulse, governing water and grain, serving as the head of the Twelve Meridians. Thus, when Zang pulses appear, they bring Stomach Qi to the Ren Ying. The characteristic of Stomach Qi is softness and flexibility. When the five pulses appear at the Ren Ying, if they show only Xian, Gou, Dai, Mao, or Shi without softness, the Zang organs have lost Stomach Qi, appearing alone, which is fatal. In Spring, abundant Stomach Qi with slight Xian is "Wei" (slight/mild), which denotes a healthy person.)
Abundant Xian with little Stomach Qi indicates Liver Disease. (Excess Xian and deficient Stomach Qi mean the Liver lacks Grain Qi, hence Liver Disease.) Only Xian without Stomach Qi indicates death. (Liver lacking Grain Qi causes the Xian pulse to appear alone, leading to death.) Stomach Qi combined with Mao (autumn/metal pulse) indicates disease in Autumn. (In Spring, when Stomach Qi appears, if there is only softness without Xian, but Mao is present within the Stomach pulse, it means Lung Qi is invading the Liver. Since Stomach Qi manifests as Xian, disease will occur in Autumn.) Ping An Commentary: In the note "Gu Zhi Qiu", the character "Gu" (thus) was mistakenly printed as "Yu" (desire) in Yuan's edition.
Excessive Mao indicates Metal Disease. (Spring pulse showing Mao exceeding Stomach Qi implies Metal overcoming Wood, hence Metal Disease.) Ping An Commentary: "Jin" (Metal) is written as "Jin" (Now) in the *Su Wen* and *Jia Yi Jing*. The note's "Huo" (Fire) is likely a scribal error for "Mu" (Wood).
The Zhen Zhen (True Visceral Qi) disperses into the Liver, which stores the Qi of the Tendons. (Zhen Zhen refers to the true Xian pulse. Xian without Stomach Qi is termed "San" (scattered). The Xian pulse cannot disperse itself; because the Liver scatters Qi without Stomach Qi, the True Visceral Qi disperses into the Liver. Thus, the Liver stores Shen (Spirit), residing in Hun (Ethereal Soul); the Liver stores Qi, residing in the Qi of the Tendons.) Ping An Commentary: The character "Mo" (membrane) follows "Jin" (tendon) in the *Su Wen* and *Jia Yi Jing*.
In Summer, a pulse with slight Stomach Qi and minor Gou (hook/crescent) quality is Ping (normal). Summer pulse at Ren Ying with abundant Stomach Qi and slight Gou is "Wei Gou" (slight hook), which is normal. Abundant Gou with little Stomach Qi indicates Heart Disease. (Heart disease involves poor appetite and low Grain Qi, causing the pulse at Ren Ying to show abundant Gou and little Stomach Qi, indicating Heart Disease.) Ping An Commentary: The note's "Ling" (causes) is printed as "Jin" (now) in Yuan's edition.
Only Gou without Stomach Qi indicates death. (Heart disease impairs eating; lack of Grain Qi results in Gou pulse without Stomach Qi, leading to death.) Stomach Qi combined with Shi (stone/kidney/winter pulse) indicates disease in Winter. (Heart belongs to Fire. During Summer when Heart is dominant, if Kidney pulse appears, despite having Stomach Qi, only Shi is seen. Disease will occur in Winter because Water overcomes Fire.) Excessive Shi indicates current disease. (Summer pulse has Stomach Qi but shows Shi; disease would arise in Autumn. However, if Shi is excessive now in Summer with little Stomach Qi, hostile pathogenic factors invade, hence current disease.)
The Zhen Zhen Qi connects to the Heart, which stores the Qi of Blood Vessels. (Absence of Stomach Qi in the Heart leads to pain pathology, causing the Zhen Zhen pulse to appear at the Ren Ying, hence "Zhen Zhen Tong (connects/passes through) the Heart." The Heart stores Shen, residing in Shen Qi; the Heart stores Qi, residing in the Qi of Blood Vessels.) Ping An Commentary: "Tong" (pain) is written as "Tong" (connect/pass) in the *Su Wen* and *Jia Yi Jing*.
In Late Summer, a pulse with slight Stomach Qi and weak quality is Ping (normal). Little Stomach Qi and abundant weakness indicate Spleen Disease. ( , sound mian fan, meaning soft. Late Summer is the sixth month. The Spleen distributes Stomach Qi to nourish the Four Zang organs. Thus, pulses of the Four Zang at the Ren Ying possess Stomach Qi, indicating harmony. If Spleen disease occurs, it fails to distribute Stomach Qi, leaving the Four Zang pulses devoid of Stomach Qi, causing disease in all four. Question: Late Summer is governed by the Spleen; why discuss Stomach Qi here? Answer: The Spleen is the ruler and does not reveal itself directly. Receiving Stomach Qi in Late Summer implies receiving Spleen Qi. Therefore, slight deficiency of Stomach Qi in Late Summer is considered good health. If Stomach Qi becomes scarce and weak, it is Spleen Disease, resulting in deficient and weak Stomach Qi.) Ping An Commentary: "Wei Shao Ruo Duo" is "Ruo Duo Wei Shao" in *Su Wen* and "Ruo" in *Jia Yi Jing*. Note "Wei Wei Xing Qi" is "Qi Xing" in Yuan's edition. "Ruo Geng Wei Shao Fu Xu Ruo Zhe": Yuan's edition prints "Wei" as "Zhi" and "Fu" as "Fu" (abdomen).
Only Dai (intermittent) without Stomach Qi indicates death. (One exhalation moves Qi to Heart and Lung, two beats; one inhalation moves Qi to Liver and Kidney, two beats. At the pause between breaths, Spleen receives Qi from Stomach and transmits it to the Four Zang for respiration, so the pulse pauses during this reception. This pause is called Dai. Dai means breath. During Dai, Stomach Qi should be present; if Dai pulse lacks Stomach Qi, Spleen lacks Grain Qi, leading to death.)
Weak pulse combined with Shi indicates disease in Winter. (During Late Summer Spleen/Stomach manifestation, presence of Kidney pulse signifies mild pathogenic invasion, leading to disease in Autumn.) Ping An Commentary: Note "Zhi Qiu" (to Autumn): according to the text, "Qiu" should be "Dong" (Winter).
Excessive weakness indicates current disease. (Spleen/Stomach pulse is weak, Grain Qi is scant, hence current disease.) Ping An Commentary: "Ruo" is written as " " in *Jia Yi Jing*, noted as "Ruo" in *Su Wen*.
The Zhen Zhen Qi transmits to the Spleen, which stores the Qi of Muscle Flesh. (The true pulse of the Spleen is solely Dai. Without Stomach Qi, only the Dai pulse transmits from the Spleen to the Ren Ying. The Spleen stores Shen, residing in Yi (Intellect); the Spleen stores Qi, residing in Muscle Qi.) Ping An Commentary: "Chuan" (transmit) is written as "Ru" (soft) in *Su Wen* and *Jia Yi Jing*. Note "Zhi Wu Wei Qi": "Zhi" is printed as "Ruo" (if) in Yuan's edition.
In Autumn, a pulse with slight Stomach Qi and minor Mao (hair/lung/autumn pulse) quality is Ping (normal). (Autumn Ren Ying pulse: abundant Stomach Qi, slight Mao, indicates a healthy person.) Little Stomach Qi and abundant Mao indicate Lung Disease. (Scant Grain Qi.) Ping An Commentary: "Wei Shao Mao Duo" is "Mao Duo Wei Shao" in *Su Wen* and *Jia Yi Jing*.
Only Mao without Stomach Qi indicates death. (Appearance of True Zang pulse.) Mao combined with Xian indicates disease in Spring. (Liver Qi invading Lung, persistent mild pathogenic influence, leading to disease when Wood dominates in Spring.) Ping An Commentary: Note "Shi Xie" (this pathogen) should likely be "Wei Xie" (mild pathogen) based on context.
Excessive Xian indicates current disease. (Presence of Stomach Qi but no Mao, only Xian, means Wood counter-overcomes Metal, hence current disease.)
The Zhen Zhen pulse exceeds the Lung, and failure to circulate Ying-Wei with Yin leakage indicates death. (When Zhen Zhen pulse appears, it exceeds the peaceful Qi of the Lung. "Gao" means surpass. Lung is Yin. Lack of Stomach Qi surpassing Lung's harmony injures the Lung. Lung governs Ying-Wei circulation; lung injury leads to Yin leakage, causing death.) Ping An Commentary: "Yin Xie Yue Si" (Yin leakage indicates death) is written as "Yin Yang Ye" (Yin and Yang) in the *Su Wen* and *Jia Yi Jing*.
In Winter, a pulse with slight Stomach Qi and minor Shi (stone/kidney/winter pulse) quality is Ping (normal). (Winter Ren Ying pulse: abundant weak Stomach Qi, slight Shi pulse, indicates a healthy person.) Little Stomach Qi and abundant Shi indicate Kidney Disease. (Kidney lacks Grain Qi, causing weak Qi to decrease and firm Shi pulse to increase, indicating Kidney Disease.) Ping An Commentary: "Wei Shao Shi Duo" is "Shi Duo Wei Shao" in the *Su Wen*.
Only Shi without Stomach Qi indicates death. (Appearance of True Zang pulse leads to death.) Shi combined with Gou indicates disease in Summer. (Shi pulse is Water; Gou pulse is Fire. Presence of Shi with Gou indicates mild pathogenic invasion, leading to disease in Summer.) Excessive Gou indicates current disease. (Despite Stomach Qi, excessive Gou causes current disease.)
The Zhen Zhen Qi descends to the Kidney, which stores the Qi of Marrow and Bones. (Kidney is the foundation of harmony among the Five Zang. Now, without Stomach Qi, it descends excessively to the Kidney. The Kidney stores Shen, residing in Zhi (Will); the Kidney stores Qi, residing in Marrow/Bone Qi. The above discusses using the Ren Ying Stomach pulse to observe Five Zang Qi.)
The Great Luo vessel of the Stomach is named Xu Li (Pectoralis Major/Left Chest Point), penetrating the diaphragm, connecting to the Lung, emerging below the left breast, with pulsation visible through clothing. (Diagnosing Stomach Luo vessels below. "Xu" sounds like "Xu" (ruin/empty). Xu Li means city residence. This Great Stomach Luo is the dwelling place where Five Zang and Six Fu organs derive their Qi, hence named Xu Li. Its pulse emerges below the left breast, often pulsating visibly through clothing.) Ping An Commentary: "Ying Yi" (respond to clothes) is "Ying Shou" (respond to hand) in *Jia Yi Jing*. Note "Wei Luo Zhi Mai": "Mai" (pulse) lacked the right radical originally, with "Yue" (moon/flesh) on the left, implying "Mai"; Yuan's edition prints "Fa" (method).
Pulse of Zong Qi (Pectoral Qi) being vigorous, rapid, and intermittent indicates disease in the interior. ("Zong" means revered. This great vessel is revered by blood and Qi in the body, hence Zong Qi. Pulsation resembling panting, rapid and intermittent, indicates disease in the Zang organs.) Ping An Commentary: "Mai Zong Qi" is "Mai Zong Qi Ye" in *Su Wen* and "Mai Zhi Zong Qi Ye" in *Jia Yi Jing*.
Knotted and horizontal pulse indicates accumulation. (This knotted pulse indicates abdominal accumulations. Accumulation is a Yin disease.)
Absence of pulse indicates death. (Xu Li pulse comes once and does not return, indicating exhaustion of Stomach Qi, leading to death.) Ping An Commentary: Below "Yue Si" (indicates death), the *Su Wen* has eleven characters: "Ru Zhi Xia Qi Dong Ying Yi, Zong Qi Xie Ye" (Below the breast, pulsation responds to clothes, Zong Qi leaks). Xin Zheng Jiao notes: "According to Quan Yuanqi's edition, these eleven characters are absent; *Jia Yi Jing* also lacks them." This book places them later.
To know if Cun Kou (Radial) pulse is excessive or insufficient: Cun Kou pulse feeling short upon palpation indicates headache. (Above discussed Ren Ying diagnosis; below Cun Kou diagnosis. To diagnose Cun Kou disease, one looks for excess or insufficiency. "Kou" is where Qi flows. From Guan to Yu, one cun distance, nine fen position, is where Hand Taiyin Qi flows, hence Cun Kou. Pulse movement less than nine fen is "Short". Short indicates insufficient Yang Qi, hence headache.) Ping An Commentary: *Jia Yi Jing* lacks the ten characters "Yu Zhi Cun Kou Mai Tai Guo Yu Bu Ji" (Want to know if Cun Kou pulse is excessive or insufficient).
Below the breast, pulsation responds to clothing, indicating Zong Qi leakage. (Pulse at Xu Li below breast: if Yang Qi is excessive and overflowing, pulsation responds to clothing, indicating Zong Qi leakage.)
Cun Kou pulse feeling long upon palpation indicates leg/shin pain. (Cun Kou pulse exceeding nine fen is "Long". Long indicates excess Yang and insufficient Yin, hence shin pain.)
Panting, rapid, and absent indicates death. (Long and panting leads to death.) Ping An Commentary: *Su Wen* lacks this sentence.
Cun Kou pulse feeling as if struck from below upwards indicates shoulder and back pain. (Pulse striking upward from below into the hand, as if something strikes from below, indicates excess Yang. Yang meridians travel along shoulder and back, hence shoulder/back pain.) Ping An Commentary: "Ru Cong Xia Shang Ji Zhe" is "Cu Shang Ji Zhe" (rapid upward strike) in *Su Wen* and "Cu Shang Shu Zhe" (rapid upward frequent) in *Jia Yi Jing*, noting *Su Wen* uses "Ji" (strike). Also, "Cong Xia": "Xia" (below) is printed as "Wu" (thing/object) in Yuan's edition.
Cun Kou pulse feeling deep and tight indicates disease in the interior. (Deep and tight are Yin pulses. Disease in Zang organs, hence deep and tight.) Ping An Commentary: *Su Wen* lacks "Zhong Shou" (upon hand); "Jin" (tight) is written as "Jian" (firm).
Cun Kou pulse floating and vigorous indicates disease in the exterior. (Floating and vigorous are Yang. Disease in Fu organs, hence floating and vigorous.)
Cun Kou pulse deep and weak indicates cold/fever, Shan Jia (hernia masses), and lower abdominal pain. (Deep indicates excess Yin. Weak indicates deficient Yang. Yin excess and Yang deficiency cause cold/fever, Shan Jia, and lower abdominal pain.)
Cun Kou pulse deep, horizontal, and firm indicates accumulation under the hypochondrium and horizontal accumulation pain in the abdomen. (Deep, horizontal, and firm pulse indicates Yin excess, hence accumulation under hypochondrium. Accumulation is Yin disease. Horizontal refers to pulse felt horizontally across fingers. "Ce Xiang" refers to acupoints below. Also, Yin disease involves horizontal accumulation in lower abdomen.) Ping An Commentary: *Su Wen* lacks "Jian" (firm). "Xia" is "Xie Xia" (under hypochondrium) in *Su Wen* and *Jia Yi Jing*. *Jia Yi Jing* writes "Chen" (deep) as "Jin" (tight), noting *Su Wen* is "Chen Er Heng" (deep and horizontal). Above "Fu Zhong" (in abdomen), *Jia Yi Jing* lacks "You Ji" (has accumulation). Note "Ji Xia Xue Chu Ye": other editions say "Ye Xia Xie Chu Ye" (under armpit Xie point).
Cun Kou pulse vigorous, slippery, and firm indicates severe disease in the exterior. (Cun Kou is Yang; slippery is Yang; firm is Yin. Yang excess and Yin scarcity mean severe disease in Six Fu organs.) Ping An Commentary: Below "Cun Kou", *Su Wen* has seven characters: "Mai Chen Er Chuan Yue Han Re" (Pulse deep and panting indicates cold/fever), placed later in this book.
Pulse small, solid, and firm indicates severe disease in the interior. (Small and solid are Yin; firm is Yin. Severe disease in Five Zang organs.) Ping An Commentary: *Su Wen* lacks "Yue Shen" (indicates severe).
With Stomach Qi and harmony, the disease indicates no other complications. (Even if Cun Kou pulse is small, solid, and firm, if Stomach Qi is harmonious, illness will not become critical.) Ping An Commentary: *Su Wen* lacks this clause. *Jia Yi Jing* adds "Bing Shen" (disease severe) before "You Wei Qi" (has Stomach Qi).
Pulse small, weak, and choppy indicates chronic disease. (Small, weak, and choppy indicate Yin-Yang deficiency, hence chronic disease.)
Pulse choppy, floating, large, and rapid indicates acute disease. (Choppy is Yin; floating and large are Yang. Though choppy, if floating and smooth, it indicates acute disease.) Ping An Commentary: "Se Fu Er Da Ji" is "Hua Fu Er Ji" (smooth, floating, and rapid) in *Su Wen* and "Fu Hua Er Shi Da" (floating, smooth, solid, and large) in *Jia Yi Jing*, noting *Su Wen* is "Fu Er Ji" (floating and rapid).
Slippery pulse indicates wind disease. (Qi deficiency with smooth flow is a sign of Wind Pathogen.) Ping An Commentary: Above "Mai Hua" (pulse slippery), *Su Wen* has nine characters: "Mai Ji Zhe Yue Shan Jia Shao Fu Tong" (Pulse urgent indicates hernia masses and lower abdominal pain), placed later. Note "Feng Fu" (Wind Palace): other editions write "Feng Bing" (Wind Disease).
Slow and slippery pulse indicates internal heat. (Slow and slippery are Yang. Feeling like pressing a loose rope, yet coming and going smoothly, indicates internal heat.)
Choppy pulse indicates Bi Syndrome. (Choppy is Yin. Pressing feels choppy and unsmooth, indicating cold-dampness gathering to form Bi Syndrome.)
Vigorous and tight pulse indicates distension. (Cun Kou pulse vigorous, tight, and solid indicates internal accumulation of Yin Qi, hence distension.)
Pulse following Yin-Yang principles indicates easy recovery. (Ren Ying and Cun Kou sizes conforming to the Four Seasons allow easy recovery even if diseased.) Ping An Commentary: "Shun" (follow) is "Cong" (obey/follow) in *Su Wen*.
Pulse reversing Yin-Yang and exhausting indicates difficult recovery. (Ren Ying and Cun Kou sizes not conforming to Four Seasons, reversing Yin-Yang, make recovery difficult.) Ping An Commentary: *Su Wen* lacks "Tuo Zhe" (exhausting).
Pulse reversing the Four Seasons indicates difficult recovery. (Spring/Summer Ren Ying smaller than Cun Kou; Autumn/Winter Cun Kou smaller than Ren Ying indicates pulse contrary to seasons, hence difficult recovery.) Ping An Commentary: This clause in *Su Wen* is "Mai De Si Shi Zhi Shun, Yue Bing Wu Ta, Mai Fan Si Shi Ji Bu Jian Zang, Yue Nan Yi" (Pulse conforming to Four Seasons indicates no other disease; pulse reversing Four Seasons and not intervening in Zang indicates difficult recovery). *Jia Yi Jing* is similar, except "Mai" is "An Cun Kou" (press Cun Kou) and "Nan Yi" is "Si" (death).
Urgent pulse indicates hernia masses and lower abdominal pain. (Pressing pulse feels like bowstring, indicating Yin accumulation, hence hernia masses and lower abdominal pain.)
Cun Kou pulse deep and panting indicates cold/fever. (Deep is Yin. Pulse moving like panting is Yang. Hence cold/fever.) Ping An Commentary: This clause in *Su Wen* appears earlier, after "Heng Ji Tong" (horizontal accumulation pain).
Many blue veins on the arm indicate blood loss. (Arm is Chi region. Blue-black collateral veins in Chi region indicate cold, hence blood loss due to Yang deficiency and Yin overcoming Yang, making veins blue.)
Chi pulse slow and choppy indicates lethargy and desire to lie down. (Slow is Yang; choppy is Yin. From Guan to Chi, one cun is taken as Chi region, which is Yin. Excess Yin causes lethargy and desire to lie down.) Ping An Commentary: Note "Yi Cong Guan": "Yi" (because) is omitted in Yuan's edition.
Chi pulse vigorous indicates blood loss. (Chi pulse vigorous means Yin excess and Yang deficiency, hence blood loss.) Ping An Commentary: The previous two characters "An Wo" (lie down) are explained by Wang Bing's note in *Su Wen* as belonging to the explanation of "Chi Mai Sheng" (Chi pulse vigorous) below.
Chi choppy and pulse slippery indicates profuse sweating. (Chi skin is rough/choppy; Chi pulse is slippery, indicating Yang excess and Yin deficiency, leading to frequent sweating.)
Chi cold and pulse fine indicates diarrhea. (Chi skin is cold; Chi pulse is deep and fine, indicating internal cold, hence diarrhea.)
Chi pulse coarse and constantly hot indicates internal heat. (Chi region skin is coarse and constantly hot, indicating internal heat.)
Liver pulse appearing on Geng/Xin days indicates death; Heart on Ren/Gui days; Spleen on Jia/Yi days; Lung on Bing/Ding days; Kidney on Wu/Ji days. This is called appearance of True Zang pulse, all indicating death. (True Zang pulses appear when overcome by the controlling element, hence all lead to death.)
Neck pulse rapid with panting and cough indicates water retention disease. (Neck pulse is Stomach Ren Ying pulse. Ren Ying normally pulses; now with water disease, rapid pulsation is visible with panting/cough. Some texts say it is Kidney pulse pulsating.)
Slight swelling of eyelids like waking/sleeping posture indicates water retention. ("Mu Guo" refers to upper and lower eyelids. Slight swelling of eyelids is a sign of water.) Ping An Commentary: *Su Wen* writes "Guo" as "Guo" (wrap); "Wo" has character "Can" (silkworm).
Swelling of shins indicates water retention. (Excess cold-dampness causes shin swelling, a sign of water.)
Yellow eyes indicate jaundice. (Three Yang meridians enter the eyes; thus, jaundice heat disease causes yellow eyes. "Dan" is pronounced "Dan" reverse.) Ping An Commentary: The two sentences about shins appear in *Su Wen* after "Mian Zhong Yue Feng" (face swelling indicates wind).
Yellow urine with lethargy indicates jaundice. (Heat in Kidney and Bladder, lethargy without labor, are signs of jaundice.) Ping An Commentary: *Su Wen* "Huang" (yellow)...