黄帝问曰。春脉如弦。何如而弦。岐伯对曰。春脉者肝也。东方木也。万物之所以始生也。故其气来 弱轻虚而滑。
端直以长。故曰弦。反此者病。（春弦。夏钩。秋毛。冬石。脏真之神也。此篇言真脏之脉。资生于胃。输禀于脾。合于
四时。行于五脏。五脏相通。移皆有次。如璇玑玉衡。转而不回者也。如五脏有病。则各传其所胜。至其所不胜则死。
有为风寒外乘。亦逆传所胜而死者。有为五志内伤。交相乘传而死者。有春得肺脉。夏得肾脉。真脏之神。为所不胜之
气乘之者。皆奇恒之为病也。故曰奇恒者。言奇病也。所谓奇者。使奇病不得以四时死也。恒者。得以四时死也。是以
岐伯对曰。春脉者肝也。言春时之脉。肝脏主气。而合于东方之木。如万物之始生。故其气来 弱轻虚而滑。端直以长。
盖以脏真之气。而合于四时。非四时之气。而为五脏之顺逆也。本卷五篇。皆论脉理之精微。诊辨之要妙。而各有不同。
学人宜潜心体会。而详悉其旨焉。）帝曰。何如而反。岐伯曰。其气来实而强。此谓太过。病在外。其气来不实而微。此
谓不及。病在中。（实而强者。盈实而如循长竿也。不实而微。无端长之体也。言五脏之神气。由中而外。环转不息。如
气盛强。乃外出之太过。如气不足。则衰微而在中。太过不及。皆脏真之气。不得其和平而为病也。）帝曰。春脉太过与
不及。其病皆何如。岐伯曰。太过则令人善忘。忽忽眩冒而巅疾。其不及则令人胸痛引背。下则两胁 满。（夫五脏之脉。
行气于其所生。受气于所生之母。肝行气于心。受气于肾。春脉太过则气并于上。经曰。气并于上。乱而喜忘。气上盛
而与督脉会于巅。故眩冒而巅疾也。金匮要略曰。胸痛引背。阳虚而阴弦故也。盖春木之阳。生于肾水之阴。阴气虚寒。
以致生阳不足。故胸痛引背也。胁 乃肝肾之部分。生气虚而不能外达。故逆满于中也。）帝曰。善。夏脉如钩。何如而
钩。岐伯曰。夏脉者心也。南方火也。万物之所以盛长也。故其气来盛去衰。故曰钩。反此者病。（心脉通于夏气。如火
之发焰。如物之盛长。其气惟外出。故脉来盛而去悠。有如钩象。其本有力而肥。其环转则秒而微也。）帝曰。何如而反。
岐伯曰。其气来盛去亦盛。此谓太过。病在外。其气来不盛。去反盛。此谓不及。病在中。（来盛者。盛长之本气也。去
亦盛者。太过于外也。来不盛者。盛长之气衰于内也。去反盛者。根本虚而末反盛也。）帝曰。夏脉太过与不及。其病皆
何如。岐伯曰。太过则令人身热而肤痛。为浸淫。其不及则令人烦心。上见咳唾。下为气泄。（身热肤痛者。心火太过而
淫气于外也。浸淫、肤受之疮。火热盛也。其不及则反逆于内。上熏肺而为咳唾。下走腹而为气泄矣。夫心气逆则为噫。
虚逆之气。不上出而为噫。则下行而为气泄。气泄者。得后与气。快然如衰也。）帝曰。善。秋脉如浮。何如而浮。岐伯
曰。秋脉者肺也。西方金也。万物之所以收成也。故其气来轻虚以浮。来急去散。故曰浮。反此者病。（秋气降收。
外虚内实。内实故脉来急。外虚故浮而散也。杨元如曰。诸急为寒。阴气渐来。故脉来急。阳气渐去。故去散也。）帝
曰。何如而反。岐伯曰。其气来毛而中央坚。两旁虚。此谓太过。病在外。其气来毛而微。此谓不及。病在中。（如榆荚
而两旁虚。中央实。此肺之平脉。坚则为太过矣。毛而微。是中央两旁皆虚。此所生之母气不足。而致肺气更衰微也。）
帝曰。秋脉太过与不及。其病皆何如。岐伯曰。太过则令人逆气而背痛。愠愠然。其不及则令人喘。呼吸少气而咳。上
气见血。下闻病音。（肺主周身之气。太过则反逆于外。而为背痛。肺之俞在肩背也。愠愠、忧郁不舒之貌。经曰。气并
于肺则忧。其不及则令人气虚而喘。呼吸少气而咳。虚气上逆。则血随而上行。虚气下逆。则闻呻吟之病音。盖肺主气
而司呼吸开阖。其太过则盛逆于外。其不及则虚逆于内也。）帝曰。善。冬脉如营。何如而营。岐伯曰。冬脉者肾也。北
方水也。万物之所以合脏。故其气来沉以搏。故曰营。反此者病。（营、居也。言冬气之安居于内。如万物之所以合脏也
也。沉而搏者。沉而有石也。）帝曰。何如而反。岐伯曰。其气来如弹石者。此谓太过。病在外。其去如数者。此谓不及。
病在中。（如弹石者。石而强也。肾为生气之原。数则为虚。生气不足也。）帝曰。冬脉太过与不及。其病皆何如。岐伯
曰。太过则令人解 。脊脉痛而少气。不欲言。其不及则令人心悬如病饥。 中清。脊中痛。少腹满。小便变。帝曰。
善。（肾为生气之原而主闭藏。太过则气外泄。而根本反伤。故为懈惰少气。生阳之气不足。故脊中痛。心主言而发原于
肾。根气伤。故不欲言也。其不及则心肾水火之气。不能交济。故令人心悬如病饥。 中、胁骨之杪。当两肾之处。肾
之生阳不足。故 中冷也。肾合膀胱。肾虚而不能施化。故小便变而少腹满也。）帝曰。四时之序。逆从之变异也。然脾
脉独何主。（总结上文。而言脏真之气。合于四时。有升降浮沉之序。如逆其顺序和平之气。则有变异之病矣。然四时之
脉。止合四脏。而脾脏之脉。独何所主乎。）岐伯曰。脾脉者土也。孤脏以灌四旁者也。（脾属土而位居中央。各王四季。
月十八日。不得独主于时。故为孤脏。）帝曰。然则脾善恶可得见之乎。岐伯曰。善者不可得见。恶者可见。（此言脾灌
四脏。四脏受脾之气。而各见其善。是脾之善在四脏。而不自见其善耳。）帝曰。恶者如何可见。岐伯曰。其来如水之流
者。此为太过。病在外。如乌之喙者。此谓不及。病在中。（如水之流者。灌溉太过也。如乌之喙者。黔喙之属。艮止而
不行也。）帝曰。夫子言脾为孤脏。中央土以灌四旁。其太过与不及。其病皆何如。岐伯曰。太过则令人四肢不举。其不
及则令人九窍不通。名曰重强。（经曰。四肢皆禀气于胃。而不得至经。必因于脾。乃得禀也。脾为湿土主气。湿行太过。
故令人四肢不举。经曰。五脏不和。则九窍不通。脾气不足。则五脏之气。皆不和矣。夫胃为阳土而气强。脾为阴土而
气弱。脾弱而不得禀水谷之气。则胃气益强。故名曰重强。盖言脾气虚而不能为胃行其津液者。胃强脾弱。脏腑之刚柔
不和也。张兆璜曰。九窍为水注之气。脾不得为胃行其津液。故令人九窍不通。）帝瞿然而起。再拜而稽首曰。善。吾
得脉之大要。天下至数。五色脉变。揆度奇恒。道在于一。神转不回。回则不转。乃失其机。至数之要迫近以微着之玉
版。藏之脏腑。每旦读之。名曰玉机。（此言五脏受气于胃。一以贯通。次序环转。如璇玑玉衡。合之玉板。乃揆度奇恒
之大要也。瞿然、惊悟貌。至数者。五脉之至数也。盖天地之间。六合之内。不离于五。人亦应之。故曰。天下至数。
五色脉变。揆度奇恒。道在于一。一者。五脏之神。转而不回。如逆回。则失其旋转之机矣。五脏相通。阴阳并合。脉
之至数。迫近以微。着之玉版者。有格有序也。藏之脏腑者。阴阳雌雄之相应也。每旦读之者。血气未乱也。名曰玉机
者。如璇玑玉衡也。以上论真藏之神。五脏相通。外内环转。如太过不及则病。若回而不转。乃失其机而死矣。）五脏
受气于其所生。传之于其所胜。气舍于其所生。死于其所不胜。病之且死。必先传行。至其所不胜。病乃死。此言气之
逆行也。故死。（此言五脏之气逆回。失其旋转之机而死也。平脉篇曰。水行乘金。火行乘木。名曰逆。金行乘水。木行
乘火。名曰顺也。盖神转而不回者。母行乘子也。回则不转者。子行乘母也。五脏受气于所生之子。而反舍气于所生之
母。是生气之逆行也。传之于其所胜。是克贼相传也。是以至其所不胜而死。此皆气之逆行故也。如肝受气于心。而肝
气反舍于肾。则肾气盛。肾气盛。则火气衰。火气衰。则金无所畏而伤肝。所谓舍气于其所生。死于其所不胜也。病之
且死。必先传行。言必先克贼相传而后病。至其所不胜而后死。故当先治其未病焉。金匮要略曰。上工治未病者。何也。
师曰。夫治未病者。见肝之病。知肝传脾。当先实脾。四季脾王不受邪。即勿补之。中工不晓相传。见肝之病。不解实
脾。惟治肝也。夫肝之病。补用酸。助用焦苦。益用甘味之药调之。酸入肝。焦苦入心。甘入脾。脾能伤肾。肾气微弱。
则水不行。水不行。则心火气盛则伤肺。肺被伤。则金气不行。金气不行。则肝气盛。则肝自愈。此治肝补脾之要妙也。
肝虚则用此法。实则不在用之。经曰。虚虚实实。补不足。损有余。是其义也。余脏准此。所谓病之且死。必先传行。
上工能治其未病。则不至于死矣。董帷园曰。玉机章旨。与金匮此篇。理同义合。学人宜互相参究。大有裨于治道焉。）
肝受气于心。传之于脾。气舍于肾。至肺而死。心受气于脾。传之于肺。气舍于肝。至肾而死。脾受气于肺。传之于肾。
气舍于心。至肝而死。肺受气于肾。传之于肝。气舍于脾。至心而死。肾受气于肝。传之于心。气舍于肺。至脾而死。
此皆逆死也。一日一夜五分之。此所以占死生之早暮也。（此复申明五脏之气逆传。至其所不胜而死。昧旦主甲乙。昼主
丙丁。日昃主戊己。暮主庚辛。夜主壬癸。一日一夜而五分之。如真脏脉见。至肺而死。死于薄暮。至肾而死。死于中
夜。至肝而死。死于昧旦。至心而死。死于日中。至脾而死。死于日昃。此所以占死生之早暮也。夫逆传至死。有三岁
有六岁。有三月有六月。有三日有六日。当知日之早暮。亦有三时有六时也。）黄帝曰。五脏相通。移皆有次。五脏有病。
则各传其所胜。（此总结上文。而言五脏相通。有顺传之次序。如逆传其所胜者。盖因其病而逆之也。）不治。法三月。
若六月。若三日。若六日。传五脏而当死。是顺传所胜之次。（此言逆传所胜之死。有时而有月有日也。如见肝之病。
中工不晓传脾而不治。则脾传之肾。肾传之心。心传之肺。法三月。而传之所胜之次则死矣。假如心病而欲传之肺。时
值秋三月。而金旺不受邪。法当六月。而传之所胜之次则死矣。所谓法三月。若六月也。如传于值死之月。假如肝病传
脾。而戊日受之。真脏之脉见。则当庚日而死。己日受之。则当辛日而死。此法当三日而死也。如甲乙日受之。真脏脉
见。亦当死于庚辛。此法当六日而死。所谓若三日若六日也。五脏相传而当死者。是顺传所胜之次。如甲乙肝木受病。
顺传至庚辛而死。丙丁心火受病。顺传至壬癸而死。戊己脾土受病。复传至甲乙而死。故曰顺传所胜之次而死也。此五
脏逆传。而知死之月。死之日。死之时。所谓别于阴者。知死生之期也。）故曰。别于阳者。知病从来。别于阴者。知死
生之期。言知至其所困而死。（此承上接下之文也。别于阳者。下文所谓风寒之邪。从皮毛阳分而入。故别于阳者。知病
所从来。五脏为阴。知五脏逆传而死者。上文之所谓肝病传脾。至肺而死。脾病传肾。至肝而死。故别于阴者。知至所
困而死也。）是故风者。百病之长也。（此复言外因之邪。亦逆传于所胜而死。是故者。承上文之别于阳者而言也。风
为阳邪。伤人阳气。为百病之长者。言四时八方之邪风。虽从阳分而入。而善行数变。乃为他病。）今风寒客于人。使人
毫毛毕直。皮肤闭而为热。当是之时。可汗而发也。（气主皮毛。风寒之邪。始伤阳气。故使人毫毛毕直。太阳之气主表
而主开。病则反闭而为热矣。言风寒之邪。始伤表阳之时。可发汗而愈也。）或痹不仁。肿痛。当是之时。可汤熨及火灸
刺而去之。（气伤痛。形伤肿。痹不仁而肿痛者。气伤而病及于形也。如在皮腠气分者。可用汤熨。在经络血分者。可灸
刺而去之。）弗治。病入舍于肺。名曰肺痹。发咳上气。（皮毛者。肺之合。邪在皮毛。弗以汗解。则邪气乃从其合矣。
夫皮肤气分为阳。五脏为阴。病在阳者名曰风。病在阴者名曰痹。病舍于肺。名肺痹也。痹者闭也。邪闭于肺。故咳而
上气。）弗治。肺即传而行之肝。病名曰肝痹。一名曰厥胁痛。出食。当是之时。可按若刺耳。（失而弗治。肺即传其所
胜而行之肝。病名曰肝痹。厥者逆也。胁乃肝之分。逆于胁下而为痛。故一名厥胁痛。盖言痹乃厥逆之痛证也。食气入
胃。散精于肝。肝气逆。故食反出也。按者。按摩导引也。木郁欲达。故可按而导之。肝主血。故若可刺耳。杨元如
曰。肺痹肝痹者。非病在肝肺。在肝肺之分耳。）弗治。肝传之脾。病名曰脾风。发瘅。腹中热。烦心出黄。当此之时。
可按可药可浴。（失而弗治。肝因传之脾。病名曰脾风。盖肝乃风木之邪。贼伤脾土。故名脾风。瘅、火瘅也。风淫湿土
Huangdi asked: "The spring pulse is like a string. What kind of pulse is called 'string-like' (Xian)?" Qibo replied: "The spring pulse corresponds to the Liver, which belongs to Wood in the East. It is the season when all things begin to grow. Therefore, its Qi arrives weak, light, void, and slippery, straight and long. Hence it is called 'string-like'. If it is contrary to this, it is pathological." (Note: Spring pulses are string-like, summer pulses are hook-like, autumn pulses are hair-like, and winter pulses are stone-like. This represents the divine spirit of the Zang organs' true Qi. This chapter discusses the pulses of the true Zang organs, which derive nourishment from Stomach Qi, are sustained by Spleen Qi, harmonize with the Four Seasons, and circulate through the Five Zang organs. The Five Zang organs are interconnected, and their transmission follows a specific order, much like the rotation of the Big Dipper without reversal. If disease occurs in the Five Zang organs, it transmits according to the cycle of overcoming; death ensues when it reaches the organ it cannot overcome. Some die due to external invasion by Wind-Cold, transmitting inversely to the organ it overcomes; some die due to internal injury by the Five Emotions, with mutual overacting transmission; some present with Lung pulses in Spring or Kidney pulses in Summer, where the divine spirit of the true Zang is overcome by the organ it cannot overcome. These are all considered 'Qi Heng' (extraordinary/abnormal) diseases. Thus it is said that 'Qi Heng' refers to extraordinary diseases. 'Qi' means these extraordinary diseases do not die according to the seasonal cycles. 'Heng' means diseases that follow the seasonal cycles will die according to them. Therefore, Qibo stated: 'The spring pulse corresponds to the Liver,' meaning that during Spring, the Liver governs Qi and harmonizes with the Wood of the East, just as all things begin to grow. Thus, its Qi arrives weak, light, void, and slippery, straight and long. This is because the true Qi of the Zang harmonizes with the Four Seasons, distinguishing the smoothness or obstruction of the Five Zang from the seasonal Qi itself. The first five chapters of this volume discuss the subtleties of pulse theory and the essentials of diagnosis, each with distinct focuses. Students should ponder deeply and explore their meanings thoroughly.)
Huangdi asked: "What constitutes a contrary (abnormal) pulse?" Qibo said: "If the Qi arrives solid and strong, this is called 'Excess' (Tai Guo), indicating disease in the Exterior. If the Qi arrives insubstantial and faint, this is called 'Deficiency' (Bu Ji), indicating disease in the Interior." (Note: Solid and strong means full and firm, like feeling a long bamboo pole. Insufficient and faint lacks the straight, forceful quality of a long pole. This indicates that the divine Qi of the Zang organs circulates continuously from the interior to the exterior. If Qi is abundant and strong, it is excessive outward movement; if Qi is insufficient, it is weak and remains within. Both excess and deficiency represent the true Qi of the Zang losing its harmony and causing disease.)
Huangdi asked: "Regarding the excess and deficiency of the spring pulse, what diseases do they cause?" Qibo said: "Excess causes forgetfulness, dizziness, vertigo, and head disorders. Deficiency causes chest pain radiating to the back, and downward distension in both hypochondriac regions." (Note: The pulse Qi of the Zang organs circulates to the organ it generates and receives Qi from the mother organ that generated it. Liver Qi circulates to the Heart and receives Qi from the Kidney. Excess in the spring pulse causes Qi to congregate in the upper body. The Classics state: 'When Qi congregates in the upper body, confusion and forgetfulness occur.' Excessive upward Qi meets the Du Mai at the vertex, causing vertigo and head disorders. *Jin Gui Yao Lue* states: 'Chest pain radiating to the back is due to Yang deficiency and Yin cold tension.' Generally, the Yang of Spring Wood is born from the Yin of Kidney Water. If Yin Qi is deficient and cold, the generating Yang is insufficient, causing chest pain radiating to the back. The hypochondriac region is the domain of the Liver and Kidney. When Sheng Qi is deficient and cannot reach the exterior, it rebels and causes distension in the interior.)
Huangdi said: "Good. The summer pulse is like a hook. What kind of pulse is called 'hook-like' (Gou)?" Qibo said: "The summer pulse corresponds to the Heart, which belongs to Fire in the South. It is the season when all things flourish and grow. Therefore, its Qi arrives vigorous and departs declining. Hence it is called 'hook-like'. If it is contrary to this, it is pathological." (Note: The Heart pulse corresponds to Summer Qi, like a burning flame or flourishing growth. Its Qi only moves outward, so the pulse arrives vigorously and departs leisurely, resembling a hook. The root is strong and full, while the circulation is subtle and faint.)
Huangdi asked: "What constitutes a contrary (abnormal) pulse?" Qibo said: "If the Qi arrives vigorous and departs vigorous, this is called 'Excess', indicating disease in the Exterior. If the Qi arrives not vigorous but departs vigorous, this is called 'Deficiency', indicating disease in the Interior." (Note: Arriving vigorous is the fundamental Qi of flourishing growth. Departing vigorous is excessive outward dispersal. Arriving not vigorous is the decline of flourishing Qi internally. Departing vigorous indicates a weak root but hyperactive extremities.)
Huangdi asked: "Regarding the excess and deficiency of the summer pulse, what diseases do they cause?" Qibo said: "Excess causes fever and skin pain, developing into spreading sores (Jin Yin). Deficiency causes vexation, upward coughing and expectoration, and downward Qi leakage." (Note: Fever and skin pain result from excessive Heart Fire dispersing Yin Qi externally. Spreading sores indicate intense heat. Deficiency causes rebellion internally: upward steaming of the Lungs causes coughing and expectoration; downward flow to the abdomen causes Qi leakage. Heart Qi rebellion causes belching. If rebellious Qi is deficient and does not exit upward as belching, it descends causing Qi leakage. Qi leakage refers to relief after bowel movements or passing gas.)
Huangdi said: "Good. The autumn pulse is like floating. What kind of pulse is called 'floating' (Fu)?" Qibo said: "The autumn pulse corresponds to the Lungs, which belong to Metal in the West. It is the season when all things are harvested. Therefore, its Qi arrives light, void, and floating, urgent in arrival and scattered in departure. Hence it is called 'floating'. If it is contrary to this, it is pathological." (Note: Autumn Qi descends and gathers; the exterior is void and the interior is solid. The interior solidity causes an urgent arrival; the exterior voidness causes a floating and scattered departure. Yang Yuanru stated: Urgent pulses generally indicate Cold as Yin Qi gradually increases; scattered departure indicates Yang Qi gradually receding.)
Huangdi asked: "What constitutes a contrary (abnormal) pulse?" Qibo said: "If the Qi feels like a feather, firm in the center and empty on the sides, this is called 'Excess', indicating disease in the Exterior. If the Qi feels like a feather but is faint, this is called 'Deficiency', indicating disease in the Interior." (Note: Like a elm seed, empty on sides and firm in center, this is the normal Lung pulse. Firmness indicates excess. Faintness indicates emptiness in both center and sides, showing insufficiency of the mother Qi generating it, leading to further decline of Lung Qi.)
Huangdi asked: "Regarding the excess and deficiency of the autumn pulse, what diseases do they cause?" Qibo said: "Excess causes rebellious Qi and back pain, with a feeling of depression. Deficiency causes panting, shortness of breath, coughing, upward blood spitting, and audible pathological sounds from below." (Note: The Lungs govern the Qi of the whole body. Excess causes rebellion outward, leading to back pain. The Back-Shu points of the Lungs are on the shoulder and back. 'Yun Yun' describes a state of depression and discomfort. The Classics state: 'Qi congested in the Lungs leads to sorrow.' Deficiency causes Qi deficiency and panting, shortness of breath, and coughing. Deficient Qi rebelling upward carries blood up; deficiant Qi rebelling downward produces moaning sounds. Generally, the Lungs govern Qi and control respiration. Excess causes vigorous rebellion outward; deficiency causes deficient rebellion inward.)
Huangdi said: "Good. The winter pulse is like 'Ying' (camping/storing). What kind of pulse is called 'Ying'?" Qibo said: "The winter pulse corresponds to the Kidneys, which belong to Water in the North. It is the season when all things are stored. Therefore, its Qi arrives deep and pounding. Hence it is called 'Ying'. If it is contrary to this, it is pathological." (Note: 'Ying' means dwelling or storing. It refers to Winter Qi residing peacefully within, like all things being stored. Deep and pounding indicates the characteristics of a Stone pulse.)
Huangdi asked: "What constitutes a contrary (abnormal) pulse?" Qibo said: "If the Qi arrives like bouncing stones, this is called 'Excess', indicating disease in the Exterior. If the Qi departs like a rapid pulse, this is called 'Deficiency', indicating disease in the Interior." (Note: Like bouncing stones indicates a Stone pulse that is strong. The Kidneys are the source of generating Qi. A rapid pulse indicates deficiency, meaning insufficient generating Qi.)
Huangdi asked: "Regarding the excess and deficiency of the winter pulse, what diseases do they cause?" Qibo said: "Excess causes lethargy, pain in the spinal vessels, shortness of breath, and unwillingness to speak. Deficiency causes a feeling of hunger with an empty heart, coldness in the hypochondrium, pain in the spine, abdominal fullness, and abnormal urination." (Note: The Kidneys are the source of generating Qi and govern storage. Excess causes Qi to leak outward, damaging the root, leading to lethargy and shortness of breath. Insufficient generating Yang causes spinal pain. The Heart governs speech and originates from the Kidney; damage to the root Qi causes unwillingness to speak. Deficiency prevents the interaction of Heart Fire and Kidney Water, causing a feeling of hunger with an empty heart. The hypochondrium is the tip of the rib cage, located near the Kidneys. Insufficient generating Yang of the Kidneys causes coldness there. The Kidneys pair with the Bladder; Kidney deficiency fails to transform fluids, causing abnormal urination and lower abdominal fullness.)
Huangdi said: "Good. The sequence of the Four Seasons involves changes of compliance and opposition. However, what specifically governs the Spleen pulse?" (Summarizing the above, stating that the true Qi of the Zang harmonizes with the Four Seasons, having a sequence of ascending, descending, floating, and sinking. Violating this sequence and peaceful Qi leads to pathological variations. However, the pulses of the Four Seasons correspond only to four Zang organs; what specifically governs the Spleen?) Qibo said: "The Spleen pulse belongs to Earth. It is the solitary Zang organ that irrigates the four directions." (The Spleen belongs to Earth and resides in the Center, ruling over each of the four seasons for eighteen days, not governing a single season alone, hence called the 'Solitary Zang'.)
Huangdi asked: "Then can the good or bad condition of the Spleen pulse be seen?" Qibo said: "Its goodness cannot be seen directly; its badness can be seen." (This means the Spleen irrigates the four Zang organs, which receive its Qi and show good health. Thus, the Spleen's goodness is manifested in the other four Zang, rather than appearing directly in the Spleen itself.)
Huangdi asked: "How can the badness be seen?" Qibo said: "If it flows like water, this is Excess, indicating disease in the Exterior. If it resembles the beak of a crow, this is Deficiency, indicating disease in the Interior." (Note: Flowing like water indicates excessive irrigation. Resembling a crow's beak refers to black-beaked birds, which are rigid, static, and immobile.)
Huangdi asked: "You stated the Spleen is the solitary Zang, Central Earth irrigating the four directions. Regarding its excess and deficiency, what diseases do they cause?" Qibo said: "Excess causes inability to move the limbs. Deficiency causes obstruction of the nine orifices, named 'Chong Qiang' (Heavy Rigidity)." (The Classics state: The limbs all receive Qi from the Stomach but cannot reach the meridians directly; they must rely on the Spleen to receive it. The Spleen is Wet Earth governing Qi; excessive dampness causes inability to move the limbs. The Classics state: Disharmony of the Five Zang leads to obstruction of the nine orifices. Insufficient Spleen Qi leads to disharmony of all Five Zang Qi. The Stomach is Yang Earth with strong Qi; the Spleen is Yin Earth with weak Qi. If the Spleen is weak and cannot receive Grain Qi, the Stomach Qi becomes relatively stronger, hence named 'Chong Qiang'. This implies Spleen Qi deficiency failing to transport fluids for the Stomach, resulting in Strong Stomach and Weak Spleen, a disharmony of organ rigidity and flexibility. Zhang Zhaohuang stated: The nine orifices are the pathways for fluid influx; if the Spleen cannot transport fluids for the Stomach, it causes obstruction of the nine orifices.)
Huangdi rose in alarm, bowed twice, and kowtowed, saying: "Excellent. I have grasped the great essence of pulse diagnosis, the supreme numbers of the world. Changes in the five colors and pulses, measuring the extraordinary and normal, the Dao lies in One. The Spirit turns and does not return; if it returns, it ceases to turn, thus losing its opportunity. The essential numbers are recorded on the Jade Tablet, stored in the Zang organs, read every morning, named 'Yu Ji' (Jade Machine)." (This passage states that the Five Zang receive Qi from the Stomach, connected by one Qi, circulating in order like the Big Dipper, combined with the Jade Tablet, which is the great essence for measuring the extraordinary and normal. 'Ju Ran' means alarmed and awakened. 'Zhi Shu' refers to the frequencies of the five pulses. Within heaven and earth, within the six directions, nothing exists outside the Five Phases, and humans correspond to them, hence 'supreme numbers of the world'. Changes in five colors and pulses, measuring the extraordinary and normal, the Dao lies in 'One'. 'One' refers to the divine spirit of the Five Zang, turning without returning. If it reverses, it loses the mechanism of rotation. The Five Zang are interconnected, Yin and Yang combine. The pulse frequencies are profound and subtle. Recording them on the Jade Tablet implies order and structure. Storing them in the Zang organs reflects the correspondence of Yin/Yang and Male/Female. Reading them every morning is done when blood and Qi are undisturbed. Named 'Yu Ji' like the Big Dipper. Above discusses the divine spirit of true Zang, interconnection of Five Zang, internal-external circulation. Excess or deficiency causes disease; if it reverses and does not turn, the mechanism is lost, leading to death.)
The Five Zang receive Qi from the organ they generate, transmit it to the organ they overcome, store Qi in the organ that generated them, and die when reaching the organ they cannot overcome. When death is imminent, transmission must occur first; upon reaching the organ it cannot overcome, the patient dies. This describes the retrograde flow of Qi, hence death. (This passage states that retrograde loss of rotational mechanism in Zang Qi leads to death. The *Ping Mai Pian* states: Water overcoming Metal, Fire overcoming Wood is called 'Retrograde'; Metal overcoming Water, Wood overcoming Fire is called 'Smooth'. Generally, 'Spirit turns and does not return' refers to Mother overcoming Child; 'Returns and does not turn' refers to Child overcoming Mother. Receiving Qi from the generated Child but storing it in the generating Mother is retrograde generation Qi. Transmitting to the overcome organ is destructive transmission. Thus, death occurs at the organ it cannot overcome. All this is due to retrograde Qi. For example, Liver receives Qi from Heart, but Liver Qi stores in Kidney, making Kidney Qi strong; strong Kidney Qi weakens Fire; weak Fire allows Metal to attack Liver unchecked. This is storing Qi in the generated organ and dying at the overcome organ. Imminent death requires prior transmission, meaning destructive transmission must occur before severe illness, and death follows at the overcome organ. Therefore, one should treat the uninfected organ first. *Jin Gui Yao Lue* states: The superior physician treats disease before it arises. Why? The Master said: Treating disease before it arises means seeing Liver disease, knowing it will transmit to Spleen, and first strengthening the Spleen. If Spleen is prosperous in the season and resistant to evil, no need to tonify. Inferior physicians do not understand transmission; seeing Liver disease, they fail to strengthen Spleen and only treat Liver. To treat Liver disease, use Sour herbs to tonify Liver, Bitter-roasted herbs to assist Heart, and Sweet herbs to regulate Spleen. Sour enters Liver, Bitter-roasted enters Heart, Sweet enters Spleen. Spleen controls Kidney; weak Kidney Qi stops Water flow; stopped Water flow allows Heart Fire to flourish and injure Lungs; injured Lungs stop Metal flow; stopped Metal flow allows Liver Qi to flourish, healing Liver. This is the subtlety of treating Liver by strengthening Spleen. Use this method for Liver Deficiency, not for Excess. The Classics state: Do not make deficient patients more deficient or excess patients more excess; tonify deficiency, reduce excess. This is the principle. Other Zang follow this analogy. So, imminent death requires prior transmission; superior physicians treating uninfected organs prevent death. Dong Weiyuan stated: The intent of the *Yu Ji* chapter aligns with this *Jin Gui* passage; students should study them together for great benefit in treatment.)
Liver receives Qi from Heart, transmits to Spleen, stores in Kidney, and dies at Lung. Heart receives Qi from Spleen, transmits to Lung, stores in Liver, and dies at Kidney. Spleen receives Qi from Lung, transmits to Kidney, stores in Heart, and dies at Liver. Lung receives Qi from Kidney, transmits to Liver, stores in Spleen, and dies at Heart. Kidney receives Qi from Liver, transmits to Heart, stores in Lung, and dies at Spleen. These are all deaths from retrograde transmission. Dividing day and night into five parts, one can predict the timing of death. (This reiterates retrograde transmission of Zang Qi to the overcome organ leading to death. Dawn governs Jia/Yi, Day governs Bing/Ding, Afternoon governs Wu/Ji, Dusk governs Geng/Xin, Night governs Ren/Gui. Dividing day and night into five parts: if True Zang pulse appears and transmits to Lung, death occurs at dusk; to Kidney, death at midnight; to Liver, death at dawn; to Heart, death at noon; to Spleen, death in afternoon. This predicts the timing of death. Retrograde transmission to death can take three or six years, months, or days. One must understand that daily timing also has three or six phases.)
Huangdi said: "The Five Zang are interconnected, and transmission follows a sequence. When disease occurs in the Five Zang, it transmits to the organ it overcomes." (Summarizing above, stating the Five Zang are interconnected with a smooth transmission sequence. Retrograde transmission to the overcome organ occurs due to pathological rebellion.) If untreated, according to the law, within three months, six months, three days, or six days, after transmitting through the Five Zang, death ensues. This is the sequence of smooth transmission to the overcome organ. (This states that death from retrograde transmission to the overcome organ has time limits, in months or days. For example, seeing Liver disease, inferior physicians fail to strengthen Spleen and treat nothing; then Spleen transmits to Kidney, Kidney to Heart, Heart to Lung, dying within three months following the sequence of overcoming. Suppose Heart disease wants to transmit to Lung, but it is Autumn (three months), Metal is prosperous and resists evil; the law dictates death within six months following the sequence. Hence 'law of three or six months'. If transmitting to the month of death, e.g., Liver disease transmits to Spleen, contracting on Wu day, True Zang pulse appears, death occurs on Geng day; contracting on Ji day, death occurs on Xin day. This is the law of three days. If contracting on Jia/Yi days, True Zang pulse appears, death still occurs on Geng/Xin days, which is the law of six days. Hence 'or three days or six days'. Death from sequential transmission of Five Zang follows the sequence of overcoming. E.g., Jia/Yi Wood disease smoothly transmits to Geng/Xin death; Bing/Ding Fire disease smoothly transmits to Ren/Gui death; Wu/Ji Earth disease transmits back to Jia/Yi death. Hence 'smooth transmission to overcome organ leads to death'. Knowing the month, day, and hour of death from these five retrograde transmissions is what is meant by 'distinguishing Yin, knowing the period of life and death'.)
Therefore it is said: Distinguishing Yang reveals the origin of disease; distinguishing Yin reveals the period of life and death, meaning knowing where the disease becomes trapped and fatal. (This connects previous and next sections. Distinguishing Yang refers to Wind-Cold pathogens entering from the skin-hair Yang level, so distinguishing Yang reveals the disease's origin. The Five Zang are Yin; knowing death from retrograde transmission of Five Zang (e.g., Liver to Spleen to Lung death; Spleen to Kidney to Liver death) is what is meant by distinguishing Yin, knowing where the disease becomes trapped and fatal.)
Thus, Wind is the chief of a hundred diseases. (Reiterating that external pathogens also transmit retrogradely to the overcome organ causing death. 'Thus' connects to 'distinguishing Yang'. Wind is Yang pathogen, injuring Yang Qi, and is the chief of a hundred diseases, meaning pathogens from eight directions in four seasons, though entering via Yang level, are agile and changing, often serving as the basis for other diseases.) Now, when Wind-Cold invades the person, causing all hairs to stand erect and skin pores to close leading to fever, at this time, sweating can induce release. (Qi governs skin-hair. Wind-Cold initially injures Yang Qi, causing hairs to stand erect. Tai Yang Qi governs the exterior and opening; disease causes closure and fever. Meaning when Wind-Cold initially injures exterior Yang, sweating can cure it.) Or if Bi syndrome with numbness, swelling, and pain occur, at this time, hot compresses and moxibustion/acupuncture can remove the pathogen. (Qi injury causes pain, Form injury causes swelling. Bi syndrome with numbness, swelling, and pain indicates Qi injury affecting Form. If in skin-clefts/Qi level, hot compresses can be used; if in meridians/Blood level, moxibustion and acupuncture can remove it.)
If untreated, the pathogen enters the Lung, named Lung Bi, manifesting as cough and rebellious Qi. (Skin-hair is the exterior connection of the Lung. Pathogen in skin-hair, if not resolved by sweating, enters via its connection. Skin-Qi level is Yang, Five Zang are Yin. Disease in Yang is named Feng; disease in Yin is named Bi. Pathogen lodging in Lung is named Lung Bi. Bi means closure; pathogen closes Lung, causing cough and rebellious Qi.)
If untreated, Lung transmits to Liver, named Liver Bi, also called Jue Hypochondriac Pain, with vomiting of food. At this time, massage or acupuncture can be used. (Failure to treat leads Lung to transmit to its overcome Liver, named Liver Bi. 'Jue' means rebellion. Hypochondrium is Liver's domain; rebellion in hypochondrium causes pain, hence 'Jue Hypochondriac Pain'. Bi is a painful syndrome of rebellion. Food enters Stomach, nutrients scatter to Liver; Liver Qi rebellion causes food regurgitation. Massage refers to tuina and guidance. Wood stagnation desires expansion, so massage guides it. Liver governs Blood, so acupuncture is also suitable. Yang Yuanru stated: Lung Bi and Liver Bi refer not to pathology in the organs themselves, but in their domains.)
If untreated, Liver transmits to Spleen, named Pi Feng (Spleen Wind), manifesting as Dan jaundice, abdominal heat, vexation, and yellow urine. At this time, massage, medicine, or bathing can be used. (Failure to treat leads Liver to transmit to Spleen, named Pi Feng. Liver is Wind-Wood pathogen, attacking Spleen-Earth, hence 'Spleen Wind'. Dan refers to Fire Dan. Wind invades Wet Earth...)