黄帝问曰。余闻揆度奇恒。所指不同。用之奈何。（病能篇曰。揆者。方切求之也。言切求其脉理也。度者。得其病
处。以四时度之也。奇恒者。异于恒常也。指、示也。言奇恒之道。有色脉阴阳。浅深顺逆。指示多有不同。将用何法
以得其要。）岐伯对曰。揆度者。度病之浅深也。奇恒者。言奇病也。请言道之至数。五色脉变。揆度奇恒。道在于一。
神转不回。回则不转。乃失其机。（此篇论脉因度数出入。五脏之气。相生而传。一以贯通。外内环转。如逆回则为病矣。
与脉要精微平人气象诸论之脉病不同。故曰奇病也。夫脉始于足少阴肾。生于足阳明胃。输于足太阴脾。故太阴为之行
气于三阴。灌溉于四脏。至数者。脉因出入之度数也。五色脉变者。五脏之脉。变见于色也。一者。神也。神者。五脏
血脉之神气也。盖脾为孤脏。中央土。以灌四旁。五脏受气。转而不回者也。如逆传其所胜。是回则不转。乃失其相生
旋转之机矣。故曰五脏相通。移皆有次。五脏有病。则各传其所胜。莫子晋问曰。此篇章旨。与辨脉篇趺阳脉浮而涩。
少阴脉如经也。平脉篇之寸口脉弱而迟诸节同义与。曰。仲祖之伤寒论。原本于灵素诸经。而更阐发其未尽之旨。子也
知此。可予言会悟矣。）至数之要。迫近以微。（言五脏经气相通。阴阳并合。至切近而微。故曰。诊合微之事。追阴阳
之变。）着之玉版。命曰合玉机。（玉版、玉机、二篇名。言脉行至数之要。若板籍之有格有序。故方盛衰论曰。脉事因
格。玉机论曰。五脏相通。移皆有次。合玉机者。又如璇玑玉衡之旋转也。）容色见上下左右。各在其要。（容、面也。
疏五过论曰。上经下经。揆度阴阳。奇恒五中。决以明堂。审于终始。可以横行。言奇恒之病。发于五脏之中。而五脉
之气色。外见于明堂之上下左右。各在其浅深顺逆之要耳。）其色见浅者。汤液主治。十日已。（色见浅。其病亦微。故
以汤液治之。而十日可愈。夫奇恒之道。五脏皆禀气于胃。足太阴为之转输。病则逆回而色见于面。故用汤液治之。盖
以稻米之液。助土气之资生。十干已周。俾五脏之气复。）其见深者。必齐主治。二十一日已。（色见深。其病亦深矣。
故必齐毒药攻其中。二十者。偶数之终。一者。生阳之始。以十干而再周。复得甲而化土。五脏为阴。气色为阳。二十
一日。五脏之生气已复转矣。）其见大深者。醪酒主治。百日已。（色大深。则病更深矣。醪醴、熟谷之液。其气 悍。
饮酒者。卫气先行皮肤。先充络脉。荣卫营运。则所逆之色亦散矣。因色大深。至甲十复而后已也。所谓色者。因五脏
之变而见于五色也。）色夭面脱。不治。百日尽已。脉短气绝死。（五脏之气荣于脉。五经之脉见于色。气血衰。则面色
脱而夭然不泽。故至百日。五脏之气尽而已矣。若脉短气绝。乃虚脱已极。丧无日矣。上节言回则不转。而见色之浅深。
此言气血虚脱。而为不治之死证。下节言受外淫之邪。而致荣卫内陷。）病温虚甚死。（上节言脉气之从内而外。此论荣
卫受邪。反从外而内。即下文所谓八风之胜。终而复始。玉机篇之所谓风寒客于人。从毫毛皮肤传于五脏是已。温病者。
外感风寒。发为温热之病。辨脉篇曰。风则伤卫。寒则伤荣。又曰。荣卫内陷。其数先微。盖荣卫气机。从内达外。风
寒之邪。从外内侵。荣卫受伤。则脉气反陷。然犹藉其根气盛强。则邪随正而复出于外。若正气虚甚。邪惟内侵。邪盛
正虚。必死之候也。）色见上下左右。各在其要。上为逆。下为从。女子右为逆。左为从。男子左为逆。右为从。易。重
阳死。重阴死。（此言色见上下左右。各有男女顺逆之要焉。五色篇曰。其色上行者。病益甚。其色下行。如云彻散者。
病方已。女为阴。右亦为阴。故女子色见于右为逆。见于左为从。男为阳。左亦为阳。故男子色见于左为逆。见于右为
从。易、谓如男女之左右反易。是为重阳者死。重阴者死。）阴阳反他。治在权衡相夺。（反他、言男女阴阳之色反逆
也。权衡
脉也。相夺者。夺其逆于右者从左。逆于左者从右。盖色生于脉。治其脉顺。则色亦顺矣。按方盛衰论曰。阳从左。阴
从右。盖男子之血气从左旋。女子之血气从右转。是以男子之色见于右。而从左散者顺也。女子之色见于左。而从右散
者顺也。）奇恒事也。揆度事也。（承上文而言。奇恒、脉事也。揆度、度事也。言揆度奇恒者。度脉之事也。方盛衰论
曰。度事上下。脉事因格。度事者。度阴阳上下顺逆之事也。脉事者。言脉因前后度数出入。而有一定之格也。）搏脉痹
。寒热之交（此言脉不循度旋转。而反阴阳相搏。则又为痹 寒热之病矣。但臂不遂者名曰痹。 乃足之疾也。盖经
脉五俞。出于手足。阴阳相贯。上下循行。如反相搏击。故为手足痹 寒热之病。盖阴乘于阳则为寒。阳乘于阴则为热。
阴阳相搏。则为寒热之交也。）脉孤为消气。虚泄为夺血。孤为逆。虚为从。（此言神转不回者。五脏之神气也。盖血随
气行。神气虚消。则脉不能至于手太阴。而脉孤弱矣。此太阴阳明之生气渐消。乃危殆之逆证也。如经虚下泄。此为夺
血。非生气消灭。故为从。平脉篇曰。趺阳脉不出。脾不上下。身冷肤硬。此脾胃之气虚消。而脉不能循经外转。致有
身冷肤硬之危。所谓逆者此也。辨脉篇曰。趺阳脉浮而涩。故知脾气不足。胃气虚也。又曰。少阴脉反滑而数者。故知
当屎脓也。阳明脉微沉。少阴脉微滑。此为阴实。其人必股内汗出。阴下湿也。金匮要略曰。少阴脉滑而数者。阴中即
生疮。野狼牙汤洗之。又曰。胃气下泄。阴吹而正喧。膏发煎导之。此皆虚陷之证。治之即愈。所谓顺者此也。）行奇恒之
法。以太阴始。（五脏皆禀气于胃。而不得至经。必因于脾。乃得禀也。脾为孤脏。中央土。以灌四旁。五脏相通。次序
环转。是行奇恒之法。从太阴始。）行所不胜曰逆。逆则死。行所胜曰从。从则活。（行所不胜者。五脏相克而传。即回
则不转也。行所胜者。五脏相生而传。即神转不回也。故曰。五脏相通。移皆有次。五脏有病。则各传其所胜。）八风四
时之胜。终而复始。逆行一过。不复可数。论要毕矣。（八风、八方之风也。四时之胜者。春胜长夏。长夏胜冬。冬胜夏。
夏胜秋。秋胜春也。终而复始者。言脉之逆行。而亦循度环转也。前节论本气虚消之逆传。此复论八风之邪。四时之胜。
以致脉气逆行。荣卫内陷。而亦循度回转也。逆行一过。不复可数者。言风寒客于人。始伤皮毛。而内舍于肺。肺传之
肝。肝传之脾。脾传之肾。肾传之心。逆行一过则死矣。不复如顺行之循环无端之可数也。风之邪。四时之胜。逆行环
转一周。不复可数。奇恒之道。尽于此矣。）
Huangdi asked, saying: I have heard that "Kui Du" (Measuring and Estimating) and "Qi Heng" (Abnormal and Normal) refer to different things. How should they be applied? (In the *Bing Neng* chapter, it is said: "Kui" means cutting and seeking, referring to carefully investigating the principles of the pulse. "Du" means determining the location of the disease and measuring it according to the four seasons. "Qi Heng" means differing from the constant. "Zhi" indicates showing. It means that the way of Qi Heng, regarding complexion, pulse, Yin-Yang, depth, and compliance, often shows many differences in indication. Which method should be used to grasp the essence?)
Qibo replied: Kui Du is used to measure the depth and shallowness of diseases. Qi Heng refers to discussing abnormal diseases. Please allow me to expound the ultimate number of the Dao: The changes in the five colors and pulses, when applying Kui Du and Qi Heng, lie in one principle. Shen (Spirit/Vitality) turns and does not return; if it returns, it cannot turn, thus losing its opportunity/mechanism. (This chapter discusses the pulse due to degrees of entry and exit. The Qi of the five Zang organs generates and transmits through each other, connected as one, rotating internally and externally like a ring. If it reverses and returns, it becomes disease. This differs from the pulse-disease discussions in chapters like *Mai Yao Jing Wei* and *Ping Ren Qi Xiang*, hence it is called an abnormal disease. Pulse Qi starts from the Foot-Shaoyin Kidney meridian, is born from the Foot-Yangming Stomach meridian, and is transported by the Foot-Taiyin Spleen meridian. Therefore, the Taiyin transports Qi to the three Yin meridians and irrigates the four Zang organs. "Zhi Shu" refers to the degree of pulse entry and exit. Changes in five colors and pulses mean the pulses of the five Zang organs manifest in the complexion. "One" is Shen. Shen is the vital Qi of the blood vessels of the five Zang organs. The Spleen is a solitary organ, belonging to Central Earth, which irrigates the four directions. The five Zang organs receive Qi and turn without returning. If it transmits inversely to what it overcomes, it returns without turning, thus losing the mechanism of generating and rotating. Thus it is said: The five Zang organs are interconnected, and their movement has order. When the five Zang organs are diseased, each transmits to what it overcomes. Mo Zijin asked: Is the main theme of this chapter consistent with the sections in *Bian Mai* regarding the Fuyang pulse being floating and choppy while the Shaoyin pulse is normal, and in *Ping Mai* regarding the Cunkou pulse being weak and slow? Answer: Zhang Zhongjing's *Shanghan Lun* originates from the *Lingshu* and *Suwen* classics but further elucidates their unexpressed meanings. If you understand this, you can attain enlightenment with me.)
The essence of Zhi Shu lies in being extremely close and subtle. (It means the Jing Qi of the five Zang organs are interconnected, Yin and Yang combine, reaching a state extremely close and subtle. Hence, diagnosing subtle matters allows one to pursue the changes of Yin and Yang.) Record this on the Jade Tablet, naming it "He Yu Ji" (Combining with the Jade Machine). (*Yu Ban* and *Yu Ji* are titles of two chapters. It means the essence of pulse movement and Zhi Shu is like a ledger with rules and order. Thus, *Fang Sheng Shuai Lun* says: Pulse affairs follow the grid; *Yu Ji Lun* says: The five Zang organs are interconnected, and their movement has order. "Combining with Yu Ji" is like the rotation of the celestial sphere.)
Complexion colors appearing up, down, left, and right each correspond to their key areas. (Rong refers to the face. *Shu Wu Guo Lun* says: Ancient and modern medical classics measure Yin and Yang; Qi Heng and Wuzhong are decided at Ming Tang (the nose), examining beginning and end allows one to practice freely. It means abnormal diseases originate within the five Zang organs, and the Qi color of the five pulses manifests externally at the up, down, left, and right of Ming Tang, each lying in the key points of depth and compliance.)
If the color appears shallow, treat with Decoction (Tang Ye); it will heal in ten days. (Shallow color indicates slight disease, so treat with decoction, healing in ten days. In the way of Qi Heng, all five Zang organs receive Qi from the Stomach, and the Foot-Taiyin transforms and transports it. Disease causes Qi to reverse and return, manifesting color on the face, hence treated with decoction. Essentially, using rice liquid aids Earth Qi for generation. After ten Heavenly Stems cycles, the Qi of the five Zang organs recovers.)
If the color appears deep, treat with Formulas (Qi/Zi); it will heal in twenty-one days. (Deep color indicates deep disease, so treat with medicinal formulas to attack internally. Twenty is the end of even numbers, One is the beginning of Yang generation. Repeating the ten Heavenly Stems and obtaining Jia again transforms into Earth. Five Zang are Yin, Qi color is Yang. In twenty-one days, the generating Qi of the five Zang organs recovers and turns.)
If the color appears very deep, treat with Wine (Lao Jiu); it will heal in one hundred days. (Very deep color means deeper disease. Lao Li is liquid from cooked grains, its Qi is fierce. Drinking wine makes Wei Qi move first in the skin, filling collaterals. When Ying and Wei circulate, the reversed color dissipates. Due to very deep color, it heals after ten Jia-Zi cycles. Color arises from changes in the five Zang organs manifesting in the five colors.)
Withered complexion and facial emaciation indicate untreatable conditions; death occurs at the end of one hundred days. Short pulse and exhausted Qi lead to death. (The Qi of the five Zang organs nourishes the pulses, and the pulses of the five meridians manifest in color. When Qi and Blood decline, the face becomes emaciated and withered without luster. By one hundred days, the Qi of the five Zang organs exhausts. If the pulse is short and Qi is exhausted, it is extreme deficiency and near death. The previous section discussed "returning without turning" and seeing shallow/deep colors; this section discusses Qi and Blood deficiency leading to untreatable death. The next section discusses external pathogenic factors causing Ying and Wei to sink inward.)
Warm disease with severe deficiency leads to death. (The previous section discussed pulse Qi moving from inside out; this discusses Ying and Wei receiving pathogens and moving from outside in, i.e., the victory of the Eight Winds ending in renewal. As stated in *Yu Ji Lun*: Wind-Cold invading humans travels from hair follicles and skin to the five Zang organs. Warm disease is caused by external Wind-Cold developing into warm-heat pathology. *Bian Mai* says: Wind injures Wei, Cold injures Ying. Also: Ying and Wei sinking inward, their rapid pulse becomes faint initially. Ying and Wei Qi mechanism should move from inside to outside; Wind-Cold pathogens invade from outside to inside. When Ying and Wei are injured, pulse Qi sinks inversely. However, if root Qi is strong, pathogens exit with Zheng Qi. If Zheng Qi is severely deficient, pathogens only invade inward. Excess pathogens and deficient Zheng Qi indicate inevitable death.)
Colors appearing up, down, left, and right each correspond to key areas. Upward is Reverse (Ni), downward is Compliant (Cong). For women, Right is Reverse, Left is Compliant; for men, Left is Reverse, Right is Compliant. Double Yang leads to death, Double Yin leads to death. (This states that color appearance in up/down/left/right has specific compliance/reverse keys for men and women. *Wu Se Lun* says: Color moving upward worsens the disease; color moving downward, dispersing like clouds, indicates recovery. Women are Yin, Right is also Yin, so color on the Right for women is Reverse, on the Left is Compliant. Men are Yang, Left is also Yang, so color on the Left for men is Reverse, on the Right is Compliant. Yi means reversing left/right like men/women. This is Double Yang or Double Yin, both leading to death.)
When Yin and Yang are contrary and abnormal, treatment lies in balancing and overcoming. (Fan Ta means the colors of Yin and Yang for men and women are reversed. Quan Heng refers to the pulse. Xiang Duo means overcoming the reversal on the Right by treating from the Left, and vice versa. Color is born from the pulse; treating the pulse smoothly makes the color smooth. According to *Fang Sheng Shuai Lun*: Yang follows Left, Yin follows Right. Men's Qi and Blood rotate from the Left, women's from the Right. Thus, men's color appearing on the Right dispersing from the Left is compliant; women's color appearing on the Left dispersing from the Right is compliant.)
This concerns Qi Heng matters and Kui Du matters. (Continuing from above: Qi Heng is pulse affairs; Kui Du is measurement affairs. Applying Kui Du and Qi Heng means measuring pulse affairs. *Fang Sheng Shuai Lun* says: Measurement affairs go up and down, pulse affairs follow the grid. Measurement affairs measure the compliance/reverse of Yin/Yang up and down. Pulse affairs refer to the fixed grid of pulse entry/exit based on prior degrees.)
Pulse striking, Bi syndrome, and alternating cold and heat. (This states that if the pulse does not rotate according to degree but instead Yin and Yang strike each other, it results in Bi syndrome and alternating cold and heat. Arm inability to move is called Bi, but here it refers to foot ailments. The five Shu points of meridians emerge from hands and feet, Yin and Yang interweave, circulating up and down. If they strike inversely, it causes hand-foot Bi and alternating cold/heat. Yin invading Yang causes cold; Yang invading Yin causes heat; Yin-Yang striking causes alternating cold and heat.)
Isolated pulse indicates consumption of Qi; deficient diarrhea indicates loss of Blood. Isolation is Reverse (Ni), Deficiency is Compliant (Cong). (This states that "Shen turns without returning" refers to the Shen Qi of the five Zang organs. Blood follows Qi; if Shen Qi is deficient and consumed, the pulse cannot reach Hand-Taiyin, becoming isolated and weak. This is the gradual consumption of generating Qi in Taiyin and Yangming, a critical Reverse condition. If meridian Qi is deficient and drains downward, this is loss of Blood, not consumption of generating Qi, hence Compliant. *Ping Mai* says: Fuyang pulse not emerging, Spleen not ascending/descending, body cold and skin hard—this is Spleen-Stomach Qi deficiency and consumption, pulse failing to rotate outward, causing danger. This is the Reverse. *Bian Mai* says: Fuyang pulse floating and choppy indicates insufficient Spleen Qi and deficient Stomach Qi. Also: Shaoyin pulse slippery and rapid indicates pus in stool. Yangming pulse slightly deep, Shaoyin pulse slightly slippery indicates Yin excess, causing sweating in inner thighs and dampness in genitals. *Jin Gui Yao Lue* says: Shaoyin pulse slippery and rapid indicates ulcers in the yin region, wash with *Ye Lang Ya Tang*. Also: Stomach Qi leaking downward causes flatulence, guide with *Gao Fa Jian*. These are deficiency-sinking conditions, curable with treatment. This is the Compliant.)
To practice the method of Qi Heng, start with Taiyin. (All five Zang organs receive Qi from the Stomach but cannot reach the meridians directly; they must rely on the Spleen. The Spleen is a solitary organ, Central Earth, irrigating the four directions. The five Zang organs are interconnected, rotating in order. Thus, practicing Qi Heng starts from Taiyin.)
Moving against what one cannot overcome is Reverse (Ni), leading to death; moving against what one overcomes is Compliant (Cong), leading to life. (Moving against what one cannot overcome means transmission via mutual restriction, i.e., returning without turning. Moving against what one overcomes means transmission via mutual generation, i.e., Shen turning without returning. Thus: The five Zang organs are interconnected, movement has order; when diseased, each transmits to what it overcomes.)
The victory of the Eight Winds and Four Seasons ends and begins anew. Once reversed, it cannot be counted again. The essentials are concluded. (Eight Winds refer to winds from eight directions. Victory of Four Seasons: Spring overcomes Long Summer, Long Summer overcomes Winter, Winter overcomes Summer, Summer overcomes Autumn, Autumn overcomes Spring. Ending and beginning anew means pulse reversal also rotates according to degree. The previous section discussed Reverse transmission due to intrinsic Qi deficiency; this section discusses Eight Wind pathogens and seasonal victories causing pulse reversal and Ying-Wei sinking, yet still rotating by degree. "Once reversed, cannot be counted" means Wind-Cold invades, damages skin/hair, enters Lung, transmits to Liver, Spleen, Kidney, Heart. One cycle of reversal leads to death, no longer countable like the endless cycle of compliance. One cycle of reversal by Wind pathogens and seasonal victories cannot be counted. The way of Qi Heng ends here.)