黄帝问曰。诊法何如。岐伯对曰。诊法常以平旦。阴气未动。阳气未散。饮食未进。经脉未盛。络脉调匀。气血
未乱。故乃可诊有过之脉。（此篇首论诊脉之法。夫色脉之道。至精至微。然本于阴阳气血。阴静而阳动。有所动作。
则静者动而动者散乱矣。故诊法当以平旦。夫饮食于胃。淫精于脉。脉气流经。经脉盛则络脉虚。是以饮食未进。则经
络调匀。血气未乱。故可诊有过之脉。盖言平旦之时。知有过在病。而不在阴阳之正气耳。以下四篇。皆论诊脉之法。
而各有不同焉。杨元如曰。经脉属脏。则络脉络腑。经脉属腑。则络脉络脏。经络不调。则脏腑之气不和矣。）切脉动静。
而视精明。察五色。观五脏有余不足。六腑强弱。形之盛衰。以此参伍。决死生之分。（动静者。阴阳动静也。精明、五
脏之精神见于声色也。切脉观色。以审脏腑之强弱虚实。兼视形体之盛衰。以此参伍错综而斟酌之。以决其死生之分焉。
此篇论切脉察色。听音声。观脏腑。审形体。四诊咸备。斯成脉要之精微。）夫脉者。血之府也。长则气治。短则气病。数则烦心。大则病进。（此言脉所以候阴阳气血也。血行脉中。故为血之府。荣气宗气。行于脉中。卫气行于脉外。脉随
气行。是以脉长则气平。脉短则气病矣。心主血脉。数乃热迫所生。则烦心大则病进于脉内。上二句辨脉气。下二句审
血脉。）上盛则气高。下盛则气胀。代则气衰。细则气少。涩则心痛。（上盛、谓寸口脉盛。主气上升而气高。下盛、
谓尺中脉盛。主气下逆而为胀。代脉者。动而中止。不能自还。主气之衰败也。辨脉篇曰。脉萦萦如蜘蛛丝者。阳气衰
也。言脉中之荣气宗气不足。是以脉细如丝。涩主少血。则心虚而为痛矣。莫子晋曰。代则气衰。阳气衰也。细则气少。
阴气少也。）浑浑革至如涌泉。病进而色弊。绵绵其去如弦绝。死。（此复形容病进之脉象。邪甚血亡。而为死证也。浑
浑、浊乱疾流之貌。革至者。迥异于平常也。此血脉受邪。而内乱如涌泉也。夫色生于血。病进于脉。而色亦败恶矣。
辨脉篇曰。脉绵绵如泻漆之绝者。亡其血也。绵绵其去如弦。细而欲绝者。形容其脉去之象也。病进而脉至如此之盛。
血亡而脉去如此之衰。血者神气也。邪盛正亡。不治之死证矣。以上论切脉之大概。以别阴阳气血之盛衰。王芳侯曰。
上盛则气高。至细则气少。即长则气治。短则气病之义。涩则心痛。至绵绵其去如弦绝。乃复形容数则烦心。大则病进
也。）夫精明五色者。气之华也。赤欲如白裹朱。不欲如赭。白欲如鹅羽。不欲如蓝。青欲如苍璧之泽。不欲如盐。黄
欲如罗裹雄黄。不欲如黄土。黑欲如重漆色。不欲如地苍。五色精微象见矣。其寿不久也。（此言色生于气。气生于脏。
欲其气华于色。而不欲脏象见于外也。赤如白裹朱。白如鹅羽。青如苍碧。黄如罗裹雄黄。黑如重漆。乃五脏之气。章
华于色也。赤如赭。白如盐。青如蓝。黄如土。黑如地苍。此五脏之精象见于外也。夫脏者藏也。如五脏之真色。见而
不藏。则其寿不久矣。）夫精明者。所以视万物。别白黑。审短长。以长为短。以白为黑。如是则精衰矣。（五脏主藏精
者也。精有所藏。而后能视万物。审短长。如精微象见于外。则精气内衰。视物昏 。而寿不久矣。此反结上文之义。
而言视精明者。由藏精之所资也。以上论察色。）五脏者。中之守也。（此论五脏之精气。而发于音声也。五脏守于中。
而外发于音声者。藏精之所发也。盖言声色见于外。而五脏之精。守而不溢者也。）中盛脏满。气胜伤恐者。声如从室中
言。是中气之湿也。（经云。五脏主藏精者也。故曰。五脏者。中之守也。肾为水脏。受五脏之精而藏之。如肾不受藏。
则中盛脏满矣。恐为肾志。如肾气不藏。而反胜于中。则伤动其肾志矣。气胜伤恐。则精亦外溢。故曰此中气之湿也。
声如从室中言者。音不响亮。而声不外出也。此言肾为生气之原。音声由肾气之所发。如肾脏之精气不藏。则发声之如
是也。）言而微。终日乃复言者。此夺气也。（此言五脏之精气虚。而发声之如是也。微者。声气衰微也。终日复言者。
气不接续也。伤寒论曰。实则谵语。虚则郑声。郑声者。重语也。重平声。）衣被不敛。言语善恶不避亲疏者。此神明之
乱也。（神明者。五脏之神气也。语言善恶不避亲疏者。神乱而谵语也。上节论正气之盛衰。此论邪气盛而正气昏乱）仓
廪不藏者。是门户不要也。水泉不止者。是膀胱不藏也。得守者生。失守者死。（此承上文而言五脏之精气。由中焦水谷
之所资生。藏于肾脏膀胱之府。脾胃为仓廪之官。主运化水谷。如仓廪不藏。则谷精下泄。而魄门幽户之不能禁也。膀
胱者。州都之官。津液藏焉。气化则出。水泉不止。是水惟下泄。而津液不藏也。如泄注止而得守者生。失守则死矣。
此盖言视精明。发音声。皆由肾脏所藏之精。如精盛脏满。则精液上溢。而声如从室中言。如仓廪不固。则精气夺而生
气渐绝矣。膀胱主下焦之决渎。津液虽藏。而气化则出。然有行有止。有阖有开。而又不可过泄者也。杨元如曰。按伤
寒论云。阳明病本自汗出。医更重发汗。病已瘥。尚微烦不了了者。此必大便硬故也。以亡津液。胃中干燥。故令大便
硬。当问其小便日几行。若本小便日三四行。今日再行。故知大便不久出。今为小便数少。以津液当还入胃中。故知不
久当大便也。以此论之。是膀胱之精。藏而不泻。亦还养五脏。故得守者生。失守者死。）夫五脏者。身之强也。（此
言四体百骸。髓精筋骨。亦皆由藏精之所资也。灵枢经脉篇曰。人始生。先成精。精成而脑髓生。骨为干。脉为营。筋
为刚。肉为墙。皮肤坚而毛发长。谷入于胃。脉道以通。血气乃行。盖言人之气血声色。筋骨肌肉。糜不由先天始生之
精。后天水谷之液。所资生而资养者也。）头者精明之府。头倾视深。精神将夺矣。（诸阳之神气。上会于头。诸髓之精。
上聚于脑。故头为精髓神明之府。髓海不足。则头为之倾。神气衰微。则视深目陷也。）背者胸中之府。背曲肩随。腑将
坏矣。（肩背为阳。胸腹为阴。阳为腑。阴为脏。心肺居于胸中。而俞在肩背。故背为胸之府。）腰者肾之府。转摇不能。
肾将惫矣。（两肾在于腰内。故腰为肾之外府。）膝者筋之府。屈伸不能。行则偻附。筋将惫矣。（筋会阳陵泉。膝乃筋之
会府也。偻曲其身。附、根据附而行也。筋乃肝之合。筋将惫者。肝脏之精气衰也。）骨者髓之府。不能久立。行则振掉。
骨将惫矣。得强则生。失强则死。（髓藏于骨。故骨为髓之府。不能久立。髓竭于内也。髓竭则骨将惫矣。此五者。得腑
气之强则生。失强则腑坏而脏将绝矣。以上论观五脏有余不足。六腑强弱。形之盛衰。杨元如曰。强者。六腑之气强也。
腑者脏之合。腑阳而脏阴。阳外而阴内。是以头背腰膝将惫。犹藉腑气之强。故曰观六腑之强弱。莫子晋曰。六腑之气
强。由五脏之有余。五脏之不足。又藉腑气之盛强。故曰腰者肾之府。转摇不能。肾将惫矣。阴阳脏腑之互相资生者也。）
岐伯曰。反四时者。有余为精。不足为消。应太过。不足为精。应不足。有余为消。阴阳不相应。病名曰关格。（此总结
上文而言。视精明。亮音声。强筋骨。健形体。皆由精之所资。而脏腑之精气。与四时之气相反者也。盖脏为阴。腑为
阳。秋冬为阴。春夏为阳。肾主冬令闭藏之气。而反中盛脏满。是有余者为肾藏之精。膀胱主太阳夏盛之气。而反水泉
下泄。是不足者为膀胱之消。是与四时相反者矣。若应太过而反不足为精。是肾藏之精。反泄于外矣。应不足而反有余
为消。是膀胱之水。反蓄于内矣。此脏腑阴阳之不相应。病名曰关格。关则不得小便也。此盖言州都之津。气化则出。
而视精明。发音声。资神明。坚筋骨。皆由肾脏所藏之精。而气血亦由此精之所生化也。子晋问曰。反四时而只言冬夏。
病关格而只曰不得尿。恐与经旨不合与。曰。日月营运。一寒一暑。故下文曰。彼春之暖。为夏之暑。彼秋之忿。成冬
之怒。虽四时成岁。而总属寒暑之往来。平脉篇曰。下微本大者。则为关格不通。不得尿。又曰。趺阳脉伏而涩。伏则
吐逆。水谷不化。涩则食不得入。名曰关格。是不得小便者。病名关格。吐逆者。亦名关格也。）帝曰。脉其四时动奈
何。知病之所在奈何。知病之所变奈何。知病乍在内奈何。知病乍在外奈何。请问此五者。可得闻乎。（以上论切脉气。
察精明。听音声。审脏腑之有余不足。观形体之盛衰。参伍错综。以决死生之分。此以下。复论脉合阴阳四时。诊脉而
知病之所在。病成而变为他病。候尺寸。以分别脏腑之外内。上下左右。曲尽其脉要精微之理。故复设此问焉。）岐伯曰。
请言其与天运转大也。（言人之阴阳出入。与天道运转之大相合。）万物之外。六合之内。天地之变。阴阳之应。彼春之
暖。为夏之暑。彼秋之忿。为冬之怒。四变之动。脉与之上下。（寒暑相推而岁成。一阴一阳之谓道。言四时之气。总属
寒暑之往来。脉应四时之变。亦与阴阳之上下耳。天气包乎万物之外。运转于六合之内。其变动之应。彼春之暖。为夏
之暑。言阳气从生升而至于盛长也。彼秋之忿。为冬之怒。言阴气自清肃而至于凛冽也。此四时阴阳之变动。而脉亦与
之上下浮沉。）以春应中规。夏应中矩。秋应中衡。冬应中权。（此论脉应四时之变也。规者。所以为圆之器。春时天气
始生。其脉 弱轻虚而滑。如规之圆转而动也。矩者。所以为方之器。夏时天气正方。其脉洪大。如矩之方正而盛也。
秋时天气始降。其脉浮平。有如衡之平准也。冬时天气闭藏。其脉沉石。有如权之下垂也。）是故冬至四十五日。阳气微
上。阴气微下。夏至四十五日。阴气微上。阳气微下。阴阳有时。与脉为期。期而相失。知脉所分。分之有期。故知死
时。（此言四变之动。总属阴阳之出入。而脉与之上下也。四十五日者。从冬至而至立春。从夏至而至立秋。冬至一阳初
生。阳气微上。阴气微下。至春而阳气始方。至夏盛长。而阴气下藏矣。夏至一阴初生。阴气微上。阳气微下。至秋而
阴气清凉。至冬凛冽。而阳气伏藏矣。阴阳升降出入。离合有期。而脉亦与之相应。如期而脉气相失。则知脉之所分。
分之有期。故知死时也。平脉篇曰。寸脉下不至关为阳绝。尺脉上不至关为阴绝。此皆不治。决死也。若计其余命生死
之期。期以月节克之也。即所谓分之有期。而知死时也。如冬至四十五日。阳气微上。夏至四十五日。阴气微上。而尺
脉上不至关。为阴绝于下矣。夏至四十五日。阳气微下。冬至四十五日。阴气微下。而寸脉下不至关。为阳绝于上矣。
此上下阴阳。不相交合。而反分离。与四时之期相失。故知脉之所分。而知死时也。知死时者。期以四离四绝之月节。
克之而死也。）微妙在脉。不可不察。察之有纪。从阴阳始。始之有经。从五行生。生之有度。四时为宜。（承上文而言
脉应阴阳四时之微妙。不可不细察焉。纪、纲也。察脉之纲领。当从阴阳始。即冬至阳气微上。夏至阴气微上。阴阳上
下。自有经常之理。然又从五行而生。如春木生夏火。火生长夏土。土生秋金。金生冬水。水生春木。生之有度。而四
时为五行相生之宜。）补泻勿失。与天地如一。得一之情。以知死生。（夫四时有未至而至。至而不至。至而太过。至而
不及。而人亦应之。是以脉之不及则补之。太过则泻之。与天地四时之太过不及。治之如一。与天地阴阳之道。合之如
一焉。得一之情。可以知死生矣。如脏象论之所谓谨候其时。气可与期。失时反候。五治不分。邪僻内生。工不能禁。
此因天地四时之气。而为人之死生也。如平脉篇之所谓寸脉下不至关为阳绝。尺脉上不至关为阴绝。此脉与天地四时之
气。期而相失。而为死生也。）是故声合五音。色合五行。脉合阴阳（声合天地之五音。色合天地之五行。脉合天地之阴
阳。而始能得一之情。以知死生。）是知阴盛则梦涉大水恐惧。阳盛则梦大火燔灼。阴阳俱盛则梦相杀毁伤。（此言天地
之阴阳五行。而合于人之阴阳脏腑也。梦者。魂魄神气之所游行。肝主血而藏魂。肺主气而藏魄。心主火而为阳。肾主
水而为阴。是以阴盛则梦大水。阳盛则梦大火。阴阳俱盛。两不相降。故梦相杀毁伤也。）上盛则梦飞。下盛则梦堕。（王
氏曰。气上则梦上。故飞。气下则梦下。故堕。）甚饱则梦予。甚饥则梦取。（予与同。有余故梦予。不足故梦取。此言
中焦脾胃之气。有虚有实。而形诸梦也。）肝气盛则梦怒。肺气盛则梦哭。（气并于肝则怒。并于肺则悲。故与梦相合。）
Huangdi asked, "How is pulse diagnosis conducted?" Qibo replied, "Pulse diagnosis is usually performed at dawn. At this time, Yin qi has not yet stirred, Yang qi has not yet dispersed, food and drink have not been taken in, the Jingmai (Primary Meridians) are not yet full, the Luomai (Collateral Vessels) are harmonious and even, and the Yingqi (Nutritive Qi) and Xueqi (Blood Qi) are not yet disturbed. Therefore, only then can abnormal pulses be diagnosed." (This section begins by discussing the method of pulse diagnosis. The principles of observing complexion and palpating the pulse are extremely subtle and profound, but they are rooted in Yin-Yang, Qi, and Blood. Yin is static while Yang is active. If there is movement, the static becomes dynamic, and the dynamic becomes scattered and chaotic. Thus, pulse diagnosis should be conducted at dawn. Food enters the Stomach, transforms into essence, and enters the vessels. Pulse Qi flows through the meridians; if the Jingmai are excessive, the Luomai become deficient. Therefore, before food intake, the meridian and collateral Qi are harmonious, and blood and Qi are undisturbed, allowing for the diagnosis of abnormal pulses. This implies that at dawn, one can discern abnormalities in pathogenic factors rather than in the righteous Qi of Yin and Yang. The following four chapters all discuss pulse diagnosis, each with its own characteristics. Yang Yuanru stated: The Jingmai belong to the Zang organs, so the Luomai belong to the Fu organs; the Jingmai belong to the Fu organs, so the Luomai belong to the Zang organs. If the meridians and collaterals are not harmonious, the Qi of the Zang and Fu organs will not be harmonious.) By palpating the pulse to perceive its dynamics and stillness, observing the clarity of the eyes, examining the five complexions, observing whether the Zang organs have excess or deficiency, assessing the strength or weakness of the Fu organs, and evaluating the flourishing or declining state of the physique, these aspects are cross-referenced to determine the boundary between life and death. (Dynamics and stillness refer to the Yin-Yang dynamics. 'Jingming' refers to the spirit of the Zang organs manifesting in voice and expression. Through pulse palpation and color observation, the strength, weakness, excess, and deficiency of the Zang organs are examined, along with the physical condition. These factors are intricately weighed to decide the prognosis of life and death. This chapter discusses pulse taking, color observation, listening to sounds, observing the Zang organs, and assessing the physique, integrating the four diagnostic methods to achieve the subtlety of pulse essentials.) The Mai (Vessel/Pulse) is the residence of Blood. A long pulse indicates regulated Qi; a short pulse indicates diseased Qi; a rapid pulse indicates mental restlessness; a large pulse indicates disease progression. (This explains that the pulse reflects Yin-Yang, Qi, and Blood. Blood circulates within the vessels, so the vessel is the residence of blood. Ying Qi (Nutritive Qi) and Zong Qi (Gathering Qi) circulate within the vessels, while Wei Qi (Defensive Qi) circulates outside. The pulse follows the movement of Qi; thus, a long pulse indicates peaceful Qi, and a short pulse indicates diseased Qi. The Heart governs blood vessels; a rapid pulse is caused by heat forcing the pulse, leading to vexation; a large pulse indicates disease advancing within the vessels. The first two sentences distinguish Qi dynamics, and the last two examine blood vessels.) Excess in the upper part indicates rising Qi (shortness of breath); excess in the lower part indicates downward counterflow Qi causing distension; a Dai pulse (intermittent pulse) indicates Qi decline; a thin pulse indicates Qi deficiency; a choppy pulse indicates heart pain. ('Upper excess' refers to an excess pulse at the Cun position, indicating rising Qi and shortness of breath. 'Lower excess' refers to an excess pulse at the Chi position, indicating downward counterflow Qi causing distension. The Dai pulse stops temporarily and cannot recover on its own, indicating Qi decline. The Bian Mai Pian states: 'A pulse like a spider's thread indicates Yang Qi decline.' This means insufficient Ying Qi and Zong Qi in the pulse result in a thread-thin pulse. 'Choppy' indicates blood deficiency, leading to heart pain due to Heart deficiency. Mo Zijin said: Dai pulse indicates Qi decline, i.e., Yang Qi decline; thin pulse indicates Qi deficiency, i.e., Yin Qi deficiency.) A turbulent, rapid pulse surging like a spring indicates disease progression and deteriorated complexion; a pulse that fades away slowly like a breaking string indicates death. (This further describes the pulse image of disease progression. Extreme pathogenicity and blood loss lead to a fatal syndrome. 'Hunhun' describes a turbid, chaotic, and rapid flow. 'Ge zhi' means significantly different from normal. This indicates pathogens affecting the blood vessels, causing internal chaos like a gushing spring. Complexion is generated by blood; as disease progresses in the pulse, the complexion also deteriorates. The Bian Mai Pian states: 'A pulse lingering like the end of pouring lacquer indicates blood loss.' 'Mian mian qi qu ru xian jue' describes the fading quality of the pulse. As disease progresses and the pulse becomes overly vigorous, but blood is lost and the pulse fades rapidly, it indicates that blood is the carrier of Shen Qi (Spirit). When pathogens are excessive and righteous Qi perishes, it is an untreatable fatal syndrome. The above discusses the general principles of pulse taking to distinguish the excess and deficiency of Yin-Yang and Qi-Blood. Wang Fanghou said: 'Upper excess leads to high Qi' to 'thin pulse indicates little Qi' corresponds to 'long pulse indicates regulated Qi, short pulse indicates diseased Qi'. 'Choppy pulse causes heart pain' to 'fading like a broken string' reiterates 'rapid pulse causes vexation, large pulse indicates disease progression'.) Clear eyes and five complexions are the splendor of Qi. Red should resemble white silk wrapping cinnabar, not hematite; white should resemble goose feathers, not azurite; green should resemble the luster of dark jade, not salt; yellow should resemble raw yellow earth wrapped in silk, not loess; black should resemble heavy lacquer, not dark soil. If the subtle images of the five colors appear (indicating the exposure of organ essences), life expectancy will be short. (This explains that color is generated by Qi, and Qi by the Zang organs. One desires Qi to manifest as splendor in the complexion, not the true image of the Zang organs exposed externally. Red like white-wrapped cinnabar, white like goose feathers, green like dark jade, yellow like silk-wrapped realgar, black like heavy lacquer represent the splendor of Zang Qi. Red like hematite, white like salt, green like azurite, yellow like earth, black like dark soil represent the exposure of Zang essence externally. 'Zang' means storage. If the true colors of the Zang organs are exposed without being stored, life will be short.) Clear vision allows one to see all things, distinguish black and white, and judge length and shortness. If one perceives long as short and white as black, it indicates the decline of Jing (Essence). (The Zang organs store Essence. Only when Essence is stored can one observe things clearly. If the subtle signs of decline appear externally, internal Essence is depleted, vision becomes blurred, and life expectancy is short. This reverses the previous meaning, stating that observing clear eyes depends on the function of storing Essence. The above discusses color observation.) The Zang organs are the guardians within. (This discusses the Essence-Qi of the Zang organs manifesting in voice. The Zang organs guard internally and manifest externally in voice, which is the emission of stored Essence. It means that voice and expression appear externally, while the Essence of the Zang organs is guarded and not溢出 (overflowing).) Internal fullness and organ distension, with excessive Qi injuring the fear response, result in a voice sounding as if coming from a room; this indicates dampness in the Middle Jiao. (The Classic says: The Zang organs store Essence. Thus, they are the internal guardians. The Kidney is the Water Organ, receiving and storing the Essence of all Zang organs. If the Kidney fails to store, internal fullness occurs. Fear is the emotion of the Kidney. If Kidney Qi does not store but overflows internally, it injures the Kidney's emotional aspect. Excessive Qi injuring fear causes Essence to overflow externally, hence described as Middle Jiao dampness. A voice sounding like it comes from a room is dull and does not project outward. This explains that the Kidney is the source of generating Qi, and voice emanates from Kidney Qi. If Kidney Essence-Qi is not stored, the voice manifests this way.) A faint voice, repeating speech throughout the day, indicates Qi depletion. (This explains that weak Zang Essence-Qi results in such vocalization. Faintness indicates衰微 (decline) of voice and Qi. Repeating speech indicates Qi failure to connect. The Shang Han Lun states: Excess leads to delirious speech; deficiency leads to Zheng Sheng (repetitive speech). Zheng Sheng refers to repetitive words.) Inability to manage clothing and bedding, and speaking indiscriminately about good and bad without avoiding relatives or strangers, indicates disorder of Shen Ming (Spirit). (Shen Ming refers to the Spirit of the Zang organs. Indiscriminate speech is delirium due to Spirit disorder. The previous section discussed the excess and deficiency of righteous Qi; this section discusses pathogenic excess causing righteous Qi confusion.) Failure of Cang Lin (Spleen/Stomach) to store indicates failure of the gates (orifices) to control; unceasing water springs (urination) indicate Bladder failure to store. Retention of Essence leads to life; loss of retention leads to death. (This continues the discussion on Zang Essence-Qi, generated by Middle Jiao grain and water, stored in the Kidney and Bladder. The Spleen and Stomach are the officials of the granary, governing digestion. If the granary fails to store, grain essence leaks downward, and the anal sphincter cannot control. The Bladder is the official of the reservoir, storing fluids, which are excreted upon Qi transformation. Unceasing urination means fluid leaks downward without storage. If leakage stops and retention is achieved, life ensues; loss of retention leads to death. This emphasizes that clear vision and voice depend on Kidney-stored Essence. If Essence is excessive and organs full, Essence-fluid overflows upward, causing a muffled voice. If the granary is insecure, Essence is depleted, and vital Qi gradually perishes. The Bladder governs Lower Jiao drainage; although fluids are stored, they are excreted via Qi transformation, having both flow and stop, opening and closing, and must not be excessively drained. Yang Yuanru cited the Shang Han Lun: Yangming disease with spontaneous sweating, treated with excessive sweating, may resolve but leave mild vexation due to dryness and hard stool from fluid loss. Asking about urine frequency helps predict bowel movements. Reduced urine indicates fluids returning to the Stomach, predicting imminent defecation. This demonstrates that Bladder Essence stores without leaking and nourishes the Zang organs; thus, retention brings life, loss brings death.) The Zang organs are the strength of the body. (This explains that limbs, bones, marrow, and sinews are also sustained by stored Essence. The Ling Shu Jing Mai Pian states: Human life begins with Essence, forming brain and marrow. Bones are the framework, vessels supply Ying, sinews provide rigidity, flesh forms the wall, skin is firm, and hair grows. Grain enters the Stomach, vessels open, and Qi-Blood circulate. All bodily aspects rely on congenital Essence and acquired grain-water fluids.) The Head is the residence of Jing Ming (Clear Vision/Spirit). Head drooping and deep-set eyes indicate impending loss of Spirit. (Yang Spirit converges on the head; Marrow Essence gathers in the brain. Thus, the head is the residence of Marrow and Spirit. Insufficiency of the Sea of Marrow causes head drooping; decline of Shen Qi causes sunken eyes.) The Back is the residence of the Chest. Curved back and drooping shoulders indicate deterioration of the Fu organs. (Shoulder and back are Yang, chest and abdomen are Yin. Yang corresponds to Fu, Yin to Zang. The Heart and Lung reside in the chest, with their Shu points on the back. Thus, the back is the residence of the chest.) The Waist is the residence of the Kidney. Inability to turn or shake the waist indicates Kidney exhaustion. (The two Kidneys are located within the waist, making the waist the external residence of the Kidney.) The Knees are the residence of Sinews. Inability to flex and extend, or walking stooped and leaning, indicates Sinew exhaustion. (Sinews converge at Yanglingquan; the knee is the convergence point. Stooping and leaning indicate Sinew weakness, reflecting Liver Essence decline.) The Bones are the residence of Marrow. Inability to stand for long periods or trembling while walking indicates Bone exhaustion. Strength leads to life; loss of strength leads to death. (Marrow is stored in bones; inability to stand indicates Marrow depletion. Marrow depletion leads to bone exhaustion. These five conditions: retaining Fu Qi strength ensures life; losing strength leads to Fu deterioration and Zang extinction. The above discusses observing Zang excess/deficiency, Fu strength/weakness, and physical flourishing/decline. Yang Yuanru stated: Strength refers to Fu Qi strength. Fu is the partner of Zang; Fu is Yang, Zang is Yin; Yang is external, Yin is internal. Thus, head, back, waist, and knee decline still rely on Fu Qi strength, hence observing Fu strength. Mo Zijin stated: Fu Qi strength stems from Zang excess. Zang deficiency relies on Fu strength. Thus, waist issues reflect Kidney decline. This illustrates the mutual generation of Yin-Yang and Zang-Fu.) Qibo said: Violating the Four Seasons, excess appears as Jing (refined/substantial), and deficiency appears as Xiao (consumption). Responding to excess with deficiency indicates Jing (deficiency); responding to deficiency with excess indicates Xiao (consumption). When Yin and Yang do not correspond, the disease is named Guan Ge (Obstruction and Repletion). (This summarizes that observing vision, voice, sinews, and physique depends on Essence, and Zang-Fu Essence contradicts the Four Seasons. Zang is Yin, Fu is Yang; Autumn/Winter are Yin, Spring/Summer are Yang. The Kidney governs Winter storage but shows internal fullness (excess where there should be storage); the Bladder governs Summer Yang but shows urinary leakage (deficiency where there should be abundance). This contradicts the seasons. Responding to expected excess with deficiency indicates Kidney Essence leaking; responding to expected deficiency with excess indicates Bladder Water accumulating. This non-correspondence is Guan Ge. Guan means inability to urinate. This emphasizes that fluid transformation and spiritual/physical functions depend on Kidney Essence. Zijin asked: Why only mention Winter/Summer regarding season violation, and only inability to urinate regarding Guan Ge? I reply: Sun and moon move, cold and heat alternate. As stated later: Spring warmth becomes Summer heat; Autumn severity becomes Winter cold. Though four seasons make a year, it is essentially cold-heat cycles. Ping Mai Pian states: Small Cun and large Chi indicate Guan Ge obstruction and inability to urinate. Also: Deep and choppy Duyang pulse indicates vomiting and indigestion; this is also Guan Ge.) The Emperor asked: How does the pulse move with the Four Seasons? How do we know the location of disease? How do we know disease transformation? How do we know disease temporarily inside? How do we know disease temporarily outside? Please explain these five points. (The above discussed pulse Qi, vision, voice, Zang/Fu status, and physique to determine life/death. Below, we discuss pulse correlating with Yin-Yang and Seasons, locating disease, tracking transformations, and using Cun-Chi positions to differentiate internal/external Zang/Fu, fully exploring pulse subtleties. Hence the question.) Qibo said: Let me speak of the great harmony between human Yin-Yang and heavenly rotation. Outside all things and within the Six Directions, changes in Heaven and Earth, responses of Yin and Yang. Spring warmth becomes Summer heat; Autumn severity becomes Winter cold. Movements of the Four Seasons cause the pulse to rise and fall. (Cold and heat alternate to form the year; Yin and Yang constitute the Dao. Seasonal Qi is essentially cold-heat cycles. The pulse responds to seasonal changes, rising and falling with Yin-Yang. Heaven covers all things, rotating within the Six Directions. Its changes mirror: Spring warmth to Summer heat (Yang rising to flourishing); Autumn severity to Winter cold (Yin clearing to freezing). These seasonal Yin-Yang changes cause the pulse to float and sink.) Spring pulse conforms to the Circle (Gui); Summer pulse conforms to the Square (Ju); Autumn pulse conforms to the Balance (Heng); Winter pulse conforms to the Weight (Quan). (This discusses pulse conforming to seasonal changes. Gui (compass) makes circles; Spring Qi generates, pulse is weak, light, void, and slippery, moving like a circle. Ju (square) makes squares; Summer Qi is upright, pulse is洪大 (large and full), solid like a square. Heng (balance beam); Autumn Qi descends, pulse is floating and level, like a balance. Quan (weight); Winter Qi stores, pulse is sinking and stone-like, like a hanging weight.) Thus, 45 days after Winter Solstice, Yang Qi slightly rises, Yin Qi slightly descends; 45 days after Summer Solstice, Yin Qi slightly rises, Yang Qi slightly descends. Yin and Yang have timing, matching the pulse cycle. If the timing is missed, knowing the pulse division reveals the time of death. (This explains seasonal changes as Yin-Yang entry/exit, reflected in the pulse. 45 days from Winter Solstice to Start of Spring: Yang begins to rise, Yin to descend. By Spring, Yang is upright; by Summer, Yang flourishes, Yin hides. From Summer Solstice to Start of Autumn: Yin begins to rise, Yang to descend. By Autumn, Yin cools; by Winter, Yin freezes, Yang hides. Yin-Yang ascent/descent has periods, matching the pulse. If the pulse misses the period, the division of pulse locations indicates the time of death. Ping Mai Pian states: Cun pulse not reaching Guan is Yang Absence; Chi pulse not reaching Guan is Yin Absence. These are untreatable deaths. Calculating remaining life uses monthly solar terms. Missing the seasonal period indicates death.) The subtlety of the pulse must not be ignored. Examination has guidelines, starting with Yin-Yang. Guidelines have classics, arising from Five Elements. Generation has measures, suitable for the Four Seasons. (Continuing: Pulse subtlety aligns with Yin-Yang and Seasons. 'Ji' means guideline. Examining pulse starts with Yin-Yang (Winter Solstice Yang rising, Summer Solstice Yin rising). This follows regular principles but arises from Five Elements: Wood generates Fire, Fire generates Earth, Earth generates Metal, Metal generates Water, Water generates Wood. Generation has limits, suited to the Four Seasons.) Do not miss tonification and sedation; align with Heaven and Earth. Understanding this unity allows knowledge of life and death. (Seasons may arrive early, late, excessively, or insufficiently; humans respond accordingly. Deficient pulse requires tonification; excessive pulse requires sedation, aligning with natural extremes. Understanding this unity predicts life and death. As Zang Xiang Lun states: Observe timing; missing it leads to internal pathology. As Ping Mai Pian states: Pulse missing seasonal timing leads to death.) Thus, sound matches the Five Tones, color matches the Five Elements, pulse matches Yin-Yang. (Sound matches Heavenly Five Tones; color matches Heavenly Five Elements; pulse matches Heavenly Yin-Yang. Achieving this unity allows predicting life and death.) Knowing that Yin excess dreams of crossing large waters in fear; Yang excess dreams of fire burning; Yin-Yang excess dreams of killing and injury. (Heavenly Yin-Yang and Five Elements correlate with human Zang-Fu. Dreams are journeys of Hun and Po. Liver stores Blood and Hun; Lung stores Qi and Po; Heart is Fire/Yang; Kidney is Water/Yin. Yin excess dreams of water; Yang excess dreams of fire; Yin-Yang excess, unable to descend, dreams of conflict.) Upper excess dreams of flying; lower excess dreams of falling. (Wang Shi said: Qi rising dreams of ascending/flying; Qi descending dreams of falling/dropping.) Fullness dreams of giving; hunger dreams of taking. (Giving corresponds to excess; taking corresponds to deficiency. This shows Middle Jiao Spleen-Stomach Qi has excess and deficiency, manifesting in dreams.) Liver Qi excess dreams of anger; Lung Qi excess dreams of crying. (Qi merging with Liver causes anger; merging with Lung causes grief, consistent with dreams.)