短虫多则梦聚众。长虫多则梦相击毁伤。（此言腑气实而征之于梦也。长虫短虫。肠胃之所生也。）是故持脉有道。虚静
为保。（欲知四时五行。阴阳外内。在诊脉之精微。故当虚静其心志。守而勿失焉。）春日浮。如鱼之游在波。（鱼在波。
虽出而未浮。如春升初出之象。）夏日在肤。泛泛乎万物有余。（在于皮肤。浮在外也。泛泛、充满之象。万物有余。盛
长之极也。）秋日下肤。蛰虫将去（秋气降收。如蛰虫之将去。外而内藏之象）冬日在骨。蛰虫周密。君子居室。（冬令
闭藏。故脉沉在骨。如蛰虫之封闭。如君子之居室。藏而勿出也。此言人与昆虫万物。生于天地之间。同顺生长收藏之
气。是以脉象如之。莫子晋曰。君子居室者。言修养精气之贤人。顺四时之气。行藏出入。与万物同归于生长之门。）故
曰。知内者。按而纪之。知外者。终而始之。此六者。持脉之大法。（欲知在五内腑阴阳之虚实者。按其脉而记之。欲知
外之四时阴阳者。终而始之。盖阳气之始者。阴气之将终。阴气之始者。阳气之将终也。以阴阳之出入。而应四时之脉
也。此以上答帝问脉其四时动奈何。）心脉搏坚而长。当病舌卷不能言。其 而散者。当消环自已。（此言按其脉而知
脏腑虚实之病。搏坚而长者。搏击应手。有力而长。此为太过之脉。心火太过。故当病舌卷。心主言。故不能言也。其
而散者。此为不足之脉。灵枢经曰。心脉微小为消瘅。盖心液不足。则火郁而为消渴之病。心藏神。得神机环转。而
病自已也。此以下答帝问知病之所在奈何。张兆璜曰。先心而肺。肺而肝。盖亦逆传之为病也。故曰消环自已。与上
篇之间者环也。尽气闭环同义。按甲乙经环作渴。）肺脉搏坚而长。当病唾血。其 而散者。当病灌汗。至令不复散发
也。（灵枢经云。肺脉微急为唾血。盖肺主气而主行营卫阴阳。气盛太过。则血随而上逆矣。其不及。当病灌汗。灌者。
脾土灌溉之汗。盖脾气散津。上归于肺。肺气通调。而后水津四布。今肺气虚。而不能输布水液。脾气自灌于肌腠皮肤。
至令肺气不复通调而散发也。）肝脉搏坚而长。色不青。当病坠。若搏。因血在胁下。令人喘逆。其 而散。色泽者。
当病溢饮。溢饮者。渴暴多饮。而易入肌皮肠胃之外也。（肝主血而主色。脉盛而色不见者。血蓄于下也。当病坠伤。或
为手搏所伤。因血凝胁下。故令人喘逆。盖肝脉贯膈。上注肺。血积于下。则经气上逆而为喘也。其不及而色泽者。当
病溢饮。金匮要略云。夫病水人。面目鲜泽。盖水溢于皮肤。故其色润泽也。肝主疏泄。肝气虚而渴暴多饮。以致溢于
皮肤肠胃之外而为饮也。）胃脉搏坚而长。其色赤。当病折髀。其 而散者。当病食痹。（足阳明之脉。从气冲下髀。抵
伏兔。下足趺。髀伤。故脉盛而色赤也。饮食于胃。由中焦之腐化。胃气不足。故当病食痹。）脾脉搏坚而长。其色黄。
当病少气。其 而散。色不泽者。当病足 肿。若水状也。（五脏元真之气。脾所主也。湿热太过。则色黄脉盛而少气矣。
其不及。当病足胫肿。脾气虚。故足肿也。若水状而非水病。故其色不泽。）肾脉搏坚而长。其色黄而赤者。当病折腰。
其而散者。当病少血。至令不复也。（腰者肾之府。腰伤。故肾脉盛也。伤于骨者其色赤。黄则外应于肌肉间也。其不
及。当病少血。盖肾为牝脏受五脏之精而藏之。肾之精液复上入心而为血。精虚。至令不复化赤而为血也。）帝曰。诊得
心脉而急。此为何病。病形何如。岐伯曰。病名心疝。少腹当有形也。帝曰。何以言之。岐伯曰。心为牡脏。小肠为之
使。故曰少腹当有形也。（此论诊得脏脉而病在于腑也。病形、病气见于形证也。盖脏腑经络相连。阴阳相应。是以脉见
于脏。而形见于腑也。经曰。诸急为寒。心为阳脏而畏寒。故脉急。心为君主之官而不受邪。故形见于少腹也。）帝曰。
诊得胃脉。病形何如。岐伯曰。胃脉实则胀。虚则泄。（此论诊得腑脉而病在于脏也。经曰。脾气实则腹胀。不足则为溏
泄。盖脾与胃以膜相运耳。胃为阳。脾为阴。阳病者。上行极而下。是以脉见于胃。而病见于脾也。此皆阴阳表里。上
下雌雄。相输应也。以上答帝问知病之所在奈何。子晋问曰。脏腑相通。只心脾耶。曰。此盖举二脏以俟人之类推耳。）
帝曰。病成而变。何谓。（此复问知病之变奈何也。变者。言病已成而又变为别病。）岐伯曰。风成为寒热。（风者。善行
而数变。腠理开则洒然寒。闭则热而闷。此风病已成。而变为寒热也。）瘅成为消中。（瘅、湿热病也。湿热已成。则中
土受伤。久则津液不生。变成中消之证。）厥成为巅疾。（厥者。气上逆而手足厥冷也。气惟上逆。则变为巅顶之病。方
盛衰论曰。气上不下。头痛巅疾。）久风为飧泄。（风乃木邪。久则内干脾土而成飧泄矣。故曰。春伤于风。邪气留连。
乃为洞泄。）脉风成为厉。（厉者。麻癜恶疠之疾。风乃阳热之邪。血乃阴湿之液。湿热生虫。是以风入于脉。久则变为
虫癞之疠疡。）病之变化。不可胜数。（言病之变化。不可胜数。举此数者。以类推之。）帝曰。诸痈肿筋挛骨痛。此皆安
生。岐伯曰。此寒气之肿。八风之变也。（此复言四时风寒之邪。变为痈肿挛痛之热病。）帝曰。治之奈何。岐伯曰。此
四时之病。以其胜治之愈也。（以胜治之者。以五行气味之胜。治之而愈也。如寒淫于内。治以甘热。如东方生风。风生
木。木生酸。辛胜酸之类。）帝曰。有故病。五脏发动。因伤脉色。各何以知其久暴至之病乎。（有故病而因伤五脏之色
脉。复感暴至之病。有似乎病成而变。故帝有此问。而伯嘉其详悉焉。）岐伯曰。悉乎哉问也。征其脉小色不夺者。新病
也。（征、验也。病久则色脉伤。脉小而色不夺。故知其为新病。）征其脉不夺。其色夺者。此久病也。（此言病者。由五
脏而见于脉。由五脉而见于色。至于色脉之败伤。又由色而脉。脉而脏也。）征其脉与五色俱夺者。此久病也。（血气俱
伤。故为久病。）征其脉与五色俱不夺者。新病也。（暴至之病。自外而内。色脉之伤。从内而外。故有病而色脉俱不夺
者。知其为新感之病也。此言有故久之病。至五脏之气发作而后见于色脉也。）肝与肾脉并至。其色苍赤。当病毁伤不见
血。已见血。湿若中水也。（此言毁伤形身之暴病。而即见于色脉也。金匮要略云。寸口脉沉而弱。沉即主骨。弱即主筋。
沉即为肾。弱即为肝。汗出入水中。如水伤心。历节黄汗出。此言毁伤筋骨。故肝与肾脉并至。而其色苍赤。不见血者。
谓筋骨伤而血不伤也。如已见血而血伤。则又若中水伤心。而心脉亦并至矣。盖言筋即为肝。骨即为肾。血即为心。毁
伤筋骨而即见肝肾之脉。又非见肝肾之脉。而期病之必生于肝肾也。此篇首论诊脉之要。极精极微。有病在五脏而外见
五色五脉者。有诊得脏腑。外内出入。交相贯通。故善诊者。揆阴度阳。持雌守雄。审察外内。明于始终。诊道始备。
斯为上工。）尺内两旁则季胁也。（此审别形身脏腑外内之法也。尺内、尺中也。两旁、两尺部之外旁也。季胁、两胁
之下杪也。此节首言两旁。次言前后。次言上下。盖以左右三部之脉。兼候形身之上下四旁。是关部之两旁。即形身之
两胁。寸部之两旁。即形身之两腋。书不尽言。欲后学之引伸也。此答帝问。乍在内。乍在外。奈何。杨元如曰。此
节照应推而内之。外而不内。后内以候膈。内以候胸中。照应推而外之。内而不外。）尺外以候肾。尺里以候腹。（尺以
候肾。以左右两尺而候两肾也。两肾附于季胁。是季胁之内。乃是两肾。两肾之内。乃是腹中。故以尺内候腹中。尺外
以候肾。尺之两旁。以候季胁。是两旁更出于外也。所谓外内者。脉体本圆。用指向外以候内。向内以候外。候脉之两
侧也。平按以候中。乃五脏之本位也。夫五脏之气。行于脉中。出于脉外。如脉气之向内数急。则在内之皮肤亦急。脉
气之向外数急。则在外之皮肤亦急。故所谓季胁者。即肾气之出于季胁也。而以尺部向外之两旁以候之。所谓腹中者。
即两肾之中也。故以尺部之向里以候之。即如胸中膻中者。肺脏与中气相通。膻中乃心主之相位。杨元如曰。所谓外
者。乃六脉之本位。盖脉居歧骨之外。故以本位为外。而偏于里者为内也。上节内字。训作部字。此之里字。即是内字。）
中附上。左外以候肝。内以候膈。（中附上者。附左尺而上。左手之关脉也。心肝居左。故左以候肝。膈者。胸胁内之膈
也。肝居胁内。故以关候肝。膈气在中。故以内候膈。杨元如曰。膈者。谓膈肉之下。肝脾所居之郛郭也。莫子晋
曰。胸中在上。腹中在下。膈居中央。故分寸关尺。内以候之右。附上以候脾胃。则肺与大肠心与小肠不言而可知矣。）
右外以候胃。内以候脾。（右外者。附右尺而上。右手之关脉也。脾主中土。故以肝内候脾。阴内而阳外。故以关外候胃。
张兆璜曰。此章以形身配天地之上下四旁。以土居中央。故以关内候脾。莫子晋问曰。六腑只候胃。而别腑何以候之。
曰。五脏之血气。皆胃腑之所生。故脏气不能自至于手太阴。必因于胃气。乃至于手太阴也。是以本经凡论五脏。必及
于胃。而余腑多不与焉。然而脏腑雌雄。各有并合。故曰。诊合微之事。追阴阳之变。知阴者知阳。知阳者知阴。会心
者自明也。莫仲超曰。诊候之法。各有不同。如此篇之法。以左右之前后两旁上下。以候形身之外内上下者也。如三
部九候之法。以脉之上中下。而候形身脏腑之上中下也。有以心肝居左。脾肺居右。浮为在腑。沉为在脏。盖以脏腑之
经气相举按轻重。而候五脏之气者也。诊法不同。各具其理。善诊者俱宜明了于心中。随机应变于指下。）上附上。右外
以候肺。内以候胸中。（上附上右者。从右关而上。右寸口也。心肺居上为阳。故以两寸候气。胸中者。宗气之所居也。
经曰。宗气积于胸中。命曰气海。上出于肺。循喉咙。而行呼吸。）左外以候心。内以候膻中。（左外、左寸口也。膻
中者。臣使之官。心主之相位也。张兆璜问曰。经言心肝居左。脾肺居右。是脏气之出于左右。抑脏体之偏与。曰。天
为阳。地为阴。东南为阳。西北为阴。圣人南面而立。左为阳。右为阴。天乙生水。水生木。木生火。是以心肝居左也。
地二生火。火生土。土生金。是以脾肺居右也。此先天之五行。本于阴阳水火。分而上生。非脏体之谓也。又心主脉。
肝主血。血脉生于水精。是以左手三部俱主血。肺主周身之气。脾主元真之气。气生于火。是以右手三部皆主气。此皆
阴阳互换之妙。善诊者不可不知。）前以候前。后以候后。（前曰广明。后曰太冲。寸为阳。尺为阴。故以两手关前以候
形身之前。关后以候形身之后。）上竟上者。胸喉中事也。下竟上者。少腹腰股膝胫足中事也。（上竟上者。从尺关而直
上于鱼也。下竟下者。从寸关而直下于尺也。夫身半以上为天。身半以下为地。此又以阴阳之气。竟上竟下。而候形身
之上下也。张兆璜曰。前后上下。在竟字中分别。前后者。以寸尺定位也。上下者。从下而上。从上而下也。首言两旁。
次言前后。盖以两手之脉平以分之。有如文王之卦。离南坎北。震东兑西。以候形身之四旁。上竟上。下竟下者。有如
伏羲之卦。竖以观之。而天地定位也。此章以人身配天地之六合。三部九候之法。配天地人三才。人与天地参也。）粗大
者。阴不足。阳有余。为热中也。（上章以脉体而候形身脏腑之定位。此下以脉象而候阴阳邪正之盛虚。脉者。阴阳血气
之荣行。粗大者。阳乘于阴也。阳在外。阴在内。阳乘于阴。故热中也。）来疾去徐。上实下虚。为厥巅疾。来徐去疾。
上虚下实。为恶风也。（此以脉之来去上下。以候阴阳上下外内之虚实。来疾去徐者。来盛去悠也。上实下虚者。寸实
尺虚也。此气惟上逆。阳盛阴虚。所谓一上不下。寒厥到膝。气上不下。头痛癫疾是也。来徐去疾者。来微去盛也。上
虚下实者。寸虚尺实也。此阳虚阴盛。为恶风也。盖风为阳邪。伤人阳气。在于皮肤之间。风之恶疠者。从阳而直入于
里阴。是以去疾下实也。此言内因之病。从内而外。自下而上。外因之邪。从外而内。自上而下也。）故中恶风者。阳气
受也。（此复申明外淫之邪。从阳而阴。自表而里也。阳气受邪。则正气虚伤。故来徐上虚。邪气内陷。故去疾下实。）
有脉俱沉细数者。少阴厥也。沉细数散者。寒热也。浮而散者为 仆。（此论脉因度数出入之有顺逆也。有脉者。言又有
厥脉之因。厥脉之象。与上文之上盛下虚之厥脉。厥因不同也。夫脉始于足少阴肾。生于足阳明胃。输于足太阴脾。转
When there are many short roundworms (Ascaris lumbricoides), one dreams of gathering crowds. When there are many long roundworms, one dreams of fighting and injuring each other. (This speaks of excess Qi in the Fu organs manifesting in dreams. Long and short worms are parasites generated in the intestines and stomach.) Therefore, there is a method for holding the pulse; maintaining emptiness and tranquility is the safeguard. (To understand the changes of the four seasons, five phases, Yin and Yang, interior and exterior, one must focus on the subtleties of pulse diagnosis. Thus, one should keep the mind empty and tranquil, adhering to this principle without deviation.)
In spring, the pulse floats at the surface, like fish swimming in waves. (Fish in the waves emerge but do not fully float, resembling the image of early spring when Yang Qi first rises.) In summer, the pulse is at the skin level, abundant and overflowing, like all things reaching their peak of growth. (Located at the skin, floating outwardly. "Abundant" signifies fullness. "All things having surplus" indicates the extreme of vigorous growth.) In autumn, the pulse sinks below the skin, like hibernating insects preparing to hide. (Autumn Qi descends and collects, like hibernating insects about to conceal themselves, an image of moving from exterior to interior storage.) In winter, the pulse sinks to the bones, like hibernating insects tightly sealed, or a gentleman residing indoors. (Winter governs closure and storage, so the pulse sinks to the bones, like hibernating insects sealing themselves, or a gentleman staying indoors, storing without exiting. This illustrates that humans, insects, and all things are born between Heaven and Earth, following the Qi of growth and storage; thus, the pulse images reflect this. Mo Zijin said: "Residing indoors" refers to virtuous people who cultivate Jing and Qi, adapting to the four seasons' Qi, entering and exiting in harmony with all things, returning to the gate of growth.) Therefore it is said: To know the interior, press the pulse and record its changes; to know the exterior, observe continuously from beginning to end. These six points are the great principles of pulse diagnosis. (To know the deficiency and excess of Yin and Yang in the Zang and Fu organs, press the pulse and record it. To know the changes of Yin and Yang in the external four seasons, observe cyclically. The beginning of Yang Qi marks the impending end of Yin Qi; the beginning of Yin Qi marks the impending end of Yang Qi. Through the entry and exit of Yin and Yang, one responds to the pulses of the four seasons. The above answers the Emperor's question regarding how pulses move with the four seasons.)
If the Heart pulse is firm and long, one should suffer from tongue retraction and inability to speak. If the pulse is weak and scattered, one should suffer from Xiao Ke (wasting-thirst disease), which will resolve itself as the Shen (Spirit) mechanism rotates. (This describes knowing Zang-Fu deficiency and excess through pulse palpation. Firm and long means striking the finger with force and extending long, indicating an Excess pulse. Excess Heart Fire causes tongue retraction. Since the Heart governs speech, inability to speak occurs. Weak and scattered indicates a Deficiency pulse. The *Ling Shu* states: Small and minute Heart pulse indicates Xiao Dan. Because Heart fluids are insufficient, Fire stagnates, causing Xiao Ke. The Heart stores the Shen; with the rotation of the Shen mechanism, the disease resolves itself. The following answers the Emperor's question on how to locate the disease. Zhang Zhaohuang said: Heart disease transmits to the Lung, and Lung disease to the Liver; this is also reverse transmission. Hence "Xiao Huan Zi Yi" (wasting-thirst resolves in a cycle), same meaning as "Jian Zhe Huan Ye" (diseases with intervals cycle) and "Jin Qi Bi Huan" (exhausted Qi closes the loop). According to the *Jia Yi Jing*, "Huan" is written as "Ke" (thirst).)
If the Lung pulse is firm and long, one should suffer from spitting blood. If the pulse is weak and scattered, one should suffer from Guan Han (profuse sweating), leading to the Lung Qi failing to diffuse again. (The *Ling Shu* says: Slightly urgent Lung pulse causes spitting blood. The Lung governs Qi and circulates Ying and Wei, Yin and Yang. When Qi is excessive, Blood follows upward. If deficient, Guan Han occurs. "Guan" refers to sweat irrigated by Spleen Earth. Spleen Qi disperses fluids upward to the Lung; only when Lung Qi is unobstructed do water fluids distribute everywhere. Now, with Lung Qi deficiency unable to transport fluids, Spleen Qi naturally pours into muscle clefts and skin, causing Lung Qi to fail in diffusion.)
If the Liver pulse is firm and long, but the complexion is not green, one should suffer from falls or blows, with blood stasis under the hypochondrium causing wheezing and counterflow qi. If the pulse is weak and scattered, but the complexion is lustrous, one should suffer from Yi Yin (overflowing fluid retention). Yi Yin is characterized by sudden thirst and excessive drinking, where fluids easily enter outside the muscles, skin, and intestines. (The Liver governs Blood and color. Pulse is strong but color is not green, indicating Blood accumulation below. Falls or blows cause blood coagulation in the hypochondrium, leading to wheezing because the Liver channel pierces the diaphragm and connects to the Lung; Blood stasis below causes meridian Qi to rebel upward. If deficient with lustrous color, Yi Yin occurs. The *Jin Gui Yao Lue* states: Patients with water disease have bright faces because water overflows the skin. The Liver governs free flow; Liver Qi deficiency causes sudden thirst and excessive drinking, leading to fluid overflow outside skin and intestines.)
If the Stomach pulse is firm and long, and the complexion is red, one should suffer from Zhe Bi (fractured or injured thigh). If the pulse is weak and scattered, one should suffer from Shi Bi (food obstruction). (The Foot-Yangming channel descends from Qichong to the thigh, reaches Futu, and goes down to the foot. Thigh injury causes strong pulse and red color. Food in the Stomach is transformed by Middle Jiao; Stomach Qi deficiency leads to Shi Bi.)
If the Spleen pulse is firm and long, and the complexion is yellow, one should suffer from Shao Qi (shortness of breath). If the pulse is weak and scattered, and the complexion is not lustrous, one should suffer from swelling of the lower legs, resembling edema. (The Yuan Zhen Qi of the five Zang organs is governed by the Spleen. Excess damp-heat causes yellow color, strong pulse, and shortness of breath. Deficiency causes lower leg swelling due to Spleen Qi deficiency. It resembles water but is not water disease, hence the lack of luster.)
If the Kidney pulse is firm and long, and the complexion is yellow and red, one should suffer from Zhe Yao (injured waist). If the pulse is weak and scattered, one should suffer from Shao Xue (blood deficiency), unable to recover. (The waist is the mansion of the Kidney; waist injury causes strong Kidney pulse. Bone injury manifests as red color; yellow corresponds to muscles. Deficiency causes blood deficiency. The Kidney, as a Yin organ, stores essence from the five Zang organs. Kidney essence ascends to the Heart to become blood; essence deficiency prevents transformation into blood.)
The Emperor asked: I feel an urgent Heart pulse. What is this disease? What are the symptoms? Qibo answered: The disease name is Xin Shan (Heart Hernia), and there should be a palpable mass in the lower abdomen. The Emperor asked: Why? Qibo answered: The Heart is a Yang organ (Mu Zang), and the Small Intestine is its assistant. Therefore, there should be a mass in the lower abdomen. (This discusses feeling a Zang pulse while the disease is in the Fu organ. Disease form and Qi manifest in physical signs. Meridians connect Zang and Fu, Yin and Yang correspond; thus, pulse appears in the Zang, while form appears in the Fu. The classic says: All urgencies indicate Cold. The Heart is a Yang organ fearing Cold, hence urgent pulse. As the Monarch, the Heart does not accept pathogenic factors directly, so manifestations appear in the lower abdomen.)
The Emperor asked: I feel a Stomach pulse. What are the symptoms? Qibo answered: Excess in the Stomach pulse causes distension; deficiency causes diarrhea. (This discusses feeling a Fu pulse while the disease is in the Zang organ. The classic says: Excess Spleen Qi causes abdominal distension; insufficiency causes loose stools. The Spleen and Stomach are connected by membranes. Stomach is Yang, Spleen is Yin. Yang diseases go up to the extreme then down; thus, pulse appears in the Stomach, but disease manifests in the Spleen. This reflects the correspondence of Yin-Yang, interior-exterior, upper-lower, and male-female. The above answers the Emperor's question on locating disease. Zijin asked: Do Zang and Fu only connect via Heart and Spleen? Answer: This cites two organs for analogy.)
The Emperor asked: Diseases mature and change. What does this mean? (Asking how to know disease transformation. Change means a mature disease transforms into another.) Qibo answered: Wind becomes cold and heat. (Wind moves quickly and changes often. When pores open, one feels chilly; when closed, one feels hot and stifled. This is wind disease transforming into cold and heat.) Dan (fever/heat) becomes Xiao Zhong (middle wasting). (Dan is damp-heat disease. Damp-heat damages the Central Earth, eventually depleting fluids, transforming into middle Xiao.) Jue (reversal) becomes Dian Ji (head disease). (Jue is Qi rebelling upward with cold extremities. Upward rebellion leads to head diseases. *Fang Sheng Shuai Lun* says: Qi going up but not down causes headache and dian disease.) Long-standing wind becomes Sun Xie (undigested food diarrhea). (Wind is Wood evil; long-standing, it invades Spleen Earth, causing Sun Xie. As stated: Spring wind injury lingers, becoming洞泄 [cavity diarrhea].) Pulse wind becomes Li (leprosy/malignant ulcers). (Li refers to leprosy and malignant ulcers. Wind is Yang-heat evil; Blood is Yin-damp fluid. Damp-heat generates worms. Wind entering pulses long-term transforms into worm-leprosy ulcers.) Disease changes are countless. (Listing these few allows for analogy.)
The Emperor asked: Various abscesses, tendon spasms, and bone pain—how are they generated? Qibo answered: These are swellings from Cold Qi and variations of the Eight Winds. (Discussing how seasonal Wind and Cold transform into heat diseases like abscesses and spasms.) The Emperor asked: How to treat them? Qibo answered: Treat these seasonal diseases using the controlling method (Yi Sheng Zhi Zhi Yu Ye). (Treating with the overcoming element/flavor. E.g., Cold within treated with sweet-hot; East generates Wind/Wood/Sour, Metal/Sweet overcomes Wood/Sour.)
The Emperor asked: If there is a pre-existing disease, the five Zang organs activate, damaging pulse and color, how can one distinguish new from old diseases? (Pre-existing disease damages Zang color/pulse, compounded by acute new disease. Similar to disease transformation, hence the question.) Qibo answered: Excellent question! If the pulse is small and color is undamaged, it is a new disease. (Zheng means verify. Long-term disease damages color/pulse. Small pulse with undamaged color indicates new disease.) If the pulse is undamaged but color is damaged, it is an old disease. (Disease manifests from Zang to pulse, pulse to color. Damage progresses from color to pulse to Zang.) If both pulse and five colors are damaged, it is an old disease. (Blood and Qi both damaged, hence old disease.) If both pulse and five colors are undamaged, it is a new disease. (Acute disease enters from exterior to interior; color/pulse damage emerges from interior to exterior. Undamaged color/pulse with disease indicates new external contraction. This explains how old diseases manifest in color/pulse when Zang Qi activates.)
If Liver and Kidney pulses arrive together, and the complexion is cyan-red, one should suffer from trauma without visible bleeding. If bleeding is visible, it resembles Water Poisoning (Zhong Shui). (This describes acute trauma manifesting in color/pulse. *Jin Gui Yao Lue* says: Cunkou pulse deep and weak. Deep governs bones (Kidney); weak governs sinews (Liver). Sweating then entering water damages the Heart, causing joint yellow sweat. Trauma to sinews/bones brings Liver/Kidney pulses and cyan-red color. No bleeding means sinew/bone injury without blood injury. Visible bleeding implies Heart injury, bringing Heart pulse too. Sinews=Liver, Bones=Kidney, Blood=Heart. Trauma shows Liver/Kidney pulses, but not necessarily implying disease originates solely in Liver/Kidney. This chapter emphasizes pulse essentials. Good diagnosticians measure Yin, gauge Yang, hold balance, examine interior/exterior, understand beginnings/endings, achieving mastery as superior physicians.)
The inner side of the Chi position flanks the Ji Xie (hypochondrium). (Method to differentiate body/Zang-Fu interior-exterior. Chi Nei is the Chi position. Flanks are outer sides of both Chi positions. Ji Xie is the lower tip of the hypochondrium. This section lists flanks, then front/back, then up/down. Left-right three positions monitor body quadrants. Guan flanks = body hypochondrium; Cun flanks = body axillae. Text implies more for students to extrapolate. Answers Emperor's question on alternating interior/exterior. Yang Yuanru notes: Pushing inward, if exterior doesn't enter, posterior interior monitors Diaphragm, interior monitors Chest.)
Chi exterior monitors Kidney; Chi interior monitors Abdomen. (Chi monitors Kidneys via left/right positions. Kidneys attach to Ji Xie; inside Ji Xie are Kidneys; inside Kidneys is Abdomen. Thus Chi interior monitors Abdomen, Chi exterior monitors Kidney. Chi flanks monitor Ji Xie, extending further out. "Exterior/Interior" refers to pulse shape being round; finger pushes outward to monitor interior, inward to monitor exterior, checking pulse sides. Level pressing monitors Center, the root of Five Zang. Zang Qi moves in/out of pulse. Rapid inward Qi makes internal skin tight; rapid outward Qi makes external skin tight. Ji Xie is Kidney Qi emerging outward, monitored by Chi exterior flanks. Abdomen is between Kidneys, monitored by Chi interior.)
Middle attaches up (Guan): Left exterior monitors Liver; interior monitors Diaphragm. (Middle attaches up is Guan pulse on left hand. Heart/Liver are on left, so left monitors Liver. Diaphragm is within chest/hypochondrium. Liver resides in hypochondrium, so Guan monitors Liver. Diaphragm Qi is central, so interior monitors Diaphragm. Yang Yuanru: Diaphragm is the casing below diaphragm meat housing Liver/Spleen. Mo Zijin: Chest is upper, Abdomen lower, Diaphragm central; thus Cun/Guan/Chi, interior monitors it.)
Right attaches up (Guan): Exterior monitors Stomach; interior monitors Spleen. (Right exterior is Guan pulse on right hand. Spleen governs Central Earth, so Guan interior monitors Spleen. Yin is interior, Yang is exterior, so Guan exterior monitors Stomach. Zhang Zhaohuang: Body matches Heaven/Earth quadrants; Earth is central, so Guan interior monitors Spleen. Mo Zijin asks: Only Stomach monitors Fu organs? How are others monitored? Answer: Zang Qi derives from Stomach Qi; Zang Qi cannot reach Hand-Taiyin without Stomach Qi. Thus classics mention Stomach when discussing Zang. Other Fu are less emphasized. Yet Zang-Fu pairs correspond. Diagnose subtle matters, trace Yin-Yang changes; knowing Yin knows Yang, knowing Yang knows Yin. Those who understand will clarify. Mo Zhongchao: Diagnostic methods vary. This chapter uses left-right/front-back/up-down for body monitoring. Three Positions Nine Pulses use upper-middle-lower for body monitoring. Some place Heart/Liver left, Spleen/Lung right, Floating=Fu, Deep=Zang, based on meridian Qi weight. Methods differ but have logic; good diagnosticians must know them all.)
Upper attaches up (Cun): Right exterior monitors Lung; interior monitors Chest. (Upper attaches right is Cun pulse on right hand. Heart/Lung are upper Yang, so Cun monitors Qi. Chest houses Zong Qi (Gathering Qi). Classic: Zong Qi accumulates in chest, called Sea of Qi, exits Lung, travels throat, governs respiration.)
Left exterior monitors Heart; interior monitors Dan Zhong. (Left exterior is Cun pulse on left hand. Dan Zhong is Minister Official, phase of Heart Master. Zhang Zhaohuang asks: Classics say Heart/Liver left, Spleen/Lung right. Is this Qi distribution or organ position? Answer: Heaven is Yang, Earth Yin; Southeast Yang, Northwest Yin. Sage faces South, Left Yang, Right Yin. Heaven generates Water, Water generates Wood, Wood generates Fire, hence Heart/Liver left. Earth generates Fire, Fire generates Earth, Earth generates Metal, hence Spleen/Lung right. This is innate Five Phases based on Yin-Yang/Water/Fire, ascending generation, not physical organ position. Heart governs pulse, Liver governs Blood; blood vessels generate from Water Essence, so Left Three Positions govern Blood. Lung governs周身 Qi, Spleen governs Yuan Zhen Qi; Qi generates from Fire, so Right Three Positions govern Qi. This is Yin-Yang interchange mystery; diagnosticians must know.)
Front monitors Front; Back monitors Back. (Front is Guang Ming, Back is Tai Chong. Cun is Yang, Chi is Yin. So Guan-front monitors body front, Guan-back monitors body back.)
Shang Jing Shang (End of Upper) monitors Chest and Throat matters. Xia Jing Xia (End of Lower) monitors Lower Abdomen, Waist, Thigh, Knee, Shin, Foot matters. (Shang Jing Shang is from Chi-Guan straight up to大鱼际 (Thenar eminence). Xia Jing Xia is from Cun-Guan straight down to Chi. Upper half body is Heaven, lower half is Earth. Using Yin-Yang Qi, Shang/Xia Jing monitors body up/down. Zhang Zhaohuang: Front/Back/Up/Down distinguished by "Jing". Front/Back defined by Cun/Chi. Up/Down defined by direction. First flanks, then front/back. Two hands divided horizontally like King Wen's Bagua (Li South, Kan North, Zhen East, Dui West) monitoring quadrants. Shang/Xia Jing vertically like Fuxi's Bagua (Heaven/Earth positioned). This chapter matches body to Six Directions; Three Positions Nine Pulses match Heaven-Earth-Man trinity; Man participates with Heaven and Earth.)
Pulse coarse and large: Yin insufficient, Yang excessive, causing Re Zhong (Heat in Middle). (Previous chapter used pulse body for location; this uses pulse image for Yin-Yang/Evil-Righteous excess/deficiency. Pulse is circulation of Yin-Yang Blood-Qi. Coarse/large means Yang invading Yin. Yang is exterior, Yin interior; Yang invading Yin causes Heat in Middle.)
Coming fast, departing slow: Upper Excess, Lower Deficiency, causing Jue Dian Ji (Reversal Head Disease). Coming slow, departing fast: Upper Deficiency, Lower Excess, causing E Feng (Aversion to Wind). (Using pulse coming/departing/up/down to monitor Yin-Yang/Exterior/Interior excess/deficiency. Fast come/slow depart means strong incoming, leisurely outgoing. Upper Excess/Lower Deficiency means Cun Excess/Chi Deficiency. Qi rebels upward, Yang excess/Yin deficiency, "One up not down," cold reversal to knee, headache/dian disease. Slow come/fast depart means weak incoming, strong outgoing. Upper Deficiency/Lower Excess means Cun Deficiency/Chi Excess. Yang deficiency/Yin excess causes Aversion to Wind. Wind is Yang evil, damages Yang Qi in skin. Malignant wind enters Yin from Yang, hence fast depart/Lower Excess. Internal diseases move Interior→Exterior, Bottom→Top. External evils move Exterior→Interior, Top→Bottom.)
Therefore, those struck by Evil Wind receive it in Yang Qi. (Clarifying external evils move Yang→Yin, Surface→Interior. Yang Qi receiving evil means righteous Qi damaged, hence slow come/Upper Deficiency; evil sinking means fast depart/Lower Excess.)
If pulses are all deep, fine, and rapid, it is Shao Yin Jue (Shaoyin Reversal). Deep, fine, rapid, and scattered: Cold and Heat. Floating and scattered: Pu Dao (Fainting/Collapse). (Discussing pulse degree/entry-exit顺逆. "You Mai" means additional Jue pulse characteristics, different from previous Upper Excess/Lower Deficiency Jue. Pulse starts at Foot-Shaoyin Kidney, generates at Foot-Yangming Stomach, transports at Foot-Taiyin Spleen, turns...)