原名，决死生，王冰改为三部九候，今从之。
三部者，头面为上部，胸膈为中部，胁腹为下部也。九候者，一部之中，各有三候，三三而为九候也。
通体形气，太阳主之，故两举太阳经脉，明其死生，皆必指而导之，乃以为真，此三部九候之大法也。
黄帝问曰∶余闻九针于夫子，众多博大，不可胜数。余愿闻要道，以属子孙，传之后世，着
之骨髓，藏之肝肺，歃血而受，不敢妄泄。令合天道，必有终始，上应天光，星辰历纪，下副四时五
行，贵贱更互，冬阴夏阳，以人应之，奈何？愿闻其方。
胜，平声。数，上声。藏如字。更，平声。此篇论三部九候，故帝问∶余闻九针于夫子，而九针之数，
众多博大不可胜数，今余愿闻九候之要道以属我子孙，而使传之后世，其理至微，故当着之
骨髓，藏之肝肺。其道至遵，故当歃血而受，不敢妄泄。令合天道者，令人身而合于天道也。必有终始者，
自始至终，终而复始也。合天道则上应天光，而星辰可以历纪；有终始则下副四时五行。贵贱更互，寒往
暑来，暑往寒来，而冬阴夏阳，凡此皆天地阴阳之要道。以人应之，奈何？而愿闻其方；方，犹法也。
岐伯对曰∶妙乎哉问也！此天地之至数。
伯赞其问，言九候要道，此天地之至数。
帝曰∶愿闻天地之至数，合于人形血气，通决死生，为之奈
何？
愿闻天地之至数，而合于人形血气，通决死生，即上文以人应之之意。
岐伯曰∶天地之至数，始于一，终于九焉。一者天，二者地，三者人，因而三之，三三者九，以应
九野。故人有三部，部有三候，以决死生，以处百病，以调虚实，而除邪疾。
一者，数之始；九者，数之终。故始于一，终于九焉。一者，奇也，阳也，故一者天；二者，偶也，
阴也，故二者地；三者，参也，参于天地之间，故三者人。因而三之，则天有天地人，地有天
地人，人有天地人，故三三者九。以至数而合于天地，故以应九野，九野地里之合于天度也。以至数
而合于人身，故人有三部，一部各有三候，可以决死生，处百病，调虚实，而除邪疾，此天地之
至数，合于人形血气，而通决死生也。
帝曰∶何谓三部？
三部何在？
岐伯曰∶有下部，有中部，有上部。部各有三候，三候者，有天有地有人也。必指而导之，乃以为真。
阴阳之理，从阴而阳，自下而上，故曰有下部、有中部、有上部。而一部之中，各有三候，三候者，
各有天有地有人也。必以指循切而按导之，乃为部候之真。有如后文所云也。
上部天，两额之动脉，上部地，两颊之动脉，上部人，耳前之动脉。
是头面之候有三，而为上部也。详见下文。
中部天，手太阴也，中部地，手阳明也，中部人，手少阴也。
是手阴阳之候有三，而为中部也。详见下文。
下部天，足厥阴也，下部地，足少阴也，下部人，足太阴也。故下部之天，以候肝，地
以候肾，人以候脾胃之气。
是足三阴之候有三，而为下部也。足厥阴，肝也，故下部之天以候肝；足少阴，肾也，故下部之地
以候肾；足太阴，脾也，故下
部之人以候脾，而合于胃之气。
帝曰∶中部之候奈何？
下部既明，中部之候奈何。
岐伯曰∶亦有天，亦有地，亦有人。天以候肺；地以候胸中之气；人以候心。
手太阴，肺也，故天以候肺。手阳明大肠，肺之府也，故地以候胸中之气。手少阴，心也，故人以候心。
帝曰，上部何以候之？
下部中部既明，上部何以候之。
岐伯曰∶亦有天，亦有地，亦有人。天以候头角之气；地以候口齿之气；人以候耳目之气。
上部天，两额之动脉，故天以候头角之气∶上部地，两颊之动脉，故地以候口齿之气；上部人，耳
前之动脉，故人以候耳目之气。由此观之，则头面为上部，胸膈为中部，胁腹为下部也。
三部者，各有天，各有地，各有人，三而成天，三而成地，三而成人，三而三之，合则为九。九
分为九野，九野为九藏。故神藏五，形藏四，合为九藏。五脏已败，其色必夭，夭必死矣。
上文三部者，各有天，各有地，各有人，乃三而成天，三而成地，三而成人，一部三候，三而三之，
合则为九。以至数而合于天地，则九分为九野。以天地而合于人形，则九野为九藏。九藏者，
肝肺心脾肾，藏魂魄神意志，故神藏五；大肠、小肠、胃与膀胱，藏水谷糟粕，故形藏四，合神藏形藏
而为九藏。若五脏之神气已败，不荣于外，则其色必夭，夭必死矣。
此一节论人身三部九候，合于天地之至数也。
帝曰∶以候奈何？
上节论三部九候，此下但论九候之法，故问以候奈何？
岐伯曰∶必先度其形之肥瘦，以调其气之虚实，实则泻之，虚
则补之。必先去其血脉，而后调之。无问其病，以平为期。
度，入声。九候主周身之形气，故必先度其形之肥瘦，以候其
外。调其气之虚实，以候其内，如实则泻之，如虚则补之。必先去其血脉之凝滞，而后调补其血脉之
不足，无问其病之外内，要以血脉之平为期，此候之之法也。
帝曰∶决死生奈何？
九候何以决死生。
岐伯曰∶形盛脉细，少气不足以息者，危。形瘦脉大，胸中多气者，死。形气相得者，生。三五
不调者，病。三部九候皆相失者，死。
形与脉气贵相合也，如形盛脉细而少气，不足以息者，是形体有余，脉气反衰，故危。如形瘦脉大，
而胸中多气者，是形体不足，脉气反强，故死。是必形气相得者，生。若形气相为参伍，而
不调者，病。若三部九候，皆相失者，死。
上下左右之脉，相应如参舂者，病甚。上下左右相失，不可数者，死。
数，上声。夫参伍不调，而上下左右之脉，相应于指，如参舂者，则病甚，参舂者，此上彼下，彼上此
下，不相合地。三部九候皆相失，而上下左右，相失不可数者，死，不可数者，脉体错乱，不可数其至数也。
中部之候虽独调，与众脏相失者，死。中部之候相减者，死。目内陷者，死。
夫上下左右，相应如参舂，上下左右，相失不可数，设中部之候虽独调，究与上下左右之众脏相失，
是上下左右不归于中土，故死。若上下左右之候有余，而中部之候相减，是中土不达于上下左右，故亦死。夫
上下左右，归于中部，而五脏之精，皆注于目，今目内陷，则五脏俱绝，故死。此九候以决死生之法也。
帝曰∶何以知病之所在？
欲决死生，必识病因，帝故问之。
岐伯曰∶察九候独小者病，独大者病，独疾者病，独迟者病，独热者病，独寒者病，独陷下者病。
欲知病之所在，须察九候而诊视之。如察九候，其脉有独小者病，有独大者病；其脉有独疾者病，有
独迟者病；脉中有独热者病，有独寒者病；有生阳之气，不能上升，独陷下者病，是察九候
而有七诊之病也。
以左手足上，上去踝五寸，按之，庶右手足当踝而弹之，其应过五寸以上，蠕蠕然者不病；其
应疾，中手浑浑然者，病；中手徐徐然者，病；其应上不能至五寸，弹之不应者死。
踝，蛙去声。弹，平声。蠕，音蝉。踝、蠕余篇同。中，去声。上文小大疾迟寒热为病，其病犹轻，
若陷下则生阳之气不升，其病必危。故当以两手而按其足踝，其法以左手于病者足上，上去踝五
寸按之。夫足外踝上七寸，乃承山之穴，属足太阳，今去踝五寸，则在承山之下，庶右手于病者足上，当
踝而弹之，盖左手按脉，右手导引，其脉气之应，过五寸以上，而至于承山。蠕蠕然动者，气
之和也，故为不病。其脉应手疾，而中手浑浑然者，乃气盛太过，故病，若中手徐徐然者，乃气虚不足，故
亦病。若其应，上不能至五寸，右手弹之而不应者，乃生阳之气，绝灭于下，故死。
是以脱肉，身不去者死；中部乍疏乍数者死。
数，音朔，下同。上文言生阳绝灭者死，此言生阳之气，不能外达，不能上下者皆死。是以脱肉，乃
生阳之气，不能外达，身有病而不去者死。中部人，其气上通于天，下交于地，中部之脉，乍
疏乍数，乃生阳之气不能上下，故亦死。
其脉代而钩者，病在络脉。
代者，乍疏之象也。代而钩者，乍数之象也。承上文乍疏乍数而言。若其脉代而钩者，乃经络内外
不通，故病在络脉；不死也。
九候之相应也，上下若一，不得相失，一候后，则病，二候后，则病甚，三候后，则病危。所
谓后者，应不俱也。
总承上文而言九候之相应也。阴阳上下，其动若一，不得独小独大，独疾独迟而相失也。脉有浮中
沉三候，一候后者，浮以候之，脉不应指，不应则病矣。二候后者，中以候之，脉不应指，不
应则病甚。三候后者，沉以候之，脉不应指，不应则病危。申明所谓后者，应不俱也，谓浮中沉之脉，
不俱应于指下也。凡此皆指而导之之法也。
察其腑脏，以知死生之期。
九候以决死生，以知病之所在，故察其腑脏，以知死生之期，病在腑则生，病在脏则死也。
必先知经脉，然后知病脉。真脏脉见者，胜死。
见，音现。夫察腑知病，必先知经脉，然后知病脉，察脏知死，须知真脏脉见者，至胜克之日而死。
足太阳气绝者，其足不可屈伸，死必戴眼。
九候主周身形气，而太阳经脉之气，营运于通体，故足太阳之气绝者，其足不可屈伸，死必戴眼，其足
不可屈伸者，经绝也。死必戴眼，脉绝也。太阳经脉之气，行于通体，故论九候，而举太阳经脉以明之。
此一节论九候以决死生，以知病之所在，必指而导之，乃以为真也。
帝曰∶冬阴夏阳，奈何？
帝愿闻要道，有冬阴夏阳，以人应之之语，故复问之。
岐伯曰∶九候之脉，皆沉细悬绝者为阴，主冬，故以夜半死；
盛躁喘数者为阳，主夏，故以日中死。
冬阴夏阳，乃一岁之阴阳，夜半日中，乃一日之阴阳，九候之脉，皆沉细悬绝者，为阴脉，阴主冬，
故以夜半死；若九候之脉，皆盛躁喘数者，为阳脉，阳主夏，故以日中死。
是故寒热病者，以平旦死；热中，及热病者，以日中死；病风者，以日夕死；病水者，以夜半死。
其脉乍疏乍数，乍迟乍疾者，日乘四季死。
一日之内，亦有四时，是故寒热病者，肝血内虚，为寒为热也。平旦，乃寅卯之时，肝木主气，肝脏
病，故以平旦死。热中及热病者，心火燔灼，内外皆热也，日中乃巳午之时，心火主气，心
脏病，故以日中死。病风者，秋金肃杀之气，病于肺也，日夕，乃申酉之时，肺金主气，肺脏病，故以
日夕死。病水者，冬令寒水之气，病于肾也，夜半乃亥子之时，肾水主气，肾脏病，故以夜半死。脾脏属土，
土灌四旁，若其脉乍疏乍数，乍迟乍疾，乃中土内虚不能四布，故以一日所乘之四季死。辰戌丑未，
寄王于平旦、日中、日夕、夜半也。
形肉已脱，九候虽调，犹死。
立形定气，命之曰人。若形肉已脱，坤土内败，诸脏无以资生，九候之脉虽调，犹之死也。
七诊虽见，九候皆从者，不死。
见，音现。小大疾迟寒热陷下，七诊之脉虽见，非同土败，故九候皆从者不死。
所言不死者，风气之病，及经月之病，似七诊之病而非也，故
言不死。若有七诊之病，其脉候亦败者死矣。必发哕噫。
小大疾迟寒热，为病犹轻，陷下则病非轻，故申明所以言不死者，或病气机而为风气之病，或病经脉而
为经月之病，生阳之气犹能上升，似七诊之病而不陷下，故曰非也。此所以言不死也。若有
七诊之病，而正气陷下，其脉候亦败者死矣。生阳不升，故必发哕噫，甚则为哕，土气败也，微则为噫，
土气虚也。是知七诊之病，不陷下者不死，陷下则死也。
必审问其所始病，与今之所方病，而后各切循其脉，视其经络浮沉，以上下逆从循之。其脉疾者不
病，其脉迟者病，脉不往来者死。皮肤着者死。
病有新故，善诊者，必审问其所始病，与今之所方病，然后以证合脉，以脉合证，而各切循其脉，
并视其经络之浮沉，以上下逆从而循之，其脉疾者，经络有余，故不病。其脉迟者，经络内虚，
故病。脉不往来，则气血内绝，故死。皮肤着者，久病肉脱，皮肤着者故死。
帝曰∶其可治者奈何？
脉不往来者死，皮肤着者死，其可治者奈何。
岐伯曰∶经病者治其经，孙络病者，治其孙络血。
其可治者，仍当视其经络之浮沉，以上下逆从而循之，乃为治
法也，经居络内，故经病者治其经，孙络居络外，故孙络病者治其孙络，见血而愈。
血病，身有痛者，治其经络。
经络皆主血，若经络之血病，而身有痛者，治其经络。
其病者在奇邪，奇邪之脉，则缪刺之。
奇邪者，邪不入于经，流溢于大络，而生奇病也。若其病者，在奇邪，夫奇邪之脉，则当缪刺以治之。
缪刺者，左病刺右，右病刺左也。
留瘦不移，节而刺之。
始为奇邪之病，治之不愈，邪留日深，病在于骨，肌肉瘦而邪不移，故当取其骨节而刺之。
The original name (i.e., the origin of the term "Three Parts and Nine Probes"), used to determine life and death, was changed by Wang Bing to "Three Parts and Nine Probes" (Sanbu Jiuhou). We now follow his usage.
The so-called "Three Parts" refer to: the head and face as the Upper Part, the chest and diaphragm as the Middle Part, and the hypochondrium and abdomen as the Lower Part. The so-called "Nine Probes" mean that within each part, there are three distinct pulse positions; three times three equals nine probes.
The form and Qi of the entire body are governed by the Taiyang Meridian (Foot-Taiyang Bladder Meridian). Therefore, the Taiyang Meridian is cited twice to clarify the method of determining life and death. One must guide and palpate with fingers to ascertain the truth; this is the fundamental principle of the Three Parts and Nine Probes diagnostic method.
The Yellow Emperor asked: I have heard from you about the Nine Needles (Jiu Zhen), which encompass a vast and numerous body of knowledge. I wish to hear the essential principles, so that I may pass them on to my descendants and transmit them to future generations. I shall engrave them in my bones and store them in my liver and lungs, accept them with a blood oath, and dare not disclose them recklessly. May they accord with the Heavenly Dao, having a beginning and an end, corresponding above to the celestial light and the cycles of stars, and below to the Four Seasons and Five Phases, with mutual alternation of nobility and baseness, winter Yin and summer Yang. How should the human body respond to this? I wish to hear the method.
*Sheng* is pronounced with the level tone. *Shu* is pronounced with the rising tone. *Cang* retains its original pronunciation. *Geng* is pronounced with the level tone. This chapter discusses the Three Parts and Nine Probes. Thus, the Emperor asked: I heard from you about the Nine Needles, and the number of needles is vast and incalculable. Now I wish to hear the essential principle of the Nine Probes to instruct my descendants, so they may transmit it to posterity. The principle is extremely subtle, so it must be engraved in the bones and stored in the liver and lungs. The Way is highly revered, so one must accept it with a blood oath and dare not disclose it recklessly. To "make it accord with the Heavenly Dao" means to align the human body with the Heavenly Dao. To "have a beginning and an end" means from start to finish, ending and restarting. Accordance with the Heavenly Dao corresponds above to celestial light, allowing stars to be recorded sequentially; having a beginning and an end corresponds below to the Four Seasons and Five Phases. Nobility and baseness alternate, cold goes and heat comes, heat goes and cold comes, along with winter Yin and summer Yang. All these are the essential principles of Heaven and Earth's Yin and Yang. How should the human body respond to this? Thus, I wish to hear the method; *Fang* means Law or Method.
Qibo replied: What a profound question! This is the ultimate number of Heaven and Earth.
Qibo praised the Emperor's question, stating that the essential principle of the Nine Probes is the ultimate number of Heaven and Earth.
The Emperor said: I wish to hear the ultimate number of Heaven and Earth, how it combines with human form and blood-Qi, and how it communicates to determine life and death. What should be done?
Wishing to hear the ultimate number of Heaven and Earth, and combining it with human form and blood-Qi to communicate and determine life and death, is the meaning of "responding to it with the human body" mentioned above.
Qibo said: The ultimate number of Heaven and Earth begins with One and ends with Nine. One is Heaven, Two is Earth, Three is Human. Multiplying by three, three times three is nine, corresponding to the Nine Regions (Jiu Ye) of the earth. Thus, humans have Three Parts, each with three probes, used to determine life and death, treat the hundred diseases, regulate deficiency and excess, and eliminate pathogenic disorders.
One is the beginning of numbers; Nine is the end of numbers. Hence, it begins with One and ends with Nine. One is odd and Yang, so One is Heaven; Two is even and Yin, so Two is Earth; Three is a triad, participating between Heaven and Earth, so Three is Human. Multiplying by three, Heaven has Heaven, Earth, and Human; Earth has Heaven, Earth, and Human; Human has Heaven, Earth, and Human. Thus, three times three is nine. Using ultimate numbers to combine with Heaven and Earth, it corresponds to the Nine Regions (geographical areas corresponding to celestial degrees). Using ultimate numbers to combine with the human body, humans have Three Parts, each with three probes, capable of determining life and death, treating diseases, regulating deficiency and excess, and eliminating pathogens. This is the ultimate number of Heaven and Earth, combining with human form and blood-Qi to determine life and death.
The Emperor asked: What are called the Three Parts?
Where are the Three Parts?
Qibo said: There is a Lower Part, a Middle Part, and an Upper Part. Each part has three probes. The three probes refer to Heaven, Earth, and Human. One must guide and palpate with fingers to ascertain the truth.
The principle of Yin and Yang proceeds from Yin to Yang, from bottom to top; hence, we speak of Lower, Middle, and Upper Parts. Within each part, there are three probes, each comprising Heaven, Earth, and Human. One must palpate and press with fingers to identify the true probe positions, as described in the subsequent text.
Upper Part Heaven: the arterial pulse at both temples.
Upper Part Earth: the arterial pulse at both cheeks.
Upper Part Human: the arterial pulse in front of the ears.
These are the three pulse positions of the head and face, constituting the Upper Part. See details below.
Middle Part Heaven: Hand-Taiyin (Lung Meridian).
Middle Part Earth: Hand-Yangming (Large Intestine Meridian).
Middle Part Human: Hand-Shaoyin (Heart Meridian).
These are the three pulse positions of the hand's Yin and Yang, constituting the Middle Part. See details below.
Lower Part Heaven: Foot-Jueyin (Liver Meridian).
Lower Part Earth: Foot-Shaoyin (Kidney Meridian).
Lower Part Human: Foot-Taiyin (Spleen Meridian). Thus, Lower Part Heaven probes the Liver, Earth probes the Kidney, and Human probes the Qi of the Spleen and Stomach.
These are the three pulse positions of the foot's three Yin meridians, constituting the Lower Part. Foot-Jueyin belongs to the Liver, so Lower Part Heaven probes the Liver; Foot-Shaoyin belongs to the Kidney, so Lower Part Earth probes the Kidney; Foot-Taiyin belongs to the Spleen, so Lower Part Human probes the Spleen, combined with the Qi of the Stomach.
The Emperor asked: How are the Middle Part probes?
Since the Lower Part is clear, how are the Middle Part probes?
Qibo said: There is also Heaven, Earth, and Human. Heaven probes the Lung; Earth probes the Qi of the Chest; Human probes the Heart.
Hand-Taiyin belongs to the Lung, so Heaven probes the Lung. Hand-Yangming (Large Intestine) is the Fu-organ of the Lung, so Earth probes the Qi of the Chest. Hand-Shaoyin belongs to the Heart, so Human probes the Heart.
The Emperor asked: How is the Upper Part probed?
Since the Lower and Middle Parts are clear, how is the Upper Part probed?
Qibo said: There is also Heaven, Earth, and Human. Heaven probes the Qi of the head and angles; Earth probes the Qi of the mouth and teeth; Human probes the Qi of the eyes and ears.
Upper Part Heaven, the arterial pulse at both temples, thus Heaven probes the Qi of the head and angles; Upper Part Earth, the arterial pulse at both cheeks, thus Earth probes the Qi of the mouth and teeth; Upper Part Human, the arterial pulse in front of the ears, thus Human probes the Qi of the eyes and ears. From this, we see that the head and face are the Upper Part, the chest and diaphragm are the Middle Part, and the hypochondrium and abdomen are the Lower Part.
The Three Parts each have Heaven, Earth, and Human. Three combine to form Heaven, three combine to form Earth, three combine to form Human. Three times three equals nine. Nine divides into Nine Regions, and Nine Regions correspond to Nine Viscera. Thus, there are five Spirit Viscera and four Form Viscera, totaling nine viscera. If the essence of the Five Zang organs fails, the complexion will inevitably become dull and lifeless; if lifeless, death ensues.
The aforementioned Three Parts, each having Heaven, Earth, and Human, represent three combining to form Heaven, Earth, and Human. One part has three probes; three times three equals nine. Using ultimate numbers to combine with Heaven and Earth, nine divides into Nine Regions. Combining Heaven and Earth with human form, Nine Regions become Nine Viscera. The Nine Viscera include the Liver, Lung, Heart, Spleen, and Kidney, which store Hun, Po, Shen, Yi, and Zhi, hence the five Spirit Viscera; the Large Intestine, Small Intestine, Stomach, and Bladder, which store water and grain residues, hence the four Form Viscera. Together, Spirit and Form Viscera make nine. If the spiritual Qi of the Five Zang organs has failed and cannot nourish the exterior, the complexion will become dull and lifeless, leading to death.
This section discusses how the human body's Three Parts and Nine Probes accord with the ultimate numbers of Heaven and Earth.
The Emperor asked: How to probe?
The previous section discussed the Three Parts and Nine Probes; here, only the method of the Nine Probes is discussed, so the question is: how to probe?
Qibo said: First, measure the patient's fatness or emaciation to adjust for the deficiency or excess of Qi. In excess conditions, use draining methods; in deficiency conditions, use tonifying methods. One must first remove blood stasis, then regulate. Regardless of the disease, aim for balance.
*Duo* is pronounced with the entering tone. The Nine Probes govern the form and Qi of the whole body, so one must first measure the fatness or emaciation of the form to observe the exterior. Regulate the deficiency or excess of Qi to observe the interior; if excess, drain it; if deficiency, tonify it. One must first remove stagnation in the blood vessels, then tonify deficiencies in the blood vessels. Regardless of whether the disease is internal or external, the goal is balanced blood vessels. This is the method of probing.
The Emperor asked: How to determine life and death?
How do the Nine Probes determine life and death?
Qibo said: If the body is robust but the pulse is fine and thin, with shortness of breath insufficient for respiration, the condition is critical. If the body is emaciated but the pulse is large, with excessive Qi in the chest, death occurs. If form and Qi are harmonious, survival is indicated. If the pattern is irregular and uncoordinated, disease exists. If all Three Parts and Nine Probes are discordant, death occurs.
Form and pulse-Qi should harmonize. If the body is robust but the pulse is fine and thin with shortness of breath, the form is in excess while the pulse-Qi is deficient, hence critical. If the body is emaciated but the pulse is large with excessive chest Qi, the form is deficient while the pulse-Qi is hyperactive, hence fatal. Only when form and Qi are harmonious does survival occur. If form and Qi are irregular and uncoordinated, disease exists. If all Three Parts and Nine Probes are discordant, death occurs.
If the pulses of the upper and lower, left and right correspond irregularly like pounding grain, the disease is severe. If the pulses of the upper and lower, left and right are discordant and uncountable, death occurs.
*Shu* is pronounced with the rising tone. Irregular correspondence, where the pulses of the upper and lower, left and right respond to the fingers like pounding grain, indicates severe disease. "Pounding grain" refers to alternating high and low positions, lacking harmony. If all Three Parts and Nine Probes are discordant, and the upper/lower, left/right pulses are uncountable, death occurs. "Uncountable" means the pulse body is disordered, making it impossible to count the beats.
If the Middle Part pulse is alone harmonious but discordant with the other viscera, death occurs. If the Middle Part pulse decreases, death occurs. If the eyes are sunken, death occurs.
If the upper/lower, left/right pulses correspond irregularly like pounding grain, or are discordant and uncountable, even if the Middle Part pulse is alone harmonious, it ultimately remains discordant with the other viscera. This means the upper/lower, left/right do not return to the Central Earth, hence death. If the upper/lower, left/right pulses are in excess while the Middle Part pulse decreases, the Central Earth does not reach the upper/lower, left/right, hence death. The upper/lower, left/right return to the Middle Part, and the essence of the five Zang organs pours into the eyes. If the eyes are sunken, all five Zang organs are exhausted, hence death. This is the method of using the Nine Probes to determine life and death.
The Emperor asked: How to know the location of the disease?
To determine life and death, one must identify the cause of the disease; thus, the Emperor asks.
Qibo said: Examine the Nine Probes. If one is exclusively small, there is disease; if exclusively large, there is disease; if exclusively rapid, there is disease; if exclusively slow, there is disease; if exclusively hot, there is disease; if exclusively cold, there is disease; if exclusively depressed/sunken, there is disease.
To know the disease location, one must examine the Nine Probes. If examining the Nine Probes reveals one exclusively small, there is disease; one exclusively large, there is disease; one exclusively rapid, there is disease; one exclusively slow, there is disease; one exclusively hot, there is disease; one exclusively cold, there is disease; one exclusively depressed due to failure of Yang Qi to ascend, there is disease. These are the seven diagnostic signs found by examining the Nine Probes.
Press with the left hand five cun above the ankle, while striking the right foot near the ankle with the right hand. If the response travels more than five cun upward and moves gently (*ru ru*), there is no disease. If the response is rapid and feels浑浑然 (turbulent/heavy) to the touch, there is disease. If it feels徐徐然 (slow/weak) to the touch, there is disease. If the response does not reach five cun upward, or if striking elicits no response, death occurs.
*Huai* is pronounced like *wa* departing tone. *Dan* is pronounced with the level tone. *Ru* sounds like *chan*. Pronunciations for Huai and Ru are same as previous chapters. *Zhong* is pronounced with the departing tone. The aforementioned small/large/rapid/slow/cold/hot indicate mild disease; however, depression indicates failure of generating Yang Qi to ascend, implying critical illness. Thus, one should press the ankles with both hands. The method is: place the left hand five cun above the patient's ankle. Seven cun above the lateral malleolus is the Chengshan acupoint, belonging to the Foot-Taiyang Meridian. Five cun above the ankle is below Chengshan. Simultaneously, strike the patient's foot near the ankle with the right hand. With the left hand pressing the pulse and the right hand guiding, if the pulse response travels over five cun to Chengshan and moves gently (*ru ru*), it indicates harmonious Qi, hence no disease. If the pulse responds rapidly and feels turbulent to the touch, it indicates excessive Qi, hence disease. If it feels slow/weak to the touch, it indicates deficient Qi, hence disease. If the response does not reach five cun upward, or if striking yields no response, the generating Yang Qi is extinguished below, hence death.
Therefore, if muscle wasting occurs and the body's illness persists without resolution, death occurs. If the Middle Part pulse fluctuates intermittently (sparse and frequent), death occurs.
*Shuo* is pronounced *shuo*, same below. The previous text stated that extinction of generating Yang Qi leads to death; here, it states that if generating Yang Qi cannot reach the exterior or move up/down, death occurs. Muscle wasting indicates generating Yang Qi cannot reach the exterior; if the body is ill and does not recover, death occurs. The Middle Part Human position connects Qi upwards to Heaven and downwards to Earth. If the Middle Part pulse fluctuates intermittently, it indicates generating Yang Qi cannot move up/down, hence death.
If the pulse is intermittent (*Dai*) and hooked (*Gou*), the disease is in the Collateral Vessels.
*Dai* refers to the appearance of intermittency (sparse). *Dai* and *Gou* refer to the appearance of frequency. This follows the mention of intermittent sparsity and frequency. If the pulse is intermittent and hooked, it indicates blockage inside and outside the meridians, so the disease is in the Collateral Vessels; it is not fatal.
In the response of the Nine Probes, upper and lower should be uniform and not discordant. If one probe lags, there is disease; if two lag, the disease is severe; if three lag, the condition is critical. "Lagging" means the responses are not simultaneous.
Summarizing the previous text regarding the response of the Nine Probes: Yin and Yang, upper and lower, should move uniformly, not differing in smallness/largeness or rapidity/slowness. Pulses have Floating, Middle, and Deep probes. If the Floating probe lags (pulse does not respond to pressure), there is disease. If the Middle probe lags (pulse does not respond to medium pressure), the disease is severe. If the Deep probe lags (pulse does not respond to deep pressure), the condition is critical. Clarifying "lagging" means non-simultaneous response: the Floating, Middle, and Deep pulses do not all respond under the fingers. All these refer to the method of guiding and palpating.
Examine the Fu and Zang organs to know the timing of life and death.
Using the Nine Probes to determine life and death and locate the disease, one examines the Fu and Zang organs to predict the time of death. Disease in Fu organs implies survival; disease in Zang organs implies death.
One must first understand the regular meridians, then understand the pathological pulses. Appearance of the True Zang Pulse indicates death on the day of overcoming (being controlled).
*Xian* is pronounced *xian*. To examine Fu organs and know disease, one must first understand regular meridians, then pathological pulses. To examine Zang organs and know death, one must know that appearance of the True Zang Pulse leads to death on the day of overcoming.
Extinction of Foot-Taiyang Qi results in inability to flex or extend the feet; death is accompanied by upward deviation of the eyes (staring fixedly upward).
The Nine Probes govern the form and Qi of the whole body, and the Qi of the Taiyang Meridian circulates throughout the body. Extinction of Foot-Taiyang Qi causes inability to flex/extend the feet; death involves upward deviation of the eyes. Inability to flex/extend feet indicates meridian extinction. Upward deviation of eyes indicates pulse/extinction of vessel Qi. Since Taiyang Meridian Qi circulates the whole body, discussing the Nine Probes cites the Taiyang Meridian to illustrate this.
This section discusses using the Nine Probes to determine life and death and locate disease, emphasizing that guiding and palpating is necessary to ascertain the truth.
The Emperor asked: Winter Yin and Summer Yang, what does this mean?
The Emperor wished to hear the essential principles, including "Winter Yin, Summer Yang, responding with the human body," so he asks again.
Qibo said: If all Nine Probe pulses are deep, fine, and suspended/extinct, this is Yin, governing Winter, so death occurs at midnight;
If they are full, restless, panting, and rapid, this is Yang, governing Summer, so death occurs at noon.
Winter Yin and Summer Yang refer to the Yin/Yang of a year; midnight and noon refer to the Yin/Yang of a day. If all Nine Probe pulses are deep, fine, and suspended/extinct, they are Yin pulses. Yin governs Winter, so death occurs at midnight. If all Nine Probe pulses are full, restless, panting, and rapid, they are Yang pulses. Yang governs Summer, so death occurs at noon.
Therefore, those with Cold-Heat diseases die at dawn; those with Heat-in-the-Middle or Heat diseases die at noon; those with Wind diseases die at dusk; those with Water diseases die at midnight.
Those whose pulses fluctuate intermittently (sparse/frequent, slow/rapid) die during the seasons governed by Earth (the transitional periods between seasons).
Within a single day, there are also four seasons. Thus, those with Cold-Heat diseases have deficient Liver Blood internally, manifesting as cold or heat. Dawn (Yin/Mao hours) is governed by Liver Wood. If the Liver is diseased, death occurs at dawn. Those with Heat-in-the-Middle or Heat diseases have blazing Heart Fire, with heat internally and externally. Noon (Si/Wu hours) is governed by Heart Fire. If the Heart is diseased, death occurs at noon. Those with Wind diseases are affected by the肃杀 (desolating/killing) Qi of Autumn Metal, affecting the Lungs. Dusk (Shen/You hours) is governed by Lung Metal. If the Lungs are diseased, death occurs at dusk. Those with Water diseases are affected by the cold Water Qi of Winter, affecting the Kidneys. Midnight (Hai/Zi hours) is governed by Kidney Water. If the Kidneys are diseased, death occurs at midnight. The Spleen belongs to Earth. Earth irrigates the four directions. If the pulse fluctuates intermittently (sparse/frequent, slow/rapid), it indicates deficiency of Central Earth unable to distribute to the four directions, so death occurs during the Earth-governed periods of the day. Chen, Xu, Chou, and Wei hours are subordinate to dawn, noon, dusk, and midnight respectively.
If flesh and muscle have wasted away, even if the Nine Probes are harmonious, death still occurs.
Establishing form and stabilizing Qi constitutes a person. If flesh and muscle have wasted away, Kun Earth (Spleen/Stomach) has failed internally, and the other viscera lack nourishment. Even if the Nine Probe pulses are harmonious, death still occurs.
Although the Seven Diagnoses are present, if all Nine Probes follow (are harmonious), death does not occur.
*Xian* is pronounced *xian*. Although the Seven Diagnoses (small/large/rapid/slow/cold/hot/depressed) are present, this is not equivalent to total Earth failure. Thus, if all Nine Probes are harmonious, death does not occur.
The statement "death does not occur" refers to diseases of Wind Qi or menstrual/chronic channel diseases, which resemble the Seven Diagnoses but are not truly so; hence, death does not occur. However, if the Seven Diagnoses are present and the pulse prognosis is also failed, death occurs, accompanied by hiccups or belching.
Small/large/rapid/slow/cold/hot indicate mild disease; depression indicates serious disease. Clarifying why death does not occur: either Qi mechanism disease manifests as Wind Qi disease, or channel disease manifests as chronic menstrual disease. Generating Yang Qi can still ascend. It resembles the Seven Diagnoses but lacks depression, hence "not truly so." This is why death does not occur. However, if the Seven Diagnoses are present, Zheng Qi is depressed, and the pulse prognosis has failed, death occurs. Generating Yang fails to ascend, leading to hiccups or belching. Severe cases result in hiccups (Earth Qi failure); mild cases result in belching (Earth Qi deficiency). Thus, knowing that Seven Diagnosis diseases without depression do not lead to death, but those with depression do.
One must carefully inquire about the onset of the disease and the current symptoms, then palpate each pulse, observing the floating/sinking of the meridians, and tracing according to upward/downward and reverse/compliant patterns. Rapid pulses indicate no disease; slow pulses indicate disease; absent pulses indicate death. Skin adhering tightly to bone indicates death.
Diseases have new and old origins. A skilled diagnostician must carefully inquire about the onset and current state, then match symptoms with pulses and pulses with symptoms. Palpate each pulse and observe the floating/sinking of the meridians, tracing according to upward/downward and reverse/compliant patterns. Rapid pulses indicate excess in meridians, hence no disease. Slow pulses indicate deficiency in meridians, hence disease. Absent pulses indicate internal exhaustion of Qi and Blood, hence death. Skin adhering tightly to bone indicates long-term disease with muscle wasting, hence death.
The Emperor asked: How to treat those who are curable?
Absent pulses indicate death; skin adhering to bone indicates death. How to treat the curable?
Qibo said: For Meridian diseases, treat the Meridians. For Sunluo (fine collateral) diseases, treat the blood in the Sunluo.
For the curable, one should still observe the floating/sinking of meridians, tracing according to upward/downward and reverse/compliant patterns, which constitutes the treatment method. Meridians reside inside the collaterals; thus, for Meridian diseases, treat the Meridians. Sunluo reside outside the collaterals; thus, for Sunluo diseases, treat the Sunluo until bleeding occurs, leading to recovery.
For Blood diseases with body pain, treat the meridians and collaterals.
Meridians and collaterals both govern Blood. If Blood disease in meridians/collaterals presents with body pain, treat the meridians and collaterals.
If the disease lies in "Qi Xie" (abnormal/pathogenic factors), apply Miao Ci (cross-point needling).
Qi Xie refers to pathogens that do not enter the main meridians but overflow into the large collaterals, causing unusual diseases. If the disease lies in Qi Xie, one should apply Miao Ci (cross-point needling) to treat it.
Miao Ci involves needling the left side for right-sided disease, and the right side for left-sided disease.
For lingering emaciation with fixed pathology, puncture at the joints.
Initially a Qi Xie disease, if treatment fails and the pathogen lingers deeper, affecting the bones, with muscle wasting and fixed pathology, one should puncture the bone joints.