大，推展也。帝承上编奇病而推展之，故曰大奇。上编胞络脉绝，乃先天受病，其病发于天癸未至
之时，此篇首言肝满肾满肺满，则天癸已至，形气充足，而为后天之病，病脏腑经脉，甚则死
不可治，所以大奇病之说也。
肝满，肾满，肺满皆实，即为肿。
帝承上编胞络脉绝，先天受病之意，而言肝满肾满肺满，则天癸已至，形气充盛，而为后天之病。
女子天癸，肝所主也。男子天癸，肾所主也。通体形气，肺所主也。今肝肾肺满，满则为实，故
曰皆实，实则壅滞，故曰即为肿。
肺之壅，喘而两 满。
壅，壅通，下同。壅，壅滞也，以明即为肺者，壅滞之意也。
肺主呼吸，其脉横出腋下，肺之壅，则呼吸不利，其脉不能出腋，故喘而两 满。
肝壅，两 满，卧则惊，不得小便。
肝脉上贯于膈，布胁肋。肝壅，故两 满。人卧则血归于肝，
肝壅故卧则惊。肝主疏泄，肝病则闭癃，故不得小便。
肾壅，脚下至少腹满，胫有大小，髀 大跛，易偏枯。
肾脉起于足心，上至少腹。肾壅，故脚下至少腹满，左右胫骨，有大小之不同，其髀 则肿大而跛易。
跛易，行步不正，易其常度也。胫有大小，髀 跛易，乃精髓不周于身，故偏枯。偏枯，
不周之意。此一节言肝满肾满肺满，为肿为壅，而发为后天之奇病也。
心脉满大，痫螈筋挛。
脉者心之所主，心者神之所居，心脉满大，则神机不利，故痫螈惊挛，神气不通于心包则痫，神气不行
于骨节则螈，痫则筋挛于内，螈则筋挛于外也。
肝脉小急，痫螈筋挛。
肝者血之所藏，肝脉小急，则血不充身，故亦痫螈筋挛，是知
痫螈筋挛之病，有因神气之内虚，有因肝血之不足矣。
肝脉骛暴，有所惊骇。
骛，音务，余篇同。骛，犹疾也。暴，犹促也。肝脉疾促，阴血虚而阳热盛也。血虚热盛，故有
所惊骇，上文肝脉小急，血虚阴盛则痫螈筋挛，此肝脉骛暴，血虚阳盛则惊骇也。
脉不至，若螈，不治自已。
承上文痫喑惊骇而言，当痫惊之时，其三部之脉，一时不至，口无言而苦喑，有属不治者，有属自己者。
二阴急，为痫厥，二阳急，为惊。
旧本在三阴急为疝下，今改正于此。急，不和也。承上文不治自已之意，而言二阴心肾不交，经脉不
和，而为痫厥之喑，则不治。二阴，少阴也。阳明胃络不通于心，经脉不和，而为惊骇之
喑，则自已。二阳，阳明也。此脏脉阴阳经气不和，发为痫惊之奇病也。
肾脉小急，肝脉小急，心脉小急，不鼓皆为瘕。
肾脉小急，肾脏虚寒也。肝脉小急，肝脏虚塞也。心脉小急，
心脏虚寒也。脏气虚寒，小急而脉不鼓，则皆为瘕。言肾肝与心皆可为瘕。瘕，假也。假寒气而成形也。
肾肝并沉，为石水。并浮，为风水。并虚，为死，并小弦，欲惊。
肾肝并沉，则肝气下沉于肾，故为石水。石水，肾水也。肾肝并浮，则肾气上浮于肝，故为风水。风
水，肝水也。肾肝并虚，则水不生木，故为死。肾肝并小弦，则虚而受邪，故欲惊。欲惊，正虚邪扰之意。
肾脉大急沉，肝脉大急沉，皆为疝。心脉搏滑急，为心疝。肺脉沉搏，为肺疝。
肾脉大急沉，肾气受邪而下入也。肝脉大急沉，肝气受邪而下入也。邪气下入，故皆为疝，或为肾之水
疝，或为肝之筋疝也。心脉搏滑急，则心气受邪，故为心疝。《脉要精微论》曰，诊得心脉而
急，病名心疝，少腹当有形也。肺脉沉搏，则肺气受邪，故为肺疝。肺疝，气疝也。
三阳急，为瘕。三阴急，为疝。
承上文瘕疝之意而言，三阳脉急，阳不和阴，则为瘕。三阳，太阳也。三阴脉急，阴不和阳，则为疝。
三阴，太阴也。此脏脉阴阳经气不和，发为瘕疝之奇病也。
脾脉外鼓沉，为肠 ，久自已。
肠 ，泄泻也。脾脉外鼓沉，言脾土之气，鼓动于外，不能四
布复下也。如是，则津液不行由经隧，故为肠 ，土气内逆，腐秽当下，故日久自已。
肝脉小缓，为肠 ，易治。
易，去声。肝脉小缓，肝脏虚而气机和缓也，故为肠 ，则当易治。
肾脉小搏沉，为肠 下血，血温身热者，死。
肾脉小搏沉，肾脏虚而热邪下搏也。故为肠 ，当主下血。血温于内，身热于外，火炎血竭，故死。
心肝 ，亦下血，二脏同病者，可治。
心肝 ，言心脉肝脉不和，而病肠 也。亦下血，亦为肾脉之
肠下血也。心肝二脏同病，而为肠 者，主木火相生，故为可治。
其脉小沉涩为肠 ，其身热者死，热见，七日死。
肺朝百脉，其脉小沉涩，肺气虚也。肺气虚而肠 ，其身复热，乃阴津泄于下，阳热浮于外，泄于下
则下而不上，浮于外则外而不内，阴阳离脱，故死。热见七日，不能环复，故七日死。
胃脉沉鼓涩，胃外鼓大，心脉小坚急，背膈偏枯。男子发左，
女子发右，不喑舌转，可治，三十日起。
背，旧本讹皆，今改。此举胃腑之脉，以足上文五脏之意。心主脉，而五脏之中皆有胃脉。会胃
脉沉鼓而涩，胃气不行于外矣。胃脉外鼓而大，胃气不行于内矣。沉鼓涩，外鼓大，皆非胃土柔和
之脉，胃脉如是也，心脉复小坚急，不能合胃脉而行于前后，则背膈偏枯，不能合胃脉而行于左右，
则男子偏枯发左，女子偏枯发右，胃络上通于心，而舌为心之窍，故不喑舌转，则胃络通于心，
心气通于胃，故其病不可治。三十日，则荣卫血气一周，故病当起。
其从者，喑三岁起，年不满二十者，三岁死。
《玉版论要》云∶男子右为从，女子左为从，其从者谓男子发于右，女子发于左。不同于上文之
发也。上文男子发左，女子发右，则不喑，此男子发右，女子发左，故喑。喑则胃络不通于心，心气
不通于胃，其偏枯之病，必三岁方起，若年不满二十者，天癸之精血始通，方来未艾，不能固密，故三岁
死。此言五脏经脉内虚，发为肠 ，胃腑经脉不和，发为偏枯之奇病也。此一节，举痫惊瘕疝
肠偏枯脏腑经脉不和，而为后天之奇病也。
脉至而搏，血衄身热者死，脉来悬钩浮，为常脉。
上节论脉病之死生，此下但论脉之死生也。搏，搏击也。脉至而搏，脉无胃气，故血衄身热者死。
若血衄身热，脉来悬钩而浮，
乃为血衄身热之常脉，则不死矣。
脉至如喘，名曰暴厥。暴厥者，不知与人言。
喘，疾促不伦也，脉至为喘，失其常度，故名曰暴厥。申明暴厥者，一时昏愦，不知与人言。
脉至如数，使人暴惊，三四日自已。
数，音朔，下同。数，一息六至也，脉至如数，阳热有余，故使人暴惊，暴惊则三四日自已。
脉至浮合，浮合如数，一息十至以上，是经气予不足也，微见，九十日死。
予，即与下同。脉至浮合，浮合于皮肤之上，如汤沸也。故申言浮合如数，一息十至以上，沉脉候脏，
浮脉候经，是经气予不足，而脉浮数也。微见者，微于皮肤之上，见此数极之脉，中按求之，则不见也，故至
九十日而死。经脉应月，一月一周，九十日者，三周也。若举按皆然，不超时日矣。
脉至如火薪然，是心精之予夺也，草干而死。
火薪然，如火然薪，浮焰无根也。心为火脏，脉至如是，是心
精之予夺，而见此脉也。冬时草干而死，水刑火也。
脉至如散叶，是肝气予虚也，木叶落而死。
散叶，木叶飘散之义，肝为木脏，脉至如是，是肝气予虚，而
见此脉也。秋时木叶落而死，金刑木也。
脉至如省客。省客者，脉塞而鼓。是肾气予不足也，悬去枣华而死。
华，即花，下同。省客，犹主省客至而即去也。故申言省客者，脉塞而鼓，谓脉充塞于指，即鼓
动而去，如省客之象也。肾为水脏，脉至如是，是肾气不足而见此脉也。悬去，犹言虚度，虚度
枣华之初夏，而死于土令之长夏，土刑水也。
脉至如丸泥，是胃精予不足也，榆荚落而死。
丸泥，弹丸之泥不柔和也。胃为上腑，脉至如是，是胃精予不足而见此脉也。春时榆荚
落而死，木刑土也。
脉至如横格，是胆气予不足也，禾熟而死。
格，拒也。横格，横拒于中，上下不贯也。胆气属木，生阳上
升，脉至如是，是胆气予不足而见此脉也。秋时禾熟而死，金刑木也。
脉至如弦缕，是胞精予不足也，病善言，下霜而死，不言可治。
弦缕，其急如弦，其细如缕，胸中为血海，冲任之脉皆起于胞中，并足少阴之经，至胸中而散，脉至
如是，精血内虚，是胞精予不足而见此脉也，至胸中而不能散，故病善言，下霜之时，水气生王，胞精不足，
不能生王，故死。至胸中而能散，则不善言，故不言可治。上文皆言四时之气，克我而死，此言人身之气，
不能王时而死也。
脉至如交漆，交漆者，左右旁至也。微见，三十日死。
交，作绞。此复申明胞精不足之意。绞漆之脉，左右旁流，按之无根，故申言绞漆者，左右旁至也。微
于皮肤之上，见此旁至之脉，经脉内虚，至一月而死，三十日者，经脉一周也。
脉至如涌泉，浮鼓肌中，太阳气予不足也，少气味，韭英而死。
涌泉，泉水之涌，浮鼓不返，故曰脉至如涌泉，浮鼓肌中，太阳秉容水之气以营运，脉至如是，是
太阳气予不足，而见此脉也。气为阳，味为阴，太阳有寒热阴阳之气，太阳虚，故少气味。英，
盛也。韭英，乃季春土王之时，韭英而死，土克水也。
脉至如颓土之状，按之不得，是肌气予不足也，五色先见黑，白垒发死。
垒， 同，颓土，倾颓之上，犹顽土也，状如颓土，止而不行，故按之不得，脾主肌，属土，脉至如
是，是肌气予不足而见此脉也，土主五色，先见宜黄，今五色先见黑，土虚水溢也。 ，葛
属，其色白。白 发于春，春时木王，土襄，故白 发死。
脉至如悬雍，悬雍者，浮揣，切之益大，是十二俞之予不足
也，不凝而死。
雍，作KT 。悬KT ，虚肿之KT 。上浮本大也，上浮故当浮揣；本大，故切之益大。十二经俞，流
行环转，壅滞则病，脉至如是，是十二俞之予不足而见此脉也。水凝则天寒地冻，经脉凝涩，故水凝
而死。凝，不生动也。
脉至如偃刀，偃刀者，浮之小急，按之坚大急，五脏菀热，寒
热独并于肾也，如此其人不得坐，立春而死。
偃，息也。刀，金器也。偃刀，坚刚内伏也。故申言偃刀者，轻指浮之，则脉小急，重指按之，则脉
坚大而急，肾脏五脏之精，脉至如是，是五脏菀热，寒热独并于肾而沉匿也。经脉论云，肾是
动病。坐而欲起，故如此，其人不得坐，五脏之病，独并于肾，冬失其藏，春无以生，故立春而死。
脉至如丸，滑不直手，不直手者，按之不可得也。是大肠气予不足也，枣叶生而死。
丸，园转也。不直手，滑利也。故申言不直手者，按之即无，不可得也。大肠之腑，居于胃下，
合土气以营运，脉至如是，是大肠气予不足而见此脉也。春时枣叶生而死，木克土也。
脉至如华者，令人善恐，不欲坐卧，行立常听，是小肠气予不足也，季秋而死。
华，轻浮之意，脉至如华者，肾精不升，故令人善恐，坐而欲起，故不欲坐卧，耳为肾窍，故行立常
若有听。精虚则液先虚，肾藏精，小肠主液，是小肠气予不足，而有如是之脉证也。季秋，土
气坐王之时，季秋而死，土克水也。此一节，论脉象而知脏腑经俞之病，四同身死之期，不死于病，
而死于脉，所以大奇病之说也。
Da (Great/Extensive) means to extend or unfold. The Yellow Emperor, continuing the discussion on rare diseases from the previous section, extends it further; hence it is called "Da Qi" (Great Rarity). In the previous section, the mention of "interruption of the Pericardium Collateral pulse" referred to a disease acquired congenitally, manifesting before the arrival of Tian Gui (Heavenly Water / reproductive essence). This section begins by discussing "Liver Fullness, Kidney Fullness, and Lung Fullness," indicating that Tian Gui has arrived, the form and vital energy are sufficient, and this constitutes an acquired disease affecting the Zang-Fu organs and meridians. If severe, it leads to death and is incurable; thus, this explains the concept of "Da Qi Bing" (Great Rare Diseases).
When Liver Fullness, Kidney Fullness, and Lung Fullness all present as Excess patterns, swelling occurs.
Continuing the intent of the previous section regarding the congenital disease of the interrupted Pericardium Collateral, the text discusses Liver, Kidney, and Lung Fullness to indicate that Tian Gui has arrived, and the form and Qi are abundant, constituting an acquired disease. For women, Tian Gui is governed by the Liver; for men, by the Kidney; and the whole body's form and Qi are governed by the Lung. Now, if the Liver, Kidney, and Lung are full, fullness implies Excess; therefore, it is said "all are Excess." Excess implies stagnation and obstruction; therefore, it is said "thus becomes swelling."
Lung stagnation manifests as panting and distension in both hypochondriac regions.
"Yong" (Stagnation) is synonymous with "Yong" (Support/Obstruct), used similarly below. "Yong" means stagnation, clarifying that "becoming Lung" refers to the state of stagnation.
The Lung governs respiration, and its meridian emerges horizontally from under the armpit. When the Lung is stagnant, respiration becomes difficult, and the meridian Qi cannot emerge from the axilla; thus, panting and distension in both hypochondriac regions occur.
Liver stagnation manifests as distension in both hypochondriac regions, fright during sleep, and inability to urinate.
The Liver meridian ascends through the diaphragm and spreads over the costal and hypochondriac regions. Due to Liver stagnation, there is distension in both hypochondriac regions. When a person lies down, blood returns to the Liver; due to Liver stagnation, fright occurs during sleep. The Liver governs free flow and drainage; Liver disease leads to Bi Long (strangury/inability to urinate); thus, urination is impossible.
Kidney stagnation manifests as distension from the sole of the foot to the lower abdomen, size discrepancy between the calves, enlargement of the thighs with limping, and predisposition to hemiplegia (Pian Ku).
The Kidney meridian originates at the sole of the foot and ascends to the lower abdomen. Due to Kidney stagnation, there is distension from the sole to the lower abdomen. There may be differences in size between the left and right calves, and the thighs become enlarged with limping.
"Buo Yi" refers to abnormal gait, deviating from normal standards. Size discrepancy in calves and limping/enlargement of thighs indicate that Essence and Marrow do not circulate uniformly throughout the body, leading to Pian Ku (hemiplegia). "Pian Ku" means lack of uniform circulation. This section discusses how Liver, Kidney, and Lung Fullness lead to swelling and stagnation, resulting in acquired rare diseases.
If the Heart Pulse is Full and Large, Epilepsy (Xian), convulsions (Chuang), and tendon spasm (Jin Luan) occur.
Pulses are governed by the Heart, and the Heart is the residence of Shen (Spirit). If the Heart Pulse is Full and Large, the mechanism of Shen becomes obstructed; thus, Epilepsy, convulsions, and tendon spasms occur. If Shen Qi does not communicate with the Pericardium, Epilepsy arises; if Shen Qi does not flow through the joints, convulsions arise. Epilepsy involves internal tendon spasms, while convulsions involve external tendon spasms.
If the Liver Pulse is Small and Wiry-Tight (Xiao Ji), Epilepsy, convulsions, and tendon spasms also occur.
The Liver stores Blood. If the Liver Pulse is Small and Wiry-Tight, Blood fails to nourish the body sufficiently; thus, Epilepsy, convulsions, and tendon spasms also occur. From this, we know that diseases of Epilepsy, convulsions, and tendon spasms can be caused either by internal deficiency of Shen Qi or by insufficiency of Liver Blood.
If the Liver Pulse is Rapid and Violent (Wu Bao), it indicates fright and alarm.
"Wu" sounds like "Wu"; used similarly in other chapters. "Wu" means rapid. "Bao" means sudden/violent. A rapid and violent Liver Pulse indicates Yin Blood deficiency and Yang Heat excess. Due to Blood deficiency and Heat excess, fright and alarm occur. As mentioned above, a Small and Wiry-Tight Liver Pulse with Blood deficiency and Yin excess leads to Epilepsy, convulsions, and tendon spasms; here, a Wu Bao Liver Pulse with Blood deficiency and Yang excess leads to fright and alarm.
If the Pulse is absent, and there are convulsions, it may heal spontaneously without treatment.
Continuing from the discussion on Epilepsy, aphonia, and alarm: during an attack of Epilepsy or convulsion, the pulses at the three positions may temporarily be absent. Aphonia accompanied by inability to speak may belong to incurable cases or to cases that heal spontaneously.
If the Two Yin Pulses are Wiry-Tight, it leads to Epileptic Syncope (Xian Jue); if the Two Yang Pulses are Wiry-Tight, it leads to Alarm (Jing).
In old editions, this sentence was placed after "Three Yin Tight leads to Hernia"; it is now corrected here. "Ji" (Tight/Wiry-Tight) means disharmony. Continuing the idea of "healing spontaneously," it states that if the Two Yin (Heart and Kidney) fail to interact, and the meridians are disharmonious, leading to aphonia due to Epileptic Syncope, it is incurable. "Two Yin" refers to Shao Yin. If the Yang Ming Stomach collateral does not connect to the Heart, and the meridians are disharmonious, leading to aphonia due to Alarm, it will heal spontaneously. "Two Yang" refers to Yang Ming. This describes rare diseases of Epilepsy and Alarm caused by disharmony of Yin and Yang Jing Qi in the Zang organ pulses.
If the Kidney, Liver, and Heart Pulses are all Small and Wiry-Tight, and do not beat vigorously (Bu), they all indicate Jia (masses/growths).
A Small and Wiry-Tight Kidney Pulse indicates Kidney Deficiency-Cold. A Small and Wiry-Tight Liver Pulse indicates Liver Deficiency-Stagnation. A Small and Wiry-Tight Heart Pulse indicates Heart Deficiency-Cold. When Zang Qi is deficient and cold, and the pulse is Small and Wiry-Tight without vigorous beating, it forms Jia. This means Jia can arise from the Kidney, Liver, and Heart. "Jia" means false; it takes shape by borrowing Cold Qi.
If the Kidney and Liver Pulses are both Deep (Chen), it is Shi Shui (Stone Water); if both Floating (Fu), it is Feng Shui (Wind Water); if both Deficient (Xu), it is a Death sign; if both Small and Wiry (Xian), it indicates impending Fright.
If the Kidney and Liver Pulses are both Deep, Liver Qi sinks into the Kidney, resulting in Shi Shui (Kidney Water disease). If both Floating, Kidney Qi floats up to the Liver, resulting in Feng Shui (Liver Water disease). If both Deficient, Water fails to generate Wood, resulting in death. If both Small and Wiry, deficiency allows pathogenic factors to invade, leading to impending Fright. "Yu Jing" means Zheng Qi is weak and Xie Qi disturbs.
If the Kidney Pulse is Large, Wiry-Tight, and Deep, and the Liver Pulse is Large, Wiry-Tight, and Deep, both indicate Shan (Hernia). If the Heart Pulse is Slippery, Rapid, and Wiry-Tight, it is Xin Shan (Heart Hernia). If the Lung Pulse is Deep and Forceful, it is Fei Shan (Lung Hernia).
A Large, Wiry-Tight, and Deep Kidney Pulse indicates Kidney Qi invaded by pathogen and sinking downward. A Large, Wiry-Tight, and Deep Liver Pulse indicates Liver Qi invaded by pathogen and sinking downward. Pathogen sinking downward results in Shan, which may be Kidney Water Shan or Liver Tendon Shan. A Slippery, Rapid, and Wiry-Tight Heart Pulse indicates Heart Qi invaded by pathogen, resulting in Xin Shan. The *Mai Yao Jing Wei Lun* states: "Diagnose Heart Pulse as Wiry-Tight, disease name is Heart Hernia, there should be a visible mass in the lower abdomen." A Deep and Forceful Lung Pulse indicates Lung Qi invaded by pathogen, resulting in Fei Shan. Fei Shan is Qi Shan.
If the Three Yang Pulses are Wiry-Tight, it is Jia; if the Three Yin Pulses are Wiry-Tight, it is Shan.
Continuing the meaning of Jia and Shan: Three Yang Pulse Wiry-Tight means Yang does not harmonize with Yin, resulting in Jia. "Three Yang" refers to Tai Yang. Three Yin Pulse Wiry-Tight means Yin does not harmonize with Yang, resulting in Shan. "Three Yin" refers to Tai Yin. This describes rare diseases of Jia and Shan caused by disharmony of Yin and Yang Jing Qi in the Zang organ pulses.
If the Spleen Pulse beats externally but is Deep, it is Chang Pi (dysentery/diarrhea), which heals itself after a long time.
"Chang Pi" refers to diarrhea/dysentery. Spleen Pulse beating externally but being Deep indicates Spleen Earth Qi moves outward and fails to distribute downward. Consequently, Jin Ye (Body Fluids) cannot flow through the meridians, causing Chang Pi. With Spleen Qi reversing internally, foul matter must be expelled downward; thus, it heals itself after a prolonged period.
If the Liver Pulse is Small and Slow (Huan), it is Chang Pi, which is easy to treat.
"Yi" is pronounced with the departing tone. A Small and Slow Liver Pulse indicates Liver Deficiency with harmonious and slow Qi dynamics; thus, it is Chang Pi, which should be easy to treat.
If the Kidney Pulse is Small, Forceful, and Deep, it is Chang Pi with bloody stool. If the blood is warm and the body is hot, it is a death sign.
A Small, Forceful, and Deep Kidney Pulse indicates Kidney Deficiency with Heat Pathogen pressing downward. Thus, it is Chang Pi, primarily presenting with bloody stool. Heat inside warms the blood, and heat outside raises body temperature; Fire flares and Blood dries up, resulting in death.
If the Heart and Liver are affected by Chang Pi, there is also bloody stool. If the two Zang organs are diseased simultaneously, it is treatable.
"Heart-Liver Chang Pi" refers to disharmony of Heart and Liver Pulses leading to Chang Pi. It also presents with bloody stool, similar to Kidney-related Chang Pi with bloody stool. When Heart and Liver are diseased together causing Chang Pi, it involves Wood generating Fire, so it is treatable.
If the Pulse is Small, Deep, and Choppy (Se) indicating Chang Pi, and the patient has fever, it is a death sign; if fever persists for seven days, death occurs.
The Lung commands all pulses. A Small, Deep, and Choppy Pulse indicates Lung Qi Deficiency. With Lung Qi Deficiency and Chang Pi, plus body fever, Yin fluids leak downward while Yang Heat floats outward. Leaking downward means descending without ascending; floating outward means exterior without interior. Yin and Yang separate and detach, resulting in death. Fever persisting for seven days prevents the cycle of Qi from restoring, so death occurs in seven days.
If the Stomach Pulse is Deep, beating, and Choppy, and the Stomach Pulse beats large externally, and the Heart Pulse is Small, Firm, and Wiry-Tight, it leads to Pian Ku (hemiplegia) of the back and diaphragm. In men, it manifests on the left; in women, on the right. If there is no aphonia and the tongue turns freely, it is treatable, and recovery occurs in thirty days.
"Bei" (Back) was erroneously printed as "Jie" in old editions; now corrected. This cites the Stomach Fu pulse to summarize the preceding five Zang organs. The Heart governs pulses, and within the five Zang organs, the Stomach Pulse is present. If the Stomach Pulse is Deep, beating, and Choppy, Stomach Qi fails to move outward. If the Stomach Pulse beats large externally, Stomach Qi fails to move inward. Deep-beating-Choppy and externally-large beating are not the gentle pulses of Stomach Earth. If the Stomach Pulse is like this, and the Heart Pulse is Small, Firm, and Wiry-Tight, failing to coordinate with the Stomach Pulse to move front-to-back, Pian Ku of the back and diaphragm occurs; failing to coordinate left-to-right, men develop Pian Ku on the left, and women on the right. The Stomach collateral connects upward to the Heart, and the tongue is the orifice of the Heart. Therefore, if there is no aphonia and the tongue moves freely, it indicates the Stomach collateral connects to the Heart, and Heart Qi connects to the Stomach; thus, the disease is treatable. Thirty days represents one cycle of Ying-Wei and Blood-Qi; thus, the disease should recover.
If the condition follows the "Cong" pattern (aphonia), recovery takes three years; if under twenty years old, death occurs in three years.
The *Yu Ban Lun Yao* states: For men, the right side is Cong; for women, the left side is Cong. "Cong" means men manifest on the right, women on the left, differing from the previous section. Previously, men manifested on the left and women on the right without aphonia; here, men manifest on the right and women on the left, resulting in aphonia. Aphonia indicates the Stomach collateral does not connect to the Heart, and Heart Qi does not connect to the Stomach. The Pian Ku disease will take three years to recover. If under twenty years old, Tian Gui essence and blood have just begun to flow and are not yet stable/firm, so death occurs in three years. This section discusses internal deficiency of Five Zang meridians causing Chang Pi, and disharmony of Stomach Fu meridians causing Pian Ku as rare diseases. This segment lists rare diseases of acquired origin involving disharmony of Zang-Fu and meridians, such as Epilepsy, Alarm, Jia, Shan, Chang Pi, and Pian Ku.
If the Pulse arrives with a Beating quality, accompanied by nasal bleeding (Xu) and body fever, it is a death sign. If the pulse comes Hanging-Hook Floating (Xuan Gou Fu), it is a Normal Pulse.
The previous section discussed life and death based on pulse-disease relationship; this section discusses life and death based solely on the pulse. "Bo" means striking/beating. A pulse arriving with a striking quality lacks Stomach Qi; thus, with nasal bleeding and body fever, it is a death sign. However, if there is nasal bleeding and body fever, but the pulse is Hanging-Hook Floating, this is the normal pulse for such symptoms, so it is not fatal.
If the pulse resembles panting, it is named Bao Jue (Sudden Syncope). Bao Jue patients lose consciousness and cannot speak to others.
"Panting" here means rapid and irregular. A pulse resembling panting loses its normal rhythm, hence named Bao Jue. It clarifies that Bao Jue involves sudden confusion and inability to converse.
If the pulse resembles a Rapid rate (Shuo), it causes sudden alarm; it heals spontaneously in three to four days.
"Shuo" sounds like "Shuo"; used similarly below. "Shuo" means six breaths per pulse beat. A pulse resembling Shuo indicates Yang Heat excess, causing sudden alarm. Sudden alarm heals spontaneously in three to four days.
If the pulse arrives as Fu He (Floating Combination), resembling Shuo, with more than ten beats per breath, it indicates Jing Qi insufficiency. If seen slightly, death occurs in ninety days.
"Yu" is synonymous with "Yu" (Give). Fu He pulse floats on the skin surface, like boiling water. It clarifies that Fu He resembling Shuo, with over ten beats per breath, indicates Jing Qi insufficiency. Deep pulse examines Zang, Floating pulse examines Jing; thus, Jing Qi is insufficient, resulting in Floating-Rapid pulse. "Wei Jian" (slightly seen) means faintly visible on the skin surface; this extreme rapid pulse is not felt at mid-pressure. Thus, death occurs in ninety days. Meridians correspond to months, completing one cycle per month; ninety days represent three cycles. If felt strongly at all depths, death would occur sooner.
If the pulse resembles burning firewood, it indicates Heart Essence is deprived; death occurs when grass dries.
"Burning firewood" means flames rising from wood without roots. The Heart is a Fire Zang. Such a pulse indicates Heart Essence is deprived. Death occurs in winter when grass dries, representing Water overcoming Fire.
If the pulse resembles scattered leaves, it indicates Liver Qi is deficient; death occurs when tree leaves fall.
"Scattered leaves" imply drifting wood leaves. The Liver is a Wood Zang. Such a pulse indicates Liver Qi deficiency. Death occurs in autumn when leaves fall, representing Metal overcoming Wood.
If the pulse resembles "Sheng Ke" (Visiting Guest), where the pulse feels blocked yet beating, it indicates Kidney Qi insufficiency; death occurs after the jujube flower falls.
"Hua" means flower. "Sheng Ke" implies a guest visiting briefly and leaving. It clarifies that "Sheng Ke" pulse feels obstructed yet beats and departs quickly, like a brief visitor. The Kidney is a Water Zang. Such a pulse indicates Kidney Qi insufficiency. "Xuan Qu" means passing time vainly; dying in early summer after jujube flowers fall, and then in late summer (Earth season), represents Earth overcoming Water.
If the pulse resembles pill-shaped mud, it indicates Stomach Essence is insufficient; death occurs when elm seeds fall.
"Pill mud" implies non-gentle, hard mud. The Stomach is the Upper Fu. Such a pulse indicates Stomach Essence insufficiency. Death occurs in spring when elm seeds fall, representing Wood overcoming Earth.
If the pulse resembles a horizontal grid, it indicates Gallbladder Qi is insufficient; death occurs when grain ripens.
"Ge" means rejection. Horizontal Grid means obstruction in the middle, preventing upper-lower connection. Gallbladder Qi belongs to Wood and rises as Sheng Yang. Such a pulse indicates Gallbladder Qi insufficiency. Death occurs in autumn when grain ripens, representing Metal overcoming Wood.
If the pulse resembles string threads, it indicates Bao (Uterus) Essence is insufficient. If the patient speaks excessively, death occurs at frost; if silent, it is treatable.
"String thread" means tight as a string and fine as a thread. The chest is the Sea of Blood; Chong and Ren meridians originate in the Bao, join the Foot Shaoyin meridian, and disperse in the chest. Such a pulse indicates internal deficiency of Essence and Blood, i.e., Bao Essence insufficiency. If Qi reaches the chest but fails to disperse, the patient speaks excessively. At frost, Water Qi dominates; Bao Essence is insufficient to support dominance, so death occurs. If Qi disperses in the chest, the patient does not speak excessively, so silence indicates treatability. Previous sections discussed death due to seasonal elements overcoming the body; this discusses death due to body Qi failing to dominate the season.
If the pulse resembles crossing lacquer (flowing sideways), it indicates Bao Essence insufficiency. If seen slightly, death occurs in thirty days.
"Jiao" means twisting. This reiterates Bao Essence insufficiency. The Crossing Lacquer pulse flows sideways, rootless upon pressure. It clarifies that Crossing Lacquer means flowing from sides. Faintly visible on the skin, this sideways-flowing pulse indicates internal meridian deficiency; death occurs in one month (thirty days, one meridian cycle).
If the pulse resembles a gushing spring, beating floating in the muscles, it indicates Tai Yang Qi is insufficient. With little Qi and Flavor, death occurs when leek flowers bloom.
"Gushing spring" implies surging water, floating and beating without returning. Tai Yang relies on Water Qi for circulation. Such a pulse indicates Tai Yang Qi insufficiency. Qi is Yang, Flavor is Yin; Tai Yang has Cold-Heat Yin-Yang Qi. Tai Yang deficiency leads to little Qi and Flavor. "Ying" means flourishing. Leek flowering occurs in late spring when Earth dominates; death at this time represents Earth overcoming Water.
If the pulse resembles crumbling earth, unfeelable upon pressure, it indicates Muscle Qi is insufficient. If Black color appears first among the five colors, and White Lei erupts, death occurs.
"Lei" is synonymous with " ". Crumbling earth is hardened soil, stationary and unyielding, hence unfeelable. Spleen governs muscle and belongs to Earth. Such a pulse indicates Muscle Qi insufficiency. Earth governs the five colors; yellow should appear first. Black appearing first indicates Earth deficiency and Water overflow. " ", a type of kudzu, is white. White eruptions in spring, when Wood dominates and Earth is constrained, lead to death.
If the pulse resembles Xuan Yong (uvula), feeling larger upon firm pressure, it indicates Twelve Shu points insufficiency; death occurs when water freezes.
"Yong" is written as KT. Xuan KT is a hollow swelling. Floating naturally large, it feels larger upon firm pressure. Twelve Meridian Shu points circulate continuously; stagnation causes disease. Such a pulse indicates Twelve Shu insufficiency. Water freezing implies cold heaven and frozen earth, causing meridian stagnation; thus, death from water freezing. "Ning" means lack of movement.
If the pulse resembles an inverted knife, feeling small and tight when floating, firm, large, and tight when pressed, it indicates Five Zang stagnation-heat, with Cold-Heat combining exclusively in the Kidney. The patient cannot sit; death occurs at Start of Spring.
"Yan" means resting. "Dao" is a metal instrument. Inverted Knife implies hardness hidden inside. Light pressure reveals small-tight pulse; heavy pressure reveals firm-large-tight pulse. Kidney and Five Zang Essence pulse like this indicates Five Zang stagnation-heat, with Cold-Heat sinking into the Kidney. The *Mai Jing Lun* states Kidney acting-up disease involves wanting to rise from sitting; thus, the patient cannot sit. Five Zang disease combines in the Kidney; Winter fails to store, Spring fails to generate; thus, death at Start of Spring.
If the pulse resembles a pill, slippery and not straight to the hand (ungraspable), it indicates Large Intestine Qi is insufficient; death occurs when jujube leaves sprout.
"Pill" means round and rolling. "Not straight to hand" means slippery. Pressing reveals nothing; it is ungraspable. The Large Intestine Fu resides below the Stomach, combining with Earth Qi for circulation. Such a pulse indicates Large Intestine Qi insufficiency. Death occurs in spring when jujube leaves sprout, representing Wood overcoming Earth.
If the pulse resembles Hua (flower/lightness), causing fearfulness, reluctance to sit or lie, and always listening while walking or standing, it indicates Small Intestine Qi is insufficient; death occurs in late autumn.
"Hua" means light and floating. Such a pulse indicates Kidney Essence fails to ascend, causing fear. Wanting to rise from sitting leads to reluctance to sit/lie. Ears are Kidney orifices; thus, listening while moving. Essence deficiency leads first to Fluid deficiency. Kidney stores Essence; Small Intestine governs Fluids. Small Intestine Qi insufficiency produces such pulse and symptoms. Late autumn is when Earth Qi dominates; death then represents Earth overcoming Water. This section discusses diagnosing Zang-Fu and Meridian-Shu diseases and seasons of death via pulse images. Death is due to the pulse, not the disease, explaining the "Great Rarity" concept.