人之有生，血气顺则周流一身，脉息和而诸疾不作，气血逆则运动滞涩，脉息乱而百病
生。然脉之精微，心中了了，指下难明，故西晋王叔和犹为切虑。凡诊之际，须澄神静虑，
以呼吸息数，定病患之脉候。两手各三部，分为寸、关、尺。左三部正脏心、肝、肾，小肠、
胆与膀胱为腑；右三部正脏肺、脾、命，大肠、胃与三焦为腑。每部浮按消息之，次中按消
息之，又沉按消息之。浮以诊其腑，见六腑之盛衰；沉以诊其脏，见五脏死生盈虚；中则诊
其胃气。盖胃为水谷之海，人以食为命，有胃气则生，无胃气则死。每三部三三如九，乃为
九候。复有七表、八里、九道脉，风、寒、暑、湿中伤之脉。七情、虚损、寒热之脉，当析
而论之。七表属阳，浮、芤、滑、实、弦、紧、洪。浮如指按葱叶，芤则中空有两头，滑似
流珠，实则健而有力，弦如琴弦，紧如弓弦，洪则举指极大。八里属阴，微、沉、缓、涩、
迟、伏、濡、弱。微于指下如细丝，沉若烂绵寻之至骨，缓则来往不急不慢，涩如刀刮竹状，
迟者寻之隐隐，伏潜于骨重指乃得，濡凑指边似怯，弱而去来无力。九道之脉，长、短、虚
、促、结、代、牢、动、细。长、促属阳，短、虚、结、代、牢、动、细为阴。长脉三关
度。促脉寻之极数。短脉按之不及。虚脉寻之不足，举之有余。结脉指下聚而却还。代脉动
中一止，停久乃还，有疾见之难治，若气逆得之则无忧。牢脉固结不移之状，三部若见，皆
死候也。动脉再再寻之，不离其处。细脉细细如丝，来往极微。凡此二十四脉，分别锱铢，
总而括之，浮沉迟数也。至于伤寒，寒泣血，其脉紧。伤寒复见风，则浮而缓。两感之脉，
沉大者太阳、少阴，沉长者阳明、太阴，沉弦者少阳、厥阴。阳病见沉、涩、弱、弦、微者
死，阴病见浮、大、数、动、滑者生。阳毒之脉，极浮洪；阴毒之脉，
附骨取之方有，按之即无。阴阳二厥，脉皆沉，所以使人疑之。阴厥脉沉迟而弱，阳厥
脉沉伏而滑。发热下利，脉沉弦者下重也，脉大者为未止，脉微弱者自愈，虽发热，不死。
中寒之脉亦紧，但肝中加弦，心中加洪，脾中加沉，肺中加迟涩，肾中加沉滑。伤风则风散
气，其脉浮，复见寒则浮而紧。中风之脉亦浮。五脏所中，脉与中寒类也，大抵迟浮则吉，
实大弦数则难治。伤暑气血消散，脉虚弱无力，中则阳弱阴虚，微迟似芤。伤湿之脉濡而弱，
若沉而细微，中之明矣。七情，喜、怒、忧、思、悲、恐、惊。喜则脉散，怒则脉促，悲则
脉结，恐、思则脉俱沉，忧则脉涩，惊则脉颤，皆生于气也。虚损者，脉来或浮大而无力，
或沉细而微弱。实热者，见于指下弦数殊甚，或细数异常。总而说之，春弦，夏钩，秋毛，
冬石。濡弱而长曰弦，来疾去迟曰钩，轻虚以浮曰毛，沉涩而弱曰石，此四时之常脉也。其
有太过不及，有覆有溢，有关有格。太过者，气有余。寸脉本浮，又加实大，是为阳太过也；
尺脉本沉，又加实大，是为阴太过也。不及者，气不足。浮之损小者，是阳不及也。沉之损
小者，是阴不及也。覆溢二脉者，溢自关前进上于鱼际，为外关内格，阴乘之脉也。覆脉自
关后退下入于尺泽，为内关外格，此阳乘之脉也。见如此者，乃诸脏相乘，四时相克，虽未
病，病即死，不可治也。又曰三关通度，过于洪大，则或风或痰，设若沉细，则为之不疗。
六部相贯，按之不及，极浮微者殂。再再寻之，至骨不绝者，天年有永矣，至于众病生死之
脉，若诸气胀满，浮大可疗，虚小难保。下痢宜微小，不宜洪大。恍惚颠狂者，实大为顺，
沉细为逆。消渴，数大者生，虚小难愈。水气，浮大则宜，沉细则愈而复作。霍乱，浮洪
可救，微迟不语，气少难瘥。鼻衄、吐血，利于沉细，不利于浮大。心腹痛，宜见沉细，不
宜见浮大。头痛，浮滑易除，短涩不愈。上气浮肿，浮滑可安，微细难疗。中恶，紧细易治
，浮大难痊。金疮出血。虚细则宜，实大则倾。中毒，洪大则存，细微则亡。十怪脉者，釜
沸、鱼翔、弹石、解索、屋漏、虾游、雀啄、偃刀、转豆、麻促。釜沸，如汤涌沸，息数俱
无，乃三阳数极无阴之候，旦见夕死，夕见旦死。鱼翔，脉浮肤泛泛，三阴数极，又曰亡阳
，当以死断。弹石，脉来辟辟凑指，急促而坚，乃肾经真脏脉现，遇戊己日则不治。解索，
脉散散无序，肾与命门之气皆亡，戊己日笃，辰巳日不治。屋漏之脉，如水下滴溅地貌，胃
气营卫俱绝，七八日间危矣。虾游，状如虾游水面，杳然不见，须臾又来，隐隐然不动，根据
前又去，醒者七日死，沉困者三日不治。雀啄之脉，指下来三去一，如雀啄食之状。脾元谷
气已绝于内，醒者十二日死，困者六七日亡。偃刀之脉，寻之如手循刀刃，无进无退，其数
无准，由心元血枯，卫气独居，无所归宿，见之四日难疗。转豆，形如豆周旋展转，并无息
数，脏腑空虚，正气飘散，象曰行尸，其死可立待也。麻促之脉，应指如麻子之纷乱，细微
至甚，盖卫枯荣血独涩，轻者三日，重者一日殂矣。又论四十五动止脉，以二十四气，七十
二候，应死期之准的。孟春立春日，十五动一止。明年东风解冻，蛰虫始振，鱼陟负冰时，
二
四十动一止。四年仓庚鸣，鹰化为鸠时，且如仲春惊蛰桃始华日，脉二十动一止。明年春分
，玄鸟至，雷乃发声时，三十动一止。三年春分，始电，桐始华时，四十动一止。四年季春
清明，田鼠化为 ，虹始见；谷雨，萍始生，鸣鸠拂其羽，戴胜降于桑时。（以下仿此。孟
夏立夏蝼蝈鸣，蚯蚓出，王瓜生。小满苦菜秀，靡草死，麦秋至。仲夏芒种螳螂生， 始鸣，
反舌无声。夏至鹿角解，半夏生，蜩始鸣。季夏小暑温风至，蟋蟀居壁，鹰始挚。大暑腐草
化萤，土润溽暑，大雨时行。孟秋立秋凉风至，白露降，寒蝉鸣。处暑鹰乃祭鸟，天地始肃
，禾乃登。仲秋白露鸿雁来，玄鸟归，群鸟养羞。秋分雷乃收声，蛰虫坏户，水始涸。季秋
寒露鸿雁来宾，雀入大水化为蛤，菊有黄华。霜降豺乃祭兽，草木黄落，蛰虫咸俯。孟冬立
冬水始冰，地始冻，雉入大水化为蜃。小雪虹藏不见，天气上升，地气下降，闭塞成冬。仲
冬大雪 旦不鸣，荔挺出，虎始交。冬至蚯蚓结，麋角解，水泉动。季冬小寒雁北乡，鹊始
巢。雉 。大寒鸡乳，征鸟厉疾。水泽腹坚。）若时疫之脉，则无定据，随时审思乃得，未
可轻议。欲知祟害，心脉虚散，肝脉洪盛，或浮沉长短大小无定，或错杂不伦，尤宜加意。
凡此诸脉，固鄙见莫之敢遗，然其或逆或顺，犹在详审而消息之，毋固执而有变通，则可得
之矣。
人的生存，依赖血气顺畅则周流全身，脉象平和则各种疾病不发生；若气血逆乱则运行滞涩，脉象紊乱而百病丛生。然而脉理的精微之处，心中虽然明白，但手指下却难以确切分辨，所以西晋的王叔和对此也深感忧虑。凡是在诊脉时，必须澄清心神、平静思虑，通过观察呼吸的次数，来确定病人的脉候。两手各有三部脉，分为寸、关、尺。左手三部对应的心、肝、肾为脏，小肠、胆与膀胱为腑；右手三部对应的肺、脾、命门（此处原文作“命”，指代命门或肾间动气，通常归入脏腑体系）为脏，大肠、胃与三焦为腑。每部脉先用轻力浮取以探察，再用中力中取以探察，最后用重力沉取以探察。浮取用以诊察六腑，可见六腑的盛衰情况；沉取用以诊察五脏，可见五脏的死生及盈虚状态；中取用以诊察胃气。因为胃是水谷之海，人依靠饮食维持生命，有胃气就能生存，无胃气就会死亡。每部脉分浮、中、沉三候，三部共九候，合为“九候”。另外还有七表脉、八里脉、九道脉，以及因风、寒、暑、湿邪气中伤所致的脉象，还有因七情内伤、虚损、寒热等引起的脉象，应当分别论述。
七表脉属阳，包括浮、芤、滑、实、弦、紧、洪。浮脉如手指按在葱叶上（中空感），芤脉中间空两边实，滑脉像滚动的珠子，实脉强劲有力，弦脉像琴弦一样绷紧，紧脉像弓弦一样紧张，洪脉举指时感觉极大。八里脉属阴，包括微、沉、缓、涩、迟、伏、濡、弱。微脉在指下细如丝线，沉脉像烂棉絮一样重按至骨才能触及，缓脉往来不急不慢，涩脉像刀刮竹子般艰涩，迟脉寻之隐隐约约，伏脉潜藏于骨下需重指才得，濡脉凑近指边似显怯弱，弱脉来去无力。九道脉包括长、短、虚、促、结、代、牢、动、细。长脉和促脉属阳，短脉、虚脉、结脉、代脉、牢脉、动脉、细脉属阴。长脉贯穿三关，促脉寻之极快，短脉按之不及本位，虚脉寻之不足、举之有余，结脉指下聚积而后返还，代脉跳动中有一次停顿，停留较久后才恢复，若在急症中出现难治，若是气逆所致则无需担忧。牢脉是固结不移的状态，若三部皆见，都是死候。动脉反复寻之，不离其处。细脉细细如丝，往来极微弱。以上这二十四种脉象，仔细区分，总括起来就是浮、沉、迟、数四种基本脉象。
至于伤寒病，寒邪凝泣血液，其脉紧。伤寒又感受风邪，则脉浮而缓。两感病（表里两经同时受邪）的脉象，沉大的是太阳、少阴病，沉长的是阳明、太阴病，沉弦的是少阳、厥阴病。阳病见到沉、涩、弱、弦、微的脉象主死，阴病见到浮、大、数、动、滑的脉象主生。阳毒病的脉象极浮洪，阴毒病的脉象附骨取之方有，按之即无。阴阳二厥证，脉象都沉，所以容易使人疑惑。阴厥脉沉迟而弱，阳厥脉沉伏而滑。发热伴下利，脉沉弦的是里急后重，脉大的表示病未停止，脉微弱的表示自愈，虽然发热也不会死。中寒的脉象也是紧，但在肝脏部位兼见弦脉，心脏部位兼见洪脉，脾脏部位兼见沉脉，肺脏部位兼见迟涩脉，肾脏部位兼见沉滑脉。伤风则风气散泄正气，其脉浮，如果再感受寒邪，则脉浮而紧。中风的脉象也是浮。五脏被邪气所中，脉象与中寒类似，大致迟脉、浮脉为吉，实、大、弦、数脉则难治。伤暑导致气血消散，脉虚弱无力，中暑则阳气弱阴虚，脉微迟似芤脉。伤湿的脉象濡而弱，如果沉而细微，说明湿气已深入体内。
七情（喜、怒、忧、思、悲、恐、惊）方面：喜则脉散，怒则脉促，悲则脉结，恐和思则脉俱沉，忧则脉涩，惊则脉颤，这些都源于气的变化。虚损者的脉，来势或浮大而无力，或沉细而微弱。实热者，指下感觉弦数非常显著，或细数异常。总的来说，春季脉弦，夏季脉钩（洪），秋季脉毛（浮），冬季脉石（沉）。濡弱而长为弦，来疾去迟为钩，轻虚以浮为毛，沉涩而弱为石，这是四时的常脉。如果有太过或不及，有覆脉和溢脉，有关格现象。太过者，气有余。寸脉本浮，又加实大，这是阳太过；尺脉本沉，又加实大，这是阴太过。不及者，气不足。浮取时脉形损小，是阳不及；沉取时脉形损小，是阴不及。覆脉和溢脉：溢脉从关前向上延伸至鱼际，称为外关内格，是阴乘阳的脉象；覆脉从关后向下深入尺泽，称为内关外格，是阳乘阴的脉象。出现这种情况，是诸脏相乘、四时相克的表现，即使尚未发病，一旦发病即死，不可治疗。又说三关通度，如果过于洪大，则是风或痰证，如果是沉细脉，则无法治疗。六部脉相互贯通，按之不及，极浮且微弱的会死亡。反复寻之，至骨不绝的，寿命长久。至于各种疾病生死相关的脉象：如诸气胀满，脉浮大可治，脉虚小难保。下痢宜微小，不宜洪大。恍惚颠狂者，脉实大为顺，脉沉细为逆。消渴病，脉数大者生，脉虚小难愈。水气病，脉浮大则适宜，脉沉细则愈后复发。霍乱，脉浮洪可救，脉微迟不语，气少难愈。鼻衄、吐血，利于脉沉细，不利于脉浮大。心腹痛，宜见沉细，不宜见浮大。头痛，脉浮滑易除，脉短涩不愈。上气浮肿，脉浮滑可安，脉微细难疗。中恶，脉紧细易治，脉浮大难痊。金疮出血，脉虚细则宜，脉实大则危。中毒，脉洪大则存，脉细微则亡。
十怪脉包括：釜沸、鱼翔、弹石、解索、屋漏、虾游、雀啄、偃刀、转豆、麻促。釜沸脉，如汤水涌沸，呼吸次数均无，是三阳数极无阴的征候，早上见到晚上死，晚上见到早上死。鱼翔脉，脉浮于皮肤表面泛泛而动，是三阴数极，又称亡阳，当断定为死证。弹石脉，脉来辟辟凑指，急促而坚，是肾经真脏脉显现，遇到戊己日则不治。解索脉，脉散散无序，肾与命门之气皆亡，戊己日加重，辰巳日不治。屋漏脉，如水滴溅地之貌，胃气营卫俱绝，七八日间危殆。虾游脉，状如虾游水面，杳然不见，须臾又来，隐隐然不动，根据前述规律，清醒者七日死，沉困者三日不治。雀啄脉，指下来三去一，如雀啄食之状。脾元谷气已绝于内，清醒者十二日死，困者六七日亡。偃刀脉，寻之如手循刀刃，无进无退，其数无准，由心元血枯，卫气独居，无所归宿，见到此脉四天难疗。转豆脉，形如豆子周旋展转，并无息数，脏腑空虚，正气飘散，象曰行尸，其死可立待。麻促脉，应指如麻子之纷乱，细微至极，盖卫枯荣血独涩，轻者三日，重者一日死亡。
又论四十五动止脉，以二十四节气、七十二候，作为判断死期的标准。孟春立春之日，十五动一止。明年东风解冻，蛰虫始振，鱼陟负冰时，四十动一止。四年仓庚鸣，鹰化为鸠时，例如仲春惊蛰桃始华日，脉二十动一止。明年春分，玄鸟至，雷乃发声时，三十动一止。三年春分，始电，桐始华时，四十动一止。四年季春清明，田鼠化为鴽，虹始见；谷雨，萍始生，鸣鸠拂其羽，戴胜降于桑时。（以下仿此。孟夏立夏蝼蝈鸣，蚯蚓出，王瓜生。小满苦菜秀，靡草死，麦秋至。仲夏芒种螳螂生，螗蜋始鸣，反舌无声。夏至鹿角解，半夏生，蜩始鸣。季夏小暑温风至，蟋蟀居壁，鹰始挚。大暑腐草化萤，土润溽暑，大雨时行。孟秋立秋凉风至，白露降，寒蝉鸣。处暑鹰乃祭鸟，天地始肃，禾乃登。仲秋白露鸿雁来，玄鸟归，群鸟养羞。秋分雷乃收声，蛰虫坏户，水始涸。季秋寒露鸿雁来宾，雀入大水化为蛤，菊有黄华。霜降豺乃祭兽，草木黄落，蛰虫咸俯。孟冬立冬水始冰，地始冻，雉入大水化为蜃。小雪虹藏不见，天气上升，地气下降，闭塞成冬。仲冬大雪鼩鼱不鸣，荔挺出，虎始交。冬至蚯蚓结，麋角解，水泉动。季冬小寒雁北乡，鹊始巢。雉雊。大寒鸡乳，征鸟厉疾。水泽腹坚。）若时疫之脉，则无定据，随时审思乃得，不可轻易议论。欲知祟害，心脉虚散，肝脉洪盛，或浮沉长短大小无定，或错杂不伦，尤宜加意。凡此诸脉，固鄙见莫之敢遗，然其或逆或顺，犹在详审而消息之，毋固执而有变通，则可得之矣。
Human life depends on the smooth flow of blood and qi (vital energy), which circulate throughout the body; when the pulse is harmonious, various diseases do not arise. If blood and qi become rebellious, movement becomes sluggish, the pulse becomes chaotic, and a hundred illnesses are born. However, the subtleties of the pulse are clear in the mind but difficult to discern under the fingers; thus, Wang Shuhe of the Western Jin Dynasty also felt deep concern about this. During pulse diagnosis, one must clarify the spirit and calm the thoughts, using the count of breaths to determine the patient's pulse condition. Each hand has three positions, divided into Cun (Inch), Guan (Bar), and Chi (Cubit). The left three positions correspond to the Heart, Liver, and Kidney as Zang organs (solid organs), and the Small Intestine, Gallbladder, and Bladder as Fu organs (hollow organs); the right three positions correspond to the Lung, Spleen, and Mingmen (Gate of Vitality) as Zang organs, and the Large Intestine, Stomach, and Sanjiao (Triple Burner) as Fu organs. Each position is examined by light palpation (superficial), then moderate pressure (middle), and finally heavy pressure (deep). Superficial palpation diagnoses the Fu organs, revealing their prosperity or decline; deep palpation diagnoses the Zang organs, revealing their life/death status and fullness/emptiness; middle palpation diagnoses the Stomach Qi (digestive vitality). Since the Stomach is the sea of water and grain, and humans rely on food for life, presence of Stomach Qi means life, absence means death. Each of the three positions has three depths, totaling nine examinations, known as the "Nine Palpations" (Jiu Hou). Additionally, there are Seven Exterior pulses, Eight Interior pulses, Nine Dao pulses, and pulses caused by wind, cold, summerheat, and dampness pathogenic factors, as well as those caused by seven emotions, deficiency, and cold-heat imbalances, which should be analyzed separately.
The Seven Exterior pulses belong to Yang: Floating (Fu), Knotted/Hollow (Kou), Slippery (Hua), Full/Solid (Shi), Bowstring (Xian), Tight (Jin), and Surging (Hong). Floating feels like pressing on a scallion leaf (hollow center), Kou is hollow in the middle with solid edges, Hua resembles rolling pearls, Shi is strong and forceful, Xian is taut like a zither string, Jin is tense like a bowstring, and Hong feels extremely large upon lifting the finger. The Eight Interior pulses belong to Yin: Fine/Micro (Wei), Deep (Chen), Moderate/Slow (Huan), Rough (Se), Slow (Chi), Hidden (Fu), Soft (Ru), and Weak (Ruo). Wei feels thin as a silk thread under the finger, Chen feels like rotten cotton requiring heavy pressure to reach the bone, Huan comes and goes neither fast nor slow, Se is rough like a knife scraping bamboo, Chi is faintly perceptible, Fu is hidden beneath the bone requiring heavy pressure, Ru appears timid near the finger surface, and Ruo lacks strength in both arrival and departure. The Nine Dao pulses include Long (Chang), Short (Duan), Deficient (Xu), Rapid/Interrupted (Cu), Knotted/Knotting (Jie), Intermittent (Dai), Firm (Lao), Moving (Dong), and Thready/Fine (Xi). Chang and Cu belong to Yang; Duan, Xu, Jie, Dai, Lao, Dong, and Xi belong to Yin. Chang spans all three positions, Cu is extremely rapid upon searching, Duan does not reach its proper position upon pressing, Xu feels insufficient upon searching but excessive upon lifting, Jie gathers under the finger and then returns, Dai has an interruption during beating and resumes after a long pause (difficult to treat if seen in acute conditions, but no worry if due to rebellious Qi), Lao is fixed and immovable (if seen in all three positions, it is a sign of death), Dong stays in place upon repeated searching, and Xi is fine as silk and extremely subtle in movement. These twenty-four pulses, when distinguished carefully, can be summarized into four basic types: Floating, Deep, Slow, and Rapid.
Regarding Cold Damage (Shanghan), cold congeals blood, resulting in a Tight pulse. If Cold Damage is complicated by wind, the pulse is Floating and Moderate. In Lianggan disease (simultaneous involvement of exterior and interior meridians), a Deep and Large pulse indicates Taiyang and Shaoyin involvement; Deep and Long indicates Yangming and Taiyin; Deep and Bowstring indicates Shaoyang and Jueyin. Yang diseases presenting with Deep, Rough, Weak, Bowstring, or Micro pulses indicate death; Yin diseases presenting with Floating, Large, Rapid, Moving, or Slippery pulses indicate survival. Yang Toxic disease presents with extremely Floating and Surging pulses; Yin Toxic disease pulses are only palpable deep against the bone and disappear upon light pressure. Both Yin and Yang Jue (cold extremities) present with Deep pulses, causing confusion. Yin Jue pulse is Deep, Slow, and Weak; Yang Jue pulse is Deep, Hidden, and Slippery. Fever with diarrhea: Deep and Bowstring pulse indicates tenesmus; Large pulse indicates the disease has not stopped; Micro and Weak pulse indicates spontaneous recovery; even with fever, death is unlikely. Cold invasion pulse is also Tight, but combined with Bowstring in the Liver, Surging in the Heart, Deep in the Spleen, Slow and Rough in the Lung, and Deep and Slippery in the Kidney. Wind injury disperses Qi, resulting in a Floating pulse; if complicated by cold, it becomes Floating and Tight. Stroke (Zhong Feng) pulse is also Floating. Pathogens affecting the five Zang organs present pulses similar to cold invasion; generally, Slow and Floating pulses are auspicious, while Full, Large, Bowstring, and Rapid pulses are difficult to treat. Summerheat injury dissipates blood and Qi, resulting in a Weak and powerless pulse; heatstroke results in weak Yang and deficient Yin, with a Micro, Slow pulse resembling Kou. Dampness injury presents with Soft and Weak pulses; if Deep and Fine, it indicates internal dampness.
Seven emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright): Joy causes Scattered pulse, Anger causes Rapid/Interrupted pulse, Sorrow causes Knotted pulse, Fear and Thought cause Deep pulses, Worry causes Rough pulse, and Fright causes Trembling pulse; all arise from Qi disturbances. Deficiency and damage present with pulses that are either Floating and Large but powerless, or Deep and Fine but Micro and Weak. Excess Heat presents with significantly Bowstring and Rapid pulses under the finger, or exceptionally Fine and Rapid pulses. Generally, Spring pulses are Bowstring, Summer are Hook (Surging), Autumn are Feather (Floating), and Winter are Stone (Deep). Soft, Weak, and Long is Bowstring; Fast arrival and slow departure is Hook; Light, Empty, and Floating is Feather; Deep, Rough, and Weak is Stone. These are the normal seasonal pulses. Deviations include Excess and Deficiency, Fu and Yi pulses, and Guan and Ge patterns. Excess indicates surplus Qi: Cun pulse is naturally Floating, but if additionally Full and Large, it is Yang Excess; Chi pulse is naturally Deep, but if additionally Full and Large, it is Yin Excess. Deficiency indicates insufficient Qi: Damaged and small upon superficial palpation is Yang Deficiency; damaged and small upon deep palpation is Yin Deficiency. Yi pulse extends from Guan forward to Yuji, called Outer Guan Inner Ge, a Yin invading Yang pulse. Fu pulse extends from Guan backward into Chize, called Inner Guan Outer Ge, a Yang invading Yin pulse. Such patterns indicate mutual overacting of Zang organs and mutual overcoming of seasons; even if asymptomatic, once symptoms appear, death is inevitable and untreatable. It is said that if the three positions are fully traversed and excessively Surging and Large, it indicates wind or phlegm; if Deep and Fine, it is incurable. If the six positions are connected but cannot be felt upon pressing, or are extremely Floating and Micro, death occurs. If repeatedly searched and uninterrupted even at the bone level, longevity is expected. Regarding pulses indicating life and death in various diseases: Qi distension and fullness with Floating and Large pulse is treatable, but Weak and Small is hard to preserve. Dysentery should have Micro and Small pulses, not Large and Surging. Delirium and mania: Full and Large is favorable, Deep and Fine is unfavorable. Xiao Ke (wasting-thirst): Rapid and Large indicates survival, Weak and Small is hard to cure. Water Qi (edema): Floating and Large is suitable, Deep and Fine indicates recurrence after healing. Huo Luan (cholera-like disorder): Floating and Surging is salvageable, Micro and Slow with aphasia and low Qi is hard to recover. Epistaxis and hematemesis: Favorable with Deep and Fine, unfavorable with Floating and Large. Heart and abdominal pain: Should see Deep and Fine, not Floating and Large. Headache: Floating and Slippery is easy to resolve, Short and Rough is not curable. Upper Qi edema: Floating and Slippery brings peace, Micro and Fine is hard to treat. Zhong E (evil invasion): Tight and Fine is easy to treat, Floating and Large is hard to heal. Metal wound bleeding: Weak and Fine is suitable, Full and Large indicates danger. Poisoning: Surging and Large indicates survival, Fine and Micro indicates death.
The Ten Strange Pulses are: Cauldron Boiling (Fu Fei), Fish Swimming (Yu Xiang), Striking Stone (Dan Shi), Untying Rope (Jie Suo), Leaking Roof (Wu Lou), Shrimp Swimming (Xia You), Sparrow Pecking (Que Zhuo), Reclining Knife (Yan Dao), Rolling Bean (Zhuan Dou), and Hemp Rushing (Ma Cu). Fu Fei resembles boiling soup, with no respiratory rhythm, indicating extreme Yang without Yin; morning sighting means evening death, evening sighting means morning death. Yu Xiang floats on the skin surface, indicating extreme Yin, also called Yang collapse, definitely fatal. Dan Shi strikes the finger abruptly, urgent and hard, showing the True Zang pulse of the Kidney meridian; untreatable on Wu-Ji days. Jie Su is scattered and disordered, indicating loss of Qi in Kidney and Mingmen; worsens on Wu-Ji days, untreatable on Chen-Si days. Wu Lou resembles water dripping and splashing, indicating absolute exhaustion of Stomach Qi, Ying, and Wei; critical within 7-8 days. Xia You resembles shrimp swimming on water, disappearing suddenly then reappearing faintly; based on previous rules, conscious patients die in 7 days, comatose in 3 days. Que Zhuo comes three times then stops, like a sparrow pecking; indicates extinction of Spleen Yuan and Grain Qi; conscious patients die in 12 days, comatose in 6-7 days. Yan Dao feels like running a hand along a blade, no advance or retreat, irregular rate, caused by heart blood exhaustion and solitary Wei Qi; untreatable after 4 days. Zhuan Dou rotates like beans, lacking rhythm, indicating empty viscera and dissipated righteous Qi; death is imminent. Ma Cu feels chaotic like hemp seeds, extremely fine and subtle, indicating dried Wei and stagnant Ying blood; mild cases die in 3 days, severe in 1 day.
Furthermore, the 45-interval pulse is discussed, correlating with 24 solar terms and 72 pentads as standards for predicting death. Early Spring Lichun day: 15 beats per stop. Next year, East wind thaws ice, hibernating insects stir, fish rise carrying ice: 40 beats per stop. Fourth year, Orioles sing, eagles transform into doves: e.g., Mid-Spring Jingzhe peach blossoms day, 20 beats per stop. Next year Chunfen, swallows arrive, thunder sounds: 30 beats per stop. Third year Chunfen, first lightning, paulownia blooms: 40 beats per stop. Fourth year Late Spring Qingming, field mice transform into birds, rainbows appear; Guyu, duckweed grows, turtledoves brush feathers, hoopoes descend on mulberry trees. (Following pattern: Early Summer Lixia, mole crickets sing, earthworms emerge, melons grow. Xiaoman, bitter herbs flourish, soft grass dies, wheat harvest arrives. Mid-Summer Mangzhong, mantises appear, cicadas sing, mock orioles fall silent. Xiazhi, deer horns shed, pinellia grows, cicadas sing. Late Summer Xiaoshu, warm winds arrive, crickets dwell in walls, eagles hunt. Dashu, decaying grass transforms to fireflies, soil moist and hot, heavy rains frequent. Early Autumn Liqiu, cool winds arrive, white dew falls, autumn cicadas sing. Chushu, eagles sacrifice birds, heaven and earth begin to solemnize, grains ripen. Mid-Autumn Bai Lu, wild geese arrive, swallows return, birds store food. Qiufen, thunder ceases, insects seal holes, water dries up. Late Autumn Han Lu, wild geese come as guests, sparrows enter big water transforming into clams, chrysanthemums bloom yellow. Shuangjiang, jackals sacrifice animals, plants turn yellow and fall, hibernating insects bow. Early Winter Lidong, water begins to freeze, ground begins to frost, pheasants enter big water transforming into shells. Xiaoxue, rainbows hide, heaven Qi rises, earth Qi descends, closure forms winter. Mid-Winter Daxue, shrews cease singing, licorice shoots emerge, tigers mate. Dongzhi, earthworms knot, elk horns shed, spring waters move. Late Winter Xiaohan, wild geese fly north, magpies start nests. Pheasants call. Dahan, chickens lay eggs, raptors strike fiercely. Ice thickens in water centers.) Pulse patterns of seasonal epidemics have no fixed basis; they must be assessed according to the time, and should not be lightly judged. To know calamitous harm, Heart pulse is Empty and Scattered, Liver pulse is Surging and Excessive, or Floating/Deep/Long/Short/Large/Small are indefinite, or mixed and chaotic; special attention is required. All these pulses, though my humble opinion dares not omit any, whether favorable or unfavorable, still require detailed examination and adaptation; without rigidity but with flexibility, they can be mastered.