后世知斥高阳生之讹诀，而不知辨王叔和之《脉经》，总由不读《灵》、《素》之过也
。《灵》、《素》谓∶人迎为颈脉。即结喉两边之人迎穴也，叔和则指为左手脉名。《难经》谓
∶阳得寸内九分，阴得尺中一寸。并无关脉地步，叔和则强分三段，又将奇经八脉概附两手
，分为九道。种种虚诞，真堪捧腹。至分左寸为心、小肠，左关肝、胆，左尺肾、膀胱，右
寸肺、大肠，右关脾、胃，右尺命门、三焦，其法并不见于《灵》、《素》、《难经》，即
后之仲师书中，亦无有也。后世又有各自为法，颠倒安置者。吁！五脏六腑本生成之物，可以
任人提挈视如傀儡乎？今试诘之曰∶仲师谓尺寸俱紧者，名曰伤寒。若以此部位论之，则是
五脏六腑皆病，何以止言曰太阳病耶？吾知其必无应矣。然则诸家脉法皆欺人之语，不足信
也。惟《灵》、《素》、《难经》、仲景之脉，乃古圣所贻，各有至理，且其法相同，谨摘
其要如左。
一曰经脉诊法，即手足阴阳十二经也。外病必先起于经脉，内病亦必发现于经脉，故为
诊病第一要法。经脉有三阳，可以审卫气，以卫气盛于阳经也。经脉有三阴，可以察营血，以营
血盛于阴经也。《内经》取结喉旁人迎穴为阳明脉，以候三阳经及卫气，取两手寸口，又名
气口，为太阴脉，以候三阴经及营血。其法∶人迎盛于气口一倍，为少阳病；二倍，为阳明
病；三倍，为太阳病。气口盛于人迎一倍，为少阴病；二倍，为厥阴病；三倍，为太阴病。
《难经》则括其法，于两手尺寸中，以寸候三阳，尺候三阴，关为阴阳之界。其尺寸相较法
，亦如《内经》，以人迎气口相较也。仲师之法与《难经》同。
一曰脏气诊法，分浅深为五层。第一层，极浮者为肺。《内经》谓∶皮毛为肺之合。又
谓∶脏真高于肺。《难经》谓∶三菽之重。仲师同。第二层，略浮者为心。《内经》谓∶血为心
之合。又谓∶心藏血脉之气。《难经》谓∶六菽之重。仲师同。第三层，浮沉之中者为脾。
《内经》谓∶肉为脾之合。又谓∶脾藏肌肉之气。《难经》谓∶九菽之重。仲师同。第四层
，略沉者为肝。《内经》谓∶筋为肝之合。又谓∶肝藏筋膜之气。《难经》谓∶十二菽之重
。仲师同。第五层，极沉者为肾。《内经》谓∶骨为肾之合。又谓∶肾藏骨髓之气。《难经
》谓∶按之至骨。仲师同。
凡此五者，以见阳脉为腑病，见阴脉为脏病。如三菽见洪为大肠，见细为肺，余可类推
。又以轻者为腑病，甚者为脏病。如三菽略涩为大肠，涩甚为肺，余可类推。
凡此五者，各有主脉，肺涩（又名毛）、心洪、脾缓、肝弦、肾石也。如三菽见洪，为心
火刑金，余可类推。
以上二法，平人则不见，惟病患乃见之。如病在经脉，则寸尺之诊必变于常；如病在脏
腑，则菽数之诊必变于常。随其所变见而断其病，十不失一。
一曰平脉败脉诊法。平脉者，春微弦、夏微洪、秋微毛、冬微石，四时旺脉皆有和缓胃
气，故曰微也（微也，勿认为弱）。败脉者，春但弦、夏但洪、秋但毛、冬但石，四时旺脉皆无和
缓胃气，故曰但也（但也，勿认为强）。盖脉本营血随宗气而动，宗气即呼吸天气所生，天气
有春温、夏热、秋燥、冬寒之递嬗，宗气应之亦有春弦、夏洪、秋毛、冬石之递嬗。若营血
乃饮食地气所生，其性精专有常而不变，与宗气相融，故反泯其迹，而为微弦、微洪、微毛
、微石，故曰胃气也。若无胃气，则无营血相随，脉中仅止宗气独行，但见弦、洪、毛、石
而已，故曰败脉也。凡见败脉者，为无胃气，虽
不病，亦不可救，是名真脏脉。凡脉有胃气者，虽极危之病，亦有可生。故曰∶人病脉不病
者，生；脉病患不病者，死。即此义也。此法，以伤寒初起必见邪盛之脉，则审胃气之法更
当细辨。若伤寒十日以后，亦可用此法。
一曰脉体诊法，其法有三。
一是呼吸数诊法∶一息四至为平，五六至为数，二三至为迟，数极为散，数时一止为促
，迟时一止为结，止有定数曰代。
一是手指轻重诊法∶轻取曰浮；重取曰沉；浮沉皆有，中独取无，曰芤；浮沉皆无，中
独取有，曰牢；浮无、沉有，曰伏；浮有、沉无，曰革；有力曰实；无力曰濡。
一是脉动形状诊法∶流利曰滑，凝滞曰涩，大曰洪，小曰细，过指曰长，不及曰短，劲
疾曰紧，从容曰缓，端直曰弦，厥厥而摇曰动。
以上凡二十四脉，精而熟之，可以该诸书诊法。但其断法甚多，难于详载，故仅录其脉
名。
以上皆详《灵》、《素》、仲师脏象及诊脉审病之法。若夫病之所由起，或从外因，或
从内因，但取切要于中风者，详于后。
后世之人知道斥责高阳生错误的脉诀，却不知道辨别王叔和的《脉经》，这总归是不研读《灵枢》、《素问》的过错。
《灵枢》、《素问》说：人迎是颈部的脉搏。就是结喉两侧的人迎穴，王叔和却将其指为左手脉的名称。《难经》说：阳脉在寸部内九分，阴脉在尺部内一寸。并没有关脉的位置，王叔和却强行将脉分为三段，又将奇经八脉全部附属于两手，分为九道。种种虚妄荒诞，真让人捧腹大笑。至于将左寸分为心、小肠，左关分为肝、胆，左尺分为肾、膀胱，右寸分为肺、大肠，右关分为脾、胃，右尺分为命门、三焦，这种方法并不见于《灵枢》、《素问》、《难经》，即使在后来张仲景的书中，也没有这种说法。后世又有各自制定方法，颠倒安置的。唉！五脏六腑本是自然生成的器官，可以任由人摆弄视如傀儡吗？现在试着质问他们说：张仲景说尺寸脉都紧的，名叫伤寒。如果按照这种部位理论来推断，那就是五脏六腑都病了，为什么只说是太阳病呢？我知道他们必然没有回答。既然这样，那么各家脉法都是欺人之谈，不值得相信。只有《灵枢》、《素问》、《难经》、张仲景的脉法，才是古代圣人所遗留的，各有至理，而且方法相同，谨摘录其要点如下。
第一种是经脉诊法，即手足阴阳十二经脉。外感病必定先起于经脉，内伤病也必定显现于经脉，所以这是诊病的第一要法。经脉有三阳经，可以用来审察卫气，因为卫气盛于阳经。经脉有三阴经，可以用来察验营血，因为营血盛于阴经。《内经》取结喉旁的人迎穴作为阳明脉，用来候察三阳经及卫气；取两手的寸口，又名气口，作为太阴脉，用来候察三阴经及营血。其方法是：人迎脉比气口脉大一倍，是少阳病；大两倍，是阳明病；大三倍，是太阳病。气口脉比人迎脉大一倍，是少阴病；大两倍，是厥阴病；大三倍，是太阴病。《难经》则概括了这种方法，在两手的寸尺中，以寸部候察三阳，尺部候察三阴，关部作为阴阳的分界。其寸尺比较的方法，也像《内经》那样，用人迎和气口相比较。张仲景的方法与《难经》相同。
第二种是脏气诊法，分为浅深五层。第一层，极浮的是肺。《内经》说：皮毛是肺的外合。又说：脏气中肺的位置最高。《难经》说：相当于三颗豆子的重量。张仲景与此相同。第二层，略浮的是心。《内经》说：血是心的外合。又说：心藏血脉之气。《难经》说：相当于六颗豆子的重量。张仲景与此相同。第三层，浮沉之间的是脾。《内经》说：肌肉是脾的外合。又说：脾藏肌肉之气。《难经》说：相当于九颗豆子的重量。张仲景与此相同。第四层，略沉的是肝。《内经》说：筋是肝的外合。又说：肝藏筋膜之气。《难经》说：相当于十二颗豆子的重量。张仲景与此相同。第五层，极沉的是肾。《内经》说：骨是肾的外合。又说：肾藏骨髓之气。《难经》说：按之至骨。张仲景与此相同。
凡是这五种情况，见到阳脉是腑病，见到阴脉是脏病。比如在三菽（轻取）处见到洪脉是大肠病，见到细脉是肺病，其余可类推。又用轻取为腑病，重取为脏病。比如在三菽处略涩是大肠病，涩象明显是肺病，其余可类推。
凡是这五种情况，各有主脉，肺脉涩（又名毛）、心脉洪、脾脉缓、肝脉弦、肾脉石。比如在轻取处见到洪脉，是心火克肺金，其余可类推。
以上两种方法，健康人身上看不见，只有病人身上才显现。如果病在经脉，那么寸尺的诊察必然不同于常态；如果病在脏腑，那么菽数的诊察必然不同于常态。随着其变化而判断疾病，十次不会失掉一次。
第三种是平脉败脉诊法。平脉，是指春季微弦、夏季微洪、秋季微毛、冬季微石，四季旺脉都有和缓的胃气，所以称为“微”（微，不要认为是弱）。败脉，是指春季但弦、夏季但洪、秋季但毛、冬季但石，四季旺脉都没有和缓的胃气，所以称为“但”（但，不要认为是强）。大概脉本是营血随着宗气而动，宗气即由呼吸天气所生，天气有春温、夏热、秋燥、冬寒的更替，宗气随之也有春弦、夏洪、秋毛、冬石的更替。若营血乃由饮食地气所生，其性质精专恒定而不改变，与宗气相融合，所以反而掩盖了其痕迹，表现为微弦、微洪、微毛、微石，所以称为胃气。如果没有胃气，就没有营血相随，脉中仅有宗气独行，只见弦、洪、毛、石而已，所以称为败脉。凡是见到败脉的，是没有胃气，即使不生病，也不可救治，这叫做真脏脉。凡是脉有胃气的，即使是极危重的病，也有生机。所以说：人病了脉不病的，能活；脉病了人不病的，死。就是这个道理。此法，对于伤寒初起必定见到邪气盛的脉象，那么审察胃气的方法更应当仔细辨别。如果伤寒十日以后，也可以用此法。
第四种是脉体诊法，其法有三种。
一是呼吸数诊法：一息四至为平脉，五六至为数脉，二三至为迟脉，数至极点为散脉，数时一止为促脉，迟时一止为结脉，止有定数为代脉。
一是手指轻重诊法：轻取曰浮脉；重取曰沉脉；浮沉皆有，中独取无，曰芤脉；浮沉皆无，中独取有，曰牢脉；浮无、沉有，曰伏脉；浮有、沉无，曰革脉；有力曰实脉；无力曰濡脉。
一是脉动形状诊法：流利曰滑脉，凝滞曰涩脉，大曰洪脉，小曰细脉，过指曰长脉，不及曰短脉，劲疾曰紧脉，从容曰缓脉，端直曰弦脉，厥厥而摇曰动脉。
以上共二十四种脉，精通并熟练运用，可以涵盖诸书的诊法。但其断法很多，难以详细记载，所以仅记录其脉名。
以上都详细阐述了《灵枢》、《素问》、张仲景的脏象及诊脉审病的方法。至于疾病的起因，或从外因，或从内因，但选取切要关于中风的内容，详述于后。
Later generations knew to criticize the erroneous pulse formulas of Gao Yangsheng, but did not know how to distinguish Wang Shuhe's *Mai Jing* (Pulse Classic). This is entirely due to their failure to study the *Ling Shu* (Spiritual Pivot) and *Su Wen* (Basic Questions).
The *Ling Shu* and *Su Wen* state: "Renying" refers to the neck pulse. It is precisely the Renying acupoint on both sides of the laryngeal prominence. However, Wang Shuhe identified it as the name of the left-hand pulse. The *Nan Jing* (Classic of Difficult Issues) states: "Yang pulses are located within the nine fen of the Cun position; Yin pulses are located within the one cun of the Chi position." There is no mention of a Guan position. Yet, Wang Shuhe forcibly divided the pulse into three sections and attached all eight extraordinary vessels to both hands, dividing them into nine channels. Such absurdities are truly laughable. Furthermore, regarding the division of the Left Cun into Heart and Small Intestine, Left Guan into Liver and Gallbladder, Left Chi into Kidney and Bladder, Right Cun into Lung and Large Intestine, Right Guan into Spleen and Stomach, and Right Chi into Mingmen (Gate of Vitality) and Sanjiao (Triple Burner), this method does not appear in the *Ling Shu*, *Su Wen*, or *Nan Jing*. Even in the later works of Zhang Zhongjing, such a classification is absent. Later practitioners established their own methods, arranging these correspondences arbitrarily. Alas! The Zang and Fu organs are naturally formed entities; can they be manipulated by humans like puppets? Let us now question them: Zhang Zhongjing stated that when both Cun and Chi pulses are tight, it is named Shanghan (Cold Damage). If we apply this positional theory, it would imply that all Zang and Fu organs are diseased. Why then is it referred to solely as Taiyang disease? I know they would have no answer. Therefore, all other pulse methods are deceptive and unworthy of belief. Only the pulse methods of the *Ling Shu*, *Su Wen*, *Nan Jing*, and Zhang Jingyue were handed down by ancient sages, each possessing profound principles, and their methods are consistent. I hereby extract the essentials as follows.
The first is Pulse Diagnosis of the Meridians, referring to the Twelve Meridians of Hand and Foot Yin and Yang. External diseases must originate in the meridians, and internal diseases must manifest in the meridians; thus, this is the primary method for diagnosing illness. The Three Yang meridians can be used to assess Wei Qi (Defensive Qi), as Wei Qi is abundant in the Yang meridians. The Three Yin meridians can be used to observe Ying Blood (Nutritive Blood), as Ying Blood is abundant in the Yin meridians. The *Nei Jing* (Inner Canon) takes the Renying acupoint beside the laryngeal prominence as the Yangming pulse to monitor the Three Yang meridians and Wei Qi. It takes the Cun Kou (Inch Port) at both wrists, also known as Qi Kou (Qi Port), as the Taiyin pulse to monitor the Three Yin meridians and Ying Blood. The method is as follows: If the Renying pulse is one times larger than the Qi Kou pulse, it indicates Shaoyang disease; two times larger, Yangming disease; three times larger, Taiyang disease. If the Qi Kou pulse is one time larger than the Renying pulse, it indicates Shaoyin disease; two times larger, Jueyin disease; three times larger, Taiyin disease. The *Nan Jing* summarizes this method: using the Cun position to monitor the Three Yang and the Chi position to monitor the Three Yin, with the Guan position serving as the boundary between Yin and Yang. The comparison method between Cun and Chi is also similar to the *Nei Jing*, comparing Renying and Qi Kou. Zhang Zhongjing's method is identical to that of the *Nan Jing*.
The second is Pulse Diagnosis of Zang Qi, divided into five layers of depth. The first layer, extremely superficial, corresponds to the Lung. The *Nei Jing* states: "The skin and hair are the exterior correspondence of the Lung." It also states: "Among the Zang organs, the Lung is highest." The *Nan Jing* states: "Equivalent to the weight of three beans." Zhang Zhongjing agrees. The second layer, slightly superficial, corresponds to the Heart. The *Nei Jing* states: "Blood is the exterior correspondence of the Heart." It also states: "The Heart stores the Qi of blood vessels." The *Nan Jing* states: "Equivalent to the weight of six beans." Zhang Zhongjing agrees. The third layer, intermediate between floating and deep, corresponds to the Spleen. The *Nei Jing* states: "Muscles are the exterior correspondence of the Spleen." It also states: "The Spleen stores the Qi of muscles." The *Nan Jing* states: "Equivalent to the weight of nine beans." Zhang Zhongjing agrees. The fourth layer, slightly deep, corresponds to the Liver. The *Nei Jing* states: "Tendons are the exterior correspondence of the Liver." It also states: "The Liver stores the Qi of tendons and fascia." The *Nan Jing* states: "Equivalent to the weight of twelve beans." Zhang Zhongjing agrees. The fifth layer, extremely deep, corresponds to the Kidney. The *Nei Jing* states: "Bones are the exterior correspondence of the Kidney." It also states: "The Kidney stores the Qi of bone marrow." The *Nan Jing* states: "Press until reaching the bone." Zhang Zhongjing agrees.
In all these cases, observing a Yang pulse indicates Fu disease, while observing a Yin pulse indicates Zang disease. For example, if a flooding pulse is felt at the depth of three beans, it is Large Intestine disease; if a fine pulse is felt, it is Lung disease; the rest can be inferred similarly. Alternatively, light pressure indicates Fu disease, while heavy pressure indicates Zang disease. For instance, slight choppy quality at three beans indicates Large Intestine disease, while pronounced choppy quality indicates Lung disease; the rest can be inferred similarly.
Each of these five layers has its principal pulse: the Lung pulse is Choppy (also called Hairy); the Heart pulse is Flooding; the Spleen pulse is Moderate; the Liver pulse is Bowstring-like; the Kidney pulse is Stone-like. For example, if a Flooding pulse is observed at light pressure, it indicates Heart Fire insulting Metal (Lung); the rest can be inferred similarly.
These two methods are not visible in healthy individuals but only manifest in patients. If the disease is in the meridians, the diagnosis at Cun and Chi will necessarily deviate from normal; if the disease is in the Zang and Fu organs, the diagnosis based on bean-weight depth will necessarily deviate from normal. By judging the disease according to these variations, one will rarely miss the mark (ten out of ten times accurate).
The third is Pulse Diagnosis of Normal versus Degenerate Pulses. A Normal Pulse is characterized by being slightly Bowstring-like in Spring, slightly Flooding in Summer, slightly Hairy in Autumn, and slightly Stone-like in Winter. These seasonal vigorous pulses all possess a harmonious and moderate Stomach Qi, hence termed "slightly" (Note: "Slightly" should not be confused with Weakness). A Degenerate Pulse is characterized by being purely Bowstring-like in Spring, purely Flooding in Summer, purely Hairy in Autumn, and purely Stone-like in Winter. These seasonal vigorous pulses lack harmonious and moderate Stomach Qi, hence termed "purely" (Note: "Purely" should not be confused with Strength). Generally, the pulse is driven by Ying Blood following Zong Qi (Gathering Qi). Zong Qi is generated by breathing Heaven Qi. Heaven Qi undergoes transitions of Spring Warmth, Summer Heat, Autumn Dryness, and Winter Cold; consequently, Zong Qi also undergoes transitions of Spring Bowstring, Summer Flooding, Autumn Hairy, and Winter Stone. Ying Blood, however, is generated by food and Earth Qi; its nature is refined, specific, constant, and unchanging. When it blends with Zong Qi, it obscures its traces, resulting in pulses that are slightly Bowstring, slightly Flooding, slightly Hairy, and slightly Stone-like. This is called Stomach Qi. If there is no Stomach Qi, there is no Ying Blood accompanying it; only Zong Qi moves alone in the pulse, showing merely Bowstring, Flooding, Hairy, or Stone qualities. This is called a Degenerate Pulse. Whenever a Degenerate Pulse is seen, it indicates the absence of Stomach Qi. Even if the person is not clinically ill, it is incurable; this is called True Zang Pulse. Whenever a pulse possesses Stomach Qi, even in critically dangerous conditions, survival is possible. Thus it is said: "If the person is ill but the pulse is not, there is life; if the pulse is ill but the person is not, there is death." This is the meaning behind this principle. In the case of early-stage Shanghan where pathogenic excess is evident, careful differentiation of Stomach Qi is particularly crucial. This method can also be applied after ten days of Shanghan.
The fourth is Pulse Morphology Diagnosis, comprising three methods.
First is Respiratory Count Diagnosis: Four beats per respiration is Normal; five to six beats is Rapid; two to three beats is Slow; extreme rapidity is Scattered; rapidity with intermittent stops is Urgent; slowness with intermittent stops is Knotted; stops with regular intervals are Intermitting.
Second is Finger Pressure Diagnosis: Light pressure revealing the pulse is Floating; heavy pressure revealing the pulse is Deep; present at both light and heavy pressure but absent in the middle is Hollow; absent at both light and heavy pressure but present in the middle is Firm; absent at light pressure but present at deep pressure is Hidden; present at light pressure but absent at deep pressure is Leathery; forceful is Excess; feeble is Soft.
Third is Pulse Movement Shape Diagnosis: Smooth and flowing is Slippery; stagnant and rough is Choppy; large is Flooding; small is Fine; extending beyond the finger position is Long; failing to reach the finger position is Short; tense and swift is Tight; leisurely is Moderate; straight is Bowstring-like; trembling and shaking is Moving.
The above constitute twenty-four pulse types. Mastery and familiarity with them allow one to encompass the diagnostic methods found in various texts. However, the diagnostic interpretations are numerous and difficult to record in detail; therefore, only the pulse names are recorded here.
The above details the Zang-Fu imagery and pulse diagnosis methods from the *Ling Shu*, *Su Wen*, and Zhang Zhongjing. Regarding the origins of disease, whether from external or internal factors, only the essentials relevant to Stroke (Zhong Feng) are detailed subsequently.