问曰。伤寒有五。其脉何如。难经五十八难曰。中风之脉。阳浮
而滑。阴濡而弱。湿温之脉。阳濡而弱。阴小而急。伤寒之脉。阴阳俱
盛而紧涩。热病之脉。阴阳俱浮。浮之而滑。沉之散涩。温病之脉。行在诸经。不知何经之动。各随其经之所在而
取之。
问曰。脉之辨寒暑何如。仲景曰。脉盛身寒。得之伤寒。脉虚身热。得之伤暑。
问曰。欲愈之脉何如。仲景曰。凡得病厥脉动数。服汤药更迟。脉浮大减小。初躁后静者。此皆愈证也。
问曰。病有损脉何如。雍曰。伤寒至脉多。损脉少。故仲景曰。四
损三日死。五损一日死。六损一时死。凡四息而一至。曰四损。五息一至。曰五损。六息一至。曰六损也。
问曰。死生之脉何如。仲景曰。脉阴阳俱盛。大汗出不解者死。
脉阴阳俱虚。热不止者死。脉至乍数乍疏者死。脉至如转索者死。谵言妄语。身微热。脉浮大。手足温者生。逆冷。
脉
沉细者。不过一日
死。此以前。是皆伤寒证候也。
问曰。温病刺五十九穴。何穴也。素问三十二篇曰。病甚者为五
十九刺是也。灵枢二十三篇曰。所谓五十九刺者。两手外内侧各三。
凡十二 。五指间各一。凡八 。足亦如是。亦八 。头入发一寸旁
三分。各三 。凡六 。更入发三寸边五。凡十 。耳前后口下（一作
目下）各一。项中一。凡六 。巅上一。囟会一。发际一。廉泉一。风池
二。天柱二。此五十九穴也。
右伤寒脉法针术。不止于此。此则论其叙论所载。其余各见逐经逐证之下。
问：伤寒分为五种，它们的脉象如何？《难经·五十八难》说：中风的脉象，阳部（寸口）浮而滑，阴部（尺中）濡而弱；湿温的脉象，阳部濡而弱，阴部小而急；伤寒的脉象，阴阳两部都盛大且紧涩；热病的脉象，阴阳两部都浮，轻取（浮之）滑利，重按（沉之）散涩；温病的脉象，流行于各条经脉，不知道是哪条经脉受动，随其所处的经脉位置来诊察。
问：如何辨别脉象中的寒与暑？张仲景说：脉象盛大而身体发冷的，得自于伤寒；脉象虚弱而身体发热的，得自于伤暑。
问：预示疾病将要痊愈的脉象如何？张仲景说：凡是患病时出现厥逆脉象，脉搏跳动急促快速，服用汤药后脉搏反而变慢，脉象由浮大转为减小，初起躁动而后安静，这些都是痊愈的征象。
问：所谓的“损脉”是怎么回事？郭雍说：伤寒病中多见的是至脉（脉搏次数增多），少见的才是损脉（脉搏次数减少）。所以张仲景说：四损者三日死，五损者一日死，六损者一时死（半个时辰内死亡）。凡呼吸四次脉搏才跳动一次，称为四损；五次呼吸脉搏跳动一次，称为五损；六次呼吸脉搏跳动一次，称为六损。
问：判断生死预后的脉象如何？张仲景说：脉象阴阳两部都盛大，大汗出而病不解的，主死；脉象阴阳两部都虚弱，发热不止的，主死；脉搏忽快忽慢、节律不齐的，主死；脉搏摸起来像转动的绳索一样绷紧无柔和之气的，主死。胡言乱语、神志不清，身体微热，脉象浮大，手足温暖的，预后良好可生；若手足逆冷，脉象沉细的，不超过一天就会死亡。以上这些，都是伤寒证的候象。
问：温病针刺的五十九个穴位是哪些穴位？《素问·刺热篇》（第三十二篇）说：病情严重的采用五十九刺法。《灵枢·热病》（第二十三篇）说：所谓五十九刺，是指两手外侧和内侧各三个穴位，共十二个；五指间各一个穴位，共八个；足部也是如此，也是八个；头部入发际一寸处，旁开三分，各三个穴位，共六个；再深入发际三寸处，边缘各五个穴位，共十个；耳前、耳后、口下（另一版本作眼下）各一个，项部中间一个，共六个；头顶正中一个，囟会穴一个，发际正中一个，廉泉穴一个，风池穴两个，天柱穴两个。这共计五十九个穴位。
以上关于伤寒的脉法和针术，不仅仅限于此，这里只是论述序论中所记载的内容，其余内容分别见于各经各证之下。
Q: Shanghan (Cold Damage) is divided into five types. What are their pulse characteristics? The *Nan Jing* (Classic of Difficult Issues), Chapter 58, states: For Zhongfeng (Wind Strike), the Yang position (Cun/Kou) is floating and slippery, while the Yin position (Chi/Middle) is soggy and weak; for Shiwen (Damp-Warmth), the Yang position is soggy and weak, and the Yin position is small and rapid; for Shanghan (Cold Damage), both Yin and Yang positions are full and tight-choppy; for Rebing (Heat Disease), both Yin and Yang positions are floating; superficial palpation reveals a slippery quality, while deep palpation reveals a scattered and choppy quality; for Wenbing (Warm Disease), the pulse circulates through the various meridians, and it is unknown which meridian is affected; diagnosis should be made by following the location of the affected meridian.
Q: How to distinguish between Cold and Summerheat in pulse diagnosis? Zhang Zhongjing stated: A full pulse accompanied by cold body temperature indicates Shanghan (Cold Damage); a deficient pulse accompanied by high body temperature indicates Shangshu (Summerheat Injury).
Q: What are the pulse signs indicating recovery? Zhang Zhongjing stated: In cases where Jue Mai (Pulse of Reversal/Cold Extremities) is present with rapid and frequent beats, if after administering herbal decoctions the pulse becomes slower, changes from floating-large to smaller, and shifts from initial restlessness to subsequent calmness, these are all signs of recovery.
Q: What constitutes the "Sun Mai" (Damaged/Deficient Pulse)? Guo Yong stated: In Shanghan (Cold Damage), pulses with increased frequency (Zhi Mai) are common, whereas pulses with decreased frequency (Sun Mai) are rare. Thus, Zhang Zhongjing stated: Four Sun leads to death in three days; Five Sun leads to death in one day; Six Sun leads to death within half a watch (approx. 1-2 hours). If the pulse beats once every four breaths, it is called Four Sun; once every five breaths, it is called Five Sun; once every six breaths, it is called Six Sun.
Q: What are the pulse signs for determining life and death prognosis? Zhang Zhongjing stated: If both Yin and Yang pulses are full, yet profuse sweating fails to resolve the condition, death ensues. If both Yin and Yang pulses are deficient, yet fever persists without stopping, death ensues. If the pulse is irregular, alternating between rapid and slow, death ensues. If the pulse feels like a turning rope (tight and unyielding), death ensues. However, if the patient mutters deliriously, has slight body heat, a floating-large pulse, and warm hands and feet, survival is possible. Conversely, if there is cold extremities and a deep-thin pulse, death will occur within one day. All the above constitute the syndromic manifestations of Shanghan (Cold Damage).
Q: Regarding the fifty-nine acupuncture points for treating Warm Disease, which points are they? *Su Wen* (Plain Questions), Chapter 32, states that for severe conditions, the method of Fifty-Nine Stabs is used. *Ling Shu* (Spiritual Pivot), Chapter 23, explains that the so-called Fifty-Nine Stabs include: three points on each side of the lateral and medial aspects of both hands, totaling twelve; one point between each of the five fingers, totaling eight; the same applies to the feet, totaling eight; at the head, one cun inside the hairline, three points on each side of the midline, totaling six; three cun inside the hairline, five points along the lateral border, totaling ten; one point each in front of the ear, behind the ear, and below the mouth (or below the eye in some versions), plus one point in the middle of the neck, totaling six; one point at the vertex (Baihui), one at Xinhui, one at the anterior hairline midpoint (Yintang/Lianquan area context implies specific points like Lianquan), one at Lianquan, two at Fengchi, and two at Tianzhu. These sum up to fifty-nine points.
The aforementioned pulse methods and acupuncture techniques for Shanghan (Cold Damage) are not limited to this text; this section only discusses what is recorded in the introductory treatise. The remaining details are found under the respective chapters on meridians and syndromes.