师曰呼吸者脉之头也初持脉来疾去迟此出疾入迟名曰内虚外实也初持脉来迟去疾此出迟入疾名曰内实外虚也
脉之流行气鼓之也一息脉六动气行六寸人之经络六阳六阴以及任督两跷计长一十六丈二尺平人一日一夜一万三千五
百息一日百刻二百七十息漏水下二刻脉行十六丈二尺是为一周一万三千五百息水下百刻脉行五十周共计八百一十丈一日
之度毕矣（义详灵枢脉度营气五十营诸篇）故呼吸者脉之头也（头犹纲领之谓）医以平人之呼吸准疾人之迟数则阴阳虚
实见焉如初持脉来疾而去迟来者出也去者入也此出疾而入迟也出者出于外也即其出以知其外入者入于内也即其入以知其
内其出疾而入迟故名曰内虚外实也初持脉来迟去疾此出迟而入疾故名曰内实外虚也（此明首章呼吸出入之义）
寸口脉浮为在表沉为在里数为在腑迟为在脏假令脉迟此为在脏也
表为阳里为阴故表脉浮而里脉沉腑为阳脏为阴故腑脉数而脏脉迟浮数沉迟阴阳自然之性也（此审察表里料度脏腑之
义）
寸口脉浮而紧浮则为风紧则为寒风则伤卫寒则伤营营卫俱伤骨节烦疼当发其汗也
寸口脉浮而紧病在表也浮则为中风紧则为伤寒以风性浮而寒性紧所谓风则浮虚寒则牢坚也中风则伤卫气伤寒则伤营
血营卫俱伤而骨节烦痛当发汗以解风寒此桂麻各半之证也（此明审察表里之义）
老师（指张仲景）说：呼吸是脉搏的纲领。刚切脉时，脉搏来势快而去势慢，这是出脉快、入脉慢，称为内虚外实；刚切脉时，脉搏来势慢而去势快，这是出脉慢、入脉快，称为内实外虚。
脉搏的流行是靠气推动的。一呼一吸之间，脉搏跳动六次，气运行六寸。人体的经络包括六条阳经、六条阴经以及任脉、督脉和两跷脉，总长度为十六丈二尺。正常人在一天一夜中呼吸一万三千五百次，一天分为一百刻，每刻二百七十息，漏水下降二刻，脉搏运行十六丈二尺，这称为一周。经过一万三千五百息，水漏下百刻，脉搏运行五十周，共计八百一十丈，一天的度量便完成了。（详细义理参见《灵枢》中的《脉度》、《营气》、《五十营》等篇章）。所以呼吸是脉搏的纲领（“头”即指纲领的意思）。医生以正常人的呼吸节奏作为标准，来衡量病人的脉搏迟或数，从而判断阴阳的虚实情况。比如刚切脉时，脉搏来势快而去势慢，“来”是指脉气外出，“去”是指脉气内入，这种出脉快而入脉慢的情况，因为出脉出于体表，通过出脉的速度可以了解体表的状况；入脉进入体内，通过入脉的速度可以了解体内的状况。由于出脉快而入脉慢，所以称为内虚外实。刚切脉时，脉搏来势慢而去势快，这是出脉慢而入脉快，所以称为内实外虚。（这里阐明了第一章关于呼吸出入的意义）。
寸口脉浮表示病在表，沉表示病在里，数表示病在腑，迟表示病在脏。假如脉搏迟，这就是病在脏。
表属于阳，里属于阴，所以表脉浮而里脉沉；腑属于阳，脏属于阴，所以腑脉数而脏脉迟。浮数和沉迟是阴阳自然的属性。（这里阐述了审察表里、推测脏腑的意义）。
寸口脉浮而紧，浮脉主风邪，紧脉主寒邪。风邪伤害卫气，寒邪伤害营血，营卫都受到伤害，导致骨节烦痛，应当用发汗的方法治疗。
寸口脉浮而紧，说明病在表。浮脉主中风，紧脉主伤寒。因为风的性质轻浮，寒的性质紧束，所谓“风则浮虚，寒则牢坚”。中风伤害卫气，伤寒伤害营血，营卫俱伤而导致骨节烦痛，应当发汗以解除风寒，这是桂枝麻黄各半汤证。（这里阐明了审察表里的意义）。
The Master said: Respiration is the guideline of the pulse. When initially palpating, if the pulse comes rapidly and departs slowly, this is rapid exit and slow entry, named "Internal Deficiency and External Excess". When initially palpating, if the pulse comes slowly and departs rapidly, this is slow exit and rapid entry, named "Internal Excess and External Deficiency".
The circulation of the pulse is driven by Qi. In one respiration cycle (one breath), the pulse beats six times, and Qi travels six cun. The meridians of the human body, including six Yang meridians, six Yin meridians, plus the Ren Mai (Conception Vessel), Du Mai (Governing Vessel), and the two Qiao vessels, have a total length of sixteen zhang and two chi. A healthy person breathes thirteen thousand five hundred times in a day and night. One day is divided into one hundred ke (water clock units); each ke consists of two hundred seventy breaths. When the water clock drops two ke, the pulse travels sixteen zhang and two chi, which constitutes one circuit. After thirteen thousand five hundred breaths, when the water clock has dropped one hundred ke, the pulse has circulated fifty circuits, totaling eight hundred ten zhang. Thus, the measure of one day is completed. (For detailed meaning, refer to chapters such as *Mai Du*, *Ying Qi*, and *Wu Shi Ying* in the *Ling Shu*). Therefore, respiration is the guideline of the pulse ("head" here refers to the guideline). Physicians use the respiration rate of a healthy person as a standard to judge the slowness or rapidity of a sick person's pulse, thereby revealing the deficiency or excess of Yin and Yang. For instance, when initially palpating, if the pulse comes rapidly and departs slowly, "coming" refers to the outward movement of pulse Qi, and "departing" refers to its inward movement. This situation of rapid exit and slow entry implies that since the exit occurs from the exterior, observing the exit reveals the state of the exterior; since the entry occurs into the interior, observing the entry reveals the state of the interior. Because the exit is rapid and the entry is slow, it is named "Internal Deficiency and External Excess". When initially palpating, if the pulse comes slowly and departs rapidly, this is slow exit and rapid entry, hence named "Internal Excess and External Deficiency". (This clarifies the meaning of respiration and entry/exit stated in the first chapter).
A floating pulse at the Cun Kou (Radial Artery) indicates the disease is in the Exterior; a deep pulse indicates it is in the Interior; a rapid pulse indicates it is in the Fu organs; a slow pulse indicates it is in the Zang organs. If the pulse is slow, this indicates the disease is in the Zang organs.
The Exterior belongs to Yang, and the Interior belongs to Yin; therefore, the Exterior pulse is floating and the Interior pulse is deep. The Fu organs belong to Yang, and the Zang organs belong to Yin; therefore, the Fu pulse is rapid and the Zang pulse is slow. Floating/Rapid and Deep/Slow are the natural characteristics of Yin and Yang. (This explains the principle of examining the Exterior/Interior and estimating the condition of the Zang/Fu organs).
A floating and tight pulse at the Cun Kou: floating indicates Wind pathogen, and tight indicates Cold pathogen. Wind damages the Wei Qi (Defensive Qi), and Cold damages the Ying Qi (Nutritive Blood). When both Ying and Wei are damaged, it causes vexation and pain in the bones and joints, and sweating should be induced to treat it.
A floating and tight pulse at the Cun Kou indicates the disease is in the Exterior. Floating indicates Wind Strike (Zhong Feng), and tight indicates Cold Damage (Shang Han). Since the nature of Wind is floating and deficient, and the nature of Cold is tight and firm, it is said that "Wind presents as floating and deficient, Cold presents as firm and solid." Wind Strike damages the Wei Qi, and Cold Damage damages the Ying Blood. When Ying and Wei are both damaged, causing vexation and pain in the bones and joints, sweating should be induced to resolve the Wind and Cold. This is a pattern for Guizhi Mahuang Ge Ban Tang (Cinnamon Twig and Ephedra Half-Combined Decoction). (This clarifies the principle of examining the Exterior/Interior).