人之常气禀于胃。胃者平人之常气也。人无胃气曰死。春胃微弦曰平。弦多胃少曰汗腐。但弦无胃曰死。胃而有毛
曰秋病。毛甚曰今病。藏真散于肝。肝藏筋膜之气也。（以下五节）
人自有生而后。全藉谷气为养。故一日不再食则饥。七日不食则死。可见平人之常气禀于胃。无胃气则死也。经曰。
饮食入胃。脉道乃行。又曰脉得食即高。故知脉道之行。必待此而起。夫脉者气血之府。精神之舍。而胃气者。乃精气
神三宝之神粮。而营卫之渊源也。其气流营溢卫合精。而行神于脉。虽五脏各禀。四时各正。有必见必应之时。而于人
之保合太和。必以胃气为本。是五脏四时。皆必待此而得其平也。故辨脉必先辨于胃脉。胃脉者和而大。搏而有力。于
三阳则搏而勿浮。三阴则搏而勿沉。虽本五脏应四时。而不受五脏四时之沮抑裁损。此所谓平人之元气元神也。昌大于
春夏。收藏于秋冬。使五脏之正气。得以主时而奉令。故肝得主春而脉弦。心得主夏而脉钩。脾得主季夏而脉 。肺得
主秋而脉毛。肾得主冬而脉石。而皆曰微者。正以明胃气之充壮鼓行。使五脏外循天令。而得以其和者主之也。其于五
脏皆曰藏真者。盖谓五脏所藏之本真气也。真气之本。虽起于先天所禀之阴阳。而不得胃气。则不能充之壮之以为真。
故五脏所藏。而能散能濡能高能下能通者。皆赖胃气之聚精待用。而五脏始得行其职事也。肝藏筋膜之气。心藏血脉之
气。脾藏肌肉之气。肺行营卫阴阳之气。肾藏骨髓之气。其各得赡举以固生身。以奉天令。皆胃气之常充常行耳。故必
胃多而微见弦钩 毛石者为无病。稍有衰飒。则弦钩等多见而胃少矣。夫弦钩等脉得四时而见。何尝非五脏之正。而胃
气不胜。遂成脏病。况此五脉之单见耶。单见则胃绝。而真脏之脉见。故曰死也。至若春之胃而见毛。毛与弦反。而乃
见之于春。是胃不能相为于肝以存弦令。而反受克于毛。则胃之衰败已征矣。而曰至秋病者。前此春夏三阳得令。尚能
扶我至秋。则胃不能胜而为病也。若毛甚则胃家之太和已戕。命曰今病。即今已不能掩其恶也。夫人之生。天地合德。
得阴阳五行之全。然自孩提毁齿以来。天癸未至。肾元弗充。要有待于后天之谷神以充之。故持之又久。而后先天之元
气以昌。精神之运量以足。皆胃气也。自中焦出营卫以行隧道。谓之经气合元气而积于胸中。谓之宗气。是故巨阳谓之
主气。此气之至。能先天而天弗违。故入五脏为藏真。使总摄五官百骸。能后天而奉天时。故历四时五运司天之令。以
为之应而无忒。是以胃气之脉。为人之主。自有不为四时五脏之气所掩者。内经首提而言之。此脉家根本第一义。而东
垣丹溪诸公。竞谓其和如春风杨柳。不知此特为春胃微弦之一喻耳。若微钩微石。尚有所不能喻也。至于微 。更有妙
义。胃本不 。以长夏湿土主政。蒸其溽气。火湿相搏。使正气不能高举。故其象为 ，然正唯微 。则胃气之壮可知。
此正所谓在三阳则搏而勿浮。三阴则搏而勿沉者。胃气之实象也。知此则知真藏见而主死之故矣。
人的常气禀受于胃。胃是健康人正常的脉气来源。人如果没有胃气，就会死亡。春季的脉象中带有轻微的弦象，称为平脉（正常脉象）。如果弦象多而胃气少，称为“肝腐”（肝脏功能严重受损，此处指病重之象）。如果只有弦象而没有胃气，称为死脉。春季脉象中带有毛（浮）象，预示秋季会生病。如果毛象很重，则当下就会生病。五脏的真气散布于肝，肝藏有筋膜之气。（以下五节论述同理）
人自从出生以后，完全依赖谷气来滋养身体。所以一天不吃东西就会饥饿，七天不吃东西就会死亡。这足以证明健康人的常气禀受于胃，没有胃气就会死亡。《内经》说：“饮食进入胃后，脉道才能运行。”又说：“脉象在进食后会变得高起。”因此可知，脉道的运行，必须依靠胃气的作用才能启动。脉，是气血的府库，精神的居所；而胃气，是精、气、神三宝中的“神粮”，也是营气和卫气的源头。胃气流动于营分，溢出至卫分，与精气相合，并在脉中运行精神。虽然五脏各自禀受四时之气而各有其正脉，但在人体保持整体和谐平衡的过程中，必须以胃气为根本。因此，五脏和四时，都必须依靠胃气才能达到平和的状态。所以辨别脉象，必须先辨别胃脉。胃脉的特点是柔和而大，搏动有力。在三阳经的脉象中，应搏动有力但不浮越；在三阴经的脉象中，应搏动有力但不沉伏。虽然脉象本应于五脏、对应四时，但不受五脏四时的过度抑制或损伤。这就是所谓的健康人的元气和元神。它在春夏季节盛大生长，在秋冬季节收敛收藏，使得五脏的正气能够主司当令时节并执行命令。所以，肝主春而脉呈弦象，心主夏而脉呈钩象，脾主长夏而脉呈缓象，肺主秋而脉呈毛象，肾主冬而脉呈石象。这些脉象都强调“微”字，正是为了说明胃气充盛鼓动，使五脏顺应天时，并由这种和谐状态来主导。对于五脏都提到“藏真”，是指五脏所藏的本原真气。真气的根本，虽然起源于先天禀受的阴阳，但如果得不到胃气的滋养，就不能充实壮大成为真正的真气。所以，五脏所藏的气之所以能散布、滋润、上升、下降、通畅，都依赖于胃气聚集精气以备使用，五脏才能开始履行它们的职能。肝藏筋膜之气，心藏血脉之气，脾藏肌肉之气，肺行营卫阴阳之气，肾藏骨髓之气。它们各自得到充足的供养以巩固生命，奉承天时的命令，这都是因为胃气经常充盈、经常运行的结果。所以，必须是胃气多而弦、钩、缓、毛、石五种脉象轻微显现，才算是无病。如果稍有衰弱，那么弦、钩等脉象就会多见，而胃气就少了。弦、钩等脉象顺应四时而出现，何尝不是五脏的正脉？但如果胃气不胜任，就会形成脏病，更何况是这五种脉象单独出现呢？单独出现就意味着胃气绝灭，而真脏脉出现，所以说会死亡。至于春季的脉象中见到毛象，毛象与弦象相反，却出现在春季，这是胃气不能辅助肝木维持弦令，反而受到金气（毛象属肺金）的克制，这说明胃气的衰败已经显露了。说“到秋天生病”，是因为此前春夏三阳得令，尚能扶持人体到秋天，但胃气不能胜任而导致生病。如果毛象很甚，则胃中的太和之气已经被残害，称为“当下生病”，即现在就已经无法掩盖其恶劣状况了。人的生存，是天地的德行相合，获得了阴阳五行的完整禀赋。然而从幼儿换牙以来，天癸未到，肾元未充，必须有赖于后天的谷神来充实它。所以持守得久，先天的元气才能昌盛，精神的运化才能充足，这些都依靠胃气。胃气从中焦生出营卫，运行于隧道，称为经气；经气与元气结合积聚于胸中，称为宗气。所以巨阳（太阳经）被称为主气。这股气到达时，能先于天时而行而不违背天道，所以进入五脏成为藏真，总摄五官百骸；能后于天时而顺应天时，所以经历四时五运司天之令，与之相应而没有差错。因此，胃气之脉，作为人体的主宰，自有不被四时五脏之气所掩盖的特点。《内经》首先提出这一点，这是脉学的根本第一义。而李东垣、朱丹溪诸位先生，竞相形容它像春风中的杨柳，不知道这仅仅是针对“春胃微弦”这一种情况的比喻罢了。如果是微钩、微石，还有难以用比喻说明的地方。至于微缓，更有深妙的含义。胃本身并不呈现缓象，因为长夏湿土主政，蒸腾湿气，火湿相搏，使正气不能高举，所以它的形象表现为缓。然而正因为脉象微缓，才可知胃气的壮盛。这正是所谓“在三阳则搏而勿浮，在三阴则搏而勿沉”的胃气实象。懂得这一点，就知道真脏脉出现而主死的缘故了。
The normal Qi of humans is endowed by the Stomach. The Stomach is the source of normal Qi in healthy individuals. If a person lacks Stomach Qi, they will die. In spring, if the pulse has a slight *Xian* (Wiry) quality with Stomach Qi, it is called a Ping Pulse (Normal Pulse). If there is much Wiry quality but little Stomach Qi, it is called "Liver Corruption" (a sign of severe liver dysfunction and critical illness). If there is only Wiry quality without Stomach Qi, it is called a Death Pulse. If the pulse shows a *Mao* (Floating/Hair-like) quality in spring, disease will occur in autumn. If the Floating quality is excessive, disease will manifest immediately. The True Qi of the Zang organs scatters into the Liver, which stores the Qi of the sinews and fascia. (The following five sections follow similar logic.)
Since birth, humans rely entirely on Grain Qi for nourishment. Therefore, not eating for one day causes hunger, and not eating for seven days leads to death. This demonstrates that the normal Qi of healthy individuals is endowed by the Stomach; without Stomach Qi, death ensues. The Classics state: "When food enters the Stomach, the vessel pathways begin to flow." It also states: "The pulse rises after eating." Thus, we know that the flow of vessel pathways must be initiated by this [Stomach Qi]. The pulse is the residence of Blood and Qi, and the dwelling of Spirit. Stomach Qi is the spiritual grain of the Three Treasures (Jing, Qi, Shen), and the origin of Ying (Nutritive) and Wei (Defensive) Qi. Its flow permeates Ying, overflows into Wei, combines with Essence, and circulates Spirit within the vessels. Although each Zang organ receives its respective seasonal Qi and maintains its own correct pulse, in maintaining the harmonious balance of the human body, Stomach Qi must be the foundation. Therefore, the five Zang organs and four seasons all require this [Stomach Qi] to achieve harmony. Hence, distinguishing pulses requires first distinguishing the Stomach Pulse. The Stomach Pulse is characterized by being gentle and large, beating strongly and powerfully. In the three Yang channels, it beats strongly but does not float; in the three Yin channels, it beats strongly but does not sink. Although the pulse originates from the five Zang organs and corresponds to the four seasons, it should not be suppressed or diminished by them. This is what is referred to as the Yuan Qi (Original Qi) and Yuan Shen (Original Spirit) of a healthy person. It expands during spring and summer, and stores during autumn and winter, allowing the righteous Qi of the five Zang organs to govern their respective seasons and execute commands. Thus, the Liver governs spring and presents a Wiry pulse; the Heart governs summer and presents a Hook (Cord-like) pulse; the Spleen governs late summer and presents a Slow (Huan) pulse; the Lungs govern autumn and present a Floating (Mao) pulse; the Kidneys govern winter and present a Stone (Sinking) pulse. All these pulses emphasize the term "slight" (Wei), precisely to illustrate that Stomach Qi is abundant and vigorous, enabling the five Zang organs to follow heavenly mandates and be governed by this harmony. When referring to the five Zang organs storing "True Qi," it refers to the fundamental True Qi stored within them. Although the root of True Qi arises from the Yin and Yang endowed at conception, without Stomach Qi, it cannot be enriched and strengthened to become true. Therefore, the ability of the Qi stored in the five Zang organs to scatter, moisten, ascend, descend, and unblock relies on Stomach Qi gathering essence for use, allowing the five Zang organs to perform their functions. The Liver stores the Qi of sinews and fascia; the Heart stores the Qi of blood vessels; the Spleen stores the Qi of muscles; the Lungs circulate Ying, Wei, Yin, and Yang Qi; the Kidneys store the Qi of bone marrow. Each obtains sufficient nourishment to consolidate life and serve heavenly mandates, all due to the constant fullness and circulation of Stomach Qi. Therefore, only when Stomach Qi is abundant and the Wiry, Hook, Slow, Floating, and Stone qualities are slightly manifested is the person considered free of disease. If there is any decline, the Wiry and Hook qualities will appear more frequently, and Stomach Qi will be deficient. The Wiry and Hook pulses appearing according to the seasons are indeed the righteous pulses of the five Zang organs; however, if Stomach Qi is insufficient, it leads to Zang organ disease, let alone the isolated appearance of these five pulses. Isolated appearance indicates the extinction of Stomach Qi and the manifestation of the True Zang Pulse, hence it signifies death. Regarding the appearance of a Floating (Mao) pulse in spring: since Floating contradicts Wiry, its appearance in spring means Stomach Qi fails to assist the Liver in maintaining the Wiry mandate and instead suffers control by Metal (Floating pulse belongs to Lung/Metal). This signals the decay of Stomach Qi. The statement "disease in autumn" implies that during the preceding spring and summer, the Yang channels were dominant and could still support the body into autumn, but Stomach Qi was unable to cope, leading to illness. If the Floating quality is excessive, the Taihe (Great Harmony) of the Stomach has been destroyed, termed "current illness," meaning the pathology is already evident and cannot be concealed. Human life results from the union of Heaven and Earth, possessing the completeness of Yin, Yang, and Five Elements. However, from childhood until the eruption of permanent teeth, Tian Gui (Heavenly Water/Reproductive Essence) has not arrived, and Kidney Essence is not filled. There is a reliance on postnatal Grain Spirit to enrich it. Only through long-term maintenance can congenital Original Qi flourish, and the operation of Spirit become sufficient; all of this depends on Stomach Qi. Stomach Qi emerges from the Middle Jiao to generate Ying and Wei Qi, circulating through the meridians, known as Jing Qi (Meridian Qi); Jing Qi combines with Original Qi and accumulates in the chest, known as Zong Qi (Gathering Qi). Thus, Ju Yang (Greater Yang/Taiyang) is called the Master Qi. When this Qi arrives, it acts prior to heaven without violating natural laws, entering the five Zang organs as True Zang Qi, governing the five senses and hundred bones; it acts subsequent to heaven while complying with time, responding to the mandates of the four seasons and five movements without error. Therefore, the Stomach Pulse serves as the master of humans, inherently unconcealed by the Qi of the four seasons and five Zang organs. The *Nei Jing* mentions this first; it is the primary principle of pulse diagnosis. Li Dongyuan and Zhu Danxi, among others, competed to describe it as like willow catkins in the spring breeze, unaware that this is merely a metaphor for the "spring Stomach slight Wiry" pulse. Metaphors fail for slight Hook or Stone pulses. The slight Slow pulse holds even deeper significance. The Stomach itself does not present a Slow pulse; rather, because damp earth governs late summer, steaming humidity, and fire and dampness contend, preventing righteous Qi from rising high, the image appears as Slow. Precisely because it is slightly Slow, the vigor of Stomach Qi can be known. This is exactly the "strong but not floating in three Yang, strong but not sinking in three Yin" solid image of Stomach Qi. Understanding this reveals why the appearance of True Zang Pulses signifies death.