轻下手于皮肤之上曰“举”，以诊心肺之气也（心肺为阳，浮而为上。）略重按于肌肉之间
曰“按”，以诊脾胃之气也（脾胃居中，故其气应乎中。）重手推于骨肉之下曰“寻”，以诊肝
肾之气也（肝肾为阴，沉而在下。
两手六部皆为肺脉，肺为脏腑之华盖，凡一切脏腑病，其气必上熏于肺，而应之于脉。
如心病六脉必洪，肝病六脉必弦，肾病六脉必沉，肺病六脉必涩，脾病六脉必缓。（是怠缓，
不是和缓。）按之指下浊者为邪甚，清者为正复。有神者吉，无神者凶，有力者为热为实，无
力者为虚为寒，此为最验。李濒湖云∶“脉者脏腑之气，非脏腑所居之地也。”余每见时医于
两手六部中，按之又按，曰∶某脏腑如此，某脏腑如此又如彼。俨若脏腑居于两手之间，可
扪而得，种种欺人之丑态，实则自欺之甚也。
《素问·脉要精微论》曰∶“尺内两旁，则季胁也（尺内，尺中也，两旁，两尺部之外旁
也，季胁，两胁之下秒也。何以谓之季，言胁之尽处也。）尺外以候肾，尺里以候腹（两肾附于
季胁，是季胁之内乃是两肾，两肾之内乃是腹中，故以尺内候腹中，尺外以候肾，尺之四旁
以候季胁，是两旁更出于外也。杨元如曰∶‘所谓外者，乃六脉之本位。脉居歧骨之外，故
以本位为外，而偏于里者为内也。’高士宗云∶‘脉气自下而上，故先论之尺部左右外内也）
。’中附上，左外以候肝，内以候膈（中附上者，附左尺而上左手之关脉也。肝居胁内，故以
关候肝，膈气在中，故以内候膈。膈谓膈肉之下，肝脾所居之郛廓也。）右外以候胃，内以候
脾（右者，附右尺而上右手之关脉也。脾主中土，故以关内候脾，阴内而阳外，故以关外候胃
。问曰∶六腑独言候胃何义。曰∶五脏之气血皆胃腑之所生，故脏气不能自至于手太阴，必
因胃气乃至。是以《本经》凡论五脏必及于胃，而余腑不与焉，然而脏腑雌雄各有并合，言
心而小肠在其中矣，言肺而大肠在其中矣，余脏准此。高士宗云∶‘脉气自下而中，故次论
关部之左右外内也。’）上附上，右外以候肺，内以候胸中（上附上者，从右关而上右寸口也。
胸中者，宗气之所居也。《经》曰∶宗气积于胸中，命曰气海，上出于肺，循喉咙而行呼吸
，）前以候前，后以候后，膻中（左者，左寸口也，心者，君主之官也，膻中者，臣使之官，君主
之相位也。高士宗云∶‘脉气自中而上，故终论寸部之左右外内也。’）前以候前，后以候后
（脉有外内，复有前后，前以候前，尺前，关前，寸前，以候形身之前也。后以候后，寸后，
关后，尺后，以候形身之后也。）上竟上者，胸喉中事也。下竟下者，少腹，腰股，膝、胫，
足中事也。”（脉有内外前后，复有上下，是脉体之六合也。上竟上者，自寸上而竟上于鱼际
也。喉主天气，位居胸上，故为胸喉中事，乃上以候上也。下竟下者，自尺下而竟下于肘中
也。足履乎地，股、膝、胫、足居腰与少腹之下，故为少腹、腰、股、膝、胫、足中事，乃下以
候下也。
参各家注，此审别形声，脏腑，外内之法也。首言两旁，次言前后，次言上下。盖以左
右三部之脉，正候之外，推而及于三部之两旁，三部之前后，且上而极于鱼际之上，下而极
于尺泽之下，无所不到，可谓候法无余蕴矣。今即以尺内两旁则季胁也，引一语而比例之。
既以尺部之两旁候形身之季胁，便知关部之两旁可以候形身之两胁，寸部之两旁可以候形身
之两腋。书不尽言，学人当得其意而引伸也。其曰前后者，以寸、关、尺各部，前一分为前
，后一分为后，乃各部之交界处也。其曰上下者，言上而更上于寸，下而更下于尺也。总而
言之，首言外内，次言前后，盖以两手之脉，平以分之，有如文王之卦，离南坎北，震东兑
西，以候形身之四旁。上竟上 ，下竟下者，有如伏羲之卦，竖以观之，而天地定位也。此
章以人身配六合，三部九候法，以人身配三才，所谓人身小天地者此也。
问曰∶《经》言心肝居左，脾肺居右，是脏气之出于左右，抑脏体之偏与。曰∶天为阳
，地为阴，东南为阳，西北为阴。圣人南面而立，左为阳，右为阴。天一生水，水生木，木
生火，是以心肝居左也。地二生火，火生土，土生金，是以脾肺居右也。此先天之五行，本
于阴阳水火，分而上生，非脏体之谓也。又心主脉，肝主血，血脉生于水精，是以左手三部
俱主血，肺主周身之气，脾主元真之气，气生于火，是以右手三部皆主气，此皆阴阳互换之
妙，善诊者不可不知。
愚按∶诊候之法，各家不同，善诊者便宜熟记于心，随机应变，则指下了然矣。余视此着
时行诸书，虽高一格，而究竟为唐宋后各家之小技也。今欲为初学启蒙，遽以《灵》、《
素》授之，恐学人畏其难而中阻，然又恐示之以“易”则争趋于“易”，终无以造乎精微之
域，反为斯道害。惟《内经·脉要精微论》一章，各家脉书，不过绘其部位，而所言诊法，
大不相符，相沿已久，必不能一时更改其说。但《圣经》炳如日星，录此一节，以俟后之学
者，起而明之。
在皮肤表面轻轻按压称为“举”，用以诊察心肺之气（心肺属阳，位置浮浅而在上）。稍微用力按至肌肉层之间称为“按”，用以诊察脾胃之气（脾胃位居中焦，所以其气应于中部）。重手推寻至骨肉之下称为“寻”，用以诊察肝肾之气（肝肾属阴，位置深沉而在下）。
两手六部脉象皆与肺有关，因为肺是脏腑的华盖（覆盖于其他脏腑之上的脏器），凡是所有脏腑的疾病，其病气必然向上熏蒸于肺，并反映在脉象上。例如：心病的六部脉必呈洪大之象，肝病的六部脉必呈弦急之象，肾病的六部脉必呈沉细之象，肺病的六部脉必呈涩滞之象，脾病的六部脉必呈缓怠之象（此处指怠慢无力，而非和缓有力）。如果按之指下感觉浑浊不清，说明邪气盛；感觉清朗，说明正气恢复。脉有神气为吉兆，无神气为凶兆；脉有力者为热证或实证，脉无力者为虚证或寒证，这是最准确的判断方法。李时珍说：“脉是脏腑之气的表现，并非脏腑所居住的地方。”我常常见到当时的医生在两手的六部脉中，反复按压，说：“某脏腑如此，某脏腑又那样。”仿佛脏腑就居住在两手之间，可以摸到一样，种种欺人的丑态，实际上是自欺欺人罢了。
《素问·脉要精微论》说：“尺部内侧两旁，对应季胁（尺内，即尺脉的中部；两旁，指两尺部的外侧旁处；季胁，指两胁的最下端。为什么叫‘季’？意思是胁肋的尽头处。）尺部外侧以候肾，尺部内侧以候腹（两肾附着于季胁，所以季胁之内即是两肾，两肾之内即是腹腔，因此用尺部内侧候腹中，用尺部外侧候肾，尺部的四旁用来候季胁，这说明两旁比外侧更靠外。杨元如说：‘所谓外，是指六脉的本位。脉位于歧骨之外，所以以本位为外，而偏于里的为内。’高士宗说：‘脉气自下而上行，所以先论述尺部的左右内外。’）中部往上附连处，左手外侧以候肝，内侧以候膈（中附上，指附于左尺之上到达左手关脉的位置。肝位于胁内，所以用关脉候肝；膈气居于中焦，所以用内侧候膈。膈指的是膈肌之下，肝脾所在的廓室。）右手外侧以候胃，内侧以候脾（右者，指附于右尺之上到达右手关脉的位置。脾主中土，所以用关内候脾；阴在内而阳在外，所以用关外候胃。问：六腑唯独提到候胃是什么意思？答：五脏的气血都源于胃腑，所以脏气不能独自到达手太阴肺经，必须依赖胃气才能到达。因此《内经》凡论述五脏必定涉及胃，而其他腑则不单独提及。然而脏腑阴阳各有配合，言心则小肠在其中，言肺则大肠在其中，其余脏腑以此类推。高士宗说：‘脉气自中而上行，所以接着论述关部的左右内外。’）上部往上附连处，右手外侧以候肺，内侧以候胸中（上附上，指从右关之上到达右寸口的位置。胸中，是宗气所在之处。《内经》说：宗气积聚于胸中，称为气海，向上出于肺，沿喉咙而行呼吸。）前部以候身体前侧，后部以候身体后侧，膻中（左侧，指左寸口。心是君主之官，膻中是臣使之官，相当于君主的宰相之位。高士宗说：‘脉气自中而上行，所以最后论述寸部的左右内外。’）前部以候前，后部以候后（脉有内外之分，又有前后之分。前部以候前，即尺前、关前、寸前，用来候形体身躯的前面部分。后部以候后，即寸后、关后、尺后，用来候形体身躯的后面部分。）脉象向上延伸至尽头，对应的是胸喉中的事情。脉象向下延伸至尽头，对应的是少腹、腰、大腿、膝、小腿、足中的事情。（脉有内外前后，又有上下，这是脉体的六合关系。上竟上，指从寸部向上一直延伸到鱼际处。喉主管天气，位置在胸上，所以属于胸喉中的事，这是上以候上。下竟下，指从尺部向下一直延伸到肘中。足踏在地，大腿、膝、小腿、足位于腰与少腹之下，所以属于少腹、腰、大腿、膝、小腿、足中的事，这是下以候下。）
综合各家注解，这是审辨形声、脏腑、内外之法。首先讲两旁，其次讲前后，再次讲上下。大概是因为左右三部脉除了正候之外，还推及到三部的两旁、三部的前后，并且向上极至于鱼际之上，向下极至于尺泽之下，无所不到，可以说是候法没有遗漏了。现在仅以“尺内两旁则季胁也”这一句话来类推。既然尺部的两旁候形体身躯的季胁，便可知关部的两旁可以候形体身躯的两胁，寸部的两旁可以候形体身躯的两腋。书本不能完全表达言语，学习者应当领会其意并加以引申。所说的“前后”，是指寸、关、尺各部，前一分为前，后一分为后，这是各部的交界处。所说的“上下”，是指向上再超过寸部，向下再超过尺部。总而言之，首先讲外内，其次讲前后，大概是因为两手的脉，平分为四部分，如同文王的卦象，离在南坎在北，震在东兑在西，用来候形体身躯的四旁。上竟上、下竟下，如同伏羲的卦象，竖着观察，天地定位。这一章将人身配属六合，三部九候法将人身配属三才，这就是所谓“人身小天地”的道理。
问：《内经》说心肝居左，脾肺居右，这是脏气出于左右，还是脏体本身偏向一侧？答：天为阳，地为阴，东南为阳，西北为阴。圣人面向南站立，左边为阳，右边为阴。天一生水，水生木，木生火，所以心肝居左。地二生火，火生土，土生金，所以脾肺居右。这是先天五行，本于阴阳水火，分而生化，并非指脏器的实体位置。另外，心主脉，肝主血，血脉生于水精，所以左手三部都主血；肺主周身之气，脾主元气，气生于火，所以右手三部都主气，这都是阴阳互换的妙理，善于诊察的人不可不知道。
我按语：诊候的方法，各家不同，善于诊察的人应当熟记于心，随机应变，那么手指下自然清楚明了。我看这些流行的书籍，虽然格调稍高，但终究只是唐宋以后各家的小技巧。现在如果想为初学者启蒙，直接传授《灵枢》、《素问》，恐怕学习者畏惧困难而中途受阻；然而如果展示给他们的太“容易”，大家又会争相追求简易，最终无法达到精微的境界，反而损害这门学问。只有《内经·脉要精微论》这一章，各家的脉书，不过描绘其部位，而所说的诊法，大多不相符合，相沿已久，不可能一时更改其说法。但《圣经》（指《内经》）光辉如日月星辰，收录这一节内容，以期待后来的学者起来阐明它。
Gently pressing on the skin is called "Ju" (Lifting), used to diagnose Qi of the Heart and Lung (Heart and Lung are Yang, floating and located superiorly). Slightly increasing pressure to the muscle layer is called "An" (Pressing), used to diagnose Qi of the Spleen and Stomach (Spleen and Stomach reside in the Middle Jiao, so their Qi corresponds to the middle). Heavily pushing down to the bone-muscle junction is called "Xun" (Seeking), used to diagnose Qi of the Liver and Kidney (Liver and Kidney are Yin, deep and located inferiorly).
The six positions (three on each hand) of both hands all relate to the Lung, as the Lung is the "Hua Gai" (Canopy of the Zang-Fu organs, covering other organs). For any disease of the Zang-Fu organs, the pathological Qi must ascend to熏 (smoke/steep) the Lung and manifest in the pulse. For example: In Heart disease, the six pulses must be Hong (Surging); in Liver disease, the six pulses must be Xian (Wiry); in Kidney disease, the six pulses must be Chen (Deep); in Lung disease, the six pulses must be Se (Choppy); in Spleen disease, the six pulses must be Huan (Sluggish/Weak - here referring to weakness rather than a harmonious rate). If the pulse feels turbid under the fingers, it indicates abundant pathogenic factors; if it feels clear, it indicates the recovery of healthy Qi. A pulse with Shen (Spirit/Essence) is auspicious; one without Shen is ominous. A forceful pulse indicates Heat or Excess; a feeble pulse indicates Deficiency or Cold. This is the most reliable method. Li Shizhen said: "The pulse is the manifestation of Zang-Fu Qi, not the location where the Zang-Fu organs reside." I often see contemporary physicians repeatedly pressing the six positions of both hands, saying, "This Zang is like this, that Zang is like that," as if the Zang-Fu organs were physically located between the hands and could be palpated directly. Such deceptive postures are essentially self-deception.
Su Wen · Mai Yao Jing Wei Lun states: "The inner sides of the Chi position correspond to the Ji Xie (lower lateral ribs). 'Chi Nei' refers to the center of the Chi pulse; 'Liang Pang' refers to the outer flanks of the two Chi positions; 'Ji Xie' refers to the lowest part of the lateral ribs. Why is it called 'Ji'? It means the extremity of the ribs. The outer side of the Chi position awaits the Kidney, and the inner side awaits the Abdomen (The two Kidneys attach to the Ji Xie; thus, inside the Ji Xie are the two Kidneys, and inside the Kidneys is the abdominal cavity. Hence, the inner Chi awaits the abdomen, the outer Chi awaits the Kidney, and the four sides of the Chi await the Ji Xie, indicating that the sides are even more external. Yang Yuanru stated: 'What is called 'external' is the original position of the six pulses. The pulse lies outside the styloid process, so the original position is external, while the interior is internal.' Gao Shizong stated: 'Qi flows from bottom to top, so we first discuss the left-right and internal-external aspects of the Chi position.) Attached upwards from the middle, the left outer side awaits the Liver, and the inner side awaits the Diaphragm (Zhong Fu Shang refers to attaching upwards from the Left Chi to the Guan pulse of the left hand. The Liver resides within the hypochondrium, so the Guan position awaits the Liver; Diaphragm Qi resides in the middle, so the inner side awaits the Diaphragm. The Diaphragm refers to the space below the diaphragm muscle, where the Liver and Spleen reside.) The right outer side awaits the Stomach, and the inner side awaits the Spleen (Right refers to attaching upwards from the Right Chi to the Guan pulse of the right hand. The Spleen governs Central Earth, so the inner Guan awaits the Spleen; Yin is internal and Yang is external, so the outer Guan awaits the Stomach. Question: Why do the Six Fu organs mention only awaiting the Stomach? Answer: The Qi and Blood of the Five Zang organs are generated by the Stomach Fu organ. Therefore, Zang Qi cannot reach the Hand Taiyin Lung meridian on its own but must rely on Stomach Qi to arrive. Thus, in the Classic, whenever the Five Zang are discussed, the Stomach is always mentioned, while other Fu organs are not. However, Zang and Fu have yin-yang pairings; mentioning the Heart implies the Small Intestine is included, mentioning the Lung implies the Large Intestine is included, and the rest follow this pattern. Gao Shizong stated: 'Qi flows from the middle upwards, so next we discuss the left-right and internal-external aspects of the Guan position.') Attached upwards from the upper part, the right outer side awaits the Lung, and the inner side awaits the Chest Center (Shang Fu Shang refers to moving upwards from the Right Guan to the Right Cun Kou. The Chest Center is the residence of Zong Qi (Pectoral Qi). The Classic states: Zong Qi accumulates in the chest, called the Sea of Qi, emerges upward from the Lung, travels along the throat, and governs respiration.) The anterior aspect awaits the anterior body, and the posterior aspect awaits the posterior body, including the Dan Zhong (Left refers to the Left Cun Kou. The Heart is the Ruler, and the Dan Zhong is the Envoy Minister, acting as the Chancellor to the Ruler. Gao Shizong stated: 'Qi flows from the middle upwards, so finally we discuss the left-right and internal-external aspects of the Cun position.') The anterior aspect awaits the anterior, and the posterior aspect awaits the posterior (The pulse has internal and external distinctions, as well as anterior and posterior. Anterior awaits anterior, i.e., anterior Chi, Guan, and Cun, awaiting the front of the body. Posterior awaits posterior, i.e., posterior Cun, Guan, and Chi, awaiting the back of the body.) When the pulse extends to the extreme upper end, it concerns matters of the chest and throat. When the pulse extends to the extreme lower end, it concerns matters of the lower abdomen, waist, thighs, knees, shins, and feet. (The pulse has internal, external, anterior, and posterior, as well as upper and lower, constituting the Six Harmonies of the pulse body. 'Shang Jing Shang' (Upper to the extreme) means extending from the Cun upwards to the Yu Ji point. The throat governs Heavenly Qi and is located superiorly in the chest, so it belongs to chest-throat matters, which is awaiting the superior with the superior. 'Xia Jing Xia' (Lower to the extreme) means extending from the Chi downwards to the Elbow Center. Feet tread on the ground, and thighs, knees, shins, and feet are located below the waist and lower abdomen, so they belong to lower-abdomen-waist-thigh-knee-shin-foot matters, which is awaiting the inferior with the inferior.)
Synthesizing various annotations, this is the method for distinguishing form, sound, Zang-Fu, and internal-external relationships. It first discusses the sides, then the front and back, then the upper and lower. Generally, besides the standard waiting of the three positions on the left and right, it extends to the sides of the three positions, the front and back of the three positions, reaching up to above Yu Ji and down to below Chi Ze, leaving nothing uncovered. This can be said to exhaust the methods of waiting. Taking just the phrase "Chi Nei Liang Pang Ze Ji Xie Ye" as an analogy: since the sides of the Chi position await the Ji Xie of the body, one can infer that the sides of the Guan position can await the hypochondrium of the body, and the sides of the Cun position can await the axillae of the body. Books cannot fully express speech; learners should grasp the intent and extend it. By "front and back," it means that for each Cun, Guan, and Chi position, the front half-inch is front, and the back half-inch is back, representing the junction areas of each position. By "upper and lower," it means going further up beyond the Cun and further down beyond the Chi. In summary, it first discusses internal-external, then front-back. Roughly, the two hands' pulses are divided horizontally into four parts, resembling King Wen's trigrams, with Li (Fire) in the South and Kan (Water) in the North, Zhen (Thunder) in the East and Dui (Lake) in the West, awaiting the four sides of the body. "Shang Jing Shang" and "Xia Jing Xia" resemble Fuxi's trigrams, viewed vertically, establishing the positions of Heaven and Earth. This chapter maps the human body to the Six Harmonies, and the Three Positions and Nine Waitings method maps the human body to the Three Powers (Heaven, Earth, Humanity), which is what is meant by "the human body is a small universe."
Question: The Classic states that the Heart and Liver reside on the left, and the Spleen and Lung reside on the right. Is this because Zang Qi originates from the left and right, or because the physical organs are biased to one side? Answer: Heaven is Yang, Earth is Yin; Southeast is Yang, Northwest is Yin. When the Sage stands facing South, the left is Yang and the right is Yin. One Water generates Wood, Wood generates Fire, therefore the Heart and Liver reside on the left. Two Fire generates Earth, Earth generates Metal, therefore the Spleen and Lung reside on the right. This is the Pre-Heaven Five Elements, rooted in Yin-Yang, Water, and Fire, dividing and generating upwards; it does not refer to the physical position of the organs. Furthermore, the Heart governs vessels, and the Liver governs blood; blood vessels are born from Water Essence, so the three positions on the left all govern blood. The Lung governs Qi throughout the body, and the Spleen governs Original Qi; Qi is born from Fire, so the three positions on the right all govern Qi. These are the wonders of Yin-Yang interchange, which skilled diagnosticians must know.
My Commentary: Methods of diagnosis vary among schools. Skilled diagnosticians should memorize these well, adapt flexibly, and the pulse will become clear under their fingers. I view these popular books as slightly elevated, yet ultimately merely minor techniques of later generations (post-Tang and Song). If one wishes to enlighten beginners, teaching them the Ling Shu and Su Wen directly might cause them to fear the difficulty and stop midway. However, showing them something too "easy" might lead them to pursue simplicity exclusively, never reaching the realm of subtlety, thereby harming this art. Only the chapter "Mai Yao Jing Wei Lun" in the Nei Jing remains. Other pulse books merely depict the locations, and their described diagnostic methods often do not match, having been followed for a long time and impossible to change instantly. But the Classic shines like the sun and stars. I record this section to await future scholars who will clarify it.