（时医开口辄云脉象，便知其惯习欺人小技，而学术必陋。凡医书论脉愈详，读者愈难体
会，大抵不肯说实话耳。今读此论，句句是实话，喜而录之，并拟韵以便记诵。）
生死于人大矣，而能于两手方寸之地，微末之动，即能决其生死，何其近于诬也，然古
人往往百不失一者何哉。其大要则以胃气为本。盖人之所以生，本乎饮食，《灵枢》云∶“
谷入于胃，乃传之肺，五脏六腑，皆以受气。”寸口属肺金，为百脉之所会，故其来也，有
生气以行乎其间，融和调畅，得中土之精英，此为有胃气，得者生，失者死，其大较也。其
次则推天运之顺逆。人气与天气相应，如春气属木脉宜弦，夏气属火脉宜洪之类，反是则与
天气不应。又其气则审脏气之生克，如脾病畏弦，木克土也，肺病畏洪，火克金也。反是则
与脏气无害。又其次则辨病脉之从违。病之与脉，各有宜与不宜，如脱血之后，脉宜静细，
而反洪大，则气亦外脱矣。寒热之证，脉宜洪数，而反细弱，则真元将陷矣。至于真脏之脉
，乃因胃气已绝，不营五脏。所以何脏有病，则何脏之脉独现。凡此皆《内经》、《难经》
等书，言之明白详尽，学人苟潜心观玩，洞然易晓，此其可决者也。至云诊脉即可以知何病
，又云人之死生，无不能先知，则又非也。盖脉之变迁无定，或有卒中之邪，未即通于经络
，而脉一时未变者。或病轻而不能现于脉者。或有沉痼之疾，久而与气血相并，一时难辨其
轻重者。或有根据经传变，流动无常，不可执一时之脉，而定其是非者。况病之名有万，而脉
之象不过数十种，且一病而数十种之脉无不可见，何能诊脉而即知其何病，此皆推测偶中，
以此欺人也。若夫真脏之脉，临死而终不现者，则何以决之，是必以望、闻、问三者，合而
参观之，亦百不失一矣。故以脉为可凭，而脉亦有时不足凭。以脉为不可凭，而又凿凿乎其
可凭，总在医者熟读经学，更深思自得，则无所不验矣。若世俗无稽之说，皆不足听。
（当时的医生一开口就谈论脉象，这就显露出他们习惯于用欺骗人的小伎俩，其学术水平必然低劣。凡是医书中关于脉学的论述越详细，读者就越难以领会其中真意，这大多是因为作者不肯说真话罢了。现在读到这篇论述，句句都是实话，因此高兴地记录下来，并拟成韵文以便于记忆背诵。）
生死对于人来说是大事，然而能在两手寸口方寸之地那微末的跳动中，就能决断生死，这听起来何其接近于荒谬呢？然而古人往往能做到百次诊断不失一次，这是为什么呢？其中的关键要领在于以“胃气”为根本。人之所以能生存，根本在于饮食，《灵枢》中说：“食物进入胃中，然后传送给肺，五脏六腑都由此接受水谷精气。”寸口属于肺金，是全身血脉汇聚之处，所以它的搏动，其中有生气在运行，表现为融和、调畅，具备中土脾胃的精华，这就是有胃气。得胃气者生，失胃气者死，这是一般规律。
其次要推究天运的顺逆。人体的气与天气相应，比如春气属木，脉象宜弦；夏气属火，脉象宜洪大之类。如果相反，就是与天气不相适应。
再次要审察脏气的生克关系，比如脾病畏惧弦脉，因为木克土；肺病畏惧洪脉，因为火克金。如果出现相反的情况，则对脏气没有妨害。
又其次要辨别病证与脉象的从违（顺逆）。病证与脉象，各有适宜与不适宜的对应。比如在大量失血之后，脉象宜静细，如果反而洪大，说明气也向外脱逸了。寒热之证，脉象宜洪数，如果反而细弱，说明真元将要陷落。至于真脏脉的出现，是因为胃气已经断绝，不能滋养五脏。所以哪一脏有病，哪一脏的脉象就会单独显现。以上这些内容在《内经》、《难经》等书中都有明白详尽的阐述，学习者如果潜心研读玩味，就能豁然开朗、容易理解，这些是可以据以决断的。
至于说诊脉就可以知道是什么具体的病，又说人的生死没有不能预先知道的，这又是错误的。因为脉象的变化没有定式，有的可能是中受了猝发的邪气，尚未立即通达经络，导致脉象暂时未变；有的是病情轻浅而不能反映在脉象上；有的是沉疴痼疾，日久与气血相搏结，一时难以辨别轻重；有的是依据经络传变，流动无常，不可执着于一时的脉象来定是非。况且疾病的名称有上万种，而脉象不过几十种，并且一种疾病可以出现几十种不同的脉象，怎么能通过诊脉就直接知道是什么病呢？这些都是推测偶然命中，以此欺骗人的说法。
如果是真脏脉，到了临死时最终也没有显现出来，那又怎么决断呢？这必须将望、闻、问三法结合起来综合观察，才能做到百次诊断不失一次。所以说，脉象可以作为凭据，但有时也不足凭信；说脉象不可凭信，但它又有确凿可凭的时候。关键在于医者熟读经典著作，深入思考并有所自得，这样就没有不验证准确的了。至于世俗那些无稽之谈，都不值得听信。
(The contemporary physicians, upon opening their mouths to discuss pulse conditions, reveal their habit of employing deceptive tricks and their necessarily inferior academic standards. The more detailed the discussions on pulseology in medical books, the harder it is for readers to grasp the essence, largely because the authors are unwilling to speak the truth. Having read this treatise, where every sentence is truthful, I joyfully recorded it and drafted it into verse for easier memorization.)
Life and death are matters of great significance to humans. Yet, being able to determine life and death from the minute movements within the square-inch area of both wrists seems, how close to absurdity! However, why did the ancients often succeed without a single failure? The general principle lies in taking Stomach Qi (Stomach Qi) as the root. Human life depends fundamentally on diet. As stated in *Ling Shu* (Spiritual Pivot): "When grain enters the stomach, it is transmitted to the Lung, and all five zang organs and six fu organs receive qi." Cun Kou (Cun Kou, the radial artery pulse point) belongs to Metal of the Lung and is the convergence point of all vessels. Therefore, its arrival features vitality moving within, appearing harmonious, smooth, and regulated, embodying the essence of the Central Earth (Spleen/Stomach). This is having Stomach Qi; those who possess it live, those who lose it die—this is the general rule.
Secondly, one must deduce the favorable or unfavorable trends of heavenly movements. Human qi corresponds with heavenly qi. For instance, Spring qi belongs to Wood, so the pulse should be Wiry (Wiry Pulse); Summer qi belongs to Fire, so the pulse should be Surging (Surging Pulse), and so forth. If contrary, it does not accord with heavenly qi.
Thirdly, one must examine the generation and restriction relationships among Zang organ qi. For example, Spleen disease fears the Wiry pulse, as Wood restricts Earth; Lung disease fears the Surging pulse, as Fire restricts Metal. If the opposite occurs, there is no harm to the Zang organ qi.
Fourthly, one must distinguish between compliance and deviation in disease-pulse relationships. Diseases and pulses have appropriate and inappropriate correspondences. For instance, after massive blood loss, the pulse should be quiet and fine; if it is instead surging and large, it indicates that Qi is also escaping outward. In cases of cold or heat syndromes, the pulse should be surging and rapid; if it is instead fine and weak, it indicates that True Yuan (True Primordial Qi) is about to collapse. As for the appearance of True Zang Pulses (True Zang Pulse), it occurs because Stomach Qi has been exhausted and can no longer nourish the five zang organs. Thus, whichever zang organ is diseased, the pulse of that specific zang organ will appear alone. All these points are clearly and thoroughly explained in books such as *Nei Jing* (Inner Canon) and *Nan Jing* (Classic of Difficult Issues). If students study them with concentration and contemplation, they will understand them clearly and easily; these aspects can be used for diagnosis.
However, claiming that pulse diagnosis alone can identify the specific disease, or that one can predict life and death with absolute certainty beforehand, is incorrect. Pulse changes are unpredictable. There may be sudden pathogenic factors that have not yet penetrated the meridians, causing the pulse to remain temporarily unchanged. Or the disease may be mild and thus not manifest in the pulse. Or there may be chronic stubborn diseases that have merged with Qi and Blood over time, making it difficult to assess severity at first glance. Or the disease may follow meridian transmission patterns, flowing unpredictably, making it impossible to judge right and wrong based solely on a momentary pulse. Moreover, while there are tens of thousands of disease names, there are only dozens of pulse types. Furthermore, a single disease can present with dozens of different pulses. How can one know the specific disease merely by diagnosing the pulse? These claims are merely coincidental guesses used to deceive people.
If True Zang Pulses do not appear even at the moment of death, how then can one make a judgment? One must combine Observation (Inspection), Auscultation and Olfaction, Inquiry, and Palpation for comprehensive analysis, thereby achieving high accuracy. Therefore, while the pulse can serve as a reference, it is sometimes unreliable. While some say the pulse is unreliable, it is indeed reliable in certain contexts. It ultimately depends on the physician’s thorough study of classics and deep, independent reflection, ensuring universal validity. Superficial and baseless theories of the secular world are not worth listening to.