（脉之形，余以实情告后人，若违心装神仙，丧天良，评论必遭天诛。）
气府存气，血府存血。卫总管由气府行周身之气，故名卫总管。荣总管由血府行周身之
血，
周身气管。荣总管，体薄形细，长在卫总管之前，与卫总管相连，散布头面四肢，近皮肉长
，即周身血管。气在气府，有出有入，出入者，呼吸也。目视耳听，头转身摇，掌握足步，
灵机使气之动转也。血自血府入荣总管，由荣总管灌入周身血管，渗于管外，长肌肉也。气
管近筋骨生，内藏难见。血管近皮肉长，外露易见。气管行气，气行则动；血管盛血，静而
不动。头面四肢按之跳动者，皆是气管，并非血管。如两眉棱骨后凹处，俗名两太阳，是处
肉少皮连骨，按之跳动，是通头面之气管。两足大指次指之端，是处肉少皮连骨，按之跳动
，是通两足之气管。两手腕横纹高骨之上，是处肉少皮连骨，按之跳动，是通两手之气管。
其管有粗有细，有直有曲，各人体质不同。胳膊肘下近手腕肉浓，气管外露者短。胳膊肘下
近手腕肉薄，气管外露者长。如外感中人，风入气管，其管必粗，按之出肤。寒入气管，管
中津液必凝，凝则阻塞其气，按之跳动必慢。火入气管，火气上炙，按之跳动必急。人壮邪
气胜，管中气多，按之必实大有力。人弱正气衰，管中气少，按之必虚小无力。久病无生机
之人，元气少，仅止上行头面两手，无气下行，故足面按之不动。若两手腕气管上，按之似
有似无，或细小如丝，或指下微微乱动，或按之不动，忽然一跳，皆是气将绝之时。此段言
人之气管，生平有粗细、曲直之不同。管有短长者，因手腕之肉有薄浓也。按之大小者，虚
实也。跳动之急慢者，寒火之分也。前所言明明是脉，不言脉者，因前人不知有左气门、右
气门、血府、气府、卫总管、荣总管、津门、津管、总提、遮食、珑管、出水道，在腹是何
体质，有何用处。论脏腑、包络，未定准是何物。论经络、三焦，未定准是何物。并不能指
明经络是气管、血管。论脉理，首句便言脉为血府，百骸贯通。言脉是血管，气血在内流通
，周而复始。若以流通而论，此处血真能向彼处流，彼处当有空隙之地，有空隙之地，则是
血虚，无空隙之地，血流归于何处？古人并不知脉是气管，竟着出许多《脉诀》，立言虽多
，论部位一人一样，并无相同者。
古人论脉二十七字，余不肯深说者，非谓古人无容足之地，恐后人对症无论脉之言，诊
脉断
脏腑，不能伤筋骨，不能伤皮肉，所伤者无非气血。气有虚实，实者邪气实，虚者正气虚。
正气虚，当与“半身不遂门”四十种气虚之症、“小儿抽风门”二十种气虚之症，互相参考
。血有亏瘀，血亏必有亏血之因，或因吐血、衄血，或溺血、便血，或破伤流血过多，或崩
漏、产后伤血过多；若血瘀，有血瘀之症可查，后有五十种血瘀症互相参考。惟血府之血，
瘀而不活，最难分别。后半日发烧，前半夜更甚，后半夜轻，前半日不烧，此是血府血瘀；
血瘀之轻者，不分四段，惟日落前后烧两时，再轻者，或烧一时，此内烧兼身热而言；若午
后身凉，发烧片刻，乃气虚参 之症；若天明身不热，发烧止一阵，乃参附之症。不可混含
从事。
（关于脉象的形态，我将实际情况如实告知后人，如果违背良心装神弄鬼，丧失天良，评论必遭上天诛灭。）
气府中储存气，血府中储存血。卫总管负责运行全身的气，所以称为卫总管。荣总管负责运行全身的血液，即周身血管。荣总管管壁薄、形体细，位于卫总管之前，与卫总管相连，散布于头面四肢，贴近皮肉生长，也就是我们所说的周身血管。气在气府中，有出有入，出入的过程就是呼吸。眼睛看、耳朵听，头部转动、身体摇晃，手掌掌握、脚部行走，这些都是灵机驱使气进行运动的结果。血液从血府进入荣总管，由荣总管灌注到周身血管，渗透于血管之外，从而滋养肌肉。气管靠近筋骨生长，内部隐藏难以看见；血管贴近皮肉生长，外露容易看见。气管运行气，气行则动；血管盛载血，静止不动。头面四肢按压时感到跳动的，都是气管，并非血管。例如两眉棱骨后的凹陷处，俗称“太阳穴”，此处肉少皮连骨，按压时跳动，这是通往头面的气管。两足大脚趾和二脚趾的末端，此处肉少皮连骨，按压时跳动，这是通往双脚的气管。两手手腕横纹高骨之上，此处肉少皮连骨，按压时跳动，这是通往双手的气管。这些管子有粗有细，有直有曲，因个人体质不同而各异。胳膊肘下方靠近手腕处肉质浓厚，外露的气管就短；胳膊肘下方靠近手腕处肉质单薄，外露的气管就长。如外感病邪中人，风邪侵入气管，该管必然变粗，按压时突出皮肤。寒邪侵入气管，管中的津液必然凝结，凝结则阻塞气的运行，按压时跳动必然缓慢。火邪侵入气管，火热之气上灼，按压时跳动必然急促。人体壮实、邪气胜者，管中气多，按压必然实大有力。人体虚弱、正气衰者，管中气少，按压必然虚小无力。久病无生机的人，元气少，仅能上行至头面和双手，没有气下行，所以足面按压不跳动。如果两手手腕处的气管上，按压时似有似无，或细小如丝，或指下微微乱动，或按压不动忽然跳一下，这都是气即将断绝时的表现。这段文字讲的是人的气管，生平就有粗细、曲直的不同。管子有长短之分，是因为手腕处的肉有厚薄之别。按压时感觉大小的差异，反映的是虚实状况。跳动急慢的区别，反映的是寒热之分。前面所说的明明是脉，却不称其为脉，是因为前人不知道有左气门、右气门、血府、气府、卫总管、荣总管、津门、津管、总提、遮食、珑管、出水道等结构，不清楚它们在腹部的体质形态和用处。论述脏腑、包络时，未确定它们究竟是什么物体。论述经络、三焦时，也未确定它们究竟是什么物体。并不能明确指出经络就是气管和血管。论述脉理时，开篇就说脉是血府，贯通百骸。说脉是血管，气血在体内流通，周而复始。如果以流通来论，这里的血真的流向那里，那里应当有空隙之地，如果有空隙之地，那就是血虚；如果没有空隙之地，血流归向何处？古人并不知道脉其实是气管，竟然编写出许多《脉诀》，立言虽然很多，但论述的部位因人而异，并没有相同之处。
古人对脉象的论述仅有二十七字，我不肯深入解说，并不是说古人没有容身之地，而是担心后人对着病症不谈脉理，通过诊脉来判断脏腑，却不知疾病所伤的无非是气血。气有虚实之分，实者是邪气实，虚者是正气虚。正气虚，应当与“半身不遂门”中的四十种气虚症状、“小儿抽风门”中的二十种气虚症状，互相参考。血有亏虚和瘀滞两种情况，血亏必有导致血亏的原因，或因吐血、鼻出血，或尿血、便血，或因外伤流血过多，或崩漏、产后失血过多；如果是血瘀，有血瘀的症状可以查证，后面有五十种血瘀症供互相参考。只有血府中的血液，瘀滞而不活，最难分辨。后半日发烧，前半夜更严重，后半夜减轻，前半日不发烧，这是血府血瘀的表现；血瘀较轻的，不分四个时段，只在日落前后发烧两小时，再轻一点的，或者只发烧一小时，这里说的内烧兼带身热；如果午后身体凉爽，只是发烧片刻，那是气虚参汤证的症状；如果天明时身体不热，发烧只持续一阵，那是参附汤证的症状。不可含糊从事。
(The shape of the pulse, I inform future generations of the actual situation. If one acts against conscience to pretend to be a deity and loses their moral integrity, their comments will surely suffer heavenly punishment.)
The Qi Mansion (Qi Fu) stores Qi, and the Blood Mansion (Xue Fu) stores Blood. The Wei General Manager (Wei Zongguan) is responsible for circulating Qi throughout the body, hence its name. The Rong General Manager (Rong Zongguan) is responsible for circulating Blood throughout the body, which constitutes the systemic blood vessels. The Rong General Manager has thin walls and a slender form, located anterior to the Wei General Manager, connected to it, and distributed across the head, face, and limbs. It grows close to the skin and flesh, representing the systemic blood vessels. Qi resides in the Qi Mansion, with egress and ingress; this process of entering and exiting is respiration. Vision, hearing, head turning, body swaying, hand grasping, and foot walking are all movements driven by the spiritual mechanism (Ling Ji) acting upon Qi. Blood enters the Rong General Manager from the Blood Mansion, is infused into the systemic blood vessels by the Rong General Manager, and渗uates outside the vessel walls to nourish muscles. The Qi vessels grow near the sinews and bones, hidden internally and difficult to see. The blood vessels grow near the skin and flesh, exposed externally and easy to see. The Qi vessels transport Qi, and when Qi moves, there is motion; the blood vessels hold Blood, remaining static and motionless. The pulsations felt upon pressing the head, face, and limbs are all Qi vessels, not blood vessels. For example, the concave area behind the supraorbital ridge, commonly known as the temporal region, where flesh is scant and skin adheres to bone, exhibits pulsation upon pressure; this is the Qi vessel connecting to the head and face. At the tips of the great toe and second toe of both feet, where flesh is scant and skin adheres to bone, pulsation upon pressure indicates the Qi vessels connecting to both legs. Above the transverse crease and high bone of both wrists, where flesh is scant and skin adheres to bone, pulsation upon pressure indicates the Qi vessels connecting to both hands. These vessels vary in thickness (coarse or fine) and curvature (straight or curved), differing according to individual constitution. Where the flesh is thick near the wrist below the elbow, the exposed Qi vessel is short. Where the flesh is thin near the wrist below the elbow, the exposed Qi vessel is long. In cases of external contraction, if Wind pathogen enters the Qi vessel, the vessel must become coarse and protrude from the skin upon pressure. If Cold pathogen enters the Qi vessel, the fluids within the vessel must coagulate; coagulation obstructs Qi flow, causing the pulsation upon pressure to be slow. If Fire pathogen enters the Qi vessel, the fiery Qi scorches upward, causing the pulsation upon pressure to be rapid. In robust individuals with excess pathogenic factors, there is abundant Qi in the vessel, resulting in a firm, large, and forceful pulse upon pressure. In weak individuals with deficient healthy Qi, there is scarce Qi in the vessel, resulting in a deficient, small, and powerless pulse upon pressure. In patients with chronic illness lacking vital energy, Yuan Qi is scarce, capable only of ascending to the head and hands, with no Qi descending, thus the dorsum of the foot shows no movement upon pressure. If at the Qi vessels on both wrists, the sensation upon pressure is faintly present or absent, or fine as a thread, or slightly chaotic under the finger, or unresponsive with a sudden jump, these are signs that Qi is about to perish. This section discusses human Qi vessels, noting differences in thickness, curvature, length, and pressure response due to constitutional variations in flesh thickness, deficiency/excess states, and cold/heat conditions. What was previously described as the pulse is actually the Qi vessel. The reason it is not called the pulse is that predecessors were unaware of structures such as the Left Qi Valve, Right Qi Valve, Blood Mansion, Qi Mansion, Wei General Manager, Rong General Manager, Jin Gate, Jin Tube, Zong Ti, Zhe Shi, Long Tube, and Chu Shui Dao, and did not understand their anatomical nature or function in the abdomen. Discussions on Zang-Fu organs and Pericardium failed to identify what these entities truly were. Discussions on Meridians and San Jiao also failed to clarify their nature. They could not explicitly state that meridians consist of Qi vessels and blood vessels. In discussions on pulse theory, the opening statement claims the pulse is the Blood Mansion, penetrating all bones. Claiming the pulse is a blood vessel implies Qi and Blood circulate internally in a cycle. If viewed as circulation, if blood flows from here to there, there should be empty space left behind; empty space implies Blood Deficiency. If there is no empty space, where does the flowing blood go? Ancients did not know the pulse was actually the Qi vessel, yet they compiled many *Mai Jue* (Pulse Rhymes). Although their statements were numerous, the described locations varied from person to person, with no consistency.
My reluctance to deeply expound on the ancients' twenty-seven characters regarding the pulse is not to deny them any validity, but to warn future generations against diagnosing Zang-Fu organs based solely on pulse reading while ignoring symptoms, failing to recognize that pathology affects neither sinews/bones nor skin/flesh directly, but rather Qi and Blood. Qi has Deficiency and Excess patterns: Excess refers to Pathogenic Qi Excess, while Deficiency refers to Healthy Qi Deficiency. Healthy Qi Deficiency should be cross-referenced with the forty types of Qi Deficiency symptoms in the "Hemiplegia Chapter" and the twenty types in the "Pediatric Convulsion Chapter." Blood has Deficiency and Stasis patterns. Blood Deficiency must have a cause, such as hematemesis, epistaxis, hematuria, melena, excessive bleeding from trauma, metrorrhagia/metrostaxis, or postpartum blood loss. Blood Stasis has observable symptoms; refer to the fifty types of Blood Stasis symptoms listed later. However, Blood Stasis within the Blood Mansion is the most difficult to distinguish. Fever occurring in the latter half of the day, worsening in the first half of the night, improving in the second half, and absent in the first half of the day, indicates Blood Stasis in the Blood Mansion. Mild Blood Stasis presents as fever for two hours around sunset, without division into four periods. Even milder cases may involve fever for only one hour; this internal heat accompanies general body heat. If the body is cool in the afternoon with only brief fever episodes, it indicates a Syndrome requiring Ginseng (Shen). If the body is not hot at dawn, with fever lasting only one episode, it indicates a Syndrome requiring Ginseng and Aconite (Shen Fu). One must not treat these ambiguously.