医家以岐黄为祖。其所论脉，不过测病情、决死生而已，未有所谓太素也。扁
鹊、仓公之神，仲景、叔和之圣，亦无所谓太素也。何后世有所谓太素者，不惟测
人之病情，而能占人之穷通。不惟决人之死生，而能知人之祸福，岂其术反过于先
圣耶？是亦风鉴巫家之教耳。初学之士，先须格致此理，免为邪说摇惑，则造诣日
精，而仓、扁、张、王之堂可闯矣。故太素乃医之旁门，不得不辨，亦恶紫乱朱，距邪放淫之意。
又∶太素之说，固为不经，然其间亦有可采者。如曰脉形圆净，至数分明，谓
之清。脉形散涩，至数模糊，谓之浊。质清脉清，富贵而多喜。质浊脉浊，贫贱而
多忧。质清脉浊，此谓清中之浊。外富贵而内贫贱，失意处多，得意处少也。质浊
脉清，此谓浊中之清。外贫贱而内富贵，得意处多，失意处少也。若清不甚清，浊
不甚浊，其得失相半而无大得丧也。富贵而寿，脉清而长。贫贱而夭，脉浊而促。
清而促者，富贵而夭。浊而长者，贫贱而寿。此皆太素可采之句也，然亦不能外乎
风鉴，故业太素者，不必师太素。但师风鉴，风鉴精而太素之说自神矣。至其甚
者，索隐行怪，无所不至，是又巫家之教耳。孔子曰∶攻乎异端，斯害也已，正士岂为之。
脉案者，窃公案之义。医者察得病情，立定方法，使病邪不能逃吾之方论。药
至而邪伏，譬之老吏听讼，援律定刑，使奸人无所逃也。
一书某年、某月、某地、某人。二书其人年之高下，形之肥瘦长短，色之黑白
枯润，声之清浊长短。三书其人之苦乐病由，始于何日。四书初时病证，服某药，
次服某药，再服某药。某药少效，某药不效。五书时下昼夜孰甚，寒热孰多，喜恶
何物，脉之三部九候如何。六引经旨以定病名。某证为标，某证为本。某证为急，
当先治。某证为缓，当后治。某脏当补，某脏当泻。七书当用某方，加减某药。某
药补某脏，某药泻某脏。君臣佐使之理，吐下汗和之意，一一详尽。
书年之干支，月之春秋者，占运气也。书某地者，占方宜也。书年形声色者，
用之以合脉也。书苦乐者，占七情也。书始于何日者，占久近也。历问某病证药物
而书其验否者，以之斟酌己见也。书昼夜寒热者，辨气血也。书喜恶何物者，察阴
阳脏腑也。书脉状者，以之合年形声色病证也。书经旨者，如法家引律，使确乎不
可逃也。书病名者，用药如用兵，师出贵有名也。书标本者，识轻重也。书方药君
臣之理者，欲病患达而尝也。凡看王公大人，贵宦儒门之病，必书此一案，便无一
毫苟且，自然奏功。即不愈，亦免误投药剂之疑也。
陶弘景曰∶晋时有一才人，欲刻正周易及诸药方，先与祖讷共论。祖云∶辩释
经典，纵有异同？不足以伤风教。至于汤药，小小不达，便至于寿夭所由，则后人
受弊不少，何可轻以裁断。祖之此言，可为仁识，足为龟镜矣。
《曲礼》曰∶医不三世，不服其药。宋景濂云∶古之医师，必通于三世之书。所
谓三世者，一曰黄帝针灸，二曰神农本草，三曰素问脉经。《脉经》所以察证，本
草所以辨药，针灸所以祛疾。非是三者，不足以言医。传经者，既明载其说，复斥
其非，而以父子相承三世为言，何其惑与？夫医之为道，必志虑渊微，机颖明发，
然后可与于斯，虽父不能必其子也。
施笠泽曰∶愚按古今之称神医者，莫若扁鹊、仓公。而扁鹊之术，则受之长桑
君。仓公之术，则传之公乘、阳庆，初未闻以世传也。至如李东垣、朱丹溪、滑伯
仁辈，皆豪杰自振者。是知医在读三世书，而不在于祖父之三世也。
医家以岐伯、黄帝为祖师。他们所论述的脉诊，不过是推测病情、决断生死罢了，并没有所谓“太素脉”的说法。扁鹊、仓公的神妙，张仲景、王叔和的圣明，也没有所谓“太素脉”。为什么后世会有所谓的“太素脉”呢？它不仅能推测人的病情，还能占卜人的穷困与显达；不仅能决断人的生死，还能预知人的祸福，难道这种技术反而超过了先代圣人吗？这不过是看相算命巫术一类的教条罢了。初学的医者，必须先探究明白这个道理，以免被邪说迷惑动摇，这样造诣才能日益精进，从而能够进入仓公、扁鹊、张仲景、王熹（此处指王叔和或泛指名家，原文作王，结合语境应指前文提到的名医群体）的高深境界。所以，“太素脉”是医学中的旁门左道，不得不加以辨析，这也是厌恶紫色扰乱朱色（比喻邪说混淆正道）、抵制邪说泛滥的意思。
又说：“太素脉”的说法，固然荒诞不经，但其中也有可取之处。比如：脉象形态圆滑洁净，至数（脉搏跳动的频率）分明，称为“清”。脉象形态散乱涩滞，至数模糊不清，称为“浊”。体质清奇且脉象清，主富贵且多喜悦。体质浑浊且脉象浊，主贫贱且多忧愁。体质清奇而脉象浊，这叫“清中之浊”。外表富贵而内心贫贱，失意的时候多，得意的时候少。体质浑浊而脉象清，这叫“浊中之清”。外表贫贱而内心富贵，得意的时候多，失意的时候少。如果清得不算很清，浊得不算很浊，那么得失参半，没有大的得失变化。富贵且长寿，脉象清而长。贫贱且短命，脉象浊而急促。脉象清而急促，主富贵但短命。脉象浊而长，主贫贱但长寿。这些都是太素脉中可取的语句，但也离不开看相之术，所以从事太素脉的人，不必专门师从太素脉的理论，只需师从看相之术，看相精通了，太素脉的说法自然就显得神奇了。至于那些过分夸张、索隐行怪的做法，无所不用其极，这又是巫术一类的教条了。孔子说：“钻研异端邪说，这是有害的啊。”正人君子怎么会去做这种事呢？
所谓“脉案”，是窃取古代公堂判案（公案）的含义。医生察明了病情，确立了治疗方法，使病邪无法逃脱我的方论约束。药物到达体内而病邪潜伏，就像老练的官吏审理诉讼，依据法律定下刑罚，使奸恶之人无处可逃。
一份脉案包含以下内容：第一，记录某年、某月、某地、某人。第二，记录此人的年龄高低，体型的肥瘦长短，肤色的黑白枯润，声音的清浊长短。第三，记录此人的苦乐状况及病因，始于哪一天。第四，记录初期的病症，服用过什么药，接着服用了什么药，再次服用了什么药。哪种药稍微见效，哪种药无效。第五，记录当下昼夜哪个时段症状更重，寒热哪个更多，喜欢和厌恶什么东西，脉象的三部九候情况如何。第六，引用经典旨意来确定病名。哪个证候是标，哪个证候是本。哪个证候紧急，应当先治疗。哪个证候缓和，应当后治疗。哪个脏腑应当补益，哪个脏腑应当泻除。第七，记录应当使用什么方剂，加减什么药物。哪种药物补益哪个脏腑，哪种药物泻除哪个脏腑。君臣佐使的原理，吐法、下法、汗法、和法的用意，一一详尽记录。
记录年份的干支、季节的春秋，是为了占测五运六气。记录某个地方，是为了占测地域适宜性。记录年龄、形体、声色，是用来与脉象相互印证。记录苦乐，是为了占测七情（喜、怒、忧、思、悲、恐、惊）。记录始于哪一天，是为了占测病程的久暂。逐一询问各种病症药物的疗效并记录下来，是为了斟酌自己的见解。记录昼夜寒热，是为了辨别气血。记录喜欢厌恶什么东西，是为了察验阴阳脏腑。记录脉状，是为了与年龄、形体、声色、病症相互印证。引用经典旨意，就像法家引用法律条文一样，使诊断确凿无疑，无法逃避。记录病名，是因为用药如同用兵，军队出动贵在有名分。记录标本，是为了识别病情的轻重。记录方药君臣配比的原理，是想让病患通达理解并尝试接受。凡是诊治王公大人、权贵宦官、儒雅门第的病人，必须书写这样的脉案，就能做到丝毫马虎不得，自然能取得疗效。即使病没治好，也能避免误投药剂的嫌疑。
陶弘景说：“晋朝时有一位才俊，想要刻印《周易》正本及各路药方，先与祖讷共同讨论。祖讷说：‘辩释经典，纵然有异同之处，也不足以伤害风俗教化。至于汤药，稍有不懂，就会导致寿命长短的原因，那么后人受到的弊害不少，怎么可以轻易裁断决定。’祖讷的这番话，可以说是仁爱的见识，足以作为借鉴。”
《曲礼》说：“如果不是传承三代的医生，就不要服用他的药。”宋濂说：“古代的医师，必须通晓三世之书。所谓的三世，一是《黄帝针灸》，二是《神农本草》，三是《素问》和《脉经》。《脉经》用来察验证候，《本草》用来辨别药物，《针灸》用来祛除疾病。不是这三者，不足以谈论医学。传经者，既然明确记载了这种说法，又斥责它的错误，却把父子相传三代作为标准，这是多么糊涂啊！医学之道，必须志向思虑深远微妙，机敏颖悟明达，然后才可以参与这门学问，即使是父亲也不能保证儿子一定能学会。”
施笠泽说：“我考察古今被称为神医的人，没有比得上扁鹊、仓公的。而扁鹊的技术，是从长桑君那里学来的。仓公的技术，是从公乘、阳庆那里传承的，起初并未听说是以世代相传为标准。至于像李东垣、朱丹溪、滑伯仁这些人，都是豪杰自我振作起来的。由此可知，学医在于读三世之书，而不在于祖父是否传了三代。”
Medical practitioners regard Qibo and the Yellow Emperor (Huangdi) as their ancestors. The pulse diagnoses they discussed were merely for inferring the condition of illness and determining life or death; there was no such thing as "Taisu Pulse" (Taisu Mai, a method of fortune-telling through pulse diagnosis). Neither the divine skills of Bian Que and Cang Gong nor the sagacity of Zhang Zhongjing and Wang Shuhe included any reference to "Taisu Pulse." Why did later generations introduce this so-called "Taisu Pulse"? It not only infers one's medical condition but also predicts one's poverty or prosperity; it not only determines life or death but also foretells good or bad fortune. Could this technique surpass that of the ancient sages? This is merely the doctrine of physiognomy and witchcraft. Beginners in medicine must first investigate and understand this principle to avoid being misled by heretical theories, so that their expertise may daily improve, allowing them to enter the halls of mastery occupied by Cang Gong, Bian Que, Zhang Zhongjing, and others. Therefore, "Taisu Pulse" is a heterodox branch of medicine and must be distinguished; this is done to reject purple for disturbing vermilion (a metaphor for rejecting heresy for orthodoxy) and to curb the spread of evil doctrines.
Furthermore, although the theory of "Taisu Pulse" is indeed absurd, there are some aspects worth adopting. For instance: if the pulse shape is round and clean, with distinct frequency (Zhisu, the rate of pulse beats), it is called "Qing" (Clear). If the pulse shape is scattered and choppy, with indistinct frequency, it is called "Zhuo" (Turbid). If both constitution and pulse are Qing, it indicates wealth and nobility accompanied by much joy. If both constitution and pulse are Zhuo, it indicates poverty and low status accompanied by much worry. If the constitution is Qing but the pulse is Zhuo, this is called "Qing within Zhuo." It suggests outward wealth and nobility but inner poverty and low status, with more moments of frustration than success. If the constitution is Zhuo but the pulse is Qing, this is called "Zhuo within Qing." It suggests outward poverty and low status but inner wealth and nobility, with more moments of success than frustration. If neither Qing nor Zhuo is extreme, gains and losses are balanced without significant gain or loss. Wealth and longevity correspond to a Qing and long pulse. Poverty and premature death correspond to a Zhuo and rapid pulse. A Qing but rapid pulse indicates wealth but short life. A Zhuo but long pulse indicates poverty but longevity. These are the adoptable phrases of Taisu Pulse, yet they still rely on physiognomy. Thus, those practicing Taisu Pulse need not specifically study Taisu theory; instead, they should study physiognomy. Once physiognomy is mastered, the claims of Taisu Pulse will naturally seem miraculous. As for those who go too far, seeking hidden meanings and acting strangely, employing every possible means, these are again doctrines of witchcraft. Confucius said, "To attack heterodox doctrines is harmful." How can upright scholars engage in such things?
The term "Pulse Case" (Mai An) borrows the meaning of official judicial records (Gong An). When a physician observes the condition of an illness and establishes a treatment method, the pathogenic factors cannot escape the constraints of the prescription. When the medicine reaches the interior and the pathogens subside, it is like an experienced magistrate hearing a lawsuit, citing laws to determine punishment, leaving no escape for the wicked.
A single pulse case includes the following: First, record the year, month, location, and name of the patient. Second, record the patient's age, body type (fat, thin, tall, short), complexion (black, white, dry, moist), and voice quality (clear, turbid, long, short). Third, record the patient's state of happiness or suffering, the cause of the illness, and the date of onset. Fourth, record the initial symptoms, what medicines were taken initially, subsequently, and repeatedly. Note which medicine had slight effect and which had none. Fifth, record which time of day (day vs. night) the symptoms are worse, whether cold or heat predominates, what the patient likes or dislikes, and the status of the Three Positions and Nine Palpations (Sanbu Jiuhou) of the pulse. Sixth, cite classical principles to determine the disease name. Identify which syndrome is the Branch (Biao) and which is the Root (Ben). Determine which syndrome is urgent and requires immediate treatment, and which is mild and can be treated later. Specify which Zang organ needs tonification and which needs purgation. Seventh, record which formula should be used and which herbs added or subtracted. Explain which herb tonifies which Zang organ and which purges which. Detail the principles of Sovereign, Minister, Assistant, and Courier (Jun Chen Zuo Shi), and the intentions behind emetic, purgative, diaphoretic, and harmonizing methods.
Recording the Heavenly Stems and Earthly Branches of the year and the seasons of Spring and Autumn is for predicting the Five Movements and Six Qi (Wuyun Liujie). Recording the specific location is for assessing regional suitability. Recording age, form, voice, and color is to correlate them with the pulse. Recording happiness or suffering is to assess the Seven Emotions (Qi Qing). Recording the date of onset is to assess the duration of the illness. Asking about various symptoms and drug effects and recording their validity is to refine one's own judgment. Recording day/night and cold/heat differences is to differentiate Qi and Blood. Recording likes and dislikes is to inspect Yin-Yang and Zang-Fu organs. Recording pulse characteristics is to correlate them with age, form, voice, color, and symptoms. Citing classical principles is like legal scholars citing statutes, making the diagnosis irrefutable. Recording the disease name is because prescribing medicine is like deploying troops; military action requires a just cause. Recording Root and Branch is to recognize severity. Recording the principles of Sovereign, Minister, etc., in formulas is to help patients understand and accept the treatment. Whenever treating nobles, high officials, or scholarly families, one must write such a case record to ensure meticulousness, thereby ensuring efficacy. Even if the illness is not cured, it avoids suspicion of erroneous medication.
Tao Hongjing said: "During the Jin Dynasty, a talented scholar wished to print the correct text of the *I Ching* (Book of Changes) and various medical prescriptions, and first discussed this with Zu Ne. Zu Ne said, 'Debating and interpreting classics, even if there are differences, does not harm social morals. However, regarding herbal decoctions, a slight misunderstanding can lead to causes of life or death, causing significant harm to future generations. How can one lightly make judgments?' Zu Ne's words demonstrate benevolent insight and serve as a worthy mirror."
The *Qu Li* states: "Do not take medicine from physicians who have not studied for three generations." Song Lian said: "Ancient physicians must be proficient in the books of the Three Generations. The so-called Three Generations refer to: first, *Huangdi Zhenjiu* (Yellow Emperor’s Acupuncture and Moxibustion); second, *Shennong Bencao* (Divine Farmer’s Materia Medica); third, *Suwen* (Basic Questions) and *Maijing* (Pulse Classic). *Maijing* is used to observe syndromes, *Bencao* to distinguish herbs, and acupuncture/moxibustion to eliminate diseases. Without these three, one cannot speak of medicine. Those transmitting the classics clearly recorded this view but also refuted its errors, yet insisted on father-to-son transmission over three generations. How confused is this! The Way of Medicine requires profound thought and acute intelligence; only then can one participate in it. Even a father cannot guarantee his son will succeed."
Shi Lizze said: "Upon examining ancient and modern times, those called divine physicians are none other than Bian Que and Cang Gong. Bian Que’s skills were learned from Changsang Jun. Cang Gong’s skills were transmitted from Gongcheng and Yang Qing. Initially, there was no mention of hereditary transmission. Figures like Li Dongyuan, Zhu Danxi, and Hua Bo Ren were all heroes who rose through their own efforts. Thus, we know that learning medicine lies in studying the books of the Three Generations, not in whether one’s grandfather transmitted it for three generations."