凡脉证不相合，必有一真一假，须细辨之。如外虽烦热，而脉见微弱者，必虚
火也。腹虽胀满，而脉见微弱者，必胃虚也。虚火虚胀，其堪攻乎？此宜从脉
之真虚，不从证之假实也。其有本无烦热，而脉见洪数者，非火邪也。本无胀
滞，而脉见弦强者，非内实也。无热无胀，其堪泻乎？此宜从证之真虚，不从脉之
假实也。如寒邪内伤，或食停气滞，而心腹急痛，以致脉道沉伏，或促或结，此以
邪闭经络而然。既有痛胀等实证可掳，则脉之虚乃假虚，当从证不从脉。又若伤寒，
四肢厥逆，寒战，而脉见数滑，此由内热格阴。何以知之？以病由传经渐致，并非
直中阴经，从无热证转寒之理，既有数滑之脉可据，则外证之虚为假虚，亦从脉不
从证也。
《内经》谓∶少阴所在，其脉不应。（谓沉细不应指也。）历验不然，此伪说也，不必为
其所惑。
岐伯曰∶前部（寸也）。外者，（外谓浮候。）足太阳也，（膀胱经脉。）内者，（沉候。）足厥阴也。（肝
经脉。）中部（关也。）外者，足阳明也，（胃经脉。）内者，足太阴也。（脾经脉。）后部（尺也。）外
者，足少阳也，（胆经脉。）内者，足少阴也。（肾经脉。）前部中央（不浮不沉为中候。）直者，（直对斜
言，观下文自明）手少阴（心经脉。）太阳也。（小肠经脉。）中部中央直者，手厥阴也。（心包络经脉。）
后部中央直者，手太阴（肺经脉。）阳明也。（大肠经脉。）
按此与《素问·脉要精微论》不同，殊无理。盖《内经》乃后人所撰，非
出一手，故互异。但此为下文奇经八脉章本，存之。
前部横于寸口丸丸者，（横如连横之横，浮中沉一体，无异也。说详下文。丸丸犹动脉，所谓如豆也。
详动脉。横于寸口丸丸者，谓寸口脉团结滑动如丸，浮中沉皆然也。）任脉也。（《脉经》则云寸口紧细实长，下至
关，为任脉。此与岐伯异，参察可也。）三部俱浮，（督脉属阳，故浮。）直上直下者，（直谓不斜，观
下文自明。）督脉也。三部俱牢，（沉实也。冲为血海，阴盛故沉实。）直上直下者，冲脉也。前
部（阳跷属阳，故候于寸）左右（两手也）弹者，（弦紧弹指。）阳跷也。后部（阴跷属阴，故候于尺）左右弹
者，阴跷也。中部（带脉居中，故候于关）左右弹者，带脉也。从足少阴（犹言尺沉分，即上文所谓后
部内为足少阴也）斜至足太阳者，（足太阳，上文属前部外，乃寸浮分也。从尺沉分上至寸浮分，与督脉三部俱浮，
冲脉三部俱沉实，皆直上直下者不同，故曰斜也。）阳维也。（属阳，故始沉终浮。）从足少阳（上文言后部外者足少
阳，乃尺浮分也）斜至足厥阴者，（上文言前部内者足厥阴，乃寸沉分也。）阴维也。（属阴，故始浮终沉。）
\r图\p01-e19a2.bmp\r
甲 寸浮候 乙 关浮候 丙 尺浮候 丁 寸中候 戊 关中候
巳 尺中候 庚 寸沉候 辛 关沉候 壬 尺沉候
\r图\p01-e19a3.bmp\r
横于寸部丸丸者，任脉也。（横于寸部甲丁庚也。借算书勾股法譬之，甲乙丙直线为股，甲丁庚横
线为勾，庚戊丙斜线为弦，任脉见寸口三部，如勾之横。）寸关尺俱浮者，督脉也。（甲乙丙也，如股
之直。）寸关尺俱沉者，冲脉也。（庚辛壬也，亦如股之直。）从足少阴斜至足太阳者，阳维也。
（即从尺沉斜至寸浮，乃壬戊甲也，如弦之斜。）从足少阳斜至足厥阴者，阴维也。（即从尺浮斜至寸沉，
乃丙戊庚也，亦如弦之斜。）
按李濒湖则以脉常行之道为中，而有时偏于外而近臂廉，有时偏于内而近臂中
筋间。为图明之。
所谓从足少阴斜至足太阳者，乃从尺内斜至寸外也。所谓从足少阳至足厥阴
者，乃从尺外至寸内也。所谓左右弹者，即内外弹也。与愚说不同，未知孰是，请质高明。
再按奇经之病，当以证诊，勿专恃脉，其病证详针灸奇经病篇。
凡是脉象与症状不相符合的情况，必定有一个是真象，一个是假象，必须仔细辨别。例如，虽然体表感觉烦热，但脉象却微弱，这一定是虚火。腹部虽然胀满，但脉象却微弱，这一定是胃气虚弱。既然是虚火和虚性的胀满，怎么可以用攻下法呢？这种情况应当依据脉象反映出的真实虚证，而不被症状表现出的虚假实证所迷惑。有的情况是本无烦热，但脉象却洪大数急，这并不是火邪；本无胀闷停滞，但脉象却弦硬有力，这也不是体内实邪。既然没有热象也没有胀满，怎么可以用泻下法呢？这种情况应当依据症状反映出的真实虚证，而不被脉象表现出的虚假实证所迷惑。如果是寒邪内伤，或者食物停滞、气机阻滞，导致心腹剧烈疼痛，致使脉道沉伏，或者出现急促或结代的脉象，这是因为邪气闭塞经络所致。既然有疼痛胀满等实证可以确证，那么脉象显示的虚象就是假虚，应当依据症状而不依据脉象。另外，若是伤寒病，四肢厥冷逆乱，寒战发抖，但脉象却见数而滑利，这是由内热格拒阴气（真热假寒）所致。怎么知道是这样呢？因为疾病是由传经逐渐发展而来，并非直中阴经，从来没有从热证转为寒证的道理，既然有数滑的脉象作为依据，那么外在表现的虚象就是假虚，也应当依据脉象而不依据症状。
《黄帝内经》说：少阴经所在的部位，其脉象不应指。（意思是脉象沉细，按之不应手。）但我历次验证发现并非如此，这是伪说，不必为此所迷惑。
岐伯说：前部（即寸口），外侧（指浮取），对应足太阳经（膀胱经脉）；内侧（指沉取），对应足厥阴经（肝经脉）。中部（即关部），外侧，对应足阳明经（胃经脉）；内侧，对应足太阴经（脾经脉）。后部（即尺部），外侧，对应足少阳经（胆经脉）；内侧，对应足少阴经（肾经脉）。前部中央（不浮不沉为中取），正中的脉，对应手少阴经（心经脉）和手太阳经（小肠经脉）。中部中央正中的脉，对应手厥阴经（心包络经脉）。后部中央正中的脉，对应手太阴经（肺经脉）和手阳明经（大肠经脉）。
按：此处所述与《素问·脉要精微论》不同，极其无理。大概《内经》是后人编纂而成，并非出自一人之手，所以内容互有差异。但这是下文论述奇经八脉章节的基础，故保留下来。
在寸口处横向搏动如豆粒滚动者，（横指连横之横，浮中沉三部一体，没有差异。详见下文。丸丸如同动脉，所谓像豆子一样跳动。详参动脉。横于寸口如丸丸滚动，是指寸口脉团结滑动如丸状，浮中沉三部都是这样。）这是任脉。（《脉经》则说寸口脉紧细实长，下至关部，为任脉。这与岐伯的说法不同，可以参考考察。）三部脉都浮，（督脉属阳，所以脉浮。）直上直下者，（直指不斜，观下文自明。）这是督脉。三部脉都牢（沉实有力），直上直下者，这是冲脉。前部（阳跷脉属阳，所以在寸部候察），左右两手弹指者，（弦紧且弹指。）这是阳跷脉。后部（阴跷脉属阴，所以在尺部候察），左右两手弹指者，这是阴跷脉。中部（带脉居中，所以在关部候察），左右两手弹指者，这是带脉。从足少阴经（犹言尺部沉分，即上文所说的后部内侧为足少阴经）斜行至足太阳经者，（足太阳经，上文属于前部外侧，乃寸部浮分。从尺部沉分上行至寸部浮分，与督脉三部俱浮、冲脉三部俱沉实且直上直下的情况不同，所以称为“斜”。）这是阳维脉。（属阳，所以起始沉终浮。）从足少阳经（上文说后部外侧为足少阳经，乃尺部浮分）斜行至足厥阴经者，（上文说前部内侧为足厥阴经，乃寸部沉分。）这是阴维脉。（属阴，所以起始浮终沉。）
[图]
甲 寸部浮取 乙 关部浮取 丙 尺部浮取 丁 寸部中取 戊 关部中取
己 尺部中取 庚 寸部沉取 辛 关部沉取 壬 尺部沉取
[图]
横于寸部如丸丸滚动者，是任脉。（横于寸部的甲、丁、庚三处。借用算术勾股定理来比喻，甲乙丙直线为股，甲丁庚横线为勾，庚戊丙斜线为弦，任脉见于寸口三部，就像勾那样横向。）寸、关、尺三部都浮者，是督脉。（即甲乙丙，像股那样直。）寸、关、尺三部都沉者，是冲脉。（即庚辛壬，也像股那样直。）从足少阴斜行至足太阳者，是阳维脉。（即从尺部沉分斜至寸部浮分，乃壬戊甲，像弦那样斜。）从足少阳斜行至足厥阴者，是阴维脉。（即从尺部浮分斜至寸部沉分，乃丙戊庚，也像弦那样斜。）
按：李濒湖认为脉常行的道路为中，有时偏向外侧靠近手臂边缘，有时偏向内侧靠近手臂中间筋间。他为此绘图说明。
所谓从足少阴斜至足太阳者，是从尺部内侧斜至寸部外侧。所谓从足少阳至足厥阴者，是从尺部外侧至寸部内侧。所谓左右弹者，即内外弹指。这与我的说法不同，不知谁是谁非，请教于高明之士。
再按：奇经的病证，应当以症状诊断为主，不要专门依赖脉象，其病证详情参见针灸奇经病篇。
Whenever the pulse and symptoms do not correspond, there must be one true aspect and one false aspect; careful differentiation is required. For instance, although there is external restlessness and heat, if the pulse appears weak and faint, it must be deficient fire (deficient heat). Although the abdomen is distended and full, if the pulse appears weak and faint, it must be stomach deficiency (deficiency of Stomach Qi). Given deficient fire and deficient distension, how can purgation be applied? In such cases, one should follow the true deficiency indicated by the pulse, rather than the false excess suggested by the symptoms. Conversely, if there is essentially no restlessness or heat, yet the pulse appears surging and rapid, it is not due to pathogenic fire. If there is essentially no distension or stagnation, yet the pulse appears wiry and strong, it is not internal excess. With no heat and no distension, how can purgation be applied? In such cases, one should follow the true deficiency indicated by the symptoms, rather than the false excess suggested by the pulse. For example, when cold pathogens injure internally, or food stagnates with qi obstruction, causing acute pain in the heart and abdomen, leading to a deep and hidden pulse, or a hurried or knotted pulse, this results from pathogenic closure of the meridians. Since there are evident excess symptoms like pain and distension, the deficiency shown by the pulse is false deficiency; one should follow the symptoms rather than the pulse. Furthermore, in cases of Cold Damage (Shanghan), where the four limbs are cold and inverted, accompanied by chills and shivering, but the pulse appears rapid and slippery, this is due to internal heat repelling yin (true heat with false cold signs). How do we know this? Because the disease develops gradually through transmission between channels, not by direct invasion into the Yin channels; there is no principle of transforming from heat syndromes to cold syndromes. Since there is evidence of a rapid and slippery pulse, the external deficiency signs are false deficiency; one should follow the pulse rather than the symptoms.
The *Neijing* states: Wherever Shaoyin is located, its pulse does not respond. (Meaning the pulse is deep and fine, not palpable upon pressing.) However, repeated verification shows this is not the case; this is a spurious theory, and one need not be confused by it.
Qibo said: The anterior part (Cun position), exterior (superficial palpation), corresponds to Foot-Taiyang (Bladder Meridian); interior (deep palpation) corresponds to Foot-Jueyin (Liver Meridian). The middle part (Guān position), exterior, corresponds to Foot-Yangming (Stomach Meridian); interior, corresponds to Foot-Taiyin (Spleen Meridian). The posterior part (Chǐ position), exterior, corresponds to Foot-Shaoyang (Gallbladder Meridian); interior, corresponds to Foot-Shaoyin (Kidney Meridian). The center of the anterior part (neutral palpation, neither superficial nor deep), the straight pulse, corresponds to Hand-Shaoyin (Heart Meridian) and Hand-Taiyang (Small Intestine Meridian). The center of the middle part, the straight pulse, corresponds to Hand-Jueyin (Pericardium Meridian). The center of the posterior part, the straight pulse, corresponds to Hand-Taiyin (Lung Meridian) and Hand-Yangming (Large Intestine Meridian).
Note: This differs from the *Suwen · Mai Yao Jing Wei Lun*, which is highly illogical. Presumably, the *Neijing* was compiled by later authors and did not originate from a single hand, hence the discrepancies. However, since this serves as the basis for the following chapter on the Eight Extraordinary Vessels, it is retained.
When the pulse at Cun transversely throbs like a rolling bean (transverse refers to horizontal movement, consistent across superficial, neutral, and deep palpation; see details below. "Wanwan" resembles the Moving Pulse, described as feeling like a bean), this indicates the Ren Mai (Conception Vessel). (*Mai Jing* states that a tight, fine, solid, and long pulse at Cun extending to Guan indicates the Ren Mai; this differs from Qibo’s description, so reference both for examination.) When all three positions (Cun, Guan, Chǐ) are floating (Du Mai belongs to Yang, hence floating), and move straight up and down (straight means not oblique; see below for clarification), this indicates the Du Mai (Governing Vessel). When all three positions are firm (deep and solid; Chong Mai is the Sea of Blood, so excessive Yin makes it deep and solid), and move straight up and down, this indicates the Chong Mai (Penetrating Vessel). At the anterior part (Yang Qiao belongs to Yang, thus palpated at Cun), if there is pulsation beating to the left and right (wiry, tight, and beating against the fingers), this indicates Yang Qiao Mai (Yang Heel Vessel). At the posterior part (Yin Qiao belongs to Yin, thus palpated at Chǐ), if there is pulsation beating to the left and right, this indicates Yin Qiao Mai (Yin Heel Vessel). At the middle part (Dai Mai is central, thus palpated at Guan), if there is pulsation beating to the left and right, this indicates Dai Mai (Girdle Vessel). From Foot-Shaoyin (referring to the deep aspect of Chǐ, i.e., the interior of the posterior part mentioned above) obliquely to Foot-Taiyang (Foot-Taiyang, mentioned above as exterior of the anterior part, i.e., the superficial aspect of Cun; moving from deep Chǐ to superficial Cun differs from the straight-up-and-down movement of Du Mai [floating in all three] and Chong Mai [firm in all three], hence termed "oblique"), this indicates Yang Wei Mai (Yang Linking Vessel). (Belongs to Yang, hence starts deep and ends superficial.) From Foot-Shaoyang (mentioned above as exterior of the posterior part, i.e., the superficial aspect of Chǐ) obliquely to Foot-Jueyin (mentioned above as interior of the anterior part, i.e., the deep aspect of Cun), this indicates Yin Wei Mai (Yin Linking Vessel). (Belongs to Yin, hence starts superficial and ends deep.)
[Figure]
A: Cun Superficial | B: Guan Superficial | C: Chǐ Superficial | D: Cun Neutral | E: Guan Neutral
F: Chǐ Neutral | G: Cun Deep | H: Guan Deep | I: Chǐ Deep
[Figure]
Transverse throbbing at Cun like a rolling bean indicates Ren Mai. (Transverse at A, D, G. Using arithmetic Pythagorean theorem analogy: line ABC is the leg/gou, line ADG is the cross/you, line GEI is the hypotenuse/xian; Ren Mai appearing in the three Cun positions is like the transverse gou.) Floating in Cun, Guan, and Chǐ indicates Du Mai. (ABC, like the straight leg.) Deep in Cun, Guan, and Chǐ indicates Chong Mai. (GHI, also like the straight leg.) Oblique from Foot-Shaoyin to Foot-Taiyang indicates Yang Wei Mai. (i.e., oblique from deep Chǐ to superficial Cun, namely I-E-A, like the oblique xian.) Oblique from Foot-Shaoyang to Foot-Jueyin indicates Yin Wei Mai. (i.e., oblique from superficial Chǐ to deep Cun, namely C-E-G, also like the oblique xian.)
Note: Li Binhu considered the normal course of the pulse as central, sometimes deviating outward near the arm's edge, and sometimes inward near the tendon between the arm's bones. He illustrated this with diagrams.
He stated that "oblique from Foot-Shaoyin to Foot-Taiyang" means from the inner Chǐ to the outer Cun. "From Foot-Shaoyang to Foot-Jueyin" means from the outer Chǐ to the inner Cun. "Beating left and right" means beating internally and externally. This differs from my explanation; I do not know who is correct, and I submit this for discussion with experts.
Furthermore, regarding diseases of the extraordinary vessels, diagnosis should rely primarily on symptoms, not solely on pulse taking. Details of these syndromes are provided in the section on Acupuncture Diseases of the Extraordinary Vessels.