距，言坚锐不柔也。屋漏，点滴无伦也。水流，去而不返也。是皆脾气绝而怪脉见，亦但代无胃之义，故曰“
脾死”。距，权舆切，鸡足钩距也。）平肾脉来，喘喘累累如钩，按之而坚，曰肾平。（冬脉沉石，故
按之而坚。若过于石，则沉伏不振矣。故必喘喘累累，如心之钩，阴中藏阳而得微石之义，是为肾之平脉。）
冬以胃气为本，（石而和也。）病肾脉来，如引葛，按之益坚，曰肾病；（脉如引葛，坚搏牵连也。按
之益坚，石甚不和也。亦石多胃少之义，故曰“肾病”。）死肾脉来，发如夺索，辟辟如弹石，曰肾死。
（索如相夺，其劲必甚。辟辟如弹石，其坚必甚。即但石无胃之义，故曰“肾死”。）太阳脉至，洪大以
长；（此言人之脉气，必随天地阴阳之化而为之卷舒也。太阳之气王于谷雨后六十日，是时阳气太盛，故
其脉洪大而长也。）少阳脉至，乍数乍疏，乍短乍长；（少阳之气王于冬至后六十日，是时阳气尚微，阴气未
退，故长数为阳，疏短为阴而进退未定也。）阳明脉至，浮大而短。（阳明之气王于雨水后六十日，是时阳气
未盛，阴气尚存，故脉浮大而仍兼短也。此但言三阳而不及三阴，因《难经》有“太阴之至，紧大而长；少阴
之至，紧细而微；厥阴之至，沉短而敦”，则固已补其缺略矣。）太阳脏独至，厥喘，虚气逆，是阴不足阳有
余也，表里当俱泻，取之下俞；（此言脏气不和而有一脏太过者，气必独至，诸证不同，针治亦
异也。太阳者，膀胱经也。太阳独至，则为厥逆，为喘气，为虚气冲逆于上。盖膀胱与肾为表里，皆水
脏也。以水脏而阳气独至，则阳有余、阴不足矣，当于二经取其下俞。膀胱下俞名束骨，肾经之俞名太溪。
肾阴不足而亦泻之，以阳邪俱盛也，故必表里兼泻，而后可遏其势。）阳明脏独至，是阳气重并也，当
泻阳补阴，取之下俞；（阳明者，足阳明胃经也。阳明为十二经脉之海而行气于三阳，若其独至，则阳气因
邪而重并于本脏，故当泻胃之阳，补脾之阴而取之下俞也。阳明之俞名陷谷，太阴之俞名太白。）
少阳脏独至，是厥气也，跷前卒大，取之下俞。
（少阳者，足少阳胆经也。胆经之病连于肝，其气善逆，故少阳独至者是厥气也。然厥气必始于足下，故于跷
前察之。跷，阳跷也，属足太阳经之申脉。阳跷之前，乃少阳之经，少阳气盛则跷前卒大，故当取少阳
之下俞穴名临泣。卒、猝同。跷有五音，跷、皎、乔、脚，又极虐切。）少阳独至者，一阳之过也。（此
释独至之义为一脏之太过。举少阳而言，则太阳、阳明之独至者，其为三阳、二阳之太过可知矣。一阳，
少阳也。）太阴脏搏者，用心省真，五脉气少，胃气不平，三阴也，宜治其下俞，补阳泻阴。（太阴者，
足太阴脾经也。搏，坚强之谓，即所谓伏鼓也。太阴脾脉，本贵和缓，今见鼓搏，类乎真脏。若真脏果见，
不可治也，故当用心省察其真。今太阴脏搏，即太阴之独至；太阴独至，则五脏之脉气俱少而胃气亦不
平矣，是为三阴之太过也；故宜治其下俞，补足阳明之陷谷，泻足太阴之太白。）二阴独啸，少阴厥也，
阳并于上，四脉争张，气归于肾，宜治其经络，泻阳补阴。（二阴者，足少阴肾经也。独啸，独炽之谓，
盖啸为阳气所发，阳出阴中，相火上炎，则为少阴热厥，而阳并于上，故心、肝、脾、肺四脉为之争张，而
其气则归于肾。故曰“独啸”，宜治其表里之经络而泻足太阳，补足少阴也。太阳经穴名昆仑，络穴名飞
扬，少阴经穴名复溜，络穴名大钟。）一阴至，厥阴之治也，真虚 心，厥气留薄，发为白汗，调食和药，
治在下俞。（一阴者，足厥阴肝经也。至，即独至之义。治，主也。肝邪独至，真气必虚，木火相干，故
心为 痛。厥气，逆气也。逆气不散，则留薄于经；气虚不固，则表为白汗；调和药食，欲其得宜；用针
治之，乃在下俞。厥阴之俞，名曰太冲。按调食和药，不独一经为然，古经多略，当会其意。
，音渊，酸疼也。）太阳脏象三阳而浮也；少阳脏象一阳也，一阳脏者，滑而不实也；阳明脏象大浮也。
（太阳之象三阳者，阳行于表，阳之极也，故脉浮于外。少阳之象一阳者，少阳为阳之里，阴
之表，所谓半表半里，阳之微也，故虽滑不实。阳明虽太阳之里，而实少
阳之表，比之滑而不实者，则大而浮矣。仲景曰∶尺寸俱浮者，太阳受病也；尺寸俱长者，阳明受病也；尺
寸俱弦者，少阳受病也。）太阴脏搏，言伏鼓也。（伏鼓者，沉伏而鼓击，即坚搏之谓。仲景曰∶尺寸俱沉细
者，太阴受病也。）二阴搏至，肾沉不浮也。（二阴，少阴肾经也。二阴搏而独至者，言肾但沉而不浮也。
仲景曰∶尺寸俱沉者，少阴受病也；尺寸俱微缓者，厥阴受病也。）欲知寸口太过与不及，寸口之脉，
中手短者，曰头痛；（寸口，气口也。短为阳不及，阳不及则阴凑之，故头痛。短者，短于下也。脉短于下，
则邪并于上，故头痛。中，去声。）寸口脉中手长者，曰足胫痛；（长为阴不足，阴不足则阳凑之，故足
胫痛。）寸口脉中手促上击者，曰肩背痛；（脉来急促而上部击手者，阳邪盛于上也，故为肩背痛。）
寸口脉沉而坚者，曰病在中；（沉为在里，坚为阴实，故病在中。）寸口脉浮而盛者，曰病在外；（浮为在
表，盛为阳强，故病在外。）寸口脉沉而弱，曰寒热及疝瘕，少腹痛；（沉为阳虚，弱为阴虚，阳虚则外寒，
阴虚则内热，故为寒热也。然沉弱之脉，多阴少阳，阴寒在下，故为疝为瘕，为少腹痛。瘕，积聚也。）
寸口脉沉而横，曰胁下有积，腹中有横积痛；（横，急数也。沉主在内，横主有积，故胁腹有积而痛。仲
景曰∶积者，脏病也，终不移；聚者，腑病也，发作有时，展转痛移，为可治。诸积大法，脉来细而附骨
者，乃积也∶寸口，积在胸中；微出寸口，积在喉中；关上，积在脐旁；上关上，积在心下；微下关，积
在少腹；尺中，积在气冲；脉出左，积在左；脉出右，积在右；脉两出，积在中央，各以其部处之。）
寸口脉沉而喘，曰寒热。（喘，急促也。脉沉而喘，热在内也。热在内而为寒热，即“诸禁鼓栗，皆属于火”
之谓。）脉盛滑坚者，曰病在外；（阳脉而坚，故病在外。）脉小实而坚者，病在内。（阴脉而坚，故病在内。）
脉小弱以涩，谓之久病；（小弱者气虚，涩者血少，气虚血少，久病而然。）脉滑浮而疾者，谓之新病。（
滑而浮者，脉之阳也。阳脉而疾，邪之
盛也。邪盛势张，是为新病。）脉急者，曰疝瘕少腹痛，（弦急者，阴邪盛，故为疝瘕少腹病。）脉滑曰风，
（滑脉流利，阳也，风性动，亦阳也，故脉滑曰风。）脉涩曰痹，（涩为阴脉，血不足也，故当病痹。）缓而
滑曰热中，（缓因胃热，滑以强阳，故病热中。夫缓为纵缓之状，非动之迟缓也。）盛而紧曰胀，（盛则中气滞，
紧则邪有余，故为胀也。）臂多青脉曰脱血，（血脱则气去，气去则寒疑，疑泣则青黑，故臂见青色。言臂
则他可知矣。）尺脉缓涩，谓之解 ，（尺主阴分，缓为气衰，涩为血少，故当病解 。解 者，困倦难状
之名也。）安卧脉盛，谓之脱血，（凡脉盛者邪必盛，邪盛者卧必不安。今脉盛而卧安，知非气分阳邪，而为
阴虚脱血也。此亦承尺脉而言，凡尺脉盛者多阴虚，故当脱血。）尺涩脉滑，谓之多汗，（谓尺肤涩而尺脉
滑也。尺肤涩者，营血少也；尺脉滑者，阴火盛也。阳盛阴虚，故为多汗。）尺寒脉细，谓之后泄，（尺肤
寒者，脾之阳衰，以脾主肌肉四肢也。尺脉细者，肾之阳衰，以肾主二阴下部也。脾肾虚寒，故为后泄。）
脉尺粗常热者，谓之热中。（尺粗为真阴不足，常热为阴火有余，故谓之热中也。）见其色，知其病，命曰
明；按其脉，知其病，命曰神；问其病，知其处，命曰工。（见色者，望其容貌之五色也；按脉者，切其寸
口之阴阳也；问病者，问其所病之缘由也。知是三者，则曰明、曰神、曰工而诊法尽矣。）夫色脉与
尺之相应也，如桴鼓影响之相应也，不得相失也，此亦本末根叶之出候也，故根死则叶枯矣，色脉形肉不得相
失也，故知一则为工，知二则为神，知三则神且明矣。（此言色、脉、形、肉，皆当详察。在色可望，在脉
可按，其于形肉，则当验于尺之皮肤。盖以尺之皮肤，诊时必见，验于此而形肉之盛衰概可知矣。夫有诸中
必形诸外，故色之与脉，脉之与形肉，亦犹桴鼓影响之相应，本末根叶之候不相失也。三者皆当参合，故知
三则神且明矣。桴，击鼓槌也。桴，孚、浮二音。）色青者其脉弦也，赤者其脉钩也，黄者其脉代也，白者
其脉毛，黑者其脉石。见其色而不得其脉，反得其相胜之脉，则死矣；得其相生之脉，则病已矣。（不得其脉，
言不得其合色之正脉也。相胜之脉，如青色得毛脉，以金克木之类是也。相生之脉，如青色得石脉，以水
生木之类是也。）五脏之所生，变化之病形，先定其五色、五脉之应，其病乃可别也。色、脉已定，调其脉之
缓、急、大、小、滑、涩，而病变定矣。（缓、急以至数言，小、大、滑、涩以形体言。滑，不涩也，往来
流利，如盘走珠；涩，不滑也，虚细而迟，往来觉难，如雨沾沙，如刀刮竹。六者相为对待，调此六者，
则病变可以定矣。此以缓、急、大、小、滑、涩而定病变，总诸脉之纲领也。后世诸医论疾微有不同者，又
当参互，然必宗越人、仲景为主。夫浮为阳为表，诊为风为虚；沉为阴为里，诊为湿为实；迟为在脏，为寒为
冷；数为在腑，为热为燥；滑为血有余，涩为气独滞，似亦得矣。殊不知其浮为在表，则散、大而芤可类也；
沉而在里，则细、小而伏可类也；迟者为寒，则徐，缓、涩、结之属可类也；数者为热，则洪、滑、疾、促之
属可类也；虚者为不足，则短、濡、微、弱之属可类也；实者为有余，则弦、紧、动、革之属可类也。此其
大概，人所易知者。即此六者之中，复有大相悬绝之要，则人多不能识也。夫浮为表矣，而凡阴虚者脉必浮
而无力，是浮不可以概言表，可升散乎？沉为里矣，而凡表邪初感之甚者，阴寒束于皮毛，阳气不能外达，则
脉必先见沉紧，是沉不可以概言里，可攻内乎？迟为寒矣，而伤寒初退，余热未清，脉多迟滑，是迟不可以
概言寒，可温中乎？数为热矣，而凡虚损之候阴阳俱亏，气血败乱者，脉必急数，愈数者愈虚，愈虚者愈数，
是数不可以概言热，可寒凉乎？微、细类虚矣，而痛极壅闭者脉多伏匿，是伏不可以概言虚，可骤补乎？洪、
弦类实矣，而真阴大亏者必关格倍常，是强不可以概言实，可消伐乎？夫如是者，于纲领之中，复有大纲
领者存焉。设不能以四诊相参，而欲孟浪任意，则未有不覆人于反掌间者，此脉道之所以难言，毫厘不可不辨
也。）脉急
者尺之皮肤亦急，脉缓者尺之皮肤亦缓，脉小者尺之皮肤亦减而少气，脉大者尺之皮肤亦贲而起，脉滑者尺
之皮肤亦滑，脉涩者尺之皮肤亦涩。凡此变者，有微有甚，故善调尺者不待于寸，善调脉者不待于色，能参
合而行之者，可以为上工，上工十全九，行二者为中工，中工十全七，行一者为下工，下工十全六。（此正
本末根叶之义也。以尺寸言，则尺为根本，寸为枝叶；以脉色言，脉为根本，色为枝叶。故善调尺者不待乎
寸，善调脉者不待于色也。然必能兼合三者而参行之，更为本末皆得而万无一失，斯足称为上工，而十可全
其九；若知二知一者，不过中下之材，故所全者亦惟六七而已。）调其尺，言其病，从外知内，审其尺之缓、
急、大、小、滑、涩，肉之坚、脆，而病形定矣。（寸口之脉，由尺达寸，故但诊尺部之脉，其内可知。通
身形体，难以尽见，然肉之盛衰，必形于腕后，故但察尺部之肉，其外可知。是以独调其尺而病形定矣。）
视人之目窠上微痈，如新卧起伏，其颈脉动，时咳，按其手足上， 而不起者，风水肤胀也。（目窠，目下卧
蚕处也。痈，壅也，即新起微肿状。颈脉，人迎脉也。 而不起，按之有窝也。是即风水肤胀之外候。
窠，间科。痈，去声。 ，音夭。）尺肤滑，其淖泽者，风也。（阳受风气，故病风者尺肤滑而淖泽也。）
尺肉弱者，解 安卧；脱肉者，寒热不治。（尺肉弱者，肌必消瘦。肉瘦阴虚，当为解 。解 者，身
体困倦，故欲安卧。无邪而脱肉寒热者，真阴败也，故不治。）尺肤滑而泽脂者，风也。（泽脂，即前淖
泽之谓。风者阳气，阳在肌肤，故滑而泽脂。）尺肤涩者，风痹也。（尺肤涩者血少，血不能营，
故为风痹。）尺肤粗如枯鱼之鳞者，水 饮也。（如枯鱼之鳞，干涩甚也。以脾土衰而肌肉消，水得乘之，
是为 饮。 、溢同。）尺肤热甚，脉盛躁者，病温也，其脉盛而滑者，病且出也。（尺肤热者，其
距离，是指脉象坚硬锐利而不柔和。屋漏，是指脉搏点滴落下、毫无规律。水流，是指脉搏去而不返。这些都是脾气断绝而怪脉出现的表现，也仅仅是代脉没有胃气的含义，所以说“脾死”。（距，读音为权舆切，指鸡脚上的钩距。）
平肾脉的来势，急促连续如钩状，重按感觉坚实，这叫做肾平。（冬季脉象本应沉石，所以重按时感觉坚实。如果过于像石头一样，就会沉伏而没有生机。因此必须急促连续，像心脏脉象那样带钩意，在阴中蕴含阳气并得到微石的含义，这才是肾的平脉。）
冬季以胃气为本底。（即石脉但和缓。）病肾脉的来势，像牵引葛藤一样，越按越坚硬，这叫做肾病；（脉象像牵引葛藤，坚硬搏动且牵连不断。越按越坚硬，说明石脉太过且不和谐。这也是石多胃少的含义，所以说“肾病”。）死肾脉的来势，像争夺绳索一样劲急，或者像弹击石头一样辟辟作响，这叫做肾死。（绳索像互相争夺，其劲急必然很严重。像弹击石头一样，其坚硬必然很严重。这就是只有石脉而没有胃气的含义，所以说“肾死”。）
太阳脉至，洪大而且长；（这是说人的脉气，必然随着天地阴阳的变化而卷舒。太阳之气旺于谷雨后的六十天，这时阳气太盛，所以其脉洪大而长。）少阳脉至，忽快忽慢，忽短忽长；（少阳之气旺于冬至后的六十天，这时阳气尚微弱，阴气未退，所以长数为阳，疏短为阴，进退未定。）阳明脉至，浮大而且短。（阳明之气旺于雨水后的六十天，这时阳气未盛，阴气尚存，所以脉浮大但仍兼有短象。这里只说了三阳脉而没有提三阴脉，因为《难经》中有“太阴之至，紧大而长；少阴之至，紧细而微；厥阴之至，沉短而敦”，这就已经补足了缺略。）
太阳脏独至（单独亢盛），出现厥逆喘息，虚气上逆，这是阴不足而阳有余，表里应当都泻，取用下俞穴；（这是说脏气不和而有一脏太过，气必然独至，各种证候不同，针治也不同。太阳者，是膀胱经。太阳独至，就会出现厥逆、喘气、虚气冲逆于上。因为膀胱与肾互为表里，都是水脏。既然是水脏却阳气独至，那就是阳有余、阴不足了，应当在两经取用下俞穴。膀胱的下俞名叫束骨，肾经的俞穴名叫太溪。肾阴不足也要泻它，因为阳邪俱盛，所以必须表里兼泻，然后才能遏制病势。）
阳明脏独至，这是阳气重并（重叠合并），应当泻阳补阴，取用下俞穴；（阳明者，是足阳明胃经。阳明是十二经脉的海，运行气于三阳，如果它独至，那么阳气就会因邪气而重并于本脏，所以应当泻胃之阳，补脾之阴，并取用下俞穴。阳明的俞穴名叫陷谷，太阴的俞穴名叫太白。）
少阳脏独至，这是厥气，阳跷脉前突然变大，取用下俞穴。（少阳者，是足少阳胆经。胆经的病连及肝脏，其气善于上逆，所以少阳独至的是厥气。然而厥气必然始于足下，所以在跷脉前察视。跷，指阳跷，属于足太阳经的申脉穴。阳跷之前，乃是少阳经所在，少阳气盛则跷前突然变大，所以应当取少阳的下俞穴名叫临泣。卒、猝同义。跷有五音：跷、皎、乔、脚，又读极虐切。）
少阳独至，是一阳的过错。（这是解释独至的含义为一脏的太过。举少阳来说，那么太阳、阳明的独至，就是三阳、二阳的太过可知了。一阳，指少阳。）
太阴脏搏（搏击有力），要用心省察真脏脉，五脉气少，胃气不平，这是三阴（太阴）的问题，适宜治其下俞穴，补阳泻阴。（太阴者，是足太阴脾经。搏，指坚强之意，就是所谓的伏鼓。太阴脾脉，本来贵在和缓，现在见到鼓搏，类似真脏脉。如果真是真脏脉见，就不可治了，所以应当用心省察其是否是真脏脉。现在太阴脏搏，就是太阴的独至；太阴独至，那么五脏的脉气都少而胃气也不平了，这是三阴的太过；所以适宜治其下俞穴，补足阳明之陷谷，泻足太阴之太白。）
二阴独啸（独炽），是少阴厥气，阳气并于上部，四脉争张，气归于肾，适宜治其经络，泻阳补阴。（二阴者，是足少阴肾经。独啸，指独炽的意思，因为啸是阳气所发，阳出于阴中，相火上炎，就成为少阴热厥，而阳气并于上，所以心、肝、脾、肺四脉为之争张，而其气则归于肾。所以说“独啸”，适宜治其表里的经络而泻足太阳，补足少阴。太阳经穴名叫昆仑，络穴名叫飞扬，少阴经穴名叫复溜，络穴名叫大钟。）
一阴至，是厥阴的主治，真气虚心痛，厥气留滞薄结，发为白汗，调和饮食药物，治在下俞。（一阴者，是足厥阴肝经。至，即独至的意思。治，主的意思。肝邪独至，真气必虚，木火相干，所以心痛。厥气，逆气。逆气不散，就留滞薄结于经脉；气虚不固，体表就出白汗；调和药食，想要得其适宜；用针治疗，就在下俞。厥阴的俞穴，名叫太冲。按：调食和药，不仅仅是一经如此，古经大多简略，应当领会其意。 ，音渊，酸疼。）
太阳脏象现三阳之象而浮；少阳脏象现一阳之象，一阳脏者，滑而不实；阳明脏象现大浮。（太阳之象现三阳，是因为阳行于表，是阳之极，所以脉浮于外。少阳之象现一阳，是因为少阳为阳之里，阴之表，所谓半表半里，是阳之微，所以虽然滑但不实。阳明虽然是太阳之里，但却是少阳之表，比起滑而不实的，就显得大而浮了。仲景说：尺寸俱浮者，太阳受病；尺寸俱长者，阳明受病；尺寸俱弦者，少阳受病。）
太阴脏搏，说的是伏鼓。（伏鼓，指沉伏而鼓击，就是坚搏的意思。仲景说：尺寸俱沉细者，太阴受病。）
二阴搏至，是肾脉沉而不浮。（二阴，指少阴肾经。二阴搏而独至，是说肾但沉而不浮。仲景说：尺寸俱沉者，少阴受病；尺寸俱微缓者，厥阴受病。）
想知道寸口脉太过与不及，寸口的脉，按之感觉短的，叫做头痛；（寸口，就是气口。短为阳不及，阳不及则阴凑合它，所以头痛。短，是短于下部。脉短于下部，则邪气并于上部，所以头痛。中，读去声。）
寸口脉按之感觉长的，叫做足胫痛；（长为阴不足，阴不足则阳凑合它，所以足胫痛。）
寸口脉按之急促而上部击手的，叫做肩背痛；（脉来急促而上部击手，是阳邪盛于上，所以为肩背痛。）
寸口脉沉而坚的，叫做病在中（体内）；（沉为在里，坚为阴实，所以病在中。）
寸口脉浮而盛的，叫做病在外（体表）；（浮为在表，盛为阳强，所以病在外。）
寸口脉沉而弱的，叫做寒热及疝瘕，少腹痛；（沉为阳虚，弱为阴虚，阳虚则外寒，阴虚则内热，所以为寒热。然而沉弱的脉，多阴少阳，阴寒在下，所以为疝为瘕，为少腹痛。瘕，是积聚。）
寸口脉沉而横的，叫做胁下有积，腹中有横积痛；（横，指急数。沉主在内，横主有积，所以胁腹有积而痛。仲景说：积者，是脏病，终不移；聚者，是腑病，发作有时，辗转痛移，是可以治的。诸积的大法，脉来细而附骨的，乃是积：寸口，积在胸中；微出寸口，积在喉中；关上，积在脐旁；上关上，积在心下；微下关，积在少腹；尺中，积在气冲；脉出左，积在左；脉出右，积在右；脉两出，积在中央，各以其部位处之。）
寸口脉沉而喘（急促）的，叫做寒热。（喘，急促。脉沉而喘，热在内。热在内而为寒热，就是“诸禁鼓栗，皆属于火”的意思。）
脉小弱以涩的，谓之久病；（小弱是气虚，涩是血少，气虚血少，是久病的表现。）
脉滑浮而疾的，谓之新病。（滑而浮，是脉之阳。阳脉而疾，是邪之盛。邪盛势张，是新病。）
脉急的，叫做疝瘕少腹痛，（弦急是阴邪盛，所以为疝瘕少腹病。）
脉滑的叫风，（滑脉流利，属阳，风性动，也属阳，所以脉滑叫风。）
缓而滑的叫热中，（缓因胃热，滑以强阳，所以病热中。夫缓是纵缓之状，不是动之迟缓。）
臂多青脉的叫脱血，（血脱则气去，气去则寒凝，凝泣则青黑，所以臂见青色。说臂则其他可知。）
尺脉缓涩的，谓之解 （懈怠困倦），（尺主阴分，缓为气衰，涩为血少，所以当病解 。解 者，是困倦难状的名字。）
安卧而脉盛的，谓之脱血，（凡脉盛者邪必盛，邪盛者卧必不安。现在脉盛而卧安，知道不是气分阳邪，而是阴虚脱血。这也是承接尺脉而言，凡尺脉盛者多阴虚，所以当脱血。）
尺涩脉滑的，谓之多汗，（谓尺肤涩而尺脉滑。尺肤涩，是营血少；尺脉滑，是阴火盛。阳盛阴虚，所以为多汗。）
尺寒脉细的，谓之泄泻，（尺肤寒，是脾之阳衰，因为脾主肌肉四肢。尺脉细，是肾之阳衰，因为肾主二阴下部。脾肾虚寒，所以为泄泻。）
脉尺粗常热的，谓之热中。（尺粗为真阴不足，常热为阴火有余，所以叫热中。）
见其色，知其病，叫做明；按其脉，知其病，叫做神；问其病，知其处，叫做工。（见色者，望其容貌的五色；按脉者，切其寸口的阴阳；问病者，问其所病的缘由。知这三者，就叫做明、叫做神、叫做工，而诊法穷尽了。）
夫色脉与尺之相应，就像桴鼓影响一样相应，不能相失，这也是本末根叶的表现，所以根死则叶枯。色脉形肉不得相失，所以知一者为工，知二者为神，知三者则神且明了。（这是说色、脉、形、肉，都应当详察。在色可望，在脉可按，其于形肉，则应当验于尺的皮肤。因为尺的皮肤，诊时必见，验于此而形肉的盛衰概可知矣。夫有诸中必形诸外，所以色与脉，脉与形肉，也像桴鼓影响一样相应，本末根叶的征候不相失。三者都应当参合，所以知三则神且明了。桴，击鼓槌。桴，读孚、浮二音。）
色青的其脉弦，赤的其脉钩，黄的其脉代，白的其脉毛，黑的其脉石。见其色而不得其脉，反得其相胜之脉，则死；得其相生之脉，则病已。（不得其脉，指不得其合色的正脉。相胜之脉，如青色得毛脉，以金克木之类是。相生之脉，如青色得石脉，以水生木之类是。）
五脏所生，变化之病形，先定其五色、五脉之应，其病乃可别。色、脉已定，调其脉之缓、急、大、小、滑、涩，而病变定矣。（缓、急以至数言，小、大、滑、涩以形体言。滑，不涩，往来流利，如盘走珠；涩，不滑，虚细而迟，往来觉难，如雨沾沙，如刀刮竹。六者相为对待，调此六者，则病变可以定。此以缓、急、大、小、滑、涩而定病变，总诸脉之纲领。后世诸医论疾微有不同，又当参互，然必宗越人、仲景为主。夫浮为阳为表，诊为风为虚；沉为阴为里，诊为湿为实；迟为在脏，为寒为冷；数为在腑，为热为燥；滑为血有余，涩为气独滞，似亦得。殊不知其浮为在表，则散、大而芤可类；沉而在里，则细、小而伏可类；迟者为寒，则徐、缓、涩、结之属可类；数者为热，则洪、滑、疾、促之属可类；虚者为不足，则短、濡、微、弱之属可类；实者为有余，则弦、紧、动、革之属可类。此其大概，人所易知。即此六者之中，复有大相悬绝之要，则人多不能识。夫浮为表矣，而凡阴虚者脉必浮而无力，是浮不可以概言表，可升散乎？沉为里矣，而凡表邪初感之甚者，阴寒束于皮毛，阳气不能外达，则脉必先见沉紧，是沉不可以概言里，可攻内乎？迟为寒矣，而伤寒初退，余热未清，脉多迟滑，是迟不可以概言寒，可温中乎？数为热矣，而凡虚损之候阴阳俱亏，气血败乱者，脉必急数，愈数者愈虚，愈虚者愈数，是数不可以概言热，可寒凉乎？微、细类虚矣，而痛极壅闭者脉多伏匿，是伏不可以概言虚，可骤补乎？洪、弦类实矣，而真阴大亏者必关格倍常，是强不可以概言实，可消伐乎？夫如是者，于纲领之中，复有大纲领者存焉。设不能以四诊相参，而欲孟浪任意，则未有不覆人于反掌间者，此脉道之所以难言，毫厘不可不辨也。）
脉急者尺之皮肤亦急，脉缓者尺之皮肤亦缓，脉小者尺之皮肤亦减而少气，脉大者尺之皮肤亦贲而起，脉滑者尺之皮肤亦滑，脉涩者尺之皮肤亦涩。凡此变者，有微有甚，故善调尺者不待于寸，善调脉者不待于色，能参合而行之者，可以为上工，上工十全九，行二者为中工，中工十全七，行一者为下工，下工十全六。（这是正本末根叶的意义。以尺寸言，则尺为根本，寸为枝叶；以脉色言，脉为根本，色为枝叶。所以善调尺者不待乎寸，善调脉者不待于色。然必能兼合三者而参行之，更为本末皆得而万无一失，斯足称为上工，而十可全其九；若知二知一者，不过中下之材，故所全者亦惟六七而已。）
调其尺，言其病，从外知内，审其尺之缓、急、大、小、滑、涩，肉之坚、脆，而病形定矣。（寸口之脉，由尺达寸，所以但诊尺部之脉，其内可知。通身形体，难以尽见，然肉之盛衰，必形于腕后，所以但察尺部之肉，其外可知。是以独调其尺而病形定。）
视人之目窠上微痈（微肿），如新卧起伏，其颈脉动，时咳，按其手足上，凹陷而不起的，是风水肤胀。（目窠，目下卧蚕处。痈，壅，即新起微肿状。颈脉，人迎脉。凹陷而不起，按之有窝。是即风水肤胀之外候。窠，间科。痈，去声。 ，音夭。）
尺肤滑，其淖泽（润泽）的，是风。（阳受风气，所以病风者尺肤滑而淖泽。）
尺肉弱的，解 安卧；脱肉的，寒热不治。（尺肉弱，肌必消瘦。肉瘦阴虚，当为解 。解 者，身体困倦，故欲安卧。无邪而脱肉寒热，是真阴败，所以不治。）
尺肤滑而泽脂的，是风。（泽脂，即前淖泽之意。风者阳气，阳在肌肤，所以滑而泽脂。）
尺肤粗如枯鱼之鳞的，是水 饮（水饮）。（如枯鱼之鳞，干涩甚。以脾土衰而肌肉消，水得乘之，是为 饮。 、溢同。）
尺肤热甚，脉盛躁的，病温，其脉盛而滑的，病将出。（尺肤热，其...）
Ju (Distance), refers to a pulse that is hard, sharp, and not flexible. Wulou (House Leak), refers to a pulse that drops drop by drop without rhythm. Shuili (Water Flow), refers to a pulse that departs and does not return. These are all manifestations of the strangeness pulses appearing due to the exhaustion of Spleen Qi, representing only the meaning of Dai Pulse (Intermittent Pulse) lacking Stomach Qi; therefore, it is said "Spleen Death". (Ju, pronounced as Quanyu, refers to the spur on a chicken's foot.)
The Ping Kidney Pulse (Normal Kidney Pulse) comes with a rapid, continuous rhythm like a hook, and feels firm upon deep pressure; this is called Kidney Ping. (Winter pulses should be sunken and stone-like, hence feeling firm upon deep pressure. If it is too stone-like, it becomes sunken and stagnant without vitality. Therefore, it must be rapid and continuous, resembling the Heart's hook-like quality, harboring Yang within Yin and obtaining the meaning of slight stone-ness; this is the Normal Kidney Pulse.)
Winter is based on Stomach Qi. (i.e., Stone pulse but harmonious). The Bing Kidney Pulse (Diseased Kidney Pulse) comes like pulling a vine, becoming harder upon pressure; this is called Kidney Disease. (The pulse resembles pulling a vine, firm and pulsating with connection. Becoming harder upon pressure indicates excessive Stone-ness and disharmony. This also signifies more Stone than Stomach Qi, hence "Kidney Disease.") The Si Kidney Pulse (Dead Kidney Pulse) comes like ropes being pulled in contention, or crackling like stones being struck; this is called Kidney Death. (If ropes contend, their tension must be severe. Crackling like stones indicates extreme hardness. This represents having only Stone pulse without Stomach Qi, hence "Kidney Death".)
When Taiyang Pulse arrives, it is surging, large, and long. (This speaks of human pulse Qi rolling and expanding according to the changes of Heaven and Earth Yin-Yang. Taiyang Qi dominates for sixty days after Guyu (Grain Rain); at this time, Yang Qi is excessive, so its pulse is surging, large, and long.) When Shaoyang Pulse arrives, it is suddenly rapid and suddenly slow, suddenly short and suddenly long. (Shaoyang Qi dominates for sixty days after Dongzhi (Winter Solstice); at this time, Yang Qi is still weak, and Yin Qi has not retreated, so length and rapidity represent Yang, while sparsity and shortness represent Yin, indicating indecision in advance and retreat.) When Yangming Pulse arrives, it is floating, large, and short. (Yangming Qi dominates for sixty days after Yushui (Rain Water); at this time, Yang Qi is not yet strong, and Yin Qi still exists, so the pulse is floating and large but still accompanied by shortness. Here, only the Three Yang pulses are mentioned without the Three Yin pulses, because Nan Jing states: "Taiyin arrival is tight, large, and long; Shaoyin arrival is tight, fine, and minute; Jueyin arrival is sunken, short, and solid," which already supplements this omission.)
When Taiyang Zang (Organ) alone arrives (hyperactivity), there is Jue Ni (Reversal Cold/Convulsion), panting, and reverse flow of empty Qi; this indicates Yin deficiency and Yang excess. Both Exterior and Interior should be drained, selecting the Lower-Shu points. (This speaks of Zang Qi disharmony where one Zang is excessive; Qi necessarily arrives alone, presenting different symptoms requiring different acupuncture treatments. Taiyang refers to the Bladder Meridian. Taiyang arriving alone causes Jue Ni, panting, and reverse flow of empty Qi upwards. Since Bladder and Kidney are Exterior-Interior pairs and both are Water Zang, if Water Zang has exclusive Yang arrival, it means Yang excess and Yin deficiency. One should select the Lower-Shu points of both meridians. The Lower-Shu of Bladder is named Shugu (BL65), and the Shu point of Kidney is named Taixi (KI3). Even though Kidney Yin is deficient, it is also drained because Yang pathogens are abundant; thus, simultaneous draining of Exterior and Interior is necessary to curb the momentum.)
When Yangming Zang alone arrives, it is Heavy Combination of Yang Qi. One should drain Yang and tonify Yin, selecting the Lower-Shu points. (Yangming refers to the Foot-Yangming Stomach Meridian. Yangming is the Sea of the Twelve Meridians and circulates Qi among the Three Yangs. If it arrives alone, Yang Qi heavily combines with the Zang due to pathogens; thus, one should drain Stomach Yang, tonify Spleen Yin, and select the Lower-Shu points. The Lower-Shu of Yangming is named Xangu (ST41), and the Shu point of Taiyin is named Taibai (SP3).)
When Shaoyang Zang alone arrives, it is Jue Qi (Reversal Qi). The front of the Qiao vessel suddenly becomes large; select the Lower-Shu point. (Shaoyang refers to the Foot-Shaoyang Gallbladder Meridian. Gallbladder disease connects to the Liver; its Qi tends to reverse. Thus, Shaoyang arriving alone is Jue Qi. However, Jue Qi must start from below the feet; therefore, observe the front of the Qiao vessel. Qiao refers to Yang Qiao, belonging to Shenmai (BL62) of the Foot-Taiyang Meridian. The area anterior to Yang Qiao is where the Shaoyang Meridian lies. When Shaoyang Qi is abundant, the front of Qiao suddenly enlarges; thus, one should select the Lower-Shu point of Shaoyang, named Linqi (GB41). Zu and Cu are synonymous. Qiao has five pronunciations: Qiao, Jiao, Qiao, Jiao, and also reads Ji Nüe Qie.)
Shaoyang arriving alone is the fault of One Yang. (This explains the meaning of "arriving alone" as the excess of one Zang. Taking Shaoyang as an example, the arriving alone of Taiyang and Yangming implies the excess of Three Yang and Two Yang respectively. One Yang refers to Shaoyang.)
When Taiyain Zang Bo (Pulsates strongly), one must carefully examine the True Zang pulse. The Qi of the Five Pulses is scant, Stomach Qi is unbalanced; this is a matter of Three Yin (Tiyain). It is suitable to treat the Lower-Shu points, tonifying Yang and draining Yin. (Tiyain refers to the Foot-Ta iyain Spleen Meridian. Bo means firm and strong, i.e., Fugu (Hidden Drum). The Tiyain Spleen pulse values harmony and slowness; now seeing drumming beating resembles the True Zang pulse. If the True Zang pulse truly appears, it is incurable; thus, one must carefully examine if it is indeed the True Zang pulse. Now, Tiyain Zang Bo is the arriving alone of Tiyain; Tiyain arriving alone means the Qi of the Five Zangs is scant and Stomach Qi is unbalanced, constituting the excess of Three Yin. Thus, it is suitable to treat the Lower-Shu points, tonifying Xangu (ST41) of Foot-Yangming and draining Taibai (SP3) of Foot-Ta iyain.)
Er Yin (Two Yin) Du Xiao (Howls Alone/Blazes Alone) is Shaoyin Jue Qi. Yang combines with the Upper, Four Pulses compete and expand, and Qi returns to the Kidney. It is suitable to treat the Meridians and Collaterals, draining Yang and tonifying Yin. (Er Yin refers to the Foot-Shaoyin Kidney Meridian. Du Xiao means blazing alone; Xiao is emitted by Yang Qi. Yang emerging from Yin, with Minister Fire flaming upward, results in Shaoyin Heat Jue Ni, with Yang combining above. Thus, the pulses of Heart, Liver, Spleen, and Lung compete and expand, while Qi returns to the Kidney. Hence "Du Xiao"; it is suitable to treat the Exterior-Interior meridians, draining Foot-Taiyang and tonifying Foot-Shaoyin. The Jing-Well point of Taiyang is Kunlun (BL60), the Luo-Connecting point is Feiyang (BL58); the Jing-River point of Shaoyin is Fuliu (KI7), the Luo-Connecting point is Dazhong (KI4).)
Yi Yin (One Yin) arrives; this is the treatment of Jueyin. True Qi is deficient, Heart hurts. Jue Qi remains and binds, causing White Sweat. Regulate diet and medicine, treating at the Lower-Shu point. (Yi Yin refers to the Foot-Jueyin Liver Meridian. Arrives means arriving alone. Treatment means governing. When Liver Pathogen arrives alone, True Qi must be deficient; Wood and Fire interfere, causing Heart pain. Jue Qi is Reverse Qi. If Reverse Qi does not dissipate, it remains and binds in the meridians; if Qi is deficient and insecure, White Sweat appears on the surface. Regulating food and medicine aims for appropriateness; using acupuncture treats at the Lower-Shu. The Lower-Shu of Jueyin is named Taichong (LR3). Note: Regulating diet and medicine applies not just to one meridian; ancient classics are often brief, so one must grasp the intent. Yuan, sound Yuan, means sour pain.)
Taiyang Zang manifests the image of Three Yang and is floating; Shaoyang Zang manifests the image of One Yang; One Yang Zang is slippery but not solid; Yangming Zang manifests large and floating. (Taiyang manifesting Three Yang images is because Yang travels on the Exterior, being the extreme of Yang, so the pulse floats externally. Shaoyang manifesting One Yang image is because Shaoyang is the interior of Yang and exterior of Yin, known as Half-Exterior Half-Interior, being slight Yang; thus, although slippery, it is not solid. Yangming, although interior to Taiyang, is exterior to Shaoyang; compared to slippery-but-not-solid, it appears large and floating. Zhongjing said: If Cun and Chi are both floating, Taiyang is affected; if Cun and Chi are both long, Yangming is affected; if Cun and Chi are both string-taut, Shaoyang is affected.)
Tiyain Zang Bo speaks of Fugu (Hidden Drum). (Fugu means sunken/stagnant and drumming, i.e., firm pulsation. Zhongjing said: If Cun and Chi are both sunken and fine, Tiyain is affected.)
Er Yin Bo Zhi (Two Yin Pulsates Arriving) means Kidney is sunken and does not float. (Er Yin refers to Shaoyin Kidney Meridian. Er Yin pulsating and arriving alone means Kidney is only sunken and not floating. Zhongjing said: If Cun and Chi are both sunken, Shaoyin is affected; if Cun and Chi are both minute and slow, Jueyin is affected.)
To know whether the Cun Kou (Inch Port) pulse is Excessive or Insufficient: If the Cun Kou pulse feels short upon pressing, it is Headache. (Cun Kou is Qi Kou. Shortness indicates Yang insufficiency; when Yang is insufficient, Yin gathers, causing headache. Short means short at the lower part. If the pulse is short below, pathogens combine above, causing headache. Zhong is pronounced with the departing tone.)
If the Cun Kou pulse feels long upon pressing, it is Pain in the Legs and Calves. (Length indicates Yin insufficiency; when Yin is insufficient, Yang gathers, causing leg and calf pain.)
If the Cun Kou pulse feels urgent and strikes the upper hand upon pressing, it is Shoulder and Back Pain. (A pulse coming urgently and striking the upper hand indicates Yang pathogens are abundant above, causing shoulder and back pain.)
If the Cun Kou pulse is sunken and firm, the disease is in the Middle (Interior). (Sunken indicates Interior; firm indicates Yin Excess, so the disease is in the Middle.)
If the Cun Kou pulse is floating and vigorous, the disease is in the Exterior. (Floating indicates Exterior; vigorous indicates Strong Yang, so the disease is in the Exterior.)
If the Cun Kou pulse is sunken and weak, it indicates Alternating Chills and Fever, Hernia Masses, and Lower Abdominal Pain. (Sunken indicates Yang Deficiency; weak indicates Yin Deficiency. Yang deficiency leads to external cold; Yin deficiency leads to internal heat, hence alternating chills and fever. However, sunken-weak pulses have much Yin and little Yang; Yin-Cold is below, causing Hernia and Masses, and Lower Abdominal Pain. Xia refers to accumulations.)
If the Cun Kou pulse is sunken and transverse (rapid/tight), there is accumulation under the ribs and horizontal accumulation pain in the abdomen. (Transverse means rapid/tight. Sunken governs the interior; Transverse governs accumulation, hence accumulation and pain in the hypochondrium and abdomen. Zhongjing said: Accumulation is Zang disease, never moving; Gathering is Fu disease, occurring at times, shifting pain, and is treatable. The general rule for accumulations: A pulse that is fine and adheres to the bone indicates accumulation. At Cun Kou, accumulation is in the chest; slightly out of Cun Kou, in the throat; at Guan, beside the navel; above Guan, below the heart; slightly below Guan, in the lower abdomen; at Chi, in Qichong. Pulse appearing on the left indicates accumulation on the left; on the right, on the right; appearing on both, in the center. Treat each according to its location.)
If the Cun Kou pulse is sunken and panting (rapid), it indicates Alternating Chills and Fever. (Panting means rapid. Sunken and rapid pulse indicates Heat in the interior. Heat in the interior causing chills and fever corresponds to "All spasms, shivering, and trembling belong to Fire".)
Vigorous, slippery, and firm pulses indicate disease in the Exterior. (Yang pulse and firm, so disease in the Exterior.)
Small, solid, and firm pulses indicate disease in the Interior. (Yin pulse and firm, so disease in the Interior.)
Small, weak, and choppy pulses indicate Long-standing Disease. (Small and weak indicate Qi deficiency; choppy indicates Blood deficiency. Qi and Blood deficiency result from long-standing disease.)
Slippery, floating, and rapid pulses indicate New Disease. (Slippery and floating are Yang pulses. Yang pulse and rapid indicates Pathogen abundance. Pathogen abundance and vigor signify new disease.)
Urgent pulses indicate Hernia Masses and Lower Abdominal Pain. (String-taut and urgent indicate Yin Pathogen abundance, causing hernia and lower abdominal disease.)
Slippery pulses indicate Wind. (Slippery pulse is smooth and belongs to Yang; Wind nature is movement, also Yang; thus, slippery pulse indicates Wind.)
Choppy pulses indicate Bi Syndrome. (Choppy is a Yin pulse, indicating Blood deficiency, hence Bi syndrome.)
Slow and slippery pulses indicate Heat in the Middle. (Slowness is due to Stomach Heat; slipperiness strengthens Yang, causing Heat in the Middle. Slowness here refers to relaxation, not delayed movement.)
Vigorous and tight pulses indicate Distension. (Vigorous means Middle Qi stagnation; tight means Pathogen excess, causing distension.)
Many blue veins on the arm indicate Blood Loss. (Blood loss leads to Qi departure; Qi departure leads to cold coagulation; coagulation leads to cyanosis/blackness, hence blue color on the arm. Mentioning the arm implies other areas too.)
Chi pulse slow and choppy indicates Xie Xi (Laxity/Fatigue). (Chi governs the Yin aspect; slow indicates Qi decline; choppy indicates Blood scarcity, hence Xie Xi. Xie Xi is a name for difficult-to-describe fatigue.)
Resting with a vigorous pulse indicates Blood Loss. (Whenever pulse is vigorous, Pathogen must be abundant; when Pathogen is abundant, rest must be uneasy. Now, pulse is vigorous but rest is peaceful, knowing it is not Qi/Yang Pathogen, but Yin Deficiency and Blood Loss. This also follows the Chi pulse; whenever Chi pulse is vigorous, it is mostly Yin Deficiency, hence Blood Loss.)
Chi choppy and pulse slippery indicates Profuse Sweating. (Refers to Chi skin being choppy and Chi pulse being slippery. Choppy Chi skin indicates scarce Ying Blood; slippery Chi pulse indicates abundant Yin Fire. Yang excess and Yin deficiency cause profuse sweating.)
Chi cold and pulse fine indicates Posterior Diarrhea. (Cold Chi skin indicates Spleen Yang decline, as Spleen governs muscles and limbs. Fine Chi pulse indicates Kidney Yang decline, as Kidney governs the lower orifices. Spleen and Kidney deficiency-cold cause posterior diarrhea.)
Rough and constantly hot Chi pulse indicates Heat in the Middle. (Rough Chi indicates True Yin deficiency; constant heat indicates abundant Yin Fire, hence Heat in the Middle.)
Seeing the complexion and knowing the disease is called Ming (Bright); palpating the pulse and knowing the disease is called Shen (Divine); asking about the disease and knowing its location is called Gong (Skillful). (Seeing complexion involves observing the five colors of appearance; palpating pulse involves cutting the Yin-Yang of Cun Kou; asking disease involves inquiring into the causes. Knowing these three makes one Ming, Shen, and Gong, exhausting diagnostic methods.)
The correspondence between Color, Pulse, and Chi is like the response of a drumstick to a drum or shadow to form; they cannot be lost. This is also the manifestation of roots, branches, trunks, and leaves; thus, if the root dies, the leaves wither. Color, Pulse, Form, and Flesh must not be discordant. Knowing one makes one Gong, knowing two makes one Shen, knowing three makes one Shen and Ming. (This says Color, Pulse, Form, and Flesh should be examined in detail. Color can be observed, Pulse can be palpated, and Form/Flesh should be verified on the Chi skin. Since Chi skin is always visible during diagnosis, verifying here allows knowing the prosperity/decline of Form/Flesh. What is inside must manifest outside; thus, Color and Pulse, Pulse and Form/Flesh correspond like drumstick-drum or shadow-form, and root-branch signs do not mismatch. All three should be combined; knowing three makes one Shen and Ming. Fu is a drumstick. Fu reads Fu or Fu.)
Green complexion corresponds to String-taut pulse; Red to Hook pulse; Yellow to Dai (Moderate) pulse; White to Hair (Light) pulse; Black to Stone (Heavy) pulse. Seeing the color but not getting the corresponding pulse, but instead getting the mutually overcoming pulse, indicates death; getting the mutually generating pulse indicates recovery. (Not getting the pulse means not getting the correct pulse matching the color. Mutually overcoming pulse: e.g., Green color getting Hair pulse, Metal overcoming Wood. Mutually generating pulse: e.g., Green color getting Stone pulse, Water generating Wood.)
For diseases generated by the Five Zangs and their changing forms, first determine the correspondence of the Five Colors and Five Pulses, then the diseases can be distinguished. Once Color and Pulse are determined, regulating the Pulse's Slow, Urgent, Large, Small, Slippery, and Choppy qualities will fix the disease variation. (Slow/Urgent refer to frequency; Small/Large/Slippery/Choppy refer to shape. Slippery means not choppy, flowing smoothly like pearls in a plate; Choppy means not slippery, void, fine, and slow, difficult to move like rain soaking sand or knife scraping bamboo. These six oppose each other; regulating these six fixes disease variation. This uses Slow, Urgent, Large, Small, Slippery, Choppy to determine disease variation, serving as the general outline of all pulses. Later physicians may differ slightly, but must reference Yue Ren and Zhongjing. Floating is Yang/Exterior, diagnosing Wind/Deficiency; Sunken is Yin/Interior, diagnosing Dampness/Excess; Slow is in Zang, Cold/Cool; Rapid is in Fu, Heat/Dryness; Slippery is Blood excess, Choppy is Qi stagnation; this seems correct. However, one does not realize that Floating being Exterior includes Scattered, Large, and Kong pulses; Sunken being Interior includes Fine, Small, and Hidden pulses; Slow being Cold includes Slow, Relaxed, Choppy, and Intermittent pulses; Rapid being Heat includes Surging, Slippery, Rapid, and Interrupted pulses; Deficiency includes Short, Soft, Minute, and Weak pulses; Excess includes String-taut, Tight, Moving, and革 (Leather) pulses. This is the general knowledge. Among these six, there are crucial distinctions that many fail to recognize. Although Floating is Exterior, Yin Deficiency pulses are floating but forceless; thus, Floating cannot generally mean Exterior, nor can it be lifted/dispersed? Although Sunken is Interior, severe initial Exterior contraction by Yin-Cold prevents Yang from reaching the exterior, showing Sunken-Tight pulse first; thus, Sunken cannot generally mean Interior, nor can it be purged internally? Although Slow is Cold, after early-stage Cold damage recedes with residual heat, pulses are often Slow-Slippery; thus, Slow cannot generally mean Cold, nor can it be warmed internally? Although Rapid is Heat, in deficiency patterns with Yin-Yang depletion and Qi-Blood chaos, pulses are urgent-rapid; the more rapid, the more deficient; thus, Rapid cannot generally mean Heat, nor can it be cooled? Minute and Fine resemble Deficiency, but extreme pain obstruction shows Hidden pulses; thus, Hidden cannot generally mean Deficiency, nor can it be abruptly tonified? Surging and String-taut resemble Excess, but severe True Yin deficiency shows Guan Ge (Obstruction/Regurgitation) exceeding normal; thus, Strong cannot generally mean Excess, nor can it be reduced/drained? In such cases, within the outline, there is a super-outline. If one cannot combine the Four Diagnoses and acts rashly, one will surely overturn the patient instantly. This is why Pulse Dao is hard to explain; every hair's breadth must be distinguished.)
If the pulse is urgent, the Chi skin is also urgent; if the pulse is slow, the Chi skin is also slow; if the pulse is small, the Chi skin is diminished and lacks Qi; if the pulse is large, the Chi skin bulges and rises; if the pulse is slippery, the Chi skin is also slippery; if the pulse is choppy, the Chi skin is also choppy. All these variations have minor and severe degrees. Thus, one skilled in adjusting Chi need not wait for Cun; one skilled in adjusting Pulse need not wait for Color. One who can combine and practice them can be a Shang Gong (Superior Physician), achieving nine successes out of ten. Practicing two makes one Zhong Gong (Middle Physician), achieving seven successes out of ten. Practicing one makes one Xia Gong (Inferior Physician), achieving six successes out of ten. (This is the meaning of Root/Branch and Trunk/Leaf. Regarding Cun-Chi, Chi is the root, Cun is the branch; regarding Pulse-Color, Pulse is the root, Color is the branch. Thus, skilled in Chi need not wait for Cun; skilled in Pulse need not wait for Color. But one must combine all three to ensure no errors, worthy of being called Shang Gong, saving nine out of ten. Those knowing only two or one are middle/inferior talent, saving only six or seven.)
Adjust the Chi, speak of the disease, knowing the interior from the exterior. Examine the Chi's Slow, Urgent, Large, Small, Slippery, Choppy qualities, and the flesh's Firm/Brittle nature, and the disease form is fixed. (Cun Kou pulse extends from Chi to Cun; thus, diagnosing only the Chi pulse reveals the interior. The whole body is hard to see fully, but flesh prosperity/decline manifests at the wrist; thus, observing only Chi flesh reveals the exterior. Hence, adjusting only Chi fixes the disease form.)
Observing a person's eye sockets having slight swelling, like newly risen after lying down, neck vessels pulsating, occasional coughing, and pressing the hands/feet leaving an indentation that does not rise immediately, indicates Feng Shui Skin Distension. (Eye socket is the area under the eyes, like a silkworm. Yong means blockage, i.e., new slight swelling. Neck vessel is Renying pulse. Indentation not rising means a pit forms upon pressing. These are external signs of Feng Shui Skin Distension. Ke means cavity. Yong, departing tone. Yao, sound Yao.)
Chi skin slippery and glossy indicates Wind. (Yang receives Wind Qi; thus, Wind patients have slippery and glossy Chi skin.)
Weak Chi flesh indicates Xie Xi and desire to rest; Emaciated flesh indicates untreatable Alternating Chills and Fever. (Weak Chi flesh means muscles must emaciate. Emaciated flesh indicates Yin Deficiency, leading to Xie Xi. Xie Xi means body fatigue, hence desiring rest. No pathogen but emaciation with chills/fever indicates True Yin collapse, hence untreatable.)
Chi skin slippery and oily indicates Wind. (Oily refers to previous glossiness. Wind is Yang Qi; Yang in skin/flesh makes it slippery and oily.)
Chi skin choppy indicates Wind Bi. (Choppy Chi skin indicates Blood scarcity; Blood cannot nourish, hence Wind Bi.)
Chi skin rough like dried fish scales indicates Water Retention. (Like dried fish scales means extreme dryness/choppiness. Due to Spleen Earth decline and muscle wasting, Water takes advantage, causing Water Retention. Yi and Yi are the same.)
Extremely hot Chi skin and vigorous/restless pulse indicates Warm Disease; if the pulse is vigorous and slippery, the disease is about to exit. (Hot Chi skin, its...)