凡脉顺四时者谓春弦夏洪秋毛冬石中有和气软滑而长乃是不病之人得病即易为治疗盖从
和气
而生也用法万全如气反脉逆形气相失名曰不可治是形盛气虚形虚气盛故不可治也凡人形气俱
虚安谷者过期而死不安谷者不过期而死安谷谓饮食且进期是八节之气候也(鸡峰方)
诊脉治病必先度人之肥瘦以调气之虚实虚则补之实则泄之若形瘦脉大胸中多气者必死是
形气
俱不足而脉反有余故死也故人形盛脉细少气不足者危危者近于死也犹有可治之理以气不足而
形盛故也其形气相得者生是人形气肥瘦长短气候相得故生也参五不调者病谓脉气交乱而不调
故病也上下寸关尺三部脉如参椿者病甚也三部脉左右手十至不可数者死是一呼一吸脉来往十
至以上无生气也故死矣(鸡峰方)
大凡诊脉先定四时之脉便取太过不及虚实冷热寒温至数损益阴阳衰盛五行生克脏腑所属
看之
以为大法然后取其人形神长短肥瘦气候虚实盛衰性气高下布衣血食老幼强弱但顺形神四时五
气气候无过者生之本其形气与五行者危病若过盛而形气反逆脉有悬绝者死不治矣(鸡峰普济
方)
郭玉广汉人也后汉章帝时为侍郎为人善别脉知人生死帝令童男衣女子之衣诈云其病使玉
诊脉王曰此女谁言病据脉状阳盛阴弱臣谓非女帝善之迁五官中郎将
凡是脉象顺应四时变化的，称为顺脉。春季脉象微弦，夏季脉象微洪，秋季脉象微毛（浮），冬季脉象微石（沉），其中蕴含柔和、滑利且长的“和气”，这就是没有疾病的人。一旦患病，脉象就会改变，但容易治疗，因为是从“和气”中产生的。治疗方法万无一失。如果气机与脉象相反，形体与正气相背离，就叫做“不可治”。这是因为形盛而气虚，或者形虚而气盛，所以不可治。大凡一个人形体和正气都虚弱，如果能进食，就能超过八节气候的期限而死；如果不能进食，就不能超过八节气候的期限而死。“安谷”指饮食还能进用，“期”是指八节的气候变化。（出自《鸡峰方》）
诊脉治病，必须先估量人的肥瘦，以调节气的虚实。虚则补益，实则泻泄。如果形体消瘦，脉象却盛大，胸中多气，必定死亡。这是因为形气和正气都不足，而脉象反而有余，所以死亡。因此，人若形体壮盛，脉象细弱，少气乏力，这是危重之症，接近死亡，但还有可治的道理，因为气不足而形盛。如果形气相得（协调），就能生存，这是因为人的形体肥瘦长短与气候相适应，所以能生存。如果参伍不调（脉气交错混乱而不协调），就是生病，因为脉气交乱而不调，所以生病。如果寸、关、尺三部脉象像参椿（参差不齐）一样，病情就很严重。如果左右手三部脉，一呼一吸之间脉来十次以上，无法计数，这是死证，因为一呼一吸脉来往十次以上，没有生气，所以死亡。（出自《鸡峰方》）
大凡诊脉，先确定四时的脉象，然后观察太过、不及、虚、实、冷、热、寒、温、至数（脉搏次数）、损益、阴阳衰盛、五行生克、脏腑所属等，以此作为大法。然后观察这个人的形神、长短、肥瘦、气候、虚实、盛衰、性气高下、布衣血食（平民或贵族）、老幼、强弱等。只要顺应形神、四时、五气、气候，没有过分的，就是生的根本。如果形气与五行相悖，就是危重的病。如果脉象过于盛极而形气反而逆乱，脉有悬绝（如悬丝欲断）的情况，就是死证，不可治疗了。（出自《鸡峰普济方》）
郭玉是广汉人，在后汉章帝时期担任侍郎。他为人善于辨别脉象，知道人的生死。皇帝让童男穿上女子的衣服，假装说是病人，让郭玉诊脉。郭玉说：“这位女子是谁？为什么说她是病人？根据脉象来看，阳盛阴弱，我认为这不是女子。”皇帝称赞他，升迁他为五官中郎将。
Those whose pulse conforms to the four seasons is called a compliant pulse. In spring, the pulse is slightly wiry (Xian); in summer, slightly flooding (Hong); in autumn, slightly floating like down (Mao); in winter, slightly deep like a stone (Shi). Within these, there exists a "harmonious qi" (Heqi) that is soft, slippery, and long; this characterizes a person without disease. Once illness occurs, the pulse changes, but it becomes easy to treat because it originates from the "harmonious qi." The treatment method is foolproof. If the qi opposes the pulse, and the form (xing) and qi are discordant, it is termed "incurable." This is because the form is excessive while the qi is deficient, or the form is deficient while the qi is excessive, hence incurable. Generally, if a person's form and qi are both deficient, yet they can eat, they will die after exceeding the cycle of the eight solar terms; if they cannot eat, they will not exceed the cycle of the eight solar terms before dying. "An gu" refers to the ability to take food and drink; "qi" refers to the climatic cycles of the eight solar terms. (From *Jifeng Fang*)
To diagnose and treat diseases via pulse taking, one must first estimate the patient's fatness or thinness to adjust for the deficiency or excess of qi. Deficiency requires tonification; excess requires purgation. If the body is emaciated, yet the pulse is large, and there is excessive qi in the chest, death is certain. This is because both form and qi are insufficient, yet the pulse appears excessive, leading to death. Therefore, if a person has a robust form but a fine pulse, with shortness of breath and insufficiency, it is a critical condition, nearing death, yet still potentially treatable because the qi is insufficient while the form is robust. If form and qi are harmonious (xiang de), life is sustained, as the person's physical attributes (fatness, thinness, height, length) align with the climate, thus ensuring survival. If the pulse is disordered and irregular (can wu bu tiao), disease exists because the pulse qi is chaotic and uncoordinated. If the pulses at the Cun, Guan, and Chi positions on both hands are uneven and irregular like interlocking pegs (can chun), the disease is severe. If the pulses in the three positions of both left and right hands beat more than ten times per respiration cycle and are uncountable, it is a death sign, as there is no vital energy when the pulse beats over ten times per breath; hence, death ensues. (From *Jifeng Fang*)
Generally, in pulse diagnosis, one first determines the seasonal pulses, then observes excess (tai guo), deficiency (bu ji), deficiency (xu), excess (shi), cold (leng), heat (re), cold (han), warmth (wen), frequency (zhi shu), gain and loss (sun yi), decline and prosperity of yin and yang, generation and restriction of the Five Elements, and organ associations, establishing these as general principles. Then, observe the individual's spirit and form, stature, fatness or thinness, climatic conditions, deficiency or excess, prosperity or decline, temperament, social status (commoner or noble), age (old or young), and strength. As long as one conforms to the spirit and form, four seasons, five qi, and climate without excess, this is the root of life. If the form and qi contradict the Five Elements, the disease is critical. If the pulse is excessively extreme and the form and qi reverse, showing suspended and severed pulses (xuan jue), it is a death sign and incurable. (From *Jifeng Puji Fang*)
Guo Yu was from Guanghan. During the reign of Emperor Zhang of Later Han, he served as a Gentleman of the Palace (Shilang). He was skilled at distinguishing pulses and knowing the time of death. The Emperor ordered a young boy to wear women's clothing, feigning illness, and asked Guo Yu to diagnose him. Guo Yu said, "Who is this woman? Why do you say she is ill? According to the pulse state, yang is excessive and yin is weak; I believe this is not a woman." The Emperor praised him and promoted him to Director of the Central Palace Attendants (Wuguan Zhonglangjiang).