凡诊脉之法，先要定得三部，位分明白；又要晓得十二经络、五脏六腑，及五脏配合五行、四时生克之
理；又要知得脉之息数，分别浮、沉、迟、数、滑、涩，及诸脉阴阳主病之原也。何谓三部？谓人两手俱有
寸、关、尺也。凡诊脉，先以中指揣摩掌后，有小高骨，就是关脉。然后下前后二指，关前至鱼际，得同身
之一寸，故名为寸口，为阳；关后至尺泽，得同身之一寸，故名为尺部，为阴。又寸脉六分，关脉六分，其
上三分，入于寸内，是阳得寸内九分，阳数九也∶尺内七分，关下三分，入于尺内，是阴得尺内一寸，阴数
十也。终始一寸九分此也。又长人脉长，当疏排指；短人脉短，当密排指。人瘦小，则轻取之；人肥大，则
重取之。性急人脉急，性缓人脉缓。又有反关脉，在三部之后或臂侧。若过寸口上鱼际者，名曰鱼际脉。有
左大右小者，有左小右大者，有贵人两手清微而无脉者，有两手俱洪大者。须用心诊视。凡诊脉，先须调
平自己气息，男左女右，初轻按消息之，次中按消息之，再重按消息之。推而上
消息之，上即关之前也；推而下消息之，下即关之后也；推而内消
息之，内即脏之脉也；推而外消息之，外即腑之脉也。然后自寸、关、尺，逐步寻究。一呼一吸之间，要
以脉行四至为率。闰以太息脉五至，是为平脉也。其有太过不及，则为病脉也。凡人十二经动脉，循环一
昼夜五十周，朝于寸口，会于平旦。《内经》凡诊平人之脉，常以平旦。至诊病脉，则不以昼夜拘也。《难
经》独取寸口者，即手太阴之经也。上古诊法有三∶其一，各于十二经动脉见处，分为三部，天、地、人以候
各脏腑；其二，寸口、人迎参之，以验引绳四时之大小以决病；其三，独取寸口，以内外分脏腑，以高下定
身形，斯叔和所取以为寸口脏腑之位也。
何谓五脏六腑？盖五脏者，心、肝、脾、肺、肾也；六腑者，胆、胃、大肠、小肠、膀胱、三焦也。左
手关前一分为人迎，右手关前一分为气口。左手寸口，心与小肠之脉所出，君火也；左手关
部，肝与胆之脉所出，风木也；左手尺部，肾与膀胱之脉所出，寒水也；右手寸口，肺与大肠之脉所出，燥金
也；右手关部，脾与胃之脉所出，湿土也；右手尺部，命门与三焦之脉所出，相火也。盖五脏者，藏精气
而不泻，满而不能实；六腑者，传化物而不藏，实而不能满。故脉始于中焦，饮食入口，藏胃，精微之化，
注于手太阴肺、手阳明大肠、足阳明胃、足太阴脾、手太阴心、手太阳小肠、足太阳膀胱、足少阴肾、手
厥阴心胞、手少阳三焦、足少阳胆、足厥阴肝、复还注于手太阴肺，循环灌溉，朝于寸口，人迎，以处百
病而决死生也。
然以对待之位言之，则左寸火克右寸金，左关木克右关土，左尺水克右尺火。左刚右柔，有夫妇之别也。
然左手属阳，右手属阴。左寸君火以尊而在上，右尺相火以卑而在下，有君臣之道也。又以
循环之序言之，盖以右寸金生左尺水，水又生左关木，木又生左寸火，火复通右尺相火，相火又生右关土，
土又生右寸金，而金复生水，此五行更相生养，循环无端，有子母之亲也。盖子能令母实，
母能令子虚是也。治法云∶虚则补其母，实则泻其子。如水生木，
是水为母，木为子；木复生火，是木受窃气，故水怒而克火。所谓
子逢窃气，母乃力争。火又生土，是火为母，土为子，土见火被水克，故怒而克水。所谓母被鬼伤，子来
力救。假如肝木有余，是肺金不足，金不能克木，故木无所畏，其气有余，反搏激肺金而乘其脾土也。故曰
搏所不胜而乘所胜也。此五脏之气，内相淫并为疾也。又如肝木气少不及，则不能以制土。土无所畏，而遂妄
行，乃凌其肾水矣，故曰所胜妄行，而所生者受病也。肝木之气不平，则肺金之气自搏，故曰所不胜搏之也。
盖木气不平，土金交搏，相迫为疾，故曰气迫也。相生、相克、相胜展转无穷，举一以例其余也。
何谓五脏配合五行、四时、五音？盖五行者，金、木、水、火、土也；四时者，春、夏、秋、冬也；
五音者，宫、商、角、征、羽也。肝主筋，其华在爪，其藏魂，其声呼，其液泣，应角音，调而直，
属木，应乎春令，其色青，其味酸；心主血脉，其荣在色，其藏神，其养血，其候音，其声言，其液汗，应
征音，和而长，属火，应乎夏令，其色赤，其味苦；肺主皮毛，其华在毛，其藏魄，其声器，
其液涕，应商音，轻而劲，属金，应乎秋令，其色白，其味辛；肾主骨，其华在发，其充在骨，其藏精与志，
其候耳，其声呻，其液唾，应羽音，沉而深，属水，应乎冬令，其色黑，其味咸；脾主肌
肉，其华在唇四白，其充在肌，其藏意与志，其声歌，其液涎，应宫音，大而和，属土，应乎四季月，其
色黄，其味甘，是五脏配合五行、四时、五音也。何谓四季之脉？谓春弦、夏钩、秋毛、
冬石。然春脉弦者，谓正月寅，二月卯，木旺，春日脉浮，如鱼游在波，虽出犹未全浮，故其脉弦而长，
以应东方肝木之气也；夏脉钩者，谓四月巳，五月午，火上炎，夏日在肤，阳气太盛，故其脉
来有力，浮大而数，以应南方心火之气也；秋脉毛者，谓七月申，八月酉，金旺，而金性轻浮，秋日下肤，
随阳气渐降，将欲藏去，故其脉来浮涩而短，以应西方肺金之气也；冬脉石者，谓十月玄，
十一月子，水旺，而水性下流，冬日在骨，阳气伏藏，故其脉沉濡软滑，以应北方肾水之气也；辰戌丑未
四季月，脉迟缓者，谓土性浓重，其脉来和缓而大，以应中央脾土之气也。四时之脉，虽有弦、
钩、毛、石之分，然春三月，六部中俱带弦；夏三月，俱带洪；秋三月，俱带浮；冬三月，俱带沉。六部
内按之，又兼和缓为有胃气，此无病之脉也。若乃见弦、钩、毛、石而无和缓，此是真脏之脉，
人不病而死也。大抵脉者，气血之先也，气血盛则脉盛，气血衰则脉衰，气血热则脉数，气血寒则脉迟，
气血壮则脉大，气血微则脉小，气血和则脉平。试以脉之大纲言之，初持脉，轻手候之，脉见
于皮肤之间者，阳也，腑也，心脉之应也。盖心肺在上，故其脉皆浮，若浮大而散者，心也；浮涩而短者，
肺也。重手按之，脉附于肌肉之下者，阴也，脏也，肝肾之应也。盖肝肾在下，故其脉皆沉，
若弦而长者，肝也；沉而软滑者，肾也。不轻不重，中而取之，脉应于肌肉之间，阴阳相适，中和之应，
脾胃之候也。盖脾居中州，故脉缓而大，此五脏不病之平脉也。诊视者必熟知平脉，然后可以辨病脉也。若短
小而见于皮肤之间者，阴乘阳也；洪大而见于肌肉之下者，阳乘阴也。寸尺皆然。
又以脉之十二经细分之，脉有浮沉，诊有轻重也。左寸先以轻手得之，是小肠属表；后以重手如六菽之
重得之，是心属里。心在肺下，主血脉。心脉循血脉而行，按至血脉而得为浮；稍加力，脉道粗大为大；
又稍加力，脉道润软而散，此乃浮大而散，不病之脉也。若出于血脉之上，见于皮肤之间，是其浮也；入于血
脉之下，见于筋骨之分，是其沉也。左关先以轻手得之，是胆属表；后以重手如十二菽之重取之，是肝属里。
肝在脾下，主筋。肝脉循筋而行。按至筋平，脉道如筝弦者为弦，次稍加力，脉道迢迢为长，此弦、
长为不病之脉也。若出于筋上，见于皮肤血脉之间，是其浮也；入于筋下，见于骨上，是其沉也。左尺先
以轻手得之，是膀胱属表；后以重手取之，度如十五菽之重而得之，是肾属里。肾在肝下，主
骨。肾脉循骨而行，按至骨上得之为沉；又重手按之，脉道无力者
为濡；举指来疾流利者为滑，此乃沉濡而滑，不病之脉也。若出于骨上，见于皮肤血脉筋肉之间，是其浮
也；入而至骨，是其沉也。右寸先以轻手得之，是大肠属表；后以重手取之，如三菽之重得之，
是肺属里。肺居最高，主皮毛。肺脉循皮毛而行，按至皮毛而得者为浮；稍加力，脉道不利为涩；又稍加力，
脉道缩入关中，上半指不动；下半指微动者为短，此浮涩而短，不病之脉也。若出于皮毛
之上，见于皮肤之表，是其浮也；入于血脉筋肉之分，是其沉也。右关先以轻手得之，是胃属表；后以重手取
之，如九菽之重得之，是脾属里。脾在心下，主肌肉。脾脉循肌肉而行，按至肌肉，脉道如微风杨柳梢之状为
缓；又稍加力，脉道敦实者为大，此为缓大，不病之脉也。若出于肌肉之上，见于皮毛之间者，是其浮也；入
于肌肉之下，见于筋骨之分者，是其沉也。右尺先以轻手得之，是三焦为表；后以重手得之，是命门属里，
为相火，气与肾通也。
又有三部九候之诀。三部者，寸、关、尺也；九候者，浮、中、沉也。凡三部，每部各有浮、中、沉
三候，三而三之，为九候也。浮主皮肤，候表及腑；中主肌肉，以候胃气；沉主筋骨，候里及脏
也。寸为阳，为上部，法天，为心肺，以应上焦，主心胸以上至头之有疾也；关为阴阳之中，为中部，法人，
为肝脾，以应中焦，主膈以下至脐之有疾也；尺为阴，为下部，法地，为肾命，以应下焦，
主脐以下至足之有疾也。此三部诊候之大法也。
又脉有上下、来去、至止，此六字不明，则阴阳虚实不别也。上者、来者、至者为阳；下者、去者、止
者为阴。上者、自尺部上于寸口，阳生于阴也；下者，自寸口下于尺部，阴生于阳也。来者，自骨肉之分，
而出于皮肤之际，气之升也。去者自皮肤之际，而还于骨肉之分，气之降也。应曰至，息曰止也。
何谓生克之理？谓五行有相克、相生也。相生者，谓金生水、水生木、木生火、火生土、土生金是也；
相克者，谓金克木、木克土、土克水、水克火、火克金是也。凡脉遇相生者吉，相克者凶，
何也？盖心若见沉细，肝见短涩，肾见迟缓，肺见洪大，脾见弦长，
皆遇克也，为鬼贼相侵，危证也。又心若见缓，肝见洪，肺见沉之类，是子扶养于母，遇我之脉生也，虽
病易瘥。至而肾病传肝，肝病传心之类，此母来抑子，病虽不死，亦延绵日久矣。又我克者
为妻，假如春属木，脉见脾土，是夫得妻脉也。妻来乘夫，虽非正克，然春中独见脾脉，土乘木衰，土乘之，
则生金来克木耳。若肝脉弦缓，而本体尚存，脾土虽乘之，为微邪，不足虑也；若本脉全无，而独见脾缓之
脉，为害必矣。《脉赋》云∶假令春得肺脉为鬼，得心脉则为肝儿，肾为其母，脾则为妻。故春得脾而莫疗，
冬见心而不治，夏得肺而难瘥，秋得肝亦何疑。此即四时休旺，以例生克之义也。然人脉之息数，出气为呼，
入气为吸。一呼一吸，为之一息。一息之间。脉来四至或五至，为平和，不大不小，和缓舒畅，
此无病之脉也。至于三迟二败，冷而危也；六数七极，热之甚也；八脱九死，极于十一二至，与夫奄奄两息一
至，则又散而为变也。如六数七极，热也，脉中有力，为有神矣，当泄其热；三迟二败，寒也，脉中有力，
为有神矣，当去其寒；若数极迟败中，不复有力，为无神也，将何所悖耶？可与之决死期矣。
然脉理大要，元人又谓不出于浮、沉、迟、数、滑、涩六脉也。浮脉轻手取之；沉脉重手取之；迟、数
之脉，以己之呼吸而取之；滑、涩之脉，则又察乎往来之形也。浮者，阳也，脉在肉上行也，
轻手乃得。而芤、洪、散、大、长、濡、弦，皆轻手而得之类也。沉者，阴也。脉在肉下行也，重手乃得。
而伏、石，短、细、牢、实，皆重手而得之类也。迟者，脉不急也，一息二、三至。而濡、缓皆迟之类也。
数者，脉来速也，一息六、七至。而疾、促皆数之类也。至于滑、涩之脉，则以往来察其形状也。浮为阳，
在表，为风、为虚；沉为阴，在里，为湿、为实；数则在腑，为热、为阳、
为燥；迟则在脏，为寒、为冷、为阴；滑为血多气少；涩为气多血
少；滑为血有余；涩为气独滞。是浮、沉、迟、数、滑、涩六脉，此诊家之要法也。
男子左手脉常大于右手者，为顺；女子右手脉常大于左手者，为顺。男脉在关上，女脉在关下。男子尺
脉常弱，寸脉常盛；女子尺脉常盛，寸脉常弱，是其常也。反者，男得女脉为不足，女得男脉为太过。是
以男子不可久泻，女子不可久吐。上部有脉，下部无脉，其人当吐，不吐不死；上部无脉，下部有脉，病
虽重，不死，何也？盖人有迟脉，谓有元气，犹树之有根也。凡人左手属阳，右手属阴；汗多亡阳，下多
亡阴。诸阴为寒，诸阳为热。
至于疾病为证，又有阴阳表里之辨。盖六淫之邪，袭于经络，而未入于胃腑，如左手人迎脉紧盛，大于
气口一倍，为外感风寒，皆属于表，为阳也，腑也。七情之气，郁于心腹之内，不能越散。
饮食五味之伤，留于肠胃之间，不能通泄。如右手气口脉大人迎一倍，脉紧盛，为内伤饮食，皆属于里，为
凡是诊察脉象的方法，首先要确定寸、关、尺三部的位置，部位划分要清晰明确；又要通晓十二经络、五脏六腑的生理联系，以及五脏与五行、四时之间相生相克的道理；还要知道脉搏的至数（一呼一吸间脉搏跳动的次数），分辨浮、沉、迟、数、滑、涩等脉象，以及各种脉象阴阳属性所主疾病的原理。
什么叫三部？是指人的两手都有寸、关、尺三个部位。凡诊脉，先用中指触摸手腕后方，那里有一块高起的骨头，这就是关脉的位置。然后在关脉的前后各放下食指和无名指，从关脉向前到鱼际穴，长度相当于患者自身的一寸，所以称为“寸口”，属于阳；从关脉向后到尺泽穴，长度也相当于患者自身的一寸，所以称为“尺部”，属于阴。此外，寸脉占六分，关脉占六分，其中上面的三分进入寸内，这样阳气在寸内共有九分，阳数为九；尺部内有七分，关下三分进入尺内，这样阴气在尺内共有一寸，阴数为十。寸关尺总共长一寸九分，就是这个道理。又因为人的身形有高矮之分，身材高大的人，手指排列应当疏朗一些；身材矮小的人，手指排列应当紧密一些。身体瘦小的人，诊脉时手法要轻取；身体肥大的人，诊脉时手法要重取。性格急躁的人，脉象往往急促；性格舒缓的人，脉象往往缓慢。还有反关脉，出现在三部之后或手臂侧面。如果脉象超过寸口到达鱼际处，称为“鱼际脉”。有的左脉大右脉小，有的左脉小右脉大，有的尊贵之人两手脉象微弱甚至摸不到，有的两手脉象都洪大。这些都需要用心诊察。
凡是诊脉，首先必须调匀自己的呼吸气息，遵循男左女右的原则，先轻轻按压以体察脉象，再中等力度按压以体察脉象，最后重重按压以体察脉象。向上推按以体察，向上即关脉之前；向下推按以体察，向下即关脉之后；向内推按以体察，向内即反映脏腑之脉；向外推按以体察，向外即反映六腑之脉。然后从寸、关、尺逐步仔细寻究。在一呼一吸之间，脉搏跳动四次为标准。若有闰余，通过深长的叹息使脉搏跳动五次，这称为平脉（正常脉象）。如果脉象太过或不及，就是病脉。
人在十二经脉中的动脉，一昼夜循环五十周，早晨汇聚于寸口，在平旦（清晨）时刻最为明显。《黄帝内经》说，凡是诊察健康人的脉象，常在平旦进行。至于诊察病脉，则不受昼夜限制。《难经》主张独取寸口，是因为寸口是手太阴肺经所在。上古时期的诊法有三种：其一，在十二经动脉显现的部位，分为天、地、人三部，用来候察各个脏腑；其二，比较寸口和人迎脉的大小，结合四季变化来判断疾病；其三，独取寸口，用内外区分脏腑，用高低定身形，这是王叔和所采用的寸口脏腑定位法。
什么叫五脏六腑？五脏是心、肝、脾、肺、肾；六腑是胆、胃、大肠、小肠、膀胱、三焦。左手关前一分为人迎，右手关前一分为气口。左手寸口，是心与小肠脉气发出的地方，属君火；左手关部，是肝与胆脉气发出的地方，属风木；左手尺部，是肾与膀胱脉气发出的地方，属寒水；右手寸口，是肺与大肠脉气发出的地方，属燥金；右手关部，是脾与胃脉气发出的地方，属湿土；右手尺部，是命门与三焦脉气发出的地方，属相火。
大概五脏的功能是贮藏精气而不妄泄，保持充满但不能壅实；六腑的功能是传导消化物而不能久藏，保持充实但不能满溢。所以脉气始于中焦，饮食入口，储藏于胃，经过精微物质的转化，注入到手太阴肺、手阳明大肠、足阳明胃、足太阴脾、手少阴心、手太阳小肠、足太阳膀胱、足少阴肾、手厥阴心包、手少阳三焦、足少阳胆、足厥阴肝，最后又回流注入手太阴肺，循环灌溉，早晨汇聚于寸口和人迎，以此来诊治百病并判断生死。
然而从对应的位置来说，左寸（火）克制右寸（金），左关（木）克制右关（土），左尺（水）克制右尺（火）。左边刚强右边柔和，就像夫妇的区别一样。但是左手属阳，右手属阴。左寸的君火尊贵而在上，右尺的相火卑微而在下，这就有了君臣的道理。再从循环的顺序来说，右寸金生左尺水，水又生左关木，木又生左寸火，火又通达右尺相火，相火又生右关土，土又生右寸金，而金复生水，这是五行互相滋生养育，循环无端，就像母子之间的亲情。正如所说，子能令母实，母能令子虚。治疗原则说：虚证就补其母，实证就泻其子。比如水生木，水是母，木是子；木再生火，是木受到窃取了气机，所以水愤怒而去克火。所谓子遇到被窃取气机，母亲就会力争。火生土，火是母，土是子，土看到火被水克制，所以愤怒而去克水。所谓母亲被鬼贼伤害，儿子就来尽力救援。假如肝木之气有余，说明肺金不足，金不能克制木，所以木无所畏惧，其气有余，反而搏击肺金并乘袭脾土。所以说，搏击所不胜（我克者）并乘袭所胜（克我者）。这是五脏之气内部相互淫乱而成为疾病。又如肝木之气虚弱不及，就不能制约脾土。脾土无所畏惧，于是妄行，进而凌犯肾水，所以说，所胜者妄行，而生我者受病。肝木之气不平，肺金之气自然与之搏击，所以说，所不胜来搏击它。大概木气不平，土金交相搏击，相互逼迫而成疾，所以说气迫。相生、相克、相胜辗转无穷，举一例可以类推其余。
什么叫五脏配合五行、四时、五音？五行是金、木、水、火、土；四时是春、夏、秋、冬；五音是宫、商、角、徵、羽。肝主管筋，荣华表现在爪甲，藏魂，声音为呼，体液为泪，对应角音，音调调和而直，属木，对应春季，颜色青，味道酸；心主管血脉，荣华表现在面色，藏神，负责养血，征候表现为声音，声音为言，体液为汗，对应徵音，音调和谐而长，属火，对应夏季，颜色赤，味道苦；肺主管皮毛，荣华表现在毛发，藏魄，主管声音，体液为涕，对应商音，音调轻劲，属金，对应秋季，颜色白，味道辛；肾主管骨，荣华表现在头发，充养在骨骼，藏精与志，征候表现为耳，声音为呻，体液为唾，对应羽音，音调深沉而深远，属水，对应冬季，颜色黑，味道咸；脾主管肌肉，荣华表现在口唇四周，充养在肌肉，藏意与志，声音为歌，体液为涎，对应宫音，音调宏大而和谐，属土，对应四季的最后一个月（季月），颜色黄，味道甘。这就是五脏配合五行、四时、五音的道理。
什么叫四季的脉象？是指春弦、夏钩（洪）、秋毛（浮）、冬石（沉）。春天的脉象叫弦，是指正月寅月，二月卯月，木气旺盛，春日脉象浮起，像鱼游动在水波中，虽然浮出但尚未完全浮起，所以脉象弦而长，以应合东方肝木之气；夏天的脉象叫钩（洪），是指四月巳月，五月午月，火气上炎，夏日脉象在皮肤表层，阳气太盛，所以脉象来势有力，浮大而数，以应合南方心火之气；秋天的脉象叫毛（浮），是指七月申月，八月酉月，金气旺盛，而金性轻浮，秋日脉象下沉至皮肤之下，随着阳气逐渐下降，即将收藏潜去，所以脉象来势浮涩而短，以应合西方肺金之气；冬天的脉象叫石（沉），是指十月亥月，十一月子月，水气旺盛，而水性下流，冬日脉象在骨骼深处，阳气伏藏，所以脉象沉濡软滑，以应合北方肾水之气；辰、戌、丑、未这四个季节交替的月份，脉象迟缓，是指土性浓重，其脉象来势和缓而大，以应合中央脾土之气。四季的脉象，虽然有弦、钩、毛、石的区别，但是春季三个月，六部脉中都带有弦象；夏季三个月，都带有洪象；秋季三个月，都带有浮象；冬季三个月，都带有沉象。在六部内按压时，又兼有和缓之象就是有胃气，这是无病的脉象。如果见到弦、钩、毛、石而没有和缓之象，这就是真脏脉，人即使没有生病也会死亡。
大体上说，脉是气血的先导，气血盛则脉盛，气血衰则脉衰，气血热则脉数，气血寒则脉迟，气血壮则脉大，气血微则脉小，气血调和则脉平。试从脉的大纲来说，初持脉时，轻手候察，脉象见于皮肤之间的，是阳，是腑，是心脉的应象。因为心肺在上，所以它们的脉象都浮，如果浮大而散的，是心脉；浮涩而短的，是肺脉。重手按压，脉象附在肌肉之下的，是阴，是脏，是肝肾的应象。因为肝肾在下，所以它们的脉象都沉，如果弦而长的，是肝脉；沉而软滑的，是肾脉。不轻不重，中等力度取脉，脉象应于肌肉之间，阴阳相适，是中和的应象，脾胃的征候。因为脾居中州，所以脉象缓而大，这是五脏无病的平脉。诊视者必须熟知平脉，然后才能辨别病脉。如果脉短小而见于皮肤之间的，是阴乘阳；脉洪大而见于肌肉之下的，是阳乘阴。寸部和尺部都是如此。
再从十二经脉细分脉象，脉有浮沉，诊察有轻重。左寸先以轻手取得，是小肠属表；后用重手如六颗豆子的重量取得，是心属里。心在肺下，主管血脉。心脉循行于血脉之中，按至血脉而得为浮；稍加力，脉道粗大为大；再稍加力，脉道润软而散，这是浮大而散，不病的脉象。如果出于血脉之上，见于皮肤之间，是其浮；入于血脉之下，见于筋骨之分，是其沉。左关先以轻手取得，是胆属表；后用重手如十二颗豆子的重量取之，是肝属里。肝在脾下，主管筋。肝脉循行于筋之中。按至筋平，脉道像筝弦者为弦，其次稍加力，脉道迢迢为长，这是弦、长，不病的脉象。如果出于筋上，见于皮肤血脉之间，是其浮；入于筋下，见于骨上，是其沉。左尺先以轻手取得，是膀胱属表；后用重手取之，度量如十五颗豆子的重量而得之，是肾属里。肾在肝下，主管骨。肾脉循行于骨之中，按至骨上得之为沉；再用重手按之，脉道无力者为濡；举指来势疾速流利者为滑，这是沉濡而滑，不病的脉象。如果出于骨上，见于皮肤血脉筋肉之间，是其浮；入而至骨，是其沉。右寸先以轻手取得，是大肠属表；后用重手取之，如三颗豆子的重量得之，是肺属里。肺居最高，主管皮毛。肺脉循行于皮毛之中，按至皮毛而得者为浮；稍加力，脉道不利为涩；再稍加力，脉道缩入关中，上半指不动；下半指微动者为短，这是浮涩而短，不病的脉象。如果出于皮毛之上，见于皮肤之表，是其浮；入于血脉筋肉之分，是其沉。右关先以轻手取得，是胃属表；后用重手取之，如九颗豆子的重量得之，是脾属里。脾在心下，主管肌肉。脾脉循行于肌肉之中，按至肌肉，脉道像微风中杨柳梢的状态为缓；再稍加力，脉道敦实者为大，这是缓大，不病的脉象。如果出于肌肉之上，见于皮毛之间者，是其浮；入于肌肉之下，见于筋骨之分者，是其沉。右尺先以轻手取得，是三焦为表；后用重手取得，是命门属里，为相火，气与肾相通。
又有三部九候的诀法。三部是指寸、关、尺；九候是指浮、中、沉。凡三部，每部各有浮、中、沉三候，三乘以三，共为九候。浮候主皮肤，候表证及腑病；中候主肌肉，以候胃气；沉候主筋骨，候里证及脏病。寸为阳，为上部，法天，对应心肺，以应上焦，主治心胸以上至头部的疾病；关为阴阳之中，为中部，法人，对应肝脾，以应中焦，主治膈以下至脐部的疾病；尺为阴，为下部，法地，对应肾命，以应下焦，主治脐以下至足部的疾病。这是三部诊候的大法。
另外脉有上下、来去、至止，这六个字如果不明白，就无法辨别阴阳虚实。上、来、至属于阳；下、去、止属于阴。上，是从尺部上行至寸口，阳生于阴；下，是从寸口下行至尺部，阴生于阳。来，是从骨肉之分，而出于皮肤之际，是气的上升。去，是从皮肤之际，而还于骨肉之分，是气的下降。应称为至，息称为止。
什么叫生克的道理？是指五行有相克、相生。相生，是指金生水、水生木、木生火、火生土、土生金；相克，是指金克木、木克土、土克水、水克火、火克金。凡是脉象遇到相生的情况吉利，遇到相克的情况凶险，为什么呢？因为心脉若见沉细，肝脉见短涩，肾脉见迟缓，肺脉见洪大，脾脉见弦长，这都是遇到相克，为鬼贼相侵，是危重的证候。又比如心脉若见缓，肝脉见洪，肺脉见沉之类，是子扶养于母，遇到生我的脉象，虽然生病也容易痊愈。如果是肾病传肝，肝病传心之类，这是母来抑制子，病虽然不死，也会拖延日久。我又克者为妻，假如春季属木，脉见脾土，是夫得到妻的脉象。妻来乘夫，虽然不是正克，但是在春季单独见到脾脉，土乘木衰，土乘之后，会生金来克木。如果肝脉弦缓，而本体尚存，脾土虽然乘之，为微邪，不必忧虑；如果本脉全无，而单独见到脾缓之脉，危害必然很大。《脉赋》说：假如春季得肺脉为鬼，得心脉则为肝儿，肾为其母，脾则为妻。所以春季得脾脉难以治疗，冬季见心脉无法治愈，夏季得肺脉难以痊愈，秋季得肝脉又何疑呢。这就是四时的休旺，以此类推生克的含义。
然而人的脉搏至数，出气为呼，入气为吸。一呼一吸，称为一息。一息之间，脉来四至或五至，为平和，不大不小，和缓舒畅，这是无病的脉象。至于三迟二败，是冷而危重；六数七极，是热得很厉害；八脱九死，极于十一二至，以及奄奄一息两息才一至，则是散而为变。比如六数七极，是热，脉中有力，为有神，应当泄其热；三迟二败，是寒，脉中有力，为有神，应当去其寒；如果在数极迟败之中，不再有力，为无神，那将如何呢？可以据此决断死期了。
然而脉理的大要，元代医家又说不出浮、沉、迟、数、滑、涩六脉之外。浮脉轻手取之；沉脉重手取之；迟、数之脉，以自己的呼吸来取之；滑、涩之脉，则观察其往来的形态。浮者，阳也，脉在肉上行，轻手即可得。而芤、洪、散、大、长、濡、弦，都属于轻手可得的一类。沉者，阴也。脉在肉下行，重手才可得。而伏、石、短、细、牢、实，都属于重手可得的一类。迟者，脉不急也，一息二、三至。而濡、缓都属于迟的一类。数者，脉来速也，一息六、七至。而疾、促都属于数的一类。至于滑、涩之脉，则通过往来察其形状。浮为阳，在表，为风、为虚；沉为阴，在里，为湿、为实；数则在腑，为热、为阳、为燥；迟则在脏，为寒、为冷、为阴；滑为血多气少；涩为气多血少；滑为血有余；涩为气独滞。这就是浮、沉、迟、数、滑、涩六脉，这是诊家的要法。
男子左手脉常大于右手，为顺；女子右手脉常大于左手，为顺。男脉在关上，女脉在关下。男子尺脉常弱，寸脉常盛；女子尺脉常盛，寸脉常弱，这是常态。反之，男得女脉为不足，女得男脉为太过。因此男子不可久泻，女子不可久吐。上部有脉，下部无脉，其人应当呕吐，不吐也不会死；上部无脉，下部有脉，病虽重，不会死，为什么呢？因为人有迟脉，谓有元气，就像树有根一样。凡人左手属阳，右手属阴；汗多亡阳，下利多亡阴。诸阴为寒，诸阳为热。
至于疾病为证，又有阴阳表里的辨别。大概六淫之邪，侵袭于经络，而未进入胃腑，如左手人迎脉紧盛，大于气口一倍，为外感风寒，皆属于表，为阳，为腑。七情之气，郁结于心腹之内，不能发散。饮食五味之伤，留于肠胃之间，不能通泄。如右手气口脉大人迎一倍，脉紧盛，为内伤饮食，皆属于里，为...
The methods of pulse diagnosis first require determining the three positions (Cun, Guan, Chi), ensuring clear distinction; one must also understand the twelve meridians, five zang organs, and six fu organs, as well as the principles of generation and restriction among the five elements, four seasons, and five zang organs. One must also know the pulse rate per breath cycle, distinguish between floating (Fu), deep (Chen), slow (Chi), rapid (Shu), slippery (Hua), and choppy (Se) pulses, and understand the origin of yin and yang diseases associated with various pulses.
What are the three positions? They refer to the Cun, Guan, and Chi positions present in both hands of a person. For pulse diagnosis, first use the middle finger to palpate behind the palm where there is a small high bone; this is the Guan position. Then place the index and ring fingers before and after the Guan position. From Guan forward to the大鱼际 (Thenar eminence), measuring one cun of the patient's own body length, it is named Cun Kou (Inch Port), which belongs to Yang. From Guan backward to the尺泽 (Chize, LU5), measuring another cun of the patient's own body length, it is named Chi Bu (Foot Section), which belongs to Yin. Furthermore, the Cun pulse occupies 6 fen, and the Guan pulse occupies 6 fen. The upper 3 fen enter into the Cun, making the total Yang within the Cun 9 fen, corresponding to the Yang number nine. The Chi section contains 7 fen, and the lower 3 fen of the Guan enter into the Chi, making the total Yin within the Chi one cun, corresponding to the Yin number ten. The total length from beginning to end is one cun and nine fen. Additionally, for tall people, fingers should be spaced widely; for short people, fingers should be placed closely. For thin/small individuals, light pressure is used; for fat/large individuals, heavy pressure is used. For impatient people, the pulse tends to be urgent; for calm people, the pulse tends to be slow. There is also the Reverse Guan Pulse (Fanguan Mai), located behind the three positions or on the side of the arm. If the pulse extends beyond the Cun Kou to the大鱼际 (Thenar eminence), it is called the Yuji Pulse (Yuji Mai). Some have larger left pulses and smaller right pulses, some have smaller left and larger right, some noble persons have faint or imperceptible pulses in both hands, and some have large and surging pulses in both hands. Careful observation is required.
When diagnosing the pulse, one must first regulate their own breathing. Follow the principle of male left, female right. Initially, apply light pressure to observe; then medium pressure; finally, heavy pressure. Push upwards to observe; upwards refers to before the Guan. Push downwards to observe; downwards refers to after the Guan. Push inward to observe; inward refers to the Zang organ pulses. Push outward to observe; outward refers to the Fu organ pulses. Then investigate step by step from Cun, Guan, to Chi. Between one exhalation and one inhalation, the pulse should beat four times as the standard. With an extra long breath, it beats five times; this is the Normal Pulse (Ping Mai). Excess or deficiency indicates a Disease Pulse (Bing Mai). The arterial pulses of the twelve meridians circulate fifty times in a day and night, gathering at the Cun Kou at dawn. The *Neijing* states that normal pulses are often diagnosed at dawn. However, disease pulses are not restricted by day or night. The *Nanjing* advocates taking only the Cun Kou because it is the location of the Hand Taiyin Lung Meridian. Ancient diagnostic methods had three types: First, dividing the visible points of the twelve meridian arteries into Heaven, Earth, and Human sections to inspect each Zang organ. Second, comparing the Cun Kou and Renying pulses to verify seasonal changes and determine disease. Third, exclusively using the Cun Kou, distinguishing Zang and Fu by interior/exterior, and body shape by high/low. This is the method adopted by Wang Shuhe for the Zang-Fu positions of the Cun Kou.
What are the Five Zang and Six Fu organs? The Five Zang are Heart, Liver, Spleen, Lung, Kidney. The Six Fu are Gallbladder, Stomach, Large Intestine, Small Intestine, Bladder, Sanjiao (Triple Burner). The point one division before the Guan on the left hand is Renying; one division before the Guan on the right hand is Qikou. The Cun Kou on the left hand is where the pulses of the Heart and Small Intestine emerge, belonging to Ministerial Fire (Jun Huo). The Guan section on the left hand is where the pulses of the Liver and Gallbladder emerge, belonging to Wind-Wood. The Chi section on the left hand is where the pulses of the Kidney and Bladder emerge, belonging to Cold-Water. The Cun Kou on the right hand is where the pulses of the Lung and Large Intestine emerge, belonging to Dry-Metal. The Guan section on the right hand is where the pulses of the Spleen and Stomach emerge, belonging to Damp-Earth. The Chi section on the right hand is where the pulses of the Mingmen (Gate of Life) and Sanjiao emerge, belonging to Ministerial Fire (Xiang Huo). Generally, the Five Zang store essence and Qi without leaking, remaining full but not solid. The Six Fu transmit and transform substances without storing, remaining solid but not full. Thus, pulse qi begins in the Middle Jiao. Food enters the mouth, stores in the Stomach, transforms into refined essence, and flows into the Hand Taiyin Lung, Hand Yangming Large Intestine, Foot Yangming Stomach, Foot Taiyin Spleen, Hand Shaoyin Heart, Hand Taiyang Small Intestine, Foot Taiyang Bladder, Foot Shaoyin Kidney, Hand Jueyin Pericardium, Hand Shaoyang Sanjiao, Foot Shaoyang Gallbladder, Foot Jueyin Liver, and finally returns to the Hand Taiyin Lung, circulating and irrigating, gathering at the Cun Kou and Renying to treat all diseases and determine life and death.
Speaking of corresponding positions, the Left Cun (Fire) restricts the Right Cun (Metal); the Left Guan (Wood) restricts the Right Guan (Earth); the Left Chi (Water) restricts the Right Chi (Fire). The left is firm, the right is soft, resembling the distinction between husband and wife. However, the left hand belongs to Yang, and the right hand belongs to Yin. The Jun Huo (Ruler's Fire) in the Left Cun is honorable and above; the Xiang Huo (Minister's Fire) in the Right Chi is humble and below, reflecting the way of ruler and minister. Speaking of the order of circulation, the Right Cun Metal generates the Left Chi Water; Water generates the Left Guan Wood; Wood generates the Left Cun Fire; Fire connects to the Right Chi Ministerial Fire; Ministerial Fire generates the Right Guan Earth; Earth generates the Right Cun Metal; and Metal generates Water again. This is the mutual generation and nourishment of the Five Elements, cycling endlessly, like the intimacy between mother and child. As stated, "The child can make the mother full; the mother can make the child empty." Treatment principles state: "Tonify the mother for deficiency; drain the child for excess." For example, Water generates Wood; Water is the mother, Wood is the child. If Wood generates Fire, and Wood has its Qi stolen, Water becomes angry and restricts Fire. This is "when the child suffers from stolen Qi, the mother strives hard." Fire generates Earth; Fire is the mother, Earth is the child. If Earth sees Fire being restricted by Water, it becomes angry and restricts Water. This is "when the mother is injured by ghosts, the son comes to rescue." Suppose Liver Wood has excess; this means Lung Metal is deficient. Metal cannot restrict Wood, so Wood fears nothing, its Qi is excessive, and it counter-attacks Lung Metal and overwhelms Spleen Earth. Thus, it attacks what it does not overcome and overwhelms what it overcomes. This is internal disorder of the Five Zang Qi leading to disease. Conversely, if Liver Wood Qi is insufficient, it cannot control Spleen Earth. Earth fears nothing and acts recklessly, thereby oppressing Kidney Water. Thus, "what is overcome acts recklessly, and what generates it suffers." If Liver Wood Qi is unbalanced, Lung Metal Qi naturally attacks it, hence "what is not overcome attacks it." When Wood Qi is unbalanced, Earth and Metal clash, forcing each other into disease, hence "Qi oppression." Generation, restriction, and overcoming cycle infinitely; take one example to illustrate the rest.
What is the correspondence of Five Zang with Five Elements, Four Seasons, and Five Tones? The Five Elements are Metal, Wood, Water, Fire, Earth. The Four Seasons are Spring, Summer, Autumn, Winter. The Five Tones are Gong, Shang, Jue, Zhi, Yu. The Liver governs tendons, its brilliance is in the nails, it houses the Hun (Ethereal Soul), its sound is shouting, its fluid is tears, corresponds to the Jue tone, harmonious and straight, belongs to Wood, corresponds to Spring, color green, taste sour. The Heart governs blood vessels, its brilliance is in the complexion, it houses the Shen (Spirit), it nourishes blood, its sign is voice, its sound is speech, its fluid is sweat, corresponds to the Zhi tone, harmonious and long, belongs to Fire, corresponds to Summer, color red, taste bitter. The Lung governs skin and hair, its brilliance is in the hair, it houses the Po (Corporeal Soul), it controls voice, its fluid is nasal mucus, corresponds to the Shang tone, light and vigorous, belongs to Metal, corresponds to Autumn, color white, taste pungent. The Kidney governs bones, its brilliance is in the hair, it fills the bones, it houses Jing (Essence) and Zhi (Willpower), its sign is hearing, its sound is groaning, its fluid is saliva, corresponds to the Yu tone, deep and profound, belongs to Water, corresponds to Winter, color black, taste salty. The Spleen governs muscles, its brilliance is in the lips, it fills the muscles, it houses Yi (Intellect) and Zhi (Willpower), its sound is singing, its fluid is salivary fluid, corresponds to the Gong tone, grand and harmonious, belongs to Earth, corresponds to the last month of each season, color yellow, taste sweet. This is the correspondence of Five Zang with Five Elements, Four Seasons, and Five Tones.
What are the seasonal pulses? They are Spring String-like (Xian), Summer Hook-like (Gou/Hong), Autumn Feather-like (Mao/Fu), Winter Stone-like (Shi/Chen). The Spring pulse is Xian: In the first month (Yin) and second month (Mao), Wood is prosperous. The Spring pulse floats like a fish swimming in waves, emerging but not fully floating, hence string-like and long, responding to the East Liver Wood Qi. The Summer pulse is Gou (Hong): In the fourth month (Si) and fifth month (Wu), Fire flares up. The Summer pulse is at the skin level, Yang Qi is too abundant, hence the pulse comes with force, floating, large, and rapid, responding to the South Heart Fire Qi. The Autumn pulse is Mao (Fu): In the seventh month (Shen) and eighth month (You), Metal is prosperous. Metal nature is light and floating. The Autumn pulse sinks below the skin as Yang Qi gradually descends and prepares to hide, hence the pulse comes floating, choppy, and short, responding to the West Lung Metal Qi. The Winter pulse is Shi (Chen): In the tenth month (Hai) and eleventh month (Zi), Water is prosperous. Water nature flows downward. The Winter pulse is in the bones, Yang Qi is hidden, hence the pulse is deep, soft, and slippery, responding to the North Kidney Water Qi. In the months of Chen, Xu, Chou, and Wei (seasonal transition months), the pulse is slow and relaxed, indicating Earth nature is heavy, the pulse comes harmonious and large, responding to the Central Spleen Earth Qi. Although seasonal pulses differ in Xian, Gou, Mao, and Shi, in the three months of Spring, all six positions carry a Xian quality; in Summer, all carry Hong; in Autumn, all carry Fu; in Winter, all carry Chen. Pressing within the six positions, if accompanied by harmony and relaxation, it indicates Stomach Qi, which is a healthy pulse. If Xian, Gou, Mao, or Shi appear without harmony and relaxation, these are True Zang Pulses (Zhen Zang Mai), indicating death even without apparent illness.
Generally, the pulse is the precursor of Qi and Blood. Abundant Qi and Blood mean abundant pulse; deficient Qi and Blood mean deficient pulse. Hot Qi and Blood mean rapid pulse; cold Qi and Blood mean slow pulse. Strong Qi and Blood mean large pulse; weak Qi and Blood mean small pulse. Harmonious Qi and Blood mean balanced pulse. Broadly speaking, upon initial palpation, light touch reveals pulses at the skin level, which are Yang, Fu, and correspond to the Heart. Since Heart and Lung are superior, their pulses are all floating. Floating, large, and scattered indicates Heart; floating, choppy, and short indicates Lung. Heavy touch reveals pulses beneath the muscle, which are Yin, Zang, and correspond to Liver and Kidney. Since Liver and Kidney are inferior, their pulses are all deep. String-like and long indicates Liver; deep, soft, and slippery indicates Kidney. Medium pressure reveals pulses between muscle and skin, representing balance of Yin and Yang, the response of Harmony, and the sign of Spleen and Stomach. Since Spleen resides in the Central Region, the pulse is slow and large. This is the normal pulse of healthy Zang organs. Diagnosticians must thoroughly understand normal pulses to distinguish disease pulses. A short pulse appearing at the skin level indicates Yin invading Yang; a large and surging pulse appearing beneath the muscle indicates Yang invading Yin. This applies to both Cun and Chi.
Further subdividing by the twelve meridians, pulses have floating and deep qualities, requiring different pressures. For the Left Cun, light touch reveals the Small Intestine (Exterior); heavy touch (weight of six beans) reveals the Heart (Interior). The Heart is below the Lung, governing blood vessels. The Heart pulse travels with the blood vessels; pressing until the vessel is felt is floating. Adding slight pressure makes the vessel channel coarse and large. Adding more pressure makes the vessel channel moist, soft, and scattered; this floating, large, and scattered quality is a healthy pulse. If it emerges above the blood vessel to the skin, it is floating; if it enters below the blood vessel to the bone/tendon, it is deep. For the Left Guan, light touch reveals the Gallbladder (Exterior); heavy touch (weight of twelve beans) reveals the Liver (Interior). The Liver is below the Spleen, governing tendons. The Liver pulse travels with the tendons. Pressing to the tendon level, if the vessel feels like a zither string, it is Xian (String-like). Slightly adding pressure makes it long (Tiao Tiao); this Xian and Long quality is healthy. If it emerges above the tendon to the skin/blood vessel, it is floating; if it enters below the tendon to the bone, it is deep. For the Left Chi, light touch reveals the Bladder (Exterior); heavy touch (weight of fifteen beans) reveals the Kidney (Interior). The Kidney is below the Liver, governing bones. The Kidney pulse travels with the bones; pressing to the bone yields deep. Heavy pressing with no force indicates Ru (Soft). Lifting the finger reveals swift and smooth flow, indicating Hua (Slippery); this deep, soft, and slippery quality is healthy. If it emerges above the bone to the skin/muscle, it is floating; if it reaches the bone, it is deep. For the Right Cun, light touch reveals the Large Intestine (Exterior); heavy touch (weight of three beans) reveals the Lung (Interior). The Lung is highest, governing skin and hair. The Lung pulse travels with the skin/hair; pressing to the skin yields floating. Adding slight pressure makes the vessel channel obstructed, indicating Se (Choppy). Adding more pressure causes the vessel to shrink into the Guan area; the upper half of the finger remains still while the lower half moves slightly, indicating Short (Duan); this floating, choppy, and short quality is healthy. If it emerges above the skin/hair to the surface, it is floating; if it enters into the blood vessel/muscle layer, it is deep. For the Right Guan, light touch reveals the Stomach (Exterior); heavy touch (weight of nine beans) reveals the Spleen (Interior). The Spleen is below the Heart, governing muscles. The Spleen pulse travels with the muscles; pressing to the muscle, if the vessel feels like willow tips in a breeze, it is Huan (Slow/Relaxed). Adding slight pressure makes the vessel solid and large; this slow and large quality is healthy. If it emerges above the muscle to the skin/hair, it is floating; if it enters below the muscle to the bone/tendon, it is deep. For the Right Chi, light touch reveals the Sanjiao (Exterior); heavy touch reveals the Mingmen (Interior), which is Ministerial Fire, with Qi connecting to the Kidney.
There is also the secret of Three Sections and Nine Inspections. Three Sections refer to Cun, Guan, Chi. Nine Inspections refer to Floating, Medium, Deep. Each of the three sections has Floating, Medium, and Deep inspections, totaling nine. Floating inspection governs the skin, observing Exterior and Fu diseases. Medium inspection governs the muscle, observing Stomach Qi. Deep inspection governs the bone/tendon, observing Interior and Zang diseases. Cun is Yang, Upper Section, modeling Heaven, corresponding to Heart/Lung, addressing the Upper Jiao, governing diseases from the chest/heart up to the head. Guan is the center of Yin/Yang, Middle Section, modeling Humanity, corresponding to Liver/Spleen, addressing the Middle Jiao, governing diseases from the diaphragm down to the navel. Chi is Yin, Lower Section, modeling Earth, corresponding to Kidney/Mingmen, addressing the Lower Jiao, governing diseases from the navel down to the feet. This is the general method of Three-Section diagnosis.
Furthermore, pulses have Up/Down, Coming/Going, Arrival/Stop. If these six concepts are unclear, Yin/Yang and Deficiency/Excess cannot be distinguished. Up, Coming, Arrival belong to Yang. Down, Going, Stop belong to Yin. Up means rising from Chi to Cun, Yang born from Yin. Down means descending from Cun to Chi, Yin born from Yang. Coming means emerging from the bone/tendon depth to the skin surface, the ascent of Qi. Going means returning from the skin surface to the bone/tendon depth, the descent of Qi. "Arrival" refers to the beat; "Stop" refers to the interval between beats.
What is the logic of Generation and Restriction? It refers to the Five Elements' mutual generation and restriction. Generation: Metal generates Water, Water generates Wood, Wood generates Fire, Fire generates Earth, Earth generates Metal. Restriction: Metal restricts Wood, Wood restricts Earth, Earth restricts Water, Water restricts Fire, Fire restricts Metal. Generally, pulses encountering generation are auspicious; those encountering restriction are ominous. Why? If the Heart pulse appears deep and fine, Liver pulse short and choppy, Kidney pulse slow and relaxed, Lung pulse large and surging, Spleen pulse string-like and long, these all encounter restriction, representing invasion by "Ghost Thieves," indicating critical conditions. Conversely, if Heart pulse appears slow, Liver pulse surging, Lung pulse deep, etc., this represents the child nourishing the mother, encountering a pulse that generates me. Even if ill, recovery is easy. If Kidney disease transmits to Liver, and Liver to Heart, this is the mother suppressing the child. The disease may not be fatal but will linger. Also, what I restrict is my "Wife." For example, in Spring (Wood), if the Spleen Earth pulse appears, the husband receives the wife's pulse. If the wife overwhelms the husband, although not a direct restriction, seeing only the Spleen pulse in Spring means Earth overwhelms weak Wood. After Earth overwhelms, it generates Metal to restrict Wood. If the Liver pulse is string-like and relaxed, retaining its original form, the Spleen Earth's overwhelming effect is minor evil, not worrying. But if the original pulse is completely absent, and only the Spleen relaxed pulse appears, the harm will be severe. The *Mai Fu* says: "Suppose Spring gets Lung pulse, it is Ghost; gets Heart pulse, it is Liver's child; Kidney is Mother; Spleen is Wife." Thus, Spring getting Spleen pulse is hard to treat; Winter seeing Heart pulse is incurable; Summer getting Lung pulse is difficult to heal; Autumn getting Liver pulse is equally doubtful. This illustrates the meaning of generation and restriction through the waxing and waning of the four seasons.
However, the pulse rate depends on exhalation (Hu) and inhalation (Xi). One exhale and one inhale constitute one Xi (breath cycle). Between one Xi, the pulse beats four or five times, indicating peace, neither too big nor too small, harmonious and smooth, which is a healthy pulse. Three beats per Xi or two failures indicate cold and danger. Six rapid or seven extreme beats indicate severe heat. Eight depletion or nine death, up to eleven or twelve beats, or lingering with one beat every two breaths, indicate dispersion and transformation. For example, six rapid/seven extreme is Heat; if the pulse has force, it has Shen (Spirit), so drain the heat. Three slow/two failure is Cold; if the pulse has force, it has Shen, so remove the cold. If in rapid/extreme/slow/failure states, there is no longer force, it lacks Shen; how can this be resolved? One can predict the time of death.
The essence of pulse theory, according to Yuan dynasty physicians, lies in the six pulses: Floating, Deep, Slow, Rapid, Slippery, Choppy. Floating pulse is taken with light touch; Deep pulse with heavy touch. Slow and Rapid pulses are measured by one's own breathing. Slippery and Choppy pulses are observed by their coming and going shapes. Floating is Yang, pulse travels above the muscle, obtained with light touch. Kous, Hong, San, Da, Chang, Ru, Xian all belong to light-touch categories. Deep is Yin, pulse travels below the muscle, obtained with heavy touch. Fu, Shi, Duan, Xi, Lao, Shi all belong to heavy-touch categories. Slow means the pulse is not urgent, beating two or three times per Xi. Ru and Huan belong to Slow. Rapid means the pulse comes quickly, beating six or seven times per Xi. Ji and Cu belong to Rapid. Slippery and Choppy pulses are distinguished by their movement shape. Floating is Yang, exterior, Wind, Deficiency. Deep is Yin, interior, Dampness, Excess. Rapid is in Fu organs, Heat, Yang, Dryness. Slow is in Zang organs, Cold, Yin. Slippery means much Blood and little Qi. Choppy means much Qi and little Blood. Slippery means Blood excess. Choppy means Qi stagnation alone. These six pulses—Floating, Deep, Slow, Rapid, Slippery, Choppy—are the essential methods of pulse diagnosis.
For men, the left pulse is usually larger than the right; this is favorable. For women, the right pulse is usually larger than the left; this is favorable. Men's pulse is above the Guan; women's pulse is below the Guan. Men's Chi pulse is usually weak, Cun pulse strong; Women's Chi pulse is usually strong, Cun pulse weak. This is the norm. Reversal: Man getting Woman's pulse indicates insufficiency; Woman getting Man's pulse indicates excess. Therefore, men should not undergo prolonged purgation; women should not undergo prolonged emesis. If there is pulse in the upper part but none in the lower part, the person should vomit; if they do not vomit, they will not die. If there is no pulse in the upper part but pulse in the lower part, even if the disease is severe, they will not die. Why? Because having a slow pulse implies the presence of Yuan Qi (Original Qi), like a tree having roots. Generally, the left hand belongs to Yang, the right to Yin. Excessive sweating destroys Yang; excessive downward discharge destroys Yin. All Yin is Cold; all Yang is Heat.
Regarding disease syndromes, there is a distinction between Yin/Yang and Exterior/Interior. Generally, pathogenic factors of the Six Evils invade the meridians but have not entered the Stomach Fu. If the Left Hand Renying pulse is tight and surging, double the size of the Qikou pulse, it is external contraction of Wind-Cold, belonging to Exterior, Yang, and Fu. Emotional Qi (Seven Emotions) stagnates within the heart and abdomen, unable to disperse. Injury from the Five Flavors of food and drink remains in the intestines and stomach, unable to be discharged. If the Right Hand Qikou pulse is larger than the Renying pulse by double, and is tight and surging, it is internal injury from diet, belonging to Interior, Yin...