东方角木春肝木。木畏金。遇肺金乘木大逆。八月死。
南方征火夏心火。畏水。遇肾水乘火大逆。十一月死。
中央宫土脾土。畏木。遇肝木乘土大逆。二月死。
西方商金秋肺金。畏火。遇心火乘金大逆。五月死。
北方羽水冬肾水。畏土。遇脾土乘水大逆。六月死。（此即前四季相克脉也。前言其所死之日。此言其所死之月。
故两存之。）
春得冬脉只是虚。（谓春脉弦。反得冬石脉。是肾水。为木之母从后来乘肝木之子。为虚邪。）兼令补肾病自除。
（母虚则补之）若得夏脉缘心实。（得夏洪脉。是心火。为木之子从前来乘肝木之母。为实邪。）还应泻子自无虞。（子
实则泻之。）夏秋冬脉皆如是。在前为实后为虚。春中若得四季脉。不治多应病自除。（四季缓脉。是脾土。为木之妻不
胜于夫。为微邪。虽不治而病自愈。）
凡诊候安神靖气。男先诊左手。女先诊右手。将中指揣得关位。却以第一指着寸部令彻骨。
渐徐举指。关尺部皆然。（此先重而后轻也。活人书云。先浮按消息之。次中按。次重按。此先
轻而后重也。亦得。）
脉来五十动一止者。五脏六腑受气足。其人无病。
脉来四十动一止者。一脏无气。谓肾气先尽也。其人后四年春草生时死。
脉来三十动一止者。二脏无气。其人后三年谷雨至时死。
脉来二十动一止者。三脏无气。其人后二年桑椹赤时死。
脉来十动一止者。四脏无气。其人后一年草枯时死。
脉来五动一止者。五脏无气。其人后五日死。
王叔和云。脉来四动一止八日死。三动一止六七日死。两动一止三四日死。（别本云。但此
止者非结脉促脉之止也。此是代脉之止也。至于代脉。非达人者难窥者乎。）
东方属角木，对应春季和肝木。木畏惧金。如果遇到肺金克制肝木，这是大逆之象，患者会在八月死亡。
南方属征火，对应夏季和心火。火畏惧水。如果遇到肾水克制心火，这是大逆之象，患者会在十一月死亡。
中央属宫土，对应长夏（或四季之末）和脾土。土畏惧木。如果遇到肝木克制脾土，这是大逆之象，患者会在二月死亡。
西方属商金，对应秋季和肺金。金畏惧火。如果遇到心火克制肺金，这是大逆之象，患者会在五月死亡。
北方属羽水，对应冬季和肾水。水畏惧土。如果遇到脾土克制肾水，这是大逆之象，患者会在六月死亡。（这就是前文提到的四季相克脉象。前文说的是死亡的具体日子，这里说的是死亡的月份，所以两者都保留记录。）
春季如果诊得冬季的脉象，只是虚邪。（所谓春脉应弦，反而得到冬季石脉，这是肾水作为木之母，从后来乘袭肝木之子，属于虚邪。）兼用补益肾病的方法即可自行消除。（母虚则补其母）如果诊得夏季的脉象是因为心气实。（得到夏季洪脉，这是心火作为木之子，从前来乘袭肝木之母，属于实邪。）还应采用泻子法即可无虞。（子实则泻其子）。夏季、秋季、冬季的脉象情况都是如此。脉象出现在前为实，出现在后为虚。如果在春季中间诊得四季脉（指缓脉），通常不治疗疾病也会自愈。（四季缓脉，是脾土，作为木之妻，不胜于夫，属于微邪，虽然不治疗而病自愈。）
凡是诊候，要安神定气。男性先诊左手，女性先诊右手。将中指按在关位上，然后用食指去探查寸部，要求按至骨。逐渐缓慢地抬起手指，关部和尺部也是这样操作。（这是先重按后轻按的方法。《活人书》说：先浮取以观察脉象，再中取，最后重取。这是先轻后重的方法，也是可以的。）
脉搏跳动五十次出现一次停顿，说明五脏六腑受气充足，这个人没有病。
脉搏跳动四十次出现一次停顿，说明有一脏无气，说是肾气先耗尽。这个人将在四年后春草生长时死亡。
脉搏跳动三十次出现一次停顿，说明有两脏无气。这个人将在三年后谷雨时节到来时死亡。
脉搏跳动二十次出现一次停顿，说明有三脏无气。这个人将在两年后桑椹变红时死亡。
脉搏跳动十次出现一次停顿，说明有四脏无气。这个人将在一年后草木枯黄时死亡。
脉搏跳动五次出现一次停顿，说明五脏无气。这个人将在五天后死亡。
王叔和说：脉搏跳动四次出现一次停顿，八天后死亡；三次出现一次停顿，六七天死亡；两次出现一次停顿，三到四天后死亡。（别本注释说：这里的“止”不是结脉或促脉的止，而是代脉的止。至于代脉，不是通达医理的人难以窥探其中的奥妙。）
The East corresponds to Jue Wood, Spring, and Liver Wood. Wood fears Metal. If Lung Metal overacts on Liver Wood, it is a great reversal (Da Ni), and death will occur in the eighth month.
The South corresponds to Zheng Fire, Summer, and Heart Fire. Fire fears Water. If Kidney Water overacts on Heart Fire, it is a great reversal, and death will occur in the eleventh month.
The Center corresponds to Gong Earth, the late summer season (or end of four seasons), and Spleen Earth. Earth fears Wood. If Liver Wood overacts on Spleen Earth, it is a great reversal, and death will occur in the second month.
The West corresponds to Shang Metal, Autumn, and Lung Metal. Metal fears Fire. If Heart Fire overacts on Lung Metal, it is a great reversal, and death will occur in the fifth month.
The North corresponds to Yu Water, Winter, and Kidney Water. Water fears Earth. If Spleen Earth overacts on Kidney Water, it is a great reversal, and death will occur in the sixth month. (This refers to the pulse patterns of mutual restriction among the four seasons mentioned earlier. The previous text specified the day of death, while this section specifies the month; therefore, both are recorded.)
If a Winter pulse is obtained in Spring, it indicates only Deficient Pathogenic Factor (Xu Xie). (The Spring pulse should be Wiry [Xian]; obtaining the Stone-like pulse of Winter indicates that Kidney Water, as the Mother of Wood, attacks from behind the Son of Liver Wood, constituting a Deficient Pathogen.) Supplementing the diseased Kidney will resolve it spontaneously. (When the Mother is deficient, tonify her.) If a Summer pulse is obtained due to Heart Excess, there is no cause for alarm. (Obtaining the Flood-like [Hong] pulse of Summer indicates that Heart Fire, as the Son of Wood, attacks from ahead of the Mother of Liver Wood, constituting an Excess Pathogen.) Draining the Son will ensure safety. (When the Son is excess, drain him.) The same logic applies to pulses obtained in Summer, Autumn, and Winter. Pulses appearing "ahead" indicate Excess, while those appearing "behind" indicate Deficiency. If a Four Seasons pulse (referring to the Moderate [Huan] pulse) is obtained in mid-Spring, the illness will likely resolve spontaneously without treatment. (The Moderate pulse of the Four Seasons belongs to Spleen Earth. As the Wife of Wood, it does not overpower the Husband, constituting a Minor Pathogen; thus, even without treatment, the disease heals itself.)
When performing pulse diagnosis, one must calm the mind and quiet the spirit. For males, diagnose the Left Hand first; for females, diagnose the Right Hand first. Place the middle finger at the Guan position, then use the index finger to probe the Cun position, pressing firmly to the bone. Gradually and slowly lift the fingers; the same applies to the Guan and Chi positions. (This method involves heavy pressure followed by light pressure. The *Liu Ren Shu* states: first palpate superficially to observe the pulse, then moderately, and finally deeply. This method involves light pressure followed by heavy pressure, which is also acceptable.)
If the pulse stops after fifty beats, the Qi of the Five Zang and Six Fu organs is sufficient, and the person is healthy.
If the pulse stops after forty beats, one Zang organ has lost its Qi, specifically indicating that Kidney Qi has been exhausted first. The person will die when spring grass grows, four years later.
If the pulse stops after thirty beats, two Zang organs have lost their Qi. The person will die when Grain Rain arrives, three years later.
If the pulse stops after twenty beats, three Zang organs have lost their Qi. The person will die when mulberry fruits turn red, two years later.
If the pulse stops after ten beats, four Zang organs have lost their Qi. The person will die when grass withers, one year later.
If the pulse stops after five beats, all five Zang organs have lost their Qi. The person will die in five days.
Wang Shuhe stated: If the pulse stops after four beats, death occurs in eight days; if it stops after three beats, death occurs in six or seven days; if it stops after two beats, death occurs in three to four days. (Alternative texts note: The "stop" here does not refer to the pauses in Knotted [Jie] or Surging [Cu] pulses, but rather to the pauses in Interpolated [Dai] pulses. As for Dai pulses, they are difficult to comprehend unless one is a master of medical principles.)