切脉定知生死路。但向止代涩中取。
内经云。切脉动静而视精明。察五色。观五脏有余不足。六腑强弱。形之盛衰。可以决
生死
为
看取涩脉与止代。此是死期之大概。涩脉喻外有形证。未可断他殂大命。若无形证
与代同。
素问曰代。难经曰止。二义同也。脉不应止。满五十动而无代。则五脏之气通布不穷矣。
夫
能至肾。至肝而还也。知肾气先尽矣。夫五脏有气者生。无气者死。涩细而迟。往来难时一
止。为精血不足之候。与代相似。然三秋诊脉得涩而有胃气。为秋令平脉。右手寸口浮短而
涩为肺正脉。既非死脉。亦非病脉也。若尺寸脉俱浮而涩。其外证必发热。恶寒头疼。项强
腰痛。以至牵连百骨节俱痛。太阳经伤寒也。可汗之而愈。举此数端。则知涩脉大不可例言
也。故云。喻外有形证。意极明悉。学人当三思之。若尺脉者人之根本。人有原气故不死。
涩脉为精血不足之候。若独见于尺中则为必死之候。故曰与代同也。
欲知死期何以取。古贤推定五般土。阳土须知不过阴。阴土遇阳当细数。四季中央
戊己同。
五土者。以气候言之也。凡人身五行与天地同。以天地论则人身可知。天地人三才既可
知。
候变
七十
土
生
四
休
休
王
二
不
金生水。故季秋金休而变冬。冬水也。水生木。故季冬水休而变春。此乃土在四时之中。天
有五星。镇在中。地有五岳。嵩居中。人有五脏。脾主中州。五土既皆居中。故知万物之中
。四时之中。七十二候之中。皆以土为主也。天若失土。则万象无次序。而不能圆覆于上。
地若失土。则万物无变化。而不能承载于下。人若失土。则禀受不备也。以此数论。则知天
地万物皆以土为要。然有阳土。有阴土。艮为阳土。而坤为阴土。艮者东北之卦也。时为十
二月、正月之交。万物之所成。终而成始也。坤者西南之卦也。时为六月、七月之交。万
盛极。还元气归神伏也。一阳生于子。六阳极于午。六阴极于亥。四月阳土。育生万物。
此无乎不盛。而土力已衰矣。故曰阳土。须知不过阴也。十月阴土。取藏万物。至此不生
而土力将旺矣。故曰阴土遇阳当细数也。内经曰。阴阳者天地之道也。老子曰。万物负阴而
抱阳。冲气以为和矣。系辞云。一阴一阳之谓道。大抵阴无阳不生。阳无阴不长。阴阳和合
。则生生化化之理不穷矣。阴与阳相离。则生生化化之理绝矣。孟子曰。老而无妻曰鳏。老
而无夫曰寡。孤阳绝阴者。与鳏夫寡妇之义同也。
假如申年肾止代。十动一岁分明主。尺部失主鬼称尊。其人子年夏季死。
老阳之数极于九。老阴之数极于十。十动应一脏者。阴阳之数完矣。细而计之五脏气备。
则
年
则鬼称尊。应其期而死。
鬼贼脉在年内死。此事人间尽称会。春得肺脉死庚辛。愚者反嫌药不对。叔和脉经
论精微。
四时之脉。应其时者为从。胜其时者为逆。内经曰。脉从四时谓之可治。脉逆四时为不
可治
在庚
尺部伏似树无根。阴毒阳寒合其类。回阳着艾后仍看。切骨若无堪下泪。
难经曰。人之有尺脉。譬如树之有根本。人有原气。故知不死。尺部伏而不动。则如树
之无
令阳
若人六脉动摇摇。又怕其中无胃气。
内经曰。四时皆以胃气为本。故云。六脉无胃气则不能生。假如弦脉。属木应肝。于时
为春
神也
有土
屋漏雀啄恶见脾。余部见之皆不畏。死期常例有多门。弹石解索须细论。此候不逾
于一季。
火二木三量
内经云。脾者土也。孤脏以溉四旁者也。善者不可得见。恶者即见。如雀之啄。如水之
下
为
石
弹
约
去。
气。
绝也
之。
每季土旺十八日。此法古今永无失。黄帝一法四分三。一法亦云三十日。随分远近
各不同。
土无正行。寄旺四季。故立春节后。肝木旺七十二日。立夏节后心火旺七十二日。立秋
节后
亦大
四时
土之
唯是伤寒最无定。汗吐下后脉须静。忽然相反即难医。外边尤怕乖形证。
伤寒古谓之大病。其死生存亡在乎旬日之间。伤寒之为病。自背得之则入太阳。或入少
阴。
病汗
其
脉息至少冷虚惫。至多热壅非为怪。补虚泻实更仍前。见此分明还可验。
脉来一呼再至。一吸再至。不大不小。则阴阳各当其分。而不相胜也。故曰平人。减之。
法
实
则脉
谓
上医四事尽须谙。脉病证治要相参。有一乖违难措手。此即难医大不堪。
学医之道。须谙脉病证治四事。难经云。知一为下工。知二为中工。知三为上工。上工
十全
更有久病及暴病。大都要论须详贯。久病脉变即不中。死候当知宜早辨。暴病脉变
亦多端。
脉要精微论曰。有故病五脏发动。因脉伤色。各何以知其久暴至之病乎。微其脉小。色
不夺
与五
脉不
前为阳关后阴。妇人反此是冠簪。乘凌覆溢相侵夺。营卫调和理更深。
关者阴阳之界也。关前为阳。名曰寸口。关后为阴。名曰尺泽。男子为阳。得阴而生。
先生
故寸
女子
谓此
出为
格其实
则曰关
欲识童男与童女。诀在寸关并尺里。自然紧数甚分明。都缘未散精华气。
男女有阴阳之质不同。天癸与精液之形亦异。阴天海满而失血。阳动阴合而泄精。故女
子二
谐。
之所
本经自病最难医。纵疗何年有瘥时。
难经云。忧愁思虑则伤心。形寒饮冷则伤肺。恚怒气逆则伤肝。饮食劳倦则伤脾。久坐
湿地
形以阴为主。故于肺言形寒饮冷。于肾言久坐湿地。强力入水。夫正经有一定。则体既可分
矣。
则气
广大
言动
间藏七传无外证。强将丸散与扶持。
难经云。七传者其所胜也。间藏者传其子也。假令心病传肺。肺传肝。肝传脾。脾传肾。
肾
心
伤寒中风自难看。指下逢之脉撩乱。合吐而泻即非良。汗脉见时须发汗。然虽得汗
状如珠。
。此状见之当
伤寒者。古谓之大病。风者百病之长也。其始得之脉亦难看。又况伤寒中风外证多端。
未诊
宜下
云。
漓。夫汗者。真气至阳之液也。若乃汗出如珠。着身不流。则精绝。精绝则气先死。气绝则
上下
更有死脉多般样。难经细说那堪忘。从上损下死即迟。死脉多从下损上。连得五脏
死疾时。
难经云。脉有损至。然至之脉。一呼再至曰平。三至曰离经。四至曰夺精。五至曰死。
六至
绝
而
不
病
肺
者
病候脉状多中取。要知大抵医门户。有一乖违即不中。但看强者惟为主。
脉为医门之先。其理微妙未易研究。大抵问而知之以观其外。切而知之以察其内。证之
与脉
复有久病更难看。或与健人脉一般。忽然加至脉翻变。脉病不应好买棺。
内经云。形气有余。脉气不足者死。脉气有余。形气不足者生。且脉者气血之先。气血
盛则
若遇风疾及劳病。妙法看时如抵圣。风疾脾缓空费力。劳疾心数难存命。风疾无令
脉至迟。
风疾劳疾生死脉别。若悟玄机有如抵圣。风邪之中于人也。其状奄忽。善行数变。其猝
中于
辨。若脾脉缓而无力者。最为难治。盖风喜归肝。肝木克于脾。则大便洞泄。千金方云。中
风大
风淫
复而
中州
伤寒中风得死脉。但将真药与病门。药灵病退脉须和。脉若准前病难救。
伤寒中风本为大患。更见死脉。十无一生。若根据仲景法度。随证施治。则正气胜邪。间
有生
病
如此定知生死期。可作医家箕本柄。若能指下悟玄机。便是灵台挂明镜。\x
王叔和云。脉理精微非言可传。心中了了。指下难明。后人能顿悟玄机。则心中洞然如
挂明
切脉可以确定生死的关键。主要依据止脉、代脉和涩脉来判断。
《内经》说：通过切脉的动静，观察眼睛的神采（精明），审视面色五色，查看五脏的有余与不足，六腑的强与弱，以及形体的盛衰，就可以决断生死。
看取涩脉与止代脉，这是判断死期的大致依据。涩脉比喻外部有明显的症状表现，还不能断定他会死亡。如果没有任何外部症状，却出现代脉，那就不同了。
《素问》说“代”，《难经》说“止”，这两种说法含义相同。脉搏不应该出现停顿，跳动满五十次而没有代象，那么五脏之气就能通畅布散而不穷尽。如果能到达肾脏，再返回肝脏，说明肾气已经先耗尽。五脏有气则生，无气则死。涩脉细而迟，往来困难，偶尔有一次停顿，这是精血不足的征候。这与代脉相似。然而，在秋季诊脉得到涩脉且有胃气，是秋季的平脉（正常脉）。右手寸口脉浮短而涩，是肺的正脉，既不是死脉，也不是病脉。如果尺寸两部脉都浮而涩，外部症状必定有发热、恶寒、头痛、项强、腰痛，甚至牵连全身骨节都痛，这是太阳经受伤寒，可以用发汗法治疗而痊愈。列举这几端情况，就知道涩脉不能一概而论说是死脉。所以说“比喻外部有形证”，意思非常明确清楚。学医的人应当深思。至于尺脉，是人的根本。人有原气所以不死。涩脉是精血不足的征候，如果单独出现在尺部，就是必死的征候。所以说“与代脉相同”。
想要知道死期如何推断？古代贤人推定为五种土的情况。阳土的日子肯定不超过阴土的日子，阴土遇到阳日应当仔细推算。四季中央戊己土相同。
这五种土，是从气候角度说的。凡是人身五行与天地相同，以天地来论述，人身的情况就可以知道了。天、地、人三才既然可以知晓，气候的变化也可以了解。
金生水，所以季秋时金处于休的状态而转变为冬水。水生木，所以季冬时水处于休的状态而转变为春木。这就是土在四时之中。天上有五星，镇星居中；地上有五岳，嵩山居中；人有五脏，脾主中州。五土既然都居中，所以知道万物之中、四时之中、七十二候之中，都以土为主。天如果失去土，万象就没有次序，不能圆覆于上；地如果失去土，万物就没有变化，不能承载于下；人如果失去土，禀受就不完备。以此数论，就知道天地万物都以土为重要。然而有阳土，有阴土。艮卦为阳土，坤卦为阴土。艮是东北的卦，时间是十二月、正月之交，万物所成终而成始。坤是西南的卦，时间是六月、七月之交，万物极盛，元气回归神伏。一阳生于子月，六阳极于午月，六阴极于亥月。四月是阳土，孕育生长万物，这里无不兴盛，但土力已经衰弱了，所以说阳土须知不超过阴土。十月是阴土，收藏万物，到这里不再生长，但土力将要旺盛了，所以说阴土遇阳当仔细推算。《内经》说：阴阳是天地之道。老子说：万物背负阴而怀抱阳，冲气以为和。《系辞》说：一阴一阳叫做道。大抵阴没有阳不能生，阳没有阴不能长，阴阳和合，那么生生化化的道理就不会穷尽。阴与阳相离，那么生生化化的道理就断绝了。孟子说：老而无妻叫鳏，老而无夫叫寡。孤阳绝阴，与鳏夫寡妇的意义相同。
假如申年肾脉出现止或代，十动对应一岁，分明主宰。尺部失主，鬼贼称尊。此人如果在子年夏季死亡。
老阳之数极于九，老阴之数极于十。十动对应一脏，阴阳之数就完备了。仔细计算，五脏气备，如果是鬼贼脉，在年内死亡，这件事人间都称会。春季得肺脉，死于庚辛日。愚者反而嫌弃药不对症。叔和《脉经》论述精微。
四时的脉，应合时令的为顺，胜过时令的为逆。《内经》说：脉从四时叫做可治，脉逆四时为不可治。
尺部脉伏，像树没有根。阴毒阳寒同类相合。回阳灸艾后仍然要看，切骨若无，令人堪悲流泪。
《难经》说：人如果有尺脉，就像树有根本。人有原气，所以知道不死。尺部脉伏而不跳动，就像树没有根。
如果有人六脉动摇不定，又怕其中没有胃气。
《内经》说：四时都以胃气为本。所以说：六脉无胃气就不能生。假如弦脉，属木应肝，在时令为春，有神。有土。
屋漏雀啄恶见脾，其余部位见到都不害怕。死期常例有很多门路。弹石解索须仔细讨论。这种征候不超过一季。
火二木三量。
《内经》说：脾是土，是孤脏，用来灌溉四旁。好的表现不可得见，坏的表现即见。如鸟雀啄食，如水之下滴。气绝也。
每季土旺十八日，这种方法古今永远不失。黄帝有一种法四分三，另一种法也说三十日，随分远近各不同。
土没有正行，寄旺于四季。所以立春节后，肝木旺七十二日；立夏节后，心火旺七十二日；立秋节后……
只有伤寒最没有定规。汗、吐、下之后，脉必须静。忽然相反就难医治，外部尤其怕违背形证。
伤寒古时候称为大病，其死生存亡在乎旬日之间。伤寒这种病，从背部得之则入太阳经，或入少阴经。
其脉息至少冷虚惫，至多热壅不为怪。补虚泻实更仍前，见此分明还可验。
脉来一呼再至，一吸再至，不大不小，那么阴阳各当其分，而不相胜。所以叫平人。减之……
上医四事尽须谙，脉病证治要相参。有一乖违难措手，此即难医大不堪。
学医之道，须谙脉、病、证、治四事。《难经》说：知一为下工，知二为中工，知三为上工。上工十全……
更有久病及暴病，大都要论须详贯。久病脉变即不中，死候当知宜早辨。暴病脉变亦多端。
《脉要精微论》说：有故病五脏发动，因脉伤色，各何以知其久暴至之病乎？微其脉小，色不夺……
前为阳关后阴，妇人反此是冠簪。乘凌覆溢相侵夺，营卫调和理更深。
关是阴阳的界限。关前为阳，名叫寸口；关后为阴，名叫尺泽。男子为阳，得阴而生。先生……女子……谓此出为格其实则曰关。
欲识童男与童女，诀在寸关并尺里。自然紧数甚分明，都缘未散精华气。
男女有阴阳之质不同，天癸与精液之形亦异。阴天海满而失血，阳动阴合而泄精。故女子二……谐。之所。
本经自病最难医，纵疗何年有瘥时。
《难经》说：忧愁思虑则伤心，形寒饮冷则伤肺，恚怒气逆则伤肝，饮食劳倦则伤脾，久坐湿地……
形以阴为主，故于肺言形寒饮冷，于肾言久坐湿地，强力入水。夫正经有一定，则体既可分矣。
则气广大言动间藏七传无外证，强将丸散与扶持。
《难经》说：七传者其所胜也。间藏者传其子也。假令心病传肺，肺传肝，肝传脾，脾传肾，肾……心。
伤寒中风自难看，指下逢之脉撩乱。合吐而泻即非良，汗脉见时须发汗。然虽得汗状如珠。
伤寒者，古谓之大病。风者百病之长也。其始得之脉亦难看。又况伤寒中风外证多端。未诊宜下云。
漓。夫汗者，真气至阳之液也。若乃汗出如珠，着身不流，则精绝。精绝则气先死。气绝则上下……
更有死脉多般样，《难经》细说那堪忘。从上损下死即迟，死脉多从下损上。连得五脏死疾时。
《难经》说：脉有损至。然至之脉，一呼再至曰平，三至曰离经，四至曰夺精，五至曰死，六至……绝而不病肺者病候脉状多中取。
要知大抵医门户。有一乖违即不中。但看强者惟为主。
脉为医门之先，其理微妙未易研究。大抵问而知之以观其外，切而知之以察其内。证之与脉……
复有久病更难看，或与健人脉一般。忽然加至脉翻变，脉病不应好买棺。
《内经》说：形气有余，脉气不足者死。脉气有余，形气不足者生。且脉者气血之先，气血盛则……
若遇风疾及劳病，妙法看时如抵圣。风疾脾缓空费力，劳疾心数难存命。风疾无令脉至迟。
风疾劳疾生死脉别，若悟玄机有如抵圣。风邪之中于人，其状奄忽，善行数变，其猝中于……辨。若脾脉缓而无力者，最为难治。盖风喜归肝，肝木克于脾，则大便洞泄。千金方云：中风大……风淫……复而中州。
伤寒中风得死脉，但将真药与病门。药灵病退脉须和，脉若准前病难救。
伤寒中风本为大患，更见死脉，十无一生。若根据仲景法度，随证施治，则正气胜邪，间有生……病。
如此定知生死期，可作医家箕本柄。若能指下悟玄机，便是灵台挂明镜。
王叔和说：脉理精微非言可传。心中了了，指下难明。后人能顿悟玄机，则心中洞然如挂明镜。
Pulse diagnosis can determine the critical path of life and death. The judgment mainly relies on the *Zhi* pulse (pulse with intermittent pauses), *Dai* pulse (intermittent pulse), and *Se* pulse (choppy pulse).
The *Neijing* (Classic of Internal Medicine) states: By feeling the dynamics of the pulse, observing the spirit in the eyes (*Jingming*), examining the five colors of the complexion, assessing the excess or deficiency of the Zang organs, and the strength or weakness of the Fu organs, as well as the flourishing or declining state of the body, one can decide upon life and death.
Examining the *Se* pulse and the *Zhi/Dai* pulses provides a general indication of the time of death. The *Se* pulse implies that there are obvious external symptoms present; therefore, it cannot be immediately concluded that death is imminent. However, if there are no external symptoms but a *Dai* pulse appears, the situation is different.
The *Suwen* (Basic Questions) refers to "Dai," while the *Nanjing* (Classic of Difficult Issues) refers to "Zhi"; these two terms share the same meaning. The pulse should not exhibit pauses. If it beats fifty times without showing a *Dai* pattern, the Qi of the five Zang organs can circulate freely without exhaustion. If the pulse reaches the Kidney and then returns to the Liver, it indicates that Kidney Qi has been exhausted first. Life depends on the presence of Qi in the five Zang organs, and death occurs when Qi is absent. The *Se* pulse is fine, slow, difficult to move, and occasionally pauses; this is a sign of insufficiency of Essence and Blood. It resembles the *Dai* pulse. However, obtaining a *Se* pulse with Stomach Qi during autumn is considered a normal pulse for that season. A floating, short, and *Se* pulse at the Cun Kou point on the right hand is the correct pulse for the Lung; it is neither a death pulse nor a disease pulse. If both the Chi and Cun positions show floating and *Se* pulses, external symptoms such as fever, aversion to cold, headache, stiffness of the neck and back, lower back pain, and even pain throughout all bone joints will likely appear. This indicates Taiyang channel Cold Damage (Shanghan), which can be cured by inducing sweating. These examples demonstrate that the *Se* pulse cannot be universally categorized as a death pulse. Thus, saying "it implies external symptomatic manifestations" makes the meaning very clear. Students of medicine should reflect deeply on this. Regarding the Chi pulse, it is the root of human life. Humans do not die because they possess Yuan Qi (Original Qi). The *Se* pulse signifies insufficiency of Essence and Blood; if it appears exclusively in the Chi position, it is a sign of certain death. Hence, it is said to be "similar to the Dai pulse."
To know how to predict the time of death, ancient sages deduced five types of Earth elements. For Yang Earth days, one must know they do not exceed Yin Earth days; for Yin Earth days encountering Yang days, careful calculation is required. The Wu and Ji Earths of the central seasons are identical.
These five Earths refer to climatic conditions. The Five Elements of the human body correspond to Heaven and Earth. By understanding Heaven and Earth, one can understand the human body. Since Heaven, Earth, and Humanity (the Three Powers) can be understood, changes in climate can also be discerned.
Metal generates Water; thus, in late autumn, Metal is in a state of Rest (Xiu) and transitions into Winter Water. Water generates Wood; thus, in late winter, Water is in a state of Rest and transitions into Spring Wood. This illustrates that Earth exists within the four seasons. In Heaven, there are five stars, with Zhenxing (Saturn) in the center; on Earth, there are five great mountains, with Songshan in the center; in Humanity, there are five Zang organs, with the Spleen governing the Central Region. Since the five Earths are all central, it is known that among all things, the four seasons, and the seventy-two pentads, Earth is the primary element. If Heaven loses Earth, phenomena lose order and cannot cover from above; if Earth loses Earth, things lose change and cannot support from below; if Humanity loses Earth, endowment is incomplete. Based on these principles, it is known that Heaven, Earth, and all things regard Earth as essential. However, there are Yang Earth and Yin Earth. The Gen trigram represents Yang Earth, and the Kun trigram represents Yin Earth. Gen is the trigram of the Northeast, corresponding to the transition between the twelfth and first months, where things complete their cycle and begin anew. Kun is the trigram of the Southwest, corresponding to the transition between the sixth and seventh months, where things reach peak abundance, and primal Qi returns to hidden Spirit. One Yang arises in the Zi month, six Yangs peak in the Wu month, and six Yins peak in the Hai month. The fourth month is Yang Earth, nurturing and generating all things, where everything flourishes, yet the power of Earth is already declining; hence, it is said that Yang Earth must not exceed Yin Earth. The tenth month is Yin Earth, storing all things; here, growth ceases, but the power of Earth is about to flourish; hence, it is said that Yin Earth encountering Yang requires careful calculation. The *Neijing* states: Yin and Yang are the Way of Heaven and Earth. Laozi stated: All things carry Yin and embrace Yang, harmonizing through the interaction of Qi. The *Xici* (Commentary on the Appended Statements) says: One Yin and one Yang is called the Dao. Generally, Yin cannot generate without Yang, and Yang cannot grow without Yin. When Yin and Yang combine, the principle of generation and transformation is inexhaustible. If Yin and Yang separate, the principle of generation and transformation is cut off. Mencius said: An old man without a wife is called Guan; an old woman without a husband is called Gua. Isolated Yang and severed Yin are analogous to the meanings of widowers and widows.
For example, in the year of Shen, if the Kidney pulse shows Zhi or Dai, ten beats correspond to one year, clearly indicating the ruler. If the Chi position loses its ruler and the Ghost Thief pulse prevails, the person may die in the summer of the Zi year.
The number of Old Yang peaks at nine, and the number of Old Yin peaks at ten. Ten beats corresponding to one Zang organ means the numbers of Yin and Yang are complete. Carefully calculated, if the Qi of the five Zang organs is sufficient, but the Ghost Thief pulse appears, death will occur within the year. This matter is widely recognized. In spring, obtaining the Lung pulse leads to death on Geng or Xin days. Fools mistakenly complain that the medicine is incorrect. Shuhe's *Maiking* discusses these subtleties.
Pulses of the four seasons that accord with the season are favorable (Cong); those that overcome the season are unfavorable (Ni). The *Neijing* states: Pulse following the four seasons is treatable; pulse opposing the four seasons is untreatable.
A Chi pulse that is deep and hidden is like a tree without roots. Yin toxicity and Yang cold belong to the same category. After applying moxibustion to restore Yang, one must still examine; if the bones feel lifeless, tears may flow.
The *Nanjing* states: Having a Chi pulse in humans is like a tree having roots. Because humans have Original Qi, they do not die. If the Chi pulse is deep and immobile, it is like a tree without roots.
If the six pulses of a person are trembling, one must fear the absence of Stomach Qi.
The *Neijing* states: The four seasons all take Stomach Qi as the foundation. Thus, it is said: Without Stomach Qi in the six pulses, life cannot be sustained. For instance, the Xian (Bowstring) pulse belongs to Wood and corresponds to the Liver, occurring in the season of Spring. It possesses Spirit. It contains Earth.
The Wulou (House Leaking) and Quezhuo (Sparrow Pecking) patterns are abhorrent when seen in the Spleen; seeing them in other positions is not feared. There are many ways to determine the time of death. Danshi (Finger Striking Stone) and Jiesuo (Untying Rope) require detailed discussion. This condition does not exceed one quarter. Fire is two, Wood is three, measure accordingly.
The *Neijing* says: The Spleen is Earth, the solitary Zang organ that irrigates the four directions. Its good manifestations are invisible; its bad manifestations appear immediately, like a sparrow pecking or water dripping. Qi is exhausted.
Earth prospers for eighteen days in each season; this method has never failed since ancient times. Huangdi's method divides into quarters of three; another method says thirty days, varying according to proximity.
Earth has no fixed movement but prospers in the four seasons. Therefore, after the Start of Spring solar term, Liver Wood prospers for seventy-two days; after the Start of Summer, Heart Fire prospers for seventy-two days; after the Start of Autumn...
Only Cold Damage (Shanghan) is most unpredictable. After sweating, vomiting, or purging, the pulse must become calm. If it suddenly reverses, it is difficult to treat; externally, deviation from physical signs is particularly feared.
Cold Damage was called a major disease in antiquity; survival or death depends on periods of ten days. This disease, if contracted from the back, enters the Taiyang channel or the Shaoyin channel.
The pulse may be minimal, cold, deficient, and exhausted, or maximal, hot, and congested; neither is strange. Tonifying deficiency and draining excess restores the previous state; seeing this clearly allows verification.
When the pulse comes twice per exhalation and twice per inhalation, neither large nor small, Yin and Yang each occupy their proper portion without overcoming each other. This is called a healthy person. Reduction...
The superior physician must master four aspects: pulse, disease, syndrome, and treatment. They must be cross-referenced. If one deviates, handling becomes difficult; this is extremely hard to treat.
The way of learning medicine requires mastering the four aspects of pulse, disease, syndrome, and treatment. The *Nanjing* states: Knowing one makes a junior practitioner; knowing two makes a mid-level practitioner; knowing three makes a senior practitioner. A senior practitioner achieves ten successes...
There are also chronic and acute diseases; major discussions must be thorough. Chronic disease pulse changes may not align; signs of death should be identified early. Acute disease pulse changes are also diverse.
The *Mai Yao Jingwei Lun* states: With pre-existing diseases, the five Zang organs activate, damaging the pulse and complexion. How can one distinguish long-standing from sudden illnesses? If the pulse is minute and the complexion is not depleted...
Front is Yang Guan, Back is Yin; for women, this is reversed like a hairpin. Overwhelming and overflowing invade each other; harmonizing Ying and Wei involves deeper principles.
Guan is the boundary of Yin and Yang. Front Guan is Yang, named Cun Kou; Back Guan is Yin, named Chi Ze. Men are Yang, born from Yin. First generated... Women... Said this emerges as Ge, actually then called Guan.
To identify virgins, the secret lies in Cun, Guan, and Chi. Naturally tight and rapid, clearly distinct, due to undispersed essence and Qi.
Men and women differ in Yin-Yang constitution; Tian Gui and semen forms also differ. Yin heaven fills and causes blood loss; Yang moves and Yin combines to release essence. Thus women two... Harmonious. Of what.
Diseases of the main channels are hardest to treat; no matter how long treated, when will recovery come?
The *Nanjing* states: Worry and thought damage the Heart; cold form and cold drinks damage the Lungs; anger and qi rebellion damage the Liver; diet and fatigue damage the Spleen; sitting long in dampness...
Form is primarily Yin; thus, regarding the Lung, cold form and cold drinks are mentioned; regarding the Kidney, sitting long in dampness and forcing entry into water are mentioned. The regular channels have fixed rules, so the body can be divided.
Then Qi is vast. Speaking and moving, inter-Zang transmission and seven-transmission have no external signs; forcibly using pills and powders to support...
The *Nanjing* states: Seven-transmission is what overcomes; Inter-Zang transmission transmits to the son. For example, Heart disease transmits to Lung, Lung to Liver, Liver to Spleen, Spleen to Kidney, Kidney... Heart.
Cold Damage and Wind Strike are naturally hard to see; meeting them under the fingers, the pulse is chaotic. Combining vomiting and diarrhea is not good; when the sweat pulse appears, sweating is required. Although sweat is obtained, the shape is like beads.
Cold Damage was called a major disease in antiquity. Wind is the chief of hundred diseases. The initial pulse is also hard to see. Moreover, Cold Damage and Wind Strike have many external signs. Undiagnosed, suitable for purging, it is said...
Dripping. Sweat is the liquid of true Qi and extreme Yang. If sweat comes out like beads, sticking to the body without flowing, Essence is exhausted. Exhaustion of Essence means Qi dies first. Exhaustion of Qi means upper and lower...
There are many kinds of death pulses; the *Nanjing* explains them in detail, how can they be forgotten? Damage from top to bottom delays death; death pulses often arise from bottom damage to top. Continuously obtaining five Zang death diseases...
The *Nanjing* states: Pulses have Sun and Zhi. Regarding Zhi pulses: two beats per breath is Ping (normal); three beats is Li Jing (departing from the channel); four beats is Duo Jing (exhaustion of essence); five beats is Si (death); six beats... Exhaustion and not Lung disease, symptom and pulse status mostly taken in the middle.
To know generally the gate of medicine. If one deviates, it is incorrect. Only look at the strong as the master.
Pulse is the forefront of the medical gate; its principles are subtle and hard to research. Generally, asking to know observes the exterior; cutting to know examines the interior. Syndrome and pulse...
Furthermore, chronic diseases are harder to see; sometimes the pulse resembles that of a healthy person. Suddenly adding beats, the pulse changes; if pulse and disease do not match, it is good to buy a coffin.
The *Neijing* states: Excess in Form and Qi, deficiency in Pulse Qi leads to death. Excess in Pulse Qi, deficiency in Form and Qi leads to life. Pulse is the precursor of Qi and Blood; when Qi and Blood are abundant...
If encountering Wind Disease and Labor Disease, the wonderful method of viewing is like Di Sheng. Wind Disease with slow Spleen is futile effort; Labor Disease with rapid Heart is hard to survive. Wind Disease should not let the pulse arrive slowly.
Distinction between life and death pulses in Wind and Labor diseases; if realizing the mystery, it is like Di Sheng. Wind evil attacking humans, its appearance is sudden,善于 changing locations, sudden attack... Distinguish. If Spleen pulse is slow and powerless, it is hardest to treat. Wind likes to return to Liver; Liver Wood overcomes Spleen, causing loose stools. Qianjin Fang says: Wind strike big... Wind excessive... Restore and Central State.
Cold Damage and Wind Strike obtaining death pulses; only give true medicine to the disease gate. If medicine is effective, disease retreats, pulse must harmonize; if pulse remains the same, disease is hard to save.
Cold Damage and Wind Strike are originally major afflictions; seeing death pulses, ten cases yield none alive. If following Zhang Zhongjing's methods, treating according to syndrome, then Righteous Qi defeats Evil, occasionally there is survival... Disease.
Thus determining the time of life and death can serve as the handle for medical practitioners. If one can realize the mystery under the fingers, it is like hanging a bright mirror on the spiritual platform.
Wang Shuhe said: Pulse principles are subtle and cannot be transmitted by words. Clear in mind, difficult under fingers. Later generations who can suddenly realize the mystery will have minds clear as if hanging a bright mirror.