师曰∶脉有三部，道之根源，荣卫流行，不失衡铨。肾沉心洪，肺浮肝弦，此自经常，不失铢
分。出入升降，刻漏周旋，水下二刻，一周循环，当复寸口，虚实见焉。变化相乘，阴阳相干。风
则浮虚，寒则牢坚，沉潜水 ，支饮急弦，动则为痛，数则热烦，设有不应，知变所缘。三部不同，
病各异端，太过可怪，不及亦然。邪不空见，中必有奸，审察表里，三焦别焉。知其所舍，消息诊
看，料度脏腑，独见若神。为子条记，传与贤人。
师曰∶呼吸者，脉之头也。初持脉，来疾去迟，此出疾入迟，名曰内虚外实也。初持脉，来迟
去疾，此出迟入疾，名曰内实外虚也。
师持脉，病患欠者，无病也。脉之呻者，病也。言迟者，风也。摇头言者，里痛也。行迟者，
表强也。坐而伏者，短气也。坐而下一脚者，腰痛也。里实护腹，如怀卵物者，心痛也。
问曰∶人病恐怖者，其脉何状？曰∶脉形如循丝累累然，其面白脱色也。人愧者，其脉何类？
曰∶脉浮而面色乍白乍赤也。
问曰∶脉有残贼，何谓也？曰∶脉有弦紧浮滑沉涩，此六者名为残贼，能为诸脉作病也。
问曰∶脉有灾怪，何谓也？曰∶假令人病，脉得太阳，与形证相应，因为作汤，比还服汤如食
顷，病患乃大吐，若下痢，腹中痛。师曰∶我前来不见此证，今乃变异，是名灾怪。又问曰∶何缘
作此吐痢？答曰∶或有旧时服药，今乃发作，故名灾怪耳。
肥人责浮，瘦人责沉。肥人当沉今反浮，瘦人当浮今反沉，故责之。
寸脉下不至关为阳绝，尺脉上不至关为阴绝，此皆不治，决死也。若计其余命死生之期，期以
月节克之也。
脉病患不病，号曰行尸，以无生气，卒眩仆不识人者，短命则死。人病脉不病，名曰内虚，以
无谷神，虽困无苦。
问曰∶紧脉从何而来？曰∶假令亡汗若吐，以肺里寒，故令脉紧也。假令咳者，坐饮冷水，故
令脉紧也。假令下痢，以胃中虚冷，故令脉紧也。
寸口脉缓而迟，缓则阳气长，其色鲜，其颜光，其声商，毛发长；迟则阴气盛，骨髓生，血满
，肌肉紧薄鲜硬。阴阳相抱，营卫俱行，刚柔相搏，名曰强也。
寸口脉浮而大，浮为虚，大为实，在尺为关，在寸为格，关则不得小便，格则吐逆。
寸口脉弱而迟，弱者卫气微，迟者营中寒。营为血，血寒则发热；卫为气，气微者心内饥，饥
而虚满，不能食也。
寸口脉弱而缓，弱者阳气不足，缓者胃气有余，噫而吞酸，食卒不下，气填于膈上也。
寸口脉微而涩，微者卫气不行，涩者营气不足。营卫不能相将，三焦无所仰，身体痹不仁。营
气不足，则烦疼，口难言。卫气虚，则恶寒数欠。三焦不归其部，上焦不归者，噫而酢吞；中焦不
归者，不能消谷引食；下焦不归者，则遗溲。（酢，古醋字。）
寸口脉微而涩，微者卫气衰，涩者营气不足。卫气衰，面色黄，荣气不足，面色青。营为根，
卫为叶，营卫俱微，则根叶枯槁，而寒栗、咳逆、吐腥、吐涎沫也。
寸口脉微，尺脉紧，其人虚损多汗，知阴常在，绝不见阳也。
寸口诸微亡阳，诸濡亡血，诸弱发热，诸紧为寒。诸乘寒者则为厥，郁冒不仁，以胃无谷气，
脾涩不通，口急不能言，战而栗也。
问曰∶何以知乘腑？何以知乘脏？曰∶诸阳浮数为乘腑，诸阴迟涩为乘脏。
老师说道：脉诊分为寸、关、尺三部，这是脉学的根本所在。营气与卫气在体内循环运行，不失去衡量的标准。肾脉沉，心脉洪大，肺脉浮，肝脉弦，这是正常的常脉，不差分毫。脉搏的出入升降，随着时间的流逝而周而复始，水下二刻（约27分钟），气血完成一次全身循环，最后回到寸口脉，通过脉象的虚实可以判断病情。脉象的变化相互影响，阴阳相互干扰。风邪致病脉象多浮虚，寒邪致病脉象多牢坚，水饮内停脉象多沉潜，支饮（悬饮）脉象多急弦，动脉主痛证，数脉主热证和心烦。如果脉象与上述规律不符，就要探究其变化的原因。三部脉象不同，疾病的表现也各异，脉象太过或不及都是异常现象。邪气不会凭空出现，体内必有奸邪潜伏，审察病位在表还是在里，分清三焦所属部位。知道病邪所在的部位，斟酌诊断方法，推测脏腑病变，就能像神一样有独到的见解。我把这些条理记录下来，传授给贤能之人。
老师说：呼吸是脉搏运行的先导。刚开始切脉时，如果脉搏来势快而去势慢，这叫“出疾入迟”，称为内虚外实证。刚开始切脉时，如果脉搏来势慢而去势快，这叫“出迟入疾”，称为内实外虚证。
老师切脉时，如果病人打哈欠，说明没有病。如果病人呻吟，说明有病。说话迟缓的，是有风邪。摇头说话的，是里有疼痛。行走迟缓的，是表证强盛（如太阳伤寒）。坐着伏案的，是短气。坐着时一只脚垂下的，是腰痛。身体蜷缩护住腹部，像怀着蛋物一样的，是心痛。
问：人患病感到恐惧时，脉象是什么样子？答：脉象像顺着丝线摸去那样连续不断且细弱，面色苍白无血色。人感到羞愧时，脉象是什么样的？答：脉象浮取可见，且面色时而白时而红。
问：脉象中有“残贼”脉，是什么意思？答：脉象中的弦、紧、浮、滑、沉、涩这六种脉象被称为残贼，它们能导致其他各种脉象出现病变。
问：脉象中有“灾怪”现象，是什么意思？答：假如某人患病，脉象表现为太阳病脉，且症状与脉象相符，于是给他服用汤药。等到服药不久后，病人突然发生剧烈呕吐，或者下痢，腹痛。老师说：“我刚才诊脉时没见到这些症状，现在却发生了变异，这就叫灾怪。”又问：为什么会发生这种呕吐和下痢？回答说：可能是病人以前服用的药物，到现在才发作，所以叫做灾怪。
对于肥胖的人，应当责求沉脉；对于消瘦的人，应当责求浮脉。肥胖的人本该见沉脉却反见浮脉，消瘦的人本该见浮脉却反见沉脉，因此要追究病因。
寸脉向下不到关部，称为阳绝；尺脉向上不到关部，称为阴绝。这些都是不治之症，注定死亡。如果要计算剩余寿命的死生期限，是以月令节气相克来推算的。
脉象有病而人看起来没病，叫做“行尸”，因为缺乏生气，突然眩晕跌倒、不认识人的，短期就会死亡。人有病而脉象正常，叫做“内虚”，因为缺乏谷气之神，虽然困顿但没有痛苦。
问：紧脉是从哪里来的？答：假如有人亡汗或呕吐，因为肺里有寒，所以导致脉紧。假如有人咳嗽，因为喝了冷水，所以导致脉紧。假如有人下痢，因为胃中虚冷，所以导致脉紧。
寸口脉缓而迟，缓则阳气生长，面色鲜艳，容颜光亮，声音清亮（商音属金，此处指声音清越），毛发茂盛；迟则阴气旺盛，骨髓生成，血液充盈，肌肉坚实紧致。阴阳相互抱合，营卫共同运行，刚柔相互搏击，这就叫做强壮。
寸口脉浮而大，浮表示虚，大表示实。在尺部出现为“关”，在寸部出现为“格”。关则小便不通，格则呕吐逆乱。
寸口脉弱而迟，弱表示卫气微弱，迟表示营中有寒。营属于血，血寒则发热；卫属于气，气微弱则心中感觉饥饿，但因虚满而不能进食。
寸口脉弱而缓，弱表示阳气不足，缓表示胃气有余（指胃中有湿滞或食积等实邪，此处结合下文看是指胃气不和或有余邪），嗳气吞酸，食物突然咽不下去，气填塞在膈上。
寸口脉微而涩，微表示卫气运行不畅，涩表示营气不足。营卫不能互相配合，三焦无所依赖，身体麻木不仁。营气不足，则烦闷疼痛，口难言。卫气虚，则怕冷且频繁打哈欠。三焦不归其本部，上焦不归者，嗳气并吞酸水；中焦不归者，不能消化谷物和引导饮食；下焦不归者，则遗尿失禁。（酢，古同醋字。）
寸口脉微而涩，微表示卫气衰弱，涩表示营气不足。卫气衰弱，面色发黄；营气不足，面色发青。营是根，卫是叶，营卫都微弱，就像根叶枯槁一样，会出现寒战、咳嗽气逆、吐腥臭物、吐涎沫等症状。
寸口脉微，尺脉紧，这个人虚损且多汗，可知阴气常在，阳气断绝不见。
寸口脉象凡是微的，都是亡阳；凡是濡的，都是亡血；凡是弱的，都发热；凡是紧的，都是寒证。凡是受寒邪侵袭的，就会发生厥逆，郁冒且麻木不仁，因为胃中没有谷气，脾脏涩滞不通，口唇紧急不能说话，战栗发抖。
The Master said: Pulse diagnosis is divided into three positions (Cun, Guan, Chi), which is the root of pulse theory. Ying (Nutritive) Qi and Wei (Defensive) Qi circulate within the body without losing their balance and measure. The Kidney pulse is deep (Chen), the Heart pulse is surging (Hong), the Lung pulse is floating (Fu), and the Liver pulse is string-taut (Xian); these are the normal constant pulses, accurate to the finest degree. The entering and exiting, ascending and descending of the pulse rotate with time; after two ke (approx. 27 minutes) of water dripping in a clepsydra, one complete circulation occurs, returning to the Cun position, where deficiency and excess can be observed. Changes interact with each other, and Yin and Yang interfere with one another. Wind pathogens present as floating and deficient (Xu); Cold pathogens present as firm and solid (Lao). Water retention presents as deep and submerged; Branching Fluid Retention (Zhi Yin) presents as rapid and taut. A Moving pulse (Dong) indicates pain; a Rapid pulse (Shu) indicates heat and restlessness. If the pulse does not correspond to these patterns, one must understand the cause of the variation. The three positions differ, and diseases have various origins; an Excessive pulse is abnormal, just as an Insufficient pulse is. Pathogenic factors do not appear out of nowhere; there must be hidden evils within. Examine whether the pathogen is in the Exterior or Interior, and distinguish the San Jiao (Triple Burner). Knowing where the pathogen resides and adjusting the diagnostic approach allows one to predict Zang-Fu organ pathology with divine insight. I have recorded these points in detail to pass them on to worthy individuals.
The Master said: Respiration is the leader of the pulse. When initially palpating the pulse, if the arrival is rapid and the departure is slow (Out-rapid, In-slow), it is named Internal Deficiency and External Excess. If initially palpating the pulse, the arrival is slow and the departure is rapid (Out-slow, In-rapid), it is named Internal Excess and External Deficiency.
When the Master palpates the pulse, if the patient yawns, there is no disease. If the patient groans, there is disease. Slow speech indicates Wind. Shaking the head while speaking indicates interior pain. Walking slowly indicates exterior stiffness (e.g., Taiyang Cold Damage). Sitting and leaning forward indicates shortness of breath. Sitting with one leg hanging down indicates lower back pain. Curling up and protecting the abdomen, as if holding an egg, indicates heart pain.
Question: What is the pulse condition when a person suffers from fear? Answer: The pulse feels like tracing a continuous thread (fine and unbroken), and the face is pale and devoid of color. Question: What kind of pulse does a person feel when ashamed? Answer: The pulse is floating, and the complexion alternates between white and red.
Question: What is meant by "destructive" (Can Zei) pulses? Answer: String-taut (Xian), tight (Jin), floating (Fu), slippery (Hua), deep (Chen), and choppy (Se) are the six types called destructive, as they can cause pathological changes in various other pulses.
Question: What is meant by "disaster" (Zai Guai) phenomena in pulses? Answer: Suppose a person is ill, and the pulse corresponds to Taiyang disease, matching the symptoms, so a decoction is prepared. Shortly after taking the medicine, the patient suddenly vomits severely, or experiences diarrhea and abdominal pain. The Master says: "I did not see these symptoms earlier, but now there is a variation; this is called a disaster." Another asks: "What causes this vomiting and diarrhea?" The answer is: "Perhaps medication taken long ago is now manifesting; hence it is called a disaster."
For obese persons, one should look for a Deep (Chen) pulse; for thin persons, one should look for a Floating (Fu) pulse. If an obese person who should have a deep pulse instead has a floating one, or a thin person who should have a floating pulse instead has a deep one, one must investigate the cause.
If the Cun pulse does not extend down to the Guan position, it is called Yang Extinction; if the Chi pulse does not extend up to the Guan position, it is called Yin Extinction. These are all untreatable and indicate death. To calculate the remaining lifespan, one predicts the time of death based on the clash of monthly solar terms.
If the pulse shows disease but the person appears healthy, it is called a "Walking Corpse," lacking vital energy; sudden dizziness, collapse, and loss of consciousness lead to early death. If the person is diseased but the pulse is normal, it is called Internal Deficiency, lacking Grain Spirit; although distressed, there is no suffering.
Question: Where does the Tight (Jin) pulse come from? Answer: For example, due to excessive sweating or vomiting, cold in the Lungs causes the pulse to become tight. For example, due to coughing caused by drinking cold water, the pulse becomes tight. For example, due to diarrhea caused by deficiency-cold in the Stomach, the pulse becomes tight.
At the Cun position, a Slow (Chi) and Moderate (Huan) pulse indicates that Yang Qi is growing, resulting in a fresh complexion, bright facial appearance, clear voice, and long hair; Slowness indicates abundant Yin Qi, bone marrow generation, full blood, and firm, thin, hard muscles. Yin and Yang embrace each other, Ying and Wei Qi circulate together, and hardness and softness interact; this is called strength.
At the Cun position, a Floating (Fu) and Large (Da) pulse: Floating indicates deficiency, Large indicates excess. At the Chi position, this is called Guan (Closure), leading to inability to urinate; at the Cun position, this is called Ge (Reverse), leading to vomiting and regurgitation.
At the Cun position, a Weak (Ruo) and Slow (Chi) pulse: Weak indicates deficient Wei Qi; Slow indicates Cold in Ying. Ying is Blood; Blood Cold causes fever. Wei is Qi; deficient Qi causes a sensation of hunger in the heart, but due to empty fullness, one cannot eat.
At the Cun position, a Weak (Ruo) and Moderate (Huan) pulse: Weak indicates insufficient Yang Qi; Moderate indicates surplus Stomach Qi (often implying dampness or food stagnation), belching, acid regurgitation, sudden inability to swallow food, and Qi filling the upper Diaphragm.
At the Cun position, a Fine (Wei) and Choppy (Se) pulse: Fine indicates blocked Wei Qi movement; Choppy indicates insufficient Ying Qi. Ying and Wei fail to support each other, leaving the San Jiao without reliance, causing numbness and paralysis of the body. Insufficient Ying Qi causes irritability and pain, and difficulty speaking. Deficient Wei Qi causes aversion to cold and frequent yawning. If the San Jiao fails to return to its proper sector: Upper Jiao failure leads to belching and acid regurgitation; Middle Jiao failure leads to inability to digest grains and absorb food; Lower Jiao failure leads to urinary incontinence. (Cu is an ancient character for vinegar/acid.)
At the Cun position, a Fine (Wei) and Choppy (Se) pulse: Fine indicates declining Wei Qi; Choppy indicates insufficient Ying Qi. Declining Wei Qi results in a yellow complexion; insufficient Ying Qi results in a green complexion. Ying is the root, Wei is the leaf; if both Ying and Wei are weak, the roots and leaves wither, leading to chills, coughing and reverse qi, vomiting of fishy substances, and spitting of saliva/phlegm.
At the Cun position, a Fine (Wei) pulse, and at the Chi position, a Tight (Jin) pulse: The person is deficient and sweats excessively; this indicates Yin is constantly present, while Yang is completely absent.
All Fine (Wei) pulses at the Cun position indicate Yang Exhaustion; all Soft (Ru) pulses indicate Blood Loss; all Weak (Ruo) pulses indicate Fever; all Tight (Jin) pulses indicate Cold. All conditions affected by Cold result in Jue (Cold Limb Reversal), depression and vertigo, and numbness, because the Stomach lacks Grain Qi, the Spleen is stagnant and obstructed, the mouth/lips are tight preventing speech, and there is trembling and shivering.
Question: How do we know if the pathogen has invaded the Fu organs? How do we know if it has invaded the Zang organs? Answer: All Yang pulses that are Floating and Rapid indicate invasion of the Fu organs; all Yin pulses that are Slow and Choppy indicate invasion of the Zang organs.