问曰；脉有三部，阴阳相乘。荣卫血气，在人体躬。呼吸出入，上下于中，因息游布，津液流通。随时
动作，效象形容，春弦秋浮，冬沉夏洪。察色观脉，大小不同，一时之间，变无经常，尺寸参差，或短或长。上
下乖错，或存或亡。病辄改易，进退低昂。心迷意惑，动失纪纲。愿为具陈，令得分明。师曰∶子之所问，
道之根源。脉有三部，尺寸及关。
寸为上部，关为中部，尺为下部。
荣卫流行，不失衡铨。
衡铨者，称也，可以称量轻重。《内经》曰∶春应中规，夏应中矩，秋应中衡，冬应中权。荣行脉中，卫
行脉外，荣卫与脉相随，上下应四时，不失其常度。
肾沉、心洪、肺浮、肝弦，此自经常，不失铢分。
肾，北方水，王于冬，而脉沉。心，南方火，王于夏，而脉洪。肺，西方金，王于秋，而脉浮。肝，东
方木，王于春，而脉弦，此为经常，铢分之不差也。
出入升降，漏刻周旋，水下二（赵本作“百”。熊校记∶水下二刻，赵本二作百。按注，成本自作二，
不误。赵本或别有意也）刻，一周循环。
人身之脉，计长一十六丈二尺，一呼脉行三寸，一吸脉行三寸，一呼一吸为一息，脉行六寸。一日一夜，
漏水下百刻，人一万三千五百息，脉行八百一十丈，五十度周于身。则一刻之中，人一百三十五息，脉行八丈
一尺，水下二刻。人二百七十息，脉行一十六丈二尺，一周于身也。脉经之行，终而复始，若循环之无端也。
当复寸口，虚实见焉。
脉经（医统本作“经脉”）之始，从中焦注于手太阴寸口，二百七十息，脉行一周身，复还至于寸口。寸
口为脉之经始，故以诊视虚实焉。经曰∶虚实死生之要，皆见于寸口之中。
变化相乘，阴阳相干。风则浮虚，寒则牢坚；沉潜水蓄，（赵本医统本皆作“ ”）支饮急弦；动则为
痛，数则热烦。
风伤阳，故脉浮虚；寒伤阴，故脉牢坚；蓄积于内者，谓之水蓄，故脉沉潜；支散于外者，谓之支饮，
故脉急弦。动则阴阳相搏，相搏则痛生焉。数为阳邪气胜，阳胜则热烦焉。
设有不应，知变所缘，三部不同，病各异端。
脉与病不相应者，必缘传变之所致。三部以候五脏之气，随部察其虚实焉。
太（赵本作“大”）过可怪，不及亦然，邪不空见，中（赵本作“终”）必有奸，审察表里，三焦别焉，
知其所舍，消息诊看，料度腑脏，独见若神。为子条记，传与贤人。
太过、不及之脉，皆有邪气干于正气，审看在表在里，入腑入脏，随其所舍而治之。
师曰∶呼吸者，脉之头也。
《难经》曰∶一呼脉行三寸，一吸脉行三寸，以脉随呼吸而行，故言脉之头也。
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。
外为阳，内为阴。《内经》曰∶来者为阳，去者为阴。是出以候外，入以候内。疾为有余，有余则实；
迟为不足，不足则虚。来疾去迟者，阳有余而阴不足，故曰内虚外实；来迟去疾
者，阳不足而阴有余，故曰内实外虚。
问曰∶上工望而知之，中工问而知之，下工脉而知之，愿闻其说。师曰∶病家人请云，病患若发热，身
体疼，病患自卧。师到，诊其脉，沉而迟者，知其瘥也。何以知之？（赵本有“若”字）表有病者，脉当
浮大，今脉反沉迟，故知愈也。
望以观其形证，问以知其所苦，脉以别其表里。病苦发热、身疼，邪在表也，当卧不安，而脉浮数。今病患
自卧，而脉沉迟者，表邪缓也，是有里脉而无表证，则知表邪当愈也。
假令病患云，腹内卒痛，病患自坐。师到，脉之，浮而大者，知其瘥也。何以知之？若里有病者，脉当
沉而细，今脉浮大，故知愈也。
腹痛者，里寒也。痛甚则不能起，而脉沉细。今病患自坐，而脉浮大者，里寒散也，是有表脉而无里证也。
则知里邪当愈。是望证、问病、切脉三者相参而得之，可为十全之医。《针经》曰∶知一为上，知二为神，知
三神且明矣。
师曰∶病家人来请云，病患发热，烦极。明日师到，病患向壁卧，此热已去也。设令脉不和，处言已愈。
发热、烦极，则不能静卧。今向壁静卧，知热已去。
设令向壁卧，闻师到，不惊起而 视，若三言三止，脉之，咽唾者，此诈病也。设令脉自和，处言汝（赵本
医统本皆作“此”）病大重，当须服吐下药，针灸数十百处，乃愈。
诈病者，非善人，以言恐之，使其畏惧，则愈。医者意也，此其是欤？
师持脉，病患欠者，无病也。
《针经》曰∶阳引而上，阴引而下，阴阳相引，故欠。阴阳不相引，则病；阴阳相引则和。是欠者，无病也。
脉之，呻者，病也。
呻，为呻吟之声，身有所苦，则然也。
言迟者，风也。
风客于中，则经络急，舌强难运用也。
摇头言者，里痛也。
里有病，欲言，则头为之战摇。
行迟者，表强也。
表强者，由筋络引急，而行步不利也。
坐而伏者，短气也。
短气者，里不和也，故坐而喜伏。
坐而下一脚者，腰痛也。
《内经》曰∶腰者，身之大关节也。腰痛，为大关节不利，故坐不能正，下一脚，以缓腰中之痛也。
里实护腹，如怀卵物者，心痛也。
心痛，则不能伸仰，护腹以按其痛。
师曰∶伏气之病，以意候之，今月之内，欲有伏气。假令旧有伏气，当须脉之。若脉微弱者，当喉中
痛似伤，非喉痹也。病患云∶实咽中痛，虽尔今复欲下利。
冬时感寒，伏藏于经中，不即发者，谓之伏气。至春分之时，伏寒欲发，故云今月之内∶欲有伏气。
假令伏气已发，当须脉之，审在何经。得脉微弱者，知邪在少阴，少阴之脉，循喉咙，寒气客之，必发咽痛；
肾司开阖，少阴治在下焦，寒邪内甚，则开阖不治，下焦不约，必成下利。故云∶虽尔咽痛，复欲下利。
问曰∶人病（赵本无“病”字）恐怖者，其脉何状？师曰∶脉形如循丝，累累然，其面白脱色也。
《内经》曰∶血气者，人之神。恐怖者，血气不足，而神气弱也。脉形似循丝，累累然，面白脱色者，
《针经》曰∶血夺者，
色夭然不泽。其脉空虚，是知恐怖，为血气不足。
问曰∶人不饮，其脉何类？师曰∶其脉自涩，（赵本医统本皆无“其”字）唇口干燥也。
涩为阴，虽主亡津液，而唇口干燥，以阴为主内，故不饮也。
问曰∶人愧者，其脉何类？师曰∶脉浮，而面色乍白乍赤。
愧者，羞也。愧则神气怯弱，故脉浮，而面色变改不常也。
问曰∶经说，脉有三菽、六菽重者，何谓也？师曰∶脉者，（赵本无“者”字）人以指按之，如三菽之
重者，肺气也；如六菽之重者，心气也；如九菽之重者，脾气也；如十二菽之重者，肝气也；按之至骨者，肾气也。
菽，豆也。《难经》曰∶如三菽之重，与皮毛相得者，肺部也；如六菽之重，与血脉相得者，心部也；如
九菽之重，与肌肉相得者，脾部也；如十二菽之重，与筋平者，肝部也；按之至骨，
举指来疾者，肾部也。各随所主之分，以候脏气。
假令下利，寸口、关上、尺中，悉不见脉，然尺中时一小见，脉再举头（赵本注∶“一云按投”）者，肾
气也。若见损脉来至，为难治。
《脉经》曰∶冷气在胃中，故令脉不通。下利不见脉，则冷气客于脾胃。今尺中时一小见，为脾虚肾气
所乘。脉再举头者，脾为肾所乘也。若尺中之脉更或减损，为肾气亦衰，脾复
胜之，鬼贼相刑，故云难治。是脾胜不应时也。
问曰∶脉有相乘、有纵、有横、有逆、有顺，何（赵本有“谓”字）也？师曰∶水行乘火，金行乘木，
名曰纵；火行乘水，木行乘金，名曰横；水行乘金，火行乘木，名曰逆；
金行乘水，木行乘火，名曰顺也。
金胜木，水胜火。纵者，言纵任其气，乘其所胜；横者，言其气横逆，反乘所不胜也。纵横，与恣纵、
恣横之义通。水为金子，火为木子，子行乘母，其气逆也；母行乘子，其气顺也。
问曰∶脉有残贼，何谓也？师曰∶脉有弦、紧、浮、滑、沉、涩，此六者（赵本作“脉”）名曰残贼，能
为诸脉作病也。
为人病者，名曰八邪，风寒暑湿伤于外也，饥、饱、劳、逸伤于内也。经脉者，荣卫也。荣卫者，阴阳
也。其为诸经脉作病者，必由风寒暑湿，伤于荣卫，客于阴阳之中，风则脉浮，寒则脉紧，中暑则脉滑，中湿
则脉涩，伤于阴则脉沉，伤于阳则脉浮。所以谓之残贼者，伤良曰残，害良曰贼，以能伤害正气也。
问曰∶脉有灾怪，何谓也？师曰∶假令人病，脉得太阳，与形证相应，因为作汤。比还送汤如食顷，病
人乃大吐，若下利，腹中痛。师曰∶我前来不见此证，今乃变异，是名灾怪；又问曰∶何缘作此吐利？答曰∶
或有旧时服药，今乃发作，故名（赵本作“为”）灾怪耳。
医以脉证与药相对而反变异，为其灾可怪，故名灾怪。
问曰∶东方肝脉，其形何似？师曰∶肝者木也，名厥阴，其脉微弦濡弱而长，是肝脉也。肝病自得濡
弱者，愈也。
《难经》曰∶春脉弦者，肝、东方木也，万物始生，未有枝叶，故脉来濡弱而长，故曰弦。是肝之平脉，
肝病得此脉者，为肝气已和也。
假令得纯弦脉者，死。何以知之？以其脉如弦直，
（赵本有“此”字）是肝脏伤，故知死也。
纯弦者，为如弦直而不软，是中无胃气，为真脏之脉。《内经》曰∶死肝脉来，急益劲，如新张弓弦。
南方心脉，其形何似？师曰∶心者火也，名少阴，其脉洪大而长，是心脉也。心病自得洪大者，愈也。
心王于夏，夏则阳外胜，气血淖溢，故其脉来洪大而长也。
假令脉来微去大，故名反，病在里也。脉来头小本大者，（赵本无“者”字）故名复，病在表也。上微头
小者，则汗出；下微本大者，则为关格不通，不得尿。头无汗者可治，有汗者死。
心脉来盛去衰为平，来微去大，是反本脉。《内经》曰∶大则邪至，小则平。微为正气，大为邪气。来以
候表，来微则知表和；去以候里，去大则知里病。《内经》曰∶心脉来不盛去反盛，此为不及，病在中。头小
本大者，即前小后大也。小为正气，大为邪气，则邪气先在里，今复还于表，故名曰复。不云去
而止云来者，是知在表。《脉经》曰∶在上为表，在下为里。汗者心之液。上微为浮之而微，头小为前小，则
表中气虚，故主汗出。下微（医统本有“为”字）沉之而微，本大为后大，沉则在里，大
则病进。《内经》曰∶心为牡脏，小肠为之使。今邪甚下行，格闭小肠，使正气不通，故不得尿，名曰关格。
《脉经》曰∶阳气上出，汗见于头，今关格正气不通，加之头有汗者，则阳气不得下通而上脱也。其无汗者，
虽作关格，然阳（医统本有“气”字）未衰，而犹可治。
西方肺脉，其形何似？师曰∶肺者金也，名太阴，其脉毛浮也，肺病自得此脉。若得缓迟者，皆愈；若得
数者，则剧。何以知之？数者南方火，火克西方金，法
当痈肿，为难治也。
轻虚浮曰毛，肺之平脉也。缓迟者，脾之脉，脾为肺之母，以子母相生，故云皆愈；数者，心之脉，火克
金，为鬼贼相刑，故剧。肺主皮毛，数则为热，热客皮肤，留而不去，则为痈疡。经
曰∶数脉不时，则生恶疮。
问曰∶二月得毛浮脉，何以处言至秋当死。师曰∶二月之时，脉当濡弱，反得毛浮者，故知至秋死。二月
肝用事，肝脉属木，（赵本作“肝属木，脉”）应濡弱，反得毛浮（赵本有“脉”字）者，是肺脉也。肺
属金，金来克木，故知至秋死。他皆仿此。
当春时反见秋脉，为金气乘木，肺来克肝，夺王脉而见，至秋肺王，肝气则绝，故知至秋死也。
师曰∶脉，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。
肥人肌肤浓，其脉当沉；瘦人肌肤薄，其脉当浮。今肥人脉反浮，瘦人脉反沉，必有邪气相干，使脉
反常，故当责之。
师曰∶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（赵本作，
“生死”）之期，期以月节克之也。
《脉经》曰∶阳生于寸，动于尺；阴生于尺，动于寸。寸脉下不至关者，为阳绝，不能下应于尺也；尺脉
上不至关者，为阴绝，不能上应于寸也。《内经》曰∶阴阳离决，精气乃绝。此阴阳偏绝，故皆决死。
期以月节克之者，谓如阳绝死于春夏，阴绝死于秋冬。
师曰∶脉病患不病，名曰行尸，以无王气，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。
脉者，人之根本也。脉病患不病，为根本内绝，形虽且强，卒然气脱，则眩晕僵仆而死，不曰行尸而何。
人病脉不病，则根本内固，形虽且羸，止内虚尔。谷神者，谷气也。谷气既足，
自然安矣。《内经》曰∶形气有余，脉气不足死；脉气有余，形气不足生。
那些属于死阴的脉象，如果是死阴一类，不超过三天就会死亡，因为形体已经显露出损伤的缘故。
问：脉有上、中、下三部，阴阳相互影响。营卫气血，存在于人体之中。呼吸出入，在体内上下运行，随着气息游动布散，津液得以流通。随着季节变化而动作，呈现出相应的形象与形态，春天脉弦，秋天脉浮，冬天脉沉，夏天脉洪。观察面色和诊察脉象，大小各不相同，短时间内，变化没有固定常规，寸关尺三部的脉位参差不齐，有的短有的长。上下部位错乱，有的存在有的消失。病情总是改变，进退起伏不定。心中迷惑，行为失去法度。希望详细陈述，让我能分辨清楚。老师说：你所问的，是道的根源。脉有三部，即寸、关、尺。
寸为上部，关为中部，尺为下部。
营卫流行，不失衡平标准。
衡铨，就是秤，可以用来称量轻重。《内经》说：春脉应合乎规，夏脉应合乎矩，秋脉应合乎衡，冬脉应合乎权。营气行于脉中，卫气行于脉外，营卫与脉相随，上下顺应四时，不失常度。
肾脉沉、心脉洪、肺脉浮、肝脉弦，这是正常的常脉，不差分毫。
肾，属北方水，旺于冬季，所以脉沉。心，属南方火，旺于夏季，所以脉洪。肺，属西方金，旺于秋季，所以脉浮。肝，属东方木，旺于春季，所以脉弦，这是正常的常脉，不差分毫。
气的出入升降，漏壶滴水旋转循环，水下二刻，完成一周循环。
人身之脉，共计长一十六丈二尺，一呼脉行三寸，一吸脉行三寸，一呼一吸为一息，脉行六寸。一天一夜，漏水下一百刻，人一万三千五百息，脉行八百一十丈，五十周循环于全身。那么一刻之中，人一百三十五息，脉行八丈一尺，水下二刻。人二百七十息，脉行一十六丈二尺，一周于身。脉经的运行，终而复始，像圆环一样没有端点。
应当再回到寸口，虚实的征象就显现出来了。
脉经（医统本作“经脉”）的开始，从中焦注入手太阴肺经的寸口，二百七十息，脉行一周身，又返回到寸口。寸口是脉的起始处，所以通过诊视这里来判断虚实。经说：虚实死生的关键，都见于寸口之中。
变化相互乘袭，阴阳相互干扰。风邪则脉浮虚，寒邪则脉牢坚；水饮蓄积于内则脉沉潜，支饮则脉急弦；动脉主痛，数脉主热烦。
风伤阳，所以脉浮虚；寒伤阴，所以脉牢坚；蓄积于内的，称为水蓄，所以脉沉潜；散布于外的，称为支饮，所以脉急弦。动则是阴阳相搏，相搏则疼痛产生。数是阳邪气胜，阳胜则热烦。
如果有不相应的情况，要知道变化的缘由，三部脉不同，病的表现也各异。
脉与病不相应，必定是由于传变所致。三部脉用来候察五脏之气，随部位察其虚实。
太过令人奇怪，不及也是如此，邪气不会凭空出现，其中必定有奸邪，审察表里，三焦分别清楚，知道邪气所在之处，斟酌诊断，推测脏腑，独见如神。为你条理记录，传给贤人。
太过、不及的脉，都有邪气干扰正气，审看是在表还是在里，入腑还是入脏，随其所舍而治疗。
老师说：呼吸，是脉动的先导。
《难经》说：一呼脉行三寸，一吸脉行三寸，因为脉随着呼吸而行，所以说它是脉的头绪。
初持脉时，来势疾而去势迟，这是出疾入迟，名叫内虚外实。初持脉时，来势迟而去势疾，这是出迟入疾，名叫内实外虚。
外为阳，内为阴。《内经》说：来者为阳，去者为阴。所以出以候外，入以候内。疾为有余，有余则实；迟为不足，不足则虚。来疾去迟者，阳有余而阴不足，所以叫内虚外实；来迟去疾者，阳不足而阴有余，所以叫内实外虚。
问：上工望而知之，中工问而知之，下工脉而知之，希望听听其中的道理。老师说：病人家属来说，病人如果发热，身体疼，病人自己躺着。医生到了，诊察他的脉，沉而迟的，知道他要好了。为什么知道？表有病，脉应当浮大，现在脉反而沉迟，所以知道痊愈了。
望以观察形证，问以了解痛苦，脉以辨别表里。病苦发热、身疼，邪在表，应当卧不安，而脉浮数。现在病人自己躺着，而脉沉迟，说明表邪缓和，是有里脉而无表证，就知道表邪将要痊愈。
假如病人说，腹内突然疼痛，病人自己坐着。医生到了，诊察他的脉，浮而大的，知道他要好了。为什么知道？如果里有病，脉应当沉而细，现在脉浮大，所以知道痊愈了。
腹痛，是里寒。痛甚则不能起，而脉沉细。现在病人自己坐着，而脉浮大，说明里寒消散，是有表脉而无里证，就知道里邪将要痊愈。这是望证、问病、切脉三者参合而得，可以成为十全的医生。《针经》说：知其一为上，知其二为神，知其三既神且明矣。
老师说：病人家属来请，说病人发热，烦躁至极。第二天医生到了，病人面向墙壁躺着，这说明热已退去。假如脉不和，处方说已经痊愈。
发热、烦躁至极，就不能静卧。现在面向墙壁静卧，知道热已退去。
假如面向墙壁躺着，听到医生来了，不惊起而是斜眼看，或者说话三次停顿三次，诊脉时吞咽唾沫，这是诈病。假如脉自和，处方说你的病很重，必须服用吐下药，针灸数十上百处，才能痊愈。
诈病的人，不是好人，用言语恐吓他，使他畏惧，病就好了。医者凭意会，说的就是这个吧？
医生持脉，病人打哈欠的，没有病。
《针经》说：阳引而上，阴引而下，阴阳相互牵引，所以打哈欠。阴阳不相引，则生病；阴阳相引则平和。所以打哈欠，是没有病。
诊脉时，呻吟的，是有病。
呻吟，是痛苦的声音，身体有所苦楚，就会这样。
说话迟缓的，是有风邪。
风邪客于体内，经络拘急，舌强难以运用。
摇头说话的，是里有痛。
里有病，想要说话，头就会战摇。
行走迟缓的，是表强。
表强，是因为筋络牵引拘急，导致行走不利。
坐着伏身的，是短气。
短气，是里不和，所以坐着喜欢伏身。
坐着时一只脚垂下的，是腰痛。
《内经》说：腰，是身体的大关节。腰痛，是大关节不利，所以坐不能正，垂下一只脚，以缓解腰中的疼痛。
里有实邪护住腹部，像怀着蛋物一样的，是心痛。
心痛，不能伸仰，护住腹部以按压疼痛。
老师说：伏气病，要用心意去候察，这个月之内，将有伏气发作。假如旧有伏气，必须诊脉。如果脉微弱，应当喉咙痛似受伤，但不是喉痹。病人说：确实咽中痛，虽然如此，现在又想下利。
冬季感受寒邪，伏藏于经脉中，不立即发作的，称为伏气。到了春分之时，伏寒欲发，所以说这个月之内：将有伏气。
假如伏气已发，必须诊脉，审察在哪一经。得到脉微弱的，知道邪在少阴，少阴之脉，循喉咙，寒气客之，必发咽痛；肾司开阖，少阴治在下焦，寒邪内甚，则开阖不治，下焦不约，必成下利。所以说：虽然咽痛，又想下利。
问：人患病恐惧时，脉象什么样？老师说：脉形如循丝，累累然，面色苍白脱色。
《内经》说：血气，是人的神。恐惧者，血气不足，而神气弱也。脉形似循丝，累累然，面白脱色者，《针经》说：血夺者，颜色枯槁无光泽。脉空虚，是知道恐惧，为血气不足。
问：人不喝水，脉象什么样？老师说：脉自涩，唇口干燥。
涩为阴，虽主亡津液，但唇口干燥，以阴为主在内，所以不喝水。
问：人羞愧时，脉象什么样？老师说：脉浮，而面色乍白乍赤。
愧，是羞。羞愧则神气怯弱，所以脉浮，而面色改变不常。
问：经说，脉有三菽、六菽重者，是什么意思？老师说：脉，人用手指按之，如三菽重的，是肺气；如六菽重的，是心气；如九菽重的，是脾气；如十二菽重的，是肝气；按之至骨的，是肾气。
菽，是豆。《难经》说：如三菽重，与皮毛相得的，是肺部；如六菽重，与血脉相得的，是心部；如九菽重，与肌肉相得的，是脾部；如十二菽重，与筋平的，是肝部；按之至骨，举指来疾的，是肾部。各随所主之分，以候脏气。
假如下利，寸口、关上、尺中，都看不到脉，然而尺中偶尔小现一次，脉再举头（赵本注：“一说按投”）的，是肾气。如果见到损脉来至，为难治。
《脉经》说：冷气在胃中，所以令脉不通。下利不见脉，则冷气客于脾胃。现在尺中偶尔小现一次，为脾虚肾气所乘。脉再举头的，脾被肾所乘。如果尺中之脉更或减损，为肾气亦衰，脾复胜之，鬼贼相刑，所以说难治。这是脾胜不应时。
问：脉有相乘、有纵、有横、有逆、有顺，是什么意思？老师说：水行乘火，金行乘木，名叫纵；火行乘水，木行乘金，名叫横；水行乘金，火行乘木，名叫逆；
金行乘水，木行乘火，名叫顺。
金胜木，水胜火。纵者，言纵任其气，乘其所胜；横者，言其气横逆，反乘所不胜也。纵横，与恣纵、恣横之义通。水为金子，火为木子，子行乘母，其气逆也；母行乘子，其气顺也。
问：脉有残贼，是什么意思？老师说：脉有弦、紧、浮、滑、沉、涩，这六种（赵本作“脉”）名叫残贼，能为诸脉作病。
为人病者，名叫八邪，风寒暑湿伤于外，饥、饱、劳、逸伤于内。经脉，是营卫。营卫，是阴阳。它们为诸经脉作病，必定由风寒暑湿，伤于营卫，客于阴阳之中，风则脉浮，寒则脉紧，中暑则脉滑，中湿则脉涩，伤于阴则脉沉，伤于阳则脉浮。所以称之为残贼，伤良曰残，害良曰贼，因为能伤害正气。
问：脉有灾怪，是什么意思？老师说：假如人病，脉得太阳，与形证相应，因此作汤药。等到送汤药回来大约一顿饭功夫，病人却大吐，或者下利，腹中痛。医生说：我先前没见此证，现在变异，这叫灾怪；又问：为什么会有此吐利？答：或者有旧时服药，现在才发作，所以名叫灾怪。
医以脉证与药相对而反变异，为此灾可怪，所以名灾怪。
问：东方肝脉，形状什么样？老师说：肝属木，名叫厥阴，其脉微弦濡弱而长，这是肝脉。肝病自得濡弱者，愈。
《难经》说：春脉弦者，肝、东方木也，万物始生，未有枝叶，所以脉来濡弱而长，所以叫弦。这是肝之平脉，肝病得此脉者，为肝气已和。
假如得纯弦脉者，死。为什么知道？因为脉如弦直，（赵本有“此”字）这是肝脏伤，所以知死。
纯弦者，为如弦直而不软，是中无胃气，为真脏之脉。《内经》说：死肝脉来，急益劲，如新张弓弦。
南方心脉，形状什么样？老师说：心属火，名叫少阴，其脉洪大而长，这是心脉。心病自得洪大者，愈。
心旺于夏，夏则阳外胜，气血淖溢，所以脉来洪大而长。
假如脉来微去大，名叫反，病在里。脉来头小本大者，（赵本无“者”字）名叫复，病在表。上微头小者，则汗出；下微本大者，则为关格不通，不得尿。头无汗者可治，有汗者死。
心脉来盛去衰为平，来微去大，是反本脉。《内经》说：大则邪至，小则平。微为正气，大为邪气。来以候表，来微则知表和；去以候里，去大则知里病。《内经》说：心脉来不盛去反盛，此为不及，病在中。头小本大者，即前小后大也。小为正气，大为邪气，则邪气先在里，今复还于表，所以名叫复。不云去而止云来者，是知在表。《脉经》说：在上为表，在下为里。汗者心之液。上微为浮之而微，头小为前小，则表中气虚，所以主汗出。下微（医统本有“为”字）沉之而微，本大为后大，沉则在里，大则病进。《内经》说：心为牡脏，小肠为之使。今邪甚下行，格闭小肠，使正气不通，所以不得尿，名叫关格。《脉经》说：阳气上出，汗见于头，今关格正气不通，加之头有汗者，则阳气不得下通而上脱也。其无汗者，虽作关格，然阳（医统本有“气”字）未衰，而犹可治。
西方肺脉，形状什么样？老师说：肺属金，名叫太阴，其脉毛浮，肺病自得此脉。若得缓迟者，皆愈；若得数者，则剧。为什么知道？数者南方火，火克西方金，法当痈肿，为难治。
轻虚浮曰毛，肺之平脉。缓迟者，脾之脉，脾为肺之母，以子母相生，所以云皆愈；数者，心之脉，火克金，为鬼贼相刑，所以剧。肺主皮毛，数则为热，热客皮肤，留而不去，则为痈疡。经说：数脉不时，则生恶疮。
问：二月得毛浮脉，为什么说至秋当死？老师说：二月之时，脉当濡弱，反得毛浮者，故知至秋死。二月肝用事，肝脉属木，（赵本作“肝属木，脉”）应濡弱，反得毛浮（赵本有“脉”字）者，是肺脉也。肺属金，金来克木，故知至秋死。其他都仿照此理。
当春时反见秋脉，为金气乘木，肺来克肝，夺王脉而见，至秋肺王，肝气则绝，故知至秋死。
老师说：脉，肥人责浮，瘦人责沉。肥人当沉，今反浮；瘦人当浮，今反沉，所以责之。
肥人肌肤浓，其脉当沉；瘦人肌肤薄，其脉当浮。现在肥人脉反浮，瘦人脉反沉，必有邪气相干，使脉反常，所以当责之。
老师说：寸脉下不至关，为阳绝；尺脉上不至关，为阴绝。这些都不治，决死。如果计算其余命死生（赵本作“生死”）之期，期以月节克之。
《脉经》说：阳生于寸，动于尺；阴生于尺，动于寸。寸脉下不至关者，为阳绝，不能下应于尺；尺脉上不至关者，为阴绝，不能上应于寸。《内经》说：阴阳离决，精气乃绝。此阴阳偏绝，所以皆决死。
期以月节克之，谓如阳绝死于春夏，阴绝死于秋冬。
老师说：脉病患不病，名叫行尸，以无王气，卒眩仆不识人者，短命则死。人病脉不病，名叫内虚，以无谷神，虽困无苦。
脉，是人之根本。脉病患不病，为根本内绝，形虽且强，卒然气脱，则眩晕僵仆而死，不曰行尸而何。
人病脉不病，则根本内固，形虽且羸，止内虚尔。谷神者，谷气也。谷气既足，自然安矣。《内经》说：形气有余，脉气不足死；脉气有余，形气不足生。
Those belonging to the Yin of Death (Si Yin), if they are of the category of the Yin of Death, will result in death within no more than three days, because the damage is manifested in the physical form.
Question: The pulse has three sections (Bu), where Yin and Yang interact. Ying (Nutrient) and Wei (Defensive) Qi and Blood exist within the human body. Through inhalation and exhalation, they move up and down within the body, circulating and distributing with the breath, allowing fluids to flow smoothly. They act according to the seasons, presenting corresponding images and forms: string-like (Xian) in spring, floating (Fu) in autumn, deep (Chen) in winter, and full/hong (Hong) in summer. Observing the complexion and examining the pulse reveals differences in size; within a short time, changes follow no fixed pattern. The Cun, Guan, and Chi positions may be uneven, sometimes short, sometimes long. Upper and lower parts may be disordered, sometimes present, sometimes absent. Diseases constantly change, advancing or retreating, rising or falling. One may become confused and lose one's bearings. I wish for a detailed explanation so that I may distinguish them clearly. The Master said: What you ask is the root of the Dao. The pulse has three sections: Cun, Guan, and Chi.
Cun is the upper section, Guan is the middle section, and Chi is the lower section.
Ying and Wei circulate without losing their balance and standard.
Heng Quan refers to a scale, used to weigh weight and lightness. The *Nei Jing* (Inner Canon) states: Spring should conform to the compass (Gui), Summer to the square (Ju), Autumn to the balance (Heng), and Winter to the plumb line (Quan). Ying moves within the vessels, while Wei moves outside the vessels. Ying and Wei follow the vessels, responding up and down to the four seasons, maintaining their normal measure.
The Kidney pulse is deep (Chen), the Heart pulse is full/large (Hong), the Lung pulse is floating (Fu), and the Liver pulse is string-like (Xian). These are the constant pulses, accurate to the finest degree.
The Kidney belongs to Water in the North, prospers in Winter, hence the pulse is deep. The Heart belongs to Fire in the South, prospers in Summer, hence the pulse is full/large. The Lung belongs to Metal in the West, prospers in Autumn, hence the pulse is floating. The Liver belongs to Wood in the East, prospers in Spring, hence the pulse is string-like. These are the constant pulses, accurate to the finest degree.
The movement of entering and exiting, ascending and descending, rotates with the water clock. After two ke (time units) of water dripping, one complete cycle occurs.
The vessels in the human body total sixteen zhang and two chi in length. In one exhalation, the pulse travels three cun; in one inhalation, it travels three cun. One exhalation and one inhalation constitute one xi (breath), during which the pulse travels six cun. In one day and night, one hundred ke of water drip, the person takes thirteen thousand five hundred breaths, and the pulse travels eight hundred ten zhang, completing fifty cycles around the body. Thus, in one ke, the person takes one hundred thirty-five breaths, the pulse travels eight zhang and one chi, and two ke of water drip. In two hundred seventy breaths, the pulse travels sixteen zhang and two chi, completing one cycle around the body. The circulation of the pulse begins and ends again, like a circle without beginning or end.
One should return to the Cun Kou (Radial Artery at the wrist) to observe the manifestations of deficiency and excess.
The Pulse Classic (Yi Tong Ben edition reads "Jing Mai" Meridian Vessel) begins at the Middle Jiao, flowing into the Hand Taiyin Lung Meridian at the Cun Kou. In two hundred seventy breaths, the pulse completes one cycle around the body and returns to the Cun Kou. Since Cun Kou is the starting point of the pulse, one diagnoses deficiency and excess here. The Classics state: The key to life and death regarding deficiency and excess is all seen within the Cun Kou.
Changes multiply each other, and Yin and Yang interfere with each other. Wind results in a floating and empty pulse; Cold results in a firm and solid pulse. Deep and submerged indicates water retention; Branch Yin (fluid retention) presents with an urgent and string-like pulse. A Moving pulse indicates pain; a Rapid pulse indicates heat and vexation.
Wind injures Yang, hence the pulse is floating and empty. Cold injures Yin, hence the pulse is firm and solid. Accumulation inside is called Water Retention, hence the pulse is deep and submerged. Dispersion outside is called Branch Yin, hence the pulse is urgent and string-like. Movement indicates Yin and Yang struggling against each other; when they struggle, pain arises. Rapid indicates the victory of Yang pathogenic factors; when Yang prevails, heat and vexation arise.
If there are non-correspondences, one must understand the cause of the change. The three sections differ, and diseases have different origins.
When the pulse does not correspond to the disease, it is necessarily due to transmission and transformation. The three sections are used to inspect the Qi of the Five Zang organs; one inspects deficiency and excess according to the section.
Excess is strange, and insufficiency is also strange. Pathogens do not appear out of nowhere; there must be hidden evil within. Carefully inspect the exterior and interior, distinguish the Three Jiao, know where the pathogen resides, adjust the diagnosis, estimate the state of the Fu and Zang organs, and see with clarity as if divine. I will record this for you in detail to pass on to worthy men.
Both excessive and insufficient pulses indicate that pathogens are interfering with healthy Qi. One must determine whether it is in the exterior or interior, entering the Fu or Zang organs, and treat according to where it resides.
The Master said: Respiration is the head (guide) of the pulse.
The *Nan Jing* (Classic of Difficult Issues) states: In one exhalation, the pulse travels three cun; in one inhalation, it travels three cun. Because the pulse follows respiration, it is said to be the head of the pulse.
At the initial grasp of the pulse, if the arrival is rapid and the departure is slow, this is rapid exit and slow entry, named Interior Deficiency and Exterior Excess. At the initial grasp, if the arrival is slow and the departure is rapid, this is slow exit and rapid entry, named Interior Excess and Exterior Deficiency.
Exterior is Yang, Interior is Yin. The *Nei Jing* states: Arrival is Yang, Departure is Yin. Thus, exit inspects the exterior, and entry inspects the interior. Rapid indicates surplus; surplus means excess. Slow indicates insufficiency; insufficiency means deficiency. Rapid arrival and slow departure mean Yang is surplus and Yin is insufficient, hence Interior Deficiency and Exterior Excess. Slow arrival and rapid departure mean Yang is insufficient and Yin is surplus, hence Interior Excess and Exterior Deficiency.
Question: The superior physician knows by observation, the average physician knows by inquiry, and the inferior physician knows by pulse diagnosis. I wish to hear the reasoning behind this. The Master said: When the patient's family says, "The patient has fever and body ache, and lies down," and upon arrival, the physician palpates the pulse and finds it deep and slow, he knows the patient will recover. Why? If there is an exterior disease, the pulse should be floating and large. Now the pulse is instead deep and slow, so we know recovery is imminent.
Observation inspects the physical signs and symptoms; inquiry learns of the suffering; pulse differentiation distinguishes the exterior and interior. Suffering from fever and body ache indicates the pathogen is in the exterior, where one should lie restless with a floating and rapid pulse. Now the patient lies quietly with a deep and slow pulse, indicating the exterior pathogen has eased. There is an interior pulse but no exterior syndrome, so we know the exterior pathogen will heal.
Suppose the patient says, "I have sudden abdominal pain," and sits up. Upon arrival, the physician palpates the pulse and finds it floating and large, knowing recovery is near. Why? If there is an interior disease, the pulse should be deep and fine. Now the pulse is floating and large, so we know recovery is near.
Abdominal pain indicates interior cold. Severe pain prevents standing, accompanied by a deep and fine pulse. Now the patient sits up with a floating and large pulse, indicating the interior cold has dispersed. There is an exterior pulse but no interior syndrome, so we know the interior pathogen will heal. By combining observation of signs, inquiry about illness, and palpation of the pulse, one can become a perfect physician. The *Zhen Jing* (Needle Canon) states: Knowing one aspect is superior, knowing two is divine, knowing three is both divine and bright.
The Master said: When the patient's family comes requesting, saying "The patient has fever and extreme vexation." The next day, when the physician arrives, the patient lies facing the wall. This indicates the heat has gone. Even if the pulse is not harmonious, the prescription states recovery.
Fever and extreme vexation prevent quiet lying. Now lying quietly facing the wall indicates the heat has subsided.
If the patient lies facing the wall, but upon hearing the physician's arrival, does not startle up but looks sideways, or speaks three times pausing three times, and swallows saliva while being palpated, this is feigned illness. Even if the pulse is naturally harmonious, the prescription states: "Your illness is severe. You must take emetic and purgative medicines, and undergo dozens or hundreds of acupuncture points to recover."
Feigned illness is not done by good people. By frightening them with words, causing fear, the illness heals. The physician relies on mental perception; this is likely what is meant.
When the physician holds the pulse and the patient yawns, there is no illness.
The *Zhen Jing* states: Yang draws upward, Yin draws downward. Yin and Yang draw each other, hence yawning. If Yin and Yang do not draw each other, illness occurs; if they draw each other, harmony is achieved. Thus, yawning indicates no illness.
Palpating the pulse, groaning indicates illness.
Groaning is the sound of suffering; when the body suffers, one groans.
Speaking slowly indicates Wind.
Wind lodging in the interior causes meridians and collaterals to contract, making the tongue stiff and difficult to move.
Shaking the head while speaking indicates interior pain.
When there is interior illness and one wishes to speak, the head trembles and shakes.
Walking slowly indicates Exterior Stiffness.
Exterior stiffness is caused by the contraction of meridians and collaterals, leading to difficulty in walking.
Sitting and leaning forward indicates Shortness of Breath.
Shortness of breath indicates interior disharmony, so one sits and prefers to lean forward.
Sitting with one leg hanging down indicates Waist Pain.
The *Nei Jing* states: The waist is the major joint of the body. Waist pain involves dysfunction of the major joints, so one cannot sit upright and hangs one leg to relieve the pain in the waist.
Protecting the abdomen as if holding an egg indicates Heart Pain.
Heart pain prevents extending and lying back; one protects the abdomen to press on the pain.
The Master said: The disease of Hidden Qi (Fu Qi) must be anticipated mentally. Within this month, Hidden Qi is expected. If there is pre-existing Hidden Qi, one must palpate the pulse. If the pulse is weak and faint, there should be throat pain resembling injury, but it is not Hou Bi (throat obstruction). The patient says: "Indeed, my throat hurts. Although so, I now desire diarrhea."
Contracting Cold in Winter and hiding it in the meridians without immediate onset is called Hidden Qi. By the time of the Spring Equinox, the hidden Cold desires to emerge, hence "within this month: Hidden Qi is expected."
If Hidden Qi has emerged, one must palpate the pulse to determine which meridian is affected. Obtaining a weak and faint pulse indicates the pathogen is in the Shaoyin (Lesser Yin). The Shaoyin meridian runs along the throat; Cold lodging there必然 causes throat pain. The Kidney governs opening and closing; Shaoyin manages the Lower Jiao. If Cold is severe internally, opening and closing fail, the Lower Jiao is not constrained, and diarrhea inevitably results. Hence: "Although there is throat pain, there is also desire for diarrhea."
Question: When a person suffers from terror/fear, what is the pulse shape? The Master said: The pulse feels like tracing silk, bead-like (lei lei), and the face is pale and loses color.
The *Nei Jing* states: Blood and Qi are the Spirit of man. Those who are terrified have insufficient Blood and Qi, and weak Shen Qi. A pulse feeling like tracing silk, bead-like, with a pale and colorless face—the *Zhen Jing* states: When Blood is depleted, the complexion is dull and lacks luster. An empty pulse indicates that terror is due to insufficient Blood and Qi.
Question: When a person does not drink, what is the pulse like? The Master said: The pulse is naturally Choppy (Se), and the lips and mouth are dry.
Choppy is Yin. Although it mainly indicates loss of Body Fluids, dry lips and mouth, governed by Yin internally, explain why the person does not drink.
Question: When a person feels ashamed, what is the pulse like? The Master said: The pulse is Floating, and the complexion alternates between white and red.
Ashame is shame. Shame makes Shen Qi timid and weak, hence the pulse is Floating, and the complexion changes irregularly.
Question: The Classics mention pulses weighted at three beans (San Shu) and six beans (Liu Shu). What does this mean? The Master said: When a person presses the pulse with their fingers:
Weight equivalent to three beans indicates Lung Qi.
Weight equivalent to six beans indicates Heart Qi.
Weight equivalent to nine beans indicates Spleen Qi.
Weight equivalent to twelve beans indicates Liver Qi.
Pressing to the bone indicates Kidney Qi.
Shu refers to beans. The *Nan Jing* states: Weight of three beans, touching the skin and hair, corresponds to the Lung region. Weight of six beans, touching the blood vessels, corresponds to the Heart region. Weight of nine beans, touching the muscles, corresponds to the Spleen region. Weight of twelve beans, level with the tendons, corresponds to the Liver region. Pressing to the bone, with the finger lifting quickly, corresponds to the Kidney region. Each corresponds to its respective zone to inspect Zang Qi.
Suppose there is diarrhea, and the Cun, Guan, and Chi positions show no pulse. However, the Chi position occasionally shows a small pulse, and the pulse rises twice (Zhao Ben note: "Another reading says 'presses down'"), indicating Kidney Qi. If a Damaged pulse appears, it is difficult to treat.
The *Mai Jing* (Pulse Classic) states: Cold Qi in the stomach causes the pulse to be obstructed. Diarrhea without a visible pulse indicates Cold Qi lodging in the Spleen and Stomach. The occasional small appearance in the Chi position indicates Spleen deficiency with Kidney Qi encroaching. The pulse rising twice indicates the Spleen is overcome by the Kidney. If the Chi pulse diminishes further, Kidney Qi is also declining, and the Spleen overcomes it again. This is a "Ghost-Thief" mutual punishment, hence difficult to treat. This is Spleen overcoming when it should not.
Question: What are Mutual Overcoming (Xiang Cheng), Vertical (Zong), Horizontal (Heng), Reverse (Ni), and Smooth (Shun) in the pulse? The Master said: Water overcoming Fire, and Metal overcoming Wood, are called Vertical (Zong). Fire overcoming Water, and Wood overcoming Metal, are called Horizontal (Heng). Water overcoming Metal, and Fire overcoming Wood, are called Reverse (Ni). Metal overcoming Water, and Wood overcoming Fire, are called Smooth (Shun).
Metal overcomes Wood, and Water overcomes Fire. "Vertical" means letting the Qi go unchecked to overcome what it normally controls. "Horizontal" means the Qi acts horizontally and rebelliously, overcoming what it normally does not control. Zong and Heng share meanings with Zi Zong (indulgence) and Zi Heng (rebellion). Water is the child of Metal, and Fire is the child of Wood. When the child overcomes the mother, the Qi is Reverse; when the mother overcomes the child, the Qi is Smooth.
Question: What are the Destructive and Harmful (Can Zei) pulses? The Master said: String-like (Xian), Tight (Jin), Floating (Fu), Slippery (Hua), Deep (Chen), and Choppy (Se) are these six types, named Destructive and Harmful, because they can cause pathology in various pulses.
For human illness, these are named Eight Evils: Wind, Cold, Summer-heat, and Dampness injure externally; Hunger, Fullness, Labor, and Rest injure internally. The meridians are Ying and Wei. Ying and Wei are Yin and Yang. For them to cause pathology in the meridians, it must be due to Wind, Cold, Summer-heat, and Dampness injuring Ying and Wei, lodging in Yin and Yang. Wind causes a Floating pulse; Cold causes a Tight pulse; Summer-heat causes a Slippery pulse; Dampness causes a Choppy pulse; Injury to Yin causes a Deep pulse; Injury to Yang causes a Floating pulse. They are called Destructive and Harmful because harming the good is "Destructive" (Can), and damaging the good is "Harmful" (Zei), as they can harm Healthy Qi.
Question: What is the "Disaster and Wonder" (Zai Guai) pulse? The Master said: Suppose a patient has a Taiyang pulse, corresponding to the signs and symptoms, and a decoction is prepared. Before returning with the medicine, roughly the time it takes to eat a meal, the patient suddenly vomits severely or has diarrhea with abdominal pain. The physician says: "I did not see this symptom before; now it has changed. This is called Disaster and Wonder." Another asks: "Why does this vomiting and diarrhea occur?" The answer is: "Perhaps old medication taken previously is now taking effect, hence it is named Disaster and Wonder."
When the physician matches the pulse and signs with the medicine, but a variation occurs, it is considered a disaster and wonder, hence the name.
Question: What does the Liver pulse of the East look like? The Master said: The Liver belongs to Wood, named Jueyin. Its pulse is slightly string-like, soft, weak, and long. This is the Liver pulse. If Liver disease presents with a soft and weak pulse, the patient will recover.
The *Nan Jing* states: The Spring pulse is string-like because the Liver belongs to Wood in the East. When all things begin to grow, without branches or leaves, the pulse comes soft, weak, and long, hence called string-like. This is the Normal Pulse of the Liver. If Liver disease presents this pulse, it means Liver Qi is harmonized.
If a Pure String-like pulse is obtained, the patient will die. Why? Because the pulse is straight like a bowstring (Zhao Ben adds "this"), indicating Liver damage, hence death is known.
A Pure String-like pulse is straight and unyielding, lacking Stomach Qi, representing the True Zang pulse. The *Nei Jing* states: The dying Liver pulse comes urgent and strong, like a newly tightened bowstring.
What does the Heart pulse of the South look like? The Master said: The Heart belongs to Fire, named Shaoyin. Its pulse is full, large, and long. This is the Heart pulse. If Heart disease presents with a full and large pulse, the patient will recover.
The Heart prospers in Summer. In Summer, Yang wins externally, and Blood and Qi overflow, hence the pulse comes full, large, and long.
If the pulse arrives weakly and departs largely, it is named "Reverse" (Fan), and the disease is in the Interior. If the pulse head is small and the base is large, it is named "Return" (Fu), and the disease is in the Exterior. If the upper part is weak and the head is small, there will be sweating. If the lower part is weak and the base is large, there will be Guan Ge (Obstruction and Reflux) blockage, preventing urination. If the head has no sweat, it is treatable; if the head has sweat, it is fatal.
A Heart pulse arriving vigorous and departing weak is normal. Arriving weak and departing largely is a Reverse Basic Pulse. The *Nei Jing* states: Large indicates pathogen arrival; Small indicates peace. Weak represents Healthy Qi; Large represents Pathogenic Qi. Arrival inspects the Exterior; arriving weak indicates Exterior harmony. Departure inspects the Interior; departing largely indicates Interior disease. The *Nei Jing* states: If the Heart pulse does not arrive vigorously but departs vigorously, this is Insufficiency, and the disease is in the Center. "Head small, base large" means front small, back large. Small is Healthy Qi, Large is Pathogenic Qi. If the pathogen was first in the Interior and now returns to the Exterior, it is named "Return." Not mentioning departure but only arrival indicates knowledge of the Exterior. The *Mai Jing* states: Upper is Exterior, Lower is Interior. Sweat is the fluid of the Heart. "Upper weak" means floating and weak; "head small" means front small. This indicates Qi deficiency in the Exterior, hence sweating. "Lower weak" (Yi Tong Ben adds "is") means pressing and weak; "base large" means back large. Pressing indicates Interior; Large indicates disease progression. The *Nei Jing* states: The Heart is a Yang organ, and the Small Intestine is its envoy. Now the pathogen descends severely, blocking the Small Intestine, preventing Healthy Qi from flowing, hence inability to urinate, named Guan Ge. The *Mai Jing* states: Yang Qi exits upward, sweat appears on the head. Now with Guan Ge and blocked Healthy Qi, plus sweat on the head, Yang Qi cannot descend and escapes upward. If there is no sweat, although Guan Ge occurs, Yang (Yi Tong Ben adds "Qi") has not declined, and it is still treatable.
What does the Lung pulse of the West look like? The Master said: The Lung belongs to Metal, named Taiyin. Its pulse is Hair-like (Mao) and Floating. If Lung disease presents this pulse... If it presents a Slow and Late pulse, both indicate recovery; if it presents a Rapid pulse, the condition worsens. Why? Rapid is Southern Fire; Fire overcomes Western Metal. According to the method, carbuncles and swellings should occur, making it difficult to treat.
Light, void, and floating is called Mao, the Normal Pulse of the Lung. Slow and Late is the Spleen pulse. The Spleen is the Mother of the Lung; through maternal-son generation, recovery is indicated. Rapid is the Heart pulse. Fire overcomes Metal, representing Ghost-Thief mutual punishment, hence worsening. The Lung governs skin and hair. Rapid indicates Heat. If Heat lodges in the skin and remains, it becomes carbuncles and ulcers. The Classics state: If the Rapid pulse persists, malignant sores arise.
Question: Obtaining a Hair-like Floating pulse in the second lunar month, why say death will come in Autumn? The Master said: In the second month, the pulse should be Soft and Weak. Obtaining a Hair-like Floating pulse instead indicates death in Autumn. In the second month, the Liver is active. The Liver pulse belongs to Wood, (Zhao Ben reads "Liver belongs to Wood, pulse") and should be Soft and Weak. Obtaining a Hair-like Floating pulse (Zhao Ben adds "pulse") is the Lung pulse. The Lung belongs to Metal. Metal overcomes Wood, hence death in Autumn is known. Others follow this pattern.
Seeing the Autumn pulse in Spring indicates Metal Qi overcoming Wood, Lung overcoming Liver. The King Pulse is stolen and replaced. By Autumn, when the Lung is King, the Liver Qi will be exhausted, hence death in Autumn is known.
The Master said: For the pulse, examine Floating in fat people, and Deep in thin people. Fat people should have a Deep pulse; now it is Floating instead. Thin people should have a Floating pulse; now it is Deep instead. Hence, we examine/reproach them.
Fat people have thick skin and flesh, so their pulse should be Deep. Thin people have thin skin and flesh, so their pulse should be Floating. Now the fat person's pulse is Floating, and the thin person's pulse is Deep. There must be pathogenic interference causing the pulse to be abnormal, hence we examine them.
The Master said: If the Cun pulse does not reach down to the Guan, it is Yang Extinction. If the Chi pulse does not reach up to the Guan, it is Yin Extinction. All these are untreatable and determined to be fatal. If calculating the remaining lifespan and time of death, the period is determined by the monthly solar terms overcoming each other.
The *Mai Jing* states: Yang is born at Cun and moves at Chi; Yin is born at Chi and moves at Cun. If the Cun pulse does not reach down to the Guan, it is Yang Extinction, unable to respond down to the Chi. If the Chi pulse does not reach up to the Guan, it is Yin Extinction, unable to respond up to the Cun. The *Nei Jing* states: When Yin and Yang separate and决 (decide/break), Essence and Qi perish. Here, Yin and Yang are partially extinct, hence all are determined to die.
"Determined by monthly solar terms overcoming" means, for example, Yang Extinction dies in Spring and Summer, and Yin Extinction dies in Autumn and Winter.
The Master said: When the pulse is normal but the patient is ill, it is called a "Walking Corpse" (Xing Shi). Lacking King Qi, sudden dizziness and collapse with unconsciousness lead to short life and death. When the patient is ill but the pulse is normal, it is called Interior Deficiency. Lacking Grain Spirit, though distressed, there is no suffering.
The pulse is the root of man. Pulse normal but patient ill means the root is internally severed. Although the form is strong, sudden Qi depletion leads to dizziness, collapse, and death. How else but to call it a Walking Corpse?
Patient ill but pulse normal means the root is internally solid. Although the form is emaciated, it is merely interior deficiency. Grain Spirit refers to Grain Qi. Once Grain Qi is sufficient, one is naturally at peace. The *Nei Jing* states: Surplus Form Qi and Insufficient Pulse Qi lead to death; Surplus Pulse Qi and Insufficient Form Qi lead to life.