《素问·平人气象论》岐伯曰∶人一呼脉再动，一吸脉亦再动，呼吸定息脉五动，闰以太息，命曰平
人。平人者，不病也。常以不病调病患，医不病，故为病患平息以调之为法。人一呼脉一动，一吸脉一动，曰
少气。人一呼脉三动，一吸脉三动而躁，尺热，曰病温；尺不热，脉滑，曰病风；涩，曰痹。人一呼脉四动以
上曰死，脉绝不至曰死，乍疏乍数曰死。平人之常气禀于胃，胃者，平人之常气也，人无胃气曰逆，逆者死。
脉之动者，阴阳气血升降出入也。其气根于呼吸，故仲景言呼吸脉之头也。一呼一吸，名一息，三息中必
有一长息，如岁之有闰，名太息也。一呼一吸，而脉四动，连长息计之，则三息中多三动，分计每息有五动，
名五至也，如此为无病之平人。以无病患之呼吸，合病脉之至数，其迟其数可见也。假如一呼脉止一动，一吸
脉一动，此为迟脉，阳气衰少也。一呼脉三动，一吸脉三动，此为数脉，若兼躁动，而尺肤热者，温病也；
尺肤不热，而脉兼滑者，是内有风痰，如中风之类也；脉兼涩者，邪痹经络也。若一呼脉至四动以上，其气有
出无入，本元外脱也；脉绝不至者，气血竭也；乍疏乍数者，元气散乱也，故皆主死。胃为脏腑之海，脏腑皆
赖胃中谷气充养，故人无胃气，其病为逆，逆则死之征也。
太阳脉至，洪大以长；少阳脉至，乍数乍疏，乍短乍长；阳明脉至，浮大而短。
此以阳气生旺开阖，而现于脉象也。太阳为开，阳气正旺，故脉洪大且长也；少阳为枢，阳气始生，未能
调达，故脉乍数乍疏，乍长乍短，与上节之乍疏乍数，气散无力者，迥乎不同，不可不知也；两阳合明名阳明，
阳旺极而气阖也，故脉浮大者，阳之象，短者，阖象也。以此验三阳之气，生旺出入之道，与天地相同。假如
夏令，阳旺极而阴将生，是阳明之短脉，乃为秋
令浮短涩之先兆。其三阴经之开阖枢，亦然。故《难经》曰∶太阴之至，紧大而长。此阴气旺也，故太阴为开。
又云∶少阴之至，紧细而微。此阴气始生，故少阴为枢。又云∶厥阴之至，沉细而敦。此阴气已极，故厥阴
为阖。《难经》以此三阴三阳名旺脉，谓合天地生旺之气也。惟《难经》言冬至后得甲子，少阳旺；再得甲子，
阳明旺；再得甲子，太阳旺。此但指天地阳气生旺而言。《内经》言开阖枢者，指人身经气流行而言，各有义
理不同也。又《素问·至真要大论》曰∶厥阴之至，其脉弦；少阴之至，其脉钩；太阴之至，其脉沉；少阳之
至，大而浮；阳明之至，短而涩；太阳之至，大而长。此言客气流行，应乎脉象者，与前诸义又不同。是故圣
经之论阴阳，千变万化，各有义理所主，不可错乱。故经曰∶知其要者，一言而终，不知其要，流散无穷。所
以前章李仕材凭臆见注解脉象，脏腑部位阴阳错乱也。
春胃微弦，曰平；弦多胃少，曰肝病；但弦无胃，曰死；胃而有毛，曰秋病，毛甚，曰今病。脏真散于肝，
肝藏筋膜之气也。
五脏具五行之性，故各脏脉形不同，而合五时之气化，然以胃气和缓之象为本，故五时之脉，但微现本脏
之脉形，方为吉也。假如肝木旺于春，两手之脉弦，弦者，细长而调达，必以和缓胃气为主，而微兼弦象曰平，
平者，无病也；若弦多胃气少，则肝气横逆而病矣；但弦无胃气，则真脏脉现而死矣；若弦缓兼毛，毛者，浮
短涩，肺脏之本脉，而主秋令，弦多胃少者，肝气太过也，兼毛者，肝气不足也，至秋金旺，则肝木更亏而病
矣；若毛甚，则春见秋脉，生气告匮，实时病也。先天真元之气，散布于肝，肝为震，后天之阳，始生筋膜，
故筋膜之气藏于肝，而肝主筋也。
夏胃微钩，曰平；钩多胃少，曰心病；但钩无胃，
曰死；胃而有石，曰冬病；石甚，曰今病。脏真通于心，心藏血脉之气也。
心火旺于夏，两手之脉钩，钩者，如钩微曲向下，其上圆活转动而浮，必以和缓胃气为主，微现钩象曰平；
若钩多胃气少，则心火亢逆而病矣；但钩无胃气，则坚硬不转动，是真脏脉现，则死也；若钩缓中兼石，石者，
沉实而滑，肾脏之本脉，而主冬令，此心火不足，至冬水旺，则心气愈亏而病矣；若石甚，则阴盛阳衰，实时
病也。真元之气通于心，以生血脉，而血脉藏于心，故心主血脉也。
长夏胃微软弱，曰平；弱多胃少，曰脾病；但代无胃，曰死；软弱有石，曰冬病；石甚，曰今病。脏真濡
于脾，脾藏肌肉之气也。
脾土旺于四季，而主令长夏未月，以土位于中，而未为一岁之中也。脾司鼓运，代行各脏之气于周身，故
其本脉名代。软弱者，阴土柔象也，胃为阳土，其气刚，刚柔相济，而得中和之气，故微有软弱之象曰平；如
弱多，则阳气少，脾乏鼓运之力而病矣；若但代无胃，则真脏脉现而死也；软弱有石，曰冬病，石甚，曰今病，
与心同。盖火土一源，长夏心火犹旺也。真元之气蒸液濡于脾，以长养肌肉，故肌肉之气藏于脾，而脾主肌肉也。
秋胃微毛，曰平；毛多胃少，曰肺病；但毛无胃，曰死；毛而有弦，曰春病；弦甚，曰今病。脏真高于肺，
以行营卫之气也。
肺金旺于秋，两手之脉毛，毛者，浮短涩，阳气初降变阴之象，必以和缓胃气为主，而微有毛象曰平；若
毛多胃气少，则
肺气不调而病矣；但毛无胃气，则真脏脉现而死也；若毛而有弦，以收肃之令，而现生发之脉，其阳不敛，
至春发泄更甚而病矣；若弦甚，则反气化时令而即病也。肺为华盖，部位最高，真元之气上达于肺，故权衡一
身之气，以行营卫阴阳表里也。
冬胃微石，曰平；石多胃少，曰肾病；但石无胃，曰死；石而有钩，曰夏病；钩甚，曰今病。脏真下于肾，
肾藏骨髓之气也。
肾水旺于冬，两手之脉石，石者，沉实软滑，阳气归藏之象，必以和缓胃气为主，而微有石象，曰平；若
石多胃气少，则肾阳衰，阴寒太过而病矣；但石无胃气，则真脏脉现而死也；若石而有钩，以归藏之令，而见
升浮之脉，阳先发露，至夏令则水涸，必生热病矣；若钩甚，是反其归藏之令，实时病也。真元之气下根于肾，
骨髓乃精气所成，而藏于肾，故肾主骨也。
《素问·平人气象论》中，岐伯说：人每次呼气时脉搏跳动两次，每次吸气时脉搏也跳动两次，在呼吸转换的间歇（定息）时脉搏多跳一次，若加上偶尔的深长呼吸（太息），称为平人。所谓平人，就是没有疾病的人。通常用健康人的脉象来对照病人的脉象，医生自身无病，所以通过调整自己的呼吸节奏来为病人诊脉作为法则。如果人每次呼气脉搏只跳动一次，每次吸气也只跳动一次，这叫做少气。如果人每次呼气脉搏跳动三次，每次吸气也跳动三次且脉势躁急，尺部皮肤发热，这是温病；尺部皮肤不热，但脉象滑利，这是风病；脉象涩滞，这是痹证。如果人每次呼气脉搏跳动四次以上，或者脉搏断绝不再跳动，或者脉律忽快忽慢，都主死亡。正常人的常气来源于胃，胃是平人的常气所在，人如果没有胃气就称为逆，逆则死。
脉搏的跳动，是阴阳气血升降出入的表现。气的根本在于呼吸，所以张仲景说呼吸是观察脉搏的关键。一呼一吸称为一息，在三息之中必然有一次较长的呼吸，就像年份中有闰月一样，称为太息。一呼一吸之间，脉搏跳动四次，连同长息计算，三息中多跳三次，平均分配每息有五次跳动，称为五至，像这样就是无病的平人。用无病患的呼吸频率，结合病脉的至数，就能看出脉象的迟与数。假如一呼脉搏停止不动或仅动一次，一吸脉搏动一次，这是迟脉，表示阳气衰少。一呼脉搏动三次，一吸脉搏动三次，这是数脉，如果兼有躁动且尺肤发热，就是温病；尺肤不热而脉兼滑利，说明内有风痰，如中风之类；脉兼涩滞，说明邪气痹阻经络。如果一呼脉搏跳动四次以上，说明气只有出没有入，本元外脱；脉搏断绝不至，说明气血枯竭；脉律忽疏忽数，说明元气散乱，所以这些都主死。胃是脏腑的海，脏腑都依赖胃中的谷气充养，所以人如果没有胃气，其病势为逆，逆则是死亡的征兆。
太阳经的脉象，洪大且长；少阳经的脉象，忽快忽慢，忽短忽长；阳明经的脉象，浮大而短。
这是以阳气的生、旺、开、阖变化，反映在脉象上。太阳主开，阳气正旺盛，所以脉象洪大且长；少阳主枢，阳气刚开始生发，未能调达顺畅，所以脉象忽快忽慢，忽长忽短，这与上一节提到的气散无力导致的忽疏忽数截然不同，不可不知道；两阳合明称为阳明，阳气极盛而气机闭合，所以脉象浮大是阳的征象，短是闭合的征象。以此验证三阳之气的生、旺、出、入之道，与天地自然规律相同。假如在夏季，阳气极盛而阴气将生，这就是阳明短脉，它是秋季浮、短、涩脉的先兆。三阴经的开、阖、枢也是如此。所以《难经》说：太阴经的脉象，紧大而长。这是因为阴气旺盛，所以太阴主开。又说：少阴经的脉象，紧细而微。这是因为阴气刚开始生发，所以少阴主枢。又说：厥阴经的脉象，沉细而敦厚。这是因为阴气已至极点，所以厥阴主阖。《难经》用这三阴三阳的名称来命名旺脉，认为它们符合天地生旺之气。只是《难经》说冬至后得到甲子日，少阳旺；再得甲子日，阳明旺；再得甲子日，太阳旺。这仅仅指天地阳气的生旺而言。《内经》所说的开阖枢，是指人身经气的流行而言，各有不同的义理。又《素问·至真要大论》说：厥阴经的脉象弦；少阴经的脉象钩；太阴经的脉象沉；少阳经的脉象大而浮；阳明经的脉象短而涩；太阳经的脉象大而长。这是说客气流行，应验于脉象，与前诸种义理又不同。所以圣人的经典论述阴阳，千变万化，各有其主要的义理，不可错乱。因此经文说：懂得要领的人，一句话就能终结道理；不懂要领的人，就会流散无穷。所以前章李仕材凭借主观见解注解脉象，导致脏腑部位和阴阳错乱。
春季脉象带有微微的弦象且有胃气，称为平人；弦象多而胃气少，称为肝病；只有弦象而没有胃气，称为死证；脉象有胃气且带有毛象（浮短涩），预示秋季生病；毛象明显，称为当下即病。脏真之气散布于肝，肝藏筋膜之气。
五脏具备五行的属性，所以各脏的脉形不同，并与五时的气化相合，然而都以胃气和缓的征象为本，所以五时的脉象，只要微微显现本脏的脉形，才是吉兆。假如肝木在春季旺盛，两手脉象呈弦象，弦象的特点是细长而调达，必须以和缓的胃气为主，并微微兼有弦象才叫平，平就是无病；如果弦多胃气少，那么肝气横逆就会生病；如果只有弦象没有胃气，那么真脏脉出现就会死；如果脉象弦缓兼有毛象，毛象是浮短涩，是肺脏的本脉，主秋季，弦多胃气少说明肝气太过，兼有毛象说明肝气不足，到了秋季金气旺盛时，肝木更加亏损就会生病；如果毛象非常明显，那么在春季见到秋季的脉象，生气告罄，当下就会生病。先天真元之气，散布于肝，肝属震卦，后天之阳开始生发筋膜，所以筋膜之气藏于肝，肝主筋。
夏季脉象带有微微的钩象且有胃气，称为平人；钩象多而胃气少，称为心病；只有钩象而没有胃气，称为死证；脉象有胃气且带有石象（沉实），预示冬季生病；石象明显，称为当下即病。脏真之气通于心，心藏血脉之气。
心火在夏季旺盛，两手脉象呈钩象，钩象的特点是像钩子一样微曲向下，其上端圆活转动且浮，必须以和缓的胃气为主，微微显现钩象才叫平；如果钩多胃气少，那么心火亢逆就会生病；如果只有钩象没有胃气，那么脉象坚硬不转动，是真脏脉出现，就会死；如果脉象钩缓中兼有石象，石象是沉实而滑，是肾脏的本脉，主冬季，这说明心火不足，到了冬季水气旺盛时，心气更加亏损就会生病；如果石象非常明显，那么阴盛阳衰，当下就会生病。真元之气通于心，以生血脉，而血脉藏于心，所以心主血脉。
长夏季节脉象带有微微的软弱之象且有胃气，称为平人；软弱之象多而胃气少，称为脾病；只有代脉（歇止）而没有胃气，称为死证；软弱之象中带有石象，预示冬季生病；石象明显，称为当下即病。脏真之气濡润于脾，脾藏肌肉之气。
脾土在四季旺盛，并主宰长夏未月，因为土位于中央，而未月是一年的中间。脾负责鼓动运化，代行各脏之气于周身，所以它的本脉名为代脉。软弱是阴土的柔顺征象，胃是阳土，其气刚健，刚柔相济，从而获得中和之气，所以微微有软弱之象叫平；如果软弱之象过多，那么阳气少，脾缺乏鼓动运化的力量就会生病；如果只有代脉没有胃气，那么真脏脉出现就会死；软弱伴有石象，预示冬季生病，石象明显，预示当下即病，这与心病的情况相同。因为火土同源，长夏时节心火仍然旺盛。真元之气蒸腾津液濡润于脾，以长养肌肉，所以肌肉之气藏于脾，脾主肌肉。
秋季脉象带有微微的毛象且有胃气，称为平人；毛象多而胃气少，称为肺病；只有毛象而没有胃气，称为死证；毛象中带有弦象，预示春季生病；弦象明显，称为当下即病。脏真之气高于肺，以运行营卫之气。
肺金在秋季旺盛，两手脉象呈毛象，毛象是浮短涩，是阳气初降变为阴气的征象，必须以和缓的胃气为主，并微微有毛象才叫平；如果毛多胃气少，那么肺气不调就会生病；如果只有毛象没有胃气，那么真脏脉出现就会死；如果毛象中带有弦象，以收敛肃杀的时令，却现出生发的脉象，阳气不能收敛，到了春季发泄更甚就会生病；如果弦象非常明显，那么违背气化时令，当下就会生病。肺为华盖，位置最高，真元之气上达于肺，所以权衡一身之气，以运行营卫阴阳表里。
冬季脉象带有微微的石象且有胃气，称为平人；石象多而胃气少，称为肾病；只有石象而没有胃气，称为死证；石象中带有钩象，预示夏季生病；钩象明显，称为当下即病。脏真之气下归于肾，肾藏骨髓之气。
肾水在冬季旺盛，两手脉象呈石象，石象是沉实软滑，是阳气归藏的征象，必须以和缓的胃气为主，并微微有石象，叫平；如果石多胃气少，那么肾阳衰，阴寒太过就会生病；如果只有石象没有胃气，那么真脏脉出现就会死；如果石象中带有钩象，以归藏的时令，却见升浮的脉象，阳气过早显露，到了夏季则水涸，必定生热病；如果钩象非常明显，那么违背其归藏的时令，当下就会生病。真元之气下根于肾，骨髓乃精气所成，而藏于肾，所以肾主骨。
In the "Ping Ren Qi Xiang Lun" (Treatise on the Pulse and Manifestations of a Healthy Person) of the *Su Wen* (Basic Questions), Qibo stated: When a person exhales, the pulse beats twice; when they inhale, the pulse also beats twice. At the pause between breaths (Ding Xi), it beats five times in total. If we account for occasional deep sighs (Tai Xi), this is called a Ping Ren (Healthy Person). A Ping Ren is one who is not diseased. Typically, one uses the pulse of a healthy person to adjust for that of a patient. Since the physician is healthy, the method is to regulate one's own breathing to diagnose the patient. If upon one exhalation the pulse beats once, and upon one inhalation it beats once, this is called Shao Qi (Deficient Qi). If upon one exhalation the pulse beats three times, and upon one inhalation it beats three times with a restless quality, and the skin at the chi position is hot, this indicates Wen Bing (Warm Disease); if the chi skin is not hot but the pulse is slippery, this indicates Feng Bing (Wind Disease); if the pulse is choppy, this indicates Bi Syndrome (Obstruction). If upon one exhalation the pulse beats four or more times, or if the pulse ceases completely, or if the pulse rhythm is intermittently slow and rapid, these all indicate death. The normal qi of a healthy person is derived from the Stomach; the Stomach is the source of normal qi. If a person lacks Stomach Qi, it is termed Ni (Rebellious/Contrary), and Ni leads to death.
The movement of the pulse reflects the ascending, descending, exiting, and entering of Yin-Yang, Qi, and Blood. The root of this Qi lies in respiration; therefore, Zhang Zhongjing stated that respiration is the key to observing the pulse. One exhalation and one inhalation constitute one Xi (Breath Cycle). Among three breath cycles, there must be one longer breath, similar to a leap month in a year, called Tai Xi. In one breath cycle, the pulse beats four times. Including the long breath, among three cycles there are three extra beats; averaged out, each cycle has five beats, called Wu Zhi (Five Beats). This represents a healthy, disease-free state. By combining the respiration rate of a healthy person with the beat count of a pathological pulse, one can discern whether the pulse is Chi (Slow) or Shu (Rapid). For instance, if the pulse stops or beats only once per exhalation, and beats once per inhalation, this is a Chi Pulse, indicating deficient Yang Qi. If the pulse beats three times per exhalation and three times per inhalation, this is a Shu Pulse. If accompanied by restlessness and heat at the chi skin, it is a Warm Disease; if the chi skin is not hot but the pulse is slippery, it indicates internal Wind-Phlegm, such as in Stroke; if the pulse is choppy, it indicates pathogenic obstruction of the meridians. If the pulse beats four or more times per exhalation, it means Qi exits but does not enter, indicating the external collapse of the Yuan Qi (Original Qi). If the pulse ceases completely, it indicates exhaustion of Qi and Blood. If the pulse rhythm is intermittently sparse and rapid, it indicates scattered Original Qi. Thus, all these indicate death. The Stomach is the sea of the Zang-Fu organs; all Zang-Fu organs rely on the Grain Qi from the Stomach for nourishment. Therefore, if a person lacks Stomach Qi, their condition is contrary, which is a sign of death.
The Tai Yang (Greater Yang) pulse is Hong Da (Surging and Large) and Chang (Long). The Shao Yang (Lesser Yang) pulse is intermittently rapid and sparse, intermittently short and long. The Yang Ming (Bright Yang) pulse is Fu Da (Floating and Large) and Duan (Short).
These manifestations reflect the generation, prosperity, opening, and closing of Yang Qi. Tai Yang governs Opening; since Yang Qi is prosperous, the pulse is surging, large, and long. Shao Yang governs the Pivot; since Yang Qi has just begun to generate and cannot yet flow smoothly, the pulse is intermittently rapid and sparse, intermittently long and short. This is distinctly different from the intermittent sparsity and rapidity caused by scattered and weak Qi mentioned in the previous section, a distinction one must know. Two Yangs combining to form brightness is called Yang Ming; when Yang Qi reaches its peak, the Qi closes. Thus, a floating and large pulse is a sign of Yang, and a short pulse is a sign of closing. Using this to verify the generation, prosperity, exit, and entry of the Three Yang Qi aligns with the laws of Heaven and Earth. For example, in summer, when Yang Qi is at its peak and Yin Qi begins to generate, the short pulse of Yang Ming is a precursor to the floating, short, and choppy pulses of autumn. The same applies to the Opening, Closing, and Pivot of the Three Yin meridians. Thus, the *Nan Jing* states: The arrival of Tai Yin presents as Jin Da Er Chang (Tight, Large, and Long). This is because Yin Qi is prosperous, so Tai Yin governs Opening. It further states: The arrival of Shao Yin presents as Jin Xi Er Wei (Tight, Fine, and Minute). This is because Yin Qi has just begun to generate, so Shao Yin governs the Pivot. It also states: The arrival of Jue Yin presents as Chen Xi Er Dun (Deep, Fine, and Solid). This is because Yin Qi has reached its extreme, so Jue Yin governs Closing. The *Nan Jing* names these prosperous pulses according to the Three Yin and Three Yang, asserting they conform to the generative and prosperous Qi of Heaven and Earth. However, the *Nan Jing* says that after the Winter Solstice, upon obtaining the Jia Zi day, Shao Yang becomes prosperous; upon obtaining another Jia Zi day, Yang Ming becomes prosperous; upon obtaining another Jia Zi day, Tai Yang becomes prosperous. This refers only to the generation and prosperity of Heavenly Yang Qi. The *Nei Jing*'s discussion of Opening, Closing, and Pivot refers to the circulation of Human Meridian Qi, possessing different principles. Furthermore, the *Su Wen·Zhi Zhen Yao Da Lun* states: The arrival of Jue Yin presents as Xian (Wiry); the arrival of Shao Yin presents as Gou (Hooked); the arrival of Tai Yin presents as Chen (Deep); the arrival of Shao Yang presents as Da Er Fu (Large and Floating); the arrival of Yang Ming presents as Duan Er Se (Short and Choppy); the arrival of Tai Yang presents as Da Er Chang (Large and Long). This discusses the circulation of Guest Qi responding to pulse manifestations, differing again from the previous meanings. Therefore, the sage classics discuss Yin and Yang with thousands of transformations, each having its primary principle, which must not be confused. Hence the scripture says: Those who understand the essence need only one word to conclude; those who do not understand the essence scatter infinitely. This is why Li Shicai’s previous annotations of pulse manifestations based on subjective views led to confusion regarding Zang-Fu locations and Yin-Yang.
In Spring, a pulse with slight Xian (Wiry) qualities and Stomach Qi is Ping (Normal); if Xian qualities are excessive and Stomach Qi is deficient, it indicates Liver Disease; if there is only Xian without Stomach Qi, it indicates Death; if Stomach Qi is present with Mao (Feather-like/Floating) qualities, illness will occur in Autumn; if Mao qualities are severe, illness occurs immediately. The Zhen Zhen (True Essence) Qi scatters into the Liver, which stores the Qi of the sinews/fascia.
The Five Zang organs possess the nature of the Five Elements, so their pulse forms differ and harmonize with the Qi transformation of the Five Seasons. However, the basis is always the mild and moderate image of Stomach Qi. Thus, in the five seasons, if the pulse merely slightly manifests the shape of its corresponding Zang organ, it is auspicious. For instance, Liver Wood prospers in Spring, and both wrists show a Xian pulse. Xian is characterized by being slender, long, and smooth-flowing. It must be primarily governed by mild Stomach Qi, with a slight Xian image, to be considered Ping (Normal/Healthy). If Xian is excessive and Stomach Qi is deficient, Liver Qi rebels horizontally causing disease. If there is only Xian without Stomach Qi, the True Zang Pulse appears, leading to death. If the pulse is Xian-Huan (Wiry and Moderate) combined with Mao (Feather-like) qualities—where Mao is floating, short, and choppy, the native pulse of the Lung governing Autumn—excessive Xian indicates Liver Qi excess, while the presence of Mao indicates Liver Qi deficiency. When Autumn Metal Qi prospers, Liver Wood suffers further depletion, causing disease. If Mao is severe, seeing an Autumn pulse in Spring indicates the exhaustion of Sheng Qi (Generating Qi), resulting in immediate illness. The innate True Yuan Qi distributes into the Liver. The Liver corresponds to Zhen (Thunder), where post-natal Yang begins to generate fascia. Thus, the Qi of fascia is stored in the Liver, and the Liver governs the sinews.
In Summer, a pulse with slight Gou (Hooked) qualities and Stomach Qi is Ping; if Gou is excessive and Stomach Qi is deficient, it indicates Heart Disease; if there is only Gou without Stomach Qi, it indicates Death; if Stomach Qi is present with Shi (Stone-like/Deep) qualities, illness will occur in Winter; if Shi qualities are severe, illness occurs immediately. The Zhen Zhen Qi connects to the Heart, which stores the Qi of the blood vessels.
Heart Fire prospers in Summer, and both wrists show a Gou pulse. Gou is curved downward like a hook, round and active at the top, and floating. It must be primarily governed by mild Stomach Qi, with a slight Gou image, to be considered Ping. If Gou is excessive and Stomach Qi is deficient, Heart Fire rebels hyperactively causing disease. If there is only Gou without Stomach Qi, the pulse becomes hard and unyielding, the True Zang Pulse appears, leading to death. If the pulse is Gou-Huan combined with Shi qualities—where Shi is deep, solid, soft, and slippery, the native pulse of the Kidney governing Winter—this indicates insufficient Heart Fire. When Winter Water Qi prospers, Heart Qi becomes more depleted, causing disease. If Shi is severe, Yin is excessive and Yang is deficient, resulting in immediate illness. True Yuan Qi connects to the Heart to generate blood vessels, which are stored in the Heart; thus, the Heart governs the blood vessels.
In Late Summer, a pulse with slight Ruo Ruo (Weak and Soft) qualities and Stomach Qi is Ping; if Ruo Ruo is excessive and Stomach Qi is deficient, it indicates Spleen Disease; if there is only Dai (Intermittent) without Stomach Qi, it indicates Death; if Ruo Ruo is present with Shi qualities, illness will occur in Winter; if Shi qualities are severe, illness occurs immediately. The Zhen Zhen Qi moistens the Spleen, which stores the Qi of the muscles.
Spleen Earth prospers in the Four Seasons and governs the Wei Month of Late Summer, as Earth is central and Wei is the middle of the year. The Spleen directs drumming and transport, acting on behalf of the Qi of all Zang organs throughout the body; thus, its native pulse is named Dai (Intermittent). Ruo Ruo is the soft image of Yin Earth. The Stomach is Yang Earth, with rigid Qi. Rigidity and softness complement each other to achieve neutral harmony; thus, a slight Ruo Ruo image is Ping. If Ruo Ruo is excessive, Yang Qi is deficient, the Spleen lacks drumming power, and disease occurs. If there is only Dai without Stomach Qi, the True Zang Pulse appears, leading to death. Ruo Ruo with Shi indicates Winter illness; severe Shi indicates immediate illness, identical to Heart disease. This is because Fire and Earth share a source, and Heart Fire remains prosperous in Late Summer. True Yuan Qi steams fluids to moisten the Spleen to nourish muscles; thus, the Qi of muscles is stored in the Spleen, and the Spleen governs the muscles.
In Autumn, a pulse with slight Mao (Feather-like) qualities and Stomach Qi is Ping; if Mao is excessive and Stomach Qi is deficient, it indicates Lung Disease; if there is only Mao without Stomach Qi, it indicates Death; if Mao is present with Xian qualities, illness will occur in Spring; if Xian qualities are severe, illness occurs immediately. The Zhen Zhen Qi rises above the Lung to circulate Ying and Wei Qi.
Lung Metal prospers in Autumn, and both wrists show a Mao pulse. Mao is floating, short, and choppy, representing the initial descent of Yang Qi transforming into Yin. It must be primarily governed by mild Stomach Qi, with a slight Mao image, to be considered Ping. If Mao is excessive and Stomach Qi is deficient, Lung Qi fails to regulate, causing disease. If there is only Mao without Stomach Qi, the True Zang Pulse appears, leading to death. If Mao is present with Xian qualities, the contracting and肃 (solemn) seasonal command manifests a generating pulse; Yang fails to consolidate. In Spring, emission becomes more severe, causing disease. If Xian is severe, it reverses the Qi transformation seasonal order, causing immediate illness. The Lung is the Canopy, located highest. True Yuan Qi ascends to the Lung, weighing and measuring the Qi of the whole body to circulate Ying, Wei, Yin, Yang, Exterior, and Interior.
In Winter, a pulse with slight Shi (Stone-like) qualities and Stomach Qi is Ping; if Shi is excessive and Stomach Qi is deficient, it indicates Kidney Disease; if there is only Shi without Stomach Qi, it indicates Death; if Shi is present with Gou qualities, illness will occur in Summer; if Gou qualities are severe, illness occurs immediately. The Zhen Zhen Qi descends to the Kidney, which stores the Qi of the marrow and bones.
Kidney Water prospers in Winter, and both wrists show a Shi pulse. Shi is deep, solid, soft, and slippery, representing the storage of Yang Qi. It must be primarily governed by mild Stomach Qi, with a slight Shi image, to be considered Ping. If Shi is excessive and Stomach Qi is deficient, Kidney Yang declines, Yin-Cold is excessive, and disease occurs. If there is only Shi without Stomach Qi, the True Zang Pulse appears, leading to death. If Shi is present with Gou qualities, the storage command manifests a rising and floating pulse; Yang reveals itself prematurely. By Summer, water dries up, inevitably causing Heat disease. If Gou is severe, it reverses the storage command, causing immediate illness. True Yuan Qi roots downward in the Kidney. Marrow is formed from Essence and stored in the Kidney; thus, the Kidney governs the bones.