夫诊候之道，医者之难精也，若非灯下辛苦，勤于记诵，参师访友，昼夜不遑，
造次颠沛，寤寐俯仰，存心于此，安能知圣神之妙哉！古人曰∶按其脉，知其疾，命
曰神，以悟其探赜索隐之妙。又曰∶切其脉，治其病，谓之巧，以明其指别之功也。
盖三指相去毫厘之近，主病若千里之远，观夫指别之功，世人固以为难，命曰神，岂容易可至哉！
常考于经，脉有三部，寸、关、尺也。从鱼际至高骨，却行一寸曰寸，从寸上一
分曰鱼际，从寸至尺曰尺泽，寸后尺前为关，关前为阳，即寸口也。关后为阴，即
尺脉也。阳出阴入，以关为界，寸主上焦，头手皮毛，关主中焦，腹及腰，尺主下焦，
小腹及足，此三部所主大略也。又有左右两手三部，为之六脉也。又有人迎、气口、
神门所主，又各不同，盖左手关前曰人迎，右手关前曰气口，两关之后一分，即曰神
门。故《脉法》赞曰∶肝心主左，肺脾主右，肾为命门，俱出尺部，魂魄谷神，皆
见寸口，所谓左手关前，心之部也，其经手少阴与手太阳为表里，小肠合为腑；左
手关上，肝之部也，其经足厥阴与足少阳为表里，胆合为腑；左手关后，肾之部也，
其经足少阴与足太阳为表里，膀胱合为腑；右手关前，肺之部也，其经手太阴与手阳
明为表里，大肠合为腑；右手关上，脾之部也，其经足太阴与足阳明为表里，胃合
为腑；右手关后，命门之部也，其经手厥阴与手少阳为表里，三焦合为腑；此谓六部所主脏腑，十二经之义也。
又《脉要精微论》曰∶尺内两旁，则季胁也，尺外以候肾，尺里以候腹，中附
上，左外以候肝，内以候膈；右外以候胃，内以候脾，上附上，右外以候肺，内以候
胸中；左外以候心，内以候膻中，前以候前，后以候后；上竟上者，胸喉中事也，下
竟下者，小腹腰股膝胫足中事也。粗大者，阴不足，阳有余，为热中也。来疾去徐，上
实下虚，为厥颠疾；来徐去疾，上虚下实，为恶风也。故中风者，阳气受也，有脉俱
沉细数者，少阴厥也；沉细数散者，寒热也；浮而散者，为 仆；诸浮而数者，皆
在阳为热，其有躁者在手。诸细而沉者，皆在阴，则为骨痛，其有静者在足；数动一
代者，病在阳之脉也，泄及便脓血。诸过者切之，涩者阳气有余也，滑者阴气有余
也；阳气有余，为身热无汗，阴气有余，为多汗身寒，阴阳有余，则无汗身寒。推而
外之，内而不外者，有心腹积也；推而内之，外而不内者，身有热也；推而上之，上
而不下者，腰足痛也；推而下之，下而不
上者，头项痛也；按之至骨，脉气少者，腰脊痛而身有痹也。以上诸疾，若非指明心
了，焉可得而妙也。
又《平人气象论》曰∶一呼脉再动，一吸脉亦再动，呼吸定息，脉行五动，为以
大息，不大不小，不长不短，不滑不涩，不浮不沉，不迟不数，命曰平人。平人者，不
病也。盖平人之常气禀乎胃，胃气者，平人之常气也，所以人常禀气于胃，故脉以
胃气为本也。《正理论》曰∶谷入于胃，脉道乃行合。《灵枢经》曰∶胃为水谷之海也。
又曰∶脉应四时曰平，四时之脉，皆以胃气为本，谓春弦夏洪，秋毛冬石，春之胃
脉微弦曰平，余皆仿此，逆四时则病矣。
若诊妇人之脉，妊身则慎勿乱投汤散，其妇人之脉，诊得少阴脉动甚，则有子也。
又曰∶阴搏阳，则有子也。又曰∶身汗而无脉者，即有妊也。盖重身者，问其月事，
观其体貌，然主治不可忽也。
又经曰∶察色按脉，先别阴阳。盖阴阳者，天地之道也，是以治病者，必求其
本，本于阴阳寒暑，四时五脏之根也。以脉言之，则浮沉也。以部言之，则尺寸也。
故经云∶脉者阴阳之法，以应五脏，是谓呼出心与肺，吸入肾与肝，呼吸之间，脾
受谷味，其味在中也。以浮沉论之，则曰∶浮者阳也，沉者阴也，应在脏腑，则浮而
大散者心，浮而短涩者肺也，所以心肺俱浮也。牢而长者肝也，按之而大，举指来
实者肾也，所以肝肾俱沉也。迟缓而长者脾也，脾为中州，所以脉在中也。仲景曰∶
大、浮、数、动、滑，皆阳也，沉、涩、弱、弦、微，皆阴也。阳者热也，阴者寒也，所
以寒则脉来沉而迟，热则脉来浮而数，故曰∶诸数为热，诸迟为寒，无如此验也。
《脉经》曰∶诸浮为风，诸紧为痛，诸伏为聚，诸弦为饮，芤者失血，长则气治，短
则气病，涩则烦心，大则病进，浮为在表，沉为在里，迟为在脏，数为在腑。又形壮
脉细，少气不足以息者危；形瘦脉大，胸
中气多者毙。形气相得者生，三五不调者死，三部九候，皆相失者死，此先圣诊脉
之大法也。故曰∶凡治病，则察其形气色泽治之，无候其时也。所以形气相得者生，
色泽以浮者病易已，脉从四时者可治，脉弱似滑者，是有胃气，此皆易治也。若形
气相失，或色夭不泽，及脉逆四时，或脉益坚，皆不可治，经所谓必察四难而明告
之。又若病热脉静，泄而脉大，脱血脉实，汗后脉躁，此皆难治也。若疮疽之人，脓
血大泄，脉滑数者，难治也。凡 脓多，或如清泔，脉滑大散，寒热发渴者，治之无
功也。若患肺疮也，咳嗽脓血，脉见洪滑，治之难痊矣。大凡诊脉见浮数，应当发热，
而反恶寒，虽头项拘急，四肢烦痛，或复战栗渴甚者，但有痛处，欲发疮肿也。
诊察脉象的道理，是医生最难精通的技艺。如果不是在灯下刻苦钻研，勤于记忆背诵，向老师请教、与朋友切磋，日夜不停歇，即使在匆忙困顿或睡眠翻身之际，也时刻留心于此，怎么能知晓圣神医术的精妙呢！古人说：通过切按脉象来了解疾病，称为“神”，这是领悟其探究深奥隐秘道理的精妙之处。又说：通过切脉来治疗疾病，称为“巧”，这是明确其手指辨别病情的功效。大概三指之间的距离仅有毫厘之近，但所主知的病情却相差千里之远。观察这手指辨别的功效，世人固然认为很难，称之为“神”，难道是可以轻易达到的境界吗！
经常考察经典医籍，脉象分为三部，即寸、关、尺。从鱼际穴到高骨（桡骨茎突），向后退行一寸的地方叫作“寸”；从寸口向前一分的地方叫作“鱼际”；从寸口到尺泽穴叫作“尺”；寸口之后、尺部之前为“关”。关前为阳，即寸口脉；关后为阴，即尺脉。阳气出于外，阴气入于内，以关部为界限。寸部主要主管上焦，对应头部、手部及皮毛；关部主要主管中焦，对应腹部及腰部；尺部主要主管下焦，对应小腹及足部。这是三部脉所主范围的概略。又有左、右两手各三部，合称为六脉。此外还有人迎、气口、神门所主的部位，又各不相同。大概左手关前叫人迎，右手关前叫气口，两关之后一分处，就叫神门。所以《脉法》称赞道：肝、心主于左手，肺、脾主于右手，肾与命门都出现在尺部，魂、魄、谷神，都显现于寸口。所谓左手关前，是心的分部，其经脉手少阴心经与手太阳小肠经互为表里，小肠合为腑；左手关上，是肝的分部，其经脉足厥阴肝经与足少阳胆经互为表里，胆合为腑；左手关后，是肾的分部，其经脉足少阴肾经与足太阳膀胱经互为表里，膀胱合为腑；右手关前，是肺的分部，其经脉手太阴肺经与手阳明大肠经互为表里，大肠合为腑；右手关上，是脾的分部，其经脉足太阴脾经与足阳明胃经互为表里，胃合为腑；右手关后，是命门的分部，其经脉手厥阴心包经与手少阳三焦经互为表里，三焦合为腑。这叫做六部所主的脏腑，以及十二经脉的意义。
另外，《素问·脉要精微论》说：尺部内侧两旁，对应季胁；尺部外侧用来候测肾脏，尺部内侧用来候测腹部；中部向上延伸，左手外侧用来候测肝脏，内侧用来候测膈膜；右手外侧用来候测胃，内侧用来候测脾脏；再向上延伸，右手外侧用来候测肺脏，内侧用来候测胸中；左手外侧用来候测心脏，内侧用来候测膻中。脉象的前部候测身体前侧的病，后部候测身体后侧的病。尺部脉象向上尽头的，对应胸部和喉中的事情；向下尽头的，对应小腹、腰、大腿、膝盖、小腿和足部的事情。脉象粗大的，是阴不足而阳有余，属于热中病。脉象来势急而去势缓的，是上实下虚，属于厥逆或癫疾；脉象来势缓而去势急的，是上虚下实，属于恶风病。所以中风病，是阳气受邪所致。如果脉象都沉细数，是少阴经的厥逆；脉象沉细数且散乱，是寒热病；脉象浮而散乱的，是仆倒病。所有浮而数的脉象，都在阳分，属于热证，如果伴有躁动，病在手经。所有细而沉的脉象，都在阴分，则导致骨痛，如果伴有静止（不躁动），病在足经。脉象数动而有间歇的，病在阳分之脉，表现为泄泻及大便脓血。所有异常的脉象都要切按，涩脉表示阳气有余，滑脉表示阴气有余；阳气有余，表现为身热无汗；阴气有余，表现为多汗身寒；阴阳都有余，则无汗身寒。推按脉象向外，如果脉气内敛而不外显，说明有心腹积滞；推按脉象向内，如果脉气外浮而不内敛，说明身体有热；推按脉象向上，如果脉气上行不下行，说明腰足疼痛；推按脉象向下，如果脉气下行不上行，说明头项疼痛；按压至骨，脉气微弱者，说明腰脊疼痛且身体有痹症。以上各种疾病，如果不是心里明白指明，怎么能达到精妙的境界呢？
另外，《素问·平人气象论》说：一次呼气脉跳动两次，一次吸气脉也跳动两次，呼吸之间定息时，脉跳动五次，这叫做大息（正常呼吸节奏）。脉象不大不小，不长不短，不滑不涩，不浮不沉，不迟不数，这叫作平人（健康人）。平人，就是不生病的人。大概平人的常气禀受于胃，胃气就是平人的常气，所以人常禀受胃气，因此脉象以胃气为本。《正理论》说：食物进入胃中，脉道才能运行。《灵枢经》说：胃是水谷之海。又说：脉象顺应四时变化叫作平脉。四时的脉象，都以胃气为本，谓春季脉弦、夏季脉洪、秋季脉毛（浮）、冬季脉石（沉）。春季的胃脉微带弦象叫作平脉，其余季节都仿照此理，违背四时规律就会生病。
如果诊察妇女的脉象，怀孕时要谨慎不要乱投汤药散剂。诊察妇女脉象，如果得到少阴脉动甚（搏动强烈），就是有孕了。又说：阴脉搏击阳位，就是有孕了。又说：身体出汗但没有脉象的，就是有孕了。大概对于孕妇，要询问她的月经情况，观察她的体貌，然而主治原则不可忽略。
另外经典说：观察面色、切按脉象，首先要辨别阴阳。大概阴阳，是天地的规律，所以治病的人，必须探求根本，根本在于阴阳、寒暑、四时、五脏的根源。从脉象来说，就是浮和沉。从部位来说，就是寸和尺。所以经典说：脉象是阴阳的法度，以应合五脏。呼出之气关联心和肺，吸入之气关联肾和肝，呼吸之间，脾接受水谷精微，其味在中焦。从浮沉来论述，就说：浮脉属阳，沉脉属阴，应合脏腑的话，浮而大散的脉象对应心，浮而短涩的脉象对应肺，所以心和肺的脉象都浮。牢而长的脉象对应肝，按之感觉宽大，举指时感觉充实的脉象对应肾，所以肝和肾的脉象都沉。迟缓而长的脉象对应脾，脾位于中州（中焦），所以脉象在中部。张仲景说：大、浮、数、动、滑，都属于阳脉；沉、涩、弱、弦、微，都属于阴脉。阳代表热，阴代表寒，所以寒证脉象来势沉而迟，热证脉象来势浮而数，所以说：凡是数脉都是热证，凡是迟脉都是寒证，没有比这更准确的验证了。
《脉经》说：所有浮脉主风证，所有紧脉主痛证，所有伏脉主积聚，所有弦脉主饮邪，芤脉主失血，长脉主气治（气机通畅），短脉主气病，涩脉主心烦，大脉主病进（病情发展），浮脉主表证，沉脉主里证，迟脉主脏病，数脉主腑病。另外，形体壮实而脉象细弱，气息少不足以呼吸的，预后危险；形体消瘦而脉象盛大，胸中气多的，预后不良。形与气相得的能生存，三五不调（脉象紊乱）的死亡，三部九候（全身多处脉象）都失常的死亡，这是先圣诊脉的大法。所以说：凡是治病，要观察病人的形体、气色、色泽并加以治疗，不要拘泥于时间。所以形气相得的能生存，色泽浮润的病症容易治愈，脉象顺应四时的可以治疗，脉象软弱似滑的，是有胃气的表现，这些都属于容易治疗的。如果形气相失，或者面色枯槁无光泽，以及脉象违背四时规律，或者脉象更加坚硬，都不可治疗，经典所谓必须察明四种难治的情况并明确告知病人。另外，如果是热病而脉象安静，泄泻而脉象盛大，脱血而脉象实大，发汗后脉象躁动，这些都难以治疗。如果是疮疽患者，脓血大量排出，脉象滑数的，难以治疗。如果脓液很多，或者像清泔水一样稀薄，脉象滑大散乱，伴有寒热口渴的，治疗无效。如果患有肺痈，咳嗽脓血，脉象见洪滑的，治疗难以痊愈。大凡诊脉见到浮数脉，应当发热，反而恶寒，虽然头项拘急，四肢烦痛，或者又出现战栗渴甚的症状，但只要疼痛部位固定，就是要发生疮肿了。
The principle of pulse diagnosis is the most difficult skill for physicians to master. Unless one studies diligently under the lamp, memorizes frequently, consults teachers, and discusses with friends, day and night without rest, and keeps this in mind even during hasty or turbulent times, as well as in sleep and waking, how can one understand the subtleties of sage-like medical arts? The ancients said: "Palpating the pulse to know the disease is called 'Shen' (Divine), to comprehend the mystery of exploring profound truths." It is also said: "Cutting the pulse to treat the disease is called 'Qiao' (Skillful), to clarify the merit of finger discrimination." The distance between three fingers is merely a hair's breadth, yet the diseases they indicate are as far apart as a thousand miles. Observing the merit of finger discrimination, people naturally consider it difficult; calling it 'Shen', how could it be easily attained!
Frequently consulting classics, the pulse has three positions: Cun (Inch), Guan (Bar), and Chi (Cubit). From the Yuji point (LU10) to the high bone (radial styloid process), moving backward one cun is called 'Cun'; one fen forward from Cun is 'Yuji'; from Cun to Chize (LU5) is 'Chi'; behind Cun and before Chi is 'Guan'. Front of Guan is Yang, which is the Cun position; behind Guan is Yin, which is the Chi pulse. Yang emerges outward, Yin enters inward, with Guan as the boundary. Cun governs the Upper Jiao (Upper Burner), corresponding to the head, hands, skin, and hair; Guan governs the Middle Jiao (Middle Burner), corresponding to the abdomen and waist; Chi governs the Lower Jiao (Lower Burner), corresponding to the lower abdomen and feet. This is the general scope governed by the three positions. There are also left and right hands, each with three positions, making six pulses. Additionally, there are Yingc (Renying), Kou (Qikou), and Shenmen, each governing differently. Generally, the front of Guan on the left hand is Yingc, the front of Guan on the right hand is Qikou, and one fen behind both Guans is Shenmen. Thus, the *Mai Fa* praises: "Liver and Heart govern the left, Lung and Spleen govern the right, Kidney and Mingmen (Gate of Life) appear in the Chi position; Hun (Ethereal Soul), Po (Corporeal Soul), and Gu Shen (Grain Spirit) all manifest at Cun." Specifically, the front of Guan on the left hand is the Heart's domain; its meridian is Hand Shaoyin Heart Meridian and Hand Taiyang Small Intestine Meridian, which are exterior-interior pairs, with Small Intestine forming the Fu organ; the Guan position on the left hand is the Liver's domain; its meridian is Foot Jueyin Liver Meridian and Foot Shaoyang Gallbladder Meridian, exterior-interior pairs, with Gallbladder forming the Fu organ; the rear of Guan on the left hand is the Kidney's domain; its meridian is Foot Shaoyin Kidney Meridian and Foot Taiyang Bladder Meridian, exterior-interior pairs, with Bladder forming the Fu organ; the front of Guan on the right hand is the Lung's domain; its meridian is Hand Taiyin Lung Meridian and Hand Yangming Large Intestine Meridian, exterior-interior pairs, with Large Intestine forming the Fu organ; the Guan position on the right hand is the Spleen's domain; its meridian is Foot Taiyin Spleen Meridian and Foot Yangming Stomach Meridian, exterior-interior pairs, with Stomach forming the Fu organ; the rear of Guan on the right hand is the Mingmen domain; its meridian is Hand Jueyin Pericardium Meridian and Hand Shaoyang Sanjiao Meridian, exterior-interior pairs, with Sanjiao forming the Fu organ. This refers to the Zang-Fu organs governed by the six positions and the meaning of the Twelve Meridians.
Furthermore, the *Su Wen: Mai Yao Jing Wei Lun* states: "The inner sides of Chi correspond to the hypochondrium; the outer side of Chi observes the Kidneys, the inner side observes the abdomen; the middle part extending upward, the outer side of the left observes the Liver, the inner side observes the Diaphragm; the outer side of the right observes the Stomach, the inner side observes the Spleen; extending further up, the outer side of the right observes the Lungs, the inner side observes the Chest; the outer side of the left observes the Heart, the inner side observes the Danzhong (Chest Center). The anterior part observes the anterior body, the posterior part observes the posterior body. The end of Chi extending upward corresponds to matters of the chest and throat; extending downward corresponds to matters of the lower abdomen, waist, thighs, knees, calves, and feet. A coarse pulse indicates Yin deficiency and Yang excess, constituting Heat Zhong (Heat in the Middle). A pulse coming swiftly and departing slowly indicates Upper Excess and Lower Deficiency, constituting Jue Ni (Reversal Cold) or Dian Ji (Epilepsy); a pulse coming slowly and departing swiftly indicates Upper Deficiency and Lower Excess, constituting Aversion to Wind. Therefore, Zhong Feng (Wind Stroke) is caused by Yang Qi receiving pathogenic factors. If pulses are all deep, fine, and rapid, it is Shao Yin Jue Ni (Shaoyin Reversal); if deep, fine, rapid, and scattered, it is Cold-Heat; if floating and scattered, it is Pu Dao (Collapse). All floating and rapid pulses belong to Yang and indicate Heat; if accompanied by agitation, the disease is in the Hand meridians. All fine and deep pulses belong to Yin, causing Bone Pain; if accompanied by stillness, the disease is in the Foot meridians. A pulse that is rapid, moving, and intermittent indicates disease in the Yang pulse, manifesting as diarrhea and pus-blood in stool. All abnormal pulses must be palpated; a Se pulse indicates Yang Qi excess, a Hua (Slippery) pulse indicates Yin Qi excess; Yang Qi excess manifests as body heat and no sweat, Yin Qi excess as profuse sweating and cold body, both Yang and Yin excess as no sweat and cold body. Pushing the pulse outward, if internal but not external, there is accumulation in the heart and abdomen; pushing inward, if external but not internal, there is body heat; pushing upward, if ascending but not descending, there is pain in the waist and feet; pushing downward, if descending but not ascending, there is pain in the head and neck; pressing to the bone, if pulse Qi is weak, there is pain in the waist and spine and Bi Syndrome (Obstruction) in the body. For the above diseases, unless one clearly understands them, how can one achieve subtlety?
Furthermore, the *Su Wen: Ping Ren Qi Xiang Lun* states: "With one exhalation, the pulse moves twice; with one inhalation, the pulse also moves twice. Between breaths, the pulse moves five times, called Da Xi (Great Breath). Not large nor small, not long nor short, not slippery nor choppy, not floating nor sunken, not slow nor rapid, this is called a Ping Ren (Normal Person). A Ping Ren is one who is not diseased. Generally, the normal Qi of a Ping Ren is derived from the Stomach. Stomach Qi is the normal Qi of a Ping Ren. Since humans constantly derive Qi from the Stomach, the pulse takes Stomach Qi as its root. The *Zheng Li Lun* states: "When food enters the Stomach, the pulse channels then flow." The *Ling Shu* states: "The Stomach is the Sea of Water and Grain." It also says: "Pulses responding to the Four Seasons are called Ping Pulses. The pulses of the Four Seasons all take Stomach Qi as their root. Spring is Xian (Wiry), Summer is Hong (Surging), Autumn is Mao (Feather-like/Float), Winter is Shi (Stone-like/Deep). A Spring pulse slightly wiry is called Ping; others follow this pattern. Violating the Four Seasons leads to disease.
When diagnosing women's pulses, if pregnant, one must be cautious and not indiscriminately administer decoctions or powders. Diagnosing women's pulses, if the Shao Yin pulse beats vigorously, pregnancy exists. It is also said: "Yin pulse striking Yang indicates pregnancy." It is also said: "Sweating body without pulse indicates pregnancy." Generally, for pregnant women, inquire about menstruation, observe physique, but do not neglect primary treatment.
Furthermore, classics state: "Observe complexion and palpate pulse, first distinguish Yin and Yang." Yin and Yang are the Way of Heaven and Earth. Therefore, treating diseases requires seeking the root, which lies in Yin-Yang, Cold-Heat, Four Seasons, and the roots of the Five Zang Organs. In terms of pulse, this refers to Floating and Sunken. In terms of position, this refers to Cun and Chi. Thus, classics say: "Pulse is the method of Yin-Yang, responding to the Five Zang Organs. Exhalation relates to Heart and Lung, inhalation relates to Kidney and Liver. Between breaths, the Spleen receives grain essence, its flavor is in the center." Discussing Floating and Sunken: Floating is Yang, Sunken is Yin. Corresponding to Zang-Fu, a Floating, large, and scattered pulse corresponds to the Heart; a Floating, short, and choppy pulse corresponds to the Lung; thus, Heart and Lung pulses are both Floating. Firm and long corresponds to the Liver; pressing feels large, lifting feels solid corresponds to the Kidney; thus, Liver and Kidney pulses are both Sunken. Slow, delayed, and long corresponds to the Spleen. The Spleen is in the Central Province (Middle Jiao), so the pulse is in the middle. Zhang Zhongjing said: "Large, Floating, Rapid, Moving, Slippery are all Yang pulses; Deep, Choppy, Weak, Wiry, Micro are all Yin pulses. Yang represents Heat, Yin represents Cold. Therefore, Cold presents with Deep and Slow pulses, Heat presents with Floating and Rapid pulses. Thus, 'All Rapid pulses indicate Heat, all Slow pulses indicate Cold,' there is no more accurate verification than this.
The *Mai Jing* states: "All Floating pulses indicate Wind, all Tight pulses indicate Pain, all Hidden pulses indicate Accumulation, all Wiry pulses indicate Fluid Retention, Khong (Hollow) pulses indicate Blood Loss, Long pulses indicate Qi Regulation, Short pulses indicate Qi Disease, Choppy pulses indicate Vexing Heart, Large pulses indicate Disease Progression, Floating indicates Exterior, Sunken indicates Interior, Slow indicates Zang Disease, Rapid indicates Fu Disease. Furthermore, robust form with thin pulse, shortness of breath, is critical; emaciated form with large pulse, excessive Qi in chest, is fatal. Form and Qi matching leads to life, irregularity of three and five leads to death, loss of harmony in Three Positions and Nine Hopes leads to death. This is the great method of pulse diagnosis by ancient sages. Thus, it is said: 'In treating diseases, observe form, Qi, color, and luster to treat, do not wait for specific times.' Therefore, matching form and Qi leads to life, floating luster indicates easy recovery, pulses following Four Seasons are treatable, weak and seemingly slippery pulses indicate presence of Stomach Qi, all these are easy to treat. If form and Qi mismatch, or color is dull and lusterless, or pulses violate Four Seasons, or pulses become harder, all are untreatable. Classics say one must examine four difficulties and inform clearly. Also, heat disease with quiet pulse, diarrhea with large pulse, blood loss with solid pulse, post-sweating restless pulse, all are difficult to treat. For carbuncles and ulcers, with massive pus and blood discharge, slippery and rapid pulses are difficult to treat. If pus is abundant or like clear rice water, pulse is slippery, large, and scattered, with chills, fever, and thirst, treatment is futile. If suffering from Lung Abscess, coughing pus and blood, pulse appears Hong and Slippery, treatment is hard to cure. Generally, seeing Floating and Rapid pulses should indicate fever, but if aversion to cold occurs instead, although with stiff head and neck, vexing pain in limbs, or trembling and severe thirst, if there is a fixed painful area, it indicates impending carbuncle swelling."