马云。内有不足有余虚实等义。皆所以较其盛衰也。吴云。方。比也。比方阴阳多少。五度强弱。何者为
盛。何者为衰也。
气之多少 张云。多少。言盛衰也。高云。气。阴阳之气也。人身阴阳之气。有多而盛。有少而衰。
阳从左阴从右 张云。阳气主升。故从乎左。阴气主降。故从乎右。高云。向明而治。左阳右阴。
故阳从左。阴从右。
老从上少从下 张云。老人之气。先衰于下。故从上者为顺。少壮之气。先盛于下。故从下者为顺。
盖天之生气。必自下而升。而人气亦然也。故凡以老人。而衰于上者。其终可知。少壮而衰于下者。其始可知。
皆逆候也。高云。四时之气。秋冬为阴。从上而下。春夏为阳。从下而上。故老从上。少从下。盖老为秋冬之
阴。少为春夏之阳也。
是以春夏归阳为生 马云。春夏或病或脉。归阳为生。若阴病阴脉。如秋冬者。为死。张云。春夏
以阳盛之时。或证或脉。皆当归阳为生。若得阴候。如秋冬者。为逆为死。
反之则归秋冬为生 马云。反之则秋冬归阴为生。若阳病阳脉。如春夏者为死。是以人之气有多少。
逆之则皆能为厥也。张云。反之。谓秋冬也。秋冬以阴盛阳衰之时。故归阴为顺。曰生。然不曰归春夏为死者。
可见阴中有阳。未必至害。而阳为阴贼。乃不免矣。高云。人身春夏之时。其气归阳为生。归秋冬之阴为死。
若反之则归秋冬为死者。归秋冬反为生。反之而生。气之逆也。是以阴阳之气。无论多少。若逆之。则皆为厥矣。
一上不下 张云。阳逆于上而不下。则寒厥到膝。老人阳气从上。膝寒犹可。少年之阳。不当衰而
衰者。故最畏阴胜之时。老人阳气本衰。是其常也。故于秋冬无虑焉。高云。阴阳之气。不相顺接。便为厥。
如阴气一上。阳气不下。则阴盛阳虚。故寒厥到膝。
头痛巅疾 吴云。此谓巅疾。有巅崩偃仆之义。张云上
实下虚。故病如此。志云。愚谓此下。当有少者春夏生。老者春夏死句。或简脱耶。
求阳不得求阴不审 张云。厥之在人也。谓其为阳。则本非阳盛。谓其为阴。则又非阴盛。故皆不可
得。盖以五脏隔绝。无征可验。若居旷野无所闻。若伏空室无所见。乃病则绵绵不解。势甚凋敝。若弗能终其
日者。岂真阴阳之有余者耶。
绵绵乎属不满日 张云。绵。古绵字。高云。今绵绵一息之微。属望其生。若不能满此一日矣。简按
诗大雅疏。绵绵。微细之辞。王盖取气息绵 之义。属。高读为瞩也。
是以少气之厥 赵府本。熊本。少气。作少阴。马吴张并从之。志高仍原文。简按据王注。及下文是
为少气之语。则知作少阴。误也。
籍籍 马云。众多也。吴云。积尸状。张云。多惊惕也。志云。野狼籍也。简按野狼籍。披离杂乱貌。前
江都易王传。国中口语籍籍。志注为是。
菌香 脉经。作园苑。千金。作园花。志云。香蕈之小者。盖虽有生气而无根。简按此注非也。广雅。
菌。薰也。其叶谓之蕙。又屈原离骚。杂申椒与菌桂兮。蜀都赋。菌桂临岩。知全注为得。
阳物 志云。龙也。乃龙雷之火游行也。
阳气有余阴气不足 吴云。凡人阳气不足。阴气有余。则当昼而寐。若阳气有余。阴气不足。则当夕
而梦。张云。所以为厥为梦者。皆阳不附阴之所致。
五诊 吴云。五内见证也。阴阳。三阴三阳也。
以在经脉 吴云。在。察也。经脉。十二经之脉也。马高同。简按书舜典。在璇玑玉衡。注。在。察
也。今从吴注。
十度 马云。度人度民之度。俱入声。余皆去声。志并去声。注云。度。量也。十度者。度人脉。度
脏。度肉。度筋。度俞。度阴阳气。度上下。度民。度君。度卿也。高。以下文度民君卿四字。移于阴阳气尽
之下。注云。十度。一曰度人。二曰度脉。三曰度脏。四曰度肉。五曰度筋。六曰度俞。七曰度阴阳气尽。八曰
度民。九曰度君。十曰度卿。民不得同卿。卿不得同于君。就其心志。而揆度之。简按王义允当。故马吴张从之。
脉度脏度肉度筋度俞度 张云。脉度者。如经脉脉度等篇。是也。脏度。如本脏肠胃平人绝谷等篇。
是也。肉度。如卫气失常等篇。是也。筋度。如经筋篇。是也。俞度。如气府气穴本输等篇。是也。度。数也。
散阴颇阳 吴云。颇。跛同。阴阳散乱偏颇也。简按玉篇。颇。不平也。偏也。王注非。
脉脱不具 吴云。脉或不显也。张云。此其脉有所脱。而阴阳不全具矣。
诊无常行 张云。诊此者。有不可以阴阳之常法行也。盖谓其当慎耳。吴云。不拘于一途也。
诊必上下度民君卿 张云。贵贱尊卑。劳逸有异。膏粱藜藿。气质不同。故当度民君卿。分别上下。以为诊。
至阴虚天气绝 马云。地位乎下。为至阴。若至阴虚。则天气绝而不降。何也。以其无所升也。天
位乎上。为至阳。若至阳盛。则地气无自而足。何也。以其无所降也。此设言也。故人有阳气。阳气者。卫气
也。人有阴气。阴气者。营气也。能使阴阳二气。交会于一处者。惟至人乃能行之。吴云。至阴。脾也。天气。
肺也。高云。至阴。太阴也。至阴虚。则人之地气不升。地气不升。天气绝。至阳。太阳也。
至阳盛。则人之天气有余。天气有余。故地气不足。必阴阳并交。无有虚盛。
阳气先至阴气后至 张云。凡阴阳之道。阳动阴静。阳刚阴柔。阳唱阴随。阳施阴受。阳升阴降。
阳前阴后。阳上阴下。阳左阴右。数者为阳。迟者为阴。表者为阳。里者为阴。至者为阳。去者为阴。进者为
阳。退者为阴。发生者为阳。收藏者为阴。阳之行速。阴之行迟。故阴阳并交者。必阳先至。而阴后至。是以
圣人之持诊者。在察阴阳先后。以测其精要也。
六十首 吴云。六十年之岁首也。言论阴阳之变与常。乃尽于六十年间也。张云。禁服篇。所谓通
于九针六十篇之义。今失其传矣。高云。奇脉恒脉。脉势不同。六十日而更一气。乃以六十为首也。简按十六
难云。脉有三部九候。有阴阳。有轻重。有六十首。吕广曰。首。头首也。盖三部从头者。脉辄有六十首。盖
诸注并属附会。今仍王义。
诊合微之事 吴云。合于幽微也。志云。声合五音。色合五行。脉合阴阳也。张云。参诸诊之法。
而合其精微也。
章五中之情 吴云。五中。五脏也。张云。章。明也。志云。五内之情志也。简按马云。五中者。
古经篇名。非。义具下文王注。
定五度之事 马云。即前十度也。吴张同。志云。五度者。度神之有余有不足。气有余有不足。血
有余有不足。形有余有不足。志有余有不足也。高云。五度。即上文之五诊也。简按马注似是。
切阴不得阳 张云。言人生以阳为主。不得其阳。焉得不亡。如阴阳别论曰。所谓阴者真脏也。见
则为败。败必死矣。所谓阳者。胃脘之阳也。平人气象论曰。人无胃气死。
脉无胃气死。是皆言此阳字。
守学不湛 张云。湛。明也。（本于马注。）若但知得阳。而不知阳中有阴。及阴平阳秘之道者。是
为偏守。其学亦属不明。志云。湛。甚也。吴。湛。作知。高。作谌。注云。谌。信也。简按湛训明。无所考。
然于文义为得。
故治不久 张云。不明缓急之用。安望其久安长治。而万世不殆哉。高云。左右上下先后。不能尽知。
故日治其病。而人不久。
用之有绝 绝。诸本作纪。当改。吴云。纪。法也。张云。纪。条理也。
起所有余 吴云。起。病之始也。有余。客邪有余。不足。正气不足。言病之所起。虽云有余。然亦
可以知其虚而受邪矣。张云。起。兴起也。言将治其有余。当察其不足。盖邪气多有余。正气多不足。若只知
有余。而忘其不足。取败之道也。
脉事因格 吴云。格者。穷至其理也。言揆度病情之高下。而脉事因之穷。至其理也。马云。度其
事之上下。脉之因革。则诊法无不备矣。简按马读格为革。因革。乃沿革之义。其意不通。
是以诊有大方 吴云。此下论作医之方。大方。大法也。
坐起有常 张云。举动不苟。而先正其身。身正于外。心必随之。故诊之大方。必先乎此。
出入有行 吴云。行。去声。德行也。医以活人为事。其于出入之时。念念皆真。无一不敬。则德
能动天。诚能格心。故可以转运周旋。而无往弗神矣。
司八正邪 吴云。司。推步也。张云。司。候也。高云。司。主也。简按司。伺同。前灌夫传。太
后亦已使候司。则
知张之义确矣。
视其大小 吴云。大小。二便也。张同。志云。视脉之大小。高同。
合之病能 马云。病能。读为病耐。阴阳应象大论云。病之形能也。张云。能。情状之谓。简按能。
古与态通。
视息视意 吴云。视息。视其呼吸高下也。视意。视其志趣远近。苦乐忧思也。志云。视息者。候
呼吸之往来。脉之去至也。视意者。闭户塞牖。系之病者。数问其情。以从其意也。
不失条理 张云。条者。犹干之有枝。理者。犹物之有脉。即脉络纲纪之谓。
亡言妄期 吴。亡。作妄。高云。亡言。无征之言也。简按今从吴注。
马云说：文中提到的“内”、“不足”、“有余”、“虚”、“实”等概念，都是用来比较人体正气与邪气的盛衰状况的。吴云说：“方”，意为比较。即通过比较阴阳的多少、五度（指脉、脏、肉、筋、俞等方面的度量）的强弱，来判断何者为盛，何者为衰。
关于气的多少：张云说：所谓“多少”，指的是盛衰。高云说：气，指的是阴阳之气。人身体的阴阳之气，有多而盛的，也有少而衰的。
阳气从左，阴气从右：张云说：阳气主升发，所以顺应左边的方位；阴气主沉降，所以顺应右边的方位。高云说：面向光明治理事物时，左边属阳，右边属阴，所以阳气从左，阴气从右。
老年人病势向上，年轻人病势向下：张云说：老年人的气，先在下部衰退，所以病势向上发展是顺证；年轻人的气，先在下部旺盛，所以病势从下部发展是顺证。大概天的生气，必定是从下方向上升发，人的气也是如此。所以凡是老年人，如果上部衰退，其结局可以预知；年轻人如果下部衰退，其起始原因可以知晓。这些都是逆证的表现。高云说：四时的气候，秋冬属于阴，气从上往下行；春夏属于阳，气从下往上行。所以老年人对应秋冬之阴，年轻人对应春夏之阳。
因此，春夏季节归附于阳为生：马云说：在春夏季节，无论是病症还是脉象，如果表现为阳证阳脉，即为生；如果表现为阴证阴脉，就像秋冬季节那样，则为死。张云说：春夏是阳气旺盛的时候，无论是症状还是脉象，都应当归属于阳才能生存。如果出现像秋冬那样的阴候，就是逆证，主死。
反之，则归附于秋冬为生的情况不存在（或理解为：若反之，则归附于秋冬为生是不成立的，或者指秋冬归阴为生）：马云说：反过来讲，如果是秋冬季节，归附于阴为生。如果出现阳证阳脉，就像春夏季节那样，则为死。因为人的气有盛有衰，如果违背了这种规律，都会导致厥证。张云说：所谓的“反之”，是指秋冬季节。秋冬是阴气盛、阳气衰的时候，所以归附于阴是顺证，称为生。这里没有说“归附于春夏为死”，是因为可以看出阴中还有阳，未必会造成危害，而阳被阴所克制伤害，才不免于致死。高云说：人在春夏之时，气归附于阳为生，归附于秋冬之阴为死。如果说反过来归附于秋冬为死的情况，那归附于秋冬反而成了生，这是反常而生，是气的逆乱。所以无论阴阳之气有多少，如果逆乱，都会导致厥证。
一上不下：张云说：阳气逆乱在上而不能下行，就会导致寒厥到达膝盖。老人的阳气本已从上衰退，膝盖寒冷还算正常；少年的阳气不应当衰退却衰退了，所以最畏惧阴气胜过的时节。老人阳气本来衰弱，这是常态，所以在秋冬季节不必担忧。高云说：阴阳之气不相顺接，就会发生厥证。比如阴气一上，阳气不下，就会导致阴盛阳虚，所以寒厥到达膝盖。
头痛巅疾：吴云说：这里说的“巅疾”，有头顶崩裂、仆倒的意思。张云上：这是因为上实下虚，所以出现这样的病症。志云说：我认为这里下面应当有“少年春夏生，老者春夏死”的句子，可能是简牍脱漏了。
求阳不得，求阴不审：张云说：厥证在人身上，说是阳盛吧，原本并非阳盛；说是阴盛吧，又并非阴盛。所以都无法确切得到验证。这就像五脏隔绝，没有征象可以检验，如同居住在旷野听不到声音，如同伏在空室里看不到东西，病情缠绵不解，气势非常凋敝，甚至不能维持一整天，这难道真是阴阳有余吗？
绵绵乎属不满日：张云说：绵，古通“绵”字。高云说：现在的“绵绵”指气息微弱的一息之间，指望他存活，好像不能满过这一天了。按：《诗经·大雅》疏中说，“绵绵”是微细的词义，王冰大概是取气息绵长的意思。“属”，高读作“瞩”。
是以少气之厥：赵府本、熊本将“少气”写作“少阴”，马、吴、张都依从这一版本。志高仍保留原文。按：根据王冰注及下文“是为少气”的说法，可知写作“少阴”是错误的。
籍籍：马云说：众多的样子。吴云说：堆积尸体的样子。张云说：多惊恐警惕的样子。志云说：像野兽散乱的样子。按：野兽散乱，形容披离杂乱的样子。前《江都易王传》中说“国中口语籍籍”，志高的注释是正确的。
菌香：《脉经》写作“园苑”，《千金方》写作“园花”。志云说：是小一点的香蕈。大概虽然有生气但没有根。按：这个注释不对。《广雅》说：“菌，薰也。”它的叶子叫蕙。又有屈原《离骚》中说“杂申椒与菌桂兮”，《蜀都赋》中说“菌桂临岩”，知道全注释是正确的（指菌桂）。
阳物：志云说：指龙。乃是龙雷之火游行的表现。
阳气有余，阴气不足：吴云说：凡人如果阳气不足，阴气有余，就会在白天睡觉；如果阳气有余，阴气不足，就会在傍晚做梦。张云说：之所以出现厥和梦，都是阳气不能依附于阴所致。
五诊：吴云说：指五脏的见证。阴阳，指三阴三阳。
以在经脉：吴云说：“在”，意思是察验。经脉，指十二经脉。马、高观点相同。按：《尚书·舜典》中“在璇玑玉衡”，注解说“在”是察验的意思。现在依从吴注。
十度：马云说：“度人”、“度民”的“度”俱读入声，其余都读去声。志高都读去声。注解说：“度”，度量。十度，是指度量人脉、度量脏、度量肉、度量筋、度量俞、度量阴阳气、度量上下、度量民、度量君、度量卿。高认为，根据下文“度民、君、卿”四个字，将其移到“度阴阳气”之后。注解说：十度，一是度人，二是度脉，三是度脏，四是度肉，五是度筋，六是度俞，七是度阴阳气尽，八是度民，九是度君，十是度卿。民不能同于卿，卿不能同于君，要根据他们的心志来揆度。按：王冰的解释允当，所以马、吴、张都依从它。
脉度、脏度、肉度、筋度、俞度：张云说：脉度，如《经脉》、《脉度》等篇所述。脏度，如《本脏》、《肠胃》、《平人绝谷》等篇所述。肉度，如《卫气失常》等篇所述。筋度，如《经筋》篇所述。俞度，如《气府》、《气穴》、《本输》等篇所述。“度”，指数目。
散阴颇阳：吴云说：“颇”同“跛”，指阴阳散乱偏颇。按：《玉篇》说：“颇”，不平，偏斜。王冰的注释不对。
脉脱不具：吴云说：脉可能不显现。张云说：这是脉有所脱失，阴阳不全具备。
诊无常行：张云说：诊断这种情况，不能用阴阳的常规方法来进行。大概是要谨慎罢了。吴云说：不拘泥于一种途径。
诊必上下度民君卿：张云说：贵贱尊卑、劳逸不同，饮食膏粱藜藿不同，气质也不同。所以应当度量民、君、卿，分别上下，作为诊断的依据。
至阴虚，天气绝：马云说：地位在下，为至阴。如果至阴虚，那么天气就断绝而不下降。为什么呢？因为没有什么可升发的。天位在上，为至阳。如果至阳盛，那么地气就没有来源而充足。为什么呢？因为没有什么可降下的。这是假设性的言论。所以说人有阳气，阳气就是卫气；人有阴气，阴气就是营气。能使阴阳二气交会于一处的，只有至人能实行。吴云说：至阴，指脾。天气，指肺。高云说：至阴，指太阴。至阴虚，那么人的地气不升。地气不升，天气就断绝。至阳，指太阳。至阳盛，那么人的天气有余。天气有余，所以地气不足。必须阴阳并交，没有虚盛之分。
阳气先至，阴气后至：张云说：大凡阴阳的道理，阳动阴静，阳刚阴柔，阳唱阴随，阳施阴受，阳升阴降，阳前阴后，阳上阴下，阳左阴右。数者为阳，迟者为阴。表者为阳，里者为阴。至者为阳，去者为阴。进者为阳，退者为阴。发生者为阳，收藏者为阴。阳的运行速度快，阴的运行速度慢。所以阴阳并交的，一定是阳先到，而阴后到。因此圣人持诊的原则，在于考察阴阳的先后，以测知其精要。
六十首：吴云说：六十年为一轮岁首。论述阴阳的变化与常态，都在六十年间穷尽了。张云说：《禁服》篇所说的通晓九针六十篇的意义，现在失传了。高云说：奇脉和恒脉，脉势不同，六十日更替一气，所以以六十为首。按：《难经·十六难》说：脉有三部九候，有阴阳，有轻重，有六十首。吕广说：首，头首也。大概三部从头开始，脉就有六十首。大概各种注释都属于附会，现在仍依从王冰的意思。
诊合微之事：吴云说：合于幽微之处。志云说：声音合五音，面色合五行，脉象合阴阳。张云说：参合各种诊法，而合其精微之处。
章五中之情：吴云说：五中，指五脏。张云说：章，明也。志云说：五内的情志。按：马云说：五中是古经篇名，不是。意义见下文王注。
定五度之事：马云说：即前十度。吴、张观点相同。志云说：五度，是指度量神的有余和不足，气的有余和不足，血的有余和不足，形的有余和不足，志的有余和不足。高云说：五度，即上文所说的五诊。按：马注似是而非。
切阴不得阳：张云说：人生以阳为主，得不到阳，怎么能不亡故。如《阴阳别论》说：所谓阴，是真脏脉。出现了就是败象，败象必然死亡。所谓阳，是胃脘之阳。《平人气象论》说：人无胃气死，脉无胃气死。这都是说的这个“阳”字。
守学不湛：张云说：湛，明也（基于马注）。如果只知道阳，而不知道阳中有阴，以及阴平阳秘的道理，这就是偏守，其学问也不高明。志云说：湛，甚也。吴：湛，作知。高：作谌。注解说：谌，信也。按：湛解释为明，无所考证，但在文义上是通的。
故治不久：张云说：不明白缓急的用法，怎么希望他能长久安定治理，而万世不危殆呢？高云说：左右上下先后，不能完全知道，所以说治疗他的病，而人不能久活。
用之有绝：绝，各本作纪，应当改正。吴云说：纪，法也。张云说：纪，条理也。
起所有余：吴云说：起，病的开始。有余，客邪有余。不足，正气不足。说病的起因，虽然说是有余，然而也可以知道是因为虚而受邪。张云说：起，兴起。说将要治疗有余，应当察视其不足。大概邪气多有餘，正气多不足。如果只知道有余，而忘记其不足，是取败之道。
脉事因格：吴云说：格者，穷究其理。说揆度病情的高下，而脉事因此穷究至其理。马云说：度其事之上下，脉之因革，则诊法无不备矣。按：马读“格”为“革”，因革，乃沿革之义，其意不通。
是以诊有大方：吴云说：此下论作医之方。大方，大法也。
坐起有常：张云说：举动不苟且，先端正自身。身正于外，心必随之。所以诊的大法，必须先从这里开始。
出入有行：吴云说：行，读去声，德行也。医以活人为事，其在出入之时，念念皆真，无一不敬，则德能动天，诚能格心。故可以转运周旋，而无往弗神矣。
司八正邪：吴云说：司，推步也。张云说：司，候也。高云说：司，主也。按：司，伺同。前《灌夫传》说：太后亦已使候司。则知张之义确矣。
视其大小：吴云说：大小，二便也。张同。志云说：视脉之大小。高同。
合之病能：马云说：病能，读为病耐。《阴阳应象大论》说：病之形能也。张云说：能，情状之谓。按：能，古与态通。
视息视意：吴云说：视息，视其呼吸高下也。视意，视其志趣远近，苦乐忧思也。志云说：视息者，候呼吸之往来，脉之去至也。视意者，闭户塞牖，系之病者，数问其情，以从其意也。
不失条理：张云说：条者，犹干之有枝。理者，犹物之有脉。即脉络纲纪之谓。
亡言妄期：吴：亡，作妄。高云说：亡言，无征之言也。按：今从吴注。
Ma Yun states: The concepts mentioned in the text, such as "internal," "deficiency," "excess," "emptiness," and "fullness," are all used to compare the prosperity and decline of the body's righteous qi (vital energy) and pathogenic factors. Wu Yun states: "Fang" means comparison. It involves comparing the quantity of Yin and Yang, and the strength of the "Five Measures" (referring to measurements of pulse, zang organs, flesh, sinews, and shu points), to determine what is prosperous and what is declining.
Regarding the quantity of Qi: Zhang Yun states: By "quantity," it refers to prosperity and decline. Gao Yun states: Qi refers to the Qi of Yin and Yang. In the human body, the Qi of Yin and Yang can be abundant and prosperous, or scarce and declining.
Yang Qi follows the left, Yin Qi follows the right: Zhang Yun states: Yang Qi governs ascending, so it corresponds to the left side. Yin Qi governs descending, so it corresponds to the right side. Gao Yun states: When facing brightness to manage affairs, the left is Yang and the right is Yin; thus, Yang Qi follows the left, and Yin Qi follows the right.
Elderly people's conditions tend upward, young people's conditions tend downward: Zhang Yun states: The Qi of the elderly declines first in the lower part, so a condition trending upward is a favorable sign. The Qi of the vigorous and young is first abundant in the lower part, so a condition originating from the lower part is a favorable sign. Generally, the generating Qi of Heaven rises from below, and the Qi of humans is the same. Therefore, for the elderly, if the upper part declines, the outcome can be predicted; for the young, if the lower part declines, the initial cause can be known. These are all signs of reversal (adverse conditions). Gao Yun states: The climate of the four seasons, autumn and winter belong to Yin, with Qi moving from top to bottom; spring and summer belong to Yang, with Qi moving from bottom to top. Thus, the elderly correspond to the Yin of autumn and winter, and the young correspond to the Yang of spring and summer.
Therefore, in spring and summer, returning to Yang indicates life: Ma Yun states: During spring and summer, whether symptoms or pulses, if they manifest as Yang patterns and pulses, it indicates life; if they manifest as Yin patterns and pulses, resembling autumn and winter, it indicates death. Zhang Yun states: Spring and summer are times when Yang Qi is abundant; both symptoms and pulses should belong to Yang to sustain life. If Yin signs resembling autumn and winter appear, it is a reversal indicating death.
Conversely, returning to Yin in autumn and winter indicates life: Ma Yun states: Conversely, in autumn and winter, returning to Yin indicates life. If Yang symptoms and pulses resembling spring and summer appear, it indicates death. Since human Qi has varying degrees of abundance and scarcity, violating these norms leads to Jue syndrome (reversal cold/heat). Zhang Yun states: The term "conversely" refers to autumn and winter. Autumn and winter are times when Yin Qi is abundant and Yang Qi is declining, so returning to Yin is favorable, indicating life. The text does not say "returning to spring and summer indicates death" because it shows that within Yin there is still Yang, which may not necessarily cause harm, whereas Yang being harmed by Yin inevitably leads to death. Gao Yun states: In spring and summer, Qi returning to Yang indicates life, while returning to the Yin of autumn and winter indicates death. If conversely, returning to autumn and winter were considered death, then returning to autumn and winter would actually indicate life. This reverse occurrence signifies the reversal of Qi. Thus, regardless of the quantity of Yin and Yang Qi, if it is reversed, it leads to Jue syndrome.
One goes up but does not come down: Zhang Yun states: When Yang Qi rebels upward and fails to descend, it leads to Cold Jue reaching the knees. For the elderly, whose Yang Qi naturally declines from above, cold knees are acceptable. For youths, whose Yang Qi should not decline but does, they most fear times when Yin Qi prevails. Elderly people naturally have declining Yang Qi, which is their normal state, so they need not worry during autumn and winter. Gao Yun states: When Yin and Yang Qi do not connect smoothly, Jue occurs. For example, if Yin Qi rises and Yang Qi fails to descend, it results in Yin excess and Yang deficiency, causing Cold Jue to reach the knees.
Headache and Dian Disease: Wu Yun states: "Dian disease" here implies the meaning of cranial collapse and falling prostrate. Zhang Yun states: This is due to Upper Excess and Lower Deficiency, hence such symptoms occur. Zhi Gao states: I believe the text below should contain the sentence "Young people live in spring and summer, the elderly die in spring and summer," which may have been lost in transcription.
Seeking Yang yields nothing, seeking Yin is unclear: Zhang Yun states: Regarding Jue in humans, if one says it is Yang excess, it is originally not Yang excess; if one says it is Yin excess, it is also not Yin excess. Thus, neither can be confirmed. It is like the five Zang organs being isolated, with no signs to verify, similar to living in a wilderness hearing nothing, or lying in an empty room seeing nothing. The illness lingers unresolved, and the condition becomes very depleted, unable to last even a full day. Is this truly due to an excess of Yin and Yang?
Lingering breath, insufficient for a day: Zhang Yun states: "Mian" is an ancient form of "mian." Gao Yun states: Modern "mian mian" refers to the faintness of a single breath, hoping for survival, yet it seems he cannot last the full day. Note: The commentary on *Shi Jing* (Book of Songs) states that "mian mian" describes something minute and fine. Wang Bing likely took the meaning of lingering breath. "Zhu" is read by Gao as "zhu" (to look at).
Therefore, the Jue of Shao Qi (Deficient Qi): The Zhao Fu edition and Xiong Ben edition write "Shao Qi" as "Shao Yin." Ma, Wu, and Zhang follow this version. Zhi Gao retains the original text. Note: Based on Wang Bing's commentary and the subsequent phrase "this is called Shao Qi," writing "Shao Yin" is incorrect.
Ji Ji: Ma Yun states: Numerous. Wu Yun states: The appearance of piled corpses. Zhang Yun states: Many instances of fright and vigilance. Zhi Gao states: Like scattered wild beasts. Note: Scattered wild beasts describe a disordered and chaotic appearance. In the *Biography of Prince Yi of Jiangdu*, it says "the colloquial speech in the state was ji ji," supporting Zhi Gao's annotation.
Jun Xiang (Mushroom Fragrance): *Mai Jing* writes it as "Yuan Yuan," *Qian Jin Fang* writes it as "Yuan Hua." Zhi Gao states: It refers to small mushrooms. Although they have vitality, they lack roots. Note: This annotation is incorrect. *Guang Ya* states: "Jun is Xun." Its leaves are called Hui. Furthermore, Qu Yuan's *Li Sao* says "Mixing Shenjiao and Jungui," and *Shu Du Fu* says "Jungui faces the cliff." This confirms that the interpretation of Jungui (Cinnamon) is correct.
Yang Wu: Zhi Gao states: Refers to the dragon. It is the wandering of Dragon-Lei Fire.
Yang Qi Excess, Yin Qi Deficiency: Wu Yun states: If a person has Yang Qi deficiency and Yin Qi excess, they sleep during the day. If they have Yang Qi excess and Yin Qi deficiency, they dream in the evening. Zhang Yun states: The causes of Jue and dreams are both due to Yang failing to attach to Yin.
Wu Zhen (Five Diagnoses): Wu Yun states: Refers to the manifestations of the five internal organs. Yin and Yang refer to the Three Yin and Three Yang.
Within the Jing Mai (Meridians): Wu Yun states: "Zai" means to examine. Jing Mai refers to the Twelve Meridians. Ma and Gao agree. Note: In *Shang Shu* (Book of Documents), "Zai Xuanji Yuheng," the commentary explains "Zai" as examining. We follow Wu's note here.
Shi Du (Ten Measures): Ma Yun states: The "Du" in "Du Ren" and "Du Min" is pronounced with entering tone; the rest are pronounced with departing tone. Zhi Gao pronounces all with departing tone. The annotation states: "Du" means measure. The Ten Measures are: measuring human pulse, measuring Zang organs, measuring flesh, measuring sinews, measuring Shu points, measuring Yin and Yang Qi, measuring upper and lower parts, measuring common people, measuring rulers, and measuring ministers. Gao argues that based on the following text mentioning "Du Min, Jun, Qing," these should be moved after "measuring Yin and Yang Qi." The annotation lists: 1. Measure human, 2. Measure pulse, 3. Measure Zang, 4. Measure flesh, 5. Measure sinew, 6. Measure Shu, 7. Measure Yin/Yang Qi completely, 8. Measure people, 9. Measure ruler, 10. Measure minister. People cannot be equated with ministers, nor ministers with rulers; one must estimate based on their mindset. Note: Wang Bing's interpretation is sound, so Ma, Wu, and Zhang follow it.
Mai Du, Zang Du, Rou Du, Jin Du, Shu Du: Zhang Yun states: Mai Du is found in chapters like *Jing Mai* and *Mai Du*. Zang Du is found in *Ben Zang*, *Chang Wei*, *Ping Ren Jue Gu*, etc. Rou Du is in *Wei Qi Shi Chang*. Jin Du is in *Jing Jin*. Shu Du is in *Qi Fu*, *Qi Xue*, *Ben Shu*, etc. "Du" here refers to numerical measurement.
Scattering Yin and Po Yang: Wu Yun states: "Po" is synonymous with "Bo" (limping), referring to the scattering and bias of Yin and Yang. Note: *Yu Pian* states: "Po" means uneven or biased. Wang Bing's note is incorrect.
Mai Tuo Bu Ju (Pulse Depletion Not Complete): Wu Yun states: The pulse may not be visible. Zhang Yun states: This indicates pulse depletion, where Yin and Yang are not fully present.
Zhen Wu Chang Xing (Diagnosis Has No Fixed Method): Zhang Yun states: Diagnosing this condition cannot rely on the standard methods of Yin and Yang. It implies caution is needed. Wu Yun states: It is not confined to a single approach.
Diagnosis Must Measure Upper/Lower, People, Ruler, Minister: Zhang Yun states: Due to differences in status, labor/rest, diet (rich vs. coarse), and constitution, one must measure the common people, rulers, and ministers, distinguishing upper and lower levels to guide diagnosis.
Zhi Yin Xu, Tian Qi Jue (Extreme Yin Deficiency, Heavenly Qi Cut Off): Ma Yun states: Earth is positioned below, representing Extreme Yin. If Extreme Yin is deficient, Heavenly Qi cuts off and does not descend. Why? Because there is nothing to ascend. Heaven is positioned above, representing Extreme Yang. If Extreme Yang is excessive, Earthly Qi has no source to become sufficient. Why? Because there is nothing to descend. This is a hypothetical statement. Humans possess Yang Qi, which is Wei Qi (Defensive Qi); humans possess Yin Qi, which is Ying Qi (Nutritive Qi). Only the Perfect Person (Zhi Ren) can make these two Qi intersect in one place. Wu Yun states: Extreme Yin refers to the Spleen. Heavenly Qi refers to the Lung. Gao Yun states: Extreme Yin refers to Tai Yin. If Extreme Yin is deficient, Earthly Qi does not ascend. If Earthly Qi does not ascend, Heavenly Qi cuts off. Extreme Yang refers to Tai Yang. If Extreme Yang is excessive, Heavenly Qi is in surplus. If Heavenly Qi is in surplus, Earthly Qi is deficient. Yin and Yang must intersect without deficiency or excess.
Yang Qi Arrives First, Yin Qi Arrives Later: Zhang Yun states: Generally, the principle of Yin and Yang is: Yang moves, Yin is still; Yang is firm, Yin is soft; Yang sings, Yin follows; Yang acts, Yin receives; Yang ascends, Yin descends; Yang precedes, Yin follows; Yang is above, Yin is below; Yang is left, Yin is right. Fast numbers are Yang, slow numbers are Yin. Exterior is Yang, Interior is Yin. Arrival is Yang, departure is Yin. Advancement is Yang, retreat is Yin. Generation is Yang, storage is Yin. Yang moves fast, Yin moves slow. Therefore, when Yin and Yang intersect, Yang arrives first, and Yin arrives later. Thus, the sage's principle of diagnosis lies in observing the sequence of Yin and Yang to grasp the essence.
Liu Shi Shou (Sixty Heads): Wu Yun states: A sixty-year cycle head. Discussing the changes and constants of Yin and Yang, exhausted within sixty years. Zhang Yun states: As mentioned in the *Jin Fu* chapter regarding the understanding of the Sixty Chapters of Nine Needles, now lost. Gao Yun states: Extraordinary and constant meridians have different pulse trends, changing one Qi every sixty days, hence taking sixty as the head. Note: *Nan Jing* Chapter 16 states: Pulses have three parts and nine positions, Yin and Yang, light and heavy, and sixty heads. Lu Guang says: Head means beginning. Perhaps the three parts start from the head, resulting in sixty heads. Most annotations seem forced; we follow Wang Bing's meaning.
Zhen He Wei Zhi Shi (Diagnosis Combines Subtle Matters): Wu Yun states: Combining with the subtle. Zhi Gao states: Sound combines with Five Tones, color combines with Five Elements, pulse combines with Yin and Yang. Zhang Yun states: Integrating various diagnostic methods to combine their subtleties.
Zhang Wu Zhong Zhi Qing (Clarify the Feelings of the Five Interiors): Wu Yun states: Wu Zhong refers to the five Zang organs. Zhang Yun states: Zhang means to clarify. Zhi Gao states: The emotions of the five interiors. Note: Ma Yun states: Wu Zhong is an ancient classic chapter title, which is incorrect. The meaning is in Wang Bing's commentary below.
Ding Wu Du Zhi Shi (Determine the Affairs of the Five Measures): Ma Yun states: Refers to the previous Ten Measures. Wu and Zhang agree. Zhi Gao states: The Five Measures refer to measuring the excess and deficiency of Spirit, Qi, Blood, Form, and Will. Gao Yun states: The Five Measures refer to the Five Diagnoses mentioned earlier. Note: Ma's annotation seems plausible.
Qie Yin Bu De Yang (Palpating Yin Without Obtaining Yang): Zhang Yun states: Human life relies on Yang. Without Yang, how can one not perish? As stated in *Yin Yang Bie Lun*: What is called Yin is the True Zang pulse. Its appearance indicates decay, and decay leads to death. What is called Yang is the Yang of the Stomach House. *Ping Ren Qi Xiang Lun* states: Humans without Stomach Qi die, pulses without Stomach Qi die. All these refer to this character "Yang."
Shou Xue Bu Zhan (Guarding Learning Without Clarity): Zhang Yun states: Zhan means clear (based on Ma's note). If one only knows Yang but not that Yang contains Yin, nor the way of Yin balance and Yang stability, this is partial guarding, and the learning is unclear. Zhi Gao states: Zhan means extreme. Wu: Zhan is written as Zhi (know). Gao: Written as Chen (faith). Annotation: Chen means faith. Note: Interpreting Zhan as clear lacks textual evidence but fits the context well.
Thus Treatment Is Not Long-Lasting: Zhang Yun states: Without understanding the use of urgency and slowness, how can one expect long-term stability and safety for ten thousand generations? Gao Yun states: Not fully knowing left/right, upper/lower, before/after, one treats the disease daily, yet the person does not survive long.
Use Has Its Limits (Jue): Jue, in all editions written as Ji, should be corrected. Wu Yun states: Ji means law/method. Zhang Yun states: Ji means order/structure.
Qi Suo You Yu (Originating from Excess): Wu Yun states: Qi means the beginning of disease. You Yu means pathogenic excess. Bu Zu means righteous Qi deficiency. Saying the disease originates from excess implies knowing that deficiency allows pathogenic invasion. Zhang Yun states: Qi means arising. To treat excess, one must observe deficiency. Pathogens are often in excess, while righteous Qi is often deficient. Knowing only excess and forgetting deficiency is a path to failure.
Mai Shi Yin Ge (Pulse Matters Follow Ge): Wu Yun states: Ge means exhausting the principle. Estimating the severity of the disease, pulse matters thereby exhaust the principle. Ma Yun states: Measuring the upper/lower of events, the changes in pulses, ensures comprehensive diagnostic methods. Note: Ma reads "Ge" as "Ge" (change/reform). "Yin Ge" means evolution, which makes little sense.
Therefore, Diagnosis Has Da Fang (Great Method): Wu Yun states: Below discusses the method of practicing medicine. Da Fang means great principle.
Zuo Qi You Chang (Sitting and Rising Have Regularity): Zhang Yun states: Movements are not careless; first rectify oneself. Body rectified externally, mind follows. Thus, the great method of diagnosis must begin here.
Chu Ru You Hang (Entering and Exiting Have Conduct): Wu Yun states: Hang, pronounced departing tone, means virtue/conduct. Medicine aims to save lives. During entry and exit, thoughts are true, respect is unwavering. Virtue moves Heaven, sincerity influences the heart. Thus, one can navigate freely and act divinely everywhere.
Si Ba Zheng Xie (Oversee Eight Regular Evils): Wu Yun states: Si means推算 (calculate). Zhang Yun states: Si means observe. Gao Yun states: Si means master/govern. Note: Si is synonymous with Si (spy/watch). In *Guan Fu Biography*, it says "The Empress Dowager also sent observers." Thus, Zhang's meaning is accurate.
Shi Qi Da Xiao (Observe Their Big and Small): Wu Yun states: Da Xiao refers to urination and defecation. Zhang agrees. Zhi Gao states: Observe the big and small of the pulse. Gao agrees.
He Zhi Bing Neng (Combine With Disease State): Ma Yun states: Bing Neng is read as Bing Nai. *Yin Yang Ying Xiang Da Lun* says: The form and state of disease. Zhang Yun states: Neng means condition/state. Note: Neng is anciently interchangeable with Tai (state/appearance).
Shi Xi Shi Yi (Observe Breath and Intent): Wu Yun states: Shi Xi means observing the depth of breathing. Shi Yi means observing the distance of aspirations, suffering, joy, worry, and thought. Zhi Gao states: Shi Xi means monitoring the coming and going of breath and the departure and arrival of the pulse. Shi Yi means closing doors and windows, focusing on the patient, frequently asking about their situation to follow their intent.
Bu Shi Tiao Li (Not Losing Order and Principle): Zhang Yun states: Tiao is like branches on a trunk. Li is like veins in an object. It refers to the network and discipline of meridians.
Wang Yan Wang Qi (No Words, False Expectations): Wu: Wang is written as Wang (false). Gao Yun states: Wang Yan means words without evidence. Note: Following Wu's note here.