左右须候四时脉。四十五〔动为一息〕(日三气毕)。
难经曰。脉不满五十动一止。一脏无气。脉诀生死歌云。五十不止身无病。数内有止皆知病。正本难经。
今此乃曰四十五动为一息。及六部脉歌。皆以四十五动为准。乖于内经。谬于名数。今于后六歌。
皆当改作五十动为是。且一息者一呼一吸也。四十五动。非止一息也。若以息为止息。则脉经所谓
五十动不止者。五脏六腑皆受气。即无病。五十动一止五岁死。五动一止五日死。四十五动。除去五动。
而不及五十。不知何意。今详此句。想因四时脉而言。或本于内经。冬至夏至各四十五日。为阴阳上
下之期。一时六气九十日。三气得四十五日。今改为四十五日。以合内经。李 范脉髓。作四十五动图说。
亦巧而未敢信。通真子洁古诸解穿凿。皆非。盖脉之流行。如环无端。无一息之停。未尝以五十动一止为限。
但止即为病。根据数而止。期以岁死。不根据数而止。则为结促代三病脉矣。
指下〔弦〕(浮)急洪〔紧〕(数)时。便是有风兼热极。忽然匿匿慢沉细。冷疾缠身〔无他事〕(兼患气)。
贼脉频来问五行。屋漏雀啄终不治。
左手头指〔火〕(木之子)。〔四十五动〕(五十动脉)无他事。
左手者。病患之手。头指者。医者按脉。初下第一部之指。下准此。心火为木之子。
三十一动忽然沉。顿饭忽来还复此。春中候得夏须忧。夏若得之秋绝体。秋脉如斯又准前。
冬若候之春必死。
脉沉顿饭之久然后来。乃绝止之脉。见于三十一动之间。三十动一止。应在三年死。今云在三
月一时之后。是以月为年也。此下六歌之非皆然。当以在后生死候歌为正。
左右手均需诊察四时脉象。四十五次搏动算作一息(日三气毕)。
《难经》说:脉搏不满五十次而有一次停跳,说明有一脏无气。《脉诀·生死歌》云:脉搏五十次不停止则身体无病,次数中有停跳都知道是有病。正本清源依据《难经》。
如今这里却说四十五次搏动为一息,以及六部脉的歌诀,都以四十五次搏动为标准,违背了《内经》,在名称和数量上是错误的。现在后面的六首歌诀,都应当改为五十次搏动才是正确的。况且一息是指一次呼气与一次吸气。四十五次搏动,并不只是一息。如果把“止”理解为呼吸的停顿,那么《脉经》所说的“五十次搏动不停止,五脏六腑都得到气血,即无病;五十次搏动停一次,五年后死;五次搏动停一次,五天后死”。四十五次搏动,减去五次搏动,就达不到五十次了,不知道这是什么意思。现在详细考察这句话,猜想是因为谈论四时脉而言,或者本源于《内经》。冬至夏至各四十五日,是阴阳升降的时期。一时六气共九十日,三气得四十五日。现在改为四十五日,以符合《内经》。李范《脉髓》作了四十五次搏动的图说,虽然巧妙但不敢轻信。通真子洁古等人的各种解释牵强附会,都不对。大概脉气的流行,如环无端,没有一息的停顿,未曾以五十次搏动停一次为界限。只要停跳就是有病,根据数目的规律停跳,预测死于某年;不根据数目规律停跳,就是结、促、代三种病脉了。
指下感觉弦、浮、急、洪、紧、数等脉象时,便是有风兼热极。忽然变得匿匿慢沉细,则是冷疾缠身(兼患气)。
贼脉频繁出现询问五行,屋漏脉、雀啄脉最终不治。
左手食指(火为木之子)。(四十五次搏动)(五十次脉搏)无他事。
左手是病患的手。头指是医生按脉时,最初下的第一部手指,下面以此类推。心火是木之子。
三十一动忽然沉。一顿饭工夫忽然来又恢复这样。春季中候得此脉夏季须忧虑。夏季若得此脉秋季必死。秋季脉象如此又以前为准。冬季若候得此脉春季必死。
脉沉一顿饭之久然后来,这是绝止之脉。出现在三十一动之间。三十动一止,应在三年后死。如今说在三月一时之后,是以月为年。这下面六首歌诀的错误都是这样。应当以在后的生死候歌为正确。
Both left and right hands must be examined for the pulse corresponding to the four seasons. Forty-five beats constitute one respiration (completion of three Qi in a day).
The *Nan Jing* states: If the pulse stops before reaching fifty beats, it indicates that one Zang organ lacks Qi. The *Mai Jue · Sheng Si Ge* says: If there are no stops in fifty beats, the body is free of disease; if there are stops within the count, it is known to be diseased. This corrects the source based on the *Nan Jing*.
However, this text now claims that forty-five beats constitute one respiration, and the verses for the six pulse positions all use forty-five beats as the standard. This contradicts the *Nei Jing* and is erroneous in nomenclature and quantity. Therefore, the subsequent six verses should all be revised to state that fifty beats are correct. Moreover, "one respiration" refers to one exhalation and one inhalation. Forty-five beats do not constitute merely one respiration. If "stop" were interpreted as the pause between respirations, then as stated in the *Mai Jing*: "If fifty beats occur without stopping, the five Zang and six Fu organs all receive Qi, indicating no disease; if the pulse stops after fifty beats, death occurs in five years; if the pulse stops after every five beats, death occurs in five days." Subtracting five beats from forty-five results in fewer than fifty, leaving the meaning unclear. Upon detailed examination of this sentence, it is speculated that it was mentioned in the context of seasonal pulses, or perhaps derived from the *Nei Jing*. The period from Winter Solstice to Summer Solstice is forty-five days, marking the cycle of Yin and Yang ascent and descent. One season comprises six Qi totaling ninety days; three Qi amount to forty-five days. Now changing it to forty-five days aligns with the *Nei Jing*. Li Fan's *Mai Sui* provides a diagrammatic explanation for forty-five beats. Although clever, I dare not trust it blindly. Various interpretations by Tongzhenzi Jieguo and others are forced and incorrect. Generally, the circulation of pulse Qi is like a circle without end, pausing not even for an instant, and has never been limited to a stop after fifty beats. Any stop indicates disease. If the stop follows a numerical pattern, death can be predicted by year; if it does not follow a numerical pattern, it constitutes the three pathological pulses: Ji (Knotted), Cu (Hasty), and Dai (Intermittent).
When the pulse feels Xian (String-like), Fu (Floating), Ji (Rapid/Urgent), Hong (Surging), Jin (Tight), or Shu (Rapid) under the fingers, it indicates Wind combined with extreme Heat. Suddenly becoming Ni Ni Man Chen Xi (Slow, Deep, Fine) suggests Cold Disease entangling the body (accompanied by Qi disorders).
When Zei Pulses (Thief Pulses) frequently appear, consult the Five Elements. Wu Lou (House Leak) and Que Zhuo (Sparrow Pecking) pulses are ultimately untreatable.
The left index finger corresponds to Fire (Fire is the son of Wood). (Forty-five beats) (Fifty-beat pulse) implies no other issues.
The "left hand" refers to the patient's hand. The "head finger" refers to the physician's first finger placed at the initial position during pulse taking; the same applies subsequently. Heart Fire is the son of Wood.
If the pulse becomes suddenly deep at thirty-one beats, and returns to this state after a meal time, it indicates that finding this pulse in the middle phase of Spring causes concern for Summer; finding it in Summer leads to death in Autumn. The pulse in Autumn follows this precedent. Finding it in Winter leads to death in Spring.
A pulse that remains deep for the duration of a meal before returning is a Jue Zhi (Severed/Stopping) pulse. Appearing within thirty-one beats, a stop after thirty beats predicts death in three years. The current text mentions "after three months and one hour," treating months as years. The errors in the following six verses are similar. The correct standard should be found in the subsequent verse regarding life and death prognoses.