脉诀阐微（修订版）
清·陈士铎
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鬼真君脉诀序
《脉诀》自王叔和传后，世鲜其人，谁知叔和止注脉经，误传有《脉诀》也。叔和既无《脉诀》，何传诀而不传经？以《脉经》之多不及《脉诀》之约也。然《脉诀》始于高阳生，非叔和原文也。铎遇云中逸老于燕市，传法之备，而不传《脉经》者，以《素问》《灵枢》二书言脉之多也。虽然，于多之中而求其约，安在必求脉于《灵》、《素》哉?鬼真君名臾区，云中逸老弟子也。貌甚奇，面长尺有一寸，发短而鬈，深目身高，耳垂下且大，非凡近士也。且歧天师备传方法，何不传脉于铎。因授是书，皆切脉法也。夫真君为天师之徒，天师传道之备，胡真君传脉之约乎?盖病分脏腑，若脉则传脏而不及腑，宁脉与病异哉？不知病必兼脏，而脉不可兼脏也。《灵》、《素》二书，有时合而言之，何今传《脉诀》独与病殊乎?以脏病而腑亦病，腑病而脏亦病，故治脏而腑在其中，切脏而腑亦在其内，又何必合言之。所以单言脏而不及腑也。真君之传，虽出于天师，亦真君之独见也。传止五篇，其言约矣。然皆言脏之文，治脏不可通之治腑哉?
山阴陈士铎敬之甫别号远公题于文笔峰之小琅琊
第一篇
脉理甚微，原非一言可尽，人病多变，又岂一脉能包。论其阴阳，别其生死，察其脏腑，观其症候，既上中下之宜分，必寸关尺之自定。左寸心，左关肝，火木宁无至性；右寸肺，右关脾，土金本有深情。唯两尺为肾，水火实难分配，中间是命，左右还可同观。三焦别上中下以相诊，余经合寸关尺而共视。盖部位乌容倒置，辨贵分明，而表里何必细分，不宜拘执。虽按指以三部为法，数息便悟断经，顾看脉以五脏为主，知脏即通治腑。察四时之节气，春夏异于秋冬；审一日之晷时，寅卯殊于申酉。大约逢克则凶，逢生可救，我生则缓，我克难医。因五行而推断，举一隅而可知。弦似乎紧，涩似乎微，浮与芤相反，沉与伏宁殊。洪同实状，弱带濡形，辨之既清，病将安遁。故急则为痛，弦则为风，紧则为邪，缓则为虚，微则为冷，数则为热，滑则痰多，涩则郁塞，洪为火旺，大为血干，沉为阴寒，迟为困乏，小者气衰，细者血涸，浮者气升，伏者脉结，芤多失血，实多壅气，弱者阴亏，濡是湿犯，长是正气之和，短是邪气之克，代为正气之衰，革为正气之脱，结为邪气之搏，促为正气之耗，动有变动之机，静有安宁之喜。毛主火之将旺，石乃水之极沉，耎是力薄，坚乃邪深，钩为气血之和，躁为气血之燥，搏击指而有太过之虞，散去指而无可留之状。脉嫌其绝脉，脉贵其平。既知各脉之异同，可断诸症之常变。然而诊脉必须得时，要在日之平旦。按指原无异法，贵取气之甚清，自然虚实易明，盛衰易辨矣。
陈士铎曰：脉理之不明也，久矣。以致看病不真，用药寡效，是脉之精微不可不讲也。然而精微出于浅近，过求乎窈杳，反致失之。此鬼真君脉诀之妙，妙在浅近，使人人易知而深入也。
又曰：脉有阴阳之不同，王叔和分七表八里，似乎切脉之分明，不知无一脉无阴阳，非浮为阳而沉为阴，迟为阴而数为阳也。阴中有阳，阳中有阴，于中消息，全在临症明察之，心可意会，非笔墨能绘画耳。
又曰：十二经各有脉，分十二经看之，自然玄妙入神。然而过求其精，反失其约。盖五脏之脉，能统摄七腑，腑病治脏，脏安而腑自安。故脉诀止消言脏，而不必言腑也。
又曰：切脉以呼吸为准。一呼脉二动，一吸脉二动，为平人无病之脉，有余不足皆病也。世人切脉，多以三指齐按于寸关尺以候各脉，焉得备观其阴阳虚实邪正之分哉。必须先以一指观其左寸，后及左关，又及左尺，然后又及右寸，又及右关，又及右尺，逐步分别，再以三指准之，则何异何同，始了然于胸中。见浮言其风，见沉言其积，见迟言其痛，见数言其热，自能阴阳莫逃，邪正有别，虚实不淆矣。
又曰：春夏秋冬长夏各有定脉，《内经》已详言之。春主弦，夏主钩(钩即微洪之意)，秋主毛，冬主石，长夏主软弱，太过不及均是病征，尤不可见者，克我之脉。如春宜弦而见毛，夏宜钩而见石，及至秋冬未有不病者，余可类推。
又曰：脉随血而行，而血随时而运。病脉行至克我之脉，则病必重，行至生我之脉，则病必轻。盖金脉逢金时必旺，木脉逢金时必衰，故木病值寅卯则当其令，逢申酉则失其时。观寅卯申酉之旺衰，即知金木病情症候矣。即一木而可通之火土水金，即寅卯申酉而可通之子午亥辰戌丑未也。
又曰：脏腑之病虽各不同，要不外五行之生克，逢生则病易愈也，逢克则病难痊也，我生则泻我之气，我克则劳我之神，脏腑为战争之地，胸腹为角斗之场，敌虽扫除，而斩杀甚多，伤损必过，调停于生克之间，和解于败亡之内，仍于金木水火土而善用也。
又曰：脉有相似而实不相同者，尤宜分辨。盖脉似相同而病实各异，一经错认，死生反掌，可不慎欤。
又曰：脉之秘诀，大约三十八字尽之。而每字实有秘要，非一言可尽也，既非一言可尽，而鬼真君何以每一字皆用一言以诏示天下，岂脉诀贵少而不贵多乎？不知诀不必太多，而论诀正不可太少也。
又曰：急则为痛，言见急脉即为痛病也。急似乎数而未至于数也，急似乎紧而未至于紧也，有不可缓之状，乃气与火相斗，邪与正相争也。
又曰：弦则为风，弦乃春天之正脉，春天见弦脉，正风木之得令，非病也，苟见于夏秋冬季，则弦为风矣。
又曰：紧则为邪，邪者，亦风之类，但风邪感之甚骤，则脉必现紧耳。
又曰：缓则为虚，虚者，重按之不能鼓指也，鼓指亦非太劲之谓，言其不能微微鼓指耳，最宜活看。
又曰：数则为热，热乃火病，火性炎上，其性最速，故数脉作热论也。但数不同，有阴数阳数之异，有初数久数之分，然而热则一也。
又曰：滑则痰多，天下至滑者，无过于水，痰亦水也，水多则痰，生痰多则滑宜见也。然而水病不一，滑脉不常，何故单以痰多属滑也？不知水未结痰，其体静，水既结痰，其体动也，动极则滑极，脉见滑矣，非痰多而何。
又曰：涩则郁塞，涩脉乃往来不甚舒畅也。此阴阳不合，气血不达，外感于风寒，内阻于忧郁，抑塞而不通也，郁而未发之状，六部见此象，具能成病，尤于肝经不宜。一见涩脉，即以解郁通塞之药急治之，随手奏功也。
又曰：洪为火旺，洪者来大而去数也。洪与大有分，按指若大久之而不见其大，止见其数，重按之不见其数，而仍见大者为洪也。夏见此脉为宜，否则皆火旺之极也。
又曰：大为血干，大者重按而仍洪也。火之有余，乃血之不足，血不能制火，乃见大脉。在夏天则犹非大忌，然见大脉即宜补血滋阴，以水伏火之为得耳。
又曰：沉为阴寒，沉者至深之象。深则未有不阴，阴则未有不寒者也，入石洞而阴寒逼人者，正以其深沉耳。
又曰：迟为困乏，迟者言俟之而不能深进也，行百里者半九十，非迟之谓乎。是其力乏神困，欲进而不能，非可进而不肯进也。
又曰：小者气衰，小脉言气之小而不能大也，气之不充故耳。
又曰：细脉言脉之细而不能粗也，江河细流，正水之缩也，人身之血少，自然脉细矣。
又曰：伏脉按指始终不可得，或隐隐约约，或有或无者也。是邪气搏结正气而不能出也，用药出之者生，然出之骤，亦非佳兆。
又曰：实脉不独按指有力，且有不可止抑之状，非正气之有余，乃邪气之有余也，邪气有余，自然壅塞正气矣。
又曰：长脉之现正气之和也，有胃气则脉自修长，有从容和缓之象。
又曰：短脉者，欲长而不能，欲速而不达，因邪气之克犯正气，正负邪胜也。
又曰：代脉之现，正气之衰，不得不止以息其气也，有痰气壅膈不散，亦现代脉者，然正气不衰，痰安能作祟，使脉中止而不还乎。
又曰：结脉其来则缓，而时有现止，是力不能不止也。明是正气甚衰，不敢与邪相斗，邪气搏结于一身耳。
又曰：毛脉言如羽毛之拂体，乃有余之象，火将浮而又息之状。夏秋间之正脉也，在夏则生气之旺也，在秋则旺气之衰也，在他时则热气之盛也，宜于活看。
又曰：石脉乃沉脉之至，藏之极也，冬时正脉，余时见之为寒冷矣。
又曰：钩脉洪而不大之象，如钩之有留也，乃胃脉和平，火不盛而司其令，夏日见之尤为平脉也。
又曰：躁脉似动而非动，似数而非数，似促而非促，似急而非急，若有干枯烦扰之状。
又曰：绝脉者，言脉之将断而未断，可续而不续也，死亡之时，必现此脉。
又曰：平脉者，言各脉得其平也，如浮不甚浮，沉不甚沉，迟不甚迟，数不甚数耳，人现平脉，多系胃气之全也，胃气无伤，又宁有疾病哉，此脉之所以贵得其平耳。
又曰：鬼真君脉诀，止得三十八字，然而人之疾病，已尽括于其内，要在辨其异中之同，与同中之异，则因常可以通变，遇变可以用常，随时随地随症随人无不可以起死回生矣，又何必拘拘于日之平旦，乘人之清气诊病哉。
又曰：五脏七腑各有脉，俱在寸关尺观之，内经分三部之内外前后上下以细察其部位，何其详也。而鬼真君独重五脏，将七腑略而不言，止将三焦命门以示世，又皆不专属之肾，何其略也？不知脏可以包腑，而腑不可以包脏，论府太详，必至反遗夫脏矣。不若专言五脏，治脏而治府在其中矣，三焦乃府之一，何独举而言之？因世错认三焦在于肾中，故特指明也。命门为十二经之主，世人不知，而以右尺观之，恐失命门之义，故鬼真君辨明之也。
又曰：或曰王叔和脉诀，因遗落心包，遂至传疑千载，今鬼真君之诀，将七府全然不讲，不更滋甚乎？然而切脉止可切五脏也。七腑部位，内经虽分，似乎有一定之理，而究难别脏府之异。不若单切五脏，论其五行之生克，病情反无可遁也。此鬼真君不言七腑，真是至捷之法，亦是至玄之机，幸勿作王叔和遗落心包一例而并讥之也。
又曰：脉贵知微，然而得其微又甚难，暗中摸索而欲使脏府之疾病了然于手指之间，易乎，不易乎？虽然切脉必须问症，症是府病，即以脏之脉合之，脏之脉不病，即是府病也，治府而病可愈。症是脏病亦以脏之脉合之，脏之脉病，是非府病也，治脏而病亦愈矣。苟知此法，又何微之不可得哉。
又曰：凡人之脉，多不相同，不可以此人之脉，概论诸彼人也。看人之脉，当取其左右两手之脉一一而消息之，辨其何部独异，乃断何经之病，庶几得之。
又曰：看脉须看有神无神，实是秘诀。而有神无神何以别之，无论浮沉迟数滑涩大小之各脉，按指下若有条理，先后秩序不乱者，此有神之至也。若按指充然有力者，有神之次也。其余按指而微微鼓动者，亦谓有神。倘按指而散乱者，或有或无者，或来有力而去无力者，或轻按有力，重按绝无者，或时而续时而断者，或欲续而不能，或欲接而不得，或沉细之中倏有依稀之状，或洪大之内忽有飘渺之形，皆是无神之脉。脉至无神，即为可畏，当用大补之剂救之，倘因循等待，必变为死脉，而后救之晚矣。
又曰：人有天生细微之脉，不可动曰虚弱，当统六部同观之。倘一脉独旺，一脉独急，余脉皆现细微，此非虚弱之脉也，旺乃火盛，而急乃邪侵也，以此消息，断然不差。
又曰：切脉贵先调息，吾息调而后可以察病人之息。盖病人之息，呼吸不到，未有能调者也。倘医者之息不平，又何以知病人之息哉。盖学医者平日学导引之法，则呼吸之间无太过不及，自然下指之时，息数可以分别，可以察病人之脉也。
又曰：看脉必须看症，盖症所以印证夫脉也。夫人之脉不同，有天生阴脉，不现于皮毛之内，又将何处看脉。故必观其症候之若何，而症候正难辨也。或看其起居之静躁，静为阴而躁为阳也；看其饮食之寒热，喜寒为热喜热为寒也；问其大小便之燥湿短长，燥短而实，而湿长为虚也；辨其口舌之黄白峭滑，黄峭为邪盛，而白滑为正衰也。是观症所以济切脉之穷，而切脉所以辅观症之妙耳。
《脉诀阐微》（修订版）
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鬼真君脉诀序
《脉诀》自王叔和传承之后，世间很少见到相关著作，谁知道王叔和只是注释了《脉经》，误传还有《脉诀》。既然王叔和没有编写《脉诀》，为什么只流传口诀而不流传经文？这是因为《脉经》的内容太多，不如《脉诀》简练。然而，《脉诀》始于高阳生，并非王叔和的原文。我在燕京集市遇到一位云中地区的隐逸老人，他传授的方法非常完备，但不传授《脉经》，是因为《素问》和《灵枢》这两部书中关于脉学的论述太多了。虽然如此，在众多的论述中寻求简练，又何必一定要从《灵枢》、《素问》中去探求脉学呢？鬼真君名叫臾区，是云中隐逸老人的弟子。相貌很奇特，脸长一尺一寸，头发短而卷曲，眼窝深，身材高大，耳垂大且下垂，不是普通的读书人。况且岐天师（岐伯）完备地传授了治疗方法，为什么不把脉法传授给我呢？于是传授了这本书，都是切脉的方法。鬼真君作为天师的徒弟，天师传道非常完备，为什么鬼真君传脉却如此简略呢？大概疾病分属脏腑，如果论脉则只传脏而不涉及腑，难道脉与病不同吗？不知道疾病必然兼涉脏，而脉不可以兼涉脏。《灵枢》、《素问》两书，有时将脏腑合在一起说，为什么现在流传的《脉诀》唯独与病不同呢？因为脏病则腑也病，腑病则脏也病，所以治疗脏而腑的治疗就在其中，切诊脏而腑也在其内，又何必合在一起说。所以单说脏而不涉及腑。鬼真君的传授，虽然出于天师，也是鬼真君的独特见解。传授只有五篇，言辞很简练。但都是讲脏的条文，治疗脏不可不通用于治疗腑吗？
山阴陈士铎敬之甫别号远公题于文笔峰之小琅琊
第一篇
脉理非常精微，原本不是一句话能说完的，人的病情变化多端，又岂是一个脉象能概括的。论述阴阳，辨别生死，观察脏腑，查看症候，既然上、中、下三部应当区分，寸、关、尺的位置自然确定。左寸对应心，左关对应肝，火木之气难道没有刚烈之性吗？右寸对应肺，右关对应脾，土金之气本来有深厚之情。唯有两尺对应肾，水火的分配确实难以明确，中间是命门，左右还可以一同观察。三焦分别上、中、下三部以相互诊察，其余经脉合并寸、关、尺一起审视。大概部位怎么允许颠倒，辨别贵在分明，而表里何必细分，不应该拘泥固执。虽然用手指按诊以三部为法，数呼吸次数就能领悟断经的依据，但看脉以五脏为主，知道脏就通晓治腑的道理。观察四时的节气，春夏不同于秋冬；审视一天的时辰，寅卯时不同于申酉时。大约遇到相克则凶险，遇到相生可救治，我生则脉缓，我克则难医。根据五行来推断，举一反三就可以知晓。弦脉似乎像紧脉，涩脉似乎像微脉，浮脉与芤脉相反，沉脉与伏脉难道不同吗？洪脉同实脉状似，弱脉带濡脉形似，辨别清楚了，病将哪里躲藏。所以急脉则为痛，弦脉则为风，紧脉则为邪气，缓脉则为虚，微脉则为冷，数脉则为热，滑脉则痰多，涩脉则郁塞，洪脉为火旺，大脉为血干，沉脉为阴寒，迟脉为困乏，小脉者气衰，细脉者血涸，浮脉者气升，伏脉者脉结，芤脉多失血，实脉多壅气，弱脉者阴亏，濡脉是湿邪侵犯，长脉是正气的调和，短脉是邪气的克制，代脉是正气的衰退，革脉是正气的脱失，结脉是邪气的搏结，促脉是正气的耗损，动脉有变动之机，静脉有安宁之喜。毛脉主火将旺，石脉乃水之极沉，软脉是力量薄弱，坚脉乃邪气深入，钩脉为气血的和缓，躁脉为气血的燥急，搏击手指而有太过之虞，散去手指而无可留之状。脉忌讳绝脉，脉可贵在于平脉。既然知道了各脉的异同，可以判断诸症的常变。然而诊脉必须得宜于时机，要在日出的清晨。按指原本没有不同的方法，贵在取气息非常清静的时候，自然虚实容易明白，盛衰容易辨别了。
陈士铎说：脉理的不明，已经很久了。以至于看病不真切，用药效果少，这是脉的精微之处不可不讲啊。然而精微出于浅近，过分追求深远，反而导致失误。这鬼真君脉诀的妙处，妙在浅近，使人人容易知晓而深入。
又说：脉有阴阳的不同，王叔和分为七表八里，似乎切脉分明，不知道没有一脉没有阴阳，不是说浮为阳而沉为阴，迟为阴而数为阳。阴中有阳，阳中有阴，其中的消息，全在临症时明察，心里可以意会，不是笔墨能描绘的。
又说：十二经脉各有脉，分十二经来看，自然玄妙入神。然而过分追求精微，反而失去简练。大概五脏的脉，能统摄六腑，腑病治脏，脏安则腑自安。所以脉诀只需说脏，不必说腑。
又说：切脉以呼吸为标准。一呼脉跳动两次，一吸脉跳动两次，是健康无病之人的脉，有余或不足都是病。世人切脉，多以三指同时按在寸关尺以候各脉，怎么能全面观察其阴阳虚实邪正的区别呢？必须先以一指观察左寸，然后及左关，又及左尺，然后又及右寸，又及右关，又及右尺，逐步分别，再以三指准测，那么何异何同，才能在胸中了然。见浮脉言其为风，见沉脉言其为积，见迟脉言其为痛，见数脉言其为热，自然阴阳无法逃脱，邪正有别，虚实不混淆。
又说：春夏秋冬长夏各有定脉，《内经》已详细言之。春主弦，夏主钩（钩即微洪之意），秋主毛，冬主石，长夏主软弱，太过不及均是病征，尤其不可见的，是克我之脉。如春宜弦而见毛，夏宜钩而见石，到了秋冬没有不病的，其余可类推。
又说：脉随血而行，而血随时间而运行。病脉行至克我之脉，则病必重，行至生我之脉，则病必轻。大概金脉逢金时必旺，木脉逢金时必衰，所以木病值寅卯时则当其令，逢申酉时则失其时。观察寅卯申酉的旺衰，就知道金木的病情症候了。即一木而可通之火土水金，即寅卯申酉而可通之子午亥辰戌丑未也。
又说：脏腑的病虽各不相同，总不外乎五行的生克，逢生则病易愈，逢克则病难痊，我生则泻我之气，我克则劳我之神，脏腑为战争之地，胸腹为角斗之场，敌人虽扫除，而斩杀甚多，伤损必过，调停于生克之间，和解于败亡之内，仍于金木水火土而善用也。
又说：脉有相似而实际不相同的，尤其应该分辨。大概脉似相同而病实际各异，一经错认，生死反掌，能不谨慎吗？
又说：脉的秘诀，大约三十八个字概括。而每个字实在有秘要，不是一句话能说完的，既然不是一句话能说完，而鬼真君为什么每一个字都用一句话来昭示天下，难道脉诀贵少而不贵多吗？不知道诀不必太多，而论诀正不可太少。
又说：急则为痛，是说见急脉即为痛病。急似乎数而未至于数，急似乎紧而未至于紧，有不可缓之状，乃气与火相斗，邪与正相争。
又说：弦则为风，弦乃春天的正脉，春天见弦脉，正是风木得令，非病，如果在夏秋冬季出现，则弦为风。
又说：紧则为邪，邪者，也是风之类，但风邪感之甚骤，则脉必现紧。
又说：缓则为虚，虚者，重按之不能鼓指，鼓指亦非太劲之说，言其不能微微鼓指，最宜活看。
又说：数则为热，热乃火病，火性炎上，其性最速，故数脉作热论。但数不同，有阴数阳数之异，有初数久数之分，然而热则一也。
又说：滑则痰多，天下至滑者，无过于水，痰亦水也，水多则痰，生痰多则滑宜见。然而水病不一，滑脉不常，何故单以痰多属滑？不知道水未结痰，其体静，水既结痰，其体动也，动极则滑极，脉见滑矣，非痰多而何。
又说：涩则郁塞，涩脉乃往来不甚舒畅。此阴阳不合，气血不达，外感于风寒，内阻于忧郁，抑塞而不通，郁而未发之状，六部见此象，具能成病，尤于肝经不宜。一见涩脉，即以解郁通塞之药急治之，随手奏功。
又说：洪为火旺，洪者来大而去数。洪与大有分，按指若大久之而不见其大，止见其数，重按之不见其数，而仍见大者为洪。夏见此脉为宜，否则皆火旺之极。
又说：大为血干，大者重按而仍洪。火之有余，乃血之不足，血不能制火，乃见大脉。在夏天则犹非大忌，然见大脉即宜补血滋阴，以水伏火之为得。
又说：沉为阴寒，沉者至深之象。深则未有不阴，阴则未有不寒者也，入石洞而阴寒逼人者，正以其深沉耳。
又说：迟为困乏，迟者言俟之而不能深进，行百里者半九十，非迟之谓乎。是其力乏神困，欲进而不能，非可进而不肯进。
又说：小者气衰，小脉言气之小而不能大，气之不充故耳。
又说：细脉言脉之细而不能粗，江河细流，正水之缩，人身之血少，自然脉细。
又说：伏脉按指始终不可得，或隐隐约约，或有或无。是邪气搏结正气而不能出，用药出之者生，然出之骤，亦非佳兆。
又说：实脉不独按指有力，且有不可止抑之状，非正气之有余，乃邪气之有余，邪气有余，自然壅塞正气。
又说：短脉者，欲长而不能，欲速而不达，因邪气之克犯正气，正负邪胜。
又说：代脉之现，正气之衰，不得不止以息其气，有痰气壅膈不散，亦现代脉者，然正气不衰，痰安能作祟，使脉中止而不还。
又说：结脉其来则缓，而时有现止，是力不能不止。明是正气甚衰，不敢与邪相斗，邪气搏结于一身。
又说：毛脉言如羽毛之拂体，乃有余之象，火将浮而又息之状。夏秋间之正脉，在夏则生气之旺，在秋则旺气之衰，在他时则热气之盛，宜于活看。
又说：软脉不能刚健之状，明是力之不胜。
又说：钩脉洪而不大之象，如钩之有留，乃胃脉和平，火不盛而司其令，夏日见之尤为平脉。
又说：躁脉似动而非动，似数而非数，似促而非促，似急而非急，若有干枯烦扰之状。
又说：绝脉者，言脉之将断而未断，可续而不续，死亡之时，必现此脉。
又说：平脉者，言各脉得其平，如浮不甚浮，沉不甚沉，迟不甚迟，数不甚数。人现平脉，多系胃气之全，胃气无伤，又宁有疾病哉，此脉之所以贵得其平。
又说：鬼真君脉诀，止得三十八字，然而人之疾病，已尽括于其内，要在辨其异中之同，与同中之异，则因常可以通变，遇变可以用常，随时随地随症随人无不可以起死回生，又何必拘拘于日之平旦，乘人之清气诊病。
又说：五脏七腑各有脉，俱在寸关尺观之，内经分三部之内外前后上下以细察其部位，何其详。而鬼真君独重五脏，将七腑略而不言，止将三焦命门以示世，又皆不专属之肾，何其略？不知脏可以包腑，而腑不可以包脏，论府太详，必至反遗夫脏。不若专言五脏，治脏而治府在其中，三焦乃府之一，何独举而言之？因世错认三焦在于肾中，故特指明。命门为十二经之主，世人不知，而以右尺观之，恐失命门之义，故鬼真君辨明之。
又说：或曰王叔和脉诀，因遗落心包，遂至传疑千载，今鬼真君之诀，将七府全然不讲，不更滋甚乎？然而切脉止可切五脏。七腑部位，内经虽分，似乎有一定之理，而究难别脏府之异。不若单切五脏，论其五行之生克，病情反无可遁。此鬼真君不言七腑，真是至捷之法，亦是至玄之机，幸勿作王叔和遗落心包一例而并讥之。
又说：脉贵知微，然而得其微又甚难，暗中摸索而欲使脏府之疾病了然于手指之间，易乎，不易乎？虽然切脉必须问症，症是府病，即以脏之脉合之，脏之脉不病，即是府病，治府而病可愈。症是脏病亦以脏之脉合之，脏之脉病，是非府病，治脏而病亦愈。苟知此法，又何微之不可得。
又说：凡人之脉，多不相同，不可以此人之脉，概论诸彼人。看人之脉，当取其左右两手之脉一一而消息之，辨其何部独异，乃断何经之病，庶几得之。
又说：看脉须看有神无神，实是秘诀。而有神无神何以别之，无论浮沉迟数滑涩大小之各脉，按指下若有条理，先后秩序不乱者，此有神之至。若按指充然有力者，有神之次。其余按指而微微鼓动者，亦谓有神。倘按指而散乱者，或有或无者，或来有力而去无力者，或轻按有力，重按绝无者，或时而续时而断者，或欲续而不能，或欲接而不得，或沉细之中倏有依稀之状，或洪大之内忽有飘渺之形，皆是无神之脉。脉至无神，即为可畏，当用大补之剂救之，倘因循等待，必变为死脉，而后救之晚矣。
又说：人有天生细微之脉，不可动曰虚弱，当统六部同观。倘一脉独旺，一脉独急，余脉皆现细微，此非虚弱之脉，旺乃火盛，而急乃邪侵，以此消息，断然不差。
又说：切脉贵先调息，吾息调而后可以察病人之息。盖病人之息，呼吸不到，未有能调者也。倘医者之息不平，又何以知病人之息。盖学医者平日学导引之法，则呼吸之间无太过不及，自然下指之时，息数可以分别，可以察病人之脉。
又说：看脉必须看症，盖症所以印证夫脉。夫人之脉不同，有天生阴脉，不现于皮毛之内，又将何处看脉。故必观其症候之若何，而症候正难辨。或看其起居之静躁，静为阴而躁为阳；看其饮食之寒热，喜寒为热喜热为寒；问其大小便之燥湿短长，燥短而实，而湿长为虚；辨其口舌之黄白峭滑，黄峭为邪盛，而白滑为正衰。是观症所以济切脉之穷，而切脉所以辅观症之妙。
*Pulse Jue Chan Wei* (Revised Edition)
Qing Dynasty · Chen Shiduo
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Preface to the Pulse Jue by Ghost True Lord (Gui Zhen Jun)
Since Wang Shuhe transmitted the *Pulse Jue*, there have been few practitioners in the world. Who knew that Wang Shuhe only annotated the *Mai Jing* (Classic of Pulse Diagnosis), and mistakenly passed down the existence of a *Pulse Jue*? Since Wang Shuhe did not write a *Pulse Jue*, why was the Jue transmitted but not the Jing? It is because the content of the *Mai Jing* is too voluminous, whereas the *Pulse Jue* is concise. However, the *Pulse Jue* originated from Gao Yangsheng, not from Wang Shuhe's original text. I met an elderly recluse from Yunzhong in the markets of Yanjing (Beijing). He transmitted methods that were extremely comprehensive but did not transmit the *Mai Jing*, because the discussions on pulse diagnosis in the *Suwen* (Basic Questions) and *Lingshu* (Spiritual Pivot) are already so abundant. Nevertheless, seeking conciseness within abundance, why must one necessarily seek pulse theory solely in the *Lingshu* and *Suwen*? The Ghost True Lord, whose name was Yu Qu, was a disciple of this Yunzhong recluse. His appearance was very peculiar: his face was one chi and one cun long, his hair was short and curly, his eyes were deep-set, his stature was tall, and his earlobes were large and drooping; he was not an ordinary scholar. Furthermore, if Grand Master Qi (Qibo) had comprehensively transmitted medical methods, why did he not transmit pulse diagnosis to me? Thus, he transmitted this book, which contains all the methods of palpation. As a disciple of the Grand Master, the Grand Master transmitted the Dao comprehensively, why did the Ghost True Lord transmit pulse diagnosis so concisely? Perhaps diseases are divided into Zang and Fu organs; if discussing pulses, it transmits knowledge of Zang but omits Fu. Is it that pulses differ from diseases? One does not realize that diseases inevitably involve both Zang and Fu, whereas pulses cannot encompass both. The *Lingshu* and *Suwen* sometimes discuss them together; why does the currently circulated *Pulse Jue* differ uniquely from disease descriptions? Because when a Zang organ is diseased, the corresponding Fu organ is also affected, and vice versa. Therefore, treating the Zang implicitly treats the Fu, and palpating the Zang inherently involves the Fu; thus, there is no need to discuss them jointly. Hence, it speaks only of Zang and omits Fu. Although the Ghost True Lord's transmission originates from the Grand Master, it is also his unique insight. The transmission consists of only five chapters, with concise language. Yet, these are all texts regarding Zang organs; can treatment of Zang not be applied to Fu?
Chen Shiduo, courtesy name Jingzhi, pseudonym Yuangong, respectfully inscribed at Xiaolangya on the Wenyi Peak.
Chapter One
The principles of pulse diagnosis are extremely subtle; originally, they cannot be exhausted in a single statement. Human diseases vary greatly; how could a single pulse pattern cover all cases? Discussing Yin and Yang, distinguishing life from death, observing Zang and Fu organs, and examining symptoms, since the Upper, Middle, and Lower positions must be distinguished, the Cun, Guan, and Chi positions naturally become fixed. The Left Cun corresponds to the Heart, the Left Guan to the Liver; do Fire and Wood lack their inherent vigorous nature? The Right Cun corresponds to the Lung, the Right Guan to the Spleen; Earth and Metal possess profound affection by nature. Only the two Chi positions correspond to the Kidney; the allocation of Water and Fire is truly difficult to assign clearly. In the middle lies the Mingmen (Gate of Life); left and right can still be observed together. The Sanjiao (Triple Burner) is diagnosed separately according to Upper, Middle, and Lower sections, while other meridians are viewed collectively through Cun, Guan, and Chi. How can positions be allowed to be inverted? Differentiation values clarity. Why must Exterior and Interior be subdivided? One should not be rigidly attached. Although using fingers to palpate follows the method of three positions, counting breaths allows one to comprehend the basis for judging meridians. However, viewing pulses prioritizes the Five Zang organs; knowing the Zang allows one to understand the treatment of Fu. Observing the solar terms of the four seasons, Spring and Summer differ from Autumn and Winter; examining the hours of the day, Yin-Mao hours differ from Shen-You hours. Generally, encountering mutual restriction (Ke) indicates misfortune, while encountering mutual generation (Sheng) offers salvation. If I generate, the pulse is slow; if I restrict, it is difficult to treat. Inferring based on the Five Elements, knowing one corner reveals the others. Xian (Wiry) seems similar to Jin (Tight), Se (Choppy) seems similar to Wei (Fine/Weak), Fu (Floating) is opposite to Kou (Hollow), and Chen (Deep) differs from Fu (Hidden). Hong (Surging) resembles Shi (Full), while Ruo (Weak) carries the form of Ru (Soggy). Once clearly differentiated, where will the disease hide? Therefore, Ji (Urgent/Rapid) indicates pain, Xian indicates Wind, Jin indicates pathogenic factors, Huan (Slow/Lax) indicates deficiency, Wei indicates cold, Shu (Rapid) indicates heat, Hua (Slippery) indicates much phlegm, Se indicates stagnation, Hong indicates flourishing Fire, Da (Large) indicates dried Blood, Chen indicates Yin-Cold, Chi (Delayed) indicates exhaustion, Xiao (Small) indicates Qi decline, Xi (Thready) indicates Blood depletion, Fu indicates rising Qi, Fu indicates knotted pulse, Kou indicates blood loss, Shi indicates Qi stagnation, Ruo indicates Yin deficiency, Ru indicates dampness invasion, Chang (Long) indicates the harmony of Healthy Qi, Duan (Short) indicates the restriction by Pathogenic Qi, Dai (Intermittent) indicates the decline of Healthy Qi, Ge (Drum-Taut) indicates the collapse of Healthy Qi, Jie (Knotted) indicates the struggle of Pathogenic Qi, Cu (Cursory) indicates the consumption of Healthy Qi, Dong (Moving) has the mechanism of change, Jing (Still/Quiet) has the joy of peace. Mao (Feather-like) governs the impending flourishing of Fire, Shi (Stone-like) is the extreme depth of Water, Ruan (Soft) indicates weak strength, Jian (Firm) indicates deep-seated pathogens, Gou (Hook) represents the harmony of Qi and Blood, Zao (Restless) represents the dryness of Qi and Blood, striking the finger suggests excess, dispersing from the finger suggests nothing remains. Pulses fear the Jue (Cut-off) pulse; pulses value the Ping (Normal) pulse. Having known the similarities and differences of each pulse, one can judge the constancy and variation of various symptoms. However, pulse diagnosis must be timed correctly, preferably at dawn (Pingdan). Finger placement has no different methods; it values taking advantage of when Qi is very clear. Naturally, Deficiency and Excess become easy to clarify, and Flourishing and Decline become easy to distinguish.
Chen Shiduo says: The obscurity of pulse principles has existed for a long time. This leads to inaccurate diagnoses and ineffective medication. Thus, the subtleties of pulses must be studied. However, subtlety arises from the proximate and simple; over-seeking the profound and distant leads to error. The wonder of the Ghost True Lord's Pulse Jue lies in its simplicity, making it easy for everyone to understand and delve into.
He also said: Pulses differ in Yin and Yang. Wang Shuhe divided them into Seven Exterior and Eight Interior categories, seemingly making pulse differentiation clear. But he did not know that every pulse contains Yin and Yang; it is not simply that Floating is Yang and Deep is Yin, or Delayed is Yin and Rapid is Yang. Yin contains Yang, and Yang contains Yin. The nuances lie in careful observation during clinical practice; the mind can apprehend them intuitively, but they cannot be fully depicted by ink and brush.
He also said: Each of the Twelve Meridians has its own pulse. Viewing them by dividing the Twelve Meridians naturally leads to profound mystery. However, over-seeking precision loses conciseness. The pulses of the Five Zang organs can command the Six Fu organs. Treating the Zang for Fu diseases ensures that when the Zang is peaceful, the Fu becomes peaceful. Therefore, the Pulse Jue needs only discuss Zang, not Fu.
He also said: Palpation is standardized by respiration. Two beats per exhalation and two beats per inhalation constitute the pulse of a healthy person without disease; any excess or deficit indicates illness. People today often press three fingers simultaneously on Cun, Guan, and Chi to monitor pulses, but how can they comprehensively observe the distinctions of Yin/Yang, Deficiency/Excess, and Pathogen/Healthy Qi? One must first use one finger to observe Left Cun, then Left Guan, then Left Chi, then Right Cun, Right Guan, and Right Chi, step-by-step differentiation, and finally use three fingers for verification. Then, what is different and what is the same becomes clear in the mind. Seeing a Floating pulse, speak of Wind; seeing a Deep pulse, speak of accumulation; seeing a Delayed pulse, speak of pain; seeing a Rapid pulse, speak of heat. Naturally, Yin and Yang cannot escape, Pathogen and Healthy Qi are distinct, and Deficiency and Excess are not confused.
He also said: Spring, Summer, Autumn, Winter, and Late Summer each have fixed pulses, as detailed in the *Neijing*. Spring governs Xian (Wiry), Summer governs Gou (Hook) (Hook means slightly Surging), Autumn governs Mao (Feather-like), Winter governs Shi (Stone-like), and Late Summer governs Ruan-Ruo (Soft and Weak). Excess and Deficiency are both signs of disease. Especially invisible/unfavorable are pulses that restrict me. For example, Spring should show Xian but shows Mao; Summer should show Gou but shows Shi. By Autumn and Winter, there is no one who is not ill; the rest can be inferred similarly.
He also said: Pulses travel with Blood, and Blood moves with time. When a pathological pulse reaches a phase that restricts me, the disease will be severe; when it reaches a phase that generates me, the disease will be mild. Generally, Metal pulses flourish when meeting Metal times, and Wood pulses decline when meeting Metal times. Therefore, Wood diseases peak during Yin-Mao hours and lose momentum during Shen-You hours. Observing the flourishing and decline of Yin-Mao-Shen-You reveals the condition of Metal and Wood diseases. Just as one Wood element connects to Fire, Earth, Water, and Metal, so do Yin-Mao-Shen-You connect to Zi-Wu-Hai-Chen-Xu-Chou-Wei.
He also said: Although diseases of Zang and Fu organs differ, they ultimately revolve around the generation and restriction of the Five Elements. Meeting generation makes recovery easy; meeting restriction makes cure difficult. "I generate" drains my Qi; "I restrict" exhausts my Spirit. Zang and Fu are battlefields; the chest and abdomen are arenas. Even if enemies are cleared, many are slain, and damage exceeds limits. Mediating between generation and restriction, reconciling within defeat, still requires skillful application of Metal, Wood, Water, Fire, and Earth.
He also said: There are pulses that appear similar but are actually different, requiring particular discrimination. Pulses may seem identical while diseases differ greatly; a single misrecognition can reverse life and death in an instant. Can one not be cautious?
He also said: The secret of pulses is summarized in roughly thirty-eight characters. Yet each character holds secrets that cannot be exhausted in one sentence. Since it cannot be exhausted in one sentence, why did the Ghost True Lord use one sentence for each character to reveal to the world? Does the Jue value brevity over verbosity? No. The Jue need not be too long, but the explanation of the Jue must not be too short.
He also said: "Ji implies pain" means seeing a Ji pulse indicates a painful disease. Ji seems like Shu (Rapid) but is not quite Shu; Ji seems like Jin (Tight) but is not quite Jin. It has an unrelenting quality, representing the struggle between Qi and Fire, and the conflict between Pathogen and Healthy Qi.
He also said: "Xian implies Wind." Xian is the correct pulse of Spring. Seeing a Xian pulse in Spring indicates Wind-Wood is in season, not a disease. If seen in Summer, Autumn, or Winter, then Xian indicates Wind.
He also said: "Jin implies Pathogen." Pathogens are also a type of Wind, but if Wind-Pathogen strikes suddenly, the pulse must manifest as Jin.
He also said: "Huan implies Deficiency." Deficiency means heavy pressure cannot make the finger bounce (Gu Zhi). "Bouncing" does not mean overly forceful; it means unable to gently bounce. This must be viewed flexibly.
He also said: "Wei implies Cold." Cold is Han (Cold). Regardless of position, seeing Wei mostly indicates Cold syndromes.
He also said: "Shu implies Heat." Heat is a Fire disease. Fire nature flares upward and is fastest, hence Shu pulse is discussed as Heat. However, Shu varies: there are Yin-Shu and Yang-Shu, initial-Shu and prolonged-Shu, yet Heat remains one concept.
He also said: "Hua implies much Phlegm." Nothing in the world is smoother than water; Phlegm is also water. Too much water creates phlegm; generating much phlegm makes Hua pulse visible. However, Water diseases vary, and Hua pulses are not constant. Why attribute Hua solely to phlegm? Not knowing that before water forms phlegm, its body is static; once formed, its body is dynamic. Extreme movement leads to extreme smoothness, hence Hua pulse appears. Is it not due to much phlegm?
He also said: "Se implies Stagnation." Se pulse is not very smooth in its coming and going. This is Yin-Yang disharmony, Qi-Blood blockage, external contraction of Wind-Cold, internal obstruction by depression, suppression without flow, a state of stagnation not yet erupted. Seeing this image in all six positions can cause disease, especially unfavorable for the Liver Meridian. Upon seeing Se pulse, immediately treat with herbs to resolve stagnation and unblock obstructions, achieving quick results.
He also said: "Hong implies Flourishing Fire." Hong comes large and goes rapid. Hong and Da are distinguished: if pressing feels large for a long time but does not appear large, only appearing rapid, and heavy pressing does not show rapidity but still shows largeness, this is Hong. Seeing this in Summer is appropriate; otherwise, it indicates extreme Fire flourishing.
He also said: "Da implies Dry Blood." Da means heavy pressing still feels Hong. Excess Fire indicates insufficient Blood; Blood cannot control Fire, hence Da pulse appears. In Summer, this is not a major taboo, but seeing Da pulse warrants tonifying Blood and nourishing Yin, using Water to subdue Fire.
He also said: "Chen implies Yin-Cold." Chen is the image of extreme depth. Deep implies Yin; Yin implies Cold. Entering a stone cave, the biting cold is precisely due to its depth.
He also said: "Chi implies Exhaustion." Chi means waiting but unable to advance deeply. "One who travels a hundred li is half done at ninety"—is this not Chi? It is lack of strength and spirit, wanting to advance but unable to, not unwilling to advance.
He also said: "Xiao implies Qi Decline." Xiao pulse indicates Qi is small and cannot be large, due to Qi insufficiency.
He also said: Xi pulse indicates the pulse is thin and cannot be coarse. Small streams of rivers represent condensed water; little Blood in the body naturally results in thin pulses.
He also said: Fu pulse is obtained immediately upon pressing; Qi lifts and rises.
He also said: Fu pulse is never obtained throughout pressing, or is faint, existing or non-existing. This is Pathogenic Qi binding Healthy Qi, preventing emergence. Medication to expel it brings survival, but sudden expulsion is not a good omen.
He also said: Kou pulse is hollow inside, as if empty. Loss of Blood means no Blood nourishes internally; how can it not be hollow?
He also said: Shi pulse is not only forceful upon pressing but also has an unstoppable quality. It is not excess of Healthy Qi, but excess of Pathogenic Qi. Excess Pathogenic Qi naturally obstructs Healthy Qi.
He also said: Ruo pulse lacks strong flourishing qualities; Yin Deficiency dares not contend with Yang Qi.
He also said: Ru pulse indicates stickiness/stagnation. Dampness adheres and wets, does it not?
He also said: Chang pulse manifests the harmony of Healthy Qi. With Stomach Qi, the pulse naturally grows long, showing leisurely and moderate qualities.
He also said: Duan pulse wants to be long but cannot, wants to be fast but fails. This is due to Pathogenic Qi attacking Healthy Qi, where Healthy Qi is defeated and Pathogen prevails.
He also said: Dai pulse manifests the decline of Healthy Qi, forcing pauses to rest the Qi. Phlegm-Qi blocking the diaphragm without dissipating also presents Dai pulse. However, if Healthy Qi is not declining, how can Phlegm wreak havoc to cause pulse cessation without return?
He also said: Ge pulse, where the pulse comes turbid and chaotic, striking the finger, indicates the impending collapse of Healthy Qi.
He also said: Jie pulse comes slowly but occasionally stops; this is inability to continue due to weakness. Clearly, Healthy Qi is severely declined, daring not fight the Pathogen, which binds within the body.
He also said: Cu pulse is urgent and hurried; Qi is consumed, and momentum is hard to relax.
He also said: Dong pulse has a restless posture; extreme movement generates change.
He also said: Jing pulse is opposite to Dong; remaining still means no change, bringing natural peace.
He also said: Mao pulse feels like feathers brushing the body, indicating excess, a state where Fire is about to float and then subside. It is the normal pulse of mid-Summer/Autumn. In Summer, it signifies flourishing Sheng (Growth) Qi; in Autumn, declining Wang (Prosperous) Qi; in other times, flourishing Re (Heat) Qi. It should be viewed flexibly.
He also said: Shi pulse is the extreme of Chen pulse, the ultimate storage. It is the normal pulse of Winter; seeing it in other seasons indicates Cold.
He also said: Ruan pulse lacks firmness, clearly indicating insufficient strength.
He also said: Jian pulse is extremely hard; Pathogenic Qi has penetrated deeply, labor cannot break it.
He also said: Gou pulse is Surging but not Large, like a hook retaining something. It is the peaceful Stomach pulse, where Fire is not excessive but governs the season. Seeing it in Summer is particularly a Normal pulse.
He also said: Zao pulse resembles Dong but is not Dong, resembles Shu but is not Shu, resembles Cu but is not Cu, resembles Ji but is not Ji, having a dry and troubled appearance.
He also said: Bo pulse means striking the finger. All pulses can strike the finger, all belonging to Excess.
He also said: San pulse is the sign of untying knots, wanting to stay but unable to, wanting to exist but unable to.
He also said: Jue pulse means the pulse is about to break but hasn't, can continue but doesn't. At the time of death, this pulse must appear.
He also said: Ping pulse means each pulse achieves balance, e.g., Floating is not excessively floating, Deep is not excessively deep, Delayed is not excessively delayed, Rapid is not excessively rapid. Humans presenting Ping pulse mostly have complete Stomach Qi. If Stomach Qi is undamaged, how could there be disease? This is why Ping pulse is valued for achieving balance.
He also said: The Ghost True Lord's Pulse Jue contains only thirty-eight characters, yet human diseases are fully encompassed within them. The key is distinguishing sameness in difference and difference in sameness. Thus, following constancy allows adapting to change; encountering change allows applying constancy. Anytime, anywhere, with any symptom or person, one can revive the dying. Why be rigid about dawn or relying on clear Qi for diagnosis?
He also said: Five Zang and Seven Fu organs each have pulses, all observed at Cun, Guan, and Chi. The *Neijing* divides the three positions into interior/exterior, front/back, upper/lower for detailed location inspection—how thorough! Yet the Ghost True Lord focuses solely on Five Zang, briefly omitting Seven Fu, only mentioning Sanjiao and Mingmen to the world, neither exclusively belonging to Kidney. How brief! Not knowing Zang can encompass Fu, but Fu cannot encompass Zang. Discussing Fu too thoroughly inevitably neglects Zang. Better to speak only of Five Zang; treating Zang includes treating Fu. Sanjiao is one of the Fu organs; why mention it alone? Because people mistakenly locate Sanjiao within the Kidney, so it is specifically clarified. Mingmen is the master of Twelve Meridians; people do not know this and view it at Right Chi, fearing loss of Mingmen's meaning, hence the Ghost True Lord clarifies it.
He also said: Some say Wang Shuhe's Pulse Jue omitted Pericardium, causing doubt for millennia. Now the Ghost True Lord's Jue completely ignores Seven Fu, isn't this worse? However, palpation can only palpate Five Zang. Although *Neijing* divides Fu locations, seemingly having fixed logic, ultimately it is hard to distinguish Zang/Fu differences. Better to palpate only Five Zang, discussing Five Element generation/restriction, leaving disease nowhere to hide. This Ghost True Lord not speaking of Seven Fu is truly the most expedient method and profound mechanism. Do not criticize it alongside Wang Shuhe's omission of Pericardium.
He also said: Pulses value knowing subtlety, yet obtaining subtlety is very difficult. Feeling blindly and wanting diseases of Zang/Fu to be clear under fingertips—is it easy or difficult? Although palpation must ask symptoms: if symptoms indicate Fu disease, combine with Zang pulse; if Zang pulse is not diseased, it is Fu disease; treating Fu heals the disease. If symptoms indicate Zang disease, combine with Zang pulse; if Zang pulse is diseased, it is not Fu disease; treating Zang heals the disease. Knowing this method, what subtlety cannot be obtained?
He also said: Everyone's pulses differ greatly; one cannot generalize one person's pulse to others. When viewing pulses, compare left and right hands one by one, discern which position is uniquely abnormal, then judge which meridian is diseased, thereby likely succeeding.
He also said: Viewing pulses requires checking for Shen (Spirit/Essence); this is truly a secret. How to distinguish Shen? Regardless of Floating/Deep, Delayed/Rapid, Slippery/Choppy, Large/Small pulses, if under the finger there is order and sequence without confusion, this is maximum Shen. If pressing feels full and powerful, this is secondary Shen. Others feeling slight vibration under pressing are also considered Shen. If pressing feels scattered, existing/non-existing, coming powerful but going weak, light pressing powerful but heavy pressing absent, intermittent continuity, wanting to continue but unable, wanting to connect but failing, vague shapes in Deep-Thin, or fleeting forms in Large-Surging—all are pulses without Shen. Pulses reaching "no Shen" are terrifying; use major tonic formulas to save them. If delaying, they will become Dead Pulses, and saving them will be too late.
He also said: Some people have naturally fine/thin pulses; do not immediately call them Weak. Observe all six positions together. If one position is uniquely flourishing, one uniquely urgent, while others are fine/thin, this is not Weak pulse. Flourishing indicates Fire Excess; Urgent indicates Pathogen Invasion. Judging by this, errors are unlikely.
He also said: Palpation values adjusting breath first; only after my breath is adjusted can I observe the patient's breath. Patients' breath, if breathing is inadequate, cannot be regulated. If the physician's breath is uneven, how can one know the patient's breath? Physicians learning daily Dao Yin methods ensure breath has no excess or deficit. Naturally, when pressing, breath count can be distinguished, allowing observation of patient's pulse.
He also said: Viewing pulses must view symptoms, for symptoms verify pulses. People's pulses differ; some have naturally Yin pulses, not visible on skin/surface. Where else to view pulses? Thus, one must observe symptoms. Symptoms are hard to distinguish. Observe activity/rest: Rest is Yin, Activity is Yang. Observe diet preference: Preferring Cold indicates Heat, preferring Heat indicates Cold. Ask about urination/defecation dryness/wetness/short/long: Dry/Short/Solid indicates Excess; Wet/Long indicates Deficiency. Distinguish tongue coating yellow/white/coarse/smooth: Yellow/Coarse indicates Pathogen Excess; White/Smooth indicates Healthy Qi Decline. Observing symptoms supplements the limitations of palpation; palpation assists the subtlety of observing symptoms.