脉。一呼一至曰离经。二呼一至曰夺精。三呼一至名困。四呼一至曰命绝。
六脉轻清和滑者。姓名富贵寿康强。按之重浊兼粗涩。下贱愚蒙定不扬。
魂（象木。色青。春服。养筋。王候。绝秋。液泣。声呼。音角。味酸。性喧。气
呼。不足悲。有余怒。平脉弦。贼脉浮。臭膻。死于庚辛。）
神（象火。色赤。王夏绝冬。候舌养血。液汗。声唉。音征。味苦。性暑。气呵。不足忧。有余唉。平脉洪。贼脉
沉。臭焦。死于壬癸。）
意（象土。色黄。王季。绝春。候唇。养肉。液声。涎歌。音宫。味甘。性静。气呼。不足利而少气。有余胀满。
平脉缓。贼脉弦。臭香。死于甲乙。）
魄（象金。色白。王秋。绝夏。液涕。声皮毛。候鼻。声哭。音商。味辛。性凉。气呻。不足则悲。有余喘嗽。平
脉浮短。贼脉洪大。臭腥。死于丙丁。）
志（象水。色黑。王冬。绝季。候耳。养骨。液吐。声呻。音羽。味盐。性凛。气吸。不足厥。有余肠泄。）
命门与三焦同肾（王脉沉。贼脉缓。臭腐。死于戊己。）
脉一呼再至曰平和。三至一曰离经。四至曰夺精。五至曰困。六至曰绝命。
寸口多弦尺小弦。如此方知一丈夫。尺中涌涌寸家怯。借问还如是一姑。
一静其心。二忌外虑。三均呼吸。四轻清于皮肤间。按其腑脉。五微重指于肌肉间。求其胃脉。六沉指于骨上。取
其脏脉也。七察病患息数之来。或以独迟独疾等。为七诊者非也。谓如以独热独疾。为二脉者。疾乃六至脉。其疾其数。
本自主热。岂得独疾独热为二候。迟脉本主寒。却言独寒独迟为异体。全非义理。今以灵枢经中七诊脉法。特为解注。
所谓释缚脱艰于后学人矣。忽左右手脉。大小有偏。男子左脉大。右脉小。则顺。左脉小。右脉大。为逆。
春肝琴弦似动条。夏脉枝蔓逐风摇。春弦。夏长。
秋细风高黄叶落。冬紧只缘阳气消。秋细。冬紧。
春心浮浮似羽毛。夏大看看日渐高。春浮。夏大。
秋洪遍野如流水。冬散还摧大墓牢。秋洪。冬散。
春脾初暖软绵绵。夏迟樱桃步向前。春缓。夏迟。
秋虚尺应泉下水。冬撒长流出九泉。秋虚。冬长。
春肺之脉正微微。夏短秋光火气低。春微。夏短。
秋浮金色然舒艳。冬涩入墓也无疑。秋浮。冬涩。
春肾濡弱水性旋。夏滑波涛浪近川。春弱。夏滑。
九秋沉伏洞迟歇。十月黄河彻底坚。
忽左右手脉。大小有偏者。女子右脉大。左脉小。为顺。右脉小。左脉大。为逆。脉如雀啄者（忽滴滴而不相连。）
如屋漏者。（忽起时如数多也。） 如虾游者。（时复起寻如不没。反又起也。） 如鱼翔者。（如鱼不行而掉尾。又身
动而尾动。反又动入。） 如弹石者。（来去时压压而急也。） 如解索者。（动而数而随散。次须却结也。）
上见此六脉至十日死。
脉十动一止。一年。草枯时死。二十动一止。二年。桑椹赤时死。三十动一止。三年。谷雨时死。四十动一止。四
年。春草盛时死。五十动一止。五年内死。若动数遇此脉者。安而寿长。无恙也。五十动不止者。为呼吸。为一息。肉
得五至。闰以大息。生寿。
脉有气血之光。气血盛。则脉盛。气血衰。则脉衰。气血热。则脉数。气血寒。则脉迟。气血散。则脉弱。气血平。
则脉缓。脉涩者。少血多气。脉滑者。少气多血。脉微细者。血气俱少。脉盛大者。血盛气反。但凡脉微不可吐。脉虚
细者不可下人形盛脉细气。少不足以息者。形瘦脉大。胸中多气者死。形气相得者生。三五不调者死。男子脉以弦长。
和滑为本。由胃脉壮实。资生脏腑之脉气。故寿无恙。如脉之来软弱无力者。为虚脉。紧牢有力者。为实。出此为虚。
入此为实。言者为虚。不言者为实。缓者为虚。急者为实。痒者为虚。痛者为实。外痛内快。为外实内虚。内痛外快者
为内实外虚邪气盛则实。精气脱则虚。凡人之脉盛。皮热腹胀。前后不通。闷瞀。此谓五实。脉细。皮寒气少。泄痢前
后。饮食不入。此谓五虚也。其五实五虚者。皆死候也。五实者。乃五脏之实也。五虚者。乃五脏之虚也。五实之所属
者。脉盛心也。皮热。肺也。腹胀。脾也。前后不通。肾也。心闷瞀。肝也。五虚之所属者。脉细。心也。皮寒。肺也。
气少。肝也。泄泻前后。肾也。饮食不入。脾也。此五实五虚之证也。既恶时。有生者何。虚者浆粥入胃。泄住而痢止。
则虚者活。实者身得汗。而胃膈宽。则实者生。平调病法也。
脉象。一呼之间脉搏跳动一次，称为离经（病情危重，偏离常度）。两呼之间脉搏跳动一次，称为夺精（精气耗损）。三呼之间脉搏跳动一次，称为困（正气困顿）。四呼之间脉搏跳动一次，称为命绝（生命终结）。
六部脉象轻取清扬和滑的，主姓名富贵、长寿健康强壮。重按感觉浑浊兼有粗涩感的，主地位卑贱、愚钝且命运不显达。
魂（对应木象。颜色青。旺于春季，绝于秋季。主管筋脉滋养。王候时脉弦，贼邪时脉浮。气味膻。死于庚辛日。体液为泪。声音为呼。音律属角。味道酸。性情喧闹。气机表现为呼气。不足则悲伤，有余则愤怒。）
神（对应火象。颜色赤。旺于夏季，绝于冬季。主管舌与血液滋养。王候时脉洪，贼邪时脉沉。气味焦。死于壬癸日。体液为汗。声音为唉。音律属徵。味道苦。性情暑热。气机表现为呵气。不足则忧愁，有余则唉叹。）
意（对应土象。颜色黄。旺于长夏，绝于春季。主管唇部与肌肉滋养。王候时脉缓，贼邪时脉弦。气味香。死于甲乙日。体液为涎。声音为歌。音律属宫。味道甘。性情安静。气机表现为呼气。不足则乏力少气，有余则胀满。）
魄（对应金象。颜色白。旺于秋季，绝于夏季。主管皮毛与鼻窍。王候时脉浮短，贼邪时脉洪大。气味腥。死于丙丁日。体液为涕。声音为哭。音律属商。味道辛。性情凉。气机表现为呻吟。不足则悲伤，有余则气喘咳嗽。）
志（对应水象。颜色黑。旺于冬季，绝于长夏。主管耳窍与骨骼滋养。王候时脉沉，贼邪时脉缓。气味腐。死于戊己日。体液为唾。声音为呻。音律属羽。味道咸。性情凛冽。气机表现为吸气。不足则厥逆，有余则肠泄。）
脉象一呼两次跳动，称为平和（正常脉象）。三呼一次跳动，称为离经。四呼一次跳动，称为夺精。五呼一次跳动，称为困。六呼一次跳动，称为绝命。
寸口脉多弦而尺中脉小弦，这样才知道是男子。尺中脉涌涌有力而寸口脉怯弱，请问这是不是女子？
诊脉要领：一静心定志。二忌杂念外扰。三均匀呼吸。四手指轻清置于皮肤间，以按察腑脉。五手指微重置于肌肉间，以求胃脉。六手指沉按至骨上，以取脏脉。七察看病人的息数变化，或者发现独迟、独疾等情况。认为“独迟”、“独疾”等是七诊的说法是不对的。如果说把“独热”、“独疾”当作两种脉象，那么“疾”本身就是六至以上的脉，其疾速之数，本来由内热所致，怎么能把“独疾”、“独热”当作两个独立的脉候呢？“迟”脉本来主寒，却说“独寒”、“独迟”是异体脉，完全不合义理。现在依据《灵枢经》中的七诊脉法，特别进行解释注解，这对于后学之人来说，如同解开束缚、摆脱艰难一样。
忽然左右手脉象大小有偏颇。男子左脉大、右脉小，则为顺；左脉小、右脉大，则为逆。
春肝脉如琴弦，似动条柔。夏脉如枝蔓，随风摇曳。（春弦，夏长。）
秋脉细如风高黄叶落，冬脉紧只因阳气消。（秋细，冬紧。）
春心脉浮浮似羽毛，夏脉大大日渐高。（春浮，夏大。）
秋脉洪遍野如流水，冬脉散还摧大墓牢。（秋洪，冬散。）
春脾脉初暖软绵绵，夏脉迟樱桃步向前。（春缓，夏迟。）
秋脉虚尺应泉下水，冬脉撒长流出九泉。（秋虚，冬长。）
春肺之脉正微微，夏脉短秋光火气低。（春微，夏短。）
秋脉浮金色然舒艳，冬脉涩入墓也无疑。（秋浮，冬涩。）
春肾脉濡弱水性旋，夏脉滑波涛浪近川。（春弱，夏滑。）
九月秋脉沉伏洞迟歇，十月冬脉黄河彻底坚。
忽然左右手脉象大小有偏颇者，女子右脉大、左脉小，为顺；右脉小、左脉大，为逆。
脉象如雀啄者（忽滴滴而不相连），如屋漏者（忽起时如数多也），如虾游者（时而复起寻如不没，反又起也），如鱼翔者（如鱼不行而掉尾，又身动而尾动，反又动入），如弹石者（来去时压压而急也），如解索者（动而数而随散，次须却结也）。
以上见到这六种脉象，至多十日死。
脉象每十动出现一次止歇，预示一年死亡，在草木枯黄时死。每二十动出现一次止歇，预示二年死亡，在桑椹变红时死。每三十动出现一次止歇，预示三年死亡，在谷雨时节死。每四十动出现一次止歇，预示四年死亡，在春草茂盛时死。每五十动出现一次止歇，预示五年内死亡。如果脉动数遇到这种脉象，但病人安卧且寿命长，则是无恙的表现。
脉象五十动不止，称为一息（一次呼吸周期）。肉得五至，闰以大息，主生寿。
脉象有气血的光泽。气血盛，则脉盛；气血衰，则脉衰。气血热，则脉数；气血寒，则脉迟。气血散，则脉弱；气血平，则脉缓。脉涩者，少血多气。脉滑者，少气多血。脉微细者，血气俱少。脉盛大者，血盛气反。
凡是脉微不可用吐法，脉虚细者不可用下法。人形盛而脉细，气少不足以息者死。形瘦而脉大，胸中多气者死。形气相得者生，三五不调者死。
男子脉以弦长、和滑为本，因为胃脉壮实，资生脏腑之脉气，故寿命长而无恙。如果脉来软弱无力，为虚脉；紧牢有力，为实脉。出此为虚，入此为实。言者为虚，不言者为实。缓者为虚，急者为实。痒者为虚，痛者为实。外痛内快，为外实内虚；内痛外快，为内实外虚。邪气盛则实，精气脱则虚。
凡人之脉盛，皮热，腹胀，前后不通，闷瞀，此谓五实。脉细，皮寒，气少，泄痢前后，饮食不入，此谓五虚也。这五实五虚，都是死候。五实者，乃五脏之实也。五虚者，乃五脏之虚也。五实之所属者：脉盛属心，皮热属肺，腹胀属脾，前后不通属肾，心闷瞀属肝。五虚之所属者：脉细属心，皮寒属肺，气少属肝，泄泻前后属肾，饮食不入属脾。这就是五实五虚的证候。既然如此凶恶，为何还有存活者？虚证者，若浆粥能入胃，泄住而痢止，则虚者活。实证者，若身体得汗，而胃膈宽畅，则实证者生。这是平调病情的法则。
Pulse. One beat per exhalation is called Li Jing (deviation from the normal, indicating critical illness). One beat per two exhalations is called Duo Jing (loss of essence). One beat per three exhalations is called Kun (exhaustion). One beat per four exhalations is called Ming Jue (death).
If the six pulses are light, clear, harmonious, and slippery when lightly pressed, it indicates nobility, wealth, longevity, health, and strength. If they feel turbid, coarse, and choppy when heavily pressed, it indicates low status, dullness, and lack of prominence.
Hun (Corresponds to Wood. Color: Green. Prosperous in Spring, Extinct in Autumn. Nourishes tendons. Normal pulse: Xian [Wiry]. Pathological pulse: Fu [Floating]. Odor: Musky. Death occurs on Geng/Xin days. Fluid: Tears. Sound: Shout. Pitch: Jue. Taste: Sour. Nature: Noisy. Qi movement: Exhalation. Deficiency leads to sorrow; excess leads to anger.)
Shen (Corresponds to Fire. Color: Red. Prosperous in Summer, Extinct in Winter. Governs tongue and blood nourishment. Normal pulse: Hong [Surging]. Pathological pulse: Chen [Deep]. Odor: Scorched. Death occurs on Ren/Gui days. Fluid: Sweat. Sound: Sigh. Pitch: Zhi. Taste: Bitter. Nature: Hot. Qi movement: Exhaling with sound. Deficiency leads to worry; excess leads to sighing.)
Yi (Corresponds to Earth. Color: Yellow. Prosperous in Late Summer, Extinct in Spring. Governs lips and flesh nourishment. Normal pulse: Huan [Moderate]. Pathological pulse: Xian [Wiry]. Odor: Fragrant. Death occurs on Jia/Yi days. Fluid: Saliva. Sound: Song. Pitch: Gong. Taste: Sweet. Nature: Quiet. Qi movement: Exhalation. Deficiency leads to fatigue and shortness of breath; excess leads to distension.)
Po (Corresponds to Metal. Color: White. Prosperous in Autumn, Extinct in Summer. Governs skin/hair and nasal orifices. Normal pulse: Fu Duan [Floating and Short]. Pathological pulse: Hong Da [Surging and Large]. Odor: Fishy. Death occurs on Bing/Ding days. Fluid: Nasal mucus. Sound: Cry. Pitch: Shang. Taste: Pungent. Nature: Cool. Qi movement: Moaning. Deficiency leads to sorrow; excess leads to asthma and cough.)
Zhi (Corresponds to Water. Color: Black. Prosperous in Winter, Extinct in Late Summer. Governs ears and bone nourishment. Normal pulse: Chen [Deep]. Pathological pulse: Huan [Moderate]. Odor: Rotten. Death occurs on Wu/Ji days. Fluid: Spittle. Sound: Moan. Pitch: Yu. Taste: Salty. Nature: Cold/Biting. Qi movement: Inhalation. Deficiency leads to Jue [cold extremities/fainting]; excess leads to intestinal diarrhea.)
Ming Men (Gate of Life) and San Jiao (Triple Burner) correspond to Kidney. Normal pulse: Chen [Deep]. Pathological pulse: Huan [Moderate]. Odor: Rotten. Death occurs on Wu/Ji days.]
One beat per two exhalations is called Ping He (Harmonious/Normal). Three beats per one exhalation is called Li Jing. Four beats per one exhalation is called Duo Jing. Five beats per one exhalation is called Kun. Six beats per one exhalation is called Jue Ming.
If the Cun Kou [Inch position] pulse is wiry and the Chi [Cubit position] pulse is small and wiry, this indicates a male. If the Chi pulse is surging and vigorous while the Cun pulse is weak, this indicates a female.
Diagnostic principles: 1. Calm the mind. 2. Avoid external distractions. 3. Regulate breathing. 4. Lightly press at the skin level to palpate the Fu organ pulses. 5. Press slightly heavier at the muscle level to seek the Stomach pulse. 6. Press deeply to the bone to obtain the Zang organ pulses. 7. Observe changes in the patient's respiration rate, such as isolated slowness or rapidity. The notion that "isolated slowness" or "isolated rapidity" constitutes separate diagnostic categories is incorrect. For instance, regarding "isolated heat" or "isolated rapidity," "rapid" itself refers to a pulse with more than six beats per cycle; its speed is inherently due to internal heat, so it cannot be treated as two separate pulse conditions. "Slowness" inherently governs cold; claiming "isolated cold" or "isolated slowness" as distinct entities contradicts logical principles. Here, we specifically annotate based on the Seven Diagnostics pulse method in the *Ling Shu* [Spiritual Pivot], thereby relieving confusion for future students.
Regarding sudden asymmetry between left and right hand pulses: In men, a larger left pulse and smaller right pulse is favorable (Shun); a smaller left pulse and larger right pulse is unfavorable (Ni).
Spring Liver pulse resembles a zither string, flexible and moving. Summer pulse resembles branches swaying in the wind. (Spring: Wiry; Summer: Long/Growing.)
Autumn pulse is fine/thin like yellow leaves falling in high wind; Winter pulse is tight because Yang Qi diminishes. (Autumn: Fine; Winter: Tight.)
Spring Heart pulse floats lightly like feathers; Summer pulse becomes large and rises daily. (Spring: Floating; Summer: Large.)
Autumn pulse is surging everywhere like flowing water; Winter pulse scatters like collapsing tombs. (Autumn: Surging; Winter: Scattered.)
Spring Spleen pulse is soft and mild like early warmth; Summer pulse is slow like a cherry blossom walking forward. (Spring: Moderate/Slow; Summer: Slow.)
Autumn pulse is empty/virtual at the Chi position like spring water; Winter pulse extends long like water flowing from deep springs. (Autumn: Empty; Winter: Long.)
Spring Lung pulse is faint/microscopic; Summer pulse is short with low fire energy in autumn light. (Spring: Faint; Summer: Short.)
Autumn pulse floats brightly like gold; Winter pulse is choppy and enters the tomb without doubt. (Autumn: Floating; Winter: Choppy.)
Spring Kidney pulse is soft and weak like rotating water; Summer pulse is slippery like waves near the river. (Spring: Weak; Summer: Slippery.)
Ninth month (Autumn) pulse sinks and lies hidden, slow and resting; Tenth month (Winter) pulse is solid throughout like the frozen Yellow River.
Regarding sudden asymmetry in left and right pulses: In women, a larger right pulse and smaller left pulse is favorable; a smaller right pulse and larger left pulse is unfavorable.
Pulse resembling a sparrow pecking (sudden drops, not continuous), resembling a leaking roof (sudden rises, irregular intervals), resembling a shrimp swimming (occasionally rising then disappearing, then rising again), resembling a fish gliding (fish not moving forward but wagging tail, body and tail moving alternately), resembling a stone being flicked (coming and going rapidly and forcefully), resembling a loosening rope (moving frequently then scattering, then knotting again).
Seeing any of these six pulses indicates death within ten days.
A pause after every ten beats indicates death within one year, occurring when grass withers. A pause after every twenty beats indicates death within two years, occurring when mulberries turn red. A pause after every thirty beats indicates death within three years, occurring during Grain Rain (Guyu). A pause after every forty beats indicates death within four years, occurring when spring grass is lush. A pause after every fifty beats indicates death within five years. However, if the pulse frequency encounters such pauses but the patient remains calm and lives long, there is no ailment.
Fifty beats without interruption constitute one respiratory cycle (Xi). Flesh receiving five beats, supplemented by a deep sigh, indicates longevity.
The pulse reflects the luster of Qi and Blood. Abundant Qi and Blood result in a full pulse; deficient Qi and Blood result in a weak pulse. Hot Qi and Blood result in a rapid pulse; cold Qi and Blood result in a slow pulse. Scattered Qi and Blood result in a weak pulse; balanced Qi and Blood result in a moderate pulse. A choppy pulse indicates less Blood and more Qi. A slippery pulse indicates less Qi and more Blood. A micro-fine pulse indicates deficiency of both Blood and Qi. A large-surge pulse indicates abundant Blood but relatively deficient Qi.
Generally, a micro pulse contraindicates emesis; a deficient-thin pulse contraindicates purgation. A robust physique with a thin pulse and insufficient breath indicates death. A thin physique with a large pulse and excessive chest Qi indicates death. When physique and Qi are harmonious, life prevails; when they are discordant (three-five mismatch), death ensues.
For men, the fundamental pulse should be Wiry-Long and Harmonious-Slippery, as a strong Stomach pulse nourishes the Qi of the Zang and Fu organs, ensuring longevity and health. A pulse coming softly and weakly is a Deficient pulse; a tight, firm, and forceful pulse is an Excess pulse. "Exiting" indicates Deficiency; "entering" indicates Excess. Speaking indicates Deficiency; silence indicates Excess. Slow indicates Deficiency; urgent indicates Excess. Itching indicates Deficiency; pain indicates Excess. External pain with internal comfort indicates External Excess and Internal Deficiency; internal pain with external comfort indicates Internal Excess and External Deficiency. Excess arises from pathogenic Qi abundance; Deficiency arises from vital Essence depletion.
When the pulse is full, accompanied by hot skin, abdominal distension, blockage of urination/defecation, and mental cloudiness/oppression, this is called Five Excesses. When the pulse is fine, accompanied by cold skin, shortness of breath, diarrhea/dysentery with urinary/blockage issues, and inability to eat, this is called Five Deficiencies. Both Five Excesses and Five Deficiencies are signs of impending death. Five Excesses refer to the Excess states of the Five Zang organs; Five Deficiencies refer to their Deficient states. Specifically: Full pulse belongs to Heart; hot skin belongs to Lung; abdominal distension belongs to Spleen; blockage of front/back (urination/defecation) belongs to Kidney; mental oppression belongs to Liver. Conversely: Fine pulse belongs to Heart; cold skin belongs to Lung; shortness of breath belongs to Liver; diarrhea/blockage belongs to Kidney; inability to eat belongs to Spleen. These are the patterns of Five Excesses and Five Deficiencies. Since these are ominous, how can survival occur? In Deficiency cases, if grain porridge enters the stomach and diarrhea/dysentery stops, the patient survives. In Excess cases, if the body sweats and the stomach/diaphragm feels relaxed, the patient survives. This is the method of balancing disease.