肝脉来盈实而滑，如循长竿，曰肝病。（盈实而滑，弦之太过也。长竿无梢，则失其和缓之
意，此弦多胃少，故肝病。）
心脉来喘喘连属，其中微曲，曰心病。（喘喘连属，急数之象。其中微曲，则尚未至于全
曲，钩多胃少之象也。）
脾脉来实而盈数，如鸡举足，曰脾病。（实而盈数，如鸡之举足，虽不能如践地之和，亦不
至如鸟距之疾，弱多胃少之象也。）
肺脉来不上不下，如循鸡羽，曰肺病。（不上不下，涩之象也。如循鸡羽，浮之象也。毛多
胃少，肺金之病将见也。）
肾脉来如引葛，按之益坚，曰肾病。（引葛者，牵连引蔓之象也。按之益坚，则石多胃少，肾病将见也。）
肝脉来急益劲，如新张弓弦，曰肝死。（曰劲曰急，强急不和，比之新张弓弦，绝无胃气矣，安得不死。）
心脉来前曲后居，如操带钩，曰心死。（前曲者，轻举而坚大也。后居者，重按而牢实也。
操带钩者，状其弹指之象也。但钩无胃者，其死必矣。）
脾脉来锐坚如鸟之喙，如鸟之距，如屋之漏，如水之流，曰
脾死。（鸟喙者，状其硬也。鸟距者，状其急也。屋漏者，乱
也。水流者，散也。冲和之气全无，中州之官已绝矣。）
肺脉来如物之浮，如风吹毛，曰肺死。（如物之浮，则无根矣。如风吹毛，则散乱矣。但毛
无胃，则肺气绝矣。）
肾脉来发如夺索，辟辟如弹石，曰肾死。索而曰夺，则互引而疾急矣。石而曰弹，则
坚劲而无伦矣。但石无胃，故曰肾死。
【按】《难经·十五难》与《内经》不同，或
《内经》有而《难经》缺，或《难经》有而《内经》无。然《难经》本以《内经》为宗，不知
何以异同乃尔。学人惟当以《内经》为主，无多岐之惑也。
肝脉来势充盈坚实且滑利，如同触摸长竹竿，这是肝病的表现。（脉象充盈坚实而滑利，是弦脉太过亢盛的表现。长竹竿没有梢头，就失去了柔和舒缓的意蕴，这属于弦脉多而胃气少，所以判断为肝病。）
心脉来势急促连绵不断，其中略微弯曲，这是心脏病的表现。（脉象急促连绵，是急数的征象。其中略微弯曲，说明尚未达到完全弯曲的程度，这是钩脉多而胃气少的征象。）
脾脉来势坚实充盈且快速，如同鸡抬脚行走，这是脾脏病的表现。（脉象坚实充盈且快速，像鸡抬脚一样，虽然不能像脚踏地那样平和，但也还不至于像鸟爪那样疾速，这是弱脉多而胃气少的征象。）
肺脉来势不上不下，如同触摸鸡的羽毛，这是肺脏病的表现。（不上不下，是涩脉的征象。如同触摸鸡羽，是浮脉的征象。毛脉多而胃气少，预示肺金之病即将出现。）
肾脉来势如同牵引葛藤，按压时更加坚硬，这是肾脏病的表现。（所谓“引葛”，是牵连蔓延的征象。按压时更加坚硬，则是石脉多而胃气少，肾病即将出现的征象。）
肝脉来势紧急强劲，如同刚刚拉开的弓弦，这是肝的死证。（称为劲、称为急，表示强急不和，比作刚拉开的弓弦，完全没有胃气，怎么能不死呢。）
心脉来势前曲后直，如同拿着衣带上的钩子，这是心的死证。（前曲，指轻取时感觉坚硬盛大。后居，指重按时感觉牢靠实硬。操带钩，形容其弹指的征象。只有钩脉而没有胃气，死亡是必然的。）
脾脉来势尖锐坚硬，如同鸟嘴，如同鸟爪，如同屋顶漏雨，如同水流不止，这是脾的死证。（鸟嘴，形容其坚硬。鸟爪，形容其急迫。屋漏，形容其杂乱。水流，形容其散乱。冲和之气全无，中焦脾胃的功能已经断绝了。）
肺脉来势如同物体漂浮，如同风吹毛发，这是肺的死证。（如同物体漂浮，说明没有根基。如同风吹毛发，说明散乱无序。只有毛脉而没有胃气，肺气就已经断绝了。）
肾脉来势如同两人争夺绳索，又像石头敲击发出的辟辟声，这是肾的死证。“夺索”意味着互相牵引且疾速。“弹石”意味着坚硬强劲而无伦次。只有石脉而没有胃气，所以说是肾死。
【按语】《难经·十五难》与《内经》有所不同，有时《内经》有而《难经》缺，有时《难经》有而《内经》无。然而《难经》本以《内经》为宗旨，不知道为何会有这样的异同。学习的人应当以《内经》为主，以免产生多方面的困惑。
The Liver pulse arrives full, solid, and slippery, resembling the feeling of sliding along a long bamboo pole; this indicates Liver disease. (Full, solid, and slippery represents an excess of the Wiry [Xian] pulse. A long pole lacks a tip, thereby losing its harmonious and gentle quality; this signifies excessive Wiry characteristics with insufficient Stomach Qi, hence indicating Liver disease.)
The Heart pulse arrives rapid and continuous, with a slight curvature in the middle; this indicates Heart disease. (Rapid and continuous represents an image of urgency and frequency. The slight curvature indicates that it has not yet reached full curvature; this is an image of excessive Hook [Gou] characteristics with insufficient Stomach Qi.)
The Spleen pulse arrives solid, full, and rapid, resembling a chicken lifting its foot; this indicates Spleen disease. (Solid, full, and rapid, like a chicken lifting its foot, although it cannot match the harmony of feet touching the ground, it is not as swift as bird claws; this is an image of excessive Weak characteristics with insufficient Stomach Qi.)
The Lung pulse arrives neither rising nor falling, resembling the feeling of sliding along a chicken feather; this indicates Lung disease. (Neither rising nor falling is an image of the Choppy [Se] pulse. Resembling a chicken feather is an image of the Floating [Fu] pulse. Excessive Hair [Mao] characteristics with insufficient Stomach Qi suggest that a Lung Metal disease is about to manifest.)
The Kidney pulse arrives as if pulling on creeping vines, becoming harder upon pressure; this indicates Kidney disease. ("Pulling vines" refers to the image of entangled and spreading roots. Hardening upon pressure indicates excessive Stone [Shi] characteristics with insufficient Stomach Qi, suggesting that Kidney disease is imminent.)
The Liver pulse arrives urgent and vigorous, like a newly strung bowstring; this indicates a fatal condition of the Liver. (Described as vigorous and urgent, it is strong, rigid, and disharmonious, compared to a newly strung bowstring, completely lacking Stomach Qi; how can death not ensue?)
The Heart pulse arrives curving forward and remaining stationary backward, like handling a belt hook; this indicates a fatal condition of the Heart. ("Curving forward" means firm and large upon light palpation. "Remaining stationary backward" means secure and solid upon heavy palpation. "Handling a belt hook" describes the snapping sensation against the finger. If there is only the Hook characteristic without Stomach Qi, death is inevitable.)
The Spleen pulse arrives sharp and hard, like a bird's beak, like a bird's spur, like water leaking from a roof, like flowing water; this indicates a fatal condition of the Spleen. (Bird's beak describes hardness. Bird's spur describes urgency. Roof leak describes disorder. Flowing water describes dispersion. The harmonious Qi is entirely absent, and the official functions of the Central Earth have ceased.)
The Lung pulse arrives floating like an object, or like wind blowing hair; this indicates a fatal condition of the Lung. (Floating like an object indicates a lack of root. Like wind blowing hair indicates dispersion and chaos. If there is only the Hair characteristic without Stomach Qi, Lung Qi is exhausted.)
The Kidney pulse arrives like two parties struggling for a rope, or sounding like stones striking each other; this indicates a fatal condition of the Kidney. ("Struggling for a rope" implies mutual pulling and haste. "Striking stones" implies hardness and vigor without order. Since there is only the Stone characteristic without Stomach Qi, it is said to be a fatal condition of the Kidney.)
[Commentary] Chapter 15 of *Nan Jing* (Classic of Difficult Issues) differs from *Nei Jing* (Inner Canon). Sometimes *Nei Jing* contains content missing in *Nan Jing*, and vice versa. However, *Nan Jing* takes *Nei Jing* as its foundation; it is unclear why such discrepancies exist. Students should primarily rely on *Nei Jing* to avoid confusion arising from divergent interpretations.