九难曰∶何以别知脏腑之病耶？
然∶数者腑也，迟者脏也。数则为热，迟则为寒。诸阳为热，
诸阴为寒。故以别知脏腑之病也。
此分别脏腑之病也。人一呼一吸为一息，脉亦应之。一息之间脉四至，闰以太息脉五至，命
曰平人。平人者，不病之脉也，其有增减，则为病矣。一息三至曰迟，不及之脉也。一息六至
曰数，太过之脉也。脏为阴，腑为阳。脉数者属腑，为阳为热；脉迟者属脏，为阴为寒。又推
言所以数属腑，迟属脏之义，故曰诸阳为热，诸阴为寒也。然此但言其阴阳大概耳，未可泥也。
按∶腑病亦有迟脉，脏病亦有数脉，以迟数别脏腑，固不可执，而以迟数分寒热，亦有未尽
然者。夫迟为阴脉，医者一呼一吸，病者脉来三至，去来极慢者是也。迟脉为病，皆因内伤生
冷寒凉之物，外涉水冰阴寒之气，多中于脏，或中于腑，或入于腠理，以致气血稽迟不行，故
主阳气虚，气血凝滞，为阴盛阳衰之候。观其迟之微甚，而识寒之浅深，此道其常也。若迟而
有力更兼涩滞，举按皆然者，乃热邪壅结，隧道不利，失其常度，故脉反呈迟象。然未可造次，
必验之于证，如胸脘饱闷，便秘溺赤，方是主热之迟脉也。若景岳所云∶伤寒初解，遗热未清，
经脉未充，胃气未复，脉必迟滑，或见迟缓。河间云∶热盛自汗，吐利过极，则气液虚损，脉
亦迟而不能数，此又营气不足，复为热伤，不能运动热邪，反为所阻，失其转输之机，故缓慢
而行迟也。再迟而不流利为涩，迟而歇止为结，迟濡浮大且缓为虚，似是而非，尤当辨认也。
数脉为阳，医者一呼一吸，病者脉来六七至者是也。数脉主热，为病进，为阴不胜阳，故脉来
太过也。
然∶亦主寒者。若脉来浮数，大而无力，按之豁然而空，微细欲绝，此阴盛于下，逼
阳于上，虚阳浮露于外，而作身热面赤戴阳，故脉数软大无神也。丹溪云∶脉数盛大，按之涩
而外有热证，名中寒，乃寒流血脉，外证热而脉即数，亦此义也。越人只言其常，而未言其变，
经文简奥，如此等概略之言甚多，学人当细心领会，不可刻舟求剑也。
回答说：脉数（脉搏跳动快）的属于腑，脉迟（脉搏跳动慢）的属于脏。脉数表示有热证，脉迟表示有寒证。所有的阳经病变多表现为热，所有的阴经病变多表现为寒。因此通过脉象的迟与数来辨别和知晓脏腑的疾病。
这是区分脏腑疾病的方法。人一呼一吸称为一息，脉搏也随之相应。在一息之间，脉搏跳动四次，如果遇到深长的呼吸（太息），脉搏跳动五次，这被称为健康人（平人）。所谓健康人，是指没有疾病的脉象，如果脉搏次数有增减，那就是病了。一息脉搏跳动三次叫做迟脉，是不足的脉象。一息脉搏跳动六次叫做数脉，是过盛的脉象。脏属于阴，腑属于阳。脉数的归属于腑，属阳、属热；脉迟的归属于脏，属阴、属寒。这里又进一步推论了为什么数脉属于腑、迟脉属于脏的道理，所以说诸阳为热，诸阴为寒。然而这只是说明了阴阳的大致情况，不可拘泥固执。
按语：腑病也有出现迟脉的情况，脏病也有出现数脉的情况，仅凭迟数和数来区分脏腑固然不可执着，但仅凭迟数和数来划分寒热，也并不是完全准确的。迟脉属于阴脉，医生一呼一吸，病人脉搏来去三次，往来极慢的就是迟脉。迟脉所主的疾病，都是因为内伤生冷寒凉的食物，外感涉水冰阴寒之气，大多侵犯脏，或者侵犯腑，或者侵入腠理（皮肤纹理及肌肉间隙），导致气血运行迟缓停滞，所以主要主阳气虚弱，气血凝滞，是阴盛阳衰的证候。观察迟脉的程度轻重，从而认识寒邪的深浅，这是常理。如果迟脉而有力，更兼涩滞，举按都如此，那是热邪壅结，经络不通利，失去了常态，所以脉象反而呈现迟象。然而不可草率断定，必须结合症状验证，如胸脘部饱闷，便秘尿赤，这才是主热证的迟脉。如果像张景岳所说：伤寒初愈，余热未清，经脉未充盛，胃气未恢复，脉象必然迟滑，或见迟缓。刘河间说：热盛导致自汗，吐泻过度，导致气液虚损，脉象也会迟而不能数，这又是营气不足，又被热邪损伤，不能推动热邪运行，反而被热邪阻滞，失去了转输的机能，所以缓慢而行迟。再迟而不流利就是涩脉，迟而有间歇就是结脉，迟而濡软浮大且缓就是虚脉，似是而非，尤其应当仔细辨认。
数脉属于阳，医生一呼一吸，病人脉搏来去六七次的就是数脉。数脉主热，表示病情进展，是阴不能胜阳，所以脉搏来去太过。
回答说：数脉也主寒证。如果脉来浮数，大而无力，重按豁然空虚，微细欲绝，这是阴寒盛于下，逼迫阳气浮越于上，虚阳浮露于外，而出现身体发热、面色发红、戴阳（面赤如妆）的症状，所以脉象数而软大无神。朱丹溪说：脉象数而盛大，重按涩而外表有热证，名叫中寒，这是寒邪流入血脉，外表证候热而脉象即数，也是这个道理。扁鹊（越人）只说了常理，而没有说明变局，经文简奥，像这样概括性的言语很多，学习者应当细心领会，不可拘泥刻板。
Chapter 9 asks: How can one distinguish and know the diseases of the Zang (Solid) and Fu (Hollow) organs?
The response states: A rapid pulse (Shu Mai, fast pulse) indicates a Fu organ disease, while a slow pulse (Chi Mai, slow pulse) indicates a Zang organ disease. A rapid pulse signifies Heat, and a slow pulse signifies Cold. All Yang-related conditions manifest as Heat, and all Yin-related conditions manifest as Cold. Therefore, one distinguishes and knows Zang and Fu diseases through the slowness or rapidity of the pulse.
This section differentiates diseases of the Zang and Fu organs. One inhalation and exhalation constitute one "Xi" (respiration cycle), and the pulse corresponds to it. Within one Xi, the pulse beats four times; if accompanied by a deep sigh (Tai Xi), it beats five times. This is termed a "Ping Ren" (healthy person). A healthy person is defined by having a pulse without disease; any increase or decrease in frequency indicates pathology. Three beats per Xi is called Chi Mai (slow pulse), representing an insufficient pulse. Six beats per Xi is called Shu Mai (rapid pulse), representing an excessive pulse. The Zang organs belong to Yin, and the Fu organs belong to Yang. A rapid pulse belongs to the Fu organs, corresponding to Yang and Heat; a slow pulse belongs to the Zang organs, corresponding to Yin and Cold. Furthermore, it deduces the rationale for why rapid pulses belong to Fu organs and slow pulses to Zang organs, stating that all Yang relates to Heat and all Yin to Cold. However, this only describes the general principles of Yin and Yang and should not be applied rigidly.
Commentary: Fu organ diseases may also present with a slow pulse, and Zang organ diseases may also present with a rapid pulse. It is indeed inflexible to distinguish solely between Zang and Fu based on slowness or rapidity. Similarly, distinguishing Cold and Heat solely based on these two pulse qualities is not entirely accurate. The Chi Mai (slow pulse) is a Yin pulse. When the physician completes one respiration cycle and the patient's pulse beats three times, moving very slowly, this is the Chi Mai. Diseases associated with the Chi Mai are often caused by internal injury from consuming cold, raw, or cooling foods, or external exposure to icy, wet, and Yin-cold qi. These pathogens mostly affect the Zang organs, sometimes the Fu organs, or penetrate into the Cou Li (skin texture and interstitial spaces), causing Qi and Blood to stagnate and fail to circulate freely. Thus, it primarily indicates deficiency of Yang Qi, stagnation of Qi and Blood, and a pattern of Excess Yin and Deficient Yang. By observing the degree of slowness, one can discern the depth of the Cold pathogen; this is the normal rule. However, if the Chi Mai is forceful and additionally choppy (Se), feeling so upon both light and heavy pressure, it indicates Heat pathogen accumulation and obstruction of the meridians, deviating from the norm, thus presenting a seemingly slow pulse. One must not jump to conclusions but must verify with clinical signs. For instance, if there is fullness and oppression in the chest and epigastrium, constipation, and dark urine, then it is a Chi Mai indicating Heat. As Zhang Jingyue stated: After the initial resolution of Shang Han (Cold Damage), residual heat may remain unclarified, meridians may not yet be filled, and Stomach Qi may not have recovered; the pulse will necessarily be Chi-Hua (slow and slippery) or appear Chi-Huan (slow and moderate). Liu Hejian stated: Excessive sweating due to intense Heat, or extreme vomiting and diarrhea leading to depletion of Qi and Body Fluids, can result in a slow pulse that fails to become rapid. This occurs when Ying Qi (Nutritive Qi) is deficient and further damaged by Heat, unable to move the Heat pathogen, which instead obstructs it, losing its transport mechanism, thus resulting in a slow pulse. If the pulse is slow and not smooth, it is Se Mai (choppy pulse); if slow with intermittent pauses, it is Jie Mai (knotted pulse); if slow, soggy, floating, large, and moderate, it is Xu Mai (deficiency pulse). These are similar yet distinct, requiring careful differentiation.
The Shu Mai (rapid pulse) belongs to Yang. When the physician completes one respiration cycle and the patient's pulse beats six or seven times, this is the Shu Mai. The Shu Mai primarily indicates Heat, signifying disease progression, where Yin cannot overcome Yang, resulting in an excessive pulse rate.
The response adds: It can also indicate Cold. If the pulse is floating and rapid, large but forceless, and feels hollow upon deep pressure, being minute and nearly imperceptible, this indicates Yin-Cold excess at the lower body forcing Yang Qi to float upward. The deficient Yang floats outward, manifesting as feverish sensation, red face, and Dai Yang (floating false yang with facial flushing like makeup). Consequently, the pulse appears rapid, soft, large, and lacking spirit. Zhu Danxi stated: A pulse that is rapid and vigorous, yet choppy upon deep pressure, accompanied by external Heat symptoms, is named Zhong Han (internal Cold). This is because Cold flows into the blood vessels; although external symptoms show Heat, the pulse becomes rapid, following this same principle. Yue Ren (Bian Que) only discussed the normal patterns and did not address the variations. The classic texts are concise and profound, containing many such generalized statements. Students must comprehend them carefully and avoid applying them rigidly like marking a boat to find a lost sword.