六难曰∶脉有阴盛阳虚，阳盛阴虚，何谓也？
然∶浮之损小，沉之实大，故曰
阴盛阳虚。沉之损小，浮之实大，故曰阳盛阴虚。是阴阳虚实之意也。
浮沉者，下指轻重也；盛虚者，阴阳盈亏也。滑氏曰∶轻手取之而见损小，重手取之而见实大，
知其为阴盛阳虚也。重手取之而见损小，轻手取之而见实大，知其为阳盛阴虚也。大抵轻手取之阳之
分，重手取之阴之分，不拘何部，率以此推之。前四难论阴阳平脉而及于病脉，此节专论阴阳虚实，
太过不及之义，阴阳之法似同，而平病微甚各异，不可不察。徐氏谓上文属于阴，属于阳，平脉也。
恐不尽然。
七难曰∶经言少阳之至，乍大乍小，乍短乍长；阳明之至，浮大而短，太阳之至，洪大而长；
少阴之至，紧大而长；太阴之至，紧细而微，厥阴之至，沉短而敦。此六者，是平脉耶？将病脉也？
然∶皆王脉也。
洪脉似浮而大兼有力，举按之则泛泛然满三部，状如水之洪流，波之涌起，脉来大而鼓也。紧脉
带数如切绳，如转索，丹溪谓如纫线，譬如以二股三股纠合为绳，必旋绞而转，始得紧而成绳者是也。
细脉如线极细，三候不断不散者是也。微脉似有似无，浮软如散，重按之欲绝者
是也。上文言三阳三阴之旺脉，此言三阴三阳之旺时。至，言其气至而脉应之也。少阳之至，乍大乍小，乍短
乍长者，以少阳阳气尚微，离阴未远，故其脉无定也。阳明之至，浮大而短者，阳明阳气已盛，然尚未极，故
浮大而短也。太阳之至，洪大而长者，太阳之阳极盛，故洪大而长也。太阴之至，紧大而长者，太阴为阴之始，
故有紧象，而尚有长太阳脉也。少阴之至，紧细而微者，少阴之阴渐盛，故紧细而微也。厥阴之至，沉短而敦
者，敦，沉重貌，以厥阴阴之至，故沉短而敦，阴脉之极也。此六者，非本然之平脉，亦非有过之病脉，乃六
气应时而至之旺脉也。首称经言，即《素问·平人气象论》太阳脉至，洪大以长；少阳脉至，乍数乍疏，乍短
乍长；阳明脉至，浮大而短之义，引申而言之也。
其气以何月各王几日？
然∶冬至之后得甲子少阳王，复得甲子阳明王，复得甲子太阳王，复得甲子少阴王，
复得甲子太阴王，复得甲子厥阴王。王各六十日，六六三百六十日，以成一岁，此三阳三阴之王时日大要也。
古历以十一月甲子合朔冬至为历元。然岁周三百六十五日四分日之一，则日有零余，岁各有差，越人申
《素问·六节藏象论》之义，以六六之节成一岁。其自冬至之后得甲子，即是来年初之气分，为岁差之活法也。
其甲子或在小寒之初，或在大寒之初，以应乎少阳之气。少阳之阳，其阳尚微，复得甲子，应乎阳明。阳明则
阳已盛，复得甲子，应乎太阳。太阳则阳极盛，阳极则阴生而太阴用事，故复得甲子，应乎太阴。太阴之阴气
尚微，复得甲子，应乎少阴。少阴之阴已盛，复得甲子，应乎厥阴。厥阴则阴极盛，阴盛则阳生，如是无已，
此三阴三阳之旺
脉，随六甲之日数者如此。
按∶《归藏》商易，取用乎坤，而以十二辟卦，候一岁十二月消息，亦即乾坤二卦六爻之旁解
也。盖干之六阳，自十一月建子，冬至一阳始生，为地雷复卦，即干之初九爻。十二月建丑，
二阳生，为地泽临卦，即干九二爻。正月建寅，三阳生，为地天泰卦，即干九三爻。二月建卯，
四阳生，为雷天大壮卦，即干九四爻。三月建辰，五阳生，为泽天 卦，即干九五爻。至四月
建巳，六阳充足，而为干为天，即干之上九爻，此一年之乾卦也。五月建午，夏至一阴生，为
天风垢卦，即坤之初六爻。六月建未，二阴生，为天山 卦，即坤六二爻。七月建申，三阴生，
为天地否卦，即坤六三爻。八月建酉，四阴生，为风地观卦，即坤六四爻。九月建戌，五阴生，
为山地剥卦，即坤六五爻。至十月建亥，六阴纯静，而为坤为地，即坤之上六爻。此一年之坤
卦也。夫坤为万物之母，而能生物，然坤本纯阴，必待干与之交，而得其阳，然后始能生万物
也。十二支次序，世人皆以子为首，因坤临十月亥，坤为纯阴之卦，阴极则阳生，故十一月冬
至，一阳升于地上，为地雷复也。不知造化端倪，实不在子而在午。盖天地交而万物生，是干
坤交 之初，即为万物造端之始。然交必阳体充足而后能交，干之六阳，乃充足于四月之巳，
次为午，故干至五月建午，始与坤交，是则干足于巳而动于午，巳午皆火，故伏羲卦干居正南。
干之外体属火，干中含蓄阴精属金，故五行家言庚金长生在巳。所谓长生者、乃指其生之之原
而言也。干之初动于午，每年五月夏至之时，干上九之一阳，已升至天顶极高，不得不转而向
下，向下即感动坤阴之气上升而交，故天地三交，五月建午为第一交，六月未为第二交，七月
申为第三交，所谓坤三索于干也。乾坤交而谓之索者，以坤本纯阴，必索于干而后有阳，始能
生化也。干阳入坤而化为气，气生而为云为雨。盖十二辟卦，干位，巳火也；坤位，亥水也。
干与坤交，火入水中而化为气，以水为质，火为性也。人与天地参，试以一碗，人张口气呵之
则生水，故知气之形属水，而其所以能升腾行动者则火也。《爻辞》曰∶见群龙无首吉，言气
升能为云雨，故喻为龙，而干与坤三交，则干上四五之三爻尽入于坤，而干上爻巳火之首，早入
亥水之中，为育生胚胎之兆，故龙之无首吉也。此节言三阳三阴之六气，与《素问·六微旨》诸
论主气客气者有间。越人谓冬至复得甲子者，以冬至为地雷复，一阳始生之初，应少阳甲木春
升之气，而甲子为干支之首，六气莫不由之更改，故用以察一岁阴阳之气也。
六难说：脉象中有阴气盛而阳气虚，以及阳气盛而阴气虚的情况，这是什么意思呢？
回答说：轻取（浮取）时脉象细弱无力，重取（沉取）时脉象充实有力，这就叫做阴盛阳虚。重取（沉取）时脉象细弱无力，轻取（浮取）时脉象充实有力，这就叫做阳盛阴虚。这就是阴阳虚实的意思。
所谓“浮”和“沉”，是指下指力度的轻重；所谓“盛”和“虚”，是指阴阳的盈亏状态。滑寿（滑氏）说：轻手取脉若见细弱，重手取脉若见充实，可知是阴盛阳虚。重手取脉若见细弱，轻手取脉若见充实，可知是阳盛阴虚。大抵来说，轻手取脉对应阳分的状况，重手取脉对应阴分的状况，不论在哪一部脉，都大致依此推论。前四难讨论了阴阳平和之脉及病脉，这一节专门讨论阴阳的虚实，即太过与不及的含义。阴阳的道理看似相同，但平脉与病脉的细微差别却各不相同，不可不仔细考察。徐氏认为上文提到的属于阴、属于阳的是平脉，恐怕不完全正确。
七难说：医经中说少阳之气到来时，脉象忽大忽小，忽短忽长；阳明之气到来时，脉象浮大而短；太阳之气到来时，脉象洪大而长；少阴之气到来时，脉象紧大而长；太阴之气到来时，脉象紧细而微；厥阴之气到来时，脉象沉短而敦厚。这六种脉象，是平和之脉呢，还是病脉呢？
回答说：这都是当令旺盛的脉象（王脉）。
洪脉似浮且大兼有力量，举按之时感觉满布三部，形状像水的洪流，波浪涌起，脉来宏大且搏动有力。紧脉带有数象，如同切绳，如同转索，丹溪谓其如纫线，譬如将两股或三股绞合为绳，必须旋转绞合，才能成为紧而成绳的样子。细脉如线般极细，寸关尺三候不断不散。微脉似有似无，浮取软如散漫，重按之几乎断绝。上文论述了三阳三阴的旺脉，这里说的是三阴三阳的旺时。“至”，指的是气机到达而脉象相应。少阳之气到来，脉象忽大忽小，忽短忽长的原因，是因为少阳阳气尚微弱，离阴气不远，所以其脉象没有定势。阳明之气到来，脉象浮大而短的原因，是因为阳明阳气已盛，但尚未达到极点，所以脉象浮大而短。太阳之气到来，脉象洪大而长的原因，是因为太阳阳气极盛，所以脉象洪大而长。太阴之气到来，脉象紧大而长的原因，是因为太阴是阴气的开始，所以有紧象，且还保留着太阳脉的长象。少阴之气到来，脉象紧细而微的原因，是因为少阴的阴气逐渐旺盛，所以脉象紧细而微。厥阴之气到来，脉象沉短而敦厚的原因，“敦”意为沉重貌，因为厥阴是阴气的极致，所以脉象沉短而敦厚，这是阴脉的极端表现。这六种脉象，并非本然的平脉，也非有过之的病脉，而是六气应时而至的旺脉。开头称引“经言”，即《素问·平人气象论》中关于太阳脉至洪大以长，少阳脉至乍数乍疏乍短乍长，阳明脉至浮大而短的义理，加以引申阐述。
这些气在何月各当令几日？
回答说：冬至之后遇到甲子日，少阳当令；再遇到甲子日，阳明当令；再遇到甲子日，太阳当令；再遇到甲子日，少阴当令；再遇到甲子日，太阴当令；再遇到甲子日，厥阴当令。每一气当令六十日，六个六十日共三百六十日，构成一岁，这是三阴三阳当令时日的大要。
古代历法以十一月甲子合朔冬至作为历元。然而岁周天数为三百六十五日又四分之一日，因此每日有余数，每年都有差异。越人（扁鹊）阐发《素问·六节藏象论》的意义，以六个六十日的节律构成一岁。那从冬至之后得甲子，就是来年初之气分，这是应对岁差的一种灵活方法。那个甲子日或许在小寒之初，或许在大寒之初，以顺应少阳之气。少阳的阳气尚微弱，再得甲子，顺应阳明。阳明则阳气已盛，再得甲子，顺应太阳。太阳则阳气极盛，阳极则阴生而太阴主事，所以再得甲子，顺应太阴。太阴的阴气尚微弱，再得甲子，顺应少阴。少阴的阴气已盛，再得甲子，顺应厥阴。厥阴则阴气极盛，阴盛则阳生，如此循环不已，这三阴三阳的旺脉，随着六甲之日数的变化就是这样。
按语：《归藏》商易，取用乎坤卦，并以十二辟卦，预测一岁十二月的消息变化，这也是乾坤二卦六爻的旁通解释。大概乾卦的六阳，自十一月建子，冬至一阳始生，为地雷复卦，即乾之初九爻。十二月建丑，二阳生，为地泽临卦，即乾九二爻。正月建寅，三阳生，为地天泰卦，即乾九三爻。二月建卯，四阳生，为雷天大壮卦，即乾九四爻。三月建辰，五阳生，为泽天夬卦，即乾九五爻。至四月建巳，六阳充足，而为乾为天，即乾之上九爻，这是一年中的乾卦。五月建午，夏至一阴生，为天风姤卦，即坤之初六爻。六月建未，二阴生，为天山遁卦，即坤六二爻。七月建申，三阴生，为天地否卦，即坤六三爻。八月建酉，四阴生，为风地观卦，即坤六四爻。九月建戌，五阴生，为山地剥卦，即坤六五爻。至十月建亥，六阴纯静，而为坤为地，即坤之上六爻，这是一年中的坤卦。坤为万物之母，能生育万物，然而坤本是纯阴，必须等待与乾相交，从而获得阳，然后才能生育万物。十二地支的次序，世人皆以子为首，因为坤临十月亥，坤为纯阴之卦，阴极则阳生，所以十一月冬至，一阳升于地上，为地雷复。殊不知造化的端倪，实在不在子而在午。盖天地交而万物生，是乾坤交合之初，即为万物造端之始。然而交合必须阳体充足而后能交，乾的六阳，乃充足于四月之巳，其次为午，所以乾至五月建午，始与坤交，则是乾足于巳而动于午，巳午皆属火，所以伏羲卦象中乾居正南。乾之外体属火，乾中含蓄阴精属金，所以五行家说庚金长生在巳。所谓长生者，乃是指其生成的本源而言。乾之初动于午，每年五月夏至之时，乾上九之一阳，已升至天顶极高，不得不转而向下，向下即感动坤阴之气上升而交合，所以天地三交，五月建午为第一交，六月未为第二交，七月申为第三交，所谓坤三索于干也。乾坤交合而谓之索者，因为坤本是纯阴，必须索取于乾而后有阳，始能生化。乾阳入坤而化为气，气生而为云为雨。大概十二辟卦中，乾位对应巳火；坤位对应亥水。乾与坤交，火入水中而化为气，以水为质，火为性。人与天地参同，试以一碗为例，人张口呵气则生水，故知气的形属水，而其所以能升腾行动者则是火。《爻辞》说：“见群龙无首吉”，言气升能为云雨，故喻为龙，而乾与坤三交，则乾上四五之三爻尽入于坤，而乾上爻巳火之首，早入亥水之中，为育生胚胎之兆，故龙之无首吉。这一节论述三阳三阴的六气，与《素问·六微旨》诸论主气客气有所不同。越人说冬至后复得甲子，是以冬至为地雷复，一阳始生之初，应少阳甲木春升之气，而甲子为干支之首，六气莫不由之更改，故用以察一岁阴阳之气。
Chapter 6 states: There are pulse conditions of Yin excess and Yang deficiency, and Yang excess and Yin deficiency. What does this mean?
The response is: When palpated lightly (superficially), the pulse is thready and weak; when palpated heavily (deeply), it is full and forceful. This is called Yin excess and Yang deficiency. When palpated deeply, the pulse is thready and weak; when palpated superficially, it is full and forceful. This is called Yang excess and Yin deficiency. This illustrates the meaning of Yin/Yang and Deficiency/Excess.
"Superficial" and "Deep" refer to the lightness or heaviness of finger pressure; "Excess" and "Deficiency" refer to the surplus or deficit of Yin and Yang. Hua Shou (Hua Shi) stated: If light pressure reveals a thready and weak pulse, while heavy pressure reveals a full and large pulse, one knows it is Yin excess and Yang deficiency. If heavy pressure reveals a thready and weak pulse, while light pressure reveals a full and large pulse, one knows it is Yang excess and Yin deficiency. Generally speaking, light pressure corresponds to the Yang aspect, and heavy pressure corresponds to the Yin aspect. Regardless of the pulse position, this principle can be applied. The previous four chapters discussed balanced pulses and pathological pulses regarding Yin and Yang; this chapter specifically discusses the excess and deficiency of Yin and Yang, i.e., the concepts of excessiveness and insufficiency. Although the principles of Yin and Yang appear similar, there are subtle differences between balanced pulses and pathological pulses in terms of severity, which must not be overlooked. Xu believed that the aforementioned references to Yin and Yang referred to balanced pulses, but this may not be entirely accurate.
Chapter 7 states: The classics say that when Shaoyang Qi arrives, the pulse fluctuates between large and small, short and long; when Yangming Qi arrives, the pulse is floating, large, and short; when Taiyang Qi arrives, the pulse is surging, large, and long; when Shaoyin Qi arrives, the pulse is tight, large, and long; when Taiyin Qi arrives, the pulse is tight, fine, and minute; when Jueyin Qi arrives, the pulse is deep, short, and solid. Are these six types balanced pulses or pathological pulses?
The response is: They are all Wang pulses (pulses of the reigning season).
A Hong pulse (Surging Pulse) resembles a floating and large pulse with strength; upon lifting or pressing, it feels full across all three positions (cun, guan, chi), resembling a torrent of water or rising waves, coming in a large and vigorous manner. A Jin pulse (Tight Pulse) carries a rapid quality, feeling like cutting a rope or twisting a cord; Danxi described it as like threading a needle, akin to twisting two or three strands together to form a rope, requiring rotation to become tight and cord-like. A Xi pulse (Fine Pulse) is extremely thin like a thread, uninterrupted and undispersed across the three positions. A Wei pulse (Minute Pulse) seems present yet absent, floating softly as if scattered, nearly disappearing upon heavy pressure. The above text discussed the Wang pulses of the Three Yang and Three Yin meridians; here, it refers to the times when these Qi phases are dominant. "Arrival" means the Qi reaches its peak and the pulse responds accordingly. When Shaoyang Qi arrives, the pulse fluctuates because Shaoyang Yang Qi is still slight and close to Yin, hence its indeterminate nature. When Yangming Qi arrives, the pulse is floating, large, and short because Yangming Yang Qi is abundant but not yet at its extreme. When Taiyang Qi arrives, the pulse is surging, large, and long because Taiyang Yang Qi is at its peak abundance. When Taiyin Qi arrives, the pulse is tight, large, and long because Taiyin marks the beginning of Yin, thus showing tightness while retaining the length characteristic of Taiyang. When Shaoyin Qi arrives, the pulse is tight, fine, and minute because Shaoyin Yin Qi is gradually becoming abundant. When Jueyin Qi arrives, the pulse is deep, short, and solid ("Dun" means heavy/solid); since Jueyin represents the extremity of Yin, the pulse becomes deep, short, and solid, representing the extreme of Yin pulses. These six are neither inherent balanced pulses nor pathological pulses with excess; rather, they are Wang pulses corresponding to the arrival of the Six Qi according to the seasons. The opening reference to "the classics" extends the meaning from *Suwen: Ping Ren Qi Xiang Lun*, which describes Taiyang pulses as surging, large, and long; Shaoyang pulses as fluctuating in number/rarity, short/long; and Yangming pulses as floating, large, and short.
In which month does each Qi reign for how many days?
The response is: After the Winter Solstice, upon encountering a Jiazi day, Shaoyang reigns; upon the next Jiazi day, Yangming reigns; upon the next, Taiyang reigns; upon the next, Shaoyin reigns; upon the next, Taiyin reigns; upon the next, Jueyin reigns. Each phase reigns for sixty days. Six cycles of sixty days equal three hundred and sixty days, constituting one year. This is the general rule for the timing of the Three Yin and Three Yang reigns.
Ancient calendars used the conjunction of the first Jiazi day in the eleventh lunar month with the Winter Solstice as the calendar epoch. However, since a solar year is 365.25 days, there are fractional days remaining, causing annual variations. Bian Que (Yue Ren) elaborated on the meaning of *Suwen: Liu Jie Zang Xiang Lun* by using six cycles of sixty days to constitute a year. The Jiazi day following the Winter Solstice marks the beginning of the first Qi period of the coming year, serving as a flexible method to address calendar drift. This Jiazi day may fall at the beginning of Minor Cold or Major Cold, aligning with Shaoyang Qi. Shaoyang Yang is still slight; the subsequent Jiazi aligns with Yangming, where Yang is already abundant. The next Jiazi aligns with Taiyang, where Yang is at its peak. Peak Yang generates Yin, so Taiyin takes over; the next Jiazi aligns with Taiyin. Taiyin Yin is still slight; the next Jiazi aligns with Shaoyin. Shaoyin Yin is already abundant; the next Jiazi aligns with Jueyin. Jueyin Yin is at its peak; peak Yin generates Yang. This cycle continues endlessly. Thus, the Wang pulses of the Three Yin and Three Yang change according to the Jiazi days as follows.
Commentary: The *Guicang* (Book of Hidden Changes), an ancient Yi Jing variant, utilized the Kun hexagram and the Twelve辟 Hexagrams (Zodiac Hexagrams) to predict the waxing and waning of the twelve months in a year. This is also a lateral interpretation of the six lines of the Qian and Kun hexagrams. Specifically, Qian's six Yang lines begin with the eleventh month (Zi), Winter Solstice, when one Yang is born, forming the Fu Hexagram (Earth over Thunder), corresponding to the initial nine of Qian. In the twelfth month (Chou), two Yangs are born, forming Lin Hexagram (Earth over Lake), corresponding to the second nine of Qian. In the first month (Yin), three Yangs are born, forming Tai Hexagram (Earth over Heaven), corresponding to the third nine of Qian. In the second month (Mao), four Yangs are born, forming Dazhuang Hexagram (Thunder over Heaven), corresponding to the fourth nine of Qian. In the third month (Chen), five Yangs are born, forming Guai Hexagram (Lake over Heaven), corresponding to the fifth nine of Qian. By the fourth month (Si), six Yangs are complete, forming Qian Hexagram (Heaven over Heaven), corresponding to the top nine of Qian; this constitutes the Qian cycle of the year. In the fifth month (Wu), Summer Solstice brings one Yin, forming Gou Hexagram (Heaven over Wind), corresponding to the initial six of Kun. In the sixth month (Wei), two Yins are born, forming Dun Hexagram (Heaven over Mountain), corresponding to the second six of Kun. In the seventh month (Shen), three Yins are born, forming Pi Hexagram (Heaven over Earth), corresponding to the third six of Kun. In the eighth month (You), four Yins are born, forming Guan Hexagram (Wind over Earth), corresponding to the fourth six of Kun. In the ninth month (Xu), five Yins are born, forming Bo Hexagram (Mountain over Earth), corresponding to the fifth six of Kun. By the tenth month (Hai), six Yins are pure and quiet, forming Kun Hexagram (Earth over Earth), corresponding to the top six of Kun; this constitutes the Kun cycle of the year. Kun is the mother of all things and can generate them, but being purely Yin, it must interact with Qian to acquire Yang before it can generate.
Although people traditionally consider Zi as the start of the twelve branches, because Kun governs the tenth month (Hai) and is purely Yin, Yin extremity generates Yang, so at the Winter Solstice in the eleventh month, one Yang rises above ground, forming Fu. However, the true origin of creation lies not in Zi but in Wu. Heaven and Earth interact to generate all things; this interaction is the beginning. Interaction requires sufficient Yang; Qian's Yang is fully sufficient in the fourth month (Si) and moves in the fifth month (Wu). Thus, Qian interacts with Kun starting in the fifth month (Wu). Si and Wu belong to Fire, so in Fuxi's Bagua arrangement, Qian is located due South. Qian's outer body belongs to Fire, while its inner essence contains Yin belonging to Metal; hence, Five Elements theory states that Geng Metal is born in Si. "Birth" here refers to the source of generation. Qian's initial movement occurs in Wu. At the Summer Solstice in May, the single Yang line at the top of Qian has reached the highest point in the sky and must turn downward. This downward motion stirs Kun Yin to rise and interact. Thus, there are three interactions: the first in the fifth month (Wu), the second in the sixth month (Wei), and the third in the seventh month (Shen). This is described as Kun seeking Yang from Qian three times. "Seeking" implies that Kun, being purely Yin, must seek Yang from Qian to achieve transformation. Qian Yang enters Kun and transforms into Qi, which manifests as clouds and rain. In the Twelve Zodiac Hexagrams, Qian corresponds to Si Fire, and Kun corresponds to Hai Water. When Qian and Kun interact, Fire enters Water and transforms into Qi, with Water as substance and Fire as nature. Humans mirror heaven and earth: if one breathes onto a bowl, moisture forms. Thus, the form of Qi belongs to Water, but its ability to rise and move belongs to Fire. The *Yao Ci* says, "Seeing a group of dragons without a head is auspicious." This metaphorically describes Qi rising to form clouds and rain, likened to dragons. During the three interactions between Qian and Kun, the upper three lines of Qian enter Kun, and the head of Si Fire (top line of Qian) enters Hai Water, signifying the embryo of life. Hence, "dragons without a head" is auspicious. This section discusses the Six Qi of the Three Yin and Three Yang, which differs from the discussion of Principal and Guest Qi in *Suwen: Liu Wei Zhi*. Yue Ren stated that the Jiazi after Winter Solstice corresponds to Fu Hexagram, the beginning of one Yang, aligning with the ascending Qi of Shaoyang Jia Wood in spring. Since Jiazi is the first of the Sexagenary Cycle, all Six Qi changes derive from it, making it suitable for observing the Yin and Yang Qi of the year.