平按∶此篇自篇首至无劳用力也，见《灵枢》卷八第四十八《禁服》篇，又见《甲乙经》卷
四《经脉》第一上编。自雷公曰病之益甚至伤于食饮，见《灵枢》卷八第四十九《五色》篇，《甲
乙》同上。自一日一夜五十营至乍数乍疏也，见《灵枢》卷二第五《根结》篇，《甲乙》同上。
自黄帝曰气口何以独为五脏主气至治之无功矣，见《素问》卷三第十一《五藏别论》篇，又见《甲
乙》卷二《十二经脉络脉支别》第一下编。自凡刺之道至取之其经，见《灵枢》卷二第九《终始》
篇，又见《甲乙》卷五第五《针道终始》篇。自人迎一盛至命曰关格，又见《素问》卷三第九《六
节藏象论》篇。自黄帝问于岐伯曰人病胃管至故胃管为痈帝曰善，见《素问》卷十三第四十六《病
能论》篇，又见《甲乙》卷十一第八《邪气聚于下脘发内痈》篇。自安卧至末，
见《灵枢》卷十一第七十四《论疾诊尺》篇，又见《甲乙》卷十一第六《五气溢发消渴黄瘅》篇。
雷公问于黄帝曰∶细子得之受业，通九针六十篇，旦暮勤服之，近者编绝，远者简垢，然尚
讽诵弗置，未尽解于意矣。（南方来者，九针之道有六十篇，其简之书，远年者编有断绝，其近
年者简生尘垢，言其深妙，学久日勤，未能达其意也。平按∶远者《灵枢》作久者二字。近远二字，
据注宜互易。）外揣言浑束为一，未知其所谓也。（揣，初委反，度也。浑，户昆反，合也。束，总
要也。五脏六腑吉凶善恶，其气在内，循手太阴脉总合为一，见于寸口外部之中，可以手按度量，
令人得知者，未通其意也。）夫大则无外，小则无内，大小无极，高下无度，束之奈何？（经脉之
气，合天地之数，与道通洞，苞裹六合，故大无外也。气贯毫微，则小无内也。然则无形不可以大小
极，不可以高下测，欲以总为一者，殊不可知也。平按∶注与道通洞四字，袁刻脱。）士之才力
或有浓薄，知虑褊浅，不能博大深奥，自强于学未若细子，细子恐其散于后世，绝于子孙也，敢
问约之奈何？（褊，鞭缅反。人之所学，未若细子，惟恐其至道绝于后代，无及子孙，故问其要，
传之不朽也。细子者，雷公自谦之辞也。平按∶若上《灵枢》无未字。）黄帝答曰∶善乎哉问也！
此先师所禁坐私传之也，割臂歃血为盟也，子若欲得之，何不齐乎？（平按∶歃原作 ，恐传写之
讹，谨根据《灵枢》作歃。为盟《灵枢》作之盟，齐作斋，下同。）雷公再拜而起曰∶请闻命矣。于
是乃齐宿三日而请曰∶敢问今日正阳，细子愿以受盟。黄帝乃与俱入齐室，割臂歃血。黄帝祝曰∶
今日正阳，歃血传方，敢背此言者，必受其殃。雷公再拜曰∶细子受之。黄帝乃左握其手，右授
之书，曰∶慎之慎之，（上古贷季传至岐伯，岐伯授之黄帝，故贷季为先师也。非其人不可授道，
故须禁之坐私传也。方，要道。以盟誓授人。）吾为子言之。凡刺之理，经脉为始，（吾方愈病，
各为其要，圣人杂合行之，以针为轻小，能愈大疾，故先言之。人之十二经脉、奇经八脉、十五
络脉经络于身，营卫阴阳气之经坠，生之夭寿，莫不由之，故为始也。平按∶注坠字恐系隧字传
写之误。）营其所行，知其度量，（刺之理者，必须经营循十二经诸络脉等所行之气，并知脉之
长短度量也。平按∶注脉之长短，脉字袁刻误作肺。）内次五脏，别其六腑，（从于脏腑，流出
经脉行身外，故脏腑称内。知内之道，先次五脏内中之阴，次别六腑内中之阳也。平按∶注知内袁
刻误作知道。）审察卫气，为百病母，调其虚实，乃止泻其血络，血络尽而不殆。（次知卫气为
阳行外，受诸邪气以为百病，次欲知经络虚实，实者乃止而泻之，先泻大小血络，血邪尽已，得
无危殆也。平按∶虚实下《灵枢》重虚实二字。血络尽而不殆《灵枢》作血尽不殆矣。）雷公曰∶
此皆细子之所以通也，未知其所约也。黄帝曰∶夫约方者，犹约囊也，囊满不约则输泄，方成弗
约则神弗与俱。（约，节量也。方，法也。方以诊气，囊以盛气，故得比之。囊满不为节约，必泄
其气；诊法成已，不为节约，以泄神气。神气去矣，不与周运，故曰不俱也。）雷公曰∶愿为下材
者，勿满而约之。黄帝曰∶未满而知约之，以为工，不可以天下师焉。（摄生之道，材有上下。
诊法成已，节约合理，得长生久视，材德之上，可为天下之师；诊法未能善成，故曰未满而能节
而行，得为国师，是按脉而知病生所由，称之为工，材之不下也。平按∶《灵枢》天下上有为字。）
雷公曰∶愿闻为工。（为工是持脉之道，故问也。）黄帝曰∶寸口主中，按此《九卷》、《素问》
肺脏手太阴脉动于两手寸口中、
两手尺中。夫言口者，通气者也。寸口通于手太阴气，故曰寸口。气行之处，亦曰气口。寸口气口
更无异也。中，谓五脏，脏为阴也。五脏之气，循手太阴脉见于寸口，故寸口脉主于中也。人
迎主外，（结喉两箱，足阳明脉迎受五脏六腑之气以养于人，故曰人迎。下经曰∶人迎，胃脉也。
又云∶任脉之侧动脉，足阳明，名曰人迎。《明堂经》曰∶颈之大动脉，动应于手，挟结喉，以候
五脏之气。人迎胃脉，六腑之长，动在于外，候之知内，故曰主外。寸口居下，在于两手，以为
阴也；人迎在上，居喉两旁，以为阳也。《九卷·终始》篇曰∶平人者，不病也；不病者，脉口
人迎应四时也；应四时者，上下相应，俱往俱来也。脉口，谓是手太阴脉行气寸口，故寸口脉口
亦无异也。既上下俱往俱来，岂以二手为上下也。又《九卷·终始》篇云∶人迎与太阴脉口俱盛
四倍以上，命曰关格。即知手太阴无人迎也。又《素问》第五卷云胃管痈诊，岐伯曰∶当得胃脉
沉细，胃沉细者气逆，气逆者人迎甚盛，盛则热，人迎者胃脉也，逆盛则热聚于胃口而不行，故
胃管为痈。此经所言人迎寸口之处数十有余，竟无左手寸口以为人迎，右手关上以为寸口，而旧
来相承，与人诊脉，纵有小知，得之别注，人多以此致信，竟无根据，不可行也。平按∶注两胃
管，管字袁刻均误作营。）两者相应，俱往俱来，若引绳小大齐等，（寸口人迎两者，上下阴阳
虽异，同为一气，出则二脉俱往，入则二脉俱来，是二人共引一绳，彼牵而去，其绳并去，此引
而来，其绳并来，寸口人迎，因呼吸牵脉往来，其动是同，故曰齐等也。）春夏人迎微大，秋冬
寸口微大，如此者名曰平人。（譬彼引绳之动，大小齐等，细寻其动，非无小异，故此牵此动之
端为大，彼端微小，彼动之端为大，此端微小；脉亦如之，上下虽一，因呼吸而动，以春夏之阳，
秋冬之阴，故微有大小。春夏阳气盛实，故脉顺之，微大为平；秋冬阴气盛实，故脉顺之，微大为
平。平者，和气无病者也。平按∶注故
微有大小，袁刻脱微字。）人迎大一倍于寸口，病在少阳；人迎二倍，病在太阳；人迎三倍，病
在阳明。（计春夏人迎大于寸口少半已去，少阳即已有病，其病犹微，故未言之。成倍方言，以
病成可名，故曰病在少阳，言一倍等。按不病之人，寸口人迎脉动大小一种，春夏之时，人迎之
动微大寸口，以为平好。人迎之脉渐大小半、大半至于一倍，即知少阳有病。少阳盛气未大，故
得过阴一倍，名曰少阳之病，致使人迎之脉一倍大于寸口。少阳病气渐盛，过于阴气二倍，名曰
太阳之病，则人迎之脉二倍大于寸口。太阳病气渐盛，过于阴气三倍，名曰阳明之病，则人迎之
脉三倍大于寸口也。平按∶《灵枢》“病在少阳”作“病在足少阳，一倍而躁，在手少阳”，“病
在太阳”作“病在足太阳，二倍而躁，病在手太阳”，“病在阳明”作“病在足阳明，三倍而躁，
病在手阳明”。《甲乙》二倍作再倍。）盛则为热，（阳气内盛为热，故人迎脉盛也。）虚则为寒，
（阳气内虚，阴乘为寒，故人迎脉虚也。）紧则为痛痹，（其气动紧似急也。此肌肉之间有寒温
气，故为痛痹也。平按∶注寒温，温字根据下注寒湿气居，恐系湿字传写之讹。）代则乍甚乍间。
（代，止也。脉绝不来，故曰代也。代者，邪气客于血络之中，随饮食而变，故病乍甚乍间也。）
盛则泻之，（人迎一盛者泻于少阳，二盛泻于太阳，三盛泻于阳明也。）虚则补之，（人迎虚者，
人迎小于寸口也。小于寸口一倍补于少阳，二倍补于太阳，三倍补于阳明也。）紧痛则取之分肉，
（分肉之间，寒湿气居。）代则取血络且饮药，（邪在血络，致令脉代，可刺去邪血，饮汤实之。）
陷下则灸之，（谓其诸脉血气不满，陷下不见，是中寒，故须灸之。）不盛不虚，以经取之，名
曰经刺。（不盛不虚，正经自病也。假令心痛，中风得之，肝来乘心，从后而来，名为虚邪。饮
食劳倦，脾来乘心，从前来者，名为实邪。伤寒得之，肺来乘心，从所不胜来者，名曰微邪。中
湿得之，肾来乘心，从
所胜来者，名曰贼邪。以上四病，皆是他邪为之，须视心之虚实，补泻他经。伤暑得病，起于自
藏，以为正邪，宜疗自经，故曰以经取之，名曰经刺也。）人迎四倍者，且大且数，名曰外格，
死不治。（人迎三倍，各病一阳，至四倍，其阳独盛，外拒于阴，阴气不行，故曰格阳。格，拒
也。阳气独盛，故大而且数。以无阴气，独盛必衰，故死不疗。平按∶《灵枢》名曰下有“溢阳，
溢阳为”五字。）必审按其本末，察其寒热，以验其脏腑之病。（必须审按人迎寸口内外本末，
察其脉中寒暑，然后验知脏腑中之病也。）寸口大于人迎一倍，病在厥阴；寸口二倍，病在少阴；
寸口三倍，病在太阴。（秋冬寸口大于人迎少半已去，厥阴即已有病，其病犹微，故未言之。以
病成可名，故曰病在厥阴，言一倍等。按不病患，寸口人迎脉动大小一种，秋冬之时，寸口之动
微大人迎，以为平好。寸口之脉至于一倍，即知厥阴有病。厥阴之气衰少，故得过阳一倍，名曰厥
阴之病，致使寸口之脉一倍大于人迎。阴气虽少，得过阳气二倍，名曰少阴之病，则寸口之脉二
倍大于人迎。太阴最大，过于阳气三倍，名曰太阴之病，则寸口之脉三倍大于人迎也。平按∶《灵
枢》“病在厥阴”作“病在足厥阴，一倍而躁，在手心主”，“病在少阴”作“病在足少阴，二
倍而躁，在手少阴，”“病在太阴”作“病在足太阴，三倍而躁，在手太阴”。《甲乙》二倍
作再倍。又《甲乙》无“寸口三倍，病在太阴”八字。）盛则胀满、寒中、食不化，（寸口阴气大
于人迎三倍，病在太阴，太阴之病自有虚实，是以寸口阴盛，则腹中寒气胀满，有寒中食不化也。
平按∶寒中食不化《甲乙》作寒则食不消化。）虚则热中、出糜、少气、溺色变，（阴虚阳气来
乘，肠胃中热，故大便出强如黄糜。少阴气虚，故少气溺色黄也。平按∶注出强如黄糜袁刻作出
糜如黄疽。）紧则为痹，（风寒湿气，留于分肉间为痹，故令寸口脉紧实也。）代则乍痛
乍止。（寸口脉动而中止不还曰代。邪客分肉，致令卫气之行乍行乍止，故令其痛乍有乍止也。平
按∶《甲乙》作“代则乍寒乍热，下热上寒”，注云∶《太素》作代则乍痛乍止。）盛则泻之，虚
则补之，（下言疗方，盛泻之法，惟人迎可知也。）紧则先刺而后灸之，（紧有痹痛，先以痛为
输荥，针刺已，然后于其刺处灸之。平按∶注荥袁刻作营。刺处袁刻作刺后。）代则取血络而泄之，
（代则乍痛乍止，故刺去邪血之络也。平按∶而泄之《灵枢》作而后调之，《甲乙》同，注云∶
“《太素》作泄。”注乍痛袁刻误作乍病。）陷下则徒灸之。陷下者，脉血结于中，中有着血，
血寒故宜灸。（徒，空也。诸脉陷下不见，是脉中寒，血结聚，宜空灸之，不假先刺也。平按∶徒
灸《甲乙》作从灸。注血结袁刻作血倍，不假误作不复。）不盛不虚，以经取之。（准人迎可知也。）
寸口四倍，名曰内关。内关者，且大且数，死不治。（阴气三倍大于阳气，病在三阴，至于四倍，
阴气独盛，内皆闭塞，阳不得入，故为内关。关，闭也。寸口大而又数，即阴气将绝，故死不疗也。
平按∶内关袁刻误作内闲，注同，根据原本更正。）必察其本末之寒温，以验其脏腑之病，（必察
寸口人迎大小终始寒温，则知内外脏腑之病也。平按∶之寒温《甲乙》作察其寒热。）通其荥输，
乃可传于大数，大数日盛则徒泻，虚则徒补，（候知五脏六腑病之所在，先须针药通其荥输，然
后传于灸刺大数，谓空补泻之数也。平按∶《甲乙》大数日盛作大曰盛，虚上有小曰二字，两徒
字均作从。）紧则灸刺且饮药，（脉之紧者，三疗俱行。紧，谓动而中止。小数中有还者，曰结
也。）陷下则徒灸之，（准前人迎。平按∶《甲乙》徒作从。）不盛不虚，以经取之。所谓经治
【平按】：本篇从开头至“无劳用力也”这一段，见于《灵枢》卷八第四十八篇《禁服》，同时也见于《甲乙经》卷四《经脉》第一上编。从“雷公曰病之益甚”至“伤于食饮”，见于《灵枢》卷八第四十九篇《五色》，《甲乙经》同上。从“一日一夜五十营”至“乍数乍疏也”，见于《灵枢》卷二第五篇《根结》，《甲乙经》同上。从“黄帝曰气口何以独为五脏主气”至“治之无功矣”，见于《素问》卷三第十一篇《五藏别论》，同时也见于《甲乙经》卷二《十二经脉络脉支别》第一下编。从“凡刺之道”至“取之其经”，见于《灵枢》卷二第九篇《终始》，同时也见于《甲乙经》卷五第五篇《针道终始》。从“人迎一盛”至“命曰关格”，同时也见于《素问》卷三第九篇《六节藏象论》。从“黄帝问于岐伯曰人病胃管”至“故胃管为痈帝曰善”，见于《素问》卷十三第四十六篇《病能论》，同时也见于《甲乙经》卷十一第八篇《邪气聚于下脘发内痈》。从“安卧”至结尾，见于《灵枢》卷十一第七十四篇《论疾诊尺》，同时也见于《甲乙经》卷十一第六篇《五气溢发消渴黄瘅》。
雷公向黄帝问道：“学生我拜师受业，通晓了九针（古代九种针具及其理论）六十篇的内容，早晚勤奋修习，近的书籍竹简编绳已断，远的书籍竹简积满灰尘，然而仍然诵读不停，但对于其中的意旨尚未完全理解。”（注释：南方流传的九针之道有六十篇，那些古老的竹简书籍，年代久远的编绳已经断裂，年代较近的竹简上也生了尘垢，以此形容学问深奥微妙，学习日久勤勉，但未能透彻领悟其意旨。平按：此处“远者”在《灵枢》中作“久者”。根据注文，“近”与“远”二字应当互换。）“外揣（通过外部表现推测内部情况）说将万物浑合束为一统，但我还不知道它具体指什么。”（注释：揣，音初委反，意为度量。浑，音户昆反，意为合。束，意为总要。五脏六腑的吉凶善恶，其气机存在于体内，沿着手太阴肺经总合为一，显现于寸口脉的外部之中，可以通过手部按压来度量，从而让人知晓，但我对此尚不通晓其意旨。）“大道广大则无外，微小则无内，大小没有极限，高下没有尺度，如何将其约束统一呢？”（注释：经脉之气，契合天地的数理，与大道相通贯通，包裹六合宇宙，所以大无外。气贯穿毫毛细微之处，所以小无内。既然无形之气不可以用大小来穷尽，不可以用高下来测量，想要将其总括为一，实在难以知晓。平按：注文中“与道通洞”四字，袁刻本脱漏。）“士人的才力或许有厚薄之分，智识思虑或许狭隘浅显，不能达到博大深奥的境界，自我勉励求学也不如细子（雷公自谦之称），我担心这些道理会散失于后世，断绝于子孙，冒昧请问如何将其简约概括？”（注释：褊，音鞭缅反。人所学习的道理，不如细子深厚，唯恐至高之道断绝于后代，无法惠及子孙，所以询问其要领，以便传承不朽。细子是雷公自谦的称呼。平按：若参照《灵枢》，“未”字不存在。）
黄帝回答说：“问得好啊！这是先师禁止私下传授的，需要割臂歃血（割破手臂滴血入酒中盟誓）订立盟约。你如果想要得到它，何不斋戒呢？”（平按：原文“歃”字原作某字，恐怕是传写错误，谨根据《灵枢》改为“歃”。“为盟”在《灵枢》中作“之盟”，“齐”作“斋”，下同。）雷公再次叩拜起身说：“请听您的教诲。”于是斋戒宿夜三天后请求说：“冒昧请问今天是正阳之日，学生我愿意接受盟誓。”黄帝便与他一起进入斋室，割破手臂滴血盟誓。黄帝祝告说：“今天是正阳之日，滴血传授医方，敢违背此言的人，必定遭受灾殃。”雷公再次叩拜说：“学生我接受盟誓。”黄帝左手握住他的手，右手递给他书，说：“谨慎啊谨慎啊！”（注释：上古贷季传给岐伯，岐伯传给黄帝，所以贷季是先师。不是合适的人选不可传授大道，所以禁止私下传授。方，指要道。以盟誓的方式授人。）“我来为你讲述。凡是针刺的道理，以经脉为起始，”（注释：我的方法旨在治愈疾病，各有其要点，圣人综合施行各种疗法，因为针具轻便小巧，能治愈大病，所以首先讲述。人的十二经脉、奇经八脉、十五络脉经络遍布全身，营卫阴阳之气运行其中，决定生命的夭折与长寿，没有不与此相关的，所以以经脉为起始。平按：注文中“坠”字恐怕是“隧”字传写之误。）“经营其所运行的气血，知道其长短度量，”（注释：针刺的道理，必须经营遵循十二经及诸络脉等所运行的气血，并知道脉道的长短度量。平按：注文中“脉之长短”，“脉”字袁刻本误作“肺”。）“向内依次区分五脏，辨别其六腑，”（注释：从脏腑流出经脉行于身外，所以称脏腑为内。知晓内在的道理，先依次区分五脏内部的阴气，再辨别六腑内部的阳气。平按：注文中“知内”，“内”字袁刻本误作“道”。）“审察卫气，它是百病的根源，调理其虚实，然后泻除其血络，血络中的邪血排尽就不会有危险。”（注释：依次知晓卫气属阳行于体表，承受各种邪气成为百病的根源，接着想要知晓经络的虚实，实证则停止进补而进行泻法，先泻除大小血络，血中邪气排尽，便可得以免除危殆。平按：虚实之下，《灵枢》重复“虚实”二字。“血络尽而不殆”在《灵枢》中作“血尽不殆矣”。）
雷公说：“这些都是学生我所通晓的，但还不知道如何简约。”黄帝说：“简约方剂，就像约束口袋一样，口袋满了如果不约束就会泄漏，方剂形成了如果不简约，神气就不能与之俱存。”（注释：约，意为节量。方，意为法。方剂用来诊治气机，口袋用来盛装气，所以可以相比。口袋满了如果不加节约约束，必然泄漏其气；诊治方法形成后，如果不加节约约束，就会泄漏神气。神气离去，不与周运配合，所以说不能俱存。）雷公说：“愿意为下等材料的人，不要满溢而加以约束。”黄帝说：“未满而知晓如何约束，可以称为工匠，但不能作为天下的老师。”（注释：养生之道，人才有上下之分。诊治方法形成后，节约合理，得以长生久视，是才德之上，可以作为天下的老师；诊治方法未能善成，所以说未满而能节制而行，可以做国家的老师，这是通过按脉而知晓疾病产生的缘由，称之为工匠，是不差的人才。平按：《灵枢》中“天下”上有“为”字。）雷公说：“希望听闻如何成为工匠。”（注释：成为工匠是持脉的道理，所以询问。）
黄帝说：“寸口脉主要反映内脏疾病，”（注释：参考《九卷》、《素问》，肺脏手太阴脉动于两手寸口中、两手尺中。所谓“口”，是通气的地方。寸口通于手太阴肺气，所以叫寸口。气运行的地方，也叫气口。寸口和气口没有区别。中，指五脏，脏属阴。五脏之气，循着手太阴脉显现于寸口，所以寸口脉主要反映内脏情况。）“人迎脉主要反映外在疾病，”（注释：结喉两侧，足阳明胃脉迎受五脏六腑之气以滋养人体，所以叫人迎。下经说：人迎，是胃脉。又说：任脉侧面的动脉，足阳明经，名叫人迎。《明堂经》说：颈部的大动脉，跳动应手，夹着结喉，用以候察五脏之气。人迎是胃脉，六腑之长，跳动在于外部，候察外部可知晓内部，所以叫主外。寸口居下，位于两手，属阴；人迎在上，位于喉旁，属阳。《九卷·终始》篇说：平和的人，是不生病的；不生病的人，脉口和人迎应合四季变化；应合四季变化，就是上下相应，一同往来。脉口，是指手太阴脉行气于寸口，所以寸口脉口也没有区别。既然上下一同往来，怎么会以双手来分上下呢？又《九卷·终始》篇说：人迎和太阴脉口都盛大四倍以上，名叫关格。由此可知手太阴脉没有人迎。又《素问》第五卷讲胃管痈的诊断，岐伯说：应当得到胃脉沉细，胃脉沉细则气逆，气逆则人迎脉非常盛大，盛大则热，人迎是胃脉，气逆盛大则热气聚集于胃口而不行，所以胃管发生痈肿。这部经文所说的关于人迎、寸口的位置有数十处之多，竟然没有左手寸口作为人迎，右手关上作为寸口的说法，而旧来相传，给人诊脉，即使有一点小知，得到的也是别处的注解，人们大多因此相信，竟然没有根据，不可实行。平按：注文中两个“胃管”，“管”字袁刻本均误作“营”。）“两者相互呼应，一同往来，就像拉绳子一样大小整齐相等，”（注释：寸口和人迎两者，上下阴阳虽然不同，同属一气，出则二脉一同前往，入则二脉一同回来，就像两人共引一根绳子，那边牵去，绳子一并而去，这边引来，绳子一并而来，寸口和人迎，因呼吸牵引脉气往来，其运动是相同的，所以叫齐等。）“春夏季节人迎脉微大，秋冬季节寸口脉微大，像这样的人名叫平人（健康人）。”（注释：比如拉绳子的运动，大小整齐相等，仔细寻找其运动，并非完全没有微小差异，所以这一端牵动为大，那一端微小，那一端动为大，这一端微小；脉也是如此，上下虽一，因呼吸而动，由于春夏阳气盛实，秋冬阴气盛实，所以微有大小。春夏阳气盛实，所以脉顺应它，微大为平；秋冬阴气盛实，所以脉顺应它，微大为平。平，是和气无病的意思。平按：注文中“故微有大小”，袁刻本脱漏“微”字。）
“人迎脉比寸口大一倍，病在少阳；人迎大二倍，病在太阳；人迎大三倍，病在阳明。”（注释：考虑到春夏人迎比寸口稍大半以上时，少阳就已经有病，但病情还很轻微，所以没有提及。等到形成倍数时才说，因为病已成方可命名，所以说病在少阳，指一倍等。按：不生病的人，寸口和人迎脉动大小一致，春夏之时，人迎的脉动比寸口微大，视为正常良好。人迎的脉逐渐增大半倍、大半至一倍，就知道少阳有病。少阳盛气未到大极，所以超过阴气一倍，名叫少阳的病，致使人的迎脉一倍大于寸口。少阳病气渐盛，超过阴气二倍，名叫太阳的病，则人迎脉二倍大于寸口。太阳病气渐盛，超过阴气三倍，名叫阳明的病，则人迎脉三倍大于寸口。平按：《灵枢》中“病在少阳”作“病在足少阳，一倍而躁，在手少阳”，“病在太阳”作“病在足太阳，二倍而躁，病在手太阳”，“病在阳明”作“病在足阳明，三倍而躁，病在手阳明”。《甲乙经》中二倍作再倍。）“盛大则为热，”（注释：阳气内盛为热，所以人迎脉盛大。）“虚弱则为寒，”（注释：阳气内虚，阴气乘袭为寒，所以人迎脉虚弱。）“紧脉则为痛痹，”（注释：其气运动紧似急迫。这是肌肉之间有寒温之气，所以为痛痹。平按：注文中“寒温”，“温”字根据下文“寒湿气居”，恐怕是“湿”字传写之讹。）“代脉则病情忽轻忽重。”（注释：代，止也。脉气断绝不来，所以叫代。代脉，是邪气客居于血络之中，随着饮食而变化，所以病情忽轻忽重。）“盛大则用泻法，”（注释：人迎一盛者泻少阳，二盛泻太阳，三盛泻阳明。）“虚弱则用补法，”（注释：人迎虚者，是人迎小于寸口。小于寸口一倍补少阳，二倍补太阳，三倍补阳明。）“紧痛则在分肉间取穴，”（注释：分肉之间，寒湿气停留。）“代脉则刺血络并服药，”（注释：邪在血络，导致脉象代，可刺去邪血，喝汤药以充实正气。）“脉陷下则用灸法，”（注释：谓其诸脉血气不满，陷下不见，是中寒，所以需要灸法。）“不盛不虚，以本经取穴，名叫经刺。”（注释：不盛不虚，是正经自病。假令心痛，中风所致，肝气来乘心，从后而来，名叫虚邪。饮食劳倦，脾气来乘心，从前来者，名叫实邪。伤寒所致，肺气来乘心，从所不胜来者，名叫微邪。中湿所致，肾气来乘心，从所胜来者，名叫贼邪。以上四种病，都是他邪所致，须查看心的虚实，补泻他经。伤暑致病，起于自身脏腑，为正邪，宜治疗本经，所以说以经取穴，名叫经刺。）
“人迎大四倍者，且大且数，名叫外格，死症难治。”（注释：人迎三倍，各病一阳，至四倍，其阳独盛，外拒于阴，阴气不行，所以叫格阳。格，拒也。阳气独盛，所以大而且数。因为没有阴气，独盛必衰，所以死症难治。平按：《灵枢》“名曰”下有“溢阳，溢阳为”五字。）“必须审慎按其本末，察其寒热，以验证其脏腑之病。”（注释：必须审慎按察人迎寸口内外本末，察其脉中寒暑，然后验证知晓脏腑中之病。）
“寸口脉比人迎大一倍，病在厥阴；寸口大二倍，病在少阴；寸口大三倍，病在太阴。”（注释：秋冬寸口比人迎稍大半以上时，厥阴就已经有病，但病情还很轻微，所以没有提及。因为病已成方可命名，所以说病在厥阴，指一倍等。按：不生病的人，寸口和人迎脉动大小一致，秋冬之时，寸口的脉动比人迎微大，视为正常良好。寸口的脉至于一倍，就知道厥阴有病。厥阴之气衰少，所以超过阳气一倍，名叫厥阴的病，致使寸口脉一倍大于人迎。阴气虽少，超过阳气二倍，名叫少阴的病，则寸口脉二倍大于人迎。太阴最大，超过阳气三倍，名叫太阴的病，则寸口脉三倍大于人迎。平按：《灵枢》中“病在厥阴”作“病在足厥阴，一倍而躁，在手心主”，“病在少阴”作“病在足少阴，二倍而躁，在手少阴”，“病在太阴”作“病在足太阴，三倍而躁，在手太阴”。《甲乙经》中二倍作再倍。又《甲乙经》无“寸口三倍，病在太阴”八字。）“盛大则胀满、寒中、食物不消化，”（注释：寸口阴气大于人迎三倍，病在太阴，太阴的病自有虚实，所以寸口阴盛，则腹中寒气胀满，有寒中食物不消化的症状。平按：寒中食不化，《甲乙经》作寒则食不消化。）“虚弱则热中、大便出糜状物、少气、小便颜色改变，”（注释：阴虚阳气来乘，肠胃中热，所以大便排出强如黄糜状物。少阴气虚，所以少气、小便色黄。平按：注文中“出强如黄糜”，袁刻本作“出糜如黄疽”。）“紧脉则为痹证，”（注释：风寒湿气，留于分肉间为痹，所以令寸口脉紧实。）“代脉则疼痛忽有忽止。”（注释：寸口脉动而中止不还叫代。邪客分肉，导致卫气之行忽行忽止，所以令其痛忽有忽止。平按：《甲乙经》作“代则乍寒乍热，下热上寒”，注云：《太素》作“代则乍痛乍止”。）“盛大则用泻法，虚弱则用补法，”（注释：下面所说的疗方，盛泻之法，只有人迎脉可知晓。）“紧脉则先针刺后艾灸，”（注释：紧有痹痛，先以痛处为输荥穴，针刺后，然后在针刺处艾灸。平按：注文中“荥”，袁刻本作“营”。刺处，袁刻本作“刺后”。）“代脉则刺血络泄邪，”（注释：代则乍痛乍止，所以刺去邪血之络。平按：而泄之，《灵枢》作“而后调之”，《甲乙经》同，注云：“《太素》作泄。”注文中“乍痛”，袁刻本误作“乍病”。）“陷下则只用灸法。陷下者，脉血结于中，中有瘀血，血寒所以适宜灸法。”（注释：徒，空也。诸脉陷下不见，是脉中寒，血结聚，适宜空灸，不需要先刺。平按：徒灸，《甲乙经》作“从灸”。注文中“血结”，袁刻本作“血倍”，“不假”误作“不复”。）“不盛不虚，以本经取穴。”（注释：准照人迎脉可知晓。）
“寸口大四倍，名叫内关。内关者，且大且数，死症难治。”（注释：阴气三倍大于阳气，病在三阴，至于四倍，阴气独盛，内部皆闭塞，阳不得入，所以为内关。关，闭也。寸口大而又数，即阴气将绝，所以死症难治。平按：内关，袁刻本误作“内闲”，注同，根据原本更正。）“必须察其本末之寒温，以验证其脏腑之病，”（注释：必须察寸口人迎大小终始寒温，则知内外脏腑之病。平按：之寒温，《甲乙经》作“察其寒热”。）“通其荥穴输穴，才可以传授大的法则，大的法则说：盛则只用泻法，虚则只用补法，”（注释：候知五脏六腑病之所在，先须针药通其荥穴输穴，然后传授于灸刺大数，谓空补泻之数。平按：《甲乙经》“大数日盛”作“大曰盛”，“虚”上有“小曰”二字，两个“徒”字均作“从”。）“紧脉则灸刺并服药，”（注释：脉之紧者，三种疗法俱行。紧，谓动而中止。小数中有还者，叫结。）“陷下则只用灸法，”（注释：准照前人迎。平按：《甲乙经》“徒”作“从”。）“不盛不虚，以本经取穴。所谓经治……”
[Ping An]: This section, from the beginning of the chapter to "wu lao yong li ye" (no need for strenuous effort), is found in *Ling Shu* (Spiritual Pivot), Volume 8, Chapter 48, "Jin Fu" (Prohibitions and Services), and also in *Jia Yi Jing* (Classified Classic of Acupuncture and Moxibustion), Volume 4, "Jing Mai" (Meridians), Part 1, Upper Compilation. From "Lei Gong said: The disease worsens..." to "...injury from food and drink," it is found in *Ling Shu*, Volume 8, Chapter 49, "Wu Se" (Five Colors), and *Jia Yi Jing* is the same. From "One day and one night, fifty circuits..." to "...suddenly rapid and suddenly slow," it is found in *Ling Shu*, Volume 2, Chapter 5, "Gen Jie" (Roots and Knots), and *Jia Yi Jing* is the same. From "Huang Di asked: Why does the Qi Kou (Radial Pulse) alone serve as the master of the Five Zang Organs?" to "...treatment yields no merit," it is found in *Su Wen* (Basic Questions), Volume 3, Chapter 11, "Wu Zang Bie Lun" (Discussion on the Distinction of the Five Zang Organs), and also in *Jia Yi Jing*, Volume 2, "Shi Er Jing Luo Mai Zhi Bie" (Branches of the Twelve Meridians and Collaterals), Part 1, Lower Compilation. From "Fan ci zhi dao" (The general principle of acupuncture...) to "...take from its meridian," it is found in *Ling Shu*, Volume 2, Chapter 9, "Zhong Shi" (Beginning and End), and also in *Jia Yi Jing*, Volume 5, Chapter 5, "Zhen Dao Zhong Shi" (The Way of Needling: Beginning and End). From "Ren Ying yi sheng" (Ren Ying pulse one excess...) to "...called Guan Ge (Gate Closure)," it is also found in *Su Wen*, Volume 3, Chapter 9, "Liu Jie Zang Xiang Lun" (Discussion on the Six Jie and Viscera Manifestations). From "Huang Di asked Qi Bo: When a person suffers from stomach tube..." to "...thus the stomach tube becomes an abscess, the Emperor said 'Well done'," it is found in *Su Wen*, Volume 13, Chapter 46, "Bing Neng Lun" (Discussion on Disease Capabilities), and also in *Jia Yi Jing*, Volume 11, Chapter 8, "Xie Qi Ju Yu Xia Wan Fa Nei Yong" (Evil Qi Gathering in the Lower Stomach Causing Internal Abscess). From "An wo" (Resting and lying down) to the end, it is found in *Ling Shu*, Volume 11, Chapter 74, "Lun Ji Zhen Chi" (Discussion on Diagnosing Diseases by Measuring the Limbs), and also in *Jia Yi Jing*, Volume 11, Chapter 6, "Wu Qi Yi Fa Xiao Ke Huang Dan" (Overflow of Five Qi, Wasting-Thirst, and Jaundice).
Lei Gong asked Huang Di: "I, your humble student, have received instruction from you and mastered the sixty chapters of the Nine Needles. I study them diligently morning and evening; the bamboo slips of nearby books have broken binding cords, and those of distant books are covered in dust. Yet I continue to recite without ceasing, but I have not yet fully understood their meaning." (Note: The Nine Needles tradition from the South comprises sixty chapters. For ancient bamboo slip books, the bindings of older ones have broken, while newer ones gather dust, indicating the depth and subtlety of the learning, which requires long-term diligence but remains difficult to fully grasp. Ping An: In *Ling Shu*, "yuan zhe" (distant ones) is written as "jiu zhe" (long-time ones). According to the commentary, the characters "jin" (near) and "yuan" (distant) should be swapped.) "The concept of 'Wai Chuai' (inferring internal states from external signs) states that all things are integrated into one unity, but I do not know what this specifically refers to." (Note: Chuai, pronounced 'chu wei', means to measure or estimate. Hun, pronounced 'hu kun', means to combine. Shu means summary. The auspiciousness and malignancy of the Five Zang and Six Fu organs reside internally; their Qi integrates through the Hand Taiyin Lung Meridian into one manifestation at the Cun Kou (Radial Pulse) externally, where it can be palpated and measured to be known. However, I do not comprehend its intent.) "The Great has no outside, the Small has no inside; size has no limit, height and depth have no measure. How can they be bound together?" (Note: The Qi of the meridians aligns with the numbers of Heaven and Earth, connecting thoroughly with the Dao, encompassing the Six Directions, thus having no outside. Qi penetrates the finest hairs, thus having no inside. Since formless Qi cannot be exhausted by size or measured by height/depth, attempting to summarize it into one is indeed unknowable. Ping An: The four characters "yu dao tong dong" (connecting thoroughly with the Dao) are missing in the Yuan edition's commentary.) "Scholars' talents vary in thickness or thinness; their knowledge and thoughts may be narrow and shallow, unable to reach broad and profound depths. My self-discipline in study is inferior to yours, 'Xi Zi' (a humble term Lei Gong uses for himself). I fear these teachings will scatter in later generations and be cut off from my descendants. I dare to ask: How can they be simplified?" (Note: Bian, pronounced 'bian mian', means narrow. People's learning is not as deep as Xi Zi's; fearing the Supreme Dao will be lost to future generations and fail to benefit descendants, he asks for the essence to ensure immortality. 'Xi Zi' is Lei Gong's self-deprecating name. Ping An: Comparing with *Ling Shu*, the character 'wei' (not) is absent above.)
Huang Di replied: "Excellent question! This was prohibited by our predecessors from being passed on privately; it requires cutting arms and drinking blood to swear an oath. If you wish to receive it, why do you not purify yourself first?" (Ping An: The original text had a corrupted character for 'sha' (swallow/drink blood); corrected to 'sha' based on *Ling Shu*. 'Wei meng' in *Ling Shu* is 'zhi meng'; 'qi' is written as 'zhai' (fast/purify), same below.) Lei Gong bowed twice and rose, saying: "Please instruct me." He then fasted for three nights and requested: "Daring to ask, today is the day of pure Yang; I, your humble student, wish to accept the oath." Huang Di entered the purification room with him, cut his arm, and drank blood. Huang Di prayed: "Today is the day of pure Yang; we drink blood to transmit the prescription. Whoever dares to betray these words shall suffer disaster." Lei Gong bowed twice and said: "Your humble student accepts it." Huang Di held his left hand and gave him the book with his right, saying: "Be cautious, be cautious!" (Note: Dai Ji transmitted to Qi Bo in ancient times, and Qi Bo transmitted to Huang Di; thus Dai Ji is the predecessor. The Dao must not be taught to unworthy persons, hence the prohibition against private transmission. 'Fang' means essential principles. Transmitting via oath.) "I will explain to you. The principles of acupuncture begin with the meridians," (Note: My methods aim to cure diseases, each with its key points. Sages combine various therapies; since needles are light and small, capable of curing major ailments, I speak of them first. The twelve regular meridians, eight extraordinary vessels, and fifteen collaterals traverse the body. The movement of Ying, Wei, Yin, and Yang Qi determines life span and health, nothing escapes them, so they are the beginning. Ping An: The character 'zhui' (fall) in the note is likely a scribal error for 'sui' (tunnel/path).) "Manage the Qi flowing within them, and know their measurements," (Note: The principle of needling requires managing and following the Qi flowing through the twelve meridians and collaterals, and knowing the length and measurement of the pulses. Ping An: In the note, 'mai' (pulse) is erroneously printed as 'fei' (lung) in the Yuan edition.) "Internally, sequence the Five Zang organs, and distinguish the Six Fu organs," (Note: Meridians flow out from the Zang-Fu to the exterior, so Zang-Fu are called 'internal'. To understand the internal, first sequence the Yin of the Five Zang, then distinguish the Yang of the Six Fu. Ping An: In the note, 'zhi nei' (know internal) is erroneously printed as 'zhi dao' (know way) in the Yuan edition.) "Examine the Wei Qi (Defensive Qi), which is the mother of a hundred diseases; regulate their deficiency and excess, then drain the blood collaterals. Once the blood collaterals are cleared, there will be no danger." (Note: First understand that Wei Qi, being Yang and moving externally, receives various evil Qi to become the source of a hundred diseases. Then determine the deficiency/excess of the meridians. For excess, stop tonifying and apply draining methods, starting with major and minor blood collaterals. Once blood evil is exhausted, danger is avoided. Ping An: *Ling Shu* repeats 'xu shi' (deficiency/excess) after these terms. 'Xue luo jin er bu dai' in *Ling Shu* is 'xue jin bu dai yi'.)
Lei Gong said: "These are all things I understand, but I do not know how to simplify them." Huang Di said: "Simplifying a prescription is like tying a bag. If a bag is full and not tied, it leaks. If a prescription is formed but not simplified, the Shen (Spirit) will not accompany it." (Note: Yue means restraint/moderation. Fang means method. Prescriptions diagnose Qi, bags hold Qi, hence the comparison. A full bag untied will leak Qi; a diagnosis method unsimplified will leak Shen Qi. When Shen Qi departs, it does not circulate with the body, hence 'not accompanying'.) Lei Gong said: "For those of lower capacity, do not let it fill up before restraining it." Huang Di said: "If one knows how to restrain before the condition is full, one may be called a craftsman (Gong), but cannot serve as a teacher for the world." (Note: In the path of preserving life, talents vary. When diagnosis methods are complete and restrained reasonably, leading to long life, one is of superior virtue and talent, fit to be a teacher for the world. If diagnosis methods are not yet perfected, but one can restrain and act, one may serve as a state teacher, diagnosing disease origins via pulse. Such a person is called a 'Gong' (craftsman/doctor), representing talent that is not inferior. Ping An: *Ling Shu* adds the character 'wei' (to be) before 'tian xia' (the world).) Lei Gong said: "I wish to hear about becoming a Gong." (Note: Becoming a Gong relates to the art of pulse-taking, hence the question.)
Huang Di said: "Cun Kou (Radial Pulse) governs internal [conditions]," (Note: Referencing *Jiu Juan* and *Su Wen*, the Lung Meridian of Hand-Taiyin moves at the Cun Kou and Chi Kou of both hands. 'Kou' means passage for Qi. Cun Kou connects to Hand-Taiyin Qi, hence named Cun Kou. Where Qi flows, it is also called Qi Kou. Cun Kou and Qi Kou are identical. 'Zhong' refers to the Five Zang, which are Yin. The Qi of the Five Zang manifests at Cun Kou via the Hand-Taiyin meridian, so Cun Kou pulse governs the interior.) "Ren Ying (Carotid Pulse) governs external [conditions]," (Note: On both sides of the Adam's apple, the Foot-Yangming Stomach Meridian welcomes the Qi of the Five Zang and Six Fu to nourish the body, hence named Ren Ying. Lower classics say: Ren Ying is the Stomach Meridian. Also: The arterial pulse on the side of the Ren Mai, Foot-Yangming, is named Ren Ying. *Ming Tang Jing* says: The large artery in the neck, beating at the hand, flanking the Adam's apple, is used to observe the Qi of the Five Zang. Ren Ying is the Stomach Meridian, head of the Six Fu, beating externally; observing it reveals the interior, hence 'governs external'. Cun Kou is below, at the two hands, considered Yin; Ren Ying is above, at the throat sides, considered Yang. *Jiu Juan · Zhong Shi* says: A peaceful person is disease-free. Disease-free people have pulses at Mai Kou and Ren Ying corresponding to the Four Seasons. Corresponding to Four Seasons means upper and lower respond, coming and going together. Mai Kou refers to Hand-Taiyin Qi moving at Cun Kou, so Cun Kou Mai Kou are identical. If upper and lower come and go together, how can two hands define upper and lower? Also, *Jiu Juan · Zhong Shi* says: If Ren Ying and Taiyin Mai Kou are both excessive by four times, it is called Guan Ge. Thus, Hand-Taiyin has no Ren Ying. Also, *Su Wen* Vol 5 discusses stomach tube abscess diagnosis: Qi Bo said, the pulse should be Chen Xi (deep and fine). Chen Xi Stomach pulse indicates reversed Qi; reversed Qi makes Ren Ying very excessive; excessive means heat. Ren Ying is Stomach Meridian; reversed and excessive means heat gathers at the stomach opening and does not move, causing stomach tube abscess. This scripture mentions Ren Ying and Cun Kou locations dozens of times, yet never designates Left Hand Cun Kou as Ren Ying or Right Hand Guan Shang as Cun Kou. Traditional practice, even with slight knowledge, relies on other annotations, which people trust despite lacking basis, and thus should not be followed. Ping An: In the notes, both instances of 'wei guan' (stomach tube) have 'guan' erroneously printed as 'ying' in the Yuan edition.) "They correspond to each other, coming and going together, like pulling a rope with equal tension," (Note: Cun Kou and Ren Ying, though differing in upper/lower Yin/Yang, share one Qi. Upon exit, both pulses go; upon entry, both pulses return. It is like two people pulling one rope: if pulled away, the rope goes; if pulled back, the rope comes. Cun Kou and Ren Ying, driven by respiration, move together, hence 'equal'.) "In Spring and Summer, Ren Ying is slightly larger; in Autumn and Winter, Cun Kou is slightly larger. Such a person is called a Ping Ren (Healthy Person)." (Note: Like pulling a rope, tensions are equal, but subtle differences exist. One end pulls larger, the other smaller; vice versa. Pulses are similar: though one, they move with respiration. Due to abundant Yang Qi in Spring/Summer and Yin Qi in Autumn/Winter, there are slight size differences. Spring/Summer Yang abundance suits the pulse, making slight enlargement normal. Autumn/Winter Yin abundance suits the pulse, making slight enlargement normal. 'Ping' means harmonious Qi without disease. Ping An: The character 'wei' (slightly) is missing in the phrase 'gu wei you da xiao' in the Yuan edition's note.)
"If Ren Ying is one time larger than Cun Kou, the disease is in Shaoyang; two times larger, in Taiyang; three times larger, in Yangming." (Note: Considering Spring/Summer when Ren Ying is slightly larger than Cun Kou, Shaoyang disease already exists but is mild, hence not mentioned. Naming occurs when the disease forms, e.g., 'one time' implies Shaoyang disease. Normally, non-diseased persons have equal pulse sizes. In Spring/Summer, Ren Ying is slightly larger than Cun Kou, which is normal. As Ren Ying grows by half, then more, to one time, Shaoyang disease is indicated. Shaoyang Qi is not yet extreme, exceeding Yin by one time, named Shaoyang disease, making Ren Ying one time larger than Cun Kou. As Shaoyang disease Qi grows, exceeding Yin by two times, it is named Taiyang disease, making Ren Ying two times larger. As Taiyang disease Qi grows, exceeding Yin by three times, it is named Yangming disease, making Ren Ying three times larger. Ping An: *Ling Shu* writes 'disease in Foot-Shaoyang, one time and restless, in Hand-Shaoyang'; 'disease in Foot-Taiyang, two times and restless, in Hand-Taiyang'; 'disease in Foot-Yangming, three times and restless, in Hand-Yangming'. *Jia Yi Jing* writes 'two times' as 'zai bei' (again).) "Excess indicates Heat," (Note: Internal excess of Yang Qi causes Heat, hence Ren Ying pulse is excessive.) "Deficiency indicates Cold," (Note: Internal deficiency of Yang Qi allows Yin to invade, causing Cold, hence Ren Ying pulse is deficient.) "Tight pulse indicates Painful Bi (Obstruction)," (Note: The Qi movement is tight and urgent. Cold and warm Qi in muscles cause Painful Bi. Ping An: In the note, 'wen' (warm) is likely a scribal error for 'shi' (damp) based on the following note 'han shi qi ju' (cold and damp Qi reside).) "Intermittent pulse indicates symptoms fluctuating between severe and mild." (Note: Dai means stopping. Pulse cessation is called Dai. Dai pulse occurs when evil Qi lodges in blood collaterals, changing with diet, causing symptoms to fluctuate.) "Excess requires Draining," (Note: Ren Ying one excess drains Shaoyang; two excesses drain Taiyang; three excesses drain Yangming.) "Deficiency requires Tonifying," (Note: Ren Ying deficiency means Ren Ying is smaller than Cun Kou. One time smaller tonifies Shaoyang; two times smaller tonifies Taiyang; three times smaller tonifies Yangming.) "Tight pain requires selecting points in the muscle spaces," (Note: Cold and damp Qi reside in muscle spaces.) "Intermittent pulse requires draining blood collaterals and administering medicine," (Note: Evil in blood collaterals causes Dai pulse;刺 (puncture) to remove evil blood and drink decoctions to strengthen.) "Sunken/depressed pulse requires Moxibustion," (Note: When vessel Qi and Blood are insufficient and sunken/unseen, it indicates internal Cold, requiring moxibustion.) "Neither excess nor deficiency requires treating the affected meridian, called Jing Ci (Meridian Puncture)." (Note: Neither excess nor deficiency indicates direct disease of the proper meridian. E.g., Heart pain caused by Wind Stroke: Liver Qi attacking Heart from behind is Deficient Evil; Diet/Labor fatigue: Spleen Qi attacking Heart from front is Excess Evil; Cold Damage: Lung Qi attacking Heart from the overcoming cycle is Minor Evil; Dampness: Kidney Qi attacking Heart from the overcome cycle is Robber Evil. These four evils are external; check Heart's Xu/Shi and tonify/drains others. Summerheat disease originates from the organ itself, is Direct Evil, and should treat its own meridian, hence 'treat the meridian', called Jing Ci.)
"If Ren Ying is four times larger, both large and rapid, it is called Wai Ge (External Gate Closure), a fatal untreatable condition." (Note: At three times, each affects one Yang. At four times, Yang is exclusively excessive, rejecting Yin externally, blocking Yin Qi. 'Ge' means rejection. Exclusive Yang excess is large and rapid. Without Yin, exclusive excess leads to decline, hence fatal. Ping An: *Ling Shu* adds five characters after 'ming yue': 'Yi Yang, Yi Yang wei' (Overflowing Yang, Overflowing Yang is...).) "Must carefully examine its root and branch, observe Cold and Heat, to verify Zang-Fu diseases." (Note: Must carefully examine Ren Ying/Cun Kou internal/external roots/branches, observe Cold/Heat in pulses, then verify Zang-Fu diseases.)
"If Cun Kou is one time larger than Ren Ying, the disease is in Jueyin; two times larger, in Shaoyin; three times larger, in Taiyin." (Note: In Autumn/Winter, when Cun Kou is slightly larger than Ren Ying, Jueyin disease exists but is mild, hence not mentioned. Naming occurs when disease forms. Normally, non-diseased persons have equal pulses. In Autumn/Winter, Cun Kou is slightly larger than Ren Ying, which is normal. When Cun Kou reaches one time larger, Jueyin disease is indicated. Jueyin Qi is weak, exceeding Yang by one time, named Jueyin disease, making Cun Kou one time larger than Ren Ying. Though Yin is little, exceeding Yang by two times is named Shaoyin disease, making Cun Kou two times larger. Taiyin is largest, exceeding Yang by three times is named Taiyin disease, making Cun Kou three times larger. Ping An: *Ling Shu* writes 'disease in Foot-Jueyin, one time and restless, in Hand-Jueyin (Pericardium)'; 'disease in Foot-Shaoyin, two times and restless, in Hand-Shaoyin'; 'disease in Foot-Taiyin, three times and restless, in Hand-Taiyin'. *Jia Yi Jing* writes 'two times' as 'zai bei'. Also, *Jia Yi Jing* lacks the eight characters 'Cun Kou san bei, bing zai Taiyin'.) "Excess causes distension/fullness, Cold in the Middle, and indigestion," (Note: Cun Kou Yin Qi is three times larger than Ren Ying, disease in Taiyin. Taiyin disease has Xu/Shi. Cun Kou Yin excess causes abdominal cold distension, Cold in Middle, and indigestion. Ping An: 'Han zhong shi bu hua' in *Jia Yi Jing* is 'han ze shi bu xiao hua'.) "Deficiency causes Heat in the Middle, discharge of pus-like stool, shortness of breath, and change in urine color," (Note: Yin deficiency allows Yang to invade, causing Heat in intestines/stomach, leading to stool resembling yellow pus. Shaoyin Qi deficiency causes shortness of breath and yellow urine. Ping An: Note 'chu qiang ru huang mi' is erroneously printed as 'chu mi ru huang ju' in Yuan edition.) "Tight pulse indicates Bi syndrome," (Note: Wind-Cold-Damp Qi remaining in muscle spaces causes Bi, making Cun Kou pulse tight.) "Intermittent pulse indicates pain that starts and stops suddenly." (Note: Cun Kou pulse stops and does not return is called Dai. Evil in muscles causes Wei Qi movement to start and stop, hence pain fluctuates. Ping An: *Jia Yi Jing* writes 'Dai ze za han za re, xia re shang han' (Intermittent pulse brings alternating cold and heat, lower heat upper cold); note says: *Tai Su* writes 'Dai ze za tong za zhi'.) "Excess requires Draining, Deficiency requires Tonifying," (Note: Regarding treatment formulas below, the draining method for excess is known only via Ren Ying.) "Tight pulse requires needling first, then moxibustion," (Note: Tightness involves Bi-pain. First use the painful area as Ying-Shu point, needle, then moxa at the needle site. Ping An: Note 'ying' is erroneously printed as 'ying' (camp/nutrient) in Yuan edition. 'Ci chu' is erroneously printed as 'ci hou' (after needling).) "Intermittent pulse requires draining blood collaterals," (Note: Intermittent pulse causes sudden pain/stop, so puncture to remove evil blood collaterals. Ping An: 'Er xie zhi' in *Ling Shu* is 'er hou tiao zhi'; *Jia Yi Jing* same, note says: "*Tai Su* writes 'xie'". Note 'za tong' is erroneously printed as 'za bing' in Yuan edition.) "Sunken/depressed pulse requires moxibustion alone. Sunken/depressed means blood stasis in the vessels, with stagnant blood, cold blood, hence suitable for moxibustion." (Note: Tu means empty/alone. Vessels sunken/unseen indicate cold in vessels, blood stagnation, suitable for empty moxibustion without prior needling. Ping An: 'Tu jiu' in *Jia Yi Jing* is 'cong jiu'. Note 'xue jie' is erroneously printed as 'xue bei'; 'bu jia' erroneously printed as 'bu fu'.) "Neither excess nor deficiency requires treating the affected meridian." (Note: Follows Ren Ying logic.)
"If Cun Kou is four times larger, it is called Nei Guan (Internal Gate Closure). Nei Guan is both large and rapid, a fatal untreatable condition." (Note: Yin Qi three times larger than Yang, disease in Three Yin. At four times, Yin is exclusively excessive, closing internally, blocking Yang entry, hence Nei Guan. 'Guan' means closure. Cun Kou large and rapid indicates Yin Qi nearing extinction, hence fatal. Ping An: 'Nei Guan' is erroneously printed as 'Nei Xian' in Yuan edition, note same; corrected per original.) "Must observe the Cold/Warmth of root and branch to verify Zang-Fu diseases," (Note: Must observe Cun Kou/Ren Ying size/endings Cold/Warmth to know internal/external Zang-Fu diseases. Ping An: 'Zhi han wen' in *Jia Yi Jing* is 'cha qi han re'.) "Unblock their Ying and Shu points, then the great principles can be transmitted. The great principles say: Excess requires draining alone, Deficiency requires tonifying alone," (Note: Knowing the location of Zang-Fu diseases, first use needles/herbs to unblock Ying-Shu points, then transmit the great principles of moxa/needling, referring to empty tonification/draining counts. Ping An: *Jia Yi Jing* 'Da shu ri sheng' is 'Da yue sheng'; 'Xu' has 'Xiao yue' above; both 'tu' are 'cong'.) "Tight pulse requires moxa, needling, and medicine," (Note: For tight pulses, all three therapies apply. Tight means movement stops. Small number with return is called Jie (knotted).) "Sunken/depressed pulse requires moxibustion alone," (Note: Following previous Ren Ying. Ping An: *Jia Yi Jing* 'tu' is 'cong'.) "Neither excess nor deficiency requires treating the affected meridian. So-called Jing Zhi..."