黄帝问岐伯曰。诊法常以平旦阴气未动。阳气未散。（诊法在旦凡有五要。故须旦以诊色脉肺气行至手太阴十
二经络所有善恶之气。皆集寸口。故曰未动未入。诸阳脉中。故曰。未散此为一也。）饮食未进。（进饮食已其气。
即行善恶散。而难知故曰。未进食此为二也。）经脉未盛。（未进饮食。故十二经气未盛。此为三也。）络脉调均。（以
经未盛。大络亦未盛。故络脉调均。此为四之也。）气血未乱。故乃可诊。（卫气营血相参。以行其道故名为乱。今
并未行即气血。未乱此为五也。平旦有斯五义。故取平旦。察色诊脉易知。善恶之也。）有过之脉。切脉动静。（营
卫将诸脉善恶行手太阴过寸口时。以手切按其脉动静。即知其善恶之也。）而视精明察五色。（视其面部及明堂脏腑
分肉精明天恶五色之别。）观五脏有输余不足。五府强弱形之盛衰。（五府谓头背腰膝髓。五府者也。以此切脉察色。
视知五脏气之虚实。五府气之强弱及身形盛衰之也。）以此参伍。决死生之分。（以此平旦切脉察色。知脏腑形气。
参伍商量以决人之死生之分之也。）夫脉者血之府。（以下切脉也。谷入于胃化而为血行于经脉以奉生身。故经脉以
为血之府之也。）长则气治短则气病。（寸口之中满九分者。为长八分七分为短也。）数则为烦心。（动疾曰数。）大
则病进。（洪盛曰大。）上盛则气高。（人迎脉不时盛。）下盛则气胀。（寸口脉不盛气胀充也。）代则气衰。（久而一
至为代。）滑则气少。（脉滑利故气少。）涩则心痛。（脉之动难为涩也。）浑浑单至如涌泉病进。（如涌泉上冲人手
也。）而绝弊弊绰绰其去如弦绝者死。（弊弊绰绰未详。脉来卒去。比之弦断。此为死候有本绝为化之也。）夫精明
五色者。气之华也。（次察色者也。五行之气变为精华之色。各见于面及明堂部。内明堂鼻之也。）赤欲如以帛裹。
朱不欲如赭也。白欲如白璧之泽。不欲如垩也。一曰白欲如鹅羽。不欲如 黄欲如罗裹。雄黄不欲如黄土也。黑欲
如重漆色。不欲如炭也。一曰如地。青欲如青。璧之泽不欲如蓝青也。（赭赤土也垩。白土阿洛反。）五色精微象见
矣。其寿不久。（精明五色微暗象见者。名曰色夭寿命不久之也。）夫精明者。所以视万物。别白黑。审短长。以长
为短。以白为黑。是精则衰矣。（万物精明。则黑白辨矣。若不精明。则黑白不分。是夭色也。）五脏者中之府也。
中盛满气伤恐音声如从室中言是中气之湿也。（次听声者也。六腑贮于水谷以为外腑。五脏藏于精神。故为中腑五
脏之气有余。盛满将有惊恐。有伤者乃是中气。得湿上冲胸嗌。故使声重如室中言也。）言而微终日乃复言者。此
夺气也。（言声微小又不用言者当是有所夺气。气少故尔也。）衣被不敛。言语善恶不避。亲疏者。此神明之乱也。
（是其阳明之气热盛为病心乱故其身不知所为其言不识善恶以其五神失守故也。）仓廪所藏是门户不恶也。（脾胃之
气失守。则仓廪不藏。以其咽口门户不自要约遂食于身不便之物也。）水泉不止是膀胱不藏也。（水泉小便也人之小
便不能自禁者以 胞不能藏约故遗尿不止也。）得守者生失守者死。（如前之病神明不乱得守者生。其神明乱失守者
死也之。）夫五脏身之强也。（五脏藏神。藏神为身主故是身之强也。）头者精明之府也。头惫视深精将夺矣。（头为一身
之天天有日月人之头有二目五脏之精皆成于目故人之头为精明府所以精明将夺力极头倾视深力意视也惫蒲介反。）背者
胸之府背曲肩随府将坏矣。（心肺二输在上当背太阳故背为胸府背曲肩随而乘胸臆将坏也之。）腰者肾之府转摇不能肾将
惫矣。（肾在腰脊之中故腰不随肾将惫矣惫病也。）膝者筋之府屈伸不能行则偻跗筋将惫矣。（身之大筋聚结于膝膝之屈
伸不能行则曲腰向跗皆是膝筋急缓故知筋将病也。）髓者骨之府也不能久立行则掉标骨将惫。（髓为骨液髓高则胫疼不能
久立行则掉标战动即知骨将病矣。）得强则生失强则死。（摄养前之五府得身强者为生失者为死也。）岐伯曰反四时者有
余为精不足为消。（上黄帝将问自说其义周备故岐伯言强之得失所以人虽失强反于四时得有余者则五脏精胜为生人之失
强得不足者则五脏消损为死。）应大过不足为精有余为消。（寸口人迎相过一倍以上为应大过也大过得气不足则五脏精胜
气过有余则热故五脏消损之也。）阴阳不相应病名曰关格。（人迎寸口四倍以上曰阴阳不相应不相应者阳气外格阴气内关
之病也。）诊血脉者多赤多热多HT 痛多多黑为久痹多赤多黑多青皆见寒热也身痛面色微黄齿垢黄爪甲上黄黄瘅。（血
脉者络脉也瘅音丹内黄病也。）诊目痛赤脉从上下者太阳病。（足太阳经从目内 上额故有赤脉从上下贯瞳子者太阳之络
令人目痛当疗太阳。）从下上者阳明病。（手足阳明之经并从鼻至目内 故有赤脉从下上者阳明之络令目有痛当疗阳明之
也。）从外走内者少阳病。（手足少阳经皆从目外来去于目锐 走于目内故有赤脉从外入目者少阳之络令目有痛当疗少
阳。）诊寒热赤脉从上下至瞳子见一脉一岁死见一脉半一岁半死见二脉二岁死见二脉半二岁半死见三脉三岁死。（赤脉从
上下者太阳之络也太阳络脉从上下至瞳子三脉一时至者至三年死乃至唯见一脉至一年死者三阳者太阳也太阳之气最大
故独见者至一年死二阳者阳明也。至阳明有二络见其气不大故二年死一阳者少阳也至少阳有三络见其阳气少故得三年死
也。）诊龋齿痛按其阳明之脉来有过者独热在左左热在右右热在上上热在下下热。（手阳明脉从左右手指上行入下齿中上
至于鼻足阳明脉从鼻下行入上齿中下至左右足指手足二阳明脉有病经所部过时独热者二脉一葙独偏热也手足阳明独热
在左葙者即左葙热也独热在右葙者即右葙热也得手阳明脉热即知下齿龋也足阳明左右得热准手阳明可知然得足阳明热
即知上齿龋也独热在头在左为上在足在右为下准手则足之左右可知龋者上下牙齿肿痛或出脓血此皆因热风气所致故得
热为候也据此正经两葙俱诊阳明即太阴两手俱有如何脾肺独出于右理必不然也。）婴儿病其头毛皆逆上者必死。（肾主于
血肾腑足太阳脉上头以荣头毛婴儿血衰将死故头毛逆上也。）耳间青脉起者螈痛。（耳间青脉足少阳胆脉也婴儿无病则络
陷有病则起起者螈痛之候也。）大便赤青辨食泄小者手足寒难已飧泄脉小手足温易已也。（婴儿大便所出青赤辨异者名曰
飧泄飧音孙脉小手足冷者飧泄难已脉小为顺手足温阳气荣四末故易已也。）黄帝问曰何以知怀子之且生也岐伯曰身有病
而无邪脉也。（以子在身故虽病其病之气不至于脉故无邪脉也。）黄帝问岐伯曰诊得心脉而急此为何病病形何如答曰病名
心疝少腹当有形曰何以言之曰心为牡脏小肠为之使故曰少腹当有形黄帝曰善。（诊得心脉心为阳也急为寒也寒气在心太
阳小肠故少腹有形形疝积者也。）黄帝曰诊得胃脉疝形何如岐伯曰胃脉实则胀虚则泄。（胃脉软弱为平今得胃气实脉即知
胃中胀满若得胃气虚脉即知泄利胃虚故脉虚也。）曰病成而变何如。（人病成极变为他病未知变作何病之也。）曰风成为
寒热。（风病在中成极变为诸寒热病也。）瘅成为消中。（瘅脾胃热也脾胃内热日久变为消中消中汤饮内消病也。）厥成为
癫疾。（阳明热厥成极上实下虚变为癫疾也。）久风为飧泄。（春伤于风在肠胃之间日久变为泄利之病。）贼风成为疠。（贼
风入腠不泄成极变为疠亦之谓大疾眉落鼻柱等坏之也。）病之变化不可胜数。（夫病变为他疾有斯五种若随心随物HT
衍多端不可胜数但可以智量处调之取中纵医方千卷未足以为当之也。）黄帝曰有病厥者诊右脉沉左脉不然病主安在岐伯
曰冬诊之右脉固当沉紧此应四时。（厥寒厥也左手不得沉紧得浮迟故曰不然也冬阴也右手亦阴也沉紧亦阴也冬时右手得
沉紧之脉固当顺四时也。）左浮而迟此逆四时在左当主病诊在肾颇在肺当腰痛。（左阳也浮肺脉也冬时得左手肺脉虚邪来
乘故肾病腰痛颇在于肺此即是左手有肺脉之也。）曰何以言之曰少阴脉贯肾上胃肓络肺今得肺脉肾为之病故肾为腰痛黄
帝曰善。（肾脉足少阴从肾上膈入肺中故冬时左手得肺脉肾为腰痛也。）厥阴有余病阴痹。（足厥阴肝脉也脉循股阴入毛
中环阴器上抵少腹故脉气有余者是其阴气盛故为阴痹者谓阴器中寒而痛。）不足病生热痹。（厥阴脉气虚者少阳来乘阴器
中热而痛也痹痛之也。）滑则狐疝风。（厥阴脉气滑者阳气盛微热以其气盛微热乘阴故为狐疝风也风气也狐夜不得尿日出
方得人之所病与狐同故曰狐疝一曰孤疝谓三焦孤腑为疝故曰孤疝也。）涩则病少腹积厥气也。（涩多血少气微寒以其厥阴
多血少气有寒故少腹中血积厥气也。）少阴有余病皮痹隐轸。（少阴足少阴肾脉也从足涌泉上贯肝入归中肺主皮毛故少阴
阴气有余病于皮痹又病皮中隐轸皮起风疾也。）不足病肾痹。（少阴之肺虚受寒湿之气入肾故为肾痹也。）滑则病肾风疝。
（少阴气虚太阳气乘微热故为肾风疝痛也。）涩则病积溲血。（气少微寒为血多为血积盛而 血。）太阴有余则病肉痹寒
中。（足太阴脾脉也主肉故太阴盛以为肉痹寒中也。）不足病脾痹。（太阴不足即脾虚受邪故为脾痹也。）滑则病脾风疝。
（得足太阴脉滑则是脾虚阳明气乘故脾病风疝之也。）涩则病积心腹时胀满。（得太阴脉涩即少气微寒多血故为血积太阴
脉注心中心腹时胀满也。）阳明有余病脉痹身时热。（胃足阳明脉正别上至脾入腹里属胃散而之脾上通于心故阳明有余不
足心有病也心主于脉是以阳明有余为脉痹身时之热者也。）不足病心痹。（阳明气虚不足太阴乘故为心痹。）滑则病心风
疝。（阳明气盛微热故心病风疝也。）涩则病积时善惊。（阳明气虚阴乘微寒血多为积积气时上冲心故喜惊之也。）太阴有
余病骨痹身重。（足太阳膀胱脉也足太阳脉气有余盛乘于少阴少阴主骨今少阴病名曰骨痹寒湿在骨故身重之也。）不足病
肾痹。（太阳虚而不足则少阴肾气使盛故为肾痹。）滑则为肾风疝。（太阳脉滑则阳盛微热乘肾肾病风疝之。）涩则病积善
时癫疾。（诊得太阳脉涩则少气微寒多血下为血积也善积气时上冲头则为癫疾之也。）少阳有余病筋痹胁满。（足少阳胆
脉也肝主筋也足少阳盛阴病故为筋痹肝病胁满也。）不足病肝痹。（阳虚阴盛故为肝痹也。）滑则病肝风疝。（得少阳滑者
则少阳气盛微热乘肝故肝病风疝也。）涩则病积时筋急目痛。（得少阳脉涩少阳气少微寒多血为积也足少阳脉起目锐 故
脉寒筋急目痛也。）
黄帝问岐伯说：诊脉通常选择在清晨进行，此时阴气尚未发动，阳气尚未耗散。（诊法在清晨有五个要点。因此需要选择清晨来诊察面色和脉象，因为肺气运行到手太阴肺经及十二经络，所有善恶之气都汇聚于寸口，所以说“未动”、“未入”。在诸阳脉中，所以说“未散”，这是第一点。）饮食尚未摄入。（进食后，谷气即行，善恶之气分散而难以知晓，所以说“未进食”，这是第二点。）经脉之气尚未旺盛。（因为未进饮食，所以十二经之气尚未旺盛，这是第三点。）络脉调和均匀。（因为经脉未盛，大络也未盛，所以络脉调和均匀，这是第四点。）气血尚未紊乱。（卫气和营血相互参合，以运行其道，所以称为乱。现在它们并未运行，即气血未乱，这是第五点。清晨具备这五种意义，所以选取清晨，观察面色、诊察脉象容易知晓善恶。）对于有异常的脉象，切按脉动的动静。（营卫将各种脉象的善恶运行到手太阴经过寸口时，用手切按其脉象的动静，就能知道其善恶。）同时观察眼睛的神采，辨别五色。（观察面部及明堂脏腑分肉的精微与天恶五色的区别。）观察五脏输穴的有余和不足，五府（头、背、腰、膝、髓）的强弱及形体的盛衰。（五府指头、背、腰、膝、髓，属于五府。通过切脉察色，视知五脏气的虚实，五府气的强弱以及身形盛衰的情况。）以此综合参伍，决断死生的界限。（以此在清晨切脉察色，了解脏腑形体之气，综合商量以决断人的死生界限。）脉，是血液汇聚的地方。（以下讲切脉。谷物进入胃中化生为血，运行于经脉中以奉养身体，所以经脉作为血的府库。）脉长则气机调畅，脉短则气机有病。（寸口中满九分的为长，八分为短。）脉数则为心烦。（跳动疾速称为数。）脉大则病势进展。（洪大盛壮称为大。）上部脉盛则气逆（人迎脉不时盛大）。下部脉盛则气胀（寸口脉不盛，气胀充也）。代脉则气衰。（久缓而至一次称为代。）滑脉则气少（脉滑利故气少）。涩脉则心痛（脉动艰难称为涩）。（浑浑沌沌单至，如涌泉上冲人手，病势进展。）若脉去弊弊绰绰，像弦断一样，主死。（弊弊绰绰含义不明。脉来突然离去，比之弦断，此为死候，有根本绝灭化为无的意思。）精明和五色，是气的精华。（其次察色。五行之气变为精华之色，分别见于面部及明堂部位，内明堂指鼻子。）赤色想要像白帛包裹朱砂那样润泽，不想要像赭石那样枯暗。白色想要像白璧那样光泽，不想要像垩土那样枯白。一说白色想要像鹅羽那样洁白，不想要像……黄色想要像罗裹雄黄那样润泽，不想要像黄土那样枯黄。黑色想要像重漆色那样黑亮，不想要像炭那样枯黑。一说像地色。青色想要像青璧那样光泽，不想要像蓝靛那样枯暗。（赭是赤土，垩是白土。）如果五色的精微之象显露出来，寿命就不长了。（精明五色微暗之象出现，名叫色夭，寿命不久。）精明，是用来观看万物，辨别黑白，审察长短的。如果把长看作短，把白看作黑，这就是精气衰退了。（万物看得精明，则黑白能分辨。如果不精明，则黑白不分，这是夭折之色。）五脏是中焦的府库。中焦气盛满，伤及惊恐，声音像从室中发出，这是中气有湿。（其次听声。六腑贮放水谷，作为外腑；五脏藏纳精神，所以为中腑。五脏之气有余，盛满将有惊恐，有伤者乃是中气，得湿邪上冲胸咽，所以使声音沉重像从室中说话一样。）说话声音微小，整天才说几句话，这是夺气。（言声微小又不愿多说话，应当是有所夺气，气少所以如此。）衣被不整理，言语善恶不分，不避亲疏，这是神明混乱。（这是阳明之气热盛为病，心乱所以身体不知所为，言语不识善恶，因为五神失守的缘故。）仓廪所藏之物不能固守，是门户不闭。（脾胃之气失守，则仓廪不藏，因为咽口门户不能自我约束，遂食于身上不便之物。）水泉不止，是膀胱不藏。（水泉指小便。人的小便不能自禁，因为胞不能藏约，所以遗尿不止。）能守住正气就生，失去守正就死。（如前所述，神明不乱，得守者生；神明乱，失守者死。）五脏是身体的强盛所在。（五脏藏神，藏神为身之主，所以是身体的强盛所在。）头是精明的府库。头倾视深，精气将被剥夺。（头是一身的天，天有日月，人的头有二目，五脏之精皆成于目，所以人的头为精明府。所以精明将夺，力极头倾，视深，力意视也。惫，蒲介反。）背是胸府的所在。背曲肩随，府将坏矣。（心肺二输在上当背太阳，故背为胸府。背曲肩随而乘胸臆，将坏也。）腰是肾的府库。转摇不能，肾将惫矣。（肾在腰脊之中，故腰不随，肾将惫矣。惫，病也。）膝是筋的府库。屈伸不能，行则偻跗，筋将惫矣。（身之大筋聚结于膝，膝的屈伸不能，行则曲腰向跗，皆是膝筋急缓，故知筋将病也。）髓是骨的府库。不能久立，行则掉标，骨将惫。（髓为骨液，髓高则胫疼，不能久立，行则掉标战动，即知骨将病矣。）得到强盛则生，失去强盛则死。（摄养前述的五府，得到身强者为生，失去者为死。）岐伯说：违背四时规律的，有余为精胜，不足为消损。（以上黄帝将要问，自己先说其义周备，所以岐伯说强的得失。所以人虽失强，反于四时，得有余者则五脏精胜为生；人之失强，得不足者则五脏消损为死。）应大过不足为精，有余为消。（寸口人迎相过一倍以上为应大过。大过得气不足则五脏精胜，气过有余则热，故五脏消损。）阴阳不相应，病名曰关格。（人迎寸口四倍以上叫阴阳不相应。不相应者是阳气外格，阴气内关的病。）诊血脉者，多赤多热，多痛多瘀，多多黑为久痹，多赤多黑多青皆见寒热也。身痛，面色微黄，齿垢黄，爪甲上黄，黄瘅。（血脉指络脉。瘅音丹，内黄病也。）诊目痛，赤脉从上下者，太阳病。（足太阳经从目内眦上额，故有赤脉从上下贯瞳子者，太阳之络令人目痛，当疗太阳。）从下上者，阳明病。（手足阳明之经并从鼻至目内眦，故有赤脉从下上者，阳明之络令目有痛，当疗阳明之也。）从外走内者，少阳病。（手足少阳经皆从目外来去于目锐眦，走于目内，故有赤脉从外入目者，少阳之络令目有痛，当疗少阳。）诊寒热，赤脉从上下至瞳子，见一脉一岁死，见一脉半一岁半死，见二脉二岁死，见二脉半二岁半死，见三脉三岁死。（赤脉从上下者，太阳之络也。太阳络脉从上下至瞳子，三脉一时至者，至三年死，乃至唯见一脉至一年死者。三阳者太阳也，太阳之气最大，故独见者至一年死。二阳者阳明也，至阳明有二络，见其气不大，故二年死。一阳者少阳也，至少阳有三络，见其阳气少，故得三年死也。）诊龋齿痛，按其阳明之脉，来有过者独热，在左左热，在右右热，在上上热，在下下热。（手阳明脉从左右手指上行入下齿中，上至于鼻；足阳明脉从鼻下行入上齿中，下至左右足指。手足二阳明脉有病，经所部过时独热者，二脉一厢独偏热也。手足阳明独热在左厢者即左厢热也，独热在右厢者即右厢热也。得手阳明脉热即知下齿龋也，足阳明左右得热准手阳明可知，然得足阳明热即知上齿龋也。独热在头在左为上，在足在右为下，准手则足之左右可知。龋者上下牙齿肿痛或出脓血，此皆因热风气所致，故得热为候也。据此正经两厢俱诊阳明即太阴，两手俱有，如何脾肺独出于右，理必不然也。）婴儿病，其头毛皆逆上者必死。（肾主于血，肾腑足太阳脉上头以荣头毛，婴儿血衰将死，故头毛逆上也。）耳间青脉起者，螈痛。（耳间青脉足少阳胆脉也。婴儿无病则络陷，有病则起，起者螈痛之候也。）大便赤青辨食泄小者，手足寒难已；飧泄脉小，手足温易已也。（婴儿大便所出青赤辨异者名曰飧泄，飧音孙。脉小手足冷者飧泄难已，脉小为顺，手足温阳气荣四末，故易已也。）黄帝问：何以知怀子之且生也？岐伯曰：身有病而无邪脉也。（以子在身，故虽病其病之气不至于脉，故无邪脉也。）黄帝问岐伯：诊得心脉而急，此为何病？病形何如？答曰：病名心疝，少腹当有形。曰：何以言之？曰：心为牡脏，小肠为之使，故曰少腹当有形。黄帝曰：善。（诊得心脉，心为阳也，急为寒也。寒气在心，太阳小肠，故少腹有形，形疝积者也。）黄帝曰：诊得胃脉，疝形何如？岐伯曰：胃脉实则胀，虚则泄。（胃脉软弱为平，今得胃气实脉即知胃中胀满，若得胃气虚脉即知泄利，胃虚故脉虚也。）曰：病成而变何如？（人病成极变为他病，未知变作何病之也。）曰：风成为寒热。（风病在中成极，变为诸寒热病也。）瘅成为消中。（瘅脾胃热也，脾胃内热日久变为消中，消中汤饮内消病也。）厥成为癫疾。（阳明热厥成极，上实下虚，变为癫疾也。）久风为飧泄。（春伤于风，在肠胃之间，日久变为泄利之病。）贼风成为疠。（贼风入腠不泄，成极变为疠，亦之谓大疾，眉落鼻柱等坏之也。）病之变化不可胜数。（夫病变为他疾有斯五种，若随心随物衍多端，不可胜数，但可以智量处调之取中，纵医方千卷未足以为当之也。）黄帝曰：有病厥者，诊右脉沉，左脉不然，病主安在？岐伯曰：冬诊之，右脉固当沉紧，此应四时。（厥寒厥也，左手不得沉紧，得浮迟故曰不然也。冬阴也，右手亦阴也，沉紧亦阴也，冬时右手得沉紧之脉固当顺四时也。）左浮而迟，此逆四时，在左当主病诊在肾，颇在肺，当腰痛。（左阳也，浮肺脉也。冬时得左手肺脉，虚邪来乘，故肾病腰痛，颇在于肺，此即是左手有肺脉之也。）曰：何以言之？曰：少阴脉贯肾上胃肓络肺，今得肺脉，肾为之病，故肾为腰痛。黄帝曰：善。（肾脉足少阴从肾上膈入肺中，故冬时左手得肺脉，肾为腰痛也。）厥阴有余病阴痹。（足厥阴肝脉也，脉循股阴入毛中环阴器，上抵少腹，故脉气有余者是其阴气盛，故为阴痹者谓阴器中寒而痛。）不足病生热痹。（厥阴脉气虚者，少阳来乘，阴器中热而痛也，痹痛之也。）滑则狐疝风。（厥阴脉气滑者，阳气盛微热，以其气盛微热乘阴，故为狐疝风也，风气也。狐夜不得尿，日出方得，人之所病与狐同，故曰狐疝。一曰孤疝，谓三焦孤腑为疝，故曰孤疝也。）涩则病少腹积厥气也。（涩多血少气微寒，以其厥阴多血少气有寒，故少腹中血积厥气也。）少阴有余病皮痹隐轸。（少阴足少阴肾脉也，从足涌泉上贯肝入归中肺，主皮毛，故少阴阴气有余病于皮痹，又病皮中隐轸，皮起风疾也。）不足病肾痹。（少阴之肺虚受寒湿之气入肾，故为肾痹也。）滑则病肾风疝。（少阴气虚，太阳气乘，微热，故为肾风疝痛也。）涩则病积溲血。（气少微寒为血多，为血积盛而 血。）太阴有余则病肉痹寒中。（足太阴脾脉也，主肉，故太阴盛以为肉痹寒中也。）不足病脾痹。（太阴不足即脾虚受邪，故为脾痹也。）滑则病脾风疝。（得足太阴脉滑则是脾虚，阳明气乘，故脾病风疝之也。）涩则病积心腹时胀满。（得太阴脉涩即少气微寒多血，故为血积，太阴脉注心中，心腹时胀满也。）阳明有余病脉痹身时热。（胃足阳明脉正别上至脾，入腹里属胃散而之脾，上通于心，故阳明有余不足心有病也。心主于脉，是以阳明有余为脉痹，身时之热者也。）不足病心痹。（阳明气虚不足，太阴乘，故为心痹。）滑则病心风疝。（阳明气盛微热，故心病风疝也。）涩则病积时善惊。（阳明气虚阴乘，微寒，血多为积，积气时上冲心，故喜惊之也。）太阴有余病骨痹身重。（足太阳膀胱脉也，足太阳脉气有余盛乘于少阴，少阴主骨，今少阴病名曰骨痹，寒湿在骨，故身重之也。）不足病肾痹。（太阳虚而不足，则少阴肾气使盛，故为肾痹。）滑则为肾风疝。（太阳脉滑则阳盛，微热乘肾，肾病风疝之。）涩则病积善时癫疾。（诊得太阳脉涩则少气微寒多血，下为血积也，善积气时上冲头，则为癫疾之也。）少阳有余病筋痹胁满。（足少阳胆脉也，肝主筋也，足少阳盛阴病，故为筋痹，肝病胁满也。）不足病肝痹。（阳虚阴盛，故为肝痹也。）滑则病肝风疝。（得少阳滑者则少阳气盛，微热乘肝，故肝病风疝也。）涩则病积时筋急目痛。（得少阳脉涩，少阳气少微寒，多血为积也。足少阳脉起目锐眦，故脉寒筋急目痛也。）
Huangdi asked Qibo, saying: Pulse diagnosis is usually performed at dawn, when the Yin qi has not yet moved and the Yang qi has not yet dispersed. (There are five requirements for pulse diagnosis at dawn. Therefore, it is necessary to diagnose complexion and pulse at dawn because Lung Qi travels to the Hand-Taiyin Lung Meridian and all twelve meridians; all good or evil Qi gathers at the Cun Kou (radial artery). Thus it is said "not moved" and "not entered". Among the Yang meridians, it is said "not dispersed"; this is the first point.) Food and drink have not been taken. (After eating and drinking, the Qi moves, and good or evil Qi scatters, making it difficult to know. Thus it is said "food not taken"; this is the second point.) The Qi of the main meridians is not yet vigorous. (Because food and drink have not been taken, the Qi of the twelve main meridians is not yet vigorous; this is the third point.) The collateral vessels are balanced. (Because the main meridians are not vigorous, the large collaterals are also not vigorous, so the collateral vessels are balanced; this is the fourth point.) The Blood and Qi are not yet chaotic. (Wei Qi (Defensive Qi) and Ying Qi (Nutritive Qi) interact to travel their pathways, hence called chaos. Now they have not traveled, meaning Blood and Qi are not chaotic; this is the fifth point. Dawn possesses these five meanings, hence dawn is chosen to observe complexion and diagnose pulse, making it easy to discern good or evil.) For abnormal pulses, palpate the movement and stillness of the pulse. (When Ying Qi and Wei Qi carry the good or evil of various meridians through the Hand-Taiyin passing the Cun Kou, palpating the pulse's movement and stillness with the hand reveals its nature.) Simultaneously, observe the spirit in the eyes and distinguish the Five Colors. (Observe the subtleties of the face and Ming Tang (nose), distinguishing the essence and the differences of the Five Colors.) Observe the excess and deficiency of the Shu points of the Zang organs, and the strength or weakness of the Five Fu (Head, Back, Waist, Knees, Marrow) along with the flourishing or decline of the physical form. (The Five Fu here refer to the Head, Back, Waist, Knees, and Marrow. By palpating the pulse and observing the complexion, one can know the deficiency or excess of Zang organ Qi, the strength or weakness of Fu organ Qi, and the flourishing or decline of the body shape.) Synthesize these observations to determine the boundary between life and death. (By palpating the pulse and observing the complexion at dawn, understanding the Qi of the Zang organs and physical form, and synthesizing them, one decides the boundary of life and death.) The pulse is the residence of Blood. (Below discusses pulse diagnosis. Grain enters the Stomach, transforms into Blood, and travels in the meridians to nourish the body; thus the meridians serve as the residence of Blood.) A long pulse indicates regulated Qi; a short pulse indicates diseased Qi. (A pulse filling nine fen at the Cun Kou is long; eight fen is short.) A rapid pulse indicates vexation in the Heart. (Rapid beating is called Rapid.) A large pulse indicates advancing disease. (Vigorous and full is called Large.) Excess in the upper part indicates Qi rebellion (Ren Ying pulse is occasionally excessive). Excess in the lower part indicates Qi distension (Cun Kou pulse is not excessive, but Qi is distended). A Choppy pulse indicates Qi decline. (Slow and arriving once per breath is called Choppy.) A Slippery pulse indicates deficient Qi (Slippery pulse implies deficient Qi). A Wiry pulse indicates Heart pain (Difficult pulsation is called Wiry). (Chaotic and single arrival, surging like a spring entering the hand, indicates advancing disease.) If the pulse departs abruptly and weakly, like a broken string, it indicates death. (The meaning of "abruptly and weakly" is unclear. The pulse arrives suddenly and departs, compared to a broken string; this is a sign of death, indicating the root is severed and transformed into nothingness.) The spirit and the Five Colors are the brilliance of Qi. (Next, observe the complexion. The Qi of the Five Elements transforms into the brilliant colors of the Five Colors, appearing on the face and Ming Tang area; internally, the Ming Tang refers to the nose.) Red should resemble white silk wrapping cinnabar, not ochre. White should resemble the luster of a white jade disc, not chalk. Alternatively, white should resemble goose feathers, not... Yellow should resemble yellow silk wrapping realgar, not yellow earth. Black should resemble heavy lacquer, not charcoal. Alternatively, like earth. Green should resemble the luster of a green jade disc, not indigo. (Ochre is red earth; chalk is white earth.) If the subtle images of the Five Colors appear, the lifespan will not be long. (If the subtle, dark images of the spirit and Five Colors appear, it is called "pale complexion," indicating a short lifespan.) The spirit is used to see all things, distinguish black from white, and judge length and shortness. To mistake long for short, or white for black, indicates that Jing (Essence) is declining. (To see all things clearly allows distinction between black and white. If not clear, black and white are indistinguishable, which is a sign of premature aging.) The Zang organs are the residences of the Middle Jiao. Excess Qi in the middle leads to fright, and the voice sounds as if coming from a room; this indicates dampness in the Middle Qi. (Next, listen to the voice. The Six Fu store water and grain, serving as external Fu; the Five Zang store spirit, serving as internal Fu. Excess Qi in the Zang organs leads to fright; damage to the Middle Qi combined with dampness rising to the chest and throat causes the voice to sound heavy, as if speaking from inside a room.) Speaking in a low voice, only speaking a few words throughout the day, indicates loss of Qi. (Low voice and unwillingness to speak indicate Qi loss; there is little Qi.) Not arranging clothes and bedding, speaking without distinguishing good from bad, and ignoring kinship and distance, indicates confusion of the Shen (Spirit). (This is due to excessive heat in the Yangming Qi causing Heart confusion; thus the body does not know what to do, and speech lacks discrimination of good and bad, because the Five Shen have lost their post.) The storage of the Granaries cannot be controlled, indicating the gate is not closed. (Loss of control of Spleen and Stomach Qi means the Granaries cannot store; the mouth/gate cannot self-restrain, leading to ingestion of inappropriate substances.) Unceasing flow of water springs indicates the Bladder cannot store. ("Water springs" refers to urine. Inability to control urination occurs because the Bladder cannot restrain, leading to continuous enuresis.) Those who maintain control live; those who lose control die. (As mentioned before, if the Shen is not confused and maintains control, one lives; if the Shen is confused and loses control, one dies.) The Zang organs are the strength of the body. (The Zang organs store Shen; storing Shen makes them the master of the body, hence the strength of the body.) The head is the residence of the spirit. Head drooping and deep-set eyes indicate that Jing is being depleted. (The head is the heaven of the body; heaven has sun and moon, human head has two eyes, and the essence of the five Zang organs forms in the eyes. Thus the head is the residence of the spirit. When Jing is depleted, strength fails, head droops, and eyes sink.) The back is the residence of the Chest. Back curvature and shoulder drooping indicate the residence is failing. (The Shu points of the Heart and Lungs are located on the upper back, corresponding to the Taiyang; thus the back is the residence of the Chest. Back curvature and shoulder drooping compress the chest, indicating failure.) The waist is the residence of the Kidney. Inability to turn or shake indicates the Kidney is failing. (The Kidney is in the lumbar spine; thus inability to move the waist indicates Kidney failure. "Failing" means sick.) The knees are the residence of the sinews. Inability to bend and extend, stooping when walking, indicates the sinews are failing. (Large sinews gather at the knees. Inability to bend and extend, stooping when walking, results from tendon tightness or laxity at the knees, indicating sinew disease.) Marrow is the residence of the bones. Inability to stand for long periods, trembling when walking, indicates the bones are failing. (Marrow is the fluid of bone. High marrow levels cause shin pain, inability to stand long, and trembling when walking, indicating bone disease.) Gaining strength leads to life; losing strength leads to death. (Nourishing the aforementioned five residences and gaining bodily strength leads to life; losing them leads to death.) Qibo said: Violating the Four Seasons, excess indicates Jing victory, while deficiency indicates consumption. (Above, Huangdi was about to ask, but stated the meaning comprehensively himself. Thus Qibo speaks of gain and loss of strength. Even if one loses strength, violating the Four Seasons, having excess means the Five Zang Jing wins and leads to life; losing strength and having deficiency means the Five Zang are consumed and leads to death.) Responding to excessive deficiency indicates Jing victory; excess indicates consumption. (When Ren Ying and Cun Kou differ by more than one fold, it is called "Responding to Excessive Difference." If Qi is insufficient despite the difference, the Five Zang Jing wins; if Qi is excessive, it generates heat, consuming the Five Zang.) If Yin and Yang do not correspond, the disease is named Guan Ge (Closure and Obstruction). (When Ren Ying and Cun Kou differ by four times or more, it is called "Yin and Yang do not correspond." Non-correspondence means Yang Qi is obstructed externally and Yin Qi is closed internally.) Diagnosing blood vessels: many red indicates heat; many pain indicates stasis; many black indicates chronic Bi syndrome; many red, black, and green together indicate alternating cold and heat. Body pain, slightly yellow complexion, yellow dental plaque, yellow nails indicate Huang Dan (Jaundice). ("Blood vessels" refers to collaterals. Dan sounds like 'dan', an internal yellow disease.) Diagnosing eye pain: red vessels moving from top to bottom indicate Taiyang disease. (Foot-Taiyang Meridian starts from inner canthus and goes up to forehead; thus red vessels crossing the pupil from top to bottom indicate Taiyang collateral causing eye pain; treat Taiyang.) From bottom to top indicate Yangming disease. (Hand and Foot-Yangming meridians run from nose to inner canthus; thus red vessels moving from bottom to top indicate Yangming collateral causing eye pain; treat Yangming.) From outside to inside indicate Shaoyang disease. (Hand and Foot-Shaoyang meridians go from outside the eye to the outer canthus and then to the inner eye; thus red vessels entering the eye from outside indicate Shaoyang collateral causing eye pain; treat Shaoyang.) Diagnosing alternating cold and heat: red vessels extending from top to bottom to the pupil. Seeing one vessel predicts death in one year; seeing one and a half vessels predicts death in one and a half years; seeing two vessels predicts death in two years; seeing two and a half vessels predicts death in two and a half years; seeing three vessels predicts death in three years. (Red vessels from top to bottom are Taiyang collaterals. Taiyang collateral vessels extend from top to bottom to the pupil. If three vessels arrive simultaneously, death occurs in three years. If only one vessel arrives, death occurs in one year. San Yang is Taiyang; Taiyang Qi is largest, so seeing only one vessel predicts death in one year. Er Yang is Yangming; Yangming has two collaterals, seeing less Qi predicts death in two years. Yi Yang is Shaoyang; Shaoyang has three collaterals, seeing less Yang Qi predicts death in three years.) Diagnosing toothache: palpate the Yangming pulse. Where there is excess, there is isolated heat. Heat on the left corresponds to left heat; heat on the right corresponds to right heat; heat above corresponds to upper heat; heat below corresponds to lower heat. (Hand-Yangming Meridian runs from fingers up to lower teeth and nose; Foot-Yangming Meridian runs from nose down to upper teeth and toes. Disease in Hand and Foot-Yangming meridians causes isolated heat in the affected pathway. Isolated heat in the left side means left heat; isolated heat in the right side means right heat. Heat in Hand-Yangming pulse indicates lower tooth decay; heat in Foot-Yangming indicates upper tooth decay. Isolated heat in the head on the left is upper; in the foot on the right is lower. Tooth decay involves swelling, pain, or pus/blood in upper/lower teeth, caused by wind-heat. Thus heat is the sign. According to regular meridians, both sides diagnose Yangming/Taiyin, present in both hands. How could Spleen and Lung uniquely appear on the right? This reasoning is certainly incorrect.) Infant illness: if head hair stands on end, death is certain. (Kidney governs Blood; Kidney-Fu Foot-Taiyang Meridian goes up to the head to nourish head hair. Infant blood is deficient and near death, so head hair stands on end.) Blue veins appearing between the ears indicate convulsive pain. (Blue veins between ears are Foot-Shaoyang Gallbladder Meridian. Infants without illness have collapsed collaterals; with illness, they rise. Rising indicates convulsive pain.) Stool with red and green differentiation in infants with small diarrhea: cold hands and feet make it hard to cure; Sun Xie (undigested food diarrhea) with small pulse and warm hands/feet is easy to cure. (Infant stool with distinct red and green parts is called Sun Xie. Small pulse with cold hands/feet makes Sun Xie hard to cure; small pulse is favorable, warm hands/feet indicate Yang Qi nourishing extremities, making it easy to cure.) Huangdi asked: How to know if a pregnant woman is about to give birth? Qibo said: The body has symptoms, but the pulse is free of pathogenic signs. (Because the fetus is in the body, although there is illness, the pathological Qi does not reach the pulse, hence no pathogenic pulse.) Huangdi asked Qibo: Diagnosing a rapid and tense Heart pulse. What disease is this? What are the symptoms? Answer: The disease is named Xin Shan (Heart Hernia); there should be a mass in the lower abdomen. Asked: Why say so? Answer: The Heart is a Yang organ, and the Small Intestine is its envoy; thus there should be a mass in the lower abdomen. Huangdi said: Good. (Diagnosing Heart pulse: Heart is Yang; tension is Cold. Cold Qi in Heart affects Taiyang Small Intestine, causing mass in lower abdomen, known as hernia accumulation.) Huangdi asked: Diagnosing Stomach pulse, what is the hernia-like condition? Qibo said: Stomach pulse excess indicates distension; deficiency indicates diarrhea. (Soft Stomach pulse is normal. Excess pulse indicates Stomach distension; deficiency pulse indicates diarrhea due to Stomach deficiency.) Asked: How does disease change after formation? Answer: Wind becomes cold and heat. (Wind disease becoming extreme transforms into various cold and heat diseases.) Dan becomes Xiao Zhong (Middle Consumption). (Dan is Spleen/Stomach heat. Internal heat over time transforms into Xiao Zhong, a disease of internal consumption via soup/drinks.) Jue becomes Dian Ji (Manic Disorder). (Yangming heat Jue becomes extreme, upper excess and lower deficiency, transforming into manic disorder.) Long-term wind becomes Sun Xie (undigested food diarrhea). (Spring wind injury in intestines/stomach over time transforms into diarrhea.) Zei Feng (Robber Wind) becomes Li (Leprosy). (Zei Feng enters pores and does not exit; becoming extreme transforms into Li, also called major disease, causing eyebrow loss, nasal collapse, etc.) Changes of disease are countless. (Disease changes into other ailments in five ways. Depending on heart and object, variations are endless and countless. One can only use wisdom to adjust and find the center. Even a thousand medical volumes would not suffice to cover them all.) Huangdi asked: There is a patient with Jue (cold limbs). Right pulse is deep; left pulse is not so. Where is the disease primarily located? Qibo said: In winter diagnosis, the right pulse should naturally be deep and tight; this corresponds to the Four Seasons. (Jue refers to cold Jue. Left hand should not be deep and tight; getting floating and slow is why it is "not so". Winter is Yin; right hand is also Yin; deep and tight is also Yin. In winter, right hand getting deep/tight pulse naturally complies with Four Seasons.) Left is floating and slow; this violates the Four Seasons. On the left, the disease should be diagnosed in the Kidney, somewhat in the Lung, and should involve back pain. (Left is Yang; floating is Lung pulse. In winter, getting Lung pulse in left hand means empty pathogen attacks, causing Kidney disease and back pain, somewhat involving Lung. This is having Lung pulse in left hand.) Asked: Why say so? Answer: Shaoyin Meridian passes through Kidney, up to Stomach/Huang, and connects to Lung. Now getting Lung pulse, Kidney suffers disease, hence Kidney causes back pain. Huangdi said: Good. (Kidney pulse Foot-Shaoyin goes from Kidney up diaphragm into Lung; thus in winter, getting Lung pulse in left hand causes Kidney back pain.) Jueyin excess causes Yin Bi (Cold Pain in Genitals). (Foot-Jueyin Liver Meridian follows groin, enters pubic region, surrounds genitals, reaches lower abdomen. Excess pulse Qi means Yin Qi is abundant, hence Yin Bi, meaning cold pain in genitals.) Deficiency causes Re Bi (Heat Pain in Genitals). (Jueyin pulse Qi deficiency allows Shaoyang to attack; heat and pain in genitals occur.) Slippery indicates Hu Shan (Fox Hernia) and Wind. (Jueyin pulse Qi slippery means Yang Qi is abundant with slight heat. Abundant Qi and slight heat attack Yin, causing Fox Hernia/Wind. Fox hernia gets name because foxes cannot urinate at night but can at sunrise; human disease is similar. Alternatively, Gu Shan (Solitary Hernia), referring to Triple Burner as solitary Fu causing hernia.) Wiry indicates abdominal accumulation and Jue Qi. (Wiry indicates much Blood, little Qi, slight cold. Because Jueyin has much Blood and little Qi with cold, Blood accumulates in lower abdomen and Jue Qi arises.) Shaoyin excess causes Pi Bi (Skin Bi) and Yin Zhen (urticaria). (Shaoyin Foot-Kidney Meridian starts from Yongquan, passes Liver, returns to Lung, governs skin/hair. Excess Yin Qi causes Pi Bi and Yin Zhen, skin eruptions/wind disease.) Deficiency causes Shen Bi (Kidney Bi). (Shaoyin Lung deficiency accepts Cold-Damp Qi entering Kidney, causing Kidney Bi.) Slippery causes Shen Feng Shan (Kidney Wind Hernia). (Shaoyin Qi deficiency allows Taiyang to attack with slight heat, causing Kidney Wind Hernia pain.) Wiry indicates accumulation and hematuria. (Little Qi, slight cold, much Blood leads to Blood accumulation.) Taiyin excess causes Rou Bi (Muscle Bi) and Han Zhong (Cold in Middle). (Foot-Taiyin Spleen Meridian governs flesh. Taiyin abundance causes Muscle Bi and Cold in Middle.) Deficiency causes Pi Bi (Spleen Bi). (Taiyin deficiency means Spleen deficiency accepting pathogen, causing Spleen Bi.) Slippery causes Pi Feng Shan (Spleen Wind Hernia). (Getting Foot-Taiyin slippery pulse means Spleen deficiency, Yangming Qi attacks, causing Spleen Wind Hernia.) Wiry indicates accumulation and intermittent abdominal distension/fullness. (Getting Taiyin wiry pulse means little Qi, slight cold, much Blood, causing Blood accumulation. Taiyin pulse notes Heart; intermittent heart/abdominal distension occurs.) Yangming excess causes Mai Bi (Vessel Bi) and intermittent body heat. (Stomach Foot-Yangming Meridian branches to Spleen, enters abdomen, belongs to Stomach, disperses to Spleen, connects to Heart. Yangming excess/deficiency affects Heart. Heart governs vessels; thus Yangming excess causes Vessel Bi and intermittent body heat.) Deficiency causes Xin Bi (Heart Bi). (Yangming Qi deficiency allows Taiyin to attack, causing Heart Bi.) Slippery causes Xin Feng Shan (Heart Wind Hernia). (Yangming Qi abundant with slight heat causes Heart Wind Hernia.) Wiry indicates accumulation and frequent fright. (Yangming Qi deficiency allows Yin to attack, slight cold, much Blood causes accumulation. Accumulation Qi rushes to Heart intermittently, causing fright.) Taiyin excess causes Gu Bi (Bone Bi) and heavy body. (Foot-Taiyang Bladder Meridian. Taiyang Qi excess attacks Shaoyin. Shaoyin governs bones. Now Shaoyin disease is named Bone Bi; Cold-Damp in bones causes heaviness.) Deficiency causes Shen Bi (Kidney Bi). (Taiyang deficiency allows Shaoyin Kidney Qi to become abundant, causing Kidney Bi.) Slippery causes Shen Feng Shan (Kidney Wind Hernia). (Taiyang slippery pulse means Yang abundance, slight heat attacks Kidney, causing Kidney Wind Hernia.) Wiry indicates accumulation and frequent manic disorder. (Diagnosing Taiyang wiry pulse means little Qi, slight cold, much Blood, causing Blood accumulation below. Accumulation Qi rushes to head intermittently, causing manic disorder.) Shaoyang excess causes Jin Bi (Sinew Bi) and flank fullness. (Foot-Shaoyang Gallbladder Meridian. Liver governs sinews. Foot-Shaoyang abundance causes Yin disease, hence Sinew Bi; Liver disease causes flank fullness.) Deficiency causes Gan Bi (Liver Bi). (Yang deficiency, Yin abundance, hence Liver Bi.) Slippery causes Gan Feng Shan (Liver Wind Hernia). (Getting Shaoyang slippery pulse means Shaoyang Qi abundant, slight heat attacks Liver, causing Liver Wind Hernia.) Wiry indicates accumulation, frequent sinew stiffness, and eye pain. (Getting Shaoyang wiry pulse means Shaoyang Qi little, slight cold, much Blood causes accumulation. Foot-Shaoyang Meridian starts at outer canthus; thus pulse cold causes sinew stiffness and eye pain.)