按∶《素问》无者字。）皆死。（此之五色，皆为他克，不得其时，不疗皆死。但色难知，且根据
一义如此也。平按∶《素问》死字下有也字。）
平按∶此篇自篇首至末，见《灵枢》卷一第四《邪气脏腑病形》篇，又见《甲乙》卷四第二上
篇。
黄帝曰∶邪之中人，其病形何如？岐伯答曰∶虚邪之中身也，洫 动形。正邪之中人也微，
先见于色，不知于身，若有若无，若亡若存，有形无形，莫知其情。黄帝曰∶善。（虚邪，谓八
虚邪风也。正邪，谓四时风也。四时之风，生养万物，故为正也。八虚之风，从虚乡来，伤损于
物，故曰虚风。虚正二风，性非谷气，因腠理开辄入，故曰邪风。虚邪中人，入腠理，如水逆流于
洫，毛立动形，故为人病。正邪中人，微而难识，先见不觉于身，故轻而易去也。平按∶《甲乙》
无黄帝曰至岐伯答曰十六字。洫 《灵枢》、《甲乙》作洒浙。《甲乙》无若有若无四字。）
黄帝问岐伯曰∶余闻之，见其色，知其病，命曰明；按其脉，知其病，命曰神；问其病而知
其处，命曰工。余愿闻之，见而知之，按而得之，问而极之，为之奈何？（察色之明，按脉之神，
审问之工，为诊之要，故并请之。平按∶《甲乙》无此一段及下岐伯答曰四字。问其病，问字原抄
作间，谨根据《灵枢》及本注作问。）岐伯答曰∶夫色脉与尺之相应也，如桴鼓影响之相应也，不
得相失也，
（桴，伏留反，击鼓槌也。答中色、脉及尺，以为三种，不言问也。色，谓面色。脉，谓寸口。尺，
谓尺中也。五脏六腑善恶之气，见于色部、寸口、尺中，三候相应，如槌鼓、形影、声响，不相
失也。如肝色面青，寸口脉弦，尺肤有异，内外不相失也。平按∶尺之下《甲乙》有皮肤二字。）
此亦本末根叶之出候也，故根死则叶枯矣。（此则尺地以为根茎，色脉以为枝叶，故根死枝叶枯
变。平按∶《甲乙》根上无故字。注茎袁刻作基。）色脉形肉不得相失也，（形肉，即是尺之皮
肤。色、脉、尺肤三种不相失也。）故知一则为工，知二则为神，知三则神且明矣。（故但知问
极一者，唯可为工；知问及脉二者，为神；知问及脉，并能察色，称曰神明也。平按∶注可原作
有，旁改作可，袁刻可有二字并列，非是。）黄帝问曰∶愿卒闻之。岐伯答曰∶（平按∶《甲乙》
无色脉形肉至岐伯答曰三十九字。）色青者其脉弦，（青为肝色，弦为肝脉，故青、弦为肝表也。
问色、脉、尺三种之异，今但答色、脉不言尺者，以尺变同脉故也。）色赤者其脉钩，（赤为心色，
钩为心脉，赤、钩为心表也。）色黄者其脉代，（黄为脾色，代为脾脉，黄、代为脾表也。）色白
者其脉毛，（白为肺色，毛为肺脉，白、毛为肺表也。）色黑者其脉石。（黑为肾色，石为肾脉，
黑、石为肾表也。石一曰坚，坚亦石也。）见其色而不得其脉，反得其相胜之脉，则死矣；（假令
肝病得见青色，其脉当弦，反得毛脉，是肺来乘，肝被克，故死。余脏准此也。）得其相生之脉，
则病已矣。（假令肝病见青色，虽不见弦而得石脉，石为肾脉，是水生木，是得相生之脉，故病
已也。）黄帝问岐伯曰∶五脏之所生，变化之病形何如？岐伯答曰∶必先定其五色五脉之应，其病
乃可别也。（欲知五脏所生变化之病，先定面之五色、寸口五脉，即病可知矣。）黄帝问曰∶色脉
已定，别之奈何？岐伯答曰∶调其脉之
缓、急、小、大、滑、涩，而病变定矣。（虽得本脏之脉，而一脉便有六变，观其六变，则病形
可知矣。平按∶小大《甲乙》作大小，病变作病形。注矣字袁刻脱。）黄帝问曰∶调之奈何？岐
伯答曰∶脉急者，尺之皮肤亦急；（脉急者，寸口脉急也。尺之皮肤者，从尺泽至关，此为尺分
也；尺分之中，关后一寸动脉，以为诊候尺脉之部也；一寸以后至尺泽，称曰尺之皮肤。尺皮肤
下，手太阴脉气从脏来至指端，从指端还入于脏，故尺下皮肤与尺寸脉六变同也。皮肤者，以手
扪循尺皮肤，急与寸口脉同。）脉缓者，尺之皮肤亦缓；（寸口脉缓，以手扪循尺皮肤缓也。）脉
小者，尺之皮肤亦减而少气；（寸口脉小，尺之皮肤减而少气也。）脉大者，尺之皮肤亦贲而起；
（寸口脉大，尺之皮肤贲起能大。一曰亦大，疑是人改从大。平按∶亦贲而起《甲乙》作亦大。）
脉滑者，尺之皮肤亦滑；（按寸口脉滑，即尺皮肤亦滑。平按∶脉滑上《甲乙》有“脉沉者，尺
之皮肤亦沉”九字。）脉涩者，尺之皮肤亦涩。（寸口脉来蹇涩，尺之皮肤亦涩不滑也。）凡此六
变者，有微有甚，故善调尺者，不待于寸口，（寸口与尺各有六变，而六变各有微甚，可审取之。
前调寸口脉六变，又调于尺中六变，方可知病。若能审调尺之皮肤六变，即得知病，不假诊于寸口
也。平按∶《灵枢》、《甲乙》变上无六字，寸下无口字。）善调脉者，不待于色。（善调寸口之
脉知病，亦不假察色而知也。）能参合而行之者，可以为上工，上工十全九；行二者为中工，中工
十全七；行一者为下工，下工十全六。（察色、诊脉、调尺，三法合行，得病之妙，故十全九，
名曰上工。但知尺、寸二者，十中全七，故为中工。但明尺一法，十中全六，以为下工也。平按∶
《甲乙》上工、中工、下工不重，全下均有其字。）
【按语】：《素问》中没有“者”字。）都主死。（这五种面色，都是被其他行所克制，且不在其当令之时，不进行救治都会死亡。只是面色难以辨认，暂且依据这一义理如此理解罢了。平按：《素问》在“死”字下有“也”字。）
【平按】：此篇从篇首到末尾，见于《灵枢》卷一第四《邪气脏腑病形》篇，又见于《甲乙经》卷四第二上篇。
黄帝说：邪气侵袭人体，其病症表现是怎样的？岐伯回答说：虚邪侵袭身体时，脉管（洫）搏动，形体随之动摇。正邪侵袭人体则很轻微，先表现在面色上，身体没有感觉，若有若无，似有似无，有形或无形，没有人能知道它的具体情况。黄帝说：好。（虚邪，指的是八方来的虚邪贼风。正邪，指的是四季正常的风。四季的风，生养万物，所以称为正风。八方的风，从空虚之处而来，损伤万物，所以称为虚风。虚风和正风，性质都不是谷气，因为腠理开放就侵入，所以称为邪风。虚邪侵入人体，进入腠理，就像水逆流于沟渠，毫毛竖起，形体动摇，所以使人患病。正邪侵入人体，轻微而难识别，先表现在面色上，身体不觉察，所以病情轻浅而易于去除。平按：《甲乙经》没有从“黄帝曰”到“岐伯答曰”的十六个字。“洫”，《灵枢》、《甲乙经》作“洒浙”。《甲乙经》没有“若有若无”四个字。）
黄帝问岐伯说：我听说，观察面色就能知道疾病，叫做明；切按脉搏就能知道疾病，叫做神；询问病情就能知道病位，叫做工。我希望听听，通过观察而知晓，通过切按而得知，通过询问而穷尽，该怎么做呢？（观察面色的明察，切按脉搏的神妙，审问病情的工巧，是诊断的要领，所以一并请教。平按：《甲乙经》没有这一段以及下面岐伯回答的四个字。“问其病”，“问”字原抄本作“间”，谨根据《灵枢》及本注改为“问”。）岐伯回答说：面色、脉搏和尺肤（前臂内侧皮肤）之间的相应关系，就像鼓槌击鼓、形体与影子、声音与回响那样相应，不能相违背，（桴，音fú，击鼓的槌子。回答中提到了色、脉和尺，作为三种诊法，没有提到问诊。色，指面色。脉，指寸口脉。尺，指尺肤。五脏六腑的善恶之气，表现在面色部位、寸口脉和尺肤上，这三种候象相应，就像槌击鼓、形随影、声应响，不相违背。比如肝色面青，寸口脉弦，尺肤有异常，内外不相违背。平按：《甲乙经》在“尺”字下有“皮肤”二字。）这也是本末根叶的表现，所以根死了叶子就会枯干。（这里把尺肤当作根茎，面色和脉搏当作枝叶，所以根死则枝叶枯萎变化。平按：《甲乙经》“根”字上没有“故”字。注中的“茎”字，袁刻本作“基”。）面色、脉搏和形肉（尺肤）不能相违背，（形肉，就是尺肤。色、脉、尺肤三种不相违背。）所以懂得其中一种就可以称为工，懂得两种可以称为神，懂得三种就可以称为神明矣。（所以只懂得问诊这一种，只能称为工；懂得问诊和脉诊两种，称为神；懂得问诊、脉诊，并能观察面色，称为神明。平按：注中的“可”字原作“有”，旁改为“可”，袁刻本“可”“有”二字并列，不对。）黄帝问：希望详尽地听您讲讲。岐伯回答说：（平按：《甲乙经》没有从“色脉形肉”到“岐伯答曰”的三十九个字。）面色青的人，其脉象弦，（青为肝之色，弦为肝之脉，所以青、弦是肝的外在表现。询问色、脉、尺三种的不同，现在只回答色、脉而不提尺，是因为尺的变化同于脉的缘故。）面色赤的人，其脉象钩，（赤为心之色，钩为心之脉，赤、钩是心的外在表现。）面色黄的人，其脉象代，（黄为脾之色，代为脾之脉，黄、代是脾的外在表现。）面色白的人，其脉象毛，（白为肺之色，毛为肺之脉，白、毛是肺的外在表现。）面色黑的人，其脉象石。（黑为肾之色，石为肾之脉，黑、石是肾的外在表现。石，一说为坚，坚也是石的意思。）看到面色却得不到相应的脉象，反而得到相克制的脉象，就会死亡；（假如肝病见到青色，脉应当弦，反而得到毛脉，这是肺来乘袭，肝被克制，所以死亡。其余脏腑以此类推。）如果得到相生之脉，病就会痊愈。（假如肝病见到青色，虽然没有见到弦脉而得到石脉，石为肾脉，这是水生木，是得到相生之脉，所以病会痊愈。）黄帝问岐伯说：五脏产生的疾病，变化的病症表现是怎样的？岐伯回答说：必须先确定五色五脉的对应关系，然后疾病才可以辨别。（想要知道五脏所产生变化的疾病，先确定面部的五色、寸口的五脉，那么疾病就知道了。）黄帝问：面色和脉象已经确定，如何辨别呢？岐伯回答说：调察脉象的缓、急、小、大、滑、涩六种变化，病变就可以确定了。（虽然得到了本脏的脉象，但一脉便有六种变化，观察这六种变化，就可以知道病症表现。平按：“小大”在《甲乙经》中作“大小”，“病变”作“病形”。注中的“矣”字，袁刻本脱漏。）黄帝问：如何调察呢？岐伯回答说：脉象急的，尺部皮肤也紧张；（脉象急，指寸口脉急。尺部皮肤，从尺泽穴到关元穴，这叫尺分；尺分之中，关后一寸动脉处，是诊候尺脉的部位；一寸以后到尺泽穴，称为尺之皮肤。尺皮肤下，手太阴脉气从内脏来到指尖，再从指尖返回内脏，所以尺下皮肤与尺寸脉的六种变化相同。用扪摸的方式检查尺皮肤，紧张程度与寸口脉相同。）脉象缓的，尺部皮肤也松弛；（寸口脉缓，用手扪摸尺皮肤也松弛。）脉象小的，尺部皮肤也减弱且少气；（寸口脉小，尺部皮肤减弱且少气。）脉象大的，尺部皮肤也贲起而大；（寸口脉大，尺部皮肤贲起显得大。一说也是大，怀疑是人改从“大”字。平按：“亦贲而起”在《甲乙经》中作“亦大”。）脉象滑的，尺部皮肤也滑利；（按寸口脉滑，即尺皮肤也滑。平按：《甲乙经》在“脉滑”前有“脉沉者，尺之皮肤亦沉”九个字。）脉象涩的，尺部皮肤也涩滞。（寸口脉来蹇涩，尺部皮肤也涩滞不滑。）凡是这六种变化，有轻微也有严重，所以善于调察尺肤的人，不需要等待诊察寸口，（寸口和尺各有六种变化，而六种变化各有轻重，可以仔细取察。前面调察寸口脉的六种变化，又调察尺中的六种变化，才能知道疾病。如果能审慎调察尺肤的六种变化，就能知道疾病，不需要假借诊察寸口了。平按：《灵枢》、《甲乙经》“变”字上没有“六”字，“寸”字下没有“口”字。）善于调察脉象的人，不需要等待观察面色。（善于调察寸口脉以知病，也不需要假借观察面色就能知道。）能将三者结合运用的，可以称为上工，上工治愈率十分之九；运用两种的为中工，中工治愈率十分之七；只运用一种的为下工，下工治愈率十分之六。（观察面色、诊察脉搏、调察尺肤，三法合用，得病之妙，所以十全九，称为上工。只懂得尺、寸两种，十中治愈七，所以为中工。只明白尺这一种方法，十中治愈六，称为下工。平按：《甲乙经》上工、中工、下工不重复，“全”字下均有“其”字。）
[Note]: The *Suwen* does not contain the character "zhe" (者).) All [cases] result in death. (These five colors all indicate being overcome by other elements, occurring out of season; without treatment, all result in death. However, observing color is difficult; for now, we understand this based on this single principle.) Ping An: In the *Suwen*, the character "ye" (也) follows the character "si" (死).)
[Ping An]: This section, from the beginning to the end of the chapter, appears in Volume 1, Chapter 4 ("Evil Qi, Zang-Fu Organs, and Disease Manifestations") of the *Lingshu*, and also in Volume 4, Part 2, Upper of the *Jiayi Jing*.
The Yellow Emperor asked: When evil qi invades a person, what are the manifestations of the disease? Qibo replied: When xu xie (deficient evil/evil wind from empty directions) invades the body, the blood vessels (xu) pulsate, and the form moves. When zheng xie (correct evil/normal seasonal wind) invades a person, it is subtle; it first manifests in the complexion, but is not felt in the body. It seems to exist yet not exist, to be present yet absent, to have form yet be formless; no one knows its true nature. The Yellow Emperor said: Excellent. (Xu xie refers to the evil winds from the eight empty directions. Zheng xie refers to the winds of the four seasons. The winds of the four seasons nourish all things, thus they are called "correct." The winds of the eight directions come from empty places and damage things, thus they are called "deficient." Both deficient and correct winds are not grain qi; because they enter when the couli (pores/cutaneous interstices) open, they are called "evil winds." When xu xie enters the body, it penetrates the couli, like water flowing backward in a ditch; the hair stands erect, and the form moves, thus causing disease in humans. When zheng xie enters the body, it is subtle and hard to recognize; it first appears in the complexion without being felt in the body, thus it is light and easy to dispel. Ping An: The *Jiayi Jing* lacks the sixteen characters from "Huangdi yue" to "Qibo da yue." "Xu" (洫) is written as "zhazhe" (洒浙) in the *Lingshu* and *Jiayi Jing*. The *Jiayi Jing* lacks the four characters "ruo you ruo wu" (若有若无).)
The Yellow Emperor asked Qibo: I have heard that observing the color to know the disease is called "ming" (clear/perceptive); palpating the pulse to know the disease is called "shen" (divine/profound); asking about the disease to know its location is called "gong" (skilled). I wish to hear how to observe and know, palpate and obtain, and ask and exhaust. How should this be done? (The clarity of observing color, the profundity of palpating the pulse, and the skillfulness of examining questions are the essentials of diagnosis, so I ask about them all. Ping An: The *Jiayi Jing* lacks this paragraph and the four characters "Qibo da yue" below it. "Wen qi bing" (ask his disease): The original copy writes "wen" (问) as "jian" (间); strictly following the *Lingshu* and this note, it is corrected to "wen".) Qibo replied: The correspondence between color, pulse, and chi skin (skin of the forearm) is like the correspondence between a drumstick striking a drum, a form casting a shadow, or a sound echoing; they must not be lost. (Fu, pronounced fú, is the drumstick. The answer mentions color, pulse, and chi, constituting three methods, excluding inquiry. Color refers to facial complexion. Pulse refers to the cunkou (radial artery at the wrist). Chi refers to the chi area (forearm skin). The good and evil qi of the zang and fu organs manifest in the color areas, cunkou, and chi. These three indicators correspond, like a stick hitting a drum, a form with its shadow, or a sound with its echo, without deviation. For example, if the liver color is green, the cunkou pulse is wiry, and the chi skin is abnormal, the internal and external do not deviate. Ping An: The *Jiayi Jing* adds the two characters "pi fu" (skin) after "chi".) This is also the manifestation of the root and branches; therefore, if the root dies, the leaves wither. (Here, the chi skin is regarded as the root and stem, while color and pulse are regarded as the branches and leaves; thus, if the root dies, the branches and leaves wither and change. Ping An: The *Jiayi Jing* lacks the character "gu" (therefore) before "gen" (root). In the note, "jing" (stem) is printed as "ji" (base) in the Yuan edition.) Color, pulse, and form/flesh (chi skin) must not deviate from each other. (Form/flesh refers to the chi skin. The three—color, pulse, and chi skin—must not deviate.) Therefore, knowing one makes one a gong (skilled), knowing two makes one shen (profound), and knowing three makes one shen qie ming (profound and clear). (Thus, knowing only one method [inquiry] allows one to be a gong; knowing two methods [inquiry and pulse] makes one shen; knowing inquiry, pulse, and being able to observe color is called shen ming. Ping An: In the note, "ke" (can) was originally "you" (have), corrected marginally to "ke"; the Yuan edition has both characters, which is incorrect.) The Yellow Emperor asked: I wish to hear this completely. Qibo replied: (Ping An: The *Jiayi Jing* lacks the thirty-nine characters from "se mai xing rou" to "Qibo da yue".) When the color is green, the pulse is xian (wiry); (Green is the color of the Liver; xian is the pulse of the Liver; thus, green and xian represent the Liver's exterior. Asking about the differences among color, pulse, and chi; now only answering color and pulse without mentioning chi, because chi changes are the same as the pulse.) When the color is red, the pulse is gou (hooked); (Red is the color of the Heart; gou is the pulse of the Heart; thus, red and gou represent the Heart's exterior.) When the color is yellow, the pulse is dai (modulated/interrupted); (Yellow is the color of the Spleen; dai is the pulse of the Spleen; thus, yellow and dai represent the Spleen's exterior.) When the color is white, the pulse is mao (feathery); (White is the color of the Lung; mao is the pulse of the Lung; thus, white and mao represent the Lung's exterior.) When the color is black, the pulse is shi (stone-like). (Black is the color of the Kidney; shi is the pulse of the Kidney; thus, black and shi represent the Kidney's exterior. Shi is also interpreted as jian (hard); jian is also shi.) If one sees the color but does not get the corresponding pulse, and instead gets a controlling (overcoming) pulse, death will occur; (For example, in Liver disease, if green is seen, the pulse should be xian; if a mao pulse is obtained instead, this is the Lung overcoming the Liver, thus death. The other organs follow this pattern.) If one gets a generating (nourishing) pulse, the disease will resolve. (For example, in Liver disease, if green is seen, even if the xian pulse is not present but a shi pulse is obtained, shi is the Kidney pulse; this is Water generating Wood, meaning a generating pulse is obtained, thus the disease resolves.) The Yellow Emperor asked Qibo: What are the disease manifestations generated and changed by the Five Zang organs? Qibo replied: One must first determine the correspondence of the five colors and five pulses, then the diseases can be distinguished. (To know the diseases generated and changed by the five zang organs, one must first determine the five colors of the face and the five pulses of the cunkou, then the disease can be known.) The Yellow Emperor asked: Once color and pulse are determined, how are they distinguished? Qibo replied: By adjusting/observing the six variations of the pulse—huan (slow/relaxed), ji (rapid/tense), xiao (small), da (large), hua (slippery), and se (rough)—the disease changes are determined. (Although one obtains the pulse of the primary organ, each pulse has six variations; observing these six variations reveals the disease manifestation. Ping An: "Xiao da" (small large) is written as "da xiao" (large small) in the *Jiayi Jing*; "bing bian" (disease change) is written as "bing xing" (disease manifestation). The character "yi" (particle indicating completion) is missing in the Yuan edition.) The Yellow Emperor asked: How is the adjustment/observation done? Qibo replied: When the pulse is ji (tense), the chi skin is also tense; (Pulse ji refers to the cunkou pulse being tense. Chi skin refers to the area from Chize to Guan; this is the chi division. Within the chi division, the arterial point one cun behind Guan is the site for diagnosing the chi pulse; from one cun behind to Chize is called the chi skin. Under the chi skin, the Hand Taiyin pulse qi comes from the zang to the fingertips and returns from the fingertips to the zang; thus, the skin under the chi corresponds to the six variations of the size and inch pulses. Palpating the chi skin with the hand shows tension consistent with the cunkou pulse.) When the pulse is huan (relaxed), the chi skin is also relaxed; (Cunkou pulse huan means palpating the chi skin reveals relaxation.) When the pulse is xiao (small), the chi skin is also diminished and lacks qi; (Cunkou pulse xiao means the chi skin is diminished and lacks qi.) When the pulse is da (large), the chi skin is also bulging and large; (Cunkou pulse da means the chi skin bulges and appears large. Another reading says "also large," suspected to be a correction to "da." Ping An: "Yi ben er qi" (also bulging and rising) is written as "yi da" (also large) in the *Jiayi Jing*.) When the pulse is hua (slippery), the chi skin is also slippery; (Palpating the cunkou pulse as hua means the chi skin is also slippery. Ping An: The *Jiayi Jing* adds nine characters before "mai hua": "Mai chen zhe, chi zhi pi fu yi chen" (When the pulse is deep, the chi skin is also deep).) When the pulse is se (rough), the chi skin is also rough. (The cunkou pulse comes in a hesitant and rough manner, and the chi skin is also rough and not slippery.) Regarding these six variations, there are slight and severe degrees. Therefore, one who is skilled at observing the chi skin does not need to wait for the cunkou; (Both cunkou and chi have six variations, and each variation has slight or severe degrees, which can be carefully examined. Previously, observing the six variations of the cunkou pulse and then the six variations in the chi region allows one to know the disease. If one can carefully observe the six variations of the chi skin, one can know the disease without needing to diagnose the cunkou. Ping An: The *Lingshu* and *Jiayi Jing* lack the character "liu" (six) before "bian" (variation) and the character "kou" (mouth/wrist) after "cun" (inch).) One who is skilled at observing the pulse does not need to wait for the color. (Being skilled at observing the cunkou pulse to know the disease also does not require observing the color to know.) One who can integrate and practice all three can be considered a Shang Gong (Superior Physician), whose cure rate is nine out of ten; one who practices two is a Zhong Gong (Medium Physician), whose cure rate is seven out of ten; one who practices one is a Xia Gong (Inferior Physician), whose cure rate is six out of ten. (Observing color, diagnosing pulse, and adjusting chi skin: integrating these three methods captures the subtleties of disease, hence nine out of ten cured, named Shang Gong. Knowing only two methods [chi and cunkou], curing seven out of ten, is Zhong Gong. Understanding only one method [chi], curing six out of ten, is Xia Gong. Ping An: In the *Jiayi Jing*, Shang Gong, Zhong Gong, and Xia Gong are not repeated; the character "qi" (its) follows "quan" (complete/all) in each case.)