言经脉病脉之各有分别。
黄帝问曰。人之居处动静勇怯。脉亦为之变乎。(按三部九候论。至血气形志篇。与灵枢之九针论。前后相符。只此
篇与脏气发时论。少有异别。然此篇章旨。乃九候论之所谓必先知经脉。然后知病脉。脏气法时论章旨。乃九候论之所
谓察其腑脏。以知死生之期。盖九针九篇。九九八十一篇。论在灵枢经内。此复论三部九候之法。故必先知经脉生始之
原。而后知九候之病脉。知五脏生克之理。而后知死生之期。故设此二问。)岐伯对曰。凡人之惊恐恚劳动静。皆为变也。
(言人之居处安静。其气和平。自有经常之脉。如动作过用。则变而为病脉矣。)是以夜行。则喘出于肾。淫气病肺。(肾
属亥子。而气主闭藏。夜行则肾气外泄。故喘出于肾。肾为本。肺为末。肾气上逆。故淫伤于肺也。夫喘属肺证。又曰。
阳明厥则喘。汗出于肺主之皮毛。而生于胃腑之津液。此章首论喘。次论汗者。言经脉荣卫。生于胃腑水谷之津。而通
会于肺气。是有经常之理。如劳动过伤。则五脏气逆。而脉亦为之变。故先论其变。而后论其常焉。)有所堕恐。喘出于
肝。淫气害脾。(堕则伤筋。筋即为肝。故喘出于肝。木胜土。故淫气害脾。)有所惊恐。喘出于肺。淫气伤心。(惊则气
乱。故喘出于肺。肺者心之盖。故淫气伤心。)度水跌仆。喘出于肾与骨。(跌则伤骨。骨即为肾。故喘出焉。徐公遐曰。
肾生骨髓。髓生肝。骨者肾之精气所注。末言骨者。则五脏之生气。可类推之。)当是之时。勇者气行则已。怯者则着而
为病也。(言此数者。皆伤五脏之气。勇者逆气已过。正气复顺。怯者则留着为病。而见病脉矣。)故曰。诊病之道。观
人勇怯骨肉皮肤。能知其情。以为诊法也。(夫气有勇怯。理有疏密。皮肤有浓薄。骨肉有坚脆。能知其情。以为诊法之
要。)故饮食饱甚。汗出于胃(汗者水谷之津液。饱甚则胃满。故汗出焉。)惊而夺精。汗出于心。(血乃心之精。汗乃血
之液。惊伤心气。汗出于心。故曰夺精。经云。夺汗者无血。)持重远行。汗出于肾。(持重远行则伤骨。故汗出于肾。)
疾走恐惧。汗出于肝。(疲罢伤筋。故汗出于肝。)摇体劳苦。汗出于脾。(劳伤四体。故汗出于脾。)故春秋冬夏四时阴
阳生病。起于过用。此为常也。(四时阴阳。自有经常。血气循行。各有调理。如动作过伤。则血气妄逆而生病。此自然
之理也。口问篇曰。百病之始生也。皆生于风雨寒暑。阴阳喜怒。饮食居处。大惊卒恐。则血气分离。阴阳破散。经络
厥绝。脉道不通。阴阳相逆。卫气稽留。经脉空虚。血气不次。乃失其常。是以惊恐恚劳。动作饮食。以致喘汗出者。
皆使气血不次。脉道失常。故欲知经度之循行。先识变常之逆气。徐公遐曰。喘汗之证。乃经气逆行。故首提曰脉亦为
之变。又曰。能知其情。以为诊法。)食气入胃。散精于肝。淫气于筋。(肝者土之胜。制则生化。故散精于肝。肝者
筋其应。故淫气于筋。经曰。谷入于胃。脉道乃通。血气乃行。是荣卫气血。皆水谷之所资生。而水谷入胃。各有淫散
输转之道。故又必先知经脉生始之原。而后知病脉也。)食气入胃。浊气归心。淫精于脉。(经曰。受谷者浊。胃之食气。
故曰浊气。胃络上通于心。故入胃之食。气归于心。子令母实也。心气通于脉。故淫精于脉。伯高曰。谷始入于胃。其
精微者。先出于胃之两焦。以溉五脏。别出而行荣卫之道。其大气之搏而不行者。积于胸中。命曰气海。出于肺。循喉
咙而司呼吸。又曰。谷入于胃。乃传之肺。五脏六腑。皆以受气。所谓先出于胃之两焦者。入胃之谷气。先下淫于腑。
上归于心肺。以养五脏气。此章论经脉之道。由水谷之精。以养腑脏。腑脏之精。淫于经脉。气口成寸。以决死生。所
谓五脏皆禀气于胃。而至于手太阴也。其别出两行之荣卫与宗气。又当别论。同志者。当细玩诸经。体认明白。)脉气流
经。经气归于肺。肺朝百脉。输精于皮毛。(脉气者。水谷之精气。而行于经脉中也。经、大经也。言入胃之谷气。先淫
气于脉。百脉之经气。总归于大经。经气归于肺。是以百脉之气。皆朝会于肺也。肺会皮毛。故复输精于皮毛。)毛脉合
精。行气于腑。(经云。血独盛。则淡渗皮肤。生毫毛。夫皮肤主气。经脉主血。毛脉合精者。血气相合也。六腑为阳。
故先受气。张兆璜曰。淡渗皮毛之血。与经脉之血相合。故曰毛脉合精。)腑精神明。留于四脏。(腑精神明者。六腑之
津液相成。而神乃自生也。谷气入胃。淫精于脉。乃传之肺。肺气散精。行气于腑。腑精留于四脏。以养五脏之气。故
曰。谷入于胃。乃传之肺。五脏六腑。皆以受气。)气归于权衡。权衡以平。气口成寸。以决死生。(权衡、平也。言脉
之浮沉出入。阴阳和平。故曰权衡以平。气口、手太阴之两脉口。成寸者。分尺为寸也。言五脏六腑。受气于谷。浮精
于脉。变见于气口。以决其死生。)饮入于胃。游溢精气。上输于脾。脾气散精。上归于肺。通调水道。下输膀胱。水精
四布。五经并行。(入胃之饮。精气上输于脾。脾气散精。上归于肺。盖脾主为胃行其津液者也。肺应天而主气。故能通
调水道。而下输膀胱。所谓地气升而为云。天气降而为雨也。水精四布者。气化则水行。故四布于皮毛。五经并行者。
通灌于五脏之经脉也。平脉篇曰。谷入于胃。脉道乃行。水入于经。其血乃成。故先论食而后论其饮焉。)合于四时五脏。
阴阳揆度。以为常也。(五脏、五行之气也。揆度、度数也。总结上文。而言经脉之道。合于四时五行之次序。阴阳出入
之度数。以为经脉之经常。)太阳脏独至。厥喘。虚气逆。是阴不足。阳有余也。表里当俱泻。取之下俞。(此言脏腑
经脉。有阴阳相合之常度。如偏阴偏阳之独至。则为厥喘诸病。所谓先知经脉。今识病脉也。太阳脏独至者。太阳之经
气独至。而无阴气之和也。阳气惟上。故下厥上喘。而虚气上逆也。是阴不足而阳有余。表里俱当泻。盖太阳经气。发
原于下。而上出于肤表。故当表里俱泻。而取之下俞。)阳明脏独至。是阳气重并也。当泻阳补阴。取之下俞。(阴阳系
日月篇曰。寅者正月之生阳也。主左足之少阳。未者六月。主右足之少阳。卯者二月。主左足之太阳。午者五月。主右
足之太阳。辰者三月。主左足之阳明。巳者四月。主右足之阳明。此两阳合于前。故曰阳明。阳明之独至。是太少重并
于阳明。阳盛故阴虚矣。此言阴阳并合。乃经脉之常。如阳并于阳。阴并于阴。则为病脉矣。故曰。持雌守雄。弃阴附
阳。不知并合。诊故不明。)少阳脏独至。是厥气也。跷前卒大。取之下俞。(少阳主初生之气。生气厥逆于下。以致脏
脉之独大于跷前也。跷者。奇经之跷脉。足少阳经脉。在阳跷之前。故跷前卒大。朱卫公曰。言跷前卒大者。释明三阳
之脉。候足之三阳也。盖生阳之气。皆从下而上。由阴而阳。故俱取之下俞。又申明三阴三阳之候。候十二经之本脉也。
如跷前少阳之脉卒大。而厥阴之动脉微小者。是为少阳独至也。所谓太阳少阳太阴少阴者。论阴阳之经脉也。经脉连于
脏腑。故曰脏。所谓一阳二阳一阴二阴者。论三阴三阳之气也。此节论有病经而及于无病之气者。有病气而及于有形之
经者。盖病在经者由脏而经。由经而气。病在气者由气而经。由经而脏也。)少阳独至者。一阳之过也。(此申明经气之
各有别也。夫一阴一阳。分而为三阴三阳。三阴三阳。合于手足十二经脉。十二经脉。合于十二脏。腑所以藏物。故亦
名脏也。所谓太阳阳明少阳脏独至者。言三阳经脉之独盛也。三阳经脉之独盛者。是三阳气之太过也。)太阴脏搏者。用
心省真。五脉气少。胃气不平。三阴也。宜治其下俞。补阳泻阴。(此言三阴三阳之经气。皆有手有足也。夫手之太阴。
足之太阴。是为三阴。是以太阴之脏脉相搏者。须用心省察。其为手之太阴。足之太阴乎。如五脉气少者。手太阴之过
也。盖肺朝百脉。而输精于脏腑。肺气搏而不行。则五脉之气皆少。是以五脉气少者。知在手之太阴也。脾主为胃行其
津液。脾气搏而不行。是以胃气不平。胃气不平者。知在足之太阴也。手之太阴。足之太阴。而后谓之三阴也。足之三
阴。从足走腹。手之三阴。从腹走手。手足经气。交相贯通。故独取之下俞。徐公遐曰。此复申明所谓三阴三阳者。概
手足而言也。盖阴阳之气。皆从下而上。故独取之下俞。)一阳独啸。少阳厥也。(此言经厥而及于气也。夫气激于喉中
而浊。谓之言。气激于舌端而清。为之啸。盖气郁而欲伸出之。一阳之气独啸者。盖因少阳之经气厥逆也。所谓少阳独
至。一阳之过者。言气盛而及于经也。一阳独啸。少阳厥者。言经逆而及于气也。分而论之。有气有经。合而论之。经
气之相关也。朱卫公曰。以太阴开于其间者。当知三阴三阳之经气。皆若是也。张兆璜曰。少阳厥者。木火之气郁
也。木郁之发。松吟高山。虎啸岩岫。古之善啸者。听溪中虎声而泻之。一阳独啸之义。盖取诸此与。)阳并于上。四
脉争张。气归于肾。宜治其经络。泻阳补阴。(阳并者。太阳阳明之气相并也。四脉者。太阳之小肠膀胱。阳明之胃与大
肠。即四形藏之脉也。四脉争张。以致阳并于上。亦经厥而及于气也。肾为生气之原。此三阳之气。虚陷于肾。不能与
阳相接。故宜泻其阳之络。补其阴之经。阴阳平而经气和矣。四脉争张。四形藏之气盛也。气归真虚。五神藏之气虚也。)
一阴至。厥阴之治也。真虚 心。厥气留薄。发为白汗。调食和药。治在下俞。( 音狷。此言经气逆。而病及于脏也。
一阴者。厥阴也。是以一阴气至。当厥阴主治。而反见脏真之虚。心为 痛。盖厥阴之气。发于命门。为心主之包络。
厥阴气逆。以至真虚而心痛也。厥逆之气。留薄于心下。则上迫于肺。故发为白汗。夫真虚痛心。病在内也。经气厥逆。
病在外也。病在内者。治以药食。病在外者。治以针砭。故宜调食和药。治其下俞。夫所谓一阳二阳三阳。一阴二阴三
阴者。阴阳之二气也。所谓太阳阳明少阳。太阴厥阴少阴者。概脏腑经气而言也。人禀天地阴阳之气。而成此形。是有
有形之脏腑经脉。有无形之阴阳六气也。虽然。脏不离乎经。经不离乎气。气不离乎脏。经气贯通。脏气并合。阴阳出
入。上下循环。是以有论三阳之独至者。有论在手经足经者。有论经病而及于气。气病而及于经者。有论阴阳之不相合
者。有论经气逆而病及于脏者。此皆阴阳之道。可合可分。书不尽言。举一以 十。学人当知一经之气若是。则十二经
可知。能引而伸之。进乎技矣。厥阴之治。谓当足厥阴之经脉主治也。此言三阴三阳之气。可合于六经。可通于脏腑。
当与末节合论三阴之气而各有分别焉。)帝曰。太阳脏何象。(太阳脏者。谓小肠膀胱之经脉也。象者。效象形容。此
复论经气之见于脉者。各有别也。此言三阴三阳之气合于十二经而应于脉。非气之行于脉中也。故太阳之脉象上三阳之
气盛而浮。少阳之脉象上一阳气之初生也。若一阳之气行于脉中。则滑而不实矣。此申明阳脏独至阴脏相搏者。乃因气
而见于脉。故曰少阳独至者。一阳之过也。)岐伯曰。象三阳而浮也。(象者。像也。三阳。阳盛之气也。言太阳之脏脉。
象阳盛之气而浮也。)帝曰。少阳脏何象。岐伯曰。象一阳也。(少阳脏者。三焦甲胆之经气。故象一阳初动之生阳。)一
阳脏者。滑而不实也。(所谓一阳二阳者。乃三阳之气也。气应脉外。故以脉之浮沉。以效象阴阳之气。如在一阳之脏脉。
则见脉体之滑象矣。盖阳气搏于脉中。其脉则滑。阳欲外浮。故不实也。此反结上文。而言一阳之脏脉。与一阳之气见
于脉者之不同也。)帝曰。阳明脏何象。岐伯曰。象大浮也。(阳明脏者。胃与大肠之经脉也。阳明者。两阳合明。阳气
合并。则阳热盛。故其象大浮。象大浮者。二阳之气也。)太阴脏搏。言伏鼓也。二阴搏至肾。沉不浮也。(此复结阴脏
之经脉。与阴气之见于脉者之不同也。太阴脏搏者。乃太阴之经脉相搏。故见脉象之伏鼓。如二阴之气相搏。以至于少
阴之肾。只见乎沉而不浮。盖以脉象之浮沉。以别阴阳之气。以脉体之滑动不实。鼓动而伏。以别阴阳之脉也。此篇论
欲识病脉。先知经脉。然欲知经脉。又当体析其经与气焉。)
黄帝问道:人的居住环境、活动状态以及勇敢或怯懦的性格,是否也会使脉象发生变化呢?(按《三部九候论》到《至真要大论》,与《灵枢·九针论》前后相符,只有本篇与《脏气法时论》稍有不同。然而这两篇的宗旨,乃是《三部九候论》所说的“必须先了解正常经脉,然后才能识别病脉”,以及《脏气法时论》所说的“通过观察脏腑功能,来推断生死期限”。大概《灵枢》中的九针等九篇,共八十一篇,论述都在《灵枢经》内,这里又专门论述三部九候的方法,所以必须先知道经脉生成的本源,然后才能了解九候的病脉;懂得五脏生克之理,然后才能知晓生死期限。因此设立这两个问题。)岐伯回答说:凡是人的惊恐、愤怒、劳累、运动或静止,都会导致脉象变化。(意思是人的居住安静,其气血平和,自有正常的脉象;如果动作过度使用,就会变为病脉。)所以夜间行走,喘息之气出于肾,邪气淫溢伤害肺。(肾对应亥子时,主闭藏。夜间行走则肾气外泄,所以喘息出于肾。肾为本,肺为末,肾气上逆,所以淫伤于肺。喘属于肺的证候,又说阳明经气厥逆也会喘。汗由肺主皮毛,并生于胃腑的津液。本章先论喘,后论汗,是说经脉营卫之气,生于胃腑水谷之津液,而通会于肺气,这是有常规道理的。如果劳动过度损伤,则五脏气机逆乱,脉象也随之改变,所以先论述其变化,而后论述其常态。)如果有坠落受惊,喘息之气出于肝,邪气淫溢伤害脾。(坠落则伤筋,筋归属于肝,所以喘息出于肝。木克土,所以邪气伤害脾。)如果有突然惊恐,喘息之气出于肺,邪气淫溢伤害心。(惊则气乱,所以喘息出于肺。肺是心的覆盖物,所以邪气伤害心。)如果涉水跌倒,喘息之气出于肾和骨。(跌倒则伤骨,骨归属于肾,所以喘息出于此。徐公遐说:肾生骨髓,髓生肝,骨是肾之精气所注。最后提到骨,那么五脏的生气可以类推了。)在这个时候,勇敢的人气机运行通畅就没事了,怯弱的人则气机滞留而发病。(意思是这几者都损伤五脏之气,勇敢的人逆气已过,正气恢复顺畅;怯弱的人则气机留着成为疾病,出现病脉。)所以说,诊病的道理,观察人的勇敢与怯弱、骨肉皮肤的状况,能了解其情状,以此作为诊法的关键。(气有勇怯之分,生理结构有疏密之别,皮肤有厚薄之差,骨肉有坚脆之异,能了解这些情况,作为诊法的要领。)所以饮食过饱,汗出于胃(汗是水谷的津液,吃得太饱则胃满,所以出汗。)受到惊吓耗夺心神,汗出于心(血是心的精微,汗是血的液体,惊吓伤心气,汗出于心,所以说夺精。经文说:夺汗者无血。)手持重物远行,汗出于肾(持重远行则伤骨,所以汗出于肾。)急速奔跑且恐惧,汗出于肝(疲劳伤筋,所以汗出于肝。)身体摇动劳作辛苦,汗出于脾(劳伤四肢,所以汗出于脾。)所以春夏秋冬四季因阴阳生病,都起于过度使用,这是常理。(四时阴阳自有常规,气血循行各有调理,如果动作过度损伤,则气血妄逆而生病,这是自然之理。《口问篇》说:百病的发生,都生于风雨寒暑、阴阳喜怒、饮食居处、大惊卒恐,这会导致血气分离,阴阳破散,经络厥绝,脉道不通,阴阳相逆,卫气稽留,经脉空虚,血气无序,从而失去常态。因此惊恐、愤怒、劳累、动作、饮食,导致喘和出汗,都是使气血无序,脉道失常。所以想要知道经脉的循行,先要认识变常的逆气。徐公遐说:喘汗的证候,是经气逆行,所以首先提出“脉也为此变化”,又说“能了解其情状,作为诊法”。)
食物进入胃中,将精微散布于肝,淫溢滋养于筋。(肝属木,克制脾土,制则生化,所以将精微散布于肝。肝主筋,所以淫气于筋。经文说:谷入于胃,脉道乃通,血气乃行。这说明营卫气血,都是水谷所资生的,而水谷入胃,各有淫散输转的途径,所以必须先知经脉生成的本源,而后知病脉。)食物进入胃中,浊气归于心,淫溢精微于脉。(经文说:受谷者浊。胃中的食气,所以叫浊气。胃络上通于心,所以入胃的食物之气归于心,这是子令母实。心气通于脉,所以淫精于脉。伯高说:谷始入于胃,其精微者,先出于胃的两焦,以灌溉五脏,别出而行营卫之道。其中大气搏结而不行的,积聚在胸中,名叫气海,出于肺,循喉咙而司呼吸。又说:谷入于胃,乃传之肺,五脏六腑皆以受气。所谓先出于胃的两焦,是指入胃的谷气,先下淫于腑,上归于心肺,以养五脏气。本章论经脉之道,是由水谷之精来养脏腑,脏腑之精,淫于经脉,气口成寸,以决死生。所谓五脏都禀受气于胃,而至于手太阴肺经。另外两行运行的营卫与宗气,又应当另作讨论,志同道合者,应当细玩诸经,体认明白。)脉气流经,经气归于肺,肺朝百脉,输精于皮毛。(脉气,是水谷的精气,而行于经脉中。经,指大经。意思是入胃的谷气,先淫气于脉,百脉的经气,总归于大经,经气归于肺,所以百脉之气,都朝会于肺。肺合皮毛,所以再输精于皮毛。)毛脉合精,行气于腑。(经文说:血独盛,则淡渗皮肤,生毫毛。皮肤主气,经脉主血,毛脉合精,就是血气相合。六腑为阳,所以先受气。张兆璜说:淡渗皮毛的血,与经脉的血相合,所以叫毛脉合精。)腑精神明,留于四脏。(腑精神明,是指六腑的津液相成,神气自然产生。谷气入胃,淫精于脉,乃传之肺,肺气散精,行气于腑,腑精留于四脏,以养五脏之气。所以说:谷入于胃,乃传之肺,五脏六腑皆以受气。)气归于权衡,权衡以平,气口成寸,以决死生。(权衡,即平的意思。说脉的浮沉出入,阴阳和平,所以叫权衡以平。气口,是手太阴肺经的两个脉口。成寸,是将尺部分为寸部。意思是五脏六腑受气于谷,浮精于脉,变见于气口,以此决定死生。)饮水进入胃中,游溢精气,上输于脾,脾气散精,上归于肺,通调水道,下输膀胱,水精四布,五经并行。(入胃的饮,精气上输于脾,脾气散精,上归于肺。盖脾主为胃行其津液。肺应天而主气,所以能通调水道,而下输膀胱,所谓地气升而为云,天气降而为雨。水精四布,是气化则水行,所以四布于皮毛。五经并行,是通灌于五脏的经脉。《平脉篇》说:谷入于胃,脉道乃行,水入于经,其血乃成。所以先论食而后论饮。)合于四时五脏,阴阳揆度,以为常也。(五脏,是五行之气。揆度,是度数。总结上文,说经脉之道,合于四时五行之次序,阴阳出入之度数,作为经脉的常规。)
太阳脏独至,出现厥逆喘促,虚气上逆,这是阴不足,阳有余。表里应当俱泻,取足部的下俞穴。(这是说脏腑经脉有阴阳相合的常度,如偏阴偏阳之独至,则为厥喘诸病。所谓先知经脉,今识病脉。太阳脏独至,是太阳的经气独至,而无阴气之和。阳气惟上,所以下厥上喘,而虚气上逆。这是阴不足而阳有余,表里俱当泻。盖太阳经气,发源于下,而上出于肤表,所以应当表里俱泻,而取之下俞。)阳明脏独至,是阳气重并。应当泻阳补阴,取足部的下俞穴。(《阴阳系日月篇》说:寅是正月之生阳,主左足之少阳;未是六月,主右足之少阳;卯是二月,主左足之太阳;午是五月,主右足之太阳;辰是三月,主左足之阳明;巳是四月,主右足之阳明。这两阳合于前,所以叫阳明。阳明之独至,是太少二阳重并于阳明,阳盛故阴虚。这是说阴阳并合,乃经脉之常,如阳并于阳,阴并于阴,则为病脉。所以说:持雌守雄,弃阴附阳,不知并合,诊故不明。)少阳脏独至,是厥气。跷脉之前突然盛大,取足部的下俞穴。(少阳主初生之气,生气厥逆于下,以致脏脉之独大于跷前。跷者,奇经之跷脉,足少阳经脉,在阳跷之前,所以跷前卒大。朱卫公说:言跷前卒大者,解释三阳之脉,候足之三阳。盖生阳之气,皆从下而上,由阴而阳,所以俱取之下俞。又申明三阴三阳之候,候十二经之本脉。如跷前少阳之脉卒大,而厥阴之动脉微小者,是为少阳独至。所谓太阳少阳太阴少阴者,论阴阳之经脉。经脉连于脏腑,故曰脏。所谓一阳二阳一阴二阴者,论三阴三阳之气。此节论有病经而及于无病之气者,有病气而及于有形之经者。盖病在经者由脏而经,由经而气;病在气者由气而经,由经而脏。)少阳独至,是一阳的过错。(这是申明经气各有分别。夫一阴一阳,分而为三阴三阳,三阴三阳,合于手足十二经脉,十二经脉,合于十二脏。腑所以藏物,故亦名脏。所谓太阳阳明少阳脏独至者,言三阳经脉之独盛。三阳经脉之独盛者,是三阳气之太过。)太阴脏搏,须用心省察真气,五脉气少,胃气不平,属于三阴。宜治其下俞,补阳泻阴。(这是说三阴三阳之经气,皆有手有足。夫手之太阴,足之太阴,是为三阴,是以太阴之脏脉相搏者,须用心省察,其为手之太阴,还是足之太阴?如五脉气少者,是手太阴的过错。盖肺朝百脉,而输精于脏腑,肺气搏而不行,则五脉之气皆少,是以五脉气少者,知在手之太阴。脾主为胃行其津液,脾气搏而不行,是以胃气不平。胃气不平者,知在足之太阴。手之太阴,足之太阴,而后谓之三阴。足之三阴,从足走腹;手之三阴,从腹走手。手足经气,交相贯通,故独取之下俞。徐公遐说:此复申明所谓三阴三阳者,概手足而言。盖阴阳之气,皆从下而上,故独取之下俞。)一阳独啸,是少阳厥逆。(这是说经厥而及于气。夫气激于喉中而浊,谓之“言”;气激于舌端而清,为之“啸”。盖气郁而欲伸出之。一阳之气独啸者,盖因少阳之经气厥逆。所谓少阳独至,一阳之过者,言气盛而及于经;一阳独啸,少阳厥者,言经逆而及于气。分而论之,有气有经;合而论之,经气之相关。朱卫公说:以太阴开于其间者,当知三阴三阳之经气,皆若是。张兆璜说:少阳厥者,木火之气郁也。木郁之发,松吟高山,虎啸岩岫。古之善啸者,听溪中虎声而泻之。一阳独啸之义,盖取诸此。)阳并于上,四脉争张,气归于肾,宜治其经络,泻阳补阴。(阳并,是太阳阳明之气相并。四脉,是太阳的小肠膀胱,阳明的胃与大肠,即四形藏之脉。四脉争张,以致阳并于上,也是经厥而及于气。肾为生气之原,此三阳之气,虚陷于肾,不能与阳相接,故宜泻其阳之络,补其阴之经,阴阳平而经气和。四脉争张,是四形藏之气盛;气归真虚,是五神藏之气虚。)一阴至,是厥阴的治理。真虚无心,厥气留薄,发为白汗,调食和药,治在下俞。(音狷。这是说经气逆,而病及于脏。一阴者,厥阴也。是以一阴气至,当厥阴主治,而反见脏真之虚。心为痛,盖厥阴之气,发于命门,为心主之包络。厥阴气逆,以至真虚而心痛。厥逆之气,留薄于心下,则上迫于肺,故发为白汗。夫真虚痛心,病在内;经气厥逆,病在外。病在内者,治以药食;病在外者,治以针砭。故宜调食和药,治其下俞。夫所谓一阳二阳三阳,一阴二阴三阴者,阴阳之二气也。所谓太阳阳明少阳,太阴厥阴少阴者,概脏腑经气而言。人禀天地阴阳之气,而成此形,是有有形之脏腑经脉,有无形之阴阳六气。虽然,脏不离乎经,经不离乎气,气不离乎脏,经气贯通,脏气并合,阴阳出入,上下循环。是以有论三阳之独至者,有论在手经足经者,有论经病而及于气,气病而及于经者,有论阴阳之不相合者,有论经气逆而病及于脏者。此皆阴阳之道,可合可分,书不尽言,举一以隅。学人当知一经之气若是,则十二经可知,能引而伸之,进乎技矣。厥阴之治,谓当足厥阴之经脉主治。此言三阴三阳之气,可合于六经,可通于脏腑,当与末节合论三阴之气而各有分别焉。)
皇帝问:太阳脏有什么脉象?(太阳脏者,谓小肠膀胱之经脉。象者,效象形容。此复论经气之见于脉者,各有别。此言三阴三阳之气合于十二经而应于脉,非气之行于脉中也。故太阳之脉象上三阳之气盛而浮,少阳之脉象上一阳气之初生。若一阳之气行于脉中,则滑而不实。此申明阳脏独至阴脏相搏者,乃因气而见于脉,故曰少阳独至者,一阳之过。)岐伯答:象三阳而浮。(象者,像也。三阳,阳盛之气。言太阳之脏脉,象阳盛之气而浮。)皇帝问:少阳脏有什么脉象?岐伯答:象一阳。(少阳脏者,三焦胆之经气,故象一阳初动之生阳。)一阳脏者,滑而不实。(所谓一阳二阳者,乃三阳之气。气应脉外,故以脉之浮沉,以效象阴阳之气。如在一阳之脏脉,则见脉体之滑象。盖阳气搏于脉中,其脉则滑,阳欲外浮,故不实。此反结上文,而言一阳之脏脉,与一阳之气见于脉者之不同。)皇帝问:阳明脏有什么脉象?岐伯答:象大浮。(阳明脏者,胃与大肠之经脉。阳明者,两阳合明,阳气合并,则阳热盛,故其象大浮。象大浮者,二阳之气。)太阴脏搏,言伏鼓也。二阴搏至肾,沉不浮也。(此复结阴脏之经脉,与阴气之见于脉者之不同。太阴脏搏者,乃太阴之经脉相搏,故见脉象之伏鼓。如二阴之气相搏,以至于少阴之肾,只见乎沉而不浮。盖以脉象之浮沉,以别阴阳之气,以脉体之滑动不实,鼓动而伏,以别阴阳之脉。此篇论欲识病脉,先知经脉,然欲知经脉,又当体析其经与气。)
Elucidates the principle that normal and pathological meridians have distinct characteristics.
The Yellow Emperor asked: Do a person's living environment, activity levels, and disposition (courage or timidity) also cause changes in the pulse? (According to the *San Bu Jiu Hou Lun* [Treatise on Three Regions and Nine Palpations] through the *Zhi Zhen Yao Da Lun* [Great Treatise on the Most Essential Truths], and consistent with the *Jiu Zhen Lun* [Treatise on the Nine Needles] in the *Ling Shu*, the accounts align. Only this chapter and the *Zang Qi Fa Shi Lun* [Treatise on Organ Functions Corresponding to Time] show slight differences. However, the purport of these chapters corresponds to what is stated in the *San Bu Jiu Hou Lun*: "One must first understand normal meridians before understanding pathological pulses," and what is stated in the *Zang Qi Fa Shi Lun*: "By observing the zang-fu organs, one can determine the period of life and death." Generally, the nine chapters on nine needles within the *Ling Shu Jing* [Spiritual Pivot], totaling eighty-one chapters, discuss these topics. Here, the method of three regions and nine palpations is discussed again. Therefore, one must first know the origin of the generation of normal meridians before understanding the pathological pulses of the nine palpations; and understanding the generative and controlling cycles of the five zang organs allows one to know the timing of life and death. Thus, these two questions are posed.) The Qi Bo replied: All instances of fright, anger, labor, movement, or stillness in humans result in pulse variations. (This means that when a person lives quietly, their qi and blood are harmonious, possessing a regular pulse; however, if physical exertion is excessive, it transforms into a pathological pulse.) Therefore, walking at night causes panting originating from the Kidney, with pathogenic qi overflowing to damage the Lung. (The Kidney corresponds to the Hai and Zi hours and governs closure and storage. Walking at night causes Kidney qi to leak outward, hence panting originates from the Kidney. The Kidney is the root, and the Lung is the branch; when Kidney qi rebels upward, it damages the Lung. Panting is a syndrome of the Lung; it is also said that rebellion of the Yangming meridian causes panting. Sweat is governed by the Lung's domain of skin and hair, and is generated from the fluids of the Stomach. This chapter discusses panting first and sweat second, indicating that the Ying and Wei qi of the meridians are generated from the water and grain fluids of the Stomach and converge in the Lung's qi, which is the regular physiological principle. If labor causes excessive injury, the qi of the five zang organs rebels, and the pulse changes accordingly. Hence, the variations are discussed first, followed by the normal state.) If there is a fall accompanied by fear, panting originates from the Liver, and pathogenic qi overflows to harm the Spleen. (Falling injures the sinews, which correspond to the Liver; thus, panting originates from the Liver. Wood overcomes Earth, so pathogenic qi harms the Spleen.) If there is sudden fright, panting originates from the Lung, and pathogenic qi overflows to damage the Heart. (Fright causes qi chaos, hence panting originates from the Lung. The Lung covers the Heart, so pathogenic qi damages the Heart.) If wading through water or falling, panting originates from the Kidney and bones. (Falling injures the bones, which correspond to the Kidney; thus, panting arises here. Xu Gongxia stated: The Kidney generates marrow, and marrow generates the Liver; bones are where the essence and qi of the Kidney accumulate. Mentioning bones last implies that the vital qi of the five zang organs can be inferred by analogy.) At such times, courageous individuals experience smooth qi flow and recover, while timid individuals suffer from stagnant qi and develop disease. (This means these factors all injure the qi of the five zang organs. In courageous individuals, rebellious qi passes, and righteous qi returns to smoothness; in timid individuals, qi stagnates causing disease, manifesting as pathological pulses.) Therefore, it is said: The way to diagnose disease involves observing a person's courage or timidity, and the condition of their bones, flesh, and skin, to understand their constitution, which serves as a key diagnostic method. (Qi has distinctions of courage and timidity; physiological structures vary in density; skin varies in thickness; bones and flesh vary in firmness. Understanding these conditions is essential for diagnosis.) Thus, eating until extremely full causes sweat to originate from the Stomach (Sweat is the fluid of food and drink; extreme fullness fills the Stomach, causing sweating). Being startled and losing essence causes sweat to originate from the Heart (Blood is the essence of the Heart, and sweat is the fluid of blood. Startle injures Heart qi, causing sweat from the Heart; hence it is called "losing essence." The classic states: "Those who lose sweat have no blood"). Carrying heavy weights over long distances causes sweat to originate from the Kidney (Carrying heavy loads and traveling far injures the bones, hence sweat originates from the Kidney). Running fast while fearful causes sweat to originate from the Liver (Exhaustion injures the sinews, hence sweat originates from the Liver). Bodily shaking and arduous labor cause sweat to originate from the Spleen (Labor injures the four limbs, hence sweat originates from the Spleen). Therefore, diseases arising from yin and yang in the four seasons are caused by overexertion; this is the constant rule. (Yin and yang of the four seasons have their regularities, and qi and blood circulation have their own regulation. If physical action causes excessive injury, qi and blood rebel recklessly, leading to disease; this is natural law. The *Kou Wen Pian* [Treatise on Mouth Questions] states: The onset of all diseases arises from wind, rain, cold, heat, yin-yang emotions, diet, residence, great surprise, or sudden fear. These cause separation of qi and blood, dispersion of yin and yang, interruption of collaterals, blockage of pulse channels, reversal of yin and yang, retention of Wei qi, emptiness of meridians, disorder of qi and blood, and loss of normalcy. Therefore, fright, anger, labor, movement, and diet lead to panting and sweating by disrupting qi and blood order and altering pulse channels. To understand meridian circulation, one must first recognize the rebellious qi of variation and constancy. Xu Gongxia stated: Panting and sweating syndromes are due to reverse flow of meridian qi; thus, it is first mentioned that "the pulse also changes for this," and further, "understanding their condition establishes the diagnostic method.")
When food enters the Stomach, its essence is dispersed to the Liver and nourishes the sinews. (The Liver belongs to Wood, overcoming Earth; under control, transformation occurs, dispersing essence to the Liver. The Liver governs sinews, thus nourishing them. The classic states: "When grain enters the Stomach, the pulse channel flows, and qi and blood move." This indicates that Ying, Wei, qi, and blood are all produced from water and grain. Since water and grain enter the Stomach, they have specific pathways for overflow, dispersion, and transport. Thus, one must first know the origin of meridian generation before understanding pathological pulses.) When food enters the Stomach, turbid qi returns to the Heart, and essence overflows into the vessels. (The classic states: "Those receiving grain produce turbid qi." The food qi in the Stomach is thus called turbid qi. The Stomach collateral connects upward to the Heart, so food qi entering the Stomach returns to the Heart, following the principle of the child stimulating the mother. Heart qi connects to the vessels, thus overflowing essence into the vessels. Bo Gao stated: "Grain initially enters the Stomach; its finest essences first emerge from the two jiao of the Stomach to irrigate the five zang organs, exiting separately to follow the path of Ying and Wei. The large qi that gathers and does not circulate accumulates in the chest, named the Sea of Qi, emerging from the Lung, circulating through the throat to govern respiration." It also states: "Grain enters the Stomach, then transmits to the Lung, and all five zang and six fu organs receive qi." What is meant by "first emerging from the two jiao of the Stomach" is that grain qi entering the Stomach first overflows downward to the fu organs and upward to the Heart and Lung to nourish the five zang organs. This chapter discusses the way of meridians: water and grain essence nourishes the zang-fu organs, and zang-fu essence overflows into the meridians. The Qi Kou (Radial Pulse) forms the cun position to decide life and death. It is said that the five zang organs all receive qi from the Stomach, reaching the Hand Taiyin Lung Meridian. The separate Ying and Wei and Zong Qi flowing in two lines should be discussed separately. Those with shared aspirations should carefully study the various classics and comprehend them clearly.) Meridian qi flows through the channels, and channel qi returns to the Lung. The Lung directs all vessels and transmits essence to the skin and hair. (Meridian qi refers to the fine essence of water and grain circulating within the meridians. "Jing" refers to the main channels. It means that grain qi entering the Stomach first overflows into the vessels; the channel qi of all hundred vessels totals in the main channel, and channel qi returns to the Lung. Thus, the qi of all hundred vessels converges in the Lung. The Lung governs skin and hair, thus transmitting essence to them.) Skin and vessel essence combine, transmitting qi to the fu organs. (The classic states: "If blood alone is abundant, it渗uates into the skin, generating hair and down." Skin governs qi, and vessels govern blood. Combining skin and vessel essence means the union of blood and qi. The six fu organs are yang, so they receive qi first. Zhang Zhaohuang stated: The blood渗uating into the skin and hair combines with the blood in the meridians, hence called combining skin and vessel essence.) Fu organ spirit becomes bright, remaining in the four zang organs. (Fu organ spirit becoming bright means the fluids of the six fu organs interact to generate spiritual brightness. Grain qi enters the Stomach, overflows essence into the vessels, transmits to the Lung, Lung qi disperses essence, transmits qi to the fu organs, and fu essence remains in the four zang organs to nourish the qi of the five zang organs. Thus, it is said: "Grain enters the Stomach, then transmits to the Lung, and all five zang and six fu organs receive qi.") Qi returns to equilibrium, balanced by the scale, the Qi Kou forms the cun position to decide life and death. ("Quanheng" means balance. It refers to the floating, sinking, entering, and exiting of the pulse, where yin and yang are harmonious, hence called balanced by the scale. "Qi Kou" refers to the pulse points of the Hand Taiyin Lung Meridian. "Cheng Cun" means dividing the chi section into the cun section. It means the five zang and six fu organs receive qi from grain, float essence into the vessels, and manifest changes at the Qi Kou to decide life and death.) When drink enters the Stomach, its essence floats and overflows, transmitting upward to the Spleen. The Spleen disperses essence, returning it upward to the Lung, regulating water passages, transmitting downward to the Bladder. Water essence distributes in four directions, and the five meridians run together. (Drink entering the Stomach sends essence upward to the Spleen; the Spleen disperses essence, returning it upward to the Lung. The Spleen governs transporting fluids for the Stomach. The Lung corresponds to Heaven and governs qi, thus regulating water passages and transmitting downward to the Bladder, like earth qi rising to become clouds and heaven qi descending to become rain. "Water essence distributes in four directions" means qi transformation moves water, distributing it to the skin and hair. "Five meridians run together" means irrigating the meridians of the five zang organs. The *Ping Mai Pian* [Treatise on Normal Pulses] states: "Grain enters the Stomach, the pulse channel flows; water enters the vessels, blood is formed." Hence, food is discussed before drink.) This conforms to the four seasons and five zang organs, measuring yin and yang, establishing the constant rule. (The five zang organs represent the qi of the Five Phases. "Kuidu" means measurement/degree. Summarizing the above, the way of meridians conforms to the sequence of the four seasons and Five Phases, and the degrees of yin-yang entry and exit, serving as the regularity of meridians.)
Taiyang Zang exclusively arrives, presenting with jue逆 (reversal) and panting, with empty qi rebelling upward. This indicates yin insufficiency and yang excess. Both exterior and interior should be drained, selecting the lower shu points below. (This states that zang-fu meridians have the constant degree of yin-yang combination. Exclusive arrival of biased yin or yang leads to jue and panting syndromes. This illustrates knowing normal meridians to identify pathological pulses. "Taiyang Zang exclusively arrives" means the Taiyang meridian qi arrives exclusively without yin harmony. Yang qi tends upward, causing lower jue and upper panting, with empty qi rebelling upward. This is yin insufficiency and yang excess; both exterior and interior should be drained. Since Taiyang meridian qi originates below and emerges to the surface, both exterior and interior should be drained, selecting the lower shu points.) Yangming Zang exclusively arrives, indicating heavy accumulation of yang qi. One should drain yang and tonify yin, selecting the lower shu points below. (The *Yin Yang Xi Ri Yue Pian* [Treatise on Yin-Yang Correlating with Days and Months] states: Yin is the first month's generating yang, governing the left foot Shaoyang; Wei is the sixth month, governing the right foot Shaoyang; Mao is the second month, governing the left foot Taiyang; Wu is the fifth month, governing the right foot Taiyang; Chen is the third month, governing the left foot Yangming; Si is the fourth month, governing the right foot Yangming. These two yangs combine anteriorly, hence called Yangming. Exclusive arrival of Yangming indicates heavy accumulation of Shaoyin and Taiyang on Yangming; yang excess leads to yin deficiency. This states that yin-yang combination is the norm of meridians; if yang accumulates on yang or yin on yin, it becomes pathological. Thus, it says: "Holding the female and guarding the male, abandoning yin to attach to yang, not understanding accumulation, makes diagnosis unclear.") Shaoyang Zang exclusively arrives, indicating jue qi. Suddenly large at the front of the Qiao vessels, select the lower shu points below. (Shaoyang governs initial generating qi. Generating qi rebels downward, causing the zang pulse to be exclusively larger than the front of the Qiao. Qiao refers to the extraordinary Qiao meridians; the Foot Shaoyang meridian is anterior to the Yang Qiao, hence suddenly large at the front of Qiao. Zhuweigong stated: Saying "suddenly large at the front of Qiao" explains that the three yang pulses palpate the three foot yang meridians. Generating qi rises from below, moving from yin to yang, so all select the lower shu points. It further clarifies that the palps of the three yin and three yang observe the root pulses of the twelve meridians. If the Shaoyang pulse at the front of Qiao is suddenly large, while the Jueyin artery is minute, this is exclusive arrival of Shaoyang. Discussing Taiyang, Shaoyang, Taiyin, and Shaoyin refers to yin-yang meridians. Meridians connect to zang-fu, hence called Zang. Discussing one yang, two yang, one yin, two yin refers to the qi of the three yin and three yang. This section discusses having diseased meridians affecting non-diseased qi, and diseased qi affecting structured meridians. Disease in meridians proceeds from zang to meridian to qi; disease in qi proceeds from qi to meridian to zang.) Exclusive arrival of Shaoyang is the fault of one yang. (This clarifies that meridian qi has distinct differences. One yin and one yang divide into three yin and three yang; three yin and three yang combine with the hand and foot twelve meridians; twelve meridians combine with twelve zang-fu. Fu organs store substances, hence also called zang. "Exclusive arrival of Taiyang, Yangming, and Shaoyang Zang" refers to the exclusive prosperity of the three yang meridians. Exclusive prosperity of three yang meridians means excessive three yang qi.) Taiyin Zang pulsation requires careful examination of true qi. The five pulses lack qi, stomach qi is uneven, belonging to the three yin. One should treat the lower shu points, tonifying yang and draining yin. (This states that the meridian qi of the three yin and three yang includes both hand and foot. The Hand Taiyin and Foot Taiyin constitute the three yin. Thus, when Taiyin zang pulses interact, one must carefully examine whether it is Hand Taiyin or Foot Taiyin. If the five pulses lack qi, it is the fault of Hand Taiyin. The Lung directs all vessels and transmits essence to zang-fu; if Lung qi gathers without moving, the qi of all five pulses lacks. Thus, lacking qi in five pulses indicates Hand Taiyin. The Spleen transports fluids for the Stomach; if Spleen qi gathers without moving, stomach qi is uneven. Uneven stomach qi indicates Foot Taiyin. Hand Taiyin and Foot Taiyin together are called the three yin. The three foot yin meridians travel from foot to abdomen; the three hand yin meridians travel from abdomen to hand. Hand and foot meridian qi interconnect, so only the lower shu points are selected. Xu Gongxia stated: This reiterates that "three yin and three yang" generally refers to hand and foot. Since yin-yang qi rises from below, only the lower shu points are selected.) One yang whistling exclusively indicates Shaoyang jue. (This states that meridian jue affects qi. Qi agitated in the throat becomes turbid, called "speech"; qi agitated at the tip of the tongue becomes clear, called "whistling." It implies qi stagnating and wanting to extend. Exclusive whistling of one yang qi is due to Shaoyang meridian qi rebellion. "Exclusive arrival of Shaoyang, fault of one yang" means qi excess affecting meridians; "exclusive whistling of one yang, Shaoyang jue" means meridian rebellion affecting qi. Analyzed separately, there is qi and meridian; analyzed jointly, there is meridian-qi correlation. Zhuweigong stated: With Taiyin opening in between, one should know that the meridian qi of the three yin and three yang is all like this. Zhang Zhaohuang stated: Shaoyang jue is stagnation of wood and fire qi. When wood stagnation erupts, pines chant on high mountains, tigers roar in rocky peaks. Ancient experts in whistling listened to tiger sounds in streams and treated accordingly. The meaning of exclusive whistling of one yang is derived from this.) Yang accumulating above, four pulses competing to expand, qi returns to the Kidney. One should treat the meridians and collaterals, draining yang and tonifying yin. (Yang accumulation refers to the merging of Taiyang and Yangming qi. The four pulses refer to the intestines and bladder of Taiyang, and the stomach and large intestine of Yangming, i.e., the pulses of the four form-storage organs. Competition of the four pulses leads to yang accumulating above, which is also meridian jue affecting qi. The Kidney is the source of generating qi. These three yang qi sink vacuously into the Kidney, unable to connect with yang. Thus, one should drain the yang collaterals and tonify the yin meridians, balancing yin and yang to harmonize meridian qi. Competition of the four pulses indicates excess qi of the four form-storage organs; qi returning to true emptiness indicates deficiency of qi in the five spirit-storage organs.) Arrival of one yin is the governance of Jueyin. True deficiency causes heart pain, jue qi lingers and presses, manifesting as white sweat. Regulate diet and harmonize medicine, treating the lower shu points. (Pronounced 'juan'. This states that meridian qi rebellion causes disease affecting the zang. One yin is Jueyin. Thus, when one yin qi arrives, Jueyin should govern, but instead, true zang deficiency appears. Heart pain occurs because Jueyin qi originates from the Gate of Vitality (Mingmen) and is the Pericardium of the Heart Master. Jueyin qi rebellion leads to true deficiency and heart pain. Jue rebellious qi lingers and presses below the heart, forcing upward to the Lung, causing white sweat. True deficiency with heart pain is disease inside; meridian qi rebellion is disease outside. Disease inside is treated with food and medicine; disease outside is treated with acupuncture and moxibustion. Thus, regulate diet and harmonize medicine, treating the lower shu points. The terms one yang, two yang, three yang, one yin, two yin, three yin refer to the two qi of yin and yang. Taiyang, Yangming, Shaoyang, Taiyin, Jueyin, Shaoyin generally refer to zang-fu meridian qi. Humans inherit heaven-earth yin-yang qi to form this body, possessing structured zang-fu meridians and unstructured six qi of yin-yang. Although zang does not leave the meridian, meridian does not leave the qi, and qi does not leave the zang, with meridian-qi connection and zang-qi combination, yin-yang entry-exit, and upper-lower circulation. Hence, some discuss exclusive arrival of three yang, some discuss hand and foot meridians, some discuss meridian disease affecting qi and qi disease affecting meridians, some discuss non-combination of yin-yang, and some discuss meridian qi rebellion affecting zang. These are all ways of yin-yang, combinable and separable. Writing cannot fully express speech; citing one example illuminates ten. Students should know that if the qi of one meridian is like this, the qi of twelve meridians can be known. Extending this leads to mastery. Governance of Jueyin means treatment via the Foot Jueyin Liver Meridian. This states that qi of three yin and three yang can combine with the six meridians and connect to zang-fu, to be discussed jointly with the final section regarding the three yin qi having respective distinctions.)
The Emperor asked: What is the image of the Taiyang Zang? (Taiyang Zang refers to the meridians of the Small Intestine and Bladder. "Image" means manifestation or description. This re-discusses how meridian qi manifests in the pulse with distinct differences. This states that qi of three yin and three yang combines with the twelve meridians and responds in the pulse, not that qi travels within the pulse. Thus, the Taiyang pulse image reflects the abundance and floating nature of San Yang qi; the Shaoyang pulse image reflects the initial generation of Yi Yang qi. If Yi Yang qi travels within the pulse, it would be slippery but not solid. This clarifies that exclusive arrival of yang zang and interaction of yin zang manifest in the pulse due to qi, hence "Exclusive arrival of Shaoyang is the fault of one yang.") Qi Bo answered: It resembles San Yang and floats. (Image means resemblance. San Yang refers to abundant yang qi. It means the Taiyang zang pulse resembles abundant yang qi and floats.) The Emperor asked: What is the image of the Shaoyang Zang? Qi Bo answered: It resembles Yi Yang. (Shaoyang Zang refers to the meridian qi of the Triple Burner and Gallbladder, thus resembling the generating yang of Yi Yang's initial movement.) One Yang Zang is slippery but not solid. (The terms one yang and two yang refer to the qi of the three yang. Qi corresponds outside the pulse, so pulse floating and sinking reflect yin-yang qi. In the pulse of One Yang Zang, a slippery quality is seen. Yang qi combats within the pulse, making it slippery; yang desires to float outward, hence not solid. This contrasts with the previous text, distinguishing the pulse of One Yang Zang from the manifestation of One Yang qi in the pulse.) The Emperor asked: What is the image of the Yangming Zang? Qi Bo answered: It resembles large and floating. (Yangming Zang refers to the meridians of the Stomach and Large Intestine. Yangming means two yangs combined and bright; when yang qi merges, yang heat is abundant, hence its image is large and floating. Resembling large and floating represents the qi of Er Yang.) Taiyin Zang pulsation describes deep and drum-like beating. Two Yin pulsating reaches the Kidney, sinking but not floating. (This concludes the difference between yin zang meridians and the manifestation of yin qi in the pulse. Taiyin Zang pulsation means Taiyin meridians interact, showing a deep and drum-like pulse image. If Two Yin qi interacts reaching the Shaoyin Kidney, it only shows sinking without floating. Pulse floating and sinking distinguish yin-yang qi; pulse body sliding, not solid, drumming and deep distinguishes yin-yang pulses. This chapter discusses recognizing pathological pulses by first knowing normal meridians, but to know meridians, one must analyze the distinction between meridian and qi.)