The terms that make TCM writing hard to read, with pinyin and the Chinese.
同一个概念在各语言里怎么叫。中医术语的惯用译法差异很大（比如"痰"在法语文献里是 glaires，不是机器直译），所以这张表只覆盖核心概念词，且不做机器翻译。尚未收录的语言如实列出，不冒充已覆盖。
| English | 中文 | Español | Français | Deutsch | Português | 日本語 |
|---|---|---|---|---|---|---|
| Qi | 气 | qi (energía vital) | qi (énergie vitale) | Qi (Lebensenergie) | qi (energia vital) | 気（き） |
| Yin | 阴 | yin | yin | Yin | yin | 陰（いん） |
| Yang | 阳 | yang | yang | Yang | yang | 陽（よう） |
| Five Phases | 五行 | cinco fases (cinco elementos) | cinq phases | fünf Wandlungsphasen | cinco fases | 五行（ごぎょう） |
| Blood | — | sangre | sang | Blut | sangue | 血（けつ） |
| Essence | — | esencia | essence | Essenz | essência | 精（せい） |
| Spirit | — | espíritu | esprit | Geist | espírito | 神（しん） |
| Meridian | — | meridiano | méridien | Meridian | meridiano | 経絡（けいらく） |
| Acupoint | — | punto de acupuntura | point d'acupuncture | Akupunkturpunkt | ponto de acupuntura | 経穴（けいけつ）・ツボ |
| Collateral | — | colateral | collatéral | Leitbahn (Luo) | colateral | 絡脈（らくみゃく） |
| Deficiency | 虚 | deficiencia (vacío) | vide (insuffisance) | Leere (Mangel) | deficiência (vazio) | 虚（きょ） |
| Excess | 实 | exceso (plenitud) | plénitude (excès) | Fülle | excesso (plenitude) | 実（じつ） |
| Exterior | 表 | exterior | extérieur | Äußeres | exterior | 表（ひょう） |
| Interior | 里 | interior | intérieur | Inneres | interior | 裏（り） |
| Cold | 寒 | frío | froid | Kälte | frio | 寒（かん） |
| Heat | — | calor | chaleur | Hitze | calor | 熱（ねつ） |
| Dampness | — | humedad | humidité | Feuchtigkeit | umidade | 湿（しつ） |
| Dryness | 燥 | sequedad | sécheresse | Trockenheit | secura | 燥（そう） |
| Wind | 风 | viento | vent | Wind | vento | 風（ふう） |
| Phlegm | — | flema | glaires | Schleim | flema | 痰（たん） |
| Blood stasis | 瘀血 | estasis de sangre | stase de sang | Blutstagnation | estase sanguínea | 瘀血（おけつ） |
| Pulse | 脉 | pulso | pouls | Puls | pulso | 脈（みゃく） |
| Tongue | — | lengua | langue | Zunge | língua | 舌（ぜつ） |
| Diagnosis | — | diagnóstico | diagnostic | Diagnose | diagnóstico | 診断（しんだん） |
| Tonify | — | tonificar | tonifier | tonisieren (stärken) | tonificar | 補（ほ） |
| Harmonise | — | armonizar | harmoniser | harmonisieren | harmonizar | 和解（わかい） |
| Clear heat | — | despejar el calor | éliminer la chaleur | Hitze klären | limpar o calor | 清熱（せいねつ） |
| Acupuncture | 针刺 | acupuntura | acuponcture | Akupunktur | acupuntura | 鍼（はり） |
| Moxibustion | 艾灸 | moxibustión | moxibustion | Moxibustion | moxabustão | 灸（きゅう） |
| Cupping | 拔罐 | ventosas | ventouses | Schröpfen | ventosaterapia | 吸い玉（すいだま） |
| Tuina | 推拿 | tuina (masaje chino) | tuina (massage chinois) | Tuina | tuiná | 推拿（すいな） |
| Pattern | — | patrón | tableau (syndrome) | Muster | padrão | 証（しょう） |
| Formula | — | fórmula | formule (préparation) | Rezeptur | fórmula | 方剤（ほうざい） |
| Herb | — | planta medicinal | plante médicinale | Heilpflanze | erva medicinal | 生薬（しょうやく） |
| Needling sensation | — | sensación de puntura (deqi) | sensation de piqûre (deqi) | Nadelgefühl (Deqi) | sensação de agulhamento (deqi) | 得気（とっき） |
已收录：Español · Français · Deutsch · Português · 日本語 计划中：한국어 · Русский · العربية
The medical tradition of China, with about two millennia of written record.
中国的医学传统，有约两千年的文献记载。
The cooler, quieter, interior, resting, material aspect of a phenomenon.
事物中偏于寒凉、安静、内在、收藏、物质的一面。
The warmer, more active, exterior, moving, functional aspect.
事物中偏于温热、活动、外在、升发、功能的一面。
Functional activity — the capacity to transform, move, warm, hold and protect. Not a measurable substance.
功能活动——转化、推动、温煦、固摄、防御的能力。不是可测量的物质。
The nourishing material aspect, paired with Qi as the moving aspect.
滋养的物质一面，与"气"的推动一面相对。
Thin fluids that moisten, and thicker fluids that nourish joints and marrow.
清稀者润养肌肤，稠厚者滋养关节与骨髓。
The constitutional, slow-changing aspect; what you were born with plus what you drew from food and rest.
本质、变化缓慢的一面：先天所禀，加后天饮食休息所得。
Consciousness, awareness and emotional presence; read in the eyes as the key prognostic sign.
神志、意识与精神状态；望神主要看目光，被视为最重要的预后征象。
Six functional systems (Heart, Liver, Spleen, Lung, Kidney, Pericardium) — not anatomical organs.
六套功能系统（心、肝、脾、肺、肾、心包）——不是解剖器官。
Six "hollow" systems associated with receiving, transforming and transmitting.
六套"中空"系统，与受纳、传化、排泄相关。
The collective term for the TCM organ systems and their relationships.
中医脏腑系统及其相互关系的统称。
Wood, Fire, Earth, Metal and Water as five patterns of change, with generating and controlling relations.
木火土金水五种变化方式，含相生与相克关系。
Qi described as circulating at the surface and resisting external influences.
分布于体表、被认为能抗御外邪的那部分气。
Qi described as moving with the Blood and nourishing internally.
与血同行、偏于内养的那部分气。
The root Qi associated with the Kidney system and with constitutional vitality.
与肾系及先天元气相关的那部分气。
Qi associated with breath, the chest and the heart.
与呼吸、胸中及心相关的那部分气。
A concept and a point in the lower back, associated with the root of Yang.
腰部的概念与腧穴，与传统"阳气之根"相关。
The region below the navel used as a focus of attention in practice. Not an organ or a standard point.
小腹一带，练功时注意力所放之处。不是器官，也不在标准经穴名单中。
The relational map of channels used to organise reasoning about the body.
用来组织身体推理的通道关系图。
The branching, finer level of the channel system.
经络系统中分支、更细的一层。
Six Yang and six Yin channels, each linked to a Zang or Fu system.
六阳经与六阴经，各与一脏或一腑相连。
Eight vessels outside the primary twelve, including the Governing and Conception Vessels.
十二正经之外的五条以上特殊通道，含督脉与任脉。
Wind, Cold, Summer-heat, Damp, Dryness and Fire — descriptions of external influences.
风、寒、暑、湿、燥、火——对"外界影响"的描述语言。
The most abstract of the six: signs that move around or come on suddenly.
六淫中最抽象者：游走不定或突然出现的征象。
Describes contraction, slowing and a preference for warmth.
描述收缩、迟缓与喜温的倾向。
The influence associated with hot weather and heavy fluid loss.
与暑热天气及津液耗损相关的描述。
Describes heaviness, sluggishness and turbidity — a common pattern category.
描述沉重、黏滞、浑浊——常见的证候范畴。
Describes drying of skin, throat, stool and fluids.
描述皮肤、咽喉、大便与津液的干燥倾向。
The most active and "hot" of the six; also used for internal heat patterns.
六淫中最活跃、最"热"者；也用于内部热类证候。
Joy, anger, worry, pensiveness, grief, fear and fright — described as affecting the organ systems.
喜、怒、忧、思、悲、恐、惊——传统认为会影响脏腑系统。
A pattern category describing turbidity, heaviness or mental clouding — not only literal mucus.
描述浑浊、沉重或神志不清的证候范畴，不专指可见的痰液。
A pattern describing fixed, stabbing pain, dark complexion or masses.
描述固定刺痛、面色晦暗或有形积块的证候。
A pattern describing distension, moving discomfort and emotionally-driven symptoms.
描述胀、走窜不适及与情绪相关的证候。
One of the eight principles: insufficient reserve, describing weakness and depletion.
八纲之一：正气不足，表现为虚弱与耗损。
One of the eight principles: an overly strong presence of something, describing fullness.
八纲之一：某一方面过盛，表现为实满。
One of the eight principles: the locus is at the surface.
八纲之一：病位偏于体表。
One of the eight principles: the locus is deeper inside.
八纲之一：病位偏于内里。
A pattern category describing cold signs and a preference for warmth.
描述寒象与喜温表现的证候范畴。
A pattern category describing heat signs such as thirst, redness and restlessness.
描述口渴、红赤、烦躁等热象的证候范畴。
Looking, listening/smelling, asking and palpating — combined into one pattern.
望、闻、问、切——四者合为"一证"。
Reading complexion, bearing and above all the tongue.
观察神色形态，尤重舌象。
Reading voice, breathing, cough and odour.
听语声、呼吸、咳嗽，辨气味。
A long structured history: sleep, appetite, digestion, temperature, pain, emotions.
结构化长问诊：睡眠、饮食、消化、寒热、疼痛、情志等。
Feeling the pulse at three positions on each wrist, plus the abdomen and channels.
按寸口三部脉，兼及腹诊与经络触诊。
Twenty-eight classical qualities read at three depths and three positions.
在浮中沉三候、寸关尺三部分辨的二十八种脉象。
The radial pulse position, read in three sections: cun, guan and chi.
桡动脉处诊脉部位，分寸、关、尺三部。
Reading the tongue body and coating. Affected by light, medicine, coffee and smoking.
观察舌质与舌苔。受光线、用药、咖啡与吸烟影响。
Colour, shape, moisture and movement — read as indicating deeper states.
颜色、形态、润燥与动态——被认为反映较深层的状况。
Colour, thickness and distribution — read as reflecting recent digestive and fluid states.
颜色、厚薄与分布——被认为反映较近的消化与津液状况。
Exterior/Interior, Cold/Heat, Deficiency/Excess, Yin/Yang — a sorting framework, not a diagnosis.
表里、寒热、虚实、阴阳——分类框架，不是诊断结论。
The TCM unit of conclusion, derived from all four examinations together.
中医的结论单位，由四诊合参得出。
The core reasoning step of TCM: turning findings into a pattern, then choosing a strategy.
中医核心推理步骤：把四诊所得归纳为证，再确定治法。
Distinguishing the underlying condition from its manifest expression, and the order of addressing them.
区分根本与表现，以及处理的先后次序。
A defined location on the body; 361 are standardised by the WHO in the Western Pacific standard.
身体上的确定位置；WHO 西太平洋标准共标准化 361 穴。
A proportional unit for locating points, defined relative to the individual body.
定位腧穴所用的比例单位，以个人形体为基准。
The most distal of the five transport points, at the tips of the fingers or toes.
五输穴中最末端者，位于指（趾）端。
The second of the five transport points, just beyond the joint.
五输穴之二，位于掌指（跖趾）关节之前。
The third of the five transport points, often also the source point.
五输穴之三，常与原穴重合。
The fourth of the five transport points, above the wrist or ankle.
五输穴之四，位于腕踝之上。
The fifth of the five transport points, near the elbow or knee.
五输穴之五，位于肘膝附近。
A cleft point, classically associated with acute presentations.
郄穴，经典中多与急性表现相关。
Eight points described as the meeting places of Qi, Blood, vessels, sinews, bone, marrow, Zang and Fu.
八处腧穴，分别称为气、血、脉、筋、骨、髓、脏、腑之会。
Eight points paired with the extraordinary vessels, used in four classical combinations.
与奇经八脉相通的八处腧穴，经典中配成四组使用。
A tender spot used as a point without a fixed location or name.
无固定位置与名称、以压痛点取用的腧穴。
The dull ache, heaviness or spreading warmth reported when a needle reaches the intended point.
针刺到位时出现的酸、麻、胀、重或传导感。
The Chinese pharmacopoeia tradition and the books that record it.
中国的药物学传统及记载它的典籍。
Cold, cool, warm and hot — the thermal character assigned to a herb.
寒、凉、温、热——药物的寒热属性。
Pungent, sweet, sour, bitter and salty — matched to the five phases.
辛、甘、酸、苦、咸——与五行相对应。
The meridian system a herb is said to act upon.
药力所归、所作用的经络系统。
Whether a herb action is described as rising, descending, floating outward or sinking inward.
药物作用趋向于升、降、浮、沉中的哪一种。
A designed combination of herbs, not a single plant — the basic unit of prescribing.
经过配伍的组方，而不是单味药——处方的单位。
The ingredient that addresses the principal aspect of the pattern.
针对证候主要方面的药物。
The ingredient that supports the chief or addresses a secondary aspect.
辅助君药或针对次要方面的药物。
The ingredient that moderates side effects or adds a needed direction.
制约偏性或补充所需方向的药物。
The ingredient that harmonises the formula or directs it to a region.
调和诸药或引经报使的药物。
Preparing a herb by heating, soaking, steaming or honey-frying to reduce toxicity or alter action.
以炒、炙、蒸、煮等方法处理药材，以减毒或改变药性。
Several herbs boiled together and the liquid drunk.
数味药同煎，服用煎液。
A formula recorded in the Han-dynasty classical texts, used as a standard.
出自汉代经典文献、被后世奉为准绳的方剂。
A manufactured, standardised Chinese herbal product — pills, granules or capsules.
工业化、标准化的中药制品——丸、颗粒或胶囊。
Inserting fine sterile needles at selected points, usually retained 15-30 minutes.
以一次性无菌毫针刺入选定腧穴，通常留针 15–30 分钟。
Burning dried mugwort near or on a point to deliver gentle heat.
点燃艾绒，靠近或置于穴位施以温热。
Cups held to the skin by suction, leaving marks that fade in days.
以负压吸附于皮肤，留下数日消退的罐印。
Stroking the skin with a smooth tool to produce petechiae.
以光滑器具在皮肤上刮拭，出现瘀点。
A structured bodywork tradition using pressing, rolling and joint mobilisation.
结构化手法体系，含按、滚、揉与关节活动。
Movement, breath and attention practised together.
动作、呼吸与意念合练。
A moving practice and martial art, studied in English research mostly as gentle physical activity.
一种动态练法与武术，英语研究中多作为缓和身体活动研究。
The ancient forerunner of qigong — guiding and stretching the body and breath.
气功的前身——导气令和、引体令柔。
Using the thermal and flavour properties of ordinary foods in the same framework as herbs.
按与中药相同的性味框架使用日常食物。
The tradition of daily practices for maintaining health rather than treating illness.
以日常起居、饮食、运动维持健康的传统，偏于"未病先养"。
The twenty-four divisions of the agricultural year, used to time seasonal health advice.
一年二十四段的时间划分，用于安排顺时养生。
The Inner Canon of the Yellow Emperor — the foundational text, compiled around the Han dynasty.
《黄帝内经》——中医奠基之作，约成书于汉代。
The first of the two parts of the Inner Canon, covering theory and its principles.
《内经》两部分之一，偏于理论原则。
The second part of the Inner Canon, with much of the material on needling.
《内经》另一部分，含大量针刺相关内容。
The Classic of Difficult Issues, which formalised the pulse and the five transport points.
《难经》——系统化论述脉学与五输穴。
The earliest Chinese materia medica, listing 365 substances in three grades.
最早的药物学专著，载药 365 种，分上中下三品。
Treatise on Cold Damage — the source of the classical formula tradition.
《伤寒论》——经方传统的源头。
Essentials of the Golden Cabinet, by the same author, covering internal and miscellaneous diseases.
《金匮要略》——同一作者所著，论内伤杂病。
The Great Compendium of Materia Medica, compiled in the sixteenth century with 1,892 substances.
《本草纲目》——明代编成，载药 1,892 种。
The Classic of the Pulse, which standardised twenty-four pulse qualities.
《脉经》——系统化了二十四脉。
A Han-dynasty physician remembered for surgery and for the "five animal frolics" exercise set.
汉代医家，以外科与"五禽戏"著称。
The Han-dynasty physician credited with the classical formula tradition.
汉代医家，被奉为经方传统的奠基人。
The Ming-dynasty author of the Great Compendium of Materia Medica.
明代药物学家，《本草纲目》作者。
The Tang-dynasty physician whose writings on medical ethics are still quoted.
唐代医家，其医德论述至今被引用。
How the roles inside a formula are described: one herb leads, others support it, moderate it, or guide it to where it is needed.
方剂内各味药角色的传统说法：君药主病，臣药相助，佐药制约调和，使药引经报使。
A pair describing how deep a pattern sits - at the surface of the body, or deeper inside. It is also used for the paired relationship between certain organs and meridians.
描述病位深浅的一对概念：病在体表为表，病在脏腑为里。也用来表示某些脏腑与经络之间的配对关系。
A pair describing the thermal tendency of a pattern, judged mainly from symptoms such as aversion to cold, thirst, colour and pulse, rather than by temperature alone.
描述证候寒热倾向的一对概念，主要从恶寒、口渴、面色、脉象等症状判断，而不只是看体温。
Whether the body's own resources are short (deficiency) or something is in excess (excess). This pair decides the direction of treatment.
正气不足为虚，邪气有余为实。这一对概念决定治疗的方向。
Upright qi is the body's own capacity to resist and recover. Pathogenic qi is whatever challenges it. Illness is described as the contest between the two.
正指人体自身的抗病与恢复能力，邪指致病因素。疾病被描述为二者之间的消长。
The direction and rhythm in which qi is described as moving - rising, descending, leaving and entering. Much of treatment aims at restoring this movement.
气在体内升降出入的方向与节律。治疗在很大程度上是恢复这种运动。
A later framework for acute febrile illness, developed mainly by Qing-era physicians as a complement to the cold-damage tradition.
主要形成于清代、用于急性热病的辨证框架，是对伤寒传统的补充。
One of the six fu. It is described as a functional division of the torso into upper, middle and lower regions rather than as an organ with a clear anatomical counterpart.
六腑之一。传统上按上、中、下把躯干分为三个功能区，并没有明确对应的解剖器官。
Felt with light pressure and weaker when pressed harder. Classically associated with the exterior.
轻按即得、重按反弱的脉象。传统上与表证相关。
Felt only with heavier pressure. Classically associated with the interior.
需重按才明显的脉象。传统上与里证相关。
Faster than the normal rate - classically more than five beats per breath. Associated with heat.
比正常快的脉象，传统以一次呼吸超过五至为度。与热相关。
Slower than the normal rate - classically fewer than four beats per breath. Associated with cold.
比正常慢的脉象，传统以一次呼吸不足四至为度。与寒相关。
Smooth and rounded, described in the classics as beads running over a plate. Traditionally seen with phlegm, food stagnation, and in pregnancy.
圆滑流利，古人形容如盘走珠。传统上见于痰浊、食积，也见于妊娠。
Taut, straight and springy, described as a plucked string. Traditionally linked to the Liver system and to pain.
端直而长、如按琴弦。传统上与肝系及疼痛相关。
Points on each limb meridian below the elbow or knee, classified as Well, Spring, Stream, River and Sea. Each has a different classical emphasis.
四肢肘膝以下每条经上的五个特定穴，分为井、荥、输、经、合。传统上各有所主。
A point on each meridian where the source qi is said to pass and stay. Commonly used in classical practice.
每条经上传统认为原气经过与留止的腧穴，古典临床常用。
A point from which a connecting vessel is said to branch off, linking a paired interior-exterior meridians.
络脉由此分出的腧穴，传统认为能沟通相表里的两条经脉。
A point on the chest or abdomen where the qi of a given organ is said to gather. Used mainly for that organ's disorders.
位于胸腹部，传统认为是脏腑之气汇聚之处，主要用于该脏腑的相关证候。
Points along the upper back, one for each major organ, described as that organ's access on the body surface.
分布在背部，每一脏腑各有一个，传统认为是脏腑之气在体表的通路。
The paired methods of needling and burning moxa at points. The classics usually discuss them together rather than as separate subjects.
针刺与艾灸两种方法的合称。经典中通常合并讨论，而不是分作两门。
A pulse described as floating, thin and soft, likened to floating cotton; classical sources associate it with dampness or with deficiency.
浮而细软，如帛在水中，古籍多与湿或虚相联系。
Deep, thin and soft; classical sources associate it with deficiency of qi and Blood.
沉而细软，古籍多与气血不足相联系。
Slow, with irregular missed beats at intervals; classical sources associate it with cold or with stagnation of qi and Blood.
缓而时有一止，止无定数；古籍多与寒或气血瘀滞相联系。
Beats that pause at regular intervals; classical sources treat it as a sign of serious depletion, and modern practice would assess it as a possible arrhythmia.
脉来一止，止有定数；古籍视为虚损较重之象，现代应作为心律不齐加以评估。
Rapid, with irregular pauses; classical sources associate it with heat or with stagnation.
数而时有一止，止无定数；古籍多与热或瘀滞相联系。
Floating and large but empty in the middle, likened to pressing a spring onion stalk; classical sources associate it with sudden loss of Blood or fluids.
浮大中空，如按葱管；古籍多与突然失血或津液耗损相联系。
Adding or removing herbs from a classical formula so that it fits the individual presentation; the routine way a formula is adjusted in practice.
在经典方的基础上增删药味，使其贴合个体情况；是实际运用中调整方剂的常规做法。
The classical instructions for preparing and taking a decoction, covering soaking, timing, number of boils and whether it is taken warm. Amounts are not given on this site.
关于煎煮与服用汤剂的传统说明，包括浸泡、火候、煎次与温服等。本站不提供用量。
The idea that certain herbs direct the action of a formula toward a particular meridian or region of the body.
认为某些药物能引导方剂作用于特定经络或部位的看法。
Twelve deeper branches of the main meridians said to run more internally; a classical scheme of description rather than a demonstrated anatomical structure.
十二正经别行的分支，被认为走行较深；属传统描述体系，而非已证实的解剖结构。
Descriptions of muscular and tendinous pathways, used in classical texts for musculoskeletal reasoning and today in tuina teaching.
对肌肉与肌腱走行的描述，古籍用于筋骨类推理，今多用于推拿教学。
The division of the body surface into twelve regions corresponding to the meridians, used in classical writing to describe how exterior influences are said to enter.
把体表按经络划分为十二个区域，古籍用以说明外邪被认为如何侵入。
A pattern description in which signs of excess appear in the upper body while deficiency signs appear below.
一种证候描述：上部表现为实象，下部表现为虚象。
A classical way of describing Liver fire affecting the Lung, giving a dry cough alongside irritability-type signs.
描述肝火影响肺的一种传统说法，表现为干咳并伴烦躁类征象。
A pattern of Liver yang rising, described with headache, dizziness, tinnitus and irritability.
肝阳上扰的一类证候，常描述为头痛、眩晕、耳鸣与烦躁。
Reading a person's overall vitality and presence, especially the eyes, as part of the first examination.
通过整体神态与目光判断人的状态，属四诊之首望诊的内容。
A presentation in which the person looks alert with clear eyes, taken in classical practice as a favourable sign.
精神清醒、目光有神的表现，传统视为预后较好的征象。
A dull, withdrawn presentation with clouded eyes, taken in classical practice as an unfavourable sign.
精神萎靡、目光晦暗的表现，传统视为预后不良的征象。
A brief improvement in a severely ill person that classical texts describe as misleading; in modern terms it resembles what is sometimes called terminal lucidity.
重病之人突然短暂好转的表现，古籍认为具有误导性；现代观察中类似所谓回光返照。
A classical list of eighteen herb pairs said to be mutually incompatible, so that they are not put together in one formula. The list comes from later materia medica tradition rather than from the earliest texts.
传统列举的十八组相互「相反」的药对，认为不宜同方配伍使用。此说出自后世本草传统，并非最早医籍原有。
A parallel classical list of nineteen herb pairs whose combination is traditionally avoided. It is a heritage rule of practice, and the modern evidence behind each pair varies widely.
另一份传统列举的十九组配伍相畏的药对。属传统实践规则，各组在现代证据上的强弱差别很大。
Four classical regions where the qi of the channels is described as running in larger thoroughfares - the head, the chest, the abdomen and the lower leg. Used to explain why a local point and a distant point may be combined.
传统描述经气通行较盛的四个部位——头、胸、腹、胫。用于说明局部取穴与远端取穴可以配合的道理。
The colour of the film on the tongue surface, classically described as white, yellow, grey or black. It is judged together with thickness and moisture, never from the colour alone.
舌面舌苔的颜色，传统描述分白、黄、灰、黑四类。须与厚薄、润燥合看，不可单凭颜色一项。
A classical composition technique in which a small quantity of a herb of the opposite nature is added to a formula, so that a strong action becomes more tolerable.
传统组方技巧：在一首方中加入少量药性相反的药物，使原方的峻烈之性较易耐受。
A classical distinction between meeting a pattern directly with what opposes it, and treating it paradoxically by appearing to follow it. It is a reasoning principle, not something to attempt personally.
传统提出的治则区分：以与病性相逆的方法直接治疗，或以表面顺应病象的方法反向治疗。属思辨原则，不是可以个人尝试的操作。
The classical principle that approach should be adapted to the season, the locality and the individual. It is part of why two people with a similar presentation may be handled differently.
传统原则：因时、因地、因人而调整方法。这也是为什么表现相近的两个人，处理方式可能不同。
A Qing-dynasty text on warm diseases (acute febrile illness) by Wu Tang, who wrote under the name Wu Jutang, completed in 1798. It is the book most often named for the three-jiao framework, which sorts the course of a febrile illness into upper, middle and lower stages. Because it is set out as numbered items of analysis rather than as a continuous treatise, it reads more like a working manual, and several of its formula names are still in circulation. Cited here as a classical source: it tells you what the tradition recorded, not what has been shown.
清代温病（急性发热性疾病）著作，吴瑭（字鞠通）撰，成书于 1798 年。以三焦为纲，将温病过程分作上、中、下三焦，是后世言三焦辨证者最常称引之书。全书以逐条辨析的体例写成，而非连续通论，故读来近于临证手册；书中若干方名至今沿用。本库中作为古典出处引用：它说明传统文献如何记载，不代表已被现代研究证实。
Compiled by Huangfu Mi in the Western Jin and conventionally dated to around 259 CE, it is generally described as the earliest extant Chinese book devoted to acupuncture and moxibustion. It gathers and reorganises earlier material — above all from the Huangdi Neijing — on channels, points, needling method and contraindications, and it is one of the reasons point names and locations survive in a form that can be compared across periods. Its own arrangement is not the same as modern point numbering, so its counts should not be expected to match a modern chart.
西晋皇甫谧编集，一般定于公元 259 年前后，通常被认为是现存最早的针灸专著。它汇辑并重新编排《黄帝内经》等早期文献关于经脉、腧穴、刺法与刺禁的记述；腧穴名称与定位之所以能在不同时代之间对勘，本书是重要原因之一。本书的编排与现代腧穴编号不同，读者不应指望其穴数与今之穴位图相合。
A Ming-dynasty compendium by Zhang Jiebin, better known by his courtesy name Zhang Jingyue, usually dated to 1624 and set out in sixty-four juan. It covers theory, examination, patterns and formulas, and it is the work most often quoted for his new formulas and for his emphasis on the kidney and on what he called genuine yin and genuine yang. It is one physician's systematised life practice rather than an official school text. A citation here records what the book says, not what has been demonstrated.
明代张介宾（以字景岳行世）所撰综合性医书，一般定于 1624 年，六十四卷。内容涵盖理论、诊法、证候与方剂；后世称引本书，多为其「新方」，以及他对肾与所谓真阴真阳的强调。此书是一位医家一生实践的体系化总集，而非官定教本。本库引用只记其所言，不代表已被证明。
An official Qing-dynasty compilation, completed in 1742 by Wu Qian and others at the Imperial Academy of Medicine, in ninety juan. It was written to serve as a standard teaching text, and that is the best way to read it: not as a place where new doctrine was proposed, but as the version of the tradition a physician was expected to know in the eighteenth century. Its sections on bone-setting, on smallpox and on the pulse are often cited on their own.
清代官修医书，1742 年由吴谦等奉敕在太医院主持编成，九十卷。其编纂目的在于作为标准教本，故宜作教科书读——此书并非提出新说之处，而是十八世纪医者所应掌握的那套通行知识。其正骨、痘疹、脉学等部分常被单独称引。
A Song-dynasty official formulary, named for the government dispensary that issued it. The text grew over time: it began as a formulary of the Imperial Medical Office in the late eleventh century and reached its best-known form in the twelfth, so no single date of composition can honestly be given. Its importance lies in being an early example of standardised ready-made formulas rather than formulas written for one patient at one time; several of its formula names remain familiar.
宋代官修方书，以颁行它的官办药局（太平惠民和剂局）为名。其文本累增而成：初编于十一世纪后期太医局，通行本形成于十二世纪，故不宜给出唯一的成书年份。其意义在于，这是标准化成药（而非为一人一时所拟之方）的早期范例；书中若干方名至今仍为常人所知。
A text on children's illness usually dated to 1119, drawn from the practice of the Song physician Qian Yi and arranged by his followers after his death. It is regularly described as one of the earliest Chinese books devoted to paediatrics, and it is among the places where the view is set out that a child's condition is harder to read than an adult's and can change quickly. Several of its formula names remain in use. As with every classical source in this library, it records what was written, not what has been established.
论小儿疾病的著作，一般定于 1119 年，本于宋代医家钱乙的临证经验，由其门人于其身后整理编次。历来被视为中医最早的儿科专书之一；「小儿病较成人难辨、变化又速」一类看法，即在此一系统的著作中提出。书中若干方名至今沿用。与本库所有古典出处一样，本条只记文献所载，不代表已被现代研究证实。
A collection of the teachings of the Yuan physician Zhu Zhenheng, who practised under the name Danxi, gathered by his students and edited later; the best-known edition is usually dated to 1481. It is the text most often quoted for his view that the body's yin is readily depleted and should be conserved. Because it was assembled by several hands over a long period, not every section can be attributed to Zhu himself, and a reader should not treat the whole book as his own writing.
元代医家朱震亨（号丹溪）学术论述的汇编，由其门人辑录、后人校订，通行本一般定于 1481 年。后世称引本书，多为其阴精易于亏耗、宜加护惜之论。由于成书经多人之手、历时较久，书中并非每一节都可径归于朱氏本人，读者不宜将全书视作其一手所写。
A Ming-dynasty rearrangement of the Huangdi Neijing by Zhang Jiebin (Zhang Jingyue), usually dated to 1624 and set out in thirty-two juan. It adds no new doctrine: it takes the existing text apart and regroups it by subject — channels, points, patterns, needling — so that material scattered through different chapters can be read together. It is a study tool, and that is its use here: it lets you see where a statement sits in the tradition without having to accept the compiler's framing as authority.
明代张介宾（张景岳）对《黄帝内经》的重编，一般定于 1624 年，三十二卷。本书不另立新说，而是将《内经》拆散后按门类重排——经脉、腧穴、病证、刺法等——使散在各篇的材料可以合观。它是一部研读工具；本库取它，也是同一理由：便于看清某一说法在传统中的位置，而不必以编者的框架为权威。
A short and unusual Qing book by Wang Qingren, published in 1830. The author states that he inspected the organs of the dead — including bodies at execution grounds and unclaimed bodies in burial grounds — and of animals, and that on that basis he found the received descriptions wrong; he reassigned the names of several organs and proposed formulas from his reading of blood stasis. It is worth knowing for two reasons: it is a rare case of a Chinese physician of the period arguing from what he had seen dissected, and readers since have disagreed sharply about how far his corrections actually hold.
清代王清任所撰的一部篇幅不大而颇为特殊的书，刊于 1830 年。作者自称验视死者脏腑（包括刑场尸体与义冢无主尸骸）及动物脏腑，据此认为旧说有误，遂改订若干脏腑之名，并据其对瘀血的理解拟出方剂。本书值得知道的原因有二：一是当时罕有中国医家以亲见解剖之物立论，此为其一；二是后世读者对其「改正」究竟成立多少，争议很大。
A Qing-dynasty book on women's disorders attributed to Fu Shan, a figure far better remembered as a calligrapher and as a loyalist of the fallen Ming than as a physician. It first appeared in print in 1827, more than a century after his death, and the attribution to him has been questioned. Whatever its origin, it became one of the most widely read gynaecology texts in the tradition and its formulas are still taught. Both the authorship and any reported effect should be read here as matters of record, not of proof.
清代妇科著作，题署傅山（傅青主）—— 他在后世的名声主要来自书法与遗民身份，而非医名。本书初刊于 1827 年，晚于其卒年百有余年，作者归属素来有争议。无论出于谁手，它都是传统中流传最广的妇科书之一，其方至今仍被讲授。作者归属与任何所述作用，在本库中都应作为记载之事读，而非已证之事。
A modern technique in which pairs of inserted needles are connected to a device that passes a small continuous electric current between them, replacing or supplementing hand manipulation. The intensity is kept within the range the person finds comfortable. Because it is easier to standardise than manual needling, it is the form most often used in research as well as in clinics. Published trials cover post-operative nausea and vomiting, several pain conditions and other outcomes; the overall picture is that findings are inconsistent and that many studies are small or at high risk of bias, so for most indications it has not been established. Cautions listed in standard acupuncture texts: not applied across the chest or along the spine in people with a cardiac pacemaker or other implanted electronic device, avoided in people with a seizure disorder, and avoided over the trunk during pregnancy.
针刺后在成对针柄接通微量脉冲电流，以电流替代或加强手法刺激的现代针法，强度以受术者耐受为度。因较手法更易标准化，除临床常见外也是针灸研究中最常用的形式。已发表试验涉及术后恶心呕吐、多种疼痛等方向；总体结果并不一致，且不少研究样本小或偏倚风险高，除少数方向外大多未被证实。针灸文献常规列为禁忌：心脏起搏器或其他植入式电子装置者不在胸背横向通电，癫痫者不用，孕期不用于腰腹。
A herbal paste, a powder mixed with a liquid, or a ready-made patch applied to an acupuncture point and left in place for hours, sometimes covered. It is used as an alternative to needling, especially for children and people who dislike needles, and it is the form used in the seasonal 'summer plaster' (三伏贴) campaigns run by hospitals in China. Because the preparation stays against the skin for hours, the problems reported are mostly local: redness, itching, contact dermatitis, and — with the irritant formulas that are meant to blister — burns, blisters and marks that last. Whether choosing a named point makes any difference to the outcome, compared with applying the same preparation elsewhere, has not been established.
将药膏、药粉调敷或成品贴片敷于穴位并留置数小时，常另加覆盖。因免去针刺，常用于儿童与畏针者，也是国内医院「三伏贴」采用的剂型。因药物与皮肤长时间接触，所报问题多在局部：红、痒、接触性皮炎；若用的是意在发泡的刺激性配方，则可致灼伤、水疱与遗留痕迹。选穴是否使结果不同于把同一药物敷在他处，未被证实。
Soaking the feet and lower legs in warm water — plain, or with a herbal decoction or granules added — usually before sleep. In China this is much more a home practice than a clinic procedure. The honest summary: the benefits people report (sleep, cold feet, general comfort) are largely subjective, and controlled evidence for foot bathing beyond the effect of simple warming is limited, so it has not been established. The risks are ordinary but worth saying plainly. Immersion burns happen to people who cannot feel heat well — diabetic or other peripheral neuropathy — and water that feels merely warm to a hand can scald a numb foot. Soaking is also a bad idea when there are open sores or an active skin infection, and when deep vein thrombosis is suspected in that leg. Anyone with diabetes, peripheral arterial disease or reduced sensation should test the temperature with something other than the foot itself.
睡前以温水（可加药汁或颗粒）浸泡双足与小腿。在国内这主要是家庭自养而非诊室操作。如实说：人们报告的助眠、暖足、舒适等益处以主观感受为主，除单纯温热作用外，足浴的对照证据有限，未被证实。风险是日常的但值得讲清：浸泡烫伤发生在对热不敏感的人身上——糖尿病或其他周围神经病变；手感只是温的水，麻木的脚却已烫伤。有开放创面或活动性皮肤感染时不应浸泡；该下肢怀疑深静脉血栓时也不应浸泡。糖尿病、下肢动脉病变或感觉减退者应以足以外的部位试温。
Small seeds — traditionally vaccaria (王不留行) seeds, in clinics often metal or magnetic beads — taped to points on the outer ear and left for a few days, with the person pressing them several times a day. The ear is used both because its surface is richly innervated and easy to reach, and because a separate auricular microsystem maps the whole body onto it. Evidence for auricular pressing is dominated by small trials with high risk of bias; it has not been established. The cautions are specific. Adhesive tape commonly causes contact dermatitis; skin under a pressed bead can break down; and the ear is cartilage, so an infection that reaches the perichondrium (auricular perichondritis) is hard to treat and can permanently deform the ear. Auricular texts also list pregnancy among the cautions for some points. Anything left taped on should come off at the first sign of increasing pain, spreading redness or swelling.
以小粒（传统用王不留行籽，诊所常改用金属或磁珠）用胶布固定于耳廓穴位，留置数日，每日自行按压数次。取耳既因耳廓神经支配密集且便于操作，也因另有一套把全身投射于耳的耳穴微系统。耳穴压豆的证据以小样本、偏倚风险高的试验为主，未被证实。注意事项很具体：胶布常见引起接触性皮炎；珠子受压处皮肤可破溃；耳廓为软骨，感染一旦波及软骨膜（耳廓软骨膜炎）治疗棘手，并可致耳廓永久变形。耳穴文献亦把孕期列为部分穴位的慎用情形。留置物一旦出现疼痛加重、发红扩大或肿胀，应立即取下。
A short-handled, hammer-like instrument whose head holds five or seven fine needles clustered together; the practitioner taps the skin lightly and quickly to produce redness or pin-point bleeding without deep puncture. It is also called a cutaneous needle or seven-star needle (皮肤针 / 七星针), and the technique is called 叩刺. Because it breaks the skin — even if only at the level of capillaries — infection control is not optional: the needle head should be single-use and disposable, and shared cluster needles are a documented route for blood-borne virus transmission. It is avoided in people with bleeding disorders or on anticoagulants, over varicose veins, moles, broken or infected skin, and on the face. Its most-studied uses are in skin and hair conditions; the evidence is preliminary and has not been established.
柄端簇集五至七枚细针的锤状器具，以轻快叩打使皮肤潮红或微渗血而不深刺。又称皮肤针、七星针，手法称「叩刺」。因有皮肤破损（即使仅及毛细血管），消毒不是可选项：针头应一次性使用，共用簇针是血源性病毒传播的已记载途径。出血性疾病、服用抗凝药者不用；静脉曲张、色素痣、破损或感染皮肤处不用；面部不用。研究较多的是皮肤与毛发方向，证据属初步，未被证实。
Moxibustion in which the heat source does not touch the skin: a slice of fresh ginger, a slice of garlic, a layer of salt or a herbal cake is placed between the burning moxa and the point. Ginger is the commonest interposed material (隔姜灸); each material is traditionally chosen for a different purpose. Putting something between the moxa and the skin slows and spreads the heat, but it does not prevent burns — the interposed material dries out, and burns from indirect moxibustion are regularly reported in the medical literature, including full-thickness burns and burns that people with reduced sensation did not feel happening. Thin or scarred skin needs particular care, and the smoke exposure is the same as for any moxa.
艾炷或艾条不直接接触皮肤，而在其与穴位之间隔以姜片、蒜片、盐或药饼的灸法。以姜片最多，称隔姜灸；不同隔物各有传统取意。隔物使热变缓变散，但并不能避免灼伤——隔物会被烘干，医学文献中隔物灸致伤的报告并不少见，包括深达全层的烧伤，以及感觉减退者毫无察觉地发生的烧伤。皮肤菲薄或瘢痕处尤须谨慎；烟雾暴露与其他灸法相同。
Also called 药物灸 or 发泡灸: an irritant herbal paste — traditionally mustard seed (白芥子), garlic, and in older formulas cantharides (斑蝥) — is applied to a point and left long enough to raise a blister. No moxa is burned. The blister is the intended effect, so the technique should be described plainly: it is a deliberately produced chemical burn of the skin. Reported outcomes include second-degree burns, secondary infection, keloid or hypertrophic scarring, and patches of hypopigmentation or hyperpigmentation that can outlast any benefit. Cantharides (Spanish fly, 斑蝥) is poisonous if swallowed and has caused fatal poisoning; this library records its historical use and offers no advice on using it. Because what is produced is an open wound, aftercare is not optional. Reported benefits rest largely on uncontrolled observation and have not been established.
又称药物灸、发泡灸：以刺激性药膏（传统多用白芥子、大蒜，古方亦用斑蝥）敷于穴位并留置至起泡，并不用艾火。水疱正是所追求的效果，故需如实描述：这是人为造成的皮肤化学性灼伤。已报告的后果包括二度烧伤、继发感染、瘢痕疙瘩或增生性瘢痕，以及可长期存在、比任何获益都更持久的色素减退或沉着斑。斑蝥（Spanish fly）口服有毒，曾有致死中毒报道；本库仅记其历史用法，不提供任何使用建议。因结果是皮肤破损，其后护理不是可选项。所报益处多来自无对照的观察，未被证实。
The most common modern moxibustion technique: a cigar-shaped stick of compressed mugwort (艾, Artemisia argyi) is lit at one end and held a few centimetres above the point, or moved in small circles, until the skin is warm and pink. Because distance and time are under the operator's control, two hazards are predictable: a burn from holding it too close or letting ash drop, and fire — a moxa stick smoulders rather than flames and stays hot a long time, and discarded ends have started fires. Smoke is the third: moxa smoke contains fine particulate matter, carbon monoxide and polycyclic aromatic hydrocarbons, indoor air quality in moxibustion clinics has been measured as poor, and ventilation matters. Anyone with asthma, or with an allergy to mugwort or the Asteraceae family, is at particular risk — mugwort pollen is itself a major seasonal allergen, and contact dermatitis to the plant is described.
现代最常用的灸法：将艾绒卷制的艾条一端点燃，悬于穴位上方数厘米，或作小幅度回旋，至局部温热潮红。因距离与时间由操作者掌握，两类风险可以预见：过近或落灰致烫伤；以及火灾——艾条是阴燃而非明火，且长时间保持高温，丢弃的残端曾引燃物品。第三是烟雾：艾烟含细颗粒物、一氧化碳与多环芳烃，灸疗场所的室内空气质量实测不佳，通风很重要。哮喘者、艾属或菊科过敏者风险尤高——艾蒿花粉本身就是重要的季节性过敏原，接触性皮炎亦有记载。
The shape of the tongue body as read in tongue examination: enlarged or thin, cracked, teeth-marked along the edges, stiff, flaccid, tremulous or shortened. An enlarged tongue with scalloped edges is the classical pairing; a thin, cracked tongue is traditionally read as a deficit of fluids or nourishment. Shape is always read together with colour and coating, never on its own. In the published literature, agreement between examiners on tongue shape is generally low to moderate, and whether a given shape identifies a specific named pattern has not been confirmed.
舌诊中观察舌体形状的称法：胖大或瘦薄、裂纹、边缘齿痕、强硬、痿软、颤动、短缩。胖大而边有齿痕是传统上最典型的一组；瘦薄而裂传统上读作津液或阴血不足。舌形必须与舌色、舌苔合参，不单独作判断。已发表文献中不同判读者对舌形的一致度普遍偏低到中等；某一舌形能否对应某一特定证型，未被证实。
One of the standard items of inquiry: do you feel more sensitive to cold, or more sensitive to heat? The classical distinctions include aversion to cold together with fever, alternating chills and fever, tidal fever, and feeling cold that warmth does not relieve. In use, this question is a screener rather than a measurement. Whether a fever is present should be settled with a thermometer; the felt sensation of aversion to cold is not interchangeable with a recorded body temperature.
问诊的固定项目之一：怕冷还是怕热。传统的区分包括恶寒与发热并见、寒热往来、潮热、以及加衣被而寒不减。实际使用中这是筛查性问题而不是测量：是否发热应当用体温计实测；「恶寒」这种主观感受不能替代记录到的体温。
The inquiry item on sweating: sweating spontaneously during the day, sweating during sleep, sweating confined to the head, sweating on only one side of the body, or no sweating at all. Sweating confined to one side or to one region of the body is the entry that matters most, because it can accompany a neurological lesion - this library flags the overlap rather than interpreting it. Sweating during sleep is a very commonly reported symptom with a wide differential, and is not specific to any named pattern; that specificity has not been confirmed.
问诊中关于汗的项目：白天自汗、睡中出汗、仅头部汗出、仅半身汗出、或全无汗。其中半身汗出与局限于某一局部的汗出最值得警惕，因为可伴随神经系统病变——本库只指出这一重叠，不作解释。睡中出汗是极为常见的主诉，鉴别面很宽，并不专属于某一证型；这一特异性未被证实。
The inquiry item covering appetite, thirst, preference for hot or cold drinks, and unusual tastes in the mouth - bitter, sweet, sour or metallic. Poor appetite and altered taste are common and non-specific across a very wide range of conditions. A taste disturbance that does not resolve, or a sudden change in appetite together with weight loss, belongs in a conventional evaluation rather than in a pattern reading.
问诊中涵盖食欲、口渴、喜热饮还是冷饮、以及口中异常味觉的项目——口苦、口甜、口酸、口中有金属味等。食欲减退与味觉改变在极广范围内都是常见的非特异性表现。持续不缓解的味觉异常，或食欲骤变同时伴体重下降，应当进入常规检查而不是按证型解读。
The inquiry item on sleep: trouble falling asleep, waking early, waking repeatedly, dream-disturbed sleep, or sleeping excessively. Insomnia is common and has many causes. The tradition assigns it to patterns such as heart-spleen deficiency or internal harassment by phlegm-heat, but which of these a given person fits is not reliably separable by questioning alone. Loud snoring with pauses in breathing and marked daytime sleepiness should be assessed for obstructive sleep apnoea - a condition with an established diagnostic pathway that this library does not stand in for.
问诊中有关睡眠的项目：入睡困难、早醒、易醒、多梦、或嗜睡。失眠常见且原因众多。传统上会归入心脾两虚、痰热内扰一类证型，但仅凭问诊并不能可靠判断一个人属其中哪一种。打鼾响亮并伴有呼吸中断、白天明显嗜睡，应当按阻塞性睡眠呼吸暂停去评估——这一疾病有成熟的诊断路径，本库不替代它。
Examination by touch: palpating the body surface, the abdomen and the limbs for temperature, tenderness, distension, masses and swelling. Abdominal palpation separates a distension the person reports from a distension the examiner actually finds, and separates an abdomen that welcomes pressure from one that rejects it. Any mass, any persistent tenderness, and any swelling that pits under pressure belong in a conventional workup. Palpation describes what can be felt; it does not determine what it is.
以手触按身体表面、腹部与四肢，了解寒热、压痛、胀满、包块与肿胀的诊法。腹部按诊区分「自觉胀满」与「按诊所得」，也区分喜按与拒按。任何包块、持续存在的压痛、以及按压后凹陷不起的肿胀，都应进入常规检查流程。按诊描述摸到了什么，不判定它是什么。
The area below the left nipple where the heartbeat can be seen or felt. Anatomically this is the apical impulse of conventional medicine. In the classical literature the site was palpated to judge the state of the ancestral qi, zong qi. This library keeps the term because it comes from the canon, and records the overlap plainly: a visible, forceful or displaced apical impulse is a recognised physical sign in cardiology, and assessing it belongs to that pathway - not to blood pressure measurement, an electrocardiogram or an echocardiogram standing aside for it.
左乳下方可以看见或摸到心尖搏动的部位。解剖上即现代医学所说的心尖搏动。古典文献在此处诊察宗气的盛衰。本库保留这个术语是因为它出自经典，同时把重叠说清楚：心尖搏动可见、有力或移位，是心脏科公认的体征，其评估属于那条路径，而不是让血压测量、心电图或超声心动图让位。
Six points on the legs where, in classical writing, the qi of the six fu organs is said to converge. The standard set: ST 36 for the stomach, ST 37 for the large intestine, ST 39 for the small intestine, GB 34 for the gallbladder, BL 40 for the bladder, and BL 39 for the triple burner. They are described in the Lingshu. They are needle sites used by licensed practitioners, not self-care instructions; needling is invasive and carries documented adverse events.
六腑之气下合于足三阳经的六个穴位，见于《灵枢》。通行配属：胃合足三里（ST36）、大肠合上巨虚（ST37）、小肠合下巨虚（ST39）、胆合阳陵泉（GB34）、膀胱合委中（BL40）、三焦合委阳（BL39）。注意三焦之下合穴委阳属足太阳膀胱经。本库只作定位概念记录：这些是执业者操作的针刺部位，不是自我操作建议；针刺属侵入性操作，有出血、感染、气胸等已记载的不良事件。
Points where two or more meridians are described as crossing or meeting; classical texts express this as 'the meeting of ...'. The Zhenjiu Jiayijing records such points systematically. Common examples include SP 6 (the three leg yin meridians) and GV 14 (hand and foot yang meridians with the governing vessel). Which points count as crossing points, and how many there are, differ between sources; this library records the disagreement rather than choosing a number.
两条或两条以上经脉交会通过之处的穴位，古典文献以「某某之会」表述，《针灸甲乙经》对此有系统记载。通行示例：三阴交（SP6）为足三阴之会，大椎（GV14）为手足三阳与督脉之会。交会穴的具体条目与总数，历代文献与各教材所列并不一致；本库记「记载不一」，不替文献选一个数字。交点描述属定位概念，不构成任何操作建议。
The classical method of locating points by dividing the body into proportional units measured from bony landmarks, described in the Lingshu chapter on bone measurement. The cun here is proportional, not a fixed length: the same 12 cun spans a forearm that is longer on a taller body. Widely cited values include 12 cun from the anterior to the posterior hairline, 8 cun between the nipples, 5 cun from the umbilicus to the pubic symphysis, and 12 cun from the cubital crease to the wrist crease. Individual items differ slightly between textbooks.
以骨节为标志、按比例折算长度以定穴位的古典方法，见于《灵枢·骨度》篇。这里的「寸」是比例寸，不是绝对长度：同一 12 寸落在不同身高的人身上，实际长度不同。常见数值：前发际正中至后发际正中 12 寸、两乳头之间 8 寸、脐中至耻骨联合上缘 5 寸、肘横纹至腕掌侧横纹 12 寸。个别条目在不同教材之间数值略有出入，本库不逐条裁决。此为专业取穴的文献方法，不适用于自行操作。
The twelve regular meridians each have one collateral vessel; adding the collateral of the conception vessel, that of the governing vessel, and the great collateral of the spleen gives fifteen, set out in the Lingshu chapter on the meridians. Each has a luo-connecting point, conventionally: LU 7, LI 6, ST 40, SP 4, HT 5, SI 7, BL 58, KI 4, PC 6, TE 5, GB 37, LR 5, plus the conception vessel point Jiuwei, the governing vessel point Changqiang, and SP 21 as the great splenic collateral. These are needle sites, not self-care instructions.
十二正经各有一络脉，再加任脉络、督脉络、脾之大络，共十五，见于《灵枢·经脉》篇。各有络穴，通行为：列缺（LU7）、偏历（LI6）、丰隆（ST40）、公孙（SP4）、通里（HT5）、支正（SI7）、飞扬（BL58）、大钟（KI4）、内关（PC6）、外关（TE5）、光明（GB37）、蠡沟（LR5），任脉络鸠尾、督脉络长强、脾之大络大包（SP21）。本库只作结构记录：络穴是执业者操作的针刺部位，不是自我操作建议。
A framework in the Lingshu chapter on the seas: the sea of marrow (the brain), the sea of qi (the chest, at Shanzhong), the sea of grain and water (the stomach), and the sea of blood, identified in that chapter as the Chong vessel, called the sea of the twelve meridians. The chapter names upper and lower locations where each sea's influence is said to surface. Translating those classical locations into modern point names is done differently by different commentaries; this library records that the correspondences are contested rather than fixing one mapping.
《灵枢·海论》篇的四海框架：髓海（脑）、气海（膻中）、水谷之海（胃）、血海（该篇指冲脉，又称十二经之海）。篇中对每一海各记其「输」之上下所在。这些古典部位如何对应到现代穴名，各家注解并不一致；本库记「对应存在不同解释」，不替文献选定一种。四海是理论结构概念，本库不据其作任何判断或建议。
A term from the Suwen chapter on innate endowment, where the arrival of tian gui marks the stage at which menstruation begins in women and seminal emission becomes possible in men, and its decline marks the closing of that stage. What tian gui denotes is disputed in the commentary tradition: some read it as a substance generated from kidney essence that governs reproduction, others tie it more closely to menses or to semen. This library records the disagreement. It is not equivalent to any modern endocrine measure, and questions about puberty, amenorrhea or fertility belong with a licensed clinician, not with a classical term.
《素问·上古天真论》用语：天癸至则女子月事以时下、男子精气溢泻，天癸竭则该阶段结束。天癸究竟指什么，注家说法不一 —— 一说肾精所化、主生殖的物质，一说与月事、精液关系更近。本库记分歧，不裁决。它不等同于任何现代内分泌指标；青春期发育、闭经、生育等问题应由执业医师评估，本库不提供诊断与方案。
The classical umbrella term for disease mechanism: whatever the cause, the disorder is described as a disturbance of the balance between yin and yang. It covers the standard patterns - excess of yang giving heat, excess of yin giving cold, deficiency of yang giving cold of the deficient type, deficiency of yin giving heat of the deficient type - and the situations in which one side is too weak to hold the other. The honest limit matters more than the coverage. Yin and yang are not quantities that can be measured, and there is no instrument that returns a yin-yang value. The term classifies a state that has already been observed by other means; it does not identify a disease, does not forecast an outcome, and does not distinguish between conditions whose modern management differs completely. A person with fatigue, a person with heart failure and a person with anaemia may all be described in the library's sources as having a disturbance of this kind. That is a statement about the descriptive system, not about the three people, whose prospects are very different. It is therefore not a diagnosis and not an explanation that closes a question. Where a symptom can be traced to a named modern cause, that cause is the one that carries the consequences.
古典病机的总括用语：无论起因如何，疾病状态被描述为阴阳之间平衡关系的失调。它涵盖几类常见表述 —— 阳盛则热、阴盛则寒、阳虚则寒（虚寒）、阴虚则热（虚热），以及一方虚损不能制约另一方的情形。 真正要紧的是它的边界，而不是它的覆盖面。阴阳不是可测量的量，也没有任何仪器能给出一个「阴阳值」。这个术语是对已经由其他途径观察到的状态做归类；它不指认某一种病、不预测结局、也不区分现代处理完全不同的几种情况。一个疲乏的人、一个心力衰竭的人、一个贫血的人，在本库文献里都可能被描述为这一类失调 —— 这是关于描述体系的一句话，不是关于这三个人的一句话，而这三个人的预后差别极大。 因此它不是诊断，也不是一个能让问题收尾的解释。当某个症状能追到明确的现代病因时，承担后果的是那个病因。
In the classical account the spleen and stomach have a direction: the clear part of what is taken in is carried upward, the turbid part is sent downward. When that direction is disturbed the classical texts describe it in the same vocabulary they use for the symptoms - belching, hiccup, nausea, vomiting, a sense of fullness, loose stools, or the reverse, failure to pass anything. The descriptive value is real and the mapping is not. The complaints named here are distributed today across reflux disease, gastroparesis, functional dyspepsia, functional bowel disorders, bowel obstruction and a range of others, and these are not interchangeable. Two of them change the timescale decisively: vomiting or absolute constipation with failure to pass flatus or stool, especially with a distended abdomen, is a surgical question measured in hours, and vomiting that follows a head injury or is accompanied by chest pain, breathlessness or neurological signs belongs in an emergency department the same day. Vomiting in an infant, or vomiting with bile in a newborn, is likewise not a pattern to be classified. This library records the term as a way classical sources organised these symptoms. It does not sort them into a clinical order, and it does not offer a regimen for any of them.
古典论述里脾胃有方向：摄入之物其清者上升、其浊者下降。这个方向乱了，古典文本就用症状本身的语言来描述它 —— 嗳气、呃逆、恶心、呕吐、痞满、下利，或反过来，通降不行、秘结不通。 描述价值是真的，对应关系不是。这里列举的不适，今天分布在胃食管反流、胃轻瘫、功能性消化不良、功能性肠病、肠梗阻以及其他若干情况之间，而这些彼此不能互换。其中两种会决定性地改变时间尺度：呕吐或完全停止排便排气（尤其伴腹胀）是按小时计算的外科问题；外伤后呕吐，或伴胸痛、呼吸困难、神经体征的呕吐，当天就该在急诊评估。婴儿呕吐、新生儿含胆汁的呕吐同样不是拿来辨个证型的事。 本库记录这个术语，是记古典文献如何组织这些症状；本库不对它们排临床次序，也不提供任何方案。
Biao and ben - branch and root - distinguish the presenting manifestation from the underlying condition they are taken to express. The rule for ordering treatment is stated in the classics and repeated in the textbooks: in an urgent situation deal with the branch first, once the situation is stable deal with the root, and when both press, deal with both together. It is a rule about sequence, not a licence to treat symptoms and stop there. The rule is also, read honestly, a statement about its own limits. In the classical materials the urgent cases were the ones a physician of the time could actually attend to. The presentations that carry the shortest timelines today - crushing chest pain radiating to the back or arm, sudden facial droop or limb weakness or speech failure, breathlessness at rest or inability to lie flat, massive bleeding, passing blood in stool, sudden severe abdominal pain with a rigid abdomen - are not within the reach of a clinic consultation at any speed, and classifying them as branch or root changes nothing about that. They go to emergency care first. What the rule does say is useful in its own terms: stabilise first, look for the cause after, and do not let the search for an underlying pattern delay the thing that keeps the patient alive. This library records the principle. It does not apply it, and it makes no recommendation based on it.
标与本，区分「表现出来的」与「被认为是其根由的」。治疗的次序规则在古典文献中提出、在教材中反复出现：急则治其标，缓则治其本，标本俱急则标本同治。这是一条关于先后顺序的规则，不是「先压一压症状就到此为止」的许可。 老实读，这条规则同时也是关于它自己边界的一句话。古典材料里的「急」，是当时医者确实接得住的那部分。而今天时间尺度最短的那些表现 —— 压榨性胸痛放射到背部或手臂、突发的口角歪斜／肢体无力／言语不能、静息呼吸困难或不能平卧、大出血、便血、突发的剧烈腹痛伴板状腹 —— 无论快慢都不在门诊辨证的处理范围内，把它们归成标或本都改变不了这一点。这些先走急救。而这条规则本身说的东西仍然有用：先稳住，再找原因，别让寻找根本证型这件事耽误了保住性命的那件事。 本库记录这条治则，不应用它，也不据它给出任何建议。
One of the three 'accordance' principles: the season is taken into account when deciding on treatment. The classical reasoning is that the body's qi follows the year - outward and open in warm months, inward and conserved in cold ones - so the same presentation may call for a different approach in midsummer than in deep winter. Something in this maps onto what is now measured directly: a large share of respiratory infection is seasonal and the season is documented in surveillance data, and cold exposure is a measurable cardiovascular stress. That overlap is worth stating. What is not supported is the further step classical texts sometimes take, namely that a given diagnosis should be managed differently in July than in January on seasonal grounds alone. This library is not aware of evidence establishing that, and records it as unconfirmed. The practical consequence of the principle in a modern setting is mostly about ordinary timing rather than any change in clinical approach: heat and cold are real exposures, and people who are very young, very old, pregnant, or living with heart or lung disease have less margin in both directions.
三因制宜之一：决定治法时把时令考虑进去。古典的推理是人气随岁时而变 —— 温热之令向外开泄、寒凉之令向内收藏 —— 所以同一组表现在盛夏与严冬未必用同一路数。 这里面有一部分能直接对接到今天有实测的东西：相当大比例的呼吸道感染呈季节性，这一点在监测数据里有明确记录；寒冷暴露是可测量的心血管负荷。这个重叠值得写出来。不被支持的是古典文本有时候往前多走的那一步 —— 仅仅因为季节，同一个诊断在七月和在一月就应当不同处理。本库不知道有证据确立这一点，记为「未被证实」。 这条原则落到现代语境里的实际后果，多半落在日常时令起居上而非改变临床处理：寒与热是真实暴露，而非常年幼、非常年老、孕期，或患有心肺疾病的人，两个方向上的余量都更小。
The second of the three: the person is taken into account - age, sex, constitution, build, habit of body and their existing condition. It is the classical form of what is now called individualised medicine, and the instinct behind it is sound: people differ, and the differences are real. The limit is that individualisation in the classical sense is not the same thing as safety. The categories it uses - a robust constitution, a weak one, a body inclined to heat or to cold - are clinical impressions recorded in the literature, not risk strata, and they do not carry the information that changes management: what else the person is taking, how their kidneys and liver are functioning, whether they are pregnant, whether they are on an anticoagulant, whether this presentation is new for them. Two patients described with the same classical constitution can be at very different risk. So the principle holds as an argument against treating a label rather than a person. It does not by itself make an intervention safer, and this library does not use it to support any recommendation.
三因制宜之二：把「人」考虑进去 —— 年龄、性别、体质、形体的强弱肥瘦以及当下所处状态。这是古典形态的「个体化医学」，背后的直觉是对的：人与人不同，而且这差异是真的。 边界在于，古典意义上的个体化不等于安全。它使用的类别 —— 壮实、虚弱、素体偏热、素体偏寒 —— 是文献里记录的临床印象，不是风险分层，也不携带真正改变处理的信息：这个人还在吃什么、肝肾功能如何、是否妊娠、是否在用抗凝药、这个表现对他是不是新出现的。被归为同一种古典体质的两个人，风险可以差得很远。 因此这条原则作为「治病名还是治人」的论证是成立的；它本身并不让某项处置变得更安全，本库也不据它支持任何建议。
The third of the three: the place is taken into account. Classical sources link geography to constitution and to which patterns are commonly seen, and the observation has a genuine modern counterpart - altitude, climate, vector distribution, iodine and other trace elements in soil and water, ultraviolet exposure, and the endemic diseases that follow from all of these are documented in epidemiology. What the classical sources add on top of that is a set of recommendations about which herbs suit which region, and that part this library does not carry. It is not supported by evidence we can point to, and the regional differences that are documented do not translate into different treatment of the same condition in the way the texts assume. A further caution belongs here: herbal material moving across borders is subject to the same problems everywhere - misidentified species, substitution, contamination with heavy metals or residues arising from cultivation and processing - and these are properties of the supply chain, not of the region. The principle is recorded as an early argument that place matters for health. This library does not convert it into advice.
三因制宜之三：把「地」考虑进去。古典文献把地理与体质、与常见证型联系起来，而这个观察确实有现代对应物 —— 海拔、气候、媒介生物分布、土壤与水中碘及其他微量元素、紫外线暴露，以及由这些派生的地方病，都在流行病学里有记录。 古典文献在此之上附加的那部分 —— 某地宜用某药的种种主张 —— 本库不收录。没有我们指得出的证据支持它，而且有记录的地区差异，也不按文本设想的方式转化为对同一疾病的不同处理。这里还该加一条提醒：跨境流动的药材在各地都面临同一批问题 —— 品种误认、掺伪替代、重金属与农药残留污染 —— 这些是供应链的属性，不是产地的属性。 本条原则作为「地域影响健康」的早期论证记录在案；本库不把它转成建议。
The classical account gives the heart two linked jobs: it holds the blood and it holds the vessels the blood moves through. Its qi is what is said to push the blood around the circuit, and the state of that circuit is read off the pulse and, in the classical phrasing, off the complexion and the tongue. The part that now maps directly onto something measurable is the pump and the conduits: heart rate, rhythm, blood pressure, and the pulse itself can all be recorded. The part that does not map is the scope of the organ. The classical heart also houses the shen, the seat of mind and consciousness, so a term that began as a statement about circulation and a term that began as a statement about mental life are carried by the same word. Reading the two together - as either an early discovery of the circulation or as a claim that emotional states arise from the heart muscle - does violence to the sources in opposite directions. This library keeps them apart. The presentations that shadow this term today keep their own clock: chest pain spreading to the back, arm or jaw, especially with sweating or breathlessness, belongs in emergency care, and an irregular pulse is measured, not classified.
古典论述给心两项相连的职责：它主血，也主血所行的脉。心气被认为推动血液在脉中运行，而这个运行状态由脉象读出，按古典说法也显于面色与舌。 今天能直接对上可测量之物的，是泵与管道本身：心率、节律、血压、脉搏都可以记录。对不上的是这个脏器的范围。古典的「心」同时藏神，是精神意识之所舍，于是一个起初关于循环的说法与一个起初关于精神活动的说法，被同一个字承载着。把两者合起来读 —— 无论是读成「早就发现了循环」，还是读成「情绪由心肌产生」—— 都是从相反两个方向曲解文献。本库把两者分开记。 与这条术语形影不离的若干表现，今天各自带着自己的时钟：放射到背部、手臂或下颌的胸痛，尤其伴出汗或呼吸困难，属于急救范畴；脉搏不规则是去测量，不是去归类。
The classical lung does two movements at once. Diffusion carries clear qi and fluids upward and outward, opens the skin and body hair, and is what the sources credit with the defensive qi that closes or opens the pores. Descending sends what has been taken in downward, keeps the airway clear and, in the classical account, regulates the waterways - which is why the lung appears in discussions of oedema and of urine as well as of breathing. Breathing is now measured directly, and the clearing of the airway has a documented mechanism in mucociliary clearance. The move to water metabolism is where the mapping thins: the classical lung takes on work that today is attributed to the kidneys, the vasculature and the hormonal control of salt and water, and the term does not distinguish between them. Two sounds that classical texts describe together are separated today, and the separation matters: a wheeze arising in the small airways and a harsh inspiratory noise arising in the large airway are not the same urgency. Neither is breathlessness that appears only when lying flat, nor blood in the sputum, nor sudden one-sided chest pain with breathlessness. This library records the term as a way the sources organised these complaints and does not sort them.
古典的肺同时做两个方向的运动。宣发把清气与津液向上向外布散、开泄皮毛，文献把腠理的开合、卫气的敷布归在它名下；肃降则把所受纳的向下通降，保持气道通利，并且在古典论述里「通调水道」—— 这也是肺会出现在水肿与小便讨论里的原因，而不只出现在呼吸讨论里。 呼吸今天可以直接测量，气道的通利也有明确记载的机制（黏液纤毛清除）。变薄的是往水液代谢的那一跃：古典的肺承担了今天归给肾脏、血管以及水盐激素调节的那部分工作，而这个术语并不区分它们。 古典文本放在一起描述的两个声音，今天被分开，而且这个分开要紧：起于小气道的哮鸣，与起于大气道的吸气期粗糙响声，不是同一种紧急程度。只在平卧时出现的呼吸困难、痰中带血、突发的单侧胸痛伴呼吸困难，同样如此。本库记录这个术语，是记文献如何组织这些不适；本库不对它们排次序。
The classical spleen has one job described with two words. Transportation is the moving of the essence derived from food and drink; transformation is the handling of water, so that dampness does not accumulate. On this reading the spleen is the source of what the body builds itself from after birth, and the term carries most of the classical discussion of digestion, of loose stools, of fatigue after eating, and of accumulated fluid. The first thing to say about it is that this spleen is not the anatomical spleen. The organ that bears that name in anatomy filters blood and holds a reserve of platelets and immune cells; it is removed surgically, and digestion continues. What the classical term describes is distributed today across small-bowel absorption, pancreatic exocrine function, hepatic metabolism and the gut microbiota, none of which the term separates. Carrying the translation across without saying so produces the most common misreading in this part of the literature. For the complaints it names, the sorting is done by investigation and not by classification: unintended weight loss, difficulty swallowing, blood in the stool or vomit, jaundice, and new indigestion appearing after middle age each have a defined pathway that does not begin with a pattern name.
古典的脾只做一件事，用两个字描述：运，是转输水谷精微；化，是处理水液，使湿不内停。按这个说法，脾是出生之后身体用以自养的来源，古典关于消化、便溏、食后困倦与水湿停聚的讨论，大半挂在这个术语上。 关于它，第一句该说的是：这个脾不是解剖学的脾。解剖学上叫这个名字的器官负责滤血、储留血小板与免疫细胞；它被手术切除，消化照旧进行。而这个古典术语所描述的功能，今天分布在小肠吸收、胰腺外分泌、肝脏代谢与肠道菌群之间，术语本身并不区分它们。把这个译名直接搬过来而不加说明，就产生了这一部分文献里最常见的误读。 对于它所提到的那些不适，分诊靠检查而不靠归类：不明原因的体重下降、吞咽困难、便血或呕血、黄疸、中年以后新发的消化不良，各有明确的处理路径，而那条路径不是从一个证候名开始的。
Free flow is the classical liver's principal function: it keeps the movement of qi unobstructed, and through that it is credited with emotional ease, with the discharge of bile, with assisting the digestion the spleen and stomach carry out, and - together with the liver's storing of blood - with the regularity of menstruation. When the function is said to fail, the vocabulary used is stagnation, and the complaints gathered under it run from irritability and a sense of distension to irregular periods. There is something measurable underneath part of this: psychophysiological stress responses are real and recordable, and bile flow has a physiology of its own. What is not a mapping is the organ identity. The classical liver includes work now assigned to the central nervous system and to emotional regulation, and it is not the organ whose enzymes are measured on a blood test. Reading a raised transaminase as stagnation, or reading stagnation as a liver disease, are the same error made from two sides. The overlap that matters clinically is the reverse one: an abnormal liver blood test calls for a search for viral hepatitis, fatty liver, alcohol and drug-induced injury, and herbal products and dietary supplements are a frequently under-reported cause of the last of these. Distension and low mood may be named by this term; a diagnosis of depression or anxiety is not made by it.
疏泄是古典肝的主要功能：它使气机调畅，由此被认为主司情绪的舒展、胆汁的排泄、协助脾胃的运化，并与肝藏血一起关系到月经的规律。这个功能被认为失职时，所用的词是「郁」，归在它名下的不适从烦躁、胀满一直到经期紊乱。 这里面有一部分底下确实有可测之物：心理生理性的应激反应是真实且可记录的，胆汁的排泄也有它自己的生理。对不上的是脏器的同一性。古典的肝包含今天归给中枢神经系统与情绪调节的那部分工作；它并不是那个在血液化验里被测量转氨酶的器官。把转氨酶升高读成「肝郁」，或把「肝郁」读成一种肝病，是从两侧犯下的同一个错误。临床上真正要紧的重叠是反过来的那一层：肝功能化验异常，需要的是去找病毒性肝炎、脂肪肝、酒精与药物性肝损伤，而草药产品与膳食补充剂是其中最后一项里常被漏报的原因。 胀满与低落可以由这个术语命名；抑郁症或焦虑症的诊断不由它作出。
In the classical account the kidney governs water by means of qi transformation: it receives what has been processed, separates the clear from the turbid, and governs the opening and closing that decide how much is passed as urine. The term therefore appears wherever the sources discuss oedema, scanty or copious urine, and incontinence. Urine output, blood pressure and the hormones that regulate salt and water are all measurable today, and the kidney's role in them is documented in detail, so this is one of the closest correspondences in the whole vocabulary. The scope is nevertheless not the same. The classical kidney also stores the essence that governs growth, reproduction, the bones and the teeth, and opens at the ear, which puts development, fertility, bone loss and hearing loss under the same word as fluid balance. Calling a case of this pattern a kidney disease, or calling chronic kidney disease by this name, both lose information that changes what happens next. Two cautions belong with the term. A falling urine output is the earliest sign of acute kidney injury and remains reversible while the obstruction or the cause is still findable. And the safety line this library repeats throughout belongs here most of all: interstitial renal fibrosis and urothelial carcinoma caused by aristolochic acid are documented outcomes of herbal exposure, and no threshold of exposure below which they have been shown not to occur has been established.
古典论述里，肾通过气化来主水：受纳已经运化过的水液，分清别浊，并主司决定尿量多少的开合。因此这个术语出现在文献讨论水肿、小便不利或清长、以及遗尿失禁的地方。 尿量、血压与调节水盐的激素今天都可以测量，肾脏在其中的作用有详尽记载 —— 这是整套词汇里对应得最紧密的一条之一。但范围并不相同。古典的肾还藏着主生长发育、生殖、骨与齿的「精」，并且开窍于耳，于是发育、生育、骨量流失与听力下降，和体液平衡被同一个字统辖着。把一个这种证型称为肾病，或把慢性肾脏病按这个名称来理解，两边都丢掉了会改变后续处理的信息。 这条术语该带两条提醒。其一，尿量减少是急性肾损伤最早的表现，在梗阻或病因还找得到的时候仍属可逆。其二，本库反复重申的那条安全线在这里最该重提：由马兜铃酸引起的肾间质纤维化与尿路上皮癌，是草药暴露已有记载的后果，且并未确立过「低于某个暴露量就不会发生」的阈值。
The classical stomach receives what is eaten and drunk, ripens and decomposes it, and passes it downward; its movement is descending, paired against the spleen's ascending one. Harmony in the classical stomach means things going down rather than up, which is why the vocabulary of this term - fullness, belching, nausea, vomiting, hiccup - is a vocabulary of direction. Accommodation, acid secretion and gastric emptying are all measurable, and the stomach is directly inspectable, so the correspondence is closer here than for most organs of the same series. What does not correspond is the prognostic use. 'Stomach qi' in the sources is a judgement about whether a person is holding their own, expressed as 'where there is stomach qi there is life, where there is none there is death'. That is a statement about how the texts weigh a clinical impression and not a quantity with a unit. The complaints this term collects are the ones with the most clearly defined pathways in modern practice, and the direction of travel runs from symptom to investigation: progressive difficulty swallowing, painful swallowing, unintended weight loss, vomiting blood, black stools, iron-deficiency anaemia, and new indigestion after middle age each carry an endoscopy indication rather than a pattern. Two of the causes that can be looked for directly are Helicobacter pylori infection and non-steroidal anti-inflammatory drugs. Vomiting in pregnancy is separated from the hyperemesis that produces ketosis and electrolyte disturbance by measurement, not by inspection of the tongue.
古典的胃受纳饮食、腐熟水谷、并通降下行；它的运动方向是降，与脾的升相对。古典所谓「胃和」，指的是该下去的下去而不是反上来，这也是这个术语的词汇表 —— 痞满、嗳气、恶心、呕吐、呃逆 —— 是一整套关于方向的词汇的原因。 胃的容受、胃酸分泌与胃排空今天都可以测量，胃腔本身也可以直接观察，所以这里与同一系列的大多数脏器相比，对应要更紧密。对不上的是它被用于预后的那层用法。文献里的「胃气」是对一个人是否还撑得住的判断，表达为「有胃气则生，无胃气则死」。这是关于文本如何权衡临床印象的一句话，不是一个带单位的量。 这个术语所汇集的不适，恰恰是现代实践中路径界定得最清楚的那一批，而方向是从症状走向检查：进行性吞咽困难、吞咽痛、不明原因体重下降、呕血、黑便、缺铁性贫血、中年以后新发的胃脘不适，各自带的是内镜检查指征，而不是一个证型。可以直接去查的两种病因是幽门螺杆菌感染与非甾体抗炎药。妊娠呕吐与已经引起酮症和电解质紊乱的妊娠剧吐，靠测量分开，不靠看舌。
The classical account assigns the lung two jobs at once: it governs the qi of the whole body, and it controls the act of breathing. Closely attached to this are three further statements - that the lung diffuses and descends, that it governs the skin and body hair, that it opens into the nose - and the claim that it regulates the waterways, which is why it is called the upper source of water. Only the middle clause maps onto something a machine can record. Respiration is measured: respiratory rate, oxygen saturation, spirometry, peak flow, arterial gases. The other clauses do not resolve into a single measurable quantity. There is no reading for the qi of the whole body, and the classical lung is not coextensive with the anatomical organ - the same word carries the skin, the nose, the defensive surface and the passage of fluids. The practical weight of the term sits elsewhere: in the presentations it gathers under one heading. Breathlessness keeps a differential that has to be walked rather than assigned - asthma and COPD, pneumonia, pulmonary embolism, pneumothorax, heart failure, anaphylaxis, aspiration, and in children croup and inhaled foreign body. A low resting saturation, or one that has dropped clearly from a person's own baseline, is a measurement, not a pattern, and breathlessness at rest with chest pain is an emergency pathway. Chronic nasal obstruction and loss of smell likewise have their own named causes - allergic rhinitis, chronic rhinosinusitis, nasal polyps - and in the case of smell, neurological and post-viral ones too.
古典论述把两项职责同时给了肺：主一身之气，又司呼吸。与之相连还有三条 —— 肺主宣发肃降、主皮毛、开窍于鼻，以及「通调水道」，故称「水之上源」。 几项里只有「司呼吸」对得上今天能记录的东西：呼吸频率、血氧饱和度、肺功能与峰流速、动脉血气都可测量。其余几项并不收敛成某一个可测量的量 —— 「一身之气」没有对应的读数，且古典的「肺」与解剖的肺并不等大：同一个字同时承载了皮毛、鼻、卫表与津液的输布。 这个术语真正的分量在别处：在于它把一组主诉收在同一个名目下。气短今天有一张必须走完的鉴别表，而不是一个可以指派的名目 —— 哮喘与慢阻肺、肺炎、肺栓塞、气胸、心力衰竭、严重过敏反应、误吸，儿童还要想到急性喉炎与气道异物。静息血氧低于正常范围、或明确低于本人的基线，那是测量值而不是「证」；静息状态下气短并伴胸痛，走的是急诊路径。长期鼻塞与嗅觉减退同样各有其现代病名 —— 变应性鼻炎、慢性鼻窦炎、鼻息肉；嗅觉一条还要算上神经系统与感染后的原因。 本库只作记录，不作裁决：肺主气与肺主皮毛是古典体系的陈述，不是可以拿去替代上述鉴别的结论。
Spleen Governs Ascending the Clear is the upward half of the classical spleen's work. Having transformed and transported the products of food and drink, the spleen is said to send the refined portion - the clear - upward to the heart and lung, where it becomes qi and blood. When the ascending fails, the classical texts describe dizziness, heaviness, fatigue and loose stools; when the failure is pronounced they speak of the sinking of central qi, and place prolapse under the same heading. No instrument returns a value for the clear, and none for central qi sinking. What does exist today is the cluster of complaints the term gathers, and for those the correspondence runs in the opposite direction from the wording: they are not one disorder with one upward-moving cause, they are several disorders with separate workups. Chronic diarrhoea with unintentional weight loss, blood in the stool, or new iron-deficiency anaemia is investigated - coeliac disease, inflammatory bowel disease, colorectal cancer and malabsorption are on that list, and they are found by endoscopy, biopsy and blood tests rather than by the word sinking. Prolapse is named and staged in its own right. Dizziness is first split into central and peripheral, because posterior-circulation stroke is on the central side and early imaging being normal does not close it. The classical spleen is also not the anatomical spleen: people live normally after splenectomy, and the organ that removes worn blood cells is not the organ this term is about. This library records both statements and does not reconcile them.
「脾主升清」是古典脾运化职责里向上的那一半：脾把饮食水谷运化之后，将其中的精微部分 —— 「清」—— 上输心肺，化生气血。升清失职，古典描述为眩晕、身重、疲乏、便溏；更进一步则称「中气下陷」，并把脱垂一类病证收在同一名目下。 没有任何仪器能给出「清」的值，也没有能给「中气下陷」的值。今天真正存在的是这个术语所收拢的那组主诉；而对这组主诉，对应关系与字面方向正好相反 —— 它们不是一个「升不上去」的病，而是若干各有检查路径的病。慢性腹泻合并非刻意的体重下降、便血、或新出现的缺铁性贫血，是要查的：乳糜泻、炎症性肠病、结直肠癌、吸收不良都在这张单子上，而它们靠内镜、活检与血液检查找到，不靠「下陷」这个词。脱垂本身另有命名与分度。眩晕先分中枢与外周，因为后循环卒中在中枢那一侧，而早期影像正常并不能关掉它。 古典的脾也不是解剖的脾：脾切除后消化照旧，清除衰老血细胞的那个器官不是这个术语所说的。本库两边都记，不代为调和。
Liver Stores Blood is the classical statement that the liver holds the blood, regulates the volume in circulation, and releases it according to demand. Attached to it are the liver's governance of the sinews and its opening into the eyes, the monthlies being counted under its charge, and the hun - the ethereal soul - being lodged there. This is one of the organ-function terms with a partial modern correspondence, and it is worth being precise about where the correspondence is. The liver does receive a large share of the cardiac output through the portal vein and does hold a substantial blood volume, and it does make most of the clotting proteins, which is why advanced liver disease produces a bleeding tendency that can be measured. Those are real. What is not a modern claim is the rest of it: that the liver meters blood out on demand, and that menstruation, the eyes and the sinews fall under its charge. The presentations gathered here keep their own thresholds. Heavy menstrual bleeding is defined by volume and by consequence, and its causes are named - fibroids, adenomyosis, thyroid disease, perimenovulatory and perimenopausal change, and bleeding disorders such as von Willebrand disease - and it is evaluated rather than labelled. Any bleeding after the menopause is evaluated without waiting. The classical liver is also not the anatomical one: hepatitis, cirrhosis and hepatocellular carcinoma carry their own names and their own screening, and herbal and dietary supplements are among the causes of drug-induced liver injury that are most often missed because nobody asks. Someone taking an anticoagulant or an antiplatelet drug who begins bleeding is in that workup, not in a pattern.
「肝藏血」是古典的陈述：肝藏血、调节运行中血的量，并按需要释放之。与之相连的还有肝主筋、开窍于目，经水归其统摄，以及魂舍于肝。 这是脏腑功能术语里与现代有一条**部分**对应的一条，值得把对应落在哪里说准。肝脏确实经门静脉接受很大一部分心输出量，确实含有相当的血容量，也确实合成大部分凝血因子 —— 所以晚期肝病会出现可以测出的出血倾向。这几条是真实的。不构成现代主张的是其余部分：肝按需「放血」这一机制说法，以及经水、目、筋归其统摄。 这一术语收拢的主诉各有各的阈值。月经过多由出血量与后果定义，病因各有其名 —— 子宫肌瘤、子宫腺肌病、甲状腺疾病、围绝经期改变、以及血管性血友病一类的出血性疾病 —— 它是被评估的，不是被贴上一个证的标签。绝经后任何出血都不等、直接评估。古典的肝也不是解剖的肝：肝炎、肝硬化、肝细胞癌各有其名与其筛查路径；而草药与膳食补充剂是药物性肝损伤里最常被漏掉的一类原因，因为往往没人问起。正在服用抗凝或抗血小板药物而出现出血的人，走的是那条检查路径，不是某个证。
Kidney Stores Essence is the classical claim that the kidney holds the jing, the essential material inherited at conception and replenished from food and drink, and that this store governs growth, development, reproduction and ageing. Bound to it are the statements that the kidney governs the bones and generates marrow, that the brain is the sea of marrow, that the teeth are the surplus of bone, that its bloom shows in the hair, and that it opens into the ears and the two lower openings. There is no measurable jing. There is a genuine, if incomplete, overlap with endocrinology and development: puberty, fertility, the gonadal axis, bone accrual and loss, and blood formation in the marrow all sit inside this term's range, and all of them today have measured quantities attached. But the overlap is not an equivalence, and the classical kidney carries far more than the anatomical one - the same word holds reproduction, bone, marrow, teeth, hair, hearing and the lower openings. Three hard lines follow from the complaints this term gathers. Infertility is evaluated as a couple, because the contribution is not one-sided, and it is not brought to an endpoint by naming a kidney. Delayed puberty has defined thresholds and defined causes. Bone loss has a measured bone mineral density and a measured fracture risk, and unlike most of what this term covers it can be slowed - which is precisely why naming it early matters. Separately: chronic kidney disease is largely silent until it is advanced, is defined by measured filtration and measured albumin in the urine, and the label kidney deficiency is a well-recognised reason people arrive late. Aristolochic acid is recorded here as the standing safety line - it causes kidney failure and urothelial cancer, and it reached people through herbal products.
「肾藏精」是古典的主张：肾藏先天之精与后天之精，这一储备主生长、发育、生殖与衰老。与之绑定还有：肾主骨生髓、脑为髓海、齿为骨之余、其华在发、开窍于耳及二阴。 「精」没有可测量的值。倒是存在一处真实但不完整的重叠，落在内分泌与发育上：青春期、生育力、性腺轴、骨的获得与丢失、骨髓造血，都在这个术语的射程之内，而这些今天都各自配有可测量的量。但重叠不等于等同，古典的「肾」所承载的远比解剖肾多 —— 同一个字同时管生殖、骨、髓、齿、发、耳与二阴。 由这个术语所收拢的主诉推出三条硬线。不孕不育是按「一对」来评估的，因为原因不总在一侧，且它不会因为给肾起个名字就走到终点。青春期延迟有明确的阈值与明确的病因。骨量流失有可测的骨密度与可测的骨折风险，而且与这个术语所覆盖的多数内容不同，它是可以被减缓的 —— 正因如此，早一点叫出它的现代名字才有意义。另有一层：慢性肾病在进展之前基本无声，由测得的滤过率与尿白蛋白定义，而「肾虚」这个标签正是人们就诊偏晚的已知原因之一。马兜铃酸作为常设安全线记在此处 —— 它导致肾衰竭与尿路上皮癌，而它是通过草药产品到达人身上的。
Kidney Grasps Qi is the classical statement that the lung governs the outflow of breath while the kidney is the root that receives and holds the incoming qi - the lung is the governor of the qi, the kidney its root. When the kidney fails to grasp, the texts describe breathing out more than in, shortness of breath on exertion, and difficulty drawing the breath fully down. Of all the organ-function terms this is among the closest to a modern observable, and the honesty lies in separating the observation from the mechanism. The observation is real and measurable: exertional breathlessness, an inability to complete inspiration, and breathlessness that eases sitting up are all things that can be recorded today, and they carry named, measurable causes - hyperinflation and a flattened diaphragm in COPD, orthopnoea and paroxysmal nocturnal breathlessness with a measurable ejection fraction and natriuretic peptide in heart failure, restriction, neuromuscular weakness, anaemia, deconditioning. The mechanism as stated is not a mechanism in that sense; the kidney is not holding the breath down. It is worth recording that the kidney does have real respiratory connections, but they are not this one: it handles acid and base, so metabolic acidosis produces deep rapid breathing; it makes erythropoietin, so kidney disease causes anaemia and anaemia causes breathlessness; and when it fails to handle water, pulmonary oedema follows. Those are three genuine routes from kidney to breathing, and none of them is what the classical term describes. Safety line: breathlessness that only eases sitting upright, or that wakes a person at night, is heart failure until something else is shown, and new breathlessness at rest is an emergency pathway.
「肾主纳气」是古典的陈述：肺主呼气，肾为气之根，受纳并摄住吸入的气 —— 「肺为气之主，肾为气之根」。肾不纳气时，文献描述为呼多吸少、动则气喘、吸气不能下达。 在所有脏腑功能术语里，这条属于离现代可观察之物最近的一条，而诚实之处在于把「观察」与「机制」分开。观察是真的、可测量的：劳力性气短、吸气不能吸到底、坐起才缓解的气短，今天都能记录，且各有其名、各有测量值 —— 慢阻肺的肺过度充气与膈肌低平；心力衰竭里的端坐呼吸与夜间阵发性呼吸困难，可测射血分数与利钠肽；限制性肺病、神经肌肉无力、贫血、体能失适应。而字面所说的机制不是这个意义上的机制：肾并不「摄住」吸进去的气。 值得记下的是：肾与呼吸确实存在真实的联系，但不是这一条 —— 它管酸碱，所以代谢性酸中毒会出现深快呼吸；它造促红素，所以肾病会贫血、贫血会气喘；它处理不了水，就会出现肺水肿。这是从肾到呼吸的三条真实通路，没有一条是这条古典术语所说的。安全线：只有坐起才缓解的气短、或夜间把人憋醒的气短，在排除其他之前按心力衰竭处理；新出现的静息气短走急诊路径。
Heart Stores the Spirit is the classical statement that the heart houses the shen - consciousness, mental activity, sleep - and is for that reason called the great governor of the five zang and six fu. Disturbance of the shen is described as restlessness, poor sleep, palpitations, forgetfulness and, at its far end, delirium and loss of contact. Both possible readings of this term are wrong, and this library records that rather than choosing. Reading it as a claim that the heart muscle thinks is false. Reading it as praise for having anticipated the brain is equally false: the classical heart governs blood and houses the shen because the word does both, and flattening that into either an early neurology or a cardiology claim destroys the sources in opposite directions. The links that actually exist between the heart and mental state today are indirect and measurable: the brain is perfused by the circulation, so arrhythmia, heart failure, low output and syncope change mentation; atrial fibrillation and other sources send clots to the brain, so a rhythm problem presents as a stroke; and the association between depression and cardiovascular outcomes is well documented without anyone claiming the emotion lives in the myocardium. The presentations gathered under this term carry the heaviest safety line in this batch. Palpitations get an electrocardiogram, because atrial fibrillation is found that way and is a stroke-risk finding. Insomnia and anxiety have their own differential - thyroid disease, caffeine and stimulant and medication effects, sleep apnoea, substance use, and delirium, which in an older person is usually infection, medication or a metabolic disturbance and is a medical emergency. And the one that admits no delay: despair with thoughts of self-harm needs a human being now, not a pattern name and not a term.
「心藏神」是古典的陈述：心藏神 —— 意识、精神活动、睡眠 —— 因此被称为「五脏六腑之大主」。神乱被描述为心神不宁、失眠、心悸、健忘，其极则为谵语、神志不清。 这个术语的两种读法都错，本库记下这一点而不在其中选边。读成「心肌在思考」是错的。读成「古人预见了脑」同样错：古典的「心」既主血又藏神，是因为这个字同时承载两者；把它压扁成早期的神经学，或压成一条心脏病学主张，是从相反两个方向破坏文献。今天心与精神状态之间真实存在的联系是间接的、可测量的：脑靠循环灌注，所以心律失常、心力衰竭、低排血量与晕厥都会改变神志；房颤等来源会把栓子送进脑，于是一个节律问题以卒中起病；而抑郁与心血管结局之间的关联有充分记录，却没有人主张情绪住在心肌里。 这一术语名下的主诉，是本批里安全线最重的一组。心悸要做心电图 —— 房颤是这么查出来的，而它是一个卒中风险发现。失眠与焦虑各有其鉴别：甲状腺疾病、咖啡因与兴奋剂及药物作用、睡眠呼吸暂停、物质使用，以及谵妄 —— 在老年人身上，谵妄通常是感染、药物或代谢紊乱所致，属于内科急症。还有一条没有商量余地：绝望并伴有自伤念头，需要的是此刻有一个人，不是一个证名，也不是一个术语。
The choppy pulse is described as rough and uneven, its beats passing with difficulty - the standard image is of scraping bamboo with a light knife, or of cutting dry wood. Classical sources associate it with depleted Blood, exhausted essence, and with stagnation of qi and Blood. Two things about this term are worth separating. The first is that it is a tactile judgement, and published studies of agreement between practitioners on pulse qualities repeatedly report low concordance: two experienced practitioners palpating the same wrist frequently do not record the same name. This library records that rather than smoothing it away. The second is that the pulse properties which can be checked - rate, rhythm, amplitude - are real haemodynamic quantities, and where a choppy-feeling pulse has a measurable counterpart today it is usually on one of two axes: an irregular rhythm, or a low-amplitude and slowly rising waveform. Irregular rhythm is established by electrocardiography rather than by the finger, and atrial fibrillation is worth finding because it is a stroke-risk finding. The slowly rising, low-amplitude pulse is described in cardiology as pulsus parvus et tardus and is discussed in connection with severe aortic stenosis, which is an echocardiographic diagnosis. This library does not present pulse palpation as a way of detecting either. Not established: that any named pulse quality identifies a specific named disease, or that the classical categories of Blood depletion, essence exhaustion and qi-Blood stagnation correspond to separable measurable states.
涩脉被描述为往来艰涩、如轻刀刮竹，或如刀劈干木。古籍多与血少、精伤、气滞血瘀相联系。 这个术语有两层值得分开。其一，它是触觉判断；已发表的研究对「不同执业者就同一腕部给出同一脉名」的一致率反复报告偏低 —— 两位有经验的执业者按同一手腕，常常记下不同的脉名。本库记下这一点，而不是把它抹平。其二，脉象里真正可核对的那几项（至数、节律、幅度）是真实的血流动力学量；今天能与「涩」的指感对得上的，通常落在两条轴之一：节律不齐，或幅度低而上升缓慢的波形。节律不齐由心电图确定，不靠指下；房颤值得查出来，因为它是一个卒中风险发现。幅度低、上升缓慢的脉搏在心脏病学里被描述为迟脉（pulsus parvus et tardus），多与重度主动脉瓣狭窄一起被讨论，而那是超声心动图的诊断。本库不把切脉当作查这两者的手段。 未被证实：任一脉名能指认某一特定疾病；古典的「血少」「精伤」「气滞血瘀」对应得上可以被分开测量的三种状态。
Broad, large and forceful, arriving as a full wave and ebbing quickly - the classical image is of a swelling wave or a flooding torrent. Classical sources place it with exuberant Heat, above all the Yangming stage. This is one of the pulse terms where a real correspondence can be stated without strain, because fever produces the haemodynamic change the description records: peripheral vasodilatation with a raised heart rate gives a large, bounding, quick-filling pulse. Hyperdynamic circulations of other kinds do the same - thyrotoxicosis, severe anaemia, pregnancy, arteriovenous shunting - and each of them is identified by measurement, not by palpation. The second half of the classical description, that the wave ebbs away quickly once it has peaked, resembles what cardiology calls a collapsing or water-hammer pulse, most often discussed in aortic regurgitation; a resemblance is a resemblance, and this library does not present the fingered pulse as a way of detecting valve disease, which is found by auscultation and echocardiography. The safety line attaches to the presentation rather than to the pulse. A sustained rapid rate with a measured fever in someone who is unwell is a number to be worked up. A bounding pulse in a person with chest pain, breathlessness or altered mentation belongs on an emergency pathway. Not established: that the surging pulse distinguishes infectious from non-infectious fever, or that it marks any stage of any illness reliably enough to act on.
洪脉被描述为浮大有力、来盛去衰，如波涛汹涌。古籍多把它归于热盛，尤其是阳明气分。 这是脉象术语里能比较不吃力地说出真实对应的一条：发热本身就产生这段文字所记录的血流动力学改变 —— 外周血管扩张加上心率增快，指下的脉就变得宽大、有力、充盈迅速。其他高动力循环状态也一样：甲状腺功能亢进、重度贫血、妊娠、动静脉分流，而这些都靠测量确定，不靠切脉。古典描述的后半段 —— 波峰之后迅速衰减 —— 与心脏病学所说的陷落脉（水冲脉）相似，后者最常在主动脉瓣关闭不全里被讨论；相似只是相似，本库不把指下的脉当作检出瓣膜病的手段，瓣膜病由听诊与超声心动图确定。 安全线系在主诉上而不是脉上：持续心率增快加上测得的发热，这是一个要查的数字；一个宽大有力的脉出现在有胸痛、气短或神志改变的人身上，走的是急诊路径。未被证实：洪脉能区分感染性与非感染性发热，或能可靠到可以据此处置地标示疾病的某一阶段。
Thin as a thread yet distinctly felt: narrow and of small amplitude, but not absent. Classical sources associate it with deficiency of both qi and Blood and with dampness. Amplitude is a real property of the arterial waveform, and it does fall when stroke volume falls or when the peripheral vessels constrict. Shock, hypovolaemia, cold exposure, low-output heart failure and severe aortic stenosis all produce it. That is the genuine overlap. What does not travel is the inference drawn from it. A thin radial pulse is also simply what a thin wrist feels like, and it is produced by body habitus, by oedema over the artery, and by how hard the examiner presses - none of which is a statement about the person's volume state. Low output is measured with blood pressure, capillary refill, urine output, lactate and, where needed, echocardiography; it is not graded by the finger. The line worth keeping: a rapid, thready pulse in a person who is hypotensive, cold, confused, or passing little urine is a shock pathway and is measured, and in a person with chest pain or breathlessness it belongs to the emergency differential. Not established: that a thready pulse distinguishes deficiency from dampness, or that it identifies anaemia - anaemia is a haemoglobin measurement.
细脉被描述为脉细如线，但应指明显：幅度小而非无。古籍多与气血两虚及湿邪相联系。 幅度是动脉波形的一项真实属性，每搏输出量下降或外周血管收缩时它确实会变小：休克、血容量不足、受寒、低排血量的心力衰竭、重度主动脉瓣狭窄都会造成它。这是真实的重叠部分。不能照搬的是由此推出的结论：细弱的桡动脉脉搏，也可能只是细的手腕本来就是这个手感 —— 体形、动脉上的水肿、以及按压的轻重都会造成它，而这些都不是对这个人容量状态的一句陈述。低排血量靠血压、毛细血管再充盈、尿量、乳酸，需要时靠超声心动图来测量；它不靠指下来分级。 值得留下的一条线：一个细数而弱的脉出现在低血压、皮肤湿冷、神志改变或少尿的人身上，那是休克路径，是要测量的；出现在有胸痛或气短的人身上，属于急诊鉴别。未被证实：细脉能区分「虚」与「湿」，或能指认贫血 —— 贫血是血红蛋白的测量值。
Taut, tense and forceful, classically likened to a twisted rope or to pressing a taut cord, and said to push sideways against the fingers. Classical sources associate it with cold, with pain, and with retained food. Of the six pulses in this batch this is the one whose classical associations have the most straightforward physiological reading: pain and cold both raise sympathetic tone, raised sympathetic tone constricts the vessels and makes the arterial wall harder to compress, so the observation has a basis - and both cold exposure and acute pain are accompanied by measurable changes in heart rate, blood pressure and skin temperature. What does not follow is that the finger can sort one from the other, or that a taut pulse tells you which of the three classical causes is in play. The weight of the term is again in the complaints it gathers. Pain is not a destination in this library: chest pain radiating to the back or between the shoulders, chest pain with a difference in blood pressure between the two arms, abdominal pain after trauma, a rigid abdomen, and pain with neurological signs each have a time-scaled pathway that does not run through a pulse name. Retained food is not a diagnosis; vomiting with abdominal distension and no passage of stool or flatus is a surgical question on an hourly scale. Not established: that the tight pulse corresponds to any single measurable vascular quantity.
紧脉被描述为脉来绷急、如按绳索或转索，左右弹人手。古籍多与寒、痛、宿食相联系。 本批六脉里，紧脉是古典关联最容易被生理学照亮的那一类：疼痛与寒冷都会提高交感张力，交感张力升高使血管收缩、动脉壁更难被压瘪 —— 所以这个观察有依据，而受寒与急性疼痛两者今天都伴随心率、血压与皮温的可测量变化。不能推出的是：指下能区分这两者，或一个绷紧的脉能告诉你三种古典原因里是哪一种。 这一术语的分量同样落在它收拢的主诉上。疼痛在本库里不是终点：放射到背部或两肩之间的胸痛、伴两臂血压差的胸痛、外伤后的腹痛、板状腹、伴有神经体征的疼痛，各有其以小时或分钟计的通路，都不经过脉名的中转。宿食不是一个诊断：呕吐伴腹胀且无排便排气，是以小时计的外科问题。未被证实：紧脉对应某一个可测量的血管量。
Deeper than deep: the pulse cannot be felt at all until heavy pressure reaches the bone. Classical sources associate it with blockage of pathogenic qi in the interior, with cold extremities and loss of consciousness, and with extreme pain. This is the pulse term with the simplest honest answer, because a radial pulse that can barely be felt is a finding that today is measured rather than interpreted. It means the pressure reaching the wrist is low or the vessel is constricted - shock in its various forms, profound hypothermia, severe dehydration - or that the artery itself is the reason: variation in the course of the radial artery, previous harvest of the vessel for a bypass graft, arterial occlusion, subclavian or innominate disease, and Takayasu arteritis are all recorded causes of an impalpable radial pulse, and none of them is a statement about the person's state at that moment. Obesity and oedema make the same examination hard. Blood pressure is the measurement; where it cannot be obtained, the carotid or femoral pulse is. The safety line that admits no delay: in an unresponsive person with no pulse and no normal breathing this is cardiac arrest, and the response is chest compressions and calling for help - not a pattern name, not a pulse quality, and not something to be reasoned out at the wrist. Not established: that a hidden pulse distinguishes the classical causes listed above from one another.
伏脉比沉脉更深：重按至骨乃得，轻取中取皆不应指。古籍多与邪闭于内、四肢厥逆、神志不清以及痛极相联系。 这是本批里诚实答案最简单的一条 —— 一个几乎摸不到的桡动脉脉搏，今天是被测量而不是被解释的发现。它意味着到达腕部的压力很低或血管收缩：各类休克、重度低体温、严重脱水；也可能是动脉本身的原因 —— 桡动脉走行变异、既往取该血管做旁路移植、动脉闭塞、锁骨下动脉或头臂干病变、以及大动脉炎，都是「桡动脉触不到」的已记载原因，而没有一条是关于这个人当下状态的陈述。肥胖与水肿同样会让这次触诊变难。血压是那个测量值；测不到时，改触颈动脉或股动脉。 没有商量余地的安全线：一个无反应的人，摸不到脉搏、也没有正常呼吸，这是心脏骤停，回应是胸外按压与呼救 —— 不是一个证名、不是一个脉象性质，也不是可以在腕部慢慢推理的事情。未被证实：伏脉能区分上面列出的几种古典原因。
Moderate is the one term in this batch that can name a healthy finding, and that is worth saying first. In the classical sources the moderate pulse comes four beats to one breath, even and unhurried - and a pulse of about that rate, steady and regular, is the normal pulse, the one said to have stomach qi. Alongside it, spelt with the same character, is the slack or lax pulse: slow and loose, associated with dampness and with deficiency of the spleen. The rate half of the term is now a number on a clock: four beats per breath only converts to a rate if a respiratory rate is assumed, and the conversion is unnecessary because rate is counted directly. A resting rate in the sixties is ordinary. A persistently low rate with a normal rhythm is common in trained athletes, and it is also a recognised presentation of hypothyroidism, which is a blood test. The quality half - slack, loose, unhurried - is a tactile judgement, and like every pulse quality it is subject to the low inter-practitioner agreement recorded elsewhere in this batch. One caution specific to this term: because moderate can name the normal pulse, recording it is not by itself a finding, and it should not be read as reassurance that some measured abnormality elsewhere has been accounted for - a low rate with dizziness or with a blackout, for instance, is still a rhythm that wants an electrocardiogram.
缓脉是本批里唯一可以指一个健康发现的术语，这一点值得先说。在古典文献里，缓脉一息四至，从容和缓 —— 大致这个至数、稳而齐的脉，就是平脉，也就是所谓「有胃气」的脉。与之并存的，是同一个字写成的另一层意思：缓而弛纵、松懈无力，古籍多与湿邪及脾虚相联系。 这个术语里「至数」那一半今天已经是钟表上的一个数字：一息四至只有在假定一个呼吸频率时才能换算成至数，而这个换算并不必要 —— 心率本来就直接计数。静息心率六十余次是常见的。持续偏慢而节律正常，在训练有素的运动员身上常见，同时也是甲状腺功能减退已被记载的一种表现，而那是一项血液检查。「性质」那一半 —— 松弛、弛缓、不迫 —— 是触觉判断，与本批其他脉象一样，受制于前面记下的低一致率。 专属于这一条的一句提醒：既然缓可以指平脉，那么记下它本身并不是一个发现，也不该被读成「别处那个测出来的异常已经被解释过了」—— 例如心率偏慢伴头晕或伴晕厥，那仍然是一个要做心电图的节律。