浮之最着者为洪，水面上波翻浪涌；沉之至隐者为伏，石脚下迹遁踪潜。
洪脉胀兼呕，阴虚火上浮。
应时惟夏月，来盛去悠悠。
（经曰∶“诸腹胀大，皆属于热。”呕，初起为寒，郁则为热。经曰∶“诸逆上冲，皆属于火。”阴虚阳
盛，脉多洪。惟夏日应时。濒湖曰∶“拍拍而浮是洪脉。”《素问》曰∶“来盛去衰。”）
伏脉症宜分，伤寒酿汗深。
浮沉俱不得，着骨始能寻。
（伤寒一手伏，曰单伏；两手伏，曰双伏。乃火邪内郁，不得发越，阳极似阴，故脉伏；必大汗而解。又
有夹阴伤寒，先有伏阴在内，外复感寒，阴盛阳衰，四肢厥逆，六脉沉伏，须投姜、附，灸关元，脉乃出。
按二症极宜分。）
迟而一止为结，数而一止为促。迟为寒结，则寒之极矣；数为热促，则热之至矣。
结脉迟中止，阳微一片寒。
诸般阴积症，温补或平安。
（越人曰∶“结甚则积甚，结微则积微。浮结内有积病，沉结内有积聚。”）
促脉形同数，须从一止看。
阴衰阳独甚，泄热只宜寒。
（濒湖曰∶“三焦郁火炎炎盛，进必无生退有生。”按促只宜泄热除蒸，误用温补，立见危殆。）
动则独胜为阳，代则中止为阴。动代变迁，阴阳迭见。
动脉阴阳搏，专司痛与惊。
当关一豆转，尺寸不分明。
（《脉经》曰∶“动乃数脉见于关，上下、无头无尾，如豆大，厥厥动摇。”仲景曰∶“阴阳相搏名曰动。
阳动则汗出，阴动则发热。”濒湖曰∶“动脉专司痛与惊，汗因阳动热因阴。”）
浮脉中最显著的是洪脉，就像水面上波涛汹涌；沉脉中最隐蔽的是伏脉，就像在石头底下踪迹潜藏。
洪脉多见于腹胀兼呕吐的症状，这是阴虚导致火气上浮。
洪脉应合的季节只有夏季，其特点是来势盛大而去势悠长。
（《内经》说：“各种腹部胀大的病证，都归属于热邪。”呕吐，初起时属于寒邪，郁结久了则化为热邪。《内经》又说：“各种向上冲逆的症状，都归属于火邪。”阴虚而阳盛，脉象多表现为洪脉。只有在夏季才与时令相应。李时珍说：“脉搏跳动拍击有力且浮显是洪脉。”《素问》说：“来势盛大而去势衰弱。”）
伏脉的症状需要仔细分辨，伤寒病中发汗解表的过程较深。
无论浮取还是沉取都摸不到，必须重按至骨才能寻得。
（伤寒病中如果只有一只手的脉伏，称为单伏；两只手的脉都伏，称为双伏。这是由于火邪内郁，不能发散，阳气极盛而似阴，所以脉象伏匿；必须通过大汗才能解除。又有夹阴伤寒的情况，体内先有伏藏的阴寒，体外又感受寒邪，阴盛阳衰，四肢厥冷，六脉沉伏，必须投用干姜、附子，并灸关元穴，脉象才会出现。按这两种病症极需区分。）
迟脉中出现一次停顿为结脉，数脉中出现一次停顿为促脉。迟脉伴有停顿为寒结，说明寒邪已至极点；数脉伴有停顿为热促，说明热邪已至极点。
结脉在迟的基础上出现中止，是一派阳气微弱的寒象。
对于各种阴邪积聚的病症，采用温补法或许能平安无事。
（扁鹊说：“结脉严重则积聚严重，结脉轻微则积聚轻微。浮结脉提示体内有积病，沉结脉提示体内有积聚。”）
促脉的形态同于数脉，必须从其中止的特点来看。
这是阴气衰竭而阳气独盛，治疗泄热只宜用寒凉药。
（李时珍说：“三焦郁火炽盛，病情进展则无生机，退守则还有生机。”按：促脉只适宜泄热除蒸，误用温补，立刻会见危险。）
动脉表示阴阳偏胜属阳，代脉表示中止属阴。动与代的变迁，体现了阴阳交替显现。
动脉是阴阳相搏的结果，专门主管疼痛和惊悸。
脉搏在关部如豆粒般转动，寸部和尺部界限不分明。
（《脉经》说：“动脉是数脉出现在关部，上下没有头尾，像豆粒大小，剧烈动摇。”张仲景说：“阴阳相互搏结称为动。阳动则出汗，阴动则发热。”李时珍说：“动脉专门主管疼痛和惊悸，汗出因阳动，发热因阴动。”）
The most prominent of floating pulses is the Hong pulse, resembling waves surging on the water surface; the most concealed of sunken pulses is the Fu pulse, resembling traces hidden beneath stones.
Hong pulse is associated with abdominal distension and vomiting, caused by Yin deficiency leading to hyperactive fire floating upward.
It corresponds only to the summer season, characterized by a vigorous onset and a leisurely decline.
(The *Classic of Internal Medicine* states: "All cases of abdominal distension and enlargement belong to heat." Vomiting, in its initial stage, belongs to cold; if constrained for a long time, it transforms into heat. The *Classic* also states: "All symptoms of upward rushing belong to fire." When Yin is deficient and Yang is excessive, the pulse is often Hong. It corresponds to the seasonal timing only in summer. Li Shizhen said: "Beating forcefully and floating is the Hong pulse." The *Su Wen* says: "Vigorous arrival and weak departure.")
Symptoms of the Fu pulse require differentiation; in Cold Damage (Shanghan), the depth of inducing sweating is profound.
It cannot be felt at either superficial or deep levels; one must press to the bone to locate it.
(If the pulse is Fu in one hand during Cold Damage, it is called Single Fu; if in both hands, it is called Double Fu. This occurs when Fire pathogen is internally constrained and cannot vent out; extreme Yang resembles Yin, hence the Fu pulse; resolution requires profuse sweating. There is also Cold Damage with internal Yin constraint, where latent Yin cold exists internally while external cold is contracted; Yin is excessive and Yang is deficient, causing cold limbs and six pulses being sunken and Fu. One must administer Ginger (*Sheng Jiang*) and Aconite (*Fu Zi*), and moxa the Guanyuan point, for the pulse to emerge. These two conditions must be strictly distinguished.)
A Chi pulse with intermittent stops is the Jie pulse; a Shuo pulse with intermittent stops is the Cu pulse. Chi with stops indicates Cold constraint, meaning extreme cold; Shuo with stops indicates Heat urgency, meaning extreme heat.
Jie pulse stops amidst a slow rhythm, indicating a patch of Yang deficiency and cold.
For various Yin accumulation disorders, warming and tonification may bring peace.
(Bian Que said: "Severe Jie implies severe accumulation; slight Jie implies slight accumulation. Floating Jie indicates internal accumulation disease; Sunken Jie indicates internal mass formation.")
Cu pulse shape resembles the Shuo pulse; one must observe the intermittent stop.
Yin is depleted while Yang alone is excessive; clearing heat requires only cold-natured herbs.
(Li Shizhen said: "When Sanjiao constrained fire blazes intensely, progression leads to no survival, while regression allows survival." Note: Cu pulse is suitable only for clearing heat and removing steaming; misusing warming and tonifying methods will immediately lead to peril.)
Dong pulse indicates exclusive Yang excess; Dai pulse indicates interruption and is Yin. The transition between Dong and Dai shows alternating manifestations of Yin and Yang.
Dong pulse results from the struggle of Yin and Yang, specifically governing pain and fright.
At the Guan position, it turns like a bean; the Cun and Chi positions are indistinct.
(The *Mai Jing* states: "Dong is a Shuo pulse appearing at the Guan position, without head or tail above or below, large as a bean, trembling violently." Zhang Zhongjing said: "Yin and Yang struggling together is named Dong. Yang Dong causes sweating; Yin Dong causes fever." Li Shizhen said: "Dong pulse specifically governs pain and fright; sweating arises from Yang Dong, fever from Yin Dong.")