同一中空，而虚实分焉。虚而空者为芤，实而空者为革。悟透实与虚，旁通芤与革。
芤字训慈葱，中央总是空。
医家持拟脉，血脱满江红。
（戴同父曰∶“营行脉中，脉与血为形。芤脉中空，血脱之象也。”）
革脉惟旁实，形同按鼓皮。
劳伤神恍惚，梦破五更遗。
（按∶革主亡精，芤主亡血。《脉经》言均为失血之候，混淆莫别。不过革亦有亡血者。）
松紧聚散，物理之常。散即松之极者也，紧即聚之极者也。紧如转索，散似飞花。紧散相反，形容如生。
紧脉弹人手，形如转索然。
热为寒所束，温散药居先。
（诸紧为寒为痛。人迎紧甚，伤于寒；气口紧甚，伤于食。腹痛尺紧，中恶浮紧，咳嗽沉紧，皆主死症。
按浮紧宜散，沉紧宜温。）
散脉最难医，本离少所根据。
往来至无定，一片杨花飞。
（柳氏云∶“无统纪，无拘束，至数不齐，或来多去少，或去多来少，涣散不收。）
浮之轻者为濡，平沙面雨霏千点，沉之重者为牢，锦匣里绵裹一针。
濡脉按须轻，萍浮水面生。
平人多损寿，莫作病患评。
（《脉经》曰∶濡脉极软而浮，如帛在水中，轻手乃得，按之无有。”按濡主血虚之病，又主伤湿，平人不
宜见此脉。濒湖曰∶“平人若见似无根。”）
牢脉实而坚，常居沉伏边。
疝 犹可治，失血命难延。
（《脉经》曰∶“似沉似伏，实大弦长。”仲景曰∶“寒则牢坚，有牢固之象。”按牢长属肝，疝 肝病，
实病见实脉，可治。扁鹊曰∶“失血脉，脉宜沉细，反浮大而牢者，死。”虚病见实脉也。）
同样是中间空虚的脉象，但虚证和实证的区分就在这里。虚证而中空的是芤脉（Kou Mai, 芤脉），实证而中空的是革脉（Ge Mai, 革脉）。透彻领悟了实与虚的区别，就能旁通芤脉与革脉的差异。
“芤”字解释为慈葱（一种大葱），中间总是空的。
医生诊察这种脉象时，若见血脱（Blood loss）则面色满江红。
（戴同父说：“营气运行于脉管之中，脉与血构成形体。芤脉中空，是血脱的象征。”）
革脉只有旁边坚实，形状如同按压鼓皮。
劳损内伤导致精神恍惚，五更时分梦遗精泄。
（按语：革脉主要主亡精，芤脉主要主亡血。《脉经》说两者都是失血的征候，容易混淆难以辨别。不过革脉也有出现于亡血情况下的。）
松与紧、聚与散，是物理变化的常态。散就是松到了极点，紧就是聚到了极点。紧脉像转动的绳索，散脉像飞舞的花朵。紧与散相反，形容得生动逼真。
紧脉弹指的感觉，形状如同转动的绳索。
热邪被寒邪束缚，治疗应以温散药物为先。
（各种紧脉多主寒证或痛证。人迎脉紧甚，是伤于寒；气口脉紧甚，是伤于食。腹痛且尺脉紧，中恶且脉浮紧，咳嗽且脉沉紧，都主死症。
按语：浮紧宜用发散法，沉紧宜用温法。）
散脉最难医治，因为根本缺乏少阴之气的依托。
脉搏往来至数不定，像一片杨花飞舞。
（柳氏说：“没有统纪，没有拘束，至数不齐，有时来多去少，有时去多来少，涣散不收摄。”）
轻取时浮在表面的是濡脉（Ru Mai, 濡脉），如同平沙面上细雨千点；重取时深伏于里的是牢脉（Lao Mai, 牢脉），如同锦匣里包裹着一根针。
濡脉按压时必须轻柔，像浮萍生长在水面上。
健康人出现此脉会损伤寿命，不要当作病患的脉象来评价。
（《脉经》说：“濡脉极软而浮，像帛在水中，轻手才能触及，按之无有。”按语：濡脉主血虚病，又主伤湿，健康人不应该见到这种脉。李时珍（濒湖）说：“健康人如果见到类似无根的脉象。”）
牢脉坚实有力，常位于沉伏的部位。
疝气还可以治疗，失血则生命难保。
（《脉经》说：“似沉似伏，实大弦长。”张仲景说：“寒则牢坚，有牢固之象。”按语：牢长属肝，疝气是肝病，实证见到实脉，可以治疗。扁鹊说：“失血脉，脉象宜沉细，反而浮大而牢的，主死。”这是虚证见到实脉的表现。）
Translation of the original text into modern Chinese, then into academic English based on WHO standards.
Same central emptiness, yet deficiency and excess are distinguished. Deficient and empty is Kou Mai (Kou Pulse, Scallion-like pulse); Excess and empty is Ge Mai (Ge Pulse, Drum-skin pulse). Comprehend thoroughly the reality of excess and deficiency, and you will understand the distinction between Kou and Ge pulses.
The character "Kou" is defined as a scallion (Cibotium barometz or similar hollow vegetable), with the center always empty.
When physicians palpate this pulse, [if associated with] Blood loss (Xue Tuo), the face may appear flushed red.
(Dai Tongfu stated: "Ying Qi circulates within the vessels; the vessel and blood constitute the form. The central emptiness of the Kou pulse is a sign of Blood loss.")
The Ge pulse is firm only on the sides, resembling the skin of a drum when pressed.
Due to exhaustion and injury, the spirit becomes inattentive; at dawn, seminal emission occurs from broken dreams.
(Note: Ge pulse primarily indicates loss of Essence (Jing), while Kou pulse primarily indicates loss of Blood. The *Mai Jing* states both are signs of blood loss, leading to confusion. However, Ge pulse can also occur in cases of blood loss.)
Looseness and tension, gathering and scattering, are normal physical changes. Scattering is the extreme of looseness; tension is the extreme of gathering. Tension resembles a twisting rope; scattering resembles flying flowers. Tension and scattering are opposites, described vividly.
The Tension pulse (Jin Mai) feels elastic under the finger, shaped like a twisting rope.
When Heat is constrained by Cold, warming and dispersing herbs should be prioritized.
(All Tension pulses indicate Cold or Pain. If the Renying pulse is excessively tense, it indicates Cold injury; if the Qikou pulse is excessively tense, it indicates Food stagnation. Abdominal pain with Tension at the Chi position, sudden evil attack with superficial Tension, coughing with deep Tension—all indicate fatal conditions.
Note: Superficial Tension requires dispersing methods; Deep Tension requires warming methods.)
The Scattering pulse (San Mai) is the most difficult to treat, as it lacks the foundation of Shaoyin Qi.
The arrival and departure of the pulse are irregular, like flying catkins.
(Liu said: "Without order, without constraint, the rate is uneven; sometimes more arrives than departs, sometimes more departs than arrives, scattered and unrestrained.")
Superficial and light upon palpation is Ru Mai (Ru Pulse, Soft/Deficient pulse), like rain falling on flat sand; Deep and heavy upon palpation is Lao Mai (Lao Pulse, Firm/Deep pulse), like a needle wrapped in silk inside a brocade box.
The Ru pulse must be palpated lightly, appearing like duckweed floating on water.
In healthy individuals, its presence damages longevity; do not evaluate it as a pathological pulse for patients.
(The *Mai Jing* states: "The Ru pulse is extremely soft and superficial, like silk floating in water; it is felt only with light pressure and disappears upon pressing." Note: Ru pulse indicates Blood deficiency diseases and Dampness injury; it should not be seen in healthy people. Li Shizhen (Binhu) said: "If a healthy person presents a pulse resembling one without root...")
The Lao pulse is solid and firm, usually located at the deep and hidden positions.
Hernia (Shan Qi) is still treatable; [if associated with] Blood loss, life cannot be prolonged.
(The *Mai Jing* states: "Resembling deep and hidden, solid, large, wiry, and long." Zhang Zhongjing said: "Cold makes it firm and hard, having the image of solidity." Note: Long Lao pulse belongs to the Liver; Hernia is a Liver disease. An excess condition presenting an excess pulse is treatable. Bian Que said: "For Blood loss, the pulse should be deep and fine; if it is instead superficial, large, and Lao, it indicates death." This is an excess pulse appearing in a deficiency condition.)