大浮数动滑阳脉。阴病见阳生可得。沉涩弦微弱属阴。阳病见阴终死厄。（仲景云。脉大浮数动滑。此名阳也。脉沉
涩若弦微。此名阴也。阴病见阳脉者生。阳病见阴脉者死。）阴阳交互最难明。轻重斟量当别白。（脉虽有阴阳。须看轻
重以分表里。在下文。）轻手脉浮为在表。表实浮而兼有力。但浮无力表中虚。自汗恶风常淅淅。（伤寒先要辨表里虚实。
此四者为急。仲景云。浮为在表。沉为在里。然表证有虚有实。浮而有力者表实也。无汗不恶风。浮而无力者。表虚也。
自汗恶风也。）重手脉沉为在里。里实脉沉来亦实。重手无力大而虚。此是里虚宜审的。（里证亦有虚实。脉沉而有力者。
里实也。故腹满。大便不通。沉而无力者。里虚也。或泄利或阴证之类。以上八句。辨表里虚实尽矣。）风则虚浮寒牢坚。
水停水 必沉潜。动则为痛数为热。支饮应须脉急弦。太过之脉为可怪。不及之脉亦如然。（仲景云。风则虚浮。寒则牢
坚。沉潜水 。支饮急弦。动则为痛数则热烦。太过可怪。不及亦然。邪不空见。中必有奸。）荣卫太盛名高章。高章相
搏名曰纲。荣卫微时名 （徒颊切。恐惧也。）卑 卑相搏损名彰。荣卫既和名缓迟。缓迟名沉此最良。九种脉中辨虚实。
长沙之诀妙难忘。（仲景云。寸口卫气盛名曰高。荣气盛名曰章。高章相搏。名曰纲。卫气弱名曰 。荣气弱名曰卑。
卑相搏。名曰损。卫气和名曰缓。荣气和名曰迟。缓迟相搏。名曰沉。大抵仲景脉法。论伤寒与杂病脉法异。故予尝撰
仲景三十六种脉法。）瞥瞥有如羹上肥。此脉定知阳气微。萦萦来如蛛丝细。却是体中阴气衰。脉如泻漆之绝者。病患亡
血更何疑。（仲景云。脉瞥瞥如羹上肥者。阳气微也。脉萦萦如蜘蛛丝者。阳气衰也。脉绵绵如泻漆之绝者。亡血也。阳
气衰。千金云。作阴气衰。）阳结蔼蔼如车盖。阴结循竿亦象之。（仲景云。蔼蔼如车盖者。阳结也。累累如循竿者。阴
结也。）阳盛则促来一止。阴盛则结缓而迟。（此谓促结二脉也。仲景云。脉来缓。时一止。名曰结。脉来数时一止。名
曰促脉阳盛则促。阴盛则结。）纵横逆顺宜审察。残贼灾怪要须知。（仲景云。脉有相乘。有纵有横。有逆有顺。何谓也。
曰水行乘火。金行乘木。名曰纵。火行乘水。木行乘金。名曰横。水行乘金。火行乘木。名曰逆。金行乘水。木行乘火。
名曰顺也。又曰。脉有残贼。何谓也。师曰。脉有弦、紧、浮、滑、沉、涩。此六者。名残贼。能为诸贼作病也。又问
曰。脉有灾怪。何谓也。答曰。旧时服药。今乃发作。故谓灾怪。）脉静人病内虚故。人安脉病曰行尸。（仲景云。脉病
人不病曰行尸。以无主气。故眩仆不知人。人病脉不病。名曰内虚。以无谷神。虽困无苦。）右手气口当主气。主血人迎
左其位。气口紧盛食必伤。人迎紧盛风邪炽。（左为人迎。右为气口。人迎紧盛。伤于风。气口紧盛。伤于食也。）数为
在腑迟为脏。浮为在表沉在里。（仲景云。浮为在表。沉为在里。数为在腑。迟为在脏。）脉浮而缓风伤荣。浮紧兼涩寒
伤卫。脉微大忌令人吐。欲下犹防虚且细。（仲景云。脉微不可吐。虚细不可下。）沉微气弱汗为难。三者要须常审记。（孙
用和云。阴虚。脉沉微而气弱者。不可汗。三者汗、下、吐三候。脉有不可行者。切当审也。）阳加于阴有汗证。左手沉
微却应未。（素问云。阳加于阴。谓之汗。）趺阳胃脉定死生。（仲景说趺阳脉者。凡十有一。）太溪肾脉为根蒂。（伤寒必
诊太溪趺阳者。谓以肾脉胃脉为主。仲景讥世人握手不及足者以此。）脉来六至或七至。邪气渐深须用意。浮大昼加并属
阳。沉细夜加分阴位。九至以上来短促。状若涌泉无入气。更加悬绝渐无根。命绝天真当死矣。（孙尚云。脉及七至六至
以上。浮大。昼加病。沉细夜加病。更及八至。精气消。神气乱。必有散脱精神之候。须切急为治疗。又加之九至十至。
虽和扁亦难救。如八至九至。加以悬绝。悬绝者无根也。如泉之通。脉无入气。天真尽而必死矣。）病患三部脉调匀。大
小浮沉迟数类。此是阴阳气已和。勿药自然应可喜。（仲景脉。寸口、关上、尺中三处。大小浮沉迟数同类。虽有寒热不
解。此脉已和。虽剧。当愈。）
大的、浮的、数的、动的、滑的脉象属于阳脉。阴病出现阳脉，说明生机可得。沉的、涩的、弦的、微的、弱的脉象属于阴脉。阳病出现阴脉，最终会有死亡的厄运。（张仲景说：脉象大、浮、数、动、滑，这叫做阳脉。脉象沉、涩、或弦、微，这叫做阴脉。阴病见到阳脉的，主生；阳病见到阴脉的，主死。）阴阳脉象交错在一起是最难辨明的，必须仔细权衡轻重以分辨清楚。（脉象虽有阴阳之分，但必须看其轻重的变化来区分表里，详见下文。）轻取（手指轻按）脉浮，表示病在表。表实证，脉浮而且兼有力量。只是脉浮而没有力量，是表虚证，患者常自汗出、怕风，身体感觉寒冷如被冷水洒湿一样。（伤寒首先要辨别表里虚实，这四点最为紧急。张仲景说：浮脉主表，沉脉主里。然而表证也有虚和实之分，脉浮而有力量的是表实证，无汗、不怕风；脉浮而无力量的，是表虚证，表现为自汗、怕风。）重取（手指重按）脉沉，表示病在里。里实证，脉沉而且来得也坚实有力。重按时感觉无力，且脉形大而空虚，这是里虚证，应当仔细审察。（里证也有虚实之分，脉沉而有力的是里实证，所以会出现腹部胀满、大便不通；脉沉而无力的，是里虚证，或者是泄泻、痢疾或阴证之类。以上八句，将表里虚实的辨证讲尽了。）风邪致病，脉象多虚浮；寒邪致病，脉象多牢坚。水饮停聚，脉象必沉潜。动脉主痛，数脉主热，支饮病应当见急弦之脉。太过盛的脉象令人惊怪，不及的脉象也是如此。（张仲景说：风邪致病脉虚浮，寒邪致病脉牢坚，水饮停聚脉沉潜，支饮脉急弦，动脉主痛，数脉主热烦，太过令人惊怪，不及也是如此。邪气不会凭空出现，体内必有奸邪潜伏。）营卫之气太盛叫做“高章”，高章相互搏结叫做“纲”。营卫之气微弱时叫做“卑”（徒颊切，恐惧之意），卑相互搏结损伤叫做“彰”（此处疑为“损”之误或通假，原文作彰，结合上下文及仲景原文应为“损”）。营卫既调和叫做“缓迟”，缓迟相合叫做“沉”，这是最好的脉象。在九种脉象中辨别虚实，长沙太守张仲景的秘诀美妙难忘。（张仲景说：寸口脉卫气盛叫做“高”，营气盛叫做“章”，高章相搏，叫做“纲”。卫气弱叫做“伡”（音伡，怯弱之意），营气弱叫做“卑”，伡卑相搏，叫做“损”。卫气和叫做“缓”，营气和叫做“迟”，缓迟相搏，叫做“沉”。大体上张仲景的脉法，论述伤寒与杂病的脉法不同，所以我曾撰写过张仲景三十六种脉法。）脉象瞥瞥（piē piē，轻浮貌）像羹汤上面的油脂，这种脉象一定知道是阳气微弱。脉象萦萦（yíng yíng，细弱貌）像蜘蛛丝那样细，却是体内阴气衰败。脉象像泻漆那样断绝（形容脉来急促而去势突然中断），病患亡血还有什么可怀疑的呢。（张仲景说：脉象瞥瞥像羹汤上面的油脂，是阳气微。脉象萦萦像蜘蛛丝，是阳气衰。脉象绵绵像泻漆之绝，是亡血。阳气衰，《千金方》说是阴气衰。）阳结脉蔼蔼（ǎi ǎi，盛大貌）像车盖，阴结脉累累（lěi lěi，连续貌）像顺着竹竿摸上去一样。（张仲景说：蔼蔼像车盖，是阳结。累累像循竿，是阴结。）阳盛则出现促脉，脉来一止；阴盛则出现结脉，脉来缓慢而迟。（这里说的是促脉和结脉。张仲景说：脉来缓慢，偶尔停止一次，叫做结脉。脉来快速，偶尔停止一次，叫做促脉。阳盛则促，阴盛则结。）纵横逆顺的脉象应当仔细审察，残贼、灾怪等异常脉象必须知晓。（张仲景说：脉有相乘，有纵有横，有逆有顺。为什么呢？回答说：水行乘火，金行乘木，叫做纵。火行乘水，木行乘金，叫做横。水行乘金，火行乘木，叫做逆。金行乘水，木行乘火，叫做顺。又说：脉有残贼，是什么呢？老师说：脉有弦、紧、浮、滑、沉、涩这六种，叫做残贼，它们能导致各种疾病产生。又问：脉有灾怪，是什么呢？回答说：以前服过的药，现在才发作，所以称为灾怪。）脉静而人病，是因为内部虚弱。人安而脉病，叫做行尸。（张仲景说：脉病人不病叫做行尸，因为没有主宰的气，所以会眩晕仆倒、不知人事。人病脉不病，叫做内虚，因为没有谷神（胃气），虽然困顿但没有痛苦。）右手气口脉主要主气，左手人迎脉主要主血。（注：此处原文逻辑似有误，通常左为人迎主血/外感，右为气口主气/内伤，或依具体流派而定，此处依原文翻译：左手为人迎，右手为气口。人迎脉紧盛，是风邪炽盛；气口脉紧盛，是饮食损伤。）脉数在腑，脉迟在脏。脉浮在表，脉沉在里。（张仲景说：浮脉在表，沉脉在里。数脉在腑，迟脉在脏。）脉浮而缓，是风邪伤及营气；脉浮紧兼涩，是寒邪伤及卫气。脉微大，切忌让人吐；想要用下法，还要防备脉虚且细。（张仲景说：脉微不可用吐法，脉虚细不可用下法。）脉沉微且气弱，发汗很难（成功），这三点（沉、微、气弱）必须经常审察牢记。（孙用和说：阴虚，脉沉微且气弱的，不可发汗。汗、下、吐三种治法，脉象有不可行的情况，务必审慎。）阳加于阴才有汗证。左手脉沉微，却应该还没有出汗。（《素问》说：阳加于阴，叫做汗。）趺阳脉（足背动脉）可以断定生死。（张仲景论述趺阳脉，共有十一条。）太溪脉（内踝后动脉）是肾脉的根本。（伤寒必须诊察太溪和趺阳脉，是以肾脉和胃脉为主。张仲景讥笑世人握手不及足，就是因为这个原因。）脉来一息六至或七至，说明邪气渐深，须用心诊治。脉浮大且在白天加重，并属于阳位；脉沉细且在夜间加重，分属阴位。九至以上的脉短促，状若涌泉，没有入气（指脉搏去势无根）。再加上悬绝（脉象极度不调）且逐渐无根，天命绝灭，天真之气耗尽，就会死亡。（孙尚说：脉达到七至、六至以上，脉浮大，白天加重病情；脉沉细，夜间加重病情。再达到八至，精气消耗，神气混乱，必有散脱精神的征兆，必须急切治疗。如果再加九至、十至，即使是扁鹊也难以救治。如果是八至、九至，加上悬绝。悬绝就是无根。像泉水通畅，脉无入气，天真之气耗尽必然死亡。）病患三部脉调匀，大小、浮沉、迟数类似，这是阴阳之气已经调和，不用药自然就会好转，值得欣喜。（张仲景的脉法：寸口、关上、尺中三处，大小、浮沉、迟数同类，虽然有寒热不解，但脉象已和，即使病重，也会痊愈。）
The pulse types of large (Da), floating (Fu), rapid (Shuo), moving (Dong), and slippery (Hua) belong to Yang pulses. When a Yin disease presents with a Yang pulse, vitality can be obtained. The pulse types of deep (Chen), choppy (Se), string-taut (Xian), thready (Wei), and weak (Ruo) belong to Yin pulses. When a Yang disease presents with a Yin pulse, death is the ultimate outcome. (Zhang Zhongjing stated: Pulses that are large, floating, rapid, moving, or slippery are named Yang. Pulses that are deep, choppy, string-taut, or thready are named Yin. If a Yin disease presents with a Yang pulse, it indicates life; if a Yang disease presents with a Yin pulse, it indicates death.) The interaction between Yin and Yang pulses is the most difficult to clarify; one must carefully weigh their severity to distinguish them clearly. (Although pulses have Yin and Yang distinctions, one must observe their depth and force to differentiate between exterior and interior, as detailed in the following text.) Light palpation revealing a floating pulse indicates the pathogen is in the Exterior. In an Exterior Excess pattern, the pulse is floating and accompanied by strength. If the pulse is merely floating without strength, it indicates an Exterior Deficiency pattern, characterized by spontaneous sweating, aversion to wind, and a sensation of coldness as if splashed by water. (In Shanghan [Cold Damage], distinguishing between Exterior/Interior and Excess/Deficiency is paramount. Zhang Zhongjing stated: Floating indicates the Exterior, Deep indicates the Interior. However, Exterior patterns have both Excess and Deficiency. A floating pulse with strength indicates Exterior Excess, with no sweating and no aversion to wind. A floating pulse without strength indicates Exterior Deficiency, with spontaneous sweating and aversion to wind.) Heavy palpation revealing a deep pulse indicates the pathogen is in the Interior. In an Interior Excess pattern, the deep pulse also feels solid and forceful. If heavy palpation reveals weakness, and the pulse form is large but empty, this is an Interior Deficiency pattern, which requires careful examination. (Interior patterns also have Excess and Deficiency. A deep pulse with strength indicates Interior Excess, leading to abdominal fullness and constipation. A deep pulse without strength indicates Interior Deficiency, such as diarrhea, dysentery, or Yin patterns. The above eight lines exhaustively discuss the differentiation of Exterior/Interior and Excess/Deficiency.) Wind pathogens cause pulses that are typically deficient and floating; Cold pathogens cause pulses that are firm and hard. Water retention causes pulses that are necessarily deep and sunken. The Moving pulse indicates pain; the Rapid pulse indicates heat; Branching Fluid Retention [Zhi Yin] should present with a rapid and taut pulse. Pulses that are excessive are startling, and those that are deficient are similarly so. (Zhang Zhongjing stated: Wind causes deficiency and floating; Cold causes firmness and hardness; water retention causes deep and sunken pulses; Branching Fluid Retention causes rapid and taut pulses; the Moving pulse indicates pain; the Rapid pulse indicates heat and restlessness. Excess is startling, and deficiency is similar. Pathogenic factors do not appear out of nowhere; there must be hidden pathology within.) When Ying [Nutrient] and Wei [Defensive] Qi are excessively strong, it is called "Gao Zhang" [High Chapter]. When Gao Zhang interact, it is called "Gang" [Cord]. When Ying and Wei Qi are weak, it is called "Bei" [Low/Humble] (pronounced 'tu jia', meaning fear). When Bei interacts with itself causing damage, it is called "Sun" [Damage] (Note: Text says 'Zhang', but context implies 'Sun' based on Zhang Zhongjing's original text). When Ying and Wei are harmonious, it is called "Huan Chi" [Slow and Delayed]. Huan Chi combined is called "Chen" [Deep/Sinking], which is the best state. Distinguishing Excess and Deficiency among the nine types of pulses, the secrets of Changsha [Zhang Zhongjing] are wonderful and unforgettable. (Zhang Zhongjing stated: Abundance of Wei Qi at the Cunkou [Radial artery] is named Gao; abundance of Ying Qi is named Zhang. Gao and Zhang interacting is named Gang. Weakness of Wei Qi is named Chu [Weak]; weakness of Ying Qi is named Bei. Chu and Bei interacting is named Sun. Harmony of Wei Qi is named Huan; harmony of Ying Qi is named Chi. Huan and Chi interacting is named Chen. Generally, Zhang Zhongjing's pulse methods for Shanghan differ from those for miscellaneous diseases, so I once compiled his thirty-six pulse methods.) A pulse that flickers like fat on soup surface indicates definitely that Yang Qi is weak. A pulse that winds like a spider's silk indicates that Yin Qi in the body is declining. A pulse like the sudden cessation of pouring lacquer indicates blood loss, leaving no room for doubt. (Zhang Zhongjing stated: A pulse flickering like fat on soup indicates weak Yang Qi. A pulse winding like a spider's silk indicates declining Yang Qi. A pulse continuous yet abrupt like pouring lacquer indicates blood loss. Note: *Qianjin Fang* states this indicates declining Yin Qi.) An Yang Knotting pulse resembles a chariot canopy [grand and expansive]; a Yin Knotting pulse resembles feeling along a bamboo pole [continuous and firm]. (Zhang Zhongjing stated: Grand like a chariot canopy is Yang Knotting. Continuous like feeling along a pole is Yin Knotting.) Yang Excess leads to the Cu [Surging] pulse, where the pulse stops occasionally. Yin Excess leads to the Jie [Knotted] pulse, which is slow and delayed. (This refers to the Cu and Jie pulses. Zhang Zhongjing stated: A pulse that is slow and occasionally stops is named Jie. A pulse that is rapid and occasionally stops is named Cu. Yang Excess causes Cu; Yin Excess causes Jie.) One should carefully examine the longitudinal, transverse, adverse, and smooth pulses, and must know about the殘賊 [Can Zei] [Residual Evils] and Zai Guai [Disaster/Monster] anomalies. (Zhang Zhongjing stated: Pulses have mutual overcoming, including Longitudinal, Transverse, Adverse, and Smooth. Why? Answer: Water overcoming Fire, Metal overcoming Wood is named Longitudinal. Fire overcoming Water, Wood overcoming Metal is named Transverse. Water overcoming Metal, Fire overcoming Wood is named Adverse. Metal overcoming Water, Wood overcoming Fire is named Smooth. Also: What are Residual Evils? Teacher said: String-taut, Tight, Floating, Slippery, Deep, Choppy—these six are named Residual Evils, capable of causing various diseases. Asked: What are Disaster/Monsters? Answer: Medicines taken previously only now manifest effects, hence called Disaster/Monster.) If the pulse is quiet but the person is ill, it is due to internal deficiency. If the person is well but the pulse is diseased, it is called "Walking Corpse". (Zhang Zhongjing stated: Diseased pulse but healthy person is called Walking Corpse, lacking ruling Qi, leading to dizziness, collapse, and unconsciousness. Healthy pulse but sick person is called Internal Deficiency, lacking Grain Spirit [Stomach Qi]; although distressed, there is no suffering.) The Right Hand Qikou [Radial] pulse primarily governs Qi; the Left Hand Renying [Radial] pulse primarily governs Blood. (Note: Text specifies Left as Renying, Right as Qikou. Renying tight and excess indicates fierce Wind Evil; Qikou tight and excess indicates Food Injury.) Rapid indicates Fu [Yang Organs]; Slow indicates Zang [Yin Organs]. Floating indicates Exterior; Deep indicates Interior. (Zhang Zhongjing stated: Floating indicates Exterior; Deep indicates Interior. Rapid indicates Fu; Slow indicates Zang.) Floating and Slow pulse indicates Wind injuring Ying Qi; Floating, Tight, and Choppy pulse indicates Cold injuring Wei Qi. A Micro and Large pulse strictly forbids emesis; if considering purgation, one must still guard against Deficiency and Thready/Small pulses. (Zhang Zhongjing stated: Micro pulse cannot be treated with emesis; Deficient and Thready pulses cannot be treated with purgation.) Deep, Micro, and Qi weakness make sweating difficult; these three signs must always be carefully remembered. (Sun Yonghe stated: For Yin Deficiency, if the pulse is Deep and Micro and Qi is weak, sweating is contraindicated. Among Sweating, Purgation, and Emesis therapies, there are pulse conditions where they cannot be performed; caution is essential.) Sweat occurs when Yang acts upon Yin. If the Left Hand pulse is Deep and Micro, sweat has likely not yet occurred. (*Suwen* states: Yang acting upon Yin is called Sweat.) The Fuyang [Dorsalis Pedis] pulse determines life and death. (Zhang Zhongjing discussed the Fuyang pulse in eleven instances.) The Taixi [Posterior Tibial] pulse is the root of the Kidney. (Shanghan requires examining Taixi and Fuyang pulses, prioritizing Kidney and Stomach pulses. Zhang Zhongjing criticized people who only check the hand and not the foot for this reason.) A pulse rate of six or seven beats per respiration indicates the pathogen is gradually deepening, requiring attentive treatment. Floating and Large pulses worsening during the day belong to Yang positions; Deep and Fine pulses worsening at night belong to Yin positions. Pulses exceeding nine beats are short and hurried, resembling a gushing spring without returning energy. If accompanied by Xuan Jue [Suspension and Severance] and gradual loss of root, the mandate of Heaven ends, True Nature is exhausted, and death ensues. (Sun Shang stated: Pulses reaching six or seven beats per respiration, if Floating and Large, worsen during the day; if Deep and Fine, worsen at night. Reaching eight beats consumes Essence-Qi and confuses Shen-Qi, indicating a risk of spirit scattering, requiring urgent treatment. Nine or ten beats are difficult even for Bian Que to save. Eight or nine beats with Xuan Jue [rootless] indicate no return of energy, exhaustion of True Nature, and inevitable death.] If the pulses in the Three Positions [Cun, Guan, Chi] of the patient are uniform, with similar characteristics in size, floating/deep, and slow/rapid, this indicates that Yin and Yang Qi are already harmonized. Without medication, recovery will naturally occur, which is a cause for joy. (Zhang Zhongjing's pulse method: If Cun, Guan, and Chi positions show similar characteristics in size, floating/deep, and slow/rapid, even if cold-heat symptoms persist, the pulse is harmonized. Even if severe, recovery will occur.)