问曰。脉有阴阳者。何谓也。答曰。凡脉大浮。数动滑。此名阳也。脉沉涩。弱弦微此名阴也。凡阴病见阳脉者生。
阳病见阴脉者死。
按弦为少阳脉。此以弦为阴脉者。兼见沉涩微弱而言阴病。见阳脉者生阳气内复阴邪外出欲汗而解也。如厥阴中风
脉。浮为欲愈。不浮为未愈是也。阳病见阴脉者死。外显阳证。内伏阴邪。正衰邪胜也。如谵言妄语。脉沉细者。死是
也。○又按微为厥阴脉而传经热邪。亦尺寸俱微岂热邪至极而脉反微耶。殊不知伤寒之邪传至厥阴。正气虽已大伤而邪
气亦以向衰所以不数实而反微也。
问曰脉有阳结阴结者。何以别之。答曰。其脉浮而数能食。不大便者。此为实。名曰阳结也。期十七日当剧。其脉
沉而迟不能食身体重大便反硬名曰阴结也。期十四日当剧。
浮数阳脉也。阳病不大便。当不能食。今反能食。是阳气结而阴不得和也。至十七日传少阴水。水不胜火。故当剧
沉迟阴脉也。阴病当下利。今反大便硬是阴气结而阳不得和也。至十四日传阳明土。土不胜水故当剧。
问曰。病有洒淅恶寒。而后发热者何答曰。阴脉不足阳往从之。阳脉不足阴往乘之。曰。何谓阳不足。答曰。假令
寸口脉微。名曰阳不足。阴气上入阳中则洒淅恶寒也。曰何谓阴不足。答曰假令尺脉弱名曰阴不足。阳气下陷入阴中则
发热也。
洒淅恶寒。而复发热脉寸微尺弱者。阳虚阴往从之也。少顷发热。则脉必数盛矣。此胜复之常内伤虚损多此。
阳脉浮阴脉弱者。则血虚。血虚则筋急也。
言寸口浮大。而尺内迟弱也。与太阳中风阳浮阴弱同脉异证。彼言风邪伤卫营弱卫强。此言营血本虚。故其证自区。
别然尺中迟弱者。汗下俱禁究竟本虚也。
其脉沉者营气微也。其脉浮而汗出。如流珠者。卫气衰也。脉霭霭如车盖者。名曰阳结也。脉累累如循长竿者。名
曰阴结也。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。亡其血也。
阳结霭霭如车盖。形容浮大而虚。阴结累累如循长竿体。贴指下弦而强直。阳微瞥瞥如羹上肥仿佛虚濡无力。阳衰
萦萦如蜘蛛丝。譬拟沉细欲绝。亡血绵绵如泻漆之绝描写前大后细之状。皆历历如绘。○此阳结。阴结。是言脉法与前
论病证不同不可牵合。
脉来缓时一止。复来者。名曰结脉来数时一止复来者。名曰促脉。阳盛则促阴盛则结此皆病脉。脉按之来缓而时一
止复来者。名曰结。又脉来动而中止更来小数中有还者反动名曰结阴也。脉来动而中止不能自还。因而复动名曰。代阴
也。得此脉者。必难治。
结促是有留滞于中。故脉见止歇力能自还。代脉是阳气衰微不能自还杂病见之必死惟伤寒。有心悸脉代者。寒饮停
蓄故也。
问曰。翕奄沉名曰。滑何谓也。师曰。沉为纯阴翕为正阳。阴阳和合。故令脉滑关尺自平。阳明脉微沉。食饮自可。
少阴脉微滑。滑者紧之。浮名也。沉为阴实其人必股内汗出阴下湿也。
翕浮也。奄忽也。言忽焉而浮忽。焉。而沉故为滑也。滑本阳实阴部见阳。脉为阳邪乘阴故股内汗出。
阴阳相搏名曰。动阳动则汗出。阴动则发热。形冷恶寒者。此三焦伤也。若数脉见于关上。上下无头。尾如豆大厥
厥动摇者。名曰动也。
按脉之动者。皆缘阴阳不和。故不能贯通。三部而虚者。受邪则动所以动于寸口为阳动。阳动则汗出。动于尺内为
阴动。阴动则发热。如不汗出。发热而反形冷恶寒。此三焦真火受伤也。盖动脉虽多见于关上。然尺寸亦常见之。本文
又言若数脉见于关上。若字甚活。是举一隅为例耳。今世以尺寸之动。强饰为滑。殊不知动脉是阴阳相搏虚者。则动。
故单见一部滑脉是邪实有余多兼见。二三部或两手俱滑。以此辨之。则动滑之虚实判然矣。
阳脉浮大而濡。阴脉浮大而濡。阴脉与阳脉同等者。名曰缓也。
脉虽浮大。而软按之。仍不绝者。为缓若。按之即无是虚脉非缓脉也。
脉浮而紧者。名曰。弦也。弦者状如弓弦按之不移也。脉紧者如转索无常也。
浮紧而弦者。少阳脉也。若沉紧而弦。即是里寒阴脉矣。
脉浮而数浮。为风数为虚风为热虚为寒风。虚相搏则洒淅恶寒也。
脉浮而数为虚。风发热之候证虽发热而本属虚寒是以仍洒淅。恶寒故言数为虚。虚为寒明所以当用温顺。散邪不可
竟行表散也。
脉浮而滑浮。为阳滑为实。阳实相搏其脉数疾。卫气失度。浮滑之脉。数疾发热。汗出不解者。此为难治。
浮滑为表实当汗出。而解今汗出不解。皆缘卫气热极较常度行之过疾。所以脉反数疾。不解况既汗出伤阴。则营亦
受病是知邪已入腑。表里俱热故难治也。
脉浮而迟面热赤而战惕者。六七日当汗出而解反发热者。瘥迟迟为无阳不能作汗。其身必痒也。
脉浮而迟。为营气不能外行。于卫分卫中。阳虚不能作汗。而瘥迟致汗。湿留于肌表而身痒作疮也。
师持脉病患欠者。无病也脉之呻者病也。言迟者风也。摇头言者。里痛也。行迟者表强也。坐而伏者。短气也坐而
下一脚者。腰痛也里实护腹如怀卵物者心痛也。
师曰呼吸者。脉之头也初持脉来疾去迟。此出疾入迟名曰。内虚外实也。初持脉来迟去疾此出迟入疾名曰。内实外
虚也。
初持脉来疾去迟言自尺内至于寸口。为心肺盛而肝肾虚。此出疾入迟言自筋骨出于皮肤以脉盛于表故曰。内虚外实
初持脉来迟去疾言自寸口下于尺内为心肺虚而肝肾旺此出迟入疾言自皮肤入于筋骨。以脉盛于内。故曰内实外虚。
假令脉来微去大病在里也。脉来头小本大病在表也。上微头小者。则汗出。下微本大者则为关格不通不得尿头无汗
者可治有汗者死。
脉来微去。大者言浮取则微沉取则大为病在里也。脉来头小本大者。言脉初来小取之渐渐大为病在表也上微头小者。
言浮取之微而前小后大为表气不固而自汗也。下微本大者。言沉取之微而按久益大为里邪拒 而关格不通头无汗者。乃
邪入膀胱阳气未脱犹可治也。盖伤寒暴病。非杂证津液久虚之比。
假令下利寸口关上尺中悉不见脉。然尺中时一小见脉再举头者。肾气也。若见损脉来至为难治。
三部俱伏而尺中时见小滑。一二至。此为阴中伏阳也。若寸口略见短小。一二至。尺中绝不至者。为损脉见之必难
治也。
问曰曾为人所难紧脉从何而来师曰假令亡汗。若吐以肺里寒故令脉紧也。假令咳者坐饮冷水。故令脉紧也。假令下
利以胃中虚冷故令脉紧也。
紧脉皆为寒。寒邪在表则浮紧在里则沉紧。此言吐下后。脉紧为肺胃受伤若更兼咳及利又为水饮。内伏之候当以辛
温散水为务也。
寸口脉浮为在表。沉为在里数为在腑迟为在脏假令脉迟此为在脏也。
此以浮沉迟数定表里脏腑而全重于迟为在脏句故重申以明之设脉见浮迟虽有表证只宜小建中和之终非麻黄青龙。所
宜以脏气本虚故也。○凡言寸口统三部而言。针经以寸口人迎分别脏腑也。
问曰。何以知乘腑何以知乘脏师曰。诸阳浮数为乘腑诸阴迟涩为乘脏也。
寸口脉弱而迟弱者卫气微迟者营中寒营为血。血寒则发热。卫为气气微者心内饥饥而虚满不能食也。
寸口脉弱为真阳气。微则肾中阴火挟痰饮而聚于膈上。故心悬悬。若饥状。而虚痛不能食也。至于寸口迟为营中。
寒营为血之本。血寒而反发热其义何居。盖寸口脉迟其阳必陷于阴分尺中紧盛更小待言所以为发热也。
寸口脉弱而缓弱者阳气不足。缓者胃气有余噫而吞酸食。卒不下气填于膈上也。
噫而吞酸是胃中虚火挟痰饮上逆非坠痰降逆之药不足以镇之此言暴病与老人之胃虚痰逆噫气不同。
寸口脉微而涩微者。卫气不行。涩者营气不足营卫不能相将。三焦无所仰身体痹不仁营气不足。则烦疼口难言。卫
气虚则恶寒数欠。三焦不归其部。上焦不归者噫。而酢吞中焦不归者。不能消谷引食下焦不归者。则遗溺。（酢醋同）
三焦因营卫不行。无所根据仰故气不归其部。上焦不归则物不能传化。故噫而酢吞。中焦不归则不能腐熟水谷下焦不
归。则不能约制溲便也。
寸口脉微而涩微者。卫气衰涩者。营气不足卫气衰面色黄营气不足面色青营为根卫为叶营卫俱微则根叶枯槁而寒栗
咳逆。唾腥吐涎沫也。
咳逆而唾腥吐。涎沫阴虚火炎可知也。加以寒栗则卫虚不能外护。又可知矣以脉见寸口故其证悉在上部耳。
少阴脉弱而涩弱者。微烦涩者厥逆。
气虚则脉弱而烦血虚则脉涩而厥。
趺阳脉浮而涩。少阴脉如经也。其病在脾。法当下利何以知之。若脉浮大者气实血虚也。今趺阳脉浮。而涩故知脾
气不足胃气虚也。以少阴脉弦。而浮才见此为调脉故称如经也。若反滑而数者。故知当屎脓也。
趺阳脉浮涩为脾胃不足。故当下利此易明也。至少阴脉弦而浮。称为调和。如经之脉。此必有说焉盖伤寒热。传少
阴仍得弦浮阳脉为轻若见沉。迟则为少阴。病脉矣。夫所谓弦者。少阳生发之气也。浮者太阳表证之脉也。虽证见少阴。
而少阴病脉不见不失经常之度。故为调脉若见滑数。则为邪热内盛。必挟热便脓血也。○凡言趺阳皆当推之气口。少阴
皆当验于尺。部若必候。诸于足在妇人殊为未倾谓手不及足之讥所不辞也。
趺阳脉迟。而缓胃气如经也。趺阳脉浮。而数浮则伤胃。数则动脾。此非本病医。误下之所为也。营卫内陷其数先
微。脉反但浮其人。必大便硬气噫而除何以言之。本以数脉。动脾其数。先微故知脾气不治。大便硬气。噫而除今脉反
浮其数改微邪气独留心中。则饥邪热不杀谷潮。热发渴数。脉当迟缓。脉因前后度数如法病者则饥数脉不时而生恶疮也。
趺阳胃脉以迟缓。为经当不当浮数。若见浮数知医误下而伤胃动脾也。营卫环转之气。以误下而内陷其数脉必先改
为微而脾气不治。大便硬气噫而除此皆邪客于脾所致邪热独留心下。虽饥复不杀谷。抑或潮热发渴未有愈期必数脉之先
微者仍迟缓如其经常始饥而消谷也。若数脉从前不改。则邪热未陷。于脾但郁于营卫。主生恶疮而已。
诸脉浮数当发热而洒淅恶寒。若有痛处。饮食如常者。蓄积有脓也。
脉浮数而恶寒。知表邪不散。而为热。今饮食如常为里邪已。去若有 肿为热壅经络。若无肿处必邪留脏腑随内外
而发痈脓也。
脉浮而大浮。为风虚大为气强。风气相搏。必成瘾疹身体为痒。痒者名泄。风久久为痂癞。
脉浮大为邪气在表。表邪本当即解。今相持不散必是汗出。泄风之故当发瘾疹身痒而生疮疥也。
趺阳脉浮而芤浮者。卫气衰芤者。营气伤其身体瘦肌肉甲错浮芤相搏。宗气衰微四属断绝。
身体瘦削宗气衰微胃气虚寒。不能荣养。四末可知。加以肌肉结硬皮肤皴驳。故为甲错。必内有蓄积将发痈脓之兆
也。
趺阳脉滑而紧。滑者胃气实紧者。脾气强。持实击强痛还自伤以手把刃坐作疮也。
此言胃受有形而实脾为热盛而强。脏腑相并。为患而痛。故言以实击强。治当量其虚实虚则消导实则攻下可也。
趺阴脉大而紧者当即下利为难治。
趺阳脉紧为寒邪伤胃故必下利下利脉大为利盛故难治也。
趺阳脉沉而数沉为实数消谷紧者。病难治。
沉数者。热伏于内。故易已沉紧。为寒伏于内。故难治也。
趺阳脉微而紧。紧则为寒。微则为虚微紧相搏。则为短气。
胃中虚寒。则阳气郁伏。不伸故短气。
趺阳脉紧。而浮。浮为虚紧为寒浮。为腹满紧为绞痛浮紧相搏肠鸣而转。转则气动膈气乃下。少阴脉下出其阴肿。
大而虚也。
膈中之水气因火击动。所以肠鸣转而下泄。则脾胃虚寒。可知若少阴。脉不至则下焦虚寒。不能营运水气必致留结
阴。分而为阴肿虚大也。
趺阳脉浮。浮则为虚浮虚相搏。故令气KT 言胃气虚竭也。脉滑则为哕。此为医咎。责虚取实守空。迫血脉浮鼻中
燥者。必衄也。
脉滑为哕者。胃虚不能散水。水结中焦。逼虚火上逆故为哕也。脉浮必衄者。浮为表邪。不散邪郁上焦必迫血上行
而为衄也。胃气素虚之人。误施辛温发。散则虚阳将欲外亡。所以脉浮鼻燥。皆缘责虚取实之故也。此与误发少阴汗者。
同科而减等。少阴少血动其血。则下厥上竭而难治。阳明多血但 患未已耳。
寸口脉浮大而医反下之。此为大逆浮。则无血大则为寒。寒气相搏。则为肠鸣。医乃不知而反。饮冷水令大汗出。
水得寒气冷。必相拣其人则KT 。
寸口脉浮为表邪。而反下之为逆矣。以其人阳气下陷故不为痞结而但肠鸣即当将差就错内和其气而反与之水寒。其
胃致水气相搏且夹带浊饮上乾清气故令KT 也。○胡其章曰大则为寒。寒字当作邪字看。
寸口脉微而缓微者。卫气疏疏则其肤空缓者。胃气实。实则谷消而水化也。谷入于胃脉道乃行水入于经其血乃成营
盛则其肤必疏三焦绝经名曰血崩。
此言卫虚营盛气衰血热三焦之火失其常度并热于守经之血而妄行故为崩下不止耳。
问：脉象有阴、阳之分，这是什么意思？
答：凡是脉象大、浮、数、动、滑的，都称为阳脉。凡是脉象沉、涩、弱、弦、微的，都称为阴脉。凡是阴证见到阳脉的，主生；阳证见到阴脉的，主死。
按：弦脉本属少阳（足少阳胆经）之脉，这里将其归为阴脉，是因为兼见沉、涩、微弱等脉象而言，这是指阴病。见到阳脉者生，是因为阳气内复，阴邪外出，想要通过出汗而解。例如厥阴（足厥阴肝经）中风，脉象浮是快要痊愈的表现，不浮则是未愈。阳证见到阴脉者死，是因为外显阳证，内伏阴邪，正气衰败而邪气亢盛。例如胡言乱语、神志不清，脉象沉细的，主死。
又按：微脉本是厥阴之脉，如果是传经的热邪，为什么寸关尺三部脉都微呢？难道不是热邪至极反而脉微吗？殊不知伤寒之邪传入厥阴时，正气虽然已经大伤，但邪气也已经趋向衰退，所以脉不数实反而微。
问：脉象有阳结和阴结，如何区别它们？
答：如果脉象浮而数，能进食，大便不通的，这是实证，称为阳结。预计在第十七日病情会加重。如果脉象沉而迟，不能进食，身体沉重，大便反而干硬的，称为阴结。预计在第十四日病情会加重。
浮数是阳脉。阳病大便不通，应当不能进食，现在反而能进食，这是阳气结滞而阴气不能调和。到了第十七日，病传至少阴（足少阴肾经），水不胜火，所以病情会加重。
沉迟是阴脉。阴病应当下利，现在反而大便干硬，这是阴气结滞而阳气不能调和。到了第十四日，病传至阳明（足阳明胃经），土不胜水，所以病情会加重。
问：有的病人先恶寒战栗，而后发热，这是什么原因？
答：阴脉不足，阳气就会往从它；阳脉不足，阴气就会去乘袭它。什么叫阳不足？回答说：假如寸口脉微，叫做阳不足。阴气上入阳分，就会恶寒战栗。什么叫阴不足？回答说：假如尺脉弱，叫做阴不足。阳气下陷入阴中，就会发热。
恶寒战栗而又发热，脉象寸部微、尺部弱的，是阳虚导致阴气往从。过了一会儿发热，脉象必然变得数而盛大。这是胜复（阴阳相互胜负）的正常现象，内伤虚损多属于这种情况。
阳脉浮、阴脉弱的，则是血虚。血虚则筋脉拘急。
这里说的是寸口脉浮大，而尺部迟弱。这与太阳中风（太阳经受风邪所致的病证）“阳浮阴弱”的脉象相同，但证候不同。前者是说风邪伤卫，营弱卫强；这里是说营血本虚，所以证候自然有别。然而尺中迟弱的，汗法和下法都禁忌，因为本质是虚。
脉象沉的，是营气微弱。脉象浮而且汗出如流珠状的，是卫气衰败。脉象蔼蔼然像车盖一样的，称为阳结。脉象累累然像摸长竿一样的，称为阴结。脉象瞥瞥然像羹汤上面的浮油一样的，是阳气微弱。脉象萦萦然像蜘蛛丝一样的，是阳气衰败。脉象绵绵然像泻漆断绝时的样子（前大后细），是亡血。
阳结“蔼蔼如车盖”，形容脉浮大而虚；阴结“累累如循长竿”，形容脉体贴指下，弦而强直。阳微“瞥瞥如羹上肥”，仿佛虚濡无力；阳衰“萦萦如蜘蛛丝”，比喻脉沉细欲绝；亡血“绵绵如泻漆之绝”，描写脉前大后细的形状。这些都描绘得历历在目。○这里的阳结、阴结，是指脉法，与前文论述的病证不同，不可牵强附会。
脉来迟缓，偶尔停止，过后又来的，称为结脉。脉来快速，偶尔停止，过后又来的，称为促脉。阳盛则促，阴盛则结，这都是病脉。脉按之来缓，偶尔停止，过后又来的，称为结脉。另外，脉来跳动中途停止，再次来时稍快，中间有回还之象，再次跳动的，称为结阴脉。脉来跳动中途停止，不能自行恢复，因而再次跳动的，称为代阴脉。得到这种脉象的，一定难治。
结脉、促脉是有留滞在中间，所以脉见止歇，但力量还能自行恢复。代脉是阳气衰微，不能自行恢复。杂病见到代脉必死，只有伤寒病中有因心悸出现代脉的，是因为寒饮停蓄的缘故。
问：脉象忽浮忽沉称为滑脉，这是什么意思？
老师说：沉代表纯阴，翕（合聚之意）代表正阳。阴阳和合，所以使脉象滑利。关部和尺部脉象自平。阳明（足阳明胃经）脉微沉，饮食正常。少阴（足少阴肾经）脉微滑。滑脉是紧脉的浮象。沉为阴实，其人大腿内侧必定出汗，阴部潮湿。
翕是浮的意思，奄是忽然的意思。说忽然而浮，忽然而沉，所以称为滑脉。滑本属阳实，在阴部见到阳脉，是阳邪乘袭阴分，所以大腿内侧出汗。
阴阳相搏称为动。阳动则汗出，阴动则发热。形体寒冷、恶寒的，这是三焦受伤。如果数脉出现在关上，上下没有头尾，像豆子一样大小，厥厥动摇的，称为动脉。
按：脉象的动，都是因为阴阳不和，所以不能贯通三部。三部皆虚者，受邪则动。所以在寸口出现的是阳动，阳动则汗出；在尺部出现的是阴动，阴动则发热。如果不汗出、发热反而形体寒冷、恶寒的，这是三焦真火受伤。动脉虽多见于关上，但寸、尺也常见。本文又说“若数脉见于关上”，“若”字很灵活，是举一例为例罢了。现今世人将寸、尺的动脉强行解释为滑脉，却不知道动脉是阴阳相搏，虚者则动。所以单见一部脉滑是邪实有余，多兼见二、三部或两手俱滑。以此辨别，则动、滑脉的虚实就判然不同了。
阳脉浮大而濡，阴脉浮大而濡，阴脉与阳脉同等程度的，称为缓脉。
脉虽然浮大，但软，按之仍然不绝的，是缓脉。如果按之即无，是虚脉，不是缓脉。
脉浮而紧的，称为弦脉。弦脉的样子像弓弦，按之不移。脉紧的像转索一样无常。
浮紧而弦的，是少阳脉。如果沉紧而弦，就是里寒阴脉了。
脉浮而数，浮为风，数为虚。风为热，虚为寒。风寒虚相搏，就会恶寒战栗。
脉浮而数为虚风、发热之候。证候虽然发热，但本质属虚寒，所以仍然恶寒战栗。所以说数为虚，虚为寒。明此道理，所以当用温顺散邪之法，不可竟行表散。
脉浮而滑，浮为阳，滑为实。阳实相搏，其脉数疾，卫气失去常度。浮滑之脉，数疾、发热、汗出不解的，这为难治。
浮滑为表实，应当汗出而解。现在汗出不解，都是因为卫气热极，较常度行之过疾，所以脉反数疾不解。况且既已汗出伤阴，则营气也受病，可知邪已入腑，表里俱热，所以难治。
脉浮而迟，面热赤而颤抖恐惧的，六七日应当汗出而解，反而发热的，病愈迟缓。迟为无阳，不能作汗，其身必定发痒。
脉浮而迟，是营气不能外行于卫分，卫中阳虚不能作汗，病愈迟缓，湿留于肌表而身痒作疮。
老师切脉，病人打哈欠的，是无病。脉象呻吟的，是有病。说话迟缓的，是有风。摇头说话的，是里有痛。行走迟缓的，是表强。坐而俯身的，是短气。坐而伸下一脚的，是腰痛。里实护腹像怀着卵物的，是心痛。
老师说：呼吸是脉象的开端。初持脉，来疾去迟，这叫出疾入迟，称为内虚外实。初持脉，来迟去疾，这叫出迟入疾，称为内实外虚。
初持脉来疾去迟，意思是自尺内至于寸口，心肺盛而肝肾虚。这叫出疾入迟，意思是自筋骨出于皮肤，以脉盛于表，所以说内虚外实。
初持脉来迟去疾，意思是自寸口下于尺内，心肺虚而肝肾旺。这叫出迟入疾，意思是自皮肤入于筋骨，以脉盛于内，所以说内实外虚。
假如脉来微而去大，大病在里。脉来头小本大，大病在表。上部微头小，则汗出；下部微本大，则为关格不通，不得小便。头无汗者可治，有汗者死。
脉来微去大，意思是浮取则微，沉取则大，为病在里。脉来头小本大，意思是脉初来小，取之渐渐大，为病在表。上部微头小，意思是浮取之微而前小后大，为表气不固而自汗。下部微本大，意思是沉取之微而按久益大，为里邪拒而关格不通。头无汗者，乃邪入膀胱，阳气未脱，犹可治。大概伤寒暴病，不同于杂证津液久虚的情况。
假如下利，寸口、关上、尺中都不见脉，然而尺中时常稍微见到一两次脉，再举头（重按）才见的，是肾气尚存。如果见到损脉，脉来至数减少，为难治。
三部脉俱伏，而尺中时见小滑一二至，此为阴中伏阳。如果寸口略见短小一二至，尺中绝不至，为损脉，见到必难治。
问：曾经被人诘难，紧脉从何而来？
老师说：假如亡汗，或者呕吐，因为肺里有寒，所以令脉紧。假如咳嗽，因为坐饮冷水，所以令脉紧。假如下利，因为胃中虚冷，所以令脉紧。
紧脉皆为寒。寒邪在表则浮紧，在里则沉紧。这里说吐下后，脉紧为肺胃受伤，如果更兼咳嗽及下利，又是水饮内伏的征候，当以辛温散水为务。
寸口脉浮为在表，沉为在里，数为在腑，迟为在脏。假如脉迟，这是在脏。
这里以浮沉迟数定表里脏腑，而全重于“迟为在脏”一句，所以重申以明之。设脉见浮迟，虽有表证，只宜小建中和之，终非麻黄青龙所宜，以脏气本虚故也。○凡言寸口，统括三部而言。《针经》以寸口、人迎分别脏腑。
问：如何知道病在腑？如何知道病在脏？
老师说：诸阳浮数为乘腑，诸阴迟涩为乘脏。
寸口脉弱而迟，弱者为卫气微，迟者为营中寒。营为血，血寒则发热。卫为气，气微者心内饥，饥而虚满，不能食。
寸口脉弱为真阳气微，则肾中阴火挟痰饮而聚于膈上，故心悬悬若饥状，而虚痛不能食。至于寸口迟为营中寒，营为血之本，血寒而反发热，其义何在？盖寸口脉迟，其阳必陷于阴分，尺中紧盛更待言，所以为发热。
寸口脉弱而缓，弱者为阳气不足，缓者为胃气有余，噫气而吞酸，食物卒不下，气填于膈上。
噫气而吞酸是胃中虚火挟痰饮上逆，非坠痰降逆之药不足以镇之。此言暴病与老人之胃虚痰逆噫气不同。
寸口脉微而涩，微者是卫气不行，涩者是营气不足。营卫不能相将，三焦无所仰，身体痹不仁。营气不足，则烦疼，口难言。卫气虚则恶寒数欠。三焦不归其部：上焦不归者，噫而酢吞；中焦不归者，不能消谷引食；下焦不归者，则遗溺。（酢同醋）
三焦因营卫不行，无所根据仰，故气不归其部。上焦不归则物不能传化，故噫而酢吞；中焦不归则不能腐熟水谷；下焦不归则不能约制溲便。
寸口脉微而涩，微者是卫气衰，涩者是营气不足。卫气衰面色黄，营气不足面色青。营为根，卫为叶，营卫俱微则根叶枯槁，而寒栗咳逆，唾腥吐涎沫。
咳逆而唾腥吐涎沫，阴虚火炎可知也。加以寒栗则卫虚不能外护，又可知矣。以脉见寸口，故其证悉在上部耳。
少阴脉弱而涩，弱者微烦，涩者厥逆。
气虚则脉弱而烦，血虚则脉涩而厥。
趺阳脉浮而涩，少阴脉如经也。其病在脾，法当下利。何以知之？若脉浮大者，气实血虚也。今趺阳脉浮而涩，故知脾气不足，胃气虚也。以少阴脉弦而浮，才见此为调脉，故称如经也。若反滑而数者，故知当屎脓也。
趺阳脉浮涩为脾胃不足，故当下利，此易明也。至少阴脉弦而浮，称为调和如经之脉，此必有说焉。盖伤寒热传少阴，仍得弦浮阳脉为轻，若见沉迟则为少阴病脉矣。夫所谓弦者，少阳生发之气也。浮者太阳表证之脉也。虽证见少阴，而少阴病脉不见，不失经常之度，故为调脉。若见滑数，则为邪热内盛，必挟热便脓血。○凡言趺阳皆当推之气口，少阴皆当验于尺部。若必候诸于足，在妇人殊为未倾，谓手不及足之讥所不辞也。
趺阳脉迟而缓，胃气如经也。趺阳脉浮而数，浮则伤胃，数则动脾。此非本病，医误下之所为也。营卫内陷，其数先微，脉反但浮，其人必大便硬，气噫而除。何以言之？本以数脉动脾，其数先微，故知脾气不治，大便硬，气噫而除。今脉反浮，其数改微，邪气独留心中，则饥，邪热不杀谷，潮热发渴，数脉当迟缓。脉因前后度数如法，病者则饥。数脉不时而生，恶疮也。
趺阳胃脉以迟缓为经，不当浮数。若见浮数，知医误下而伤胃动脾也。营卫环转之气，以误下而内陷，其数脉必先改为微，而脾气不治，大便硬，气噫而除。此皆邪客于脾所致，邪热独留心下，虽饥复不杀谷，抑或潮热发渴，未有愈期。必数脉之先微者仍迟缓，如其经常，始饥而消谷也。若数脉从前不改，则邪热未陷于脾，但郁于营卫，主生恶疮而已。
诸脉浮数，当发热而洒淅恶寒。若有痛处，饮食如常者，蓄积有脓也。
脉浮数而恶寒，知表邪不散而为热。今饮食如常为里邪已去。若有肿，为热壅经络；若无肿处，必邪留脏腑，随内外而发痈脓也。
脉浮而大，浮为风，虚大为气强。风气相搏，必成瘾疹，身体为痒。痒者名泄风，久久为痂癞。
脉浮大为邪气在表，表邪本当即解。今相持不散，必是汗出泄风之故，当发瘾疹、身痒而生疮疥也。
趺阳脉浮而芤，浮者为卫气衰，芤者为营气伤。其身体瘦，肌肉甲错。浮芤相搏，宗气衰微，四属断绝。
身体瘦削，宗气衰微，胃气虚寒，不能荣养四末可知。加以肌肉结硬，皮肤皴驳，故为甲错。必内有蓄积，将发痈脓之兆也。
趺阳脉滑而紧，滑者为胃气实，紧者为脾气强。持实击强，痛还自伤，以手把刃，坐作疮也。
此言胃受有形而实，脾为热盛而强，脏腑相并为患而痛，故言以实击强。治当量其虚实，虚则消导，实则攻下可也。
趺阴脉大而紧者，当即下利，为难治。
趺阳脉紧为寒邪伤胃，故必下利。下利脉大为利盛，故难治也。
趺阳脉沉而数，沉为实，数消谷。紧者，病难治。
沉数者，热伏于内，故易已。沉紧为寒伏于内，故难治也。
趺阳脉微而紧，紧则为寒，微则为虚。微紧相搏，则为短气。
胃中虚寒，则阳气郁伏不伸，故短气。
趺阳脉紧而浮，浮为虚，紧为寒。浮为腹满，紧为绞痛。浮紧相搏，肠鸣而转，转则气动膈，气乃下。少阴脉下出，其阴肿大而虚也。
膈中之水气因火击动，所以肠鸣转而下泄，则脾胃虚寒可知。若少阴脉不至，则下焦虚寒，不能营运水气，必致留结阴分，而为阴肿虚大也。
趺阳脉浮，浮则为虚。浮虚相搏，故令气KT（气逆）。言胃气虚竭也。脉滑则为哕，此为医咎，责虚取实，守空迫血。脉浮鼻中燥者，必衄也。
脉滑为哕者，胃虚不能散水，水结中焦，逼虚火上逆，故为哕也。脉浮必衄者，浮为表邪不散，邪郁上焦，必迫血上行而为衄也。胃气素虚之人，误施辛温发散，则虚阳将欲外亡，所以脉浮鼻燥，皆缘责虚取实之故也。此与误发少阴汗者，同科而减等。少阴少血，动其血则下厥上竭而难治。阳明多血，但患未已耳。
寸口脉浮大而医反下之，此为大逆。浮则无血，大则为寒。寒气相搏，则为肠鸣。医乃不知而反饮冷水，令大汗出。水得寒气，冷必相拣，其人则KT。
寸口脉浮为表邪，而反下之为逆矣。以其人阳气下陷，故不为痞结而但肠鸣。即当将差就错，内和其气，而反与之水寒其胃，致水气相搏，且夹带浊饮上乾清气，故令KT也。○胡其章曰：大则为寒，寒字当作邪字看。
寸口脉微而缓，微者卫气疏，疏则其肤空。缓者胃气实，实则谷消而水化也。谷入于胃，脉道乃行。水入于经，其血乃成。营盛则其肤必疏，三焦绝经，名曰血崩。
此言卫虚营盛，气衰血热，三焦之火失其常度，并热于守经之血而妄行，故为崩下不止耳。
Question: What is meant by the division of pulse into Yin and Yang?
Answer: Pulses that are large (Da), floating (Fu), rapid (Shu), moving (Dong), or slippery (Hua) are named Yang pulses. Pulses that are deep (Chen), choppy (Se), weak (Ruo), wiry (Xian), or fine/micro (Wei) are named Yin pulses. In a Yin syndrome, if a Yang pulse is seen, there is hope for survival; in a Yang syndrome, if a Yin pulse is seen, death ensues.
Note: The wiry (Xian) pulse originally belongs to Shaoyang (Foot-Shaoyang Gallbladder Meridian). Here it is classified as a Yin pulse because it appears combined with deep, choppy, weak, and micro characteristics, indicating a Yin disease. Seeing a Yang pulse indicates recovery because Yang Qi returns internally and Yin pathogenic factors exit externally, leading to resolution through sweating. For example, in Jueyin (Foot-Jueyin Liver Meridian) wind-strike, a floating pulse indicates impending recovery, while a non-floating pulse indicates no recovery. A Yang syndrome presenting with a Yin pulse signifies death due to external manifestation of Yang symptoms but internal entrapment of Yin pathogens, where healthy Qi is depleted and pathogenic factors prevail. For instance, delirious speech accompanied by a deep and fine pulse indicates death.
Furthermore, the micro (Wei) pulse is characteristic of Jueyin. If heat transmitted from meridions causes all three positions (Cun, Guan, Chi) to appear micro, does this not imply extreme heat resulting in a micro pulse? Actually, when Cold Damage pathogens reach Jueyin, although Healthy Qi is severely damaged, the Pathogenic Qi is also waning. Thus, the pulse is not rapid and full but rather micro.
Question: How can one distinguish between Yang Knotting (Yang Jie) and Yin Knotting (Yin Jie) in pulses?
Answer: If the pulse is floating and rapid, the patient can eat, but suffers from constipation, this is an Excess pattern, named Yang Knotting. It is expected that the condition will worsen on the seventeenth day. If the pulse is deep and slow, the patient cannot eat, feels heavy in the body, yet suffers from dry stool, this is named Yin Knotting. It is expected that the condition will worsen on the fourteenth day.
Floating and rapid are Yang pulses. In Yang diseases with constipation, loss of appetite is typical. The fact that the patient can eat indicates Yang Qi knotting while Yin Qi fails to harmonize. By the seventeenth day, the disease transmits to Shaoyin (Foot-Shaoyin Kidney Meridian); since Water cannot overcome Fire, the condition worsens.
Deep and slow are Yin pulses. In Yin diseases, diarrhea is typical. The fact that the stool is dry indicates Yin Qi knotting while Yang Qi fails to harmonize. By the fourteenth day, the disease transmits to Yangming (Foot-Yangming Stomach Meridian); since Earth cannot overcome Water, the condition worsens.
Question: Some patients experience chills followed by fever. What is the cause?
Answer: When Yin pulse is insufficient, Yang Qi follows it; when Yang pulse is insufficient, Yin Qi attacks it. What is meant by Yang insufficiency? If the Cun position pulse is micro, it is called Yang insufficiency. Yin Qi ascending into the Yang region causes chills. What is meant by Yin insufficiency? If the Chi position pulse is weak, it is called Yin insufficiency. Yang Qi sinking into the Yin region causes fever.
Chills followed by fever, with a micro Cun pulse and weak Chi pulse, indicate Yang deficiency allowing Yin to follow. Shortly after, fever arises, and the pulse becomes rapid and vigorous. This is the normal cycle of victory and defeat (Sheng Fu), common in internal injury and deficiency.
A floating Yang pulse and weak Yin pulse indicate Blood deficiency, which leads to tendon tension.
This refers to a floating and large Cun pulse but a slow and weak Chi pulse. Although the pulse pattern is similar to Taiyang Wind Strike (Taiyang Bing - Taiyang Meridian Syndrome) characterized by "floating Yang and weak Yin," the pathology differs. Taiyang Wind Strike involves Wind damaging Wei (Defensive) Qi, leading to weak Ying (Nutritive) and strong Wei. Here, the root is inherent Ying-Blood deficiency, hence the distinct clinical presentation. However, a slow and weak Chi pulse contraindicates both sweating and purging methods due to underlying deficiency.
A deep pulse indicates微弱 Ying Qi. A floating pulse with sweat resembling flowing pearls indicates decline of Wei Qi. A pulse appearing vast like a chariot canopy is named Yang Knotting. A pulse appearing continuous like feeling a long bamboo pole is named Yin Knotting. A pulse flickering like fat floating on soup indicates微弱 Yang Qi. A pulse winding like a spider's thread indicates declining Yang Qi. A pulse continuous like pouring lacquer stopping abruptly indicates loss of Blood.
Yang Knotting ("vast like a chariot canopy") describes a floating, large, and empty pulse. Yin Knotting ("continuous like a long pole") describes a pulse that is wiry, strong, and straight against the finger. Yang微弱 ("flickering like fat on soup") implies emptiness and weakness. Yang decline ("winding like a spider thread") metaphorically describes a deep, fine, nearly imperceptible pulse. Blood loss ("continuous like pouring lacquer stopping") describes a pulse that is large initially and thin at the end. These descriptions are vivid. Note that these definitions of Yang and Yin Knotting refer specifically to pulse methodology and differ from previous discussions on disease patterns; they should not be conflated.
A pulse that is slow and occasionally stops before resuming is named Knotted Pulse (Jie Mai). A pulse that is rapid and occasionally stops before resuming is named Urgent Pulse (Cu Mai). Yang excess leads to Urgent Pulse; Yin excess leads to Knotted Pulse. Both are pathological pulses. Specifically, a slow pulse with occasional pauses is Knotted Pulse. Additionally, if a pulse beats, stops, resumes slightly faster, and shows a return beat, it is Knotted Yin Pulse. If a pulse beats, stops, cannot resume spontaneously, and only resumes after force, it is Substitute Yin Pulse (Dai Mai). Obtaining such a pulse indicates difficult treatment.
Knotted and Urgent pulses involve stagnation; thus, the pause is temporary, and force can resume. Substitute Pulse indicates severe Yang Qi depletion unable to resume spontaneously. In miscellaneous diseases, seeing a Substitute Pulse implies death. However, in Cold Damage, palpitations with a Substitute Pulse occur due to cold-fluid retention.
Question: What is meant by "Xi Yan Chen" being named Slippery Pulse (Hua Mai)?
The Master said: Deep represents pure Yin; Xi (gathering/combining) represents correct Yang. When Yin and Yang harmonize, the pulse becomes slippery. The Guan and Chi positions remain balanced. Yangming pulse is slightly deep, and digestion is normal. Shaoyin pulse is slightly slippery. Slippery here refers to the floating aspect of a tight pulse. Deep indicates Yin Excess; the patient will have sweating in the inner thighs and dampness in the genital area.
Xi means floating; Yan means suddenly. Suddenly floating and suddenly deep constitutes a slippery pulse. Slippery is inherently Yang Excess. Seeing Yang pulse in the Yin region indicates Yang pathogen attacking Yin, causing thigh sweating.
When Yin and Yang contend, it is called Moving Pulse (Dong Mai). Yang movement causes sweating; Yin movement causes fever. Cold form and aversion to cold indicate Sanjiao injury. If a rapid pulse appears at the Guan position without head or tail, bean-sized and trembling, it is named Moving Pulse.
Note: Moving pulses arise from disharmony of Yin and Yang, preventing smooth flow through the three positions. Deficiency in the three positions makes one susceptible to pathogens, causing movement. Movement at Cun is Yang Movement, causing sweating. Movement at Chi is Yin Movement, causing fever. If there is no sweating or fever, but instead cold form and aversion to cold, it indicates injury to the True Fire of the Sanjiao. Although Moving Pulse is common at Guan, it also appears at Cun and Chi. The text mentions "if rapid pulse appears at Guan," implying this is just one example. Modern practitioners mistakenly interpret Cun/Chi moving pulses as slippery. However, Moving Pulse results from Yin-Yang contention in deficiency states. Single-position slippery pulse indicates Excess pathogen; multiple positions or bilateral slippery pulses indicate different conditions. This distinguishes the Excess/Deficiency nature of Moving vs. Slippery pulses.
If Yang pulse is floating, large, and soft, and Yin pulse is floating, large, and soft, and both are equal, it is named Slow/Relaxed Pulse (Huan Mai).
Although floating and large, if soft and unbroken upon pressure, it is Huan Pulse. If it disappears upon pressure, it is Empty Pulse, not Huan Pulse.
Floating and tight pulse is named Wiry Pulse (Xian Mai). Wiry pulse resembles a bowstring, firm upon pressure. Tight pulse resembles a turning rope, variable.
Floating, tight, and wiry is Shaoyang pulse. Deep, tight, and wiry is Interior Cold Yin pulse.
Floating and rapid: Floating indicates Wind, Rapid indicates Deficiency. Wind generates Heat, Deficiency generates Cold. Contention of Wind, Cold, and Deficiency causes chills.
Floating and rapid indicates Deficient Wind and Fever signs. Although fever is present, the root is Deficient Cold, hence chills persist. Thus, "rapid" implies Deficiency, and "deficiency" implies Cold. Treatment should use warm, gentle dispersal, not harsh exterior-releasing methods.
Floating and slippery: Floating is Yang, Slippery is Excess. Yang-Excess contention causes rapid and frantic pulse, disrupting Wei Qi regulation. Floating-slippery pulse with rapid/frantic rhythm, fever, and unremitting sweating is difficult to treat.
Floating-slippery indicates Exterior Excess, usually resolving with sweat. Unremitting sweat occurs because Wei Qi heat is extreme, moving too fast, causing rapid/frantic pulse. Sweating damages Yin, affecting Ying Qi. Pathogen has entered the Fu organs, causing Interior-Exterior Heat, making it difficult to treat.
Floating and slow pulse with facial redness, heat, and trembling indicates that by day 6-7, sweat should resolve the condition. Persistent fever delays recovery. Slow indicates lack of Yang to produce sweat, leading to itching.
Floating and slow pulse indicates Ying Qi failing to move outward to Wei. Yang deficiency in Wei prevents sweating. Delayed recovery allows dampness to remain on the skin surface, causing itching and sores.
When the Master takes the pulse, yawning indicates health. Moaning during pulse-taking indicates illness. Sluggish speech indicates Wind. Shaking head while speaking indicates interior pain. Slow walking indicates Exterior stiffness. Sitting bent over indicates shortness of breath. Sitting with one leg extended indicates lower back pain. Protecting the abdomen as if holding an egg indicates Heart pain.
The Master said: Respiration is the beginning of the pulse. Initially, if the pulse comes fast and goes slow (Out-fast, In-slow), it is Interior Deficiency and Exterior Excess. If it comes slow and goes fast (Out-slow, In-fast), it is Interior Excess and Exterior Deficiency.
Coming fast and going slow means from Chi to Cun, Heart/Lung are excess while Liver/Kidney are deficient. Out-fast, In-slow means moving from sinews/bones to skin, with pulse strength on the exterior, hence Interior Deficiency, Exterior Excess.
Coming slow and going fast means from Cun down to Chi, Heart/Lung are deficient while Liver/Kidney are robust. Out-slow, In-fast means moving from skin to sinews/bones, with pulse strength internally, hence Interior Excess, Exterior Deficiency.
If pulse comes micro and goes large, major disease is in the Interior. If pulse starts small and ends large, major disease is in the Exterior. Upper micro/small head indicates sweating. Lower micro/large root indicates Guan-Ge obstruction, inability to urinate. Head without sweat is treatable; head with sweat is fatal.
Pulse coming micro and going large means superficial touch is micro, deep touch is large, indicating Interior disease. Pulse starting small and ending large means initial touch is small, increasing upon pressure, indicating Exterior disease. Upper micro/small head means superficial touch is micro, front small back large, indicating insecure Exterior Qi and spontaneous sweating. Lower micro/large root means deep touch is micro, increasing with prolonged pressure, indicating Interior pathogen rejection and Guan-GE obstruction. Head without sweat means pathogen enters Bladder, Yang Qi not exhausted, still treatable. Acute Cold Damage differs from chronic miscellaneous diseases with fluid depletion.
In case of diarrhea, if Cun, Guan, and Chi pulses are absent, but Chi occasionally shows a small slip once or twice upon lifting, this is remaining Kidney Qi. If a Damaged Pulse (Sun Mai) appears with reduced frequency, it is difficult to treat.
Three positions submerged, but Chi occasionally shows small slip 1-2 beats, indicates Hidden Yang within Yin. If Cun shows slight shortness 1-2 beats, and Chi is absent, this is Damaged Pulse, indicating difficult treatment.
Question: Where does the Tight Pulse (Jin Mai) come from?
Master said: If there is profuse sweating or vomiting due to Cold in Lung, the pulse becomes tight. If coughing due to drinking cold water, the pulse becomes tight. If diarrhea due to Cold deficiency in Stomach, the pulse becomes tight.
Tight pulse always indicates Cold. Exterior Cold yields Floating-Tight; Interior Cold yields Deep-Tight. Here, post-vomiting/purging tight pulse indicates Lung/Stomach injury. Combined with cough/diarrhea, it indicates internal water-fluid retention. Treatment requires acrid-warm herbs to disperse water.
Cun pulse floating indicates Exterior; deep indicates Interior; rapid indicates Fu organ; slow indicates Zang organ. Slow pulse indicates Zang involvement.
Here, Exterior/Interior and Fu/Zang are determined by floating/deep and rapid/slow, emphasizing "slow indicates Zang." Even with floating-slow pulse and Exterior signs, Xiao Jian Zhong Tang is indicated, not Ma Huang Tang or Qing Long Tang, due to inherent Zang deficiency. Note: "Cun" generally refers to all three positions. *Zhen Jing* distinguishes Zang/Fu using Cun and Ren Ying.
Question: How to know if pathogen invades Fu or Zang?
Master said: All Yang pulses (floating/rapid) indicate invasion of Fu; all Yin pulses (slow/choppy) indicate invasion of Zang.
Cun pulse weak and slow: Weak indicates微弱 Wei Qi; slow indicates Cold in Ying. Ying is Blood; Blood Cold causes fever. Wei is Qi;微弱 Wei Qi causes hunger sensation, false fullness, and anorexia.
Weak Cun pulse indicates微弱 True Yang Qi, allowing Kidney Yin Fire to carry phlegm-fluid to Diaphragm, causing heart hunger sensation and false pain/anorexia. Slow Cun pulse indicates Cold in Ying (root of Blood). Why does Blood Cold cause fever? Because Yang sinks into Yin, and Chi pulse is tight/full, causing fever.
Cun pulse weak and slow/relaxed: Weak indicates Yang Qi deficiency; relaxed indicates Stomach Qi excess. Belching and acid regurgitation occur, food doesn't descend, Qi fills Diaphragm.
Belching and acid regurgitation result from Stomach Deficient Fire carrying phlegm-fluid upward. Heavy sedatives are needed. This differs from elderly Stomach deficiency or acute illness belching.
Cun pulse micro and choppy: Micro indicates Wei Qi stagnation; choppy indicates Ying Qi deficiency. Ying-Wei fail to support each other; Sanjiao lacks reliance. Body numbness and bi-syndrome occur. Ying deficiency causes irritability, pain, difficulty speaking. Wei deficiency causes aversion to cold and frequent yawning. Sanjiao fails to govern its regions: Upper failure causes belching/acid; Middle failure causes inability to digest food; Lower failure causes urinary incontinence.
Sanjiao relies on Ying-Wei. Without them, Qi fails to govern regions. Upper failure impedes transformation; Middle failure impedes rotting/ripening; Lower failure impedes controlling urine/feces.
Cun pulse micro and choppy: Micro indicates Wei Qi decline (yellow complexion); choppy indicates Ying Qi deficiency (green complexion). Ying is root, Wei is leaf. Both deficient means root and leaf wither, causing chills, cough, reverse qi, bloody sputum, and saliva foam.
Bloody sputum and foam indicate Yin deficiency with Fire flaming up. Chills indicate Wei deficiency failing to protect exterior. Since pulse is at Cun, symptoms manifest in upper body.
Shaoyin pulse weak and choppy: Weak indicates slight irritability; choppy indicates cold extremities.
Qi deficiency causes weak pulse and irritability; Blood deficiency causes choppy pulse and cold extremities.
Fuyang pulse floating and choppy; Shaoyin pulse is normal. Disease is in Spleen, typically causing diarrhea. Why? If pulse were floating-large, it would be Qi Excess/Blood Deficiency. Now Fuyang is floating-choppy, indicating Spleen Qi deficiency and Stomach Qi weakness. Shaoyin is wiry-floating, considered harmonious/normal. If it were slippery-rapid, pus in stool would be expected.
Fuyang floating-choppy indicates Spleen-Stomach deficiency causing diarrhea. Shaoyin wiry-floating is considered harmonious. Wiry represents Shaoyang generating Qi; floating represents Taiyang Exterior syndrome. Although Shaoyin symptoms appear, absence of typical Shaoyin pulse (deep-slow) maintains normalcy. Slippery-rapid indicates Internal Heat Excess, likely causing bloody pus stool. Note: Fuyang corresponds to Qikou (Radial artery); Shaoyin corresponds to Chi position. Examining feet is less practical for women.
Fuyang pulse slow and relaxed indicates normal Stomach Qi. Fuyang pulse floating and rapid: Floating injures Stomach; Rapid agitates Spleen. This is iatrogenic error from inappropriate purging. Ying-Wei sink inward. Rapid pulse first becomes微弱, then pulse becomes merely floating. Patient develops hard stool, belching, and relief. Why? Originally, rapid pulse agitated Spleen. As rapid pulse微弱s, Spleen function fails, causing hard stool and belching. Now pulse floats, rapid微弱s, leaving pathogenic heat in Heart. Hunger persists, but heat fails to digest food, causing tidal fever and thirst. Pulse should return to slow/relaxed. If pulse norms are restored, hunger resolves. If rapid pulse persists, heat remains in Ying-Wei, causing sores.
Fuyang pulse normally slow-relaxed. Floating-rapid indicates iatrogenic injury. Purging caused Ying-Wei sinking. Rapid pulse微弱s, Spleen fails, hard stool/belching occur. Heat lingers in Heart, causing hunger without digestion, tidal fever, thirst. Recovery requires pulse returning to normal. If rapid pulse persists, heat stays in Ying-Wei, causing sores.
All floating-rapid pulses usually accompany fever and chills. If there is painful area but normal diet, it indicates abscess formation.
Floating-rapid with chills indicates unresolved Exterior Heat. Normal diet means Interior is clear. Swelling indicates Heat blocking collaterals; no swelling suggests pathogen in Zang-Fu, developing abscess internally or externally.
Floating and large pulse: Floating indicates Wind, Large indicates Qi Excess. Wind-Qi contention causes nettle rash and itching. Chronic itching leads to scabs and leprosy-like conditions.
Floating-large indicates Exterior pathogen. Should resolve, but persistence suggests sweating leaking Wind, causing rashes, itching, and sores.
Fuyang pulse floating and knotted (Kou): Floating indicates Wei Qi decline; Kou indicates Ying Qi injury. Emaciation and rough skin (armor-like scaling) occur. Floating-Kou contention leads to Zong Qi decline and severance of Four Extremities.
Emaciation and Zong Qi decline indicate Stomach Cold failing to nourish extremities. Rough skin indicates internal accumulation and impending abscess.
Fuyang pulse slippery and tight: Slippery indicates Stomach Excess; Tight indicates Spleen Strength. Clashing Excess against Strength harms oneself, like handling blades. Treatment depends on Excess/Deficiency: tonify/guide for Deficiency, purge for Excess.
Fuyin pulse large and tight indicates immediate diarrhea, difficult to treat.
Fuyang tight indicates Cold injuring Stomach, causing diarrhea. Large pulse during diarrhea indicates excessive loss, hence difficult.
Fuyang pulse deep and rapid: Deep indicates Excess; Rapid indicates digestion. Tight indicates difficult treatment.
Deep-rapid indicates hidden Heat, easier to treat. Deep-tight indicates hidden Cold, harder to treat.
Fuyang pulse微弱 and tight: Tight is Cold;微弱 is Deficiency. Contention causes shortness of breath.
Stomach Cold-Deficiency traps Yang Qi, causing shortness of breath.
Fuyang pulse tight and floating: Floating is Deficiency; Tight is Cold. Floating causes abdominal fullness; Tight causes colic. Contention causes bowel sounds and gas movement. Gas moves Diaphragm downward. Shaoyin pulse reveals lower Jiao Cold-Damp causing genital swelling.
Diaphragmatic fluid moved by Fire causes bowel sounds and diarrhea, indicating Spleen-Stomach Cold. Absent Shaoyin pulse indicates Lower Jiao Cold failing to circulate fluid, causing genital swelling.
Fuyang pulse floating indicates Deficiency. Floating-Deficiency contention causes Qi rebellion (stomach Qi exhaustion). Slippery pulse indicates hiccups (iatrogenic error from treating Deficiency as Excess). Floating pulse with dry nose indicates epistaxis.
Slippery hiccups result from Stomach deficiency failing to disperse fluid, causing middle Jiao fluid knotting forcing Deficient Fire upward. Floating epistaxis results from Exterior pathogen stagnating in Upper Jiao forcing blood upward. Mistakenly using acrid-warm diaphoretics in deficient patients risks Yang collapse, causing floating pulse and dry nose. This parallels misusing sweating on Shaoyin (causing Upper Exhaustion/Lower Reversal), but Yangming has more Blood, so prognosis is slightly better.
Cun pulse floating-large treated with purgation is major error. Floating indicates Blood deficiency; Large indicates Cold. Cold contention causes bowel sounds. Doctor mistakes this for Heat, gives cold water, inducing sweat. Cold water meets Cold pathogen, causing Qi rebellion.
Cun floating indicates Exterior pathogen; purgation is error. Yang Qi sinks, causing bowel sounds instead of palpable mass. Instead of harmonizing, giving cold water clashes with Stomach Cold, causing fluid-pathogen contention and turbid fluids harassing Clear Qi, leading to Qi rebellion. Hu Qizhang notes: "Large indicates Cold" – read "Cold" as "Pathogen".
Cun pulse微弱 and slow:微弱 indicates loose Wei Qi, leading to porous skin. Slow indicates solid Stomach Qi, digesting grain and transforming water. Grain enters Stomach, pulse channels open. Water enters meridians, Blood forms. Abundant Ying makes skin porous. Sanjiao meridians severed, named Blood Collapse (Beng Xia).
This describes Wei Deficiency, Ying Excess, Qi Decline, Blood Heat. Sanjiao Fire loses regulation, heating Blood vessels, causing persistent bleeding.