或曰∶识脉其难乎！余曰∶子但知识脉之难，而不知审脉之更难也。所谓识脉者，如滑伯仁之《诊家
枢要》曰∶浮，不沉也；沉，不浮也。迟，不及也；数，太过也。虚，不实也；实，不虚也。滑，不涩
也，涩，不滑也。长，不短也；短，不长也。大，不小也，小，不大也。缓，不逮也。弱，不盛也。伏，不见
也。软，无力也。微，不显也。散，不聚也。洪，洪大也。细，微细也。代，更代也。牢，坚牢也。动
者，滑大于关上也。弦者，状如弓弦，按之不移。紧者，如转索无常也。芤者，浮大而按之中空。革者，
中空而外坚也。结者，缓而有止；促者，数而有止也。以对待之法识之，犹易分别于指下。所谓审脉
者，体认所见之脉何因，所主之病何证，以心印之而后得也。《平脉篇》曰∶浮为在表，沉为在里，数为
在腑，迟为在脏。又曰∶浮则为风，浮则为热，浮为气实，浮为气虚，浮则无血，浮则为虚，是将为外感
乎？为内伤乎？为气乎？为血乎？为实乎？为虚乎？是必审其证之表里、阴阳、寒热、虚实，病之久病、
新病，脉之有力、无力，而断之以意也。如扁鹊知桓侯疾之浅深，望而知之也；知虢太子不死，问而知之
也。华佗闻呻吟之声而取蛇毒，闻而知之也。后人恶能及二君之神智，然必四诊咸备，而后可保万全，故曰审脉之更难
也。
有人问：“识别脉象很难吧！”我说：“你只知道识别脉象难，却不知道审察脉象更难。”所谓识别脉象，就像滑伯仁在《诊家枢要》中所说：浮脉，是不沉的；沉脉，是不浮的。迟脉，是至数不及正常的；数脉，是至数太过正常的。虚脉，是不实的；实脉，是不虚的。滑脉，是不涩的；涩脉，是不滑的。长脉，是不短的；短脉，是不长的。大脉，是不小的；小脉，是不大的。缓脉，是不急迫的。弱脉，是不盛强的。伏脉，是看不见的。软脉，是没有力气的。微脉，是不明显的。散脉，是不聚拢的。洪脉，是洪大的。细脉，是微细的。代脉，是有更替间歇的。牢脉，是坚牢的。动脉，是滑而大于关部的。弦脉，形状像弓弦，按之不移位。紧脉，像转动绳索那样无常不定。芤脉，浮大而按之中空。革脉，中空而外坚。结脉，缓慢而有间歇；促脉，快速而有间歇。用这种对待比较的方法来识别脉象，在指下还容易分辨。所谓审察脉象，是要体认所见的脉象是什么原因引起的，主什么病证，用心印证后才能得到确切判断。《平脉篇》说：浮脉表示病在表，沉脉表示病在里，数脉表示病在腑，迟脉表示病在脏。又说：浮脉可能是风邪，浮脉可能是热邪，浮脉可能是气实，浮脉可能是气虚，浮脉可能无血，浮脉可能是虚证，这将是外感吗？是内伤吗？是气病吗？是血病吗？是实证吗？是虚证吗？这必须审察证候的表里、阴阳、寒热、虚实，疾病的久病、新病，脉象的有力、无力，然后用意断决。比如扁鹊知道蔡桓侯疾病由浅入深，是通过望诊知道的；知道虢太子没有死，是通过问诊知道的。华佗听到呻吟声而取出蛇毒，是通过闻诊知道的。后人怎能比得上这两位医生的神智，但是必须四诊（望、闻、问、切）都具备，才可以保证万无一失，所以说审察脉象更难。
Someone asked, "Is it difficult to recognize the pulse?" I replied, "You only know that recognizing the pulse is difficult, but you do not know that examining the pulse is even more difficult." What is meant by recognizing the pulse is as described in *Zhenjia Shuyao* (Key Essentials of Pulse Diagnosis) by Hua Borén: The *Fu* pulse (Floating pulse) is not sunken; the *Chen* pulse (Deep pulse) is not floating. The *Chi* pulse (Slow pulse) has a frequency less than normal; the *Shu* pulse (Rapid pulse) has a frequency exceeding normal. The *Xu* pulse (Deficient pulse) is not solid; the *Shi* pulse (Excess pulse) is not deficient. The *Hua* pulse (Slippery pulse) is not rough; the *Se* pulse (Choppy pulse) is not slippery. The *Chang* pulse (Long pulse) is not short; the *Duan* pulse (Short pulse) is not long. The *Da* pulse (Large pulse) is not small; the *Xiao* pulse (Fine pulse) is not large. The *Huan* pulse (Moderate pulse) is not urgent. The *Ruo* pulse (Weak pulse) is not vigorous. The *Fu* pulse (Hidden pulse) is not visible. The *Ruan* pulse (Soft pulse) lacks strength. The *Wei* pulse (Minute pulse) is not distinct. The *San* pulse (Scattered pulse) is not gathered. The *Hong* pulse (Surging pulse) is surging and large. The *Xi* pulse (Thready pulse) is minute and fine. The *Dai* pulse (Intermittent pulse) involves alternation or pause. The *Lao* pulse (Firm pulse) is firm and solid. The *Dong* pulse (Moving pulse) is slippery and larger at the Guan position. The *Xian* pulse (Wiry pulse) resembles a bowstring and does not shift when pressed. The *Jin* pulse (Tight pulse) is like a twisting rope, irregular in nature. The *Kou* pulse (Hollow pulse) is floating and large but empty upon pressure. The *Ge* pulse (Drum-taut pulse) is empty inside and firm outside. The *Jie* pulse (Knotted pulse) is slow with pauses; the *Cu* pulse (Hasty pulse) is rapid with pauses. By using the method of comparative opposition to recognize pulses, it is still relatively easy to distinguish them under the fingers. What is meant by examining the pulse is to comprehend the cause of the observed pulse and the disease syndrome it indicates, confirming it through mental insight before reaching a conclusion. The *Ping Mai Pian* (Chapter on Normal Pulses) states: A floating pulse indicates pathology in the Exterior; a deep pulse indicates pathology in the Interior; a rapid pulse indicates pathology in the Fu organs; a slow pulse indicates pathology in the Zang organs. It further states: A floating pulse may indicate Wind; a floating pulse may indicate Heat; a floating pulse may indicate Qi excess; a floating pulse may indicate Qi deficiency; a floating pulse may indicate Blood deficiency; a floating pulse may indicate Deficiency. Does this signify an external contraction? An internal injury? A Qi disorder? A Blood disorder? An Excess syndrome? A Deficiency syndrome? One must carefully examine the syndrome's Exterior/Interior, Yin/Yang, Cold/Heat, and Excess/Deficiency; whether the disease is chronic or acute; and whether the pulse is forceful or feeble, and then make a judgment through deliberate reasoning. For instance, Bian Que knew the depth of Duke Huan of Cai's illness through observation (*Wang*); he knew the Crown Prince of Guo was not dead through inquiry (*Wen*). Hua Tuo extracted snake venom upon hearing groans through auditory examination (*Wen*). How could later generations match the divine wisdom of these two masters? However, only when all four diagnostic methods—Observation, Listening and Smelling, Inquiry, and Palpation—are fully employed can one ensure absolute safety. Therefore, it is said that examining the pulse is even more difficult.