沉脉主里，主寒主积。有力痰食，无力气郁。
沉迟虚寒，沉数热伏，沉紧冷痛，沉缓水蓄，
沉牢痼冷，沉实热极，沉弱阴虚，沉细痹湿，
沉弦饮痛，沉滑宿食，沉伏吐利，阴毒聚积。
脉按之至骨曰沉。对待浮表，是曰主里。寒乃水寒，积乃脏积，总属阴凝，故
见沉脉。沉而有力，有物在里，非痰即食。（痰宜用王隐君滚痰丸，食宜用仲景大承气汤之类。）沉而
无力，里原非实，但气不伸。（宜和剂四七汤、河间正气天香散之类。）沉为在里而复迟，虚寒可
必。（宜仲景理中丸或附子理中汤之类。）沉为在里而加数，伏热何疑。（宜宝鉴既济解毒汤、导赤散、黄
连解毒汤之类。）沉而紧，则寒为敛实，故冷痛也。（宜金匮乌头煎、和剂来复丹之类。）沉而缓，则阳不
健行，故水蓄焉。（宜仲景五苓散、苓桂术甘汤之类。）沉而牢，乃阴寒之滞着，应当痼冷。（宜和剂
来复丹，大七香丸。）沉而实，是阳气之聚搏，宜乎热深。（宜仲景大承气汤、子和神芎丸之类。）沉为
阴，弱为虚，沉弱必主阴虚。（宜金匮肾气丸、六味丸之类。）沉为里，细为湿，沉细定成痹湿。
（宜金匮桂枝附子汤、和剂渗湿汤或胃苓汤之类。）沉为阴，弦为饮。沉弦则饮停腹阴而时痛。（宜仲景小
青龙汤、五苓散之类。）沉为里，滑为食，沉滑则食宿肠里而难推。（宜仲景大承气汤、洁古枳术丸、丹
溪保和丸之类。）沉已气沉于骨，伏则至骨如无。势甚笃危，须分久暴。暴则既吐且利而
暴脱，温补可回；（宜和剂大七香丸、仲景理中汤或藿香正气散之类。）久则阴毒聚积之久阻，峻攻莫
愈。（宜枳实理中丸之类。）
沉脉主要反映病位在里，主寒证和积滞。脉象有力者多为痰饮或食积，无力者多为气机郁滞。
沉迟脉主虚寒，沉数脉主热邪内伏，沉紧脉主冷痛，沉缓脉主水湿停蓄。
沉牢脉主顽固性寒冷，沉实脉主热极，沉弱脉主阴虚，沉细脉主痹症与湿邪。
沉弦脉主饮邪与疼痛，沉滑脉主宿食，沉伏脉主呕吐泄泻及阴毒积聚。
脉搏按至骨方得名为沉脉。相对于浮脉所主的表证，沉脉主里证。寒即水寒，积即脏腑积滞，总体属于阴气凝滞，因此出现沉脉。
沉而有力，说明里有实物阻滞，不是痰就是食积。（痰证宜用王隐君的滚痰丸，食积宜用张仲景的大承气汤之类。）
沉而无力，说明里本非实证，只是气机不能舒展。（宜用《太平惠民和剂局方》的四七汤、刘河间的正气天香散之类。）
沉脉在里且兼见迟象，必为虚寒。（宜用张仲景的理中丸或附子理中汤之类。）
沉脉在里且兼见数象，确为伏热无疑。（宜用李东垣《医学发明》的既济解毒汤、导赤散、黄连解毒汤之类。）
沉而紧，说明寒邪收敛致实，故见冷痛。（宜用《金匮要略》的乌头煎、《和剂局方》的来复丹之类。）
沉而缓，说明阳气不健运，故水湿停蓄。（宜用张仲景的五苓散、苓桂术甘汤之类。）
沉而牢，是阴寒之邪滞留附着所致，应当表现为顽固性寒冷。（宜用《和剂局方》的来复丹、大七香丸。）
沉而实，是阳气聚结搏动所致，适宜表现为热邪深重。（宜用张仲景的大承气汤、张子和的神芎丸之类。）
沉属阴，弱属虚，沉弱脉必主阴虚。（宜用《金匮要略》的肾气丸、六味地黄丸之类。）
沉主里，细主湿，沉细脉定成痹症与湿邪。（宜用《金匮要略》的桂枝附子汤、《和剂局方》的渗湿汤或胃苓汤之类。）
沉属阴，弦主饮。沉弦脉则饮邪停聚于腹部阴分而时常疼痛。（宜用张仲景的小青龙汤、五苓散之类。）
沉主里，滑主食。沉滑脉则宿食停滞于肠道深处难以推荡排出。（宜用张仲景的大承气汤、张洁古的枳术丸、朱丹溪的保和丸之类。）
沉脉已是气沉于骨，伏脉则是按至骨处似有若无。病情严重危急，必须区分新病久病。新病则既吐又利而突然虚脱，温补法可挽回；（宜用《和剂局方》的大七香丸、张仲景的理中汤或藿香正气散之类。）久病则是阴毒积聚日久阻滞，峻猛攻下法也不能治愈。（宜用枳实理中丸之类。）
The deep pulse (Chen Mai, Deep Pulse) primarily indicates interior syndrome, cold syndrome, and accumulation. A forceful deep pulse suggests phlegm or food retention, while a feeble one suggests qi stagnation.
A deep and slow pulse indicates deficiency-cold; a deep and rapid pulse indicates latent heat; a deep and tight pulse indicates cold pain; a deep and moderate pulse indicates water retention.
A deep and firm pulse indicates entrenched cold; a deep and excess pulse indicates extreme heat; a deep and weak pulse indicates yin deficiency; a deep and fine pulse indicates bi-syndrome with dampness.
A deep and wiry pulse indicates fluid retention and pain; a deep and slippery pulse indicates retained food; a deep and hidden pulse indicates vomiting, diarrhea, and accumulation of yin-toxin.
The pulse is termed "deep" when it can only be felt upon pressing to the bone. In contrast to the floating pulse which indicates exterior syndromes, the deep pulse indicates interior syndromes. Cold refers to water-cold, and accumulation refers to organ accumulations; generally, these belong to yin coagulation, hence the appearance of a deep pulse.
If the deep pulse is forceful, there is a tangible pathogen in the interior, either phlegm or food retention. (For phlegm, Wang Yinjun's Gun Tan Wan [Rolling Phlegm Pill] is suitable; for food retention, Zhang Zhongjing's Da Cheng Qi Tang [Major Order the Qi Decoction] is suitable.)
If the deep pulse is feeble, the interior is originally not excess, but merely qi fails to extend. (Si Qi Tang [Four-Seven Decoction] from *Heji Jufang* [Formulas of the Bureau of Taiping People's Welfare Pharmacy] or Zhengqi Tianxiang San [Zhengqi Tianxiang Powder] by Liu Hejian are suitable.)
If the pulse is deep indicating an interior location and also slow, deficiency-cold is certain. (Li Zhong Wan [Regulate the Middle Pill] or Fuzi Lizhong Tang [Aconite Regulate-the-Middle Decoction] by Zhang Zhongjing are suitable.)
If the pulse is deep indicating an interior location and also rapid, latent heat is beyond doubt. (Jiji Jiedu Tang [Jiji Detoxification Decoction] from Li Dongyuan's *Yixue Mingbai*, Dao Chi San [Guide Out the Red Powder], and Huanglian Jiedu Tang [Coptis Detoxification Decoction] are suitable.)
If deep and tight, cold has contracted and solidified, thus causing cold pain. (Wutou Jian [Aconite Decoction] from *Jinkui Yaolue* [Essential Prescriptions of the Golden Cabinet] or Laifu Dan [Laifu Pill] from *Heji Jufang* are suitable.)
If deep and moderate, yang fails to circulate vigorously, thus water retains. (Wu Ling San [Five-Ling Powder] or Ling Gui Zhu Gan Tang [Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction] by Zhang Zhongjing are suitable.)
If deep and firm, it is the stagnation and adherence of yin-cold, corresponding to entrenched cold. (Laifu Dan [Laifu Pill] or Da Qixiang Wan [Great Fragrant Pill] from *Heji Jufang* are suitable.)
If deep and excess, it is the gathering and struggling of yang qi, fitting for deep heat. (Da Cheng Qi Tang [Major Order the Qi Decoction] by Zhang Zhongjing or Shenxiong Wan [Shenxiong Pill] by Zhang Zihe are suitable.)
Deep belongs to yin, weak belongs to deficiency; a deep and weak pulse must indicate yin deficiency. (Shenqi Wan [Kidney Qi Pill] or Liuwei Wan [Six-Ingredient Pill] from *Jinkui Yaolue* are suitable.)
Deep indicates interior, fine indicates dampness; a deep and fine pulse definitely forms bi-syndrome with dampness. (Guizhi Fuzi Tang [Cinnamon Twig and Aconite Decoction] from *Jinkui Yaolue*, Shenshi Tang [Dampness-Oozing Decoction] or Weiling Tang [Stomach-Wuling Decoction] from *Heji Jufang* are suitable.)
Deep belongs to yin, wiry indicates fluid retention. A deep and wiry pulse means fluids stop in the yin aspect of the abdomen and cause intermittent pain. (Xiao Qinglong Tang [Minor Green Dragon Decoction] or Wu Ling San [Five-Ling Powder] by Zhang Zhongjing are suitable.)
Deep indicates interior, slippery indicates food; a deep and slippery pulse means retained food lodges deep in the intestines and is hard to expel. (Da Cheng Qi Tang [Major Order the Qi Decoction] by Zhang Zhongjing, Zhizhu Wan [Aurantium and Atractylodes Pill] by Zhang Jiegu, or Baohe Wan [Preserve Harmony Pill] by Zhu Danxi are suitable.)
The deep pulse already indicates qi sinking to the bone; the hidden pulse feels as if absent even at the bone level. The condition is severe and critical, requiring differentiation between acute and chronic onset. Acute onset involves sudden vomiting and diarrhea leading to sudden collapse, which can be reversed with warming and tonifying methods. (Da Qixiang Wan [Great Fragrant Pill] from *Heji Jufang*, Lizhong Tang [Regulate-the-Middle Decoction] by Zhang Zhongjing, or Huoxiang Zhengqi San [Agastache Corrective Qi Powder] are suitable.) Chronic onset involves long-term obstruction by accumulated yin-toxin, which cannot be cured by harsh purgation. (Zhishi Lizhong Wan [Immature Bitter Orange Regulate-the-Middle Pill] is suitable.)