洪脉为热，其阴则虚。细脉为湿，其血则虚。
洪脉满指，浮大兼备，阳有余之象，故当为热。有余于阳，则不足于阴，故为
阴虚。细为阴脉，细藐不振，阴湿之候。细又为血虚者，盖脉以血为体，细藐之甚，体于何有？故血虚。
缓大者风，缓细者湿，缓涩血少，缓滑内热。
空疏缓大，风所致也。缓漫濡细，湿所侵也。缓而涩滞，血必少也。缓而滑疾，内有热也。
濡小阴虚，弱小阳竭。阳竭恶寒，阴虚发热。
濡小之脉，即所谓如帛浮水面，有上无下，阴虚之候也。弱小之脉，体不充，
势不鼓，阳竭之候也。阳竭，则阴乘阳，故恶寒。阴虚，则阳乘阴，故发热。（阳竭者
补阳，宜四君 附之类。阴竭者补阴，宜六味丸、四物汤之类。）
四君子汤（见第十六）
六味丸（见第十六）
四物汤（见第二十一）
阳微恶寒，阴微发热。男微虚损，女微泻血。
《脉经》云∶微脉不胜寻按，若有若无，言其虚极也。寸微为阳微，阳微即阳虚，
而阴气上入阳中，故恶寒也。尺微为阴微，阴微即阴虚，而阳气下陷入阴中，故发
热也。男人得此，不惟恶寒发热，而且为虚损。女人得此，不惟恶寒发热，而且为
泻血。（虚损者未必不失血，泻血者未必不成虚损。男子补其阳，女子补其阴。）
阳动汗出，阴动发热，为痛与惊，崩中失血。
《伤寒论》曰∶阴阳相搏，名曰动。又曰∶数脉见于关上，上下无头尾，如豆大，
厥厥动摇者，名曰动。既云在关，是居尺寸之中，若不能分阴分阳者。然云阴阳相
搏，又云阳动阴动，又似乎有胜有负。故阳虚者，为阳动阳负，负则外卫不密，而汗自出矣。阴虚者，
为阴动阴负，负则内守不宁，而热自发矣。为痛为惊者，阴阳不和。气搏击则痛，气撺迸则惊。味厥
厥动摇四字，情形宛然。阴阳相搏不和，则卫、守两失其职，而崩中失血之证，有自来矣。（阳卫阴守。）
洪脉主热证，若因阴液不足所致，则表现为阴虚。细脉主湿邪，若因血液亏虚所致，则表现为血虚。
洪脉充满指下，兼具浮象和大象，是阳气有余的征象，所以应当归属于热证。阳气有余，则阴气相对不足，因此属于阴虚。细脉属于阴脉，细微不振，是阴湿之候。细脉又主血虚，因为脉以血液为形体基础，如果脉象极其细微，形体尚且不存在，哪里还有血液呢？所以属于血虚。
缓而大的脉象主风邪，缓而细的脉象主湿邪，缓而涩的脉象主血少，缓而滑的脉象主内热。
空疏且缓大的脉象，是由风邪引起的。缓漫且濡细的脉象，是由湿邪侵袭所致。缓而涩滞的脉象，血液必然稀少。缓而滑疾的脉象，体内有热。
濡小的脉象，就是所说的像丝帛漂浮在水面上，只有上部感觉而没有下部感觉，这是阴虚的征象。弱小的脉象，脉体不充盈，脉势不鼓动，这是阳竭的征象。阳竭，则阴气乘袭阳气，所以厌恶寒冷。阴虚，则阳气乘袭阴分，所以发热。（对于阳竭者应补阳，适宜使用四君子汤加附子之类的方剂。对于阴竭者应补阴，适宜使用六味丸、四物汤之类的方剂。）
四君子汤（见第十六节）
六味丸（见第十六节）
四物汤（见第二十一节）
阳微脉见恶寒，阴微脉见发热。男子出现此脉多为虚损，女子出现此脉多为泻血。
《脉经》说：微脉经不起寻按，若有若无，形容其极度虚弱。寸口脉微称为阳微，阳微即阳虚，阴气上入阳位，所以厌恶寒冷。尺部脉微称为阴微，阴微即阴虚，阳气下陷入阴位，所以发热。男子得了这种脉象，不仅恶寒发热，而且会形成虚损。女子得了这种脉象，不仅恶寒发热，而且会出现泻血。（虚损者未必没有失血，泻血者未必不成为虚损。男子应补其阳，女子应补其阴。）
阳动脉见汗出，阴动脉见发热，表现为疼痛与惊悸，以及崩中失血。
《伤寒论》说：阴阳相互搏结，叫做动脉。又说：数脉出现在关部，上下没有头尾，像豆粒大小，厥厥动摇不定，叫做动脉。既然说在关部，就是处于尺寸之间，如果不能区分阴分和阳分的话。然而又说阴阳相搏，又说阳动和阴动，似乎又有胜负之分。所以阳虚者，表现为阳动而阳负，负则外卫不固密，从而汗自出。阴虚者，表现为阴动而阴负，负则内守不宁静，从而热自发。出现疼痛和惊悸，是因为阴阳不和。气机搏击则痛，气机冲撞迸发则惊。品味“厥厥动摇”这四个字，情形宛然如现。阴阳相搏而不和，则卫气和守气都失去职能，于是崩中失血的病症，也就由此产生了。（阳主卫外，阴主内守。）
Hong pulse (Surging Pulse) indicates heat; if due to yin deficiency, it manifests as Yin Deficiency. Xi pulse (Fine Pulse) indicates dampness; if due to blood deficiency, it manifests as Blood Deficiency.
The Hong pulse fills the fingers, possessing both floating and large characteristics, which is a sign of excess yang; therefore, it should be attributed to heat. Excess in yang implies insufficiency in yin; thus, it constitutes Yin Deficiency. The Xi pulse is a yin pulse; its fineness and lack of vigor indicate a condition of yin-dampness. Furthermore, the Xi pulse indicates blood deficiency because the pulse takes blood as its substance. If the pulse is extremely fine, where is the substance? Hence, it indicates blood deficiency.
A Huan pulse (Slow/Relaxed Pulse) that is large indicates wind; one that is fine indicates dampness; one that is choppy indicates scanty blood; one that is slippery indicates internal heat.
A hollow, slow, and large pulse is caused by wind. A slow, overflowing, soggy, and fine pulse is invaded by dampness. A slow and choppy pulse indicates that blood must be scanty. A slow and slippery-rapid pulse indicates internal heat.
Ru pulse (Soggy Pulse) and Xiao pulse (Small Pulse) indicate Yin Deficiency; Ruo pulse (Weak Pulse) and Xiao pulse indicate Yang Exhaustion. Yang Exhaustion leads to aversion to cold; Yin Deficiency leads to fever.
The Ru and Xiao pulses are what is described as "like silk floating on water," felt only at the surface but not deep down, which is a sign of Yin Deficiency. The Ruo and Xiao pulses have a body that is not full and a momentum that does not surge, which is a sign of Yang Exhaustion. When Yang is exhausted, yin overcomes yang, leading to aversion to cold. When yin is deficient, yang overcomes yin, leading to fever. (For Yang Exhaustion, tonify yang, suitable formulas include Si Jun Zi Tang (Four Gentlemen Decoction) with Fu Zi (Aconite Root), etc. For Yin Exhaustion, tonify yin, suitable formulas include Liu Wei Wan (Six-Ingredient Pill) and Si Wu Tang (Four Substance Decoction), etc.)
Si Jun Zi Tang (Four Gentlemen Decoction) (see Section 16)
Liu Wei Wan (Six-Ingredient Pill) (see Section 16)
Si Wu Tang (Four Substance Decoction) (see Section 21)
Yang Wei pulse (Minute Pulse) presents with aversion to cold; Yin Wei pulse presents with fever. In men, this indicates deficiency damage (Xu Sun); in women, it indicates bleeding from the bowels or uterus (Xie Xue).
The *Mai Jing* (Pulse Classic) states: The Wei pulse cannot withstand pressing; it seems to exist and not exist, describing extreme deficiency. A Wei pulse at the Cun position is called Yang Wei; Yang Wei means Yang Deficiency, where yin qi enters the yang region, causing aversion to cold. A Wei pulse at the Chi position is called Yin Wei; Yin Wei means Yin Deficiency, where yang qi sinks into the yin region, causing fever. Men obtaining this pulse suffer not only from aversion to cold and fever but also develop deficiency damage. Women obtaining this pulse suffer not only from aversion to cold and fever but also experience bleeding. (Those with deficiency damage may not necessarily lose blood; those with bleeding may not necessarily develop deficiency damage. Men should tonify their yang; women should tonify their yin.)
Yang Dong pulse (Moving Pulse) presents with sweating; Yin Dong pulse presents with fever, pain, and fright, as well as metrorrhagia and blood loss.
The *Shang Han Lun* (Treatise on Cold Damage) states: When yin and yang struggle against each other, it is named Dong (Moving). It also states: A Shu pulse (Rapid Pulse) appearing at the Guan position, without head or tail above and below, resembling a bean in size, trembling vigorously, is named Dong. Since it is said to be at the Guan position, it lies between the Cun and Chi positions, making it difficult to distinguish yin and yang divisions. However, it speaks of yin-yang struggle, and also distinguishes Yang Dong and Yin Dong, implying superiority and inferiority. Thus, for Yang Deficiency, it manifests as Yang Dong with Yang losing; losing means the exterior defense is not tight, leading to spontaneous sweating. For Yin Deficiency, it manifests as Yin Dong with Yin losing; losing means interior retention is unsettled, leading to spontaneous fever. Pain and fright occur due to disharmony of yin and yang. Qi struggling causes pain; Qi rushing and bursting causes fright. The phrase "trembling vigorously" vividly describes the situation. When yin and yang struggle and are not harmonious, both Wei Qi (Defensive Qi) and Shou Qi (Retaining Qi) fail in their duties, leading to conditions such as metrorrhagia and blood loss. (Yang governs defense; Yin governs retention.)