虚寒相搏，其名为革。男子失精，女子失血。
《伤寒论》辨脉法云∶脉弦而大，弦则为减，大则为芤。减则为寒，芤则为虚。
虚寒相搏，此名为革。妇人则半产漏下，宜补血。男子则亡血失精。（宜填精。）此节正革
脉之注脚也。盖革如皮革，急满指下。今云脉弦而大，非革而何？只此四字，可以
尽革脉之形状矣。弦则为减以下，又发明所以为革，并革之所以为病也。弦则脉体
弦急细敛，是阳气之减少也。弦而大，是改细敛为阔大，其弦急之体仍在。弦急为
阳减，改大则中芤。阳减为寒，中芤为虚。既虚且寒，徒革于外，而中则空，在女
则为半产漏下，在男则为亡血失精，是皆中空之验。
阳盛则促，肺痈阳毒。阴盛则结，疝瘕积郁。
数脉时见一止，名曰促。数则为热，为阳盛，主上焦热聚成毒，或热聚肺
成痈。（阳毒宜清散，如黄芩、花粉、连翘、枳壳、荆防之类。肺痈宜清解，如仲景桔梗汤之类。）
脉气流行，为其阻碍，故一止也。不数而缓，时见一止，名曰结，为阴盛，主阴分或腹中聚疝痼瘕。
（宜元戎万病紫菀丸、宝鉴沉香桂附丸之类。）久积成郁，气坚结不散，脉气至此，亦为所碍，故一
止也。《难经》十八难曰∶结甚则积甚，结微则积微，是又当审止歇之多寡，而断病之轻重耳。
虚邪与寒邪相互搏结，这种脉象称为革脉。男子会出现遗精滑泄，女子会出现崩漏失血。
《伤寒论·辨脉法》中说：脉象弦而大，弦脉代表阳气衰减，大脉代表中空如芤。阳气衰减则生内寒，中空如芤则为血虚。虚邪与寒邪相互搏结，这就叫做革脉。妇女因此会出现小产或淋漓不断的下血，应当采用补血疗法；男子因此会出现亡血或遗精，应当采用填精益髓的疗法。这一节正是对革脉的注解。大概革脉就像皮革一样，按之紧急且充满指下。现在说脉象弦而大，如果不是革脉又是什么呢？仅这四个字，就可以穷尽革脉的形状了。“弦则为减”以下的内容，又阐明了之所以形成革脉的原因，以及革脉导致疾病的机理。弦脉表现为脉体弦急、细窄收敛，这是阳气减少的表现。脉象由细敛变为阔大，但其弦急的本质仍在。弦急表示阳气衰减，变得阔大则中间空虚（即芤脉）。既虚又寒，外表呈现革象，内部却中空，在女性身上表现为小产和漏下，在男性身上表现为亡血和失精，这些都是内部中空的验证。
阳气偏盛则出现促脉，多见于肺痈和阳毒证；阴气偏盛则出现结脉，多见于疝气和癥瘕积聚郁滞。
数脉（快速脉）偶尔出现一次停顿，称为促脉。数脉主热，主阳气亢盛，通常提示上焦热邪聚集化毒，或者热邪聚于肺部形成肺痈。（对于阳毒证适宜清热散邪，如使用黄芩、天花粉、连翘、枳壳、荆芥、防风等药物；对于肺痈适宜清热解毒，如张仲景的桔梗汤等方剂。）脉气运行受到阻碍，所以会出现一次停顿。如果脉不数而缓，偶尔出现一次停顿，称为结脉，这属于阴气偏盛，主要提示阴分或腹中有疝气积聚或顽固性的癥瘕肿块。（适宜使用元戎万病紫菀丸、宝鉴沉香桂附丸等方剂。）久积而成郁结，气机坚硬凝结不散，脉气运行至此也会受到阻碍，所以出现一次停顿。《难经·十八难》说：结脉停顿明显则积聚严重，结脉停顿轻微则积聚轻微，因此应当审查停顿次数的多少，从而判断疾病的轻重程度。
Deficiency and cold combine, this is named Ge pulse (Cymbal Pulse). In men, it manifests as loss of essence; in women, as loss of blood.
The *Shanghan Lun* (Treatise on Cold Damage Diseases), Chapter on Differentiating Pulses, states: "The pulse is wiry and large. Wiry indicates reduction; large indicates hollow (Kou). Reduction implies cold; hollow implies deficiency." Deficiency and cold combining is what is called the Ge pulse. In women, it leads to spontaneous abortion or continuous uterine bleeding, for which tonifying blood is indicated. In men, it leads to hemorrhage or loss of essence, for which replenishing essence is indicated. This section serves as a commentary on the Ge pulse. Essentially, the Ge pulse feels like leather, tight and full under the fingers. To say the pulse is wiry and large—if not the Ge pulse, then what? These four characters suffice to describe the morphology of the Ge pulse completely. The following text explains the cause of the Ge pulse and how it gives rise to disease. A wiry pulse body is wiry, tense, fine, and constricted, indicating a reduction of Yang Qi. When it changes from fine/constricted to large, the wiry/tense nature remains. Wiry/tense signifies Yang reduction; becoming large signifies central hollowing (Kou). Yang reduction creates cold; central hollowing creates deficiency. Both deficient and cold, it presents as Ge externally but is empty internally. In women, this manifests as spontaneous abortion and metrorrhagia; in men, as hemorrhage and seminal emission. All these are signs of internal emptiness.
Yang excess leads to Cu pulse (Surging/Intermittent Pulse), associated with Lung abscess and Yang toxin. Yin excess leads to Jie pulse (Knotted/Intermittent Pulse), associated with hernia, mass, and accumulation/stagnation.
A rapid pulse that occasionally stops is named Cu pulse. Rapidness indicates heat and Yang excess, primarily pointing to heat aggregation in the Upper Jiao forming toxins, or heat aggregating in the lungs forming a lung abscess. (For Yang toxin, clearing and dispersing is suitable, using herbs such as Huangqin [Scutellariae Radix], Huafen [Trichosanthis Radix], Lianqiao [Forsythiae Fructus], Zhike [Aurantii Fructus], Jingjie [Schizonepetae Herba], Fangfeng [Saposhnikoviae Radix]. For lung abscess, clearing and resolving is suitable, such as Zhongjing's Jiegeng Tang [Platycodon Decoction].) The flow of pulse qi is obstructed, hence the occasional stop. If the pulse is not rapid but slow, occasionally stopping, it is named Jie pulse. This indicates Yin excess, primarily suggesting hernias or stubborn masses in the Yin aspect or abdomen. (Formulas such as Yuanrong Wanbing Ziwan Wan or Baojian Chenxiang Guifu Wan are suitable.) Long-term accumulation leads to stagnation; Qi becomes hard and knotted without dispersing. When pulse qi reaches this point, it is also obstructed, hence the occasional stop. The *Nan Jing* (Classic of Difficult Issues), Difficulty 18, states: "Severe knotting indicates severe accumulation; slight knotting indicates slight accumulation." Therefore, one must examine the frequency of pauses to judge the severity of the disease.