脉之行动，如以气鼓葱叶中之水，使之流动也。有浮有沉，有迟有数，有涩
有滑。
浮 古人于一身中分三部九候，后人亦于寸口中分三部九候。寸关尺三部也，
部各有浮中沉三候，三而三之，九候也。是故候之于皮毛间而即得之者，谓之浮；
候之于筋骨间乃得之者，谓之沉；候之于皮毛之下，筋骨之上，适当肌肉之中而得
之者，谓之中。
沉 沉之极名伏。
数 疾也，躁也。一息六至，数而跳突名动。
迟 与数相反，一息三至。
《内经》谓人一呼（出气也）脉再动，（动，即至也。）一吸（入气也）脉再动，呼
吸定息（一呼一吸为
一息，定息者，前息已尽，后息未起之时也。）脉五动，闰以太息，（数息必有一息略长者，
名太息，如月之
有闰也。一呼一吸本止四动，有五动者，则以其为太息也。诊时当别令一无病患，
调定呼吸，默数得十息，诊者亦
默数，得四十五至，为平脉。）命曰平人。一呼脉一动，一吸脉一动，曰少气。
（即一息二至也，此
迟之甚。）一呼脉三动，一吸脉三动，（即一息六至，此为数。）而躁，（即数疾意。）尺热，（
尺，即手臂。）
曰温病。（温病热证。）一呼脉四动（即一息八至）以上，曰死。脉绝不至，（不特迟，且不至。）
曰死。乍疏（疏，即迟）乍数，曰死。
滑 滑即滑溜之谓，言其行动往来之流利也。在平脉则为血充，在病脉则
为血热鼓动，痰气流注。
涩糙 涩也。与滑相反，往来粘滞者是。
浮沉有得于禀赋者，趾高气扬之辈脉多浮，镇静沉潜之士脉多沉也。（又肥人多沉，
瘦人多浮。）有变于时令者，春夏气升而脉浮，秋冬气降而脉沉也。其因病而致者，则
病在上、（人身之上部也。）在表、在腑者，其脉浮。（上、表、腑皆属阳，浮脉亦属阳，
阳病见阳脉也。）
在下、在里、在脏者，其脉沉也。
问∶浮则外有脉而内无脉，谓之里虚；沉则内有脉而外无脉，谓之表虚。可乎？
曰∶不由禀赋时令与外感内伤，无故而浮沉，谓之虚，可也。以浮为阴失守，沉为
阳内陷也。有故则不可，如以为可，则四季之月，无病之人，脉本和平，常居
中候，亦可断为表里兼虚乎？然则古人谓浮为里虚，又谓浮脉举之有余，按之
不足。其说非欤？曰∶谓浮为虚者，必浮而兼虚者乃名之，非浮即可名虚也。谓浮
为虚于里者，必有里虚之实乃名之，非浮则必虚其里也。至脉体之为虚为实，
本不因浮沉而变，实则浮沉皆有余，虚则浮沉皆不足。而轻取之与重按，
势有不同。则夫脉之实者，愈按愈实，虚者愈按愈虚。盖重按则脉被遏抑，实者鼓击
有力，故愈形其实，虚者无力鼓击，故愈形其虚。是则举之有余，按之不足，
止可言浮而虚者，不可言浮而实者也。或曰∶如子言，浮而实者愈按愈实，是三候
皆有，又何以名之为浮乎？曰∶浮脉本浮，按抑之而后沉，不按之则仍浮，故曰浮
也。又问∶亦有脉浮而言表虚，何也？曰∶外感发汗太过，或内伤自汗太多，皆令
表阳虚，气外越，故浮也。
迟数得于禀赋，则性躁急者脉多数，性宽缓者脉多迟。变于时令，则晴燠
而脉躁，阴寒而脉静也。至其应病，则亦如之矣。仲景以迟为脏寒，数为腑热，可
不泥。以腑亦有寒，脏亦有热也。
滑涩亦有得之禀赋者乎？曰∶富贵之子，神气通畅，则脉亦流畅；贫贱之子，
神气沮抑，则脉亦蹇滞，此即《太素》以脉之滑涩论穷通之意也。若夫时令，则肝
脉属春而微滑，肺脉属秋而微涩矣。至其应病，则本乎气血之通塞耳。
脉象的搏动，就像用气息吹动葱叶中的水，使其流动一样。脉象有浮、沉之分，有迟、数之别，有涩、滑之异。
浮脉：古人将人体分为三部九候，后人也在寸口脉处划分三部九候。寸、关、尺为三部，每部各有浮、中、沉三种取脉力度，三乘以三，即为九候。因此，在皮肤表面轻取即得的脉象，称为浮脉；需要在筋骨之间重按才能得知的脉象，称为沉脉；在皮肤之下、筋骨之上，恰好在肌肉中间取到的脉象，称为中脉。
沉脉：沉脉极深者称为伏脉。
数脉：疾速也，躁动不安。一呼一吸之间脉搏跳动六次，若兼有跳突感则称为动脉。
迟脉：与数脉相反，一呼一吸之间脉搏跳动三次。
《黄帝内经》说，人每次呼气（出气），脉搏跳动两次；每次吸气（入气），脉搏也跳动两次。在一呼一吸结束、下一次呼吸尚未开始的间隙（定息），脉搏跳动五次，加上偶尔出现的较长的一次呼吸（太息，如同月份中的闰日），称为平人（健康人）。具体诊法时，应让无病患之人调节好呼吸，默数十次呼吸，医者亦默数，共得四十五次搏动，此为正常脉象。如果一呼脉搏只跳动一次，一吸也只跳动一次（即一息仅两至），这属于极度迟缓，称为少气。如果一呼脉搏跳动三次，一吸也跳动三次（即一息六至，此为数脉），且伴有躁动不安，尺部（手臂内侧）发热，这称为温病（温热性质的病证）。如果一呼脉搏跳动四次以上（即一息八至以上），称为死证。脉搏完全停止不再跳动，称为死证。脉搏忽慢忽快，也称为死证。
滑脉：滑即滑溜之意，形容其往来流利顺畅。在正常脉象中代表血液充盈，在病脉中则代表血热鼓动或痰气流注。
涩脉：粗糙滞涩之意。与滑脉相反，往来粘滞不畅即是涩脉。
浮脉和沉脉有的取决于先天禀赋，趾高气扬的人脉象多浮，镇静沉稳的人脉象多沉。（另外，肥胖人多沉脉，消瘦人多浮脉。）有的随季节时令变化，春夏阳气升发则脉浮，秋冬阳气收敛则脉沉。因病而致的，病位在上部、在表、在腑的，其脉象多浮。（上部、表、腑皆属阳，浮脉亦属阳，阳病见阳脉。）病位在下部、在里、在脏的，其脉象多沉。
问：浮脉表示外有脉象而内无脉象，称为里虚；沉脉表示内有脉象而外无脉象，称为表虚。这样理解可以吗？
答：如果不是因为禀赋、时令或外感内伤，无故出现浮或沉，可以称为虚，这是以浮为阴气失守，沉为阳气内陷。但如果是有病因导致的，就不能这样说。如果认为可以，那么四季之中，无病之人，脉象本来平和，常处于中候位置，难道也可以断定为表里俱虚吗？既然如此，古人说浮脉主里虚，又说浮脉“举之有余，按之不足”。这种说法不对吗？回答说：说浮脉主虚，必须是浮脉兼见虚象才称之为虚，并非只要是浮脉就是虚。说浮脉主里虚，必须有里虚的实证依据才称之为里虚，并非浮脉就一定导致里虚。至于脉体的虚实质，并不因浮沉而改变，实脉则浮沉皆有力，虚脉则浮沉皆无力。只是轻取与重按的感觉不同罢了。所以实脉越按越感觉坚实，虚脉越按越感觉虚弱。这是因为重按时脉被遏制压抑，实脉鼓击有力，所以更显现其实象；虚脉无力鼓击，所以更显现其虚象。因此，“举之有余，按之不足”，只能用来描述浮而虚的脉象，不能用来描述浮而实的脉象。有人问：按照您的说法，浮而实的脉象越按越实，三部皆有，那又凭什么称之为浮脉呢？回答说：浮脉本性是浮，按压之后才显得沉，不按压则仍然浮，所以称为浮脉。又问：也有脉浮而主表虚的情况，为什么呢？回答说：外感病发汗太过，或内伤病自汗太多，都会导致表阳虚，气向外越，所以脉象浮。
迟脉和数脉有的取决于先天禀赋，性情急躁的人脉多数，性情宽缓的人脉多迟。随季节变化，天气晴朗温暖则脉躁动，阴寒天气则脉静。至于对应病症，也是如此。张仲景认为迟脉主脏寒，数脉主腑热，不可拘泥。因为腑也有寒，脏也有热。
滑脉和涩脉也有取决于先天禀赋的吗？回答说：富贵之人，神气通畅，脉象也就流畅；贫贱之人，神气受挫压抑，脉象也就蹇滞，这就是《太素》通过脉象的滑涩来论述命运穷通的意思。至于季节时令，肝脉属春而微滑，肺脉属秋而微涩。至于对应病症，则根本在于气血的通塞情况。
The movement of the pulse is like using Qi (vital energy) to blow through the water inside a scallion leaf, causing it to flow. The pulse presents as Floating or Sinking, Slow or Rapid, Choppy or Slippery.
Floating Pulse: The ancients divided the human body into Three Regions and Nine Probes (San Bu Jiu Hou), while later practitioners also divided the Cun Kou (radial artery) pulse into Three Regions and Nine Probes. The Cun, Guan, and Chi positions constitute the Three Regions; each region has three probing depths: Superficial (Fu), Middle (Zhong), and Deep (Chen). Three times three equals nine probes. Therefore, a pulse obtained immediately with light pressure on the skin surface is called the Floating Pulse; a pulse obtained only with heavy pressure between the tendons and bones is called the Sinking Pulse; and a pulse obtained in the middle of the muscle layer, below the skin but above the tendons and bones, is called the Middle Pulse.
Sinking Pulse: When the Sinking Pulse is extremely deep, it is called the Hidden Pulse (Fu Mai).
Rapid Pulse: It is swift and restless. If the pulse beats six times per respiratory cycle (one exhalation and one inhalation), and is accompanied by a jumping sensation, it is called the Moving Pulse (Dong Mai).
Slow Pulse: Opposite to the Rapid Pulse, it beats three times per respiratory cycle.
The *Nei Jing* (Inner Canon) states that for every exhalation, the pulse moves twice; for every inhalation, the pulse moves twice. At the end of a full breath cycle (Ding Xi - the moment after one cycle ends and before the next begins), the pulse moves five times. This includes occasional longer breaths (Tai Xi - great sighs, analogous to leap months in a calendar). A healthy person (Ping Ren) is defined by this rhythm. In clinical practice, one should observe a healthy individual regulating their breathing, silently counting ten breath cycles, during which the pulse beats forty-five times; this is considered the Normal Pulse (Ping Mai). If the pulse beats once per exhalation and once per inhalation (two beats per cycle), this is an extreme slowness called "Shortness of Qi" (Shao Qi). If the pulse beats three times per exhalation and three times per inhalation (six beats per cycle, i.e., Rapid), accompanied by restlessness and heat in the Chi area (inner aspect of the forearm), it is called Warm Disease (Wen Bing). If the pulse beats four times or more per exhalation (eight times or more per cycle), it indicates death. If the pulse ceases completely, it indicates death. If the pulse alternates between sparse (slow) and rapid, it indicates death.
Slippery Pulse: "Slippery" implies smoothness and slickness, describing a fluent and smooth flow. In a normal pulse, it indicates abundant blood; in a pathological pulse, it indicates blood heat driving the pulse or the flow of phlegm-dampness.
Choppy Pulse: Rough and obstructed. Opposite to the Slippery Pulse, a pulse that flows with stickiness and obstruction is Choppy.
The presence of Floating or Sinking pulses can be determined by innate constitution. Arrogant individuals often have a Floating pulse, while calm and profound individuals often have a Sinking pulse. (Additionally, obese people tend to have Sinking pulses, and thin people tend to have Floating pulses.) They can also vary with seasonal changes: in Spring and Summer, when Qi ascends, the pulse is Floating; in Autumn and Winter, when Qi descends, the pulse is Sinking. When caused by disease, if the pathology is located in the Upper part, Exterior, or Fu organs, the pulse is Floating. (Upper, Exterior, and Fu are all Yang; the Floating pulse is also Yang; thus, Yang diseases present with Yang pulses.) If the pathology is located in the Lower part, Interior, or Zang organs, the pulse is Sinking.
Question: Does a Floating pulse indicate that there is pulse activity externally but not internally, signifying Interior Deficiency? Does a Sinking pulse indicate that there is pulse activity internally but not externally, signifying Exterior Deficiency? Is this correct?
Answer: If the Floating or Sinking pulse appears without cause from constitution, season, external pathogens, or internal injury, it can be termed Deficiency, interpreted as Yin failing to hold or Yang sinking inward. However, if there is a specific cause, this interpretation is invalid. For instance, in any season, a healthy person's pulse is harmonious and typically found at the Middle probe level; would we then diagnose them with simultaneous Exterior and Interior Deficiency? Furthermore, the ancients stated that the Floating pulse indicates Interior Deficiency, yet also described it as "abundant upon lifting, insufficient upon pressing." Is this contradictory? I say: To call a Floating pulse "Deficient," it must exhibit signs of Deficiency alongside the Floating quality; merely being Floating does not make it Deficient. To say a Floating pulse indicates Interior Deficiency requires evidence of actual Interior Deficiency; it does not mean a Floating pulse inherently causes Interior Deficiency. The substance of the pulse as Deficient or Excess does not change due to Floating or Sinking. An Excess pulse is forceful in both Floating and Sinking probes; a Deficient pulse is weak in both. The difference lies in the sensation of light versus heavy pressure. An Excess pulse feels harder upon deeper pressure because the suppression highlights its vigorous beating; a Deficient pulse feels weaker upon deeper pressure because it lacks the strength to beat against the pressure. Thus, "abundant upon lifting, insufficient upon pressing" applies only to Floating pulses that are Deficient, not to those that are Excess. Some might ask: If a Floating-Excess pulse becomes harder upon pressing, showing characteristics in all three probes, why is it still called Floating? Answer: The nature of the pulse is fundamentally Floating; it only appears Sinking when pressed. Without pressure, it remains Floating, hence the name. Another question: Why do some Floating pulses indicate Exterior Deficiency? Answer: Excessive sweating from external contraction, or excessive spontaneous sweating from internal injury, leads to Deficiency of Exterior Yang and the outward floating of Qi, resulting in a Floating pulse.
The Slowness or Rapidity of the pulse can depend on innate constitution: irritable temperaments tend toward Rapid pulses, while relaxed temperaments tend toward Slow pulses. Seasonal variations also apply: warm weather makes the pulse restless, while cold weather makes it quiet. Regarding disease correlation, the same principles apply. Zhang Zhongjing associated Slow pulses with Cold in the Zang organs and Rapid pulses with Heat in the Fu organs; however, one should not rigidly adhere to this, as Fu organs can also have Cold and Zang organs can have Heat.
Do Slipperiness and Choppy qualities also depend on innate constitution? Yes. Noble individuals, whose Shen (spirit) and Qi flow freely, have smooth pulses; poor individuals, whose Shen and Qi are suppressed, have obstructed pulses. This aligns with the *Tai Su* concept of judging fortune and misfortune through the slipperiness or choppy nature of the pulse. Regarding seasons, the Liver pulse belongs to Spring and is slightly Slippery; the Lung pulse belongs to Autumn and is slightly Choppy. In terms of disease manifestation, these qualities fundamentally reflect the obstruction or free flow of Qi and Blood.