小儿一岁后，手腕短促，按脉为难。诊者用一指转侧，辨寸关尺三部，以浮取、中取、
沉取候之。左九候，右九候。三五岁，脉以七八至而细数者为平和。增为热，减为寒。(《
集成
》)
浮(轻手着于皮肤之上而即见也。)主表，属腑，属阳。风邪六气，外因之病。有力为表
实，
无力为表虚，皆浮也。虚弱病久，临危时，脉亦无力而浮，为外感内伤之别。(《心法》)
浮而虚甚为散脉，主神离气脱。浮如葱管为芤脉，主亡血。浮如按鼓为革脉，主亡精。
浮而
柔细为濡脉，主伤湿，又主血虚。浮而有力为洪脉，主呕胀，又主阳盛阴虚。浮而无力为虚
脉，主血虚。(陈修园)
沉重手按于肌肉之下而始见也。主里，属脏属阴，七情饮食，内因之病。但暴怒者、水
肿者、腹痛极者、瘟疫汗下不能出者，脉亦沉。(《心法》)
沉而着骨为伏脉，主热邪内郁。沉而底硬为革脉，沉而细软为弱脉，主气衰，然清贵者
有此脉。(陈修园)
迟(一息脉来二三至，或一息一至。)主寒，属阴。有力为寒痛，无力为虚痛。伤暑、滞
食、困水，以及冷风迫汗、凝滞气血者，脉皆迟。(陈修园)
迟而不愆为缓脉，迟而不流为涩脉，主血少。迟而偶停为结脉，主积聚，又主阳微，以
及气郁血壅痰滞。迟而止有定数为代脉，主气竭，妊娠无忌。(东修园)
数一息脉来五六至，或一息七八至也。主热属阳。有力为实热，无力为虚热。但内痛甚
者、汗将出者、虚阳将越者、泻痢、痞疡、初产、喘咳、脉亦数。(陈修园)
数而流利为滑脉，主痰饮食积。数而牵转为紧脉，主寒，主痛。数而时止为促脉，主三
焦郁火。数见于关为动脉，主痛、主惊，男亡阳，女血崩。(陈修园)
大脉状粗大如指如箸。主实，邪气盛，胃气衰，故脉大而不缓。(陈修园)
大而涌沸为洪脉，大而坚硬为实脉。(陈修园)
细脉状细小如线也。主虚，属阴。又主真阴将亡。(陈修园)
细而不显为微脉，主阳微欲绝。细而小浮为濡脉，细而小沉为弱脉。(陈修园)
短脉来短促，上不及寸，下不及尺。主素弱，又主伤酒，以及三焦气壅，宿食不消。(
陈修园)
长脉来迢长，上至鱼际，下至尺泽也。主素强，平脉也。(陈修园)
虚应指无力。主虚。身热为伤暑，不热为血少。(陈修园)
虚而沉小者为弱，主血虚。虚而浮小者为濡，主气虚。虚而模糊者为微，主目阳气绝。
虚而干滞者为涩，主血虚，亦主死血。(陈修园)
虚而形小为细，主气冷。虚而形缩为短，主气损。(陈修园)
实应指有力。主实，又主热郁，以及伤食、气痛、谵语等证。(陈修园)
实而流利者为滑，主血病。实而迢长者为长，主气滞。实而涌沸者为洪，主热极，亦主
内虚。实而端直者为弦，主肝邪症瘕疝疟。(陈修园)
缓脉来四至，从容不迫。主正复，平脉也。但缓而和者主正复，缓而怠者主中湿。(陈
修园)
两手六部，皆为肺脉。肺为脏腑之华盖，凡一切脏腑病，其气上薰于肺而应于脉。心病
六脉
皆洪，肝病六脉皆弦，肾病六脉皆沉，肺病六脉皆涩，脾病六脉皆缓。按之指下浊者为邪甚
，清者为正复；有神者吉，无神者凶；有力者为热、为实，无力者为寒、为虚，此为最验。
(陈修园)
凡病内虚者，脉弱为宜，洪大则忌。病外感者，阳脉为宜，阴脉则忌。(陈修园)
凡脉有胃气，有神气而和缓者吉，合于时令者吉，与面上五色中见那一色相生者吉，反
是者凶。(陈修园)
何为无病脉。一息四至是也。何谓五脏早脉。心宜洪，肺宜涩，肝宜弦，脾宜缓，肾宜
沉，
又兼一段冲和之气，为胃气是也。何谓四时平脉。春弦、夏洪、秋涩、冬沉、四季之末和缓
是也。何谓男女异脉。男为阳，寸大于尺；女为阴，尺大于寸是也。(陈修园)
雀啄连连，止而又作，为肝绝。屋漏水落，半时一滴，为胃绝。弹石沉弦，按之指搏，
为肾
绝。忽密忽疏，乱如解索，为脾绝。本不动而末摇，如鱼之翔，为心绝。虾游冉冉，忽然一
跃，为大肠绝。釜沸空浮，绝无根脚，为肺绝。(陈修园)
诊外感，其初则由经络，病在表，轻者寸浮盛，重者关尺亦浮盛。迨传入里，内热重则
脉沉矣。病在上则见于寸，病在中则见于关，病在下则见于尺。(王汉皋)
寸脉伏，无虚证，是风寒闭也，为表虚，不可发汗。尺脉伏，无虚证，是湿热闭也，为
里虚，不可利二便。(王汉皋)
左脉弱，右脉强，主汗多，遗精，肝郁证。右脉弱，左脉强，主腹痛易怒。及误服补火
丸散，必生肝热，滑精诸证。(王汉皋)
右脉盛，左手无脉，主痰结气虚。左脉盛，右手无脉，主食滞肝郁。(王汉皋)
脉有反象，皆郁极而闭阻者也。如肝病左关弦，郁则弦而细，郁极则细而结，甚则伏。
然其弦反见于相克之经，故右关弦也。余例推。(王汉皋)
保精日久者，两尺俱盛，故六脉重取皆实，无遗精病。(王汉皋)
男右脉强，左脉沉细无力者，主气弱，内有湿热也，不数日必遗精。若尺弱者必已遗精
也。女脉如是者必白浊白淫。脉有结者必白带。(王汉皋)
寸脉强，尺脉弱，主阳实阴虚。每病上热下寒，上实下虚，浮阳上越，虚寒等证。(王
汉皋)
寸脉弱，尺脉强，主阳虚阴实，每易病风寒，及湿热等证。宜细辨。(王汉皋)
凡无病者，浮取无脉，为表虚，以平素易汗为据。即有外感，汗剂宜慎。沉取无脉，为
里虚
，以平素易泄为据。即有积滞，攻下剂宜慎。中取迟弱者中气虚，以平素不能食，精神弱为
据。惟生而双伏之六阴脉，不在此论。以其人能食而精神不弱为据。(王汉皋)
一部脉见三象四象，如右寸洪，肺热也；洪而滑，又有痰，而中有一线之细，是其虽细
而力
强，乃能见象于洪滑之内，主上焦有痛。不为促结弦大而为细，其痛是郁热，非实火，治宜
解郁清肺化痰，不宜寒凉，不宜攻伐。余仿此。(王汉皋)
劳病吐血脉浮，若重诊无脉，是无根将脱也。一切虚病、老病、久病、产病，均贵重诊
有脉
也。大汗者，其脉轻诊弱，重诊强，乃有未出之汗，虽止之而不能止。若轻诊强，重诊无，
亦将脱也。惟浮沉皆得，脉力平缓，愈之象也。(王汉皋)
感寒者畏寒，左三部皆浮数，故身热而痛。左鱼际亦浮数而细，故头大痛。若右三部亦
浮数，则恶食。如无风则无汗，非阳明热者不渴。(王汉皋)
凡两关重取至数不匀，而见结促，即郁也。须解肝脾郁。在杂疾须先解郁，而后治病。
常有脉证相符，医治不应者，皆有郁未解也。(王汉皋)
按∶《褚氏遗书》多诊识脉。识脉者必辨脉，辨脉者辨其形象也。浮脉轻清在上，轻按
即见
，如木漂于水面也。沉脉重浊在下，重按乃得，如石坠于水底也。迟脉往来迟慢，为不及之
象。数脉往来急迫，为太过之象。大脉形粗，如箸如指。细脉形细，如丝如线。短脉不及本
位。长脉过乎本位。虚脉迟大而软，按之无力。实脉浮沉皆见，长大带弦，按而有力也。缓
脉往来和匀，如春风微吹杨柳梢也。濡脉浮而软，如帛在水中，轻按即见也。洪脉如洪水波
涛汹涌之象。浮而有力，来盛去衰，即大脉钩脉也。涩脉艰涩而迟，如轻刀刮竹也。滑脉流
利不止，如珠走盘也。弦脉刚劲而直，可以举百钧，有力之象。弱脉柔软而细，不能举一羽
，无力之象。芤脉中空，是实而空者，如搦葱管也。革脉中空，是实而空者，如按鼓皮也。
紧脉紧急有力，即不松之谓，如转索也。散脉浮散无力，即不聚之谓，如杨花飘散也。伏脉
沉伏于下，推筋着骨始见也。结脉迟而时有一止也。促脉数而时有一止也。动脉两头俱俯，
中间高起，形如豆粒，厥厥动摇也。代脉迟而中止，不能自还，每至一止有定数，如四时之
禅代不愆其期也。脉象既辨，而一部见二象、三象、四象者，乃一一能识也。是卷以幼科诊
治，脉理尚未备载，若广而求之，则有脉经在。(惕厉子)
\r左寸关尺图\pn-n6.bmp\r
左寸(表)小肠(里)心 主上焦
左关(表)胆(里)肝 主中焦
左尺(表)膀胱(里)肾 主下焦
掌后高骨为关，关前为寸，关后为尺。凡诊脉，视掌后高骨下指，先关后寸尺，人短则
指密排，人长则指疏排，为一定之法。
\r右寸关尺图\pn-n7.bmp\r
右寸(表)大肠(里)肺 主上焦
右关(表)胃(里)脾 主中焦
右尺(表)心包(里)命门 主下焦
小儿满一岁后，手腕短小，诊脉较为困难。医生需用单指转动侧按，来辨别寸、关、尺三部脉象，分别采用轻取（浮取）、中取、重取（沉取）的方法来候察脉象。左手有九种候法，右手也有九种候法。三至五岁的儿童，脉搏一息跳动七八次且脉细数，属于平和正常的脉象。脉搏次数增多为热证，减少为寒证。（引自《集成》）
浮脉：手指轻触皮肤表面即可触及。主表证，属腑，属阳。多由风邪及六淫外感引起。脉浮而有力为表实证，脉浮而无力为表虚证，两者皆见浮象。若病久体虚，临危之时，脉亦无力而浮，需以此与外感内伤相鉴别。（引自《心法》）
浮而极度虚弱散漫的为散脉，主神气离散、元气脱失。浮大中空如葱管的为芤脉，主失血。浮大中空如按鼓皮的为革脉，主精血亏耗。浮而柔细的为濡脉，主湿邪侵袭，也主血虚。浮而有力的为洪脉，主呕吐胀满，也主阳气盛阴虚。浮而无力的为虚脉，主血虚。（陈修园）
沉脉：手指重按至肌肉之下才能触及。主里证，属脏，属阴。多由七情内伤或饮食不节引起。但暴怒者、水肿者、腹痛剧烈者、瘟疫病经发汗攻下后邪气仍不得出者，脉象也会呈现沉象。（引自《心法》）
沉而极深着骨的为伏脉，主热邪内郁。沉而底部坚硬的为革脉（注：此处原文可能有误，通常革脉浮，此处依原文翻译），沉而细软的为弱脉，主气衰，但地位清贵之人也可能出现此脉。（陈修园）
迟脉：一息脉搏跳动二三次，或一次呼吸跳动一次。主寒证，属阴。脉迟有力为寒痛，脉迟无力为虚痛。伤暑、食滞、水饮困阻，以及冷风迫汗、气血凝滞等情况，脉象皆迟。（陈修园）
迟而从容和缓的为缓脉，迟而往来不畅的为涩脉，主血少。迟而偶尔停跳的为结脉，主积聚，也主阳气微弱，以及气郁、血壅、痰滞。迟而停跳有固定规律的为代脉，主气竭，孕妇见此脉无妨。（陈修园）
数脉：一息脉搏跳动五六次，或七八次。主热证，属阳。脉数有力为实热，脉数无力为虚热。但内部疼痛剧烈者、汗液将出者、虚阳即将外越者、泻痢、痞疡、刚分娩后、喘咳患者，脉象也会数。（陈修园）
数而流利圆滑的为滑脉，主痰饮、饮食积滞。数而牵转紧张的为紧脉，主寒证，主痛证。数而偶尔停跳的为促脉，主三焦郁火。数脉出现在关部为动脉，主痛证、主惊证，男子多见亡阳，女子多见血崩。（陈修园）
大脉：脉形粗大如手指或筷子。主实证，表示邪气盛，胃气衰，所以脉大但不缓和。（陈修园）
细脉：脉形细小如线。主虚证，属阴。也主真阴即将枯竭。（陈修园）
细而不明显的为微脉，主阳气微弱欲绝。细而小浮的为濡脉，细而小沉的为弱脉。（陈修园）
短脉：脉来短促，向上不及寸部，向下不及尺部。主素体虚弱，也主饮酒过度，以及三焦气机壅滞，宿食不消。（陈修园）
长脉：脉来迢长，向上超过鱼际，向下到达尺泽。主素体强壮，是平脉（正常脉象）。（陈修园）
虚脉：应指无力。主虚证。身热者为伤暑，不热者为血少。（陈修园）
虚而沉小的为弱脉，主血虚。虚而浮小的为濡脉，主气虚。虚而模糊不清的为微脉，主目系阳气绝。虚而干涩阻滞的为涩脉，主血虚，也主死血（瘀血）。虚而形小的为细脉，主气冷。虚而形缩的为短脉，主气损。（陈修园）
实脉：应指有力。主实证，也主热郁，以及伤食、气痛、谵语等证候。（陈修园）
实而流利的为滑脉，主血病。实而迢长的为长脉，主气滞。实而汹涌澎湃的为洪脉，主热极，也主内虚。实而端直如弦的为弦脉，主肝邪、症瘕、疝气、疟疾。（陈修园）
缓脉：一息四至，从容不迫。主正气恢复，是平脉。但缓而调和者主正气恢复，缓而怠惰者主中湿。（陈修园）
两手六部脉，初按皆为肺脉。因为肺为脏腑之华盖，凡是一切脏腑病变，其病气上熏于肺而反映在脉象上。心病六脉皆洪，肝病六脉皆弦，肾病六脉皆沉，肺病六脉皆涩，脾病六脉皆缓。按之指下浑浊者为邪气盛，清澈者为正气恢复；有神者为吉，无神者为凶；有力者为热、为实，无力者为寒、为虚，这是最准确的判断方法。（陈修园）
凡是内虚的病证，脉弱为宜，洪大则禁忌。外感病证，阳脉为宜，阴脉则禁忌。（陈修园）
凡是脉有胃气、有神气且和缓的吉利，符合时令特点的吉利，与面部五色中相生的一色相合的吉利，反之则为凶。（陈修园）
什么是无病脉？一息四至就是。什么叫五脏常脉？心脉宜洪，肺脉宜涩，肝脉宜弦，脾脉宜缓，肾脉宜沉，又兼有一段冲和之气，这就是胃气。什么叫四时平脉？春弦、夏洪、秋涩、冬沉、四季末月脉象和缓，就是。什么叫男女异脉？男子为阳，寸脉大于尺脉；女子为阴，尺脉大于寸脉，就是。（陈修园）
雀啄连连，止而又作，为肝绝。屋漏水落，半时一滴，为胃绝。弹石沉弦，按之指下搏动，为肾绝。忽密忽疏，乱如解索，为脾绝。本不动而末摇，如鱼之翔，为心绝。虾游冉冉，忽然一跃，为大肠绝。釜沸空浮，绝无根脚，为肺绝。（陈修园）
诊察外感病，初期则由经络传入，病在表，轻者寸脉浮盛，重者关尺脉也浮盛。等到传入里，内热重则脉沉。病在上部则见于寸脉，病在中部则见于关脉，病在下部则见于尺脉。（王汉皋）
寸脉伏，若无虚证，是风寒闭塞所致，属表虚，不可发汗。尺脉伏，若无虚证，是湿热闭塞所致，属里虚，不可利大小便。（王汉皋）
左脉弱，右脉强，主汗多、遗精、肝郁证。右脉弱，左脉强，主腹痛、易怒。如果误服补火丸散，必生肝热，出现滑精诸证。（王汉皋）
右脉盛，左手无脉，主痰结气虚。左脉盛，右手无脉，主食滞肝郁。（王汉皋）
脉有反象，都是郁极而闭阻所致。如肝病左关脉弦，郁结则脉弦而细，郁极则脉细而结，甚则脉伏。然而其弦脉反而见于相克之经，故右关脉弦。其余类推。（王汉皋）
保精日久的人，两尺脉俱盛，所以六脉重取皆实，不会患遗精病。（王汉皋）
男子右脉强，左脉沉细无力者，主气弱，内有湿热，不几日必遗精。若尺脉弱者，必定已经遗精。女子脉象如此者，必患白浊、白淫。脉有结象者，必患白带。（王汉皋）
寸脉强，尺脉弱，主阳实阴虚。每易患上证热下寒、上实下虚、浮阳上越、虚寒等证。（王汉皋）
寸脉弱，尺脉强，主阳虚阴实，每易患风寒及湿热等证。应当仔细辨别。（王汉皋）
凡是无病之人，浮取无脉，为表虚，以平时容易出汗为依据。即使有外感，发汗剂宜慎用。沉取无脉，为里虚，以平时容易腹泻为依据。即使有积滞，攻下剂宜慎用。中取迟弱者为中气虚，以平时不能进食、精神衰弱为依据。只有天生双伏脉的六阴脉，不在此论。因为其人能食且精神不衰弱为依据。（王汉皋）
一部脉出现三象四象，如右寸脉洪，是肺热；洪而滑，又有痰，其中有一线之细，是其虽细而力强，乃能在洪滑之内见到细象，主上焦有痛。如果不表现为促、结、弦、大而是细脉，其痛是郁热，非实火，治疗宜解郁清肺化痰，不宜用寒凉药，不宜攻伐。其余仿此类推。（王汉皋）
劳病吐血脉浮，若重诊无脉，是无根将脱之象。一切虚病、老病、久病、产后病，均贵重诊有脉。大汗者，其脉轻诊弱，重诊强，是有未出之汗，虽然止汗也不能止。若轻诊强，重诊无，也将脱绝。只有浮沉皆得，脉力平缓，是痊愈之象。（王汉皋）
感受寒邪者畏寒，左三部脉皆浮数，故身热而痛。左鱼际脉亦浮数而细，故头大痛。若右三部脉也浮数，则恶食。如无风则无汗，不是阳明热证就不渴。（王汉皋）
凡是两关重取至数不匀，而出现结脉、促脉，即是郁结。须解肝脾之郁。在杂病中须先解郁，而后治病。常有脉证相符，医治不应者，皆有郁未解也。（王汉皋）
按：《褚氏遗书》多有诊脉识脉之法。识脉者必辨脉，辨脉者辨其形象。浮脉轻清在上，轻按即见，如木漂于水面。沉脉重浊在下，重按乃得，如石坠于水底。迟脉往来迟慢，为不及之象。数脉往来急迫，为太过之象。大脉形粗，如箸如指。细脉形细，如丝如线。短脉不及本位。长脉过乎本位。虚脉迟大而软，按之无力。实脉浮沉皆见，长大带弦，按而有力。缓脉往来和匀，如春风微吹杨柳梢。濡脉浮而软，如帛在水中，轻按即见。洪脉如洪水波涛汹涌之象。浮而有力，来盛去衰，即大脉钩脉。涩脉艰涩而迟，如轻刀刮竹。滑脉流利不止，如珠走盘。弦脉刚劲而直，可以举百钧，有力之象。弱脉柔软而细，不能举一羽，无力之象。芤脉中空，是实而空者，如搦葱管。革脉中空，是实而空者，如按鼓皮。紧脉紧急有力，即不松之谓，如转索。散脉浮散无力，即不聚之谓，如杨花飘散。伏脉沉伏于下，推筋着骨始见。结脉迟而时有一止。促脉数而时有一止。动脉两头俱俯，中间高起，形如豆粒，厥厥动摇。代脉迟而中止，不能自还，每至一止有定数，如四时之禅代不愆其期。脉象既辨，而一部见二象、三象、四象者，乃一一能识也。是卷以幼科诊治，脉理尚未备载，若广而求之，则有脉经在。（惕厉子）
左寸（表）小肠（里）心 主上焦
左关（表）胆（里）肝 主中焦
左尺（表）膀胱（里）肾 主下焦
掌后高骨为关，关前为寸，关后为尺。凡诊脉，视掌后高骨下指，先关后寸尺，人短则指密排，人长则指疏排，为一定之法。
After a child reaches one year of age, the wrist is short and narrow, making pulse diagnosis difficult. The practitioner uses a single finger to rotate and press laterally to distinguish the Cun (Inch), Guan (Bar), and Chi (Cubit) positions, employing light pressure (Fu/Float), medium pressure, and heavy pressure (Chen/Sink) to examine the pulse. There are nine examination methods for the left hand and nine for the right hand. For children aged three to five, a pulse rate of seven to eight beats per respiration that is fine and rapid indicates a healthy state. An increased rate indicates Heat, while a decreased rate indicates Cold. (From *Jicheng*)
Floating Pulse (Fu Mai): Tangible upon light touch on the skin surface. It governs Exterior syndromes, belongs to the Fu organs, and is Yang in nature. It is caused by Wind pathogenic factors and the Six Exogenous Pathogens. A floating pulse with force indicates Exterior Excess, while a floating pulse without force indicates Exterior Deficiency; both present as Floating. In cases of prolonged weakness or impending death, the pulse may also be weak and floating, which serves to differentiate between exogenous and endogenous diseases. (From *Xinfa*)
The Scattered Pulse (San Mai) is extremely weak and floating, governing the dispersion of Spirit and depletion of Qi. The Chop-pulse (Kou Mai) floats like an onion stalk, governing blood loss. The Drums-skin Pulse (Ge Mai) floats like pressing a drum, governing loss of essence. The Soft Pulse (Ru Mai) is floating, soft, and fine, governing dampness injury and blood deficiency. The Surging Pulse (Hong Mai) is floating and forceful, governing vomiting and distension, and also indicates Yang excess with Yin deficiency. The Deficient Pulse (Xu Mai) is floating and weak, governing blood deficiency. (Chen Xiuyuan)
Deep Pulse (Chen Mai): Tangible only after heavy pressure below the muscle layer. It governs Interior syndromes, belongs to the Zang organs, and is Yin in nature. It is caused by Seven Emotions and dietary injuries. However, patients with violent anger, edema, severe abdominal pain, or plague where sweating and purgation fail to expel the pathogen may also present with a Deep pulse. (From *Xinfa*)
The Hidden Pulse (Fu Mai) sinks deeply to the bone, governing internal stagnation of Heat. The Ge Mai is hard at the bottom when deep; the Weak Pulse (Ruo Mai) is fine and soft when deep, governing Qi decline, though it may appear in individuals of high status. (Chen Xiuyuan)
Slow Pulse (Chi Mai): Two or three beats per respiration, or even one beat per respiration. It governs Cold and is Yin in nature. Forceful Slow pulse indicates Cold pain; weak Slow pulse indicates Deficient pain. Injuries from Summerheat, food stagnation, water retention, cold wind forcing sweat, and stagnation of Qi and Blood all present with a Slow pulse. (Chen Xiuyuan)
The Moderate Pulse (Huan Mai) is Slow but unhurried; the Choppy Pulse (Se Mai) is Slow and non-flowing, governing blood deficiency. the Knotted Pulse (Jie Mai) is Slow with occasional pauses, governing accumulations, also indicating mild Yang and Qi stagnation, blood obstruction, and phlegm retention. the Intermitting Pulse (Dai Mai) is Slow with regular pauses, governing Qi exhaustion, but is harmless in pregnancy. (Chen Xiuyuan)
Rapid Pulse (Shu Mai): Five to six beats per respiration, or seven to eight beats. It governs Heat and is Yang in nature. Forceful Rapid pulse indicates Excess Heat; weak Rapid pulse indicates Deficient Heat. However, patients with severe internal pain, those about to sweat, those with impending collapse of deficient Yang, dysentery,痞 (Pi) ulcers, postpartum women, asthma, and cough may also present with a Rapid pulse. (Chen Xiuyuan)
The Slippery Pulse (Hua Mai) is Rapid and smooth, governing phlegm and food accumulation. the Tight Pulse (Jin Mai) is Rapid and twisting/tense, governing Cold and Pain. the Hasty Pulse (Cu Mai) is Rapid with occasional pauses, governing stagnant Fire in the Triple Burner. the Moving Pulse (Dong Mai) appears at the Guan position, governing Pain and Fright; in men, it indicates Yang collapse; in women, uterine bleeding. (Chen Xiuyuan)
the Large Pulse (Da Mai) is thick and large like a finger or chopstick. It governs Excess, indicating abundant pathogenic factors and declining Stomach Qi, hence the pulse is Large but not relaxed. (Chen Xiuyuan)
the Surging Pulse (Hong Mai) is Large and boiling; the Solid Pulse (Shi Mai) is Large and hard. (Chen Xiuyuan)
the Fine Pulse (Xi Mai) is small and thin like a thread. It governs Deficiency and is Yin in nature. It also indicates impending depletion of True Yin. (Chen Xiuyuan)
the Micro Pulse (Wei Mai) is Fine and indistinct, indicating Yang Qi nearly exhausted. the Soft Pulse (Ru Mai) is Fine and superficially floating; the Weak Pulse (Ruo Mai) is Fine and deeply sinking. (Chen Xiuyuan)
the Short Pulse (Duan Mai) comes short, not reaching up to Cun or down to Chi. It governs constitutional weakness, alcohol injury, and Qi stagnation in the Triple Burner with undigested food. (Chen Xiuyuan)
the Long Pulse (Chang Mai) comes long, extending up to Yuji and down to Chize. It governs constitutional strength and is a normal pulse. (Chen Xiuyuan)
the Deficient Pulse (Xu Mai) feels weak under the finger. It governs Deficiency. Fever indicates Summerheat injury; absence of fever indicates blood deficiency. (Chen Xiuyuan)
Weak when Deep and Small governs Blood Deficiency. Soft when Floating and Small governs Qi Deficiency. Micro when vague governs the extinction of Yang Qi in the eyes. Choppy when dry and obstructed governs Blood Deficiency and dead blood (stasis). Fine when small in shape governs Cold Qi. Short when contracted in shape governs Qi damage. (Chen Xiuyuan)
the Solid Pulse (Shi Mai) feels forceful under the finger. It governs Excess, also heat stagnation, food injury, Qi pain, and delirium. (Chen Xiuyuan)
Slippery when Solid and smooth governs Blood disease. Long when Solid and extended governs Qi stagnation. Surging when Solid and boiling governs extreme Heat and also internal Deficiency. String-taut when Solid and straight governs Liver pathogens, masses, hernia, and malaria. (Chen Xiuyuan)
the Moderate Pulse (Huan Mai) has four beats per respiration, calm and unhurried. It governs the recovery of Zheng Qi and is a normal pulse. Harmonious Moderate pulse indicates Zheng recovery; lethargic Moderate pulse indicates Dampness invasion. (Chen Xiuyuan)
All six positions of both hands initially reflect the Lung pulse because the Lung is the canopy of the Zang and Fu organs; any organ pathology affects the Lung and manifests in the pulse. Heart disease presents with Surging pulses in all six positions; Liver disease with String-taut pulses; Kidney disease with Deep pulses; Lung disease with Choppy pulses; Spleen disease with Moderate pulses. Turbid feeling under the finger indicates strong pathogens; clear feeling indicates Zheng recovery. Pulses with Shen (Spirit) are auspicious; those without Shen are ominous. Forceful pulses indicate Heat and Excess; weak pulses indicate Cold and Deficiency. This is the most reliable method. (Chen Xiuyuan)
For internal Deficiency diseases, a Weak pulse is appropriate, while Large and Surging pulses are contraindicated. For external contraction diseases, Yang pulses are appropriate, while Yin pulses are contraindicated. (Chen Xiuyuan)
Pulses with Wei Qi (Stomach Qi), Shen (Spirit), and harmony are auspicious; those conforming to the seasons are auspicious; those generating mutually productive relationships with the five colors of the face are auspicious; the opposite is inauspicious. (Chen Xiuyuan)
What is the pulse of a healthy person? Four beats per respiration. What are the constant pulses of the five Zang organs? Heart should be Surging, Lung Choppy, Liver String-taut, Spleen Moderate, Kidney Deep, combined with a harmonious Qi, which is the Wei Qi. What are the normal seasonal pulses? Spring String-taut, Summer Surging, Autumn Choppy, Winter Deep, and Moderate at the end of each season. What are the different pulses of men and women? Men are Yang, with Cun larger than Chi; Women are Yin, with Chi larger than Cun. (Chen Xiuyuan)
Sparrow-pecking continuously, stopping then starting again, indicates Liver exhaustion. Water dripping from a leaking roof, one drop every half hour, indicates Stomach exhaustion. Beating stone, deep and string-taut, pulsating under the finger, indicates Kidney exhaustion. Suddenly dense then sparse, chaotic like untied cords, indicates Spleen exhaustion. Base still but tip shaking, like a fish swimming, indicates Heart exhaustion. Shrimp swimming slowly, suddenly leaping once, indicates Large Intestine exhaustion. Cauldron boiling, empty and floating, lacking roots, indicates Lung exhaustion. (Chen Xiuyuan)
Diagnosing external contractions: initially, the pathogen enters the meridians, remaining in the Exterior. Mild cases show surging Floating pulses at Cun; severe cases show surging Floating pulses at Guan and Chi. Once transmitted to the Interior, if internal Heat is severe, the pulse becomes Deep. Diseases in the Upper Jiao manifest at Cun; Middle Jiao at Guan; Lower Jiao at Chi. (Wang Hangao)
If the Cun pulse is Hidden without Deficiency signs, it is due to Wind-Cold closure, representing Exterior Deficiency, and sweating therapy is contraindicated. If the Chi pulse is Hidden without Deficiency signs, it is due to Damp-Heat closure, representing Interior Deficiency, and promoting urination or defecation is contraindicated. (Wang Hangao)
Left pulse weak, Right pulse strong: governs excessive sweating, seminal emission, and Liver Qi stagnation. Right pulse weak, Left pulse strong: governs abdominal pain and irritability. Misuse of warming pills/powders will generate Liver Heat and symptoms like slippery seminal emission. (Wang Hangao)
Right pulse strong, Left pulse absent: governs Phlegm accumulation and Qi Deficiency. Left pulse strong, Right pulse absent: governs food stagnation and Liver Qi stagnation. (Wang Hangao)
Reversed pulse images result from extreme stagnation and blockage. For example, Liver disease shows String-taut pulse at Left Guan; stagnation makes it String-taut and Fine; extreme stagnation makes it Fine and Knotted, or even Hidden. However, the String-taut quality may appear in the counteracting meridian, hence String-taut at Right Guan. Other cases follow this logic. (Wang Hangao)
Those who preserve Jing for a long time have strong pulses at both Chi positions, so all six pulses feel Solid upon heavy pressure, and they do not suffer from seminal emission. (Wang Hangao)
Men with strong Right pulse and sunken, fine, weak Left pulse: governs Qi weakness and internal Damp-Heat, leading to seminal emission within days. If Chi pulse is weak, seminal emission has already occurred. Women with such pulses suffer from white turbidity or leukorrhea. Pulses with Knotted qualities indicate leukorrhea. (Wang Hangao)
Strong Cun pulse, weak Chi pulse: governs Yang Excess and Yin Deficiency. Prone to upper Heat/lower Cold, upper Excess/lower Deficiency, floating Yang rising, and Deficient Cold. (Wang Hangao)
Weak Cun pulse, strong Chi pulse: governs Yang Deficiency and Yin Excess. Prone to Wind-Cold and Damp-Heat. Careful differentiation is required. (Wang Hangao)
Healthy individuals: No pulse upon light pressure indicates Exterior Deficiency, based on habitual sweating. Even with external contraction, sweating agents must be used cautiously. No pulse upon heavy pressure indicates Interior Deficiency, based on habitual diarrhea. Even with stagnation, purgative agents must be used cautiously. Slow and weak pulse upon medium pressure indicates Middle Qi Deficiency, based on inability to eat and weak spirit. Only congenital Double-Hidden pulses (Six Yin Pulses) are excluded, as these individuals can eat and have strong spirits. (Wang Hangao)
When one position shows three or four pulse images, e.g., Right Cun is Surging (Lung Heat); Surging and Slippery indicates Phlegm; a thread of Fine within indicates that although Fine, the force is strong, visible within the Surging-Slippery image, governing upper Jiao pain. If it is Fine rather than Hasty, Knotted, String-taut, or Large, the pain is due to Stagnant Heat, not Excess Fire. Treatment should resolve stagnation, clear Lung, and transform Phlegm, avoiding cold/cooling herbs and attacking therapies. Others follow this pattern. (Wang Hangao)
In consumption diseases with hematemesis, if the pulse is Floating but disappears upon heavy pressure, it indicates rootless Qi about to collapse. For all Deficiency, elderly, chronic, and postpartum diseases, having a pulse upon heavy pressure is crucial. In excessive sweating, if the pulse is weak on light pressure but strong on heavy pressure, it indicates unexpressed sweat; stopping it is impossible. If strong on light pressure but absent on heavy pressure, collapse is imminent. Only pulses felt at both Floating and Deep levels with moderate force indicate recovery. (Wang Hangao)
Cold contraction causes aversion to cold; Left Three Positions are Floating and Rapid, causing fever and pain. Left Yuji is also Floating, Rapid, and Fine, causing severe headache. If Right Three Positions are also Floating and Rapid, there is food aversion. Without Wind, there is no sweat; without Yangming Heat, there is no thirst. (Wang Hangao)
If the two Guan positions show irregular rates with Knotted or Hasty qualities upon heavy pressure, it indicates Stagnation. One must resolve Liver and Spleen Stagnation. In miscellaneous diseases, resolve Stagnation first, then treat the disease. Cases where pulse and symptoms match but treatment fails often involve unresolved Stagnation. (Wang Hangao)
Note: *Chu Shi Yi Shu* contains much knowledge on pulse diagnosis. Identifying pulses requires distinguishing their images. Floating pulse is light and clear above, visible on light touch, like wood floating on water. Deep pulse is heavy and turbid below, felt only on heavy touch, like a stone sinking. Slow pulse is sluggish, indicating insufficiency. Rapid pulse is urgent, indicating excess. Large pulse is thick, like a chopstick or finger. Fine pulse is thin, like silk or thread. Short pulse does not reach its proper position. Long pulse exceeds its proper position. Deficient pulse is slow, large, and soft, weak on pressure. Solid pulse is seen at both Floating and Deep levels, large and long with a String-taut quality, forceful on pressure. Moderate pulse is even and harmonious, like spring breeze blowing willow tips. Soft pulse is Floating and soft, like silk in water, visible on light touch. Surging pulse resembles turbulent floodwaters. Floating and forceful, vigorous onset and declining termination, is the Large/Gou pulse. Choppy pulse is rough and slow, like scraping bamboo with a sharp knife. Slippery pulse flows continuously, like pearls rolling on a plate. String-taut pulse is rigid and straight, capable of lifting heavy weights, a sign of force. Weak pulse is soft and fine, unable to lift a feather, a sign of weakness. Chop-pulse is hollow inside, solid yet empty, like squeezing an onion stalk. Drums-skin pulse is hollow inside, solid yet empty, like pressing a drum skin. Tight pulse is urgent and forceful, i.e., not loose, like twisting cords. Scattered pulse is Floating, scattered, and weak, i.e., not gathered, like poplar catkins drifting. Hidden pulse sinks deeply, felt only by pushing tendons to the bone. Knotted pulse is Slow with occasional stops. Hasty pulse is Rapid with occasional stops. Moving pulse dips at both ends, rises in the middle, shaped like a bean, trembling vigorously. Intermitting pulse is Slow with central stops, unable to recover itself, stopping regularly at fixed intervals, like the succession of seasons without error. Once pulse images are distinguished, multiple images in one position can be identified. This volume focuses on pediatric diagnosis, so pulse theory is not fully covered; for comprehensive study, refer to *Mai Jing*. (Tili Zi)
Left Cun (Exterior) Small Intestine (Interior) Heart - Governs Upper Jiao
Left Guan (Exterior) Gallbladder (Interior) Liver - Governs Middle Jiao
Left Chi (Exterior) Bladder (Interior) Kidney - Governs Lower Jiao
The high bone behind the palm is the Guan position; anterior to Guan is Cun; posterior to Guan is Chi. In pulse diagnosis, place fingers relative to the high bone behind the palm, starting with Guan, then Cun and Chi. For shorter individuals, fingers are placed closely; for taller individuals, fingers are spaced apart. This is a fixed rule.
Right Cun (Exterior) Large Intestine (Interior) Lung - Governs Upper Jiao
Right Guan (Exterior) Stomach (Interior) Spleen - Governs Middle Jiao
Right Chi (Exterior) Pericardium (Interior) Mingmen - Governs Lower Jiao