仲景云∶脉来缓（缓当作迟）时一止复来者名曰结，又脉来动而中止，更来小数，中有还者
反动名曰结，阴也。脉来动而中止不能自还，此动而中止复来，代也，得此脉者必难治。自还者，
此动而中止复来数于前动也。不
能自还者，动而中止复来如前动同而不数也。故有结脉者有促脉者有代脉者。结者阴也，阴盛则
结。脉来缓，时一止复来曰结，主胸满烦躁。促者阳也，阳盛则促。脉来数，时一止复来曰促，
主积聚气痞，忧思所成。大抵结促之脉虽时一止，为病脉，非死也，惟代者真死矣。往来缓动，
中止不能自还，周而复动名曰代也。代者死也。仲景《伤寒论》云∶脉促代，心悸动，炙甘草汤主之。
高阳生，五代时人，着《脉诀歌括》，托为王氏叔和，而今本杂以洁古《伤寒脉入式歌》，
又被熊宗立妄注，大为俗学之惑。叔和晋人也，自有《脉经》，尚复抵牾大段古书，难尽信也。
脉家书甚多，当以《内经》为主。滑氏《诊家枢要》以浮沉迟数滑涩六者为提纲，余补以有力无
力二者。丹溪以血气痰火为病之提纲，则脉滑在血分而有余为痰，凡有形者从之；涩在气分而有
余为火，凡无形者从之。浮在表，沉在里，迟为寒，数为热，有力为实，无力为虚。执此提纲，
脉可得而明矣。（《医通》）
张仲景说：脉搏跳动缓慢，偶尔停跳一次后又恢复搏动的，称为结脉；又有一种情况是脉搏跳动过程中突然中止，随后再次搏动时频率稍快，且中间有回返之象，这种也叫做结脉，属于阴证。另一种情况是脉搏跳动过程中突然中止，不能自行恢复，虽然之后再次搏动，但这是代脉，出现这种脉象的患者必定难以治愈。“能自还”是指脉搏中止后再次搏动的次数比之前频繁；“不能自还”是指脉搏中止后再次搏动与之前的搏动相同，并不比之前频繁。因此，有的脉象是结脉，有的是促脉，有的是代脉。结脉属阴，阴气过盛则形成结脉。脉搏跳动缓慢，偶尔停跳一次后又恢复的，称为结脉，主要主胸中胀满、烦躁不安。促脉属阳，阳气过盛则形成促脉。脉搏跳动快速，偶尔停跳一次后又恢复的，称为促脉，主要主体内积聚、气机痞塞，多由忧思所导致。大抵来说，结脉和促脉虽然偶尔停跳，属于病脉，但并非死脉；只有代脉才是真死脉。脉搏往来缓慢，中途停止且不能自行恢复，周而复始地搏动，称为代脉。代脉主死亡。张仲景在《伤寒论》中说：脉搏出现促脉或代脉，伴有心悸动摇症状的，用炙甘草汤主治。
高阳生是五代时期的人，撰写了《脉诀歌括》，假托为王氏叔和（王叔和）所作，而现在的版本中混杂了洁古（张元素）的《伤寒脉入式歌》，又被熊宗立胡乱加注，大大被世俗学者所迷惑。王叔和是晋代人，自有《脉经》，尚且与大部分古书相抵触，难以完全相信。脉学书籍很多，应当以《黄帝内经》为主流标准。滑寿的《诊家枢要》以浮、沉、迟、数、滑、涩六种脉象作为提纲，我补充了有力和无力的两种辨别方法。朱丹溪以血、气、痰、火作为疾病的提纲，那么脉滑表示血分有余而为痰，凡是形质存在的病邪顺其性质治疗；脉涩表示气分有余而为火，凡是无形质的病邪顺其性质治疗。浮脉主表证，沉脉主里证，迟脉主寒证，数脉主热证，有力为实证，无力为虚证。掌握这个提纲，脉象就可以辨明清楚了。（出自《古今医统大全》引《医通》）
Zhang Zhongjing stated: When the pulse is slow (slow should be interpreted as delayed) and stops occasionally before resuming, it is called Jie Pulse (Knotted Pulse). Another manifestation is when the pulse movement stops abruptly, resumes with a slightly faster rate, and shows a returning rebound; this is also called Jie Pulse, indicating a Yin syndrome. If the pulse movement stops abruptly and cannot recover on its own, although it resumes later, this is Dai Pulse (Intermittent Pulse); patients with this pulse are difficult to treat. "Recovering on its own" means that after the stop, the subsequent pulsations occur more frequently than before. "Cannot recover on its own" means that after the stop, the resumption of pulsation is identical to the previous rhythm without increased frequency. Therefore, there are Jie Pulses, Cu Pulses, and Dai Pulses. Jie Pulse belongs to Yin; an excess of Yin leads to Jie Pulse. A slow pulse that stops occasionally and then resumes is called Jie Pulse, primarily indicating chest fullness and irritability. Cu Pulse belongs to Yang; an excess of Yang leads to Cu Pulse. A rapid pulse that stops occasionally and then resumes is called Cu Pulse (Rapid Intermittent Pulse), primarily indicating accumulation and Qi stagnation (Pi Syndrome), often caused by worry and overthinking. Generally speaking, although Jie and Cu pulses stop occasionally and are pathological, they are not fatal; only Dai Pulse indicates true death. When the pulse moves slowly, stops midway, cannot recover on its own, and repeats cyclically, it is called Dai Pulse. Dai Pulse indicates death. Zhang Zhongjing in *Shanghan Lun* (Treatise on Cold Damage Disorders) stated: When the pulse presents as Cu or Dai accompanied by palpitations, Zhi Gancao Tang (Honey-P fried Licorice Decoction) should be used.
Gao Yangsheng was a person from the Five Dynasties period who wrote *Maijue Ge Kua* (Songbook of Pulse Secrets), falsely attributing it to Wang Shuhe. The current version mixes Jiegu's (*Zhang Yuansu*) *Shanghan Mai Rushi Ge*, and has been wrongly annotated by Xiong Zongli, greatly confusing vulgar scholars. Wang Shuhe was a Jin Dynasty scholar who authored *Mai Jing* (Pulse Classic); even his work contradicts many ancient texts, so it cannot be fully trusted. There are many pulse books, but one should take *Neijing* (Inner Canon of the Yellow Emperor) as the primary authority. Hua Shi (Hua Sui) in *Zhenjia Shuyao* (Key Essentials of Pulse Diagnosis) took Floating, Deep, Slow, Rapid, Slippery, and Choppy as the outline, and I supplemented it with Forceful and Weak categories. Zhu Danxi took Blood, Qi, Phlegm, and Fire as the outline for diseases. Thus, a Slippery pulse indicates excess in the Blood aspect manifesting as Phlegm; for tangible pathogens, treat according to their nature. A Choppy pulse indicates excess in the Qi aspect manifesting as Fire; for intangible pathogens, treat according to their nature. Floating indicates Exterior syndromes, Deep indicates Interior syndromes, Slow indicates Cold, Rapid indicates Heat, Forceful indicates Excess syndromes, and Weak indicates Deficiency syndromes. By grasping this outline, the pulse can be clearly understood. (From *Yitong*)