春脉弦，其气来柔软弱虚而滑，端直以长，名之曰弦，反此者病，其气来实而强，名为
太过，病在外，其气来不实而微，此为不及，病在中，太过则令人善忘忽忽。冒眩巅疾，不
及则令人胸痛引背下，两胁 满。
夏脉钩，其气来盛去衰，反此者病，其气来盛去亦盛，此为太过。病在外，其气来不盛
，去反盛，此为不及，病在中，太过则令人身热而肤痛，为浸湿，不及则令人烦心，上见咳
唾，下为气泄。
秋脉浮，其气来轻虚以浮，其气来急去散，故曰浮。反此者病，帝曰∶何如反，其气来
毛而中央坚，而两旁虚，此谓太过，病在外，其气来毛而微，此谓不及，病在中，太过则令
人逆气而背痛，愠愠然，不及则令人喘，呼吸少气而咳，上气见血，下闻病音。
冬脉营，其气来沉而博，故曰营。反此者病，其气来如弹石者，此谓太过，病在外，其
去如数者，此谓不及，病在中，太过则令人解 ，脊脉痛而少气，不欲言，其不及则令人心
悬。如病饥，眇中清，脊中痛，少腹满，小便变。
脾无善脉，止见恶脉，盖脾脉以和缓为主。故四时之脉虽不同，春脉弦，夏脉钩，秋脉
毛，冬脉营，皆要有脾脉，若脾脉不见，便是五脏真脉见，真脉见者死，所以脾无善脉者，
谓其常脉便是吉脉，其太过不及，皆为病脉，太过则令人四肢不举，其来如水之流者、太过
也，湿胜则然耳，不及则令人九窍不通，名曰重强，其来如鸟之啄者、不及也，土不用事则
然耳，湿胜而其脉如流，邪乃伤肾，土不用事而九窍不利，因受木所制，木制则脾受水矣，
九窍不利，故多生浮肿胀满之疾，久而成水。
春季的脉象呈弦象，其脉搏来势柔软、弱、虚而滑利，端正且长，称为弦脉；与此相反则为病态。若脉搏来势坚实有力，称为“太过”，病位在体表；若脉搏来势不实而微弱，称为“不及”，病位在体内。“太过”会导致人容易遗忘、神情恍惚、头晕目眩甚至头部疾病；“不及”则会导致胸痛牵引至背部，两侧胁肋部胀满。
夏季的脉象呈钩象（洪大），其脉搏来势盛大而去势衰弱，与此相反则为病态。若脉搏来势盛大，去势也盛大，称为“太过”，病位在体表；若脉搏来势不盛大，去势反而盛大，称为“不及”，病位在体内。“太过”会导致身体发热且皮肤疼痛，表现为湿邪浸渍的症状；“不及”会导致心烦意乱，上部出现咳嗽吐痰，下部出现气泄（如遗尿或失气）。
秋季的脉象呈浮象，其脉搏来势轻虚而浮，来势急而去势散，所以称为浮脉。与此相反则为病态。黄帝问：怎样算是相反？若脉搏来势如羽毛般轻浮但中间坚硬而两旁虚弱，这称为“太过”，病位在体表；若脉搏来势如羽毛般轻浮而微弱，这称为“不及”，病位在体内。“太过”会导致人气逆和背痛，心中郁闷不快；“不及”会导致人喘息，呼吸短少并伴有咳嗽，气逆吐血，下部可听到病变的声音（如肠鸣等）。
冬季的脉象呈营象（沉），其脉搏来势深沉而搏动有力，所以称为营脉。与此相反则为病态。若脉搏来势像弹石一样坚硬，这称为“太过”，病位在体表；若脉搏去势急促（数），这称为“不及”，病位在体内。“太过”会导致人肌肉松弛无力（解㑊），脊柱经脉疼痛且气短，不想说话；“不及”会导致人心悬空感，如同患饥饿病，季胁部清冷，脊柱疼痛，小腹胀满，小便异常。
脾脏没有所谓的“善脉”（完美的脉象），只见到“恶脉”（异常的脉象），因为脾脉以平和缓柔为主。所以四季的脉象虽然不同，春脉弦，夏脉钩，秋脉毛，冬脉营，但都必须兼有脾脉的特征。如果看不到脾脉的特征，那就是五脏的“真脏脉”显露，真脏脉显露者主死。所以说脾没有善脉，是指其正常的脉象本身就是吉利的脉象，无论是太过还是不及，都属于病脉。太过会导致四肢不能抬举，其脉象如水流动般滑利无度，这是太过，是湿邪偏胜所致；不及会导致九窍不通畅，称为“重强”，其脉象如鸟啄食般短促，这是不及，是土气不旺所致。湿邪偏胜时脉象如水流，邪气会伤害肾脏；土气不旺导致九窍不利，是因为受到肝木的克制，木克土则脾受水湿侵害，九窍不利，因此多产生浮肿、胀满的疾病，日久便形成水肿。
The pulse of spring is Xian (String-like). Its arrival is soft, weak, empty, and slippery, straight and long; this is called Xian. If it is contrary to this, it indicates disease. If its arrival is solid and strong, it is called "Excess" (Tai Guo), indicating disease in the exterior. If its arrival is not solid but faint, it is called "Deficiency" (Bu Ji), indicating disease in the interior. Excess causes one to be prone to forgetfulness, mental confusion, dizziness, and disorders of the head and vertex. Deficiency causes chest pain radiating to the back and fullness in both hypochondriac regions.
The pulse of summer is Gou (Hook-like). Its arrival is vigorous while its departure is weak; if contrary to this, it indicates disease. If its arrival is vigorous and its departure is also vigorous, this is called "Excess," indicating disease in the exterior. If its arrival is not vigorous but its departure is relatively vigorous, this is called "Deficiency," indicating disease in the interior. Excess causes body heat and skin pain, manifesting as dampness infiltration. Deficiency causes vexation and anxiety, with coughing and expectoration appearing above, and Qi leakage (such as enuresis or flatus) below.
The pulse of autumn is Fu (Floating). Its arrival is light, empty, and floating; its arrival is rapid while its departure is scattered; thus it is called Fu. If contrary to this, it indicates disease. The Yellow Emperor asked: How is it contrary? If the arrival feels like a feather but is firm in the center and empty on both sides, this is called "Excess," indicating disease in the exterior. If the arrival is feather-like and faint, this is called "Deficiency," indicating disease in the interior. Excess causes rebellious Qi and back pain, with a feeling of oppression. Deficiency causes panting, shortness of breath, and coughing, with blood appearing due to rebellious Qi, and pathological sounds audible below.
The pulse of winter is Ying (Surging/Deep). Its arrival is deep and broad, thus it is called Ying. If contrary to this, it indicates disease. If the arrival feels like throwing stones, this is called "Excess," indicating disease in the exterior. If the departure is rapid, this is called "Deficiency," indicating disease in the interior. Excess causes muscle relaxation (Xie Ji), pain in the spinal meridians, shortness of breath, and reluctance to speak. Deficiency causes a sensation of the heart hanging empty, as if suffering from hunger, coldness in the lateral costal region, spinal pain, lower abdominal fullness, and changes in urination.
The Spleen has no "auspicious pulse" (perfect pulse); only "inauspicious pulses" (abnormal pulses) are seen, because the Spleen pulse is primarily characterized by harmony and moderation. Therefore, although the pulses of the four seasons differ—Spring Xian, Summer Gou, Autumn Mao (Feather-like), Winter Ying—they must all contain the characteristic of the Spleen pulse. If the Spleen pulse characteristics are absent, it means the True Pulse of the Zang organs is revealed. When the True Pulse is revealed, death ensues. Thus, saying the Spleen has no auspicious pulse means that its normal pulse is itself an auspicious sign. Both Excess and Deficiency are pathological pulses. Excess causes the limbs to be unable to move; its pulse flows like water, which is Excess, caused by excessive Dampness. Deficiency causes the nine orifices to be obstructed, named "Zhong Qiang" (Heavy Stiffness); its pulse is like a bird pecking, which is Deficiency, caused by the failure of Earth Qi to function. When Dampness is excessive, the pulse flows like water, and pathogenic factors injure the Kidney. When Earth Qi fails to function and the nine orifices are obstructed, it is because it is constrained by Wood. Wood constraining leads to the Spleen being harmed by Water. Due to the obstruction of the nine orifices, diseases such as edema, swelling, and fullness often arise, eventually forming fluid retention.