东垣云∶不病之脉，不求其神，而神无不在也；有病之脉，则当求其神之有无。谓如六数、七极，热
也，脉中（此中字浮中沉之有）有力（言有胃气）即有神矣，为泄其热；三迟、二败，寒也，脉中有
力（说并如上）即有神矣，为去其寒。若数极、迟败中，不复有力，为无神也，将何所恃耶？苟不知此，
而遽泄之、去之，神将何以根据而主耶？故经曰∶脉者气血之先，气血者人之神也。善夫！
浮，不沉也。按之不足，轻举有余，满指浮上曰浮。为风虚动之候，为胀，为风，为痞，为满不食，
为表热，为喘。浮大，伤风鼻塞。浮滑疾，为宿食。浮滑，为饮。左寸浮主伤风发热，头疼目眩及风痰，浮
而虚迟，心气不足，心神不安，浮散心气耗，虚烦，浮而洪数心经热；关浮，腹胀，浮而数风热入肝经，浮
而促怒气伤肝，心胸逆满，浮大胸胁胀满，尺浮膀胱风热，小便赤涩，浮大而芤男子小便血，妇人崩带，
浮而迟冷疝脐下痛。右寸浮肺感风寒，咳喘，清涕，自汗，体倦，浮而洪，肺热而咳，浮而迟肺寒喘嗽；
关浮脾虚中满不食，浮大而涩为宿食，浮而迟脾胃
虚，尺浮风邪客下焦，大便秘，浮而虚元气不足，浮而数下焦风热，大便秘。
沉，不浮也。轻手不见，重手乃得，为阴逆阳郁之候，为实，为寒，为气，为水，为停饮，为
瘕，
为胁胀，为厥逆，为洞泄。沉细为少气，沉迟为痼冷，沉滑为宿食，沉伏为霍乱。沉而数内热，沉而迟
内寒，沉而弦心腹冷痛。左寸沉心内寒邪为痛，胸中寒饮胁疼；关沉伏寒在经，两胁刺痛，沉弦 癖内痛；
尺沉肾脏感寒，腰背冷痛，小便浊而频，男为精冷，女为血结，沉而细，胫酸阴痒，溺有余沥。右寸沉肺
冷寒痰停蓄，虚喘少气，沉而紧滑咳嗽，沉细而滑，骨蒸寒热，皮毛焦干；关沉胃中寒积，中满吞酸；沉
紧悬饮；尺沉病水，腰脚疼，沉细下利，又为小便滑，脐下冷痛。
迟，不及也。以至数言之，呼吸之间，脉仅三至，减于平脉一至也。为阴盛阳亏之候，为寒，为不
足。浮而迟，表有寒；沉而迟，里有寒。居寸为气不足，居尺为血不足。气寒则缩，血寒则凝也。左寸迟
心上寒，精神多惨；关迟筋寒急，手足冷，胁下痛；尺迟肾虚便浊，女人不月。右寸迟肺感寒，冷痰气短；
关迟中焦寒及脾胃伤冷物，不食，沉迟为积；尺迟为脏寒泄泻，少腹冷痛，腰脚重。
数，太过也。一息六至，过平脉两至也。为烦满。
上为头疼、上热；中为脾热口臭、胃烦、呕逆；右为颊热、目赤；左下为小便黄赤、大便秘涩。浮数表有
热，沉数里有热。
虚，不实也。散大而软，举按豁然，不能自固，气血俱虚之诊也。为暑，为虚烦、多汗，为恍惚、多
惊，为小儿惊风。
实，不虚也。按举不绝，逼逼而长，动而有力，不疾不迟。为三焦气满之候，为呕，为痛，为气塞，
为食积，为气聚，为痢，为伏阳在内。左寸实心中积热，口舌疮，咽痛，实大头面热风，烦躁体疼，面
赤；关实腹胁痛，满实而浮大肝盛，目暗赤痛；尺实少腹痛，小便涩，实而滑淋沥、茎痛、溺赤，实大膀
胱热溺难，实而紧腰痛。右寸实胸中热，痰嗽烦满，实而浮肺热，咽燥痛，喘咳气壅；关实伏阳蒸内，脾
虚食少，胃气滞，实而浮脾热消中，善饥，口干，劳倦；尺实脐下痛，便难，或时下痢。
洪，大而实也。举按有余，来至大而去且长，腾上满指。为荣络大热，血气燔灼之候，为表里皆热，
为烦，为咽干，为大小便不通。左寸洪心经积热，眼赤，口疮，头痛，内烦；关洪肝热及身痛，四肢浮
热；尺洪膀胱热，小便赤涩。右寸洪肺热毛焦，唾粘咽干，洪而紧喘急；关洪胃热，反胃，呕吐，口干，
洪而紧为胀；尺洪腹满，大便难，或下血。
微，不显也。依稀轻细，若有若无。为血气俱虚之候，为虚弱，为泄，为虚汗，为崩漏败血不止，为
少气。浮而微者，阳不足，必身恶寒；沉而微者，阴不足，主脏寒下利。左寸微心虚忧惕，荣血不足；关
微四肢恶寒拘急；尺微败血不止，男为伤精尿血，女为崩带。右寸微上焦寒痞，冷痰不化，中寒少气；关
微胃寒气胀，食不化，脾虚噫气，心腹冷痛；尺微脏寒泄泻，脐下冷痛。
弦，按之不移，举之应手，端直如丝弦。为血气收敛，为阳中伏阴，或经络间为寒所入，为痛，为
疟，为拘急，为寒热，为血虚盗汗，为寒凝气结，为冷痹，为疝，为饮，为劳倦。弦数为劳疟，双弦胁急
痛，弦长为积。左寸弦头疼，心惕，劳伤，盗汗，乏力；关弦胁肋痛， 癖，弦紧为疝瘕，为瘀血，弦小
寒癖；尺弦少腹痛，弦滑腰脚痛。右寸弦肺受寒咳嗽，胸中有寒痰；关弦脾胃伤冷，宿食不化，心腹冷
痛，又为饮；尺弦脐下急痛不安，下焦停水。
缓，不逮也。往来迂缓，呼吸徐徐，以气血向衰，故脉体为之徐缓尔！为风，为虚，为痹，为弱，为
痛。在上为项强，在下为脚弱。浮缓为风，沉缓血气虚，左寸缓心气不足，怔忡多忘，亦主项背急痛；关
缓风虚眩晕，腹胁气结；尺缓肾虚冷，小便数，女人月事多。右寸缓肺气浮，言语气短；关缓胃弱气虚，
浮缓脾气虚弱。不沉不浮从容和缓，乃脾家本脉也；尺缓下寒脚弱，风气秘滞，浮缓肠风泄泻，沉缓小腹
感冷。
滑，不涩也。往来流利，如珠走盘，不进不退，为血实气壅之候，盖血不胜于气也。为呕吐，为痰
逆，为宿食，为经闭。滑而不断经不闭，其断者经闭。上为吐逆，下为气结，滑数为结热。左寸滑心
热，滑而实大心惊舌强；关滑肝热，头目为患；尺滑小便淋沥，尿赤，茎中痛。右寸滑痰饮呕逆，滑而实
肺热毛发焦，膈壅咽干，痰嗽，头目昏，涕唾粘；关滑脾热口臭及宿食不化吐逆，滑实胃热；尺滑因相
火炎而引饮多，脐冷腹鸣，或时下利，妇人主血实气壅，月事不通，若和滑为孕。
涩，不滑也。虚细而迟，往来极难，参伍不调，如雨沾沙，如轻刀刮竹然。为气多血少之候，为少
血，为亡汗，为血痹痛，为伤精，女人有孕为胎痛，无孕为败血病。左寸涩心神虚耗不安及冷气心痛；关
涩肝虚血散，肋胀胁满身痛；尺涩男子伤精及疝，女人月事虚败，若有孕主胎漏。右寸涩荣卫不和，上焦
冷痞，气短，臂痛；关涩脾弱不食，胃冷而呕；尺涩大便涩，津液不足，小腹寒，足胫逆冷。（经云∶滑者伤
热，涩者中雾露金革。）
长，不短也。指下有余，而过于本位，气血皆有
余也。为阳毒内蕴，三焦烦郁，为壮热。
短，不长也。两头无中间有，不及本位，气不足以前导其血也。为阴中伏阳，为三焦气壅，为宿食
不消。
大，不小也。浮取之若洪而浮，沉取之大而无力。为血虚气不能相入也。经曰∶大则病进。
小，不大也。浮沉取之悉皆损小。在阳为阳不足，在阴为阴不足；前大后小，则头疼、目眩；前小
后大，则胸满、短气。
紧，有力而不缓也。其来劲急，按之长，举之若牵绳转索之状。为邪风激搏，伏于荣卫之间，为痛，为
寒。浮紧为伤寒身疼；沉紧为腹中有寒，为风痫。左寸紧头热目痛项强，紧而沉心中气逆冷痛；关紧心腹
满痛，胁痛肋急，紧而盛伤寒浑身痛，紧而实 癖；尺紧腰脚脐下痛，小便难。右寸紧鼻塞膈壅，紧而沉
滑肺实咳嗽；关紧腹痛吐逆，紧盛腹胀伤食；尺紧下焦筑痛。
弱，不盛也。极沉细而软，怏怏不前，按之欲绝未绝，举之即无。由精气不足，故脉息痿弱而不振
也。为元气亏耗，为痿弱不前，为痼冷，为哄热，为泄精，为虚汗。老得之顺，壮得之逆。左寸弱阳
虚，心悸自汗；关弱筋痿无力，妇人主产后客风面肿；尺弱小便数，肾虚耳聋，骨肉酸痛。右寸弱身冷多寒，
胸中短气；关弱脾胃虚食不化；尺弱下焦冷痛，大便滑。
动，其状如大豆厥厥动摇，寻之有，举之无；不往不来，不离其处，多于关部见之。动为痛，为惊，
为虚劳体痛，为崩脱，为泄痢。阳动则汗出，阴动则发热。
伏，不见也。轻手取之绝不可见，重取之附着于骨。为阴阳潜伏关膈闭塞之候，为积聚，为瘕疝，为
食不消，为霍乱，为水气，为荣卫气闭而厥逆。关前得之为阳伏，关后得之为阴伏。左寸伏心气不足，神
不守常，沉忧抑郁；关伏血冷，腰脚痛及胁下有寒气；尺伏肾寒精虚，疝瘕寒痛。右寸伏胸中气滞，寒
痰冷积；关伏中脘积块作痛及脾有停滞；尺伏脐下冷痛，下焦虚寒，腹中痼冷。
促，阳脉之极也。脉来数，时一止复来者曰促。阳独盛而阴不能相和也，或怒逆上亦令脉促。促为气
涌，为狂闷，为瘀血发狂，又为气，为血，为饮，为食，为痰。盖先以气热脉数五者，或一有留滞乎其
间，则因之而为促。非恶脉也，虽然，加即死，退即生，亦可畏哉！
结，阴脉之极也。脉来缓，时一止复来者曰结。阴独盛而阳不能相入也。为 结，为积聚，为七情所
郁。浮结为寒邪滞经，沉结为积气在内，又为气，为
血，为饮，为痰。盖先以气寒脉缓而五者，或一有留滞于其间，则因而为结。故张长沙谓结、促皆病脉。
芤，浮大而软，寻之中空傍实，傍有中无，诊在浮举重按之间，为失血之候。大抵气有余血不足，血
不能统气，故虚而大若芤之状也。左寸芤主心血妄行，为吐为衄；关芤主胁间血气痛，或腹中瘀血，亦
为吐血目暗；尺芤小便血，女人月事为病。右寸芤胸中积血，为衄，为呕；关芤肠痈瘀血及呕血不食；尺
芤大便血。又云前大后细，脱血也，非芤而何？
革，沉伏实大，如按鼓皮曰革。气血虚寒，革易常度也。妇人则半产漏下，男子则亡血失精，又为中
风、寒湿之诊。
濡，无力也。虚软无力，应手散细，如绵絮之浮水中，轻手乍来，重手却去。为气血俱不足之候，为
少气，为无血，为疲损，为自汗，为下冷，为痹。左寸濡心虚易惊，盗汗，短气；关濡荣卫不和，精神离
散，体虚少力；尺濡男为伤精，女为脱血，小便数，自汗多。右寸濡关热憎寒，气乏体虚；关濡脾软
不化物，胃虚不进食；尺濡下元冷惫，肠虚泄泻。
牢，坚牢也。沉而有力，动而不移。为里实表虚，关中气促，为劳伤痿极。大抵其脉近乎无胃气
者，故诸家皆为危殆之脉，云亦主骨间疼痛，气居
于表。
疾，盛也。快于数为疾，呼吸之间脉七至，热极之脉也。在阳犹可，在阴为逆。
细，微眇也。指下寻之，往来微细如线。盖血冷气虚，不足以充故也。为元气不足，乏力无精，内外
俱冷，痿弱洞泄，为忧劳过度，为伤湿，为积，为痛在内及在下。
代，更代也。动而中止，不能自还，因而复动，由是复止，寻之良久，乃复强起为代。主形容羸瘦，
口不能言。若不因病而人羸瘦，其脉代止，是一脏无气，它脏代之，真危亡之兆也。若因病而气血骤
损，以至元气不续，或风家、痛家脉见止代，只为病脉。故伤寒家亦有心悸而脉代者，腹心痛亦有结涩止
代不匀者，勿以为凶。盖凡痛之脉，不可准也。又妊娠或有脉代者，此必三月余之胎也，亦无虑焉。
散，不聚也。有阳无阴，按之满指，散而不聚，来去不明，漫无根柢。为气血耗散，腑脏气绝。在
病脉主虚阳不敛，又主心气不足，大抵非佳脉也。
李东垣说：没有疾病时的脉象，不需要刻意去寻求“神”，但“神”自然存在于其中；而有疾病时的脉象，则应当考察其“神”的有无。例如，脉象数（每呼吸一次跳动六次以上）或极（每呼吸一次跳动七次以上），属于热证，如果脉中（指浮、中、沉取时）有力（意指有胃气），就是有“神”了，治疗时应通过发汗等方法来泄除热邪；脉象迟（每呼吸一次跳动三次以下）或败（微弱无力），属于寒证，如果脉中有力，就是有“神”了，治疗时应去除寒邪。如果在数极或迟败的脉象中，不再有力，就是无“神”了，那还依靠什么来维持生命呢？如果不知道这个道理，就急于使用泻法或祛寒法，那么“神”将凭借什么作为主宰呢？所以医经说：脉是气血的先导，气血就是人的神。说得真好！
浮脉，就是不沉。轻按感觉不足，重按反而显得有余，满指皆感脉位表浅称为浮脉。它是风虚动扰的征候，主胀满、风邪、痞块、脘腹胀满不食、表热、气喘。浮大脉，主伤风鼻塞。浮滑疾脉，主宿食停滞。浮滑脉，主痰饮。左寸部浮脉，主伤风发热、头痛目眩及风痰；浮而虚迟，主心气不足、心神不安；浮散脉，主心气耗散、虚烦；浮而洪数脉，主心经热盛。右关部浮脉，主腹胀；浮而数，主风热入肝经；浮而促，主怒气伤肝、心胸逆满；浮大脉，主胸胁胀满；尺部浮脉，主膀胱风热、小便赤涩；浮大而芤脉，男子主小便血，妇人主崩漏带下；浮而迟脉，主冷疝、脐下痛。右寸部浮脉，主肺感风寒、咳喘、清涕、自汗、体倦；浮而洪脉，主肺热咳嗽；浮而迟脉，主肺寒喘嗽。右关部浮脉，主脾虚中满不食；浮大而涩脉，主宿食；浮而迟脉，主脾胃虚；尺部浮脉，主风邪客于下焦、大便秘结；浮而虚脉，主元气不足；浮而数脉，主下焦风热、大便秘结。
沉脉，就是不浮。轻手按摸不见，重手才能触及，这是阴气逆乱、阳气郁遏的征候，主实证、寒证、气滞、水饮、停饮、癥瘕、胁胀、厥逆、洞泄。沉细脉，主少气；沉迟脉，主久冷之疾；沉滑脉，主宿食；沉伏脉，主霍乱。沉而数脉，主内热；沉而迟脉，主内寒；沉而弦脉，主心腹冷痛。左寸部沉脉，主心内寒邪作痛、胸中寒饮胁疼；右关部沉伏脉，主寒在经络、两胁刺痛；沉弦脉，主癖积内痛；尺部沉脉，主肾脏感寒、腰背冷痛、小便浑浊频数，男子主精冷，女子主血结；沉而细脉，主小腿酸痛、阴部瘙痒、尿后余沥不尽。右寸部沉脉，主肺冷寒痰停蓄、虚喘少气；沉而紧滑脉，主咳嗽；沉细而滑脉，主骨蒸潮热、皮毛焦干。右关部沉脉，主胃中寒积、中满吞酸；沉紧脉，主悬饮；尺部沉脉，主水肿、腰脚疼痛；沉细脉，主下利，又主小便失禁、脐下冷痛。
迟脉，就是不及。从至数来说，一呼一吸之间，脉搏仅跳动三次，比平脉少了一次。这是阴盛阳亏的征候，主寒证、不足证。浮而迟脉，主表有寒；沉而迟脉，主里有寒。脉见于寸部，主气不足；见于尺部，主血不足。气寒则收缩，血寒则凝滞。左寸部迟脉，主心上寒、精神多惨淡；右关部迟脉，主筋寒拘急、手足冷、胁下痛；尺部迟脉，主肾虚便浊，女子主月经不行。右寸部迟脉，主肺感寒邪、冷痰气短；右关部迟脉，主中焦寒及脾胃损伤生冷食物、不食，若见沉迟则为积滞；尺部迟脉，主脏寒泄泻、少腹冷痛、腰脚沉重。
数脉，就是太过。一息跳动六次，超过平脉两次。主烦闷胀满。上部出现主头疼、上热；中部出现主脾热口臭、胃烦、呕逆；右侧出现主颊热、目赤；左下部出现主小便黄赤、大便秘涩。浮数脉，主表有热；沉数脉，主里有热。
虚脉，就是不实。脉形散大柔软，举按之时豁然空虚，不能自固，这是气血俱虚的诊断。主暑病、虚烦、多汗、恍惚、易惊、小儿惊风。
实脉，就是不虚。按举不绝，搏动强劲而长，动而有力，不快不慢。这是三焦气满的征候，主呕吐、疼痛、气塞、食积、气聚、痢疾、伏阳在内。左寸部实脉，主心中积热、口舌生疮、咽痛，实脉兼大头面热风、烦躁体疼、面赤；右关部实脉，主腹胁痛，满实而浮大主肝盛、目暗赤痛；尺部实脉，主少腹痛、小便涩，实而滑主淋沥、茎痛、尿赤，实大主膀胱热溺难，实而紧主腰痛。右寸部实脉，主胸中热、痰嗽烦满，实而浮主肺热、咽燥痛、喘咳气壅；右关部实脉，主伏阳蒸内、脾虚食少、胃气滞，实而浮主脾热消中、善饥、口干、劳倦；尺部实脉，主脐下痛、大便难，或时下痢。
洪脉，就是大而实。举按有余，来时盛大而去时且长，腾上满指。这是营络大热、血气燔灼的征候，主表里皆热、烦渴、咽干、大小便不通。左寸部洪脉，主心经积热、眼赤、口疮、头痛、内烦；右关部洪脉，主肝热及身痛、四肢浮热；尺部洪脉，主膀胱热、小便赤涩。右寸部洪脉，主肺热毛焦、唾粘咽干，洪而紧主喘急；右关部洪脉，主胃热、反胃、呕吐、口干，洪而紧主胀满；尺部洪脉，主腹满、大便难，或下血。
微脉，就是不显。依稀轻细，若有若无。这是血气俱虚的征候，主虚弱、泄泻、虚汗、崩漏败血不止、少气。浮而微脉，主阳不足，必身恶寒；沉而微脉，主阴不足，主脏寒下利。左寸部微脉，主心虚忧惕、荣血不足；右关部微脉，主四肢恶寒拘急；尺部微脉，主败血不止，男子主伤精尿血，女子主崩漏带下。右寸部微脉，主上焦寒痞、冷痰不化、中寒少气；右关部微脉，主胃寒气胀、食不化、脾虚噫气、心腹冷痛；尺部微脉，主脏寒泄泻、脐下冷痛。
弦脉，按之不移，举之应手，端直如丝弦。这是血气收敛、阳中伏阴，或经络间为寒邪所入的征候，主疼痛、疟疾、拘急、寒热、血虚盗汗、寒凝气结、冷痹、疝气、痰饮、劳倦。弦数脉，主劳疟；双弦脉，主胁急痛；弦长脉，主积聚。左寸部弦脉，主头疼、心悸、劳伤、盗汗、乏力；右关部弦脉，主胁肋痛、癖积，弦紧主疝瘕、瘀血，弦小主寒癖；尺部弦脉，主少腹痛，弦滑主腰脚痛。右寸部弦脉，主肺受寒咳嗽、胸中有寒痰；右关部弦脉，主脾胃伤冷、宿食不化、心腹冷痛，又主痰饮；尺部弦脉，主脐下急痛不安、下焦停水。
缓脉，就是不及。往来迂缓，呼吸徐徐，因为气血趋向衰弱，所以脉体变得徐缓。主风邪、虚证、痹证、弱证、疼痛。在上部出现主项强，在下部出现主脚弱。浮缓脉，主风邪；沉缓脉，主血气虚。左寸部缓脉，主心气不足、怔忡健忘，也主项背急痛；右关部缓脉，主风虚眩晕、腹胁气结；尺部缓脉，主肾虚冷、小便频数，女子主月经量多。右寸部缓脉，主肺气浮、言语气短；右关部缓脉，主胃弱气虚，浮缓主脾气虚弱。不沉不浮、从容和缓，这是脾脏的本脉；尺部缓脉，主下寒脚弱、风气秘滞，浮缓主肠风泄泻，沉缓主小腹感冷。
滑脉，就是不涩。往来流利，如珠走盘，不进不退，这是血实气壅的征候，大概是血不胜于气所致。主呕吐、痰逆、宿食、经闭。滑而不断者经不闭，断绝者经闭。上部出现主吐逆，下部出现主气结，滑数脉主结热。左寸部滑脉，主心热，滑而实大主心惊舌强；右关部滑脉，主肝热、头目患病；尺部滑脉，主小便淋沥、尿赤、茎中痛。右寸部滑脉，主痰饮呕逆，滑而实主肺热毛发焦、膈壅咽干、痰嗽、头目昏、涕唾粘；右关部滑脉，主脾热口臭及宿食不化吐逆，滑实主胃热；尺部滑脉，因相火炎盛而引饮多、脐冷腹鸣，或时下利，妇人主血实气壅、月事不通，若脉和滑则是怀孕之兆。
涩脉，就是不滑。脉形虚细而迟，往来极难，参伍不调，如雨沾沙、如轻刀刮竹。这是气多血少的征候，主少血、亡汗、血痹痛、伤精，女人有孕主胎痛，无孕主败血病。左寸部涩脉，主心神虚耗不安及冷气心痛；右关部涩脉，主肝虚血散、肋胀胁满身痛；尺部涩脉，男子主伤精及疝，女子主月事虚败，若有孕主胎漏。右寸部涩脉，主荣卫不和、上焦冷痞、气短、臂痛；右关部涩脉，主脾弱不食、胃冷而呕；尺部涩脉，主大便涩、津液不足、小腹寒、足胫逆冷。（医经说：滑脉伤热，涩脉中雾露金革之气。）
长脉，就是不短。指下感觉有余，超过本位，这是气血皆有餘的征候。主阳毒内蕴、三焦烦郁、壮热。
短脉，就是不長。两头无中间有，不及本位，这是气不足以前导其血的征候。主阴中伏阳、三焦气壅、宿食不消。
大脉，就是不小。浮取之若洪而浮，沉取之大而无力。这是血虚气不能相入的征候。医经说：大脉则病进。
小脉，就是不大。浮沉取之皆损小。在阳分主阳不足，在阴分主阴不足；前大后小，主头疼、目眩；前小后大，主胸满、短气。
紧脉，就是有力而不缓。其来劲急，按之长，举之若牵绳转索之状。这是邪风激搏，伏于荣卫之间的征候，主疼痛、寒证。浮紧脉，主伤寒身疼；沉紧脉，主腹中有寒、风痫。左寸部紧脉，主头热目痛项强，紧而沉主心中气逆冷痛；右关部紧脉，主心腹满痛、胁痛肋急，紧而盛主伤寒浑身痛，紧而实主癖积；尺部紧脉，主腰脚脐下痛、小便难。右寸部紧脉，主鼻塞膈壅，紧而沉滑主肺实咳嗽；右关部紧脉，主腹痛吐逆，紧盛主腹胀伤食；尺部紧脉，主下焦筑痛。
弱脉，就是不盛。极沉细而软，怏怏不前，按之欲绝未绝，举之即无。这是由于精气不足，所以脉息痿弱而不振。主元气亏耗、痿弱不前、久冷、哄热、泄精、虚汗。老年人得此脉为顺，青壮年得此脉为逆。左寸部弱脉，主阳虚、心悸自汗；右关部弱脉，主筋痿无力，妇人主产后客风面肿；尺部弱脉，主小便频数、肾虚耳聋、骨肉酸痛。右寸部弱脉，主身冷多寒、胸中短气；右关部弱脉，主脾胃虚食不化；尺部弱脉，主下焦冷痛、大便滑泄。
动脉，其状如大豆厥厥动摇，寻之有，举之无；不往不来，不离其处，多于关部见到。动脉主疼痛、惊恐、虚劳体痛、崩脱、泄痢。阳动则汗出，阴动则发热。
伏脉，就是不见。轻手取之绝不可见，重取之附着于骨。这是阴阳潜伏、关膈闭塞的征候，主积聚、瘕疝、食不消、霍乱、水气、荣卫气闭而厥逆。关前得之为阳伏，关后得之为阴伏。左寸部伏脉，主心气不足、神不守常、沉忧抑郁；右关部伏脉，主血冷、腰脚痛及胁下有寒气；尺部伏脉，主肾寒精虚、疝瘕寒痛。右寸部伏脉，主胸中气滞、寒痰冷积；右关部伏脉，主中脘积块作痛及脾有停滞；尺部伏脉，主脐下冷痛、下焦虚寒、腹中久冷。
促脉，是阳脉的极端。脉来数，时常有一次停止后又复来的叫做促脉。这是阳独盛而阴不能相和，或者怒气逆上也令脉促。促脉主气涌、狂闷、瘀血发狂，又主气、血、饮、食、痰停滞。大概先有气热脉数这五种情况，或者其中有一种留滞，因而成为促脉。这不是恶脉，虽然如此，加重即死，减轻即生，也是可畏的！
结脉，是阴脉的极端。脉来缓，时常有一次停止后又复来的叫做结脉。这是阴独盛而阳不能相入。主阴结、积聚、七情所郁。浮结脉，主寒邪滞经；沉结脉，主积气在内，又主气、血、饮、痰停滞。大概先有气寒脉缓这五种情况，或者其中有一种留滞，因而成为结脉。所以张仲景说结、促都是病脉。
芤脉，浮大而软，寻之中空傍实，旁有中无，诊察在浮举重按之间，这是失血的征候。大体上是气有余血不足，血不能统气，所以虚而大像芤草管一样的形状。左寸部芤脉，主心血妄行，表现为吐血、衄血；右关部芤脉，主胁间血气痛，或腹中瘀血，也主吐血目暗；尺部芤脉，主小便血，女子主月经病。右寸部芤脉，主胸中积血，表现为衄血、呕血；右关部芤脉，主肠痈瘀血及呕血不食；尺部芤脉，主大便血。又说前大后细，是脱血，不是芤脉是什么？
革脉，沉伏实大，如按鼓皮叫做革脉。这是气血虚寒，革易常度的征候。妇人则主半产漏下，男子则主亡血失精，又主中风、寒湿的诊断。
濡脉，就是无力。虚软无力，应手散细，如棉絮浮在水中，轻手乍来，重手却去。这是气血俱不足的征候，主少气、无血、疲损、自汗、下冷、痹证。左寸部濡脉，主心虚易惊、盗汗、短气；右关部濡脉，主荣卫不和、精神离散、体虚少力；尺部濡脉，男子主伤精，女子主脱血、小便频数、自汗多。右寸部濡脉，主关热憎寒、气乏体虚；右关部濡脉，主脾软不化物、胃虚不进食；尺部濡脉，主下元冷惫、肠虚泄泻。
牢脉，就是坚牢。沉而有力，动而不移。这是里实表虚、关中气促、劳伤痿极的征候。大体上这种脉接近无胃气，所以各家都认为是危殆之脉，也说主骨间疼痛，气居于表。
疾脉，就是盛。快于数为疾，一呼一吸之间脉跳七次，是热极的脉象。在阳分还可以，在阴分则为逆。
细脉，就是微眇。指下寻之，往来微细如线。大概是血冷气虚，不足以充盈的缘故。主元气不足、乏力无精、内外俱冷、痿弱洞泄、忧劳过度、伤湿、积聚、疼痛在内及在下。
代脉，就是更代。动而中止，不能自还，因而复动，由是复止，寻之良久，乃复强起为代。主形体羸瘦、口不能言。如果不因病而人羸瘦，其脉代止，是一脏无气，它脏代之，真是危亡的征兆。如果因病而气血骤损，以至元气不续，或者风家、痛家脉见止代，只是病脉。所以伤寒家也有心悸而脉代的，腹心痛也有结涩止代不匀的，不要以为是凶兆。大概凡是疼痛的脉，不可作为准绳。另外妊娠或有脉代的，这一定是三个多月胎儿，也不必担忧。
散脉，就是不聚。有阳无阴，按之满指，散而不聚，来去不明，漫无根柢。这是气血耗散、腑脏气绝的征候。在病脉中主虚阳不敛，又主心气不足，大体上不是好脉。
Li Dongyuan said: For the pulse of a person without disease, there is no need to deliberately seek "Shen" (Spirit/Vitality), yet "Shen" naturally exists within it; however, for the pulse of a person with disease, one must examine the presence or absence of "Shen". For instance, a Shu Mai (Rapid Pulse, beating more than six times per respiration) or Ji Mai (Extremely Rapid Pulse, beating seven times per respiration) indicates Re Syndrome (Heat Pattern). If the pulse is You Li (Forceful) at the Fu, Zhong, and Chen levels (indicating the presence of Wei Qi/Stomach Qi), it possesses "Shen", and treatment should involve releasing heat through methods such as sweating. Conversely, a Chi Mai (Slow Pulse, beating less than four times per respiration) or Bai Mai (Declining/Weak Pulse) indicates Han Syndrome (Cold Pattern). If the pulse is You Li (Forceful) at these levels, it possesses "Shen", and treatment should focus on dispelling cold. However, if in pulses that are extremely rapid or slow/weak, there is no longer any forcefulness, this indicates a lack of "Shen"; upon what basis can life be sustained? If one does not understand this principle and hastily applies purgative or cold-dispelling methods, upon what will "Shen" rely as its master? Therefore, the Classics state: The pulse is the precursor of Qi and Xue (Blood); Qi and Xue are the Shen (Spirit) of humans. How true this is!
Fu Mai (Floating Pulse) is not Chen (Deep). It feels insufficient under light pressure but abundant under heavy pressure, filling the fingers at a superficial level. It is a sign of Wind-Xu (Wind-Deficiency) agitation, indicating distension, Wind pathogen, Pi (Glomus/blockage), abdominal fullness with anorexia, exterior Heat, wheezing, and cough. A Fu Da (Floating and Large) pulse indicates Shang Feng (Wind-Cold injury) with nasal congestion. A Fu Hua Ji (Floating, Slippery, and Rapid) pulse indicates Su Shi (Retained Food). A Fu Hua (Floating and Slippery) pulse indicates Yin (Phlegm-Fluids). At the Left Cun position, a Fu pulse indicates Shang Feng Fa Re (Wind-Cold injury with fever), headache, dizziness, and Feng Tan (Wind-Phlegm); if Fu Er Xu Chi (Floating, Deficient, and Slow), it indicates Xin Qi Bu Zu (Heart Qi Deficiency) and Xin Shen Bu An (Restless Heart Spirit); if Fu San (Floating and Scattered), it indicates Xin Qi Hao (Consumption of Heart Qi) and Xu Fan (Deficient Irritability); if Fu Er Hong Shu (Floating, Surging, and Rapid), it indicates Xin Jing Re (Heat in the Heart Meridian). At the Right Guan position, a Fu pulse indicates Fu Zhang (Abdominal Distension); if Fu Er Shu (Floating and Rapid), it indicates Feng Re Ru Gan Jing (Wind-Heat entering the Liver Meridian); if Fu Er Cu (Floating and Interrupted), it indicates Nu Qi Shang Gan Gan (Anger injuring the Liver), chest and heart reverse fullness; if Fu Da (Floating and Large), it indicates chest and hypochondriac distension; at the Chi position, a Fu pulse indicates Bladder Wind-Heat with red, scanty urination; if Fu Er Da Kou (Floating, Large, and Hollow), men present with hematuria, women with Beng Dai (Metrorrhagia and Leukorrhea); if Fu Er Chi (Floating and Slow), it indicates Leng Shan (Cold Hernia) and pain below the umbilicus. At the Right Cun position, a Fu pulse indicates Lung affected by Wind-Cold, with cough, wheezing, clear rhinorrhea, spontaneous sweating, and fatigue; if Fu Er Hong (Floating and Surging), it indicates Lung Heat with cough; if Fu Er Chi (Floating and Slow), it indicates Lung Cold with wheezing and cough. At the Right Guan position, a Fu pulse indicates Pi Xu Zhong Man Bu Shi (Spleen Deficiency with central fullness and anorexia); if Fu Er Da Se (Floating, Large, and Choppy), it indicates Su Shi (Retained Food); if Fu Er Chi (Floating and Slow), it indicates Pi Wei Xu (Spleen-Stomach Deficiency); at the Chi position, a Fu pulse indicates Wind-Evil lodging in the Lower Jiao with constipation; if Fu Er Xu (Floating and Deficient), it indicates Yuan Qi Bu Zu (Insufficiency of Primal Qi); if Fu Er Shu (Floating and Rapid), it indicates Lower Jiao Wind-Heat with constipation.
Chen Mai (Deep Pulse) is not Fu (Floating). It is invisible to light pressure but palpable only with heavy pressure. It signifies Yin Rebellion and Yang Depression, indicating Excess patterns, Cold patterns, Qi stagnation, Water retention, Phlegm-Fluids accumulation, Zha (Masses), hypochondriac distension, Jue Ni (Reversal Cold), and Dong Xie (Watery Diarrhea). Chen Xi (Deep and Fine) indicates Shao Qi (Shortness of Breath); Chen Chi (Deep and Slow) indicates Gu Leng (Chronic Cold); Chen Hua (Deep and Slippery) indicates Su Shi (Retained Food); Chen Fu (Deep and Hidden) indicates Huo Luan (Vomiting and Diarrhea syndrome). Chen Er Shu (Deep and Rapid) indicates Internal Heat; Chen Er Chi (Deep and Slow) indicates Internal Cold; Chen Er Xian (Deep and Wiry) indicates Cold Pain in the Heart and Abdomen. At the Left Cun position, a Chen pulse indicates Cold Evil in the Heart causing pain, and Cold Fluids in the chest causing hypochondriac pain; at the Right Guan position, a Chen Fu pulse indicates Cold in the meridians causing stabbing pain in both hypochondria; a Chen Xian pulse indicates Nei Tong from Pi Ji (Accumulations); at the Chi position, a Chen pulse indicates Kidney Cold causing cold pain in the waist and back, turbid and frequent urination; in men, it indicates Jing Leng (Cold Sperm); in women, it indicates Xue Jie (Blood Stasis). A Chen Er Xi (Deep and Fine) pulse indicates leg soreness, genital itching, and dribbling after urination. At the Right Cun position, a Chen pulse indicates Lung Cold with stagnant Cold Phlegm, deficiency wheezing, and shortness of breath; a Chen Er Jin Hua (Deep, Tight, and Slippery) pulse indicates cough; a Chen Xi Er Hua (Deep, Fine, and Slippery) pulse indicates Bone-steaming Fever and dry, scorched skin/hair. At the Right Guan position, a Chen pulse indicates Stomach Cold Accumulation with central fullness and acid regurgitation; a Chen Jin (Deep and Tight) pulse indicates Xuan Yin (Hanging Fluids); at the Chi position, a Chen pulse indicates Edema with waist and leg pain; a Chen Xi (Deep and Fine) pulse indicates diarrhea and slippery urination with cold pain below the umbilicus.
Chi Mai (Slow Pulse) is "Bu Ji" (Insufficient). In terms of frequency, during one respiration cycle, the pulse beats only three times, one beat less than the normal pulse. It signifies Yin Excess and Yang Deficiency, indicating Cold patterns and Deficiency. Fu Er Chi (Floating and Slow) indicates Exterior Cold; Chen Er Chi (Deep and Slow) indicates Interior Cold. If found at the Cun position, it indicates Qi Deficiency; if at the Chi position, it indicates Blood Deficiency. Cold Qi causes contraction; Cold Blood causes coagulation. At the Left Cun position, a Chi pulse indicates Cold in the Heart with a gloomy spirit; at the Right Guan position, a Chi pulse indicates Cold in the tendons causing stiffness, cold hands and feet, and hypogastric pain; at the Chi position, a Chi pulse indicates Kidney Deficiency with turbid urine, and in women, Amenorrhea. At the Right Cun position, a Chi pulse indicates Lung Cold with Cold Phlegm and shortness of breath; at the Right Guan position, a Chi pulse indicates Middle Jiao Cold and Spleen-Stomach damage from cold foods, anorexia; if Chen Chi (Deep and Slow), it indicates Accumulation; at the Chi position, a Chi pulse indicates Zang Cold with diarrhea, cold pain in the lower abdomen, and heavy waist and legs.
Shu Mai (Rapid Pulse) is "Tai Guo" (Excessive). It beats six times per respiration, two beats more than the normal pulse. It indicates irritability and fullness. Upper appearance indicates headache and Upper Heat; Middle appearance indicates Spleen Heat with bad breath, Stomach irritability, and vomiting/regurgitation; Right appearance indicates cheek heat and red eyes; Lower Left appearance indicates yellow-red urine and constipation. Fu Shu (Floating and Rapid) indicates Exterior Heat; Chen Shu (Deep and Rapid) indicates Interior Heat.
Xu Mai (Deficient Pulse) is "Bu Shi" (Not Excess). It is scattered, large, and soft; upon lifting and pressing, it feels hollow and cannot sustain itself. This is a diagnosis of joint Qi and Blood Deficiency. It indicates Summerheat, Xu Fan (Deficient Irritability), excessive sweating, trance-like states, fright, and Infantile Convulsions.
Shi Mai (Excess Pulse) is "Bu Xu" (Not Deficient). Upon lifting and pressing, it is unceasing, strong and long, moving with force, neither fast nor slow. It is a sign of Fullness of Qi in the Three Jiao, indicating vomiting, pain, Qi blockage, Food Retention, Qi Aggregation, Dysentery, and latent Yang inside. At the Left Cun position, a Shi pulse indicates Accumulated Heat in the Heart with mouth/tongue sores and sore throat; if Shi combined with Tai Tou Mian Re Feng (Large Head/Face Wind-Heat), it indicates irritability, body pain, and red face; at the Right Guan position, a Shi pulse indicates abdominal and hypochondriac pain; if Man Shi Er Fu Da (Full, Excess, Floating, and Large), it indicates Liver Excess with dim vision and red eye pain; at the Chi position, a Shi pulse indicates lower abdominal pain and scanty urination; if Shi Er Hua (Excess and Slippery), it indicates strangury, penile pain, and red urine; if Shi Da (Excess and Large), it indicates Bladder Heat with difficult urination; if Shi Er Jin (Excess and Tight), it indicates lower back pain. At the Right Cun position, a Shi pulse indicates Heat in the Chest with phlegm-cough, irritability, and fullness; if Shi Er Fu (Excess and Floating), it indicates Lung Heat with dry/sore throat, wheezing, cough, and Qi oppression; at the Right Guan position, a Shi pulse indicates latent Yang steaming internally, Spleen Deficiency with poor appetite, and Stomach Qi stagnation; if Shi Er Fu (Excess and Floating), it indicates Pi Re Xiao Zhong (Spleen Heat with Consuming-Thirst), polyphagia, dry mouth, and fatigue; at the Chi position, a Shi pulse indicates pain below the umbilicus, difficult defecation, or occasional dysentery.
Hong Mai (Surging Pulse) is Da Er Shi (Large and Excess). Upon lifting and pressing, there is surplus; it arrives large and departs long, filling the fingers upward. It signifies Great Heat in the Ying Collaterals and blazing Qi/Blood, indicating Heat in both Exterior and Interior, irritability, dry throat, and obstruction of urination and defecation. At the Left Cun position, a Hong pulse indicates Accumulated Heat in the Heart Red Meridian with red eyes, mouth sores, headache, and internal irritability; at the Right Guan position, a Hong pulse indicates Liver Heat with body pain and floating heat in the four limbs; at the Chi position, a Hong pulse indicates Bladder Heat with red, scanty urination. At the Right Cun position, a Hong pulse indicates Lung Heat with scorched hair, sticky saliva, and dry throat; if Hong Er Jin (Surging and Tight), it indicates urgent wheezing; at the Right Guan position, a Hong pulse indicates Stomach Heat with fan wei (reverse vomiting), vomiting, and dry mouth; if Hong Er Jin (Surging and Tight), it indicates distension; at the Chi position, a Hong pulse indicates abdominal fullness, difficult defecation, or bleeding.
Wei Mai (Micropulse) is "Bu Xian" (Not Manifest). It is faint, light, and fine, seeming to exist and not exist. It signifies joint Qi and Blood Deficiency, indicating weakness, diarrhea, spontaneous sweating, unstoppable Beng Lou (Metrorrhagia/Metrostaxis due to failed blood), and shortness of breath. Fu Er Wei (Floating and Micropulse) indicates Yang Insufficiency,必然 (necessarily) accompanied by aversion to cold; Chen Er Wei (Deep and Micropulse) indicates Yin Insufficiency, primarily Zang Cold with diarrhea. At the Left Cun position, a Wei pulse indicates Heart Deficiency with worry/fright and insufficiency of Ying Blood; at the Right Guan position, a Wei pulse indicates aversion to cold and stiffness in the four limbs; at the Chi position, a Wei pulse indicates unstoppable failed blood; in men, Jing Shang Niao Xue (Kidney Injury with Hematuria); in women, Beng Dai (Metrorrhagia and Leukorrhea). At the Right Cun position, a Wei pulse indicates Upper Jiao Cold Pi (Glomus), undissipated Cold Phlegm, Middle Cold with shortness of breath; at the Right Guan position, a Wei pulse indicates Stomach Cold with Qi distension, indigestion, Spleen Deficiency with belching, and cold pain in heart/abdomen; at the Chi position, a Wei pulse indicates Zang Cold with diarrhea and cold pain below the umbilicus.
Xian Mai (Wiry Pulse) does not shift when pressed, responds to lifting, straight like a silk string. It signifies Qi/Blood convergence, Yin hidden within Yang, or Cold invading the meridians. It indicates pain, malaria, stiffness, alternating cold/fever, Blood Deficiency with night sweats, Cold coagulation with Qi knotting, Cold Bi (Obstruction), hernia, Phlegm-Fluids, and fatigue. Xian Shu (Wiry and Rapid) indicates Lao Nie (Chronic Malaria); Shuang Xian (Double Wiry) indicates urgent hypochondriac pain; Xian Chang (Wiry and Long) indicates Ji Ju (Accumulations). At the Left Cun position, a Xian pulse indicates headache, palpitations, fatigue, night sweats, and weakness; at the Right Guan position, a Xian pulse indicates hypochondriac pain and Pi Ji (Accumulations); if Xian Jin (Wiry and Tight), it indicates Shan Xia (Hernia/Masses) and Yu Xue (Blood Stasis); if Xian Xiao (Wiry and Small), it indicates Han Pi (Cold Accumulation); at the Chi position, a Xian pulse indicates lower abdominal pain; if Xian Hua (Wiry and Slippery), it indicates waist/leg pain. At the Right Cun position, a Xian pulse indicates Lung Cold with cough and Cold Phlegm in the chest; at the Right Guan position, a Xian pulse indicates Spleen-Stomach damage from cold, undigested food, cold pain in heart/abdomen, and Phlegm-Fluids; at the Chi position, a Xian pulse indicates urgent pain below the umbilicus and Water retention in the Lower Jiao.
Huan Mai (Moderate/Relaxed Pulse) is "Bu Dai" (Not Arriving/Tardy). It moves slowly and leisurely with respiration because Qi and Blood are declining, making the pulse body slow. It indicates Wind, Deficiency, Bi Syndrome, Weakness, and pain. Appearing upper, it indicates neck stiffness; appearing lower, it indicates weak legs. Fu Huan (Floating and Moderate) indicates Wind; Chen Huan (Deep and Moderate) indicates Qi/Blood Deficiency. At the Left Cun position, a Huan pulse indicates Heart Qi Deficiency with palpitations and forgetfulness, also Neck/Back stiffness/pain; at the Right Guan position, a Huan pulse indicates Wind-Deficiency with vertigo and Qi knotting in abdomen/hypochondria; at the Chi position, a Huan pulse indicates Kidney Cold with frequent urination, and in women, Menorrhagia. At the Right Cun position, a Huan pulse indicates Floating Lung Qi with short speech; at the Right Guan position, a Huan pulse indicates Stomach Weakness/Qi Deficiency, while Fu Huan (Floating and Moderate) indicates Spleen Qi Deficiency. Non-floating, non-deep, calm, and moderate is the Ben Mai (Root Pulse) of the Spleen; at the Chi position, a Huan pulse indicates Lower Cold with weak legs and Qi stagnation; Fu Huan (Floating and Moderate) indicates Chang Feng Xie Xie (Intestinal Wind Diarrhea); Chen Huan (Deep and Moderate) indicates Cold invasion of the lower abdomen.
Hua Mai (Slippery Pulse) is "Bu Se" (Not Choppy). It flows smoothly like pearls rolling on a plate, neither advancing nor retreating excessively. It signifies Blood Excess and Qi Stagnation, where Blood cannot overcome Qi. It indicates vomiting, Phlegm-Rebellion, retained food, and amenorrhea. If Hua Mai is continuous, menstruation is not closed; if interrupted, menstruation is closed. Upper appearance indicates vomiting/regurgitation; lower appearance indicates Qi knotting; Hua Shu (Slippery and Rapid) indicates Knotting Heat. At the Left Cun position, a Hua pulse indicates Heart Heat; if Hua Er Shi Da (Slippery, Excess, and Large), it indicates Heart Fright and stiff tongue; at the Right Guan position, a Hua pulse indicates Liver Heat affecting head/eyes; at the Chi position, a Hua pulse indicates strangury, red urine, and penile pain. At the Right Cun position, a Hua pulse indicates Phlegm-Fluids with vomiting/regurgitation; if Hua Er Shi (Slippery and Excess), it indicates Lung Heat with scorched hair, diaphragm obstruction, dry throat, phlegm-cough, dizziness, and sticky discharge; at the Right Guan position, a Hua pulse indicates Spleen Heat with bad breath and undigested food/vomiting; if Hua Shi (Slippery and Excess), it indicates Stomach Heat; at the Chi position, a Hua pulse indicates excessive drinking due to Minister Fire flaring, cold umbilicus with borborygmus, or occasional diarrhea; in women, it signifies Blood Excess and Qi Stagnation with amenorrhea; if He Hua (Harmonious and Slippery), it indicates Pregnancy.
Se Mai (Choppy Pulse) is "Bu Hua" (Not Slippery). It is deficient, fine, and slow, moving with extreme difficulty, irregular like rain soaking sand or a light knife scraping bamboo. It signifies Excess Qi and Deficient Blood, indicating Blood Deficiency, loss of sweat, Blood Bi pain, Jing Injury; in pregnant women, it indicates Tai Tong (Fetal Pain); in non-pregnant women, it indicates Bai Xue Bing (Failed Blood Disease). At the Left Cun position, a Se pulse indicates Heart Spirit deficiency/unrest and Cold Qi Heart Pain; at the Right Guan position, a Se pulse indicates Liver Blood Deficiency with scattering, rib/flank distension, and body pain; at the Chi position, a Se pulse indicates Jing Injury and Hernia in men, and menstrual failure in women; if pregnant, it indicates Tai Lou (Fetal Leakage). At the Right Cun position, a Se pulse indicates Ying-Wei Disharmony, Upper Jiao Cold Pi, shortness of breath, and arm pain; at the Right Guan position, a Se pulse indicates Spleen Weakness with anorexia and Cold Stomach with vomiting; at the Chi position, a Se pulse indicates difficult defecation, fluid insufficiency, lower abdominal cold, and cold lower legs/shins. (The Classics state: Slippy pulses injure with Heat; Choppy pulses are struck by Fog, Dew, Metal, and Leather.)
Chang Mai (Long Pulse) is "Bu Duan" (Not Short). It feels abundant under the finger, extending beyond its original position, indicating surplus of both Qi and Blood. It indicates internal accumulation of Yang Toxin, irritation/stagnation in the Three Jiao, and high fever.
Duan Mai (Short Pulse) is "Bu Chang" (Not Long). It lacks extremities but has a middle, failing to reach its original position, indicating Qi insufficiency to guide Blood. It indicates Yang hidden within Yin, Qi stagnation in the Three Jiao, and undigested retained food.
Da Mai (Large Pulse) is "Bu Xiao" (Not Small). Superficially it resembles Hong (Surging) and Fu (Floating); deeply it is large but forceless. It indicates Blood Deficiency where Qi cannot enter. The Classics state: Da Mai indicates disease progression.
Xiao Mai (Small Pulse) is "Bu Da" (Not Large). Both superficial and deep palpation reveal diminution. In Yang positions, it indicates Yang Insufficiency; in Yin positions, it indicates Yin Insufficiency; Front Large Back Small indicates headache and dizziness; Front Small Back Large indicates chest fullness and shortness of breath.
Jin Mai (Tight Pulse) is You Li (Forceful) but not Huan (Relaxed). It comes with vigor and urgency, feeling long when pressed, and resembling a twisted rope when lifted. It signifies Evil Wind struggling and lodging between Ying and Wei, indicating pain and Cold. Fu Jin (Floating and Tight) indicates Shang Han (Cold Damage) with body pain; Chen Jin (Deep and Tight) indicates Cold in the abdomen and Feng Xian (Wind Epilepsy). At the Left Cun position, a Jin pulse indicates Head Heat, Eye Pain, and Neck Stiffness; if Jin Er Chen (Tight and Deep), it indicates Reverse Cold Pain in the Heart; at the Right Guan position, a Jin pulse indicates Heart/Abdominal Fullness/Pain, Hypochondriac Pain/Rib Stiffness; if Jin Er Sheng (Tight and Vigorous), it indicates Whole Body Pain from Cold Damage; if Jin Er Shi (Tight and Excess), it indicates Pi Ji (Accumulations); at the Chi position, a Jin pulse indicates Waist/Leg/Umbilical Pain and difficult urination. At the Right Cun position, a Jin pulse indicates Nasal Congestion and Diaphragm Obstruction; if Jin Er Chen Hua (Tight, Deep, and Slippery), it indicates Lung Excess with Cough; at the Right Guan position, a Jin pulse indicates Abdominal Pain and Vomiting; if Jin Sheng (Tight and Vigorous), it indicates Abdominal Distension from Food Injury; at the Chi position, a Jin pulse indicates Lower Jiao Beating Pain.
Ruo Mai (Weak Pulse) is "Bu Sheng" (Not Vigorous). It is extremely deep, fine, and soft, reluctant to advance; pressing feels near cessation but not quite, lifting makes it disappear. Due to Jing-Qi insufficiency, the pulse is atrophic and weak. It indicates Yuan Qi Consumption, atrophy/weakness, chronic cold, false heat, spermatorrhea, and spontaneous sweating. Obtained by the elderly, it is favorable; obtained by the vigorous, it is adverse. At the Left Cun position, a Ruo pulse indicates Yang Deficiency with palpitations and spontaneous sweating; at the Right Guan position, a Ruo pulse indicates tendon atrophy/weakness, and in women, Postpartum External Wind with facial swelling; at the Chi position, a Ruo pulse indicates frequent urination, Kidney Deficiency with deafness, and bone/muscle soreness. At the Right Cun position, a Ruo pulse indicates cold body with aversion to cold and shortness of breath in the chest; at the Right Guan position, a Ruo pulse indicates Spleen-Stomach Deficiency with indigestion; at the Chi position, a Ruo pulse indicates Lower Jiao Cold Pain and slippery stool.
Dong Mai (Moving Pulse) resembles a soybean trembling in place; it is felt upon searching but disappears upon lifting; it does not move forward or backward, staying in its place, mostly seen at the Guan position. It indicates pain, fright, deficiency-fatigue with body pain, Beng Tuo (Collapse), and diarrhea/dysentery. Yang Dong indicates sweating; Yin Dong indicates fever.
Fu Mai (Hidden Pulse) is "Bu Jian" (Not Visible). Light pressure reveals nothing; heavy pressure finds it adhering to the bone. It signifies Yin/Yang hiding, Guan Ge (Diaphragm) obstruction, indicating accumulations, hernias, indigestion, Huo Luan, Water Qi, and Ying-Wei closure leading to Jue Ni. Found before the Guan, it is Yang Fu; found after the Guan, it is Yin Fu. At the Left Cun position, a Fu pulse indicates Heart Qi Deficiency, Spirit not guarding normally, and depression; at the Right Guan position, a Fu pulse indicates Cold Blood, waist/leg pain, and Cold Qi in hypochondria; at the Chi position, a Fu pulse indicates Kidney Cold with Essence Deficiency and Cold Pain from Hernia/Masses. At the Right Cun position, a Fu pulse indicates Qi Stagnation in the Chest and Cold Phlegm/Accumulation; at the Right Guan position, a Fu pulse indicates Masses in Zhong Wan causing pain and Spleen Stagnation; at the Chi position, a Fu pulse indicates Cold Pain below the umbilicus, Lower Jiao Deficiency-Cold, and chronic Cold in the abdomen.
Cu Mai (Interrupted Pulse) is the extreme of Yang Pulses. The pulse is rapid, occasionally stopping and then resuming. It signifies Yang Excess alone unable to harmonize with Yin, or anger causing Qi rebellion. It indicates surging Qi, mania/oppression, Blood Stasis causing mania, and stagnation of Qi, Blood, Fluids, Food, or Phlegm. Generally, prior conditions of Qi Heat and Rapid Pulse (five types) with one type of stagnation cause Cu Mai. It is not necessarily a malignant pulse; although severe cases lead to death, improvement leads to survival, thus it is formidable!
Jie Mai (Knotted Pulse) is the extreme of Yin Pulses. The pulse is slow, occasionally stopping and then resuming. It signifies Yin Excess alone unable to admit Yang. It indicates Yin Knotting, Accumulations, and Seven Emotions Depression. Fu Jie (Floating and Knotted) indicates Cold Evil stagnating in meridians; Chen Jie (Deep and Knotted) indicates accumulated Qi inside, and stagnation of Qi, Blood, Fluids, or Phlegm. Generally, prior conditions of Qi Cold and Slow Pulse (five types) with one type of stagnation cause Jie Mai. Thus, Zhang Changsha stated that Jie and Cu are both pathological pulses.
Kou Mai (Hollow Pulse) is Fu Er Da Ruan (Floating, Large, and Soft); searching reveals empty center and solid sides, with substance on the sides but void in the middle. Diagnosed between light lifting and heavy pressing, it signifies Blood Loss. Generally, it indicates Qi Excess and Blood Deficiency, where Blood cannot control Qi, resulting in a large, hollow shape like a reed stem. At the Left Cun position, a Kou pulse indicates Wild Flow of Heart Blood, manifesting as vomiting or epistaxis; at the Right Guan position, a Kou pulse indicates Blood-Qi pain in hypochondria or abdominal Blood Stasis, also vomiting and dim vision; at the Chi position, a Kou pulse indicates hematuria and menstrual disorders in women. At the Right Cun position, a Kou pulse indicates Accumulated Blood in the Chest, manifesting as epistaxis or vomiting; at the Right Guan position, a Kou pulse indicates Intestinal Abscess, Blood Stasis, vomiting blood, and anorexia; at the Chi position, a Kou pulse indicates hematochezia. It is also said: Front Large Back Thin indicates Blood Loss; how could it not be Kou Mai?
Ge Mai (Leather Pulse) is Chen Fu Shi Da (Deep, Hidden, Excess, and Large), feeling like pressing a drumhead. It signifies Qi/Blood Deficiency-Cold and deviation from normal pulse qualities. In women, it indicates miscarriage and spotting; in men, it indicates Blood Loss and Essence Loss, also serving as a diagnosis for Wind Stroke and Cold-Dampness.
Ru Mai (Soggy Pulse) is "Wu Li" (Forceless). It is deficient, soft, and forceless, responding as scattered and fine, like cotton floating in water; light pressure brings it, heavy pressure makes it go. It signifies joint Qi and Blood Insufficiency, indicating shortness of breath, Blood Deficiency, exhaustion, spontaneous sweating, Lower Cold, and Bi Syndrome. At the Left Cun position, a Ru pulse indicates Heart Deficiency with easy fright, night sweats, and shortness of breath; at the Right Guan position, a Ru pulse indicates Ying-Wei Disharmony, scattered spirit, and physical weakness; at the Chi position, a Ru pulse indicates Jing Injury in men, Blood Loss in women, frequent urination, and excessive sweating. At the Right Cun position, a Ru pulse indicates Guan Heat with aversion to cold, Qi乏 (Lack), and physical weakness; at the Right Guan position, a Ru pulse indicates Spleen Softness with indigestion and Stomach Deficiency with inability to eat; at the Chi position, a Ru pulse indicates Lower Origin Cold/Exhaustion and Intestinal Deficiency with diarrhea.
Lao Mai (Firm Pulse) is "Jian Lao" (Solid and Firm). It is deep and forceful, moving without shifting. It indicates Interior Excess and Exterior Deficiency, Qi urgency in the middle, and extreme fatigue/atrophy from overwork. Generally, this pulse approaches having no Wei Qi, so all schools consider it a critical pulse. It also indicates pain between bones, with Qi residing in the exterior.
Ji Mai (Racing Pulse) is "Sheng" (Vigorous). Faster than Shu (Rapid), it beats seven times per respiration, indicating Extreme Heat. In Yang positions, it is acceptable; in Yin positions, it is adverse.
Xi Mai (Fine Pulse) is "Wei Miao" (Subtle). Searching under the finger, it moves subtly and finely like a thread. This is due to Cold Blood and Deficient Qi failing to fill the vessels. It indicates Yuan Qi Deficiency, fatigue/lack of essence, internal/external cold, atrophy/watery diarrhea, excessive worry/work, Dampness Injury, Accumulations, and pain in the interior/lower body.
Dai Mai (Intermittent Pulse) is "Geng Dai" (Replacing). It moves, stops, cannot return on its own, resumes movement, stops again; after searching for a long time, it rises strongly again. It indicates emaciation and inability to speak. If not due to disease but the person is emaciated with a Dai Mai stop, it means one Zang lacks Qi and other Zangs compensate, signaling true danger/death. If due to disease with sudden Qi/Blood loss leading to Yuan Qi discontinuity, or in Wind/Pain cases showing stops/interruptions, it is merely a disease pulse. Thus, Shang Han practitioners also see Dai pulses with palpitations, and abdominal pain cases show irregular Jie/Se stops; do not regard them as ominous. Generally, pulses in pain cases are not reliable standards. Additionally, pregnancy may present with a Dai Mai, likely indicating a fetus of over three months, which requires no worry.
San Mai (Scattered Pulse) is "Bu Ju" (Not Gathering). It has Yang but no Yin; pressing fills the fingers, but it scatters without gathering, coming and going unclearly, with no root. It signifies Qi/Blood dissipation and Zang-Fu Qi exhaustion. In disease pulses, it indicates Floating Yang failing to consolidate and Heart Qi Deficiency; generally, it is not a favorable pulse.