平人无脉移于外络兄位弟乘阳溪列缺此言反关之脉平人无脉者非无脉也谓寸口脉不应指
而反从尺旁过肺之列缺大肠之阳溪刺斜出于外络其三部定位九候浅深俱与平常应见于寸口者
无异若兄固有之位弟窃而乘之此反常异众之脉千百中仅一二也
病脉既明吉凶当别经脉之外又有真脉肝绝之脉循刀责责心绝之脉转豆躁疾脾则雀啄如屋
之漏如水之流如杯之覆肺绝如毛无根萧索麻子动摇浮波之合肾脉将绝至如省客来如弹石去如
解索命脉将绝虾游鱼翔至如涌泉绝在膀胱真脉既形胃已无气参察色证断之以臆此言真脏之脉
真脏者如肝见纯弦脉无胃气谓之真脏肝脉之绝指下如循刀责责然劲急之状全无和缓之意故谓
真脏主死其心绝之脉指下如转豆之状厥厥动摇躁疾之势故心绝也脾绝之脉如雀之啄木频啄数
下而少一停止也又如屋漏之水其数勺勺一顷而一滴又如流水去而不返之象又如杯水倾覆之状
此皆脾绝之脉也肺绝之脉如风吹羽毛轻泛无根萧索不振之义又如麻子碎小之多又如浮波一开
一合之状此皆肺之绝脉也其肾绝之脉至如省客而偶一来去也又如弹石指下沉石有力而击指又
如解索指下如索分解之状此皆肾之绝脉也虾游者其状如虾在水中缓缓而前倏然而退鱼翔者状
如鱼之在水始则浮游掉尾少则悠然而逝此皆命之绝脉也涌泉者状如泉之泛溢从下涌上之象此
系膀胱之绝脉也人之真脏脉者谓肝见纯弦心见纯洪肺见纯毛肾见纯石而无胃气和缓之脉故谓
真脏之脉若真脉既形则知胃已无气盖脉以胃气为本脉无胃气故皆死之兆也然脉理既明更当参
察色证一一据理而断之则死生吉凶之法其验无不如影之随形响之应声者也盖医道之难所难在
理之不明医理之难尤难在脉理之不精脉理之最详而易领会者莫过于（崔嘉彦）四言举要也学
者
当熟读深究默识参悟则胸中自然洞彻所谓得心应手之巧其在斯乎
平人（健康无病之人）的脉象如果移位于外络，兄位被弟位所乘，出现在阳溪、列缺穴处，这就是所说的反关脉。所谓平人无脉，并不是真的没有脉，而是指寸口脉在常规部位不应指（摸不到脉搏），反而从尺部旁边经过，通过肺经的列缺穴和大肠经的阳溪穴，斜向刺出至外络。其三部九候的浅深定位，都与平常应在寸口显现的脉象无异，就像兄长固有的位置被弟弟窃取并占据一样。这是反常且与众不同的脉象，千百人中仅有一二人出现。
病脉既然已经明了，吉凶应当辨别。在经脉之外，又有真脏脉。肝绝之脉，指下感觉如循刀刃般责责作响；心绝之脉，指下感觉如豆粒转动，躁动疾速；脾绝之脉，如雀啄食，又像屋顶漏雨，像水流去不返，像杯碗倾覆；肺绝之脉，如羽毛轻浮无根，萧索不振，如麻子碎小动摇，如浮波一开一合；肾脉将绝时，脉来如省客（偶尔来访的客人）般偶而一至，去时如弹石般沉实有力击指，又如解索般指下如绳索分解之状；命门之脉将绝时，如虾游般忽隐忽现，如鱼翔般悠然逝去；至如涌泉般从下向上泛溢之象，此为膀胱之绝脉。真脏脉既已显现，说明胃气已无。诊察时需参合面色与证候，依据医理进行判断，这就是所说的真脏脉。
所谓真脏脉，例如肝脉见到纯弦而无胃气，称为真脏。肝脉绝时，指下感觉如同抚摸刀刃，劲急之状，全无和缓之意，故谓真脏主死。心绝之脉，指下感觉如豆粒转动，厥厥动摇，有躁疾之势，故为心绝。脾绝之脉，如雀鸟啄木，频频啄击，数下后少有一次停顿；又像屋漏之水，勺勺之间许久才滴下一滴；又像流水去而不返的景象；又像杯水倾覆的状态，这些都是脾绝之脉。肺绝之脉，如风吹羽毛，轻泛无根，有萧索不振之意；又如麻子般细碎众多；又如浮波一开一合之状，这些都是肺之绝脉。肾绝之脉，脉来如省客般偶然一来一去；又如弹石，指下感觉沉石有力而击指；又如解索，指下感觉如绳索分解之状，这些都是肾之绝脉。虾游者，其状如虾在水中缓缓前行，突然又退去；鱼翔者，其状如鱼在水中，起初浮游摆尾，不久便悠然逝去，这些都是命门之绝脉。涌泉者，其状如泉水泛溢，从下向上涌出的景象，这属于膀胱之绝脉。人的真脏脉，是指肝见纯弦、心见纯洪、肺见纯毛、肾见纯石，而没有胃气和缓之脉，所以称为真脏之脉。如果真脏脉已经显现，就知道胃气已无。因为脉以胃气为本，脉无胃气，所以都是死亡的征兆。然而脉理既然已经明了，更应当参合察验面色与证候，一一依据医理进行断决，那么判断死生吉凶的方法，其验证无不准确，如同影子跟随形体、回声响应声音一样。大概医道之难，难在医理不明；医理之难，尤其难在脉理不精。脉理中最详细且容易领会的，莫过于崔嘉彦的《四言举要》。学者应当熟读深究，默记参悟，则胸中自然通透彻悟，所谓得心应手的巧妙，就在于此吧。
In a healthy person (Pingren, an individual without disease), if the pulse is displaced to the external collaterals and the "younger brother" position usurps the "elder brother" position, appearing at the Yangxi and Lieque acupoints, this is referred to as the Fan Guan Mai (Reverse Gate Pulse). The statement that a healthy person has no pulse does not mean the complete absence of pulsation; rather, it indicates that the Cun Kou (Inch Port) pulse is not palpable at its standard location but instead passes from beside the Chi (Cubit) position, emerging obliquely through the Lieque point of the Lung Meridian and the Yangxi point of the Large Intestine Meridian into the external collaterals. Its depth and positioning within the Three Positions (Cun, Guan, Chi) and Nine Probes are identical to those normally found at the Cun Kou. It is akin to a younger brother usurping the elder brother's rightful place. This is an anomalous pulse differing from the majority, occurring in only one or two out of a thousand people.
Once pathological pulses are understood, auspicious and inauspicious signs must be distinguished. Beyond the regular meridians, there exist Zhen Zang Mai (True Visceral Pulses). The pulse indicating Liver failure feels under the fingers like tracing a knife edge (Ze Ze sound); the pulse indicating Heart failure feels like beans rolling, restless and rapid; the pulse indicating Spleen failure resembles a sparrow pecking, or water leaking from a roof, flowing away without return, or a cup overturned; the pulse indicating Lung failure is like floating feathers with no root, desolate and listless, like numerous small hemp seeds trembling, or like floating waves opening and closing; when the Kidney pulse is about to fail, it comes occasionally like a visiting guest (Sheng Ke), goes like stones being flicked (heavy and striking the finger), or like untying a knot (rope unraveling); when the Ming Men (Gate of Life) pulse is about to fail, it appears like a shrimp swimming (suddenly advancing then retreating) or a fish gliding (initially floating and wagging its tail, then leisurely disappearing); resembling a gushing spring overflowing upwards indicates Bladder failure. Once the True Visceral Pulse manifests, it signifies that Stomach Qi is exhausted. Diagnosis requires observing facial complexion and symptoms, making judgments based on medical principles; this describes the True Visceral Pulse.
The term "True Visceral Pulse" refers to conditions such as the Liver showing a pure Xian (Wiry) pulse without Stomach Qi. When the Liver pulse fails, it feels under the fingers like touching a knife blade—tense and urgent, completely lacking a harmonious and gentle quality—thus indicating death. The Heart failure pulse feels like rolling beans, trembling and restless, indicating Heart failure. The Spleen failure pulse resembles a bird pecking at wood: frequent pecks followed by occasional pauses; like water leaking from a roof, dropping slowly; like flowing water that does not return; or like an overturned cup. These are all Spleen failure pulses. The Lung failure pulse is like wind blowing feathers, light and rootless, desolate and weak; like many tiny hemp seeds; or like floating waves opening and closing. These are Lung failure pulses. The Kidney failure pulse comes occasionally like a visitor; feels heavy and hard like flicking stones; or unravels like a loosened rope. These are Kidney failure pulses. "Xia You" (Shrimp Swimming) resembles a shrimp moving forward slowly then suddenly retreating; "Yu Xiang" (Fish Gliding) resembles a fish floating and wagging its tail before leisurely vanishing. These are Ming Men failure pulses. "Yong Quan" (Gushing Spring) resembles water surging upward from below, indicating Bladder failure. The human True Visceral Pulse refers to the Liver showing pure Wiry, Heart showing pure Rapid/Full, Lung showing pure Floating/Hair-like, and Kidney showing pure Deep/Stony pulses, devoid of the harmonious Stomach Qi. Hence, they are called True Visceral Pulses. If the True Pulse manifests, it confirms the absence of Stomach Qi. Since the pulse relies on Stomach Qi as its foundation, the absence of Stomach Qi signifies death. However, once the principles of pulse diagnosis are clear, one must further examine facial colors and clinical manifestations, judging each case according to principle. Then, the methods for determining life and death, fortune and misfortune, will be as accurate as a shadow following a form or an echo responding to a sound. The difficulty of medicine lies primarily in unclear principles; the difficulty of principles lies especially in imprecise pulse theory. Among pulse theories, the most detailed and easiest to comprehend is Cui Jiayan's Si Yan Ju Yao (Four-Character Essentials). Scholars should study it thoroughly, memorize it deeply, and reflect upon it, so that their understanding becomes clear and intuitive. The skill of "heart attuning with the hand" resides here.