脉得诸沉责其有水浮气与风沉实或里沉数为阳沉迟为阴浮大出厄虚小可惊此言水病脉证
之义也水气有四曰气水曰风水曰石水曰里水其水虽诸种不一而脉之见沉者在在皆兼即气水风
水之在表而脉应浮者亦必有沉沉欲下之势盖沉下者水之性也以状言浮则以位言耳若沉而数乃
为阳水证必兼阳而热多沉而迟乃为阴水证必兼阴而寒多水脉浮大水气涣散灾厄将出之象水脉
虚小则正衰邪存诚可惊也
胀满脉弦土制于木湿热数洪阴寒迟弱浮为虚满紧则中实浮大可治虚小危极此言胀满脉证
之义也胀谓胀于外满谓满于中排脏腑而郭胸胁急皮肤而露筋脉脐凸腰圆鼓之如鼓胸腹之疾也
大抵起于饮食不节起居失宜房室过劳忧思无极致气壅滞留中而胀满之疾渐起矣故实者少虚者
多热者少寒者多皆成于脾胃者矣盖脾胃者土也居中而溉四脏若见弦脉知木来侮土更为不吉若
见数洪必湿热之郁若见迟弱乃阴寒所凝浮则气散外虽满而中必虚紧则气敛外固坚而中更实浮
而大者元气之振作与病形相宜故云可治虚而小者知元气衰微又与病形相反故云危极也
五脏为积六腑为聚实强者生沉细者死此言积聚脉证生死之义也（难经五十五难曰）积者
阴
气也聚者阳气也阴沉而伏阳浮而动又曰积者五脏所生聚者六腑所成积凡有五肝之积名曰肥气
心之积名曰伏梁脾之积名曰痞气肺之积名曰息贲肾之积名曰奔豚其病各有五其痛有常处六腑
为聚其病奔向流行痛无常处越人以阴阳分脏腑故有五六之名耳所以论积聚分脏腑者亦不过以
沉伏留止不移者属阴阴则为脏浮动聚散不常者属阳阳则为腑耳其脉实强者阳脉也一以征邪正
之相搏一以征元本之壮实从腑从阳故曰生其脉沉细者阴脉也一以征邪气之深入一以征元本之
衰微从脏从阴故曰死
脉象呈现各种沉象，应当责求体内有水饮；脉象浮起，多与气滞和风邪有关。脉象沉实，或里位见沉数脉，属于阳证；脉象沉迟，属于阴证。脉象浮大，提示病情危重，灾厄即将显现；脉象虚小，则令人惊惧。这段话阐述了水病脉证的含义。
水气病分为四种：气水、风水、石水、里水。虽然水病的种类不一，但脉象见沉的，处处都兼有沉象。即使是气水、风水在表，脉象应当见浮，但也必然带有沉而欲下的趋势。这是因为“沉”是水的本性。从形态上讲，“浮”是指部位而言。如果脉沉而数，就是阳水证，必然兼有阳热之象；如果脉沉而迟，就是阴水证，必然兼有阴寒之象。水病脉象浮大，是水气涣散、灾厄将出的征象；水病脉象虚小，则是正气衰败、邪气留存，确实值得惊惧。
胀满病的脉象若见弦脉，是木来克制土（脾胃受肝木制约）；脉数洪，多为湿热；脉迟弱，多为阴寒；脉浮，提示为虚满；脉紧，提示中焦充实。脉象浮大者尚可治疗，脉象虚小者则危险至极。这段话阐述了胀满脉证的含义。
“胀”是指体表肿胀，“满”是指腹内痞满。这种病症排挤脏腑，扩张胸胁，紧绷皮肤，显露筋脉，肚脐突出，腰部变圆，腹部鼓胀如鼓，这是胸腹部的疾病。大体上，此病起因于饮食不节制、起居失常、房事过度劳累、忧思无度，导致气机壅滞，留积于中焦，从而逐渐形成胀满之疾。因此，实证较少，虚证较多；热证较少，寒证较多，这些大多是由脾胃受损所致。因为脾胃属土，位居中央，灌溉滋养四脏。如果见到弦脉，说明木气来侮犯脾土，更为不吉；如果见到数洪脉，必然是湿热郁结；如果见到迟弱脉，乃是阴寒凝滞；脉浮则说明气机涣散，外表虽胀满，内部必定虚弱；脉紧则说明气机收敛，外表坚固坚实，内部更加充实。脉象浮大，表示元气振作，与病形相适宜，所以说可以治疗；脉象虚小，表示元气衰微，又与病形相反，所以说危险至极。
五脏形成的称为“积”，六腑形成的称为“聚”。脉象实强者可生，脉象沉细者死。这段话阐述了积聚脉证生死预后的含义。（《难经·五十五难》说：）“积”是阴气所致，“聚”是阳气所致。阴脉沉伏，阳脉浮动而动。又说：“积”由五脏产生，“聚”由六腑形成。“积”共有五种：肝脏的积名叫“肥气”，心脏的积名叫“伏梁”，脾脏的积名叫“痞气”，肺脏的积名叫“息贲”，肾脏的积名叫“奔豚”。它们的病症各有五种表现，疼痛有固定位置。六腑形成的是“聚”，其病症游走流行，疼痛没有固定位置。越人（秦越人，即扁鹊）用阴阳来区分脏腑，所以有了五和六的名称。之所以论述积聚分属脏腑，也不过是因为沉伏停留、移动不变的属于阴，阴则对应脏；浮动聚散、不常固定的属于阳，阳则对应腑。脉象实强，是阳脉，一方面征验邪正相搏，一方面征验元气的壮实，病从腑、从阳，所以说能生。脉象沉细，是阴脉，一方面征验邪气深入，一方面征验元气的衰微，病从脏、从阴，所以说死亡。
The pulse presenting various sunken (Chen, 沉) qualities indicates the presence of water retention. A floating (Fu, 浮) pulse is often associated with Qi stagnation and Wind pathogen. A sunken and solid (Shi, 实) pulse, or a sunken-heat (Chen-Shu, 沉数) pulse at the interior level, belongs to Yang syndrome; a sunken-slow (Chen-Chi, 沉迟) pulse belongs to Yin syndrome. A floating and large (Da, 大) pulse suggests critical illness with impending disaster; a deficient and small (Xu-Xiao, 虚小) pulse is alarming. This passage elucidates the principles of pulses and symptoms in Water Disease (Shui Bing, 水病).
Water-Qi disease is divided into four types: Qi Water (Qi Shui, 气水), Feng Water (Feng Shui, 风水), Shi Water (Shi Shui, 石水), and Li Water (Li Shui, 里水). Although the varieties of water disease are numerous, whenever the pulse presents as sunken, it invariably carries the quality of sunkenness. Even for Qi Water and Feng Water located at the exterior, where the pulse should theoretically be floating, there must inevitably be a tendency towards sunkenness. This is because "sunken" reflects the nature of water. In terms of morphology, "floating" refers to the position. If the pulse is sunken and rapid (Shu, 数), it constitutes a Yang Water syndrome, necessarily accompanied by Yang heat; if the pulse is sunken and slow (Chi, 迟), it constitutes a Yin Water syndrome, necessarily accompanied by Yin cold. A floating and large pulse in water disease indicates the dispersion of water qi and the emergence of disaster; a deficient and small pulse indicates the decline of righteous Qi and the persistence of pathogenic factors, which is indeed alarming.
In distension-fullness disease, a wiry (Xian, 弦) pulse indicates Wood overacting on Earth (Spleen/Stomach constrained by Liver); a rapid and surging (Hong, 洪) pulse indicates damp-heat; a slow and weak (Ruo, 弱) pulse indicates Yin-cold; a floating pulse indicates deficiency-type fullness; a tight (Jin, 紧) pulse indicates excess in the middle jiao. A floating and large pulse is treatable; a deficient and small pulse is critically dangerous. This passage elucidates the principles of pulses and symptoms in Distension-Fullness (Zhang Man, 胀满).
"Distension" (Zhang, 胀) refers to swelling on the exterior; "fullness" (Man, 满) refers to stuffiness within the interior. This condition displaces the Zang-Fu organs, expands the chest and hypochondrium, tenses the skin, exposes the sinews, protrudes the umbilicus, rounds the waist, and causes the abdomen to swell like a drum. It is a disease of the chest and abdomen. Generally, this disease arises from irregular diet, improper daily routine, excessive sexual activity and fatigue, and unending worry and thought, leading to Qi congestion and stasis in the middle jiao, gradually giving rise to distension-fullness. Therefore, excess patterns are few while deficiency patterns are many; heat patterns are few while cold patterns are many, all resulting from Spleen and Stomach dysfunction. The Spleen and Stomach belong to Earth, reside in the center, and irrigate the four other Zang organs. If a wiry pulse is seen, it indicates Wood invading Earth, which is particularly inauspicious. If a rapid and surging pulse is seen, it must be due to damp-heat stagnation. If a slow and weak pulse is seen, it is caused by Yin-cold coagulation. A floating pulse indicates Qi dispersion; although the exterior appears full, the interior is definitely deficient. A tight pulse indicates Qi contraction; although the exterior appears firm and solid, the interior is even more excess. A floating and large pulse indicates the revitalization of Yuan Qi, harmonious with the pathological form, hence it is said to be treatable. A deficient and small pulse indicates the decline of Yuan Qi, contrary to the pathological form, hence it is said to be critically dangerous.
Accumulation (Ji, 积) originates in the Five Zang organs; Gathering (Ju, 聚) originates in the Six Fu organs. A strong and robust pulse indicates survival; a sunken and fine pulse indicates death. This passage elucidates the life-and-death prognosis in Accumulation-Gathering diseases. (*Nan Jing*, Chapter 55 states:) "Accumulation" is caused by Yin Qi; "Gathering" is caused by Yang Qi. Yin pulses are sunken and hidden; Yang pulses are floating and moving. It further states: "Accumulations" arise from the Five Zang organs; "Gatherings" are formed by the Six Fu organs. There are five types of Accumulation: The accumulation of the Liver is named Fei Qi (Fei Qi, 肥气); the accumulation of the Heart is named Fu Liang (Fu Liang, 伏梁); the accumulation of the Spleen is named Pi Qi (Pi Qi, 痞气); the accumulation of the Lung is named Xi Ben (Xi Ben, 息贲); the accumulation of the Kidney is named Ben Tun (Ben Tun, 奔豚). Their diseases each have five manifestations, and their pain has fixed locations. Gatherings in the Six Fu organs move and flow freely, with pain having no fixed location. Yue Ren (Yue Ren, 越人, i.e., Bian Que) distinguished Zang and Fu using Yin and Yang, hence the names five and six. The reason for discussing Accumulation and Gathering in relation to Zang and Fu is simply that those which are sunken, hidden, stationary, and immobile belong to Yin, and Yin corresponds to Zang; those which are floating, gathering, scattering, and irregular belong to Yang, and Yang corresponds to Fu. A strong and robust pulse is a Yang pulse, indicating both the struggle between pathogenic and righteous Qi and the robustness of the original constitution. Since it follows Fu and Yang, it indicates survival. A sunken and fine pulse is a Yin pulse, indicating both the deep invasion of pathogenic Qi and the decline of the original constitution. Since it follows Zang and Yin, it indicates death.