滑脉主痰或伤于食下为畜血上为吐逆此言滑脉之为病也滑脉近于水象痰乃水饮所结薄则
稠粘老则 不腐不化之食象亦如之皆有物之脉也在下则见于尺主蓄血病若见于寸滑脉流利
势不安定自当为吐逆然所吐非痰即食设无痰食是为呕逆则脉又当见涩矣
涩脉少血或中寒湿反胃结肠自汗厥逆此言涩脉之为病也血少则枯涩理势之必然者寒湿袭
人肌腠痹着气道不通脉亦滞涩反胃则朝食暮吐暮食朝吐胃无余液而大便秘结脉安得不涩自汗
者汗时时自出也汗出则血耗矣卫气散失四肢厥寒是谓亡阳阳亡血耗脉必见涩滞矣
弦脉主饮病属胆肝弦数多热弦迟多寒浮弦支饮沉弦悬痛阳弦头痛阴弦腹痛此言弦脉之为
病也弦脉主饮夫饮入于胃必阳气为之游溢输布若阳气力薄不能游溢输布即见弦阴敛束之脉则
水饮停留于中矣盖胆为甲木肝为乙木停饮而见弦脉其病当在胆与肝耳数则为热弦而兼数者病
亦多热迟则为寒弦而兼迟者病亦多寒弦则为饮弦而浮则停饮在上名曰支饮不在胃而支流于心
胸间也弦而沉则饮停在下当为悬痛不在胃而悬留于腹胁间也弦脉主饮又主痛者以弦寒敛束气
不舒畅耳阳弦者寸弦也邪在三阳三阳走头上故头痛也阴弦者尺弦也邪在三阴三阴走腹里故腹
痛也
紧脉主寒又主诸痛浮紧表寒沉紧里痛此言紧脉之为病也紧脉主寒紧与弦相似所谓如转索
者是也阳为寒束故紧又主诸痛耳浮以候表浮而兼紧寒在表也沉以候里沉而兼紧寒在里也里为
阴分寒袭阴分阳困阴凝故痛也
滑脉主痰饮或饮食停滞，在下则导致蓄血，在上则引起呕吐逆气。这是论述滑脉所主的病证。滑脉的形态接近于水象，痰饮乃是水液停聚凝结而成，质地稀薄时稠粘，陈旧不化的食物其象也与此相似，这些都是有实质病理产物的脉象。若滑脉出现在尺部，主蓄血病；若出现在寸部，滑脉流利且势态不安定，自然应当表现为呕吐逆气。然而所吐出的物质如果不是痰就是食积，假如没有痰食阻滞却出现呕逆症状，那么脉象又应当表现为涩脉了。
涩脉主血少或寒湿内侵，可导致反胃、结肠便秘、自汗及四肢厥逆。这是论述涩脉所主的病证。血液亏少则脉道枯涩，这是情理上的必然。寒湿侵袭人体肌腠，导致痹阻，气道不通，脉气也会滞涩。反胃表现为早晨吃的食物晚上吐出，晚上吃的食物早晨吐出，因胃中津液枯竭而大便秘结，脉象怎能不涩呢？自汗是指汗液时时自行流出，汗出过多则耗伤血液，卫气散失，四肢厥冷寒冷，这称为亡阳。阳气亡失、血液耗损，脉象必定呈现涩滞之象。
弦脉主饮病，归属于胆和肝。弦数脉多属热证，弦迟脉多属寒证。浮弦脉主支饮，沉弦脉主悬痛。这是论述弦脉所主的病证。弦脉主饮病，水饮进入胃中，必须依靠阳气的游溢输布才能正常运行。如果阳气力量薄弱，不能游溢输布，就会出现弦阴收敛束迫的脉象，从而导致水饮停留于体内。胆属甲木，肝属乙木，停饮而出现弦脉，其病位应当在胆与肝。脉数为热，弦脉兼见数象者，病多属热；脉迟为寒，弦脉兼见迟象者，病多属寒。弦脉主饮，若弦脉兼浮，则停饮在上部，名为支饮，不在胃而在心胸部之间流动；若弦脉兼沉，则停饮在下部，应当表现为悬痛，不在胃而在腹胁之间悬留。弦脉既主饮又主痛，是因为弦脉具有寒性收敛束迫的特点，使气机不畅。所谓“阳弦”，指寸口脉弦，邪气在三阳经，三阳经上行头部，所以出现头痛；所谓“阴弦”，指尺部脉弦，邪气在三阴经，三阴经走行腹部内部，所以出现腹痛。
紧脉主寒邪，又主各种疼痛。浮紧脉主表寒，沉紧脉主里痛。这是论述紧脉所主的病证。紧脉主寒邪，紧脉与弦脉相似，形容其形态如同旋转的绳索。阳气被寒邪束缚故见紧脉，紧脉又主各种疼痛。浮脉以候表证，浮脉兼紧，说明寒邪在表；沉脉以候里证，沉脉兼紧，说明寒邪在里。里部属于阴分，寒邪侵袭阴分，导致阳气被困、阴气凝滞，故而产生疼痛。
The Slippery Pulse (Hua Mai, 滑脉) governs Phlegm-Fluid (Tan Yin, 痰饮) or food retention. Below it leads to Blood Stasis (Xue Yu, 瘀血); above it causes vomiting and rebellious Qi (Ou Ni, 呕逆). This discusses the diseases governed by the Slippery Pulse. The Slippery Pulse resembles the image of water. Phlegm-Fluid is formed by the accumulation and condensation of fluid; when thin, it is sticky; old, undigested food presents a similar image. These are pulses indicating the presence of pathological substances. If the Slippery Pulse appears at the Chi position (尺部), it governs Blood Stasis disease. If it appears at the Cun position (寸部), the Slippery Pulse is smooth and its momentum is unstable, naturally manifesting as vomiting and rebellious Qi. However, if what is vomited is neither phlegm nor food, and yet vomiting and rebellious Qi occur, the pulse should instead appear Choppy (Se Mai, 涩脉).
The Choppy Pulse (Se Mai, 涩脉) governs blood deficiency or invasion by Cold-Dampness, which can lead to Rebellious Vomiting (Fan Wei, 反胃), intestinal obstruction/constipation, spontaneous sweating, and cold extremities (Jue Ni, 厥逆). This discusses the diseases governed by the Choppy Pulse. When blood is deficient, the vessels become withered and choppy, which is logically inevitable. When Cold-Dampness invades the muscle-couplings (Ji Cou, 肌腠), causing Bi obstruction (Bi Zhuo, 痹着) and blocking the Qi mechanism, the pulse also becomes stagnant and choppy. Rebellious vomiting manifests as eating in the morning and vomiting in the evening, or eating in the evening and vomiting in the morning; due to the depletion of stomach fluids and constipation, how can the pulse not be choppy? Spontaneous sweating refers to sweat flowing out continuously. Excessive sweating consumes blood, and the dispersal of Defensive Qi (Wei Qi, 卫气) leads to cold extremities, which is termed Yang Collapse (Wang Yang, 亡阳). With the collapse of Yang and consumption of blood, the pulse must appear stagnant and choppy.
The Wiry Pulse (Xian Mai, 弦脉) governs Fluid Retention (Yin Bing, 饮病) and is associated with the Gallbladder and Liver. A Wiry-Thready Rapid Pulse (Xian Shu, 弦数) indicates Heat; a Wiry-Thready Slow Pulse (Xian Chi, 弦迟) indicates Cold. A Floating-Wiry Pulse (Fu Xian, 浮弦) governs Branch Fluid (Zhi Yin, 支饮); a Sinking-Wiry Pulse (Chen Xian, 沉弦) governs Hanging Pain (Xuan Tong, 悬痛). This discusses the diseases governed by the Wiry Pulse. The Wiry Pulse governs Fluid Retention. When fluids enter the Stomach, they must be circulated and distributed by the transformative power of Yang Qi. If Yang Qi is weak and cannot circulate and distribute them, a Wiry-Yin constricting pulse appears, leading to the retention of fluids within. The Gallbladder belongs to Jia Wood, and the Liver belongs to Yi Wood. When fluid retention presents with a Wiry Pulse, the pathology lies in the Gallbladder and Liver. Rapidness indicates Heat; a Wiry pulse combined with Rapidness indicates that the disease is mostly Heat. Slowness indicates Cold; a Wiry pulse combined with Slowness indicates that the disease is mostly Cold. The Wiry Pulse governs fluid retention. If the Wiry pulse is Floating, the retained fluid is in the upper part, named Branch Fluid, located not in the Stomach but flowing between the Heart and Chest. If the Wiry pulse is Sinking, the retained fluid is in the lower part, manifesting as Hanging Pain, located not in the Stomach but hanging in the abdomen and hypochondrium. The Wiry Pulse governs both fluid retention and pain because the Wiry nature implies Cold constriction, causing Qi mechanism to be unsmooth. "Yang Wiry" refers to a Wiry pulse at the Cun position; pathogenic factors in the Three Yang meridians travel to the head, thus causing headache. "Yin Wiry" refers to a Wiry pulse at the Chi position; pathogenic factors in the Three Yin meridians travel to the interior of the abdomen, thus causing abdominal pain.
The Tight Pulse (Jin Mai, 紧脉) governs Cold and various pains. A Floating-Tight Pulse (Fu Jin, 浮紧) governs Exterior Cold; a Sinking-Tight Pulse (Chen Jin, 沉紧) governs Interior Pain. This discusses the diseases governed by the Tight Pulse. The Tight Pulse governs Cold. The Tight Pulse is similar to the Wiry Pulse, described as resembling a rotating rope. Yang Qi is constrained by Cold, hence the Tight pulse; it also governs various pains. The Floating pulse diagnoses the Exterior; a Floating pulse combined with Tightness indicates Cold in the Exterior. The Sinking pulse diagnoses the Interior; a Sinking pulse combined with Tightness indicates Cold in the Interior. The Interior belongs to the Yin aspect. When Cold invades the Yin aspect, Yang is trapped and Yin coagulates, thus causing pain.