疝气弦急积聚在里牢急者生弱急者死此言疝气脉证宜别也疝气者气聚而大外仍敛束故脉
见弦急皆从寒湿积郁于里得之若弦急而牢见积聚之有根亦征元本之壮实脉症两宜故曰生若但
急而弱急则邪盛弱则正衰更非积聚在里者之所宜故曰死
腰痛之脉多沉而弦兼浮者风兼紧者寒弦滑痰饮濡细肾着大乃肾虚沉实闪肭此言腰痛脉证
之义也腰痛者足之六经病也足三阳从头走足足三阴从足入腹各经受邪则随各经之所过者为痛
诸经腰痛脉多沉弦者沉为在里弦则为痛故多沉弦也兼浮者风沉弦中有泛泛欲浮之势风虚之象
也兼紧者寒寒紧敛也兼滑者痰饮痰饮滑利也兼濡细者肾着肾着者湿濡细渗着也兼大者肾虚肾
虚不敛藏而反空松虚大也兼实者闪肭闪肭非瘀血则气滞皆成凝滞故沉实也
香港脚有四迟寒数热浮滑者风濡细者湿此言香港脚脉证之义也香港脚一证成于寒湿者十常八九
（内经）曰清湿袭邪病起于下诚哉是言也其始发甚微发亦易解若不早治愈发愈重甚至痿痹不
仁
者有之发于三阳者轻三阴者重初发时大类伤寒头痛发热恶寒呕吐但足屈伸不能或痛或红为异
耳在阳分多恶寒壮热头痛红紫热肿患多在外廉阳分三阳经所过之处面光泽脉多浮在阴分多恶
寒甚或厥逆不发热或呕逆或腹痛下利或微赤而热或反极冷患多在腿内廉阴分三阴经所过之处
面青惨脉多沉此言阴阳之大概也香港脚总不出寒热风湿四者脉来三至为迟迟则为寒脉来六至为
数数即热证若为风邪所袭脉必浮滑湿气所侵脉必濡细是在圆机活法谨察脉证而分别之斯善矣
疝气脉象弦而急，若腹部有积聚且脉象牢而急，预后良好；若脉象弱而急，则预后不良。这是论述疝气的脉证，应当加以辨别。所谓疝气，是指气机聚结于内，外形虽然收敛束紧，所以脉象表现为弦急。这多是由于寒湿积郁于体内所致。如果脉象弦急且牢，说明积聚有根，也征示元气根本壮实，脉象与症状相宜，所以说预后良好（生）。如果只是脉急而弱，急表示邪气盛，弱表示正气衰，这就不符合积聚在体内的情况了，所以说预后不良（死）。
腰痛的脉象多呈沉而弦，兼见浮脉的属风，兼见紧脉的属寒，兼见滑脉的是痰饮，兼见濡细脉的是肾着病，脉象大的属肾虚，脉象沉实的属闪肭（扭伤）。这是论述腰痛脉证的义理。腰痛是足部六经的病证。足三阳经从头走向足底，足三阴经从足部进入腹部，各经受邪，疼痛部位就随着各经脉循行经过的地方而定。各种经络引起的腰痛，脉象多呈沉弦，因为沉主里证，弦主痛证，所以多见沉弦脉。兼见浮脉，是因为风邪，沉弦之中带有泛泛欲浮的趋势，这是风虚之象。兼见紧脉，是因为寒邪，寒性收引紧束。兼见滑脉，是因为痰饮，痰饮性质滑利。兼见濡细脉，是因为肾着病，“肾着”是指湿气渗着于肾府。兼见大脉，是因为肾虚，肾虚不能敛藏，反而空松虚大。兼见实脉，是因为闪肭，闪肭如果不是瘀血就是气滞，都会形成凝滞，所以脉象沉实。
香港脚（脚气）病，脉迟属寒，脉数属热，脉浮滑属风，脉濡细属湿。这是论述香港脚脉证的义理。“香港脚”这一病症，十常八九是由寒湿引起的。《内经》说：“清湿之邪侵袭人体，疾病起于下部。”这确实是至理名言。该病初发时症状很轻微，也容易解除，如果不早治愈，发作会越来越重，甚至出现痿痹、不知痛痒的情况。发于三阳经的病情较轻，发于三阴经的病情较重。初发时，症状很像伤寒，有头痛、发热、恶寒、呕吐等症状，但区别在于足部屈伸不能，或者疼痛、发红。病在阳分者，多恶寒、壮热、头痛、局部红紫、热肿，患病部位多在腿外侧，即三阳经经过的地方，面色光泽，脉象多浮。病在阴分者，多恶寒严重，甚至四肢厥冷而不发热，或者呕吐逆气、腹痛下利，或者微赤而热，或者反而极冷，患病部位多在腿内侧，即三阴经经过的地方，面色青惨，脉象多沉。这是阴阳病证的概况。香港脚总离不开寒、热、风、湿四种因素。脉来一息三至为迟，迟则为寒证；脉来一息六至为数，数即为热证。如果是风邪所袭，脉必浮滑；如果是湿气所侵，脉必濡细。关键在于圆机活法，仔细诊察脉证并分别对待，这才是高明的医术。
The pulse of hernia (Shan Qi, a condition characterized by abdominal pain and distension) is wiry (Xian, indicating tension or pain) and rapid. If there is an accumulation in the interior and the pulse is firm (Lao, indicating excess and solidity) and rapid, survival is indicated; if the pulse is weak and rapid, death is indicated. This discusses the pulse and symptoms of hernia, which should be distinguished. Hernia refers to the gathering of Qi internally, while the exterior remains constricted; thus, the pulse appears wiry and rapid. This usually results from cold-dampness accumulating and stagnating in the interior. If the pulse is wiry, rapid, and firm, it indicates that the accumulation has a root, signifying robust Yuan Qi (Original Qi). Since the pulse and symptoms are consistent, survival is indicated. However, if the pulse is merely rapid but weak, rapidness indicates excess pathogenic factors, while weakness indicates deficiency of healthy Qi. This is inconsistent with internal accumulation, hence death is indicated.
The pulse for lower back pain (Yao Tong) is mostly deep (Chen, indicating interior conditions) and wiry. A superficial (Fu, indicating exterior conditions) pulse suggests wind; a tight (Jin, indicating cold or pain) pulse suggests cold; a slippery (Hua, indicating phlegm or dampness) pulse indicates phlegm-fluids (Tan Yin); a soggy-thin (Ru Xi, indicating dampness or deficiency) pulse indicates Kidney-Involution (Shen Zhuo, a condition where dampness adheres to the lower back); a large (Da, indicating deficiency or heat) pulse indicates Kidney Deficiency (Shen Xu); a deep-firm (Chen Shi) pulse indicates sprain/strain (Shan Na). This elucidates the principles of pulse and symptoms in lower back pain. Lower back pain is a disease of the six meridians of the foot. The three Yang meridians of the foot travel from the head to the feet, while the three Yin meridians travel from the feet into the abdomen. When each meridian is invaded by pathogens, pain occurs along its pathway. For lower back pain involving various meridians, the pulse is mostly deep and wiry because deepness indicates interior involvement and wiriness indicates pain. A superficial component indicates wind, manifesting as a floating tendency within the deep-wiry pulse, representing the image of wind-deficiency. A tight component indicates cold, as cold causes contraction and tightening. A slippery component indicates phlegm-fluids, which are slippery in nature. A soggy-thin component indicates Kidney-Involution, where dampness infiltrates and adheres. A large component indicates Kidney Deficiency, where the Kidney fails to consolidate and becomes empty and loose. A firm component indicates sprain/strain; whether due to blood stasis or Qi stagnation, both lead to obstruction, resulting in a deep-firm pulse.
Hong Kong Foot (Xiang Gang Jiao, commonly known as Beriberi or gouty arthritis in TCM context) presents with a slow (Chi, indicating cold) pulse for cold, a rapid (Shu, indicating heat) pulse for heat, a floating-slippery pulse for wind, and a soggy-thin pulse for dampness. This explains the pulse and symptomology of Hong Kong Foot. Eight or nine out of ten cases of this condition arise from cold-dampness. As stated in the *Neijing* (Inner Canon): "Clear dampness attacks the body, and diseases originate from below." This is indeed true. Initially, the onset is subtle and easily resolved; however, if not treated early, it worsens with each recurrence, potentially leading to flaccidity, bi-syndrome (painful obstruction), and anesthesia. Manifestations in the Three Yang meridians are mild, while those in the Three Yin meridians are severe. At onset, symptoms resemble Taiyang Cold Damage (Shang Han), including headache, fever, aversion to cold, and vomiting. The distinguishing features are the inability to flex or extend the feet, or pain/redness. In the Yang aspect, there is often aversion to cold, high fever, headache, redness/purple discoloration, and hot swelling. The lesions are mostly on the lateral side of the leg (pathway of the Three Yang meridians), the complexion is lustrous, and the pulse is mostly superficial. In the Yin aspect, there is severe aversion to cold, possibly with cold extremities (Jue Ni) and no fever, or vomiting/reversal of Qi, abdominal pain, and diarrhea. There may be slight redness and heat, or extreme cold. Lesions are mostly on the medial side of the leg (pathway of the Three Yin meridians), the complexion is dark/gloomy, and the pulse is mostly deep. This outlines the general distinction between Yin and Yang aspects. Hong Kong Foot generally involves cold, heat, wind, and dampness. A pulse arriving at three beats per breath cycle is slow, indicating cold. A pulse arriving at six beats per breath cycle is rapid, indicating heat. Wind invasion typically presents with a floating-slippery pulse, while dampness invasion presents with a soggy-thin pulse. Success depends on flexible application of principles, careful observation of pulses and symptoms, and appropriate differentiation.