风伤于卫浮缓有汗伤寒于荣浮紧无汗此言风寒之邪而脉浮缓浮紧之不同也凡风邪之伤于
人也则卫气受之故脉浮而缓卫气受伤则腠理疏泄故有汗寒邪之伤于人也则荣血受之故脉浮而
紧荣血受伤则腠理固密故无汗
暑伤于气脉虚身热湿伤于血脉缓细涩此言暑湿之邪而脉虚涩之不同也暑乃阳邪性热而散
暑伤元气故脉虚身热湿为水湿血液相近湿伤血分故脉缓细涩
伤寒热病脉喜浮洪沉微涩小证反必凶汗后脉静身凉则安汗后脉躁热甚必难阳病见阴病必
危殆阴病见阳虽困无害上不至关阴气已绝下不至关阳气已竭代脉止歇脏绝倾危散脉无根形损
难医此言伤寒证之脉也（经云）人之伤于寒也则为病热热病火邪有余虽是阴寒之邪袭人生气
中
郁蒸而成热病故脉喜浮而洪大此脉症相应故喜焉若脉见沉微涩小即是阳病见阴脉故症反必凶
伤寒得汗邪解正复热退身凉而安矣若得汗后脉仍躁而热加甚是正气已衰必难乎其有生矣阳病
见阴者热病得沉微涩小之阴脉言证与脉反故亦危殆阴病见阳脉者是转寒凛而变温和病虽困笃
自当无害尺为阴尺脉上不至关是阴气已绝于下寸为阳寸脉下不至关是阳气已竭于上是阴阳离
异矣代脉止歇者乃脏真气不能接续其倾危可立见也散脉无根者谓脉外散而不敛内无根蒂之固
若形见损伤必难医治矣
风邪侵袭卫分，脉象表现为浮而缓，伴有汗出；寒邪侵袭营分，脉象表现为浮而紧，无汗。这是在说明风寒之邪导致脉象浮缓与浮紧的不同之处。凡是风邪伤人，首先侵犯卫气，所以脉象浮而缓；卫气受伤，腠理（皮肤毛孔及皮下组织间隙）疏松泄越，因此有汗。寒邪伤人，首先侵犯营血，所以脉象浮而紧；营血受伤，腠理固密，因此无汗。
暑邪伤气，脉象虚，身体发热；湿邪伤血脉，脉象缓、细、涩。这是在说明暑湿之邪导致脉象虚涩的不同之处。暑属于阳邪，性质炎热且发散，暑邪损伤元气，所以脉象虚而身体发热；湿与水湿相近，湿邪损伤血分，所以脉象缓、细、涩。
伤寒热病，脉象喜见浮洪，若见沉微、涩、小等脉，证候相反则必然凶险。发汗后，若脉象平静、身体凉爽，则平安；发汗后，若脉象躁动、热势更甚，则必定难治。阳病见到阴脉，必危殆；阴病见到阳脉，虽然困顿但无害。寸脉下不至关部，是阳气已竭；尺脉上不至关部，是阴气已绝。代脉出现止歇，是脏腑真气断绝，病情倾危；散脉无根，形体受损，难以医治。这是在论述伤寒证候的脉象。（《内经》说）人受寒邪侵袭，就会发生热病。热病是因为火邪有余，虽然是阴寒之邪袭击人体，使生机郁蒸而成热病，所以脉象喜见浮而洪大。此脉症相应，所以说是“喜”。如果脉象出现沉、微、涩、小，即是阳病见到阴脉，所以证候相反必然凶险。伤寒得汗后，邪气解除，正气恢复，热退身凉，则平安。如果得汗后脉象仍然躁动，热势加重，这是正气已经衰败，必定难以生存。阳病见到阴脉，是指热病出现沉、微、涩、小的阴脉，证候与脉象相反，所以也危殆。阴病见到阳脉，是指转寒凛而变为温和，病虽困笃，自然无害。尺部属阴，尺脉上不过关部，是阴气在下方已绝；寸部属阳，寸脉下不过关部，是阳气在上方已竭，这是阴阳离异了。代脉出现止歇，是脏的真气不能接续，其倾危之状可以立刻见到。散脉无根，是指脉象外散而不收敛，内无根蒂之固，如果形体出现损伤，必定难以医治。
Wind pathogen invading the Wei (Defensive) level presents with a floating and moderate pulse accompanied by sweating; Cold pathogen invading the Ying (Nutritive) level presents with a floating and tight pulse without sweating. This describes the difference in pulses—floating/moderate versus floating/tight—caused by Wind and Cold pathogens. When Wind pathogen attacks the human body, it affects the Wei Qi (Defensive Qi), thus the pulse is floating and moderate. When Wei Qi is injured, the Cou Li (pores and interstitial spaces) become loose and leaky, resulting in sweating. When Cold pathogen attacks the human body, it affects the Ying Blood, thus the pulse is floating and tight. When Ying Blood is injured, the Cou Li become firm and dense, resulting in no sweating.
Summerheat pathogen injuring Qi presents with a deficient pulse and bodily heat; Dampness pathogen injuring the blood vessels presents with a slow, fine, and choppy pulse. This describes the difference in pulses—deficient/choppy—caused by Summerheat and Dampness pathogens. Summerheat is a Yang pathogen with hot and dispersing nature; it injures Yuan Qi (Primordial Qi), hence the pulse is deficient and the body is hot. Dampness is close to water-dampness; it injures the Blood level, hence the pulse is slow, fine, and choppy.
In Cold Damage (Shanghan) febrile diseases, a floating and surging pulse is favorable. If the pulse is deep, minute, choppy, or small, indicating a contradiction between symptoms and pulse, the prognosis is definitely ominous. After sweating, if the pulse becomes calm and the body cools, the patient will be safe. After sweating, if the pulse remains restless and heat intensifies, recovery will be difficult. Yang diseases presenting Yin pulses indicate critical danger; Yin diseases presenting Yang pulses, though severe, are not harmful. If the Cun (inch) pulse does not reach down to the Guan (bar) position, Yang Qi is exhausted. If the Chi (cubit) pulse does not reach up to the Guan position, Yin Qi is exhausted. Dai pulse (intermittent pulse) with pauses indicates the exhaustion of Zang organ true Qi, leading to imminent collapse. San pulse (Scattered pulse) without root, combined with physical deterioration, is difficult to treat. This discusses the pulses of Shanghan syndromes. As stated in the Classics: "When humans are injured by Cold, they develop febrile disease." Febrile disease arises from excess Fire pathogen. Although it is caused by Yin-Cold pathogen attacking the body, causing the vital energy to stagnate and steam into heat, the pulse favors being floating and surging. Since this pulse corresponds to the symptoms, it is considered favorable. However, if the pulse appears deep, minute, choppy, or small, it represents a Yang disease presenting Yin pulses, so the contradictory symptoms indicate an ominous prognosis. In Shanghan, after sweating, the pathogen is resolved, Zheng Qi (Upright Qi) recovers, heat subsides, and the body cools, ensuring safety. If after sweating the pulse remains restless and heat increases, it indicates that Zheng Qi has already declined, making survival unlikely. Yang disease presenting Yin pulses refers to febrile disease presenting deep, minute, choppy, or small Yin pulses; since the syndrome and pulse contradict each other, it is also critical. Yin disease presenting Yang pulses refers to a transition from cold rigidity to warmth; although the condition is severe, it is naturally harmless. The Chi position belongs to Yin; if the Chi pulse does not extend up to the Guan position, Yin Qi is exhausted below. The Cun position belongs to Yang; if the Cun pulse does not extend down to the Guan position, Yang Qi is exhausted above. This represents the separation of Yin and Yang. The Dai pulse with pauses indicates that the True Qi of the Zang organs cannot continue, and its critical state is immediately apparent. The San pulse without root means the pulse scatters outward without gathering, lacking internal stability like a root. If physical form shows damage, it is undoubtedly difficult to treat.