经曰∶诊脉之道，观人勇怯，肌肉皮肤，能知其情，以为诊法也。凡人之形，长不及短，大不及小，肥不及瘦。人
之色，白不及黑，嫩不及苍，薄不及浓。而况肥人湿多，瘦人火多，白者肺气虚，黑者肾气足。形色既殊，脏腑亦异。
外证虽同，治法迥别。所以肥人贵脉浮，瘦人贵脉沉，躁人疑脉缓，缓人疑脉躁，以其不可一概述也。试陈一二，可以
例推。
东阳陈兄，露筋，体稍长。患体虚而劳，头痛，甚至有诀别之言。余察其脉弦而大带数，以人参、白术为君，川芎、
陈皮为佐，至五、六日未减，众皆讶之，以药之不对也。余曰∶药力有次第矣，更少俟一二宿，当自安。忽其季来问∶
何不少加黄 ？予笑不答。又经一宿，忽自言病顿愈。予脉之，觉指下稍盛。又半日，病者言膈上满，不觉饥，视其腹
纹已隐矣。予曰∶夜来药中，莫加黄 否？曰∶然。止与三帖。遂速与二陈汤加浓朴、枳壳、黄连，以泻其卫，三帖而
安。
又浦江义门郑兄，年二十余，秋间大发热，口渴，妄言妄见，病似邪鬼。七、八日后，召我治。脉之两手，洪数而
实，视其形肥，面赤带白，却喜露筋，脉本不实，凉药所致。此因劳倦成病，与温补药自安。曰∶柴胡七、八帖矣。以
黄附子汤，冷与之饮。三帖后，困倦鼾睡，微汗而解，脉亦稍软。继以黄 白术汤，至十日，脉渐收敛而小，又与，
半月而安。
夫黄 补气药也。此两人者，一则气虚，一则气实，便有宜不宜存焉，可不审乎！
《内经》说：诊脉的方法，要观察病人的勇敢或怯懦，以及肌肉皮肤的状况，从而了解病情，作为诊断的依据。大凡人的形体，长的不及短的，大的不及小的，胖的不及瘦的。人的面色，白的不及黑的，嫩的不及苍老的，薄的不及浓厚的。何况胖人多湿，瘦人多火，白色的人肺气虚，黑色的人肾气足。既然形色不同，脏腑也就各异。外在症状虽然相同，治疗方法却截然不同。所以胖人脉象以浮为贵，瘦人脉象以沉为贵，急躁的人若脉缓则令人怀疑，迟缓的人若脉躁也令人怀疑，因为不能一概而论。试举一二例子，可以以此类推。
东阳县的陈先生，青筋暴露，身体稍长。患有体虚兼劳损之病，头痛，甚至说出诀别的话。我诊察他的脉象弦而大且带数，用人参、白术作为主药，川芎、陈皮作为辅药，到了五、六天病情没有减轻，众人都感到惊讶，认为药不对症。我说：药力需要过程，再等一两个晚上，自然会安定。忽然他的弟弟来问：为什么不稍微加一点黄芪？我笑着不回答。又过了一夜，他忽然自己说病突然痊愈了。我再诊他的脉，感觉指下稍微有力。又过了半天，病人说膈上胀满，不觉饥饿，看他的腹纹已经隐没了。我问：昨晚的药中，莫非加了黄芪吗？他说：是的。只给了三帖药。于是迅速给予二陈汤加上厚朴、枳壳、黄连，以泻其卫分之邪，三帖后便安定了。
又有浦江县义门郑先生，二十多岁，秋天时发高热，口渴，胡言乱语，看见幻象，病状像被鬼怪附身。七八天后，请我去治疗。诊两手脉象，洪大、数且实，看他的形体肥胖，面赤带白，却喜欢露出青筋，脉本不实，这是凉药所致。这是因为劳倦成病，用温补药自然能安宁。他说：柴胡已经吃了七八帖了。我用黄芪附子汤，冷着给他喝。三帖后，困倦打鼾睡觉，微微出汗而病解，脉也变得稍软。接着用黄芪白术汤，到十天时，脉逐渐收敛变小，又继续服用，半个月后痊愈。
The *Classic of Internal Medicine* states: The method of pulse diagnosis involves observing a person's courage or timidity, as well as the condition of their muscles and skin, to understand the pathology and establish diagnostic methods. Generally speaking, in terms of body shape, the tall are not inferior to the short, the large are not inferior to the small, and the fat are not inferior to the thin. In terms of complexion, white is not inferior to black, tender is not inferior to dark/rustic, and thin is not inferior to dense. Moreover, fat people tend to have more dampness, while thin people tend to have more fire; those with white complexions have deficient Lung Qi, while those with black complexions have sufficient Kidney Qi. Since physical appearances differ, the internal organs also vary. Although external symptoms may be identical, treatment methods are radically different. Therefore, for fat people, a floating pulse is preferred; for thin people, a deep pulse is preferred. A restless person with a slow pulse raises suspicion, just as a sluggish person with a rapid pulse does, because conditions cannot be generalized. I will briefly present two cases to illustrate how one can infer others from these examples.
Mr. Chen from Dongyang had visible subcutaneous veins (exposed sinews) and was slightly tall. He suffered from deficiency and exhaustion, accompanied by headache, to the extent that he spoke words of farewell. Upon examining his pulse, I found it wiry, large, and rapid. I used *Ren Shen* (Ginseng Radix) and *Bai Zhu* (Atractylodis Macrocephalae Rhizoma) as the sovereign drugs, and *Chuan Xiong* (Ligusticum Chuanxiong Rhizome) and *Chen Pi* (Citri Reticulatae Pericarpium) as ministering drugs. After five or six days, there was no improvement, and everyone was surprised, believing the prescription did not match the syndrome. I said, "The medicinal action requires time; wait another night or two, and you will recover." Suddenly, his younger brother came to ask, "Why didn't you add some Huang Qi?" I smiled and did not answer. After another night, Mr. Chen suddenly declared that his illness had abruptly resolved. Upon re-examining his pulse, I felt it was slightly stronger under my fingers. Half a day later, the patient complained of fullness above the diaphragm and loss of appetite. Observing that his abdominal striae had already faded, I asked, "Did you add Huang Qi to the medicine last night?" He replied, "Yes." Only three doses had been given. Consequently, I quickly prescribed *Er Chen Tang* (Two-Cured Decoction) augmented with *Hou Po* (Magnoliae Officinalis Cortex), *Zhi Ke* (Aurantii Fructus Immaturus), and *Huang Lian* (Coptidis Rhizoma) to drain the Wei level (Defensive Level). After three doses, he recovered.
Another case involved Mr. Zheng from Yimen, Pujiang, who was in his early twenties. In autumn, he suffered from high fever, thirst, delirious speech, and visual hallucinations, appearing as if possessed by evil spirits. Seven or eight days later, he summoned me for treatment. Palpating both wrists, the pulse was surging, rapid, and excess. His body was fat, his face red with a whitish hue, yet he exhibited exposed veins. The pulse was originally not truly excess; this state was caused by the administration of cooling medicines. This illness resulted from fatigue and overwork, which should be treated with warming and tonifying medicines to restore peace. He stated, "I have already taken seven or eight doses of *Chai Hu* (Bupleuri Radix)." I prepared *Huang Qi Fuzi Tang* (Astragalus and Prepared Aconite Decoction) and administered it cold. After three doses, he became drowsy, slept with snoring, and recovered through slight sweating. His pulse became slightly softer. Subsequently, I prescribed *Huang Qi Bai Zhu Tang* (Astragalus and Atractylodes Decoction). By the tenth day, his pulse gradually converged and became smaller. With continued treatment, he recovered after half a month.
Huang Qi (Astragali Radix) is a Qi-tonifying herb. These two patients were different: one had Qi deficiency, the other had Qi excess. Thus, there are indications and contraindications. Can one fail to examine carefully?