人一呼脉行三寸，一吸脉行三寸，呼吸定息，脉行六寸。一昼一夜，一万三千五百息，脉行八百一十丈，此平人血
气营运之定数也。医者欲知血气之病与不病，非切脉不足以得之。脉之状不一，载于《脉经》者二十有四∶浮、沉、芤、
滑、实、弦、紧、洪、微、缓、涩、迟、伏、濡、弱、数、细、动、虚、促、结、代、革、散。其状大率多兼见。人之
为病有四∶曰寒、曰热、曰实、曰虚。故学脉者，亦必以浮、沉、迟、数为之纲，以察病情，此不易之论也。然涩之见，
固多虚寒，亦有痼热为病者。医于指下见有不足之气象，便以为虚，或以为寒，孟浪与药，无非热补，轻病为重。重病
为死者多矣。何者？人之所借以为生者，血与气也。或因忧郁，或因浓味，或因无汗，或因补剂，气腾血沸，清化为浊，
老痰宿饮，胶固杂糅，脉道阻涩，不能自行，亦见涩状。若重取至骨，来似有力且带数，以意参之，于证验之，形气但
有热证，当作痼热可也。此论为初学人发，圆机之士必以为赘。东阳吴子，年方五十，形肥味浓，且多忧怒，脉常沉涩，
自春来得痰气病。医认为虚寒，率与燥热香窜之剂，至四月间两足弱，气上冲，饮食减。召我治之，予曰∶此热郁而脾
虚，痿厥之证作矣，形肥而脉沉，未是死证。但药邪太盛，当此火旺，实难求生。且与竹沥下白术膏尽二斤，气降食进，
一月后大汗而死。书此以为诸贤覆辙戒云！
人每一次呼气，脉气运行三寸；每一次吸气，脉气也运行三寸。在呼吸之间停顿的瞬间（定息），脉气共运行六寸。一昼一夜，人体呼吸一万三千五百次，脉气运行八百一十丈，这是健康人气血循环运行的固定规律。医生想要了解患者气血是否有病，不通过切脉是无法得知的。脉象的形态多种多样，王叔和在《脉经》中记载了二十四种：浮、沉、芤、滑、实、弦、紧、洪、微、缓、涩、迟、伏、濡、弱、数、细、动、虚、促、结、代、革、散。这些脉象大多兼夹出现。人的疾病主要有四种：寒证、热证、实证、虚证。因此，学习诊脉的人，必须以浮、沉、迟、数这四种脉象为纲领，来察辨病情，这是不可改变的原则。然而，涩脉的出现，固然多见于虚寒证，也有因久积之热邪致病的。医生如果在指下感觉到脉象有不足的气象，就认为是虚证或寒证，鲁莽地给予药物，无非是温热补益之剂，导致轻病转重，重病者多因此死亡。为什么呢？人赖以生存的是血和气。有的人因为忧郁，有的人因为饮食肥甘厚味，有的人因为无汗，有的人因为误用补药，导致气机升腾、血液沸腾，清稀之气转化为浑浊之物，老痰和宿饮胶结混杂，阻碍脉道，使气血不能自行通畅，也会出现涩脉的形态。如果重按至骨，脉搏似乎有力且带有数象，用心推究，结合症状验证，如果形体和气机只表现出热证，那么应当诊断为久积之热邪。这篇论述是为了启发初学者而作，通晓变通的医家必定认为这是多余的话。东阳吴先生，年龄刚五十岁，形体肥胖，饮食浓烈，且多忧怒，脉象常呈沉涩，从春季开始患上痰气病。医生认为是虚寒证，一律给予燥热香窜的药物，到了四月间，两足痿软无力，气机上冲，饮食减少。请我去诊治，我说：这是热邪郁结而脾气虚弱，痿厥之证即将发作。形体肥胖而脉象沉，还不是死证。只是药邪太盛，正值火旺之时，实在难以求生。我只给他服用竹沥并送服白术膏，总共用了二斤，结果气降食进，一个月后大汗淋漓而死。写下此文，以此警示各位贤达避免重蹈覆辙！
With each exhalation, the pulse travels three cun; with each inhalation, the pulse also travels three cun. At the pause between breaths (Dingxi), the pulse travels a total of six cun. In one day and night, there are 13,500 respiratory cycles, during which the pulse travels 810 zhang. This is the fixed number for the circulation of Qi and Blood in a healthy person. To determine whether Qi and Blood are diseased or healthy, physicians cannot rely on anything other than pulse diagnosis (Qiemai). The appearances of pulses are varied; twenty-four types are recorded in *Mai Jing* (Pulse Classic): Floating (Fu), Sinking (Chen), Hollow (Kou), Slippery (Hua), Full/Excess (Shi), String-taut (Xian), Tight (Jin), Surging (Hong), Faint (Wei), Slow/Lazy (Huan), Choppy (Se), Delayed (Chi), Hidden (Fu), Soft (Ru), Weak (Ruo), Rapid (Shu), Fine/Thready (Xi), Moving (Dong), Deficient (Xu), Frequent (Cu), Knotted (Jie), Intermittent (Dai), Leathery (Ge), and Scattered (San). These pulse forms often appear in combination. Human diseases generally fall into four categories: Cold (Han), Heat (Re), Excess (Shi), and Deficiency (Xu). Therefore, those learning pulse diagnosis must take Floating, Sinking, Delayed, and Rapid as their guiding principles to examine pathological conditions; this is an unchangeable principle. However, although the appearance of a Choppy pulse (Se) is mostly seen in Deficiency-Cold patterns, it can also occur in cases of entrenched Heat (Gu Re). When a physician feels a sense of insufficiency under the fingers, they may rashly diagnose it as Deficiency or Cold and administer hot tonifying medicines indiscriminately. This turns mild illnesses into severe ones, and many patients with severe illnesses die because of it. Why? What humans borrow for life is Blood and Qi. Due to depression, rich diet, lack of sweating, or misuse of tonics, Qi may surge and Blood may boil, transforming clear essence into turbid matter. Old phlegm and retained fluids become sticky and mixed, obstructing the pulse channels so that Qi and Blood cannot flow freely, resulting in a Choppy pulse appearance. If pressing heavily to the bone reveals a pulse that seems forceful and rapid, one should deduce this mentally and verify it through symptoms. If the physical constitution and Qi only show Heat signs, it should be diagnosed as Entrenched Heat. This discussion is intended to enlighten beginners; skilled practitioners who understand flexibility will likely consider it superfluous. Mr. Wu from Dongyang, aged fifty, was obese, consumed rich foods, and suffered from frequent worry and anger. His pulse was frequently Sinking and Choppy. From spring, he contracted a Phlegm-Qi disease. Physicians diagnosed it as Deficiency-Cold and uniformly administered drying, heating, aromatic, and penetrating agents. By April, his legs became weak, Qi rushed upward, and his appetite decreased. I was summoned to treat him and said: "This is Heat stagnation with Spleen Deficiency; Wei Jue syndrome (limping and cold limbs) is about to manifest. Although the body is obese and the pulse is Sinking, this is not yet a death sign. However, the medicinal pathogen is too strong, and amidst the flourishing Fire, survival is difficult." I prescribed Bamboo Sap (Zhuli) followed by Baizhu Gao (White Atractylodes Paste), consuming two jin in total. His Qi descended, and his appetite improved, but he died after one month from profuse sweating. I record this to warn all scholars against repeating these mistakes!