结脉，往来缓，时一止复来（《脉经》）。《脉诀》言∶或来或去，聚而却还。与结无关。仲景有累累如循长竿曰阴结，
蔼蔼如车盖曰阳结。《脉经》又有如麻子动摇，旋引旋收，聚散不常者曰结，主死。此三脉，名同实异也。
〔体状诗〕结脉缓而时一止，独阴偏盛欲亡阳。浮为气滞沉为积，汗下分明在主张。
〔相类诗〕见代脉。
〔主病诗〕结脉皆因气血凝，老痰结滞苦沉吟。内生积聚外痈肿，疝瘕（假）为殃病属阴。结主阴盛之病。越人曰∶
结甚则积甚，结微则气微，浮结外有痛积，伏结内有积聚。
代脉，动而中止，不能自还，因而复动（仲景）。脉至还入尺，良久方来（吴氏）。脉一息五至，肺、心、脾、肝、
肾五脏之气，皆足五十动而一息，合大衍之数，谓之平脉。反此则止乃见焉，肾气不能至，则四十动一止；肝气不能至，
则三十动一止。盖一脏之气衰，而他脏之气代至也。《经》曰∶代则气衰。滑伯仁曰∶若无病，羸瘦脉代者，危脉也。
有病而气血乍损，气不能续者，只为病脉。伤寒心悸脉代者，复脉汤主之，妊娠脉代者。其胎百日。代之生死，不可不
辨。
〔体状诗〕动而中止不能还，复动因而作代看。病者得之犹可疗，平人却与寿相关。
〔相类诗〕数而时至名为促，缓止须将结脉呼。止不能回方是代，结生代死自殊涂。促、结之止无常数，或二动、
三动，一止即来。代脉之止有常数，必根据数而止，还入尺中，良久方来也。
〔主病诗〕代脉元因脏气衰，腹痛泄痢下元亏。或为吐泻中宫病，女子怀胎三月兮。《脉经》曰∶代散者死。生泄
及便脓血。五十不止身无病，数内有止皆知定。四十一止一脏绝，四年之后多亡命。三十一止即三年，二十一止二年应。
十动一止一年殂，更观气色兼形证。两动一止三四日，三四动止应六七。五六一止七八朝，次第推之自无失。戴同父曰∶
脉必满五十动，出自《难经》；而《脉诀》五脏歌，皆以四十五动为准，乖于经旨。柳东阳曰∶古以动数候脉，是吃紧
语。须候五十动，乃知五脏缺失。今人指到腕臂，即云见了。夫五十动，岂弹指间事耶？故学人当诊脉、问证、听声、
观色，斯备四珍而无失。
结脉，脉搏往来缓慢，偶尔出现一次停顿后继续跳动（出自《脉经》）。《脉诀》中说：有时来有时去，聚集后又退去。这与结脉无关。张仲景提到：脉搏累累如同顺着长竹竿摸到那样，称为阴结；脉搏蔼蔼如同车盖那样，称为阳结。《脉经》中又说：脉搏像麻子一样动摇，旋转牵引又收回，聚散无常的称为结，主死症。这三种脉象，名称相同但实质不同。
〔体状诗〕结脉缓慢且偶尔停止，独盛的阴气偏颇导致阳气欲亡。浮取为气机阻滞，沉取为积滞内停，发汗或攻下之法需根据主治者判断。
〔相类诗〕参见代脉。
〔主病诗〕结脉皆因气血凝滞，老痰结聚停滞令人痛苦呻吟。体内产生积聚，体外发生痈肿，疝气和瘕块（假）造成祸殃，病症属于阴证。结脉主阴盛之病。越人（扁鹊）说：结脉严重则积聚严重，结脉轻微则气机微弱。浮取见结脉，外部有痛性积聚；伏取见结脉，内部有积聚。
代脉，脉搏跳动中途停止，不能自行恢复，因而再次跳动（出自张仲景）。脉搏回到尺部，很久之后才再次到来（出自吴氏）。一息之间脉搏跳动五次，肺、心、脾、肝、肾五脏之气，都充足能够跳动五十次为一息，符合大衍之数，这称为平脉（正常脉象）。与此相反则会出现停顿，肾气不能到达，则四十次跳动后出现一次停顿；肝气不能到达，则三十次跳动后出现一次停顿。大概是一脏之气衰弱，而其他脏之气代为至也。《内经》说：代脉表示气衰。滑伯仁说：如果没有疾病，身体消瘦而脉象代的，是危重脉象。如果有病而气血突然受损，气不能接续的，只是病脉。伤寒病出现心悸且脉象代的，用复脉汤主治；妊娠期间脉象代的，说明胎儿一百天。代脉关乎生死，不可不辨别。
〔体状诗〕跳动中途停止不能恢复，再次跳动因此被视为代脉。病人得了此脉尚可治疗，健康人出现此脉却与寿命相关。
〔相类诗〕数脉而时常停止名为促脉，缓脉而停止应当称为结脉。停止不能回还才是代脉，结脉主生代脉主死，二者路径截然不同。促脉和结脉的停止没有固定次数，或是两次、三次跳动，一次停止后即来。代脉的停止有固定次数，必须依据次数而止，脉搏回到尺部，很久之后才来。
〔主病诗〕代脉原本因为脏气衰弱，腹痛泄痢导致下元亏虚。或者是呕吐腹泻导致的脾胃病变，女子怀孕三个月时也会出现。《脉经》说：代脉兼散脉者死。出现生泄及大便脓血。五十次跳动不停止，身体无病；数脉中有停顿都能知晓确定。四十一动出现一次停顿，一脏绝气，四年之后多死亡。三十一动出现一次停顿，三年应验。二十一动出现一次停顿，二年应验。十动出现一次停顿，一年殂落。还要观察气色兼看形体证候。两动出现一次停顿，三四日应验；三四动出现一次停顿，应六七。五六一动出现一次停顿，七八朝应验，按次序推演自然不会失误。戴同父说：脉象必须满五十动，出自《难经》；而《脉诀》中的五脏歌诀，都以四十五动为标准，违背了经典旨意。柳东阳说：古代以动数来候脉，这是关键的话语。必须候满五十动，才知道五脏的缺失。现在的人手指刚碰到腕臂，就说看见了。那五十动，难道是弹指间的事吗？所以学习之人应当诊脉、问证、听声、观色，这样备齐四诊就不会失误。
Jie Pulse (Knotted Pulse, Ji Mai), the pulse comes and goes slowly, occasionally pausing once before resuming (from *Mai Jing*). *Mai Jue* states: sometimes coming, sometimes going, gathering then retreating. This is unrelated to Jie Pulse. Zhang Zhongjing mentions: pulses that are clustered like feeling along a long bamboo stalk are called Yin Jie; pulses that are abundant like a chariot canopy are called Yang Jie. *Mai Jing* also states: pulses that shake like hemp seeds, rotating and pulling back, gathering and scattering irregularly are called Jie, indicating death. These three pulses share the same name but differ in substance.
[Body Form Poem] Jie Pulse is slow with occasional pauses; excessive Yin dominance threatens Yang depletion. Floating indicates Qi stagnation, deep indicates accumulation; one must distinguish between sweating and purging methods based on the practitioner's judgment.
[Similarity Poem] See Dai Pulse.
[Main Disease Poem] Jie Pulse arises from Qi and Blood coagulation, old phlegm stagnation causing bitter groaning. Internal accumulations and external carbuncles arise; hernias and masses cause disaster, the disease belongs to Yin. Jie governs diseases of Yin excess. Yue Ren (Bian Que) said: Severe Jie indicates severe accumulation, mild Jie indicates weak Qi. Floating Jie indicates external painful accumulation, hidden Jie indicates internal accumulation.
Dai Pulse (Intermittent Pulse, Dai Mai), the pulse moves then stops, cannot return to itself, thus moving again (from Zhang Zhongjing). The pulse returns to the Chi position, arriving only after a long interval (from Wu Shi). In one breath, the pulse beats five times. The Qi of the Lung, Heart, Spleen, Liver, and Kidney organs should each be sufficient for fifty beats per breath, conforming to the number of Great Expansion (Da Yan), which is called Ping Pulse (Normal Pulse). Opposite to this, pauses appear. If Kidney Qi cannot arrive, there is a pause after forty beats; if Liver Qi cannot arrive, there is a pause after thirty beats. Generally, when the Qi of one organ declines, the Qi of another organ takes over to arrive. *Jing* says: Dai indicates Qi decline. Hua Boren said: If there is no disease, but the body is emaciated and the pulse is Dai, it is a critical pulse. If there is disease and Qi and Blood are suddenly damaged, and Qi cannot continue, it is merely a pathological pulse. In Shanghan disease with palpitations and Dai pulse, Fumai Tang (Recovery Pulse Decoction) is the primary treatment. In pregnancy, a Dai pulse indicates the fetus is one hundred days old. The life-and-death implications of Dai pulse must not be ignored.
[Body Form Poem] Moving then stopping without returning, subsequent movement leads one to view it as Dai. For patients, obtaining this pulse is still treatable; for healthy people, it relates to lifespan.
[Similarity Poem] Rapid pulse with occasional stops is named Cu Pulse (Surging Pulse, Cu Mai); slow pulse with stops should be called Jie Pulse. Only when the stop does not return is it Dai; Jie implies life while Dai implies death, their paths diverge significantly. The stops in Cu and Jie pulses have no fixed count, occurring after two or three beats, pausing once then resuming. The stops in Dai pulse have a fixed count, always pausing according to the number, returning to the Chi position, and arriving only after a long interval.
[Main Disease Poem] Dai Pulse originates from organ Qi decline, abdominal pain and diarrhea depleting the Lower Yuan. It may also result from vomiting and diarrhea affecting the Middle Palace (Spleen/Stomach), or in women during the third month of pregnancy. *Mai Jing* states: Dai combined with Scattered pulse indicates death. Occurs with loose stools and pus/blood in stool. Fifty beats without stopping indicate no illness; pauses within rapid pulses can be known and determined. A pause at forty-one beats indicates one organ failing, with death likely within four years. A pause at thirty-one beats corresponds to three years. A pause at twenty-one beats corresponds to two years. A pause at ten beats corresponds to one year. One must also observe complexion and physical signs. Two beats with one pause correspond to three or four days; three or four beats with one pause correspond to six or seven. Five or six beats with one pause correspond to seven or eight mornings. Deduce in order, and errors will be avoided. Dai Tongfu stated: Pulses must complete fifty beats, originating from *Nan Jing*; however, the Five Organs song in *Mai Jue* uses forty-five beats as the standard, deviating from classical principles. Liu Dongyang said: Ancient practitioners used beat counts to examine pulses, which is crucial. One must monitor fifty beats to know the deficiencies of the five organs. Today's practitioners touch the wrist and arm briefly and claim to have seen everything. Is fifty beats really a matter of snapping fingers? Therefore, students must examine the pulse, inquire about symptoms, listen to sounds, and observe colors, thereby completing the Four Examinations without error.