洪则既大且数，累累珠联，如循琅 。来则极盛，去则稍衰（素问）。凡浮芤实大，皆属洪类。不
似实脉之举按逼逼，滑脉之软滑流利，大脉之大而且长也。（语出张璐。又濒湖体状诗曰∶脉来洪盛去还衰，
满指滔滔应夏时；若在春秋冬月分，升阳散火莫狐疑。相类诗曰∶洪脉来时拍拍然，去衰来盛似波澜；欲知实
脉参差处，举按弦长 坚。诊家正眼云∶洪脉只是根脚阔大，却非硬坚。若使大而坚硬，则为实脉，而非洪
脉矣。）洪为火气燔灼。凡烦渴、狂躁、斑疹、腹胀、头疼、面热、咽干、口疮、痈肿等症，靡不由此曲形。
如见脉洪而浮，则为表热；脉洪而沉，则为里热；脉洪而滑，则为兼痰。至于阳亢之极而足冷尺弱，屡下而热
势不除，洪数不减，与脉浮而洪，身汗如油，泄泻虚脱，脉见洪盛者，皆为难治，不可强也。（经曰，形瘦脉
多气者死，景岳曰∶若
洪大至极，甚至四倍以上者∶是即阴阳离绝关格之脉也。林之翰曰∶凡久嗽久病之人，及失血下痢者，俱忌洪脉。）
微则似有若无，欲绝不绝，指下按之，稍有模糊之象。凡细小虚涩，皆属微类。不似弱脉之小弱
分明，细脉之纤细有力也。（语出张璐。又濒湖体状相类诗曰∶微脉轻微瞥瞥乎，按之欲绝有如无；微为阳弱
细阴弱，细比于微略较粗。）微为阳气衰微之候。凡种种畏寒、虚怯、胀满、呕吐、泄泻、眩晕、厥逆并伤精
失血等症，皆于微脉是形，治当概作虚治。（语出景岳。又李士材曰∶仲景云，瞥瞥如羹上肥状，
其软而无力也。萦萦如蜘蛛丝状，其细而难见也。轻取之而如无，故曰阳气衰；重按之而欲绝，故曰阴气竭。
长病得之死，谓正气将次灭绝也；卒病得之生，谓邪气不至深重也。）然有痛极脉闭，脉见沉伏，与
面有热色，邪未欲解，并阴阳俱停，邪气不传，而脉俱见微者。若以微为虚象，不行攻发，何以通邪气之滞
耶．必热除身安，方为欲愈之兆耳。（李时珍曰∶轻诊即见，重按如欲绝者，微也。往来如线而常有者，细也。）
洪脉既宽大又快速，脉搏连续不断如珠串相连，触感如同抚摸温润的玉石。来势极盛，去势稍衰（出自《素问》）。凡是浮脉、芤脉、实脉、大脉，都属于洪脉的类别。不像实脉在轻取和重按时都感到坚实有力，不像滑脉那样柔软流利，也不像大脉那样既宽大又长。（这段话出自张璐。另外李时珍《濒湖脉学·体状诗》说：脉来洪盛而去时稍衰，满指滔滔如水应合夏季之时；如果在春秋冬三季出现，应当升阳散火，不要犹豫不决。《相类诗》说：洪脉来时拍击有力，去势衰而来势盛，像波澜起伏；想知道实脉与洪脉的不同之处，在于实脉举按之下弦长且坚硬。《诊家正眼》说：洪脉只是根部宽阔宏大，却并不坚硬。如果脉大而坚硬，那就是实脉，而不是洪脉了。）洪脉代表火气炽盛灼烧。凡是烦躁口渴、狂躁不安、斑疹发出、腹胀、头痛、面部发热、咽喉干燥、口舌生疮、痈肿等症状，没有不是由此病机所呈现的。如果见到脉洪而浮，就是表热证；脉洪而沉，就是里热证；脉洪而滑，就是兼有痰湿。至于阳气亢盛到极点导致脚冷、尺脉微弱，多次攻下后热势仍不消除，洪数脉不减，以及脉浮而洪、身体出汗如油、泄泻虚脱、脉象洪盛的，都属于难治之症，不可强行治疗。（《内经》说，形体消瘦而脉气多者死，张景岳说：如果洪大至极，甚至达到正常四倍以上的：这就是阴阳离绝、关格不通的脉象。林之翰说：凡是久咳久病的人，以及失血、下痢的患者，都忌讳出现洪脉。）
微脉似乎有又似乎无，想要断绝却又未完全断绝，手指按压下去，感觉稍有模糊的形象。凡是细小、虚弱、涩滞的脉，都属于微脉的类别。不像弱脉那样小弱分明，不像细脉那样纤细但仍有力量。（这段话出自张璐。另外李时珍《濒湖脉学·体状相类诗》说：微脉轻微闪烁，按压时好像要断绝又像没有；微脉反映阳气衰弱，细脉反映阴气衰弱，细脉比微脉略微粗一些。）微脉是阳气衰微的征候。凡是各种畏寒、虚弱怯懦、胀满、呕吐、泄泻、眩晕、四肢厥逆以及伤精、失血等症状，都在微脉上有所体现，治疗应当一概作为虚证来处理。（这段话出自张景岳。另外李士材说：张仲景描述为“瞥瞥如羹上肥”的样子，那是软而无力的样子；“萦萦如蜘蛛丝”的样子，那是细而难以看见的样子。轻取时好像没有，所以说是阳气衰；重按时想要断绝，所以说是阴气竭。久病之人得此脉主死，意味着正气即将灭绝；急病之人得此脉主生，意味着邪气并不深重。）然而也有因疼痛极度剧烈导致脉道闭塞，脉象沉伏，或者面色红赤，邪气尚未解除，以及阴阳俱停、邪气不传变，而脉象都表现为微的情况。如果把微脉仅仅当作虚象，不进行攻邪发散的治疗，怎么能疏通邪气的阻滞呢？必须等到热除身安，才是将要痊愈的征兆。（李时珍说：轻取即见，重按好像要断绝的，是微脉。往来如线但始终存在的，是细脉。）
Hong pulse (Surging Pulse) is both large and rapid, with beats linked continuously like a string of pearls, feeling as if touching polished jade. The arrival is extremely vigorous, while the departure is slightly weaker (from *Suwen*). Any floating (Fou), knotted (Kou), solid (Shi), or large (Da) pulses belong to the category of Hong pulse. It does not feel firm and forceful upon both light and heavy pressure like the Shi pulse, nor is it soft and slippery like the Hua pulse, nor is it merely large and long like the Da pulse. (This passage is from Zhang Lu. Additionally, Li Shizhen's *Binhu Tizhuang Shi* states: "The pulse comes surging and strong but deploys weaker; filling the fingers with a torrential flow, corresponding to summer time; if seen in spring, autumn, or winter months, one should raise yang and scatter fire without hesitation." The *Xianglei Shi* states: "When the Hong pulse arrives, it beats forcefully; the departure is weak while the arrival is strong, resembling waves; to know the difference between the Shi pulse and Hong pulse, note that the Shi pulse is string-like and long, hard and firm when lifted and pressed." *Zhenjia Zhengyan* states: "The Hong pulse is simply broad at the root, yet not hard and firm. If it is large and hard, it is the Shi pulse, not the Hong pulse.") Hong pulse signifies blazing and scorching fire qi. Symptoms such as irritability and thirst, mania and restlessness, macules and rashes, abdominal distension, headache, facial heat, dry throat, mouth ulcers, and carbuncles are all manifestations arising from this pathogenesis. If the pulse is Hong and floating, it indicates exterior heat; if Hong and deep, it indicates interior heat; if Hong and slippery, it indicates concomitant phlegm. As for extreme hyperactivity of yang leading to cold feet and weak chi pulse, or heat persisting despite repeated purgation with no reduction in the Hong-rapid pulse, or a floating and Hong pulse accompanied by sweat like oil, diarrhea with collapse, or a surging pulse in cases of collapse, these are all difficult-to-treat conditions and should not be forced. (*Jing* states: "Those who are emaciated but have excessive pulse qi will die." Zhang Jingyue states: "If the pulse is excessively large and Hong, even more than four times normal: this is the pulse of separation of yin and yang, Guan-Ge syndrome." Lin Zhihan states: "For those with chronic cough or chronic illness, as well as those with blood loss or dysentery, a Hong pulse is contraindicated.")
Wei pulse seems present yet absent, on the verge of disappearing but not completely cut off; under the finger upon pressing, there is a slightly blurred sensation. Any fine, small, deficient, or choppy pulses belong to the category of Wei pulse. It is not distinctively small and weak like the Ruo pulse, nor is it fine yet forceful like the Xi pulse. (This passage is from Zhang Lu. Additionally, Li Shizhen's *Binhu Tizhuang Xianglei Shi* states: "The Wei pulse is slight and flickering; pressing it feels as if it is about to disappear yet is not; Wei indicates weakness of yang, Xi indicates weakness of yin; Xi is slightly coarser compared to Wei.") Wei pulse is a sign of decline and deficiency of yang qi. Various symptoms such as aversion to cold, deficiency and timidity, distension and fullness, vomiting, diarrhea, vertigo, cold extremities, injury to essence, and blood loss all manifest through the Wei pulse, and treatment should generally address them as deficiency patterns. (This passage is from Zhang Jingyue. Additionally, Li Shicai states: "Zhang Zhongjing described it as 'flickering like fat floating on soup,' indicating softness and lack of strength; 'lingering like a spider's thread,' indicating fineness and difficulty in perception. Light palpation reveals nothing, hence it is said to be deficiency of yang; heavy palpation feels as if it is about to cease, hence it is said to be exhaustion of yin. In chronic diseases, obtaining this pulse indicates death, meaning righteous qi is about to perish; in acute diseases, obtaining this pulse indicates survival, meaning pathogenic qi is not severe.") However, there are cases where extreme pain causes pulse blockage, resulting in a deep and hidden pulse; or where the face has a red hue and pathogenic factors have not yet resolved; or where yin and yang are stagnant and pathogenic factors do not transmit, yet the pulse appears Wei. If Wei pulse is regarded solely as a sign of deficiency and attacking and dispersing methods are not employed, how can the stagnation of pathogenic qi be unblocked? Only when heat is eliminated and the body feels comfortable is it a sign of impending recovery. (Li Shizhen states: "Seen upon light palpation, but feeling as if it will cease upon heavy pressure, this is Wei. Coming and going like a thread but constantly present, this is Xi.")