（内经谓之钩。又谓之大。）
应指虽浮大。来盛去衰便曰洪。（洪。夏脉也。春秋冬见之。则病脉也。然就夏来盛去衰如钩。则为平脉。若来盛去
亦盛。此为太过。来不盛。去反盛。此为不及。亦病脉也。如钩者。浮候之来盛下垂。由如钩状。去衰。则又柔和矣。
故为平脉。）真阴不足。邪气相攻。（人之正气。阴阳相配者也。阴阳和。则无病。阴不足。则阳盛。阳盛则生火。火者。
偏胜之气也。偏胜之气。为邪气。邪气即邪火。）寸洪身热兼肤痛。咳唾烦心亦可穷。（阳盛。故身热。火不得浅。故肤
痛。火泻肺。故咳呕。心恶热。故烦。）呕与胀。察阙中。（胃喜清凉而恶热。呕者。火上炎也。火郁而不散也。）尺虚宜
壮水。泄痢不宜逢。（尺脉洪、相火旺也。宜壮水以制阳光。若泄痢尺脉洪者。难治。）
李濒湖、谓洪脉非夏升阳散火宜。愚按新病身强。及洪见寸关者。升阳数火可也。若久病身弱。及洪见两尺者。又
宜以滋阴降火为是。
（濒湖引内经云。气来虚微为不及。病在内。愚按虚脉、浮大无力、微脉、浮细无力、火中不能见细。则虚不可兼
言微矣。今考内经、谓气来不实而微。为不及。不实者细无力之谓也。故可言微。濒湖硬以不实故作虚字误。）
虚来浮大 无力。夏宜逢之暑病居。（暑病发热有汗脉虚者。宜清暑益气。若阴热恶寒无汗脉浮数。而不虚者。宜清
暑解表。）寸虚自汗多惊悸。（虚脉主气血虚。正气虚则邪气实。邪气实便是火火食气则表虚、汗者、心之液也。血所化、
表既虚。创营亦不固。血随火化。外泄于表。为自汗。心藏神。血虚则神失所养。故多惊。火气冲心。故跳动而多悸。）
关主中宫胀不舒。（血虚肝郁则胀、脾胃虚。中气不足亦胀。）潮热骨蒸痿候尺。（阳气终巳。阴气始干。阴虚则交午时阴
分。而阳气并之。阳胜则外越为肌肤热。内烁为骨髓热。热在骨。谓之骨蒸。日如潮水之应时而至。谓之潮热。骨枯髓
竭。足不任身。谓足骨痿。）却怜久病定亡躯。
（《内经》称其为钩脉。又称大脉。）
脉象应指虽浮大，但来势强盛、去势衰弱，便称为洪脉。（洪脉是夏季的平脉。若在春、秋、冬三季出现，则是病脉。然而，若脉象如钩一般，浮取时来势强盛、下沉时柔和减弱，则为正常脉象。如果来势强盛，去势也强盛，这是太过；如果来势不强盛，去势反而强盛，这是不及。这两种情况都是病脉。所谓“如钩”，是指浮取时来势强盛，下沉时如同钩状般柔和减弱，因此称为平脉。）真阴不足，邪气相互攻伐。（人的正气，是阴阳相互配合的结果。阴阳调和，则无疾病。阴液不足，则阳气偏盛。阳气偏盛则生火。火，是偏胜之气。偏胜之气即为邪气，邪气也就是邪火。）寸口脉洪，身体发热兼有皮肤疼痛，咳嗽、唾痰、心烦也可由此穷尽。（阳气偏盛，所以身体发热。火热之邪不能浅留，所以皮肤疼痛。火邪下泻伤肺，所以咳嗽、呕吐。心恶热，所以心烦。）呕吐与腹胀，需观察阙中部位。（胃喜欢清凉而厌恶燥热。呕吐，是火上炎所致。火邪郁结而不能发散。）尺部脉虚宜壮水制阳，泄痢病不宜见到洪脉。（尺脉洪大，是相火旺盛的表现。适宜用壮水的方法来制约阳光般的亢盛之火。如果是泄痢病且尺脉洪大，则难以治疗。）
李濒湖认为洪脉在夏季不应使用升阳散火的治法。我按：新病体质强壮，以及洪脉出现在寸、关部位的，可以使用升阳散火的方法。如果是久病体质虚弱，以及洪脉出现在两尺部位的，又适宜以滋阴降火为主。
（李濒湖引用《内经》说：“气来虚微为不及，病在内。”我按：虚脉是浮大无力，微脉是浮细无力，火热证中不能见到细脉，那么虚脉不可兼言微脉了。现在考证《内经》，说的是气来不实而微，为不及。“不实”是指细而无力的意思。所以说可以言微。李濒湖强行将“不实”解释为“虚”字是错误的。）
虚脉来势浮大无力，夏季适宜遇到，多见于暑病。（暑病发热有汗且脉象虚者，适宜清暑益气。如果是阴虚内热、恶寒无汗、脉浮数但不虚者，适宜清暑解表。）寸口脉虚，自汗多，易惊悸。（虚脉主气血虚弱。正气虚则邪气实。邪气实便是火。火消耗气，导致表虚。汗，是心的津液。血所化生，体表既已虚，营气也不固守。血随火化，外泄于体表，形成自汗。心藏神，血虚则神失所养，所以容易惊恐。火气冲心，所以心跳跳动而多心悸。）关部脉虚主要主中焦胀满不舒。（血虚肝郁则胀满，脾胃虚弱，中气不足也会胀满。）尺部脉虚见潮热骨蒸，是痿证的候象。（阳气终尽，阴气始干。阴虚则在午时阴分受扰，而阳气并合之。阳胜则外越表现为肌肤热，内烁表现为骨髓热。热在骨，称为骨蒸。每日如潮水般按时而至，称为潮热。骨枯髓竭，足不能支撑身体，称为足骨痿。）可惜久病之人定会导致躯体衰亡。
(The *Neijing* refers to it as the "Hook" pulse. It is also called the "Large" pulse.)
Although the pulse feels floating and large upon pressure, if it comes with strength and deploys with weakness, it is termed the Flood (Hong) pulse. (The Flood pulse is the normal summer pulse. If seen in spring, autumn, or winter, it is a pathological pulse. However, if the pulse resembles a hook—coming strongly on superficial palpation and weakening softly upon deepening—it is a normal pulse. If it comes strongly and also deploys strongly, this is Excess; if it comes weakly but deploys strongly, this is Deficiency. Both are pathological pulses. The term "resembling a hook" means that on superficial palpation, the arrival is strong, and the departure softens like a hook's curve, thus indicating a normal pulse.) True Yin insufficiency allows pathogenic factors to attack each other. (Human righteous Qi is the harmonious combination of Yin and Yang. When Yin and Yang are in harmony, there is no disease. Insufficiency of Yin leads to Excess of Yang. Excess of Yang generates Fire. Fire is an excessive Qi. This excessive Qi becomes pathogenic Qi, which is essentially pathogenic Fire.) A Flood pulse at the Cun position indicates body heat accompanied by skin pain; coughing, expectoration, and vexation can also be traced to this. (Yang excess causes body heat. Because Fire cannot remain superficial, it causes skin pain. Fire drains the Lung, causing cough and vomiting. The Heart dislikes heat, causing vexation.) Vomiting and abdominal distension should be observed at the Quezhong area. (The Stomach prefers coolness and dislikes heat. Vomiting is caused by Fire flaming upward. Fire is constrained and not dispersed.) At the Chi position, a Deficient pulse requires strengthening Water to control Yang; Flood pulses are unfavorable in cases of diarrhea and dysentery. (A Flood pulse at the Chi position indicates hyperactive Ministerial Fire. It is appropriate to strengthen Water to restrain the blazing Yang. However, if a patient with diarrhea or dysentery presents a Flood pulse at the Chi position, it is difficult to treat.)
Li Binhu stated that for a Flood pulse in summer, methods of raising Yang and scattering Fire should not be used. I observe: For new diseases where the constitution is strong, and when a Flood pulse appears at the Cun and Guan positions, raising Yang and scattering Fire is acceptable. However, for chronic diseases where the constitution is weak, and when a Flood pulse appears at both Chi positions, nourishing Yin and descending Fire is the correct approach.
(Li Binhu cited the *Neijing*: "Qi coming empty and slight indicates Deficiency, with disease inside." I observe: The Deficient pulse is floating, large, and forceless; the Minute pulse is floating, fine, and forceless. In Fire patterns, a fine pulse cannot be seen; therefore, the Deficient pulse cannot be described as combined with Minute. Upon examining the *Neijing*, it states that Qi coming "not solid" and slight indicates Deficiency. "Not solid" refers to being fine and forceless. Thus, one can speak of slightness. Li Binhu erroneously forced the interpretation of "not solid" into the character "Deficient".)
The Deficient pulse arrives floating, large, and forceless; encountering it in summer is common in Summerheat diseases. (For Summerheat diseases presenting fever, sweating, and a Deficient pulse, clearing Summerheat and benefiting Qi is appropriate. If there is Yin-heat with aversion to cold, no sweating, a floating-rapid pulse that is not Deficient, clearing Summerheat and releasing the exterior is appropriate.) A Deficient pulse at the Cun position indicates spontaneous sweating and frequent palpitations. (The Deficient pulse governs Qi and Blood deficiency. Righteous Qi deficiency leads to Pathogenic Qi excess. Pathogenic Qi excess constitutes Fire. Fire consumes Qi, leading to Exterior deficiency. Sweat is the fluid of the Heart. Transformed from Blood, when the Exterior is deficient, Ying Qi is also insecure. Blood transforms with Fire and leaks outward to the Exterior, resulting in spontaneous sweating. The Heart houses the Spirit; Blood deficiency causes the Spirit to lose its nourishment, hence frequent fright. Fire Qi rushing to the Heart causes palpitations.) A Deficient pulse at the Guan position primarily indicates middle-jiao distension and discomfort. (Blood deficiency with Liver constraint causes distension; Spleen and Stomach deficiency and insufficient Middle Qi also cause distension.) A Deficient pulse at the Chi position with tidal fever and bone-steaming indicates the prognosis for Wei syndrome. (When Yang Qi ends and Yin Qi begins to dry, Yin deficiency disturbs the Yin aspect at noon, allowing Yang Qi to merge with it. Yang excess floats outward causing skin heat, and scorches inward causing marrow heat. Heat in the bone is called bone-steaming. Arriving daily like the tide at specific times is called tidal fever. Withered bones and exhausted marrow render the feet unable to support the body, known as foot bone Wei.) Alas, for those with chronic illness, this inevitably leads to physical decline.