（芤而弦曰革。主阴虚失血。与芤同。今附于此。脉经。谓芤脉浮大而 。按之中央空。两边实。旧谓前后为两边
者。固非矣。李士材以浮沉为两边。亦不是。有力谓之实。浮中沉相去无几。岂有浮候实。沉候实。而中候独见其空者
乎。据内经论浮脉云。其气来毛。中央坚。两旁虚。此谓太过。由是推之。则两边指两旁也。盖芤脉浮大而 。按之两
旁浮实。而中央独陷下。此血不充之象。故主失血诸症）
轻手乱之浮大 。重按中空边实芤。（芤。草名。中空如葱。血行脉中。失血者其脉中空。故以芤比之。）寸关吐衄
肠痈病。尺部崩淋便血流。（吐血、衄血、肠痈、血崩、血淋。大便下血等症。皆阳盛阴。虚也。摧阳。故其脉浮大。惟
阴虚。故其脉中空盛）
有表无里大而散。至数不齐。杨花无定空中泛。左寸怔忡。右寸自汗。（散主气实血虚。心主血。血虚则心神恍惚不
宁。曰怔忡。气实者。邪气实也。邪气实则热。热则气泄故自汗。）左关温饮兮。（阴虚生内热胃热则津液耗。而发渴。
渴多饮。渗入肌肤会肠胃之外。谓之滋饮）右关食痹。胳肿亦堪断。（胃热则不和。不和则不消谷。因而痞闷。曰食痹、
、足肿也。 明肾经。下循胫外廉。冒热故 肿。）尺为血大虚。两尺如斯终专算。（经以医脉散为血少。载同父曰。
肾脉散诸病脉代散。皆不可治也。）
（芤脉兼见弦象称为革脉。主要主阴虚失血之证，与芤脉病机相同，故在此附注。《脉经》记载：芤脉浮大中空，按之中央空，两边实。旧说认为前后为两边的说法是错误的。李士材以浮、沉为两边，也不正确。有力才称为实，若浮、中、沉三部相差不大，怎会有浮候实、沉候实，而唯独中候见空的情况呢？根据《内经》论浮脉云：“其气来毛，中央坚，两旁虚”，这是指太过之脉。由此推断，“两边”指的是指下的两旁。大概芤脉浮大而中空，按之两旁浮实，而中央独陷下，这是血液不充盈的征象。所以主治失血诸症。）
轻手乱取则见浮大中空，重按则边实中空的脉象是芤脉。（芤，是一种草名，中间空心像葱一样。血液行于脉中，失血者的脉象中间空虚，所以用芤草来比喻。）寸部和关部出现芤脉，主吐血、衄血、肠痈等病；尺部出现芤脉，主崩漏、淋证、大便下血等症。（吐血、衄血、肠痈、血崩、血淋、大便下血等症状，都是阳盛阴亏所致。阳气被摧折，所以脉象浮大；唯有阴虚，所以脉象中空。）
有表无里，脉形大而散漫，至数不齐，如同杨花在空中浮动没有定所。左寸见散脉，主怔忡；右寸见散脉，主自汗。（散脉主气实血虚。心主血，血虚则心神恍惚不宁，称为怔忡。气实是指邪气实，邪气实则生热，热则气泄，所以自汗。）左关见散脉，主温饮（即水饮内停）。（阴虚生内热，胃热则津液耗伤而发渴，口渴多饮，水渗入肌肤肠胃之外，称为滋饮/水饮）。右关见散脉，主食痹，也可诊断出肢体浮肿。（胃热则不和，不和则不能消化谷物，因而痞闷，称为食痹；足肿也与此有关。肾经下行沿胫骨外廉，冒受热气故导致肿胀。）尺部见散脉为血大虚，两尺脉皆如此者，最终专断为死证或难治之证。（经典医书认为医家诊得散脉为血少，戴同父说：肾脉散，以及诸病脉代散，都是不可治的死证。）
(When the Kou pulse [Kou Mai, a hollow pulse resembling a leek stalk] is combined with a string-like tension, it is called the Ge pulse [Ge Mai, a firm and hard pulse]. It primarily indicates Yin deficiency with blood loss, sharing the same pathogenesis as the Kou pulse; thus, it is appended here. The *Mai Jing* (Classic of Pulse Diagnosis) states: "The Kou pulse is floating and large, yet empty in the center; upon pressing, the center is empty while the sides are solid." The old interpretation that "front and back" constitute the sides is incorrect. Li Shicai's interpretation that "floating and deep" constitute the sides is also inaccurate. "Solid" implies strength. If there is little difference between the floating, middle, and deep positions, how could the floating position be solid and the deep position be solid, while only the middle position appears empty? According to the *Nei Jing* (Inner Canon) on the Floating pulse [Fu Mai]: "Its qi comes like hair, firm in the center, and deficient on both sides," referring to an Excessive condition. From this, we deduce that "both sides" refers to the lateral aspects under the fingers. Essentially, the Kou pulse is floating and large yet empty; upon pressing, the sides are floating and solid, while the center alone sinks down. This is a sign of blood insufficiency. Therefore, it governs various conditions of blood loss.)
Lightly palpating reveals a floating, large, and hollow pulse; heavy pressing reveals solidity at the edges and emptiness in the center—this is the Kou pulse. ("Kou" is a name for a plant, hollow in the middle like a green onion. Blood flows within the vessels; in cases of blood loss, the pulse becomes hollow in the center, hence the comparison to the Kou plant.) A Kou pulse at the Cun (inch) and Guan (bar) positions indicates vomiting blood, epistaxis, or intestinal abscess. A Kou pulse at the Chi (cubit) position indicates uterine bleeding, strangury, or hematochezia. (Conditions such as vomiting blood, epistaxis, intestinal abscess, metrorrhagia, bloody strangury, and hematochezia are all caused by Yang excess and Yin deficiency. Yang is constrained, resulting in a floating and large pulse; due to Yin deficiency, the pulse is hollow in the center.)
A pulse that exists on the surface but lacks depth, appearing large and scattered, with irregular rhythm, is likened to willow catkins floating aimlessly in the air. A Scattered pulse [San Mai] at the left Cun position indicates palpitations [Zhengchong]; at the right Cun position, it indicates spontaneous sweating. (The Scattered pulse indicates Qi excess and Blood deficiency. The Heart governs Blood; Blood deficiency leads to a restless and unsettled mind, termed palpitations. Qi excess refers to pathogenic Qi excess; pathogenic excess generates heat, which causes Qi leakage and thus spontaneous sweating.) A Scattered pulse at the left Guan position indicates retained fluids/water drinking [Wen Yin]. (Yin deficiency generates internal heat; stomach heat consumes body fluids, causing thirst. Excessive drinking leads to water infiltrating the skin and outside the intestines and stomach, termed retained fluids.) A Scattered pulse at the right Guan position indicates food stagnation obstruction [Shi Bi], and can also diagnose limb edema. (Stomach heat leads to disharmony; disharmony prevents the digestion of grains, resulting in fullness and obstruction, termed food stagnation obstruction. Edema of the feet is also related. The Kidney meridian descends along the outer edge of the tibia; exposure to heat causes swelling.) A Scattered pulse at the Chi position indicates severe Blood deficiency. If both Chi positions exhibit this, it ultimately signifies a terminal or incurable condition. (Classics state that physicians diagnose Scattered pulses as indicating low Blood. Dai Tongfu stated: A Scattered pulse in the Kidney position, or a Scattered pulse appearing among other pulse types in various diseases, are all signs of incurability.)