七洪者。阳也。指下寻之极大。举之有余。曰洪。主头疼四肢浮热。大肠不通。
燥热粪结口干遍身疼痛。
洪者。阳火也。何为阳火。纯阳而无阴也。指下寻之极大。阳邪传入里也。
举之有余。客邪犹在表也。此为伤寒表邪未已。传入阳明里证。惟其邪
在表。故有头疼身痛。四肢浮热之证。惟其邪入于里。故有大肠不通。燥
热粪结口干之证也。治以大柴胡汤主之。洁古曰。洪脉者按之实。举之
盛。洪者阳太过。阴不及。主头痛四肢热。大便难。小便赤涩。夜卧不安。治
法阳证下之则愈。如下之随证虚实。有大承气汤。有小承气汤。有大柴
胡汤。桃仁汤。随证用之。此证有两议。或按之无。举之盛。当解表。不可下。
经言脉浮不可下。下之则死。脉沉当下。下之则愈。脉浮为在表。脉沉为
在里。
按脉经云。洪脉极大在指下。一曰浮而大。
洪脉根源本是阳。遇其季夏自然昌。若逢秋季及冬季。发汗通肠始得凉。
洪。阳火也。宜旺于夏季。夏乃火退土旺之时。其脉宜缓。今脉犹有洪。是
为当退不退。然土生长于火。故六月谓之长夏。其离母气也不远。当此
之时。全赖火土合德。万物得以化生功成而退。自然之理。故曰。遇其季
夏自然昌也。若逢秋季。乃建戌之月。是火归墓之时。其脉当毛。于此而
见洪脉。则为当藏而不藏。冬季乃建丑之月。是火方养之时。其脉当石。
于此而见洪脉。则为不当旺而即旺。二者虽土寄旺之时。然三阴用事。
而脉犹见洪。是为阳邪乘阴。在表则有头疼身痛。四肢浮热等证。在里
则有大便不通。燥粪结涩口干等证。在表者发其汗。在里者通其肠。阳
邪退而身自凉矣。云岐子曰。其脉举按皆盛。本为相火之象。发汗从表。
通肠从里。从表宜麻黄汤。从里宜大承气汤。仲景云。谓身体疼痛。主夏
得洪大脉。知其病瘥也。通肠七宣丸。七圣丸。大柴胡汤。大承气汤选用
之。
按经云。洪则为气。一作热。又云。洪大者伤寒热病。又云。脉来洪大袅袅
者社祟。又云脉洪大者。若烦满。沉细者腹中痛。
七、洪脉，属于阳脉。手指下按压时感觉脉形极大，轻取时脉搏有力有余，称为洪脉。它主要主治头痛、四肢浮热、大肠传导不利。以及燥热导致的大便干结、口干、全身疼痛等症状。
洪脉，是阳火之象。什么是阳火？就是纯阳而没有阴气制约。手指下按压时感觉脉形极大，说明阳邪已经传入体内（里证）。轻取时脉搏有力有余，说明外感客邪仍然停留在体表（表证）。这是伤寒病中，体表的邪气尚未解除，又传入了阳明经的里证。正因为邪气仍在体表，所以出现头痛、身体疼痛、四肢浮热等症状；正因为邪气已入里，所以出现大肠不通、燥热粪结、口干等症状。治疗应以大柴胡汤为主方。洁古先生（张元素）说：洪脉按下去坚实，举起来盛大。洪脉代表阳气太过，阴气不足。主治头痛、四肢发热、大便困难、小便赤涩、夜间睡眠不安。治疗方法对于阳证，使用攻下法即可痊愈。但如果根据病情虚实进行攻下，有大承气汤、小承气汤、大柴胡汤、桃仁汤等，需随证选用。此证有两种不同的议论：有的认为如果按下去无力而举起来盛大，应当解表，不可攻下。经典经文说：脉浮不可攻下，攻下会导致死亡；脉沉才应该攻下，攻下才能痊愈。脉浮表示病在表，脉沉表示病在里。
据《脉经》记载：洪脉在指下感觉极大。另一种说法是浮大而有力。
洪脉的根源本是阳气，遇到夏季自然旺盛。如果遇到秋季和冬季，需要通过发汗、通利肠道才能使身体清凉。
洪脉，是阳火之象，适宜在夏季旺盛。夏季是火气退去、土气旺盛的时候，其脉象宜缓和。现在脉象仍然呈现洪大，这是应当衰退却没有衰退。然而土气生长于火气，所以六月被称为长夏。此时离火的母气不远。在这个时候，全赖火与土的德性相合，万物得以化生、功成而退，这是自然的道理。所以说：“遇到季夏自然昌盛。”如果遇到秋季，是建戌之月，是火气归墓的时候，其脉象应当像毛一样轻浮（秋脉毛）。在此时见到洪脉，就是应当潜藏而不潜藏。冬季是建丑之月，是火气正在休养的时候，其脉象应当像石一样沉实（冬脉石）。在此时见到洪脉，就是不应当旺盛却立即旺盛。这两种情况虽然都发生在土气寄旺的时节，但此时三阴经主事，而脉象仍然见洪，这是阳邪乘袭阴位。在表则有头痛、身痛、四肢浮热等症状；在里则有大便不通、燥粪结涩、口干等症状。在表的用发汗法，在里的用通肠法。阳邪退去，身体自然凉爽。云岐子说：其脉举按都盛大，本来是相火的征象。从表治疗宜用麻黄汤，从里治疗宜用大承气汤。仲景说：如果身体疼痛，主症在夏季得到洪大脉，知道病将要痊愈。可选用通肠七宣丸、七圣丸、大柴胡汤、大承气汤等。
据经典经文记载：洪脉主气虚（一说主热）。又说：洪大的脉象见于伤寒热病。又说：脉来洪大且飘忽不定（袅袅），是社祟（鬼神作怪或精神异常）所致。又说：脉洪大且伴有烦闷胀满，若脉转为沉细则是腹中疼痛。
7. The Hong (Surging) pulse belongs to Yang. When pressed with the fingers, it feels extremely large; when lightly lifted, there is an excess of force. This is called the Hong pulse. It primarily governs headache, floating heat in the four limbs, and dysfunction of the Large Intestine. It also governs symptoms such as dry-heat-induced fecal impaction, dry mouth, and generalized body pain.
The Hong pulse is a manifestation of Yang Fire. What is Yang Fire? It is pure Yang without Yin to constrain it. When pressed, it feels extremely large, indicating that Yang pathogenic factors have transmitted into the interior (Li syndrome). When lightly lifted, there is an excess of force, indicating that external guest pathogens remain on the exterior (Biao syndrome). This represents a condition where the exterior pathogens of Cold Damage (Shanghan) have not yet resolved, but have transmitted to the Yangming interior syndrome. Because the pathogen remains on the exterior, symptoms such as headache, body pain, and floating heat in the four limbs occur. Because the pathogen has entered the interior, symptoms such as intestinal obstruction, dry-heat fecal impaction, and dry mouth occur. Treatment should primarily use Da Chai Hu Tang (Major Bupleurum Decoction). Jiegu (Zhang Yuansu) stated: "When pressed firmly, the Hong pulse is solid; when lifted, it is vigorous. The Hong pulse indicates excessive Yang and insufficient Yin. It governs headache, heat in the four limbs, difficulty in defecation, dark and scanty urination, and restless sleep at night." For Yang syndromes, treatment using purgation leads to recovery. However, depending on the deficiency or excess of the condition during purgation, one may select Da Cheng Qi Tang (Major Order the Qi Decoction), Xiao Cheng Qi Tang (Minor Order the Qi Decoction), Da Chai Hu Tang (Major Bupleurum Decoction), or Tao Ren Tang (Peach Kernel Decoction), according to the specific presentation. There are two differing opinions on this syndrome: some argue that if the pulse is weak upon pressing but vigorous upon lifting, one should resolve the exterior and must not use purgation. The Classics state: "If the pulse is floating, do not purge; purging will lead to death. If the pulse is sunken, one should purge; purging will lead to recovery." A floating pulse indicates the disease is in the exterior, while a sunken pulse indicates the disease is in the interior.
According to the *Mai Jing* (Classic of Pulse Diagnosis): "The Hong pulse feels extremely large under the fingers." Another description says it is "floating and large."
The root of the Hong pulse is Yang; it naturally flourishes during the summer season. If encountered in autumn or winter, one must induce sweating and unblock the intestines to achieve coolness.
The Hong pulse is a manifestation of Yang Fire and is appropriate to flourish in summer. Summer is the time when Fire recedes and Earth becomes prosperous; thus, the pulse should be moderate. If the pulse remains Hong now, it signifies a failure to recede when it should. Since Earth grows from Fire, the sixth month is called Long Summer (Chang Xia). At this time, it is not far from the Qi of its mother (Fire). During this period, the harmonious virtue of Fire and Earth allows all things to transform, complete their functions, and retreat. This is the natural order. Hence, it is said: "Encountering late summer, it naturally flourishes." If encountered in autumn, which is the month of Xu (Dog), when Fire returns to its tomb, the pulse should be like hair (light/floating, characteristic of Autumn). To see a Hong pulse here means failing to hide when one should. Winter is the month of Chou (Ox), when Fire is nourishing/resting, and the pulse should be like stone (deep/sunken, characteristic of Winter). To see a Hong pulse here means flourishing when one should not. Although both times involve Earth being dominant, the Three Yin meridians are in charge, yet the pulse still appears Hong. This indicates Yang pathogens attacking Yin positions. On the exterior, there are symptoms such as headache, body pain, and floating heat in the four limbs; on the interior, there are symptoms such as constipation, dry fecal impaction, and dry mouth. For those on the exterior, use diaphoresis (sweating); for those on the interior, use intestinal unblocking. As Yang pathogens retreat, the body naturally cools. Yunqi Zi stated: "When lifted and pressed, the pulse is vigorous; this is originally the image of Ministerial Fire." Treating from the exterior suits Ma Huang Tang (Ephedra Decoction); treating from the interior suits Da Cheng Qi Tang (Major Order the Qi Decoction). Zhongjing stated: "If there is body pain, and in summer a Hong-large pulse is obtained, it indicates the disease will recover." One may selectively use Tong Chang Qi Xuan Wan (Seven Wonders Pill for Unblocking the Intestines), Qi Sheng Wan (Seven Sages Pill), Da Chai Hu Tang (Major Bupleurum Decoction), or Da Cheng Qi Tang (Major Order the Qi Decoction).
According to the Classics: "Hong indicates Qi [deficiency] (or Heat)." It also states: "A Hong-large pulse is seen in Cold Damage and febrile diseases." It further states: "If the pulse comes Hong-large and wavering (niao niao), it is due to She Chong (spiritual affliction)." It also states: "If the pulse is Hong-large accompanied by irritability and fullness, but turns sunken and fine, it indicates abdominal pain."