三缓者。阴也。指下寻之。往来迟缓。小于迟脉曰缓。主四肢烦闷。气促不安。
（按他本于小字下有一驶字）
缓者。阴土也。何为阴土。皇极内篇。以脾为二阴之土故也。夫脾为二阴
之土。而脉缓者何也。脉经新撰有曰。脾者土也。德则为缓。恩则为迟。是
以太阴之脉缓而迟。故指法曰。指下寻之。往来迟缓。小于迟脉也。脉经
又曰。缓脉小驶于迟。何也。夫驶者。疾也。大抵平人脉。四至闰以太息。共
成五至。迟脉者。一息三至。其意盖曰缓脉者。比平人之脉。则又稍迟。较
之迟脉。则又小驶耳。故其主病。则皆脾病。经曰。土不及。其病内舍心腹。
外在肌肉四肢。以其四肢属脾。故四肢烦闷也。经又曰。去不及甚。病留
满痞塞。病而留满痞塞。则中气不和。所以气促不安也。洁古曰。证在太
阳。风伤卫。当服桂枝汤。易云。四肢烦满。气促不安。枳术汤主之。按脉经
云。缓脉去来亦迟小驶于迟。一曰浮大而散。阴浮于阳同等。
来往寻之状若迟。肾间生气耳鸣时。邪风积气冲背脑。脑后三针痛即移。
缓脉。指下寻之。一来一往。如丝在机。不卷其轴。其状有似乎迟。此太阴
湿土之气也。土气盛。则下加于肾。肾主藏者也。肾气被克而起。故曰肾
者生气。肾开窍于耳。肾气不藏。则上冲于耳。故又耳鸣。况缓脉又主风
痹之疾。痹者风寒湿三者合而成也。夫肾与膀胱。相为表里。今脉而见
缓。知有积久之风邪。湿气。循足太阳之经。夹脊上冲于背。而为疼痛。治
之者当于脑后针足太阳膀胱之穴。以夺其风邪之气。则其痛自瘳矣。
他释皆云当取之浮白穴。夺肾之邪。其痛即止。脑后是浮白穴。主耳聋
背项痛也。愚按浮白。乃足少阳之穴。非肾穴也。其穴在耳后入发一寸。
非脑后也。或者曰。浮白乃足太阳少阳之会。针之以取其邪焉可也。张
世贤曰。太阳中风。脉缓。颈项强急。难以转侧。可针风池风府隐白三穴。
再服桂枝汤。则痛可移也。若缓大者。属脾脉。
按经云。缓而滑曰热中。
三缓脉，属于阴。手指下寻按，脉搏往来迟缓。比迟脉稍小且略快者称为缓脉。主要主四肢烦闷、气促不安的症状。（注：其他版本在“小”字下有一个“驶”字）。
缓脉对应阴土。什么是阴土？《皇极内篇》认为脾是二阴之土。既然脾是二阴之土，为什么脉象表现为缓呢？《脉经新撰》中说：“脾属土，其德为缓，其恩为迟。”因此太阴脾的脉象是缓而迟。所以指法描述为：手指下寻按，脉搏往来迟缓，比迟脉稍小且略快。《脉经》又说：“缓脉比迟脉稍小且略快。”为什么呢？“驶”意为疾速。大抵正常人的脉搏，四次跳动加上一次深长的叹息（闰以太息），共成五次跳动。迟脉是一息三至。其意大概是说：缓脉比正常人的脉搏稍慢，但比迟脉则稍快一些。因此它的主病都是脾病。经文说：“土气不足，病邪内舍于心腹，外在表现于肌肉四肢。”因为四肢属脾，所以出现四肢烦闷。经文又说：“若土气不及严重，则病邪停留导致满闷痞塞。”病邪停留导致满闷痞塞，则中焦之气不和，所以出现气促不安。洁古先生（张元素）说：“证候在太阳经，风邪伤及卫分，应当服用桂枝汤。”《易经》相关论述提到：“四肢烦满，气促不安，用枳术汤主治。”按《脉经》记载：“缓脉来去也迟，比迟脉稍小且略快。一说浮大而散，阴浮于阳同等。”
来往寻按时感觉像迟脉。肾间生气导致耳鸣。邪风积气冲击背脑，脑后针刺三处疼痛即刻转移。
缓脉，手指下寻按，一来一往，像丝线在织机上，不卷动轴心。其形态似乎与迟脉相似。这是太阴湿土之气。土气盛，则向下加临于肾。肾主藏精。肾气被克制而起动，所以说肾产生生气。肾开窍于耳，肾气不藏，则上冲于耳，所以又出现耳鸣。况且缓脉又主风痹之疾。痹症是由风寒湿三者结合而成。肾与膀胱相为表里。现在脉象见到缓，可知有久积的风邪、湿气，沿着足太阳膀胱经，夹脊上行冲击背部，从而引起疼痛。治疗时应当在脑后针刺足太阳膀胱经的穴位，以祛除风邪之气，那么疼痛自然痊愈。
其他解释都说应当取浮白穴，以祛除肾之邪气，疼痛即止。脑后是浮白穴，主治耳聋、背项痛。我按察认为：浮白穴是足少阳胆经的穴位，不是肾经穴位。该穴位于耳后入发际一寸处，并非脑后。或许有人说：浮白穴是足太阳、足少阳的交会穴，针刺它可以祛除邪气，这也是可以的。张世贤说：“太阳中风，脉缓，颈项强急，难以转侧，可针刺风池、风府、隐白三穴，再服用桂枝汤，则疼痛可缓解。”如果脉象缓而大，属于脾脉。
按经文记载：“缓而滑的脉象，主热中病。”
Three types of Huan (Slow and Moderate) pulse belong to Yin. When seeking the pulse with fingers, it feels slow and moderate in its coming and going. It is called Huan when it is slightly smaller and faster than Chi (Slow) pulse. Huan pulse mainly indicates symptoms of vexation and stuffiness in the four limbs, shortness of breath, and restlessness.
(Note: Other editions have the character "Shi" [fast] after the character "Xiao" [small].)
Huan pulse corresponds to Yin Earth. What is Yin Earth? *Huangji Neipian* states that the Spleen is the Earth of the Two Yins. Since the Spleen is the Earth of the Two Yins, why does the pulse manifest as Huan? *Maijing Xinzhuan* states: "The Spleen belongs to Earth; its virtue manifests as Huan (moderate), and its grace manifests as Chi (slow)." Therefore, the pulse of Taiyin (Spleen) is Huan and slow. Thus, the finger technique describes: when seeking the pulse, it feels slow and moderate in its coming and going, being slightly smaller and faster than Chi pulse. *Maijing* also says: "Huan pulse is slightly smaller and faster than Chi pulse." Why? "Shi" means fast. Generally, a normal person's pulse beats four times, plus one deep sigh (compensatory deep breathing), totaling five beats per respiration cycle. Chi pulse beats three times per respiration. The implication is that Huan pulse is slightly slower than the normal pulse, but slightly faster than Chi pulse. Therefore, the diseases it indicates are all Spleen diseases. The Classics state: "When Earth qi is insufficient, the disease resides internally in the heart and abdomen, and externally in the muscles and four limbs." Because the four limbs belong to the Spleen, vexation and stuffiness in the four limbs occur. The Classics also state: "If Earth qi insufficiency is severe, pathogenic factors remain causing fullness and obstruction." Pathogenic retention causing fullness and obstruction leads to disharmony of Middle Qi, resulting in shortness of breath and restlessness. Zhang Jiegou said: "When the syndrome is in the Taiyang channel, and Wind pathogen injures the Wei (Defensive) level, Guizhi Tang (Cinnamon Twig Decoction) should be taken." Relevant discussions in the *I Ching* mention: "For vexation and fullness in the four limbs and shortness of breath, Zhizhu Tang (Atractylodes and Immature Bitter Orange Decoction) is indicated." According to *Maijing*: "Huan pulse comes and goes slowly, slightly smaller and faster than Chi pulse. Another description is floating, large, and scattered, with Yin floating equal to Yang."
The state of the pulse coming and going when sought resembles Chi pulse. Vital Qi arising from the Kidney causes tinnitus. Evil wind and accumulated Qi rush to the back and brain; needling three points at the back of the head immediately shifts the pain.
Huan pulse, when sought under the fingers, comes and goes like a thread on a loom, not rolling the axis. Its appearance seems similar to Chi pulse. This is the Qi of Taiyin Damp-Earth. When Earth Qi is abundant, it descends upon the Kidney. The Kidney governs storage. When Kidney Qi is suppressed and rises, it is said that "the Kidney generates vital Qi." The Kidney opens into the ears; if Kidney Qi fails to store, it rushes upward into the ears, causing tinnitus. Moreover, Huan pulse also indicates Wind-Bi (Obstruction Syndrome). Bi syndrome is formed by the combination of Wind, Cold, and Dampness. The Kidney and Bladder are interior-exteriorly related. Now, seeing Huan pulse indicates long-standing accumulation of Wind pathogen and Dampness, which follows the Foot-Taiyang Bladder channel, clamping the spine and rushing up to the back, causing pain. Treatment should involve needling points on the Foot-Taiyang Bladder channel at the back of the head to drain the Wind pathogen Qi, after which the pain will naturally heal.
Other interpretations claim that Fubai (GB12) point should be taken to drain Kidney pathogen, stopping the pain. Fubai is located at the back of the head and treats deafness and pain in the back and neck. I examine that Fubai is a point of the Foot-Shaoyang Gallbladder channel, not the Kidney channel. This point is located one cun behind the ear into the hairline, not at the back of the head. Some say that Fubai is an intersection of the Foot-Taiyang and Foot-Shaoyang channels, and needling it can drain pathogen, which is acceptable. Zhang Shixian said: "In Taiyang Wind-stroke, with Huan pulse, stiff and rigid neck and nape, difficult to turn the side, one may needle Fengchi (GB20), Fengfu (GV16), and Yinbai (SP1) three points, then take Guizhi Tang (Cinnamon Twig Decoction), and the pain can be relieved." If the pulse is Huan and large, it belongs to the Spleen pulse.
According to the Classics: "Huan and slippery pulse indicates Heat in the Middle Jiao."