经曰知者一言而终。不知者流散无穷。脉之为说。前已论辨于各脉之下。今又以分合偶比类五字。
以经纶错综之。庶无惑矣。
分 有脉之形。分谓脉各有形状。当先明辨。便了然不疑。大小浮沉滑涩。可以指别。迥然各异。
辨之于毫厘之间。使其形不相混。如举有按无为浮。按有举无为沉之类。
有脉之证。分。谓脉之一字独见为证。如寸浮。中风头痛之类。不杂他脉。独为证。今脉诀歌
在各脉之后者。是也。或独见一部。或通见三部。或两手俱现。
合 有合众脉之形为一脉者。谓如似沉似伏。实大长弦之合。为牢。极软浮细之合。为濡。之类。
有合众脉之形为一证者。谓浮缓为不仁。浮滑为饮。浮洪大而长为风眩癫疾。有二脉合者。有三四脉
合者。大抵脉独见为证者鲜。参合众脉为证者多。今脉诀独取平三关一脉论证。而遗其合众脉以论证者。
今各补注于后。以全其脉证。（此条补注节抄不及备录）且一脉虽独见。而为证亦不一。如浮。为风。
又为虚。又为气。各不同。此又一脉之证合也。必备论之。以证相参。而考脉。则思过半矣。洁古张元
素医学启源云。右寸大肠。肺脉之所出也。先以轻手得之。是大肠属表。后以重手得之。是肺属里。
肺合皮毛。肺脉寻皮
毛而行。持脉。指法如三菽之重。按至皮毛而得为浮。稍稍加力。脉道不利为涩。又稍加力。脉道
缩入关中。上半指不动。下半指微动。为短。此乃浮涩而短。肺不病之脉也。肺脉本部。在于皮毛之上。
见于肤表。是其浮也。入于皮毛之下。见于血脉肌肉之分。是其沉也。六部仿此。此诊之定法。可以
合众脉之形矣。
偶 脉合阴阳。必有偶对。经曰善为脉者。必以比类奇恒。从容知之。
浮沉者。脉之升降也。浮升在上。沉降在下。为诸脉之根本。为阴阳之定位。为表里之定诊。
浮法天。有轻清在上之象。沉法地。有重浊在下之象。浮为风为虚。体高而气浮也。沉为中坚。为内蕴。
体聚而不散也。论诸脉者。必先此二脉。
迟数者。脉之紧慢也。脉以四五至为平。减一至为三至曰迟。增一至为六至曰数。难经曰。迟阴
为在脏。数阳为在腑。迟则为寒。数则为热。亦偶言之也。中藏经曰。数在上。阳中之阳。在下。阴中之阳。
迟在上。阳中之阴。在下。阴中之阴。数在中则中热。迟在中则中寒。寒用热助。热用寒助。本乎阴
阳也。虚实者。脉之刚柔也。按之浮中沉。皆有力。为实。迟大而软。按之豁豁然空。为虚。虚实之由。
皆以有余不足占之。故以按而知。经曰其气来实强。为太过。病在外。气来虚微。为不及。病在内。
血实脉实。血虚脉虚。亦皆偶而言之。论表里虚实。必以此二脉。中藏经曰。脉举之滑。按之微。看在
何部。以断其脏。又按之沉小弱微短涩软濡。俱为脏虚。其脉举按皆盛者实也。又长浮数疾洪紧弦大。
俱曰脏实。其脉浮而实大者。腑实也。轻手按之滑。重手按之平者。腑虚也。左右寸口。沉结实大者。
上实也。左右寸弱而微者。上
虚也。左右尺脉伏而涩者。下实也。尺中脉滑而濡者。下虚也。尺中微涩短小者。俱属下虚也。许叔
微曰。浮缓为表虚。伤风解肌。浮紧涩有力为表实。伤寒发汗。脉沉无力为里虚。可温。沉而有力
紧实为里实。可下。此论伤寒表里虚实。凡此皆非单论脉虚实之理。长短者。脉之盈缩也。脉盈过
于本位曰长。脉缩不及本位曰短。长有见于尺寸。有通见于三部。短只见于尺寸。盖必质于中。而
后知过于中为长。不及于中为短。经曰长则气治。短则气病。脉有三阴三阳。而长短在其中。是亦偶
而言之。又曰人长脉长。人短脉短。又因人形体而别。滑涩者。脉之通滞也。脉通则流利无碍曰滑。
脉滞则蹇涩不流曰涩。内经曰滑者阴气有余。涩者阳气有余。难经三阴三阳。滑涩对举。千金曰。
滑者多血少气。涩者多气少血。皆偶言也。以二义考之。阴气有余者血多也。血多则气少。脉者血之
府也。营行脉中。今血多故流利圆滑。阳气有余者气多也。气多则血少。故艰涩而散。一止复来。
先明气血之多少。斯知滑涩之理。洪微者。脉之盛衰也。血热而盛。气随以溢。满指洪大。冲涌有余。
洪为脉之盛也。气虚而寒。血随而涩。应指微细。欲绝非绝。微为脉之衰也。紧缓者。脉之急慢也。
紧为伤寒。寒则伤营。营受寒邪。脉络激搏。若风起水涌。既如切绳。又如转索。缓为风结。皮肤不仁。
营血不流。卫气独行。不能疾速。血虚顽痹。脉为缓慢。营受寒邪则脉紧。营血蹇涩则脉缓。二脉
由营而见。沉氏曰紧为阴。阴主寒。寒则物敛。而有拘变之象。又主痛。诸痛皆原于寒。又主宿食。
由胃虚挟寒。不能腐化故也。缓为阳热主血虚。血虚则脉体弱。又主气虚。气虚则脉体无力。又主风。
风者阳邪。主舒启纵弛故也。
动伏者。脉之出处也。出见于外。故数见关上。如豆大。出类而异于三部者动也。处藏于内。
不见其形。脉行筋下者伏也。二者犹人物之出处也。
结促者。因止以别阴阳之盛也。阳盛则促。脉疾而时止。阴盛则结。脉徐而时止。虽有止非死
脉也。代则死脉也。促结为偶。而代无对。脉不可以偶对言者。不敢凿也。三因方尽为偶名。而以
弦弱、芤微、濡革、散代、亦为偶。非一阴一阳也。因知其不可尽以偶言也。必一阴一阳而后可偶。
然又有脉偶而同见者。如大小缓急疾徐疏数之类。经曰前大后小。前小后大。来疾去徐。来徐去疾。
去不盛来反盛。去盛来不盛。乍大乍小。乍短乍长。乍疏乍数。是二脉偶见也。亦有两手偶见者。
如左大右小。左小右大之类。
比 比者所以明相类之脉。比其类而合之。因其疑也。辨其异而分之。
决其疑也。内经曰脾虚浮似肺。肾小浮似脾。肝急沉似肾。此皆三者之所乱也。然从容得之。以知
其比类也。注云以三脏相近。故脉象参差而相类。是以三惑乱为治之过失矣。必从容比类而得三脏之
形状。故浮缓曰脾。浮短曰肺。浮而滑曰心。急紧而散曰肝。搏沉而滑曰肾。不能比类。则疑惑弥甚。
是以脉经立相类之脉。今立比字为纲。使从容比类。先明于未诊之先。免交疑于持脉之际。脉经曰
浮与芤相类。一曰与洪相类。弦与紧相类。滑与数。沉与伏。微与涩。软与弱。缓与迟。革与实。千
金云牢与实。今细详之。有弦细。有芤虚。有濡芤。有洪散。
有牢伏。有数脉同类者。洪散俱大也。而散无力。濡弱同极软而细也。有浮沉之异。微细俱小也。
而微无力。芤类浮也。按之边有中无。濡类芤也。按之如无。沉伏牢同居下也。按有余曰沉。按实大长
弦曰牢。按不见脉行筋下曰伏。弦细同直长之形。同收敛之义也。亦有大小之分。弦如弦之直。
细如线之细。迟缓同慢也。有三至四至之异。大慢小衰之别。涩微易识也。何疑乎相类。牢与实。
革与实。非相类也。脉赋云。洪与实形同仿佛。是相类也。洪实同有力而大也。洪分沉浮之异。
实合浮沉而皆有力。弦与紧之异。弦左右无。而中直如弦。紧左右弹。而有如转索。虽相类而甚
相远也。又有数脉之相类。如涩促结代。同一止也。而全不同。他如濡弱迟。如芤虚。如微细濡
弱涩。已辨于各脉条下。
类 易曰方以类聚。又曰本乎天者亲上。本乎地者亲下。则各从其类也。内经曰脉合阴阳。
又曰察之有纪。从阴阳始。众脉阴阳。各以类从。知乎此。则七表八里九道之非。不胶固于先入之
言矣。旨哉蔡西山之论也。曰凡平脉。不大不细。不长不短。不浮不沉。不滑不涩。应手中和。意
思欣欣。难以名状者。为胃气。其太过为大为长为实为坚为强为浮为芤为滑为洪为急为促者。皆阳也。
其不及为细为短为虚为软为沉为结为伏为涩为微者。皆阴也。阳搏阴为弦。阴搏阳为紧。阴阳相搏
为动。寒虚相搏为革。阴阳分离为散。阴阳不续为代。
难经曰。诸阳为热。诸阴为寒。数则为热。迟则为寒。浮为表。沉为里。三因方云。博则二十四字。
不滥丝毫。约则浮沉迟数。总括纲纪。故知浮为风为虚。沉为湿为实。迟为寒为冷。数为热为燥。
风湿寒热属外。虚
实冷燥属内。内外既分。三因顿别。三点刘立之亦以浮沉迟数四字为纲。以教学人。浮风沉气。迟
冷数热。分别三部为证。此诚初学入门。然必搏学反约。然后能知脉之妙。若遽以此自足。则今汝画矣。
故述此于分合比偶类五字之后。
经文说：懂的人一语道破，不懂的人则流散无穷。关于脉象的论述，此前已在各脉条下进行了辨析。现在又通过“分、合、偶、比、类”这五个字，对错综复杂的脉理进行梳理，希望能使人不再困惑。
**分**
有脉形的区分。“分”是指脉各有其形状，应当首先明确辨别，才能了然无疑。如大、小、浮、沉、滑、涩等，可以通过指感加以区别，迥然不同。要在毫厘之间进行辨别，使它们的形态不混淆。例如举之有余按之不足为浮（Floating pulse, 轻取即得），按之有余举之不足为沉（Deep pulse, 重按始得）之类。
有脉证的区分。“分”是指单凭一个脉象独立出现作为诊断依据。例如寸部见浮脉，诊断为中风头痛之类，不夹杂其他脉象，单独作为证候判断。这就是《脉诀》在各脉之后所歌咏的内容。有的独见于一部，有的通见于三部，有的两手都出现。
**合**
有将多种脉形合为一脉的情况。例如似沉似伏、实大长弦相合，称为牢脉（Lao pulse, Deep, firm, large, long and tense）；极软浮细相合，称为濡脉（Ru pulse, Soft, floating and fine）。
有将多种脉形合为一证的情况。例如浮缓为不仁（Loss of sensation），浮滑为饮（Fluid retention），浮洪大而长为风眩癫疾（Wind dizziness and epilepsy）。有两脉相合的，有三四脉相合的。大体上，单凭一脉独见作为证候判断的情况很少，参合众脉作为证候判断的情况很多。现在的《脉诀》只选取平人三关的一脉来论证，而遗漏了结合众脉来论证的内容。现在在后面分别补充注释，以完善脉证。（此条补注节抄，不及备录）而且一脉虽然独见，但作为证候也不止一种。例如浮脉，既主风，又主虚，又主气，各不相同。这又是单脉之证的综合体现。必须详细论述，通过证候相互参照来考察脉象，那么思虑就过半了。洁古张元素在《医学启源》中说：右寸是大肠经和肺经脉气所出之处。先用轻手诊得，说明大肠属表；后用重手诊得，说明肺属里。肺合皮毛，肺脉循行于皮毛之上。持脉时，指法如三菽之重，按至皮毛而得为浮脉；稍稍加力，脉道不利为涩脉；再稍加力，脉道缩入关中，上半指不动，下半指微动，为短脉。这是浮、涩、短并见的脉象，是肺未病的脉象。肺脉的本部，在于皮毛之上，见于肤表，这就是它的浮象；进入皮毛之下，见于血脉肌肉之分，这就是它的沉象。六部脉仿照此法。这是诊脉的定法，可以综合各种脉形了。
**偶**
脉象配合阴阳，必有偶对。经文说：善于诊脉的人，一定运用比类奇恒的方法，从容地知晓。
浮和沉，是脉象的升降。浮升在上，沉降在下，是诸脉的根本，是阴阳的定位，是表里的定诊。浮法天，有轻清在上的意象；沉法地，有重浊在下的意象。浮主风主虚，体高而气浮；沉主中坚主内蕴，体聚而不散。论及诸脉，必先从此二脉开始。
迟和数，是脉象的紧慢。脉搏以一息四五至为平脉，减少一至为三至叫迟，增加一至为六至叫数。《难经》说：迟属阴，病在脏；数属阳，病在腑。迟则为寒，数则为热。这也是偶言。《中藏经》说：数在上，为阳中之阳；在下，为阴中之阳。迟在上，为阳中之阴；在下，为阴中之阴。数在中则中热，迟在中则中寒。寒用热药辅助，热用寒药辅助，根本在于阴阳。虚和实，是脉象的刚柔。按之浮中沉皆有力，为实脉；迟大而软，按之豁豁然空，为虚脉。虚实的原因，都以有余和不足来判断，所以通过按压来感知。经文说：脉气来实强，为太过，病在外；气来虚微，为不及，病在内。血实则脉实，血虚则脉虚，也都是偶言。论及表里虚实，必须以这两脉为准。《中藏经》说：脉举之滑，按之微，看在何部，以断其脏。又按之沉小弱微短涩软濡，俱为脏虚；其脉举按皆盛者为实。又长浮数疾洪紧弦大，俱曰脏实；其脉浮而实大者，腑实也；轻手按之滑，重手按之平者，腑虚也。左右寸口，沉结实大者，上实也；左右寸弱而微者，上虚也；左右尺脉伏而涩者，下实也；尺中脉滑而濡者，下虚也；尺中微涩短小者，俱属下虚。许叔微说：浮缓为表虚，伤风解肌；浮紧涩有力为表实，伤寒发汗；脉沉无力为里虚，可温；沉而有力紧实为里实，可下。这是论伤寒表里虚实。凡此皆非单论脉虚实之理。
长和短，是脉象的盈缩。脉盈过于本位叫长，脉缩不及本位叫短。长可见于尺寸，或通见于三部；短只见于尺寸。因为必须质测于中，而后知过于中为长，不及于中为短。经文说：长则气治，短则气病。脉有三阴三阳，而长短在其中，这也是偶言。又说：人长脉长，人短脉短，又因人形体而别。
滑和涩，是脉象的通滞。脉通则流利无碍叫滑，脉滞则蹇涩不流叫涩。《内经》说：滑者阴气有余，涩者阳气有余。《难经》三阴三阳，滑涩对举。《千金方》说：滑者多血少气，涩者多气少血，都是偶言。从这两义考察，阴气有余者血多也，血多则气少。脉是血之府，营行脉中，今血多故流利圆滑。阳气有余者气多也，气多则血少，故艰涩而散，一止复来。先明气血之多少，斯知滑涩之理。
洪和微，是脉象的盛衰。血热而盛，气随以溢，满指洪大，冲涌有余，洪为脉之盛也。气虚而寒，血随而涩，应指微细，欲绝非绝，微为脉之衰也。
紧和缓，是脉象之急慢。紧为伤寒，寒则伤营，营受寒邪，脉络激搏，若风起水涌，既如切绳，又如转索。缓为风结，皮肤不仁，营血不流，卫气独行，不能疾速，血虚顽痹，脉为缓慢。营受寒邪则脉紧，营血蹇涩则脉缓。二脉由营而见。沈氏说：紧为阴，阴主寒，寒则物敛，而有拘变之象，又主痛，诸痛皆原于寒，又主宿食，由胃虚挟寒，不能腐化故也。缓为阳热主血虚，血虚则脉体弱，又主气虚，气虚则脉体无力，又主风，风者阳邪，主舒启纵弛故也。
动和伏，是脉象的出处。出见于外，故数见关上，如豆大，出类而异于三部者为动脉（Moving pulse, Like a bean, rolling back and forth）；处藏于内，不见其形，脉行筋下者为伏脉（Hidden pulse, Deep and hidden, only felt with heavy pressure）。二者犹人物之出处也。
结和促，是因止歇以别阴阳之盛也。阳盛则促，脉疾而时止；阴盛则结，脉徐而时止。虽有止非死脉也。代则死脉也。促结为偶，而代无对。脉不可以偶对言者，不敢凿也。《三因方》尽为偶名，而以弦弱、芤微、濡革、散代，亦为偶，非一阴一阳也。因知其不可尽以偶言也。必一阴一阳而后可偶。然又有脉偶而同见者，如大小缓急疾徐疏数之类。经文说：前大后小，前小后大，来疾去徐，来徐去疾，去不盛来反盛，去盛来不盛，乍大乍小，乍短乍长，乍疏乍数，是二脉偶见也。亦有两手偶见者，如左大右小，左小右大之类。
**比**
比是用来阐明相似脉象的。比较其类而合之，因其疑也；辨其异而分之，决其疑也。《内经》说：脾虚浮似肺，肾小浮似脾，肝急沉似肾。此皆三者之所乱也。然从容得之，以知其比类也。注云：以三脏相近，故脉象参差而相类，是以三惑乱为治之过失矣。必从容比类而得三脏之形状，故浮缓曰脾，浮短曰肺，浮而滑曰心，急紧而散曰肝，搏沉而滑曰肾。不能比类，则疑惑弥甚。是以《脉经》立相类之脉，今立比字为纲，使从容比类，先明于未诊之先，免交疑于持脉之际。《脉经》说：浮与芤相类，一曰与洪相类；弦与紧相类；滑与数，沉与伏，微与涩，软与弱，缓与迟，革与实。《千金方》云牢与实。今细详之，有弦细，有芤虚，有濡芤，有洪散，有牢伏，有数脉同类者。洪散俱大也，而散无力；濡弱同极软而细也，有浮沉之异；微细俱小也，而微无力；芤类浮也，按之边有中无；濡类芤也，按之如无；沉伏牢同居下也，按有余曰沉，按实大长弦曰牢，按不见脉行筋下曰伏；弦细同直长之形，同收敛之义也，亦有大小之分，弦如弦之直，细如线之细；迟缓同慢也，有三至四至之异，大慢小衰之别；涩微易识也，何疑乎相类？牢与实，革与实，非相类也。《脉赋》云：洪与实形同仿佛，是相类也。洪实同有力而大也，洪分沉浮之异，实合浮沉而皆有力。弦与紧之异，弦左右无而中直如弦，紧左右弹而有如转索，虽相类而甚相远也。又有数脉之相类，如涩促结代，同一止也，而全不同。他如濡弱迟，如芤虚，如微细濡弱涩，已辨于各脉条下。
**类**
《易经》说：方以类聚。又说：本乎天者亲上，本乎地者亲下，则各从其类也。《内经》说：脉合阴阳，又曰察之有纪，从阴阳始。众脉阴阳，各以类从。知乎此，则七表八里九道之非，不胶固于先入之言矣。旨哉蔡西山之论也，曰：凡平脉，不大不细，不长不短，不浮不沉，不滑不涩，应手中和，意思欣欣，难以名状者，为胃气。其太过为大为长为实为坚为强为浮为芤为滑为洪为急为促者，皆阳也。其不及为细为短为虚为软为沉为结为伏为涩为微者，皆阴也。阳搏阴为弦，阴搏阳为紧，阴阳相搏为动，寒虚相搏为革，阴阳分离为散，阴阳不续为代。
《难经》说：诸阳为热，诸阴为寒。数则为热，迟则为寒。浮为表，沉为里。《三因方》云：博则二十四字，不滥丝毫；约则浮沉迟数，总括纲纪。故知浮为风为虚，沉为湿为实，迟为寒为冷，数为热为燥。风湿寒热属外，虚实冷燥属内。内外既分，三因顿别。三点刘立之亦以浮沉迟数四字为纲，以教学人。浮风沉气，迟冷数热，分别三部为证。此诚初学入门，然必搏学反约，然后能知脉之妙。若遽以此自足，则今汝画矣。故述此于分合比偶类五字之后。
The classic states: Those who understand will conclude in one word; those who do not understand will scatter endlessly. Regarding the discussion of pulses, distinctions have already been made under each pulse category previously. Now, by using the five characters "Fen" (Differentiation), "He" (Combination), "Ou" (Pairing), "Bi" (Comparison), and "Lei" (Classification), the intricate and complex pulse theories are organized, so that confusion may be avoided.
**Fen (Differentiation)**
There is differentiation of pulse forms. "Fen" refers to the fact that each pulse has its own shape, which must be clearly distinguished first to achieve clarity without doubt. Pulses such as Large (Da), Small (Xiao), Floating (Fu), Deep (Chen), Slippery (Hua), and Choppy (Se) can be distinguished by finger sensation, being distinctly different from one another. They must be differentiated within the finest details to ensure their shapes do not mix. For example, feeling abundant upon light pressure but deficient upon heavy pressure is Floating (Fu); feeling deficient upon light pressure but abundant upon heavy pressure is Deep (Chen).
There is differentiation of pulse signs/symptoms. "Fen" refers to a single pulse appearing independently as a diagnostic sign. For instance, a Floating pulse at the Cun position indicates Wind-stroke headache, without mixing with other pulses, serving as an independent diagnosis. This corresponds to the songs in *Mai Jue* (Pulse Rhymes) following each pulse description. Such pulses may appear independently in one position, across all three positions, or in both hands.
**He (Combination)**
There are cases where multiple pulse forms combine into one pulse type. For example, the combination of resembling Deep and Hidden, Solid, Large, Long, and Tense constitutes the Lao pulse (Lao pulse, Deep, firm, large, long and tense); the combination of extremely soft, Floating, and Fine constitutes the Ru pulse (Ru pulse, Soft, floating and fine).
There are cases where multiple pulse forms combine into one clinical syndrome. For example, Floating and Slow indicates loss of sensation (Bu Ren); Floating and Slippery indicates Fluid Retention (Yin); Floating, Surging, Large, and Long indicates Wind Dizziness and Epilepsy (Feng Xuan Dian Ji). Some involve two combined pulses, others three or four. Generally, diagnosing based on a single independent pulse is rare, whereas combining multiple pulses for diagnosis is common. The current *Mai Jue* only selects a single pulse from the three positions of a healthy person for diagnosis, omitting the combination of multiple pulses. These omissions are now supplemented below to complete the pulse-sign correlation. (This supplementary note is excerpted and not fully recorded.) Furthermore, even if a single pulse appears independently, it does not correspond to only one syndrome. For instance, a Floating pulse may indicate Wind, Deficiency, or Qi disorders, each different. This represents the combination of syndromes associated with a single pulse. Detailed discussion is required; by cross-referencing symptoms to examine pulses, half of the understanding is achieved. Zhang Yuansu (Jiegu) stated in *Yi Xue Qi Yuan*: The Right Cun position is where the Qi of the Large Intestine and Lung meridians emerges. Feeling it with light pressure indicates the Large Intestine belongs to the Exterior; feeling it with heavy pressure indicates the Lung belongs to the Interior. The Lung governs the skin and hair, and its pulse travels along the skin and hair. When holding the pulse, applying pressure equivalent to three chickpeas yields a Floating pulse when felt at the skin level; slightly increasing pressure results in a Choppy pulse due to obstructed flow; further increasing pressure causes the pulse to retreat to the Guan and Chi positions, with no movement at the upper finger and slight movement at the lower finger, indicating a Short pulse. This combination of Floating, Choppy, and Short is the pulse of a non-diseased Lung. The root of the Lung pulse lies above the skin, manifesting on the surface, which is its Floating aspect; entering below the skin into the blood vessels and muscles, it is its Deep aspect. The six positions follow this pattern. This is the fixed method of diagnosis, allowing for the integration of various pulse forms.
**Ou (Pairing)**
Pulses coordinate with Yin and Yang, necessarily having paired opposites. The classic states: A skilled pulse reader must use analogy and comparison of the extraordinary to know them calmly.
Floating and Deep are the rising and sinking of pulses. Floating rises upward; Deep sinks downward. They are the foundation of all pulses, the positioning of Yin and Yang, and the definitive diagnosis of Exterior and Interior. Floating follows Heaven, having the image of lightness and clarity above; Deep follows Earth, having the image of heaviness and turbidity below. Floating indicates Wind and Deficiency, with a high body and floating Qi; Deep indicates central firmness and internal accumulation, with a gathered and undispersed body. Discussing all pulses must begin with these two.
Slow (Chi) and Rapid (Shu) are the tightness and slowness of pulses. A normal pulse beats four or five times per breath. Reducing by one beat to three times is called Slow; increasing by one beat to six times is called Rapid. *Nan Jing* states: Slow belongs to Yin and indicates Zang organ disease; Rapid belongs to Yang and indicates Fu organ disease. Slow indicates Cold; Rapid indicates Heat. This is also a pairing. *Zhong Zang Jing* states: Rapid at the Upper position is Yang within Yang; at the Lower position, it is Yang within Yin. Slow at the Upper position is Yin within Yang; at the Lower position, it is Yin within Yin. Rapid in the Middle indicates Middle Heat; Slow in the Middle indicates Middle Cold. Cold is assisted by Heat therapies; Heat is assisted by Cold therapies, fundamentally based on Yin and Yang.
Deficient (Xu) and Excess (Shi) are the hardness and softness of pulses. If pressing at Floating, Middle, and Deep levels reveals strength, it is Excess. If Slow, Large, and Soft, feeling hollow upon pressure, it is Deficient. The cause of Deficiency and Excess is determined by surplus and insufficiency, known through palpation. The classic states: Strong incoming Qi indicates Excess, disease in the Exterior; weak outgoing Qi indicates Insufficiency, disease in the Interior. Blood Excess leads to Pulse Excess; Blood Deficiency leads to Pulse Deficiency. This is also paired. Discussing Exterior/Interior and Deficiency/Excess must rely on these two pulses. *Zhong Zang Jing* states: If the pulse is Slippery upon lifting and微弱 (Wei) upon pressing, the specific position determines the Zang organ. Sinking, Small, Weak, Micro, Short, Choppy, Soft, and Ru pulses all indicate Zang Deficiency. Pulses that are strong upon both lifting and pressing indicate Excess. Long, Floating, Rapid,疾 (Ji), Surging, Tight, Tense, and Large pulses all indicate Zang Excess. Floating and Solid/Large indicate Fu Excess; Slippery upon light pressure and Normal upon heavy pressure indicate Fu Deficiency. Sinking, Firm, Solid, and Large at the Left and Right Cun indicate Upper Excess; Weak and Micro at the Left and Right Cun indicate Upper Deficiency. Hidden and Choppy at the Left and Right Chi indicate Lower Excess; Slippery and Ru at the Chi indicate Lower Deficiency; Micro, Choppy, Short, and Small at the Chi all belong to Lower Deficiency. Xu Shuwei stated: Floating and Slow indicates Exterior Deficiency, Wind injury requiring muscle-relieving treatment; Floating, Tight, Choppy, and Forceful indicates Exterior Excess, Cold injury requiring sweating treatment; Deep and Forceless indicates Interior Deficiency, treatable with warming; Deep, Forceful, Tight, and Solid indicates Interior Excess, treatable with purgation. This discusses Cold Injury Exterior/Interior and Deficiency/Excess. All these are not merely discussing the principles of pulse Deficiency and Excess.
Long (Chang) and Short (Duan) are the fullness and contraction of pulses. When the pulse exceeds its original position, it is Long; when it fails to reach its original position, it is Short. Long may be seen at Cun and Chi, or throughout all three positions; Short is only seen at Cun and Chi. One must measure relative to the middle to know that exceeding the middle is Long and failing to reach the middle is Short. The classic states: Long indicates regulated Qi; Short indicates diseased Qi. With Three Yin and Three Yang pulses, Long and Short are included, representing another pairing. It is also said: Tall people have Long pulses; short people have Short pulses, distinguishing based on body shape.
Slippery (Hua) and Choppy (Se) are the smoothness and stagnation of pulses. Smooth flow without obstruction is Slippery; stagnant, difficult, and non-flowing is Choppy. *Nei Jing* states: Slippy indicates excess Yin Qi; Choppy indicates excess Yang Qi. *Nan Jing* pairs Slippery and Choppy among the Three Yin and Three Yang. *Qian Jin Fang* states: Slippery indicates much Blood and little Qi; Choppy indicates much Qi and little Blood. Both are pairings. Analyzing these two meanings: Excess Yin Qi means excess Blood; more Blood means less Qi. The pulse is the mansion of Blood, Ying flows within the pulse; thus, excess Blood makes it slippery and round. Excess Yang Qi means excess Qi; more Qi means less Blood, making it difficult, choppy, and scattered, pausing then resuming. First understanding the balance of Qi and Blood allows one to know the principle of Slippery and Choppy.
Surging (Hong) and Micro (Wei) are the flourishing and declining of pulses. Hot Blood and flourishing Qi overflow, filling the fingers with a Surging and Large pulse, surging abundantly; Surging is the flourishing of pulses. Deficient Qi and Cold cause Blood to become choppy, responding to the finger as Micro and Fine, nearly disappearing yet not gone; Micro is the decline of pulses.
Tight (Jin) and Relaxed (Huan) are the urgency and slowness of pulses. Tight indicates Cold Injury; Cold injures Ying, which receives the Cold pathogen, causing vessel agitation like wind rising and water surging, cutting a rope or turning a cord. Relaxed indicates Wind binding, skin numbness, Ying Blood not flowing, Wei Qi moving alone without speed, Blood Deficiency leading to stiff paralysis, resulting in a Slow pulse. Ying receiving Cold pathogens leads to Tight pulses; Ying Blood stagnation leads to Relaxed pulses. These two pulses manifest through Ying. Shen Shi stated: Tight is Yin; Yin governs Cold, causing contraction and tension, also governing Pain (all pains originate from Cold), and retained food (due to Stomach deficiency with Cold, unable to digest). Relaxed is Yang-Heat governing Blood Deficiency; Blood Deficiency makes the pulse body weak; it also governs Qi Deficiency (Qi Deficiency makes the pulse body forceless); it also governs Wind (Wind is a Yang pathogen, governing relaxation and flaccidity).
Moving (Dong) and Hidden (Fu) are the emergence and concealment of pulses. Emerging outward, often felt at the Guan position, large as a bean, distinct from the three positions, is the Moving pulse (Moving pulse, Like a bean, rolling back and forth); Concealed inward, form unseen, where the pulse runs beneath the tendons, is the Hidden pulse (Hidden pulse, Deep and hidden, only felt with heavy pressure). These two are like the emergence and concealment of people.
Knotted (Jie) and Interrupted (Cu) are distinguished by pauses to identify the flourishing of Yin and Yang. Yang flourishing leads to Cu pulse: rapid pulse with occasional pauses. Yin flourishing leads to Jie pulse: slow pulse with occasional pauses. Although they have pauses, they are not death pulses. Dai pulse is a death pulse. Cu and Jie are paired, while Dai has no pair. Not all pulses can be described by pairing; dare not be dogmatic. *San Yin Fang* lists many paired names, such as Tense/Weak, Hollow/Micro, Soft/Leather, Scattered/Dai, noting they are not strictly one Yin and one Yang. Thus, not all can be paired. Only true Yin-Yang pairs can be matched. However, there are pulses that appear together as pairs, such as Large/Small, Slow/Rapid, Urgent/Relaxed, Fast/Slow, Sparse/Rapid. The classic states: Front Large Back Small, Front Small Back Large, Coming Rapid Going Slow, Coming Slow Going Rapid, Going weak Coming strong, Going strong Coming weak, Suddenly Large Suddenly Small, Suddenly Short Suddenly Long, Suddenly Sparse Suddenly Rapid—these are pairs of two pulses appearing. There are also pairs appearing in both hands, such as Left Large Right Small, Left Small Right Large.
**Bi (Comparison)**
Comparison is used to clarify similar pulses. Comparing classes to unite them resolves doubt; distinguishing differences to separate them resolves uncertainty. *Nei Jing* states: Spleen deficiency Floating resembles Lung; Kidney Small Floating resembles Spleen; Liver Urgent Sinking resembles Kidney. These three are confused. However, by calmly obtaining them, one knows their comparative nature. The commentary notes: Because the three Zang organs are close, their pulse images vary and resemble each other, leading to diagnostic errors. One must calmly compare and classify to obtain the shapes of the three Zang organs: Floating and Slow is Spleen; Floating and Short is Lung; Floating and Slippery is Heart; Urgent, Tight, and Scattered is Liver; Beating, Deep, and Slippery is Kidney. Failure to compare leads to greater confusion. Therefore, *Mai Jing* established similar pulses; now establishing "Bi" as the guideline allows calm comparison before diagnosis, avoiding doubt during palpation. *Mai Jing* states: Floating and Hollow are similar; one says Floating and Surging are similar; Tense and Tight are similar; Slippery and Rapid, Deep and Hidden, Micro and Choppy, Soft and Weak, Slow and Relaxed, Leather and Solid are similar. *Qian Jin Fang* says Lao and Solid are similar. Upon detailed examination: Tense and Fine, Hollow and Deficient, Ru and Hollow, Surging and Scattered, Lao and Hidden, and Rapid pulses have similarities. Surging and Scattered are both Large, but Scattered lacks force; Ru and Weak are both extremely soft and Fine, differing in Floating vs. Deep; Micro and Fine are both Small, but Micro lacks force; Hollow resembles Floating, empty at edges but present in center upon pressing; Ru resembles Hollow, feeling absent upon pressing; Deep, Hidden, and Lao are all deep; abundant upon pressing is Deep; solid, large, long, and tense upon pressing is Lao; pulse not felt running under tendons upon pressing is Hidden; Tense and Fine share a straight, long shape and constrictive meaning, though differing in size—Tense like a string, Fine like a thread; Slow and Relaxed are both slow, differing in beats (3-4) and magnitude (Large slow vs. Small decline); Choppy and Micro are easy to recognize, why doubt similarity? Lao and Solid, Leather and Solid are not similar. *Mai Fu* states: Surging and Solid look alike, hence similar. Both Surging and Solid are forceful and Large; Surging differs in Floating/Deep, while Solid is forceful in both. Difference between Tense and Tight: Tense has no lateral rebound, straight in middle like a string; Tight rebounds laterally, like turning a cord. Though similar, they are very distant. Among Rapid pulses, Choppy, Interrupted, Knotted, and Dai all have pauses but are completely different. Others like Ru/Weak/Slow, Hollow/Deficient, Micro/Fine/Ru/Weak/Choppy have been distinguished in respective pulse sections.
**Lei (Classification)**
*I Ching* states: Methods gather by class. It also states: That which originates from Heaven亲近s the Upper; that which originates from Earth亲近s the Lower; thus each follows its class. *Nei Jing* states: Pulses coordinate with Yin and Yang; observation has order, starting from Yin and Yang. All pulses of Yin and Yang follow their respective classes. Understanding this prevents rigid adherence to the incorrect views of Seven Tables, Eight Interiors, and Nine Channels. How profound is Cai Xishan's argument: Any normal pulse is neither Large nor Small, neither Long nor Short, neither Floating nor Deep, neither Slippery nor Choppy; it responds moderately, bringing joy to the mind, indescribable—this is Stomach Qi. Its excess manifests as Large, Long, Solid, Firm, Strong, Floating, Hollow, Slippery, Surging, Urgent, Interrupted—all Yang. Its insufficiency manifests as Small, Short, Deficient, Soft, Deep, Knotted, Hidden, Choppy, Micro—all Yin. Yang beating Yin creates Tense; Yin beating Yang creates Tight; Yin and Yang beating each other creates Moving; Cold and Deficiency beating each other creates Leather; Yin and Yang separating creates Scattered; Yin and Yang discontinuing creates Dai.
*Nan Jing* states: All Yang indicates Heat; all Yin indicates Cold. Rapid indicates Heat; Slow indicates Cold. Floating indicates Exterior; Deep indicates Interior. *San Yin Fang* states: Broadly, there are twenty-four characters, not wasting a bit; briefly, Floating, Deep, Slow, and Rapid summarize the guidelines. Thus, Floating indicates Wind and Deficiency; Deep indicates Dampness and Excess; Slow indicates Cold and Chill; Rapid indicates Heat and Dryness. Wind, Dampness, Cold, Heat belong to External; Deficiency, Excess, Cold, Dryness belong to Internal. Once Internal and External are divided, the Three Causes are instantly distinguished. Liu Lizhi also used Floating, Deep, Slow, and Rapid as guidelines for teaching students. Floating-Wind, Deep-Qi, Slow-Cold, Rapid-Heat, distinguishing symptoms by the three positions. This is truly introductory for beginners, but one must study extensively and then simplify to understand the subtleties of pulses. If satisfied with this immediately, you will stagnate. Therefore, this is described after the five characters Fen, He, Bi, Ou, Lei.