体象 微脉极细，而又极软；似有若无，欲绝非绝。
微之为言，近于无也。仲景曰∶“瞥瞥如羹上肥。”状其软而无力也。“萦萦如蚕丝。”状其细而难见也。古
人“似有若无，欲绝非绝”八字，真为微脉传神。
主病 微脉模糊，气血大衰。左寸微者，心虚忧惕。微在左关，寒挛气乏。左尺得微，髓竭精枯。
右寸微者，中寒少气。微在右关，胃寒气胀。右尺得微，阳衰寒极。
按算数者以十微为一忽，十忽为一丝，十丝为一毫，十毫为一厘。由是推之，则一厘之少，分而为万，方
始名微，则微之渺小难见可知。世俗未察微脉之义，每见脉之细者，辄以微、细二字并称，是何其言之
不审耶？轻取之而如无，故曰阳气衰；重按之而欲绝，故曰阴气竭。若细脉则稍稍较大，显明而易见，非
如微脉之模糊而难见也。虽其证所患略同，而其形亦不可不辨。时珍云∶“微主久虚血弱之病，阳微
则恶寒，阴微则发热。”自非峻补，难可回春。而伪诀所云∶“漩之败血小肠虚。”何以置之微脉乎？若不
兼他象，虽微而来去未乱，犹可图存于百一。卒病得之，犹或可生者，谓邪气不至深重也。长病得之，多
不可救者，正气将次绝灭，草木之味难借以支持耳。
在伤寒证惟少阴有微脉，他经则无。其太阳膀胱为少阴之府，才见脉微恶寒，仲景早从少阴施治，而
用附子、干姜矣。盖脉微恶寒，正阳气衰微所至。诗云∶“彼月而微，此日而微；今此下民，亦孔之哀。”在天
象之阳且不可微，然则人身之阳顾可微哉！肾中既已阴盛阳微，寒自内生，复加外寒斩关直入，其人
顷刻云亡。故仲景以为卒病，而用辛热以回一线真阳于重泉之下也。卒中寒者，阳微阴盛，最为危急。
《素问·调经论篇》曰∶“阴盛生内寒。”因厥气上逆，寒气积于胸中而不泄，则温气去，寒独留，留则血
凝，血凝则脉不通，其脉盛大以涩，故中寒。夫既言阴盛生内寒矣，又言故中寒者，岂非内寒先生，外寒
内中之耶！经既言血脉不通矣，又言其脉盛大以涩者，岂非以外寒中，故脉盛大，血脉闭，故脉涩耶！此
中深有所疑，请申明之。一者，人身卫外之阳最固，太阳卫身之背，阳明卫身之前，少阳卫身之两侧，今
不由三阳而直中少阴，岂真从天而下？盖厥气上逆，积于胸中，则胃寒；胃寒则口食寒物，鼻吸寒气，皆
得入胃。肾者，胃之关也，外寒斩关直入少阴肾脏，故曰中寒也。此经隐而未言者也。一者，其脉盛大以
涩，虽曰中寒，尚非卒病，卒病中寒，其脉必微。盖经统言伤寒、中寒之脉，故曰盛大以涩。仲景以伤寒为
热病，中寒为寒病，分别言之。伤寒之脉，大都以大浮数动滑为阳，沉涩弱弦微为阴，阳病而见阴脉且
主死，况阴病卒病，必无反见阳脉盛大之脉。若只盛大以涩，二阳一阴，亦何卒急之有哉！此亦经所隐
而难窥者也。
【体象】
微脉极其细小，又极其柔软；感觉似有若无，想要断绝却又未完全断绝。
“微”这个字的意思，是接近于无。张仲景说：“像羹汤表面漂浮的油脂那样轻浮。”这是形容其软弱而无力的样子。“像蚕丝那样连绵不断。”这是形容其细微而难以看见的样子。古人用“似有若无，欲绝非绝”这八个字，真是把微脉的神韵描绘得淋漓尽致。
【主病】
微脉模糊不清，表明气血极度衰弱。
左寸部出现微脉，说明心气虚弱，心中忧虑惊恐。
微脉出现在左关部，说明寒邪凝滞导致筋脉拘挛，气力匮乏。
左尺部出现微脉，说明骨髓枯竭，精血干涸。
右寸部出现微脉，说明中焦受寒，气息短少。
微脉出现在右关部，说明胃中有寒气，导致腹部胀满。
右尺部出现微脉，说明阳气衰败，寒邪极盛。
按照计算单位的人说：十个“微”等于一个“忽”，十个“忽”等于一根“丝”，十根“丝”等于一“毫”，十“毫”等于一“厘”。由此推算，一厘的数量极少，将其分割到万分之一，才配称为“微”，由此可见微脉的渺小和难以看见。世俗之人没有考察清楚微脉的含义，每当见到细小的脉象，就随意将“微”和“细”两个字并列使用，这是什么话不严谨呢？轻取（手指轻轻按压）时感觉好像没有，所以说是阳气衰败；重按（手指用力按压）时感觉快要断绝，所以说是阴气枯竭。至于细脉，则稍微大一些，明显且容易看见，不像微脉那样模糊而难以看见。虽然它们所对应的病症大致相同，但脉象形态也不可不予以辨别。李时珍说：“微脉主要主久病体虚、血液弱小的病症。阳微则怕冷，阴微则发热。”如果不是用峻猛的补药，很难使病情好转恢复生机。而伪托的《脉诀》中说：“漩涡状的脉象是败血和小肠虚的表现。”这种说法怎么能放在微脉的解释里呢？如果不兼见其他脉象，即使脉象微弱，但来去节奏不乱，还有一百种情况中的一种可以存活的机会。如果是突发疾病出现这种脉象，或许还有救，这是因为邪气还没有深入严重。如果是长期患病出现这种脉象，大多不可救治，因为正气即将灭绝，普通的草木药物难以借以支撑身体。
在伤寒证中，只有少阴病会出现微脉，其他经络则没有。太阳膀胱经是少阴肾经的表里腑脏，刚刚出现脉微恶寒的症状，张仲景早就从少阴病进行治疗，而使用附子、干姜了。大概是因为脉微恶寒，正是阳气衰微所致。《诗经》说：“月亮昏暗，太阳昏暗；现在的百姓，也是多么悲哀啊。”在天象中，阳气尚且不能昏暗，那么人身上的阳气怎么可以微弱呢！肾脏中既然已经阴气盛而阳气微，寒气自然从体内产生，再加上外来的寒邪直冲关口进入体内，这个人很快就会死亡。所以张仲景认为这是突发的重病，而用辛热性质的药物来挽回一线真阳于九泉之下。突然中寒的人，是阳微阴盛，最为危急。
《素问·调经论篇》说：“阴气盛则产生内寒。”由于厥逆之气向上逆行，寒气积聚在胸中而不能发散，那么温煦的气离去，只有寒气独留，寒气停留则血液凝滞，血液凝滞则脉道不通，其脉象盛大而涩，所以称为中寒。既然说了阴盛生内寒，又说因此中寒，难道不是内寒先产生，然后外寒侵入其中吗！经文既然说了血脉不通，又说其脉象盛大而涩，难道不是因为外寒入侵，所以脉象盛大，血脉闭塞，所以脉象涩吗！这里心中有很深的疑惑，请予以阐明。第一点，人身卫护体外的阳气最坚固，太阳经卫护身体的背部，阳明经卫护身体的前面，少阳经卫护身体的两侧，现在如果不经过三阳经而直接中伤少阴，难道真的是从天上掉下来吗？大概是厥逆之气向上逆行，积聚在胸中，导致胃寒；胃寒则吃进去寒凉的食物，吸入的寒气，都能进入胃中。肾是胃的关口，外寒直冲关口进入少阴肾脏，所以称为中寒。这是经文隐含而没有明说的地方。第二点，其脉象盛大而涩，虽然说是中寒，但还不是突发急病，突发急病的中寒，脉象必定微弱。大概经文统言伤寒和中寒的脉象，所以说盛大而涩。张仲景将伤寒视为热病，将中寒视为寒病，分别论述。伤寒的脉象，大多以大、浮、数、动、滑为阳脉，沉、涩、弱、弦、微为阴脉，阳病见到阴脉尚且主死，何况阴病或突发疾病，必然不会有反见阳脉盛大的脉象。如果只是盛大而涩，属于二阳一阴，又有什么紧急急促的呢！这也是经文隐含而难以窥探的地方。
[Physical Characteristics]
The Wei (Micro) pulse is extremely fine and extremely soft; it seems to exist but not really, as if about to cease yet not completely cut off.
The term "Wei" implies proximity to nothingness. Zhang Zhongjing said: "Like the fat floating on the surface of soup." This describes its softness and lack of strength. "Like silk threads." This describes its fineness and difficulty in being seen. The ancients' eight characters "seems to exist but not really, as if about to cease yet not completely cut off" truly capture the spirit of the Wei pulse.
[Main Pathologies]
The Wei pulse is vague and indistinct, indicating a great decline of Qi and Blood.
If the Wei pulse appears at the Left Cun position, it indicates Heart deficiency with anxiety and fright.
If the Wei pulse appears at the Left Guan position, it indicates cold contraction and Qi insufficiency.
If the Wei pulse is obtained at the Left Chi position, it indicates exhaustion of marrow and withering of essence.
If the Wei pulse appears at the Right Cun position, it indicates middle jiao cold and shortness of breath.
If the Wei pulse appears at the Right Guan position, it indicates stomach cold and abdominal distension.
If the Wei pulse is obtained at the Right Chi position, it indicates Yang decline and extreme cold.
According to those who calculate units: ten "Wei" equal one "Hu", ten "Hu" equal one "Si" (thread), ten "Si" equal one "Hao" (hair), and ten "Hao" equal one "Li". From this deduction, since one "Li" is very small, dividing it into ten thousand parts only then can it be named "Wei", thus showing how minute and hard to see the Wei pulse is. The common people, failing to examine the meaning of the Wei pulse, often mention "Wei" and "Xi" (Fine) together whenever they see a fine pulse. How imprecise their speech is! When lightly pressed, it feels as if non-existent, hence it is called Yang Qi decline; when heavily pressed, it feels as if about to cease, hence it is called Yin Qi exhaustion. The Xi (Fine) pulse is slightly larger, obvious and easy to see, unlike the Wei pulse which is vague and hard to see. Although the conditions they indicate are somewhat similar, their forms must not fail to be distinguished. Li Shizhen said: "The Wei pulse primarily governs diseases of long-term deficiency and weak blood. Yang Wei leads to aversion to cold, Yin Wei leads to fever." Without potent tonification, it is difficult to restore health. As for the pseudo-pulse manual saying: "Swirling敗血 (stagnant blood) indicates Small Intestine deficiency." How can this be placed under the Wei pulse? If there are no other accompanying signs, even if the pulse is weak but the rhythm is not chaotic, there is still a chance of survival in one out of a hundred cases. If obtained in an acute disease, life might still be saved, implying that the pathogenic factor has not penetrated deeply. If obtained in a chronic disease, it is mostly incurable because the healthy Qi is about to extinguish, and ordinary herbal medicines cannot support it.
In Taiyang disease patterns, only Shaoyin presents with the Wei pulse; other meridians do not. The Taiyang Bladder is the interior-exterior pair of the Shaoyin Kidney. Once the Wei pulse and aversion to cold appear, Zhang Zhongjing would treat from the Shaoyin perspective early on, using Fuzi (Prepared Aconite Root) and Ganjiang (Dried Ginger). This is because the Wei pulse with aversion to cold is precisely due to the decline of Yang Qi. The Book of Songs says: "The moon is dim, the sun is dim; the people below are indeed sorrowful." Even in celestial phenomena, Yang cannot be dim; how much less can human Yang be weak! Since the Kidney already has Yin excess and Yang deficiency, cold arises internally. If external cold also breaks through directly, the person will perish shortly. Thus, Zhang Zhongjing considered it an acute critical condition and used acrid-hot herbs to rescue the last ray of True Yang from the depths. Sudden attack by cold involves Yang deficiency and Yin excess, which is most critical.
The *Suwen · Tiaojing Lun* states: "Yin excess generates internal cold." Due to Jue Qi (rebellious Qi) moving upward, cold accumulates in the chest and does not dissipate, causing warm Qi to depart and leaving only cold. Where cold stays, blood coagulates; where blood coagulates, pulses become obstructed. Its pulse is large and forceful yet choppy, hence termed "Zhong Han" (Cold Strike). Having stated that Yin excess generates internal cold, why also say "therefore Cold Strike"? Does this not mean internal cold arises first, followed by external cold entering? Having stated that blood vessels are obstructed, why also say the pulse is large and choppy? Is it not because external cold strikes, causing the pulse to be large, and blood vessels close, causing the pulse to be choppy? There is deep doubt here; please clarify. First, the Wei Yang protecting the exterior of the body is most solid. Taiyang protects the back, Yangming protects the front, and Shaoyang protects the sides. Now, if it bypasses the Three Yang and directly strikes Shaoyin, could it truly fall from the sky? It is likely that Jue Qi moves upward and accumulates in the chest, causing Stomach cold; Stomach cold allows cold food and inhaled cold air to enter the Stomach. The Kidney is the gate of the Stomach; external cold breaks through the gate directly into the Shaoyin Kidney, hence called "Zhong Han". This is what the classic implied but did not state explicitly. Second, the pulse being large and choppy, although called Cold Strike, is not necessarily an acute sudden disease. Acute Cold Strike would definitely present with a weak pulse. Perhaps the classic generally discusses the pulses of Shanghan (Cold Damage) and Zhonghan (Cold Strike), hence saying large and choppy. Zhang Zhongjing treats Shanghan as a heat disease and Zhonghan as a cold disease, discussing them separately. The pulse of Shanghan is mostly Da (Large), Fu (Floating), Shu (Rapid), Dong (Surging), Hua (Slippery) as Yang pulses, and Chen (Deep), Se (Choppy), Ruo (Weak), Xian (Wiry), Wei (Micro) as Yin pulses. If a Yang disease shows a Yin pulse, it indicates death; how much more so if a Yin disease or acute disease reversely shows a Yang pulse like Large? If only large and choppy, involving two Yang and one Yin, what urgency is there? This is also what the classic implied and was hard to discern.