体象 涩脉蹇滞，如刀刮竹；迟细而短，三象俱足。
涩者，不流利之义。《素问·三部九候篇》曰∶“参伍不调者病。”谓其凝滞而至数不和匀也。《脉诀》以
轻刀刮竹为喻者，刀刮竹则阻滞而不滑也。通真子以如雨沾沙为喻者，谓雨沾金石则滑而流利，雨
沾沙土则涩而不流也。时珍以病蚕食叶为喻者，谓其迟慢而艰难也。
主病 涩为血少，亦主精伤。左寸涩者，心痛怔忡。涩在左关，血虚肋胀。左尺得涩，精伤胎漏。
右寸涩者，痞气自汗。涩在右关，不食而呕。右尺得涩，大便艰秘，腹寒胫冷。
中焦取汁变化而赤，是谓血；壅遏营气令无所避，是谓脉。两者同质异名。况血为阴液，多则滑利，少则
枯涩，势所然也。精也，血也，皆属于阴，故共主之。借以供神明之用者血也，血少则不能养心而痛作；积
久而加以惊疑，则怔忡至矣。肝为血海，血少则不能自荣，而所部作痛。肾伤则精无余蓄，男子溲淋，妇
人血败胎漏，真阳丧矣。肺家真气既亏，胸中不能营运，则为痞塞；不能卫外而为固，则汗时自出；出则
液耗，谓之脱液；漏而不止，卫气散失四肢厥寒，谓之亡阳；阳亡液脱，故亦主涩。血少则脾阴弱而食减
呕作，甚而朝食暮吐，暮食朝吐，或随食随吐。胃无余液，血少则津液枯，无由下致，而大便艰。腹寒胫冷，
皆缘血少不获随真阳之气以营运耳。
兼脉 涩而坚大，为有实热；涩而虚软，虚大炎灼。
涩本血少而再得坚大之形，乃邪火炽甚，阴不胜阳；若仅见虚软，此属无根之火熏灼耳。或因忧郁，或
因浓味，或因无汗，或因妄补，气腾血沸，清化为浊，老痰宿饮，胶固杂糅，脉道阻涩，不能自至，亦见涩状。
若重取至骨，似有力而带数，以意参之于证，验之形气，但有热证，当作痼热可也。
按一切世间之物，濡润者则必滑，枯槁者则必涩。故滑为痰饮，涩主阴衰，理有固然，无足辨者。肺之为
脏，气多血少，故右寸见之为合度之诊。肾之为脏，专司精血，故右尺见之为虚残之候。不问男妇，凡尺
中沉涩者，必艰于嗣，正血少精伤之确证也。故女人怀子而得涩脉，则血不足养胎；如无孕而得涩脉，
将有阴衰髓竭之忧。伪诀云∶“指下寻之似有，举之全无。”则是微脉而非涩脉矣。叔和谓其“一止复
来”，亦有疵病。盖涩脉往来迟难，有类乎止而实非止也。又曰∶“细而迟，往来难，且散者。”乃浮分多而
沉分少，有类乎散，而实非散也。须知极细极软、似有若无为微脉，浮而且细且软为濡脉，沉而且细且
软为弱脉。三者之脉，皆指下模糊，有似乎涩，而实有分别也。然一脉涩也，更有外邪相袭，使气分不利
而成滞涩，卫气散失，使阳衰不守而成虚涩；肠胃燥渴，津液亦亡，使血分欲尽而成枯涩；在诊之者自
为灵通耳。
【体象】涩脉往来艰涩阻滞，就像用刀刮竹子一样；其脉象表现为迟、细、短，这三种特征都具备。
涩，是不流利的意思。《素问·三部九候篇》说：“参伍不调者病。”指的是脉搏凝滞且至数（跳动频率）不匀。《脉诀》用轻刀刮竹来比喻，是因为刀刮竹子时会有阻滞而不滑润的感觉。通真子用雨滴沾沙土来比喻，意思是雨水落在金石上则滑利流畅，而落在沙土上则涩滞不流。李时珍用病蚕吃桑叶来比喻，是指其动作迟缓缓慢且艰难。
【主病】涩脉主要提示血少，也主精液损伤。左寸部出现涩脉，是心痛和怔忡（心跳不安）的表现。涩脉出现在左关部，是血虚导致胁肋胀满。左尺部出现涩脉，是精伤导致胎漏（妊娠期阴道少量出血）。右寸部出现涩脉，是痞气（胸腹间结块或气滞）和自汗。涩脉出现在右关部，是不想进食却伴有呕吐。右尺部出现涩脉，是大便干结难解，腹部寒冷且小腿发冷。
中焦脾胃摄取水谷精微，变化而成红色的血液，这就是血；约束营气使其在脉道中运行而不外溢，这就是脉。两者本质相同但名称不同。况且血属于阴液，血量多则脉道滑利，血量少则脉道枯涩，这是必然的趋势。精和血都属于阴，所以涩脉共同主这两种病症。依靠血来供养神明的是心，血少就不能滋养心脏而导致心痛发作；如果积久再加上惊恐疑虑，那么怔忡就会严重发生。肝为血海，血少就不能自我荣养，其所管辖的部位就会疼痛。肾受伤则精气没有剩余蓄积，男子会出现小便淋沥，女子会出现经血败坏、胎漏，这是真阳丧失的表现。肺家真气既然亏损，胸中不能正常营运，就会产生痞塞感；不能卫护体表而固密，就会时常自汗；出汗则津液消耗，称为脱液；如果漏汗不止，卫气散失，四肢厥冷，称为亡阳；阳气亡失、津液脱失，所以也主涩脉。血少则脾阴虚弱而食欲减退并引发呕吐，严重时甚至早晨吃的晚上吐出来，晚上吃的早晨吐出来，或者随吃随吐。胃中没有剩余的津液，血少则津液枯竭，无法下行滋润肠道，从而导致大便干结。腹部寒冷和小腿发冷，都是因为血少不能跟随真阳之气进行营运的缘故。
【兼脉】涩脉如果兼见坚大，是有实热；涩脉如果兼见虚软，是无根之火熏灼导致的虚大。
涩脉本因血少所致，如果再见到坚大的脉形，那是邪火炽盛，阴气不能制约阳气；如果仅仅见到虚软，这属于无根之火熏灼所致。也有可能是因为忧郁，或者因为食用浓味厚腻的食物，或者因为无汗，或者因为错误进补，导致气机升腾、血液沸腾，清稀转化为浑浊，老痰和宿饮胶固混杂，阻碍脉道，使气血不能顺畅到达，也会呈现涩脉的形态。如果重按至骨，感觉似乎有力且带有数脉（快速），结合症状判断，验证形体和气色，只要有热证，可以当作顽固的热证来处理。
按照世间一切事物，湿润润滑的必然滑利，干枯粗糙的必然涩滞。所以滑脉主痰饮，涩脉主阴衰，道理本来如此，无需争辩。肺作为脏腑，气多血少，所以在右寸部见到涩脉是符合常度的诊法。肾作为脏腑，专门主管精血，所以在右尺部见到涩脉是虚损残败的征候。不问男女，凡是尺部脉象沉涩的，必定难以生育，这正是血少精伤的确实证据。所以女人怀孕而得到涩脉，说明血不足以养胎；如果没有怀孕而得到涩脉，将有阴衰髓竭的忧虑。伪托的《脉诀》说：“指下寻找时似乎有脉，举手轻取时全无。”这是微脉而不是涩脉了。王叔和说它“一止复来”（偶尔停顿后恢复），也有瑕疵。因为涩脉往来迟缓困难，看起来像是有停顿但实际上并非真正的停顿。他又说：“细而迟，往来难，且散漫。”这是浮取时脉象多而沉取时脉象少，看起来像散脉但实际上并非散脉。需要知道，极细极软、似有若无的是微脉，浮取且细且软的是濡脉，沉取且细且软的是弱脉。这三种脉象，在指下都模糊不清，似乎与涩脉相似，但实际上是有区别的。然而，单一涩脉，更有外邪侵袭，使气分不利而形成滞涩；卫气散失，使阳气衰微不能固守而形成虚涩；肠胃燥渴，津液也亡失，使血分欲尽而形成枯涩；这需要诊脉者自己灵活通达地辨别。
[Body Image] The Se pulse (Se Mai, Cymose Pulse) is rough and obstructed, like a knife scraping bamboo; it presents with the three characteristics of Slow (Chi), Fine (Xi), and Short (Duan).
"Se" means not smooth or fluent. The *Suwen: Sanbu Jiuhou Pian* states: "Irregularities in the rhythm indicate disease." This refers to stagnation and an uneven pulse rate. The *Maijue* uses the metaphor of a light knife scraping bamboo because scraping bamboo causes obstruction and lacks slipperiness. Tong Zhenzi uses the metaphor of rain soaking into sand, meaning that while rain on metal or stone is slippery and fluid, rain on sand is rough and does not flow smoothly. Li Shizhen uses the metaphor of a sick silkworm eating leaves, indicating slowness and difficulty.
[Main Pathology] The Se pulse primarily indicates Blood deficiency and also signifies Essence injury. A Se pulse at the Left Cun position indicates Heart pain and palpitations (Zhengchong). A Se pulse at the Left Guan position indicates Liver Blood deficiency causing hypochondriac distension. A Se pulse at the Left Chi position indicates Essence injury leading to fetal leakage (bleeding during pregnancy). A Se pulse at the Right Cun position indicates Qi stagnation (Pi qi) and spontaneous sweating. A Se pulse at the Right Guan position indicates anorexia accompanied by vomiting. A Se pulse at the Right Chi position indicates difficult and constipated bowel movements, abdominal coldness, and cold calves.
The middle jiao extracts essences from food and drink, transforming them into red Blood; this is called Blood. It confines Ying Qi so that it has nowhere to escape; this is called the Pulse. Both share the same substance but have different names. Moreover, Blood belongs to Yin fluids; when abundant, the pulse is slippery and fluid, and when deficient, it is withered and rough, which is inevitable. Essence and Blood both belong to Yin, hence the Se pulse governs both conditions. Blood is what nourishes the Shen (Spirit); when Blood is deficient, it fails to nourish the Heart, causing pain. If prolonged and compounded by fright or doubt, palpitations become severe. The Liver is the Sea of Blood; when Blood is deficient, it cannot nourish itself, causing pain in its associated regions. Kidney injury results in no surplus Essence; men experience dysuria, women experience menstrual blood deterioration and fetal leakage, indicating the loss of True Yang. When Lung Qi is deficient, circulation in the chest is impaired, leading to stuffiness; when it fails to protect the exterior and maintain solidity, spontaneous sweating occurs. Sweating consumes fluids, termed Fluid depletion. If leakage continues, Wei Qi dissipates, leading to cold extremities, termed Yang collapse. With Yang collapse and Fluid depletion, the Se pulse appears. Blood deficiency weakens Spleen Yin, reducing appetite and inducing vomiting; in severe cases, morning food is vomited in the evening, evening food in the morning, or immediate vomiting after eating. Stomach lack of residual fluids and Blood deficiency lead to dry Jin-Ye (Body Fluids), preventing downward lubrication and causing constipation. Abdominal coldness and cold calves occur because insufficient Blood cannot follow True Yang Qi for circulation.
[Combined Pulses] A Se pulse combined with Firm and Large qualities indicates Excess Heat; a Se pulse combined with Empty and Soft qualities indicates deficiency heat caused by rootless fire blazing.
Since the Se pulse originates from Blood deficiency, if it additionally presents as Firm and Large, it signifies rampant pathogenic Fire where Yin cannot control Yang. If it only presents as Empty and Soft, it belongs to rootless fire scorching. It may also result from depression, rich and greasy diet, absence of sweating, or erroneous tonification, causing Qi to surge and Blood to boil, transforming clear essence into turbidity. Old phlegm and retained fluids become sticky and mixed, obstructing the pulse channel, preventing smooth arrival, and presenting a Se appearance. If deep pressure reveals strength and rapidity (Shu pulse), combined with clinical signs and physical constitution showing heat symptoms, it should be treated as stubborn Heat.
Generally, moist objects are slippery, and dry objects are rough. Thus, Slippery pulses govern Phlegm-Fluids, and Se pulses govern Yin decline; this principle is inherent and beyond dispute. The Lung, being an organ with abundant Qi and little Blood, shows a normal diagnostic pattern when a Se pulse appears at the Right Cun. The Kidney, responsible for Essence and Blood, shows a sign of deficiency and decay when a Se pulse appears at the Right Chi. Regardless of gender, a Deep and Se pulse at the Chi positions invariably indicates infertility, confirming Blood deficiency and Essence injury. Therefore, if a pregnant woman presents with a Se pulse, it indicates insufficient Blood to nourish the fetus; if a non-pregnant woman presents with a Se pulse, she faces the worry of Yin decline and Marrow exhaustion. The spurious *Maijue* states: "Searching under the fingers, it seems present; lifting the fingers, it is completely absent." This describes the Micro pulse (Wei Mai), not the Se pulse. Wang Shuhe's description of it as "stopping once then returning" is also flawed. The Se pulse is slow and difficult in its movement; it resembles a stop but is not truly a stop. He also described it as "Fine and Slow, difficult in movement, and scattered." This implies more pulse force at the superficial level than the deep level, resembling the Scattered pulse (San Mai) but not actually being one. One must know that the Micro pulse is extremely fine and soft, seeming present yet absent; the Wet pulse (Ru Mai) is superficial, fine, and soft; the Weak pulse (Ruo Mai) is deep, fine, and soft. These three pulses are all vague under the fingers and seem similar to the Se pulse, but they are distinct. However, a single Se pulse can also arise from external pathogens invading, causing Qi stagnation and roughness; from Wei Qi dissipation, causing Yang deficiency and failure to hold, resulting in deficiency-related roughness; or from intestinal and stomach dryness and thirst, causing Jin-Ye loss and Blood exhaustion, resulting withered roughness. It requires the practitioner to be spiritually agile and discerning.