体象 革大弦急，浮取即得；按之乃空，浑如鼓革。
恰如鼓皮，外则绷急，内则空虚也。故浮取于鼓面而已即得，若按之则虚而无物矣。
主病 革主表寒，亦属中虚。左寸革者，心血虚痛。革在左关，疝瘕为祟。左尺得革，精空可必。
右寸革者，金衰气壅。革在右关，土虚而疼。右尺得革，殒命为忧。女人得之，半产漏下。
脉如皮革，表邪有余，而内则不足。惟表有寒邪，故弦急之象先焉；惟中亏气血，故空虚之象显焉。男人
诸病，多由精血不足之故。女人半产漏下者，亦以血骤去，故脉则空也。
按革者，皮革之象也。浮举之而弦急，非绷急之象乎？沉按之而豁然，非中空之象乎？仲景曰∶“脉弦而
大，弦则为减，大则为芤；减则为寒，芤则为虚；虚寒相搏，此名为革。”此节正革脉之注脚也。革如皮革，
急满指下。今云“脉弦而大”，只此四字可以尽革脉之形状矣。“弦则为减”以下，又发明所以为革之
义也。叔和云∶“三部脉革，长病得之死，新病得之生。”时珍云∶“此芤、弦二脉相合，故为亡精失血之候。
诸家脉书皆以为即牢脉也。故或有革无牢，或有牢无革，混淆莫辨。不知革浮牢沉，革虚牢实，形与证
皆异也。”《甲乙经》曰∶“浑浑革革，至如涌泉，病进而色弊；绵绵其去如弦绝者死。”谓脉来混浊革变，
急如泉涌，出而不返也。观其曰“涌泉”，则浮取之不止于弦大，而且数、且搏、且滑矣。曰“弦绝”，则重按
之不止于豁然，而且绝无根蒂矣。故曰“死”也。王贶以为溢脉者，因《甲乙经》有“涌泉”之语，而附会
其说也。不知溢脉者，自寸而上贯于鱼际，直冲而上，如水之沸而盈溢也，与革脉奚涉乎？丹溪曰∶“如
按鼓皮。”其于中空外急之义，最为切喻。伯仁以革为变革之义误矣。若曰变革，是怪脉也，而革果怪
脉乎？则变革之义何居耶？
【体象】革脉的形态表现为脉体宽大、弦硬且紧急，轻取（浮取）即可触及；重按则感觉中空，整体感觉如同按压皮革。
这就像鼓皮一样，外部紧绷急迫，内部却是空虚的。所以轻取于皮肤表面就能感觉到，如果重按下去，就会感到虚空而没有实质内容。
【主病】革脉主要主表寒证，也属于中焦虚损。左寸部出现革脉，提示心血虚损疼痛。革脉出现在左关部，是疝气或癥瘕积聚在作祟。左尺部出现革脉，必定是精气空虚。
右寸部出现革脉，提示肺气衰败、气机壅滞。革脉出现在右关部，提示脾胃虚弱而疼痛。右尺部出现革脉，有性命之忧。女性出现这种脉象，多为半产（小产）或崩漏下血。
脉象如皮革一般，表明表邪有余，而体内正气不足。正因为有表寒邪气，所以先出现弦急的脉象；正因为中焦气血亏虚，所以显现出空虚的脉象。男性各种疾病，多是由于精血不足造成的。女性发生半产或漏下，也是因为血液突然大量流失，所以脉象呈现空象。
按之如皮革之象。轻举手指时脉来弦急，这不正是绷紧急迫的象吗？沉按手指时脉来豁然中空，这不正是中间空虚的象吗？张仲景说：“脉象弦而且大，弦脉意味着阳气减损，大脉意味着中空如芤；减损则主寒，中空则主虚；虚与寒相互搏结，这就叫做革脉。”这一节正是对革脉的解释。革脉如同皮革，指下感觉急满。如今说“脉弦而大”，仅这四个字就可以概括革脉的形状了。“弦则为减”以下的内容，又阐明了之所以称为革脉的道理。王叔和说：“三部脉都见革象，久病得此脉者死，新病得此脉者生。”李时珍说：“这是芤脉和弦脉两种脉象相合，所以是亡精失血的征候。各家脉书都认为革脉就是牢脉。因此有的书中只有革脉没有牢脉，有的只有牢脉没有革脉，混淆难辨。不知道革脉浮取可见，牢脉沉取方得；革脉属虚，牢脉属实，形态与证候都是不同的。”《甲乙经》说：“脉来浑浊革变，急如涌泉，病情进展且面色败坏；脉去绵绵不绝如弓弦断裂者死。”这是说脉来混浊革变，急迫如泉水涌出，只出不返。看它说“涌泉”，说明轻取不仅不止于弦大，而且数、搏、滑。说“弦绝”，说明重按不仅不止于豁然，而且完全没有根蒂。所以说“死”。王贶认为这是溢脉，是因为《甲乙经》中有“涌泉”一词，就附会这种说法。不知道溢脉是从寸部向上贯穿至鱼际，直冲而上，像水沸腾溢出一样，这与革脉有什么关系呢？朱丹溪说：“像按鼓皮。”这对于中空外急的含义，比喻最为贴切。伯仁将革解释为变革的意思，是错误的。如果说变革，那是怪脉，但革脉真的是怪脉吗？那么变革的意思又在哪里呢？
[Body Image] The morphology of the Ge pulse (Leather Pulse) is characterized by a large, wiry, and tense body; it can be felt upon light palpation (superficial touch), but feels hollow upon heavy pressure, resembling the sensation of pressing on leather.
It is exactly like drum skin: taut and urgent on the outside, yet empty inside. Therefore, it is detected immediately upon superficial palpation; if pressed heavily, it feels empty without substance.
[Main Diseases] The Ge pulse primarily indicates exterior cold and also belongs to deficiency in the middle jiao. If the Ge pulse appears at the Left Cun position, it indicates deficiency pain of Heart Blood. If the Ge pulse is at the Left Guan position, it suggests pathology such as hernia or masses (Zhijia). If the Ge pulse is found at the Left Chi position, it definitely indicates emptiness of essence.
If the Ge pulse appears at the Right Cun position, it indicates decline of Metal (Lung Qi) and qi stagnation. If the Ge pulse is at the Right Guan position, it indicates Spleen/Stomach deficiency with pain. If the Ge pulse is found at the Right Chi position, it warns of danger to life. In women, this pulse indicates spontaneous abortion (half-birth) or metrorrhagia (continuous bleeding).
The pulse resembles leather, indicating excess pathogenic factors at the exterior and insufficiency within. Because there is exterior cold pathogen, the wiry and urgent image appears first; because of the deficiency of qi and blood in the center, the empty image becomes prominent. Various diseases in men are mostly due to insufficiency of essence and blood. Women suffering from spontaneous abortion or metrorrhagia also have an empty pulse because blood is suddenly lost.
Palpating it reveals the image of leather. When lifting lightly, the pulse is wiry and urgent; is this not the image of tension? When pressing deeply, the pulse is suddenly hollow; is this not the image of central emptiness? Zhang Zhongjing said: "The pulse is wiry and large; wiry implies reduction [of yang], large implies void like the Kou pulse; reduction implies cold, void implies deficiency; deficiency and cold clashing together is named Ge." This section serves as a footnote explaining the Ge pulse. Ge resembles leather, feeling full and urgent under the fingers. Now saying "the pulse is wiry and large," these four characters alone can fully describe the shape of the Ge pulse. The following lines "wiry implies reduction..." further elucidate the reason for being called Ge. Wang Shuhe said: "If the pulses in all three positions are Ge, a chronic patient will die, while an acute patient will survive." Li Shizhen said: "This is the combination of the Kou pulse and the Xian pulse, thus serving as a sign of loss of essence and blood. Most pulse manuals consider Ge and Lao pulses to be the same. Thus, some texts mention only Ge without Lao, or only Lao without Ge, causing confusion. They do not know that Ge is superficial and Lao is deep; Ge is deficient and Lao is excess; their forms and syndromes are different." The *Jia Yi Jing* states: "Muddy and turbulent, rushing like a gushing spring, the disease advances and the complexion deteriorates; lingering and departing like a broken string, death ensues." This refers to the pulse coming turbulently and changing rapidly, urgent like a gushing spring, exiting without returning. Observing the term "gushing spring," it implies that upon superficial palpation, it is not only wiry and large, but also rapid, forceful, and slippery. Observing the term "broken string," it implies that upon deep palpation, it is not only suddenly hollow, but completely lacks root. Hence it says "death." Wang Kuang considered this to be the Yi pulse (Overflowing Pulse) because of the term "gushing spring" in the *Jia Yi Jing*, thereby forcing an interpretation. He did not know that the Yi pulse rises from the Cun position up through the Yuji point, rushing straight upward like boiling water overflowing; what does this have to do with the Ge pulse? Zhu Danxi said: "Like pressing on drum skin." This metaphor best captures the meaning of emptiness inside and urgency outside. Boren mistakenly interpreted Ge as meaning "transformation/change." If it meant transformation, it would be one of the strange pulses (Guai Mai); but is the Ge pulse truly a strange pulse? Then where does the meaning of transformation lie?