人身之脉 本乎荣卫 荣者阴血 卫者阳气 荣行脉中 卫行脉外 脉不自行 随气而至 气动脉应 阴阳之义
气如橐 血如波澜 血脉气息 上下循环 十二经中 皆有动脉 手太阴经 可得而息 此经属肺 上系吭嗌
脉之大会 息之出入 初持脉时 令仰其掌 掌后高骨 是谓关上 关前为阳 关后为阴 阳寸阴尺 先后推寻
寸关与尺 两手各有 揣得高骨 上下左右 男女脉同 惟尺则异 阳弱阴盛 反此病至 调停自气 呼吸定息
四至五至 平和之则 三至名迟 迟则为冷 六至为数 数即热证 转迟转冷 转数转热 在人消息 在人差别
迟数即得 即辨浮沉 浮表沉里 深浅酌斟 浮数表热 迟数里热 浮迟表虚 沉迟冷结 察其六部 的在何处
一部两经 一脏一腑 左寸属心 合于小肠 关为肝胆 尺肾膀胱 右寸主肺 大肠同条 关则脾胃 尺命三焦
不特脏腑 身亦主之 上下中央 三部分齐 寸候胸上 关候膈下 尺候于脐 直至跟踝 左脉候左 右脉候右
病随所在 不病者否 浮沉迟数 有内外因 外因于天 内缘于人 天则阴阳 风雨晦明 人喜怒忧 思悲恐惊
外因之浮 则为表证 沉里迟寒 数则热盛 内因浮脉 虚风所为 沉气迟冷 数躁何疑 表里寒热 风气冷燥
辨内外因 脉证参考 浮沉之脉 亦有当然 浮为心肺 沉属肾肝 脾者中州 浮沉之问 肺重三菽 皮毛相得
六菽为心 得之血脉 脾九菽重 得于肌肉 肝与筋平 重十二菽 惟有肾脉 独沉之极 按之至骨 举指来疾
脉理浩繁 总括于四 六难七难 专衍其义 析而言之 七表八里 又有九道 其名乃备 浮而无力 是名芤脉
有力为洪 形状可识 沉而有力 其脉为实 无力微弱 伏则沉极 脉迟有力 滑而流利 无力缓涩 退同一例
数而有力 脉名为紧 小紧为弦 疑似宜审 合则为四 离为七八 天机之秘 神授之诀 举之有余 按之不足
泛泛浮浮 如水漂木 芤脉何似 绝类慈葱 指下成窟 有边无中 滑脉如珠 往来转旋 举按皆盛 实脉则然
弦如张弦 紧如细线 洪较之浮 大而力健 隐隐约约 微渺难寻 举无按有 便指为沉 似迟不迟 是谓之缓
如雨沾沙 涩难而短 迟则极缓 伏按至骨 濡则软软 弱则忽忽 既知七表 又知八里 九道之形 不可不记
诸家九道 互有去取 不可相无 可以相有 过于本位 相引曰长 短则不及 来去乖张 形大力薄 其虚可知
促结俱止 促数结迟 代止不然 止难回之 三脉皆止 当审毫厘 牢比弦紧 转坚转劲 动则动摇 厥厥不定
细如一线 小而有力 弦大虚芤 脉曰改革 涣漫不收 其脉为散 急疾曰数 脉最易见 即脉求病 病无不明
病参之脉 可决死生 然有应病 有不相应 此最宜详 不可执定 人安脉病 是曰行尸 人病脉和 可保无危
中风脉浮 滑兼痰气 其或沉滑 勿以风治 或浮或沉 而微而虚 扶危温痰 风未可疏 寒中太阳 浮紧而涩
及传而变 各状难悉 阳明则长 少阳则弦 太阴入里 迟沉必兼 及入少阴 其脉遂紧 厥阴热深 脉伏厥冷
在阳当汗 次利小便 表解里病 其脉实坚 此其大略 治法之正 至于大法 自有仲景 伤寒有五 脉非一端
阴阳俱盛 紧涩者寒 阳浮而滑 阴濡而弱 此名中风 勿用寒药 阳濡而弱 阴小而急 此非风寒 乃湿温病
阴阳俱盛 病热之极 浮之而滑 沉之散涩 惟有温病 脉散诸经 各随所在 不可指名 暑伤于气 所以脉虚
弦细芤迟 体状无余 或涩或细 或濡或缓 是皆中湿 可得而断 疟脉自弦 弦迟多寒 弦数多热 随时变迁
风寒湿气 合而为痹 浮涩而紧 三脉乃备 香港脚之脉 其状有四 浮弦为风 濡弱湿气 迟涩因寒 洪数热郁
风汗湿温 热下寒熨 腰痛之脉 皆沉而弦 兼浮者风 兼紧者寒 濡细则湿 实则闪肭 指下既明 治斯不忒
尺脉虚弱 缓涩而紧 病为足痛 或者痿病 涩则无血 厥寒为甚 尺微无阴 下痢逆冷 热厥脉伏 时或而数
便秘必难 治不可错 疝脉弦急 积聚在里 牢急者生 弱急者死 沉迟浮涩 疝瘕寒痛 痛甚则伏 或细或动
风寒暑湿 气郁生涎 下虚上实 皆晕而眩 风浮寒紧 湿细暑虚 涎弦而滑 虚脉则无 治眩晕法 尤当审谛
先理痰气 次随证治 滑数为呕 代者霍乱 微滑者生 涩数凶断 偏弦为饮 或沉弦滑 或结或伏 痰饮中节
咳嗽所因 浮风紧寒 数热细湿 房劳涩难 右关濡者 饮食伤脾 左关弦短 疲极肝衰 浮短肺伤 法当咳嗽
五脏之嗽 各视本部 浮紧虚寒 沉数实热 洪滑多痰 弦涩少血 形盛脉细 不足以息 沉少伏匿 皆是死脉
惟有浮大 而嗽者生 外证内脉 参考秤停 下手脉沉 便知是气 沉极则伏 涩弱难治 其或沉滑 气兼痰饮
沉弦细动 皆气痛证 心痛在寸 腹痛在关 下部在尺 脉象显然 心中惊悸 脉必代结 饮食之悸 沉伏动滑
癫痫之脉 浮洪大长 滑大坚疾 痰蓄心狂 乍大乍小 乍长乍短 此皆邪脉 神志昏乱 汗脉浮虚 或涩或濡
软散洪大 渴饮无余 遗精白浊 当验于尺 结芤动紧 二证之的 鼻头色黄 小便必难 脉浮弦涩 为不小便
便血则芤 数则赤黄 实脉癃闭 热在膀胱 诸证失血 皆见芤脉 随其上下 以验所出 大凡失血 脉贵沉细
设见浮大 后必难治 水肿之证 有阴有阳 察脉观色 问证须详 阴脉沉迟 其色青白 不渴而泻 小便清涩
脉或沉数 色赤而黄 燥屎赤溺 兼渴为阳 胀满脉弦 脾制于肝 洪数热胀 迟弱阴寒 浮为虚满 紧则中实
浮则可治 虚则危急 胸痞脉滑 为有痰结 弦伏亦痞 涩则气劣 肝积肥气 弦细青色 心为伏梁 沉芤色赤
脾积痞气 浮大而长 其色脾土 中央之黄 肺积息贲 浮毛色白 奔豚属肾 沉急面黑 五脏为积 六腑为聚
积在本位 聚无定处 紧浮牢 小而沉实 或结或伏 为聚为积 实强者生 沉小者死 生死之别 病同脉异
气口紧盛 为伤于食 食不消化 浮滑而疾 滑而不匀 必是吐泻 霍乱之候 脉代勿讶 夏月泄泻 脉应暑湿
洪而数溲 脉必虚极 治暑温泻 分其小便 虚脱固肠 罔或不痊 无 不痢 脉宜滑大 浮弦急死 沉细无害
五疽实热 脉必洪数 如或微涩 证其虚弱 骨蒸劳热 脉数而虚 热而涩小 必殒其 如汗加咳 非药可除
头痛阳弦 浮风紧寒 风热洪数 温细而坚 气虚头痛 虽弦必涩 痰厥则滑 肾厥坚实 痈疽浮数 恶寒发热
若有痛处 痈疽所发 脉数发热 而疼者阳 不数不热 不疼阴疮 发痈之脉 弦洪相搏 细沉而滑 肺肝俱数
寸数而实 肺痈已成 寸数虚涩 肺痿之形 肺痈色白 脉宜短涩 死者浮大 不白而赤 肠痈难知 滑数可推
数而不热 肠痈何疑 迟紧未脓 下以平之 洪数脓成 不下为宜 阴搏于下 阳别于上 血气和调 有子之象
手之少阴 其脉动甚 尺按不绝 沉为有孕 少阴属心 心主血脉 骨为胞门 脉应于尺 或寸脉微 关滑尺数
往来流利 如雀之啄 或诊三部 浮沉一止 或平而虚 当问月水 男女之别 以左右取 左疾为男 右疾为女
沉实在右 浮大在右 右女左男 可以为 离经六至 沉细而滑 阵痛连腰 胎实时脱 血瘕弦急 而大者生
虚小弱者 即见死形 半产漏下 革脉主之 弱即血耗 立见倾危 诊小儿脉 浮沉为先 浮表沉里 便知其源
大小滑涩 虚实迟 容根据脉形 以审证治 大凡妇人 及夫婴稚 病同丈人 脉即同例 惟有妇人 胎产血气
小儿惊疳 变蒸等类 各有方法 与丈夫异 要知妇孺 贵识证形 问始之详 脉难尽凭 望闻问切 神圣工巧
愚者脉脉 明者了了 病脉诊法 大略如斯 若乃持脉 犹所当知 谓如春弦 夏名钩脉 秋则为毛 冬则为石
实强大过 病见于外 虚微不及 病决在内 四脉各异 四时各论 皆以胃气 而为之本 胃气者何 脉之中和
过与不及 皆是偏颇 春主肝木 夏主心火 脾土乘旺 则在长夏 秋主肺金 冬主肾水 五脏脉象 与五运配
肝脉弦长 厌匕聂匕 指下寻之 如循揄叶 益坚而滑 如循长竿 是谓太过 受病于肝 急如张弦 又如循刀
如按琴瑟 肝死之应 浮大如散 心和且安 累匕如环 如循琅 病则益数 如鸡举足 死操带钩 后踞前曲
浮涩而短 蔼匕如盖 此肺之平 按之益大 病如循羽 不下不上 死则消索 吹毛 匕 沉濡而滑 肾乎则若
上大下锐 滑如雀啄 肾之病脉 啄啄连属 连属之中 然而微曲 来如解索 去如弹石 已死之肾 在人审识
脾者中州 平和不见 然亦可察 中大而缓 来如雀啄 如滴漏水 脾脏之衰 脉乃见此 又有肥瘦 修长侏儒
肥沉瘦浮 短促长疏 各分诊法 不可一途 难尽者意 难穷者理 得之于心 应之于指 勉旃小子 日诵琅琅
造道之玄
人体的脉象，根本在于营气和卫气。营气是阴血，卫气是阳气。营气在脉管中运行，卫气在脉管外运行。脉管本身不能自行跳动，而是随着气的推动而搏动。气带动脉搏，脉搏随之响应，这体现了阴阳的道理。
气就像风箱，血就像波澜。血脉之气，上下循环往复。在十二经脉中，都有动脉搏动，但手太阴肺经的脉动，可以通过呼吸来诊察。这条经脉属于肺，向上连接咽喉。脉搏的大会合处，与呼吸的出入相应。
初诊脉时，让患者手掌向上。手腕后方的高骨，称为“关”。关的前面为阳部（寸），关的后面为阴部（尺）。阳部对应寸口，阴部对应尺部，通过先后推寻来辨别。寸、关、尺三部，左右两手各有分布。揣摸到那个高骨后，在其上下左右进行诊察。男女的脉象大体相同，只有尺部有所不同。如果阳气虚弱而阴气盛，或者反过来，都是疾病的表现。
诊脉时要调整呼吸，以一次完整的呼吸（一息）为单位。脉搏在一息之间跳动四到五次，是平和健康的准则。一息跳动三次称为“迟”脉，迟脉主寒证；一息跳动六次称为“数”脉，数脉主热证。脉越迟越冷，脉越快越热。这需要医者仔细体会和分辨。
确定了迟或数之后，接着辨别浮脉和沉脉。浮脉主表证，沉脉主里证，需要斟酌其深浅程度。浮而数的脉象主表热，迟而数的脉象主里热，浮而迟的脉象主表虚，沉而迟的脉象主寒凝。观察六部脉象，确定病位在哪里。
每一部脉对应两条经络，一个脏和一个腑。左手的寸部属心，与小肠相表里；关部属肝胆；尺部属肾和膀胱。右手的寸部主肺，与大肠相表里；关部属脾胃；尺部属命门和三焦。
不仅脏腑有对应的脉位，身体其他部位也有对应关系。将身体分为上、中、下三部分，寸、关、尺与之齐平。寸部候胸部以上，关部候膈肌以下至腹部，尺部候脐部直至脚跟踝部。左脉主要反映身体左侧的情况，右脉主要反映身体右侧的情况。病邪所在之处脉象会有变化，没有病变的地方则无异常。
浮、沉、迟、数四种脉象，有内因和外因之分。外因来自自然界，包括阴阳、风雨、晦明等气候因素；内因来自人的情绪，包括喜怒忧思悲恐惊七情。
外因导致的浮脉，表现为表证；沉脉主里，迟脉主寒，数脉主热盛。内因导致的浮脉，多由虚风引起；沉脉主气滞，迟脉主冷，数脉主躁动。对于表里、寒热、风气、冷燥等病因，需要参考脉象和症状进行辨别。
浮脉和沉脉也有其特定的归属。浮脉主要对应心肺，沉脉主要对应肾肝。脾位于中州（中部），处于浮沉之间。诊脉时，轻取肺脉如三片豆的重量，感觉在皮毛层面；重取六片豆的重量，感觉在心脉层面（血脉）；再重取九片豆的重量，感觉在脾脉层面（肌肉）；重取十二片豆的重量，感觉在肝脉层面（筋）；唯有肾脉，沉至极点，需按至骨头才能触及，举指时脉搏反应迅速。
脉理虽然浩繁，但可以总括于四种基本脉象。《难经》的第六难和第七难专门阐述其义。细分起来，有七表、八里，又有九道脉，名称完备。
浮而无力，名为芤脉；有力则为洪脉，形状可以识别。沉而有力，名为实脉；无力微弱，伏脉则是沉脉的极致。脉迟而有力，滑利流利；无力缓涩，退行同一类例。数而有力，名为紧脉；小且紧为弦脉，疑似情况应当审慎。
合起来为四种基本脉，离为七八种变脉，这是天机的秘密，神授的秘诀。举之有余，按之不足，泛泛浮浮，像水漂木一样。芤脉像什么？极像慈葱（葱白），指下成窟窿，有边无中。滑脉像珠子，往来转动。举按皆盛，是实脉的特征。
弦脉像张开的弓弦，紧脉像细线。洪脉比浮脉大且力健。隐隐约约，微渺难寻，举之无而按之有，便指为沉脉。似迟不迟，是谓缓脉。如雨沾沙，涩滞难行且短。迟脉极缓，伏脉按至骨。濡脉软软，弱脉忽忽。
既然知道了七表脉，又知道了八里脉，九道脉的形状不可不记。各家对九道脉的取舍互有不同，不可完全去掉，也可以相互补充。超过本位，相互牵引叫做长脉；不及本位叫做短脉。来去乖张，形大力薄，可知其虚。
促脉、结脉都伴有间歇。促脉数而止，结脉迟而止，代脉的停止不同，难以恢复。这三种脉都有间歇，应当仔细审察毫厘之差。牢脉比弦紧更坚硬强劲。动脉则动摇不定，厥厥不定。细脉如一线，小而有力。弦大虚芤，脉名改革（此处原文可能有误，通常指革脉，革脉浮大而中空，如按鼓皮）。涣漫不收，脉名为散。急疾曰数，脉最易见。
即从脉象求病，病无不明。参考病证与脉象，可以决断生死。但是有的脉象与病相应，有的不相应，这点最应详细考察，不可固执死板。人安脉病，这叫“行尸”（外表健康但内部已死）；人病脉和，可以保证无危险。
中风脉浮，兼滑说明有痰气。如果脉沉滑，不要当作风邪治疗。或者浮或者沉，而微而虚，扶危救急温化痰饮，风邪不可轻易疏解。寒邪中于太阳经，脉浮紧而涩。等到传变，各种症状难以详尽。阳明经脉长，少阳经脉弦，太阴经入里，迟沉必兼。进入少阴经，脉遂紧。厥阴经热深，脉伏厥冷。
在阳分应当发汗，其次利小便。表解里病，脉实坚，这是大概的治疗法则。至于大法，自有张仲景。伤寒有五类，脉象并非一端。阴阳俱盛，紧涩者为寒；阳浮而滑，阴濡而弱，这名叫中风，不要用寒药。阳濡而弱，阴小而急，这不是风寒，乃是湿温病。
阴阳俱盛，是热病的极点。浮取而滑，沉取散涩。惟有温病，脉散于各经，各随所在，不可指名。暑气伤于气，所以脉虚。弦、细、芤、迟，体状无余。或者涩或者细，或者濡或者缓，这些都是中湿，可以断言。
疟疾的脉自弦，弦迟多寒，弦数多热，随时间变迁。风寒湿气，合而为痹证，浮涩而紧，三脉乃备。香港脚（脚气病）的脉，其状有四：浮弦为风，濡弱为湿气，迟涩因寒，洪数为热郁。
风用汗法，湿用温法，热用下法，寒用熨法。腰痛的脉，皆沉而弦。兼浮者为风，兼紧者为寒，濡细则为湿，实则闪（扭伤）。指下既明，治疗就不会差错。
尺脉虚弱，缓涩而紧，病为足痛，或者是痿病。涩则无血，厥寒严重。尺脉微弱无阴，下痢逆冷。热厥脉伏，时而数。便秘必难，治疗不可出错。疝脉弦急，积聚在里。牢急者生，弱急者死。沉迟浮涩，疝瘕寒痛。痛甚则伏，或细或动。
风寒暑湿，气郁生涎，下虚上实，皆晕而眩。风浮寒紧，湿细暑虚，涎弦而滑，虚脉则无。治眩晕法，尤当审谛。先理痰气，次随证治。滑数为呕，代者霍乱。微滑者生，涩数凶断。偏弦为饮，或沉弦滑，或结或伏。痰饮中节，咳嗽所因。
浮风紧寒，数热细湿。房劳涩难。右关濡者，饮食伤脾。左关弦短，疲极肝衰。浮短肺伤，法当咳嗽。五脏之嗽，各视本部。浮紧虚寒，沉数实热。洪滑多痰，弦涩少血。形盛脉细，不足以息。沉少伏匿，皆是死脉。惟有浮大，而嗽者生。
外证内脉，参考秤停。下手脉沉，便知是气。沉极则伏，涩弱难治。其或沉滑，气兼痰饮。沉弦细动，皆气痛证。心痛在寸，腹痛在关，下部在尺，脉象显然。心中惊悸，脉必代结。饮食之悸，沉伏动滑。
癫痫之脉，浮洪大长。滑大坚疾，痰蓄心狂。乍大乍小，乍长乍短，此皆邪脉，神志昏乱。汗脉浮虚，或涩或濡。软散洪大，渴饮无余。遗精白浊，当验于尺。结芤动紧，二证之的。
鼻头色黄，小便必难。脉浮弦涩，为不小便。便血则芤，数则赤黄。实脉癃闭，热在膀胱。诸证失血，皆见芤脉。随其上下，以验所出。大凡失血，脉贵沉细。设见浮大，后必难治。
水肿之证，有阴有阳。察脉观色，问证须详。阴脉沉迟，其色青白，不渴而泻，小便清涩。脉或沉数，色赤而黄，燥屎赤溺，兼渴为阳。胀满脉弦，脾制于肝。洪数热胀，迟弱阴寒。浮为虚满，紧则中实。浮则可治，虚则危急。
胸痞脉滑，为有痰结。弦伏亦痞，涩则气劣。肝积肥气，弦细青色。心为伏梁，沉芤色赤。脾积痞气，浮大而长，其色脾土，中央之黄。肺积息贲，浮毛色白。奔豚属肾，沉急面黑。
五脏为积，六腑为聚。积在本位，聚无定处。紧浮牢小而沉实，或结或伏，为聚为积。实强者生，沉小者死。生死之别，病同脉异。气口紧盛，为伤于食。食不消化，浮滑而疾。滑而不匀，必是吐泻，霍乱之候。
脉代勿讶。夏月泄泻，脉应暑湿。洪而数溲，脉必虚极。治暑温泻，分其小便。虚脱固肠，罔或不痊。无[字]不痢，脉宜滑大。浮弦急死，沉细无害。五疽实热，脉必洪数。如或微涩，证其虚弱。
骨蒸劳热，脉数而虚。热而涩小，必殒其[命]。如汗加咳，非药可除。头痛阳弦，浮风紧寒。风热洪数，温细而坚。气虚头痛，虽弦必涩。痰厥则滑，肾厥坚实。痈疽浮数，恶寒发热。若有痛处，痈疽所发。
脉数发热，而疼者阳。不数不热，不疼阴疮。发痈之脉，弦洪相搏。细沉而滑，肺肝俱数。寸数而实，肺痈已成。寸数虚涩，肺痿之形。肺痈色白，脉宜短涩。死者浮大，不白而赤。
肠痈难知，滑数可推。数而不热，肠痈何疑。迟紧未脓，下以平之。洪数脓成，不下为宜。阴搏于下，阳别于上，血气和调，有子之象。手之少阴，其脉动甚。尺按不绝，沉为有孕。
少阴属心，心主血脉。骨为胞门，脉应于尺。或寸脉微，关滑尺数，往来流利，如雀之啄。或诊三部，浮沉一止。或平而虚，当问月水。男女之别，以左右取。左疾为男，右疾为女。沉实在右，浮大在右。右女左男，可以为[凭]。
离经六至，沉细而滑。阵痛连腰，胎实时脱。血瘕弦急，而大者生。虚小弱者，即见死形。半产漏下，革脉主之。弱即血耗，立见倾危。
诊小儿脉，浮沉为先。浮表沉里，便知其源。大小滑涩，虚实迟[速]。容根据脉形，以审证治。大凡妇人及夫婴稚，病同丈人，脉即同例。惟有妇人胎产血气，小儿惊疳、变蒸等类，各有方法，与丈夫异。要知妇孺，贵识证形。问始之详，脉难尽凭。望闻问切，神圣工巧。愚者脉脉，明者了了。病脉诊法，大略如斯。
若乃持脉，犹所当知。谓如春弦，夏名钩脉，秋则为毛，冬则为石。实强大过，病见于外。虚微不及，病决在内。四脉各异，四时各论。皆以胃气，而为之本。胃气者何？脉之中和。过与不及，皆是偏颇。
春主肝木，夏主心火。脾土乘旺，则在长夏。秋主肺金，冬主肾水。五脏脉象，与五运配。肝脉弦长，厌匕聂匕（形容柔和之态），指下寻之，如循揄叶（榆叶）。益坚而滑，如循长竿，是谓太过。受病于肝，急如张弦，又如循刀，如按琴瑟。肝死之应，浮大如散。心和且安，累匕如环（形容圆润），如循琅玕。病则益数，如鸡举足。死操带钩，后踞前曲。
浮涩而短，蔼匕如盖（形容轻浮），此肺之平。按之益大，病如循羽，不下不上。死则消索，吹毛。匕[沉]濡而滑，肾乎则若上大下锐。滑如雀啄，肾之病脉。啄啄连属，连属之中，然而微曲。来如解索，去如弹石，已死之肾。在人审识。
脾者中州，平和不见。然亦可察，中大而缓。来如雀啄，如滴漏水，脾脏之衰，脉乃见此。又有肥瘦，修长侏儒。肥沉瘦浮，短促长疏。各分诊法，不可一途。难尽者意，难穷者理。得之于心，应之于指。勉旃小子，日诵琅琅。造道之玄。
The pulse of the human body is rooted in Ying (Nutritive Qi) and Wei (Defensive Qi). Ying is Yin Blood, while Wei is Yang Qi. Ying circulates within the vessels, and Wei circulates outside the vessels. The vessels do not beat on their own; they move with the Qi. Qi moves, and the pulse responds, embodying the principle of Yin and Yang.
Qi is like a bellows, and blood is like waves. The Qi of the blood vessels circulates up and down continuously. In the twelve meridians, there are arterial pulses, but the pulse of the Hand-Taiyin Lung Meridian can be examined through respiration. This meridian belongs to the Lung and connects upward to the throat. The great convergence of the pulse corresponds to the inhalation and exhalation of breath.
When initially examining the pulse, instruct the patient to hold their palm upward. The high bone behind the wrist is called the Guan (Cuff/Bar). The area anterior to the Guan is Yang (Cun/Inch), and the area posterior to the Guan is Yin (Chi/Cubit). The Yang position corresponds to Cun, and the Yin position corresponds to Chi; they are distinguished by sequential palpation. The Cun, Guan, and Chi positions are present in both hands. After locating the high bone, palpate above, below, and to the sides. The pulse characteristics are generally the same for men and women, except for the Chi position. If Yang is weak and Yin is excessive, or vice versa, it indicates disease.
During pulse diagnosis, regulate your own breathing. A normal, healthy pulse beats four to five times per complete respiratory cycle (one Xi). Three beats per cycle constitute a Chi (Slow) pulse, which indicates Cold syndromes. Six beats per cycle constitute a Shu (Rapid) pulse, which indicates Heat syndromes. The slower the pulse, the colder the condition; the faster the pulse, the hotter the condition. This requires careful observation and differentiation by the practitioner.
Once Slow or Rapid is determined, differentiate between Fu (Floating) and Chen (Sinking) pulses. Fu indicates Exterior syndromes, while Chen indicates Interior syndromes; their depth must be assessed carefully. A Fu-Shu pulse indicates Exterior Heat; a Chi-Shu pulse indicates Interior Heat; a Fu-Chi pulse indicates Exterior Deficiency; a Chen-Chi pulse indicates Cold accumulation. Observe the six pulse positions to locate the pathology precisely.
Each position corresponds to two meridians, one Zang organ, and one Fu organ. The Left Cun position belongs to the Heart and pairs with the Small Intestine; the Guan position belongs to the Liver and Gallbladder; the Chi position belongs to the Kidney and Bladder. The Right Cun position governs the Lung and pairs with the Large Intestine; the Guan position belongs to the Spleen and Stomach; the Chi position belongs to the Mingmen (Gate of Life) and Sanjiao (Triple Burner).
Beyond organs, different body parts also correspond to pulse positions. The body is divided into Upper, Middle, and Lower sections, corresponding to Cun, Guan, and Chi respectively. The Cun position diagnoses the chest and above; the Guan position diagnoses from below the diaphragm to the abdomen; the Chi position diagnoses from the umbilicus down to the heels and ankles. The Left pulse primarily reflects the left side of the body, and the Right pulse primarily reflects the right side. Pathological changes occur where the disease resides, while unaffected areas remain normal.
The Fu, Chen, Chi, and Shu pulses have both External and Internal causes. External causes stem from nature, including Yin-Yang dynamics, wind, rain, darkness, and brightness. Internal causes stem from human emotions, specifically the Seven Emotions: joy, anger, worry, thought, sadness, fear, and fright.
An External cause manifesting as a Fu pulse indicates an Exterior syndrome; a Chen pulse indicates Interior pathology; a Chi pulse indicates Cold; a Shu pulse indicates Excessive Heat. An Internal cause manifesting as a Fu pulse is often due to Deficient Wind; a Chen pulse indicates Qi stagnation; a Chi pulse indicates Cold; a Shu pulse indicates restlessness. To distinguish between External and Internal causes, and to identify patterns such as Exterior/Interior, Cold/Heat, Wind, Cold, and Dryness, one must reference both pulse and symptoms.
Fu and Chen pulses also have specific organ associations. Fu pulses mainly correspond to the Heart and Lung; Chen pulses mainly correspond to the Kidney and Liver. The Spleen resides in the Middle Earth (central region) and lies between Fu and Chen depths. When palpating, light pressure equivalent to three bean weights feels the Lung pulse at the skin level; moderate pressure equivalent to six bean weights feels the Heart pulse in the blood vessels; heavier pressure equivalent to nine bean weights feels the Spleen pulse in the muscles; deep pressure equivalent to twelve bean weights feels the Liver pulse in the tendons. Only the Kidney pulse sinks to the extreme, requiring palpation down to the bone, where it responds swiftly upon lifting the finger.
Although pulse theory is vast, it can be summarized into four basic types. Chapters 6 and 7 of the *Nan Jing* (Classic of Difficult Issues) elaborate on these meanings. Subdivided, there are Seven Superficial (Biao), Eight Interior (Li), and Nine Distinct types, covering all names.
A Fu pulse that is forceless is called Kou (Hollow); if forceful, it is Hong (Surging), recognizable by its shape. A Chen pulse that is forceful is Shi (Full); if forceless and weak, it is Fu (Hidden), which is the extreme of sinking. A Chi pulse that is forceful and smooth is Hua (Slippery); if forceless, slow, and choppy, it falls into the category of Tui (Retreating/Sluggish). A Shu pulse that is forceful is Jin (Tight); small and tight is Xian (Wiry); similar appearances require careful scrutiny.
Combining these yields four basics; separating them yields seven or eight variations. These are secrets of heaven and divine teachings. A pulse that feels abundant when lifted but deficient when pressed is Fu. It floats superficially, like wood drifting on water. What does the Kou pulse resemble? Like a green onion stalk; under the fingers, it feels hollow, with edges but no center. The Hua pulse resembles a bead, rolling back and forth. Abundant upon both lifting and pressing characterizes the Shi pulse.
Xian resembles a drawn bowstring; Jin resembles a thin thread. Hong is larger and stronger than Fu. Faint and elusive, difficult to find, absent on lifting but present on pressing defines the Chen pulse. Slower than Chi but not quite Chi is Huan (Lax). Choppy and short, like rain soaking into sand, is Se (Choppy). Chi is extremely slow; Fu is pressed to the bone. Ru (Soggy) is soft; Ruo (Weak) is fleeting. Having understood the Seven Superficial and Eight Interior pulses, one must memorize the shapes of the Nine Distinct types.
Various schools differ in selecting among the Nine Distinct types; none should be entirely discarded, yet they may complement each other. Extending beyond the standard position with mutual traction is Chang (Long); falling short is Duan (Short). Irregular coming and going with large form but weak force indicates Deficiency. Cu (Hasty) and Jie (Knotted) pulses both feature pauses. Cu is rapid with pauses; Jie is slow with pauses; Dai (Intermittent) pauses are different and difficult to recover from. All three feature pauses, requiring meticulous examination. Lao (Firm) is harder and stronger than Xian and Jin. Dong (Agitated) pulses shake and are unstable. Xi (Fine) is like a single thread, small but forceful. Ge (Leather) is large, empty, and hollow. San (Scattered) pulses are diffuse and uncollected. Rapid and swift is Shu. Pulse diagnosis is straightforward; identifying disease through pulse reveals all pathologies.
Referencing disease alongside pulse allows judgment of life and death. However, some pulses match the disease, while others do not; this must be studied carefully and not applied rigidly. "Person healthy, pulse diseased" is called "Walking Corpse"; "Person diseased, pulse harmonious" guarantees safety without danger.
Stroke (Zhong Feng) presents with a Fu pulse; combined with Hua indicates Phlegm-Qi. If Chen-Hua, do not treat as Wind. Whether Fu or Chen, if Micro and Weak, rescue the critical state by warming and resolving Phlegm; do not lightly disperse Wind. Cold invading the Taiyang meridian presents with Fu-Jin-Se pulses. Upon transmission and transformation, symptoms vary widely. Yangming meridian pulses are Long; Shaoyang are Xian; Taiyin entering the interior combines Chi and Chen. Entering Shaoyin, the pulse becomes Jin. In Jueyin with deep heat, the pulse is Fu with cold extremities.
For Exterior conditions, induce sweating; then promote urination. If the Exterior is resolved but Interior pathology remains with a Shi-Jian pulse, this is a general guideline. For major principles, rely on Zhang Zhongjing. There are five types of Shanghan (Cold Damage), with diverse pulses. Yin and Yang both excess with Jin-Se indicates Cold; Yang Fu-Hua and Yin Ru-Ruo indicates Zhong Feng (Wind Strike); avoid Cold-natured herbs. Yang Ru-Ruo and Yin Xiao-Ji indicates not Wind-Cold, but Shi Wen (Damp-Warmth).
Yin and Yang both excess indicates extreme Heat. Fu-Hua and Chen-San-Se indicates only Warm Disease (Wen Bing), where pulses scatter across meridians according to location, making specific naming difficult. Summerheat injures Qi, resulting in a Xu (Deficient) pulse. Xian, Xi, Kou, and Chi cover various forms. Se, Xi, Ru, or Huan all indicate Dampness invasion.
Malaria pulses are naturally Xian; Xian-Chi indicates more Cold; Xian-Shu indicates more Heat, changing with time. Wind, Cold, and Dampness combining create Bi (Obstruction) syndromes, presenting with Fu-Se-Jin pulses. Foot Qi (Hong Kong Jiao) has four presentations: Fu-Xian for Wind, Ru-Ruo for Dampness, Chi-Se for Cold, Hong-Shu for Heat郁 (Stagnation).
Wind treated with sweating; Dampness with warming; Heat with purging; Cold with moxibustion/warming. Waist pain pulses are generally Chen-Xian. Combined Fu indicates Wind; combined Jin indicates Cold; Ru-Xi indicates Dampness; Shi indicates sprain/trauma. Clear finger identification ensures accurate treatment.
Weak Chi pulses with Huan-Se-Jin indicate foot pain or Wei (Atrophy) syndromes. Se indicates Blood deficiency with severe Cold reversal. Micro Chi indicates Yin deficiency, leading to dysentery and cold extremities. Heat reversal presents with Fu pulses, occasionally Shu. Constipation is difficult to treat; errors are dangerous. Hernia pulses are Xian-Ji, indicating internal accumulation. Lao-Ji indicates survival; Ruo-Ji indicates death. Chen-Chi-Fu-Se indicates Hernia-Zha (masses) and Cold pain. Severe pain leads to Fu pulses, or Xi/Dong.
Wind, Cold, Summerheat, and Dampness causing Qi stagnation and Saliva-Phlegm, with lower Deficiency and upper Excess, lead to dizziness and vertigo. Wind presents Fu; Cold presents Jin; Dampness presents Xi; Summerheat presents Xu; Saliva-Phlegm presents Xian-Hua; Deficiency presents empty pulses. Treating vertigo requires careful scrutiny: first resolve Phlegm-Qi, then treat symptoms. Hua-Shu indicates vomiting; Dai indicates Huoluan (Colic/Vomiting-Diarrhea). Micro-Hua indicates survival; Se-Shu indicates凶 (ominous/death). Pian Xian indicates Fluid retention (Yin); Chen-Xian-Hua, Jie, or Fu also indicate Phlegm-Fluid affecting cough.
Exterior Wind presents Fu; Cold presents Jin; Heat presents Shu; Dampness presents Xi. Sexual exhaustion presents Se-difficulty. Right Guan Ru indicates dietary injury to the Spleen. Left Guan Xian-Duan indicates liver exhaustion from fatigue. Fu-Duan indicates Lung injury, necessitating cough treatment. Coughs of the five Zang organs depend on their respective positions. Fu-Jin-Xu-Cold; Chen-Shu-Shi-Heat. Hong-Hua indicates much Phlegm; Xian-Se indicates little Blood. Robust body with fine pulse unable to sustain breath, or Chen-Shao/Fu-Ni, are all Death pulses. Only Fu-Da with cough indicates survival. Correlate external signs with internal pulses.
Deep pulse indicates Qi disorder. Extreme Deep is Fu; Se-Ruo is hard to treat. Chen-Hua indicates Qi combined with Phlegm-Fluid. Chen-Xian-Xi-Dong all indicate Qi-Pain syndromes. Heart pain at Cun; Abdominal pain at Guan; Lower body pain at Chi. Palpitations always show Dai-Jie pulses. Dietary palpitations show Chen-Fu-Dong-Hua. Epilepsy pulses are Fu-Hong-Da-Chang. Hua-Da-Jian-Ji indicates Phlegm accumulating in the Heart causing madness. Fluctuating size/length indicates Evil pulses and mental confusion. Sweating shows Fu-Xu, or Se/Ru. Soft-Scattered-Hong-Da with thirst indicates fluid loss. Nocturnal emission and white turbidity are verified at Chi. Jie-Kou-Dong-Jin confirm these two conditions. Yellow nose tip indicates difficult urination. Fu-Xian-Se indicates urinary retention. Hematochezia shows Kou; Shu indicates red/yellow urine. Shi pulse indicates strangury with Heat in the Bladder. All hemorrhagic conditions show Kou pulses; check upper/lower to locate bleeding. Generally, for hemorrhage, Shen-Xi (Deep-Fine) is precious. Fu-Da suggests difficult treatment later.
Edema has Yin and Yang types. Observe pulse, color, and symptoms in detail. Yin Edema: Chen-Chi pulse, blue-white complexion, no thirst, diarrhea, clear/difficult urination. Yang Edema: Chen-Shu pulse, red-yellow complexion, dry stool, red urine, accompanied by thirst. Distension with Xian pulse indicates Liver controlling Spleen. Hong-Shu indicates Heat distension; Chi-Ruo indicates Cold distension. Fu indicates false fullness; Jin indicates solid interior. Fu is treatable; Xu is critical. Chest oppression with Hua pulse indicates Phlegm knotting. Xian-Fu also indicates oppression; Se indicates poor Qi.
Liver accumulation (Fei Qi) is Xian-Xi with blue color. Heart accumulation (Fu Liang) is Chen-Kou with red color. Spleen accumulation (Pi Qi) is Fu-Da-Chang, yellow earth color. Lung accumulation (Xi Ben) is Fu-Mao with white color. Ben Tun belongs to Kidney, showing Chen-Ji pulse with black face. Five Zang accumulations are Ji; Six Fu aggregations are Ju. Ji stays in fixed locations; Ju moves. Jin-Fu-Lao-Xiao-Chen-Shi, or Jie-Fu, indicate Ju or Ji. Strong/Shi indicates survival; Small/Chen indicates death. Same disease, different pulses determine life/death.
Qikou (Radial artery at wrist) tight/excessive indicates food injury. Undigested food shows Fu-Hua-Ji. Uneven Hua indicates vomiting/diarrhea, Huoluan syndrome. Dai pulse is not alarming. Summer diarrhea matches Summerheat-Dampness: Hong pulse with frequent urination, extremely Xu pulse. Treat Summerheat-Damp diarrhea by separating fluids via urination. For collapse, secure intestines; recovery is certain. Dysentery without [specific symptom]: pulse should be Hua-Da. Fu-Xian-Ji indicates death; Chen-Xi is harmless. Five Jaundices with Excess-Heat show Hong-Shu pulses. Micro-Se indicates weakness. Bone-steaming consumption shows Shu-Xu pulse. Heat with Se-Xiao indicates death. Sweat plus cough cannot be cured by medicine alone.
Headache with Yang Xian: Fu for Wind, Jin for Cold. Wind-Heat shows Hong-Shu; Warmth shows Xi-Jian. Qi-deficiency headache is Xian-Se even if Xian. Phlegm-Jue shows Hua; Kidney-Jue shows Jian-Shi. Carbuncles/Furuncles show Fu-Shu with chills/fever. Painful location indicates carbuncle origin. Shu pulse with fever and pain indicates Yang sore; non-Shu/non-hot/painless indicates Yin sore. Carbuncle onset shows Xian-Hong interacting; Fine-Chen-Hua indicates Lung/Liver Shu. Cun-Shu-Shi indicates Lung Abscess formed; Cun-Shu-Xu-Se indicates Lung Withering. Lung Abscess color white, pulse should be Duan-Se. Death shows Fu-Da; not white but red indicates severity. Intestinal abscess is hard to know; Hua-Shu can deduce it. Shu without heat confirms intestinal abscess. Chi-Jin before pus formation requires purging; Hong-Shu after pus formation advises against purging.
Yin pulsates below, Yang differs above; harmonious Blood-Qi indicates pregnancy. Hand-Shaoyin pulse moves strongly. Uninterrupted Chi Chen indicates pregnancy. Shaoyin belongs to Heart, which governs Blood-Vessels. Bones are the womb gate; pulse responds at Chi. If Cun is Micro, Guan is Hua, Chi is Shu, flowing smoothly like a sparrow pecking. Or examine three positions: Fu/Chen pause once. Or Ping/Xu, ask about menstruation. Gender distinction by left/right: Left rapid is Male, Right rapid is Female. Chen-Shi on Right, Fu-Da on Right. Right Female, Left Male, can be relied upon.
Li Jing (departing from normal) six beats, Chen-Xi-Hua with labor pains connecting to waist indicates imminent delivery. Blood mass (Xia) is Xian-Ji; large indicates survival. Xu-Xiao-Ruo indicates death form. Miscarriage and leakage dominated by Ge pulse. Ruo indicates Blood depletion, immediate danger.
Pediatric pulse diagnosis prioritizes Fu/Chen. Fu indicates Exterior, Chen indicates Interior, revealing the source. Size, Hua/Se, Xu/Shi, Chi/Shu allow assessment based on pulse form. Generally, women and infants follow adult rules, except for female pregnancy/birth/blood issues, and pediatric convulsions/rickets/developmental fevers, which have distinct methods differing from males. Knowing women and children requires recognizing symptom forms. Detailed inquiry is primary; pulse alone is insufficient. Inspection, Auscultation/Olfaction, Inquiry, and Palpation constitute the Divine, Profound, Skillful, and Ingenious arts. The foolish see only pulses; the wise understand clearly. This covers the basics of disease-pulse diagnosis.
Regarding holding the pulse, one must know: Spring is Xian (Wiry); Summer is Gou (Hook); Autumn is Mao (Feather); Winter is Shi (Stone). Excessive strength indicates Exterior disease; Deficiency indicates Interior disease. These four pulses vary by season, all rooted in Stomach Qi. What is Stomach Qi? It is the harmony and balance of the pulse. Excess or deficiency is deviation.
Spring governs Liver Wood; Summer governs Heart Fire. Spleen Earth peaks in Late Summer. Autumn governs Lung Metal; Winter governs Kidney Water. Five Zang pulses correspond to the Five Movements. Liver pulse is Xian-Chang, gentle and soft; seeking under fingers feels like touching elm leaves. Hardening and smoothing like touching a long pole indicates Excess. Liver disease: tight like a bowstring, cutting like a knife, pressing like a zither. Liver death pulse: Fu-Da like scattered fibers. Heart health: peaceful and safe, round like a ring, smooth like jade. Heart disease: increasingly rapid, like a chicken lifting its feet. Heart death: hook-like, squatting rear, bent front.
Lung pulse: Fu-Se-Duan, light like a canopy. Normal lung pulse is smooth. Pressing makes it larger. Disease feels like touching feathers, neither rising nor falling. Death pulse: fading like blowing hair. Kidney pulse: Chen-Ru-Hua, large top/small bottom. Disease pulse: pecking like a sparrow, continuous but slightly curved. Death pulse: unraveling rope, shooting stone. Recognize these states.
Spleen is Central Earth, peaceful and unseen, but observable. Large middle and slow, coming like sparrow pecking or dripping water, indicates Spleen decline. Body types matter: fat/slim, tall/short. Fat pulses sink; slim pulses float. Short pulses are rapid; long pulses are sparse. Diagnosis varies by type, not uniform. Intent is hard to exhaust; principles are hard to穷 (reach). Grasped in heart, responded by fingers. Encourage students to recite daily. The mystery of the Dao.