体象 洪脉极大，状如洪水；来盛去衰，滔滔满指。
主病 洪为盛满，气壅火亢。左寸洪大，心烦舌破。右寸
洪大，胸满气逆。左关见洪，肝木太过。右关见洪，脾土胀热。左尺洪大，水枯便难。右尺洪大，龙火燔灼。
【按】洪脉，即大脉也。如尧时洪水之洪，喻其盛满之象。在卦为离，在时为夏，在人为心。时当朱夏，
天地之气，酣满畅遂；脉者，气之先声，故应之以洪。洪者，大也，以水喻也。又曰钩者，以木喻也。夏木
繁滋，枝叶敷布，重而下垂，故如钩也。钩即是洪，名异实同。《素问》以洪脉为来盛去衰，颇有微旨。
大抵洪脉，只是根脚阔大，却非坚硬；若使大而坚硬，则为实脉而非洪脉矣。《内经》谓大则病进，亦以其气
方张也。黄帝问曰∶“夏脉如钩，何如而钩？”岐伯曰∶“夏脉心也，南方火也，万物所以盛长也。其气来
盛去衰，故曰钩。反此者病。”黄帝曰∶“何如而反？”岐伯曰∶“其气来盛去亦盛，此谓太过，病在外。其气
来不盛去反盛，此谓不及，病在中。太过则令人身热而肤痛，为浸淫。不及则令人烦心，上见咳唾，下为
气泄。”王叔和云∶“夏脉洪大而散，名曰平脉。反得沉濡而滑者，是肾之乘心，水之克火，为贼邪，死不治。
反得大而缓者，是脾之乘心，子之扶母，为实邪，虽病自愈。反得弦细而长者，是肝之乘心，母之归子，为
虚邪，虽病易治。反得浮涩而短者，是肺之乘心，金之凌火，为微邪，虽病即瘥。凡失血、下利、久嗽，久病
之人，俱忌洪脉。”《脉经》曰∶“形瘦脉大而多气者死”，可见形症不与脉相合者，均非吉兆。
【体象】洪脉的形态极大，就像洪水一样；来势强盛而去势衰退，滔滔不绝，充满指下。
【主病】洪脉代表气机盛满，火热亢盛。左寸部出现洪大脉，主心烦、舌体破损。右寸部出现洪大脉，主胸中胀满、气机上逆。左关部见到洪脉，主肝木之气太过。右关部见到洪脉，主脾土胀满发热。左尺部出现洪大脉，主肾水枯竭、大便困难。右尺部出现洪大脉，主命门之火（龙火）炽盛灼烧。
【按语】洪脉，就是大脉。如同尧帝时期的洪水，用来比喻其盛大充满的形态。在八卦中对应离卦，在季节中对应夏季，在人体脏腑中对应心脏。正值盛夏时节，天地之气酣畅饱满、通畅顺遂；脉象是气的先兆声音，所以应合为洪脉。洪，就是大的意思，用水来比喻。又说“钩”，是用树木来比喻。夏季草木繁茂滋长，枝叶舒展铺陈，沉重而下垂，所以像钩子一样。钩其实就是洪，名称不同但实质相同。《素问》说洪脉是来势强盛而去势衰退，其中颇有深意。大体上洪脉，只是根基宽阔宏大，却并不坚硬；如果脉象大而坚硬，那就是实脉而不是洪脉了。《内经》说“大则病进”，也是因为它的气血正处于旺盛扩张的阶段。黄帝问道：“夏季的脉象像钩一样，怎样才算是钩脉？”岐伯回答说：“夏季的脉象对应心脏，属于南方火行，是万物茂盛生长的表现。它的脉气来势强盛而去势衰退，所以叫作钩脉。与此相反的就是病脉。”黄帝问：“怎样算是相反呢？”岐伯说：“脉气来势强盛，去势也强盛，这叫做‘太过’，病邪在体表外部。脉气来势不强盛，去势反而强盛，这叫做‘不及’，病邪在体内中部。太过就会让人身体发热且皮肤疼痛，导致浸淫疮疡。不及就会让人心烦，上部出现咳嗽吐痰，下部出现气泄（如遗尿或失气）。王叔和说：“夏季脉象洪大且散漫，称为平脉（正常脉象）。如果反而得到沉濡而滑的脉象，这是肾水克制心火，称为贼邪，病情危重难以治愈。如果反而得到大而缓的脉象，这是脾土助益心火，子扶母，称为实邪，虽然生病但会自愈。如果反而得到弦细而长的脉象，这是肝木助益心火，母归子，称为虚邪，虽然生病但容易治疗。如果反而得到浮涩而短的脉象，这是肺金凌犯心火，金克火，称为微邪，虽然生病很快就能痊愈。凡是失血、腹泻、久咳以及久病的人，都忌讳出现洪脉。”《脉经》说：“形体消瘦但脉象大且多气的人预后不良（死）”，可见形体症状与脉象不相符合的，都不是吉兆。
[Body Image] The Hong pulse (Surging Pulse) is extremely large in form, resembling floodwater; it arrives with vigor and departs with weakness, flowing continuously and filling the fingers.
[Main Diseases] The Hong pulse indicates qi abundance and hyperactive fire. If the left Cun position shows a large Hong pulse, it indicates mental restlessness and tongue ulceration. If the right Cun position shows a large Hong pulse, it indicates chest fullness and rebellious qi. If a Hong pulse is seen at the left Guan position, it indicates excessive Liver Wood qi. If a Hong pulse is seen at the right Guan position, it indicates Spleen Earth distension and heat. If the left Chi position shows a large Hong pulse, it indicates depletion of Kidney Water and difficult defecation. If the right Chi position shows a large Hong pulse, it indicates blazing Mingmen Fire (Dragon Fire).
[Commentary] The Hong pulse is synonymous with the Da pulse (Large Pulse). Like the floods during the reign of Emperor Yao, it metaphorically describes its abundant and expansive nature. In the Eight Trigrams, it corresponds to Li (Fire); in the seasons, it corresponds to Summer; in the human body, it corresponds to the Heart. During midsummer, the qi of heaven and earth is saturated, full, and smoothly flowing; the pulse is the precursor sound of qi, thus responding with the Hong pulse. "Hong" means large, using water as a metaphor. It is also called "Gou" (Hook), using wood as a metaphor. In summer, trees flourish and grow, spreading branches and leaves that hang heavily downward, thus resembling a hook. Gou is essentially Hong; the names differ but the reality is the same. *Su Wen* states that the Hong pulse arrives with vigor and departs with weakness, containing profound significance. Generally, the Hong pulse has a broad base but is not hard; if it is large and hard, it is a Shi pulse (Excess Pulse) rather than a Hong pulse. *Nei Jing* states "Large indicates disease progression," because the qi is currently expanding vigorously. The Yellow Emperor asked: "The summer pulse resembles a hook; how does one recognize a hook?" Qibo replied: "The summer pulse corresponds to the Heart and Southern Fire, representing the flourishing growth of all things. Its qi arrives strongly and departs weakly, hence it is called a Hook. Deviating from this indicates disease." The Yellow Emperor asked: "How does it deviate?" Qibo said: "If the qi arrives strongly and departs strongly, this is termed 'Excess' (Tai Guo), indicating disease in the exterior. If the qi arrives weakly and departs strongly, this is termed 'Deficiency' (Bu Ji), indicating disease in the interior. Excess causes fever and skin pain, leading to oozing sores. Deficiency causes mental restlessness, upper symptoms like coughing and expectoration, and lower symptoms like Qi leakage." Wang Shuhe stated: "In summer, a pulse that is Hong, large, and scattered is considered a Ping Mai (Normal Pulse). If instead one finds a Chen Ru Er Hua pulse (Deep, Soft, and Slippery), this is Kidney Water overcoming Heart Fire, known as Zei Xie (Robber Evil), which is fatal and untreatable. If instead one finds a Da Huan pulse (Large and Slow), this is Spleen Earth supporting Heart Fire (Child supporting Mother), known as Shi Xie (Real Evil); although sick, recovery will occur spontaneously. If instead one finds a Xian Xi Er Chang pulse (Wiry, Fine, and Long), this is Liver Wood returning to Heart Fire (Mother benefiting Child), known as Xu Xie (Empty Evil); although sick, it is easy to treat. If instead one finds a Fu Se Er Duan pulse (Floating, Choppy, and Short), this is Lung Metal oppressing Heart Fire (Metal suppressing Fire), known as Wei Xie (Minor Evil); although sick, it will heal quickly. For patients with blood loss, diarrhea, chronic cough, or long-term illness, a Hong pulse is contraindicated." *Mai Jing* states: "Those who are emaciated yet have a large pulse with abundant Qi will die." This shows that when physical signs do not match the pulse, it is generally an inauspicious omen.