体象 涩脉蹇滞，如刀刮竹；迟细而短，三象俱足。
主病 涩为血少，亦主精伤。寸涩心痛，或为怔忡。关涩
阴虚，因而中热。右关土虚；左关胁胀。尺涩遗淋，血痢可决；孕为胎病，无孕血竭。
兼脉 涩而坚大，为有实热。涩而虚软，虚火炎灼。
【按】涩者，不流利、不爽快之义也。《内经》曰∶“参伍不调”，谓之
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。李时珍以病蚕食叶为喻者，谓其迟慢而艰难也。伪诀
云∶“指下寻之似有，举之全无”，则是微脉而非涩脉也。王叔和谓其一止复来，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。”且涩者，乃浮分多而沉分少，有类乎散而实非
散也。须知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，皆指下模糊而不清
爽，有似乎涩而确有分别也。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，故左
尺见之，为虚残之候。不问男妇，凡尺中沉涩者，必艰于嗣，正血少精伤之症也。如怀子而得涩脉，则血不
足以养胎。如无孕而得涩脉，将有阴衰髓竭之忧。
大抵一切世间之物，濡润则必滑，枯槁则必涩；故滑为痰饮，涩主阴衰，理有固然，无足疑者。
【脉象特征】涩脉的形态艰涩阻滞，就像用刀刮竹子一样；其特点是至数迟、脉形细、脉势短，这三种特征都具备。
【主病】涩脉主要主血虚，也主精液损伤。寸部出现涩脉，主心痛，或者是怔忡（心中悸动不安）。关部出现涩脉，主阴虚，进而导致中焦有热。右关部见涩脉，主脾土虚弱；左关部见涩脉，主胁肋胀满。尺部出现涩脉，主遗精或淋证，也可判断为血痢；孕妇见涩脉，提示胎元有病；未孕者见涩脉，则是血液枯竭之象。
【兼脉】涩脉若兼见坚大之象，说明体内有实热。涩脉若兼见虚软之象，说明是虚火炎上灼烧。
【按语】“涩”的意思是不流利、不爽快。《内经》说：“参伍不调”，指的是气血凝滞而脉搏节律不匀。《脉诀》用轻刀刮竹来比喻，意思是刀刮竹子时会有阻滞感而不滑利。通真子用雨沾沙土来比喻，意思是雨水落在金石上则滑利流畅，落在沙土上则涩滞不流。李时珍用病蚕吃桑叶来比喻，意思是动作迟慢而艰难。伪托的《脉诀》中说：“指下寻之似有，举之全无”，这描述的是微脉而不是涩脉。王叔和认为涩脉有一止复来的特点，这也是有瑕疵的说法。因为涩脉往来迟缓艰难，看似有停顿，但实际上并非真正的停跳。又说：“细而迟，往来难”。而且涩脉在浮取时较多，沉取时较少，看似像散脉但实际上不是散脉。必须知道：极软且似有若无的是微脉，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，指下感觉模糊不清爽，看起来似乎与涩脉相似，但确实有区别。肺这个脏器，气多血少，所以右寸部见到涩脉，属于合乎常度的脉象。肾这个脏器，专门主管精血，所以左尺部见到涩脉，是虚损严重的征候。不论男女，凡是尺部脉象沉涩的，必定难以生育，这正是血少精伤的病症。如果怀孕而得到涩脉，说明血液不足以滋养胎儿。如果没有怀孕而得到涩脉，将有阴衰髓竭的忧患。
大体而言，世间一切事物，湿润润滑则必然滑利，干枯粗糙则必然涩滞；所以滑脉主痰饮，涩脉主阴液衰少，道理本来如此，不足为疑。
[Image of the Pulse] The image of the Se (Choppy) pulse is obstructed and stagnant, like a knife scraping bamboo; it is slow, thin, and short, with all three characteristics fully present.
[Main Diseases] The Se pulse indicates blood deficiency, and also governs essence injury. A Se pulse at the Cun (inch) position indicates heart pain, or palpitations (Zhenchong). A Se pulse at the Guan (bar) position indicates Yin deficiency, leading to heat in the middle jiao. At the Right Guan position, it indicates Spleen Earth deficiency; at the Left Guan position, it indicates hypochondriac distension. A Se pulse at the Chi (cubit) position indicates spermatorrhea or stranguria, and can also be determined as bloody dysentery; in pregnancy, it indicates fetal pathology; without pregnancy, it indicates blood exhaustion.
[Combined Pulses] If the Se pulse is combined with firmness and largeness, it indicates excess heat. If the Se pulse is combined with emptiness and softness, it indicates deficient fire flaming upward.
[Commentary] "Se" means not smooth or unrefreshing. The *Neijing* states: "irregular and uneven," referring to stagnation where the pulse rate is not uniform. The *Maijue* uses the metaphor of a light knife scraping bamboo, meaning that scraping bamboo causes obstruction and lacks smoothness. Tongzhenzi uses the metaphor of rain soaking into sand, meaning that rain on metal or stone is smooth and fluid, whereas rain on sand is choppy and does not flow. Li Shizhen uses the metaphor of a silkworm eating leaves while ill, meaning the movement is slow and difficult. The spurious *Maijue* states: "seeking under the finger seems to exist, lifting reveals nothing," which describes the Wei (Minute) pulse rather than the Se pulse. Wang Shuhe claimed it has a pause before returning, which is also a flaw. This is because the Se pulse comes and goes slowly and with difficulty, resembling a pause, but is actually not a pause. It is also said: "thin and slow, coming and going with difficulty." Furthermore, the Se pulse is more prominent in the floating layer and less so in the sinking layer, resembling the San (Scattered) pulse but is not actually the San pulse. One must know that extremely soft, seeming to exist yet not existing, is the Wei pulse; floating, thin, and soft is the Ru (Soggy) pulse; sinking, thin, and soft is the Ruo (Weak) pulse. These three pulses are all vague and unclear under the fingers, appearing somewhat similar to the Se pulse but having definite distinctions. The Lung is an organ with much Qi and little Blood, so seeing this pulse at the Right Cun position is within normal limits. The Kidney is an organ specifically responsible for Essence and Blood, so seeing this pulse at the Left Chi position is a sign of severe deficiency and depletion. Regardless of gender, whenever the Chi position presents a sinking and Se pulse, conception will certainly be difficult; this is precisely the syndrome of blood deficiency and essence injury. If one is pregnant and obtains a Se pulse, it means there is insufficient blood to nourish the fetus. If one is not pregnant and obtains a Se pulse, there is the worry of Yin decline and marrow exhaustion.
Generally speaking, all things in the world, if moist and lubricated, will necessarily be Hua (Slippery); if dry and withered, they will necessarily be Se. Therefore, the Hua pulse governs phlegm-fluid retention, and the Se pulse governs Yin decline; this principle is inherent and beyond doubt.