浮泛无根之脉，气之外越也，却宜于闭塞不通之证，若多汗与滑泄者见之，反为气散气
脱，
而不治矣。故伤风化热，久不得汗，热灼津干，肌肤 KT ，肺气迫塞，呼吸喘促。其脉每
于皮毛之间，而不见起伏，不分至数。所谓汗出不彻，阳气怫郁在表；又所谓正气却结于
脏，故邪气浮之，与皮毛相得者也。以酸甘入辛散剂中，津液得回，大气得敛，即汗出而脉
盛矣。何者?气必一吸而后能一嘘也。若夫温热之病，汗出不止，而浮滑数疾，是真阴内脱
也；伤寒邪深，脉微欲绝，得药后脉暴浮，与下利甚而脉空豁，是真阳内脱也；困病日久，
屡次反复，其脉渐见浮薄，是阴阳并脱也。大抵此脉，久病沉困痿倦，与外感新病得汗下后
，俱不宜见。其久病，间有因于燥痰，痰结便秘，气浮而然者，所谓滑而浮散，摊缓风，用
清痰理气，脉转沉弱，无虑也；若药不应，又常汗出，必死。新病，有伤寒、疟疾，断谷数
日，胃气空虚而然者，督令进食，脉即沉静矣。所谓浆粥入胃，则虚者活也；不能进食，与
食即注下者死。盖浮薄者津空也，津空而气结者生，津空而气散者死。
凡脉空大无根，按之即散，此阴虚而元气将溃也。用酸甘之剂，敛气归根，脉渐坚敛而
实，
即为转关，可望生机；若敛而不实，愈硬愈空又去生远矣。尝见湿温，夹伤生冷，先妄发汗
，继过清渗，三焦气怯，膀胱气陷，咳而气上冲击，遍身大汗，大便微溏，小便短涩，舌淡
白无苔，小腹胀硬如石，两胫 肿，脉来空大，稍按即指下如窟，动于两边，应指即回，一
息十动以上。急用酸温，枣仁、龙骨、山萸、南烛、首乌、牛膝，入附子、木香、远志、桃
仁化积剂中。先两尺敛实，继两关坚实，舌苔渐见白浓转黄，而诸证见瘳。此误汗、误渗，
表里俱伤，真阳离根，大气外越，若专用辛热，大汗而脱矣。若用酸温之后，脉愈空愈硬，
而应指犹能有力者，不得即委不治。又当减酸，俾将微汗。虚甚者，以甘温佐之。其汗必先
战也，汗后，脉必转沉弱，转用酸温调之补之。大凡浮而无根之脉，俱宜兼用酸敛，其真阳
离根，脉见芤弦者，每数至一息十动以上，是元阳不安其宅也，宜以酸入辛热剂中。其真阴
离根，虚势游弋，脉见 浮散者，宜以酸入甘温剂中。至于温暑，热伤气分，脉浮而洪数
且散者，喘促汗出，宜以酸入甘寒剂中，如生脉散之类。得酸而脉敛者，正气有权也；不敛
而加数者，真气败也。此皆内虚脉浮者之治法也，皆无与于表邪发散之例。
浮泛无根之脉，是气向外越脱的表现，这种脉象反而适宜出现在闭塞不通的证候中；如果是多汗与滑泄（大便失禁或腹泻）的患者出现这种脉象，反而是气散、气脱的表现，属于不治之症。
所以，伤风后化热，长时间无法出汗，热邪灼伤津液导致干枯，肌肤干燥粗糙，肺气被逼迫壅塞，呼吸急促喘息。其脉象往往在皮毛之间显现，却看不到明显的起伏波动，也分辨不出至数（脉搏跳动的次数）。这就是所谓的“汗出不彻，阳气怫郁在表”；又所谓“正气退却结聚于脏，所以邪气浮越于外，与皮毛相合”。在辛散的药物中加入酸甘性质的药物，使津液得以恢复，大气得以收敛，就会自然出汗而脉象变得盛大有力。为什么呢？因为气必须在一呼之后才能一吸。
至于温热病，汗出不止，且脉象浮滑数疾，这是真阴在内脱失的表现；伤寒邪气深入，脉象微弱几乎要断绝，服药后脉象突然变浮，以及下利严重且脉象空豁无力，这是真阳在内脱失的表现；久病困顿，屡次反复，脉象逐渐变得浮薄，这是阴阳同时脱失的表现。大抵这类脉象，在久病沉困痿倦的状态下，以及外感新病经过发汗、攻下治疗后，都不应该出现。
对于久病的情况，间或有因燥痰所致，痰结便秘，气机浮越而导致的，就是所谓的“滑而浮散”，属于摊缓风（中风先兆或轻症），使用清化痰热、调理气机的方法，如果脉象转为沉弱，就不用担忧了；如果用药无效，又经常出汗，必定死亡。
对于新病的情况，有伤寒、疟疾，断食数日，胃气空虚而导致的，督促进食，脉象就会立即沉静下来。这就是所谓的“浆粥入胃，则虚者活也”；如果不能进食，或者吃了食物随即泻下的，属于死证。大概浮薄的脉象是因为津液枯竭，津液枯竭而气机结聚的还能生，津液枯竭而气机涣散的就会死亡。
凡是脉象空大无根，按压即散开的，这是阴虚而元气即将溃败的表现。使用酸甘性质的药剂，收敛气机使其归根，脉象逐渐坚实收敛而充实，就是病情转折的关键，有望恢复生机；如果收敛后仍然不实，脉象越发坚硬且中空，那就离生机越来越远了。
我曾见过湿温病，夹杂损伤生冷食物，先误用发汗法，继而又过度使用清热渗利之法，导致三焦气怯，膀胱气陷，咳嗽且气上冲，遍身大汗，大便微溏，小便短少涩滞，舌淡白无苔，小腹胀硬如石头，两小腿肿胀，脉象来势空大，稍微按压指下就像陷入窟窿一样，搏动在两边，应指即回，一息跳动十次以上。紧急使用酸温性质的药物，如枣仁、龙骨、山萸肉、南烛、首乌、牛膝，加入附子、木香、远志、桃仁组成的化瘀积剂中。先是两尺部脉象敛实，接着两关部脉象坚实，舌苔逐渐由白浓转黄，各种症状减轻。这是误汗、误渗，导致表里俱伤，真阳离根，大气外越，如果专用辛热药物，会导致大汗淋漓而气脱。如果在用酸温药之后，脉象更加空硬，但应指仍有力量，不能立刻放弃治疗。应当减少酸味药的比例，使得微微出汗。虚损严重的，用甘温药物辅助。出汗前必然会有战栗，出汗后，脉象必然转为沉弱，转而使用酸温药物调理补益。大凡浮而无根的脉象，都适宜兼用酸敛之法。那些真阳离根，脉象见芤弦的，每呼吸一次跳动十次以上，这是元阳不安于其宅舍，适宜将酸味药加入辛热剂中。那些真阴离根，虚势游移不定，脉象见浮散的，适宜将酸味药加入甘温剂中。至于温暑病，热邪损伤气分，脉象浮而洪数且散的，伴有喘促汗出，适宜将酸味药加入甘寒剂中，如生脉散之类。得到酸味药后脉象收敛的，说明正气有权能固摄；不收敛反而加数的，说明真气败坏。这些都是内虚导致脉浮的治疗法则，都与通过发散表邪的方法无关。
A floating, superficial, and rootless pulse indicates the outward逸ion of Qi. This type of pulse is actually appropriate for conditions characterized by obstruction and blockage; however, if seen in patients with excessive sweating or slippery diarrhea (incontinence), it indicates the dispersion and collapse of Qi, which is considered incurable.
Therefore, in cases where wind injury transforms into heat, and prolonged inability to sweat leads to heat scorching and drying up body fluids, resulting in dry and rough skin, forced congestion of Lung Qi, and rapid breathing with asthma, the pulse often manifests between the skin and hair without obvious rising and falling fluctuations, making it difficult to count the beats. This corresponds to the concept of "incomplete sweating, with Yang Qi constrained at the exterior"; or as stated, "Zheng Qi retreats and knots within the Zang organs, so pathogenic factors float outward, harmonizing with the skin and hair." By adding sour and sweet herbs to acrid-dispersing formulas, body fluids are restored, and the Great Qi is gathered, leading to natural sweating and a vigorous pulse. Why? Because Qi must inhale before it can exhale.
In warm-heat diseases, if sweating is incessant and the pulse is floating, slippery, rapid, and hurried, this indicates the internal collapse of True Yin. In cold damage with deep-seated pathogens, if the pulse is faint and nearly imperceptible, but suddenly becomes floating after medication, or if severe diarrhea presents with an empty and hollow pulse, this indicates the internal collapse of True Yang. In chronic debilitating illnesses that recur repeatedly, if the pulse gradually becomes thin and floating, this indicates the simultaneous collapse of both Yin and Yang. Generally, such pulses should not be seen in chronic conditions marked by sinking, depression, flaccidity, and fatigue, nor in new external contraction diseases after sweating or purgation therapies have been applied.
For chronic conditions, occasionally caused by dry phlegm leading to phlegm accumulation and constipation, causing Qi to float, this is described as "slippery and floating-scattered," associated with Tan Huan Feng (a precursor or mild form of stroke). Using methods to clear phlegm and regulate Qi, if the pulse turns sinking and weak, there is no need for worry; however, if treatment fails and sweating persists, death is inevitable.
For acute conditions, such as cold damage or malaria, where fasting for several days leads to emptiness of Stomach Qi, urging the patient to eat will cause the pulse to become calm and still. As stated, "When gruel enters the Stomach, the deficient will survive"; conversely, inability to eat or immediate expulsion of food via diarrhea indicates death. Essentially, a thin and floating pulse signifies emptiness of fluids. If fluids are empty but Qi is knotted, survival is possible; if fluids are empty and Qi is dispersed, death ensues.
Whenever a pulse is large, empty, and rootless, scattering upon pressure, it indicates Yin deficiency and impending collapse of Yuan Qi. Using sour and sweet agents to gather Qi and return it to its root, if the pulse gradually becomes firm, collected, and solid, this marks a turning point toward recovery; however, if gathering fails to produce solidity, and the pulse becomes harder yet more hollow, the prognosis worsens significantly.
I once treated a case of damp-warmth complicated by cold-damage from raw foods. The patient was first wrongly induced to sweat, then overly treated with clearing and draining methods, leading to weakness of San Jiao Qi and sinking of Bladder Qi. Symptoms included coughing with upward rushing Qi, profuse whole-body sweating, slight loose stools, scanty and dysuric urination, a pale white tongue without coating, a hard and stone-like distension in the lower abdomen, swelling of both calves, and a large, empty pulse that felt like a void upon slight pressure, beating on both sides, returning immediately upon contact, exceeding ten beats per respiration. Urgently, I used sour and warm herbs: Suan Zao Ren (Ziziphi Spinosae Semen), Long Gu (Fossilia Ossis Mastodi), Shan Yu Rou (Corni Fructus), Nan Zhu (Myrica rubra), Shou Wu (Polygoni Multiflori Radix), and Niu Xi (Achyranthis Bidentatae Radix), incorporated into a formula containing Fu Zi (Aconiti Lateralis Radix Praeparata), Mu Xiang (Aucklandiae Radix), Yuan Zhi (Polygalae Radix), and Tao Ren (Persicae Semen) to resolve stasis. First, the Chi positions (both wrists) became firm; subsequently, the Guan positions became solid. The tongue coating thickened white then turned yellow, and symptoms improved. This case involved erroneous sweating and draining, damaging both interior and exterior, causing True Yang to lose its root and Great Qi to escape outward. Had purely acrid-hot herbs been used, it would have led to collapse via profuse sweating. However, after using sour-warm herbs, if the pulse remained empty and hard but still responded with strength, one should not abandon treatment. One should reduce the amount of sour herbs to induce slight sweating. For severe deficiency, supplement with sweet-warm herbs. Before sweating, chills are expected; afterward, the pulse typically shifts to sinking and weak, requiring adjustment and tonification with sour-warm agents. Generally, floating and rootless pulses benefit from combined use of sour-astringent methods. When True Yang loses its root and the pulse appears Kou (hollow) and Xian (wiry), beating over ten times per respiration, indicating Yuan Yang is unsettled in its residence, sour herbs should be added to acrid-hot formulas. When True Yin loses its root and deficiency manifests as wandering instability, with a floating-scattered pulse, sour herbs should be added to sweet-warm formulas. In warm-summer heat diseases, where heat damages Qi, presenting with a floating, surging, rapid, and scattered pulse accompanied by asthma and sweating, sour herbs should be added to sweet-cold formulas, such as Sheng Mai San (Generate the Pulse Powder). If the pulse gathers after administering sour herbs, it indicates Zheng Qi has control; if it does not gather and becomes faster, it indicates failure of True Qi. These are all treatment principles for floating pulses caused by internal deficiency, unrelated to dispersing exterior pathogens.