代为气衰。固止有常数。此死脉也。经又云黄脉代。此盖指脾脉而应于四时
。遇春得胃气而兼见微弦。遇夏得胃气而兼见微洪。遇秋得胃气而兼见微浮。遇冬得胃气而
兼见微石。此乃四时更代之代。而非死脉之代。此代之义。又不可不知。
促脉乃数而一止。此为阳极亡阴。主痰壅阳经。积留胃府。或主三焦郁火炎盛。或发狂
班。
或生毒疽。五积停中。脉因为沮。最不宜于病后。若势进不已。则为可危。五积者血气痰饮
食也。若此得之新病。元气未败。不必深虑。但有如促之脉。或渐见于虚痨垂危之顷。死期
可卜。或暴作于惊遑造次之候。气复自愈脱阴见促终非吉兆。肿胀见促不交之。否促脉则
亦有死者矣。
动乃数脉见于关上下。无头尾。如豆大。忽忽动摇。仲景曰∶阴阳相搏名曰动。阳动则
汗出
。阴动则发热。形冷恶寒。此三焦伤也。主病为痛为惊为泄痢为亡精为失血。虚者倾摇。胜者
自安。此皆病脉也。又有平人而动者。太素云∶三部宽长是上贤。更于胆脉带长弦。豁然应
指如龙动。翊赞明君万万年。又云∶肾部忽然动滑时。为官必定有迁移。更看三部宽洪应。
用意消详仔细推。素问曰∶妇人手少阴脉动甚者孕子也。是皆吉兆之脉也。
肝绝之脉。循刀贲贲。心绝之脉。转豆躁疾。脾则雀啄。如屋之漏。如水之流。如杯之
覆。肺绝如毛。无根萧索。麻子动摇。浮波之合。肾脉将绝。至如省客。来如弹石。去如解索。
命脉将绝。 游鱼翔。至如涌泉。绝在膀胱。真脉既形。胃已无气。参察色证。断之以意。
代脉（指脉搏跳动有规律地间歇）是由于气虚衰败所致。其停止的时间有一定的常数，这是死脉的表现。医经又提到“黄脉代”，这大概是指脾脉顺应四季变化的情况：遇到春天，脾脉得到胃气的滋养而兼见轻微的弦象；遇到夏天，得到胃气而兼见轻微的洪象；遇到秋天，得到胃气而兼见轻微的浮象；遇到冬天，得到胃气而兼见轻微的石象（沉实如石）。这是四季更替所致的代脉，而不是代表死亡的代脉。关于“代”字的含义，又是不可不知道的。
促脉（指脉搏数急而有间歇）是脉率快且偶尔有一次停顿。这表示阳热极盛导致阴液耗竭，主要主痰浊壅塞于阳经，积滞停留在胃腑；或者主三焦郁火炽盛；或者表现为发狂、出现斑疹；或者生毒疮疽。五积（指血、气、痰、饮、食五种病理产物积聚）停滞在中焦，导致脉象因受阻而呈现促象。这种情况最不宜出现在疾病后期。如果病情趋势不断进展，就十分危险。所谓五积，是指血、气、痰、饮、食。如果是新近患病，元气尚未败坏，不必过分担忧。但是，如果出现类似促脉的脉象，或者逐渐出现在虚劳病垂危之际，死亡日期可以预测；或者突然发作于惊恐仓促之时，虽然气机恢复后可能自愈，但脱阴证见到促脉终究不是吉兆。肿胀病见到促脉，若阴阳之气不能交通，则预后不良；否则，促脉也有导致死亡的案例。
动脉（指脉搏短小滑数，如豆动摇）是在关部上下显现的数脉，没有明显的头尾，大小如豆子，忽忽动摇不定。张仲景说：“阴阳相互搏结，称为动。”阳气发动则汗出；阴气发动则发热，身体寒冷，恶寒，这是三焦受损的表现。主病为疼痛、惊悸、泄泻痢疾、失精、失血。正气虚弱者脉象倾摇不稳，正气胜复者则自安。这些都是病脉。又有健康人出现动脉的情况，《太素》说：“三部脉宽长者是上等的贤人，如果在胆脉处带有长弦之象，豁然应指如同龙动，辅佐明君万万年。”又说：“肾部忽然出现动滑之象时，做官的人必定会有职务迁移。再看三部脉是否宽洪应指，用心仔细推究。”《素问》说：“妇女手少阴脉动甚的是怀孕。”这些都是吉兆的脉象。
肝绝的脉象，急促有力如刀背摩擦。心绝的脉象，如豆粒转动，躁动急速。脾绝的脉象，如雀啄食，又像屋顶漏雨，像水流不止，像杯子倾倒。肺绝的脉象，如羽毛般轻浮无根，萧条零落，如麻子动摇，如浮波合散。肾脉将绝时，至脉如省客（忽来忽去），来势如弹石坚硬，去势如解索（散乱无序）。命门之脉将绝时，如游鱼翔动，又如涌泉。绝脉出现在膀胱经。真脏脉既然已经显现，说明胃气已无。通过参察面色和症状，用心断定预后。
Dai pulse (intermittent pulse with regular intervals) is caused by the decline of Qi. Its cessation occurs at a constant interval, which is a sign of death. The classics also mention "Yellow Dai," which likely refers to the Spleen pulse responding to the four seasons: in Spring, when endowed with Stomach Qi, it presents with a slight Xian (wiry) quality; in Summer, endowed with Stomach Qi, it presents with a slight Hong (surging) quality; in Autumn, endowed with Stomach Qi, it presents with a slight Fu (floating) quality; in Winter, endowed with Stomach Qi, it presents with a slight Shi (stone-like/sinking) quality. This is the Dai pulse resulting from the succession of the four seasons, not the Dai pulse indicating death. The meaning of "Dai" must be understood.
Cu pulse (rapid pulse with irregular pauses) is a rapid pulse with occasional stops. This indicates extreme Yang heat leading to the exhaustion of Yin fluids. It primarily signifies phlegm turbidity obstructing the Yang meridians and accumulation remaining in the Stomach organ; or it signifies blazing stagnant fire in the San Jiao (Triple Burner); or it manifests as madness and macules; or toxic sores and carbuncles. The Five Accumulations (blood, Qi, phlegm, fluid retention, and food stagnation) stagnate in the middle jiao, causing the pulse to become Cu due to obstruction. This is most unfavorable after an illness has progressed. If the trend continues unabated, it is critical. The Five Accumulations refer to blood, Qi, phlegm, fluid retention, and food. If this occurs in a new disease where Yuan Qi (Original Qi) has not yet failed, there is no need for deep concern. However, if a pulse resembling Cu appears, or gradually emerges during the critical stage of Xu Lao (consumptive disease), the time of death can be predicted. Or if it suddenly arises during moments of panic and haste, although self-recovery may occur upon the restoration of Qi, seeing Cu pulse in Tuo Yin (collapse of Yin) is ultimately an inauspicious omen. In cases of swelling and distension, if Cu pulse indicates that Yin and Yang cannot interact, the prognosis is poor; otherwise, Cu pulse can also lead to death.
Dong pulse (moving pulse) is a Shu (rapid) pulse appearing above and below the Guan position, without distinct head or tail, about the size of a bean, trembling suddenly. Zhang Zhongjing stated: "When Yin and Yang struggle against each other, it is called Dong." When Yang moves, sweat is produced; when Yin moves, fever occurs, accompanied by cold form and aversion to cold, indicating injury to the San Jiao. It indicates diseases such as pain, fright, diarrhea and dysentery, loss of essence, and hemorrhage. In deficiency states, the pulse shakes and wavers; in excess states, the body remains stable. These are all pathological pulses. There are also healthy individuals who present with Dong pulses. *Tai Su* states: "If the three positions are broad and long, the person is virtuous; if the Gallbladder pulse carries a long and wiry quality, appearing clearly under the finger like a dragon moving, they will assist the wise ruler for ten thousand years." It also says: "When the Kidney position suddenly shows Dong and Hua (slippery) qualities, an official will surely change posts. Observe whether the three positions are broad and full, and deduce carefully with intent." *Su Wen* states: "If the Hand-Shaoyin pulse of a woman moves vigorously, she is pregnant." These are all auspicious pulses.
The pulse of Liver exhaustion is urgent and forceful, like rubbing against a knife edge. The pulse of Heart exhaustion turns like beans, restless and rapid. The pulse of Spleen exhaustion resembles a sparrow pecking, or like water leaking from a roof, flowing endlessly, or like an overturned cup. The pulse of Lung exhaustion is like feathers, rootless and desolate, shaking like hemp seeds, merging like floating waves. When the Kidney pulse is about to cease, the arrival is like a visitor briefly stopping (Xi Ke), coming hard like a flicked stone, and departing like untying a knotted cord. When the Mingmen (Gate of Life) pulse is about to cease, it floats like a swimming fish, or surges like a spring. The cessation pulse appears in the Bladder meridian. Once the Zhen Zang Mai (True Organ Pulse) forms, the Wei Qi (Stomach Qi) is gone. By observing complexion and symptoms, one judges the outcome through careful deliberation.