弦脉其状端直以长。若筝弦从中直过。挺然指下。体为阳中阴。藏司肝。时属春。运王
木也
。经云轻虚以滑者平。实滑如循长竿者病。劲急如新张弓弦者死。戴同父曰∶弦而软者其病
轻。弦而硬者其病重。纯弦为负死脉也。弦缓平脉也。弦临土位。克脉也。弦见于秋。反克
脉也。春病无弦。失主脉也。其病主诸疟支饮悬饮头痛鬲痰寒热 瘕尺中阴疝两足拘挛。右
关见
弦胃寒腹疼。若不食者脉本克土必难治。此则大概脉与病符也。又有如弦之脉。本非真弦。
而或兼见而或相类。弦固类细而细。则如丝线之应。指又类紧而紧。则如转索之不绝为。体
既异。主病亦殊但紧则为诸痛依稀若弦之。无力耳。弦兼洪为火炽。弦兼滑为内热。弦兼迟
为痼冷。弦不鼓为藏寒。弦兼涩秋逢为老疟。弦兼细数。主阴火煎熬。精髓血液日竭。痨瘵
垂亡之候也。若诸失血而见弦大为病进。见弦小为阴销。痰清见弦为脾。土已败。真津上溢
。非痰也。又有似疟。阴阳两亏。寒热往来。脉亦见弦。急扶真元。亦有生者。若误作疟
治如近岁闽司理王讳猷公所以枉没于见病治病之舛剂也。大要弦脉而病属经者。易治属腑
者。难治属藏者。不治指下细别吉凶胤列矣。
濡脉极软。如水面浮绵。轻诊则得。重按无有。弱脉极软。重按乃得。轻诊无有。脉学
云浮
细如绵曰濡。沉细如绵曰弱。浮而极细如绝曰微。沉而极细不断曰细。又云轻诊即见重按如欲
绝者微也。往来如线而常有者细也。仲景曰脉瞥瞥如羹上肥者阳气微。萦萦如蚕丝细者阴气衰
。此四脉者虽形体不一。大较皆阴阳两亏。病从内得。或失精亡血。或泄汗伤湿。或气促心
惊。或虚胀消瘅。或筋骨痿痹。老弱久病见之顺。少年春夏见之逆。治法皆宜调营益气。填
精补髓。固脾健胃急施拯救。方得全生。凡诊此脉。须察胃气多少。预示吉凶。庶不召谤。
弦脉的形态端正直长，就像筝弦从中间笔直穿过，挺然显现于指下。其体性属于阳中之阴，在脏腑中主管肝脏，在季节中对应春季，在五行运化中属木。经书说：脉象轻虚而滑利的是平脉（正常脉）；实大而滑，像触摸长竹竿一样的是病脉；劲急有力，像新张开的弓弦一样的是死脉。戴同父说：弦而柔软者，病情轻；弦而坚硬者，病情重。纯弦无胃气的脉是主死的凶脉。弦而缓和的是平脉。弦脉出现在土位（脾胃），是克贼之脉。弦脉出现在秋季，是反克之脉。春季生病却没有出现弦脉，是失去了主时之脉的表现。弦脉所主的疾病主要有各种疟疾、支饮、悬饮、头痛、膈间痰饮、寒热往来、瘕积、尺部阴疝、两足拘挛。右关部见到弦脉，主胃寒腹痛。如果伴有不能进食的症状，因为脉本克土，必定难以治疗。这大概是一般脉象与病症相符的情况。又有类似弦脉的脉象，本来不是真正的弦脉，或者兼见其他脉象，或者形态相似。弦脉固然类似于细脉，但细脉如丝线应指；又类似于紧脉，但紧脉如绳索转动般连绵不绝。既然体性不同，所主疾病也各异。紧脉主要主各种疼痛，只是力度稍弱，隐约像弦脉罢了。弦脉兼见洪大，主火气炽盛；弦脉兼见滑数，主内热；弦脉兼见迟脉，主久冷痼疾；弦脉按之不鼓动，主脏寒；弦脉兼见涩象，若在秋季遇到，主老疟疾；弦脉兼见细数，主阴火煎熬，精髓血液日渐枯竭，这是劳瘵即将死亡的征候。如果是各种失血病人见到弦大脉，说明病情进展；见到弦小脉，说明阴液消亡。痰清稀而见弦脉，说明脾土已败坏，上溢的不是痰，而是真津。又有类似疟疾的情况，阴阳两亏，寒热往来，脉象也见弦，此时急需扶持真元，也有治愈的可能。如果误当作疟疾治疗，就像近年福建司理王猷公那样，因见病治病而用错药方，最终枉死。大要而言，弦脉若病在经络，容易治疗；若病在腑，难治；若病在脏，不治。指下细细辨别，吉凶自现。
濡脉极其柔软，像浮在水面的棉絮，轻取即可触及，重按则无。弱脉也极其柔软，必须重按才能触及，轻取则无。《脉学》中说：浮而极细如绵的叫濡脉，沉而极细如绵的叫弱脉。浮而极细似有似无的叫微脉，沉而极细不断绝的叫细脉。又说：轻取即见，重按似欲断绝的是微脉；往来如线且持续存在的是细脉。张仲景说：脉象瞥瞥如羹汤上的浮油，是阳气微弱；萦萦如蚕丝般细软，是阴气衰败。这四种脉象虽然形体不一，但大体都是阴阳两亏，病从内生。或因失精亡血，或因泄汗伤湿，或因气促心惊，或因虚胀消渴，或因筋骨痿痹。年老体弱或久病之人见到这些脉象为顺证，少年人在春夏季节见到则为逆证。治疗方法都应当调和营卫、益气、填精补髓、固护脾胃，急切施行拯救措施，才能保全生命。凡是诊察到这几种脉象，必须考察胃气的多少，以预示吉凶，这样才不会招致非议。
The Xian (Wiry) pulse is characterized by a straight and long shape, resembling the string of a zither passing directly through the middle, standing firm under the fingers. Its nature belongs to Yin within Yang, governs the Liver in the Zang-Fu organs, corresponds to Spring in the seasons, and is associated with Wood in the Five Movements and Six Qi theory. The Classics state: A pulse that is light, void, and slippery indicates health; one that is solid, slippery, and feels like touching a long bamboo pole indicates disease; one that is stiff and urgent, like a newly tightened bowstring, indicates death. Dai Tongfu said: A Xian pulse that is soft indicates mild disease; one that is hard indicates severe disease. A pure Xian pulse without the stomach qi is a fatal pulse. A Xian pulse that is slow and harmonious is a normal pulse. A Xian pulse appearing in the Earth position (Spleen/Stomach) represents a controlling (overacting) relationship. A Xian pulse appearing in Autumn represents a reverse controlling relationship. If disease occurs in Spring but the Xian pulse is absent, it signifies the loss of the ruling pulse for that season. The diseases primarily governed by the Xian pulse include various types of malaria, Zhi-Yin (fluid retention in the hypochondrium), Xuan-Yin (fluid retention hanging in the chest), headache, phlegm obstructing the diaphragm, alternating chills and fever, Jia-Ji (masses), Yin-Hernia at the Chi position, and spasms/contracture of both legs. A Xian pulse seen at the Right Guan position indicates Cold in the Stomach and abdominal pain. If accompanied by an inability to eat, since the pulse controls the Earth element, it is difficult to treat. This generally describes the correspondence between pulse and disease. There are also pulses similar to Xian, which are not true Xian pulses, either appearing concurrently or being morphologically similar. Although Xian resembles Xi (Fine) pulse, Xi feels like a silk thread under the finger; it also resembles Jin (Tight) pulse, but Jin feels like a turning rope that never ceases. Since their natures differ, the diseases they indicate also differ. Jin pulse mainly indicates various pains, merely feeling slightly weaker and vaguely like Xian. A Xian pulse combined with Hong (Surging) indicates blazing Fire; combined with Hua (Slippery), it indicates internal Heat; combined with Chi (Slow), it indicates chronic Cold; if it does not throb under pressure, it indicates Cold in the Zang organs; if combined with Se (Choppy) and encountered in Autumn, it indicates chronic malaria; if combined with Xi (Fine) and Shuo (Rapid), it indicates Yin-Fire simmering, leading to daily depletion of essence and blood, a sign of impending death from Lao-Zhai (consumption). In cases of hemorrhage, a Xian-Da (Large) pulse indicates disease progression, while a Xian-Xiao (Small) pulse indicates Yin consumption. Clear sputum with a Xian pulse indicates failure of Spleen Earth; what overflows is not phlegm but genuine fluids. There are also conditions resembling malaria, where Yin and Yang are both deficient, with alternating chills and fever, and the pulse appears Xian. In such cases, urgently supporting the True Yuan (Original Qi) may lead to recovery. If mistakenly treated as malaria, as happened to Wang You, Prefect of Fujian in recent years, due to treating symptoms without understanding the root cause via incorrect prescriptions, it can result in wrongful death. Generally, if the disease associated with a Xian pulse is in the meridians, it is easy to treat; if in the Fu organs, difficult; if in the Zang organs, untreatable. Careful differentiation under the fingers reveals auspiciousness or inauspiciousness.
The Ru (Soggy) pulse is extremely soft, like cotton floating on water; it is felt with light palpation but disappears with heavy pressure. The Ruo (Weak) pulse is also extremely soft; it is felt only with heavy pressure and disappears with light palpation. *Mai Xue* (Pulse Studies) states: Floating and extremely fine like cotton is called Ru; sunken and extremely fine like cotton is called Ruo. Floating and extremely fine, seeming almost absent, is called Wei (Micro); sunken and extremely fine but unbroken is called Xi (Fine). It is also said: Felt immediately with light pressure but seeming to vanish with heavy pressure is Wei; flowing like a thread and continuously present is Xi. Zhang Zhongjing said: A pulse flickering like fat floating on soup indicates slight Yang Qi; a pulse lingering and thin like silk threads indicates declining Yin Qi. Although these four pulses differ in form, they generally all indicate deficiency of both Yin and Yang, with disease arising internally. Causes may include loss of essence and blood, sweating damaging dampness, shortness of breath and palpitations, empty distension and wasting-thirst, or flaccidity and bi-syndrome of sinews and bones. Seeing these pulses in the elderly, weak, or those with chronic illness is favorable (Shun); seeing them in youths during Spring and Summer is unfavorable (Ni). The treatment method should always involve regulating Ying and Wei, benefiting Qi, filling essence and supplementing marrow, consolidating the Spleen, and strengthening the Stomach. Urgent rescue measures must be taken to preserve life. When diagnosing these pulses, one must examine the degree of Stomach Qi to predict auspiciousness or inauspiciousness, thereby avoiding blame.