缓为脾脉。主乎中。应乎肌肉。阳寸阴尺。上下同等。不浮不沉。不大不小。不徐不疾
。不
微不弱。和缓有力。鼓指有神。如丝在经。不卷其轴。又如微风轻 柳梢。蔡西山曰意思忻
忻。难以名状。四时五脏得此为有胃气。其体属地天之交。阳中有阴。阴中有阳。藏司脾。
时应长夏。运主季土也。不分男女老弱。心身得此。志和神畅。百病得此。不治自愈。然缓
有二。此乃有胃气雍容和缓之缓也。又有缓弛之缓。缓纵之缓。缓弱之缓。缓弛者伤湿也。
缓纵者风热也。缓弱者气虚也。缓而兼涩者血虚也。浮缓者风伤经络。沉缓者湿伤脏腑。洪
缓湿热。细缓寒湿。是皆有病之脉。而非真缓脉也。尚有阴虚浮洪无力而缓。阳虚沉细无力
而缓是。仅肖缓之。体
而非得缓之。神者也。若弦居土位。缓临水宫。盖克脉也。看此缓脉。要察胃气多少鼓击高
下去来迟速便得真确。悟从心解。未可一诊了事也。
滑脉平匀。乃得胃气之脉也。故经云。脉弱以滑。是有胃气。又云滑者阳气盛。微有热
。按
之指下鼓击有力有神。如珠圆滑。替替不绝。男得此无病。女得此有胎。乃真滑脉也。若病
则属痰饮。浮滑风痰。沉滑食痰。滑数痰火。滑短宿食。寸滑呕吐。关滑蓄血。尺滑 淋遗
泄。亦脉证相应之脉也。而特有如滑之脉。骤诊亦得平和。不大不小。不见歇止。不见克胜
息数如常。只是平动不鼓。牒牒而去。稍按即无此为元气已脱。仅存余气留连脏腑。经脉之
中未尽断耳。先于死期旬日内便见此脉。乃绝脉也。虽有卢扁。亦难复苏。每见医者尚于此
际。执以为痰。化气消痞。攻剂任投。只速其亡耳。抑何昧于生死之顿殊乎。
缓脉是脾脏的脉象。它主宰中焦，应合于肌肉。寸部与尺部的阴阳表现上下均衡，不浮不沉，不大不小，不快不慢，不微不弱。脉势和缓有力，搏动有神，如同丝线在经脉中运行，不卷曲其轴心；又好似微风轻拂柳梢。蔡西山说这种状态心情愉悦，难以用语言形容。四季五脏若出现此脉，说明有“胃气”（指脾胃运化功能及生机）。其形态属于地天交泰之象，阳中有阴，阴中有阳。脾藏司管此脉，时令对应长夏，运气主司季土。无论男女老少，身心若得此脉，则志意调和、精神舒畅；百病若见此脉，即使不治疗也能自愈。然而缓脉有两种情况：此处指的是带有胃气、雍容和缓的真缓脉。另外还有缓弛之缓、缓纵之缓、缓弱之缓。缓弛者是由于伤湿所致；缓纵者是风热所致；缓弱者则是气虚所致；缓而兼涩者，是血虚所致。浮缓脉表示风邪损伤经络；沉缓脉表示湿邪损伤脏腑；洪缓脉表示湿热；细缓脉表示寒湿。这些都是有病之脉，而非真正的缓脉。还有阴虚导致的浮洪无力而缓，阳虚导致的沉细无力而缓，这些只是形似缓脉，却不得缓脉的神韵。如果弦脉出现在土位（脾脉之位），缓脉出现在水宫（肾脉之位），这是相克的脉象。诊察这种缓脉，必须仔细辨别胃气的多少，通过观察搏动的起伏、高下、来去、迟速，才能确切诊断。这需要用心领悟，不能仅凭一次诊察就草率了事。
滑脉平和均匀，是得到胃气的脉象。所以医经说：“脉象弱而滑，是有胃气的表现。”又说：“滑脉表示阳气旺盛，略有发热。”重按之下，指下搏动有力且有神，如同圆珠滚动般圆滑，连续不断。男子得此脉无病，女子得此脉可能有孕，这才是真正的滑脉。如果是病脉，则属于痰饮范畴。浮滑脉为风痰，沉滑脉为食痰，滑数脉为痰火，滑短脉为宿食。寸部滑脉主呕吐，关部滑脉主蓄血，尺部滑脉主淋证、遗精或泄泻。这也是脉证相应的脉象。但还有一种类似滑脉的情况，初诊时看似平和，脉体不大不小，没有歇止，息数如常，只是平动而不鼓指，脉流断续而去，稍加按压即消失。这是元气已脱，仅存余气留连于脏腑经脉之中，尚未完全断绝。如果在死期前十几天内出现这种脉象，就是绝脉。即使是卢医（扁鹊）再世，也难以使其复苏。我常见到医生在此时仍固执地认为是痰证，使用化痰、行气、消痞、攻下的方剂随意投药，只会加速病人的死亡。这真是对生死巨大差异的愚昧无知啊。
The Huan (Slow/Relaxed) pulse is the pulse of the Spleen. It governs the Middle Jiao and corresponds to the muscles. The Yin and Yang manifestations at the Cun (inch) and Chi (cubit) positions are equal above and below; it is neither floating nor sunken, neither large nor small, neither slow nor rapid, neither minute nor weak. Its rhythm is harmonious and relaxed yet forceful, with spirit in its beating. It resembles a silk thread moving within the meridians, not coiling its axis; or like a gentle breeze brushing the tips of willow branches. Cai Xishan described this state as one of joyful contentment, difficult to name. When the Four Seasons and Five Zang organs exhibit this pulse, it indicates the presence of Wei Qi (Stomach Qi, representing digestive function and vital vitality). Its form embodies the interaction between Heaven and Earth, with Yang containing Yin and Yin containing Yang. The Spleen Zang governs this pulse, corresponding seasonally to Late Summer, and operationally ruling over the Earth element of the final season. Regardless of gender, age, or strength, if the body and mind possess this pulse, the will is harmonious and the spirit is cheerful; if hundred diseases present this pulse, they may heal spontaneously without treatment. However, there are two types of Huan pulses: the one discussed here is the true Huan pulse, characterized by the abundant, harmonious relaxation of Wei Qi. There is also the Huan of laxity, the Huan of looseness, and the Huan of weakness. Huan of laxity results from injury by Dampness; Huan of looseness results from Wind-Heat; Huan of weakness indicates Qi Deficiency; Huan combined with Se (Choppy) indicates Blood Deficiency. A Floating-Huan pulse indicates Wind injuring the collaterals; a Sunken-Huan pulse indicates Dampness injuring the Zang-Fu organs; a Full-Huan pulse indicates Damp-Heat; a Thin-Huan pulse indicates Cold-Dampness. These are all pathological pulses, not the true Huan pulse. Additionally, there is the Huan pulse that is Floating and Full but weak due to Yin Deficiency, and the Huan pulse that is Sunken and Thin but weak due to Yang Deficiency. These merely resemble the form of the Huan pulse but lack its spirit. If the Xian (Wiry) pulse appears in the Earth position (Spleen's domain), and the Huan pulse appears in the Water palace (Kidney's domain), this represents a controlling (overacting) relationship. To examine this Huan pulse accurately, one must observe the degree of Wei Qi, noting the height and depth, coming and going, and speed of the beats through palpation. This requires mental comprehension and cannot be concluded after a single examination.
The Hua (Slippery) pulse is smooth and even, representing a pulse that has obtained Wei Qi. Thus, the classics state: "A pulse that is weak yet slippery indicates the presence of Wei Qi." It also states: "A slippery pulse indicates abundant Yang Qi and slight heat." Upon pressing, the beating under the fingers is forceful and spirited, rolling smoothly like round pearls, continuous and unbroken. For men, obtaining this pulse indicates health; for women, it suggests pregnancy. This is the true Slippery pulse. If pathological, it belongs to Phlegm-Fluid retention. A Floating-Slippery pulse indicates Wind-Phlegm; a Sunken-Slippery pulse indicates Food-Phlegm; a Slippery-Rapid pulse indicates Phlegm-Fire; a Slippery-Short pulse indicates retained food. A Slippery pulse at the Cun position indicates vomiting; at the Guan position, it indicates stored blood; at the Chi position, it indicates stranguria, seminal emission, or diarrhea. These are also pulses corresponding to symptoms. However, there is a pulse resembling the Slippery pulse which, upon initial diagnosis, seems peaceful, neither large nor small, without interruptions, with normal respiratory rates, but moves flatly without being forceful, flowing intermittently, and disappearing slightly upon pressure. This indicates that Yuan Qi (Original Qi) has collapsed, with only residual Qi lingering in the Zang-Fu organs and meridians, not yet completely severed. If this pulse appears ten days before death, it is a Jue (Extinction) pulse. Even if Lu Bian (Lu Yixia/Bian Que) were alive, it would be difficult to revive the patient. I often see physicians at this stage stubbornly diagnosing it as Phlegm, administering formulas to resolve phlegm, move Qi, dissipate nodules, and purge aggressively, which only accelerates death. How ignorant they are of the drastic difference between life and death!