无脉之候。所因不一。久病无脉。气绝者死。暴病无脉。气郁可治。伤寒痛风痰积经闭
。忧惊折伤。关格吐利。气运不应斯皆勿忌。
概论不胜春弦。涩欺涩弦气少。病作秋时。无弦。春病无气死推更有
兼其
所胜。春弦而缓相持。气多为平。气少长夏为病。无弦春病无气可知死期。春弦钩扶易愈。
春弦滑抑退迟。胜负扶抑。例举可知。
脉证似反非反。因之而变。无伤。极实而有羸状。寒湿 。脉沉细。极虚而有盛候。脉
虚大
而无常。病虚脉细。因服寒凉而搏指。阴虚出汗。误服参 而脉强。伤寒粪秘脉迟胃实宜下
。痛风兼秘何妨。
诊脉之要有三。曰举曰按曰寻。轻手得之曰举。重手取之曰按。不轻不重。委曲求之曰
寻。
初持脉轻手候之。脉见皮毛之间者阳也。府也。亦心肺之应也。重手按之。脉伏于肉下者阴
也。藏也。亦肝肾之应也。不轻不重而取之。其脉应乎血肉之间者。阴阳相适。中和之应。
脾胃之候也。若浮中沉之不见。则委曲而求之。若隐若现。则阴阳伏隐之脉也。六部皆然。
上下来去至止六字。为脉之。神机也。不明六字则虚实阴阳不别也。上者为阳。来者为
阳。
至者为阳。下者为阴。去者为阴。止者为阴。上者自尺部上于寸口阳。生于阴也。下者自寸
口下于尺部。阴生于阳也。来者自骨肉之分。而出于皮毛之际气之升也。去者自皮肤之际。
而还于骨肉之分。气之降也。应曰至。息曰止。
无脉的证候，其成因各不相同。久病出现无脉，若是元气衰竭则预后不良（死亡）；突发疾病出现无脉，若是气机郁滞则尚可治疗。伤寒、痛风、痰积、经闭、忧惊、折伤、关格、吐利，以及运气学说中不应出现的脉象，这些情况都不必过分忌讳。
概括而言，春季脉象若不胜于正常的弦脉，或者涩脉欺压弦脉且气少，病情将在秋季发作。若无弦脉，春季患病而无生气可推知死期。还要兼看其所胜的脉象。春季脉象弦而缓，两者相持，气多则为平脉；气少则在长夏季节发病。无弦脉的春季患病，可知其死期。春季脉象弦而钩（洪），扶助正气易愈；春季脉象弦而滑，抑制邪气则退去较慢。胜负扶抑的道理，举例即可知晓。
脉象与证候看似相反实则不反，因此病情发生变化，并无大碍。极实之证却呈现羸弱之状，多为寒湿，脉象沉细；极虚之证却呈现盛实之候，脉象虚大而不恒定。病属虚证而脉象细，是因为服用寒凉药物后脉搏搏指有力；阴虚出汗，误服人参后脉象强劲。伤寒导致便秘，脉迟，胃实宜用下法；痛风兼有便秘又何妨？
诊脉的要领有三点：叫作举、按、寻。轻手取脉叫作举；重手取脉叫作按；不轻不重，委曲求之叫作寻。初持脉时轻手候之，脉象显现于皮毛之间的是阳脉，属于腑，也是心肺的应象。重手按之，脉象潜伏于肌肉之下的是阴脉，属于脏，也是肝肾的应象。不轻不重而取之，脉象应于血肉之间的是阴阳相适，是中和之象，也是脾胃的征候。如果浮、中、沉三部都见不到脉象，则需委曲求之。若脉象若隐若现，则是阴阳伏隐之脉。六部脉皆如此。
上、下、来、去、至、止这六个字，是脉的神机所在。不明白这六个字，就无法辨别虚实和阴阳。上者为阳，来者为阳，至者为阳；下者为阴，去者为阴，止者为阴。上者是从尺部上行至寸口，表示阳生于阴。下者是从寸口下行至尺部，表示阴生于阳。来者是从骨肉之分而出于皮毛之际，是气的上升；去者是从皮肤之际而还于骨肉之分，是气的下降。跳动称为“至”，停息称为“止”。
The condition of pulselessness has various causes. In chronic illness, pulselessness indicates Qi exhaustion and is fatal; in acute illness, pulselessness due to Qi stagnation is treatable. Conditions such as Shanghan (Cold Damage), gout, phlegm accumulation, amenorrhea, worry and fright, traumatic injury, Guan-Ge (obstruction with vomiting and diarrhea), excessive vomiting and diarrhea, and pulse patterns inconsistent with the seasonal climate运 (Qi movement) should not be overly feared.
Generally speaking, if the spring pulse does not exceed the normal wiry (Xian) quality, or if a choppy (Se) pulse suppresses the wiry pulse with deficient Qi, the disease will manifest in autumn. If there is no wiry quality in spring, the absence of vital Qi in spring illness indicates the time of death. One must also consider the pulse qualities that overcome each other. A spring wiry pulse with a moderate (Huan) quality indicates equilibrium; abundant Qi signifies health, while deficient Qi leads to illness in late summer. The absence of a wiry pulse in spring illness allows one to predict the time of death. A spring wiry pulse accompanied by a hook-like (Gou/Hong) quality suggests easy recovery with supportive treatment; a spring wiry pulse with a slippery (Hua) quality indicates slower resolution with suppressing treatment. The principles of victory, defeat, support, and suppression can be understood through examples.
Pulse and symptoms may appear contradictory but are not truly so, leading to changes in the disease without causing harm. Extreme excess conditions may present with emaciated signs, often due to cold-dampness, with a deep (Chen) and fine (Xi) pulse. Extreme deficiency conditions may present with full/exuberant signs, with a vacuous and large (Xu Da) pulse that is irregular. Deficiency diseases with fine pulses may result from taking cold-natured herbs, causing the pulse to beat firmly against the fingers. Yin deficiency with sweating, mistakenly treated with Ginseng (Renshen), results in a strong pulse. In Shanghan with constipation, a slow (Chi) pulse and excess stomach heat indicate the need for purgation; gout with constipation is not necessarily problematic.
The essentials of pulse diagnosis are three: Ju (lifting), An (pressing), and Xun (searching). Light pressure to feel the pulse is called Ju. Heavy pressure to seek the pulse is called An. Neither light nor heavy, searching meticulously, is called Xun. Initially holding the pulse with light pressure, if the pulse is felt between the skin and hair, it is Yang, associated with the Fu organs, and corresponds to the Heart and Lungs. Pressing heavily, if the pulse is found beneath the muscle, it is Yin, associated with the Zang organs, and corresponds to the Liver and Kidneys. With neither light nor heavy pressure, if the pulse is felt between flesh and blood, it indicates harmony between Yin and Yang, representing the neutral state, and corresponds to the Spleen and Stomach. If the pulse is not visible at floating, middle, or deep levels, one must search meticulously. If the pulse appears faintly or intermittently, it indicates hidden Yin and Yang. This applies to all six positions.
The characters Up, Down, Come, Go, Arrival, and Stop constitute the spirit and mechanism of the pulse. Without understanding these six characters, one cannot distinguish between deficiency/excess and Yin/Yang. Up is Yang, Come is Yang, Arrival is Yang; Down is Yin, Go is Yin, Stop is Yin. "Up" refers to the pulse moving from the Chi position up to the Cun position, indicating Yang arising from Yin. "Down" refers to the pulse moving from the Cun position down to the Chi position, indicating Yin arising from Yang. "Come" refers to the pulse emerging from the bone-flesh junction to the skin surface, representing the ascending of Qi. "Go" refers to the pulse returning from the skin surface to the bone-flesh junction, representing the descending of Qi. The beating is called "Arrival," and the pause is called "Stop."