浮〔属阳〕浮在皮毛，如水漂木，举之有余，按之不足。
浮脉为阳表病居，〔三秋得令知无恙，久病逢之却可
惊〕迟风数热紧寒拘。浮而有力多风热，〔表实则有力也。〕无力而浮〔表虚〕是血虚。
寸浮头痛眩生风，或有风痰聚在胸，关上土衰兼木旺，尺中二便不流通。〔下焦〕
浮而盛大为洪，浮而软大为虚，浮而细软为濡，浮而弦芤为革，浮而无根为散，浮而
中空为芤。
沉〔属阴〕沉行筋骨，如水投石，按之有余，举之不足。
沉潜水蓄阴经病，数热迟寒滑有痰。无力而沉〔里虚〕虚与气，沉而有力〔里实〕积并寒。
寸沉痰郁水停胸，〔又主血〕关主中寒痛不通，尺部浊遗并泄痢，肾虚腰及下元 。
沉而细软为弱，沉而弦劲为牢，沉而着骨为伏。
迟〔属阴〕迟脉属阴，象为不及，往来迟慢，三至一息。
迟司脏病或多痰，沉痼 瘕仔细看；有力而迟为冷痛，迟而无力定虚寒。
寸迟必是上焦寒，关主中寒痛不堪，尺是肾虚腰脚重，溲便不禁疝牵丸。
迟不流利为涩，迟而歇止为结。
数〔属阳〕数脉为阳，象为太过，一息六至，往来越度。
数脉为阳热可知，只将君相火来医，〔阳数君火，阴数相火。〕实宜凉泻〔有实火。〕虚宜
补，〔无力虚火。〕肺病秋深却畏之。〔肺为金脏贼邪，秋为克令凶征。〕
寸数咽喉口舌疮，吐红咳嗽肺生疡，〔数而虚主肺痿。〕当关胃火并肝火，尺属滋阴降火汤。
数而流利为滑，数而弦急为紧，数而有止为促，数如豆粒为动，数而过极为疾。
滑〔阳中之阴。〕滑脉转旋，往来流利，盘珠之形，荷露之义。
滑脉为阳元气衰，痰生百病食生灾，上为吐逆下蓄血，女脉调时定有胎。
寸滑膈痰生呕吐，吞酸舌强或咳嗽，当关宿食肝脾热。泄痢 淋看尺部。〔滑主痰饮，浮滑风痰，
沉滑食痰，滑数痰火，滑短宿食。〕
涩〔属阴〕涩脉蹇滞，如刀刮竹，迟细而短，三象俱虚。
涩因血少或伤精，反胃亡阳汗雨淋，寒湿入营为血痹，女人非孕即无经。〔孕为胎病，无血养胎，
无孕血竭。〕
寸涩心虚痛对胸，胃虚胁胀察关中，尺为精血俱伤候，肠结溲淋或下红。〔涩主血少精伤之病。〕
肺之为脏，气多血少，见之为宜。肾之为脏，专主精血，左尺沉涩，为血少精伤，主艰嗣，男妇皆然。
虚〔属阴〕虚合四形，浮大迟软，及乎寻按，几不可见。
脉虚身热为伤暑，自汗〔右寸〕怔忡〔左寸〕惊悸多，发汗阴虚须早治，养荣益气莫蹉跎。
血不荣心寸口虚，关中腹胀食难舒，〔左关久虚，血不荣筋，肝伤也。〕骨蒸痿痹伤精血，却在神
门两部居。〔左尺水衰，右尺火衰也。〕
虚异于散，虚脉按之，虽软犹见；散脉按之，绝不可见。虚异于濡，虚则迟大无力，濡则细小无
力。虚异于芤，虚则愈按愈软，芤则重按仍见。气为阳主浮分，血为阴主沉分，浮分大而沉分空，故主血
虚。
实〔属阳〕实脉有力，长大而坚，应指 ，三候皆然。
实脉为阳火郁成，发狂谵语吐频频，或为阳毒或伤食，
大便不通或气疼。
寸实应知而热风，咽疼舌强气填胸，当关胃热中宫满，〔右关见实，肝火胁痛。〕尺实腰肠痛不通。
实异于紧，紧脉绷急而不宽舒，宽满而不和柔，实异于牢，牢则但见沉分，实则三候皆然。
长〔属阳〕长脉迢迢，首尾俱端，直上直下，如循长竿。
长脉迢迢大小匀，反常为病似牵绳，若非肠毒颠狂病，即是阳明热势深。〔长主有余之症。〕
经曰∶长则气治，须知长而和缓，即为平脉，长而硬满，即属病脉。首尾相应，非若他脉之上下
参差，首尾不匀者也。凡实牢弦紧，皆兼长脉，故长主有余之症。
短〔属阴〕短脉涩小，首尾俱俯，中间突起，不能满部。
短脉原于三部寻，短而滑数酒伤神，浮为血涩沉为痞，寸主头疼尺腹疼。
经曰∶短则气病，盖气属阳，主乎充沛，若短脉浊见，气衰之候矣。短非两头断绝也，特两头俯下
，中间突而浮起，仍自贯通者也。经曰∶短则气病，短主不足之症。
洪〔属阳〕洪脉极大，状如洪水，来盛去衰，滔滔满指。
洪脉阳盛血应虚，相火炎炎热病居，胀满胃翻须早治，阴虚泄痢可愁如。
寸洪心火上焦炎，脉肺洪时金不堪，肝火胃热关内察，肾虚阴火尺中看。
微〔属阴〕微脉极细，而又极软，似有若无，欲绝非绝。
气血微时脉亦微，恶寒〔阳微〕发热〔阴微〕汗淋漓，男为劳极诸虚候，女作崩中带下医。
寸微气促或心惊，关脉微时胀满胸，尺部见之精血弱，恶寒消疸痛呻吟。〔微主久虚血弱之病
，故阳微恶寒，阴微发热。〕
轻取之而如无，阳气衰也，重按之而欲绝，阴气绝也。微则模糊，细则显明，故细比于微，稍稍较
大也。
细〔属阴〕细直而软，累累萦萦，状如丝线，较显于微。
细脉萦萦血气衰，诸虚劳损七情乖，若非湿气侵腰肾，即是伤精汗泄来。
寸细应知呕吐频，〔左寸见细，怔忡不寐。〕入关腹胀胃虚形，〔左关细者，肝阴枯竭。〕尺逢定是
丹田冷，〔属右尺。〕泄痢遗精号脱阴〔属左尺。〕
细为血少气衰，故吐衄得沉细者生。忧劳过度者脉亦细。
濡〔阴中之阳。〕濡脉细软，见于浮分，举之乃见，按之即空。
濡为亡血阴虚病，髓海丹田暗已亏，汗雨夜来蒸入骨，血山崩倒湿浸脾。
寸濡阳微自汗多，〔左寸见濡，健忘惊悸。〕关中其奈血虚何，〔右关濡，则脾虚湿浸。〕尺
伤精血虚寒甚，温补真阴可起 。
濡之浮软类于虚，但虚形大而坎形小，濡之细小类于弱，但弱在沉而濡在浮，濡之无根类于散，但散
从浮大而渐至沉绝，濡从浮小而渐至不见。从大至无，为全凶之象；从小至无，为吉凶相半也。濡主血
虚之病，又为伤湿。
弱〔属阴〕弱脉细小，见于沉分，举之则无，按之乃得。
弱脉阴虚阳气衰，恶寒发热骨筋痿，多惊多汗精神减，
益气调营急早医。
寸弱阳虚病可知，关为胃弱与脾衰，欲求阳陷〔右尺〕阴虚〔左尺〕，病须把神门两部推。
〔弱主气虚之症，阳陷入阴，故恶寒发热。弱主筋，沉主骨，气虚则脉弱，寸弱阳虚，尺弱阴虚，关弱
胃虚。〕
紧〔阴中之阳。〕紧脉有力，左右弹人，如绞转索，如切紧绳。
紧为诸痛主于寒，喘咳风痫吐冷痰，浮紧表寒须发越，紧沉温散自然安。
寸紧人迎气口分〔左为人迎，右为气口，当取关前一分。〕当关心腹痛沉沉，〔左关浮紧伤寒，右关
浮紧伤食。〕尺中有紧为阴冷，定是奔豚与疝疼。〔紧为寒为痛，人迎紧伤于寒，气口紧盛伤于食。〕
紧脉之挺劲而急，与弦脉相类，但比弦脉更加挺劲之异，及转如绳索之异。〔中恶浮紧，咳嗽沉紧，皆
主死。〕
缓〔属阴〕缓脉四至，往来和匀，微风轻毡，杨柳初春。
缓脉营衰卫有余，或风或湿或脾虚，上为项强下痿痹，分别浮沉大小区。
寸缓风邪项背拘，关为风眩胃家虚，神门濡泄或风秘，或者蹒跚足力迂。〔浮缓为风，沉缓为湿，
缓大风虚，缓细湿痹，缓涩脾虚，缓弱气虚。〕
缓而和匀，不浮不沉，不大不小，不疾不迟，应手中和，意思欣欣，悠悠扬扬，难以名状者，此
真胃气脉也。一切脉中，皆须挟缓，谓之胃气。如春脉微弦，夏脉微洪，秋脉微毛，冬脉微实，皆为平
脉。但得本脏之脉，如但弦但洪，但毛但石，无胃气以和之，则真脏脉见，而主死矣。故
曰有胃气则生，无胃气则死，是以缓脉不主疾病，惟考其兼见之脉，方可断其为病耳。
弦〔阳中之阴。〕弦如琴弦，轻虚而滑，端直以长，指下挺然。
弦应东方肝胆经，饮痰寒热疟缠身，浮沉迟数须分别，大小单双有重轻。
寸弦头痛膈多痰〔左寸心痛。〕寒热 瘕察左关，关右胃寒心腹痛，尺中阴疝脚拘挛。
弦为初春之象，天气犹寒，如琴弦之稍紧。长为暮春之象，纯阳无寒，故如木干之迢直。
弦而软，其病轻；弦而硬，其病重。两关俱弦，谓之双弦，若不能食，为木来贼土，土已败也，必不
可治。
动〔属阳〕动无头尾，其形如豆，厥厥动摇，必兼滑数。
动脉兼司痛与惊，汗因阳动〔关前为阳。〕热因阴，〔关后为阴。〕或为泄痢拘挛病，男子亡精女
子崩。
经曰∶妇人手少阴动甚者，妊子也。动脉两头俯下，中间突起，有类于短，但短脉为阴，不数不硬不
滑，动脉为阳，且数且硬且滑也。
促〔属阳〕促为急促，数时一止，如趋而厥，进则必死。
促脉惟将火病医，〔左寸心火，右寸脉火。〕气血痰食饮推之，〔右关食滞，左关血滞。〕时时
喘咳皆痰积，或发狂斑与毒疽。
结〔属阴〕结为凝结，缓时一止，徐行而代，颇得其旨。
结脉缓而时一止，浊阴偏盛欲亡阳，浮为气滞沉为积，汗下分明在主张。
结脉皆因气血凝，老痰结滞苦呻吟，内生积聚分痈
肿，疝瘕为殃病属阴。
浮分为阳结，沉分为阴结，结而有力方者为积聚，结而无力者，真气衰弱，宜行温补。
代〔属阴。〕代为禅代，止有常数，不能自还，良久复动。
代脉原因脏气衰，腹痛泄痢下元亏，或为吐泻中宫病，女子怀胎三月兮。两动一止三、四日，三
、四动止应六、七，五、六动止七、八朝，次第推之自不失。
伤寒心悸，霍乱昏烦，跌打重伤，怀胎三月，俱不忌代。痛甚者脉多代，老得代脉者生，少得代脉者死。
革〔阳中之阴。〕革大弦急，浮取即得，按之即空，浑如鼓革。
革脉形如按鼓皮，芤弦相合脉寒虚，女人半产并崩漏，男子营虚或梦遗。
革与牢皆大而弦，革浮牢沉，革虚牢实，形证皆异。三部脉革，长病得之死，卒病得之生。
牢〔阴中之阳。〕牢在沉分，大而弦实，浮中二候，了不可得。
寒则牢坚里有余，腹心寒痛木乘脾，疝 瘕何害也，失血阴虚却忌之。
牢与伏皆在沉分，但伏必推筋着骨，乃见其形，牢则略重按之，便满指有力。
散〔属阴〕散脉浮乱，有表无里，中候渐空，按则绝矣。〔渐重渐无，渐轻渐有。〕
散似杨花散漫飞，去来无定至难齐，产为生兆胎为堕，久病逢之不必医。
左寸怔忡右寸汗，溢饮左关应软散，右关软散 肿，散居两尺魂应断。
散为肾绝之诊，代为脾绝之诊。肾脉本沉，而散则按之不可得见，先天之资始绝矣。脾脉主信
，而代则歇至，不愆其期，后天之资生绝矣。
芤〔阳中之阴。〕芤乃草名，绝类慈葱，浮沉俱有，中候独空。
芤形浮大软如葱，按之傍有中央空，火犯阳经血上溢，热浸阴络下流红。
寸芤脱血在于胸，关内逢之血脏空，尺部见之多下血，赤淋红痢漏崩中。
营行脉中，脉以血为形，芤脉中空，脱血之象也。
伏〔属阴〕伏为隐伏，更下于沉，推筋着骨，始得其形。
伏为霍乱吐频频，腹痛多系宿食停，蓄饮老痰成积聚。散寒温里莫因循。
食郁胸中双寸伏，欲吐不吐常兀兀，当关腹痛困沉沉，关后疝疼还破腹。
伤寒欲吐阳将解，厥逆腹疼症属阴。
疾〔属阳。〕疾为急疾，数之至极，七至八至，脉流薄疾。
疾为阳极阴为绝，脉号离经魂魄别，渐进渐疾亢火炎，旦夕之中自殒灭。
怪脉 雀啄连来四、五啄，〔连三、五至而歇，歇而再至，如雀啄食。〕屋漏少刻一点落，
〔良久一至，屋漏滴水之状，〕弹石硬来寻即散，〔从骨间劈劈而至，如指弹石。〕落指散乱如解索，〔
散乱如解绳索。〕鱼翔似有又如无，〔浮时忽一沉，譬之鱼翔，似有似无。〕 游静中忽一跃，
〔静时忽一劲，如 游静中一跃。〕寄语医家仔细看，六脉
见一休下药。
真脏脉 真脏脉见，乃决死期。
肝病则脉弦，弦而劲急，如循刀刃，真肝脉见也。庚日笃，辛日死，死于申酉时。心病则脉洪，洪
而鼓躁，如操带钩，真心脉见也。壬日笃，癸日死，死于亥子时。脾病则脉软，脉来如屋之漏，如水之
流，解然不鼓，真脾脉见也。甲日笃，乙日死，死于寅卯时。肺病则脉涩，涩而轻短，如风吹毛，真肺脉
见也。丙日笃，丁日死，死于己午时。肾病则脉石，石而搏激，如雀之啄，真肾脉见也。戊日笃，己日
死。死于辰戌丑未时。其有过时者，仓公所谓能食也。
【浮脉】浮脉属于阳，脉位浅表，位于皮毛之间，就像木头漂在水面上一样，轻取时脉搏有力，重按时力量减弱。
浮脉主阳证、表证，[如果在秋季（三秋）出现符合时令的浮脉，说明身体无恙；但如果是久病之人出现浮脉，则令人担忧]。迟脉主风邪，数脉主热，紧脉主寒邪导致的拘挛。浮而有力的多属风热，[这是表实证的表现]。浮而无力的属于表虚，是血虚所致。
寸部出现浮脉，会导致头痛、眩晕，甚至生风，或者有风痰积聚在胸部；关部出现浮脉，提示脾土虚弱兼肝木旺盛；尺部出现浮脉，提示下焦二便不通畅。
浮而盛大的是洪脉，浮而软大的是虚脉，浮而细软的是濡脉，浮而弦芤的是革脉，浮而无根的是散脉，浮而中空的是芤脉。
【沉脉】沉脉属于阴，脉位深沉，位于筋骨之间，就像石头投入水中一样，重按时脉搏有力，轻取时力量减弱。
沉脉主水饮停蓄于阴经的病证，数脉主热，迟脉主寒，滑脉主有痰。沉而无力属于里虚，多为虚证和气滞；沉而有力属于里实，多为积滞和寒凝。
寸部出现沉脉，主痰郁和水停于胸，[也主血病]；关部主中寒引起的疼痛不通；尺部主小便浑浊遗精以及泄痢，肾虚导致腰部和下元不适。
沉而细软的是弱脉，沉而弦劲的是牢脉，沉而贴骨的是伏脉。
【迟脉】迟脉属于阴，脉象表现为不及，往来缓慢，一息跳动三次。
迟脉主脏病或多痰，仔细诊察可发现沉痼或瘕积；迟而有力为冷痛，迟而无力定属虚寒。
寸部出现迟脉，必是上焦有寒；关部主中寒，疼痛难忍；尺部主肾虚，腰部脚部沉重，小便失禁或疝气牵引睾丸。
迟而不流利的是涩脉，迟而有间歇的是结脉。
【数脉】数脉属于阳，脉象表现为太过，一息跳动六次，往来急促过度。
数脉属阳，可知为热证，只需根据君火和相火来治疗，[阳数对应君火，阴数对应相火]。实证宜用凉泻法，[因为有实火]；虚证宜用补法，[因为是无力的虚火]。但在深秋时节患肺病者却应畏惧数脉，[因为肺属金脏，易受贼邪侵害，秋季是克制金的凶险时令]。
寸部出现数脉，主咽喉口舌生疮，吐血咳嗽，肺部生疡，[数而虚主肺痿]；关部主胃火和肝火；尺部宜用滋阴降火的方剂。
数而流利的是滑脉，数而弦急的是紧脉，数而有间歇的是促脉，数如豆粒跳动的是动脉，数得极快的是疾脉。
【滑脉】滑脉属于阳中之阴。滑脉转动灵活，往来流利，像盘中的珠子滚动，又像荷叶上的露珠滚动。
滑脉属阳，但也可能表示元气衰败，痰湿引发百病，饮食不节产生灾祸，上行导致呕吐逆气，下行蓄积瘀血，女性月经调准时出现滑脉，定是有孕。
寸部出现滑脉，主膈间有痰，引起呕吐，吞酸，舌强或咳嗽；关部主宿食停滞，肝脾有热；尺部看泄痢和淋证。[滑脉主痰饮，浮滑主风痰，沉滑主食痰，滑数主痰火，滑短主宿食]。
【涩脉】涩脉属于阴。涩脉蹇滞不畅，像刀刮竹子一样，迟、细、短三种特征都具备，均属虚证。
涩脉因血少或伤精所致，可见于反胃、亡阳、大汗淋漓，寒湿侵入营分导致血痹，女性若非怀孕就是闭经。[怀孕是胎病，因无血养胎；若无孕则是血竭]。
寸部出现涩脉，主心虚胸痛；关部主胃虚胁胀；尺部主精血俱伤，肠结、小便淋沥或便血。[涩脉主血少精伤的病证]。
肺作为脏腑，气多血少，见到涩脉是适宜的。肾作为脏腑，专门主管精血，左尺出现沉涩脉，是血少精伤的表现，主难以生育，男女皆然。
【虚脉】虚脉综合了四种形态，浮、大、迟、软，等到寻按之时，几乎看不见。
脉虚且身热是伤暑，自汗[见于右寸]，怔忡[见于左寸]，惊悸较多，发汗后阴虚须及早治疗，调养荣气益气不要错过时机。
血不能滋养心脏，寸口脉虚；关部腹胀，食物难以消化，[左关久虚，血不能滋养筋脉，是肝受伤]；骨蒸、痿痹、伤精血，出现在神门两部[指尺部]。[左尺水衰，右尺火衰]。
虚脉不同于散脉，虚脉按之，虽然软但仍能感觉到；散脉按之，完全感觉不到。虚脉不同于濡脉，虚脉迟大无力，濡脉细小无力。虚脉不同于芤脉，虚脉越按越软，芤脉重按仍能感觉到。气属阳，主要反映在浮分；血属阴，主要反映在沉分。浮分大而沉分空，所以主血虚。
【实脉】实脉属于阳。实脉有力，长大而坚实，应指有力，三部脉都一样。
实脉属阳，由火郁而成，表现为发狂、谵语、频繁呕吐，或者是阳毒或伤食，大便不通或气痛。
寸部出现实脉，应知是热风，咽痛舌强，气塞满胸；关部主胃热，中宫胀满，[右关见实脉，可能是肝火导致的胁痛]；尺部主腰肠疼痛不通。
实脉不同于紧脉，紧脉绷急而不宽舒，宽大满溢但不柔和；实脉不同于牢脉，牢脉只在沉分出现，实脉三部都有。
【长脉】长脉属于阳。长脉悠长，首尾端正，直上直下，像顺着长竿触摸。
长脉悠长，大小均匀，反常则为病，像牵拉绳子一样，如果不是肠毒或颠狂病，就是阳明热势深重。[长脉主有余的病症]。
经典说：长则气治，要知道长而和缓，就是平脉；长而硬满，就属于病脉。首尾相应，不像其他脉那样上下参差，首尾不均匀。凡是实、牢、弦、紧脉，都兼有长脉的特征，所以长脉主有余的病症。
【短脉】短脉属于阴。短脉涩小，首尾都向下俯，中间突起，不能充满脉位。
短脉需要在三部细细寻找，短而滑数是酒伤神志，浮取主血涩，沉取主痞块，寸部主头疼，尺部主腹疼。
经典说：短则气病，因为气属阳，主充沛，如果短脉浊现，是气衰的征候。短脉不是两头断绝，只是两头俯下，中间突而浮起，仍然贯通。经典说：短则气病，短脉主不足的病症。
【洪脉】洪脉属于阳。洪脉极大，形状像洪水，来势盛而去势衰，滔滔不绝充满手指。
洪脉阳盛，血应当虚，相火炎炎，主热病，胀满、胃翻须及早治疗，阴虚泄痢令人发愁。
寸部洪脉，主心火上炎于上焦；肺脉洪大时，金气不堪忍受；肝火、胃热可在关部察知；肾虚阴火在尺部查看。
【微脉】微脉属于阴。微脉极细，而又极软，似有若无，想要断绝却又未绝。
气血微弱时脉也微弱，恶寒[阳微]发热[阴微]，大汗淋漓，男性表现为劳损至极的各种虚证，女性表现为崩漏带下。
寸部微脉，主气促或心惊；关部微脉，主胀满胸闷；尺部出现微脉，主精血虚弱，恶寒、黄疸消退、疼痛呻吟。[微脉主久虚血弱的病，所以阳微恶寒，阴微发热]。
轻取时好像没有，是阳气衰败；重按时想要断绝，是阴气绝灭。微脉模糊，细脉显明，所以细脉比微脉稍稍大一些。
【细脉】细脉属于阴。细脉直而软，连绵不断，形状像丝线，比微脉明显。
细脉连绵，主血气衰败，各种虚损劳伤，七情乖违，如果不是湿气侵袭腰肾，就是伤精出汗所致。
寸部细脉，应知频繁呕吐，[左寸见细脉，主怔忡不寐]；进入关部，主腹胀胃虚，[左关细者，肝阴枯竭]；尺部逢细，定是丹田寒冷，[属右尺]；泄痢遗精称为脱阴，[属左尺]。
细脉主血少气衰，所以吐衄患者得到沉细脉者生。忧劳过度的人脉也会细。
【濡脉】濡脉属于阴中之阳。濡脉细软，出现在浮分，轻取才看得见，重按即空。
濡脉主亡血阴虚病，髓海丹田暗中已亏，夜间盗汗如雨渗入骨中，血崩倒毙或湿气浸脾。
寸部濡脉，主阳微自汗多，[左寸见濡，主健忘惊悸]；关部无奈血虚何，[右关濡，则脾虚湿浸]；尺部伤精血虚寒甚，温补真阴可起死回生。
濡脉的浮软类似虚脉，但虚脉形大，濡脉形小；濡脉的细小类似弱脉，但弱脉在沉分，濡脉在浮分；濡脉的无根类似散脉，但散脉从浮大逐渐至沉绝，濡脉从浮小逐渐至不见。从大到无，是全凶之象；从小到无，是吉凶参半。濡脉主血虚病，又主伤湿。
【弱脉】弱脉属于阴。弱脉细小，出现在沉分，轻取则无，重按才得。
弱脉主阴虚阳气衰，恶寒发热，骨筋痿软，多惊多汗，精神减退，益气调营须及早医治。
寸部弱脉，阳虚病可知；关部主胃弱与脾衰；欲求阳陷[右尺]、阴虚[左尺]，病须从神门两部推究。[弱脉主气虚之症，阳陷入阴，故恶寒发热。弱脉主筋，沉脉主骨，气虚则脉弱，寸弱阳虚，尺弱阴虚，关弱胃虚]。
【紧脉】紧脉属于阴中之阳。紧脉有力，左右弹人，像绞转的绳索，像切紧的绳子。
紧脉主诸痛，源于寒邪，喘咳、风痫、吐冷痰，浮紧表寒须发汗解表，紧沉温散自然安。
寸部紧脉，人迎和气口要分开诊察，[左为人迎，右为气口，当取关前一分]；关部主心腹痛沉沉，[左关浮紧伤寒，右关浮紧伤食]；尺部有紧脉为阴冷，定是奔豚与疝疼。[紧为寒为痛，人迎紧伤于寒，气口紧盛伤于食]。
紧脉的挺劲而急，与弦脉相似，但比弦脉更加挺劲，及转如绳索的不同。[中恶浮紧，咳嗽沉紧，都主死]。
【缓脉】缓脉属于阴。缓脉四至，往来和匀，像微风轻毡，杨柳初春。
缓脉主营衰卫有余，或是风邪，或是湿邪，或是脾虚，上行导致项强，下行导致痿痹，需分别浮沉大小区别。
寸部缓脉，主风邪导致项背拘急；关部主风眩、胃家虚；神门部主濡泄或风秘，或者行走蹒跚足力迟缓。[浮缓为风，沉缓为湿，缓大风虚，缓细湿痹，缓涩脾虚，缓弱气虚]。
缓而和匀，不浮不沉，不大不小，不疾不迟，应手中和，意思欣欣，悠悠扬扬，难以名状的，这是真胃气脉。一切脉中，都必须挟带缓脉，称为胃气。如春脉微弦，夏脉微洪，秋脉微毛，冬脉微实，都是平脉。只得到本脏之脉，如但弦但洪，但毛但石，没有胃气来调和，则真脏脉出现，主死。所以说有胃气则生，无胃气则死，因此缓脉不主疾病，只有考察其兼见的脉，才能判断其为病。
【弦脉】弦脉属于阳中之阴。弦脉像琴弦，轻虚而滑，端直以长，指下挺然。
弦脉对应东方肝胆经，主饮痰、寒热、疟疾缠身，浮沉迟数须分别，大小单双有重轻。
寸部弦脉，主头痛、膈间多痰，[左寸心痛]；寒热瘕积察左关；关右主胃寒、心腹痛；尺部主阴疝、脚拘挛。
弦脉是初春之象，天气犹寒，像琴弦稍紧。长脉是暮春之象，纯阳无寒，所以像木干迢直。
弦而软，病轻；弦而硬，病重。两关俱弦，谓之双弦，如果不能进食，是木来克土，土已败坏，必不可治。
【动脉】动脉属于阳。动脉无头尾，形状如豆，厥厥动摇，必兼滑数。
动脉兼司痛与惊，汗出因阳动[关前为阳]，热因阴动[关后为阴]，或者是泄痢拘挛病，男子亡精女子崩漏。
经典说：妇人手少阴动甚者，是怀孕。动脉两头俯下，中间突起，有点像短脉，但短脉属阴，不数不硬不滑，动脉属阳，且数且硬且滑。
【促脉】促脉属于阳。促脉为急促，数时一止，像奔跑跌倒，进则必死。
促脉只将火病来医，[左寸心火，右寸脉火]，气血痰食饮推之，[右关食滞，左关血滞]，时时喘咳皆痰积，或者发狂斑与毒疽。
【结脉】结脉属于阴。结脉为凝结，缓时一止，徐行而代，颇得其旨。
结脉缓而时一止，浊阴偏盛欲亡阳，浮为气滞沉为积，汗下分明在主张。
结脉皆因气血凝，老痰结滞苦呻吟，内生积聚分痈肿，疝瘕为殃病属阴。
浮分为阳结，沉分为阴结，结而有力方者为积聚，结而无力者，真气衰弱，宜行温补。
【代脉】代脉属于阴。代脉为禅代，止有常数，不能自还，良久复动。
代脉原因脏气衰，腹痛泄痢下元亏，或者是吐泻中宫病，女子怀胎三月兮。两动一止三、四日，三、四动止应六、七，五、六动止七、八朝，次第推之自不失。
伤寒心悸，霍乱昏烦，跌打重伤，怀胎三月，都不忌讳代脉。痛甚者脉多代，老得代脉者生，少得代脉者死。
【革脉】革脉属于阳中之阴。革脉大弦急，浮取即得，按之即空，浑如鼓皮。
革脉形如按鼓皮，芤弦相合脉寒虚，女人半产并崩漏，男子营虚或梦遗。
革与牢皆大而弦，革浮牢沉，革虚牢实，形证皆异。三部脉革，长病得之死，卒病得之生。
【牢脉】牢脉属于阴中之阳。牢脉在沉分，大而弦实，浮中二候，完全得不到。
寒则牢坚里有余，腹心寒痛木乘脾，疝瘕何害也，失血阴虚却忌之。
牢与伏皆在沉分，但伏必推筋着骨，乃见其形，牢则略重按之，便满指有力。
【散脉】散脉属于阴。散脉浮乱，有表无里，中候渐空，按则绝矣。[渐重渐无，渐轻渐有]。
散似杨花散漫飞，去来无定至难齐，产为生兆胎为堕，久病逢之不必医。
左寸怔忡右寸汗，溢饮左关应软散，右关软散水肿，散居两尺魂应断。
散脉是肾绝之诊，代脉是脾绝之诊。肾脉本沉，而散则按之不可得见，先天之资始绝矣。脾脉主信，而代则歇至，不愆其期，后天之资生绝矣。
【芤脉】芤脉属于阳中之阴。芤乃草名，绝类慈葱，浮沉俱有，中候独空。
芤形浮大软如葱，按之傍有中央空，火犯阳经血上溢，热浸阴络下流红。
寸芤脱血在于胸，关内逢之血脏空，尺部见之多下血，赤淋红痢漏崩中。
营行脉中，脉以血为形，芤脉中空，是脱血的象征。
【伏脉】伏脉属于阴。伏脉为隐伏，更下于沉，推筋着骨，始得其形。
伏脉主霍乱吐频频，腹痛多系宿食停，蓄饮老痰成积聚。散寒温里莫因循。
食郁胸中双寸伏，欲吐不吐常兀兀，当关腹痛困沉沉，关后疝疼还破腹。
伤寒欲吐阳将解，厥逆腹疼症属阴。
【疾脉】疾脉属于阳。疾脉为急疾，数之至极，七至八至，脉流薄疾。
疾脉为阳极阴为绝，脉号离经魂魄别，渐进渐疾亢火炎，旦夕之中自殒灭。
怪脉 雀啄连来四、五啄，[连三、五至而歇，歇而再至，如雀啄食]。屋漏少刻一点落，[良久一至，屋漏滴水之状]，弹石硬来寻即散，[从骨间劈劈而至，如指弹石]。落指散乱如解索，[散乱如解绳索]。鱼翔似有又如无，[浮时忽一沉，譬之鱼翔，似有似无]。鲦游静中忽一跃，[静时忽一劲，如鲦游静中一跃]。寄语医家仔细看，六脉见一休下药。
真脏脉 真脏脉见，乃决死期。
肝病则脉弦，弦而劲急，如循刀刃，真肝脉见也。庚日笃，辛日死，死于申酉时。心病则脉洪，洪而鼓躁，如操带钩，真心脉见也。壬日笃，癸日死，死于亥子时。脾病则脉软，脉来如屋之漏，如水之流，解然不鼓，真脾脉见也。甲日笃，乙日死，死于寅卯时。肺病则脉涩，涩而轻短，如风吹毛，真肺脉见也。丙日笃，丁日死，死于己午时。肾病则脉石，石而搏激，如雀之啄，真肾脉见也。戊日笃，己日死。死于辰戌丑未时。其有过时者，仓公所谓能食也。
[Floating Pulse] The Floating pulse belongs to Yang. It is superficial, located at the skin and hair level, resembling wood floating on water. It is abundant upon light palpation (lifting) but deficient upon heavy pressure (pressing).
The Floating pulse indicates Yang syndromes and Exterior diseases. [If appearing in the three autumn months in accordance with the season, it signifies health; however, if appearing in chronic illnesses, it is alarming.] The Slow pulse indicates Wind, the Rapid pulse indicates Heat, and the Tight pulse indicates Cold causing constraint. A Floating pulse that is forceful often indicates Wind-Heat [this represents an Exterior Excess pattern]. A Floating pulse that is forceless indicates an Exterior Deficiency pattern, resulting from Blood deficiency.
At the Cun position, a Floating pulse causes headache, dizziness, and internal Wind, or the accumulation of Wind-Phlegm in the chest. At the Guan position, it indicates Spleen Earth weakness combined with Liver Wood hyperactivity. At the Chi position, it indicates obstruction in urination and defecation in the Lower Jiao.
A Floating and vigorous pulse is Hong (Surging); a Floating and soft-large pulse is Xu (Deficient); a Floating and fine-soft pulse is Ru (Soggy); a Floating, Xian (Wiry), and Kou (Scallion-stem) pulse is Ge (Hollow/Drum-skin); a Floating pulse without root is San (Scattered); a Floating pulse with an empty center is Kou (Scallion-stem).
[Sinking Pulse] The Sinking pulse belongs to Yin. It is deep, located at the sinews and bones, resembling a stone sinking into water. It is abundant upon heavy pressure but deficient upon light palpation.
The Sinking pulse indicates Water retention in Yin meridians. A Rapid pulse indicates Heat, a Slow pulse indicates Cold, and a Slippery pulse indicates Phlegm. A Sinking pulse that is forceless indicates Interior Deficiency, characterized by deficiency and Qi stagnation. A Sinking pulse that is forceful indicates Interior Excess, characterized by accumulation and Cold coagulation.
At the Cun position, a Sinking pulse indicates Phlegm stagnation and Water retention in the chest [also indicating Blood disorders]. At the Guan position, it indicates pain due to Middle Jiao Cold obstruction. At the Chi position, it indicates turbid urine, spermatorrhea, diarrhea, and dysentery, as well as Kidney deficiency affecting the waist and Lower Yuan.
A Sinking and fine-soft pulse is Ruo (Weak); a Sinking and wiry-taut pulse is Lao (Firm); a Sinking pulse adhering to the bone is Fu (Hidden).
[Slow Pulse] The Slow pulse belongs to Yin. Its image represents insufficiency; it moves slowly, beating three times per respiration cycle.
The Slow pulse indicates Zang organ diseases or excessive Phlegm; careful examination can reveal chronic accumulations or masses. A Slow pulse that is forceful indicates Cold pain; a Slow pulse that is forceless indicates definite Deficiency-Cold.
At the Cun position, a Slow pulse indicates Upper Jiao Cold. At the Guan position, it indicates Middle Jiao Cold causing unbearable pain. At the Chi position, it indicates Kidney deficiency, heaviness in the waist and legs, incontinence, or hernia pulling to the testicles.
A Slow pulse that is not smooth is Se (Choppy); a Slow pulse with intermittent pauses is Jie (Knotted).
[Rapid Pulse] The Rapid pulse belongs to Yang. Its image represents excess; it beats six times per respiration cycle, moving excessively fast.
The Rapid pulse is Yang and indicates Heat. Treatment should focus on Ministerial Fire and Sovereign Fire. [Yang Rapid corresponds to Sovereign Fire, Yin Rapid corresponds to Ministerial Fire.] Excess patterns require cooling purgation [due to Excess Fire]; Deficiency patterns require tonification [due to forceless Deficient Fire]. However, Lung diseases in late autumn should fear the Rapid pulse [as the Lung is a Metal organ susceptible to thief pathogens, and Autumn is a destructive season for Metal].
At the Cun position, a Rapid pulse indicates sores in the throat, mouth, and tongue, hemoptysis, cough, and lung ulcers [Rapid and weak indicates Lung Flaccidity]. At the Guan position, it indicates Stomach Fire and Liver Fire. At the Chi position, formulas for nourishing Yin and descending Fire are indicated.
A Rapid and smooth pulse is Hua (Slippery); a Rapid and wiry-taut pulse is Jin (Tight); a Rapid pulse with intermittent pauses is Cu (Interrupted); a Rapid pulse like a bean is Dong (Agitated); a Rapid pulse reaching extremity is Ji (Hasty).
[Slippery Pulse] The Slippery pulse belongs to Yin within Yang. The Slippery pulse rotates smoothly, flowing freely, resembling pearls on a plate or dew on a lotus leaf.
The Slippery pulse is Yang but may indicate decline of Yuan Qi. Phlegm generates hundred diseases, and improper diet causes disasters. Upward, it causes vomiting and regurgitation; downward, it causes blood stasis. In women, if the menstrual cycle is regular and a Slippery pulse appears, pregnancy is certain.
At the Cun position, a Slippery pulse indicates Phlegm in the diaphragm causing vomiting, acid regurgitation, stiff tongue, or cough. At the Guan position, it indicates retained food and Heat in the Liver and Spleen. At the Chi position, observe diarrhea, dysentery, and strangury. [Slippery pulse indicates Phlegm-fluids: Floating-Slippery indicates Wind-Phlegm, Deep-Slippery indicates Food-Phlegm, Slippery-Rapid indicates Phlegm-Fire, Slippery-Short indicates retained food.]
[Choppy Pulse] The Choppy pulse belongs to Yin. The Choppy pulse is stagnant and rough, like a knife scraping bamboo. It exhibits Slowness, Fineness, and Shortness, all three indicating Deficiency.
The Choppy pulse results from Blood deficiency or Essence injury, manifesting as reverse stomachache, loss of Yang, profuse sweating, Blood Bi caused by Cold-Damp invading the Ying level, and amenorrhea in women unless pregnant. [Pregnancy involves fetal pathology due to lack of blood to nourish the fetus; non-pregnancy implies blood exhaustion.]
At the Cun position, a Choppy pulse indicates Heart deficiency and chest pain. At the Guan position, it indicates Stomach deficiency and flank distension. At the Chi position, it indicates injury to both Essence and Blood, intestinal constipation, strangury, or lower bleeding. [The Choppy pulse indicates diseases of Blood and Essence deficiency.]
The Lung, as an organ, has much Qi and little Blood; thus, a Choppy pulse is appropriate. The Kidney, as an organ, exclusively governs Essence and Blood; a Sinking-Choppy pulse at the Left Chi indicates Blood and Essence deficiency, leading to difficulty conceiving, applicable to both men and women.
[Deficient Pulse] The Deficient pulse combines four characteristics: Floating, Large, Slow, and Soft. Upon searching and pressing, it is barely visible.
A Deficient pulse with body heat indicates Summerheat injury. Spontaneous sweating [at Right Cun], palpitations [at Left Cun], and frequent fright/panic occur. Yin deficiency after sweating requires early treatment; nourishing Ying and tonifying Qi should not be delayed.
Blood failing to nourish the Heart manifests as a Deficient pulse at the Cun position. Abdominal distension and difficulty digesting food occur at the Guan position. [Long-term deficiency at Left Guan indicates Blood failing to nourish sinews, signifying Liver injury]. Bone-steaming, flaccidity, Bi syndrome, and Essence/Blood injury appear at the Shenmen positions [Chi pulses]. [Left Chi indicates Water deficiency, Right Chi indicates Fire deficiency].
The Deficient pulse differs from the Scattered pulse: upon pressing, the Deficient pulse remains soft but perceptible, whereas the Scattered pulse disappears completely. The Deficient pulse differs from the Soggy pulse: the Deficient pulse is Slow, Large, and forceless, while the Soggy pulse is Fine and forceless. The Deficient pulse differs from the Scallion-stem pulse: the Deficient pulse becomes softer with deeper pressure, while the Scallion-stem pulse is still perceptible upon heavy pressure. Qi belongs to Yang and dominates the Floating layer; Blood belongs to Yin and dominates the Sinking layer. If the Floating layer is large and the Sinking layer is empty, it indicates Blood deficiency.
[Excess Pulse] The Excess pulse belongs to Yang. The Excess pulse is forceful, large, long, and firm, responding strongly to touch, consistent across all three positions.
The Excess pulse is Yang, formed by Fire stagnation, manifesting as mania, delirium, frequent vomiting, Yang toxicity, or food injury, accompanied by constipation or Qi pain.
At the Cun position, an Excess pulse indicates Wind-Heat, sore throat, stiff tongue, and Qi filling the chest. At the Guan position, it indicates Stomach Heat and Middle Jiao fullness [Excess at Right Guan may indicate Liver Fire causing flank pain]. At the Chi position, it indicates unrelenting pain in the waist and intestines.
The Excess pulse differs from the Tight pulse: the Tight pulse is tense and uncomfortable, wide and full but not soft. The Excess pulse differs from the Firm pulse: the Firm pulse appears only in the Sinking layer, while the Excess pulse appears in all three layers.
[Long Pulse] The Long pulse belongs to Yang. The Long pulse is distant, with both ends even, going straight up and down, like tracing a long bamboo pole.
The Long pulse is distant and uniform in size; if abnormal, it resembles a pulled rope. Unless it is intestinal toxin or mania, it indicates deep Yangming Heat. [The Long pulse indicates Excess syndromes.]
The Classic states: "Long means Qi is regulated." One must know that a Long and harmonious pulse is a Normal pulse, while a Long and hard/full pulse is a Pathological pulse. The head and tail correspond, unlike other pulses that are uneven. All Excess, Firm, Wiry, and Tight pulses accompany the Long pulse; thus, the Long pulse indicates Excess syndromes.
[Short Pulse] The Short pulse belongs to Yin. The Short pulse is Choppy and Small, with both ends drooping and the middle protruding, failing to fill the pulse position.
The Short pulse is found by searching all three positions. Short and Slippery-Rapid indicates alcohol damaging the Spirit. Floating indicates Blood stagnation; Sinking indicates Pi (fullness/blockage). Cun indicates headache; Chi indicates abdominal pain.
The Classic states: "Short means Qi disease." Since Qi belongs to Yang and is abundant, a turbid Short pulse indicates Qi decline. The Short pulse is not severed at both ends, but rather droops at the ends and protrudes in the middle, remaining connected. The Classic states: "Short means Qi disease"; the Short pulse indicates Insufficiency syndromes.
[Surging Pulse] The Surging pulse belongs to Yang. The Surging pulse is extremely large, resembling floodwater, coming vigorously and departing weakly, overflowing the fingers.
The Surging pulse indicates Yang Excess and corresponding Blood deficiency. Blazing Ministerial Fire indicates Heat diseases. Fullness and stomach reversal require early treatment; Yin deficiency with diarrhea/dysentery is worrying.
At the Cun position, a Surging pulse indicates Heart Fire blazing in the Upper Jiao. When the Lung pulse is Surging, Metal cannot withstand it. Liver Fire and Stomach Heat are observed at the Guan position. Kidney deficiency and Yin Fire are seen at the Chi position.
[Micro Pulse] The Micro pulse belongs to Yin. The Micro pulse is extremely fine and extremely soft, seeming present yet absent, on the verge of disappearing but not gone.
When Qi and Blood are micro, the pulse is micro. Chills [Yang micro], fever [Yin micro], and profuse sweating occur. In men, it indicates extreme fatigue and various deficiency conditions; in women, it indicates metrorrhagia and leukorrhea.
At the Cun position, a Micro pulse indicates shortness of breath or heart fright. At the Guan position, a Micro pulse indicates chest fullness. At the Chi position, it indicates weak Essence and Blood, chills, resolving jaundice, and painful groaning. [The Micro pulse indicates chronic deficiency and weak Blood; thus, Yang micro causes chills, Yin micro causes fever.]
Light palpation feeling empty indicates Yang Qi decline; heavy palpation feeling near-extinction indicates Yin Qi extinction. The Micro pulse is vague, while the Fine pulse is distinct; thus, the Fine pulse is slightly larger than the Micro pulse.
[Fine Pulse] The Fine pulse belongs to Yin. The Fine pulse is straight and soft, continuous and thin, resembling a silk thread, more distinct than the Micro pulse.
The Fine pulse, continuous and thin, indicates decline of Blood and Qi, various deficiencies, labor injuries, and emotional disharmony. If not Dampness invading the waist and Kidneys, it indicates Essence injury and sweating.
At the Cun position, a Fine pulse indicates frequent vomiting [Left Cun Fine indicates palpitations and insomnia]. Entering the Guan position indicates abdominal distension and Stomach deficiency [Left Guan Fine indicates Liver Yin exhaustion]. Meeting the Fine pulse at the Chi position indicates cold in the Dantian [Right Chi]. Diarrhea, dysentery, and spermatorrhea are called Yin collapse [Left Chi].
The Fine pulse indicates Blood scarcity and Qi decline; thus, patients with hematemesis/hematochezia who have a Deep-Fine pulse survive. Those overworked also have a Fine pulse.
[Soggy Pulse] The Soggy pulse belongs to Yang within Yin. The Soggy pulse is Fine and Soft, appearing in the Floating layer, visible upon lifting but empty upon pressing.
The Soggy pulse indicates Blood loss and Yin deficiency. The Sea of Marrow and Dantian are secretly depleted. Night sweats soak the bones like rain. Blood collapse or Spleen dampness infiltration occurs.
At the Cun position, a Soggy pulse indicates Yang micro and spontaneous sweating [Left Cun Soggy indicates forgetfulness and fright]. At the Guan position, it addresses Blood deficiency [Right Guan Soggy indicates Spleen deficiency with Damp infiltration]. At the Chi position, it indicates severe Essence/Blood deficiency and Cold; warming and tonifying True Yin can restore health.
The Soggy pulse's floating softness resembles the Deficient pulse, but the Deficient pulse is large while the Soggy is small. The Soggy pulse's fineness resembles the Weak pulse, but the Weak is in the Sinking layer while the Soggy is in the Floating layer. The Soggy pulse's rootlessness resembles the Scattered pulse, but the Scattered pulse goes from Floating-Large to Deep-Extinction, while the Soggy pulse goes from Floating-Small to invisible. From large to nothing is fully ominous; from small to nothing is half auspicious/half ominous. The Soggy pulse indicates Blood deficiency and Damp injury.
[Weak Pulse] The Weak pulse belongs to Yin. The Weak pulse is Fine and Small, appearing in the Sinking layer, absent upon lifting but obtained upon pressing.
The Weak pulse indicates Yin deficiency and Yang Qi decline, chills, fever, sinew/bone flaccidity, frequent fright/sweating, and mental depletion. Tonifying Qi and regulating Ying requires urgent treatment.
At the Cun position, a Weak pulse indicates Yang deficiency. At the Guan position, it indicates Stomach weakness and Spleen decline. To seek Yang sinking [Right Chi] and Yin deficiency [Left Chi], one must examine the Shenmen positions. [The Weak pulse indicates Qi deficiency syndromes; Yang sinks into Yin, causing chills and fever. The Weak pulse governs sinews, the Deep pulse governs bones. Qi deficiency leads to Weak pulse: Cun Weak is Yang deficiency, Chi Weak is Yin deficiency, Guan Weak is Stomach deficiency.]
[Tight Pulse] The Tight pulse belongs to Yin within Yang. The Tight pulse is forceful, flicking left and right, like twisted ropes or cut tight strings.
The Tight pulse governs various pains due to Cold, wheezing/cough, wind-epilepsy, and vomiting cold Phlegm. Floating-Tight Exterior Cold requires release via sweating; Tight-Deep Cold requires warming and dispersing for natural relief.
At the Cun position, distinguish between Renying [Left] and Qikou [Right] [take one cun anterior to the Guan]. At the Guan position, it indicates deep heart/abdominal pain [Left Guan Floating-Tight indicates Cold Damage, Right Guan Floating-Tight indicates Food Injury]. At the Chi position, a Tight pulse indicates Yin Cold, definitely Ben Tun (fleeing tumor) or Hernia pain. [Tight indicates Cold and Pain; Renying Tight indicates Cold injury, Qikou Tight indicates Food injury.]
The Tight pulse's tautness and urgency resemble the Wiry pulse, but is more taut and twists like a rope. [Zhong E Floating-Tight and Cough Deep-Tight both indicate death.]
[Relaxed Pulse] The Relaxed pulse belongs to Yin. The Relaxed pulse has four beats per respiration, moving harmoniously, like a gentle breeze on felt or willows in early spring.
The Relaxed pulse indicates Ying decline and Wei excess, or Wind, Dampness, or Spleen deficiency. Upward it causes neck stiffness; downward it causes flaccidity/Bi. Differentiate by Floating/Deep, Large/Small.
At the Cun position, a Relaxed pulse indicates Wind pathogen causing neck/back constraint. At the Guan position, it indicates Wind vertigo and Stomach deficiency. At the Shenmen position, it indicates loose stools or Wind constipation, or staggering gait. [Floating-Relaxed is Wind, Deep-Relaxed is Damp, Relaxed-Large is Qi deficiency, Relaxed-Fine is Damp-Bi, Relaxed-Choppy is Spleen deficiency, Relaxed-Weak is Qi deficiency.]
A Relaxed pulse that is harmonious, neither Floating nor Deep, neither Large nor Small, neither Rapid nor Slow, responsive and neutral, joyful and leisurely, is the True Stomach Qi pulse. All pulses must contain Relaxedness, called Stomach Qi. Spring pulse slightly Wiry, Summer pulse slightly Surging, Autumn pulse slightly Hairy, Winter pulse slightly Solid are all Normal pulses. Only obtaining the Zang pulse alone, such as purely Wiry, Surging, Hairy, or Stone-like, without Stomach Qi to harmonize, reveals the True Zang pulse, indicating death. Thus, "With Stomach Qi there is life; without Stomach Qi there is death." Therefore, the Relaxed pulse does not indicate disease itself; only by examining accompanying pulses can disease be diagnosed.
[Wiry Pulse] The Wiry pulse belongs to Yin within Yang. The Wiry pulse resembles a lute string, light, void, slippery, straight, long, and prominent under the finger.
The Wiry pulse corresponds to the East Liver/Gallbladder meridians, indicating fluid retention, Phlegm, Cold/Heat, and Malaria. Differentiate by Floating/Deep, Slow/Rapid; Single/Double indicates severity.
At the Cun position, a Wiry pulse indicates headache and diaphragmatic Phlegm [Left Cun Heart pain]. Cold/Heat masses are observed at Left Guan. Right Guan indicates Stomach Cold and heart/abdominal pain. Chi position indicates Yin hernia and leg cramps.
The Wiry pulse is the image of early spring, when weather is still cold, like a slightly tightened string. The Long pulse is the image of late spring, pure Yang without cold, like a straight tree trunk.
Wiry and soft indicates mild disease; Wiry and hard indicates severe disease. Both Guans Wiry is called Double Wiry; if unable to eat, Wood attacks Earth, Earth is ruined, and it is incurable.
[Agitated Pulse] The Agitated pulse belongs to Yang. The Agitated pulse has no head or tail, shape like a bean, trembling, always accompanying Slippery and Rapid qualities.
The Agitated pulse governs pain and fright. Sweating due to Yang agitation [anterior to Guan is Yang], Heat due to Yin agitation [posterior to Guan is Yin], or diarrhea/dysentery and cramps. Men suffer essence loss; women suffer uterine bleeding.
The Classic states: "If the woman's Hand-Shaoyin Agitated pulse is pronounced, she is pregnant." The Agitated pulse droops at both ends and protrudes in the middle, resembling the Short pulse, but the Short pulse is Yin, not Rapid/Hard/Slippery, whereas the Agitated pulse is Yang, and is Rapid, Hard, and Slippery.
[Interrupted Pulse] The Interrupted pulse belongs to Yang. The Interrupted pulse is hurried, pausing occasionally during Rapid beats, like running and stumbling; progression leads to death.
The Interrupted pulse treats Fire diseases [Left Cun Heart Fire, Right Cun Lung Fire]. Analyze Qi, Blood, Phlegm, Food, and Fluids [Right Guan Food stagnation, Left Guan Blood stagnation]. Frequent wheezing/cough indicates Phlegm accumulation; mania, macules, or toxic abscesses may occur.
[Knotted Pulse] The Knotted pulse belongs to Yin. The Knotted pulse is condensed, pausing occasionally during Slow beats, moving slowly and substituting, capturing the essence.
The Knotted pulse is Slow with occasional pauses; Turbid Yin prevails, threatening Yang loss. Floating indicates Qi stagnation; Sinking indicates accumulation. Sweat or purge methods must be chosen wisely.
The Knotted pulse arises from Qi and Blood coagulation, old Phlegm stagnation causing groaning. Internal accumulations/masses separate into carbuncles/abscesses; hernias/masses cause harm, belonging to Yin syndromes.
Floating layer Knotted is Yang Knotted; Sinking layer Knotted is Yin Knotted. Knotted and forceful square-shaped indicates accumulation; Knotted and forceless indicates true Qi decline, requiring warming and tonification.
[Substitute Pulse] The Substitute pulse belongs to Yin. The Substitute pulse is alternating, pausing at regular intervals, unable to return immediately, moving again after a long time.
The Substitute pulse originates from Zang Qi decline, abdominal pain, diarrhea, and Lower Yuan deficiency. Or it indicates vomiting/diarrhea Middle Jiao disease, or pregnancy in women for three months. Two beats then pause indicates 3-4 days; 3-4 beats then pause indicates 6-7 days; 5-6 beats then pause indicates 7-8 days. Deduce sequentially without error.
Cold Damage palpitations, Cholera confusion, severe trauma, and three-month pregnancy do not forbid the Substitute pulse. Severe pain often shows Substitute pulse; elderly with Substitute pulse survive, young with Substitute pulse die.
[Hollow/Drum-skin Pulse] The Hollow pulse belongs to Yin within Yang. The Hollow pulse is Large, Wiry, and Urgent, obtained upon light palpation, empty upon pressing, like a drum skin.
The Hollow pulse feels like pressing a drum skin; Kou and Xian combine indicating Cold and Deficiency. Women suffer miscarriage and metrorrhagia; men suffer Ying deficiency or nocturnal emissions.
Both Hollow and Firm pulses are Large and Wiry; Hollow is Floating, Firm is Deep; Hollow is Deficient, Firm is Excess; forms and symptoms differ. Three-position Hollow pulse: chronic illness leads to death, acute illness leads to survival.
[Firm Pulse] The Firm pulse belongs to Yang within Yin. The Firm pulse is in the Sinking layer, Large, Wiry, and Solid; Floating and Middle layers yield nothing.
Cold makes Firm and solid with Interior Excess. Abdominal/heart Cold pain due to Wood attacking Spleen. What harm do hernias/masses do? But avoid in Blood loss and Yin deficiency.
Both Firm and Hidden pulses are in the Sinking layer, but Hidden requires pushing sinews to bone to see form; Firm requires slight heavy pressure to feel full-force under fingers.
[Scattered Pulse] The Scattered pulse belongs to Yin. The Scattered pulse is Floating and Chaotic, having exterior but no interior, Middle layer gradually empty, extinct upon pressing. [Gradually heavier yields less, gradually lighter yields more.]
The Scattered pulse flies like scattered catkins, coming and going不定ly, difficult to align. Childbirth indicates life sign, fetus indicates abortion; chronic illness meeting this need not treat.
Left Cun palpitations, Right Cun sweating. Overflowing drink at Left Guan should be Soft-Scattered. Right Guan Soft-Scattered indicates edema. Scattered at both Chi positions indicates soul severance.
The Scattered pulse is the diagnosis of Kidney extinction; the Substitute pulse is the diagnosis of Spleen extinction. The Kidney pulse is naturally Deep, but Scattered is undetectable upon pressing, extinguishing the先天 (Pre-heaven) origin. The Spleen pulse governs trust/timing, but Substitute pauses without missing its period, extinguishing the 后天 (Post-heaven) generation.
[Scallion-stem Pulse] The Scallion-stem pulse belongs to Yin within Yang. Kou is a plant name, resembling green onions, present in Floating and Sinking layers, but empty in the Middle layer.
The Kou shape is Floating, Large, and Soft like a scallion; pressing sides are full but center is empty. Fire invading Yang meridians causes upper bleeding; Heat soaking Yin collaterals causes lower red flow.
Cun Kou indicates blood loss in the chest. Meeting Kou at Guan indicates empty Blood organs. Seeing Kou at Chi indicates lower bleeding, red strangury, red dysentery, leakage, and metrorrhagia.
Ying flows within vessels; vessels take Blood as form. The Kou pulse is empty in the center, the image of blood loss.
[Hidden Pulse] The Hidden pulse belongs to Yin. The Hidden pulse is concealed, deeper than Sinking, requiring pushing sinews to bone to obtain form.
The Hidden pulse indicates Cholera with frequent vomiting. Abdominal pain is mostly due to retained food. Retained fluids and old Phlegm form accumulations. Disperse Cold and warm the Interior without delay.
Food stagnation in the chest causes Hidden pulse at both Cuns. Wanting to vomit but unable, constantly unsettled. Guan position abdominal pain is heavy and deep. Posterior Guan hernia pain breaks the abdomen.
Cold Damage wanting to vomit indicates Yang is about to resolve. Cold limbs and abdominal pain indicate Yin syndrome.
[Hasty Pulse] The Hasty pulse belongs to Yang. The Hasty pulse is urgent, the extreme of Rapid, beating seven to eight times per respiration, pulse flow thin and rapid.
The Hasty pulse indicates Yang extremity and Yin extinction. The pulse is called Li Jing (departing from the vessel), soul and spirit separate. Gradual progression to Hasty indicates Hyperactive Fire; death occurs within morning and evening.
Strange Pulses Sparrow-pecking comes four or five pecks continuously [pauses after 3-5 beats, then resumes, like a sparrow pecking food]. House-leak falls a drop after a short while [one beat after a long time, like water dripping from a leaking roof]. Striking stones come hard and scatter quickly [coming from between bones crackling, like fingers striking stones]. Falling fingers scatter like untying a rope [scattered like untied cords]. Fish-swimming seems present yet absent [floating suddenly sinks once, like fish swimming, seeming present yet absent]. Minnow-swimming suddenly leaps in stillness [still suddenly becomes vigorous, like a minnow leaping in still water]. Tell physicians to look carefully; seeing one of the six pulses, do not administer medicine.
True Zang Pulse When the True Zang pulse appears, the time of death is decided.
Liver disease shows Wiry pulse, Wiry and taut like touching a blade edge; True Liver pulse appears. Geng day worsens, Xin day dies, dying at Shen/You hours. Heart disease shows Surging pulse, Surging and turbulent like holding a belt hook; True Heart pulse appears. Ren day worsens, Gui day dies, dying at Hai/Zi hours. Spleen disease shows Soft pulse, coming like a leaking roof or flowing water, relaxed without pulsation; True Spleen pulse appears. Jia day worsens, Yi day dies, dying at Yin/Mao hours. Lung disease shows Choppy pulse, Choppy and light/short like wind blowing feathers; True Lung pulse appears. Bing day worsens, Ding day dies, dying at Wu/Si hours. Kidney disease shows Stone pulse, Stone and pounding like a sparrow pecking; True Kidney pulse appears. Wu day worsens, Ji day dies. Dies at Chen/Xu/Chou/Wei hours. Those who pass the time, Cang Gong said they can eat.