滑伯仁曰∶人之为病，虽曰不过寒热虚实四者，而脉多兼见也。热则流通，凡浮大数长，皆热也；寒
则坚凝，凡沉小迟短，皆寒也。实则形刚，凡实滑弦紧，皆实也；虚则形柔，凡虚涩濡缓，皆虚也。他如《难
经》所谓一阴一阳者，脉来沉而滑；一阴二阳者，脉来沉滑而长；一阴三阳者，脉来浮滑而长，时一沉也；一
阳一阴者，脉来浮涩；一阳二阴者，脉来长而沉涩；一阳三阴者，脉来沉涩而短，时一浮者，尽皆兼见义也。
浮而有力则为风，
风包四气而言∶如浮缓浮弦则为伤风，浮紧则为伤寒，浮虚则为伤暑，浮濡则为伤湿。四气在表皆浮，更
与人迎相应，则为外感在经无疑。
浮而无力斯为虚；
经曰∶诸浮者，肾不足也，瞥瞥有如羹上肥，定知此脉阳气微。乍病见浮脉，乃伤风邪，
久病宜沉反见浮脉，里寒表热也。然必与气口相应，则为内伤，气血虚损。
浮数风热微欲解，
浮数，伤风挟热也。带微者，邪不传而欲解。
浮迟身痒汗亦无；
里虚不能作汗，其身必痒。
独浮喘胀表中热，
表邪盛，故气逆喘胀。
浮紧滑疾百合辜；
百合，伤寒病也。
浮大隐疹久为癞，
浮为风虚，大为气强，风气相搏，必成瘾疹发痒，久久为癞。
浮滑痰饮痛如锥。
浮滑为风痰，为走刺疼痛。
沉而有力则为积，
凡脉浮盛为病，在表在外；沉坚为病，在里在内。
无力应和气不平；
沉为诸郁。
为水为泄为厥逆，停饮胁胀兼 瘕；沉数里寒内热盛。
与人迎相应，则邪伏阴经而为实热。
沉迟血冷里寒生；
与气口相应，则血凝气滞而为沉寒。
沉重伤暑弱堕发，
沉重为伤暑发热。沉弱者，发必堕落。
沉弦腹心冷痛并；沉紧而数冷又热，沉紧不数悬饮成；
沉细少气臂不举，
两寸则两臂不举。
沉重前绝瘀血凝。
沉重，如重物沉水，不复浮起，故冬脉曰石。直前绝者，有瘀滞也。
迟而无力虚且寒，
与人迎相应，则湿寒凝滞；与气口相应，则虚冷沉积。
迟而有力痛为害；
或心痛，或腹痛，或胁痛。
应尺血虚寸气虚，
寸口得之为气虚，尺中得之为血虚，总是肾虚不安。亦有痰凝气滞，伏热蹇涩而然者，必寻之无力，乃
为真迟。
迟沉寒内浮寒外；
脉迟沉或芤，寒在里则腹痛。迟浮，寒在表则肢冷。
迟涩咽酸 瘕成，
迟涩则湿热凝滞，或为咽酸，或为 瘕。
迟滑腹中觉胀大；
迟而滑为腹胀。
惟有季夏及左尺，逢此便是肾经败。
季夏，六月也。此时得迟脉，则土旺水亏，须急滋肾水以救之。非六月而左尺见迟脉者，亦为土克水，
须急滋补以救之。
数而有力则为热，
与人迎相应，则风燥热烦。
无力疮疡痛痒亟；
平人遇此，主即发疮疡痈疽，年幼者或发疹痘。
若还细数又无力，阴虚火动休轻视；
与气口相应，则阴虚阳盛。甚者左右俱细数无力，或左尺寸数尤甚。
数浮火炎烦且满，
数浮，表有热也。数为烦满。
数沉里热不须议；
数沉，里有热也。
上见烦热与头疼，中为口嗅兼呕逆；左则目赤肝火炎，右下二便秘而赤；数而带滑痰火盛，或为呕吐或
痛极。
滑脉为实为停痰，
滑为气血实，与人迎相应，则风痰潮溢；与气口相应，则涎饮凝滞。
或为瘀血宿食兼；为满为咳为鬼疰，不匀气逆呕涎粘；
滑而大小不匀，必吐，为病进。滑为逆气。
滑浮大小腹作痛，
滑浮者，大小腹皆痛。
滑弱阴痛溺如挽；
滑弱则阴中痛，小便亦然。
滑散瘫痪不仁症，
痰多气血少也。
滑实胃热非廉纤。
滑实为胃热，带数则为结热。非廉纤者，言热重也。
涩为不足伤精血，
与气口相应，则精竭血枯。
为厥为痢为恶寒；
涩为四肢逆冷，为下痢，为恶寒。涩细则大寒。
或为无汗为心痛，
涩为无汗，为心痛。
涩芤瘀血结成团；
涩芤为衄血，或为失血。
涩紧为痹因寒湿，
涩而紧为痹，为寒湿，为中雾露。
涩沉之病亦一般；
涩沉亦为寒湿，与人迎相应，则风湿寒痹。
妇人有孕胎中痛，无孕还须败血成。
大为病进脉之贼，
经曰∶脉来浑浑革革如涌泉者，病进而危。昔人以秋潮之汹涌者，状其大也。要之即非时而见洪大脉也。
浮大表病沉里厄∶
经曰∶大则病进。浮大表病，沉大里病。浮大昼加昼死，沉大夜加夜死。
前大后小头痛眩，前小后大胸满塞；
《难》曰∶前大后小，头痛目眩；前小后大，胸满短气。前谓寸，后谓尺。
气愈盛兮血愈虚，
大为血虚而气盛。
必缓而大为正脉。
中缓而大者为正脉。
缓为正复脉之本，
缓为胃气将复，为病退。
非时得之气血虚；
非土旺之时单见缓脉，则气血虽和，而投虚身必倦怠。
在上项强下脚弱，
寸缓项强，尺缓脚弱。
沉缓眩晕浮痹肤；
沉缓为虚，故眩晕；浮缓风寒，故麻痹。
带滑为热紧为痛，
缓滑为热中，缓紧为脾疼。与人迎相应，则风热入脏；与气口相应，则怒极伤筋。
缓迟虚冷咽难哺；
缓迟为虚寒相搏，食冷则咽痛；
缓弱吞酸食不下，
缓者，胃气有余；弱者，阳气不足。胃欲消化而阳气不运，故噫而吞酸，食卒不下，填于胸膈也。
左尺单见命将殂。
左尺肾部，单见缓脉，全无沉滑，为土盛水亏，不治。
以上八脉，《内经》谓之八要。盖浮沉二脉以别其表里，迟数二脉以别其寒热，滑涩二脉以察气血虚实，
大缓二脉以察病之安危。苟能得其要领，杂脉可以类推。
洪为胀痛为热烦，
为胀满，为头痛及遍身疼痛，为热，为烦，大便不通。
洪实为癫洪大祟；
洪实者癫，洪大者祟。
洪紧痈疽喘急粗，
洪紧与气口相应，则气攻百脉，为痈疽，为喘急，亦为胀。
洪浮阳邪症来见。
洪浮与人迎相应，则寒壅诸阳，外见阳症，大小便秘。
实为伏热咳且吐，
实与人迎应，则风寒贯经，郁热在内，熏
蒸脾胃不食，气喘作咳，或时呕吐。
实涩气塞痢且坠；
实涩与气口相应，则气血壅滞，为三焦痞塞，食积湿热成痢，里急后坠。
实紧作泄胃家寒，或时腰痛亦难住。
实紧为阴不胜阳，为胃寒，为大便不禁，为腰痛。
弦为血弱有劳伤，
弦乃肝部本脉，见于他部，则为血虚。主盗汗，手足酸疼，皮毛枯槁。
中虚且寒停饮浆；
弦与气口相应，则饮水停积，令人中虚寒。
胸胁疼痛体拘急，
与人迎相应，则风走注痛，甚者四肢拘急，冷痹。
疟疾寒热善惊惶；
为疟为惊。
弦紧恶寒疝癖病，
经络中有寒故也。
上下左右积弦长；
弦而长，为上下左右有积。
弦钩胁下痛如刺，
弦而钩，为胁下刺痛。
双弦急痛转难当。
双弦为胁下急痛，乃无水以缓之也。
紧则为寒为疼痛，
与人迎相应，则经络伤寒；与气口相应，则脏腑作痛。
为咳为喘为满胸；人迎紧盛伤寒症，
人迎紧盛，为伤寒。
气口紧盛食冲冲；
气口紧盛，为伤饮食。
紧沉必知痛在腹，恐成冷气与痫风；紧数寒热相来往，
紧而数，为寒热往来。
紧滑宿食吐蛔虫；
紧滑为蛔动，为宿食吐逆。
紧急遁尸乱血脉，
紧而急，为遁尸。
单紧而浮肺水攻；
浮紧为肺经有水。
浮沉俱紧中雾露，头项强急溺妄通。
浮紧，或寸紧，则雾露中于上焦。见太阳症发热，头项强痛，腰挛胫酸。沉紧，或尺紧，则雾露中于
下焦。见少阴症足冷，便溺妄出，为难治。若浮沉俱紧，三焦俱中其邪，脐痛，手足冷者死；手足温，自吐利
者生。
长为阳毒入脏深，热闭阳明烦莫禁；坐卧不安身壮热，
长脉来去不绝，见于左关人迎之位，感于阳邪热毒，在心肝二经。传之下焦，其热壅闭，乃阳淫热痰，
主浑身壮热，坐卧不安。表证多则微汗，里证多则下之。又，尺寸俱长者，阳明本脉也。
长大癫痫更迷心；
长大则为癫狂痫疾，乃痰热迷于肝心所致。
长缓微邪犯下体，
与人迎相应，则微邪自愈；与气口相应，则脏气平治。
寸长足胫痛相侵。
经曰∶长而缓者、病在下。又云∶寸口中手长者，足胫痛。
芤主血瘀不流通，
芤与人迎相应，则邪壅吐衄；与气口相应，则荣虚妄行而为瘀滞。
热入小肠淋沥脓；
心主血则不受邪，故热入小肠，淋沥脓血疼痛。
崩漏衄吐随所主，
寸芤则为衄血吐血，关芤则为便血，尺芤则下虚有瘀，崩漏尿血。
芤紧或数肠内痈。
芤紧或挟洪数者，主荣脉留滞于肠胃之间。多见关部，致生血痈。
微主中寒气血虚，
微与气口相应，则阳虚脱泄。仲景云∶脉萦萦如蛛丝细者，阳气衰也。
为衄为崩为急拘；
衄血，崩漏，四肢拘急。
微浮呕逆分内外，
内伤则为阳虚，外感则为风暑。
微沉自利汗有无；
微沉，阴气已亏，脏寒下利作泄，或虚汗不止，或亡阳无汗。
微弱少气面无色，男精女带共焦枯；
微弱为少气，主男子失精溺血，女子崩中漏下，致面色焦枯。
微涩亡血增寒热，曾经汗下医之辜。
脉微而涩者，病当恶寒，后乃发热。所以然者，医发其汗，令阳气微，又大下之，令阴气弱。阳微恶寒，
阴弱发热，理也。久则夏月恶寒，冬月恶热。盖夏月阳气在外，胃中虚冷，阳气内微，故反恶寒。冬月阳气在
内，胃中烦热，阴气内弱，故反恶热。昼寒夜热，亦此义也。
细为寒湿为胀泄，
细与人迎相应，则诸经中湿，湿则胀满，湿多成泄。
细滑僵仆兼呕热；
细而滑，为僵仆，为呕吐，为发热。
细紧 瘕积聚萦，或为刺痛为痿蹶；
细而紧，为 瘕积聚，为病在内，为刺痛，为身痛痿蹶。叔和云∶胫酸髓冷是也。
内伤得之心神劳，
忧思过度也。
五脏凝涎损气血；
与气口相应，则五脏凝涎，气血俱虚。
惟有冬季为时脉，不疗自痊王氏诀。
冬脉宜沉细而滑，故叔和云∶如逢冬季经霜月，不疗其 必自痊。
濡为亡血为冷痹，
濡为亡血，为冷痹。仲景云∶脉来绵绵，如泻漆之绝，前大后小者，亡其血也。痹亦有因寒湿散漫而
脉濡者，必与人迎应也。
虚汗不止又乏气，
濡为自汗，为气弱。
蒸热飧泄下体重，
濡与气口相应，则飧泄脚弱，骨蒸潮热。
濡弱内热外又寒，其人小便必不利。
濡而弱，内热外冷，自汗小便难。
弱主阳虚胫体酸，
弱乃六极之脉，与人迎相应，则风湿缓纵；与气口相应，则筋绝痿弛。
客风冷气巧相钻；
关上得之主挟风热，关后得之主挟冷气。诀云∶弱主气居于表，产后客风面肿。又云∶只为风邪与气连。
阴弱血虚筋急痛，
尺属阴，主血虚，不能润筋，故筋急能。
阳弱气喘行步难；
寸属阳，主气虚作喘，行步无力。
虚汗泄精成痼冷，少壮得之不等闲。
老年人得弱脉则顺，少壮人得弱脉则逆。
虚则为虚为伤暑，
与人迎相应∶则经络伤暑；与气口相应，则荣卫虚损。
脚弱喘促食不消；
虚为脚弱，为喘促，为食不消。
恍惚惊风皆所主，虚烦多汗亦同条；
虚主心中恍惚，小儿惊风，虚烦自汗。
虚大劳役损元气，
虚而大，为劳役损气。
虚涩房劳肾水焦。
虚而涩，为房劳损精。
革乃虚寒相搏成，崩漏半产亡血精；
仲景云∶脉弦而大，弦则为减，大则为芤，减则为寒，芤则为虚，寒虚相搏曰革。女人半产崩漏，男子亡
血失精。
更是中风兼感湿，为满为急异常情。
与人迎相应，则中风暑湿；与气口相应，则半产脱精。
动脉多见关部中，
仲景曰∶若数脉见于关上，上下无头尾，如豆大，厥厥动摇者，名曰动脉也。
或惊或痛来相攻；
与人迎相应，则寒疼冷痛；与气口相应，则心惊胆寒。
四肢拘挛多疼痛，虚劳血痢与崩中；
动为拘挛，动主体虚劳，崩中血痢。
阳动汗出阴发热，形冷恶寒阳不通；
仲景曰∶阴阳相搏名曰动。言阴阳相搏则虚阳动，为阳虚，故汗出。阴动为阴虚，故发热。如不汗出发
热，而反形冷恶寒者，阳气不通，而致身冷恶寒也。
若见转豆如麻促，此是肺枯胃亦亡。
散脉不聚命将崩，到此无由得再生；
与人迎相应，则淫邪脱泄；与气口相应，则精血败耗。
五脏气散利不禁，六腑气散四肢青。
手足寒，上气。
伏因邪闭成霍乱，
与人迎相应，则寒暑湿邪固闭，而成霍乱。
积疝溏泄贯脓窠；
伏为宿食，为疝瘕，为溏泄，为恶脓贯肌。
寸伏痰热尺寒积，关伏寒热两为 ；
寸得之为痰为热，尺得之为寒为积，关中则痰热俱有，寒热不定。
蓄水停痰气厥逆，
为停痰蓄水，为诸气上冲，为厥逆。
伏涩吐逆神思多。
伏则吐逆，涩则食不得入，关格症也。与气口应者，乃凝思劳神过多，不可专责外邪也。
短为气滞心腹痛，宿食内积三焦壅；
Bo Ren Hua stated: Although human diseases are generally categorized into cold, heat, deficiency, and excess, pulse patterns often present combined characteristics. Heat causes free flow; thus, floating (Fu, superficial), large (Da, expansive), rapid (Shu, fast), and long (Chang, extending beyond the position) pulses all indicate heat conditions. Cold causes firmness and coagulation; therefore, sunken (Chen, deep), small (Xiao, thin), slow (Chi, delayed), and short (Duan, not reaching the position) pulses all indicate cold conditions. Excess manifests as rigid forms; solid (Shi, forceful), slippery (Hua, smooth), wiry (Xian, taut), and tight (Jin, tense) pulses all indicate excess conditions. Deficiency manifests as soft forms; deficient (Xu, empty), choppy (Se, rough), soggy (Ru, floating and fine), and moderate (Huan, relaxed) pulses all indicate deficiency conditions. Furthermore, as described in the *Nan Jing* (Classic of Difficult Issues): "One Yin and One Yang" presents as a sunken and slippery pulse; "One Yin and Two Yang" presents as a sunken, slippery, and long pulse; "One Yin Three Yang" presents as a floating, slippery, and long pulse, occasionally with a sunken beat; "One Yang and One Yin" presents as a floating and choppy pulse; "One Yang and Two Yin" presents as a long, sunken, and choppy pulse; "One Yang Three Yin" presents as a sunken, choppy, and short pulse, occasionally with a floating beat. These all illustrate the meaning of combined pulse presentations.
A floating pulse with strength indicates Wind pathogen;
Wind encompasses the four external climatic factors: a floating-soggy or floating-wiry pulse indicates Wind-Cold injury; a floating-tight pulse indicates Cold injury; a floating-deficient pulse indicates Summerheat injury; a floating-soggy pulse indicates Dampness injury. When the four pathogens are at the exterior, the pulse is always floating. If it corresponds with the *Renying* pulse (carotid artery, indicating exterior/Yang conditions), it is undoubtedly an exterior channel infection.
A floating pulse without strength indicates Deficiency;
The classics state: Various floating pulses indicate Kidney Qi insufficiency; the pulse flickers like fat floating on soup, definitely indicating weak Yang Qi. A newly acquired disease presenting a floating pulse indicates Wind pathogen injury; a chronic disease that should present a sunken pulse but instead shows a floating pulse indicates interior cold and exterior heat. However, if it corresponds with the *Qikou* pulse (radial artery, indicating interior/Yin conditions), it signifies internal injury due to Qi and Blood deficiency.
Floating and rapid pulses indicate slight Wind-Heat about to resolve;
Floating and rapid pulses indicate Wind injury complicated by Heat. If accompanied by a slight quality, the pathogen has not transmitted and is about to resolve.
Floating and slow pulses cause body itching and no sweat;
Interior deficiency prevents sweat production, causing inevitable body itching.
Isolated floating pulse with wheezing and distension indicates intense exterior heat;
Exterior pathogens are abundant, causing rebellious Qi leading to wheezing and distension.
Floating, tight, slippery, and rapid pulses appear in Baihe Disease (Lily Disease);
Baihe Disease is a condition following Cold damage.
Floating and large pulses with hidden rashes becoming leprosy over time;
Floating indicates Wind-Deficiency, Large indicates strong Qi. When Wind and Qi clash, urticaria and itching inevitably occur; prolonged cases develop into leprosy.
Floating and slippery pulses indicate Phlegm-Fluids and pain like awl piercing.
Floating and slippery pulses indicate Wind-Phlegm, manifesting as stabbing pain.
Sunken pulse with strength indicates accumulation;
Generally, floating and vigorous pulses indicate disease in the exterior/external; sunken and firm pulses indicate disease in the interior/internal.
Sunken pulse without strength corresponds to disharmony of harmonious Qi;
Sunken pulses indicate various stagnations.
Sunken pulses indicate Water retention, diarrhea, and reversal cold; fluid retention with hypochondriac distension and masses; Sunken-Rapid pulses indicate interior cold with intense internal heat.
Corresponding with the *Renying* pulse, pathogens lodge in the Yin channels causing excess heat.
Sunken-Slow pulses indicate cold blood and interior cold generation;
Corresponding with the *Qikou* pulse, blood coagulates and Qi stagnates, forming deep cold.
Heavy pulses indicate Summerheat fever; Weak pulses indicate hair loss;
Heavy pulses indicate Summerheat fever. Sunken-weak pulses indicate hair falling out.
Sunken-Wiry pulses indicate cold pain in abdomen and heart; Sunken-Tight-Rapid pulses indicate cold alternating with heat; Sunken-Tight non-rapid pulses indicate hanging fluid formation;
Sunken-Fine pulses indicate shortness of breath and inability to raise arms;
If both Cun positions are sunken-fine, both arms cannot be raised.
Heavy pulses, sinking like a heavy weight without rising, indicate blood stasis coagulation.
"Heavy" resembles a heavy object sinking in water, never rising; hence, the Winter pulse is called Stone pulse. "Straight forward cessation" indicates stasis obstruction.
Slow pulse without strength indicates deficiency and cold;
Corresponding with the *Renying* pulse, damp-cold stagnates; corresponding with the *Qikou* pulse, deficiency-cold accumulates.
Slow pulse with strength causes harm through pain;
This may be heart pain, abdominal pain, or hypochondriac pain.
Slow pulse at Chi indicates Blood deficiency; Slow pulse at Cun indicates Qi deficiency;
A slow pulse at Cun indicates Qi deficiency; at Chi, Blood deficiency. This generally reflects unstable Kidney deficiency. It can also result from Phlegm stagnation, Qi constraint, latent heat, and sluggishness, provided the pulse is found to be weak upon pressure, confirming true slowness.
Slow and sunken indicate cold in the interior; Floating indicates cold in the exterior;
A slow-sunken or knotted pulse with cold in the interior causes abdominal pain. Slow-floating pulse with cold in the exterior causes cold limbs.
Slow-Choppy pulses cause sour throat and mass formation;
Slow-choppy pulses indicate damp-heat stagnation, potentially causing sour throat or abdominal masses.
Slow-Slippery pulses indicate abdominal bloating;
Slow and slippery pulses indicate abdominal distension.
Only in late summer (June) and at the left Chi position, encountering this pulse indicates failure of the Kidney meridian.
Late summer refers to June. Obtaining a slow pulse then indicates Earth prosperity and Water depletion; urgent nourishment of Kidney Water is required. If a slow pulse appears at the left Chi outside of June, it also indicates Earth overcoming Water, requiring urgent tonification.
Rapid pulse with strength indicates Heat;
Corresponding with the *Renying* pulse, Wind-dryness and heat irritability occur.
Rapid pulse without strength urgently indicates sores, ulcers, pain, and itching;
In healthy individuals, this pulse indicates imminent onset of sores, ulcers, or carbuncles; in children, it may indicate rash or smallpox.
If additionally fine, rapid, and without strength, Yin deficiency with Fire hyperactivity must not be overlooked;
Corresponding with the *Qikou* pulse, this indicates Yin deficiency and Yang excess. Severe cases show fine, rapid, and weak pulses on both sides, or especially rapid pulses at the left Cun-Guan-Chi positions.
Rapid-Floating pulses indicate Fire flaming up with irritability and fullness;
Rapid-floating indicates exterior heat. Rapid indicates irritability and fullness.
Rapid-Sunken pulses indicate interior heat,无需 discussion;
Rapid-sunken indicates interior heat.
Upper presentation involves irritability, heat, and headache; middle presentation involves bad breath and vomiting/reversal; left side involves red eyes and Liver Fire flaming up; lower right involves constipation and dark urine; Rapid-Slippery pulses indicate intense Phlegm-Fire, possibly causing vomiting or extreme pain.
Slippery pulses indicate Excess and retained Phlegm;
Slippery pulses indicate abundant Qi and Blood. Corresponding with *Renying*, Wind-Phlegm surges; corresponding with *Qikou*, saliva and fluids stagnate.
It may also involve blood stasis and retained food; causing fullness, cough, or ghost infections; irregular pulse with rebellious Qi, vomiting sticky saliva;
An irregular slippery pulse (varying size) indicates vomiting and disease progression. Slippery pulses indicate rebellious Qi.
Slippery-Floating pulses cause pain in upper and lower abdomen;
Slippery-floating indicates pain in both upper and lower abdomen.
Slippery-Weak pulses cause genital pain and difficult urination;
Slippery-weak pulses cause pain in the yin region and similar urinary symptoms.
Slippery-Scattered pulses indicate paralysis and numbness;
Indicates excessive Phlegm and insufficient Qi and Blood.
Slippery-Solid pulses indicate Stomach Heat, not mild (intense heat).
Slippery-solid indicates Stomach Heat; if accompanied by rapidity, it indicates bound heat. "Not mild" implies intense heat.
Choppy pulses indicate insufficiency damaging Essence and Blood;
Corresponding with *Qikou*, this indicates exhaustion of Essence and withering of Blood.
It causes reversal cold, dysentery, and aversion to cold;
Choppy pulses indicate cold extremities, dysentery, and aversion to cold. Choppy-fine pulses indicate severe cold.
Or it causes lack of sweat and heart pain;
Choppy pulses indicate absence of sweat and heart pain.
Choppy-Knotted pulses indicate blood stasis forming clumps;
Choppy-knotted pulses indicate epistaxis or hemorrhage.
Choppy-Tight pulses indicate Bi syndrome due to Cold-Damp;
Choppy-tight pulses indicate Bi syndrome, Cold-Damp, or exposure to mist/dew.
Choppy-Sunken diseases are similar;
Choppy-sunken also indicates Cold-Damp. Corresponding with *Renying*, it indicates Wind-Cold-Damp Bi syndrome.
In women, pregnancy with fetal pain, or non-pregnancy with failed blood formation.
Large pulses indicate disease progression, the thief of pulses;
The classics state: Pulses coming turbidly and vigorously like a gushing spring indicate disease progression and danger. Ancients compared this to surging autumn tides. Essentially, it is a洪 (Hong, flooding) or large pulse appearing out of season.
Floating-Large indicates exterior disease; Sunken-Large indicates interior distress;
The classics state: Large pulses indicate disease progression. Floating-large indicates exterior disease; sunken-large indicates interior disease. Floating-large worsening during day leads to death by day; sunken-large worsening at night leads to death by night.
Large anterior and small posterior cause headache and dizziness; Small anterior and large posterior cause chest fullness and blockage;
*Nan Jing* states: Large anterior/small posterior causes headache and vertigo; small anterior/large posterior causes chest fullness and shortness of breath. Anterior refers to Cun, posterior to Chi.
Qi becomes more abundant while Blood becomes more deficient;
Large pulses indicate Blood deficiency and Qi abundance.
Moderate and large pulses are the normal pulse.
Moderately moderate and large pulses are the normal pulse.
Moderate pulse is the root of recovery;
Moderate pulses indicate the return of Stomach Qi and disease retreat.
Obtained out of season indicates Qi and Blood deficiency;
If a moderate pulse appears alone when Earth Qi is not prosperous, although Qi and Blood are harmonious, the body will feel fatigued.
At the top, stiff neck; at the bottom, weak legs;
Cun-moderate causes stiff neck; Chi-moderate causes weak legs.
Sunken-Moderate causes dizziness; Floating-Moderate causes skin numbness;
Sunken-moderate indicates deficiency, causing dizziness; floating-moderate indicates Wind-Cold, causing numbness.
Accompanied by slippery indicates Heat; accompanied by tight indicates Pain;
Moderate-slippy indicates Heat in the center; moderate-tight indicates Spleen pain. Corresponding with *Renying*, Wind-Heat enters the zang organs; corresponding with *Qikou*, extreme anger damages tendons.
Moderate-Slow indicates deficiency-cold, difficulty swallowing;
Moderate-slow indicates struggle between deficiency and cold; eating cold food causes throat pain.
Moderate-Weak indicates acid regurgitation and inability to eat;
Moderate indicates surplus Stomach Qi; weak indicates insufficient Yang Qi. The Stomach desires digestion, but Yang Qi fails to transport, causing belching, acid regurgitation, and food stuck in the chest/diaphragm.
Left Chi showing only moderate pulse indicates impending death.
At the Left Chi (Kidney area), a solitary moderate pulse without sunken-slippery qualities indicates Earth excess and Water depletion, which is untreatable.
The above eight pulses are called the Eight Essentials in the *Nei Jing*. Floating and sunken distinguish exterior and interior; slow and rapid distinguish cold and heat; slippery and choppy examine Qi and Blood deficiency/excess; large and moderate examine disease safety/danger. Grasping these essentials allows deduction of complex pulses.
Flooding pulses indicate distension, pain, heat, and irritability;
Causing distension, headache, whole-body pain, heat, irritability, and constipation.
Flooding-Solid indicates mania; Flooding-Large indicates demonic influence;
Flooding-solid indicates mania; flooding-large indicates demonic influence.
Flooding-Tight indicates carbuncles, ulcers, wheezing, and coarse breathing;
Flooding-tight corresponding with *Qikou* indicates Qi attacking all vessels, causing carbuncles, ulcers, wheezing, and distension.
Flooding-Floating indicates Yang pathogen symptoms appearing.
Flooding-floating corresponding with *Renying* indicates Cold obstructing Yang, manifesting exterior Yang symptoms and constipation.
Solid pulses indicate latent heat, cough, and vomiting;
Solid corresponding with *Renying* indicates Wind-Cold penetrating channels,郁 heat inside steaming the Stomach/Spleen, causing anorexia, wheezing, cough, or occasional vomiting.
Solid-Choppy pulses indicate Qi blockage, dysentery, and tenesmus;
Solid-choppy corresponding with *Qikou* indicates Qi and Blood congestion, San Jiao blockage, food stagnation, damp-heat dysentery with tenesmus.
Solid-Tight causes diarrhea and Stomach cold, or persistent lower back pain.
Solid-tight indicates Yin failing to overcome Yang, Stomach cold, uncontrollable defecation, and lower back pain.
Wiry pulses indicate weak Blood and劳伤 (overstrain);
Wiry is the native pulse of the Liver; appearing elsewhere indicates Blood deficiency. It indicates night sweats, soreness/pain in hands/feet, and dry skin/hair.
Center deficiency and cold retain fluids;
Wiry corresponding with *Qikou* indicates retained drinking fluids, causing center deficiency and cold.
Hypochondriac pain and body stiffness;
Corresponding with *Renying*, Wind travels causing pain; severely, limbs become stiff and cold-bi occurs.
Malaria with chills/fever and fright;
Indicates malaria and fright.
Wiry-Tight indicates aversion to cold, hernia, and masses;
Due to Cold in the meridians.
Accumulations above/below/left/right present wiry-long pulses;
Wiry-long indicates accumulations in upper/lower/left/right areas.
Wiry-Hook indicates stabbing pain under ribs;
Wiry-hook indicates stabbing pain under the hypochondrium.
Double wiry indicates unbearable acute pain.
Double wiry indicates acute pain under ribs due to lack of Water to soften it.
Tight pulses indicate Cold and pain;
Corresponding with *Renying*, meridians suffer Cold damage; corresponding with *Qikou*, zang-fu organs hurt.
Causes cough, wheezing, and chest fullness; Renying tight and vigorous indicates Cold damage;
Renying tight/vigorous indicates Cold damage.
Qikou tight and vigorous indicates food impact;
Qikou tight/vigorous indicates dietary injury.
Tight-Sunken definitely indicates abdominal pain, fearing cold gas and epilepsy; Tight-Rapid indicates alternating cold and heat;
Tight-rapid indicates alternating cold and heat.
Tight-Slippery indicates retained food and vomiting roundworms;
Tight-slippy indicates moving roundworms and retained food with vomiting.
Tight-Urgent indicates fleeing corpse disrupting blood vessels;
Tight-urgent indicates fleeing corpse syndrome.
Single tight and floating indicates Lung water attack;
Floating-tight indicates water in the Lung meridian.
Floating and sunken both tight indicate exposure to mist/dew, stiff neck/head, and erratic urination.
Floating-tight, or Cun-tight, indicates mist/dew affecting the Upper Jiao. Symptoms include Taiyang fever, stiff neck/head pain, lumbar cramping, and shin soreness. Sunken-tight, or Chi-tight, indicates mist/dew affecting the Lower Jiao. Symptoms include Shaoyin cold feet and erratic urination, which is difficult to treat. If both floating and sunken are tight, all three Jiaos are affected; umbilical pain and cold limbs indicate death; warm limbs and spontaneous vomiting/diarrhea indicate survival.
Long pulses indicate Yang toxin entering deep into zang organs, heat closing Yangming with uncontrollable irritability; restlessness and high fever;
Long pulses come and go continuously. Appearing at the left Guan/Renying position, it indicates Yang pathogenic heat-toxin affecting Heart and Liver meridians. Transmitting to Lower Jiao, heat blocks, causing Yang excess and phlegm-heat, manifesting as high fever and restlessness. Exterior signs suggest slight sweating; interior signs suggest purgation. Also, long pulses at both Cun and Chi are the native pulse of Yangming.
Long-and-large pulses cause epilepsy and mental confusion;
Long-large pulses indicate mania, epilepsy, and insanity, caused by Phlegm-Heat confusing Liver and Heart.
Long-moderate indicates minor pathogens affecting lower body;
Corresponding with *Renying*, minor pathogens heal themselves; corresponding with *Qikou*, organ Qi balances.
Cun-long invades foot and shin pain.
Classics state: Long and moderate indicates disease below. Also: Long pulse at Cun indicates foot/shin pain.
Knotted pulses indicate stagnant blood flow;
Knotted corresponding with *Renying* indicates pathogen obstruction causing vomiting/epistaxis; corresponding with *Qikou*, Ying deficiency causes reckless movement and stasis.
Heat entering Small Intestine causes dribbling pus;
Heart governs Blood and does not accept pathogens; thus, heat entering Small Intestine causes dribbling pus, blood, and pain.
Metrorrhagia, epistaxis, and vomiting depend on location;
Cun-knotted indicates epistaxis/vomiting blood; Guan-knotted indicates bloody stool; Chi-knotted indicates lower deficiency with stasis, metrorrhagia, and hematuria.
Knotted-Tight or Rapid indicates intestinal abscess.
Knotted-tight or accompanied by flooding-rapid indicates Ying pulse stagnation in intestines/stomach, often seen at Guan, causing blood abscess.
Micro pulses indicate interior cold and Qi/Blood deficiency;
Micro corresponding with *Qikou* indicates Yang deficiency and collapse/diarrhea. Zhongjing said: Pulses thin as spider silk indicate Yang Qi decline.
It causes epistaxis, metrorrhagia, and acute stiffness;
Epistaxis, metrorrhagia, limb stiffness.
Micro-Floating vomiting/reversal distinguishes interior/exterior;
Internal injury indicates Yang deficiency; external contraction indicates Wind/Summerheat.
Micro-Sunken spontaneous diarrhea with or without sweat;
Micro-sunken indicates Yin Qi deficit, cold zang diarrhea, endless deficiency sweat, or Yang collapse without sweat.
Micro-Weak indicates shortness of breath and pale face; men lose essence, women have leukorrhea, both withered;
Micro-weak indicates shortness of breath, men's seminal emission/hematuria, women's metrorrhagia/leukorrhea, leading to withered complexion.
Micro-Choppy indicates blood loss increasing cold/heat, a fault of previous sweating/purging treatment.
Micro-choppy pulses indicate initial aversion to cold followed by fever. This occurs because doctors induced sweating (weakening Yang) and purging (weakening Yin). Weak Yang causes cold aversion; weak Yin causes fever. Prolonged cases cause cold aversion in summer and heat aversion in winter. In summer, Yang is exterior, Stomach is cold/deficient internally, so Yang weakness causes cold aversion. In winter, Yang is interior, Stomach is hot internally, so Yin weakness causes heat aversion. Day cold/night heat follows this logic.
Fine pulses indicate Cold-Damp, distension, and diarrhea;
Fine corresponding with *Renying* indicates dampness in all channels, causing distension and diarrhea.
Fine-Slippy indicates collapse and vomiting with heat;
Fine-slippy indicates collapse, vomiting, and fever.
Fine-Tight indicates masses and accumulations, or stabbing pain and flaccidity;
Fine-tight indicates masses/accumulations, internal disease, stabbing pain, and body pain/flaccidity. Shuhe said: Shin soreness and cold marrow exemplify this.
Internal injury affects Heart Spirit labor;
Excessive worry/thought.
Five Zang condense saliva damaging Qi and Blood;
Corresponding with *Qikou*, Five Zang condense saliva, damaging Qi and Blood.
Only in Winter is it a seasonal pulse, healing without treatment per Wang Shi's formula.
Winter pulses should be sunken, fine, and slippery. Shuhe said: If encountered in frosty winter months, the disease heals spontaneously without treatment.
Soggy pulses indicate blood loss and cold-bi;
Soggy indicates blood loss and cold-bi. Zhongjing said: Pulses continuous like leaking lacquer, large anterior/small posterior, indicate blood loss. Bi can also be soggy due to scattered Cold-Damp, corresponding with *Renying*.
Endless deficiency sweat and Qi fatigue;
Soggy indicates spontaneous sweat and weak Qi.
Steaming fever, undigested diarrhea, and heavy lower body;
Soggy corresponding with *Qikou* indicates undigested diarrhea, weak legs, and bone-steaming tidal fever.
Soggy-Weak indicates internal heat and external cold, with difficult urination.
Soggy-weak indicates internal heat/external cold, spontaneous sweat, and difficult urination.
Weak pulses indicate Yang deficiency and shin/body soreness;
Weak is one of the Six Extremes pulses. Corresponding with *Renying*, Wind-Damp relaxes; corresponding with *Qikou*, tendons fail and flaccidity occurs.
Guest Wind and Cold Qi cleverly penetrate;
Obtained at Guan indicates Wind-Heat complication; obtained behind Guan indicates Cold Qi complication. Formula says: Weak indicates Qi residing at exterior, postpartum guest wind causes facial swelling. Also: Only Wind pathogen connects with Qi.
Yin weakness, Blood deficiency, tendon stiffness and pain;
Chi belongs to Yin, governing Blood deficiency. Inability to moisten tendons causes stiffness.
Yang weakness causes wheezing and difficulty walking;
Cun belongs to Yang, governing Qi deficiency causing wheezing and weak walking.
Deficiency sweat, sperm leakage, forming chronic cold; obtaining weak pulse in youth/adulthood is serious.
Weak pulse is favorable in elderly, unfavorable in youth/adults.
Deficiency pulses indicate deficiency and Summerheat injury;
Corresponding with *Renying*: meridians suffer Summerheat; corresponding with *Qikou*: Ying-Wei deficiency.
Weak legs, wheezing, indigestion;
Deficiency indicates weak legs, wheezing, and indigestion.
Absence of mind, convulsions are all governed by it; deficiency irritability and profuse sweat are same category;
Deficiency governs mental absence, pediatric convulsions, deficiency irritability, and spontaneous sweat.
Deficiency-Large indicates labor damaging Yuan Qi;
Deficiency-large indicates labor damaging Qi.
Deficiency-Choppy indicates sexual excess scorching Kidney Water.
Deficiency-choppy indicates sexual excess damaging Essence.
Leather pulse forms from struggle between deficiency and cold, metrorrhagia, miscarriage, blood/Essence loss;
Zhongjing said: Wiry and large pulse; wiry indicates reduction, large indicates knotted; reduction indicates cold, knotted indicates deficiency. Cold and deficiency struggling is called Leather pulse. Women experience miscarriage/metrorrhagia; men experience blood/Essence loss.
Also Wind-stroke complicated by Dampness, causing fullness and urgency abnormal feelings.
Corresponding with *Renying*, Wind-stroke/Summerheat/Dampness; corresponding with *Qikou*, miscarriage/Essence loss.
Moving pulse mostly appears at Guan;
Zhongjing said: If rapid pulse appears at Guan, without head/tail, bean-sized, trembling, it is called Moving pulse.
Fright or pain attacks;
Corresponding with *Renying*, cold pain; corresponding with *Qikou*, heart fright and gallbladder fear.
Limb spasms and much pain, consumption, bloody dysentery, and metrorrhagia;
Moving indicates spasms; moving indicates consumption, metrorrhagia, bloody dysentery.
Yang moving causes sweat, Yin moving causes fever; body cold and aversion to cold indicates Yang blockage;
Zhongjing said: Yin-Yang struggle is called Moving. Yin-Yang struggle causes deficient Yang to move, leading to Yang deficiency and sweat. Yin moving indicates Yin deficiency and fever. If no sweat but fever, yet body cold and aversion to cold, it indicates Yang blockage causing cold/aversion.
If resembling rolling beans or hemp seeds with rapidity, Lung is withered and Stomach perished.
Scattered pulses do not gather, life is collapsing, no way to regenerate;
Corresponding with *Renying*, evil pathogens cause collapse; corresponding with *Qikou*, Essence/Blood is exhausted.
Five Zang Qi scattered causes uncontrolled diarrhea; Six Fu Qi scattered causes blue limbs.
Cold hands/feet, rebellious Qi.
Hidden due to pathogen closure causes cholera;
Corresponding with *Renying*, Cold/Summerheat/Damp pathogens close tightly, causing cholera.
Accumulations, hernias, loose stools, and pus penetration;
Hidden indicates retained food, hernias, loose stools, and foul pus penetrating muscle.
Cun-hidden indicates Phlegm-Heat; Chi-hidden indicates Cold-Accumulation; Guan-hidden indicates both Phlegm-Heat and Cold-Heat uncertainty;
Cun-hidden indicates Phlegm/Heat; Chi-hidden indicates Cold/Accumulation; Guan-hidden indicates both Phlegm-Heat and uncertain Cold-Heat.
Water retention, stopped Phlegm, Qi reversal cold;
Indicates stopped Phlegm/Water retention, rebellious Qi of all types, reversal cold.
Hidden-Choppy causes vomiting/reversal and excessive thought.
Hidden causes vomiting/reversal; choppy indicates inability to eat, Guan-Ge syndrome. Corresponding with *Qikou*, it is due to excessive thinking/spirit labor, not solely external pathogens.
Short pulses indicate Qi stagnation, heart/abdominal pain; retained food accumulating, San Jiao blockage;