脉有要诀，胃、神、根三字而已。人与天地相参，脉必应乎四时。而四时之中，均以胃
气为本。如春弦、夏洪、秋毛、冬石，而其中必兼有和缓悠扬之意，乃为胃气，谓之平人。
若弦多胃少，曰肝病；洪多胃少，曰心病；毛多胃少，曰肺病；石多胃少，曰肾病。如但见
弦、洪、毛、石，而胃气全无者，则危矣。夫天有四时，而弦、洪、毛、石四脉应之，四时
之中，土旺各十八日，而缓脉应之。共成五脉，五脏分主之。如肝应春，其脉弦；心应夏，
其脉洪；肺应秋，其脉毛；冬应肾，其脉石；脾土应长夏，其脉缓也。然而心、肝、脾、肺
、肾虽各主一脉，而和缓之象必寓乎其中乃为平脉，否则即为病脉。若但见弦、洪、毛、石
而胃气全无者，即为真象脉见矣。凡诊脉之要，有胃气曰生，胃气少曰病，胃气尽曰不治
乃一定之诊法，自古良工，莫能易也。
夫胃气全亏，则大可危。胃气稍乖，犹为可治，即当于中候求其神气。中候者，浮、中、沉
之中也。如六数、七极，热也，中候有力，则有神矣。三迟、二败，寒也，中候有力，则有
神矣。脉中有神则清之而热即退，温之而寒即除。若寒热偏胜，中候不复有神，清温之剂将
虽然，神气不足，犹当察其根气。根气者，沉候应指是也。三部九候，以沉分为根，而
两尺又为根中之根也。《脉诀》云∶寸关虽无，尺犹未绝，如此之流，何忧殒灭。历试之，
洵非虚语。夫人之有脉，如树之有根，枝叶虽枯，根蒂未坏，则生意不息。是以诊脉之法，
必求其根以为断，而总其要领，实不出胃、神、根，三者而已。
如或胃、神、根三者，稍有差忒，则病脉斯见。其偏于阳，则浮、芤、滑、实、洪、数
、长、大、紧、革、牢、动、疾、促以应之；其偏于阴，则沉、迟、虚、细、微、涩、短、
小、弦、濡、伏、弱、结、代、散以应之。惟有缓脉，一息四至，号曰平和，不得断为病脉
耳。其他二十九字，皆为病脉。必细察其形象，而知其所主病。其曰浮，不沉也，主病在表
沉，不浮也，主病在里。迟，一息三至也，为寒。数，一息五至也，为热。滑，往来流利
也，为痰、为饮。涩，往来滞涩也，为血少气凝。虚，不实也，为劳倦。实，不虚也，为邪
实。洪，大而有力也，为积热。大，虚而无力也，为体弱。微，细而隐也，小，细而显也，
为气少。弦，端直之象也，为水饮。长，过乎本位也，为气旺。短，不及本位也，为气少。
紧，如引绳转索也，为寒、为痛。弱，微细之甚也，为气血两亏。濡，沉而细也，为真火不
足。动，如豆粒动摇之象也，为气血不续。伏，脉不出也，为寒气凝结，又或因痛极而致。
促，数时一止也，为热盛。结，缓时一止也，为寒盛。芤，边有中无也，为失血。代，动而
中止，有至数也，亦为气血不续，又为跌打闷乱，以及有娠数月之兆。革，浮而坚急也，为
精血少。牢，沉而坚硬也，为胃气不足。疾，数之甚也，为极热。散，涣而不聚也，为卫气
散漫。惟有缓者，和之至也，为无病。其所主病，大略如此。如或数脉相参而互见，则合而断之，以知其病。
至于脉有真假，有隐伏，有反关，有怪脉，均宜一一推求，不可混淆。何谓真假？如热
证脉涩细，寒证反鼓指之类。何谓隐伏？如中寒腹痛，脉不出。又外感风寒，将有正汗，亦
脉不出。书云∶一手无脉，曰单伏；两手无脉，曰双伏。何谓反关？正取无脉，反在关骨之
上，或见于左，或见于右，诊法不可造次。何谓怪脉？两手之脉，如出两人，或乍大乍小，
迟数不等，此为祟症。
又有老少之脉不同，地土方宜不同，人之长短肥瘦不同，诊法随时而斟酌。然而脉证相
应者，常也。脉证不相应者，变也。知其常而通其变，诊家之要，庶不相远矣。然总其要领
总不出胃、神、根三字。三字无亏，则为平人。若一字乖违，则病见矣。若一字全失，则
危殆矣。必须胃、神、根三者俱得，乃为指下祯祥之兆。此乃诊家之大
法，偶为笔之于书，以备参考。
The key essentials of pulse diagnosis can be summarized in just three characters: "Stomach Qi" (Wei Qi, the nourishing energy derived from digestion), "Spirit" (Shen, the vitality and responsiveness of the pulse), and "Root" (Gen, the deep-seated foundation of the pulse). Humans are interconnected with Heaven and Earth, and the pulse must correspond to the four seasons. Among the four seasons, Stomach Qi serves as the fundamental basis. For instance, in spring the pulse is wiry (Xian), in summer it is surging (Hong), in autumn it is floating/hairy (Mao), and in winter it is stone-like/deep (Shi); however, within these seasonal pulses, there must be a harmonious and gentle quality, which indicates the presence of Stomach Qi, defining a healthy individual (Ping Ren). If the wiry quality predominates while Stomach Qi is scant, it indicates Liver disease; if the surging quality predominates while Stomach Qi is scant, it indicates Heart disease; if the floating quality predominates while Stomach Qi is scant, it indicates Lung disease; if the stone-like quality predominates while Stomach Qi is scant, it indicates Kidney disease. If only the wiry, surging, floating, or stone-like qualities are seen without any trace of Stomach Qi, the condition is critical.
Heaven has four seasons, corresponding to the wiry, surging, floating, and stone-like pulses. Within each season, Earth energy peaks for eighteen days, corresponding to the slow/moderate pulse (Huan). Together, these form five pulses, governed by the Five Zang Organs. The Liver corresponds to Spring with a wiry pulse; the Heart corresponds to Summer with a surging pulse; the Lungs correspond to Autumn with a floating pulse; the Kidneys correspond to Winter with a stone-like pulse; and Spleen Earth corresponds to Late Summer with a moderate pulse. Although the Heart, Liver, Spleen, Lungs, and Kidneys each govern one specific pulse type, the quality of moderation and gentleness must be inherent within them to constitute a normal pulse; otherwise, it is a pathological pulse. If only the wiry, surging, floating, or stone-like qualities are observed without any Stomach Qi, this represents the manifestation of True Zang Pulses (Zhen Zang Mai). The essential principle of pulse diagnosis is: presence of Stomach Qi indicates life, scarcity of Stomach Qi indicates disease, and absence of Stomach Qi indicates untreatable conditions. This is an immutable diagnostic law that no skilled physician since antiquity has been able to alter.
If Stomach Qi is completely depleted, the situation is highly dangerous. If Stomach Qi is slightly disturbed, it remains treatable; in such cases, one should seek the "Spirit" at the Middle Level (Zhong Hou) of pressure. The Middle Level refers to the intermediate pressure between superficial (Fu), middle (Zhong), and deep (Chen) palpation. For example, a pulse rate of six or seven beats per breath indicates Heat; if the Middle Level feels forceful, it possesses Spirit. A pulse rate of three or two beats per breath indicates Cold; if the Middle Level feels forceful, it also possesses Spirit. When the pulse contains Spirit, clearing methods will resolve Heat, and warming methods will dispel Cold. However, if Cold or Heat dominates excessively and the Middle Level lacks Spirit, although clearing and warming agents may be administered, due to insufficient Spirit, one must examine the "Root Qi". Root Qi refers to the sensation felt at the Deep Level (Chen Hou). In the Three Regions and Nine Positions method, the Deep Level constitutes the Root, and the two Chi positions (at the wrist) are the root of the root. As stated in the *Mai Jue* (Pulse Classic): "Even if the Cun and Guan positions lack a pulse, if the Chi position is not exhausted, why worry about death?" Repeated verification confirms this is not empty talk. Human pulses are like tree roots; even if branches and leaves wither, as long as the rootstock remains intact, the vitality continues. Therefore, the method of pulse diagnosis must seek the Root for judgment. Summarizing the essentials, they do not exceed the three factors: Stomach Qi, Spirit, and Root.
If there is any deviation in Stomach Qi, Spirit, or Root, pathological pulses will appear. Those biased towards Yang include floating (Fu), knotted/empty (Kou), slippery (Hua), excess/solid (Shi), surging (Hong), rapid (Shu), long (Chang), large (Da), tight (Jin), leathery (Ge), firm (Lao), moving (Dong), swift (Ji), and hurried/cessating (Cu). Those biased towards Yin include deep (Chen), slow (Chi), deficient (Xu), fine/thin (Xi), minute (Wei), choppy (Se), short (Duan), small (Xiao), wiry (Xian), soft/limp (Ru), hidden (Fu), weak (Ruo), intermittent (Jie), alternating (Dai), and scattered (San). Only the moderate pulse (Huan), beating four times per breath, is termed peaceful and cannot be diagnosed as pathological. The other twenty-nine pulse types are all pathological. One must carefully observe their characteristics to determine the associated diseases. Floating means not sinking, indicating exterior disease; Deep means not floating, indicating interior disease. Slow is three beats per breath, indicating Cold. Rapid is five beats per breath, indicating Heat. Slippery flows smoothly, indicating Phlegm or Fluid Retention. Choppy flows sluggishly, indicating Blood deficiency and Qi stagnation. Deficient is not solid, indicating fatigue from overwork. Excess is not deficient, indicating Pathogenic Excess. Surging is large and forceful, indicating accumulated Heat. Large is deficient and forceless, indicating physical weakness. Minute is fine and faint; Small is fine and distinct, both indicating Qi deficiency. Wiry is straight and rigid, indicating Water-Fluids. Long extends beyond its normal position, indicating abundant Qi. Short does not reach its normal position, indicating Qi deficiency. Tight feels like twisting rope, indicating Cold or Pain. Weak is extremely fine and thin, indicating dual deficiency of Qi and Blood. Soft is deep and fine, indicating insufficiency of True Fire. Moving resembles a rolling bean, indicating discontinuity of Qi and Blood. Hidden does not surface, indicating congealed Cold or extreme pain. Hurried is rapid with occasional pauses, indicating Excessive Heat. Intermittent is slow with occasional pauses, indicating Excessive Cold. Knotted is hollow on the sides but empty in the center, indicating blood loss. Alternating stops during movement with regular intervals, also indicating discontinuity of Qi and Blood, or appearing after trauma, mental distress, or as a sign of pregnancy after several months. Leathery is floating and hard/tense, indicating deficiency of Essence and Blood. Firm is deep and hard, indicating insufficiency of Stomach Qi. Swift is extremely rapid, indicating Extreme Heat. Scattered is dispersed and uncollected, indicating dissipation of Defensive Qi. Only the Moderate pulse represents perfect harmony and indicates health. The diseases indicated are roughly as described above. If multiple pulse types coexist, they should be analyzed together to diagnose the illness.
Regarding pulse phenomena, there are true/false pulses, hidden pulses, reversed-gate pulses, and strange pulses, all of which require careful differentiation to avoid confusion. What are true/false? For example, a heat syndrome presenting with choppy/fine pulses, or a cold syndrome presenting with a forceful/pounding pulse. What are hidden pulses? For instance, in abdominal pain due to internal Cold, the pulse may not be palpable. Or in external contraction of Wind-Cold, before the appearance of proper sweating, the pulse may also be absent. Texts state: absence of pulse in one hand is called Single Hidden (Dan Fu); absence in both hands is called Double Hidden (Shuang Fu). What is a reversed gate? When the pulse is not found at the standard location but appears above the Guan bone, either on the left or right side, diagnosis requires caution. What are strange pulses? When the pulses in both hands seem to come from two different sources, varying suddenly in size or speed, this indicates a demonic affliction.
Furthermore, pulses differ between the young and old, vary according to local geography and climate, and differ based on a person's height and build; thus, diagnostic methods must be adapted accordingly. However, when pulse and symptoms correspond, it is the norm; when they do not correspond, it is a variation. Understanding the norm and mastering the variation is the essence of pulse diagnosis. Nevertheless, the core essence remains the three characters: Stomach Qi, Spirit, and Root. If these three are intact, the person is healthy. If one deviates, disease manifests. If one is entirely lost, the condition is critical. Only when Stomach Qi, Spirit, and Root are all present does it signify a auspicious sign under the fingers. This is the great method of pulse diagnosis, recorded here for reference.