浮脉木漂水上如；迟风数热紧寒居。浮而有力为表实，无力而浮是表虚。水行润下脉来沉，筋骨之间软滑匀。沈迟寒痛沈数热，水蓄气凝是病因。迟来一息至惟三，阳不胜阴气血寒，是司脏病多冷痛，莫把涩虚一例看。数脉一息六至间，阴微阳盛必狂烦，浮为表热沈里热，惟有儿童作吉看。滑脉如珠替替然，往来流利却还前，浮滑多痰沈宿食，如脉调时有孕焉。涩脉短滞往来艰，散止依稀应指间，男主伤精而损血，女非胎病即经难。(原注：如雨沾沙，如刀刮竹，曰涩。)
虚脉无涯类谷空，举之迟大按之松，脉虚身热为伤暑，自汗惊悸又怔仲。实脉指间逼逼强，浮沉皆得大而长，或为阳毒或积食，谵语频频更发狂。长脉迢迢大小匀，反常为病似牵绳，若非阳毒癫痫病，即是阳明热势深。短脉惟寻尺寸中，两头缩缩气不松，浮为血涩沈为痞，寸主头疼尺腹痛。脉来洪盛去还衰，满指滔滔应夏时，病主阴虚阳热甚，若兼泻痢必难医。(原注：洪数俱大而洪有力，微细俱小而微无力。)
微脉轻微瞥瞥乎，按之欲绝有如无，男为劳极气虚候，女作崩中带下医。举如转索切如绳，脉象因之得紧名，总是寒邪来作寇，内为腹痛外身疼。缓脉四至最从容，柳梢袅袅飑轻风，浮缓伤风项背强，沈缓伤湿痿痹同。芤形外实中央空，软而浮大类如葱，火犯阳经血上溢，热侵阴络下流红。弦脉迢迢端直长，肝经木旺土应伤，弦迟寒痛弦数热，疟疾阴疝总难当。(原注：弦为阴为寒。)
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。牢脉常居沉伏间，长而实大又微弦，此属寒凝多腹痛，革虚牢实本相悬。濡脉浮细按须轻，水面浮棉力不禁，或为血虚或受湿，急宜温补救真阴。弱来无力按之柔，柔细而沉不见浮，阳陷入阴气血损，恶寒发热骨痿休。(原注：寸弱阳虚，关弱胃虚，尺弱阴虚。)
散似杨花散漫飞，去来无力至难齐；产为生兆胎为坠，久病逢之不必医。细脉如丝应指来，多因劳损卫荣衰，虚人虚证原为顺，吐衄得之生可回。伏脉推筋著骨寻，指下裁动隐然深；伤寒欲汗阳将解，厥逆脐疼证属阴。动脉摇摇数在关，无头无尾豆形圆；阳动汗多阴动热，为痛为惊不得安。促脉数而时一止，此为阳热欲亡阴，三焦郁火炎炎盛，急服清凉脉自平。结脉缓而时一止，独阴偏盛欲亡阳，浮为气滞沈为积，汗下分明在主张。动而中止不能还，复动因而作代观。此是脏衰难应指，休将促结一例看。(原注：促结之止无定数，代则如期而止。)
七绝脉歌
雀啄连来三五啄(肝绝)，屋漏半日一点落(胃绝)，弹石硬来寻即散(肾绝)，搭指散乱如解索(脾绝)，鱼翔似有亦似无(心绝)，虾游静中一跳跃(大肠绝)，更有釜沸涌如羹(肺绝)，旦占夕死不须药。
妇人脉法
(原注：女子左关弦长而出鱼际者，血盛、思男之候也)。
妇人两尺盛于两寸，常也。若肾脉沉涩，或肝脉沉紧者，经闭不调也。尺脉微迟，为居经，月事三月一下，血气不足也。尺大而旺、搏指有力者，孕也。三部浮沉相等、无他病而经停者，亦孕也(原注：两寸浮大、两关滑利、两尺滑实而带数，此胎脉也)。左寸动滑，左尺实大，为男；右寸动滑，有尺实大，为女(原注：寸动男，尺动女。寸口滑实为男，尺中滑实为女。两寸俱滑实，为双男。两尺俱滑实，为双女。左寸右尺俱滑实，为一男一女)。若体弱之妇，尺内按之不绝，便是有子。月断病多，六脉不病，亦为有子。妇人不月，脉滑而代者，两月胎息也；滑疾而散者，胎已三月也；重手按之滑疾不散者，五月也；妊娠脉实大者，吉；沉细者，难产；脉革者，坠胎；离经者，产期。
小儿脉法
小儿五岁以下，气血未盛，经脉未充，无以别其脉象，故以食指络脉之形于外者察之。食指第一节寅位，为风关；第二节卯位，为气关；第三节辰位，为命关。以男左女有为则。纹色紫曰热，红曰伤寒，青曰惊风，白曰疳疾，淡黄隐隐为无病，黑色曰危。在风关为轻，气关为重，命关为危。脉纹入掌为内钩纹，弯内为风寒，弯外为食积。及五岁以上，乃以一指取寸关尺之处。常以六至为率，加则为热，减则为寒，皆如诊大人法。小儿脉乱、身热、汗出、不食、食即吐出，为变蒸。四末独冷，鼓栗恶寒，面赤气和，涕泪交至，必为痘疹。半岁以下，于额前眉端发际之间，以名中食三指候之，食指近发为上，名指近眉为下，中指为中，三指俱热，外感于风，鼻塞咳嗽；三指俱冷，外感于寒，内伤饮食，发热吐泻。食中二指热，主上热下寒；名中二指热，主夹惊；食指热，主食滞。
小儿惊纹主病歌
指纹何故忽然浮邪在皮肤未足愁。腠理不通为表证，急行疏解汗之瘳(原注：纹直而细者，为虚寒少气，难愈。粗而色显者，为邪干正气，易治。纹中有断续如流珠形者，为宿食)。
若见关纹渐渐沉，须知入里病方深。莫将风药轻相试，合向阳明证里寻。身安定见红黄色，红艳多从寒里得，淡红隐隐本虚寒，莫把深红认为热。关纹见紫热之征，青色为风木所称，伤食紫青痰气逆，三关青黑祸难胜。指纹淡淡亦堪惊，总是先天禀赋轻。脾胃本虚中气弱，切防攻伐损胎婴。关纹涩滞甚因由邪遏阴荣卫气留。食郁中焦痰热炽，不行推荡更何求。纹形弓反里，咳嗽感寒因。纹形弓反外，热痰夹食惊。流珠与长珠，伤食腹痛频。如枪或如针，热痰风不宁。来蛇有湿热，呕逆成疳积。去蛇伤饮食，渴烦而吐泻。形乱如鱼骨，惊痰身发热。形分如水字，饮食有停滞。透关射指中，风热痰结胸。透关直射甲，肝旺脾受克。
名医脉论
凡内伤证，左脉常细而涩，右脉多浮而大(原注：疟病之脉，亦两手不一)。盖阳气下陷，不能生阴，故血枯而左脉细涩；脾胃亏损，不能生金，故气虚而右脉浮大。(张石顽)
凡虚损证脉浮大者，属阳虚；细数者，属阴虚。芤为失血。若两手俱芤，中有一部独弦者，为有瘀蓄未尽，当去其瘀；若见数大者，为火旺；弦数者，为骨蒸，均难治。(张石顽)
虚损转潮热、泄泻，脉短数者，为无胃气，不治；脉小而数者，亦不治。
尺中弦急者，必因房劳发热，若关尺俱弦细而急者，不治。
脉微者薄也，为阳气虚不能卫其外，宜通脉四逆汤；细者小也，为阴血虚不能荣其中，宜当归建中汤。(陈修园)(原注：尺脉微者为里急，禁汗，禁下。)
妇女之脉，两尺涩而不连属者，闭经之象也。
肺气素虚之人，及久嗽伤肺者，偶有感冒微发热、头疼，脉必浮大而虚，切忌服发散药。一发则肺气耗散，不能安卧，只须葱白豆豉汤足矣。
凡脉乍大乍小、时沈时浮者，乃血气虚而随火用事也，宜归脾加减调之。
风寒之脉，左手浮大而紧。温病之脉，右手浮大而数。
凡房劳而眩晕者，左脉涩，而右手关尺必浮弦而长。(萧廉泉)
凡左手寸关浮缓而弦、余脉如常者，乃上部有风热也。
左寸浮大而散，右寸浮涩而短；左关弦软而长，有关缓大而软；两尺沈滑而搏，皆平脉也。
浮脉要尺中有力，为先天肾水可恃，发表无虞。沈脉要右关有力，为后天脾胃可凭，攻下无虞。(盛启东)
六部脉中，有少冲和之气者，即是病脉。或反见他脏之脉，是本脏气衰，而他脏之气乘之也。如脾胃虚损，则肝木乘之，故肝强脾弱，右关脉必弦也。(石顽)
贵人脉，常清虚流利。富人脉，常和滑有神。贱者之脉，多壅浊。贫者之脉，多蹇涩。先富贵而后贱，则气郁血衰，脉必不能流利和滑也。(石顽)
富贵之人恒劳，心肾精血内戕，病脉多虚，纵有表里客邪，不胜大汗大下，全以顾虑元气为主。贫贱之人藜藿充肠，风霜切体，筋骸素惯疲劳，脏腑多系坚固，即有病苦忧劳，不能便伤神志，一以攻发为先。(石顽)
肥人肌肉丰厚，胃气沉潜，初感风寒，未得即见表脉，但鼻塞声重，涕唾稠黏即是风寒所伤。若虽鼻塞声重，而咳痰不出，极力咯之，乃得一线黏痰，甚则咽腭肿胀者，乃风热也。瘦人肌肉浅薄，胃气外泄，即发热头痛，脉来浮数，多属于火，但于辛凉发散之中当顾其阴。(石顽)
西北之人，惯受风寒，素食煤火，外内坚固，所以脉多沉实，一切表里诸邪，不伤则已，伤则必重，非大汗大下不能中病。滇粤之人恒受瘴热，惯食槟榔，表里疏豁，所以脉多微数，按之少实，搏有风寒只宜清解，不得轻用发散。江南之人禀赋最薄，脉多不实，且偏属东方木，火最盛，故温病为多，搏发热身痛，不可大发其汗，只宜轻剂解肌。(石顽)
新病虽各部脉脱，中部存者，是有胃气，可治。久病而右手关尺软弱，按之有神，可卜精血之末艾，他部虽危，治之可生；若尺中弦急，按之搏指，或细弱脱绝者，不治。(石顽)
下指浮大，按久索然者，正气大虚之象。下指濡弱，久按搏指者，里病表和之象。下指微弦，按久和缓者，久病问安之象。大抵病人之脉，下指虽见乏力，或弦细不和，按至十余至渐和者，必能收功。若下指似和，按久微涩，不能应指，或渐觉弦硬者，必难取效。(石顽)
凡温热病，脉以数盛有力为顺，细小无力为逆。得汗后，脉不衰，反盛躁，尤逆也。六阳之脉，偏于浮大，其沉候，即在常脉之中候，非沉候，全无也。六阴之脉，偏于沉细，其浮候，即在常脉之中候，非浮候，全无也。(费晋卿)
脉大而无力，为阳虚。脉散而无力，有阴虚。(薛立斋)
凡脉弱而停至者，乃内伤之证，急宜补气血以调之，缓则不治。(萧廉泉)
费晋卿脉法歌
脉乃命脉，气血统宗。气能率血，气行血从。右寸为肺，所以主气；百脉上通，呼吸所击。左寸为心，生血之经；一气一血，赖以养形。其在右关，脾胃属土，仓廪之官，水谷之府。其在左关，肝胆之部，风阳易动，不宜暴怒。右尺合门，釜下之火，日用必需，是可补助。左尺肾水，性命之根，与右尺火，并号神门。部位既明，当知脉象；切脉之时，不宜盂浪。以我中指，先按关上，前后二指，寸尺相向。脉有七诊，浮中及沉，左右判别，上阳下阴。九候之法，即浮中沉，三而三之，分部推寻。别有一种，名曰斜飞，尺则犹是寸关相违。更有一种，正位全无，反出关后，大象模糊。男脉左大，女脉右盛；男子寸强，女子尺胜。脉应四时，递相判别，春弦夏洪，秋毛冬石。五脏之脉，各部分见，先能知常，方能知变。心脉浮大，肺脉浮涩，肝脉沉弦，肾脉沉实。脾胃之脉，和缓得中，右尺命火，与心脉同。临诊脉时，虚心静气，虚则能精，静则能细。以心之灵，通于指端，指到心到，会悟参观。脉来太过，外感为病；脉来不及，内伤之证。人之大气，积于胸中，呼吸出入，上下流通。呼出之气，由心达肺；吸入之气，肝肾相济。呼吸定息，迟数可别，一息四至，和平之极；五至为常，亦无差忒；三至为迟，迟乃寒结；二损一败，不可复活；六至为数，数即病热；七至为疾，热甚危急；若八九至，阳竭阴绝。浮脉在上，轻按即得，肌肤之间，百不失一。沉脉在下，主里主阴，按至筋骨，受病最深。浮沉迟数，脉之大端，四者既明，余脉详看。大纲秩然，条目宜审，滑涩虚实，亦为要领。浮脉上泛，如水漂木，轻取即得，重按不足。芤脉如葱，轻平而空，浮沉俱有，但虚其中。如按鼓皮，其名曰革，中沉俱空，阳亢阴竭。肌肉之下，其脉为沉，重按乃得，病发于阴。弦大而沉，厥名曰牢，气凝血结，浊阴混淆。沈极为伏，三候如无，气机闭塞，真阳已孤。迟脉为寒，气凝血滞，若损与败，不可复治。迟而一止，其名曰结，气血错乱，兼主冷积。结虽时止，至数无常。代则有定，气血消亡。数脉气热，其阴必虚，若因风火，则为有余。热甚则疾，一息七至，八九为极，烦冤而死。数而一止，其脉为促，多主肺痈，郁热阳毒。滑脉宅痰，亦主诸气，气盛痰多，往来流利。动脉如豆，多见于关，若在寸尺，阴阳两悭。涩为血少，往来涩滞，血不养气，艰难而至。虚脉如何？往来无力，浮中如常，沉候亏缺。濡脉浮小，如水漂棉，轻取无力，重按豁然。微脉更虚，有无之间，气血亏损，病势颠连。散脉无定，涣而不收，元气将败，如水浮沤。弱脉在下，似弦非弦，沉细而软，不宜壮年。细则更沉，如发如丝，行于筋骨，虚寒可知。短脉气病，见于寸尺，不能满部，真阳遏抑。实脉之来，三候有力，更大于牢，邪滞郁结。洪脉上涌，与洪水同，泛泛不已，热盛于中。大脉较阔，来刚去柔，正虚邪盛，病进可忧。弦脉劲直，如张弓弦，木旺克土，痰饮连绵。弦而弹转，其脉为紧，为寒为痛，浮沉宜审。寸尺之脉，有时而长，过于本位，毗阴毗阳。惟有缓脉，悠悠扬扬，是为胃气，见之吉祥。别有一种，怠缓近迟，血虚气弱，积湿可知。一切病证，不外三因，何证何脉，辨之贵真。不能殚述，自可引伸；神而明之，存乎其人。
附：时方歌
补可扶弱之剂(歌十首，方二十四)
Floating pulse (Fu Mai, floating pulse) resembles wood floating on water; Slow pulse (Chi Mai, slow pulse) is like wind blowing, Rapid pulse (Shu Mai, rapid pulse) indicates heat, and Tight pulse (Jin Mai, tight pulse) indicates cold. A floating pulse with force indicates Exterior Excess syndrome (Biao Shi), while a floating pulse without force indicates Exterior Deficiency syndrome (Biao Xu).
Water flows downward; the Sinking pulse (Chen Mai, sinking pulse) appears between the sinews and bones, soft, slippery, and even. A Sinking-Slow pulse indicates cold pain, while a Sinking-Rapid pulse indicates heat; water retention and qi stagnation are the causes.
The Slow pulse beats only three times per respiration, indicating that Yang cannot overcome Yin and there is cold in Qi and Blood. This often manifests as cold pain in Zang organs; do not confuse it with the Choppy pulse (Se Mai, choppy pulse) or Deficient pulse.
The Rapid pulse beats about six times per respiration, indicating weak Yin and flourishing Yang, inevitably leading to mania and restlessness. Floating-Rapid indicates Exterior heat, while Sinking-Rapid indicates Interior heat; however, for children, a Rapid pulse is considered auspicious.
The Slippery pulse (Hua Mai, slippery pulse) feels like beads rolling continuously, flowing smoothly and returning strongly. Floating-Slippery often indicates phlegm, while Sinking-Slippery indicates retained food. If the pulse is harmonious and menstruation has ceased, pregnancy may be present.
The Choppy pulse is short and stagnant, difficult to move forward and backward. The Scattered pulse (San Mai, scattered pulse) is faint and intermittent, barely perceptible. In men, it indicates injury to essence and blood loss; in women, it indicates either fetal disease or menstrual difficulties. (Original note: Like rain soaking into sand, or a knife scraping bamboo, this is called Choppy.)
The Deficient pulse (Xu Mai, deficient pulse) has no boundary, resembling an empty husk. Light pressure reveals it as slow, large, and loose upon heavy pressure. A Deficient pulse with body heat indicates damage from summerheat. Spontaneous sweating, palpitations, and fright are also symptoms.
The Excess pulse (Shi Mai, excess pulse) feels strong and pressing between the fingers, detectable by both light and heavy pressure, appearing large and long. It may indicate Yang toxin or retained food, accompanied by frequent delirium and even madness.
The Long pulse (Chang Mai, long pulse) is distant and uniform in size. When abnormal, it resembles pulling a rope. Unless it is Yang toxin or epilepsy, it indicates deep Heat in the Yangming channel.
The Short pulse (Duan Mai, short pulse) is sought only at the Cun and Chi positions, shrinking at both ends with constrained Qi. Floating indicates stagnant blood, while Sinking indicates fullness. Cun position relates to headache, and Chi position relates to abdominal pain.
When the pulse comes vigorously but recedes weakly, filling the fingers with a surging sensation, it corresponds to the summer season. It indicates Yin deficiency with excessive Yang heat; if accompanied by diarrhea and dysentery, it is difficult to treat. (Original note: Both Hong and Shu pulses are large, but Hong is forceful, while Wei and Xi pulses are small, but Wei is weak.)
The Micro pulse (Wei Mai, micro pulse) is faint and flickering, almost imperceptible upon heavy pressure, seeming to exist yet not. In men, it indicates extreme exhaustion and Qi deficiency; in women, it indicates metrorrhagia and leukorrhea.
Light pressure feels like turning cords, heavy pressure feels like a rope; thus named Tight pulse. It is always caused by Cold pathogen invading, causing internal abdominal pain and external body pain.
The Moderate pulse (Huan Mai, moderate pulse) beats four times per respiration, most leisurely, like willow branches swaying in a gentle breeze. Floating-Moderate indicates wind strike with stiffness in the neck and back; Sinking-Moderate indicates dampness injury with flaccidity and bi-syndrome.
The Scallion pulse (Kou Mai, scallion pulse) is solid externally but hollow in the center, soft and floating, resembling a scallion stalk. Fire attacking Yang meridians causes upper bleeding, while heat invading Yin collaterals causes lower bleeding.
The Wiry pulse (Xian Mai, wiry pulse) is distant, straight, and long. Liver Wood flourishing injures Earth. Wiry-Slow indicates cold pain, Wiry-Rapid indicates heat; malaria and Yin hernia are generally difficult to manage. (Original note: Wiry represents Yin and Cold.)
The Leathery pulse (Ge Mai, leathery pulse) feels like pressing a drum skin, combining characteristics of Kou and Xian pulses, indicating Cold and Deficiency. In women, it indicates miscarriage and metrorrhagia; in men, it indicates Ying deficiency or nocturnal emission.
The Firm pulse (Lao Mai, firm pulse) resides in the Sinking and Deep positions, being long, substantial, large, and slightly wiry. It belongs to Cold coagulation with frequent abdominal pain. Ge is Deficient, Lao is Excess, fundamentally distinct.
The Soft pulse (Ru Mai, soft pulse) is Floating and fine, requiring light pressure, like cotton floating on water, unable to withstand force. It indicates Blood deficiency or dampness invasion; warm tonification to rescue True Yin is urgently needed.
The Weak pulse (Ruo Mai, weak pulse) is powerless and soft upon heavy pressure, fine and Sinking without Floating. Yang sinking into Yin damages Qi and Blood, leading to aversion to cold, fever, and bone flaccidity. (Original note: Cun Ruo indicates Yang deficiency, Guan Ruo indicates Stomach deficiency, Chi Ruo indicates Yin deficiency.)
Scattered like flying poplar catkins, going and coming without strength, irregular in rhythm; it signifies birth in delivery and fetal dropping in pregnancy, and in chronic illness, it is incurable.
The Fine pulse (Xi Mai, fine pulse) arrives like a thread, often due to labor damage and decline of Wei and Ying. For deficient persons with deficient syndromes, it is favorable; if seen with hematemesis or epistaxis, recovery is possible.
The Deep pulse (Fu Mai, deep pulse) requires pushing tendons to the bone to find, moving subtly deep under the fingers; in Shanghan, it indicates impending sweat and resolution of Yang; in Jueyin with umbilical pain, it belongs to Yin.
The Moving pulse (Dong Mai, moving pulse) trembles rapidly at the Guan position, headless and tailless, round like a bean. Yang Moving indicates profuse sweating, Yin Moving indicates heat; it causes pain and fright, preventing peace.
The Surging pulse (Cu Mai, surging pulse) is Rapid with occasional pauses, indicating Yang heat threatening to consume Yin. With blazing fire stagnating in the Sanjiao, urgent administration of cooling agents will normalize the pulse.
The Knotted pulse (Jie Mai, knotted pulse) is Slow with occasional pauses, indicating exclusive Yin flourishing threatening to consume Yang. Floating indicates Qi stagnation, Sinking indicates accumulation; differentiation between sweating and purging methods is crucial.
If the movement stops and does not return, resuming motion makes it appear as a Replacement pulse (Dai Mai). This indicates Zang decline and difficulty in responding to the finger; do not group Cu and Jie together. (Original note: Pauses in Cu and Jie are irregular, while Dai pauses occur regularly.)
Seven Absolute Pulses Song
Peck like a sparrow, three or five pecks in succession (Liver absolute);
Leak like a roof drop, one drop every half day (Stomach absolute);
Hard like striking stone, scattering immediately upon search (Kidney absolute);
Disordered on the finger, like untying a knot (Spleen absolute);
Fish swimming, seemingly present yet absent (Heart absolute);
Shrimp jumping, a single leap amidst stillness (Large Intestine absolute);
Pot boiling, surging like soup (Lung absolute);
Diagnosed in the morning, death by evening, no medicine needed.
Women's Pulse Methods
(Original note: If the Left Guan position in women is wiry, long, and extends beyond the Yuji point, it indicates abundant blood and a tendency to conceive a male.)
In women, the two Chi positions being stronger than the two Cun positions is normal. If the Kidney pulse is Sinking-Choppy, or the Liver pulse is Sinking-Tight, it indicates amenorrhea and irregular menstruation. A Micro-Slow Chi pulse indicates Ju Jing (menstruation occurring once every three months), due to insufficient Qi and Blood. A Large and vigorous Chi pulse, beating forcefully against the finger, indicates pregnancy. If all three positions are equal in Floating and Sinking, with no other illness but stopped menstruation, it is also pregnancy (Original note: Floating-Large at two Cun, Slippery at two Guan, Slippery-Substantial with slight Rapidness at two Chi—this is the fetal pulse). Left Cun Moving-Slippery and Left Chi Substantial-Large indicate a male; Right Cun Moving-Slippery and Right Chi Substantial-Large indicate a female (Original note: Cun Moving indicates male, Chi Moving indicates female. Cun Kou Slippery-Substantial indicates male, Chi Zhong Slippery-Substantial indicates female. Both Cun Slippery-Substantial indicates twin males. Both Chi Slippery-Substantial indicates twin females. Left Cun and Right Chi Slippery-Substantial indicates one male and one female). If a weak woman’s Chi position feels unbroken upon pressure, she is pregnant. Even with frequent menstrual interruptions, if the six pulses show no illness, she is pregnant. In women with amenorrhea, a Slippery-Replacement pulse indicates two months of fetal development; a Slippery-Rapid-Scattered pulse indicates three months; a Slippery-Rapid pulse that remains when pressed heavily indicates five months. A Substantial-Large pulse in pregnancy is auspicious; Sinking-Fine indicates difficult labor; Ge pulse indicates threatened abortion; Li Jing pulse indicates the time of delivery.
Children's Pulse Methods
For children under five, Qi and Blood are not yet abundant, and meridians are not filled, so pulse images cannot be distinguished. Instead, observe the collateral vessels of the index finger. The first segment of the index finger at the Yin position is the Wind Gate; the second segment at the Mao position is the Qi Gate; the third segment at the Chen position is the Life Gate. Observe the left hand for boys and the right hand for girls. Purple color indicates Heat, Red indicates Shanghan, Green indicates Fright Wind, White indicates Gani disease, faint yellow indicates health, and black indicates danger. At the Wind Gate is mild, at the Qi Gate is severe, at the Life Gate is critical. Collateral vessels entering the palm form an inward hook; curving inward indicates Wind-Cold, curving outward indicates Food Retention. Above age five, use one finger to locate Cun, Guan, and Chi. Generally, six beats per respiration is the standard; more indicates Heat, less indicates Cold, similar to diagnosing adults. Children with chaotic pulse, body heat, sweating, anorexia, and vomiting after eating experience Bian Zheng. Cold extremities alone, shivering with aversion to cold, red face with harmonious Qi, and copious tears and snot indicate variola (smallpox). For infants under six months, use the middle and index fingers to check between the forehead, eyebrow ends, and hairline. Index finger near hair is Upper, middle finger near eyebrow is Lower, middle finger is Middle. Heat in all three fingers indicates external Wind attack with nasal congestion and cough; cold in all three indicates external Cold attack with internal dietary injury, fever, vomiting, and diarrhea. Heat in index and middle fingers indicates Upper Heat and Lower Cold; heat in middle and ring fingers indicates complicated Fright; heat in the index finger indicates Food Stagnation.
Song on Diseases Indicated by Children's Fright Marks
Why does the fingerprint suddenly float? Pathogen is in the skin, do not worry too much. Blocked pores indicate Exterior syndrome; urgently use dispersing methods to induce sweat and cure. (Original note: Straight and thin lines indicate Deficient-Cold and little Qi, difficult to cure. Thick and prominent lines indicate pathogen interfering with healthy Qi, easy to treat. Lines with discontinuities like flowing pearls indicate retained food.)
If the Guan mark gradually sinks, know that the pathogen has entered the interior and the disease is deep. Do not lightly try wind-dispersing medicines; seek solutions in Yangming Interior syndromes. Generally seeing red and yellow colors: bright red often comes from Cold inside, faint red originally indicates Deficient-Cold, do not mistake deep red for Heat. Guan mark showing purple is a sign of Heat, green is controlled by Wind-Wood. Food injury with purple-green indicates reversed Phlegm-Qi; green-black across the three gates brings disaster hard to overcome. Faint fingerprints are also alarming, always due to light congenital endowment. Spleen and Stomach originally deficient with weak Middle Qi, beware of attacking methods damaging the fetus/infant. Why is the Guan mark choppy and stagnant? Pathogen suppresses Yin Ying and Wei Qi stays. Food stagnation in Middle Jiao with blazing Phlegm-Heat, what else can be done without pushing it out? Bow shape inward indicates cough due to Cold attack. Bow shape outward indicates Phlegm-Heat complicated by Food and Fright. Flowing pearls and long pearls indicate frequent abdominal pain from food injury. Like a spear or needle indicates Phlegm-Heat and restless Wind. Incoming snake indicates Damp-Heat, vomiting and reversal leading to Gani accumulation. Outgoing snake indicates dietary injury, thirst, irritability, vomiting, and diarrhea. Shape chaotic like fish bones indicates Fright-Phlegm and body heat. Shape divided like water character indicates food stagnation. Penetrating gate shooting to finger center indicates Wind-Heat and Phlegm binding in chest. Penetrating gate shooting directly to nail indicates Liver flourishing suppressing Spleen.
Famous Doctors' Pulse Discussions
In all Internal Injury syndromes, the Left pulse is often Fine and Choppy, while the Right pulse is often Floating and Large (Original note: Malaria pulses also differ between hands). This is because Yang Qi sinks and cannot generate Yin, causing Blood dryness and a Fine-Choppy Left pulse; Spleen and Stomach are damaged and cannot generate Metal, causing Qi deficiency and a Floating-Large Right pulse. (Zhang Shiweng)
In all Deficiency and Damage syndromes, a Floating-Large pulse belongs to Yang deficiency; a Fine-Rapid pulse belongs to Yin deficiency. Kou indicates blood loss. If both hands are Kou, but one position is uniquely Wiry, it indicates incomplete stasis retention, which should be removed; if Rapid-Large is seen, it indicates Fire flourishing; Wiry-Rapid indicates Bone-steaming Fever, both are difficult to treat. (Zhang Shiweng)
If Deficiency and Damage turn into tidal fever and diarrhea, a Short-Rapid pulse indicates lack of Stomach Qi and is untreatable; a Small-Rapid pulse is also untreatable.
A Wiry-Urgent Chi position must be due to sexual exhaustion causing fever; if both Guan and Chi are Wiry-Fine and Urgent, it is untreatable.
A Micro pulse is thin, indicating Yang Qi deficiency failing to protect the exterior; Tongmai Sini Decoction is suitable. A Fine pulse is small, indicating Yin Blood deficiency failing to nourish the interior; Danggui Jianzhong Decoction is suitable. (Chen Xiuyuan) (Original note: Micro Chi pulse indicates interior urgency, prohibit sweating and purging.)
In women's pulses, if both Chi positions are Choppy and disconnected, it is a sign of amenorrhea.
For people with inherent Lung Qi deficiency, or those who have injured the Lung with chronic cough, if they occasionally catch a cold with slight fever and headache, the pulse will definitely be Floating-Large and Deficient. Strongly avoid taking dispersing medicines. Once taken, Lung Qi dissipates, inability to lie down peacefully; Congbai Douchi Tang is sufficient.
Whenever the pulse suddenly becomes large or small, sometimes Sinking and sometimes Floating, it is due to Qi and Blood deficiency following Fire usage; Guipi Decoction with modifications is suitable for regulation.
Wind-Cold pulse: Left hand Floating-Large and Tight. Warm Disease pulse: Right hand Floating-Large and Rapid.
For dizziness due to sexual exhaustion, the Left pulse is Choppy, and the Right Guan and Chi positions must be Floating-Wiry and Long. (Xiao Lianquan)
Whenever the Left Cun and Guan are Floating-Moderate and Wiry, with other pulses normal, it indicates Wind-Heat in the upper part.
Left Cun Floating-Large and Scattered, Right Cun Floating-Choppy and Short; Left Guan Wiry-Soft and Long, Guan Moderate-Large and Soft; both Chi Sinking-Slippery and Forceful—all are Normal pulses.
Floating pulse requires force at Chi to rely on innate Kidney Water, ensuring safety in releasing the Exterior. Sinking pulse requires force at Right Guan to rely on acquired Spleen and Stomach, ensuring safety in purging the Interior. (Sheng Qidong)
Among the six positions, if there is a slight harmonious Qi, it is a pathological pulse. Or if pulses of other Zang organs appear oppositely, it means the original Zang Qi is declining and another Zang Qi is exploiting it. For example, if Spleen and Stomach are deficient, Liver Wood exploits them, so Liver is strong and Spleen weak, making the Right Guan pulse necessarily Wiry. (Shiweng)
Nobles' pulses are usually clear, empty, and smooth. Rich people's pulses are usually harmonious, slippery, and spirited. Poor people's pulses are often obstructed and turbid. Poor people's pulses are often sluggish and choppy. Those who were rich and noble then became poor have Qi stagnation and Blood decline, so their pulses cannot be smooth and harmonious. (Shiweng)
Rich and noble people often labor, damaging Heart and Kidney Essence and Blood internally; pathological pulses are mostly Deficient. Even with Exterior-Interior exogenous pathogens, they cannot withstand heavy sweating or purging; the main concern is protecting Yuan Qi. Poor and low-status people eat coarse food, endure wind and frost, their muscles and bones are accustomed to fatigue, and their Zang-Fu are generally solid. Even with illness and worry, they do not easily injure their spirit and mind; treatment prioritizes attacking and releasing. (Shiweng)
Fat people have thick muscles and submerged Stomach Qi. Initially contracting Wind-Cold, they do not immediately show Exterior pulses; only nasal congestion, heavy voice, and thick sputum indicate Wind-Cold injury. If although there is nasal congestion and heavy voice, coughing produces no phlegm, and after great effort only a thread of sticky phlegm comes out, or even swelling of the throat and palate, it is Wind-Heat. Thin people have shallow muscles and leaking Stomach Qi; even with fever and headache, the pulse is Floating-Rapid, mostly belonging to Fire, but within acrid-cool dispersing methods, one must protect Yin. (Shiweng)
People in the Northwest are accustomed to Wind-Cold and coal heating, solid externally and internally, so pulses are mostly Sinking-Substantial. All Exterior-Interior pathogens, if not injuring, fine; if injuring, must be severe, requiring heavy sweating and purging to hit the target. People in Dian-Yunnan and Guangdong are constantly exposed to miasma heat and accustomed to eating betel nut, so their Exterior-Interior is loose and open, pulses are mostly Micro-Rapid, lacking substance upon pressure. If contracting Wind-Cold, only clearing and resolving is suitable, do not lightly use dispersing methods. People in Jiangnan have the thinnest constitution, pulses are mostly unsubstantial, and lean towards Eastern Wood, where Fire is strongest, so Warm Diseases are common. Contracting fever and body pain, do not heavily sweat, only light agents to resolve the muscle layer are suitable. (Shiweng)
In new illnesses, even if various positions show pulse disappearance, if the Middle position remains, there is Stomach Qi, and it is treatable. In chronic illness, if Right Guan and Chi are weak and soft but spirited upon pressure, it predicts that Essence and Blood are not exhausted; although other positions are critical, treatment can lead to life. If Chi is Wiry-Urgent, beating forcefully against the finger, or Fine-Weak and disappearing, it is untreatable. (Shiweng)
Pressing Floating-Large, feeling empty after long pressure, is a sign of major Qi deficiency. Pressing Ru-Ruo, feeling forceful after long pressure, is a sign of Interior disease with harmonious Exterior. Pressing slightly Wiry, feeling harmonious and slow after long pressure, is a sign of improvement in chronic illness. Generally, for patients' pulses, although pressing feels weak, or Wiry-Fine and unharmonious, if becoming harmonious after ten-plus beats, success can be achieved. If pressing seems harmonious, but after long pressure slightly Choppy, unable to respond to the finger, or gradually feeling Wiry-Hard, efficacy is difficult to obtain. (Shiweng)
In all Warm-Thermal diseases, a Rapid-Vigorous-Forceful pulse is favorable, while Fine-Small-Weak pulse is unfavorable. After sweating, if the pulse does not decline but becomes vigorous and restless, it is especially unfavorable. Six Yang pulses tend to be Floating-Large; their Sinking examination lies within the normal Middle examination, it is not that Sinking examination is completely absent. Six Yin pulses tend to be Sinking-Fine; their Floating examination lies within the normal Middle examination, it is not that Floating examination is completely absent. (Fei Jinqing)
Pulse Large but Weak indicates Yang deficiency. Pulse Scattered but Weak indicates Yin deficiency. (Xue Lizhai)
Whenever the pulse is Weak with pauses, it is an Internal Injury syndrome; urgently tonify Qi and Blood to regulate it, otherwise it becomes untreatable. (Xiao Lianquan)
Fei Jinqing's Pulse Method Song
Pulse is the life pulse, commanding Qi and Blood. Qi leads Blood, when Qi moves, Blood follows. Right Cun is Lung, governing Qi; hundred vessels connect upward, struck by respiration. Left Cun is Heart, the vessel generating Blood; one Qi one Blood, relying on to nourish the form. At Right Guan, Spleen and Stomach belong to Earth, officials of granaries, repositories of water and grain. At Left Guan, Liver and Gallbladder sector, Wind-Yang easily moves, do not rage violently. Right Chi combines door, fire under the pot, daily necessity, can be supplemented. Left Chi Kidney Water, root of life and nature, with Right Chi Fire, both called Shenmen. Once positions are clear, know pulse images; when cutting pulse, do not be careless. Use my middle finger, first press Guan, front and back fingers, Cun and Chi facing each other. Pulse has seven examinations, Floating, Middle, and Sinking, left-right discrimination, upper-Yang lower-Yin. Nine-pulse method is Floating-Middle-Sinking, three times three, searching by section. Another type is named Fei Fei (Slanting Fly), Chi is same, Cun-Guan contrary. Another type, no correct position, emerges behind Guan, image vague. Male pulse Left Large, Female pulse Right Vigorous; Men Cun Strong, Women Chi Superior. Pulse responds to four seasons, distinguish sequentially, Spring Wiry Summer Large, Autumn Hairy Winter Stone. Five Zang pulses, appear in respective sections, first know normal, then know change. Heart pulse Floating-Large, Lung pulse Floating-Choppy, Liver pulse Sinking-Wiry, Kidney pulse Sinking-Substantial. Spleen-Stomach pulse, harmonious and moderate, Right Chi Ming Fire, same as Heart pulse. When examining pulse, empty heart and quiet spirit, emptiness allows precision, quietness allows detail. With heart's spirit, connect to fingertips, finger reaches heart reaches, comprehend and observe. Pulse coming too much, External Attack disease; pulse coming too little, Internal Injury syndrome. Human Great Qi, accumulates in chest, respiration in and out, circulating up and down. Exhaled Qi, from Heart to Lung; Inhaled Qi, Liver-Kidney complement. Respiration fixed beat, Slow-Rapid distinguish, four beats per respiration, peak of peace; five beats is normal, no error; three beats is Slow, Slow is Cold knot; two damage one defeat, cannot revive; six beats is Rapid, Rapid is disease heat; seven beats is疾 (Ji/Fast), heat extreme critical; if eight-nine beats, Yang exhausts Yin perishes. Floating pulse above, light press obtains, between skin and flesh, rarely fails. Sinking pulse below, governs Interior governs Yin, press to sinew-bone, disease deepest. Floating-Sinking-Slow-Rapid, main points of pulse, these four clarified, examine others carefully. Outline orderly, items should be reviewed, Slippery-Choppy-Deficient-Excess, also key essentials. Floating pulse floats up, like wood floating, light press obtains, heavy press insufficient. Kou pulse like scallion, light-flat and empty, Floating-Sinking both present, but hollow inside. Like pressing drum skin, named Ge, Middle-Sinking both empty, Yang hyperactive Yin exhausted. Below muscle, pulse is Sinking, heavy press obtains, disease originates in Yin. Wiry-Large-Sinking, named Lao, Qi clots Blood knots, turbid Yin confuses. Sinking extreme is Fu, three examinations like none, Qi mechanism blocked, True Yang lonely. Slow pulse is Cold, Qi clots Blood stagnates, if damage and defeat, cannot recover. Slow with one pause, named Jie, Qi-Blood disorder, also governs Cold accumulation. Jie although pauses, beat count irregular. Dai has fixed rhythm, Qi-Blood perish. Rapid pulse Qi hot, its Yin must be deficient, if due to Wind-Fire, then is Excess. Heat extreme then Fast, one respiration seven beats, eight-nine extreme, distress and die. Rapid with one pause, pulse is Cu, mostly governs Lung Abscess, stagnant heat Yang toxin. Slippery pulse houses Phlegm, also governs all Qi, Qi flourishes Phlegm many, flowing smoothly. Moving pulse like bean, mostly seen at Guan, if at Cun-Chi, Yin-Yang both scarce. Choppy is Blood few, flowing choppy, Blood not nourishing Qi, difficult arrival. How is Deficient pulse? Flowing powerless, Floating-Middle like normal, Sinking examination deficient. Ru pulse Floating-Small, like cotton floating, light press powerless, heavy press sudden. Micro pulse more deficient, between existence and none, Qi-Blood loss, disease continuous. Scattered pulse indefinite, scattered not gathering, Yuan Qi about to fail, like floating bubbles. Weak pulse below, like Wiry not Wiry, Sinking-Fine-Soft, not suitable for prime years. Fine then deeper, like hair like silk, moving between sinew-bone, Deficient-Cold known. Short pulse Qi disease, seen at Cun-Chi, cannot fill section, True Yang suppressed. Excess pulse comes, three examinations forceful, larger than Lao, pathogen stagnation knot. Hong pulse surges up, same as flood water, endless surging, heat flourishing in middle. Large pulse wider, comes hard goes soft, Zheng deficient pathogen excess, disease advancing worrying. Wiry pulse stiff straight, like drawn bowstring, Wood flourishes suppresses Earth, Phlegm-Drunkenness continuous. Wiry and bouncing, pulse is Jin, is Cold is Pain, Floating-Sinking should review. Cun-Chi pulses, sometimes Long, exceeding original position, adjacent Yin adjacent Yang. Only Moderate pulse, leisurely swaying, is Stomach Qi, seeing it auspicious. Another kind, sluggish near Slow, Blood deficient Qi weak, accumulated dampness known. All disease syndromes, not outside Three Causes, what syndrome what pulse, distinguishing precious truth. Cannot exhaust description, can naturally extend; divine and understand, depends on person.
Appendix: Contemporary Formula Songs
Tonifying agents to support weakness (Ten songs, Twenty-four formulas)