粤稽炎农御世。而医之名始立。夫医者济世之统名也。名虽一而实有内外科之异也。科之分有内外。
盖因人之疾有内外故也。因其疾以命医。神而明之。则因内可以推外。由外可以测内。精微之理。岂易
言哉。胡为乎今之重于内者精其内。而疮科或有所遗。专于外者精其外。而方脉或有未谙。斯二者诚
未合乎中庸之道。不几失先正之薪传乎。故惟仁者之心。深长周密。思欲兼之而无遗内遗外之憾者。
必先以脉为首务也。灵枢经云。见其色。知其病。命曰明。按其脉。知其病。命曰神。嗟嗟。神其难言也。夫诚
以病在脏腑。不能以告人而脉告之。脉不能以接人而指接之。则是脉也者。乃天真委和之气。非图可
状。非言可传。维在人之会心而已。独不见王叔和之脉经乎。王忠父之脉旨乎。李濒湖之脉学。戴同父
之刊误等书乎。寓之于目。悟之于心。措之于指。运之于意。于是乎病之浅深无不彰明较着也哉。是以
诊脉之道。不易精也。因其不易精而竟忽之。其误天下也多矣。爰采脉学歌诀。辨脉之形象。并遴外科
肿溃脉法辨症之顺逆。颜之卷首。聊补学人上达之功云尔。
浮 浮如木在水中浮浮大中空乃是（芤）拍拍而浮是（洪）脉。来时虽盛去悠悠。浮脉轻平似捻葱
（虚）来迟大豁然空。浮而柔细为（濡）脉（散）似杨花无定踪。肿疡为虚为风。溃疡为虚宜补
沉沉帮筋骨自调匀（伏）则推筋着骨寻。沉细如绵真（弱）脉弦长实大是（牢）形。肿疡为邪气深。溃
疡为遗毒在内。
迟 迟来一息至惟三。阳不胜阴气血寒。但把浮沉分表里。消阴须益火之源。脉来三至号为迟。小驶
于迟作（缓）持。迟细而难知是（涩。）浮而迟大以（虚）推。
肿疡为寒为虚。溃疡亦为寒为虚。
数 数脉息间常六至。阴微阳盛必狂烦。浮沉表里分虚实。惟有儿童作吉看。数比平人多一至。（紧）
来如数似弹绳。数而时止名为（促。）数见关中（动）脉形。数脉为阳热可知。只将君相火来医。实宜
凉泻虚宜补。肺病秋深却畏之。
肿疡为热。数而洪者欲脓。溃疡为病进。数甚者难医。
滑 滑脉如珠替替然。往来流利却还前。莫将滑（数）为同类。数脉惟看至数间。
肿疡为热为痰。溃疡为热为虚。为邪气未退。
涩 细迟短涩往来难。散止依稀应指间。如雨沾沙容易散。病蚕食叶慢而艰。参伍不调名曰涩。轻刀
刮竹短而难（微）似杪芒微 甚。浮沉不别有无间。
肿疡为气实气滞。溃疡为血虚。为脉病相应。
虚 举之迟大按之松。脉状无涯类谷空。莫把（芤）虚为一例。芤来浮大似慈葱。
肿疡宜内托。溃疡宜大补。
实 浮沉皆得大而长。应指无虚 强。热蕴三焦成壮火。通肠发汗始安康。实脉浮沉有力强。（紧）
来弹索转无常。须知（牢）脉帮筋骨。实大微弦更带长。
肿疡为邪气太盛。溃疡为邪气不退。
长 过于本位脉名长。（弦）则非然但满张。弦脉与长争较远。良工尺度自能量。
肿疡为有余。宜内消溃疡为气治则易愈。
短 两头缩缩名为短。（涩）短迟迟细且难。短涩而浮秋喜见。三春为贼有邪干。
肿疡为元气不足。溃疡为大虚宜大补。
洪 脉来洪盛去还衰。满指滔滔应夏时。若在春秋冬月分。升阳散火莫狐疑。洪脉来时拍拍然。去衰
来盛似波澜欲知（实）脉参差处。举按弦长 坚。
肿疡为热盛。宜宣热拔毒。壮实者下之。溃疡为邪气盛。药之不退者难愈。
微 微脉轻微瞥瞥乎。按之欲绝有如无。微为阳弱（细）阴弱。细比于微略较 。
肿疡为虚。服药渐充者佳。溃疡亦为虚。若微而匀者为脉病相应。
紧 举如转索切如绳。脉象因之得紧名。总是寒邪来作寇。内为腹痛外为疼。
肿疡脉浮紧。发热恶寒。或有痛处。是为痈疽。溃疡主气沉滞。为有外寒。
缓 缓脉阿阿四至通。柳梢袅袅 轻风。欲从脉里求神气。只在从容和缓中。
肿疡为虚。溃疡为有胃气。为脉病相应。
芤 中空傍实乃为芤。浮大而迟虚脉呼。芤更带弦名曰（革。）血亡芤革血虚虚。
肿疡为血虚。溃疡为脉病相应。
弦 弦来端直似丝弦。（紧）则如绳左右弹。紧言其力弦言象。（牢）脉弦长沉伏间。
肿疡主血气不和。为痛。溃疡为血虚。双弦为贼邪侵脾。加数则危矣。
革 革脉形如按 皮。芤弦相合脉寒虚。女人半产并崩漏。男子营虚或梦遗。
牢 弦长实大脉牢坚。牢位常居沉伏间。（革）脉芤弦自浮起。革虚牢实要详看。
肿疡为邪盛。溃疡为邪气不退。
濡 浮而柔细知为濡。沉细而柔作（弱）持。（微）则浮微如欲绝。（细）来沉细近于微。
弱 弱来无力按之柔。柔细而沉不见浮。阳陷入阴精血弱。白头犹可少年愁。
肿疡宜托里。溃疡为脉病相应。宜补。
散 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。散脉无拘散漫然。濡来
浮细水中绵。浮而迟大为虚脉。芤脉中空有两边。
肿疡为气虚不收。溃疡独见者死。
细 细来累累细如丝。应指沉沉无绝期。春夏少年俱不利。秋冬老弱却相宜。
细为气聚血少。有此症者逆。
伏 伏脉推筋着骨寻。指间才动隐然深。伤寒欲汗阳将解。厥逆脐疼症属阴。
肿疡为阴中伏阳邪。溃疡为阳伏阴中。为内蚀。为流注浸淫。难治。宜温补。
动 动脉摇摇数在关。无头无尾豆形团。其原本是阴阳抟。虚者摇兮胜者安。
动主痛。阳动汗之。阴动温之。
促 促脉数而时一止。此为阳极欲亡阴。三焦郁火炎炎盛。进必无生退可生。
肿疡为热为病进。溃疡为热不退。渐进者死。
结 结脉缓而时一止。独阴偏胜欲亡阳。浮为气滞沉为积。汗下分明在主张。
肿疡为气结。溃疡为气不调。则危。
代 动而中止不能还。复动因而作代看。病者得之犹可疗。平人却与寿相关。数而时止名为（促）缓
止须将结脉呼。止不能回方是代。结生代死自殊途。两动一止三四日。三四动止应六七。五六一止
七八朝。次第推之自无失。
肿溃俱不利。
脉数不时见。当生恶疮。脉数身无热。内有痈脓。脉数应当发热而反恶寒。若有痛处。当发痈。
脉浮而数。 肿在外。宜先托里。恐邪入内。脉沉而实。宜先疏通。以绝其源。脉不浮不沉。无内外症。知其
在经。宜和荣卫。
脉数发热而痛者发于阳。脉不数不发热而痛者发于阴。
痈脉宜洪大而数。若沉紧者死。疽脉宜沉而实。若浮洪而散者死。
痈疽无脉者气闭也。宜行气。其脉自见。
Tracing back history, when Emperor Yandi (Shennong) governed the world, the name of "medicine" was formally established. "Medicine" is a general term for saving the world. Although the name is the same, in reality, there are differences between Internal Medicine and Surgery. The division of specialties into internal and external exists because human diseases have differences between internal Zang-Fu organs and external body surfaces. Based on the disease to define medical practice, if one can be spiritually insightful and clearly understand, then internal pathology can deduce external symptoms, and external manifestations can measure internal mechanisms. The subtle principles are not easily explained in words. Why do those who value Internal Medicine today master the internal aspects but neglect surgery, while those specializing in Surgery master the external aspects but are unfamiliar with pulse diagnosis (Fangmai)? These two situations indeed do not conform to the Doctrine of the Mean, and are they not losing the legacy passed down by former sages? Therefore, only those with a benevolent heart, whose thoughts are profound, long, and meticulous, wishing to integrate both without regretting the omission of either internal or external aspects, must first prioritize pulse diagnosis. The *Ling Shu* states: "Observing the complexion to know the disease is called 'Ming' (Brightness); palpating the pulse to know the disease is called 'Shen' (Spirit)." Alas, the realm of "Shen" is difficult to express in words. If the disease is in the Zang-Fu organs, the patient cannot tell the doctor, but the pulse tells it; the pulse cannot connect with people directly, but fingers can touch the pulse. Thus, the pulse is the Qi of innate truth and harmony, which cannot be depicted by drawings nor fully transmitted by words; it lies only in the practitioner's intuitive understanding. Have you not read Wang Shuhe's *Mai Jing* (Pulse Classic), Wang Zhongfu's *Mai Zhi* (Pulse Essence), Li Binhu's *Mai Xue* (Pulse Studies), Dai Tongfu's *Kan Wu* (Corrections), and other books? Imbue them in your eyes, comprehend them in your heart, apply them with your fingers, and operate them with your mind. Then, the depth and superficiality of diseases will become clearly manifest. Therefore, the way of diagnosing pulses is not easy to master. Because it is not easy to master, yet people neglect it, the errors causing harm to the world are numerous. Hence, I have collected pulse study rhymes, distinguished pulse images, and selected surgical pulse methods for swelling and ulceration to distinguish favorable and unfavorable symptoms, placing them at the beginning of this volume, merely hoping to supplement the efforts of learners to reach higher levels.
Floating Pulse (Fu Mai): Floating like wood floating in water; large and hollow in the middle is Kou Pulse (Kou Mai); beating and floating is Hong Pulse (Hong Mai), coming vigorously and going leisurely. Floating pulse is light and smooth like pinching an onion (Xu Pulse, Xu Mai), coming late, large, and suddenly empty. Floating and soft/thin is Ru Pulse (Ru Mai); San Pulse (San Mai) is like poppy flowers with no fixed trace. For abscesses (Zhongyang), floating indicates deficiency or wind; for ulcers (Ku Yang), floating indicates deficiency, suitable for tonification.
Sinking Pulse (Chen Mai): Deep and pressing against muscles and bones, naturally regulated; Fu Pulse (Fu Mai) requires pushing muscles to feel the bone. Sinking and fine like cotton is true Ruo Pulse (Ruo Mai); string-taut, long, solid, and large is Lao Pulse (Lao Mai). For abscesses, sinking indicates deep pathogenic factors; for ulcers, sinking indicates residual toxins inside.
Slow Pulse (Chi Mai): One breath beats only three times; Yang fails to overcome Yin, Qi and Blood are cold. Distinguish exterior and interior by floating and sinking; eliminate Yin cold by benefiting the source of Fire. Three beats per breath is called Chi; slightly faster than Chi is Huan Pulse (Huan Mai); Chi, fine, and hard to identify is Se Pulse (Se Mai); floating, Chi, and large is Xu Pulse. For abscesses, Chi indicates cold or deficiency; for ulcers, Chi also indicates cold or deficiency.
Rapid Pulse (Shu Mai): Six beats per breath; Yin deficiency and Yang excess lead to mania and irritability. Distinguish deficiency and excess by floating/sinking and exterior/interior; for children, rapid pulse is auspicious. Rapid pulse has one beat more than normal; Jin Pulse (Jin Mai) feels like a plucked string; Shu with intermittent stops is Cu Pulse (Cu Mai); Shu appearing at the Guan position is Dong Pulse (Dong Mai). Shu indicates Yang heat, treat Jun and Xiang fire. Excess requires cooling purgation, deficiency requires tonification; Lung patients fear Shu in late autumn. For abscesses, Shu indicates heat; Shu and Hong suggest pus formation; for ulcers, Shu indicates disease progression, extreme Shu is hard to treat.
Slippery Pulse (Hua Mai): Like pearls rolling continuously, flowing smoothly returning forward. Do not confuse Hua with Shu; Shu is determined by beat count. For abscesses, Hua indicates heat or phlegm; for ulcers, Hua indicates heat or deficiency, pathogenic factors not yet retreated.
Choppy Pulse (Se Mai): Fine, slow, short, choppy, difficult flow; San pulse stops faintly. Like rain soaking sand, easily scattered; like diseased silkworms eating leaves, slow and difficult. Irregular rhythm is called Se; scraping bamboo lightly feels short and difficult; Wei Pulse (Wei Mai) is extremely weak like awns. Floating and sinking show no distinction between having and not having. For abscesses, Se indicates Qi excess or stagnation; for ulcers, Se indicates Blood deficiency, matching pulse and symptom.
Deficient Pulse (Xu Mai): Light pressure feels slow and large, heavy pressure feels loose; pulse shape boundless like empty grain. Do not confuse Xu with Kou; Kou comes floating and large like an onion. For abscesses, use internal support (Nei Tuo); for ulcers, major tonification.
Excess Pulse (Shi Mai): Both floating and sinking yield large and long pulses, feeling strong without deficiency. Heat accumulating in Triple Burner forms vigorous fire; bowel purgation and sweating bring health. Shi pulse is forceful in floating and sinking; Jin pulse feels like snapping cords. Lao pulse presses against muscles and bones; Shi, large, slightly string-taut, and longer. For abscesses, Shi indicates excessive pathogenic factors; for ulcers, Shi indicates pathogenic factors not retreating.
Long Pulse (Chang Mai): Exceeding the standard position is Chang; Xian Pulse (Xian Mai) is not so, just full and tense. Xian competes with Chang distally, skilled practitioners measure accordingly. For abscesses, Chang indicates surplus, suitable for internal resolution; for ulcers, Chang indicates Qi regulation, easy to heal.
Short Pulse (Duan Mai): Shrinking at both ends is Duan; Se-Duan is slow, fine, and difficult. Duan-Se floating is favorable in autumn, but dangerous in spring/summer due to evil interference. For abscesses, Duan indicates insufficient Yuan Qi; for ulcers, Duan indicates major deficiency, suitable for major tonification.
Surging Pulse (Hong Mai): Coming surging, going declining, filling the finger like summer waves. In spring, autumn, winter, raise Yang and scatter fire without hesitation. Hong feels beating, going decline coming vigor like waves. To distinguish Shi pulse, press string-taut and firm. For abscesses, Hong indicates severe heat, suitable for venting heat and extracting toxins; strong constitutions may be purged; for ulcers, Hong indicates盛 pathogenic factors, hard to heal if drugs fail.
Minute Pulse (Wei Mai): Extremely slight, vanishing upon pressure. Wei indicates Yang weakness; Xi (Fine) indicates Yin weakness; Xi is slightly stronger than Wei. For abscesses, Wei indicates deficiency, gradual improvement with medicine is good; for ulcers, Wei also indicates deficiency, uniform Wei matches pulse and symptom.
Tight Pulse (Jin Mai): Lifting like twisting ropes, cutting like strings, named Jin due to image. Always cold evil invading, causing abdominal pain internally and pain externally. Abscess with floating-Jin pulse, fever, aversion to cold, or painful area indicates carbuncle/furuncle; ulcer indicates Qi stagnation and external cold.
Relaxed Pulse (Huan Mai): Four beats per breath, gentle like willow branches in light wind. Seeking spirit in pulse lies in calmness and relaxation. For abscesses, Huan indicates deficiency; for ulcers, Huan indicates Stomach Qi, matching pulse and symptom.
Gourd-shaped Pulse (Kou Mai): Hollow middle, solid sides is Kou; floating, large, and slow is called Xu. Kou with string-taut quality is Ge Pulse (Ge Mai); blood loss in Kou-Ge indicates Blood deficiency. For abscesses, Kou indicates Blood deficiency; for ulcers, Kou matches pulse and symptom.
String-taut Pulse (Xian Mai): Straight like a silk string; Jin feels like rope vibrating left/right. Jin describes force, Xian describes form; Lao is Xian-long sinking/deep. Abscess indicates Qi-Blood disharmony and pain; ulcer indicates Blood deficiency. Double Xian indicates evil invading Spleen, adding Shu is critical.
Leather Pulse (Ge Mai): Form like pressing a drum head; Kou-Xian combination indicates cold and deficiency. Women: miscarriage and metrorrhagia; Men: Ying deficiency or nocturnal emission.
Deep-firm Pulse (Lao Mai): String-taut, long, solid, large, firm; located in sinking/deep. Ge floats from Kou-Xian; distinguish Ge-deficiency from Lao-excess. For abscesses, Lao indicates pathogenic excess; for ulcers, Lao indicates pathogenic factors not retreating.
Soft Pulse (Ru Mai): Floating, soft, thin is Ru; sinking, fine, soft is Ruo. Wei is floating-minute like vanishing; Xi is sinking-fine near Wei.
Weak Pulse (Ruo Mai): Weak, powerless, soft upon pressure, fine, sinking, not floating. Yang sinking into Yin, Essence-Blood weak; acceptable in old age, worrying in youth. For abscesses, suitable for supporting interior; for ulcers, matches pulse and symptom, suitable for tonification.
Scattered Pulse (San Mai): Scattered like flying poppy flowers, irregular arrival. Birth sign for labor, abortion for fetus; chronic illness meeting this needs no treatment. San is unconstrained and scattered; Ru is floating-fine like cotton in water. Floating-slow-large is Xu; Kou is hollow with two sides. For abscesses, San indicates Qi deficiency failing to consolidate; isolated San in ulcers indicates death.
Fine Pulse (Xi Mai): Continuous like threads, sinking without vanishing. Unfavorable for youths in spring/summer; suitable for elderly in autumn/winter. Xi indicates Qi gathering and Blood scarcity, adverse if symptomatic.
Hidden Pulse (Fu Mai): Push muscles to find, moving faintly deep under fingers. Typhoid wanting sweat indicates Yang resolving; Jueyin cold abdomen pain belongs to Yin. For abscesses, Fu indicates hidden Yang evil in Yin; for ulcers, Fu indicates hidden Yang in Yin, internal erosion, metastatic abscesses, difficult to treat, suitable for warming tonification.
Moving Pulse (Dong Mai): Shaking, rapid at Guan, bean-shaped without head/tail. Originates from Yin-Yang contention; shaking in deficiency, stability in excess. Dong governs pain; Yang-Dong requires sweating, Yin-Dong requires warming.
Crisis Pulse (Cu Mai): Rapid with intermittent stops, indicating Yang extreme about to consume Yin. Triple Burner郁 fire blazing; progression leads to death, retreat allows survival. For abscesses, Cu indicates heat and progression; for ulcers, Cu indicates unretreated heat, progressive death.
Knotted Pulse (Jie Mai): Slow with intermittent stops, Yin excess about to consume Yang. Floating indicates Qi stagnation, sinking indicates accumulation; sweating vs purging depends on judgment. For abscesses, Jie indicates Qi knotting; for ulcers, Jie indicates Qi dysregulation, critical.
Intermittent Pulse (Dai Mai): Stops and does not return immediately, counted as Dai. Disease getting Dai is treatable; healthy person getting Dai relates to lifespan. Rapid-intermittent is Cu; slow-intermittent is Jie. Stop not returning is Dai; Jie lives, Dai dies, paths differ. Two beats-stop: 3-4 days; four-beats-stop: 6-7 days; five-beats-stop: 7-8 days.推算 follows order. Abscess/Ulcer both unfavorable with Dai.
Rapid pulse appearing occasionally suggests malignant sores. Rapid pulse without body heat suggests internal carbuncle/pus. Rapid pulse should cause fever but causes aversion to cold; if painful area exists, carbuncle will erupt.
Floating-Rapid pulse, swelling outside, first support interior to prevent internal invasion. Sinking-Solid pulse, first dredge to cut off source. Neither floating nor sinking, no exterior/interior symptoms, known to be in meridians, harmonize Ying and Wei.
Rapid pulse with fever and pain originates from Yang; non-rapid, non-fever pain originates from Yin.
Carbuncle pulse should be Hong, large, and rapid; if Sinking-Tight, death ensues. Furuncle pulse should be Sinking and Solid; if Floating-Hong and Scattered, death ensues.
Abscess/Furuncle without pulse indicates Qi closure, suitable for promoting Qi circulation, pulse will reappear.