绣按四言脉要，始于宋南康紫虚隐君崔嘉彦希范所着。盖以初学脉理未谙，得此可为诵习。故后靳州李言
闻、云间李士材、海盐冯楚瞻，皆于己着集内，将此删改，附刻篇末，业已行世。独惜尚有驳杂未清之
处，爰取士材改本，加意增删，俾文义简明，脉症悉赅，庶读者一览而知。而不致有繁多缺略之憾耳。
脉为血脉，百骸贯通。大会之地，寸口朝宗。
脉者，血脉也，血脉附气，周于一身，循环无间，故百骸皆资贯通，而寸口为各经诸脉大会之地。肺处至
高，形如华盖，凡诸脏腑各经之气，无不上蒸于肺，而于寸口之地宗而朝之耳。
诊人之脉，令仰其掌。掌后高骨，是名关上。
医者复手大指，着于病患高骨之处，随以中指对抵以定关部。至于尺寸，则以前后二指着定。如病患长，
则下指宜疏；病患短，则下指宜密。
关前为阳，关后为阴。阳寸阴尺，先后推寻。
鱼际至高骨止有一寸，故以寸名；尺泽至高骨却有一尺，故以尺名；关界尺寸之间，故以关名。经曰∶身
半之上，同天之阳；身半之下，同地之阴。故以关前之寸为阳以候上焦，关后之尺为阴以候下焦，关处
前后之中以候中焦。凡诊必先从寸至关，从关至尺，定其先后，以推其理而寻其象也。
胞络与心，左寸之应。惟胆与肝，左关所认。膀胱及肾，左尺为定。胸中及肺，右寸昭彰，胃与脾脉，
属在右关。大肠并肾，右尺班班。男子之脉，左大为顺。女人之脉，右大为顺。男尺恒虚，女尺恒盛。
按古脏腑脉配两手，皆以内经所立脉法为定，而不敢易。左为阳，故男左脉宜大；右为阴，故女右脉宜大。
寸为阳，故男所盛在阳而尺恒虚；尺为阴，故女所盛在阴而尺恒盛。
人迎气口，上下对待。一肺一胃，经语莫悖。神门属肾，在两关后。
人迎脉在挟喉两旁一寸五分，胃脉循于咽喉而入缺盆。凡胃脘之阳，是即人迎之气之所从出。故诊人迎之
脉，亦在右关胃腑胃阳之处，而可以卜在上头项外感之疾也。气口在于鱼际之后一寸，肺朝百脉，肺主
气，故诊气口之脉，即在右寸肺脏肺阴之部，而可以卜在中在胸内伤之疾也。统论皆可以候脏腑之气，灵枢素
问言之甚明，并无左右分诊之说。叔和悖而更之，议之者多矣。人之精神，寄于两肾。故两肾脉无，则其神
已灭，而无必生之候矣。
脉有七诊，曰浮中沉，上下左右，七法推寻。
浮于皮毛之间轻取而得曰浮，以候腑气。中于肌肉之间略取而得曰中，以候胃气。沉于筋骨之间重取而得
曰沉，以候脏气，上于寸前一分取之曰上，以候咽喉中事。下于尺后一分取之曰下，以候少腹腰股胫膝之事。
合之左右两手共为七诊，以尽其推寻之力焉。
又有九候，曰浮中沉。三部各三，合而为名。每部五十，方合于经。
五脏之气各足，则五十动而一息，故候必以五十为准。每手三部各三，共为九候，合之应得四百五十之数，
两手共得九百之数。
五脏不同，各有本脉。左寸之心，浮大而散。右寸之肺，浮涩而短。肝在左关，沉而弦长。肾在左尺，
沉石而濡。右关属脾，脉象和缓。右尺相火，与心同断。
五脏各有平脉，平脉即本脉。知其本脉无乖，而后知病脉之故也。
四时百病，胃气为本。
胃为水谷之海，资生之本也。凡病诊得脉缓和匀，不浮不沉，不大不小，不疾不徐，意思悠悠，便为胃气。
不拘四季，得食则生，不得则死。今人混将时令克应推循过极，殊失胃气之本矣。
凡诊病脉，平旦为准。虚静凝神，调息细审。
平旦饮食未进，经脉未动，络脉调匀，气血未乱，可诊有过之脉。至于医家亦须先无思虑，以静以虚，调
其息气，凝神指下，精细详察，以求病之所归耳。
一呼一吸，合为一息。脉来四至，平和之则。五至无 ，闰以太息。三至为迟，迟则为冷。六至为数，
数即热病。转迟转冷，转数转热。
医以己之呼吸调匀定息。如一呼吸，得脉四至，是即和平之准则也。五至何以无 ，盖以人之气息长短不定
，每于三息五息之候，必有一息之长，故曰太息。如医一息而见脉来五至，此非病脉之急，是医气息之长也，
故五至不为有 。惟脉一息三至，即为迟慢不及；六至，即为急数太过。若至一至二至，则为转迟转冷；七至
八至，则为转数转热；而非寿生之脉矣。
迟数既明，浮沉须别。浮沉迟数，辨内外因。外因于天，内因于人。天有阴阳，风雨晦明。人喜怒忧，
思悲恐惊。
天之六气淫人，如风淫则病在末，阴淫则病在寒，明淫则病在暑，雨淫则病在湿，晦淫则病在燥，阳淫则
病在火，是外因也。人之七情伤人，如喜伤心，怒伤肝，忧伤肺，思伤脾，恐伤肾，惊伤胆，悲伤心，是
内因也。
浮表沉里，迟寒数热。沉数里热，浮数表热。浮迟表寒，沉迟冷结。
此提浮沉迟数四脉之纲，以分在表在里寒热各见之症也。
浮脉法天，轻手可得。泛泛在上，如水漂木。有力为洪，来盛去悠。无力为芤，有边无中。迟大为虚，
仔细推求。虚极则散，涣漫不收。浮小为濡，如绵浮水。濡甚则微，若有若无。更有革脉，芤弦合看。共
是七脉，皆于浮候。
此以浮脉提纲，而取洪芤虚散濡微革七脉之兼乎浮者统汇于下也。浮脉应于肉分肌表，故轻手取之即见，
正如木漂水面之意。洪脉来极盛大，按之有力，去则稍衰，正如波涛汹涌，来盛而去则悠耳。芤则浮沉易
见，而中豁然空虚，故有着葱之喻，亦非中候绝无，但比之浮沉二候，则觉无力。虚则虽浮且大，而按之无力，
且更迟缓。散则虚浮无力，按之则无，正如杨花飘散，比于虚脉则甚。濡则浮小而软，如绵浮水。微则
浮取欲绝不绝，若有若无，较之濡脉软小更极。革则浮多沉少，外急内虚，正仲景所谓弦则为寒，芤则为虚，
虚寒相搏，其名曰革之意。
沉脉法地，如石在水。沉极则伏，推筋至骨。有力为牢，大而弦长。牢甚则实， 而强。无力为弱，
状如细绵。细极为细，如蛛丝然。共是五脉，皆于沉看。
此以沉脉提纲，而取伏牢实弱细五脉之兼乎沉者汇于下也。沉脉应于筋骨，故必重按乃得，正如石之坠于
水里之意。伏则沉之至极，故必推之筋骨始见。牢则沉大弦长，按之有力，不似革脉浮取强直，而中
则空。实则三部皆坚，而力更甚于牢。弱则沉极细软，却极分明。细则沉细直软更甚于弱，故比状如蛛丝。
迟脉属阴，一息三至。有力为缓，少 于迟。往来和匀，春柳相似。迟细为涩，往来极滞。迟有一止，
其名曰结。迟止有常，应作代看。共是四脉，皆于迟测。
此以迟脉提纲，而取缓涩结代四脉之兼乎迟者统汇于下也。迟为往来迟慢，故一息而见三至。缓则往来和匀
，软若春柳，即是胃气之脉。涩则迟滞不利，状如轻刀刮竹。代则迟而中止，不能自还，但止有定数，
而不愆期。
数脉属阳，一息六至。往来流利，滑脉可识。有力为紧，切绳极似。数时一止，其名为促。数如豆粒。
动脉无惑。共为四脉，皆于数得。
此以数脉提纲，而取滑紧促动四脉之兼乎数者统汇于下也。数则往来急数，故一息而见脉有六至。滑则往
来无滞，有如珠之走盘。紧则紧急有力，状如弦紧弹手，故有切绳之喻。数时一止为促，状如疾行而
蹶。数而两头俱俯，中间高起，有似豆粒厥厥动摇。是谓之动。
别脉有三，长短与弦。不及本位，短脉可原。过于本位，长脉绵绵。长而端直，状似弓弦。
此长短与弦三脉，非浮沉迟数可括，故别列于此。短者，上不通于鱼际，下不通于尺泽，有短缩不伸之意。
长者，通尺泽鱼际，上下皆引，有迢迢过于本位之情。若弦则劲直不挠，有似弓弦，不似紧脉弦急弹人。
一脉一形，各有主病。脉有相兼，还须细订。
有一脉之形象，必有一脉所主之病。有兼见之脉象，即有兼见之症，可细就其兼见之脉。以例其症耳。
浮脉主表，腑病所居。有力为风，无力血虚。浮迟表冷，浮数风热。浮紧风寒，浮缓风湿。浮虚伤暑，浮
芤失血。浮洪虚火，浮微劳极。浮濡阴虚，浮散虚剧。浮弦痰饮，浮滑痰热。
浮虽属阳，主表主腑，但浮而见洪数弦滑有力之脉，固属主热主火主痰主风；若浮而见迟缓芤虚微涩与散
无力之脉，又为主虚主湿主冷主暑主危之象矣。故脉当视所兼以为辨别。下文仿此。
沉脉主里，为寒为积。有力痰食，无力气郁。沉迟虚寒，沉数热伏。沉紧冷痛，沉缓水蓄。沉牢痼冷，
沉实热极。沉弱阴虚，沉细虚湿。沉弦饮痛，沉滑食滞。沉伏吐利，阴毒积聚。
沉虽属阴属里，然沉而见迟紧牢缓细弱诸脉，方谓属虚属寒属积属
聚；若沉而见实数诸脉，则沉更不谓属阴，又当自阴以制其火以除其热也。
迟脉主脏，阴冷相干。有力为痛，无力虚寒。
迟虽属阴，仍当以有力无力分其寒实寒虚。盖寒实则为滞为痛，而寒虚则止见其空虚也。
数脉主腑，主吐主狂。有力实热，无力虚疮。
数虽属阳，仍当以有力无力分其热实热虚。盖热实则必为狂为燥，而热虚则止见其虚疮耳。
滑司痰饮，右关主食。尺为蓄血，寸必吐逆。涩脉少血，亦主寒湿。反胃结肠，自汗可测。
滑司痰饮，而亦有主食主血主吐之分。涩本血少，而亦有寒涩湿涩之别。但血枯则上必见反胃，而下必见
肠结；肠结胃反，则水液自尔不行，而有上逆为汗之势矣。
长则气治，短则气病。浮长风痫，沉短痞塞。
长为肝经平脉，故未病脉长，是为气治。短即肺之平脉，若非右寸及于秋见，则必有气损之病矣。至长独
于浮见，则为风火相搏而痫以生；短以沉见，则为虚寒相合而痞以成。
细则气衰，大则病进。涩小阴虚，弱小阳竭。
脉以和平为贵。凡脉细如蛛丝之状，其气自属衰弱；大而满溢应指有力，是为病势方张。至于三部皆小，
较细显极而脉涩不快，是为精血虚损。既小而脉不大，又脉痿弱不起，是为阳气衰弱。皆当分别审视。
洪为热极，其伤在阴。微为气衰，其损在阳。浮洪表实，沉洪里实。阳微恶寒，阴微发热。
洪为热极，其伤在阴，但须分其表里。微为气衰，其损在阳，亦须分其阳分阴分，以别恶寒发热之治也。
紧主寒痛，有表有里。缓主平和，兼见须虑。缓滑痰湿，缓大风虚。缓涩血伤，缓细湿痹。
浮紧则为寒闭于表，必有身痛头痛恶寒等症可察。沉紧则为寒束于里，必有肚腹胀满逆痛等症可察。缓为
虚，大为风，缓大脉见则为风虚。缓为食停，细为气滞，缓细脉见，其痹必生。缓为气衰，涩为血损，缓而
见涩，其损必甚。缓则湿滞不消，滑则痰饮内蓄，缓与滑见，则湿必停而痰益甚。
阳盛则促，肺痈热毒。阴盛即结，疝瘕积郁。
数而有止为促，非阳盛乎，故有肺痈热毒之症；迟而有止为结，非阴盛乎，故有疝瘕积郁之症。
弦脉主饮，木侮脾经。阳弦头痛，阴弦腹疼。动主搏击，阴阳不调。阳动汗出，为痛为惊。阴动则热，
崩中失血。
脉弦而土必虚，则湿自无土制而痰以生。故弦而在于寸，寸主上焦，其痛必在于头；弦在于尺，尺主下焦，
其痛必在于腹。动为阴阳不和，动见于寸，则心肺受累而惊痛与汗自至；动见于尺，则肾水受累，而崩
中失血自生。
虚寒相搏，其名曰革。男子失精，女子漏血。若见脉代，真气衰绝。脓血症见，大命必折。伤寒霍乱，
跌打闷绝。疮疽痛甚，女胎三月。
革脉由于精血亏损，故尔脉空不实，而见男子失精女子漏血之症。至于脉代而绝，或脓血症见，未有不死。
惟有伤寒霍乱，跌仆疮疽，痛甚胎产见之，以其暴伤暴闭，勿作死治也。
脉之主病，有宜不宜。阴阳顺逆，吉凶可推。
病有阴阳，脉亦阴阳，顺应则吉，逆见则凶。下言脉症相应顺逆，总
不出乎此理以为之贯通也。
中风之脉，却喜浮迟。坚大急疾，其凶可知。类中因气，身凉脉虚。类中因痰，脉滑形肥。类中因火，
脉数面赤。
风有真中类中之各别。真中虽属实症，而亦由虚所招，故脉喜其浮迟，而忌坚急，恐其正虚邪胜，决无生
也。类中本非风中，特症相似而名，故症与脉各以类见。而不能以一致耳。
伤寒热病，脉喜浮洪。沉微涩小，症反必凶。汗后脉静，身凉则安。汗后脉燥，热盛必难。始自太阳，
浮紧而涩。及传而变，名状难悉。阳明则长，少阳则弦。太阴入里，沉迟必兼。及入少阴，其脉遂沉。厥
阴热深，脉伏厥冷。阳症见阴，命必危殆。阴症见阳，虽困无害。中寒紧涩，阴阳俱紧。法当无汗，有汗伤
命。
病阳脉宜见阳，病阴脉宜见阴。故伤寒热病之症，宜见洪数之脉，与伤寒汗后不宜见脉燥之象耳。即云寒
邪传变，名状莫悉。与阴寒直
中，阴阳俱紧，脉不一端。然大要阳得阴脉，脉与症反，命必危殆。若阴症而见浮大数动洪滑之阳，其脉虽
与症反，在他症切忌，而伤寒邪气初解，病虽危困，亦未有害。惟伤寒汗出症虚，而脉反见阴阳俱紧，是其元
气已脱，脉气不和，非吉兆也。
[Editor's Note] The "Four-Character Pulse Essentials" (Siyan Maiyao) originated from Cui Jiayan (courtesy name Xifan), a recluse known as Zixu Yinjun of Nankang, during the Song Dynasty. It was likely written because beginners had not yet mastered pulse theory, and this text could serve as a material for recitation and study. Consequently, later scholars such as Li Yanwen from Jinzhou, Li Shicai from Yunjian, and Feng Chuzhan from Haiyan, all included revised versions of this text in their own collected works, appended to the end of their books, which have already circulated in the world. Unfortunately, there remain parts that are mixed and unclear. Therefore, taking Li Shicai's revised version as a base, I carefully added and deleted content to make the meaning concise and comprehensive regarding pulses and symptoms, hoping that readers can understand it at a glance without regretting its verbosity or omissions.
Pulse refers to blood vessels, penetrating through all bones and limbs. The meeting place is the Cun Kou (Inch Port).
The pulse is the blood vessel; blood vessels rely on Qi to circulate throughout the body without interruption, so all bones and tissues depend on it for connection. The Cun Kou is the gathering point of all meridians and vessels. The Lung resides at the highest position, shaped like an imperial canopy. The Qi of all organs and meridians steams upward to the Lung and gathers at the Cun Kou.
To diagnose a person's pulse, instruct them to extend their palm upward. The prominent bone behind the palm is named Guan (Bar).
The physician places the thumb on the patient's prominent bone, then aligns the middle finger opposite to determine the Guan position. The Cun (Inch) and Chi (Cubit) positions are determined by the index and ring fingers anteriorly and posteriorly. If the patient is tall, the fingers should be spaced wider; if short, they should be closer together.
Anterior to Guan is Yang, posterior to Guan is Yin. Yang corresponds to Cun, Yin to Chi; search sequentially.
From the大鱼际 (Thenar eminence) to the high bone is one Cun, hence named Cun; from 尺泽 (Chize, LU5) to the high bone is one Chi, hence named Chi; Guan lies between Cun and Chi. The classics state: The upper half of the body corresponds to Heaven's Yang; the lower half corresponds to Earth's Yin. Thus, the Cun anterior to Guan is Yang to inspect the Upper Jiao; the Chi posterior to Guan is Yin to inspect the Lower Jiao; the Guan area inspects the Middle Jiao. Diagnosis must always proceed from Cun to Guan, and from Guan to Chi, establishing sequence to deduce principles and observe patterns.
The Pericardium Meridian and Heart correspond to the Left Cun. The Gallbladder and Liver correspond to the Left Guan. The Bladder and Kidney correspond to the Left Chi. The Chest and Lung correspond clearly to the Right Cun. The Stomach and Spleen belong to the Right Guan. The Large Intestine and Kidney (Note: Text says Kidney, typically Triple Burner/Ming Men) are distinct in the Right Chi. For men, a larger Left pulse is favorable. For women, a larger Right pulse is favorable. Men's Chi pulses are often deficient; women's Chi pulses are often abundant.
According to ancient organ-pulse correspondence for both hands, the methods established in the *Neijing* (Inner Canon) are definitive and unchangeable. Left is Yang, so men's Left pulses should be large; Right is Yin, so women's Right pulses should be large. Cun is Yang, so men's excess is in Yang, making Chi often deficient; Chi is Yin, so women's excess is in Yin, making Chi often abundant.
Renying (Stomach) and Qikou (Lung) pulses face each other above and below. One represents Lung, the other Stomach; classic teachings must not be violated. Shenmen (Kidney) belongs to the Kidney, located behind both Guans.
The Renying pulse is located 1.5 cun lateral to the throat; the Stomach meridian follows the throat into the Supraclavicular Fossa. The Yang of the stomach originates from the Renying Qi. Thus, diagnosing the Renying pulse occurs at the Right Guan (Stomach/Yang area) to predict external diseases of the head and neck. The Qikou pulse is one cun behind the Thenar eminence. The Lung commands all vessels and governs Qi; thus, diagnosing the Qikou pulse occurs at the Right Cun (Lung/Yin area) to predict internal injuries of the chest. Generally, these can inspect organ Qi, as clearly stated in the *Lingshu* and *Suwen*, without distinction of left/right diagnosis. Wang Shuhe contradicted this, leading to much debate. Human spirit resides in the two Kidneys. If Kidney pulses are absent, the spirit is extinguished, and survival is impossible.
There are seven diagnostic methods: Floating, Middle, Deep; Upper, Lower, Left, Right. Search using these seven methods.
Light pressure on skin/hair yields Floating (Fu), inspecting Fu organ Qi. Moderate pressure on muscle yields Middle (Zhong), inspecting Stomach Qi. Heavy pressure on bone/tendon yields Deep (Chen), inspecting Zang organ Qi. Pressure one fen anterior to Cun yields Upper (Shang), inspecting throat conditions. Pressure one fen posterior to Chi yields Lower (Xia), inspecting lower abdomen, waist, thighs, shins, and knees. Combined with left and right hands, these form seven diagnoses to exhaust searching efforts.
There are also nine inspections: Floating, Middle, Deep. Three positions each have three depths, totaling nine. Fifty beats per position conform to the classics.
When the five Zang organs' Qi is sufficient, fifty beats constitute one respiration cycle. Hence, counting fifty beats is standard. Each hand has three positions with three depths, totaling nine inspections. Together, they amount to 450 beats per hand, and 900 beats for both hands.
The five Zang organs differ, each having its normal pulse. Left Cun Heart: Floating, large, and scattered. Right Cun Lung: Floating, choppy, and short. Liver at Left Guan: Deep, wiry, and long. Kidney at Left Chi: Deep, stone-like, and moist. Right Guan Spleen: Harmonious and moderate. Right Chi Ministerial Fire: Judged similarly to the Heart.
Each Zang has a normal pulse (Ping Mai), which is its root pulse. Knowing the root pulse is normal allows understanding of pathological pulses.
In four seasons and hundred diseases, Stomach Qi is the root.
The Stomach is the sea of water and grain, the root of nourishment. A pathological pulse showing harmony, uniformity, neither floating nor deep, neither large nor small, neither rapid nor slow, and leisurely indicates Stomach Qi. Regardless of season, food sustains life; lack of food leads to death. Modern practitioners over-analyze seasonal conflicts, losing the essence of Stomach Qi.
Diagnose pulses at dawn. Empty the mind, calm the spirit, regulate breath, and examine carefully.
At dawn, before eating, meridians are still, collaterals are balanced, and Qi/blood are undisturbed, allowing detection of abnormal pulses. Physicians must also clear thoughts, maintain emptiness and stillness, regulate breath, focus on fingertips, and observe meticulously to determine disease origin.
One exhalation and one inhalation constitute one respiration (Xi). Four beats per Xi indicate health. Five beats are normal, adjusted for sighs (Tai Xi). Three beats are Slow (Chi), indicating cold. Six beats are Rapid (Shu), indicating heat. Slower means colder; faster means hotter.
Physicians regulate their own breathing. Four beats per Xi is the healthy standard. Why are five beats not abnormal? Human breath varies; occasionally one breath is longer than others, called a sigh. If a physician takes a longer breath and sees five beats, it is not pathological urgency but physiological variation. Only three beats per Xi is truly Slow (deficient); six beats is Rapid (excessive). One or two beats indicates extreme cold; seven or eight beats indicates extreme heat; these are not signs of longevity.
Having clarified Slow/Rapid, distinguish Floating/Deep. Floating/Deep and Slow/Rapid differentiate internal/external causes. External causes stem from Heaven; internal causes from Humans. Heaven has Yin/Yang, wind/rain/darkness/light. Humans have joy/anger/worry, thought/sorrow/fear/fright.
Heaven's six qi pathogenic factors: Wind affects extremities; Yin/Cold affects cold pathology; Brightness/Heat affects summerheat; Rain/Dampness affects dampness; Darkness/Dryness affects dryness; Yang/Fire affects fire pathology. These are external causes. Human seven emotions: Joy injures Heart; Anger injures Liver; Worry injures Lung; Thought injures Spleen; Fear injures Kidney; Fright injures Gallbladder; Sadness injures Heart. These are internal causes.
Floating indicates Exterior; Deep indicates Interior. Slow indicates Cold; Rapid indicates Heat. Deep-Rapid indicates Interior Heat; Floating-Rapid indicates Exterior Heat. Floating-Slow indicates Exterior Cold; Deep-Slow indicates Cold accumulation.
This outlines the four main pulses (Floating, Deep, Slow, Rapid) to differentiate exterior/interior and cold/heat symptoms.
Floating pulse follows Heaven, easily felt lightly. It floats superficially, like wood on water. Forceful is Hong (Surging), coming strong and departing slowly. Deficient is Kou (Hollow), present at edges but empty in center. Slow-Large is Xu (Deficient), requiring careful search. Extremely deficient becomes San (Scattered), loose and unrestrained. Floating-Small is Ru (Soggy), like cotton on water. Very soggy becomes Wei (Micro), seeming present yet absent. Ge (Leather) combines Kou and Xian (Wiry). All seven are Floating-type.
Floating pulse corresponds to skin/muscle surface, felt lightly like wood on water. Hong pulse comes strongly, feels forceful when pressed, departs slowly, like surging waves. Kou pulse is felt at floating/deep levels but empty in middle, like a scallion stalk. Xu pulse is floating/large but deflates upon pressure, slower than normal. San pulse is floating/weak, disappears on pressure, like willow catkins dispersing. Ru pulse is floating/small/soft, like cotton on water. Wei pulse is barely perceptible, softer/smaller than Ru. Ge pulse is more floating than deep, tense outside but empty inside, matching Zhang Zhongjing's description: "Wiry indicates cold, Hollow indicates deficiency; deficiency and cold combine, named Leather."
Deep pulse follows Earth, like stone in water. Extreme deep is Fu (Hidden), pressing to bone. Forceful is Lao (Tense), large and wiry/long. Very tense is Shi (Solid), hard and strong. Deficient is Ruo (Weak), like fine cotton. Extremely thin is Xi (Thready), like spider silk. All five are Deep-type.
Deep pulse corresponds to tendons/bones, requiring heavy pressure like a stone sinking. Fu pulse is extremely deep, requiring pressure to tendons/bones. Lao pulse is deep/large/wiry/long, forceful on pressure, unlike Ge which is tense superficially but empty inside. Shi pulse is firm in all three positions, stronger than Lao. Ruo pulse is extremely deep/thin/soft but distinct. Xi pulse is deeper/thinner/softer than Ruo, like spider silk.
Slow pulse belongs to Yin, three beats per Xi. Forceful is Huan (Relaxed), less frequent than Slow. Smooth and even, like spring willows. Slow-Thin is Se (Choppy), very stagnant. Slow with pause is Jie (Knotted). Regular pauses suggest Dai (Intermittent). All four are Slow-type.
Slow indicates sluggish flow, three beats per Xi. Huan pulse is smooth/even, soft like spring willows, indicating Stomach Qi. Se pulse is sluggish/stagnant, like scraping bamboo with a dull knife. Dai pulse stops regularly without recovering immediately, pausing at fixed intervals.
Rapid pulse belongs to Yang, six beats per Xi. Smooth flow identifies Hua (Slippery). Forceful is Jin (Tight), like cutting a rope. Rapid with pause is Cu (Hasty). Like a bean, Dong (Moving) is unmistakable. All four are Rapid-type.
Rapid indicates hurried flow, six beats per Xi. Hua pulse flows smoothly without obstruction, like pearls rolling on a plate. Jin pulse is tight/forceful, vibrating against fingers like a plucked string. Cu pulse is rapid with irregular pauses, like stumbling while running. Dong pulse rises in the middle with depressed ends, trembling like a bean.
Three other pulses: Long, Short, and Wiry. Short does not reach its proper position. Long exceeds its position, continuous. Long and straight resembles a bowstring.
Long, Short, and Wiry are distinct from Floating/Deep/Slow/Rapid. Short pulse does not reach the Thenar or Chize, appearing contracted. Long pulse extends beyond boundaries, appearing extended. Wiry pulse is stiff/unyielding, like a bowstring, unlike Tight which is sharp/vibrating.
Each pulse shape governs specific diseases. Combined pulses require detailed analysis.
Each pulse image corresponds to a specific disease. Combined pulse images indicate combined symptoms; analyze combined pulses to deduce symptoms.
Floating pulse governs Exterior, Fu organ diseases. Forceful indicates Wind; Deficient indicates Blood deficiency. Floating-Slow indicates Exterior Cold; Floating-Rapid indicates Wind-Heat. Floating-Tight indicates Wind-Cold; Floating-Relaxed indicates Wind-Damp. Floating-Deficient indicates Summerheat injury; Floating-Hollow indicates Blood loss. Floating-Surging indicates Deficient Fire; Floating-Micro indicates Exhaustion. Floating-Soggy indicates Yin deficiency; Floating-Scattered indicates Critical deficiency. Floating-Wiry indicates Phlegm-Fluid; Floating-Slippery indicates Phlegm-Heat.
Although Floating is Yang/Exterior/Fu, combined with Surging/Rapid/Wiry/Slippery/Forceful, it indicates Heat/Fire/Phlegm/Wind. Combined with Slow/Relaxed/Hollow/Deficient/Micro/Choppy/Scattered/Deficient, it indicates Deficiency/Damp/Cold/Summerheat/Critical states. Differentiate based on combinations. The following follows this pattern.
Deep pulse governs Interior, Cold and Accumulation. Forceful indicates Phlegm-Food retention; Deficient indicates Qi stagnation. Deep-Slow indicates Deficient Cold; Deep-Rapid indicates Hidden Heat. Deep-Tight indicates Cold Pain; Deep-Relaxed indicates Water retention. Deep-Tense indicates Chronic Cold; Deep-Solid indicates Extreme Heat. Deep-Weak indicates Yin deficiency; Deep-Thin indicates Deficient Dampness. Deep-Wiry indicates Fluid Pain; Deep-Slippery indicates Food stagnation. Deep-Hidden indicates Vomiting/Diarrhea; Yin Toxin accumulation.
Although Deep is Yin/Interior, combined with Slow/Tight/Tense/Relaxed/Thin/Weak, it indicates Deficiency/Cold/Accumulation/Gathering. Combined with Solid/Rapid, it is not purely Yin; treat by clearing Heat from Yin level.
Slow pulse governs Zang organs, Yin-Cold interference. Forceful indicates Pain; Deficient indicates Deficient Cold.
Although Slow is Yin, distinguish Cold-Excess (stagnation/pain) from Cold-Deficiency (emptiness) by forcefulness.
Rapid pulse governs Fu organs, vomiting and mania. Forceful indicates Excess Heat; Deficient indicates Deficient Sores/Ulcers.
Although Rapid is Yang, distinguish Heat-Excess (mania/dryness) from Heat-Deficiency (deficient sores) by forcefulness.
Slippery governs Phlegm-Fluids; Right Guan governs Food; Chi governs Blood stasis; Cun indicates Vomiting. Choppy indicates Blood deficiency, also Cold-Damp. Regurgitation and intestinal constipation, spontaneous sweating can be predicted.
Slippery governs Phlegm-Fluids but also relates to Food/Blood/Vomiting. Choppy indicates Blood deficiency but distinguishes Cold-Choppy from Damp-Choppy. Blood exhaustion leads to upper regurgitation and lower intestinal constipation; fluid blockage causes upward reversal manifesting as sweating.
Long indicates Qi regulation; Short indicates Qi pathology. Floating-Long indicates Wind-Epilepsy; Deep-Short indicates Obstruction.
Long is the normal Liver pulse, indicating regulated Qi. Short is the normal Lung pulse; if seen elsewhere or not in Autumn, it indicates Qi damage. Floating-Long alone suggests Wind-Fire combusting causing Epilepsy; Deep-Short suggests Deficient-Cold combining causing Obstruction.
Thready indicates Qi decline; Large indicates Disease progression. Choppy-Small indicates Yin deficiency; Weak-Tiny indicates Yang exhaustion.
Harmony is precious. Thready like spider silk indicates weak Qi; Large/full/forceful indicates advancing disease. Small in all three positions, thready/choppy, indicates Essence-Blood deficiency. Small/not large, weak/flaccid, indicates Yang deficiency. Examine separately.
Surging indicates Extreme Heat, injuring Yin. Micro indicates Qi decline, damaging Yang. Floating-Surging indicates Exterior Excess; Deep-Surging indicates Interior Excess. Yang-Micro indicates Aversion to Cold; Yin-Micro indicates Fever.
Surging indicates Extreme Heat injuring Yin; distinguish Exterior/Interior. Micro indicates Qi decline damaging Yang; distinguish Yang/Yin aspects to treat aversion to cold vs. fever.
Tight governs Cold-Pain, Exterior or Interior. Relaxed governs Harmony, consider combinations. Relaxed-Slippery indicates Phlegm-Damp; Relaxed-Large indicates Great Wind-Deficiency. Relaxed-Choppy indicates Blood injury; Relaxed-Thin indicates Damp Bi.
Floating-Tight indicates Cold closing Exterior (body/head pain, aversion to cold). Deep-Tight indicates Cold binding Interior (abdominal distension/pain). Relaxed-Large indicates Wind-Deficiency. Relaxed-Thin indicates Food stagnation/Qi stagnation causing Bi syndrome. Relaxed-Choppy indicates severe Qi/Blood damage. Relaxed-Damp stagnation + Slippery-Phlegm accumulation worsens Damp/Phlegm.
Yang excess causes Cu (Hasty); Lung Abscess, Heat-Toxin. Yin excess causes Jie (Knotted); Hernia, Masses, Stagnation.
Rapid with pause is Cu, indicating Yang excess/Lung Abscess. Slow with pause is Jie, indicating Yin excess/Hernia/Masses.
Wiry governs Fluids, Wood insulting Spleen. Yang-Wiry causes Headache; Yin-Wiry causes Abdominal Pain. Moving indicates Struggle, Yin-Yang disharmony. Yang-Moving causes Sweating, Pain, Fright. Yin-Moving causes Heat, Metrorrhagia/Blood loss.
Wiry pulse implies Spleen deficiency, leading to Damp/Phlegm. Wiry at Cun (Upper Jiao) causes Headache; Wiry at Chi (Lower Jiao) causes Abdominal Pain. Moving indicates Yin-Yang disharmony. At Cun, affecting Heart/Lung causes Fright/Pain/Sweating. At Chi, affecting Kidney Water causes Metrorrhagia/Blood loss.
Deficient-Cold combination is named Ge (Leather). Men lose Essence; Women leak Blood. If Dai (Intermittent) pulse appears, True Qi is exhausted. Pus/Blood symptoms indicate fatal outcome. Typhoid Cholera, Trauma, Suffocation. Severe Carbuncles, Female Pregnancy (3 months).
Ge pulse results from Essence-Blood depletion, feeling empty/unfirm, causing Men's Essence loss/Women's Blood leakage. Dai pulse exhaustion or Pus/Blood symptoms are fatal. Exceptions: Typhoid/Cholera/Trauma/Carbuncles/Severe Pain/Pregnancy, due to sudden injury/blockage, should not be treated as fatal.
Pulses governing diseases have suitability. Yin-Yang compliance determines Auspicious/Ominous outcomes.
Diseases have Yin/Yang; Pulses have Yin/YANG. Compliance is auspicious; opposition is ominous. The following discusses pulse-symptom compliance/opposition based on this principle.
Wind Stroke pulse favors Floating-Slow. Firm-Large-Urgent indicates Ominous outcome. Type-Stroke due to Qi: Cool body, Deficient pulse. Type-Stroke due to Phlegm: Slippery pulse, Fat body. Type-Stroke due to Fire: Rapid pulse, Red face.
True Wind Stroke is Excess but caused by Deficiency; favors Floating-Slow, avoids Firm/Urgent to prevent Evil overcoming Righteousness. False Wind Stroke (Lei Zhong) mimics Wind but differs in cause; symptoms/pulses vary by category (Qi/Phlegm/Fire).
Typhoid/Febrile diseases favor Floating-Surging. Deep/Micro/Choppy/Small with contrary symptoms is Ominous. Post-sweat quiet pulse, cool body indicates Safety. Post-sweat dry pulse, intense Heat indicates Difficulty. Starting Taiyang: Floating-Tight/Choppy. Transmission changes: Hard to list. Yangming: Long. Shaoyang: Wiry. Taiyin entering Interior: Deep-Slow. Shaoyin: Deep. Jueyin Deep Heat: Hidden pulse, Cold limbs. Yang disease with Yin pulse: Life endangered. Yin disease with Yang pulse: Dangerous but harmless. Cold invasion: Tight/Choppy, Yin-Yang both Tight. Should be anhidrotic; sweating harms life.
Yang diseases suit Yang pulses; Yin diseases suit Yin pulses. Typhoid/Febrile diseases suit Surging/Rapid pulses; post-sweat should not show Dry pulse. Cold transmission is complex. Direct Cold invasion shows Tight pulses in both Yin/Yang. Generally, Yang disease with Yin pulse is critical. Yin disease with Yang pulse (Floating/Large/Rapid/Moving/Surging/Slippery) is usually contraindicated, but in early Typhoid resolution, it may not be harmful. However, Typhoid with sweating/deficiency showing Tight pulses in both sides indicates Qi collapse and disharmony, which is inauspicious.