〔一〕微者阴也。〔指下寻之极微再再〕寻之若有若无。（欲绝非绝。又曰按之如欲尽。）曰微。
主败血不止。面色无光。
若有若无。欲绝非绝。所以形容微之不可见。按之如欲尽。谓必轻手诊则可见。重手按则欲尽
而无也。微与濡弱相类。极软而浮细曰濡。极软而沉细曰弱。极细而软。无浮沉之别者。微脉也。微与
涩细何以分。细而又短于微来往蹇滞曰涩。细而稍大常有曰细。细而稍长似有似无曰微。合五脉相
类者详分之。则微脉可知矣。阳微恶寒。阴弱发热。微浮虽甚不成病。不可劳。脉经曰。脉者气血之候。
气血既微。则脉亦微矣。沉微则补阴。浮微则补阳。调补之道。以此为准。凡得是脉。必羸弱气虚为宜。
故风劳气虚之病。多得是脉。柳氏曰。脉分四时。春夏发生长旺。畏见此脉。秋冬见尚庶几。又曰人
禀气以生。若微脉太过。阳亏气乏。何足以生。
指下寻之有若无。漩之败血小肠虚。崩中日久为白带。漏下多时骨亦枯。微脉关前气上侵。当关
郁结气排心。尺下见之脐下积。身寒饮水即呻吟。
微在尺为阴盛阳虚。故为身寒。不可饮水。若饮水。则两寒相搏。痛而呻吟也。通真子曰多声。池
氏曰身寒饮水。李氏曰好饮冷水。皆非也。
〔二〕沉者阴也。〔指下寻之似有举之全无缓度三关状如烂绵〕（举之不足。按之有余。重按乃得。
有肌肉之下。）曰沉。主气胀两胁。手足时冷。
轻指于皮肤间不可得。徐按至肌肉中部间应指。又按至筋骨下部乃有力。此沉脉也。沉与浮相反。
与伏相近。沉脉。重按乃得于筋骨下部。若伏脉。则虽重按至筋骨下部亦不见。必用指推开筋
方可见脉。难经曰伏者脉行筋下也。内经曰推而内之。推而外之。皆是用指推筋脉以求之。非一定
其指。于病患臂上。俟其脉之自见也。此持脉口诀也。脉经曰沉者阴脉之始也。其象。按之至
筋骨得之者。是也。其体沉潜。深居诸脉之下。有地之气焉。凡诸脉即沉而见。则知其在阴而里受之。
今脉诀曰按之似有。状如烂绵。曰沉。如此则沉弱沉微沉细之脉。又当何如而诊之。甚失脉经之意矣。
经曰关以后者阴之动也。脉当见一寸。而沉。过者法曰太过。减者法曰不及。岂有按之似有状若烂绵
之不及也。
按之〔似〕（即）有举还无。气满三焦脏腑虚。冷气不调三部壅。通肠健胃始能除。
按之似有。是沉微脉。非独沉也。今改云按之即有。沉为阴。通肠宜温药利之。
寸脉沉兮胸有痰。当关气〔短〕（痞）痛难堪。
气短者。气不能相续。似喘而实非。气上冲。似呻吟而无痛。乃气急而短促也。今曰痛难堪。则非
气短。脉经曰。关沉。心下有冷气。苦满吞酸。则痛者气痞不通而痛也。
若在尺中腰脚重。小便稠数色如泔。
〔三〕缓者阴也。指下寻之。往来迟缓。〔小于迟脉〕（去来亦迟。小 于迟。又曰阳脉浮大而
濡。阴脉浮大而濡。阴脉与阳脉同等。）曰缓。〔主四肢烦闷气促不安〕
缓者二义。去来亦迟。小 于迟。每居中部或下部间。柔软而慢。但小于沉脉。兼之缓软。此有
邪之诊。为不及之缓。阴阳气和。阳寸阴尺。上下同等。同浮大而软。无有偏胜。此无邪之诊。为阴
阳和缓之缓。缓与迟二脉相类。缓脉大而慢。迟脉小而衰。缓者卫有余而营不足。迟者阴气盛而阳气衰。
二诊不同。迟脉一息三至。缓脉一息四至。脉经曰。缓脉小 于迟。今脉诀反云小于迟脉。误矣。
四肢烦闷。气促不安。皆非缓脉之证。
来往寻之状若迟。肾间生气耳鸣时。邪风积气来冲背。脑后三针痛即移。
缓脉关前搐项筋。当关气结腹难伸。尺上若逢 冷结。夜间常梦鬼随人。
〔四〕涩者阴也。〔指下寻之似有举之全无前虚后实无复次序〕（细而迟往来难。且散。或一止
复来。又曰短而止。）曰涩。主腹痛。女子有孕。胎痛。无孕。败血为痛。
脉来蹇涩。细而迟。不能流利圆滑。涩者涩也。与滑相反。如刀刮竹。竹皮涩。又有节。刀刮而行涩。
遇节则倒退。有涩脉往来难之意。如雨沾沙。沙者不聚之物。雨虽沾之。其体亦细而散。有涩脉往
来散之意。或一止复来。是因涩不流利之止。与结促代之止不同。玉函经曰。切脉定知生死路。但向止
代涩中取。看取涩脉与止代。此是死期之大概。涩脉与外有形证。未可断他殂大命。若是形证与代同。尺
部见之皆死定。黎氏曰代者止也。一脏绝。他脏代至。为真死脉。不分三部。随应皆是。涩者。三五不调。
如雨沾沙。为精血不足之候。与代相似。然三秋诊得涩而有胃气为平脉。右手寸口。浮短而涩。为肺正脉。
二者皆非
死脉。若尺寸俱浮紧而涩。外证必发热恶寒。项强腰痛。牵连百节俱痛。乃太阳经伤寒。汗之愈。举此
数端。以见涩脉与代脉不可例观。尺脉者人之根本。涩为精血不足之候。若独于尺中见涩。则死候也。
脉经曰。涩脉之象。往来蹇滞。行而多碍。夫脉者资血气而行。血气损伤。营卫行涩。故脉亦涩。
脉诀曰。按之似有。举之全无。是有沉涩无浮涩。经曰一阴一阳。谓脉来浮而涩也。则是浮中亦有涩。
岂独沉有涩乎。盖浮而涩者营卫伤。沉而涩者精血损。表里之证不同。故脉亦异。岂独有里而无表乎。
难经曰。前小后大。前大后小。其前后以尺寸论也。今云前虚后实。涩为少血。其形蹇滞。细短且散。
安能后实。若后实则非涩矣。其曰无复次序。即内经所谓参伍不调。上下如参舂之脉。是脉之乱。脉
乱则死矣。今以脉经改之。
涩脉如刀刮竹行。丈夫有此号伤精。妇人有孕胎中痛。无孕还须败血成。
涩脉关前胃气并。当关血散不能停。尺部如斯逢逆冷。体寒脐下作雷鸣。
〔五〕迟者阴也。〔指下寻之重手乃得隐隐〕（一息三至。去来极迟。）曰迟。主肾虚不安。
中风口 。脉浮而迟则生。今脉诀于迟脉曰重手乃得。是无浮迟之脉乎。立脉之名曰迟。以其比
平人一息四至。减去一至。故也。今曰隐隐。果何所似。且如蛛丝曰气衰。如风吹毛曰肺死。微甚欲
绝。伏甚不出。则庶可隐隐形容之。三至为迟。何隐隐乎。
〔迟脉人逢状且难〕（三至为迟一息间。）
迟脉一息三至。以至数之。至为易见。
遇其季夏不能痊。神工诊着知时候。〔道是脾来水必干〕（或者脾虚或肾寒。）
通真子曰。迟脉属肾。肾水忧在土。土季夏旺。洁古云迟本土也。当仿此一脉为时胜故长。
夏胜冬。土克水。池氏曰。季夏现迟。季夏土正旺。胜其肾水。水必枯。病不痊。抑脾土。滋肾水。
方为良工。以愚考之。内经曰脉迟者为脏病。难经曰迟者阴也。迟为在脏。非脾旺脉。亦非属肾
之脉。假使季夏土旺。脾能克肾。不缘脉迟。阿阿和大而缓。是脾之正脉。是因季夏时而旺。不病
之脉。若素有肾虚之病。则忧之。若曰因时旺脉。能克所胜。则是春肝脉旺。必克脾土。四时旺脉。
因序而见。人人四时皆病矣。今此脉诀之意。盖以夏月万物盛大。阳旺之时。而得迟脉为失时反证。
阴气大盛。脾者阴中之至阴也。迟在脾则脾冷。肾者亦阴也。迟在肾则肾冷。内经曰未有藏形。
于春夏而脉沉涩。秋冬而脉浮大。命曰逆四时。今迟脉在夏。亦逆四时也。
寸口迟脉心上寒。当关腹痛饮浆难。流入尺中腰脚重。浓衣重覆也嫌单。
〔六〕伏者阴也。〔指下寻之似有呼吸定息全无再再寻之不离三关〕（极重按之。着骨乃得。
又曰关上沉不出。又曰脉行筋下。）曰伏。主毒瓦斯闭藏三关。四肢沉重。手足时冷。
伏脉者。初下指轻按。不见。次寻之中部。又不见。次重手极按。又无其象。直待以手推其
筋于外而诊。乃见。盖脉行筋下也。若如常诊。不推筋以求。则无所见。昧者以为脉绝矣。沉脉因
按而知。伏脉因推而得。
伏与沉相似。沉者重按乃得。伏者重按亦不得。必推筋乃见也。若重按不得。推筋着骨全无。则脉绝
无而死矣。脉诀曰。指下寻之似有。则非伏也。呼吸定息全无。则脉绝也。再再寻之不离三关。三
关。三部一寸九分之位也。岂他脉之诊乃离舍三关乎。此脉诀言伏脉之状最谬。
阴毒伏气切三焦。不动营家气不调。不问春秋与冬夏。徐徐〔发汗〕（调理）始能消。
伏为积聚。有物为积。有营积。有卫积。有藏积。随所积而施治。可也。今曰不动营家气不调。
是先治营血而气自调也。必也治营积而见伏脉者方可。若夫气积。及食物积。藏积。又当各治其本。
且气为是动。血为所生者。难经曰。气留而不行者。为气先病。血滞而不濡者。为血后病。故先为是动。
后为所生病。以此论之。当先调气而血自顺。亦有血先病而气后病者。随病施治可也。难乎执一。其
因物聚者。又必以所恶者攻之。以所喜者诱之。亦不专于先动营也。通真子曰。伏脉不可发汗。更
宜消息。诚哉是言。内经曰其有邪者渍形以为汗。其在皮者汗而发之。仲景曰脉浮者。病在表。可发汗。
又曰表有病。脉当浮。今伏脉乃在里之病。岂宜发汗。虽曰徐徐。其动表一也。非其治也。洁古又引
阳盛阴虚。汗之则愈。以升麻汤、麻黄汤、麻黄附子细辛汤为治。亦非也。难经所云。仲景所述。曰
阳盛阴虚者。谓伤寒之邪。在表为阳。在里为阴。邪入皮肤。恶寒发热。是表虚而受邪曰阳虚。未传
入里。里未受邪。曰阴盛。故云汗之则愈。非论伏脉为阴盛也。假使阴毒为病。正当随浅深。用温药祛逐。
其可发汗邪。
积气胸中寸脉伏。当关肠癖常暝目。尺部见之食不消。〔坐卧不安〕（ 瘕攻痛）还破腹。
〔七〕濡者阴也。〔指下寻之似有按之根据前却去〕（极软而浮细。轻手乃得。不任寻按。）曰濡。
主少气。五心烦热。脑痛耳鸣。下元冷极。
有余于上曰浮。既浮而细曰软。浮而软细曰濡。按之无有。举之则浮细而极软。必轻手乃可得。
脉经曰如帛衣在水中。帛漫在水。虚浮见于水面。若用指按之。则随手而软散。不与手应。此濡脉之状也。
濡与迟弱相近。一息三至。随浮沉而见曰迟。极软而浮细。轻手乃得。不能沉。曰濡。轻软而沉细。
按之乃得。重按欲绝。指下不能起伏。不能浮。曰弱。濡弱迟微之脉。皆气血之不足者也。大病后。
或产妇。喜见此等脉。平人强人忌见之。更随时随病消息之。脉诀曰指下寻之似有。与言伏脉同。何
是何非耶。且诸脉之应。皆一来一去。如曰来疾去迟。曰来盛去不盛。以别钩脉。外实内虚之诊。
今曰按之根据前却去。其状果何如耶。内经曰软。脉经曰濡。同一脉也。难经曰春脉弦。濡弱而长。按
之濡。举之来实者。肾也。沉濡而滑曰石。是皆兼他脉。以濡在中和为胃气之本。为平脉。旺脉。
若濡脉独见。则病脉也。内经曰心脉 散。当消环自已。肝 散。病溢饮。胃 散。病食痹。脾 散。
色不泽。足 肿。肾 散。病少血。其言 散脉。与搏坚而长对。言病也。故难经亦以气来虚微。
来实强。对言之。非所谓濡与虚弱之诊也。
〔按之似有举之无〕（举全无力按如无。）
脉诀。此句全非濡诊。活人书曰。按之似无。举之全无力。曰濡。今从之。髓海丹田定已枯。
四体骨蒸劳热甚。脏腑终传命必殂。濡脉关前〔人足汗〕（虚自汗。）
脉诀足字本为充足之足。昧者误以手足之足训之。今改为自汗。庶无误也。
当关少气精神散。尺部绵绵却恶寒。骨与肉疏都不管。
〔八〕弱者阴也。指下寻之如烂绵相似。〔轻手乃得重手乃无怏怏不能前〕（极软
而沉细。按之如绝指下。）曰弱。〔主气居于表〕生产后客风面肿。
弱者扶持不起之状。不能起伏。不任寻按。大体与濡相类。濡脉细软而浮。弱脉则
细软而沉。以此别之。病后见此脉为顺。强人平人见之。为损为危。独见一部或二部犹庶几。
三部六部皆见之。甚矣。脉经论弱云。按之乃得。举之无有。今脉诀云轻手乃得。重手乃
无。与脉经相反。今改之。又弱为虚候。气血损减。今云气居于表。果何证乎。表病脉必
因浮而见。今弱脉沉细在下。何以诊表。素问曰。而肿曰风。不拘于产后也。弱脉亦难以验风。
〔三关〕（脉行）怏怏不能前。〔只为风邪与气连〕（软细而沉似烂绵。）少年得此
须忧重。老弱逢之病却痊。关前弱脉阳道虚。关中〔有此气多疏〕（虚热胃虚疏。一作气多粗尤非）
脉经曰。关弱胃气虚。胃中有客热。脉弱为虚。热作病。有热。不可大攻之。热去则
寒起矣。池氏曰。关乃阴阳分处。脉弱则阴阳隔绝。主气喘。李 范因之。今按气喘者脉必实。
脉弱则气乏。不足以息。今根据脉经改之。柳氏曰气虚羸弱。弱脉乃见。寸弱为阳气虚。尺弱为阴
气虚。关弱为胃虚。仲景曰诸弱发热。乃弱为阳虚。虚而发热。非实热也。大抵阳少阴多。皆为
不足之候。脉经曰弱为虚为悸。内经曰脉弱
以滑。是有胃气。命曰易治。脉小弱以涩。谓之久病。同一弱也。以滑涩相兼而易诊。
[1] The Micro pulse (Wei Mai, faint pulse) belongs to Yin syndromes. [When seeking with the fingers, it feels extremely faint; upon repeated searching] it seems present yet absent. (It appears as if it is about to disappear but does not completely vanish. It is also described as: when pressed heavily, it feels as though it is about to exhaust.) This is called the Micro pulse.
It primarily indicates unremitting failure of blood (Bai Xue), and a lusterless complexion.
"Seeming present yet absent, appearing to vanish yet not fully gone" describes the invisibility of the Micro pulse. "Feeling as though it is about to exhaust when pressed heavily" means that it can only be perceived with light pressure; heavy pressure makes it feel like it is disappearing or actually disappears. The Micro pulse is similar to the Soggy (Ru) and Weak (Ruo) pulses. Extremely soft and floating-thin is the Soggy pulse; extremely soft and sinking-thin is the Weak pulse; extremely thin and soft, without distinction between floating and sinking, is the Micro pulse. How to distinguish the Micro pulse from the Choppy (Se) and Thin (Xi) pulses? A thin pulse that is shorter than the Micro pulse and has a hesitant, obstructed flow is called Choppy; a thin pulse that is slightly larger and constantly present is called Thin; a thin pulse that is slightly longer and seems to have and not have is called Micro. By distinguishing these five similar pulses in detail, the Micro pulse can be understood. Yang deficiency presenting with a Micro pulse causes aversion to cold; Yin deficiency presenting with a Weak pulse causes fever. Although a Micro pulse may float, even if pronounced, it does not constitute a major disease, but labor should be avoided. The *Mai Jing* (Classic of Pulse Diagnosis) states: "The pulse is the indicator of Qi and Blood. Since Qi and Blood are micro/faint, the pulse is also micro/faint." For a sinking Micro pulse, tonify Yin; for a floating Micro pulse, tonify Yang. The principle of regulation and tonification is based on this. Whenever this pulse is obtained, the body must be emaciated and Qi-deficient, which is appropriate. Therefore, diseases such as Wind-Lao (chronic wasting due to wind) and Qi deficiency often present this pulse. Liu Shi said: Pulses vary by season. In spring and summer, when Yang Qi arises and grows vigorous, one fears seeing this pulse; in autumn and winter, seeing it is somewhat acceptable. He also said: Humans are born endowing Qi; if the Micro pulse is excessive, Yang is deficient and Qi is lacking, how can life be sustained?
Seeking under the finger, it seems to have and not have; swirling敗血 (failure of blood) indicates small intestine deficiency. Long-term Bing Zhong (uterine bleeding) turns into white leukorrhea; long-term Lou Xia (dripping bleeding) causes bones to wither. If the Micro pulse appears at the Cun (inch) position before Guan, Qi invades upward; at the Guan (bar) position, stagnant Qi presses against the Heart; at the Chi (cubit) position, there is an accumulation below the navel, chills, and groaning after drinking water.
Micro pulse at Chi indicates Yin excess and Yang deficiency, hence chills. One should not drink water. If water is drunk, the two colds clash, causing pain and groaning. Tong Zhen Zi said "many sounds," Chi Shi said "chills and drinking water," Li Shi said "likes drinking cold water"; all are incorrect.
[2] The Deep pulse (Chen Mai) belongs to Yin syndromes. [Seeking under the finger, it seems present but vanishes when lifted; slowly passing through the three positions, resembling rotten cotton] (Light pressure is insufficient, heavy pressure yields abundance; obtained only with heavy pressure. Located beneath the muscle.) This is called the Deep pulse. It primarily indicates abdominal distension in both hypochondria, and cold hands and feet.
With light fingers, it cannot be found at the skin level; slowly pressing to the middle of the muscle layer, it responds to the finger; pressing further to the lower bone-tendon level, it becomes forceful. This is the Deep pulse. The Deep pulse is opposite to the Floating pulse and close to the Hidden pulse. The Deep pulse is obtained only with heavy pressure at the lower bone-tendon level. As for the Hidden pulse, even with heavy pressure to the bone-tendon level, it is not seen; one must use the finger to push aside the tendon to see the pulse. The *Nan Jing* (Classic of Difficult Issues) states: "The Hidden pulse runs beneath the tendons." The *Nei Jing* (Inner Canon) states: "Push inward, push outward," meaning using the finger to push the tendon and vessel to seek the pulse, not fixing the finger on the patient's arm waiting for the pulse to appear naturally. This is the secret of holding the pulse. The *Mai Jing* states: "The Deep pulse is the beginning of Yin pulses." Its image is obtained by pressing to the bone and tendon. Its nature is deep and submerged, residing deeply below other pulses, possessing the Qi of Earth. If any pulse appears deep, it indicates pathology in the Yin and interior. Now, the *Mai Jue* (Pulse Rhymes) says "seems present when pressed, resembling rotten cotton," calling it Deep. In this case, how should Deep-Weak, Deep-Micro, and Deep-Thin pulses be diagnosed? This greatly deviates from the intent of the *Mai Jing*. The *Jing* states: "Behind the Guan is the movement of Yin; the pulse should be visible for one cun and deep. Exceeding is termed 'Excess'; diminishing is termed 'Deficiency.' How can 'seeming present when pressed, resembling rotten cotton' be considered Deficiency?"
Pressed [seems] (actually) present, lifted completely absent; Qi fills the Triple Burner, Zang-Fu organs are deficient. Cold Qi fails to regulate, blocking the three positions; unblocking the intestines and strengthening the stomach is required for elimination.
"Seeming present when pressed" refers to the Deep-Micro pulse, not just Deep. Now corrected to "present when pressed." Deep is Yin; unblocking the intestines requires warm herbs to promote drainage.
Cun pulse Deep indicates phlegm in the chest. Guan pulse [Shortness of Qi] (Stagnation) causes unbearable pain.
Shortness of Qi means Qi cannot continue, resembling panting but not truly so; Qi rushes upward, resembling groaning but without pain; it is rapid and short breathing. Now saying "unbearable pain" is not Shortness of Qi. The *Mai Jing* states: "Guan Deep indicates cold Qi in the epigastrium, bitter fullness, and acid regurgitation; thus pain is due to Qi stagnation and blockage."
If at Chi, heavy waist and legs, thick and frequent urination with color like rice washings.
[3] The Moderate/Slack pulse (Huan Mai) belongs to Yin syndromes. Seeking under the finger, the flow is slow and delayed. [Smaller than the Slow pulse] (Coming and going is also slow, smaller than Slow. Also said: Yang pulse is Floating-Big and Soft; Yin pulse is Floating-Big and Soft; Yin and Yang pulses are equal.) This is called the Moderate pulse. [Indicates vexation and stuffiness in limbs, rapid breathing, and restlessness]
Moderate pulse has two meanings. Coming and going is slow, smaller than Slow, usually located in the middle or lower positions, soft and slow, merely smaller than Deep pulse, combined with slackness. This is a diagnosis of pathogenic factors, representing Deficient Moderate pulse. When Yin and Yang Qi are harmonious, Yang at Cun and Yin at Chi are equal above and below, both Floating-Big and soft, without bias. This is a diagnosis of no pathogenic factors, representing Harmonious Moderate pulse of Yin and Yang. Moderate and Slow pulses are similar. Moderate pulse is Big and slow; Slow pulse is Small and declining. Moderate pulse indicates Wei Qi excess and Ying Qi deficiency; Slow pulse indicates Yin Qi excess and Yang Qi decline. These two diagnoses differ. Slow pulse is three beats per respiration; Moderate pulse is four beats per respiration. The *Mai Jing* states: "Moderate pulse is smaller than Slow." Now the *Mai Jue* reverses this, saying "smaller than Slow pulse," which is erroneous.
Vexation and stuffiness in limbs, rapid breathing and restlessness, are not symptoms of the Moderate pulse.
Seeking back and forth, shape resembles Slow pulse; vitality arising from Kidney causes tinnitus. Pathogenic wind and accumulated Qi rush to the back; three needles behind the head relieve pain immediately.
Moderate pulse at Cun draws neck tendons; at Guan, Qi knots making abdomen difficult to extend; at Chi, if encountering cold accumulation, dreaming of ghosts following one at night.
[4] the Choppy pulse (Se Mai) belongs to Yin syndromes. [Seeking under the finger seems present, lifting completely absent; anterior deficiency posterior excess, no regular order] (Thin and slow, difficult to come and go, scattered, or stopping once then returning. Also said: Short and stopping.) This is called the Choppy pulse. It indicates abdominal pain. In pregnant women, fetal pain; in non-pregnant women, pain due to failed blood (stasis).
The pulse comes hesitantly and chopply, thin and slow, unable to flow smoothly and roundly. Se means rough/choppy. It is opposite to Slippery pulse. Like a knife scraping bamboo: bamboo skin is rough and has nodes; the knife scrapes roughly and retreats at nodes, indicating the difficulty of the Choppy pulse. Like rain wetting sand: sand does not gather; although rain wets it, its form is thin and scattered, indicating the scattering nature of the Choppy pulse. Or stopping once then returning: this stop is due to lack of smoothness, different from the stops of Knotted (Jie), Rapid-intermittent (Cu), and Intermittent (Dai) pulses. The *Yu Han Jing* states: "Cutting the pulse to know the path of life and death, look within Stop, Dai, and Se. Observing Se pulse and Stop/Dai, this is the general sign of death." However, if Se pulse has external physical signs, one cannot judge immediate death. If physical signs match Dai pulse and Se is seen at Chi, death is certain. Li Shi said: Dai is a stop; when one Zang fails, another Zang takes over, constituting a true death pulse, regardless of the three positions. Se is irregular (three-five times uneven), like rain wetting sand, indicating insufficiency of Essence and Blood. It resembles Dai. However, obtaining Se pulse in the third autumn with Stomach Qi is a normal pulse. Right Cun Kou, Floating-Short and Se, is the correct pulse of Lung. Neither is a death pulse. If Cun and Chi are both Floating-Tight and Se, external signs must include fever, aversion to cold, stiff neck, low back pain, and pain throughout all joints, indicating Taiyang channel Cold Damage, cured by sweating. Citing these points shows Se and Dai pulses cannot be viewed identically. Chi pulse is the root of humans; Se indicates insufficiency of Essence and Blood. If Se is seen exclusively at Chi, it is a death omen.
The *Mai Jing* states: "The image of Se pulse is hesitant and obstructed flow, moving with many hindrances. The pulse relies on Blood and Qi to move; when Blood and Qi are damaged, Ying and Wei flow roughly, so the pulse is also Se."
The *Mai Jue* states: "Seeming present when pressed, completely absent when lifted." This implies only Deep-Se exists, not Floating-Se. The *Jing* states: "One Yin One Yang means the pulse comes Floating and Se." Thus, Se exists in Floating as well. How could only Deep have Se? Floating-Se indicates damage to Ying and Wei; Deep-Se indicates damage to Essence and Blood. Exterior and Interior patterns differ, so pulses differ. How could there be only Interior without Exterior?
The *Nan Jing* states: "Anterior small posterior big, anterior big posterior small," discussing front and back via Cun and Chi. Now it says "anterior deficiency posterior excess." Se indicates little Blood, its form is hesitant, thin, short, and scattered. How can it be posterior excess? If posterior were excess, it would not be Se. "No regular order" refers to what the *Nei Jing* calls "Can Wu Bu Tiao" (irregularity), where upper and lower resemble pounding mortar; this is chaotic pulse. Chaotic pulse leads to death. Now corrected according to the *Mai Jing*.
Se pulse moves like knife scraping bamboo; men having this are labeled as injuring Essence. Women with pregnancy have fetal pain; without pregnancy, it must be formed by failed blood.
Se pulse at Cun combines with Stomach Qi; at Guan, Blood scatters and cannot stay; at Chi, such conditions meet reverse cold, body chills, rumbling below navel.
[5] the Slow pulse (Chi Mai) belongs to Yin syndromes. [Seeking under the finger, heavy pressure yields faint presence] (Three beats per respiration, coming and going extremely slow.) This is called Slow pulse. It indicates Kidney deficiency and unrest.
Stroke with mouth deviation. Pulse Floating and Slow indicates survival. Now the *Mai Jue* says for Slow pulse "heavy pressure yields," implying there is no Floating-Slow pulse? The name Slow is established because it subtracts one beat from the normal four beats per respiration. Now saying "faint," what does it resemble? Just as spider silk indicates Qi decline, wind-blown wool indicates Lung death, Micro almost vanishing, Hidden extremely hidden, can barely be described as faint. Three beats is Slow, why faint?
[When people encounter Slow pulse, the condition is difficult] (Three beats is Slow within one respiration.)
Slow pulse is three beats per respiration; counting beats makes it easy to see.
Encountering late summer, recovery is unlikely. The divine doctor diagnosing knows the timing. [Saying spleen arrives, Water must dry up] (Either Spleen deficiency or Kidney cold.)
Tong Zhen Zi said: Slow pulse belongs to Kidney; Kidney Water worries about Earth; Earth is vigorous in late summer. Jie Gu said Slow is Earth-like. One should imitate this pulse growing due to seasonal dominance.
Summer conquers Winter, Earth conquers Water. Chi Shi said: Late summer showing Slow, Earth is vigorous, conquering Kidney Water, Water must wither, illness will not recover. Suppress Spleen Earth, nourish Kidney Water, this is the work of a good doctor. Examining this myself: The *Nei Jing* states "Slow pulse indicates Zang disease"; the *Nan Jing* states "Slow is Yin"; Slow is in the Zang, not a Spleen-vigorous pulse, nor a Kidney-belonging pulse. Suppose late summer Earth is vigorous, Spleen can conquer Kidney, not due to Slow pulse. Ah-Ah Big and Slow is the correct pulse of Spleen, vigorous due to late summer season, a non-diseased pulse. If one has chronic Kidney deficiency, one should worry. If saying seasonal vigorous pulse can conquer what it overcomes, then Spring Liver pulse vigorous must conquer Spleen Earth. Four seasons' vigorous pulses appear due to sequence; everyone would be diseased in four seasons. The intent of this *Mai Jue* seems to be that in summer when all things are grand and Yang is vigorous, obtaining Slow pulse is a counter-seasonal adverse sign. Yin Qi is excessively strong. Spleen is the greatest Yin among Yin; Slow in Spleen means Spleen cold; Kidney is also Yin; Slow in Kidney means Kidney cold. The *Nei Jing* states: "Without organ form, in spring and summer pulse is Deep-Choppy, in autumn and winter pulse is Floating-Big, named contrary to four seasons." Now Slow pulse in summer is also contrary to four seasons.
Cun kou Slow pulse indicates cold in heart; Guan position abdominal pain, difficulty swallowing liquids; flowing to Chi, heavy waist and legs; thick clothes and heavy covers still feel too thin.
[6] the Hidden pulse (Fu Mai) belongs to Yin syndromes. [Seeking under the finger seems present, during breath pause completely absent, repeatedly seeking does not leave the three positions] (Extremely heavy press, touching bone to obtain. Also said: Guan Deep does not emerge. Also said: Pulse runs beneath tendons.) This is called Hidden pulse. It indicates toxic gases closing the three positions, heavy limbs, and cold hands and feet.
For Hidden pulse, initially pressing lightly, it is not seen. Seeking in the middle layer, still not seen. Pressing heavily to the extreme, still no image. Only by pushing the tendon outward with hand to diagnose, it is seen. Because the pulse runs beneath the tendon. If diagnosing normally without pushing tendon to seek, nothing is seen. Ignorant people think the pulse has ceased. Deep pulse is known by pressing; Hidden pulse is obtained by pushing.
Hidden and Deep are similar. Deep is obtained by heavy press; Hidden is not obtained by heavy press, must push tendon to see. If heavy press fails, pushing tendon to bone yields nothing, then pulse ceases and death occurs. The *Mai Jue* says: "Seeking under finger seems present," then it is not Hidden. "Completely absent during breath pause," then pulse has ceased. "Repeatedly seeking does not leave the three positions." Three positions refer to the location of three sections, one cun nine fen. Do other pulses' diagnoses leave the three positions? This description of Hidden pulse in the *Mai Jue* is most absurd.
Yin toxin and Hidden Qi cut through Triple Burner, failing to move Ying family, Qi fails to regulate. Regardless of spring, autumn, winter, or summer, slowly [sweating] (regulating) can eliminate it.
Hidden refers to accumulation. Having substance is Ji (accumulation); there is Ying accumulation, Wei accumulation, Zang accumulation. Treat according to the accumulation. Now saying "fail to move Ying family, Qi fails to regulate" implies treating Ying blood first so Qi regulates. This is only valid if treating Ying accumulation presenting Hidden pulse. For Qi accumulation, food accumulation, Zang accumulation, treat their roots respectively. Moreover, Qi is "Shi Dong" (active change), Blood is "Suo Sheng" (generated consequence). The *Nan Jing* states: "Qi remaining and not moving is Qi disease first; Blood stagnating and not moistening is Blood disease later." Thus first is Shi Dong, later is Suo Sheng Disease. Based on this, should first regulate Qi so Blood flows smoothly. There are cases where Blood disease first and Qi disease later; treat according to disease. Hard to stick to one rule. For those caused by material gathering, must attack with what is disliked and lure with what is liked, not solely focusing on moving Ying first. Tong Zhen Zi said: "Hidden pulse cannot be treated by sweating, more suitable to consider carefully." Truly said. The *Nei Jing* states: "Those with pathogens, soak form to make sweat; those in skin, sweat to release." Zhang Zhongjing stated: "Pulse Floating, disease in exterior, can sweat." Also: "Exterior disease, pulse should be Floating." Now Hidden pulse is interior disease, how can sweating be suitable? Although saying "slowly," it still moves the exterior, which is not the correct treatment. Jie Gu again cited Yang Excess Yin Deficiency, sweating cures it, using Sheng Ma Tang, Ma Huang Tang, Ma Huang Fu Zi Xi Xin Tang for treatment, also incorrect. What the *Nan Jing* and Zhang Zhongjing described regarding Yang Excess Yin Deficiency means: Cold Damage pathogen, in exterior is Yang, in interior is Yin. Pathogen enters skin, aversion to cold and fever, this is exterior deficiency receiving pathogen called Yang Deficiency; not yet transmitted to interior, interior not receiving pathogen called Yin Excess. Thus sweating cures it, not discussing Hidden pulse as Yin Excess. Suppose Yin Toxin disease, should follow depth, use warm herbs to expel, how can sweating be used?
Accumulated Qi in chest, Cun pulse Hidden; Guan position intestinal dysentery, often closing eyes; Chi position seeing it, food not digesting, [restless sitting and lying] (mass attacking pain) also breaks abdomen.
[7] the Soggy pulse (Ru Mai) belongs to Yin syndromes. [Seeking under finger seems present, pressing according to previous retreat] (Extremely soft and floating-thin, obtained with light hand, cannot bear seeking or pressing.) This is called Soggy pulse. It indicates shortness of Qi, heat in five centers, brain pain and tinnitus, extreme cold in lower origin.
Excess above is Floating; since Floating and thin is Soft; Floating and soft-thin is Soggy. Pressing yields nothing; lifting yields floating-thin and extremely soft, must use light hand to obtain.
The *Mai Jing* states: "Like silk clothing in water, silk floats on water, void-floating seen on surface; if using finger to press, it follows hand becoming soft and scattered, not responding to hand." This is the state of Soggy pulse.
Soggy is close to Slow and Weak. Three beats per respiration, appearing with floating/sinking is Slow. Extremely soft and floating-thin, obtained with light hand, cannot sink, is Soggy. Light-soft and sinking-thin, obtained by pressing, heavy press desires extinction, finger cannot rise/fall, cannot float, is Weak. Soggy, Weak, Slow, and Micro pulses are all insufficiency of Qi and Blood. After severe illness, or postpartum, liking to see such pulses. Normal people and strong people should avoid seeing them; further consider time and disease. The *Mai Jue* says: "Seeking under finger seems present," same as describing Hidden pulse, which is right and which is wrong? And all pulses respond with one coming and one going, e.g., "coming fast going slow," "coming vigorous going not vigorous," to distinguish Hook pulse, exterior solid interior empty diagnosis. Now saying "pressing according to previous retreat," what is its state? The *Nei Jing* calls it Ruan (Soft); the *Mai Jing* calls it Ru (Soggy); they are the same pulse. The *Nan Jing* states: "Spring pulse String-like, Ruan-Ruo and long, pressing Ruan, lifting comes solid, is Kidney." Deep-Ruan and Slippery is Stone. All combine other pulses. Ruan at center harmony is root of Stomach Qi, normal pulse, vigorous pulse. If Ruan pulse appears alone, it is pathological pulse. The *Nei Jing* states: Heart pulse Scattered, should heal itself in a cycle. Liver Scattered, disease Yi Yin. Stomach Scattered, disease Shi Bi. Spleen Scattered, color not lustrous, foot swelling. Kidney Scattered, disease little blood. Speaking of Scattered pulse, contrasted with Firm-Hard-Long, speaking of disease. Thus *Nan Jing* also contrasts Qi coming void-faint with coming solid-strong, not referring to Soggy and Weak-Ruo diagnosis.
[Pressing seems present lifting absent] (Lifting completely powerless, pressing like nothing.)
The *Mai Jue*, this sentence is entirely incorrect for Soggy diagnosis. The *Huo Ren Shu* states: "Pressing seems absent, lifting completely powerless, called Soggy." Now following it. Marrow sea and Dantian definitely already withered; four limbs bone-steaming劳热 (deficiency heat) severe; viscera finally transmit, life must perish. Soggy pulse at Cun [person's foot sweat] (deficient spontaneous sweating).
The character Zu in *Mai Jue* originally meant sufficient/full. Ignorant people mistakenly interpreted it as foot/hand foot. Now changed to spontaneous sweating, to avoid error.
Guan position shortness of Qi, spirit scatters; Chi position continuous but aversion to cold. Bone and flesh loose, do not care.
[8] the Weak pulse (Ruo Mai) belongs to Yin syndromes. Seeking under finger resembles rotten cotton. [Light hand obtains, heavy hand loses, unwillingly cannot advance] (Extremely soft and sinking-thin, pressing like extinction under finger.) This is called Weak pulse. [Indicates Qi residing in exterior] Postpartum external wind facial swelling.
Weak is like supporting but unable to rise, unable to rise/fall, cannot bear seeking/pressing. Generally similar to Soggy. Soggy pulse is thin-soft and floating; Weak pulse is thin-soft and sinking, distinguished by this. Seeing this pulse after illness is favorable; seeing it in strong/normal people is damaging and dangerous. Seeing in one or two positions is somewhat acceptable; seeing in three positions and six locations is severe.
The *Mai Jing* discusses Weak: "Obtained by pressing, absent when lifting." Now the *Mai Jue* says "obtained by light hand, lost by heavy hand," opposite to *Mai Jing*. Now corrected. Also Weak is deficiency pattern, Qi and Blood damaged. Now saying "Qi resides in exterior," what syndrome is this? Exterior disease pulse must appear due to Floating; now Weak pulse is sinking-thin below, how to diagnose exterior? The *Su Wen* states: "Swelling is Wind," not limited to postpartum. Weak pulse also difficult to verify Wind.
[Three positions] (Pulse travels) unwillingly cannot advance. [Only because wind pathogen connects with Qi] (Soft-thin and sinking like rotten cotton.) Young people getting this must worry heavily; old and weak meeting it, illness recovers. Cun position Weak pulse Yang path deficient; Guan position [having this Qi much sparse] (Deficient heat Stomach deficiency sparse. Another version Qi much coarse especially incorrect)
The *Mai Jing* states: Guan Weak Stomach Qi deficient, guest heat in Stomach, pulse Weak is deficiency, heat causes disease, having heat, cannot attack strongly; heat goes then cold rises. Chi Shi said: Guan is division of Yin and Yang, pulse Weak then Yin and Yang separated, main asthma. Li Fan followed. Now analyzing: Asthma pulse must be Solid; pulse Weak means Qi lacks, insufficient for breath. Now corrected according to *Mai Jing*. Liu Shi said: Qi deficiency emaciation, Weak pulse appears. Cun Weak Yang Qi deficiency; Chi Weak Yin Qi deficiency; Guan Weak Stomach deficiency. Zhang Zhongjing stated: All Weak fevers, thus Weak is Yang deficiency, deficiency causing fever, not excess heat. Generally Yang few Yin many, all are insufficiency patterns. The *Mai Jing* states: Weak is deficiency and palpitations. The *Nei Jing* states: Pulse Weak with Slippery, has Stomach Qi, named easy to treat. Pulse Small-Weak with Choppy, named long-standing disease. Same Weak, easy to diagnose combining Slippery and Choppy.