小序 病有不尽凭于脉者，然凭脉以断者，十居其九，乃取其宜忌者而标示焉，使不啻影之随
形，以戒世之侥幸于万一，遗师其咎者也。
脉之主病，有宜不宜；阴阳顺逆，吉凶可知。
有是病则有是脉，与病相宜则顺，不相宜则逆。逆之与顺，何从区别，是又在阴阳耳。如表病见表脉，里
病见里脉，实病见实脉，虚病见虚脉，阳病见阳脉，阴病见阴脉之类，皆顺而相宜者也。反此则逆。逆顺
一分，而病之吉凶从可推矣。
中风之脉，却喜浮迟；数大急疾，兼见难支。
中风之脉，各有所兼。盖新风挟旧邪，或外感，或内伤，其脉随之忽变。兼寒则脉浮紧，兼风则脉浮缓，兼
热则脉浮数，兼痰则脉浮滑，兼气则脉沉涩，兼火则脉盛大，兼阳虚则脉微亦大而空，兼阴虚则脉数
亦如细丝，阴阳俱虚则微数或微细。虚滑为头中痛，缓迟为营卫衰。大抵阳浮而数，阴濡而弱，浮滑沉
滑，微虚散数，皆为中风。风性空虚，中之于表，虚浮迟缓，虽为正气不足，犹可补救。急大数疾，邪不受制，
必死无疑。可见大数而犹未至急疾者，尚不可谓其必死也。
伤寒热病，脉喜浮洪；沉微涩小，证反必凶，汗后脉静，身凉则安；汗后脉躁，热甚必难。阳证见
阴，命必危殆；阴证见阳，虽困无害。
《素问·热论》曰∶“今夫热病者，皆伤寒之类也。”又曰∶“人之伤于寒也，则为病热，热虽甚不死。”观此
则知伤寒虽是阴寒之邪袭人，正气与之抗拒，郁蒸成热，亦理势之必然者。抗拒在表故脉浮，郁蒸成
热故脉洪。热病得此阳脉，知正气不陷缩而能鼓发，胜邪必矣，故喜焉。若沉微涩小，是皆阴类，证阳脉
阴，表病见里，证与脉反，邪盛正衰，凶之兆也。至若汗后邪解正复，此时脉躁盛者亦应宁静，身体自然
凉和。设脉仍躁而热加甚，是正气已衰，邪气更进，必难乎其为生矣。即《素问·评热论》所谓“有病
温者，汗出辄复热而脉躁疾，不为汗衰，狂言，不能食，病名阴阳交”也。阳证见阴者，见阴脉也，即上文
所云热病而得沉微涩小之类，言证与脉反，故亦危殆。阴证见阳者，见阳脉也，亦似与证相反，惟伤寒
则不然。伤寒自表入里，从阳之阴，刻刻侵搏，层层渐入。今阴病得阳脉，是转寒凛而变温和，起深沉而
出浮浅，死阴忽作生阳，病虽困笃，自当无害。故仲景云∶“阴病见阳脉者生，阳病见阴脉者死。”
伤暑脉虚，弦细芤迟；若兼滑实，别证当知。
经曰∶“脉虚身热，得之伤暑。”《甲乙经》曰∶“热伤气而不伤形，所以脉虚者是也。”若《难经·四十九
难》曰∶“其脉浮大而散。”殊有未然。夫脉大而散，乃心之本脉，非病脉也。故仲景不言，但补其偏曰∶“弦
细芤迟。”芤即虚豁也。弦、细、迟即热伤气之应也。统而言之曰虚，分而言之曰弦、细、芤、迟，其不以浮大
之脉混入虚脉之中，称为病暑之脉，虑何周耶。若面垢身热，伤暑之证已见，而脉反滑实，将兼痰与食矣。
劳倦内伤，脾脉虚弱；汗出脉躁，死证可察。
动而生阳，身固不宜太逸。东垣论升阳益胃汤方后云∶“小役形体，使胃气与药得以转运升发。”此即
动而生阳之义也。若烦扰而过于劳，则肢体转旋，四肢举动，阳气张乱，无往非脾气之伤，故脾脉虚弱
为顺也。如汗出而脉反躁疾，则为逆矣，安得不死。
疟脉自弦，弦数者热，弦迟者寒，代散者绝。
《素问·疟论》曰∶“夫 疟皆生于风。”故疟因风暑之邪，客于风木之府，木来乘土，脾失转输，不能运
水谷之精微，遂多停痰留饮。弦应风木，又主痰饮，无痰不成疟，故曰“疟脉自弦”。数热、迟寒，自然之理。
独见代散之脉，则正气虚脱，不续不敛之象，邪盛正衰，定主凶折。
泄泻下痢，沉小滑弱；实大浮洪，发热则恶。
泄痢见于下部，无论因之内外，总属伤阴耗里之虚证，沉小滑弱，乃为相宜。若实大浮洪则恶矣。实大
与虚反，浮洪与里反，邪盛正衰，不言可喻。再加发热，则阴气弥伤，而里气弥耗，不至躁亡不已。
呕吐反胃，浮滑者昌；弦数紧涩，结肠者亡。
呕吐反胃，上焦之病也。浮为虚，滑为痰，是其正象，可以受补，故曰昌也。脉弦者，虚也。木来乘土，胃气无
余，土将夺矣。数则为热，热当消谷，而反吐谷，乃知数为虚数，虚则不运，数则气促，呕吐不止，胃将渐败。
《金匮要略》云∶“阳气微，膈气虚，脉乃数。”紧则为寒，无阳以运，故上出而呕吐。涩脉枯涩，吐亡津液之
所致。水谷之海枯，遂致粪如羊屎，必死不治。
霍乱之候，脉代勿讶；厥逆迟微，是则可嗟。
霍乱之证，挥霍撩乱，不能自持，因一时清浊混乱，卒吐暴下，临时不能接续，非死脉也。厥逆而舌卷囊
缩，脉至迟微，阳衰阴盛，真元渐绝之象。暴脱者能渐生，而渐绝者又何能暴起哉！
嗽脉多浮，浮濡易治；沉伏而紧，死期将至。
嗽乃肺疾，脉浮为宜。兼见濡者，病将退也。沉则邪已入里，紧则寒邪不散，均主病危。
喘息抬肩，浮滑是顺；沉涩肢寒，皆为逆证。
喘证无非风与痰耳。浮为阳，为表，为风；滑为阳中之阴，而为痰，为食。若能散其邪，则机关可利；推其物，
则否塞可通；故曰顺。脉沉为阴，为里，为下部；涩为阴，为虚。乃元气不能接续，岂能充四肢乎？是以喘息
抬肩，而四肢又寒也。若更见散脉，则元真将随喘而散，死亡必矣，故曰逆。
火热之证，洪数为宜；微弱无神，根本脱离。
病热而有火证，火则脉应洪数。若得沉微之阴脉，是无火矣。无火而仍病热则知为无根之阳，虚见热
象也。故主危殆。
骨蒸发热，脉数为虚；热而涩小，必殒其躯。
骨蒸者，肾水不足，壮火僭上，虚、数二脉，是其本然。蒸热而见涩小之脉，涩则精血少，小则元气衰，真阴
日损，邪火日增，所谓发热脉静，不可救药耳。
劳极诸虚，浮软微弱；土败双弦，火炎则数。
劳极损伤，气血日耗，形体渐衰，所见之脉，随病呈象，如空虚之浮，不鼓之软，欲绝之微，无力之弱，虽云
病脉，然与病犹相宜也。至若双弦乃知土败，急数定为火炎。盖弦为肝木，双弦则木太盛，久病之土，何
堪其侮，故知其必败也。数已为热，急数则躁疾直强，略无半点和柔，邪火炎炎，真阴自绝，六至以上，便
不可治。
失血诸证，脉必现芤；缓小可喜，数大堪忧。
芤有中空之象，失血者宜尔也。缓小脉顺为可喜。脉数而大，邪盛正衰，为火烁真阴，诚为可忧。
蓄血在中，牢大却宜；沉涩而微，速愈者希。
血蓄于内，瘀凝不行，瘀凝则脉大，不行则脉牢，亦因病呈象也。逐之使去，巢穴一空，而致新不难矣。设
脉沉小涩微，是病有余而脉反不足，病有物而脉若无物，既不能自行其血，又难施峻猛之剂，安望其
速愈耶？
三消之脉，浮大者生，细微短涩，形脱堪惊。
三消皆燥热太过，惟见浮大之脉为吉耳。若脉细微短涩，则气血之虚衰枯槁，不言可知。再加身体瘦
悴，是谓形脱，即戴人所云燔木则为炭，燔金则为液，燔石则为灰，煎海水则为盐，鼎水形气两败，岂直
可惊已哉！
小便淋闭，鼻色必黄；数大可疗，涩小知亡。
热乘津液，则水道不利。水道不利而有热，必郁蒸而外发黄色，见于鼻者，以鼻为肺窍耳。数大为火象，
火证见之，又何妨乎？若逢涩小，为精血败坏，死亡将亟矣。
癫乃重阴，狂乃重阳；浮洪吉象，沉急凶殃。
癫狂既分阴阳，而脉皆取浮洪者，盖浮洪者属阳，在阳狂者得之，固与证相宜；即阴癫者得之，亦将从
阴转阳，自里达表之象，故均为吉兆。若沉而急，沉则入阴迫里，急则强急不柔，是无胃气之脉也。不论
狂癫，凶殃立至。
痫宜虚缓；沉小急实，或但弦急，必死不失。
痫本虚痰，脉来虚缓，自应然也。若沉小急实，或虚而弦急者，肝之真藏脉见矣，安望其生耶？
疝属肝病，脉必弦急。牢急者生，弱急者死。
疝为肝病，弦急，肝脉之常也。况弦敛急直，气不鼓畅者，咸主痛胀，疝则未有不痛不胀者，故弦急而牢，
见积聚之有根，亦见原本之壮实。疝系阴寒之咎，牢主里寒之脉，最为相合。若急则邪盛，弱则正衰，必
有性命之忧矣。
胀满之脉，浮大洪实；细而沉微，岐黄无术。
胀满属有余之证，宜见有余之脉，浮大洪实是也。沉细而微，知元气已衰，证实脉虚，无复他望矣。
心腹之痛，其类有九；细迟速愈，浮大延久。
心腹痛而脉见细迟，是气减舒徐，厥邪欲退，理应从吉。设或浮大，重则邪气方张，里证而得表脉，大非
所宜；轻亦为中虚之证，不能收捷得之效也。
头痛多弦，浮紧易治；如呈短涩虽救何及。
弦为阴脉，乃阳虚不能张大，或致外邪所乘。况头乃诸阳之府，而为邪束于外，使阳气遏郁，故脉多近
弦。或浮或紧，不出风寒，初起者散之则愈。若短则阳脱于上，涩则阴衰于下，至于手足厥寒至节者，与
真心痛无异，必死不治。
腰痛沉弦，浮紧滑实；何者难疗，兼大者失。
足三阴从足入腹，脉来沉弦者，沉为在里，弦为主痛。然何以又兼浮象乎？乃沉弦者，中有泛泛欲上之
势，因风厥阴所谓腰中如张弓弦者是也。故状其风邪虚浮之性，非言在表之浮也。紧则兼寒，滑为痰
聚，实因闪挫，本乎外因，虽困无害。如房室过度，烦劳不节，以致精力耗竭，腰膂空虚。夫腰者，肾之府，力
出于膂，而腰者膂所系，其为痛也，转侧呻吟，屈伸不得，膝酸胫冷，腰寒面黑，行则伛偻，不能久立，此肾
脏虚衰之极，无可收敛，反见空松，故按之豁然而大，自不作靖，咎将谁执。壮盛者犹可挽回，中年以后，
最为难治。
香港脚有四，迟数浮濡；脉空痛甚，何可久持。
香港脚发于三阳者轻，发于三阴者重。以三阴属脏，经络居里，若非藏气大虚，邪不易及。陈无择谓风寒
暑湿四邪，皆能成病，则迟数浮濡，犹与证合。痛则日盛而脉乃空虚，邪盛正衰，比之伤寒身凉脉躁，势
则相反，而咸非吉兆，总以病脉背驰耳。
五脏为积，六腑为聚；实强可生，沉细难愈。
积也，聚也，皆实证也。实脉强盛，邪正相搏，一以征元本之壮实，从府从阳，故曰可生。其脉沉细者，阴脉
也，一以征邪气之深入，故曰难愈。
中恶腹胀，紧细乃生；浮大维何，邪气已深。
人之正气。自内达表，自胸腹而达四肢者，其常也。卒中外邪，则正气不能达外，而反退缩于中，则气机
敛实，而紧细之脉象见矣，腹安得不胀？药力一助，正气必张，邪气必散，紧者仍舒，细者仍充，而本来之
面目可还也，故知其生。若脉浮大，则正先散越，散越于外则里更虚，里更虚则邪必深入，而欲为之治，
不亦难乎？
鬼祟之脉，左右不齐；乍大乍小，乍数乍迟。
鬼祟犯人，左右二手脉象不一，忽大忽小，忽数忽迟，无一定之形也。
五疸实热，脉必洪数；过极而亢，渴者为恶。
五疸实热，湿与热郁，外不得通，内不得泄， 蒸成黄，故曰实热。脉来固应洪数，然洪数太过，则必发渴。
黄为表蒸，渴为里热，表里亢热，阴何以堪？况疸为湿郁，而汗溺不通，渴则更加之饮，愈增其病矣。
水病之状，理必兼沉；浮大出厄，虚小可惊。
水病有阴有阳，诸种不一，而沉则在在皆兼，即气水、风水之在表，而脉应浮者，亦必有沉沉欲下之势。
盖沉下者，水之性也。此则专以状言。如指浮者，则以位言耳。水脉浮大，知水气渐散，灾厄将出之象。若
脉虚小，则正衰邪存，诚可惊也。
痈疽之脉，浮数为阳，迟则属阴，药宜酌量。痈疽未溃，洪大为祥；若其已溃，仍旧则殃。
其脉浮数者，以血泣而气复从之，邪与正郁，郁则化热，故数也。在表、在阳，故浮也。正为邪搏，则宣畅外
卫之力薄，故复恶寒。据脉证似与伤寒表证无异，但伤寒虽有痛，或在头，或在身体，或在骨节，未有痛
止于一处者。今痛止一处而脉数，此处必化热为脓，正痈疽所发之处也。即《伤寒论·辨脉法》所谓
“诸脉浮数，当发热而洒淅恶寒，若有痛处，饮食如常者，蓄积有脓”是也。如此者，乃为阳毒。若脉不数，
身不热，所患之处不疼，是邪客阴分，不能鼓发，多致内陷；然必兼有烦懊呕逆、胸膈不安等证，否则不
热不疼，脉又不数，是一不病患也，何得谓之阴疮，而反重于阳证耶？方痈疽之未溃也。无论成脓与否，
热邪郁蓄，外不疏通，脉之鼓涌洪大，是其宜也。至于已溃，则热泄邪解，而洪大之脉宜衰矣。溃而不衰，
一派热邪，正从何复，诚为大可惧者。与《素问·评热病论》所谓“病温者，汗出辄复热，而脉躁疾，不
为汗衰，病名阴阳交”而阳飞越，虽治无益。
肺痈已成，寸数而实；肺痿之形，数而无力。肺痈色白，脉宜短涩，浮大相逢，气损血失。肠痈实
热，滑数可必；沉细无根，其死可测。
Preface Diseases are not entirely determined by pulse diagnosis; however, in nine out of ten cases, judgment is made based on the pulse. Here, suitable and unsuitable pulses are indicated to ensure accuracy, like a shadow following its form, warning people against relying on chance and avoiding negligence that would bring blame.
Pulses indicating disease have suitability and unsuitability; the smoothness or reversal of Yin and Yang reveals auspicious or ominous outcomes.
Where there is a disease, there is a corresponding pulse. If the pulse suits the disease, it is smooth (favorable); if not, it is reversed (unfavorable). How to distinguish between reversal and smoothness? This lies in Yin and Yang. For example, exterior diseases presenting with exterior pulses, interior diseases with interior pulses, excess diseases with excess pulses, deficiency diseases with deficiency pulses, Yang diseases with Yang pulses, and Yin diseases with Yin pulses are all favorable and suitable. The opposite is unfavorable. Distinguishing between favorable and unfavorable allows one to deduce the prognosis of the disease.
For stroke (Zhong Feng), a floating and slow pulse is favorable; a rapid, large, and urgent pulse indicates difficulty in support.
The pulse in stroke varies with accompanying factors. New wind may carry old pathogens, or it may be external contraction or internal injury, causing the pulse to change suddenly. Accompanied by cold, the pulse is floating and tight; accompanied by wind, floating and relaxed; accompanied by heat, floating and rapid; accompanied by phlegm, floating and slippery; accompanied by Qi stagnation, deep and choppy; accompanied by fire, large and vigorous; accompanied by Yang deficiency, faint yet large and empty; accompanied by Yin deficiency, rapid yet fine as a silk thread; with both Yin and Yang deficiency, faint and rapid or faint and fine. A deficient and slippery pulse indicates headache; a relaxed and slow pulse indicates decline of Ying and Wei. Generally, a Yang pulse is floating and rapid, while a Yin pulse is soggy and weak. Floating-slippery, deep-slippery, faint-deficient, scattered, and rapid pulses are all signs of stroke. Wind nature is empty; when attacking the exterior, a floating, relaxed, and slow pulse indicates insufficient righteous Qi but remains remediable. An urgent, large, rapid, and疾 (fast) pulse means the pathogen is uncontrollable, leading inevitably to death. Thus, a large and rapid pulse that has not yet become urgent does not necessarily mean death.
In cold damage (Shang Han) and febrile diseases, a floating and洪 (surging) pulse is favorable; a deep, faint, choppy, or small pulse indicates an ominous condition. After sweating, if the pulse calms and the body cools, peace ensues; if the pulse remains restless after sweating and heat intensifies, recovery is difficult. When Yang syndromes present Yin pulses, life is endangered; when Yin syndromes present Yang pulses, although distressed, there is no harm.
The *Su Wen: Re Lun* states: "All febrile diseases now belong to the category of cold damage." It also says: "When humans are injured by cold, they develop febrile diseases; even if the heat is severe, death will not occur." From this, we understand that although cold damage is an attack by Yin-cold pathogens, the righteous Qi resists, leading to stagnation and steaming into heat, which is inevitable. Resistance at the exterior causes the pulse to float; stagnation turning into heat causes the pulse to surge. Febrile diseases presenting these Yang pulses indicate that righteous Qi is not sinking or contracting but is able to mobilize and expand, ensuring victory over pathogens, hence the favorability. Deep, faint, choppy, and small pulses are all Yin-type pulses. A Yang syndrome with Yin pulses, or an exterior disease showing interior pulses, indicates opposition between syndrome and pulse, excess pathogen, and deficiency of righteous Qi, signaling misfortune. After sweating, if pathogens are resolved and righteous Qi recovers, a previously restless pulse should calm, and the body should naturally cool. If the pulse remains restless and heat worsens, righteous Qi is depleted and pathogens advance, making survival unlikely. This corresponds to the *Su Wen: Ping Re Lun* saying: "Those with warm diseases who sweat and immediately reheat with a restless and rapid pulse, whose pulse does not subside with sweating, who speak deliriously and cannot eat, are named 'Yin-Yang Intersection'." Yang syndromes seeing Yin pulses refer to seeing Yin pulses, such as the deep, faint, choppy, and small pulses mentioned above for febrile diseases, where syndrome and pulse oppose, thus endangering life. Yin syndromes seeing Yang pulses refer to seeing Yang pulses. Although seemingly opposite to the syndrome, this differs in cold damage. Cold damage moves from exterior to interior, from Yang to Yin, constantly invading layer by layer. Now, if a Yin disease presents a Yang pulse, it signifies a transformation from cold chill to warmth, rising from depth to superficiality, turning dead Yin into living Yang. Although the disease is critical, it is naturally harmless. Thus, Zhang Zhongjing said: "Yin diseases presenting Yang pulses live; Yang diseases presenting Yin pulses die."
Pulse in summer-heat injury is deficient, wiry, thin, knotted, and slow; if accompanied by slippery and excess, other syndromes should be known.
Classics state: "Deficient pulse with body heat results from summer-heat injury." The *Jia Yi Jing* states: "Heat injures Qi but not form, hence the deficient pulse." However, the *Nan Jing: Chapter 49* stating "the pulse is floating, large, and scattered" is incorrect. A large and scattered pulse is the normal pulse of the Heart, not a pathological one. Therefore, Zhang Zhongjing does not mention it but supplements the bias by saying: "Wiry, thin, knotted, and slow." Knotted implies emptiness. Wiry, thin, and slow are responses to heat injuring Qi. Generally termed deficient, specifically described as wiry, thin, knotted, and slow. He did not mix floating-large pulses into deficient pulses as the pulse of summer-heat disease, showing thorough consideration. If the face is greasy and body hot, indicating summer-heat syndrome, but the pulse is slippery and excess, it suggests accompaniment of phlegm and food retention.
Due to fatigue and internal injury, the Spleen pulse is weak; sweating with a restless pulse indicates a fatal sign.
Movement generates Yang; the body should not be too idle. Dong Yuan, after discussing the Sheng Yang Yi Wei Tang formula, said: "Slight physical activity allows Stomach Qi to transport and ascend with the medicine." This is the meaning of movement generating Yang. If烦躁 (restless) and overly laborious, limb movement and action cause Yang Qi to scatter chaotically, injuring Spleen Qi everywhere. Thus, a weak Spleen pulse is favorable. If sweating occurs with a restless pulse, it is unfavorable, leading to death.
Malaria pulses are naturally wiry; wiry-rapid indicates heat, wiry-slow indicates cold, and alternating-scattered indicates severance.
The *Su Wen: Na Lun* states: "All malaria arises from wind." Thus, malaria is caused by wind-heat pathogens lodging in the Wood organ (Liver). Wood overacting on Earth (Spleen) causes loss of transportation, failing to transform grain essence, leading to phlegm and fluid retention. The wiry pulse corresponds to Wind-Wood and governs phlegm-fluid; without phlegm, there is no malaria, hence "Malaria pulses are naturally wiry." Rapid indicates heat, slow indicates cold, natural logic. Only seeing an alternating-scattered pulse indicates righteous Qi depletion, discontinuity, and lack of convergence, excess pathogen, and deficiency of righteous Qi, definitely leading to凶折 (fatal outcome).
Diarrhea and dysentery show deep, small, slippery, or weak pulses; excess, large, floating, or surging pulses with fever are ominous.
Diarrhea and dysentery occurring in the lower part, regardless of internal or external causes, always belong to deficiency syndromes injuring Yin and consuming the interior. Deep, small, slippery, and weak pulses are appropriate. Excess, large, floating, and surging pulses are ominous. Excess-large opposes deficiency; floating-surging opposes the interior. Excess pathogen and deficient righteous Qi are self-evident. Adding fever further injures Yin and consumes interior Qi, leading to restlessness and death.
Vomiting and reverse peristalsis (Fan Wei) show floating-sliply pulses indicating prosperity; wiry-rapid, tight, or choppy pulses with intestinal obstruction indicate death.
Vomiting and reverse peristalsis are diseases of the Upper Jiao. Floating indicates deficiency, slippery indicates phlegm, which are correct images allowing tonification, hence "prosperity." A wiry pulse indicates deficiency. Wood overacting on Earth leaves Stomach Qi exhausted, threatening Earth. Rapid indicates heat; heat should digest grain, but vomiting grain indicates rapid pulse is due to deficiency. Deficiency fails to transport; rapid causes shortness of breath. Continuous vomiting leads to gradual Stomach failure. The *Jin Gui Yao Lue* says: "With slight Yang Qi and deficient Diaphragm Qi, the pulse becomes rapid." Tight indicates cold; without Yang to move, it comes up as vomiting. Choppy pulse is dry and rough, caused by loss of fluids through vomiting. The Sea of Water and Grain dries up, leading to feces like sheep droppings, inevitably fatal.
In Huo Luan (cholera-like disorder), do not be surprised by an alternating pulse; cold limbs with slow and faint pulses are lamentable.
Huo Luan symptoms involve sudden turmoil and inability to control oneself, due to temporary confusion of clear and turbid Qi, sudden vomiting and violent diarrhea, where pulses cannot continue temporarily, but this is not a dying pulse. Cold limbs with curled tongue and contracted scrotum, with slow and faint pulses, indicate Yang decline and Yin excess, a sign of gradual exhaustion of True Yuan. Sudden collapse can gradually recover, but gradual exhaustion cannot rise suddenly!
Cough pulses are mostly floating; floating-soggy is easy to treat; deep-hidden and tight indicate approaching death.
Cough is a Lung disease; floating pulse is suitable. Accompanied by soggy, the disease will retreat. Deep indicates pathogens entered the interior; tight indicates cold pathogens not dispersing, both indicating critical illness.
Wheezing with raised shoulders: floating-slippy is favorable; deep-choppy with cold limbs are all unfavorable signs.
Wheezing involves only wind and phlegm. Floating is Yang, exterior, wind; slippery is Yin within Yang, phlegm, food. Dispersing pathogens benefits mechanisms; pushing out objects clears blockage; hence "favorable." Deep pulse is Yin, interior, lower part; choppy is Yin, deficiency. Righteous Qi cannot continue, how can it fill the limbs? Hence wheezing with raised shoulders and cold limbs. Seeing a scattered pulse additionally means True Essence scatters with wheezing, leading to certain death; hence "unfavorable."
Fire-heat syndromes suit surging-rapid pulses; faint and weak without spirit indicates root detachment.
Febrile disease with fire syndrome requires surging-rapid pulse. Obtaining deep-faint Yin pulse means no fire. No fire but still febrile indicates rootless Yang, false heat image. Hence critical.
Bone-steaming fever: rapid pulse indicates deficiency; heat with choppy-small pulse ensures demise.
Bone-steaming is insufficient Kidney Water, with vigorous Fire usurping upwards. Deficient and rapid pulses are inherent. Steaming heat with choppy-small pulse: choppy means less essence and blood, small means衰竭 (decline) of righteous Qi. True Yin daily damaged, evil fire daily increased. As stated, "fever with quiet pulse" is incurable.
Extreme fatigue and various deficiencies show floating-soft, faint, or weak pulses; double-wiry indicates Earth failure, rapid indicates Fire flare-up.
Extreme fatigue damages, daily consuming Qi and Blood, gradually decaying form. Pulses presented follow the disease: floating like emptiness, soft without drumming, faint near extinction, weak without power. Though disease pulses, they suit the disease. Double-wiry indicates Earth failure; urgent-rapid confirms Fire flare-up. Wiry is Liver Wood; double-wiry means Wood too excessive. Long-diseased Earth cannot withstand bullying, hence inevitable failure. Rapid is heat; urgent-rapid is restless, rigid, lacking any gentleness. Evil fire blazing, True Yin self-severs. More than six beats per breath is untreatable.
Various blood-loss syndromes must show knotted (Kou) pulse; relaxed-small is pleasing, rapid-large is worrying.
Knotted pulse has a hollow center, suitable for blood loss. Relaxed-small pulse is favorable and pleasing. Rapid-large pulse, excess pathogen and deficient righteous Qi, fire roasting True Yin, truly worrying.
Blood stasis in the middle: firm and large pulses are suitable; deep, choppy, and faint pulses rarely heal quickly.
Blood stasis inside, coagulated and not moving. Coagulation makes pulse large; non-movement makes pulse firm, presenting according to disease. Expelling it empties the nest, making new generation easy. If pulse is deep, small, choppy, and faint, the disease has excess but pulse lacks, disease has substance but pulse seems empty. Unable to move blood itself, hard to apply harsh medicines, how can quick healing be expected?
Three Xiao (wasting-thirst) pulses: floating-large indicates life; fine, small, short, and choppy with form depletion are alarming.
Three Xiao are excessive dryness-heat; only floating-large pulse is auspicious. Fine, small, short, and choppy pulses indicate Qi-Blood deficiency, decay, and withering, self-evident. Adding emaciation is called form depletion. As Dai Ren said: burning wood becomes charcoal, metal becomes liquid, stone becomes ash, boiling seawater becomes salt. Form and Qi both defeated, not just alarming!
Urination dribbling and closure: nasal color must be yellow; rapid-large is treatable, choppy-small indicates death.
Heat affecting fluids makes water passages unfavorable. Unfavorable passages with heat steam outward to yellow, appearing on the nose as it is the Lung orifice. Rapid-large is Fire image; seeing it in Fire syndrome is acceptable. Encountering choppy-small indicates essence-blood ruin, imminent death.
Dian is heavy Yin, Kuang is heavy Yang; floating-large is auspicious, deep-urgent is ominous.
Dian and Kuang divided into Yin and Yang, yet both take floating-large pulses. Floating-large belongs to Yang. In Yang Kuang, it suits the syndrome; in Yin Dian, it transforms from Yin to Yang, from interior to exterior, hence both auspicious. Deep and urgent: deep enters Yin pressing interior; urgent is rigid and unyielding, a pulse without Stomach Qi. Regardless of Kuang or Dian, ominous disaster arrives immediately.
Xian (epilepsy) suits deficient-relaxed; deep-small-urgent-excess, or merely wiry-urgent, ensures death without fail.
Xian is originally deficient-phlegm; pulse coming deficient-relaxed is natural. Deep-small-urgent-excess, or deficient-wiry-urgent, shows Liver's Zang pulse, how can life be hoped for?
Han (hernia) belongs to Liver disease, pulse must be wiry-urgent. Firm-urgent indicates life, weak-urgent indicates death.
Han is Liver disease; wiry-urgent is normal Liver pulse. Moreover, wiry-contracting-urgent-straight, with Qi not moving smoothly, all govern pain and distension. Han always involves pain and distension. Thus, wiry-urgent and firm shows accumulation with roots and original strength. Han is fault of Yin-cold; firm governs interior-cold pulse, most compatible. Urgent means excess pathogen; weak means deficient righteous Qi, surely endangering life.
Distension-fullness pulses: floating-large, surging, excess; fine and deep-faint, Qi-Huang have no method.
Distension-fullness is an excess syndrome, suitable for excess pulses like floating-large, surging, excess. Deep-fine and faint indicates righteous Qi already declined, excess syndrome with deficient pulse, no other hope.
Heart and abdominal pain, nine categories; fine-slow heals quickly, floating-large prolongs.
Heart/abdominal pain with fine-slow pulse means Qi reduction and relaxation, Jue pathogens retreating, naturally auspicious. If floating-large, heavily pathogens flourishing, interior syndrome with exterior pulse, highly unsuitable; lightly it is Middle Deficiency, unable to achieve quick effect.
Headache mostly wiry; floating-tight easy to treat; if short-choppy, rescue is futile.
Wiry is Yin pulse, Yang deficiency unable to expand, or external pathogens attacking. Head is mansion of all Yang; bound by external pathogens, Yang Qi obstructed, hence pulse often near wiry. Floating or tight, not exceeding wind-cold; initial stage disperses to heal. Short means Yang escapes upward; choppy means Yin declines downward. Until cold limbs reach joints, identical to True Heart Pain, inevitably fatal and untreatable.
Lower back pain deep-wiry, floating-tight, slippery-excess; which is hard to treat? One accompanied by large loses.
Foot Three Yin enter abdomen from feet. Deep-wiry pulse: deep is interior, wiry governs pain. Why floating image? Deep-wiry has a rising tendency, like Wind-Jueyin saying "waist like drawn bowstring." Describing wind-pathogen floating nature, not exterior floating. Tight accompanies cold; slippery is phlegm gathering; excess is due to sprain, external cause, harmless though distressed. Like excessive sexual activity, fatigue irregularity, exhausting energy, waist empty. Waist is Kidney mansion, power from back, waist connected to back. Pain turns side groans, cannot bend/stretch, knee sore, shin cold, waist cold, face black, stooping walk, cannot stand long. Extreme Kidney deficiency, no convergence, appears loose, pressing hollow and large, not quiet. Who blames? Vigorous can recover; post-middle age hardest to treat.
Hong Jiao (gout/paralysis) has four types: slow-rapid, floating-soggy; pulse empty with severe pain, how long can it last?
Hong Jiao starting in Three Yang is light; in Three Yin is heavy. Three Yin belongs to Zang, meridians interior. Unless Zang Qi greatly deficient, pathogens don't easily reach. Chen Wu Ze said wind-cold-summer-heat-dampness four pathogens all cause disease; thus slow-rapid-floating-soggy still matches syndrome. Pain increases daily, pulse becomes empty, excess pathogen deficient righteous Qi. Compared to cold damage body cool pulse restless, situation opposite, neither auspicious, total disease-pulse deviation.
Five Zang form Ji (accumulation), Six Fu form Ju (gathering); excess-strong can live, deep-fine hard to heal.
Ji and Ju are both excess syndromes. Excess pulse strong, pathogen-righteous contending, one marks original strength, following Fu and Yang, hence can live. Pulse deep-fine is Yin pulse, one marks pathogen deep entry, hence hard to heal.
Zhong E (sudden evil) abdominal distension: tight-fine indicates life; floating-large what? Pathogen already deep.
Human righteous Qi normally reaches exterior from interior, chest-abdomen to limbs. Suddenly attacked by external evil, righteous Qi cannot reach exterior, retreats to middle, Qi mechanism contracts solid, tight-fine pulse appears, how can abdomen not distend? Medicine aids, righteous Qi expands, pathogen scatters, tight relaxes, fine fills, original face returns, hence life. If pulse floating-large, righteous first scatters outward, interior more deficient, pathogen deeper, treatment difficult!
Gui Sui (demon oppression) pulse: left-right uneven; suddenly large-small, suddenly rapid-slow.
Demon oppression attacks, left-right hand pulses differ, suddenly large-small, suddenly rapid-slow, no fixed shape.
Five Jaundice excess-heat: pulse must be surging-rapid; extreme hyperactivity, thirst indicates bad.
Five Jaundice excess-heat, dampness-heat stagnant, unable to pass outside or exit inside, steaming into yellow, hence excess-heat. Pulse should be surging-rapid, but too much surging-rapid causes thirst. Yellow is exterior steaming, thirst is interior heat, exterior-interior hyperactive heat, how can Yin bear? Moreover, Jaundice is damp-stagnation, sweat-urine blocked, thirst adds drinking, increasing disease.
Water disease state: reason must accompany deep; floating-large exits disaster, deficient-small alarming.
Water disease has Yin and Yang, various types, but deep accompanies everywhere. Even Qi-water, Wind-water exterior with floating pulse, must have deep-downward tendency. Downward is water nature. Speaking of shape. Finger floating speaks of position. Water pulse floating-large knows water Qi gradually scattering, disaster exiting. Pulse deficient-small, righteous decline pathogen exists, truly alarming.
Carbuncle-abscess pulse: floating-rapid is Yang, slow is Yin, medicine should be weighed. Carbuncle-abscess unruptured, surging-large auspicious; if ruptured, remaining same is calamity.
Floating-rapid pulse: blood sluggish, Qi follows, pathogen-righteous stagnant, stagnation turns heat, hence rapid. Exterior-Yang, hence floating. Righteous fought by pathogen, exterior defense weak, hence chills. Pulse-syndrome similar to cold damage exterior, but cold damage pain anywhere head-body-joints, never localized. Now pain localized with rapid pulse, here turns heat to pus, exactly carbuncle-abscess site. *Shang Han Lun: Bian Mai Fa* says: "All floating-rapid pulses, should have fever and shivering chills, if painful spot, eating/drinking normal, accumulation has pus." This is Yang Du. If pulse not rapid, body not hot, affected spot not painful, pathogen lodges in Yin division, cannot mobilize, mostly sinks inward; but must accompany烦躁 (restlessness), nausea/vomiting, chest-diaphragm unease, otherwise no heat/pain, pulse not rapid, not a patient, how call Yin sore, heavier than Yang syndrome? Just before carbuncle-abscess rupture. Regardless of pus formation, heat-pathogen stagnant, exterior not unblocked, pulse surging-large is suitable. Once ruptured, heat leaks pathogen resolves, surging-large pulse should decline. Ruptured not declining, all heat-pathogen, how does righteous recover, truly frightening. Corresponds to *Su Wen: Ping Re Lun* "Warm disease, sweat then reheat, pulse restless-rapid, not subsiding with sweat, named Yin-Yang Intersection" and Yang flying away, treatment useless.
Lung Abscess formed: Cun rapid and excess; Lung萎 (flaccidity) form: rapid but powerless. Lung Abscess white color, pulse suits short-choppy, meeting floating-large, Qi damaged blood lost. Intestinal Abscess excess-heat, slippery-rapid certain; deep-fine rootless, death measurable.