（伏短细实牢皆统于沉）
沉。阴水也。重手按下。至筋骨乃得。如绵裹砂。内刚外柔。如石投水。必极于底曰沉。是气满三焦。而不运于脏
腑。为阴逆阳郁之候。其病在里。为寒为水蓄为气。有力里实。必痰食有形之物。凝滞于内。无力里虚。乃无形之气。
郁结于中。沉迟痼冷。沉数伏热。沉滑痰食。沉涩气郁。沉伏霍乱。沉牢冷积沉弦饮痛。沉紧冷痛。沉弱阴痛。沉缓寒
湿。寸沉左为寒邪在心。右为寒痰停蓄。伤寒两寸沉曰难治。平人两寸沉曰无阳。多艰于寿。关沉伏寒在经。
左主两胁刺痛。右主中满吞酸。尺沉肾寒。主腰背冷痛。男子精冷。女子血结。沉细为阴痒。 伏类于沉。然沉行筋骨
间。伏行骨上重按着骨。指下裁动曰伏。阴水也。积阴冷毒之气。滞于三焦。为关格闭塞之候。伏而数曰热厥。亢极而
兼水化也。伏而迟曰寒厥。阴极而气将绝也。惟伤寒脉伏。主大汗而解。寻之两头无。中间有。不及本位。状如米粒曰
短。阴金也。是气不足以导其血。为不及之病。涩微动结。皆兼短脉。过于悲哀之人。其脉多短。短而滑数为酒伤。寸
短头痛。关短宿食。尺短胫冷。又关不诊短。短见于关上。是上不通寸为阳绝。下不通尺为阴绝。若应指沉沉。不绝
如丝曰细。阴也。为吐衄。为忧劳过度。为湿。凡血衰气少则顺。否则逆。若中取之沉取之脉。皆幅幅有力曰实。属土。
是伏阳在内。寒锢于外。实而静为气血有余。实而躁为里有邪。妇人尺实为有孕。实统牢革。牢革之脉。古人多混
淆莫辨。不知革浮牢沉。革虚牢实。形证各异。故革脉见浮部。其按之坚固有力。动而不移曰牢。阴中有阳。里实表虚。
病主胸中气促。骨间疼痛。大抵其脉近于无胃气。故诸家皆谓危殆之脉。
(Fu pulse, Duan pulse, Xi pulse, Shi pulse, and Lao pulse are all categorized under the Chen pulse.)
Chen (Sinking) Pulse. It belongs to the image of Yin Water. With heavy pressure applied, it is felt only when pressing down to the level of muscles and bones. It feels like sand wrapped in cotton: firm inside but soft outside; or like a stone thrown into water, sinking to the very bottom before being identified as Chen. This indicates that Qi is full within the Sanjiao (Triple Burner) but fails to circulate and transform within the Zang-Fu organs. It represents a syndrome of Yin rebellion and Yang depression. The pathology is interior, manifesting as Cold, fluid retention, or Qi stagnation. If the pulse is forceful, it indicates an Interior Excess syndrome, necessarily caused by tangible pathogenic factors such as Phlegm or Food Stagnation condensing internally. If the pulse is weak, it indicates an Interior Deficiency syndrome, caused by intangible Qi constraint in the middle Jiao. A Chen pulse combined with Chi (Slow) indicates entrenched Cold; combined with Shuo (Rapid), it indicates latent Heat; combined with Hua (Slippery), it indicates Phlegm and Food retention; combined with Se (Choppy), it indicates Qi depression; combined with Fu (Deep/Hidden), it indicates Huoluan (Colic disorder); combined with Lao (Firm), it indicates Cold accumulation; combined with Xian (Wiry), it indicates Fluid retention and pain; combined with Jin (Tight), it indicates Cold pain; combined with Ruo (Weak), it indicates Yin-type pain; combined with Huan (Lax), it indicates Cold-Dampness. At the Cun (Inch) position, a Chen pulse on the left indicates Cold pathogen affecting the Heart; on the right, it indicates Cold-Phlegm retention. In Shanghan (Cold Damage) disease, a bilateral Chen pulse at the Cun positions is termed difficult to treat. In healthy individuals, a bilateral Chen pulse at the Cun positions indicates "No Yang," suggesting a short lifespan. At the Guan (Bar) position, a Chen pulse indicates Cold pathogen in the meridians; on the left, it governs stabbing pain in both hypochondriac regions; on the right, it governs abdominal fullness and acid regurgitation. At the Chi (Cubit) position, a Chen pulse indicates Kidney Cold, governing cold pain in the lower back and body; in men, it manifests as cold semen; in women, it manifests as blood coagulation/stasis. A Chen pulse combined with Xi (Fine) indicates itching in the yin region.
The Fu (Hidden) pulse is similar to the Chen pulse. However, while the Chen pulse is located between muscles and bones, the Fu pulse lies above the bones; with heavy pressure reaching the bone, the movement is felt under the fingers, which is defined as Fu. It also belongs to the image of Yin Water. It represents the accumulation of Yin-Cold toxic Qi stagnating in the Sanjiao, leading to a syndrome of Guan-Ge (obstruction). A Fu pulse combined with Shuo (Rapid) indicates Re Jue (Heat Jue), where Yang is extremely hyperactive and combines with Water transformation. A Fu pulse combined with Chi (Slow) indicates Han Jue (Cold Jue), where Yin is extreme and Qi is about to perish. Only in Shanghan disease does a Fu pulse indicate resolution through profuse sweating.
When searching for the pulse, if there is no movement at the two ends but movement in the middle, failing to reach its proper position, and resembling a grain of rice in shape, it is called Duan (Short) pulse. It belongs to the image of Yin Metal. This indicates that Qi is insufficient to guide Blood, representing a deficiency disease. Se (Choppy), Wei (Micro), Dong (Surging), and Jie (Knotted) pulses all accompany the Duan pulse. Individuals who have experienced excessive grief often present with a Short pulse. A Duan pulse combined with Hua (Slippery) and Shuo (Rapid) indicates injury from alcohol. A Short pulse at the Cun position indicates headache; at the Guan position, it indicates retained food; at the Chi position, it indicates cold calves. Furthermore, the Guan position is generally not assessed for Shortness. If Shortness appears at the Guan, it signifies that upward connection to the Cun is Yang extinction, and downward connection to the Chi is Yin extinction.
If the pulse responds deeply and continuously like a silk thread, it is called Xi (Fine) pulse. It belongs to Yin. It governs vomiting blood and epistaxis, excessive worry and fatigue, and Dampness. Generally, if Blood is deficient and Qi is scarce, this pulse is favorable (Shun); otherwise, it is unfavorable (Ni). If, during moderate and deep palpation, the pulse feels strong and distinct, it is called Shi (Excess/Solid) pulse. It belongs to Earth. This indicates hidden Yang inside and Cold constricting outside. A Shi pulse that is quiet indicates abundance of Qi and Blood; a Shi pulse that is restless indicates internal pathogens. In women, a Shi pulse at the Chi position indicates pregnancy. The Shi pulse encompasses the Lao (Firm) and Ge (Leather) pulses. Ancient physicians often confused Lao and Ge pulses, failing to distinguish them. One must know that Ge is superficial and Lao is deep; Ge indicates Deficiency while Lao indicates Excess. Their forms and syndromes differ. Therefore, the Ge pulse appears in the superficial layer; when pressed, it is firm and forceful. The Lao pulse beats without moving, indicating Yang within Yin, Interior Excess, and Exterior Deficiency. The diseases primarily involve shortness of breath in the chest and pain between the bones. Generally, these pulses approach a state lacking Stomach Qi, so various schools consider them critical and dangerous pulses.