（其象呼吸之间脉仅三至，来去极慢）
迟司脏病或多痰，沉痼 瘕仔细看，有力而迟为冷痛，迟而无力是虚寒。（此首总言迟
寸迟心（左）肺（右）上焦寒（左寸迟，心上寒，精气多惨，右寸迟，肺受寒，冷痰气短，）
中寒痛不堪（左关，筋寒急，手足冷，胁下痛，右关，中焦寒，脾胃伤冷，食不化，）左尺肾
虚（故便浊）女不月，右为泄泻疝牵丸（脏寒泄泻，小腹冷痛，腰脚重而无力。此首统言左右
迟而细软为微（其象极细而软，若有若无，多兼于迟，按之无欲绝之状。）
气血微兮脉亦微，恶寒（阳微也）发热（阴微也）汗淋漓，男为劳极诸虚候，女作崩中带下
寸微气促与心惊（右寸，中寒少气，又兼上焦寒痞、冷痰不化，左寸，心忧惕，荣血不
）关脉微时胀满形（左关微，中满气乏，四肢寒冷，拘急右关微，胃寒气胀，食不化，脾虚噫
气，心腹间冷疼，）尺部见之精血弱（左尺微，伤精尿血，）脏寒泄泻痛呻吟（右尺微，脏寒泄
痢，脐下冷积痛疼。此首统言左右两手微脉病。）
迟而无力为弱（其象极软而沉细，怏怏不前，按之如欲绝，举手即无。弱犹愈于微。）
脉弱阴虚阳气衰（气虚则脉弱，寸弱阳虚，关弱胃虚，尺弱阴虚，）恶寒发热骨筋萎，多
惊多汗精多泄，益气调营（弱脉必宜补）及早医。（此首总言弱脉病。）
寸汗心虚（左寸弱，阳虚心悸自汗）右身冷（右寸弱病，又兼短气，）关中筋萎（肝主筋，
弱，故筋萎少力，又兼女人主产后客风面肿）胃脾虚（右关弱，脾胃虚而食不能化，）欲知阳
陷明微病，骨痛耳聋（左尺弱，胃虚之故）粪数遗（右尺弱，大便滑，又兼下焦冷痛。此首统
言左右手弱脉病。）
迟而有力为缓（其象比浮而稍大，似迟而小疾，一息四至，来往纡缓，呼吸徐徐。缓脉
，从容和缓者为正脉，前人所云，诸病脉缓，为胃气回，不治自愈者是。若气血衰而迟缓，
缓脉 营卫衰，或痹（缓而细）或湿（沉而缓）或脾虚（缓而涩，）上为项强下脚软，浮风
（缓兼浮，伤风）沉弱（缓兼沉，血气衰弱）细区分。（此首总言缓脉病。）
寸缓心虚（左寸缓，心气不足，怔忡多忘，又兼项背拘急痛）肺则浮（右寸缓，肺气浮，
语短气，）当关风眩（左关缓，风虚眩晕，又兼腹胁气急）胃虚求（右关缓，胃弱气虚，）尺为
肾冷便频数（左尺缓，肾虚冷，小便多，）下寒风秘便常忧（右尺缓，下寒脚弱，风气闭滞。）
迟而时止时结（其象来时缓甚，时一止，复又来。前人云∶阴凝则结。又云∶结脉亦因
思虑过度，脾气不足。又云∶脉结者，亦病四肢不快，为气所结。）
结脉皆因气血凝，老痰结滞苦沉吟，内生积聚外痈肿，疝瘕亡阳汗自淋（凡结脉，主疝
结，七情郁结，老痰滞结，一切气血凝结，又为亡阳、为汗下，内为积聚，外为痈肿，兼浮
寒结，兼沉气结。此首总言结脉病。
数
（其象一息六至，数数然来。）
数脉为阳热可知，只将君相火来医，实宜凉泻虚温补，肺病秋深却忌之。（此首总言数
脉病。）
寸数咽喉（右寸数）口舌（左寸数）疮，吐红咳嗽肺生疡（左右寸同，又兼头疼上热，）当关
胃火
（右关数，胃火，脾热口臭，烦满呕逆）并肝火（左关数，肝火目赤），尺用滋阴降火汤（左右
尺同，主肾火炽，小便黄赤，大便闭塞。此首统言左右两手数脉病。）
数而弦急为紧（其象来时劲急，按之长，左右弹指，举之若牵绳转索之状，又名急脉。）
紧为诸痛主于寒，癖积风痫吐冷痰，浮紧汗之（紧兼浮，表寒身痛）沉紧下（紧兼沉，里
寒腹痛，）人迎（因伤寒）气口（因伤食）更须看。（此首总言紧脉病。）
左头目项（左寸紧头热、目痛、项强）右鼻膈（右寸紧、鼻塞、膈壅，）关从心腹胁筋寻（
左关
，心腹满痛、胁痛筋急，右关，脾腹痛、吐逆）尺为腰脚脐下痛，知是奔豚与疝疼（左尺，腰
脚脐下痛，又兼小便难，右尺，下焦气筑痛。此首统言左右手紧脉病。）
数而时止为促（其象来时数，时一止，复又来，徐疾无一定，有迫促之状。凡脉促者，
亦病气痛，亦病怫郁，亦病气血不疏通。）
脉促惟将火病医（三焦有郁火，）其因有五细推之（气、血、热、痰、饮，）时时咳嗽皆痰
积，或发狂 与毒疽，（皆瘀血之故。此言总言促脉病。）
数见关中为动（其象数见关中，形圆如豆，无头无尾，厥厥动摇，寻之有，举之无，不
往不来，不离其处。动脉亦为神气不安，脱血虚劳。）
动脉专司气与惊，汗因阳动热因阴，或为泄痢拘挛病，男子亡阳女子崩。（此首总言动
脉病。）
(The image of the Slow pulse is that within one respiration cycle, the pulse beats only three times, coming and going extremely slowly.)
The Slow pulse governs Zang organ diseases or the presence of excessive phlegm; one must carefully examine cases of chronic entrenched diseases and abdominal masses. A Slow pulse with force indicates Cold pain, while a Slow pulse without force indicates Deficiency-Cold. (This verse generally discusses the Slow pulse.)
A Slow pulse at the Left Cun position indicates Cold in the Heart (Left Cun corresponds to the Heart), where essence and Qi often appear bleak; a Slow pulse at the Right Cun position indicates Cold in the Lung, manifesting as cold phlegm and shortness of breath. (This line collectively describes the pathology of Slow pulses at the left and right Cun positions.)
A Slow pulse at the Left Guan position indicates Cold in the sinews causing stiffness and urgency, cold hands and feet, and pain under the ribs; a Slow pulse at the Right Guan position indicates Middle Jiao Cold, injury to the Spleen and Stomach by cold, and indigestion. (This line collectively describes the pathology of Slow pulses at the left and right Guan positions.)
A Slow pulse at the Left Chi position indicates Kidney Deficiency, leading to turbid urine and amenorrhea in women; a Slow pulse at the Right Chi position indicates diarrhea and hernia pulling on the testicles (Cold in the Zang organs causes diarrhea, cold pain in the lower abdomen, and heaviness/weakness in the waist and legs). This line collectively describes the pathology of Slow pulses at the left and right Chi positions.
The Fine pulse is extremely thin and soft, seeming to be there yet not there, often accompanying the Slow pulse; upon pressing, it feels as if it is about to vanish. (Its image is extremely thin and soft, seeming to be there yet not there, often accompanying the Slow pulse, feeling as if it is about to vanish when pressed.)
When Qi and Blood are weak, the pulse is also fine, presenting symptoms of aversion to cold (due to Yang deficiency), fever (due to Yin deficiency), and profuse sweating. In men, this manifests as various deficiency conditions resulting from extreme exhaustion; in women, it manifests as metrorrhagia and leukorrhea.
A Fine pulse at the Left Cun position indicates rapid breathing and palpitations (Right Cun Fine: Middle Jiao Cold with shortness of breath, accompanied by Upper Jiao Cold stagnation and untransformed cold phlegm; Left Cun Fine: Heart anxiety and fright, with deficient Ying-Blood);
A Fine pulse at the Left Guan position indicates abdominal distension (Left Guan Fine: Fullness in the middle, lack of Qi, cold limbs, and stiffness; Right Guan Fine: Stomach Cold causing distension, indigestion, Spleen Deficiency causing belching, and cold pain between the heart and abdomen);
A Fine pulse at the Left Chi position indicates weakness of essence and blood (Left Chi Fine: Injury to essence with hematuria); a Fine pulse at the Right Chi position reveals Zang Cold diarrhea with groaning in pain (Right Chi Fine: Zang Cold causing dysentery, cold accumulation pain below the umbilicus). This line collectively describes the pathology of Fine pulses in both hands.
The Weak pulse is Slow and without force. (Its image is extremely soft and deep-thin, sluggish in movement, feeling as if it is about to vanish when pressed, and disappearing immediately when lifted. The Weak pulse is slightly better than the Fine pulse.)
A Weak pulse indicates Yin Deficiency and decline of Yang Qi (Qi deficiency leads to a Weak pulse: Cun Weak indicates Yang deficiency, Guan Weak indicates Stomach deficiency, Chi Weak indicates Yin deficiency). Symptoms include aversion to cold, fever, atrophy of bones and sinews, frequent fright, excessive sweating, and seminal emission. One should tonify Qi and regulate Ying-Blood (Weak pulses require tonification) and treat early. (This verse generally discusses Weak pulse pathology.)
Left Cun Weak indicates sweating due to Heart Deficiency (Left Cun Weak: Yang deficiency with palpitations and spontaneous sweating); Right Cun Weak indicates cold body (Right Cun Weak disease, accompanied by shortness of breath);
Left Guan Weak indicates sinew atrophy (The Liver governs sinews; Weakness leads to sinew atrophy and lack of strength, and in women, it indicates postpartum exogenous wind causing facial swelling); Right Guan Weak indicates Stomach and Spleen Deficiency (Right Guan Weak: Spleen and Stomach deficiency leading to inability to digest food);
Left Chi Weak indicates that knowing Yang sinking clarifies the subtle disease, presenting with bone pain and deafness (Left Chi Weak: Due to Stomach deficiency); Right Chi Weak indicates frequent loose stools and incontinence (Right Chi Weak: Slippery stool, accompanied by Lower Jiao cold pain). This line collectively describes the pathology of Weak pulses in both hands.
The Moderate pulse is Slow but with force. (Its image is slightly larger than the Floating pulse, resembling Slow but slightly faster, beating four times per respiration cycle, moving slowly and gently, with leisurely breathing. A Moderate pulse that is calm and harmonious is the normal pulse; as predecessors said, "Moderate pulse in all diseases indicates the return of Stomach Qi, healing without treatment." However, if Qi and Blood decline leading to Slowness and Laxity, it indicates decline of Ying and Wei, Bi syndrome (Moderate and thin), Dampness (Deep and Moderate), or Spleen Deficiency (Moderate and choppy), manifesting as neck stiffness above and weak legs below, Wind from Floating (Moderate plus Floating indicates Wind invasion), and Weakness from Deep (Moderate plus Deep indicates Qi and Blood decline). These must be distinguished carefully. This verse generally discusses Moderate pulse pathology.)
Left Cun Moderate indicates Heart Deficiency (Left Cun Moderate: Insufficient Heart Qi, palpitations, forgetfulness, accompanied by stiffness and pain in the neck and back); Right Cun Moderate indicates Lung Floating (Right Cun Moderate: Lung Qi floating, short speech and breath);
Left Guan Moderate indicates Wind-dizziness at the Guan position (Left Guan Moderate: Wind-deficiency dizziness, accompanied by urgency of Qi in the abdomen and hypochondrium); Right Guan Moderate indicates seeking for Stomach Deficiency (Right Guan Moderate: Weak Stomach and Qi deficiency);
Left Chi Moderate indicates Cold Kidney with frequent urination (Left Chi Moderate: Kidney Cold with frequent urination); Right Chi Moderate indicates worry over constipation due to Lower Jiao Wind-Cold (Right Chi Moderate: Lower Jiao Cold with weak legs, obstruction of Wind-Qi).
The Knotted pulse is Slow with intermittent stops. (Its image comes slowly and very slowly, stopping occasionally before resuming. Predecessors said: "Yin coagulation causes knotting." Also: "Knotted pulse is also due to excessive thinking and insufficient Spleen Qi." Also: "Pulse knottedness also indicates discomfort in the four limbs, caused by Qi knotting.")
Knotted pulses are all due to Qi and Blood coagulation, bitter lingering from old phlegm knotting, internal accumulations and external carbuncles, hernias and masses, Yang collapse with spontaneous sweating. (Generally, Knotted pulses govern hernia knots, emotional depression knots, old phlegm stagnation knots, all Qi and Blood coagulations, as well as Yang collapse and sweating after purging. Internally they indicate accumulations, externally carbuncles, combined with Floating Cold knots, combined with Deep Qi knots. This verse generally discusses Knotted pulse pathology.)
Rapid Pulse (Its image beats six times per respiration cycle, rapidly coming.)
Rapid pulses belong to Yang Heat, known clearly; treat them by addressing Ministerial Fire. Excess requires cooling and purging, Deficiency requires warming and tonifying, but Rapid pulses are contraindicated in Lung diseases during late Autumn. (This verse generally discusses Rapid pulse pathology.)
Right Cun Rapid indicates throat sores; Left Cun Rapid indicates mouth and tongue sores, vomiting blood, coughing, and lung ulcers (Both Cun positions together, accompanied by headache and upper heat);
Right Guan Rapid indicates Stomach Fire (Right Guan Rapid: Stomach Fire, Spleen Heat with bad breath, irritability, fullness, nausea, and vomiting) and Liver Fire (Left Guan Rapid: Liver Fire with red eyes);
Both Chi positions Rapid use Ziyin Jianghuo Tang (Nourish Yin and Descend Fire Decoction) (Both Chi positions together indicate blazing Kidney Fire, yellow-red urine, and fecal impaction). This line collectively describes Rapid pulse pathology in both hands.
Tight pulse is Rapid and wiry-tense. (Its image comes forceful and tense, long when pressed, vibrating left and right against the fingers, feeling like pulling a rope or twisting cord when lifted, also called Urgent pulse.)
Tight pulses govern various pains, primarily due to Cold,癖积 (masses), wind-epilepsy, and vomiting of cold phlegm. Floating-Tight requires sweating (Tight plus Floating indicates Exterior Cold with body pain); Deep-Tight requires purging (Tight plus Deep indicates Interior Cold with abdominal pain). One must also observe the Renying point (for Cold damage) and Qikou pulse (for Food damage). (This verse generally discusses Tight pulse pathology.)
Left Cun Tight affects head, eyes, and neck (Left Cun Tight: Head heat, eye pain, neck stiffness); Right Cun Tight affects nose and diaphragm (Right Cun Tight: Nasal congestion, diaphragmatic fullness);
Left Guan Tight seeks from Heart, abdomen, hypochondrium, and sinews (Left Guan: Abdominal fullness/pain, hypochondriac pain, sinew urgency); Right Guan Tight involves Spleen abdominal pain and vomiting/regurgitation;
Left Chi Tight affects waist, legs, and pain below the umbilicus, indicating Ben Teng and hernia pain (Left Chi: Waist/leg pain below umbilicus, accompanied by difficult urination); Right Chi Tight involves Qi pounding pain in the Lower Jiao. This line collectively describes Tight pulse pathology in both hands.
Surging pulse is Rapid with intermittent stops. (Its image comes Rapid, stopping occasionally before resuming, with irregular speed, having an urgent appearance. Generally, Surging pulses also indicate Qi pain, oppression/stagnation, and unsmooth flow of Qi and Blood.)
Surging pulses are treated only by addressing Fire diseases (Stagnant Fire in the San Jiao). There are five causes to investigate carefully: Qi, Blood, Heat, Phlegm, and Fluid Retention. Frequent coughing is all due to Phlegm accumulation; madness and toxic carbuncles are all due to Blood stasis. This statement generally discusses Surging pulse pathology.
Moving pulse appears frequently at the Guan position. (Its image appears frequently at the Guan position, round like a bean, with no head or tail, quivering and shaking, felt upon searching, not felt upon lifting, neither moving forward nor backward, staying in its place. Moving pulses also indicate unsettled Spirit and Qi, blood loss, and deficiency consumption.)
Moving pulses exclusively govern Qi disturbances and fright. Sweating is due to Yang movement, fever is due to Yin movement. It may also cause dysentery/diarrhea and spasms/cramps. In men, it indicates Yang collapse; in women, metrorrhagia. (This verse generally discusses Moving pulse pathology.)