代为气衰。固止有常数。此死脉也。经又云黄脉代。此盖指脾脉而应于四时
。遇春得胃气而兼见微弦。遇夏得胃气而兼见微洪。遇秋得胃气而兼见微浮。遇冬得胃气而
兼见微石。此乃四时更代之代。而非死脉之代。此代之义。又不可不知。
促脉乃数而一止。此为阳极亡阴。主痰壅阳经。积留胃府。或主三焦郁火炎盛。或发狂
班。
或生毒疽。五积停中。脉因为沮。最不宜于病后。若势进不已。则为可危。五积者血气痰饮
食也。若此得之新病。元气未败。不必深虑。但有如促之脉。或渐见于虚痨垂危之顷。死期
可卜。或暴作于惊遑造次之候。气复自愈脱阴见促终非吉兆。肿胀见促不交之。否促脉则
亦有死者矣。
动乃数脉见于关上下。无头尾。如豆大。忽忽动摇。仲景曰∶阴阳相搏名曰动。阳动则
汗出
。阴动则发热。形冷恶寒。此三焦伤也。主病为痛为惊为泄痢为亡精为失血。虚者倾摇。胜者
自安。此皆病脉也。又有平人而动者。太素云∶三部宽长是上贤。更于胆脉带长弦。豁然应
指如龙动。翊赞明君万万年。又云∶肾部忽然动滑时。为官必定有迁移。更看三部宽洪应。
用意消详仔细推。素问曰∶妇人手少阴脉动甚者孕子也。是皆吉兆之脉也。
肝绝之脉。循刀贲贲。心绝之脉。转豆躁疾。脾则雀啄。如屋之漏。如水之流。如杯之
覆。肺绝如毛。无根萧索。麻子动摇。浮波之合。肾脉将绝。至如省客。来如弹石。去如解索。
命脉将绝。 游鱼翔。至如涌泉。绝在膀胱。真脉既形。胃已无气。参察色证。断之以意。
Dai pulse (intermittent pulse with regular intervals) is caused by the decline of Qi. Its cessation occurs at a constant interval, which is a sign of death. The classics also mention "Yellow Dai," which likely refers to the Spleen pulse responding to the four seasons: in Spring, when endowed with Stomach Qi, it presents with a slight Xian (wiry) quality; in Summer, endowed with Stomach Qi, it presents with a slight Hong (surging) quality; in Autumn, endowed with Stomach Qi, it presents with a slight Fu (floating) quality; in Winter, endowed with Stomach Qi, it presents with a slight Shi (stone-like/sinking) quality. This is the Dai pulse resulting from the succession of the four seasons, not the Dai pulse indicating death. The meaning of "Dai" must be understood.
Cu pulse (rapid pulse with irregular pauses) is a rapid pulse with occasional stops. This indicates extreme Yang heat leading to the exhaustion of Yin fluids. It primarily signifies phlegm turbidity obstructing the Yang meridians and accumulation remaining in the Stomach organ; or it signifies blazing stagnant fire in the San Jiao (Triple Burner); or it manifests as madness and macules; or toxic sores and carbuncles. The Five Accumulations (blood, Qi, phlegm, fluid retention, and food stagnation) stagnate in the middle jiao, causing the pulse to become Cu due to obstruction. This is most unfavorable after an illness has progressed. If the trend continues unabated, it is critical. The Five Accumulations refer to blood, Qi, phlegm, fluid retention, and food. If this occurs in a new disease where Yuan Qi (Original Qi) has not yet failed, there is no need for deep concern. However, if a pulse resembling Cu appears, or gradually emerges during the critical stage of Xu Lao (consumptive disease), the time of death can be predicted. Or if it suddenly arises during moments of panic and haste, although self-recovery may occur upon the restoration of Qi, seeing Cu pulse in Tuo Yin (collapse of Yin) is ultimately an inauspicious omen. In cases of swelling and distension, if Cu pulse indicates that Yin and Yang cannot interact, the prognosis is poor; otherwise, Cu pulse can also lead to death.
Dong pulse (moving pulse) is a Shu (rapid) pulse appearing above and below the Guan position, without distinct head or tail, about the size of a bean, trembling suddenly. Zhang Zhongjing stated: "When Yin and Yang struggle against each other, it is called Dong." When Yang moves, sweat is produced; when Yin moves, fever occurs, accompanied by cold form and aversion to cold, indicating injury to the San Jiao. It indicates diseases such as pain, fright, diarrhea and dysentery, loss of essence, and hemorrhage. In deficiency states, the pulse shakes and wavers; in excess states, the body remains stable. These are all pathological pulses. There are also healthy individuals who present with Dong pulses. *Tai Su* states: "If the three positions are broad and long, the person is virtuous; if the Gallbladder pulse carries a long and wiry quality, appearing clearly under the finger like a dragon moving, they will assist the wise ruler for ten thousand years." It also says: "When the Kidney position suddenly shows Dong and Hua (slippery) qualities, an official will surely change posts. Observe whether the three positions are broad and full, and deduce carefully with intent." *Su Wen* states: "If the Hand-Shaoyin pulse of a woman moves vigorously, she is pregnant." These are all auspicious pulses.
The pulse of Liver exhaustion is urgent and forceful, like rubbing against a knife edge. The pulse of Heart exhaustion turns like beans, restless and rapid. The pulse of Spleen exhaustion resembles a sparrow pecking, or like water leaking from a roof, flowing endlessly, or like an overturned cup. The pulse of Lung exhaustion is like feathers, rootless and desolate, shaking like hemp seeds, merging like floating waves. When the Kidney pulse is about to cease, the arrival is like a visitor briefly stopping (Xi Ke), coming hard like a flicked stone, and departing like untying a knotted cord. When the Mingmen (Gate of Life) pulse is about to cease, it floats like a swimming fish, or surges like a spring. The cessation pulse appears in the Bladder meridian. Once the Zhen Zang Mai (True Organ Pulse) forms, the Wei Qi (Stomach Qi) is gone. By observing complexion and symptoms, one judges the outcome through careful deliberation.