浮主于表。行从肉上。如循榆荚。如水漂木。体法天。属阳藏。司肺。时属秋。运主金
也。
浮紧伤寒。浮缓伤风。浮迟中风。浮数伤热。浮洪热极。浮洪而实。热结经络。浮弦头痛。
浮滑风痰。浮虚伤暑。浮濡汗泄。浮微气虚。浮散劳极。此则大概主于浮脉。而尚有兼诊之
殊者也。至若浮芤失血。浮革亡血。内伤感冒。而见虚浮无力痨瘵阴虚。而见浮大兼疾。火
衰阳虚。而见浮缓不鼓。久病将倾。而见浑浑革至
。浮大有力。叔和亦云∶脉浮而无根者死。然亦可以浮诊而用治表之剂乎。夫曰。浮多主表
症曰。如浮悉属内病表里。不明生死系之矣。
沉主于里。动乎筋骨之间。如石沉水。必极其底。外柔内刚。愈按愈实。体同地。属阴
藏。司肾。时属冬。运主水也。两尺若得沉实有神。此为根深蒂固。修龄广嗣之征。如病沉紧内
寒。沉数内热。沉弦内痛。沉缓为湿。沉牢冷痛。沉滑痰食。沉弱气弱兼汗。沉伏闭痛。此
则大率主于沉脉。而尚有兼诊之殊也。至于沉而散。沉而绝。沉而代。沉而短。沉不鼓。久
病与阳病得此垂亡之候也。若沉而芤。沉而濡。沉而涩。沉而细。沉而结。主亡血伤精六极
之脉诸如此类。不得概以沉属寒。属痛而混投。温散之剂也。更有如沉之脉。每见表邪初感
之际。风寒外束。经络壅盛。脉必先见沉紧。或伏或止。是又不得以阳证阴脉为惑。惟亟投
以清表之剂。则应手汗泄而解矣。此沉脉之疑似。不可不辨也。
The floating pulse primarily indicates exterior syndromes. The qi of the pulse moves along the surface of the muscles, feeling under the fingers like stroking the pods of a elm tree, or like a piece of wood floating on water. Its form mimics Heaven, belongs to Yang Zang organs, governs the Lung, corresponds to the season of Autumn, and its movement is governed by Metal.
A floating-tight pulse is commonly seen in Shanghan (Cold Damage); a floating-slow pulse in Shangfeng (Wind Injury); a floating-delayed pulse in Zhongfeng (Wind Stroke); a floating-rapid pulse in injury by Heat; a floating-hong pulse indicating extreme Heat. If it is floating, hong, and solid, it indicates Heat accumulation in the collaterals; a floating-wiry pulse often presents with headache; a floating-slippery pulse indicates Wind-Phlegm; a floating-deficient pulse indicates injury by Summerheat; a floating-thin pulse indicates excessive sweating; a floating-micro pulse indicates Qi deficiency; a floating-scattered pulse indicates extreme exhaustion. These are the general indications of the floating pulse, yet there are differences in diagnosis based on combined pulses. For instance, a floating-kou pulse is seen in blood loss; a floating-ge pulse in loss of blood. In cases of internal injury with common cold presenting a floating-deficient and powerless pulse, or in consumption (Laozai) with Yin deficiency presenting a floating-large and rapid pulse, or in Fire decline and Yang deficiency presenting a floating-slow pulse that fails to beat vigorously, or in prolonged critical illness about to collapse presenting a chaotic, leather-like urgent pulse, as well as in cases of floating-large and forceful pulses. He Suhe also stated: "A floating pulse without root indicates death." However, can all such cases be treated with exterior-releasing formulas based solely on the floating pulse? Some say: Floating pulses mostly indicate exterior symptoms. Others say: All floating pulses belong to interior diseases. If the distinction between interior and exterior is unclear, life and death issues become confused.
The deep pulse primarily indicates interior syndromes. The movement occurs between the sinews and bones, sinking like a stone to the bottom of water. It appears soft on the outside but firm on the inside, becoming more solid with deeper pressure. Its form is analogous to Earth, belongs to Yin Zang organs, governs the Kidney, corresponds to the season of Winter, and its movement is governed by Water. If the two Chi positions exhibit a deep, solid, and spirited pulse, this signifies a deep-rooted constitution, which is a sign conducive to longevity and progeny. In pathological contexts, a deep-tight pulse indicates interior Cold; a deep-rapid pulse indicates interior Heat; a deep-wiry pulse indicates interior pain; a deep-slow pulse indicates Dampness; a deep-deep-firm pulse indicates Cold pain; a deep-slippery pulse indicates Phlegm and food retention; a deep-weak pulse indicates Qi deficiency accompanied by sweating; a deep-hidden pulse indicates obstruction and pain. These generally represent the indications of the deep pulse, though diagnostic nuances exist for combined pulses. Conversely, pulses that are deep-scattered, deep-abrupt, deep-interrupted, deep-short, or deep-lacking vigor are signs of impending demise in prolonged illnesses or Yang diseases. Pulses that are deep-kou, deep-thin, deep-choppy, deep-fine, or deep-interrupted primarily indicate loss of blood, injury to essence, and the six extremes. Such patterns should not be indiscriminately categorized as Cold or Pain, nor should warming and dispersing formulas be blindly administered. Furthermore, pulses resembling the deep pulse often appear at the initial stage of external pathogen invasion. When Wind-Cold binds the exterior and the collaterals are congested, the pulse may initially present as deep-tight, hidden, or intermittent. In such cases, one should not be confused by the phenomenon of "Yang syndrome presenting Yin pulse"; instead, clear exterior formulas should be promptly administered, leading to resolution through sweating. This ambiguity regarding the deep pulse must be clearly distinguished.