脉有阳结阴结者何以别之答曰其脉浮而数不能食不大便者此为实名曰阳结也期十七日当剧其脉沉而迟不能食身体重
大便反硬名曰阴结期十四日当剧
脉浮而数不能食不大便此为阳实名曰阳结阳实而无阴以和之其气必结期十七日当剧也脉沉而迟不能食身体重大便反
硬名曰阴结阴盛而无阳以和之其气必结期十四日当剧也阴盛大盒饭溏不溏而硬故谓之反凡大便秘涩粪若羊矢者皆阴结之
证也十七日剧者火为阳大衍之数地二生火天七成之合而为九积至二九为十八日则火气盛矣阳性疾故不及期而剧也十四日
剧者水为阴大衍之数天一生水地六成之合而为七积至二七十四日则水气盛矣阴性迟故及期而剧也此言阴阳之大数不必泥
也
脉来缓时一止复来者名曰结脉来数时一止复来者名曰促脉阳盛则促阴盛则结此为病脉
曰病脉者以其阴阳之偏也
脉霭霭如车盖者名曰阳结也脉累累如循长竿者名曰阴结也脉瞥瞥如羹上肥者阳气微也脉萦萦如蜘蛛丝者阳气衰也脉
绵绵如泻漆之绝者亡其血也
脉霭霭郁动如车盖之升沉者名曰阳结也脉累累不平如循长竿之硬节者名曰阴结也脉瞥瞥虚飘如羹上之油珠者阳气微
也脉萦萦细弱如蜘蛛之轻丝者阳气衰也脉绵绵断续如泻漆之频绝者亡其血也
阴阳相搏名曰动阳动则汗出阴动则发热形冷恶寒者此三焦伤也若数脉见于关上上下无头尾如豆大厥厥动摇者名曰动
也
阴阳相搏二气郁勃而动荡名曰动阳气动则阳升于阴卫泄而汗出阴气动则阴闭于阳卫郁而热发动虽在阳脉之中而实阴
阳所俱有也脉动而见形冷恶寒者此三焦之阳气伤也若脉数见于关上上下无头尾如豆大厥厥动摇者此名曰动动者气郁于中
不能升降也关所以候中焦关上不动者中气之治升降推迁之得政也盖阴升于寸则遂其上浮之性不至为动阳降于尺则遂其下
沉之性不能为动惟阴欲升脾土虚而不能升阳欲降胃土弱而不能降则二气郁于关上而见动形上下无头尾如豆大厥厥动摇者
二气虚弱不能升降之状也关者阴阳出入之关阴自此升而为阳阳自此降而为阴此实阴阳升降之枢轴故曰关乃中气之所变现
也（关上动数如豆厥厥动摇上下不至尺寸此死脉也）
脉象中有阳结和阴结两种，如何区别它们呢？回答说：如果脉象浮而数，不能进食，大便秘结不通，这属于实证，称为阳结。预计第十七天病情会加重。如果脉象沉而迟，不能进食，身体沉重，大便反而干硬，这称为阴结。预计第十四天病情会加重。
脉象浮而数，不能进食，大便秘结不通，这是阳实之证，称为阳结。阳实而无阴气来调和，其气机必然郁结，预计第十七天病情会加重。脉象沉而迟，不能进食，身体沉重，大便反而干硬，这称为阴结。阴盛而无阳气来调和，其气机必然郁结，预计第十四天病情会加重。阴气盛大时，大便本应溏泄，现在反而干硬，所以称之为“反”。凡是导致大便秘涩、粪便像羊屎一样的情况，都属于阴结的证候。
第十七天病情加重的原因，是因为火属阳，根据大衍之数，地二生火，天七成之，合而为九，积至两个九为十八日，此时火气旺盛。由于阳的性质急疾，所以不到十八日就在第十七天就发作了。第十四天病情加重的原因，是因为水属阴，根据大衍之数，天一生水，地六成之，合而为七，积至两个七为十四日，此时水气旺盛。由于阴的性质迟缓，所以到了第十四天就发作了。这里讲的是阴阳的大致规律，不必拘泥于具体的数字。
脉搏来势缓慢，偶尔出现一次停顿，之后又恢复跳动，这种脉象称为结脉。脉搏来势急促，偶尔出现一次停顿，之后又恢复跳动，这种脉象称为促脉。阳气偏盛则出现促脉，阴气偏盛则出现结脉，这些都是病理性脉象。所谓病脉，是因为阴阳之气偏颇所致。
脉象气势充沛，如同车盖般宽大隆起，这称为阳结。脉象累累相连，如同抚摸长竿般坚硬不平，这称为阴结。脉象轻浮浅表，如同热汤表面的油脂漂浮不定，这是阳气微弱的表现。脉象细弱连绵，如同蜘蛛丝般细微，这是阳气衰败的表现。脉象绵绵不断但时有中断，如同倾倒漆液时突然断绝，这是亡血（失血）的表现。
脉象气势充沛且郁动，如同车盖升沉起伏，这称为阳结。脉象累累不平，如同抚摸长竿上的硬节，这称为阴结。脉象轻虚飘忽，如同热汤表面的油珠，这是阳气微弱的表现。脉象细弱如蜘蛛轻丝，这是阳气衰败的表现。脉象断续不连，如同倾倒漆液时频繁断绝，这是亡血的表现。
阴阳二气相互搏击，称为“动”脉。如果是阳气动，则会导致汗出；如果是阴气动，则会导致发热。如果出现形体寒冷、恶寒的症状，这是三焦受损的表现。如果在关部出现数脉，上下没有头尾，大小如豆粒，剧烈动摇不定，这种脉象称为动脉。
阴阳二气相互搏击，两股气机郁勃而动荡，称为“动”。阳气动则阳气上升于阴分，卫气外泄而汗出；阴气动则阴气闭阻于阳分，卫气郁滞而发热。“动”虽然常出现在阳脉中，但实际上是阴阳二气共同作用的结果。如果脉动同时伴有形冷恶寒的症状，这是三焦阳气受损的表现。如果脉数出现在关部，上下无头尾，大小如豆粒，剧烈动摇不定，这就称为动脉。所谓“动”，是指气机郁结在中焦，不能正常升降。关脉之所以用来候察中焦，是因为关部是中气治理、升降推迁得政的地方。一般来说，阴气上升至寸部，则顺应其上浮的特性，不会形成阳动；阴气下降至尺部，则顺应其下沉的特性，也不会形成动脉。只有当阴气欲升而脾土虚弱无法升举，阳气欲降而胃土衰弱无法下降时，二气才会郁结在关部，出现上下无头尾、大小如豆粒、剧烈动摇的动脉。这是二气虚弱、不能升降的状态。关部是阴阳出入的关口，阴气从此处上升转化为阳，阳气从此处下降转化为阴，这里是阴阳升降的枢纽，所以说关脉是中气所变现出来的。（如果关部脉动数如豆粒，厥厥动摇，上下不及寸部和尺部，这是死脉。）
There are two types of pulse presentations: Yang Jie (Yang Knotting/Binding) and Yin Jie (Yin Knotting/Binding). How can they be distinguished? The answer is: If the pulse is floating and rapid, accompanied by an inability to eat and constipation, this constitutes a excess syndrome known as Yang Jie (Yang Knotting/Binding). It is expected that the condition will worsen on the seventeenth day. If the pulse is deep and slow, accompanied by an inability to eat, heaviness of the body, and conversely hard stools, this is known as Yin Jie (Yin Knotting/Binding). It is expected that the condition will worsen on the fourteenth day.
A pulse that is floating and rapid, with an inability to eat and constipation, indicates Yang Excess (Excess of Yang), known as Yang Jie (Yang Knotting/Binding). When there is Yang Excess without Yin to harmonize it, the Qi mechanism must become knotted, and the condition is expected to worsen on the seventeenth day. A pulse that is deep and slow, with an inability to eat, heaviness of the body, and conversely hard stools, is known as Yin Jie (Yin Knotting/Binding). When Yin is excessive without Yang to harmonize it, the Qi mechanism must become knotted, and the condition is expected to worsen on the fourteenth day. When Yin Qi is abundant, stool should naturally be loose; if it becomes hard instead, it is termed "conversely" (Fan). Any case involving constipation and dry, pellet-like stools resembling sheep dung belongs to the syndrome of Yin Jie (Yin Knotting/Binding).
The reason for worsening on the seventeenth day lies in Fire, which belongs to Yang. According to the Da Yan numbers (Great Expanding Numbers), Earth generates 2 for Fire, and Heaven completes it with 7, summing to 9. Accumulating two sets of nine equals eighteen days, at which point Fire Qi becomes abundant. Since Yang nature is swift, the worsening occurs before the full period, i.e., on the seventeenth day. The reason for worsening on the fourteenth day lies in Water, which belongs to Yin. According to the Da Yan numbers, Heaven generates 1 for Water, and Earth completes it with 6, summing to 7. Accumulating two sets of seven equals fourteen days, at which point Water Qi becomes abundant. Since Yin nature is sluggish, the worsening occurs precisely at the period, i.e., on the fourteenth day. This discusses the general principles of Yin and Yang and should not be interpreted too literally regarding specific numbers.
When the pulse arrives slowly but occasionally stops and then resumes, it is named Jie Mai (Knotted Pulse). When the pulse arrives rapidly but occasionally stops and then resumes, it is named Cu Mai (Rapid/Pulsating Pulse). Yang Excess leads to Cu Mai (Rapid/Pulsating Pulse), while Yin Excess leads to Jie Mai (Knotted Pulse); these are pathological pulses. Pathological pulses arise from the bias or imbalance of Yin and Yang.
A pulse that appears abundant and expansive like a chariot canopy is named Yang Jie (Yang Knotting/Binding). A pulse that feels continuous and hard like running fingers along a long bamboo pole is named Yin Jie (Yin Knotting/Binding). A pulse that flutters lightly like fat/oil floating on soup indicates weak Yang Qi. A pulse that is thin and weak like a spider's silk indicates declining Yang Qi. A pulse that is continuous yet intermittently breaks, like pouring lacquer that suddenly cuts off, indicates loss of Blood (Wang Xue).
A pulse that is abundant and turbulent, rising and falling like a chariot canopy, is named Yang Jie (Yang Knotting/Binding). A pulse that is uneven and hard like touching the knots of a long pole is named Yin Jie (Yin Knotting/Binding). A pulse that is empty and floating like oil beads on soup indicates weak Yang Qi. A pulse that is fine and weak like a spider's light thread indicates declining Yang Qi. A pulse that is intermittent like frequently cutting-off lacquer pouring indicates loss of Blood (Wang Xue).
When Yin and Yang Qi beat against each other, it is called Dong Mai (Moving Pulse). If Yang Qi moves, sweating occurs; if Yin Qi moves, fever occurs. If the patient presents with cold limbs and aversion to cold, this indicates injury to the San Jiao (Triple Burner). If a rapid pulse is seen at the Guan position (Cun-Guan-Chi positions: Cuneiform, Inch, Cubit), lacking head and tail, about the size of a bean, and trembling violently, it is named Dong Mai (Moving Pulse).
When Yin and Yang Qi beat against each other, causing turbulent agitation, it is called "Dong" (Movement). Yang movement causes Yang Qi to rise into Yin, leading to leakage of Wei Qi (Defensive Qi) and sweating. Yin movement causes Yin Qi to close off Yang, leading to stagnation of Wei Qi and heat generation. Although "Dong" often appears in Yang pulses, it actually involves both Yin and Yang. If pulse movement accompanies cold limbs and aversion to cold, this indicates injury to the Yang Qi of the San Jiao (Triple Burner). If a rapid pulse is found at the Guan position, lacking head and tail, about the size of a bean, and trembling violently, it is named Dong Mai (Moving Pulse). "Dong" signifies Qi stagnation in the middle, preventing proper ascending and descending. The Guan position monitors the Middle Jiao because it is where Zhong Qi (Middle Qi) governs the dynamics of ascent and descent. Generally, when Yin rises to the Cun position, it follows its upward nature and does not form Yang movement; when Yin descends to the Chi position, it follows its downward nature and does not form movement. Only when Yin desires to ascend but Spleen Earth is too weak to lift it, and Yang desires to descend but Stomach Earth is too weak to lower it, do the two Qi mechanisms stagnate at the Guan position, presenting as a pulse without head or tail, bean-sized, and trembling violently. This reflects the state of weak Qi unable to ascend and descend. The Guan position is the gate of Yin and Yang exit and entry; Yin ascends here to become Yang, and Yang descends here to become Yin. Thus, it is the pivot of Yin-Yang ascent and descent, meaning the Guan pulse manifests the state of Zhong Qi (Middle Qi). (If the pulse at the Guan position beats rapidly like a bean, trembling violently, and extending neither to Cun nor Chi, it is a death pulse.)