然有真正外感初起，阳（阳气）为阴（阴邪）蔽，脉反不浮者，亦有紧数而略兼浮者，审其发热
、无汗、头身疼痛，为表邪而开达之，阳气得通，脉始转浮。更有里邪解后，表邪外达，沉
小数实之脉，转为浮缓，浮缓为外解之征，日内可冀得汗，此先里后表病也；其有里邪解后
，而脉反浮躁者。此邪火伤阴，病胜脏也，名阴阳交（阳邪交于阴分），不治。又有内伤阳气
虚者，脉必浮而无力；阴血虚者，脉必浮而空豁，浮而弦数。是浮不可概言表。即谓浮而无
力为虚，浮而有力为实，似可不误，然有浮大弦硬之极，甚至四倍以上者，又非有力之谓，
乃真阴涸极，孤阳无根，胃气已无，真脏脉见，不可不知。又有兼脉，如浮紧风寒，浮数风
热，浮虚伤暑（暑月汗多，伤阴、伤气，所以脉虚），浮缓伤湿，浮大伤热，浮滑宿食，浮芤
失血之类，更宜参看。
然而，有真正的外感病初起阶段，阳气被阴邪遮蔽，脉象反而不浮的；也有脉象紧数且略微兼带浮象的。仔细审视其发热、无汗、头身疼痛的症状，判断为表邪（侵袭体表的病邪），采用开达（宣散透发）的方法治疗，待阳气得以通畅，脉象才会转为浮象。
更有甚者，在里邪解除后，表邪向外透达，原本沉小数实的脉象，转变为浮缓脉。浮缓脉是外邪解除的征象，预计日内可以出汗，这属于先治里后治表的病证；如果有里邪解除后，脉象反而变得浮躁的。这是邪火损伤阴液，病情胜过脏腑功能的表现，称为阴阳交（阳邪与阴分相搏结），属于不治之症。
又有内伤导致阳气虚弱的，脉象必然浮而无力；阴血虚弱的，脉象必然浮而空豁，且兼见弦数之象。因此，不能一概而论地说浮脉就是表证。即使认为浮而无力为虚证，浮而有力为实证，似乎可以避免错误，但是有脉象浮大、弦硬到了极点，甚至超过正常四倍以上的，这又不是所谓“有力”的意思，而是真阴枯竭至极，孤阳没有根基，胃气已经消失，出现了真脏脉（脏腑真气外露的脉象），这一点不可不知道。
此外还有兼脉的情况，如浮紧脉主风寒，浮数脉主风热，浮虚脉主伤暑（暑天出汗多，损伤阴液和气，所以脉象虚），浮缓脉主伤湿，浮大脉主伤热，浮滑脉主宿食（积滞的食物），浮芤脉主失血之类，更应当参考查看。
However, in the initial stage of a true external contraction (exogenous disease), when Yang Qi (vital energy) is obstructed by Yin Evil (pathogenic cold/dampness), the pulse may paradoxically not be floating; it may also be tight and rapid with a slight floating quality. Upon carefully examining symptoms such as fever, absence of sweating, and pain in the head and body, if determined to be an exterior pathogen (external evil invading the surface), treatment should employ methods to open and disperse (ventilate and release). Once Yang Qi becomes unobstructed, the pulse will then transform into a floating quality.
Furthermore, after interior pathogens are resolved and exterior pathogens move outward, a pulse that was previously deep, small, rapid, and solid transforms into a floating and moderate (relaxed) pulse. A floating and moderate pulse is a sign of exterior resolution, with perspiration expected within a day; this characterizes a disease pattern treated first from the interior and subsequently from the exterior. Conversely, if after the resolution of interior pathogens, the pulse becomes instead floating and restless, this indicates that pathogenic fire has damaged Yin fluids, and the disease has overcome the Zang organs. This condition is named "Yin-Yang Jiao" (interaction of Yang pathogen with the Yin level) and is considered untreatable.
In cases of internal injury leading to deficiency of Yang Qi, the pulse must be floating but forceless; in cases of deficiency of Yin Blood, the pulse must be floating and empty/hollow, often accompanied by wiry and rapid qualities. Therefore, one cannot generalize that a floating pulse invariably indicates an exterior syndrome. Even if one posits that a floating pulse that is forceless indicates deficiency, while one that is forceful indicates excess—seemingly avoiding error—one must recognize that a pulse that is extremely floating, large, wiry, and hard, even exceeding four times the normal magnitude, does not signify "forcefulness." Rather, it signifies extreme depletion of True Yin, rootless solitary Yang, exhaustion of Stomach Qi, and the appearance of the True Zang Pulse (pulse reflecting the protrusion of organ essence without stomach qi support); this fact must not be overlooked.
Additionally, there are combined pulse patterns: floating-tight indicates Wind-Cold; floating-rapid indicates Wind-Heat; floating-empty indicates damage from Summerheat (due to excessive sweating in summer months damaging Yin and Qi, resulting in an empty pulse); floating-moderate indicates damage from Dampness; floating-large indicates damage from Heat; floating-slippery indicates retained food (food stagnation); and floating-hollow indicates blood loss. These cases require further reference and examination.