大浮数滑动阳脉，阴病见阳生可得∶沉涩弦微弱属阴，阳病见阴终死厄∶阴阳交互最玄微，浮中沉法却明
白。
阴阳脉皆五者，脉从五行生也。邪在表则见阳脉，邪在里则见阴脉。阴病见阳脉者生，邪自里之表，欲汗
解也。如厥阴中风，脉微浮为欲愈，不浮为未愈是也。阳病见阴脉者死，邪自表达里，正气亏陷，如谵语脉沉
是也。《活人书》谓杂病与伤寒脉不同，其实同也，况伤寒中亦有杂病，杂病中亦有伤寒。伤寒杂病脉之阴阳一
而已矣。自《百证歌》举其概，丹溪发其微，然后知脉当从仲景与叔和《脉经》，不当泥高阳生之《脉诀》也。
浮脉察表之实虚，
伤寒先辨人迎，及传而变，次别诸经。
尺寸俱浮太阳表；浮而紧涩是伤寒，浮而数者热不小；
脉尺寸俱浮、有力有神者，可汗；脉迟者，不可汗。
浮而缓者是伤风，
宜解肌，不可汗。
浮大有力热易晓；浮而长大（太阳）合阳明，浮而弦大少阳了。
中切阳明少阳经，尺寸俱长阳明病；浮长有力兼太阳，
无汗，宜发汗。
长大有力为热甚；
当解肌。
长数有力热可平，长滑实大宜通利∶尺寸俱弦和少阳，
凡弦脉只可和解。
浮弦兼表汗乃定；弦迟弦小弦微虚，
内寒宜温。
弦大弦长滑热盛。
热甚宜解。
沉脉察里虚与实，尺寸沉细属太阴；沉微少阴微缓厥（阴），沉迟无力阴气深；
脉沉微、沉细、沉迟、沉伏无力，为无神，为阴盛而阳微，急宜生脉回阳。
沉疾有力为热实，养阴退阳邪不侵。
脉沉疾、沉滑、沉实有力，为有神，为热实，为阳盛阴微，急宜养阴以退阳也。大抵沉诊之法，最为紧
关之要，以决阴阳冷热用药，生死在于毫发之间，不可不仔细察之。凡脉中
有力为有神可治，无力为无神难治。抑论伤寒脉非一端，阴阳俱紧涩，伤寒也；若前伤寒，郁热未净，重感于
寒，则变为温疟。阳浮阴弱，伤风也；若前伤风，蕴热未已，重感风，则变为风温。阳濡阴急，当夏先伤湿而
后伤暑，乃湿温脉也。阳浮阴濡，当春先伤温气而后感风，乃风温脉也。阳脉洪数，阴脉实大，温毒脉也。当
春夏感热而又遇湿热，两热相合，故温毒发斑。阳脉濡弱，阴脉弦紧，湿温脉也。长夏先伤湿而后伤暑，阴阳
俱盛，温疟脉也。先伤风寒，余热未净，重感于寒所致。若脉阴阳皆沉，而证似太阳者，乃冬时天暖，温气所
犯。或同病异名，或同脉异经，病皆起于中宫湿土，与伤寒相似，不可不辨。
脉象大、浮、数、滑、动属于阳脉，阴病出现阳脉表示生机尚存，病情有望好转；脉象沉、涩、弦、微、弱属于阴脉，阳病出现阴脉则预后不良，甚至危及生命。阴阳脉象的变化最为玄妙精微，但通过浮、中、沉三部诊法却可以辨明。
阴阳脉象各具备五种形态，是因为脉气顺应五行生克的规律。邪气在体表则出现阳脉，邪气在体内则出现阴脉。阴病出现阳脉者主生，说明邪气从里出表，正气驱邪外出，即将通过发汗而解。例如厥阴中风，脉象微浮表示将要痊愈，若不浮则表示未愈。阳病出现阴脉者主死，说明邪气由表入里，正气亏虚下陷，例如谵语（神志不清，胡言乱语）而脉象沉伏即是此理。《活人书》认为杂病与伤寒的脉象不同，其实是一样的，何况伤寒中也夹杂杂病，杂病中也夹杂伤寒。伤寒与杂病的脉象，其阴阳属性本质上是一致的。自《百证歌》概括了大概，朱丹溪阐发了其中的精微之处，此后才知脉诊应当遵循张仲景和王叔和的《脉经》，而不应当拘泥于高阳生的《脉诀》。
浮脉用于察测体表的虚实。治疗伤寒首先要辨别人迎脉（颈动脉，候阳），待病邪传变后，再辨别各经的脉象。
寸关尺三部脉象俱浮，是太阳表证；脉浮而紧涩，是伤寒；脉浮而数，是热势不轻。
脉象寸关尺俱浮、有力且有神气的，可以用发汗法；脉象迟的，不可用发汗法。
脉浮而缓，是伤风，宜用解肌法，不可用强力发汗法。
脉浮大有力，热势容易知晓；脉浮而长大，对应阳明经；脉浮而弦大，对应少阳经。
切按中部脉象以察阳明、少阳经病变。寸关尺三部脉象俱长，是阳明病；若脉浮长有力兼有太阳表证，无汗，宜用发汗法。
脉长大有力，表示热势严重，应当用解肌法。
脉长数有力，热势可平复；脉长滑实大，宜用通利法。寸关尺三部脉象俱弦，属少阳病。
凡是弦脉，只可用和解法。
若浮弦兼有表证，方可用汗法确定治疗方案；若脉弦迟、弦小、弦微且虚弱，属内寒，宜用温法。
脉弦大、弦长、滑数，表示热势盛，热势严重时宜用解法。
沉脉用于察测体内的虚实。寸关尺三部脉象沉细，属太阴病；脉沉微，属少阴病；脉微缓，属厥阴病；脉沉迟无力，表示阴气深重。
脉象沉微、沉细、沉迟、沉伏且无力，为无神，表示阴盛阳微，急需使用生脉回阳法。
脉沉疾有力，表示热实证，宜用养阴退阳法，使邪气不能侵犯。
脉象沉疾、沉滑、沉实有力，为有神，表示热实证，阳盛阴微，急需养阴以退阳。大致而言，沉诊的方法是最为关键的要领，以此决断阴阳冷热用药，生死往往在于毫厘之间，不可不仔细诊察。凡脉中有力即为有神，可治；无力即为无神，难治。
况且论述伤寒脉象并非只有一种情况：阴阳俱紧涩，是伤寒；如果此前患伤寒，郁热未清，又再次感受寒邪，则变为温疟。阳脉浮、阴脉弱，是伤风；如果此前患伤风，蕴热未止，又再次感受风邪，则变为风温。阳脉濡、阴脉急，是在夏季先伤湿而后伤暑，这是湿温的脉象。阳脉浮、阴脉濡，是在春季先伤温气而后感风，这是风温的脉象。阳脉洪数，阴脉实大，是温毒的脉象。在春夏季节感受热邪而又遇湿热，两热相合，所以温毒发斑。阳脉濡弱，阴脉弦紧，是湿温的脉象。长夏季节先伤湿而后伤暑，阴阳俱盛，是温疟的脉象。先伤风寒，余热未净，再次感受寒邪所致。如果脉象阴阳皆沉，而症状类似太阳病，这是冬季天气温暖，被温气所犯。或者同一种病有不同的名称，或者相同的脉象出现在不同的经络，这些病都起于中宫湿土，与伤寒相似，不可不加以辨别。
The pulse qualities of large (Da), floating (Fu), rapid (Shu), slippery (Hua), and surging (Dong) belong to Yang pulses. If Yin diseases present with Yang pulses, it indicates life potential and a favorable prognosis; conversely, if Yang diseases present with Yin pulses—specifically deep (Chen), choppy (Se), wiry (Xian), thready (Wei), or weak (Ruo)—it indicates a poor prognosis and potential death. The interaction between Yin and Yang pulses is most profound and subtle, yet becomes clear through the method of palpating at superficial (Fu), middle (Zhong), and deep (Chen) levels.
When both Yin and Yang pulses exhibit five distinct qualities, it is because the pulse follows the generation cycle of the Five Elements (Wu Xing). When pathogenic factors are in the exterior, Yang pulses appear; when they are in the interior, Yin pulses appear. If a Yin disease presents with Yang pulses, it signifies survival, as the pathogen moves from the interior to the exterior, aiming for resolution through sweating. For example, in Jueyin wind-stroke, a slightly floating pulse indicates impending recovery, while a non-floating pulse indicates no recovery. If a Yang disease presents with Yin pulses, it signifies death, as the pathogen moves from the exterior to the interior, causing the righteous Qi to collapse and sink; for instance, delirium accompanied by a deep pulse exemplifies this. The *Huoren Shu* (Book of Vitality) claims that the pulses of miscellaneous diseases differ from those of cold damage syndromes, but in reality, they are the same. Moreover, cold damage syndromes often contain elements of miscellaneous diseases, and vice versa. The Yin-Yang nature of pulses in both cold damage and miscellaneous diseases is fundamentally identical. Since the *Baizheng Ge* summarized the general principles and Zhu Danxi elucidated their subtleties, it has been understood that pulse diagnosis should follow Zhang Zhongjing and Wang Shuhe's *Mai Jing* (Classic of Pulse Diagnosis), rather than adhering rigidly to Gao Yangsheng's *Mai Jue* (Pulse Rhymes).
The floating pulse assesses deficiency and excess in the exterior. In treating cold damage syndromes, one must first differentiate the Renying pulse (carotid artery, reflecting Yang), and after transmission and transformation, differentiate the pulses of the various meridians.
If the Cun, Guan, and Chi positions all present a floating pulse, it is a Taiyang exterior syndrome; a pulse that is floating and tight/choppy indicates cold damage; a pulse that is floating and rapid indicates significant heat.
If the Cun, Guan, and Chi pulses are all floating, forceful, and possess Shen (spirit/vitality), diaphoresis (sweating method) may be used; if the pulse is slow, diaphoresis is contraindicated.
A pulse that is floating and moderate/relaxed indicates wind injury; muscle-releasing methods should be used, not strong diaphoresis.
A pulse that is floating, large, and forceful makes the heat easy to identify; a pulse that is floating and long/large corresponds to the Yangming meridian; a pulse that is floating and wiry/large corresponds to the Shaoyang meridian.
Palpating the middle position assesses the Yangming and Shaoyang meridians. If the Cun, Guan, and Chi positions all present a long pulse, it is a Yangming disease; if the pulse is floating and long with force, combined with Taiyang exterior signs, and there is no sweat, diaphoresis is appropriate.
A pulse that is long, large, and forceful indicates severe heat; muscle-releasing methods should be employed.
A pulse that is long, rapid, and forceful suggests the heat can be pacified; a pulse that is long, slippery, solid, and large indicates the need for purgation/drainage. If the Cun, Guan, and Chi positions all present a wiry pulse, it belongs to the Shaoyang meridian.
Generally, wiry pulses should only be treated with harmonizing methods.
If the pulse is floating and wiry with exterior signs, sweating may be determined as the treatment; if the pulse is wiry-slow, wiry-small, or wiry-thready/weak and deficient, it indicates internal cold and requires warming methods.
A pulse that is wiry-large, wiry-long, or slippery-rapid indicates excessive heat; when heat is severe, resolving methods should be used.
The deep pulse assesses deficiency and excess in the interior. If the Cun, Guan, and Chi positions all present a deep and thready pulse, it belongs to the Taiyin meridian; a deep and thready pulse belongs to the Shaoyin meridian; a micro-slow pulse belongs to the Jueyin meridian; a deep, slow, and forceless pulse indicates profound Yin qi.
A pulse that is deep, micro, thready, slow, or hidden and forceless lacks Shen, indicating Yin excess and Yang deficiency; immediate use of Shengmai Huayang (Generate Pulse and Return Yang) methods is required.
A pulse that is deep, rapid, and forceful indicates heat-excess; nourishing Yin to retreat Yang prevents pathogenic invasion.
A pulse that is deep, rapid, slippery, or solid and forceful possesses Shen, indicating heat-excess, Yang excess, and Yin deficiency; immediate nourishment of Yin to retreat Yang is required. Generally, the method of deep palpation is the most critical key point, used to decide on Yin/Yang and cold/heat treatments. Life and death hang in the balance, so careful observation is indispensable. A pulse with force indicates Shen and is treatable; a pulse without force indicates lack of Shen and is difficult to treat.
Furthermore, the discussion of cold damage pulses is not limited to one type: if both Yin and Yang aspects present with tight and choppy pulses, it is cold damage; however, if previous cold damage left stagnant heat uncleaned, and cold is contracted again, it transforms into warm malaria. If the Yang pulse is floating and the Yin pulse is weak, it is wind injury; however, if previous wind injury left accumulated heat unresolved, and wind is contracted again, it transforms into wind-warmth. If the Yang pulse is soggy and the Yin pulse is urgent, it indicates dampness injured first and summer-heat second during summer, which is the pulse of damp-warmth. If the Yang pulse is floating and the Yin pulse is soggy, it indicates warm qi injured first and wind contracted second during spring, which is the pulse of wind-warmth. If the Yang pulse is洪 (Hong/surging) and rapid, and the Yin pulse is solid and large, it is the pulse of warm toxin. Contracting heat in spring/summer and encountering damp-heat results in two heats combining, causing warm toxin to manifest as macules. If the Yang pulse is soggy and weak, and the Yin pulse is wiry and tight, it is the pulse of damp-warmth. In late summer, dampness is injured first and summer-heat second, with both Yin and Yang flourishing, resulting in the pulse of warm malaria. This occurs when wind-cold is initially injured, residual heat remains uncleaned, and cold is contracted again. If the pulse shows both Yin and Yang as deep, yet symptoms resemble Taiyang disease, it is due to warm weather in winter allowing warm qi to invade. There may be same-disease-different-names or same-pulse-different-meridians scenarios. These diseases all originate from the damp earth of the Middle Jiao and resemble cold damage; they must not fail to be differentiated.