轻按之则无。重按之则有。有而有力。则脉实也。有而无力。则虚甚也。沉而迟。此寒也。
沉而数。伏火也。沉而滑。有伏痰也。妇人或主有娠。沉而涩。有瘀血也。或失血。沉而弦。阳
绝也。不治。沉而细必四至。此气血虚也。
太过不及不治。
四至以下。俱为迟脉。视其至数之微甚。为温补之轻重。如脉迟而汗出不止者死。
数而有力。阴败也。数而无力。阳虚也。数而滑。辨其有力无力。分治。虽危不死。数而涩。
血内热也。数而弦。真脏脉也。不治。数而细。大虚也。急补之。
有形体之长。如无病而出鱼际。寸与尺等。露而不陷也。有往来之长。谓来有余韵也。此脉
最善。
与长脉相反。虽无病不佳。
往来流利。此胃气也。滑而浮主痰。滑而有力。有食也。滑而无力。胃虚也。滑而有力兼数
。痰火盛也。滑而细。必四至。平人脉也。太过血虚。不及气虚。
弦如弓弦之弦。按之勒指。胃气将绝。五脏无土。木气太甚。即真脏脉也。凡病脉见之即凶。
与滑相反。
按之如发。细脉必沉。但得见滑。即是正脉。平人多有之。若见弦数。即是枯脉。六腑内绝。
不治。
但浮而不数。阳虚也。（补中益气汤主之。）浮而数。阴虚也。（黑逍遥散主之。不应。用
疏肝益肾汤。少间六味饮主之。黑逍遥逍遥加熟地即是。）沉而不数。阴中之阳虚也。（八味丸
主之）。沉而数。阴中之阴虚也。（左归饮都气饮主之）浮而迟。阳中之阳虚也。（黄 建中汤
主之）沉而迟。阳中之阴虚也。
（右归饮主之）乍沉乍浮。乍大乍小。乍迟乍数。或三或五。阴阳俱虚也。（十全大补汤主之。此一段阴阳气血分发。
尤极精细的当。医家得此。直是枕中之秘。）
轻取时感觉不到脉象，重按时才能感觉到。如果重按有力，就是实脉；如果重按无力，就是虚损非常严重。
脉象沉而迟缓，这是寒证。
脉象沉而快速，这是伏火（潜藏的火热邪气）。
脉象沉而滑利，体内有潜伏的痰饮。
妇女出现这种脉象，可能主怀孕。
脉象沉而涩滞，是有瘀血阻滞，或者是失血所致。
脉象沉而弦急，是阳气断绝的表现，属于不治之症。
脉象沉而细弱，且脉搏跳动次数正常（四至），这是气血两虚。
脉象太过或不及正常范围，均属于难治或不治之症。
脉搏跳动不足四至（每呼吸一次脉动少于四次），都称为迟脉。根据脉搏迟慢程度的轻重，来决定温补治疗的力度大小。例如，脉象迟且汗出不止的，预后不良，主死。
脉象数（快）而有力，是阴液败坏的表现。
脉象数而无力，是阳虚的表现。
脉象数而滑利，需辨别其有力还是无力，从而区分治疗方法。虽然病情危重但不会死亡。
脉象数而涩滞，是血分内有热邪。
脉象数而弦急，是真脏脉（无胃气的脉象），属于不治之症。
脉象数而细弱，是大虚之证，必须紧急进补。
脉体长，好像没有病一样，脉气延伸至鱼际部位，寸部和尺部的脉势相等，显露而不凹陷。脉气往来长盛，指脉来有余韵。这种脉象最为吉利。
与长脉相反（指短脉），即使没有疾病，也不是好现象。
脉气往来流利，这是有胃气的表现。
脉滑而浮，主痰证。
脉滑而有力，说明有食积。
脉滑而无力，说明胃气虚弱。
脉滑而有力兼见数象，说明痰火旺盛。
脉滑而细，且脉搏跳动次数正常（四至），是平人（健康人）的脉象。太过则血虚，不及则气虚。
脉象最沉，仿佛吸在皮肤之间，脉气来势不舒展，这是血液大亏，或者是有瘀血阻滞。
脉象像弓弦一样直硬，按压时勒手，这是胃气将绝，五脏缺乏土气滋养，木气太盛，即真脏脉。凡是疾病中出现这种脉象即为凶兆。它与滑脉相反。
脉象按之如丝发般细微，细脉必定沉取才得。如果能摸到滑脉，就是正常的脉象，健康人多有此脉。如果见到弦数脉，就是枯脉（无生机之脉），六腑内部机能断绝，属于不治之症。
脉浮而不数，是阳虚。（用补中益气汤主治。）
脉浮而数，是阴虚。（用黑逍遥散主治。若无效，用疏肝益肾汤。稍缓后用六味地黄丸主治。黑逍遥散即逍遥散加熟地黄而成。）
脉沉而不数，是阴中之阳虚。（用八味丸主治。）
脉沉而数，是阴中之阴虚。（用左归饮、都气饮主治。）
脉浮而迟，是阳中之阳虚。（用小建中汤主治。）
脉沉而迟，是阳中之阴虚。（用右归饮主治。）
脉象忽沉忽浮，忽大忽小，忽迟忽数，或三至或五至，这是阴阳俱虚。（用十全大补汤主治。这一段关于阴阳气血的分辨，极其精细恰当。医者得到此法，简直是枕中的秘密。）
When light pressure is applied, the pulse is imperceptible. With heavy pressure, it becomes palpable. If it is forceful under heavy pressure, it is a Shi (Excess) pulse; if it is weak under heavy pressure, it indicates severe deficiency (Xu).
A Chen (Deep) and Chi (Slow) pulse indicates Cold syndrome.
A Chen (Deep) and Shu (Rapid) pulse indicates Fu Huo (Hidden Fire).
A Chen (Deep) and Hua (Slippery) pulse indicates Fu Tan (Hidden Phlegm).
In women, this may indicate pregnancy.
A Chen (Deep) and Se (Choppy) pulse indicates Yu Xue (Blood Stasis) or blood loss.
A Chen (Deep) and Xian (Wiry) pulse indicates Jue Yang (Extinction of Yang Qi), which is untreatable.
A Chen (Deep) and Xi (Fine) pulse with four beats per respiration indicates Qi and Blood deficiency.
Pulses that are excessive or deficient in nature are difficult to treat.
Fewer than four beats per respiration are all classified as Chi (Slow) pulses. The degree of slowness determines the intensity of warm tonification therapy. For instance, a Chi (Slow) pulse accompanied by incessant sweating indicates a fatal prognosis.
A Shu (Rapid) and forceful pulse indicates Yin exhaustion.
A Shu (Rapid) and weak pulse indicates Yang deficiency.
A Shu (Rapid) and slippery pulse requires differentiation based on forcefulness or weakness for treatment. Although critical, death is not inevitable.
A Shu (Rapid) and choppy pulse indicates internal heat in the blood.
A Shu (Rapid) and wiry pulse is a Zang Zhen Mai (True Organ Pulse), indicating untreatability.
A Shu (Rapid) and fine pulse indicates severe deficiency, requiring urgent tonification.
A long pulse body, resembling a healthy state, extending to the Yuji (LU10) area, with equal strength at the Cun (Inch) and Chi (Cubit) positions, exposed but not sunken. A pulse with long arrival and departure, possessing residual resonance, is the most auspicious.
Opposite to the Long pulse (i.e., Short pulse); even without disease, it is not favorable.
A smooth flow of Qi and blood indicates the presence of Wei Qi (Stomach Qi).
A Slippery and Floating pulse primarily indicates Phlegm.
A Slippery and forceful pulse indicates Food Stagnation.
A Slippery and weak pulse indicates Spleen/Stomach deficiency.
A Slippery, forceful, and Rapid pulse indicates flourishing Phlegm-Fire.
A Slippery and Fine pulse with four beats per respiration is a Ping Ren (Healthy Person) pulse. Excessiveness implies Blood deficiency; insufficiency implies Qi deficiency.
The deepest pulse, seeming to adhere to the skin, with an uncomfortable arrival, indicates severe Blood deficiency or Blood Stasis.
A Wiry pulse, hard like a bowstring and pressing tightly against the finger, indicates the extinction of Wei Qi (Stomach Qi), lack of Earth element nourishing the Five Zang organs, and excessive Wood Qi. This is a Zang Zhen Mai (True Organ Pulse). Its appearance in any disease portends凶 (misfortune/death). It is opposite to the Slippery pulse.
A pulse felt like hair strands upon pressure, where the Xi (Fine) pulse must be sought at the deep level. If a Slippery pulse is found, it is the normal pulse, common in healthy people. If a Wiry and Rapid pulse appears, it is a Ku Mai (Withered Pulse), indicating the internal severance of the Six Fu organs, which is untreatable.
Floating but not Rapid: Yang deficiency. (Treated with Buzhong Yiqi Tang.)
Floating and Rapid: Yin deficiency. (Treated with Hei Xiaoyao San. If ineffective, use Shugan Yishen Tang. After slight improvement, Liuwei Dihuang Wan is used. Hei Xiaoyao San is Xiaoyao San plus Shudi.)
Deep but not Rapid: Deficiency of Yang within Yin. (Treated with Bawei Wan.)
Deep and Rapid: Deficiency of Yin within Yin. (Treated with Zuogui Yin and Duqi Yin.)
Floating and Slow: Deficiency of Yang within Yang. (Treated with Xiao Jianzhong Tang.)
Deep and Slow: Deficiency of Yin within Yang. (Treated with Yougui Yin.)
Intermittently Deep and Floating, Large and Small, Slow and Rapid, or three or five beats per respiration: Simultaneous deficiency of Yin and Yang. (Treated with Shiquan Dabu Tang. This section on the differentiation of Yin, Yang, Qi, and Blood is extremely precise and appropriate. For physicians, it is a secret treasure kept at the pillow.)